Health status and health systems financing in the MENA region: roadmap to universal health coverage

Abstract

BackgroundSince the declaration of the Millennium Development Goals (MDGs) in 1990, many countries of the Middle East and North Africa (MENA) region made some improvements in maternal and child health and in tackling communicable diseases. The transition to the global agenda of Sustainable Development Goals brings new opportunities for countries to move forward toward achieving progress for better health, well-being, and universal health coverage. This study provides a profile of health status and health financing approaches in the MENA region and their implications on universal health coverage.MethodsTime-series data on socioeconomics, health expenditures, and health outcomes were extracted from databases and reports of the World Health Organization, the World Bank and the United Nations Development Program and analyzed using Stata 12 statistical software. Countries were grouped according to the World Bank income categories. Descriptive statistics, tables and charts were used to analyze temporal changes and compare the key variables with global averages.ResultsNon-communicable diseases (NCDs) and injuries account for more than three quarters of the disability-adjusted life years in all but two lower middle-income countries (Sudan and Yemen). Prevalence of risk factors (raised blood glucose, raised blood pressure, obesity and smoking) is higher than global averages and counterparts by income group. Total health expenditure (THE) per capita in most of the countries falls short of global averages for countries under similar income category. Furthermore, growth rate of THE per capita has not kept pace with the growth rate of GDP per capita. Out-of-pocket spending (OOPS) in all but the high-income countries in the group exceeds the threshold for catastrophic spending implying that there is a high risk of households getting poorer as a result of paying for health care.ConclusionThe alarmingly high prevalence of NCDs and injuries and associated risk factors, health spending falling short of the GDP and GDP growth rate, and high OOPS pose serious challenges for universal health coverage. Using multi-sector interventions, countries should develop and implement evidence-informed health system financing roadmaps to address these obstacles and move forward toward universal health coverage.

Prevalence, Determinants, and Effects of Food Insecurity among Middle Eastern and North African Migrants and Refugees in High-Income Countries: A Systematic Review

“…The Middle East and North Africa cover an extensive geographic region stretching from Morocco to Iran, involving 20 countries [ 14 ]. Since the 1960s, the ongoing conflicts and a variety of divisions in MENA have significantly altered the stability in the region [ 14 , 15 ], leading to a situation where a substantial proportion of refugees all over the world being from MENA countries. The UN High Commissioner for Refugees (UNHCR) states that about two-thirds of refugees (67%) come from Syria (6.7 m), Afghanistan (2.7 m), South Sudan (2.3 m), Myanmar (1.1 m), Somalia (900,000), Sudan (725,000), and the Democratic Republic of the Congo (720,300) [ 14 ].…”

“…However, studies involving migrants/refugees from MENA countries were relatively few compared to those involving older immigrant populations or populations from other regions in the world (e.g., Liberians [ 22 ], and Cambodians and Brazilians [ 23 ] in the USA, and Latinos in Canada [ 24 ]). According to Asbu et al [ 15 ], there are gaps in knowledge about the health status of MENA migrants who have recently arrived in HICs. It is only in comparatively recent times that researchers have sought to investigate experiences of the migrant and refugee arrivals in terms of food insecurity, nutrition, and health [ 6 ].…”

Evaluating hospital websites in Kuwait to improve consumer engagement and access to health information: a cross-sectional analytical study

“…It is clear from the expenditure data that the public healthcare system in Kuwait is heavily reliant on treatment as opposed to preventative services [ 26 ]. The alarming rates of non-communicable and chronic diseases pose serious challenges for the government [ 28 ] and demand better patient engagement and education via accessible means in todays’ connected world (i.e. online health-related websites).…”

Productivity change of national health systems in the WHO Eastern Mediterranean region: application of DEA-based Malmquist productivity index

“…The healthcare system constitutes a small part of the economies of most countries in the Eastern Mediterranean Region (EMR) with the total expenditures on health (TEH) as share of gross domestic product (GDP) being much lower than global averages [ 1 ]. The region is faced with high burden of communicable and non-communicable diseases (NCDs).…”