Health Sector Reform Program in Egypt / 国際保健医療

ABSTRACT

<B>Introduction</B><BR>Health Sector Reform Program (HSRP) in Egypt started in 1997 to improve equity, efficiency, quality and sustainability of Egyptian health systems. This study aims to review reports and publications regarding HSRP in Egypt and to analyze its achievements and problems.<BR><B>Methods</B><BR>Documents of international organizations and other relevant agencies, such as reports of health sector reform programs and statistics, were reviewed and analyzed.<BR><B>Results</B><BR>HSRP aimed to improve quality of health services and equality of access, and to establish sustainable health financing mechanisms, while focusing on primary health care. Major components of HSRP were health service delivery, health financing, and evaluation. It started in five pilot governorates. Based on the Family Health Model (FHM), each family registered to a physician or a health facility, and was provided with essential medical services called Basic Benefits Package (BBP). Family Health Fund (FHF), the newly established financing agency of FHM, provided health staff with incentives from a pooled fund. Against the original plan, FHF could not function as a health insurance fund, and was financially unsustainable. Mechanisms of health facility accreditation and health services performance evaluation with incentives were installed to ensure the quality of health services.In addition, health staff training programs were enhanced, health facilities and equipment in rural areas were improved, and referral systems were strengthened.<BR><B>Conclusions</B><BR>HSRP introduced a family health model for the first time in Egypt in pilot governorates. Focusing basic health service provision, HSRP succeeded to improve equity, efficiency and quality of health services. However, sustainable health insurance mechanisms were not established yet, and involvement of private health service providers were very limited. It is needed to bring in commitment of Egyptian government across the sectors and to develop health systems that secure good quality of health services for all Egyptians.