The Libyan National Health Care SystemThe Libyan National Health Care SystemOverview and SWOT AnalysisOverview and SWOT Analysis

By: Ghada Elmasuri By: Ghada Elmasuri Department of Oral & Maxillofacial SurgeryDepartment of Oral & Maxillofacial Surgery

Tripoli Medical CenterTripoli Medical Center

The Libyan National Health Care The Libyan National Health Care SystemSystem

Country profile The Health

System Health

Indicators SWOT Analysis Health priorities Conclusion References

Country Country ProfileProfile

The 4th largest African country (1.775 million sq.km)

Located in the center of North Africa, with the longest Mediterranean coastline of about 2000 km.

Bordered by Egypt, Sudan, Chad, Niger, Algeria and Tunisia.

Country ProfileCountry Profile

Capital : Tripoli (Tarabulus) pop. est. 1.68 million

Natural Natural ResourcesResources

Oil is the backbone of the Libyan economy, natural gas, gypsum

An OPEC member and holds the largest oil reserves in Africa

Population & DemographyPopulation & Demography

Population (in millions)

Selected Years, 1960–2009

1.3 19602.0 19703.0 19804.3 19905.2 20005.7 2009

Population Growth Rate: 2.216% (2008 est )

Libya's Ethnic GroupsLibya's Ethnic Groups

Arabs

LanguagesLanguages

Arabic is the official Language, Barber, Italian , English are widely understood in the major cities

ReligionsReligions

100% Sunni Muslim

The Libyan Health Care The Libyan Health Care SystemSystem

The Libyan Health Care The Libyan Health Care SystemSystem

The public health system operates on several levels:• The 1st level consists of the basic health care units, providing curative and preventive services for 5.000 to 10.000 citizens.• The 2nd level comprises the basic health care centers, serving 10,000 to 26,000 citizens.• The 3rd level consists of the polyclinics. Staffed by specialized physicians, containing laboratories, radiological services and a pharmacy, these polyclinics serving about 50,000 to 60,000 citizens.• At the 4th level, there are hospitals in rural areas and the central hospitals in urban areas.• The 5th level comprises the specialized hospitals.

Organization Structure Of Libyan Organization Structure Of Libyan MOHMOH

Ministry of Health

Minister of Health

Secretary GeneralManagement

administrative & financial affair

Awareness& education

PlanningMedical services&

equipmentsPharmaceuticals productsi Primary health care

National services Projects

Emergency &first aid services

Offices

Ministry affairLegal affair

Technical cooperationInternal assessment

workforceFollow up

Total expenditure on health of % of GDP

Health Expenditure indicators (2007est Health Expenditure indicators (2007est WHO)WHO)

Total expenditure on health (per capita) 223

Total expenditure on health of % of GDP3.7

General government expenditure on health as %of total health expenditure

69.5%

Ministry of health budget as % of government budget

7%Source: Statistical report summary on the

main health indicators.

Human and physical resources indicators Human and physical resources indicators 20072007

Physicians per 10000 population 25Dentists per 10000 population

2.7

Pharmacists per 10000 population

8

Nursing and midwifery personnel 50No of graduated medical students

13050

No of graduated dental studentsNo of pharmaceutical graduated

45603022

Source: Statistical report summary on the main health indicators.

Human and physical resources indicators Human and physical resources indicators 20072007

Source: Statistical report summary on the main health indicators.

Specialized hospitals 25General hospitals 21Rural hospitals 32Central hospitals 19Total no. of public hospitals 96Primary haelth care facilities 1177Beds per 10 000 population 39Total no. of beds in public hospitals

20289

PHC facilities per 10 000 2.3

The Libyan National Health Care SystemThe Libyan National Health Care System

StrengthStrength

1. 11 of 12 global indicators of Health for All by 2000 were believed to be achieved by the end of last century in Libya2. The motto of Libyan health policy is "health for all by all“. Basic & comprehensive health care including rehabilitation, disability and old-age benefits are provided to all citizens free of charge. The goal

of this policy is to create a society in which every member can play an active role, both socially and economically, and in which services are equally distributed among the whole population.3. The proportion of imported HR in Libya has dropped from >80% in the 70s to <8% in 2005.

WeaknessWeakness

1. Poor management: the predominant form of management in the Libyan health sector is lassez fair –management (hands off).2. Poor inter sectoral cooperation and coordination and absence of comprehensive national programs. Ex. the main cause of death in children after the first year of life is road traffic accidents as there is no inter sectoral cooperation and coordination with the education,

transport, circulation and civil engineering sections.

WeaknessWeakness

3. Absence of a national health information system, absence of health system research as an integral part of national health development resulted in poor and uninformed decisions, poor planning and evaluation

Libya produced only 2.4 health publications

4. Poor data-information-intelligence cycle and surveillance

WeaknessWeakness

5. For a small population scattered over the vast geographical area, the potential of e-health solutions as electronic medical records for health service management and telemedicine are not yet applied in health.

6. Poor planning and evaluation and low quality impact assessment, duplicated efforts, and waste of time and resources Ex. Projects only limited to buildings and construction of hospitals.

WeaknessWeakness

7. Bias towards rural areas and concentration of local human resources in certain regions. Ex. Tripoli Medical Center a public hospital in Tripoli with 1500 beds, >3000 physicians , Dentists , medical

Auxillaries. The Libyan government allocated a budget of 250 million Dollars that formed (7%) of the total health budget expenditure.

WeaknessWeakness

8. About $100-200 million are spent annually by the Goverment for medical treatment of Libyan citizens abroad.

9. More is spent as an out of pocket payment by Libyans traveling for treatment to neighboring countries and Europe.

Opportunities Opportunities

1. The gradual reintegration of Libya into the international economy, leading to better availability of medicines and health technologies.2. Health care is available to all citizens free of charge by the public sector.3. A growing private health sector is emerging and health insurance is being considered.4. The country boasts the highest literacy and educational rates in Africa.5. The Government is substantially increasing the development budget for health services.6. Clear-cut and comprehensive strategies have been prepared for HIV/AID and TB.

ThreatsThreats

1. Lack of human resources for health planning and management.2. Coordination among national institution is a challenge. 3. Lack of procedures and application management protocols.4. The high prevalence of smoking “more than 30% of the adult male population smoke regularly”.

ThreatsThreats

5. High mortality and disability rates (13%) due to road traffic Injuries( 4–5 deaths per day and even

ThreatsThreats

6. Increasing incidence of AIDS and hepatitis duo to illegal immegration.

Priorities for transforming the Libyan Health Care SystemHealth Care System

1. Restructuring of medical and paramedical human resources through redistribution of human resources and training of necessary cadres.2. Improving, updating and developing health facilities, including developing some health delivery points into health centers.3. Adopting health care management protocols.4. Co-ordination and integration and improving the health information system. 5. Focusing on public health programmers.

ReferencesReferences

The Work of WHO in the Eastern Mediterranean RegionHuman World Development Indicators 2004 Development Report, New York, UNDP,2006.  Library of Congress – Federal Research Division- http://lcweb2.loc.govhttp://news.bbc.co.uk Libyan National Health ServicesThe Need to Move to Management-by-Objectives(www.ljm.org.ly) http://www.health.gov.lyhttp:looklex.com/e.o/libya.htmCountry Cooperation Strategy for WHO and the Libyan Arab Jamahiriya 2005–2009