Ageing and intergenerational family ties in Arab countries

This paper explores the dominant issues in intergenerational ties in Arab countries with a view to highlighting patterns, trends and challenges as well as policy implications. The data were drawn from a review of scholarly work and published literature in Arab countries and from a regional mapping of ageing policies and programmes in 2012. Social and health ageing policies in the region have been set with the premise that the family represents the core safety net for older Arabs. Yet demographic, sociocultural and economic transitions, as well as political conflict in the Arab world, are bringing profound changes to familial structures. This review feeds into efforts to promote health and social reforms that approach intergenerational solidarity from several fronts: providing equitable old-age income security, fostering cross-generational interactions, embracing caregivers and home-based care, promoting age-responsive actions in emergencies and conflicts, and prioritizing context- and country-specific research on the levels, types and trends in intergenerational and familial support

Aging in lebanon: perils and prospects

Lebanon is currently experiencing unique and dynamic demographic shifts towards an aging population: past and present fertility are among the lowest in the Arab region and crude mortality rates have decreased in the past few decades from 9.1 to 7.1 per thousand. Increased waves of emigration of youthful adults seeking better work opportunities elsewhere, as well as counter-waves of 'return migration' of older Lebanese workers from neighboring host countries contribute further to the 'rectangularization' of the population pyramid. These trends are accompanied by an epidemiolog-ical transition towards non-communicable diseases, mental disorders and degenerative diseases as the leading causes of mortality and morbidity in lieu of communicable diseases. We examine in this paper the implications of these transformations on the health profile of older persons and on the social and health care available to them. Findings are discussed within the prevailing conflicts and political strife in the country, family transformations and structural settings including pension systems, health coverage, family support channels and social fabric, and nursing home-care. The paper ends with recommendations and options for reforms

Demographics and the social reckoning in the Arab region

Demographic transitions in the Arab countries, due to declining birth rates and mortality rates since the 1980s, are reflected in a low proportion of children, a relatively stable proportion of elderly and a high proportion of people of working age. This [youth bulge] of young, active, working-age individuals in the current population may open a demographic window for countries to benefit from increased savings and investment This paper reviews the demographic situation in the Arab region and the impact of education, employment/ migration, health status and participation in society on the further development of the region, including the impact of these factors on ageing and gender issues. The intent is to draw attention to the importance of these demographic changes and highlight the need for action to maximize the potential benefit to the population in this region

Tuberculosis and migration: a review

In the past decade, the number of new cases of tuberculosis worldwide has barely declined and national tuberculosis control and elimination programmes in many high-income countries worldwide are increasingly challenged to address the problem of disease in foreign-born residents and migrant workers. Routine immigration medical screening, either before or after arrival in the recipient country, is designed to avoid the admission of migrants who pose a public health threat. Screening measures, however, have changed with time largely based on respect for individuals' rights. This paper reviews the measures that are being used by countries to screen immigrants and improve their health well-being, and presents cases studies from two Eastern Mediterranean Region countries

Delivery of health services in Arab countries: a review

This paper reviews the essential components of health care delivery systems in Arab countries and their development over the past 3 decades. The changes and challenges which evolved during the last half of the 20th century have had a significant impact on health systems and on health outcomes. An adequate network of hospitals and primary health care facilities has been established in most Arab countries of the Region. The increased participation of civil society has impacted positively on health systems. However, the main challenge is represented by the move towards market economies. In many developing economies, macroeconomic reforms have often necessitated cuts in public spending on social sectors. Cost-sharing policies have been implemented in order to compensate for diminishing government budgets allocated to health. However, this is not to minimize the enormous strides that have been made in all countries nor the important challenges that need to be addressed

Access and barriers to health care delivery in Arab countries: a review

This paper reviews some of the main obstacles encountered by the population [or rather by different social groups] in accessing health services in Arab countries. These obstacles can be social and cultural, administrative and organizational or financial and may impact on gender and ethnic groups to different degrees. Governments are urged to address the health inequalities that result from these obstacles and promote equity, solidarity and fairness through social policies that enhance social and national development

Health services to groups with special needs in the Arab world: a review

This paper examines the health services provided to the older population [especially those with physical limitations] and the people with mental illnesses in Arab countries and their evolution over the past 3 decades. The paper reviews utilization issues related to morbidity, transportation, patient-provider relationship, cost, stigma and organizational barriers that often impede access and compliance with the care provided or recommended. Health systems in the region need to acknowledge the specific needs of these patients in their national programmes. Raising awareness is an important step in this regard

Historical development of health systems in the Arab countries: a review

In the first of 5 papers about health systems and services in the Arab countries, the historical development of health systems over the past 3 decades is reviewed. The evolution of health care has been impressive with major strides accomplished by governments to improve the health status of their respective population. However, the progress has been uneven in view of the differentials in resources and opportunities. This development was made possible through the implementation of national social and economic development agendas. Most of the Arab countries adopted the declaration of Alma-Ata in 1978. The United Nations agencies and especially the World Health Organization have expanded support to all the Arab countries of the Eastern Mediterranean region. Key challenges to health systems remain. Member States are encouraged to address these challenges in concert with all concerned stakeholders. Efforts are needed to promote the centrality of health in comprehensive socioeconomic development

Historical development of health professions', education in the Arab world

This paper reviews the historical development of health professions'education in the Arab countries and highlights the role that the World Health Organization has played in the support of the health workforce. Challenges such as the migration of health professionals, the need for additional educational opportunities in public health and in the management of health services and the need to adapt education to address the needs of society are discussed. Efforts are needed to develop further the quality and relevance of education and to address the needs of the health systems and the welfare of communities. The production of research in cooperation with policy-makers to enhance decisions and policies based on evidence needs increased attention

Rebuilding of the Lebanese health care system: health sector reforms

The civil war in Lebanon from 1975 to 1992 had a significant negative impact on the public health care system. This paper describes the health care system in Lebanon and its financing as of 2001. The efforts that have been made and are being made to rehabilitate and reform this sector since the end of the war are outlined