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Who Benefits from Public Healthcare Subsidies in Egypt?


  • Ahmed Shoukry Rashad

    () (Department of Economics, Philipps-Universität Marburg, Marburg 35037, Germany
    Department of Economics, Faculty of Commerce, Damanhour University, Damanhour 22514, Egypt)

  • Mesbah Fathy Sharaf

    () (Department of Economics, Faculty of Commerce, Damanhour University, Damanhour 22514, Egypt
    Department of Economics, Faculty of Arts, University of Alberta, Edmonton, AB T6G 2H4, Canada)


Direct subsidization of healthcare services has been widely used in many countries to improve health outcomes. It is commonly believed that the poor are the main beneficiaries from these subsidies. We test this hypothesis in Egypt by empirically analyzing the distribution of public healthcare subsidies using data from Egypt Demographic and Health Survey and Egypt National Health Accounts. To determine the distribution of public health care subsidies, we conducted a Benefit Incidence Analysis. As a robustness check, both concentration and Kakwani indices for outpatient, inpatient, and total healthcare were also calculated. Results show some degree of inequality in the benefits from public healthcare services, which varied by the type of healthcare provided. In particular, subsidies associated with University hospitals are pro-rich and have inequality increasing effect, while subsidies associated with outpatient and inpatient care provided by the Ministry of Health and Population have not been pro-poor but have inequality reducing effect (weakly progressive). Results were robust to the different analytical methods. While it is widely perceived that the poor benefit the most from health subsidies, the findings of this study refute this hypothesis in the case of Egypt. Poverty reduction measures and healthcare reforms in Egypt should not only focus on expanding the coverage of healthcare benefits, but also on improving the equity of its distribution.

Suggested Citation

  • Ahmed Shoukry Rashad & Mesbah Fathy Sharaf, 2015. "Who Benefits from Public Healthcare Subsidies in Egypt?," Social Sciences, MDPI, Open Access Journal, vol. 4(4), pages 1-15, November.
  • Handle: RePEc:gam:jscscx:v:4:y:2015:i:4:p:1162-1176:d:59440

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    References listed on IDEAS

    1. Wagstaff, Adam & Bilger, Marcel & Buisman, Leander R. & Bredenkamp, Caryn, 2014. "Who benefits from government health spending and why? a global assessment," Policy Research Working Paper Series 7044, The World Bank.
    2. Ronelle Burger & Caryn Bredenkamp & Christelle Grobler & Servaas van der Berg, 2012. "Have public health spending and access in South Africa become more equitable since the end of apartheid?," Development Southern Africa, Taylor & Francis Journals, vol. 29(5), pages 681-703, December.
    3. Adam Wagstaff, 2012. "Benefit‐incidence analysis: are government health expenditures more pro‐rich than we think?," Health Economics, John Wiley & Sons, Ltd., vol. 21(4), pages 351-366, April.
    4. Owen O'Donnell & Eddy van Doorslaer & Ravi P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Deni Harbianto & Charu C. Garg & Piya Hanvoravongchai & Mohammed N. Huq & Anup Karan & Gabriel M., 2007. "The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia," World Bank Economic Review, World Bank Group, vol. 21(1), pages 93-123.
    5. Anselmi, Laura & Lagarde, Mylène & Hanson, Kara, 2015. "Going beyond horizontal equity: An analysis of health expenditure allocation across geographic areas in Mozambique," Social Science & Medicine, Elsevier, vol. 130(C), pages 216-224.
    6. Ahmed Rashad & Mesbah Sharaf, 2015. "Catastrophic and Impoverishing Effects of Out-Of-Pocket Health Expenditure: New Evidence from Egypt," Working Papers 974, Economic Research Forum, revised Nov 2015.
    7. Matteo Morgandi & Joana Silva & Victoria Levin, 2012. "Inclusion and Resilience : The Way Forward for Social Safety Nets in the Middle East and North Africa, OVERVIEW
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    Cited by:

    1. Badran & Mona Farid, 2017. "Electronic Health Records Prospects in Egypt: A Demand-Side Perspective," 28th European Regional ITS Conference, Passau 2017 169447, International Telecommunications Society (ITS).
    2. Joana Silva & Victoria Levin & Matteo Morgandi, 2013. "Inclusion and Resilience : The Way Forward for Social Safety Nets in the Middle East and North Africa," World Bank Publications, The World Bank, number 14064.
    3. Jerry D. Marx, 2016. "Healthy Communities: What Have We Learned and Where do We Go from Here?," Social Sciences, MDPI, Open Access Journal, vol. 5(3), pages 1-4, August.

    More about this item


    benefit incidence analysis; healthcare subsidies; inequality; poverty; Egypt;

    JEL classification:

    • A - General Economics and Teaching
    • B - Schools of Economic Thought and Methodology
    • N - Economic History
    • P - Economic Systems
    • Y80 - Miscellaneous Categories - - Related Disciplines - - - Related Disciplines
    • Z00 - Other Special Topics - - General - - - General


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