The path towards universal health coverage in the Arab uprising countries Tunisia, Egypt, Libya, and Yemen

The Lancet (Impact Factor: 45.22). 01/2014; 383(9914). DOI: 10.1016/S0140-6736(13)62339-9
Source: PubMed


The constitutions of many countries in the Arab world clearly highlight the role of governments in guaranteeing provision of health care as a right for all citizens. However, citizens still have inequitable health-care systems. One component of such inequity relates to restricted financial access to health-care services. The recent uprisings in the Arab world, commonly referred to as the Arab spring, created a sociopolitical momentum that should be used to achieve universal health coverage (UHC). At present, many countries of the Arab spring are considering health coverage as a priority in dialogues for new constitutions and national policy agendas. UHC is also the focus of advocacy campaigns of a number of non-governmental organisations and media outlets. As part of the health in the Arab world Series in The Lancet, this report has three overarching objectives. First, we present selected experiences of other countries that had similar social and political changes, and how these events affected their path towards UHC. Second, we present a brief overview of the development of health-care systems in the Arab world with regard to health-care coverage and financing, with a focus on Egypt, Libya, Tunisia, and Yemen. Third, we aim to integrate historical lessons with present contexts in a roadmap for action that addresses the challenges and opportunities for progression towards UHC.

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Available from: Mohamad Alameddine, Sep 18, 2014
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    • "One crucial consequence of the growing recourse to private provision is that, despite Tunisia's health insurance coverage, out-of-pocket payments on health care have continued to rise. This has predictably accentuated household vulnerability to sudden economic shocks or longer-term poverty (Arfa and Elgazzar 2013; Elgazzar et al. 2010; Saleh et al. 2014). The result, already evident in recent research, is growing health inequality alongside growing social inequalities (Ben Romdhane and Grenier 2009; Boutayeb and Helmert 2011); indeed recent estimates suggest that health expenditure by households is responsible for nearly one fifth (18 %) of the increase in poverty in recent years (Abu-Zaineh et al. 2013a, b; Elgazzar et al. 2010). "
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