Physicians\u27 motivation in the Ministry of Health and Population - Egypt: challenges and opportunities.

Amidst the different problems encountered at the Egyptian Ministry of Health (MOHP) and Population, the issue of physicians\u27 retention is on the rise. The Egyptian public health system reportedly lost more than five percent of its workforce of physicians in less than three years (2016-2018), as documented by CAPMAS and the Egyptian Medical Syndicate in 2016. Clinicians are not only skipping the practice from the MOHP, but even a number of academic institutions report a decreasing number of candidates interested in pursuing such a previously known attractive career path as faculty in the different schools of medicine. Figures about the increased migration rates of Egyptian doctors are also striking, partly attributable to the various hurdles they face within the MOHP. Adopting a qualitative research approach, the motives of clinicians to practice in the public sector are investigated in this study. Theories and definitions of motivation are explored to explain how motivation starts and what is required to maintain it. The research showed that various factors push and pull Egyptian doctors from practice in the MOHP; their individual motivations highly change due to organizational and cultural conditions. Reported constraints included the challenging career development opportunities, the inadequate infrastructure, as well as inefficient management, and inadequate legislative environment. Doctors’ attrition, shifting to private practice and migration to the Arab and Gulf countries are some commonly encountered consequences of low motivation. Physicians\u27 shortage is an issue in both developing and developed countries. Securing the needed human resources for the health care services is vital. Several policies were developed to bridge this gap, including performance-based financing and training complementary personnel. In Egypt, some measures were adopted such as obliging fresh graduates to fill in the gaps and piloting the delegation of certain tasks to mid-level personnel. However, as the current study indicates, additional expenditure on health is the real step that the Egyptian health system should implement to ensure healthier living conditions for the most underprivileged citizens. Reforms in governance and administration should follow, with changes to medical education and training entities

Population-based rapid assessment of avoidable blindness survey in Sohag governorate in Egypt.

OBJECTIVES: To determine the prevalence and causes of blindness and vision impairment, and the coverage and quality of cataract surgical services, among population aged 50 years and older in Sohag governorate in Egypt. DESIGN: A population-based cross-sectional survey using two-stage cluster random sampling following the rapid assessment of avoidable blindness methodology. SETTING: A community-based survey conducted by six teams of ophthalmologists, assistants and local guides. Enrolment and examination were door-to-door in selected clusters. PARTICIPANTS: Using 2016 census data, 68 population units were randomly selected as clusters (of 60 people) with probability proportionate to population size. Anyone aged 50 years and older, residing in a non-institutional setting in a cluster for at least 6 months, was eligible to participate. PRIMARY AND SECONDARY OUTCOME MEASURES: The prevalence and causes of blindness and vision impairment. Secondary outcomes were CSC and effectiveness and participant-reported barriers to cataract surgery. RESULTS: Of 4078 participants enrolled, 4033 (98.9%) were examined. The age-adjusted and sex-adjusted prevalence of blindness, severe vision impairment and moderate vision impairment were 5.9% (95% CI 4.8% to 6.9%), 4.7% (95% CI 3.8% to 5.7%) and 18.9% (95% CI 16.8% to 21.0%), respectively. Cataract caused most of blindness (41.6%), followed by non-trachomatous corneal opacity (15.7%) and posterior segment diseases (14.5%). Cataract surgical coverage (CSC) for persons for visual acuity <3/60 was 86.8%, the proportion of cataract surgeries with poor visual outcome was 29.5% and effective CSC (eCSC) was 44.9%. eCSC was lower in women than men. The most frequently reported barrier to surgery was cost (51.5%). CONCLUSIONS: The prevalence of blindness in Sohag governorate is higher than districts in other middle-income countries in the region. CSC was high; however, women suffer worse quality-corrected CSC than men. The quality of cataract surgery needs to be addressed, while health system strengthening across government and private settings could alleviate financial barriers

Employing People with Disability in Egypt / توظيف ذوي الإعاقة في مصر

The main purpose of this paper is to develop an integrated approach to enable a business environment for PwD in Egypt. It examines legal and social aspects of the issue in Egypt and other countries, and suggests policy alternatives to increase the chance of PwD to reach decent jobs

Population-based cross-sectional prevalence survey of diabetes and diabetic retinopathy in Sohag—Egypt, 2019

Objectives To determine the prevalence of diabetes mellitus (DM), prevalence of diabetic retinopathy (DR) and sight-threatening conditions among persons with DM aged 50 years and older in Sohag governorate in Upper Egypt.Design Population-based, cross-sectional survey using the standardised Rapid Assessment of Avoidable Blindness with the addition of the Diabetic Retinopathy module methodology.Settings Sohag governorate in Egypt where 68 clusters were selected using probability proportional to population size. Households were selected using the compact segment technique.Participants 4078 people aged 50 years and older in 68 clusters were enrolled, of which 4033 participants had their random blood sugar checked and 843 examined for features of DR.Primary and secondary outcomes The prevalence of DM and DR; secondary outcome was the coverage with diabetic eye care.Results The prevalence of DM was 20.9% (95% CI 19.3% to 22.5%). The prevalence in females (23.8%; 95% CI 21.4% to 26.3%) was significantly higher than in males (18.9%; 95% CI 17.1% to 20.7%) (p=0.0001). Only 38.8% of persons diagnosed with diabetes had good control of DM. The prevalence of DR in the sample was 17.9% (95% CI 14.7% to 21.1%). The prevalence in females was higher (18.9%; 95% CI 14.0% to 23.8%) than in males (17.1%; 95% CI 13.0% to 21.2%). Up to 85.3% of study participants have never had eye examination. Sight-threatening DR (R4 and/or M2) was detected in 5.2% (95% CI 3.4% to 7.0%) with only 2.3% having had laser treatment.Conclusion The prevalence of uncontrolled DM in Sohag governorate in Egypt is higher than the national prevalence. There is a high prevalence of sight-threatening retinopathy and/or maculopathy with few people having access to diabetic eye care. A public health approach is needed for health promotion, early detection and management of DR