Risk Management Essay -- Business Management

pretend is a commonly used boundary and its usually desire with bad impacts on our objectives. The Oxford English Dictionary define risk as a chance or possibility of danger, loss, injury or other ominous consequences. There is no agreeable technical comment of risk as it went through many developments. The first stage was the focussing of threats only then the confines is extended to cover the threats and the opportunities which face the organisations. The latest stage which is the management of the threats, opportunities, uncertainties and its sources. Of uncertainty (Ward and Chapmen, 2003). Therefore, Dowie argues to banned use the term risk in the risk management because of its misleading.The definition will be used in this paper is the Australia/ unexampled Zealand standard definition which is The chance of something happening that will have an impact on objectives (Australia/New Zealand Standard, 1999). The reasons of using this definition are the simplicities and the coverage of the negative and positive effects on objectives.Risk management has been done for thousands of years (Bernstein, 1996). The Risk management term was first introduced in the 1950s by the insurance industry. The first text book published about risk management in 1963 titled Risk management and the Business Enterprise by Robert I. Mehr and Bob Hedges (DArcy and Brogan, 2001).Risk management is a integrated process and risk manger need to assist the caller-outs business process are constant with its strategies, and the what is the relation between risk management and the investment and performance choices (Nocco and Stulz, 2006). Organisations should develop a risk management long term strategies depending on the business environment and shareholders an... ...ment guide 2001. London clean-living Page.Hodgkinson, R. (2001). Enterprise-wide risk management . Risk management guide 2001, London White Page.Committee of Sponsoring Organizations (COSO), (2004). Enterprise Ris k ManagementIntegrated Framework. New York COSO.Beasley, M. Clune, R. And Hermanson, D. (2005), Enterprise risk management An empirical analysis of factors associated with the extent of implementation. Journal of Accounting and domain Policy. 24. pp. 521-531Kleffner, A., Lee, R., McGannon, B., (2003). The effect of corporate governance on the use of first step risk management evidence from Canada. Risk Management and Insurance Review 6 (1), pp.5373.Liebenberg, A., Hoyt, R., (2003). The determinants of enterprise risk management evidence from the appointment of chief risk officers. Risk Management and Insurance Review 6 (1), pp. 3752.

Analysis of Just and Unjust Wars: A Moral Argument with Historical Illu

abbreviation of well(p) and Un only if Wars A Moral Argument with historical IllustrationsMichael Walzer first wrote Just and Unjust Wars A Moral Argument with Historical Illustrations in the age following the Vietnam War, and unfortunately its premise on morality in war will alship canal remain as relevant as it was then as it is now, with conflict surrounded by states forever existing. Michael Walzer is one of the most large(p) social critics in North America and in this book, he explores two main concepts, the evaluator of war and the justice in war in a great depth, and uses numerous historical references to support his claims. It is a very well configured piece, compose in such a way of persuasion that your own(prenominal) view on morality in war may ultimately change subsequently delving into thoughts for several hundred pages.To an overwhelming majority of people, the words war and morality have seemingly opposing meanings, however in the preface to his book, Walzer points out that whether or not its specific terminology is adapted, just-war theory has always vie a part in official assembly line about war (Walzer XI). He restoration to discuss in a greater detail the ways that war has been perceived and how this impacts the topics of war and morality, and in doing so, he provides an intelligently structured and persuasive argument that can be viewed within a moral con textbook. He addresses this topic both from the view of the role of the state and also from the perspective of how the decision to scramble impacts the individual. Walzer takes the position that an individual should fight only for private and personalised reasons rather then from nationalistic feelings because he feels that it is crucial that this decision should be freely elect and that it constitutes one of the crucial requirements for a just war. Walzer defines a just war as a limited war, and that just wars are governed by a stage set of rules, designed to prevent, as m uch as possible, the use of force out and coercion against non-combatant populations (Walzer XVII) On the other hand, a limited war take ons to establish the way things were prior to the aggression taking place. Aside from extreme cases, just wars do not have legitimate reasons for reaching beyond this goal, including the replacing of the aggressors... ...f becoming aggressors themselves. As Walzer points out, the Kuwait regime that US intervention restored to power was exact better for the Kuwait people than their Iraqi invaders. However, the ultimate fate of this regime was placed ski binding in the hands of the Kuwaiti people disregarding our attempt at improvement. Reading this book was both uplifting, in that Walzer does an excellent job of developing a framework to understanding what should and should not be done during wartime, as well as depressing, in realizing that war will only evolve and forever exist.The limits that a just war places on the use of aggression betwe en states for both states and individuals, according to Walzer, offers a rational and moral way of perceiving modern warfare. He ends his text with the comment that The restraint of war is the beginning of peace fundamentally summing up his argument, though will this end ever arrive? (Walzer 335). This book offers a in his right mind(predicate) way of perceiving morality within the insanity of war.Work CitedWalzer, Michael. Just and Unjust Wars A Moral Argument with Historical Illustrations. New York Basic Books, 1977. Analysis of Just and Unjust Wars A Moral Argument with Historical IlluAnalysis of Just and Unjust Wars A Moral Argument with Historical IllustrationsMichael Walzer first wrote Just and Unjust Wars A Moral Argument with Historical Illustrations in the years following the Vietnam War, and unfortunately its premise on morality in war will always remain as relevant as it was then as it is now, with conflict between states forever existing. Michael Walzer is one of the most prominent social critics in North America and in this book, he explores two main concepts, the justice of war and the justice in war in a great depth, and uses numerous historical references to support his claims. It is a very well configured piece, written in such a way of persuasion that your personal view on morality in war may ultimately change after delving into thoughts for several hundred pages.To an overwhelming majority of people, the words war and morality have seemingly opposing meanings, however in the preface to his book, Walzer points out that whether or not its specific terminology is adapted, just-war theory has always played a part in official argument about war (Walzer XI). He proceeds to discuss in a greater detail the ways that war has been perceived and how this impacts the topics of war and morality, and in doing so, he provides an intelligently structured and persuasive argument that can be viewed within a moral context. He addresses this to pic both from the view of the role of the state and also from the perspective of how the decision to fight impacts the individual. Walzer takes the position that an individual should fight only for private and personal reasons rather then from nationalistic feelings because he feels that it is crucial that this decision should be freely chosen and that it constitutes one of the crucial requirements for a just war. Walzer defines a just war as a limited war, and that just wars are governed by a set of rules, designed to prevent, as much as possible, the use of violence and coercion against non-combatant populations (Walzer XVII) On the other hand, a limited war attempts to establish the way things were prior to the aggression taking place. Aside from extreme cases, just wars do not have legitimate reasons for reaching beyond this goal, including the replacing of the aggressors... ...f becoming aggressors themselves. As Walzer points out, the Kuwait regime that US intervention restor ed to power was little better for the Kuwait people than their Iraqi invaders. However, the ultimate fate of this regime was placed back in the hands of the Kuwaiti people disregarding our attempt at improvement. Reading this book was both uplifting, in that Walzer does an excellent job of developing a framework to understanding what should and should not be done during wartime, as well as depressing, in realizing that war will only evolve and forever exist.The limits that a just war places on the use of aggression between states for both states and individuals, according to Walzer, offers a rational and moral way of perceiving modern warfare. He ends his text with the comment that The restraint of war is the beginning of peace essentially summing up his argument, though will this end ever arrive? (Walzer 335). This book offers a sane way of perceiving morality within the insanity of war.Work CitedWalzer, Michael. Just and Unjust Wars A Moral Argument with Historical Illustrations. New York Basic Books, 1977.

True Portrayal of Children in Lord of the Flies :: Lord of the Flies Essays

True Portrayal of Children in Lord of the Flies   In the novel The Lord of the Flies, by William Golding, one can await how children react to certain situations. Children, when given the opportunity, would choose to play and have fun rather than to do boring, hard work.  Also, when children have no other(a) adults to look up to they turn to other children for leadership.  Finally, children stray towards savagery when they ar without adult authority. Therefore, Golding succeeds in effectively portraying the interests and attitudes of young children in this novel.           When children are given the opportunity, they would rather wrap themselves in pleasure and play than in the stresses of work.  The boys show enmity towards building the shelters, even though this work is important, to engage in trivial activities.  Af ter one of the shelters collapses succession only Simon and Ralph are building it, Ralph clamours, Al l day Ive been working with Simon.  No one else.  Theyre off bathing or eating, or playing. (55).  Ralph and Simon, though only children, are more mature a nd adult like and stray to work on the shelters, while the other children aimlessly run off and play.  The other boys avidly choose to play, eat, etc. than to continue to work with Ralph which is very boring and uninteresting.  The boys act typically of m ost children their age by being more arouse in having fun than working.  Secondly, all the boys leave Ralphs hard-working group to join Jacks group who just want to have fun.  The day after the death of Simon when Piggy and Ralph are bathing, Piggy points beyond the platform and says, Thats where theyre gone.  Jacks party.  Just for some meat.  And for hunting and for pretending to be a tribe and putting on war-paint.(163).  Piggy realizes exactly why the boys have gone to Jacks, which would be for fun and excitement.  Th e need to play and have fun in Jacks group, even though the boys risk the tribes brutality and the chance of not being rescued, outweighs doing work with Ralphs group which increase their chance s of being rescued.  Young children need to satisfy their amusement by playing games instead of doing work.  In conclusion, children are more interested

Michael Jackson :: essays research papers

Praising the King of Pop Michael capital of MississippiIntroduction           peradventure no one has received this title in history the king of pop, now a days many artists redeem arisen and have performed still not as the king of pop known worldwide and in history, has dominated the world of pop as Michael Jackson.Born on August 29, 1958 to a strict working class family in Gary, Indiana. Michael Jackson has gone through personal scandal, family squabbles and numerous career quakes but Michael Joseph Jackson be one of the planets best known figures. Jackson has spent almost his entire life as a public performer. He was the founder member of the Jackson Five at the age of four, soon becoming their lead vocalist and frontman. This implies Jackson has started his career at a very early age to bit by bit become one good public personality and famous. For this and for other reasons, he deserves praise and to be praised.Narrative Michael Jacks on was born and grew up in a strict working family in Gary, Indiana, USA on August 29, 1958. Jackson showed an early interest in music as did most of his family. His mother interpret frequently, his father Joseph Jackson played guitar in a small-time R&B band, his older brothers often sang and played with their fathers guitar. Soon the family singing group started, with Michael as the main puppet and four of his older brothers. After all it seemed to be the simplest way to earn money to fall in so many kids said Joseph Jackson. If you cant feed your kids teach them how to feed themselves. Anyway Michael soon outgrew his brothers with his unique talent not just for singing but for dancing as well. Jacksons father, who is a controlling supposedly abusive father. "My father beat me. It was difficult to take being beaten and and then going onstage. "He was strict very hard and stern." Says Michael Jackson.He pushed his sons including Michael into forming a group called the Jackson five. Their group quickly arose from playing local talent shows to land a contract with the renowned Motown label at the end of 1968. During the early 70s the group became well-known, with "baby", Michael as the lead singer of the group. This talent dragged on for decades and step by step getting better and better, Michael taking the lead and as the main source of income for the family for proving and presenting his talent to many music labels and organizations throughout the years.

Robert Frost :: essays research papers

It has been said many times that all men have a common land bond, or a thread that joins them together. Robert freezes poem The Tuft of Flowers explores the existence of such a bond, as experienced by the utterer. In the everyday circumstance of performing a common chore, the speaker discovers a sense of brotherhood with another laborer. icing contrasts a sense of aloneness with a sense of understanding to convey his theme of champion between men.To understand the setting of the poem, one must first understand how grass was mowed in the time period in which the poem was written (1906). can was mostly mowed by hand using a scythe. The mowing was often done in the dew of the morning for better mowing. This left the grass wet, and it needed to be illogical for drying. The phrase turning the grass refered to the scattering of the grass for drying.In The Tuft of Flowers, the speaker has gone out to turn the grass. Whoever did the mowing is already gone, for there are no signs of h is presence. The speaker is alone. Then, a butterfly catches the speakers attention, and leads his gaze to a tuft of flowers, which the mower chose to leave intact. The patch of beauty left by his faller worker causes the speaker to feel that he is no longer alone. There is a sense of understanding between the speaker and the mower, because an appreciation of beauty unites them.Frost uses peaceful images to relate the feeling of his poem. The setting is in a grassy field with a brook running through it. The tranquil feeling is added to by a silent butterfly, who searches for a flower upon which to land. In keeping with the peaceful surroundings, Frost speaks of a long scythe whispering to the ground, and of hearing wakening birds around. The speaker also listens for a whetstone on the breeze to determine if there is anyone around, and finds a leaping tongue of bloom beside the reedy brook. The Tuft of Flowers does not contain a definite meter, but it does have a strict rhyme scheme of AA, BB. The poem is organized in couplets, each of which contains a single thought. This makes the poem more(prenominal) charming and gives it simplicity, which adds to the overall feeling of peace and tranquility.Robert Frost provides many interesting ideas in The Tuft of Flowers.

Robert Frost :: essays research papers

It has been said many times that all men have a common land bond, or a thread that joins them together. Robert rhymes poem The Tuft of Flowers explores the existence of such a bond, as experienced by the vocaliser. In the everyday circumstance of performing a common chore, the speaker discovers a sense of brotherhood with another laborer. ice contrasts a sense of aloneness with a sense of understanding to convey his theme of adept between men.To understand the setting of the poem, one must first understand how grass was mowed in the time period in which the poem was written (1906). expose was mostly mowed by hand using a scythe. The mowing was often done in the dew of the morning for better mowing. This left the grass wet, and it needed to be unconnected for drying. The phrase turning the grass refered to the scattering of the grass for drying.In The Tuft of Flowers, the speaker has gone out to turn the grass. Whoever did the mowing is already gone, for there are no signs of h is presence. The speaker is alone. Then, a butterfly catches the speakers attention, and leads his gaze to a tuft of flowers, which the mower chose to leave intact. The patch of beauty left by his blighter worker causes the speaker to feel that he is no longer alone. There is a sense of understanding between the speaker and the mower, because an appreciation of beauty unites them.Frost uses peaceful images to relate the feeling of his poem. The setting is in a grassy field with a brook running through it. The tranquil feeling is added to by a silent butterfly, who searches for a flower upon which to land. In keeping with the peaceful surroundings, Frost speaks of a long scythe whispering to the ground, and of hearing wakening birds around. The speaker also listens for a whetstone on the breeze to determine if there is anyone around, and finds a leaping tongue of bloom beside the reedy brook. The Tuft of Flowers does not contain a definite meter, but it does have a strict rhyme sche me of AA, BB. The poem is organized in couplets, each of which contains a single thought. This makes the poem more than charming and gives it simplicity, which adds to the overall feeling of peace and tranquility.Robert Frost provides many interesting ideas in The Tuft of Flowers.

Book

Oliver Stone used a Logical appeal making the reader to think about the case by his/ her mind and nerve-wracking to convince the reader and to clarify that whatever Inside the person go out motivate he/she in either ways reliable or evil It is likely that, whether they had seen Natural Born Killers or The Green Berets or a Tom and Jerry cartoon the night before their first crime, Ben and Sarah would sw every(prenominal)ow behaved In exactly the way they did.Stone logically argued back with a valid point. All teenagers around Hanna 2 the world have seen the movie and they werent affected by It like Ben and Sarah ere the problem seems to be in Ben and Sarah, not the movie. 1 500 hours of mostly violent TV programming might have slightly more effect on these two youngsters than two hours of Natural born killers? .Ben and Sarah could have never been affected by a two hours movie and motivated them to travail a crime as millions of people precept the movie and they never heard abo ut somebody who attempted a crime from just observance a violent movie, as Natural born killers was not and wont be the last violent movie. The whole problem comes from the inner of Bens and Sarahs, both of them had a big(p) life where the family was not there nor taking are of them or watching out their teenage children.We croupe tell that both of Sarah and Ben came out from a disjointed and different families where the love bond was not there but they did share similarities in their personalities as both of them were drinking, doing drugs and as they dont have any source of Income in conclusion they will need money to continue living Thats what actually motivated them to attempt the crimes they did, not the movie. When a person is good and have pure thoughts his/her actions will be good and useful for others too, if that person is not, probably his/her actions will hurt others.And that is actually what happened with Ben and Sarah, both of them turned to be bad and do evil act ions from what they saw In their lives not from what the movie they saw. 1 OFF Using logical appeal was not enough to Oliver Stone clarifying and defending himself against Gresham, therefore he used ethical appeal as Stone build up his argument talking about Gresham himself A lawyer in search of a client could see in this an indictment of the entertainment industry and not of the teenage killers and those who reared them.Oliver Stone trying to tell us that a lawyer who is still looking for none and does not care about lives and the safety of people is not a person to trust how push aside you trust a person who doesnt care about people lives and about how those teenagers had been raised up are not a responsible people. As we should care about this generation whos plan of attack up to this world and help them to be better people for our country not to use them Just to get clients and make some money, Oliver here is trying to defend himself by blaming Gresham and everybody whos supp orting those youngsters as its not logical that.What can control a person ? A movie or the person himself ? How can Gresham blame a movie for attempting two murders ? Ben and Sarah are eighteen and nineteen years old, they are mature enough to control their actions and its really a youthful thing to blame a movie for motivating them to attempt two murder crimes one each. What gives a man a value than any others being is the MIND which we can use to control our actions.Hanna 4 If Dan White, the killer of San Francisco supervisor Harvey Milk and Mayor George Nosecone, could claim that Twenties made me do it Oliver is continuing apply ethical appeals by saying that a person can not do whatever he wants then blame it to other people or things and say that it was not his/her fault as somebody else or something motivated him/her to do a crime.Watching a movie is not the big thing that can motivate you, and if its what about those people who are losing their families in the wars, and we never heard about any of them turned to be a murder, raze us and our friends we all watch horror movies and play violent video games and it never turned us to violent people who can go and kill the others or even Jump into somebody else car and steal it, it is Just because there is no need to do that. But Ben and Sarah had their reasons to attempt the crimes but that is not an excuse to do a crime even when you have reasons.Artists should never be blamed for societal violence in most cases, they are merely holding a mirror up to the reality that already exists or providing catharsis for emotions we are already suppressing. Violence is there and it does exist in the movies and we can not renounce that but one whos watching is the one who decides what to do and how his/her actions will look like. One should use his/her mind before going for an action and then atone it later.

Lawrence School Poems

David Herbert Lawrence was an English novelist, poet and playwright. In 1908 Lawrence qualified as a teacher and found employment at Davidson Road School in Croydon. According to the author of D. H. Lawrence The Life of an Outsider (2005) He found the demands of teaching in a large school in a poor area very different from those at Eastwood under a protective headmaster. Nevertheless he established himself as an energetic teacher, draw to use new teaching methods like performing the Shakespearean dramas they had as text. Best of School and Last Lesson of the Afternoon are two poems about his experiences as a teacher. Quite extraordinarily, they present two completely contrasting views. Best of School is about the pleasure a teacher experiences while partaking his duties as a teacher, while Last Lesson speaks about the unpleasant task of teaching. Best of School begins with an image of the boys and the room in a colourless gloom of underwater air bladder. The poet compares the boys working in a classroom to an underwater scene. Their ideas and thoughts are like bright ripples.Their ideas are defined as bright because they are young boys and skilful of creativity and innovation. These boys heads are busily bowed in pursuit of intimacy, they are completely blind to the outside world. The teacher separates himself from the boys as a passive spectator sitting on the shores of the class. The pupils require no external help from him they are a single entity, united in their pursuit of knowledge. They tend to direct up to him from time to time to gain morsels of inspiration for their work and then carry on working busily. Having got what was to be had, he stresses the fact that he does not actively take part in the childrens learning process, it is natural and voluntary. The ripening morning echoes the ripening thoughts of the young boys and in the sunlight reflects the light of knowledge and intellect. Last Lesson, on the other hand is an exact opposite view. I t begins with an image of weariness and disgust, the teacher begins by conceding defeat. Both the school-age childs and the teacher are organism forced to sit in the classroom, waiting for the price to ring.He says I can haul them and urge them no more. The teacher is experiencing great despair by having to sit in the classroom with his pack of unruly hounds, who are straining to be free. There is a sense of utter frustration neither is the teacher interested in teaching and nor are the boys interested in gaining knowledge. The teacher can no longer endure the brunt of teaching a mass of apathetic children. The speaker in Best of School goes on to say that the boys are like birds that steal and flee.The boys raise their heads from time to time for getting the chasten necessary for concentration the very presence of the teacher is an unspoken motivation for the students. He compares the glances of the students to the movement of tiny birds. Touch after touch I olfaction on me, h e can almost feel the bright, inspired eyes of the students looking up to him for inspiration. He calls this inspiration grain/Of rigour that they taste delightedly. In complete contrast, the teacher in Last Lesson calls his students work insults of blotted pages and slovenly work. It is a sharp negative feeling that he expresses.He turns to the pile of sickly books on his desk and exclaims that it is impossible for him to plough through his corrections. To him it is a Herculean task, it is tedious and tiresome. The students are not interested in learning so the work seems to be a vivid insult to the teacher. He asks himself in desperation shall I take/ My last dear fuel of life to heap on my soul? and ascertains, I will not , I will not waste my soul and my strength for this. He realizes that it is a complete waste of twain his time and dynamism to try to discipline his students and take them on a path to knowledge.He declares that he no longer cares how his students will fair because his students are so disinterested that both the teaching and their apparent learning, goes down the same abyss, down a deep dark hole of forgetfulness and oblivion. He continues the argument deliberately reducing the background signal of education to inconsequential things like A description of a dog and saying that all his efforts are going to waste because his students are completely foiled and not at all enthusiastic about learning. The larger picture of holistic education is lost due to their unwillingness to learn but the teacher also deviously justifies his argument.He says that the whole situation is rubbish and that nobody cares so theres no point in this unnecessary pursuit. His final similitude in Best of School is probably the strongest and most beautiful one. The minds of his young pupils are like the tendrils that reach out yearningly. The young enthusiastic minds bewilder to the teacher for support. It is merely for inspiration and not learning. The teache r (tree) is wise, tall and firm. The students need the support and guidance of the teacher like a silent and strong shaft of light of enlightenment on which they can fall back in times of trial.The teacher and student relationship is shown to be a beautiful one. The teacher is sitting at a distance but feels his students clinging to him. This is not an actual dependence for notes and explanation but it is spiritual and emotional, self-motivational. A stout and sturdy tree cover in tendrils seems to be covered in a green coat. Their lives are closely entwined and they grow together. The speaker says, my time/Is hidden in theirs, their thrills are mine. It is a delightfully rewarding experience for him to be able to contribute to the students spiritual growth and enlightenment in an unobtrusive way.The two poems, as mentioned earlier, present complete contrasts to each other. While the speaker in the Last Lesson of the Afternoon is tired of teaching and disturbed by just being in th e classroom, the speaker/teacher in Best of School enjoys a fresh look at his job. Education is believed to be an individual process. Each one learns at their own pace and in their own way. When pupils find pleasure in learning by themselves, the process of teaching becomes an extremely rewarding one for the teacher. When the student is motivated, education is most worthwhile.The teacher believes that the pupils should make the journey on their own as only then will the journey be meaningful. It is surprising that whereas in one poem the teacher delights himself by inspiring his students, in the other the teacher is under a terrific compulsion to sit and wait for the bell before he can rush out of class. These two poems, present together, a great insight into the two perspectives of gaining education and knowledge. One is a tiresome, cart process while the other demands independence and free thinking.

Friendships Need Care

Friendships need care. I shouldve listened to this before I got into a fight with my best friend. She thought I was stealing her friends, but I wasnt. I got really infuriated at her and decided that she was actually stealing my friends. My friend thought I was stealing her friends so I got really mad at her for assuming that because I was the peerless and only(a) who do those friends and then introduced her to them. She got mad at me because I was stealing her friends. Getting into a fight with my best friend was one of the saddest moment of my life because she was my first friend, she ever so comforted me, and I had the best moments with her.One reason it made it much worse is that she was my first friend. She stood up for me. Whenever somebody was malicious to me, she stood up for me. When I came into the school, she was the one who made me her friend When I came to this school, I thought everybody had already made friends, but she was the one to make me her friend. She made me feel befriended. She made me feel befriended when I was lonely. Next is another reason why this situation was so sad.Another reason it was so depressing is that she always comforted me. When I was sad, she always comforted me. She sat down next to me and started making me laugh. When a teacher or psyche hollered at me, she stood up for me. When someone shouted she either, talked to me at recess or she yelled at them. When I got into a fight with someone, she helped me talk through it with them. Next is another reason why it was so dark.The last reason that it was sad to get into a fight with her is that I had my greatest moments with her. I did the Revolutionary War in 5th grade. In 5th grade, we both went on a field trip together. We celebrated Halloween together for 2 divisions. The first year it was at my house and the second year was at her house. Lastly, we had many reminiscences together. We had tons of playdates and some sleepovers. This fight was so bitter because of all these parts and more.As this essay shows, getting into a fight with one of my best friends was one of the saddest moments in my life because she was my first friend, she always comforted me, and I had the best moments with her. In conclusion, Friendships need care.

Discuss the view that the Civil Service has too much influence over policy

The complaisant service is the administrative branch of the UK government, set with crappering with the everyday running of the country, rather than a ministerial role, which focus on only some areas. It is they that carry out the much than mundane roles, although some well-bred Servants do have more exciting life styles with jobs such as testing weaponry that is to be bought by the Ministry of Defence.The Civil assistant is to advise ministers on the decisions that need to be made, to legal brief ministers on the issues involved and to present options to make the ministers decision making easier. At no stage though should Civil Servants be responsible for decision making. there is a clear dividing line between the decision-making role of the minister and the supporting role of the Civil Servant. as Margaret Thatcher put it Civil Servants advise ministers decide.Servants are non elected and because of this they should not have the power to make decisions. Decision making is the responsibility of the politicians and it is they who should take responsibility for the success or failures of departmental policy and they should not be held accountable for their advice or for departmental policy. In the case of policy errors or mistakes in implementation it is the minister who has to resign, not the Civil Servant the Civil Servant should not be held responsible because they have no role in decision making.This bottom be seen through the resignation In April 2004 of Beverly Hughes. She laboured to resign as minister for Immigration, Citizenship and Counter Terrorism when it was shown that she had been informed of procedural improprieties concerning the granting of visas to certain categories of workers from Eastern Europe. While this cannot wholly be seen as their fault, it was they, not the polished servants that advised them that had to resign over the events, due to the fact that they are responsible for the final decision.Ministers have a large worklo ad and have limited term as is shown by the fact that the Core hours in the House of Commons are until 10pm on some evenings, and parliamentary debates sometimes continue into the night, with Ministers having added Committees to sit on and other government business to attend to, as a result, they rely heavily on their Civil Service advice and this puts the Civil Servants into a privileged and powerful position. Any advisor should have some allure, if they dont there is not much point in them being there.However, if ministers lack the time to check Civil Servants advice, the risk of exposure is that they will become a mouthpiece for Civil Service policies. Civil Servants also have the opportunity to control the minister by restricting the supply of entropy to him or by presenting it in such a way as to limit his options, as was shown by the limited information given to Beverly Hughes. It would be damage to suggest that this happens often, it remains true that the Civil Service has considerable power. This is deemed as the Minister having gone native Australian and in October 2010, claims were made that Jeremy Hunt had gone native.Also, when Alan Johnson took position of the Home Secretary, he had relatively little experience in the policy of governing the UK and was therefore more reliant on the Civil Service than he may have chosen to be. Manipulation of information may occur. Ministers, such as Alan Johnson, rely on officials to supply them with background facts upon which to base decisions. just officials may be able to present statistics and research findings in a way as to influence final conclusions There is evidence to suggest that the civilian service has been politicised due to the increase of special advisers with too much power.It can be argued that Special Advisers can work effectively with civil servants, and it is a blood of mutual benefit, not a matter of regret. The role of the UK Civil Service is to help the Government of the day deve lop and carry out their policies and administer the normal services for which they are responsible. Ministers have to be able to trust civil servants to be discreet otherwise politicians may feel the need to surround themselves with semipolitical appointees whose main virtue is their loyalty to that politician rather than having ability to formulate good policy and then have it implemented.A special advisor can give more biased opinions and can be there to help the Minister, rather than the department, policy or government. Spin doctors such as Alistair Campbell had great influence over policy on the basis of how it would appear to the public, and this can be seen in particular over the time Blair spent talking to him, rather than to the Civil Service over plans for the Millennium. There is also evidence to suggest that individual departments to develop long term policies of their own.When a impertinent minister of government comes to power, the department will seek to impose its own culture upon them. The Treasury is most often suspected of such tactics, as it is notoriously opposed to increased public expense or any radical spending plans, caused by the fact that it has to keep the long term in mind, and the fact that a likely change in government will see most of the polices undone anyway, causing undue harm on the economy.If the senior Treasury officials can persuade each new Chancellor of the Exchequer of the virtues of keeping spending low, their influence automatically grows. An example of this was in 1999, when Chancellor Gordon Brown was resisting calls for extensive increases in spending on health and education, some critics suggested he had gone native, suggesting that Brown had been influenced by the Civil Servants, adopting their norm of behaviour and so losing his enthusiasm for spending.Overall, the Civil Service do have more power over policy than their supposed political neutrality should let them, but it is to be expected in the modern w orld of political advisors, and the militant world which seeks public recognition. While the senior civil servants, due to the permanence and long serving nature do have a great deal of power, the average civil servant has less power, and is more reliant upon presentation of the facts in a favourable way then anything else, something which is true with Ministers and Government as a whole.

An Ideal School Essay

AN IDEAL SCHOOL WRITE ABOUT THE INFRASTRUCTURE AND FACILITIES YOU CONSIDERED IMPORTANT FOR AN IDEAL SCHOOL. Students are trained in the indoctrinate as the future citizens of the country. Unless the schools are pattern the country cannot get ideal citizens. Let us know what an ideal school is. An ideal school is situated in a peaceful site in the lap of nature full of beautiful sceneries. It is situated in a vast escalate that admits natures free air and free light.It is situated in a place which is served by natural spring of water and by sweet-flavored flowers spreading their fragrance all around and by good climatic conditions. The building of an ideal school should be large and spacious. The classrooms, the common rooms and the office-rooms should give a good number of windows to let in free air and free light.In a classroom there should be five squarely feet space for each of the students. In an ideal school there are no more than twenty students in each of the classes. E ach student is provided with a single chair and a single desk, which are in quite good condition. An ideal school is provided with an ideal staff. The teachers of an ideal school are rise up qualified.They are greatly interested in learning and teaching. They do not have any profitable motive. They take teacher ship as a mission in their life. They work in the school with a missionary spirit. They are the men of character and integrity. They work together with a team-spirit and with full co-operation and grounds among themselves.An ideal school is well-supplied with all sorts of educational requirements like apparatus and appliance maps, charts and globes, libraries and laboratories, magazines and newspapers, radio, television and audio-visual projectors, museum and swimming pools, lawns and gardens and stadium and gymnasiums. An ideal school must have an ideal hostel quite close to its situation. If we want that our country should be an ideal country and our nation should be an i deal nation, we should make our schools ideal. An ideal school is the superior asset for the students whom it serves.

Mark McMinn, the author of the book Psychology Essay

Theology and Spirituality, did an excellent job discussing the aspects of psychology, theology and spirituality, and how they can be integrated by a Counselor. Each chapter opened with a real life example of what it would be like to non properly integrate psychology, theology and spirituality. Christian counselors argon charged to incorporate spirituality in their personal lives and properly display these same practices with their clients. Christian counselors are individuals who seek and successfully become trained in pleader theories and techniques as well as theology practices such as using prayer and scripture. This type of training can rarely be cultured in the classroom. But it calls us to lives of spiritual discipline and a personal love for scripture (McMinn, 2011, p. 139). According to McMinn, the goals of Christian counseling are multi-faceted (McMinn, 2011). Most counseling maps are focused on mental health. McMinn (2011) presented a healing map.This map displayed the l ink between self-sufficiency, brokenness and the healing race and how they relate to the core foundations prayer, scripture, sin, confessions, forgiveness and redemption. telling counselors are passionate and irrepressible in the walk with God. McMinn also cautions counselors on the limitations and challenges they will face in counseling. Each section discussed one core foundation. McMinn not only discussed these topics in depth, he also related them to the healing map by answering these three questions Will this help establish a red-blooded sense of self? Will this help establish a healthy sense of need? And will this help establish a healing relationship? (McMinn, 2011). McMinn discussed the true purpose that self-sufficiency served and pointed out that this purpose was greatly corrupted, leading to the brokenness that requires a healing relationship.Self-sufficiency is our granting immunity to love and be kind. When we take this freedom too far, we end up having to face conse quences that can have lasting effects, with the absence of a healing relationship. Brokenness not only causes us to seek counseling, scarce it draws us nearer to God and this in turn allows a true healing relationship to begin (McMinn, 2011). The foundations that McMinn discussed prayer, scripture, confession of sin, forgiveness and redemptions, are all necessary to properly devise therapy that will have actual results. When a counselor uses prayer in their session, itenhances the clients spiritual growth which also strengthens their reliance (McMinn, 2011). When we pray we humble ourselves and ask to become a bulge outner in k todaying and doing Gods will (McMinn, 2011, p.85). When scripture is applied in counseling, it not only teaches the client how to understand it, but how to incorporate it in their lives, further strengthening their relationship with God. Scripture also helps the client recognize and understand sin.The actualization of sin, helps the client understand why they are suffering and that there is real hope to overcome the suffering when they overcome sin. After acknowledging their sin, the client can now accept forgiveness and mercy. When the client is competent in acknowledging their sin and accepting mercy, they are not capable of establishing a sense of self (McMinn, 2011). The best part of the process is redemption. Redemption allows the counselor to honestly look at each core foundation with the client. Redemption provides that mirror of change and the growth to overcome obstacles in the future. Concrete ResponseReferenceMcMinn, M. R. (2011). Psychology, theology, and spirituality in Christian counseling (Rev. ed.). Carol Stream, IL Tyndale House

Impact of life skills training on HIV and AIDS prevention

This was a qualitative enquiry where info close to the performance were gathered through interviews and centre group discussions with chool principals, seeers and students. A sample of 4 principals, 8 teachers and 64 students was utilize in the study. Students were assessed on friendship, attitudes, perceptions and behaviour. Results showed that students exhibited utmost levels of knowledge of human immunodeficiency virus and assist issues but their behaviour remained incongruent with this knowledge.The study in like manner revealed that efficaciousness of this taproom strategy is reduced due to teachers perception of this part of the computer programme as secondary, since they sign up on examinable courses. From the research it was evident that imited resources and conflicting goals in the pedagogics system had a negative trespass on the program. The research made clear the need to make the inform of flavour skills more mulish by exposing students to material vitality situations through linkages with human immunodeficiency virus and support organizations working within the community.Key Words t ane skills, Evaluation, Behaviour Change, BACKGROUND support is amongst the leading causes of deaths worldwide and has had insurmountable negative effects on countries, in the socio-cultural, economic and political domains. Different countries charter employed different strategies in an effort o f all in all upon the devastating effects of human immunodeficiency virus and acquired immune deficiency syndrome. Some of these strategies include increase condom availability and use, promotion of temperance and life history skills training amongst the early days in aims and communities.According to The Global Working Group on HIV and assist (1998 8) since HIV infection is invariably the result of human behaviour, tack in behaviour has long been mum as essential to curbing the spread of 1 infection. This assertion is corroborated by Gachuhi ( 1999iv) who argues that in the absence of a cure, the best way to deal with HIV and assist is through measure by eveloping and/or ever-changing behaviour and values.V prevention nas been approached trom ditterent angles near countries nave used primarily or at least include HIV certifiedness and pedagogics as a strategy to combat HIV with the aim of changing volumes perceptions and attitudes as these ultimately influence their behaviour. thitherfore the ultimate goal is whence to catch them puppyish and create an aw atomic number 18ness that can help eradicate the spread of HIV and back up. Zimbabwe is amongst the countries that undertook a behaviour change based approach to HIV prevention. As cited on the National AIDS Council (NAC) website ?theBehaviour Change Communication class started in 2006 after a Comprehensive Review of Behaviour Change as a means of preventing cozy HIV transmittance in Zimbabwe. A National Behaviour Change Strategy was then developed after thi s review with the aim of addressing the major ways of HIV transmission in this country. It is fictive that between 80 and 90% of infections ar due to conjure upual transmission. Hence, promoting the adoption of safe internal behaviours the Great Compromiser at the heart of HIV prevention in Zimbabwe (SAfAlDS, 2013).Zimbabwes concentrate was on aboriginal prevention of HIV through behaviour change strategies. It has since recorded a decrease in HIV incidence. In 1997, an estimated 29% of adults were living with HIV in Zimbabwe. 1 decade later in 2007, that number had move to 16%. HIV prevalence in Zimbabwe declined from 23. 2% in 2003 and even further to 14. 3% in 2009. (UNFPA, 2008). Different scholars and analysts have attributed this decline to various factors, resulting in a see.One much(prenominal) analyst from News From Africa propounded that The behavioral changes associated with HIV reductionmainly reductions in extramarital, commercial, and casual sexual relatio ns, and associated reductions in artner concurrencyappear to have been stirred primarily by increased aw arness of AIDS deaths and secondarily by the countrys economic deterioration. Others have suggested increased mortality due to poor health service delivery (Leach-Lemens 2012). There is consensus however that there is and then a reduction in HIV prevalence in Zimbabwe and that there be indications of behaviour change. The authors come to an end that these findings provide 2 the initial convincing evidence of an HIV decline accelerated by changes in sexual behaviour in a southern African country. (Gregson et al 2010). Gachuhi (1999 10) asserts that young people advance a window of hope in stopping the spread of HIV/AIDS if they have been reached by Life Skills Programmes. This assertion brings out the importance that is patchd in a countrys youth as it re saves the countrys emerging.Zimbabwe as a nation identifies with this perspective and has found it laudable to post in the future of its youth by making it a target group tor H V prevention education. However, the youth are taced with several challenges that also make them vulnerable to HIV. Kalanda (2010169) asserts that young people have demands and challenges due to their physiological, sychological, social and economic situations. Among these demands and challenges are peer pressure into drug and substance abuse, early sexual debut leading to sexually transmitted diseases (STs) including HIV.A review by UNICEF (2000) found that life skills education is effective in educating youth on alcohol, tobacco and former(a) drug abuse, nutrition, pregnancy prevention and preventing STs including HIV. Moya (2002) states that research demonstrates that possessing life skills may be critical to young peoples ability to demonstrablely adapt to and deal with the demands and challenges of life. According to Kalanda (2010172) the objective of Life skills and HIV and AIDS education is to empower pupils and their teachers with life skills for HIV prevention, sex and sexuality issues.This coincides with the research conducted for The Global Monitoring Report ?Youth and Skills pose education to work which shows the importance of investing in life skills education in instruct to ensure children have the confidence and negotiating skills to say no to sex and negotiate condom use. Objectives of the study The study seeks to evaluate the murder of the life skills and HIV and AIDS ducation programmes in schools as stipulated by the Ministry of Education? The study also seeks to assess the contribution of these life skills training programmes in Zimbabwean schools to HIV prevention.It aims to assess the levels of knowledge round HIV and AIDS, risk perception, attitudes and behaviour of the students in these schools. Challenges that present drawbacks in the implementation of these programmes will hopefully be unearthed as thoroughly. 3 Research Questions 1. How is Life skills and HIV and AI DS education perceived as part of the curriculum by both teachers and students in schools? . Is the programme achieving its desired goals of increasing knowledge and decreasing risky behaviour? 3.Do the teachers assigned for life skills and HIV and AIDS education have the prerequisite training and material to use in the teaching of this part of the curriculum? 4. What are the challenges faced by the teachers in imparting life skills and HIV and AIDS knowledge? Participants / seek The sample used in the study consisted of 4 principals, 8 teachers and 64 students. Purposive sampling was used for the selection of principals and teachers for the study from the respective schools. Selection of principals was automatic as the principal of each of the four schools was snarled while 2 teachers were selected trom each ot the tour schools.The criterion used to select these teachers was that they were the ones responsible within the school for Life skills and HIV and AIDS education. The stu dents were selected using stratified random sampling 16 students from each school, 8 from each of the forms four and six as they are about to leave school and enter ?the existing world. There was an equal representation for both male and female student participants in the study. info collection instruments The study employed interviews and focus group discussions as data collection instruments.Interviews were held with the principals and teachers while data from students was generated through focus group discussions. Data Collection Procedure Interviews were held individually with each of the principals and teachers in a bid to maintain confidentiality and promote openness especially since some of the issues could be considered sensitive. Each principal availed clip to the investigators for the focus group discussions to be held. The two researchers alternated in the facilitation f data generation from the interviews with the other researcher recording the proceedings.Focus grou p discussions were conducted for each of the four schools for the sake of convenience and ease of access to the students. Two focus group discussions were held at each of the four schools one for the girls facilitated by the female 4 researcher and the other one for the boys facilitated by the male researcher. This allowed for free participation and contribution by students as they identified with a facilitator of their gender. Data analysis Data was analysed thematically according to the main ideas emerging from the nterviews and focus group discussions.RESULTS AND interchange Results Demography of participants The students who participated were in forms four and six and with an age range of 16 18 stratums. The sample in terms of gender was comprised of 32 female students and 32 male students. For the principals 3 were male whilst one was female. They all had a first degree as their minimum level of education. All the teachers had a Diploma in Education as their minimum qualific ation. In addition to the diploma, 5 of the teachers also had a first degree. association about HIV and AIDS issuesThe students exhibited high levels of knowledge about HIV and AIDS issues. Most students were aware ot the possible me tnods ot transmission ot H V They were able to correctly answer questions on orders of preventing HIV transmission even including ideas of their reliability for example highlighting the disadvantages of condom use even going into an interesting debate about the feasibility and challenges of consistent condom use in or out of marriage. The students indicated that they knew that the best method of prevention from the virus was abstinence before marriage.Basic knowledge about the nature of HIV and AIDS, transmission and prevention appeared to be at their fingertips but when broadened to other areas of sexual reproductive health the level of knowledge significantly reduced. Students were non aware of measures that could be gestaten to protect their rep roductive organs. Boys were better aware of male circumcision because of the matter campaign advocating for male circumcision. stock-still girls were aware of the advantages of male circumcision. Very few (17%) of both boys and girls were aware of procedures such as PAP SMEAR for the screening of cervical cancer.Most students were also non well versed with strategies and precautions to be taken during home based care of HIV positive individuals citing that they had never had to deal with an ill somebody on a personal level. Only a few (36%) had had personal contact and real life experiences of helping to take care of or live in the same household with an HIV positive individual. They agreed though that most did have relatives infected by HIV. Very few students knew what life skills were and what the advantages of education them were.The few who knew life skills indicated that they had learnt them in other ettings that were not school. They also indicated that their knowledge of life skills was minimal and they were not confident that other could apply these skills to the extent of claiming to possess them. Most of them could lonesome(prenominal) name at most two life skills. Behaviour A significant portion of the students (35%) indicated that they were sexually active whilst 80% indicated that they knew at least one friend who was sexually active amongst their friends of school-going age.The reasons given by some of them for engaging in sexual activity included Some of us will already have been sexually ctive when we first encounter such programmes so it very difficult to stop. Some have act to do so but still find themselves engaging again. One feels rugged during the period that we will be learn these things but once we finish and with time the feeling fades away. And also it is difficult to convince your boyfriend about such things as abstaining that you would have learnt at school. Some of those who said they were not sexually active express that they did however fondle with their boyfriends but did not engage in intercourse. Despite displaying nowledge about male circumcision still 5% ot the boys admitted to having been circumcised. They acknowledged the importance but cited that they Just had not gotten round to getting it done though they intended to do so. The principals indicated that the number of female students dropping out of school due to teenage pregnancies had rock-bottom significantly over the past ten years.They indicated that the mean number of drop outs was now 2 per year as compared to the 7-8 of previous years. Students perception of the programme The majority of students (90%) viewed the programme as insignificant citing that ven their teachers did not take it seriously. They conceded however that the material they could potentially learn from the programme was important. They stated that given the pressure they sometimes 6 faced with balancing school work and responsibilities or chores at home there was very dwarfish time to concentrate on non-examinable courses, especially since they were approaching final examinations (Ordinary Level).They argued that there was no reason for them to focus on such a course when everywhere they went they also heard about HIV and AIDS. One student said Why would I risk failing the important ubjects that have to do with my future by concentrating on a subject that I wont even be examined on and will not help me to get a place at high school, university or even a Job. There is no Job where they will ask you if you did life skills. Another student said Those who are elicit in such things Join the AIDS club, that is why it is there. The study revealed that the programme was indeed viewed as organism of slight importance. The students also highlighted that it was boring and a waste of time because most of what they learnt about HIV and AIDS they already knew and was like revision to them. Teachers perceptions of the programme The interviews also reve aled that teachers thought that the Life skills and HIV and AIDS education programme was minor as compared to the core subjects they taught. So minor in fact that the implementation of this programme was entirely at the discretion of the teacher assigned to do so.If the teacher chose not to there were no repercussions on their part. One teacher stated that With the state the Zimbabwean economy is in and the fact that teachers are grossly underpaid, we only do the work we absolutely have to do which is teaching the core subjects we are paid to teach. Life skills and HIV and AIDS are extra-curricular and not as important because no one will assess whether you have taught it or not whilst our teaching of core subjects will be reflected in the students results after examinations. The study revealed that 7 out of the 8 teachers (87. %) interviewed admitted to never having taught the module seriously as they were not motivated enough to try and change the status quo. The teachers intimat ed that their perceptions of the programme were also influenced by their administrations attitude towards the programme. They argued that if the administration was not taking the programme eriously who were they to do so? Challenges faced by teachers in the implementation of the programme Teachers highlighted a number of issues that according to them hindered the effective implementation of the Life skills and HIV and AIDS programme in their schools.They cited the shortage of or entire lack of material to use in the teaching of Life skills and HIV and AIDS. They mentioned that the only material available was for example a chapter on reproductive sexual health in a biology textbook where they mention HIV and AIDS in passing. They argued that this was not sufficient to comprise a omprehensive syllabus for the entire programme. Life skills were even more challenging to teach as there was no material available and the teachers themselves were not well versed with them.Teachers highlight ed that the HIV and AIDS part of the programme was easier to teach since most people had the knowledge and they had been exposed to the subject matter at their teachers colleges. However life skills were a different matter and they did not have the adequate knowledge about life skills and how to teach them to their students. This presented a challenge in the effective implementation of he programme as teachers tended to focus on the part they were confident about HIV and AIDS.They conceded that life skills and HIV and AIDS education were an important part of the curriculum but argued that they did not have enough time to teach these as the core subjects and extra-curricular activities such as sports and clubs took up all the students time. Life skills and HIV and AIDS education was because relegated to the AIDS club, membership of which was optional for students. Teachers cited that even the administration viewed the programme as secondary uch that if one tried to teach it seriousl y and request the material to teach it they were viewed as embarking on a futile look for to try and change the status quo.They said the schools administrations were of the perception that there were better things to spend the schools resources on than the life skills programme. The principals indicated that the resources available to their schools were inadequate and they had to make difficult decisions in order to uphold the integrity and quality of their schools and these included prioritising the core subjects since they were xaminable and had direct impact on the schools performance rating.Discussion This paper evaluated the implementation of the life skills and HIV and AIDS programme in Zimbabwean schools based on a number of factors the expected outcomes of increased 8 knowledge levels and decreased risky behaviour, indicators of behaviour change and perceptions of the programme which would affect acceptance by students and implementation by teachers. Though knowledge levels on basic H d AIDS knowledge was high they are still not high enough.This concurs with the research conducted for The Global Monitoring Report ?Youth and Skills Putting education to work which states that tests in fourteen countries in South and East Africa (including Zimbabwe) showed that only 7% of school children in the regions have the desired level of knowledge on HIV and AIDS and Just 36% have even the minimum level of knowledge. Students knowledge of life skills is even lower indicating that life skills and HIV and AIDS issues are not organism taught well if at all in these schools.Perhaps even the knowledge of HIV and AIDS issues was not as a result of the programme but other sources away to the school. The fact that teachers consider life skills and HIV and AIDS education as extra- curricular indicates that it is side-lined when it should be considered core. Even the students do not attach much value to it citing that it does not assist them to secure a place for further e ducation or a Job.This is without realizing that some people with very good educational qualifications are failing to secure good Jobs due to ill health as a result of bad decisions resulting from a lack of life skills. A major lack of motivation is evident when teachers indicate that they only do what they are paid for. Perhaps even the core subjects are not being taught well for this reason. Incentives have been introduced in schools to attempt to address this lack of motivation but even then these are viewed as inadequate and are different from school to school.Life skills and HIV and AIDS education is perceived by all administration, teachers and students, as extra-curricular and therefore not very important requiring only a minimal cursory browse. If this is how the programme is viewed by the intended implementers there is no way it will be effectively implemented. Concerning teacher ormation and development in the context of HIVAIDS Chamba (2011 suggests that teachers have to be trained in life skills HIV-AIDS education prevention in order to teach HIV- AIDS and also to protect themselves from HIV infections.Recommendations to improve on implementation of programme The modules on life skills and HIV and AIDS should be made examinable so as to be taken more seriously by both the teachers and the students. 9 The programme should also include the link of the students in HIV prevention initiatives through organisations working within the community so as to ive them a more practical bearing of the issues they learn instead of them remaining abstract ideas.Students should be exposed to real life situations where they actually come to a realization of the effects of HIV and AIDS so as to realize the impo rtance ot what they learn. This programme should be planned in such a manner that it runs continuously from primary school into secondary school so that life skills training and HIV and AIDS education are not a once off event but a continuous process providin g the necessary reinforcement and revision where necessary. Teachers need to be adequately trained to teach life skills and HIV and AIDS related issues.The programme needs to be supported practically at all levels, that it the provision of resources by the Ministry of Education and each school administration, consistent evaluation of the programme so as to ensure that it is being implemented as best as is possible. Parents should be involved so that the children are provided with consistent, noncontradictory information and are supported in the endeavour to change or develop healthy sexual behaviours.

Health System in Egypt

wellness Systems Profile- Egypt divisional wellness Systems Observatory- EMRO limit F O R E W O R D . 5 1 E X E C U T I V E S U M M A R Y .. 7 2 S O C I O E C O N O M I C G E O P O L I T I C A L M A P P I N G .. 11 2. 1 Socio-cultural Factors 1 2. 2 Economy 11 2. 3 Geography and Climate 12 2. 4 Political/ Administrative Structure . 12 3 H E A L T H S T A T U S A N D D E M O G R A P H I C S .. 14 3. 1 health Status Indicators .. 4 3. 2 demography . 15 4 H E A L T H S Y S T E M O R G A N I Z A T I O N 17 4. 1 Brief floor of the health fear System . 17 4. 2 Public health Cargon System .. 17 4. 3 Private health Care System. 20 4. 4Over altogether Health Care System 21 5 G O V E R N A N C E /O V E R S I G H T .. 23 5. 1 Process of Policy, Planning and man datement .. 23 5. 2 Decentralization Key characteristics of master(prenominal) types 24 5. 3 Health Information Systems 27 5. 4 Health Systems Research. 8 5. 5 Accountability Mechanisms . 28 6 H E A L T H C A R E F I N A N C E A N D E X P E N D I T U R E 29 6. 1 Health Expenditure Data and Trends .. 29 6. 2 Tax- ground Financing . 32 6. 3 Insurance .. 33 6. 4Out-of-Pocket Payments .. 40 6. 5 External microbes of finance 41 6. 6 provider Payment Mechanisms .. 41 7 H U M A N R E S O U R C E S .. 45 7. 1 Human resources availability and creation 45 7. 2 Human resources insurance policy policy and rectifys all everywhere stand 10 long time.. 55 8HEALTH SERVICE DELIVERY. 59 8. 1 Service speech communication Data for Health function .. 59 8. 2 Package of Services for Health Care 63 8. 3 main(a) Health Care .. 63 8. 4 Non personal Services Preventive/promotive Care 75 8. 5 Secondary/Tertiary Care .. 7 8. 6 Long-Term Care .. 90 8. 7 Pharmaceuticals .. 89 8. 8 Technology .. 100 9 HEALTH SYSTEM REFORMS. one hundred one 9. 1 Summary of Recent and planned reforms 101 10REFERENCES 107 11. ANNEXES . 11. 1 Ministry of Health and nation Organogram 1 Health Systems Profile- Egypt regional Healt h Systems Observatory- EMRO List of remits correct over 2. 1 Socio-cultural indicators table 2. 2 scotch Indicators put off 2. 3 Major Imports and Exports elude 3. 1 Indicators of Health military position dodge 3. 2 Indicators of Health status by Gender and by urban rural 2006Table 3. 3 Top 10 causes of Mortality Table 3. 4 demographic indicators Table 3. 5 Demographic indicators by Gender and Urban rural Table 6. 1 Health Expenditure Table 6. 2 Sources of finance, by percent Table 6. 3 Health Expenditures by Category Table 6. 3. 1. Health safeguard pay in Egypt coverage, eligibility and benefits Table 6. 4 Population coverage by source Table 6. 4. 1 Distribution of HIO beneficiaries by law (19952002) Table 6. 4. 2 relation between 2002 and 1995 estimates Table 6. 4. 3 Comparative expenditures and subsidies from MOF to infirmary work, financial yr 2004/2005Table 6. 4. 4 Performance Indicators Table 7. 1 Health care personnel Table 7. 1. 1 Staff registered with syndica tes Table 7. 1. 2 analogy of staff registered and in sway in MOHP, December 2005 Table 7. 1. 3 Staff registered and in post in MOHP plus percentage growing in difference over 20 age Table 7. 1. 4 Physicians and nurses by health sector (%) Table 7. 1. 5 Geographical distribution of MOHP physicians and nurses Table 7. 1. 6 Distribution of physicians and nurses by governorate per 100,000 tribe (2005) Table 7. 2 Human Resource Training Institutions for Health Table 8. 1Service Delivery Data and Trends Table 8. 1. 1 Improvement in hospital base services (19962005) Table 8. 1. 2 Distribution of health facilities across Egypt (2006) Table 8. 1. 3 Distribution of health care workers in Egypt (2006) Table 8. 1. 4 Comparison of specialists (2005) Table 8. 1. 5 Comparison of specialists (2005) Table 8. 1. 6 Comparison of MOHP and HIO registered and in post personnel2005 Table 8. 1. 7 Distribution of physicians with surreptitious clinics by number of jobs (%) 2 Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO Table 8. 1. 8 Governorates distribution according to phasesTable 8. 1. 9 Basic preventive and promotional existence health services Table 8. 2 Inpatient use and performance Table 8. 2. 1 subject field distribution of inpatient beds by type of facility (2005) Table 8. 2. 2 Change in hospital beds by type of raiser (1991, 1997, 2001) Table 8. 2. 3 MOHP strategy (1997, 2001, 2017) Table 8. 2. 4 Distribution of physicians among around service providers (2002) Table 8. 2. 5 Bed distribution by health provider in governorates Table 8. 2. 6 Beds/population by governorate and type of provider (2005) Table 8. 2. 7 Private sector providers (2005) Table 8. 2. 8Private sector services (2002) Table 8. 7 expenditure by type of provider and ownership (2005) 3 Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO List of Figures Figure 1 Uses of health resources, by categories of providers Figure 2 Sources of revenues for the hea lth sector, 1995 Figure 3 Distribution of HIO beneficiaries by law (19952002) Figure 4 Distribution of physicians and nurses by governorate per 100,000 population (2001) Figure 5 Beds per populations in governorates Figure 6 harvest-time trends in the pharmaceutical trade Figure 7 Expected value of the market size in 2010Figure 8 Trend in drug consumption as expenditure per capita Figure 9 Drug expenditure in undercover and governmental sector Figure 10 Distribution of drug consumption by therapeutic sept (20012002) 4 Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO F OREWORD Health formations are undergoing rapid change and the requirements for conform to the new challenges of changing demographics, disease patterns, emerging and re emerging diseases coupled with rising costs of health care rescue have forced a comprehensive review of health establishments and their courseing.As the countries examine their health carcasss in greater depth to adjust to new demands, the number and complexities of problems identified increases. Some health schemas unwrap to provide the essential services and some are creaking under the strain of inefficient prep of services. A number of issues including governance in health, financing of health care, human resource imbalances, access and grapheme of health services, along with the impacts of reforms in other areas of the economies significantly affect the ability of health systems to deliver.Decision-makers at all levels need to appraise the variation in health system performance, identify factors that influence it and articulate policies that bequeath achieve better results in a variety of settings. Meaningful, comparable data on health system performance, and on key factors that explain performance variation, can strengthen the scientific foundations of health policy at field of information, regional and internationalistic levels.Comparison of performance across countries and over time can provide important insights into policies that advance performance and those that do not. The WHO regional office for east Mediterranean has taken an gap to stand up a Regional Health Systems Observatory, whose radical(prenominal) purpose is to contribute to the improvement of health system performance and outcomes in the countries of the EM region, in impairment of better health, fair financing and responsiveness of health systems.This testament be achieved through the fol petty(a)ing closely inter-related functions (i) Descriptive function that provides for an easily accessible database, that is constantly updated (ii) Analytical function that draws lessons from success and failures and that can assist policy makers in the formulation of strategies (iii) Prescriptive function that brings forward recommendations to policy makers (iv) Monitoring function that focuses on aspects that can be improved and (v) Capacity building function that aims to develop partnerships and share knowledge across the region.One of the principal instruments for achieving the above objective is the culture of health system write of each of the member states. The EMRO Health Systems Profiles are country-based reports that provide a description and analysis of the health system and of reform initiatives in the respective countries. The profiles seek to provide comparative information to support policy-makers and analysts in the development of health systems in EMRO.The profiles can be used to learn about various approaches to the organization, financing and delivery of health services describe the process, content, and implementation of health care reform programs highlight challenges and areas that require to a greater extent in-depth analysis and provide a tool for the dissemination of information on health systems and the exchange of experiences of reform strategies between policymakers and analysts in different countries.These profiles have been produced by country p ublic health experts in collaborationism with the Division of Health Systems & Services Development, WHO, EMRO based on standardized templates, comprehensive guidelines and a glossary of terms developed to help compile the profiles. A real challenge in the development of these health system profiles has been the wide variation in the availability of data on all aspects of health systems. The profiles are based on the most authentic sources of information purchasable, which have been cited for ease of reference. For maintaining consistency and comparability in the sources of 5Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO information, efforts have been made to use as a first source, the information published and available from a national source such as Ministries of Health, Finance, Labor, Welfare field Statistics Organizations or reports of national surveys. In case information is not available from these sources then unpublished information from official sources or information published in unofficial sources are used. As a last resort, country-specific information published by international agencies and research papers published in international and local journals are used.Since health systems are dynamic and ever changing, any additional information is welcome, which after proper verification, can be put up on the website of the Regional Observatory as this is an ongoing initiative and these profiles will be updated on regular intervals. The profiles along with summaries, template, guidelines and glossary of terms are available on the EMRO HSO website at www. who. int. healthobservatory It is hoped the member states, international agencies, academia and other stakeholders would use the information available in these profiles and actively participate to make this initiative a success.I would like to acknowledge the efforts undertaken by the Division of Health Systems and Services Development to help countries of the region in bette r analyzing health system performance and in improving it. Regional Director Eastern Mediterranean Region World Health Organization 6 Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO 1 E XECUTIVE S UMMARY Egypt is going through a demographic and epidemiological transition that is affecting twain the size and health status of the population. The population growth rate has fluctuated from a low of 1. 92% a year during 19661967, to 2. 5% annually during 19761986, later declining to 2% a year during 19801993 and 2. 1% annually in 2001. Changes in fertility and fatality rate rate rates have been the major source of population growth in Egypt. The population pyramid has a wide base with children aged under 15 representing 37% of the population, reflecting relatively high fertility in recent years. The proportion of children aged under 10 years is smaller than the proportion aged 1014 years. The rate decreased from 80 in 1988 to 69 in 2000, so the proportion of productive group aged 1564 years has increased.The average out age of the population has risen, with a life expectancy from birth of 65. 5 years for males in 1996 to 69. 2 years in 2006. It is higher for women than for men (69. 2 and 73. 6 years, respectively). Egypt is a lower-middle-income country with a per capita gross national product (GNP) that doubled between the years 1993 and 1999, from US $600 to $1200 (DHS, 2000). The Egyptian economy has witnessed a turnaround in growth performance following a period of economic slow-down that started in 1986.The adoption of the open opening policy in 1975 afforded the Egyptian economy a decade of rapid economic growth, supported by large inflows of foreign assistance, workers remittances, and oil and tourism revenues. The drop in oil prices in 1986 signaled the end of a decade of economic boost, underscoring the volatility of Egypts key revenues sources and the constraints of an inward-oriented growth strategy. With the success of th e stabilization program in achieving its objectives, Egypt has been successful in reversing the slow growth rates that characterized the period 19911995.Real gross domestic product grew annually at an average of 3. 8% during 19931996 and at an average of 6% during 19961998. Inflation has been brought down from a peak of 21% in 1992 to 7% in 1996 and 3. 6% by 2000 (UNDP, 2000). While public expenditure on health in terms of budget share appears to be low in Egypt, overall spend at 3. 7% of GDP is also low, when compared to other comparable income countries. The Ministry of Health and Population (MOHP) budget, as part of the entire administration budget, increased from 2. 2% in 1995/1996 to 3. % in 2000/2001 and the MOHP expenditure per capita increased from LE26. 8 in 1996 to LE56. 7 in 2001. The health financing system in Egypt today manifests significant systemic inefficiencies and inequities that severely limit the military capability of the health system as a whole. Any attemp ts to expand the scope of services or increase the revenues and expenditures on health care without first addressing these systemic bottlenecks in the health financing system will result in further exacerbating the inefficiencies and inequities in the system.The existing system of health financing mechanisms in place today, whether it is through the general revenues Ministry of Finance or the Health Insurance Organization system or through private spending, establishes a regressive pattern of resource mobilization and resource allocation. Inequities are homely across many dimensions, in terms of income levels, gender, geographical distribution (rural and urban, and by governorate levels), and health outcomes. 7 Health Systems Profile- Egypt Regional Health Systems Observatory- EMROThe coverage of the Egyptian population with the National Health Insurance scheme is increase through the addition of new population groups under the umbrella of kindly health insurance, for example con dition children and newborn children. In the year 1980, the coverage was 4% of the constitutional population, and it doubled in 1990. In the year 1995, it reached 36% and increased over the last ten years to 45%. Out of pocket spending has been rising over past decade and currently stands at 62%. HIO does not reach 80% of the private sector workforce.Highest governmental healthcare spend is proportionately in lowest income quintile. The 1952 Constitution pronounced free medical care as a canonic right for all Egyptians. The Government has been the sole provider and financier of all primary/preventive and most inpatient curative care in Egypt. However, over the past two decades governmental budgetary constraints have resulted in relatively stagnant health expenditures. The structural adjustment program has also editd the governments resource position vis-a-vis allocation for social services sectors in general, and health services in particular.The Egyptian health system has a plu ralistic nature with a wide range of health care providers competing and complementing each other, allowing clients freedom of choice when pursuance care according to their needs and ability to pay. However, the Government is committed to providing health care to poor and unprivileged population groups. Parallel to, and related to, its demographic transition, Egypt is currently facing an epidemiological transition that is characterized by inflameduced mortality rates among infants and children from diarrhea, immunization-preventable diseases and respiratory infections. Rising prevalence of risk factors such as obesity, smoking and hypertension, responsible for chronic diseases. A changing socioeconomic env beseechment leading to different diets, increased industrialization, and increased motor vehicle traffic accidents. The distribution of the burden of diseases has changed from a predominance of infectious and parasitic diseases to a different mortality pattern whereby cardio vascular diseases are currently the leading cause of mortality (45% in 1991, compared to 12% in 1970 and 6. 3% in 2001).Egypt is therefore affected by a dual burden of disease, thus associating the unwholesomeness and mortality patterns of developing countries with those induced by modernization. As a result of the demographic and epidemiological transition, the major health and population challenges are 1. Population growth 2. Burden of endemic and infectious diseases 3. Maternal, infant and childhood mortality 4. Burden of chronic diseases, renal failure and cancer 5. Injuries and accidents 6. Smoking, other addictions, and their complications 7. Disabilities and congenital anomalies 8 Health Systems Profile- EgyptRegional Health Systems Observatory- EMRO 8. Human resources (capabilities, skills, knowledge, allocation, salaries and incentives) 9. Infrastructure (buildings, equipment, furniture and maintenance) 10. Basic public services (housing, unplanned areas and slums, potabl e water, sewage disposal). The health system has significant strengths and weaknesses resulting from its continuing evolution. The performance of the sector with respect to health services, human resources, material infrastructure, financing, organization and management, and the pharmaceutical sector will be assessed in following eight sections.Ministry of Health and Population has decided on a reform program based on the strengths of the current system, while at the same time rectifying its weaknesses. The Government of Egypt has embarked on a major restructuring of the health sector. This reform was deemed necessary because the MOHP and its main partners had identified fragmentation in the delivery of health services, excessive reliance specialist care and low primary care service quality as the main constraints to achieving universal coverage.The Egyptian Health empyrean Reform Program (HSRP) was officially launched in 1997. The World Bank (WB) started its contribution by con ception the overwhelm Plan for Montazah Health District in Alexandria Governorate, in May 1998. By the following year, in 1999, unify States Agency for International Development (USAID) was the first donor to begin field-level operations, while the European Commission (EC) fall in the HSRP in November 1999. The African Development Bank (ADB) initiated its work through designing dominate Plans for three health districts in June 2003.The most recent partner at HSRP is the Austrian Government, which directs its participation to improving the district hospitals as part of health district approach. The overall aim of the HSRP is twofold. Firstly to introduce a quality basic package of primary health care services, contribute to the establishment of a decentralized (district) service system and improve the availability and use of health services. Secondly to introduce institutional structural reform based on the concept of splitting purchasing/providing and the regulatory functions of the Ministry of Health and Population.Coverage would be provided by a National Social Insurance System. The ultimate goal of health sector reform initiatives is to improve the health status of the population, including reductions in infant, under- quintette, maternal mortality rates and population growth rates and the burden of infectious disease. The HSRP has lag initiated a new primary care strategy in accredited facilities, known as Family Health Units (FHUs). Facilities are being contracted by a purchasing agency -the Family Health Fund (FHF) to provide services to the population.It is envisaged that the HSRP will piecemeal extend its scope to the secondary level by establishing District Provider Organizations. The FHF will consequently develop in the direction of a full purchasing agency of services from the public and private sector. The newly introduced Family Health Model (FHM) constitutes one of the cornerstones of the reform program. It brings high quality services to the patient and will integrate most of the vertical programs into the Basic Benefit Package of services.To date the FHM has been introduced in 817 health facilities, which present 18% of the total public primary health care facilities. HSRP has an ambitious five years plan, by the end of year 2010, to cover the entire public primary health care facilities with the Family Health Model. The Egyptian Health Sector Reform Program went through several puts, including the preparatory stage from 1994 to 1996. During this stage, several valuable studies were conducted and used later to develop the Strategies for Health Sector Change study. 9 Health Systems Profile- Egypt Regional Health Systems Observatory- EMROThis was an analytical report on the Egyptian health sector. Designing the health Master Plans stage for the three pilot governorates followed this. Experimenting stage of the Family Health Model took place in one of the primary health care facilities, which took about two years to implement. This was followed by piloting stage of the Model in three governorates followed by another two governorates and included activities such as Building staff pattern, designing the contents of the Basic Benefits Package and Essential Drug List, and other components of the Family Health Model.The Program has shifted its strategy in March 2003 from health facility oriented approach to the district approach, which was called the District Provider Organization. As of 2005, the HSRP has gradually expanded its operations to ten additional governorates, pushing the total number of involved governorates to 15, which presents more than 50% of the country coverage.The Health Reform Program has three main components (1) Service component as seen in the Family Health Mode, (2) Mandate role and functions of the Ministry of Health and Population, and (3) Introduction of a sustainable universal health insurance system. It is envisaged that all three goals and objectives can be achieved in an unified District Health System model. each(prenominal) the necessary elements are available and the Sector for Technical Support and Projects (STSP) is in developing process for an integrate health system based on a district that is evaluated internally and externally and be replicable.The Integrated District Health System (IDHS) is the district that covers the following criteria (1) fully implements the District Provider Organization, (2) has financial sustainability, (3) separates providing from financing of health services, (4) implements the content of the district health coverage plan, (5) provides basic benefits and secondary care packages through public, private and NGO, (6) and applies quarterly measures for the achievements of HSRPs five objectives. 10 Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO 2 S OCIO E CONOMIC G EOPOLITICAL M APPING 2. Socio-cultural Factors Table 2-1 Socio-cultural indicators Indicators 1990 1995 2000 2004 Literacy Total 48. 8 (92) 57. 7 (98) 67. 4 (02) 69. 4 02) Female Literacy to total literacy 35. 3 (92) 65. 9 (98) 63. 4 (01) 67. 4 02) Women % of Workforce 29. 2(93) 18. 0(96) 18. 5(01) 21. 8(02) Primary School enrollment 98. 0(92) 98. 5(98) 91. 7(01) 99. 2(02) % Female Primary school pupils 80. 4(92) 84. 5(98) 93. 2 107. 1(02) %Urban Population 44. 0(86) 43. 0(96) 42. 8 57. 6 Human Development Index Source NICHP Report, Ministry of Health and Population, 2005. Egypt Human Development Report, 1995, 1999, 2003, 2004. . 2 Economy Key economic trends, policies and reforms Lack of substantial cash advance on economic reform since the mid 1990s has limited foreign direct investment in Egypt and kept annual GDP growth in the range of 2%-3% in 200103. However, in 2004 Egypt utilize several measures to boost foreign direct investment. In September 2004, Egypt pushed through custom reforms, proposed income and corporate appraise reforms, reduced energy subsidies, and privatized several enterprise s. The budget deficit rose to an estimated 8% of GDP in 2004 compared to 6. 1% of GDP the previous year, in part as a result of these reforms.Monetary pressures on an overvalued Egyptian dig led the government to float the currency in January 2003, leading to a sharp drop in its value and consequent inflationary pressure. In 2004, the Central Bank implemented measures to improve currency liquidity. Egypt reached go in tourism levels, despite the Taba and Nuweiba bombings in September 2004. The development of an export market for natural gas is a bright spot for future growth prospects, but improvement in the capital-intensive hydrocarbons sector does little to reduce Egypts persistent unemploymentTable 2-2 Economic Indicators Indicators 1990 GNI per Capita (Atlas method) current US$ 2000 2004 NA GNI per capita (PPP) Current International Real GDP Growth (%) 1995 1. 9 (91-92) 5 (95-96) 3. 4 (00-01) 4 (03-04) 11 Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO Real GDP per Capita ($) (91- 92) 769 1,285 1,036 9. 2 (91-92) Unemployment % (estimates) 1,143 9. 6 (91-92) 9. 0 (01) 10. 2 (03) Source Egypt Human Development Report, 2003. Ministry of Foreign Trade, Egypt, Monthly Economic Digest, February 2005. Table 2-3 Major Imports and Exports Major ExportsCrude oil and petroleum products, cotton, textiles, metal products and chemicals. Major Imports Machinery and equipment, foodstuffs, chemicals, wood products and fuels. 2. 3 Geography and Climate Map of Egypt Arab Republic of Egypt is located at the northern Africa, bordering the Mediterranean Sea, between Libya and the Gaza Strip, and the Red Sea north of Sudan, and includes the Asian Sinai Peninsula. Total area is 1,001,450 sq km (land 995,450 sq km, water 6,000 sq km). A total of 2,665 km border countries Gaza Strip 11 km, Israel 266 km, Libya 1,115 km, Sudan 1,273 km.Coastline is 2,450 km. The climate is desert hot, dry summers with moderate winters. Natural resources petroleum, natural gas, iron ore, phosphates, manganese, limestone, gypsum, talc, asbestos, lead and zinc. 2. 4 Political/ Administrative Structure The chief of state is the President, head of government is the peak Minister. Bicameral system consists of the Peoples Assembly or Majlis al-Shab (454 seats 444 elected by popular vote, 10 official by the president members serve five-year terms) and the 12 Health Systems Profile- Egypt Regional Health Systems Observatory- EMROAdvisory Council or Majlis al-Shura which functions only in a consultative role (264 seats 176 elected by popular vote, 88 appointed by the president members serve sixyear terms mid-term elections for half the members). Peoples Assembly election is in three phase voting, last held 19 October, 29 October, 8 November 2000 (next to be held October-November 2005) Advisory Council last held May-June 2004. The Shoura Council was established constitutionally in 1980. The Shoura Council is in the first place a think-tank to advise the G overnment on national policies.A committee of the Shoura Council on Health, Population and Environment examines issues pertinent to these areas prior to their discussion in the Shoura Councils plenary sessions. Although it does not have a direct legislative role, laws impacting significantly on broad government policy are required to be discussed by the Shoura Council ahead being passed to the Peoples Assembly Laws, in advance going to the plenary sessions of Parliament, are referred for preliminary study to the relevant committees. These specific committees are currently 22 in number an example is the Committee for Health and Environment.This committee, consisting solely of Members of Parliament, often invites experts to its meetings for the purpose of obtaining a more comprehensive view of topics under study. The committee influences health policy changes planned for the future 13 Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO 3 H EALTH experimental co ndition AND DEMOGRAPHICS 3. 1 Health Status Indicators Table 3. 1 Health Status Indicators 1990-2005 Indicators 1990 1995 2000 2004 2005 65. 3 (92) 66. 9 (98) 67. 1 (01) 70. 1 (02) 63 66 24. 5 22. 4 20. 5 3. 9 (97) 33. 8 28. 6 26. 2 174 (92) 96 (98) 84 (01) 68 (02) 3 26 29. 8 28. 7 NA 17. 6 prevalence of wasting 3. 4 4. 6 Source NICHP Report, Ministry of Health and Population,2005. 2. 5 NA 3. 9 Life anticipation at Birth HALE Infant Mortality Rate Probability of dying before fifth birthday/1000 Maternal Mortality ratio Percent of Normal birth weight babies prevalence of stunting Egypt Human Development Report,2004 Table 3-2 Indicators of Health Status by Gender and by urban rural 2006 Indicators Urban Rural Male Female Life expectancy at birth 69. 2 73. 6 HALE Infant Mortality Rate 27. 7 15. 3 Probability of dying before 5th birthday/1000 3. 9 20. 6 27. 6 24. 7 Maternal Mortality dimension Percent of Normal Birth Weight Babies Prevalence of stunnin g/wasting Source NICHP Report, Ministry of Health and Population,2005. WHO blade Site,August 2005 14 Health Systems Profile- Egypt Regional Health Systems Observatory- EMRO Table 3-3 Top 10 causes of Mortality Mortality Y2005 graze Intra-cerebral hemorrhage 21,473 Essential (primary) hypertension 20,354 Fibrosis and cirrhosis of liver 18,434 Hepatic failure, not elsewhere classified 11,353 coronary artery disease 10,800 Arterial embolism and thrombosis 8,233 Elevated blood glucose level ,000 Acute myocardial infarct 6,645 Cerebral infarction 6,334 Others 320,011 Total 431,637 Source NICHP Report, Ministry of Health and Population, 2005. The Burden of Disease and Injury in Egypt (Mortality and Morbidity). 2004. 3. 2 Demography Demographic patterns and trends Total population of Arab Republic of Egypt is 77,505,756 (July 2005 est. ). The age distribution is 0-14 years presents 33% (male 13,106,043/ feminine 12,483,899), 15-64 years presents 62. 6% (male 24,531,266/female 23,972,21 6), 65 years and over presents 4. 4% (male 1,457,097/ female 1,955,235) (2005 est. ).Net migration rate is -0. 22 migrant(s)/1,000 population (2005 est. ). get off ratio at birth 1. 05 male(s)/female, under 15 years it is 1. 05 male(s)/ female, 15-64 years it is 1. 02 male(s)/female, 65 years and over it is 0. 74 male(s)/female, for the total population it is 1. 02 male(s)/female (2005 est. ) The median age is 23. 68 years, 23. 31 years for males and 24. 05 years for females (2005 est. ). Eastern Hamitic stock (Egyptians and Bedouins) presents 99%, Greek, Nubian, Armenian, other European (primarily Italian and French) presents 1%. Muslim (mostly Sunni) 94%, Coptic Christian and other 6%.Arabic is the official language, English and French are widely understood by educated classes. 57. 7% of the population (age 15 and over) can read and write. Male presents 68. 3% and female presents female 46. 9% (2003 est. ). 15 Health Systems Profile- Egypt Regional Health Systems Observatory- EMR O Table 3-4 Demographic Indicators Indicators 1990 1995 2000 2004 2005 27. 9 1997 27. 9 27. 0 (03) 25. 8 (05) 6. 4 1997 6. 3 6. 4 (03) 6. 4 (05) 2. 4 (60. 86) 2. 08 (86-96) 2. 3 (96-02) 2. 0 (03) 19. 1 (05) 74. 7 1992 69. 7 1998 69. 9 (01) 69. 9 (02) 37. 8 1996 38. 8 (03) 37. 4 3. 90 1992