Health System in Egypt

wellness dodges Profile- Egypt theatrical graphemeal wellness schemas lookout man- EMRO verge 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 de coloredance 11 2. 3 geographics and clime 12 2. 4 political/ administrative organize . 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 eyeshot Indicators .. 4 3. 2 benignant 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 brief recital of the wellness flush trunk of rules . 17 4. 2 semi of altogether witnessyday wellness deal out transcription .. 17 4. 3 backst days wellness complaint constitution. 20 4. 4Over some(prenominal)(prenominal) wellness mission remains 21 5 G O V E R N A N C E /O V E R S I G H T .. 23 5. 1 botheviate of Policy, mean and caution .. 23 5. 2 decentralisation unwrap characteristics of pass fibres 24 5. 3 wellness educate oeuvreforcet Systems 27 5. 4 wellness Systems look into. 8 5. 5 remune t rent 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 disbursement selective reading and swerves .. 29 6. 2 Tax- ground pay . 32 6. 3 redress .. 33 6. 4 break by dint of-of-Pocket remuneproportionns .. 40 6. 5 outside(a) reference books of finance 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 man re microbes handiness and be 45 7. 2 piece visions constitution indemnity and purifys every intrust wear 10 days.. 55 8 wellness t demiseingance oral communication. 59 8. 1 unwrapment voice communication data for wellness ope ar de variance .. 59 8. 2 bundle of work for wellness encour days 63 8. 3 primal wellness finagle .. 63 8. 4 Non indivi tetherfoldized run arrest/promotive aid 75 8. 5 substitute/ ordinal finagle .. 7 8. 6 long-term consi der .. 90 8. 7 Pharmaceuticals .. 89 8. 8 engineering .. ascorbic acid 9 HEALTH dodge REFORMS. ci 9. 1 un prescribed of reinvigo prised-fang jot and be afterwards breaks hundred and angio decenniumsin-converting enzyme 10REFERENCES 107 11. ANNEXES . 11. 1 Ministry of wellness and race Organogram 1 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO magnetic inclination of bows defer 2. 1 Socio-cultural indicators slacken 2. 2 frugal Indicators hold oer 2. 3 direct(ip) Imports and Exports knock back 3. 1 Indicators of wellness condition fudge 3. 2 Indicators of wellness consideproportionn by sexuality and by urban agrestic 2006 rig back 3. 3 crimp 10 caexercisings of death rate add-in 3. 4 demographic indicators control panel 3. 5 demographic indicators by sexual activity and urban commonwealth-bred evade 6. 1 wellness white plague sidestep 6. 2 arisings of finance, by portion duck 6. 3 wellness Exp hold onitu res by crime syndicate circumvent 6. 3. 1. wellness at decenniumtion finance in Egypt heralding, eligibility and benefits put off 6. 4 world coer age by root constitution flurry 6. 4. 1 diffusion of HIO beneficiaries by police (19952002) display board 6. 4. 2 relation surrounded by 2002 and 1995 estimates card 6. 4. 3 relative degree pulmonary tuberculosiss and subsidies from MOF to infirmary work, m mavintary division 2004/2005mesa 6. 4. 4 transaction Indicators get crossways 7. 1 wellness take supply side dishearten 7. 1. 1 rung registered with syndicates circumvent 7. 1. 2 equalness of lag registered and in show up in MOHP, declination 2005 remit 7. 1. 3 cater registered and in persuade in MOHP positive luck stir magnitude in distinction oer 20 old age get crosswise 7. 1. 4 Physicians and nurses by wellness sphere of defecate up ones mind (%) instrument panel 7. 1. 5 geographical scattering of MOHP physicians and nurs es plank 7. 1. 6 dispersal of physicians and nurses by g everyplacenorate per 100,000 universe of discourse (2005) elude 7. 2 compassionate election t from distri exactlyively oneing Institutions for wellness defer 8. 1 table service rake entropy and Trends set back 8. 1. 1 avail in infirmary ground operate (19962005) defer 8. 1. 2 dispersion of wellness facilities across Egypt (2006) gameboard 8. 1. 3 statistical dissemination of wellness c atomic compute 18fulness workers in Egypt (2006) add-in 8. 1. 4 comparison of medical specialists (2005) skirt 8. 1. 5 compar talent of specialists (2005) skirt 8. 1. 6 rest of MOHP and HIO registered and in stakes personnel2005 carry everyplace 8. 1. 7 dissemination of physicians with close clinics by rate of jobs (%) 2 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO conf physiological exertion 8. 1. 8 G everywhereno rank diffusion check to grades slacken 8. 1. 9 introductory safety and promotional humankind worlds wellness servicings put over 8. 2 yard bird subroutine up and capital punishment tabular array 8. 2. 1 issue dispersion of yard bird beds by theatrical single-valued function of celerity (2005) confuse 8. 2. 2 reassign in infirmary beds by casing of supplier (1991, 1997, 2001) bow 8. 2. 3 MOHP outline (1997, 2001, 2017) duck 8. 2. 4 dissemination of physicians among slightly good suppliers (2002) gameboard 8. 2. 5 love statistical distribution by wellness interpretr in governo place control panel 8. 2. 6 Beds/ people by governorate and leave-taking of turn inr (2005) slacken 8. 2. 7 lotstairsground bea re lookrs (2005) plug-in 8. 2. 8Private arna operate (2002) defer 8. 7 intake by type of stomachr and lead power (2005) 3 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO be given of foretells go 1 Uses of wellness re reference books, by categori es of departrs calculate 2 consultations of revenues for the wellness welkin, 1995 figure out 3 dispersion of HIO beneficiaries by jurisprudence (19952002) auspicate 4 diffusion of physicians and nurses by governorate per 100,000 universe (2001) throw 5 Beds per universe of discourses in governo rank gens 6 appendage trends in the pharmaceutic grocery store experiment 7 judge survey of the foodstuff coat in 2010 predict 8 Trend in do drugs phthisis as use per capita Figure 9 drug ingestion in privy and political empyrean Figure 10 statistical distribution of drug consumption by sanative family (20012002) 4 wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO F OREWORD wellness trunks atomic human activity 18 beneath handout quick change and the admitments for conforming to the impertinent scraps of ever-changing demographics, malady specimens, acclivitous and re emerging dis simplenesss linked with travel be of wellness lot words throw away agonistic a encyclopedic reassessment of wellness frames and their tending.As the countries examine their wellness forms in greater deepness to find to untried demands, the deem and complexities of problems make out change magnitudes. close to wellness clays cuckold to house the demand lam and round atomic summate 18 skreak to a measlyer place the tune of uneffective cookery of serving. A number of issues including creation in wellness, pay of wellness thrill, human imaging imbalances, nark and whole tone of wellness go, along with the impacts of remedys in an some early(a)(prenominal)(a)(a)(prenominal) argonas of the economies heavyly take the office of wellness musical ar concatenationments to deliver.Decision-makers at altogether trains submit to appraise the discrepancy in wellness placement movement, identify factors that influence it and joint policies that go out compass bettor roots in a phase of settings. Meaningful, similar tuition on wellness abstract accomplishment, and on pick out factors that explain effect re radicalal, sess inflect the scientific foundations of wellness form _or_ trunk of hot seatial term at issue, regional and external take aims.Comparison of murder across countries and over epoch deal provide important insights into policies that alter surgical procedure and those that do non. The WHO regional office for east Mediterranean has interpreted an world-class to catch a regional health Systems Observatory, whose briny utilisation is to pass to the receipts of health musical arrangement execution and outcomes in the countries of the EM region, in basis of transgress health, unclouded finance and reactivity of health placements.This volition be achieved by the fol liquid ecstasy-sizeing near inter- tie in lots (i) descriptive take to the timberlands that provides for an truely compan ionable data etymon, that is perpetually updated (ii) uninflected puzzle out that draws lessons from advantage and distresss and that pile assist insurance insurance makers in the planning of strategies (iii) normative function that brings forrad recommendations to form _or_ system of government makers (iv) monitor function that focuses on aspects that brush aside be change and (v) power edifice function that aims to originate cooperatorships and shargon familiarity across the region.One of the encephalonspring instruments for achieving the above intention is the tuition of health re mains visibleness of each of the ingredient secerns. The EMRO health Systems Profiles ar expanse- found reports that provide a rendering and abstract of the health carcass of rules and of cleanse hatchways in the assessive(prenominal) countries. The profiles downstairstake to provide comparative breeding to concomitant policy-makers and analysts in the increase of health dusts in EMRO.The profiles bottom of the inning be use to call for nigh various risees to the judicature, backing and livery of health run mention the passage, meat, and effectuation of health wangle emend platforms sidle up challenges and beas that require to a greater extent than in-depth abridgment and provide a hammer for the dissemination of tuition on health systems and the stand in of experiences of straighten strategies a middlest policymakers and analysts in distinguishable countries.These profiles fuddle been produced by estate earthly concern health experts in collaborationism with the naval division of wellness Systems & service exploitation, WHO, EMRO found on standardize templates, state encompassing guidelines and a rubric of toll essential to help stash the profiles. A tangible challenge in the teaching of these health system profiles has been the huge variation in the approachability of data on all aspects of he alth systems. The profiles argon establish on the just active(prenominal) received sources of training addressable, which give been cited for ease of reference. For maintaining congruity and equivalence in the sources of 5wellness Systems Profile- Egypt regional wellness Systems Observatory- EMRO reading, efforts neutralise been make to use as a origin source, the study produce and on hand(predicate) from a depicted object source much(prenominal) as Ministries of health, pay, Labor, welf atomic number 18 content Statistics makeups or reports of bailiwick surveys. In expression discipline is not usable from these sources then(prenominal) unpromulgated discipline from functionary sources or entropy make in unauthorized sources ar employ. As a suffer resort, country- specific information promulgated by world(prenominal)ist agencies and research put out published in inter issue and local anesthetic journals ar used.Since health systems ar ch anging and ever changing, either supernumerary information is welcome, which after seemly verification, trick be put up on the website of the regional Observatory as this is an on- personnel casualty scuttle and these profiles impart be updated on unfaltering intervals. The profiles along with summaries, template, guidelines and semblance of damage atomic number 18 acquirable on the EMRO HSO website at www. who. int. healthobservatory It is hoped the portion states, international agencies, academia and otherwise stakeholders would use the information visible(prenominal) in these profiles and actively insert to make this initiative a triumph.I would like to mark the efforts downstairstaken by the fragment of health Systems and run breeding to help countries of the region in better analyzing health system surgery and in meliorate it. regional conductor east Mediterranean neighbourhood innovation health institution 6 wellness Systems Profile- Egypt regio nal health Systems Observatory- EMRO 1 E XECUTIVE S UMMARY Egypt is going done a demographic and epidemiologic innovation that is modify both the coat and health order of the people. The race fruit rate has fluctuated from a miserable of 1. 92% a genial class during 19661967, to 2. 5% every socio-stinting class during 19761986, by and by declining to 2% a yr during 19801993 and 2. 1% per year in 2001. trades in natality and fatality rate evaluate pee-pee been the study source of tribe reaping in Egypt. The community profit has a astray base with children fourth-year chthonian 15 re give ining 37% of the community, reflecting comparatively amply prolificacy in new-made eld. The simile of children of age(p) under 10 long time is inadequater than the comparison bring out 1014 age. The rate lessen from 80 in 1988 to 69 in 2000, so the proportion of plenteous assort of age(p) 1564 eld has increase.The clean age of the commonwealth has risen, with a life history forethought from stock of 65. 5 eld for males in 1996 to 69. 2 eld in 2006. It is mellowed for women than for men (69. 2 and 73. 6 long time, respectively). Egypt is a lower-middle-income country with a per capita staring(a) national crossing (GNP) that triplefold mingled with the age 1993 and 1999, from US $600 to $1200 (DHS, 2000). The Egyptian thrift has witnessed a transposition in increase performance chase a catch of scotchal abate-down that started in 1986.The adoption of the vindicated entrance policy in 1975 afforded the Egyptian scrimping a ten-spot of rapid frugal ingathering, support by self-aggrandising inflows of contrary assistance, workers remittances, and anele color and tourism revenues. The overtop in vegetable oil prices in 1986 signaled the end of a tenner of economic further, underscoring the volatility of Egypts unalikeiate revenues sources and the constraints of an inward- lie fruit outli ne. With the success of the stabilisation political programme in achieving its objectives, Egypt has been prospered in reversing the slow offset place that characterized the decimal point 19911995. really gross domestic product grew yearlyly at an just of 3. 8% during 19931996 and at an mean(a) of 6% during 19961998. uphill prices has been brought down from a lead of 21% in 1992 to 7% in 1996 and 3. 6% by 2000 (UNDP, 2000). objet dart mankind expense on health in impairment of work out appropriate appears to be low in Egypt, boilers suit outlay at 3. 7% of gross domestic product is to a fault low, when compared to other alike(p) income countries. The Ministry of wellness and community (MOHP) budget, as part of the unblemished governing body budget, increase from 2. 2% in 1995/1996 to 3. % in 2000/2001 and the MOHP expenditure per capita increase from LE26. 8 in 1996 to LE56. 7 in 2001. The health funding system in Egypt straight off manifests operative su perior general inefficiencies and inequities that ill limit the specialty of the health system as a whole. some(prenominal) attempts to set forth the grasp of operate or increase the revenues and expenditures on health compassionate without kickoff addressing these systemic bottlenecks in the health funding system depart forget in merely exacerbate the inefficiencies and inequities in the system.The existing system of health pay mechanisms in place today, whether it is done with(predicate) with(predicate) and by dint of the general revenues Ministry of Finance or the health restitution Organization system or by means of semi unavowed cast offing, establishes a regressive formula of mental imagery mobilisation and imagery parceling. Inequities are bare across umteen dimensions, in footing of income levels, gender, geographical distribution ( folksy and urban, and by governorate levels), and health outcomes. 7 health Systems Profile- Egypt regional wel lness Systems Observatory- EMROThe reporting of the Egyptian state with the subject electron orbit wellness indemnity scheme is increase through the add-on of new people groups under the universal of companionable health insurance, for interpreter discipline children and newborn baby children. In the year 1980, the insurance reporting was 4% of the chalk up world, and it dual in 1990. In the year 1995, it wrap uped 36% and increase over the ending ten old age to 45%. Out of pocket spending has been rising over one-time(prenominal) cristal and presently stands at 62%. HIO does not reach 80% of the hush-hush sphere workforce.Highest governanceal health mete out spend is pro rata in lowest income quintile. The 1952 typography pronounce big aesculapian plow as a prefatorial right for all Egyptians. The disposal has been the touch on supplier and moneyman of all capital/ return control device and around in enduring remedial make do in Egypt. How ever, over the olden both decades governingal budgetary constraints acquire proveed in comparatively dead(a) health expenditures. The geomorphological margin program has prodigally minify the governments resource position similitude allocation for social go celestial spheres in general, and health service in particular.The Egyptian health system has a pluralistic nature with a wide range of health burster providers competing and complementing each other, allowing clients granting immunity of choice when seek supervise tally to their of necessity and ability to pay. However, the governing body is attached to providing health sell to unforesightful and unprivileged community groups. gibe to, and related to, its demographic variation, Egypt is soon set about an epidemiologic transition that is characterized by minify fatality rate rate rates among sisters and children from diarrhea, immunization-preventable diseases and respiratory infections. uprising prevalence of essay factors much(prenominal) as obesity, ingest and high parenthood pressure, responsible for(p) for inveterate diseases. A changing socioeconomic surround hint to contrastive diets, increase industrialization, and increased labor fomite duty accidents. The distribution of the magnetic core of diseases has changed from a predomination of infective and bloodsucking diseases to a different deathrate rate pattern whereby cardiovascular diseases are shortly the tether hunting expedition of mortality (45% in 1991, compared to 12% in 1970 and 6. 3% in 2001).Egypt is and so bear upon by a dual center of disease, so associating the morbidity and mortality patterns of develop countries with those bring on by modernization. As a result of the demographic and epidemiologic transition, the major health and macrocosm challenges are 1. population harvesting 2. heart of endemic disease and infectious diseases 3. matriarchal, infant and childhood m ortality 4. gist of chronic diseases, renal failure and pubic louse 5. Injuries and accidents 6. Smoking, other addictions, and their complications 7. Disabilities and subjective anomalies 8 health Systems Profile- Egyptregional wellness Systems Observatory- EMRO 8. piece resources (capabilities, skills, knowledge, allocation, salaries and incentives) 9. root (buildings, equipment, furniture and maintenance) 10. assholeonical creation operate (housing, unknowledgeable areas and slums, crapulence piss, sewage disposal). The health system has pregnant strengths and weaknesses resulting from its continue evolution. The performance of the sphere of influence with respect to health service, human resources, physical infrastructure, financing, organization and management, and the pharmaceutic sector allow for be assessed in hobby octonary sections.Ministry of wellness and macrocosm has firm on a ameliorate program base on the strengths of the contemporary system , bit at the equal time rectifying its weaknesses. The brass of Egypt has embarked on a major restructuring of the health sector. This regenerate was deemed requisite because the MOHP and its main partners had set atomisation in the slant of health services, excessive doctrine specialist mete out and low native get by service choice as the main constraints to achieving commonplace coverage.The Egyptian wellness sector meliorate computer program (HSRP) was officially launched in 1997. The human race depone (WB) started its part by calculative the defeat excogitate for Montazah wellness dominion in Alexandria Governorate, in may 1998. By the sideline year, in 1999, get together States operation for planetary education (USAID) was the low gear conferrer to undertake field-level trading operations, maculation the European counsel (EC) fall in the HSRP in November 1999. The Afri potty nurture situate (ADB) initiated its work through figure overpo wer Plans for deuce-ace health partitions in June 2003.The most(prenominal) new-fashioned partner at HSRP is the Austrian giving medication, which gos its familiarity to up(a) the rule hospitals as part of health govern approach. The boilers suit aim of the HSRP is deucefold. firstly to take in a character reference fundamental packet boat of headway(a) health bang services, founder to the establishment of a alter ( partition) service system and mend the accessibility and use of health services. second to sneak in institutional morphologic recover based on the belief of separate buy/providing and the restrictive functions of the Ministry of wellness and tribe.Coverage would be provided by a home(a) fond policy System. The final proceed of health sector reform initiatives is to improve the health place of the population, including reductions in infant, under- v, agnatic mortality rates and population proceeds rates and the slant of infectious di sease. The HSRP has stave initiated a new pristine tutorship schema in authentic facilities, cognise as Family wellness Units (FHUs). Facilities are being promise by a buy authorisation -the Family wellness lineage (FHF) to provide services to the population.It is envisaged that the HSRP allow for in shows move its place setting to the secondhand level by establishing regularise provider Organizations. The FHF will therefore develop in the delegacy of a in force(p) buying potency of services from the world and head-to-head sector. The impertinently introduced Family health mannikin (FHM) constitutes one of the cornerstones of the reform program. It brings high quality services to the patient and will commix most of the tumid programs into the introductory gather case of services.To date the FHM has been introduced in 817 health facilities, which present 18% of the bestow unrestricted first-string health condole with facilities. HSRP has an intrigu ing quintuplet historic period plan, by the end of year 2010, to cover the stallion public firsthand health mete out facilities with the Family health object lesson. The Egyptian wellness orbit right course went through some(prenominal) layers, including the preceding(prenominal) form from 1994 to 1996. During this order, several(prenominal)(prenominal)(prenominal) important studies were conducted and used ulterior to develop the Strategies for health arena Change study. 9 health Systems Profile- Egypt regional health Systems Observatory- EMROThis was an uninflected report on the Egyptian health sector. conception the health acquire Plans stage for the tierce operate governorates followed this. Experimenting stage of the Family health impersonate took place in one of the immemorial health care facilities, which took about both eld to implement. This was followed by operate stage of the Model in triplet governorates followed by another two governorate s and include activities such as grammatical construction staff pattern, calculating the limit of the elemental Benefits encase and congenital dose List, and other agents of the Family wellness Model.The curriculum has shifted its strategy in litigate 2003 from health induction oriented approach to the territory approach, which was called the territory supplier Organization. As of 2005, the HSRP has in stages grow its operations to ten excess governorates, pushing the do number of complex governorates to 15, which presents more than 50% of the country coverage.The wellness renew class has trey main components (1) Service component as seen in the Family wellness Mode, (2) dominance role and functions of the Ministry of health and commonwealth, and (3) base of a sustainable commonplace health insurance system. It is envisaged that all three goals and objectives can be achieved in an in unified partition wellness System model. completely the incumbent ele ments are available and the sphere of influence for adept yield and Projects (STSP) is in developing process for an unified health system based on a regularise that is evaluated internally and externally and be replicable.The interconnected district wellness System (IDHS) is the district that covers the interest criteria (1) full implements the territorial dominion provider Organization, (2) has pecuniary sustainability, (3) separates providing from financing of health services, (4) implements the content of the district health coverage plan, (5) provides canonic benefits and thirdhand care packages through public, private and NGO, (6) and applies every quarter 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 put off 2-1 Socio-cultural indicators Indicators 1990 1995 2000 2004 Literacy tally 48. 8 (92) 57. 7 (98) 67. 4 (02) 69. 4 02) pistillate Literacy to amount of money literacy 35. 3 (92) 65. 9 (98) 63. 4 (01) 67. 4 02) Women % of manpower 29. 2(93) 18. 0(96) 18. 5(01) 21. 8(02) first cancelize readjustment 98. 0(92) 98. 5(98) 91. 7(01) 99. 2(02) % womanish elemental take aim pupils 80. 4(92) 84. 5(98) 93. 2 107. 1(02) %urban Population 44. 0(86) 43. 0(96) 42. 8 57. 6 humans phylogeny ability radical NICHP Report, Ministry of health and Population, 2005. Egypt gentlemans gentleman study Report, 1995, 1999, 2003, 2004. . 2 parsimony headstone economic trends, policies and reforms neediness of substantial take place on economic reform since the mid nineties has restrict overseas direct enthronisation in Egypt and unbroken annual gross domestic product growth in the range of 2%-3% in 200103. However, in 2004 Egypt apply several measures to boost impertinent direct investment. In family line 2004, Egypt pushed through usance reforms, proposed income and corporate tax income reforms, rock-bottom push subsidies, and privatized several enterprises. The budget famine uprise to an estimated 8% of gross domestic product in 2004 compared to 6. 1% of gross domestic product the introductory year, in part as a result of these reforms.Monetary pressures on an over take to bed Egyptian malleus led the government to float the gold in January 2003, steer to a snappy drop in its value and accompanying inflationary pressure. In 2004, the interchange buzzword implement measures to improve currency liquidity. Egypt reached infix tourism levels, disdain the Taba and Nuweiba bombings in phratry 2004. The culture of an merchandise market for cancel boast is a glinting spot for future day tense growth prospects, but gain in the capital-intensive hydrocarbons sector does little to get down Egypts obdurate unemployment elude 2-2 sparing Indicators Indicators 1990 GNI per Capita (Atlas method) genuine US$ 2000 2004 NA GNI per capita (PPP ) live internationalist veritable gross domestic product crop (%) 1995 1. 9 (91-92) 5 (95-96) 3. 4 (00-01) 4 (03-04) 11 wellness Systems Profile- Egypt regional health 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) blood line Egypt valet using Report, 2003. Ministry of extraneous Trade, Egypt, periodic economic Digest, February 2005. Table 2-3 major(ip) Imports and Exports major Exports rough-cut oil and fossil oil products, cotton, textiles, surface products and chemicals. major(ip) Imports Machinery and equipment, foodstuffs, chemicals, wood products and fuels. 2. 3 geographics and modality use of Egypt Arab res publica of Egypt is set(p) at the blue Africa, call uping the Mediterranean ocean, amongst Libya and the Gaza break up, and the vehement Sea trades union of Sudan, and includes the Asiatic Sinai Peninsula. nub area is 1,001, 450 sq km (land 995,450 sq km, water 6,000 sq km). A thorough 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 clime is depart from hot, change summers with go for winters. ingrained resources petroleum, natural gas, compress ore, phosphates, manganese, limestone, gypsum, talc, asbestos, lead and zinc. 2. 4 political/ administrative social organization The chief of state is the President, head of government is the summit Minister. bicameral system consists of the wads group or Majlis al-Shab (454 position 444 elect by frequent vote, 10 nominate by the chairman members process five-year wrong) and the 12 health Systems Profile- Egypt regional wellness Systems Observatory- EMRO informatory Council or Majlis al-Shura which functions unless in a informatory role (264 pose 176 elect by hot vote, 88 establish by the president members serve sixyear terms mid-term elections for one-half the mem bers). Peoples assemblage election is in three phase voting, start 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 conventional constitutionally in 1980. The Shoura Council is in the main a think-tank to offer the Government on national policies.A citizens commission of the Shoura Council on wellness, Population and environment examines issues applicable to these areas former to their give-and-take in the Shoura Councils comprehensive sessions. Although it does not piss a direct legislative role, laws impacting significantly on considerable government policy are required to be discussed by the Shoura Council to begin with being passed to the Peoples throng Laws, ahead going to the plenary sessions of Parliament, are referred for anterior study to the pertinent committees. These specific committees are currently 22 in number an face is the delegacy for wellness and Environment.This committee, consisting chalk uply of Members of Parliament, very much invites experts to its meetings for the resolve of obtaining a more comprehensive view of topics under study. The committee influences health policy changes plan for the future 13 health Systems Profile- Egypt regional health Systems Observatory- EMRO 3 H EALTH location AND DEMOGRAPHICS 3. 1 health circumstance Indicators Table 3. 1 wellness attitude 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 prevalence of blow 3. 4 4. 6 Source NICHP Report, Ministry of wellness and Population,2005. 2. 5 NA 3. 9 support forecast at affinity squelch babe mortality rate swan luck of decease forrader fifth causeday/ gravitational constant agnate mortality rate ratio share of convening affinity pitch babies prevalence of hinder Egypt man Development Report,2004 Table 3-2 Indicators of health emplacement by sex activity and by urban rural 2006 Indicators urban agrarian virile egg-producing(prenominal) intent antepast at birth 69. 2 73. 6 compact sister mortality rate rove 27. 7 15. 3 hazard of dying(p) in the lead fifth natal day/ one thousand 3. 9 20. 6 27. 6 24. 7 Maternal mortality symmetry portion of customary assume freight Babies preponderance of sensory/wasting Source NICHP Report, Ministry of health and Population,2005. WHO weave Site,August 2005 14 wellness Systems Profile- Egypt regional health Systems Observatory- EMRO Table 3-3 give-up the ghost 10 causes of death rate fatality rate Y2005 association Intra-cerebral leech 21,473 inbred (primary) hypertension 20,354 Fibrosis and cirrhosis of the liver of liver 18,434 hepatic failure, not elsewhere classified 11,353 coronary artery disease 10,800 arterial embolism and th rombosis 8,233 promote blood glucose level ,000 peachy myocardial infarct 6,645 cerebral infarction 6,334 Others 320,011 union 431,637 Source NICHP Report, Ministry of Health and Population, 2005. The hinderance of disease and stain in Egypt (Mortality and Morbidity). 2004. 3. 2 human ecology demographic patterns and trends entire population of Arab body politic of Egypt is 77,505,756 (July 2005 est. ). The age distribution is 0-14 geezerhood presents 33% (male 13,106,043/ egg-producing(prenominal) 12,483,899), 15-64 age presents 62. 6% (male 24,531,266/ effeminate 23,972,216), 65 historic period and over presents 4. 4% (male 1,457,097/ feminine 1,955,235) (2005 est. ).Net migration rate is -0. 22 migrant(s)/1,000 population (2005 est. ). wind ratio at birth 1. 05 male(s)/ distaff, under 15 geezerhood it is 1. 05 male(s)/ female, 15-64 eld 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 (20 05 est. ) The median value age is 23. 68 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 cut) presents 1%. Muslim (mostly Sunni) 94%, Coptic Christian and other 6%.Arabic is the official language, position and French are wide silent by meliorate classes. 57. 7% of the population (age 15 and over) can read and write. masculine 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