Feasibility of Implementing Universal Healthcare Coverage in Egypt: A Qualitative Study

Background: Universal healthcare coverage (UHC), where a basic package of health services is accessible to the entire population without enduring financial hardships, is currently considered as a global priority and an overarching goal of every healthcare system. As many developing countries, the Egyptian healthcare system suffers from notable inefficiency and failure to meet people basic needs in terms of offering decent and satisfactory health services, and therefore, exploring the potential of implementation of UHC is urgently needed.

Objective: The aim of this study was to assess the applicability of social health insurance (SHI) model as being the equitable right strategy in order to fully implement UHC in Egypt.

Methods: This qualitative study was conducted over a period of 3 months using semi-structured interviews and desk review. A series of interviews were conducted among 20 different stakeholders during six visits. The interviewees were senior experts in a number of national and international organizations concerned with healthcare development. They represented four main groups: Policy makers, service providers, SHI beneficiaries (patients), and NGOs representatives. A framework approach was used to analyse the qualitative data.

Results: Participants identified several factors that affect the implementation of UHC in Egypt based on the strengths and weaknesses of the current Egyptian healthcare system and potential future perspectives.  The main themes highlighted were the challenges faced by the existing SHI system, and barriers affecting tax-financed system.

Conclusion: The study provides supportive evidence that SHI is the right equitable strategy provided that it is implemented appropriately. Concomitant with the new health insurance law presented currently for public discussion, an explicit roadmap for SHI reform taking into consideration pressing challenges is required.