An interview with Dr. Abla Alfi, “Deputy Minister of Health and Population for Population Affairs”
Interview with Dr. Abla Alfi, “Deputy Minister of Health and Population for Population Affairs”
The development of Egypt’s population in the past hundred years has been rapid, and this has multiple dimensions, especially the dimension related to the Demographic Health Survey, which confirms that there is a relationship between population size and health level. Therefore, Egypt launched the National Strategy for Population and Development 2023-2030, in compliance with the directives of President Abdel Fattah El-Sisi to place the issue of population and development at the top of the national priorities.
On this strategy and its role in reassessing the population situation with its health outcomes, an interview withEarth Guards Dr. Abla Alfi, “Deputy Minister of Health and Population for Population Affairs.” In this dialogue, we will look through her vision - the vision that contributes to the management of this vital file - at the population as a comprehensive force for the state, and how to improve population characteristics in a way that supports public health.. So to the lines of the dialogue.
How do you see the role of the Ministry of Health and Population in achieving the Sustainable Development Goals (SDGs) in light of the national agenda “Egypt Vision 2030”?
The National Population Strategy - which was launched last year - laid out the basics of dealing with the population issue from a completely different perspective than what was usual in previous thought mechanisms on the population issue. Today, we have become more focused on population characteristics. Our focus is no longer on the number of births only; Hence, we can achieve distinct demographic characteristics, according to what we approach from a human rights perspective that works to space out the times of successive pregnancies, from three to five years.
We believe in the freedom of every couple to decide when to have children or not, and we believe in their right to determine the number of children they wish to have, but this must be based on science and be an informed decision. Therefore, we at the Ministry of Health and the National Population Council took it upon ourselves to raise the family’s awareness and provide information that helps them make an informed decision regarding when to have children, while paying attention to the period between the birth of one child and another, which is the golden period of a thousand days in the first two years of the child’s life.
From this perspective, we can maximize all the characteristics of the Egyptian person, and this means that he has the best health capabilities, and that he has mental capabilities. Then he acquires skills and shines in acquiring knowledge and learning as a citizen and human being capable of production and able to give to Egypt.
We based this perspective on an old problem, which is that people in Egypt believed that the best time interval between two pregnancies was two years or less. However, science has proven the error of this belief, and has confirmed that this narrow time distance causes a child to suffer from autism four times more than a child who has three or five years between him and his brother, and this group of children is also affected by stunting three times more than children who are born between them and him. Their siblings are three years old, and the mother suffers from anemia. Because she did not have enough time to recover and reconstitute her body. During this period, the child is deprived of his most important rights, which is the right to breastfeeding. If a woman becomes pregnant one year after giving birth, she will not be able to breastfeed her child for two years, especially the second year, which is responsible for the maturity of the eyes, visual acuity, and mental clarity.
So, we worked to maximize the spacing between successive pregnancies from three to five years, and we also worked to educate the family about the importance of avoiding early marriage. Because this prevents a girl from living her childhood, which is the childhood that is known and estimated at approximately 18 years, where her right to enjoy her childhood is violated, and when she marries young, she is thus a child raising a child, which is inhumane, as the responsibility of a family is imposed on her without her realizing the dimensions and meanings of the family.
After that, the result is divorce or the disappearance of the husband for any reason, leaving her with a child without official papers in many cases; Then this child becomes without health care, least of all access to vaccinations, or any other rights, and then the wife is forced to register her child in the name of her father or brother, so the issue turns from a problem of early marriage to a problem of lineage mixing. We have seen many examples of this social complexity, and the subsequent financial problems that the mother falls into, as she becomes without a source of livelihood and is unable to raise her child well. Her life and the life of her child are destroyed.
For all of this, we have adopted in the population file the elimination of early marriage and pregnancy, and we are also working to combat illiteracy, especially among girls. Because the rate of illiteracy among them is high, and it is illiteracy that prevents the girl from making sound decisions, or from saying no. Whoever depends on others is not free. The third issue is the issue of the high unemployment rate among women, and we are addressing this through an integrated file in the National Population Council in cooperation with the Ministry of Health and all relevant ministries, international institutions and national councils.
Regarding the law regulating the granting of public facilities’ obligations to establish, manage, operate and develop health facilities, issued No. (87) of 2024 - What are the expected results of this law to develop the health sector?
I consider this law a gift to the Egyptian people, as it is based on developing health facilities, supporting their infrastructure, providing them with advanced medical equipment, helping them to accommodate large numbers of citizens, and raising the quality of services provided to them, provided that the low-income people have a share of treatment at the state’s expense, and as for those who can afford the costs of treatment, the medical facility for them will be a private facility.
Hence, we work - in accordance with this law - to provide the necessary management for such facilities, and to support them financially in agreement with the state, and within the limits of the law between a period of 3 and 15 years, then - after the end of the usufruct contract - the ownership of these facilities and the equipment they contain returns to the state. As for the doctors who will not be retained by the state, they will have their full financial and employment rights and be transferred to other places.
Are there new efforts regarding the use and expansion of the concept of telemedicine and the provision of medical consultations via the Internet, as two methods of health sector governance?
Telemedicine has its basics, and one of the basics of the national program launched by the President of the Republic for telemedicine is that there be a doctor close to the case, and as for the other doctor who follows up on the case remotely, he can view the case reports and its X-rays while he is in another place, where he can make a medical decision regarding the condition he diagnoses remotely by communicating between himself and the other doctor; That is, the direct processor.
We were able to apply this method in nurseries, but it is a dangerous method that relies on a non-comprehensive vision. If a child vomits - for example - this could be due to normal cold symptoms, or it could be due to meningitis, which requires an urgent medical procedure called a “spinal tap”, using antibiotics, otherwise the child will end up with a disability. Therefore, Egypt followed an international system within the framework of the presidential initiative, which is to have integrated cooperation between the doctor directing the case and the doctor who follows it up remotely.
What about the amendments made to the National Population and Development Strategy, and what are the expected achievements of this strategy?
It was expected that the implementation of the National Population and Development Strategy would be completed in 2030, but we saw the acceleration - in accordance with the instructions of the Prime Minister - in its implementation. Therefore, we are working to launch an urgent plan that was studied by professors and members of the Ministerial Committee for the National Population Strategy, and it was also studied by His Excellency the Minister of Health and Population, and this launch will take place - God willing - within the next ten days.
How can initiatives - such as the “Golden Thousand Days” - contribute to building new generations that are physically, psychologically and socially healthy?
The “Golden Thousand Days” is the heart of Egypt’s health, and it is the fertile land that produces Egyptian citizens at the highest level. The world has viewed it as the best investment project in the entire world. Because it invests in people by 85% at a stage that people do not usually pay attention to; I mean infancy and childhood, as this is the most important stage in which we must focus on our children.
I repeat once again that this stage - the golden day of the thousand - is extremely important. The couple must prepare healthily - so that they can build a healthy family - by postponing the first pregnancy for a year; In order to explore their social relationship, and the possibility of providing a suitable environment to raise a healthy and psychological child, treat anemia, and for the wife to take folic acid. To prevent congenital malformations, and for the couple to treat urinary and reproductive infections, and to control blood pressure and sugar.
After that, the wife must take care of her health, and enjoy a safe pregnancy period, while taking iron medications, vitamins, and good nutrition. In order to take positive care of her child, she must learn all the skills and knowledge that can help her care for her child and breastfeed him. In addition, the birth must be a natural birth, unless there is a medical reason - this is about 15% of birth cases - that requires a cesarean section.
In 2018, Mr. President launched 100 Million Health, from which a number of important initiatives emerged; What are the most notable achievements of these initiatives to date?
It is common that the “100 Million Health” initiative is linked to eliminating the “C” virus, and eliminating this virus was the best thing that Egypt achieved, in saving many families from its dangers. If the Ministry of Health had nothing other than this achievement, it would be enough for it to be proud. It is an achievement equal to the future of a country!
A number of initiatives fall under this great initiative, such as maternal and child health initiatives, or maternal and fetal health initiatives, kidney disease, early diagnosis of breast tumors, as well as the Golden 1000 Days, and the diagnosis of hearing loss in newborns, who must be careful not to be negligent in screening for their hearing, so that serious problems do not occur to them, especially if they become two years old, as we will not be able to help them.
Presidential initiatives have developed a network of public health basics for the Egyptian citizen, and in the Ministry of Health we hope that all the outcomes of presidential initiatives will be based in primary health care and therapeutic medicine, considering that these are an essential part of the services provided in the Ministry of Health, and this is what His Excellency the President of the Republic always recommends, and that every presidential initiative - with its outcomes - will be at the top of the services provided in the Ministry. Health.
Mr. President launched the Bedaya Initiative under the slogan “A New Beginning for Human Building.” What is the role assigned to the Ministry of Health in this initiative, and what are the targeted results?
There is no beginning without health; Therefore, the basis for the beginning is sound health for every Egyptian citizen, and this is what called on the Deputy Prime Minister and Minister of Health and Population - His Excellency Dr. Khaled Abdel Ghaffar - to think about the first steps of this national project, as we started with the life line, specifically from the age of minus one, and by this we mean pre-marital counseling until the age of 65 and above, the first of which is the first six years, which is the beginning of the stage that we call the golden beginning. Therefore, we at the Ministry of Health focus on every child born in Egypt, so that he can obtain his health rights, and this is in cooperation between us and the Ministry of Education. So that he gets his right to go to nursery, and we also cooperate with the Ministry of Social Solidarity. So that he receives the necessary social care, and we also cooperate with the Ministry of Youth and Sports. So that the child can practice sports, and we cooperate with the Ministry of Culture; To develop his mind, and even Al-Azhar, the Endowments, and the Church are all cooperating with us in implementing this national initiative.
In conclusion, what are the most important files expected to be dealt with in the coming period?
There is no file more important than the population issue, as it is the first issue that considers the future of the entire country in terms of development, citizens and the economy. Therefore, our main concern in the Ministry of Health and the National Population Council is success in this file, and we will succeed and, God willing, make a qualitative leap. To achieve the desired goals before the end of its time plan.
The second file is the ideal upbringing for the Egyptian citizen. Therefore, we worked to maximize population characteristics, and follow the method of spacing between births, while supporting them healthily, educationally, and economically. The result will be the well-being of the citizen, which will ultimately be confirmed by the Sustainable Development Index and the Human Development Index, and with all the efforts Egypt has made, we will - God willing - rise to very high levels in such indicators, and compete with developed countries.
