The Health Care The Health Care Employment Market In Employment Market In

EgyptEgypt

ByBy

Dr. Mohamed Kamal MD,Dr. Mohamed Kamal MD,

Quality ManagerQuality Manager

MBA, TQMD (AUCMBA, TQMD (AUC))

What is the labour market for What is the labour market for health workershealth workers

The labor market for health professionals is derived The labor market for health professionals is derived fromfrom

and directly connected to the market for health and and directly connected to the market for health and medicalmedical

services services The process for delivering health-care servicesThe process for delivering health-care services requires the input of health workers, along with otherrequires the input of health workers, along with other inputs, such as medicines, equipment and other inputs, such as medicines, equipment and other

health-carehealth-care supplies. Clinics and hospitals have a demand for supplies. Clinics and hospitals have a demand for

healthhealth workers in order to produce health services, which areworkers in order to produce health services, which are demanded by purchasers of health care. demanded by purchasers of health care.

This point is often overlooked. The This point is often overlooked. The demand for health services is linked demand for health services is linked to theto the

willingness of the government, willingness of the government, patients, health insurers andpatients, health insurers and

other purchasers of health care, such other purchasers of health care, such as donors, to fund health services.as donors, to fund health services.

Egypt’s Health Care System Egypt’s Health Care System

Public/Private/ Social Health Insurance Public/Private/ Social Health Insurance NHS style government/public health NHS style government/public health system system

Social Health Insurance (employer based Social Health Insurance (employer based and school children) Private Sector and school children) Private Sector

% of GDP spent on Health: 6.3% (Canada: % of GDP spent on Health: 6.3% (Canada: 10%) in 2006 – WHO estimates 10%) in 2006 – WHO estimates

Private expenditure on health as % of total Private expenditure on health as % of total expenditure on health (58.6%) – WHO expenditure on health (58.6%) – WHO estimates estimates

The growing gap between the supply of The growing gap between the supply of health care professionals and the demand health care professionals and the demand forfor

their services is recognized as a key issue their services is recognized as a key issue for health and development worldwide.for health and development worldwide.

Policy-makers, planners and managers Policy-makers, planners and managers continue to seek effective means to recruit continue to seek effective means to recruit andand

retain staff. One way to achieve this is to retain staff. One way to achieve this is to develop and implement effective incentive develop and implement effective incentive schemes. schemes.

What is the Labour What is the Labour Market? Market?

Local? Local? Regional? Regional? International? International? Today’s labour market? Today’s labour market? Tomorrow’s labour market? Tomorrow’s labour market? The labour market in 30 years from The labour market in 30 years from

now? now?

What Does the Labor What Does the Labor Market Need?Market Need?

KnowledgeKnowledge:: Most up to date and Relevant Most up to date and Relevant

education and learningeducation and learning Skills:Skills: to use the knowledge and to to use the knowledge and to

mitigate and manage the challenges of mitigate and manage the challenges of work and life work and life

AttitudeAttitude:: Positive – to work and develop Positive – to work and develop individually, within groups and individually, within groups and communities and probably within the world communities and probably within the world as a whole. as a whole.

What are the Skills What are the Skills needed?needed?

Strong thinking, communication, Strong thinking, communication, entrepreneurial skills, adaptability, entrepreneurial skills, adaptability, labour market skills, problem labour market skills, problem solving, decision making, team work, solving, decision making, team work, responsibility and interpersonal responsibility and interpersonal skills Can this be a negative edge in skills Can this be a negative edge in traditional hierarchical work traditional hierarchical work structures? structures?

Human Resource Challenges in EgyptHuman Resource Challenges in Egypt Egypt’s Health Egypt’s Health reformsreforms in hospitals and the in hospitals and the

Family Health Model require changes in staff Family Health Model require changes in staff skills and mixskills and mix..

Workforce Workforce distributiondistribution poorly allocated: poorly allocated: Between urban and rural areasBetween urban and rural areas Between primary, secondary, and Between primary, secondary, and

tertiary caretertiary care Among different specialtiesAmong different specialties

New New management skillsmanagement skills due to increasing due to increasing complexity of health systems.complexity of health systems.

The need` for The need` for linking training programslinking training programs to to actual staffing needs.actual staffing needs.

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Do you know who this Do you know who this is?is?

  

IMHOTEPIMHOTEP

Egyptian Born 27Egyptian Born 27thth century  BCEcentury  BCE

Considered to be the Considered to be the first achitect, first achitect, engineer and engineer and PHYSICIAN! PHYSICIAN!

Future Outlook of Future Outlook of Healthcare IndustryHealthcare Industry

It is a unique industry!! : It is a unique industry!! : The healthcare industry includes : The healthcare industry includes :

Establishments ranging from small-town Establishments ranging from small-town private practices of physicians who employ private practices of physicians who employ only one medical assistant Busy inner-city only one medical assistant Busy inner-city hospitals that provide thousands of diverse hospitals that provide thousands of diverse jobs. Combining : Medical hi-tech Human jobs. Combining : Medical hi-tech Human touch Communication tools Diagnostic touch Communication tools Diagnostic facilities Treats and administer care around facilities Treats and administer care around the clock to the need of million of all social the clock to the need of million of all social classes of people and to the widest age classes of people and to the widest age group from intra-uterine to terminally group from intra-uterine to terminally elderlyelderly ill . ill .

Outlook of HC Outlook of HC employment :employment :

In US; Healthcare will generate 3.2 million new In US; Healthcare will generate 3.2 million new wage and salary jobs between 2008 and 2018, wage and salary jobs between 2008 and 2018, more than any other industry, largely in more than any other industry, largely in response to rapid growth in the elderly response to rapid growth in the elderly population. In Egypt; Many job openings should population. In Egypt; Many job openings should arise in all healthcare employment settings as a arise in all healthcare employment settings as a result of the new strong movement towards result of the new strong movement towards investment and/or stimulation package for this investment and/or stimulation package for this sectors. Also the big NGO organizations.sectors. Also the big NGO organizations.

New comers from abroadNew comers from abroad THE EXPECTED INCREASE OF HEALTH THE EXPECTED INCREASE OF HEALTH

BUDGUT TO 12% WITHIN 4 YEARSBUDGUT TO 12% WITHIN 4 YEARS

The healthcare The healthcare OpportunitiesOpportunities

Medical tourismMedical tourism the private-public partnershipsthe private-public partnerships new legislation and the strong new legislation and the strong

contribution of the non-contribution of the non-governmental organization in the governmental organization in the field of healthcarefield of healthcare

Sustain its growth paceSustain its growth pace

There is a believe that healthcare There is a believe that healthcare industry is expected to sustain its industry is expected to sustain its growth pace in near future owing to growth pace in near future owing to the escalation of the burden of the escalation of the burden of diseases. And inappropriate diseases. And inappropriate demographic balance which will demographic balance which will create demand for better healthcare create demand for better healthcare facilities. facilities.

GDP Growth & health conscious :GDP Growth & health conscious :

These countries have become more health These countries have become more health conscious, leading to an increase in the conscious, leading to an increase in the usage of more expensive therapies and high usage of more expensive therapies and high innovative products.. A wide range of innovative products.. A wide range of economic and structural reforms were economic and structural reforms were adopted in the region while public and adopted in the region while public and private investment projects were launched to private investment projects were launched to pursue economic diversification and human pursue economic diversification and human capital development as well as investment in capital development as well as investment in oil and gas, infrastructure, and other oil and gas, infrastructure, and other economic sectors. economic sectors.

Employment Demand for tele-medicine Employment Demand for tele-medicine expert / data transfer & management expert / data transfer & management expert / IT expert / healthcare expert / IT expert / healthcare economists / actuarial expert / Hi-tech economists / actuarial expert / Hi-tech maintenance will rise due to the fast maintenance will rise due to the fast growing of healthcare insurance sector growing of healthcare insurance sector including the social and the private one. including the social and the private one. Hospitals will be the slowest growing Hospitals will be the slowest growing segment within the healthcare industry segment within the healthcare industry because of efforts to control hospital costs because of efforts to control hospital costs and the increasing use of outpatient and the increasing use of outpatient clinics and other alternative care sites clinics and other alternative care sites

Optimistic future :Optimistic future :

The pharmaceutical The pharmaceutical industry, information industry, information technology and distribution technology and distribution are expected to grow. are expected to grow. Moreover, biotechnology Moreover, biotechnology and R&D are expected to and R&D are expected to grow but at a lower rate. grow but at a lower rate.

According to the Egypt Human According to the Egypt Human Development Report13, health professionals Development Report13, health professionals are concentrated in urban centres, such as are concentrated in urban centres, such as Cairo and Alexandria, and Upper Egypt.Cairo and Alexandria, and Upper Egypt.

Study results reveal that, in these areas, Study results reveal that, in these areas, private and parastatal health facilities are private and parastatal health facilities are practically non-existent. Available public practically non-existent. Available public health facilities, in turn, are often poorly health facilities, in turn, are often poorly equipped, causing stress and frustration to equipped, causing stress and frustration to health professionals. Moreover, these health professionals. Moreover, these health facilities do not offer possibilities for health facilities do not offer possibilities for further professional training and further professional training and specializationspecialization

Health Professionals in Egypt?Health Professionals in Egypt?

20

Results of Workforce Assessment in Results of Workforce Assessment in one of the Pilot Governoratesone of the Pilot Governorates

21

Example of EgyptWorkforce Analysis Results

Current Staff Profile Current Staff Profile

Staff Composition Staff Composition

22

Current Staff Profile Current Staff Profile

Registered vs. Actually Working StaffRegistered vs. Actually Working Staff

23

Why is there a shortage of nurses in Egypt and

globally

The composition of nurse supply in The composition of nurse supply in selected EMRO countries (2005)selected EMRO countries (2005)

All nurses in countries of the region with the All nurses in countries of the region with the exception of Egypt, Yemen and Afghanistan have exception of Egypt, Yemen and Afghanistan have a minimum of 2 years post secondary education. a minimum of 2 years post secondary education.

If the definition of nurses is restricted to If the definition of nurses is restricted to qualified nurses (nurses who have at least 2 qualified nurses (nurses who have at least 2 years of post-secondary/ high school education) years of post-secondary/ high school education) then the ratio in Egypt drops to 0.18 nurses per then the ratio in Egypt drops to 0.18 nurses per 1000 population, which is an extremely low ratio 1000 population, which is an extremely low ratio by any standards. by any standards.

Different types of nursesDifferent types of nurses

There are 3 types of nurse education and There are 3 types of nurse education and predominantly three types of nurses in predominantly three types of nurses in Egypt today: Egypt today:

High school nursing education High school nursing education which which (referred to as secondary level school in (referred to as secondary level school in Egypt) Egypt) Technical institute nursing education Technical institute nursing education (2 (2

years of post high school education) years of post high school education) University nursing education University nursing education (4 years of (4 years of

post high school education) post high school education)

Shortage according to Shortage according to Economists and the rest of the Economists and the rest of the

worldworld

-Conservative culture: women don't -Conservative culture: women don't want to become nurses or work as want to become nurses or work as nurses in Egypt nurses in Egypt The problem of the The problem of the nurse image as a barrier for women to nurse image as a barrier for women to become nurses seems to be no longer an become nurses seems to be no longer an issue (except perhaps in Upper Egypt to a issue (except perhaps in Upper Egypt to a limited extent) limited extent)

--Government don't pay nurses enough Government don't pay nurses enough to attract them to work with great to attract them to work with great workloadworkload

Few nursing schools- not enough Few nursing schools- not enough nurses being produced nurses being produced

Nurses leave Egypt to work in the the Nurses leave Egypt to work in the the Arabic/Persian Gulf Arabic/Persian Gulf

On the Road to Professionalism: Past, Present and Future

Sporadic Unplanned Training.

Multiple Level of Education

Absence of Practice Law.

Inadequate Appearance.

Non coordinated Efforts for Improvement.

Limited Cooperation between MoH and MoEd.

Maldistribution

THE NURSE WE NEEDTHE NURSE WE NEED

Upgrading nurses' knowledge, Upgrading nurses' knowledge, performance and attitude to comply with performance and attitude to comply with International standards capable of working International standards capable of working in the region and internationally, in the region and internationally, consequently reflecting positively on consequently reflecting positively on nurses image.nurses image. Building their knowledge Building their knowledge and performance excellence on research and performance excellence on research evidence, community needs and evidence, community needs and international connections.international connections.

Current Status of Workforce QualificationCurrent Status of Workforce Qualification

201,669201,669

6,2 %6,2 %

0.9 %0.9 %

85 %85 %

7.9 %7.9 %

Total numbers of nurses registered in Syndicate till Year 2006

Bachelor Degree

Technical Institute Degree

Secondary Technical Institute Degree

Others

Current Status of Nursing Workforce

With Respect to Int. Standards

Ratio of Nurses to population =

Required nurses by 2020

Required nurses by 2020taking in consideration drop out

rate of 4%

Number of nurses in registry

Deficiency based on international standards

==

==

0.27%

242,000

260,000

204,000

38,000

Current Nursing No.

Current No. of Nursing School

No. of Nursing School Graduates

Annually

No. of Nursing Faculties Graduates

No. of Technical Institutes Graduates

Annual dropout Ratio(MOH Nursing)

204,000 Nurses

MOH 165,000 nurse

Others 39,000 nurses

6500 Nurses

1200 Nurses

1000 Nurses

240 Nursing Schools

4% from the total workforce

Conclusion of Current Status – Statistics 2008

ConsideringTotal No. of Beds - MOH

Primary Health Care

96,000 beds

International ratio

51,987 (+) nurse

5199 facilities

45,000 (-) nurse

Graduation Year

Graduates Numbers

2003 2175

2004 2379

2005 2352

2006 2302

2007 1287

2008 1200

Numbers of Faculty of Nursing Graduates Numbers of Faculty of Nursing Graduates

From 2003 to 2008From 2003 to 2008 Alarm!!

Figure Illustrating Deficiency in Some GovernoratesFigure Illustrating Deficiency in Some Governorates

1,581

360

2,102

6,577

4,591

206

890487

2,447

471

2,973

4,006

1,058

1,8421,842

QenaQena LuxoLuxorr

KShKSh

1,7601,760

SohaSohagg

DKDK

TotalTotalDef PrimaryDef PrimaryDef CurativeDef Curative

Manpower DistributionManpower Distribution

Nurse/Patient Ratio 1:250Nurse/Patient Ratio 1:250 Physician/Patient Ratio 1:400Physician/Patient Ratio 1:400

Year 2005Year 2005

Nurse/10000 Population for Enrolled 14.82Nurse/10000 Population for Enrolled 14.82 Nurse/10000 Population for incharge 13.36Nurse/10000 Population for incharge 13.36

Year 2003Year 2003

Why does anyone work in the public sector?Why does anyone work in the public sector?

Nurses prefer the public sector after they Nurses prefer the public sector after they get married because of much less work get married because of much less work demands, no one can fire you, you have demands, no one can fire you, you have health insurance and pension benefits, health insurance and pension benefits, and better hours(Nurse 5) and better hours(Nurse 5)

**The private sector presence is strongest **The private sector presence is strongest in Cairo and Alexandria; however it is not in Cairo and Alexandria; however it is not as prevalent in rural governorates and as prevalent in rural governorates and therefore, it is not always a viable option therefore, it is not always a viable option for a nurse depending on her for a nurse depending on her geographical location geographical location

““If we continue to do If we continue to do things the way we things the way we did we will remain did we will remain where we arewhere we are”.”.

Stephen Covey

Where do nurses work? Where do nurses work?

About 80% of nurses are employed About 80% of nurses are employed by the public sector in 2008 (with by the public sector in 2008 (with some dual employment) some dual employment)

Salary levels are determined by Salary levels are determined by the central government as part of the central government as part of overall public sector payment overall public sector payment structurestructure

National Demand for National Demand for NursesNurses

Bifurcated Demand Bifurcated Demand Public sector demand- Public sector demand- The salary of a nurse in the public sector: LE 165 for The salary of a nurse in the public sector: LE 165 for

a Diploma level nurse (nurse with high school nurse) a Diploma level nurse (nurse with high school nurse) LE 250 for a Bachelor level nurse (nurse with 4 LE 250 for a Bachelor level nurse (nurse with 4

years of post high school university education). years of post high school university education). With incentives,, the salary of a nurse in the public With incentives,, the salary of a nurse in the public

sector rarely exceeds LE 1000. sector rarely exceeds LE 1000.

Private demand for nurses –The salary of a nurse in Private demand for nurses –The salary of a nurse in the private sector: -starting salaries advertised at LE the private sector: -starting salaries advertised at LE 800 and 800 and

-up to LE 7000 for qualified and experienced bachelor -up to LE 7000 for qualified and experienced bachelor level nurses in private hospitals in Cairo and level nurses in private hospitals in Cairo and Alexandria Alexandria

The supply of nurses- willingness to workThe supply of nurses- willingness to work

MOHP sources believe that there is (leakage); MOHP sources believe that there is (leakage); 7000 nurses exit the market for various reasons 7000 nurses exit the market for various reasons (work abroad, stay home or work in another (work abroad, stay home or work in another sector) sector)

The resultant increase of 3000 nurses every year The resultant increase of 3000 nurses every year

to the nurse labor force is believed to be lower to the nurse labor force is believed to be lower than what is needed. (MOHP Director of Nursing) than what is needed. (MOHP Director of Nursing)

4% leakage is an educated guess by the director of 4% leakage is an educated guess by the director of nursing- no data! nursing- no data!

Education Output Education Output ProjectionProjection

12,000

10,000

21,000

3906

1394

2020

2015

2012

2010

2009

30

40

60

25

12

YearNumber of Institutes

Expected number of Graduates

Data

Includes post primary and post secondary

Future Outlook - Future Outlook - Employment :Employment :

Demand for dental care will rise due to greater Demand for dental care will rise due to greater retention of natural teeth by middle-aged and retention of natural teeth by middle-aged and older persons, greater awareness of the older persons, greater awareness of the importance of dental care, and an increased importance of dental care, and an increased ability to pay for services. Dentists will use ability to pay for services. Dentists will use support personnel such as dental hygienists and support personnel such as dental hygienists and assistants to help meet their increased assistants to help meet their increased workloads. workloads.

--

Central Cont Education Training through Foreign

Experts

Overseas travel On site training Hosp and PHC

Maintain performance

Nursing Fellowship Program

Continuing Education and Performance

2500/year

10,000/year

-30% of workforceHospital nurses

5% PHC

Holland Hull UNorth

Spanish

Spain Thailand

Gaps are challengingGaps are challenging

The most significant gaps the developing The most significant gaps the developing countries will face are : retaining the best countries will face are : retaining the best healthcare providers. Adaptation of the healthcare providers. Adaptation of the very advanced technology The new model very advanced technology The new model of distant treatment will make earnings of distant treatment will make earnings for the ordinary physicians very difficult for the ordinary physicians very difficult and most of the well trained doctors and and most of the well trained doctors and nurses and hi-technicians will spend their nurses and hi-technicians will spend their productive lives outside our countries, productive lives outside our countries, most properly in Europe and in turkey. most properly in Europe and in turkey.

ChallengesChallenges

Glaring gaps and inequities in health persist both Glaring gaps and inequities in health persist both within and between countries, underscoring our within and between countries, underscoring our collective failure to share the dramatic health collective failure to share the dramatic health advances equitably.advances equitably.

At the same time, fresh health challenges loom. At the same time, fresh health challenges loom. New infectious, environmental, and behavioural New infectious, environmental, and behavioural risks, at a time of rapidrisks, at a time of rapid

demographic and epidemiological transitions, demographic and epidemiological transitions, threaten health securitythreaten health security

of all. Health systems worldwide are struggling of all. Health systems worldwide are struggling to keep up, as they become more complex and to keep up, as they become more complex and costly, placing additional demands on healthcostly, placing additional demands on health

..

Professional education has not kept pace Professional education has not kept pace with these challenges,with these challenges,

largely because of fragmented, outdated, largely because of fragmented, outdated, and static curriculaand static curricula

that produce ill-equipped graduates.that produce ill-equipped graduates. The problems are systemic: mismatch of The problems are systemic: mismatch of

competencies to patient and population competencies to patient and population needs; poor teamwork; persistent gender needs; poor teamwork; persistent gender stratification of professional status;stratification of professional status;

narrow technical focus without broader narrow technical focus without broader contextual understanding;contextual understanding;

episodic encounters rather than continuous episodic encounters rather than continuous care;care;

predominant hospital orientation at the predominant hospital orientation at the expense of primary care; quantitative and expense of primary care; quantitative and qualitative imbalances in the professional qualitative imbalances in the professional labour market; and weak leadership to improve labour market; and weak leadership to improve health-system performance. Laudable effortshealth-system performance. Laudable efforts

to address these deficiencies have mostly to address these deficiencies have mostly floundered, partly becausefloundered, partly because

of the so-called tribalism of the professions—ie, of the so-called tribalism of the professions—ie, the tendency of thethe tendency of the

various professionsvarious professions

Regional marketsRegional markets

Egyptian Nurses working in the Egyptian Nurses working in the GulfGulf

In 2007, In 2007, Egypt had a general unemployment Egypt had a general unemployment rate rate of 11.2%, male unemployment rate of of 11.2%, male unemployment rate of 7.10% and female unemployment rate of 7.10% and female unemployment rate of 24.3%. 24.3%. Therefore, training nurses for export Therefore, training nurses for export could be an opportunity because of the benefit could be an opportunity because of the benefit to the Egyptian economy to the Egyptian economy

In addition to In addition to remittancesremittances, if nurses who leave are , if nurses who leave are required to pay certain taxes to support nurses’ required to pay certain taxes to support nurses’ education in Egypt and compensate the government education in Egypt and compensate the government for the free education they received, this could also for the free education they received, this could also be useful for the health sector. be useful for the health sector.

It would also make sense for the government in this It would also make sense for the government in this case to case to encourage and regulate private nursing encourage and regulate private nursing educationeducation.. ..

Medical Tourism Government acted Medical Tourism Government acted already Private sector opportunities already Private sector opportunities

Government acted already Government acted already Privatization and tax allowances Privatization and tax allowances

Pull Pull

Increasing demand for health Increasing demand for health professionals in Gulf countries professionals in Gulf countries

Much higher salaries for all groups of Much higher salaries for all groups of health professionals in receiving countries health professionals in receiving countries

Better practical education and career Better practical education and career opportunities in receiving countries opportunities in receiving countries

Supply of health Supply of health professionals professionals

Between 2001 and 2008, the number of Between 2001 and 2008, the number of nursing staff increased by almost 24,000 nursing staff increased by almost 24,000 (from 83,879 to 107,717); the number of (from 83,879 to 107,717); the number of pharmacists increased by about 8500 (from pharmacists increased by about 8500 (from 3,375 to 11,953); and the number of 3,375 to 11,953); and the number of physicians increased by roughly 11,000 physicians increased by roughly 11,000 (from 40,422 to 51,491). The number of (from 40,422 to 51,491). The number of dentists increased the least, with 3,000 dentists increased the least, with 3,000 more in 2008 compared to 2001, from 5,770 more in 2008 compared to 2001, from 5,770 to 8,85612. The total increase of medical to 8,85612. The total increase of medical staff did not result, however, in equal health staff did not result, however, in equal health coverage across the country. coverage across the country.

New 2003 labor New 2003 labor regulationsregulations

it seems important to examineit seems important to examine the effect of the new labor law on employment, in the effect of the new labor law on employment, in

particular on informalparticular on informal employment. Theoretically, one would expect the employment. Theoretically, one would expect the

new law to enablenew law to enable employers to hire and fire workers more easily and employers to hire and fire workers more easily and

hence to enable themhence to enable them to hire more workers formally. In the following to hire more workers formally. In the following

section we test the hypothesissection we test the hypothesis that the introduction of the new labor law has led to that the introduction of the new labor law has led to

more formalmore formal private employment.private employment. 4.4.

RemmemberRemmember

? Treat people with disrespect. Keep ? Treat people with disrespect. Keep them waiting unnecessarily. Steal them waiting unnecessarily. Steal their thunder by using their ideas their thunder by using their ideas without giving them credit. Say one without giving them credit. Say one thing then do the complete opposite. thing then do the complete opposite. Break promises regularly.Break promises regularly.

There are, however, quite a few common traits There are, however, quite a few common traits when it comes to being professional. This when it comes to being professional. This

includes the followingincludes the following:: 1. Competence. You’re good at what you do – and you 1. Competence. You’re good at what you do – and you

have the skills and knowledge that enable you to do have the skills and knowledge that enable you to do your job well.your job well.

2. Reliability. People can depend on you to show up on 2. Reliability. People can depend on you to show up on time, submit your work when it’s supposed to be ready, time, submit your work when it’s supposed to be ready, etc.etc.

3. Honesty. You tell the truth and are upfront about 3. Honesty. You tell the truth and are upfront about where things stand.where things stand.

4. Integrity. You are known for your consistent 4. Integrity. You are known for your consistent principles.principles.

5. Respect For Others. Treating all people as if they 5. Respect For Others. Treating all people as if they mattered is part of your approach.mattered is part of your approach.

6. 6. Self-Upgrading. Rather than letting your skills or knowledge . Rather than letting your skills or knowledge become outdated, you seek out ways of staying current.become outdated, you seek out ways of staying current.

7. Being Positive. No one likes a constant pessimist. Having an 7. Being Positive. No one likes a constant pessimist. Having an upbeat attitude and trying to be a problem-solver makes a big upbeat attitude and trying to be a problem-solver makes a big difference.difference.

8. Supporting Others. You share the spotlight with colleagues, 8. Supporting Others. You share the spotlight with colleagues, take time to show others how to do things properly, and lend an take time to show others how to do things properly, and lend an ear when necessary.ear when necessary.

9. Staying Work-Focused. Not letting your private life 9. Staying Work-Focused. Not letting your private life needlessly have an impact on your job, and not spending time at needlessly have an impact on your job, and not spending time at work attending to personal matters.work attending to personal matters.

10. Listening Carefully. People want to be heard, so you give 10. Listening Carefully. People want to be heard, so you give people a chance to explain their ideas properly.people a chance to explain their ideas properly.

The more you put into practice the points listed The more you put into practice the points listed above, the better your chances will be to create a above, the better your chances will be to create a positive reputation for yourself. This can positive reputation for yourself. This can ultimately translate into raises and promotions, ultimately translate into raises and promotions, chances to work on more assignments that you chances to work on more assignments that you enjoy, less likelihood of being downsized when enjoy, less likelihood of being downsized when layoffs are being considered, and the respect of layoffs are being considered, and the respect of peers and senior management.peers and senior management.

You also benefit from feelings of increased self-You also benefit from feelings of increased self-worth and dignity. Plus you keep yourself worth and dignity. Plus you keep yourself marketable for the future. All in all, some very marketable for the future. All in all, some very good reasons to as professional as possible.good reasons to as professional as possible.

Other Staff Requirements Other Staff Requirements

Staff TypeStaff Type CurrentCurrent RequiredRequired GAPGAP RatioRatio

DentistsDentists 9292 4545 4747 2.02.0

PharmacistsPharmacists 287287 117117 170170 2.52.5

Admin StaffAdmin Staff 17071707 11281128 579579 1.51.5

Medical TechniciansMedical Technicians

DentistryDentistry 7373 1010 6363 7.37.3

Lab.Lab. 107107 4949 5858 2.22.2

RadiologyRadiology 221221 1616 205205 13.813.8

68

What are typical causes What are typical causes of high turnover?of high turnover?

Stress on the job:Stress on the job: Shift rotationShift rotation Mandatory overtimeMandatory overtime Physical demandsPhysical demands Safety issuesSafety issues Psychological demandsPsychological demands

Aging workforce / retirementAging workforce / retirement

Factors cited as contributing to high Factors cited as contributing to high turnover of RNsturnover of RNs

Poor pay and benefitsPoor pay and benefits Poor relationships with physiciansPoor relationships with physicians Lack of voice in patient care issuesLack of voice in patient care issues Mandatory overtime and lack of Mandatory overtime and lack of

scheduling flexibilityscheduling flexibility Patient load and pace of work due to Patient load and pace of work due to

understaffing understaffing Lack of access to supervisors and Lack of access to supervisors and

mentorsmentors Documentation requirementsDocumentation requirements

Challenges and Challenges and opportunitiesopportunities

Labour mobility in the region is Labour mobility in the region is structurally driven by demographic, structurally driven by demographic, social and economicsocial and economic

differentials between labour abundant differentials between labour abundant and resource abundant countries. While and resource abundant countries. While the causes ofthe causes of

labour mobility can be perceived as labour mobility can be perceived as challenges to the development of the challenges to the development of the region (for instance,region (for instance,

high population growth resulting in high youth high population growth resulting in high youth unemployment), migration can be an unemployment), migration can be an importantpillar for local and national importantpillar for local and national development policies, when mainstreamed into development policies, when mainstreamed into national developmentnational development

plans. Thus, migration and labour mobility can plans. Thus, migration and labour mobility can be part of a solution to development imperativesbe part of a solution to development imperatives

that is consistent with local governance and that is consistent with local governance and social models, while allowing individuals to social models, while allowing individuals to achieveachieve

their full potential for the growth and their full potential for the growth and development of the region.development of the region.

Egyptian Marketing?

SellingPublic RelationsAdvertisingPromotion

(Almost) Anything Can be (Almost) Anything Can be MarketedMarketed

ConsumerGoods

andServices

ConsumerGoods

andServices

Business-to-

BusinessMarketing

Business-to-

BusinessMarketing

Idea,Place,People

Marketing

Idea,Place,People

Marketing

Not-For-Profit

Marketing

Not-For-Profit

Marketing

BE THE CHANGE YOU BE THE CHANGE YOU WANT TO SEE IN THE WANT TO SEE IN THE

WORLDWORLD

GHANDIGHANDI