Externe Publikationen

Social protection for better health in Arab countries

Loewe, Markus
Externe Publikationen (2026)

DOI: https://doi.org/10.1093/oxfordhb/9780197761465.013.0030
Information

After World War II, countries in the Middle East and North Africa (MENA) started from low levels of socioeconomic development. Especially health indicators were worse than in most other world regions. This changed drastically when MENA countries became independent and started to invest into the social protection of citizens against health risks. They built up powerful social health insurance schemes, and today, many of their health indicators are almost on the same level as in Europe or North America. During the 1980s and 1990, however, most MENA governments reduced healthcare spending again as an element of structural adjustment programs, and focused increasingly on health services that are particularly important for the urban upper and middle classes, their main allies in society, but not so much for the poor. Therefore, MENA health systems suffer again from significant deficits regarding fairness, efficiency, and effectiveness. Financial, legal, and geographical obstacles restrict access for large parts of the population. The coexistence of multiple social protection schemes for different population groups reflects and intensifies already existing social inequalities. Deficits in quality and tidiness and the prevalence of informal fees charged for “good” treatment reduce further the value of public health services. Efficiency suffers from irrational prioritizations in fund allocation and from a lack of customer orientation. And the effects of MENA health systems, although not really bad, could still be better, which has become more than obvious during the recent COVID-19 pandemic.