Health

• Introduction 

The individual’s health is one of the basic components of society. It is a necessity for the development of a human being. So it is important to work to protect the individual’s health and prevent diseases by providing the necessary services to early discovery of diseases and to provide full treatment for his recovery from the disease and its complications.

As the health is a human right and access to health care for everyone in line with all the social categories is the responsibility of the state,

And in a general overview the systems of providing the health care in Egypt can be divided into the following: –

• The governmental system
• The private system
• The health insurance system

 And during working with citizens and the work communities and some areas to enjoy the health care services and achieving the social justice to improve the quality of life for them through these available systems several factors that affect the availability of these systems with its different services for citizens were found including:

• Health services needs
• The availability of the possibilities of providing the provided service
• The level and quality of the provided service
• The size of the physical burden on the service applicant
• Psychological satisfaction of the citizen (the patient – his family – the community)
• The availability of a database that can contribute to good planning of health services provided through these sectors
• So the organization had an important role through health programs in the attempt to provide a comprehensive, accessible, available, acceptable, has a suitable cost, continuous and fair health care in partnership with these sectors

 The overall objectives which the program seeks to achieve

The work in the health program aims to reduce the spread of diseases and strengthen the behavior and good health practices and disease prevention and the treatment of the patients and this is in the basis of emphasizing on the rights of citizens.

The work fields

• Reducing the harmful practices and violence against women and enable them to obtain their rights and increase the community awareness of their cases.
• Improve the quality of health services and inflict citizens in the public institutions.
• Health education and early detection of pathogens, prevention from it and its treatment.
• Increasing the numbers of the regular women and practicing the proper health behavior in the areas of reproductive health.

The work strategies in the programs 

The health strategies depends on several key areas, the most important are: –

• Affirming the right of Egyptian citizens in health and social care as a right guaranteed by the Constitution with a commitment to national and international conventions.
• Partnership with the concerned authorities (government sector – the private sector – civil sector) to achieve the objectives
• Raising the level of primary health care preventatively, therapeutically and instructively
• Training and development of different human resources cadres ((local volunteer leaderships – service providers and health units “doctors – nurses – pioneers of health workers – administrators” members of the boards of directors of the partner associations – community organizations such as the elected committees and advocacy committees).
• Motivation and lobbying by the citizens as a methodology of work in the adoption of various health issues
• Expanding the base of beneficiaries and making balance in the availability of the right to enjoy health services, particularly for women and the girl child

The most important targeted categories

The work in the health issues is done in several categories: –

• Direct categories in the care with the right and its availability and enjoying it (Children – girls at the age of circumcision and their families – teenagers and their families – young men and women prospective spouses – women of childbearing age and onwards)
• Indirect categories ((Local volunteer leaderships – service providers in the health units ” Doctors – nurses – pioneers of health workers – administrators ” members of the boards of directors of the partner associations – community organizations such as the elected committees and advocacy committees).

• Some of the categories that are targeted in general, such as ((Local volunteer leaderships – service providers in the health units ” Doctors – nurses – pioneers of health workers – administrators ” members of the boards of directors of the partner associations – community organizations such as the elected committees and advocacy committees).

There are specific categories that be focused on it based on the competent program, for example, (Working with women of childbearing age prospective spouses – teenagers and their families – organizations and individuals actors to change – religious leadership – the media – leaders of local civil societies – girls at the age of circumcision – malnourished children).

 Criteria for the selection of the local leaders working on the programs 

• She or he has an intermediate educational qualification at least.
• Have enough time to work and accept the legal thought and volunteerism.
• From the residents of the work area.
• Preferably has experience and has a willingness to learn.
• Prepared for home visits and have skills in communication.
• Has a good reputation in the area.

The most important outputs of the program 

– Preventive and curative health program (nutrition / detection and analysis campaigns)

• The number of cases of healing children from malnutrition diseases.
• The number of cases from the women mothers of children ending proper nutrition level curriculums.
• The number of cases of prevention and treatment of sexually transmitted diseases.
• The number of cases of early detection and treatment of various diseases (Thoracic – Internal Medicine – Orthopedics – Dentistry – Otolaryngology – Dermatology).

– Reproductive health program (Family planning / Practices are unacceptable for Women (circumcision – violence against women) teenagers’ health / mental health / Ladies care after childbearing age: –

• The number of new regular women.
• The number of cases of accepted practices (female circumcision).
• The number of pregnant women healing.
• Improving the situation of people with psychological illnesses.
• Women healing after child-bearing age from various diseases.
• Teenagers care and improving in their health status.
• The Number of trainees have received specialized training.
• According to the standards of quality of health services at the Ministry of Health.

The indicators of achieving the objectives of the programs

Preventive and curative health program (nutrition): –

There are three standard indicators of which the nutritional status of children is classified: –

• Height for age / weight for height / weight for age)

Reproductive Health Program (family planning/ circumcision / teenagers’ health: –

• Customer satisfaction about the quality of providing the provided health services
• Increase the number of regulars by at least 25% of the services provided

 Quality standards for the program 

Preventive and curative health program (nutrition)

• The evolution of the growth curve by comparing the weight with the age
• Natural percentage of hemoglobin
• women passes the posttest
• Regularity of the women in the classes by at least 75%

The reproductive health program (family planning / pregnant women)

• The continuation of the women in using the means
• The refrain of the cases which exceeded the age of circumcision
• The women surmounting / teenagers / newly married couples / parents of teenagers’ pretest and posttest with the awareness classes.
• Natural percentages (for hemoglobin – albumin sugar – RH for pregnant women).
• Births of children not infected with diseases of malnutrition.
• Healing of the cases that have been examined.
• Trainees acquire the knowledge and skills associated with the target.
• The application of the trainees the skills acquired through training.

 The most important partners 

– Governmental partners

Ministry of Health and Population in coordination with primary health care sector and preventive services and population and family planning sector.

 And this through three levels of service delivery and referral system is implemented through them as follows: –

The first level

(Primary health care) which its services include health education / Maternal and Child Welfare Services / Reproductive health and women’s health and family planning services / fight infectious diseases / fight and treatment of endemic diseases / environmental sanitation / fight the diarrheal diseases in the children

 The second level

Central and public hospitals in the capitals of administrative centers and it offers its services through outpatient clinics and internal departments of various medical specialties.

 The third level of service

Educational and specialized public hospitals in the governorate capitals such as(El Sahel Teaching Hospital – Shubra General Hospital – Abu El Manga Hospital – El Mabarrat Hospital).

 Research centers

• The national institute for endocrine and diabetes.
• National Nutrition Institute.
• National Institute of endemic diseases and liver.

 – The Private sector

• Pharmaceutical companies.
• Volunteer doctors.
• Some food companies.

– Civil society organizations

• Medical centers of civil associations and of the places of worship.
• Egyptian Foundation for the fight against breast cancer.
• El Nadim Center for psychological Health.
• The civil associations’ legal and psychological support centers.
• Association of Friends of diabetics.

– Networks

The network of civil associations working in the field of supporting women’s rights in Egypt.

Legal frameworks and international resolutions and conventions associated with the program

The health in international conventions and treaties

• Article 25 of the Universal Declaration of Human Rights: Article recognizes the right of all persons in adequate standard of living including guarantees relating to health, safety and the health correlation of other rights such as the right to food and the right to housing.
• Article 12 of the International Covenant of Economic, Social and Cultural Rights: States recognize commitment to this Covenant where Article 12 provides for the right of every human to the enjoyment of the highest attainable standard of physical and mental health.
• Article 12 of the Convention on the Elimination of All Forms of Discrimination against Women. This paragraph addresses the guarantees to access to health services without discrimination, including services related to family planning. This paragraph addresses health services related to pregnancy, childbirth and post-natal period and providing free services when needed, as well as adequate nutrition during pregnancy and lactation.
• Charter of the Rights of the Child and the rights of the Arab child Constitution.
• Law No. 12 of 1996, the first comprehensive legislation for the Egyptian child each child protection laws were compiled in this law.

Health in the Egyptian constitution: –

• Article (17) The State shall guarantee social and health insurance services to all the citizens.
• Article (16) The State shall guarantee cultural, social and health services, and work to ensure them particularly to the village in an easy and regular for lifting its level.

 Tools / approaches / documents in the organization / or from outside the organization used

• There are some fixed models that are used such as (Record of the follow up of the cases – The examination books – Transfers’ books – Medicines exchange books).
• Educational materials (Teenagers health guides- Pregnancy care – Endemic diseases and prevention – Circumcision – First aid – Blood contamination diseases – Breast cancer tumors – Sexually transmitted diseases – Patient rights – Sexually transmitted diseases).
• Approaches to raise the awareness (nutrition / sexuality education / family planning / infectious diseases – psychological health – care pregnancy – women care after child bearing age).

Areas expected to expand in the future

• Expected to expand the work of reproductive health program with delve deeper into the work with the category of religious leadership and teenagers and their families for the severe need for it among the citizens as well as the opportunities to provide the support of the Ministry of Health and Population and some financing opportunities
• The expansion of the work in the field of women’s rights support.

The logical steps taken to implement the program

There are major general steps and others linked to the program

The general steps are represented in: –

Develop criteria for the selection of partners / Holding a meeting with the largest number of partners to view the project and its details / Receiving formal approval from the project work partners / holding preliminary meetings with the citizens to view the project and strategies with focusing on the rights approach down to the election of a representative committee of the citizens as a partner party in the project this is followed by a study to identify the needs and design of the project proposal and the signing of the contract and then the implementation in light of the responsibilities and the roles of all the partners

The steps associated with the program are represented in: –

• Determining the standards of the target.
• Determining the administrative and financial systems and models that are used (Record of the follow up of the cases – The examination books – Transfers’ books – Medicines exchange books).

Preventive and curative health program (treatment of malnutrition for children / examination and treatment campaigns)

• Examination by specialists
• The cases obtain of medicines
• The cases Obtain the necessary analysis
• Transfer the cases that need interventions to the most competent authorities
• Repeating the analysis again for the infected cases to make sure from the healing

The follow up of the infected cases (the joining and follow up of the infected children) ..

• The joining is based on comparing the weight with the age.
• Measuring the percentage of hemoglobin.
• Medical examination and diagnosis of the specialist doctor.

The children follow up

• The children come from 3 to 6 times at least to the nutrition clinic during the project period (children follow up is done by a specialist doctor includes continuing medical examination / measuring the weight and height – measuring the percentage of hemoglobin – blood and stool tests and repeating it again – the follow up and recording the results for each case).
• The implementation of the classes activities through (Preparation and processing places of the classes / courses / curriculum / educational methods – appending the targeted to the classes – conduct pre-measuring for the studies associated with the objectives and the curriculum themes – Taking active learning curriculum in ways that emphasize the participation of the learners – follow up to the practical application of the acquired skills).

The reproductive health program (pregnant women / circumcision)

• Perform tests in the beginning of joining
• The women comes to the clinic from 4 to 6 times at least during the pregnancy.
• The targeted obtain the medicines
• Repeat the tests in the last month to measure the percentage of improvement.

Circumcision

• Determining the targeted standards and concerned parties with focusing on (the most serious category of 13 years or less).
• The application of common standards in preparing the curriculum / messages in addition to embedding the health, psychological and social, religious and legal aspects.
• Pretest and posttest conducted for the targeted in the light of the curriculum
• The use of specialists in various aspects
• Follow up and record the results for each case

Family planning

• Determining the targeted standards.
• Determining the administrative and financial systems.
• Determining the procedures and the women obtain the service including (designs that are used – Administrative of the program, such as the card of using a mean signed by the doctor – record book of the regulars).