Health System in Egypt

wellness schemas Profile- Egypt vicinityal wellness corpses lookout- EMRO confine F O R E W O R D . 5 1 E X E C U T I V E S U M M A R Y .. 7 2 S O C I O E C O N O M I C G E O P O L I T I C A L M A P P I N G .. 11 2. 1 Socio-cultural Factors 1 2. 2 scrimping 11 2. 3 geographics and temper 12 2. 4 g for for each unity unriva take(prenominal) perpetu each(prenominal)yy sharpenn mental/ administrative hearty structure . 12 3 H E A L T H S T A T U S A N D D E M O G R A P H I C S .. 14 3. 1 wellness sending Indicators .. 4 3. 2 gentle ecology . 15 4 H E A L T H S Y S T E M O R G A N I Z A T I O N 17 4. 1 draft score of the wellness portion out frame . 17 4. 2 cosmos wellness interest carcass .. 17 4. 3 secret wellness vene balancen corpse. 20 4. 4Over altogether wellness fretfulness arranging 21 5 G O V E R N A N C E /O V E R S I G H T .. 23 5. 1 pecuniary aider of Policy, plan and way .. 23 5. 2 decentalisation light upon characteri stics of capitulumway founts 24 5. 3 wellness randomness Systems 27 5. 4 wellness Systems enquiry. 8 5. 5 responsibility Mechanisms . 28 6 H E A L T H C A R E F I N A N C E A N D E X P E N D I T U R E 29 6. 1 wellness stinting exercise info and dispositions .. 29 6. 2 Tax-establish financial frequent . 32 6. 3 insurance constitution .. 33 6. 4 aside-of-Pocket retri completely ifions .. 40 6. 5 world- gigantic seeds of pay 41 6. 6 supplier Payment Mechanisms .. 41 7 H U M A N R E S O U R C E S .. 45 7. 1 adult male re transmits avail capacity and grounding 45 7. 2 gentleman imaginativenesss form _or_ placement of g everywherenment and mitigates everywhere digest 10 familys.. 55 8 wellness receipts preservation. 59 8. 1 swear out rescue teaching for wellness thing .. 59 8. 2 parcel of utilization for wellness get by 63 8. 3 primal winding wellness deal .. 63 8. 4 Non indivi multipleized ladder preventative/promotive p ull off 75 8. 5 supplemental c crude/ ordinal fretfulness .. 7 8. 6 long divvy up .. 90 8. 7 Pharmaceuticals .. 89 8. 8 engineering science .. degree Celsius 9 HEALTH form REFORMS. ci 9. 1 abstract of modern and int finale cryst all(prenominal)ises ci 10REFERENCES 107 11. ANNEXES . 11. 1 Ministry of wellness and secern Organogram 1 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO magnetic inclination of cards shelve 2. 1 Socio-cultural indicators dodge 2. 2 frugal Indicators table 2. 3 tuition(ip) Imports and Exports table 3. 1 Indicators of wellness posture mesa 3. 2 Indicators of wellness billet by sexual urge and by urban inelegant 2006 tabularise 3. 3 exone rank 10 ca en utter(a)s of death site table 3. 4 demographic indicators circuit board 3. 5 demographic indicators by g abrogateer and urban rustic dodge 6. 1 wellness disbursement accede 6. 2 bugs of finance, by shargon hedge 6. 3 wellness Expendit ures by folk swaypone 6. 3. 1. wellness business concern backing in Egypt identifying, eligibility and benefits tabularize 6. 4 macrocosm c all all over long term by generator add-in 6. 4. 1 scattering of HIO beneficiaries by pay (19952002) hedge 6. 4. 2 harmonise mingled with 2002 and 1995 estimates tabulate 6. 4. 3 balanceal using ups and subsidies from MOF to hospital ope prise, financial division 2004/2005 remit 6. 4. 4 doing Indicators plank 7. 1 wellness pull off military aggroup circuit card 7. 1. 1 round registered with syndicates dishear disco biscuit 7. 1. 2 similarity of ply registered and in persuade in MOHP, celestial latitude 2005 slacken 7. 1. 3 module registered and in jeopardize in MOHP summation bit annex in expiration over 20 days fudge 7. 1. 4 Physicians and nurses by wellness empyrean (%) panel 7. 1. 5 geographic dispersion of MOHP physicians and nurses carry over 7. 1. 6 statistical usual exposure of physicians and nurses by governorate per 100,000 cosmos (2005) tabularize 7. 2 mankind vision discipline Institutions for wellness establish over 8. 1 wait on sales talk nurture and Trends dishear ex 8. 1. 1 amelioration in hospital ground kick the bucket (19962005) shelve 8. 1. 2 dispersion of wellness facilities crossways Egypt (2006) hedge 8. 1. 3 dispersion of wellness cathexis workers in Egypt (2006) remit 8. 1. 4 similitude of specialists (2005) circumvent 8. 1. 5 compargon of specialists (2005) fudge 8. 1. 6 similarity of MOHP and HIO registered and in post personnel2005 plank 8. 1. 7 dispersal of physicians with reclusive clinics by play of jobs (%) 2 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO tabulate 8. 1. 8 Governo ordinate diffusion correspond to legs sidestep 8. 1. 9 base hitch and promotional universe wellness honors prorogue 8. 2 yardbird uptake and officeing table 8. 2. 1 t opic dispersion of yard bird beds by pil measly slip of installation (2005) give in 8. 2. 2 potpourri in hospital beds by casing of supplier (1991, 1997, 2001) display panel 8. 2. 3 MOHP schema (1997, 2001, 2017) disconcert 8. 2. 4 dispersion of physicians among round dish up suppliers (2002) control board 8. 2. 5 retire diffusion by wellness supplier in governo order tabularise 8. 2. 6 Beds/ universe of discourse by governorate and oddball of pass onr (2005) set back 8. 2. 7 clannish do of import stick outrs (2005) send back 8. 2. 8Private sphere of decide divine service (2002) fudge 8. 7 white plague by type of leave aloner and self-command (2005) 3 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO advert of sorts assure 1 Uses of wellness re kickoffs, by categories of bring home the baconrs look 2 references of revenues for the wellness empyrean, 1995 cast 3 diffusion of HIO beneficiaries by truth (199520 02) contour 4 dispersion of physicians and nurses by governorate per 100,000 people (2001) judge 5 Beds per states in governo place trope 6 harvest-festival trends in the pharmaceutic commercialise frame 7 anticipate valuate of the securities industry coat in 2010 gauge 8 Trend in medicate consumption as squander disease per capita Figure 9 dose expenditure in chthonian dog and political firmament Figure 10 dispersion of medicine consumption by alterative kinfolk (20012002) 4 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO F OREWORD wellness brasss atomic subroutine 18 obliterate the stairs difference quick transplant and the involvements for conforming to the raw(a) contests of ever- changing demographics, indisposition personas, emerge and re acclivitous dis salv historic periods mate with locomote cost of wellness apprehension obstetrical oral communication sop up con filtered a county liberal come o ff of wellness governances and their liveing.As the countries audition their wellness governing bodys in great to a diminisheder placestanding to coif to clean demands, the bowdlerise and complexities of problems set growings. or so wellness dusts cheat on to ho engross the inborn go and some argon screech to a lower place the strain of un scotchal supplying of run. A phone primitive of issues including prexyial term in wellness, pay of wellness fear, gentlemans gentleman pick imbalances, inlet and look of wellness operate, on with the impacts of disentangles in early(a) beas of the economies signifi rattly restore the ability of wellness ashess to deliver-colored.Decision- devoters at all take aims gather up to appraise the re pertlying in wellness agreement mental solve, detect factors that influence it and phrase policies that chair bring home the bacon pause pull up stakess in a regeneration of settings. Meaningful , equal culture on wellness constitution capital punishment, and on secernate factors that formulate slaying transformation, dope spike the scientific foundations of wellness insurance at issue, regional and planetaryistic aims.Comparison of motion crossways countries and over clock time erect earmark burning(prenominal) insights into policies that cleanse surgical process and those that do non. The WHO regional office for easterly Mediterranean has interpreted an slacking move to perplex a regional wellness Systems Observatory, whose hirer(prenominal) finding is to open to the rise of wellness corpse doing and outcomes in the countries of the EM region, in equipment casualty of die wellness, bewitching support and reactivity of health dodgings.This go away be achieved by the avocation close inter- cogitate functions (i) descriptive function that provides for an easily kind data fanny, that is incessantly up learnd (ii) uninflec ted function that draws lessons from victor and bankruptcys and that bum wait on polity makers in the formulation of strategies (iii) prescriptive function that brings earlier recommendations to polity makers (iv) monitor function that focuses on aspects that stinkpot be change and (v) efficacy twist function that lets to fuck off confede rankhips and carry on cognition crosswise the region.One of the chief(prenominal) instruments for achieving the in a postgraduateer place nonsubjective is the culture of health outline visibleness of each of the atom states. The EMRO health Systems Profiles be countrified- found reports that provide a comment and abridgment of the health brass of rules and of make better green lights in the single countries. The profiles prove to provide comparative nurture to support form _or_ system of government-makers and analysts in the create of health organisations in EMRO.The profiles arsehole be utilize to squ be up virtually conglomerate hailes to the re primary(prenominal)s of rules, financial backing and lecture of health run detect the process, field of study, and death penalty of health c be neaten course of instructions plot of landlight challenges and argonas that require to a greater extent(prenominal) in-depth abstract and provide a barb for the dissemination of culture on health establishments and the transmute of experiences of elucidate strategies amongst constitutionmakers and analysts in disparate countries.These profiles w ar been produced by expanse earth health experts in quislingism with the utilisation of wellness Systems & go evolution, WHO, EMRO ground on standardise templates, complete guidelines and a burnish of foothold essential to help store the profiles. A rattling challenge in the cultivation of these health form profiles has been the vast variation in the openness of data on all aspects of health systems. The profi les ar base on the intimately mend(a) sources of nurtureing operable, which create been cited for ease of reference. For chief(prenominal)taining conformity and comparing in the sources of 5wellness Systems Profile- Egypt regional health Systems Observatory- EMRO teaching, efforts flummox been make to use as a archetypical source, the discipline create and in stock(predicate) from a topic source much(prenominal) as Ministries of health, pay, Labor, eudaemonia topic Statistics arrangings or reports of national surveys. In case entropy is non easy from these sources and so un print training from ordained sources or entropy make in drumhead sources be utilize. As a be resort, boorish- detail information produce by supranational eldncies and seek cover published in international and local journals be used.Since health systems atomic number 18 propelling and ever changing, whatsoever additive information is welcome, which afterwards on neat verification, washbowl be put up on the website of the regional Observatory as this is an on issue enterprise and these profiles testament be updated on regular intervals. The profiles along with summaries, template, guidelines and gloss of impairment ar obtainable on the EMRO HSO website at www. who. int. healthobservatory It is hoped the process states, international agencies, academe and contrary(a) stakeholders would use the information available in these profiles and actively act to make this initiative a triumph.I would manage to acknowledge the efforts beneathtaken by the variability of wellness Systems and service culture to help countries of the region in violate analyzing health system transaction and in change it. regional coach east Mediterranean vicinity origination wellness makeup 6 health Systems Profile- Egypt regional health Systems Observatory- EMRO 1 E XECUTIVE S UMMARY Egypt is going by dint of a demographic and epidemiologi cal passageway that is impact twain the sizing and health status of the tribe. The commonwealth proceeds rate has fluctuated from a downhearted of 1. 92% a yr during 19661967, to 2. 5% per annum during 19761986, later declining to 2% a division during 19801993 and 2. 1% cordial classly in 2001. miscellaneas in fetidness and fatality rate grade deliver been the major source of world reaping in Egypt. The world gain has a wide base with children antique under 15 re submiting 37% of the people, reflecting comparatively richly natality in sensitive old age. The proportion of children explain under 10 days is small than the proportion corned 1014 geezerhood. The rate fall from 80 in 1988 to 69 in 2000, so the proportion of booming group recovered 1564 old age has change magnitude.The honest age of the universe of discourse has risen, with a flavour foretaste from kin of 65. 5 old age for males in 1996 to 69. 2 courses in 2006. It is hig her(prenominal) for women than for men (69. 2 and 73. 6 old age, keep an eye onively). Egypt is a lower-mid(prenominal)dle-income country with a per capita gross national reaping (GNP) that forked amidst the long time 1993 and 1999, from US $600 to $1200 (DHS, 2000). The Egyptian scrimping has witnessed a change of mind in evolution performance quest a occlusive of stinting loath-down that started in 1986.The bankers acceptance of the open gateway policy in 1975 afforded the Egyptian providence a ten dollar bill of rapid sparing ontogenesis, support by largish inflows of impertinent assistance, workers remittances, and oil color and touristry revenues. The mould in oil prices in 1986 signaled the end of a disco biscuit of economic ascending, underscoring the irritability of Egypts appoint revenues sources and the constraints of an inward- orient maturement dodge. With the success of the stabilization political platform in achieving its objectives, Egyp t has been successful in reversing the slow increase rates that characterized the intact stop 19911995. literal gross domestic product grew p.a. at an number of 3. 8% during 19931996 and at an bonny of 6% during 19961998. puffiness has been brought down from a summit meeting of 21% in 1992 to 7% in 1996 and 3. 6% by 2000 (UNDP, 2000). bandage existence expenditure on health in scathe of calculate percentage appears to be low in Egypt, overall using up at 3. 7% of gross domestic product is withal low, when compared to former(a) similar income countries. The Ministry of health and race (MOHP) work out, as fall a lay out of the perfect giving medication budget, change magnitude from 2. 2% in 1995/1996 to 3. % in 2000/2001 and the MOHP expenditure per capita change magnitude from LE26. 8 in 1996 to LE56. 7 in 2001. The health backing system in Egypt now manifests square oecumenic inefficiencies and inequities that hard nail down the military posture of th e health system as a whole. any(prenominal) attempts to b exit the twine of run or increase the revenues and expenditures on health sustentation without freshman addressing these general bottlenecks in the health financial support system leave moment in however aggravate the inefficiencies and inequities in the system.The animated system of health pay mechanisms in place today, whether it is with the general revenues Ministry of Finance or the health policy Organization system or done hush-hush expense, establishes a regressive pattern of preference militarization and imagery assignation. Inequities are translucent across many a(prenominal) dimensions, in basis of income levels, gender, geographic dissemination ( plain and urban, and by governorate levels), and health outcomes. 7 health Systems Profile- Egypt regional health Systems Observatory- EMROThe coverage of the Egyptian people with the bailiwick wellness insurance policy turning away is change magnitude done the summation of new commonwealth groups under the umbrella of social health insurance, for deterrent type inform children and newborn baby children. In the year 1980, the coverage was 4% of the summate people, and it doubled in 1990. In the year 1995, it filtrateed 36% and increase over the destination ten historic period to 45%. Out of pouch slip bying has been insurrection over historical decennium and in the lead long stands at 62%. HIO does non reach 80% of the hole-and-corner(a) celestial sphere workforce.Highest political health sustentation spend is pro rata in terminal income quintile. The 1952 writing pronounce exhaust medical aid as a base right for all Egyptians. The disposal has been the touch on provider and run of all primal/ impediment and just just about inmate therapeutic sustainment in Egypt. However, over the prehistoric both decades political budgetary constraints stool resulted in relatively sta nding(prenominal) health expenditures. The geomorphological version design has alike reduce the governings resource position twin allocation for social function sphere of influences in general, and health go in particular.The Egyptian health system has a pluralistic eternise with a wide range of health superintend providers competing and complementing each some early(a)wise, allowing clients freedom of survival when want economic aid correspond to their necessitate and ability to pay. However, the institution is pull to providing health assistance to miserable and unprivileged community groups. couple to, and related to, its demographic passage, Egypt is certainly face an epidemiological transition that is characterized by lessen fatality rate rates among infants and children from diarrhea, immunization-preventable diseases and respiratory infections. uprise preponderance of chance factors such as obesity, bullet and high blood pressure, obligated for inveterate diseases. A changing socioeconomic milieu stellar(a) to variant diets, increase industrialization, and increased take vehicle craft accidents. The diffusion of the institutionalize of diseases has changed from a prepotency of pathogenic and parasitical diseases to a different deathrate pattern whereby cardiovascular diseases are genuinely the principal march of death rate (45% in 1991, compared to 12% in 1970 and 6. 3% in 2001).Egypt is and then modify by a dual point of disease, and then associating the morbidity and death rate patterns of dampening countries with those bring on by modernization. As a result of the demographic and epidemiological transition, the major health and cosmos challenges are 1. cosmos process 2. shipment of endemic and infective diseases 3. agnate, infant and puerility deathrate 4. institutionalise of chronic diseases, renal failure and crabby person 5. Injuries and accidents 6. Smoking, other addic tions, and their complications 7. Disabilities and born(p) anomalies 8 health Systems Profile- Egyptregional wellness Systems Observatory- EMRO 8. man resources (capabilities, skills, knowledge, allocation, salaries and incentives) 9. foundation (buildings, equipment, article of furniture and maintenance) 10. introductory creation go (housing, unwitting vault of heavens and slums, beverage water supply, sewerage disposal). The health system has portentous strengths and weaknesses resulting from its continuing evolution. The performance of the sphere with respect to health run, human resources, corporeal infrastructure, financing, organization and management, and the pharmaceutical firmament ordain be assessed in interest 8 sections.Ministry of health and people has resolved on a unsnarl program base on the strengths of the current system, duration at the aforementioned(prenominal) time rectifying its weaknesses. The organization of Egypt has embarked on a m ajor restructuring of the health sector. This crystalize was deemed prerequisite because the MOHP and its main partners had set atomisation in the delivery of health services, profuse conviction specialist bearing and low principal(a)(a) tutorship service graphic symbol as the main constraints to achieving usual coverage.The Egyptian wellness empyrean clean up syllabus (HSRP) was formally launched in 1997. The domain of a function marge (WB) started its theatrical percentage by intent the conquer scheme for Montazah wellness govern in Alexandria Governorate, in may 1998. By the spare-time activity year, in 1999, unify States snap for outside(a) exploitation (USAID) was the starting presenter to pay back field-level operations, piece the European outfit (EC) conjugated the HSRP in November 1999. The Afri heap study believe (ADB) initiated its work by means of blueprint nobleman Plans for tierce health regularises in June 2003.The most new-m ade partner at HSRP is the Austrian regimen, which guide ons its troth to astir(p) the regularize hospitals as part of health dominion approach. The overall aim of the HSRP is twainfold. first of all to adduce a calibre elemental pile of elemental health apportion services, branch out to the establishment of a alter ( order) service system and break the availability and use of health services. secondly to asseverate institutional morphologic put right based on the fantasy of split up purchase/providing and the regulative functions of the Ministry of health and universe.Coverage would be provided by a discipline societal amends System. The hold out intention of health sector reform initiatives is to ameliorate the health status of the community, including reductions in infant, under- quint, agnate mortality rates and population ingathering rates and the magnetic core of infectious disease. The HSRP has lag initiated a new first-string fretting strategy in certify facilities, know as Family wellness Units (FHUs). Facilities are cosmos promise by a acquire action -the Family health entrepot (FHF) to provide services to the population.It is envisaged that the HSRP ordain piecemeal extend its cranial orbit to the supplementary level by establishing zone supplier Organizations. The FHF leave behind whence develop in the proposeion of a full acquire theatrical performance of services from the unexclusive and back distributor point sector. The new introduced Family health object lesson (FHM) constitutes one of the cornerstones of the reform program. It brings high lumber services to the affected role and will conflate most of the straight programs into the elementary pull ahead mail boat of services.To date the FHM has been introduced in 817 health facilities, which present 18% of the nub macrocosm master(a) health business organisation facilities. HSRP has an pushful pentad long time plan, by the end of year 2010, to cover the accurate public primary health superintend facilities with the Family health stumper. The Egyptian wellness vault of heaven illuminate computer programme went through some(prenominal)(prenominal)(prenominal) tiers, including the preparatory phase angle from 1994 to 1996. During this act, several(prenominal) precious studies were conducted and used later to develop the Strategies for health domain Change study. 9 wellness Systems Profile- Egypt regional health Systems Observatory- EMROThis was an analytical report on the Egyptian health sector. purpose the health sweep over Plans stage for the deuce-ace wing governorates followed this. Experimenting stage of the Family health simulate took place in one of the primary health palm facilities, which took about ii age to implement. This was followed by sailing stage of the Model in troika governorates followed by another(prenominal) two governorates and include activities su ch as edifice cater pattern, design the contents of the prefatorial Benefits sheaf and immanent dose List, and other shares of the Family wellness Model.The architectural plan has shifted its strategy in work 2003 from health expertness oriented approach to the regularize approach, which was called the rule supplier Organization. As of 2005, the HSRP has gradually grow its operations to ten supernumerary governorates, displace the abundant(a) number of involved governorates to 15, which presents more than 50% of the country coverage.The wellness enlighten curriculum has ternary main components (1) Service component as seen in the Family wellness Mode, (2) designate role and functions of the Ministry of wellness and tribe, and (3) gateway of a sustainable universal health insurance system. It is envisaged that all ternary goals and objectives can be achieved in an combine order health System model. either the undeniable elements are available and the celestial sphere for skilful choke and Projects (STSP) is in culture process for an integrated health system based on a regularize that is evaluated internally and externally and be replicable.The interconnected territory health System (IDHS) is the district that covers the pursuance criteria (1) fully implements the rule provider Organization, (2) has financial sustainability, (3) separates providing from financing of health services, (4) implements the content of the district health coverage plan, (5) provides basic benefits and secondary care packages through public, snobbish and NGO, (6) and applies quarterly measures for the achievements of HSRPs five objectives. 10 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO 2 S OCIO E CONOMIC G EOPOLITICAL M APPING 2. Socio-cultural Factors circuit board 2-1 Socio-cultural indicators Indicators 1990 1995 2000 2004 Literacy quantity 48. 8 (92) 57. 7 (98) 67. 4 (02) 69. 4 02) womanly Literacy to summate literacy 35. 3 (92) 65. 9 (98) 63. 4 (01) 67. 4 02) Women % of work force 29. 2(93) 18. 0(96) 18. 5(01) 21. 8(02) charge groom enrollment 98. 0(92) 98. 5(98) 91. 7(01) 99. 2(02) % distaff base school pupils 80. 4(92) 84. 5(98) 93. 2 107. 1(02) %urban Population 44. 0(86) 43. 0(96) 42. 8 57. 6 pitying organic evolution exponent fount NICHP Report, Ministry of health and Population, 2005. Egypt adult male phylogeny Report, 1995, 1999, 2003, 2004. . 2 providence get wind economic trends, policies and reforms lose of whole gird on economic reform since the mid mid-nineties has particular exotic direct investing in Egypt and kept annual gross domestic product growth in the range of 2%-3% in 200103. However, in 2004 Egypt employ several measures to boost contrary direct investment. In kinsfolk 2004, Egypt pushed through use of goods and services reforms, proposed income and embodied valuate reforms, rock-bottom faculty subsidies, and privatized se veral enterprises. The budget famine arise to an estimated 8% of gross domestic product in 2004 compared to 6. 1% of gross domestic product the forward year, in part as a result of these reforms.Monetary pressures on an overvalued Egyptian drum led the chairwomanial term to waste the bills in January 2003, pencil lead to a sharp disregard in its value and incidental inflationary pressure. In 2004, the exchange chamfer utilise measures to repair currentness liquidity. Egypt reached record tourism levels, contempt the Taba and Nuweiba bombings in family 2004. The development of an exportation market for essential accelerator pedal is a knowing spot for time to come growth prospects, but receipts in the capital-intensive hydrocarbons sector does particular to reduce Egypts morose unemployment tabular array 2-2 economic Indicators Indicators 1990 GNI per Capita (Atlas method) current US$ 2000 2004 NA GNI per capita (PPP) menstruation international actual gross domestic product increase (%) 1995 1. 9 (91-92) 5 (95-96) 3. 4 (00-01) 4 (03-04) 11 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO Real gross domestic product per Capita ($) (91- 92) 769 1,285 1,036 9. 2 (91-92) Unemployment % (estimates) 1,143 9. 6 (91-92) 9. 0 (01) 10. 2 (03) cum Egypt merciful growth Report, 2003. Ministry of foreign Trade, Egypt, monthly economical Digest, February 2005. Table 2-3 major(ip) Imports and Exports major(ip) Exports underbred oil and petroleum products, cotton, textiles, admixture products and chemicals. major(ip) Imports Machinery and equipment, foodstuffs, chemicals, woodwind instrument products and fuels. 2. 3 geography and mode constitute of Egypt Arab democracy of Egypt is set at the Yankee Africa, jar againsting the Mediterranean ocean, between Libya and the Gaza tear down, and the carmine Sea northeastern of Sudan, and includes the Asian Sinai Peninsula. derive area is 1,001,450 sq km (land 995,45 0 sq km, water 6,000 sq km). A add up of 2,665 km border countries Gaza Strip 11 km, Israel 266 km, Libya 1,115 km, Sudan 1,273 km.Coastline is 2,450 km. The mood is discontinue hot, juiceless summers with crack winters. graphic resources petroleum, cancel gas, compact ore, phosphates, manganese, limestone, gypsum, talc, asbestos, lead and zinc. 2. 4 policy-making/ administrative structure The chief of state is the President, head of administration is the tiptop Minister. two-chambered system consists of the rafts gather or Majlis al-Shab (454 seat 444 choose by hot vote, 10 institute by the president members serve five-year terms) and the 12 health Systems Profile- Egypt regional health Systems Observatory- EMRO consultive Council or Majlis al-Shura which functions only in a consultatory role (264 set 176 choose by familiar vote, 88 prescribed by the president members serve sixyear terms mid-term elections for one-half the members). Peoples multitude electi on is in collar phase voting, last held 19 October, 29 October, 8 November 2000 (next to be held October-November 2005) Advisory Council last held May-June 2004. The Shoura Council was establish constitutionally in 1980. The Shoura Council is generally a think-tank to purpose the Government on national policies.A citizens committal of the Shoura Council on health, Population and surround examines issues relevant to these areas former to their interchange in the Shoura Councils all-encompassing sessions. Although it does not ca-ca a direct legislative role, laws impacting importantly on broad government policy are needful to be discussed by the Shoura Council onward being passed to the Peoples manufacturing Laws, out front going to the plenary sessions of Parliament, are referred for front study to the relevant committees. These specific committees are currently 22 in number an example is the deputation for wellness and Environment.This committee, consisting jus t of Members of Parliament, a great deal invites experts to its meetings for the purpose of obtaining a more comprehensive thought of topics under study. The committee influences health policy changes intend for the future 13 wellness Systems Profile- Egypt regional health Systems Observatory- EMRO 3 H EALTH spot AND DEMOGRAPHICS 3. 1 wellness placement Indicators Table 3. 1 health spot Indicators 1990-2005 Indicators 1990 1995 2000 2004 2005 65. 3 (92) 66. 9 (98) 67. 1 (01) 70. 1 (02) 63 66 24. 5 22. 4 20. 5 3. 9 (97) 33. 8 28. 6 26. 2 174 (92) 96 (98) 84 (01) 68 (02) 3 26 29. 8 28. 7 NA 17. 6 preponderance of wasting away 3. 4 4. 6 Source NICHP Report, Ministry of health and Population,2005. 2. 5 NA 3. 9 brio foresight at line of descent nip infant deathrate locate fortune of anxious(p) forward fifth natal day/ thou parental deathrate ratio per centum of familiar extradite fish babies preponderance of impede Egypt valet Development Report,200 4 Table 3-2 Indicators of health stipulation by sexual practice and by urban rural 2006 Indicators urban folksy young-begetting(prenominal) egg-producing(prenominal) liveliness expectancy at bloodline 69. 2 73. 6 pinch babe mortality rate number 27. 7 15. 3 luck of last before fifth natal day/ kB 3. 9 20. 6 27. 6 24. 7 Maternal mortality ratio share of convention consume tip Babies prevalence of sensational/wasting Source NICHP Report, Ministry of health and Population,2005. WHO vane Site,August 2005 14 wellness Systems Profile- Egypt regional health Systems Observatory- EMRO Table 3-3 aggrandizement 10 causes of deathrate mortality Y2005 tell Intra-cerebral haemorrhage 21,473 indwelling (primary) hypertension 20,354 Fibrosis and cirrhosis of the liver of liver 18,434 liverwort failure, not elsewhere classify 11,353 coronary artery disease 10,800 arterial embolism and thrombosis 8,233 rattling(a) blood glucose level ,000 exquisi te myocardial infarct 6,645 cerebral infarction 6,334 Others 320,011 totality 431,637 Source NICHP Report, Ministry of Health and Population, 2005. The angle of affection and stigma in Egypt (Mortality and Morbidity). 2004. 3. 2 demography demographic patterns and trends substance population of Arab res publica of Egypt is 77,505,756 (July 2005 est. ). The age distribution is 0-14 historic period presents 33% (male 13,106,043/ womanly 12,483,899), 15-64 historic period presents 62. 6% (male 24,531,266/ pistillate 23,972,216), 65 old age and over presents 4. 4% (male 1,457,097/ egg-producing(prenominal) 1,955,235) (2005 est. ).Net migration rate is -0. 22 migrant(s)/1,000 population (2005 est. ). trip out ratio at possess 1. 05 male(s)/ womanly, under 15 years it is 1. 05 male(s)/ female, 15-64 years it is 1. 02 male(s)/female, 65 years and over it is 0. 74 male(s)/female, for the total population it is 1. 02 male(s)/female (2005 est. ) The median value age is 23. 6 8 years, 23. 31 years for males and 24. 05 years for females (2005 est. ). easterly Hamitic stock (Egyptians and Bedouins) presents 99%, Greek, Nubian, Armenian, other European (primarily Italian and French) presents 1%. Moslem (mostly Sunni) 94%, Coptic Christian and other 6%.Arabic is the authoritative language, English and French are astray tacit by educate classes. 57. 7% of the population (age 15 and over) can contain and write. manful presents 68. 3% and female presents female 46. 9% (2003 est. ). 15 Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO Table 3-4 demographic Indicators Indicators 1990 1995 2000 2004 2005 27. 9 1997 27. 9 27. 0 (03) 25. 8 (05) 6. 4 1997 6. 3 6. 4 (03) 6. 4 (05) 2. 4 (60. 86) 2. 08 (86-96) 2. 3 (96-02) 2. 0 (03) 19. 1 (05) 74. 7 1992 69. 7 1998 69. 9 (01) 69. 9 (02) 37. 8 1996 38. 8 (03) 37. 4 3. 90 1992