Cash transfers and state-citizen relation in Egypt: Takaful and Karama in a development context

The purpose of this study is to find out how the new cash transfer program, Takaful and Karama, implemented by the Egyptian government is affecting the relationship between the Egyptian state and its citizens. This is done through depicting the accounts of the two main actors in this relation: the state and its citizens. In the quest for achieving the objective of this study, a qualitative approach is being applied through using content analysis to depict the account of the state and semi-structured interviews to depict the accounts of the beneficiaries of and the applicants to the program. The study first puts this new cash transfer program in a broader context through examining its relation to the current economic, social and political-economic scene in Egypt. In a second step, the study finds how the beneficiaries of and applicants to the program interact with the state and how they perceive some aspects of the program such as conditionality and means-testing. In a final and third step, the study finds the effect of this new cash transfer program on the relationship between community and family members. Three main findings are derived from this study. The first finding is that the social policy in Egypt is ending more and more to be a liberal residual policy that is consisted of a number of palliative measures which are constituting what is called a social safety net. The aim of this net is to offset the effects of the economic reform policies on those who are conceived to be the deserving destitute. The rest of the population are asked to provide for themselves in the market. Cash transfers are being used as if they are the magic bullet for development and complementary policies are being missed. Macroeconomic stability is becoming the overriding goal to which all other goals, job creation and income protection, are subordinated. The second finding is that while people do not consider means-testing and conditionality as intrusive they tend to have their own ways to deal with means-testing and targeting. Personal discretion and human intervention will always be there and technology cannot be the cure for such defects especially in a context where informality is the norm. The third finding is that targeting is creating a state of competition and envy among community and family members. People tend to compete over the scarce resource and power relations will continue to play a role in such context

After COVID-19: Mitigating Domestic Gender-based Violence in Egypt in Times of Emergency

In times of crises and emergencies, violence against women tends to increase. The outbreak of COVID-19 has resulted in severe precautionary measures such as social isolation, physical distancing, staying at home, curfews and lockdowns, which brought “normal” life to a halt and created a temporary convergence between the public and the private. The pandemic has forced the global community to turn its gaze back to the private, and compelled them to pay attention to the old/new problem of gender-based violence, particularly, domestic violence that spiked during the pandemic. Against such a backdrop, and using a critical feminist lens that analyzes the historical socio-political roots of the problem, this paper revisits the national structures, mechanisms, strategies and policies that address gender-based violence in Egypt. Data for this paper was collected through various methods to measure and analyze domestic violence in Egypt. These included qualitative research tools such as expert interviews in addition to secondary data such as literature review on the policy problem, and a desk review of the official data, relevant laws, policies, and law enforcement practices related to domestic violence. This policy paper argues that while COVID-19 exacerbated a set of deeply-seated problems that have limited the efficacy of national policy interventions, it provided a rare opportunity for a comprehensive reassessment of the national structures of gender-based violence reporting, socio-legal interventions, and risk-mitigation. The paper further argues that while the current policies, institutions, laws and efforts have taken into consideration some of the particular challenges presented by COVID-19 in addressing domestic violence in Egypt, there remains room for more interventions that are sensitive to the root causes of the problem through a set of policy measures. The paper focuses on emergency services during COVID-19 through a close-up analysis of the efficacy of state-run shelters for survivors of domestic violence. Shelters continue to be globally recognized as one of the main tools for mitigating domestic violence. With that in mind, the paper analyzes the main challenges facing service providers of Shelters in Egypt and the gap that exists between international and national standards. While critical of the UN calls for combatting domestic violence worldwide without providing member states with the necessary resources or technical aid to do so, this paper demonstrates how a combined lack of resources, along with a set of complex legal loopholes and socio-cultural set of gendered beliefs about women’s role in the family unit render shelters practically useless as tools to tackle domestic violence in Egypt. COVID-19 did however, highlight the importance of the private sphere to the economic and social realms and its life sustaining role worldwide, thus making interventions to combat domestic violence both a policy and public health necessity. The paper concludes with a number of short, medium and long-term recommendations to combat domestic and gender-based violence on a national scale in Egypt post COVID-19

Sinteza i antimikrobno djelovanje fuzioniranih heterocikličkih pirola

Pyrrole derivatives 1a,b were used as precursors for the preparation of pyrrolo[2,3-d]pyrimidine derivatives 2a,b-7a,b. Also, the formation and structure of different pyrrolotriazolopyrimidine derivatives 8a,b-11a,b were discussed. Some of the prepared products showed potent antimicrobial activity.Pirolni derivati 1a,b upotrebljeni su kao prekursori za pripravu derivata pirolo2,3-dpirimidina 2a,b7a,b. Diskutirano je i nastajanje i struktura različitih derivata pirolotriazolopirimidina 8a,b11a,b. Neki od sintetiziranih spojeva posjeduju izraženo antimikrobno djelovanje

Optic nerve head perfusion changes in eyes with proliferative diabetic retinopathy treated with intravitreal ranibizumab or photocoagulation: a randomized controlled trial

Background: Proliferative diabetic retinopathy (PDR) is a serious sight-threatening disease, and half of the patients with high-risk PDR can develop legal blindness within 5 years, if left untreated. This study was aimed at comparing panretinal photocoagulation (PRP) and intravitreal ranibizumab injections in terms of radial peripapillary capillary (RPC) density on optical coherence tomography angiography (OCTA) in patients with treatment-naive PDR.  Methods: This open-label, prospective, randomized clinical trial included 50 patients with treatment-naive PDR with optic disc neovascularization and randomized them into two groups: group 1, with patients undergoing two sessions of PRP 2 weeks apart, and group 2, with patients received three intravitreal ranibizumab injections (0.5 mg) 1 month apart for 3 consecutive months. Patients underwent a full ophthalmological examination, including best-corrected distance visual acuity (BCDVA) measurement in the logarithm of minimal angle of resolution (logMAR) notation and OCTA before intervention and monthly after the last laser session or the first intravitreal ranibizumab injection for 3 months of follow-up. Visual field (VF) was tested at the beginning and end of 3 months.   Results: Forty-two (84%) eyes completed the 3-month follow-up, including 22 eyes in the PRP group (88%) and 20 (80%) eyes in the ranibizumab group. The two groups were comparable in terms of demographic characteristics, diabetes duration, baseline BCDVA, glycated hemoglobin level, OCTA parameters, VF indices, and intraocular pressure (all P > 0.05). The RPC density change from baseline to the 3-month follow-up was significantly lower in the PRP group than in the ranibizumab group (mean difference in RPC density change: - 3.61%; 95% confidence interval: - 5.57% to - 1.60%; P = 0.001). The median (interquartile range) logMAR change from baseline to the 3-month follow-up (0.0 [0.2]) was significantly higher in the PRP group than in the ranibizumab group (- 0.15 [0.3]; P < 0.05). The median changes in central foveal thickness from baseline to the 3-month follow-up differed significantly between the two groups (P = 0.001). Conclusions: In eyes with PDR and neovascularization of the disc RPC density on OCTA increased in the ranibizumab group and decreased in the PRP group. Visual acuity gain was higher in the ranibizumab group than in the PRP group. Future multicenter trials addressing our limitations are required to verify the findings of this study

Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: findings from the Global Burden of Disease Study 2013

Moradi-Lakeh M, Forouzanfar MH, Vollset SE, et al. Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: findings from the Global Burden of Disease Study 2013. Annals of the Rheumatic Diseases. 2017;76(8):annrheumdis-2016-210146

Future and potential spending on health 2015-40 : development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Background The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. Methods We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted. Findings We estimated that global spending on health will increase from US$9.21 trillion in 2014 to$24.24 trillion (uncertainty interval [UI] 20.47-29.72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5.3% (UI 4.1-6.8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4.2% (3.8-4.9). High-income countries are expected to grow at 2.1% (UI 1.8-2.4) and low-income countries are expected to grow at 1.8% (1.0-2.8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and$195 (157-258) per capita in 2040. Increases in national health spending to reach the level of the countries who spend the most on health, relative to their level of economic development, would mean $321 (157-258) per capita was available for health in 2040 in low-income countries. Interpretation Health spending is associated with economic development but past trends and relationships suggest that spending will remain variable, and low in some low-resource settings. Policy change could lead to increased health spending, although for the poorest countries external support might remain essential.Peer reviewe

Future and potential spending on health 2015-40: Development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Background: The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. Methods: We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted. Findings: We estimated that global spending on health will increase from US$9.21 trillion in 2014 to$24.24 trillion (uncertainty interval [UI] 20.47-29.72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5.3% (UI 4.1-6.8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4.2% (3.8-4.9). High-income countries are expected to grow at 2.1% (UI 1.8-2.4) and low-income countries are expected to grow at 1.8% (1.0-2.8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and$195 (157-258) per capita in 2040. Increases in national health spending to reach the level of the countries who spend the most on health, relative to their level of economic development, would mean $321 (157-258) per capita was available for health in 2040 in low-income countries. Interpretation: Health spending is associated with economic development but past trends and relationships suggest that spending will remain variable, and low in some low-resource settings. Policy change could lead to increased health spending, although for the poorest countries external support might remain essential