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

Egypt
How are the issues of expected services, monitoring and evaluation, performance
assessment, transfer of funds, and settlement of disputes addressed in the contract?
Expected services are addressed in item 5 of the contract: “The primary health care services
delivered by Second Party to individuals related to First Party include services defined by
the Primary Health Care Services basic benefit package, and clarified in the attached
schedule except immunization services which are carried out through the related health
office. Second Party is committed to deliver all data of the individuals who will take
immunization.”
Monitoring and evaluation are addressed in item 18 of the contract: “Second Party is committed
to facilitate the processes of reviewing for the evaluation and monitoring department
affiliated to First Party on monthly basis. They are also committed to all the policies and
work procedures of HSRP and any modification or updates that may become valid.”
Performance assessment and transfer of funds are addressed in item 17 of the contract:
“Payments are succeeded on four terms quarterly per year, such that each term will be
paid as follows:
− 50% of the term in return for contracting (Flat Rate)
− Remaining 50% in return for service performance, based on quality and
performance indicators defined in the Family Health Fund (First Party).”
Settlement of disputes is addressed in item 24 of the contract: “Any differences in
implementing, executing or explaining any item of the contract or any dispute that may
occur should be referred to the Governorate Administrative Legal Authorities (State’s
Council Courts). In case of referring back to court or to any other side, Second Party
should continue providing services for beneficiaries and with the same conditions of the
contract until the dispute is settled by a court decision or by a final decision from the
specialized authority or by paying all the sums of money obtained in return for cancelling
the contract”.
What are the types of services offered by the provider? On which basis have they been
selected, e.g. for a specific population?
The basic benefits package is designed to prevent and treat the most prevalent and
pressing health problems among individuals in a population. The basic benefits package
includes: child health services, women’s health services, health services for all age groups and
laboratory work.
In order to design and select health services in the package for Egypt, four criteria were
used:
The most common health needs of the population to reduce suffering and improve well-being.
Severity of illnesses and diseases affecting the population.
Cost-effectiveness of interventions to treat or cure those illnesses and diseases and attain the
most health value for money spent.
Availability of financial resources.
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