EGYPT | Summary

OVERVIEW


GDP: 303.092 Billion USD1
Health Expenditure (% of GDP): 4.95%2
 
  • Population: 102,334,404 Million
  • Housing: 43.1% Urban, 56.9% Rural

HISTORY 


In modern Egypt, many of the health efforts started in the 1950s. The National Committee for Population Matters was established to review issues of the population in 1953. This was the beginning of humanitarian aid with successful policies in 1973, 1980, and 1986 to improve the welfare and health of Egyptians. The committee has also provided access for international donors to provide funds. The Ministry of Health and Population was eventually established in 1995 to manage the welfare and health of the population. 
 
In recent decades, Egypt has intended to increase healthcare access but runs into many barriers. The nation has implemented health policy throughout the years and provides support through the private sector to provide more services. The Egyptian Health insurance was created in 1964 and increased coverage for many populations. This was extended to students in 1993 with the Student Health Insurance Program (SHIP), introducing 15 million new beneficiaries. The Curative Care Organization was also established in 1964 as a nonprofit system run under the Ministry of Health and Population. Each CCO runs independently with the surplus revenue invested in service improvement. 
 
In 1974, President Sadat initiated an Open Door Economic Policy (ODEP) calling for a revitalization of the private sector and has affected social policies in the country. This started a reversal to the social transformation started by President Nasser in 1952. The Open Door Policy shifted the economy to more of capitalism which grew the private health sector. Between 1975 and 1990, the total number of private beds rose significantly and private health facilities continue to expand today.   
 
In 2011, the Arab Spring revolution began, which brought about pro-democracy protests in many arab countries, including Egypt. The purpose was to increase democracy and cultural freedom. The political and social impacts are still felt today and have influenced policies and the economy. In Egypt, widespread public dissatisfaction with basic living conditions spurred the Arab Spring. As a result, Egypt has experienced political instability and slow economic growth affecting health reform. Many reform initiatives have been discussed but only few have been implemented such as the pharmacoeconomic unit in the Ministry of Health to improve the disproportionately high spending on pharmaceuticals.5,11  
 
Egypt adopted a new constitution in 2014, which strongly addresses health as a fundamental human right and is committed to expanding coverage and access to quality services for all Egyptians. The progress towards universal health coverage is motivated by the recent approval of the Social Health Insurance. Although it’s in its early stages, the law will ensure adequate and sustainable funding for health and intends to reduce out-of-pocket expenditures.10

HEALTH & HEALTH SYSTEM


The health system in Egypt is governed by the Ministry of Health and Population with five sectors of administration including: central administration for the minister’s office, curative health services, population and family planning, preventative health services, and administration and finance. The Ministry is also divided into the public and private sector. The public sector comprises the government and parastatal organizations. Parastatal refers to quasi-governmental organizations such as the Health Insurance Organization (HIO) and the Curative Care Organization (CCO).1 The HIO was originally created as an umbrella organization to provide all Egyptians with health coverage and care. The four broad classes of beneficiaries under HIO are all employees working in the government sector, some public and private sector employees, pensioners, and widows.7 However, HIO only covers 60% of the population and provides basic coverage through their own hospitals and clinics. The public health system faces many challenges such as underfunding, low quality care, lack of medical equipment, and qualified personnel.5 Government investment in the public system is also low with only 1.5% of total GDP for public health expenditures.6 Total health expenditures for all sectors totaled 4.75% of national GDP.5 Public healthcare financing consists of 72% from employee tax, 25% from the Ministry of Finance, 2% from the private sector, and 1% from external sources.7   
 
Due to low standards of care in public facilities, many Egyptians seek care in private facilities if they are able to afford it. The health system is becoming more privatized and is receiving support from the government to increase privatization. Egyptian citizens are able to obtain insurance coverage through private insurers with government support. The CCO contracts with individuals and companies to provide private inpatient and outpatient care as well. Private healthcare facilities consist of nonprofit organizations and for-profit hospitals and clinics. With higher quality care, the private sector is currently dominating the portion of health services provided in Egypt.1 Many mosques also provide medical services and in some instances better care is offered at these sites than public services as well.5 Unfortunately, people still have to pay large out-of-pocket expenses for care. It was last reported that 60% of health spending came from out-of-pocket spending for all types of care.4 
 
The Egyptian Government has been emphasizing on providing Universal Health Coverage through the Universal Health Insurance Law in 2018. It intends to restructure the system by providing coverage to all and making health services affordable for citizens. There has also been national focus on public health interventions to improve all health indicators. These initiatives have received international recognition and Egypt continues to receive humanitarian aid from many entities around the world that strengthen public health.9 However, there are still key challenges in Egypt that affect the health sector. Equity and Social injustice are the major challenges that drive the illness-poverty cycle. Investing in the socio-economic future of Egypt is crucial to the well being and health of the nation.10 

HEALTH INDICATORS & DEMOGRAPHICS


Egypt has experienced significant improvements in their health indicators since 1960. Humanitarian aid and public health interventions have resulted in these favorable health outcomes. In 1960, the total fertility rate was at 6.72 per woman, child mortality was 315 per 1,000 live births, and infant mortality was 210 per 1,000 live births. Now the rates are at 3.3, 16.9, and 13.2, respectively. In 1980, the maternal mortality rate was 352 and life expectancy was 58. Now, the rate is 37 and life expectancy is 71.1.16 
 
With over 100 million people, Egypt is the 2nd most populated country in the Middle East and North Africa. It does face overcrowding in urban areas because approximately 95% of the population lives on 4% of the land along the Nile river delta. It has led to pollution and traffic while placing a strain on resources, such as clean drinking water.4 The majority of the population is young but they do struggle with high unemployment rates. Poverty has also doubled over the last 15 years. International organizations and the United States continue to invest in Egypt and they are a path to further improve the health of Egyptians.   
 
  • Fertility Rate: 3.3 live births per woman  
  • Life Expectancy (Female, Male): 75, 70 
  • Infant Mortality Rate: 13.2 deaths per 1,000 live births  
  • Child Mortality Rate: 16.9 per 1,000 live births
  • Maternal Mortality Rate: 37 deaths per 100,000 live births
  • Egyptian Arab: 95% 
  • Other: 5%  
  • 0-14 years: 33.62% (male 18,112,550/female 16,889,155)
  • 15-24 years: 18.01% (male 9,684,437/female 9,071,163)
  • 25-54 years: 37.85% (male 20,032,310/female 19,376,847)
  • 55-64 years: 6.08% (male 3,160,438/female 3,172,544)
  • 65 years and over: 4.44% (male 2,213,539/female 2,411,457) (2020 est.)

References

  1. Egypt, Arab Rep. . Data. https://data.worldbank.org/country/egypt-arab-rep?view=chart.
  2. Current health expenditure (% of GDP). Data. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS
  3. Egypt Demographics. Worldometer. https://www.worldometers.info/demographics/egypt-demographics/
  4. Thelwell, K. (2020, August 17). 7 Facts about Healthcare in Egypt. https://borgenproject.org/healthcare-in-egypt/  
  5. Gericke, C., Britain, K., Elmahdawy, M., & Elsisi, G. (2018, May 16). Health System in Egypt. https://link.springer.com/referenceworkentry/10.1007/978-1-4614-6419-8_7-1
  6. Guide to Healthcare in Egypt: Allianz Care. (n.d.). https://www.allianzcare.com/en/support/health-and-wellness/national-heal...
  7. Jurjus, A. (2015). The Health System in Egypt: An Overview. https://www.syndicateofhospitals.org.lb/Content/uploads/SyndicateMagazin...
  8. Just Landed, S. (2014, May 24). Introduction to Health in Egypt. https://www.justlanded.com/english/Egypt/Egypt-Guide/Health/Introduction 
  9. User, S. (2021, January 05). Egypt's Health Care System. https://www.cghd.org/index.php/global-health-partnerships-and-solutions/profiles/43-egypts-health-care-system 
  10. World Health Organization. (2018, May). Country Cooperation Strategy at a Glance. https://apps.who.int/iris/bitstream/handle/10665/137164/ccsbrief_egy_en.pdf;jsessionid=241E95F079C608B743E6A66EE332A3F4?sequence=1 
  11. History.com Editors. (2018, January 10). Arab Spring. https://www.history.com/topics/middle-east/arab-spring 
  12. World Bank Country and Lending Groups. (n.d.). https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups 
  13. Egypt Population (LIVE). (n.d.). https://www.worldometers.info/world-population/egypt-population/  
  14. Egypt Demographics. (n.d.). https://www.worldometers.info/demographics/egypt-demographics/  
  15. Egypt’s Universal Healthcare Act. (2017, December 12). https://enterprise.press/wp-content/uploads/2017/12/Egypts-Universal-Healthcare-Act-A-Primer.pdf 
  16. Gapminder Tools. (n.d.). https://www.gapminder.org/tools/ 
  17. Kinuthia, S. (2018, July 20). Major Ethnic Groups in Egypt.  https://www.worldatlas.com/articles/what-is-the-ethnic-composition-of-egypt.html  
  18. Egypt Age structure. Egypt Age structure - Demographics. http://www.indexmundi.com/egypt/age_structure.html. 

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