Letters / Public health - Motivation letter review for scholarship [2]

letter of Motivation

Dear The Europubhealth+ Selection Committee,

Egypt is building a new health system after the Egyptian Parliament approved a new universal health coverage law in 2018 which is an unprecedented attempt to regulate Egypt's healthcare sector. I aim to take a role in this important initiative towards reforming and improving Egypt's health care system.

I have a strong interest in the field of public health. Working as a pharmacist and lab analyst in ( ) in Egypt, and as a researcher in health policies for a civil society organization,(). The duality of working in both a public institution and a civic organization has given me enough practical experience to understand the Egyptian health system, and also to have a passion for the field of public health in general. Therefore, the program will expand my public health background and knowledge and exposure to public health current challenges globally and different approaches and solutions to mitigate such challenges, and improve the access of quality health care in transition, as this is the current situation in Egypt.

Pursuing a degree with Europubhealth is of great value to achieve my personal and professional goals. First, I will get the opportunity to engage with people from different cultures on many levels, which will help me understand the societal and cultural differences, and learn their implications in public health. Second, I will build on my academic and practical knowledge and skills to nurture my career in the field of public health. Third, the program will allow me to engage with several universities in different countries and new academic communities.

I believe that having more than five years of experience in public health, health policy, and drug policy makes me a good candidate for admission to this program and a scholarship. In addition, working in a covid-19 task force for ( )to analyze health policies and measures taken to contain the pandemic has expanded my understanding of global health. Thus, studying this unique double-degree program will be a good added value to my career in global health.

I chose this program because it is highly specialized and focuses on issues that are important to me. I like the way the program is structured, its aim and objectives are exactly what I seek to learn and develop upon. In the second year of the program, I am planning to specialize in Governance of Health System in Transition as I feel this is what I need to be able to contribute efficiently to the reform of the healthcare system in Egypt under the new health insurance law. For instance, considering my previous experience in health policies, I think that this pathway is the most suitable for me, given my keen interest in several problems facing universal health insurance, such as integrating informal employment, which represents a large percentage in Egypt, into the new comprehensive health insurance system, and the mechanisms needed to maintain the sustainability of financing health service. Hence, a study of health economics and health governance would be very helpful.

Sincerely,

Ahmed

Scholarship / OKP scholarship, study Master of Public Health (MPH): Health Systems Policy and Management track [2]

scholarship essay

Give a brief outline (minimum of 50 and maximum of 4000 characters) of the issue or problem hindering the development of your country. Indicatie how you would like to contribute to solving this problem, using the knowledge and expertise gained by attending the study programme or course. Use the following information as guideline to your answer.

Shortages of water could become a major obstacle to public health and development. The global health burden associated with these conditions could be staggering, with an estimated 1.6 million deaths every year from diseases associated with lack of access to safe drinking water, inadequate sanitation, and poor hygiene. Diseases related to unsafe water, poor sanitation, and lack of hygiene are some of the most common causes of illness and death among the poor of developing countries. According to the World Health Organization (WHO), 1.6 million deaths each year can be attributed specifically to these health determinants. The global literature on drought and health highlights a variety of health effects for people in developing countries where certain prevailing social, economic, and environmental conditions increase their vulnerability, especially with climate change. Despite the increased focus on climate change, relatively less is known about the health-drought impacts. In general, there are very few studies on the impact of water shortage and climate change on public health and disease patterns. Climate change has been called the "biggest global health threat of the 21st century" (WHO, 2016; WHO, 2003; Whitmee et al., 2015; WHO, 2012; Watts et al., 2019; WHO, 2018). The effects of climate change on human health are wild-ranging from direct impacts of extreme weather such as hurricanes, drought, and heatwaves to indirect effects mediated through natural systems such as the rise and re-emergence of vector- and waterborne diseases. Climate change also has momentous consequences for Sustainable Development Goal Three (SDG3) on health and well-being as well as the rest of the other 16 SDGs.

In the context of Egypt, Egypt is also struggling with desertification, raw sewage, limited freshwater resources, polluted Nile water, and rapid population growth. Moreover, Climate change negatively impacts agricultural, environmental, and natural systems, affecting livelihoods depending on those resources. Besides the pressure on the Nile water supply in Egypt, climate change has increasingly become a threat.

The COVID-19 pandemic has demonstrated the fragility of global health systems, their inflexibility, and their lack of ability to deal with serious health threats. Egypt also suffered from the pandemic, and the Egyptian health system was ill-equipped to deal with a health threat of this magnitude. The Egyptian health system already suffers from health justice gaps that make it more fragile than others (as is the case in many countries of the global south). For example, the proportion of out-of-pocket expenditures in the health sector is more than 60%.

In this context, the problem that concerns me is the absence of a comprehensive health insurance system in Egypt that is flexible and able to deal with the predicted health effects of water shortage and climate change. Egypt had failed attempts to create comprehensive health insurance because of many challenges such as the high percentage of the informal sector in Egypt, which in some estimates represent 40%, besides maintaining financial sustainability for 10-15 years, during which the new law of health insurance will be implemented to reach all governorates of Egypt. Egypt is embarking on a new universal health insurance (UHI) system to cover all Egyptians by 2032, in line with the UHI law (Ahram Online, 2019).]The implementation of the first phase started in Port Said in 2019 with gradual geographic expansion to follow (Mathauer et al., 2019). When fully implemented, the system is expected to ensure quality health services and adequate levels of financial protection for all. UHI is a compulsory system based on social solidarity, where those who cannot afford contributions will be exempted, based on a decree issued by the prime minister to regulate exemptions (UHI law, Article 2). The family is the main insurance coverage unit within the new system, in contrast to the existing system, which provides uncoordinated, separate coverage to each family member, leaving some uninsured (Nassar & El-Saharty, 2010).

From my work experience as a health policies researcher , I can point to the lack of health coverage in Egypt as one of the critical reasons hindering development and putting many households and individuals under constant pressure to fall into poverty. Despite the national poverty reduction, around 29% of Egyptians are still living under the poverty line (CAMPAS 2021); at the same time, this percentage is at risk of increasing due to the COVID-19 impact. Concerning the critical challenges on all political, social, and economic levels to improve Egyptian living conditions, the absence of health protection is a long-term issue that may severely affect both poor and middle social classes in Egypt. Therefore, Egypt needs all the possible expertise that can collaborate and work jointly on this issue.

Considering the potential health risks from climate change and severe water shortages, I believe that a comprehensive health system that is resilient and able to deal with health threats is a vital measure. In addition, there are no various study programs to study public health in Egypt, and there is no such type of research that links public health, water shortages, and climate change in Egypt and its impact on the most vulnerable groups. Therefore, my goal is to study public health and try to find solutions to the impact of water shortage and climate change on public health and disease patterns.