Provision of Basic Healthcare Services by Non-State Actors in Arab Countries: Benefits and Risks

Organization(s): ESCWA
Author: Allison Minor, Katherine Brooks
Regions: Arab States, Middle East and North Africa
Country: Bahrain, Egypt, Iraq, Jordan, Lebanon, Sudan, Tunisia
Year: 2013
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Basic social services such as education, water and sanitation, healthcare and housing are intended to
meet essential human needs. States are given the task of guaranteeing equal access to these services, either through direct provision or through the regulation of services provided by other institutions, such as businesses or civil society organizations.

Following independence, most Arab countries built comprehensive systems of social services, which
the State provides to the population free of charge. With population growth, however, and in the wake of
socio -economic crises and armed conflict, these systems were pushed beyond their capacity. Private sector and civil society organizations began addressing the gaps in coverage and quality deficits that characterized state service provision.

In order to assess the extent of this change, and to support countries in assessing their current welfare
mix, ESCWA’s Social Development Division has started to research the distribution of responsibilities
between the State, the market and civil society in the provision of social services and social protection.
In a series of technical papers we will look at the patterns of service provision by non-state actors. Questions that need to be explored include: Is the involvement of non-state actors increasing access to essential services, in particular for vulnerable groups? How does the State regulate standards and ensure the quality of services provided by market- based or non- profit organizations? How can synergies between different institutions be optimized, and duplication avoided?

This paper is the first in this series. It looks at non-state provision of basic healthcare services, seeking to highlight the benefits and the risks that emanate from non-state provision of social services. It largely draws on case studies of Bahrain, Egypt, Iraq, Jordan, Lebanon, Sudan, and Tunisia.

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