Economic Challenges for Enhancing Public-Private Partnerships in Universal Health Insurance in Egypt

Document Type : Original Article

Authors

1 Associate Professor, Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, Egypt.

2 Technical officer at Universal Health Insurance Authority UHIA, Egypt

3 General manager of EHA Port-Said Branch, Egypt.

4 Senior Investment Support Officer at Egyptian Drug Authority, Egypt.

5 Assistant Professor, Financial Economics Department, School of Business Administration, Ahram Canadian University, Egypt.

Abstract

Public-Private Partnerships (PPPs) play a critical role in improving healthcare quality, efficiency, and financial sustainability. In Egypt, the Egyptian Universal Health Insurance (UHI) program, launched in 2018, aims to achieve Universal Health Coverage (UHC). However, Public-Private Partnerships (PPPs) successful implementation faces economic and governance challenges, particularly regarding private sector engagement, strategic purchasing, and service integration.
This study aims to enhance the role of the (PPPs) in the (UHI) system in Egypt by identifying the economic challenges facing (PPPs). The study employs an inductive approach using qualitative methods, incorporating a descriptive approach through a literature review of published research and official data alongside semi-structured interviews with seven purposefully selected public and private sector stakeholders. Data collection focused on economic implications, market conditions, monitoring mechanisms, and implementation challenges.
The findings emphasize that the private sector's major role in enhancing service provision within PPPs, while its contribution to infrastructure development remains limited. The main economic challenges include strict pricing processes, delays in payment mechanisms, inflation rates, and the high cost of accreditation.
Enhancing the role of PPPs within the UHI system requires a well-defined governance framework, value-based pricing, and strategic service integration to strengthen Egypt’s Universal Health Insurance (UHI) system. To boost private sector participation while ensuring financial sustainability, the study recommends adopting well-suited PPP models, such as BOO for specialized services and DBFO for integrated clinical and non-clinical services. Clear regulations, financing strategies, and competitive procurement mechanisms are essential for maintaining cost efficiency, service quality, and equitable healthcare access within the UHI framework.

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