General people’s Committee for Health & Environement G.S.P.L.A.J. LIBYA General people’s Committee for Health & Environement Primary Health care development plan

Technical levels: Primary Health care. Secondary Health Care. Tertiary Health care.

Health Services Structure Tertiary health care Specialized hospitals (21) Primary health care Polyclinics (37) Primary health care units & centers (1355) ) Communicable disease centers (23) Secondary health care Rural hospitals (26) General hospitals (36)

Core elements of Health plan 2009-2013. Promoting health care system. Disease control program. Maintenance of health care facilities. primary health care developments. Development of health manpower. Developments of health care programs. Development of national heath environment program. 4

4/19/2017 المركز الوطني Reforming the health services developmental plan 2009- 2013 take in consideration of changing the approach from Hospital based to community based. PHC developmental plan depend on family practice as core element for this changes:

LIBYAN ARAB JAMAHIRIYA 1.665.000 S.KM 6

No, of Population 1984 - 2006 No. of Population Census Year The Annual Growth Rate 3.231.059 1984 4.21 4.389.739 1995 2.86 5.323.991 2006 1.83 Population Doubling Time = 30 Years 7

PHC coverage (%) Population with safe drinking water 89 Population with local health care 100 Infants attended by trained personnel 94 Deliveries attended by trained Personnel 99 Infants immunized against :T.B {BCG } 99 POLIO 99 DPT 98 Measles 96 8

Population Growth From 1973 - 2006

Distribution of Population Urban \ Rural 10

Population Gender Distribution 2006 11

Population pyramid

Distribution of Population ( 2006 ) Libyan \ Non-Libyan 13

Health System Structure

People’s Committee for Health & Environment Secretary Under Secretary Directorates Legal Affairs Committee Affairs Offices Technical Cooperation Internal auditing Follow up Quality Assurance Human Resources Development Health Information Center Central hospitals & Medical Centers National Center for Communicable Diseases National Council for Medical responsibilities National program for organ transplantation General Authority of Environment Libyan board for medical specialties National Company for Drugs & Supplies National company for maintenance of med equip General company for manufacturing of medical equipment & supplies People’s Committee for Health & Environment Health Construction Projects Study and Planning Supervision & Follow up Contracting Admin & Finances Admin & relation services Financing Personnel Health Education Media Education Written material education Conferences Private Sector & National Services National services Private sector Departments Planning Information section Research & Studies Programming & Planning Medical Services Hospital Affairs Dental Services Labs & Blood banks Recruitment & Evaluation Drugs & Medical Equipment Registration and Inspection Medical equipment and supplies Drugs & Narcotics Drug Research Primary Health Care Evaluation & Follow up School Health Mother and Child Health Occupational Health Emergency & Ambulance Services Technical affairs Air & sea ambulance Vehicles & Stores Notification

Health Services indicators

HealthCare Expenditure Financing Indicators % YEAR Total health expenditure as % of GDP 3.3 2006 Per capita Government expenditure on health (USD) 180 Expenditure on health as % of total government expenditure 7.5 Out of pocket as % of total expenditure on health 23 2004

Health status indicators Infant mortality rate for (1000 life births ) 24.4 Under five mortality rate (1000 life births ) 30.1 Maternity mortality rate (10,000 life births ) 4 Main causes of death are : - cardiovascular diseases , accidents ,(RTA) and Tumors . NO major health hazard due to any infectious disease in Libya. 18

PHC development plan 2009- 2013 19

Elements of Primary health care In Libya.

In addition to elements of PHC declared in Ala mata Libya had add other areas of PHC care these are : mental health, school health, occupational health and social and medical care of elderly.

In view of presence of: High coverage by PHC facilities. Human resources. Materials and financial resources. Strong political well to have functioning health services at highest level required for Libyans.

The reforms of PHC system is possible

All we need is to put all of this together in one system

The family practitioner will: Provide medical care to the all family members including referring patients to appropriate secondary and tertiary levels Document and reporting of family health events Participate in Primary health care programs: MCh, Immunization, school health ...

This will lead to: Improvement Provision of medical care . Improvement of reporting system and documentation. Development of referral system. Improvement of the quality of PHC programs

PHC Center Family Physician Family Physician Family Physician

Tertiary Services Secondary Services Family Physician Family Physician Family Physician Family Physician

4 main points to focus on: 1- Skilled health care personnel. 2- Health care facilities reforms. 3- Other supportive services. 4- Referral system.

Training of doctors in family practice (400 doctor). The implementation of the plan is already started by: Training of doctors in family practice (400 doctor). increasing salaries for medical and paramedical personnel. implementing of relative logistics' as family medical documents (file)- re-location of equipments and maintains of some heath facilities. computing rates (1 family practice team per 2000 citizen). mapping & geographical distribution of health centers targeted by this plan.

Areas of Cooperation

training of medical personnel. development of referral system. documentation system. Development of guidelines.

Thanks