[Changes in health care in the Middle East and North African regions]

A three-day conference, Regional Seminar on Health Sector Development, was held in Cairo in June 1997. Top policy makers from countries in the region Middle East and North Africa were invited. At this conference, the World Bank presented a model aimed at solving the health care problems in this region. Egypt was used to illustrate the current problems. In this country, birth rate and infant mortality are decreasing while the population is increasing. Owing to infectious diseases in children and chronic diseases in the elderly, the demand for health care is great. However, physicians, pharmacists and nurses frequently are poorly trained and more interested in money than in quality of care. Outpatient clinics and hospitals are funded by the government and by major companies. In addition there are private practices. No reliable statistical data are available. What regulation there is, is mostly aimed at users of the health care facilities (to limit the demand for care). The World Bank proposal implied that governments should be less concerned with the provision of care and more with the regulation of care provisions. Care givers' pay should be made dependent on observation of rules still to be defined, for instance with regard to rational treatment protocols. The Netherlands was presented as an example with regard to the (financial) organization of health care. The two countries have been co-operating for years in a number of projects. Hopefully, the expertise of the World Bank and good co-operation between all countries involved will lead to improvement of the health care in the region Middle East and North Africa.