Abstract
Universal health coverage (UHC) is the big objective in health policy which several countries are seeking to achieve. Egypt is no different and its endeavors to attain UHC have been going on since the 1960s. This article discusses the status of UHC in Egypt using theories of political science and economics by analyzing the historical transformations in the Egyptian health system and its institutional settings. This article then specifically examines the path dependence theory against the sociopolitical background of Egypt and assesses any pattern between the theory and the current UHC status in Egypt. The important finding of this analysis is that the health policies and reforms in Egypt have been significantly influenced and limited by its historical institutional structure and development. Both the health policies and the institutional settings adopted a dependent path that limited Egypt’s endeavors to achieve the universal coverage. This dependent path also yielded many of the present-day challenges as in the weaknesses of the healthcare financing system and the inability to extend health coverage to the poor and the informal sector. These challenges subsequently had a negative impact on the accessibility of the healthcare services.
Highlights
Universal health coverage (UHC), the big term in health policy, is the ultimate aim for several countries and intergovernmental organizations such as the World Health Organization
This article is structured in two main sections: “Section [1]: Path Dependence Theory” discusses the characteristics, framework, and application of path dependence theory and is followed by “Section [2]: The Sociopolitical Alterations and the Health Sector in Egypt,” which describes an analysis of the sociopolitical transformation and its reflection on the health sector and the status of UHC in Egypt
As shown in the previous sections, combining literature on the development of UHC in Egypt and on path dependence theory can provide a possible explanation of the current status of the health sector based on the sociopolitical background of Egypt
Summary
Universal health coverage (UHC), the big term in health policy, is the ultimate aim for several countries and intergovernmental organizations such as the World Health Organization. The orthodox simple explanation of the path-dependent processes is that “the social world often follows a particular trajectory: an open period during which there are a number of plausible alternatives, a critical juncture where contingent events result in one of these alternatives being selected, and feedback that constrains actors to keep to that particular path” [6] Another definition that emphasizes the surroundings of the action or decision is that path dependence “is a specific form of complex dynamics: It provides an analytical framework to explain and assess the ever-changing outcomes of the combination of and interaction amongst factors of continuity/ discontinuity, growth and development, hysteresis and creativity, routines and ‘free will’, which all characterize economic action in a dynamic perspective that is able to appreciate the role of historic time” [2, 4]. It is worth mentioning that information on the number of beneficiaries and the coverage percentage in 2017 is not available as shown in Figure 1; the significant increase in the population size in 2017 provides an idea about Egypt’s UHC challenge in the upcoming years
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