integration of maternal health in new universal health insurance law
Faculty of medicine Banha
Maternal health is the health of women during pregnancy, childbirth and the postpartum period. Safe motherhood is often a positive and fulfilling experience, however, in many women it is associated with suffering, ill-health and even death. (1)
Egypt achieved positive advances in maternal and child health over the past twenty years, however, recent evidence indicates that this progress is beginning to plateau, requiring significant efforts to prevent gains from being lost.
In addition, Demographic and health survey (DHS) 2014 revealed that the total fertility rate starts to increase from 3 to 3.5 births per women since 2008 which poses a major challenge. (2)
There is still wide disparity in maternal and child health across the country, with the areas such as Upper Egypt and other rural areas facing challenges of lack of access to services, increased malnutrition and lack of access to hygiene and sanitation. Women living in Upper Egypt had a more difficult time accessing high-quality maternal care; being twice more likely to die as a result of pregnancy than women in Lower Egypt.
Gender differences in disease burdens and needs must also be acknowledged. Nearly half of Egyptian women who would prefer a female doctor are treated by a male, likely limiting their level of comfort discussing sensitive matters and subsequent uptake of family planning. (3) Women in Egypt are also more likely to be uninsured, illiterate, and have risk factors for NCDs, including obesity and hypertension, raising the need for targeted outreach approaches.
The government has prioritized reproductive, maternal, newborn and child health interventions as an element of its sustainable development strategy. Its aim is to provide comprehensive health services (promotive, preventive, emergency and curative services) for all, through the implementation of the new health coverage law and the primary health care network. (2)
The new universal health coverage law was officially announced on January 2018, it is a unique attempt to regulate the national healthcare sector, ensuring a comprehensive healthcare coverage to all Egyptians. It is also one of the main components of Egypt’s sustainable development strategy (Egypt Vision 2030).
The family is the basic unit of care, and integrated care will be provided through the accredited primary health care units/family health centers, as well as public and private sectors within well-defined packages and referral mechanisms.
It is worth mentioning that reproductive services including maternity care are exempted under the new law which will ensure universality and good quality of care to all pregnant women.