Person: El-Saharty, Sameh
Health, Nutrition and Population
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Health policy; health reform; health systems; health management; public health; maternal health; child health; non-communicable diseases; health service delivery; human resources; primary health care; hospital reform; health insurance; health financing; Global, Middle East region; Africa region; South Asia region
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Health, Nutrition and Population
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Last updated: January 13, 2025
Biography
Sameh El-Saharty works as Lead Health Policy Specialist at the World Bank in Washington, DC. Before joining the Bank, he held several positions with international organizations, academic institutions, and consulting firms such as USAID, WHO, UNFPA, Harvard University, the American University in Cairo, Georgetown University, and Pathfinder International. He has extensive experience for over 40 years working as researcher, technical advisor, and international consultant on public health, health policy and management, health insurance, and health sector reform programs in more than 30 countries in the MENA region, Africa, South Asia, and in the US. His recent work has focused on health systems with particular interest in health service delivery. He is currently a member of the Harvard School of Public Health (HSPH) Dean’s Leadership Council, HSPH Alumni Council, the Executive Committee of the World Bank-International Monetary Fund Arab Association, and the Advisory Committee of the MENA Health Policy Forum. He is a Medical Doctor, graduated from Cairo University, and earned an MPH degree from the Military Medical Academy, Egypt, a Fellowship in Social and Economic Policy from Harvard Kennedy School, and a Master of Health Policy and Management from Harvard School of Public Health.
23 results
Publication Search Results
Now showing 1 - 10 of 23
Publication The Burden of Road Traffic Injuries in Jordan: Evidence for Policy(Washington, DC: World Bank, 2024-08-01) Bader, Rania; Fawzi, Imad; Elfadel, Diya; Bajaj, Tripti; El-Saharty, Sameh; Sunna, Lana; Dahdah, SaidRoad traffic injuries (RTIs) are a critical public health issue in Jordan, as highlighted in the 2022 Annual Report on Road Traffic Injuries. With 169,409 crashes recorded, resulting in 562 deaths and a range of injuries, RTIs have emerged as the leading cause of death for children and young people, and the second-leading cause for adults aged 20-64. This study aims to understand RTI-induced disabilities in Jordan, identify contributing factors, and assess the associated costs for patients. Employing a mixed-methods approach, the research included quantitative and qualitative data collection through hospital-based surveillance and follow-up surveys at one- and three-months post-injury. Six hospitals across Jordan participated, including both public and private institutions. Key informant interviews with stakeholders from various sectors were conducted to gain comprehensive insights. The study’s findings reveal that most RTI patients were male (79 percent) with an average age of 34 years. Crashes predominantly occurred during early mornings and night hours on main roads, involving mainly cars (72 percent) and motorcycles/bicycles (40 percent). A significant number of patients (74 percent) received prehospital care, primarily from ambulance staff. Most patients (66 percent) were fully conscious upon arrival at the emergency room. Injury analysis showed that 58 percent of patients had a single injury, with extremities being the most affected area. Common treatments included sutures and surgical operations, with internal fixation for fractures being prevalent. Financially, 49 percent of patients incurred immediate costs upon hospital admission, and follow-up care also resulted in out-of-pocket expenses, particularly for physiotherapy and medications. Disability outcomes indicated that 79 percent of patients experienced some disability at the one-month follow up, with varying degrees from mild to extreme. By the third month, 73 percent reported no disability, though 26 percent continued to experience mild impairments. This study underscores the significant burden of RTIs in Jordan, highlighting the need for targeted interventions to reduce injuries and support affected individuals.Publication Global Experience of Institutional Development: Support for Libya’s Primary Health Care Institute(World Bank, Washington, DC, 2023-08-01) El-Jardali, Fadi; Hatefi, Arian; Daher, Najla; Kak, Mohini; Shubber, Zara; El-Saharty, Sameh; Karem, GhassanThe COVID-19 pandemic has underscored the significance of national and local actors in responding to health emergencies, prompting a reevaluation of public health paradigms. Prior to the pandemic, effective healthcare systems relied on coordinated and robust institutions to optimize resource allocation, enhance healthcare access, and achieve national health goals. Nations with strong health institutes dedicated to promoting, restoring, and maintaining health systems demonstrated better control over health costs and improved health outcomes.Publication Strengthening the Pharmaceutical System in the Kingdom of Saudi Arabia: Towards a Medicine Policy to Support Vision 2030(World Bank, Washington, DC, 2020) Alghaith, Taghred; Almoteiry, Khalid; Alamri, Adwa; Alluhidan, Mohammed; Alharf, Adel; Al-Hammad, Bander; Aliafali, Ibrahim; Seiter, Andreas; Pisani, Elizabeth; Herbst, Christopher H.; El-Saharty, Sameh; Alazemi, NaharThis document presents the major issues that were discussed in the process of working towards the development of a new medicines policy in Saudi Arabia, examining current national practice in light of international practices and experiences. The document is designed to foster discussion and help inform the development of a new national medicine policy. A detailed accounting of the evidence informing policy choices to be highlighted in an updated medicine policy are presented in Part I of this discussion paper; a proposed new National Medicine Policy itself is presented in Part ll. A new Medicine policy, once finalized and approved, will need to be implemented in a highly dynamic environment and must therefore allow for flexibility. It will need to be followed by the implementation of regulations, closely monitored, and adapted as necessary over time.Publication COVID-19 and Mental Health in Vulnerable Populations: A Narrative Review(World Bank, Washington, DC, 2021-03) Das, Abhery; Bruckner, Tim; Saxena, Shekhar; Alqunaibet, Ada; Almudarra, Sami; Herbst, Christopher H.; Alsukait, Reem; El-Saharty, Sameh; Algwaizini, AbdullahThis paper examines the global implications of COVID-19 on mental health, with a focus on four particularly vulnerable populations: (1) unemployed adults; (2) youth; (3) older-age populations; and (4) healthcare workers. Considering the global public health burden of mental disorders, understanding COVID-19’s psychological impact on vulnerable populations may provide policy makers with the information necessary to effectively direct resources. The paper focuses on these populations because racial, gender, and social class disparities endure in most educational and work opportunities.25 Additionally, health systems and work environments can perpetuate inequality among vulnerable populations, often leading to worse health outcomes. Previous pandemics and natural disasters have exacerbated income and health disparities for vulnerable populations.25 Similarly, the economic shutdown may disproportionately affect low-income or racial minority workers who work in sector most affected by COVID-19. Youth and older populations remain vulnerable because of factors associated with their age, whereas frontline healthcare workers face overwhelmed health systems and a higher risk of infection. Focusing on these vulnerable populations, the narrative review summarizes the literature addressing mental health and the COVID-19 pandemic. This paper is organized as follows: the next section summarizes current literature on the psychological impact of COVID-19 on four vulnerable populations. The following section then summarizes the findings for each of the populations, followed by a section discussing those results. The next sections provide an understanding of the current state of global mental health and recommend short, medium, and long-term policy solutions.Publication Fostering Human Capital in the Gulf Cooperation Council Countries(Washington, DC: World Bank, 2020-06-19) Kheyfets, Igor; El-Saharty, Sameh; Ajwad, Mohamed Ihsan; Herbst, Christopher H.; Ajwad, Mohamed IhsanThe formation of human capital--the knowledge, skills, and health that people accumulate over their lifetimes--is critical for the six Gulf Cooperation Council (GCC) countries. Human capital contributes not only to□ human development and employment but also to the long-term sustainability of a diversified economic growth model that is knowledge based and private sector driven. This approach is critical, given that income from oil and gas will eventually decline and that the nature of work is evolving in response to rapid technological changes, in turn demanding new skill sets. The GCC governments have demonstrated their strong political will for □this shift: four of them are among the first countries to join the World □Bank’s Human Capital Project—a global effort to improve investments in people as measured by the Human Capital Index. The GCC countries face four main challenges: Low levels of basic proficiency among schoolchildren; A mismatch between education and the labor market; A relatively high rate of adult mortality and morbidity; A unique labor market , in which wages in the public sector are more generous than in the private sector and government employment of nationals is virtually guaranteed To address these challenges, this report outlines four strategies in a “whole-of-government” approach: Investing in high-quality early childhood development; Preparing healthier, better educated, and skilled youth for the future; Enabling greater adult labor force participation; Creating an enabling environment for human capital formation These strategies are based on best practices in other countries and feature some of the GCC countries’ plans, including their national “Visions,” to take their economies and societies further into the twenty-first century. With the COVID-19 pandemic, the GCC countries face additional challenges that may worsen some preexisting vulnerabilities and erode human capital. In response, the GCC governments have taken multiple measures to protect their populations’ health and their economies. Any□ country’s decision to reopen its economy needs to closely consider public health consequences to avoid a resurgence of infections and any further erosion of its human capital. The COVID-19 crisis underscores that the need to accelerate and improve investment in human capital has never been greater. Once the GCC countries return to a “new normal,” they will be in a position to achieve diversified and sustainable growth by adopting, and then tailoring, the strategies presented in this report.Publication The impact of Seven Major Noncommunicable Diseases on Direct Medical Costs, Absenteeism, and Presenteeism in Gulf Cooperation Council countries(Taylor and Francis, 2021-07-06) Finkelstein, Eric Andrew; Malkin, Jesse D.; Baid, Drishti; Alqunaibet, Ada; Mahdi, Khaled; Hamad Al-Thani, Mohammed Bin; Bin Belaila, Buthaina Abdulla; Nawakhtha, Ebrahim Al; Alqahtani, Saleh; El-Saharty, Sameh; Herbst, Christopher H.To estimate the current burden of seven major noncommunicable diseases on direct medical costs, absenteeism, and presenteeism in the six countries in the Gulf Cooperation Council: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. The economic burden of noncommunicable diseases in Gulf Cooperation Council countries is substantial, suggesting that successful preventive interventions have the potential to improve both population health and reduce costs. Further research is needed to capture a broader array of noncommunicable diseases and to develop more precise estimates.Publication Improving Maternal and Reproductive Health in South Asia: Drivers and Enablers(Washington, DC: World Bank, 2016-11-17) Ohno, Naoko; El-Saharty, Sameh; Sarker, Intissar; Chowdhury, SadiaSouth Asia Region (SAR) has decreased maternal mortality ratio (MMR) by 65 percent between 1990 and 2013, which was the greatest progress among all world regions. Such achievement implores the question, What made SAR stand out against what is predicted by standard socioeconomic outcomes? Improving Maternal and Reproductive Health in South Asia: Drivers and Enablers identifies the interventions and factors that contributed to reducing MMR and improving maternal and reproductive health (MRH) outcomes in SAR. In this study, the analytical framework assumes that improving MRH outcomes is influenced by a multitude of forces from within and outside the health system and considers factors at the household and community levels, as well as interventions in other sectors and factors in the enabling environment. The analysis is based on a structured literature review of the interventions in SAR countries, relevant international experience, and review of the best available evidence from systematic reviews. The focus of the analysis is mainly on assessing the effectiveness of interventions. The findings from this study indicate that the most effective interventions that prevent maternal mortality are those that address the intra-partum stage - the point where most maternal deaths occur - and include improving skilled birth attendance coverage, increasing institutional delivery rates, and scaling up access to emergency obstetric care. There is also adequate evidence that investing in family planning to increase contraceptive use also played a key role during the inter-partum phase by preventing unwanted pregnancies and thus averting the risk of maternal mortality in SAR countries. Outside the programmatic interventions, the levels of household income, women’s education, and completion of secondary education of girls were also strongly correlated with improved MRH outcomes. Also, there is strong evidence that health financing schemes - both demand and supply side - and conditional cash transfer programs were effective in increasing the uptake of MRH services. The study points out to many other interventions with different degrees of effectiveness. The study also identified four major reasons for why SAR achieved this progress in MMR reduction. The best practices and evidence of what works synthesized in this study provide an important way forward for low- and middle-income countries toward achieving the health-related Sustainable Development Goals.Publication The Economic Impact on Households and Nations of NCDs : A Review of Existing Evidence(Taylor and Francis, 2011-09-14) Engelgau, Michael; Rosenhouse, Sandra; El-Saharty, Sameh; Mahal, AjayIn developing countries, the noncommunicable disease (NCD) and risk factor burdens are shifting toward the poor. Treating chronic diseases can be expensive. In developing countries where generally much health care costs are borne by patients themselves, for those who live in poverty or recently escaped severe poverty, when faced with large, lifelong out-of-pocket expenses, impoverishment persists or can reoccur. These patterns have implications for national economic growth and poverty-reduction efforts. NCDs can change spending patterns dramatically and result in significantly reducing non–medical-related spending on food and education. In India, about 40% of household expenditures for treating NCDs are financed by households with distress patterns (borrowing and sales of assets). NCD short- and long-term disability can lead to a decrease in working-age population participation in the labor force and reduce productivity and, in turn, reduce per capita gross domestic product growth. To fully capitalize on the demographic dividend (i.e., aging of the population resulting in less dependent children, not yet more dependent elderly, and greater national productivity), healthy aging is necessary, which, in turn, requires effectively tackling NCDs. Last, from an equity standpoint, the economic effect of NCDs, evident at the household level and at the country level, will disproportionately affect the poor and vulnerable populations in the developing world.Publication Bangladesh : Maternal and Reproductive Health at a Glance(World Bank, Washington, DC, 2014-11) El-Saharty, Sameh; Sarker, Intissar; Secci, FedericaBangladesh is among the most densely populated countries in the world. Poverty remains high at 43 percent of the population subsist on less than United States (U.S.) $1.25 per day (2010). Bangladesh achieved several millennium development goal (MDG) targets in education, health, and poverty reduction. Gender equality and women's empowerment are important determinants of reproductive health. While fertility and contraceptive prevalence rate (CPR) are evenly distributed, wide gaps in access to maternal health services remain. Bangladesh will need to focus on increasing political commitment to adolescent health; focusing interventions on high-fertility and high maternal mortality ratio (MMR) areas; addressing human resources constraints; and harnessing the use of technology.Publication Maldives: Maternal and Reproductive Health at a Glance(World Bank, Washington, DC, 2014-11) Ohno, Naoko; El-Saharty, Sameh; Sarker, Intissar; Secci, Federica; Nagpal, SomilMaldives, a middle income country, is on track to meet most of the Millennium Development Goals (MDGs), while gender gap requires attention. Maldives has made great progress in improving maternal health and has achieved MDG. The total fertility rate has declined to 2.3 in 2012. Contraceptive use has increased but high unmet need of 28.1 percent is of concern. Skilled birth attendance is high at 95 percent. Access to maternal health services is fairly equitable by residence and wealth quintile, while geographical access to services remains challenging. Also, unwanted pregnancies among young women are on the rise. Maldives has initiated a number of interventions to increase adolescents needs for sexual and reproductive health services, improve quality of RMNCH services, and increase utilization of health services at local level.
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