Health System in Algeria

Prepared by:
Dr. Raed Elsaeed
Dr. Mohamed Eldoushy
Dr. Mohamed shamaa
Dr. Mohamed ramadan
 Algeria geographically
 Algeria is a country located in North Africa.
It is the largest country in Africa and the
tenth largest country in the world. It is
bordered by Tunisia to the northeast, Libya to
the east, Niger to the southeast, Mali and
Mauritania to the southwest, Western Sahara
to the west, Morocco to the northwest, and
the Mediterranean Sea to the north.
 Algeria demographic
Age ratio

The estimated population of Algeria is around 46 million, 70%

60%
50%
according to the United Nations. The country has a relatively 40%
30%

young population, with around 28% of the population under 20%

10%

the age of 15 and only around 7% over the age of 65. 0%

under 15 between 15-65 above 65

Arabic is the official language, while Berber and French are

also widely spoken. literacy rate

The literacy rate in Algeria is around 80%, with a slightly 20% literate

higher rate for men than for women. The country has made unlettered

significant progress in education, with the government 80%

investing heavily in the sector over the years.
 Regulation/Governance
 Algeria has a public health system that
is primarily funded and run by the
government. The system is organized
into three main components:
regulation/governance, financing, and
service provision.
 Regulation health system in Algeria:

 The health system in Algeria is regulated by the Ministry of Health, Population, and Hospital
Reform, which is responsible for setting healthcare policies, regulating healthcare providers, and
overseeing the delivery of healthcare services throughout the country. The healthcare system in
Algeria is a mixture of public and private healthcare services.
 The public healthcare system is funded and operated by the government and provides free or low-
cost healthcare services to Algerian citizens and legal residents. The private healthcare sector is
small and provides care primarily to those who can afford to pay for it.
 The Ministry of Health is responsible for regulating both public and private healthcare providers
in Algeria. The ministry sets standards for the provision of healthcare services, licenses healthcare
facilities, and professionals, and enforces regulations to ensure the quality and safety of
healthcare services.
 Regulation health system in Algeria:

 The Ministry of Health also oversees the management of Algeria's public hospitals and clinics,
which provide primary, secondary, and tertiary healthcare services to the population.
 These facilities are staffed by healthcare professionals, including doctors, nurses, and other allied
health professionals. In recent years, Algeria has invested in improving its healthcare system
through the expansion of healthcare facilities, the recruitment of more healthcare professionals,
and the implementation of new healthcare technologies.
 However, like many other countries, Algeria continues to face challenges in delivering equitable
access to healthcare services to all of its citizens, particularly those living in rural or remote areas.
 Regulatory bodies in Algeria
 Ministry of Health
 National Health Insurance Fund
 National Agency for the Development of Health Services.
 National Agency for the Evaluation and Accreditation of
Health Institutions.
 Algerian Medical Council.
 Algerian Dental Association.
 Role of each body and how functions:
 Ministry of Health, Population and Hospital Reform: As mentioned earlier, the Ministry of
Health is responsible for setting policies, regulating healthcare providers, and overseeing the
delivery of healthcare services throughout the country.
 The ministry sets healthcare standards, licenses healthcare providers regulates pharmaceuticals
and medical devices, and coordinates healthcare policies and programs.

 National Health Insurance Fund (Caisse Nationale de l'Assurance Maladie - CNAM): The
CNAM is responsible for managing the country's health insurance system and providing
coverage for healthcare services.
 The fund is financed by contributions from employers, employees, and the government, and it
provides coverage for a range of medical services, including hospitalization, consultations, and
prescription drugs.
 Role of each body and how functions

 National Agency for the Development of Health Services (Agence Nationale de Développement
de la Santé - ANDS): The ANDS is responsible for implementing national health policies and
programs and coordinating health system development projects.
 The agency works to improve access to healthcare services, particularly in underserved areas,
and to promote the development of health infrastructure and human resources.
 National Agency for the Evaluation and Accreditation of Health Institutions (Agence
Nationale d'Evaluation et d'Accréditation en Santé - ANAES): The ANAES is
responsible for evaluating and accrediting healthcare institutions in Algeria.
 The agency assesses the quality of healthcare services provided by hospitals, clinics, and
other healthcare facilities and provides guidance and support for improving their
performance.
 Role of each body and how functions:
 Algerian Medical Council (Conseil de l'Ordre des Médecins d'Algérie - COMA): The COMA is
responsible for regulating the medical profession in Algeria, including licensing and disciplinary
matters.
 The council is composed of elected representatives from the medical profession and works to ensure
that medical practitioners adhere to ethical and professional standards.
 Algerian Dental Association (Association Algérienne de Chirurgie Dentaire - AACD): The AACD
is responsible for regulating the dental profession in Algeria, including licensing and disciplinary
matters.
 The association works to ensure that dental practitioners adhere to ethical and professional standards and
promotes the development of dental education and research in Algeria.
 Each regulatory body has its own functions and responsibilities, but they all work together
to ensure that healthcare services in Algeria are provided safely, efficiently, and with high-
quality standards.
 Financing in health system in Algeria

 The financing of Algeria's health system is primarily the responsibility of

the government, which allocates funding for healthcare through the national
budget.
 The country's health expenditure as a percentage of GDP was 6.4% in 2019,
which is below the global average of around 10% but comparable to other
middle-income countries in the region.
 The main sources of funding for Algeria's health system include
government revenue, health insurance contributions, and out-of-pocket
payments by individuals.
Financing in health system in Algeria

 The National Health Insurance Fund (CNAM) is a key source of financing

for healthcare services, with the government providing subsidies to support
the fund's operations. Private health insurance is also available but is
limited to a small portion of the population.
 Despite government efforts to increase funding for healthcare in recent
years, there are concerns about the adequacy of funding to meet the
growing demand for healthcare services.
 The country's health system has struggled with shortages of medical
supplies, equipment, and personnel, particularly in rural areas.
 In terms of the fairness of the financing system, there are some concerns
about the equity of access to healthcare services in Algeria.
Financing in health system in Algeria

 While the government provides free or low-cost healthcare services to Algerian citizens and legal
residents, there are still barriers to access for some populations, particularly those living in rural
or remote areas.
 Out-of-pocket payments can also create financial barriers for some individuals, particularly those
with lower incomes.
 To address these issues, the government has implemented several measures to improve access to
healthcare services, including increasing the number of healthcare facilities, expanding health
insurance coverage, and investing in the recruitment and training of healthcare professionals.
 However, more needs to be done to ensure that healthcare services are accessible and affordable
for all Algerians, regardless of their socioeconomic status or geographic location.
 service provision:

 Algeria's health service provision is organized through a mix of public and

private healthcare providers.
 The public sector provides the majority of healthcare services, including primary
care, hospital care, and specialized care.
 The private sector is small but growing, and it includes private hospitals, clinics,
and individual practitioners.
 Primary healthcare services are provided through a network of health centers and
clinics, which are primarily located in urban areas.
service provision:

 These facilities provide a range of services, including preventive care,

maternal and child health services, and treatment for common illnesses and
injuries.
 The government has made efforts to expand access to primary healthcare
services in rural and remote areas by building new health centers and
clinics and deploying mobile healthcare units.
 Hospital care in Algeria is provided through a network of public hospitals,
which are operated by the Ministry of Health.
 The country has several large teaching hospitals in major urban centers, as
well as smaller regional hospitals and specialized hospitals.
service provision:
 In recent years, the government has invested in the modernization and
expansion of hospital infrastructure, including the construction of new
hospitals and the renovation of existing facilities.
 Specialized healthcare services, such as cancer treatment, organ
transplantation, and cardiovascular care, are provided by a limited number of
specialized hospitals and clinics, primarily in urban areas.
 These services are generally not widely available in rural or remote areas.
 The private sector in Algeria is small but growing, and it includes private
hospitals, clinics, and individual practitioners.
service provision:
 Private healthcare providers primarily serve urban areas and offer a range
of services, including primary care, hospital care, and specialized care.
 Private healthcare services are generally more expensive than public
services, and they are primarily used by those who can afford to pay out-
of-pocket or who have private health insurance.
 Overall, the quality of healthcare services in Algeria varies depending on
the location, with urban areas generally having better access to healthcare
services and higher quality care than rural or remote areas.
 The government has made efforts to improve access to healthcare services
and quality of care, particularly in underserved areas, but there is still work
to be done to ensure that all Algerians have access to high-quality,
affordable healthcare services.
 performance of Algeria Health System according to
WHO
 According to the WHO's most recent report on the health system in Algeria, the country has made
significant progress in improving health outcomes over the past few decades.
 Life expectancy at birth has increased from 65.4 years in 2000 to 77.3 years in 2019, and infant
mortality rates have decreased from 33.1 deaths per 1,000 live births in 2000 to 15.9 deaths per
1,000 live births in 2019.
 In terms of health service coverage, Algeria has achieved near-universal coverage of basic health
services, including immunizations, antenatal care, and skilled birth attendance.
 The country has also made significant progress in reducing the burden of communicable diseases,
such as malaria and tuberculosis, through effective prevention and treatment programs.
 performance of Algeria Health System
according to WHO
 However, despite these achievements, the health system in Algeria still faces significant challenges.
 The country has a high burden of non-communicable diseases, such as cardiovascular disease and
cancer, which require more specialized and complex healthcare services.
 Additionally, there are disparities in healthcare access and quality between urban and rural areas, with
rural areas generally having less access to healthcare services and lower quality care.
 Algeria's health system inputs, including health expenditure and healthcare workforce, are generally
adequate compared to other countries in the region.
 However, there is a need to improve the efficiency and effectiveness of healthcare spending, as well as
to address workforce shortages and maldistribution in certain areas.
 Comparison with averages of the Globe, EMR or respective WHO
region, and Income level
 Based on data available on the WHO website, here is a
Life expectancy at birth
comparison of some key health indicators for Algeria with 2019
the global, EMR or respective WHO region, and income 78.00%

level averages: 72.00%

66.00%

 Life expectancy at birth (years):

 Algeria: 77.3 (2019) - Global average: 72.6 (2019) - EMR average: 70.7
(2019) - Upper middle-income country average: 75.3 (2019)
 Infant mortality rate (per 1,000 live births): Infant mortality rate/1000
live brith
 Algeria: 15.9 (2019) - Global average: 28.2 (2019) - EMR average: 20.1 15.9
28.2
20.1 17.1
(2019) - Upper middle-income country average: 17.1 (2019)
 Comparison with averages of the Globe, EMR or respective WHO
region, and Income level
 Maternal mortality ratio (per 100,000 live births): Maternal mortality
 Algeria: 113 (2017) - Global average: 211 (2017) - EMR average: 196 ratio /1000 live birth
(2017) - Upper middle-income country average: 73 (2017) 1200
800
400
 Health expenditure per capita (US$ PPP): 0
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lg v er v er un
A a a o
 Algeria: 894 (2017) - Global average: 1,184 (2017) - EMR average: 473 lo
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G i- n
(2017) - Upper middle-income country average: 1,150 (2017) m
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Health expenditure per capita

 Algeria performs better than the global and EMR averages for most $$
of the health indicators listed above, except for health expenditure
1200
per capita, where it falls behind the global and upper middle-income 800
400
country averages. However, Algeria's health outcomes and service 0
ia ge ge try
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coverage still fall below those of many high-income countries. For A
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instance, the life expectancy at birth in Algeria is about 10 years G
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lower than the average for high-income countries. U

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erm
 Indicator Algeria Tunisia Morocco 50
45
40
Population (2023, in millions) 46 12 38 35
30
25
Health expenditure to GDP ratio (2019) 20
6.40% 6.40% 5.40% 15
10
5
0
Health expenditure per capita (2019) Population (2023, in millions)
242$ 287$ 172$ Series1 Series2 Series3
350
Life expectancy at birth (2021) 76.6 76.3 76.3 300
250 287
242
Infant mortality rate (2020) 19.6 11.4 19.7 200
150 172

Maternal mortality ratio (2017) 100

113 60 72 50
0
Hospital beds per 1,000 population 1.9 2.3 1.0 Health expenditure per capita (2019)/$$

Series1 Series2 Series3

76.65 25 120 6.60%

76.6 100 113 6.40%
76.55 76.6 20 6.40% 6.40%
6.20%
19.6 19.7 80
76.5 6.00%
76.45 15 60 72
60 5.80%
76.4
40 5.60%
76.35 10 11.4
76.3 20 5.40%
76.3 76.3 5.40%
76.25 5 5.20%
0
76.2 Maternal mortality ratio (2017) 5.00%
76.15 0 4.80%
Life expectancy at birth (2021) Infant mortality rate (2020) Health expenditure to GDP ratio (2019)

Series1 Series2 Series3 Series1 Series2 Series3 Series1 Series2 Series3 Series1 Series2 Series3
 gaps in Inputs and outcomes
 Here are some of the key gaps:
 Inputs:
 Healthcare workforce: While Algeria has a relatively high number of healthcare workers per capita
compared to other countries in the region, there are still significant shortages and maldistribution of
healthcare professionals, particularly in rural areas.
 This can lead to reduced access to healthcare services and lower quality care.
 Health infrastructure: While Algeria has made significant investments in healthcare infrastructure over
the past decade, there are still gaps in access to healthcare facilities and equipment, particularly in rural
areas.
 This can limit the availability and quality of healthcare services. Health technologies: While Algeria has made
progress in adopting new health technologies, there are still gaps in the availability and use of modern healthcare
technologies, such as telemedicine and electronic health records.
 These technologies can improve the quality and efficiency of healthcare services.
 gaps in Inputs and outcomes

 Outcomes:
 Non-communicable diseases: Algeria has a high burden of non-communicable diseases, such
as cardiovascular disease, cancer, and diabetes.
 These diseases require more specialized and complex healthcare services than infectious diseases
and can lead to increased morbidity and mortality if not effectively managed.
 Health disparities: There are significant disparities in healthcare access and quality between
urban and rural areas in Algeria, with rural areas generally having less access to healthcare
services and lower quality care.
 This can lead to inequitable health outcomes and exacerbate health disparities between different
populations.
gaps in Inputs and outcomes

 Health system efficiency: While Algeria's health expenditure per capita is relatively high
compared to other countries in the region, there are still gaps in the efficiency and
effectiveness of healthcare spending.
 This can lead to inefficiencies in healthcare delivery, such as overuse of expensive technologies
or unnecessary hospitalizations, which can drive up healthcare costs and reduce the availability
of resources for other health priorities.
 Addressing these gaps will require significant investments in the healthcare workforce, health
infrastructure, and health technologies, as well as policy reforms to improve the efficiency and
effectiveness of healthcare spending.
 Additionally, strategies to address non-communicable diseases and reduce health
disparities, particularly in rural areas, will be critical to improving health outcomes in
Algeria.
 options to fill gaps
 Based on the identified gaps in inputs and outcomes of the health system in
Algeria, here are some potential options to fill those gaps:
 Inputs:
 Healthcare workforce: Develop and implement policies to increase the number of healthcare
workers, particularly in rural areas, through measures such as expanding medical education
programs, offering incentives for healthcare professionals to work in rural areas, and
strengthening community-based healthcare delivery models.
 Health infrastructure: Increase investment in healthcare infrastructure, particularly in rural
areas, by building new healthcare facilities, upgrading existing facilities, and improving
access to medical equipment and supplies.
 Health technologies: Expand the use of modern healthcare technologies, such as
telemedicine and electronic health records, to improve healthcare delivery and efficiency.
 options to fill gaps
 Outcomes:
 Non-communicable diseases: Develop and implement national strategies to prevent and manage non-
communicable diseases, including measures to promote healthy lifestyles, increase access to screening
and early detection, and expand access to specialized healthcare services.
 Health disparities: Develop and implement policies to reduce health disparities between urban and
rural areas, such as increasing investment in rural healthcare infrastructure and expanding access to
healthcare services through community-based healthcare delivery models.
 Health system efficiency: Implement policies to improve the efficiency and effectiveness of healthcare
spending, such as promoting evidence-based practices, incentivizing cost-effective healthcare delivery
models, and improving coordination and integration of healthcare services.
 It is important to note that implementing these options will require significant investment and policy
reforms, as well as strong political commitment and stakeholder engagement.
 Additionally, there may be other options to fill the identified gaps that are specific to the context and
needs of the Algerian health system, which would require further analysis and consultation with relevant
stakeholders.
required information for further analysis

 Further analysis of the health system in Algeria may require additional information, such as:
 More detailed information on healthcare spending, including a breakdown of spending by
sector, provider type, and service type, to better understand the allocation and use of
healthcare resources.
 Information on the quality of healthcare services, including measures of patient outcomes
and satisfaction, to assess the effectiveness of healthcare delivery and identify areas for
improvement.
 Data on health workforce distribution, including the number and distribution of healthcare
workers by region and facility type, to better understand the mal distribution of healthcare
professionals and inform policies to address workforce shortages.
required information for further analysis

 Information on the burden and distribution of non-communicable diseases,

including data on incidence, prevalence, and mortality rates, to inform
strategies for the prevention and management of these diseases.
 Data on the availability and use of modern healthcare technologies, such as
telemedicine and electronic health records, assess the potential for these
technologies to improve healthcare delivery and efficiency.
 Collecting this additional information will require coordination and
collaboration among relevant stakeholders, including government agencies,
healthcare providers, and international organizations.
 It may also require investment in data collection systems and capacity-building
for data analysis and use.
 References
 World Health Organization (WHO). (2021). Algeria. Retrieved from
https://www.who.int/countries/dza/en/
 WHO. (2020). World Health Statistics 2020: Monitoring health for the SDGs.Retrieved from
https://www.who.int/gho/publications/world_health_statistics/2020/en/
 El-Hadi, A., Fadlallah, R., & Raad, E. (2017). Health system in Algeria: A review of health
policy-making process. International Journal of Health Planning and Management, 32(2),
e173-e186. doi: 10.1002/hpm.2331
 The World Bank. (2021). Algeria. Retrieved from https://data.worldbank.org/country/algeria
 Global Burden of Disease Collaborative Network. (2019). Global Burden of Disease Study
2019 (GBD 2019) Results. Seattle, United States: Institute for Health Metrics and Evaluation
(IHME), 2020. Retrieved from http://ghdx.healthdata.org/gbd-results-tool.