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v On average, 174 mothers die for every 100.000 live births with increasing rates in some governorates. v One in 12 Children die before reaching the age of 5. The average is one in seven for rural areas in Upper Egypt. v Less than 40% of the population is covered by social or private health insurance. v Poor individuals and families pay a greater proportion of their personal income for health care expenses than the wealthier do. v Sixty percent of all primary care visits take place in private sector facilities. Doctors refer public patients to private clinics. Public primary care facilities lack supplies and drugs and staff is inadequately trained. v Physician training is insufficient and there is a shortage of skilled nurses. v Total government spending for health care is low compared to global standards and insufficient to expand coverage of the poor, treat the growing population and treat the more expensive chronic and non-communicable diseases and injuries. v Drug spending and consumption are high and cost and quality controls are weak. v According to international standards and compared to countries of similar income, Egypt has a very high surplus of physicians and hospital beds. v Fifty percent of deaths in emergency cases are due to improper case management. v There is 29 different uncoordinated governmental bodies managing the public health care system. v Fifty percent of deaths in emergency cases are due to improper case management. v There is 29 different uncoordinated governmental bodies managing the public health care system. v Fifty percent of deaths in emergency cases are due to improper case management. v There is 29 different uncoordinated governmental bodies managing the public health care system. v Fifty percent of deaths in emergency cases are due to improper case management. v There is 29 different uncoordinated governmental bodies managing the public health care system. v Fifty percent of deaths in emergency cases are due to improper case management. v There is 29 different uncoordinated governmental bodies managing the public health care system. · GAINING THE NATION POLITICAL SUPPORT
In In 1985, Dr Sallam was appointed chairman
of the Health, Environment and Population Committee of the ruling National Democratic Party. The committee is a major formulator
of Egypt’s Health and Population Policy. Under Dr. Sallam's leadership the committee played a major role in establishing
a new health strategy for Egypt. Most of the decision makers has been involved in the discussions of the new vision including
the President.
SUPPORT FROM THE PARLIAMENT
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GAINING THE POLITICAL SUPPORT
The vision I conceived for Egypt Health Reform was the result of extensive discussions and deliberations in Qena and other Governorates, which involved doctors, politicians and local people in the area. This vision was further crystallized in the Senate but many experts locally and internationally worked extensively to translate these ideas into a feasible health sector reform.
I introduced the first concrete health reform strategy to the Health Committee in the National Democratic Party which I chaired in 1986.In the thoughts we have given excited a lot of interest and in 1988 President Mubarak attended for three hours the discussions of the new vision. As I became a member of the Senate in 1989, I had the chance of mobilizing the support for the new strategy in the Parliament .The Senate produced several documents on the subject. The final document was discussed and approved in the same week I was appointed minister of health and population in the new government. This brought the parliament and executive agencies closer to a single strategy. My first task was to gain the political support for the health reform and for this I initiated continuous, active dialogue on all levels of policy. We also sought out contributions from the public, the civic society, the parliament, the governorates and the media. Although we succeeded to set health as a priority on the national political agenda, we aimed to strengthen the political commitment by making the public part of the reform agenda. It was expected that we will wait till we finish the studies and consider for the new fiscal year but the Prime Minister accepted to discuss the reform and to support some initial programs to improve the quality and the accessibility of the service. Soon the public starts to feel the impaction of these new programs which was the best showcase for
Among the many resources needed for reform, human resources represent the cornerstone for any appreciable development. Likely enough, we gained the support of the doctors, nurses, managers and workers in the health sectors, who formulated the driving force for the continuity of reform and paved our way to success. The government increased its budget allocation to the health sector. The civic society and the donors started to work for getting more resources. The parliament made health as a priority and this has contributed to our resources.
On the other front we got engaged with local and international experts to produce an acceptable document for the Donors and International Organizations.