REGISTERED NO.

: 18125356

MAJOR:
MARKETING MANAGEMENT

1
INDEX
Introduction 3
Vision 4
Mission 4
ENVIRONMENTAL SCANNING 4
PART1: External Environment Analysis: 5
PESTEL Analysis (Macro Environment) 5
Porter’s 5 Forces Model 19
Opportunities & Threats (OT) 22
Pair Wise Analysis (EFAS) 23
External Factors Analysis (EFAS) 24
PART2: Internal Environment Analysis: 25
Strength & Weakness (SW) 25
Pair Wise Analysis (IFAS) 26
Internal Factors Analysis (IFAS) 27
Clarifications 28
Strategic Factor Analysis Summary (SFAS) 29
Objectives 30
STRATEGIC FACTORS ANALYSIS 32
Strategic Position and Action Evaluation (SPACE Matrix) 32
Clarifications 33
TOWS Analysis 34
Clarifications 34
The Usage of Digital transformation in the healthcare sector 38
Value Innovation “Blue Ocean Strategy” 39
Product Development Strategy 40
Joint Venture Strategy 40
Quantitative Strategic Planning Matrix (QSPM) 41
Clarifications 42
STRATEGY IMPLEMENTATION 43
Internal Policies and Procedures for the selected strategies 43
CONTROL AND EVALUATION 50
Balance Score Card 50
References 54

2
INTRODUCTION
The health care system in Egypt faces multiple challenges in improving and ensuring the
health and wellbeing of the Egyptian people, moreover; the high birth rate combined with a
longer life expectancy is increasing the population pressure on the Egyptian health system,
as well the healthcare sector in Egypt had problems to provide the needed healthcare services
with minimum 1.6 beds per 1000 population in 2014.1 (worldbank.org)

Not just that the only the burden but also the combating illnesses associated with poverty and
lack of education, diseases and illnesses associated with modern lifestyle or that have
appeared suddenly, as in the covid-19 pandemic which has swept the whole world not just
Egypt since the beginning of the last year 2020.

When focusing on the Egyptian healthcare sector, we can see that it consists of two main
parts: 2 (dhsprogram.com)

I. The Public Sector:

This sector lay under the supervision of the Ministry of Health and Population (MOHP)
and composed of quasi-governmental organizations, including the Health Insurance
Organization (HIO), the Curative Care Organization (CCO), and the Teaching Hospitals
and Institutes Organization (THO). that covers large segments of the working persons,
students, and widows and the other needed segments for this kind of healthcare; side
by side with referring that The HIO covers about 60% of the population through
premiums deducted from employee’s salaries.

II. The Private sector:

The private sector includes for-profit and nonprofit organizations and covers
everything from traditional midwives, private pharmacies, private doctors, and private
hospitals of all sizes, clinics, insurance companies, rehabilitation centers…etc, as well
a large number of nongovernmental organizations (NGOs) providing services,
including affiliated clinics and other charitable organizations, all of which are
registered with the Ministry of Social Affairs (MOSA).

When comparing both sectors to each other, it seen obliviously the public sector has lowest
services standard compared to the private due many reasons that will be shown during this
analysis especially when moving towards applying the digital transformation inside this sector
like using the artificial intelligence in medical devices, remote-communications with patients
depending on various type of online applications, electronic health record, and so on and that
in line with Egypt's vision 2030 and the aim to achieve the sustainable development goals
especially the fifth goal related to health and well-being.33 (UN.org) On another hand the current
funding for the medical sector in Egypt usually comes from one of the following four sectors:2
ü Government Sector;
ü Public Sector;
ü Private Sector;
ü Household payments.

3
Moreover; in view of the current global events, where the Covid-19 pandemic which has struck
all countries of the world, the Egyptian Ministry of Health and Population is working to take all
preventive measures on all health sectors that would limit the spread of the virus and enhance
the capacity of all hospitals to receive infected cases with its long experience of developing
and implementing by engaging with development partners internally and externally.

Vision:
Using the digital system to build a healthy nation that is a leader in various fields and is able
to compete globally.

Mission
Developing the health sector system and achieve the digital transformation to serve all
targeted segments of society in parallel with the Egyptian state’s strategy that aims to preserve
the health of citizens by providing preventive services, a prevention plan, predicting diseases
and epidemics, and early detection of diseases in both peace and war. With an emphasis on
decentralization in providing health care requirements to all governorates inside Egypt and for
all Egyptians through developing the technological systems used and training professional
human cadres, whether medical or administrative, in a way that serves Egypt's vision and
enhances it, achieves citizens' satisfaction and maintains financial protection for those who
cannot afford it and to promote achieving of the sustainable development goals for future
generations.

ENVIRONMENTAL SCANNING
Environmental scanning is necessary to be done due to the rapid changes which is taking
place in both external and internal environment, those changes have a great impact on
developing the Egyptian Healthcare sector, therefore the analysis of those outside/inside
elements help in maximizing the strength, minimizing the weakness, grabbing the
opportunities, and diffusing threats which help in developing and modernizing the health
sector in Egypt and implement the policy of digital transformation.3 (linkedin.com)

Moreover; the environmental scanning helps in optimum use of resources by making optimum
utilization of human, natural and capital resources, as well reduce wastage and make optimum
use of available resources. Therefore; it's important to make the environmental scanning that
aids accordingly in the decision-making process by selecting the best alternative strategy from
among various available alternatives. 3 (linkedin.com)

In the following part, we will start with making the external environment analysis at the first
level; then to be followed by making internal environment analysis.

4
PART 1:
External Environment Analysis

PESTEL Analysis (Macro Environment):

1- Political Factors:

Egypt follows the democratic-republican system that is based on citizenship and rule of
law and contributes to constructing human civilization. As stated in the Egyptian
constitution, the Egyptian political system basically depends on political and partisan
pluralism, peaceful rotation of power, separation and balance of powers, the inevitable
correlation between powers and responsibilities, and respect for human rights and
freedoms. Egypt is part of the Islamic world and the Arab nation. The state belongs to the
African continent, cherishes its Asian dimension through Sinai.5 (eggate.com)

The President of the Republic is the head of state and the head of executive power. He is
elected every four years in a peaceful rotation of power. He shall carry out his
responsibilities according to the manner prescribed in the Constitution. Abdel Fattah al-
Sisi was elected as president in May 2014, he was re-elected for another four-year term in
March 2018. 8 (sis.com)

Since the Revolution of 25th of January, and after the step down of President Mubarak,
several constitutional declarations and reforms were presented, including abrogating the
constitution of 1971, approving supplementary articles by referendum of 19th March 2011,
declaring a new constitution of 2012, announcing the new 33 constitutional articles on July
2013, and finally drafting a new permanent constitution by the 50-member panel before
being approved by 98.1% of the Egyptian population on 24th of January 2014. 5 (eggate.com)

While international indicators signify Egypt's constant endeavor to maintain its

governmental stability, as shown in the following figure, that indicates an increase in
government stability, to reach 0.05 in 2000, then returning to face a decline during the
following 8 years, followed by increasing to reach -0.51 in 2008. Then it faced another
decreased in the following years due to the influence of a group of factors, reaching its
lowest point in the period between 2013 and 2014 which was -1.64, followed by rising
significantly in 2019 to reach -1.07.6(theglobaleconomy.com)

Since assuming power, President Adel Fattah El-Sisi has made very important visits over
the past years, which would have strengthened Egypt's role in the region, especially in the
period following the events of 2011. Moreover; these visits focused positively on 2019,
which reflected positively on the country's foreign relations with the neighboring countries
and the rest of the world countries which encourages more investment opportunities in
Egypt, especially since its presidency for the African Union in 2019.

5
SOURCE: WWW.THEGLOBALECONOMY.COM

Although despite the fact that the beginning of 2020 was full of tensions and difficult events
in the Middle East and North Africa region, which put Egypt's foreign policy under
observation that includes, but not limited to, the spread of the Covid-19 pandemic, which
has greatly affected the world air traffic movements which got limited, accordingly the
diplomatic visits and international movements were decreased as well but in spite of this,
Egypt sent a group of medical aid to China and Italy, plus to the Turkish parliament's
passage of a bill allowing the government to deploy forces in Libya to intervene in the civil
war in addition to the events of Iran and the Renaissance Dam crisis, which puts Egypt in
many of the new challenges facing these successive external events that would influence
the Egyptian government's desire to develop a number of sectors, including the health
sector and its shift towards digitalization.

The "100 Million Seha" project for the treatment and early detection of those infected with
hepatitis C virus (HCV) and the detection of non-communicable diseases to more than 50
million Egyptian citizens is a turning point in the health care system in Egypt as one of the
most important internal campaigns that reflects government stability and the government's
ability to develop health care plans since it was launched in July 2018 and managed to
finish checking millions of people for free in just seven months. This project falls within the
framework of upgrading the health system in Egypt, improving the general health of the
Egyptian citizens, implementing the "Egyptian Person Building Strategy" and achieving the
Sustainable Development Strategy which is considering a part of Egypt’s vision 2030.7
(100millionseha.eg)

In short, we can say that Egypt's external borders are also secure due to the president's
anti-terrorism policies, as well the current government has good diplomatic relations with
most countries of the world, as the Egyptian political system aims to enhance stability and
the advancement of Egyptian society at all levels including the health sector, in line with
Egypt's vision 2030 and enhances the Egyptian needs of the achievement of sustainable
development goals for future generations.

6
2- Economic Factors:

Egypt has one of the most developed and diversified economies in the Middle East and
that was until 2010, as we can see the Egyptian economy was growing an average of 5
percent a quarter as a result of several economic reforms. The uncertain political, security,
and policy environment since 2011 has restricted economic growth and failed to alleviate
persistent unemployment, especially among the young. In late 2016, the shortages of
dollars led Cairo to turn to the International Monetary Fund (IMF) for 3 years with a $12
billion loan program.

According to the Central Bank of Egypt, the Egyptian economy contracted 1.7% year-on-
year in the second quarter of 2020, and that according to estimates announced by Egypt’s
Ministry of Planning and Economic Development and that was the first quarterly
contraction since the first quarter of 2011.8

SOURCE: TRANDINGECONOMICS.COM - CENTRAL BANK OF EGYPT

7
As well; when comparing the core consumer prices in Egypt by the end of December
2020, we can see that it has got increased by 3.80% over the same month in the previous
year while it decreased significantly since the Egyptian state floated its currency.9

SOURCE: TRANDINGECONOMICS.COM - CENTRAL BANK OF EGYPT

Another study of the Egyptian Central Bank shows that Egypt's annual inflation rate
declined to 5.4 percent in December of 2020 from 5.7 percent in November and that due
to many factors among of them the lower prices of vegetables and other food products.10

SOURCE: TRANDINGECONOMICS.COM - CENTRAL BANK OF EGYPT

8
There is no noticeable change in wages, as the minimum wage in Egypt remained
unchanged at 2000 EGP per month since 2019 although it has been somewhat higher
since the currency float in 2016.11

SOURCE: TRANDINGECONOMICS.COM - EGYPT | CAPMAS

According to the Central Agency for Public Mobilization and Statistics (CAPMAS), the
number of employed persons in Egypt has been increased to be 26,110 thousand in the
third quarter of 2020 from 24,115 thousand in the second quarter of the same year.12

SOURCE: TRANDINGECONOMICS.COM - EGYPT | CAPMAS

9
While the number of unemployed persons (the following graph) in Egypt increased to
2574 Thousand in the second quarter of 2020 from 2236 Thousand in the first quarter for
the same year.13

SOURCE: TRANDINGECONOMICS.COM - EGYPT | CAPMAS

and that of the total population which jumped from 99.0 million people in 2019 to
be 101,450,411 million people in January 2021 according to the latest figures of the
Central Agency for Public Mobilization and Statistics (CAPMAS).14

SOURCE: TRANDINGECONOMICS.COM - EGYPT | CAPMAS

10
Interest rates in Egypt have been fallen by 0.5 percentage points, on September 28th,
2020, when the Central Bank lowered interest rates by 0.5 percentage points to 8.75%.
to an annual rate of 8.25% with referring to that a reduction in interest rates counters a
weakening of prices as well it also revitalizes the economy and helps to increase
exports.15

SOURCE:
COUNTRYECONOMY.COM
CENTRAL BANK OF EGYPT

On another hand, according to the Central Bank of Egypt, the sectoral breakdown of total
foreign direct investment (FDI) inflows as depicted in the following chart (chart 12) shows
that the oil sector has the biggest share (52.4 percent) along with various sectors as
shown below.16

SOURCE: EGYPT
EXTERNAL POSTION
QUARTERLY REPORT
VOLUME NO 68 FY
2019-2020

CENTRAL BANK OF EGYPT

11
As well; we can see in the below the difference between the total value of exports and the
total value of imports for the indicated period.17

SOURCE: WWW.CAPMAS.GOV.EG - EGYPT | CAPMAS

Finally; the World Bank approved US$50 million for Egypt as an emergency response
under the World Bank Group’s new Fast Track COVID-19 Facility in May 2020 which is a
global effort to help strengthen the COVID-19 response and shorten the time to recovery
to be spent mainly on the health sector according to the following graph.18

SOURCE: WORLDBANK.ORG

12
3- Social Factors:

The Egyptian demographic profile:

Egypt is the most populous country in the Arab world and the third most populous country
in Africa, behind Nigeria and Ethiopia. According to the Egyptian Central Agency for Public
Mobilization and Statistics
(CAPMAS) Most of the Egyptian
land considered as desert,
therefore most of the Egyptian
population approximately 95% of
the population lives within 20 km
of the Nile River and its delta; vast
areas of the country remain
sparsely populated or uninhabited
as shown in this population
distribution map.19
SOURCE: WWW.CAPMAS.GOV.EG - EGYPT | CAPMAS

Since 2000, this growth in birth got slowed, as a result of high population growth, high
unemployment, and significant civil unrest have hit the country in the last two decades,
although it has still reached 72 years in 2020, which is just one year below the global life
expectancy.20

SOURCE:
WWW.STATISTA.COM

Languages
Arabic is the main and official language, moreover; other language like English, French,
German are widely understood among educated classes.21

Religious beliefs:
Egyptian society is divided into the following categories; Muslims (the majority are
Sunnis) 90%, and Christians (various denominations) 10%21

13
Regarding the number of immigrants or those who acquired the characteristics of
immigrants from what they immigrated to the country of Egypt as shown in the following
graph during the period 2007-2019, with noting an increase of their number in the year of
2010.22

SOURCE: WWW.CAPMAS.GOV.EG - EGYPT | CAPMAS

As shown in the following graph, higher education graduates in government

universities including colleges qualified to work in the medical sector that got increased
during 2018-2019 to be 428,561 compared to the previous years.23

SOURCE: WWW.CAPMAS.GOV.EG - EGYPT | CAPMAS

14
With referring to the increase of patients’ numbers that have rescued through the
government sector during the indicated period.24

SOURCE: WWW.CAPMAS.GOV.EG - EGYPT | CAPMAS

Noting the decreasing of hospitals in the government sector throughout the

governorates in 2009 due to the conversion of integration hospitals to basic care units
(health units) from 1187 in 2006 to be only 691 in 2018. 25

SOURCE: WWW.CAPMAS.GOV.EG - EGYPT | CAPMAS

15
 Also, it must be mentioned in this part to the cost of medical treatment for citizens inside
and outside the country at the expense of the state.26

SOURCE:
WWW.CAPMAS.GOV.EG
EGYPT | CAPMAS

4- Technological Factors:
Egypt seeks digital transformation in alignment with its vision of 2030 and Egypt’s digital
transformation strategy on building Digital Egypt by laying the foundations for the
transformation of Egypt into a digital society through three main planks:27 (mcit.gov.eg)

§ Digital Transformation:

Digital services started in Port Said as a pilot project in cooperation with other
ministries, including 36 digital services, at the national level, namely, traffic,
documentation, procurement, and investment services aiming to provide these
digital services to the whole Egyptian citizens, anywhere in the country, in digital
format, through different channels like electronic portals, mobile applications,
service centers, and call centers offices.

§ Digital Skills and Jobs:

By implementing a number of initiatives and programs to develop digital skills in

various technology fields, support innovation, and promote entrepreneurship
among the Egyptian human resources to not only meet the needs of the local
market but also to qualify young people to compete internationally, with referring
that these programs offered training to almost 4000 trainees on ICT fields,
exceeded in 2019 to reach 13000 trainees, with aiming to reach 115000 trainees
during the fiscal year 2020-2021.

16
 § Digital Innovation:

By promoting research and development, innovation, and entrepreneurship in the

field of ICT to drive sector growth, support sustainable national development, and
position Egypt as a regional innovation hub.28

SOURCE:
WWW.CAPMAS.GOV.EG
EGYPT | CAPMAS

Briefly; Egypt's shift towards digitalization helps attract a lot of investors as it qualifies
Egypt to keep pace with global technological development, which will have a great impact
on saving a lot of time, effort, and money compared to traditional methods.

5- Ecological (Environmental) Factors:

The increase in the use of technology led to rising in carbon emissions in addition to the
waste of other natural environmental resources such as water or deliberate damage to
other resources such as polluted air from car exhaust, factories, etc., which consequently
affects the health of citizens.29, 30

SOURCE:
WWW.CAPMAS.GOV.EG –

EGYPT | CAPMAS

17
 However; the Global Health Expenditure Report issued from the World Health
Organization (WHO) pointing a rapid upward trajectory in global health spending which is
well noticeable in low- and middle-income countries where health spending is growing at
an average of 6% per year compared to 4% in high-income countries with referring to that
the governments usually provide an average of 51% of a country’s health spending only,
while more than 35% of health spending per country comes from citizens' expenses, thus
resulting consequence of this is 100 million people pushed into extreme poverty each
year.31 (WHO)

Among many cities, the World Health Organization announced having high levels of
particulate matter contributing to poor air quality in Cairo and Delta cities, thus, it can be
said that no matter what health campaigns the Egyptian country offers, environmental
pollution will continue to have the upper hand in affecting the health of the Egyptian citizens
negatively if no radical solutions are put in place. 31 (WHO)

Therefore; the transition towards what is called a green economy, as well the green
technology, would save energy by building a low carbon society with little or no impact on
the environment through the use of correct and safe scientific methods that resulting in
keep citizen's health.

6- Legal Factors:

On 27 December 2017, the Egyptian Parliament has taken a crucial step towards the
reform of Egypt’s health insurance system by approving the new Comprehensive Health
Insurance Law no. 2 of 2018 which comes to extend the health insurance system to all
citizens and improve the health services.32 (riad-riad.com)

The new Law covers all citizens, whether they are public or private employees, seasonal
or permanent workers, men or women, children or adults. It also covers workers’ spouses,
parents, and children as well as work injuries. It applies mandatorily to all citizens existing
in Egypt and optionally to Egyptians working or living abroad. It can be also extended to
foreigners who are earning their income or living in Egypt subject to reciprocity. AS well;
the government shall guarantee free healthcare services to people who are unable to pay
the contribution fees according to the rules to be determined by the Prime Minister and it
shall get implemented through 6 phases as follows: 32 (riad-riad.com)

1st phase : covers 5 governorates: Port Said, Suez, Ismailia, North Sinai, and South Sinai.
2nd phase: covers 5 governorates: Luxor, Marsa Matrouh, Red sea, Qena, and Aswan.
3rd phase: covers 5 governorates: Alexandria, Al-Bihira, Damietta, Suhag, and Kafr el-Sheikh.
4th phase : covers 5 governorates: Beni-Suif, Assiut, Minya, Wadi-Algadeed, and Fayoum.
5th phase : covers 4 governorates: Al-Dakhleya, Al-Sharqiya, Al-Gharbia, and Al-Monofya.
6th phase : covers 3 governorates: Cairo, Giza, and Qaliobia.

This law needs to be achieved within maximum 15 years from the effective date of the law
during this period, the government should improve health care facilities in order to raise
their efficiency and quality while training workers and the medical staff to keep pace with
this change.

18
 On another hand; the Country of Egypt established a program aimed at harnessing ICTs
to enhance the medical services provided to the whole citizens which is compatible with
Egypt’s vision of 2030 as well as the Sustainable Development Goals’ progress in Egypt.

Porter’s 5 Forces Model:

When talking about the desire to achieve digital transformation within Egyptian healthcare, in
the public sector. It is also important to use this tool for analyzing the external environment to
be aware of the competition or challenges in facing this transformation towards using the
digital transformation; as follows:

1- Threat of New Entrants:

The health sector in Egypt consists of two main parts, which we simply refer to with the
public and private sectors, and it can be said that both sectors include many highly qualified
medical professionals whether doctors, nurses, or administrators. The public medical
sector is considered the most suitable for a large segment of Egyptian citizens, as it
contains qualified doctors, professors, and consultants who graduated from government
universities such as Qasr Al-Aini and Ain Shams ... etc., In addition to the high cost of
treatment in the private sector. In general, the shift towards digitalization represents a
major challenge in the health sector, as will be explained below:

ü Barriers to Enter:
The spread of the covid-19 epidemic has placed health sectors around the world in
a great challenge, and we can see that in Egypt as well, where many of the private
clinics and hospitals have switched to the remote-communication system, where
the patient can book and check with a doctor online via using any of the internet
application which became a necessity and present the results of the required
analyzes as long as her of his condition does not require direct contact with the
medical team, as is the case in many internal diseases, which led to alleviating
pressure on emergency and clinics in this sector, with referring to this sector was a
pioneer in using some of the modern technologies before the outbreak of the
pandemic by taking the lead in using modern technological methods and
encouraging patients to use them whenever to booking, or to check the investigation
results or to check their medical records and store their medical histories to the
concerned system they deal with. According to that, we can see how this sector is
almost ready to turn into full digital transformation with its highly trained human
resources who are ready to deal with using the modern technological. But it takes
a lot of cash flows that qualify the private sector for a complete transformation
towards medical digitization, knowing that this sector serves about 35% of patients,
in addition to the high prices of services provided.

On another hand; in the public sector which is preferred by most the Egyptian citizen
as it contains qualified doctors, professors, and consultants who graduated from
government universities and serve around 60% of the population. The recent crisis
that struck the world emphasized the need to accelerate the development of this
sector and its shift towards medical digitization to take advantage of the possibility
of having a remote-communication system as is the need in many cases that do not

19
 need direct medical supervision and thus reduce the pressure on hospitals and
medical centers affiliated with the Ministry of Health

This needs a lot of investments in this sector, in addition to the proper training the
human resources inside this sector, whether at the medical or administrative level,
as well; finding a plan to overcome the resistance of the human resources that may
occur, especially administrative ones, to shift towards digitization for fear of
dispensing with them or reducing their number in the future.

ü Higher Economies of scale:

Because of the experience possessed by the private healthcare sector, which the
epidemic crisis clearly showed, as they had the lead in using modern technology in
dealing with many patients remotely compared to the public medical sector, and
therefore this point must be taken as an advantage point when implementing the
digital transformation plan in the public sector, and this will save the cost of using
foreign experts in giving training for human resources who are working already in
the public sector.

ü Brand loyalty:
Many Egyptians prefer the idea of dealing with doctors who have graduated from
government universities, especially Qasr al-Aini which is greater than graduates of
private or international universities, as they see that these doctors have scientific
and practical experience, whether they were working in the public or private sectors.

ü Large capital requirements:

The critical necessity for huge investments in the public health care sector to ensure
its complete transformation towards medical digitization within the specified
timeline, in addition to the need to spend on health care research, forecasting
diseases and epidemics, and spending on combating endemic diseases.

ü Government policies:
Egyptian law guarantees the right to provide medical care to all Egyptian or non-
Egyptian citizens residing on Egyptian territory, in addition, that, the new medical
insurance law that will be applied in all governorates of Egypt during the 15-year
period that began in 2018 guarantees the right to treatment for those who are
unable and for all workers The state in all its sectors.

2- Bargaining Power of Buyers:

The desires of the "Egyptian citizen" as buyers in this step to obtain the medical care at a
minimum cost side by side to the high possible quality, with knowing that the cost of
treatment in the private sector is much higher than the public sector; thus, can be shaped
according to:
ü Number of customers and size of the order for each of them:
Customers usually have a lot of power when there aren’t many of them or when the
customers have many alternatives to deal with, when applying that to the medical
sectors and according to this analysis we can say when it depends on quality of
services, there will be many of alternatives to compare between, especially with
affordable prices, therefore the healthcare sector can gain high profits depending

20
 on the value base which should consider as ultimate goal of healthcare sector in
Egypt by creating value and building affordable prices.

ü Differences between competitors & switching cost:

Another way to control the costs of services is determined by the health care
providers in the Egyptian market by providing insurance through specified
insurance companies; thus give patients the upper hand and the power to choose
and dictate which terms or company can fit with their standard of living, which leads
to having more competitions between those companies resulting lowering in prices.

3- Threat of Substitute Products (Services):

The threat in the Egyptian public health sector is the availability of many alternatives for
the same type of service offered by healthcare providers either in the same sector or in
the private sector with slight differences in prices from one provider to another, which gives
Egyptian patients an opportunity to make comparison and selection on the basis of price
and quality.

This can be managed through the Ministry of Health by monitoring services prices that got
presented for the same type of the same service by providing a unified pricelist for all types
of services that can be applied either to clinics, radiations centers, labs or medicines and
to be renewed on annual basis.

4- Bargaining Power of Suppliers:

The availability of suppliers and their diversity in the medical market is an important factor
that can support the provision of appropriate service at reasonable prices to a large
segment of citizens, but also these suppliers can control the prices of the medicinal
components provided, which lead to an increase in the prices of the services provided
especially when they are limited or there is no available substitution to any of them

Therefore, it is incumbent upon the Ministry of Health, supported by the government, to

develop appropriate plans to control the prices of necessary materials that are included in
many parts of the medical sector which can affect the provided services without causing a
negative effect on the citizens health by end.

5- Rivalry Among Existing Competitors:

The private medical sector and the public medical sector are the two poles of competition
in the Egyptian health market. The private medical sector naturally seeks to acquire the
largest part of the Egyptian market share due to having many advantages as qualified
human resources, training programs that qualify its employees to provide a distinguished
service. This was clearly evident during this period, as the Covid-19 pandemic forced many
sectors, including the health sector, to change their methods of dealing, especially the
direct interaction with the public citizens and to rely more on remote-communication
through using modern technological methods, which enhances the capacity of the private
sector and its superiority in this point.

21
 Therefore, the public healthcare sector should focus not only on price but also on providing
unique healthcare services with a high standard of quality As well as digital transformation
to satisfy their patients and to relieve pressure on medical staff and hospitals, especially
when there is no need for dealing directly with the medical teams.

Opportunities and Threats:

Depending on what has mentioned above through using the previous tools in analyzing the
external environment for the public and the private healthcare sectors, the following list for
opportunities and threats can be drawn up as follows for the public sector as this is the sector
that we should focus on developing as it serves more than 60% of the citizens.:

Opportunities
O1 Apply the new health insurance law to T1
all Egyptians within a specific timeline
O2 Launching the first part of T2
the health insurance project
in the Canal cities
O3 The new law includes treatment for all T3
citizens, even those who cannot afford
this cost
O4 Launching exchange programs for the T4
experiences between the public and
private sectors, benefiting from the
experience working in the private sector
in training the public sector employees,
as well; saving the cost for the
expenses of using foreign experts for
the same purpose
O5 Allocating part of the World Bank loan to T5
promote the health sector
O6 The strong tendency supported by the T6
commitment of the government towards
digitalization
O7 Use aids and programs funded by the T7
United Nations and the World Health
Organization to develop this sector,
along with other relevant sectors
O8 The general tendency of spending on T8
research work on treating viruses and
predicting diseases after the end of this
pandemic
O9 Dependence on the list of senior T9
professors who graduated from the
government universities like Al-Qasr al-
Aini, Ain shams … etc.
O10 The need to reduce pressure on the T10
medical teams, especially in times of
crisis
Threats
The critical need for large financial
investments to develop this sector
The resistance of the public employees
to the idea of applying any new changes
on the traditionally used system
The collapse of the medical staff at a time
of crises
Strong competition with the private
sector
High population rise
Slow economic growth
The high rate of illiteracy
(24.6% in July 2019)
The strong experience of the private
sector in using modern technological
methods in communicating with patients
The reluctance of a large segment of
patients to respond and use the modern
communication methods and their
preference for the traditional ways (paper
and pen)
Quality of services provided in the private
sectors

22
 O11 The potential market for providing the T11 Suppliers control the prices of some
needed medical supplies and equipment medical supplies, especially in times of
crisis

Pair Wise (EFAS)

O1 O4 O6 O7 O8 T1 T2 T7 T8 T9 Total Weight

O1 1 0 1 2 1 1 1 1 1 9 10

O4 1 2 1 1 1 1 2 1 1 11 12.22

O6 2 1 1 1 1 2 2 0 2 12 13.33

O7 1 1 1 2 1 1 2 2 2 13 14.44

O8 0 0 0 1 1 2 1 0 2 7 7.8

T1 2 1 2 1 0 1 2 2 2 13 14.44

T2 1 0 0 1 0 0 1 1 2 6 6.7

T7 1 0 0 0 0 1 1 0 1 4 4.44

T8 1 1 2 0 2 1 2 1 2 12 13.34

T9 0 1 0 0 0 0 1 1 0 3 3.33

Total 90 100%

23
External Factors Analysis (EFAS)
Weighted
Factors Weight Rating score comments

Opportunities
O1 Apply the new health insurance law to all
Egyptians within a specific timeline 10 5 50
O4 Establishing exchange programs for the
experiences between the public and private
sectors, and thus benefiting from the experience
of the private sector in training employees of the 12.22 4 48.88
state’s government apparatus and providing for
the expenses of using foreign experts
O6 The strong tendency supported by the
commitment of the government towards 13.33 5 66.65
digitalization
O7 Use aids and programs funded by the United
Nations and the World Health Organization to
develop this sector, along with other relevant 14.44 3 43.32
sectors
O8 The general tendency of spending on research
work on treating viruses and predicting diseases 7.8 4 31.2
after the end of this pandemic
Threats
T1 The critical need for large financial investments
to develop this sector 14.44 5 72.2

T2 The resistance of the public employees to the

idea of applying any new changes on the 6.7 2 13.4
traditionally used system
T7 The high rate of illiteracy (24.6% in July 2019) 4.4 3 13.2
T8 The strong experience of the private sector in
using modern technological methods in 13.34 4 53.36
communicating with patients
T9 The reluctance of a large segment of patients
to respond and use the modern communication 3.33 3 9.99
methods and their preference for the traditional
ways (paper and pen)

TOTAL SCORE 100% 4.02

24
PART 2:
Internal Environment Analysis
Strength & Weakness (SW)
Strength
S1 A huge bulk of professional and well- W1
trained medical teams (doctors and
nurses)
S2 A potential market to invest in, and to W2
develop especially after the spread of
the Covide-19 pandemic
S3 Launching the first phase of the W3
comprehensive health insurance
system in the Canal governorates
S4 Strong media campaigns such as the W4
100 Million Seha campaign helped in
raising the awareness of citizens about
the importance of having medical
follow-up
S5 Having the biggest and trusted names W5
among other medical providers such as
the Egyptian Heart Institute, Cancer
Institute … etc.
S6 Expanding the establishment of a one- W6
day treatment system to relieve
pressure on medical facilities
S7 The most trusted sector among many W7
citizens all over Egypt
S8 The intention to expand the use of W8
electronic government programs such
as the electronic cash transactions
program
S9 Provides treatment to a large segment W9
of citizens, about 60% of the population
(detection and medication)
S10 A strong network of multiple service W10
providers that includes a large bulk of
university hospitals and institutes,
including laboratories and radiology
departments ...etc.
S11 W11
Weakness
Poor health insurance system and weak
medical service coverage
Shortage of medical staff due to the
lowest of salaries
Long waiting time for the patients in clinics
and hospitals
Weak infrastructure and the provided
logistical services
Inaccuracy of data for most patients
dealing with this sector
Lack of efficiency and effectiveness of
workers in the public health sector
Poor technology, leads to the lack of a
strong system for linking patients’ data
and tracking their medical history as
well; their families when moving from
one service provider to another in the
public sector
Poor referral system from one level of
service to another, which puts great
pressure on central service providers
such as the National Heart Institute
The gap between the available
resources especially the financial one
had by the public health sector
compering with the private sector or
even the international standard
Huge number of the Egyptian patients
have a lack of awareness for having a
healthy lifestyle system, or the
importance of public health and proper
nutrition because ignore any kind of
annual medical examinations
The medical services provided are not
trustworthy and do not match the
citizens' needs, therefore; some
patients move to complete their
25
 treatment in the private sector if
affordable for them
W12 Shortage in providers (hospitals), as
well the equipment
W13 The concentration of service providers
in the capital, such as the Heart Institute
or Cancer Institute, constitutes an
additional burden on the residents of
the governorates, especially Upper
Egypt

Pair Wise (IFAS)

S1 S2 S5 S7 S9 W2 W3 W7 W8 W13 Total Weight

S1 1 1 1 1 0 0 1 0 1 6 6.7

S2 1 1 1 1 0 0 1 1 1 7 7.9

S5 1 1 1 1 0 0 0 0 0 4 4.44

S7 1 1 1 1 0 1 1 0 1 7 7.8

S9 1 1 1 1 2 2 1 2 1 12 13.3

W2 2 2 2 2 0 1 1 1 2 13 14.44

W3 2 2 2 1 0 1 1 1 1 11 12.2

W7 1 1 2 1 1 1 1 1 1 10 11

W8 2 1 2 2 0 1 1 1 1 11 12.22

W13 1 1 2 1 1 0 1 1 1 9 10

Total 90 100%

26
Internal Factors Analysis (IFAS)
Weighted
Factors Weight Rating score comments

Strength
S1 A huge bulk of professional and well-trained 6.7 3 20.1
medical teams (doctors and nurses)
S2 A potential market to invest in, and to develop
especially after the spread of the Covide-19 7.9 3 23.7
pandemic
S5 Having the biggest and trusted names among
other medical providers such as the Egyptian 4.44 3 13.32
Heart Institute, Cancer Institute … etc.
S7 The most trusted sector among many citizens 7.8 4 31.2
all over Egypt
S9 Provides treatment to a large segment of
citizens, about 60% of the population (detection 13.3 3 39.9
and medication)
Weakness
W2 Shortage of medical staff due to the lowest of 14.44 4 57.76
salaries
W3 Long waiting time for the patients in clinics 12.2 4 48.8
and hospitals
W7 Poor technology, leads to the lack of a strong
system for linking patients’ data and tracking their
medical history as well; their families when moving 11 3 33
from one service provider to another in the public
sector
W8 Poor referral system from one level of service
to another, which puts great pressure on central 12.22 3 36.66
service providers such as the National Heart
Institute
W13 The concentration of service providers in
the capital, such as the Heart Institute or Cancer 10 2 20
Institute, constitutes an additional burden on the
residents of the governorates, especially Upper
Egypt

TOTAL SCORE 100% 3.24

27
CLARIFICATIONS:
From what mentioned above, it can be said that based on the result of analyzing the external
environment, which was equal to 4.02, the Ministry of the Egyptian Health has the strong
ability to exploit the available opportunities towards the digital transformation and to overcome
the threats it faces depending on the opportunities available to it in outstanding way,
represented which we can see in the strong trend supported by the government's commitment
to apply the digitization method in all platforms and for all ministries, not just the Ministry of
Health, in line with Egypt's 2030 goals, to transform for Digital Egypt and in line with the
sustainable development goals, especially the third goal related to having good health and
well-being through the optimal use of all resources, especially aid and programs funded by
the United Nations and the World Health Organization, to develop this sector, along with other
related sectors listed, as well as benefit from the huge experience that belongs to the private
health sector in the application of digitization and the use of digital applications in
communication with patients plus to training the employees in the public sector and that will
cover the expenses of using foreign experts for the same purpose. Which can support in facing
the threats for needing huge financial investments to develop this sector by the utilizing the
usage of the expertise of the private sector at this point along with optimal use of aid and
funded programs and that will have a great impact on extermination the resistance of the
public employees to the idea of transforming into a digital system.

Moreover; and depending on the result of analyzing the internal environment, which was
equal to 3.24 which can significant acceptable situation as the public health sector which is
covering about 60% of the population as it’s the most trusted sector for having detection and
medication; as well it can be a potential market to invest in, especially after the spread of the
Covide-19 pandemic as if in the whole world with talking into consideration that the shortage
of medical staff plus to the poor system and poor technology when talking about referral or
linking another provider to another as if resulting for the long waiting list for the patients which
constitutes a real threat to this sector.

The next step will be creating the final Strategic Factor Analysis Summary (SFAS) matrix
amalgamates the IFAS & EFAS matrices together into a single matrix to the generation of an
overall score, thus, providing a holistic, overarching view on each factor in order to establish
the effective strategy that should be applied.

28
Strategic Factor Analysis Summary (SFAS)

Factors Weight Rating Weighted score

Establishing exchange programs for the

experiences between the public and private
O4 sectors, and thus benefiting from the experience 10 4 40
of the private sector in training employees of the
state’s government apparatus and providing for
the expenses of using foreign experts
The strong tendency supported by the
O6 commitment of the government towards 18 5 90
digitalization
Use aids and programs funded by the United
O7 Nations and the World Health Organization to
develop this sector, along with other relevant 9 3 27
sectors
T1 The critical need for large financial investments 12 5 60
to develop this sector
The resistance of the public employees to the
T2 idea of applying any new changes on the 5 2 10
traditionally used system
The strong experience of the private sector in
T8 using modern technological methods in 3 4 12
communicating with patients
A potential market to invest in, and to develop
S2 especially after the spread of the Covide-19 8 3 24
pandemic
S7 The most trusted sector among many citizens all 8 4 32
over Egypt
Provides treatment to a large segment of
S9 citizens, about 60% of the population (detection 5 3 15
and medication)
W2 Shortage of medical staff due to the lowest of 10 4 40
salaries
W3 Long waiting time for the patients in clinics and 4 4 16
hospitals
Poor referral system from one level of service to
W8 another, which puts great pressure on central 8 3 24
service providers such as the National Heart
Institute

TOTAL SCORE 100% 3.90

29
OBJECTIVES:
The Ministry of Health is currently playing three distinct roles in the same time, which are:

ü Providing the services;

ü Funding;
ü Auditing.

and with the issuance of the new health insurance law, which seeks to separate the three
roles from each other while keeping health services related to achieving social justice in line
with Egypt Vision 2030 completely free for all citizens as:

ü family Medicine;
ü Epidemiological Medicine;
ü Gynecology and women health;
ü Preventive Medicine;
ü Etc.

According to the new law, Funding is affiliated with the Ministry of Finance and subject to
direct cabinet oversight, Health Services come under the Health Care Authority, and for
Auditing, it is subject to the Accreditation and Supervision Authority, and it reports directly
to the Presidency.

According to that we can conclude the following common objectives:

1- Focusing on the effective implementation of the transformation towards using the

digital system in the public healthcare sector.
2- Achieving social justice in the provided health services for all citizens.
3- Effective utilization of the health financing resources.
4- Providing a standard quality of life for Egyptian citizens by improving the medical
services provided and developing those services in line with the latest international
systems.
5- Overcome the shortage in the medical teams.

Otherwise; the following objectives could be specified briefly according to:

1- Financial Objectives:

ü Increase the government expenditure on the healthcare sector from 4.34 in

2016 to be 8.3 in 2030;
ü Improve the utilization of the health financing resources; through increase the
governmental expenditure on the healthcare system to reach 500 USD per
capita by 2025;
ü Improve new healthcare programs like medical tourism to increase the return
on investment (ROI) by 40% by 2030;
ü Expanding the establishment of a wide network of hospitals far from Cairo by
2030, which covers patients in areas far from the capital.

30
2- Internal Process / Operational Objectives:

ü Increase the numbers of healthcare professionals in Egypt, like skilled

physicians' numbers to be 1.5 per 1000 people in 2025; instead of 0.5 per 1000
people in 2018, as well nurses' numbers to be 4 per 1000 citizen in 2025 instead
of 1.9 per 1000 citizen in Egypt in 2018;
ü Increase the medical coverage for 100% of the Egyptian citizen by 2030;
ü Improve the infrastructure of the sector as a whole;
ü Improving the health status of Egyptians as well; increase the number of beds
and raise the efficiency of the services provided;
ü Guarantee to transform completely from paperwork to use digital applications
by 2030;
ü Cover 100% of hospitals and any related clinics with the required infrastructure
to be able to use the new digital applications;
ü Change transaction from the traditional ways to record patients’ data to
completely digital transformation.

3- Customer Objectives:

ü Fulfill patients’ needs about having short time for waiting, accuracy results..etc.
ü Work to continue awareness campaigns to raise patients’ awareness against
diseases and epidemics and pay attention to public health (as the 100 million
Seha campaign and the personal hygiene campaign to prevent Covid-19) and
increase the targeted sectors of these campaigns in a way that preserves the
health of Egyptians;
ü Market development by preparing patients for the idea of transformation and
using the digital system in this sector, especially in this sensitive time, by
increasing awareness of remote-communication, similar to what happened in
the private sector;
ü Increasing awareness about the harms of using drugs without medical
supervision, which leads to a reduction in the percentage of medicine and the
impact negatively on public health as a whole.

4- Learning and growth / Personnel Objectives:

ü Increase the numbers of training programs;

ü Increase the numbers of skilled and well-trained doctors and nurses by 20230
to assist in completing the medical coverage for 100% of the Egyptians;
ü Improving human resource management system to select and hire the strong
and qualified professionals;
ü Ensure that all public sector hospitals are accredited by the JCI "Join
Commission International" or ISO “International Organization for
Standardization.

31
STRATEGIC FACTORS ANALYSIS:

Strategic Position and Action Evaluation (SPACE Matrix)

Financial Strength (FS) Rate Competitive Advantage (CA) Rate

Use aids and programs funded by the The strong tendency supported by the
United Nations and the World Health 3 commitment of the government towards -5
Organization to develop this sector … digitalization

The critical need for large The strong experience of the private sector
financial investments to develop 5 in using modern technological methods in -4
this sector communicating with patients

Establishing exchange programs for

the experiences between the public
and private sectors, and thus 4 Shortage of medical staff in the public -4
benefiting from the experience of the medical sector
private sector in training employees of
the state’s government apparatus and
providing for the expenses of using
foreign experts

Average = 4 Average = -4.3

Environmental Stability (ES) Rate Industry Strength (IS) Rate

The strong experience of the private A potential market to invest in, and to
sector in using modern technological -4 develop especially after the spread of the 3
methods in communicating with Covide-19 pandemic
patients

Poor referral system from one level of

service to another, which puts great -3 The most trusted sector among many 4
pressure on central service providers citizens all over Egypt
such as the National Heart Institute

The resistance of the public

employees to the idea of applying any -2 Provides treatment to a large segment of 3
new changes on the traditionally used citizens, about 60% of the population
system

Average = -3 Average = 3.3

32
 Y-Axis X-Axis

Financial Strength (FS) = 4 Competitive Advantage (CA) = -4.3

Environmental Stability (ES) = -3 Industry Strength (IS) = 3.3

Y-Axis = 4 + (-3) = 1 X-Axis = (-4.3) + (3.3) = -1

CLARIFICATIONS:
According to the above graph and the final score of the space matrix indicates the following
results:
ü The public health sector should follow the conservative strategy;
ü The public healthcare sector has a financial strength but also with low competitive
disadvantage in comparing with the private health sector;
ü A slightly stable sector, but suffering from low growth.

The following procedures must be observed:

ü Development of existing services provided;
ü Follow the "Product Development Strategy" - to be discussed later;
ü Entering new markets to provide a budget that can be used in development such as
the medical tourism market.

33
TOWS analysis

S2 | A potential market to W2 | Shortage of medical staff

Internal invest in W3 | Long waiting time for patients
Factors S7 | The most trusted sector in hospitals
External S9 | Provides treatment to W8 | Poor referral system
Factors 60% of the population

O4 | Establishing exchange
programs for the
experiences between
the public and private
sectors
O6 | The strong tendency
supported by the
government towards
the digitalization
O7 | Use aids and programs
funded to develop this
sector
(SO) MAX-MAX
Mix matching between those
two parts can powerfully help
in building successful
strategies by using strengths
to get maximum benefits from
available opportunities.
More details will be discussed in
the below
(WO) MAX-MINI
Mix matching between those
two parts can help in
generating strategies that aim
to gain advantages of using
the available opportunities to
overcome the internal
weakness.
More details will be discussed in
the below

T1 | The critical need for large

financial investments to
develop this sector
T2 | The resistance of the
public employees to
transform into digital
system
T8 | The strong experience
of the private sector in
using modern
technological methods
in communicating with
patients
(ST) MINI-MAX
Mix matching here can be
used in generating strategies
that depend on using the
internal strengths in facing
the external threats.
More details will be discussed in
the below
(WT) MINI-MINI
Mix matching here can be
used in generating strategies
that minimize weaknesses and
avoid threats.
More details will be discussed in
the below

According to the factors used in building the TOWS matrix, the following strategies could be
concluded and applied inside the public healthcare sector.

CLARIFICATIONS:
SO Strategy - MAX-MAX:

• O4 | S2:
Implementing programs to exchange experiences between the public and private
sectors to benefit from the private sector’s vast experience in applying digital
transformation and training administrative employees, doctors, and nursing in the
public sector to use all modern digital applications. Otherwise, the public sector has a
large base of public, university, and insurance hospitals that are subject to the control
of the Ministry of Health. As if many types of research related to combating diseases

34
 and epidemics are being developed and worked within this huge number of hospitals,
and thus its development will contribute to the development of medical scientific
research in Egypt.

• O6 | S7:
The Egyptian Ministry of Health has extensive medical assets such as educational
institutes and university hospitals, including qualified doctors and expert nursing, so
many citizens have strong confidence in this sector, on the other hand, as the
government is moving towards implementing a fully digital transformation system in all
of its government agencies, including in that public medical sector and the provision of
financial allocations for that, which contributes to increasing this percentage to cover
patients to reach 100% of treatment coverage for all segments of people by 2030, in
line with Egypt's vision of "digital Egypt".

• O7 | S9:
According to the World Bank, the Ministry of Health covers the treatment of 60% of
citizens at the lowest cost compared to the private sector, and the development of this
sector requires a lot of investments to improve the infrastructure to ensure the optimal
transition towards digitalization. Since Egypt gets a lot of financial aid from the United
Nations and the World Health Organization to develop the public sector in general, the
efficient use of those funds can contribute strongly to the development of this sector.

Strategic alternatives from SO strategy:

ü Covering more patients;
ü Gain knowledge from transferring expertise between the public and private
sectors;
ü Enriching and developing scientific research and research to combat diseases
and epidemics;
ü Improving the general health of Egyptians;
ü Raise the efficiency of the services provided;
ü upgrading the infrastructure;
ü Raise the efficiency of employees in the public medical sector.

WO Strategy-MAX-MINI:

• O4 | W2:
Many of the qualified doctors or nurses prefer not to join or work on the public medical
sector for many reasons, including poor salaries, the inability to deal with the pressure
present in it due to its weak capacity and infrastructure, and the lack of resources and
supplies that help them complete their work. Thus, the development of this sector and
its conversion towards the use of the modern technological methods, as well; the
exchange programs between it and the private sector will support transforming
experiences to it that leads to help doctors and other employees to contribute their
work.

• O6 | W3:
The public medical sector has a long known history of long waiting lists for patients
inside hospitals and clinics, which exhausts them, as they go to book an appointment

35
 for the examination and then wait when the examination date comes on the same day,
which burdens patients and causes pressure on them and on the facility itself too, in
addition to the waiting lists for operations.

Therefore, the digital transformation will help in existing in finding solutions for this
problem by creating electronic tools such as "A digital Medical Record" for every
patient that can be used in
ü Shortening the time by reviewing the medical history and the development of the
condition;
ü In the case of chronic diseases that require dispensing of medicines on a
monthly basis, such as blood pressure, patients can go to the pharmacy directly
to get their medicine. and so on.

• O7 | W8:
Donations and cash assistance provided by the World Health Organization and the
United Nations to Egypt can be used to raise the efficiency of the medical system and
support the digital transformation in a way that helps build an electronic network
between different service providers within the public sector, which helps relieve
pressure on it and ensure the maintenance of data efficiency and the accuracy of
transferring patients from one university hospital to another when they want to obtain
other services for them for example, thus saving on costs and time.

Strategic alternatives from WO strategy:

ü Effective utilization of the receiving funds and donations in improving the digital
transformation process;
ü Overcome the shortage of medical staff,
ü Reduce the long waiting list for patients;
ü Improving referral system between medical providers in the same sector;
ü Overcome the resistance of the public employees to apply the process of digital
transformation.

ST Strategy- MINI-MAX:

• T1 | S2:
The public medical sector in Egypt has extensive medical assets such as educational
institutes and universities' hospitals, including well-experienced and qualified medical
teams, so it needs more investments to develop it on international standards, and this
development is reflected in the contribution to the development of scientific medical
research in Egypt and thus Preserving the health of citizens, eliminating many
communicable diseases, and combating epidemics.

• T2 | S7:
However, this sector is considered the most trusted sector among large numbers of
citizens, and that its development will necessarily be reflected in the preservation of
their health, and therefore this must be taken into account first when applying digital
transformation to it, as the majority of employees of this sector resist the idea of digital
transformation and the application for fear From being laid off or reducing their numbers
in the future, and thus depriving them of their salaries and other benefits that they may
get.

36
 • T8 | S9:
Exploiting and transferring the existing expertise of the private sector, in cooperation
with it, in the application of digital solutions in the public medical sector, allows
increasing the volume of patients’ treatment coverage to reach 100% by 2030.

Strategic alternatives from ST strategy:

ü Development of scientific medical research in Egypt and thus preserving the health of
citizens;
ü Eliminating many communicable diseases, and combating epidemics;
ü Overcome the lack of employees’ awareness about the importance of applying digital
transformation;
ü Attract more talented staff to join this sector and motivate the existing ones;

WT Strategy - MINI-MINI – “Retrenchment”:

• T1 | W2:
The public medical sector in Egypt is in dire need of more investments and funds to
improve its absorptive and treatment capabilities, which contributes to reducing the
turnover between professionals in this sector.

• T2 | W3:
Reliance on traditional methods of registering patients and transferring their data from
one service provider to another contributes to prolonging waiting lists, as well as the
resistance of this sector's employees to apply the transformation towards the digital
system, which is negatively reflected on the health of citizens. Therefore, this aspect
must be taken into consideration when applying the digital development strategy to
ensure the success of the application on the ground.

• T8 | W8:
The private sector develops itself and grows in a way that makes it have a clear imprint
in the medical system in Egypt, which is somewhat considered a threat that must be
taken into consideration when looking at the dilapidated public sector, which suffers
from poor infrastructure and facilities as a whole, as well as the services it provides.

Strategic alternatives from WT strategy:

ü Developing the public sector to be similar to the private sector, thus reducing
employee turnover;
ü Develop methods of transferring patient data to reduce long waiting times;
ü Provide incentives and rewards to the exiting staff to encourage them to develop this
sector without fear of losing their jobs;
ü Reducing drug wastage or misuse due to incorrect patient data.

37
The Usage of Digital transformation in the healthcare sector:

The Ministry of Health can apply one of the below strategies in order to improve its capabilities
towards transforming, using, and applying digital system inside its public sector, but first, we
need to list some examples for the application of using technology in healthcare:

1- Internet of Things (IOT):

Which help in tracking patients' commitment to the given treatment plans or giving an alarm
when there is a need for immediate medical attention that healthcare professionals need
to be aware with, and connect with the patients proactively by collecting and analyzing
patients' data on a regular basis thus can save their life, time, and improve their lifestyle
as well; improve medical researches through working on the collected data.

2- Using Robots:
The spread of the Coronavirus pandemic has imposed new methods of dealing with
patients. Reliance on the use of robots has become an indispensable necessity in the
medical sector, as it is possible to rely on it internally in hospitals when needed to deliver
medicines and so on to patients inside their rooms without making any direct interaction
between them and the medical teams in a way that preserves the health of medical staff
from infection and reduces the pressure placed on them. It can also be relied upon to assist
in performing delicate medical procedures, surgical robotics with its metalheads for
surgical precision which can reduce the long waiting lists, saving doctors’ efforts, saving
patients’ lives, as well; cost and time. There is a long list of how we can rely on using
reboots in healthcare sector like using the sanitation robots that can be used in cleaning
via using UV light to disinfect patients' rooms of any bacteria and viruses within
minutes.38,39

3- Electronic Medical Records:

Transferring patients' data to the electronic medical record leads to the preservation of
their medical history along with any surgery they have had in the past, previous diagnoses,
and medications they are taking, especially in the case of chronic diseases ...etc., which
allow doctors to deal efficiently their patient's problems.

4- Mobile Application:
Relying on the use of mobile applications in the medical field has also become an
indispensable necessity, through which it is possible to book appropriate appointments for
clinics without the need to go for reservations within the hospital and wait until the role of
examination comes, as well; receive labs or x-rays results without the need to go to the
service provider, and that all by linking the patient's data With service providers who deal
with them. This technology can also be used to share medical notifications about the
correct methods of nutrition, the benefit of exercising and proper health habits, or as a
reminder of medication appointments or examination.

5- Remote-Communication Applications:
This would help to overcome the distance between patients and doctors, especially for
patients living in Upper Egypt, through the use of remote communication applications,
whether on mobile phones or on laptops, especially in some cases that do not require
direct examination or in some cases of primary examination.

The list is too long, many other applications and ideas can be added, but let's say moreover;
to what has been mentioned above, the below strategies could be also be added.

38
Value Innovation “Blue Ocean Strategy”:

Focusing on applying the innovation of digital applications in the medical services provided by
the public sector to create value for the patients treated by this sector with equivalent to the
Egyptian government commitment towards achieving and using the digital technologies in all
ministries including the health sector through the following four factors;

ELIMINATE
Traditional paperwork;
Wasting time doing the manual
processes;
The waste of the patients’ data;
Professionals turnover;
The waste of medicines and drugs;
CREATE
Digital services,
Digital medical records;
Digital medical network for physicians
and providers;
Competitive advantage;
Real-time health information;
Digital linking system between
professionals and patients;
Exchange programs;
Strong infrastructure.

REDUCE RAISE
Medical errors; Medical coverage;
Costs; Access to the health services 24 hrs. /
Waiting time; 7days;
Weak technology Efficiency;
Wasted financial resources; Patients' satisfaction;
Resistance of employees to the Provided services quality;
application of the new technological Service accessibility;
system. Human resource management;

39
Product Development Strategy:

Depending on the use of this strategy to mitigate risks in developing a new concept for the
services provided, by achieving progress towards the development of digital transformation in
the public medical sector through:

ü Remote communication applications

ü Electronic medical records,
ü Robots in surgical procedures,
ü The Internet of things,
ü Mobile application.

As explained earlier, in a way that guarantees the satisfaction of patients and improves the
level of services provided, thus improving citizens' health and overcoming other traditional
obstacles.

Otherwise; We can add another development to this point by focusing on preparing the public
sector to enter the medical tourism market depending on the shift to digitalization along with
new innovative applications that can add value to the services provided and build a strong
competitive advantage in the healthcare sector by exploiting the location Geographical Egypt.
The distinctive and temperate atmosphere that you enjoy throughout the year, in addition to
the presence of a large number of natural beaches and medicinal lakes that will contribute to
the prosperity of tourist treatment. On the other hand, medical tourism can add more benefits
as follows:
ü Strong foreign exchange earner;
ü Help with economic recovery, and reduce the unemployment rate;
ü Motivating the health sector to continuously develop itself;
ü Support in increasing local pharmaceutical industries.

Joint Venture Strategy:

Establishing cooperative exchange programs between the public and private healthcare
sectors to exchange experiences and benefit from the experience of the private sector in the
field of transformation towards the use of digitization in the medical field, as well as:

ü Training public sector staff on how to use the new technology; and
ü Raise their level of performance in a way that reducing the turnover rate
ü Benefiting from this exchange in raising the level of research scientific in the field of
combating diseases and epidemics;

Which will reflect in

ü Improving the provided services,
ü Raising the efficiency;
ü Decreasing the cost;
ü Minimizing the medical errors,
ü Reducing the waiting time;
ü Avoid wasting patients’ data; and
ü Improving citizens’ health by the end.

40
Quantitative Strategic Planning Matrix (QSPM)

Value Innovation Product Joint

External/Internal “Blue Ocean Development Venture
Factors Strategy” Strategy Strategy
Weight AS* TAS* Weight AS TAS Weight AS TAS
Establishing exchange
programs for the experiences
O4 between the public and 10 5 50 10 2 20 10 5 50
private sectors …
The strong tendency
O6 supported by the
commitment of the 18 5 90 18 5 90 18 4 72
government towards
digitalization
Use aids and programs
funded by the United Nations
O7 and the World Health
Organization to develop this 9 4 36 9 2 18 9 4 36
sector …
The critical need for large
T1 financial investments to 12 5 60 12 2 24 12 3 36
develop this sector
The resistance of the public
employees to the idea of
T2 applying any new changes 5 3 15 5 1 5 5 1 5
on the traditionally used
system

41
 The strong experience of the
private sector in using
T8 modern technological 3 4 12 3 2 6 3 5 15
methods in communicating
with patients
S2 A potential market to invest in 8 4 32 8 4 32 8 4 24
The most trusted sector
S7 among many citizens all over 8 3 24 8 3 24 8 4 32
Egypt
Provides treatment to about
S9 60% of the population … 5 5 25 5 3 15 5 3 15
W2 Shortage of medical staff … 10 2 20 10 3 30 10 3 30
W3 Long waiting time for the
patients in hospitals 4 3 12 4 2 8 4 2 8
W8 Poor referral system from
one level of service to 8 4 32 8 2 16 8 3 24
another …
TOTAL 1 4.08 1 2.88 1 3.47
AS*: Attractiveness Score TAS*: Total Attractiveness Score

CLARIFICATIONS:
The Quantitative Strategic Planning Matrix (QSPM) mainly use for evaluating possible strategies by providing an analytical method for
comparing feasible alternative actions, therefore; and according to the previous results we can conclude the following results:

The total Attractiveness Score for the “Value Innovation - Blue Ocean Strategy” is 4.08 which is higher than the other two strategies,
therefore we recommend on relying on using this strategy at the first level. This strategy can guarantee the achievement towards using
digitalization in the medical field by creating value depending on using the newest innovative applications by developing the exchange
programs between private and public sector to create a real-time health information system while minimizing the medical errors; long
waiting time for patients, the waste of financial resources, as well; raise the efficiency and the quality of the provided services leads to
patients' satisfaction by the end depending on eliminating numbers of factors like the traditional way of doing paperwork; which wasting
time on doing the manual processes; resulting in the waste of the patients’ data, as well; medicines and drug.

42
STRATEGY IMPLEMENTATION

Internal Policies and Procedures for the selected strategies

Action Plan
Action Date Budget Responsible Accountable Consulted Status Outcomes Evaluation/KPIs
Value Innovation “Blue Ocean Strategy”
Improve 400 Billion Ministry of Ministry of Ministry of Organized Establish % Allocations of
public 2030 EGP Finance Finance ICT adequate the Ministry of
healthcare ICT Finance for
providers Infrastructure development
infrastructure

Ministry of
Linked 2027 35 Million Ministry of Planning, Digitalization % From
digital EGP Finance Follow-up, Ministry of On going system government
system and ICT linked payments for local
Administrative between all development
Reform Ministries

Exchange 15 Million Ministry of Enhancing the % from

programs 2030 EGP Health Ministry of Ministry of On going position of the Allocations
between Health Health public sector in Ministry
private and the field of of
public sectors digital health Health

43
 Training and % from
Human 5 Ministry of Ministry of planning Provide Allocations
resource 2021 Million Higher Health sector in On going skilled Ministry
management; EGP Education MOH employees in of
different Health
sectors
needed by
MOH

1 Ministry Ministry Ministry %

Digital 2030 Million of of of Organized Preservation Ministry of
medical EGP Health Health Health patients' Health
records; medical history
in one
combined file

Reduce
Training Training and wasted %
for healthcare Ministry Ministry planning time and Ministry of
providers in 2024 350,000 of Health of Health sector in On going traditional Health
public EGP MOH paperwork, the
sector waste of the
patients’ data

Product Development Strategy

Medical By activating % From
coverage for 900 Billion The Egyptian Ministry of Minister of the government
100% of the 2030 EGP Parliament Finance investment Organized new health payments for local
Egyptian insurance law development
patients

44
 Linking
Digital 10 Billion Ministry of Ministry of Ministry of between
applications 2026 EGP Finance Health ICT Organized all patients and % Ministry of
all Finance
of the medical
providers

Foreign
exchange
Medical earner that
tourism Ministry of motivating the
project Planning, health sector
Follow-up, to continuously % Allocations
2028 100 Billion Ministry of Ministry of and Organized develop itself; of the Ministry of
EGP Finance Health Administrative and support in Finance
Reform increasing
local
pharmaceutical
industries

Healthcare 2026 200,000 Ministry of Ministry of Training and Improving staff % Ministry of
staff EGP Health Health planning Organized skills Health
Development sector in
MOH

Preparation for 3 To support in % Allocations

international 2030 Billion Ministry of Ministry of Ministry of Organized the medical of the Ministry of
accreditation EGP Finance Health Planning tourism Finance
program

45
 Joint Venture Strategy
Cooperative 15 Million Enhancing the %
exchange 2030 EGP Ministry of Ministry of Ministry of On going position of the Allocations from
programs Health Health Health public sector in Ministry
the field of of Health
digital health

Medical 2030 500,000 Ministry of Ministry of Training and Improving staff % Ministry of
healthcare EGP Higher Health planning Organized skills Health
staff Education sector in
Improvement MOH

% Allocations of
Improve 22 Billion Ministry Ministry Academy of raising the the Ministry of
scientific 2021 EGP of of Scientific On going level of Finance for
research Finance Health Research research development
scientific in the
field of
combating
diseases and
epidemics

Full 2026 50 Billion Ministry of Ministry of Ministry of Organized Cover 100% of % Ministry of
digitalization EGP Finance Health ICT the Egyptians Finance
transformation Patients

SO Strategy - MAX-MAX
Promote 120 Billion 100% of the % Ministry
quality of 2030 EGP The Egyptian Ministry of Minister of On going Egyptians of
health for the Parliament Finance Health patients Finance

46
 total
Egyptian
population

900 Billion 100% of % From Ministry

Establishing EGP Ministry of Ministry of Minister of On going the of
Digital 2030 Finance Finance ICT Egyptians Finance
Transformation patients
System in MoH

Raise the 2025 4 Billion Minister of Minister of Minister of Organized Enhance % Ministry of
efficiency for EGP Health Health Health Egyptians Health
the services health
provided

WO Strategy-MAX-MINI
Digital Effective
Transformation 2030 25000 Billion Ministry of Ministry of Minister of On going utilization of % Ministry of
Applications EGP Health Health ICT the receiving Health
funds and
donations in
improving the
digital
transformation
process

Training
Ministry of and Overcome the %
Staff training 2027 80,000 Higher Ministry of planning Organized resistance of Ministry of
EGP Education Health sector in the public Health
MOH employees to
apply the

47
 process of
digital
transformation

Digital linking 2030 5 Million Ministry of Ministry of Minister of On going Improving % Ministry of
system EGP Health Health ICT referral system Health
between
medical
providers in
the same
sector

ST Strategy- MINI-MAX
Ministry of Training and Overcome the
Increase staff 2021 250,000 Higher Ministry of planning On going lack of % Ministry of
awareness EGP Education Health sector in employees’ Health
MOH awareness
about the
importance of
applying digital
Transformation

Development 2021 4 Billion Minister of Minister of Minister of Organized Enhance % Ministry of

of scientific EGP Health Health Health Egyptians Health
research Health
in Egypt

Develop Ministry of Training and

training, and 2021 1 Million Higher Ministry of Organized % Ministry of
EGP Education Health Health

48
 evaluation planning Motivation to
programs sector in use the new
for the MOH system
employees

WT Strategy - MINI-MINI
90 Ministry of Training and %Ministry of
Reduce the 2030 Billion Higher Ministry of planning Organized Motivation to Health
staff turnover EGP Education Health sector in use the new
MOH system

Reduce the 2
extra waiting Million Ministry of Ministry of Ministry of Organized End waiting %Ministry of
time for 2023 EGP Health Health Health lists in clinics Health
patients and hospitals

Provide
Motivate the 250.000 Ministry of Ministry of Ministry of incentives to %Ministry of
existing staff 2021 EGP Health Health Health Organized encourage Health
staff to
develop this
sector without
fear of losing
their jobs;

Increase Reducing drug

efficiency 2024 900.000 Ministry of Ministry of Ministry of Organized wastage due %Ministry of
for staff EGP Health Health Health to incorrect Health
members patient data

49
CONTROL AND EVALUATION

Balance Score Card:

Objectives Measures (KPIs) Targets Initiatives

Financial Objectives
Increase the government %
expenditure on the healthcare funds for healthcare 8.3% Increase the financial allocations for the public
sector from 4.34% in 2016 to be sector healthcare sector
8.3% in 2030

Improve the utilization of the health

financing resources; through
increase the governmental
expenditure on the healthcare
system to reach 500 USD per capita
by 2025
% 500 USD Government spending on improving the healthcare
expenditure per capita per capita sector in the discussion of the state budget
by 2025

Improve new healthcare programs % 40% Designing new programs targeting Arab and
like medical tourism to increase the ROI form Medical by European tourism, based on Egypt's possession of
return on investment (ROI) by 40% Tourism 2030 a large group of natural springs that aid in healing
by 2030 from many diseases.

50
 Expanding the establishment of a % 30%
wide network of hospitals far from Expenditure covering Increase numbers of healthcare providers
Cairo by 2030, which covers by 2030
patients in areas far from the capital From government

Internal Process / Operational Objectives

Increase the numbers of healthcare
professionals in Egypt, like skilled % 1.5
physicians' numbers to be 1.5 per of professionals Doctor
1000 people in 2025; instead of 0.5 (doctors & Increase numbers of qualified professionals per
per 1000 people in 2018, as well & 4 nurses 1000 citizens
nurses' numbers to be 4 per 1000 nurses) In 2025
citizen in 2025 instead of 1.9 per
1000 citizen in Egypt in 2018;

Increase the medical coverage for % 100% Activating coverage through the new health
100% of the Egyptian citizen by medical coverage By 2030 insurance law
2030;

Improve the infrastructure of the % 90%

sector as a whole; infrastructure by 2030 Make it ready for new technical changes

Guarantee to transform completely % 70%

from paperwork to use digital Digitization by Make it ready for using new digitization system
applications by 2030; 2030

51
 Customer Objectives
Fulfill patients’ needs about having % 80%
short time for waiting, accuracy customers’ by Increase customers’ satisfactions
results...etc. satisfactions 2030

Market development by preparing % 75%

patients for the idea of customers’ awareness by Increase customers’ awareness
transformation and using the digital 2030
system in this sector…

Work to continue awareness % %

campaigns to raise patients’ customers’ awareness 88 Increase customers’ awareness
awareness against diseases and
epidemics

Learning and growth / Personnel Objectives

Increase the numbers of training % training programs 90% Overcome the Resisting of implementation the
programs; digital system

Increase the numbers of skilled and

well-trained doctors and nurses by %
20230 to assist in completing the hiring qualified medical 60% Offer attractive incentives and offers
medical coverage for 100% of the teams
Egyptians;

52
 Improving human resource
management system to select and
hire the strong and qualified
professionals;
Ensure that all public sector
hospitals are accredited by the JCI
"Join Commission International" or
ISO “International Organization for
Standardization.
% Improve the productivity of human recourses to be
Of HRM 65% able to target the qualified medical team members
% Quality and monitoring system covering the public
of hospitals and other 85% healthcare providers
healthcare providers
53
References
1- https://data.worldbank.org/indicator/SH.MED.BEDS.ZS
2- https://dhsprogram.com/pubs/pdf/SPA5/02chapter02.pdf
3- https://www.linkedin.com/pulse/8-important-needs-importance-environmental-scanning-business-sharma/
4- https://www.sis.gov.eg/section/10/275?lang=en-us
5- https://egypt.eggate.com/node/210
6- https://www.theglobaleconomy.com/Egypt/wb_political_stability/
7- http://www.100millionseha.eg/
8- https://tradingeconomics.com
9- https://tradingeconomics.com
10- https://tradingeconomics.com/egypt/inflation-cpi
11- https://tradingeconomics.com/egypt/minimum-wages
12- https://tradingeconomics.com/egypt/employed-persons
13- https://tradingeconomics.com/egypt/unemployed-persons
14- https://tradingeconomics.com/egypt/population
15- https://countryeconomy.com/key-rates/egypt
16- www.cbe.org.eg
17- https://www.capmas.gov.eg/Pages/IndicatorsPage.aspx?page_id=6128&ind_id=2129
18- https://projects.worldbank.org/en/projects-operations/project-detail/P173912
19- https://www.capmas.gov.eg/HomePage.aspx
20- https://www.statista.com/statistics/1071029/life-expectancy-egypt-historical/
21- https://www.cia.gov/the-world-factbook/countries/egypt/#geography
22- https://www.capmas.gov.eg/Pages/IndicatorsPage.aspx?page_id=6135&ind_id=1097
23- https://www.capmas.gov.eg/Pages/IndicatorsPage.aspx?page_id=6142&ind_id=1082
24- https://www.capmas.gov.eg/Pages/IndicatorsPage.aspx?page_id=6141&ind_id=2519
25- https://www.capmas.gov.eg/Pages/IndicatorsPage.aspx?page_id=6141&ind_id=2519
26- https://www.capmas.gov.eg/Pages/IndicatorsPage.aspx?page_id=6141&ind_id=2519
27- https://mcit.gov.eg/en/Digital_Egypt#:~:text=Digital%20Transformation,-
Recognizing%20the%20ICT&text=Egypt%20has%20been%20adopting%20a,a%20faster%20and%20simp
ler%20way.
28- https://www.capmas.gov.eg/Pages/IndicatorsPage.aspx?page_id=6134&ind_id=2262
29- https://www.capmas.gov.eg/Pages/IndicatorsPage.aspx?page_id=6145&ind_id=2227
30- http://www.eeaa.gov.eg/en-us/topics/general/envhealth.aspx
31- https://www.who.int/news/item/20-02-2019-countries-are-spending-more-on-health-but-people-are-still-
paying-too-much-out-of-their-own-pockets
32- http://www.riad-riad.com/en/publications/egypts-comprehensive-health-insurance-law
33- https://www.un.org/development/desa/disabilities/envision2030.html
34- https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD?locations=EG-XN
35- https://mped.gov.eg/EgyptVision?lang=en
36- https://data.worldbank.org/indicator/SH.MED.PHYS.ZS
37- https://data.worldbank.org/indicator/SH.MED.NUMW.P3
38- https://www.asme.org/topics-resources/content/top-6-robotic-applications-in-medicine
39- https://www.asme.org/topics-resources/content/top-6-robotic-applications-in-medicine
40- https://medicalfuturist.com/robotics-healthcare/

54