Africa > North Africa > Egypt > Egypt Health Profile

Egypt: Egypt Health Profile

2012/03/09

Medical-Outreach-

Social safety nets

Compensatory welfare structures have existed in Egypt since the initiation of economic liberalization and privatization measures. Different governmental funds, partially financed by Western donors, attempt to help the high number of marginalized citizens. However, social safety nets do not meet the needs of the people. With the low levels of government expenditures in health (2.3% in 2006) and education (between 4-5% of GDP in 2006), the safety nets have no luck of compensating the one-third of the people living in poverty and do not keep the pace with people increase and the accompanying hikes in enrollment. In 2008, the government, under pressure of public discontent, raised subsidies for food and energy.

In the 2005 and 2007 Egypt Human Development Reports, the government, in collaboration with UNDP, tried to develop a strategic vision of how to combat poverty and strengthen social safety in the country. However, the national has still failed to develop a social program to complement its market economy reforms. Against the background of growing tax revenue since 2003, the low level of spending for health and education is alarming.

Islamic movements continue to play an significant and growing role in the social safety net. Private health spending is as well growing.

Equal opportunity

According to the Egyptian constitution, the national is the guardian of opportunity for all its citizens. Over the years, however, the regime has favored the interests and request of some social groups over others. Those who were living below the poverty line remained there, while others (e.g., the large bureaucracy) benefited from national services. The economic reform schedule has significantly strengthened a circle of businessmen and corporations.

While economic increase is accelerating, evolution in human development is still uneven. According to an International Labor Organization study, young people, the majority of the in general people, are particularly vulnerable to poverty. In a 2005 World Economic Forum study that covered the world gender gap in 58 nations, Egypt ranked last. One positive development is women’s increased access to education, particularly higher education, and public office. According to a 2006 Freedom Home study on Women’s Rights in the Middle East and North Africa, women’s literacy is expected to improve further. For the majority of Egyptian women, however, the way to empowerment will be long and should not be taken for granted.

The Christian (mostly Coptic) minority is underrepresented in the public sector and faces discrimination.

HEALTH & DEVELOPMENT


Most of the people has easy access to health care. Egypt has an extensive network of health facilities ensuring easy access to basic health services for its people. Management of the health system is highly centralized at the overstaffed Ministry of Health and People (MOHP). Different public entities (MOHP, other ministries (Higher Education, Defense and Interior), the Health Insurance Organization (HIO), private practitioners and nongovernmental organizations (NGOs)) are involved in managing, financing and providing health services, without performance assessment mechanisms or quality assurance. The HIO covers only 45% of the people and there is a growing unregulated private sector. Nationally produced pharmaceuticals account for additional than a third of health spending.


Communicable diseases have largely been controlled in Egypt; high coverage rates for routine immunization, vaccine-preventable diseases have shown a remarkable decline in the last decade. Egypt has been considered as a polio-free country since 2006. The neonatal tetanus incidence rate is 0.06 per 1000 births. There were no reported cases of diphtheria. Prevalence of Schistosoma mansoni infection decreased from 14.5% in 1995 to 0.9% in 2007 and the prevalence of Schistosoma hematobium infection decreased from 5.4% in 1995 to 0.6% in 2007. Hepatitis B and C continue to be a public health problem in Egypt with data suggesting their incidence, particularly hepatitis C, may be increasing. A 1996–1997 survey of individuals aged two years old or older indicated the in general prevalence of anti-HCV and HBsAg was 18.9% and 4.5%, respectively. Tuberculosis is considered to be the third most significant communicable disease problem next schistosomiasis and hepatitis C. Egypt ranks part nations with mid/low level of tuberculosis incidence. The prevalence of HIV/AIDS part 15–49 year-olds is approximately 0.03%. Epizootic outbreaks of avian influenza were reported in Egypt with 20 human cases and 5 related deaths confirmed in 2007. Most human cases of A/H5N1 in Egypt had exposure to backyard poultry. Maternal and child health present continuing challenges. Maternal mortality and infant mortality rates remain high. Iron deficiency anaemia is prevalent and malnutrition is common in children under five particularly in rural Upper Egypt.


Noncommunicable diseases are on the rise. Neuro-psychiatric disorders and digestive system diseases are leading causes of morbidity accounting for 19.8% and 11.5% of the non-fatal burden respectively, followed by chronic respiratory diseases (6.9%), injuries (6.7%) and cardiovascular diseases (5.6%). Osteoarthritis, injuries and asthma are the leading causes of disability. The majority common cancers are breast, liver, bladder and lymph nodes.


Lifestyle-associated disorders are of growing importance. Smoking, substance abuse, lack of exercise, overconsumption of fatty and salty foods, non-use of car seatbelts and non-observance of traffic rules contribute to a significant proportion of the in general morbidity and mortality.


Environmental conditions are a major determinant of health. Air pollution in Egypt, particularly in Cairo, Cairo Metropolitan and Alexandria has been of concern for a number of years. Particulate matter is the majority common air pollutant in urban and industrial areas. Lead was completely phased out from petrol distributed in Cairo, Alexandria and most of the cities of Lower Egypt in late 1997, and as a result, lead concentration in the atmosphere of Cairo city centre and residential areas decreased markedly during the years 1997–2002 reaching less than 30% of those recorded during the early 1990s.


Economic challenges continue. Egypt's economy relies on tourism, remittances from Egyptians working abroad, revenues from the Suez Canal and oil. It has managed to improve its macroeconomic performance throughout most of the last decade in the areas of fiscal policy, monetary and structural reform. Recognizing the role of the private sector in development, the government has made job creation and creating an improved climate for investment and private sector development specific priorities. Agriculture accounts for 14% of GDP, industry 30% and services 56%. The major export is petroleum and petroleum products (28.7%). Poverty has declined over the completed few decades with the Millennium Development Goal Second Country Statement for Egypt suggesting that as a national average the MDG commitment to halve poverty by 2015 will be realized. A World Bank-supported Poverty Alleviation Study carried out in 2002 showed that poverty incidence fell from 19.4% in 1995–1996 to 16.7% in 1999–2000.

OPPORTUNITIES

• The existence of a wide primary health care network providing easily accessible health services (95% of the people is within 5 kilometers of a facility).
• An extensive infrastructure of physicians, clinics and hospitals.
Egypt as well has been able to provide the vast majority of the people with access to safe water and sanitation.

CHALLENGES

• The existence of a multitude of health care providers and financing mechanisms.
• Under funding and rising cost of care.
• Over-employment in the public sector with low remuneration and low motivation.
• People growth

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