Ageing and intergenerational family ties in Arab countries.

This paper explores the dominant issues in intergenerational ties in Arab countries with a view to highlighting patterns, trends and challenges as well as policy implications. The data were drawn from a review of scholarly work and published literature in Arab countries and from a regional mapping of ageing policies and programmes in 2012. Social and health ageing policies in the region have been set with the premise that the family represents the core safety net for older Arabs. Yet demographic, sociocultural and economic transitions, as well as political conflict in the Arab world, are bringing profound changes to familial structures. This review feeds into efforts to promote health and social reforms that approach intergenerational solidarity from several fronts: providing equitable old-age income security, fostering cross-generational interactions, embracing caregivers and home-based care, promoting age-responsive actions in emergencies and conflicts, and prioritizing context- and country-specific research on the levels, types and trends in intergenerational and familial support.

Demographics and the social reckoning in the Arab region.

Demographic transitions in the Arab countries, due to declining birth rates and mortality rates since the 1980s, are reflected in a low proportion of children, a relatively stable proportion of elderly and a high proportion of people of working age. This "youth bulge" of young, active, working-age individuals in the current population may open a demographic window for countries to benefit from increased savings and investment. This paper reviews the demographic situation in the Arab region and the impact of education, employment, migration, health status and participation in society on the further development of the region, including the impact of these factors on ageing and gender issues. The intent is to draw attention to the importance of these demographic changes and highlight the need for action to maximize the potential benefit to the population in this region.

Tuberculosis and migration: a review.

In the past decade, the number of new cases of tuberculosis worldwide has barely declined and national tuberculosis control and elimination programmes in many high-income countries worldwide are increasingly challenged to address the problem of disease in foreign-born residents and migrant workers. Routine immigration medical screening, either before or after arrival in the recipient country, is designed to avoid the admission of migrants who pose a public health threat. Screening measures, however, have changed with time largely based on respect for individuals' rights. This paper reviews the measures that are being used by countries to screen immigrants and improve their health well-being, and presents cases studies from two Eastern Mediterranean Region countries.

Tuberculosis and migration: a review

In the past decade, the number of new cases of tuberculosis worldwide has barely declined and national tuberculosis control and elimination programmes in many high-income countries worldwide are increasingly challenged to address the problem of disease in foreign-born residents and migrant workers. Routine immigration medical screening, either before or after arrival in the recipient country, is designed to avoid the admission of migrants who pose a public health threat. Screening measures, however, have changed with time largely based on respect for individuals' rights. This paper reviews the measures that are being used by countries to screen immigrants and improve their health well-being, and presents cases studies from two Eastern Mediterranean Region countries

Demographics and the social reckoning in the Arab region

Demographic transitions in the Arab countries, due to declining birth rates and mortality rates since the 1980s, are reflected in a low proportion of children, a relatively stable proportion of elderly and a high proportion of people of working age. This [youth bulge] of young, active, working-age individuals in the current population may open a demographic window for countries to benefit from increased savings and investment This paper reviews the demographic situation in the Arab region and the impact of education, employment/ migration, health status and participation in society on the further development of the region, including the impact of these factors on ageing and gender issues. The intent is to draw attention to the importance of these demographic changes and highlight the need for action to maximize the potential benefit to the population in this region

Historical development of health systems in the Arab countries: a review.

In the first of 5 papers about health systems and services in the Arab countries, the historical development of health systems over the past 3 decades is reviewed. The evolution of health care has been impressive with major strides accomplished by governments to improve the health status of their respective population. However, the progress has been uneven in view of the differentials in resources and opportunities. This development was made possible through the implementation of national social and economic development agendas. Most of the Arab countries adopted the declaration of Alma-Ata in 1978. The United Nations agencies and especially the World Health Organization have expanded support to all the Arab countries of the Eastern Mediterranean region. Key challenges to health systems remain. Member States are encouraged to address these challenges in concert with all concerned stakeholders. Efforts are needed to promote the centrality of health in comprehensive socioeconomic development.

Historical development of health professions' education in the Arab world.

This paper reviews the historical development of health professions' education in the Arab countries and highlights the role that the World Health Organization has played in the support of the health workforce. Challenges such as the migration of health professionals, the need for additional educational opportunities in public health and in the management of health services and the need to adapt education to address the needs of society are discussed. Efforts are needed to develop further the quality and relevance of education and to address the needs of the health systems and the welfare of communities. The production of research in cooperation with policy-makers to enhance decisions and policies based on evidence needs increased attention.

Delivery of health services in Arab countries: a review.

This paper reviews the essential components of health care delivery systems in Arab countries and their development over the past 3 decades. The changes and challenges which evolved during the last half of the 20th century have had a significant impact on health systems and on health outcomes. An adequate network of hospitals and primary health care facilities has been established in most Arab countries of the Region. The increased participation of civil society has impacted positively on health systems. However, the main challenge is represented by the move towards market economies. In many developing economies, macroeconomic reforms have often necessitated cuts in public spending on social sectors. Cost-sharing policies have been implemented in order to compensate for diminishing government budgets allocated to health. However, this is not to minimize the enormous strides that have been made in all countries nor the important challenges that need to be addressed.

Access and barriers to health care delivery in Arab countries: a review.

This paper reviews some of the main obstacles encountered by the population (or rather by different social groups) in accessing health services in Arab countries. These obstacles can be social and cultural, administrative and organizational or financial and may impact on gender and ethnic groups to different degrees. Governments are urged to address the health inequalities that result from these obstacles and promote equity, solidarity and fairness through social policies that enhance social and national development.

Health services to groups with special needs in the Arab world: a review.

This paper examines the health services provided to the older population (especially those with physical limitations) and the people with mental illnesses in Arab countries and their evolution over the past 3 decades. The paper reviews utilization issues related to morbidity, transportation, patient-provider relationship, cost, stigma and organizational barriers that often impede access and compliance with the care provided or recommended. Health systems in the region need to acknowledge the specific needs of these patients in their national programmes. Raising awareness is an important step in this regard.

Historical development of health professions- education in the Arab world

This paper reviews the historical development of health professions'education in the Arab countries and highlights the role that the World Health Organization has played in the support of the health workforce. Challenges such as the migration of health professionals, the need for additional educational opportunities in public health and in the management of health services and the need to adapt education to address the needs of society are discussed. Efforts are needed to develop further the quality and relevance of education and to address the needs of the health systems and the welfare of communities. The production of research in cooperation with policy-makers to enhance decisions and policies based on evidence needs increased attention

Historical development of health systems in the Arab countries: a review

In the first of 5 papers about health systems and services in the Arab countries, the historical development of health systems over the past 3 decades is reviewed. The evolution of health care has been impressive with major strides accomplished by governments to improve the health status of their respective population. However, the progress has been uneven in view of the differentials in resources and opportunities. This development was made possible through the implementation of national social and economic development agendas. Most of the Arab countries adopted the declaration of Alma-Ata in 1978. The United Nations agencies and especially the World Health Organization have expanded support to all the Arab countries of the Eastern Mediterranean region. Key challenges to health systems remain. Member States are encouraged to address these challenges in concert with all concerned stakeholders. Efforts are needed to promote the centrality of health in comprehensive socioeconomic development

Health services to groups with special needs in the Arab world: a review

This paper examines the health services provided to the older population [especially those with physical limitations] and the people with mental illnesses in Arab countries and their evolution over the past 3 decades. The paper reviews utilization issues related to morbidity, transportation, patient-provider relationship, cost, stigma and organizational barriers that often impede access and compliance with the care provided or recommended. Health systems in the region need to acknowledge the specific needs of these patients in their national programmes. Raising awareness is an important step in this regard

Access and barriers to health care delivery in Arab countries: a review

This paper reviews some of the main obstacles encountered by the population [or rather by different social groups] in accessing health services in Arab countries. These obstacles can be social and cultural, administrative and organizational or financial and may impact on gender and ethnic groups to different degrees. Governments are urged to address the health inequalities that result from these obstacles and promote equity, solidarity and fairness through social policies that enhance social and national development

Delivery of health services in Arab countries: a review

This paper reviews the essential components of health care delivery systems in Arab countries and their development over the past 3 decades. The changes and challenges which evolved during the last half of the 20th century have had a significant impact on health systems and on health outcomes. An adequate network of hospitals and primary health care facilities has been established in most Arab countries of the Region. The increased participation of civil society has impacted positively on health systems. However, the main challenge is represented by the move towards market economies. In many developing economies, macroeconomic reforms have often necessitated cuts in public spending on social sectors. Cost-sharing policies have been implemented in order to compensate for diminishing government budgets allocated to health. However, this is not to minimize the enormous strides that have been made in all countries nor the important challenges that need to be addressed

Rebuilding of the Lebanese health care system: health sector reforms.

The civil war in Lebanon from 1975 to 1992 had a significant negative impact on the public health care system. This paper describes the health care system in Lebanon and its financing as of 2001. The efforts that have been made and are being made to rehabilitate and reform this sector since the end of the war are outlined.

Rebuilding of the Lebanese health care system: health sector reforms

The civil war in Lebanon from 1975 to 1992 had a significant negative impact on the public health care system. This paper describes the health care system in Lebanon and its financing as of 2001. The efforts that have been made and are being made to rehabilitate and reform this sector since the end of the war are outlined

The impact of civil disturbances on the migration of physicians: the case of Lebanon.

This report examines the impact of war on the migratory patterns of physicians in Lebanon, a country with ever-raging civil disturbances for the past 15 years. The data base included two cohorts of medical graduates of the American University of Beirut: the 1960 through 1969 cohort, whose education and training were completed before the onset of the civil war, and the 1970 through 1979 cohort, who was exposed to the turmoil in Lebanon during either their study or their residency training. Between- and within-cohort comparison of their locations 5 years after graduation was made. Findings suggest that there is an association between civil instability and migration. This relationship could not be explained by possible confounders like nationality, training abroad, and board certification. On the contrary, factors that potentiated migration in the earlier cohort before the onset of the war were less frequent in the latter cohort with the increased tendency to migrate.

Lebanon's health care policy: a case study in the evolution of a health system under stress.

Lebanon's experience in the development of its health care system over the last century is reviewed; inasmuch as experiences can be generalizable, the case of Lebanon reflects the attempts of middle-income countries to balance the public and private sectors' roles in health care. Lebanon's health care system followed a predictable trend that was accelerated and intensified by the civil disturbances during the past decade. Its main feature has been the absence of a coherent and sustained health policy that promotes a stable and long-lasting relationship between the public and the private sectors in health. The role of the State has been most effective during periods of political, social and economic stability, when serious planning efforts could be undertaken and resultant policies be implemented. An effective partnership between the State and the private sector is recommended for the reconstruction of Lebanon's health care system, as well as for other countries with a strong private sector involvement in health care.