Egypt

Healthcare

Healthcare is an important aspect of a nation’s human capital. The Organisation for Economic Co-operation and Development (OECD) states that raising the health of the overall population stimulates a country’s economy. According to one estimate, a country that sees an improvement in life expectancy of five years – a reflection of rising health levels – will see its economy grow up to 0.5% faster than one where life expectancy is static.[47]

This section assesses the Egyptian population’s general health; provides an overview of illnesses and diseases in the country; and discusses the prevalence of TB infections and HIV/Aids, as well as treatment initiatives. The availability of healthcare and healthcare practitioners is also discussed.

New-born, infant and under-five deaths

Egypt experienced a large decrease in the number of deaths among new-borns, infants and children under five between 1990 and 2015. The total number of new-born deaths decreased from 64,664 to 35,818 during this period, representing a 44.6% decline. Over the same time, the number of infant deaths dropped by half, from 123,126 to 56,914, and the number of deaths of children under five fell by 60.5%, from 166,650 to 65,775.[48]

Consequently, the mortality rates for Egyptian new-borns, infants and children under five have shown significant improvement between 1990 and 2015. New-born and infant mortality rates declined from 33.4 to 12.8 deaths per 1,000 live births and 63 to 20.3 deaths per 1,000 live births respectively over this period. The mortality rate of children under five dropped from 85.9 to 24 deaths per 1,000 live births over the same period.[49] This is a significant achievement, and indicates that healthcare provision improved over this period.

Table 3.9: Neonatal, infant and under-five mortality rates (deaths per 1,000 live births) (1990–2015)

  1990 1995 2000 2005 2010 2015
Neonatal mortality rate 33.4 26.9 22.3 19.0 15.5 12.8
Infant mortality rate 63.0 49.4 37.0 29.2 24.3 20.3
Under-five mortality rate 85.9 64.6 46.5 35.6 29.0 24.0

Source: World Bank, 2017[50]

Figure 3.9
Source: World Bank, 2017[51]
Figure 3.9: Mortality rates for new-borns, infants and children under five (1990–2015)

The mortality rate of new-borns in Egypt in 2015 was lower than those of Algeria, Morocco, Nigeria and the world average, but higher than South Africa’s. The country’s infant and under-five mortality rates were lower than those of Algeria, Morocco, South Africa, Nigeria and the world average.

Table 3.10: Country comparisons of new-born, infant and under-five mortality rates (deaths per 1,000 live births) (2015)

  Egypt Algeria Morocco Nigeria South Africa World
Neonatal mortality rate 12.8  15.5  17.6 34.3 11.0 19.2
Infant mortality rate 20.3  21.9  23.7 75.7 36.2 31.7
Under-five mortality rate 24.0  25.5  27.6 108.8 40.5 42.5

Source: World Bank, 2017[52]

Diseases

The World Health Organization distinguishes between communicable diseases and non-communicable diseases. Communicable diseases include common colds, influenza, sexually transmitted diseases, cholera, and malaria. Non-communicable diseases are diseases that are acquired through poor hygiene; poor diet, insufficient nutrition or irregular eating patterns; extensive tobacco or drug use; a sedentary lifestyle with little or no physical activity; through genetic mutations; or neurological or psychiatric conditions. Non-communicable diseases include diabetes, respiratory diseases, congenital anomalies, cancer and digestive diseases, amongst others.

According to the World Health Organization, non-communicable diseases are a major cause of death throughout the world, causing many deaths before the age of 60 which could be prevented through timely detection and appropriate treatment and care.[53]

In 2014, approximately 84% of deaths in Egypt were caused by non-communicable diseases (NCDs), with cardiovascular diseases causing 46% of deaths, cancers 14%, respiratory diseases 4%, diabetes 1%, and other NCDs 19%.[54]

Smoking cigarettes or the use of tobacco, unhealthy diets associated with obesity, and hypertension are key risk factors related to NCDs, especially cardiovascular diseases. The Egypt Health Issues Survey 2015 identified several of these risk factors among the population aged 15–59 years:[55]

  • A 20.9% prevalence rate of smoking cigarettes or other tobacco products, with a prevalence rate of 46.4% for males. Approximately half of the population under 15 years is exposed to smoking in the home.
  • Around 1 in 4 women is overweight and 2 in 4 women are obese, while 1 in 3 men is overweight and 1 in 4 is obese. Alarmingly, more than half of the population is overweight and/or obese (76% of women and 61.1% of men).
  • A 17% prevalence of hypertension, with 1 in 3 women and 1 in 4 men being hypertensive.
  • Obese women have a 27.8% prevalence of hypertension, while obese men have a 30% prevalence.
  • Men who smoke cigarettes or any other tabacco products have a 16.6% prevalence of hypertension.
Figure 3.10
Source: World Health Organisation, 2014[56]
Figure 3.10: Deaths by cause in Egypt (2014)

Cardiovascular diseases

The World Health Organisation reported 476 deaths per 100,000 people caused by cardiovascular diseases in 2000, and 445 deaths per 100,000 people in 2012. Over this period, the number of deaths due to cardiovascular diseases decreased by only 6.5%. In 2012, the death rate due to cardiovascular disease was significantly lower among females (388 per 100,000 people) than among males (516).[57]

Figure 3.11
Source: World Health Organisation, 2014[58]
Figure 3.11: Cardiovascular diseases deaths in Egypt per 100,000 population (2002–2012)

HIV/Aids and tuberculosis are discussed below.

HIV/Aids

The most recent data shows that in 2015, approximately 11,000 people were living with HIV in Egypt – an increase from 10,000 in 2014.[59] From 2010 to 2015, the annual number of deaths due to Aids remained below 500 people, while the annual number of new infections increased from 1,000 in 2010 to approximately 1,500 in 2015.[60] In 2015, the estimated HIV prevalence in Egypt among the population between 15 and 49 was less than 0.1%.[61] Though prevalence of the disease is so low, the percentage of people infected with HIV who have access to antiretroviral therapy (ART) medication is minimal, despite it having more than doubled from 8% in 2010 to 19% in 2015.[62] Only around one fifth of those infected with HIV in Egypt are receiving ART treatment.

Table 3.11: HIV/Aids estimates (2015)

HIV/Aids estimates Realistic estimate Low estimate High estimate
Total population living with HIV/Aids 11,000 7,200 19,000
Adults aged 15 and up living with HIV/Aids 11,000 7,000 19,000
Children aged 0–14 living with HIV/Aids <500 <200 <500
Deaths due to Aids <500 <200 <1,000

Source: UNAIDS, 2016[63]

Tuberculosis (TB)

Figure 3.12 shows a staggered decrease in the incidence of TB in Egypt, which declined by almost half from 26 cases per 100,000 people in 2000 to 15 per 100,000 people in 2015.[64]

Figure 3.12
Source: World Bank, 2017[65]
Figure 3.12: Incidence of tuberculosis (per 100,000 people) (2000–2015)

The TB detection rate in Egypt decreased from 61% of TB cases detected in 2000 to 59% in 2015. The TB treatment success rate dropped from 87% in 2000 to 84% in 2014.[66] So, while more than 80% of detected TB cases are treated successfully, the fact that only half of cases are detected suggests that in reality, a far larger number of TB cases go untreated.

Figure 3.13
Source: World Bank, 2017[67]
Figure 3.13: TB detection and treatment success rates (2000–2015)

Over the last 15 years, the TB death rate among HIV-negative Egyptians decreased from 1.6 to 0.24 deaths per 100,000 people. Between 2000 and 2015, the TB death rate among HIV-positive Egyptians increased from 0.01 to 0.02 deaths per 100,000 people.[68]

Figure 3.14
Source: World Health Organisation, 2016[69]
Figure 3.14: TB death rate among HIV-negative and HIV-positive people (2000–2015)

Business impact of malaria, HIV/Aids and TB

The business impact of malaria, HIV/Aids and tuberculosis, as surveyed by the World Economic Forum (WEF) in Egypt, is minimal when compared to the business impact in many other countries.[70] Table 3.12 indicates how Egypt ranks out of a total of 138, compared to Morocco, Nigeria and South Africa.

Egypt ranked 1st out of 138 countries for its impact of malaria and HIV/Aids on business, and 16th for its impact of TB on business, which is far better than in Morocco, South Africa and Nigeria.[71]

Table 3.12: Business impact of malaria, TB, HIV/Aids (2016–2017)

  Egypt Morocco South Africa Nigeria
Business impact of Value Rank/138 Value Rank/138 Value Rank/138 Value Rank/138
Malaria 6.8 1 N/A N/A 5.1 30 3.6 58
Tuberculosis 6.7 16 5.7 69 3.7 130 5.0 91
HIV/Aids 6.9 1 5.7 61 3.4 130 4.5 105

Source: World Economic Forum, 2016[72]

Structure and nature of healthcare

Healthcare practitioners

In 2014, there were 0.84 physicians and 1.48 nurses and midwives per 1,000 people in Egypt. This is significantly lower than the latest figures for the world average of 1.54 physicians and 3.28 nurses and midwives per 1,000 people in 2011.[73]

According to a member of the parliamentary health committee, by late 2016, 377 public hospitals had shut down due to the severe shortage of doctors. Salaries for doctors in Egypt are very low, those working in public hospitals are paid roughly 1,200 Egyptian pounds per     month.[74] As a result, a high percentage of Egyptians living abroad are medical professionals.[75] In December 2016, the government considered introducing a bill aimed at preventing doctors from emigrating. The bill would prevent Egyptian doctors from travelling abroad unless they had spent 10 years serving in the country’s public hospitals.[76]

A further reason why many medical professionals emigrate is because of the lack of adequate infrastructure and equipment in Egyptian hospitals, which often hampers them from doing their work.[77] In some cases, doctors end up buying urgent medical supplies from their own salaries in order to be able to practice.[78]

As a result of the acute nursing shortage, many of Egypt’s private hospitals employ large contingents of foreign nurses from countries such as the Philippines, India, Algeria and     Bulgaria.[79] Many Egyptians shy away from training as nurses because the profession is not well paid, and is not respected, largely due to ignorance about the role of the nurse.[80]

Between 2003 and 2009, the number of physicians per 1,000 people increased almost five-fold. The ratio dropped again sharply to 0.814 in 2014. The number of nurses and midwives per 1,000 people decreased by 28.1% between 2004 and 2014, while the number of dentists rose by 22.2%. In 2014, there were 0.329 pharmacists per 1,000.[81]

Table 3.13: Registered healthcare practitioners per 1,000 people (2003–2014)

Health practitioners 2003 2004 2007 2009 2014
Physicians 0.533 2.604 2.804 0.814
Nursing and midwifery 1.994 1.434
Dentists 0.135 0.165
Pharmacists 0.329

Source: World Health Organisation, 2016[82]

Clinics and hospitals

In 2011, there were a total of 1,702 healthcare facilities in Egypt, with private hospitals accounting for 55% of these. More than half of these (55%) were private hospitals, and just over a third of these (37.8%) were government hospitals.[83] (See table 3.14 and figure 3.15 below.)

Table 3.14: Number and types of healthcare facilities (2011)

Healthcare facilities Number of facilities
Government hospital 643
General hospital 11
Health insurance authority hospital 38
Public university hospital 74
Private hospital 936

Source: Multiples Group, 2015[84]

Figure 3.15
Source: Multiples Group, 2015[85]
Figure 3.15: Distribution of healthcare facilities (2011)
  • Country Profile
  • Introduction
  • Broad Economic Indicators
  • Currency and Exchange Rate
  • Competitiveness and Ease of Doing Business
  • Foreign Investment and Largest Companies
  • Foreign Aid
  • Country Strategic Framework
  • Summary of Economic Conditions
  • Implications, Challenges and Recommendations
  • Population
  • Living Standards and Poverty Levels
  • Healthcare
  • Implications, Challenges and Recommendations
  • Qualifications Profile of the Population and Workforce
  • Levels of Schooling and Basic Education
  • Technical and Vocational Education and Training
  • Tertiary Education
  • Innovation in Egypt
  • Implications, Challenges and Recommendations
  • Labour Force
  • Employment by Sector
  • Employment by Skill Level
  • Employment by Occupation
  • Labour Productivity
  • Unemployment and Job Creation
  • Expatriates, Immigrants and the Egyptian Diaspora
  • Wage and Salary Trends and Social Insurance
  • Industrial Relations Framework
  • Labour Market Efficiency
  • The Fourth Industrial Revolution
  • Implications, Challenges and Recommendations

Socio-Demographic Indicators

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