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Iraqs national health policy defines the principles, objectives and vision for improving

population health and nutrition status and reducing inequalities in health all over the country.
The policy provides a framework, concrete foundation and attainable direction for future
investment and action in the health sector development. Strategic and detailed operational
guidance for implementing the action plans identified in this policy will turn the policy into
tangible change accordingly. Implementation will be coordinated, monitored and governed by
multi-sectoral stakeholders to deliver change, modernization and the planned health gains.
The Ministry of Health has formed a core technical team representing all the key departments
and with the dynamic participation of other relevant sectors like Finance, Planning,
Parliament, Professional Associations supported by World Health Organization at Eastern
Mediterranean Regional Office as well as WHO Country Office; all those experts have
effectively pooled their knowledge and experience into drafting the Iraqi National Health
Policy.
Central to the policy directions of the new Iraqi Government is to attain health care goals and
overcome systemic challenges particularly what is related to cost and access to quality health
care services. Several principles that guide the evolution of health care policy are spelt out in
this document. Particularly important is that health is a constitutional right to all Iraqi
citizens. Then that the legitimate mandate of the Governments as the overall legislate,
enforce and adjudicate authority for the safety, welfare and public order of everyone within
its jurisdiction. The public justice the essential public health programmes like vaccinations
promote safety and public order; a network of quality health care providers facilitates the
well-being of society by meeting peoples physical, social and mental needs.
Public justice in health policy demands that the Iraqi Government work effectively to ensure
adequate access to quality health care as a means of preventing intractable burden of disease.
This means that governments should ensure that everyone has access to some basic level of
good health care. The Iraqi health care system should contribute to improving overall
health of the population and reductions in poverty related to health expenditures particularly
the out of pocket expenditure that reached 41% of the total health expenditures . The question
is setting the stage for greater equity, improving standards, assuring efficiency and value for
money in health care and modernizing the Iraqi health care systems on feasible and
sustainable grounds.
The core of the National Health Policy is to move forward the Iraqi health sector agenda
towards Universal Health Coverage so that every citizen will have ready access to the needed
health care services at the right quality standards. The National Health Policy discussed and
analysed during the last few months and further refined during a series of consultation
meetings and concluded over a four days high level workshop to reflect the strong ownership
of the Ministry of Health at central, regional and Governorate levels and raise the major
issues, challenges and commitments for scaling up good governance, stewardship, systems
strengthening, continued professional development and securing logistics and supplies for
health services to meet the needs of the population.
It is within this context that the health policy is being proposed. The policy views health in its
broadest sense as a multi-sectoral programme focusing on the physical, social, economic, and
balancing the pressing emergency and humanitarian needs of the country with the health
sector development and reform dimensions which can bring total health gains to individuals,
their families and communities. There is therefore a paradigm shift from curative action to
health promotion and the prevention of ill-health; meanwhile health systems modernization
and strengthening are eminent in this vision.
The policy argues that a healthy population can only be achieved if there are robust
leadership and good governance, adequate financial, human and physical resources in the
health sector, improvements in environmental hygiene and sanitation proper housing and
town planning provision of safe water provision of safe food and nutrition encouragement of
regular physical exercise improvements in personal hygiene immunization of mothers and
children prevention of injuries in our work places prevention of road accidents practicing of
safe reproductive life. The disease profile and mortality patterns of the country are directly
linked to these factors.
The Government and Ministry of Health of Iraq articulated their vision towards a future of a
healthy and prosperous Iraq through an enabling environment and strong responsive health
systems whereby all citizens should have the opportunity to achieve and maintain the highest
level of health and wellbeing. The Ministry of Health is committed to do all what is possible
to enhance and promote physical, mental and social wellbeing.
The strategic objectives of MoH are:
1. To scale up progress towards universal health coverage and increase geographical and
financial access to basic services;
2. To ensure that people live long, healthy and productive lives without increased risks
of injury, disability or financial hardship;
3. To creating and sustain effective and efficient health systems that deliver quality
health care services for all;
4. To ensure availability of adequate resources in the health sector and adopt a firm
balance of emergency services and health sector development;
5. To reduce the excessive risk and burden of morbidity, mortality and disability,
especially among the poor and vulnerable groups;
6. To address inequalities of access to health, populations and nutrition services and
health outcomes;
7. To foster closer collaboration and partnership between the health sector and
communities, other sectors and private providers.
The national health policy is founded on the principle that health is a multisectoral outcome
and as a result all sectors, governmental and non-governmental agencies in society should be
responsible for creating those conditions, but the primary responsibility for ensuring the
conditions for good health lies with the collective agencies that represent the interests of the
population (freely expressed through democratic institutions)that is, the public authorities
and their public administration.
The Government of Iraq and its public institutions led by Ministry of Health (at the national,
regional, and local levels), to programme the implementation and monitor progress and
challenges along the course of the policy. Therefore, it is important to note that MoH is the
primary public institution responsible for developing a national health policy. Iraqs national
health policy is drafted by the Iraqi Ministry of Health in consultation and collaboration with
key health stakeholders. The process was guided by the developments, challenges and
achievements of health sector over the last few decades and also incorporating evidence and
experiences from the region and world-wide scrutinizing what worked and what did not
aiming to build on those experiences and maximize health gains for all Iraqis during the next
decade.
The policy was developed through a dynamic participatory process and followed the WHO
health systems components namely; governance and stewardship, financing health, human
resources for health, health information system, health service delivery, medical technology
and pharmaceuticals. The policy covers ten year from 2014 to 2023 with the overarching
ambition to achieve universal health coverage for all the Iraqi population equitably and cost
effective.

Primary Health Care (PHC) is essential health care based on practical, scientifically sound,
and socially acceptable methods and technologies made universally accessible to individuals
and families in the community through their full participation in the spirit of self-reliance and
self-determination.
Technically, the health care system in Iraq has been on a centralized, curative and hospital-
oriented model. Such a system has lacked the capacity to deliver services that address the
major health problems faced by the majority of the population in an equitable and sustainable
manner. The current structure of PHC is not based on cost-effective interventions that would
ensure maximum health gains for available resources. Neither is it capable of responding
effectively and efficiently to the complex and growing health needs of the population. The
implementation of Basic Health Services Package (BHSP) will therefore address these issues
and ensure the timely delivery of cost-effective, integrated and standardized health services
tailored to meet the priority health issues faced by the majority of the population.
The BHSP will ensure delivery of equitable and accessible health services through four layers
of health facilities, starting from the community health house up to the district hospital level.
Gradually, the implementation of BHSP will be rolled out to all health districts in all
governorates. This process will enable Iraq to meet the benchmarks of National Development
Strategy (NDS) 2010 2014, International Compact with Iraq (ICI), Millennium
Development Goals (MGDs) and the 2005 constitution of Iraq, which stipulates the
devolution and decentralization of financial and administrative authority to the regional and
governorates levels.
The MoH began to develop the BHSP under the strengthening primary health systems
(SPHCS) project. The process started with a review of the health status of the Iraqi
population to determine major health problems and to identify health services essential for
addressing these problems. The PHC network was also assessed in terms of its infrastructure
and human resources in order to determine the scope and type of services it is capable of
delivering.
The health status of Iraqs population has suffered major blows due to decades of war and
economic sanctions. This has resulted in a severe drop in Iraqs gross domestic product and
consequently its public expenditure on health. Health services have deteriorated and the
sector has faced continuous shortages in drugs and other supplies. Moreover, the current
ongoing conflict and poor security situation has further damaged the countrys health
infrastructure. Many health professionals have fled for safety to neighboring countries and
abroad and the populations access to basic health services has become increasingly impaired.
The Primary Health Care program strengthens the MOH efforts in order to have a system
which is focused on PHC principles and values, assists MOH in the revision of National
Health Strategy 2009-2013 in order to better align it to the current priorities, assists MOH in
the formulation of National PHC strategy with focus on family practice model of service
delivery, and assists MOH in the Finalization of Health Information System and Human
Resources for Health plans.

Iraq Healthcare System


Iraqs healthcare system is classified as primary by the world health organization, which
indicates it is based upon practical, scientifically sound and socially acceptable methods and
technologies made universally accessible to individuals and families in the community
through their full participation in the spirit of self-reliance and self-determination.[1]
The Iraqi healthcare system is in great need of rebuilding since the invasion of 2003 and fall
of the Saddam regime. Numbers from the various surveys reflect this: According to MICS,
the Multiple Indicator Cluster Surveys administered by UNICEF and the Iraqi government,
the number of immunized children dropped from 60.7% in 2000 to 38.5% in 2006. It bounced
back to 46.5% in 2011, but this number is still considerably lower than pre-invasion rates.
According to the World Health Organization, in 2011 Iraqs doctor to patient ratio was 7.8 to
10,000. This rate was exponentially lower than surrounding countriesSyria, Lebanon,
Jordan and Palestine.
Overview
The Iraqi healthcare system is primarily central, with certain allocation of government
funding going towards the sector per year. According to the World Health Organization, there
are 1,146 primary health centers headed by mid-level workers; and 1,185 health centeres,
headed by medical doctors. There are 229 hospitals, including 61 teaching hospitals.
Government spending on healthcare has increased in the last ten years, according to the
World Bank: In 2003 spending was at 2.7% of GDP, and in 2010 it had jumped to 8.4%.
However, the disbursement of these funds remains in question, as there is still a lack of
facilities, medication and staff to show for it.
Iraq Health Insurance
Currently 96.4% of Iraqi-s are without health insurance. There is no health insurance system
to serve the public, and so they rely on the Iraqi central government-run public health care
system, with little advocacy or diversity of treatment options.
Saddam Era Healthcare
From 1993-2003 the Saddam regime reduced public health expenditure by 90 %. This
resulted in a serious deterioration within the healthcare system, with salaries of medical
personnel decreasing and malnutrition and water-borne diseases becoming more and more
common.
In 2003 the American Invasion unfortunately destroyed nearly 12 percent of Iraqs hospitals
and two public health laboratories. However, the US occupation and subsequent international
aide spurred the operation of 240 hospitals and 1200 primary health care centers.
Current Key Players in Iraq Healthcare system
The World Health Organization Representatives Office in Iraq supports the Government
and health authorities at central and local level in strengthening health services, addressing
public health issues and supporting and promoting research for health. Physicians, public
health specialists, scientists, social scientists and epidemiologists provide appropriate
technical support and collaboration upon the request or acceptance of national authorities.
Other key players include USAID, United Nations agencies, such as UNDP, other
humanitarian organizations as well as development partners.
Cancer in Iraq
The top concern among most governorates in Iraq is the increasing rise of cancer rates. When
interviewing the government of Kurdistan, one official reported that the number one priority
of service provision was oncology centers. The need for these oncology treatment centers is
great as increasingly diagnosed patients are having to seek treatment outside Iraqin more
developed countries with stronger healthcare systems, such as Dubai, Lebanon, or the United
States.
Patients pay a high price for travel expenses and for healthcare outside Iraq, but they are
willing to do so because the treatment in these regions is of much more quality than what is
offered in Iraq.
Healthcare Treatment in Iraq
According to one Iraqi resident, living in Kirkuk, the Iraqi healthcare system is not nearly as
beneficial as foreign healthcare systems. She was diagnosed with a spinal injury and was told
she needed surgery. She researched the cost of surgery in Kirkukand was quoted the price
of $7,000. Because her native Iraqi hospital did not offer post-operative care (she would be
allowed to stay in the hospital only until the evening after the surgery, and then would have to
return home right away), she chose to travel outside Iraq to receive the surgery, for a sum
total of $10,000. She chose to receive the surgery outside Iraq so she could receive follow-up
treatment and care for her surgery, and not risk infection by going home the same day.
Investment Opportunity
There are significant investment opportunity within the healthcare sector in Iraq. The
anecdotal evidence cited above is common among native Iraqi residents. Their perception of
their own healthcare system is not positive, and is suspicious. The Iraqi central and local
governments are aware of the gaps in their current system and are seeking guidance to fill
these. Please contact info@irfad.org for more information on how you can participate in the
development of this important sector.

Iraqs national health policy promotes universal health coverage


Kebijakan kesehatan nasional Iraq mempromosikan cakupan kesehatan yang universal
31 March 2015 In view of the mounting challenges facing the health system in Iraq,
including an influx of over 2.5 million internally displaced persons, availability of staff in
health facilities affected by terrorist incidents and the funding constraints of the health sector,
a major step has been taken by the Ministry of Health to formulate the national health policy
of Iraq and respond to national health priorities identified by the New Iraqi Government
Programme.

To achieve this objective, a 4-day workshop was conducted in Istanbul, Turkey from 1 to 4
March 2015. The workshop was attended by high-level officials from the Iraqi Parliament,
Council of Ministers, Federal and Kurdistan region Ministries of Health, leaders of the
central health sector institutions, Health Directorates, Professional Associations for
Physicians, Pharmacists and Dentists and other key stakeholders of the health sector.
The workshop, technically facilitated by WHO, analysed the current state of health in Iraq
and discussed pressing national health priorities and the health mandates of the new
Government to finalize Iraqi national health policy.
Dr Isam Namiq, Deputy Minister of Health of Iraq, presented Iraq's health vision for Iraq to
guide the discussion and overall deliverables. The conceptual framework and prerequisite for
universal health coverage and how national health policy could deliver this to the Iraqi
population over the next decade were discussed.
The current Government has placed the health agenda high on the development framework
declaring an ambitious 10 objectives health programme for implementation during its
constitutional term.
A task force has been formed comprising representatives from the Ministries of Health,
Higher Education, Finance, Planning, and representatives from governorates to review and
finalize the policy document by April/May 2015 and present it to the Ministry of Health and
Health and Environment Committee in the Parliament to affect the approval process.
A high-level consensus-building meeting on the national health policy document has been
further scheduled to take place in Iraq during the second half of 2015.