Ismail Sallam & Egypt Health Legacy 1996-2002

WELCOME

These pages were created to provide a historical account of Egyptian Health Care over half a century of my life. As a student of history before medicine, I firmly believe understanding our past could guide us to a better future. As I started the reform our main worries was how to provide health care for those without access and the underserved. Could we have the courage and the power to execute a reform that is targeting alleviation of disparities in health? From that sentiment, I wanted to describe the Egyptian experience of reform (1996-2002) and a personal story of global medical education. I hope both stories will help those in the developing world, those in the developed world, those who are sick and those who seek to help the sick on their journey for better health.

picturegallery102499.tmp/49.jpg

The Vision for better Health System

Dr Sallam lead health and population sector reform strategy that changed the image of Egyptian health care (1996-2002). His ground-breaking vision was based on elimination of disparities within the health sector. In five years time, there was a significant improvement of Egypt’s key health indicators enabling Egypt to make a remarkable leap to rank 43^rd out of 191 countries on the index of health performance (WHO, 2000).

PREVENTIVE MEDICINE

Preventive medicine enjoyed a leading role under the leadership of Dr Sallam. Successful public health programs resulted in the containment of epidemics (typhoid, meningitis and summer diarrhea) that jeopardized the health of the Egyptian people prior to 1996. Egypt was declared as Malaria free country and intensive efforts were made to increase awareness to prevent AIDS. Immunization programs have been enlarged so as to include all women and children. There was a marked decline in Tuberculosis, and Neonatal Tetanus. Diphtheria and whooping cough almost disappeared. His ceaseless efforts led to marked reduction in infection with Schistosomiasis from 25% to 3.5%. Maternal mortality and morbidity decreased significantly as well as infant morbidity and mortality. A teeth decay prevention campaign was launched among children. Complementing the primary and preventive care reform strategy, Healthy Egyptians 2010 set an agenda for disease prevention and health promotion. It is a new concept for thinking about the future, identifying problems, monitoring health outcomes, and taking action. This initiative gives special emphasis to community participation and can tailor its objectives and targets as needed.

HEALTH ACCESSIBILITY &EQUITY

By the end of 1998, 100% of the unprivileged groups were provided with accessible health services after the Completion of primary health care infrastructure and the introduction of mobile clinics.

FAMILY MEDICINE

FAMILY MEDICINE CONCEPT DRIVES PRIMARY CARE REFORM

The family is the cornerstone of Egyptian society. The cornerstone of Egypt’s new health care model is Family Medicine. The holistic medical approach and integrated care system (pediatrics, reproductive and adult medicine) increases the likelihood that preventive and early intervention care, for example, for maternal and child health, reaches those who most need it. The family Medicine team better serves clients with young children or with limited time and resources to travel to different places because several family members can obtain different types of care during one visit.

MENTAL HEALTH REFORM

An integral strategy for mental and psychological care was adopted. Thereupon, prevention and cure from mental diseases have become an essential part of primary health care. Psychological clinics were opened in all governorates and public hospitals. The major mental hospitals were totally renovated with new management. Social care became part of patient’s management. Major rehabilitation programs were introduced.

Health Diplomacy

Dr. Sallam implemented the provision of humanitarian assistance at the international and domestic levels as a continuous component of the Ministry's capacity. This policy was based on Dr. Sallam’s strong belief that humanitarian channels could relieve many political or cultural disagreements. He is strong believer that Health Diplomacy, as a part of comprehensive development, could play a vital role in Human Security and World Stability.

Women Empowerment & Health

ALLEVIATION OF GENDER DISPARITIES IN EGYPT HEALTH REFORM

COMPREHENSIVE WOMEN EMPOWERMENT PROGRAMS

Dr Sallam innovatively, directed the establishment of a large number of Women’s Club within the health facility, to cover over 1000 villages in rural, unprivileged areas of Egypt. Through Women’s Club a comprehensive women empowerment programs were implemented to provide women with services like reproductive health orientation programs, illiteracy classes, cultural and awareness sessions, vocational training programs economic microcredit opportunities ....etc

THE RIGHT OF WOMEN IN QUALITY REPRODUCTIVE HEALTH

Dr Sallam insured the human right for every woman to be accessible to a quality reproductive health services. He stood firmly to point out that no comprehensive development could be achieved without the empowerment of women and maximization of their capacity to participate efficiently and effectively in economic, social, political and cultural development.

MINISTERIAL DECREE ABOLISHING FEMALE GENITAL MUTILATION
After a few months of his appointment as Minister of Health and Population, Prof. Sallam was able to promulgate a ministerial decree abolishing Female Genital Mutilation – a culturally and politically sensitive issue that his predecessors in the Health Ministry had mostly steered clear of. Prof. Sallam successfully addressed this issue, both in public and in the nation’s courts, by presenting it as a response to the demands of every Egyptian woman.

Quality
Dr. Sallam considered quality improvement of health services as one of the main targets of the Health Sector Reform Strategy. To that end, he established the Department for Quality in 1997 to train highly skilled cadres at central and governorate levels; create the appropriate climate for implementing quality programs; lay down a comprehensive strategy for quality programs and accreditation system; determine performance standards, produce curative and primary health care standards and guidelines booklets; establish a comprehensive supervisory system for buildings, equipment or services; and link quality programs to an information system network for performance follow-up. Monitoring, surveillance and evaluation were taken seriously as Dr Sallam believed that in the third world there is a need to set up different criteria for monitoring system that will ensure continuity and sustainability of attained achievement.

ACKNOWLEDGMENT

I WISH TO EXPRESS MY DEEP APPRECIATION FOR MY STUDENTS, STAFF, COLLEAGUES AND FRIENDS WHO SUPPORTED THE ESTABLISHMENT AND SHAPING OF EGYPT'S HEALTH LEGACY (1996-2002). I AM ALSO INDEBTED TO THOSE WHO HELPED WITH THE CREATION OF THIS WEBSITE..
I WELCOME ALL THOSE WHO CONTRIBUTED TO EGYPTIAN HEALTH REFORM (1996--2002) FROM ALL OVER THE WORLD TO SHARE THEIR EXPERIENCE ON THIS WEBSITE.