Abstract

The right to health is a fundamental human right, medications constitute a vital component of any health system worldwide. Hence, access to medicines is one entitlement of the right to health, and governments pay increasing concerns to improve equitable access to healthcare and medications among all citizens. Egypt is a middle income country, with tight resources and capabilities to spend on health, and a pluralistic and fragmented healthcare system. Therefore, aggravated challenges are facing the government towards the achievement of the "Health for all" constitutional right. Identifying where inequalities exist, and monitoring their change over time, is a major prerequisite towards creating an equity-oriented health sector. Therefore, Egypt Health Issues Survey from 2015 was used to assess the situation of equitable access to healthcare as represented in treating the Non Communicable Diseases, and to gauge the extent to which the different socio-economic determinants impact access to medications among NCD patients. Only 69.2% of the population of NCD patients in the age range (15-59 years) have a complete access to NCD treatment, while the other 30.8% have incomplete access to treatment. Irrespective of age, gender, place of residence, income, education, marital and employment status, private facilities were the provider of choice, for receiving NCD(s) care and treatment. Hence, NCD patients incur higher financial burden; the average out-of-pocket spending on treatment in a private health care facility is 3.5 times more than in a governmental healthcare facility. NCD treatment is an essential treatment that should be accessible for all patients irrespective of their age, sex, place of residence, economic status, etc. However, significant inequalities in accessing NCD treatment were detected among the different social groups, where complete access to NCD treatment is skewed against the poor, young-aged, males and those living outside Urban Governorates. Inequalities in the different socioeconomic factors impacted the inequality in accessing treatment with varying degrees; the main determinant is wealth, responsible for over 90% of the detected inequality; followed by education, age, and type of place of residence. Generally, policymakers should work on improving the overall population access to NCD treatment through improving medications availability and affordability at both private and governmental healthcare facilities, and special programs should target underprivileged groups. The results and inequality data generated from this research should provide a foundation for incorporating equity into evidence-based health planning, and also assessing whether current health initiatives promote equity in accessing treatment.

Department

Public Policy & Administration Department

Degree Name

MA in Public Policy

Graduation Date

2-1-2020

Submission Date

May 2019

First Advisor

Shawky, Sherine

Committee Member 1

Rashad, Hoda

Extent

78 p.

Document Type

Master's Thesis

Rights

The author retains all rights with regard to copyright. The author certifies that written permission from the owner(s) of third-party copyrighted matter included in the thesis, dissertation, paper, or record of study has been obtained. The author further certifies that IRB approval has been obtained for this thesis, or that IRB approval is not necessary for this thesis. Insofar as this thesis, dissertation, paper, or record of study is an educational record as defined in the Family Educational Rights and Privacy Act (FERPA) (20 USC 1232g), the author has granted consent to disclosure of it to anyone who requests a copy.

Institutional Review Board (IRB) Approval

Not necessary for this item

Comments

I would like to acknowledge with gratitude the Social Research Center of the American University in Cairo and the generous contributions of the FORD Foundation for giving me this valuable opportunity to participate in the training course, and pursuing the Professional Diploma Degree in the Research Methods and their Applications in Guiding and Evaluating Policies.

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