An interview with Dr. Ahmed Al-Sabki, “Chairman of the Health Care Authority”

Interview with Dr. Ahmed Al-Sabki, “Chairman of the Health Care Authority”

Hama Al-Earth is pleased to conduct this distinguished dialogue with Dr. Ahmed Al-Sabki, “Head of the Health Care Authority, and General Supervisor of the Comprehensive Health Insurance andDecent Life projects in the Ministry of Health and Population.” In this dialogue, we will review the Authority’s efforts to achieve health goals, discuss the challenges it faces, and anticipate its future plans. To ensure a healthy and dignified life for all Egyptians… here are the lines of dialogue.

We would like to start by getting to know the Authority; Its main objectives, and how can the Sustainable Development Goals (SDGs) be achieved through its programmes?

The Health Care Authority is one of the three bodies entrusted with implementing the comprehensive health insurance project, which is a social and solidarity project. It is an Egyptian governmental body with an independent legal personality, reporting to the Minister of Health and Population, and was established pursuant to Law No. (2) of 2018 and its executive regulations, as one of the three main pillars of the new comprehensive health insurance project, which is managed by three main bodies:

• Health Care Authority: The main provider of health services, and it is the state’s main tool in controlling and organizing the provision of comprehensive health insurance system services.
• Comprehensive Health Insurance Authority: responsible for purchasing services strategically and contracting with health authorities from both the governmental and private sides.
• Health Accreditation and Supervision Authority: responsible for issuing quality standards, and also accrediting health facilities, which is a basic condition for entering this system.

The comprehensive health insurance project seeks to achieve the goals of sustainable development, as it ensures the provision of health services with the highest quality standards to all citizens, regardless of social or economic status. Which contributes to improving general health and well-being, and promoting equal access to health care services. The project also depends on cooperation with various local and international partners to strengthen and improve the health insurance system. In this way, the project contributes significantly to achieving the Sustainable Development Goals (SDGs).

The Authority seeks to achieve comprehensive health coverage for all citizens by 2030; Where have we reached, and what are the main steps you are taking to achieve the goal?

The political leadership pays great attention to the health sector, and His Excellency President Abdel Fattah El-Sisi is the historical leader of health reform in Egypt, since he announced the starting signal for the launch of the first phase of the comprehensive health insurance system in Port Said Governorate in July 2019. Port Said was the nucleus of the first phase and the starting point, and now we are in six governorates covering the Canal Region and the South Upper Egypt Region, and the governorates of Port Said included, Luxor, Ismailia, South Sinai, Suez, and Aswan.

His Excellency directed that the timetable – for implementing the comprehensive health insurance system – be compressed to less than two-thirds of the period, so that by 2030 all Egyptians will be covered, and soon the second phase, which is scheduled to take two years, will be in five other governorates, and includes the governorates of Kafr El-Sheikh, Minya, Damietta, Marsa Matrouh, and North Sinai.

The comprehensive health insurance system is based on 8 basic axes and pillars, which are implemented in every governorate scheduled to be qualified to enter the comprehensive health insurance system, and include: strategic planning, infrastructure preparation, medical and non-medical equipment, mechanization and digital transformation, institutional transformation, qualification for registration and accreditation, human resources and training, registration of beneficiaries, opening family medicine files, and awareness-raising. And the media.

Health planning is one of the most important axes, as health planning for family medicine units and centers is based on the absence of geographical barriers, and easy access for citizens to the health service, as the distance between the citizen and the nearest unit does not exceed 5 km, and the distance between the citizen and the nearest family medicine center does not exceed 10 km, dynamic maps and advanced information are used, and the population census is calculated so that the family medicine unit serves 20 thousand citizens, while the center serves 40 thousand Citizen.

As for health planning for hospitals, it depends on the appropriate health service reaching citizens in each governorate, the use of epidemiological maps for each governorate, determining the readiness of infrastructure and information in hospitals in each governorate, in accordance with internationally recognized standards, and specifying a detailed statement of the hospitals affiliated with all the different authorities in each governorate.

We have indeed succeeded in providing the authority’s beneficiaries with more than 45 million medical services of international quality, and providing more than 27 million medical services, through the authority’s family medicine centers and units, in addition to performing 550 various operations and surgeries, including advanced and/or special operations with the latest technologies, in addition to the success of accrediting 232 facilities in the governorates of the first phase, as well as the completion of mechanization and transformation. 100% digital services in family medicine centers and units, and 80% in hospitals.

What challenges has the Authority faced in achieving universal health coverage so far, and how have they been overcome?

One of the biggest challenges we faced at the beginning of implementing the system was the method of providing health services according to the new comprehensive health insurance system. The idea of ​​family medicine facilities – including family medicine units and centers – is the nucleus of the comprehensive health insurance system. Since the family doctor provides 80% of the health service that the citizen needs, we had to change the citizen’s mind about the importance and role of family medicine, and not go directly to the hospital except in emergency cases only, or according to the referral system, according to the medical opinion of the family doctor; This idea contributed to reducing pressure on hospitals.

We also had a big challenge, which was the geographical nature and demographic characteristics of the population of some governorates, such as in South Sinai and Aswan, where they had a special nature in sound health planning, and health re-planning itself differed from one governorate to another, but the citizen felt the difference after implementing the system in its first phase, and re-planning the health sector on a sound scientific basis.

Quality and efficiency in the provision of health services are considered among the priorities announced by the Authority, through which a noticeable qualitative leap in comprehensive health insurance has been achieved. How does the Authority ensure the provision of high-quality and efficient health services to all beneficiaries?

The Health Care Authority is the largest entity in the field of health care in the public and private sectors, and it owns health facilities accredited, according to the various accreditation standards of GAHAR, which are recognized – internationally – by the global organization ISQua, as the number of facilities that obtained the degree of total accreditation reached 135 medical facilities affiliated with the Authority, while the total number of initially accredited health facilities reached 98 facilities in the governorates of implementing the system. Comprehensive health insurance for the six: Port Said, Luxor, Ismailia, South Sinai, Suez, Aswan; This is a total of 233 medical facilities that have various degrees of accreditation.

What are the mechanisms used to monitor and evaluate the performance of health facilities affiliated with the Authority?

The comprehensive health insurance system is based on 3 main bodies, and the new comprehensive health insurance system relies on separating service provision from its financing and control over it; Therefore, the three bodies were established that manage the comprehensive health insurance system. The Health Care Authority is the main provider of the service, and the Health Accreditation and Oversight Authority is the body entrusted with accrediting health facilities, in accordance with the quality standards recognized by the international ESCWA organization, and following up on the application of quality standards within health facilities. As for the Comprehensive Health Insurance Authority, it is the financier of the service.

In addition to self-monitoring represented by the Internal Audit Department, which is responsible for reviewing all procedures that take place within the Authority in all its departments, and we have an evaluation and follow-up department; All of them are tools for self- and internal control in the Authority, to ensure the quality of work outcomes.

The Authority also launched a code of principles and ethics of professional conduct, the objectives of which are to define agreed-upon frameworks to achieve a balance between the rights and duties of the Authority and its employees, and to achieve “Egypt Vision 2030.”

What are the most prominent digital transformation technologies that have been adopted to improve health services, facilitate access to them, and their role in achieving the Sustainable Development Goals (SDGs)?

The automation systems and digital transformation mechanisms within the Healthcare Authority were based on 6 axes, in line with the country’s trends in digital transformation for all government sectors and institutions. To facilitate the provision of services to citizens, and to create secure databases.

It includes the six axes that ensure the accurate and secure information structure within the Health Care Authority in all its branches and facilities, whether the governorates in which the comprehensive health insurance system is implemented currently or in the future, with the phased application of the system in the rest of the governorates of the Republic – the first of which is: creating a unified electronic medical file, to facilitate the patient’s access to health services, and facilitate access to patient data that helps the doctor take the necessary medical measures, and develop a treatment plan after reviewing his medical history EMR, in addition to Human Resources Management, Asset Management, ERP, Electronic Archiving, and finally RCM Claims Management.

To achieve the Authority’s objectives, there is certainly cooperation with multiple parties. What are the most important partnerships that the Authority has concluded with local and international institutions?

The Health Care Authority was keen to benefit from international success partners, with the aim of improving the quality of health service provided to beneficiaries of the comprehensive health insurance system, and achieving leadership in health care. Therefore, we were keen to support the twinning file and partnerships with development partners. For example, but not limited to, the most prominent multilateral development partners were: the World Bank, the European Union, the World Health Organization, and the United Nations Children’s Fund. The most prominent countries with which the Authority was keen to strengthen partnerships were: Japan, France, Sweden, Denmark, and Finland.

The most prominent areas of cooperation were: applying the latest management and operating systems, training health service providers on the latest standards, in addition to continuing to improve the health care system in Egypt, bringing it to a global stage, contributing to providing an attractive infrastructure for investments, applying clinical governance, and improving health care measures, as well as transferring health technology systems, mechanizing medical services, electronic transactions, and transformation. Digital technology, exploiting innovative technologies in the field of artificial intelligence, telemedicine, and technical support for the comprehensive health insurance system. This contributes to the localization of the latest international expertise, the sustainability of service quality, and ensures the provision of distinguished and comprehensive health care for all Egyptians, while these elements together are the pillars of revitalizing investment in the health sector and ensuring its growth.

In addition to strengthening the health tourism program in the Healthcare Authority’s hospitals, this is under the umbrella of the brand “We take care of you in Egypt”, in a professional manner, in accordance with the latest standards, and using the latest digital marketing methods; To achieve the Authority’s vision of placing Egypt at the forefront of the global medical tourism map, because we possess all the elements to be among the leading countries in the field of medical tourism.

How does the Authority support research and development in the field of health, and are there current research projects that the Authority is working on to improve health services?

The Public Authority for Healthcare Research Incubator was launched, to be a vital platform to enhance interaction and exchange of experiences, and to benefit from all available learning opportunities. With the aim of contributing to supporting decision-making in several key areas covering five main axes: health economics, medical research, operating systems, health policies, and public health; This, in turn, will contribute to providing high-quality services, improving the quality of health care, and supporting best practices and modern technologies.

We have a distinguished elite of doctors and consultants who have participated in several research papers around the world and have received international awards and honors. Because we believe that the human resource is the Authority’s most valuable resource, we were keen to train service providers, send them abroad, or bring in experts to ensure the continuity of upgrading human resources, and so far we have provided more than 60,000 training programs to the human cadres working in the Authority.

Health awareness is an integral part of improving public health. What are the efforts made by the Authority in the field of health awareness and education, and dissemination of comprehensive health insurance efforts?

The Authority participated in more than 40 awareness initiatives in comprehensive health insurance governorates, most notably: seminars to raise awareness of the comprehensive health insurance system, mechanisms for subscription and registration in the system, and “Go down and be reassured” campaigns, “You are the support,” “Protect your heart,” “Your health is your wealth,” “Be a hero and fight diseases.” etc. This takes place in conjunction with the presidential initiatives in which the Authority participates, such as the early screening initiative to detect tumors, early detection of hearing loss in newborns, women’s health, kidney disease, and maternal and fetal health. This is in the Authority’s various facilities in the comprehensive health insurance governorates.

What are the most prominent future challenges facing the Authority to complete the comprehensive health insurance system, and how do you see ways to overcome them to achieve the goals?

The first phase of the comprehensive health insurance system put the successes and challenges into perspective, to move forward towards starting the other successive phases. Each stage has its requirements. The second stage includes million-dollar governorates, and this is a major challenge.

What is your personal vision and hopes for the future of the health system in Egypt in light of the Authority’s efforts?

The modern Egyptian health system is based on three important stages, which are: health reform from a technological standpoint, the authority’s vision of developing technological systems in the health care sector – considering that the future of health care will be led by it in terms of service provision – and restoring citizen confidence in government health services, by building a new health care system based on governance, development and technology.

It is planned to use artificial intelligence solutions, which will enable us to predict diseases, accurately and quickly diagnose diseases, analyze big data, improve work efficiency, education, training and medical research, remote diagnosis, draw a genetic map of diseases, and personalized medicine. In a large country like Egypt, it is not possible to launch a project of this gigantic size to achieve comprehensive health coverage except by relying on technology.

In conclusion, we express our deep appreciation to Dr. Ahmed El-Sobki for what he presented – in detail – about the efforts made by the Health Care Authority under his leadership, hoping that this dialogue will shed light on the steps of “Egypt Vision 2030”, and on what the state has achieved in terms of Sustainable Development Goals (SDGs) in the health sector. Especially.