Health care delivery system

Prepared By:

Walaa Gamal

Outlines

-Introduction

-General organization of health system

-Function of MOHP

-Organization of MOHP

-Hospital services types

-Epidemiological transition

-Problem facing private health care

-Strategies to regulate public, private interaction

--References

Introduction
The Egyptian health care system faces multiple challenges in improving and
ensuring the health and wellbeing of the Egyptian people. The system faces not
only the burden of combating illnesses associated with poverty and lack of
education, but it must also respond to emerging diseases and illnesses associated
with modern lifestyle. Emerging access to global communications and commerce
is raising the expectations of the population for more and better care and for
advanced health care technology. A high birth rate combined with a longer life
expectancy is increasing the population pressure on the Egyptian health system.
By the year 2021 it is estimated that the population of Egypt will have grown to
about 92 million people.

General Organization of the Health System

Egypt has a highly pluralistic health care system, with many different public and
private providers and financing agents. Health services in Egypt are currently
managed, financed, and provided by agencies in all three sectors of the economy—
government, parastatal, and private.

1.The government sector

represents activities of ministries that receive funding from the Ministry of

Finance.

Function of MOHP
-Provider

-Payor

-Policy maker

-Regulator

2. The parastatal sector

Is governed by its own set of rules and regulations, has separate budgets, and
exercises more autonomy in daily operations. However, from a political
perspective, the Ministry of Health and population (MOHP) has a controlling share
of decision

making in parastatal organizations including the Health Insurance Organization

(HIO), the Curative Care Organization (CCO), and the Teaching Hospitals and
Institutes Organization.

3. The private sector

Includes for-profit and nonprofit organizations and covers everything from private
pharmacies, private doctors, and private hospitals of all sizes. Also in this sector
are a large number of nongovernmental

organizations (NGOs) providing services, including religiously affiliated clinics

and other charitable organizations

Organization of the Ministry of Health and Population

The organizational structure of the MOHP consists of two functional structures: the
administrative structure and service delivery structure

1- Administrative Structure

The main functions of administrative structure include planning, supervision, and

program management

All functions of the central headquarters are divided into five broad sector
divisions:

1) Central administration for the minister’s office

2) Curative health services

3) Population and family planning,

4) Basic and preventive health services

5) Administration and finance.

There are 13 headquarter undersecretaries in charge of various functions reporting

to the minister. The responsibilities of these undersecretaries include preventive
care, laboratories, primary health care, endemic diseases, curative care, research
and development, pharmaceuticals, dentistry, family planning, and nursing.

2- Service Delivery Structure

The MOHP is currently the major provider of primary, preventive, and curative
care in Egypt, The MOHP service delivery units are organized along a number of
different dimensions. These include
- Geographic (rural and urban)

- Structural (health units, health centers, and hospital)

-functional (maternal child health centers)

- Programmatic (immunization, and diarrheal disease control).

MOHP Public Health Programs: -

The MOHP has attempted to target many health priorities in Egypt through vertical
programs that rely heavily on donor assistance.

These programs include the following

1-Population, Reproductive Health, and Family Planning Program

2- Control of Diarrheal Diseases and Acute Respiratory Infections Programs

3 -Expanded Program on Immunization

4 -Maternal Health

Egypt is currently facing an epidemiological transition that is characterized by:

■ Reduced mortality rates among infants and children from diarrhea,

immunization-preventable diseases and respiratory infections.
■ Rising prevalence of risk factors such as obesity, smoking and hypertension,
responsible for chronic diseases.

■ A changing socioeconomic environment leading to different diets, increased

industrialization, and increased motor vehicle traffic accidents.

As a result of the demographic and epidemiological transition, the major

health and population challenges are:

1-Population growth

2-Burden of endemic and infectious diseases

3-Maternal, infant and childhood mortality

4-Burden of chronic diseases, renal failure and cancer

5-Injuries and accidents

6-Smoking, other addictions, and their complications

7-Disabilities and congenital anomalies

8-Human resources (capabilities, skills, knowledge, allocation, salaries)

9-Infrastructure (buildings, equipment, furniture and maintenance)

10-Basic public services (housing, unplanned areas.

Problems and challenges facing private health care in Egypt

* Inadequate quality of private health care services.

* Presence of some unreachable areas.

* Insufficient public budget allocated for quality private health care services.

* Deficiencies in the private health care referral system.

*Distribution of health facilities and services according to community needs.

* Providing required number of qualified family physicians.

*Implementing health insurance system covering all community members and

providing sufficient resources.

* Upgrading the quality of undergraduate medical education for physicians and

nurses. Developing a strong health system having the ability of accrediting,
monitoring, and evaluating the provided services.

Ministry of Health strategy to regulate public/private interactions (Institutional)

* Provide integrated basic health care services for mothers, children, and to all
family members emphasizing risk areas and risk groups.

* Assure quality standards in providing private health care package of services.

* Community mobilization and participation.

*Decentralize planning, implementation, and monitoring.

*Apply health strategies of private health care sector.

*Capacity building and training of family physicians and nurses.

Actions for implementing private health care strategies

*Definition of an integrated basic package of private health care services and its
quality indicators, built on scientific basis and needs assessment.

*Development of a separate system responsible for the financial needs of PHC

services.

*Cooperation between public and private sectors in providing health services.

* Implement concept of family medicine.

* Strengthen the existing referral system.

*Improving the quality of emergency basic and comprehensive services which

includes developing technical protocols and guidelines, competency-based training
of health provides, and continuous university support.
References
El Zanaty and Associates, “Egypt Household Health Service and Utilization
Survey”, 2019.

Helsinki Consulting Group. “Master plan of Facility -based Health Services in

Sohag Governorate”, February. 2020.