The successes and the challenges of Egyptian Health Sector Reform Program

Abstract

Objective The aim of this study was to evaluate the effectiveness and the efficiency of the Egyptian Health Sector Reform Program in achieving universal coverage for all citizens with high-quality basic health services. Background The Government of Egypt launched the Health Sector Reform Program in 1997. The program introduces the family health model as the principle for reform, and aims to insure universal coverage of all citizens with a basic package of health services. Participants and methods A simple random sample of 10 family health units was selected from the total 220 units in Menoufia Governorate. Each selected unit was subjected to data collection and analysis of infrastructure, resources management, quality indicators, referral system, coverage, and utilization, and questionnaire was administered for a sample of patients and providers to measure their satisfaction. Results Coverage with family health fund was 83% for insured, 86% for uninsured, and 77% for exempted. Active enrollment was 44% for insured, 60% for uninsured, and 14% for exempted. The average utilization visit of the population was 1.1 visits per year. The percentage of different curative utilization visits as regards total curative visits was 47% for insured, 49% for uninsured, and 4% for exempted. There was low utilization of medical instruments. The overall patient satisfaction was 66%, and only 11% of providers were satisfied with their salaries. The final evaluation of all aspects of quality indicators according to the Egyptian Accreditation Program was 55%. The average total cost per visit was 33 LE, and the average revenue per visit was 6 LE. Conclusion Our study results show that the rate of active enrollment was low. There is underutilization among coverage people and low-quality indicators. Thus, there is a need for regular monitoring and evaluation to improve these indicators and increase customer satisfaction.