The role of contractual arrangements in improving health sector ...

Egypt
The health sector reform programme organized a provider survey and several focus
groups for nongovernmental organization providers to assess the size of their market. The
following is a summary of findings, which indicate a recent increase in the magnitude of
nongovernmental organization work.
Nongovernmental organizations serve a wide rage of beneficiaries, mostly at the low and mid
socioeconomic levels, which represent the majority of the population.
Well-trained university professors increasingly join the nongovernmental organization sector.
Nongovernmental organizations are based on a non-profit concept, which gives more trust in
dealing with population versus the private sector targeting to profit.
Several nongovernmental organizations have introduced the diagnostic services technology
including MRI, CATscan and ultrasonography, resulting in an increase in the utilization
rate.
Most nongovernmental organizations receive donations, which maintain their financial
sustainability.
What is the interest of nongovernmental organizations/private sector in receiving public
sector financing?
According to the District Provider Organization approach, all district populations have
to be covered with the family health model. The Ministry of Health and Population primary
health care facilities cover only a percentage of this population; nongovernmental
organization and private facilities will cover the remaining population. Montazah Health
District in Alexandria Governorate, with a population of 1 million, is a good example for such
approach, in which the Ministry facilities will cover 35%–40% of the population, and private
and nongovernmental organization facilities will cover 60%–75% of the population.
Contracting with private clinics will guarantee the registration of a number of families
to the clinics based on the size of the facility. Refusing the contracting issue will waste a
chance for the private/nongovernmental organization to have a pool of families in its
catchment area.
Does the political environment enable/disable the execution of such contractual
arrangements?
The approach of the District Provider Organization within the health sector reform
programme’s long-term objectives is to encourage contractual arrangements between the
Ministry of Health and Population and the private sector. The Ministry of Health and
Population carried out several studies assessing: the capacity of private sector services,
including mosque and church clinics; the Family Heath Fund contracting strategy, and SWOT
(strengths, opportunities, weaknesses, threats) analysis for private–public partnership. The
Ministry has highlighted on several occasions the urgent need for partnership between the
public and private sectors, and ministerial decrees have been issued to emphasize the role of
the Family Health Fund in supporting contractual arrangements with private and
nongovernmental organization providers.
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