This thesis deals with the quality of public health services in the primary health care clinics in lower income areas in Cairo. There are multiple factors affecting such quality, including the motivation of the workforce, the infrastructure and equipment of the facility, and the modes of finance and management. The research examines whether the accreditation of health clinics by the Egyptian Ministry of Health and Population affects these factors and hence improves the quality of the service provided. To do this, the research is based on a comparative study between accredited and non-accredited health care facilities; where accreditation is granted based on patients’ rights, patients’ care, environmental and clinical safety, information management, clinical and non clinical services, and management of the facility, quality improvement program, and integration of care. Although the accreditation period has expired for all accredited facilities in Cairo, some improvements to the quality of health care services were introduced as a result of the accreditation. Forty four interviews were conducted with public health workers and health service visitors (patients) in two accredited clinics and two non- accredited. The interviews were transcribed and data was analyzed using qualitative method of analysis. The results have shown that the accredited clinics are more organized, regularly inspected, and hence patients are more satisfied with the quality of service. However, it was noted that there are common impediments to improvement of health services in all public health clinics, like; poor equipments, old outdated devices, lack of utilities, and insufficient medicine supply; which act as de-motivating factors to most of the health workers. The thesis comes to the conclusion that these common factors point out to the need for wider reforms in the health service sector beyond introducing the accreditation system of public health clinics. These reforms should focus on a considerably more investment in the health service sector to modernize the service as well as improving the incentive system for health workers, improving the processes of purchase and maintenance of equipment, revising the essential drug list, and focusing on patients’ education.


Political Science Department

Degree Name

MA in Public Policy

Graduation Date


Submission Date

May 2013

First Advisor

Abdelhalim, Khaled

Committee Member 1

Elwardani, Nile

Committee Member 2

Ali, Hamid


139 p.

Document Type

Master's Thesis

Library of Congress Subject Heading 1

Medical care -- Egypt -- Cairo.

Library of Congress Subject Heading 2

Public health -- Egypt -- Cairo.


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Institutional Review Board (IRB) Approval

Approval has been obtained for this item


I wish to first thank my supervisor Dr Khaled Abdelhalim for his continuous support and guidance and his insightful ideas, and thank the rest of my committee members; Dr. Nile Elwardani for her valuable discussions and inputs and her commitment to guiding me through writing my research and conducting the alysis and Dr. Hamid Ali for his support and valuable input. I also wish to extend my sincere gratitude to Dr. Hassan Salah, WHO and Dr. Emad Ezzet, MOH, who through their expertise provided me with valuable information and whom without their support I would not have been able to conduct my research. I also wish to thank Dr. Tonia Rifaey, WHO for sharing her expertise with me and guiding me throughout my research. Special acknowledgement to my family: Special thanks to my father who have always taught me the value of education and provided me with unconditiol love and care and who has always been there for me guiding and advising me on critical issues in my life. I am also grateful to my mother who has provided me with a lot of support throughout my life and whom without her I would not have achieved any of my goals. I also wish to extend my gratitude to my husband who supported and encouraged me to complete my masters, and my two lovely boys Hussein and Seif for all the love and positive energy they give me.