Policy dialogue in Egypt
Estimation Year
1997
Actual Policy Use
At the dialogue stage, NHA results have been used to 1) identify problems; 2) serve as a catalyst for change by attaching data that convey the magnitude of a problem; and 3) act as an advocacy instrument to stimulate action.
The Egyptian Ministry of Health and Population and collaborating international agencies (World Bank, U.S. Agency for International Development, and European Commission used NHA findings along with non-financial data to initiate a policy dialogue that led to the design and ongoing implementation of a primary health care restructuring initiative.
NHA contributed to the promotion of this initiative when it showed that Egypt spent nearly 4 percent of its GDP on health care, with household out-of-pocket expenditures amounting to almost 50 percent of total expenditures and the Ministry of Health and Population accounting for less than 20 percent of total expenditures. While the overall sum spent on primary care should have been adequate to provide a set of basic services to all the population, most of the funding was not organized or allocated in efficient ways.In addition, the burden of household expenditures was very inequitably distributed, with the poor spending the largest share of income on health. This resulted in lower levels of access to care by the poor and those living in rural areas.
Such findings provided the Minister of Health and Population with the information needed to convince the People’s Assembly, the public, and those working in the ministry of the need to significantly restructure the way primary health care was organized and financed in Egypt. NHA also provided valuable information to the international donors to inform their discussions with the government. Consequently, the minister and the donors held a series of discussions in which they arrived at a mutually acceptable reform agenda as well as financing support.
Source
NHA findings from Rannan-Eliya, R., K.H. Nada, A.M. Kamal, and A.I. Ali. October 1997. Egypt National Health Accounts, 1994-95. Special Initiatives Report 3. Bethesda, MD: Partnerships for Health Reform, Abt Associates Inc.
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