Health System in Egypt

Abstract

With over 95 million inhabitants, Egypt is the second most populous country in the Middle East and North Africa. Poverty has nearly doubled over the last 15 years. Egypt has a very young population, and youth unemployment has become a major societal issue.

Egypt’s health-care system is pluralistic combining both public and private providers and financers. The largest public health-care payers are the Health Insurance Organization (HIO) and the Curative Care Organization (CCO). HIO covers 60% of the population, and provides basic coverage to employees, students, and widows through their own hospitals and clinics. CCO contracts with individuals and companies to provide inpatient and outpatient care that was developed through the privatization of Egypt’s health-care providers over the last two decades. Although the public system provides basic universal coverage, it is plagued by chronic underfunding, low service quality, and high out-of-pocket payments.

The private sector comprises private hospitals, doctors, and pharmacies, perceived as of higher quality than public services. Most private services are paid for out-of-pocket; private health insurance is insignificant.

With only 4.75% of GDP spent on health, total health expenditure (THE) in Egypt is low compared to other lower-middle-income countries. Out-of-pocket payments comprise over 60% of THE. Spending on pharmaceuticals is relatively high with over 25% of THE, mostly in the form of out-of-pocket costs. Another problem is the lack of communication between public and private providers.

Widespread public dissatisfaction with basic living conditions spurred the Arab Spring revolution in 2011. Since then, the country has seen sustained political instability and slow economic growth which have thwarted most long-term plans for health reform. Several reform measures have been publicly discussed, but only few were implemented such as the introduction of a pharmacoeconomics unit in the Ministry of Health to curb the disproportionately high spending on pharmaceuticals.

A long-term national strategy is needed to address issues of growing inequalities in financial access to care, the perceived low quality of public services, as well as the growing privatization of health care which furthers the existing inequalities in access to care.