Egyptian Health System Review

Flashcards based on lecture notes about the Egyptian Health System, focusing on universal health coverage, social health insurance, and reforms.

What is the main goal of the health pillar in the strategic vision for health in 2030 in Egypt?

The improvement of the health of citizens within a framework of justice and equity, achieving universal healthcare coverage for all Egyptians and ensuring high-quality services.

What does universal health coverage ensure?

Access to needed health services (including prevention, promotion, treatment, and rehabilitation) of sufficient quality without exposing the user to financial hardship.

List four important criteria for providing quality universal health care.

Universal, Accessible, Comprehensive, and Portable.

What are the three dimensions of universal health coverage?

Population (who is covered), Services (which services are covered), and Direct costs (proportion of the costs covered).

Name the six building blocks of a health system according to the WHO framework.

Service delivery, Health workforce, Information, Medical products/vaccines/technologies, Financing, and Leadership/Governance.

When did the social health insurance system (SHI) start in Egypt?

1964

What is the HIO in Egypt?

Health Insurance Organization, a public institutional, government-owned entity under the Egyptian Minister of Health and Population.

What are three main challenges facing the Health Insurance Organization on the road to UHC?

Structural/Management, Resources, and Financial challenges

Give an example of a structural or management challenge for the HIO.

Incomplete Population Coverage (informal sector), Multiple Functions, Multiple Coverage Laws, etc.

What is a major financial challenge for the HIO?

Low Government investment in health, Fragmented fund pooling, Unrealistic low premium rate, etc.

What are some challenges regarding service delivery within the HIO?

Patients’ dissatisfaction, Growing prevalence of NCDs, Absence of National Clinical Practice Guidelines, Poor Quality

List the major characteristics of the New Social Health Insurance Law.

Single Payer, 100% Population Coverage, Provider Mix (Public – Private), Cost Sharing, etc.

What are the three main structures of the HIO?

Management structure, Service delivery structure, and Referral structure.

What are the three governmental administrative structures of the Egyptian health system?

Governmental, Parastatal, and Private

What is the role of the central headquarters in the governmental administrative structure?

Responsible for the planning, supervising and management of programs.

How are service delivery units arranged in the Egyptian governmental health system?

Based on geographic (rural/urban), structural (health units/centers/hospitals), functional (MCH centers), and programmatic (immunization, diarrheal disease control) criteria.

What is a parastatal organization in the Egyptian health system?

A “quasi-governmental” organization where the government partly shares in decision-making but it has its own rules, regulations and separate budget.

Name three organizations within the Egyptian health system's parastatal system.

Teaching Hospital Organization (THO), Curative Care Organization (CCO), Health Insurance Organization (HIO).

What does the Curative Care Organization (CCO) do?

Operates in specific governorates, contracts with other entities for the provision of care and is considered the main healthcare provider by the Ministry of Health.

What types of organizations are included in the Egyptian health system's private sector?

Profit and non-profit organizations providing all aspects of healthcare.

Which ministry manages the Primary Health Care Centers and Units in Egypt?

Ministry of Health and Population (MOHP)

What percentage of health services is provided by the Ministry of Health and Population?

Around 30-35%

Approximately what percentage of health services are provided by the private sector in Egypt?

Around 30%

What percentage of the Egyptian population is allegedly covered by the social insurance system, administered by the HIO?

60%

What percentage of health expenditures are covered by the HIO?

6%

What percentage of health expenditure in Egypt was paid 'out of pocket' in 2008/2009?

Over 72%

Where do Egyptians prefer to seek care for check-ups and outpatient services?

Private doctors.

What percentage of inpatient beds are in public medical facilities in Egypt?

Around 90%

What is the government's plan regarding health insurance by 2030?

To implement a system of universal health insurance for every Egyptian.

What are the goals for Egyptian health coverage by 2030?

All Egyptians have access to Family Health Service (FHS) and mandatory Social Health Insurance (SHI).

When did Egypt sign a joint UHC 2030 Global Compact?

2018

When did the Egyptian Parliament approve a new universal SHI law?

2018

How will the new SHI law be implemented across the Egyptian governorates?

Gradual implementation through the 27 governorates will take place over 15 years.

Which governorate was the first to implement the new SHI system?

Port Said

When was the new SHI system launched in Port Said?

July 1, 2019

When is the new SHI system expected to be implemented in Greater Cairo?

2031-2032

Under the new SHI law, what are the three main entities involved in health service provision?

Public provider organization, Social Health Insurance Organization (SHIO), and Accreditation and Monitoring organization.

What is the main responsibility of the Social Health Insurance Organization (SHIO) under the new law?

Financing agency responsible for financing the services.

What is the role of the Accreditation and Monitoring Organization

Providing license and continuous monitoring and evaluation

What is the role of Family Health Service (FHS) units under the new Law?

Provide the primary level of healthcare through a GP who will act as gate keeper and refer cases to hospitals and clinics