Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Dec 22:10:1045739.
doi: 10.3389/fpubh.2022.1045739. eCollection 2022.

Healthcare system development in the Middle East and North Africa region: Challenges, endeavors and prospective opportunities

Maram Gamal Katoue  1 , Arcadio A Cerda  2 , Leidy Y García  2 , Mihajlo Jakovljevic  3   4   5
Affiliations
Review

Healthcare system development in the Middle East and North Africa region: Challenges, endeavors and prospective opportunities

Maram Gamal Katoue et al. Front Public Health. .

Abstract

Background: Countries in the Middle East and North Africa (MENA) region have been investing in the development of their health systems through implementing reforms to improve health care delivery for their nations. However, these countries are still facing challenges in providing equitable, high quality healthcare services. There is limited published literature supporting the previous and ongoing attempts that have been made to improve health system performance in MENA countries.

Aims: This review aims to describe experiences of health system development efforts in the MENA region, highlight progress, identify challenges that need be addressed and future opportunities to achieve responsive and efficient health systems. It also aimed to provide recommendations to further support these health systems toward evolution and performance improvement.

Methods: A literature review was conducted by searching different databases including PubMed, Scopus, Google Scholar and other electronic resources to identify articles and publications describing health systems development in the MENA region from 1975 to 2022. It also included grey literature, reports and policy and planning documents by international organizations. The identified references were reviewed to extract, analyze, organize and report the findings.

Results: The review revealed emerging evidence describing governmental initiatives to introduce health system reforms at different levels in the MENA countries. These include initiatives targeting the various elements controlling health system reform: financing, payment, organization, regulation and behavior of providers and consumers. There are several challenges facing the health systems of MENA countries including the rising burden of chronic diseases, inequitable access to health services, deficiency in health workforce, shortage in the use of effective health information systems and leadership challenges. The review identified several key areas that can benefit from further improvement to support health system reforms. These include improving the structure, organization and financing of health systems, health workforce development, effective data management and engagement of key stakeholders to achieve adequate health system reforms.

Conclusion: The MENA countries have made significant steps to improve the performance of their health systems; yet achieving a comprehensive health reform will require collaboration of various stakeholders including health policy makers, healthcare professionals, and central to the success of the reform, the patients.

Keywords: MENA; health financing; health outcomes; health reform; health system performance; health workforce.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Visual illustration of the elements of the Flagship Framework.
See this image and copyright information in PMC

References

    1. Mendonca VDM, van Diesen A, Beise J, Lee S, Lian B, Mshvidobadze A, et al. . MENA Generation 2030. Amman: United Nations Children's Fund (UNICEF) Regional Office for the Middle East and North Africa; (2019).
    1. The World Bank . Fairness and Accountability: Engaging in Health Systems in the Middle East and North Africa: The World Bank Health Nutrition and Population Sector Strategy for MENA (2013–2018). Washington DC: The World Bank; (2013).
    1. Plus S. Health Trends in the Middle East and North Africa: A Regional Overview of Health Financing and the Private Health Sector. Rockville, MD: Abt Associates Inc; (2018).
    1. Mate K, Bryan C, Deen N, McCall J. Review of health systems of the Middle East and North Africa region. Int Encyclopedia Public Health. (2017) 4:347–56. 10.1016/B978-0-12-803678-5.00303-9 - DOI
    1. Pierre-Louis AMA, Francisca Ayodeji; Karam, Hadia Samaha. Public Health in the Middle East and North Africa: Meeting the Challenges of the Twenty-first Century. WBI Learning Resources Series. Washington, DC: The World Bank; (2004).