Reforming social protection systems in Arab countries: 5th meeting

Mr. George Azzi, ESCWA consultant for social insurance systems, and Ms. Maya Charrouf, assistant researcher for the social protection division, presented the key results of a comprehensive literature review prepared by ESCWA, which studied the relevance of subsidized health insurances for Arab countries. The study shed light on the policies and design features of the existing health insurance characteristics and frameworks and thus assessed their effects on progress towards universal health coverage.

The two speakers discussed the importance of the changes in health financing in alleviating the burden of health expenditures on the most vulnerable groups by increasing government health spending while decreasing out-of-pocket payments. According to the study, most Arab countries' health systems are underfunded, and current systems of subsidized health insurance are insufficient to provide comprehensive protection during crisis; thus, the trend towards a universal health coverage demands an increase in health expenditures, better resource mobilization, and more efficient use of domestic resources.

In terms of response policies, the study recommends securing sufficient funding from multiple sources to maintain the ability to provide appropriate and highly efficient health services for all, particularly vulnerable groups, and to ensure a more effective role for the state in the registration process, as well as to work on designing appropriate and costed  benefit packages (services),  type of health services and their providers, and finally determining the level of financial support for contribution payments by vulnerable households following the presentation, participants were given a series of questions on whether their country has population groups among the most vulnerable that are not yet covered by health insurance systems as well as effective and efficient approaches to extending health insurance coverage to the hard-to-reach populations.

Most speakers in this context stressed that health insurance is still not comprehensive for numerous groups, particularly the most vulnerable, and that countries face several major challenges in this sector, such as fundings and inclusion of workers in the informal sector

The ESCWA consultant, Ms. Balsam Halawi, provided a presentation on ESCWA’s Social Protection Programme – Rapid Assessment Framework (SPP-RAF), which is a quantitative approach to analyzing social assistance programme data. ESCWA developed the SPP-RAF to assist member states in evidence-based social policy making based on social assistance beneficiary data analysis. The discussion covered monitoring and assessing methodologies, as well as an outline of the framework’s principles.

Ms. Halawi also highlighted the framework’s primary stages, which are the analysis of beneficiary characteristics and targeting characteristics, coverage assessment, and changes of beneficiaries’ socio-economic situation over time, with specific examples. The presentation also featured a full description of the essential training resources, particularly the framework’s training handbook, in addition to providing an overview of the Jordanian experience, where ESCWA offered training seminars on data analysis of social protection programs for male and female workers of the National Aid Fund.

The Group of Experts on Social Protection Reform expressed interest in the framework developed by ESCWA for analyzing social assistance beneficiary data and records of social protection programs, and they inquired about the framework’s requirements in terms of skills, as well as the infrastructure required for its operation (computer hardware capacity, informatics programs, databases, etc.).

Mrs. Halawi noted that the analytical framework is based on a statistical software package, which is publicly available for free, and which does not require advanced computer features, but rather relies heavily on the availability of MS Windows and MS EXCEL.

Mr. Marco Schaefer, Chief of ESCWA’s Social Protection Section, presented a framework to establish Comprehensive National Social Protection Systems and Reforms Country Profiles, which ESCWA established jointly with the International Policy Center for Inclusive Growth (IPC-IG) in Brazil.

Mr. Schaefer emphasized that the significance of this project stems from a general lack of knowledge and comprehensive understanding of social protection systems in the Arab region, as well as the need to learn through comparison between countries’ social protection reform pathways, adding that the completed SP country profiles can be important in terms of substantiating social policy decision-making processes as part of social protection reforms.

He provided an overview of the country profiles template in terms of style and content that includes the country context, an explanation of social protection systems and the regulatory environment surrounding them, social protection coverage, and expenditures. The country profiles are also expected to include a section about proposed recommendations for reforming social protection systems and cost estimates for implementing the proposed reforms.

Afterward, Mr. Schaefer described the country profile drafting process, starting with defining the country and ending with releasing the report (country profiles for the country). Subsequently he summarized the roles of the three actors involved in the process (government, local collaborator, and ESCWA) of developing the country profiles.

The participants commended ESCWA’s social protection team’s efforts to equip countries with tools to support their attempts to change their social protection systems and programs. They believed that the country profiles would enable them to evaluate the social protection systems in their countries and identify and address shortcomings at the existing system’s as well as at the programme level.

Mrs. Mona Fattah, ESCWA’s Social Protection Officer, provided a brief presentation on the Ministerial Forum on “The Future of Social Protection in the Arab Region: Building a Vision for the Post-Covid-19 Reality,” which was organized by the UN’s Issue Based Coalition on Social Protection in the Arab Region (lead by ILO, UNICEF and supported by ESCWA), and held virtually with the support of the International Policy Center for Inclusive Growth (IPC-IG),on Tuesday 30 November 2021.

The twenty Arab Countries (members of ESCWA), who were present at the high-level forum, approved a ministerial declaration as a result of the meeting.

Ms. Fattah reported on the preparatory stages for the forum and its declaration as well as on the preliminary technical meeting held on October 21, 2021, during which the four main topics were discussed, namely, Social Protection:

1. Coverage,
2. Shock Responsiveness
3. Financing,
4. Governance,

Based on the outcomes of the introductory meeting, the organizers coordinated technical consultations with all Arab member states of ESCWA on the draft ministerial declaration that was formulated accordingly.

Regarding the final version of the ministerial declaration, Ms. Fattah stated that it is a document of principles approved by the participating ministers and senior officials in the forum, and it stipulates the main guidelines for social protection after the Covid-19 pandemic, which will, to some extent, inform the social protection related policymaking of Arab countries and international partners. Subsequently she summarized the key content of the declaration on each of the four elements.

The participants stressed the declaration’s relevance as a reference document and as a framework that supports their respective countries’ social protection reforms in view of expanding social protection systems’ inclusiveness, sustainability, shocks responsiveness, and governance. It was highlighted that ESCWA is fully prepared to provide technical assistance to its member states in any of the areas addressed by the declaration through collaboration with the ESCWA’s social protection team.