@ @òî÷îjÛaë@òîz—Ûa@òîàänÛa@òîÈà€u

@ @òîz—Ûa@áÄäÛaë@pbŽbîÛa@wßbã‹i

  
 
 
 

@ @òîÜjÔnß@ôúŠë@åça‹Ûa@ÉšìÜÛ@òîÜîÜ¥@òŽaŠ†

 

@ @òîz—Ûa@áÄäÛaë@pbŽbîÛa@wßbã‹i
@ @òî÷îjÛaë@òîz—Ûa@òîàänÛa@òîÈà€u

2005
 ‫  
‪..‬‬
‫ﺍﻫﺘﻤﺖ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ ﻣﻨﺬ ﻧﺸﺄ‪‬ﺎ ﲟﻨﺎﻗﺸﺔ ﺍﻟﻘﻀﺎﻳﺎ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ‬
‫ﻭﺍﻟﻨﻮﻋﻴﺔ ﺧﺎﺻﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﻨﻈﻢ ﺍﻟﺼﺤﻴﺔ ﻭﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﻭﺳﻴﺎﺳﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻭﺍﻋﺘﻤﺪﺕ ﺍﳉﻤﻌﻴﺔ ﰲ ﺫﻟﻚ ﻋﻠﻰ ﻋﺪﺩ ﻣﻦ ﺍﻷﺩﻭﺍﺕ ﻛﺎﻥ ﻣﻦ ﺃﳘﻬﺎ ﻋﻘﺪ ﺍﳌﺆﲤﺮﺍﺕ ﻭﺍﻟﻨﺪﻭﺍﺕ‪ ،‬ﻭﻣﻨﻬﺎ ﻋﻠﻰ‬
‫ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ ﻣﺆﲤﺮ "ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ" ﻋﺎﻡ ‪ ،١٩٩١‬ﻭﻣﺆﲤﺮ "ﺍﻻﺳﺘﺨﺪﺍﻡ‬
‫ﺍﻟﺮﺷﻴﺪ ﻟﻠﺪﻭﺍﺀ" ﻋﺎﻡ ‪ ،١٩٩٣‬ﻭﻣﺆﲤﺮ "ﺑﺎﲡﺎﻩ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺍﻟﺸﺎﻣﻞ" ﻋﺎﻡ ‪ .٢٠٠٣‬ﻭﻛﺎﻥ ﻣﻦ‬
‫ﻫﺬﻩ ﺍﻷﺩﻭﺍﺕ ﻧﺸﺮﺓ ﺍﳉﻤﻌﻴﺔ "ﻣﻨﱪ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﺔ" ﻭﺍﻟﱵ ﺍﺳﺘﺨﺪﻣﺖ ﰲ ﻧﺸﺮ ﺍﳌﻘﺎﻻﺕ ﻭﻓﺘﺢ ﻗﻨﺎﺓ‬
‫ﻟﻠﺤﻮﺍﺭ ﺣﻮﻝ ﺍﻟﻘﻀﺎﻳﺎ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﻛﺎﻥ ﻣﻦ ﺃﻫﻢ ﻫﺬﻩ ﺍﻟﻘﻀﺎﻳﺎ‪ :‬ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﰲ ﻣﺼﺮ‬
‫– ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ – ﻗﻀﺎﻳﺎ ﺻﺤﺔ ﺍﳌﺮﺃﺓ – ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ ..‬ﺍﱁ‪ .‬ﻛﻤﺎ ﺃﺻﺪﺭﺕ‬
‫ﺍﳉﻤﻌﻴﺔ ﻋﺪﺩﺍﹰ ﻣﻦ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻭﺍﻷﲝﺎﺙ ﻣﻨﻬﺎ‪ :‬ﺃﺛﺮ ﺍﺗﻔﺎﻗﻴﺔ ﺍﳉﺎﺕ ﻋﻠﻰ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﻣﺼﺮ –‬
‫ﺍﻟﻮﺿﻊ ﺍﻟﺮﺍﻫﻦ ﻟﻠﺤﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻤﺮﺃﺓ ﰲ ﻣﺼﺮ‪ ..‬ﺍﱁ‪ .‬ﻛﻤﺎ ﻋﻘﺪﺕ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﻨﺪﻭﺍﺕ ﺣﻮﻝ‬
‫ﳏﺪﺩﺍﺕ ﺍﻟﺼﺤﺔ ﰲ ﻣﺼﺮ ﻭﺃﻳﻀﺎﹰ ﺗﺄﺛﺮ ﺻﺤﺔ ﺍﳌﻮﺍﻃﻨﲔ ﰲ ﻣﺼﺮ ﺑﺎﳌﺘﻐﲑﺍﺕ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺍﻟﻌﺎﳌﻴﺔ‪.‬‬
‫ﻭﺍﻣﺘﺪﺍﺩﺍﹰ ﳍﺬﻩ ﺍﻟﻸﻧﺸﻄﺔ‪ ،‬ﻧﺸﺄﺕ ﻓﻜﺮﺓ ﺇﺻﺪﺍﺭ ﻭﻧﺸﺮ ﺗﻘﺮﻳﺮ ﺩﻭﺭﻱ ﻋﻦ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ‪ .‬ﻭﱂ ﻳﻜﻦ ﺍﳍﺪﻑ ﻣﻦ ﺍﻟﺘﻘﺮﻳﺮ ﺗﻜﺮﺍﺭ ﺍﳉﻬﻮﺩ ﺍﻟﻌﺪﻳﺪﺓ ﺍﻟﱵ ﺗﺒﺬﳍﺎ ﺟﻬﺎﺕ ﻣﺘﻌﺪﺩﺓ‬
‫ﺑﺎﺻﺪﺍﺭ ﺗﻘﺎﺭﻳﺮ ﺻﺤﻴﺔ‪ ،‬ﻭﺇﳕﺎ ﻛﺎﻥ ﺍﳍﺪﻑ ﻫﻮ ﺭﺻﺪ ﻭﲢﻠﻴﻞ ﺍﻟﻮﺍﻗﻊ ﺍﳌﺼﺮﻱ ﺍﻟﺼﺤﻲ ﻣﻦ ﻭﺟﻬﺔ ﻧﻈﺮ‬
‫ﺍ‪‬ﺘﻤﻊ ﺍﳌﺪﱐ ﺍﻟﺬﻱ ﺗﻨﺘﻤﻲ ﺇﻟﻴﻪ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ‪.‬‬
‫ﻭﻣﻨﺬ ﻧﺸﺄﺓ ﻫﺬﻩ ﺍﻟﻔﻜﺮﺓ‪ ،‬ﺣﺮﺻﺖ ﺍﳉﻤﻌﻴﺔ – ﳑﺜﻠﺔ ﰲ ﺑﺮﻧﺎﳎﻬﺎ‪ :‬ﺑﺮﻧﺎﻣﺞ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻟﻨﻈﻢ‬
‫ﺍﻟﺼﺤﻴﺔ – ﻋﻠﻰ ﺍﺳﺘﺪﻋﺎﺀ ﺃﻛﱪ ﻋﺪﺩ ﳑﻜﻦ ﻣﻦ ﺫﻭﻱ ﺍﻟﺮﺃﻱ ﻭﺍﳋﱪﺓ ﰲ ﺍﻟﺼﺤﺔ‪ ،‬ﻛﻤﺎ ﺣﺮﺻﺖ ﻋﻠﻰ ﲤﺜﻴﻞ‬
‫ﺃﻛﱪ ﻋﺪﺩ ﻣﻦ ﺍﳉﻬﺎﺕ ﺍﳌﻌﻨﻴﺔ ﺑﺎﻟﺼﺤﺔ ﰲ ﻣﺼﺮ – ﻭﺇﻥ ﻛﺎﻥ ﲤﺜﻴﻼﹰ ﻏﲑ ﺭﲰﻲ – ﻟﻠﻤﺸﺎﺭﻛﺔ ﰲ ﺍﻹﻋﺪﺍﺩ‬
‫ﻭﺍﻟﺘﺨﻄﻴﻂ ﻹﺻﺪﺍﺭ ﻣﺜﻞ ﻫﺬﺍ ﺍﻟﺘﻘﺮﻳﺮ‪ ،‬ﻭﻧﻌﲏ ﺍﻹﺻﺪﺍﺭ ﺍﻷﻭﻝ ﻣﻨﻪ‪ .‬ﻓﺒﺪﺃ ﺍﳌﺸﺮﻭﻉ ﺑﻌﻘﺪ ﻋﺪﺩ ﻛﺒﲑ ﻣﻦ‬
‫ﺍﻟﻨﺪﻭﺍﺕ ﺍﳌﺼﻐﺮﺓ ﺩﻋﻲ ﺇﻟﻴﻬﺎ ﻋﺪﺩ ﻣﻦ ﺍﳋﱪﺍﺀ ﰲ ﳎﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﳝﺜﻠﻮﻥ ﻗﻄﺎﻋﺎﺕ ﳐﺘﻠﻔﺔ‬
‫ﻭﲣﺼﺼﺎﺕ ﳐﺘﻠﻔﺔ ﻟﻠﻤﺴﺎﳘﺔ ﻣﻊ ﺍﳉﻤﻌﻴﺔ ﰲ ﻭﺿﻊ ﺍﻹﻃﺎﺭ ﺍﻟﻔﻜﺮﻱ ﻭﺍﳌﻨﻬﺠﻲ ﻟﻠﺘﻘﺮﻳﺮ‪ ،‬ﻭﺍﻻﺗﻔﺎﻕ‬
‫ﻋﻠﻰ ﳏﺘﻮﻳﺎﺕ ﺍﻟﺘﻘﺮﻳﺮ )ﺃﺑﻮﺍﺑﻪ ﻭﻓﺼﻮﻟﻪ(‪ ،‬ﺇﺿﺎﻓﺔ ﺇﱃ ﺍﳌﺴﺎﳘﺔ ﰲ ﲢﺪﻳﺪ ﳏﺮﺭﻱ ﺍﻟﻔﺼﻮﻝ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﻭﻗﺪ ﺗﻠﻰ ﺫﻟﻚ ﺧﻄﻮﺍﺕ ﻋﺪﻳﺪﺓ ﲤﺜﻠﺖ ﰲ ﺍﻻﺗﻔﺎﻕ ﺍﻟﻨﻬﺎﺋﻲ ﻋﻠﻰ ﳏﺘﻮﻳﺎﺕ ﺍﻟﺘﻘﺮﻳﺮ ﻭﻃﺮﻳﻘﺔ ﺗﻘﺴﻴﻢ‬
‫ﻓﺼﻮﻟﻪ‪ ،‬ﰒ ﺍﻻﺗﻔﺎﻕ ﻣﻊ ﻋﺪﺩ ﻣﻦ ﺍﶈﺮﻳﻦ ﺍﻷﺳﺎﺳﻴﲔ ﻭﻓﺎﻕ ﻋﺪﺩﻫﻢ ﺍﻟﻌﺸﺮﺓ ﳏﺮﺭﻳﻦ ﻣﻦ ﻗﻄﺎﻋﺎﺕ‬
‫ﻭﲣﺼﺼﺎﺕ ﳐﺘﻠﻔﺔ‪ .‬ﻭﻃﻠﺐ ﻣﻦ ﺃﻏﻠﺐ ﺍﶈﺮﺭﻳﻦ ﻛﺘﺎﺑﺔ ﺛﻼﺙ ﻣﺴﻮﺩﺍﺕ ﻣﺘﺘﺎﻟﻴﺔ‪ ،‬ﺍﻷﻭﱃ ﳌﺮﺍﺟﻌﺘﻬﺎ ﻭﻓﻘﺎﹰ‬
‫ﻟﻠﺒﻨﻮﺩ ﺍﳌﺘﻔﻖ ﻋﻠﻴﻬﺎ ﺳﻠﻔﺎﹰ‪ ،‬ﰒ ﺍﻟﺜﺎﻧﻴﺔ ﻟﻠﻌﺮﺽ ﻋﻠﻰ ﻋﺪﺩ ﺃﻭﺳﻊ ﻣﻦ ﺍﳋﱪﺍﺀ ﰲ ﺇﻃﺎﺭ ﻣﺎﺋﺪﺓ ﺣﻮﺍﺭ‬
‫ﻟﻠﻮﺻﻮﻝ ﻟﻠﻤﺴﻮﺩﺓ ﺍﻟﻨﻬﺎﺋﻴﺔ ﺍﻟﱵ ﺗﺮﺍﻋﻲ ﻗﺪﺭ ﺍﻹﻣﻜﺎﻥ ﺍﳌﻘﺘﺮﺣﺎﺕ ﻭﺍﻟﺘﻮﺻﻴﺎﺕ ﺍﻟﻨﺎﲡﺔ ﻋﻦ ﺍﻟﻨﻘﺎﺵ‬
‫ﲟﺎﺋﺪﺓ ﺍﳊﻮﺍﺭ‪ .‬ﻭﻛﺎﻥ ﺍﳊﺮﺹ ﻋﻠﻰ ﻫﺬﻩ ﺍﳋﻄﻮﺍﺕ ﺍﳌﻄﻮﻟﺔ ﻫﺎﺩﻓﺎﹰ ﺇﱃ ﺇﺷﺮﺍﻙ ﺃﻛﱪ ﻋﺪﺩ ﻣﻦ ﺍﳌﺘﺨﺼﺼﲔ‬
‫ﻭﺍﳌﻬﺘﻤﲔ ﺑﻘﻀﺎﻳﺎ ﺍﻟﺼﺤﺔ ﰲ ﻣﺼﺮ ﻭﻓﺘﺢ ﺍﻟﺒﺎﺏ ﻟﻶﺭﺍﺀ ﺍﳌﺨﺘﻠﻔﺔ ﻗﺪﺭ ﺍﻹﻣﻜﺎﻥ‪.‬‬
‫ﻭﻗﺪ ﺍﻋﺘﻤﺪ ﺍﻹﺻﺪﺍﺭ ﺍﻷﻭﻝ ﻣﻦ "ﺗﻘﺮﻳﺮ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ" ﻭﺍﻟﺬﻱ ﺑﲔ ﺃﻳﺪﻳﻜﻢ‬
‫ﺍﻵﻥ ﻋﻠﻰ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻭﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳌﺘﺎﺣﺔ ﺑﺎﻟﻔﻌﻞ ﻣﻊ ﳏﺎﻭﻻﺕ ﺟﺎﺩﺓ ﻟﺘﺪﻗﻴﻘﻬﺎ‪ ،‬ﻟﻜﻨﻨﺎ ﱂ ﻧﻠﺠﺄ ﻹﻧﺘﺎﺝ‬
‫ﺑﻴﺎﻧﺎﺕ ﺟﺪﻳﺪﺓ ﻣﻦ ﺧﻼﻝ ﺃﲝﺎﺙ ﺧﺎﺻﺔ ﺑﺎﻟﺘﻘﺮﻳﺮ‪.‬‬
 ‫ﻭﻗﺪ ﺭﻭﻋﻲ ﰲ ﺍﻹﺻﺪﺍﺭ ﺍﻷﻭﻝ ﻣﻦ ﺍﻟﺘﻘﺮﻳﺮ ﺃﻥ ﻳﻐﻄﻲ ﺃﻛﱪ ﻗﺪﺭ ﻣﻦ ﻗﻀﺎﻳﺎ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ‬
‫ﻭﺍﻟﻨﻮﻋﻴﺔ ‪ -‬ﺩﻭﳕﺎ ﺗﻔﺎﺻﻴﻞ ﻛﺜﲑﺓ ‪ -‬ﻭﺃﻥ ﻳﺄﰐ ﲢﻠﻴﻠﻴﺎﹰ ﻗﺪﺭ ﺍﻹﻣﻜﺎﻥ‪ .‬ﻗﺪ ﳚﺪ ﺍﻟﻘﺎﺭﺉ ﺍﺧﺘﻼﻓﺎﹰ ﰲ ﻣﻨﻬﺞ‬
‫ﺍﻟﺘﺤﻠﻴﻞ ﻭﺍﺳﺘﻨﺘﺎﺝ ﺍﻟﺮﺅﻯ ﺍﳌﺴﺘﻘﺒﻠﻴﺔ ﺑﲔ ﻓﺼﻞ ﻭﺁﺧﺮ ‪ -‬ﺑﺎﺧﺘﻼﻑ ﺍﶈﺮﺭﻳﻦ ﻭﺍﺧﺘﻼﻑ ﺍﻟﻘﻀﺎﻳﺎ ‪ -‬ﺍﻷﻣﺮ‬
‫ﺍﻟﺬﻱ ﻭﺟﺪﻧﺎﻩ ﻣﻔﻴﺪﺃ ﻭﻣﺜﲑﺍﹰ ﻟﻔﺘﺢ ﺍﳊﻮﺍﺭ‪ ،‬ﻋﻠﻰ ﺃﻧﻪ ﻗﺪ ﻳﺘﻢ ﺍﻻﺗﻔﺎﻕ ﻋﻠﻰ ﺗﻮﺣﻴﺪ ﻣﻨﺎﻫﺞ ﺍﻟﺘﺤﻠﻴﻞ ﰲ‬
‫ﺍﻹﺻﺪﺍﺭﺍﺕ ﺍﻟﺘﺎﻟﻴﺔ‪.‬‬
‫ﻭﻧﺘﻤﲎ ﰲ ﺍﻟﻨﻬﺎﻳﺔ ﺃﻥ ﻧﻜﻮﻥ ﻗﺪ ﻗﺪﻣﻨﺎﹰ ﺗﻘﺮﻳﺮﺍﹰ ﻣﺘﻜﺎﻣﻼﹰ ﺑﻌﺾ ﺍﻟﺸﻲﺀ ﳝﻜﻦ ﺍﻟﺒﻨﺎﺀ ﻋﻠﻴﻪ ﻭﳝﻜﻦ ﺗﻄﻮﻳﺮﻩ‬
‫ﰲ ﺍﻹﺻﺪﺍﺭﺍﺕ ﺍﻟﺘﺎﻟﻴﺔ‪.‬‬
‫‪@ @òîz—Ûa@áÄäÛaë@pbŽbîÛa@wßbã‹i‬‬
‫‪òî÷îjÛaë@òîz—Ûa@òîàänÛa@òîÈà€u‬‬
 @ @õa‡çg
@ @
@ @
@ @@Bòî÷îjÛaë@òîz—Ûa@òîà䀀€nÛa@òîÈà€€uB@ð‡èm
@ @Ýîܧa@bÈÛa@ë‹Û@ÝàÈÛa@a‰ç
@ @
@ @ŠìnׇÛa@ˆbnŽþa

@ @æbàÈã@‡à«@çŒ
@ @òîÈà§a@÷Žûß
@ @÷íìÛa@ñbäÓ@òÈßbu@M@kĐÛa@òîÜØÛ@÷Žû¾a@‡îàÈÛaë
@ @
@ @
 ‫‪1‬‬
‫ ‬
‫ﺇﲰﺎﻋﻴﻞ ﻳﻮﺳﻒ‬ ‫•‬
‫
ﺃﺳﺘﺎﺫ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ – ﻛﻠﻴﺔ ﺍﻟﻄﺐ – ﺟﺎﻣﻌﺔ ﻗﻨﺎﺓ ﺍﻟﺴﻮﻳﺲ‬
‫ﻋﻀﻮ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ‪ ،‬ﻭﻋﻀﻮ ﳎﻠﺲ ﺇﺩﺍﺭ‪‬ﺎ ﺳﺎﺑﻘﺎﹰ‬ ‫
‬

‫ﲨﺎﻝ ﺍﻟﺴﻤﺮﺓ‬ ‫•‬

‫
ﺃﺳﺘﺎﺫ ﻃﺐ ﺍﻟﺼﻨﺎﻋﺎﺕ – ﻛﻠﻴﺔ ﺍﻟﻄﺐ – ﺟﺎﻣﻌﺔ ﺍﻟﻘﺎﻫﺮﺓ‬

‫ﺳﻠﻤﻰ ﺟﻼﻝ‬ ‫•‬

‫
ﺃﺳﺘﺎﺫ ﻃﺐ ﺍ‪‬ﺘﻤﻊ – ﻛﻠﻴﺔ ﺍﻟﻄﺐ )ﺑﻨﺎﺕ( – ﺟﺎﻣﻌﺔ ﺍﻷﺯﻫﺮ‬

‫ﻋﻼﺀ ﺷﻜﺮ ﺍﷲ‬ ‫•‬

‫
ﺍﺳﺘﺸﺎﺭﻱ ﺇﻋﺎﻗﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ‬
‫
ﺭﺋﻴﺲ ﳎﻠﺲ ﺇﺩﺍﺭﺓ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ‬

‫ﳏﻤﺪ ﺣﺴﻦ ﺧﻠﻴﻞ‬ ‫•‬

‫
ﺍﺳﺘﺸﺎﺭﻱ ﺃﻣﺮﺍﺽ ﺍﻟﻘﻠﺐ – ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫ﻋﻀﻮ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ‪ ،‬ﻭﺭﺋﻴﺲ ﳎﻠﺲ ﺇﺩﺍﺭ‪‬ﺎ ﺍﻟﺴﺎﺑﻖ‬ ‫
‬

‫ﳏﻤﺪ ﺭﺀﻭﻑ ﺣﺎﻣﺪ‬ ‫•‬

‫
ﺃﺳﺘﺎﺫ ﻋﻠﻢ ﺍﻷﺩﻭﻳﺔ ﺑﺎﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺮﻗﺎﺑﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺍﻟﺪﻭﺍﺋﻴﺔ‬
‫ﻋﻀﻮ ﳎﻠﺲ ﺇﺩﺍﺭﺓ ﻏﺮﻓﺔ ﺍﻟﺪﻭﺍﺀ – ﺍﲢﺎﺩ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﳌﺼﺮﻳﺔ‬ ‫
‬
‫ﻋﻀﻮ ﳉﻨﺔ ﺍﻟﺜﻘﺎﻓﺔ ﺍﻟﻌﻠﻤﻴﺔ ﺑﺎ‪‬ﻠﺲ ﺍﻷﻋﻠﻰ ﻟﻠﺜﻘﺎﻓﺔ – ﻣﺼﺮ‬ ‫
‬
‫ﻋﻀﻮ ﳎﺲ ﺇﺩﺍﺭﺓ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ‬ ‫
‬

‫ﻣﻬﻲ ﺍﻟﺘﺤﻴﻮﻱ‬ ‫•‬

‫
ﺃﺳﺘﺎﺫ ﻃﺐ ﺍ‪‬ﺘﻤﻊ – ﻛﻠﻴﺔ ﺍﻟﻄﺐ – ﺟﺎﻣﻌﺔ ﻋﲔ ﴰﺲ‬

‫ﻧﺎﺩﻳﺔ ﺭﺯﻕ ﺍﷲ‬ ‫•‬

‫
ﺃﺳﺘﺎﺫ ﻃﺐ ﺍ‪‬ﺘﻤﻊ ‪ -‬ﻛﻠﻴﺔ ﺍﻟﻄﺐ ‪ -‬ﺟﺎﻣﻌﺔ ﻗﻨﺎﺓ ﺍﻟﺴﻮﻳﺲ‬
‫ﻋﻀﻮ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ‪ ،‬ﻭﻣﺴﺘﺸﺎﺭ ﺑﺮﻧﺎﻣﺞ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻟﻨﻈﻢ ﺍﻟﺼﺤﻴﺔ‬ ‫
‬

‫‪ 1‬ﺍﻷﲰﺎﺀ ﻣﺮﺗﺒﺔ ﺗﺼﺎﻋﺪﻳﺎﹰ ﻭﻓﻘﺎﹰ ﻟﻸﲜﺪﻳﺔ ﺍﻟﻌﺮﺑﻴﺔ‬

 ‫ﳒﻮﻯ ﺧﻼﻑ‬ ‫•‬
‫ﻣﺪﻳﺮ ﺗﻨﻔﻴﺬﻱ ﲟﺸﺮﻭﻉ ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ – ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬ ‫
‬
‫ﻋﻀﻮ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ‬ ‫
‬

‫ﻫﺎﻟﺔ ﺍﻟﺪﻣﻨﻬﻮﺭﻱ‬ ‫•‬

‫
ﺃﺧﺼﺎﺋﻲ ﺃﻣﺮﺍﺽ ﺍﻟﻨﺴﺎﺀ ﻭﺍﻟﺘﻮﻟﻴﺪ‬
‫
ﻋﻀﻮ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ‪ ،‬ﻭﻋﻀﻮ ﳎﻠﺲ ﺇﺩﺍﺭ‪‬ﺎ ﺳﺎﺑﻘﺎﹰ‬

‫ﻫﺒﺔ ﻧﺼﺎﺭ‬ ‫•‬

‫
ﺃﺳﺘﺎﺫ ﺍﻻﻗﺘﺼﺎﺩ – ﻛﻠﻴﺔ ﺍﻻﻗﺘﺼﺎﺩ ﻭﺍﻟﻌﻠﻮﻡ ﺍﻟﺴﻴﺎﺳﻴﺔ – ﺟﺎﻣﻌﺔ ﺍﻟﻘﺎﻫﺮﺓ‬

‫ﻳﻮﺳﻒ ﻭﻫﻴﺐ‬ ‫•‬

‫
ﺃﺳﺘﺎﺫ ﻃﺐ ﺍ‪‬ﺘﻤﻊ – ﻛﻠﻴﺔ ﺍﻟﻄﺐ – ﺟﺎﻣﻌﺔ ﻗﻨﺎﺓ ﺍﻟﺴﻮﻳﺲ‬
‫ﻋﻀﻮ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ‬ ‫
‬
 ‫
‬
‫‪1‬‬ ‫      
  
‬
‫‪١‬‬ ‫ﻣﻘﺪﻣﺔ‬
‫‪٢‬‬ ‫ﻋﻼﻣﺎﺕ ﺃﺳﺎﺳﻴﺔ ﰲ ﺗﻄﻮﺭ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺍﻟﻌﺼﻮﺭ ﺍﻟﻘﺪﳝﺔ ﻟﻠﻌﺼﻮﺭ ﺍﳊﺪﻳﺜﺔ‬
‫‪٤‬‬ ‫ﻣﺼﺮ ﻭﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﻐﺮﰊ "ﺍﳊﺪﻳﺚ" ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫‪٦‬‬ ‫ﺗﺄﺳﻴﺲ ﺍﳉﺎﻣﻌﺔ ﺍﳌﺼﺮﻳﺔ ﻭﺇﻧﺸﺎﺀ ﻛﻠﻴﺔ ﺍﻟﻄﺐ )‪(١٩٢٥‬‬
‫‪٨‬‬ ‫ﺗﻄﻮﺭﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ ﰲ ﺍﳊﻘﺒﺔ ﺍﻟﻨﺎﺻﺮﻳﺔ‬
‫‪٨‬‬ ‫ﺍﳌﺮﺍﺟﻊ‬

‫ ء ‪
  
 "#$ %& '( :‬‬
‫‪11‬‬ ‫*
) ‪ 
  
++
,&-+ :‬‬
‫‪١١‬‬ ‫ﻣﻘﺪﻣﺔ‬
‫‪١٦‬‬ ‫ﲢﻠﻴﻞ ﺍﳌﻮﻗﻒ ﺍﳊﺎﱄ‬
‫‪٢١‬‬ ‫ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ‬
‫‪٢٦‬‬ ‫ﺍﻻﲡﺎﻫﺎﺕ ﺍﳉﺪﻳﺪﺓ ﻭﺍﻷﻧﺸﻄﺔ ﺍﳌﺴﺘﺤﺪﺛﺔ ﰲ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫‪٣٧‬‬ ‫ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﻭﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﲢﺪﻳﺎﺕ ﺍﳌﺴﺘﻘﺒﻞ‬

‫‪47‬‬ ‫*
) ‪
 "#$ *0 12 '( :./‬‬
‫‪٤٧‬‬ ‫ﻣﻘﺪﻣﺔ‬
‫‪٤٩‬‬ ‫ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ‬
‫‪٦٥‬‬ ‫ﻣﺮﺍﺟﻊ ﺍﻟﻔﺼﻠﲔ ﺍﻷﻭﻝ ﻭﺍﻟﺜﺎﱐ‬
‫‪٦٩‬‬ ‫ﻣﻼﺣﻖ ﺍﻟﻔﺼﻠﲔ ﺍﻷﻭﻝ ﻭﺍﻟﺜﺎﱐ‬

‫‪75‬‬ ‫*
) ‪ 
 6  7 8  9
:; < :5/‬‬
‫ﻭﺻﻒ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺣﺎﻟﻴﺎﹰ ﻣﻦ ﺣﻴﺚ ﺍﻷﻋﺪﺍﺩ ‪ -‬ﺍﻟﻔﺌﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ – ﺍﻟﺘﺨﺼﺼﺎﺕ – ﺍﻟﺘﻮﺯﻳﻊ‬
‫‪٧٥‬‬ ‫ﺍﳉﻐﺮﺍﰲ‬

‫‪87‬‬ ‫*
)  ?>‪"" %& F" 
 @ A<B C*.D :‬‬
‫‪٨٧‬‬ ‫ﺃﻭﻻﹰ‪ :‬ﺍﻹﻧﻔﺎﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫‪١٠٠‬‬ ‫ﺛﺎﻧﻴﺎﹰ‪ :‬ﺗﻘﻴﻴﻢ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ ﰲ ﻣﺼﺮ‬
‫‪١١٧‬‬ ‫ﺍﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬
‫‪١٢٦‬‬ ‫ﺍﳌﺮﺍﺟﻊ‬

‫‪127‬‬ ‫*
) ‪ 

 
7J ),K "#. :HI‬‬
‫‪١٢٧‬‬ ‫ﻣﺼﺎﺩﺭ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻟﻠﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‬
‫‪١٢٩‬‬ ‫ﺍﻟﺪﻭﺭﺓ ﺍﳌﻌﻠﻮﻣﺎﺗﻴﺔ‬
‫‪١٣٠‬‬ ‫ﺗﻄﻮﺭ ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ‬
‫‪١٣٢‬‬ ‫ﺍﻟﻮﺿﻊ ﺍﳊﺎﱄ ﻟﻠﻤﺮﻛﺰ ﺍﻟﻘﻮﻣﻲ ﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫‪١٣٤‬‬ ‫ﺍﻟﻨﻈﺎﻡ ﺍﻟﻘﻮﻣﻲ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ‪Health Information System‬‬

‫@‪c‬‬
‫‪١٣٤‬‬ ‫ﺗﺎﺭﻳﺦ ﺇﻋﺪﺍﺩ ﺍﻟﻜﻮﺍﺩﺭ ﺍﻟﺒﺸﺮﻳﺔ ﻟﻠﻌﻤﻞ ﰲ ﳎﺎﻝ ﺍﻟﺘﺴﺠﻴﻞ ﻭﺍﻹﺣﺼﺎﺀ ﺍﻟﻄﱯ‬
‫‪١٣٧‬‬ ‫ﺍﳌﺴﻮﺡ ﺍﳌﻴﺪﺍﻧﻴﺔ ﻛﻤﺼﺎﺩﺭ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ‬
‫‪١٣٩‬‬ ‫ﻧﻈﺮﺓ ﻣﺴﺘﻘﺒﻠﻴﺔ‬

‫‪141‬‬ ‫*
) ‪N ON< %& :MNK‬ء‬
‫‪١٤١‬‬ ‫ﻣﻘﺪﻣﺔ‬
‫‪١٤١‬‬ ‫ﺗﻌﺮﻳﻒ ﺍﳉﻮﺩﺓ‬
‫‪١٤٢‬‬ ‫ﻣﻦ ﻫﻢ ﺍﻟﻌﻤﻼﺀ ﰲ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ )‪(Customers of Health Care‬‬
‫‪١٤٢‬‬ ‫ﺃﺑﻌﺎﺩ ﺍﳉﻮﺩﺓ‬
‫‪١٤٣‬‬ ‫ﺗﻄﻮﺭ ﻣﻔﻬﻮﻡ ﺍﳉﻮﺩﺓ‬
‫‪١٤٥‬‬ ‫ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺍﻟﻜﻠﻴﺔ )‪(TQM‬‬
‫‪١٤٦‬‬ ‫ﻗﻴﺎﺱ ﺍﳉﻮﺩﺓ ﰲ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫‪١٤٧‬‬ ‫ﻭﺻﻒ ﻭﺗﻘﻮﱘ ﺍﻟﻮﺿﻊ ﺍﳊﺎﱄ ﰲ ﻣﺼﺮ‬
‫‪١٥٥‬‬ ‫ﺍﻟﻔﺠﻮﺍﺕ ﻭﻣﻘﺘﺮﺣﺎﺕ ﻟﻠﺘﻄﻮﻳﺮ‬
‫ﻣﻠﺤﻖ )‪ :(١‬ﺑﻌﺾ ﺍﳌﺆﺷﺮﺍﺕ ﻣﻦ ﻭﺍﻗﻊ ﻣﺸﺮﻭﻋﺎﺕ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﺑﻮﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫‪١٥٧‬‬ ‫ﺍﻷﺳﺎﺳﻴﺔ‬

‫ ء ‪
  
 P '( :./‬‬
‫‪161‬‬ ‫*
) ‪
  
 P
 QR :>?K‬‬
‫‪١٦١‬‬ ‫‪ .١‬ﻣﺆﺷﺮﺍﺕ ﻣﺘﻌﻠﻘﺔ ﺑﺎﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫‪١٦٧‬‬ ‫‪ .٢‬ﻣﺆﺷﺮﺍﺕ ﺍﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻗﺘﺼﺎﺩﻳﺔ‬
‫‪١٧٠‬‬ ‫‪ .٣‬ﻣﺆﺷﺮﺍﺕ ﺗﻐﻄﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻷﻭﻟﻴﺔ‬
‫‪١٧٣‬‬ ‫‪ .٤‬ﻣﺆﺷﺮﺍﺕ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‬

‫ ء ‪ . ( TU :5/‬‬

‫‪181‬‬ ‫*
) ‪ :/‬ء  
‪
WKJ XY ..‬‬
‫‪١٨١‬‬ ‫ﺃﻭﻻﹰ‪ :‬ﺍﻟﺪﻭﺍﺀ – ﺍﳋﺼﻮﺻﻴﺎﺕ ﻭﺍﻷﺑﻌﺎﺩ‬
‫‪١٨٣‬‬ ‫ﺛﺎﻧﻴﺎﹰ‪ :‬ﺍﳌﻨﻈﻮﻣﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﻣﺼﺮ‬
‫‪١٨٦‬‬ ‫ﺛﺎﻟﺜﺎﹰ‪ :‬ﺣﺎﻝ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ‬
‫‪١٩١‬‬ ‫ﺭﺍﺑﻌﺎﹰ‪ :‬ﺣﺎﻝ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ‬
‫‪١٩٤‬‬ ‫ﺧﺎﻣﺴﺎﹰ‪ :‬ﺍﻧﻌﻜﺎﺳﺎﺕ ﺍﻻﺗﻔﺎﻗﻴﺔ ﺍﻟﺪﻭﻟﻴﺔ ﻋﻠﻰ ﺍﻷﻭﺿﺎﻉ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﻣﺼﺮ‬
‫‪١٩٧‬‬ ‫ﺳﺎﺩﺳﺎﹰ‪ :‬ﻭﻗﻔﺔ ﻭﻃﻨﻴﺔ‪ ..‬ﻭﻧﻈﺮﺓ ﻣﺴﺘﻘﺒﻠﻴﺔ‬
‫‪٢٠٢‬‬ ‫ﻣﺮﺍﺟﻊ ﻟﻠﻤﺰﻳﺪ ﻣﻦ ﺍﻟﺘﻔﺎﺻﻴﻞ‬

‫‪203‬‬ ‫*
) ‪)* ( :>+‬‬
‫‪٢٠٣‬‬ ‫ﻣﻘﺪﻣﺔ‬
‫‪٢٠٥‬‬ ‫ﺗﻘﻴﻴﻢ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻃﻔﺎﻝ ﰲ ﻣﺼﺮ‬
‫‪٢١٢‬‬ ‫ﺍﻹﻋﺎﻗﺔ‬
‫‪٢١٨‬‬ ‫ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‬
‫‪٢٣٦‬‬ ‫ﺭﺅﻳﺔ ﻣﺴﺘﻘﺒﻠﻴﺔ‬

‫@‪l‬‬
‫‪٢٤١‬‬ ‫ﺍﳋﻼﺻﺔ‬
‫‪٢٤٢‬‬ ‫ﺍﳌﺮﺍﺟﻊ‬

‫‪247‬‬ ‫*
) ‪O\ J ( : Q7‬‬
‫‪٢٤٧‬‬ ‫ﻣﻘﺪﻣﺔ‬
‫‪٢٥١‬‬ ‫ﻭﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ‬
‫‪٢٥٨‬‬ ‫ﺻﺤﺔ ﺍﻟﻄﻔﻠﺔ‬
‫‪٢٦٢‬‬ ‫ﺍﻟﻔﺘﻴﺎﺕ ﰲ ﻣﺮﺣﻠﺔ ﺍﻟﻨﻀﻮﺝ ﻭﺍﳌﺮﺍﻫﻘﺔ‬
‫‪٢٦٩‬‬ ‫ﺍﳌﺮﺣﻠﺔ ﺍﻹﳒﺎﺑﻴﺔ‬
‫‪٢٨٥‬‬ ‫ﺍﳌﺮﺃﺓ ﰲ ﻣﺮﺣﻠﺔ ﻣﺎ ﺑﻌﺪ ﺍﻧﻘﻄﺎﻉ ﺍﳊﻴﺾ‬
‫‪٢٨٨‬‬ ‫ﺭﺅﻳﺔ ﻣﺴﺘﻘﺒﻠﻴﺔ‬
‫‪٢٩٠‬‬ ‫ﺍﳌﺮﺍﺟﻊ‬

‫‪293‬‬ ‫*
) ‪ $_J 
 : ] ^NP‬‬
‫‪٢٩٣‬‬ ‫ﻣﻘﺪﻣﺔ‬
‫‪٣٠٣‬‬ ‫ﻭﺻﻒ ﻭﺗﻘﻴﻴﻢ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻌﺎﻣﻠﲔ‬
‫‪٣٠٦‬‬ ‫ﻭﺻﻒ ﻭﺗﻘﻴﻴﻢ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻌﺎﻣﻠﲔ‬
‫‪٣١١‬‬ ‫ﺭﺅﻳﺔ ﻣﺴﺘﻘﺒﻠﻴﺔ‬
‫‪٣١٦‬‬ ‫ﺍﳌﺮﺍﺟﻊ‬
‫‪٣١٧‬‬ ‫ﻣﻠﺤﻖ ‪ :١‬ﺟﺪﺍﻭﻝ‬

‫‪327‬‬ ‫*
) ‪ K*$ 
 : ] ./‬‬
‫‪٣٢٧‬‬ ‫ﻣﻘﺪﻣﺔ‬
‫‪٣٢٨‬‬ ‫ﺃﻫﺪﺍﻑ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﻭﻣﺸﻜﻼ‪‬ﺎ‬
‫‪٣٣٠‬‬ ‫ﻣﻔﺎﻫﻴﻢ ﺃﺳﺎﺳﻴﺔ ﳊﺮﻛﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ‬
‫‪٣٣٤‬‬ ‫ﺍﳌﺆﺷﺮﺍﺕ ﺍﳌﺘﺎﺣﺔ ﳊﺠﻢ ﺍﳌﺸﺎﻛﻞ ﺍﻟﻨﻔﺴﻴﺔ‬
‫‪٣٣٧‬‬ ‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺐ ﻧﻔﺴﻴﺔ ﺍﳌﺘﺎﺣﺔ ﰱ ﻣﺼﺮ‬
‫‪٣٤١‬‬ ‫ﺭﺅﻳﺔ ﻣﺴﺘﻘﺒﻠﻴﺔ‬

‫@‪x‬‬
 ‫ ‬
‫      
 ‬
‫‪ .‬ء  ‬

‫‬
‫ﻳﻘﺎﺱ ﻗﺪﻡ ﺍﻷﻧﻈﻤﺔ ﺍﻟﺼﺤﻴﺔ ﺑﻘﺪﻡ ﺍ‪‬ﺘﻤﻌﺎﺕ ﺍﻟﱵ ﻧﺸﺄﺕ ‪‬ﺎ ﻫﺬﻩ ﺍﻷﻧﻈﻤﺔ‪ ،‬ﻓﻔﻲ ﻛﻞ ﺍ‪‬ﺘﻤﻌﺎﺕ‬
‫ﻧﺸﺄﺕ ﺃﻧﻈﻤﺔ ﻟﺮﻋﺎﻳﺔ ﺍﳌﺮﺿﻰ ﻭﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﻷﱂ ﻭﺍﻟﻌﻠﺔ‪ .‬ﻭﻗﺪ ﻋﻜﺴﺖ ﺍﻷﻓﻜﺎﺭ ﺣﻮﻝ ﻣﺴﺒﺒﺎﺕ‬
‫ﺍﻷﻣﺮﺍﺽ ﻭﺍﻋﺘﻼﻝ ﺍﻟﺼﺤﺔ ﺍﻟﺜﻘﺎﻓﺔ ﺍﻟﺴﺎﺋﺪﺓ ﰲ ﳎﺘﻤﻊ ﻣﺎ ﻣﻦ ﻧﺎﺣﻴﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺩﺭﺟﺔ ﺗﻄﻮﺭ ﻫﺬﺍ‬
‫ﺍ‪‬ﺘﻤﻊ ﻣﻦ ﻧﺎﺣﻴﺔ ﺃﺧﺮﻯ‪ .‬ﻭﻣﻦ ﰒ‪ ،‬ﻓﻘﺪ ﻋﻜﺴﺖ ﺍﻷﻧﻈﻤﺔ ﺍﻟﺼﺤﻴﺔ ‪ -‬ﺑﻄﺮﻕ ﻣﺘﻌﺪﺩﺓ ‪ -‬ﺍﻟﺴﻠﻮﻙ‬
‫ﺍﻟﺴﺎﺋﺪ ﰲ ﺍ‪‬ﺘﻤﻌﺎﺕ ﲡﺎﻩ ﺍﻷﱂ‪ ،‬ﻭﺍﳌﺮﺽ‪ ،‬ﻭﺍﻟﻮﻓﺎﺓ‪ ،‬ﻭﺍﻟﺼﺤﺔ‪ .‬ﺇﻻ ﺃﻥ ﺩﺭﺟﺔ ﺍﻟﺘﻄﻮﺭ ﺍﻻﺟﺘﻤﺎﻋﻲ‬
‫ﻭﺍﻻﻗﺘﺼﺎﺩﻱ ﻭﺍﻟﻌﻠﻤﻲ ﰲ ﺃﻱ ﳎﺘﻤﻊ ﻗﺪ ﻟﻌﺒﺖ ﺩﻭﺭﺍﹰ ﻫﺎﻣﺎﹰ ﰲ ﺍﻟﻄﺮﻳﻘﺔ ﺍﻟﱵ ﻳﻌﻤﻞ ﻣﻦ ﺧﻼﳍﺎ ﺍﻟﻨﻈﺎﻡ‬
‫ﺍﻟﺼﺤﻲ ‪‬ﺬﺍ ﺍ‪‬ﺘﻤﻊ ﻭﺃﻳﻀﺎﹰ ﰲ ﺗﻮﺟﻪ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ‪ .‬ﻭﰲ ﺫﺍﺕ ﺍﻟﻮﻗﺖ‪ ،‬ﻓﻘﺪ ﻛﺎﻥ ﻟﻠﻤﺘﻐﲑﺍﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‬
‫ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻟﺴﻴﺎﺳﻴﺔ ﺃﺛﺮﺍﹰ‪ ،‬ﻟﻴﺲ ﻓﻘﻂ ﻋﻠﻰ ﲢﺪﻳﺪ ﻛﻤﻴﺔ ﻭﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ‪ ،‬ﻭﺇﳕﺎ‬
‫ﺃﻳﻀﺎﹰ ﻋﻠﻰ ﺗﻮﺟﻪ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﻭﺧﺼﺎﺋﺼﻪ‪.‬‬
‫ﻭﺑﺎﻟﻨﺴﺒﺔ ﳌﺼﺮ‪ ،‬ﻓﻠﻌﻞ ﻣﻦ ﺃﻫﻢ ﺍﻟﺴﻤﺎﺕ ﺍﳊﺎﻛﻤﺔ ﰲ ﺗﺎﺭﻳﺦ ﺗﻄﻮﺭ ﻣﻬﻨﺔ ﺍﻟﻄﺐ ﻭﺍﻟﻨﻈﻢ ﺍﻟﺼﺤﻴﺔ ﻫﻲ‬
‫ﺍﻻﻧﻔﺼﺎﻝ ﺷﺒﻪ ﺍﻟﺘﺎﻡ ﺑﲔ ﺍﻟﺘﺎﺭﻳﺦ ﻭﺍﳊﺎﺿﺮ؛ ﺑﲔ ﺍﻷﻧﻈﻤﺔ ﺍﳌﺆﺳﺴﻴﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﱵ ﻭﺟﺪﺕ‬
‫ﻣﻦ ﻋﺼﻮﺭ ﺳﺤﻴﻘﺔ‪ ،‬ﻭﺑﲔ ﺍﻟﻨﻈﺎﻡ ﺍﳊﺪﻳﺚ ﻣﻨﺬ ﻣﻄﻠﻊ ﺍﻟﻘﺮﻥ ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ‪.‬‬
‫ﻓﻜﻤﺎ ﻫﻮ ﺍﳊﺎﻝ ﰲ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺪﻭﻝ ﺍﻟﱵ ﺷﻬﺪﺕ ﻣﻮﻟﺪ ﺍﳊﻀﺎﺭﺍﺕ ﺍﻟﻘﺪﳝﺔ‪ ،‬ﻧﺸﺄ ﲟﺼﺮ ﻧﻈﺎﻣﺎﹰ‬
‫ﻣﺆﺳﺴﻴﺎﹰ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻣﻨﺬ ﻋﺪﺓ ﺁﻻﻑ ﻣﻦ ﺍﻟﺴﻨﲔ‪ .‬ﻭﰲ ﺫﺍﺕ ﺍﻟﻮﻗﺖ ﻓﻘﺪ ﻇﻠﺖ ﻣﺼﺮ ﻟﻌﺼﻮﺭ‬
‫ﻃﻮﻳﻠﺔ ﺗﻠﻌﺐ ﺩﻭﺭﺍﹰ ﻗﻴﺎﺩﻳﺎﹰ ﰲ ﺗﻌﻠﻴﻢ ﻭﺍﻟﺘﺪﺭﻳﺐ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺫﻟﻚ‪ ،‬ﻭﻣﻨﺬ ﺍﻟﻘﺮﻥ‬
‫ﺍﻟﺜﺎﻟﺚ ﻋﺸﺮ ﺍﳌﻴﻼﺩﻱ‪ ،‬ﺷﻬﺪﺕ ﺍﳌﺆﺳﺴﺔ ﺍﻟﺼﺤﻴﺔ ‪ -‬ﻛﻐﲑﻫﺎ ﻣﻦ ﻣﺆﺳﺴﺎﺕ ﻣﺼﺮ ﺍﻟﻘﺪﳝﺔ ‪ -‬ﺗﺪﻫﻮﺭﺍﹰ‬
‫ﺷﺪﻳﺪﺍﹰ ﺣﱴ ﺃﺻﺒﺤﺖ ﻏﲑ ﻣﻮﺟﻮﺩﺓ ﺗﻘﺮﻳﺒﺎﹰ ﻣﻊ ﺑﺪﺍﻳﺔ ﺍﻟﻘﺮﻥ ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ ﺍﳌﻴﻼﺩﻱ‪ .‬ﻭﺷﻬﺪ ﺍﻟﻘﺮﻥ‬
‫ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ ﺗﻄﻮﺭﺍﹰ ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺆﺳﺴﻴﺔ ﺑﺼﻮﺭﺓ ﻣﻨﻌﺰﻟﺔ ﻭﻣﻨﻔﺼﻠﺔ ﲤﺎﻣﺎﹰ ﻋﻦ ﺍﳌﻮﺭﻭﺙ‬
‫ﺍﻟﻘﺪﱘ‪ ،‬ﺣﻴﺚ ﰎ ﺗﺒﲏ ﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﻐﺮﰊ ﺍﻟﺒﻴﻮﻟﻮﺟﻲ ﺍﻟﻄﱯ ﻭﺍﻟﺬﻱ ﺳﺎﺩ ﻣﻦ ﻭﻗﺘﻬﺎ ﻭﺣﱴ ﺍﻵﻥ‪.‬‬
‫ﻭﻣﻊ ‪‬ﺎﻳﺔ ﺍﻟﻘﺮﻥ ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ ﺍﳌﻴﻼﺩﻱ ﻭﺑﺪﺍﻳﺔ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ ‪ -‬ﻭﻣﻦ ﺧﻼﻝ ﻣﺮﺍﺣﻞ ﺗﻄﻮﺭ ﻣﺘﻌﺪﺩﺓ ‪-‬‬
‫ﳕﺎ ﻫﺬﺍ ﺍﻟﻨﻤﻮﺫﺝ‪ ،‬ﻟﻴﺲ ﻓﻘﻂ ﲟﻌﺰﻝ ﻋﻦ ﺍﳌﻮﺭﻭﺙ ﺍﻟﻘﺪﱘ ﻭﺧﺼﺎﺋﺼﻪ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ؛ ﺑﻞ ﺃﻳﻀﺎﹰ ﲟﻌﺰﻝ ﻋﻦ‬
‫ﻏﺎﻟﺒﻴﺔ ﺍﻟﺸﻌﺐ ﺍﳌﺼﺮﻱ‪ .‬ﻓﻘﺪ ﻣﺜﻞ ﻫﺬﺍ ﺍﻟﻨﻤﻮﺫﺝ ﻭﺧﺪﻡ ‪ -‬ﺑﺎﻷﺳﺎﺱ ‪ -‬ﺍﻟﺼﻔﻮﺓ ﺍﻟﱵ ﻋﺎﺷﺖ ﺑﺎﳌﻨﺎﻃﻖ‬
‫ﺍﳊﻀﺮﻳﺔ ﺧﺎﺻﺔ ﰲ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ ﻣﻦ ﻣﺼﺮ ﺩﻭﳕﺎ ﺻﻌﻴﺪ ﻣﺼﺮ‪.‬‬

‫‪١‬‬
‫ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﻋﺒﻮﺭ ﻫﺬﺍ ﺍﻟﻨﻤﻮﺫﺝ ﰲ ﻣﺼﺮ ﲟﺮﺍﺣﻞ ﺗﻄﻮﺭ ﻣﺘﻌﺪﺩﺓ ﻭﺍﻟﱵ ﺗﺄﺛﺮﺕ ﺑﺪﻭﺭﻫﺎ ﺑﺎﻟﺘﺤﻮﻻﺕ‬
‫ﺍﻟﺘﺎﺭﳜﻴﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻟﺴﻴﺎﺳﻴﺔ‪ ،‬ﻓﻘﺪ ﻇﻠﺖ ﺷﺮﻭﻁ ﺍﻟﻨﺸﺄﺓ ﺣﺎﻛﻤﺔ ﻟﻔﻌﺎﻟﻴﺔ ﺍﻟﻨﻈﺎﻡ‬
‫ﻭﻗﺪﺭﺗﻪ ﻋﻠﻰ ﺍﻻﺭﺗﺒﺎﻁ ﺑﺎﻟﻨﺎﺱ ﻭﲢﻘﻴﻖ ﺍﺣﺘﻴﺎﺟﺎ‪‬ﻢ‪.‬‬

‫& ‪   ! "   !       #

$$%‬‬
‫ﻣﻦ ﻣﺼﺮ ﺍﻟﻘﺪﳝﺔ ﺇﱃ ﺍﻟﻌﺼﺮ ﺍﻟﻌﺮﰊ ﺍﻹﺳﻼﻣﻲ‬
‫ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺍﻛﺘﺸﺎﻑ ﻋﺪﺩ ﻛﺒﲑ ﻣﻦ ﺍﳌﻮﺍﺩ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻷﻣﺮﺍﺽ ﻭﺍﻟﺘﺪﺧﻼﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ ﺍﻟﻘﺪﳝﺔ‪،‬‬
‫ﺇﻻ ﺃﻥ ﻫﻨﺎﻙ ﻗﺼﻮﺭﺍﹰ ﰲ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﱵ ﺗﻌﻄﻲ ﺻﻮﺭﺓ ﻭﺍﺿﺤﺔ ﻭﻣﺘﻜﺎﻣﻠﺔ ﻋﻦ ﺍﳍﻴﻜﻞ ﺍﻟﺒﻨﻴﻮﻱ‬
‫ﻭﺍﻟﻮﻇﻴﻔﻲ ﻟﻨﻈﺎﻡ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﺫﻟﻚ ﺍﻟﻮﻗﺖ‪ .‬ﻭﻣﻊ ﺫﻟﻚ ﻓﻘﺪ ﺃﲨﻊ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺆﺭﺧﲔ ﻋﻠﻰ ﺃﻥ‬
‫ﺃﻗﺪﻡ ﻋﻠﻢ ﻃﱯ ﻗﺪ ﻧﺸﺄ ﺑﻮﺍﺩﻱ ﺍﻟﻨﻴﻞ‪.‬‬
‫ﻭﻗﺪ ﻋﺮﻑ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﺍﻟﻘﺪﳝﺔ ﺗﻮﺛﻴﻖ ﻭﺗﺴﺠﻴﻞ ﺍﳌﻼﺣﻈﺎﺕ ﻭﺍﻟﺘﺠﺎﺭﺏ ﻭﺍﳌﻤﺎﺭﺳﺎﺕ‬
‫ﺍﻟﻄﺒﻴﺔ‪ ،‬ﻭﻗﺪ ﰎ ﻫﺬﺍ ﺍﻟﺘﺴﺠﻴﻞ ﻋﻠﻰ ﺃﻭﺭﺍﻕ ﺍﻟﱪﺩﻱ ﻭﺟﺪﺭﺍﻥ ﺍﳌﻌﺎﺑﺪ‪ ،‬ﻭﺍﻟﱵ ﻣﺎ ﻧﺰﺍﻝ ﻧﺮﻯ ﺍﻟﻜﺜﲑ ﻣﻨﻬﺎ ﺣﱴ‬
‫ﺍﻵﻥ‪ .‬ﻭﻗﺪ ﰎ ﺍﻓﺘﺘﺎﺡ ﺃﻭﻝ ﻣﺪﺭﺳﺔ ﻟﻠﻄﺐ ﰲ ﻋﻬﺪ ﺍﻷﺳﺮﺓ ﺍﻷﻭﱃ ﰒ ﺗﻠﺘﻬﺎ ﻣﺪﺍﺭﺱ ﺃﺧﺮﻯ ﻋﺪﻳﺪﺓ ﳑﺎ ﺟﻌﻞ‬
‫ﻣﺼﺮ ﻣﻦ ﺃﻛﱪ ﻣﺮﺍﻛﺰ ﺍﻟﺼﺤﺔ ﻭﺍﻻﺳﺘﺸﻔﺎﺀ ﰲ ﺍﻟﻌﺎﱂ ﺍﻟﻘﺪﱘ‪.‬‬
‫ﻭﻟﻘﺪ ﰎ ﺇﻧﺸﺎﺀ ﻣﺪﺍﺭﺱ ﺍﻟﻄﺐ ﰲ ﻣﺼﺮ ﺍﻟﻘﺪﳝﺔ ﻣﻠﺤﻘﺔ ﺑﺎﳌﻌﺎﺑﺪ‪ .‬ﻭﻛﺎﻧﺖ ﺍﻟﺘﺨﺼﺼﺎﺕ ﰲ ﺍﻟﻔﺮﻭﻉ‬
‫ﺍﳌﺨﺘﻠﻔﺔ ﻣﻌﺮﻭﻓﺔ ﻟﻸﻃﺒﺎﺀ ﰲ ﻣﺼﺮ ﺍﻟﻘﺪﳝﺔ‪ ،‬ﻭﻭﻓﻘﺎﹰ ﳍﲑﻭﺩﻭﺕ ﻓﻘﺪ ﻛﺎﻥ ﻫﻨﺎﻙ ﻣﺘﺨﺼﺼﻮﻥ ﰲ‬
‫ﺍﻟﻌﻴﻮﻥ‪ ،‬ﻭﺍﻟﻔﻢ‪ ،‬ﻭﺍﻷﺳﻨﺎﻥ‪ ،‬ﻭﰲ ﻋﻼﺝ ﺁﻻﻡ ﺍﳌﻌﺪﺓ‪ ،‬ﻭﺣﱴ ﰲ ﻛﻞ ﺟﺰﺀ ﻣﻦ ﺃﺟﺰﺍﺀ ﺟﺴﻢ ﺍﻹﻧﺴﺎﻥ‪ .‬ﻛﻤﺎ ﻛﺎﻥ‬
‫ﻫﻨﺎﻙ ﻃﺒﻴﺒﺎﺕ‪ .‬ﻭﻛﺎﻧﺖ ﺍﳌﻌﺮﻓﺔ ﺑﻌﻠﻢ ﺍﻟﺘﺸﺮﻳﺢ ‪ -‬ﺧﺎﺻﺔ ‪ -‬ﻣﺘﻘﺪﻣﺔ ﺑﺴﺒﺐ ﺍﻟﺘﺤﻨﻴﻂ‪ ،‬ﻛﻤﺎ ﻛﺎﻧﺖ‬
‫ﺍﳉﺮﺍﺣﺔ ﺃﻳﻀﺎﹰ ﻣﺘﻘﺪﻣﺔ‪ .‬ﻭﰎ ﺗﻄﻮﻳﺮ ﺍﻷﺩﻭﺍﺕ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻷﺩﻭﻳﺔ ﻭﺗﺼﻨﻴﻔﻬﺎ‪ ،‬ﻭﻫﺬﺍ ﻧﺮﺍﻩ ﰲ ﺃﻭﺭﺍﻕ ﺍﻟﱪﺩﻱ‬
‫ﺍﳌﻌﺮﻭﻓﺔ ﺑﺎﺳﻢ "ﺇﻳﺒﲑﺱ ﻭﺇﺩﻭﻳﻦ ﲰﻴﺚ" ﻭﻋﻠﻰ ﺟﺪﺭﺍﻥ ﺍﳌﻌﺎﺑﺪ ﻭﺍﻟﱵ ﻳﺮﺟﻊ ﺗﺎﺭﳜﻬﺎ ﺇﱃ ‪٦٠٠٠ – ١٦٠٠‬‬
‫ﻗﺒﻞ ﺍﳌﻴﻼﺩ‪.‬‬
‫ﻭﻧﺘﻴﺠﺔ ﻟﻠﺼﺮﺍﻋﺎﺕ ﻭﺍﳊﺮﻭﺏ ﻭﺍﻟﻐﺰﻭﺍﺕ ﺍﻻﺳﺘﻌﻤﺎﺭﻳﺔ ﺍﻟﱵ ﺗﻌﺮﺿﺖ ﳍﺎ ﻣﺼﺮ ﺑﻌﺪ ﺫﻟﻚ‪ ،‬ﰎ ﻧﻘﻞ ﺍﻟﻌﻠﻮﻡ‬
‫ﺍﻟﻄﺒﻴﺔ ﺍﻟﱵ ﻧﺸﺄﺕ ﰲ ﻣﺼﺮ ﺍﻟﻘﺪﳝﺔ ﳊﻀﺎﺭﺍﺕ ﺃﺧﺮﻯ‪ ،‬ﺧﺎﺻﺔ ﺣﻀﺎﺭﺍﺕ ﺣﻮﺽ ﺍﻟﺒﺤﺮ ﺍﳌﺘﻮﺳﻂ‪.‬‬
‫ﻭﻇﻠﺖ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ ‪ -‬ﺍﻟﻌﺎﺻﻤﺔ ﺍﳉﺪﻳﺪﺓ ﳌﺼﺮ ‪ -‬ﻭﺍﻟﱵ ﺑﻨﻴﺖ ﰲ ﻋﺼﺮ ﺍﻟﺒﻄﺎﳌﺔ ﻋﺎﻡ ‪ ٣٢٣‬ﻕ‪.‬ﻡ‪ .‬ﻣﺮﻛﺰ‬
‫ﺇﺷﻌﺎﻉ ﻟﻠﻌﻠﻮﻡ ﻭﺍﳌﻌﺎﺭﻑ ﺍﻟﻄﺒﻴﺔ ﻟﻠﻌﺎﱂ ﺑﺄﺳﺮﻩ‪ .‬ﻭﺗﻈﻬﺮ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻷﺩﻟﺔ ﺃﻥ ﺍﳌﻌﺎﺭﻑ ﻭﺍﳌﻤﺎﺭﺳﺎﺕ‬
‫ﺍﻟﻄﺒﻴﺔ ﺍﻹﻏﺮﻳﻘﻴﺔ ﺗﺪﻳﻦ ﺑﺎﻟﻜﺜﲑ ﻟﻠﻄﺐ ﺍﳌﺼﺮﻱ ﺍﻟﻘﺪﱘ‪.‬‬
‫ﺧﻼﻝ ﺍﻟﻌﺼﺮ ﺍﻹﺳﻼﻣﻲ ﺍﻟﻌﺮﰊ ‪ -‬ﺧﺎﺻﺔ ﰲ ﺍﻟﻔﺘﺮﺍﺕ ﺍﻷﻭﱃ ‪ -‬ﻧﻘﻠﺖ ﺍﳊﻀﺎﺭﺓ ﺍﻹﺳﻼﻣﻴﺔ ﺍﻟﻜﺜﲑ ﻣﻦ‬
‫ﺍﳌﻌﺎﺭﻑ ﰲ ﺍﳌﻨﻄﻘﺔ ﺍﶈﻴﻄﺔ ﻟﻠﺒﻨﺎﺀ ﻋﻠﻴﻪ‪ .‬ﻓﻘﺪ ﺷﺠﻊ ﺍﻟﻌﺮﺏ ﺍﻟﺘﺮﲨﺔ ﻣﻦ ﺍﻟﻠﻐﺔ ﺍﻹﻏﺮﻳﻘﻴﺔ‪ ،‬ﻭﺃﺻﺒﺤﺖ‬
‫ﺍﻟﺪﻭﻟﺔ ﺍﻹﺳﻼﻣﻴﺔ ﻣﻠﺠﺄﹰً ﻟﻠﻤﻔﻜﺮﻳﻦ ﻭﺍﻟﻌﻠﻤﺎﺀ ﻣﻦ ﺷﱴ ﺑﻘﺎﻉ ﺍﻷﺭﺽ‪ .‬ﻭﲡﺪﺭ ﺍﻹﺷﺎﺭﺓ ﻫﻨﺎ ﺇﱃ ﺃﻥ ﺍﻟﻜﺜﲑ‬
‫ﻣﻦ ﺍﻟﻜﺘﺐ ﺍﻟﻄﺒﻴﺔ ﺍﳍﺎﻣﺔ ﰎ ﺗﺎﻟﻴﻔﻬﺎ ﰲ ﺇﻃﺎﺭ ﺍﳊﻀﺎﺭﺓ ﺍﻹﺳﻼﻣﻴﺔ‪.‬‬
‫ﻭﻟﻌﻞ ﻣﻦ ﺃﻫﻢ ﺍﻹﳒﺎﺯﺍﺕ ﺍﻟﱵ ﲤﺖ ﰲ ﻇﻞ ﺍﳊﻀﺎﺭﺓ ﺍﻹﺳﻼﻣﻴﺔ ﰲ ﳎﺎﻝ ﺑﻨﺎﺀ ﻣﺆﺳﺴﺎﺕ ﻟﻠﺮﻋﺎﻳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﻛﺎﻧﺖ ﻋﻠﻰ ﺍﻷﺭﺟﺢ ﺗﺄﺳﻴﺲ ﺍﳌﲑﺳﺘﺎﻧﺎﺕ )ﺍﳌﺴﺘﺸﻔﻴﺎﺕ(‪ ،‬ﻓﻘﺪ ﰎ ﺑﻨﺎﺀ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﻫﺬﻩ‬

‫‪٢‬‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﰲ ﻣﺼﺮ ﺧﻼﻝ ﺍﻟﻌﺼﺮ ﺍﻹﺳﻼﻣﻲ ﻭﺣﱴ ﺍﻟﻘﺮﻥ ﺍﻟﺜﺎﻟﺚ ﻋﺸﺮ ﺍﳌﻴﻼﺩﻱ‪ .‬ﻭﱂ ﺗﻜﻦ ﻫﺬﻩ‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﳎﺮﺩ ﺃﻣﺎﻛﻦ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﻌﻼﺝ‪ ،‬ﻭﺇﳕﺎ ﻟﻌﺒﺖ ﺃﻳﻀﺎﹰ ﺩﻭﺭﺍﹰ ﻫﺎﻣﺎﹰ ﰲ ﻧﻘﻞ ﺍﳌﻌﺮﻓﺔ‬
‫ﻭﺍﳌﻬﺎﺭﺍﺕ ﺍﻟﻄﺒﻴﺔ‪ .‬ﻭﻛﺎﻥ ﺍﻗﺪﻣﻬﺎ ﻣﲑﻳﺴﺘﺎﻥ "ﺍﺑﻦ ﻃﻮﻟﻮﻥ" ﻭﺍﻟﱵ ﺃﻧﺸﺄﺕ ﰲ ﺍﻟﻔﺘﺮﺓ ﺑﲔ ﻋﺎﻣﻲ ‪– ٨٧٢‬‬
‫‪.٨٧٤‬‬
‫ﻭﳚﺪﺭ ﻫﻨﺎ ﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﺃﻥ ﺑﺪﺍﻳﺔ ﻃﺐ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﰲ ﺃﻭﺭﺑﺎ ‪ -‬ﻭﺍﻟﺬﻱ ﻳﻌﺘﱪ ﻧﻘﻠﺔ ﻧﻮﻋﻴﺔ ﰲ ﺗﻄﻮﺭ ﳕﻂ‬
‫ﺍﻟﻄﺐ ﺍﻟﻌﻼﺟﻲ ﺍﻟﻐﺮﰊ ‪ -‬ﺗﻨﺘﻤﻲ ﺑﺼﻮﺭﺓ ﺃﺳﺎﺳﻴﺔ ﻟﻠﻘﺮﻥ ﺍﻟﺜﺎﻣﻦ ﻋﺸﺮ ﺍﳌﻴﻼﺩﻱ‪.‬‬
‫ﱂ ﻧﺒﻎ ﻣﻦ ﺳﺮﺩ ﺍﻟﺴﻤﺎﺕ ﺍﻟﺴﺎﺑﻘﺔ ﲤﺠﻴﺪ ﺍﳌﺎﺿﻲ؛ ﻭﺇﳕﺎ ﺇﻟﻘﺎﺀ ﺍﻟﻀﻮﺀ ﻋﻠﻰ ﻇﺎﻫﺮﺓ ﻫﺎﻣﺔ ﻭﻫﻲ ﺃﻥ ﻧﻈﻢ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ ﺍﻟﻘﺪﳝﺔ ﻭﺣﱴ ﺍﻟﻘﺮﻧﲔ ﺍﻟﺜﺎﻣﻦ ﻋﺸﺮ ﻭﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ ﺍﳌﻴﻼﺩﻳﲔ ﻗﺪ ﻧﺒﻌﺖ‬
‫ﻭﺍﺭﺗﻜﺰﺕ ﻋﻠﻰ ﺭﻭﺍﻓﺪ ﳏﻠﻴﺔ‪ ،‬ﻓﻜﺎﻧﺖ ﻣﺘﺼﻠﺔ ﺑﻌﺎﺩﺍﺕ ﻭﺗﻘﺎﻟﻴﺪ ﺍﻟﺸﻌﺐ‪ ،‬ﻭﻭﺟﺪﺕ ﻣﻦ ﺩﺍﺧﻞ ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺍﻟﻘﺎﺋﻤﺔ‪ ،‬ﻭﻛﺎﻧﺖ ﺟﺰﺀﺍﹰ ﻻ ﻳﺘﺠﺰﺃ ﻣﻦ ﺍﻟﺘﻄﻮﺭ ﺍﻟﻄﺒﻴﻌﻲ ﻟﻠﻤﺠﺘﻤﻊ ﺍﳌﺼﺮﻱ‪ .‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ‬
‫ﺫﻟﻚ ﻓﺈﻥ ﻧﻈﻢ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ﻛﺎﻧﺖ ﻗﺎﺋﻤﺔ ﻗﺒﻞ ﺇﺩﺧﺎﻝ "ﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﻄﱯ ﺍﻟﺒﻴﻮﻟﻮﺟﻲ ﺍﻟﻐﺮﰊ"‬
‫ﱂ ﺗﻜﻦ ﳏﺾ ﳑﺎﺭﺳﺎﺕ ﺩﺟﺎﻟﲔ ﺑﻞ ﺃﻧﻈﻤﺔ ﻣﺘﻄﻮﺭﺓ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺆﺳﺴﻴﺔ ﺑﻨﻴﺖ ﻋﻠﻰ ﺗﺮﺍﻛﻢ‬
‫ﻣﻌﺮﰲ ﻭﲡﺮﻳﱯ‪.‬‬

‫ﻣﺼﺮ ﰲ ﻓﺘﺮﺓ ﺍﻟﺮﻛﻮﺩ ﻭﺍﻟﺘﺮﺍﺟﻊ ﻣﻦ ﺍﻟﻘﺮﻥ ﺍﻟﺜﺎﻟﺚ ﻋﺸﺮ ﺇﱃ ﺍﻟﻘﺮﻥ ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ‬
‫ﻣﻨﺬ ﺍﻟﻘﺮﻥ ﺍﻟﺜﺎﻟﺚ ﻋﺸﺮ ﻓﺼﺎﻋﺪﺍﹰ‪ ،‬ﺑﺪﺃ ﻋﺼﺮ ﺍﻟﺮﻛﻮﺩ ﻭﺍﻟﺘﺮﺍﺟﻊ ﰲ ﻣﺼﺮ‪ .‬ﻓﻌﻨﺪ ﻗﺪﻭﻡ ﺍﳊﻤﻠﺔ ﺍﻟﻔﺮﻧﺴﻴﺔ‬
‫ﺇﱃ ﻣﺼﺮ ﰲ ﻋﺎﻡ ‪ ١٧٩٨‬ﻛﺎﻥ ﺍﻟﻌﺼﺮ ﺍﻟﺬﻫﱯ ﻟﻠﻄﺐ ﺍﻟﻌﺮﰊ ﻭﺍﳌﺆﺳﺴﺎﺕ ﻭﻛﻞ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‬
‫ﺍﻷﺧﺮﻯ ﻗﺪ ﻭﱃ‪.‬‬
‫ﻓﻤﺼﺮ ﺍﻟﱵ ﻛﺎﻥ ﻋﺪﺩ ﺳﻜﺎ‪‬ﺎ ﻗﺪ ﻭﺻﻞ ﺇﱃ ‪ ١٨,٥‬ﻣﻠﻴﻮﻥ ﻧﺴﻤﺔ ﺗﻘﺮﻳﺒﺎﹰ ﰲ ﺍﻟﻌﺼﺮ ﺍﻟﻔﺎﻃﻤﻲ‪ ،‬ﻛﺎﻧﺖ‬
‫ﻗﺪ ﻭﺻﻠﺖ ‪ -‬ﺑﻌﺪ ﺃﺭﺑﻌﺔ ﻗﺮﻭﻥ ‪ -‬ﺇﱃ ﻋﺪﺩ ﺳﻜﺎﻥ ﻳﺒﻠﻎ ‪ ٢,٥‬ﻣﻠﻴﻮﻥ ﻧﺴﻤﺔ ﺗﻘﺮﻳﺒﺎﹰ ﰲ ﺯﻣﻦ ﺍﳊﻤﻠﺔ‬
‫ﺍﻟﻔﺮﻧﺴﻴﺔ‪ .‬ﻭﻋﺎﺵ ﺍﻟﺸﻌﺐ ﺍﳌﺼﺮﻱ ‪ -‬ﻭﺍﻟﺬﻱ ﻛﺎﻥ ﺃﻛﺜﺮ ﻣﻦ ‪ %٨٥‬ﻣﻨﻪ ﻳﻌﻴﺶ ﰲ ﺍﻟﺮﻳﻒ ‪ -‬ﰲ ﺍﻧﻔﺼﺎﻝ‬
‫ﺷﺒﻪ ﺗﺎﻡ ﻋﻦ ﺍﳊﻜﻮﻣﺔ‪ ،‬ﻭﻛﻞ ﻣﺎ ﻳﺮﺑﻂ ﺑﻴﻨﻬﻤﺎ ﻫﻮ ﺍﻟﻀﺮﺍﺋﺐ ﻓﻘﻂ‪ .‬ﻭﻭﻓﻘﺎﹰ ﳌﺎ ﻗﺮﺭﻩ ﺍﻟﻔﺮﻧﺴﻴﻮﻥ‪ ،‬ﻛﺎﻧﺖ‬
‫ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻮﻃﻨﺔ ﰲ ﻣﺼﺮ ﺗﺘﻀﻤﻦ ﺍﻟﺮﻣﺪ ﻭﺍﻟﻄﺎﻋﻮﻥ ﻭﺍﻟﺪﻭﺳﻨﺘﺎﺭﻳﺎ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳉﺬﺍﻡ ﻭﺍﳉﺪﺭﻱ‬
‫ﻭﺍﻷﻧﻴﻤﻴﺎ ﺍﳌﺰﻣﻨﺔ ‪ -‬ﻧﺘﻴﺠﺔ ﻟﻸﻧﻜﻠﺴﺘﻮﻣﺎ ‪ -‬ﻭﺍﻟﺪﺭﻥ‪.‬‬
‫ﻭﰲ ﺍﳊﻘﺒﺔ ﺍﳌﻤﻠﻮﻛﻴﺔ‪ ،‬ﻭﺍﻟﱵ ﺍﻣﺘﺪﺕ ﺣﱴ ﻣﻨﺘﺼﻒ ﺍﻟﻘﺮﻥ ﺍﻟﺴﺎﺩﺱ ﻋﺸﺮ‪ ،‬ﱂ ﺗﻘﺪﻡ ﺍﻟﺪﻭﻟﺔ ﺷﻴﺌﺎﹰ‬
‫ﻟﻠﺸﻌﺐ‪ ،‬ﻭﰲ ﺍﳌﻘﺎﺑﻞ ﻃﺎﻟﺒﺖ ﺍﻟﻨﺎﺱ ﺑﺎﳌﺰﻳﺪ‪ ،‬ﻭﺗﺮﻛﺖ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺗﻨﺤﺪﺭ ﳓﻮ ﺍﻻ‪‬ﻴﺎﺭ‪.‬‬
‫ﻭﱂ ﻳﻐﲑ ﺍﻟﻐﺰﻭ ﺍﻟﻌﺜﻤﺎﱐ ﳌﺼﺮ ﺷﻴﺌﺎﹰ ﻣﻦ ﻫﺬﻩ ﺍﻟﺼﻮﺭﺓ ﺍﻟﺴﻴﺌﺔ‪ ،‬ﺑﻞ ﻟﻌﻠﻬﺎ ﻗﺪ ﺍﺯﺩﺍﺩﺕ ﺳﻮﺀﺍﹰ‪ ،‬ﻓﻘﺪ‬
‫ﺗﺮﺍﺟﻌﺖ ﻛﻞ ﺍﳌﺆﺳﺴﺎﺕ ﺗﻘﺮﻳﺒﺎﹰ ﲟﺎ ﻓﻴﻬﺎ ﻣﺆﺳﺴﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﺑﻨﺎﺀﺍﹰ ﻋﻠﻰ ﻣﺎ ﺳﺒﻖ‪ ،‬ﻳﺼﺒﺢ‬
‫ﻣﻦ ﺍﻟﺴﻬﻞ ﺗﻔﻬﻢ ﺍﻷﺳﺎﺱ ﺍﻟﺬﻱ ﺑﻨﻴﺖ ﻋﻠﻴﻪ ﺍﻟﺪﻭﻟﺔ ﺍﳌﺼﺮﻳﺔ ﺍﳊﺪﻳﺜﺔ‪ ،‬ﺣﻴﺚ ﺗﺮﺳﺐ ﻟﺪﻯ ﺍﻟﻨﺎﺱ‬
‫ﺍﻹﺣﺴﺎﺱ ﺑﻌﺪﻡ ﺍﻟﺜﻘﺔ ﻭﺳﻮﺀ ﺍﻟﻈﻦ ﲡﺎﻩ ﻛﻞ ﻣﺆﺳﺴﺎﺕ ﺍﻟﺪﻭﻟﺔ‪.‬‬
‫ﻭﰲ ﻇﻞ ﺍﻻ‪‬ﻴﺎﺭ ﺍﻟﻜﺎﻣﻞ ﻟﻜﻞ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪ ،‬ﻭﺑﻌﻴﺪﺍﹰ ﻋﻦ ﺍﻟﻜﺘﺎﺗﻴﺐ‪ ،‬ﻇﻞ ﺍﳉﺎﻣﻊ‬
‫ﺍﻷﺯﻫﺮ ﻫﻮ ﺍﳌﺆﺳﺴﺔ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﺍﻟﻮﺣﻴﺪﺓ ﺍﻟﻨﺎﺟﻴﺔ‪ ،‬ﻭﺍﻟﱵ ﻛﺎﻧﺖ ﺗﺪﺭﺱ ‪ -‬ﺑﺎﻷﺳﺎﺱ ‪ -‬ﺍﻟﻠﻐﺔ ﺍﻟﻌﺮﺑﻴﺔ‬
‫ﻭﺃﺻﻮﻝ ﺍﻟﻌﻘﻴﺪﺓ ﺍﻹﺳﻼﻣﻴﺔ‪.‬‬

‫‪٣‬‬
‫ﻭﻛﺎﻧﺖ ﻣﻼﻣﺢ ﺍﻟﺼﻮﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻜﻞ ﺍﻟﺴﻜﺎﻥ ﺗﻘﺮﻳﺒﺎﹰ ﰲ ﻣﺼﺮ ﺗﺘﻀﻤﻦ ﺍﻋﺘﻼﻝ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﺍﳉﻬﻞ‪،‬‬
‫ﻭﺍﻧﺘﺸﺎﺭ ﺍﻷﻭﺑﺌﺔ‪ .‬ﻭﻭﻓﻘﺎﹰ ﳌﺎ ﻗﺎﻟﻪ "ﳏﻤﺪ ﻋﻠﻲ ﺑﺎﺷﺎ" ﻓﻘﺪ ﻛﺎﻥ ﻋﺪﺩ ﺍﳌﺘﻌﻠﻤﲔ ﰲ ﻣﺼﺮ ﻋﻨﺪ ﺗﻮﻟﻴﻪ‬
‫ﺍﻟﺴﻠﻄﺔ ﺣﻮﺍﱄ ‪ ٢٠٠‬ﺷﺨﺼﺎﹰ ﻓﻘﻂ‪ .‬ﻭﻭﻓﻘﺎﹰ ﳌﺎ ﻗﺮﺭﻩ "ﻛﻠﻮﺕ ﺑﻴﻪ" ﻣﻨﺸﺊ ﺃﻭﻝ ﻣﺪﺭﺳﺔ ﺣﺪﻳﺜﺔ ﻟﻠﻄﺐ ﰲ‬
‫ﻣﺼﺮ‪ ،‬ﻓﻘﺪ ﻛﺎﻥ ﺣﻮﺍﱄ ‪ %٢‬ﻣﻦ ﺍﳌﺼﺮﻳﲔ ﳝﻮﺗﻮﻥ ﺳﻨﻮﻳﺎﹰ ﻧﺘﻴﺠﺔ ﻟﻠﻄﺎﻋﻮﻥ‪ .‬ﻭﻛﺎﻧﺖ ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﺎﺓ‬
‫ﻟﻸﻃﻔﺎﻝ ﲢﺖ ﺳﻦ ‪ ٣‬ﺳﻨﻮﺍﺕ‪ ،‬ﻛﻤﺎ ﻗﺪﺭﻫﺎ ﺃﻃﺒﺎﺀ ﺍﳊﻤﻠﺔ ﺍﻟﻔﺮﻧﺴﻴﺔ‪ ،‬ﺣﻮﺍﱄ ‪ %٦٠‬ﰲ ﺍﻟﻘﺎﻫﺮﺓ‪.‬‬
‫ﺃﺿﻒ ﺇﱃ ﺫﻟﻚ‪ ،‬ﺃﻥ ﺍﻟﺸﻌﺐ ﺍﳌﺼﺮﻱ ﱂ ﻳﻜﻦ ﻓﻘﻂ ﻣﻌﺰﻭﻻﹰ ﻋﻦ ﺍﻟﺸﺌﻮﻥ ﺍﻟﻌﺎﻣﺔ‪ ،‬ﺑﻞ ﻛﺎﻧﺖ ﺍﻷﻣﺔ‬
‫ﺍﳌﺼﺮﻳﺔ ﺑﻜﺎﻣﻠﻬﺎ ﻣﻌﺰﻭﻟﺔ ﺗﻘﺮﻳﺒﺎﹰ ﻋﻦ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﳊﺎﺩﺛﺔ ﰲ ﺍﻟﻌﺎﱂ ﺍﳋﺎﺭﺟﻲ ﻭﺧﺎﺻﺔ ﺍﻟﻨﻬﻀﺔ‬
‫ﺍﻷﻭﺭﻭﺑﻴﺔ‪.‬‬
‫ﻭﺑﻌﻴﺪﺍﹰ ﻋﻦ ﺍﻟﺘﺤﻠﻴﻼﺕ ﺍﳌﺨﺘﻠﻔﺔ ﻭﺍﳌﺸﺎﻋﺮ ﺍﳌﺘﺒﺎﻳﻨﺔ ﲡﺎﻩ ﺍﳊﻤﻠﺔ ﺍﻟﻔﺮﻧﺴﻴﺔ ﻭﺩﻭﺭﻫﺎ ﰲ ﻣﺼﺮ‪ ،‬ﻓﻘﺪ‬
‫ﻣﺜﻠﺖ ﻫﺬﻩ ﺍﳊﻤﻠﺔ ﻋﻼﻣﺔ ﻫﺎﻣﺔ ﰲ ﺗﻄﻮﺭ ﻣﺼﺮ ﺍﳊﺪﻳﺜﺔ‪ .‬ﻓﻘﺪ ﻛﺎﻥ ﺍﻧﻔﺘﺎﺡ ﺍﳌﺼﺮﻳﲔ ﲡﺎﻩ ﺍﻟﻌﺎﱂ‬
‫ﺍﳋﺎﺭﺟﻲ‪ ،‬ﻭﻛﺬﺍ ﺿﻌﻒ ﺩﻭﺭ ﺍﳌﻤﺎﻟﻴﻚ ﰲ ﺍﳊﻜﻢ‪ ،‬ﻭﺇﺻﺮﺍﺭ ﺍﻟﺰﻋﻤﺎﺀ ﺍﳌﺼﺮﻳﲔ ‪ -‬ﳑﺜﻠﲔ ﰲ ﻋﻠﻤﺎﺀ ﺍﻷﺯﻫﺮ ‪-‬‬
‫ﻋﻠﻰ ﺍﳌﺸﺎﺭﻛﺔ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻇﻬﻮﺭ ﺍﳌﻄﺒﻌﺔ‪ ،‬ﻛﻞ ﻫﺬﻩ ﺍﻷﺳﺒﺎﺏ ﻟﻌﺒﺖ ﺩﻭﺭﺍﹰ ﻫﺎﻣﺎﹰ ﰲ ﺇﻋﻄﺎﺀ ﻗﻮﺓ ﺩﺍﻓﻌﺔ‬
‫ﺟﺪﻳﺪﺓ ﻟﻠﺤﺮﺍﻙ ﺍﻻﺟﺘﻤﺎﻋﻲ ﰲ ﻣﺼﺮ‪.‬‬
‫ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻟﺜﺮﻭﺓ ﺍﳌﻌﺮﻓﻴﺔ ﺍﻟﱵ ﺟﻨﻴﺖ ﻣﻦ ﺧﻼﻝ ﺍﻟﻜﺘﺎﺑﺎﺕ ﻭﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﱵ ﻗﺎﻡ ‪‬ﺎ ﻋﻠﻤﺎﺀ ﺍﳊﻤﻠﺔ‬
‫ﺍﻟﻔﺮﻧﺴﻴﺔ‪ ،‬ﺗﻌﺮﺽ ﺍﳌﺼﺮﺑﻮﻥ ﻟﻠﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺘﻄﻮﺭﺍﺕ ﻭﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﳌﺆﺳﺴﻴﺔ ﻣﺜﻞ ﺑﻨﺎﺀ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﻭﺗﻨﻔﻴﺬ ﺇﺟﺮﺍﺀﺍﺕ ﺍﳊﺠﺮ ﺍﻟﺼﺤﻲ‪ .‬ﻭﻋﻠﻰ ﻭﺟﻪ ﺍﻟﻌﻤﻮﻡ‪ ،‬ﻓﺈﻥ ﻣﻜﻮﺙ ﺍﳊﻤﻠﺔ ﺍﻟﻔﺮﻧﺴﻴﺔ ﰲ ﻣﺼﺮ ﱂ ﻳﺰﺩ‬
‫ﻋﻦ ﺛﻼﺙ ﺳﻨﻮﺍﺕ‪ ،‬ﻭﱂ ﺗﺴﺘﻄﻊ ﺃﻥ ﲢﺪﺙ ﺗﻐﻴﲑﺍﹰ ﺟﺬﺭﻳﺎﹰ ﰲ ﻫﻴﺎﻛﻞ ﻭﻣﺆﺳﺴﺎﺕ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺼﺮﻱ‪.‬‬

‫  ‪   "/ " '(  )*+, -‬‬

‫ﻟﻌﺐ "ﳏﻤﺪ ﻋﻠﻲ" ‪ -‬ﻛﺸﺨﺺ ﻃﻤﻮﺡ ﻭﻋﺒﻘﺮﻱ ﻭﻋﻤﻠﻲ ﺫﻱ ﻣﺒﺎﺩﺉ ﻣﺎﻛﻴﺎﻓﻴﻠﻴﺔ ‪ -‬ﺩﻭﺭﺍﹰ ﻛﺒﲑﺍﹰ ﰲ ﺗﻐﻴﲑ‬
‫ﺗﺎﺭﻳﺦ ﻣﺼﺮ‪ .‬ﻓﻘﺪ ﻗﺎﻡ ﺑﺒﻨﺎﺀ ﺩﻭﻟﺔ ﺇﻗﻠﻴﻤﻴﺔ ﻗﻮﻳﺔ ﺣﺪﻳﺜﺔ ﻫﺪﺩﺕ ﻭﺟﻮﺩ ﺍﻟﺪﻭﻟﺔ ﺍﻟﻌﺜﻤﺎﻧﻴﺔ ﻧﻔﺴﻬﺎ‪ ،‬ﻭﺍﻟﱵ‬
‫ﻛﺎﻧﺖ ﻣﺼﺮ ﺇﺣﺪﻯ ﻭﻻﻳﺎ‪‬ﺎ‪ .‬ﻭﻟﻜﻲ ﻳﻘﻮﻡ ﺑﺒﻨﺎﺀ ﺍﳉﻴﺶ ﺍﻟﻘﻮﻱ ﺍﻟﺬﻱ ﻳﺴﺎﻧﺪ ﻃﻤﻮﺣﻪ‪ ،‬ﺳﺎﺭ "ﳏﻤﺪ ﻋﻠﻲ"‬
‫ﰲ ﻃﺮﻳﻖ ﺑﻨﺎﺀ ﺍﻟﺪﻭﻟﺔ ﺍﻟﻘﻮﻳﺔ‪ ،‬ﻭﺍﻟﺬﻱ ﺃﺩﻯ ﺑﻪ ﺇﱃ ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺍﳌﺼﺮﻳﲔ‪ .‬ﻭﻟﻜﻲ ﳛﻘﻖ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ‬
‫ﺍﻟﻄﻤﻮﺡ‪ ،‬ﻛﺎﻥ ﻋﻠﻴﻪ ﺃﻥ ﻳﻘﻮﻡ ﺑﺘﻌﺒﺌﺔ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻟﻸﻣﺔ ﺍﳌﺼﺮﻳﺔ‪ ،‬ﻭﻛﺎﻧﺖ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺘﻌﻠﻴﻢ ﻣﻦ‬
‫ﺍﶈﺎﻭﺭ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﻼﺯﻣﺔ ﻹﺩﺭﺍﻙ ﻫﺬﻩ ﺍﻷﻫﺪﺍﻑ‪.‬‬
‫ﻭﺑﻌﺪ ‪ ٣٥‬ﻋﺎﻣﺎﹰ ﻣﻦ ﺗﻮﱄ "ﳏﻤﺪ ﻋﻠﻲ" ﺍﻟﺴﻠﻄﺔ ﰲ ﻣﺼﺮ ﻛﺎﻥ ﺍﻟﻜﺜﲑ ﻗﺪ ﲢﻘﻖ‪ ،‬ﻓﺰﺍﺩﺕ ﻣﻮﺍﺭﺩ ﺍﻟﺪﻭﻟﺔ‬
‫ﺣﻮﺍﱄ ﻋﺸﺮ ﻣﺮﺍﺕ‪ ،‬ﻭﰎ ﺑﻨﺎﺀ ﺟﻴﺶ ﻳﺘﻜﻮﻥ ﻣﻦ ‪ ٢٠٠٠٠٠‬ﺟﻨﺪﻱ ﻣﻦ ﺑﻴﻨﻬﻢ ﺣﻮﺍﱄ ‪ ١٣٠٠٠٠‬ﻣﺼﺮﻳﺎﹰ‪ ،‬ﻭﺑﺪﻻﹰ‬
‫ﻣﻦ ‪ ٢٠٠‬ﺷﺨﺺ ﻣﺘﻌﻠﻢ ﻛﺎﻧﻮﺍ ﻣﻮﺟﻮﺩﻳﻦ ﰲ ﺑﺪﺍﻳﺔ ﺗﻮﻟﻴﻪ ﺃﺻﺒﺢ ﻫﻨﺎﻙ ‪ ٩٠٠٠‬ﻃﺎﻟﺐ ﰲ ﳐﺘﻠﻒ‬
‫ﻣﺮﺍﺣﻞ ﺍﻟﺘﻌﻠﻴﻢ‪.‬‬
‫ﻛﺎﻧﺖ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺒﺎﺋﺴﺔ ﻟﻠﻤﺼﺮﻳﲔ ﻭﺍﻟﱵ ﺍﻧﻌﻜﺴﺖ ﰲ ﺣﺎﻟﺔ ﳎﻨﺪﻱ ﺍﳉﻴﺶ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻟﺴﻴﺌﺔ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺗﺪﻫﻮﺭ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﺍﻟﻨﻘﺺ ﺍﻟﺸﺪﻳﺪ ﰲ ﺍﻟﻌﻤﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﺠﻴﺶ‪،‬‬
‫ﻭﺍﻟﺘﻜﻠﻔﺔ ﺍﳌﺮﺗﻔﻌﺔ ﻻﺳﺘﻘﺪﺍﻡ ﺃﻃﺒﺎﺀ ﺃﺟﺎﻧﺐ‪ ،‬ﻣﻦ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﱵ ﺃﺩﺕ ﺇﱃ ﻭﺿﻊ ﻣﺴﺄﻟﺔ "ﺗﻄﻮﻳﺮ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ" ﻋﻠﻰ ﻗﻤﺔ ﺍﻷﻭﻟﻮﻳﺎﺕ‪.‬‬

‫‪٤‬‬
‫ﻭﻗﺪ ﻛﺎﻧﺖ ﻟﻠﺤﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﺠﻴﺶ ﺃﳘﻴﺔ ﻗﺼﻮﻯ‪ ،‬ﻭﻟﺬﻟﻚ ﻓﺈﻥ ﺣﺎﻟﺔ ﳎﻨﺪﻱ ﺍﳉﻴﺶ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻟﺴﻴﺌﺔ‪ ،‬ﻭﺍﻟﺬﻳﻦ ﻛﺎﻧﻮﺍ ﻣﻬﺪﺩﻳﻦ ﺑﺎﻷﻭﺑﺌﺔ ﺍﳌﺘﻜﺮﺭﺓ ﻭﺍﻟﱵ ﺗﺰﻳﺪ ﺣﺎﻟﺘﻬﻢ ﺳﻮﺀﺍﹰ ﻛﻤﺎ ﻇﻬﺮ ﰲ ﻭﺑﺎﺀ ﺍﻟﻄﺎﻋﻮﻥ‬
‫ﻋﺎﻡ ‪ ،١٨٢٤‬ﺃﺩﺕ ﺇﱃ ﺿﺮﻭﺭﺓ ﻭﺟﻮﺩ ﺭﻋﺎﻳﺔ ﺻﺤﻴﺔ ﻭﻛﺬﺍ ﺇﺻﻼﺡ ﺃﻧﻈﻤﺔ ﺍﳌﻴﺎﻩ ﻭﺍﻟﺼﺮﻑ ﺍﻟﺼﺤﻲ‬
‫ﻭﺍﻟﻨﻈﺎﻓﺔ‪.‬‬
‫ﺗﺒﲎ "ﳏﻤﺪ ﻋﻠﻲ" ﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﻌﺴﻜﺮﻱ ﺍﻟﻔﺮﻧﺴﻲ ﲟﺎ ﻳﺘﻀﻤﻨﻪ ﻣﻦ ﺍﻟﻨﻈﺎﻡ ﺍﻟﻄﱯ ﻟﻠﺠﻴﺶ‪ ،‬ﻭﻟﺬﻟﻚ‬
‫ﻗﺎﻡ ﺑﺘﻮﻇﻴﻒ ﺑﻌﺾ ﺍﻟﻀﺒﺎﻁ ﺍﻟﻔﺮﻧﺴﻴﲔ‪ ،‬ﻭﺍﻟﺬﻳﻦ ﻛﺎﻥ ﻣﻦ ﺑﻴﻨﻬﻢ ﺿﺎﺑﻂ ﺟﺮﺍﺡ ﻓﺮﻧﺴﻲ ﺟﻌﻠﻪ "ﳏﻤﺪ‬
‫ﻋﻠﻲ" ﺍﳌﺴﺌﻮﻝ ﺍﻟﻄﱯ ﻭﺍﳉﺮﺍﺣﻲ ﺍﻷﻭﻝ ﰲ ﺍﳉﻴﺶ ﺍﳌﺼﺮﻱ ﺍﳉﺪﻳﺪ‪ .‬ﻭﻧﻈﺮﺍﹰ ﻟﻠﺤﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺴﻴﺌﺔ‬
‫ﻟﻠﺠﻴﺶ‪ ،‬ﻭﻋﺪﻡ ﺗﻮﺍﻓﺮ ﺇﻻ ﳓﻮ ‪ ٥٠‬ﻃﺒﻴﺒﺎﹰ ﻭﺻﻴﺪﻟﻴﺎﹰ ﺃﻭﺭﻭﺑﻴﺎﹰ ﻓﻘﻂ ﳋﺪﻣﺔ ﺍﳉﻴﺶ ﺍﳌﻜﻮﻥ ﻣﻦ ‪١٥٠٠٠٠‬‬
‫ﺟﻨﺪﻱ‪ ،‬ﺃﻳﻘﻦ "ﳏﻤﺪ ﻋﻠﻲ" ﺃﻥ ﺍﳊﻞ ﺍﻟﻮﺣﻴﺪ ﻫﻮ ﰲ ﺗﺪﺭﻳﺐ ﺃﻃﺒﺎﺀ ﻣﺼﺮﻳﲔ‪.‬‬
‫ﰲ ﻋﺎﻡ ‪ ١٨٢٨‬ﺍﻓﺘﺘﺤﺖ ﺃﻭﻝ ﻣﺪﺭﺳﺔ ﻃﺒﻴﺔ ﻣﺼﺮﻳﺔ ﺃﻗﻴﻤﺖ ﻋﻠﻰ ﺃﺳﺎﺱ ﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﻐﺮﰊ‪ .‬ﻭﻛﺎﻧﺖ‬
‫ﺍﳌﺪﺭﺳﺔ ﻣﻠﺤﻘﺔ ﺑﺜﻜﻨﺎﺕ ﺍﳉﻴﺶ ﰲ ﺃﺑﻮ ﺯﻋﺒﻞ‪ .‬ﻭﰲ ﺍﻟﺒﺪﺍﻳﺔ ﻛﺎﻧﺖ ﺍﳌﺪﺭﺳﺔ ﻣﺆﺳﺴﺔ ﳋﺪﻣﺔ ﺍﳉﻴﺶ‪،‬‬
‫ﻭﻛﺎﻧﺖ ﺗﻌﻴﻴﻨﺎﺕ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳌﺪﺭﺳﺔ ﺗﺄﰐ ﻣﻦ ﻣﺼﺎﺩﺭ ﻣﺘﻌﺪﺩﺓ‪ ،‬ﻭﺑﻴﻨﻤﺎ ﻛﺎﻥ ﺍﻟﻌﻨﺼﺮ ﺍﻟﺘﺮﻛﻲ ﰲ‬
‫ﺍﻟﻮﻇﺎﺋﻒ ﻳﻘﻞ ﺗﺪﺭﳚﻴﺎﹰ ﻛﺎﻥ ﺍﻟﻌﻨﺼﺮ ﺍﳌﺼﺮﻱ ﻳﺰﺩﺍﺩ‪ .‬ﻭﳌﺎ ﻛﺎﻧﺖ ﻣﻌﺮﻓﺔ ﺍﻟﻠﻐﺔ ﺍﻟﻌﺮﺑﻴﺔ ‪ -‬ﻗﺮﺍﺀﺓ ﻭﻛﺘﺎﺑﺔ ‪-‬‬
‫ﻭﺍﻟﺮﻳﺎﺿﻴﺎﺕ ﻣﻦ ﻣﺘﻄﻠﺒﺎﺕ ﺍﻟﺘﻌﻴﲔ‪ ،‬ﺍﲡﻬﺖ ﺍﻷﻧﻈﺎﺭ ﺇﱃ ﺧﺮﳚﻲ ﺍﻷﺯﻫﺮ ﻭﺍﳌﺪﺍﺭﺱ ﺍﳌﻠﺤﻘﺔ ﺑﺎﳉﻮﺍﻣﻊ‬
‫ﺍﻷﺧﺮﻯ‪ .‬ﻭﻛﺎﻧﺖ ﺍﻟﺪﺭﺍﺳﺔ ﻋﺒﺎﺭﺓ ﻋﻦ ﲬﺴﺔ ﺃﻋﻮﺍﻡ ﺗﺒﺪﺃ ﺑﻌﺎﻡ ﲤﻬﻴﺪﻱ ﻳﺘﻠﻮﻩ ﺃﺭﺑﻌﺔ ﺃﻋﻮﺍﻡ ﻣﻦ ﺍﻟﺪﺭﺍﺳﺔ‬
‫ﺍﻟﻄﺒﻴﺔ ﻋﻠﻰ ﻏﺮﺍﺭ ﺍﻟﻨﻈﺎﻡ ﺍﻟﻔﺮﻧﺴﻲ ﺍﳌﻮﺟﻮﺩ ﰲ ﺫﻟﻚ ﺍﻟﻮﻗﺖ‪.‬‬
‫ﻭﰎ ﺍﻓﺘﺘﺎﺡ ﻣﺪﺭﺳﺔ ﻟﻠﻘﺎﺑﻼﺕ ﰲ ﻋﺎﻡ ‪ ،١٨٣٢‬ﻭﻛﺎﻧﺖ ﰲ ﺍﻟﺒﺪﺍﻳﺔ ﻣﻠﺤﻘﺔ ﲟﺪﺭﺳﺔ ﺃﺑﻮ ﺯﻋﺒﻞ ﺍﻟﻄﺒﻴﺔ‪ ،‬ﻭﻛﺎﻥ‬
‫ﺍﳍﺪﻑ ﻣﻨﻬﺎ ﺗﺪﺭﻳﺐ ﺍﻟﻘﺎﺑﻼﺕ‪ .‬ﻭﻗﺪ ﺃﻧﺸﺌﺖ ﻫﺬﻩ ﺍﳌﺪﺭﺳﺔ ﻣﻦ ﺃﺟﻞ ﻏﺮﺽ ﲢﺴﲔ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﻟﻸﺟﻴﺎﻝ ﺍﳌﻘﺒﻠﺔ ﻋﻦ ﻃﺮﻳﻖ ﺗﻘﺪﱘ ﺭﻋﺎﻳﺔ ﺻﺤﻴﺔ ﻟﻸﻣﻬﺎﺕ ﻭﺍﻷﻃﻔﺎﻝ ﺑﻮﺍﺳﻄﺔ ﻛﺎﺩﺭ ﻣﺪﺭﺏ ﻣﻦ ﺍﻟﻨﺴﺎﺀ‪.‬‬
‫ﻭﻛﺎﻧﺖ ﻫﺬﻩ ﺍﳌﺪﺭﺳﺔ ﻫﻲ ﺍﳌﺆﺳﺴﺔ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﺍﻷﻭﱃ ﻟﻠﻨﺴﺎﺀ ﰲ ﺍﻟﺸﺮﻕ ﺍﻷﻭﺳﻂ‪ .‬ﻭﻛﺎﻥ ﺍﳌﻨﻬﺞ‬
‫ﺍﻟﺘﻌﻠﻴﻤﻲ ﻟﻠﻤﺪﺭﺳﺔ ﻳﺘﻜﻮﻥ ﻣﻦ ‪ ٦‬ﺳﻨﻮﺍﺕ ﺩﺭﺍﺳﻴﺔ‪ ،‬ﺧﺼﺼﺖ ﺍﻟﺴﻨﺘﲔ ﺍﻷﻭﻟﻴﺘﲔ ﻣﻨﻬﺎ ﻟﺘﻌﻠﻴﻢ‬
‫ﺍﻟﻘﺮﺍﺀﺓ ﻭﺍﻟﻜﺘﺎﺑﺔ‪ ،‬ﻭﺍﻟﺴﻨﻮﺍﺕ ﺍﻷﺭﺑﻊ ﺍﻟﺘﺎﻟﻴﺔ ﻟﻠﺘﺪﺭﻳﺐ ﻋﻠﻰ ﺍﳌﻮﺿﻮﻋﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺎﻟﻮﻻﺩﺓ ﻭﺭﻋﺎﻳﺔ ﻣﺎ ﺣﻮﻝ‬
‫ﺍﳊﻤﻞ ﻟﻸﻣﻬﺎﺕ ﻭﺭﻋﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻟﻌﻨﺎﻳﺔ ﺑﺎﳉﺮﻭﺡ ﻭﺍﻟﺘﻄﻌﻴﻤﺎﺕ‪.‬‬
‫ﻭﻗﺪ ﰎ ﺇﻧﺸﺎﺀ ﻣﺪﺭﺳﺔ ﻟﻠﺼﻴﺪﻟﺔ ﺑﻌﺪ ﻋﺎﻡ ﻭﺍﺣﺪ ﻣﻦ ﺇﻧﺸﺎﺀ ﺍﳌﺪﺭﺳﺔ ﺍﻟﻄﺒﻴﺔ‪.‬‬
‫ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻣﺎ ﺳﺒﻖ‪ ،‬ﻓﻘﺪ ﰎ ﺇﺭﺳﺎﻝ ﺍﻟﺒﻌﺜﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﺇﱃ ﺃﻭﺭﻭﺑﺎ‪ ،‬ﻭﺍﻟﱵ ﻟﻌﺒﺖ ﺩﻭﺭﺍﹰ ﻫﺎﻣﺎﹰ ﰲ‬
‫ﺍﻟﺘﻄﻮﺭ ﺍﻟﺘﺎﺭﳜﻲ ﻭﺍﻟﺜﻘﺎﰲ ﺍﳌﺼﺮﻱ‪.‬‬
‫ﻭﻛﺎﻥ ﻣﻦ ﺍﻟﻌﻼﻣﺎﺕ ﺍﳍﺎﻣﺔ ﰲ ﺗﻄﻮﺭ ﻧﻈﺎﻡ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﺫﻟﻚ ﺍﻟﻮﻗﺖ ﺇﻧﺸﺎﺀ "ﺍ‪‬ﻠﺲ ﺍﻟﻌﺎﻡ‬
‫ﻟﻠﺼﺤﺔ" ﻭﻛﺬﻟﻚ ﺇﻧﺸﺎﺀ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﰲ ﺍﻷﻗﺎﻟﻴﻢ‪ .‬ﻭﻛﺎﻥ "ﺍ‪‬ﻠﺲ ﺍﻟﻌﺎﻡ ﻟﻠﺼﺤﺔ" ﻫﻮ ﺃﻭﻝ ﻣﺆﺳﺴﺔ‬
‫ﺻﺤﻴﺔ ﺣﻜﻮﻣﻴﺔ ﰲ ﻣﺼﺮ ﺍﳊﺪﻳﺜﺔ‪ ،‬ﻭﳝﻜﻦ ﺍﻋﺘﺒﺎﺭﻩ ﻧﻮﺍﺓ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪.‬‬
‫ﻭﻗﺪ ﺷﻬﺪﺕ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﻟﺴﺎﺑﻘﺔ ﺗﺮﺍﺟﻌﺎﹰ ﺣﺎﺩﺍﹰ ﺑﻌﺪ ﻫﺰﳝﺔ "ﳏﻤﺪ ﻋﻠﻲ" ﰲ ﻋﺎﻡ ‪ ،١٨٤١‬ﻭﺍﻟﱵ ﺃﺩﺕ ﺑﻌﺪ‬
‫ﺫﻟﻚ ﺑﻮﺍﺣﺪ ﻭﺃﺭﺑﻌﲔ ﻋﺎﻣﺎﹰ ﺇﱃ ﺍﻻﺣﺘﻼﻝ ﺍﻟﱪﻳﻄﺎﱐ ﳌﺼﺮ ﰲ ﻋﺎﻡ ‪ .١٨٨٢‬ﻭﻛﺎﻥ ﻣﻦ ﺍﻟﻨﺘﺎﺋﺞ ﺍﳍﺎﻣﺔ ﳍﺰﳝﺔ‬
‫"ﳏﻤﺪ ﻋﻠﻲ" ﺗﻘﻠﺺ ﻣﺴﺘﻌﻤﺮﺍﺗﻪ ﻭﺍﻧﻜﻤﺎﺵ ﺟﻴﺸﻪ‪ ،‬ﻭﻛﺎﻥ ﳍﺎ ﺃﻳﻀﺎﹰ ﺗﺄﺛﲑﺍﹰ ﻛﺒﲑﺍﹰ ﻋﻠﻰ ﻛﻞ ﺍﻟﺘﻄﻮﺭﺍﺕ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻟﺜﻘﺎﻓﻴﺔ ﺍﻟﱵ ﲤﺖ ﰲ ﻣﺼﺮ‪ .‬ﻓﻘﺪ ﺗﺮﺍﺟﻌﺖ ﺑﺸﻜﻞ ﻛﺒﲑ ﻗﻄﺎﻋﺎﺕ‬

‫‪٥‬‬
‫ﺍﻟﺼﻨﺎﻋﺔ ﻭﺍﻟﺰﺭﺍﻋﺔ ﻭﺍﻟﺘﺠﺎﺭﺓ‪ ،‬ﳑﺎ ﺃﺩﻯ ﺇﱃ ﺍﻧﻜﻤﺎﺵ ﺍﻻﻗﺘﺼﺎﺩ ﺍﳌﺼﺮﻱ ﻭﻭﻗﻮﻋﻪ ﺗﺪﺭﳚﻴﺎﹰ ﲢﺖ ﺳﻴﻄﺮﺓ‬
‫ﺍﻟﻘﻮﻯ ﺍﻟﻐﺮﺑﻴﺔ‪.‬‬
‫ﻭﺑﻌﺪ ﺍﻧﺘﻬﺎﺀ ﺣﻘﺒﺔ "ﳏﻤﺪ ﻋﻠﻲ"‪ ،‬ﰎ ﺇﺣﺒﺎﻁ ﺍﶈﺎﻭﺭ ﺍﻟﺮﺋﻴﺴﻴﺔ ﳌﺸﺮﻭﻋﻪ ﺍﻟﻄﻤﻮﺡ‪ ،‬ﻭﻛﺎﻥ ﺍﻟﺘﻌﻠﻴﻢ ﻋﻠﻰ‬
‫ﺭﺃﺱ ﻫﺬﻩ ﺍﶈﺎﻭﺭ ﻭﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ ﻭﲤﺼﲑﻩ‪.‬‬
‫ﻭﺷﻬﺪﺕ ﻓﺘﺮﺓ ﺧﻠﻔﺎﺀ "ﳏﻤﺪ ﻋﻠﻲ" ‪ -‬ﺧﺎﺻﺔ ﰲ ﻋﻬﺪ ﺍﳋﺪﻳﻮﻱ ﺳﻌﻴﺪ ﻭﺍﳋﺪﻳﻮﻱ ﻋﺒﺎﺱ ‪ -‬ﺗﺮﺍﺟﻌﺎﹰ‬
‫ﺷﺪﻳﺪﺍﹰ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺑﺎﻷﺧﺺ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ‪ ،‬ﻭﺇﻥ ﻛﺎﻧﺖ ﻫﻨﺎﻙ ﺑﻌﺾ ﺍﶈﺎﻭﻻﺕ ﻹﺣﻴﺎﺀ ﺍﻟﺘﻌﻠﻴﻢ‬
‫ﻭﺍﻟﺜﻘﺎﻓﺔ ﻗﺪ ﺣﺪﺛﺖ ﰲ ﻋﻬﺪ ﺍﳋﺪﻳﻮﻱ ﺇﲰﺎﻋﻴﻞ ﻣﺘﻀﻤﻨﺔ ﺇﻋﺎﺩﺓ ﺇﺭﺳﺎﻝ ﺍﻟﺒﻌﺜﺎﺕ ‪ -‬ﻋﻠﻰ ﻧﻄﺎﻕ ﺿﻴﻖ‬
‫‪ -‬ﺇﱃ ﺃﻭﺭﻭﺑﺎ‪.‬‬
‫ﻭﰲ ﻋﺼﺮ ﺍﻻﺣﺘﻼﻝ ﺍﻟﱪﻳﻄﺎﱐ‪ ،‬ﺣﺪﺛﺖ ﺗﻄﻮﺭﺍﺕ ﺟﺪﻳﺪﺓ‪ .‬ﻓﻘﺪ ﰎ ﺇﺩﺍﺭﺓ ﺍﻻﻗﺘﺼﺎﺩ ﺍﳌﺼﺮﻱ ﻛﺘﺎﺑﻊ ﻟﻼﻗﺘﺼﺎﺩ‬
‫ﺍﻟﱪﻳﻄﺎﱐ‪ ،‬ﻣﺜﻠﻪ ﰲ ﺫﻟﻚ ﻣﺜﻞ ﻛﻞ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻷﺧﺮﻯ ﻭﺍﻟﱵ ﺃﺻﺒﺤﺖ ﺗﺎﺑﻌﺔ ﻟﻠﻤﺆﺳﺴﺎﺕ ﺍﻟﱪﻳﻄﺎﻧﻴﺔ‪.‬‬
‫ﻓﻌﻨﺪ ﺑﺪﺍﻳﺔ ﺍﻻﺣﺘﻼﻝ ﺍﻟﱪﻳﻄﺎﱐ ﻛﺎﻥ ﻛﻞ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﻛﻠﻴﺔ ﺍﻟﻄﺐ ﺍﳌﺼﺮﻳﺔ – ﻣﺎ ﻋﺪﺍ ﻭﺍﺣﺪﺍﹰ –‬
‫ﻣﺼﺮﻳﻮﻥ‪ .‬ﻭﰲ ﻏﻀﻮﻥ ﺑﻀﻌﺔ ﺳﻨﻮﺍﺕ ﺃﺻﺒﺢ ﻛﻞ ﺍﻟﻌﺎﻣﻠﲔ ﺗﻘﺮﻳﺒﺎﹰ ﺇﻣﺎ ﺑﺮﻳﻄﺎﻧﻴﲔ ﺃﻭ ﺃﺟﺎﻧﺐ‪ ،‬ﻭﺃﺻﺒﺤﺖ‬
‫ﺍﻟﺪﺭﺍﺳﺔ ﻣﻦ ﺍﻵﻥ ﻓﺼﺎﻋﺪﺍﹰ ﺑﺎﻟﻠﻐﺔ ﺍﻹﳒﻠﻴﺰﻳﺔ‪ ،‬ﻭﺃﺻﺒﺢ ﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﱪﻳﻄﺎﱐ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﻫﻮ ﺍﻟﺴﺎﺋﺪ‪ .‬ﻛﻤﺎ‬
‫ﺃﺻﺒﺤﺖ ﺍﻟﺪﺭﺍﺳﺔ ﲟﺼﺮﻭﻓﺎﺕ‪ ،‬ﻭﰎ ﺇﻳﻘﺎﻑ ﺍﻟﺒﻌﺜﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﻟﻠﺨﺎﺭﺝ‪ ،‬ﻭﲢﻮﻟﺖ ﻛﻠﻴﺔ ﺍﻟﻄﺐ ﺇﱃ‬
‫ﻣﺆﺳﺴﺔ ﻟﻠﻄﻠﺒﺔ ﺍﻷﻏﻨﻴﺎﺀ‪ ،‬ﻭﻛﺎﻥ ﺍﻷﻃﺒﺎﺀ ﺍﳌﺘﺨﺮﺟﻮﻥ ﻣﻨﻬﺎ ﻳﻘﻮﻣﻮﻥ ﲞﺪﻣﺔ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﺍﻟﻐﻨﻴﺔ‬
‫ﺑﺎﻷﺳﺎﺱ‪ .‬ﻭﺃﺩﺕ ﻫﺬﻩ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺇﱃ ﺗﺪﻫﻮﺭ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ ﻟﻠﺮﻳﻒ‪ ،‬ﻭﻇﻠﺖ ﻋﻠﻰ ﻫﺬﺍ ﺍﳊﺎﻝ‬
‫ﻣﺪﺓ ﻃﻮﻳﻠﺔ‪ ،‬ﻭﱂ ﲢﺪﺙ ﳏﺎﻭﻻﺕ ﺟﺪﻳﺔ ﻟﺘﻄﻮﻳﺮ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻠﺮﻳﻒ ﺇﻻ ﺑﺪﺍﻳﺔ ﻣﻦ ﻋﺎﻡ ‪.١٩٤٢‬‬
‫ﻛﻤﺎ ﺭﺃﻳﻨﺎ ﰲ ﺍﻟﺴﺎﺑﻖ‪ ،‬ﻓﻘﺪ ﺷﻬﺪ ﺗﺎﺭﻳﺦ ﻧﻈﺎﻡ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ ﰲ ﻣﺼﺮ ﻣﺮﺣﻠﺘﲔ‬
‫ﺭﺋﻴﺴﻴﺘﲔ؛ ﺍﻷﻭﱃ ﻣﻨﺬ ﺍﻟﻌﺼﻮﺭ ﺍﻟﻘﺪﳝﺔ ﻭﺣﱴ ﺗﺮﺍﺟﻊ ﺍﻟﺪﻭﻟﺔ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻹﺳﻼﻣﻴﺔ‪ ،‬ﻭﺍﻟﱵ ﲤﻴﺰﺕ ﺑﻮﺟﻮﺩ‬
‫ﺍﳌﺪﺍﺭﺱ ﺍﻟﻄﺒﻴﺔ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﻟﺮﻭﺍﻓﺪ ﺍﶈﻠﻴﺔ‪ ،‬ﻭﺍﻟﱵ ﳕﺖ ﻭﺍﺯﺩﻫﺮﺕ ﻋﱪ ﺍﻟﺘﻔﺎﻋﻞ ﻣﻊ ﺟﲑﺍ‪‬ﺎ ﰲ ﺍﳌﻨﻄﻘﺔ‬
‫ﻭﻣﻦ ﺧﻼﻝ ﻣﺼﺎﺩﺭ ﳐﺘﻠﻔﺔ ﻟﻠﻤﻌﺮﻓﺔ‪ ،‬ﺃﻣﺎ ﺍﳌﺮﺣﻠﺔ ﺍﻟﺜﺎﻧﻴﺔ ﻓﻘﺪ ﲤﻴﺰﺕ ﺑﺘﺒﲏ ﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﻄﱯ ﺍﻟﻐﺮﰊ‬
‫ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬

‫‪234-  5 !6 7$8#‬ء ‪(1925) 0  1‬‬

‫ﻛﻤﺎ ﺫﻛﺮﻧﺎ ﰲ ﺍﻟﺴﺎﺑﻖ‪ ،‬ﻓﺒﻌﺪ ﻓﺘﺮﺓ ﻗﻠﻴﻠﺔ ﻣﻦ ﺍﻻﺣﺘﻼﻝ ﺍﻟﱪﻳﻄﺎﱐ ﺃﺻﺒﺤﺖ ﺍﳌﺪﺭﺳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﳌﺼﺮﻳﺔ‬
‫ﲢﺖ ﺍﻹﺩﺍﺭﺓ ﺍﻟﱪﻳﻄﺎﻧﻴﺔ ﺑﺎﻟﻜﺎﻣﻞ‪ .‬ﻭﻇﻞ ﺍﳌﺼﺮﻳﻮﻥ ﻟﻔﺘﺮﺓ ﻃﻮﻳﻠﺔ ﻏﲑ ﻣﻔﻀﻠﲔ ﻟﻠﻌﻤﻞ ﰲ ﺍﳌﺪﺭﺳﺔ‪ ،‬ﻛﻤﺎ‬
‫ﰎ ﺇﺣﺒﺎﻁ ﳏﺎﻭﻻﺕ ﺍﳌﺼﺮﻳﲔ ﻟﻠﺘﺨﺼﺺ ﰲ ﻓﺮﻭﻉ ﺍﻟﻄﺐ ﺍﳌﺨﺘﻠﻔﺔ‪ .‬ﻓﺎﺳﺘﻤﺮﺍﺭﺍﹰ ﻟﻨﻔﺲ ﺍﳌﻨﻄﻖ ﺍﻟﺬﻱ‬
‫ﺍﺗﺒﻌﻪ "ﺍﻟﻠﻮﺭﺩ ﻛﺮﻭﻣﺮ" ﻋﻨﺪﻣﺎ ﻗﺮﺭ ﺃﻥ "ﻣﺼﺮ ﻟﻴﺴﺖ ﲝﺎﺟﺔ ﻟﻠﺘﺼﻨﻴﻊ"‪ ،‬ﻗﺎﻡ ﻫﻮ ﻧﻔﺴﻪ ﺑﺈﻋﻼﻥ ﺃﻥ "ﻣﺼﺮ‬
‫ﻟﻴﺴﺖ ﲝﺎﺟﺔ ﺇﱃ ﺇﺧﺼﺎﺋﻴﲔ‪ ،‬ﺑﻞ ﺇﱃ ﳑﺎﺭﺳﲔ ﻋﺎﻣﲔ"‪ .‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ ﺗﻨﺎﻗﺺ ﻋﺪﺩ ﺍﻟﻄﻼﺏ‬
‫ﺍﳌﺼﺮﻳﲔ ﰲ ﺍﳌﺪﺭﺳﺔ ﺍﻟﻄﺒﻴﺔ ﺑﺪﺭﺟﺔ ﻛﺒﲑﺓ ﺣﱴ ﺃﻧﻪ ﻭﺻﻞ ﰲ ﻋﺎﻡ ‪ ١٨٩٣‬ﺇﱃ ‪ ١٢‬ﻃﺎﻟﺒﺎﹰ ﻓﻘﻂ‪.‬‬
‫ﻭﺑﲔ ﻋﺎﻣﻲ ‪ ١٨٨٢‬ﻭ‪ ،١٩١٤‬ﻛﺎﻥ ﻣﻌﻈﻢ ﺍﻷﻃﺒﺎﺀ ﺍﳌﺮﺧﺺ ﳍﻢ ﺑﺎﻟﻌﻤﻞ ﻣﻦ ﺍﻷﺟﺎﻧﺐ‪ ،‬ﻛﻤﺎ ﺃﺻﺒﺢ‬
‫ﺍﻻﻟﺘﺤﺎﻕ ﺑﺎﳌﺪﺭﺳﺔ ﺍﻟﻄﺒﻴﺔ ﻧﻔﺴﻬﺎ ﻏﲑ ﻣﺘﺎﺡ ﺇﻻ ﻟﻸﺟﺎﻧﺐ ﺃﻭ ﻟﻸﺛﺮﻳﺎﺀ ﻣﻦ ﺍﳌﺼﺮﻳﲔ‪ .‬ﻭﺃﻛﺜﺮ ﻣﻦ ﺫﻟﻚ‪ ،‬ﰎ‬

‫‪٦‬‬
‫ﺇﻳﻘﺎﻑ ﺍﻟﺒﻌﺜﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ‪ -‬ﺗﻘﺮﻳﺒﺎﹰ ‪ -‬ﺇﱃ ﺃﻭﺭﻭﺑﺎ‪ ،‬ﻭﺃﺻﺒﺢ ﺍﻻﻟﺘﺤﺎﻕ ﺑﺎﳉﺎﻣﻌﺎﺕ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻣﻘﺼﻮﺭﺍﹰ ﻋﻠﻰ‬
‫ﺍﻷﻏﻨﻴﺎﺀ ﺍﻟﺬﻳﻦ ﻳﺴﺘﻄﻴﻌﻮﻥ ﲢﻤﻞ ﺍﻟﺘﻜﻠﻔﺔ‪.‬‬
‫ﻭﰲ ﻇﻞ ﻫﺬﻩ ﺍﳌﻌﻄﻴﺎﺕ‪ ،‬ﻭﺍﺗﺒﺎﻋﺎﹰ ﻟﻨﻔﺲ ﺍﻟﻨﻬﺞ ﺍﻟﺬﻱ ﺳﻨﻪ "ﻛﺮﻭﻣﺮ" ﱂ ﻳﺪﻋﻢ ﺍﻟﱪﻳﻄﺎﻧﻴﻮﻥ ﺗﺄﺳﻴﺲ‬
‫ﺟﺎﻣﻌﺎﺕ ﺃﻭ ﻛﻠﻴﺎﺕ ﰲ ﻣﺼﺮ‪ ،‬ﻭﻇﻠﺖ ﻏﺎﻳﺔ ﺍﻷﻣﺮ ﺇﻧﺸﺎﺀ ﻣﺪﺍﺭﺱ ﻓﻨﻴﺔ‪ .‬ﻭﺍﻧﻄﺒﻖ ﺫﻟﻚ ﻋﻠﻰ ﺍﳌﺪﺭﺳﺔ‬
‫ﺍﻟﻄﺒﻴﺔ ﺍﳌﺼﺮﻳﺔ ﺍﻟﱵ ﺍﺳﺘﻤﺮﺕ ﻛﻤﺎ ﻫﻲ ﻣﺪﺭﺳﺔ ﻭﺭﻓﺾ ﺃﻥ ﺗﺘﺤﻮﻝ ﺇﱃ ﻛﻠﻴﺔ‪ .‬ﻭﱂ ﺗﺘﻐﲑ ﻫﺬﻩ ﺍﻟﺼﻮﺭﺓ‬
‫ﺇﻻ ﻣﻊ ﺑﺪﺍﻳﺔ ﺻﻌﻮﺩ ﺍﳊﺮﻛﺔ ﺍﻟﻮﻃﻨﻴﺔ ﺿﺪ ﺍﻻﺳﺘﻌﻤﺎﺭ ﺍﻟﱪﻳﻄﺎﱐ‪ ،‬ﻭﺧﺎﺻﺔ ﺑﻌﺪ ﺛﻮﺭﺓ ‪ ،١٩١٩‬ﻭﺃﺻﺒﺢ‬
‫ﺗﺄﺳﻴﺲ ﺍﳉﺎﻣﻌﺔ ﺍﳌﺼﺮﻳﺔ ﻣﻦ ﺑﲔ ﺃﻫﻢ ﺍﳌﻄﺎﻟﺐ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻟﻠﺤﺮﻛﺔ ﺍﻟﻮﻃﻨﻴﺔ‪.‬‬
‫ﰎ ﺗﺄﺳﻴﺲ ﺃﻭﻝ ﺟﺎﻣﻌﺔ ﻣﺼﺮﻳﺔ ﺣﺪﻳﺜﺔ ﰲ ﻋﺎﻡ ‪ ،١٩٠٧‬ﻭﻛﺎﻧﺖ ﻋﺒﺎﺭﺓ ﻋﻦ ﻣﺒﺎﺩﺭﺓ ﺃﻫﻠﻴﺔ ﻏﲑ ﺣﻜﻮﻣﻴﺔ‪.‬‬
‫ﻭﻛﺎﻧﺖ ﻛﻠﻴﺔ "ﺍﻟﻔﻨﻮﻥ ﻭﺍﻵﺩﺍﺏ" ﻫﻲ ﺍﻟﻜﻠﻴﺔ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﻟﱵ ﺗﻜﻮﻧﺖ ﺣﻮﳍﺎ ﺍﳉﺎﻣﻌﺔ‪.‬‬
‫ﻭﰲ ﻋﺎﻡ ‪ - ١٩٢٥‬ﺑﻌﺪ ﻋﺎﻣﲔ ﻣﻦ ﺇﺻﺪﺍﺭ ﺃﻭﻝ ﺩﺳﺘﻮﺭ ‪ -‬ﰎ ﺇﻧﺸﺎﺀ ﺃﻭﻝ ﺟﺎﻣﻌﺔ ﺣﻜﻮﻣﻴﺔ ﰲ ﺍﻟﺘﺎﺭﻳﺦ‬
‫ﺍﳌﺼﺮﻱ ﺍﳊﺪﻳﺚ‪ ،‬ﻭﻫﻲ "ﺟﺎﻣﻌﺔ ﻓﺆﺍﺩ ﺍﻷﻭﻝ" ﻭﺍﻟﱵ ﺃﻃﻠﻖ ﻋﻠﻴﻬﺎ ﻓﻴﻤﺎ ﺑﻌﺪ "ﺟﺎﻣﻌﺔ ﺍﻟﻘﺎﻫﺮﺓ"‪ .‬ﻭﻛﺎﻧﺖ‬
‫ﻫﺬﻩ ﺍﳉﺎﻣﻌﺔ ﻫﻲ ﻧﺘﺎﺝ ﺻﺮﺍﻉ ﻃﻮﻳﻞ ﺧﺎﺿﺘﻪ ﺍﳊﺮﻛﺔ ﺍﻟﻮﻃﻨﻴﺔ ﺍﳌﺼﺮﻳﺔ ﻣﻨﺬ ﻋﻬﺪ "ﺍﻟﻠﻮﺭﺩ ﻛﺮﻭﻣﺮ"‪ .‬ﻭﻣﻦ‬
‫ﺑﲔ ﺃﺭﺑﻊ ﻛﻠﻴﺎﺕ ﰎ ﺗﺄﺳﻴﺴﻬﺎ ﰲ ﺍﻟﺒﺪﺍﻳﺔ ﻛﺎﻧﺖ ﻫﻨﺎﻙ ﻛﻠﻴﺔ ﻟﻠﻄﺐ‪.‬‬
‫ﰲ ﻋﺎﻡ ‪ ،١٩٢٩‬ﺃﺻﺒﺢ "ﺍﻟﺪﻛﺘﻮﺭ ﻋﻠﻲ ﺑﻴﻪ ﺇﺑﺮﺍﻫﻴﻢ" ﺃﻭﻝ ﻋﻤﻴﺪ ﻣﺼﺮﻱ ﻟﻜﻠﻴﺔ ﺍﻟﻄﺐ ﺑﻌﺪ ‪ ٣٦‬ﻋﺎﻣﺎﹰ ﻣﻦ‬
‫ﺍﻟﺴﻴﻄﺮﺓ ﺍﻟﱪﻳﻄﺎﻧﻴﺔ‪ .‬ﻭﺍﻟﺘﺤﻘﺖ ﺍﻟﻨﺴﺎﺀ ﺑﻜﻠﻴﺔ ﺍﻟﻄﺐ ﺗﺪﺭﳚﻴﺎﹰ‪ ،‬ﻭﺇﻥ ﻛﺎﻧﺖ ﺃﻋﺪﺍﺩﻫﻦ ﻗﻠﻴﻠﺔ ﺟﺪﺍﹰ‪ .‬ﻓﺒﲔ‬
‫ﻋﺎﻣﻲ ‪ ١٩٢٩‬ﻭ‪ ١٩٣٧‬ﺍﻟﺘﺤﻘﺖ ﺑﻜﻠﻴﺔ ﺍﻟﻄﺐ ‪ ٥٩‬ﻃﺎﻟﺒﺔ ﻓﻘﻂ‪.‬‬
‫ﺑﺪﺃ ﺗﻄﻮﻳﺮ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻨﺬ ﻋﺎﻡ ‪ ١٩٢٣‬ﺑﺈﻧﺸﺎﺀ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺮﻛﺰﻳﺔ‪ ،‬ﻭﺗﺒﻊ ﺫﻟﻚ ﰲ ﻋﺎﻡ ‪١٩٢٨‬‬
‫ﺇﻧﺸﺎﺀ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺮﻳﻔﻴﺔ ﻛﻌﻴﺎﺩﺍﺕ ﺧﺎﺭﺟﻴﺔ ﻣﻊ ﻭﺟﻮﺩ ﺳﺮﻳﺮﻳﻦ ﻓﻘﻂ ﻟﻠﻄﻮﺍﺭﺉ‪ .‬ﻭﰎ ﺍﺳﺘﺒﺪﺍﻝ ﻫﺬﻩ‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺮﻳﻔﻴﺔ ﰲ ﻋﺎﻡ ‪ ١٩٤٠‬ﺑﺎﳌﻜﺎﺗﺐ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ )ﻣﻜﺘﺐ ﺻﺤﺔ ﻟﻜﻞ ‪٣٠٠٠٠‬‬
‫ﻧﺴﻤﺔ(‪ .‬ﻭﻛﺎﻧﺖ ﺃﻭﻝ ﺧﺪﻣﺔ ﺻﺤﻴﺔ ﻣﺘﺨﺼﺼﺔ ﻳﺘﻢ ﺗﻘﺪﳝﻬﺎ ﺧﺎﺭﺝ ﻧﻄﺎﻕ ﺍﳌﺪﻥ ﺍﻟﻜﺒﲑﺓ ﻗﺪ ﺑﺪﺃﺕ ﰲ‬
‫ﻋﺎﻡ ‪ ١٩٠٤‬ﻣﻦ ﺧﻼﻝ ﻋﻴﺎﺩﺍﺕ ﺍﻟﻌﻴﻮﻥ ﺍﳌﺘﻨﻘﻠﺔ‪ .‬ﻭﻗﺪ ﺍﺳﺘﺨﺪﻣﺖ ﻫﺬﻩ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳌﺘﻨﻘﻠﺔ ﺃﻳﻀﺎﹰ ﰲ ﻋﺎﻡ‬
‫‪ ١٩٢٨‬ﳌﻜﺎﻓﺤﺔ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻮﻃﻨﺔ‪.‬‬
‫ﻭﰲ ﻋﺎﻡ ‪ ١٩٣٦‬ﰎ ﺇﻧﺸﺎﺀ "ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ" ﻭﺍﻟﱵ ﻛﺎﻧﺖ ﲢﺘﻮﻱ ﻋﻠﻰ ﻗﺴﻢ ﺧﺎﺹ ﺑﺎﻟﺼﺤﺔ ﺍﻟﺮﻳﻔﻴﺔ‪ .‬ﻭﻛﺎﻥ‬
‫ﻣﻦ ﻣﻬﺎﻡ ﻫﺬﺍ ﺍﻟﻘﺴﻢ ﺇﻧﺸﺎﺀ ﻣﻜﺎﺗﺐ ﺍﻟﺼﺤﺔ ﻟﻠﻘﻴﺎﻡ ﺑﺎﻹﺟﺮﺍﺀﺍﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ‪ ،‬ﻭﺃﳊﻘﺖ ‪‬ﺬﻩ ﺍﳌﻜﺎﺗﺐ‬
‫ﺃﺳﺮﺓ ﻟﻠﻌﻨﺎﻳﺔ ﺑﺼﺤﺔ ﺍﻷﻣﻬﺎﺕ ﻭﺍﻷﻃﻔﺎﻝ‪ ،‬ﻭﻭﺣﺪﺍﺕ ﻣﺘﻨﻘﻠﺔ ﻟﺘﻘﺪﱘ ﺍﻟﻌﻼﺝ‪.‬‬
‫ﰲ ﻋﺎﻡ ‪ ١٩٤٢‬ﺻﺪﺭ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٦٤‬ﻭﺍﳋﺎﺹ ﺑﺘﺤﺴﲔ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﺮﻳﻒ‪ .‬ﻭﻗﺪ ﻗﺮﺭ ﺍﻟﻘﺎﻧﻮﻥ ﺗﺄﺳﻴﺲ‬
‫ﺇﺩﺍﺭﺍﺕ ﻟﻠﺼﺤﺔ ﻭﺍﳍﻨﺪﺳﺔ ﰲ ﻛﻞ ﻣﺪﻳﺮﻳﺔ )ﳏﺎﻓﻈﺔ( ﻣﻦ ﻣﺪﻳﺮﻳﺎﺕ ﻣﺼﺮ‪ .‬ﻭﻛﺎﻧﺖ ﻣﻬﻤﺔ ﻫﺬﻩ ﺍﻹﺩﺍﺭﺍﺕ‬
‫ﲢﺴﲔ ﺍﻟﻈﺮﻭﻑ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻘﺮﻯ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻜﻞ ﻣﺪﻳﺮﻳﺔ‪ .‬ﻭﻗﺮﺭ ﺍﻟﻘﺎﻧﻮﻥ ﺃﻳﻀﺎﹰ ﺇﻧﺸﺎﺀ‬
‫ﺍ‪‬ﻤﻌﺎﺕ ﺍﻟﺼﺤﻴﺔ )ﳎﻤﻊ ﺻﺤﻲ ﻭﺍﺣﺪ ﻟﻜﻞ ‪ ١٥٠٠٠٠‬ﻧﺴﻤﺔ(‪.‬‬
‫ﻭﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺍﳊﻤﺎﺱ ﺍﻟﺬﻱ ﻗﻮﺑﻞ ﺑﻪ ﺇﻧﺸﺎﺀ ﺍ‪‬ﻤﻌﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺇﻻ ﺃﻥ ﺍﳌﺸﺮﻭﻉ ﺗﻮﻗﻒ ﺑﻌﺪ ﻋﺎﻡ‬
‫‪ ١٩٤٧‬ﻭﺫﻟﻚ ﻋﻨﺪﻣﺎ ﺁﻟﺖ ﺗﺒﻌﻴﺔ ﻛﻞ ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺇﱃ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﺗﻨﺎﻗﺼﺖ ﺑﺸﻜﻞ ﻛﺒﲑ‬
‫ﺍﳌﻴﺰﺍﻧﻴﺎﺕ ﺍﳌﺨﺼﺼﺔ ﻟﻠﻤﺪﻳﺮﻳﺎﺕ‪.‬‬

‫‪٧‬‬
 ‫‪B,  ? 
@  A! -     &#‬‬
‫ﺗﻌﺘﱪ ﺛﻮﺭﺓ ‪ ٢٣‬ﻳﻮﻟﻴﻮ ‪ ١٩٥٢‬ﻭﺍﺣﺪﺓ ﻣﻦ ﺃﻫﻢ ﺍﻟﻌﻼﻣﺎﺕ ﰲ ﺗﺎﺭﻳﺦ ﻣﺼﺮ ﺍﳊﺪﻳﺚ‪ .‬ﻭﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ ﺍﻟﺘﺎﻟﻴﺔ ﳍﺎ‬
‫"ﺍﳊﻘﺒﺔ ﺍﻟﻨﺎﺻﺮﻳﺔ" ﺃﺻﺒﺤﺖ ﺍﻟﺪﻭﻟﺔ ﻫﻲ ﺻﺎﻧﻊ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﳌﺮﺍﻗﺐ ﻭﺃﻳﻀﺎﹰ ﻣﻘﺪﻡ ﺍﳋﺪﻣﺔ ﺍﻟﺮﺋﻴﺴﻲ‪.‬‬
‫ﻓﻤﻊ ﺇﻋﻼﻥ ﺍﳉﻤﻬﻮﺭﻳﺔ ﻭﺻﺪﻭﺭ ﻗﻮﺍﻧﲔ ﺍﻹﺻﻼﺡ ﺍﻟﺰﺭﺍﻋﻲ‪ ،‬ﺗﻠﻘﻰ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﻗﻮﺓ ﺩﺍﻓﻌﺔ ﻛﺒﲑﺓ‪ .‬ﻓﻘﺪ‬
‫ﺗﺒﻨﺖ ﺍﻟﺪﻭﻟﺔ ﺳﻴﺎﺳﺔ ﻟﻠﺘﻮﺳﻊ ﺍﻟﺸﺎﻣﻞ ﰲ ﺍﻟﺒﻨﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻠﺨﺪﻣﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﺍﳌﻘﺪﻣﺔ ﻟﻠﺮﻳﻒ‪.‬‬
‫ﻭﺃﻋﻠﻦ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺘﺰﺍﻣﻪ ﺑﺘﻘﺪﱘ ﺍﳋﺪﻣﺔ ﻭﺇﺗﺎﺣﺘﻬﺎ ﻟﻠﺠﻤﻨﻴﻊ ﺩﻭﻥ ﺍﺳﺘﺜﻨﺎﺀ‪ ،‬ﻭﺫﻟﻚ ﻛﻤﺎ ﺟﺎﺀ ﰲ ﺩﺳﺘﻮﺭ‬
‫‪.١٩٦٢‬‬
‫ﻛﺎﻥ ﺍﻟﺘﺤﺪﻳﺚ‪ ،‬ﻭﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ‪ ،‬ﻭﺍﻟﺘﻮﺯﻳﻊ ﺍﳌﺘﺴﺎﻭﻱ ﺑﲔ ﺍﻟﺮﻳﻒ ﻭﺍﳊﻀﺮ ﻭﺑﲔ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ ﻭﺍﻟﻮﺟﻪ‬
‫ﺍﻟﻘﺒﻠﻲ ﻫﻲ ﺍﳌﺒﺎﺩﺉ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﱵ ﻭﺟﻬﺖ ﺻﻨﻊ ﺳﻴﺎﺳﺎﺕ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻋﺎﻣﺔ‬
‫ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ ﰲ "ﺍﳊﻘﺒﺔ ﺍﻟﻨﺎﺻﺮﻳﺔ"‪.‬‬
‫ﻓﻔﻲ ﳎﺎﻝ ﺗﻄﻮﻳﺮ ﻧﻈﺎﻡ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻋﻤﻠﺖ ﺍﻟﺪﻭﻟﺔ ﰲ ﺍﲡﺎﻫﲔ ﺭﺋﻴﺴﻴﲔ؛ ﺍﻷﻭﻝ ﻫﻮ ﺍﻟﺘﻮﺳﻊ‬
‫ﺍﻟﺮﺃﺳﻲ ﻣﻦ ﺧﻼﻝ ﺍﻟﺘﺤﺪﻳﺚ ﻭﺑﻨﺎﺀ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﻟﺘﻄﻮﻳﺮ ﺍﻟﺘﻘﲏ ﳌﻨﺎﻓﺬ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ‪ ،‬ﻭﺍﻻﲡﺎﻩ ﺍﻟﺜﺎﱐ‬
‫ﻫﻮ ﺍﻟﺘﻮﺳﻊ ﺍﻷﻓﻘﻲ ﻣﻦ ﺧﻼﻝ ﻣﺪ ﺍﳋﺪﻣﺎﺕ ﺧﺎﺭﺝ ﻧﻄﺎﻕ ﺍﳌﺪﻥ ﻭﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﻭﺻﻮﳍﺎ ﺇﱃ ﺍﻟﺮﻳﻒ‪،‬‬
‫ﻭﺃﻳﻀﺎﹰ ﺇﱃ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‪.‬‬
‫ﻭﻛﺎﻥ ﻣﻦ ﺑﲔ ﺃﻫﻢ ﺍﳌﻨﺠﺰﺍﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﺗﻠﻚ ﺍﻟﻔﺘﺮﺓ ﺧﻄﺔ ﺗﺄﺳﻴﺲ ﳕﻮﺫﺝ ﻣﺘﻜﺎﻣﻞ ﻟﻠﺘﻨﻤﻴﺔ‬
‫ﺍ‪‬ﺘﻤﻌﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ ﺗﻌﻤﻞ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺧﻼﻟﻪ‪ .‬ﻭﻗﺪ ﰎ ﺍﻟﺒﺪﺀ ﰲ ﺗﻨﻔﻴﺬ ﻫﺬﻩ ﺍﳋﻄﺔ ﰲ‬
‫ﺍﳋﻤﺴﻴﻨﻴﺎﺕ ﲢﺖ ﺍﺳﻢ "ﺍﻟﻮﺣﺪﺍﺕ ﺍ‪‬ﻤﻌﺔ" ﻗﺒﻞ ﺳﻨﻮﺍﺕ ﻋﺪﻳﺪﺓ ﻣﻦ ﺇﻋﻼﻥ "ﺃﳌﺎ ﺁﺗﺎ"‪.‬‬

‫‪CD5‬‬
‫‪1. C. Fraser Brockington. A Short History of Public Health. Second edition; J.‬‬
‫‪& A. Churchill Ltd, London 1966‬‬
‫‪2. Ebid. Occupational Medicine in the Time of the Pharos; presented in The‬‬
‫‪21st International Congress of the History of Medicine, Cairo 26th Dec. 84‬‬
‫‪- 1st Jan. 85‬‬
‫‪3. Ibrahim Gamil Badran et al. History of the Scientific Movement in Modern‬‬
‫‪Egypt; Medical Sciences; Medicine and Health in the 19th and 20th‬‬
‫‪Centuries. Academy of Scientific Research and Technology, 1995.‬‬
‫‪4. Amina Sabri Murad. Synopsis from the History of Ancient Medicine. El-‬‬
‫‪Nasr El-Hadesa Bookshop, Cairo, 1966‬‬
‫‪5. Mohamed Abdel-Hamid Bayoni. Pharos and Modern Medicine. Dar El-‬‬
‫‪Maaref 1985.‬‬
‫‪6. Suliman Hazin. The university tree in Egypt, a historical analytical vision.‬‬
‫‪Cairo University Press, Cairo, 1985.‬‬
‫‪7. Margret Stacey. The Sociology of Health and Healing. The academic‬‬
‫‪division of Unwin Hyman Ltd, London, UK.‬‬
‫‪٨‬‬
8. Studies in the political history of Egypt since the Mamluks time (Fawzy
Girgis 1955)
9. Description of Egypt. G. Chaproll. "Studies in the Habits and Traditions of
Egptian People." Translated by: Zoheir El-Shaeib, 1976.
10. Laverne Knke. Lives at Risk; Public Health at the 19th Century Egypt. The
American University in Cairo Press, 1990.
11. Amira Azhary Sonbol. The Creation of a Medical Profession in Egypt,
1800-1922. Syracuse University Press 1991.
12. Mohamed El-Mangoury. Glimpses from the History of Medical
Renaissance in Egypt from Mohamed Ali Pasha Todate. Journal of Union
of the Faculty of Medicine; First issue, April 1938.
13. Health policies, A statements of Dr. Abdoh Mahmoud Salam the Ministry
of Health to the National Assembly 22 of December 1969. Alakhbar Press.

٩
 @ @@
@ @
@ @

 ‫ء‬

  
   
@ @
@ @òîz—Ûa@òíbÇ‹Ûa@pbŽbîŽë@pbîvîmaŽa@ZÞëþa@Ý—ÐÛa@•
@ïz—Ûa@âbÄäÜÛ@ïÐîÃìÛaë@ïÜØîa@Ñ–ìÛa@ZïãbrÛa@Ý—ÐÛa@•
@ @ò߇Ծa@òîz—Ûa@pb߇©a@Êbšëcë@êŠìĐmë@émbãìØßë
@Þbª@À@òÜßbÈÛa@ôìÔÛa@åÇ@òîöb—yg@Þëa‡u@@ZsÛbrÛa@Ý—ÐÛa@•
@ @òz—Ûa
@ @òz—Ûa@óÜÇ@ïÇbàn€€€€€uüa@ÖbÐã⁄a@ZÉia‹Ûa@Ý—ÐÛa@•
@ @òîz—Ûa@pbÇbĐÔÛa@À@pbßìÜȾaë@ÝîvnÛa@âbÄã@Z÷ßb©a@Ý—ÐÛa@•
@ @õa†þa@ñ†ì€€€€€€€u@က€î€€€€î€€€€€€Ô€€€m@Z‘†bÛa@Ý—ÐÛa@•
@ @
 ‫  
‪:‬‬
‫      ‬
‫‪  . .‬‬

‫"! ‬
‫ﺻﺤﺔ ﺍﻟﻔﺮﺩ ﻣﻦ ﺍﳌﻘﻮﻣﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻠﻤﺠﺘﻤﻊ ﻓﻬﻲ ﻣﻄﻠﺐ ﺃﺳﺎﺳﻲ ﻣﻦ ﻣﻄﺎﻟﺐ ﺍﳊﻴﺎﺓ‪ ،‬ﻭﻫﻲ ﺃﻳﻀﺎ‬
‫ﺿﺮﻭﺭﺓ ﻣﻦ ﺿﺮﻭﺭﺍﺕ ﺍﻟﺘﻨﻤﻴﺔ‪ ،‬ﻓﺎﻹﻧﺴﺎﻥ ﺍﻟﺬﻱ ﺗﺘﻜﺎﻣﻞ ﻟﻪ ﺻﺤﺔ ﻧﻔﺴﻴﺔ ﻭﺟﺴﻤﻴﺔ ﻫﻮ ﺍﻹﻧﺴﺎﻥ ﺍﻷﻗﺪﺭ‬
‫ﻋﻠﻰ ﺍﻟﻌﻤﻞ ﻭﺍﻹﻧﺘﺎﺝ ﻭﲢﻘﻴﻖ ﺃﻫﺪﺍﻑ ﺍﻟﺘﻨﻤﻴﺔ‪.‬‬
‫ﻭﺍﻟﺪﻭﻟﺔ ﺍﻟﱵ ﺗﺒﻐﻲ ﺍﻟﺘﻨﻤﻴﺔ ﻻﺑﺪ ﺃﻥ ﺗﻌﻤﻞ ﻋﻠﻰ ﲪﺎﻳﺔ ﺻﺤﺔ ﺍﻟﻔﺮﺩ ﻭﻣﻨﻊ ﺍﳌﺮﺽ ﻋﻨﻪ ﰒ ﺗﻮﻓﲑ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺴﺮﻋﺔ ﺍﻛﺘﺸﺎﻑ ﺃﻱ ﺍﻧـﺤﺮﺍﻑ ﰲ ﺍﻟﺼﺤﺔ ﻧﺘﻴﺠﺔ ﺍﳌﺮﺽ ﺃﻭ ﺍﻹﺻﺎﺑﺔ ﺃﻭ ﺗﻠﻮﺙ ﺍﻟﺒﻴﺌﺔ‬
‫ﻭﺗﻮﻓﲑ ﺍﻟﻌﻼﺝ ﺍﻟﻜﺎﻣﻞ ﻟﺸﻔﺎﺋﻪ ﻣﻦ ﺍﳌﺮﺽ ﻭﻣﻀﺎﻋﻔﺎﺗﻪ‪ ،‬ﻭﻟﺬﻟﻚ ﻓﺈﻥ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﳚﺐ ﺍﻋﺘﺒﺎﺭﻫﺎ‬
‫ﺍﺳﺘﺜﻤﺎﺭﺍﹰ ﰲ ﺧﻄﺔ ﺍﻟﺘﻨﻤﻴﺔ‪.‬‬
‫ﻭﻟﻜﻲ ﻳﺘﺤﻘﻖ ﻫﺬﺍ ﺍﳍﺪﻑ ﳚﺐ ﺃﻥ ﺗﺘﺠﻪ ﺍﳋﻄﺔ ﺍﻟﺼﺤﻴﺔ ﺇﱃ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﱪﺍﻣﺞ ﺍﻟﻮﻗﺎﺋﻴﺔ‪ ،‬ﰲ‬
‫ﳐﻄﻂ ﺻﺤﻲ‪ ،‬ﻳﻬﺪﻑ ﺃﺳﺎﺳﺎ ﺇﱃ ﺍﻻﺭﺗﻘﺎﺀ ﺑﺎﻟﺼﺤﺔ‪ ،‬ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻮﻗﺎﻳﺔ ﻭﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻟﻸﻣﺮﺍﺽ‬
‫ﻭﺍﻟﻌﻼﺝ ﺍﻟﺴﻠﻴﻢ ﳍﺎ ﰲ ﺗﻮﺍﺯﻥ ﻋﻠﻤﻲ ﻳﺄﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺃﻥ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻫﻲ ﺍﳌﺴﺌﻮﻟﻴﺔ‬
‫ﺍﻷﺳﺎﺳﻴﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻛﺎﻟﺘﺰﺍﻡ ﻗﻮﻣﻲ ﺩﻭﻥ ﻣﺴﺎﺱ ﺑﺎﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ‪ ،‬ﻭﻫﻮ ﻧﺸﺎﻁ ﺗﻘﻮﻡ ﺑﻪ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻭﺗﺆﺩﻳﻪ ﺃﻳﻀﺎ ﻫﻴﺌﺎﺕ ﻭﺃﺟﻬﺰﺓ ﻋﺎﻣﺔ ﻭﺧﺎﺻﺔ ﻣﺘﻌﺪﺩﺓ‪ ،‬ﺗﺘﺒﺎﻳﻦ ﰲ ﻗﺪﺭﺍ‪‬ﺎ ﺍﻟﻔﻨﻴﺔ ﻭﺃﳕﺎﻃﻬﺎ‬
‫ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‪.‬‬

‫ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ ﲜﻤﻬﻮﺭﻳﺔ ﻣﺼﺮ ﺍﻟﻌﺮﺑﻴﺔ‬

‫ﺍﻟﺼﺤﺔ ﻫﻲ ﺣﻖ ﻣﻦ ﺣﻘﻮﻕ ﺍﻹﻧﺴﺎﻥ‪ ،‬ﻭﺿﺮﻭﺭﺓ ﺇﺗﺎﺣﺔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺃﻣﺎﻡ ﺍﳉﻤﻴﻊ ﲟﺎ ﻳﺘﻨﺎﺳﺐ ﻣﻊ‬
‫ﻛﺎﻓﺔ ﺍﻟﺸﺮﺍﺋﺢ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻫﻲ ﻣﺴﺌﻮﻟﻴﺔ ﺍﻟﺪﻭﻟﺔ‪ .‬ﻭﻫﺬﻩ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺃﻃﻠﻖ ﻋﻠﻴﻬﺎ ﺍﺳﻢ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ )‪ ،(PHC‬ﻭﻫﻲ ﻻ ﺗﻀﻤﻦ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﻮﻗﺎﺋﻴﺔ‬
‫ﻓﻘﻂ؛ ﺑﻞ ﺗﺘﻀﻤﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻭﺍﻟﺘﻨﻤﻴﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺃﻳﻀﺎﹰ‪ .‬ﻭﻳﺘﻀﻤﻦ ﻣﻔﻬﻮﻡ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﺃﻳﻀﺎ ﻣﺸﺎﺭﻛﺔ ﺍ‪‬ﺘﻤﻊ‪ ،‬ﻭﺃﳘﻴﺔ ﻫﺬﻩ ﺍﻹﺟﺮﺍﺀﺍﺕ ﻟﻠﻤﺠﺘﻤﻊ‪ ،‬ﻭﺍﺳﺘﺨﺪﺍﻡ‬
‫ﺃﺳﺎﻟﻴﺐ ﺗﻜﻨﻮﻟﻮﺟﻴﺔ ﺑﺴﻴﻄﺔ ﻭﻣﺆﺛﺮﺓ ﻭﺍﳌﺸﺎﺭﻛﺔ ﺍﻟﻔﻌﺎﻟﺔ ﻟﻠﻌﻤﺎﻟﺔ ﺍﻟﻄﺒﻴﺔ ﺍﳌﺴﺎﻋﺪﺓ‪.‬‬
‫ﻭﺍﳌﻜﻮﻧﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻫﻲ‪ :‬ﺍﻟﺘﺜﻘﻴﻒ ﺍﻟﺼﺤﻲ‪ ،‬ﺍﻟﺼﺤﺔ ﺍﻟﺒﻴﺌﻴﺔ‪ ،‬ﺍﻟﱪﺍﻣﺞ‬
‫ﺍﻟﺼﺤﻴﺔ ﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﻔﻮﻟﺔ ﻭﺍﻷﻣﻮﻣﺔ‪ ،‬ﺍﻟﺘﻄﻌﻴﻢ ﻭﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪ ،‬ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻮﻃﻨﺔ‪،‬‬
‫ﻭﺍﻟﻌﻼﺝ ﺍﳌﻨﺎﺳﺐ ﻟﻸﻣﺮﺍﺽ ﻭﺍﻹﺻﺎﺑﺎﺕ ﺍﻟﺸﺎﺋﻌﺔ‪ ،‬ﺗﻮﻓﲑ ﺍﻷﺩﻭﻳﺔ ﺍﻟﻀﺮﻭﺭﻳﺔ‪ ،‬ﻭﻧﺸﺮ ﺍﻟﻮﻋﻲ ﺑﺄﺳﺲ‬
‫ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﻃﺮﻕ ﺍﻟﻌﻼﺝ ﺍﻟﺘﻘﻠﻴﺪﻳﺔ‪.‬‬

‫‪١١‬‬
‫ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﳚﺐ ﺃﻥ ﺗﺘﺴﻢ ﺑﺎﻟﺸﻤﻮﻟﻴﺔ‪ ،‬ﺍﳉﻮﺩﺓ‪ ،‬ﺍﳌﺴﺎﻭﺍﺓ ﻭﺍﻟﻜﻔﺎﺀﺓ‪ .‬ﻭﺗﻌﺮﻑ ﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﺍﳌﻘﺪﻣﺔ ﻋﻠﻰ ﺃ‪‬ﺎ ﻣﺴﺘﻮﻯ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﻭﻟﻴﺔ ﺍﳌﻘﺪﻣﺔ ﳉﻤﻴﻊ ﺍﻷﻓﺮﺍﺩ ﺍﻟﱵ ﺗﻌﺎﰿ ﺃﻛﺜﺮ‬
‫ﺍﳌﺸﻜﻼﺕ ﺷﻴﻮﻋﺎ ﰲ ﺍ‪‬ﺘﻤﻊ ﻣﻦ ﺧﻼﻝ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﺘﺄﻫﻴﻠﻴﺔ ﻟﺘﺤﻘﻴﻖ ﺍﳊﺪ‬
‫ﺍﻷﻗﺼﻰ ﻣﻦ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺮﻋﺎﻳﺔ‪.‬‬
‫ﻭﺍﶈﻮﺭ ﺍﻷﺳﺎﺳﻲ ﻟﻠﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍ‪‬ﺘﻤﻊ ﻳﺘﺤﺮﻙ ﰲ ﻧﻄﺎﻕ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﱵ ﺗﻌﻤﻞ ﻋﻠﻰ ﲪﺎﻳﺔ‬
‫ﺻﺤﺔ ﺍﻟﻔﺮﺩ ﻭﻣﻨﻊ ﺍﳌﺮﺽ‪ ،‬ﻭﺗﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺴﺮﻋﺔ ﺍﻛﺘﺸﺎﻑ ﺃﻱ ﺍﻧـﺤﺮﺍﻑ ﰲ ﺍﻟﺼﺤﺔ ﻧﺘﻴﺠﺔ‬
‫ﺍﳌﺮﺽ‪ ،‬ﺃﻭ ﺍﻹﺻﺎﺑﺔ ﺃﻭ ﺗﻠﻮﺙ ﺍﻟﺒﻴﺌﺔ‪ ،‬ﻭﺗﻮﻓﲑ ﺍﻟﻌﻼﺝ ﻟﻴﺼﺒﺢ ﻗﺎﺩﺭﺍ ﻋﻠﻰ ﺍﻟﻌﻤﻞ ﻭﺍﻹﻧﺘﺎﺝ ﺑﺄﻛﱪ ﻛﻔﺎﺀﺓ ﻓﻨﻴﺔ‬
‫ﻭﺟﺴﻤﻴﺔ‪ ،‬ﻭﻣﻦ ﰒ ﻓﺈﻥ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﳚﺐ ﺍﻋﺘﺒﺎﺭﻫﺎ ﺍﺳﺘﺜﻤﺎﺭﺍ ﰲ ﺧﻄﺔ ﺍﻟﺘﻨﻤﻴﺔ‪ ،‬ﻭﻟﻜﻲ ﻧـﺤﻘﻖ ﻫﺬﺍ‬
‫ﺍﳍﺪﻑ ﳚﺐ ﺃﻥ ﺗﻌﺘﻤﺪ ﺍﳋﻄﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﱪﺍﻣﺞ ﺍﻟﻮﻗﺎﺋﻴﺔ ﰲ ﳐﻄﻂ ﺻﺤﻲ ﻳﻬﺪﻑ‬
‫ﺃﺳﺎﺳﺎ ﺇﱃ ﺍﻻﺭﺗﻘﺎﺀ ﺑﺎﻟﺼﺤﺔ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﻭﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﳍﺎ ﻭﺍﻟﻌﻼﺝ ﺍﻟﻜﺎﻣﻞ‬
‫ﳍﺎ ﰲ ﺗﻮﺍﺯﻥ ﻋﻠﻤﻲ ﻳﺄﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺃﻥ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻫﻲ ﺍﳌﺴﺌﻮﻟﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻮﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻛﺎﻟﺘﺰﺍﻡ ﻗﻮﻣﻲ ﺩﻭﻥ ﺍﳌﺴﺎﺱ ﺑﺎﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ‪ ،‬ﻭﻫﻮ ﻧﺸﺎﻁ ﺗﻘﻮﻡ ﺑﻪ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺗﺆﺩﻳﻪ‬
‫ﺃﻳﻀﺎ ﻫﻴﺌﺎﺕ ﻭﺃﺟﻬﺰﺓ ﻋﻠﻤﻴﺔ ﻣﺘﻌﺪﺩﺓ ﺃﺧﺮﻯ‪.‬‬
‫ﺗﺮﺗﻜﺰ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﲨﻬﻮﺭﻳﺔ ﻣﺼﺮ ﺍﻟﻌﺮﺑﻴﺔ ﻋﻠﻰ‪:‬‬
‫‪ .١‬ﺗﻨﺴﻴﻖ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺑﲔ ﻣﺆﺳﺴﺎﺕ ﻭﺃﺟﻬﺰﺓ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻭﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻷﺧﺮﻯ ﺍﻟﱵ ﺗﺮﺗﺒﻂ‬
‫ﻭﻇﺎﺋﻔﻬﺎ ﻭﺃﻧﺸﻄﺘﻬﺎ ﺑﺎﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ‪.‬‬
‫‪ .٢‬ﺗﺪﻋﻴﻢ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺗﻮﻓﲑﻫﺎ ﺑﺎﳌﻨﺎﻃﻖ ﺍﶈﺮﻭﻣﺔ ﳌﻮﺍﺟﻬﺔ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ‬
‫ﺍﻷﺳﺎﺳﻴﺔ ﳉﻤﻴﻊ ﻓﺌﺎﺕ ﺍ‪‬ﺘﻤﻊ ﺧﺎﺻﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ‪.‬‬
‫‪ .٣‬ﺗﻮﺳﻴﻊ ﻗﺎﻋﺪﺓ ﺍﳌﺸﺎﺭﻛﺔ ﰲ ﺍﻟﺘﻜﺎﻟﻴﻒ ﺍﳌﺘﺰﺍﻳﺪﺓ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ‪.‬‬
‫‪ .٤‬ﺗﺸﺠﻴﻊ ﺍﻹﻧﺘﺎﺝ ﺍﶈﻠﻰ ﻟﺘﻠﺒﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﳌﻮﺍﻃﻨﲔ ﻣﻦ ﺍﻟﺪﻭﺍﺀ ﻭﺍﻟﻄﻌﻮﻡ ﻭﺍﻷﻣﺼﺎﻝ ﻭﻭﺳﺎﺋﻞ‬
‫ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﺍﳌﺴﺘﻠﺰﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﻭﺍﳌﻌﻤﻠﻴﺔ‪.‬‬
‫‪ .٥‬ﺗﻄﻮﻳﺮ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﲟﺎ ﻳﺪﻋﻢ ﺃﺳﻠﻮﺏ ﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭﺍﺕ ﻭﺇﻋﺪﺍﺩ ﺍﳋﻄﻂ ﻭﺍﻟﱪﺍﻣﺞ ﺍﻟﺼﺤﻴﺔ‬
‫ﻭﻣﺘﺎﺑﻌﺔ ﺗﻨﻔﻴﺬﻫﺎ ﻭﺗﻮﺯﻳﻊ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺘﺎﺣﺔ ﻋﻠﻰ ﺍﶈﺎﻓﻈﺎﺕ ﻃﺒﻘﺎ ﻻﺣﺘﻴﺎﺟﺎ‪‬ﺎ‪.‬‬
‫‪ .٦‬ﺗﻨﻤﻴﺔ ﺍﳌﻮﺍﺭﺩ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﺼﺤﻴﺔ ﲜﻤﻴﻊ ﻓﺌﺎ‪‬ﺎ ﻛﻤﺎﹰ ﻭﻛﻴﻔﺎﹰ ﻭﺗﺄﻛﻴﺪ ﺣﺴﻦ ﺍﺳﺘﺨﺪﺍﻣﻬﺎ ﻭﻋﺪﺍﻟﺔ‬
‫ﺗﻮﺯﻳﻌﻬﺎ ﳌﻮﺍﻛﺒﺔ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﻟﺘﻘﻨﻴﺔ ﺍﳌﺘﻼﺣﻘﺔ ﻭﺿﻤﺎﻥ ﺟﻮﺩﺓ ﺍﻷﺩﺍﺀ‪.‬‬
‫ﺗﻌﺘﻤﺪ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﻋﺪﺓ ﳏﺎﻭﺭ ﺃﺳﺎﺳﻴﺔ‪ ،‬ﺃﻫـﻤﻬﺎ‪:‬‬
‫‪ .١‬ﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﺣﻖ ﺍﳌﻮﺍﻃﻦ ﺍﳌﺼﺮﻱ ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻛﺤﻖ ﻛﻔﻠﻪ ﻟﻪ ﺍﻟﺪﺳﺘﻮﺭ‪.‬‬
‫‪ .٢‬ﺍﻻﻟﺘﺰﺍﻡ ﺑﺎﳌﻮﺍﺛﻴﻖ ﺍﻟﻮﻃﻨﻴﺔ ﻭﺍﻟﺪﻭﻟﻴﺔ ﰲ ﺇﻃﺎﺭ ﻣﻦ ﺍﻟﺘﻌﺎﻭﻥ ﺍﻹﻧﺴﺎﱐ ﲟﺎ ﳜﺪﻡ ﺍﻟﻄﻔﻞ ﻭﺍﳌﺮﺃﺓ ﻭﺍﻷﺳﺮﺓ‬
‫ﻭﺍ‪‬ﺘﻤﻊ‪.‬‬
‫‪ .٣‬ﺍﳌﺸﺎﺭﻛﺔ ﺍﻹﳚﺎﺑﻴﺔ ﰲ ﲢﻘﻴﻖ ﺃﻫﺪﺍﻑ ﺧﻄﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻟﻠﺪﻭﻟﺔ‪.‬‬

‫‪١٢‬‬
‫‪ .٤‬ﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﻣﻔﻬﻮﻡ ﺃﻥ ﺍﻷﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻫﻮ ﺍﺳﺘﺜﻤﺎﺭ ﺫﻭ ﻋﺎﺋﺪ ﻛﺒﲑ ﺑﻜﻞ ﺍﳌﻘﺎﻳﻴﺲ‪ ،‬ﻭﺃﻧﻪ ﻣﻦ‬
‫ﺍﻟﻀﺮﻭﺭﻱ ﺯﻳﺎﺩﺓ ﻧﺼﻴﺐ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﰲ ﺍﳌﻮﺍﺯﻧﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺪﻭﻟﺔ ﻟﻠﻮﻓﺎﺀ ﺑﺎﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻷﺳﺎﺳﻴﺔ ﻟﻠﻤﻮﺍﻃﻦ ﺍﳌﺼﺮﻱ‪.‬‬
‫‪ .٥‬ﺍﻟﺘﺄﻛﺪ ﻋﻠﻰ ﻋﺪﺍﻟﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﺍﳌﺘﺨﺼﺼﺔ ﻋﻠﻰ ﺃﻗﺎﻟﻴﻢ ﺍﳉﻤﻬﻮﺭﻳﺔ‪ ،‬ﻭﺗﻮﻓﲑ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻠﻤﻨﺎﻃﻖ ﺍﶈﺮﻭﻣﺔ‪ ،‬ﻭﺫﻟﻚ ﺗﻴﺴﲑﺍ ﻋﻠﻰ ﺍﳌﻮﺍﻃﻦ ﻭﺗﻨﻔﻴﺬﺍ ﻟﺘﻮﺟﻴﻬﺎﺕ‬
‫ﺍﻟﺪﻭﻟﺔ ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻟﻘﺎﺩﻣﺔ‪.‬‬
‫ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‪:‬‬
‫‪ .١‬ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺍﻟﺘﻨﺴﻴﻖ ﻭﺍﻟﺘﻜﺎﻣﻞ ﺑﲔ ﺍﻟﻮﺯﺍﺭﺍﺕ ﺍﻟﱵ ﺗﺮﺗﺒﻂ ﺃﻧﺸﻄﺘﻬﺎ ﺑﺎﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻀﻤﺎﻥ‬
‫ﺭﻓﻊ ﺍﳌﺴﺘﻮﻯ ﺍﻟﺼﺤﻲ ﻟﻠﻤﺠﺘﻤﻊ‪.‬‬
‫‪ .٢‬ﺍﻻﺭﺗﻘﺎﺀ ﲟﺴﺘﻮﻯ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻭﻗــﺎﺋﻴﺎﹰ‪ ،‬ﻋﻼﺟﻴﺎﹰ‪ ،‬ﻭﺗﺜﻘﻴﻔﻴﺎﹰ‪ ،‬ﻭﺍﻟﺘﻮﺳﻊ ﺍﻷﻓﻘﻲ‬
‫ﰲ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﳌﺘﻜﺎﻣﻠﺔ‪ ،‬ﻭﺧﺎﺻﺔ ﲟﻨﺎﻃﻖ ﺍﻻﻣﺘﺪﺍﺩ ﺍﻟﻌﻤﺮﺍﱐ‪.‬‬
‫‪ .٣‬ﺯﻳﺎﺩﺓ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺎﻟﻴﺔ ﻟﺘﻮﻓﲑ ﻭﺗﻄﻮﻳﺮ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﺗﻮﺟﻴﻪ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺘﺎﺣﺔ ﻣﻦ ﺧﻼﻝ ﺍﻻﺗﻔﺎﻗﻴﺎﺕ‬
‫ﺍﻟﺪﻭﻟﻴﺔ ﻟﺪﻋﻢ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﻣﻮﺍﺟﻬﺔ ﺍﳌﺸﻜﻼﺕ ﺍﻟﺼﺤﻴﺔ ﺫﺍﺕ ﺍﻷﻭﻟﻮﻳﺔ‪.‬‬
‫‪ .٤‬ﺗﻄﻮﻳﺮ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﻌﺎﺟﻠﺔ ﲟﺎ ﻓﻴﻬﺎ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺘﺨﺼﺼﻴﺔ ﺍﻟﺪﻗﻴﻘﺔ ﻭﺗﻮﻓﲑﻫﺎ ﻋﻠﻰ‬
‫ﺍﳌﺴﺘﻮﻯ ﺍﻹﻗﻠﻴﻤﻲ‪.‬‬
‫‪ .٥‬ﺍﻟﺘﻮﺳﻊ ﰲ ﺧﺪﻣﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﺘﻐﻄﻴﺔ ﻓﺌﺎﺕ ﺟﺪﻳﺪﺓ ﻭﺗﻄﻮﻳﺮ ﻧﻈﻢ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ‪.‬‬
‫‪ .٦‬ﺍﻟﺘﻮﺳﻊ ﺟﻐﺮﺍﻓﻴﺎ ﰲ ﻧﻈﺎﻡ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﻻﺳﺘﺮﺩﺍﺩ ﻛﻞ ﺃﻭ ﺟﺰﺀ ﻣﻦ ﻧﻔﻘﺎﺕ ﺍﳋﺪﻣﺔ ﺍﻟﻄﺒﻴﺔ‪.‬‬
‫‪ .٧‬ﺗﺸﺠﻴﻊ ﺩﻭﺭ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﻭﺍﻟﺘﻄﻮﻋﻴﺔ ﻭﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﻻﺳﺘﻜﻤﺎﻝ ﺑﻌﺾ ﺟﻮﺍﻧﺐ ﺍﳋﻄﻂ‬
‫ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫‪ .٨‬ﺗﻮﻋﻴﺔ ﺍ‪‬ﺘﻤﻊ ﺑﺪﻭﺭﻩ ﺍﻹﳚﺎﰊ ﰲ ﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺻﺤﺔ ﺃﻓﺮﺍﺩﻩ ﻭﺇﺻﺤﺎﺡ ﺍﻟﺒﻴﺌﺔ‪.‬‬
‫‪ .٩‬ﺯﻳﺎﺩﺓ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﻟﺒﺤﻮﺙ ﺍﻟﻌﻠﻤﻴﺔ ﺍﻟﺘﻄﺒﻴﻘﻴﺔ ﻟﻼﺳﺘﻔﺎﺩﺓ ﻣﻦ ﻧﺘﺎﺋﺠﻬﺎ ﰲ ﺗﻄﻮﻳﺮ ﺍﳋﺪﻣﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﻣﺜﻞ‪:‬‬
‫ﲝﻮﺙ ﺍﻟﻨﻈﻢ ﺍﻟﺼﺤﻴﺔ ‪Health System Research‬‬ ‫‪o‬‬
‫ﺍﻟﺒﺤﻮﺙ ﺍﻟﺘﻄﺒﻴﻘﻴﺔ ﻭﲝﻮﺙ ﺍﻟﻌﻤﻠﻴﺎﺕ ‪Operational Research‬‬ ‫‪o‬‬
‫ﻟﻠﺘﻌﺮﻑ ﻋﻠﻰ ﻣﺸﺎﻛﻞ ﺃﺩﺍﺀ ﺍﳋﺪﻣﺎﺕ ﻭﲢﻠﻴﻠﻬﺎ ﻭﺍﺧﺘﻴﺎﺭ ﺃﻧﺴﺐ ﺍﳊﻠﻮﻝ ﻭﺗﻘﻴﻴﻢ ﻛﻔﺎﺀ‪‬ﺎ ﻭﻓﺎﻋﻠﻴﺘﻬﺎ‪.‬‬
‫‪ .١٠‬ﺍﻟﺘﻮﺳﻊ ﰲ ﺍﺳﺘﺨﺪﺍﻡ ﺃﺳﺎﻟﻴﺐ ﺍﻻﺳﺘﻘﺼﺎﺀ ﻭﻣﺆﺷﺮﺍﺕ ﺍﻟﺘﻨﺒﺆ ﺑﺎﻷﻣﺮﺍﺽ‪ ،‬ﺧﺎﺻﺔ ﺑﲔ ﺍﻟﻔﺌﺎﺕ‬
‫ﺍﳌﻌﺮﺿﺔ ﳍﺎ ﻭﺳﺮﻋﺔ ﺍﲣﺎﺫ ﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﻟﻼﺯﻣﺔ ﻟﻠﺴﻴﻄﺮﺓ ﻋﻠﻴﻬﺎ‪.‬‬
‫‪ .١١‬ﲢﺴﲔ ﺃﺳﻠﻮﺏ ﲣﻄﻴﻂ ﺗﻨﻤﻴﺔ ﺍﻟﻘﻮﻯ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺎﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻭﺭﺑﻂ ﺍﻟﻌﻤﻠﻴﺔ‬
‫ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﺑﺎﺣﺘﻴﺎﺟﺎﺕ ﺍ‪‬ﺘﻤﻊ‪.‬‬

‫‪١٣‬‬
 ‫ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺼﺤﻴﺔ‪:‬‬
‫ﰲ ﺇﻃﺎﺭ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ﺗﺴﺘﻬﺪﻓﻬﺎ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺣﺎﻟﻴﺎ ﻭﰲ‬
‫ﺍﳌﺮﺣﻠﺔ ﺍﻟﻘﺎﺩﻣﺔ ﻓﺈﻥ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻷﻧﺸﻄﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻭﺻﺤﺔ ﺍﳌﺮﺃﺓ ﻭﺍﻟﻄﻔﻞ‬
‫ﻭﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﻛﻮﺳﻴﻠﺔ ﻟﺘﺤﻘﻴﻖ ﺍﻷﻫﺪﺍﻑ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻋﻠﻰ ﺍﻟﻨـﺤﻮ ﺍﻟﺘﺎﱄ‪:‬‬
‫‪ .١‬ﺩﻋﻢ ﻛﻔﺎﺀﺓ ﺑﺮﻧﺎﻣﺞ ﺍﻹﻋﻼﻡ ﻭﺍﻻﺗﺼﺎﻝ ﻭﺍﻟﺘﻨﺴﻴﻖ ﻣﻊ ﺍﻷﺟﻬﺰﺓ ﺍﻹﻋﻼﻣﻴﺔ ﻟﺘﻨﻔﻴﺬ ﺑﺮﺍﻣﺞ ﺍﻟﺘﺜﻘﻴﻒ‬
‫ﺍﻟﺼﺤﻲ ﺍﻟﱵ ﺗﺴﺘﻬﺪﻑ ﺗﻐﻴﲑ ﺍﻷﳕﺎﻁ ﺍﻟﺴﻠﻮﻛﻴﺔ ﻭﺍﻟﻐﺬﺍﺋﻴﺔ ﻏﲑ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫‪ .٢‬ﺩﻋﻢ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍﻷﺟﻬﺰﺓ ﻭﺍﳉﻬﺎﺕ ﺍﳌﻌﻨﻴﺔ ﻣﻦ ﺧﻼﻝ‪:‬‬
‫‪ -‬ﺍﻟﺘﻮﺳﻊ ﰲ ﺍﻟﺘﺤﺼﻴﻨﺎﺕ ﺿﺪ ﺍﻷﻣﺮﺍﺽ ﻭﺗﻄﻮﻳﺮ ﺍﳌﻌﺎﻣﻞ ﻟﻼﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻟﻸﻣﺮﺍﺽ‪.‬‬
‫‪ -‬ﻣﺮﺍﻗﺒﺔ ﺍﻷﻏﺬﻳﺔ ﺍﶈﻠﻴﺔ ﻭﺍﳌﺴﺘﻮﺭﺩﺓ ﻟﻀﻤﺎﻥ ﺟﻮﺩ‪‬ﺎ ﻭﺳﻼﻣﺘﻬﺎ‪.‬‬
‫‪ -‬ﺍﻟﺘﺤﻜﻢ ﰲ ﻣﺼﺎﺩﺭ ﺍﻟﺘﻠﻮﺙ ﺍﻟﺒﻴﺌﻲ‪.‬‬
‫‪ -‬ﺗﻌﻤﻴﻢ ﻧﻈﺎﻡ ﺍﻟﺒﻄﺎﻗﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻜﻞ ﻣﻮﺍﻃﻦ‪.‬‬
‫‪ .٣‬ﺗﻮﻓﲑ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﳉﻤﻴﻊ ﺍﳌﻮﺍﻃﻨﲔ ﻭﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺗﻜﺎﻣﻞ ﺍﳋﺪﻣﺎﺕ ﺑﺎﳌﻨﺎﻃﻖ‬
‫ﺍﻟﻄﺒﻴﺔ‪.‬‬
‫‪ .٤‬ﺗﻮﻓﲑ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﻟﻌﺎﺟﻠﺔ ﳉﻤﻴﻊ ﺷﺮﺍﺋﺢ ﺍ‪‬ﺘﻤﻊ ﺑﺪﻭﻥ ﺃﺟﺮ ﻭﲟﻌﺪﻻﺕ ﻋﺎﻟﻴﺔ ﻣﻦ ﺍﳉﻮﺩﺓ‪.‬‬
‫‪ .٥‬ﺩﻋﻢ ﻭﺗﻄﻮﻳﺮ ﺍﳌﻌﺎﻣﻞ ﺍﻹﻗﻠﻴﻤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﳌﻮﺍﻛﺒﺔ ﺍﻟﺘﻘﻨﻴﺎﺕ ﺍﳊﺪﻳﺜﺔ ﻟﻼﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ‬
‫ﻟﻠﻤﺨﺎﻃﺮ ﺍﻟﺼﺤﻴﺔ ﻭﺗﻘﻮﻳﺔ ﺍﻟﻘﺪﺭﺍﺕ ﺍﻟﺬﺍﺗﻴﺔ ﺍﳌﻌﻤﻠﻴﺔ ﺇﻗﻠﻴﻤﻴﺎ‪.‬‬
‫‪ .٦‬ﺭﻓﻊ ﻛﻔﺎﺀﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻟﻸﻣﺮﺍﺽ ﺍﳊﺎﺩﺓ ﻭﺍﳌﺰﻣﻨﺔ‪ ،‬ﻣﻊ ﻧﺸﺮ ﻭﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺘﻘﻨﻴﺎﺕ ﺍﳊﺪﻳﺜﺔ‬
‫ﻭﺩﻋﻢ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﺍﻟﻨﻮﻋﻴﺔ ﺩﻗﻴﻘﺔ ﺍﻟﺘﺨﺼﺺ ﻭﻋﺎﻟﻴﺔ ﺍﻟﺘﻘﻨﻴﺔ ﰲ ﻧﻄﺎﻕ ﺍﻟﺘﻨﻤﻴﺔ‬
‫ﺍﻹﻗﻠﻴﻤﻴﺔ ﻭﺑﺎﻟﺘﻨﺴﻴﻖ ﻣﻊ ﺍﳉﺎﻣﻌﺎﺕ ﻭﻣﺮﺍﻛﺰ ﺍﻟﺒﺤﺚ ﺍﻟﻌﻠﻤﻲ‪.‬‬
‫‪ .٧‬ﺯﻳﺎﺩﺓ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺘﻨﻤﻴﺔ ﺍﻟﻘﻮﻯ ﺍﻟﺒﺸﺮﻳﺔ‪ ،‬ﺑﺮﻓﻊ ﻣﺴﺘﻮﻯ ﺍﻟﻜﻮﺍﺩﺭ ﺍﻟﻔﻨﻴﺔ‪ ،‬ﻟﻀﻤﺎﻥ ﻛﻔﺎﺀﺓ ﺍﻷﺩﺍﺀ ﻃﺒﻘﺎ‬
‫ﻟﻠﻤﻌﺎﻳﲑ ﺍﻟﻔﻨﻴﺔ ﻭﺗﺄﺻﻴﻞ ﺑﺮﺍﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ ﺍﳌﺴﺘﻤﺮ ﳉﻤﻴﻊ ﺍﻟﻔﺌﺎﺕ‪ ،‬ﳌﻮﺍﻛﺒﺔ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﻟﻌﻠﻤﻴﺔ‬
‫ﻭﺍﻟﺘﻘﻨﻴﺔ ﻭﺍﻟﺘﻮﺟﻪ ﻧـﺤﻮ ﲢﻘﻴﻖ ﺍﻟﺘﻮﺍﺯﻥ ﰲ ﺗﻮﺯﻳﻌﻬﺎ ﺟﻐﺮﺍﻓﻴﺎ ﻭﺑﲔ ﻣﺴﺘﻮﻳﺎﺕ ﺍﳋﺪﻣﺔ ﻭﺍﻟﻔﺌﺎﺕ‬
‫ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫‪ .٨‬ﺩﻋﻢ ﻗﻄﺎﻉ ﺍﻟﺪﻭﺍﺀ ﻣﻦ ﺧﻼﻝ ﺍﻻﻫﺘﻤﺎﻡ ﺑﻘﺎﺋﻤﺔ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﲢﺪﻳﺜﻬﺎ ﺑﺼﻔﺔ ﺩﻭﺭﻳﺔ ﻭﺗﺸﺠﻴﻊ‬
‫ﺍﻹﻧﺘﺎﺝ ﺍﶈﻠﻰ ﻭﺗﻄﻮﻳﺮ ﻭﺩﻋﻢ ﻣﻌﺎﻣﻞ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪.‬‬
‫ﻫﺬﺍ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺭﻓﻊ ﻛﻔﺎﺀﺓ ﻗﻄﺎﻉ ﺍﻟﺼﻴﺪﻟﺔ ﻭﺍﻟﺮﻗﺎﺑﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ ،‬ﻟﻠﻘﻴﺎﻡ ﺑﺪﻭﺭﻫﺎ ﻟﻠﺘﺤﻜﻢ ﰲ‬
‫ﺭﻗﺎﺑﺔ ﺟﻮﺩﺓ ﺍﳌﺴﺘﺤﻀﺮﺍﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻭﺍﳊﻴﻮﻳﺔ ﻭﺗﺴﺠﻴﻞ ﺍﻷﺩﻭﻳﺔ ﻭﺗﺴﺘﻌﲑﻫﺎ ﻭﲪﺎﻳﺔ ﺍﻹﻧﺘﺎﺝ ﺍﶈﻠﻰ‬
‫ﻭﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺣﺴﻦ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺪﻭﺍﺀ ﻭﺗﺮﺷﻴﺪ ﺍﺳﺘﻬﻼﻛﻪ‪ ،‬ﻣﻊ ﺩﻋﻢ ﻣﺮﺍﻛﺰ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻣﺮﻛﺰﻳﺎ ﻭﺇﻗﻠﻴﻤﻴﺎ‬
‫ﻭﲢﺪﻳﺚ ﻗﻮﺍﻋﺪ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻭﺍﻟﺘﺤﻘﻖ ﻣﻦ ﺻﺤﺘﻬﺎ ﻭﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻴﻬﺎ ﰲ ﺍﻟﺘﺨﻄﻴﻂ ﺍﻟﺼﺤﻲ ﻭﻧﺸﺮ‬
‫ﺍﻟﺒﻴﺎﻧﺎﺕ ﻭﺍﳌﻌﻠﻮﻣﺎﺕ ﺩﻭﺭﻳﺎ‪.‬‬

‫‪١٤‬‬
 ‫ﺍﻟﺴﻴﺎﺳﺔ ﻭﺍﻟﱪﺍﻣﺞ ﺍﻟﺴﻜﺎﻧﻴﺔ‪:‬‬
‫ﻇﻬﺮ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳌﺸﻜﻠﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻣﻦ ﺧﻼﻝ ﺍﳌﻴﺜﺎﻕ ﺍﻟﻮﻃﲏ ﺍﻟﺬﻱ ﰎ ﺇﺻﺪﺍﺭﻩ ﰲ ﺍﻟﺴﺘﻴﻨﻴﺎﺕ‪ .‬ﺍﻋﺘﱪ‬
‫ﺍﳌﻴﺜﺎﻕ ﺍﻟﻨﻤﻮ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺴﺮﻳﻊ ﻣﻌﻮﻗﺎﹰ ﳉﻬﻮﺩ ﺭﻓﻊ ﻣﺴﺘﻮﻯ ﺍﳌﻌﻴﺸﺔ ﻟﻠﺸﻌﺐ ﺍﳌﺼﺮﻱ‪ .‬ﻭﰎ ﺃﻳﻀﺎ ﰲ‬
‫ﺍﻟﺴﺘﻴﻨﺎﺕ ﻭﺿﻊ ﺑﺮﻧﺎﻣﺞ ﻗﻮﻣﻲ ﻟﺘﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻳﻬﺪﻑ ﺍﻟﱪﻧﺎﻣﺞ ﺍﻟﺬﻱ ﺃﻧﺸﺊ ﻣﻦ ﺧﻼﻝ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪،‬‬
‫ﺇﱃ ﺧﻔﺾ ﺍﻹﳒﺎﺏ ﻭﺑﺎﻟﺘﺎﱄ ﺧﻔﺾ ﺍﻟﻨﻤﻮ ﺍﻟﺴﻜﺎﱐ‪ .‬ﻭﻗﺪ ﰎ ﺇﺻﺪﺍﺭ ﺃﻭﻝ ﺳﻴﺎﺳﺔ ﻗﻮﻣﻴﺔ ﻟﻠﺴﻜﺎﻥ ﻋﺎﻡ‬
‫‪ ١٩٧٣‬ﻭﰎ ﺇﻋﺎﺩﺓ ﺻﻴﺎﻏﺘﻬﺎ ﻋﺎﻡ ‪ ،١٩٧٥‬ﺁﺧﺬﺓ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺍﻷﳘﻴﺔ ﺍﳌﺘﺰﺍﻣﻨﺔ ﻷﺭﺑﻌﺔ ﺃﺑﻌﺎﺩ ﻣﺘﺸﺎﺑﻜﺔ‬
‫ﻟﻠﻤﺸﻜﻠﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﰲ ﻣﺼﺮ‪.‬‬

‫ﺍﻟﻨﻤﻮ ﻭﺍﻟﺘﻮﺯﻳﻊ ﺍﳉﻐﺮﺍﰲ ﻭﺍﳋﺼﺎﺋﺺ ﻭﺍﳍﻴﻜﻞ‬

‫ﻛﺎﻥ ﺗﺒﲎ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﰲ ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ ﻣﺼﺤﻮﺑﺎ ﺑﺰﻳﺎﺩﺓ ﰲ ﺍﻷﻧﺸﻄﺔ ﺍﳊﻜﻮﻣﻴﺔ ﺍﳌﺮﺗﺒﻄﺔ‬
‫ﺑﺘﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪ .‬ﻓﻘﺪ ﺃﻧﺸﺄﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰲ ﺫﻟﻚ ﺍﻟﻮﻗﺖ ﻗﻄﺎﻋﺎ ﻟﺘﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﰎ ﺗﺪﺭﻳﺐ‬
‫ﻣﻮﻇﻔﻲ ﺍﳊﻜﻮﻣﺔ ﻋﻠﻰ ﺇﺩﺍﺭﺓ ﺑﺮﻧﺎﻣﺞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪ .‬ﻛﺬﻟﻚ ﰎ ﺗﻨﻔﻴﺬ ﻣﺸﺮﻭﻉ ﺍﻹﻋﻼﻡ ﻭﺍﻟﺘﻌﻠﻴﻢ‬
‫ﻭﺍﻻﺗﺼﺎﻝ ﺑﻮﺍﺳﻄﺔ ﻣﺮﻛﺰ ﰎ ﺗﺄﺳﻴﺴﻪ ﻟﻠﻬﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻼﺳﺘﻌﻼﻣﺎﺕ‪ ،‬ﻭﻳﻬﺪﻑ ﺇﱃ ﺯﻳﺎﺩﺓ ﻭﻋﻰ ﺍﻟﻌﺎﻣﺔ‬
‫ﺑﺘﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪.‬‬
‫ﻭﻗﺪ ﰎ ﺇﺻﺪﺍﺭ ﺗﻌﺪﻳﻞ ﻋﻠﻰ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻋﺎﻡ ‪ ،١٩٨٠‬ﻭﺭﻛﺰ ﺑﺸﻜﻞ ﺃﻛﱪ ﻋﻠﻰ ﺍﻻﺗﺼﺎﻝ ﺍﳌﺒﺎﺷﺮ‬
‫ﺑﲔ ﺍﻷﻓﺮﺍﺩ ﻭﺍﻷﻧﺸﻄﺔ ﺍﶈﻠﻴﺔ ﻟﺘﺸﺠﻴﻊ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪ .‬ﻭﻭﺿﻌﺖ ﺛﺎﻟﺚ ﺳﻴﺎﺳﺔ ﺳﻜﺎﻧﻴﺔ ﻗﻮﻣﻴﺔ‬
‫)ﺍﳊﺎﻟﻴﺔ( ﻋﻘﺐ ﺇﻧﺸﺎﺀ ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻠﺴﻜﺎﻥ ﰲ ﻣﻨﺘﺼﻒ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ‪ .‬ﻭﻗﺪ ﺭﻛﺰﺕ ﻫﺬﻩ ﺍﻟﺴﻴﺎﺳﺔ‬
‫ﻣﺮﺓ ﺃﺧﺮﻯ ﻋﻠﻰ ﺧﻄﻮﺭﺓ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻭﺇﺩﺭﺍﻙ ﺍﻟﺘﻔﺎﻋﻞ ﺑﲔ ﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﺘﻨﻤﻴﺔ‪.‬‬
‫ﻣﺆﺧﺮﺍ ﻭﺑﻨﺎﺀ ﻋﻠﻰ ﺗﻮﺻﻴﺎﺕ ﺍﳌﺆﲤﺮ ﺍﻟﺪﻭﱄ ﻟﻠﺴﻜﺎﻥ ﻭﺍﻟﺘﻨﻤﻴﺔ )‪ (ICPD‬ﺍﻟﺬﻱ ﻋﻘﺪ ﺑﺎﻟﻘﺎﻫﺮﺓ ﻋﺎﻡ ‪،١٩٩٤‬‬
‫ﰎ ﺗﻮﺳﻴﻊ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﲢﻘﻴﻖ ﺍﻷﻫﺪﺍﻑ ﺍﻟﺴﻜﺎﻧﻴﺔ ﺍﳌﺼﺮﻳﺔ ﻟﺘﺸﻤﻞ ﺗﻮﺍﻓﺮ ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ‬
‫ﻭﺗﺄﻳﻴﺪ ﳎﻬﻮﺩﺍﺕ ﺍﻟﺘﻨﻤﻴﺔ ﺍﶈﻠﻴﺔ ﻟﻠﻤﻨﻈﻤﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ‪ .‬ﻛﻤﺎ ﺭﻛﺰﺕ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﳉﺪﻳﺪﺓ ﻋﻠﻰ‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﺑﺘﻌﻠﻴﻢ ﺍﳌﺮﺃﺓ ﻭﻧﺎﺩﺕ ﺑﺰﻳﺎﺩﺓ ﻓﺮﺹ ﺍﻟﻌﻤﻞ ﻟﻠﺴﻴﺪﺍﺕ ﻟﺘﻘﻠﻴﻞ ﺍﻟﻔﺠﻮﺓ ﺍﻟﻨﻮﻋﻴﺔ‪.‬‬
‫ﰲ ﻳﻨﺎﻳﺮ ‪ ،١٩٩٦‬ﺃﺻﺒﺤﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ )‪ ،(MOHP‬ﻟﺘﻌﻜﺲ ﺍﳌﺴﺌﻮﻟﻴﺔ‬
‫ﺍﳌﺘﺰﺍﻳﺪﺓ ﻷﻧﺸﻄﺔ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺴﻜﺎﱐ‪.‬‬
‫ﻭﺍﺳﺘﺠﺎﺑﺔ ﻟﻼﻋﺘﺒﺎﺭﺍﺕ ﺍﻟﱵ ﰎ ﺇﻋﻼ‪‬ﺎ ﰲ ﻣﺆﲤﺮ ﺍﻟﻘﺎﻫﺮﺓ‪ ،‬ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺪﻣﺞ ﺧﺪﻣﺎﺕ‬
‫ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ ﰲ ﺑﺮﻧﺎﻣﺞ ﺃﻭﺳﻊ‪ ،‬ﻫﻮ ﺑﺮﻧﺎﻣﺞ "ﺻﺤﺔ ﺍﳌﺮﺃﺓ"‪ .‬ﻛﻤﺎ ﰎ ﺍﻟﺘﻮﺳﻊ ﰲ‬
‫ﺧﺪﻣﺎﺕ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﺧﺎﺻﺔ ﶈﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ﻭﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‪ .‬ﻭﻛﺠﺰﺀ ﻣﻦ ﻫﺬﻩ ﺍ‪‬ﻬﻮﺩﺍﺕ‪ ،‬ﻗﺎﻣﺖ‬
‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺘﺠﺪﻳﺪ ﻣﻌﻈﻢ ﺍﻟﻌﻴﺎﺩﺍﺕ ﻭﺇﺿﺎﻓﺔ ﺃﻛﺜﺮ ﻣﻦ ‪ ٣٠٠‬ﻋﻴﺎﺩﺓ ﺗﻨﻈﻴﻢ ﺃﺳﺮﺓ ﻣﺘﻨﻘﻠﺔ‬
‫ﻟﺘﺤﺴﲔ ﺗﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ‪.‬‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ ﻭﻣﻊ ﻣﻄﻠﻊ ﺍﻷﻟﻔﻴﺔ ﺍﳉﺪﻳﺪﺓ‪ ،‬ﰎ ﺇﻧﺸﺎﺀ "ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻠﻤﺮﺃﺓ"‪ .‬ﻭﻳﻬﺪﻑ ﺍ‪‬ﻠﺲ‬
‫ﺃﺳﺎﺳﺎ ﺇﱃ ﺯﻳﺎﺩﺓ ﺩﻭﺭ ﺍﳌﺮﺃﺓ ﰲ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺼﺮﻱ ﻭﺗﻘﻠﻴﻞ ﺍﻟﻔﺠﻮﺓ ﺑﲔ ﺍﻟﺮﺟﻞ ﻭﺍﳌﺮﺃﺓ ﰲ ﲨﻴﻊ ﺍ‪‬ﺎﻻﺕ‬
‫)ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﺍﻟﻌﻤﻞ‪ ..‬ﺍﱁ(‪.‬‬

‫‪١٥‬‬
 ‫)( '&‪# $ %‬‬
‫ﺗﻌﺘﱪ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺍﳌﻮﺿﻮﻋﺎﺕ ﺫﺍﺕ ﺍﻷﳘﻴﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺼﺮﻳﲔ ﻭﺍﻟﻘﻴﺎﺩﺍﺕ‬
‫ﺍﻟﺴﻴﺎﺳﻴﺔ‪ ،‬ﻭﻛﻤﺎ ﻫﻮ ﺍﳊﺎﻝ ﰲ ﻛﺜﲑ ﻣﻦ ﺍﻟﺒﻠﺪﺍﻥ‪ ،‬ﺗﻮﺍﺟﻪ ﻣﺼﺮ ﺍﺧﺘﻴﺎﺭﺍﺕ ﺻﻌﺒﺔ ﰲ ﳏﺎﻭﻟﺔ ﺗﻠﺒﻴﺔ‬
‫ﺍﳌﻄﺎﻟﺐ ﻭﺍﻟﺘﻮﻗﻌﺎﺕ ﺍﳌﺘﺰﺍﻳﺪﺓ ﻟﻠﺴﻜﺎﻥ‪.‬‬
‫ﻭﻟﻘﺪ ﺣﻘﻘﺖ ﻣﺼﺮ ﺧﻼﻝ ﺍﳊﻘﺒﺔ ﺍﳌﺎﺿﻴﺔ ﺗﻘﺪﻣﺎ ﺣﻘﻴﻘﻴﺎ ﻭﻣﻠﻤﻮﺳﺎ ﰲ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻠﺴﻜﺎﻥ‬
‫ﻭﺧﻔﺾ ﻧﺴﺒﺔ ﺍﻹﳒﺎﺏ ﺍﻟﻐﲑ ﻣﺮﻏﻮﺏ ﻓﻴﻪ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﻫﺬﻩ ﺍﳌﻜﺎﺳﺐ ﻓﻼ ﻳﺰﺍﻝ ﻫﻨﺎﻙ ﺗﺒﺎﻳﻨﺎﺕ ﻋﺮﻳﻀﺔ‬
‫ﰲ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻛﺬﻟﻚ ﺑﺪﺃﺕ ﺍﻟﺘﺤﺪﻳﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳉﺪﻳﺪﺓ ﰲ ﺍﻟﻈﻬﻮﺭ‪ ،‬ﻭﺳﻮﻑ ﺗﺰﻳﺪ ﻣﻦ ﺍﳊﺎﺟﺔ ﺇﱃ‬
‫ﻋﻼﺝ ﺍﻷﻣﺮﺍﺽ ﻭﺗﻐﻴﲑ ﺍﻟﺴﻠﻮﻙ‪.‬‬
‫ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﻭﺟﻮﺩ ﻣﻔﺎﺭﻗﺎﺕ ﺑﲔ ﻧﺘﺎﺋﺞ ﺍﳌﺴﺢ ﺍﻟﺪﳝﺠﺮﺍﰱ ﺍﻟﺼﺤﻲ ﻟﻌﺎﻡ ‪ (DHS) ١٩٩٥‬ﻭﺍﻟﺘﻘﺎﺭﻳﺮ‬
‫ﺍﳌﻨﺸﻮﺭﺓ ﺑﻮﺍﺳﻄﺔ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ )‪ (CAPMAS‬ﻓﺈﻥ ﻛﻼ ﺍﳌﺼﺪﺭﻳﻦ ﻣﺘﻤﻤﺎﻥ‬
‫ﻟﺒﻌﻀﻬﻤﺎ‪ ،‬ﻭﻳﺆﻛﺪﺍﻥ ﺃﻧﻪ ﺧﻼﻝ ﺍﳊﻘﺒﺔ ﺍﳌﺎﺿﻴﺔ ﰎ ﺇﺣﺮﺍﺯ ﺗﻘﺪﻡ ﻣﻠﻤﻮﺱ ﰲ ﺯﻳﺎﺩﺓ ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻟﻠﻔﺮﺩ‬
‫ﻭﺧﻔﺾ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ‪ ،‬ﻭﻛﺬﻟﻚ ﺧﻔﺾ ﻧﺴﺒﺔ ﺍﳊﻤﻞ ﺍﻟﻐﲑ ﻣﺮﻏﻮﺏ ﻓﻴﻪ‪ ،‬ﺇﻻ ﺃﻥ ﺍﻟﻔﺮﻕ ﻛﺒﲑ ﺑﲔ‬
‫ﳐﺘﻠﻒ ﺍﳌﻨﺎﻃﻖ‪ ،‬ﻭﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‪ ،‬ﻓﻤﺆﺷﺮﺍﺕ ﻭﺣﻀﺮ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ ﺃﻓﻀﻞ ﻣﻦ ﻣﺆﺷﺮﺍﺕ ﺍﻟﻮﺟﻪ‬
‫ﺍﻟﻘﺒﻠﻲ ﻭﻫﺬﺍ ﺍﻻﺧﺘﻼﻑ ﻳﻈﻬﺮ ﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪.‬‬
‫ﻭﺍﳌﺆﺷﺮﺍﺕ ﺍﻟﺘﺎﻟﻴﺔ ﺗﻮﺿﺢ ﺍﻷﻧﺸﻄﺔ ﻭﺍﻟﱪﺍﻣﺞ ﺍﻟﻨﺎﺟﺤﺔ ﰲ ﻣﺼﺮ‪:‬‬
‫‪ -‬ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻟﻠﻔﺮﺩ ﻋﻨﺪ ﺍﻟﻮﻻﺩﺓ ﺣﺎﻟﻴﺎ ﻫﻮ‪ ٦٥,٥‬ﺳﻨﺔ )‪.(١٩٩٢‬‬
‫‪ -‬ﻫﻨﺎﻙ ﺍﳔﻔﺎﺽ ﺑﻨﺴﺒﺔ ‪ %٣٥‬ﰲ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﺧﻼﻝ ﺍﳋﻤﺲ ﻋﺸﺮﺓ ﺳﻨﻪ ﺍﳌﺎﺿﻴﺔ‪،‬‬
‫ﻭﺍﻻﳔﻔﺎﺽ ﰲ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻷﻗﻞ ﻣﻦ ﲬﺲ ﺳﻨﻮﺍﺕ ﻛﺎﻥ ﺃﻛﺜﺮ ﻣﻦ ﺫﻟﻚ ﺑﻜﺜﲑ‪ ،‬ﺣﻴﺚ ﳝﺜﻞ‬
‫‪ %٤٠‬ﻣﻦ ﺍﻻﳔﻔﺎﺽ ﻟﻨﻔﺲ ﺍﻟﻔﺘﺮﺓ‪ ،‬ﻛﻤﺎ ﻳﺒﲔ ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﺍﻟﺪﳝﻮﺟﺮﺍﰱ ﻟﺴﻨﺔ ‪١٩٩٥‬‬
‫)‪ .(DHS‬ﻭﻣﻊ ﺫﻟﻚ‪ ،‬ﻓﺈﻥ ﺍﻻﺧﺘﻼﻑ ﺑﲔ ﻣﺼﺪﺭﻱ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻛﺒﲑ‪ .‬ﻓﺎﻷﺭﻗﺎﻡ ﺣﺴﺐ ﺍﳌﺴــﺢ‬
‫ﺍﻟﺼﺤﻲ ﺍﻟﺪﳝﻮﺟﺮﺍﰱ )‪ (DHS‬ﺃﻛﺜﺮ ﺑﻜﺜﲑ‪ ،‬ﻓﻨﺠﺪ ﺃﻥ ‪ ١٠٠٠/٦٣‬ﻭ‪ ١٠٠٠ /٨١‬ﻟﻮﻓﻴﺎﺕ ﺍﻟﺴﻨﺔ‬
‫ﺍﻷﻭﱃ ﻣﻦ ﺍﻟﻌﻤﺮ )‪ (IMR‬ﻭﺍﻟﻮﻓﻴﺎﺕ ﲢﺖ ﺳﻦ ‪ ٥‬ﺳـــﻨﻮﺍﺕ )‪ (UNDER 5 MR‬ﻋﻠﻰ ﺍﻟﺘﻮﺍﱄ‪،‬‬
‫ﺑﻴﻨﻤﺎ ﺍﻷﺭﻗﺎﻡ ﺣﺴﺐ ﺗﻘﺎﺭﻳﺮ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﳒﺪ ﻓﻴﻬﺎ ﺃﻥ ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﻟﻠﺴﻨﺔ ﺍﻷﻭﱃ‬
‫ﻣﻦ ﺍﻟﻌﻤﺮ )‪ (IMR‬ﻭﺍﻟﻮﻓﻴﺎﺕ ﻷﻗﻞ ﻣﻦ ‪ ٥‬ﺳﻨﻮﺍﺕ )‪ (U-5 MR‬ﻋﻠﻰ ﺍﻟﺘﻮﺍﱄ ﻫﻲ ‪١٠٠٠/٤٠‬‬
‫ﻭ‪ .١٠٠٠/٦٠‬ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﺣﺎﻟﻴﺎ ‪ ١٠٠٠/٤٤‬ﻭﺍﻷﻃﻔﺎﻝ > ‪ ٥‬ﺳﻨﻮﺍﺕ ‪١٠٠٠/٥٤‬‬
‫)‪.(DHS 2000‬‬
‫‪ -‬ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ )ﻭﺍﻟﱵ ﻗﺪﺭﺕ ﰲ ﺍﳌﺴﺢ ﺍﻟﻘﻮﻣﻲ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻟﺴﻨﺔ ‪ (١٩٩٢‬ﻫﻲ‬
‫‪ ١٧٤‬ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﻟﻸﻣﻬﺎﺕ ﻟﻜﻞ ﻣﺎﺋﺔ ﺃﻟﻒ ﻣﻮﻟﻮﺩ ﺣﻲ‪ ،‬ﻭﺻﻞ ﻫﺬﺍ ﺍﳌﻌﺪﻝ ﺇﱃ ‪ ٨٣‬ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﻟﻜﻞ‬
‫‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ ﺳﻨﺔ ‪) ٢٠٠٠‬ﻣﺸﺮﻭﻉ ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ(‪.‬‬
‫‪ -‬ﺍﻧﺘﺸﺎﺭ ﻣﺼﺎﺩﺭ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﺍﺭﺗﻔﺎﻉ ﻧﺴﺒﺔ ﻣﻌﺮﻓﺔ ﺍﻟﻄﺮﻕ ﺍﳌﺨﺘﻠﻔﺔ ﺑﺪﺭﺟﺔ ﺟﻴﺪﺓ‪ ،‬ﻭﺗﺼﻞ‬
‫ﻧﺴﺒﺔ ﺍﳌﺴﺘﺨﺪﻣﺎﺕ ﻟﻮﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﺇﱃ ‪ %٥٦‬ﻣﻦ ﺍﻟﺴﻴﺪﺍﺕ ﺍﳌﺘﺰﻭﺟﺎﺕ‬
‫)‪.(DHS 2000‬‬

‫‪١٦‬‬
‫‪ -‬ﻻﻗﺖ ﺑﻌﺾ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﺃﺳﻴﺔ ﺩﻋﻤﺎ ﻋﺎﳌﻴﺎ ﻛﺒﲑﺍ ﻭﺃﺻﺒﺤﺖ ﻣﻦ ﺍﳋﱪﺍﺕ ﺍﻟﻨﺎﺟﺤﺔ‪،‬‬
‫ﻣﺜﻞ ﺍﻟﱪﻧﺎﻣﺞ ﺍﳌﻮﺳﻊ ﻟﻠﺘﻄﻌﻴﻤﺎﺕ ﻭﺑﺮﻧﺎﻣﺞ ﻣﻜﺎﻓﺤﺔ ﺍﻟﺘﻬﺎﺑﺎﺕ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﺍﳊﺎﺩﺓ‬
‫ﻭﺑﺮﻧﺎﻣﺞ ﻣﻜﺎﻓﺤﺔ ﺍﻹﺳﻬﺎﻝ ﻭﺑﺮﺍﻣﺞ ﺍﻷﻣﻮﻣﺔ ﺍﻵﻣﻨﺔ‪.‬‬

‫ﺟﺪﻭﻝ )‪ :(١-١‬ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﻭﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ‬

‫ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﻭﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﻟﻔﺘﺮﺍﺕ ﲬﺴﻴﺔ ﺳﺎﺑﻘﺔ ﻋﻠﻰ ﺍﳌﺴﺢ‪ ،‬ﻣﺼﺮ ‪٢٠٠٠‬‬
‫ﻣﺮﻛﺰ ﺍﻟﻔﺘﺮﺓ‬ ‫ﺍﻟﺴﻨﻮﺍﺕ‬
‫ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ‬ ‫ﻭﻓﻴﺎﺕ‬ ‫ﻭﻓﻴﺎﺕ‬ ‫ﻭﻓﻴﺎﺕ ﻣﺎ ﺑﻌﺪ‬ ‫ﻭﻓﻴﺎﺕ ﺣﺪﻳﺜﻲ‬
‫ﺍﻟﺘﻘﺮﻳﱯ ﺃﻭ ﺍﻟﻔﺘﺮﺓ‬ ‫ﺍﻟﺴﺎﺑﻘﺔ‬
‫ﺍﳋﺎﻣﺴﺔ ﻣﻦ ﺍﻟﻌﻤﺮ‬ ‫ﺍﻷﻃﻔﺎﻝ‬ ‫ﺍﻟﺮﺿﻊ‬ ‫ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‬ ‫ﺍﻟﻮﻻﺩﺓ‬
‫ﺍﳌﺮﺟﻌﻴﺔ‬ ‫ﻟﻠﻤﺴﺢ‬
‫‪٥٤,٣‬‬ ‫‪١١,٣‬‬ ‫‪٤٣,٥‬‬ ‫‪١٩,٦‬‬ ‫‪٢٤,٠‬‬ ‫‪١٩٩٨‬‬ ‫‪٤-٠‬‬
‫‪٨٤,٢‬‬ ‫‪١٩,٤‬‬ ‫‪٦٦,١‬‬ ‫‪٣٢‬‬ ‫‪٣٤‬‬ ‫‪١٩٩٣‬‬ ‫‪٩-٥‬‬
‫‪١٠٢,٥‬‬ ‫‪٣٠,٥‬‬ ‫‪٧٤,٢‬‬ ‫‪٣٧‬‬ ‫‪٣٧,٢‬‬ ‫‪١٩٨٨‬‬ ‫‪١٤-١٠‬‬
‫‪١٤٠‬‬ ‫‪٤٦,٢‬‬ ‫‪٩٨,٣‬‬ ‫‪٥٤,٣‬‬ ‫‪٤٤‬‬ ‫‪١٩٨٣‬‬ ‫‪١٩-١٥‬‬

‫ﺟﺪﻭﻝ )‪ :(٢-١‬ﺍﳌﻌﺮﻓﺔ ﺑﻮﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‬

‫ﻧﺴﺒﺔ ﺍﻟﺴﻴﺪﺍﺕ ﺍﳌﺘﺰﻭﺟﺎﺕ ﺣﺎﻟﻴﺎ ﰲ ﻓﺌﺔ ﺍﻟﻌﻤﺮ ‪ ٤٩ -١٥‬ﺍﻟﻼﰐ ﻳﻌﺮﻓﻦ ﻭﺳﺎﺋﻞ ﻣﻌﻴﻨﺔ ﻟﺘﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻣﺼﺮ – ‪٢٠٠٠‬‬
‫ﻧﺴﺒﺔ ﺍﻟﺴﻴﺪﺍﺕ ﺍﻟﻼﰐ‬
‫ﺍﻟﻮﺳﻴﻠﺔ‬
‫ﻳﺴﺘﻌﻤﻠﻦ ﺍﻟﻮﺳﻴﻠﺔ )‪(%‬‬
‫‪١٠٠‬‬ ‫ﺃﻱ ﻭﺳﻴﻠﺔ‬
‫‪١٠٠‬‬ ‫ﺃﻱ ﻭﺳﻴﻠﺔ ﺣﺪﻳﺜﺔ‬
‫‪٩٩,٩‬‬ ‫ﺍﳊﺒﻮﺏ‬
‫‪٩٩,٩‬‬ ‫ﺍﻟﻠﻮﻟﺐ‬
‫‪٩٩,٤‬‬ ‫ﺍﳊﻘﻦ‬
‫‪--‬‬ ‫ﺣﺎﺟﺰ ﻣﻬﺒﻠﻲ‬
‫‪٥٨‬‬ ‫ﺃﻗﺮﺍﺹ ﻓﻮﺍﺭﺓ ‪ /‬ﻛﺮﱘ‬
‫‪٦٨,١‬‬ ‫ﺍﻟﻮﺍﻗﻲ ﺍﻟﺬﻛﺮﻯ‬
‫‪٧٤,٩‬‬ ‫ﺗﻌﻘﻴﻢ ﺍﳌﺮﺃﺓ‬
‫‪١٥,٧‬‬ ‫ﺗﻌﻘﻴﻢ ﺍﻟﺮﺟﻞ‬
‫‪٨٣,١‬‬ ‫ﻛﺒﺴﻮﻟﺔ ﲢﺖ ﺍﳉﻠﺪ‬
‫‪٧٧,٨‬‬ ‫ﺃﻱ ﻭﺳﻴﻠﺔ ﺗﻘﻠﻴﺪﻳﺔ‬
‫‪٣٨‬‬ ‫ﻓﺘﺮﺓ ﺍﻷﻣﺎﻥ‬
‫‪٣١,٣‬‬ ‫ﺍﻟﻘﺬﻑ ﺍﳋﺎﺭﺟﻲ‬
‫‪٦٩,٢‬‬ ‫ﺇﻃﺎﻟﺔ ﻓﺘﺮﺓ ﺍﻟﺮﺿﺎﻋﺔ‬
‫‪١,٥‬‬ ‫ﻭﺳﺎﺋﻞ ﺃﺧﺮﻯ‬
‫‪١٤٣٨٢‬‬ ‫ﻋﺪﺩ ﺍﻟﺴﻴﺪﺍﺕ‬

‫‪١٧‬‬
 ‫ﺷﻜﻞ )‪ :(١-١‬ﺗﻄﻮﺭ ﺍﳌﻌﺮﻓﺔ ﺑﺎﻟﻜﺒﺴﻮﻻﺕ ﻭﺍﳊﻘﻦ ﺑﲔ ﺍﻟﺴﻴﺪﺍﺕ ﺍﳌﺘﺰﻭﺟﺎﺕ ﺣﺎﻟﻴﺎ‪ ،‬ﻣﺼﺮ ‪٢٠٠٠- ١٩٩٢‬‬

‫‪100%‬‬
‫‪90%‬‬ ‫‪1992‬‬ ‫‪1995‬‬ ‫‪2000‬‬
‫‪80%‬‬
‫‪70%‬‬
‫‪60%‬‬
‫‪50%‬‬
‫‪40%‬‬
‫‪30%‬‬
‫‪20%‬‬
‫‪10%‬‬
‫‪0%‬‬
‫ﺍﻟﻜﺒﺴﻮﻻﺕ‬ ‫ﺍﳊﻘﻦ‬

‫ﺍﺳﺘﻤﺮﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺧﻼﻝ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﰲ ﺭﻓﻊ ﺷﻌﺎﺭﻫﺎ " ﺍﻟﺼﺤﺔ ﻟﻠﺠﻤﻴﻊ ﲝﻠﻮﻝ ﻋﺎﻡ‬
‫‪ ،"٢٠٠٠‬ﻭﲢﺖ ﻫﺬﺍ ﺍﻟﺸﻌﺎﺭ ﻗﺎﻣﺖ ﺍﳊﻜﻮﻣﺔ ﺑﻮﺿﻊ ﺍﻷﻭﻟﻮﻳﺔ ﻟﻠﻮﻓﺎﺀ ﺑﺎﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻃﻔﺎﻝ‪،‬‬
‫ﻭﺫﻟﻚ ﻋﻘﺐ ﺇﻋﻼﻥ ﺍﻟﺮﺋﻴﺲ ﻣﺒﺎﺭﻙ ﺃﻥ ﺍﻟﻔﺘﺮﺓ ‪ ١٩٩٩ -١٩٨٩‬ﺗﻌﺘﱪ ﻋﻘﺪ ﺗﻨﻤﻴﺔ ﻭﲪﺎﻳﺔ ﺍﻟﻄﻔﻞ ﺍﳌﺼﺮﻱ‪.‬‬
‫ﰲ ﻧﻔﺲ ﺍﻟﻮﻗﺖ ﰎ ﺗﺄﺳﻴﺲ ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻠﻄﻔﻮﻟﺔ ﻭﺍﻷﻣﻮﻣﺔ ﲢﺖ ﺭﺋﺎﺳﺔ ﻛﻞ ﻣﻦ ﺳﻴﺪﺓ ﻣﺼﺮ ﺍﻷﻭﱃ‬
‫ﻭﺭﺋﻴﺲ ﳎﻠﺲ ﺍﻟﻮﺯﺭﺍﺀ‪ ،‬ﻟﺘﻨﺴﻴﻖ ﺍﳉﻬﻮﺩ ﺑﲔ ﺍﻟﻮﺯﺍﺭﺍﺕ ﰲ ﳎﺎﻝ ﺍﻷﻧﺸﻄﺔ ﺍﳋﺎﺻﺔ ﺑﺎﻷﻃﻔﺎﻝ ﻭﺍﻷﻣﻬﺎﺕ‪.‬‬
‫ﻭﻣﻦ ﺃﺟﻞ ﲢﺴﲔ ﺻﺤﺔ ﺍﻟﻄﻔﻞ‪ ،‬ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺎﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﱪﺍﻣﺞ ﺍﻟﻘﻮﻣﻴﺔ‬
‫ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻹﺳﻬﺎﻝ‪ ،‬ﻭﻋﺪﻭﻯ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﺍﳊﺎﺩﺓ‪ ،‬ﻭﺧﺎﺻﺔ ﺍﻻﻟﺘﻬﺎﺑﺎﺕ ﺍﻟﺮﺋﻮﻳﺔ‪ ،‬ﻭﻧﺸﺮ ﺑﺮﻧﺎﻣﺞ‬
‫ﺗﻄﻌﻴﻢ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻭﻗﺪ ﰎ ﻭﺿﻊ ﺍﻷﻫﺪﺍﻑ ﺍﳋﺎﺻﺔ ﺑﺎﻟﻘﻀﺎﺀ ﻋﻠﻰ ﺷﻠﻞ ﺍﻷﻃﻔﺎﻝ ﻭﺍﻟﺘﻴﺘﺎﻧﻮﺱ ﺍﻟﻮﻟﻴﺪﻯ‬
‫ﻗﺒﻞ ﺣﻠﻮﻝ ﻋﺎﻡ ‪ ٢٠٠٠‬ﻭﻗﺪ ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺘﻮﺟﻴﻪ ﺍﻻﻫﺘﻤﺎﻡ ﺃﻳﻀﺎ ﺇﱃ ﺗﻘﻠﻴﻞ ﻭﻓﻴﺎﺕ‬
‫ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‪ ،‬ﻣﻦ ﺧﻼﻝ ﲢﺴﲔ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ ﻟﻠﻤﻮﺍﻟﻴﺪ ﰲ ﺍﳌﻨﺎﺯﻝ ﻭﺍﻟﻮﺣﺪﺍﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺧﻼﻝ ﺭﻋﺎﻳﺔ ﻣﺎ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ‪.‬‬
‫ﻭﻗﺪ ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪ ،‬ﻋﻘﺐ ﺩﻣﺞ ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﰲ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﺑﺎﻟﺘﺮﻛﻴﺰ‬
‫ﻋﻠﻰ ﺃﳘﻴﺔ ﺩﻣﺞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﺭﻋﺎﻳﺔ ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ‪ .‬ﻭﻗﺪ ﰎ ﺗﺒﲎ ﺳﻴﺎﺳﺔ ﺇﺻﻼﺡ ﻣﺮﺣﻠﻴﺔ‪،‬‬
‫ﻟﺘﻮﺳﻴﻊ ﻗﺎﻋﺪﺓ ﺍﳌﺴﺘﻔﻴﺪﻳﻦ ﺑﺎﻟﺘﺎﻣﲔ ﺍﻟﺼﺤﻲ ﻭﺇﺩﺧﺎﻝ ﺗﻐﲑﺍﺕ ﻟﺘﺤﺴﲔ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﻗﺪ‬
‫ﰎ ﺗﻮﺟﻴﻪ ﺍﻻﻫﺘﻤﺎﻡ ﺇﱃ ﲢﺴﲔ ﺗﻮﺯﻳﻊ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﻛﺬﻟﻚ ﺍﻟﺘﻌﻮﻳﻀﺎﺕ ﺍﻟﱵ‬
‫ﲤﻨـﺢ ﻟﻠﻌﺎﻣﻠﲔ ﺑﺎﻟﺼﺤﺔ‪ .‬ﻛﻤﺎ ﰎ ﺇﺩﺭﺍﻙ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ‪ ،‬ﳉﻤﻊ ﻭﲢﻠﻴﻞ‬
‫ﻭﺗﺴﻬﻴﻞ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﲨﻴﻊ ﺍﳌﺴﺘﻮﻳﺎﺕ ﻭﻗﺪ ﰎ ﺃﺧﺬ ﺍﳋﻄﻮﺍﺕ ﺍﻟﻼﺯﻣﺔ‬
‫ﻟﺘﺮﺳﻴﺦ ﻫﺬﻩ ﺍﻷﻧﺸﻄﺔ‪ ،‬ﻭﻣﻦ ﺍﳌﺘﻮﻗﻊ ﺃﻥ ﻳﻜﻮﻥ ﳉﻤﻴﻊ ﺧﻄﻂ ﺳﻴﺎﺳﺔ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﺗﺄﺛﲑ ﺇﳚﺎﰊ‬
‫ﻋﻠﻰ ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ‪.‬‬

‫‪١٨‬‬
 ‫ﺍﻟﺴﻠﺒﻴﺎﺕ ﺍﳌﻮﺟﻮﺩﺓ ﰲ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ‬
‫‪ .١‬ﻭﺟﻮﺩ ﻣﻔﺎﺭﻗﺎﺕ ﺑﺎﻟﻨﺴﺒﺔ ﳌﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ ﻭﺍﳌﺮﺽ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﺃﻗﻞ ﻣﻦ ﲬﺲ ﺳﻨﻮﺍﺕ ﻭﺣﺪﻳﺜﻲ‬
‫ﺍﻟﻮﻻﺩﺓ ﻭﺍﻷﻣﻬﺎﺕ‪ ،‬ﻭﻫﺬﻩ ﺍﻻﺧﺘﻼﻓﺎﺕ ﺗﺘﻀﺢ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺑﲔ ﺍﻟﻮﺟﻪ‬
‫ﺍﻟﺒﺤﺮﻱ ﻭﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‪.‬‬
‫‪ .٢‬ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺍﻻﳔﻔﺎﺽ ﺍﳌﻠﺤﻮﻅ ﰲ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ > ‪ ٥‬ﺳﻨﻮﺍﺕ‪ ،‬ﻓﺈﻥ ﻫﺬﺍ ﺍﻻﳔﻔﺎﺽ ﻗﺪ ﻭﺻﻞ‬
‫ﳊﺎﻟﺔ ﻣﻦ ﺍﻟﺜﺒﺎﺕ )‪ (PLATEAU‬ﻭﻫﻨﺎﻙ ﺣﺎﺟﺔ ﻟﺘﺮﻛﻴﺰ ﺍﳉﻬﻮﺩ ﳋﻔﺾ ﻭﻓﻴﺎﺕ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ ﺍﻟﱵ‬
‫ﺗﺼﻞ ﺍﻵﻥ ﺇﱃ ‪ %٥٠‬ﻣﻦ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ‪.‬‬
‫‪ .٣‬ﺗﻌﺘﱪ ﻧﻮﻋﻴﺔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ ﺑﻮﺍﺳﻄﺔ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﻌﺎﻣﺔ‪ ،‬ﺩﻭﻥ ﺍﳌﺘﻮﺳﻂ ﻣﻦ ﻭﺟﻬﺔ ﻧﻈﺮ‬
‫ﻣﺴﺘﺨﺪﻣﻲ ﺍﳋﺪﻣﺔ‪ .‬ﻭﻫﺬﺍ ﻳﻮﺿﺢ ﻗﻠﺔ ﺍﺳﺘﺨﺪﺍﻡ ﻫﺬﻩ ﺍﻟﻮﺣﺪﺍﺕ ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﻭﺟﻮﺩ ﺗﻐﻄﻴﺔ ﺟﻴﺪﺓ‪.‬‬
‫ﻫﺬﺍ ﺇﱃ ﺟﺎﻧﺐ ﺍﳔﻔﺎﺽ ﺍﺳﺘﺨﺪﺍﻡ ﺑﻌﺾ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺑﺼﻮﺭﺓ ﺣﺮﺟﺔ‪ :‬ﻣﺜﻞ ﺭﻋﺎﻳﺔ ﻣﺎ ﻗﺒﻞ‬
‫ﺍﻟﻮﻻﺩﺓ‪ ،‬ﻓﻘﺪ ﺑﻠﻐﺖ ﻧﺴﺒﺔ ﺍﳊﻮﺍﻣﻞ ﺍﻟﻼﰐ ﻳﺘﻠﻘﲔ ﺭﻋﺎﻳﺔ ﻣﺎ ﻗﺒﻞ ﺍﻟﻮﻻﺩﺓ ﺣﻮﺍﱄ ‪ %٣٩) %٥٠‬ﺧﺪﻣﺔ ﰲ‬
‫ﺍﻟﻘﻄـــﺎﻉ ﺍﳋﺎﺹ‪%١٣ ،‬ﺧﺪﻣﺎﺕ ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ( ﻭﰱ ﺍﻷﻣﺎﻛﻦ ﺍﻟﺮﻳﻔﻴﺔ ﺗﻜﻮﻥ ﻫـﺬﻩ ﺍﻟﻨﺴﺒﺔ ‪%١٥‬‬
‫ﻓﻘﻂ‪.‬‬
‫ﻭﺗﺸﲑ ﻧﺘﺎﺋﺞ ﺍﳌﺴﺢ ﺍﻟﺪﳝﺠﺮﺍﰱ ﺇﱃ ﺍﻧﻪ ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﻏﺎﻟﺒﻴﺔ ﺍﻟﺴﻴﺪﺍﺕ ﻗﻤﻦ ﺑﺰﻳﺎﺭﺓ ﻣﻘﺪﻡ ﺧﺪﻣﺔ‬
‫ﻃﱯ ﰲ ﻓﺘﺮﺓ ﻣﺎ ﺧﻼﻝ ﺍﳊﻤﻞ‪ ،‬ﻓﺈﻥ ﻛﺜﲑﺍ ﻣﻨﻬﻦ ﱂ ﻳﺘﻠﻘﲔ ﺭﻋﺎﻳﺔ ﺷﺎﻣﻠﺔ‪ ،‬ﺃﻱ ﺭﻋﺎﻳﺔ ﲪﻞ‬
‫ﻭﺗﻄﻌﻴﻤﺎﺕ ﺍﻟﺘﻴﺘﺎﻧﻮﺱ‪ ،‬ﻭﺑﺼﻔﺔ ﺧﺎﺻﺔ ﳛﺼﻞ ﻋﺪﺩ ﻟﻴﺲ ﺑﺎﻟﻘﻠﻴﻞ ﻣﻦ ﺍﻟﺴﻴﺪﺍﺕ ﻋﻠﻰ ﺣﻘﻦ‬
‫ﺍﻟﺘﻴﺘﺎﻧﻮﺱ ﺩﻭﻥ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺭﻋﺎﻳﺔ ﲪﻞ‪ ،‬ﻛﻤﺎ ﺃﻥ ﻫﻨﺎﻙ ﻋﺪﺩﺍ ﻣﻦ ﺍﻟﺴﻴﺪﺍﺕ ﺍﻟﻼﰐ ﺯﺭﻥ ﻣﻘﺪﻡ‬
‫ﺧﺪﻣﺔ ﻟﺮﻋﺎﻳﺔ ﻏﲑ ﻣﺘﻌﻠﻘﺔ ﺑﺎﳊﻤﻞ ﻭﲤﺜﻞ ﻫﺆﻻﺀ ﺍﻟﺴﻴﺪﺍﺕ ﻓﺮﺻﺎ ﻟﺘﺤﺴﲔ ﺍﻧﺘﺸﺎﺭ ﺧﺪﻣﺎﺕ ﺭﻋﺎﻳﺔ‬
‫ﺍﳊﻤﻞ‪.‬‬
‫ﺷﻜﻞ )‪ :(٢-١‬ﺍﺳﺘﺸﺎﺭﺓ ﻣﻘﺪﻡ ﺧﺪﻣﺔ ﻃﺒﻴﺔ ﺧﻼﻝ ﺍﳊﻤﻞ‬

‫ﻻ ﺗﻮﺟﺪ ﺭﻋﺎﻳﺔ‬ ‫ﺭﻋﺎﻳﺔ ﲪﻞ ‪ -‬ﺣﻘﻦ ﺍﻟﺘﻴﺘﺎﻧﻮﺱ ﻭ‪/‬ﺃﻭ ﺃﻱ ﺭﻋﺎﻳﺔ ﺃﺧﺮﻯ‬

‫‪ %٥٢ .٤‬ﻣﻦ ﺣﺎﻻﺕ ﺍﻟﻮﺿﻊ ﺗﺘﻢ ﰱ ﺍﳌﱰﻝ‪ ،‬ﻣﻨﻬﻢ ‪ %٧,٤‬ﺗﺘﻠﻘﻰ ﻣﺴﺎﻋﺪﺓ ﺑﻮﺍﺳﻄﺔ ﻣﻮﻟﺪﺍﺕ ﻣﺪﺭﺑﺎﺕ‬
‫ﻭ‪ %٣٥,٥‬ﺗﺘﻠﻘﻰ ﻣﺴﺎﻋﺪﺓ ﻣﻦ ﺩﺍﻳﺎﺕ‪ ،‬ﻭﺩﺭﺍﺳﺎﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﺗﻈﻬﺮ ﺃﻥ ﺣﻮﺍﱃ ‪ %٦٠‬ﻣﻦ ﻭﻓﻴﺎﺕ‬
‫ﺍﻷﻣﻬﺎﺕ ﲢﺪﺙ ﰱ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻄﺒﻴﺔ‪ ،‬ﻭﺃﻥ ‪ %٩٠‬ﻣﻦ ﻫﺬﻩ ﺍﻟﻮﻓﻴﺎﺕ ﺗﻜﻮﻥ ﺑﺴﺒﺐ ﺑﻌﺾ‬
‫ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﱴ ﳝﻜﻦ ﲡﻨﺒﻬﺎ‪.‬‬

‫‪١٩‬‬
‫‪ .٥‬ﺑﻴﻨﻤﺎ ﻳﻈﻬﺮ ﻧﻘﺺ ﺍﻟﺘﻐﺬﻳﺔ ﺍﳊﺎﺩ ﻋﻠﻰ ﺃﻧﻪ ﻣﺸﻜﻠﺔ ﻫﺎﻣﺸﻴﺔ ﺇﻻ ﺃﻥ ﻣﻌﺪﻻﺕ ﺍﻹﻋﺎﻗﺔ ﺑﺎﻟﻨﺴﺒﺔ‬
‫ﻟﻠﻨﻤﻮ ﺗﻌﺘﱪ ﻋﺎﻟﻴﺔ ﺑﺪﺭﺟﺔ ﻏﲑ ﻣﻨﺎﺳﺒﺔ‪ ،‬ﻭﺗﺼﻴﺐ ﺛﻠﺚ ﺍﻷﻃﻔﺎﻝ ﺍﳌﺼﺮﻳﲔ ﲢﺖ ﺳﻦ ‪ ٥‬ﺳﻨﻮﺍﺕ‪،‬‬
‫ﻛﻤﺎ ﺃﻥ ‪ %١٢‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺃﻗﻞ ﻭﺯﻧﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻷﻋﻤﺎﺭﻫﻢ‪ ،‬ﻧﺴﺒﺔ ﺍﻷﻧﻴﻤﻴﺎ ﺗﺼﻞ ﺇﱃ ‪ %٣٨‬ﻣﻦ‬
‫ﺍﻷﻃﻔﺎﻝ ﻗﺒﻞ ﺍﻟﺴﻦ ﺍﳌﺪﺭﺳﻰ‪ %٢٢ ،‬ﺑﲔ ﺍﳊﻮﺍﻣﻞ ﻭﺍﳌﺮﺿﻌﺎﺕ‪ .‬ﻧﻘﺺ ﺍﻟﻴﻮﺩ ﻣﻨﺘﺸﺮ ﺑﺼﻮﺭﺓ‬
‫ﻣﻠﺤﻮﻇﺔ ﰱ ‪ ٩‬ﳏﺎﻓﻈﺎﺕ ﻭﳝﺜﻞ ﺫﻟﻚ ﻣﻠﻴﻮﻧﺎﻥ ﻣﻦ ﺍﻟﺴﻜﺎﻥ‪ ،‬ﻫﺬﺍ ﺍﱃ ﺟﺎﻧﺐ ﻧﻘﺺ ﻓﻴﺘﺎﻣﲔ )ﺃ(‬
‫ﻭﺍﻟﺰﻧﻚ‪.‬‬
‫ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﻻ ﺗﻌﺘﱪ ﻣﺸﻜﻠﺔ ﺑﲔ ﺍﳌﺼﺮﻳﲔ‪ ،‬ﻓﺈﻥ ‪ %٣٤‬ﻓﻘﻂ ﻳﻌﺘﻤﺪ‬
‫ﺍﻋﺘﻤﺎﺩﺍ ﻛﻠﻴﺎ ﻋﻠﻰ ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﺧﻼﻝ ﺃﺭﺑﻌﺔ ﺃﺷﻬﺮ ﺍﻷﻭﱃ ﻣﻦ ﺍﻟﻌﻤﺮ‪.‬‬
‫‪ .٦‬ﲪﻼﺕ ﺍﻟﺘﻮﻋﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺧﺎﺻﺔ ﺍﻟﱴ ﻳﺴﺘﺨﺪﻡ ﻓﻴﻬﺎ ﺍﻟﻮﺳﺎﺋﻞ ﺍﳌﺮﺋﻴﺔ ﺍﳌﺴﻤﻮﻋﺔ)ﺍﻟﺘﻠﻔﺰﻳﻮﻥ(‬
‫ﳍﺎ ﺗﺄﺛﲑ ﻛﺒﲑ ﰱ ﺍﻟﻮﺻﻮﻝ ﻟﻠﻤﺠﺘﻤﻌﺎﺕ ﺍﶈﻠﻴﺔ ﻭﺍﻟﺘﺮﻭﻳﺞ ﻟﺘﻐﻴﲑ ﺍﻟﺴﻠﻮﻛﻴﺎﺕ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺒﻌﺾ‬
‫ﺍﳌﻤﺎﺭﺳﺎﺕ ﻣﺜﻞ ﺍﺳﺘﻌﻤﺎﻝ ﻣﻮﺍﻧﻊ ﺍﳊﻤﻞ‪ ،‬ﻭﺍﺳﺘﻌﻤﺎﻝ ﳏﻠﻮﻝ ﻣﻌﺎﳉﺔ ﺍﳉﻔﺎﻑ‪ ،‬ﻭﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ‬
‫ﺍﻟﺘﻴﺘﺎﻧﻮﺱ ﺍﻟﻮﻟﻴﺪﻯ‪ ،‬ﻭﺍﻷﻫﺘﻤﺎﻡ ﺑﺎﻟﺘﻄﻌﻴﻢ‪ ،‬ﻭﻣﻊ ﺫﻟﻚ ﺃﻇﻬﺮﺕ ﺍﻟﺘﺠﺎﺭﺏ ﺃﻥ ﻫﺬﻩ ﺍﳌﻨﺎﻓﻊ ﲤﻴﻞ ﺍﱃ‬
‫ﺍﻟﺘﻼﺷﻰ ﺳﺮﻳﻌﺎ ﺣﻴﻨﻤﺎ ﻻ ﻳﻘﻮﻡ ﻣﻘﺪﻣﻮ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﺑﺘﻘﻮﻳﺔ ﻫﺬﻩ ﺍﻟﺮﺳﺎﻻﺕ ﻭﺇﺩﺧﺎﻝ‬
‫ﺍﻟﺘﻐﲑﺍﺕ ﺍﳌﻨﺎﺳﺒﺔ ﰱ ﺗﻘﺪﱘ ﺍﻟﺮﻋﺎﻳﺔ ﻭﲢﺴﲔ ﺍﻻﺳﺘﺸﺎﺭﺍﺕ ﺍﻟﺸﺨﺼﻴﺔ‪.‬‬
‫‪ .٧‬ﻳﺘﻄﻮﺭ ﻣﺘﻮﺳﻂ ﻋﻤﺮ ﺍﻟﻔﺮﺩ ﻭﺑﺎﻟﺘﺎﱃ ﺷﻜﻞ ﻭﺗﻮﺯﻳﻊ ﺍﻟﺴﻜﺎﻥ ﻭﺍﻷﻭﺑﺌﺔ ﲟﺼﺮ ﻭﻫﺬﺍ ﻳﺆﺩﻯ ﺇﱃ ﺍﻟﺘﻐﻴﲑ‬
‫ﰱ ﺍﻟﻄﻠﺐ )‪ (DEMAND‬ﻭﺍﳊﺎﺟﺔ )‪ (NEED‬ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﻧﺴﺒﺔ ﺍﻟﺴﻜﺎﻥ > ‪ ١٥‬ﺳﻨﻪ‬
‫ﻣﺎﺯﺍﻟﺖ ﻣﺮﺗﻔﻌﺔ ﺟﺪﺍ )‪ (%٥٧‬ﻭﻋﺪﺩ ﺍﻟﺴﻜﺎﻥ ﻓﻮﻕ ﺳﻦ ﺍﻟﺴﺘﲔ ﻳﻌﺎﺩﻝ ﻓﻘﻂ ﺣﻮﺍﱃ )‪ (%٦‬ﻭﻣﻦ‬
‫ﺍﳌﺘﻮﻗﻊ ﺯﻳﺎﺩﺓ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﻭﺑﺎﻟﺘﺎﱃ ﺳﻮﻑ ﻳﺰﻳﺪ ﻃﻠﺐ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻜﻠﻔﺔ ﻟﻔﺌﺔ ﺍﳌﺴﻨﲔ‬
‫ﻭﻛﺒﺎﺭ ﺍﻟﺴﻦ‪ .‬ﻭﺍﳌﺮﺿﻰ ﺍﻟﺒﺎﻟﻐﻮﻥ ﻳﺴﺘﻬﻠﻜﻮﻥ ﻧﺴﺒﺔ ﻛﺒﲑﺓ ﻣﻦ ﻣﻮﺍﺭﺩ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‪ ،‬ﻭﺍﻹﻧﻔﺎﻕ‬
‫ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﻳﺘﻮﻗﻊ ﳕﻮﻫﺎ ﺳﺮﻳﻌﺎ‪ .‬ﻭﺑﺎﻟﻨﺴﺒﺔ ﻟﻸﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ ﻣﺜﻞ ﺍﻟﻘﻠﺐ‪ ،‬ﻭﺍﻷﻭﻋﻴﺔ ﺍﻟﺪﻣﻮﻳﺔ‬
‫ﻭﺍﻷﻭﺭﺍﻡ ﻭﺍﻟﺴﻜﺮ ﻭﺍﻟﺪﺭﻥ ﻭﺍﻹﺻﺎﺑﺎﺕ‪ ،‬ﻓﻤﺎ ﺯﺍﻟﺖ ﲤﺜﻞ ﻣﺸﺎﻛﻞ ﻛﺒﲑﺓ ﻭﻣﻬﻤﻠﺔ ﺍﱃ ﺣﺪ ﻛﺒﲑ ﻭﲢﺘﺎﺝ‬
‫ﺍﱃ ﺍﳌﻮﺍﺟﻬﺔ ﺍﻟﺼﺮﳛﺔ‪.‬‬
‫ﺇﻥ ﺍﻟﺘﺤﻮﻝ ﺍﻟﻮﺑﺎﺋﻲ ﻭﺍﻟﺬﻱ ﻳﻮﺍﻛﺒﻪ ﺍﻫﺘﻤﺎﻡ ﺃﻛﺜﺮ ﺑﺄﻣﺮﺍﺽ ﺍﻟﺒﺎﻟﻐﲔ ﻭﺍﻻﳔﻔﺎﺽ ﺍﻟﻨﺴﱯ ﰲ ﺍﻷﻣﺮﺍﺽ‬
‫ﺍﳌﻌﺪﻳﺔ ﲢﺪﺙ ﺑﻄﺮﻳﻘﺔ ﻏﲑ ﻣﺘﺠﺎﻧﺴﺔ ﰲ ﺃﻧـﺤﺎﺀ ﻣﺼﺮ‪.‬‬
‫ﻭﻣﻊ ﺫﻟﻚ ﻓﺈﻥ ﺍﻟﺘﻐﻴﲑ ﰲ ﺃﺷﻜﺎﻝ ﺍﳌﺮﺽ ﻭﻫﻴﺎﻛﻞ ﺍﻟﻌﻤﺮ ﻟﻠﺴﻜﺎﻥ ﻫﻲ ﻣﺘﻐﲑﺍﺕ‬
‫ﻫﺎﻣﺔ ﳚﺐ ﺃﺧﺬﻫﺎ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﻋﻨﺪ ﺇﺻﻼﺡ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ‪.‬‬
‫ﺇﱃ ﺟﺎﻧﺐ ﻫﺬﻩ ﺍﳌﺆﺷﺮﺍﺕ ﻫﻨﺎﻙ ﻋﺪﺩ ﻣﻦ ﺍﳌﺆﺷﺮﺍﺕ ﺍﻷﺧﺮﻯ ﺍﻟﱵ ﺗﺒﲔ ﻣﺪﻯ ﺍﳔﻔﺎﺽ ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﳑﺎ ﺟﻌﻞ ﺍﳊﺎﺟﺔ ﻣﻠﺤﺔ ﻭﻋﺎﺟﻠﺔ ﻟﻠﺒﺪﺀ ﰲ ﺗﻨﻔﻴﺬ ﺑﺮﻧﺎﻣﺞ ﻹﺻﻼﺡ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‪ .‬ﻭﻣﻦ‬
‫ﺃﻣﺜﻠﺔ ﻫﺬﻩ ﺍﳌﺆﺷﺮﺍﺕ‪:‬‬
‫‪ -‬ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﺑﺴﺒﺐ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ ﻋﺎﻡ ‪ ١٧٤) ١٩٩٣‬ﻟﻜﻞ ‪ ١٠٠,٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ( )ﻋﻠﻰ‬
‫ﻣﺴﺘﻮﻯ ﺍﳉﻤﻬﻮﺭﻳﺔ( ﻭﻳﺮﺗﻔﻊ ﻫﺬﺍ ﺍﻟﺮﻗﻢ ﰲ ﺑﻌﺾ ﺍﶈﺎﻓﻈﺎﺕ ﻭﺧﺎﺻﺔ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‪.‬‬
‫‪ -‬ﳝﻮﺕ ﻃﻔﻞ ﻣﻦ ﺑﲔ ﻛﻞ ‪ ١٢‬ﻗﺒﻞ ﺃﻥ ﻳﺼﻞ ﺍﳋﺎﻣﺴﺔ ﻣﻦ ﻋﻤﺮﻩ ﻭﻭﺍﺣﺪ ﻣﻦ ﺑﲔ ﻛﻞ ‪ ٧‬ﰲ ﺻﻌﻴﺪ‬
‫ﻣﺼﺮ‪ ،‬ﻭﺫﻟﻚ ﺑﺴﺒﺐ ﺃﻣﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺑﺎﺕ ﺍﻟﺮﺋﻮﻳﺔ ﻭﺍﻹﺳﻬﺎﻝ‪.‬‬

‫‪٢٠‬‬
‫‪ -‬ﺃﻗﻞ ﻣﻦ ‪ %٤٠‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ ﻳﺴﺘﻔﻴﺪﻭﻥ ﻣﻦ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ ،‬ﺳﻮﺍﺀ ﻣﻦ ﺧﻼﻝ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺃﻭ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‪.‬‬
‫‪ %٦٠ -‬ﻣﻦ ﺯﻳﺎﺭﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺗﻜﻮﻥ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ )ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺻﺔ( ﻭﺫﻟﻚ ﻧﺘﻴﺠﺔ‬
‫ﲢﻮﻳﻞ ﺍﻷﻃﺒﺎﺀ ﳌﺮﺿﻰ ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ )‪ (PUBLIC‬ﺇﱃ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﺑﺴﺒﺐ‪:‬‬
‫ﺿﻌﻒ ﺇﻣﻜﺎﻧﻴﺎﺕ ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ )ﺃﺩﻭﻳﺔ ﻭﺃﺟﻬﺰﺓ( ﻧﺘﻴﺠﺔ ﻟﻀﻌﻒ ﺍﻟﺘﺪﺭﻳﺐ ﻭﻋﺪﻡ‬ ‫
‬
‫ﻛﻔﺎﻳﺘﻪ ﻭﺧﺎﺻﺔ ﺍﳉﺰﺀ ﺍﻟﻌﻤﻠﻲ ﻻﻛﺘﺴﺎﺏ ﺍﳌﻬﺎﺭﺍﺕ ﺍﻟﻼﺯﻣﺔ‪.‬‬
‫ﻋﺪﻡ ﺭﺿﺎﺀ ﺍﳉﻤﻬﻮﺭ ﻋﻦ ﺃﺩﺍﺀ ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ‪.‬‬ ‫
‬
‫‪ -‬ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﻋﻠﻰ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﺿﻌﻴﻒ‪ ،‬ﻣﻘﺎﺭﻧﺔ ﺑﺎﳌﻌﺪﻻﺕ ﺍﻟﺪﻭﻟﻴﺔ‪ ،‬ﻭﻻ‬
‫ﻳﻜﻔﻰ ﻟﻠﺘﻮﺳﻊ ﻟﺘﻐﻄﻴﺔ ﺍﻟﻔﺌﺎﺕ ﺍﻟﻔﻘﲑﺓ ﻭﺍﶈﺪﻭﺩﺓ ﺍﻟﺪﺧﻞ ﻣﻊ ﻭﺟﻮﺩ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻜﺎﻧﻴﺔ‬
‫ﻭﻣﻮﺍﺟﻬﺔ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ ﻏﲑ ﺍﳌﻌﺪﻳﺔ ﻭﺍﳌﺮﺗﻔﻌﺔ ﰲ ﺗﻜﺎﻟﻴﻒ ﻋﻼﺟﻬﺎ‪.‬‬
‫‪ -‬ﺍﺭﺗﻔﺎﻉ ﺍﺳﺘﻬﻼﻙ ﺍﻷﺩﻭﻳﺔ ﻭﺍﻹﻧﻔﺎﻕ ﻋﻠﻴﻬﺎ ﻣﻊ ﻭﺟﻮﺩ ﺿﻌﻒ ﰲ ﺍﻟﺮﻗﺎﺑﺔ ﻋﻠﻰ ﻋﺪﺍﻟﺔ ﺍﻟﺘﻮﺯﻳﻊ‪.‬‬
‫‪ %٥٠ -‬ﻣﻦ ﻭﻓﻴﺎﺕ ﺍﳊﺎﻻﺕ ﺍﳊﺮﺟﺔ ﻭﺍﻟﻄﻮﺍﺭﺉ ﻧﺘﻴﺠﺔ ﻋﺪﻡ ﺍﻟﺪﻗﺔ ﰲ ﺍﻟﺘﻌﺎﻣﻞ ﺍﻟﻄﱯ ﻣﻌﻬﺎ‪.‬‬
‫‪ -‬ﺗﻌﺪﺩ ﺍﳉﻬﺎﺕ ﺍﳌﻘﺪﻣﺔ ﻟﻠﺨﺪﻣﺔ ﺣﻴﺚ ﻳﻮﺟﺪ ‪ ٢٩‬ﺟﻬﺔ ﺣﻜﻮﻣﻴﺔ ﻭﺗﺎﺑﻌﺔ ﻟﻠﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﺗﻘﺪﻡ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﻻ ﻳﻮﺟﺪ ﺑﻴﻨﻬﺎ ﺗﻌﺎﻭﻥ ﺃﻭ ﺗﻨﺴﻴﻖ‪.‬‬
‫‪ -‬ﻳﻨﻔﻖ ﺍﻷﺷﺨﺎﺹ ﻭﺍﻟﻌﺎﺋﻼﺕ ﺍﻟﻔﻘﲑﺓ )ﺍﻷﻗﻞ ﺩﺧﻼ( ﻧﺴﺒﺔ ﻛﺒﲑﺓ ﻣﻦ ﺩﺧﻠﻬﻢ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﻣﻘﺎﺭﻧﺔ ﲟﺎ ﻳﺪﻓﻌﻪ ﺍﻟﻘﺎﺩﺭﻭﻥ‪.‬‬

‫‪#   *+,‬‬
‫ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﺍﳊﺎﱄ‪ ،‬ﻧﻈﺎﻡ ﺭﺃﺳﻲ ﳛﺪ ﻣﻦ ﻓﺮﺹ ﺍﻻﺳﺘﻔﺎﺩﺓ ﺑﺄﻓﻀﻞ ﺍﳌﻤﺎﺭﺳﺎﺕ ﺍﻟﻄﺒﻴﺔ ﺍﳊﺪﻳﺜﺔ‬
‫ﺍﻟﱵ ﺗﻌﻤﻞ ﻋﻠﻰ ﲢﻘﻴﻖ ﺍﻟﻜﻔﺎﺀﺓ ﻭﺍﳉﻮﺩﺓ‪ ،‬ﺇﺫ ﺇﻥ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻴﺴﺖ ﻣﺘﺎﺣﺔ ﺟﻐﺮﺍﻓﻴﺎﹰ ﺃﻭ ﻣﺎﻟﻴﺎﹰ‪،‬‬
‫ﺑﺸﻜﻞ ﻋﺎﺩﻝ ﻭﻣﻨﺼﻒ ﺑﲔ ﻓﺌﺎﺕ ﺍﳌﻮﺍﻃﻨﲔ ﺫﻭﻯ ﺍﻟﺪﺧﻮﻝ ﺍﳌﺘﻔﺎﻭﺗﺔ ﰲ ﳐﺘﻠﻒ ﺍﶈﺎﻓﻈﺎﺕ‪ ،‬ﺑﺮﻏﻢ ﺯﻳﺎﺩﺓ‬
‫ﺃﻋﺪﺍﺩ ﺍﻷﻃﺒﺎﺀ ﻭﺃﺳﺮﺓ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺨﺼﺼﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻣﻦ ﺍﳌﺴﺘﻮﻯ ﺍﻟﺜﺎﱐ ﻭﺍﻟﺜﺎﻟﺚ ﰲ ﺍﳌﺪﻥ‬
‫ﻭﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‪ ،‬ﻓﺈﻥ ﺍﻟﺮﻳﻒ ﻭﺍﳌﻨﺎﻃﻖ ﺍﻟﻔﻘﲑﺓ ﺗﻌﺎﱏ ﻣﻦ ﻧﻘﺺ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺯﻳﺎﺩﺓ ﺗﻜﻠﻔﺘﻬﺎ‪،‬‬
‫ﳑﺎ ﻳﺆﻛﺪ ﺿﺮﻭﺭﺓ ﻭﺿﻊ ﺇﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺗﻌﻤﻞ ﻋﻠﻰ ﲢﻘﻴﻖ ﺃﻓﻀﻞ ﻗﻴﻤﺔ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻘﺎﺑﻞ‬
‫ﺍﻷﻣﻮﺍﻝ ﺍﻟﱵ ﺗﻨﻔﻖ ﻋﻠﻴﻬﺎ ﻣﻦ ﻣﻴﺰﺍﻧﻴﺔ ﺍﻟﺪﻭﻟﺔ‪.‬‬
‫ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺈﻋﺪﺍﺩ ﺑﺮﻧﺎﻣﺞ ﻹﺻﻼﺡ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‪ ،‬ﺳﺎﻫﻢ ﻓﻴﻪ ﻛﺜﲑ ﻣﻦ ﺍﳋﱪﺍﺀ‬
‫ﻣﻦ ﺩﺍﺧﻞ ﻭﺧﺎﺭﺝ ﻣﺼﺮ‪ .‬ﻭﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﻳﻌﲎ ﺍﻟﺒﻨﺎﺀ ﻋﻠﻰ ﺍﻹﳚﺎﺑﻴﺎﺕ ﺍﳌﻮﺟﻮﺩﺓ ﰲ ﺍﻟﻨﻈﺎﻡ ﺍﳊﺎﱄ‪،‬‬
‫ﻭﺇﺻﻼﺡ ﻭﺗﻘﻮﱘ ﺟﻮﺍﻧﺐ ﺍﻟﻀﻌﻒ ﻭﺍﻟﺴﻠﺒﻴﺎﺕ ﻣﻦ ﺃﺟﻞ ﺍﻟﻮﺻﻮﻝ ﻭﺇﳒﺎﺯ ﺍﻷﻫﺪﺍﻑ ﺍﻟﺼﺤﻴﺔ ﻭﻣﻦ ﺃﺟﻞ‬
‫ﺍﻟﺘﻨﺴﻴﻖ ﻭﺍﻟﺘﻌﺎﻭﻥ ﺑﲔ ﲨﻴﻊ ﻗﻄﺎﻋﺎﺕ ﺍﻟﺪﻭﻟﺔ‪ ،‬ﻟﺬﻟﻚ ﻓﺈﻥ ﺑﺮﻧﺎﻣﺞ ﺇﺻﻼﺡ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ‬
‫ﻳﻌﻤﻞ ﻋﻠﻰ ﺗﺸﺠﻴﻊ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ ﻟﺘﺪﻋﻴﻢ ﺃﻫﺪﺍﻑ ﺍﻟﺼﺤﺔ‪.‬‬

‫‪٢١‬‬
 ‫ﻭﺍﳌﺒﺎﺩﺉ ﺍﻷﺳﺎﺳﻴﺔ ﻟﱪﻧﺎﻣﺞ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﻫﻲ‪:‬‬
‫ﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ )‪ :(Universality‬ﻭﺗﻌﲎ ﺗﻐﻄﻴﺔ ﲨﻴﻊ ﺍﳌﻮﺍﻃﻨﲔ ﲟﺠﻤﻮﻋﺔ ﻣﺘﻜﺎﻣﻠﺔ ﻣﻦ‬ ‫
‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﺫﺍﺕ ﺍﻷﻭﻟﻮﻳﺔ ﲝﻴﺚ ﻳﻜﻮﻥ ﻟﻜﻞ ﻓﺮﺩ ﰲ ﺃﻱ ﻣﻜﺎﻥ ﻧﻔﺲ ﺍﻟﻔﺮﺻﺔ ﺍﳌﺘﻜﺎﻓﺌﺔ‬
‫ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺍﻻﺳﺘﻔﺎﺩﺓ ﻣﻨﻬﺎ‪.‬‬
‫ﺍﳉﻮﺩﺓ )‪ :(Quality‬ﻭﻫﻲ ﺿﻤﺎﻥ ﻭﲢﺴﲔ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﺃﻳﻀﺎ ﺃﻣﺎﻛﻦ ﺗﻘﺪﱘ‬ ‫
‬
‫ﺍﳋﺪﻣﺎﺕ )ﺍﻟﻮﺣﺪﺍﺕ ‪ /‬ﺍﳌﺴﺘﺸﻔﻴﺎﺕ( ﻟﺘﻌﻈﻴﻢ ﺍﻟﻘﺪﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﻭﺍﻹﻛﻠﻴﻨﻴﻜﻴﺔ ﻭﺭﻓﻊ‬
‫ﻣﺴﺘﻮﻯ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ ﻭﺍﻟﺘﻤﺮﻳﻀﻲ ﻭﺍﻟﺘﺪﺭﻳﺐ ﺃﺛﻨﺎﺀ ﺍﳋﺪﻣﺔ‪.‬‬
‫ﺍﻟﻌﺪﺍﻟﺔ )‪ :(Equity‬ﲤﻮﻳﻞ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻳﻌﺘﻤﺪ ﻋﻠﻰ ﺍﻟﻘﺪﺭﺓ ﻋﻠﻰ ﺩﻓﻊ ﺍﻟﺘﻜﻠﻔﺔ‪ ،‬ﺑﻴﻨﻤﺎ‬ ‫
‬
‫ﻳﻌﺘﻤﺪ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﻋﻠﻰ ﺍﳊﺎﺟﺔ ﺇﻟﻴﻬﺎ؛ ﻟﺬﺍ ﺳﻮﻑ ﻳﻜﻮﻥ ﻟﻜﻞ ﺍﳌﻨﺎﻃﻖ ﻭﺍﻷﻓﺮﺍﺩ ﻧﺼﻴﺐ ﻋﺎﺩﻝ‬
‫ﰲ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﺍﻟﻜﻔﺎﺀﺓ )‪ :(Efficiency‬ﲣﺼﻴﺺ ﻭﺗﻮﺯﻳﻊ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺎﻟﻴﺔ ﻭﺍﻟﺒﺸﺮﻳﺔ ﻭﺍﳌﻨﺸﺂﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺑﻨﺎﺀ‬ ‫
‬
‫ﻋﻠﻰ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﳌﻮﺍﻃﻨﲔ ﻭﺯﻳﺎﺩﺓ ﺍﻟﻔﺎﻋﻠﻴﺔ ﻣﻘﺎﺑﻞ ﺍﻟﺘﻜﻠﻔﺔ )‪ (Cost Effectiveness‬ﲝﻴﺚ‬
‫ﲢﺼﻞ ﺍﳊﻜﻮﻣﺔ ﻭﺍﳌﻮﺍﻃﻨﻮﻥ ﻋﻠﻰ ﺃﻛﱪ ﻗﻴﻤﺔ ﺻﺤﻴﺔ ﻣﻘﺎﺑﻞ ﻣﺎ ﻳﻨﻔﻖ ﻣﻦ ﺃﻣﻮﺍﻝ‪.‬‬
‫ﺍﻻﺳﺘﻤﺮﺍﺭﻳﺔ )‪ :(Sustainability‬ﻭﺗﻌﲎ ﺿﻤﺎﻥ ﺩﻭﺍﻡ ﻧﻈﺎﻡ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﻭﺧﺪﻣﺎﺗﻪ‬ ‫
‬
‫ﻭﻛﻔﺎﺀﺗﻪ ﺍﻟﺬﺍﺗﻴﺔ ﻟﺼﺎﱀ ﺻﺤﺔ ﺍﳌﻮﺍﻃﻨﲔ ﻭﺧﺎﺻﺔ ﺍﻷﺟﻴﺎﻝ ﺍﻟﻘﺎﺩﻣﺔ‪.‬‬

‫ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ‬

‫ﺑﺮﻧﺎﻣﺞ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﻋﻤﻠﻴﺔ ﻣﺘﺸﺎﺑﻜﺔ ﻭﻣﺴﺘﻤﺮﺓ ﲢﺘﺎﺝ ﺇﱃ ﻗﻴﺎﺩﺓ ﺣﻜﻮﻣﻴﺔ ﻭﺗﻌﺎﻭﻥ ﺑﲔ ﺍﻟﻘﻄﺎﻉ‬
‫ﺍﻟﺼﺤﻲ ﺍﳊﻜﻮﻣﻲ )ﺍﻟﻌﺎﻡ( ﻭﺍﳋﺎﺹ ﻭﻣﺸﺎﺭﻛﺔ ﺍ‪‬ﺘﻤﻊ‪.‬‬
‫ﻭﺑﺮﻧﺎﻣﺞ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﻳﻘﺪﻡ ﺭﺅﻳﺔ ﻭﺧﻄﺔ ﻣﺴﺘﻘﺒﻠﻴﺔ ﰲ ﺍﻟﻌﻘﺪﻳﻦ ﺍﻟﻘﺎﺩﻣﲔ ﻟﻠﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ‬
‫ﻣﺒﻨﻴﺔ ﻋﻠﻰ ﻭﺍﻗﻊ ﻣﺼﺮ ﺍﻟﻴﻮﻡ ﻭﺁﻣﺎﻝ ﻭﺭﻏﺒﺎﺕ ﺍﻟﺸﻌﺐ ﺍﳌﺼﺮﻱ ﻭﻗﻴﺎﺩﺍﺗﻪ‪.‬‬
‫ﻭﻣﺮﺣﻠﺔ ﺍﻟﺴﻨﻮﺍﺕ ﺍﳋﻤﺲ ﺍﻷﻭﱃ )‪ (٢٠٠٣– ١٩٩٨‬ﻣﻦ ﺍﻹﺻﻼﺡ ﲤﻬﺪ ﻟﻠﺘﻮﺟﻪ ﻟﻠﻬﺪﻑ ﺍﻟﻨﻬﺎﺋﻲ‬
‫ﻟﻠﺘﻐﻄﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ‪ ،‬ﻭﺗﺒﺪﺃ ﺑﺎﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺟﺪﻳﺪﺓ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ ،‬ﺗﺸﻤﻞ ﺑﺮﺍﻣﺞ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ‬
‫ﻭﺭﻓﻊ ﺍﳌﺴﺘﻮﻯ ﺍﻟﺼﺤﻲ ﻭﻋﻼﺝ ﺍﳌﺸﻜﻠﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ ﻣﺘﻀﻤﻨﺔ ﺃﻭﺟﻪ ﺍﻟﻌﻼﺝ‬
‫ﺩﺍﺧﻞ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭ‪‬ﺪﻑ ﺍﻟﻮﺯﺍﺭﺓ ﺇﱃ ﺃﻥ ﺗﻌﺪ ﺧﻄﺔ ﺧﺪﻣﺎﺕ ﺭﻋﺎﻳﺔ ﺃﺳﺎﺳﻴﺔ ﺫﺍﺕ ﺟﻮﺩﺓ ﻭﻓﺎﻋﻠﻴﺔ ﻋﺎﻟﻴﺔ‬
‫ﺗﺴﺘﻄﻴﻊ ﺍﻟﺪﻭﻟﺔ ﲢﻤﻞ ﺗﻜﻠﻔﺘﻬﺎ )ﳎﻤﻮﻋﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ( )‪.(Basic Benefit Package‬‬
‫ﻭﺣﺎﻟﻴﺎ ﻳﺒﺤﺚ ﺃﻏﻠﺐ ﺍﳌﻮﺍﻃﻨﲔ ‪ -‬ﲟﺎ ﻓﻴﻬﻢ ﺫﻭﻭ ﺍﻟﺪﺧﻮﻝ ﺍﻟﻀﻌﻴﻔﺔ ‪ -‬ﻋﻦ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﰲ‬
‫ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﻷﻥ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﻭﻟﻴﺔ ﺍﳊﻜﻮﻣﻴﺔ ﻏﲑ ﻛﺎﻓﻴﺔ ﻭﻳﺸﻌﺮ ﻛﺜﲑﻭﻥ ﺃﻥ ﻛﻔﺎﺀ‪‬ﺎ ﺩﻭﻥ‬
‫ﺍﳌﻄﻠﻮﺏ‪ ،‬ﻭﻳﺘﺤﻤﻞ ﺍﻟﻔﻘﺮﺍﺀ ﻋﺒﺌﺎ ﻛﺒﲑﺍ )ﻣﺎﻟﻴﺎﹰ( ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻣﻦ ﺍﻟﻘﻄﺎﻉ‬
‫ﺍﳋﺎﺹ‪.‬‬
‫ﻭﺍﳍﺪﻑ ﻣﻦ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻫﻮ ﲤﻮﻳﻞ ﻭﺩﻓﻊ ﻣﻘﺎﺑﻞ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‬
‫ﻣﻦ ﺧﻼﻝ ﻛﻴﺎﻥ ﺗﺄﻣﻴﲏ ﻣﻮﺣﺪ ﳚﻤﻊ ﺑﲔ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ‪.‬‬

‫‪٢٢‬‬
‫ﻭﻫﺬﻩ ﺍﻟﻄﺮﻳﻘﺔ ﻟﻠﺘﻤﻮﻳﻞ ﻣﻦ ﺍﳌﺘﻮﻗﻊ ﺃﻥ ﺗﺘﻴﺢ ﺣﺴﻦ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻷﻣﻮﺍﻝ ﺍﳌﺘﺎﺣﺔ‪ ،‬ﻭﲡﻌﻠﻬﺎ ﺃﻛﺜﺮ ﻓﺎﻋﻠﻴﺔ‬
‫ﻭﲣﻔﺾ ﺇﻧﻔﺎﻕ ﺫﻭﻯ ﺍﻟﺪﺧﻮﻝ ﺍﻟﺼﻐﲑﺓ ﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﻗﺪ ﻭﺟﺪ ﺃﻧﻪ ﻣﻦ ﺍﻟﻀﺮﻭﺭﻱ‬
‫ﲢﺴﲔ ﺍﻟﺮﻗﺎﺑﺔ ﻋﻠﻰ ﺟﻮﺩﺓ ﻭﻓﺎﻋﻠﻴﺔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺘﻌﺮﻑ ﻋﻠﻰ ﺭﺃﻯ ﺍﳌﻨﺘﻔﻌﲔ ﺑﺎﳋﺪﻣﺔ‪ ،‬ﻭﺃﻥ ﻓﺼﻞ‬
‫ﺍﻟﺘﻤﻮﻳﻞ ﻋﻦ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﻳﻌﻄﻰ ﺍﳌﻨﺘﻔﻌﲔ ﺣﻖ ﺍﺧﺘﻴﺎﺭ ﻣﻘﺪﻡ ﺍﳋﱪﺓ ﻭﻻ ﻳﻠﺰﻣﻬﻢ ﲟﻘﺪﻡ ﺧﺪﻣﺔ‬
‫ﺻﺤﻴﺔ ﻣﻌﲔ ﺃﻭ ﲜﻬﺔ ﳏﺪﺩﺓ‪ ،‬ﻭﻳﻜﻮﻥ ﻟﺪﻯ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺎﺕ ﻣﻦ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ ﺣﺎﻓﺰ ﺃﻛﱪ‬
‫ﻟﺘﺤﺴﲔ ﺟﻮﺩﺓ ﺧﺪﻣﺎ‪‬ﻢ ﻭﺍﺟﺘﺬﺍﺏ ﺍﳌﺮﺿﻰ ﻭﺍﻻﺣﺘﻔﺎﻅ ‪‬ﻢ‪ ،‬ﻭﺭﺿﺎﺀ ﻛﻞ ﻣﻦ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﻭﺍﳌﻨﺘﻔﻌﲔ ‪‬ﺎ‪.‬‬
‫ﻭﻓﺼﻞ ﻣﻬﺎﻡ ﺍﻟﺘﻤﻮﻳﻞ ﻋﻦ ﺗﻘﺪﱘ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺳﻴﺴﻤﺢ ﻟﻜﻞ ﺟﻬﺎﺯ ﺻﺤﻲ ﺑﺘﻨﻤﻴﺔ‬
‫ﻣﻮﺍﺭﺩﻩ ﻭﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺗﻄﻮﻳﺮ ﺍﳋﺪﻣﺎﺕ‪.‬‬
‫ﲤﺸﻴﺎ ﻣﻊ ﺍﻷﻫﺪﺍﻑ ﻭﺍﳌﺒﺎﺩﺉ ﺍﻷﺳﺎﺳﻴﺔ ﻟﱪﻧﺎﻣﺞ ﺇﺻﻼﺡ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﲜﻤﻬﻮﺭﻳﺔ ﻣﺼﺮ ﺍﻟﻌﺮﺑﻴﺔ‪،‬‬
‫ﻓﺈﻥ ﺍﳍﺪﻑ ﻫﻮ ﺇﳚﺎﺩ ﺧﺪﻣﺎﺕ ﺭﻋﺎﻳﺔ ﺃﻭﻟﻴﺔ ﻓﻌﺎﻟﻪ ﻭﺫﺍﺕ ﺟﻮﺩﺓ ﻋﺎﻟﻴﺔ ﺗﺴﺘﻄﻴﻊ ﺍﻟﺪﻭﻟﺔ ﺃﻥ ﺗﺘﺤﻤﻞ‬
‫ﺗﻜﻠﻔﺘﻬﺎ‪ ،‬ﻭﺗﻘﺪﻡ ﻣﺴﺘﻮﻯ ﺟﻴﺪﺍ ﻣﻦ ﺍﳌﻜﺎﺳﺐ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻤﻮﺍﻃﻨﲔ‪ ،‬ﻭﺗﻮﺯﻉ ﺗﻠﻚ ﺍﳌﻜﺎﺳﺐ ﻭﻣﺎ‬
‫ﻳﺼﺎﺣﺒﻬﺎ ﻣﻦ ﺗﻜﻠﻔﺔ ﺑﻌﺪﺍﻟﺔ ﻋﻠﻰ ﺍﻷﻓﺮﺍﺩ ﺣﺴﺐ ﺍﺣﺘﻴﺎﺟﺎ‪‬ﻢ ﻭﻗﺪﺭﺍ‪‬ﻢ ﻋﻠﻰ ﺩﻓﻊ ﺍﻟﺘﻜﻠﻔﺔ‪.‬‬
‫ﻭﺍﳌﻮﺍﺭﺩ ﺍﳌﺘﺎﺣﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻷﻭﻟﻴﺔ ﺗﺮﻛﺰ ﻋﻠﻰ ﳎﻤﻮﻋﺔ ﳏﺪﺩﺓ ﻣﻦ ﺍﳋــﺪﻣﺎﺕ ﺫﺍﺕ ﺍﻷﻭﻟﻮﻳﺔ "ﳎﻤﻮﻋﺔ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ" ﻭﺍﻟﱵ ﺳﻮﻑ ﻳﺴﺘﻔﻴﺪ ﻣﻨﻬﺎ ﻛﻞ ﻣﻮﺍﻃﻦ‪ ،‬ﺧﺎﺻﺔ ﻣﻦ ﻫﻮ ﰲ ﺣﺎﺟﺔ‬
‫ﺷﺪﻳﺪﺓ ﺇﻟﻴﻬﺎ ﻣﺜﻞ ﺍﻟﻨﺴﺎﺀ ﻭﺍﻷﻃﻔﺎﻝ‪ ،‬ﻭﻳﻨﺘﺞ ﻋﻨﻬﺎ ﺃﻛﱪ ﺧﻔﺾ ﻷﻋﺒﺎﺀ ﺍﳌﺮﺽ ﻭﻣﺎ ﻳﺘﻢ ﺇﻧﻔﺎﻗﻪ ﻋﻠﻰ‬
‫ﺍﻟﺮﻋﺎﻳﺔ‪ ،‬ﻭﻛﺬﻟﻚ ﻳﺴﺎﻫﻢ ﰲ ﺗﻘﻠﻴﻞ ﺍﻟﺘﺒﺎﻳﻦ ﺑﲔ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﺍﻟﺮﻳﻔﻴﺔ‪.‬‬
‫ﻭﺣﻴﺚ ﺇﻧﻪ ﻻ ﳝﻜﻦ ﻭﺍﻗﻌﻴﺎ ﺃﻥ ﺗﻜﻮﻥ ﻛﻞ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﺘﺎﺣﺔ ﻋﻠﻰ ﻛﺎﻓﺔ ﻣﺴﺘﻮﻳﺎﺕ ﺍﳋﺪﻣﺔ ﰲ ﺃﻱ‬
‫ﺩﻭﻟﺔ‪ ،‬ﻓﺈﻧﻪ ﳚﺐ ﻭﺿﻊ ﺃﻭﻟﻮﻳﺎﺕ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ﳚﺐ ﺇﺗﺎﺣﺘﻬﺎ ﻭﺗﻮﻓﲑﻫﺎ ﻣﺒﺎﺷﺮﺓ ﰲ ﻭﺣﺪﺍﺕ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﺃﻭ ﺑﻄﺮﻳﻖ ﻏﲑ ﻣﺒﺎﺷﺮ‪ ،‬ﻣﻦ ﺧﻼﻝ ﻧﻈﺎﻡ ﺍﻹﺣﺎﻟﺔ ﺇﱃ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﻷﻋﻠﻰ‪.‬‬
‫ﻭﻋﻨﺪ ﺍﺧﺘﻴﺎﺭ ﺍﳋﺪﻣﺎﺕ ﺍﻟﱵ ﺗﺪﺧﻞ ﰲ ﳎﻤﻮﻋﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﰲ ﻣﺼﺮ ﰎ ﻣﺮﺍﻋﺎﺓ‬
‫ﺍﳌﻌﺎﻳﲑ ﺍﻵﺗﻴﺔ‪:‬‬
‫‪ -‬ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﳌﻮﺍﻃﻨﲔ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫‪ -‬ﺷﺪﺓ ﺍﻷﻣﺮﺍﺽ ﺍﻟﱵ ﺗﺼﻴﺐ ﺍﳌﻮﺍﻃﻨﲔ‪.‬‬
‫‪ -‬ﺍﻟﻌﻼﻗﺔ ﺑﲔ ﺍﻟﺘﻜﻠﻔﺔ ﻭﺍﻟﻔﺎﻋﻠﻴﺔ ﰲ ﺍﻟﺘﺪﺍﺧﻼﺕ ﺍﻟﱵ ﺗﺘﺨﺬ ﻟﻌﻼﺝ ﺗﻠﻚ ﺍﻷﻣﺮﺍﺽ ﻟﻠﺤﺼﻮﻝ‬
‫ﻋﻠﻰ ﺃﻛﱪ ﻣﻘﺎﺑﻞ ﺻﺤﻲ ﻟﻸﻣﻮﺍﻝ ﺍﻟﱵ ﻳﺘﻢ ﺇﻧﻔﺎﻗﻬﺎ‪.‬‬
‫‪ -‬ﺗﻮﻓﲑ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺎﻟﻴﺔ‪.‬‬
‫ﻭﺗﺸﻤﻞ ﳎﻤﻮﻋﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪:‬‬
‫‪ -‬ﺧﺪﻣﺎﺕ ﺻﺤﺔ ﺍﻟﻄﻔﻞ‪ :‬ﺍﻟﺘﻄﻌﻴﻤﺎﺕ‪ ،‬ﻣﺮﺍﻗﺒﺔ ﳕﻮ ﻭﺗﻄﻮﺭ ﺍﻟﻄﻔﻞ‪ ،‬ﺗﺸﺨﻴﺺ ﻭﻋﻼﺝ ﺍﳊﺎﻻﺕ‬
‫ﺍﳌﺮﺿﻴﺔ ﺍﻟﺸﺎﺋﻌﺔ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺼﻐﺎﺭ ﻭﺭﻋﺎﻳﺔ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‪.‬‬
‫‪ -‬ﺧﺪﻣﺎﺕ ﺻﺤﺔ ﺍﻷﻡ‪ :‬ﺭﻋﺎﻳﺔ ﺍﻷﻡ ﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ‪ ،‬ﺧﺪﻣﺎﺕ ﺍﻟﺘﻮﻟﻴﺪ ﻭﺭﻋﺎﻳﺔ ﺍﻷﻡ ﺃﺛﻨﺎﺀ ﻓﺘﺮﺓ ﺍﻟﻨﻔﺎﺱ‪،‬‬
‫ﺍﻟﺘﺜﻘﻴﻒ ﺍﻟﺼﺤﻲ ﻭﺧﺪﻣﺎﺕ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪.‬‬

‫‪٢٣‬‬
 ‫‪ -‬ﺧﺪﻣﺎﺕ ﺻﺤﻴﺔ ﻣﻘﺪﻣﺔ ﻟﻜﻞ ﺍﻷﻋﻤﺎﺭ‪:‬‬
‫ﻣﻜﺎﻓﺤﺔ ﻭﻋﻼﺝ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ‪.‬‬ ‫
‬
‫ﻋﻼﺝ ﺍﻟﺪﺭﻥ‪.‬‬ ‫
‬
‫ﻋﻼﺝ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻮﻃﻨﺔ‪.‬‬ ‫
‬
‫ﺍﻛﺘﺸﺎﻑ ﻭﻋﻼﺝ ﻋﺪﻭﻯ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎﹰ‪.‬‬ ‫
‬
‫ﻣﻜﺎﻓﺤﺔ ﻭﻋﻼﺝ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ ﻭﺍﻷﻣﺮﺍﺽ ﻏﲑ ﺍﳌﻌﺪﻳﺔ ﻣﺜﻞ‪:‬‬ ‫
‬
‫ﺣﺎﻻﺕ ﺍﻟﺴﻜﺮ ﺍﻟﱵ ﻟﻴﺲ ﳍﺎ ﻣﻀﺎﻋﻔﺎﺕ‪.‬‬ ‫‪o‬‬
‫ﺍﻛﺘﺸﺎﻑ ﻭﻋﻼﺝ ﺿﻐﻂ ﺍﻟﺪﻡ ﺍﳌﺮﺗﻔﻊ‪.‬‬ ‫‪o‬‬
‫ﺍﻛﺘﺸﺎﻑ ﻭﻋﻼﺝ ﺣﺎﻻﺕ ﻗﺼﻮﺭ ﺍﻟﺪﻭﺭﺓ ﺍﻟﺪﻣﻮﻳﺔ‪.‬‬ ‫‪o‬‬
‫ﺍﻛﺘﺸﺎﻑ ﻭﻋﻼﺝ ﺃﻣﺮﺍﺽ ﺍﻟﻌﻴﻮﻥ‪.‬‬ ‫‪o‬‬
‫ﺍﻛﺘﺸﺎﻑ ﻭﻋﻼﺝ ﺍﳊﻤﻴﺎﺕ‪.‬‬ ‫‪o‬‬
‫ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻌﺎﺟﻠﺔ‪.‬‬ ‫‪o‬‬
‫ﺍﳉﺮﺍﺣﺎﺕ ﺍﻟﺼﻐﲑ ﺍﻟﻄﺎﺭﺋﺔ‪.‬‬ ‫‪o‬‬
‫ﻋﻨﺎﺻﺮ ﺍﳌﺴﺎﺭ ﺍﻟﺴﺮﻳﻊ ﻟﱪﻧﺎﻣﺞ ﺍﻹﺻﻼﺡ‬
‫ﻣﻦ ﺍﳌﻌﺮﻭﻑ ﺃﻥ ﻛﺜﲑﺍ ﻣﻦ ﺗﻮﺻﻴﺎﺕ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﺳﻮﻑ ﺗﺄﺧﺬ ﻭﻗﺘﺎ ﻟﻠﺘﻄﺒﻴﻖ ﻭﺳﻴﺘﺄﺛﺮ ﺍﻻﲡﺎﻩ‬
‫ﺍﻟﻨﻬﺎﺋﻲ ﻟﻠﺘﻐﻴﲑ ﰲ ﺍﻟﺘﻨﻈﻴﻢ ﻭﺍﻟﺘﻤﻮﻳﻞ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻷﻭﻟﻴﺔ ﺑﺎﻟﺒﻴﺌﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻟﺴﻴﺎﺳﻴﺔ‬
‫ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ‪ ،‬ﻭﻣﻊ ﺫﻟﻚ ﻓﻬﻨﺎﻙ ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﳋﻄﻮﺍﺕ ﳝﻜﻦ ﺗﻨﻔﻴﺬﻫﺎ ﻟﺘﺴﺎﻫﻢ ﻋﻠﻰ ﺍﳌﺪﻯ ﺍﻟﻘﺼﲑ ﰲ‬
‫ﻋﻤﻠﻴﺔ ﺍﻹﺻﻼﺡ ﺑﻐﺾ ﺍﻟﻨﻈﺮ ﻋﻦ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻭﺍﻻﲡﺎﻩ ﺍﻟﻨﻬﺎﺋﻲ‪.‬‬
‫ﺃﻧﺸﻄﺔ "ﺍﳌﺴﺎﺭ ﺍﻟﺴﺮﻳﻊ" ﺍﳌﻤﻜﻦ ﲤﻮﻳﻠﻬﺎ ﻭﺗﻄﺒﻴﻘﻬﺎ‪:‬‬
‫ﺇﻧﺸﺎﺀ ﳉﻨﺔ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺘﻘﻴﻴﻢ ﻭﻣﺘﺎﺑﻌﺔ ﻋﻤﻠﻴﺔ ﺍﻹﺻﻼﺡ‪.‬‬ ‫‪-‬‬
‫ﲢﺪﻳﺪ ﳎﻤﻮﻋﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﻋﻤﻞ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺑﺪﻳﻠﺔ ﻹﻗﺎﻣﺔ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳌﻄﻠﻮﺑﺔ‪.‬‬ ‫‪-‬‬
‫ﲢﺪﻳﺪ ﻭﺗﻄﺒﻴﻖ ﻗﺎﺋﻤﺔ ﺍﻷﺩﻭﻳﺔ ﺍﻟﻀﺮﻭﺭﻳﺔ ﻟﺪﻋﻢ ﳎﻤﻮﻋﺔ ﺍﳋﺪﻣﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﻭﺿﻊ ﺳﻴﺎﺳﺔ ﻗﻮﻣﻴﺔ ﻟﻠﺪﻭﺍﺀ‪.‬‬ ‫‪-‬‬
‫ﺇﻧﺸﺎﺀ ﻭﺣﺪﺓ ﲢﺴﲔ ﺍﳉﻮﺩﺓ‪.‬‬ ‫‪-‬‬
‫ﻭﺿﻊ ﺧﻄﺔ ﲬﺴﻴﺔ ﻛﺎﻣﻠﺔ ﻟﻠﺘﻤﻮﻳﻞ ﺍﻟﺼﺤﻲ‪.‬‬ ‫‪-‬‬
‫ﻭﺿﻊ ﺧﻄﺔ ﺍﺳﺘﺜﻤﺎﺭﻳﺔ ﺗﻔﺼﻴﻠﻴﺔ ﻟﺘﺤﺪﻳﺚ ﺍﳌﻨﺸﺂﺕ ﻣﺘﺰﺍﻣﻨﺔ ﻣﻊ ﺗﻄﺒﻴﻖ ﺍﻹﺻﻼﺡ‪.‬‬ ‫‪-‬‬
‫ﻭﺿﻊ ﺧﻄﺔ ﻗﻮﻣﻴﺔ ﻟﻠﺘﺪﺭﻳﺐ ﻟﺘﺤﺪﻳﺚ ﻣﻬﺎﺭﺍﺕ ﺍﻷﻃﺒﺎﺀ ﻭﺍﳌﻤﺮﺿﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﻭﺿﻊ ﻣﻨﻬﺞ ﻟﻠﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ ﻳﺘﻴﺢ ﻟﻠﻔﺮﻳﻖ ﺍﻟﻄﱯ ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﻭﻟﻴﺔ ﺑﻜﻔﺎﺀﺓ‪.‬‬ ‫‪-‬‬

‫‪٢٤‬‬
 ‫ﺍﻟﻔﺼﻞ ﺑﲔ ﻭﻇﻴﻔﱵ ﺍﻟﺘﻤﻮﻳﻞ ﻭﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ‪ ،‬ﰲ ﺇﻃﺎﺭ ﺩﺍﺧﻞ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪.‬‬ ‫‪-‬‬
‫ﺍﻻﺳﺘﺜﻤﺎﺭ ﰲ ﺗﻄﻮﻳﺮ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‪.‬‬ ‫‪-‬‬
‫ﺩﻭﺭ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﰲ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ‬
‫ﺗﺒﺪﺃ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﺑﺘﻄﻮﻳﺮ ﺍﻟﻌﻼﻗﺔ ﺑﲔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ‬
‫ﺍﻟﺼﺤﻲ‪ ،‬ﳑﺎ ﻳﺆﺩﻯ ﺇﱃ ﲢﺴﲔ ﺍﳌﻮﺍﺭﺩ ﺍﻟﺒﺸﺮﻳﺔ ﻭﺍﻟﻨﻈﻢ ﺍﻹﺩﺍﺭﻳﺔ‪.‬‬
‫ﻭﲟﺎ ﺃﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻫﻲ ﺍﳌﺴﺌﻮﻝ ﺍﻷﻭﻝ ﻋﻦ ﺗﻨﻈﻴﻢ ﻭﺗﻨﺴﻴﻖ ﻭﲢﻠﻴﻞ ﻛﻞ ﺃﻧﺸﻄﺔ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‪،‬‬
‫ﻓﺈ‪‬ﺎ ﺗﻘﻮﻡ ﺑﺘﺨﻄﻴﻂ ﺳﻴﺎﺳﺔ ﻣﺘﻄﻮﺭﺓ ﻟﱪﺍﻣﺞ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ‪ ،‬ﻭﺗﺘﺤﻤﻞ ﺍﶈﺎﻓﻈﺎﺕ ﻭﺍﳌﺮﺍﻛﺰ ﺗﺪﺭﳚﻴﺎ‬
‫ﻣﺴﺌﻮﻟﻴﺎﺕ ﻭﺳﻠﻄﺎﺕ ﻣﺘﺰﺍﻳﺪﺓ‪ ،‬ﻹﺩﺍﺭﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺗﻜﻮﻥ ﻟﺪﻳﻬﺎ ﺍﳌﺮﻭﻧﺔ ﻹﺩﺧﺎﻝ ﺍﻟﺘﻌﺪﻳﻼﺕ ﺣﺴﺐ‬
‫ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﶈﻠﻴﺔ‪ ،‬ﻭﺗﺼﺒﺢ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻛﻴﺎﻧﺎ ﻣﺎﻟﻴﺎ ﻗﻮﻣﻴﺎ ﺟﺪﻳﺪﺍ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻲ‪ ،‬ﻭﻋﻠﻴﻪ ﺍﳌﺴﺌﻮﻟﻴﺔ ﺍﻷﻭﱃ ﻟﺘﻤﻮﻳﻞ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻛﻤﺎ ﺗﺘﺤﻤﻞ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫ﻣﺴﺌﻮﻟﻴﺔ ﺗﻨﻔﻴﺬ ﻭﻣﺘﺎﺑﻌﺔ ﻭﺗﻘﻴﻴﻢ ﺑﺮﺍﻣﺞ ﺇﺻﻼﺡ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻭﺗﻨﺴﻴﻖ ﺍﻷﺩﻭﺍﺭ ﺑﲔ ﻛﻞ ﻣﻦ‬
‫ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻭﺍﳋﺎﺻﺔ ﺍﳌﺸﺎﺭﻛﺔ ﰲ ﺍﻟﱪﻧﺎﻣﺞ‪.‬‬
‫ﻭﻣﻦ ﺃﺟﻞ ﲢﻘﻴﻖ ﻫﺬﻩ ﺍﻟﻐﺎﻳﺔ‪ ،‬ﺗﻘﻮﻡ ﺍﻟﻮﺯﺍﺭﺓ ﺑﺘﻮﻓﲑ ﺁﻟﻴﺎﺕ ﺟﺪﻳﺪﺓ ﻟﺘﺴﻬﻴﻞ ﺍﻟﺪﻋﻢ ﺍﻟﻔﲏ ﻭﺍﻹﺩﺍﺭﻱ‬
‫ﻟﻌﻤﻠﻴﺔ ﺇﻋﺎﺩﺓ ﺍﻟﺘﻨﻈﻴﻢ ﺍﳌﻄﻠﻮﺑﺔ ﻟﻨﻈﺎﻡ ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻻﺭﺗﻘﺎﺀ ﺑﻨﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ‪،‬‬
‫ﻓﻘﺪ ﺃﻧﺸﺄﺕ ﺍﻟﻮﺯﺍﺭﺓ ﻣﻜﺘﺐ ﺍﻟﺪﻋﻢ ﺍﻟﻔﲏ ﻭﺇﺩﺍﺭﺓ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﻭﺍﳌﺮﻛﺰ ﺍﻟﻘﻮﻣﻲ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﰲ ﳎﺎﻝ‬
‫ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻛﺄﻣﺜﻠﺔ ﻟﻠﺪﻋﻢ ﺍﳌﻄﻠﻮﺏ‪.‬‬
‫ﻛﻴﻔﻴﺔ ﲤﻮﻳﻞ ﺑﺮﻧﺎﻣﺞ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ‬
‫ﺍﳌﻤﻮﻝ ﺍﻟﺮﺋﻴﺴﻲ ﳍﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ ﻫﻮ ﺍﳊﻜﻮﻣﺔ ﺍﳌﺼﺮﻳﺔ‪ ،‬ﻣﻊ ﺑﻌﺾ ﺍﳌﺸﺎﺭﻛﺔ ﺍﻟﻔﻌﺎﻟﺔ ﻣﻦ ﺍﻟﺪﻭﻝ ﺍﳌﺎﻧـﺤﺔ‬
‫ﻭﺍﳌﺴﺎﻋﺪﺓ ﺍﻟﻔﻨﻴﺔ ﻣﻦ ﻭﻛﺎﻟﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ﻭﺍﻻﲢﺎﺩ ﺍﻷﻭﺭﰊ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﻗﺮﺽ ﻣﻦ ﺍﻟﺒﻨﻚ ﺍﻟﺪﻭﱄ‪.‬‬
‫ﻳﺘﻢ ﲡﺮﺑﺔ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﰲ ﺑﻌﺾ ﺍﶈﺎﻓﻈﺎﺕ ﻛﻤﺸﺮﻭﻉ ﺍﺳﺘﺮﺷﺎﺩﻱ ﻻﺧﺘﺒﺎﺭ ﺍﳌﺸﺮﻭﻋﺎﺕ ﺍﳌﺘﻜﺎﻣﻠﺔ‬
‫ﺍﳌﻘﺘﺮﺣﺔ ﻹﺻﻼﺡ ﻧﻈﺎﻡ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻭﺗﻨﻘﻴﺤﻬﺎ ﰲ ﻣﻮﺍﻗﻊ ﲡﺮﻳﺒﻴﺔ ﰲ ﺛﻼﺙ ﳏﺎﻓﻈﺎﺕ‬
‫ﲤﺜﻞ ﺍﻷﺣﻮﺍﻝ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ ﻭﺍ‪‬ﻤﻮﻋﺎﺕ ﺍﻟﺴﻜﺎﻧﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ ﰲ ﲨﻴﻊ ﺃﻧـﺤﺎﺀ ﺍﳉﻤﻬﻮﺭﻳﺔ‪ ،‬ﻭﻫﻲ‬
‫ﺍﻹﺳﻜﻨﺪﺭﻳﺔ – ﺍﳌﻨﻮﻓﻴﺔ – ﺳﻮﻫﺎﺝ‪ ،‬ﻭﻳﺘﻢ ﺗﻨﻔﻴﺬ ﻫﺬﺍ ﺍﳌﺸﺮﻭﻉ ﺍﻟﺘﺠﺮﻳﱯ ﻟﱪﻧﺎﻣﺞ ﺇﺻﻼﺡ ﺍﻟﻘﻄﺎﻉ‬
‫ﺍﻟﺼﺤﻲ ﺗﺪﺭﳚﻴﺎ ﻭﻋﻠﻰ ﻣﺮﺍﺣﻞ ﻹﻋﻄﺎﺀ ﺍﻟﻔﺮﺻﺔ ﻟﻠﺘﺠﺮﺑﺔ ﻭﳌﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﻭﺍ‪‬ﺘﻤﻌﺎﺕ ﺍﳌﺸﺎﺭﻛﺔ ﰲ‬
‫ﺍﻟﺘﺠﺮﺑﺔ‪.‬‬
‫ﻣﺪﺧﻼﺕ ﻭﺁﻟﻴﺎﺕ ﲢﻘﻴﻖ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ‬
‫ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﻮﻗﺎﻳﺔ ﻭﺗﻐﻴﲑ ﺍﳌﻔﻬﻮﻡ ﻣﻦ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﳊﺪﺙ ﻋﻨﺪ ﻭﻗﻮﻋﻪ ﺇﱃ ﺍﻟﺘﻨﺒﺆ ﺑﻪ‪ ،‬ﻭﻫﻮ‬ ‫‪-‬‬
‫ﻧﻈﺎﻡ ﺍﻟﺘﺮﺻﺪ‪ ،‬ﻭﺫﻟﻚ ﺑﺎﻟﺘﺤﺮﻙ ﳌﻨﻊ ﺣﺪﻭﺛﻪ ﻭﺫﻟﻚ ﻣﻦ ﺧﻼﻝ ﺇﺩﺧﺎﻝ ﺍﻟﻠﻘﺎﺣﺎﺕ ﻭﺍﻟﻄﻌﻮﻡ‬
‫ﺍﳉﺪﻳﺪﺓ ﻭﺍﳊﺪﻳﺜﺔ‪.‬‬
‫ﺯﻳﺎﺩﺓ ﻧﺴﺒﺔ ﺍﻟﺘﻐﻄﻴﺔ ﺑﺎﻟﺘﻄﻌﻴﻤﺎﺕ ﺍﻹﺟﺒﺎﺭﻳﺔ ﺇﱃ ‪ ،%٩٧‬ﳑﺎ ﻳﺆﺩﻯ ﺇﱃ ﺍﻟﺴﻴﻄﺮﺓ ﻋﻠﻰ ﻛﺜﲑ ﻣﻦ‬ ‫‪-‬‬
‫ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ ﻭﺃﻣﺮﺍﺽ ﺍﻟﻄﻔﻮﻟﺔ‪.‬‬

‫‪٢٥‬‬
‫ﺇﻋﺎﺩﺓ ﻫﻴﻜﻠﺔ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻭﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﻃﺐ ﺍﻷﺳﺮﺓ‪ ،‬ﺑﺎﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺗﻘﺪﱘ ﳎﻤﻮﻋﺔ‬ ‫‪-‬‬
‫ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﺘﺄﻫﻴﻠﻴﺔ‪.‬‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳌﻮﺍﺭﺩ ﺍﻟﺒﺸﺮﻳﺔ ﻭﺍﻟﺘﻮﺳﻊ ﰲ ﺑﺮﺍﻣﺞ ﺍﻟﺘﺪﺭﻳﺐ ﻭﺗﻮﻓﲑ ﺍﻟﺘﻤﻮﻳﻞ ﺍﻟﻼﺯﻡ ﻟﺘﻨﻔﻴﺬﻫﺎ‪.‬‬ ‫‪-‬‬
‫ﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﺍﳉﻮﺩﺓ ﺍﻟﺸﺎﻣﻠﺔ ﻭﺫﻟﻚ ﻟﺘﻨﺴﻴﻖ ﺗﻄﻮﻳﺮ ﻭﺗﻮﺯﻳﻊ ﻭﻣﺮﺍﻗﺒﺔ ﻣﺴﺘﻮﻯ ﺍﻟﺮﻋﺎﻳﺔ‬ ‫‪-‬‬
‫ﻭﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺔ ﰲ ﻣﻮﺍﻗﻊ ﺗﻘﺪﳝﻬﺎ‪.‬‬
‫ﺗﻄﻮﻳﺮ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺘﻤﻮﻳﻠﻴﺔ ﻟﻠﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﺑﻨﺎﺀ ﻋﻠﻰ ﺩﺭﺍﺳﺔ ﺍﻗﺘﺼﺎﺩﻳﺔ‪.‬‬ ‫‪-‬‬
‫ﺯﻳﺎﺩﺓ ﳐﺼﺼﺎﺕ ﺍﳋﻄﺔ ﺍﻻﺳﺘﺜﻤﺎﺭﻳﺔ ﳌﺸﺮﻭﻉ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‪.‬‬ ‫‪-‬‬

‫‪9:5     1;<  2 3! 45' 678 1!!- ./0‬‬

‫‪ .١‬ﻃﺐ ﺍﻷﺳﺮﺓ )ﻃﺒﻴﺐ ﺍﻷﺳﺮﺓ(‬
‫ﻃﺐ ﺍﻷﺳﺮﺓ‪ ،‬ﻫﻮ ﺣﺠﺮ ﺍﻟﺰﺍﻭﻳﺔ ﰲ ﳕﻮﺫﺝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺍﳊﺪﻳﺜﺔ‪.‬‬
‫ﻭﻃﺐ ﺍﻷﺳﺮﺓ ﲣﺼﺺ ﻳﻀﻤﻦ‪:‬‬
‫ﺍﺳﺘﻤﺮﺍﺭﻳﺔ ﻭﴰﻮﻟﻴﺔ ﺍﻟﻌﻼﺝ‪ :‬ﻓﻄﺒﻴﺐ ﺍﻷﺳﺮﺓ ﳝﺜﻞ ﺍﻟﻠﻘﺎﺀ ﺍﻷﻭﻝ ﻣﻊ ﺃﻓﺮﺍﺩ ﺍﻷﺳﺮﺓ‪ ،‬ﻛﻤﺎ ﺃﻧﻪ‬ ‫‪-‬‬
‫ﻳﻘﻮﻡ ﺑﻌﻼﺟﻬﻢ ﲨﻴﻌﺎﹰ‪ ،‬ﻭﻫﺬﺍ ﻳﺴﺎﻋﺪ ﺃﻛﺜﺮ ﻋﻠﻰ ﺗﻔﻬﻢ ﻛﺎﻓﺔ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﱵ ﺗﺆﺛﺮ ﻋﻠﻰ‬
‫ﺻﺤﺔ ﺍﻟﻔﺮﺩ‪.‬‬
‫ﺍﻟﺘﻨﺴﻴﻖ‪ :‬ﺣﻴﺚ ﺇﻥ ﻃﺒﻴﺐ ﺍﻷﺳﺮﺓ ﻫﻮ ﻣﻘﺪﻡ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻭﺍﳌﺴﺌﻮﻝ ﻋﻦ‬ ‫‪-‬‬
‫ﺍﻹﺣﺎﻟﺔ ﰲ ﺍﳊﺎﻻﺕ ﺍﻟﱵ ﺗﺴﺘﺪﻋﻰ ﻣﺴﺘﻮﻯ ﺃﻋﻠﻰ ﻟﺘﻘﺪﱘ ﺍﳋﺪﻣﺔ‪.‬‬
‫ﻭﻗﺪ ﺭﻛﺰ ﺍﻟﻨﻤﻮﺫﺝ ﺍﳉﺪﻳﺪ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻋﻠﻰ ﳑﺎﺭﺳﺔ ﻧﻈﺎﻡ ﻃﺐ ﺍﻷﺳﺮﺓ ﻣﺮﺗﺒﺎ ﺣﺴﺐ‬
‫ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﻵﺗﻴﺔ ﻟﺰﻳﺎﺩﺓ ﺇﻣﻜﺎﻧﻴﺔ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻄﻠﻮﺑﺔ‪:‬‬
‫ﻭﺣﺪﺍﺕ ﺻﺤﺔ ﺍﻷﺳﺮﺓ‪ :‬ﻟﺘﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﳌﺮﺿﻰ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺭﺟﻴﺔ‪.‬‬
‫ﻣﺮﺍﻛﺰ ﺻﺤﺔ ﺍﻷﺳﺮﺓ‪ :‬ﻟﺘﻘﺪﱘ ﺧﺪﻣﺎﺕ ﲣﺼﻴﺼﻴﺔ ﰲ ﳎﺎﻝ ﻃﺐ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﺍﻷﻣﺮﺍﺽ ﺍﻟﺒﺎﻃﻨﻴﺔ‪ ،‬ﺍﻟﻨﺴﺎﺀ‬
‫ﻭﺍﻟﺘﻮﻟﻴﺪ ﻭﲢﺘﻮﻯ ﻋﻠﻰ ﻗﺴﻢ ﻟﻠﺠﺮﺍﺣﺎﺕ ﺍﻟﺼﻐﲑﺓ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ )ﻣﻌﻤﻞ ‪ /‬ﺍﻷﺷﻌﺔ(‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺮﻛﺰﻳﺔ‪ :‬ﺗﻘﺪﻡ ﺧﺪﻣﺎﺕ ﻋﻼﺟﻴﺔ ﺧﺎﺭﺟﻴﺔ ﻭﺩﺍﺧﻠﻴﺔ‪ ،‬ﻭﺧﺪﻣﺎﺕ ﺍﳉﺮﺍﺣﺎﺕ ﻭﺍﳊﺎﻻﺕ ﺍﻟﻌﺎﺟﻠﺔ‪.‬‬
‫ﻭﻟﺪﻋﻢ ﻭﲢﺴﲔ ﺍﳉﻮﺩﺓ ﻭﺯﻳﺎﺩﺓ ﺭﺿﺎﺀ ﺍﳌﻨﺘﻔﻊ‪ ،‬ﺗﻌﻄﻰ ﺍﻟﻔﺮﺻﺔ ﻟﻸﺳﺮﺓ ﻟﺘﻐﻴﲑ ﺃﻃﺒﺎﺋﻬﻢ‪ ،‬ﻛﻤﺎ ﻳﻘﺪﻡ ﻫﺬﺍ‬
‫ﺍﻟﻨﻈﺎﻡ ﺣﻮﺍﻓﺰ ﺟﻴﺪﺓ ﳌﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﺍﻋﺘﻤﺎﺩﺍ ﻋﻠﻰ ﺟﻮﺩﺓ ﺍﻷﺩﺍﺀ ﻭﺍﻹﻧﺘﺎﺝ‪ ،‬ﺣﱴ ﺗﻘﻠﻞ ﻣﻦ ﺣﺎﺟﺘﻬﻢ ﺇﱃ‬
‫ﺍﻟﻌﻤﻞ ﰲ ﺃﻛﺜﺮ ﻣﻦ ﻣﻜﺎﻥ‪.‬‬
‫ﺃﻫﺪﺍﻑ ﺑﺮﻧﺎﻣﺞ ﻃﺐ ﺍﻷﺳﺮﺓ‪:‬‬
‫ﺩﺭﺍﺳﺔ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺴﺘﻬﺪﻑ ﺑﺎﳋﺪﻣﺔ ﻭﲢﺪﻳﺪ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﻋﻤﻞ ﲢﻠﻴﻞ ﳍﺬﻩ ﺍﳌﺸﺎﻛﻞ ﻭﺑﻴﺎﻥ ﺣﺠﻤﻬﺎ ﻭﺃﺳﺒﺎ‪‬ﺎ ﻭﻣﺪﻯ ﺗﺄﺛﲑﻫﺎ ﻋﻠﻰ ﺍ‪‬ﺘﻤﻊ‪.‬‬ ‫‪-‬‬
‫ﻭﺿﻊ ﺗﺼﻮﺭ ﻭﺧﻄﺔ ﻋﻤﻞ ﳊﻞ ﻫﺬﻩ ﺍﳌﺸﺎﻛﻞ‪.‬‬ ‫‪-‬‬

‫‪٢٦‬‬
 ‫ﲢﺪﻳﺪ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍ‪‬ﺘﻤﻊ‪.‬‬ ‫‪-‬‬
‫ﺩﻋﻢ ﺍﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍ‪‬ﺘﻤﻊ ﺑﻔﺌﺎﺗﻪ ﺍﳌﺨﺘﻠﻔﺔ ﻟﺪﺭﺍﺳﺔ ﺍﳌﺸﺎﻛﻞ ﻭﻭﺿﻊ ﺍﳊﻠﻮﻝ ﺍﳌﻨﺎﺳﺒﺔ ﳍﺎ‪.‬‬ ‫‪-‬‬
‫ﺩﻋﻢ ﺍﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍﳍﻴﺌﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﺫﺍﺕ ﺍﻟﻌﻼﻗﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﱪﻧﺎﻣﺞ‪:‬‬
‫ﺇﻳﻔﺎﺩ ﺃﻃﺒﺎﺀ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﻣﺆﻫﻼﺕ ﻋﻠﻴﺎ ﰲ ﳎﺎﻝ ﻃﺐ ﺍﻷﺳﺮﺓ‬ ‫‪.١‬‬
‫ﻣﻦ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﻋﻤﻞ ﺑﺮﺍﻣﺞ ﺗﺪﺭﻳﺒﻴﺔ ﻟﻸﻃﺒﺎﺀ ﻭﺍﳌﻤﺮﺿﺎﺕ ﻭﳐﺘﻠﻒ ﺍﻟﻔﺌﺎﺕ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ‬ ‫‪.٢‬‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺗﺸﺘﻤﻞ ﻫﺬﻩ ﺍﻟﱪﺍﻣﺞ ﻋﻠﻰ‪:‬‬
‫ﺑﻌﺜﺎﺕ ﺧﺎﺭﺟﻴﺔ ﻟﻠﺘﺪﺭﻳﺐ ﻋﻠﻰ ﻛﻴﻔﻴﺔ ﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﻃﺐ ﺍﻷﺳﺮﺓ ﺑﺎﻟﺪﻭﻝ ﺍﳌﺘﻘﺪﻣﺔ ﻣﺜﻞ‬ ‫‪-‬‬
‫ﺍﳌﻤﻠﻜﺔ ﺍﳌﺘﺤﺪﺓ ﻭﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ ﻭﻫﻮﻟﻨﺪﺍ‪ ..‬ﺍﱁ‬
‫ﺩﻭﺭﺍﺕ ﺗﺪﺭﻳﺒﻴﺔ ﺩﺍﺧﻠﻴﺔ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍﳉﺎﻣﻌﺎﺕ ﺍﳌﺼﺮﻳﺔ ﺍﻟﱵ ﺗﻘﻮﻡ ﺑﺘﻄﺒﻴﻖ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ ﰲ‬ ‫‪-‬‬
‫ﻣﻨﺎﻫﺠﻬﺎ‪.‬‬
‫ﺗﺄﻫﻴﻞ ﺑﻌﺾ ﺍﳌﺮﺍﻛﺰ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﻟﺘﻜﻮﻥ ﻧﻮﺍﺓ ﻟﺘﺪﺭﻳﺐ ﺍﻷﻃﺒﺎﺀ ﻭﺍﻟﻌﺎﻣﻠﲔ ﰲ ﻣﺮﺍﻛﺰ‬ ‫‪.٣‬‬
‫ﻃﺐ ﺍﻟﻌﺎﺋﻠﺔ ﻭﻃﻠﺒﺔ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﻋﻠﻰ ﺑﺮﺍﻣﺞ ﻃﺐ ﺍﻷﺳﺮﺓ‪.‬‬
‫ﻭﺿﻊ ﻧﻈﺎﻡ ﻟﻺﺣﺎﻟﺔ ﺑﲔ ﻣﺴﺘﻮﻳﺎﺕ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ ﻭﻧﻈﺎﻡ ﺍﻟﺘﻐﺬﻳﺔ ﺍﳌﺮﲡﻌﺔ‬ ‫‪.٤‬‬
‫ﺣﱴ ﻧﻀﻤﻦ ﺗﻘﺪﱘ ﺧﺪﻣﺔ ﺻﺤﻴﺔ ﻣﺘﻜﺎﻣﻠﺔ ﻟﻠﻤﻮﺍﻃﻦ‪.‬‬
‫ﻭﺿﻊ ﻧﻈﺎﻡ ﻟﺘﺪﻓﻖ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺑﲔ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﻄﺮﻓﻴﺔ ﻭﺍﻟﻮﺣﺪﺍﺕ ﺍﳌﺮﻛﺰﻳﺔ ﻣﺮﻭﺭﺍ ﺑﺎﳌﺮﺍﻛﺰ‬ ‫‪.٥‬‬
‫ﻭﺍﳌﺪﻳﺮﻳﺎﺕ ﺑﺎﶈﺎﻓﻈﺎﺕ‪.‬‬
‫ﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﲤﻮﻳﻠﻰ ﻳﺘﻢ ﲟﻮﺟﺒﻪ ﲢﺴﲔ ﻣﺴﺘﻮﻯ ﺍﻷﺩﺍﺀ ﻭﺗﻮﻓﲑ ﺍﻷﺩﻭﻳﺔ ﻭﺃﻋﻤﺎﻝ ﺍﻟﺼﻴﺎﻧﺔ‬ ‫‪.٦‬‬
‫ﺍﻟﻼﺯﻣﺔ ﻟﻸﺟﻬﺰﺓ ﻭﺍﳌﺒﺎﱐ‪ ،‬ﻭﻛﺬﻟﻚ ﺻﺮﻑ ﺣﻮﺍﻓﺰ ﻟﻠﻌﺎﻣﻠﲔ ﺍﳌﺘﻤﻴﺰﻳﻦ‪.‬‬
‫ﺇﻋﺪﺍﺩ ﻛﺎﺩﺭ ﻭﻇﻴﻔﻲ ﻷﻃﺒﺎﺀ ﻃﺐ ﺍﻷﺳﺮﺓ‪ ،‬ﻳﻀﻤﻦ ﳍﻢ ﻧﻈﺎﻡ ﺍﻟﺘﺮﻗﻲ ﻟﻠﺪﺭﺟﺎﺕ ﺍﻟﻮﻇﻴﻔﻴﺔ‬ ‫‪.٧‬‬
‫ﺍﻷﻋﻠﻰ‪.‬‬
‫ﺇﻋﺪﺍﺩ ﺑﺮﻧﺎﻣﺞ ﺇﻋﻼﻣﻲ ﻟﺘﻮﻋﻴﺔ ﺍﳌﻮﺍﻃﻨﲔ ﺑﺄﳘﻴﺔ ﺍﳌﻠﻒ ﺍﻟﻌﺎﺋﻠﻲ ﻭﺩﻭﺭ ﻃﺒﻴﺐ ﺍﻷﺳﺮﺓ ﰲ ﺗﻘﺪﱘ‬ ‫‪.٨‬‬
‫ﺧﺪﻣﺔ ﺻﺤﻴﺔ ﻣﺘﻤﻴﺰﺓ ﺣﱴ ﻳﺴﺎﻫﻢ ﺍﳌﻮﺍﻃﻨﻮﻥ ﰲ ﺇﳒﺎﺡ ﺍﻟﱪﻧﺎﻣﺞ ﻭﺍﻻﺳﺘﺨﺪﺍﻡ ﺍﻷﻣﺜﻞ ﻟﻪ‪.‬‬
‫ﲢﻔﻴﺰ ﺍﳌﺸﺎﺭﻛﺔ ﺍﻟﺸﻌﺒﻴﺔ ﻋﻦ ﻃﺮﻳﻖ ﻋﻘﺪ ﺍﻟﻨﺪﻭﺍﺕ ﻣﻊ ﻗﻴﺎﺩﺍﺕ ﺍ‪‬ﺘﻤﻊ ﻟﻠﻤﺸﺎﺭﻛﺔ ﰲ ﺩﺭﺍﺳﺔ‬ ‫‪.٩‬‬
‫ﺍﳌﺸﺎﻛﻞ ﻭﲢﺪﻳﺪ ﺍﻷﻭﻟﻮﻳﺎﺕ ﻭﺍﻻﺣﺘﻴﺎﺟﺎﺕ‪.‬‬
‫ﻋﻘﺪ ﺑﺮﻭﺗﻮﻛﻮﻻﺕ ﺗﻌﺎﻭﻥ ﻣﻊ ﺍﳍﻴﺌﺎﺕ ﻭﺍﻟﻮﺯﺍﺭﺍﺕ ﻭﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻷﺧﺮﻯ ﺫﺍﺕ ﺍﻟﻌﻼﻗﺔ ﺑﺼﺤﺔ‬ ‫‪.١٠‬‬
‫ﺍﳌﻮﺍﻃﻨﲔ ﻣﺜﻞ ﻭﺯﺍﺭﺍﺕ ﺍﻟﺘﻌﻠﻴﻢ – ﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ – ﺍﻷﻭﻗﺎﻑ – ﺍﻟﺒﻴﺌﺔ – ﺍ‪‬ﻠﺲ ﺍﻷﻋﻠﻰ‬
‫ﻟﻠﺸﺒﺎﺏ ﻭﺍﻟﺮﻳﺎﺿﺔ – ﺍ‪‬ﺎﻟﺲ ﺍﶈﻠﻴﺔ – ﺍﳉﺎﻣﻌﺎﺕ‪ ..‬ﺍﱁ‪.‬‬

‫‪٢٧‬‬
 ‫‪ .٢‬ﺍﻟﺘﻮﺳﻊ ﲟﻈﻠﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﺘﻐﻄﻰ ﲨﻴﻊ ﺍﳌﻮﺍﻃﻨﲔ‬
‫ﺑﺪﺃﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪ ،‬ﻣﻨﺬ ﺳﻨﻮﺍﺕ ﺑﺈﻋﺪﺍﺩ ﺑﺮﻧﺎﻣﺞ ﻃﻤﻮﺡ‪ ،‬ﻟﺘﻄﻮﻳﺮ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫ﺍﳊﺎﱄ‪ ،‬ﻟﻴﺸﻤﻞ ﻣﻈﻠﺔ ﺗﺄﻣﻴﻨﻴﺔ ﺍﺟﺘﻤﺎﻋﻴﺔ ﺗﺸﻤﻞ ﲨﻴﻊ ﺃﻓﺮﺍﺩ ﺍﻷﺳﺮﺓ ﻛﻬﺪﻑ ﺍﺳﺘﺮﺍﺗﻴﺠﻲ ﺑﺘﻘﺪﱘ‬
‫ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺑﺄﻋﻠﻰ ﺟﻮﺩﺓ ﳑﻜﻨﺔ ﻭﺑﺮﺅﻳﺔ ﺍﺟﺘﻤﺎﻋﻴﺔ ﻭﺑﻴﺌﻴﺔ ﻭﺳﻜﺎﻧﻴﺔ‬
‫ﻭﻭﻗﺎﺋﻴﺔ ﻣﺘﻜﺎﻣﻠﺔ‪ ،‬ﺗﻀﻊ ﰲ ﺍﻋﺘﺒﺎﺭﻫﺎ ﺍﻟﻔﺌﺎﺕ ﳏﺪﻭﺩﺓ ﺍﻟﺪﺧﻞ ﻭﻏﲑ ﺍﻟﻘﺎﺩﺭﺓ‪.‬‬
‫ﻭ ﻣﻔﻬﻮﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻻ ﻳﺸﻤﻞ ﻓﻘﻂ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ‪ ،‬ﺑﻞ ﻳﺸﻤﻞ ﺃﻳﻀﺎ ﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﳉﻤﻴﻊ ﺃﻓﺮﺍﺩ ﺍﻷﺳﺮﺓ ﻭﻳﻌﺘﻤﺪ ﻋﻠﻰ ﺍﳌﺸﺎﺭﻛﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﻛﻌﻨﺼﺮ ﻓﻌﺎﻝ ﰲ ﲢﻘﻴﻖ‬
‫ﻫﺪﻑ ﺍﻟﺼﺤﺔ ﻟﻠﺠﻤﻴﻊ‪ ،‬ﻭﻗﺪ ﻛﺎﻥ ﺫﻟﻚ ﻋﻠﻰ ﻗﺎﺋﻤﺔ ﺍﻫﺘﻤﺎﻣﺎﺕ ﺍﻟﺪﻭﻟﺔ ﻣﻨﺬ ﺗﻄﺒﻴﻖ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫ﻋﻠﻰ ﻃﻼﺏ ﺍﳌﺪﺍﺭﺱ‪.‬‬
‫ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺪﺭﺍﺳﺔ ﺗﻄﺒﻴﻖ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻋﻠﻰ ﺍﻷﻃﻔﺎﻝ ﻭﺍﳌﻮﺍﻟﻴﺪ ﻭﺗﻮﻓﲑ‬
‫ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﻟﻼﺯﻣﺔ ﻟﻠﺘﻨﻔﻴﺬ ﻭﺇﻋﺪﺍﺩ ﺍﻹﻣﻜﺎﻧﻴﺎﺕ ﺍﻟﻼﺯﻣﺔ ﳌﺘﺎﺑﻌﺔ ﺍﻟﺘﻨﻔﻴﺬ ‪.١٩٩٦‬‬
‫ﻭﻟﻘﺪ ﰎ ﺇﻋﺪﺍﺩ ﻭﺻﺪﻭﺭ ﺍﻟﺒﻄﺎﻗﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻄﻔﻞ ﻛﺨﻄﻮﺓ ﺃﻭﱃ ﺑﺪﺍﻳﺔ ﻣﻦ ‪ ،١٩٩٦/٩/١‬ﻭﺗﻨﻔﻴﺬ ﺍﻟﺘﺄﻣﲔ‬
‫ﺍﻟﺼﺤﻲ ﺑﺪﺍﻳﺔ ﻣﻦ ﻣﻮﺍﻟﻴﺪ ‪ ١٩٩٧/١٠/١‬ﰲ ﲨﻴﻊ ﺃﻧـﺤﺎﺀ ﺍﳉﻤﻬﻮﺭﻳﺔ‪ ،‬ﻭﻗﺪ ﰎ ﺣﱴ ﺍﻵﻥ ﺗﻐﻄﻴﺔ ‪٥‬‬
‫ﻣﻼﻳﲔ ﻃﻔﻞ ﺑﺎﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻭﺗﺒﻠﻎ ﻧﺴﺒﺔ ﺍﻟﺘﻐﻄﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳉﻤﻬﻮﺭﻳﺔ ﺣﻮﺍﱄ ‪ %٦٥‬ﻭﺗﺘﺮﺍﻭﺡ‬
‫ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﻣﻦ ﺃﻗــﻞ ﻣﻦ ‪ %٦٠‬ﺇﱃ ﺃﻛﺜﺮ ﻣﻦ ‪ %٨٦‬ﰲ ﺑﻌﺾ ﺍﶈﺎﻓﻈﺎﺕ‪ ،‬ﻧﻈﺮﺍﹰ ﻷ‪‬ﺎ ﺧﺪﻣﺔ ﺍﺧﺘﻴﺎﺭﻳﺔ‬
‫ﻟﻠﻤﻮﺍﻃﻨﲔ‪.‬‬

‫‪ .٣‬ﺇﺩﺧﺎﻝ ﻣﻔﻬﻮﻡ ﻭﺧﺪﻣﺎﺕ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﻭﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ‬

‫ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺎﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﺑﺼﻔﺔ ﺧﺎﺻﺔ‪ ،‬ﻓﻘﺪ ﰎ ﺇﻧﺸﺎﺀ‬ ‫‪-‬‬
‫ﻭﺣﺪﺍﺕ ﻟﺮﻋﺎﻳﺔ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﺩﺍﺧﻞ ﺍﻟﻘﺮﻯ ﻭﺍﻟﻨﺠﻮﻉ ﰲ ﲨﻴﻊ‪ ،‬ﺇﻥ ﱂ ﻳﻜﻦ ﰲ ﻛﻞ ﳏﺎﻓﻈﺎﺕ‬
‫ﲨﻬﻮﺭﻳﺔ ﻣﺼﺮ ﺍﻟﻌﺮﺑﻴﺔ‪.‬‬
‫ﺗﻘﻮﻡ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳌﺘﻨﻘﻠﺔ ﻭ)ﺍﻟﻘﻮﺍﻓﻞ ﺍﻟﻄﺒﻴﺔ( ﺑﺘﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﰲ ﺍﳌﻨﺎﻃﻖ‬ ‫‪-‬‬
‫ﺍﶈﺮﻭﻣﺔ ﻭﺍﻟﻌﺸﻮﺍﺋﻴﺎﺕ ﺧﺎﺻﺔ ﰲ ﺻﻌﻴﺪ ﻣﺼﺮ‪.‬‬
‫ﺗﻌﺘﱪ ﻧﻮﺍﺩﻱ ﺍﳌﺮﺃﺓ ﺍﻟﱵ ﰎ ﺇﻧﺸﺎﺅﻫﺎ ﺑﺎﳌﺮﺍﻛﺰ ﻭﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﻣﺪﺧﻼ ﺗﻨﻤﻮﻳﺎ ﻫﺎﻣﺎ ﻟﻠﻤﺮﺃﺓ‬ ‫‪-‬‬
‫ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻭﺍﳌﺮﺃﺓ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺍﻟﺒﺪﻭﻳﺔ ﺑﺼﻔﺔ ﺧﺎﺻﺔ‪ ،‬ﻓﻌﻦ ﻃﺮﻳﻖ ﻫﺬﻩ ﺍﻷﻧﺪﻳﺔ ﳝﻜﻦ ﳏﻮ ﺃﻣﻴﺔ‬
‫ﺍﳌﺮﺃﺓ ﻭﺇﺷﺮﺍﻛﻬﺎ ﰲ ﺍﻟﻌﻤﻞ ﻭﺗﻌﻠﻴﻤﻬﺎ ﺍﻷﻋﻤﺎﻝ ﺍﳌﻬﻨﻴﺔ ﺍﻟﱵ ﺗﺮﻓﻊ ﻣﻦ ﺧﻼﳍﺎ ﺩﺧﻞ ﺃﺳﺮ‪‬ﺎ‪.‬‬
‫ﻭﺗﺸﲑ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﺴﻜﺎﻥ ﺍﻟﱵ ﺗﻨﻔﺬﻫﺎ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﲟﻔﻬﻮﻡ ﺷﺎﻣﻞ‪ ،‬ﺇﱃ ﺃﻥ ﻣﻨﻈﻮﻣﺔ‬ ‫‪-‬‬
‫ﺍﻟﻌﻤﻞ ﺍﻟﺼﺤﻲ ﺗﺘﻀﻤﻦ ﺃﻳﻀﺎ ﻭﺿﻊ ﺷﺒﻜﺔ ﻣﺘﻜﺎﻣﻠﺔ ﳋﺪﻣﺎﺕ ﺻﺤﺔ ﺍﻷﻡ ﻣﻦ ﺧﻼﻝ ﲢﻘﻴﻖ‬
‫ﺍﳌﺴﺘﻬﺪﻑ ﻣﻦ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ‪ ،‬ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﺘﺮﺍﺑﻂ ﻭﺍﻟﺘﻮﺍﺻﻞ‬
‫ﺑﲔ ﺑﺮﺍﻣﺞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﺭﻋﺎﻳﺔ ﺍﻷﻣﻬﺎﺕ ﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ‪.‬‬
‫ﻛﻤﺎ ﺃﻥ ﻣﻮﺍﺟﻬﺔ ﺍﳌﺸﻜﻠﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﺗﺄﺧﺬ ﺣﺎﻟﻴﺎ ﺃﺑﻌﺎﺩﺍﹰ ﺃﺧﻼﻗﻴﺔ ﻭﺩﻳﻨﻴﺔ ﻭﺻﺤﻴﺔ‪ ،‬ﻓﻬﻲ‬ ‫‪-‬‬
‫ﺗﻌﺘﻤﺪ ﰲ ﺍﳌﻘﺎﻡ ﺍﻷﻭﻝ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺗﻮﻓﲑ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﲟﻔﻬﻮﻣﻬﺎ ﺍﻟﺸﺎﻣﻞ‬
‫ﻭﺍﻷﻋﻢ‪ ،‬ﻟﻠﺤﻔﺎﻅ ﻋﻠﻰ ﺍﻷﺳﺮﺓ ﺍﳌﺼﺮﻳﺔ ﻭﻛﻴﺎﻥ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺼﺮﻱ‪.‬‬

‫‪٢٨‬‬
‫ﻣﻦ ﺧﻼﻝ ﺍﻟﺘﻌﺎﻭﻥ ﺑﲔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﺳﻴﺘﻢ ﺗﺪﺭﻳﺲ ﻣﻨﺎﻫﺞ ﺻﺤﻴﺔ ﻭﻭﻗﺎﺋﻴﺔ‬ ‫‪-‬‬
‫ﺟﺪﻳﺪﺓ ﻟﻠﻤﺮﺍﻫﻘﲔ‪ ،‬ﻳﺘﻢ ﺗﺰﻭﻳﺪﻫﻢ ﻣﻦ ﺧﻼﳍﺎ ﲟﻌﻠﻮﻣﺎﺕ ﺻﺤﻴﺔ ﺃﺳﺎﺳﻴﺔ‪.‬‬

‫‪ .٤‬ﻣﺒﺎﺩﺭﺓ ﻣﺼﺮﻳﲔ ﺃﺻﺤﺎﺀ ‪٢٠١٠‬‬

‫ﻫﺬﻩ ﺍﳌﺒﺎﺩﺭﺓ ﻫﻲ ﺑﺮﻧﺎﻣﺞ ﺷﺎﻣﻞ ﻟﻠﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﻳﺘﻀﻤﻦ ﺇﻋﺪﺍﺩ ﺑﺮﻧﺎﻣﺞ ﻭﻗﺎﺋﻲ ﻗﻮﻣﻲ ﳌﻮﺍﺟﻬﺔ ﺍﳌﺨﺎﻃﺮ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ‪‬ﺪﺩ ﺻﺤﺔ ﺍﻟﻔﺮﺩ ﻭﺍ‪‬ﺘﻤﻊ ﻣﻦ ﻣﻨﻈﻮﺭ "ﻣﻮﺍﻃﻨﻮﻥ ﺃﺻﺤﺎﺀ ﰲ ﳎﺘﻤﻊ ﺻﺤﻲ"‪.‬‬
‫ﻭ ﺃﻫـﻢ ﺃﻫﺪﺍﻑ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ‬
‫ﺯﻳﺎﺩﺓ ﻣﺘﻮﺳﻂ ﻋﻤﺮ ﺍﻟﻔﺮﺩ )ﻋﻤﺮ ﺃﻃﻮﻝ ﻭﺻﺤﺔ ﺃﻓﻀﻞ ﻟﻠﻤﻮﺍﻃﻦ ﺍﳌﺼﺮﻱ(‪.‬‬ ‫‪-‬‬
‫ﺗﻌﺰﻳﺰ ﺃﳕﺎﻁ ﺍﳊﻴﺎﺓ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺴﻠﻮﻙ ﺍﻟﺼﺤﻲ ﻟﻜﻞ ﺍﳌﺼﺮﻳﲔ‪.‬‬ ‫‪-‬‬
‫ﲢﻘﻴﻖ ﺍﻟﻌﺪﺍﻟﺔ ﰲ ﺇﺗﺎﺣﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻠﺠﻤﻴﻊ‪ ،‬ﲞﻔﺾ ﺍﻟﺘﺒﺎﻳﻦ ﺑﲔ ﺷﺮﺍﺋﺢ ﺍ‪‬ﺘﻤﻊ‬ ‫‪-‬‬
‫ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﻘﻮﻣﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ ﻭﺿﻤﺎﻥ ﻭﺻﻮﻝ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺫﺍﺕ ﺍﳉﻮﺩﺓ‬ ‫‪-‬‬
‫ﻭﺍﻟﻜﻔﺎﺀﺓ ﳉﻤﻴﻊ ﺍﳌﺼﺮﻳﲔ‪.‬‬
‫ﻭﲢﻘﻴﻖ ﻫﺬﻩ ﺍﻷﻫﺪﺍﻑ ﻣﻦ ﺷﺄﻧﻪ ﺃﻥ ﻳﻌﺰﺯ ﺍﻟﺼﺤﺔ ﺍﻟﺒﺪﻧﻴﺔ ﻭﺍﻟﻨﻔﺴﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺻﺤﺔ ﺍﻟﺒﻴﺌﺔ‬
‫ﻟﻜﻞ ﺍﳌﺼﺮﻳﲔ ﻭﺃﻫﻢ ﺍﳌﺸﺎﻛﻞ ﺫﺍﺕ ﺍﻷﻭﻟﻮﻳﺔ ﺍﻟﱵ ﻳﺘﻢ ﺍﻟﻌﻤﻞ ‪‬ﺎ‪:‬‬
‫ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ‪.‬‬ ‫‪-‬‬
‫ﺻﺤﺔ ﺍﻟﺒﻴﺌﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﻮﻗﺎﻳﺔ ﻭﺍﳊﺪ ﻣﻦ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﳊﻮﺍﺩﺙ‪.‬‬ ‫‪-‬‬
‫ﻣﻜﺎﻓﺤﺔ ﺍﻟﺘﺪﺧﲔ ﻭﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺃﺿﺮﺍﺭﻩ‪.‬‬ ‫‪-‬‬
‫ﻭﺳﻮﻑ ﳝﺜﻞ ﺍﻟﺘﻌﺎﻭﻥ ﺍﳌﺸﺘﺮﻙ ﻭﺗﻔﺎﻋﻞ ﺍ‪‬ﺘﻤﻊ ﺑﻜﺎﻓﺔ ﻗﻄﺎﻋﺎﺗﻪ ﻣﻊ ﺟﻬﺎﺕ ﺍﻟﺮﻳﺎﺩﺓ ﻭﺍﻟﺸﺮﻛﺎﺀ‬
‫ﺍﻷﺳﺎﺳﻴﲔ ﺩﻭﺭﺍ ﻫﺎﻣﺎ ﰲ ﺍﻟﻮﺻﻮﻝ ﺇﱃ ﺍﻟﻐﺎﻳﺔ ﻭﻭﺿﻊ ﺍﻷﻫﺪﺍﻑ ﻭﺻﻴﺎﻏﺔ ﺍﳋﻄﻂ ﻭﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺣﱴ‬
‫‪‬ﺎﻳﺔ ﻋﺎﻡ ‪.٢٠١٠‬‬
‫ﻛﻴﻒ ﺗﻌﻤﻞ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺷﺮﻛﺎﺋﻬﺎ ﻟﻀﻤﺎﻥ ﲢﻘﻴﻖ ﺃﻫﺪﺍﻓﻬﺎ‪:‬‬
‫ﺍﻟﺘﺪﺭﻳﺐ ﺍﻟﻼﺯﻡ ﻟﻠﻌﺎﻣﻠﲔ ﺍﻟﺼﺤﻴﲔ ﻟﺘﺤﺴﲔ ﻣﺴﺘﻮﻯ ﻛﻔﺎﺀﺓ ﺃﺩﺍﺋﻬﻢ‪.‬‬ ‫‪-‬‬
‫ﲡﺪﻳﺪ ﺍﳌﻨﺸﺂﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻻﺭﺗﻘﺎﺀ ‪‬ﺎ ﺇﱃ ﺍﳌﺴﺘﻮﻯ ﺍﳌﻄﻠﻮﺏ ﻟﺘﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ ﺫﺍﺕ ﺍﳉﻮﺩﺓ‪.‬‬ ‫‪-‬‬
‫ﺗﻮﻓﲑ ﺍﻷﺟﻬﺰﺓ ﻭﺍﳌﻌﺪﺍﺕ ﺍﻟﻀﺮﻭﺭﻳﺔ ﻭﺍﳌﺴﺘﻠﺰﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺗﻄﺒﻴﻖ ﻧﻈﻢ ﺍﻹﺩﺍﺭﺓ ﻭﺍﻹﺷﺮﺍﻑ ﻟﺪﻋﻢ ﺗﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ ﺫﺍﺕ ﺍﳉﻮﺩﺓ‪.‬‬ ‫‪-‬‬
‫ﺗﻮﻓﲑ ﺍﳌﻮﺍﺩ ﺍﻹﻋﻼﻣﻴﺔ ﺍﻟﻼﺯﻣﺔ ﻟﻼﺗﺼﺎﻝ ﻭﺍﳌﺸﻮﺭﺓ ﻟﻠﺘﺄﺛﲑ ﻋﻠﻰ ﺍﳌﻤﺎﺭﺳﺎﺕ ﺩﺍﺧﻞ ﺍﻷﺳﺮﺓ ﻭﺍ‪‬ﺘﻤﻊ‪.‬‬ ‫‪-‬‬

‫‪٢٩‬‬
 ‫‪ .٥‬ﺍﻟﺮﻋﺎﻳﺔ ﺍﳌﺘﻜﺎﻣﻠﺔ ﻟﻠﻄﻔﻞ ﰲ ﺣﺎﻟﺔ ﺍﻟﺼﺤﺔ ﻭﺍﳌﺮﺽ‬
‫ﻣﻦ ﺍﻻﲡﺎﻫﺎﺕ ﺍﳊﺪﻳﺜﺔ ﺍﻵﻥ ﻫﻮ ﺗﻘﺪﱘ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻣﺘﻜﺎﻣﻠﺔ ﻟﺮﻋﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ ﲢﺖ ﺳﻦ ‪ ٥‬ﺳﻨﻮﺍﺕ‪ ،‬ﻭﻫﺬﻩ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺗﺸﻤﻞ ﺍﳉﺎﻧﺐ ﺍﻟﻮﻗﺎﺋﻲ ﻭﺍﻟﻌﻼﺟﻲ ﻭﺍﻟﻨﻤﻮ ﺍﻟﻨﻔﺴﻲ ﻭﺍﻟﻌﻘﻠﻲ‪ .‬ﻭﻗﺪ ﺑﺪﺃ ﺍﻟﻌﻤﻞ ﻟﺘﻨﻔﻴﺬ ﻫﺬﻩ‬
‫ﺍﻹﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﰲ ﺳﻨﻪ ‪.١٩٩٧‬‬
‫ﻭ‪‬ﺪﻑ ﻫﺬﻩ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺇﱃ‪:‬‬
‫ﺧﻔﺾ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﱵ ﺗﻨﺸﺄ ﻣﻦ ﺃﻣﺮﺍﺽ ﺍﻟﻄﻔﻮﻟﺔ ﺍﻟﺸﺎﺋﻌﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﳊﺪ ﻣﻦ ﻣﻌﺪﻻﺕ ﺍﻹﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ‪.‬‬ ‫‪-‬‬
‫ﲢﺴﲔ ﳕﻮ ﺍﻟﻄﻔﻞ ﺑﺪﻧﻴﺎﹰ‪ ،‬ﻭﻋﻘﻠﻴﺎﹰ‪ ،‬ﻭﺍﺟﺘﻤﺎﻋﻴﺎﹰ‪.‬‬ ‫‪-‬‬
‫ﻭﻣﻜﻮﻧﺎﺕ ﻫﺬﻩ ﺍﻹﺳﺘﺮﺍﺗﻴﺠﻴﺔ‪:‬‬
‫ﲢﺴﲔ ﻛﻔﺎﺀﺓ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‬ ‫‪-‬‬
‫ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪.‬‬
‫ﲢﺴﲔ ﺍﻟﻨﻈــﺎﻡ ﺍﻟﺼﺤﻲ ﻣﻦ ﺣﻴﺚ ﺗﺄﺩﻳﺔ ﺍﳋﺪﻣﺎﺕ ﻭﺗﻮﻓـﲑ ﺍﻷﺩﻭﻳﺔ‪ ،‬ﺍﻷﺟﻬﺰﺓ‪ ..‬ﺍﱁ‪.‬‬ ‫‪-‬‬
‫ﲢﺴﲔ ﺍﳌﻤﺎﺭﺳﺎﺕ ﺍﳌﺆﺛﺮﺓ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺩﺍﺧﻞ ﺍﻷﺳﺮﺓ ﻭﺍ‪‬ﺘﻤﻊ‪.‬‬ ‫‪-‬‬
‫ﻭﺗﻨﻔﺬ ﺃﻧﺸﻄﺔ ﻫﺬﻩ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﻮﺣﺪﺓ ﺍﻟﺼﺤﻴﺔ ﻭﺍﳌﺴﺘﺸﻔﻰ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻷﺳﺮﺓ‬
‫ﺑﺎﳌﱰﻝ‪.‬‬
‫ﻭﺍﻷﻧﺸﻄﺔ ﺍﳌﺨﺘﻠﻔﺔ ﻟﺘﺤﻘﻴﻖ ﺃﻫﺪﺍﻑ ﻫﺬﻩ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻳﺘﻢ ﺗﻨﻔﻴﺬﻫﺎ ﻣﻦ ﺧﻼﻝ‪:‬‬
‫‪ .١‬ﺍﻟﻮﺣﺪﺓ ‪ /‬ﺍﳌﺴﺘﺸﻔﻰ ﺣﻴﺚ ﻳﺘﻢ‪:‬‬
‫ﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻟﻠﻤﺮﺽ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﻌﻼﺝ ﺍﻟﺴﻠﻴﻢ‪.‬‬ ‫‪-‬‬
‫ﺗﻘﺪﱘ ﺍﳌﺸﻮﺭﺓ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺴﻠﻴﻤﺔ‪.‬‬ ‫‪-‬‬
‫ﻣﺘﺎﺑﻌﺔ ﺍﳊﺎﻟﺔ ﺍﳌﺮﺿﻴﺔ ﻣﻦ ﺧﻼﻝ ﺯﻳﺎﺭﺍﺕ ﺍﳌﺘﺎﺑﻌﺔ‪.‬‬ ‫‪-‬‬
‫‪ .٢‬ﺍﻷﺳﺮﺓ ﻭﺍ‪‬ﺘﻤﻊ‪) :‬ﺭﻓﻊ ﺍﻟﻮﻋﻲ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺒﻴﺌﻲ(‬
‫ﺍﻟﺘﻌﺮﻑ ﻋﻠﻰ ﺍﳌﺮﺽ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﺘﻌﺮﻑ ﻋﻠﻰ ﻋﻼﻣﺎﺕ ﺍﳋﻄﺮ‪.‬‬ ‫‪-‬‬
‫ﺳﺮﻋﺔ ﻃﻠﺐ ﺍﳌﺸﻮﺭﺓ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺍﻟﺸﺨﺺ ﺍﳌﻨﺎﺳﺐ‪.‬‬ ‫‪-‬‬
‫ﺍﺗﺒﺎﻉ ﺗﻌﻠﻴﻤﺎﺕ ﺍﻟﻄﺒﻴﺐ ﺍﳋﺎﺻﺔ ﺑﺎﻟﻌﻼﺝ ﻭﺍﳌﺘﺎﺑﻌﺔ‪.‬‬ ‫‪-‬‬
‫ﺭﻋﺎﻳﺔ ﺍﻟﻄﻔﻞ ﺍﳌﺮﻳﺾ ﺑﺎﳌﱰﻝ‪.‬‬ ‫‪-‬‬

‫‪٣٠‬‬
 ‫‪ .٦‬ﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ‬
‫ﺑﺬﻟﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﰲ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻷﺧﲑﺓ ﺟﻬﺪﺍ ﻛﺒﲑﺍﹰ‪ ،‬ﻟﺘﺪﻋﻴﻢ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺭﻓﻊ‬
‫ﻛﻔﺎﺀ‪‬ﺎ ﻣﺜﻞ‪ :‬ﺯﻳﺎﺩﺓ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺘﺎﺣﺔ‪ ،‬ﲢﺪﻳﺚ ﺍﻷﺟﻬﺰﺓ ﻭﺍﳌﻌﺪﺍﺕ‪ ،‬ﺇﺩﺧﺎﻝ ﺗﻜﻨﻮﻟﻮﺟﻴﺎ ﺣﺪﻳﺜﻪ ﻟﻠﺘﺸﺨﻴﺺ‬
‫ﻭﺍﻟﻌﻼﺝ ﻭﲢﺴﲔ ﺍﻟﺒﻨﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺗﺪﺭﻳﺐ ﺍﻟﻔﺮﻳﻖ ﺍﻟﺼﺤﻲ‪ .‬ﻭﱂ ﻳﻮﺍﻛﺐ ﻣﻌﻈﻢ ﻫﺬﻩ ﺍﻷﻧﺸﻄﺔ‬
‫ﻗﻴﺎﺱ ﳉﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ‪.‬‬
‫ﻭﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ ﻳﻌﲎ ﰲ ﺃﺑﺴﻂ ﺻﻮﺭﺓ‪ ،‬ﺃﻥ ﻳﻜﻮﻥ ﻫﻨﺎﻙ ﻣﺮﺍﺟﻌﺔ ﻣﺴﺘﻤﺮﺓ ﻟﻠﻤﻨﺎﺥ ﺍﻟﺬﻱ ﻳﺘﻢ ﻓﻴﻪ ﺗﻘﺪﱘ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺗﻘﻴﻤﻬﺎ ﻭﻣﺘﺎﺑﻌﺔ ﺍﻟﻨﺘﺎﺋﺞ ﻭﺍﻛﺘﺸﺎﻑ ﺃﻭﺟﻪ ﺍﻟﻘﺼﻮﺭ ﻻﲣﺎﺫ ﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﻟﺘﺼﺤﻴﺤﻴﺔ‬
‫ﺍﳌﻨﺎﺳﺒﺔ ﳑﺎ ﻳﺆﺩﻯ ﺇﱃ ﲢﺴﲔ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ ﻭﺭﺿﺎﺀ ﺍﳌﺴﺘﻔﻴﺪﻳﻦ ﻋﻨﻬﺎ‪ .‬ﻭﻳﺘﻢ ﻫﺬﺍ ﺑﺘﻄﺒﻴﻖ ﻣﻌﺎﻳﲑ‬
‫ﳏﺪﺩﺓ ﻟﻠﺠﻮﺩﺓ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻸﻧﺸﻄﺔ ﻭﺍﻟﱪﺍﻣﺞ ﺍﳌﺨﺘﻠﻔﺔ ﺗﺆﺩﻯ ﺇﱃ ﺍﻛﺘﺸﺎﻑ ﺃﻭﺟﻪ ﺍﻟﻘﺼﻮﺭ‪.‬‬
‫ﻭﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ ﰲ ﳎﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻴﺲ ﻣﻔﻬﻮﻣﺎﹰ ﺟﺪﻳﺪﺍﹰ‪ ،‬ﻓﻬﻮ ﺃﺣﺪ ﻣﺒﺎﺩﺉ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻷﻭﻟﻴﺔ ﻭﻗﺪ ﺃﻭﺿﺤﺖ ﺍﻟﺘﺠﺎﺭﺏ ﺃﻥ ﻗﻠﺔ ﺍﻟﺘﺮﺩﺩ ﻭﺍﻻﺳﺘﻔﺎﺩﺓ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ ﻳﻜﻮﻥ ﺑﺴﺒﺐ‬
‫ﻋﺪﻡ ﺭﺿﺎﺀ ﺍﳌﻨﺘﻔﻌﲔ ﻣﻦ ﻧﻮﻋﻴﺔ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ‪.‬‬
‫ﺑﺪﺃ ﺍﻟﻌﻤﻞ ﺑﱪﻧﺎﻣﺞ ﺍﳉﻮﺩﺓ ﺳﻨﺔ ‪ ١٩٩٦‬ﻭﻛﺎﻧﺖ ﺃﻫـﻢ ﺃﻫﺪﺍﻓﻪ‪:‬‬
‫ﲢﺴﲔ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ ﻭﺯﻳﺎﺩﺓ ﻣﻌﺪﻝ ﺍﺳﺘﺨﺪﺍﻡ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﲢﻘﻴﻖ ﺍﻻﺳﺘﺨﺪﺍﻡ ﺍﻷﻣﺜﻞ ﻟﻺﻣﻜﺎﻧﻴﺎﺕ ﺍﳌﺘﺎﺣﺔ ﺑﺎﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺩﻋﻢ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﻼﻣﺮﻛﺰﻳﺔ ﰲ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺘﻨﻔﻴﺬ ﻭﺍﳌﺘﺎﺑﻌﺔ ﻟﻸﻧﺸﻄﺔ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬ ‫‪-‬‬
‫ﻭ ﻗﺪ ﴰﻠﺖ ﺧﻄﻮﺍﺕ ﺍﻟﺘﻄﺒﻴﻖ‪:‬‬
‫ﺍﺳﺘﺤﺪﺍﺙ ﻣﻌﺎﻳﲑ ﻟﻠﺨﺪﻣﺎﺕ ﻭﻗﺎﺋﻤﺔ ﻟﻠﻤﺘﺎﺑﻌﺔ )‪(Services Indicators & Monitoring Check List‬‬ ‫‪-‬‬
‫ﻭﺿﻊ ﺩﻟﻴﻞ ﻟﺘﺪﺭﻳﺐ ﺍﻟﻔﺌﺎﺕ ﺍﳌﺴﺘﻬﺪﻓﺔ‪.‬‬ ‫‪-‬‬
‫ﺗﺪﺭﻳﺐ ﻓﺮﻳﻖ ﻣﺮﻛﺰﻱ ﻟﻺﺷﺮﺍﻑ ﻭﺍﳌﺘﺎﺑﻌﺔ‪.‬‬ ‫‪-‬‬
‫ﺗﺪﺭﻳﺐ ﺍﳍﻴﺌﺔ ﺍﻹﺷﺮﺍﻓﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳌﺪﻳﺮﻳﺎﺕ ﻭﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺃﻃﺒﺎﺀ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ‬ ‫‪-‬‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻋﻠﻰ ﺍﺳﺘﺨﺪﺍﻡ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺎﺕ ﰲ ﲢﺴﲔ ﺍﻷﺩﺍﺀ ﻭﺣﻞ ﺍﳌﺸﻜﻼﺕ ﺍﳌﺘﻌﻠﻘﺔ ﺑﻪ‪.‬‬

‫‪ .٧‬ﺍﻹﺭﺷﺎﺩ ﺍﻟﻮﺭﺍﺛﻲ ﻭﻓﺤﺺ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‪:‬‬

‫ﻭﻫﻮ ﺑﺮﻧﺎﻣﺞ ﻗﻮﻣﻲ ﻳﻬﺪﻑ ﺇﱃ ﺍﳊﺪ ﻣﻦ ﺣﺪﻭﺙ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻮﺭﺍﺛﻴﺔ ﺍﻟﱵ ﺗﺆﺩﻯ ﺇﱃ ﺍﻹﻋﺎﻗﺔ ﻭﺍﻟﺘﺨﻠﻒ‬
‫ﺍﻟﻌﻘﻠﻲ‪ .‬ﻭﻟﺘﺤﻘﻴﻖ ﻫﺬﺍ ﺍﳍﺪﻑ ﰎ ﺗﻨﻔﻴﺬ ﻋﺪﺓ ﺃﻧﺸﻄﺔ ﻭﻫﻲ‪:‬‬
‫ﺗﺸﻜﻴﻞ ﳉﻨﺔ ﻓﻨﻴﺔ ﻋﻠﻴﺎ ﻟﻺﺷﺮﺍﻑ ﻋﻠﻰ ﺍﻟﱪﻧﺎﻣﺞ‪.‬‬ ‫‪-‬‬
‫ﺇﻋﺪﺍﺩ ﻋﻴﺎﺩﺍﺕ ﻟﻺﺭﺷﺎﺩ ﺍﻟﻮﺭﺍﺛﻲ ﻟﺘﻜﻮﻥ ﺣﻠﻘﺔ ﺍﻟﻮﺻﻞ ﺑﲔ ﻗﻄﺎﻉ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‬ ‫‪-‬‬
‫ﻭﻃﺒﻴﺐ ﺍﻷﺳﺮﺓ ﰲ ﺍﻟﺮﻳﻒ ﻭﺍﳊﻀﺮ ﻭﺍﳌﺮﺍﻛﺰ ﺍﳌﺘﺨﺼﺼﺔ ﰲ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻮﺭﺍﺛﻴﺔ ﻭﺍﻹﺭﺷﺎﺩ ﺍﻟﻮﺭﺍﺛﻲ‪.‬‬
‫ﺍﻟﺘﻌﺎﻭﻥ ﺑﲔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺍﳉﺎﻣﻌﺎﺕ ﻭﻣﺮﺍﻛﺰ ﺍﻹﺭﺷﺎﺩ ﺍﻟﻮﺭﺍﺛﻲ ﺍﳌﺘﺨﺼﺼﺔ‪.‬‬ ‫‪-‬‬
‫ﺇﻋﺪﺍﺩ ﺍﻟﻜﻮﺍﺩﺭ ﺍﻟﻔﻨﻴﺔ ﺍﻟﻼﺯﻣﺔ ﻟﻌﻴﺎﺩﺍﺕ ﺍﻹﺭﺷﺎﺩ ﺍﻟﻮﺭﺍﺛﻲ ﻭﺗﺪﺭﻳﺒﻬﺎ ﻋﻠﻰ ﺃﻋﻤﺎﻝ ﺍﻟﱪﻧﺎﻣﺞ‪.‬‬ ‫‪-‬‬

‫‪٣١‬‬
 ‫ﺇﻧﺸﺎﺀ ﻧﻈﺎﻡ ﺇﺣﺎﻟﺔ ﻓﻌﺎﻝ ﺑﲔ ﻣﺴﺘﻮﻳﺎﺕ ﺍﳋﺪﻣﺔ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬ ‫‪-‬‬
‫ﻭﻣﻦ ﺃﻫﻢ ﺍﳌﺸﺎﻛﻞ ﺍﻟﱵ ﺳﻮﻑ ﻳﺸﻤﻠﻬﺎ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ‪ :‬ﺍﻟﺘﺨﻠﻒ ﺍﻟﻌﻘﻠﻲ ‪ -‬ﺍﻷﻣﺮﺍﺽ ﺍﻟﻮﺭﺍﺛﻴﺔ ‪-‬‬
‫ﺍﻟﺘﺸﻮﻫﺎﺕ ﺍﳋﻠﻘﻴﺔ‪.‬‬
‫ﻭﺍﻟﺘﺪﺍﺧﻼﺕ ﺍﻟﱵ ﺳﻮﻑ ﻳﻘﻮﻡ ﺍﻟﱪﻧﺎﻣﺞ ﺑﺘﻨﻔﻴﺬﻫﺎ ﻫﻲ‪:‬‬
‫ﻓﺤﺺ ﺭﺍﻏﱯ ﺍﻟﺰﻭﺍﺝ‪.‬‬ ‫‪-‬‬
‫ﺍﻹﺭﺷﺎﺩ ﺍﻟﻮﺭﺍﺛﻲ ﻗﺒﻞ ﺍﳊﻤﻞ‪ ،‬ﻭﻣﺎ ﻗﺒﻞ ﺍﻟﻮﻻﺩﺓ ﻭﺃﺛﻨﺎﺀ ﺍﻟﻮﻻﺩﺓ‪.‬‬ ‫‪-‬‬
‫ﺍﻹﺭﺷﺎﺩ ﺍﻟﻮﺭﺍﺛﻲ ﳊﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ ﻻﻛﺘﺸﺎﻑ ﺍﳌﺸﺎﻛﻞ ﺍﻟﻮﺭﺍﺛﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺗﻘﺪﻡ ﺧﺪﻣﺔ ﺍﻹﺭﺷﺎﺩ ﺍﻟﻮﺭﺍﺛﻲ ﻣﻦ ﺍﻟﻮﻻﺩﺓ ﺣﱴ ﻋﻤﺮ ‪ ٣٥‬ﻋﺎﻣﺎ‪.‬‬ ‫‪-‬‬
‫ﻭﻣﻦ ﺍﻷﻧﺸﻄﺔ ﺍﻟﻨﺎﺟﺤﺔ ﺍﻟﱵ ﻗﺎﻡ ‪‬ﺎ ﺑﺮﻧﺎﻣﺞ ﻓﺤﺺ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‪ ،‬ﺍﻟﻜﺸﻒ ﺍﳌﺒﻜﺮ ﳌﺮﺽ ﻧﻘﺺ‬
‫ﻫﺮﻣﻮﻥ ﺍﻟﻐﺪﺓ ﺍﻟﺪﺭﻗﻴﺔ ﺑﲔ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‪.‬‬

‫‪ .٨‬ﺑﺮﻧﺎﻣﺞ ﺍﳊﺪ ﻣﻦ ﺍﻹﻋﺎﻗﺔ ﻭﺭﻋﺎﻳﺔ ﺫﻭﻯ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﻭﺍﻷﻃﻔﺎﻝ ﺍﳌﻌﺜﻮﺭ‬

‫ﻋﻠﻴﻬـﻢ‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﻟﺼﺤﺔ ﻟﺬﻭﻯ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﻭﺍﳌﻌﺜﻮﺭ ﻋﻠﻴﻬﻢ ﻣﻦ ﺍﳌﻮﺿﻮﻋﺎﺕ ﺑﺎﻟﻐﺔ ﺍﻷﳘﻴﺔ ﰲ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪ ،‬ﺣﻴﺚ ﺇﻥ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺃﻭ ﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻭﺍﻟﺘﺄﻫﻴﻞ ﻫﻮ ﺍﳌﺪﺧﻞ‬
‫ﺍﳊﻘﻴﻘﻲ ﻟﻠﻌﻨﺎﻳﺔ ‪‬ﺬﻩ ﺍﻟﻔﺌﺔ‪.‬‬
‫ﻭ ﻣﻦ ﺃﻫـﻢ ﺍﳌﺪﺧﻼﺕ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪:‬‬
‫ﺇﻋﺪﺍﺩ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻗﻮﻣﻴﺔ ﻟﻠﺤﺪ ﻣﻦ ﺍﻹﻋﺎﻗﺔ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﻣﺮﻛﺰ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻭﺩﻋﻢ ﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭ‬ ‫‪-‬‬
‫ﺑﺮﺋﺎﺳﺔ ﳎﻠﺲ ﺍﻟﻮﺯﺭﺍﺀ ‪.١٩٩٦‬‬
‫ﺇﻋﺪﺍﺩ ﺧﻄﺔ ﺍﻟﻮﺯﺍﺭﺓ ﺍﳋﺎﺻﺔ ﺑﺎﻹﻋﺎﻗﺔ ‪.١٩٩٦‬‬ ‫‪-‬‬
‫ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﳐﺘﻠﻔﺔ ﻭﻣﺘﻌﺪﺩﺓ ﻭﻗﺎﺋﻴﺔ ﻭﻋﻼﺟﻴﺔ ﰲ ﳎﺎﻝ ﺍﻹﻋﺎﻗﺔ‪.‬‬ ‫‪-‬‬
‫ﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺑﺎ‪‬ﺎﻥ )ﳍﺬﻩ ﺍﻟﻔﺌﺎﺕ(‪.‬‬ ‫‪-‬‬
‫ﺗﻨﻔﻴﺬ ﺑﺮﺍﻣﺞ ﺗﺪﺭﻳﺒﻴﺔ ﻟﻸﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ‪ ،‬ﻟﺮﻓﻊ ﻣﺴﺘﻮﻯ ﺃﺩﺍﺋﻬﻢ ﻭﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺇﻋﺪﺍﺩﻫﻢ‬ ‫‪-‬‬
‫ﻛﻬﻤﺰﺓ ﻭﺻﻞ ﺑﲔ ﺍﻟﻔﺮﻳﻖ ﺍﻟﻄﱯ ﻭﺍﳌﺘﺮﺩﺩﺍﺕ ﻋﻠﻰ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ‪.‬‬
‫ﺇﻧﺸﺎﺀ ﳉﻨﺔ ﻗﻮﻣﻴﺔ ﻋﻦ ﺍﻹﻋﺎﻗﺔ ﻋﺎﻡ ‪ ١٩٩٧‬ﻭﺗﺸﻤﻞ ﳑﺜﻠﲔ ﻣﻦ ﻭﺯﺍﺭﺍﺕ ﺍﻟﺼﺤﺔ‪ ،‬ﺍﻟﺸﺌﻮﻥ‬ ‫‪-‬‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻢ ﻭﺃﻫﻢ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﳍﺬﻩ ﺍﻟﻠﺠﻨﺔ ﻫﻲ " ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﻌﺘﻤﺪ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ‬
‫"ﻭﺍﻟﱵ ﺃﻗﺮ‪‬ﺎ ﺍﳍﻴﺌﺎﺕ ﺍﻟﺪﻭﻟﻴﺔ ﻭﺍﳌﻌﺎﻫﺪ ﺍﳌﺘﺨﺼﺼﺔ‪ .‬ﻭﻟﻘﺪ ﰎ ﺗﻨﻔﻴﺬ ﺃﻧﺸﻄﺔ ﻫﺬﻩ‬
‫ﺍﻹﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻣﻦ ﺧﻼﻝ ﺍﻟﺰﻳﺎﺭﺍﺕ ﺍﳌﱰﻟﻴﺔ ﻭﺍﻟﻘﻮﺍﻓﻞ ﺍﳌﺘﻨﻘﻠﺔ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍﻟﻮﺯﺍﺭﺍﺕ ﺍﳌﻌﻨﻴﺔ ﰲ‬
‫ﺑﻌﺾ ﺍﶈﺎﻓﻈﺎﺕ ﻣﻦ ﺧﻼﻝ ﺩﻣﺞ ﺍﻷﻃﻔﺎﻝ ﺍﳌﻌﺎﻗﲔ ﺑﺎﳌﺪﺍﺭﺱ ﺍﻟﻌﺎﻣﺔ‪.‬‬

‫‪٣٢‬‬
 ‫ﻭ ﻣﻦ ﺃﻣﺜﻠﺔ ﻫﺬﻩ ﺍﻷﻧﺸﻄﺔ‪:‬‬
‫ﺭﻓﻊ ﻭﻋﻰ ﺍﳉﻤﻬﻮﺭ ﻭﺍ‪‬ﺘﻤﻊ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻺﻋﺎﻗﺔ ﻭﺩﻭﺭ ﺍ‪‬ﺘﻤﻊ ﰲ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﳊﺎﻻﺕ‪ ،‬ﻣﻦ ﺧﻼﻝ‬ ‫‪-‬‬
‫ﺍﳌﺆﲤﺮﺍﺕ ﻭﻭﺭﺵ ﺍﻟﻌﻤﻞ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﻭﺿﻊ ﻧﻈﺎﻡ ﻟﻠﺘﻌﺎﻭﻥ ﺑﲔ ﺍﳉﻬﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﺍﻟﱵ ﺗﻘﻮﻡ ﺑﺘﻘﺪﱘ ﺧﺪﻣﺎﺕ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪.‬‬ ‫‪-‬‬
‫ﺇﻧﺸﺎﺀ ﻭﺭﺵ ﻟﺘﺼﻨﻴﻊ ﺍﻷﺟﻬﺰﺓ ﺍﻟﺘﻌﻮﻳﻀﻴﺔ ﰲ ﺑﻌﺾ ﺍﶈﺎﻓﻈﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﺇﻋﺪﺍﺩ ﻛﻮﺍﺩﺭ ﻭﺃﻗﺴﺎﻡ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻫﻴﻞ‪.‬‬ ‫‪-‬‬
‫ﻭﺿﻊ ﻧﻈﺎﻡ ﺟﻴﺪ ﻟﻺﺣﺎﻟﺔ ﻣﺜﻞ ﺍﻹﺣﺎﻟﺔ ﺇﱃ‪:‬‬ ‫‪-‬‬
‫ﺍﳌﻌﻬﺪ ﺍﻟﻘﻮﻣﻲ ﻟﻠﺠﻬﺎﺯ ﺍﻟﻌﺼﱯ ﻭﺍﳊﺮﻛﻲ )ﻣﻌﻬﺪ ﺷﻠﻞ ﺍﻷﻃﻔﺎﻝ ﺳﺎﺑﻘﺎ(‪.‬‬ ‫‪o‬‬
‫ﻣﻌﻬﺪ ﺍﻟﺴﻤﻊ ﻭﺍﻟﻜﻼﻡ‪.‬‬ ‫‪o‬‬
‫ﻣﻌﻬﺪ ﺭﻣﺪ ﺍﳉﻴﺰﺓ‪ ..‬ﺍﱁ‪.‬‬ ‫‪o‬‬

‫‪ .٩‬ﺗﻄﻮﻳﺮ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬

‫ﺇﻥ ﺍﻟﺪﻭﺭ ﺍﶈﻮﺭﻱ ﻟﻠﺼﺤﺔ ﰲ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻳﺘﻄﻠﺐ ﺍﻟﺘﻌﺮﻑ ﻋﻠﻰ ﺍﻷﻭﺿﺎﻉ‬
‫ﺍﻟﺼﺤﻴﺔ ﻟﻠﻤﺠﺘﻤﻊ ﻭﺗﻮﻓﲑ ﻧﻈﺎﻡ ﻓﻌﺎﻝ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻟﺪﻋﻢ ﻋﻤﻠﻴﺔ ﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭ ﺍﻟﱵ‬
‫ﺗﺘﻄﻠﺒﻬﺎ ﺇﺩﺍﺭﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﲢﺪﻳﺪ ﺃﻭﻟﻮﻳﺘﻬﺎ‪ .‬ﰲ ﺍﻟﻨﺼﻒ ﺍﻟﺜﺎﱐ ﻣﻦ ﻋﺎﻡ ‪ ١٩٩٥‬ﰎ ﺍﻟﻌﻤﻞ ﻋﻠﻰ‬
‫ﺗﻄﻮﻳﺮ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﲝﻴﺚ ﺗﻜﻮﻥ ﺃﻛﺜﺮ ﻛﻔﺎﺀﺓ ﻭﺇﳚﺎﺑﻴﺔ ﻣﻦ ﺧﻼﻝ‪:‬‬
‫ﺇﺻﺪﺍﺭ ﺑﻄﺎﻗﺔ ﺻﺤﻴﺔ ﻟﻠﻄﻔﻞ )ﻟﺘﺴﺘﻤﺮ ﻣﻌﻪ ﻛﻤﻮﺍﻃﻦ ﺧﻼﻝ ﻓﺘﺮﺓ ﺣﻴﺎﺗﻪ(‪.‬‬ ‫‪-‬‬
‫ﺇﻧﺸﺎﺀ ﻗﺎﻋﺪﺓ ﺑﻴﺎﻧﺎﺕ ﳉﻤﻴﻊ ﺑﺮﺍﻣﺞ ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ‪.‬‬ ‫‪-‬‬
‫ﲢﺪﻳﺪ ﻋﺪﺩ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﳌﻄﻠﻮﺑﺔ ﻟﻀﻤﺎﻥ ﺩﻗﺘﻬﺎ‪.‬‬ ‫‪-‬‬
‫ﲨﻊ ﻭﻣﻌﺎﳉﺔ ﻭﲢﻠﻴﻞ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻳﺪﻭﻳﺎ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﻮﺣﺪﺓ ﻧﻈﺮﻳﺎ ﻟﺼﻌﻮﺑﺔ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳊﺎﺳﺐ‬ ‫‪-‬‬
‫ﺍﻵﱄ ﻭﻋﺪﻡ ﻭﺟﻮﺩ ﺍﻟﻌﻤﺎﻟﺔ ﺍﳌﺪﺭﺑﺔ )ﻣﻨﺬ ‪ ١٩٩٩‬ﰎ ﺗﻮﻓﲑ ﺣﺎﺳﺒﺎﺕ ﺁﻟﻴﺔ ﰲ ﺑﻌﺾ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﱵ‬
‫ﻳﻮﺟﺪ ‪‬ﺎ ﻧﻈﺎﻡ ﻃﺒﻴﺐ ﺍﻷﺳﺮﺓ(‪.‬‬
‫ﺗﻮﻓﲑ ﺣﺎﺳﺐ ﺁﱄ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺗﺪﺭﻳﺐ ﻣﺴﺌﻮﱄ ﺍﻹﺣﺼﺎﺀ ﻭﺍﻟﻔﻨﻴﲔ‪.‬‬ ‫‪-‬‬
‫ﺗﺼﻤﻴﻢ ﺑﺮﻧﺎﻣﺞ ﺣﺎﺳﺐ ﺁﱄ ﳉﻤﻊ ﻭﲢﻠﻴﻞ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻭﺍﺳﺘﺨﺮﺍﺝ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻋﻠﻰ ﻣﺴﺘﻮﻯ‬ ‫‪-‬‬
‫ﺍﻹﺩﺍﺭﺍﺕ ﻭﺍﳌﺪﻳﺮﻳﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﺮﻛﺰﻳﺎ‪.‬‬
‫ﺗﺼﻤﻴﻢ ﺃﺩﻭﺍﺕ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻣﺜﻞ‪ :‬ﺍﻟﺒﻄﺎﻗﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺍﻟﺴﺠﻼﺕ ﺍﳋﺎﺻﺔ ﺑﺎﻟﻔﺌﺎﺕ‬ ‫‪-‬‬
‫ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻟﺸﻬﺮﻳﺔ‪ ..‬ﺍﱁ‪.‬‬

‫‪ .١٠‬ﺗﻜﺎﻣﻞ ﺍﳋﺪﻣﺎﺕ )ﺍﳌﻨﻄﻘﺔ ﺍﻟﺼﺤﻴﺔ( ﻭﻧﻈﺎﻡ ﺍﻹﺣﺎﻟﺔ‬

‫ﺗﺒﻨﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻣﻔﻬﻮﻡ ﺗﻜﺎﻣﻞ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳌﺮﻛﺰ ﺍﻹﺩﺍﺭﻱ ﺑﺎﻋﺘﺒﺎﺭﻩ‬
‫ﺍﳌﺪﺧﻞ ﺍﻟﺮﺋﻴﺴﻲ ﻟﺘﺤﻘﻴﻖ ﻫﺪﻑ ﺍﻟﺼﺤﺔ ﻟﻠﺠﻤﻴﻊ – ﻭﻳﻌﺘﻤﺪ ﻧﻈﺎﻡ ﺩﻋﻢ ﺍﳌﺮﻛﺰ ﺍﻟﺼﺤﻲ ﺍﻹﺩﺍﺭﻱ ﻋﻠﻰ‬

‫‪٣٣‬‬
‫ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ )ﺣﻜﻮﻣﻴﺔ ﻭﻏﲑ ﺣﻜﻮﻣﻴﺔ( ﻭﺗﺮﺑﻂ‬
‫ﺑﻴﻨﻬﺎ ﺧﻄﻮﻁ ﺗﻨﻈﻴﻤﻴﺔ ﻟﺘﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﻭﻟﻴﺴﺖ ﻣﺴﺘﻮﻳﺎﺕ ﻟﻠﻔﺼﻞ ﺑﻴﻨﻬﺎ‪.‬‬
‫ﻭﺗﻌﺮﻑ ﺍﻹﺣﺎﻟﺔ‪ :‬ﺑﺄ‪‬ﺎ ﺃﺣﺪ ﻣﻜﻮﻧﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﻫﻰ ﻧﻈﺎﻡ ﻛﺎﻣﻞ ﻭﻣﺴﺘﻤﺮ ﺫﻭ ﺍﲡﺎﻫﲔ ﻟﻠﺮﺑﻂ‬
‫ﺑﲔ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪.‬‬
‫ﻭﻧﻈﺎﻡ ﺍﻹﺣﺎﻟﺔ ﻫﻮ ﺃﺣﺪ ﺍﻷﺭﻛﺎﻥ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﺬﻱ ﳚﺐ ﺃﻥ ﻳﺘﺴﻢ ﺑﺄﻧﻪ ﻧﻈﺎﻡ‬
‫ﻓﻌﺎﻝ ﻭﻣﺘﻜﺎﻣﻞ ﻛﺠﺰﺀ ﻣﻮﺣﺪ ﻣﻌﻬﺎ ﳑﺎ ﻳﺆﺩﻯ ﻟﺘﺤﺴﲔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ‪.‬‬
‫ﻭﻳﻨﻔﺬ ﻧﻈﺎﻡ ﺍﻹﺣﺎﻟﺔ ﻣﻦ ﺧﻼﻝ ﺛﻼﺛﺔ ﻣﺴﺘﻮﻳﺎﺕ ﻫﻲ‪:‬‬
‫)ﻣﺴﺘﻮﻯ ﺃﻭﻝ(‬ ‫ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‬ ‫‪-‬‬
‫)ﻣﺴﺘﻮﻯ ﺛﺎﻥ(‬ ‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺮﻛﺰﻳﺔ ﻭﺍﻟﻌﺎﻣﺔ‬ ‫‪-‬‬
‫)ﻣﺴﺘﻮﻯ ﺛﺎﻟﺚ(‬ ‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻭﺍﻟﺘﺨﺼﻴﺼﻴﺔ‬ ‫‪-‬‬
‫ﺳﻴﺎﺳﺔ ﺍﻟﻮﺯﺍﺭﺓ ﰲ ﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﺍﻹﺣﺎﻟﺔ‪:‬‬
‫ﻗﻴﺎﻡ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺑﻔﺤﺺ ﲨﻴﻊ ﺍﳊﺎﻻﺕ ﺍﳌﺘﺮﺩﺩﺓ ﻃﻮﺍﻝ ‪ ٢٤‬ﺳﺎﻋﺔ‬ ‫‪-‬‬
‫ﻟﺘﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺍﳌﻤﺎﺭﺱ ﺍﻟﻌﺎﻡ ﻭﲢﻮﻳﻞ ﺍﳊﺎﻻﺕ ﺍﻟﱵ ﲢﺘﺎﺝ ﳌﺴﺘﻮﻯ ﺃﻋﻠﻰ ﻣﻦ ﺍﳋﺪﻣﺔ‪.‬‬
‫ﻳﻌﻤﻞ ﻗﺴﻢ ﺍﻻﺳﺘﻘﺒﺎﻝ ﻭﺍﻟﻄﻮﺍﺭﺉ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ﳌﺪﺓ ‪ ٢٤‬ﺳﺎﻋﺔ‪.‬‬ ‫‪-‬‬
‫ﻳﺴﺘﻤﺮ ﻧﻈﺎﻡ ﻋﻴﺎﺩﺍﺕ ﺍﻟﻌﻼﺝ ﺍﻻﻗﺘﺼﺎﺩﻱ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﺗﻌﻤﻞ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺼﺒﺎﺣﻴﺔ ﺑﺎﳌﺴﺘﺸﻔﻰ ﻛﻌﻴﺎﺩﺓ ﺃﺧﺼﺎﺋﻲ ﻟﻠﺤﺎﻻﺕ ﺍﶈﻮﻟﺔ ﻣﻦ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ‬ ‫‪-‬‬
‫ﺍﻷﺳﺎﺳﻴﺔ‪.‬‬
‫ﻭﺍﳌﻮﻗﻒ ﺍﳊﺎﱄ ﻟﻨﻈﺎﻡ ﺍﻹﺣﺎﻟﺔ ﻟﻴﺲ ﺑﺎﻟﻘﻮﺓ ﺍﳌﺘﻮﻗﻌﺔ ﺣﻴﺚ ﺇﻧﻪ ﻻ ﻳﻮﺟﺪ ﺇﺷﺮﺍﻑ ﺟﻴﺪ ﻣﻦ ﺍﻟﻮﺯﺍﺭﺓ ﻋﻠﻰ‬
‫ﺗﻨﻔﻴﺬ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﻭﻟﻜﻨﻪ ﻳﻌﺘﻤﺪ ﻋﻠﻰ‪:‬‬
‫ﺍﻻﺟﺘﻬﺎﺩ ﺍﻟﺸﺨﺼﻲ ﻟﻠﻄﺒﻴﺐ ﰲ ﲢﻮﻳﻞ ﺍﳊﺎﻻﺕ ﺍﳌﺮﺿﻴﺔ ﺇﱃ ﺍﳌﺴﺘﺸﻔﻰ ﺍﻟﻌﺎﻡ ﺃﻭ ﺍﳌﺮﻛﺰﻱ ﺑﺪﻭﻥ‬ ‫‪-‬‬
‫ﺃﻱ ﺩﻋﻢ ﺃﻭ ﺗﻌﻠﻴﻤﺎﺕ ﻣﻦ ﺍﻹﺩﺍﺭﺓ ﺃﻭ ﻣﺪﻳﺮﻳﺔ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﻻ ﺗﻮﺟﺪ ﺃﻱ ﺗﻐﺬﻳﺔ ﺭﺍﺟﻌﻪ ﻣﻦ ﺍﳌﺴﺘﺸﻔﻰ‪.‬‬
‫ﻣﻦ ﺧﻼﻝ ﺍﳌﺸﺮﻭﻋﺎﺕ ﺍﻟﱵ ﻋﻤﻠﺖ ﻭﺗﻌﻤﻞ ﰲ ﻗﻄﺎﻉ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺣﻴﺚ ﺇﻧﻪ ﺗﻮﺟﺪ‬ ‫‪-‬‬
‫ﳏﺎﻭﻻﺕ ﻟﺘﻄﺒﻴﻖ ﻧﻈﺎﻡ ﺍﻹﺣﺎﻟﺔ ﻣﻨﺬ ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ‪.‬‬
‫ﻣﻦ ﺧﻼﻝ ﻗﻴﺎﻡ ﻃﺒﻴﺐ ﺍﻟﻮﺣﺪﺓ ﺑﺘﺤﻮﻳﻞ ﺣﺎﻻﺕ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ ﺍﳌﺸﺘﺒﻪ ﻓﻴﻬﺎ ﳌﺴﺘﺸﻔﻴﺎﺕ‬ ‫‪-‬‬
‫ﺍﻟﺼﺪﺭ ﻭﺍﳊﻤﻴﺎﺕ ﻭﺫﻟﻚ ﺑﻮﺍﺳﻄﺔ ﻧﻈﺎﻡ ﳏﺪﺩ ﻗﺎﺋﻢ ﺣﺎﻟﻴﺎ‪.‬‬
‫ﻣﻦ ﺧﻼﻝ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻭﻫﻮ ﻧﻈﺎﻡ ﻗﺎﺋﻢ ﻭﻣﺴﺘﻤﺮ ﺣﺎﻟﻴﺎ ﺣﻴﺚ ﻳﺘﻢ ﺍﻟﺘﺤﻮﻳﻞ ﻟﻸﺧﺼﺎﺋﻲ‬ ‫‪-‬‬
‫ﲟﻌﺮﻓﺔ ﺍﳌﻤﺎﺭﺱ ﺍﻟﻌﺎﻡ ﻓﻘﻂ‪.‬‬
‫ﻭﻣﻌﻮﻗﺎﺕ ﺍﻻﺳﺘﻤﺮﺍﺭ ﳍﺬﺍ ﺍﻟﻨﻈﺎﻡ‪:‬‬
‫ﻋﺪﻡ ﻭﺟﻮﺩ ﺍﻟﺪﻋﻢ ﺍﻹﺩﺍﺭﻱ ﻭﺍﻟﺴﻴﺎﺳﻲ‪.‬‬ ‫‪-‬‬
‫ﺍﻧﺘﻬﺎﺀ ﺍﳌﺸﺎﺭﻳﻊ ﺍﻟﱵ ﻃﺒﻘﺖ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﻟﻌﺪﻡ ﻭﺟﻮﺩ ﻣﻘﻮﻣﺎﺕ ﺍﻻﺳﺘﻤﺮﺍﺭﻳﺔ‪.‬‬ ‫‪-‬‬

‫‪٣٤‬‬
 ‫ﻧﻘﺺ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺑﺎﳊﻀﺮ‪.‬‬ ‫‪-‬‬
‫ﻧﻘﺺ ﺍﻟﻘﻮﻯ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻌﺎﻣﻠﺔ ﻣﻦ ﺍﻷﻃﺒﺎﺀ ﻭﺍﻟﺘﻤﺮﻳﺾ ﺑﻮﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪.‬‬ ‫‪-‬‬

‫‪ .١١‬ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻨﺶﺀ )ﺻﺤﺔ ﺍﳌﺮﺍﻫﻘﲔ(‬

‫ﳝﻜﻦ ﺗﻌﺮﻳﻒ ﺻﺤﺔ ﺍﳌﺮﺍﻫﻖ‪ :‬ﺑﺄ‪‬ﺎ ﺍﳊﺎﻟﺔ ﺍﻟﺒﺪﻧﻴﺔ ﻭﺍﻟﺬﻫﻨﻴﺔ ﻭﺍﻟﻌﺎﻃﻔﻴﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻤﺮﺍﻫﻖ ﻭﺑﻴﻨﻤﺎ‬
‫ﺗﺸﻴﻊ ﺑﻌﺾ ﺍﻷﻣﺮﺍﺽ ﻭﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﻟﺪﻯ ﲨﻴﻊ ﺍﻷﻋﻤﺎﺭ‪ ،‬ﺇﻻ ﺃﻥ ﻛﻞ ﻣﺮﺣﻠﺔ ﻣﻦ ﻋﻤﺮ ﺍﻹﻧﺴﺎﻥ‬
‫ﳍﺎ ﳐﺎﻃﺮﻫﺎ ﺍﻟﺼﺤﻴﺔ ﺍﳋﺎﺻﺔ‪ .‬ﻭﻗﺪ ﺭﻛﺰﺕ ﺍﻟﻌﻠﻮﻡ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻟﺘﺨﺼﺼﺎﺕ ﺍﻟﺘﻘﻠﻴﺪﻳﺔ ﻋﻠﻰ ﻣﺮﺍﺣﻞ‬
‫ﻋﻤﺮ ﺍﻹﻧﺴﺎﻥ ﰲ ﻃﻮﺭ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ ﻭﺍﻟﻄﻔﻮﻟﺔ ﻭﺍﻟﺴﻨﻮﺍﺕ ﺍﻹﳒﺎﺑﻴﺔ‪ ،‬ﻭﻟﻜﻨﻬﺎ ﱂ ﺗﻮﻝ ﺍﻫﺘﻤﺎﻣﺎﹰ ﻛﺎﻓﻴﺎﹰ‬
‫ﺑﺎﳊﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﳌﻦ ﻫﻢ ﰲ ﻃﻮﺭ ﺍﳌﺮﺍﻫﻘﺔ‪.‬‬
‫ﻭﻣﺮﺣﻠﺔ ﺍﳌﺮﺍﻫﻘﺔ ﺗﻮﺍﻛﺒﻬﺎ ﺗﻐﲑﺍﺕ ﺑﺪﻳﻨﺔ ﻭﻫﺮﻣﻮﻧﻴﺔ ﻭﻧﻔﺴﻴﺔ ﻛﺒﲑﺓ ﺗﺪﻋﻮ ﺇﱃ ﺇﻋﻄﺎﺀ ﺍﳌﺮﺍﻫﻖ ﺭﻋﺎﻳﺔ‬
‫ﺻﺤﻴﺔ ﺧﺎﺻﺔ‪ .‬ﻭﻫﺬﻩ ﺍﻟﻔﺘﺮﺓ ﺗﻌﺘﱪ ﻓﺘﺮﺓ ﺣﺴﺎﺳﺔ ﰲ ﺣﻴﺎﺓ ﺍﻹﻧﺴﺎﻥ ﻣﻦ ﺣﻴﺚ ﺗﺄﺛﲑﻫﺎ ﻋﻠﻰ ﳕﻮ ﺍﻟﻔﺮﺩ‬
‫ﻣﻦ ﺍﻟﻨﺎﺣﻴﺔ ﺍﻟﻔﺴﻴﻮﻟﻮﺟﻴﺔ ﻭﺍﻟﻨﻔﺴﻴﺔ ﻭﺍﻟﺜﻘﺎﻓﻴﺔ‪ ،‬ﻭﻛﺬﻟﻚ ﺗﺄﺛﲑﻫﺎ ﻋﻠﻲ ﳕﻮ ﺍ‪‬ﺘﻤﻊ ﻭﺗﻘﺪﻣﻪ ﺑﺸﻜﻞ‬
‫ﻋﺎﻡ‪.‬‬
‫ﻭﻓﺌﺔ ﺍﳌﺮﺍﻫﻘﲔ ﲤﺜﻞ ‪ %٢٤‬ﻣﻦ ﺍ‪‬ﺘﻤﻊ‪ ،‬ﻣﻨﻬﻢ ‪ %٥٢‬ﺫﻛﻮﺭﺍﹰ ﻭ‪ %٤٨‬ﺇﻧﺎﺛﺎﹰ )ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ‬
‫‪.(١٩٩٦‬‬
‫ﻭﻣﻦ ﺍﳌﺘﻮﻗﻊ ﺃﻥ ﺗﺰﺩﺍﺩ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﺍﻟﻌﻤﺮﻳﺔ ﰲ ﺍﳌﺴﺘﻘﺒﻞ ﻧﺘﻴﺠﺔ ﺍﻻﳔﻔﺎﺽ ﺍﻟﻜﺒﲑ ﺍﻟﺬﻱ ﻃﺮﺃ ﻋﻠﻲ‬
‫ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ‪ ،‬ﺑﻌﺪ ﺗﻨﻔﻴﺬ ﺑﺮﺍﻣﺞ ﻋﺪﻳﺪﺓ ﻟﺮﻋﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻣﺜﻞ ﺍﻟﱪﻧﺎﻣﺞ‬
‫ﺍﳌﻮﺳﻊ ﻟﻠﺘﻄﻌﻴﻤﺎﺕ‪ ،‬ﺑﺮﻧﺎﻣﺞ ﻣﻜﺎﻓﺤﺔ ﺍﻟﺘﻬﺎﺑﺎﺕ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ‪ ،‬ﺑﺮﻧﺎﻣﺞ ﺍﻟﺮﻋﺎﻳﺔ ﺍﳌﺘﻜﺎﻣﻠﺔ ﻟﻠﻄﻔﻞ‬
‫ﺍﳌﺮﻳﺾ‪ ،‬ﺑﺮﻧﺎﻣﺞ ﻣﻜﺎﻓﺤﺔ ﺍﳌﻜﻮﻧﺎﺕ ﺍﻟﻐﺬﺍﺋﻴﺔ ﺍﻟﺪﻗﻴﻘﺔ‪ ..‬ﺍﱁ‪.‬‬
‫ﻭﺗﺸﲑ ﺍﻟﺪﻻﺋﻞ ﻭﻧﺘﺎﺋﺞ ﺍﻟﺒﺤﻮﺙ ﻭﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﳌﻌﻨﻴﺔ ﺑﺎﻟﺸﺒﺎﺏ‪ ،‬ﺃﻥ ﺻﺤﺔ ﺍﳌﺮﺍﻫﻖ ﰲ ﻣﺼﺮ ﻣﺸﺎ‪‬ﺔ ﺇﱃ‬
‫ﺣﺪ ﺑﻌﻴﺪ ﻟﺼﺤﺔ ﺍﳌﺮﺍﻫﻘﲔ ﰲ ﺍﻟﺪﻭﻝ ﺍﳌﻤﺎﺛﻠﺔ ﰲ ﺍﻟﻈﺮﻭﻑ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻣﻦ ﺣﻴﺚ ﺣﺠﻢ‬
‫ﻭﺗﻨﻮﻉ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻭﻣﻦ ﺍﳌﺆﺷﺮﺍﺕ ﺍﻟﱵ ﺗﻌﻜﺲ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﺔ ﻟﻠﺸﺒﺎﺏ )‪ ١٩-١١‬ﺳﻨﺔ(‪:‬‬
‫ﻧﺴﺒﺔ ﺃﻧﻴﻤﻴﺎ ﻧﻘﺺ ﺍﳊﺪﻳﺪ ﰲ ﻫﺬﻩ ﺍﻟﻔﺌﺔ‪:‬‬ ‫‪-‬‬
‫ﻭ‪ %٢٦,١‬ﺑﲔ ﺍﻹﻧﺎﺙ‪.‬‬ ‫‪ %٢٩,٥‬ﺑﲔ ﺍﻟﺬﻛﻮﺭ‬ ‫ﺃﻧﻴﻤﻴﺎ ﺑﺴﻴﻄﺔ‬ ‫‪o‬‬
‫ﻭ‪ %٢,٨‬ﺑﲔ ﺍﻹﻧﺎﺙ‪.‬‬ ‫ﺃﻧﻴﻤﻴﺎ ﻣﺘﻮﺳﻄﺔ ‪ %٠,٧‬ﺑﲔ ﺍﻟﺬﻛﻮﺭ‬ ‫‪o‬‬
‫ﻭ‪ %٠,١‬ﺑﲔ ﺍﻹﻧﺎﺙ‪.‬‬ ‫‪ %٠,١‬ﺑﲔ ﺍﻟﺬﻛﻮﺭ‬ ‫ﺃﻧﻴﻤﻴﺎ ﺣﺎﺩﺓ‬ ‫‪o‬‬
‫)ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﺍﻟﺪﳝﺠﺮﺍﰲ ‪(٢٠٠٠‬‬
‫ﻳﻌﺎﱐ ‪ %١٧‬ﻣﻦ ﺍﻟﻨﺶﺀ ﻣﻦ ﺍﻟﺘﻘﺰﻡ )‪ %١٩‬ﺑﲔ ﺍﻟﺬﻛﻮﺭ ﻭ‪ %١٥‬ﺑﲔ ﺍﻹﻧﺎﺙ(‪) .‬ﺍﳌﺴﺢ ﺍﻟﻘﻮﻣﻲ ﺣﻮﻝ‬ ‫‪-‬‬
‫ﺍﻟﻨﺶﺀ ﰲ ﻣﺼﺮ ﳎﻠﺲ ﺍﻟﺴﻜﺎﻥ ‪.(١٩٩٩‬‬
‫ﻳﻌﺎﱐ ‪ %١٠‬ﻣﻦ ﺍﻟﻨﺶﺀ ﻣﻦ ﺃﺧﻄﺎﺭ ﺍﻟﺴﻤﻨﺔ‪ ،‬ﺧﺎﺻﺔ ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ‪) .‬ﳎﻠﺲ ﺍﻟﺴﻜﺎﻥ ‪.(١٩٩٩‬‬ ‫‪-‬‬

‫‪٣٥‬‬
‫ﺃﺛﺒﺘﺖ ﺍﻹﺣﺼﺎﺋﻴﺎﺕ ﺃﻥ ﻣﺼﺮ ﻣﻦ ﺃﻗﻞ ﺍﻟﺪﻭﻝ ﺇﺻﺎﺑﺔ ﲟﺮﺽ ﺍﻹﻳﺪﺯ ﻭﺑﻠﻎ ﻋﺪﺩ ﺍﳌﺼﺎﺑﲔ ‪ ١٠٤٤‬ﺣﺎﻟﺔ‬ ‫‪-‬‬
‫)‪ %٩,٤‬ﻣﻨﻬﻢ ﻣﻦ ﺍﻟﺸﺒﺎﺏ( ﻋﺎﻡ ‪) .٢٠٠١‬ﺍﻟﱪﻧﺎﻣﺞ ﺍﻟﻘﻮﻣﻲ ﳌﻜﺎﻓﺤﺔ ﺍﻹﻳﺪﺯ(‬
‫ﻧﺴﺒﺔ ﺍﳌﺪﺧﻨﲔ ﰲ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ ‪ ١٩-١١‬ﺳﻨﺔ‪ ،‬ﻭ‪ %١١,٢‬ﺑﲔ ﺍﻟﺬﻛﻮﺭ‪ ،‬ﻭ‪ %٠,٣‬ﺑﲔ ﺍﻹﻧﺎﺙ‪) .‬ﳎﻠﺲ‬ ‫‪-‬‬
‫ﺍﻟﺴﻜﺎﻥ ‪(١٩٩٩‬‬
‫ﺯﺍﺩ ﻋﺪﺩ ﺍﳌﺆﻳﺪﻳﻦ ﳌﻨﻊ ﺧﺘﺎﻥ ﺍﻹﻧﺎﺙ ﻣﻦ ‪ %١٨‬ﻋﺎﻡ ‪ ١٩٩٥‬ﺇﱃ ‪ %٢٥‬ﻋﺎﻡ ‪) .٢٠٠٠‬ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ‬ ‫‪-‬‬
‫ﺍﻟﺪﳝﺠﺮﺍﰲ ‪(٢٠٠٠‬‬
‫ﻭﺣﻴﺚ ﺇﻥ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺣﻖ ﺃﺳﺎﺳﻲ ﻛﻔﻠﻪ ﺍﻟﺪﺳﺘﻮﺭ ﳉﻤﻴﻊ ﺍﳌﻮﺍﻃﻨﲔ ﻭﻳﺘﻤﺘﻊ ﺍﳉﻤﻴﻊ ‪‬ﺎ‪ .‬ﻓﺈﻥ‬
‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻫﻲ ﺍﳉﻬﺔ ﺍﳌﻨﻮﻃﺔ ﺑﺎﳌﺴﺌﻮﻟﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪ .‬ﻭﺗﺴﻌﻲ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺣﺎﻟﻴﺎ ﺇﱃ ﲢﻘﻴﻖ ﻫﺪﻑ ﺍﻟﺼﺤﺔ ﻟﻠﺠﻤﻴﻊ‪" ،‬ﻣﺼﺮﻳﻮﻥ ﺃﺻﺤﺎﺀ ‪ "٢٠١٠‬ﺍﻟﺬﻱ ﻳﻀﻊ‬
‫ﺑﻌﺾ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﻘﻮﻣﻴﺔ ﺍﳋﺎﺻﺔ ﺑﻔﺌﺔ ﺍﳌﺮﺍﻫﻘﲔ ﻣﻦ ﺍﻟﺸﺒﺎﺏ‪.‬‬
‫ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺸﺒﺎﺏ‪:‬‬
‫‪ .١‬ﺗﻌﺰﻳﺰ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺗﺸﻤﻞ ﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﻨﻤﻮ ﻭﻣﻨﻊ ﺗﻔﺸﻲ ﺍﻷﻣﺮﺍﺽ‪ ،‬ﻭﺍﻟﻌﺎﺩﺍﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻟﺴﻠﻴﻤﺔ ﻭﺍﻟﻌﻨﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻟﺘﻄﻌﻴﻤﺎﺕ ﻭﻛﺎﻓﺔ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﱵ ﺗﺆﺛﺮ ﰲ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﺔ‬
‫ﻟﻠﻤﺠﺘﻤﻊ‪.‬‬
‫‪ .٢‬ﲢﺴﲔ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ ﻣﻦ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﻣﺜﻞ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫– ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )ﺍﻟﺘﺎﻣﲔ ﻋﻠﻰ ﻃﻼﺏ ﺍﳌﺪﺍﺭﺱ( ‪ -‬ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳉﺎﻣﻌﻴﺔ ‪ -‬ﺍﳉﻤﻌﻴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﻋﻦ‬
‫ﻃﺮﻳﻖ ﺗﺪﺭﻳﺐ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻟﺘﻮﺍﻓﻖ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺸﺒﺎﺏ‪.‬‬
‫‪ .٣‬ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ‪ :‬ﺍﻻﻫﺘﻤﺎﻡ ﺑﻨﺸﺮ ﺍﻟﻮﻋﻲ ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ ﺑﻔﺘﺮﺓ ﺍﻟﺒﻠﻮﻍ ﻭﺻﺤﺔ ﺍﳌﺮﺃﺓ ﻭﺗﻨﻈﻴﻢ‬
‫ﺍﻷﺳﺮﺓ ﻭﻣﺸﺎﺭﻛﺔ ﺍﻟﺰﻭﺝ ﰲ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﻭﺍﻟﻮﻋﻲ ﺑﺎﻟﺼﺤﺔ ﺍﳉﻨﺴﻴﺔ ﻭﺍﻻﻫﺘﻤﺎﻡ ﺑﺘﻄﺒﻴﻖ‬
‫ﻣﻔﻬﻮﻡ ﺍﻟﻮﻻﺩﺓ ﺍﻵﻣﻨﺔ ﻭﺍﻻﻫﺘﻤﺎﻡ ﲟﺸﻜﻠﺔ ﺍﻟﺰﻭﺍﺝ ﺍﳌﺒﻜﺮ‪ ،‬ﻭﻛﺬﻟﻚ ﻣﺸﺎﺭﻛﺔ ﺍﻟﺰﻭﺟﺔ ﰲ ﺍﻟﻘﺮﺍﺭﺍﺕ‬
‫ﺍﳋﺎﺻﺔ ﺑﺎﻷﺳﺮﺓ‪.‬‬
‫‪ .٤‬ﲪﺎﻳﺔ ﺍﳌﺮﺍﻫﻘﲔ ﻣﻦ ﺍﻟﻌﻨﻒ‪ ،‬ﺧﺎﺻﺔ ﺑﲔ ﺃﻓﺮﺍﺩ ﺍﻷﺳﺮﺓ ﻛﻮﺳﻴﻠﺔ ﻟﻠﻌﻘﺎﺏ ﻋﻠﻰ ﺍﻷﺧﻄﺎﺀ‪ ،‬ﻭﻛﺬﻟﻚ‬
‫ﺍﻟﻌﻨﻒ ﺍﻟﺬﻱ ﳛﺪﺙ ﻣﻦ ﺧﻼﻝ ﻋﻤﻠﻴﺔ ﺧﺘﺎﻥ ﺍﻹﻧﺎﺙ ﻭﺫﻟﻚ ﻋﻦ ﻃﺮﻳﻖ ﻭﺿﻊ ﻗﻮﺍﻧﲔ ﲤﻨﻊ ﺟﺮﺍﺋﻢ‬
‫ﺍﻟﻌﻨﻒ ﺍﻷﺳﺮﻯ‪.‬‬
‫‪ .٥‬ﺍﳌﺴﺎﻭﺍﺓ ﻭﻋﺪﻡ ﺍﻟﺘﻔﺮﻗﺔ ﺑﲔ ﺍﻷﻭﻻﺩ ﻭﺍﻟﺒﻨﺎﺕ ﰲ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ‪.‬‬
‫‪ .٦‬ﺗﻮﺟﻴﻪ ﻭﺳﺎﺋﻞ ﺍﻹﻋﻼﻡ ﻟﻠﺘﺼﺪﻱ ﻟﻠﻤﺸﺎﻛﻞ ﺍﻟﱵ ﺗﺆﺛﺮ ﻋﻠﻰ ﺍﳌﺮﺍﻫﻘﲔ‪ ،‬ﻭﺧﺎﺻﺔ ﺍﻟﻌﻨﻒ ﻭﺍﻟﺘﻤﻴﻴﺰ‬
‫ﻭﳎﺎ‪‬ﺔ ﺍﻟﺘﺄﺛﲑ ﺍﻹﻋﻼﻣﻲ ﺍﻟﺴﻠﱯ ﻏﲑ ﺍﳌﺘﻨﺎﺳﺐ ﻣﻊ ﺍﻟﺒﻴﺌﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﰲ ﻣﺼﺮ ﻭﺍﻻﻫﺘﻤﺎﻡ‬
‫ﺑﺎﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﻣﻦ ﺣﻴﺚ ﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﻨﻈﺎﻓﺔ ﺍﻟﺸﺨﺼﻴﺔ‪.‬‬
‫ﺑﻌﺾ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ ﻟﻠﻨﺶﺀ‪:‬‬
‫ﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻄﻼﺏ ﺍﳌﺪﺍﺭﺱ‪ ،‬ﺍﻟﺬﻱ ﻳﺸﻤﻞ ‪ ١٢‬ﻣﻠﻴﻮﻥ ﻃﺎﻟﺐ ﻭﻃﺎﻟﺒﺔ‪ ،‬ﻣﻦ ﺧﻼﻝ‬ ‫‪-‬‬
‫ﺣﻮﺍﱄ ‪ ٧٠٠‬ﻋﻴﺎﺩﺓ ﻟﻠﺼﺤﺔ ﺍﳌﺪﺭﺳﻴﺔ ﻭﺗﺸﻤﻞ‪:‬‬
‫ﺧﺪﻣﺎﺕ ﻭﻗﺎﺋﻴﺔ‪.‬‬ ‫‪o‬‬

‫‪٣٦‬‬
 ‫ﺧﺪﻣﺎﺕ ﻋﻼﺟﻴﺔ‪.‬‬ ‫‪o‬‬
‫ﺧﺪﻣﺎﺕ ﺗﺄﻫﻴﻠﻴﺔ‪.‬‬ ‫‪o‬‬
‫ﺑﺮﻧﺎﻣﺞ ﻣﻜﺎﻓﺤﺔ ﺃﻧﻴﻤﻴﺎ ﻧﻘﺺ ﺍﳊﺪﻳﺪ ﺑﲔ ﺍﳌﺮﺍﻫﻘﲔ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﺘﺜﻘﻴﻒ ﺍﻟﺼﺤﻲ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﻭﺍﳉﻤﻌﻴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﻭﻭﺳﺎﺋﻞ ﺍﻹﻋﻼﻡ‬ ‫‪-‬‬
‫ﺍﳌﺨﺘﻠﻔﺔ‪ .‬ﻭﻳﺸﻤﻞ ﺍﻟﱪﻧﺎﻣﺞ ﺍﳌﻮﺿﻮﻋﺎﺕ ﺍﳌﺘﻌﻠﻘﺔ‪:‬‬
‫ﺍﻟﻨﻈﺎﻓﺔ ﺍﻟﻌﺎﻣﺔ‪.‬‬ ‫‪o‬‬
‫ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ‪.‬‬ ‫‪o‬‬
‫ﺍﻟﺘﻐﺬﻳﺔ‪.‬‬ ‫‪o‬‬
‫ﺍﻷﺣﻜﺎﻡ ﺍﻟﺸﺮﻋﻴﺔ ﻭﻓﻘﻪ ﺍﻟﻄﻬﺎﺭﺓ‪.‬‬ ‫‪-‬‬

‫ ?>=   ‪@"45' !)    0 #‬‬

‫ﺗﻮﺍﺟﻪ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ ﲢﺪﻳﺎﺕ ﻣﺘﻌﺪﺩﺓ ﺗﻀﻊ ﺻﻌﻮﺑﺎﺕ ﰲ ﻃﺮﻳﻖ ﲢﺴﲔ ﻭﺿﻤﺎﻥ ﺻﺤﺔ‬
‫ﻭﺭﻓﺎﻫﻴﺔ ﺍﻟﺸﻌﺐ ﺍﳌﺼﺮﻱ ﻓﻨـﺤﻦ ﻧﻌﺎﱐ ﻋﺒﺌﲔ ﺭﺋﻴﺴﻴﲔ‪:‬‬
‫ﻋﺐﺀ ﺍﳌﺮﺽ‪.‬‬ ‫‪-‬‬
‫ﻋﺐﺀ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻜﺎﻧﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﻓﻌﺐﺀ ﺍﳌﺮﺽ ﳝﺜﻞ ﺿﻐﻮﻃﺎ ﻣﺘﻌﺪﺩﺓ؛ ﺍﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﺟﺘﻤﺎﻋﻴﺔ ﻭﺳﻴﺎﺳﻴﺔ‪ ،‬ﻭﰲ ﻣﺼﺮ ﻧـﺤﻦ ﻧﻌﺎﱐ ﻣﻦ‬
‫ﻋﺐﺀ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﺎﲡﺔ ﻋﻦ ﺍﻟﻔﻘﺮ ﻭﺍﻟﻐﲎ ﻣﻌﺎ‪ .‬ﻫﺬﺍ ﺍﻟﻌﺐﺀ ﺍﳌﺰﺩﻭﺝ ﻳﺘﻄﻠﺐ ﺃﻭﻻ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻣﺮﺍﺽ‬
‫ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﻟﻔﻘﺮ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﻷﻣﻴﺔ ﻭﻧﻘﺺ ﺍﻟﺘﻌﻠﻴﻢ‪.‬‬
‫ﺃﻣﺎ ﺍﻟﻌﺐﺀ ﺍﻵﺧﺮ ﻓﻬﻮ ﻋﺐﺀ ﺍﻷﻣﺮﺍﺽ ﻭﺍﻷﻋﺒﺎﺀ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﻟﺘﻐﲑﺍﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺍﻟﱵ‬
‫ﴰﻠﺖ ﲨﻴﻊ ﻣﺮﺍﻓﻖ ﺍﻟﺪﻭﻟﺔ‪.‬‬
‫ﺃﻣﺎ ﻋﺐﺀ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻓﻴﺘﺠﺴﺪ ﰲ ﺍﺭﺗﻔﺎﻉ ﻣﻌﺪﻝ ﺍﳌﻮﺍﻟﻴﺪ ﻣﻊ ﺍﻟﺘﺰﺍﻳﺪ ﰲ ﻣﺘﻮﺳﻂ ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ‪.‬‬
‫ﻣﺎ ﻫﻲ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺼﺤﻴﺔ ﳌﺼﺮ ﺣﺎﻟﻴﺎ ﻭﰲ ﺍﳌﺴﺘﻘﺒﻞ؟‬
‫‪ .١‬ﺑﺮﻏﻢ ﺍﳉﻬﻮﺩ ﺍﻟﻜﺜﲑﺓ ﺍﻟﱵ ﺑﺬﻟﺖ‪ ،‬ﻓﻤﺎ ﺯﺍﻟﺖ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻜﺎﻧﻴﺔ ﲤﺜﻞ ﻋﺎﺋﻘﺎ ﻛﺒﲑﺍ ﺃﻣﺎﻡ ﺧﻄﻂ‬
‫ﺍﻟﺘﻨﻤﻴﺔ ﻭﺗﺆﺛﺮ ﻋﻠﻰ ﺍﻟﺘﻄﻮﺭ ﻭﺍﻟﻨﻤﻮ ﺍﻻﻗﺘﺼﺎﺩﻱ ﻭﺍﻟﺼﺤﻲ ﻭﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﻳﺘﻄﻠﺐ ﳊﻞ ﻫﺬﻩ‬
‫ﺍﳌﺸﻜﻠﺔ ﺗﻜﺎﺗﻒ ﲨﻴﻊ ﻗﻄﺎﻋﺎﺕ ﻭﻫﻴﺌﺎﺕ ﺍﻟﺪﻭﻟﺔ ﺫﺍﺕ ﺍﻟﻌﻼﻗﺔ‪ .‬ﻭﻛﻤﺎ ﺃﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺗﺘﺤﻤﻞ‬
‫ﺍﳌﺴﺌﻮﻟﻴﺔ ﺍﻟﻜﺎﻣﻠﺔ ﻋﻦ ﺻﺤﺔ ﺍﳌﻮﺍﻃﻨﲔ ﻓﻬﻲ ﺗﻀﻄﻠﻊ ﺑﺎﻟﻨﺼﻴﺐ ﺍﻷﻛﱪ ﻣﻦ ﺍﳌﺴﺌﻮﻟﻴﺔ ﳌﻮﺍﺟﻬﺔ‬
‫ﺍﳌﺸﻜﻠﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻭﻗﺪ ﺗﻌﻈﻢ ﻫﺬﺍ ﺍﻟﺪﻭﺭ ﺣﱴ ﺃﺳﻨﺪ ﺇﻟﻴﻬﺎ ﻣﻬﺎﻡ ﺍﻟﻌﻤﻞ ﰲ ﳎﺎﻝ ﺍﻟﺴﻜﺎﻥ‬
‫ﺑﺎﻟﻜﺎﻣﻞ ﻋﺎﻡ ‪ ١٩٩٦‬ﺑﻀﻢ ﻭﺯﺍﺭﺓ ﺍﻟﺴﻜﺎﻥ ﻭﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﺇﱃ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻟﻴﺼﺒﺢ ﻣﺴﻤﺎﻫﺎ‬
‫ﺍﻟﺮﲰﻲ "ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ" )ﻣﻨﺬ ﺫﻟﻚ ﺍﻟﺘﺎﺭﻳﺦ(‪ ،‬ﻭﻣﻦ ﰒ ﺃﺧﺬﺕ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺴﻜﺎﻧﻴﺔ‬
‫ﻣﻨﻌﻄﻔﺎﹰ ﺟﺪﻳﺪﺍﹰ ﻭﰎ ﺗﻜﺜﻴﻒ ﺍﳉﻬﻮﺩ ﻟﺪﻓﻊ ﺧﻄﻮﺍﺕ ﺣﻞ ﺍﳌﺸﻜﻠﺔ ﻭﻣﻮﺍﺟﻬﺔ ﺍﻟﺘﺤﺪﻳﺎﺕ‬
‫ﺍﳌﺴﺘﻘﺒﻠﻴﺔ ﻟﻠﺘﻨﻤﻴﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻟﺼﺤﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪.‬‬

‫‪٣٧‬‬
 ‫‪ .٢‬ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﻭﻣﻜﺎﻓﺤﺔ ﺃﻣﺮﺍﺽ ﺍﻟﻄﻔﻮﻟﺔ‪:‬‬
‫ﺭﻏﻢ ﺍﻹﳒﺎﺯﺍﺕ ﺍﻟﻜﺜﲑﺓ ﰲ ﺍ‪‬ﺎﻻﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﻓﻤﺎﺯﺍﻟﺖ ﻫﻨﺎﻙ ﻣﻌﺪﻻﺕ ﻋﺎﻟﻴﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ‬
‫ﻭﺍﻟﻮﻓﻴﺎﺕ ﺍﻟﱵ ﳝﻜﻦ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻨﻬﺎ ﺑﲔ ﺍﻷﻣﻬﺎﺕ ﻭﺍﻷﻃﻔﺎﻝ‪ ،‬ﺧﺎﺻﺔ ﺑﲔ ﻓﺌﺔ ﺍﻟﻔﻘﺮﺍﺀ ﻭﺍﻷﻣﻴﲔ‪،‬‬
‫ﻭﻛﺬﻟﻚ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﱵ ﺗﻨﻘﺼﻬﺎ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﺣﻴﺚ ﺗﻮﺟﺪ ﻣﺸﺎﻛﻞ‬
‫ﺍﻟﺼﺤﺔ ﺍﻟﺒﻴﺌﻴﺔ ﻭﺣﻴﺚ ﺗﺴﻮﺩ ﻇﺮﻭﻑ ﺳﻴﺌﺔ ﻟﻠﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﻭﻳﻌﺎﱏ ﺛﻠﺚ ﺍﻷﻃﻔﺎﻝ ﺃﻗﻞ ﻣﻦ ‪٥‬‬
‫ﺳﻨﻮﺍﺕ ﻣﻦ ﺍﻟﻌﻤﺮ ﻣﻦ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻛﻤﺎ ﺗﻨﺘﺸﺮ ﺣﺎﻻﺕ ﺍﻹﺳﻬﺎﻝ ﻭﺍﻟﺘﻬﺎﺑﺎﺕ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ‬
‫ﻭﺧﺎﺻﺔ ﺍﻻﻟﺘﻬﺎﺑﺎﺕ ﺍﻟﺮﺋﻮﻳﺔ )ﺍﻟﱵ ﲤﺜﻞ ﺣﻮﺍﱄ ‪ %٥٠‬ﻣﻦ ﺇﲨﺎﱄ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ( ﻭﻫﺬﺍ‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻋﻮﺩﺓ ﻇﻬﻮﺭ ﺑﻌﺾ ﺍﻷﻣﺮﺍﺽ ﻣﺮﺓ ﺃﺧﺮﻯ ﻣﺜﻞ ﺍﻟﺪﺭﻥ ﺍﻟﺬﻱ ﳝﺜﻞ ﻣﺸﻜﻠﺔ ﺧﻄﲑﺓ‪.‬‬
‫‪ .٣‬ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ ﻭﻋﻼﺟﻬﺎ‪:‬‬
‫ﺃﻣﺮﺍﺽ ﺍﻟﻘﻠﺐ ﻭﺍﻷﻭﻋﻴﺔ ﺍﻟﺪﻣﻮﻳﺔ ﺗﺘﺴﺒﺐ ﰲ ﺣﻮﺍﱄ ﻧﺼﻒ ﻭﻓﻴﺎﺕ ﺍﻟﺒﺎﻟﻐﲔ‪ ،‬ﻭﺗﺘﺰﺍﻳﺪ ﺍﻷﻣﺮﺍﺽ ﻏﲑ‬
‫ﺍﳌﻌﺪﻳﺔ ﺑﺎﳉﻬﺎﺯ ﺍﻟﺪﻭﺭﻱ ﻭﺍﻟﺘﻨﻔﺴﻲ ﻭﺍﻟﻌﺼﱯ‪ ،‬ﻧﺘﻴﺠﺔ ﻧﻘﺺ ﳑﺎﺭﺳﺔ ﺍﻟﺮﻳﺎﺿﺔ ﻭﺯﻳﺎﺩﺓ ﺍﻟﺘﺪﺧﲔ‬
‫ﻭﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﻭﺯﻳﺎﺩﺓ ﺍﻟﻮﺯﻥ ﻭﺍﻟﺴﻤﻨﺔ‪ .‬ﻛﻤﺎ ﺗﺘﺰﺍﻳﺪ ﺃﻣﺮﺍﺽ ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ ﻭﺍﻟﺴﻜﺮ ﻭﺍﻷﻭﺭﺍﻡ‪.‬‬
‫‪ .٤‬ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﳊﻮﺍﺩﺙ ﻭﻋﻼﺟﻬﺎ‪:‬‬
‫ﻣﻦ ﺃﻫﻢ ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ ﺣﺎﻟﻴﺎﹰ؛ ﺯﻳﺎﺩﺓ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﳊﻮﺍﺩﺙ‪ ،‬ﻛﻤﺎ ﺃﻥ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻌﺎﺟﻠﺔ ﱂ ﺗﻜﻦ‬
‫ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﳌﻄﻠﻮﺏ ﺃﻭ ﺍﳌﺘﻮﻗﻊ ﰲ ﺍﻟﻔﺘﺮﺓ ﺍﻟﺴﺎﺑﻘﺔ‪ ،‬ﻭﻛﺎﻧﺖ ﻏﲑ ﳎﻬﺰﺓ ﳌﻮﺍﺟﻬﺔ ﺣﺎﻻﺕ‬
‫ﺍﻹﺻﺎﺑﺔ ﺍﻟﺸﺪﻳﺪﺓ )ﳑﺎ ﻧﺘﺞ ﻋﻨﻪ ﺯﻳﺎﺩﺓ ﺍﻟﻮﻓﻴﺎﺕ(‪.‬‬
‫‪ .٥‬ﺭﻓﻊ ﺍﻟﻮﻋﻲ ﺍﻟﺼﺤﻲ‪:‬‬
‫ﺗﻌﺘﱪ ﺍﳊﺎﺟﺔ ﻣﻠﺤﺔ ﻟﺘﺤﺴﲔ ﻭﺩﻋﻢ ﺍﻹﻋﻼﻡ ﺍﻟﺼﺤﻲ ﻭﺗﻘﺪﱘ ﺍﳌﺸﻮﺭﺓ ﻟﻠﺠﻤﺎﻫﲑ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ‬
‫ﺍﻷﻣﺮﺍﺽ ﻭﻟﺮﻓﻊ ﻣﺴﺘﻮﻯ ﺍﻟﻮﻋﻲ ﺑﺄﻣﻮﺭ ﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﻭﳋﻔﺾ ﳐﺎﻃﺮ ﺍﻷﻣﺮﺍﺽ‬
‫ﺍﳌﻌﺪﻳﺔ ﻭﻏﲑ ﺍﳌﻌﺪﻳﺔ‪ ،‬ﻭﺫﻟﻚ ﺑﻐﺮﺽ "ﺗﻐﻴﲑ ﺍﻟﺴﻠﻮﻛﻴﺎﺕ" ﺍﻟﱵ ﺗﺆﺩﻯ ﺇﱃ ﺯﻳـﺎﺩﺓ ﺍﳌﺨﺎﻃﺮ ﻋﻠﻰ‬
‫ﺍﻟﺼﺤﺔ ﻭﺑﺎﻟﺘﺎﱄ ﺍﻟﻮﻓﺎﺓ ﺍﳌﺒﻜﺮﺓ‪.‬‬
‫ﻫﻨﺎﻙ ﻋﺪﺩ ﻣﻦ ﺍﳌﺆﺷﺮﺍﺕ ﺍﻟﱵ ﺗﺒﲔ ﻣﺪﻯ ﺍﳔﻔﺎﺽ ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﳑﺎ ﺟﻌﻞ ﺍﳊﺎﺟﺔ‬
‫ﻣﻠﺤﺔ ﻭﻋﺎﺟﻠﺔ ﻟﻠﺒﺪﺀ ﰲ ﺗﻨﻔﻴﺬ ﺍﻟﱪﻧﺎﻣﺞ ﻹﺻﻼﺡ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻋﺎﻡ ‪.١٩٩٦‬‬

‫ﺍﳌﻌﻮﻗﺎﺕ ﻭﺍﻟﺼﻌﻮﺑﺎﺕ ﺍﻟﱵ ﺗﻮﺍﺟﻪ ﺗﻨﻔﻴﺬ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﺼﺤﺔ‬

‫‪ .١‬ﺿﻌﻒ ﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﻮﺯﺍﺭﺍﺕ ﺍﻷﺧﺮﻯ ﺍﳌﻌﻨﻴﺔ )ﺍﻟﺒﻴﺌﺔ – ﺍﻟﺘﻤﻮﻳﻦ –‬
‫ﺍﻟﺘﻌﻠﻴﻢ ‪ ٠٠‬ﺍﱁ(‪.‬‬
‫‪ .٢‬ﺿﻌﻒ ﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﻔﻨﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ ﺩﺍﺧﻞ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬
‫‪ .٣‬ﻭﺟﻮﺩ ﲤﻮﻳﻞ ﻣﻦ ﺍﳍﻴﺌﺎﺕ ﺍﻟﺪﻭﻟﻴﺔ ﻣﺜﻞ )‪ ،USAID – UNICEF‬ﻭﻏﲑﻫﺎ( ﻣﻨﺬ ﺑﺪﺍﻳﺔ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ‬
‫ﻟﺘﻨﻔﻴﺬ ﺑﻌﺾ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ ﺍﻟﱵ ﻣﻦ ﺃﻫﻢ ﺃﻫﺪﺍﻓﻬﺎ ﺧﻔﺾ ﻧﺴﺒﺔ ﺍﻟﻮﻓﻴﺎﺕ ﺑﲔ‬
‫ﺍﻟﻔﺌﺎﺕ ﺍﳊﺴﺎﺳﺔ )ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ(‪ ،‬ﻭﲢﺴﲔ ﺻﺤﺔ ﺍﳌﻮﺍﻃﻦ ﺍﳌﺼﺮﻱ؛ ﺃﺩﻱ ﺫﻟﻚ ﺇﱃ ﻭﺟﻮﺩ ﺗﻌﺪﺩﻳﺔ ﰲ‬
‫ﺍﻷﻧﺸﻄﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻮﺟﻬﺔ ﺇﱃ ﺍﻟﻄﻔﻞ ﺍﻟﻮﺍﺣﺪ‪ ،‬ﺍﻟﱵ ﺗﻘﺪﻡ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻔﺮﻳﻖ ﺍﻟﺼﺤﻲ )ﺍﻟﻄﺒﻴﺐ‬
‫ﻭﺍﳌﻤﺮﺿﺔ( ﻭﺇﱃ ﺿﻌﻒ ﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﻫﺬﻩ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪.‬‬

‫‪٣٨‬‬
‫‪ .٤‬ﺗﻮﻗﻒ ﺑﻌﺾ ﺍﻷﻧﺸﻄﺔ ﲟﺠﺮﺩ ﺍﻧﺘﻬﺎﺀ ﺍﻟﺘﻤﻮﻳﻞ ﺍﳋﺎﺭﺟﻲ ﺍﳌﺨﺼﺺ ﳍﺎ‪ ،‬ﻧﻈﺮﺍﹰ ﻟﻌﺪﻡ ﻭﺟﻮﺩ ﺑﻨﻮﺩ‬
‫ﻟﻺﻧﻔﺎﻕ ﻋﻠﻴﻬﺎ ﻣﻦ ﺍﻟﻮﺯﺍﺭﺓ )ﺿﻌﻒ ﺍﳌﺨﺼﺼﺎﺕ ﺍﳌﺎﻟﻴﺔ(‪ .‬ﻭﳛﺪﺙ ﻫﺬﺍ ﲜﻤﻴﻊ ﺍﳌﺸﺎﺭﻳﻊ ﻭﺍﻟﱪﺍﻣﺞ‬
‫ﺍﳌﻤﻮﻟﺔ ﻣﻦ ﺍﳋﺎﺭﺝ ﺣﻴﺚ ﻻ ﻳﻮﺟﺪ ﺧﻄﺔ ﻟﻼﺳﺘﻤﺮﺍﺭﻳﺔ ﺑﻌﺪ ﺍﻧﺘﻬﺎﺀ ﺍﻟﺘﻤﻮﻳﻞ ‪.Sustainability‬‬
‫‪ .٥‬ﺗﻌﺪﺩ ﺍﳉﻬﺎﺕ ﺍﳌﻘﺪﻣﺔ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﻋﺪﻡ ﻭﺟﻮﺩ ﺳﻴﺎﺳﺎﺕ ﻣﻮﺣﺪﺓ ﳌﺘﺎﺑﻌﺔ ﺃﺩﺍﺀ ﻫﺬﻩ‬
‫ﺍﳉﻬﺎﺕ‪.‬‬
‫‪ .٦‬ﻗﺼﻮﺭ ﺍﻹﺷﺮﺍﻑ )ﻣﺮﻛﺰﻳﺎ ﻭﳏﻠﻴﺎ(‪:‬‬
‫ﺳﻮﺀ ﺍﺧﺘﻴﺎﺭ ﺍﳌﺸﺮﻓﲔ ﻭﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﳌﻬﺎﻡ ﺍﻹﺩﺍﺭﻳﺔ )ﻣﺪﻳﺮﻭ ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﻔﻨﻴﺔ ﻭﺍﻟﺼﺤﻴﺔ(‪.‬‬ ‫‪-‬‬
‫ﺿﻌﻒ ﻣﻔﻬﻮﻡ ﺍﻹﺷﺮﺍﻑ ﲝﻴﺚ ﻳﻜﻮﻥ ﺍﳍﺪﻑ ﺍﻟﺮﺋﻴﺴﻲ ﻣﻨﻪ ﻫﻮ ﺗﺼﻴﺪ ﺍﻷﺧﻄﺎﺀ ﻭﺍ‪‬ﺎﺯﺍﺓ ﻓﻘﻂ‬ ‫‪-‬‬
‫ﺑﺪﻭﻥ ﺃﻱ ﻋﻨﺼﺮ ﺗﺪﺭﻳﱯ ﻭﺗﻮﺟﻴﻬﻲ ﻹﺻﻼﺡ ﺍﻷﺧﻄﺎﺀ‪.‬‬
‫ﻋﺪﻡ ﻭﺟﻮﺩ ﺗﻐﺬﻳﺔ ﺭﺍﺟﻌﺔ‪.FEED BACK‬‬ ‫‪-‬‬
‫‪ .٧‬ﺿﻌﻒ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‪:‬‬
‫ﺃﻭﺿﺤﺖ ﺩﺭﺍﺳﺔ ﺃﺟﺮﻳﺖ ﻋﺎﻡ ‪ ١٩٧٨‬ﻋﻦ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﺃﻥ ‪ %٤٦‬ﻣﻦ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‬
‫ﻳﻜﻮﻥ ﻋﻦ ﻃﺮﻳﻖ ﺍﳉﺎﻧﺐ ﺍﳊﻜﻮﻣﻲ‪ ،‬ﻭﺃﻥ ‪ %٥٤‬ﻳﻜﻮﻥ ﻣﻦ ﺧﻼﻝ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﻭﺗﻌﺘﱪ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ‬
‫ﰲ ﺇﲨﺎﳍﺎ ﻣﻘﺒﻮﻟﺔ‪ ،‬ﻏﲑ ﺃﻥ ﺍﳔﻔﺎﺽ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﰲ ﺍﻟﺼﺤﺔ‪ ،‬ﺳﻮﻑ ﻳﺼﺤﺒﻪ ﺯﻳﺎﺩﺓ ﰲ‬
‫ﺍﻹﻧﻔﺎﻕ ﻣﻦ ﺧﻼﻝ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‪.‬‬
‫‪ .٨‬ﻣﺸﺎﻛﻞ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ :‬ﻭﻫﺬﻩ ﺍﳌﺸﺎﻛﻞ ﺗﺸﻤﻞ‪:‬‬
‫ﺃ‪ .‬ﺿﻌﻒ ﻣﻬﺎﺭﺍﺕ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﻭﺗﻨﺸﺄ ﻣﻦ ﻗﺼﻮﺭ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺘﺪﺭﻳﺒﻴﺔ ﺍﳌﻌﺘﻤﺪﺓ ﺃﺳﺎﺳﺎ ﻋﻠﻰ‬
‫ﺍﳉﺰﺀ ﺍﻟﻨﻈﺮﻱ‪ ،‬ﻣﻊ ﺇﳘﺎﻝ ﺍﳉﺰﺀ ﺍﻟﻌﻤﻠﻲ ﺍﳌﺘﺼﻞ ﲜﻮﺍﻧﺐ ﻋﻤﻞ ﺍﻷﻃﺒﺎﺀ ﻭﺍﳌﻤﺮﺿﺎﺕ )ﺍﳌﻬﺎﺭﺍﺕ(‪.‬‬
‫ﺍﻟﺘﻌﻠﻴﻢ ﺍﳉﺎﻣﻌﻲ ﻻ ﻳﺸﻤﻞ ﺃﻫﻢ ﺍﻷﻧﺸﻄﺔ ﺍﻟﱵ ﻳﻘﻮﻡ ‪‬ﺎ ﺍﻟﻄﺒﻴﺐ ﻛﻤﻘﺪﻡ ﻟﻠﺨﺪﻣﺔ ﺑﻌﺪ‬ ‫‪-‬‬
‫ﲣﺮﺟﻪ ﻭﺍﻟﻌﻤﻞ ﻣﻊ ﺍﳉﻤﻬﻮﺭ ﰲ ﻭﺣﺪﺍﺕ ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪.‬‬
‫ﻭﺃﻳﻀﺎ ﻋﺪﻡ ﺩﺭﺍﻳﺔ ﺍﻟﻄﺒﻴﺐ ﻭﺍﳌﻤﺮﺿﺔ ﺑﺄﻫﻢ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﻭﻃﺮﻕ ﺍﻛﺘﺸﺎﻓﻬﺎ ﻭﻋﻼﺟﻬﺎ‬
‫ﳑﺎ ﻳﺸﻜﻞ ﻋﺒﺌﺎﹰ ﻋﻠﻰ ﺍﻟﻌﺎﻣﻠﲔ ﻭﺍﳌﺴﺌﻮﻟﲔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻹﻋﺪﺍﺩ ﻣﻮﺍﺩ ﺗﺪﺭﻳﺒﻴﺔ ﺗﺸﻤﻞ‬
‫ﺟﻮﺍﻧﺐ ﺍﻟﻘﺼﻮﺭ ﻭﺍﻟﻘﻴﺎﻡ ﺑﺘﺪﺭﻳﺐ ﺍﻷﻋﺪﺍﺩ ﺍﻟﻜﺒﲑﺓ ﻣﻦ ﺍﳋﺮﳚﲔ ﻗﺒﻞ ﺃﻥ ﻳﺘﺴﻠﻤﻮﺍ ﻋﻤﻠﻬﻢ‬
‫ﻭﺃﺛﻨﺎﺀ ﻗﻴﺎﻣﻬﻢ ﺑﻪ‪.‬‬
‫ﻗﺼﻮﺭ ﺍﳌﻴﺰﺍﻧﻴﺎﺕ ﺍﳌﺪﺭﺟﺔ ﻟﻠﺘﺪﺭﻳﺐ ﻭﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ ﺍﳌﺴﺘﻤﺮ ﻟﻠﻌﺎﻣﻠﲔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬ ‫‪-‬‬
‫)ﺃﻃﺒﺎﺀ ﻭﻓﺌﺎﺕ ﻣﺴﺎﻋﺪﺓ(‪.‬‬
‫ﻋﺪﻡ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺘﺪﺭﻳﺐ ﺍﻟﻔﺌﺎﺕ ﺍﳌﺴﺎﻋﺪﺓ ﻣﺜﻞ‪ :‬ﻓﻨﻴﻲ ﺍﻷﺟﻬﺰﺓ ‪ -‬ﻣﺴﺎﻋﺪﻱ ﺍﳌﻌﺎﻣﻞ‪ ،‬ﻓﻨﻴﻲ‬ ‫‪-‬‬
‫ﺍﻷﺷﻌﺔ‪ ..‬ﺍﱁ‪.‬‬
‫ﺏ‪ .‬ﺑﺎﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ‪:‬‬
‫ﻋﺪﻡ ﺗﻮﺍﻓﺮ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪.‬‬ ‫‪-‬‬

‫‪٣٩‬‬
‫ﺳﻮﺀ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻷﺩﻭﻳﺔ ﻧﻈﺮﺍﹰ ﻟﻀﻌﻒ ﺗﺪﺭﻳﺐ ﺍﻷﻃﺒﺎﺀ‪ ،‬ﻭﻗﻠﺔ ﻭﻋﻰ ﺍﳉﻤﻬﻮﺭ‪ ،‬ﻭﻋﺪﻡ ﻭﺟﻮﺩ‬ ‫‪-‬‬
‫ﻗﻮﺍﻧﲔ ﻣﻨﻈﻤﺔ ﻻﺳﺘﺨﺪﺍﻡ ﺍﻷﺩﻭﻳﺔ ﻭﻭﺻﻔﻬﺎ‪ ،‬ﻭﺿﻌﻒ ﺍﻹﺷﺮﺍﻑ‪.‬‬
‫ﺍﻻﺳﺘﻌﺎﻧﺔ ﺑﺄﺟﻬﺰﺓ ﻃﺒﻴﺔ ﻣﻌﻘﺪﺓ‪ ،‬ﻳﺘﻢ ﺗﻜﻬﻴﻨﻬﺎ ﻭﻋﺪﻡ ﺍﺳﺘﻌﻤﺎﳍﺎ ﺑﻌﺪ ﻓﺘﺮﺓ ﻗﺼﲑﺓ‪ ،‬ﻧﻈﺮﺍﹰ‬ ‫‪-‬‬
‫ﻟﻌﺪﻡ ﺗﺪﺭﻳﺐ ﻭﻗﻠﺔ ﻭﻋﻰ ﻣﺴﺘﺨﺪﻣﻲ ﻫﺬﻩ ﺍﻷﺟﻬﺰﺓ‪.‬‬
‫ﺗﺪﺍﺧﻞ ﻣﺴﺌﻮﻟﻴﺎﺕ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻧﻈﺮﺍﹰ ﻟﻌﺪﻡ ﻭﺟﻮﺩ ﺗﻮﺻﻴﻒ ﻭﻇﻴﻔﻲ ﻟﻜﻞ ﻓﺌﺔ‬ ‫‪-‬‬
‫ﻋﻠﻰ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫‪ .٩‬ﺿﻌﻒ ﻭﻗﺼﻮﺭ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﻳﺸﻤﻞ ﺍﻟﺘﻮﺛﻴﻖ ﻭﺍﻟﺘﺴﺠﻴﻞ ﻭﺣﻔﻆ ﺍﻟﺴﺠﻼﺕ‪.‬‬
‫‪ .١٠‬ﺿﻌﻒ ﺩﻭﺭ ﺍﻟﺒﺤﻮﺙ ﺍﻟﺼﺤﻴﺔ ﳌﺴﺎﻋﺪﺓ ﻣﺘﺨﺬﻱ ﺍﻟﻘﺮﺍﺭ‪ ،‬ﻭﺍﻻﻋﺘﻤﺎﺩ ﻓﻘﻂ ﻋﻠﻰ ﺍﻟﺪﻋﻢ ﺍﻷﺟﻨﱯ‬
‫ﻟﺘﻨﻔﻴﺬ ﺑﻌﺾ ﺍﻟﺒﺤﻮﺙ ﻭﺍﳌﺴﻮﺡ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ﺗﻠﱮ ﺍﲡﺎﻫﺎﺕ ﺍﳉﻬﺎﺕ ﺍﳌﻤﻮﻟﺔ )ﰎ ﺇﻟﻐﺎﺀ ﻗﻄﺎﻉ‬
‫ﺍﻟﺘﻨﻤﻴﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﻨﺬ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ ﺣﻴﺚ ﻛﺎﻥ ﻳﺸﻤﻞ ﺍﻟﺘﺪﺭﻳﺐ ﻭﺍﻟﺒﺤﻮﺙ‪ ،‬ﰒ ﺃﻋﻴﺪ‬
‫ﰲ ﺍﻟﺘﺸﻜﻴﻞ ﺍﳉﺪﻳﺪ ﻟﺪﻳﻮﺍﻥ ﻋﺎﻡ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ‪ .(١٩٩٨‬ﻭﺃﺻﺒﺤﺖ ﺍﻟﺒﺤﻮﺙ ﺟﺰﺀﺍﹰ ﻣﻦ ﺃﻧﺸﻄﺔ‬
‫ﺍﻟﱪﻧﺎﻣﺞ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻟﻔﻨﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ ﺑﺎﻟﻮﺯﺍﺭﺓ ﺣﺴﺐ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﻌﻤﻞ‪.‬‬
‫‪ .١١‬ﻻ ﻳﻮﺟﺪ ﺗﻐﺬﻳﺔ ﺭﺍﺟﻌﺔ ‪ Feed Back‬ﺑﲔ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﳌﺮﻛﺰﻳﺔ ﻭﺍﻟﻄﺮﻓﻴﺔ ﳑﺎ ﻳﺆﺩﻯ ﺇﱃ ﻓﻘﺪ ﺍﻟﺼﻠﺔ‬
‫ﰲ ﻣﺘﺎﺑﻌﺔ ﺍﻷﻧﺸﻄﺔ ﻭﺗﻔﺎﺩﻱ ﺍﻻﺳﺘﻤﺮﺍﺭ ﰲ ﺑﻌﺾ ﺍﻷﺧﻄﺎﺀ‪.‬‬
‫‪ .١٢‬ﺿﻌﻒ ﺍﻷﺟﻮﺭ ﺍﳋﺎﺻﺔ ﺑﺎﻟﻌﺎﻣﻠﲔ ﺑﻘﻄﺎﻉ ﺍﻟﺼﺤﺔ )ﺃﻃﺒﺎﺀ – ﻓﺌﺎﺕ ﻣﺴﺎﻋﺪﺓ – ﻓﺮﻳﻖ ﺇﺷﺮﺍﰲ( ﳑﺎ‬
‫ﻳﺸﻜﻞ ﺃﺛﺮﺍﹰ ﺳﻠﺒﻴﺎﹰ ﻋﻠﻰ ﺃﺩﺍﺀ ﺍﻟﻌﺎﻣﻠﲔ ﻭﻋﺪﻡ ﺍﻫﺘﻤﺎﻣﻬﻢ ﺑﺎﻻﻧﺘﻈﺎﻡ ﺑﺎﻟﻌﻤﻞ ﺍﳊﻜﻮﻣﻲ ﻭﺍﻻﻟﺘﺰﺍﻡ‬
‫ﺑﺎﻟﻠﻮﺍﺋﺢ ﻭﺍﻟﻘﻮﺍﻧﲔ ﺍﳌﻨﻈﻤﺔ‪.‬‬
‫‪ .١٣‬ﺍﻹﺩﺍﺭﺓ ﺍﻟﻮﺳﻄﻰ ‪Mid-Level Management‬‬
‫ﺿﻌﻒ ﺍﻷﺩﺍﺀ‪.‬‬ ‫‪-‬‬
‫ﺳﻮﺀ ﺍﺧﺘﻴﺎﺭ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ )ﻣﺪﻳﺮﻱ ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ( ﻟﻌﺪﻡ ﻭﺟﻮﺩ ﺃﺳﺲ‬ ‫‪-‬‬
‫ﺛﺎﺑﺘﺔ ﻟﻼﺧﺘﻴﺎﺭ‪.‬‬
‫ﺿﻌﻒ ﺍﻷﺟﻮﺭ ﻭﺍﳊﻮﺍﻓﺰ‪.‬‬ ‫‪-‬‬
‫ﻋﺪﻡ ﺍﻟﺘﻔﺮﻍ ﳍﺬﺍ ﺍﻟﻌﻤﻞ؛ ﳑﺎ ﻳﺴﺒﺐ ﺿﻌﻔﺎﹰ ﰲ ﺍﻷﺩﺍﺀ ﻭﻣﺘﺎﺑﻌﺔ ﺍﻷﻧﺸﻄﺔ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬ ‫‪-‬‬
‫ﻋﺪﻡ ﺇﺷﺮﺍﻙ ﺍﶈﻠﻴﺎﺕ‪ ،‬ﻭﺃﻓﺮﺍﺩ ﳑﺜﻠﲔ ﻣﻦ ﺍ‪‬ﺘﻤﻊ ﰲ ﲢﺪﻳﺪ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﻭﻭﺿﻊ ﺍﻟﺘﺼﻮﺭ ﺍﳋﺎﺹ‬ ‫‪-‬‬
‫ﺑﺎﳋﻄﻂ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻱ ﺍﶈﻠﻲ‪.‬‬
‫ﻗﺼﻮﺭ ﺩﻭﺭ ﻭﺳﺎﺋﻞ ﺍﻹﻋﻼﻡ ﺍﳌﺨﺘﻠﻔﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﺮﻓﻊ ﺍﻟﻮﻋﻲ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺘﻐﺬﻭﻱ ﻟﺪﻯ ﺍﳉﻤﻬﻮﺭ‪.‬‬ ‫‪-‬‬

‫ﺍﻧﻌﻜﺎﺳﺎﺕ ﺍﻟﺴﻴﺎﺳﺎﺕ )ﻭﺍﻷﻧﺸﻄﺔ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ( ﻋﻠﻰ ﺍﳊﺎﻟﺔ‬

‫ﺍﻟﺼﺤﻴﺔ‬
‫‪ .١‬ﺗﻘﺪﱘ ﺣﺰﻣﺔ ﺃﺳﺎﺳﻴﺔ ﻣﺘﻜﺎﻣﻠﺔ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻤﺮﺃﺓ ﻭﺍﻟﻄﻔﻞ ﻣﻦ ﺧﻼﻝ ﲨﻴﻊ ﻭﺣﺪﺍﺕ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﻭﻟﻴﺔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬

‫‪٤٠‬‬
‫‪ .٢‬ﺭﻓﻊ ﻛﻔﺎﺀﺓ ﺍﻟﻘﻮﻯ ﺍﻟﺒﺸﺮﻳﺔ ﻣﻦ ﺧﻼﻝ ﺍﻟﺘﺪﺭﻳﺐ ﻭﺭﻓﻊ ﻭﺗﻄﻮﻳﺮ ﻣﻬﺎﺭﺍﺕ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﺣﱴ‬
‫ﺗﺘﻨﺎﺳﺐ ﻣﻊ ﻣﺴﺘﻮﻳﺎﺕ ﺍﳋﺪﻣﺔ ﻟﺘﻐﻄﻴﺔ ﲨﻴﻊ ﺍﻷﻣﺎﻛﻦ ﺍﻟﻨﺎﺋﻴﺔ ﻭﺍﶈﺮﻭﻣﺔ ﻣﻦ ﺍﳋﺪﻣﺔ‪.‬‬
‫‪ .٣‬ﺗﻨﻔﻴﺬ ﺑﺮﺍﻣﺞ ﺻﺤﻴﺔ ﻣﺘﺨﺼﺼﺔ ﺗﺸﻤﻞ ﺍﻻﲡﺎﻫﺎﺕ ﺍﳉﺪﻳﺪﺓ ﰲ ﺗﻘﺪﱘ ﺧﺪﻣﺔ ﻣﺘﻤﻴﺰﺓ ﻣﺜﻞ‪:‬‬
‫ﻃﺒﻴﺐ ﺍﻷﺳﺮﺓ‪ ،‬ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﳊﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ ﻛﺨﻄﺔ ﺃﻭﱄ ﳌﻨﻊ ﺍﻹﻋﺎﻗﺔ‪.‬‬
‫‪ .٤‬ﺗﻨﻔﻴﺬ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﰲ ﳎﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‪ ،‬ﻟﺘﺤﺴﲔ ﻛﻔﺎﺀﺓ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﰲ ﺻﻮﺭﺓ ﺧﺪﻣﺔ ﻣﺘﻜﺎﻣﻠﺔ ﳑﻜﻦ ﺍﳊﺼﻮﻝ ﻋﻠﻴﻬﺎ ﺑﺴﻬﻮﻟﺔ‪.‬‬
‫‪ .٥‬ﺗﻘﺪﱘ ﺣﺰﻣﺔ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺍﳌﺆﺛﺮﺓ‪ ،‬ﺑﻨﺎﺀ ﻋﻠﻰ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻭﺃﻭﻟﻮﻳﺎﺕ ﺍ‪‬ﺘﻤﻊ‬
‫ﻭﺍﳌﻮﺍﻃﻨﲔ‪.‬‬
‫‪ .٦‬ﺍﳔﻔﺎﺽ ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻔﺌﺎﺕ ﺍﳊﺴﺎﺳﺔ ﻣﺜﻞ ﺍﻷﻃﻔﺎﻝ )ﺍﻟﺮﺿﻊ‪ ،‬ﺃﻗﻞ ﻣﻦ ‪ ٥‬ﺳﻨﻮﺍﺕ(‬
‫ﻭﺍﳌﺮﺃﺓ ﰲ ﺳﻦ ﺍﻹﳒﺎﺏ‪.‬‬
‫‪ .٧‬ﺍﳔﻔﺎﺽ ﻧﺴﺒﺔ ﺍﻹﺻﺎﺑﺔ ﺑﺒﻌﺾ ﺍﻷﻣﺮﺍﺽ ﺍﻟﺸﺎﺋﻌﺔ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﻭﺍﳌﺴﺒﺒﺔ ﻟﻠﻮﻓﺎﺓ‪ ،‬ﻣﺜﻞ ﺍﻹﺳﻬﺎﻝ‬
‫ﻭﺍﻟﺘﻬﺎﺑﺎﺕ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ‪.‬‬
‫‪ .٨‬ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ ﺍﳊﺪﻳﺜﺔ ﰲ ﺍﻟﺘﺸﺨﻴﺺ ﻭﺍﻟﻌﻼﺝ‪ ،‬ﺍﳌﻼﺋﻤﺔ ﳌﺴﺘﻮﻯ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ‪،‬‬
‫ﻭﺧﺎﺻﺔ ﰲ ﳎﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻣﺜﻞ ﻣﺮﻛﺰﺍﺕ ﺍﻷﻛﺴﺠﲔ )ﺑﺪﻻ ﻣﻦ ﺍﻻﺳﻄﻮﺍﻧﺎﺕ(‬
‫ﻭﻣﻮﺳﻌﺎﺕ ﺍﻟﺸﻌﺐ ﻭﺍﻟﺴﺎﻋﺎﺕ ﺍﳌﻴﻘﺎﺗﻴﺔ‪ ..‬ﺍﱁ‪.‬‬

‫ﺍﳌﻌﻮﻧﺎﺕ ﻭﺍﳌﻨـﺢ ﻭﺍﻟﻘﺮﻭﺽ ﺍﻷﺟﻨﺒﻴﺔ ﻭﺁﺛﺎﺭﻫﺎ‬

‫ﻣﺰﺍﻳﺎ ﺍﳌﻌﻮﻧﺎﺕ ﺍﻷﺟﻨﺒﻴﺔ‪:‬‬
‫ﺧﻠﻖ ﻛﻮﺍﺩﺭ ﻣﻦ ﺍﳉﻴﻞ ﺍﳉﺪﻳﺪ ﻗﺎﺩﺭﺓ ﻋﻠﻰ ﺍﻹﺩﺍﺭﺓ ﻭﺍﻻﺑﺘﻜﺎﺭ‪.‬‬ ‫‪-‬‬
‫ﺭﻓﻊ ﺩﺭﺟﺔ ﻭﻋﻰ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﻟﺼﺤﺔ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ )ﺇﺩﺍﺭﻳﺎﹰ ‪ /‬ﻓﻨﻴﺎ( ﻣﺮﻛﺰﻳﺎ ﻭﳏﻠﻴﺎ‪.‬‬ ‫‪-‬‬
‫ﺯﻳﺎﺩﺓ ﻓﺮﺹ ﺍﻷﻃﺒﺎﺀ ﺍﻟﺸﺒﺎﻥ ﻟﻠﺴﻔﺮ ﺇﱃ ﺍﳋﺎﺭﺝ ﻣﻦ ﺧﻼﻝ ﻣﻨـﺢ ﻗﺼﲑﺓ )ﺩﻭﺭﺍﺕ ﺗﺪﺭﻳﺒﻴﺔ ﰲ‬ ‫‪-‬‬
‫ﳎﺎﻻﺕ ﺍﻹﺷﺮﺍﻑ ﻭﺍﻹﺩﺍﺭﺓ – ﺍﻟﺘﺪﺭﻳﺐ – ﺍﻹﺣﺼﺎﺀ‪ ..‬ﺍﱁ( ﻭﻣﻨـﺢ ﻃﻮﻳﻠﺔ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ‬
‫ﺍﳌﺎﺟﺴﺘﲑ ﻭﺍﻟﺪﻛﺘﻮﺭﺍﻩ‪.‬‬
‫ﺗﻮﺍﻓﺮ ﺍﳌﻮﺍﺩ ﺍﻟﻌﻠﻤﻴﺔ )ﺍﳌﻄﺒﻮﻋﺎﺕ( ﰲ ﺍ‪‬ﺎﻻﺕ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬ ‫‪-‬‬
‫ﺇﺩﺧﺎﻝ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ ﺍﳊﺪﻳﺜﺔ ﻣﻦ ﺧﻼﻝ ﺍﻷﺟﻬﺰﺓ‪ ،‬ﻭﺳﺎﺋﻞ ﺍﻻﺗﺼﺎﻝ‪ ..‬ﺍﱁ‪.‬‬ ‫‪-‬‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳉﺎﻧﺐ ﺍﻹﺣﺼﺎﺋﻲ ﰲ ﺍﻟﻌﻤﻞ ﺍﻟﺼﺤﻲ ﻭﳏﺎﻭﻟﺔ ﺗﻨﻤﻴﺘﻪ ﻭﺗﻄﻮﻳﺮﻩ‪.‬‬ ‫‪-‬‬
‫ﻋﻴﻮﺏ ﺍﳌﻌﻮﻧﺎﺕ ﺍﻷﺟﻨﺒﻴﺔ‪:‬‬
‫ﻓﺮﺽ ﺍﳌﺸﺮﻭﻋﺎﺕ ﺍﻟﱵ ﻳﺘﻢ ﲤﻮﻳﻠﻬﺎ ﻭﲢﺪﻳﺪ ﺃﻫﺪﺍﻓﻬﺎ ﻭﺍﻷﻧﺸﻄﺔ ﺍﳌﻄﻠﻮﺏ ﺗﻨﻔﻴﺬﻫﺎ ﻣﺜﻞ‪:‬‬ ‫‪-‬‬
‫ﺑﺮﺍﻣﺞ ﺍﻟﺰﻳﺎﺭﺍﺕ ﺍﳌﱰﻟﻴﺔ‪.‬‬ ‫‪o‬‬
‫ﺧﻔﺾ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ ﻋﻦ ﻃﺮﻳﻖ ﺗﻄﻌﻴﻤﺎﺕ ‪ /‬ﻣﺘﺎﺑﻌﺔ ﳕﻮ‪ /‬ﺑﺮﺍﻣﺞ‬ ‫‪o‬‬
‫ﺻﺤﻴﺔ ﳐﺘﻠﻔﺔ ﻣﺴﺘﺤﺪﺛﺔ‪.‬‬

‫‪٤١‬‬
 ‫ﺑﺮﺍﻣﺞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪.‬‬ ‫‪o‬‬
‫ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ )ﺟﺎﻣﻌﺔ ﻗﻨﺎﺓ ﺍﻟﺴﻮﻳﺲ(‪.‬‬ ‫‪o‬‬
‫ﺍﺳﺘﺮﺩﺍﺩ ﻧﻔﻘﺎﺕ ﺍﻟﻌﻼﺝ‪.‬‬ ‫‪o‬‬
‫ﲢﺪﻳﺪ ﺃﻣﺎﻛﻦ ﺗﻨﻔﻴﺬ ﻫﺬﻩ ﺍﳌﺸﺮﻭﻋﺎﺕ )ﺭﻳﻒ‪ ،‬ﺃﻭ ﺣﻀﺮ‪ ،‬ﺃﻭ ﳏﺎﻓﻈﺎﺕ ﻭﺟﻪ ﻗﺒﻠﻲ ﺃﻭ ﲝﺮﻱ(‬ ‫‪-‬‬
‫ﻭﺿﻊ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﻌﺎﻣﺔ ﻟﺒﻨﻮﺩ ﺍﻟﺼﺮﻑ ﻣﻦ ﺍﳉﻬﺔ ﺍﳌﻤﻮﻟﺔ ﻟﻠﻤﺸﺮﻭﻋﺎﺕ‪:‬‬ ‫‪-‬‬
‫ﺃﻛﺜﺮ ﻣﻦ ‪ %٥٠‬ﻳﻜﻮﻥ ﳐﺼﺼﺎﹰ ﻟﻠﺨﱪﺍﺕ ﺍﻟﻔﻨﻴﺔ )‪.(Technical Assistant‬‬ ‫‪o‬‬
‫‪ %٧٥‬ﻣﻨﻬﺎ ﻻﺳﺘﺸﺎﺭﻳﲔ ﺃﺟﺎﻧﺐ‪ ،‬ﻭ‪ %٢٥‬ﺍﺳﺘﺸﺎﺭﻳﲔ ﳏﻠﻴﲔ )ﺟﺎﻣﻌﺎﺕ(‪.‬‬ ‫‪o‬‬
‫ﺍﻟﺘﺪﺭﻳﺐ‪.‬‬ ‫‪o‬‬
‫ﺍﻟﺒﺤﻮﺙ )ﻗﺪ ﻳﻜﻮﻥ ﺟﺰﺀﺍﹰ ﻛﺒﲑﺍﹰ ﻣﻨﻬﺎ ﻏﲑ ﻣﻼﺋﻢ ﻭﻻ ﻳﺴﺘﻔﺎﺩ ﻣﻦ ﻧﺘﺎﺋﺠﻪ(‪.‬‬ ‫‪o‬‬
‫ﺷﺮﺍﺀ ﺃﺟﻬﺰﺓ ﻭﻣﻌﺪﺍﺕ ﻭﺳﻴﺎﺭﺍﺕ ﻣﻦ ﺍﻟﺒﻠﺪ ﺍﳌﻤﻮﻝ ﻟﻠﻤﺸﺮﻭﻉ‪.‬‬ ‫‪o‬‬
‫ﻛــﻞ ﻣﺸﺮﻭﻉ ﻻﺑﺪ ﺃﻥ ﻳﻘﻮﻡ ﺑﺎﻹﺷﺮﺍﻑ ﻋﻠﻴﻪ ﻭﺗﻨﻔﻴﺬ ﺃﻧﺸﻄﺘﻪ ﺑﻴﺖ ﺧﱪﺓ ﺃﺟﻨﱯ ﻭﺍﺧﺘﻴﺎﺭ ﺑﻴﺖ‬ ‫‪-‬‬
‫ﺍﳋﱪﺓ ﻳﻜﻮﻥ ﻋﻦ ﻃﺮﻳﻘﲔ ﺇﻣﺎ‪:‬‬
‫ﻣﻦ ﺧﻼﻝ ﺍﳉﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ ﻣﻦ ﺍﻟﺘﻤﻮﻳﻞ ﻭﻫﻲ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ )‪(Host Country Contract‬‬ ‫‪o‬‬
‫ﺃﻭ ﻣﻦ ﺧﻼﻝ ﺍﳉﻬﺔ ﺍﳌﻤﻮﻟﺔ )‪(Direct Contract‬‬ ‫‪o‬‬
‫ﻭﻳﻮﺟﺪ ﻓﺮﻕ ﻛﺒﲑ ﺑﲔ ﻫﺬﻳﻦ ﺍﻟﻨﻮﻋﲔ ﻣﻦ ﺍﻟﺘﻌﺎﻗﺪ ﻣﻦ ﺣﻴﺚ ﺍﳌﺒﺪﺃ ﺣﻴﺚ ﺇﻥ ﺍﻟﻨﻮﻉ ﺍﻷﻭﻝ ﻳﻌﻄﻰ‬
‫ﺍﻟﻔﺮﺻﺔ ﻟﻠﺠﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ ﻣﻦ ﺍﺧﺘﻴﺎﺭ ﺍﻻﺳﺘﺸﺎﺭﻳﲔ‪ ،‬ﻧﻮﻋﻴﺔ ﺍﻟﱪﺍﻣﺞ – ﻧﻮﻋﻴﺔ ﺍﻷﺟﻬﺰﺓ‬
‫ﻭﺃﻳﻀﺎﹰ ﺍﺧﺘﻴﺎﺭ ﺑﻴﺖ ﺍﳋﱪﺓ ﻣﻦ ﺧﻼﻝ ﺗﻘﻴﻴﻢ ﻓﺮﻳﻖ ﻣﻦ ﺍﻟﻮﺯﺍﺭﺓ )ﺍﳉﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ( ﻭﺃﻋﻀﺎﺀ‬
‫ﻣﺮﺷﺤﲔ ﳑﻦ ﳍﻢ ﺧﱪﺓ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪.‬‬
‫ﺃﻣﺎ ﺍﻟﻨﻮﻉ ﺍﻟﺜﺎﱐ ﻣﻦ ﺍﻟﺘﻌﺎﻗﺪ ﻓﻴﺘﻢ ﻣﺒﺎﺷﺮﺓ ﺑﲔ ﺍﳉﻬﺔ ﺍﳌﻤﻮﻟﺔ ﻭﺑﻴﺖ ﺍﳋﱪﺓ ﺍﻟﺬﻱ ﻳﺘﻢ ﺍﺧﺘﻴﺎﺭﻩ‬
‫ﺑﻮﺍﺳﻄﺘﻬﺎ ﺩﻭﻥ ﺍﻟﻠﺠﻮﺀ ﺃﻭ ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺭﺃﻯ ﺍﳉﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ‪ ،‬ﻭﺇﻥ ﻛﺎﻥ ﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ‬
‫ﻳﺘﻢ ﺳﺆﺍﻝ ﺍﳉﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ ﺗﺮﺷﻴﺢ ﻭﺍﺣﺪ ﺃﻭ ﺍﺛﻨﲔ ﳑﺜﻠﲔ ﳍﺎ‪ ،‬ﳊﻀﻮﺭ ﻫﺬﺍ ﺍﻟﺘﻘﻴﻴﻢ )ﻭﺗﻜﻮﻥ‬
‫ﺑﻄﺮﻳﻘﺔ ﺻﻮﺭﻳﺔ ﺣﻴﺚ ﺇ‪‬ﻢ ﰲ ﻣﻌﻈﻢ ﺍﻷﺣﻴﺎﻥ ﻳﻘﻮﻣﻮﻥ ﺑﺘﺮﺷﻴﺢ ﻣﻦ ﻳﺮﻭ‪‬ﻢ ﻭﻳﺮﺳﻠﻮﻥ ﰲ‬
‫ﻃﻠﺒﻬﻢ ﻣﻦ ﺍﳉﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ(‪.‬‬
‫ﻳﻘﻮﻡ ﺑﻴﺖ ﺍﳋﱪﺓ ﺑﻌﺪ ﺍﺧﺘﻴﺎﺭﻩ ﺑﺘﻨﻔﻴﺬ ﲨﻴﻊ ﺃﻧﺸﻄﻪ ﺍﳌﺸﺮﻭﻉ ﺍﻟﱵ ﰎ ﺗﻮﻗﻴﻌﻬﺎ ﻣﻦ ﺍﳉﺎﻧﺒﲔ‬ ‫‪-‬‬
‫)ﺍﳌﻤﻮﻝ ﻭﺍﳌﺴﺘﻔﻴﺪ( ﻣﻦ ﺧﻼﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﳉﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ ﻭﻣﻌﺎﻭﻧﻪ ﺍﳋﱪﺍﺕ ﺍﻷﺟﻨﺒﻴﺔ ﺍﻟﱵ‬
‫ﺗﻜﻮﻥ ‪ -‬ﰲ ﻣﻌﻈﻢ ﺍﻷﺣﻴﺎﻥ ‪ -‬ﺩﻭﻥ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻌﻠﻤﻲ ﺍﻟﺬﻱ ﻳﺆﻫﻠﻬﺎ ﳍﺬﺍ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﻣﻦ ﺷﺮﻭﻁ ﻫﺬﻩ ﺍﳌﻨـﺢ ﺍﻷﺟﻨﺒﻴﺔ ﻭﺟﻮﺩ ﺍﺗﻔﺎﻕ ﺃﻭ ﻣﻮﺍﻓﻘﺔ ﻣﻦ ﺍﳉﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ )ﻭﺯﺍﺭﺓ‬ ‫‪-‬‬
‫ﺍﻟﺼﺤﺔ( ﻋﻠﻰ ﲣﺼﻴﺺ ﻣﻴﺰﺍﻧﻴﺔ ﳍﺬﺍ ﺍﳌﺸﺮﻭﻉ ﲤﺜﻞ ‪ %٣٠‬ﻣﻦ ﺇﲨﺎﱄ ﻗﻴﻤﺔ ﺍﳌﻨـﺤﺔ ﺑﺎﳉﻨﻴﻪ‬
‫ﺍﳌﺼﺮﻱ‪ ،‬ﻭﺗﻮﺩﻉ ﺑﺎﻟﺒﻨﻚ ﻗﺒﻞ ﺍﻟﺒﺪﺀ ﰲ ﺗﻨﻔﻴﺬ ﺃﻧﺸﻄﺔ ﺍﳌﺸﺮﻭﻉ‪ ،‬ﻭﻗﺪ ﲡﺰﺃ ﻋﻠﻰ ﻣﺮﺍﺣﻞ ﺳﻨﻮﻳﺔ‪،‬‬
‫ﻭﻫﺬﻩ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺗﺼﺮﻑ ﻋﻠﻰ ﺑﻨﻮﺩ ﻣﺘﻔﻖ ﻋﻠﻴﻬﺎ ﻣﺜﻞ‪:‬‬
‫ﺍﻷﺟﻮﺭ ﻭﺍﳌﻜﺎﻓﺂﺕ‪.‬‬ ‫‪o‬‬

‫‪٤٢‬‬
 ‫ﺍﳌﺼﺮﻭﻓﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﻠﺘﺸﻐﻴﻞ‪.‬‬ ‫‪o‬‬
‫ﺑﱰﻳﻦ ﺍﻟﺴﻴﺎﺭﺍﺕ ﺍﳌﺴﺘﺨﺪﻣﺔ ﺑﺎﳌﺸﺮﻭﻉ‪.‬‬ ‫‪o‬‬
‫ﺍﻷﺟﻬﺰﺓ ﻭﺍﳌﻌﺪﺍﺕ ﺍﻟﱵ ﻳﺘﻢ ﲢﺪﻳﺪﻫﺎ ﻻ ﺗﻜﻮﻥ ﻣﻦ ﺟﺎﻧﺐ ﺍﳉﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ ﺑﻘﺪﺭ ﺍﺧﺘﻴﺎﺭﻫﺎ‬ ‫‪-‬‬
‫ﻭﲢﺪﻳﺪ ﻣﻮﺍﺻﻔﺎ‪‬ﺎ ﻣﻦ ﺍﳉﻬﺔ ﺍﳌﻤﻮﻟﺔ ﺑﻄﺮﻳﻘﺔ ﻣﺒﺎﺷﺮﺓ ﺃﻭ ﻏﲑ ﻣﺒﺎﺷﺮﺓ‪.‬‬
‫ﻭﻣﻌﻈﻢ ﻫﺬﻩ ﺍﻷﺟﻬﺰﺓ ﻭﺍﻟﺴﻴﺎﺭﺍﺕ ﻻ ﻳﻜﻮﻥ ﳍﺎ ﻗﻄﻊ ﻏﻴﺎﺭ ﻭﻗﺪ ﺗﻜﻮﻥ ﻣﻮﺩﻳﻼﺕ ﻗﺪﳝﺔ ﰎ‬
‫ﺍﻧﺘﻬﺎﺀ ﺍﻟﻌﻤﻞ ‪‬ﺎ ﰲ ﻣﺼﺪﺭ ﺍﻟﺒﻠﺪ ﺍﳌﻮﺭﺩ‪.‬‬
‫ﻭﻗﺪ ﺗﻜﻮﻥ ﻫﻨﺎﻙ ﲢﺴﲔ ﺣﺎﻟﻴﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺠﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ ﰲ ﺍﺧﺘﻴﺎﺭ ﺃﻋﺪﺍﺩ ﻭﻣﻮﺍﺻﻔﺎﺕ‬
‫ﺍﳌﻌﺪﺍﺕ ﺍﳌﻄﻠﻮﺑﺔ ﻭﻃﻠﺐ ﻗﻄﻊ ﺍﻟﻐﻴﺎﺭ ﺍﻟﻼﺯﻣﺔ ﻭﺃﻳﻀﺎ ﺍﻟﺼﻴﺎﻧﺔ ﻭﻫﺬﺍ ﺑﺎﻟﻄﺒﻊ ﺑﻌﺾ ﺣﻠﻮﻝ‬
‫ﺍﻟﺘﺠﺎﺭﺏ ﻣﻨﺬ ﺑﺪﺍﻳﺔ ﻫﺬﻩ ﺍﳌﺸﺮﻭﻋﺎﺕ ﰲ ﺃﻭﺍﺧﺮ ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ‪.‬‬
‫ﺇﺫﺍ ﻛﺎﻥ ﻫﻨﺎﻙ ﻧﻮﻉ ﻣﻦ ﺍﻟﺘﻘﻴﻴﻢ ﻣﻦ ﺟﺎﻧﺐ ﺍﳉﻬﺔ ﺍﳌﺴﺘﻔﻴﺪﺓ ﻟﻠﻤﺸﺎﺭﻳﻊ ﺍﻟﱵ ﻳﺘﻢ ﺗﻨﻔﻴﺬﻫﺎ‬ ‫‪-‬‬
‫ﺧﻼﻝ ‪ ٢٠‬ﺳﻨﺔ ﺍﳌﺎﺿﻴﺔ ﻓﺴﻮﻑ ﻳﻔﺎﺟﺊ ﺍﳌﺴﺌﻮﻟﻮﻥ ﺑﺄﻥ‪:‬‬
‫ﻣﻌﻈﻢ ﺍﻷﺟﻬﺰﺓ ﻗﺪ ﰎ ﺗﻜﻬﻴﻨﻬﺎ ﻟﻌﺪﻡ ﻭﺟﻮﺩ ﻗﻄﻊ ﻏﻴﺎﺭ ﺃﻭ ﻣﻴﺰﺍﻧﻴﺔ ﻟﺼﻴﺎﻧﺘﻬﺎ‪.‬‬ ‫‪o‬‬
‫ﰎ ﺗﻜﻬﲔ ﺍﻟﺴﻴﺎﺭﺍﺕ ﻭﺧﺎﺻﺔ ﺃﻧﻪ ﻟﻴﺲ ﳍﺎ ﻗﻄﻊ ﻏﻴﺎﺭ ﺃﻭ ﻣﻴﺰﺍﻧﻴﺔ ﻟﻺﺻﻼﺡ‬ ‫‪o‬‬
‫ﻭﺍﻟﺼﻴﺎﻧﺔ ﻣﻦ ﺍﳉﺎﻧﺐ ﺍﳌﺴﺘﻔﻴﺪ )ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ(‪.‬‬
‫ﺩﺍﺋﻤﺎ ﺗﻘﻮﻡ ﺍﳉﻬﺔ ﺍﳌﻤﻮﻟﺔ ﺑﺈﺭﺳﺎﺀ ﺍﻟﻌﻄﺎﺀﺍﺕ ﻋﻠﻰ ﺷﺮﻛﺎﺕ ﻣﻦ ﻧﻔﺲ ﺍﻟﺒﻠﺪ ﺍﳌﻤﻮﻝ‬ ‫‪o‬‬
‫ﻭﻳﺘﻢ ﺗﻮﺭﻳﺪ ﺃﺟﻬﺰﺓ ﻭﻣﻌﺪﺍﺕ ﻭﺳﻴﺎﺭﺍﺕ ﻻ ﺗﺘﻨﺎﺳﺐ ﻣﻊ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺪﻭﻟﺔ )ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻭﺍﳉﻬﺔ ﺍﳌﻘﺪﻣﺔ ﻟﻠﺨﺪﻣﺔ( ﻭﻗﺪ ﺗﻜﻮﻥ ﻣﻮﺩﻳﻼﺕ ﻗﺪﳝﺔ ﻻ ﻳﺘﻢ ﺍﻟﻌﻤﻞ ‪‬ﺎ‪،‬‬
‫ﻭﻫﺬﺍ ﺃﻳﻀﺎ ﻳﺮﺟﻊ ﺇﱃ ﻋﺪﻡ ﻭﺟﻮﺩ ﺟﻬﺔ ﻓﻨﻴﺔ ﻋﺎﻟﻴﺔ ﺍﳌﺴﺘﻮﻯ ﺑﺎﻟﻮﺯﺍﺭﺓ‪ ،‬ﻟﻠﻘﻴﺎﻡ‬
‫ﺑﺪﺭﺍﺳﺔ ﻣﻮﺍﺻﻔﺎﺕ ﻫﺬﻩ ﺍﻷﺟﻬﺰﺓ ﻭﺍﻟﻌﻤﻞ ﻋﻠﻰ ﻗﺒﻮﳍﺎ ﺃﻭ ﺭﻓﻀﻬﺎ‪.‬‬
‫ﺍﻟﺘﻘﻴﻴﻢ ﺍﻟﻨﻬﺎﺋﻲ ﻷﻱ ﻣﺸﺮﻭﻉ )ﻭﻫﻮ ﻣﺮﺗﺒﻂ ﺑﺎﳌﺪﺓ ﺍﶈﺪﺩﺓ ﻟﻠﻤﺸﺮﻭﻉ ﻭﺗﻜﻮﻥ ﰲ ﺣﺪﻭﺩ ‪٨-٥‬‬ ‫‪-‬‬
‫ﺳﻨﻮﺍﺕ ﻳﺘﻢ ﺑﻨﺎﺀ ﻋﻠﻰ ﺍﻻﺗﻔﺎﻗﻴﺔ ﺍﳋﺎﺻﺔ ﺑﺎﳌﺸﺮﻭﻉ( ﻭﺗﻘﻮﻡ ﺍﳉﻬﺔ ﺍﳌﻤﻮﻟﺔ ﰲ ﻣﻌﻈﻢ ﺍﻷﺣﻴﺎﻥ‬
‫ﺑﺎﺧﺘﻴﺎﺭ ﻓﺮﻳﻖ ﺍﻟﺘﻘﻴﻴﻢ ﺳﻮﺍﺀ ﻣﻦ ﺍﻷﺟﺎﻧﺐ ﺃﻡ ﺍﳌﺼﺮﻳﲔ ﻭﺗﻜﻮﻥ ﺍﻟﻨﺘﻴﺠﺔ ﺍﻟﻨﻬﺎﺋﻴﺔ ﻟﻠﺘﻘﻴﻴﻢ ﲟﺎ‬
‫ﻳﺘﻨﺎﺳﺐ ﻣﻊ ﺍﲡﺎﻫﺎﺕ ﺍﳉﻬﺔ ﺍﳌﻤﻮﻟﺔ‪.‬‬
‫ﺇﺩﺧﺎﻝ ﻧﻈﺎﻡ ﺍﳊﻮﺍﻓﺰ ﻭﺍﳌﻜﺎﻓﺂﺕ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﺎﻣﻠﲔ ﺑﺎﳌﺸﺮﻭﻋﺎﺕ ﺃﺩﻯ ﺇﱃ ﺑﻌﺾ ﺍﻟﺴﻠﺒﻴﺎﺕ‪:‬‬ ‫‪-‬‬
‫‪ .١‬ﺃﺻﺒﺢ ﻣﺼﺪﺭﺍﹰ ﻟﺮﻓﻊ ﻣﺴﺘﻮﻯ ﺍﻟﺪﺧﻞ ﻭﻟﻴﺲ ﻟﻪ ﻋﻼﻗﺔ ﺑﺎﻟﻜﻔﺎﺀﺓ ﺃﻭ ﻣﺪﻯ ﺍﻹﺑﺪﺍﻉ‪.‬‬
‫‪ .٢‬ﺃﻭﺟﺪ ﻧﻮﻋﺎﹰ ﻣﻦ ﺍﳌﻘﺎﺭﻧﺔ ﺑﲔ ﺍﻟﻌﺎﻣﻠﲔ ﺧﺎﺭﺝ ﺍﳌﺸﺮﻭﻉ ﻭﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﳌﺸﺮﻭﻉ‪.‬‬
‫‪ .٣‬ﲟﺠﺮﺩ ﺍﻧﺘﻬﺎﺀ ﲤﻮﻳﻞ ﺃﻱ ﻣﺸﺮﻭﻉ ﺗﻘﻒ ﺍﻷﻧﺸﻄﺔ ﺍﻟﱵ ﻛﺎﻧﺖ ﺗﺆﺩﻯ ﻟﻌﺪﻡ ﻭﺟﻮﺩ‬
‫ﺍﻹﺷﺮﺍﻑ ﺍﳉﻴﺪ ﻋﻠﻰ ﻫﺬﻩ ﺍﻷﻧﺸﻄﺔ ﺍﻟﱵ ﻛﺎﻥ ﳚﺐ ﺃﻥ ﺗﺴﺘﻤﺮ ﻭﺗﻘﻮﻯ ﻣﺜﺎﻝ‪:‬‬
‫ﺑﺮﺍﻣﺞ ﺍﻟﺰﻳﺎﺭﺍﺕ ﺍﳌﻴﺪﺍﻧﻴﺔ‪.‬‬ ‫
‬
‫ﺑﺮﺍﻣﺞ ﺍﻹﺳﻬﺎﻝ )ﰲ ﻓﺘﺮﺓ ﻣﻌﻴﻨﺔ ﺗﻮﻗﻒ ﻓﻴﻬﺎ ﺍﻟﺘﻤﻮﻳﻞ(‪.‬‬ ‫
‬
‫ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫
‬

‫‪٤٣‬‬
‫ﻭﻗﺪ ﻳﻜﻮﻥ ﻫﺬﺍ ﺑﺴﺒﺐ ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺍﳌﻜﺎﻓﺂﺕ ﺑﻐﺾ ﺍﻟﻨﻈﺮ ﻋﻦ ﺍﻹﺩﺍﺭﺓ‪ ،‬ﺍﻹﺷﺮﺍﻑ‪،‬‬
‫ﺍﳌﺘﺎﺑﻌﺔ‪ ،‬ﺍﻻﺳﺘﻤﺮﺍﺭﻳﺔ‪.‬‬
‫‪ .٤‬ﻭﺟﻮﺩ ﻓﻮﺍﺭﻕ ﻛﺒﲑﺓ ﺑﺎﳌﺮﺗﺒﺎﺕ ﺑﲔ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﳊﻜﻮﻣﺔ ﻭﺍﳌﻌﻴﻨﲔ )ﺍﳌﺘﻌﺎﻗﺪﻳﻦ(؛ ﳑﺎ‬
‫ﺃﺩﻯ ﺇﱃ ﻭﺟﻮﺩ ﻧﻮﻉ ﻣﻦ ﺍﳊﺴﺎﺳﻴﺔ ﰲ ﺍﻟﻌﻤﻞ‪ ،‬ﻛﻤﺎ ﺃﺩﻯ ﺇﱃ ﺃﻥ ﺟﺰﺀﺍﹰ ﻛﺒﲑﺍﹰ ﻣﻦ‬
‫ﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﻟﺼﺤﺔ ﺍﻧﺘﻘﻠﻮﺍ ﻣﻦ ﻋﻤﻠﻬﻢ ﻛﺤﻜﻮﻣﻴﲔ ﺇﱃ ﻣﺘﻌﺎﻗﺪﻳﻦ‪ ،‬ﻭﻗﺪ ﺃﺛﺮ‬
‫ﻫﺬﺍ ﻋﻠﻰ ﻛﻔﺎﺀﺓ ﺍﻟﻌﻤﻞ ﻭﺍﻹﺣﺴﺎﺱ ﺑﺎﳌﺴﺌﻮﻟﻴﺔ ﲡﺎﻩ ﺟﻬﺔ ﺍﻟﻌﻤﻞ ﺍﻷﺻﻠﻴﺔ‪.‬‬

‫ﺍﻟﻨﻈﺮﺓ ﺍﳌﺴﺘﻘﺒﻠﻴﺔ ﳋﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬

‫‪ .١‬ﺍﻟﺘﻮﺳﻊ ﰲ ﺗﻄﺒﻴﻖ ﻣﻔﻬﻮﻡ ﻃﺐ ﺍﻷﺳﺮﺓ‪ ،‬ﻭﺇﻋﺪﺍﺩ ﺍﻟﻜﻮﺍﺩﺭ ﺍﻟﺒﺸﺮﻳﺔ ﻣﻦ ﺍﻷﻃﺒﺎﺀ ﻭﺍﻟﺘﻤﺮﻳﺾ ﺍﳌﺆﻫﻠﺔ‬
‫ﻟﻠﻘﻴﺎﻡ ﺑﺘﻨﻔﻴﺬ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻊ ﺍﻟﺘﺨﻄﻴﻂ ﺍﻟﺴﻠﻴﻢ ﻟﺘﻮﺯﻳﻊ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ‪.‬‬
‫‪ .٢‬ﺍﻟﺘﻮﺳﻊ ﰲ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﺘﻐﻄﻴﺔ ﲨﻴﻊ ﺍﻟﻔﺌﺎﺕ‪ ،‬ﻭﺧﺎﺻﺔ ﺍﻷﻃﻔﺎﻝ ﺷﺎﻣﻼ ﺍﻷﻃﻔﺎﻝ ﺫﻭﻯ‬
‫ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ‪ ،‬ﻛﺬﻟﻚ ﺗﻄﺒﻴﻖ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻋﻠﻰ ﺍﻟﺴﻴﺪﺍﺕ ﰲ ﻓﺘﺮﺓ ﺍﳊﻤﻞ ﻭﺍﻹﳒﺎﺏ‬
‫ﻟﺘﻮﻓﲑ ﺧﺪﻣﺎﺕ ﺍﻷﻣﻮﻣﺔ ﺍﻵﻣﻨﺔ‪.‬‬
‫‪ .٣‬ﺍﻟﺘﻮﺳﻊ ﰲ ﺗﻄﺒﻴﻖ ﺑﺮﻧﺎﻣﺞ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ‪ ،‬ﻭﻳﺄﰐ ﰲ ﻣﻘﺪﻣﺔ ﺫﻟﻚ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺍﻟﻮﻗﺎﺋﻴﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ‪ ،‬ﻣﻊ ﺿﻤﺎﻥ ﺍﳌﺴﺎﻭﺍﺓ ﻭﺍﳉﻮﺩﺓ ﻭﺍﻟﺸﻤﻮﻟﻴﺔ ﰲ ﺗﻘﺪﱘ‬
‫ﺍﳋﺪﻣﺎﺕ ﻣﻊ ﲢﺴﲔ ﺍﻟﻜﻔﺎﺀﺓ ﻭﺍﺳﺘﻤﺮﺍﺭﻳﺔ ﺍﳋﺪﻣﺎﺕ‪.‬‬
‫‪ .٤‬ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﳊﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‪ ،‬ﻭﺍﺗﺒﺎﻉ ﺃﺣﺪﺙ ﺍﻷﺳﺎﻟﻴﺐ ﺍﻟﻌﻠﻤﻴﺔ ﻟﻠﺘﻌﺎﻣﻞ ﻣﻊ‬
‫ﺍﳊﺎﻻﺕ ﺍﳊﺮﺟﺔ‪ ،‬ﻣﻊ ﺗﻮﻓﲑ ﺍﳋﺪﻣﺔ ﰲ ﲨﻴﻊ ﺃﻧـﺤﺎﺀ ﺍﳉﻤﻬﻮﺭﻳﺔ‪.‬‬
‫‪ .٥‬ﺍﻟﺘﺤﻜﻢ ﰲ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ ﺍﳋﻄﲑﺓ ﻭﺍﻷﻣﺮﺍﺽ ﺍﻟﻄﻔﻴﻠﻴﺔ‪ ،‬ﻣﻦ ﺧﻼﻝ ﻧﻈﺎﻡ ﺟﻴﺪ ﻟﻠﺘﻮﺣﻴﺪ ﻭﺇﺩﺧﺎﻝ‬
‫ﻃﻌﻮﻡ ﺟﺪﻳﺪﺓ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ‪.‬‬
‫‪ .٦‬ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺇﺻﺎﺑﺎﺕ ﺍﳊﻮﺍﺩﺙ ﻭﻋﻼﺟﻬﺎ‪.‬‬
‫‪ .٧‬ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺭﻓﻊ ﻛﻔﺎﺀﺓ ﺍﻟﺘﻤﺮﻳﺾ ﻛﻤﻬﻨﺔ ﻓﻨﻴﺔ ﻭﺇﻧﺴﺎﻧﻴﺔ‪ ،‬ﻭﺗﺄﻫﻴﻞ ﺍﻟﻌﺎﻣﻠﲔ‪ ،‬ﻣﻊ ﻣﺮﺍﻋﺎﺓ ﲢﺴﲔ‬
‫ﻇﺮﻭﻑ ﺍﻟﻌﻤﻞ ﻭﺍﻟﻈﺮﻭﻑ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻟﻠﻔﺮﻳﻖ ﺍﻟﻄﱯ ﻭﺍﻟﺘﻤﺮﻳﺾ‪.‬‬
‫‪ .٨‬ﺍﻟﺘﺤﻜﻢ ﰲ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻜﺎﻧﻴﺔ ﺣﻴﺚ ﲤﺜﻞ ﻋﺎﺋﻘﺎ ﻛﺒﲑﺍ ﺃﻣﺎﻡ ﺧﻄﻂ ﺍﻟﺘﻨﻤﻴﺔ‪.‬‬
‫‪ .٩‬ﺍﻻﻫﺘﻤﺎﻡ ﺑﺒﻌﺾ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ﱂ ﺗﻜﻦ ﻭﺍﺿﺤﺔ ﻣﻦ ﻗﺒﻞ‪ ،‬ﻣﺜﻞ ﻣﺸﺎﻛﻞ ﺍﻟﻄﻔﻠﺔ‬
‫ﺍﻷﻧﺜﻰ ﻭﺍﻷﻃﻔﺎﻝ ﺫﻭﻯ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ‪ ،‬ﻭﺃﻣﺮﺍﺽ ﺍﻟﺪﻡ ﳑﺎ ﻳﺘﻄﻠﺐ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﻭﻋﻤﻞ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺘﺤﺪﻳﺪ ﺣﺠﻢ ﻭﻭﺑﺎﺋﻴﺎﺕ ﺗﻠﻚ ﺍﳌﺸﺎﻛﻞ‪.‬‬
‫‪ .١٠‬ﺿﺮﻭﺭﺓ ﻭﺿﻊ ﺑﺮﺍﻣﺞ ﺻﺤﻴﺔ ﻟﻔﺌﺔ ﺍﳌﺮﺍﻫﻘﲔ ﺑﻌﺪ ﺃﻥ ﺗﺰﺍﻳﺪ ﻋﺪﺩ ﻫﺬﻩ ﺍﻟﻔﺌﺔ؛ ﻧﺘﻴﺠﺔ ﺍﳔﻔﺎﺽ‬
‫ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻛﻤﺎ ﳚﺐ ﺗﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ ﺍﳋﺎﺻﺔ ﳌﺮﺣﻠﺔ ﺍﻟﺸﺒﺎﺏ ﲟﺎ ﻓﻴﻬﺎ ﻣﻦ ﺧﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ‪.‬‬
‫‪ .١١‬ﺩﻣﺞ ﺑﺮﺍﻣﺞ ﺧﺪﻣﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ ﻭﺗﻘﺪﱘ ﺧﺪﻣﺔ ﻭﺭﻋﺎﻳﺔ ﻣﺘﻜﺎﻣﻠﺔ ﺷﺎﻣﻠﺔ ﻟﻸﻃﻔﺎﻝ‪.‬‬
‫‪ .١٢‬ﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬

‫‪٤٤‬‬
‫‪ .١٣‬ﺗﺸﺠﻴﻊ ﺍﳌﺸﺎﺭﻛﺔ ﺍﻟﻔﻌﺎﻟﺔ ﻟﻠﻤﺠﺘﻤﻊ ﻟﺘﻘﺪﱘ ﻭﻣﺘﺎﺑﻌﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺗﻘﻮﻳﺔ ﺩﻭﺭ ﺍﳉﻤﻌﻴﺎﺕ‬
‫ﺍﻷﻫﻠﻴﺔ‪.‬‬
‫‪ .١٤‬ﺣﺪﻭﺙ ﺍﻟﺘﻄﻮﺭ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻲ ﻭﺍﺑﺘﻜﺎﺭ ﺃﺳﺎﻟﻴﺐ ﺣﺪﻳﺜﺔ ﻟﻠﻌﻼﺝ ﻭﺍﻟﻮﻗﺎﻳﺔ ﻭﺍﻛﺘﺸﺎﻑ ﺍﻟﻄﻌﻮﻡ‬
‫ﺍﳉﺪﻳﺪﺓ‪ ،‬ﻣﻊ ﺯﻳﺎﺩﺓ ﻭﺳﺎﺋﻞ ﺍﻻﺗﺼﺎﻝ ﻭﺗﺒﺎﺩﻝ ﺍﳋﱪﺍﺕ ﻭﺍﳌﻌﻠﻮﻣﺎﺕ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻌﺎﳌﻲ ﻣﻦ ﺷﺄﻧﻪ ﺃﻥ‬
‫ﻳﺰﻳﺪ ﺍﻟﻄﻠﺐ ﻋﻠﻰ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ ﻭﺃﺳﺎﻟﻴﺐ ﺍﻟﻮﻗﺎﻳﺔ ﺍﳊﺪﻳﺜﺔ ﺍﻟﱵ ﳚﺐ ﺃﻥ ﺗﻜﻮﻥ ﻋﻠﻰ ﺃﰎ ﺍﻻﺳﺘﻌﺪﺍﺩ‬
‫ﻟﻠﺘﻌﺎﻣﻞ ﻣﻌﻬﺎ‪.‬‬
‫‪ .١٥‬ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺯﻳﺎﺩﺓ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺎﻟﻴﺔ ﻭﺗﻮﻓﲑ ﺍﳌﻴﺰﺍﻧﻴﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺘﻨﻔﻴﺬ ﺧﻄﻂ ﻭﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺗﻄﻮﻳﺮ‬
‫ﺍﳋﺪﻣﺔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪.‬‬

‫‪٤٥‬‬
٤٦
 ‫
 
‪:‬‬
‫ 


  
‬
‫ ‬ ‫‪. .‬‬

‫"‪!"#$‬‬
‫ﺗﻌﺪ ﻣﺼﺮ ﻣﻦ ﺃﻛﱪ ﻭﺃﻛﺜﺮ ﺍﻟﺒﻼﺩ ﺍﻟﻌﺮﺑﻴﺔ ﻣﻦ ﺣﻴﺚ ﺍﻟﻜﺜﺎﻓﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻭﺗﺒﻠﻎ ﺍﳌﺴﺎﺣﺔ ﺍﻹﲨﺎﻟﻴﺔ‬
‫ﻟﻠﺪﻭﻟﺔ ﺣﻮﺍﱄ ﻣﻠﻴﻮﻥ ﻛﻴﻠﻮ ﻣﺘﺮ ﻣﺮﺑﻊ‪ ،‬ﻭﻣﻊ ﺫﻟﻚ ﻓﺈﻥ ﺃﻏﻠﺐ ﺃﺭﺍﺿﻴﻬﺎ ﺻﺤﺮﺍﺀ‪ ٪٦ ،‬ﻓﻘﻂ ﻣﻦ ﻣﺴﺎﺣﺘﻬﺎ‬
‫ﻣﺄﻫﻮﻟﺔ ﺑﺎﻟﺴﻜﺎﻥ )ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪.(١٩٩٩‬‬
‫ﻭﻗﺪ ﺗﺒﻨﺖ ﺍﳊﻜﻮﻣﺔ ﺍﳌﺼﺮﻳﺔ – ﺣﺪﻳﺜﺎﹰ ‪ -‬ﺳﻴﺎﺳﺔ ﺍﺳﺘﺼﻼﺡ ﺍﻷﺭﺍﺿﻲ ﻭﺇﻧﺸﺎﺀ ﻣﺪﻥ ﺟﺪﻳﺪﺓ ﰲ‬
‫ﺍﻟﺼﺤﺮﺍﺀ‪ ،‬ﻭﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﻫﺬﻩ ﺍﳉﻬﻮﺩ ﻓﺈﻥ ﻏﺎﻟﺒﻴﺔ ﺍﻟﺴﻜﺎﻥ ﻳﻌﻴﺸﻮﻥ ﰲ ﺩﻟﺘﺎ ﺍﻟﻨﻴﻞ‪ ،‬ﻣﺘﻤﺮﻛﺰﻳﻦ ﰲ‬
‫ﺍﳉﺰﺀ ﺍﻟﺸﻤﺎﱄ ﻣﻦ ﺍﻟﺪﻭﻟﺔ‪ ،‬ﺃﻭ ﰲ ﻭﺍﺩﻱ ﺍﻟﻨﻴﻞ ﺍﻟﻀﻴﻖ ﺟﻨﻮﺏ ﺍﻟﻘﺎﻫﺮﺓ‪.‬‬
‫ﺗﻨﻘﺴﻢ ﻣﺼﺮ ﺇﺩﺍﺭﻳﺎ ﺇﱃ ‪ ٢٧‬ﳏﺎﻓﻈﺔ‪ ،‬ﺃﺭﺑﻊ ﻣﻨﻬﺎ ﳏﺎﻓﻈﺎﺕ ﺣﻀﺮﻳﺔ )ﺍﻟﻘﺎﻫﺮﺓ – ﺍﻹﺳﻜﻨﺪﺭﻳﺔ –‬
‫ﺑﻮﺭﺳﻌﻴﺪ – ﺍﻟﺴﻮﻳﺲ( ﻟﻴﺲ ‪‬ﺎ ﺭﻳﻒ ﺑﻴﻨﻤﺎ ﻛﻞ ﻣﻦ ﺍﶈﺎﻓﻈﺎﺕ )‪ (٢٣‬ﻣﻘﺴﻤﺔ ﺇﱃ ﻣﻨﺎﻃﻖ ﺣﻀﺮﻳﺔ‬
‫ﻭﻣﻨﺎﻃﻖ ﺭﻳﻔﻴﺔ ﻭﺗﻘﻊ ‪ ٩‬ﻣﻦ ﻫﺬﻩ ﺍﶈﺎﻓﻈﺎﺕ ﰲ ﺩﻟﺘﺎ ﺍﻟﻨﻴﻞ )ﻭﺟﻪ ﲝﺮﻱ(‪ ،‬ﻭﺗﻘﻊ ‪ ٩‬ﰲ ﻭﺍﺩﻱ ﺍﻟﻨﻴﻞ )ﻭﺟﻪ‬
‫ﻗﺒﻠﻲ( ﻭﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ ﺍﳋﻤﺲ ﺍﻟﺒﺎﻗﻴﺔ ﺗﻘﻊ ﻋﻠﻰ ﺍﳊﺪﻭﺩ ﺍﻟﺸﺮﻗﻴﺔ ﻭﺍﻟﻐﺮﺑﻴﺔ ﳌﺼﺮ‪.‬‬

‫ﺗﻐﲑ ﺣﺠﻢ ﻭﻫﻴﻜﻞ ﺍﻟﺴﻜﺎﻥ )ﺍﳌﻌﺪﻝ ﺍﳊﺪﻳﺚ ﻟﻠﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ(‬

‫ﰎ ﺇﺟﺮﺍﺀ ﺁﺧﺮ ﺗﻌﺪﺍﺩ ﺳﻜﺎﱐ ﰲ ﻣﺼﺮ ﰲ ﻧﻮﻓﻤﱪ ‪ ،١٩٩٦‬ﻭﻭﻓﻘﺎ ﻟﻨﺘﺎﺋﺞ ﻫﺬﺍ ﺍﻟﺘﻌﺪﺍﺩ ﻳﺒﻠﻎ ﻋﺪﺩ ﺳﻜﺎﻥ‬
‫ﻣﺼﺮ ‪ ٥٩,٣‬ﻣﻠﻴﻮﻥ ﻧﺴﻤﺔ‪ ،‬ﻭﺗﺘﺠﺎﻭﺯ ﺍﻟﻜﺜﺎﻓﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻣﻦ ‪ ١٩٨٥‬ﻓﺮﺩﺍﹰ ﻟﻜﻞ ﻛﻴﻠﻮ ﻣﺘﺮ ﻣﺮﺑﻊ‪ .‬ﻭﻳﺘﻔﺎﻭﺕ‬
‫ﻫﺬﺍ ﺍﳌﺆﺷﺮ ﺑﺪﺭﺟﺔ ﻛﺒﲑﺓ ﺑﲔ ﺍﶈﺎﻓﻈﺎﺕ ﻣﻦ ‪ ٣١٧٥٠‬ﻓﺮﺩﺍﹰ ﻟﻜﻞ ﻛﻴﻠﻮ ﻣﺘﺮ ﻣﺮﺑﻊ ﺑﺎﻟﻘﺎﻫﺮﺓ ﺇﱃ ‪ ٣٤‬ﻓﺮﺩﺍﹰ‬
‫ﻟﻜﻞ ﻛﻴﻠﻮ ﻣﺘﺮ ﻣﺮﺑﻊ ﺑﺎﻟﺴﻮﻳﺲ‪.‬‬
‫ﻭﳝﺜﻞ ﻧﺴﺒﺔ ﺳﻜﺎﻥ ﺍﳊﻀﺮ ‪ ٪٤٣‬ﻣﻦ ﳎﻤﻮﻉ ﺍﻟﺴﻜﺎﻥ ﺍﻟﻜﻠﻰ‪.‬‬
‫ﳝﺜﻞ ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ ﺍﻟﻔﺮﻕ ﺑﲔ ﻣﻌﺪﻻﺕ ﺍﳌﻮﺍﻟﻴﺪ ﻭﺍﻟﻮﻓﻴﺎﺕ ﰲ ﺍ‪‬ﺘﻤﻊ‪ ،‬ﻭﻫﻮ ﻳﺸﲑ ﺇﱃ ﻣﺪﻯ‬
‫ﺳﺮﻋﺔ ﳕﻮ ﺍﻟﺴﻜﺎﻥ‪ ،‬ﻭﻗﺪ ﺑﺪﺃ ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ ﰲ ﻣﺼﺮ ﰲ ﺍﻻﳔﻔﺎﺽ ﻣﻨﺬ ﻋﺎﻡ ‪.١٩٨٦‬‬
‫ﻭﻗﺪ ﻛﺎﻥ ﺃﻏﻠﺐ ﺍﻻﳔﻔﺎﺽ ﰲ ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ ﻣﻨﺬ ‪ ١٩٨٦‬ﻧﺘﻴﺠﺔ ﻟﻠﺘﻐﲑﺍﺕ ﰲ ﺍﻟﺴﻠﻮﻙ ﺍﻹﳒﺎﰊ‪،‬‬
‫ﺣﻴﺚ ﺍﳔﻔﺾ ﻣﻌﺪﻝ ﺍﳌﻮﺍﻟﻴﺪ ﺍﳋﺎﻡ ﻣﻦ ﺣﻮﺍﱄ ‪ ٣٩‬ﰲ ﺍﻷﻟﻒ ﻋﺎﻡ ‪ ١٩٨٦‬ﺇﱃ ‪ ٢٧‬ﰲ ﺍﻷﻟﻒ ﰲ ﻋﺎﻡ ‪،١٩٩٤‬‬
‫ﻭﻗﺪ ﺑﺪﺃ ﺍﻻﳔﻔﺎﺽ ﰲ ﺍﻟﺜﺒﺎﺕ ﰲ ﻣﻨﺘﺼﻒ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﻣﻊ ﺗﺬﺑﺬﺏ ﻣﻌﺪﻝ ﺍﳌﻮﺍﻟﻴﺪ ﺍﳋﺎﻡ ﺣﻮﻝ ‪ ٢٧‬ﰲ‬
‫ﺍﻷﻟﻒ ﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪.١٩٩٨ -١٩٩٤‬‬
‫ﺍﳔﻔﺾ ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﺍﳋﺎﻡ ﻣﻦ ‪ ٩,٢‬ﰲ ﺍﻷﻟﻒ ‪ ١٩٨٦‬ﺇﱃ ‪ ٦,٥‬ﰲ ﺍﻷﻟﻒ ‪ ،١٩٩٨‬ﻭﻛﺎﻥ ﻻﳔﻔﺎﺽ ﺍﻟﻮﻓﻴﺎﺕ‬
‫ﺗﺄﺛﲑ ﻭﺍﺿﺢ ﻋﻠﻰ ﺯﻳﺎﺩﺓ ﺗﻮﻗﻊ ﻋﻤﺮ ﺍﻟﻔﺮﺩ ﻋﻨﺪ ﺍﳌﻴﻼﺩ‪ .‬ﻭﻗﺪ ﺍﺭﺗﻔﻊ ﺗﻮﻗﻊ ﺍﳊﻴﺎﺓ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﺑﲔ ﺍﻹﻧﺎﺙ‬
‫ﺑﺼﻮﺭﺓ ﺃﺳﺮﻉ ﻣﻦ ﺍﻟﺬﻛﻮﺭ ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪.٢٠٠١ -١٩٦٠‬‬

‫‪٤٧‬‬
 ‫ﺷﻜﻞ )‪ :(١-٢‬ﻣﻌﺪﻝ ﺍﳌﻮﺍﻟﻴﺪ ﻭﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﺍﳋﺎﻡ ﰲ ﻣﺼﺮ )‪(١٩٩٨-١٩٨٦‬‬

‫‪45‬‬
‫‪40‬‬
‫‪35‬‬
‫‪30‬‬
‫‪25‬‬
‫‪20‬‬
‫‪15‬‬
‫‪10‬‬
‫‪5‬‬
‫‪0‬‬
‫‪1986‬‬ ‫‪1988‬‬ ‫‪1990‬‬ ‫‪1992‬‬ ‫‪1994‬‬ ‫‪1996‬‬ ‫‪1998‬‬
‫ﻣﻌﺪﻝ ﺍﳌﻮﺍﻟﻴﺪ ﺍﳋﺎﻡ‬ ‫ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﺍﳋﺎﻡ‬

‫ﺟﺪﻭﻝ )‪ :(١-٢‬ﺗﻮﻗﻊ ﺍﳊﻴﺎﺓ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﺣﺴﺐ ﺍﻟﻨﻮﻉ‪ ،‬ﻣﺼﺮ ‪٢٠٠١-١٩٦٠‬‬

‫ﺃﻧﺜﻲ‬ ‫ﺫﻛﺮ‬ ‫ﺍﻟﺴﻨﺔ‬
‫‪٥٣,٨‬‬ ‫‪٥١,٦‬‬ ‫‪١٩٦٠‬‬
‫‪٥٧,٧‬‬ ‫‪٥٢,٧‬‬ ‫‪١٩٧٦‬‬
‫‪٦٣,٥‬‬ ‫‪٦٠,٥‬‬ ‫‪١٩٨٦‬‬
‫‪٦٦,٤‬‬ ‫‪٦٢,٨‬‬ ‫‪١٩٩١‬‬
‫‪٦٩‬‬ ‫‪٦٥,١‬‬ ‫‪١٩٩٦‬‬
‫‪٧١,٥‬‬ ‫‪٦٧,١‬‬ ‫‪٢٠٠١‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪٢٠٠٠‬‬

‫ﺗﺒﻨﺖ ﺍﳊﻜﻮﻣﺔ ﺍﳌﺼﺮﻳﺔ ﻋﺪﻳﺪﺍﹰ ﻣﻦ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﻟﺘﻌﺰﻳﺰ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺧﻼﻝ ﺍﻟﻨﺼﻒ ﺍﻟﺜﺎﱐ‬
‫ﻣﻦ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ‪ ،‬ﻓﻘﺪ ﰎ ﺍﻟﺘﺤﻮﻝ ﻣﻦ ﺳﻴﺎﺳﺔ ﺍﻻﻗﺘﺼﺎﺩ ﺍﳌﻐﻠﻖ ﺧﻼﻝ ﺍﻟﺴﺘﻴﻨﻴﺎﺕ ﺇﱃ ﺳﻴﺎﺳﺔ‬
‫ﺍﻟﺴﻮﻕ ﺍﳌﻔﺘﻮﺡ ﰲ ﻣﻨﺘﺼﻒ ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ‪ ،‬ﻭﻗﺪ ﳕﺎ ﺍﻻﻗﺘﺼﺎﺩ ﺑﺼﻮﺭﺓ ﺳﺮﻳﻌﺔ ﺧﻼﻝ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﺣﻴﺚ‬
‫ﺗﻀﺎﻋﻒ ﻧﺼﻴﺐ ﺍﻟﻔﺮﺩ ﻣﻦ ﺍﻟﻨﺎﺗﺞ ﺍﻟﻘﻮﻣﻲ ﺍﻹﲨﺎﱄ ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪ ١٩٩٧ – ١٩٩٣‬ﻣﻦ ‪ ٦٦٠‬ﺩﻭﻻﺭﺍﹰ ﺇﱃ‬
‫‪ ١٢٠٠‬ﺩﻭﻻﺭﺍﹰ‪ ،‬ﻭﺍﳔﻔﺾ ﻣﻌﺪﻝ ﺍﻟﺘﻀﺨﻢ ﺇﱃ ‪) ٪ ٦,٣‬ﺻﻨﺪﻭﻕ ﺍﻷﻣﻢ ﺍﳌﺘﺤﺪﺓ ﻟﻠﺘﻨﻤﻴﺔ ‪.(٢٠٠٠‬‬
‫ﻭﻗﺪ ﺻﺎﺣﺐ ﺍﻟﻨﻤﻮ ﺍﻻﻗﺘﺼﺎﺩﻱ ﺍﳉﺪﻳﺪ ﺗﻄﻮﺭ ﰲ ﻋﺪﺩ ﻣﻦ ﻣﺆﺷﺮﺍﺕ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ‬
‫ﻣﺜﻞ‪:‬‬
‫ﺯﻳﺎﺩﺓ ﻧﺴﺒﺔ ﺍﻷﺳﺮ ﺍﻟﱵ ﺗﺼﻞ ﺇﻟﻴﻬﺎ ﻣﻴﺎﻩ ﺍﻟﺸﺮﺏ ﺍﻟﻨﻘﻴﺔ ﻣﻦ ‪ (١٩٨٦) ٪٧٠‬ﺇﱃ ‪.(١٩٩٦) ٪٨٣‬‬ ‫‪-‬‬
‫ﺍﺭﺗﻔﻌﺖ ﻧﺴﺒﺔ ﺍﻹﳌﺎﻡ ﺑﺎﻟﻘﺮﺍﺀﺓ ﻭﺍﻟﻜﺘﺎﺑﺔ ﺑﲔ ﺍﻟﺒﺎﻟﻐﲔ ﺇﱃ ‪ ٪٥٣‬ﻭﻧﺴﺒﺔ ﺍﻻﻟﺘﺤﺎﻕ ﺑﺎﻟﺘﻌﻠﻴﻢ‬ ‫‪-‬‬
‫ﺍﻻﺑﺘﺪﺍﺋﻲ ﺇﱃ ‪ ٪٩٥,٢‬ﻋﺎﻡ ‪.١٩٩٧‬‬

‫‪٤٨‬‬
‫ﺍﺭﺗﻔﻌﺖ ﻧﺴﺒﺔ ﺍﻟﺘﺤﺎﻕ ﺍﻹﻧﺎﺙ ﺑﺎﻟﺘﻌﻠﻴﻢ ﺍﻻﺑﺘﺪﺍﺋﻲ ﻣﻦ ‪ (١٩٧٠) ٪٥٧‬ﺇﱃ ‪ (١٩٩٧) ٪٩١‬ﻭﺍﺭﺗﻔﻌﺖ ﻧﺴﺒﺔ‬
‫ﺍﻟﺘﺤﺎﻕ ﺍﻹﻧﺎﺙ ﺑﺎﻟﺘﻌﻠﻴﻢ ﺍﻟﺜﺎﻧﻮﻱ ﺑﺼﻮﺭﺓ ﺳﺮﻳﻌﺔ ﻣﻦ ‪ (١٩٧٠) ٪٢٣‬ﺇﱃ ‪) .(١٩٩٧) ٪٧٠‬ﻣﻌﻬﺪ ﺍﻟﺘﺨﻄﻴﻂ‬
‫ﺍﻟﻘﻮﻣﻲ ‪.(٩٧‬‬
‫ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺗﻄﻮﺭ ﻋﺪﻳﺪ ﻣﻦ ﺍﳌﺆﺷﺮﺍﺕ‪ ،‬ﻓﺈﻧﻪ ﻣﺎ ﺯﺍﻝ ﻫﻨﺎﻙ ﻓﺠﻮﺍﺕ ﻭﺍﺿﺤﺔ ﺑﲔ ﺑﻌﺾ ﺍ‪‬ﻤﻮﻋﺎﺕ‬
‫ﺍﻟﻨﻮﻋﻴﺔ‪:‬‬
‫ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺣﺼﻮﻝ ﺍﻹﻧﺎﺙ ﻋﻠﻰ ﻣﻜﺎﺳﺐ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻟﻌﻤﻞ‪ ،‬ﻓﺈﻥ ﻧﺴﺒﺔ ﺇﳌﺎﻡ ﺍﻹﻧﺎﺙ‬ ‫‪-‬‬
‫ﺑﺎﻟﻘﺮﺍﺀﺓ ﻭﺍﻟﻜﺘﺎﺑﺔ ﺗﺒﻠﻎ ﻓﻘﻂ ﺛﻠﺜﻲ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﺑﲔ ﺍﻟﺬﻛﻮﺭ‪ ،‬ﻭﻣﺸﺎﺭﻛﺔ ﺍﻹﻧﺎﺙ ﰲ ﻗﻮﺓ ﺍﻟﻌﻤﻞ‬
‫ﺗﺒﻠﻎ ﺣﻮﺍﱄ ‪ ٪١٨‬ﻣﻦ ﻣﺸﺎﺭﻛﺔ ﺍﻟﺬﻛﻮﺭ ﰲ ﻗﻮﺓ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﺍﳌﺆﺷﺮﺍﺕ ﺍﳋﺎﺻﺔ ﺑﺴﻜﺎﻥ ﺍﻟﺮﻳﻒ ﺃﻗﻞ ﻣﻦ ﻣﺜﻴﻼ‪‬ﺎ ﺑﺎﳊﻀﺮ‪.‬‬ ‫‪-‬‬
‫ﻣﺜﺎﻝ‪ :‬ﻧﺴﺒﺔ ﺳﻜﺎﻥ ﺍﻟﺮﻳﻒ ﺍﻟﺬﻳﻦ ﺗﺼﻞ ﺇﻟﻴﻬﻢ ﻣﻮﺍﺳﲑ ﻣﻴﺎﻩ ﺍﻟﺸﺮﺏ ﺍﻟﻨﻘﻴﺔ ﺗﺒﻠﻎ ‪ ٪٧٣‬ﻣﻦ‬
‫ﻧﺴﺒﺔ ﺳﻜﺎﻥ ﺍﳊﻀﺮ ﺍﻟﺬﻳﻦ ﺇﻟﻴﻬﻢ ﻣﻮﺍﺳﲑ ﻣﻴﺎﻩ ﺷﺮﺏ ﻧﻘﻴﺔ‪ ،‬ﻛﻤﺎ ﺗﺘﺴﻊ ﺍﻟﻔﺠﻮﺓ ﺑﲔ ﺍﳊﻀﺮ‬
‫ﻭﺍﻟﺮﻳﻒ ﺑﺎﻟﻨﺴﺒﺔ ﳋﺪﻣﺎﺕ ﺍﻟﺼﺮﻑ ﺍﻟﺼﺤﻲ‪ ،‬ﺣﻴﺚ ﺇﻥ ﻧﺴﺒﺔ ﺳﻜﺎﻥ ﺍﻟﺮﻳﻒ ﺍﳌﺘﺎﺡ ﳍﻢ‬
‫ﺧﺪﻣﺎﺕ ﺍﻟﺼﺮﻑ ﺍﻟﺼﺤﻲ ﲤﺜﻞ ‪ ٪٢٣‬ﻣﻦ ﻧﺴﺒﺔ ﺳﻜﺎﻥ ﺍﳊﻀﺮ ﺍﻟﺬﻳﻦ ﻟﺪﻳﻬﻢ ﺻﺮﻑ ﺻﺤﻲ‪.‬‬
‫ﻣﺴﺘﻮﻯ ﺍﻟﺘﻌﻠﻴﻢ ﺑﲔ ﺳﻜﺎﻥ ﺍﳊﻀﺮ ﺃﻓﻀﻞ ﻣﻨﻪ ﺑﲔ ﺳﻜﺎﻥ ﺍﻟﺮﻳﻒ‪.‬‬ ‫‪-‬‬

‫  
& " ‪%‬‬

‫ﻧﺸﺄﺓ ﻭﺗﻄﻮﺭ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ‬
‫ﺗﺮﺟﻊ ﺟﺬﻭﺭ ﻧﺸﺄﺓ ﻭﺗﻄﻮﺭ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﺇﱃ ﺍﻟﻌﺼﺮ ﺍﻟﻔﺮﻋﻮﱐ ﺣﻴﺚ ﺗﺸﲑ ﺍﳌﻮﻣﻴﺎﻭﺍﺕ ﻭﺃﻭﺭﺍﻕ‬
‫ﺍﻟﱪﺩﻱ ﺇﱃ ﺃﻥ ﺍﳌﺼﺮﻳﲔ ﺍﻟﻘﺪﻣﺎﺀ ﻋﺮﻓﻮﺍ ﺍﻟﻜﺜﲑ ﻋﻦ ﺗﺸﺮﻳﺢ ﺍﳉﺴـﻢ ﺍﻟﺒﺸﺮﻱ‪ ،‬ﻛﻤﺎ ﺃ‪‬ﻢ ﺃﺟـﺎﺩﻭﺍ ﻓﻦ‬
‫ﺍﻟﺘﺤﻨﻴﻂ ﻭﻭﺻﻔﻮﺍ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﻣﺜﻞ ﺍﻟﺒﻠﻬﺎﺭﺳــﻴﺎ‪ ،‬ﺍﻛﺘﺸﻔﻮﺍ ﺃﻋﺸﺎﺑﺎ ﻟﻠﻌﻼﺝ ﻣﺎﺯﺍﻝ ﺑﻌﻀﻬﺎ‬
‫ﻳﺴﺘﺨﺪﻡ ﺣﱴ ﺍﻵﻥ ﰲ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ‪.‬‬
‫ﻭﻣﺎﺭﺳﻮﺍ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺃﻧﻮﺍﻉ ﺍﳉﺮﺍﺣﺎﺕ‪ ،‬ﻭﻓﻮﻕ ﺫﻟﻚ ﺍﻫﺘﻤﻮﺍ ﺑﺎﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺻﺤﺔ ﺍﻟﺒﻴﺌﺔ‪ ،‬ﻛﻤﺎ ﻭﺿﻌﻮﺍ‬
‫ﺃﺳﺲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ ،‬ﻭﻗﺎﻣﻮﺍ ﺑﺎﻟﺘﺜﻘﻴﻒ ﺍﻟﺼﺤﻲ‪ ،‬ﻭﺗﻮﺛﻴﻖ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺑﺄﺳﻠﻮﺏ ﻣﻨﻈﻢ‬
‫ﻟﻠﺤﺪ ﺍﻟﺬﻱ ﺟﻌﻞ ﻣﺆﺭﺥ ﺍﳌﺼﺮﻳﺎﺕ ﺇﺩﻭﻳﻦ ﲰﻴﺚ ﻳﺸﻬﺪ ﺑﺄﻥ ﺑﺮﺩﻳﺔ ﺍﻳﱪﺱ ﺍﻟﺸﻬﲑﺓ ﺗﺸﺎﺑﻪ ﻣﺮﺟﻌﺎ ﻃﺒﻴﺎ‬
‫ﺣﺪﻳﺜﺎ‪.‬‬
‫ﻭﰲ ﺍﻟﻌﺼﺮ ﺍﻟﺮﻭﻣﺎﱐ ﺃﻧﺸﺄﺕ ﺍﻷﻛﺎﺩﳝﻴﺔ ﺍﻟﻄﺒﻴﺔ ﺩﺍﺭ ﺍﻟﻮﻻﺩﺓ ﺑﺎﻹﺳﻜﻨﺪﺭﻳﺔ ﺍﻟﻘﺪﳝﺔ ﻭﻋﺪﺩﺍ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﺍﻟﻄﺒﻴﺔ ﺑﺄﻣﺎﻛﻦ ﻣﺘﻔﺮﻗﺔ ﲟﺼﺮ‪.‬‬
‫ﻭﰲ ﺍﻟﻌﺼﺮ ﺍﻟﻘﺒﻄﻲ ﺍﻫﺘﻢ ﺍﻟﻘﺴﺎﻭﺳﺔ ﺑﺎﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺟﻌﻞ ﺍﻷﺩﻳﺮﺓ ﺩﻭﺭﺍ ﻟﻠﻌﻼﺝ‬
‫ﻭﺍﻟﺘﻌﻠﻴﻢ ﺇﱃ ﺟﺎﻧﺐ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺘﺜﻘﻴﻒ ﺍﳌﻮﺍﻃﻨﲔ‪.‬‬
‫ﻭﲤﻴﺰ ﺍﻟﻌﺼﺮ ﺍﻹﺳﻼﻣﻲ ﺑﺎﻫﺘﻤﺎﻣﻪ ﺍﻟﺒﺎﻟﻎ ﺑﻘﻀﺎﻳﺎ ﺍﻟﻨﻈﺎﻓﺔ ﺍﻟﺸﺨﺼﻴﺔ ﻭﺃﺭﺳﻰ ﺍﻷﺳﺲ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‬
‫ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ‪ ،‬ﻭﺃﻧﺸﺄ ﻋﺪﺩﺍ ﻣﻦ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﻟﻌﻴﺎﺩﺍﺕ ﺍ‪‬ﺎﻧﻴﺔ ﻟﻐﲑ ﺍﻟﻘﺎﺩﺭﻳﻦ‪ .‬ﻭﻣﺎﺯﺍﻝ ﻣﺴﺘﺸﻔﻰ‬
‫ﻗﻼﻭﻭﻥ ﺑﺎﻟﻘﺎﻫﺮﺓ ﻳﻌﻤﻞ ﺣﱴ ﺍﻵﻥ‪.‬‬

‫‪٤٩‬‬
‫ﻭﻗﺪ ﺃﺩﻯ ﻋﺪﻡ ﺍﻻﺳﺘﻘﺮﺍﺭ ﺍﻟﺴﻴﺎﺳﻲ ﺑﺪﺀﺍ ﻣﻦ ﺍﻟﻐﺰﻭ ﺍﻟﻌﺜﻤﺎﱐ ﳌﺼﺮ ﺣﱴ ﺃﻭﺍﺧﺮ ﺍﻟﻘﺮﻥ ﺍﻟﺜﺎﻣﻦ ﻋﺸﺮ ﺇﱃ‬
‫ﺗﺪﻫﻮﺭ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﺎﻣﺔ ﺑﺸﻜﻞ ﻣﻠﺤﻮﻅ ﻭﻣﻨﻬﺎ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﰲ ﺃﻭﺍﺧﺮ ﺍﻟﻘﺮﻥ ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ ﻭﺃﻭﺍﺋﻞ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ ﻛﺎﻧﺖ ﺟﻬﻮﺩ ﻣﺼﻠﺤﺔ ﺍﻟﺼﺤﺔ ﻗﺎﺻﺮﺓ ﻋﻠﻰ‬
‫ﻣﻜﺎﻓﺤﺔ ﺍﻷﻭﺑﺌﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ‪.‬‬
‫ﺻﺎﺣﺒﺖ ﺍﳊﻤﻠﺔ ﺍﻟﻔﺮﻧﺴﻴﺔ ﳌﺼﺮ ﻋﺎﻡ ‪ ١٨٧٨‬ﻓﺮﻗﺔ ﻃﺒﻴﺔ ﻛﺎﻥ ﻫﺪﻓﻬﺎ ﺭﻋﺎﻳﺔ ﺟﻨﻮﺩ ﺍﳊﻤﻠﺔ‬ ‫‪-‬‬
‫ﻣﻦ ﺍﻷﻭﺑﺌﺔ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻮﻃﻨﺔ ﺍﻟﺴﺎﺋﺪﺓ ﰲ ﺫﻟﻚ ﺍﻟﻮﻗﺖ ﻭﺃﺟﺮﺕ ﺍﳊﻤﻠﺔ ﺗﻌﺪﺍﺩﺍﹰ ﻟﻠﺴﻜﺎﻥ ﻋﺎﻡ‬
‫‪ ١٨٠٠‬ﻭﻛﺎﻧﺖ ﺍﻹﺩﺍﺭﺓ ﺍﻟﺼﺤﻴﺔ ﻟﻠﺠﻴﺶ ﻧﻮﺍﺓ ﺍﻟﻨﻈﺎﻡ ﺍﻹﺩﺍﺭﻱ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ﺭﺃﺳﻬﺎ‬
‫ﻛﻠﻮﺩ ﺑﻚ ﻋﺎﻡ ‪ ،١٨٢٠‬ﻭﺍﻟﺬﻱ ﺷﻜﻞ ﳎﻠﺴﺎﹰ ﺍﺳﺘﺸﺎﺭﻳﺎﹰ ﻣﻦ ﺍﻷﻃﺒﺎﺀ ﻟﻮﺿﻊ ﺳﻴﺎﺳﺔ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﻌﺎﻣﺔ‪ ،‬ﻛﻤﺎ ﺍﻓﺘﺘﺤﺖ ﺃﻭﻝ ﻣﺪﺭﺳﺔ ﻟﻠﻄﺐ ﻋﺎﻡ ‪ ١٨٢٧‬ﻭﻭﺣﺪﺍﺕ ﺍﳊﺠﺮ ﺍﻟﺼﺤﻲ ﺑﺎﳌﻨﺎﻓﺬ‬
‫ﺍﻟﺸﻤﺎﻟﻴﺔ ﻋﺎﻡ ‪ ١٨٣١‬ﻭﻭﺿﻊ ﺃﻭﻝ ﻧﻈﻢ ﻟﻠﺼﺤﺔ ﺍﳌﺪﺭﺳﻴﺔ ﻭﻧﻈﻢ ﺍﳌﻮﺍﻟﻴﺪ ﻭﺍﻟﻮﻓﻴﺎﺕ‪،‬‬
‫ﻭﺍﻟﺘﻄﻌﻴﻢ ﺿﺪ ﺍﻟﺪﺭﻥ‪.‬‬
‫ﻛﺎﻧﺖ ﺟﻬﻮﺩ ﻣﺼﻠﺤﺔ ﺍﻟﺼﺤﺔ ﰲ ﺃﻭﺍﺧﺮ ﺍﻟﻘﺮﻥ ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ ﻭﺃﻭﺍﺋﻞ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ ﻗﺎﺻﺮﺓ‬ ‫‪-‬‬
‫ﻋﻠﻰ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻭﺑﺌﺔ‪ ،‬ﻣﻜﺎﻓﺤﺔ ﻛﺎﻥ ﻗﻮﺍﻣﻬﺎ ﰲ ﺍﻟﺮﻳﻒ ﺍﻟﺪﺍﻳﺔ ﻭﻛﺎﻥ ﺩﻭﺭ ﺣﻼﻕ ﺍﻟﺼﺤﺔ ﰲ‬
‫ﺍﻟﻘﺮﻳﺔ ﻫﻮ ﺍﻟﺘﻄﻌﻴﻢ ﺿﺪ ﺍﳉﺪﺭﻯ ﻭﺍﻟﺘﻨﺒﻴﻪ ﺇﱃ ﻭﺟﻮﺩ ﻭﻓﻴﺎﺕ ﻏﲑ ﻋﺎﺩﻳﺔ ﻣﺜﻞ ﺍﻟﻮﻓﻴﺎﺕ ﺑﲔ‬
‫ﺍﻷﻗﺎﺭﺏ ﺃﻭ ﰲ ﺳﻦ ﺍﻟﺸﺒﺎﺏ ﺃﻭ ﻭﺟﻮﺩ ﻃﻔﺢ ﺃﻭ ﻋﻼﻗﺎﺕ ﻏﲑ ﻋﺎﺩﻳﺔ ﺑﲔ ﺍﳌﺘﻮﻓﲔ‪.‬‬
‫ﻛﻤﺎ ﻛﺎﻥ ﺩﻭﺭ ﺍﻟﺪﺍﻳﺔ ﰲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻭﺑﺌﺔ ﺍﻟﻜﺸﻒ ﻋﻠﻰ ﻭﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ ﺍﻟﺒﺎﻟﻐﺎﺕ ﺑﻨﻔﺲ‬ ‫‪-‬‬
‫ﺍﻷﺳﺲ ﺍﻟﱵ ﻛﺎﻥ ﻳﻘﻮﻡ ‪‬ﺎ ﺣﻼﻕ ﺍﻟﺼﺤﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻟﺮﺟﺎﻝ ﻭﺍﻷﻃﻔﺎﻝ‪.‬‬
‫ﻭ ﻳﺸﻬﺪ ﻋﺎﻡ ‪ ١٩٢٧‬ﺗﻄﻮﺭﺍ ﻣﻠﺤﻮﻇﺎ ﰲ ﺃﻧﺸﻄﺔ ﻣﺼﻠﺤﺔ ﺍﻟﺼﺤﺔ )ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺪﺍﺧﻠﻴﺔ( ﺣﲔ ﺫﺍﻙ‬
‫ﺣﻴﺚ ﺗﻘﺪﻣﺖ ﺑﱪﻧﺎﻣﺞ ﻣﻔﺼﻞ ﻟﻺﺻﻼﺡ ﺍﻟﺼﺤﻲ ﴰﻞ ﺇﻧﺸﺎﺀ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺮﻛﺰﻳﺔ ﻭﻣﺮﺍﻛﺰ ﺭﻋﺎﻳﺔ‬
‫ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ ﺑﺎﳌﺪﻥ‪ ،‬ﻭﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺃﻭﺟﻪ ﺇﺻﻼﺡ ﺍﻟﺒﻴﺌﺔ‪.‬‬
‫ﻭﰲ ﻋﺎﻡ ‪ ١٩٣٦‬ﺃﻧﺸﺌﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻮﻣﻴﺔ‪ .‬ﻭﰲ ﻋﺎﻡ ‪ ١٩٤٢‬ﺑﺪﺉ ﰲ ﺗﻨﻔﻴﺬ ﺑﺮﻧﺎﻣﺞ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﻘﺮﻭﻳﺔ ﺑﺈﻧﺸﺎﺀ ﺍ‪‬ﻤﻮﻋﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﺘﻘﺪﱘ ﺑﺮﺍﻣﺞ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻠﻤﻮﺍﻃﻨﲔ ﺑﺎﻟﺮﻳﻒ‪.‬‬
‫ﺑﻌﺪ ﻗﻴﺎﻡ ﺛﻮﺭﺓ ‪ ١٩٥٢‬ﺃﺧﺬ ﻣﻔﻬﻮﻡ ﺍﻟﻌﺪﺍﻟﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻃﺮﻳﻘﻪ ﰲ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻭﻣﻨﻬﺎ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺍﻟﺬﻱ ﺍﻧﻌﻜﺲ ﻋﻠﻰ ﳎﺎﻧﻴﺔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻼﺟﺎ ﻭﻭﻗﺎﻳﺔ‪.‬‬
‫ﻭﻗﺪ ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰲ ﻋﺎﻡ ‪ ١٩٥٩‬ﺑﺈﻧﺸﺎﺀ ﺍﳌﻨﺎﻃﻖ ﺍﻟﻄﺒﻴﺔ ﲝﻴﺚ ﺍﺻﺒﺢ ﰲ ﻛﻞ ﻣﺪﻳﺮﻳﺔ ﻣﺪﻳﺮ‬
‫ﻟﻠﺼﺤﺔ ﻟﻪ ﺳﻠﻄﺎﺕ ﻣﺪﻳﺮ ﻋﺎﻡ ﻋﻠﻰ ﲨﻴﻊ ﺍﻟﻮﺣﺪﺍﺕ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﰲ ﺍﳌﺪﻳﺮﻳﺔ ﻭﻛﺎﻧﺖ ﻫﺬﻩ‬
‫ﺍﻟﺴﻠﻄﺔ ﺗﻔﻮﻳﻀﺎ ﻣﻦ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﳌﺮﻛﺰﻳﺔ ﻛﻤﺎ ﺿﻤﺖ ﲨﻴﻊ ﺃﺟﻬﺰﺓ ﺍﻹﺷﺮﺍﻑ ﺍﶈﻠﻴﺔ ﻋﻠﻰ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﲢﺖ ﺇﺷﺮﺍﻑ ﻣﺪﻳﺮ ﺍﳌﻨﻄﻘﺔ‪.‬‬
‫ﰲ ﻋﺎﻡ ‪ ١٩٦٠‬ﻃﺒﻖ ﻧﻈﺎﻡ ﺍﻹﺩﺍﺭﺓ ﺍﶈﻠﻴﺔ ﻭﺃﺻﺒﺤﺖ ﺍﳌﻨﻄﻘﺔ ﺍﻟﻄﺒﻴﺔ ﺿﻤﻦ ﺃﺟﻬﺰﺓ ﺍﶈﺎﻓﻈﺔ‪ ،‬ﻭﰲ ﺃﻭﺍﺧﺮ‬
‫ﺍﻟﺴﺘﻴﻨﻴﺎﺕ ﺑﺪﺃ ﻧﻈﺎﻡ ﺍﻹﺩﺍﺭﺓ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﳌﺮﺍﻛﺰ ﻭﺃﺻﺒﺢ ﻣﺪﻳﺮ ﺍﻹﺩﺍﺭﺓ ﺍﻟﺼﺤﻴﺔ ﺑﺎﳌﺮﻛﺰ ﻣﺴﺌﻮﻻ ﻋﻦ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻓﻨﻴﺎﹰ‪ ،‬ﻭﻳﺘﺒﻊ ﻣﺪﻳﺮﻳﺔ ﺍﻟﺼﺤﺔ ﻭﺭﺋﻴﺲ ﳎﻠﺲ ﺍﳌﺪﻳﻨﺔ ﺇﺩﺍﺭﻳﺎ ﻭ‪‬ﺬﺍ ﺑﺪﺃﺕ ﻓﻜﺮﺓ‬

‫‪٥٠‬‬
‫ﺍﻟﻼﻣﺮﻛﺰﻳﺔ ﰲ ﺇﺩﺍﺭﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻨﺬ ﻭﻗﺖ ﻣﺒﻜﺮ‪ ،‬ﻭﻫﻲ ﻟﻴﺴﺖ ﻓﻜﺮﺓ ﺣﺪﻳﺜﺔ‪ ،‬ﻭﻟﻜﻨﻬﺎ ﲢﺘﺎﺝ ﺇﱃ‬
‫ﺩﻋﻢ ﻭﺗﻘﻮﻳﺔ ﻟﻠﻤﻬﺎﺭﺍﺕ ﺍﻹﺩﺍﺭﻳﺔ ﻟﺪﻯ ﻣﺪﻳﺮﻱ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﶈﺎﻓﻈﺎﺕ ﻭﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻛﻤﺎ ﺑﺪﺃ ﺍﻟﱪﻧﺎﻣﺞ ﺍﻟﻘﻮﻣﻲ ﻟﺘﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻋﺎﻡ ‪ .١٩٦٦‬ﻭﺯﺍﺩﺕ ﰲ ﺍﻟﺴﺘﻴﻨﻴﺎﺕ ﺃﻋﺪﺍﺩ ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ ﲝﻴﺚ ﺃﺻﺒﺤﺖ ﺗﻐﻄﻰ ﻣﻌﻈﻢ ﳏﺎﻓﻈﺎﺕ ﺍﳉﻤﻬﻮﺭﻳﺔ‪.‬‬
‫ﻭﰲ ﻳﻨﺎﻳﺮ ﻋﺎﻡ ‪ ١٩٩٦‬ﺃﺻﺒﺢ ﻣﺴﻤﻰ ﺍﻟﻮﺯﺍﺭﺓ ﺑﻌﺪ ﺿﻢ ﻭﺯﺍﺭﺓ ﺍﻟﺴﻜﺎﻥ ﺇﻟﻴﻬﺎ ﻫﻮ "ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻜﺎﻥ"‪.‬‬

‫ﻣﻘﺪﻣﺔ ﻋﻦ ﺍﻟﻨﻈﻢ ﺍﻟﺼﺤﻴﺔ‬

‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺣﻖ ﻟﻜﻞ ﻣﻮﺍﻃﻦ ﻭﻫﻲ ﻣﺘﺎﺣﺔ ﻟﻠﻤﻮﺍﻃﻦ ﺍﳌﺼﺮﻱ ﺑﻨﺴﺒﺔ ‪ ٪٩٥‬ﰲ ﺣﺪﻭﺩ ‪ ٥‬ﻛﻢ ﻣﻦ‬
‫ﺍﻟﻮﺣﺪﺓ ﺍﳌﻘﺪﻣﺔ ﻟﻠﺨﺪﻣﺔ‪.‬‬
‫ﻭﺭﺳﺎﻟﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺗﺘﻠﺨﺺ ﰲ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻤﻮﺍﻃﻨﲔ‪ ،‬ﻭﺗﺄﻣﲔ ﺑﻴﺌﺘﻬﻢ ﻟﻠﺤﻔﺎﻅ‬
‫ﻋﻠﻴﻬﻢ ﰲ ﲨﻴﻊ ﻣﺮﺍﺣﻞ ﺍﳊﻴﺎﺓ – ﻭﺫﻟﻚ ﻋﻦ ﻃﺮﻳﻖ ﺇﻧﺸﺎﺀ ﻭﺗﻮﻓﲑ ﻭﺳﺎﺋﻞ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﻄﺒﻴﺔ‪،‬‬
‫ﻭﺗﻨﺴﻴﻖ ﻭﺗﻨﻈﻴﻢ ﺍﺳﺘﺨﺪﺍﻣﺎ‪‬ﺎ – ﻭﺭﻏﻢ ﺃﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺗﺆﺩﻯ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ ﺑﺎﻻﺷﺘﺮﺍﻙ ﻭﺍﻟﺘﻌﺎﻭﻥ ﻣﻊ‬
‫ﺍﳍﻴﺌﺎﺕ ﺍﻷﺧﺮﻯ ﺍﻟﱵ ﺗﻘﺪﻡ ﺧﺪﻣﺎﺕ ﻋﻼﺟﻴﺔ ﻓﺈﻥ ﻣﺴﺌﻮﻟﻴﺔ ﺍﻟﺼﺤﺔ ﻫﻲ ﻣﺴﺌﻮﻟﻴﺔ ﲨﺎﻋﻴﺔ ﺗﺸﺎﺭﻙ‬
‫ﻓﻴﻬﺎ ﻛﻞ ﺍﻷﺟﻬﺰﺓ ﺍﻟﱵ ﺗﻘﻮﻡ ﺑﺄﻧﺸﻄﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺍﻷﺧﺮﻯ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ‬
‫ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﻫﺬﻩ ﺍﻷﻧﺸﻄﺔ ﻻ ﻳﻘﻊ ﰲ ﺍﺧﺘﺼﺎﺻﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﳌﺒﺎﺷﺮﺓ ﻓﺈﻥ ﻣﺴﺌﻮﻟﻴﺔ ﺍﻟﻮﺯﺍﺭﺓ ﰲ‬
‫ﻫﺬﻩ ﺍ‪‬ﺎﻻﺕ ﻫﻲ ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺗﺮﺷﻴﺪ ﺍﻷﺟﻬﺰﺓ ﺍﳌﺴﺌﻮﻟﺔ ﻭﺍﳌﺴﺎﳘﺔ ﰲ ﻋﻤﻠﻴﺎﺕ ﺍﻟﺘﻨﺴﻴﻖ ﺑﻴﻨﻬﺎ ﻭﺑﲔ‬
‫ﻫﺬﻩ ﺍﻷﺟﻬﺰﺓ‪.‬‬
‫ﻛﻤﺎ ﻳﺆﺛﺮ ﻛﻞ ﻣﻦ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﻭﺍﻟﻄﱯ ﻋﻠﻰ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﳌﺎ ﳍﺎ ﻣﻦ ﺍﻧﻌﻜﺎﺳﺎﺕ ﻋﻠﻰ‬
‫ﻣﺴﺘﻮﻯ ﺍﳋﺮﻳﺞ ﻣﻦ ﻣﺮﺍﻓﻖ ﺍﻟﺘﻌﻠﻴﻢ ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﻭﺧﺎﺻﺔ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﻭﺍﳌﻌﺎﻫﺪ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺣﻴﺚ ﺇﻥ‬
‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻛﻤﺴﺘﻔﻴﺪ ﻣﻦ ﻫﺬﺍ ﺍﳋﺮﻳﺞ ﺗﺘﻌﺎﻭﻥ ﻣﻊ ﺍﳉﺎﻣﻌﺎﺕ ﻭﺍﳌﻌﺎﻫﺪ ﰲ ﺗﻄﻮﻳﺮ ﺑﺮﺍﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ‬
‫ﺍﻟﻄﱯ ﻭﺗﺄﻫﻴﻞ ﺍﳋﺮﳚﲔ‪ .‬ﻛﻤﺎ ﺃﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺗﺘﻮﱃ ﺃﻳﻀﺎ ﺇﻣﺪﺍﺩ ﺃﺟﻬﺰﺓ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻹﻋﻼﻡ ﺑﺎﻹﺭﺷﺎﺩﺍﺕ‬
‫ﺍﻟﻼﺯﻣﺔ ﻟﺮﻓﻊ ﺍﻟﻮﻋﻲ ﺍﻟﺼﺤﻲ ﺑﲔ ﺍﳌﻮﺍﻃﻨﲔ ﻭﻹﺩﺧﺎﻝ ﺳﻠﻮﻛﻴﺎﺕ ﺟﺪﻳﺪﺓ ﲟﻔﺎﻫﻴﻢ ﺟﺪﻳﺪﺓ‪.‬‬
‫ﻭﻻﺑﺪ ﻣﻦ ﺍﻛﺘﻤﺎﻝ ﻋﺪﺩ ﻣﻦ ﺍﳌﻮﺍﺻﻔﺎﺕ ﻟﺘﻮﻓﲑ ﺭﻋﺎﻳﺔ ﺻﺤﻴﺔ ﺟﻴﺪﺓ ﺷﺎﻣﻠﺔ ﻣﺜﻞ ﺃﻥ ﺗﻜﻮﻥ‪ :‬ﻣﺘﻮﻓﺮﺓ‪،‬‬
‫ﻣﺘﺎﺣﺔ‪ ،‬ﻣﻘﺒﻮﻟﺔ‪ ،‬ﺗﻜﻠﻔﺘﻬﺎ ﻣﻨﺎﺳﺒﺔ‪ ،‬ﺫﺍﺕ ﻛﻔﺎﺀﺓ ﻋﺎﻟﻴﺔ‪ ،‬ﻣﺴﺘﻤﺮﺓ‪ ،‬ﻣﻨﺴﻘﺔ ﻭﻋﺎﺩﻟﺔ‪.‬‬
‫ﻭﻳﻮﺟﺪ ﻋﺪﺓ ﻧﻈﻢ ﻭﻧﻮﻋﻴﺎﺕ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﰲ ﳐﺘﻠﻒ ﳎﺘﻤﻌﺎﺕ ﺍﻟﻌﺎﱂ ﻣﻨﻬﺎ‪:‬‬
‫ﺍﻟﻄﺐ ﺍﻟﺸﻌﱯ )ﺩﻳﲏ‪ ،‬ﺳﺤﺮﻱ(‪.‬‬ ‫‪-‬‬
‫ﺍﻟﻄﺐ ﺍﻟﺮﲰﻲ )ﺣﻜﻮﻣﻲ‪ ،‬ﺧﺎﺹ‪ ،‬ﺗﺄﻣﲔ ﺻﺤﻲ(‪.‬‬ ‫‪-‬‬
‫‪ .١‬ﺍﻟﻄﺐ ﺍﻟﺸﻌﱯ‪ :‬ﺍﻟﺬﻱ ﳝﺎﺭﺱ ﺧﺎﺭﺝ ﺳﺒﻞ ﺃﻭ ﻃﺮﻕ ﺍﻟﻌﻼﺝ ﺍﻟﺮﲰﻴﺔ ﺍﳌﻌﺘﻤﺪﺓ ﻛﺒﺪﻳﻞ ﳍﺎ‪ ،‬ﻭﻻ‬
‫ﺗﺰﺍﻝ ﻗﻄﺎﻋﺎﺕ ﻏﲑ ﻗﻠﻴﻠﺔ ﺧﺎﺻﺔ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺍﻟﺒﺪﻭﻳﺔ ﻭﺍﻷﺣﻴﺎﺀ ﺍﻟﺸﻌﺒﻴﺔ ﺍﻟﻔﻘﲑﺓ ﺑﺎﳌﺪﻥ‬
‫ﺗﻠﺠﺄ ﺇﻟﻴﻪ ﺇﻣﺎ ﻷﺳﺒﺎﺏ ﺍﻋﺘﻘﺎﺩﻳﺔ ﻣﺘﻮﺍﺭﺛﺔ ﺗﺘﺼﻞ ﺑﻔﻬﻤﻬﻢ ﻟﻄﺒﻴﻌﺔ ﺍﳌﺮﺽ ﻭﺃﺳﺒﺎﺑﻪ‪ ،‬ﻭﺇﻣﺎ ﻷﺳﺒﺎﺏ‬
‫ﺍﻗﺘﺼﺎﺩﻳﺔ ﺗﺘﺼﻞ ﺑﻌﺪﻡ ﺗﻮﺍﻓﺮ ﺍﻹﻣﻜﺎﻧﺎﺕ ﳌﻮﺍﺟﻬﻪ ﻋﺐﺀ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﳌﺮﺽ ﺑﺎﻟﻄﺮﻕ ﺍﻟﺮﲰﻴﺔ‪،‬‬
‫ﻭﺇﻣﺎ ﻟﻨﻘﺺ ﺍﻹﻣﻜﺎﻧﺎﺕ ﺍﳌﺘﺎﺣﺔ ﻟﻮﺳﺎﺋﻞ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺮﲰﻴﺔ ﺃﻭ ﰲ ﺃﻣﺎﻛﻦ ﺍﻟﻮﺻﻮﻝ ﺇﱃ ﻣﻨﺎﻓﺬﻫﺎ‪.‬‬

‫‪٥١‬‬
‫ﻭﺍﻟﻄﺐ ﺍﻟﺸﻌﱯ )ﺍﻟﻌﻘﻼﱐ( ﻳﺸﻤﻞ ﺍﻟﺘﺪﺍﻭﻱ ﺑﺎﻷﻋﺸﺎﺏ ﻭﺍﻟﻜﻲ ﻭﺍﻟﻔﺼﺪ ﻭﺍﻟﺘﺪﻟﻴﻚ‪ ،‬ﻭﻛﺘﺎﺳﺎﺕ‬
‫ﺍﳍﻮﺍﺀ‪ ..‬ﺍﱁ‪.‬‬
‫ﻭﻣﻦ ﺍﳌﻼﺣﻆ ﺃﻥ ﻋﺪﺩﺍ ﻣﻦ ﻫﺬﻩ ﺍﻟﻮﺳﺎﺋﻞ ﻛﺎﻟﺘﺪﺍﻭﻱ ﺑﺎﻷﻋﺸﺎﺏ ﻭﺃﺳﺎﻟﻴﺐ ﺍﻟﻌﻼﺝ ﺍﻟﻄﺒﻴﻌﻲ ﻗﺪ‬
‫ﺩﺧﻠﺖ ﺑﺪﺭﺟﺔ ﻣﺎ ﰲ ﳎﺎﻝ ﺍﻟﺮﺅﻳﺔ ﺍﻟﻌﻠﻤﻴﺔ ﲢﺖ ﻣﻈﻠﺔ ﺍﻟﻌﻼﺝ ﺍﻟﺮﲰﻲ‪.‬‬
‫ﺍﻟﻌﻼﺝ ﺍﻟﺸﻌﱯ ﺍﻟﺪﻳﲏ ﺍﻟﺴﺤﺮﻱ ﻭﻳﺸﻤﻞ ﺍﻟﺘﺪﺍﻭﻱ ﺑﺎﻟﺮﻗﻰ ﻭﺍﻟﺴﺤﺮ ﻭﻏﲑﻫﺎ‪ ،‬ﻭﺗﻜﻮﻥ ﺍﳌﻌﺘﻘﺪﺍﺕ‬
‫ﺍﳌﺘﻮﺍﺭﺛﺔ‪ ،‬ﻭﺍﻟﻌﺎﻣﻞ ﺍﻟﻨﻔﺴﻲ ﻭﺁﺛﺎﺭ ﺍﻹﳛﺎﺀ ﻋﻮﺍﻣﻞ ﺍﺳﺘﻤﺮﺍﺭﻳﺔ ﺗﻮﺍﺟﺪﻫﺎ‪.‬‬
‫‪ .٢‬ﺍﻟﻄﺐ ﺍﻟﺮﲰﻲ‪ :‬ﻭﻳﺸﻤﻞ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﺍﳌﻘﻨﻨﺔ ﰲ ﺍﻟﻠﻮﺍﺋﺢ ﻭﺍﻟﻘﻮﺍﻧﲔ ﺍﻟﺴﺎﺭﻳﺔ‪ ،‬ﺍﻟﱵ ﺗﻌﺘﻤﺪ‬
‫ﻋﻠﻰ ﺍﻟﻌﻠﻮﻡ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ ﺍﳊﺪﻳﺜﺔ‪ ،‬ﻭﺑﻨﻈﺮﺓ ﻋﺎﻣﺔ ﻓﺈﻥ ﻧﻈﻢ ﺗﻘﺪﱘ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﳝﻜﻦ ﺗﻘﺴﻴﻤﻬﺎ‪:‬‬
‫ﺍﻟﻨﻈﺎﻡ ﺍﳊﻜﻮﻣﻲ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﻨﻈﺎﻡ ﺍﳋﺎﺹ‪.‬‬ ‫‪-‬‬
‫ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪.‬‬ ‫‪-‬‬
‫ﻭﻫﻨﺎﻙ ﺑﻌﺾ ﺍﻟﺴﺒﻞ ﺍﻟﻮﺳﻴﻄﺔ ﺑﲔ ﺍﻟﻨﻈﺎﻣﲔ ﺍﳊﻜﻮﻣﻲ ﻭﺍﳋﺎﺹ‪.‬‬ ‫‪-‬‬
‫ﻭﰲ ﺃﻣﺜﻠﺔ ﻗﻠﻴﻠﺔ ﺗﻄﻮﺭ ﺍﻟﻨﻈﺎﻡ ﺍﳊﻜﻮﻣﻲ ﺇﱃ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﻴﻢ‪.‬‬ ‫‪-‬‬
‫ﻭﰲ ﺇﻃﺎﺭ ﺗﻠﻚ ﺍﻟﻨﻈﻢ ﲣﺘﻠﻒ ﺳﺒﻞ ﺃﻭ ﻃﺮﻕ ﺗﻘﺪﱘ ﺍﻟﺮﻋﺎﻳﺔ ﻭﺍﻟﻌﻼﺝ ﻃﺒﻘﺎ ﻟﻌﺪﺓ ﻋﻮﺍﻣﻞ ﻣﻨﻬﺎ‪:‬‬
‫ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺗﻮﺍﻓﺮ ﺇﻣﻜﺎﻧﺎﺕ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﺍﳌﻄﻠﻮﺑﺔ‪.‬‬ ‫‪-‬‬
‫ﻣﺴﺘﻮﻯ ﻭﻧﻮﻋﻴﺎﺕ ﺍﳋﺪﻣﺔ ﺍﳌﻘﺪﻣﺔ‪.‬‬ ‫‪-‬‬
‫ﺗﻜﻠﻔﺔ ﺗﻮﻓﲑ ﻭﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ‪.‬‬ ‫‪-‬‬
‫ﺣﺠﻢ ﺍﻟﻌﺐﺀ ﺍﳌﺎﺩﻱ ﻋﻠﻰ ﻃﺎﻟﺐ ﺍﳋﺪﻣﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﺮﺿﺎ ﺍﻟﻨﻔﺴﻲ ﻟﻠﻌﻤﻴﻞ )ﺍﳌﺮﻳﺾ‪ ،‬ﺃﻫﻠﻪ‪ ،‬ﺍ‪‬ﺘﻤﻊ(‪.‬‬ ‫‪-‬‬
‫ﺗﻮﺍﻓﺮ ﻗﺎﻋﺪﺓ ﺑﻴﺎﻧﺎﺕ ﳝﻜﻦ ﺃﻥ ﺗﺴﻬﻢ ﰲ ﲣﻄﻴﻂ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻭﰲ ﳎﺎﻻﺕ ﺍﻟﺒﺤﺚ‬ ‫‪-‬‬
‫ﺍﻟﻌﻠﻤﻲ‪.‬‬
‫‪ .١-٢‬ﺍﻟﻌﻼﺝ ﺍ‪‬ﺎﱐ )ﺃﻭ ﺷﺒﻪ ﺍ‪‬ﺎﱏ( ﺍﻟﺬﻱ ﺗﻮﻓﺮﻩ ﺍﻟﺪﻭﻟﺔ‪:‬‬
‫ﻭﺫﻟﻚ ﰲ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻠﺪﻭﻟﺔ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﻭﺣﺪﺍﺕ ﺍﳊﻜﻢ ﺍﶈﻠﻰ ﺃﻭ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﳉﺎﻣﻌﻴﺔ‪ ،‬ﺃﻭ ﻏﲑﻫﺎ ﻣﻦ ﺍﳉﻬﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﺍﻟﱵ ﳍﺎ ﻧﻈﻢ ﻋﻼﺟﻴﺔ ﺧﺎﺻﺔ ﻣﺜﻞ ﺍﻟﻘﻮﺍﺕ ﺍﳌﺴﻠﺤﺔ‪،‬‬
‫ﺍﻟﺸﺮﻃﺔ‪ ،‬ﺑﻌﺾ ﺍﳌﺆﺳﺴﺎﺕ‪ ،‬ﻛﻤﺎ ﻳﺸﻤﻞ ﻣﺎ ﺗﻘﺪﻣﻪ ﺍﻟﺪﻭﻟﺔ ﰲ ﺑﻌﺾ ﺍﻟﻈﺮﻭﻑ ﻣﻦ ﺧﺪﻣﺎﺕ ﻋﻼﺟﻴﺔ‬
‫ﻣﻌﻴﻨﺔ ﰲ ﻏﲑ ﻭﺣﺪﺍ‪‬ﺎ )ﻋﻼﺝ ﺍﳌﻮﺍﻃﻨﲔ ﻋﻠﻰ ﻧﻔﻘﺔ ﺍﻟﺪﻭﻟﺔ(‪.‬‬

‫‪٥٢‬‬
 ‫ﻧﻘﺎﻁ ﺍﻟﻀﻌﻒ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪:‬‬
‫ﻗﺼﻮﺭ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﳌﺨﺼﺼﺔ ﻣﻦ ﺍﻟﺪﻭﻟﺔ ﺗﺆﺩﻯ ﺇﱃ ﻋﺪﻡ ﺍﻟﻮﻓﺎﺀ ﲞﺪﻣﺔ ﻃﺒﻴﺔ ﻣﺘﻜﺎﻣﻠﺔ ﻋﻠﻰ‬ ‫‪-‬‬
‫ﻣﺴﺘﻮﻯ ﻣﺮﺗﻔﻊ ﻓﻨﻴﺎ ﻭﻣﺘﻘﺒﻞ ﻣﻦ ﺍﳌﻮﺍﻃﻨﲔ ﻭﺫﻟﻚ ﻧﺘﻴﺠﺔ‪:‬‬
‫ﺍﻻﺭﺗﻔﺎﻉ ﺍﳊﺎﺩ ﺍﳌﺴﺘﻤﺮ ﰲ ﺗﻜﻠﻔﺔ ﻋﻨﺎﺻﺮ ﺍﳋﺪﻣﺔ ﺍﻟﻄﺒﻴﺔ‪.‬‬ ‫‪o‬‬
‫ﺍﻻﺑﺘﻜﺎﺭﺍﺕ ﺍﳌﺴﺘﻤﺮﺓ ﺳﻮﺍﺀ ﰲ ﻭﺳﺎﺋﻞ ﺍﻟﺒﺤﺚ ﻭﺍﻟﺘﺸﺨﻴﺺ ﺃﻭ ﰲ ﺃﺳﺎﻟﻴﺐ ﺍﻟﻌﻼﺝ‬ ‫‪o‬‬
‫ﻭﺍﻟﺘﺪﺍﺧﻼﺕ‪ ،‬ﻭﻛﻠﻬﺎ ﻭﺳﺎﺋﻞ ﻏﺎﻟﻴﺔ ﻭﻣﻜﻠﻔﺔ‪ ،‬ﺳﻮﺍﺀ ﰲ ﺗﻮﻓﲑ ﻣﺎ ﺗﺘﻄﻠﺒﻪ ﻣﻦ ﺃﺟﻬﺰﺓ‬
‫ﻭﺁﻻﺕ ﺃﻭ ﰲ ﺗﺸﻐﻴﻠﻬﺎ ﻭﺻﻴﺎﻧﺘﻬﺎ ﺃﻭ ﰲ ﲢﺪﻳﺜﻬﺎ ﺃﻭ ﰲ ﺍﳋﱪﺓ ﺍﳌﻄﻠﻮﺑﺔ ﻟﻠﺘﻌﺎﻣﻞ‬
‫ﻣﻌﻬﺎ‪.‬‬
‫ﺍﻻﺭﺗﻔﺎﻉ ﺍﳌﻄﺮﺩ ﰲ ﻣﺘﻮﺳﻂ ﺍﻷﻋﻤﺎﺭ ﻭﺍﺭﺗﻔﺎﻉ ﺗﻜﺎﻟﻴﻒ ﺭﻋﺎﻳﺔ ﺍﳌﺴﻨﲔ‪.‬‬ ‫‪o‬‬
‫ﻋﺪﻡ ﻭﺟﻮﺩ ﺣﺮﻳﺔ ﺍﺧﺘﻴﺎﺭ ﻟﻠﻤﺮﻳﺾ ﰲ ﺍﺧﺘﻴﺎﺭ ﻣﻦ ﻳﺘﻮﱃ ﻣﺴﺌﻮﻟﻴﺔ ﻋﻼﺟﻪ‪ ،‬ﺣﻴﺚ ﺇﻧﻪ ﳏﻜﻮﻡ‬ ‫‪-‬‬
‫ﺑﻨﻈﺎﻡ ﻣﻌﲔ ﺃﻭ ﺑﺎﳉﻬﺔ ﺍﻟﱵ ﻳﺘﻘﺪﻡ ﺇﻟﻴﻬﺎ‪.‬‬
‫ﻭ ﺟﻮﺩ ﺃﻛﺜﺮ ﻣﻦ ﻓﺮﺻﺔ ﻟﻼﺳﺘﻔﺎﺩﺓ ﻣﻦ ﺍﳋﺪﻣﺔ ﺍﻟﻄﺒﻴﺔ )ﻭﺫﻟﻚ ﰲ ﺣﺎﻟﺔ ﻋﺪﻡ ﻭﺟﻮﺩ ﻧﻈﺎﻡ‬ ‫‪-‬‬
‫ﺑﻄﺎﻗﺔ ﺻﺤﻴﺔ ﳝﻨﻊ ﺣﺪﻭﺙ ﺫﻟﻚ( ﳑﺎ ﻳﺆﺩﻯ ﻟﺰﻳﺎﺩﺓ ﺍﻟﻌﺐﺀ ﺇﱃ ﺍﳌﻨﺎﻓﺬ ﺍﳌﻘﺪﻣﺔ ﻟﻠﺨﺪﻣﺔ‪ ،‬ﺯﻳﺎﺩﺓ‬
‫ﺍﻟﺘﻜﻠﻔﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﺣﺘﻤﺎﻝ ﺣﺪﻭﺙ ﺗﻌﺎﺭﺽ ﺑﲔ ﳐﺘﻠﻒ ﺃﺳﺎﻟﻴﺐ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﳌﺮﻳﺾ‪.‬‬
‫‪ .٢-٢‬ﺍﻟﻌﻼﺝ ﺍﳋﺎﺹ ) ﺑﺄﺟﺮ(‪:‬‬
‫ﻭﻳﺘﻤﻴﺰ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﲝﺮﻳﺔ ﺍﳌﺮﻳﺾ ﰲ ﺍﺧﺘﻴﺎﺭ ﻣﻦ ﻳﻄﻤﺌﻦ ﺇﻟﻴﻪ ﻭﻳﺜﻖ ﻓﻴﻪ‪ ،‬ﻭﺍﳌﺴﺘﻮﻯ ﺍﻟﺬﻱ ﻳﻼﺋﻤﻪ‪ ،‬ﻭ‪‬ﺬﺍ‬
‫ﺗﺘﻼﰱ ﺇﺣﺪﻯ ﻧﻘﺎﻁ ﺍﻟﻀﻌﻒ ﰲ ﺍﻟﻨﻈﺎﻡ ﺍﳊﻜﻮﻣﻲ )ﺍ‪‬ﺎﱐ(‪ .‬ﻭﻟﻜﻦ ﻧﻘﻄﺔ ﺍﻟﻀﻌﻒ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﻟﱵ ﲢﺪﺩ‬
‫ﺍﻟﻠﺠﻮﺀ ﺇﱃ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﻫﻮ ﻋﻨﺼﺮ ﺍﻟﺘﻜﻠﻔﺔ‪ ،‬ﻭﻫﻮ ﺃﻣﺮ ﻳﺰﺩﺍﺩ ﺣﺪﺓ ﻳﻮﻣﺎ ﺑﻌﺪ ﻳﻮﻡ ﻟﻠﺰﻳﺎﺩﺓ ﺍﳌﻄﺮﺩﺓ ﰲ‬
‫ﺣﺠﻢ ﺭﺃﺱ ﺍﳌﺎﻝ ﺍﳌﻄﻠﻮﺏ ﻟﺘﻮﻓﲑ ﺍﻹﻣﻜﺎﻧﺎﺕ‪ ،‬ﻟﻼﺭﺗﻔﺎﻉ ﺍﳌﺴﺘﻤﺮ ﰲ ﻣﺼﺎﺭﻳﻒ ﺍﻟﺘﺸﻐﻴﻞ‪ .‬ﻭﰲ ﺿﻮﺀ ﺗﻠﻚ‬
‫ﺍﻟﻌﻮﺍﻣﻞ ﻭﺍﳌﺘﻐﲑﺍﺕ ﻓﺈﻥ ﺃﳘﻴﺔ ﻋﻨﺼﺮ ﺍﻟﺘﻜﻠﻔﺔ ﺍﳌﺘﺰﺍﻳﺪﺓ ﺗﺼﺒﺢ ﻋﺎﻣﻼ ﻣﺆﺛﺮﺍ ﲝﻴﺚ ﺗﻘﻞ ﺑﺼﻔﺔ‬
‫ﻣﺘﺰﺍﻳﺪﺓ ﺃﻋﺪﺍﺩ ﺍﻟﺸﺮﺍﺋﺢ ﺍﻟﻘﺎﺩﺭﺓ ﻋﻠﻰ ﺍﺳﺘﺨﺪﺍﻡ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ‪.‬‬
‫‪ .٣-٢‬ﺍﻟﻌﻼﺝ ﻣﻦ ﺧﻼﻝ ﺑﻌﺾ ﺍﻟﻨﻈﻢ ﺍﻟﻮﺳﻴﻄﺔ‪:‬‬
‫ﰲ ﳏﺎﻭﻟﺔ ﻟﺘﻘﺮﻳﺐ ﺍﻟﻔﺠﻮﺓ ﺑﲔ ﺍﻟﻨﻈﺎﻣﲔ ﺍﳊﻜﻮﻣﻲ‪ ،‬ﻭﺍﳋﺎﺹ‪ ،‬ﻣﻦ ﺯﺍﻭﻳﺔ ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺔ ﻭﺣﺮﻳﺔ‬
‫ﺍﻻﺧﺘﻴﺎﺭ ﻣﻦ ﺟﺎﻧﺐ ﻭﺯﺍﻭﻳﺔ ﺍﻟﻌﺐﺀ ﺍﳌﺎﺩﻱ ﻣﻦ ﺍﳉﺎﻧﺐ ﺍﻵﺧﺮ‪ ،‬ﻓﻘﺪ ﺍﺳﺘﺤﺪﺙ ﻋﺪﺩ ﻣﻦ ﺍﻟﻨﻈﻢ‪:‬‬
‫ﺃ‪ -‬ﻗﺪﻣﺖ ﺍﻟﻨﻈﻢ ﺍﳊﻜﻮﻣﻴﺔ ﻋﺪﺓ ﺃﺷﻜﺎﻝ ﻟﺘﻘﺪﱘ ﺧﺪﻣﺔ ﺗﻌﻠﻮ ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺔ ﺍ‪‬ﺎﻧﻴﺔ ﺍﻟﻌﺎﺩﻳﺔ‬
‫ﻭﺑﺘﻜﺎﻟﻴﻒ ﺭﻣﺰﻳﺔ ﺃﻭ ﳐﺼﺼﺔ‪ ،‬ﻣﺜﻞ ﺃﻗﺴﺎﻡ ﺍﻟﻌﻼﺝ ﺍﻻﻗﺘﺼﺎﺩﻱ‪ ،‬ﻭﺍﻟﻌﻼﺝ ﺑﺄﺟﺮ‪ ،‬ﻭﲤﺜﻞ ﻧﻈﻢ‬
‫ﺍﺳﺘﺮﺩﺍﺩ ﺍﻟﻨﻔﻘﺎﺕ )‪ (Cost Recovery‬ﻭﺟﻬﺎ ﺁﺧﺮ ﳍﺬﻩ ﺍﻷﺷﻜﺎﻝ‪.‬‬
‫ﺏ‪ -‬ﻛﻤﺎ ﻗﺪﻣﺖ ﺑﻌﺾ ﺟﻬﺎﺕ ﺍﻟﻌﻼﺝ ﺍﳋﺎﺹ ﺃﺷﻜﺎﻻ ﻣﻌﻴﻨﺔ ﺃﻭ ﳏﺘﻮﻯ ﻣﻌﻴﻨﺎ ﻟﻠﺨﺪﻣﺔ‬
‫)‪ (Package‬ﺑﺘﺴﻬﻴﻼﺕ ﻣﻌﻴﻨﺔ ‪‬ﺪﻑ ﺗﻮﻓﲑ ﻣﺴﺘﻮﻯ ﺧﺪﻣﺔ ﺃﻋﻠﻰ ﳑﺎ ﻳﺘﻴﺤﻪ ﺍﳌﺴﺘﻮﻯ‬
‫ﺍ‪‬ﺎﱐ ﺑﺘﻜﻠﻔﺔ ﺗﻘﻞ ﻋﻦ ﻧﻈﲑ‪‬ﺎ ﰲ ﺍﻟﻌﻼﺝ ﺍﳋﺎﺹ ﺍﻟﻌﺎﺩﻱ‪.‬‬

‫‪٥٣‬‬
‫ﻭﻟﻜﻦ ﻋﺎﺋﺪ ﺗﻠﻚ ﺍﻷﺷﻜﺎﻝ ﱂ ﻳﻜﻦ ﻣﻦ ﺍﻟﻨﺎﺣﻴﺔ ﺍﻟﻔﻌﻠﻴﺔ ﺑﺎﻟﻘﺪﺭ ﺍﻟﺬﻱ ﳜﻔﻒ ﻋﻦ ﻣﻮﺍﺯﻧﺔ ﺍﻟﺪﻭﻟﺔ ﻋﺐﺀ‬
‫ﺗﻜﻠﻔﺔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﱂ ﻳﻜﻦ ﰲ ﺍﳌﻘﺎﺑﻞ ﺣﻼ ﻛﺎﻣﻼ ﻟﻠﻌﺐﺀ ﺍﻟﺬﻱ ﻳﺘﺤﻤﻠﻪ ﺍﳌﺮﻳﺾ‪ ،‬ﻛﻤﺎ ﺃ‪‬ﺎ ﰲ‬
‫ﺍﳊﺎﻟﺘﲔ ﻻ ﳝﻜﻦ ﺗﺼﻨﻴﻔﻬﺎ ﻛﻨﻈﺎﻡ ﺭﻋﺎﻳﺔ ﻣﺘﻜﺎﻣﻠﺔ ﻟﻪ ﺻﻔﺔ ﺍﻟﺜﺒﺎﺕ ﻭﺍﻻﺳﺘﻤﺮﺍﺭﻳﺔ‪.‬‬
‫‪ .٤-٢‬ﻧﻈﻢ ﺍﻟﺘﺄﻣﲔ ﺿﺪ ﺍﳌﺮﺽ ﻭﺿﺪ ﺍﻹﺻﺎﺑﺔ‪:‬‬
‫ﻋﻠﻰ ﺿﻮﺀ ﺣﺘﻤﻴﺔ ﺍﺣﺘﻴﺎﺝ ﺍﳌﺮﻳﺾ ﺃﻭ ﺍﳌﺼﺎﺏ ﻟﻠﺮﻋﺎﻳﺔ ﻭﺍﻟﻌﻼﺝ ﻭﻋﻠﻰ ﺿﻮﺀ ﺍﻻﺭﺗﻔﺎﻉ ﺍﳌﻄﺮﺩ ﻭﺍﳊﺎﺩ ﰲ‬
‫ﺗﻜﻠﻔﺘﻬﺎ‪ ،‬ﻭﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﺴﺎﺑﻖ ﺍﻹﺷﺎﺭﺓ ﺇﻟﻴﻬﺎ‪.‬‬
‫ﻛﺎﻥ ﺍﳌﺨﺮﺝ ﺍﳌﻤﻜﻦ ﰲ ﺭﺃﻯ ﻛﺜﲑ ﻣﻦ ﺍﳌﺨﻄﻄﲔ ﻫﻮ ﻣﻦ ﺧﻼﻝ ﻧﻈﻢ ﺗﺄﻣﻴﻨﻴﺔ ﺗﺴﻬﻢ ﰲ ﺗﻮﻓﲑ ﻣﺼﺎﺩﺭ‬
‫ﲤﻮﻳﻞ ﻣﻼﺋﻤﺔ ﻣﻦ ﻣﺼﺎﺩﺭ ﳐﺘﻠﻔﺔ‪ :‬ﺍﻟﺪﻭﻟﺔ‪ ،‬ﺍﻟﻌﺎﻣﻠﲔ‪ ،‬ﺃﺻﺤﺎﺏ ﺃﻋﻤﺎﻝ ﺍ‪‬ﺘﻤﻊ‪ ..‬ﺍﱁ‪ ،‬ﺣﺴﺐ ﻧﻮﻋﻴﺔ‬
‫ﺍﻟﺘﻄﺒﻴﻖ ﻭﺍﻻﻧﺘﺸﺎﺭ ﻭﻣﻔﻬﻮﻡ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﺗﻜﺎﻓﻠﻲ ﻻ ﻳﻨﻔﺮﺩ ﻓﻴﻪ ﺍﳌﻀﺎﺭ ﺑﺘﺤﻤﻞ ﻛﻞ ﺍﻟﻌﺐﺀ‪ ،‬ﺑﻞ ﻳﺘﻢ‬
‫ﺗﻮﺯﻳﻊ ﺍﳌﺨﺎﻃﺮ ﺍﳌﺘﻮﻗﻌﺔ ﻋﻠﻰ ﳎﻤﻮﻉ ﺍﳌﺸﺎﺭﻛﲔ ﰲ ﺍﻟﻨﻈﺎﻡ‪.‬‬
‫ﻭﲝﻜﻢ ﻗﺎﻧﻮﻥ ﺍﻷﻋﺪﺍﺩ ﺍﻟﻜﺒﲑﺓ‪ ،‬ﻓﺈﻧﻪ ﳝﻜﻦ ﲣﻔﻴﻒ ﻧﺼﻴﺐ ﻛﻞ ﻓﺮﺩ ﻣﻦ ﺍﻟﻌﺐﺀ ﺍﳌﺎﺩﻱ‪ ،‬ﻛﻤﺎ ﺃﻥ ﻧﺼﻴﺐ‬
‫ﺍﻟﻔﺮﺩ ﻣﻦ ﺍﻟﻌﺐﺀ ﺍﳌﺎﺩﻱ ﻳﺴﺪﺩ ﰲ ﺻﻮﺭﺓ ﺍﺷﺘﺮﺍﻛﺎﺕ ﻣﻘﺴﻄﺔ ﻋﻠﻰ ﺍﳌﺪﻯ ﺍﻟﻄﻮﻳﻞ ﺑﻨﻈﺎﻡ ﺍﻻﺷﺘﺮﺍﻙ‬
‫ﺍﳌﺴﺒﻖ ﺑﺪﻻ ﻣﻦ ﲢﻤﻞ ﺍﻟﻌﺐﺀ ﻣﺮﺓ ﻭﺍﺣﺪﺓ‪.‬‬
‫ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻻﺟﺘﻤﺎﻋﻲ‪:‬‬
‫ﻭﺍﳍﺪﻑ ﺍﻷﻭﻝ ﰲ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﻫﻮ ﺗﻘﺪﱘ ﺧﺪﻣﺔ ﻃﺒﻴﺔ ﻣﺘﻜﺎﻣﻠﺔ ﺑﺄﺳﻠﻮﺏ ﺍﻟﺘﻜﺎﻓﻞ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ ،‬ﺗﺆﺩﻯ‬
‫ﺇﱃ ﲣﻔﻴﻒ ﺍﻟﻌﺐﺀ ﺍﻻﻗﺘﺼﺎﺩﻱ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﻋﻦ ﻛﺎﻫﻞ ﺍﻟﺪﻭﻟﺔ ﻭﻋﻦ ﻛﺎﻫﻞ ﺍﻷﻓﺮﺍﺩ ﻭﻟﺮﻓﻊ ﺍﳌﺴﺘﻮﻯ‬
‫ﺍﻟﺼﺤﻲ ﻣﻊ ﲢﻘﻴﻖ ﻋﺪﺩ ﻣﻦ ﺍﻷﻫﺪﺍﻑ ﺍﻟﻔﺮﻋﻴﺔ ﻣﺜﻞ‪:‬‬
‫ﺭﻓﻊ ﻛﻔﺎﺀﺓ ﺍﻹﻧﺘﺎﺝ )ﻧﺘﻴﺠﺔ ﻟﺘﻘﻠﻴﻞ ﺍﻟﻔﺎﺋﺾ ﻣﻦ ﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﺑﺴﺒﺐ ﺍﳌﺮﺽ ﻭﺗﻘﻠﻴﻞ ﺣﺪﻭﺙ‬ ‫‪-‬‬
‫ﺍﻟﻌﺠﺰ(‪.‬‬
‫ﺗﺮﺷﻴﺪ ﺍﺳﺘﻬﻼﻙ ﺍﳌﻮﺍﺩ ﻭﺍﻵﻻﺕ‪.‬‬ ‫‪-‬‬
‫ﺭﻓﻊ ﻛﻔﺎﺀﺓ ﻭﺟﻮﺩﺓ ﺍﳋﺪﻣﺔ‪.‬‬ ‫‪-‬‬
‫ﺇﺿﺎﻓﺔ ﺇﻣﻜﺎﻧﻴﺎﺕ ﺧﺪﻣﻴﺔ ﺟﺪﻳﺪﺓ‪.‬‬ ‫‪-‬‬
‫ﻭﻳﺘﻤﻴﺰ ﻫﺬﺍ ﺍﻟﻨﻮﻉ ﻣﻦ ﻧﻈﻢ ﺍﻟﺘﺄﻣﲔ‪:‬‬
‫ﺍﻟﺘﻐﻄﻴﺔ ﰲ ﺃﻏﻠﺐ ﺍﳊﺎﻻﺕ ﺍﻟﺘﻄﺒﻴﻘﻴﺔ ﻫﻲ ﺗﻐﻄﻴﺔ ﺷﺎﻣﻠﺔ ﻣﺘﻜﺎﻣﻠﺔ ﻟﻜﻞ ﻣﺎ ﺗﺘﻄﻠﺒﻪ‬ ‫‪-‬‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﻫﺬﺍ ﻫﻮ ﺍﻷﺻﻞ ﰲ ﺍﳋﻠﻔﻴﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪.‬‬
‫ﻭ ﺟﻮﺩ ﻧﻮﻉ ﻣﻦ ﺍﻟﺘﻜﺎﻓﻞ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺑﲔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﺎ ﰲ ﺍﳉﻮﺍﻧﺐ ﺍﻟﺘﻤﻮﻳﻠﻴﺔ‪،‬‬ ‫‪-‬‬
‫ﻧﺘﻴﺠﺔ ﲢﺪﻳﺪ ﺍﻻﺷﺘﺮﺍﻛﺎﺕ ﺑﻨﺴﺒﺔ ﻣﻦ ﺍﻟﺪﺧﻞ ﻭﻧﺘﻴﺠﺔ ﺇﺳﻬﺎﻡ ﺃﺻﺤﺎﺏ ﺍﻷﻋﻤﺎﻝ )ﺃﻭ ﺍﻟﺪﻭﻟﺔ‬
‫ﰲ ﺑﻌﺾ ﺍﳊﺎﻻﺕ( ﻣﻊ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﲤﻮﻳﻞ ﺍﻟﻨﻈﺎﻡ‪.‬‬
‫ﻭﺟﻮﺩ ﻧﻮﻉ ﺁﺧﺮ ﻣﻦ ﺍﻟﺘﻜﺎﻓﻞ ﺍﻻﺟﺘﻤﺎﻋﻲ ﰲ ﺗﻠﻘﻰ ﻣﺰﺍﻳﺎ ﺍﻟﻨﻈﺎﻡ‪ ،‬ﺇﺫ ﻳﺘﻜﺎﻓﻞ ﺍﻟﺴﻠﻴﻢ ﻣﻊ‬ ‫‪-‬‬
‫ﺍﳌﺮﻳﺾ‪ ،‬ﺑﻞ ﻭﻳﺘﻜﺎﻓﻞ ﺍﳌﺮﺀ ﻣﻊ ﻧﻔﺴﻪ )ﰲ ﺣﺎﻟﱵ ﺍﻟﺼﺤﺔ ﻭﺍﳌﺮﺽ(‪.‬‬

‫‪٥٤‬‬
‫ﺗﻮﻓﺮ ﻣﺒﺪﺃ ﺍﻟﺜﺒﺎﺕ ﻭﺍﻻﺳﺘﻤﺮﺍﺭﻳﺔ ﺣﻴﺚ ﺇﻥ ﺃﻏﻠﺐ ﺍﻟﻨﻈﻢ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺗﺘﻤﺘﻊ ﺑﻀﻤﺎﻥ ﻣﻦ‬ ‫‪-‬‬
‫ﺍﻟﺪﻭﻟﺔ ﻭﺍﻟﺘﺰﺍﻡ ﲟﺴﺎﻧﺪ‪‬ﺎ‪.‬‬
‫ﺣﻴﺚ ﺇﻧﻪ ﻧﻈﺎﻡ ﻻ ﻳﻬﺪﻑ ﺇﱃ ﺍﻟﺮﺑﺢ‪ ،‬ﻓﻔﻲ ﺣﺎﻟﺔ ﻭﺟﻮﺩ ﺃﻱ ﻓﺎﺋﺾ‪ ،‬ﻓﺈﻧﻪ ﻳﻮﺟﻪ ﻟﺮﻓﻊ ﻣﺴﺘﻮﻯ‬ ‫‪-‬‬
‫ﺍﳋﺪﻣﺔ ﺍﳌﻘﺪﻣﺔ ﺃﻭ ﺍﻻﺗﺴﺎﻉ ﻓﻴﻬﺎ‪ ،‬ﳑﺎ ﻳﺆﺩﻯ ﺇﱃ ﺭﻓﻊ ﻛﻔﺎﺀﺓ ﻫﺬﻩ ﺍﳋﺪﻣﺔ‪.‬‬

‫ﺍﻟﻨﻈﻢ ﺍﻟﺼﺤﻴﺔ ﲟﺼﺮ ﻭﻛﻴﻔﻴﺔ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬

‫ﺗﻨﻔﻴﺬ ﻭﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪:‬‬
‫ﻳﺘﺼﻒ ﺑﺄﻧﻪ ﺃﺣﺪ ﺍﻷﻧﻈﻤﺔ ﺍﳌﻌﻘﺪﺓ ﺣﻴﺚ ﺗﺘﻌﺪﺩ ﺟﻬﺎﺕ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ﺗﺼﻞ ﺇﱃ‬
‫ﺣﻮﺍﱄ ‪ ٢٩‬ﻫﻴﺌﺔ ﺃﻭ ﻣﻨﻈﻤﺔ ﻋﺎﻣﺔ‪ ،‬ﻭﺃﻳﻀﺎﹰ ﻳﺘﺼﻒ ﺑﺘﻌﺪﺩﻳﺔ ﻣﺼﺎﺩﺭ ﺍﻟﺘﻤﻮﻳﻞ ﻭﺍﻹﺩﺍﺭﺓ ﻭﺍﳋﺪﻣﺔ‪.‬‬
‫ﻭﻟﻜﻦ ﺍﳌﺴﺌﻮﻝ ﻋﻦ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ ﲟﺎ ﰲ ﺫﻟﻚ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ ﻫﻮ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬
‫ﻭﺃﻫﻢ ﺛﻼﺛﺔ ﻗﻄﺎﻋﺎﺕ ﻟﺘﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﲟﺼﺮ ﻫﻲ‪:‬‬
‫‪ .١‬ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ‪.‬‬
‫‪ .٢‬ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ‪.‬‬
‫‪ .٣‬ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‪.‬‬
‫‪ .١‬ﻭﻳﺘﻜﻮﻥ ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ ﺃﺳﺎﺳﺎ ﻣﻦ ﲨﻴﻊ ﻭﺣﺪﺍﺕ ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫ﻭﺃﻳﻀﺎ ﻣﻦ ﺧﻼﻝ ﻭﺣﺪﺍﺕ ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﺑﻌﺾ ﺍﻟﻮﺯﺍﺭﺍﺕ ﻭﻗﻄﺎﻉ ﺍﳉﻴﺶ ﳋﺪﻣﺔ ﺍﻟﻌﺎﻣﻠﲔ ﺑﻪ‪.‬‬
‫ﻭﻳﻨﻘﺴﻢ ﺍﳍﻴﻜﻞ ﺍﻟﺘﻨﻈﻴﻤﻲ ﺍﻟﻌﺎﻡ ﻟـﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺇﱄ‪:‬‬
‫‪Administrative Structure‬‬ ‫ﻫﻴﻜﻞ ﺇﺩﺍﺭﻱ‬ ‫‪-‬‬
‫‪Service Delivery Structure‬‬ ‫ﻫﻴﻜﻞ ﺧﺪﻣﻲ‬ ‫‪-‬‬
‫ﻭﺗﺪﺍﺭ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﻦ ﺧﻼﻝ ﲬﺴﺔ ﻗﻄﺎﻋﺎﺕ ﻋﺮﻳﻀﺔ ﺩﺍﺧﻞ ﻫﺬﻩ ﺍﳍﻴﺎﻛﻞ‪ ،‬ﺃﳘﻬﺎ‪:‬‬
‫ﻗﻄﺎﻉ ﻣﻜﺘﺐ ﺍﻟﻮﺯﻳﺮ ﻭﻳﺸﻤﻞ ﺃﻧﺸﻄﺔ ﺍﳌﺘﺎﺑﻌﺔ ﻭﺍﻹﻋﻼﻡ ﻭﺍﻟﺪﻋﻢ ﺍﻟﻔﲏ‪.‬‬ ‫‪-‬‬
‫ﻗﻄﺎﻉ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﻼﺟﻲ ﻭﺍﻟﻄﻮﺍﺭﺉ‪.‬‬ ‫‪-‬‬
‫ﻗﻄﺎﻉ ﺍﻟﺴﻜﺎﻥ ﻭﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪.‬‬ ‫‪-‬‬
‫ﻗﻄﺎﻉ ﺍﻟﺸﺌﻮﻥ ﺍﻹﺩﺍﺭﻳﺔ ﻭﺍﳊﺴﺎﺑﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﻭﻳﺮﺃﺱ ﻫﺬﻩ ﺍﻟﻘﻄﺎﻋﺎﺕ ﻭﻛﻼﺀ )ﺃﻭﻝ( ﻭﺯﺍﺭﺓ ﳌﻌﺎﻭﻧﺔ ﺍﻟﺴﻴﺪ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ‪.‬‬
‫ﻭﻳﻮﺟﺪ ‪ ١٣‬ﺇﺩﺍﺭﺓ ﻣﺮﻛﺰﻳﺔ ﻟﻸﻧﺸﻄﺔ ﺍﳌﺨﺘﻠﻔﺔ ﺩﺍﺧﻞ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﳌﺬﻛﻮﺭﺓ ﺗﻘﻮﻡ ﺑﺮﻓﻊ ﺗﻘﺎﺭﻳﺮﻫﺎ‬
‫ﺇﱃ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ‪ ،‬ﻣﻨﻬﺎ‪ :‬ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ‪ ،‬ﻭﺍﳌﻌﺎﻣﻞ‪ ،‬ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ ،‬ﻭﺍﻷﻣﺮﺍﺽ‬
‫ﺍﳌﺘﻮﻃﻨﺔ‪ ،‬ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻌﻼﺟﻴﺔ‪ ،‬ﻭﺍﻟﺘﻨﻤﻴﺔ ﻭﺍﻟﺒﺤﻮﺙ‪ ،‬ﻭﺷﺌﻮﻥ ﺍﻟﺼﻴﺪﻟﺔ‪ ،‬ﻭﻃﺐ ﺍﻷﺳﻨﺎﻥ‪ ،‬ﻭﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‬

‫‪٥٥‬‬
‫ﻭﺍﻟﺘﻤﺮﻳﺾ‪ .‬ﻫﺬﺍ ﺇﱃ ﺟﺎﻧﺐ ﺍﻹﺩﺍﺭﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﻺﻋﻼﻡ‪ ،‬ﺍﻟﺪﻋﻢ ﺍﻟﻔﲏ ﻭﺍﳌﺸﺮﻭﻋﺎﺕ‪ ،‬ﺍﻟﺘﺨﻄﻴﻂ‪ ،‬ﺍﳌﺘﺎﺑﻌﺔ‪..‬‬
‫ﺍﱁ‪.‬‬
‫ﻭﻳﺮﺃﺱ ﻛﻞ ﺇﺩﺍﺭﺓ ﻣﻦ ﻫﺬﻩ ﺍﻹﺩﺍﺭﺍﺕ ﻣﺪﻳﺮ ﻋﺎﻡ‪ ،‬ﻭﻳﺮﺃﺱ ﻛﻞ ﻋﺪﺓ ﺃﻧﺸﻄﺔ ﻳﺪﻳﺮﻫﺎ ﻣﺪﻳﺮ ﻋﺎﻡ ﻭﻛﻴﻞ ﻭﺯﺍﺭﺓ‪.‬‬
‫ﻭﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﶈﻠﻰ )ﺍﶈﺎﻓﻈﺎﺕ( ﻓﺈﻥ ﳕﻮﺫﺝ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻟﺼﺤﻴﺔ )ﺍﳍﻴﻜﻞ ﺍﻟﺘﻨﻈﻴﻤﻲ( ﻳﺘﻜﺮﺭ ﰲ ﻛﻞ‬
‫ﳏﺎﻓﻈﺔ ﻭﻳﻜﻮﻥ ﲟﺜﺎﺑﺔ ﻣﺮﺁﺓ ﳌﺎ ﻳﻨﻔﺬ ﰲ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﺮﻛﺰﻳﺎ‪.‬‬
‫ﻭﺗﻜﻮﻥ ﻣﺪﻳﺮﻳﺔ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﰲ ﻛﻞ ﳏﺎﻓﻈﺔ ﻣﺴﺌﻮﻟﺔ ﻋﻦ ﺍﻷﻧﺸﻄﺔ ﺍﻟﻔﻨﻴﺔ‪ ،‬ﻭﻟﻜﻦ ﺍﻷﻧﺸﻄﺔ‬
‫ﺍﻹﺩﺍﺭﻳﺔ ﻭﺍﻷﻧﺸﻄﺔ ﺍﻟﻴﻮﻣﻴﺔ ﺗﻜﻮﻥ ﲢﺖ ﺇﺷﺮﺍﻑ ﺍﶈﺎﻓﻆ )ﻳﻘﻮﻡ ﺍﶈﺎﻓﻆ ﺑﺎﻹﺷﺮﺍﻑ ﻋﻠﻰ ﻣﺪﻳﺮﻱ ﺍﻟﺼﺤﺔ‬
‫ﻛﺄﺣﺪ ﻣﺪﻳﺮﻱ ﺍﳋﺪﻣﺎﺕ ﰲ ﺍﶈﺎﻓﻈﺔ( ﻛﻞ ﻣﺪﻳﺮﻳﺔ ﺷﺌﻮﻥ ﺻﺤﻴﺔ ﻳﺮﺃﺳﻬﺎ ﻭﻛﻴﻞ ﻭﺯﺍﺭﺓ ﺃﻭ ﻣﺪﻳﺮ ﻋﺎﻡ ﻭﻳﻘﻮﻡ‬
‫ﺑﺮﻓﻊ ﺗﻘﺎﺭﻳﺮﻩ ﺇﱃ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬
‫ﺗﻘﻮﻡ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﰲ ‪ ٢٧‬ﳏﺎﻓﻈﺔ ﺑﺎﻹﺷﺮﺍﻑ ‪ ٢٣٠‬ﺇﺩﺍﺭﺓ ﺻﺤﻴﺔ )ﻭﻫﻲ ﻋﺪﺩ ﺍﻹﺩﺍﺭﺍﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﺗﺒﻌﺎ ﻟﻠﺘﻘﺴﻴﻢ ﺍﻹﺩﺍﺭﻱ ﺑﺎﶈﺎﻓﻈﺔ( ﺇﺩﺍﺭﺓ ﺻﺤﻴﺔ ﰲ ﻛﻞ ﻣﺮﻛﺰ ﺇﺩﺍﺭﻱ‪.‬‬
‫ﻛﻞ ﺇﺩﺍﺭﺓ ﺻﺤﻴﺔ ﻳﺮﺃﺳﻬﺎ ﻣﺪﻳﺮ ﻳﺴﺎﻋﺪﻩ ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﳌﺸﺮﻓﲔ‪ ،‬ﻭﻳﻘﻮﻡ ﺑﺮﻓﻊ ﺗﻘﺎﺭﻳﺮﻩ ﺇﱃ ﻣﺪﻳﺮ ﻋﺎﻡ ‪/‬‬
‫ﻭﻛﻴﻞ ﻭﺯﺍﺭﺓ ﻣﺪﻳﺮﻳﺔ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺔ‪.‬‬
‫ﻭﺗﻘﻮﻡ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﻮﺿﻊ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺍﳋﻄﻂ ﻛﺠﺰﺀ ﻣﻦ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﻘﻮﻣﻴﺔ‬
‫ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪.‬‬
‫ﻭﺗﻘﻮﻡ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﺑﺘﻨﻔﻴﺬ ﻫﺬﻩ ﺍﳋﻄﻂ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﻋﻠﻰ ﻣﺴﺘﻮﻯ‬
‫ﺍﶈﺎﻓﻈﺔ ﻣﻦ ﺧﻼﻝ ﺇﺩﺍﺭﺍﺕ ﻓﻨﻴﺔ ﳑﺎﺛﻠﺔ ﻛﻤﺎ ﻫﻮ ﻣﻮﺟﻮﺩ ﺑﺎﻟﻮﺯﺍﺭﺓ ﻣﺮﻛﺰﻳﺎ‪.‬‬
‫ﻭﻣﺴﺌﻮﻟﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﺮﻛﺰﻳﺎ ﻭﳏﻠﻴﺎ )ﻣﻦ ﺧﻼﻝ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺼﺤﺔ( ﻫﻮ ﺍﻟﺘﻨﻈﻴﻢ ﻭﺍﻹﺷﺮﺍﻑ ﻋﻠﻰ‬
‫ﺍﻷﻧﺸﻄﺔ ﺍﳌﺨﺘﻠﻔﺔ ﻭﺍﻟﺘﺪﺭﻳﺐ ﻟﻠﻔﺌﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﺍﳌﻘﺪﻣﺔ ﻟﻠﺨﺪﻣﺔ‪.‬‬
‫ﺃﻣﺎ ﺍﻟﺘﻨﻔﻴﺬ ﺍﳊﻘﻴﻘﻲ ﺍﻟﻔﲏ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻓﻴﻜﻮﻥ ﻣﻦ ﺧﻼﻝ ﺍﻟﻔﺮﻳﻖ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻣﻞ ﺑﺸﺒﻜﺔ‬
‫ﺍﻟﻮﺣﺪﺍﺕ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺑﻨﻈﺎﻡ ﺍﻟﻼﻣﺮﻛﺰﻳﺔ‪.‬‬
‫ﻭﲤﺜﻞ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ ﻋﻦ ﻃﺮﻳﻖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺣﻮﺍﱄ ‪ ٪٨٠‬ﻣﻦ ﺇﲨﺎﱄ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﰲ ﻣﺼﺮ‪.‬‬
‫ﻭﻭﺯﺍﺭﺓ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺘﻌﺎﻭﻥ ﺍﻟﺪﻭﱄ ﻣﺴﺌﻮﻟﺔ ﻋﻦ ﺍﳌﻴﺰﺍﻧﻴﺔ )ﺍﻟﺘﻤﻮﻳﻞ ﺍﻻﺳﺘﺜﻤﺎﺭﻱ ‪(investment budget‬‬
‫ﰲ ﺣﲔ ﺃﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻌﺎﱄ ﻣﺴﺌﻮﻟﺔ ﻋﻦ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ ﻭﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ )ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﳉﺎﻣﻌﻴﺔ( ﻭﻭﺯﺍﺭﺓ ﺍﳌﺎﻟﻴﺔ ﻣﺴﺌﻮﻟﺔ ﻋﻦ ﻣﻴﺰﺍﻧﻴﺎﺕ ﺍﻟﺘﺸﻐﻴﻞ )‪.(operational budget‬‬
‫ﺇﱃ ﺟﺎﻧﺐ ﻫﺬﻩ ﺍﳉﻬﺎﺕ‪ ،‬ﻳﻮﺟﺪ ﺛﻼﺙ ﺟﻬﺎﺕ ﻗﻮﻣﻴﺔ ﳍﺎ ﻣﺴﺌﻮﻟﻴﺎ‪‬ﺎ ﻭﻫﻲ‪:‬‬
‫ﳎﻠﺲ ﺍﻟﺼﺤﺔ )ﻟﻮﺿﻊ ﻟﻮﺍﺋﺢ ﺍﻟﺘﺸﻐﻴﻞ(‪.‬‬ ‫‪-‬‬
‫ﳎﻠﺲ ﺍﻟﺸﻮﺭﻯ )ﻭﻇﻴﻔﺘﻪ ﺍﺳﺘﺸﺎﺭﻳﺔ(‪.‬‬ ‫‪-‬‬
‫ﺍ‪‬ﻠﺲ ﺍﻷﻋﻠﻰ ﻟﻠﺼﺤﺔ )ﻳﻘﻮﻡ ﺑﺎﻟﺘﻨﺴﻴﻖ(‪.‬‬ ‫‪-‬‬

‫‪٥٦‬‬
 ‫ﻭ ﺗﻘﺪﻡ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺧﻼﻝ ﺛﻼﺛﺔ ﻣﺴﺘﻮﻳﺎﺕ‪:‬‬
‫ﺍﳌﺴﺘﻮﻯ ﺍﻷﻭﻝ )ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ(‪:‬‬ ‫‪-‬‬
‫ﻭﺗﻘﺪﻡ ﺍﳋﺪﻣﺎﺕ ﻣﻦ ﺧﻼﻝ ﺷﺒﻜﺔ ﳑﺘﺪﺓ ﻣﻦ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﰲ ﺍﻟﺮﻳﻒ ﻭﺍﳊﻀﺮ ﻳﻘﺮﺏ‬
‫ﻋﺪﺩﻫﺎ ﻣﻦ ‪ ٤٠٠٠‬ﻭﺣﺪﺓ ﻭﺗﺸﻤﻞ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺍ‪‬ﻤﻮﻋﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﻣﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﻟﺘﻜﺎﻣﻞ ﺍﻟﺼﺤﻲ )ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻘﺮﻭﻳﺔ ﺳﺎﺑﻘﺎ( ﻭﺍﳌﺮﺍﻛﺰ ﺍﻟﺼﺤﻴﺔ ﺍﳊﻀﺮﻳﺔ ﻭﻣﺮﺍﻛﺰ ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ‬
‫ﻭﺍﻟﻄﻔﻮﻟﺔ ﻭﻣﻜﺎﺗﺐ ﺍﻟﺼﺤﺔ‪.‬‬
‫ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ ﻭﻋﺪﺩﻫﺎ )‪ ،(٢٣٤٥‬ﻭﺗﻘﺪﻡ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‪،‬‬ ‫‪-‬‬
‫ﻭﺗﺸﻤﻞ‪:‬‬
‫ﺍﻟﺘﺜﻘﻴﻒ ﺍﻟﺼﺤﻲ‪.‬‬ ‫‪o‬‬
‫ﺧﺪﻣﺎﺕ ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ‪.‬‬ ‫‪o‬‬
‫ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﻭﺻﺤﺔ ﺍﳌﺮﺃﺓ ﻭﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪.‬‬ ‫‪o‬‬
‫ﻣﻜﺎﻓﺤﺔ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ‪.‬‬ ‫‪o‬‬
‫ﻣﻜﺎﻓﺤﺔ ﻭﻋﻼﺝ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻮﻃﻨﺔ‪.‬‬ ‫‪o‬‬
‫ﺇﺻﺤﺎﺡ ﺍﻟﺒﻴﺌﺔ‪.‬‬ ‫‪o‬‬
‫ﻣﻜﺎﻓﺤﺔ ﺃﻣﺮﺍﺽ ﺍﻹﺳﻬﺎﻝ ﰲ ﺍﻷﻃﻔﺎﻝ‪.‬‬ ‫‪o‬‬
‫ﺍﻟﺘﻄﻌﻴﻤﺎﺕ‪.‬‬ ‫‪o‬‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻟﺒﻌﺾ ﺍﻷﻣﺮﺍﺽ ﺍﻟﺸﺎﺋﻌﺔ ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻌﺎﺟﻠﺔ ﻟﻺﺻﺎﺑﺎﺕ ﻭﺍﳊﻮﺍﺩﺙ‬ ‫‪o‬‬
‫ﺍﻟﺒﺴﻴﻄﺔ‪.‬‬
‫ﺍﻟﻮﺣﺪﺓ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ ﻋﺒﺎﺭﺓ ﻋﻦ ﻣﺒﲎ ﻣﻜﻮﻥ ﻣﻦ ﺣﻮﺍﱄ ‪ ١٠‬ﺣﺠﺮﺍﺕ ﻟﺘﺄﺩﻳﺔ ﺍﳋﺪﻣﺔ‬
‫ﻭﺳﻜﻦ ﻟﻠﻄﺒﻴﺐ ﻭﺁﺧﺮ ﻟﻠﻤﻤﺮﺿﺎﺕ ﻭﺗﻘﺪﻡ ﺍﳋﺪﻣﺎﺕ ﳊﻮﺍﱄ ‪ ٣٠٠٠‬ﺇﱃ ‪ ٥٠٠٠‬ﻧﺴﻤﺔ ﻣﻦ‬
‫ﺍﻟﺴﻜﺎﻥ‪.‬‬
‫ﻭﻳﺘﻜﻮﻥ ﺍﻟﻔﺮﻳﻖ ﺍﻟﺼﺤﻲ ﺑﺎﻟﻮﺣﺪﺓ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ ﻣﻦ‪:‬‬
‫ﻃﺒﻴﺐ ﺃﻭ ﺃﻛﺜﺮ‪.‬‬ ‫‪o‬‬
‫ﳑﺮﺿﺘﲔ ﺃﻭ ﺃﻛﺜﺮ‪.‬‬ ‫‪o‬‬
‫ﻃﺒﻴﺐ ﺃﺳﻨﺎﻥ ﰲ ﺑﻌﺾ ﺍﻟﻮﺣﺪﺍﺕ‪.‬‬ ‫‪o‬‬
‫ﻣﻌﺎﻭﻥ ﺃﻭ ﻣﻼﺣﻆ ﺻﺤﻲ‪.‬‬ ‫‪o‬‬
‫ﻓﲏ ﺃﻭ ﻣﺴﺎﻋﺪ ﻣﻌﻤﻞ‪.‬‬ ‫‪o‬‬
‫ﻛﺎﺗﺐ‪.‬‬ ‫‪o‬‬
‫ﺃﻣﲔ ﳐﺰﻥ‪.‬‬ ‫‪o‬‬
‫ﺧﺪﻣﺎﺕ ﻣﻌﺎﻭﻧﺔ ﺭﺟﺎﻝ ﺃﻭ ﺣﺮﱘ‪.‬‬ ‫‪o‬‬

‫‪٥٧‬‬
 ‫ﺍ‪‬ﻤﻮﻋﺎﺕ ﺍﻟﺼﺤﻴﺔ )ﺍﳌﺮﺍﻛﺰ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ( ﻭﻋﺪﺩﻫﺎ ‪:٣٥٩‬‬ ‫‪-‬‬
‫ﻭﺗﻘﺪﻡ ﻫﺬﻩ ﺍﳌﺮﺍﻛﺰ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﻌﺎﺟﻠﺔ ﺃﺳﻮﺓ‬
‫ﺑﺎﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ ‪‬ﻤﻮﻋﺔ ﺃﻛﱪ ﻣﻦ ﺍﻟﺴﻜﺎﻥ ﻣﻦ ‪ ١٥‬ﺇﱃ ‪ ٢٥‬ﻧﺴﻤﺔ‪ ،‬ﻭﺫﻟﻚ ﻋﻠﻰ‬
‫ﻣﺴﺘﻮﻯ ﺍﻟﻌﻴﺎﺩﺓ ﺍﳋﺎﺭﺟﻴﺔ ﻭﺍﻟﻘﺴﻢ ﺍﻟﺪﺍﺧﻠﻲ‪ .‬ﻋﺪﺩ ﺍﻷﺳﺮﺓ ‪‬ﺬﻩ ﺍﳌﺮﺍﻛﺰ ﺣﻮﺍﱄ ‪ ٥٩٧٦‬ﺳﺮﻳﺮﺍﹰ‬
‫ﲟﻌﺪﻝ ‪ ١٥‬ﺇﱃ ‪ ٢٠‬ﺳﺮﻳﺮﺍﹰ ﻟﻜﻞ ﻣﺮﻛﺰ ﺻﺤﻲ ﺭﻳﻔﻲ‪ ،‬ﻭﻟﻸﺳﻒ ﻓﺈﻥ ﻣﻌﻈﻢ ﻫﺬﻩ ﺍﻷﺳﺮﺓ ﻏﲑ‬
‫ﻣﺴﺘﻐﻞ ﻭﻋﻠﻴﻪ ﻓﺈﻧﻪ ﻻ ﻳﻮﺟﺪ ﺧﺪﻣﺎﺕ ﺃﻗﺴﺎﻡ ﺩﺍﺧﻠﻴﺔ ﺣﻘﻴﻘﻴﺔ ‪‬ﺬﻩ ﺍﳌﺮﺍﻛﺰ‪ .‬ﻭﻫﻨﺎﻙ ﺧﻄﺔ‬
‫ﻟﺘﺤﻮﻳﻞ ﻫﺬﻩ ﺍﳌﺮﺍﻛﺰ ﺇﱃ ﻣﺮﺍﻛﺰ ﻃﺐ ﺃﺳﺮﺓ‪.‬‬
‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻜﺎﻣﻞ ﺍﻟﺼﺤﻲ )ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻘﺮﻭﻳﺔ ﺳﺎﺑﻘﺎ( ﻭﻋﺪﺩﻫﺎ )‪:(٢٣٠‬‬ ‫‪-‬‬
‫ﻭﻫﻲ ﺗﻘﺪﻡ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﰲ ﻭﺣﺪﺓ ﺭﻋﺎﻳﺔ ﺻﺤﻴﺔ ﺃﻭﻟﻴﺔ ﻣﺴﺘﻘﻠﺔ ﻟﻌﺪﺩ‬
‫ﻣﻦ ﺍﻟﺴﻜﺎﻥ ﻳﺘﺮﺍﻭﺡ ﺑﲔ ‪ ١٥‬ﺇﱃ ‪ ٢٥‬ﺃﻟﻒ ﻧﺴﻤﺔ ﻭﺗﻘﺪﻡ ﺃﻳﻀﺎ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﻌﺎﺟﻠﺔ‬
‫ﺑﺎﳌﺴﺘﺸﻔﻰ‪ ،‬ﻭﻫﺬﻩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺃﺻﺒﺤﺖ ﺗﺘﺒﻊ ﻣﻦ ﺍﻟﻨﺎﺣﻴﺔ ﺍﻟﻔﻨﻴﺔ ﺍﻟﻄﺐ ﺍﻟﻌﻼﺟﻲ‬
‫ﻭﺗﻘﺪﻡ ﺧﺪﻣﺎﺕ ﺍﳉﺮﺍﺣﺔ ‪‬ﺎ ﻭﺍﳌﻌﻤﻞ ﻭﺍﻷﺷﻌﺔ ﻭﻋﺪﺩ ﺍﻷﺳﺮﺓ ‪ ٤١٢١‬ﲟﻌﺪﻝ ‪ ٣٠‬ﺇﱃ ‪ ٦٠‬ﺳﺮﻳﺮﺍﹰ‬
‫ﺑﻜﻞ ﻣﺴﺘﺸﻔﻰ ﻭﻗﺪ ﻛﺎﻥ ﻣﻌﺪﻝ ﺍﻹﺷﻐﺎﻝ ﳍﺬﻩ ﺍﻷﺳﺮﺓ ‪ ٪٤‬ﻭﻧﺄﻣﻞ ﺯﻳﺎﺩﺓ ﻧﺴﺒﺔ ﺍﻹﺷﻐﺎﻝ‬
‫ﺑﻌﺪ ﺍﻟﺘﻄﻮﻳﺮ ﺍﻟﻨﺎﺗﺞ ﻣﻦ ﺗﺒﻌﻴﺘﻬﺎ ﺍﻟﻔﻨﻴﺔ ﻟﻠﻄﺐ ﺍﻟﻌﻼﺟﻲ‪.‬‬
‫ﺍﳌﺮﺍﻛﺰ ﺍﻟﺼﺤﻴﺔ ﺍﳊﻀﺮﻳﺔ ﻭﻋﺪﺩﻫﺎ ﺍﻵﻥ )‪:(١٩٦‬‬ ‫‪-‬‬
‫ﻭﻫﻲ ﻣﺴﺌﻮﻟﺔ ﻋﻦ ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺻﺤﻴﺔ ﺗﻌﺰﻳﺰﻳﺔ ﻭﻭﻗﺎﺋﻴﺔ ﻭﻋﻼﺟﻴﺔ ﻛﺎﻟﱵ ﺗﻘﺪﻣﻬﺎ‬
‫ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭﺍﳌﺮﻛﺰ ﺍﻟﺼﺤﻲ ﺍﳊﻀﺮﻱ ﳜﺪﻡ ﻣﻨﻄﻘﺔ ﺳﻜﺎﻧﻴﺔ ﻳﺘﺮﺍﻭﺡ ﻋﺪﺩﻫﺎ‬
‫ﺑﲔ ‪ ٢٥‬ﺇﱃ ‪ ٥٠‬ﺃﻟﻒ ﻧﺴﻤﺔ ﻭﻫﻲ ﺗﻘﺪﻡ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳌﻤﺎﺭﺱ ﺍﻟﻌﺎﻡ‬
‫ﻭﺍﻷﺧﺼﺎﺋﻲ‪ ،‬ﺃﻱ ﻳﻄﺒﻖ ‪‬ﺎ ﻧﻈﺎﻡ ﺍﻹﺣﺎﻟﺔ ﺍﻟﺪﺍﺧﻠﻲ‪ ،‬ﻭﺍﳌﺮﻛﺰ ﺍﻟﺼﺤﻲ ﺍﳊﻀﺮﻱ ﺑﻪ ﻃﺒﻴﺐ ﻟﻜﻞ‬
‫‪ ٥‬ﺁﻻﻑ ﻧﺴﻤﺔ ﻭﳑﺮﺿﺔ ﻟﻜﻞ ‪ ٢٠٠٠‬ﻧﺴﻤﺔ ﻭﻳﻘﺪﻡ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﻮﻗﺎﺋﻴﺔ‬
‫ﻟﻸﺳﻨﺎﻥ‪ ،‬ﻭﺑﻜﻞ ﻣﺮﻛﺰ ﺻﺤﻲ ﺣﻀﺮﻱ ﻣﻌﻤﻞ ﺃﻛﺜﺮ ﺗﻄﻮﺭﺍ ﻣﻦ ﻣﻌﻤﻞ ﺍﻟﻮﺣﺪﺓ ﺍﻟﺮﻳﻔﻴﺔ‬
‫ﻭﺧﺪﻣﺎﺕ ﺃﺷﻌﺔ ﻭﺧﺪﻣﺎﺕ ﺗﻮﻟﻴﺪ‪ ..‬ﺍﱁ‪.‬‬
‫ﻣﺮﺍﻛﺰ ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ‪:‬‬ ‫‪-‬‬
‫ﺗﻘﻊ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﻫﻲ ﻣﺴﺌﻮﻟﺔ ﻋﻦ ﺗﻘﺪﱘ ﺭﻋﺎﻳﺔ ﻣﺎ ﻗﺒﻞ ﺍﻟﻮﻻﺩﺓ ﻭﺍﻟﺘﻮﻟﻴﺪ ﻭﺭﻋﺎﻳﺔ ﻣﺎ‬
‫ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻃﻔﺎﻝ ﺩﻭﻥ ﺍﻟﺴﺎﺩﺳﺔ ﻭﺭﻋﺎﻳﺔ ﺃﺳﻨﺎﻥ‬
‫ﺍﻷﻣﻬﺎﺕ ﻭﺍﻷﻃﻔﺎﻝ ﻭﻫﻨﺎﻙ ﺧﺪﻣﺎﺕ ﻣﻌﻤﻠﻴﺔ ﻭﺃﺷﻌﺔ ﻓﻮﻕ ﺻﻮﺗﻴﺔ ﻭﻳﻮﺟﺪ ‪‬ﺬﻩ ﺍﳌﺮﺍﻛﺰ ‪٣٣٤‬‬
‫ﺳﺮﻳﺮﺍ ﻭﻟﻴﺲ ﺑﻜﻞ ﻣﺮﻛﺰ ﺃﺳﺮﺓ ﻭﻫﻨﺎﻙ ﺧﻄﺘﺎﻥ ﺍﻷﻭﱃ ﻟﺘﺤﺪﻳﺚ ﻣﺮﺍﻛﺰ ﺻﺤﻴﺔ ﺣﻀﺮﻳﺔ ﻭﻣﻦ‬
‫ﰒ ﺗﻨﺎﻗﺺ ﻋﺪﺩ ﺍﳌﺮﺍﻛﺰ ﺑﺼﻔﺔ ﻣﺴﺘﻤﺮﺓ‪.‬‬
‫ﻭﺍﻟﺜﺎﻧﻴﺔ ﻟﺘﺤﺴﲔ ﻭﻇﻴﻔﺘﻬﺎ ﻣﻊ ﺇﺩﺧﺎﻝ ﺩﺍﺭ ﻟﻠﺘﻮﻟﻴﺪ ‪‬ﺎ ﻭﻳﻮﺟﺪ ﺍﻵﻥ ‪ ١٩٤‬ﻣﺮﻛﺰﺍﹰ ﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ ﻣﻨﻬﺎ ‪ ١١٢‬ﻣﻠﻚ ﺍﳊﻜﻮﻣﺔ ﻭﺍﻟـ ‪ ٨٢‬ﺍﻟﺒﺎﻗﻴﺔ ﻣﺆﺟﺮﺓ – ﻣﺼﲑﻫﺎ ﺍﻟﺘﺴﻠﻴﻢ‬
‫ﳌﺎﻟﻜﻴﻬﺎ‪.‬‬

‫‪٥٨‬‬
 ‫ﻣﻜﺎﺗﺐ ﺍﻟﺼﺤﺔ ﻭﻋﺪﺩﻫﺎ ﺍﻵﻥ )‪:( ٣٥٤‬‬ ‫‪-‬‬
‫ﻭﺗﻮﺟﺪ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﺗﻘﺪﻡ ﺧﺪﻣـﺎﺕ ﺍﻟﺘﺴﺠﻴﻞ ﻟﻠﻤﻮﺍﻟﻴﺪ ﻭﺍﻟﻮﻓﻴﺎﺕ ﻭﻣﺮﺍﻗﺒﺔ‬
‫ﺍﻷﻏﺬﻳﺔ ﻭﺇﺻﺤﺎﺡ ﺍﻟﺒﻴﺌﺔ ﻭﻏﲑﻫﺎ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ‪ .‬ﻭﺳﻴﺎﺳﺔ ﺍﻟﻮﺯﺍﺭﺓ ﻫﻲ ﺇﻧﺸﺎﺀ ﺍﳌﺮﺍﻛﺰ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﳊﻀﺮﻳﺔ ﺍﻟﱵ ﺗﻘﺪﻡ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺘﻌﺰﻳﺰﻳﺔ ﻭﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ ﺍﳌﺘﻜﺎﻣﻠﺔ ﻭﻻ ﻣﺰﻳﺪ‬
‫ﻣﻦ ﻫﺬﻩ ﺍﳌﻜﺎﺗﺐ‪.‬‬
‫ﺍﳌﺴﺘﻮﻯ ﺍﻟﺜﺎﱐ ﻣﻦ ﺍﳋﺪﻣﺔ‪:‬‬ ‫‪-‬‬
‫ﺗﻘﺪﻣﻬﺎ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺮﻛﺰﻳﺔ ﰲ ﻋﻮﺍﺻﻢ ﺍﳌﺮﺍﻛﺰ ﺍﻹﺩﺍﺭﻳﺔ ﻭﺗﻘﺪﻡ ﺍﳋﺪﻣﺎﺕ ﻣﻦ ﺧﻼﻝ ﻋﻴﺎﺩﺍﺕ ﺧﺎﺭﺟﻴﺔ‬
‫ﻭﺃﻗﺴﺎﻡ ﺩﺍﺧﻠﻴﺔ ﻟﻠﺘﺨﺼﺼﺎﺕ ﺍﻟﻄﺒﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﺍﳌﺴﺘﻮﻯ ﺍﻟﺜﺎﻟﺚ ﻣﻦ ﺍﳋﺪﻣﺔ‪:‬‬ ‫‪-‬‬
‫ﺗﻘﺪﻣﻬﺎ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﰲ ﻋﻮﺍﺻﻢ ﺍﶈﺎﻓﻈﺎﺕ ﻭﻳﺪﻋﻢ ﻫﺬﺍ ﺍﳌﺴﺘﻮﻯ ﻣﻦ ﺍﳋﺪﻣﺔ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﳉﺎﻣﻌﻴﺔ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﳌﻌﺎﻫﺪ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﻣﻦ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫ﻭﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‪ .‬ﻭﻋﺪﺩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻭﺍﳌﺮﻛﺰﻳﺔ‪ ،‬ﺍﻟﺘﺎﺑﻌﺔ‬
‫ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ‪ ٢١٤‬ﻣﺴﺘﺸﻔﻰ ‪‬ﺎ ‪ ٣٢٥٩١‬ﺳﺮﻳﺮﺍﹰ ﺇﱃ ﺟﺎﻧﺐ ﻋﺪﺩ ‪ ٩٣‬ﻣﺴﺘﺸﻔﻰ ﲣﺼﺼﻴﺎﹰ‪:‬‬
‫‪ ٤‬ﻣﺴﺘﺸﻔﻴﺎﺕ ﺃﻃﻔﺎﻝ‪ ،‬ﻧﺴﺎﺀ ﻭﺗﻮﻟﻴﺪ ‪‬ﺎ ‪ ٣٩٠‬ﺳﺮﻳﺮﺍﹰ‪.‬‬ ‫‪o‬‬
‫‪ ٨١‬ﻣﺴﺘﺸﻔﻰ ﲪﻴﺎﺕ ‪‬ﺎ ‪ ٧٣٢٣‬ﺳﺮﻳﺮﺍﹰ‪.‬‬ ‫‪o‬‬
‫‪ ٨‬ﻣﺴﺘﺸﻔﻴﺎﺕ ﻟﻸﻣﺮﺍﺽ ﺍﻟﺒﺎﻃﻨﻴﺔ ‪‬ﺎ ‪ ٨١‬ﺳﺮﻳﺮﺍﹰ‪.‬‬ ‫‪o‬‬
‫ﺇﱃ ﺟﺎﻧﺐ ﻫﺬﻩ ﺍﻟﻮﺣﺪﺍﺕ ﻫﻨﺎﻙ ﻣﺮﺍﻛﺰ ﺃﺧﺮﻯ ﻟﺘﻘﺪﱘ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻣﺜﻞ‪:‬‬
‫ﻣﻜﺎﺗﺐ ﺍﻟﺘﺜﻘﻴﻒ ﺍﻟﺼﺤﻲ‪.‬‬ ‫‪o‬‬
‫ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺘﺨﺼﻴﺼﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‪.‬‬ ‫‪o‬‬
‫ﻋﻴﺎﺩﺍﺕ ﺍﻷﺣﻴﺎﺀ‪.‬‬ ‫‪o‬‬
‫ﻭﺣﺪﺍﺕ ﻭﻣﺮﺍﻛﺰ ﺍﳊﺠﺮ ﺍﻟﺼﺤﻲ‪.‬‬ ‫‪o‬‬
‫ﻭﺣﺪﺍﺕ ﻣﻘﺎﻭﻣﺔ ﺍﳌﻼﺭﻳﺎ‪.‬‬ ‫‪o‬‬
‫ﻭﺣﺪﺍﺕ ﻣﻘﺎﻭﻣﺔ ﺍﻟﻔﻼﺭﻳﺎ‪.‬‬ ‫‪o‬‬
‫ﺍﳌﻮﺍﺭﺩ ﺍﻟﺒﺸﺮﻳﺔ ﺩﺍﺧﻞ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪:‬‬
‫ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﻟﺪﻳﻪ ﻣﻮﺍﺭﺩ ﺑﺸﺮﻳﺔ ﻏﻨﻴﺔ ﻭﻗﺎﻋﺪﺓ ﻋﺮﻳﻀﺔ ﻣﻦ ﺍﻟﻌﻤﺎﻟﺔ‪ ،‬ﻭﺣﺴﺐ ﺁﺧﺮ‬
‫ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻟﻮﺯﺍﺭﺓ ‪ ،٢٠٠١‬ﻳﻘﺪﺭ ﻋﺪﺩ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ )ﻣﺮﻛﺰﻳﺎ ‪ /‬ﳏﻠﻴﺎ( ﰲ‬
‫ﲨﻴﻊ ﳏﺎﻓﻈﺎﺕ ﺍﳉﻤﻬﻮﺭﻳﺔ ﲝﻮﺍﱄ ‪ ٢٣٢٦٠٥‬ﻣﻮﻇﻔﲔ ﻳﺸﻐﻠﻮﻥ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻟﻔﻨﻴﺔ‪ ،‬ﻭﺍﻹﺷﺮﺍﻓﻴﺔ‪،‬‬
‫ﻭﺍﻟﻮﻇﺎﺋﻒ ﺍﳌﺴﺎﻋﺪﺓ ‪ ٢١٠١‬ﻣﻮﻇﻔﲔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺩﻳﻮﺍﻥ ﻋﺎﻡ ﺍﻟﻮﺯﺍﺭﺓ ‪ ٢٣٠٥٠٤‬ﻣﻮﻇﻒ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ‬
‫ﺍﶈﻠﻰ ﺑﺎﶈﺎﻓﻈﺎﺕ‪.‬‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺍﻟﻔﻌﻠﻴﺔ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻳﲔ ﺍﳌﺮﻛﺰﻱ ﻭﺍﶈﻠﻲ ﻓﻬﻲ ‪ ١٨٩٦٥٦‬ﻣﻮﻇﻔﺎﹰ )‪١٨٩١‬‬
‫ﻣﺮﻛﺰﻳﺎﹰ‪ ١٨٧٧٦٥ ،‬ﳏﻠﻴﺎﹰ(‪.‬‬

‫‪٥٩‬‬
‫ﻭﺃﻫﻢ ﺃﺳﺒﺎﺏ ﺍﻟﻔﺮﻭﻕ ﺑﲔ ﺍﻷﻋﺪﺍﺩ ﺍﻟﻔﻌﻠﻴﺔ ﻭﺍﳌﻘﻴﺪﺓ ﻫﻮ ﺍﻟﺘﺠﻨﻴﺪ )ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺬﻛﻮﺭ(‪ ،‬ﺍﻹﻋﺎﺭﺍﺕ‪ ،‬ﺍﻹﺟﺎﺯﺍﺕ‬
‫ﺑﺪﻭﻥ ﻣﺮﺗﺐ‪) .‬ﺇﺣﺼﺎﺋﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ‪.(٢٠٠١‬‬
‫ﻳﻌﻤﻞ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻋﺪﺩ ﻛﺒﲑ ﻣﻦ ﺍﻷﻃﺒﺎﺀ ﻭﺃﻋﻀﺎﺀ ﻫﻴﺌﺔ ﺍﻟﺘﻤﺮﻳﺾ‪ ٪٤٠ ،‬ﻣﻦ ﺍﻷﻃﺒﺎﺀ‬
‫ﻳﻌﻤﻠﻮﻥ ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ‪ ٪ ٥٢,٥‬ﻣﻦ ﺍﳌﻤﺮﺿﺎﺕ ﻳﻌﻤﻠﻦ ﰲ ﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ‪.‬‬
‫ﻧﺴﺒﺔ ﺍﻷﻃﺒﺎﺀ ‪ /‬ﺍﻟﺘﻤﺮﻳﺾ ‪) ٣ :٢‬ﺃﻱ ﻃﺒﻴﺐ ﻟﻜﻞ ﺃﻗﻞ ﻣﻦ ‪ ٢‬ﳑﺮﺿﺔ(‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٢-٢‬ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺎﻟﻮﺯﺍﺭﺓ‬
‫ﻣﻘﻴﺪﻳﻦ‬ ‫ﻗﺎﺋﻢ ﺑﺎﻟﻌﻤﻞ )ﻓﻌﻠﻲ(‬ ‫ﺍﻟﻔﺌﺔ‬
‫‪٥٨٩٦٩‬‬ ‫‪٤٠٣٦١‬‬ ‫ﺃﻃﺒﺎﺀ ﺑﺸﺮﻳﻮﻥ‬
‫‪٧٦٦٧‬‬ ‫ﺃﻃﺒﺎﺀ ﺃﺳﻨﺎﻥ‬
‫‪٤٦٤٠‬‬ ‫ﺻﻴﺎﺩﻟﺔ‬
‫‪٩١٧٠٣‬‬ ‫ﻫﻴﺌﺔ ﲤﺮﻳﺾ‬

‫ﺟﺪﻭﻝ )‪ :(٣-٢‬ﺗﻮﺯﻳﻊ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺑﺎﻟﺮﻳﻒ ﻭﺍﳊﻀﺮ‬

‫ﺍﳊﻀﺮ‪:‬‬
‫‪ -‬ﺍﳌﺮﺍﻛﺰ ﺍﻟﺼﺤﻴﺔ ﺍﳊﻀﺮﻳﺔ )‪ :(٢٤٦‬ﺗﻮﻓﺮ ﲨﻴﻊ ﺑﺮﺍﻣﺞ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ )ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ(‪.‬‬
‫‪ -‬ﻣﺮﺍﻛﺰ ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ )‪ :(٢٢٣‬ﺗﻮﻓﺮ ﺭﻋﺎﻳﺔ ﻣﺎ ﻗﺒﻞ ﺍﳊﻤﻞ ﻭﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ ﻭﻣﺎ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ‪.‬‬
‫‪ -‬ﺍﳌﻜﺎﺗﺐ ﺍﻟﺼﺤﻴﺔ )‪ :(٤١٨‬ﺗﻮﻓﺮ ﲨﻴﻊ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻣﻦ ﺑﻴﻨﻬﺎ ﺍﻟﺘﻄﻌﻴﻤﺎﺕ ﻭﺍﻟﻨﻈﺎﻓﺔ ﺍﻟﺒﻴﺌﻴﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺗﺴﺠﻴﻞ‬
‫ﺍﳌﻮﺍﻟﻴﺪ ﻭﺍﻟﻮﻓﻴﺎﺕ‪.‬‬
‫‪ -‬ﺗﻌﺪﺍﺩ ﺍﻟﺴﻜﺎﻥ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ )‪.(٣٠٤٤٦٣٠٦‬‬
‫ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‬
‫‪ -‬ﻭﺣﺪﺍﺕ ﺍﻟﺼﺤﺔ ﺍﻟﺮﻳﻔﻴﺔ )‪(٢٨٦٥‬‬
‫‪ -‬ﻣﺮﺍﻛﺰ ﺍﻟﺼﺤﺔ ﺍﻟﺮﻳﻔﻴﺔ )‪(٣١٠‬‬
‫‪ -‬ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺮﻳﻒ )‪(٣٠٩‬‬
‫‪ -‬ﺗﻮﻓﺮ ﻣﻦ ﺧﻼﻝ ﻫﺬﻩ ﺍﻷﻣﺎﻛﻦ ﲨﻴﻊ ﺑﺮﺍﻣﺞ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‬
‫‪ -‬ﺗﻌﺪﺍﺩ ﺍﻟﺴﻜﺎﻥ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ )‪(٣٢٩٨٣٤٩٩‬‬

‫‪ .٢‬ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ‪:‬‬
‫ﻭﻳﺘﻜﻮﻥ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﻣﻦ ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱴ ﺗﺘﺒﻊ ﻣﺒﺎﺷﺮﺓ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻣﺜﻞ‪:‬‬
‫ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪.‬‬ ‫‪-‬‬
‫ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﳌﻌﺎﻫﺪ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﻭﻫﺬﻩ ﺍﳍﻴﺌﺎﺕ ﺗﻌﺪ ﻫﻴﺌﺎﺕ ﺣﻜﻮﻣﻴﺔ ﺫﺍﺕ ﺍﺳﺘﻘﻼﻟﻴﺔ ﺍﻗﺘﺼﺎﺩﻳﺔ ﻭﺗﻘﺪﻡ ﺧﺪﻣﺎﺕ ﻋﻼﺟﻴﺔ ﺃﺳﺎﺳﺎ‪.‬‬
‫‪ .١-٢‬ﻧﻈﺎﻡ ﺗﻄﺒﻴﻖ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﲟﺼﺮ‪:‬‬
‫ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻫﻮ ﻧﻈﺎﻡ ﺣﻜﻮﻣﻲ ﺃﻭﻛﻠﺖ ﻣﺴﺌﻮﻟﻴﺔ ﺗﻨﻔﻴﺬﻩ ﺇﱃ ﻫﻴﺌﺔ ﻋﺎﻣﺔ ﻫﻲ "ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ‬
‫ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ"‪.‬‬

‫‪٦٠‬‬
 ‫ﻭﻗﺪ ﺃﻧﺸﺌﺖ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻋﺎﻡ ‪ ١٩٦٤‬ﺑﻘﺮﺍﺭ ﲨﻬﻮﺭﻱ‪.‬‬ ‫‪-‬‬
‫ﻭﻟﻠﻬﻴﺌﺔ ﳎﻠﺲ ﺇﺩﺍﺭﺓ ﻫﻮ ﺍﻟﺴﻠﻄﺔ ﺍﻟﻌﻠﻴﺎ‪ ،‬ﻭﻳﺮﺃﺳﻪ ﺭﺋﻴﺲ ﳎﻠﺲ ﺍﻹﺩﺍﺭﺓ‪.‬‬ ‫‪-‬‬
‫ﻭﺍﳍﻴﺌﺔ ﲢﺖ ﺇﺷﺮﺍﻑ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻭﻫﻮ ﺍﻟﺬﻱ ﻳﻌﺘﻤﺪ ﻗﺮﺍﺭﺍﺕ ﳎﻠﺲ ﺇﺩﺍﺭﺍ‪‬ﺎ‪ ،‬ﻭﻋﻦ ﻃﺮﻳﻘﻪ‬ ‫‪-‬‬
‫ﺗﺮﻓﻊ ﻣﺸﺮﻭﻋﺎﺕ ﺍﻟﻘﻮﺍﻧﲔ ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺇﱃ ﳎﻠﺲ ﺍﻟﻮﺯﺭﺍﺀ ﺃﻭ ﺭﺋﻴﺲ ﺍﳉﻤﻬﻮﺭﻳﺔ‪.‬‬
‫ﻣﻘﺮ ﺭﺋﺎﺳﺔ ﺍﳍﻴﺌﺔ ﺑﺎﻟﻘﺎﻫﺮﺓ‪ ،‬ﻭﺗﻨﻘﺴﻢ ﺇﱃ ﻋﺪﺓ ﻓﺮﻭﻉ‪ ،‬ﻳﺪﻳﺮ ﻛﻞ ﻓﺮﻉ ﻃﺒﻴﺐ ﻣﺘﻔﺮﻍ‪ ،‬ﻭﻳﻨﻔﺬ‬ ‫‪-‬‬
‫ﻛﻞ ﻓﺮﻉ ﺃﻧﺸﻄﺔ ﺍﳍﻴﺌﺔ ﰲ ﻗﻄﺎﻉ ﺟﻐﺮﺍﰲ ﻣﻦ ﺍﳉﻤﻬﻮﺭﻳﺔ‪ ،‬ﻭﺗﻨﻘﺴﻢ ﺍﻟﻔﺮﻭﻉ ﺇﱃ ﻣﻨﺎﻃﻖ‬
‫ﺗﺘﺒﻌﻬﺎ ﺍﻟﻮﺣﺪﺍﺕ ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﻭﻣﺴﺌﻮﻟﻴﺔ ﺍﻟﻔﺮﻭﻉ ﺃﺳﺎﺳﺎ ﻫﻲ ﺍﻟﺘﻨﻔﻴﺬ‪ ،‬ﻭﺍﳌﺸﺎﺭﻛﺔ ﰲ‬
‫ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻹﺷﺮﺍﻑ ﻭﺍﳌﺘﺎﺑﻌﺔ ﻟﻠﻤﺴﺘﻮﻳﺎﺕ ﺍﻷﺩﱏ‪.‬‬
‫ﺍﺧﺘﺼﺎﺻﺎﺕ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪:‬‬
‫ﺗﻨﻔﻴﺬ ﺗﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﳉﻤﻴﻊ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﻗﻄﺎﻋﺎﺕ ﺍﻟﺪﻭﻟﺔ‪.‬‬
‫‪ .١‬ﺗﻨﻔﻴﺬ ﺗﺄﻣﲔ ﺍﳌﺮﺽ ﻟﻠﻤﻨﺘﻔﻌﲔ ﺑﻪ ﻣﻦ ﺍﻟﻌﻤﺎﻟﺔ ﺍﳌﻨﺘﻈﻤﺔ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﺎ ﻣﻦ ﺣﻜﻮﻣﻴﲔ‪ ،‬ﻗﻄﺎﻉ‬
‫ﻋﺎﻡ‪ ،‬ﻗﻄﺎﻉ ﺧﺎﺹ‪ .‬ﻭﻳﺘﻢ ﺍﻟﺘﻮﺳﻴﻊ ﺗﺪﺭﳚﻴﺎ ﰲ ﻫﺬﻩ ﺍﻟﻘﻄﺎﻋﺎﺕ‪) .‬ﻗﺎﻧﻮﻥ ‪.(١٩٧٥‬‬
‫‪ .٢‬ﺗﻨﻔﻴﺬ ﺗﺄﻣﲔ ﺍﳌﺮﺽ ﳌﻦ ﻳﺮﻏﺐ ﻣﻦ ﺍﶈﺎﻟﲔ ﻟﻠﻤﻌﺎﺵ ﻭﻣﻦ ﺃﺭﺍﻣﻞ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﻢ‪ ،‬ﻭﺃﻳﻀﺎ ﻷﺳﺮ‬
‫ﺍﳌﻨﺘﻔﻌﲔ )ﺑﻨﻈﺎﻡ ﺧﺎﺹ(‪.‬‬
‫‪ .٣‬ﺗﻨﻔﻴﺬ ﻧﻈﺎﻡ ﺍﻟﻌﻼﺝ ﺍﻟﺘﺄﻣﻴﲏ ﻟﻠﻌﺎﻣﻠﲔ ﰲ ﺍﳊﻜﻮﻣﺔ ﻭﻭﺣﺪﺍﺕ ﺍﻹﺩﺍﺭﺓ ﺍﶈﻠﻴﺔ ﻭﺍﳍﻴﺌﺎﺕ ﺍﻟﻌﺎﻣﺔ‬
‫ﻭﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻌﺎﻣﺔ )‪.(١٩٧٥‬‬
‫‪ .٤‬ﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻟﻠﻌﺎﻣﻠﲔ ﺍﳌﻌﺮﺿﲔ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ‪‬ﺪﻑ ﺍﻻﻛﺘﺸﺎﻑ‬
‫ﺍﳌﺒﻜﺮ ﻟﻸﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‪.‬‬
‫‪ .٥‬ﺗﻨﻔﻴﺬ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻋﻠﻰ ﺍﻟﻄﻼﺏ )ﻗﺎﻧﻮﻥ ‪ ٩٩‬ﻟﺴﻨﺔ ‪.(١٩٩٢‬‬
‫‪ .٦‬ﺍﻟﻠﺠﺎﻥ ﺍﻟﻄﺒﻴﺔ )ﺇﺟﺎﺯﺍﺕ ﻣﺮﺿﻴﺔ( ﺗﻘﺮﻳﺮ ﺍﻟﻠﻴﺎﻗﺔ ﻟﻼﻟﺘﺤﺎﻕ ﺑﺎﻷﻋﻤﺎﻝ ﺃﻭ ﻣﺪ ﻣﺪﺓ ﺍﳋﺪﻣﺔ‪ ،‬ﲢﺪﻳﺪ‬
‫ﺳﺒﺐ ﺍﻟﻌﺠﺰ‪ ،‬ﺗﻘﺮﻳﺮ ﺍﳊﺎﻟﺔ ﰲ ﺑﻌﺾ ﺃﻧﻮﺍﻉ ﺍﳌﻌﺎﺷﺎﺕ ﺍﻻﺳﺘﺜﻨﺎﺋﻴﺔ‪ ..‬ﺍﱁ‪.‬‬
‫‪ .٧‬ﺃﻧﺸﻄﺔ ﺃﺧﺮﻯ ﺗﺰﺍﻭﳍﺎ ﺍﳍﻴﺌﺔ ﻣﻦ ﺧﻼﻝ ﺻﻨﺪﻭﻕ ﻟﻠﻌﻼﺝ ﺍﳋﺎﺹ‪ ،‬ﺃﻧﺸﺊ ﺑﺎﳍﻴﺌﺔ ‪‬ﺪﻑ ﺍﺳﺘﻐﻼﻝ‬
‫ﺃﻱ ﻓﺎﺋﺾ ﻣﺘﺎﺡ ﰲ ﺇﻣﻜﺎﻧﻴﺎﺕ ﺍﳍﻴﺌﺔ‪ ،‬ﻹﺗﺎﺣﺔ ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺍﳍﻴﺌﺔ ﰲ ﺑﻌﺾ ﺍﻷﺣﻮﺍﻝ ﻟﻐﲑ ﺍﳌﺆﻣﻦ‬
‫ﻋﻠﻴﻬﻢ ﺑﺄﺳﻌﺎﺭ ﻣﺮﺷﺪﺓ ﻣﺜﻞ ﺍﻟﻌﻼﺝ ﺍﻟﺸﺎﻣﻞ‪ ،‬ﺍﻟﻌﻼﺝ ﺑﺎﻹﺣﺎﻟﺔ‪.‬‬
‫‪ .٨‬ﺗﻨﻔﻴﺬ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻋﻠﻰ ﺍﻷﻃﻔﺎﻝ ﺃﻗﻞ ﻣﻦ ‪ ٥‬ﺳﻨﻮﺍﺕ ﻣﻦ ﺍﻟﻌﻤﺮ ﻣﻨﺬ ﻋﺎﻡ ‪.١٩٩٧‬‬
‫ﺃﺳﺎﻟﻴﺐ ﺗﻮﻓﲑ ﺍﳋﺪﻣﺔ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ‪:‬‬
‫ﺍﻷﺳﻠﻮﺏ ﺍﳌﺒﺎﺷﺮ‪:‬‬
‫ﻭﺫﻟﻚ ﻋﻦ ﻃﺮﻳﻖ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﰲ ﻣﺮﺍﻛﺰ ﺃﻭ ﻭﺣﺪﺍﺕ ﺗﺎﺑﻌﺔ ﺃﻭ ﳑﻠﻮﻛﺔ ﻟﻠﻬﻴﺌﺔ‪ ،‬ﻭﺗﺪﺍﺭ ﺑﻨﻈﺎﻣﻬﺎ‬ ‫‪-‬‬
‫ﻭﻳﺘﻤﻴﺰ ﻫﺬﺍ ﺍﻷﺳﻠﻮﺏ ﺑﺈﻣﻜﺎﻧﻴﺔ ﺗﺪﻗﻴﻖ ﺍﻟﺮﻗﺎﺑﺔ ﻭﺍﳌﺘﺎﺑﻌﺔ ﻭﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺇﺣﺼﺎﺀﺍﺕ‬
‫ﻭﻣﻌﻠﻮﻣﺎﺕ ﺃﻛﺜﺮ ﺳﻼﻣﺔ‪ ،‬ﻭﺇﻥ ﻛﺎﻥ ﻳﻌﻴﺒﻪ ﺇﺭﻏﺎﻡ ﺍﳌﻨﺘﻔﻊ ﻋﻠﻰ ﺍﺳﺘﻌﻤﺎﻝ ﻫﺬﻩ ﺍﻟﻮﺣﺪﺍﺕ‬
‫ﻭﺍﻹﻣﻜﺎﻧﺎﺕ‪.‬‬

‫‪٦١‬‬
‫ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﻄﺒﻴﺔ ﺍﳌﻤﻠﻮﻛﺔ ﻟﻠﻬﻴﺌﺔ‪ :‬ﻭﺍﳌﺨﺼﺼﺔ ﺃﺳﺎﺳﺎ ﳋﺪﻣﺔ ﻗﻄﺎﻋﺎﺕ ﺍﻟﻌﻤﺎﻟﺔ‬ ‫‪-‬‬
‫ﺍﳌﻨﺘﻈﻤﺔ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﺎ )ﺍﻹﺣﺼﺎﺀ ﻭﺍﻟﺘﻘﺮﻳﺮ ﺍﻟﺴﻨﻮﻱ ﻟﻠﻬﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫‪.(١٩٩٤/٩٣‬‬
‫ﺟﺪﻭﻝ )‪ :(٤-٢‬ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﻄﺒﻴﺔ ﺍﳌﻤﻠﻮﻛﺔ ﻟﻠﻬﻴﺌﺔ‬
‫‪ ٥٦٥‬ﻋﻴﺎﺩﺓ‬ ‫ﻋﻴﺎﺩﺍﺕ ﳑﺎﺭﺱ‬
‫‪ ٢٠‬ﻋﻴﺎﺩﺓ‬ ‫ﻋﻴﺎﺩﺍﺕ ﳑﺎﺭﺱ ﻋﺎﻡ ﳎﻤﻌﻪ‬
‫‪ ١٢٠‬ﻋﻴﺎﺩﺓ‬ ‫ﻋﻴﺎﺩﺍﺕ ﺷﺎﻣﻠﺔ ﻟﻸﺧﺼﺎﺋﻴﲔ‬
‫‪ ٤٥‬ﻣﺮﻛﺰﺍﹰ‬ ‫ﻣﺮﺍﻛﺰ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ‬
‫‪ ٢٦‬ﻣﺴﺘﺸﻔﻰ ‪‬ﺎ ‪ ٥٤٩٥‬ﺳﺮﻳﺮﺍﹰ‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ‬
‫* ﻻ ﻳﺸﻤﻞ ﻫﺬﺍ ﺍﳊﺼﺮ ﺍﻟﻌﻴﺎﺩﺍﺕ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺨﺼﺼﺔ ﳋﺪﻣﺔ ﺗﺄﻣﲔ ﺍﻟﻄﻼﺏ‬

‫ﺍﻷﺳﻠﻮﺏ ﻏﲑ ﺍﳌﺒﺎﺷﺮ‪ :‬ﺗﻘﺪﻡ ﺍﳋﺪﻣﺔ ﰱ ﻭﺣﺪﺍﺕ ﻭﺟﻬﺎﺕ ﻏﲑ ﺗﺎﺑﻌﺔ ﻟﻠﻬﻴﺌﺔ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﺘﻌﺎﻗﺪ‪ ،‬ﻣﺜﻞ‬
‫ﺍﳉﻬﺎﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ‪ ،‬ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﻴﺔ‪ ،‬ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﳌﺘﺨﺼﺼﺔ ﻛﺎﳊﻤﻴﺎﺕ‪ ..‬ﺍﱁ‪ ،‬ﻭﺍﳌﻌﺎﻫﺪ ﺍﳌﺘﺨﺼﺼﺔ‪ ،‬ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻘﻮﺍﺕ ﺍﳌﺴﻠﺤﺔ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﳋﺎﺻﺔ ﻭﻋﻴﺎﺩﺍﺕ ﺍﻷﻃﺒﺎﺀ ﺍﳋﺎﺻﺔ‪.‬‬
‫ﺍﳌﻮﻗﻒ ﺍﻟﺘﻄﺒﻴﻘﻲ ﳍﺬﺍ ﺍﻟﻘﻄﺎﻉ‪:‬‬
‫ﺍﻧﺘﺸﺎﺭ ﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﺩﺍﺧﻞ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﳋﺎﺻﺔ ﻟﻨﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻭﺻﻞ ﺇﱃ‪:‬‬
‫‪ ٪٩٦‬ﻣﻦ ﺍﳊﻜﻮﻣﻴﲔ )ﺍﻟﺒﺎﻗﻮﻥ ﰲ ﺍﻷﻏﻠﺐ ﳍﻢ ﻧﻈﻢ ﻋﻼﺟﻴﺔ ﻣﻦ ﺧﻼﻝ ﺟﻬﺎﺕ ﻋﻤﻠﻬﻢ(‪.‬‬ ‫‪-‬‬
‫‪ ٪٢٦‬ﻣﻦ ﺍﻟﻘﻄﺎﻋﲔ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ )ﺃﻏﻠﺐ ﺑﺎﻗﻲ ﻫﺬﺍ ﺍﻟﻘﻄﺎﻉ ﻟﻪ ﻧﻈﺎﻡ ﻋﻼﺟﻲ ﺑﺼﻮﺭﺓ ﻣﺎ ﻣﻦ‬ ‫‪-‬‬
‫ﺧﻼﻝ ﻣﺆﺳﺴﺔ ﺃﻭ ﻧﻘﺎﺑﺔ(‪.‬‬
‫‪ ٪٦٥‬ﻣﻦ ﺃﺻﺤﺎﺏ ﺍﳌﻌﺎﺷﺎﺕ )ﺍﻻﻧﻀﻤﺎﻡ ﺍﺧﺘﻴﺎﺭﻱ ﻭﻟﻪ ﻣﻮﻋﺪ ﻣﻌﲔ(‪.‬‬ ‫‪-‬‬
‫‪ ٪٢٣‬ﻣﻦ ﺍﻷﺭﺍﻣﻞ )ﺍﻻﻧﻀﻤﺎﻡ ﺍﺧﺘﻴﺎﺭﻱ(‪.‬‬ ‫‪-‬‬
‫ﺃﻛﺜﺮ ﻣﻦ ‪ ٪٦٥‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ >‪ ٥‬ﺳﻨﻮﺍﺕ ﻣﻦ ﺍﻟﻌﻤﺮ‪) .‬ﺗﺘﻔﺎﻭﺕ ﺍﻟﻨﺴﺐ ﺑﲔ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‬ ‫‪-‬‬
‫ﻧﻈﺮﺍ ﻷ‪‬ﺎ ﺧﺪﻣﺔ ﺍﺧﺘﻴﺎﺭﻳﺔ ﻟﻠﻤﻮﺍﻃﻨﲔ(‬
‫‪ .٢-٢‬ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ )‪(CURATIVE CARE ORGANIZATION; CCO‬‬
‫ﺃﻧﺸﺌﺖ ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻋﺎﻡ ‪ ١٩٦٤‬ﲢﺖ ﺇﺷﺮﺍﻑ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺫﻟﻚ ﺑﺘﺄﻣﻴﻢ ﻋﺪﺓ‬
‫ﻣﺆﺳﺴﺎﺕ ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﺧﺎﺻﺔ ﻭﺧﲑﻳﺔ‪.‬‬
‫ﻭﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﺗﻜﻮﻧﺖ ﰲ ﺍﻟﻘﺎﻫﺮﺓ ﻭﺍﻹﺳﻜﻨﺪﺭﻳﺔ ﰲ ﻧﻔﺲ ﺍﻟﻌﺎﻡ‪ ،‬ﻭﻳﻮﺟﺪ ﺣﺎﻟﻴﺎ ﺃﺭﺑﻊ ﻣﺆﺳﺴﺎﺕ‬
‫ﰲ ﳏﺎﻓﻈﺔ ﺑﻮﺭﺳﻌﻴﺪ ﻭﳏﺎﻓﻈﺎﺕ ﺍﻟﺪﻟﺘﺎ )ﺍﻟﻘﻠﻴﻮﺑﻴﺔ‪ ،‬ﺩﻣﻴﺎﻁ‪ ،‬ﻛﻔﺮ ﺍﻟﺸﻴﺦ( ﻭﻻ ﻳﻮﺟﺪ ﻣﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺧﺎﺻﺔ ﺑﺎﳌﺆﺳﺴﺔ ﰲ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‪ .‬ﻭﺗﺪﻳﺮ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﺍﻟﺴﺖ )‪ ٢١ ،(٦‬ﻣﺴﺘﺸﻔﻰ ﺗﺸﻤﻞ‬
‫ﺣﻮﺍﱄ ‪٪٤‬ﻣﻦ ﺇﲨﺎﱄ ﻋﺪﺩ ﺃﺳﺮﺓ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﲜﻤﻬﻮﺭﻳﺔ ﻣﺼﺮ ﺍﻟﻌﺮﺑﻴﺔ‪.‬‬

‫‪٦٢‬‬
‫ﻭﻧﻈﺎﻡ ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻳﺪﺍﺭ ﺑﻄﺮﻳﻘﺔ )‪ (Independently on a non profit basis‬ﻭﻟﻜﻦ ﻻ‬
‫ﻳﻬﺪﻑ ﻟﻠﺮﺑﺢ‪ ،‬ﻭﻳﺴﺘﺨﺪﻡ ﺍﻷﺟﺮ ﺍﶈﺼﻞ ﰲ ﲢﺴﲔ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ‪ ،‬ﻭﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﻫﻲ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﻌﻼﺟﻴﺔ‪.‬‬
‫‪ .٣-٢‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪:‬‬
‫ﰎ ﺇﻧﺸﺎﺀ ﺍﳍﻴﺌﺔ ﺑﺎﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ ﺭﻗﻢ ‪ ١٠٠٢‬ﻟﻌﺎﻡ ‪ ١٩٧٥‬ﻭﺗﺘﺒﻊ "ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ‬
‫ﻭﺍﳌﻌﺎﻫﺪ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ" ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺍﻟﺬﻱ ﻳﺮﺃﺱ ﳎﻠﺲ ﺇﺩﺍﺭﺓ ﺍﳍﻴﺌﺔ ﻭﻣﻘﺮﻫﺎ ﺑﺎﻟﻘﺎﻫﺮﺓ‪ ،‬ﻭﺗﻌﺘﱪ ﺍﳍﻴﺌﺔ‬
‫ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪ ،‬ﻭﺍﳍﺪﻑ ﻣﻦ ﺇﻧﺸﺎﺋﻬﺎ ﻫﻮ ﲢﻘﻴﻖ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﳌﺘﻄﻮﺭﺓ ﻟﻠﺠﻤﺎﻫﲑ ﻋﻠﻰ‬
‫ﺍﳌﺴﺘﻮﻯ ﺍﻹﻗﻠﻴﻤﻲ ﻭﺍﻟﻘﻮﻣﻲ ﲟﺎ ﻳﺴﻬﻢ ﺑﻪ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻌﻠﻤﻴﻮﻥ ﰲ ﺭﻓﻊ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻌﻠﻤﻲ ﻟﻸﺩﺍﺀ ﺑﻮﺣﺪﺍﺕ‬
‫ﺍﳍﻴﺌﺔ ﻭﻏﲑﻫﺎ‪ ،‬ﻭﻛﺬﻟﻚ ﺗﻌﻠﻴﻢ ﻃﻠﺒﺔ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﺟﻨﺒﺎ ﺇﱃ ﺟﻨﺐ ﻣﻊ ﺃﺳﺎﺗﺬﺓ ﺍﳉﺎﻣﻌﺎﺕ ﻭﺗﺪﺭﻳﺐ‬
‫ﺍﻷﻃﺒﺎﺀ ﰲ ﺍﻟﺘﺨﺼﺼﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﻭﻳﻘﻮﻡ ﺍﻟﺴﺎﺩﺓ ﺃﻋﻀﺎﺀ ﺍﳍﻴﺌﺔ ﺍﻟﻌﻠﻤﻴﻮﻥ ﺑﺈﺟﺮﺍﺀ ﺍﻷﲝﺎﺙ ﺍﳌﺨﺘﻠﻔﺔ‬
‫ﻛﻞ ﰲ ﳎﺎﻝ ﲣﺼﺼﻪ‪ ،‬ﻟﻺﺳﻬﺎﻡ ﰲ ﺇﺣﺪﺍﺙ ﺍﻟﺘﻄﻮﻳﺮ ﺍﳌﺴﺘﻤﺮ ﰲ ﺃﺳﻠﻮﺏ ﺍﻟﺘﺸﺨﻴﺺ ﻭﺍﻟﻌﻼﺝ ﻧﺘﻴﺠﺔ‬
‫ﺍﻷﲝﺎﺙ‪.‬‬
‫ﺗﺘﻜﻮﻥ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﳌﻌﺎﻫﺪ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻣﻦ‪:‬‬
‫‪ .١‬ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻭﺗﺘﻜﻮﻥ ﻣﻦ ﳎﻤﻮﻋﺔ ﺍﻷﻗﺴﺎﻡ ﺍﻹﻛﻠﻴﻨﻴﻜﻴﺔ ﻭﺍﻟﻮﺣﺪﺍﺕ ﺍﳌﺴﺎﻋﺪﺓ‬
‫ﺍﻷﺧﺮﻯ ﻭﺗﺸﻤﻞ‪:‬‬
‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺩﺍﺧﻞ ﺍﻟﻘﺎﻫﺮﺓ‪:‬‬ ‫‪-‬‬
‫‪ o‬ﻣﺴﺘﺸﻔﻰ ﺃﲪﺪ ﻣﺎﻫﺮ ﺍﻟﺘﻌﻠﻴﻤﻲ‪.‬‬
‫‪ o‬ﻣﺴﺘﺸﻔﻰ ﺍﻟﺴﺎﺣﻞ ﺍﻟﺘﻌﻠﻴﻤﻲ‪.‬‬
‫‪ o‬ﻣﺴﺘﺸﻔﻰ ﺍﳌﻄﺮﻳﺔ ﺍﻟﺘﻌﻠﻴﻤﻲ‪.‬‬
‫‪ o‬ﻣﺴﺘﺸﻔﻰ ﺍﳉﻼﺀ ﺍﻟﺘﻌﻠﻴﻤﻲ‪.‬‬
‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺧﺎﺭﺝ ﺍﻟﻘﺎﻫﺮﺓ‪:‬‬ ‫‪-‬‬
‫‪ o‬ﻣﺴﺘﺸﻔﻰ ﺑﻨﻬﺎ ﺍﻟﺘﻌﻠﻴﻤﻲ‪.‬‬
‫‪ o‬ﻣﺴﺘﺸﻔﻰ ﺷﺒﲔ ﺍﻟﻜﻮﻡ ﺍﻟﺘﻌﻠﻴﻤﻲ‪.‬‬
‫‪ o‬ﻣﺴﺘﺸﻔﻰ ﺩﻣﻨﻬﻮﺭ ﺍﻟﺘﻌﻠﻴﻤﻲ‪.‬‬
‫‪ o‬ﻣﺴﺘﺸﻔﻰ ﺳﻮﻫﺎﺝ ﺍﻟﺘﻌﻠﻴﻤﻲ‪.‬‬
‫ﻭﺗﻘﻮﻡ ﻫﺬﻩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺑﺄﺩﺍﺀ ﻛﺎﻓﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﰲ ﲨﻴﻊ‬
‫ﺍﻟﺘﺨﺼﺼﺎﺕ‪ ،‬ﻛﻤﺎ ﲡﺮﻯ ‪‬ﺎ ﻋﻤﻠﻴﺎﺕ ﺟﺮﺍﺣﻴﺔ ﺣﺪﻳﺜﺔ ﻣﺜﻞ‪ :‬ﺯﺭﻉ ﺍﻟﻜﻠﻰ‪ ،‬ﺍﻟﻐﺴﻴﻞ ﺍﻟﻜﻠﻮﻱ‪ ،‬ﻭﻋﻤﻠﻴﺎﺕ‬
‫ﺍﻟﻘﻠﺐ ﺍﳌﻔﺘﻮﺡ‪.‬‬
‫‪ .٢‬ﺍﳌﻌﺎﻫﺪ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪:‬‬
‫‪ -‬ﻣﻌﻬﺪ ﺍﻟﺴﻜﺮ‪.‬‬
‫‪ -‬ﻣﻌﻬﺪ ﺍﻟﺘﻐﺬﻳﺔ‪.‬‬
‫‪ -‬ﻣﻌﻬﺪ ﺍﻷﲝﺎﺙ ﻟﻄﺐ ﺍﳌﻨﺎﻃﻖ ﺍﳊﺎﺭﺓ‪.‬‬
‫‪ -‬ﻣﻌﻬﺪ ﲝﻮﺙ ﺍﳊﺸﺮﺍﺕ‪.‬‬

‫‪٦٣‬‬
 ‫ﻣﻌﻬﺪ ﺍﻟﺴﻤﻊ ﻭﺍﻟﻜﻼﻡ‪.‬‬ ‫‪-‬‬
‫ﻣﻌﻬﺪ ﺷﻠﻞ ﺍﻷﻃﻔﺎﻝ‪.‬‬ ‫‪-‬‬
‫ﻣﻌﻬﺪ ﺟﺮﺍﺣﺔ ﺍﻟﻘﻠﺐ ﻭﺍﻟﺼﺪﺭ‪.‬‬ ‫‪-‬‬
‫ﺍﳌﻌﻬﺪ ﺍﻟﺘﺬﻛﺎﺭﻱ ﻟﻠﺒﺤﻮﺙ ﺍﻟﺮﻣﺪﻳﺔ‪.‬‬ ‫‪-‬‬
‫ﻭﺗﻘﻮﻡ ﻫﺬﻩ ﺍﳌﻌﺎﻫﺪ ﺑﻌﻼﺝ ﺍﳊﺎﻻﺕ ﺍﳌﺘﺨﺼﺼﺔ ﺑﺄﺣﺪﺍﺙ ﺍﻷﺳﺎﻟﻴﺐ ﻭﺑﺎﺳﺘﻤﺮﺍﺭ ﺍﻷﺟﻬﺰﺓ ﺍﳌﺘﻄﻮﺭﺓ‬
‫ﻭﻛﺬﻟﻚ ﻳﻘﻮﻡ ﺍﻷﻃﺒﺎﺀ ﺑﺈﺟﺮﺍﺀ ﺍﻟﺒﺤﻮﺙ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻮﺻﻮﻝ ﻷﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻣﻦ ﺍﻷﺩﺍﺀ ﺍﻟﻌﻼﺟﻲ‬
‫ﻟﻠﻤﻮﺍﻃﻨﲔ‪.‬‬
‫‪ .٣‬ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‬
‫ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﻳﻘﺪﻡ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺑﺪﺍﻳﺔ ﻣﻦ ﺣﻼﻕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺪﺍﻳﺔ‪ ،‬ﺍﻟﺼﻴﺪﻟﻴﺎﺕ‪،‬‬ ‫‪-‬‬
‫ﺍﻟﻄﺒﻴﺐ ﺍﳋﺎﺹ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳋﺎﺻﺔ ﲜﻤﻴﻊ ﺃﺣﺠﺎﻣﻬﺎ‪ .‬ﻭﻳﺸﻤﻞ ﻫﺬﺍ ﺍﻟﻘﻄﺎﻉ ﺃﻳﻀﺎ ﻋﺪﺩ‬
‫ﻛﺒﲑﺍﹰ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ ﻭﺍﳍﻴﺌﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ‪ ،‬ﻭﻳﻘﺪﻡ ﺧﺪﻣﺎﺕ ﺻﺤﻴﺔ ﻣﺜﻞ ﺍﻟﻌﻴﺎﺩﺍﺕ‬
‫ﺍﻟﺘﺎﺑﻌﺔ ﻟﻠﺠﻮﺍﻣﻊ ﻭﺍﻟﻜﻨﺎﺋﺲ )ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺪﻳﻨﻴﺔ( ﻭﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﲑﻳﺔ‪ ،‬ﻭﻛﻠﻬﺎ ﻣﺴﺠﻠﺔ ﺑﻮﺯﺍﺭﺓ‬
‫ﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪.‬‬
‫ﺑﻌﺪ ﺇﻋﻼﻥ ﺳﻴﺎﺳﺔ ﺍﻻﻧﻔﺘﺎﺡ ﰲ ﻋﺎﻡ ‪ ،١٩٧٤‬ﺑﺪﺃ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﺍﻟﺼﺤﻲ ﰲ ﺍﻟﻨﻤﻮ ﻣﺎ ﺑﲔ ﻋﺎﻡ‬
‫‪ ١٩٩٠ ،١٩٧٥‬ﻭﺍﺭﺗﻔﻊ ﻋﺪﺩ ﺍﻷﺳﺮﺓ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺼﻮﺭﺓ ﻛﺒﲑﺓ‪.‬‬
‫ﺗﺘﺮﺍﻭﺡ ﺧﺪﻣﺎﺕ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﺍﻟﺼﺤﻰ ﻣﺎ ﺑﲔ ﻣﺴﺘﺸﻔﻴﺎﺕ ﺣﺪﻳﺜﺔ ﻛﺒﲑﺓ ﻭﳎﻬﺰﺓ ﲡﻬﻴﺰﺍ‬
‫ﻣﻌﻘﺪﺍ ﺇﱃ ﻣﺴﺘﺸﻔﻴﺎﺕ ﺻﻐﲑﺓ ﻭﻣﺮﺍﻛﺰ ﺭﻋﺎﻳﺔ ﻃﺒﻴﺔ ﻳﻮﻣﻴﺔ ﺃﻭ ﻋﻴﺎﺩﺍﺕ ﻋﺎﻣﺔ ﺷﺎﻣﻠﺔ‪.‬‬
‫ﻳﻮﺟﺪ ﻋﺪﺩ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ ﺃﻭ ﺍﳌﻨﻈﻤﺎﺕ ﺍﳋﺎﺻﺔ ﺍﻷﻫﻠﻴﺔ ﺃﻭ ﺍﻟﺘﻄﻮﻋﻴﺔ ﺩﺍﺧﻞ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ‬ ‫‪-‬‬
‫ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ‪ ،‬ﻳﻘﺪﻡ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺧﻼﻝ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺸﺎﻣﻠﺔ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﻟﺼﻐﲑﺓ‪ ،‬ﻭﻏﺎﻟﺒﺎ ﻣﺎ ﺗﻜﻮﻥ ﻣﺘﺼﻠﺔ ﺑﺒﻌﺾ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺪﻳﻨﻴﺔ ﻭﲤﻮﻝ ﺑﻨﻈﺎﻡ ﺍﳌﺸﺎﺭﻛﺔ‬
‫ﻭﺍﻟﺘﱪﻉ‪.‬‬
‫ﻣﻨﺬ ﻋﺪﺓ ﺳﻨﻮﺍﺕ ﺑﺪﺃﺕ ﺍﻟﻨﻘﺎﺑﺎﺕ ﺍﻟﻌﺎﻣﺔ ﰲ ﻣﺼﺮ )ﺍﻷﻃﺒﺎﺀ‪ ،‬ﺍﳌﻬﻨﺪﺳﲔ‪ ،‬ﺍﻟﺘﺠﺎﺭﻳﲔ‪ ..‬ﺍﱁ ( ﰲ‬ ‫‪-‬‬
‫ﺇﻧﺸﺎﺀ ﻣﺸﺮﻭﻉ ﻋﻼﺝ ﺍﻷﻋﻀﺎﺀ ﻭﺃﻓﺮﺍﺩ ﺃﺳﺮﻫﻢ ﻣﻦ ﺧﻼﻝ ﺍﺷﺘﺮﺍﻛﺎﺕ ﺳﻨﻮﻳﺔ ﻭﻣﻘﻨﻨﺔ ﻟﻜﻞ‬
‫ﻋﻀﻮ ﻭﻛﻞ ﻋﻀﻮ ﺩﺍﺧﻞ ﺃﺳﺮﺗﻪ‪ ،‬ﻭﻳﺘﻢ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﻭﻛﻠﻬﺎ ﺧﺪﻣﺎﺕ ﻋﻼﺟﻴﺔ ﻣﻦ ﺧﻼﻝ‬
‫ﻋﻴﺎﺩﺍﺕ ﺧﺎﺻﺔ ﻟﻸﻃﺒﺎﺀ‪ ،‬ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﺧﺎﺻﺔ‪ ،‬ﻳﺘﻢ ﻋﻤﻞ ﺗﻌﺎﻗﺪ ﻣﻌﻬﺎ )ﺗﻌﺎﻗﺪ ﺑﲔ ﺍﻟﻨﻘﺎﺑﺔ‬
‫ﻭﺍﻟﻄﺒﻴﺐ(‪ .‬ﻭﻳﻌﺘﱪ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﻫﻮ ﻧﻮﻉ ﻣﻦ ﺍﻟﺘﻜﺎﻓﻞ ﺑﲔ ﺃﻋﻀﺎﺀ ﻛﻞ ﻧﻘﺎﺑﺔ‪ ،‬ﺣﻴﺚ ﺇﻥ‬
‫ﺍﻻﺷﺘﺮﺍﻙ ﺍﻟﺴﻨﻮﻱ ﻳﺘﻢ ﺗﺴﺪﻳﺪﻩ ﺑﻐﺾ ﺍﻟﻨﻈﺮ ﻣﻦ ﻣﺪﻯ ﺍﻻﺳﺘﻔﺎﺩﺓ ﳑﺎ ﰎ ﺩﻓﻌﻪ ﺳﺎﺑﻘﺎ‪) .‬ﻧﻮﻉ‬
‫ﻣﻦ ﻧﻈﻢ ﺍﻟﺘﺄﻣﲔ(‬

‫‪٦٤‬‬
 ‫ﻭﻧﺴﺒﺔ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﻣﻦ ﻛﻞ ﻗﻄﺎﻉ ﳝﻜﻦ ﺃﻥ ﺗﻘﻴﻢ ﻣﻦ ﺧﻼﻝ ﺍﳉﺪﻭﻝ ﺍﻟﺘﺎﱄ‪:‬‬
‫ﺟﺪﻭﻝ )‪ :(٥-٢‬ﻧﺴﺒﺔ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﻣﻦ ﻛﻞ ﻣﻦ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﻧﺴﺒﺔ ﺍﻷﺳﺮﺓ‬ ‫ﻧﺴﺒﺔ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ‬ ‫ﺍﳌﺆﺳﺴﺎﺕ‬
‫‪%٥٧,٨‬‬ ‫‪%٦١,٤‬‬ ‫ﻭﺣﺪﺍﺕ ﻭﻣﺆﺳﺴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫‪%١٢,٨‬‬ ‫‪%٣٢‬‬ ‫ﻫﻴﺌﺎﺕ ﺗﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪:‬‬
‫‪%٣,٨‬‬ ‫ﺍﳌﻌﺎﻫﺪ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‬ ‫·‬
‫‪%٤‬‬ ‫ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ‬ ‫·‬
‫‪%٥‬‬ ‫ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬ ‫·‬
‫‪%١٦,٥‬‬ ‫‪%١,٩‬‬ ‫ﺍﳉﺎﻣﻌﺎﺕ‬
‫‪%٢,٣‬‬ ‫‪%١,٩‬‬ ‫ﻭﺯﺍﺭﺍﺕ ﺃﺧﺮﻯ‬
‫‪%١٠,٦‬‬ ‫‪%٣١,٦‬‬ ‫ﻗﻄﺎﻉ ﺧﺎﺹ‬
‫* ﺍﳌﺼﺪﺭ‪) :‬ﻗﺴﻢ ﺍﻹﺣﺼﺎﺀ ﺑﺎﻟﻮﺯﺍﺭﺓ ‪( ١٩٩٦‬‬

‫ﻭﻳﻬﺪﻑ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﺇﱃ ﲢﻘﻴﻖ ﺍﳍﺪﻑ ﺍﳌﻨﺸﻮﺩ‪ ،‬ﻭﻫﻮ ﺍﻟﺼﺤﺔ ﻟﻠﺠﻤﻴﻊ ﻣﻦ ﺧﻼﻝ ﺗﻘﺪﱘ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻣﺪﻋﻤﺔ ﺑﻨﻈﺎﻡ ﺟﻴﺪ ﻟﻺﺣﺎﻟﺔ ﻟﻠﻤﺴﺘﻮﻯ ﺍﻟﺜﺎﱐ ﻭﺍﻟﺜﺎﻟﺚ ﻣﻦ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ‪.‬‬

‫"‪
 '( )
 *+%‬‬
‫ﺍﳌﺮﺍﺟﻊ ﺍﻟﻌﺮﺑﻴﺔ‬
‫‪ .١‬ﺗﻘﺮﻳﺮ ﺍﳌﺴﺢ ﺍﻟﺪﳝﺠﺮﺍﰲ ‪.(DHS) ١٩٩٥‬‬
‫‪ .٢‬ﺗﻘﺮﻳﺮ ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ‪.١٩٩٩‬‬
‫‪ .٣‬ﺗﻘﺮﻳﺮ ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ‪ .٢٠٠٠‬ﻓﺎﻃﻤﺔ ﺍﻟﺰﻧﺎﰐ‪ ،‬ﻳﻨﺎﻳﺮ ‪ ٢٠٠١‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻜﺎﻥ – ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻠﺴﻜﺎﻥ‪.‬‬
‫‪ .٤‬ﺗﻘﺮﻳﺮ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪.١٩٩٩‬‬
‫‪ .٥‬ﺗﻘﺮﻳﺮ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪.٢٠٠٠‬‬
‫‪ .٦‬ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺘﻘﺮﻳﺮ ﺍﻟﺴﻨﻮﻱ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺝ ‪٠‬ﻡ‪٠‬ﻉ ‪.١٩٨٠‬‬
‫‪ .٧‬ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﺃ‪ ٠‬ﺩ‪ .‬ﳏﻤﻮﺩ ﳏﻤﺪ ﳏﻔﻮﻅ – ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺝ ‪٠‬ﻡ‪٠‬ﻉ ‪.١٩٨٠‬‬
‫‪ .٨‬ﺩﻟﻴﻞ ﺍﻟﻌﻤﻞ ﺑﺎﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ .‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪ ،‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ‬
‫ﻋﺎﻡ ‪.٢٠٠٠/٩٩‬‬
‫‪ .٩‬ﺍﻟﻜﺘﺎﺏ ﺍﻟﺬﻫﱯ – ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ‪ .١٩٨٦-١٩٣٦‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ – ﺝ‪.‬ﻡ‪.‬ﻉ‪.١٩٨٦ .‬‬
‫‪ .١٠‬ﻣﺒﺎﺭﻙ ﻭﺻﺤﺔ ﺍﻷﺳﺮﺓ ﺍﳌﺼﺮﻳﺔ‪ .‬ﺣﻘﺎﺋﻖ ﻭﺃﺭﻗﺎﻡ ‪ .١٩٩٥‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺝ‪.‬ﻡ‪.‬ﻉ‪.‬‬
‫‪ .١١‬ﲢﻠﻴﻞ ﻟﻮﺿﻊ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ .‬ﻣﻠﺨﺺ ﺗﻘﺮﻳﺮ ‪ -‬ﺇﺩﺍﺭﺓ ﺍﳊﺼﺮ – ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻜﺎﻥ ‪.١٩٩٩‬‬

‫‪٦٥‬‬
‫‪ .١٢‬ﳎﻠﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺍﻟﻌﺪﺩ "‪ "٣٠‬ﺳﺒﺘﻤﱪ ‪ ١٩٩٥‬ﺗﺼﺪﺭﻫﺎ ﺍﳉﻤﻌﻴﺔ ﺍﻟﻌﻠﻤﻴﺔ‬
‫ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺝ‪٠‬ﻡ‪٠‬ﻉ‪.‬‬
‫‪ .١٣‬ﺍﻟﺪﻟﻴﻞ ﺍﻻﺳﺘﺮﺷﺎﺩﻱ‪ :‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﳌﻌﺎﻫﺪ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ‪.١٩٩٦‬‬
‫‪ .١٤‬ﺗﻘﺮﻳﺮ ﺍﻟﺒﻨﻚ ﺍﻟﺪﻭﱄ ﻋﻦ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﻌﺎﳌﻴﺔ ﻳﻮﻟﻴﻮ ‪.١٩٩٣‬‬
‫‪ .١٥‬ﺗﻘﺮﻳﺮ ﻣﻨﻈﻤﺔ ﺃﻭﻛﺴﻔﺎﻡ ﻣﺎﻳﻮ ‪.١٩٩٥‬‬
‫‪ .١٦‬ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻷﻭﻟﻴﺔ ﰲ ﻣﺼﺮ ﺍﳌﺴﻮﺩﺓ ﺍﻷﻭﱃ ‪ – ١٩٩٧‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻜﺎﻥ ﺝ‪٠‬ﻡ‪٠‬ﻉ‪.‬‬
‫‪ .١٧‬ﳕﻮﺫﺝ ﻣﺼﺮﻱ ﺣﺪﻳﺚ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﻟﻘﺮﻥ ﺍﳊﺎﱄ‪ .‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴــﻜﺎﻥ ﺝ‪٠‬ﻡ‪٠‬ﻉ ‪.١٩٩٩‬‬
‫‪ .١٨‬ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳊﺎﻟﻴﺔ ﻭﻣﺪﻯ ﺗﻼﺅﻣﻬﺎ ﻣﻊ ﲣﺼﺺ ﻃﺐ ﺍﻷﺳــﺮﺓ‪ :‬ﻭﺭﻗﺔ ﻣﻘﺪﻣﺔ ﻣﻦ ﺩ‪٠‬‬
‫ﺣﺴﲎ ﺗـﻤﺎﻡ ﺭﺋﻴﺲ ﺍﻹﺩﺍﺭﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ‪ -‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫‪.١٩٩٨‬‬
‫‪ .١٩‬ﺗﻘﺮﻳﺮ ﻋﻦ ﺇﳒﺎﺯﺍﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻟﺘﺤﻘﻴﻖ ﺃﻫﺪﺍﻑ ﻋﻘﺪ ﲪﺎﻳﺔ ﺍﻟﻄﻔﻞ ﺍﳌﺼﺮﻱ )‪– ١٩٨٩‬‬
‫‪ .(١٩٩٩‬ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﺮﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ‪ ،‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ‪.٢٠٠٠‬‬
‫‪ .٢٠‬ﻗﻀﻴﺔ ﺍﻟﻄﻔﻮﻟﺔ ﰲ ﻣﺼﺮ – ﺣﺎﺿﺮﻫﺎ ﻭﻣﺴﺘﻘﺒﻠﻬﺎ‪ .‬ﺗﻘﺮﻳﺮ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﺮﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ‬
‫ﻭﺍﻟﻄﻔﻮﻟﺔ – ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ‪.٢٠٠٠‬‬
‫‪ .٢١‬ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ – ﺍﻟﻮﺍﻗﻊ ﻭﺍﻹﳒﺎﺯﺍﺕ ﻭﺍﻟﺘﺤﺪﻳﺎﺕ‪ .‬ﻭﺭﻗﺔ ﻣﻘﺪﻣﺔ ﰲ ﻣﺆﲤﺮ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻷﺳﺎﺳﻴﺔ – ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ‪.٢٠٠٠‬‬
‫‪ .٢٢‬ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪ .‬ﳎﻠﺔ ﺗﺼﺪﺭ ﻋﻦ ﻗﻄﺎﻉ ﺍﻟﺴﻜﺎﻥ ﻭﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫ﻭﺍﳌﺸﺮﻭﻉ ﺍﻹﻋﻼﻣﻲ ﻟﺪﻋﻢ ﺣﻘﻮﻕ ﺍﳌﺮﺃﺓ ﺍﻟﺼﺤﻴﺔ ﺃﻋﺪﺍﺩ ‪.٢٠٠١ ،١٤ ،١٣ ،١٠ ،٩ ،٨ ،٧‬‬
‫‪ .٢٣‬ﺗﻘﺮﻳﺮ ﻋﻦ ﺇﳒﺎﺯﺍﺕ ﻣﺸﺮﻭﻉ ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ‪ :‬ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪ ٢٠٠١ -١٩٩٦‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻜﺎﻥ )‪.(٢٠٠٢‬‬
‫‪ .٢٤‬ﻣﺼﺮﻳﻮﻥ ﺃﺻﺤﺎﺀ ﰲ ﳎﺘﻤﻊ ﺻﺤﻲ‪ .‬ﻛﺘﻴﺐ ﺃﻋﺪ ﲢﺖ ﺇﺷﺮﺍﻑ ﺃ‪ ٠‬ﺩ‪ .‬ﺇﲰﺎﻋﻴﻞ ﺳﻼﻡ‪ ،‬ﻟﻺﻋﻼﻥ ﻋﻦ‬
‫ﻣﺒﺎﺩﺭﺓ "ﻣﺼﺮﻳﻮﻥ ﺃﺻﺤﺎﺀ ‪ "٢٠١٠‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ‪.٢٠٠١‬‬
‫‪ .٢٥‬ﺩﻟﻴﻞ ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪ .‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ‬
‫‪.١٩٩٧‬‬
‫‪ .٢٦‬ﻧﻈﺎﻡ ﺿﻤﺎﻥ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺑﻮﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ .‬ﺩﻟﻴﻞ ﻋﻤﻞ ‪– ١٩٩٩‬‬
‫ﻣﺸﺮﻭﻉ ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬
‫‪ .٢٧‬ﺍﻟﻌﻤﻠﻴﺔ ﺍﻹﺩﺍﺭﻳﺔ ﰲ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ‪ .‬ﺩﻟﻴﻞ ﻋﻤﻞ ﳌﺪﻳﺮﻱ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ‪١٩٩٢‬‬
‫ﻗﻄﺎﻉ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﻌﺎﳌﻴﺔ‪.‬‬

‫‪٦٦‬‬
‫ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ – ﺑﺮﻧﺎﻣﺞ‬.‫ ﺩﻟﻴﻞ ﻋﻤﻞ ﻧﻈﺎﻡ ﺍﻹﺣﺎﻟﺔ ﻟﻠﻌﺎﻣﻠﲔ ﺑﺎﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‬.٢٨
.١٩٩٦ ‫ﺭﻓﻊ ﻛﻔﺎﺀﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‬
.١٩٩٨ ‫ ﳎﻠﺲ ﺍﻟﺴﻜﺎﻥ ﺍﻟﺪﻭﱄ‬،‫ ﻫﺎﻟﺔ ﺍﻟﺸﺎﻓﻌﻲ‬.‫ ﺍﻟﻨﺶﺀ ﻭﺳﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﻟﺔ ﰲ ﻣﺼﺮ‬.٢٩
‫ ﺭﺋﻴﺲ‬،‫ ﻋﺼﻤﺖ ﻣﻨﺼﻮﺭ‬.‫ ﻭﺭﻗﺔ ﻣﻘﺪﻣﺔ ﻣﻦ ﺩ‬.‫ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﺸﺒﺎﺏ‬.٣٠
.٢٠٠٢ ‫ﺍﻹﺩﺍﺭﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ – ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫ﺘﻤﻊ‬‫ ﳎﻠﺔ ﺍ‬.‫ ﺳﻌﺪ ﺍﻟﺪﻳﻦ ﺇﺑﺮﺍﻫﻴﻢ‬.‫ﺩ‬.‫ ﺃ‬.‫ ﻣﻘﺎﻟﺔ ﺍﻓﺘﺘﺎﺣﻴﺔ‬.‫ ﺍﻟﺼﻠﻒ ﺍﻟﺬﻛﻮﺭﻱ ﻟﻠﻤﺸﺮﻭﻉ ﺍﳌﺼﺮﻱ‬.٣١
.١٩٩٩ ‫ ﺍﻟﺴﻨﺔ ﺍﻟﺜﺎﻧﻴﺔ( ﻳﻨﺎﻳﺮ‬-٨٥ ‫ ﻳﺼﺪﺭﻫﺎ ﻣﺮﻛﺰ ﺍﺑﻦ ﺧﻠﺪﻭﻥ ﻟﻠﺘﻨﻤﻴﺔ)ﺍﻟﻌﺪﺩ‬.‫ﺍﳌﺪﱐ‬
.‫ ﺟﻮﺍﻧﺐ ﻣﻦ ﺍﻟﻈﺮﻭﻑ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺍﶈﻴﻄﺔ ﺑﺼﺤﺔ ﺍﳌﺮﺃﺓ ﺍﻹﳒﺎﺑﻴﺔ ﰲ ﺭﻳﻒ ﻣﺼﺮ‬.‫ ﺍﳌﻌﺎﻧﺎﺓ ﺍﻟﺼﺎﻣﺘﺔ‬.٣٢
.١٩٩٨ ‫ ﳎﻠﺲ ﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﻴﻮﻧﻴﺴﻒ‬.‫ﻫﻨﺪ ﺃﺑﻮ ﺍﻟﺴﻌﻮﺩ ﺧﻄﺎﺏ‬
‫ ﺍﺗﺼﺎﻻﺕ ﺷﺨﺼﻴﺔ ﺑﺒﻌﺾ ﺍﻟﻌﺎﻣﻠﲔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺍﳌﺴﺌﻮﻟﲔ ﻋﻦ ﺍﻟﻘﻄﺎﻋﺎﺕ‬.٣٣
.‫ﺍﻟﺼﺤﻴﺔ ﺍﻟﻔﻨﻴﺔ‬
Other References
1. WHO, UNICEF. Primary Health Care, Alma Ata. 1978.
2. Managerial Process for National Health Development. Guiding Principles.
1981.
3. MOH, “ Strategy for Health for all by the year 2000”. ARE, 1989.
4. El Zanaty F., Kumar N., Berman. P. ”The Egyptian Household Health care
utilization and expenditure survey. (Results from the first round).1995.
5. A New Egyptian Health Care Model for the 21st Century. Egypt Health
Sector Reform. 1998.
6. Health Care Finance in Egypt. MOH, Cost Recovery for Health Project,
1993.
7. Egypt Health Sector Reform Program”. Draft Document. 1997, MOHP.
8. Integrated Management of Childhood Illness- IMIC- Information 2000.
WHO, Geneva.
9. Health and Survival” Situational Analysis of health services and its impact
on child health. Document prepared by Dr. Nagwa Khallaf.
10. Renewal of the health – for – all strategy” Derek Yach. World Health
Forum. Volume 17, Number 4, 1996. WHO, Geneva.
11. National Adolescents strategy. Population and family planning sector,
MOHP, 2001.
12. Adolescence and state policy in Egypt. Halla E. Shafey. Population
Council, 1998.

٦٧
13. Transitions to Adulthood”. A national survey of Egyptian Adolescents.
Population Council, AUC, HIPH. Alexandria University and public health
department, Assuit University, 1999.
14. Progress in child and Adolescent health and development. WHO, Geneva,
1999.
15. National Maternal Mortality Study. HM/HC Project, MOHP & JSI, 2000.
16. Assessment of the concepts of the curricula of medical and nursing
colleges of Egyptian universities (on family health concept and approach).
Report on the study. Conducted by the Egyptian Association of
Community Medicine, 1999.

٦٨
 ‫"‪
 '( )
 ,-‬‬
‫‪ .١‬ﻣﺮﺳﻮﻡ ﺑﺈﻧﺸﺎﺀ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻮﻣﻴﺔ ﻋﺎﻡ ‪١٩٣٦‬‬

‫‪٦٩‬‬
‫‪ .٢‬ﺍﳊﺎﺟﺔ ﻟﺴﻴﺎﺳﺔ ﺻﺤﻴﺔ ﻃﻮﻳﻠﺔ ﺍﳌﺪﻯ ‪١٩٣٦‬‬

‫‪٧٠‬‬
 ‫‪ .٣‬ﺍﳍﻴﻜﻞ ﺍﻟﺘﻨﻈﻴﻤﻲ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻋﺎﻡ ‪١٩٣٦‬‬

‫ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ‬

‫ﻭﻛﻴﻞ ﺍﻟﻮﺯﺍﺭﺓ‬ ‫ﻭﻛﻴﻞ ﺍﻟﻮﺯﺍﺭﺓ‬

‫‪٧١‬‬
‫ﺇﺩﺍﺭﺓ ﺗﻨﻈﻴﻢ‬ ‫ﺇﺩﺍﺭﺓ ﺍﳌﺮﺍﻓﻖ‬ ‫ﺇﺩﺍﺭﺓ ﺍﻟﺼﺤﺔ‬ ‫ﺇﺩﺍﺭﺓ ﻣﻘﺎﻭﻣﺔ‬ ‫ﺇﺩﺍﺭﺓ‬
‫ﺇﺩﺍﺭﺓ ﺍ‪‬ﺎﺭﻱ‬ ‫ﺇﺩﺍﺭﺓ ﺍﻟﺒﻠﺪﻳﺎﺕ‬
‫ﻣﺼﺮ‬ ‫ﺍﻟﻘﺮﻭﻳﺔ‬ ‫ﺍﻟﻌﺎﻣﺔ‬ ‫ﺍﻷﻭﺑﺌﺔ‬ ‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬

‫ﻗﺴﻢ ﺍﳌﻨﺎﺯﻝ ﻏﲑ‬

‫ﺍﻟﺼﺤﻴﺔ ﻭﺍﶈﻼﺕ‬ ‫ﻗﺴﻢ ﻣﻘﺎﻭﻣﺔ‬
‫ﻗﺴﻢ ﻣﺮﺍﻗﺒﺔ‬ ‫ﻗﺴﻢ ﺭﻋﺎﻳﺔ‬ ‫ﻗﺴﻢ ﺍﻷﻣﺮﺍﺽ‬
‫ﺍﳌﻘﻠﻘﺔ ﻟﻠﺮﺍﺣﺔ‬ ‫ﺍﳊﺸﺮﺍﺕ‬
‫ﺍﻷﻏﺬﻳﺔ‬ ‫ﺍﻟﻄﻔﻞ‬ ‫ﺍﳌﺘﻮﻃﻨﺔ‬
‫ﻭﺍﳌﻀﺮﺓ ﺑﺎﻟﺼﺤﺔ‬ ‫ﻭﺍﳊﻴﻮﺍﻧﺎﺕ ﺍﻟﻀﺎﺭﺓ‬
‫ﻭﺍﳋﻄﺮﺓ‬
 ‫‪ .٤‬ﺍﳍﻴﻜﻞ ﺍﻟﺘﻨﻈﻴﻤﻲ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻋﺎﻡ ‪١٩٨٥‬‬

‫ﺃ‪.‬ﻉ‬
‫ﻣﺮﻛﺰ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻭﺍﻟﺘﻮﺛﻴﻖ‬

‫ﳎﻠﺲ ﺍﻟﺼﺤﺔ‬ ‫ﺍﳌﻜﺎﺗﺐ ﺍﻟﻄﺒﻴﺔ ﺑﺎﳋﺎﺭﺝ‬

‫ﺃ‪.‬ﻉ‬ ‫ﺍﻟﻮﺯﻳﺮ‬ ‫ﺃ‪.‬ﻉ‬

‫ﻟﻠﻤﺘﺎﺑﻌﺔ ﻭﺍﻟﺮﻗﺎﺑﺔ‬
‫ﻟﺸﺌﻮﻥ ﺍﻻﺗﺼﺎﻝ‬
‫ﺃ‪.‬ﻉ‬
‫ﺃ‪.‬ﻉ‬ ‫ﻟﺸﺌﻮﻥ ﺍﳌﺪﻳﺮﻳﺎﺕ‬
‫ﻟﻠﺸﺌﻮﻥ ﺍﻟﻘﺎﻧﻮﻧﻴﺔ‬ ‫ﺃ‪.‬ﻡ‬
‫ﻟﺸﺌﻮﻥ ﻣﻜﺘﺐ ﺍﻟﻮﺯﻳﺮ‬ ‫ﺃ‪.‬ﻉ‬
‫ﺃ‪.‬ﻉ‬ ‫ﻟﻸﻣﻦ‬
‫ﳋﺪﻣﺔ ﺍﳌﻮﺍﻃﻨﲔ‬
‫ﺃ‪.‬ﻉ‬
‫ﺃ‬ ‫ﻭﻛﻴﻞ ﺍﻟﻮﺯﺍﺭﺓ‬ ‫ﺷﺌﻮﻥ ﺍﳍﻴﺌﺎﺕ ﻭﺍﻟﺸﺮﻛﺎﺕ‬
‫ﻟﻠﻌﻼﻗﺎﺕ ﺍﻟﻌﺎﻣﺔ‬
‫ﻟﺸﺌﻮﻥ ﺍﻟﺪﻳﻮﺍﻥ‬
‫ﺃ‪.‬ﻉ‬
‫ﻟﺸﺌﻮﻥ ﺍﳋﻄﺔ‬

‫‪٧٢‬‬
‫ﺃ‪.‬ﻡ‬ ‫ﺃ‪.‬ﻡ‬ ‫ﺃ‪.‬ﻡ‬ ‫ﺃ‪.‬ﻡ‬ ‫ﺃ‪.‬ﻡ‬ ‫ﺃ ‪.‬ﻡ‬ ‫ﺃ‪.‬ﻡ‬ ‫ﺃ‪.‬ﻡ‬
‫ﻟﺸﺌﻮﻥ ﺍﻟﺼﻴﺪﻟﺔ‬ ‫ﺷﺌﻮﻥ ﻃﺐ ﺍﻷﺳﻨﺎﻥ‬ ‫ﺍﻟﺘﻨﻤﻴﺔ ﺍﻹﺩﺍﺭﻳﺔ‬ ‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﺍﳌﻜﻤﻠﺔ‬ ‫ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﻌﺎﺟﻠﺔ‬ ‫ﺍﻟﻮﻗﺎﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺻﺤﺔ ﺍﻷﺳﺮﺓ‬ ‫ﻟﻠﺸﺌﻮﻥ ﺍﻟﻮﻗﺎﺋﻴﺔ‬ ‫ﺷﺌﻮﻥ ﺍﻟﺘﻨﻤﻴﺔ ﻭﺍﻟﺒﺤﻮﺙ‬

‫ﺃ ‪.‬ﻉ‬ ‫ﺃ‪.‬ﻉ‬ ‫ﺃ‪.‬ﻉ‬ ‫ﺃ ‪.‬ﻉ‬ ‫ﺃ‪.‬ﻉ‬ ‫ﺃ ‪.‬ﻉ‬

‫ﺃ‪ .‬ﻉ‬ ‫ﻟﻠﺘﻨﻈﻴﻢ ﻭﺍﻹﺩﺍﺭﺓ‬ ‫ﻟﻠﻤﻌﺎﻣﻞ‬ ‫ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﻟﻌﺎﺟﻠﺔ‬ ‫ﻟﻠﺮﻋﺎﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﰲ‬ ‫ﳌﻜﺎﻓﺤﺔ ﺍﻷﻣﺮﺍﺽ‬ ‫ﻟﻠﺒﺤﻮﺙ‬
‫ﻟﻠﺘﻤﻮﻳﻦ ﺍﻟﻄﱯ‬ ‫ﺍﳊﻀﺮ‬ ‫ﺍﳌﻌﺪﻳﺔ‬
‫ﺃ‪.‬ﻉ‬ ‫ﺃ ‪.‬ﻉ‬
‫ﺃ ‪.‬ﻉ‬ ‫ﺃ‪.‬ﻉ‬ ‫ﺃ ‪.‬ﻉ‬ ‫ﺃ‪.‬ﻉ‬
‫ﻟﻠﺘﻤﺮﻳﺾ‬ ‫ﺗﻨﻤﻴﺔ ﺍﻟﻘﻮﻯ‬
‫ﺃ‪.‬ﻉ‬ ‫ﻟﺸﺌﻮﻥ ﺍﻷﻓﺮﺍﺩ‬ ‫ﻟﻠﻄﺐ ﺍﻟﻌﻼﺟﻲ‬ ‫ﻟﻠﺮﻋﺎﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﰲ ﺍﻟﺮﻳﻒ‬ ‫ﻟﺼﺤﺔ ﺍﻟﺒﻴﺌﺔ‬ ‫ﺍﻟﺒﺸﺮﻳﺔ‬
‫ﻟﻸﻣﺎﻧﺔ ﺍﻟﻌﺎﻣﺔ‬ ‫ﺃ‪.‬ﻉ‬
‫ﺃ‪.‬ﻉ‬ ‫ﺃ ‪.‬ﻉ‬ ‫ﺃ‪.‬ﻉ‬ ‫ﺃ ‪.‬ﻉ‬
‫ﺃ‬ ‫ﻟﻠﺨﺪﻣﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‬
‫ﺍﻟﻄﺒﻴﺔ‬ ‫ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻨﻮﻋﻴﺔ‬ ‫ﻟﺮﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ‬ ‫ﻟﻠﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‬ ‫ﺍﻟﻌﻼﻗﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻟﺘﻜﻠﻴﻒ‬ ‫ﻭﺍﻟﻄﻔﻮﻟﺔ‬ ‫ﻭﺍﻟﺼﻨﺎﻋﻴﺔ‬ ‫ﺍﳋﺎﺭﺟﻴﺔ‬
‫ﺃ‬
‫ﺃ‪.‬ﻉ‬ ‫ﺃ ‪.‬ﻉ‬ ‫ﺃ‪.‬ﻉ‬ ‫ﺃ ‪.‬ﻉ‬
‫ﺍﻵﺷﻌﺔ‬
‫ﻟﻠﻤﺆﺳﺴﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ‬ ‫ﻟﺘﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‬ ‫ﻟﱪﺍﻣﺞ ﺍﻟﺘﻐﺬﻳﺔ‬ ‫ﻟﻠﺜﻘﺎﻓﺔ ﻭﺍﻹﻋﻼﻡ‬
‫ﺍﳊﻜﻮﻣﻴﺔ‬ ‫ﺍﻟﺼﺤﻲ‬
‫ﺃ‬ ‫ﺃ‪.‬ﻉ‬
‫ﺃ ‪.‬ﻉ‬
‫ﺍﻟﺒﺤﻮﺙ ﻭﺧﺪﻣﺎﺕ‬ ‫ﳌﻜﺎﻓﺤﺔ ﻧﺎﻗﻼﺕ ﺍﻷﻣﺮﺍﺽ‬
‫ﺍﳍﻨﺪﺳﺔ ﺍﻟﻄﺒﻴﺔ‬ ‫ﺃ‪.‬ﻉ‬ ‫ﻟﻠﺼﺤﺔ ﺍﳌﺪﺭﺳﻴﺔ‬
‫ﻟﻠﻤﺠﺎﻟﺲ ﺍﻟﻄﺒﻴﺔ‬
‫ﺃ‬ ‫ﺃ ‪.‬ﻉ‬ ‫ﺃ‪.‬ﻉ‬
‫ﺍﻟﺘﺮﺍﺧﻴﺺ ﺍﻟﻄﺒﻴﺔ‬
‫ﳌﻜﺎﻓﺤﺔ ﺍﻷﻣﺮﺍﺽ‬ ‫ﻟﺸﺌﻮﻥ ﻣﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﳌﺘﻮﻃﻨﺔ‬ ‫ﺍﳊﻤﻴﺎﺕ‬
 ١٩٩٨ ‫ ﺍﳍﻴﻜﻞ ﺍﻟﺘﻨﻈﻴﻤﻲ ﻟﺪﻳﻮﺍﻥ ﻋﺎﻡ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬.٥

‫ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬

@æì÷“Ûa@ÊbĐÓ
@òíbÇ‹Ûa@ÊbĐÓ
@òí×‹¾a@ñŠa†⁄a @æì÷’@ÊbĐÓ @æb؏Ûa@ÊbĐÓ @òíbÇ‹Ûa@ÊbĐÓ @òîöbÓìÛa @k튇nÛa@ÊbĐÓ @æì÷’@ÊbĐÓ
@òîz—Ûa
òßbÈÛa@òãbßÿÛ òîz—Ûa@áîÛbÓþa @ñ‹Žþa@áîÄämë òîuýÈÛa @a‹ßþaë tìzjÛaë ‹íŒìÛa@knØß
í‹ànÛaë
òä€ìn¾a

@ÁîĐƒnÜÛ@òí×‹¾a@ñŠa†⁄a @æì÷“Û@òí×‹¾a@ñŠa†⁄a @ òíbÇ‹ÜÛ@òí×‹¾a@ñŠa†⁄a @ òîàänÛ@òí×‹¾a@ñŠa†⁄a @ knØàÜÛ@òí×‹¾a@ñŠa†⁄a

٧٣
@ÝßbÈàÜÛ@òí×‹¾a@ñŠa†⁄a
@áíìÔnÛaë@òÈibn¾aë @òÛ‡î—Ûa òÜßbØn¾a@òîz—Ûa @òí‹“jÛa@ôìÔÛa @pbÇë‹“¾aë@ÐÛa

@pb߇©@òí×‹¾a@ñŠa†⁄a @æì÷“Û@òí×‹¾a@ñŠa†⁄a @æì÷“Û@òí×‹¾a@ñŠa†⁄a @ òíbÇ‹ÜÛ@òí×‹¾a@ñŠa†⁄a @tìzjÜÛ@òí×‹¾a@ñŠa†⁄a @ ”înÐnÜÛ@òí×‹¾a@ñŠa†⁄a

@ñ‹Žþa@áîÄäm@ÝöbŽëë æbäŽþa@k€ @ò÷îjÛa @òÜubÈÛaë@òu‹¨a @òîz—Ûa@òîàänÛaë òÈibn¾aë

@kĐÜÛ@òí×‹¾a@ñŠa†⁄a @æì÷“ÜÛ@òí×‹¾a@ñŠa†⁄a @âýÇfiÛ@òí×‹¾a@ñŠa†⁄a

@ñc‹¾a@òz—Û@òßbÈÛa@ñŠa†⁄a @í‹ànÜÛ@òí×‹¾a@ñŠa†⁄a
@ïuýÈÛa @òîöbÓìÛa ïãb؏Ûaë@ïz—Ûa

@×‹¾@òí×‹¾a@ñŠa†⁄a
@ a‹ßÿÛ@òí×‹¾a@ñŠa†⁄a
@ˆb¦aë@ÕîqìnÛaë@pbßìÜȾa
òä€ìn¾a
@Ša‹ÔÛa
٧٤
 ‫  
‪:‬‬
‫        ‬
‫('&‪   ! "#$ %‬‬

‫‪'34 567/ – "0/ – /01 "2  - )*
  +   ,-‬‬
‫ﺟﺪﻭﻝ )‪ (١-٣‬ﺑﻴﺎﻥ ﺑﻌﺪﺩ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺍﻟﻘﺎﺋﻤﺔ ﺑﺎﻟﻌﻤﻞ ﻋﻦ ﻋﺎﻣﻰ ‪٢٠٠١/٩١‬‬
‫‪٢٠٠١‬‬ ‫‪١٩٩١‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﺰﻳﺎﺩﺓ ﰲ ﻫﺬﻩ ﺍﻟﻔﺘﺮﺓ‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫ﺍﳌﻌﺪﻝ‪١٠ /‬ﺍﻻﻑ ﻣﻦ ﺍﻟﺴﻜﺎﻥ‬ ‫ﺍﻟﻌﺪﺩ‬ ‫ﺍﳌﻌﺪﻝ‪١٠ /‬ﺍﻻﻑ ﻣﻦ ﺍﻟﺴﻜﺎﻥ‬ ‫ﺍﻟﻌﺪﺩ‬
‫‪٢٩,٠٩‬‬ ‫‪٦,١٨‬‬ ‫‪٤٠,٤٢٢‬‬ ‫‪٥,٨‬‬ ‫‪٣١,٣١٢‬‬ ‫ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﻮﻥ‬
‫‪٢,٣٧-‬‬ ‫‪٠,٨٨‬‬ ‫‪٥,٧٧٠‬‬ ‫‪١,١١‬‬ ‫‪٥,٩١٠‬‬ ‫ﺃﻃﺒﺎﺀ ﺍﻷﺳﻨﺎﻥ‬

‫‪٧٥‬‬
‫‪١٣,٦٤‬‬ ‫‪٠,٥٢‬‬ ‫‪٣,٣٧٥‬‬ ‫‪٠,٥٦‬‬ ‫‪٢,٩٧٠‬‬ ‫ﺍﻟﺼﻴﺎﺩﻟﺔ‬
‫‪٦٦,٩٣‬‬ ‫‪١٢,٨٢‬‬ ‫‪٩٣,٨٧٩‬‬ ‫‪٩,٤٠‬‬ ‫‪٥٠,٢٤٧‬‬ ‫ﻫﻴﺌﺔ ﺍﻟﺘﻤﺮﻳﺾ‬
‫ﻣﺼﺪﺭ ﺍﻟﺒﻴﺎﻥ‪ :‬ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‬

‫ﺟﺪﻭﻝ )‪ (٢-٣‬ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺍﳌﻘﻴﺪﺓ ﻋﻦ ﻋﺎﻣﻲ ‪٢٠٠١/٩١‬‬

‫‪٢٠٠١‬‬ ‫‪١٩٩١‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﺰﻳﺎﺩﺓ ﰲ ﻫﺬﻩ ﺍﻟﻔﺘﺮﺓ‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫ﺍﳌﻌﺪﻝ‪١٠ /‬ﺍﻻﻑ ﻣﻦ ﺍﻟﺴﻜﺎﻥ‬ ‫ﺍﻟﻌﺪﺩ‬ ‫ﺍﳌﻌﺪﻝ‪١٠ /‬ﺍﻻﻑ ﻣﻦ ﺍﻟﺴﻜﺎﻥ‬ ‫ﺍﻟﻌﺪﺩ‬

‫‪٤٢,١‬‬ ‫‪٨,٩٩‬‬ ‫‪٥٨,٨٢٩‬‬ ‫‪٧,٧٤‬‬ ‫‪٤١,٤١٢‬‬ ‫ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﻮﻥ‬

‫‪١,٨‬‬ ‫‪١,١٧‬‬ ‫‪٧,٦٣١‬‬ ‫‪١,٤٠‬‬ ‫‪٧,٤٩٥‬‬ ‫ﺃﻃﺒﺎﺀ ﺍﻷﺳﻨﺎﻥ‬
‫‪١٩,٢‬‬ ‫‪٠,٦٦‬‬ ‫‪٤,٣٤٥‬‬ ‫‪٠,٦٨‬‬ ‫‪٣,٦٤٥‬‬ ‫ﺍﻟﺼﻴﺎﺩﻟﺔ‬
‫‪٧٠,٦‬‬ ‫‪١٤,٣٦‬‬ ‫‪٩٣,٩٣١‬‬ ‫‪١٠,٢٩‬‬ ‫‪٥٥,٠٥٢‬‬ ‫ﻫﻴﺌﺔ ﺍﻟﺘﻤﺮﻳﺾ‬

‫ﻣﺼﺪﺭ ﺍﻟﺒﻴﺎﻥ‪ :‬ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‬

 ‫ﺟﺪﻭﻝ )‪ (٣-٣‬ﺍﳌﻘﻴﺪﻳﻦ ﺣﺴﺐ ﺍﻟﻮﺿﻊ ﺍﻟﻮﻇﻴﻔﻲ ﻭﺍﳌﺴﻤﻰ ﺍﻟﻮﻇﻴﻔﻲ ﻋﻦ ﻋﺎﻣﻲ ‪٢٠٠١/٩١‬‬
‫‪٢٠٠١‬‬ ‫‪١٩٩١‬‬
‫ﻏﲑ ﻗﺎﺋﻢ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﻟﻌﻤﺎﻟﺔ ﺍﻟﻔﻌﻠﻴﺔ‬ ‫ﻏﲑ ﻗﺎﺋﻢ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﻟﻌﻤﺎﻟﺔ ﺍﻟﻔﻌﻠﻴﺔ‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫ﺍﳉﻤﻠﺔ‬ ‫ﺍﳉﻤﻠﺔ‬
‫ﺍﻟﻨﺴﺒﺔ‬ ‫ﺍﻟﻌﺪﺩ‬ ‫ﺍﻟﻨﺴﺒﺔ‬ ‫ﺍﻟﻌﺪﺩ‬ ‫ﺍﻟﻨﺴﺒﺔ‬ ‫ﺍﻟﻌﺪﺩ‬ ‫ﺍﻟﻨﺴﺒﺔ‬ ‫ﺍﻟﻌﺪﺩ‬
‫‪٥٨,٨٢٩‬‬ ‫‪٣١,٣‬‬ ‫‪١٨,٤٠٧‬‬ ‫‪٦٨,٧‬‬ ‫‪٤٠,٤٢٢‬‬ ‫‪٤١,٤١٢‬‬ ‫‪٢٤,٤‬‬ ‫‪١٠,١٠٠‬‬ ‫‪٧٥,٦‬‬ ‫‪٣١,٣١٢‬‬ ‫ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﻮﻥ‬
‫‪٧,٦٣١‬‬ ‫‪٢٤,٤‬‬ ‫‪١,٨٦١‬‬ ‫‪٧٥,٦‬‬ ‫‪٥,٧٧٠‬‬ ‫‪٧,٤٩٥‬‬ ‫‪٢١,١‬‬ ‫‪١,٥٨٥‬‬ ‫‪٧٨,٩‬‬ ‫‪٥,٩١٠‬‬ ‫ﺃﻃﺒﺎﺀ ﺍﻷﺳﻨﺎﻥ‬
‫‪٤,٣٤٥‬‬ ‫‪٢٢,٣‬‬ ‫‪٩٧٠‬‬ ‫‪٧٧,٧‬‬ ‫‪٣,٣٧٥‬‬ ‫‪٣٦٤٥‬‬ ‫‪١٨,٥‬‬ ‫‪٦٧٥‬‬ ‫‪٨١,٥‬‬ ‫‪٢,٩٧٠‬‬ ‫ﺍﻟﺼﻴﺎﺩﻟﺔ‬
‫‪٩٣,٩٣١‬‬ ‫‪١٠,٧‬‬ ‫‪١٠,٠٥٢‬‬ ‫‪٨٩,٣‬‬ ‫‪٨٣,٨٧٩‬‬ ‫‪٥٥,٠٥٤‬‬ ‫‪٨,٧‬‬ ‫‪٤,٨٠٧‬‬ ‫‪٩١,٣‬‬ ‫‪٥٠,٢٤٧‬‬ ‫ﻫﻴﺌﺔ ﺍﻟﺘﻤﺮﻳﺾ‬
‫ﻣﺼﺪﺭ ﺍﻟﺒﻴﺎﻥ‪ :‬ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‬

‫ﺟﺪﻭﻝ )‪ (٤-٣‬ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﻮﻥ ﺣﺴﺐ ﺍﻟﺘﺨﺼﺺ‬

‫ﲨﻠﺔ‬
‫ﺍﳌﻌﺪﻝ ﳌﺴﺘﺨﺪﻣﻲ ﺍﳋﺪﻣﺔ‬ ‫ﻣﻘﻴﻢ ﲣﺼﺺ‬ ‫ﺃﺧﺼﺎﺋﻲ ‪ /‬ﻡ‪ .‬ﺃﺧﺼﺎﺋﻲ‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫ﺗﻮﺯﻳﻊ ﻧﺴﱮ ﺣﺴﺐ ﺍﻟﺘﺨﺼﺺ‬ ‫ﻋﺪﺩ‬
‫‪٤,٩‬‬ ‫‪١٤,٩‬‬ ‫‪٣,١٧٣‬‬ ‫‪٧٨٢‬‬ ‫‪٢,٣٩١‬‬ ‫ﺟﺮﺍﺣﺔ ﻋﺎﻣﺔ‬

‫‪٧٦‬‬
‫‪٠,١‬‬ ‫‪٠,٣‬‬ ‫‪٦٤‬‬ ‫‪٨‬‬ ‫‪٥٦‬‬ ‫ﺟﺮﺍﺣﺔ ﲡﻤﻴﻞ ﻭﺣﺮﻭﻕ‬
‫‪٠,١‬‬ ‫‪٠,٤‬‬ ‫‪٩١‬‬ ‫‪٣٣‬‬ ‫‪٥٨‬‬ ‫ﺟﺮﺍﺣﺔ ﺻﺪﺭ ﻭﻗﻠﺐ‬
‫‪٠,٠‬‬ ‫‪٠,١‬‬ ‫‪٣١‬‬ ‫‪٧‬‬ ‫‪٢٤‬‬ ‫ﺟﺮﺍﺣﺔ ﻣﺦ ﻭﺃﻋﺼﺎﺏ‬
‫‪١,٧‬‬ ‫‪٥,٢‬‬ ‫‪١,١٠٠‬‬ ‫‪٢٦٠‬‬ ‫‪٨٤٠‬‬ ‫ﺟﺮﺍﺣﺔ ﻣﺴﺎﻟﻚ ﺑﻮﻟﻴﺔ‬
‫‪١,٧‬‬ ‫‪٥,٢‬‬ ‫‪١,١١٣‬‬ ‫‪٣٤٦‬‬ ‫‪٧٦٧‬‬ ‫ﺟﺮﺍﺣﺔ ﻋﻈﺎﻡ‬
‫‪١,٨‬‬ ‫‪٥,٥‬‬ ‫‪١,١٧٤‬‬ ‫‪٣٣٨‬‬ ‫‪٨٣٦‬‬ ‫ﺟﺮﺍﺣﺔ ﺃﻧﻒ ﻭﺃﺫﻥ ﻭﺣﻨﺠﺮﺓ‬
‫‪٥,٧‬‬ ‫‪١٧,٧‬‬ ‫‪٣,٧٥٨‬‬ ‫‪١,٣٤٣‬‬ ‫‪٢,٤١٥‬‬ ‫ﺃﻣﺮﺍﺽ ﻧﺴﺎﺀ ﻭﻭﻻﺩﺓ‬
‫‪١,٧‬‬ ‫‪٥,٢‬‬ ‫‪١,٠٩٦‬‬ ‫‪٢٧٧‬‬ ‫‪٨١٩‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﻟﻌﻴﻮﻥ ﻭﺟﺮﺍﺣﺘﻬﺎ‬
‫‪٣,٥‬‬ ‫‪١٠,٩‬‬ ‫‪٢,٣١٨‬‬ ‫‪٥٩٦‬‬ ‫‪١,٧٢٢‬‬ ‫ﺃﻣﺮﺍﺽ ﺑﺎﻃﻨﺔ ﻋﺎﻣﺔ‬
‫‪٠,٥‬‬ ‫‪١,٤‬‬ ‫‪٢٩٥‬‬ ‫‪٨٥‬‬ ‫‪٢١٠‬‬ ‫ﺃﻣﺮﺍﺽ ﻗﻠﺐ ﻭﺃﻭﻋﻴﺔ ﺩﻣﻮﻳﺔ‬
‫‪٠,٥‬‬ ‫‪١,٥‬‬ ‫‪٣٢٠‬‬ ‫‪٥٨‬‬ ‫‪٢٦٢‬‬ ‫ﺃﻣﺮﺍﺽ ﻋﺼﺒﻴﺔ ﻭﻧﻔﺴﻴﺔ‬
‫‪٣,٧‬‬ ‫‪١١,٥‬‬ ‫‪٢,٤٥٠‬‬ ‫‪٦٢٣‬‬ ‫‪١,٨٢٧‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﻷﻃﻔﺎﻝ‬
‫‪١,١‬‬ ‫‪٣,٥‬‬ ‫‪٧٤٠‬‬ ‫‪٢٠٤‬‬ ‫‪٥٣٦‬‬ ‫ﺃﻣﺮﺍﺽ ﺻﺪﺭﻳﺔ‬
‫‪١,٦‬‬ ‫‪٤,٩‬‬ ‫‪١,٠٤٤‬‬ ‫‪٢٩٤‬‬ ‫‪٧٥٠‬‬ ‫ﺃﻣﺮﺍﺽ ﺟﻠﺪﻳﺔ‬
 ‫ﲨﻠﺔ‬
‫ﺍﳌﻌﺪﻝ ﳌﺴﺘﺨﺪﻣﻲ ﺍﳋﺪﻣﺔ‬ ‫ﻣﻘﻴﻢ ﲣﺼﺺ‬ ‫ﺃﺧﺼﺎﺋﻲ ‪ /‬ﻡ‪ .‬ﺃﺧﺼﺎﺋﻲ‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫ﺗﻮﺯﻳﻊ ﻧﺴﱮ ﺣﺴﺐ ﺍﻟﺘﺨﺼﺺ‬ ‫ﻋﺪﺩ‬
‫‪٠,١‬‬ ‫‪٠,٢‬‬ ‫‪٣٥‬‬ ‫‪١٢‬‬ ‫‪٢٣‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﻟﻐﺪﺩ‬
‫‪٠,٩‬‬ ‫‪٢,٩‬‬ ‫‪٦٠٨‬‬ ‫‪١٣٥‬‬ ‫‪٤٧٣‬‬ ‫ﺃﻣﺮﺍﺽ ﻣﺘﻮﻃﻨﺔ‬
‫‪١,٥‬‬ ‫‪٤,٨‬‬ ‫‪١,٠١٣‬‬ ‫‪٢٩٢‬‬ ‫‪٧٢١‬‬ ‫ﲣﺪﻳﺮ‬
‫‪٠,٥‬‬ ‫‪١,٦‬‬ ‫‪٣٤٢‬‬ ‫‪١٤٢‬‬ ‫‪٢٠٠‬‬ ‫ﺃﺷﻌﺔ ﺗﺸﺨﻴﺼﻴﺔ‬
‫‪٠,١‬‬ ‫‪٠,٣‬‬ ‫‪٦٣‬‬ ‫‪٣٤‬‬ ‫‪٢٩‬‬ ‫ﺃﺷﻌﺔ ﻋﻼﺟﻴﺔ‬
‫‪٠,٦‬‬ ‫‪٢,٠‬‬ ‫‪٤٢٠‬‬ ‫‪١٣٧‬‬ ‫‪٢٨٣‬‬ ‫ﻃﺐ ﻋﻼﺝ ﻃﺒﻴﻌﻲ‬
‫‪٣٢,٥‬‬ ‫‪١٠٠,٠‬‬ ‫‪٢١,٢٤٨‬‬ ‫‪٦,٠٠٦‬‬ ‫‪١٥,٢٤٢‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫ﺍﳌﻌﺪﻝ ﻟﻜﻞ ‪ ١٠٠‬ﺃﻟﻒ ﻣﻦ ﻣﺴﺘﺨﺪﻣﻲ ﺍﳋﺪﻣﺔ ﻣﻦ ﺍﻟﺴﻜﺎﻥ‬

‫ﺟﺪﻭﻝ )‪ (٥-٣‬ﻫﻴﺌﺔ ﺍﻟﺘﻤﺮﻳﺾ ﺣﺴﺐ ﺍﳌﺴﻤﻰ ﺍﻟﻮﻇﻴﻔﻲ‬

‫ﻗﺎﺋﻢ‬ ‫ﻣﻘﻴﺪ‬
‫ﺍﻟﺒﻴﺎﻥ‬
‫ﺍﻟﻨﺴﺒﺔ‬ ‫ﺍﻟﻌﺪﺩ‬ ‫ﺍﻟﻨﺴﺒﺔ‬ ‫ﺍﻟﻌﺪﺩ‬

‫‪٧٧‬‬
‫‪٢,٣‬‬ ‫‪١,٨٩٧‬‬ ‫‪٢,٥‬‬ ‫‪٢,٣٦٢‬‬ ‫ﻣﺸﺮﻓﺎﺕ ﲤﺮﻳﺾ‬
‫‪١,٢‬‬ ‫‪١,٠٣٠‬‬ ‫‪١,٣‬‬ ‫‪١,٢٣١‬‬ ‫ﻓﻨﻴﻮ ﲤﺮﻳﺾ‬
‫‪٠,٤‬‬ ‫‪٣١٣‬‬ ‫‪٠,٤‬‬ ‫‪٣٣٢‬‬ ‫ﺣﻜﻴﻤﺎﺕ ﻭﳑﺮﺿﺎﺕ‬
‫‪٩٠,٠‬‬ ‫‪٧٥,٤٦٤‬‬ ‫‪٩٠,١‬‬ ‫‪٨٤,٦٠٠‬‬ ‫ﻧﻈﺎﻡ ﺛﻼﺙ ﺳﻨﻮﺍﺕ‬
‫‪٤,٣‬‬ ‫‪٣,٦٣٢‬‬ ‫‪٤,١‬‬ ‫‪٣,٨٢٦‬‬ ‫ﻣﺴﺎﻋﺪﺍﺕ ﳑﺮﺿﺎﺕ ﻧﻈﺎﻡ ﺍﻟﺴﻨﺔ ﻭﺍﻟﻨﺼﻒ‬
‫‪٠,٨‬‬ ‫‪٦٦٩‬‬ ‫‪٠,٨‬‬ ‫‪٧٠٦‬‬ ‫ﺍﻟﺰﺍﺋﺮﺍﺕ ﺍﻟﺼﺤﻴﺎﺕ‬
‫‪١,٠‬‬ ‫‪٨٧٤‬‬ ‫‪٠,٩‬‬ ‫‪٨٧٤‬‬ ‫ﳑﺮﺿﺎﺕ ﺑﺎﳋﱪﺓ‬
‫‪١٠٠,٠‬‬ ‫‪٨٣,٨٧٩‬‬ ‫‪١٠٠,٠‬‬ ‫‪٩٣,٩٣١‬‬ ‫ﺍﳉﻤﻠﺔ‬
‫ﻣﺼﺪﺭ ﺍﻟﺒﻴﺎﻥ‪ :‬ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‬
 ‫ﺟﺪﻭﻝ )‪ (٦-٣‬ﻣﻌﺪﻝ ﺗﻮﺍﻓﺮ ﺧﺪﻣﺎﺕ ﻫﻴﺌﺔ ﺍﻟﺘﻤﺮﻳﺾ ﻟﻠﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ ﺣﺴﺐ ﺍﳌﺆﻫﻞ ﻟﻜﻞ ‪١٠٠٠٠‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ‬
‫ﺍﳌﻌﺪﻝ ‪ ١٠,٠٠٠ /‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ‬ ‫ﺍﻟﻌﺪﺩ‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫‪٠,٢٩‬‬ ‫‪١,٨٩٧‬‬ ‫ﻣﺸﺮﻓﺎﺕ ﲤﺮﻳﺾ‬
‫‪٠,١٦‬‬ ‫‪١,٠٣٠‬‬ ‫ﻓﲎ ﲤﺮﻳﺾ‬
‫‪٠,٠٥‬‬ ‫‪٣١٣‬‬ ‫ﻧﻈﺎﻡ ﲬﺲ ﺳﻨﻮﺍﺕ‬
‫‪١١,٥٤‬‬ ‫‪٧٥,٤٦٤‬‬ ‫ﻧﻈﺎﻡ ﺛﻼﺙ ﺳﻨﻮﺍﺕ‬
‫‪٠,٥٦‬‬ ‫‪٣,٦٣٢‬‬ ‫ﻣﺴﺎﻋﺪﺍﺕ ﳑﺮﺿﺎﺕ‬
‫‪٠,١٠‬‬ ‫‪٦٦٩‬‬ ‫ﺍﻟﺰﺍﺋﺮﺍﺕ ﺍﻟﺼﺤﻴﺎﺕ‬
‫‪٠,١٣‬‬ ‫‪٨٧٤‬‬ ‫ﳑﺮﺿﺎﺕ ﺑﺎﳋﱪﺓ‬
‫‪١٢,٨٢‬‬ ‫‪٨٣,٨٧٩‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫ﻣﺼﺪﺭ ﺍﻟﺒﻴﺎﻥ‪ :‬ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‬

‫ﺟﺪﻭﻝ )‪ (٧-٣‬ﺗﻮﺯﻳﻊ ﺍﻟﻔﻨﲔ ﺧﺮﳚﻲ ﺍﳌﻌﻬﺪ ﺍﻟﻔﲏ ﺍﻟﺼﺤﻲ‬

‫ﻧﺴﺒﺔ ﺍﻟﻘﺎﺋﻢ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﳌﻘﻴﺪﻳﻦ‬ ‫ﺍﻟﻘﺎﺋﻢ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﻟﺒﻴﺎﻥ‬

‫‪٧٨‬‬
‫‪٨٩,٤‬‬ ‫‪٩,٣٢٣‬‬ ‫‪٨,٣٣٢‬‬ ‫ﻣﻌﺎﻭﻥ ﺻﺤﻲ‬
‫‪٨٥,٣‬‬ ‫‪٨,٥١٠‬‬ ‫‪٧,٢٦١‬‬ ‫ﻓﲏ ﻣﻌﻤﻞ‬
‫‪٨٢,٠‬‬ ‫‪٤,٣٧٩‬‬ ‫‪٣,٥٨٩‬‬ ‫ﻓﲏ ﺃﺷﻌﺔ‬
‫‪٧٩,٤‬‬ ‫‪١,٤٧٧‬‬ ‫‪١,١٧٣‬‬ ‫ﻓﲏ ﺻﻨﺎﻋﺔ ﺃﺳﻨﺎﻥ‬
‫‪٨٨,٢‬‬ ‫‪٥,٠٤٤‬‬ ‫‪٤,٤٤٩‬‬ ‫ﻓﲎ ﺗﺴﺠﻴﻞ ﻃﱯ ﻭﺇﺣﺼﺎﺀ‬
‫‪٨١,٨‬‬ ‫‪٤٩٤‬‬ ‫‪٥٦٨‬‬ ‫ﻓﲏ ﺻﻴﺎﻧﺔ ﺃﺟﻬﺰﺓ ﻃﺒﻴﺔ‬
 ‫ﺟﺪﻭﻝ )‪ (٨-٣‬ﺗﻮﺯﻳﻊ ﻣﺴﺎﻋﺪﻱ ﺍﻟﻔﻨﻴﲔ‬
‫ﻧﺴﺒﺔ ﺍﻟﻘﺎﺋﻢ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﳌﻘﻴﺪﻳﻦ‬ ‫ﺍﻟﻘﺎﺋﻢ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫‪٩٦,٤‬‬ ‫‪٨,٠٨١‬‬ ‫‪٧,٧٩٠‬‬ ‫ﻣﻼﺣﻆ ﺻﺤﻰ‬
‫‪٩٤,٦‬‬ ‫‪٣,٥٢١‬‬ ‫‪٣,٣٣٠‬‬ ‫ﻣﺴﺎﻋﺪ ﻣﻌﻤﻞ‬
‫‪٩١,٥‬‬ ‫‪٨٢‬‬ ‫‪٧٥‬‬ ‫ﻣﺴﺎﻋﺪ ﺃﺷﻌﺔ‬
‫‪٩٠,٩‬‬ ‫‪٢٢‬‬ ‫‪٢٠‬‬ ‫ﻣﺴﺎﻋﺪ ﺍﻟﺼﻴﺎﺩﻟﺔ‬
‫‪٩٠,٦‬‬ ‫‪٤,٠١١‬‬ ‫‪٣,٦٣٤‬‬ ‫ﻣﺴﻌﻒ ﻧﻈﺎﻡ ﺛﻼﺙ ﺳﻨﻮﺍﺕ‬
‫‪٩٧,٤‬‬ ‫‪٣٩‬‬ ‫‪٣٨‬‬ ‫ﻣﺴﻌﻒ ﻧﻈﺎﻡ ﺳﻨﺔ ﻭﻧﺼﻒ‬

‫ﺟﺪﻭﻝ )‪ (٩-٣‬ﺗﻮﺯﻳﻊ ﺍﻟﻮﻇﺎﺋﻒ ﻏﲑ ﺍﻟﻔﻨﻴﺔ‬

‫ﻧﺴﺒﺔ ﺍﻟﻘﺎﺋﻢ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﳌﻘﻴﺪﻳﻦ‬ ‫ﺍﻟﻘﺎﺋﻢ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫‪١٠٠,٠‬‬ ‫‪٣‬‬ ‫‪٣‬‬ ‫ﻃﺒﻴﺐ ﺑﻴﻄﺮﻯ‬
‫‪٩٥,١‬‬ ‫‪١,٥٣٢‬‬ ‫‪١,٤٥٧‬‬ ‫ﻣﻬﻨﺪﺱ ﺯﺭﺍﻋﻰ‬
‫‪٩٥,٨‬‬ ‫‪٣,٣٠٦‬‬ ‫‪٣,١٦٧‬‬ ‫ﻣﺴﺎﻋﺪ ﻣﻬﻨﺪﺱ ﺯﺭﺍﻋﻲ‬

‫‪٧٩‬‬
‫‪٩٠,٨‬‬ ‫‪١٣١‬‬ ‫‪١١٩‬‬ ‫ﻣﻬﻨﺪﺱ‬
‫‪٩٦,٦‬‬ ‫‪٣,٠٠٩‬‬ ‫‪٢,٩٠٧‬‬ ‫ﻣﺴﺎﻋﺪ ﻣﻬﻨﺪﺱ‬
‫‪٩٤,٨‬‬ ‫‪٣٢٤‬‬ ‫‪٣٠٧‬‬ ‫ﻣﺴﺎﻋﺪ ﺃﺧﺼﺎﺋﻲ ﺗﻐﺬﻳﺔ‬
‫‪٩٤,٦‬‬ ‫‪٧٣٨‬‬ ‫‪٦٩٨‬‬ ‫ﻣﺴﺎﻋﺪ ﺇﺩﺍﺭﻯ‬
 ‫ﺟﺪﻭﻝ )‪ :(١٠-٣‬ﺗﻮﺯﻳﻊ ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﲔ ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ ﻓﻌﻼﹰ ﺑﺎﻟﻘﻄﺎﻋﺎﺕ ﻣﻮﺯﻋﺔ ﺣﺴﺐ ﺍﶈﺎﻓﻈﺎﺕ ﰲ ‪٢٠٠١/١/١‬‬
‫ﻣﻌﺎﻫﺪ‬ ‫ﻣﺮﺍﻛﺰ‬
‫ﻭﻣﺪﺍﺭﺱ‬ ‫ﺧﺪﻣﺎﺕ‬ ‫ﻣﺮﺍﻛﺰ‬ ‫ﺭﻋﺎﻳﺔ‬
‫ﺍﶈﺎﻓﻈﺔ‬
‫ﻗﻄﺎﻉ‬ ‫ﻭﻣﺮﺍﻛﺰ‬ ‫ﻣﻌﺎﻣﻞ‬ ‫ﺃﻣﺮﺍﺽ‬ ‫ﻭﻗﺎﺋﻴﺔ‬ ‫ﺻﺤﻴﺔ‬ ‫ﻣﻜﺎﺗﺐ‬ ‫ﺍﻷﻣﻮﻣﺔ‬ ‫ﻃﺐ‬ ‫ﻭﻇﺎﺋﻒ‬
‫ﺍﳉﻤﻠﺔ‬ ‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﻟﺘﺪﺭﻳﺐ‬ ‫ﻣﺴﺘﻘﻠﺔ‬ ‫ﻣﺘﻮﻃﻨﺔ‬ ‫ﺃﺧﺮﻯ‬ ‫ﲪﻴﺎﺕ‬ ‫ﺣﻀﺮﻳﺔ‬ ‫ﺍﻟﺼﺤﺔ‬ ‫ﻭﺍﻟﻄﻔﻮﻟﺔ‬ ‫ﺑﻨﻚ ﺩﻡ‬ ‫ﻋﻼﺟﻲ‬ ‫ﺇﺷﺮﺍﻓﻴﺔ‬
‫‪٥٢١٠‬‬ ‫‪١٥‬‬ ‫‪٠‬‬ ‫‪٣‬‬ ‫‪١٩‬‬ ‫‪٧٦‬‬ ‫‪١٣٦‬‬ ‫‪١٠٤٧‬‬ ‫‪١٧١‬‬ ‫‪٢٠٣‬‬ ‫‪٠‬‬ ‫‪٣١٥٧‬‬ ‫‪٣٨٣‬‬ ‫ﺍﻟﻘﺎﻫﺮﺓ‬
‫‪٢٢٦٠‬‬ ‫‪١٢١‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪١٤‬‬ ‫‪١٦‬‬ ‫‪١١٢‬‬ ‫‪٢٧٩‬‬ ‫‪١٢٤‬‬ ‫‪٢٠٧‬‬ ‫‪١٢‬‬ ‫‪١٢٩٤‬‬ ‫‪٧٧‬‬ ‫ﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬
‫‪٦٣٣‬‬ ‫‪٢٧‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٦‬‬ ‫‪٨‬‬ ‫‪١١‬‬ ‫‪٩٦‬‬ ‫‪٨‬‬ ‫‪٥٨‬‬ ‫‪٣‬‬ ‫‪٣٩٦‬‬ ‫‪٢٠‬‬ ‫ﺑﻮﺭ ﺳﻌﻴﺪ‬
‫‪٣٥٠‬‬ ‫‪١٢‬‬ ‫‪٠‬‬ ‫‪١٢‬‬ ‫‪٢‬‬ ‫‪٧‬‬ ‫‪١٠‬‬ ‫‪٢٦‬‬ ‫‪٢‬‬ ‫‪١١‬‬ ‫‪٢‬‬ ‫‪٢٤٨‬‬ ‫‪١٨‬‬ ‫ﺍﻟﺴﻮﻳﺲ‬
‫‪٤٠٢‬‬ ‫‪٤١‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٦‬‬ ‫‪٦٢‬‬ ‫‪٥‬‬ ‫‪٢‬‬ ‫‪٢‬‬ ‫‪٢٢٠‬‬ ‫‪٥٣‬‬ ‫ﺍﻹﲰﺎﻋﻴﻠﻴﺔ‬
‫‪١١٦٧‬‬ ‫‪١١٧‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٥‬‬ ‫‪١‬‬ ‫‪٥٥‬‬ ‫‪٨٠‬‬ ‫‪٩‬‬ ‫‪٤٩‬‬ ‫‪٦‬‬ ‫‪٨٠٧‬‬ ‫‪٣٦‬‬ ‫ﺩﻣﻴﺎﻁ‬
‫‪٣٩٥٥‬‬ ‫‪١٠٠١‬‬ ‫‪٩‬‬ ‫‪١٤‬‬ ‫‪٣٨‬‬ ‫‪١٧‬‬ ‫‪٧٩‬‬ ‫‪٩٧‬‬ ‫‪١٢١‬‬ ‫‪٢٢٠‬‬ ‫‪٥‬‬ ‫‪٢٢٤٣‬‬ ‫‪١١١‬‬ ‫ﺍﻟﺪﻗﻬﻠﻴﺔ‬
‫‪٢٣٣٣‬‬ ‫‪٤٢٤‬‬ ‫‪١‬‬ ‫‪١٢‬‬ ‫‪١٦‬‬ ‫‪٢‬‬ ‫‪٨٦‬‬ ‫‪١٣٢‬‬ ‫‪٢٠‬‬ ‫‪٧٩‬‬ ‫‪١٢‬‬ ‫‪١٤٨٠‬‬ ‫‪٦٩‬‬ ‫ﺍﻟﺸﺮﻗﻴﺔ‬

‫‪٨٠‬‬
‫‪١٤٢٥‬‬ ‫‪٢٩١‬‬ ‫‪١‬‬ ‫‪٧‬‬ ‫‪٦‬‬ ‫‪٦‬‬ ‫‪٧٥‬‬ ‫‪١٣٩‬‬ ‫‪٢٧‬‬ ‫‪٤٢‬‬ ‫‪٣‬‬ ‫‪٨٠٠‬‬ ‫‪٢٨‬‬ ‫ﺍﻟﻘﻠﻴﻮﺑﻴﺔ‬
‫‪١٥٩٨‬‬ ‫‪٥٣٧‬‬ ‫‪٤‬‬ ‫‪٩‬‬ ‫‪١‬‬ ‫‪٣‬‬ ‫‪٢٧‬‬ ‫‪٤٩‬‬ ‫‪١٢‬‬ ‫‪٣٢‬‬ ‫‪١٩‬‬ ‫‪٨٧٧‬‬ ‫‪٢٨‬‬ ‫ﻛﻔﺮ ﺍﻟﺸﻴﺦ‬
‫‪٣٤٨٢‬‬ ‫‪٥٢٨‬‬ ‫‪٠‬‬ ‫‪٤٦‬‬ ‫‪٢٢‬‬ ‫‪١٠‬‬ ‫‪١٧٥‬‬ ‫‪١٣٤‬‬ ‫‪٦٣‬‬ ‫‪١٦٤‬‬ ‫‪١٤‬‬ ‫‪٢٣٠٥‬‬ ‫‪٣١‬‬ ‫ﺍﻟﻐﺮﺑﻴﺔ‬
‫‪١٤١١‬‬ ‫‪٢٦٩‬‬ ‫‪٠‬‬ ‫‪٥‬‬ ‫‪٢‬‬ ‫‪٢‬‬ ‫‪٥٥‬‬ ‫‪٦٢‬‬ ‫‪٢٤‬‬ ‫‪٢٥‬‬ ‫‪٦‬‬ ‫‪٨٩٢‬‬ ‫‪٥٨‬‬ ‫ﺍﳌﻨﻮﻓﻴﺔ‬
‫‪٢٠٧٠‬‬ ‫‪٤٣٧‬‬ ‫‪٥٨‬‬ ‫‪٥‬‬ ‫‪١٩‬‬ ‫‪٣‬‬ ‫‪١٠٩‬‬ ‫‪٦٤‬‬ ‫‪٤٨‬‬ ‫‪١٤٧‬‬ ‫‪٠‬‬ ‫‪١١٠٣‬‬ ‫‪٧٧‬‬ ‫ﺍﻟﺒﺤﲑﺓ‬
‫‪٣٨٨٥‬‬ ‫‪٤٣٩‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٦٦‬‬ ‫‪٣٠‬‬ ‫‪٩٩‬‬ ‫‪١٢٨‬‬ ‫‪٣٩‬‬ ‫‪٢٧٣‬‬ ‫‪٤١‬‬ ‫‪٢٧٣٢‬‬ ‫‪٣٨‬‬ ‫ﺍﳉﻴﺰﺓ‬
‫‪٧٣٣‬‬ ‫‪١٦٣‬‬ ‫‪٠‬‬ ‫‪٣‬‬ ‫‪٢‬‬ ‫‪٣‬‬ ‫‪١٤‬‬ ‫‪٣٠‬‬ ‫‪١١‬‬ ‫‪٤٤‬‬ ‫‪٠‬‬ ‫‪٤٢٠‬‬ ‫‪٤٣‬‬ ‫ﺑﲏ ﺳﻮﻳﻒ‬
‫‪٧١٠‬‬ ‫‪١٣٩‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪١‬‬ ‫‪١‬‬ ‫‪٦‬‬ ‫‪٤٤‬‬ ‫‪٨‬‬ ‫‪١٣‬‬ ‫‪٧‬‬ ‫‪٤٥٢‬‬ ‫‪٣٥‬‬ ‫ﺍﻟﻔﻴﻮﻡ‬
‫‪١٦٣١‬‬ ‫‪٣٥٨‬‬ ‫‪٠‬‬ ‫‪١٤‬‬ ‫‪٣٠‬‬ ‫‪١١‬‬ ‫‪٨٥‬‬ ‫‪٧٧‬‬ ‫‪٥٠‬‬ ‫‪١٨٥‬‬ ‫‪٤‬‬ ‫‪٧٨٢‬‬ ‫‪٣٥‬‬ ‫ﺍﳌﻨﻴﺎ‬
‫‪١٥٢٣‬‬ ‫‪٢١٥‬‬ ‫‪١٥‬‬ ‫‪٨‬‬ ‫‪٦٠‬‬ ‫‪٤٧‬‬ ‫‪٨٧‬‬ ‫‪١٠١‬‬ ‫‪٤٦‬‬ ‫‪٣٣‬‬ ‫‪١٥‬‬ ‫‪٨٧٠‬‬ ‫‪٢٦‬‬ ‫ﺃﺳﻴﻮﻁ‬
‫‪١٤١١‬‬ ‫‪٣٢٧‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٨‬‬ ‫‪٤‬‬ ‫‪٦٢‬‬ ‫‪٥٣‬‬ ‫‪٢٤‬‬ ‫‪٤٧‬‬ ‫‪١‬‬ ‫‪٨٧٢‬‬ ‫‪١١‬‬ ‫ﺳﻮﻫﺎﺝ‬
‫‪٨٥٢‬‬ ‫‪٢٣٨‬‬ ‫‪١‬‬ ‫‪٣‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٥١‬‬ ‫‪٢٥‬‬ ‫‪١٢‬‬ ‫‪٣٢‬‬ ‫‪٠‬‬ ‫‪٤٦١‬‬ ‫‪٢٨‬‬ ‫ﻗﻨﺎ‬
 ‫ﻣﻌﺎﻫﺪ‬ ‫ﻣﺮﺍﻛﺰ‬
‫ﻭﻣﺪﺍﺭﺱ‬ ‫ﺧﺪﻣﺎﺕ‬ ‫ﻣﺮﺍﻛﺰ‬ ‫ﺭﻋﺎﻳﺔ‬
‫ﺍﶈﺎﻓﻈﺔ‬
‫ﻗﻄﺎﻉ‬ ‫ﻭﻣﺮﺍﻛﺰ‬ ‫ﻣﻌﺎﻣﻞ‬ ‫ﺃﻣﺮﺍﺽ‬ ‫ﻭﻗﺎﺋﻴﺔ‬ ‫ﺻﺤﻴﺔ‬ ‫ﻣﻜﺎﺗﺐ‬ ‫ﺍﻷﻣﻮﻣﺔ‬ ‫ﻃﺐ‬ ‫ﻭﻇﺎﺋﻒ‬
‫ﺍﳉﻤﻠﺔ‬ ‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﻟﺘﺪﺭﻳﺐ‬ ‫ﻣﺴﺘﻘﻠﺔ‬ ‫ﻣﺘﻮﻃﻨﺔ‬ ‫ﺃﺧﺮﻯ‬ ‫ﲪﻴﺎﺕ‬ ‫ﺣﻀﺮﻳﺔ‬ ‫ﺍﻟﺼﺤﺔ‬ ‫ﻭﺍﻟﻄﻔﻮﻟﺔ‬ ‫ﺑﻨﻚ ﺩﻡ‬ ‫ﻋﻼﺟﻲ‬ ‫ﺇﺷﺮﺍﻓﻴﺔ‬
‫‪٨٠٩‬‬ ‫‪١٥٣‬‬ ‫‪١‬‬ ‫‪٣‬‬ ‫‪١١٧‬‬ ‫‪١٤٢‬‬ ‫‪٢٤‬‬ ‫‪١٢‬‬ ‫‪٨‬‬ ‫‪٩‬‬ ‫‪٠‬‬ ‫‪٣١٦‬‬ ‫‪٢٤‬‬ ‫ﺃﺳﻮﺍﻥ‬
‫‪٢١٩‬‬ ‫‪٨٧‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪١٩‬‬ ‫‪١٥‬‬ ‫‪١٦‬‬ ‫‪٠‬‬ ‫‪٥٥‬‬ ‫‪٢٢‬‬ ‫ﻣﺮﺳﻰ ﻣﻄﺮﻭﺡ‬
‫‪١٣٧‬‬ ‫‪٥٣‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪٣‬‬ ‫‪١‬‬ ‫‪٣‬‬ ‫‪٠‬‬ ‫‪٦٧‬‬ ‫‪٥‬‬ ‫ﺍﻟﻮﺍﺩﻱ ﺍﳉﺪﻳﺪ‬
‫‪٢٧٣‬‬ ‫‪٧٢‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٠‬‬ ‫‪١‬‬ ‫‪١٧١‬‬ ‫‪١٨‬‬ ‫ﺍﻟﺒﺤﺮ ﺍﻷﲪﺮ‬
‫‪٢٩٠‬‬ ‫‪٧٨‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٨‬‬ ‫‪٢٠‬‬ ‫‪٠‬‬ ‫‪٨‬‬ ‫‪٠‬‬ ‫‪١٥١‬‬ ‫‪٢٤‬‬ ‫ﴰﺎﻝ ﺳﻴﻨﺎﺀ‬
‫‪١١١‬‬ ‫‪٣٥‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١١‬‬ ‫‪٠‬‬ ‫‪٨‬‬ ‫‪٣‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪٢٩‬‬ ‫‪٢٣‬‬ ‫ﺟﻨﻮﺏ ﺳﻴﻨﺎﺀ‬
‫‪٣١٤‬‬ ‫‪٤٤‬‬ ‫‪١‬‬ ‫‪١‬‬ ‫‪١‬‬ ‫‪٢‬‬ ‫‪٨‬‬ ‫‪١٠‬‬ ‫‪٥‬‬ ‫‪١٧‬‬ ‫‪١‬‬ ‫‪١٩١‬‬ ‫‪٣٣‬‬ ‫ﺍﻷﻗﺼﺮ‬
‫‪٣٩٢٠٤‬‬ ‫‪٦٢٢١‬‬ ‫‪٩٢‬‬ ‫‪١٥٩‬‬ ‫‪٤٣٧‬‬ ‫‪٤٠٢‬‬ ‫‪١٤٠٩‬‬ ‫‪٢٧٩٨‬‬ ‫‪٨٥٦‬‬ ‫‪١٩٣١‬‬ ‫‪١٥٤‬‬ ‫‪٢٣٣٩١‬‬ ‫‪١٣٥٤‬‬ ‫ﺍﳉﻤﻠﺔ‬
‫ﻣﺼﺪﺭ ﺍﻟﺒﻴﺎﻥ‪ :‬ﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻟﺴﻨﻮﻳﺔ ﳌﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‬

‫‪٨١‬‬
‫ﺟﺪﻭﻝ )‪ :(١١-٣‬ﺗﻮﺯﻳﻊ ﺍﻟﺼﻴﺎﺩﻟﺔ ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ ﻓﻌﻼﹰ ﺑﺎﻟﻘﻄﺎﻋﺎﺕ ﻣﻮﺯﻋﺔ ﺣﺴﺐ ﺍﶈﺎﻓﻈﺎﺕ ﰲ ‪٢٠٠١/١/١‬‬
‫ﻣﻌﺎﻫﺪ‬ ‫ﻣﺮﺍﻛﺰ‬
‫ﻭﻣﺪﺍﺭﺱ‬ ‫ﺧﺪﻣﺎﺕ‬ ‫ﻣﺮﺍﻛﺰ‬ ‫ﺭﻋﺎﻳﺔ‬
‫ﺍﶈﺎﻓﻈﺔ‬
‫ﻗﻄﺎﻉ‬ ‫ﻭﻣﺮﺍﻛﺰ‬ ‫ﻣﻌﺎﻣﻞ‬ ‫ﺃﻣﺮﺍﺽ‬ ‫ﻭﻗﺎﺋﻴﺔ‬ ‫ﺻﺤﻴﺔ‬ ‫ﻣﻜﺎﺗﺐ‬ ‫ﺍﻷﻣﻮﻣﺔ‬ ‫ﻃﺐ‬ ‫ﻭﻇﺎﺋﻒ‬
‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﻟﺘﺪﺭﻳﺐ‬ ‫ﻣﺴﺘﻘﻠﺔ‬ ‫ﻣﺘﻮﻃﻨﺔ‬ ‫ﺃﺧﺮﻯ‬ ‫ﲪﻴﺎﺕ‬ ‫ﺣﻀﺮﻳﺔ‬ ‫ﺍﻟﺼﺤﺔ‬ ‫ﻭﺍﻟﻄﻔﻮﻟﺔ‬ ‫ﺑﻨﻚ ﺩﻡ‬ ‫ﻋﻼﺟﻲ‬ ‫ﺇﺷﺮﺍﻓﻴﺔ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢٠‬‬ ‫‪١٤‬‬ ‫‪٨٢‬‬ ‫‪٠‬‬ ‫‪١٩‬‬ ‫‪٠‬‬ ‫‪٩٠‬‬ ‫‪١٢٥‬‬ ‫ﺍﻟﻘﺎﻫﺮﺓ‬
‫‪١٨‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٨‬‬ ‫‪٣٥‬‬ ‫‪١‬‬ ‫‪٢٥‬‬ ‫‪٠‬‬ ‫‪١٦٧‬‬ ‫‪١٤٠‬‬ ‫ﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٣‬‬ ‫‪١٠‬‬ ‫‪٠‬‬ ‫‪٧‬‬ ‫‪٠‬‬ ‫‪١٩‬‬ ‫‪٧‬‬ ‫ﺑﻮﺭ ﺳﻌﻴﺪ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٧‬‬ ‫‪٥‬‬ ‫ﺍﻟﺴﻮﻳﺲ‬
‫‪١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٣‬‬ ‫‪٧‬‬ ‫ﺍﻹﲰﺎﻋﻴﻠﻴﺔ‬
‫‪٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪١٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٣٩‬‬ ‫‪١٧‬‬ ‫ﺩﻣﻴﺎﻁ‬
‫‪٦٨‬‬ ‫‪٠‬‬ ‫‪٣٣‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٤‬‬ ‫‪٤‬‬ ‫‪٥‬‬ ‫‪١٠‬‬ ‫‪٠‬‬ ‫‪١٠٥‬‬ ‫‪٦١‬‬ ‫ﺍﻟﺪﻗﻬﻠﻴﺔ‬
 ‫ﻣﻌﺎﻫﺪ‬ ‫ﻣﺮﺍﻛﺰ‬
‫ﻭﻣﺪﺍﺭﺱ‬ ‫ﺧﺪﻣﺎﺕ‬ ‫ﻣﺮﺍﻛﺰ‬ ‫ﺭﻋﺎﻳﺔ‬
‫ﺍﶈﺎﻓﻈﺔ‬
‫ﻗﻄﺎﻉ‬ ‫ﻭﻣﺮﺍﻛﺰ‬ ‫ﻣﻌﺎﻣﻞ‬ ‫ﺃﻣﺮﺍﺽ‬ ‫ﻭﻗﺎﺋﻴﺔ‬ ‫ﺻﺤﻴﺔ‬ ‫ﻣﻜﺎﺗﺐ‬ ‫ﺍﻷﻣﻮﻣﺔ‬ ‫ﻃﺐ‬ ‫ﻭﻇﺎﺋﻒ‬
‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﻟﺘﺪﺭﻳﺐ‬ ‫ﻣﺴﺘﻘﻠﺔ‬ ‫ﻣﺘﻮﻃﻨﺔ‬ ‫ﺃﺧﺮﻯ‬ ‫ﲪﻴﺎﺕ‬ ‫ﺣﻀﺮﻳﺔ‬ ‫ﺍﻟﺼﺤﺔ‬ ‫ﻭﺍﻟﻄﻔﻮﻟﺔ‬ ‫ﺑﻨﻚ ﺩﻡ‬ ‫ﻋﻼﺟﻲ‬ ‫ﺇﺷﺮﺍﻓﻴﺔ‬
‫‪٧‬‬ ‫‪٠‬‬ ‫‪٩‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٣‬‬ ‫‪٦‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪٤٥‬‬ ‫‪٢١‬‬ ‫ﺍﻟﺸﺮﻗﻴﺔ‬
‫‪٢٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٤‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢٣‬‬ ‫‪١٣‬‬ ‫ﺍﻟﻘﻠﻴﻮﺑﻴﺔ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٧٩‬‬ ‫‪٧‬‬ ‫ﻛﻔﺮ ﺍﻟﺸﻴﺦ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٤٠‬‬ ‫‪٣٩‬‬ ‫‪٠‬‬ ‫‪١٨‬‬ ‫‪٠‬‬ ‫‪١٠٤‬‬ ‫‪٤١‬‬ ‫ﺍﻟﻐﺮﺑﻴﺔ‬
‫‪٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٥‬‬ ‫‪٤‬‬ ‫‪٠‬‬ ‫‪٣‬‬ ‫‪٠‬‬ ‫‪٣٢‬‬ ‫‪٢٦‬‬ ‫ﺍﳌﻨﻮﻓﻴﺔ‬
‫‪٣١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١١‬‬ ‫‪٤‬‬ ‫‪٠‬‬ ‫‪٦‬‬ ‫‪٠‬‬ ‫‪٨٤‬‬ ‫‪٣٤‬‬ ‫ﺍﻟﺒﺤﲑﺓ‬
‫‪٦٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٨‬‬ ‫‪١٣‬‬ ‫‪٠‬‬ ‫‪١٧‬‬ ‫‪٠‬‬ ‫‪١٤٣‬‬ ‫‪٩‬‬ ‫ﺍﳉﻴﺰﺓ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٢٤‬‬ ‫‪١٨‬‬ ‫ﺑﲏ ﺳﻮﻳﻒ‬
‫‪١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٤‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪٠‬‬ ‫‪١٩‬‬ ‫‪٢٨‬‬ ‫ﺍﻟﻔﻴﻮﻡ‬

‫‪٨٢‬‬
‫‪٨٨‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٠‬‬ ‫‪٣٢‬‬ ‫‪١٣‬‬ ‫‪٠‬‬ ‫‪٥‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫ﺍﳌﻨﻴﺎ‬
‫‪٦٦‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٨‬‬ ‫‪٢٥‬‬ ‫‪٦‬‬ ‫‪١٢‬‬ ‫‪٦‬‬ ‫‪٠‬‬ ‫‪٢٩‬‬ ‫‪٢٧‬‬ ‫ﺃﺳﻴﻮﻁ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٧‬‬ ‫‪٣‬‬ ‫‪٠‬‬ ‫‪٣‬‬ ‫‪٠‬‬ ‫‪٦٤‬‬ ‫‪١٨‬‬ ‫ﺳﻮﻫﺎﺝ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪١٨‬‬ ‫‪١٢‬‬ ‫ﻗﻨﺎ‬
‫‪٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٩‬‬ ‫‪٣‬‬ ‫ﺃﺳﻮﺍﻥ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٦‬‬ ‫‪٣‬‬ ‫ﻣﺮﺳﻰ ﻣﻄﺮﻭﺡ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪١‬‬ ‫ﺍﻟﻮﺍﺩﻱ ﺍﳉﺪﻳﺪ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪١٤‬‬ ‫‪١‬‬ ‫ﺍﻟﺒﺤﺮ ﺍﻷﲪﺮ‬
‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٣‬‬ ‫‪٢‬‬ ‫ﴰﺎﻝ ﺳﻴﻨﺎﺀ‬
‫‪٣‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٣‬‬ ‫‪١‬‬ ‫ﺟﻨﻮﺏ ﺳﻴﻨﺎﺀ‬
‫‪٦‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪١‬‬ ‫ﺍﻷﻗﺼﺮ‬
‫‪٣٧٩‬‬ ‫‪١‬‬ ‫‪٤٢‬‬ ‫‪١‬‬ ‫‪٤١‬‬ ‫‪٢١٠‬‬ ‫‪٢٤٠‬‬ ‫‪١٨‬‬ ‫‪١٣٥‬‬ ‫‪٠‬‬ ‫‪١١٤٧‬‬ ‫‪٦٢٨‬‬ ‫ﺍﳉﻤﻠﺔ‬
‫ﻣﺼﺪﺭ ﺍﻟﺒﻴﺎﻥ‪ :‬ﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻟﺴﻨﻮﻳﺔ ﳌﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‬
 ‫ﺟﺪﻭﻝ )‪ :(١٢-٣‬ﺗﻮﺯﻳﻊ ﺃﻃﺒﺎﺀ ﺍﻷﺳﻨﺎﻥ ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ ﻓﻌﻼﹰ ﺑﺎﻟﻘﻄﺎﻋﺎﺕ ﻣﻮﺯﻋﺔ ﺣﺴﺐ ﺍﶈﺎﻓﻈﺎﺕ ﰲ ‪٢٠٠١/١/١‬‬
‫ﻣﻌﺎﻫﺪ‬ ‫ﻣﺮﺍﻛﺰ‬
‫ﻭﻣﺪﺍﺭﺱ‬ ‫ﺧﺪﻣﺎﺕ‬ ‫ﻣﺮﺍﻛﺰ‬ ‫ﺭﻋﺎﻳﺔ‬
‫ﺍﶈﺎﻓﻈﺔ‬
‫ﻗﻄﺎﻉ‬ ‫ﻭﻣﺮﺍﻛﺰ‬ ‫ﻣﻌﺎﻣﻞ‬ ‫ﺃﻣﺮﺍﺽ‬ ‫ﻭﻗﺎﺋﻴﺔ‬ ‫ﺻﺤﻴﺔ‬ ‫ﻣﻜﺎﺗﺐ‬ ‫ﺍﻷﻣﻮﻣﺔ‬ ‫ﻃﺐ‬ ‫ﻭﻇﺎﺋﻒ‬
‫ﺍﳉﻤﻠﺔ‬ ‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﻟﺘﺪﺭﻳﺐ‬ ‫ﻣﺴﺘﻘﻠﺔ‬ ‫ﻣﺘﻮﻃﻨﺔ‬ ‫ﺃﺧﺮﻯ‬ ‫ﲪﻴﺎﺕ‬ ‫ﺣﻀﺮﻳﺔ‬ ‫ﺍﻟﺼﺤﺔ‬ ‫ﻭﺍﻟﻄﻔﻮﻟﺔ‬ ‫ﺑﻨﻚ ﺩﻡ‬ ‫ﻋﻼﺟﻲ‬ ‫ﺇﺷﺮﺍﻓﻴﺔ‬
‫‪٨٦٢‬‬ ‫‪٣‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٤٣‬‬ ‫‪٠‬‬ ‫‪٤٥٤‬‬ ‫‪٠‬‬ ‫‪١٠٨‬‬ ‫‪٠‬‬ ‫‪٢١٥‬‬ ‫‪٣٩‬‬ ‫ﺍﻟﻘﺎﻫﺮﺓ‬
‫‪٤٨٠‬‬ ‫‪٩٧‬‬ ‫‪١٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٤٠‬‬ ‫‪٥‬‬ ‫‪٥٧‬‬ ‫‪٠‬‬ ‫‪١٦٣‬‬ ‫‪٨‬‬ ‫ﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬
‫‪١٠٥‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢٤‬‬ ‫‪٠‬‬ ‫‪١٤‬‬ ‫‪٠‬‬ ‫‪٦٣‬‬ ‫‪٣‬‬ ‫ﺑﻮﺭ ﺳﻌﻴﺪ‬
‫‪٣٥‬‬ ‫‪١١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪١١‬‬ ‫‪١‬‬ ‫ﺍﻟﺴﻮﻳﺲ‬
‫‪٦٩‬‬ ‫‪١٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢٦‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢٨‬‬ ‫‪٣‬‬ ‫ﺍﻹﲰﺎﻋﻴﻠﻴﺔ‬
‫‪١٦٤‬‬ ‫‪٦٥‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٣١‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪٦٣‬‬ ‫‪٣‬‬ ‫ﺩﻣﻴﺎﻁ‬
‫‪٣٢٥‬‬ ‫‪١٣٨‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٦‬‬ ‫‪٢٩‬‬ ‫‪٢٥‬‬ ‫‪٠‬‬ ‫‪١١٣‬‬ ‫‪١٣‬‬ ‫ﺍﻟﺪﻗﻬﻠﻴﺔ‬
‫‪١٨٣‬‬ ‫‪٦١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪٢١‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪٠‬‬ ‫‪٨١‬‬ ‫‪١٤‬‬ ‫ﺍﻟﺸﺮﻗﻴﺔ‬

‫‪٨٣‬‬
‫‪٢٩٣‬‬ ‫‪١٣٧‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٦٨‬‬ ‫‪٢‬‬ ‫‪١٠‬‬ ‫‪٠‬‬ ‫‪٧٥‬‬ ‫‪٠‬‬ ‫ﺍﻟﻘﻠﻴﻮﺑﻴﺔ‬
‫‪١٣٢‬‬ ‫‪٤٧‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٩‬‬ ‫‪٠‬‬ ‫‪٥‬‬ ‫‪٠‬‬ ‫‪٥٧‬‬ ‫‪٤‬‬ ‫ﻛﻔﺮ ﺍﻟﺸﻴﺦ‬
‫‪٤٤٨‬‬ ‫‪١٧٧‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٧٢‬‬ ‫‪١٩‬‬ ‫‪٦٠‬‬ ‫‪٠‬‬ ‫‪١١٨‬‬ ‫‪٢‬‬ ‫ﺍﻟﻐﺮﺑﻴﺔ‬
‫‪١٥١‬‬ ‫‪٧١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٩‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪٠‬‬ ‫‪٥٤‬‬ ‫‪١٢‬‬ ‫ﺍﳌﻨﻮﻓﻴﺔ‬
‫‪٤٦٢‬‬ ‫‪١٦٧‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٤٤‬‬ ‫‪٧‬‬ ‫‪٧٦‬‬ ‫‪٠‬‬ ‫‪١٥٧‬‬ ‫‪١١‬‬ ‫ﺍﻟﺒﺤﲑﺓ‬
‫‪٦٦٥‬‬ ‫‪٢٩٦‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٠٤‬‬ ‫‪٠‬‬ ‫‪٥٤‬‬ ‫‪٠‬‬ ‫‪٢١٣‬‬ ‫‪٧‬‬ ‫ﺍﳉﻴﺰﺓ‬
‫‪٩٩‬‬ ‫‪٣٧‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٨‬‬ ‫‪٠‬‬ ‫‪١١‬‬ ‫‪٠‬‬ ‫‪٧‬‬ ‫‪٠‬‬ ‫‪٣٢‬‬ ‫‪٤‬‬ ‫ﺑﲏ ﺳﻮﻳﻒ‬
‫‪٩٠‬‬ ‫‪٢٩‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١١‬‬ ‫‪٠‬‬ ‫‪٥‬‬ ‫‪٠‬‬ ‫‪٣٦‬‬ ‫‪٩‬‬ ‫ﺍﻟﻔﻴﻮﻡ‬
‫‪١٦٨‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٠‬‬ ‫‪٠‬‬ ‫‪٥١‬‬ ‫‪٠‬‬ ‫‪٣٥‬‬ ‫‪٠‬‬ ‫‪٤٠‬‬ ‫‪٣٢‬‬ ‫ﺍﳌﻨﻴﺎ‬
‫‪١٥٣‬‬ ‫‪٨٢‬‬ ‫‪٢‬‬ ‫‪٣‬‬ ‫‪٤‬‬ ‫‪٠‬‬ ‫‪١٠‬‬ ‫‪٧‬‬ ‫‪٨‬‬ ‫‪٦‬‬ ‫‪٠‬‬ ‫‪٢٣‬‬ ‫‪٨‬‬ ‫ﺃﺳﻴﻮﻁ‬
‫‪١٢٥‬‬ ‫‪٣٩‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٥‬‬ ‫‪٠‬‬ ‫‪٣‬‬ ‫‪٠‬‬ ‫‪٧٧‬‬ ‫‪١‬‬ ‫ﺳﻮﻫﺎﺝ‬
‫‪٩٩‬‬ ‫‪٥٤‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٧‬‬ ‫‪٠‬‬ ‫‪٤‬‬ ‫‪٠‬‬ ‫‪٢٢‬‬ ‫‪٢‬‬ ‫ﻗﻨﺎ‬
 ‫ﻣﻌﺎﻫﺪ‬ ‫ﻣﺮﺍﻛﺰ‬
‫ﻭﻣﺪﺍﺭﺱ‬ ‫ﺧﺪﻣﺎﺕ‬ ‫ﻣﺮﺍﻛﺰ‬ ‫ﺭﻋﺎﻳﺔ‬
‫ﺍﶈﺎﻓﻈﺔ‬
‫ﻗﻄﺎﻉ‬ ‫ﻭﻣﺮﺍﻛﺰ‬ ‫ﻣﻌﺎﻣﻞ‬ ‫ﺃﻣﺮﺍﺽ‬ ‫ﻭﻗﺎﺋﻴﺔ‬ ‫ﺻﺤﻴﺔ‬ ‫ﻣﻜﺎﺗﺐ‬ ‫ﺍﻷﻣﻮﻣﺔ‬ ‫ﻃﺐ‬ ‫ﻭﻇﺎﺋﻒ‬
‫ﺍﳉﻤﻠﺔ‬ ‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﻟﺘﺪﺭﻳﺐ‬ ‫ﻣﺴﺘﻘﻠﺔ‬ ‫ﻣﺘﻮﻃﻨﺔ‬ ‫ﺃﺧﺮﻯ‬ ‫ﲪﻴﺎﺕ‬ ‫ﺣﻀﺮﻳﺔ‬ ‫ﺍﻟﺼﺤﺔ‬ ‫ﻭﺍﻟﻄﻔﻮﻟﺔ‬ ‫ﺑﻨﻚ ﺩﻡ‬ ‫ﻋﻼﺟﻲ‬ ‫ﺇﺷﺮﺍﻓﻴﺔ‬
‫‪١٢٩‬‬ ‫‪٢١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٨‬‬ ‫‪٧‬‬ ‫‪١٢‬‬ ‫‪٠‬‬ ‫‪١٨‬‬ ‫‪٠‬‬ ‫‪٦٢‬‬ ‫‪١‬‬ ‫ﺃﺳﻮﺍﻥ‬
‫‪٣٥‬‬ ‫‪١٥‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٣‬‬ ‫‪٠‬‬ ‫‪٨‬‬ ‫‪٠‬‬ ‫‪٧‬‬ ‫‪٢‬‬ ‫ﻣﺮﺳﻰ ﻣﻄﺮﻭﺡ‬
‫‪٢٥‬‬ ‫‪١٥‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١٠‬‬ ‫‪١‬‬ ‫ﺍﻟﻮﺍﺩﻱ ﺍﳉﺪﻳﺪ‬
‫‪٤٤‬‬ ‫‪٢٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٥‬‬ ‫‪٠‬‬ ‫‪١٥‬‬ ‫‪٢‬‬ ‫ﺍﻟﺒﺤﺮ ﺍﻷﲪﺮ‬
‫‪٥٢‬‬ ‫‪٢٢‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٧‬‬ ‫‪٠‬‬ ‫‪٢‬‬ ‫‪٠‬‬ ‫‪١٩‬‬ ‫‪٢‬‬ ‫ﴰﺎﻝ ﺳﻴﻨﺎﺀ‬
‫‪١٧‬‬ ‫‪٩‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٥‬‬ ‫‪٢‬‬ ‫ﺟﻨﻮﺏ ﺳﻴﻨﺎﺀ‬
‫‪٤٨‬‬ ‫‪١٥‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٨‬‬ ‫‪٠‬‬ ‫‪١‬‬ ‫‪٠‬‬ ‫‪٢٢‬‬ ‫‪١‬‬ ‫ﺍﻷﻗﺼﺮ‬
‫‪٥٤٥٩‬‬ ‫‪١٦٤٣‬‬ ‫‪١٢‬‬ ‫‪٣‬‬ ‫‪٤‬‬ ‫‪٧٢‬‬ ‫‪١٩‬‬ ‫‪١١٧١‬‬ ‫‪٧٠‬‬ ‫‪٥٠٦‬‬ ‫‪٠‬‬ ‫‪١٧٧٢‬‬ ‫‪١٨٧‬‬ ‫ﺍﳉﻤﻠﺔ‬
‫ﻣﺼﺪﺭ ﺍﻟﺒﻴﺎﻥ‪ :‬ﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻟﺴﻨﻮﻳﺔ ﳌﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‬

‫‪٨٤‬‬
‫ﺟﺪﻭﻝ ) ‪ :(١٣-٣‬ﺑﻴﺎﻥ ﺑﻌﺪﺩ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺍﳌﻘﻴﺪﻳﻦ ﺑﺎﻟﻨﻘﺎﺑﺎﺕ‬
‫‪%‬‬ ‫‪٢٠٠١‬‬ ‫‪١٩٩٧‬‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫‪١٥‬‬ ‫‪١٤٤,٣٥٤‬‬ ‫‪١٢٥,٠٠٠‬‬ ‫ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﻮﻥ‬
‫‪١٥‬‬ ‫‪١٨,٤٦٩‬‬ ‫‪١٦,٠٠٠‬‬ ‫ﺃﻃﺒﺎﺀ ﺍﻷﺳﻨﺎﻥ‬
‫‪٥٣‬‬ ‫‪٥٥,٦٨٣‬‬ ‫‪٣٦,٥٠٠‬‬ ‫ﺍﻟﺼﻴﺎﺩﻟﺔ‬
‫‪٥٦‬‬ ‫‪١٣,٢٣٧‬‬ ‫‪٨,٥٠٠‬‬ ‫ﻣﺸﺮﻓﺎﺕ ﲤﺮﻳﺾ‬
‫‪٢٠٥‬‬ ‫‪٣,٠٤٦‬‬ ‫‪١,٠٠٠‬‬ ‫ﻓﲎ ﲤﺮﻳﺾ‬
‫‪١٢٩‬‬ ‫‪١٦٩,٥٧٦‬‬ ‫‪٧٤,٠٠٠‬‬ ‫ﻧﻈﺎﻡ ﺛﻼﺙ ﺳﻨﻮﺍﺕ )ﺩﺑﻠﻮﻡ(‬
‫‪٤٩‬‬ ‫‪١٥٨١٠‬‬ ‫‪١٠,٦٠٠‬‬ ‫ﲤﺮﻳﺾ – ﺃﺧﺮﻯ‬
‫‪١١٤‬‬ ‫‪٢٠١,٦٦٩‬‬ ‫‪٩٤,١٠٠‬‬ ‫ﺇﲨﺎﱄ ﻋﺪﺩ ﺍﳌﻤﺮﺿﺎﺕ‬
‫‪٥٥‬‬ ‫‪٤٢٠,١٧٥‬‬ ‫‪٢٧١,٦٠٠‬‬ ‫ﺇﲨﺎﱄ ﺍﻟﻔﻨﻴﲔ ﻭﺍﻹﺩﺍﺭﻳﻴﲔ‬
‫‪١٨,٠٠٠‬‬ ‫ﺍﻟﻔﻨﻴﲔ‬
‫‪٤٠,٠٠٠‬‬ ‫ﺁﺧﺮﻭﻥ‬
‫‪٤٢٠,١٧٥‬‬ ‫‪٣٢٩,٦٠٠‬‬ ‫ﺇﲨﺎﱄ‬
 ‫ﺟﺪﻭﻝ ) ‪ :(١٤-٣‬ﻣﻘﺎﺭﻧﺔ ﺑﲔ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺍﳌﻘﻴﺪﻳﻦ ﻭﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻟﻌﺎﻡ ‪٢٠٠١‬‬
‫‪%‬‬ ‫ﻧﺴﺒﺔ ﺍﳌﺘﻐﻴﺒﲔ ﻋﻦ ﺍﻟﻌﻤﻞ‬ ‫ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﳌﻘﻴﺪﻳﻦ‬ ‫ﺍﻟﺒﻴﺎﻥ‬
‫‪٣١‬‬ ‫‪١٨,٤٠٧‬‬ ‫‪٤٠,٤٢٢‬‬ ‫‪٥٨,٨٢٩‬‬ ‫ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﻮﻥ‬
‫‪٢٤‬‬ ‫‪١,٨٦١‬‬ ‫‪٥,٧٧٠‬‬ ‫‪٧,٦٣١‬‬ ‫ﺃﻃﺒﺎﺀ ﺍﻷﺳﻨﺎﻥ‬
‫‪٢٢‬‬ ‫‪٩٧٠‬‬ ‫‪٣,٣٧٥‬‬ ‫‪٤,٣٤٥‬‬ ‫ﺍﻟﺼﻴﺎﺩﻟﺔ‬
‫‪٢٠‬‬ ‫‪٤٦٥‬‬ ‫‪١,٨٩٧‬‬ ‫‪٢,٣٦٢‬‬ ‫ﻣﺸﺮﻓﺎﺕ ﲤﺮﻳﺾ‬
‫‪١٦‬‬ ‫‪٢٠١‬‬ ‫‪١,٠٣٠‬‬ ‫‪١,٢٣١‬‬ ‫ﻓﲎ ﲤﺮﻳﺾ‬
‫‪١١‬‬ ‫‪٩,١٣٦‬‬ ‫‪٧٥,٤٦٤‬‬ ‫‪٨٤,٦٠٠‬‬ ‫ﻧﻈﺎﻡ ﺛﻼﺙ ﺳﻨﻮﺍﺕ )ﺩﺑﻠﻮﻡ(‬
‫‪٤‬‬ ‫‪٢٥٠‬‬ ‫‪٥,٤٨٨‬‬ ‫‪٥,٧٣٨‬‬ ‫ﲤﺮﻳﺾ – ﺃﺧﺮﻯ‬
‫‪١١‬‬ ‫‪١٠,٠٥٢‬‬ ‫‪٨٣,٨٧٩‬‬ ‫‪٩٣,٩٣١‬‬ ‫ﺇﲨﺎﱄ ﻋﺪﺩ ﺍﳌﻤﺮﺿﺎﺕ‬
‫‪١٤‬‬ ‫‪٤,٠٥٥‬‬ ‫‪٢٥,٣٧٢‬‬ ‫‪٢٩,٤٢٧‬‬ ‫ﺍﻟﻔﻨﻴﲔ‬
‫‪٦‬‬ ‫‪٨٦٩‬‬ ‫‪١٤,٨٨٧‬‬ ‫‪١٥,٧٥٦‬‬ ‫ﻣﺴﺎﻋﺪﻳﻦ ﺍﻟﻔﻨﻴﲔ‬
‫‪٥‬‬ ‫‪٤٠‬‬ ‫‪٦٩٨‬‬ ‫‪٧٣٨‬‬ ‫ﺃﺧﺮﻯ‬
‫‪١٧‬‬ ‫‪٣٦,٢٥٤‬‬ ‫‪١٧٤,٤٠٣‬‬ ‫‪٢١٠,٦٥٧‬‬ ‫ﺇﲨﺎﱄ‬

‫‪٨٥‬‬
‫ﺟﺪﻭﻝ )‪ (١٥-٣‬ﺑﻴﺎﻥ ﺑﺎﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺍﳌﻘﻴﺪﺓ ﻭﺍﻟﻘﺎﺋﻤﺔ ﺑﺎﻟﻌﻤﻞ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺎﻹﺿﺎﻓﺔ ﻟﻨﺴﺒﺔ ﺍﻟﺰﻳﺎﺩﺓ ﻋﻠﻰ ﻣﺪﺍﺭ ﺍﻟﻌﺸﺮﻳﻦ ﺳﻨﺔ ﺍﳌﺎﺿﻴﺔ‬
‫‪ ٢٠‬ﺳﻨﺔ‬ ‫‪٢٠٠٢‬‬ ‫‪١٩٩٥‬‬ ‫‪١٩٩٠‬‬ ‫‪١٩٨٢‬‬
‫ﺍﻟﺒﻴﺎﻥ‬
‫‪inc %‬‬ ‫ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﳌﻘﻴﺪﻳﻦ‬ ‫ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﳌﻘﻴﺪﻳﻦ‬ ‫ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﳌﻘﻴﺪﻳﻦ‬ ‫ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ‬ ‫ﺍﳌﻘﻴﺪﻳﻦ‬
‫‪١,٧‬‬ ‫‪٤٠٤٢٢‬‬ ‫‪٥٨٨٢٩‬‬ ‫‪٣٦٩٦٥‬‬ ‫‪٥٢٦٢٥‬‬ ‫‪٣٠٣٤٧‬‬ ‫‪٣٩٨٢٨‬‬ ‫‪١٦١٢١‬‬ ‫‪٢٢٤٦٨‬‬ ‫ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﻮﻥ‬
‫‪١,٣‬‬ ‫‪٥٧٧٠‬‬ ‫‪٧٦٣١‬‬ ‫‪٥٠٥٤‬‬ ‫‪٦٩٢٠‬‬ ‫‪٥٥٧٧‬‬ ‫‪٦٨٩٣‬‬ ‫‪٢٨١٤‬‬ ‫‪٣٥٩٢‬‬ ‫ﺃﻃﺒﺎﺀ ﺍﻷﺳﻨﺎﻥ‬
‫‪٠,٣‬‬ ‫‪٣٣٧٥‬‬ ‫‪٤٣٤٥‬‬ ‫‪٢٦١١‬‬ ‫‪٣٦٠٣‬‬ ‫‪٢٩١٥‬‬ ‫‪٣٦١٥‬‬ ‫‪٢٣٣٠‬‬ ‫‪٣٢٣٠‬‬ ‫ﺍﻟﺼﻴﺎﺩﻟﺔ‬
‫‪١,٠‬‬ ‫‪١٨٩٧‬‬ ‫‪٢٣٦٢‬‬ ‫‪٨٩٠‬‬ ‫‪١٠١٣‬‬ ‫‪٣٣٤‬‬ ‫‪٤٩٧‬‬ ‫‪٢٤٨‬‬ ‫‪٣٢٥‬‬ ‫ﻣﺸﺮﻓﺎﺕ ﲤﺮﻳﺾ‬
 ‫ﺟﺪﻭﻝ )‪ :(١٦-٣‬ﻧﺴﺒﺔ ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﲔ ﻭﺍﳌﻤﺮﺿﺎﺕ ﰲ ﻗﻄﺎﻋﺎﺕ ﺍﻟﺼﺤﺔ ﺍﳌﺨﺘﻠﻔﺔ‬
‫ﺍﳌﻤﺮﺿﺎﺕ‬ ‫ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﻮﻥ‬
‫ﺍﻟﺒﻴﺎﻥ‬
‫‪٢٠٠١‬‬ ‫‪١٩٩٧‬‬ ‫‪٢٠٠١‬‬ ‫‪١٩٩٧‬‬
‫‪٤٧,٧‬‬ ‫‪٤٤,٢‬‬ ‫‪٥٨,٦‬‬ ‫‪٦٠,٣‬‬ ‫ﺍﻟﻌﻼﺟﻰ‬
‫‪١,٤‬‬ ‫‪١,١‬‬ ‫‪٤,٠‬‬ ‫‪٢,٦‬‬ ‫ﺍﻹﺩﺍﺭﺓ‬
‫‪٥٠,٩‬‬ ‫‪٥٤,٧‬‬ ‫‪٣٧,٤‬‬ ‫‪٣٧,١‬‬ ‫ﻭﻗﺎﺋﻰ‬
‫‪١٠٠‬‬ ‫‪١٠٠‬‬ ‫‪١٠٠‬‬ ‫‪١٠٠‬‬ ‫ﺇﲨﺎﱄ‬

‫ﻼ ﺑﺎﻟﻘﻄﺎﻋﺎﺕ ﻣﻮﺯﻋﺔ ﺣﺴﺐ ﺍﶈﺎﻓﻈﺎﺕ ﰲ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬

‫ﺟﺪﻭﻝ )‪ (١٧-٣‬ﺗﻮﺯﻳﻊ ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﲔ ﻭﺍﳌﻤﺮﺿﺎﺕ ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ ﻓﻌ ﹰ‬
‫ﺍﳌﻤﺮﺿﺎﺕ‬ ‫ﺍﻷﻃﺒﺎﺀ ﺍﻟﺒﺸﺮﻳﲔ‬ ‫‪٢٠٠١‬‬
‫ﺍﻟﺒﻴﺎﻥ‬
‫ﺍﳌﻌﺪﻝ ‪١٩٩٧‬‬ ‫ﺍﳌﻌﺪﻝ ‪٢٠٠١‬‬ ‫ﺍﻟﻌﺪﺩ ‪٢٠٠١‬‬ ‫ﺍﳌﻌﺪﻝ ‪١٩٩٧‬‬ ‫ﺍﳌﻌﺪﻝ ‪٢٠٠١‬‬ ‫ﺍﻟﻌﺪﺩ ‪٢٠٠١‬‬ ‫ﺍﻟﻨﺴﺒﺔ‬ ‫ﺍﳌﻌﺪﻝ ‪ ١٠٠٠ /‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ‬
‫‪٠,٨٥‬‬ ‫‪٠,٨٣‬‬ ‫‪٩٨٩٢‬‬ ‫‪١,١٢‬‬ ‫‪٠,٦٨‬‬ ‫‪٨١٢٧‬‬ ‫‪١٨‬‬ ‫‪١١٩٣٣‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪١,٣٢‬‬ ‫‪١,٦٦‬‬ ‫‪٤٦٥٥٢‬‬ ‫‪٠,٦٥‬‬ ‫‪٠,٦٦‬‬ ‫‪١٨٥٣٢‬‬ ‫‪٤٣‬‬ ‫‪٢٨١١٩‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪٠,٨٢‬‬ ‫‪١,٠١‬‬ ‫‪٢٤٥٠٩‬‬ ‫‪٠,٥٣‬‬ ‫‪٠,٥٢‬‬ ‫‪١٢٧٢١‬‬ ‫‪٣٧‬‬ ‫‪٢٤٢٣٦‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬

‫‪٨٦‬‬
‫‪٢,٤٨‬‬ ‫‪٣,١٧‬‬ ‫‪٢٩٢٦‬‬ ‫‪٠,٩٦‬‬ ‫‪١,١٣‬‬ ‫‪١٠٤٢‬‬ ‫‪١‬‬ ‫‪٩٢٢‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﻟﺴﺎﺣﻠﻴﺔ‬
‫‪١,٢٩‬‬ ‫‪٨٣٨٧٩‬‬ ‫‪٠,٦٢‬‬ ‫‪٤٠٤٢٢‬‬ ‫‪٦٥٢٠٩‬‬ ‫ﺇﲨﺎﱄ‬
 ‫  
‪:‬‬
‫     ""!   "‬
‫‪" &' .% .#‬‬

‫‪ )*+,     :( #‬‬

‫ﻳﺮﺗﺒﻂ ﻧﻈﺎﻡ ﺍﻟﺼﺤﺔ ﰲ ﻣﺼﺮ ﲟﺆﺳﺴﺎﺕ ﻣﺘﻌﺪﺩﺓ ﺇﻣﺎ ﺣﻜﻮﻣﻴﺔ ﺃﻭ ﺧﺎﺻﺔ‪ .‬ﻭﺗﺴﺎﻫﻢ ﲨﻴﻊ‬
‫ﺍﳌﺆﺳﺴﺎﺕ ﻭﺍﳌﻌﺎﻫﺪ ﰲ ﺗﻮﻓﲑ ﻭﲤﻮﻳﻞ ﻋﺪﺩ ﻣﺘﻨﻮﻉ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﰲ ﻫﺬﺍ ﺍﳋﺼﻮﺹ ﳚﺐ ﺃﻥ‬
‫ﻧﺸﲑ ﺇﱃ ﺃﻥ ﺃﻱ ﺩﺭﺍﺳﺔ ﻟﻺﻧﻔﺎﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺗﻮﺍﺟﻪ ﻋﻘﺒﺎﺕ ﻣﺘﻌﺪﺩﺓ ﻣﺜﻞ‪:‬‬
‫ﻋﺪﻡ ﺩﻗﺔ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﳌﺘﻮﺍﻓﺮﺓ ﻋﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ ﻭﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ ﺍﻟﺒﻴﺎﻧﺎﺕ‬ ‫‪-‬‬
‫ﺍﳋﺎﺻﺔ ﺑﺎﻹﻧﻔﺎﻕ‪.‬‬
‫ﺍﺧﺘﻼﻑ ﺃﻧﻈﻤﺔ ﺍﳊﺴﺎﺑﺎﺕ ﻭﻓﻘﺎﹰ ﻟﻨﻮﻋﻴﺔ ﺍﳌﻤﻮﻟﲔ‪ ،‬ﺣﻜﻮﻣﻲ ﺃﻭ ﺧﺎﺹ ﺃﻭ ﻋﺎﻡ‪.‬‬ ‫‪-‬‬
‫ﻋﺪﻡ ﻭﺟﻮﺩ ﻧﻈﺎﻡ ﻭﺍﺿﺢ ﻟﻨﺸﺮ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺎﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﻭﻣﻦ ﻫﺬﺍ ﺍﳌﻨﻄﻠﻖ ﻓﺈﻥ ﺍﳍﺪﻑ ﺍﻷﺳﺎﺳﻲ ﳍﺬﺍ ﺍﻟﺒﺤﺚ ﻫﻮ ﺗﻮﺿﻴﺢ ﺍﳌﺼﺎﺩﺭ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻺﻧﻔﺎﻕ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺍﻻﲡﺎﻫﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻺﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‪ ،‬ﻫﺎﺩﻓﲔ ﺑﺬﻟﻚ ﺇﱃ ﻭﺿﻊ ﺗﻘﻴﻴﻢ ﻋﺎﻡ ﻟﻺﻧﻔﺎﻕ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻲ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ‪.‬‬

‫‪ -١‬ﻣﻘﺪﻣﻮ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ‬

‫ﺗﻘﻮﻡ ﻛﻞ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﻭﻣﺆﺳﺴﺎﺕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ ﺑﺘﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﻟﻸﻓﺮﺍﺩ ﻣﺒﺎﺷﺮﺓ ﺃﻭ ﺑﻄﺮﻳﻖ ﻏﲑ ﻣﺒﺎﺷﺮ ﻣﻦ ﺧﻼﻝ ﺍﻟﺘﻌﺎﻗﺪ‪.‬‬
‫ﺃ – ﺍﳊﻜﻮﻣﺔ‬
‫‪ .١‬ﻳﺘﻀﻤﻦ ﻗﻄﺎﻉ ﺍﳊﻜﻮﻣﺔ ﲨﻴﻊ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ﺗﻮﻓﺮﻫﺎ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﻭﺯﺍﺭﺍﺕ ﺃﺧﺮﻯ‪.‬‬
‫ﻭﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻫﻲ ﺍﳉﻬﺔ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﻟﱵ ﺗﻮﻓﺮ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺪﻥ ﻭﺭﻳﻒ ﻣﺼﺮ‪ ،‬ﻭﻫﻰ‬
‫ﺍﳌﺆﺳﺴﺔ ﺍﻟﻮﺣﻴﺪﺓ ﺍﳌﺴﺌﻮﻟﺔ ﻋﻦ ﺗﻮﻓﲑ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﰲ ﻣﺼﺮ‪ .‬ﻭﺗﻮﻓﺮ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ ﻣﻦ ﺧﻼﻝ ﺛﻼﺛﺔ ﻣﺴﺘﻮﻳﺎﺕ‪ :‬ﺍﳌﺴﺘﻮﻯ ﺍﳌﺮﻛﺰﻱ‪ ،‬ﻭﻣﺴﺘﻮﻯ ﺍﶈﺎﻓﻈﺎﺕ‪،‬‬
‫ﻭﺍﳌﺴﺘﻮﻯ ﺍﻟﻘﺮﻭﻱ‪ .‬ﻭﻻ ﻳﻮﺟﺪ ﻧﻈﺎﻡ ﻣﺮﺟﻌﻲ ﳏﺪﺩ ﳍﺬﺍ ﺍﻟﻨﻈﺎﻡ‪ ،‬ﻓﻠﻠﻔﺮﺩ ﺍﳊﻖ ﰲ ﻃﻠﺐ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﻣﻦ ﺃﻱ ﺟﻬﺔ ﺣﻜﻮﻣﻴﺔ ﳜﺘﺎﺭﻫﺎ ﻋﻠﻰ ﺃﻱ ﻣﺴﺘﻮﻯ )ﳏﺎﻓﻈﺔ‪ ،‬ﻣﺪﻳﺮﻳﺔ‪ ،‬ﻗﺮﻳﺔ(‪.(Nassar 1995) .‬‬
‫‪ .٢‬ﺗﻌﻤﻞ ﻭﺯﺍﺭﺍﺕ ﺣﻜﻮﻣﻴﺔ ﺃﺧﺮﻯ ﻣﺜﻞ ﻫﻴﺌﺔ ﺍﻟﺴﻜﻚ ﺍﳊﺪﻳﺪﻳﺔ‪ ،‬ﻭﺯﺍﺭﺓ ﺍﻟﺪﻓﺎﻉ‪ ،‬ﻭﺯﺍﺭﺓ ﺍﻟﺪﺍﺧﻠﻴﺔ ﻭﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻌﺎﱄ‪ ،‬ﻛﺠﻬﺎﺕ ﻣﺴﺘﻘﻠﺔ ﰲ ﺗﻮﻓﲑ ﺑﻌﺾ ﺧﺪﻣﺎﺕ ﺻﺤﻴﺔ ﻭﲤﻮﳍﺎ ﻣﻦ ﻣﻴﺰﺍﻧﻴﺎ‪‬ﺎ‪ .‬ﻓﻤﺜﻼ‬
‫ﲤﻮﻝ ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻌﺎﱄ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﻴﺔ‪ .‬ﻭﺗﻘﻮﻡ ﻭﺯﺍﺭﺓ ﺍﻟﺪﻓﺎﻉ ﺑﺘﻤﻮﻳﻞ‬
‫ﺑﻌﺾ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳋﺎﺻﺔ ﲟﺆﺳﺴﺎ‪‬ﺎ ﺍﻟﻄﺒﻴﺔ‪ ..‬ﻭﻫﻜﺬﺍ‪.‬‬

‫‪٨٧‬‬
 ‫ﺏ – ﻣﺆﺳﺴﺎﺕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ‬
‫ﺗﺘﻤﺜﻞ ﺗﻠﻚ ﺍﳌﺆﺳﺴﺎﺕ ﰲ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ ،‬ﻭﻫﻴﺌﺔ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪ ،‬ﻭﺍﳌﺆﺳﺴﺔ‬
‫ﺍﻟﻌﻼﺟﻴﺔ‪.‬‬
‫ﻭﺗﻮﻓﺮ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻛﻼﹰ ﻣﻦ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺘﺄﻣﲔ ﺿﺪ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻟﻠﻤﻮﻇﻔﲔ‪.‬‬
‫ﻭﻋﻠﻰ ﲨﻴﻊ ﺍﳌﻮﻇﻔﲔ ﺩﻓﻊ ﺃﻗﺴﺎﻁ ﺗﺄﻣﻴﻨﻴﺔ ﳏﺪﺩﺓ ﺑﻘﻮﺍﻧﲔ؛ ﺍﻟﻘﺎﻧﻮﻥ ﺍﻷﻭﻝ ﺭﻗﻢ ‪ ٣٢‬ﺍﻟﺬﻱ ﻳﻐﻄﻰ‬
‫ﻣﻮﻇﻔﻲ ﺍﳊﻜﻮﻣﺔ‪ ،‬ﻭﺍﻟﻘﺎﻧﻮﻥ ﺍﻟﺜﺎﱐ ﺭﻗﻢ ‪ ٧٩‬ﺍﻟﺬﻱ ﻳﻐﻄﻰ ﻣﻮﻇﻔﻲ ﺍﳊﻜﻮﻣﺔ ﻭﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‪ .‬ﻭﻫﻨﺎﻙ‬
‫ﻣﺆﺳﺴﺘﺎﻥ ﲡﻤﻌﺎﻥ ﻫﺬﻩ ﺍﻷﻗﺴﺎﻁ ﻭﳘﺎ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﻭﺍﳌﻌﺎﺷﺎﺕ‪.‬‬
‫ﻭﻣﻨﺬ ﻋﺎﻡ ‪ ١٩٨٤‬ﺃﺻﺒﺢ ﻟﻠﺸﺮﻛﺎﺕ ﺃﻥ ﺗﺪﻓﻊ ﺍﻷﻗﺴﺎﻁ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﳌﻮﻇﻔﻴﻬﺎ ﰲ ﺣﺎﻟﺔ ﺇﺫﺍ ﻛﺎﻧﺖ ﺗﻮﻓﺮ‬
‫ﺧﺪﻣﺎﺕ ﺻﺤﻴﺔ ﳌﻮﻇﻔﻴﻬﺎ ﰲ ﻣﻜﺎﻥ ﺁﺧﺮ ﻭﻋﻠﻴﻬﻢ ﰲ ﻛﻞ ﺍﻷﺣﻮﺍﻝ ﺩﻓﻊ ﺟﺰﺀ ﻣﻦ ﺍﻷﻗﺴﺎﻁ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﺇﱃ‬
‫ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )‪ .(Kemprecos, 1993‬ﻳﺪﻓﻊ ﺍﳌﻮﻇﻔﻮﻥ ﺍﻟﺬﻳﻦ ﻳﻨﻄﺒﻖ ﻋﻠﻴﻬﻢ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ‬
‫‪ ٧٩‬ﻟﺴﻨﺔ ‪ (%١) ١٩٧٥‬ﻣﻦ ﻣﺮﺗﺒﻬﻢ ﺍﻷﺳﺎﺳﻲ ﻭ‪ %٣‬ﻳﺪﻓﻌﻬﺎ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ‪ .‬ﰲ ﺣﲔ ﻳﺪﻓﻊ ﺍﳌﻮﻇﻔﻮﻥ‬
‫ﺍﻟﺬﻳﻦ ﻳﻨﻄﺒﻖ ﻋﻠﻴﻬﻢ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٣٢‬ﻟﺴﻨﺔ ‪ %٠,٥ ١٩٧٥‬ﻓﻘﻂ ﻣﻦ ﻣﺮﺗﺒﻬﻢ ﺍﻷﺳﺎﺳﻲ‪ .‬ﻭﻳﺴﺎﻫﻢ‬
‫ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ ﺑﻨﺴﺒﺔ ‪ .%١,٥‬ﻭﲤﻮﻝ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﻷﺻﺤﺎﺏ ﺍﳌﻌﺎﺷﺎﺕ ﻭﺍﻷﺭﺍﻣﻞ ﻣﻦ ﺧﻼﻝ ﻗﺴﻂ‬
‫ﺗﺄﻣﻴﲏ ﻧﺴﺒﺘﻪ ‪ %١‬ﻣﻦ ﺍﳌﻌﺎﺵ ﺍﻷﺳﺎﺳﻲ‪.‬‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ‪ ،‬ﳝﻮﻝ ﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﺄﻣﲔ ﺍﻟﻄﱯ ﻋﻠﻰ ﺍﻟﻄﻼﺏ ﻣﻦ ﺧﻼﻝ ﺍﺷﺘﺮﺍﻙ ﺳﻨﻮﻱ ﻳﺪﻓﻌﻪ ﺍﻟﻄﻼﺏ‬
‫ﻛﻞ ﻋﺎﻡ ﺩﺭﺍﺳﻲ ﻭﻓﻘﺎﹰ ﳊﺎﻟﺘﻬﻢ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ‪ .‬ﻭﻟﻮ ﺃﻥ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﻧﻔﺬ ﻛﻤﺎ ﳚﺐ ﻟﻜﺎﻥ ﻣﻦ‬
‫ﺍﳌﺘﻮﻗﻊ ﺃﻥ ﻳﻐﻄﻰ ‪ ١٤‬ﻣﻠﻴﻮﻥ ﻃﻔﻞ ﺗﻘﺮﻳﺒﺎﹰ ﺧﻼﻝ ‪ ٥‬ﺳﻨﻮﺍﺕ‪ .‬ﻭﻳﺴﺘﻤﺪ ﺍﻟﺘﻤﻮﻳﻞ ﻣﻦ ﻋﺪﺓ ﻣﺼﺎﺩﺭ ﻫﻲ‪:‬‬
‫ﺍﻟﻀﺮﺍﺋﺐ ﺍﳉﺪﻳﺪﺓ ﻋﻠﻰ ﺍﻟﺴﺠﺎﺋﺮ‪ ،‬ﻭﻣﺴﺎﳘﺎﺕ ﺣﻜﻮﻣﻴﺔ ﺇﺿﺎﻓﻴﺔ‪ ،‬ﻭﺗﱪﻋﺎﺕ ﻣﻦ ﻋﺎﺋﻼﺕ ﺍﻷﻃﻔﺎﻝ ﰲ ﻛﻞ‬
‫ﻣﻦ ﺍﳌﺪﺍﺭﺱ ﺍﳊﻜﻮﻣﻴﺔ ﻭﺍﳋﺎﺻﺔ ﻟﻠﺨﺪﻣﺎﺕ‪ .‬ﻭﻳﺘﻤﺘﻊ ﺍﳌﺴﺘﻔﻴﺪﻭﻥ ﲟﺠﻤﻮﻋﺔ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺗﺘﻀﻤﻦ‬
‫ﺍﻟﻔﺤﻮﺹ ﺍﻟﻄﺒﻴﺔ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ‪ ،‬ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﺍﻟﻔﺮﺩﻳﺔ‪ ،‬ﻭﻋﻼﺝ ﺍﳌﺮﺿﻰ ﺧﺎﺭﺝ ﻭﺩﺍﺧﻞ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﻣﺜﻞ ﺍﻟﻔﺤﻮﺹ ﺍﳌﻌﻤﻠﻴﺔ ﻭﺍﺧﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺺ‪ .‬ﻭﻗﺪ ﺑﺪﺃﺕ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻣﻨﺬ ﻓﺘﺮﺓ ﺃﻳﻀﺎﹰ‬
‫ﺑﺘﻄﺒﻴﻖ ﻧﻈﺎﻡ ﺗﻌﺎﻗﺪ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﻣﺜﻠﻤﺎ ﺣﺪﺙ ﻣﻊ ﺟﺎﻣﻌﺔ ﻗﻨﺎﺓ ﺍﻟﺴﻮﻳﺲ )‪(Kemprecos, 1993‬‬
‫ﺃﻣﺎ ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻓﺘﺪﺍﺭ ﻭﲤﻮﻝ ﺑﺼﻮﺭﺓ ﻣﺴﺘﻘﻠﺔ ﻣﺜﻞ ﺃﻱ ﻣﺆﺳﺴﺔ ﺑﺎﻟﻘﻄﺎﻉ‬
‫ﺍﳋﺎﺹ‪ .‬ﻭﺗﻌﺘﱪ ﻫﺬﻩ ﺍﳌﺆﺳﺴﺔ ﻣﺴﺘﻘﻠﺔ ﺑﺬﺍ‪‬ﺎ ﻣﻨﺬ ﻋﺎﻡ ‪ .١٩٨٢‬ﻭﺗﺘﻜﻮﻥ ﻣﺼﺎﺩﺭﻫﺎ ﺍﳌﺎﻟﻴﺔ ﻣﻦ ﺃﺟﻮﺭ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﳌﻌﻤﻠﻴﺔ ﻭﺧﺪﻣﺎﺕ ﺍﳌﺮﺿﻰ ﺍﳌﻘﻴﻤﲔ ﺩﺍﺧﻞ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﻷﻗﺴﺎﻁ ﻭﺍﳌﺼﺮﻭﻓﺎﺕ ﻣﻦ‬
‫ﺍﻟﺘﻌﺎﻗﺪﺍﺕ ﻭﻧﺴﺒﺔ ﻣﻦ ﻣﺒﻴﻌﺎﺕ ﺍﻷﺩﻭﻳﺔ ﻭﺍﻹﻋﺎﻧﺔ ﺍﳊﻜﻮﻣﻴﺔ ﻟﻸﺳ‪‬ﺮﺓ ﺍ‪‬ﺎﻧﻴﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻟﺘﱪﻋﺎﺕ‬
‫ﻭﺍﳌﻨﺢ‪ .‬ﻭﺗﻀﻢ ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﺩﺭﺟﺎﺕ ﳐﺘﻠﻔﺔ ﻟﻺﻗﺎﻣﺔ )ﺍﻷﻭﱃ ﻭﺍﻟﺜﺎﻧﻴﺔ ﻭﺍﻟﺜﺎﻟﺜﺔ(‪.‬‬
‫ﻭﺗﻌﺘﱪ ﺧﺪﻣﺎﺕ ﻫﺬﻩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻣﻨﺨﻔﻀﺔ ﺍﻟﺘﻜﻠﻔﺔ ﻧﺴﺒﻴﺎﹰ ﻭﺗﺴﺘﺨﺪﻡ ﻫﺬﻩ ﺍﳌﺼﺎﺭﻳﻒ ﻟﺘﺤﺴﲔ‬
‫ﺍﳋﺪﻣﺔ ﻭﲤﻮﻳﻞ ﺍﻷﺳ‪‬ﺮﺓ ﺍ‪‬ﺎﻧﻴﺔ‪.‬‬
‫ﻭﲤﻮﻝ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﺃﺳﺎﺳﺎﹰ ﻋﻦ ﻃﺮﻳﻖ ﺍﳊﻜﻮﻣﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺑﻌﺾ ﺍﻟﺪﺧﻞ ﺍﻟﺬﺍﰐ ﻣﻦ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﺍﳌﺘﻤﻴﺰﺓ ﻣﻘﺎﺑﻞ ﺃﺟﺮ‪.‬‬

‫‪٨٨‬‬
 ‫ﺝ ‪ -‬ﻣﺆﺳﺴﺎﺕ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‬
‫ﺗﻌﺪ ﺷﺮﻛﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﳋﺎﺻﺔ ﳏﺪﻭﺩﺓ ﻟﻠﻐﺎﻳﺔ ﰲ ﻣﺼﺮ ﻭﺗﺘﺮﻛﺰ ﰲ ﺍﻟﻘﺎﻫﺮﺓ ﻭﺍﻹﺳﻜﻨﺪﺭﻳﺔ‪ .‬ﻭﲡﻤﻊ ﻫﺬﻩ‬
‫ﺍﳌﺆﺳﺴﺎﺕ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺎﻟﻴﺔ ﻣﻦ ﺍﻷﻓﺮﺍﺩ ﻭﺃﺻﺤﺎﺏ ﺍﻟﻌﻤﻞ‪ .‬ﻭﺗﻮﻓﺮ ﺑﻌﺾ ﺍﳌﺆﺳﺴﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﻭﺗﺘﻠﻘﻰ ﲤﻮﻳﻼﹰ ﻣﻦ ﺑﻌﺾ ﺍﳍﻴﺌﺎﺕ ﺍﻟﺪﻭﻟﻴﺔ ﻭﺍﶈﻠﻴﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻷﻓﺮﺍﺩ‪ .‬ﻭﻫﻨﺎﻙ ﺑﻌﺾ‬
‫ﺍﳌﺴﺎﺟﺪ ﺍﻟﱵ ﺗﻘﺪﻡ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﺃﳓﺎﺀ ﻋﺪﻳﺪﺓ ﻣﻦ ﺍﳉﻤﻬﻮﺭﻳﺔ‪.‬‬
‫ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻣﺎ ﺳﺒﻖ ﻫﻨﺎﻙ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﺍﳋﺎﺻﺔ ﻟﺬﻭﻯ ﺍﻟﺪﺧﻞ ﺍﳌﺮﺗﻔﻊ ﻭﺍﳌﺘﻮﺳﻂ‪ .‬ﻭﺗﺘﻀﻤﻦ‬
‫ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺻﺔ‪ ،‬ﻭﻣﺮﺍﻛﺰ ﺍﻷﺷﻌﺔ‪ ،‬ﻭﺍﻟﺒﺎﺛﻮﻟﻮﺟﻴﺎ ﺍﻹﻛﻠﻴﻨﻴﻜﻴﺔ‪ ،‬ﻭﺍﳌﻌﺎﻣﻞ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﳊﺪﻳﺜﺔ ﺍﻟﱵ ﺍﻧﺘﺸﺮﺕ ﺑﻌﺪ ﻗﺎﻧﻮﻥ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺳﻨﺔ ‪ .١٩٧٤‬ﻭﻗﺪ ﺃﺣﺪﺙ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﳕﻮﺍﹰ ﺳﺮﻳﻌﺎﹰ ﻣﻦ‬
‫ﻧﺎﺣﻴﺔ ﺍﻷﻃﺒﺎﺀ ﻭﺍﻷﺳ‪‬ﺮﺓ ﺧﺎﺻﺔ ﺑﻌﺪ ﺭﻓﻊ ﺍﻟﻘﻴﻮﺩ ﻋﻦ ﺑﻨﺎﺀ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﰲ ﺑﺪﺍﻳﺔ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ‪ .‬ﻭﺍﺭﺗﻔﻊ‬
‫ﻋﺪﺩ ﺍﻷﺳ‪‬ﺮﺓ ﺍﻹﲨﺎﱄ ﰲ ﻣﺼﺮ ﺑﻨﺴﺒﺔ ‪ %٦٠‬ﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ ‪ ١٩٧٥‬ﺇﱃ ‪ ،١٩٩٠‬ﺑﻴﻨﻤﺎ ﺍﺭﺗﻔﻌﺖ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ‬
‫ﺑﻮﺍﻗﻊ ‪ %١٨٠‬ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‪.‬‬
‫ﻭﻳﺸﲑ ﺍﳉﺪﻭﻝ ﺭﻗﻢ )‪ (١-٤‬ﺇﱃ ﺍﻷﳘﻴﺔ ﺍﻟﻨﺴﺒﻴﺔ ﻟﻠﻘﻄﺎﻋﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﺍﻟﱵ ﺗﻮﻓﺮ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻭﻳﺘﻀﺢ ﻣﻦ ﺍﳉﺪﻭﻝ ﺃﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻫﻲ ﺍﳉﻬﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﱵ ﺗﻮﻓﺮ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ‪.‬‬
‫ﻭﻳﻮﻓﺮ ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ ﺗﻘﺮﻳﺒﺎﹰ ﺛﻼﺛﺔ ﺃﺭﺑﺎﻉ ﺍﻷﺳ‪‬ﺮﺓ ﰲ ﻣﺼﺮ‪ ،‬ﺑﻴﻨﻤﺎ ﻳﺴﺎﻫﻢ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﺑﻨﺴﺒﺔ ‪%٩‬‬
‫ﻣﻦ ﺇﲨﺎﱄ ﺍﻷﺳﺮ‪‬ﺓ ﻭﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﺑﻨﺴﺒﺔ ‪ %١٠‬ﻣﻦ ﺇﲨﺎﱄ ﺍﻷﺳ‪‬ﺮﺓ ﰲ ﻣﺼﺮ‪.‬‬

‫ﺟﺪﻭﻝ ﺭﻗﻢ )‪ :(١-٤‬ﺍﺣﺘﻴﺎﻃﻲ ﺍﻷﺳ‪‬ﺮﺓ )ﻧﺴﺒﺔ ﺍﻷﺳﺮ‪‬ﺓ ﺇﱃ ﺍﻟﻨﺴﺒﺔ ﺍﻹﲨﺎﻟﻴﺔ ﲟﺼﺮ( ‪١٩٩٧‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ‬ ‫ﻋﺪﺩ ﺍﻷﺳﺮﺓ‬ ‫ﻋﺪﺩ ﺍﻟﻮﺣﺪﺍﺕ‬ ‫ﺍﻟﻮﺻﻒ‬
‫‪%٥٦,٩٨‬‬ ‫‪٧٠٤٧٠‬‬ ‫‪١٢٣٨‬‬ ‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‬
‫‪%٢٦,٤٥‬‬ ‫‪٣٢٧١٤‬‬ ‫‪٢٢٣‬‬ ‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻷﺣﻴﺎﺀ‬
‫‪%٠,٣٩‬‬ ‫‪٤٨٢‬‬ ‫‪٦‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻮﻻﺩﺓ ﻭﺍﻷﻃﻔﺎﻝ‬
‫‪%٥,٦٥‬‬ ‫‪٦٩٨٤‬‬ ‫‪١٢‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻔﻌﻠﻴﺔ‬
‫‪%٦,١١‬‬ ‫‪٧٥٦٠‬‬ ‫‪٣٤‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺻﺪﺭ‬
‫‪%٠,١٧‬‬ ‫‪٢١٥‬‬ ‫‪١٢‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺼﺪﺭ ﻣﺴﺘﻮﺻﻔﺎﻥ ﺻﺪﺭ ﺑﺄﺳﺮﺓ‬
‫‪%٠,٠٦‬‬ ‫‪٧٣‬‬ ‫‪١‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻷﻣﺮﺍﺽ ﺍﳉﻠﺪﻳﺔ‬
‫‪%١,٤١‬‬ ‫‪١٧٤٤‬‬ ‫‪٣١‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﻃﺐ ﻭﺃﻣﺮﺍﺽ ﺍﻟﻌﻴﻮﻥ‬
‫‪%٠,٠٨‬‬ ‫‪١٠٥‬‬ ‫‪١‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻷﻭﺭﺍﻡ *‬
‫‪%٠,٠٥‬‬ ‫‪٦٨‬‬ ‫‪٩‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻮﻃﻨﺔ‬
‫‪%٦,٣٥‬‬ ‫‪٧٨٥٦‬‬ ‫‪٨٨‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﳊﻤﻴﺎﺕ‬
‫‪%٠,٩٦‬‬ ‫‪٠٠,٥٨‬‬ ‫‪٤‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻜﻠﺐ‬
‫‪%٠,١٥‬‬ ‫‪١٨٥‬‬ ‫‪٥‬‬ ‫ﺍﻟﻌﺰﻝ‬
‫‪%٠,٢٨‬‬ ‫‪٣٤٣‬‬ ‫‪٢٣٢‬‬ ‫ﻣﺮﺍﻛﺰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‬
‫ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‬
‫‪%٤,٣٩‬‬ ‫‪٥٤٣٠‬‬ ‫‪٢٠٧‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﻗﺮﻭﻳﺔ‬
‫‪%٤,٤٧‬‬ ‫‪٥٥٢٦‬‬ ‫‪٣٧٣‬‬ ‫ﻣﺮﺍﻛﺰ ﺍﻟﺼﺤﺔ ﺍﻟﻘﺮﻭﻳﺔ ) ﳎﻤﻮﻋﺎﺕ ﺻﺤﻴﺔ (‬
‫ﻣﻨﻈﻤﺎﺕ ﻭﻣﻌﺎﻫﺪ‬
‫‪%٣,١٣‬‬ ‫‪٣٨٦٩‬‬ ‫‪٨‬‬ ‫ﻫﻴﺌﺔ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﳌﻌﺎﻫﺪ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‬

‫‪٨٩‬‬
 ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ‬ ‫ﻋﺪﺩ ﺍﻷﺳﺮﺓ‬ ‫ﻋﺪﺩ ﺍﻟﻮﺣﺪﺍﺕ‬ ‫ﺍﻟﻮﺻﻒ‬
‫‪%٠,٧١‬‬ ‫‪٨٨٤‬‬ ‫‪١٠‬‬ ‫ﻣﺮﺍﻛﺰ ﻋﻼﺟﻴﺔ‬
‫‪%٤,٤٣‬‬ ‫‪٥٤٧٧‬‬ ‫‪٢١‬‬ ‫ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ‬
‫‪%٥,١٦‬‬ ‫‪٦٣٨٠‬‬ ‫‪٢٢‬‬ ‫ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺗﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺍﺕ ﺃﺧﺮﻯ‬
‫‪%١٣,٣‬‬ ‫‪١٨٨٦٩‬‬ ‫‪٣٦‬‬ ‫ﺍﳉﺎﻣﻌﺎﺕ )ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﺔ(‬
‫‪%٠,١٧‬‬ ‫‪٨٤٤‬‬ ‫‪١٠‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻄﻠﺒﺔ‬
‫‪%٠,٨٢‬‬ ‫‪١٠١٦‬‬ ‫‪١٧‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺸﺮﻃﺔ ﻭﺍﻟﺴﺠﻮﻥ‬
‫ﻣﻌﺎﻫﺪ ﺃﺧﺮﻯ‬
‫‪٠,٢٥٥‬‬ ‫‪٣٤٦‬‬ ‫‪٣‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺴﻜﻚ ﺍﳊﺪﻳﺪﻳﺔ‬
‫‪%١,٢٨‬‬ ‫‪١٥٨٢‬‬ ‫‪٢٠‬‬ ‫ﻣﻌﺎﻫﺪ ﺃﺧﺮﻯ‬
‫‪%١١,٧٦‬‬ ‫‪١٤٥٤٥‬‬ ‫‪٧٥٢‬‬ ‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺑﺎﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‬
‫‪%١٠٠‬‬ ‫‪١٢٣٦٧١‬‬ ‫‪٢١٣٩‬‬ ‫ﺍﻟﺮﻗﻢ ﺍﻟﻜﻠﻲ‬
‫* ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ‪١٩٩٧‬‬

‫‪ -٢‬ﻣﺼﺎﺩﺭ ﻭﺃﻧﻮﺍﻉ ﺍﻟﺘﻤﻮﻳﻞ ﻟﻺﻧﻔﺎﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‬

‫ﺗﻌﺪ ﺍﳊﻜﻮﻣﺔ ﺃﻫﻢ ﻣﺼﺎﺩﺭ ﺍﻟﺘﻤﻮﻳﻞ ﻭﺫﻟﻚ ﻣﻦ ﺧﻼﻝ ﺍﻟﺪﺧﻞ ﺍﳊﻜﻮﻣﻲ ﺍﻟﺬﻱ ﻳﺘﻜﻮﻥ ﻣﻦ ﺍﻟﻀﺮﺍﺋﺐ‪ ،‬ﺍﳌﻨﺢ‬
‫ﺍﻟﺪﻭﻟﻴﺔ ﻭﺍﶈﻠﻴﺔ ﰲ ﺷﻜﻞ ﺗﱪﻋﺎﺕ ﻭﻣﺴﺎﳘﺎﺕ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻭﺍﳋﺎﺻﺔ ﻭﺇﻧﻔﺎﻕ‬
‫ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳋﺎﺻﺔ ﻛﻤﺎ ﻫﻮ ﻣﻮﺿﺢ ﰲ ﺍﳉﺪﻭﻝ ﺭﻗﻢ )‪.(٢-٤‬‬

‫ﺟﺪﻭﻝ )‪ :(٢-٤‬ﻣﺼﺎﺩﺭ ﻭﺃﻧﻮﺍﻉ ﺍﻟﺘﻤﻮﻳﻞ ﻟﻠﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‬

‫ﺃﻧﻮﺍﻉ ﺍﻟﺘﻤﻮﻳﻞ‬ ‫ﻣﺼﺎﺩﺭ ﺍﻟﺘﻤﻮﻳﻞ‬
‫ﺍﻟﺪﺧﻞ ﺍﳊﻜﻮﻣﻲ ﻣﻦ ﺍﻟﻀﺮﺍﺋﺐ‬ ‫ﺍﳊﻜﻮﻣﺔ‬
‫ﺍﻟﺘﱪﻋﺎﺕ‬ ‫ﺍﳍﻴﺌﺎﺕ ﺍﳌﺎﳓﺔ ﺍﻟﺪﻭﻟﻴﺔ ﻭﺍﶈﻠﻴﺔ‬
‫ﺍﳌﺴﺎﳘﺎﺕ‬ ‫ﺍﻟﺸﺮﻛﺎﺕ ﺍﳋﺎﺻﺔ ﻭﺍﻟﻌﺎﻣﺔ‬
‫ﺍﳌﺸﺘﺮﻳﺎﺕ ﻭﺍﳌﺴﺎﳘﺎﺕ‬ ‫ﺍﻟﻘﻄﺎﻉ ﺍﳌﱰﱄ‬

‫‪ -٣‬ﻣﺼﺎﺩﺭ ﻭﺍﲡﺎﻫﺎﺕ ﺍﻹﻧﻔﺎﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‬

‫ﻳﻌﺮﺽ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٣-٤‬ﳎﻤﻮﻋﺘﲔ ﻣﻦ ﺍﻟﺒﻴﺎﻧﺎﺕ‪ .‬ﺍ‪‬ﻤﻮﻋﺔ ﺍﻷﻭﱃ ﻫﻲ ﺑﻴﺎﻧﺎﺕ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻋﻠﻰ‬
‫ﺍﳌﺴﺘﻮﻯ ﺍﻟﻘﻮﻣﻲ ﳌﺼﺮ ﻟﺴﻨﺔ ‪ ،١٩٩١ / ١٩٩٠‬ﺃﻣﺎ ﺍ‪‬ﻤﻮﻋﺔ ﺍﻟﺜﺎﻧﻴﺔ ﻓﻬﻲ ﺑﻴﺎﻧﺎﺕ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ ﻟﺴﻨﺔ ‪ .١٩٩٦/٩٥‬ﻭﺗﻌﺪ ﺍﳌﺼﺎﺩﺭ ﺍﻟﺜﻼﺛﺔ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻺﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﻫﻲ‬
‫ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ )ﺇﻧﻔﺎﻕ ﺧﺎﺹ(‪ ،‬ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ )ﻛﻞ ﻣﻦ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ( ﻭﻫﻴﺌﺔ‬
‫ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )ﺇﻧﻔﺎﻕ ﻋﺎﻡ(‪ .‬ﻭﻳﺸﻜﻠﻮﻥ ﻣﻌﺎﹰ ﺃﻛﺜﺮ ﻣﻦ ‪ %٩٥‬ﻣﻦ ﳎﻤﻮﻉ ﺇﻧﻔﺎﻕ ﺍﻟﺼﺤﺔ ﻟﺴﻨﺔ ‪/ ٩٠‬‬
‫‪ ١٩٩١‬ﻭ‪ %٩٨‬ﻟﺴﻨﺔ ‪.١٩٩٦/٩٥‬‬

‫‪٩٠‬‬
 ‫ﺟﺪﻭﻝ )‪ :(٣-٤‬ﻣﺼﺎﺩﺭ ﺍﻹﻧﻔﺎﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﰲ ﻣﺼﺮ‪٩٦/١٩٩٥ ،٩١–١٩٩٠ :‬‬
‫)ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ ﻣﺼﺮﻱ(‬
‫‪(٢) ١٩٩٦/٩٥‬‬ ‫‪(١) ١٩٩١/٩٠‬‬ ‫ﻣﺼﺎﺩﺭ ﺍﻟﺘﻤﻮﻳﻞ ﺍﳊﻜﻮﻣﻰ‬
‫‪(%٢٩) ٢١٩٥,٤‬‬ ‫‪(%٢٩) ١٢٠٨‬‬ ‫ﺍﳊﻜﻮﻣﺔ‬
‫‪(%١٤,١) ١٠٦٧,١‬‬ ‫‪( %٨,٩) ٣٧٠‬‬ ‫ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻟﻘﻮﻣﻲ‬
‫‪(%٥٥) ٤١١٢‬‬ ‫‪(%٥٥,٧) ٢٣٢٢‬‬ ‫ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ‬
‫‪(%١,٣) ١٠٠‬‬ ‫‪( %٢) ٨٠‬‬ ‫ﺍﻟﺸﺮﻛﺎﺕ‬
‫ﻏﲑ ﻣﺘﺎﺣﺔ‬ ‫‪١٨١‬‬ ‫ﺍﳌﺘﱪﻋﲔ‬
‫‪(%١,٥) ١٧١,٨‬‬ ‫ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ‬
‫‪٧٥٨٩,٥‬‬ ‫‪٤١٦٦‬‬ ‫ﺍ‪‬ﻤﻮﻉ‬
‫* ﺍﳌﺼﺪﺭ‪:‬‬
‫‪1. Des Rochers, G. “Health Care Financing”, 1996 Health Sector, World Bank.‬‬
‫‪2. Compiled from MOH, HIO, CCO and CAPMAS Expenditure Data‬‬
‫ﺃ – ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺣﻘﻴﻘﺔ ﺃﻥ ﺍﳊﻜﻮﻣﺔ ﻫﻲ ﺍﳉﻬﺔ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﻟﱵ ﺗﻮﻓﺮ ﺍﳋﺪﻣﺎﺕ ﰲ ﻣﺼﺮ ﻓﺈﻥ ﺇﻧﻔﺎﻗﻬﺎ‬
‫ﻳﺸﻜﻞ ‪ %٢٩‬ﻣﻦ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﺴﻨﺔ ‪ ،١٩٩١ / ٩٠‬ﻭﺑﻨﻔﺲ ﺍﻟﻨﺴﺒﺔ ﻟﺴﻨﺔ ‪ ١٩٩٨‬ﻛﻤﺎ‬
‫ﻳﻮﺿﺢ ﺑﺎﳉﺪﻭﻝ ﺭﻗﻢ ‪ .٣-٤‬ﻭﻳﻌﺪ ﺇﻧﻔﺎﻕ ﻛﻞ ﻣﻦ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻌﺎﱄ ﻣﺼﺪﺭﺍ ﻫﺎﻣﺎ‬
‫ﻟﻺﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ‪ ،‬ﺃﻣﺎ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﺒﻘﻴﺔ ﺍﻟﻮﺯﺍﺭﺍﺕ ﺍﳊﻜﻮﻣﻴﺔ ﻣﺜﻞ ﺍﻟﺪﻓﺎﻉ ﻭﺍﻟﺪﺍﺧﻠﻴﺔ ﻓﻴﺼﻌﺐ‬
‫ﺗﻘﻴﻴﻤﻪ‪ .‬ﻭﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٤‬ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺎﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﺍﻟﻌﺎﻡ ‪.١٩٩٧/٩٦‬‬
‫ﻭﺗﻈﻬﺮ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﳌﺘﺎﺣﺔ ﺃﻥ ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﳝﺜﻞ ‪ %٦٠,٥‬ﻣﻦ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‪ ،‬ﻭﻳﺄﰐ ﺑﻌﺪﻫﺎ‬
‫ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺑﻨﺴﺒﺔ ‪ %٣١,١‬ﻭﻳﺸﲑ ﻫﺬﺍ ﺍﳉﺪﻭﻝ ﺇﱃ ﺃﻥ ﺍﳍﻴﺌﺘﲔ ﲤﺜﻼﻥ ‪ %٩١,٦‬ﻣﻦ ﺇﻧﻔﺎﻕ‬
‫ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ )ﻳﺴﺘﺜﲎ ﻣﻦ ﺫﻟﻚ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ(‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٤-٤‬ﻣﻴﺰﺍﻧﻴﺔ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ )ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ ﻣﺼﺮﻱ(‬
‫‪٩٧/٩٦‬‬ ‫‪٩٦/٩٥‬‬ ‫ﺍﻟﺒﺎﺏ‬ ‫ﺍﳍﻴﺌﺔ‬
‫‪٤١,٧‬‬ ‫‪٣٦,٥‬‬ ‫‪I‬‬
‫‪٣٤,٢‬‬ ‫‪٣٣,١‬‬ ‫‪II‬‬ ‫ﻣﺆﺳﺴﺔ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‬
‫‪٦١,٩‬‬ ‫‪٤٥,٨‬‬ ‫‪III‬‬
‫‪٩٤٠,٧‬‬ ‫‪٨٤٥,٣‬‬ ‫‪I‬‬
‫‪٣١٤,٧‬‬ ‫‪٤٩٠,٩‬‬ ‫‪II‬‬ ‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫‪٩١٣,٨‬‬ ‫‪٧٤٣,٨‬‬ ‫‪III‬‬
‫‪٢٨٣,١‬‬ ‫‪٢٣٩,٣‬‬ ‫‪I‬‬
‫‪٨٤٦,٢‬‬ ‫‪٧٥٥,٩‬‬ ‫‪II‬‬ ‫ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻰ‬
‫‪٦١,٣‬‬ ‫‪٧١,٩‬‬ ‫‪III‬‬
‫‪٣٠,٨‬‬ ‫‪٢٤,٩‬‬ ‫‪I‬‬
‫‪١٦٠,٧‬‬ ‫‪١٣٨,٢‬‬ ‫‪II‬‬ ‫ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﺑﺎﻟﻘﺎﻫﺮﺓ‬
‫‪١٣,٣‬‬ ‫‪٨,٧‬‬ ‫‪III‬‬
‫‪١٢٩٦‬‬ ‫‪١١٤٦‬‬ ‫‪I‬‬
‫‪٤١٨٨‬‬ ‫‪١٤١٨‬‬ ‫‪II‬‬ ‫ﺍﻻﲨﺎﱃ‬
‫‪١٠٥٠‬‬ ‫‪٨٧٠,٢‬‬ ‫‪III‬‬
‫‪٦٥٣٤‬‬ ‫‪٣٤٣٤‬‬ ‫ﺍﻻﲨﺎﱃ ﺍﻟﻜﻠﻲ‬
‫* ﺍﳌﺼﺪﺭ‪ :‬ﺑﻴﺎﻧﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ‪ ،‬ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻰ‪ ،‬ﻫﻴﺌﺔ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‬

‫‪٩١‬‬
‫ﻭﺑﺪﺭﺍﺳﺔ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻳﺴﺘﻄﻴﻊ ﺍﻟﻔﺮﺩ ﺃﻥ ﻳﺪﺭﻙ ﺃﻧﻪ ﻣﻊ ﺑﺮﺍﻣﺞ ﺍﻹﺻﻼﺡ ﺍﻻﻗﺘﺼﺎﺩﻱ‪ ،‬ﺣﺪﺙ‬
‫ﺍﳔﻔﺎﺽ ﻭﺍﺿﺢ ﰲ ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻨﻮﻱ ﳌﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺎﻷﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ ﻭﺍﳉﺎﺭﻳﺔ ﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ‬
‫ﻣﻦ ‪ .١٩٨٧/ ٨٦ – ١٩٨٢/٨١‬ﻭﻛﺎﻧﺖ ﻫﺬﻩ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻨﻮﻳﺔ ﳌﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺎﻷﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ‬
‫ﻭﺍﳉﺎﺭﻳﺔ ﺳﻠﺒﻴﺔ ﻟﻸﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ ﰲ ﺳﻨﺔ ‪ ١٩٨٧/٨٦‬ﻭﺇﳚﺎﺑﻴﺔ ﻓﻘﻂ ﰲ ﻋﺎﻡ ‪ .١٩ ٩٠/٨٩‬ﻭﻣﻊ ﺗﻄﺒﻴﻖ‬
‫ﺳﻴﺎﺳﺔ ﺍﳋﺼﺨﺼﺔ ﺳﻨﺔ ‪ ١٩٩٢/٩١‬ﺍﺳﺘﻤﺮ ﻫﺬﺍ ﺍﻟﺘﻐﲑ ﺍﳌﺘﺼﺎﻋﺪ ﺣﱴ ‪ ١٩٩٦/٩٥‬ﻣﺸﲑﺍﹰ ﺇﱃ ﻭﺟﻮﺩ‬
‫ﻋﻼﻗﺔ ﻗﻮﻳﺔ ﺑﲔ ﺃﺩﺍﺀ ﺍﻻﻗﺘﺼﺎﺩ ﺍﳌﺼﺮﻱ ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻭﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﺍﳊﻜﻮﻣﻲ ﺣﱴ ﻋﺎﻡ‬
‫‪.١٩٩٦/٩٥‬‬

‫ﺷﻜﻞ )‪ :(١-٤‬ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻨﻮﻱ ﳌﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺎﻷﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ ﻭﺍﳉﺎﺭﻳﺔ‬

‫‪50‬‬

‫‪40‬‬

‫‪30‬‬

‫‪20‬‬

‫‪10‬‬

‫‪0‬‬

‫‪-10‬‬

‫‪-20‬‬
‫‪81/82 82/83 83/84 84/85 85/86 86/87 87/88 88/89 89/90 90/91 91/92 92/93 93/94 94/95 95/96‬‬

‫ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻨﻮﻳﺔ ﰲ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼــﺤﺔ‬ ‫ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻨﻮﻳﺔ ﰲ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﳊﻘﻴﻘﻴ ــﺔ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ﺭﻗﻢ ‪ ١‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﰱ ﻧﻔﺲ ﺍﻟﻮﻗﺖ ﻳﺸﲑ ﺍﳉﺪﻭﻝ )‪ (١-٤‬ﺇﱃ ﺍﳔﻔﺎﺽ ﻣﺘﻮﺳﻂ ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻟﻠﻔﺮﺩ ﺑﺎﻷﺳﻌﺎﺭ‬
‫ﺍﻟﺜﺎﺑﺘﺔ ﻟﺴﻨﺔ ‪ ١٩٩٠‬ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪ ١٩٩٠/٨٩– ١٩٨٦/٨٥‬ﻟﻴﺼﻞ ﺇﱃ ‪ ١٠,٥‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﰲ ﺳﻨﺔ‬
‫‪ .١٩٩٠/٨٩‬ﻭﻟﻘﺪ ﺍﺭﺗﻔﻊ ﻫﺬﺍ ﺍﳌﺒﻠﻎ ﺇﱃ ‪ ١٢,٥‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﻣﻊ ﺯﻳﺎﺩﺓ ﻣﻌﺪﻝ ﺍﻟﻨﻤﻮ ﺍﻟﺴﻨﻮﻱ ﳌﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﺑﺎﻷﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ ﰲ ﺳﻨﺔ ‪ ،١٩٩٥/٩٤‬ﻭﻣﻊ ﺫﻟﻚ ﻳﻈﻞ ﻫﺬﺍ ﺍﻟﺮﻗﻢ ﻣﻨﺨﻔﻀﺎﹰ ﻟﻠﻐﺎﻳﺔ ﺑﺎﳌﻘﺎﺭﻧﺔ‬
‫ﺑﺎﳌﺘﻮﺳﻂ ﺍﻟﺬﻱ ﲢﻘﻖ ﰲ ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ ﺧﺎﺻﺔ ﺃﻧﻪ ﻣﻦ ﺍﳌﻔﺘﺮﺽ ﺃﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺗﻘﺪﻡ ﺷﺮﳛﺔ ﻛﺎﻣﻠﺔ‬
‫ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ ﺑﺪﻭﻥ ﺍﺳﺘﺜﻨﺎﺀ‪.‬‬

‫‪٩٢‬‬
 ‫ﺷﻜﻞ )‪ :(٢-٤‬ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻟﻠﻔﺮﺩ ﺍﻟﻮﺍﺣﺪ ﺑﺎﻷﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ )‪(٩٥/١٩٩٤-٨٢/١٩٨١‬‬

‫‪20‬‬

‫‪15‬‬

‫‪10‬‬

‫‪5‬‬

‫‪0‬‬

‫‪-5‬‬

‫‪-10‬‬

‫‪-15‬‬
‫‪81/82 82/83 83/84 84/85 85/86 86/87 87/88 88/89 89/90 90/91 91/92 92/93 93/94 94/95 95/96‬‬

‫ﻧﺼﻴﺐ ﺍﻟﻔﺮﺩ ﻣﻦ ﺍﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼ ــﺤﺔ )ﺃﺳﻌﺎﺭ ‪(1990‬‬ ‫ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻨﻮﻳﺔ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ٢‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﻳﻮﺿﺢ ﺍﻟﺸﻜﻞ ﺭﻗﻢ )‪ (٣-٤‬ﺣﺪﻭﺙ ﺍﳔﻔﺎﺽ ﰲ ﻧﺴﺒﺔ ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺇﱃ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻡ‬
‫ﻣﻦ ‪ %٢,٨‬ﰲ ﺳﻨﺔ ‪ ١٩٨٢/٨١‬ﺇﱃ ‪ %١,٨‬ﰲ ﺳﻨﺔ ‪ .١٩٩٣/٩٢‬ﻭﻟﻘﺪ ﺯﺍﺩﺕ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﻣﺮﺓ ﺛﺎﻧﻴﺔ ﻣﻊ‬
‫ﺗﻄﺒﻴﻖ ﺍﳌﺮﺣﻠﺔ ﺍﳉﺪﻳﺪﺓ ﻟﻠﺨﺼﺨﺼﺔ ﻭﺇﻋﺎﺩﺓ ﻫﻴﻜﻠﺔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺇﱃ ‪ %٢,٢‬ﰲ ﺳﻨﺔ‬
‫‪.١٩٩٦/٩٥‬‬

‫ﺷﻜﻞ )‪ :(٣-٤‬ﻣﻌﺪﻝ ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﻨﺴﻮﺏ ﺇﱃ ﺇﻧﻔﺎﻕ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ﺍﻹﲨﺎﻟﻴﺔ‬

‫‪3‬‬

‫‪2‬‬

‫‪1‬‬

‫‪0‬‬
‫‪81/82 82/83 83/84 84/85 85/86 86/87 87/88 88/89 89/90 90/91 91/92 92/93 93/94 94/95 95/96‬‬

‫‪Ratio of MOH expenditure to total health sector expenditure‬‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ٣‬ﰱ ﺍﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻫﺬﺍ ﻭﻻ ﻳﻈﻬﺮ ﺍﲡﺎﻩ ﻣﺘﻮﺳﻂ ﻧﺼﻴﺐ ﻛﻞ ﻓﺮﺩ ﰲ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﺼﺤﻲ ﺑﺎﻷﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ‪ ،‬ﺍﻟﺘﻘﻠﺐ‬
‫ﺍﻟﻮﺍﺿﺢ ﰲ ﺍﳌﺆﺷﺮﺍﺕ ﺍﳌﺎﻟﻴﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﺣﻴﺚ ﻳﻮﺿﺢ ﺍﲡﺎﻫﺎ ﻣﺘﺼﺎﻋﺪﺍ ﻣﺴﺘﻤﺮﺍ ﻋﱪ ﺍﻟﻔﺘﺮﺓ‬
‫‪ ١٩٩٥/٩٤– ١٩٨٣/٨٢‬ﻓﻴﻤﺎ ﻋﺪﺍ ﺍﻟﺴﻨﻮﺍﺕ ‪ ١٩٨٨/٨٧‬ﻭ‪.١٩٩١/٩٠‬‬

‫‪٩٣‬‬
 ‫ﺍﻟﺸﻜﻞ )‪ :(٤-٤‬ﻣﻌﺪﻝ ﺍﻟﻨﻤﻮ ﺍﻟﺴﻨﻮﻱ ﻟﻨﺼﻴﺐ ﺍﻟﻔﺮﺩ ﰱ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﺼﺤﻲ ﺑﺎﻷﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ‬

‫‪60‬‬
‫‪50‬‬
‫‪40‬‬
‫‪30‬‬
‫‪20‬‬
‫‪10‬‬
‫‪0‬‬
‫‪-10‬‬
‫‪-20‬‬
‫‪-30‬‬
‫‪-40‬‬
‫‪83/84‬‬ ‫‪84/85 85/86‬‬ ‫‪86/87‬‬ ‫‪87/88 88/89‬‬ ‫‪89/90‬‬ ‫‪90/91‬‬ ‫‪91/92 92/93‬‬ ‫‪93/94‬‬ ‫‪94/95 94/95‬‬ ‫‪95/96‬‬

‫)‪Rate of annual growth of per capita health investment (%‬‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺍﳉﺪﻭﻝ ‪ ٤‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﻣﻊ ﺫﻟﻚ ﻓﺈﻥ ﺍﲡﺎﻩ ﻧﺴﺒﺔ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﻌﺎﻡ ﺇﱃ ﺇﲨﺎﱄ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﺼﺤﻲ‪ ،‬ﻭﻛﺬﻟﻚ ﻧﺴﺒﺔ ﺍﻻﺳﺘﺜﻤﺎﺭ‬
‫ﺍﳋﺎﺹ ﺇﱃ ﺇﲨﺎﱄ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﺼﺤﻲ ﻛﺎﻧﺖ ﻏﲑ ﺛﺎﺑﺘﺔ‪ .‬ﻓﻠﻘﺪ ﺯﺍﺩ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ ﺑﺸﻜﻞ‬
‫ﻭﺍﺿﺢ ﻣﻦ ‪ %١٠,٥‬ﰲ ﺳﻨﺔ ‪ ١٩٨٣/٨٢‬ﺣﱴ ‪ %٢٠,٥‬ﰲ ﺳﻨﺔ ‪ .١٩٨٦/٨٥‬ﻭﻟﻘﺪ ﺑﺪﺃ ﻫﺬﺍ ﺍﻻﲡﺎﻩ ﺍﻟﺼﺎﻋﺪ‬
‫ﻣﻦ ﻋﺎﻡ ‪ ١٩٧٤‬ﻣﻊ ﺳﻴﺎﺳﺔ ﺍﻻﻧﻔﺘﺎﺡ ﻭﺯﻳﺎﺩﺓ ﻋﺪﺩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳋﺎﺻﺔ‪ .‬ﻭﻗﺪ ﺷﻬﺪﺕ ﺍﻟﻔﺘﺮﺓ ﻣﻦ‬
‫‪ ١٩٩٢/٩١– ١٩٨٨/٨٧‬ﺗﻘﻠﺒﺎﺕ ﰲ ﺍﻟﺪﻭﺭ ﺍﻟﻨﺴﱯ ﻟﻜﻞ ﻣﻦ ﺍﻟﻘﻄﺎﻋﲔ ﺑﻌﺪ ﺍﻧﺘﻌﺎﺵ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‬
‫ﻭﺗﺪﻫﻮﺭ ﻧﺴﺒﺔ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ ﺇﱃ ‪ %١٠,٣‬ﰲ ﺳﻨﺔ ‪ ،١٩٩٢/٩١‬ﺍﻟﱵ ﺗﺬﺑﺬﺑﺖ ﻟﺘﺼﻞ ﺇﱃ‬
‫‪ %١٢,٨‬ﰲ ﺳﻨﺔ ‪.١٩٩٧/٩٦‬‬

‫ﺷﻜﻞ )‪ :(٥-٤‬ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ ﰲ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬

‫‪100‬‬
‫‪90‬‬
‫‪80‬‬
‫‪70‬‬
‫‪60‬‬
‫‪50‬‬
‫‪40‬‬
‫‪30‬‬
‫‪20‬‬
‫‪10‬‬
‫‪0‬‬
‫‪1982/83 1983/84 1984/85 1985/86 1986/87 The fifth 1987/88 1988/89 1989/90 1990/91 1991/92 The fifth 1992/93 1993/94 1994/95 1995/96 1996/97 The fifth‬‬
‫‪first plan‬‬ ‫‪second‬‬ ‫‪third‬‬
‫‪plan‬‬ ‫‪plan‬‬
‫‪Public Investment%‬‬ ‫‪Private Investment%‬‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ٥‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫‪٩٤‬‬
 ‫ﺷﻜﻞ )‪ :(٦-٤‬ﻧﺴﺒﺔ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﻌﺎﻡ ﰲ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨﺎﱄ ﺍﻟﻨﺎﺗﺞ ﺍﶈﻠﻲ‬

‫‪1.5‬‬

‫‪1‬‬

‫‪0.5‬‬

‫‪0‬‬
‫‪81/82‬‬ ‫‪86/87‬‬ ‫‪89/90‬‬ ‫‪90/91‬‬ ‫‪91/92‬‬ ‫‪92/93‬‬ ‫‪93/94‬‬ ‫‪94/95‬‬

‫‪MOH Ex. To GDP‬‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ٦‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﻣﺜﻞ ﲨﻴﻊ ﺍﳌﺆﺷﺮﺍﺕ ﺍﻷﺧﺮﻯ ﻓﺈﻥ ﻧﺴﺒﺔ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﻌﺎﻡ ﰲ ﺍﻟﺼﺤﺔ ﻗﺪ ﺣﺪﺙ ﻟﻪ ﺍﻧﺘﻌﺎﺵ ﰲ ﺳﻨﺔ‬
‫‪ ١٩٩٣/٩٢‬ﺑﻌﺪ ﺍﻟﺘﺪﻫﻮﺭ ﺍﻟﻌﺎﻡ ﰲ ﺍﻟﻨﺼﻒ ﺍﻷﺧﲑ ﰲ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ‪ .‬ﻭﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻓﺈﻥ ﺣﺼﺔ ﺍﻹﻧﻔﺎﻕ‬
‫ﺍﻟﺼﺤﻲ ﺍﳊﻜﻮﻣﻲ ﺇﱃ ﺇﲨﺎﱄ ﺍﳌﻴﺰﺍﻧﻴﺔ ﻗﺪ ﺍﺭﺗﻔﻊ ﻣﻦ ‪ %٢,٩‬ﻟﺴﻨﺔ ‪ ١٩٨١/٨٠‬ﺇﱃ ‪ %٣,٢‬ﻟﺴﻨﺔ‬
‫‪ .١٩٩٦/٩٥‬ﻭﻣﻊ ﺫﻟﻚ ﱂ ﺗﺼﻞ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﳌﺴﺘﻮﺍﻫﺎ ﰲ ﻣﻨﺘﺼﻒ ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ ﻭﺍﻟﱵ ﻛﺎﻧﺖ ‪.%٣,٧‬‬

‫ﺷﻜﻞ )‪ :(٧-٤‬ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﳊﻜﻮﻣﻲ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﻌﺎﻡ‬

‫‪3.3‬‬

‫‪3.2‬‬

‫‪3.1‬‬

‫‪3‬‬

‫‪2.9‬‬

‫‪2.8‬‬

‫‪2.7‬‬

‫‪2.6‬‬
‫‪80/81‬‬ ‫‪93/94‬‬ ‫‪95/96‬‬

‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﳊﻜﻮﻣﻲ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﻌــﺎﻡ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ﺭﻗﻢ ‪ ٧‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫‪٩٥‬‬
 ‫ﺏ – ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﻷﺧﲑﺓ ﰲ ﺍﻟﺘﻤﻮﻳﻞ ﺍﻟﺼﺤﻲ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ‪ :‬ﺑﺮﻧﺎﻣﺞ ﺍﺳﺘﻌﺎﺩﺓ ﺍﻹﻧﻔﺎﻕ‬
‫ﺑﺪﺃﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺮﻧﺎﳎﺎﹰ ﺟﺪﻳﺪﺍﹰ ﲤﻮﻟﻪ ﻫﻴﺌﺔ ﺍﳌﻌﻮﻧﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ﰲ ﻣﻨﺘﺼﻒ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ ﻫﻮ‬
‫ﺑﺮﻧﺎﻣﺞ "ﺍﺳﺘﻌﺎﺩﺓ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ"‪ .‬ﻭﳍﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ ﺛﻼﺛﺔ ﻣﻜﻮﻧﺎﺕ‪ ،‬ﻳﺮﻛﺰ ﺍﳌﻜﻮﻥ ﺍﻷﻭﻝ ﻋﻠﻰ‬
‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ .‬ﻭﻳﺘﻀﻤﻦ‪ (١ :‬ﺍﺳﺘﺜﻤﺎﺭ ﺟﺪﻳﺪ ﻟﺘﺤﺴﲔ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺨﺘﺎﺭﺓ‪(٢ .‬‬
‫ﺇﺻﻼﺣﺎﺕ ﺇﺩﺍﺭﻳﺔ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ‪ (٣ .‬ﺗﺪﺭﻳﺐ ﻛﻮﺍﺩﺭ ﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ (٤ .‬ﺗﺄﺳﻴﺲ ﻣﻴﺰﺍﻧﻴﺎﺕ‬
‫ﺇﻧﻔﺎﻕ ﻣﻌﺘﻤﺪﺓ ﻋﻠﻰ ﺍﻟﺘﻜﺎﻟﻴﻒ ﺍﳊﻘﻴﻘﻴﺔ ﰲ ﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻳﻘﺼﺪ ﻣﻨﻬﺎ ﲢﻘﻴﻖ ﺗﻐﻄﻴﺔ‬
‫ﺟﺰﺋﻴﺔ ﺃﻭ ﻛﻠﻴﺔ ﻟﻺﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ )ﺃﻭﺭﺍﻕ ﻣﺸﺮﻭﻉ ﻫﻴﺌﺔ ﺍﳌﻌﻮﻧﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ‪ .(١٩٩٥ ،‬ﻭﻳﻬﺪﻑ ﻫﺬﺍ ﺍﳌﻜﻮﻥ‬
‫ﺇﱃ ﺍﺳﺘﺨﺪﺍﻡ ﺇﺩﺍﺭﺍﺕ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﰲ ﲢﺴﲔ ﺍﻟﻜﻔﺎﺀﺓ ﺍﻟﻔﻨﻴﺔ ﰲ ﻣﺆﺳﺴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺗﻘﻠﻴﻞ‬
‫ﺍﻟﻌﺐﺀ ﺍﳌﺎﺩﻱ ﳋﺪﻣﺎﺕ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻋﻦ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ .‬ﻭﻗﺪ ﺑﺪﺃ ﺗﻨﻔﻴﺬ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ ‪‬ﺪﻑ ﻣﺒﺪﺋﻲ ﻫﻮ‬
‫ﺗﻨﻔﻴﺬ ﻣﺎ ﺳﺒﻖ ﰲ ‪ ٥٠‬ﻣﺴﺘﺸﻔﻰ ﺣﻜﻮﻣﻴﺎﹰ‪ ،‬ﻭﻗﺪ ﰎ ﺗﻘﻠﻴﺺ ﺍﳍﺪﻑ ﺇﱃ ‪ ٥‬ﻣﺴﺘﺸﻔﻴﺎﺕ‪.‬‬
‫ﺝ ‪ -‬ﺍﻹﻧﻔﺎﻕ ﺍﻟﻌﺎﺋﻠﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‬
‫ﻭﻳﻌﺪ ﺍﳌﺼﺪﺭ ﺍﻷﻛﱪ ﻟﻺﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻫﻮ ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ‪ .‬ﻭﻳﺸﻤﻞ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ‬
‫ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ ﻭﻣﺴﺎﳘﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻠﻤﻮﻇﻔﲔ ﺃﻳﻀﺎﹰ‪ .‬ﻭﺍﻋﺘﻤﺎﺩﺍﹰ ﻋﻠﻰ ﺗﻘﺮﻳﺮ ﺍﳉﻬﺎﺯ‬
‫ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪ ١٩٩١/٩٠‬ﻓﺈﻥ ﺗﻘﻴﻴﻢ ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ ﺍﳋﺎﺹ ﻛﺎﻥ ‪٢,٣٠٤‬‬
‫ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﺗﻘﺮﻳﺒﺎﹰ ﰲ ﺳﻨﺔ ‪ ١٩٩١/٩٠‬ﻭﲤﺜﻞ ‪ %٥٥‬ﻣﻦ ﺍﻹﲨﺎﱄ ﺃﻭ ‪ %٢,٤‬ﻣﻦ ﺍﻟﻨﺎﺗﺞ ﺍﶈﻠﻰ‬
‫ﺍﻹﲨﺎﱄ‪ .‬ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ ﰎ ﺗﻘﺪﻳﺮ ﺍﻷﻗﺴﺎﻁ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﰲ ﺣﺪﻭﺩ ‪ ٩٠‬ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﺗﻘﺮﻳﺒﺎﹰ‬
‫ﻭﻫﻲ ﻣﺴﺎﳘﺎﺕ ﺍﳌﻮﻇﻔﲔ ﻭﻣﺴﺘﻔﻴﺪﻳﻦ ﺁﺧﺮﻳﻦ ﺇﱃ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ .‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺣﻮﺍﱄ ‪١٠‬‬
‫ﻣﻼﻳﲔ ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﺗﻘﺮﻳﺒﺎ ﺗﺪﻓﻊ ﺑﻮﺍﺳﻄﺔ ﺃﻓﺮﺍﺩ ﺫﻭﻱ ﻣﻘﺪﺭﺓ ﻣﺎﺩﻳﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ‪ .‬ﻭﻳﻌﲎ‬
‫ﺫﻟﻚ ﺃﻥ ‪ %٦٥‬ﺗﻘﺮﻳﺒﺎﹰ ﻣﻦ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻳﺄﰐ ﻣﻦ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ‪(Berman 1995).‬‬
‫ﻭﺍﻋﺘﻤﺎﺩﺍ ﺃﻳﻀﺎ ﻋﻠﻰ ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪ ١٩٩٦/٩٥‬ﻓﻘﺪ ﺑﻠﻎ ﺍﻹﻧﻔﺎﻕ‬
‫ﺍﻟﻌﺎﺋﻠﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ‪ ٣٦٧٦٧٣١‬ﺟﻨﻴﻬﺎﹰ ﻣﺼﺮﻳﺎﹰ ﻳﻌﲎ ﻧﺴﺒﺔ ‪ %١,٨‬ﻣﻦ ﺍﻟﻨﺎﺗﺞ ﺍﶈﻠﻰ ﺍﻹﲨﺎﱄ‪ .‬ﻭﻗﺪ ﰎ‬
‫ﺗﻘﻴﻴﻢ ﻣﺴﺎﳘﺎﺕ ﺍﳌﻮﻇﻔﲔ ﺇﱃ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺑـ )‪ ١٣٠‬ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ ﻣﺼﺮﻱ( ﻟﻨﻔﺲ ﺍﻟﻌﺎﻡ‬
‫ﻭﺍﻟﱵ ﺟﻌﻠﺖ ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ ﺍﻟﺼﺤﺔ ﺍﳋﺎﺹ ﻳﺼﻞ ﺇﱃ ‪ %١,٩‬ﻣﻦ ﺍﻟﻨﺎﺗﺞ ﺍﶈﻠﻰ ﺍﻹﲨﺎﱄ ﳍﺬﺍ ﺍﻟﻌﺎﻡ‪.‬‬
‫ﻭﻭﻓﻘﺎ ﻟﺒﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ﻓﻠﻘﺪ ﰎ ﺗﻘﻴﻴﻢ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﻠﻔﺮﺩ‬
‫ﺍﻟﻮﺍﺣﺪ ﻟﺴﻨﺔ ‪ ١٩٩٦/٩٥‬ﲝﻮﺍﱄ ‪ ٣٩‬ﺟﻨﻴﻬﺎﹰ ﻣﺼﺮﻳﺎﹰ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﻭ‪ ٦٢,٢‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﰲ ﺍﳌﻨﺎﻃﻖ‬
‫ﺍﳊﻀﺮﻳﺔ‪ .‬ﻭﻳﻌﺪ ﻫﺬﺍ ﺍﻟﺘﻘﺪﻳﺮ ﺗﻘﺪﻳﺮﺍﹰ ﻣﺘﺤﻴﺰﺍﹰ ﻷﺩﱏ‪ ،‬ﻓﻠﻮ ﺃﻥ ﺍﺳﺘﻬﻼﻙ ﺍﻟﺪﻭﺍﺀ ﻟﻠﻔﺮﺩ ﺍﻟﻮﺍﺣﺪ ﻗﺪ ﻗﺪﺭ‬
‫ﲝﻮﺍﱄ ‪ ٥٥‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﻭﲝﻮﺍﱄ ‪ %٥٠‬ﻣﻦ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‪ ،‬ﻓﺈﻥ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﻠﻔﺮﺩ ﺍﻟﻮﺍﺣﺪ ﻛﺎﻥ‬
‫ﳚﺐ ﺃﻥ ﻳﺼﻞ ﺇﱃ ‪ ١١٠‬ﺟﻨﻴﻬﺎﺕ ﻣﺼﺮﻳﺔ‪ .‬ﻭﳑﺎ ﻻ ﺷﻚ ﻓﻴﻪ ﺃﻥ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﻫﻮ ﺍﳌﻤﻮﻝ ﺍﻷﻛﱪ‬
‫ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ‪ ،‬ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﲨﻴﻊ ﺍﻷﻓﺮﺍﺩ ﻳﺘﻢ ﺗﻐﻄﻴﺘﻬﻢ ﺑﻮﺍﺳﻄﺔ ﺧﺪﻣﺎﺕ ﺻﺤﻴﺔ‬
‫ﳎﺎﻧﻴﺔ‪.‬‬
‫ﺩ – ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫ﺗﺄﺗﻰ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻭﺍﻟﱵ ﻫﻲ ﺟﺰﺀ ﻣﻦ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﰲ ﺍﳌﺮﻛﺰ ﺍﻟﺜﺎﱐ ﻣﻦ ﺣﻴﺚ‬
‫ﻣﺼﺎﺩﺭ ﺍﻹﻧﻔﺎﻕ‪ .‬ﺗﺴﺘﻘﺒﻞ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﲤﻮﻳﻠﻬﺎ ﺃﺳﺎﺳﺎﹰ ﻣﻦ ﺍﻷﻗﺴﺎﻁ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﺍﳌﺪﻓﻮﻋﺔ‬

‫‪٩٦‬‬
‫ﳍﻴﺌﺔ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﻭﺍﳌﻌﺎﺷﺎﺕ ﺑﻮﺍﺳﻄﺔ ﺍﳊﻜﻮﻣﺔ‪ ،‬ﻭﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﺘﻮﻇﻴﻒ‬
‫ﻭﺍﳌﻮﻇﻔﲔ‪ .‬ﻭﻗﺪ ﻗﺪﺭ ﳍﺬﻩ ﺍﻷﻗﺴﺎﻁ ﺃﻥ ﺗﺼﻞ ﺇﱃ ﺣﻮﺍﱄ ‪ %٨٥‬ﻣﻦ ﺍﻟﺪﺧﻞ ﺍﻹﲨﺎﱄ‪ .‬ﻭﺗﺄﺗﻰ ﻣﺼﺎﺩﺭ‬
‫ﺍﻟﺪﺧﻞ ﺍﻹﲨﺎﱄ ﺍﻷﺧﺮﻯ ﻣﻦ ﺑﻴﻊ ﺍﳋﺪﻣﺎﺕ ﻣﺒﺎﺷﺮﺓ ﻟﻠﺠﻤﻬﻮﺭ‪ ،‬ﻭﺍﻷﺟﻮﺭ ﻭﺍﳌﺪﻓﻮﻋﺎﺕ ﻭﺍﻟﺘﺤﻮﻳﻼﺕ‬
‫ﺍﳊﻜﻮﻣﻴﺔ‪(Berman 1995).‬‬
‫ﻭﻳﺘﻜﻮﻥ ﺍﻟـ ‪ ٤,٩‬ﻣﻠﻴﻮﻥ ﺍﳌﻨﻀﻤﲔ ﻟﻨﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﰲ ﺳﻨﺔ ‪ ١٩٩٥‬ﻣﻦ ‪ %٥١‬ﻣﻮﻇﻔﲔ ﺑﺎﳊﻜﻮﻣﺔ‬
‫)ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ %٣٩ ،(٣٢‬ﻋﻤﺎﻝ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ ) ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ (٧٩‬ﻭ‪ %١٠‬ﻣﺘﻤﺜﻠﺔ ﰲ ﺍﻷﺭﺍﻣﻞ‬
‫ﻭﺃﺻﺤﺎﺏ ﺍﳌﻌﺎﺷﺎﺕ‪ .‬ﻭﰱ ﺳﻨﺔ ‪ ١٩٩٣‬ﺗﻮﺳﻌﺖ ﺗﻐﻄﻴﺔ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺑﺸﻜﻞ ﻛﺒﲑ ﻟﺘﺸﻤﻞ‬
‫ﺃﻃﻔﺎﻝ ﺍﳌﺪﺍﺭﺱ‪ .‬ﻭﻻ ﺗﻮﻓﺮ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻟﺘﺄﻣﲔ ﻟﻌﺎﺋﻼﺕ ﺍﻟﻌﻤﺎﻝ‪ .‬ﻭﻋﻠﻰ ﺍﻟﺼﻌﻴﺪ ﺍﻵﺧﺮ ﻓﺈﻥ‬
‫ﺗﻐﻄﻴﺔ ﺍﻟﺘﺄﻣﲔ ﺍﳋﺎﺹ ﰲ ﻣﺼﺮ ﳏﺪﻭﺩﺓ ﻟﻠﻐﺎﻳﺔ‪ .‬ﺣﻴﺚ ﻳﻘﺪﺭ ﺑﺄﻗﻞ ﻣﻦ ‪ %٢‬ﻣﻦ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻡ‬
‫ﰲ ﺳﻨﺔ ‪ .١٩٩٧‬ﻭﻳﺸﲑ ﻣﺎ ﺳﺒﻖ ﺇﱃ ﺍﻟﺘﻮﺯﻳﻊ ﺍﻟﺘﺎﱄ ﻟﻠﻤﺆﻣﻦ ﻋﻠﻰ ﺻﺤﺘﻬﻢ‪ % ٢٤,٩ :‬ﻟﻠﻤﻮﻇﻔﲔ‪% ٣,٢ ،‬‬
‫ﻷﺻﺤﺎﺏ ﺍﳌﻌﺎﺷﺎﺕ ﻭ‪ %٧١,٩‬ﻃﻼﺏ‪.‬‬
‫ﺷﻜﻞ )‪ :(٨-٤‬ﺗﺼﻨﻴﻒ ﺍﳌﻨﺘﻔﻌﲔ ﻣﻦ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬

‫‪120‬‬

‫‪100‬‬

‫‪80‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪(%‬‬

‫‪60‬‬

‫‪40‬‬

‫‪20‬‬

‫‪0‬‬
‫ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ‬ ‫ﺍﻷﺭﺍﻣﻞ ﻭﺍﳌﻌﺎﺷﺎﺕ‬ ‫ﺍﻟﻄﻼﺏ‬ ‫ﺍﻹﲨﺎﱄ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ٨‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﺍﳌﺸﻜﻠﺔ ﺍﻟﻮﺍﺿﺤﺔ ﳍﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻫﻲ ﺍﻟﻔﺠﻮﺓ ﺑﲔ ﺇﻧﻔﺎﻗﻬﺎ ﻭﺩﺧﻠﻬﺎ ﺍﻟﱵ ﺍﺭﺗﻔﻌﺖ ﰲ‬
‫ﺍﻟﺴﻨﻮﺍﺕ ﺍﻷﺧﲑﺓ ﻭﻗﺪﺭﺕ ﺑـ ‪ ٢٢٠‬ﻣﻠﻴﻮﻥ ﺟﻨﻴﻬﺎﹰ ﻣﺼﺮﻳﺎﹰ ﰲ ﺍﻟﺴﻨﺔ ﺍﳌﺎﻟﻴﺔ ‪ .١٩٩٥‬ﻭﰱ ﺍﻟﻮﻗﺖ ﻧﻔﺴﻪ ﻓﻔﻲ‬
‫ﺃﻭﺍﺋﻞ ﻋﺎﻡ ‪ ١٩٩٤‬ﺃﺟﺮﺕ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺗﻘﺪﻳﺮ ﺃﻭﻟﻴﺎ ﳌﺸﺮﻭﻉ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻠﻄﻼﺏ‪ ،‬ﻭﺗﺒﲔ‬
‫ﻣﻨﻪ ﺃﻥ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻹﻧﻔﺎﻕ ﺃﻋﻠﻰ ﻛﺜﲑﺍﹰ ﻣﻦ ﺧﺼﻢ ﺍﻟﺘﻤﻮﻳﻞ ﳑﺎ ﺃﺩﻯ ﺇﱃ ﺗﻮﺍﺯﻥ ﻏﲑ ﻣﺘﻮﻗﻊ ﻭﺻﻞ ﺇﱃ ‪%٨٠‬‬
‫ﺑﲔ ﺍﻹﻧﻔﺎﻕ ﻭﺍﻹﻳﺮﺍﺩ‪.‬‬

‫‪٩٧‬‬
 ‫‪ -٤‬ﺑﻨﻮﺩ ﺍﻹﻧﻔﺎﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‬
‫ﻳﻨﻔﻖ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ ﺃﻛﺜﺮ ﻣﻦ ﻧﺼﻒ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﻜﻠﻰ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﺍﻟﻨﺤﻮ ﺍﻟﺘﺎﱄ‪%٥٦ :‬‬
‫ﻣﻦ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺪﻭﺍﺀ‪ %٣٦ ،‬ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﳋﺎﺭﺟﻴﺔ ﻭ‪ %١٠‬ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﻟﺪﺍﺧﻠﻴﺔ‪.‬‬

‫ﺷﻜﻞ )‪ :(٩-٤‬ﻫﻴﻜﻞ ﺍﻹﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ‬

‫‪60%‬‬

‫‪50%‬‬

‫‪40%‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪(%‬‬

‫‪30%‬‬

‫‪20%‬‬

‫‪10%‬‬

‫‪0%‬‬
‫ﺍﻷﺩﻭﻳﺔ‬ ‫ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺭﺟﻴﺔ‬ ‫ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺪﺍﺧﻠﻴـﺔ‬
‫ﺃﻭﺟﻪ ﺍﻻﻧﻔﺎﻕ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ﺭﻗﻢ ‪ ٩‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﲟﺮﺍﺟﻌﺔ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰎ ﺍﺳﺘﻨﺘﺎﺝ ﺃﻥ ﻣﻌﻈﻢ ﺇﻧﻔﺎﻕ ﺍﻟﻮﺯﺍﺭﺓ ﻣﻮﺟﻪ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﺣﻴﺚ‬
‫ﺇﻥ ﺃﻛﺜﺮ ﻣﻦ ﻧﺼﻒ ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﻮﺟﻪ ﳍﺬﻩ ﺍﳋﺪﻣﺎﺕ ﺑﻨﺴﺒﺔ ) ‪ .( %٥٧,٩‬ﻭﺗﺘﻠﻘﻰ ﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ‪ %٢١,٢‬ﻣﻦ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‪ ،‬ﻭﺗﺄﺗﻰ ﺑﺮﺍﻣﺞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﰲ ﺍﳌﺮﻛﺰ‬
‫ﺍﻟﺜﺎﻟﺚ ﻛﻤﺴﺘﻘﺒﻞ ﻟﻼﺳﺘﺜﻤﺎﺭ ﺍﻟﺼﺤﻲ‪ .‬ﻭﺗﺄﺗﻰ ﺑﺮﻧﺎﻣﺞ ﺍﳊﻤﺎﻳﺔ ﺿﺪ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺴﺘﻮﻃﻨﺔ ﰲ ﺍﳌﺮﻛﺰ‬
‫ﺍﻟﺮﺍﺑﻊ ﻣﻦ ﺣﻴﺚ ﺍﻟﺘﻮﺯﻳﻊ‪ .‬ﻭﻳﺘﻠﻘﻰ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ‪ %٢,٨٩‬ﻣﻦ ﺇﲨﺎﱄ ﺍﺳﺘﺜﻤﺎﺭﺍﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﺳﻨﺔ ‪.١٩٩٧/٩٦‬‬

‫‪٩٨‬‬
 ‫ﺷﻜﻞ )‪ :(١٠-٤‬ﺗﻮﺯﻳﻊ ﺍﺳﺘﺜﻤﺎﺭﺍﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‬

‫‪70‬‬

‫‪57.8‬‬
‫‪60‬‬

‫‪50‬‬

‫‪40‬‬

‫‪30‬‬

‫‪21.2‬‬
‫‪20‬‬

‫‪10‬‬ ‫‪8.03‬‬
‫‪6.29‬‬
‫‪2.89‬‬ ‫‪2.84‬‬
‫‪2.05‬‬
‫‪0.36‬‬ ‫‪0.17‬‬
‫‪0‬‬
‫ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ‬ ‫ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ‬ ‫ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ‬ ‫ﻗﺴﻢ ﺍﻟﺪﺭﺍﺳﺎﺕ‬ ‫ﻗﻄﺎﻉ ﺗﻨﻈﻴﻢ‬ ‫ﺍﳊﻤﺎﻳﺔ ﻣﻦ‬ ‫ﻗﻄﺎﻉ ﺍﻷﻣﺮﺍﺽ‬ ‫ﻗﻄﺎﻉ ﻃﺐ‬ ‫ﻗﻄﺎﻉ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﻌﻼﺟﻴﺔ‬ ‫ﺍﻷﺳﺎﺳﻴﺔ‬ ‫ﺍﻟﻮﻗﺎﺋﻴﺔ‬ ‫ﻭﺍﻷﲝﺎﺙ‬ ‫ﺍﻷﻣﺮﺍﺽ ﺍﻟﻮﺑﺎﺋﻴﺔ ﺍﻷﺳﺮﺓ ﻭﺍﻟﺴﻜﺎﻥ‬ ‫ﺍﻟﺒﺎﻃﻨﺔ‬ ‫ﺍﻷﺳﻨﺎﻥ‬ ‫ﺍﻟﻄﺒﻴﺔ‬

‫‪3‬‬

‫‪2.5‬‬

‫‪2‬‬

‫‪1.5‬‬

‫‪1‬‬

‫‪0.5‬‬

‫‪0‬‬
‫ﺃﲨﺎﱄ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬ ‫ﺃﲨﺎﱄ ﺍﳍﻴﺌﺎﺕ‬ ‫ﺃﲨﺎﱄ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻜﺎﻥ‬ ‫ﻭﺍﳌﺆﺳﺴﺎﺕ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ١٠‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﻓﻀﻼﹰ ﻋﻦ ﺫﻟﻚ ﻓﺈﻥ ﺩﺭﺍﺳﺔ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺗﻮﺿﺢ ﺃﻥ ﺍﻷﺟﻮﺭ ﻭﺍﳌﺮﺗﺒﺎﺕ ﲢﺘﻞ ‪ %٦١,٤‬ﺗﻘﺮﻳﺒﺎﹰ ﻣﻦ‬
‫ﺇﲨﺎﱄ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﳉﺰﺀ ﺍﻟﺒﺎﻗﻲ ﻟﻠﻤﺴﺘﻠﺰﻣﺎﺕ‪.‬‬

‫‪٩٩‬‬
 ‫ﺷﻜﻞ )‪ :(١١-٤‬ﺗﻮﺯﻳﻊ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ )‪(١٩٩٥‬‬

‫‪1750‬‬

‫‪1500‬‬

‫‪1250‬‬

‫‪1000‬‬
‫ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ‬
‫‪750‬‬

‫‪500‬‬

‫‪250‬‬

‫‪0‬‬
‫ﺍﻷﺟﻮﺭ ﻭ ﺍﳌﺮﺗﺒﺎﺕ‬ ‫ﺍﻹﻣﺪﺍﺩﺍﺕ‬ ‫ﺍﻹﲨﺎﱄ‬

‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬ ‫ﺍﶈﺎﻓﻈﺎﺕ‬ ‫ﺍﻹﲨﺎﱄ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ١١‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﻫﻨﺎﻙ ﺍﺳﺘﻨﺘﺎﺝ ﻫﺎﻡ ﻣﻦ ﺧﻼﻝ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻟﻌﺎﻡ ‪ ١٩٩٥‬ﻭﻫﻮ ﺃﻥ ﻫﻨﺎﻙ ‪ %٣٥‬ﻣﻦ ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻡ ﻳﺬﻫﺐ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ﻭ‪ %٦٥‬ﻣﻨﻪ ﻳﺬﻫﺐ ﻟﻠﺨﺪﻣﺎﺕ ﻏﲑ‬
‫ﺍﻷﺳﺎﺳﻴﺔ ﻭﺍﻷﻛﺜﺮ ﺃﳘﻴﺔ ﻫﻮ ﺃﻥ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ ﰲ ﻣﺼﺮ ﻣﻮﺟﻪ ﺃﺳﺎﺳﺎﹰ ﻟﻐﲑ ﺧﺪﻣﺎﺕ‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪ ،‬ﺑﻴﻨﻤﺎ ﻳﺘﺮﻛﺰ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﻠﺤﻜﻮﻣﺔ ﻭﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﺃﺳﺎﺳﺎﹰ ﻋﻠﻰ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪ .‬ﻭﻗﺪ ﺳﺒﻘﺖ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺃﻥ ﺍﳌﺴﺎﻋﺪﺍﺕ ﺍﳌﺎﺩﻳﺔ ﺍﻟﱵ ﺗﻘﺪﻣﻬﺎ ﺍﳊﻜﻮﻣﺔ ﻭﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﲤﻮﻝ ‪%٧٥‬‬
‫ﻣﻦ ﻗﻄﺎﻉ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭ‪ %٢٥‬ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺧﺮﻯ ﻏﲑ ﺧﺪﻣﺎﺕ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﻻ ﻳﺪﻓﻊ ﺍﻟﻘﻄﺎﻉ‬
‫ﺍﻟﻌﺎﺋﻠﻲ ﺇﻻ ‪ %٢١‬ﻓﻘﻂ ﻣﻦ ﺇﻧﻔﺎﻗﻪ ﻟﻘﻄﺎﻉ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭ‪ %٧٧‬ﻟﻠﻤﺴﺘﻠﺰﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ )‪.(USAID, 1995‬‬
‫ﻭﻃﺎﳌﺎ ﺃﻥ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻡ ﺃﻗﻞ ﻣﻦ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺍﳋﺎﺹ‪ ،‬ﻓﺈﻥ ﻣﻘﺪﺍﺭ ﻣﺎ ﻳﻨﻔﻖ ﻋﻠﻰ ﻗﻄﺎﻉ‬
‫ﺍﳌﺴﺘﺸﻔﻰ ﺳﻴﻜﻮﻥ ﺣﺼﺔ ﺻﻐﲑﺓ ﺑﺸﻜﻞ ﻣﻠﺤﻮﻅ ﻣﻦ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‪ ،‬ﳑﺎ ﺳﻴﺆﺛﺮ ﻋﻠﻰ‬
‫ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻤﺮﺿﻰ ﺍﳌﻘﻴﻤﲔ‪.‬‬

‫‪* . */  )*+,  :(-‬‬

‫‪ -١‬ﺗﻮﺍﺯﻥ ﺍﻹﻧﻔﺎﻕ ﻭﺿﺮﻭﺭﺓ ﺍﻻﺳﺘﻬﺪﺍﻑ‬
‫ﻳﺸﲑ ﲢﻠﻴﻞ ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺍﳔﻔﺎﺿﻪ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺪﺧﻞ‪ .‬ﻭﺑﺎﺳﺘﺨﺪﺍﻡ ﻣﻴﺰﺍﻧﻴﺔ‬
‫ﺍﻷﺳﺮﺓ ﻟﻌﺎﻡ ‪ ١٩٩٦/٩٥‬ﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ )‪١٢-٤‬ﺃ‪١٢-٤ ،‬ﺏ( ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ ﺃﻥ ﻣﺘﻮﺳﻂ ﺍﻹﻧﻔﺎﻕ‬
‫ﺍﻟﺼﺤﻲ ﶈﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ﺃﻗﻞ ﺑﻜﺜﲑ ﻋﻨﺪ ﺍﳌﻘﺎﺭﻧﺔ ﲟﺮﺗﻔﻌﻲ ﺍﻟﺪﺧﻞ‪ ،‬ﰲ ﺣﲔ ﺃﻥ ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‬
‫ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺃﻋﻠﻰ ﺑﺎﻟﻨﺴﺒﺔ ﶈﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ﻋﻦ ﺫﻭﻯ ﺍﻟﺪﺧﻞ ﺍﳌﺮﺗﻔﻊ ﻣﺸﲑﺍﹰ ﺑﺬﻟﻚ ﺇﱃ ﻋﺐﺀ ﺃﻋﻠﻰ‬
‫ﻧﺴﺒﻴﺎﹰ ﻟﻺﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻋﻠﻰ ﻓﺌﺎﺕ ﺍﻟﺪﺧﻞ ﺍﶈﺪﻭﺩ‪ .‬ﻭﻳﻮﺿﺢ ﺍﻟﺸﻜﻠﲔ ‪١٢-٤‬ﺃ ﻭ‪١٢-٤‬ﺏ ﳕﻂ ﺍﻹﻧﻔﺎﻕ‬

‫‪١٠٠‬‬
‫ﺍﻟﺼﺤﻲ ﻟﻔﺌﺎﺕ ﺍﻟﺪﺧﻞ ﺍﳌﺨﺘﻠﻔﺔ ﻭﻓﻘﺎﹰ ﳋﻂ ﺍﻟﻔﻘﺮ ﺍﻷﻋﻠﻰ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ )‪ (%٤٥‬ﻭﺍﳌﻨﺎﻃﻖ‬
‫ﺍﻟﺮﻳﻔﻴﺔ )‪) (%٤٩‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ‪ (١٩٩٦‬ﻭﺗﻘﺪﺭ ﻓﺌﺔ ﺍﻹﻧﻔﺎﻕ ﺍﻷﻋﻠﻰ ﺑﺄ‪‬ﺎ ﺍﻟـ ‪ %١٠‬ﺍﻷﻋﻠﻰ ﺇﻧﻔﺎﻗﺎ‪.‬‬

‫ﺷﻜﻞ )‪ ١٢-٤‬ﺃ(‪ :‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻻﲨﺎﱃ ﺍﻹﻧﻔﺎﻕ ﻭﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻺﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺇﱃ ﺍﲨﺎﱃ ﺍﻹﻧﻔﺎﻕ‬
‫ﻟﻔﺌﺎﺕ ﺍﻟﺪﺧﻞ ﺍﳌﺨﺘﻠﻔﺔ )ﻟﻠﺮﻳﻒ(‬

‫‪120‬‬

‫‪100‬‬

‫‪80‬‬

‫‪60‬‬

‫‪40‬‬

‫‪20‬‬

‫‪0‬‬
‫ﻧﺼﻴﺐ ﻛﻞ ﻓﺌﺔ ﺍﱃ ﺍﻻﻧﻔﺎﻕ ﺍﻻﲨـﺎﱄ‬ ‫ﻧﺼﻴﺐ ﻛﻞ ﻓﺌﺔ ﺍﱃ ﺍﻻﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‬ ‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨـﺎﱄ‬
‫)ﺗﺮﺍﻛﻤﻲ(‬ ‫)ﺗﺮﺍﻛﻤﻲ(‬ ‫ﺇﻧﻔﺎﻕ ﻛﻞ ﻓﺌﺔ ﺩﺧﻠﻴﺔ‬

‫ﺃﻗﻞ ﻓﺌﺔ ﺩﺧﻞ‬ ‫ﻓﺌﺔ ﺍﻟﺪﺧﻞ ﺍﳌﺘﻮﺳﻄﺔ‬ ‫ﺃﻋﻠﻰ ﻓﺌﺔ ﺩﺧﻞ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺍﳉﺪﻭﻝ ‪ ١٢‬ﺃ ﰲ ﺍﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﺷﻜﻞ ‪ ١٢‬ﺏ‪ :‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻹﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻰ ﻭﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻺﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺇﱃ ﺇﲨﺎﱄ‬
‫ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﻔﺌﺎﺕ ﺍﻟﺪﺧﻞ ﺍﳌﺨﺘﻠﻔﺔ )ﺍﳊﻀﺮ(‬

‫‪120‬‬

‫‪100‬‬

‫‪80‬‬

‫‪60‬‬

‫‪40‬‬

‫‪20‬‬

‫‪0‬‬
‫ﻧﺼﻴﺐ ﻛﻞ ﻓﺌﺔ ﺍﱃ ﺍﻻﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻧﺼﻴﺐ ﻛﻞ ﻓﺌﺔ ﺍﱃ ﺍﻻﻧﻔﺎﻕ ﺍﻻﲨﺎﱄ‬ ‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ‬
‫)ﺗﺮﺍﻛﻤﻲ(‬ ‫)ﺗﺮﺍﻛﻤﻲ(‬ ‫ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ ﻛﻞ ﻓﺌﺔ ﺩﺧﻠﻴﺔ‬

‫ﺃﻗﻞ ﻓﺌﺔ ﺩﺧﻞ‬ ‫ﻓﺌﺔ ﺍﻟﺪﺧﻞ ﺍﳌﺘﻮﺳﻄﺔ‬ ‫ﺃﻋﻠﻰ ﻓﺌﺔ ﺩﺧﻞ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ١٢‬ﺏ ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫‪١٠١‬‬
‫ﻭﻓﻀﻼﹰ ﻋﻦ ﺫﻟﻚ ﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ١٣‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ ﻭﺍﻟﺸﻜﻞ ﺭﻗﻢ ‪ ١٣-٤‬ﺍﲡﺎﻩ ﺍﻹﻧﻔﺎﻕ‬
‫ﺍﻟﺼﺤﻲ ﻟﻠﻔﻘﺮﺍﺀ ﺍﻋﺘﻤﺎﺩﺍﹰ ﻋﻠﻰ ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ﳌﻴﺰﺍﻧﻴﺔ ﺍﻷﺳﺮﺓ‬
‫‪ ١٩٩١/٩٠ ،١٩٨٢/٨١‬ﻭ‪ ١٩٩٦/٩٥‬ﰲ ﺍﳊﻀﺮ ﻭﻳﺸﲑ ﺇﱃ ﺗﺰﺍﻳﺪ ﻣﺘﻮﺳﻂ ﺇﻧﻔﺎﻕ ﻫﺬﻩ ﺍﻟﻔﺌﺔ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﺇﱃ ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ‪.‬‬
‫ﺷﻜﻞ )‪ :(١٣-٤‬ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺇﱃ ﺇﲨﺎﱃ ﺍﻹﻧﻔﺎﻕ ﶈﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ‪١٩٨١‬ﺑﺎﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‬
‫ﻭﺍﻟﺮﻳﻔﻴﺔ ‪(%) ١٩٩٦/٩٥– ٩١/١٩٩٠ –١٩٨٢/٨١‬‬

‫‪5‬‬

‫‪4‬‬

‫‪3‬‬

‫‪2‬‬

‫‪1‬‬

‫‪0‬‬

‫‪1981/82‬‬ ‫‪1990/91‬‬ ‫‪1995/96‬‬

‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﳊﻀﺮ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ١٣‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﻟﻘﺪ ﺍﺭﺗﻔﻌﺖ ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﶈﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻣﻦ‬
‫‪ %١,٨‬ﰲ ‪ ١٩٨٢/٨١‬ﺇﱃ ‪ %٣,٣‬ﰲ‪ ١٩٩١/٩٠‬ﰒ ﺇﱃ ‪ % ٤,٧‬ﰲ ‪ ،١٩٩٦/٩٥‬ﺑﻴﻨﻤﺎ ﺯﺍﺩﺕ ﻧﻔﺲ ﺍﻟﻨﺴﺒﺔ ﻟﻔﺌﺎﺕ‬
‫ﺍﻟﺪﺧﻞ ﺍﳌﺮﺗﻔﻌﺔ ﻣﻦ ‪ %١,٨‬ﰲ ‪ ١٩٨٢/٨١‬ﺇﱃ ‪ %٣,٥‬ﰲ ‪ ١٩٩١/٩٠‬ﻭﺇﱃ ‪ %٣,٥٣١‬ﰲ ‪ ١٩٩٦/٩٥‬ﰲ ﺍﳌﻨﺎﻃﻖ‬
‫ﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭﻫﺬﺍ ﻣﻦ ﻭﺍﻗﻊ ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ﻟﻺﻧﻔﺎﻕ ‪– ١٩٨٢/٨١‬‬
‫‪ ١٩٩٢/٩١‬ﻭ‪ .١٩٩٦/٩٥‬ﻭﻳﻌﲎ ﺫﻟﻚ ﺃﻥ ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﻗﺪ ﺯﺍﺩﺕ ﺣﱴ‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻔﻘﺮﺍﺀ ﺍﻟﺬﻳﻦ ﻳﻔﺘﺮﺽ ﺃﻥ ﺗﺘﻢ ﺗﻠﺒﻴﺔ ﺧﺪﻣﺎ‪‬ﻢ ﺍﻟﺼﺤﻴﺔ ﳎﺎﻧﻴﺎﹰ‪ .‬ﻓﻀﻼﹰ ﻋﻦ ﺫﻟﻚ ﻓﺈﻥ ﻧﻈﺎﻡ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ ﻳﻌﺎﱏ ﻣﻦ ﻋﺪﻡ ﺍﻻﺳﺘﻬﺪﺍﻑ ﶈﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ﰲ ﻣﺼﺮ‪ ،‬ﺣﻴﺚ ﺗﻮﺿﺢ ﻧﺘﺎﺋﺞ‬
‫ﻣﺴﺢ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺃﻥ ﺃﻛﺜﺮ ﻣﻦ ﻧﺼﻒ ﺫﻭﻯ ﺍﻟﺪﺧﻞ ﺍﳌﺮﺗﻔﻊ ﻛﺎﻧﻮﺍ ﻣﺴﺘﻔﻴﺪﻳﻦ ﻣﻦ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﳊﻜﻮﻣﻴﺔ‪ .‬ﻭﺗﺸﲑ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﳌﻔﺼﻠﺔ ﺇﱃ ﺃﻥ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳊﻀﺮﻳﺔ ﺗﻠﻴﻬﺎ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‬
‫ﲢﻘﻖ ﺃﻋﻠﻰ ﻣﻌﺪﻻﺕ ﻟﻠﺘﺮﺩﺩ ﻣﻦ ﺟﺎﻧﺐ ﻫﺬﻩ ﺍﻟﻔﺌﺔ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺎﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‬
‫ﻭﺍﻟﺮﻳﻔﻴﺔ‪ .‬ﻭﺍﻟﻐﺮﺽ ﻣﻦ ﻭﺭﺍﺀ ﻫﺬﺍ ﺍﻟﻨﻤﻂ ﻫﻮ ﺍﻻﺳﺘﻔﺎﺩﺓ ﻣﻦ ﻣﻌﻈﻢ ﺍﻷﺳ‪‬ﺮﺓ ﺍﳊﻜﻮﻣﻴﺔ ﰲ ﻣﺼﺮ ﺍﻟﱵ‬
‫ﺗﺘﺮﻛﺰ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳊﻀﺮﻳﺔ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ )ﺷﻜﻞ ‪.(١٤-٤‬‬

‫‪١٠٢‬‬
 ‫ﺷﻜﻞ )‪ :(١٤-٤‬ﺍﻟﺰﻳﺎﺩﺓ ﺍﻷﺧﲑﺓ ﻭﻓﻘﺎﹰ ﻟﻠﻔﺌﺔ ﺍﻟﺪﺍﺧﻠﻴﺔ ﺣﺴﺐ ﻧﻮﻋﻴﺔ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ‬

‫‪90‬‬
‫‪80‬‬
‫‪70‬‬
‫‪60‬‬

‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪(%‬‬

‫‪50‬‬
‫‪40‬‬
‫‪30‬‬
‫‪20‬‬
‫‪10‬‬
‫‪0‬‬
‫ﺍﳊﻜﻮﻣﺔ‬ ‫ﻋﺎﻡ‬ ‫ﺧﺎﺹ‬ ‫ﺃﺧﺮﻯ‬
‫ﳏﺪﻭﺩﻭ ﺍﻟﺪﺧﻞ‬ ‫ﻣﺘﻮﺳﻂ‬ ‫ﻣﺮﺗﻔﻊ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ١٤‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﻳﺄﰐ ﺗﺮﺗﻴﺐ ﻓﺌﺔ ﺍﻟﺪﺧﻞ ﺍﳌﺮﺗﻔﻌﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ ﰲ ﺍﳌﺮﺗﺒﺔ ﺍﻟﺜﺎﻧﻴﺔ‪ .‬ﻭﻟﻘﺪ ﰎ‬
‫ﲨﻊ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻵﺗﻴﺔ ﻣﻌﺎﹰ ﲢﺖ ﺍﳋﺪﻣﺎﺕ ﺍﳋﺎﺻﺔ‪ :‬ﻭﻫﻰ ﺍﻟﻄﺒﻴﺐ ﺍﳋﺎﺹ‪ ،‬ﺍﻟﺼﻴﺪﻟﻴﺔ‪،‬‬
‫ﺍﻟﺸﺮﻛﺎﺕ‪ ،‬ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﻟﻨﻘﺎﺑﺎﺕ‪ .‬ﻭﻛﻤﺎ ﻫﻮ ﻣﺘﻮﻗﻊ ﻓﺈﻥ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ ﻣﻦ ﺫﻭﻯ ﺍﻟﺪﺧﻞ ﺍﳌﺮﺗﻔﻊ‬
‫ﻛﺎﻥ ﺃﻛﺜﺮ ﺍﺳﺘﻐﻼﻻ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳋﺎﺻﺔ ﺑﻴﻨﻤﺎ ‪ %٧,٧‬ﻓﻘﻂ ﻣﻦ ﳏﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ﺗﺴﺘﺨﺪﻡ ﺗﻠﻚ‬
‫ﺍﳋﺪﻣﺎﺕ‪ .‬ﻭﺗﺮﺗﻔﻊ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﺇﱃ ‪ %١٣,٧‬ﻭ‪ %٢٧,٨‬ﺑﺎﻟﻨﺴﺒﺔ ﻟﻔﺌﺎﺕ ﺍﻟﺪﺧﻮﻝ ﺍﳌﺘﻮﺳﻄﺔ ﻭﺍﻟﻌﻠﻴﺎ ﻋﻠﻰ‬
‫ﺍﻟﺘﻮﺍﱄ‪.‬‬
‫ﺷﻜﻞ )‪ :(١٥-٤‬ﺇﲨﺎﱃ ﺍﻟﺘﻜﻠﻔﺔ ﻟﻠﻤﺮﺿﻰ ﺍﳌﻘﻴﻤﲔ ﺣﺴﺐ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻰ ﻟﻔﺌﺎﺕ ﺍﻟﺪﺧﻞ ﺍﳌﺨﺘﻠﻔﺔ‬

‫‪1000‬‬
‫‪900‬‬
‫‪800‬‬
‫‪700‬‬
‫‪600‬‬
‫‪500‬‬
‫‪400‬‬
‫‪300‬‬
‫‪200‬‬
‫‪100‬‬
‫‪0‬‬
‫ﻗﻠﻴﻞ‬ ‫ﻣﺘﻮﺳﻂ‬ ‫ﻣﺮﺗﻔﻊ‬
‫ﺍﳊﻜﻮﻣﺔ‬ ‫ﻋﺎﻡ‬ ‫ﺧﺎﺹ‬ ‫ﺃﺧﺮﻯ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺍﳉﺪﻭﻝ ‪ ١٥‬ﺏ ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫‪١٠٣‬‬
‫ﻭﻻ ﺗﻘﺪﻡ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﻛﺎﻓﺔ ﺧﺪﻣﺎ‪‬ﺎ ﺑﺪﻭﻥ ﻣﻘﺎﺑﻞ ﺣﻴﺚ ﻳﺪﻓﻊ ﳏﺪﻭﺩﻭ ﺍﻟﺪﺧﻞ ﰲ‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﻣﻘﺎﺑﻞ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺪﺍﺧﻠﻴﺔ‪ .‬ﻭﻳﺴﺎﻭﻯ ﻣﺘﻮﺳﻂ ﻣﺎ ﺗﺪﻓﻌﻪ‬
‫ﻫﺬﻩ ﺍﻟﻔﺌﺔ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳊﻜﻮﻣﻴﺔ ﰲ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺪﺍﺧﻠﻴﺔ ﺣﻮﺍﱄ )‪ (١٢٠,٥‬ﺃﻱ ﺿﻌﻒ ﻣﺘﻮﺳﻂ‬
‫ﺍﳌﺮﺗﺐ ﺍﻟﺸﻬﺮﻱ ﳌﻮﻇﻒ ﺣﻜﻮﻣﻲ‪.‬‬
‫ﻭﻳﺸﲑ ﻫﻴﻜﻞ ﺍﻹﻧﻔﺎﻕ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﺍ‪‬ﺎﻧﻴﺔ ﺇﱃ ﺃﻥ ﺗﻜﺎﻟﻴﻒ ﺍﻟﺪﻭﺍﺀ ﻫﻲ ﺍﻟﻌﻨﺼﺮ ﺍﻟﺮﺋﻴﺴﻲ‬
‫ﻓﻴﻬﺎ‪ ،‬ﺣﻴﺚ ﺗﺸﲑ ﺑﻴﺎﻧﺎﺕ ﻣﺴﺢ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﻌﺎﻡ ‪ ١٩٩٥/٩٤‬ﺃﻥ ﺍﻷﺩﻭﻳﺔ ﻫﻲ ﺍﳌﻜﻮﻥ ﺍﻟﺮﺋﻴﺴﻲ ﰲ‬
‫ﺑﻨﻮﺩ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﻌﻴﺎﺩﺓ ﺍﻟﺪﺍﺧﻠﻴﺔ ﰲ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﺗﺸﻜﻞ ﺃﺗﻌﺎﺏ ﺍﻷﻃﺒﺎﺀ ﺍﳌﻜﻮﻥ‬
‫ﺍﻟﺮﺋﻴﺴﻲ ﻟﻺﻧﻔﺎﻕ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﺗﺘﺼﺎﻋﺪ ﺍﻷﺗﻌﺎﺏ ﻣﻊ ﺯﻳﺎﺩﺓ ﺍﻟﺪﺧﻞ ﺑﺎﳋﺪﻣﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﻭﺑﺼﻔﺔ ﻋﺎﻣﺔ ﺗﺪﻓﻊ ﻓﺌﺎﺕ ﺍﻟﺪﺧﻞ ﺍﳌﺘﻮﺳﻂ ﻭﺍﳌﺮﺗﻔﻊ ﻣﺒﺎﻟﻎ ﺃﻛﺜﺮ ﺍﺭﺗﻔﺎﻋﺎ ﰲ ﲨﻴﻊ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻭﻳﻌﺘﱪ ﺍﺭﺗﻔﺎﻉ ﻛﺎﻓﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺃﻫﻢ ﺃﺳﺒﺎﺏ ﻋﺪﻡ ﺍﻟﺮﺿﺎ ﳊﻮﺍﱄ ‪ %٨٣,٣‬ﻭ‪ %٦٦,٧‬ﻟﻔﺌﺎﺕ‬
‫ﺍﻟﺪﺧﻞ ﺍﳌﻨﺨﻔﻀﺔ ﻣﻦ ﺍﳌﺮﺿﻰ ﺍﳌﻘﻴﻤﲔ ﻭﺍﳌﺮﺿﻰ ﺍﳌﺘﺮﺩﺩﻳﻦ ﻋﻠﻰ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺭﺟﻴﺔ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﻟﻌﺎﻣﺔ ﻋﻠﻰ ﺍﻟﺘﻮﺍﱄ‪ ،‬ﺑﻴﻨﻤﺎ ﺗﻘﻞ ﻧﺴﺒﺔ ﻋﺪﻡ ﺍﻟﺮﺿﺎ ﻋﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺇﱃ ‪ %١٦,٧‬ﺑﺎﻟﻨﺴﺒﺔ ﻟﻺﻧﻔﺎﻕ‬
‫ﺍﳋﺎﺹ )ﺟﺪﻭﻝ ﺭﻗﻢ ‪ ١٦‬ﻭﺷﻜﻞ ﺭﻗﻢ ‪١٦‬ﺃ ﻭﺏ(‪.‬ﻭﳝﻜﻦ ﺗﱪﻳﺮ ﺫﻟﻚ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻘﻮﻝ ﺑﺄﻥ ﳏﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ‬
‫ﻋﻨﺪ ﺍﺳﺘﺨﺪﺍﻣﻬﻢ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻻ ﻳﺘﻮﻗﻌﻮﻥ ﺩﻓﻊ ﺃﻱ ﺃﺗﻌﺎﺏ‪ ،‬ﻭﻳﻌﺪ ﺃﻱ ﺇﻧﻔﺎﻕ ﻣﺼﺪﺭ ﺷﻜﻮﻯ ﳍﻢ‪.‬‬
‫ﻭﻣﻦ ﺍﳌﺜﲑ ﻟﻠﺪﻫﺸﺔ ﺃﻥ ﳒﺪ ﺍﻟﻔﺌﺎﺕ ﺍﳌﺘﻮﺳﻄﺔ ﻭﺍﻟﻌﺎﻟﻴﺔ ﻻ ﻳﻌﺘﱪﻭﻥ ﺍﺭﺗﻔﺎﻉ ﺍﻟﺘﻜﻠﻔﺔ ﺃﺣﺪ ﺍﻷﺳﺒﺎﺏ‬
‫ﺍﳍﺎﻣﺔ ﻟﻌﺪﻡ ﺍﻟﺮﺿﺎ ﻋﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳋﺎﺻﺔ )ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪١٦‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ(‪ ،‬ﺣﻴﺚ ﺇ‪‬ﻢ‬
‫ﻳﺘﻮﻗﻌﻮﻥ ﺍﺭﺗﻔﺎﻉ ﺗﻜﻠﻔﺔ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳋﺎﺻﺔ‪.‬‬

‫ﺷﻜﻞ )‪ :(١٦-٤‬ﺍﻟﺘﻜﺎﻟﻴﻒ ﻛﺴﺒﺐ ﻟﻌﺪﻡ ﺍﻟﺮﺿﺎ ﺍﻗﺘﺼﺎﺩﻳﺎﹰ ﻟﻠﻤﺮﺿﻰ ﺑﺎﻟﻌﻴﺎﺩﺓ ﺍﻟﺪﺍﺧﻠﻴﺔ )‪(%‬‬

‫‪90‬‬
‫‪80‬‬
‫‪70‬‬
‫‪60‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪\(%‬‬

‫‪50‬‬
‫‪40‬‬
‫‪30‬‬
‫‪20‬‬
‫‪10‬‬
‫‪0‬‬
‫ﻣﺴﺘﻮﻯ ﺍﻻﻧﻔﺎﻕ ﻗﻠﻴﻞ‬ ‫ﻣﺴﺘﻮﻯ ﺍﻻﻧﻔﺎﻕ ﻣﺘﻮﺳﻂ‬ ‫ﻣﺴﺘﻮﻯ ﺍﻻﻧﻔﺎﻕ ﻣﺮﺗﻔﻊ‬
‫ﺣﻜﻮﻣﺔ‬ ‫ﻋﺎﻡ‬ ‫ﺧﺎﺹ‬ ‫ﻭﺣﺪﺍﺕ ﺍﻟﺼﺤﺔ ﺑﺎﳌﺴﺠﺪ ﻭﺍﻟﻜﻨﻴﺴﺔ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ١٦‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫‪١٠٤‬‬
 ‫ﺷﻜﻞ )‪ :(١٧-٤‬ﺗﻜﻠﻔﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻛﺴﺒﺐ ﻟﻌﺪﻡ ﺍﻟﺮﺿﺎ ﻟﻠﻤﺮﺿﻲ ﺑﺎﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺭﺟﻴﺔ )‪(%‬‬

‫‪120‬‬

‫‪100‬‬

‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪\(%‬‬

‫‪80‬‬

‫‪60‬‬

‫‪40‬‬

‫‪20‬‬

‫‪0‬‬
‫ﻣﺴﺘﻮﻯ ﺍﻻﻧﻔﺎﻕ ﻗﻠﻴﻞ‬ ‫ﻣﺴﺘﻮﻯ ﺍﻻﻧﻔﺎﻕ ﻣﺘﻮﺳﻂ‬ ‫ﻣﺴﺘﻮﻯ ﺍﻻﻧﻔﺎﻕ ﻣﺮﺗﻔﻊ‬
‫ﺣﻜﻮﻣﺔ‬ ‫ﻋﺎﻡ‬ ‫ﺧﺎﺹ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ١٦‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ ﻓﺈﻥ ﺍﳌﺮﺿﻰ ﻣﻦ ﳏﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ﻻ ﻳﻨﺎﻟﻮﻥ ﺭﻋﺎﻳﺔ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ﺑﻨﻔﺲ ﺍﳉﻮﺩﺓ ﻣﺜﻞ‬
‫ﺍﻷﻓﺮﺍﺩ ﺍﻷﻓﻀﻞ ﺣﺎﻻﹰ )‪ %٢٨‬ﺇﱃ ‪ ،(%٣٥‬ﻭﺑﺎﻟﺘﺄﻛﻴﺪ ﻓﺈﻥ ﻧﺴﺒﺔ ﺍﻷﻓﺮﺍﺩ ﺍﻟﺬﻳﻦ ﻳﻌﺘﱪﻭﻥ "ﺍﻟﺘﻜﺎﻟﻴﻒ" ﺳﺒﺒﺎ‬
‫ﻟﻌﺪﻡ ﺩﺧﻮﻝ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻛﺎﻧﺖ ﺃﻋﻠﻰ ﺑﺎﻟﻨﺴﺒﺔ ﶈﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ )‪ ( %٦٢‬ﻣﻘﺎﺭﻧﺔ ﺑﻜﻞ ﻣﻦ ﺍﻟﻄﺒﻘﺔ‬
‫ﺍﳌﺘﻮﺳﻄﺔ )‪ (%٥٢‬ﻭﺍﻟﻄﺒﻘﺔ ﺍﻟﻌﻠﻴﺎ )‪.(%٤٠‬‬
‫ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﳏﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ﳚﺐ ﺇﻋﻔﺎﺅﻫﻢ ﻣﻦ ﺍﻹﻧﻔﺎﻕ ﻧﻈﲑ ﺍﻟﺮﻋﺎﻳﺔ ﰲ ﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻭﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ‪ ،‬ﻓﺈ‪‬ﻢ ﻳﺪﻓﻌﻮﻥ ﺑﺎﻟﻔﻌﻞ ﻣﻘﺎﺑﻞ ﺍﻷﺩﻭﻳﺔ ﺑﺼﻔﺔ ﺃﺳﺎﺳﻴﺔ ﻭﻟﺒﻌﺾ‬
‫ﺍﳋﺪﻣﺎﺕ ﻛﺎﻷﺷﻌﺔ ﺍﳌﻘﻄﻌﻴﺔ ﻭﺍﻻﺧﺘﺒﺎﺭﺍﺕ ﺍﳌﻌﻤﻠﻴﺔ‪ .(Kemprecos1993) .‬ﻭﻭﻓﻘﺎ ‪Berman1995‬‬
‫ﻳﺼﻞ ﻣﺘﻮﺳﻂ ﺗﻜﻠﻔﺔ ﺍﻹﻗﺎﻣﺔ ﺑﺎﳌﺴﺘﺸﻔﻰ ‪ ٢٩٤‬ﺟﻨﻴﻬﺎﹰ ﻣﺼﺮﻳﺎﹰ ﰲ ﺣﻀﺮ ﻣﺼﺮ ﻭ‪ ٢٢٨‬ﺟﻨﻴﻬﺎﹰ ﻣﺼﺮﻳﺎﹰ‬
‫ﰲ ﺍﻟﺮﻳﻒ ﺍﳌﺼﺮﻱ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﻫﺬﺍ ﺍﳌﻌﺪﻝ ﻳﺸﻤﻞ ﲨﻴﻊ ﻓﺌﺎﺕ ﺍﻟﺪﺧﻞ ﻭﲨﻴﻊ ﺃﻧﻮﺍﻉ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫)ﻣﺜﻞ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﻴﺔ ﻣﺮﺗﻔﻌﺔ ﺍﻟﺘﻜﺎﻟﻴﻒ( ﻓﺈﻥ ﺍﻟﺘﻜﺎﻟﻴﻒ ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﺗﻌﺘﱪ ﻋﺎﺋﻘﺎ ﶈﺪﻭﺩﻱ‬
‫ﺍﻟﺪﺧﻞ ﰲ ﻣﺼﺮ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﻟﻠﻤﺮﺿﻰ ﺍﳌﻘﻴﻤﲔ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٥-٤‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﺘﻮﺯﻳﻊ ﺍﻷﻓﺮﺍﺩ )‪ ١٦‬ﺳﻨﺔ ﻓﺄﻛﺜﺮ( ﺍﻟﺬﻳﻦ ﰲ ﺣﺎﺟﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﻓﻘﺎﹰ‬
‫ﳊﺎﻟﺔ ﺍﳌﺮﻳﺾ ﻭﻭﻓﻘﺎﹰ ‪‬ﻤﻮﻋﺔ ﺍﻟﺪﺧﻞ‬
‫ﻣﺴﺘﻮﻯ ﺍﻟﺪﺧﻞ‬
‫ﺍﻹﲨﺎﱄ‬ ‫ﻣﺮﺗﻔﻊ‬ ‫ﻣﺘﻮﺳﻂ‬ ‫ﻣﻨﺨﻔﺾ‬
‫‪%٢‬‬ ‫‪%٣٤‬‬ ‫‪%٣٤‬‬ ‫‪%٢٨‬‬ ‫ﺍﳌﺮﺿﻰ ﺍﳌﻘﻴﻤﻮﻥ ﰲ ﺍﳌﺴﺘﺸﻔﻰ‬
‫‪%٧٨‬‬ ‫‪%٦٦‬‬ ‫‪%٦٦‬‬ ‫‪%٧٢‬‬ ‫ﺍﳌﺮﺿﻰ ﻏﲑ ﺍﳌﻘﻴﻤﲔ ﻭﻟﻜﻦ ﰲ ﺣﺎﺟﺔ ﻟﻺﻗﺎﻣﺔ ‪‬ﺎ‬
‫‪%١٠٠‬‬ ‫‪%١٠٠‬‬ ‫‪%١٠٠‬‬ ‫‪%١٠٠‬‬
‫ﺍﻹﲨﺎﱄ‬
‫)‪(٣,٨٢٠‬‬ ‫)‪(٢,٢٣٦‬‬ ‫)‪(٥٤٢‬‬ ‫)‪(٣,٨٢٠‬‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﳏﺴﻮﺑﺔ ﻣﻦ ﺗﻘﺮﻳﺮ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ‪١٩٩٥/٩٤‬‬

‫‪١٠٥‬‬
 ‫‪ -٢‬ﺍﻟﻔﻌﺎﻟﻴﺔ‬
‫ﳝﻜﻦ ﺗﻘﻴﻴﻢ ﻓﻌﺎﻟﻴﺔ ﺃﻱ ﻧﻈﺎﻡ ﻋﻦ ﻃﺮﻳﻖ ﺗﻘﻴﻴﻢ ﻧﺘﺎﺋﺞ ﺍﻹﻧﻔﺎﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺍﻟﺼﺤﻲ‪ .‬ﻭﻳﺸﲑ ﺍﳉﺪﻭﻝ‬
‫ﺍﻟﺘﺎﱄ ﺇﱃ ﺑﻨﻮﺩ ﺍﻟﻔﻌﺎﻟﻴﺔ ﻭﺑﻨﻮﺩ ﻋﺪﻡ ﺍﻟﻔﺎﻋﻠﻴﺔ ﻟﻺﻧﻔﺎﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺍﻟﺼﺤﻲ‪:‬‬
‫ﺑﻨﻮﺩ ﻋﺪﻡ ﻓﻌﺎﻟﻴﺔ ﻧﻈﺎﻡ ﺍﻟﺼﺤﺔ ﺍﳌﺼﺮﻱ‬ ‫ﺑﻨﻮﺩ ﻓﻌﺎﻟﻴﺔ ﻧﻈﺎﻡ ﺍﻟﺼﺤﺔ ﺍﳌﺼﺮﻱ‬
‫‪ .١‬ﺍﻷﺩﺍﺀ ﺍﳌﻨﺨﻔﺾ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬ ‫‪ .١‬ﲢﺴﻦ ﰲ ﻣﺆﺷﺮﺍﺕ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻷﺳﺎﺳﻴﺔ‬ ‫‪ .٢‬ﺍﺭﺗﻔﺎﻉ ﻣﻌﺪﻝ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺘﻄﻌﻴﻢ‬
‫‪ .٢‬ﺗﺒﺎﻳﻦ ﻣﺴﺘﻮﻯ ﺍﻷﺩﺍﺀ ﰲ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬ ‫‪ .٣‬ﺍﳔﻔﺎﺽ ﰲ ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﺎﺓ ﻭﺍﻹﺻﺎﺑﺔ ﺑﺎﳌﺮﺽ‬
‫ﺗﺒﻌﺎ ﻟﻠﻤﻨﻄﻘﺔ‬ ‫‪ .٤‬ﺍﻟﺘﺤﺴﻦ ﰲ ﺑﻌﺾ ﻣﺆﺷﺮﺍﺕ ﻧﻈﺎﻡ ﺗﻮﺻﻴﻞ‬
‫‪ .٣‬ﺍﻟﺘﺪﻫﻮﺭ ﰲ ﺧﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬ ‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫‪ .٤‬ﻭﺟﻮﺩ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻟﻔﻘﺮ‬ ‫‪ .٥‬ﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﻜﺎﻣﻠﺔ ﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ‬
‫‪ .٥‬ﺍﳔﻔﺎﺽ ﻣﺴﺘﻮﻯ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻣﻬﺎﺕ‬ ‫‪ .٦‬ﻭﺟﻮﺩ ﺑﻨﻴﺔ ﲢﺘﻴﺔ ﺻﺤﻴﺔ‬
‫ﻭﺍﻷﻃﻔﺎﻝ‬ ‫‪ .٧‬ﻧﻈﺎﻡ ﻣﺘﻌﺪﺩ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫‪ .٦‬ﺍﻟﺘﺒﺎﻳﻦ ﰲ ﺗﻜﻠﻔﺔ ﺍﻟﻮﺣﺪﺓ‬
‫‪ .٧‬ﺗﻜﺪﺱ ﺍﻟﻘﻮﺓ ﺍﻟﻌﺎﻣﻠﺔ ﺍﻟﻄﺒﻴﺔ‬
‫‪ .٨‬ﺍﳔﻔﺎﺽ ﻣﻌﺪﻻﺕ ﺍﻻﺳﺘﺨﺪﺍﻡ ﻟﻠﻮﺣﺪﺓ‬
‫ﺍﻟﺼﺤﻴﺔ‬
‫‪ .٩‬ﺍﳔﻔﺎﺽ ﺍﻷﺟﻮﺭ ﺍﻟﻔﻌﻠﻴﺔ‬
‫‪ .١٠‬ﺳﻮﺀ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﳍﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ‬
‫ﺍﻟﺼﺤﻲ‪.‬‬
‫ﺃ – ﺑﻨﻮﺩ ﻓﻌﺎﻟﻴﺔ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ‬
‫‪ .١‬ﲢﺴﻦ ﰲ ﻣﺆﺷﺮﺍﺕ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ‪ :‬ﺣﺪﺙ ﲢﺴﻦ ﻭﺍﺿﺢ ﰲ ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ ﻭﻣﺘﻮﺳﻂ ﺍﻟﻌﻤﺮ‬
‫ﺍﳌﺘﻮﻗﻊ ﺃﺛﻨﺎﺀ ﺍﻟﻌﻘﺪﻳﻦ ﺍﻷﺧﲑﻳﻦ‪ .‬ﻭﻳﺸﲑ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٥‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ ﺇﱃ ﺍﻟﺘﺤﺴﻦ ﰲ‬
‫ﻣﺆﺷﺮﺍﺕ ﺍﻟﺼﺤﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻛﻤﺎ ﻫﻮ ﻣﻮﺿﺢ ﰲ ﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻟﺮﲰﻴﺔ‪ ،‬ﺣﻴﺚ ﺍﳔﻔﻀﺖ ﻣﻌﺪﻻﺕ‬
‫ﺍﻟﻮﻓﻴﺎﺕ ﻣﻦ ‪ ١٠‬ﰲ ﺍﻷﻟﻒ ﻋﺎﻡ ‪ ١٩٨١‬ﺇﱃ ‪ ٧‬ﰲ ﺍﻷﻟﻒ ﻋﺎﻡ ‪ .١٩٩٥‬ﺍﳔﻔﻀﺖ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ‬
‫ﻣﻦ ‪ ٩٧‬ﰲ ﺍﻷﻟﻒ ﺇﱃ ‪ ٦٣‬ﰲ ﺍﻷﻟﻒ ﻋﺎﻡ ‪ ١٩٩٥‬ﻭﺍﳔﻔﻀﺖ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ )ﲢﺖ ‪ ٥‬ﺳﻨﻮﺍﺕ(‬
‫ﻣﻦ ‪ ١٣٩‬ﰲ ﺍﻷﻟﻒ ‪ ١٩٩٠‬ﺇﱃ ‪ ٨١‬ﰲ ﺍﻷﻟﻒ ‪ .١٩٩٥‬ﻭﻟﻘﺪ ﺣﻘﻖ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﲢﺖ ﺍﳋﺎﻣﺴﺔ‬
‫ﺗﻘﺮﻳﺒﺎ ‪ %٥٠‬ﺍﳔﻔﺎﺿﺎﹰ ﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪.١٩٨٢-١٩٧٨‬‬
‫ﻛﺬﻟﻚ ﻭﻗﻊ ﺍﳔﻔﺎﺽ ﻭﺍﺿﺢ ﰲ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻣﻦ ‪ %٧٧‬ﻟﻜﻞ ﺃﻟﻒ ﻋﺎﻡ ‪ ١٩٨١‬ﺇﱃ ‪ %٥٤‬ﻟﻜﻞ‬
‫ﺃﻟﻒ ﰲ ‪ ،١٩٨٩‬ﻭﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﲟﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﳝﻜﻦ ﺍﺳﺘﻨﺘﺎﺝ ﺃﻧﻪ ﺣﺪﺙ ﺍﳔﻔﺎﺽ‬
‫ﻋﺎﻡ ﰲ ﺍﻹﺻﺎﺑﺔ ﺑﻌﺾ ﺍﻷﻣﺮﺍﺽ ﰲ ﻣﺼﺮ ﻣﺜﻞ ﺍﻟﺪﻓﺘﲑﻳﺎ‪ ،‬ﺍﻟﺴﻌﺎﻝ ﺍﻟﺪﻳﻜﻲ‪ ،‬ﺍﳊﺼﺒﺔ‪ ،‬ﺍﻟﺴﻞ‪،‬‬
‫ﻭﺍﻟﺒﻠﻬﺎﺭﺳﻴﺎ‪ .‬ﻭﻛﺬﻟﻚ ﺍﺭﺗﻔﻊ ﻣﺘﻮﺳﻂ ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻟﻠﺬﻛﻮﺭ ﻭﺍﻹﻧﺎﺙ ﻣﻦ ‪ ٤٩,٥‬ﺳﻨﺔ – ‪ ٥١,٩‬ﺳﻨﺔ‬
‫ﰲ ‪ ١٩٨١‬ﺇﱃ ‪ ٦٥‬ﺳﻨﺔ ‪ ٦٧ -‬ﺳﻨﺔ ﻋﺎﻡ ﻋﻠﻰ ﺍﻟﺘﻮﺍﱄ ﰲ ‪ .١٩٩٥‬ﻭﻳﻌﺰﻯ ﻫﺬﺍ ﺍﻟﺘﺤﺴﻦ ﺇﱃ ﺍﻻﳔﻔﺎﺽ‬

‫‪١٠٦‬‬
‫ﰲ ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ ﻟﻠﺮﺿﻊ‪ ،‬ﻭﻟﻸﻃﻔﺎﻝ ﻭﺍﻷﻣﻬﺎﺕ ﻭﺍﻻﳔﻔﺎﺽ ﰲ ﻣﻌﺪﻻﺕ ﺍﻹﺻﺎﺑﺔ ﰲ ﺑﻌﺾ‬
‫ﺃﻣﺮﺍﺽ ﺍﻟﻄﻔﻮﻟﺔ ﻧﺘﻴﺠﺔ ﻟﺘﻄﺒﻴﻖ ﺑﻌﺾ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺼﺤﻴﺔ ﲢﺖ ﺭﻋﺎﻳﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰲ‬
‫ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ ﻛﺎﻟﺘﻮﺳﻊ ﰲ ﺍﻟﺘﻄﻌﻴﻢ ﻭﻣﻜﺎﻓﺤﺔ ﺍﻹﺳﻬﺎﻝ‪.‬‬
‫ﺳﻨﺔ ﺍﳌﻘﺎﺭﻧﺔ‬ ‫ﺳﻨﺔ ﺍﻷﺳﺎﺱ‬ ‫ﺍﳌﺆﺷﺮﺍﺕ‬
‫)‪٦٣-(١٩٩٦‬‬ ‫)‪٩٧– (١٩٨٣‬‬ ‫ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺼﻐﺎﺭ)ﺍﳌﻌﺪﻝ ﻟﻜﻞ ﺃﻟﻒ(‬
‫)‪٧ (١٩٩٥‬‬ ‫)‪١٠ – (١٩٨١‬‬ ‫ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﺎﺓ‬
‫)‪٨١ (١٩٩٥‬‬ ‫)‪١٣٩ (١٩٨٣‬‬ ‫ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ )ﺍﳌﻌﺪﻝ ﻟﻜﻞ ﺃﻟﻒ ﻣﻦ ﻧﻔﺲ ﺍﻟﻌﻤﺮ ﻟﻜﻞ ‪١٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬
‫*‬
‫‪٥٤‬‬ ‫)‪٧٧ (١٩٨١‬‬ ‫ﻣﻌﺪﻝ ﻭﻓﺎﺓ ﺍﻷﻣﻬﺎﺕ )ﻟﻜﻞ ‪١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬
‫ﻣﻌﺪﻝ ﺣﺪﻭﺙ ﺑﻌﺾ ﺍﻷﻣﺮﺍﺽ‬
‫)‪٠,٥ (١٩٩٢‬‬ ‫)‪٠,٨ (١٩٨٠‬‬ ‫‪ -١‬ﺩﻓﺘﺮﻳﺎ‬
‫‪٠,٠١‬‬ ‫‪٠,١‬‬ ‫‪ -٢‬ﺍﻟﺴﻌﺎﻝ ﺍﻟﺪﻳﻜﻲ‬
‫)‪٥,٣ (١٩٩٢‬‬ ‫‪١٠,٨‬‬ ‫‪ -٣‬ﺗﻴﺘﺎﻧﻮﺱ ﺣﺪﻳﺚ ﺍﻟﻮﻻﺩﺓ ﻏﲑ ﳏﺪﺩ ﺍﻟﻌﻤﺮ)ﻟﻜﻞ‪(١٠٠٠٠٠‬‬
‫)‪٢,٩٨ (١٩٩٢‬‬ ‫‪٠,٨‬‬ ‫‪ -٤‬ﺷﻠﻞ ﺍﻷﻃﻔﺎﻝ‬
‫)‪٠,٨٤ (١٩٩٢‬‬ ‫‪١٥,٢‬‬ ‫‪ -٥‬ﺍﻟﺴﻞ‬
‫)‪١١,٢ (١٩٩٣‬‬ ‫)‪١٩,٧ (١٩٨٣‬‬ ‫‪ -٦‬ﺍﻟﺒﻠﻬﺎﺭﺳﻴﺎ‬
‫)‪١١,٣ (١٩٨٧‬‬ ‫)‪١٥,٢ (١٩٨٤‬‬ ‫‪ -٧‬ﺍﳊﺎﻻﺕ ﺍﻟﺮﺋﻮﻳﺔ‬
‫ﻣﻌﺪﻻﺕ ﺗﻮﻗﻊ ﺍﳊﻴﺎﺓ‬
‫‪٦٥‬‬ ‫‪٤٩,٥‬‬ ‫ﺍﻟﺬﻛﻮﺭ‬
‫‪٦٧‬‬ ‫)‪٥١,٩(١٩٨١‬‬ ‫ﺍﻹﻧﺎﺙ‬
‫ﺗﻐﻄﻴﺔ ﺍﻟﺘﻄﻌﻴﻤﺎﺕ‬
‫‪%٨٧,٨‬‬ ‫)‪%٧١,٦(١٩٨٧‬‬ ‫ﺍﻟﺴﻞ‬
‫‪%٨٦,٤‬‬ ‫)‪%٨١,٦(١٩٨٧‬‬ ‫ﺍﻟﺜﻼﺛﻲ‬
‫)‪%٨٧ (١٩٩٠‬‬ ‫)‪%٨٨,١(١٩٨٧‬‬ ‫ﺷﻠﻞ ﺍﻷﻃﻔﺎﻝ‬
‫)‪%٨٦ (١٩٩٠‬‬ ‫)‪%٧٦,١(١٩٨٧‬‬ ‫ﺍﳊﺼﺒﺔ‬
‫)‪%٦٢,٨(١٩٩٠‬‬ ‫)‪%١٢,٤(١٩٨٧‬‬ ‫ﺗﻴﺘﺎﻧﻮﺱ‪٢‬‬
‫ﺍﻷﻃﻔﺎﻝ ﻛﺎﻣﻠﻮ ﺍﻟﺘﻄﻌﻴﻢ‬
‫)‪%٧٩(١٩٨٩‬‬ ‫)‪%٧٧,١(١٩٨٠‬‬ ‫‪ -‬ﺍﻟﺴﻴﺪﺍﺕ ﺍﻟﻼﰐ ﺍﺳﺘﺨﺪﻣﻦ ﳏﻠﻮﻝ ﻣﻌﺎﳉﺔ ﺍﳉﻔﺎﻑ‬
‫)‪%٥(١٩٨٩‬‬ ‫)‪%٥٨ (١٩٨٠‬‬ ‫‪ -‬ﻧﺴﺒﺔ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻼﰐ ﺃﻭﻗﻔﻦ ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﻣﻦ ﺍﻟﺜﺪﻱ‬

‫‪ .٢‬ﺍﺭﺗﻔﺎﻉ ﻣﻌﺪﻝ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺘﻄﻌﻴﻢ‪ :‬ﺑﻠﻐﺖ ﻧﺴﺒﺔ ﺍﻷﻣﻬﺎﺕ ﺍﻟﻼﰐ ﺍﺳﺘﺨﺪﻣﻦ ﳏﻠﻮﻝ ﻣﻌﺎﳉﺔ‬
‫ﺍﳉﻔﺎﻑ ‪ %١٧‬ﺧﻼﻝ ﻋﺎﻡ ‪ %٣٧ ،١٩٨٠‬ﺧﻼﻝ ﻋﺎﻡ ‪ ١٩٨٣‬ﻭﻭﺻﻠﺖ ﺇﱃ ‪ %٩٧‬ﺧﻼﻝ ﻋﺎﻡ ‪ .١٩٩٠‬ﻭﺍﳔﻔﻀﺖ‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻸﻣﻬﺎﺕ ﺍﻟﻼﰐ ﺗﻮﻗﻔﻦ ﻋﻦ ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﺃﺛﻨﺎﺀ ﻓﺘﺮﺓ ﺍﻹﺳﻬﺎﻝ ﻣﻦ ‪%٥٨‬‬
‫ﺧﻼﻝ ‪١٩٨٠‬ﺇﱃ ‪ %٤١‬ﺧﻼﻝ ‪ ١٩٨٣‬ﻭﻭﺻﻠﺖ ﺇﱃ ‪ %٥‬ﺧﻼﻝ ‪ .١٩٨٩‬ﻭﻳﺘﻮﻗﻊ ﻟﺬﻟﻚ ﺃﻥ ﻳﻜﻮﻥ ﻟﻪ ﺃﺛﺮ ﻛﺒﲑ‬
‫ﻋﻠﻰ ﲢﺴﲔ ﺍﳊﺎﻟﺔ ﺍﻟﻐﺬﺍﺋﻴﺔ ﻟﻸﻃﻔﺎﻝ ﺃﻗﻞ ﻣﻦ ﺳﻨﺘﲔ ﻣﺜﻠﻬﻢ ﻣﺜﻞ ﺍﻷﻃﻔﺎﻝ ﻗﺒﻞ ﺳﻦ ﺍﳌﺪﺭﺳﺔ‪.‬‬
‫‪ .٣‬ﺍﳔﻔﺎﺽ ﰲ ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ ﻭﺍﻹﺻﺎﺑﺔ ﺑﺎﳌﺮﺽ‪ :‬ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ ﻓﺈﻥ ﺍﻟﺘﻌﺎﻣﻞ ﺍﳌﺒﻜﺮ ﻭﺍﳌﻨﺎﺳﺐ‬
‫ﻟﻠﺤﺎﻻﺕ ﺍﳊﺎﺩﺓ ﺑﻮﺍﺳﻄﺔ ﺗﻘﻨﻴﺎﺕ ﻣﻌﺎﳉﺔ ﺍﳉﻔﺎﻑ ﻋﱪ ﺍﻟﻔﻢ ﻗﺪ ﳒﺢ ﰲ ﺗﻘﻠﻴﻞ ﻋﺪﺩ ﺍﻟﻮﻓﻴﺎﺕ ﻣﻨﺬ‬
‫ﻋﺎﻡ ‪ .١٩٨٧‬ﻭﺃﺻﺒﺢ ﺍﻹﺳﻬﺎﻝ ﺍﻟﺬﻱ ﻛﺎﻥ ﻣﻦ ﺍﻷﺳﺒﺎﺏ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ ﻫﻮ‬

‫* ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ‬

‫‪١٠٧‬‬
‫ﺍﻟﺴﺒﺐ ﺍﻟﺜﺎﱐ ﺍﻟﺮﺋﻴﺴﻲ ﳊﺎﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ ﰲ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻭﰱ ﺍﻟﻮﻗﺖ ﻧﻔﺴﻪ ﻓﺈﻥ ﺑﺮﻧﺎﻣﺞ ﻣﻜﺎﻓﺤﺔ‬
‫ﺍﻟﺒﻠﻬﺎﺭﺳﻴﺎ ﺍﻟﺬﻱ ﻗﺪﻡ ﻋﻼﺟﺎ ﻛﻴﻤﻴﺎﺋﻴﺎ ﺟﺪﻳﺪﺍ ﳝﻜﻦ ﺗﻨﺎﻭﻟﻪ ﰲ ﺷﻜﻞ ﺟﺮﻋﺔ ﻭﺍﺣﺪﺓ ﻋﱪ ﺍﻟﻔﻢ؛ ﻗﺪ‬
‫ﻧﺘﺞ ﻋﻨﻪ ﻧﺘﺎﺋﺞ ﻣﺸﺠﻌﺔ ﰲ ﺇﺑﺎﺩﺓ ﻫﺬﺍ ﺍﳌﺮﺽ ) ﺑﻠﻬﺎﺭﺳﻴﺎ ﺍﳌﺴﺘﻘﻴﻢ ﻭﺑﻠﻬﺎﺭﺳﻴﺎ ﺍ‪‬ﺎﺭﻯ ﺍﻟﺒﻮﻟﻴﺔ(‬
‫ﰲ ﻣﻨﻄﻘﺔ ﺍﻟﺪﻟﺘﺎ‪ .‬ﻭﺣﺪﺙ ﺍﳔﻔﺎﺽ ﰲ ﻣﻌﺪﻻﺕ ﺍﻻﻧﺘﺸﺎﺭ ﻣﻦ ‪ ١٩,٧‬ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﰲ ﻋﺎﻡ ‪ ١٩٨٣‬ﺇﱃ‬
‫‪ ١١,٢‬ﻟﻜﻞ ﻣﺎﺋﺔ ﺃﻟﻒ ﰲ ﻋﺎﻡ ‪.١٩٩٣‬‬
‫‪ .٤‬ﺍﻟﺘﺤﺴﻦ ﰲ ﺑﻌﺾ ﻣﺆﺷﺮﺍﺕ ﻧﻈﺎﻡ ﺗﻮﺻﻴﻞ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ :‬ﻋﻠﻰ ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ ‪ -‬ﺍﺭﺗﻔﻌﺖ‬
‫ﻧﺴﺒﺔ ﻃﺒﻴﺐ‪١٠٠٠٠/‬ﻣﻮﺍﻃﻦ ﺇﱃ ‪ ١٩,٩‬ﻃﺒﻴﺐ ﰲ ﻋﺎﻡ ‪ ١٩٩٤‬ﻭﺍﻟﱵ ﺗﻌﺪ ﻧﺴﺒﺔ ﻋﺎﻟﻴﺔ ﺇﱃ ﺣﺪ‪.‬‬
‫‪ .٥‬ﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﻜﺎﻣﻠﺔ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ‪ :‬ﻣﻦ ﺍﳌﻌﻠﻦ ﻋﻨﻪ ﺃﻥ ‪ %٩٩‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ ﻗﺪ ﲤﺖ‬
‫ﺗﻐﻄﻴﺘﻬﻢ ﺑﺎﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ‪.‬‬
‫‪ .٦‬ﻭﺟﻮﺩ ﺑﻨﻴﺔ ﲢﺘﻴﺔ ﺻﺤﻴﺔ‪ :‬ﻻ ﺷﻚ ﺃﻥ ﻣﺼﺮ ﻣﻘﺎﺭﻧﺔ ﺑﺒﻠﺪﺍﻥ ﺃﺧﺮﻯ ﻛﺜﲑﺓ ﻟﺪﻳﻬﺎ ﻭﺣﺪﺍﺕ ﺑﻨﻴﺔ ﲢﺘﻴﺔ‬
‫ﺻﺤﻴﺔ ﻛﺎﻣﻠﺔ ﺗﻘﺮﻳﺒﺎ ﺑﺎﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﺍﻟﺮﻳﻔﻴﺔ‪.‬‬
‫‪ .٧‬ﻧﻈﺎﻡ ﺻﺤﻲ ﻣﺘﻌﺪﺩ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ :‬ﳛﻈﻰ ﺍﳌﻮﺍﻃﻦ ﺍﳌﺼﺮﻱ ﲞﺪﻣﺎﺕ ﺻﺤﻴﺔ ﳎﺎﻧﻴﺔ ﻭﻟﺪﻯ‬
‫ﻋﺪﺩ ﻟﻴﺲ ﺑﻘﻠﻴﻞ ﻣﻦ ﺍﻟﻌﻤﺎﻝ ﻭﺍﳌﻮﻇﻔﲔ ﺍﳌﺼﺮﻳﲔ ﺗﺄﻣﲔ ﺍﺟﺘﻤﺎﻋﻲ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺃﺷﻜﺎﻝ ﺃﺧﺮﻯ‬
‫ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﺜﻞ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﳌﺆﺳﺴﺎﺕ ﻭﺍﳌﻌﺎﻫﺪ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳋﺎﺻﺔ‪.‬‬
‫ﺏ‪ -‬ﺑﻨﻮﺩ ﻋﺪﻡ ﻓﻌﺎﻟﻴﺔ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﺍﳌﺼﺮﻱ‬
‫‪ .١‬ﺍﻷﺩﺍﺀ ﺍﳌﻨﺨﻔﺾ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ :‬ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﻭﺟﻮﺩ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ‬
‫ﺍﳌﺘﺴﻌﺔ ﻭﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ ،‬ﻓﺈﻥ ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻳﺘﺮﻛﺰ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﻌﻼﺟﻴﺔ‪ .‬ﻭﺗﺴﺘﻬﻠﻚ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺜﻠﺜﲔ ﺗﻘﺮﻳﺒﺎ ﻣﻦ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﳉﺎﺭﻳﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﲤﺜﻞ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺣﻮﺍﱄ ‪ %٢٥‬ﻣﻦ ﺍﳌﻴﺰﺍﻧﻴﺔ‪ .‬ﻭﺗﺴﺘﻬﻠﻚ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﺣﻮﺍﱄ ‪%١٢‬‬
‫ﻣﻦ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﳌﺘﺒﻘﻴﺔ ﻛﻤﺎ ﺫﻛﺮ ﺳﺎﺑﻘﺎ‪ .‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ ﻳﺴﺘﺤﻮﺫ ﺍﳊﻀﺮ ﻋﻠﻰ ﺍﻟﻨﺼﻴﺐ ﺍﻷﻛﱪ‬
‫ﻣﻦ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﺗﺴﺘﻘﺒﻞ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺮﻳﻔﻴﺔ ‪%٣‬‬
‫ﻓﻘﻂ ﻣﻦ ﺇﲨﺎﱄ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﻘﺎﺑﻞ ‪ %٥٨‬ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﺍﳊﻀﺮﻳﺔ‪.‬‬
‫ﻭﻫﻨﺎﻙ ﺗﺒﺎﻳﻨﺎﺕ ﻭﺍﺿﺤﺔ ﰲ ﺗﻮﺯﻳﻊ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻌﻼﺟﻴﺔ ﺑﲔ ﺍﻷﻓﺮﺍﺩ‪ .‬ﻛﺬﻟﻚ ﻓﺈﻥ‬
‫ﻧﺴﺒﺔ ﺍﻷﻃﺒﺎﺀ ﻭﳑﺮﺿﺎﺕ ﻭﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻫﻲ ‪ %٥٥‬ﻭ‪ %٥٢‬ﻋﻠﻰ ﺍﻟﺘﺮﺗﻴﺐ‬
‫ﺑﻴﻨﻤﺎ ﻳﻌﻤﻞ ‪ %٢٤‬ﻭ‪ %٣٠‬ﻓﻘﻂ ﻣﻨﻬﻢ ﰲ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ .‬ﰲ ﻧﻔﺲ ﺍﻟﻮﻗﺖ‪،‬‬
‫ﳒﺪ ﺃﻥ ﺍﻟﻨﺴﺒﺔ ﺑﲔ ﺍﻷﻃﺒﺎﺀ ﺇﱃ ﺍﳌﻤﺮﺿﺎﺕ ﻫﻲ ‪ ١,١‬ﺇﱃ ‪ ١‬ﻓﻘﻂ‪ ،‬ﺑﻴﻨﻤﺎ ﺍﳌﻌﺪﻝ ﺍﻟﺪﻭﱄ ﻟﺘﻠﻚ‬
‫ﺍﻟﻨﺴﺒﺔ ﻫﻮ ‪١‬ﺇﱃ ‪ .٣‬ﻭﻳﻌﻜﺲ ﺫﻟﻚ ﻛﻞ ﻣﻦ ﺍﻻﺧﺘﻼﻓﺎﺕ ﰲ ﺍﳌﺮﺗﺒﺎﺕ ﺑﲔ ﺍﻷﻃﺒﺎﺀ ﻭﺍﳌﻤﺮﺿﺎﺕ ﻭﺍﻟﻨﻈﺎﻡ‬
‫ﺍﻟﺼﺤﻲ ﺍﳌﻮﺟﻪ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﺃﻛﺜﺮ ﻣﻦ ﺍﻟﻮﻗﺎﺋﻴﺔ‪ .‬ﻭﻗﺪ ﺃﺩﻯ ﻧﻘﺺ ﺍﻟﺘﻤﻮﻳﻞ ﻟﻠﻤﺮﺍﻛﺰ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺍﳊﻀﺮﻳﺔ ﺇﱃ ﻧﻘﺺ ﰲ ﺍﻹﻣﺪﺍﺩﺍﺕ ﻭﺍﻷﺩﻭﻳﺔ‪ ،‬ﻭﻧﻘﺺ ﺍﻻﺣﺘﻴﺎﻃﻲ ﻣﻦ ﺍﳌﺴﺘﻠﺰﻣﺎﺕ‬
‫ﺍﻷﺳﺎﺳﻴﺔ‪ .‬ﻭﺗﺆﺛﺮ ﻫﺬﻩ ﺍﳌﺸﺎﻛﻞ ﻋﻠﻰ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﰲ ﻫﺬﻩ ﺍﻟﻮﺣﺪﺍﺕ ﻭﺗﺆﺩﻯ ﺇﱃ ﺍﳔﻔﺎﺽ ﺍﳌﻜﺎﻓﺂﺕ‬
‫ﻟﻠﻌﺎﻣﻠﲔ ‪‬ﺬﻩ ﺍﻟﻮﺣﺪﺍﺕ ﻭﻋﻼﺝ ﻏﲑ ﻣﺜﻤﺮ ﻭﺗﺸﺨﻴﺺ ﻏﲑ ﺩﻗﻴﻖ ﻭﻣﻮﺍﻗﻒ ﺳﻠﺒﻴﺔ ﻟﻸﻃﺒﺎﺀ ﻭﻓﺘﺮﺍﺕ‬
‫ﺍﻧﺘﻈﺎﺭ ﻃﻮﻳﻠﺔ‪ .‬ﻟﻘﺪ ﺃﺩﻯ ﻋﺪﻡ ﺭﺿﺎ ﺍﳌﺮﺿﻰ ﺇﱃ ﺗﻘﻠﻴﻞ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪.‬‬

‫‪١٠٨‬‬
‫ﻭﺗﻌﺪ ﺍﻷﺳﺮ‪‬ﺓ ﰲ ﺍﻟﺮﻳﻒ ﺃﻳﻀﺎ ﻏﲑ ﻣﺴﺘﻐﻠﺔ ﺑﺼﻮﺭﺓ ﺷﺪﻳﺪﺓ )‪ %٢‬ﻣﻌﺪﻝ ﺍﻹﺷﻐﺎﻝ(‪ .‬ﺧﺎﺻﺔ ﺃﻥ‬
‫ﻣﻌﻈﻢ ﺍﳌﻮﺍﺭﺩ ﺍﳊﻜﻮﻣﻴﺔ ﻟﻠﺼﺤﺔ ﰲ ﻣﺼﺮ ﻣﻮﺟﻬﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﻌﻼﺟﻴﺔ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﳌﻨﺎﻃﻖ‬
‫ﺍﳊﻀﺮﻳﺔ‪ .‬ﻭﰱ ﻋﺎﻡ ‪ ١٩٩٧/٩٦‬ﺍﻧﻘﺴﻤﺖ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺎﻟﺘﺴﺎﻭﻱ ﺗﻘﺮﻳﺒﺎ ﺑﲔ ﻗﻄﺎﻉ‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﻏﲑ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ؛ ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺫﻟﻚ ﻓﻘﺪ ﺣﻈﻴﺖ ﺧﺪﻣﺎﺕ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺑـ ‪%٦٣‬‬
‫ﻣﻦ ﻣﻴﺰﺍﻧﻴﺔ ﺍﳊﻜﻮﻣﺔ )ﻣﺘﻀﻤﻨﺔ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﻴﺔ‪ ،‬ﺧﺪﻣﺎﺕ ﻭﺯﺍﺭﺍﺕ ﺃﺧﺮﻯ ﻭﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ‬
‫ﺍﻟﺼﺤﻲ( ﻭ‪ %٣٧‬ﻓﻘﻂ ﻛﺎﻧﺖ ﻣﻮﺟﻬﺔ ﻻﺳﺘﺨﺪﺍﻣﺎﺕ ﻏﲑ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪ .‬ﻭﻛﻤﺎ ﺫﻛﺮ ‪Berman, 1995‬‬
‫"ﻓﺈﻥ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻳﻨﻔﻖ ﺍﻟﻜﺜﲑ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﻷﻗﻞ ﻓﺎﻋﻠﻴﺔ ﻣﻦ ﻧﺎﺣﻴﺔ ﺍﻟﺘﻜﻠﻔﺔ"‪ .‬ﻋﻠﻰ‬
‫ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ‪ ،‬ﻓﺈﻥ ﻣﺼﺮ ﲤﺘﻠﻚ ﺣﻮﺍﱄ ‪ ٨٠٠‬ﻭﺣﺪﺓ ﻏﺴﻴﻞ ﻛﻠﻰ ﰲ ﺍﻟﺒﻼﺩ؛ ‪ ٤٦٣‬ﻣﻨﻬﺎ ﰲ ﺍﻟﻘﻄﺎﻉ‬
‫ﺍﳊﻜﻮﻣﻲ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺫﻟﻚ ﻓﺈﻥ ﺍﳌﻨﻔﻖ ﳌﺪﺓ ﻋﺎﻡ ﻋﻠﻰ ﺍﻟﻐﺴﻴﻞ ﺍﻟﻜﻠﻮﻱ )‪ ٣٦‬ﺃﻟﻒ ﺟﻨﻴﻪ ﻣﺼﺮﻱ(‬
‫ﳝﻜﻦ ﺃﻥ ﻳﺰﻳﺪ ‪ ١٧٤‬ﺳﻨﺔ ﺻﺤﻴﺔ ﺇﺫﺍ ﻣﺎ ﰎ ﺇﻧﻔﺎﻕ ﻫﺬﺍ ﺍﳌﺒﻠﻎ ﻋﻠﻰ ﺍﻟﺘﻄﻌﻴﻢ )‪ ٢٠٠‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬
‫ﻟﻜﻞ ﺣﻴﺎﺓ ﺻﺤﻴﺔ ﺗﻮﻓﺮ(‪.‬‬
‫‪ .٢‬ﺗﺒﺎﻳﻦ ﻣﺴﺘﻮﻯ ﺍﻷﺩﺍﺀ ﰲ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺗﺒﻌﺎ ﻟﻠﻤﻨﻄﻘﺔ‪ :‬ﺗﻌﺪ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻏﲑ ﻣﻮﺯﻋﺔ‬
‫ﺑﺎﻟﺘﺴﺎﻭﻱ‪ ،‬ﺣﻴﺚ ﺗﻮﺟﻪ ﺑﺼﻔﺔ ﺧﺎﺻﺔ ﺇﱃ ﳏﺎﻓﻈﺎﺕ ﺍﳊﻀﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﲟﺤﺎﻓﻈﺎﺕ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‬
‫ﻭﺍﻟﺴﻔﻠﻲ‪ .‬ﻭﻭﻓﻘﺎ ﳌﺆﺷﺮﺍﺕ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻓﺈﻥ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ ﻟﺪﻳﻬﺎ ﺃﻋﻠﻰ ﻣﻌﺪﻻﺕ‬
‫ﻭﻓﻴﺎﺕ ﲟﺘﻮﺳﻂ )‪ .(%٧,٤‬ﻭﺗﺒﻠﻎ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ ‪ %٦,٣١‬ﰲ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ‬
‫ﺍﻟﻌﻠﻴﺎ ﰲ ﺍﳌﺘﻮﺳﻂ ﻭ‪ %٣,٣٥‬ﰲ ﻣﺼﺮ ﺍﻟﺴﻔﻠﻲ ﻭﺑﻠﻐﺖ ‪ %٢,٢‬ﰲ ﳏﺎﻓﻈﺎﺕ ﺍﳊﻀﺮ‪ .‬ﺗﺸﲑ ﺗﻐﻄﻴﺔ‬
‫ﺍﻟﺘﻄﻌﻴﻤﺎﺕ ﺇﱃ ﺍﻟﻮﺿﻊ ﺍﳉﻴﺪ ﻧﺴﺒﻴﺎ ﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮ ﻭﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ ﺍﻟﺴﻔﻠﻲ ﻣﻘﺎﺭﻧﺔ‬
‫ﲟﺤﺎﻓﻈﺎﺕ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‪ .‬ﻭﰱ ﻧﻔﺲ ﺍﻟﻮﻗﺖ ﻓﺈﻥ ﻣﻌﺪﻝ ﺍﻟﻄﺒﻴﺐ ‪ ١٠٠٠ /‬ﻣﻮﺍﻃﻦ ﻗﺪ ﻭﺻﻞ ﺇﱃ‬
‫‪ ٩,٢٦‬ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﻭﺍﳔﻔﺾ ﺇﱃ ‪ ٦,١٢‬ﰲ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ ﻭ‪ ٥,٩٤‬ﰲ ﳏﺎﻓﻈﺎﺕ‬
‫ﻣﺼﺮ ﺍﻟﺴﻔﻠﻲ‪ .‬ﻭﺗﺴﻮﺩ ﻧﻔﺲ ﺍﻟﺘﺒﺎﻳﻨﺎﺕ ﺍﻹﻗﻠﻴﻤﻴﺔ ﰲ ﻣﺆﺷﺮﺍﺕ ﺃﻃﺒﺎﺀ ﺍﻷﺳﻨﺎﻥ ‪ ١٠٠٠ /‬ﻣﻮﺍﻃﻦ‬
‫ﻭﺍﻟﱵ ﻭﺻﻠﺖ ﺇﱃ ‪ ١,٦٦‬ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﻭﺍﳔﻔﻀﺖ ﺇﱃ ‪ ,٨٣‬ﰲ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‬
‫ﻭﺇﱃ ‪ ,٨٥‬ﰲ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ ﺍﻟﺴﻔﻠﻲ‪ .‬ﻭﺗﻮﺟﺪ ﺍﺧﺘﻼﻓﺎﺕ ﺇﻗﻠﻴﻤﻴﺔ ﺃﻳﻀﺎ ﻟﻠﻤﺆﺷﺮﺍﺕ‪ :‬ﺻﻴﺪﱄ‪/‬‬
‫‪ ١٠٠٠‬ﻣﻮﺍﻃﻦ ﻭﳑﺮﺿﺔ ‪ ١٠٠٠ /‬ﻣﻮﺍﻃﻦ ﺑﲔ ﳏﺎﻓﻈﺎﺕ ﺍﳊﻀﺮ‪ ،‬ﻭﺗﺮﺗﻔﻊ ﲨﻴﻊ ﻭﺣﺪﺍﺕ ﻗﻄﺎﻉ‬
‫ﺍﻟﺼﺤﺔ ‪ ١٠٠٠/‬ﻣﻮﺍﻃﻦ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﻭﺗﺼﻞ ﻟﺬﺭﻭ‪‬ﺎ ﰲ ﺍﻟﻘﺎﻫﺮﺓ ﻭﻷﻗﻞ ﻧﺴﺒﺔ ﰲ‬
‫ﺍﻟﺒﺤﲑﺓ ﻭﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ ﻛﺈﻗﻠﻴﻢ‪ .‬ﻭﺑﺎﻟﻨﺴﺒﺔ ﳌﻌﺪﻝ ﺍﻷﺳﺮ‪‬ﺓ ‪ ١٠٠٠ /‬ﻣﻮﺍﻃﻦ‪ ،‬ﲤﺘﻠﻚ ﺍﶈﺎﻓﻈﺎﺕ‬
‫ﺍﳊﻀﺮﻳﺔ ﺍﻟﻨﺴﺒﺔ ﺍﻷﻋﻠﻰ ﺳﻮﺍﺀ ﳋﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺃﻭ ﲨﻴﻊ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ )‪٣٢,٢٨‬‬
‫ﻭ‪ .(١٦,٦٧‬ﻭﺗﺄﺗﻰ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ ﰲ ﺍﻟﻘﺎﻉ )‪ ١٣,٢٩‬ﻭ‪ .(١٠,٩‬ﻭﻳﺸﲑ ﺍﻟﺸﻜﻞ )‪(١٨-٤‬‬
‫ﻭﺍﻟﺸﻜﻞ )‪ (١٩-٤‬ﺇﱃ ﺍﻻﺧﺘﻼﻓﺎﺕ ﺍﻹﻗﻠﻴﻤﻴﺔ ﲞﺼﻮﺹ ﺍﻟﺘﻮﺯﻳﻊ ﺍﻟﻨﺴﱯ ﻟﻸﺳﺮﺓ ﺑﺎﻟﻨﺴﺒﺔ ﺇﱃ‬
‫ﺍﻟﺘﻮﺯﻳﻊ ﺍﻟﻨﺴﱯ ﻟﻠﺴﻜﺎﻥ ﻭﺍﻟﺘﻮﺯﻳﻊ ﺍﻟﻨﺴﱯ ﻟﻼﺳﺘﺜﻤﺎﺭ‪.‬‬

‫‪١٠٩‬‬
 ‫ﺷﻜﻞ )‪ :(١٨-٤‬ﺍﻟﺘﻮﺯﻳﻊ ﺍﻟﻨﺴﱯ ﻟﻸﺳﺮﺓ ﻭﺍﻟﺴﻜﺎﻥ‬

‫‪50‬‬

‫‪45‬‬

‫‪40‬‬

‫‪35‬‬

‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪\(%‬‬

‫‪30‬‬

‫‪25‬‬

‫‪20‬‬

‫‪15‬‬

‫‪10‬‬

‫‪5‬‬

‫‪0‬‬
‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬ ‫ﻣﺼﺮ ﺍﻟﺴﻔﻠﻲ‬ ‫ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ‬

‫ﻧﺴﺒﺔ ﺍﻷﺳﺮﺓ‬ ‫ﻧﺴﺒﺔ ﻋﺪﺩ ﺍﻟﺴﻜﺎﻥ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ﺭﻗﻢ ‪ ١٧‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‪.‬‬

‫ﺷﻜﻞ )‪ :(١٩-٤‬ﺍﻟﺘﻮﺯﻳﻊ ﺍﻟﻨﺴﱯ ﻟﻼﺳﺘﺜﻤﺎﺭ ﶈﺎﻓﻈﺎﺕ ﺍﳉﻤﻬﻮﺭﻳﺔ‬

‫‪25‬‬

‫‪20‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪\(%‬‬

‫‪15‬‬

‫‪10‬‬

‫‪5‬‬

‫‪0‬‬

‫ﻣﻄﺮﻭﺡ‬
‫ﺑﻮﺭ ﺳﻌﻴﺪ‬

‫ﺑﲎ ﺳﻮﻳﻒ‬

‫ﺳﻮﻫﺎﺝ‬

‫ﺳﻴﻨﺎﺀ ﺍﻟﺸﻤﺎﻟﻴﺔ‬

‫ﺳﻴﻨﺎﺀ ﺍﳉﻨﻮﺑﻴﺔ‬
‫ﺩﻣﻴﺎﻁ‬

‫ﻛﻔﺮ ﺍﻟﺸﻴﺦ‬
‫ﺍﻟﻘﺎﻫﺮﺓ‬

‫ﺍﻟﺴﻮﻳﺲ‬

‫ﺍﻟﺒﺤﲑﺓ‬

‫ﺍﳉﻴﺰﺓ‬

‫ﺍﻟﻔﻴﻮﻡ‬

‫ﺍﳌﻨﻴﺎ‬

‫ﺃﺳﻴﻮﻁ‬

‫ﺍﻷﻗﺼﺮ‬

‫ﺃﺳﻮﺍﻥ‬

‫ﺍﻟﺒﺤﺮ ﺍﻷﲪﺮ‬

‫ﺍﻟﻮﺍﺩﻱ ﺍﳉﺪﻳﺪ‬
‫ﻗﻨﺎ‬
‫ﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬

‫ﺍﻟﺪﻗﻬﻠﻴﺔ‬

‫ﺍﻟﺸﺮﻗﻴﺔ‬

‫ﺍﻟﻘﻠﻴﻮﺑﻴﺔ‬

‫ﺍﻟﻐﺮﺑﻴﺔ‬

‫ﺍﳌﻨﻮﻓﻴﺔ‬

‫ﺍﻹﲰﺎﻋﻴﻠﻴﺔ‬

‫ﺍﻻﺳﺘﺜﻤﺎﺭ‬ ‫ﺗﻮﺯﻳﻊ ﺍﻟﺴﻜﺎﻥ‬

‫* ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ﺭﻗﻢ ‪ ١٧‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‪.‬‬

‫ﻛﺬﻟﻚ ﻓﺈﻥ ﻫﻨﺎﻙ ﲢﻴﺰﺍﹰ ﰲ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﰲ ﺗﻮﺯﻳﻊ ﻣﻮﺍﺭﺩ ﺍﳊﻜﻮﻣﺔ ﺿﺪ ﺍﻟﻔﻘﺮﺍﺀ ﻭﺳﻜﺎﻥ ﺍﳌﻨﺎﻃﻖ‬
‫ﺍﻟﺮﻳﻔﻴﺔ ﻳﻌﻜﺴﻪ ﺍﻟﺘﺒﺎﻳﻦ ﰲ ﺍﻟﺪﻋﻢ ﺍﳌﺎﱄ ﺍﳊﻜﻮﻣﻲ ﺑﲔ ﺃﺳ‪‬ﺮﺓ ﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻟﱵ‬
‫ﻫﻲ ﺍﳌﺼﺪﺭ ﺍﻟﻮﺣﻴﺪ ﺍﳌﺘﺎﺡ ﻟﺮﻋﺎﻳﺔ ﺍﳌﺮﺿﻰ ﺍﻟﺪﺍﺧﻠﲔ ﻟﺴﺎﻛﲏ ﺍﻟﺮﻳﻒ‪ ،‬ﻭﺃﺳ‪‬ﺮﺓ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﳉﺎﻣﻌﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻭﺍﳌﺘﺎﺣﺔ ﺃﺳﺎﺳﺎ ﻟﺴﻜﺎﻥ ﺍﳊﻀﺮ ﻭﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‪ .‬ﺣﻴﺚ ﺑﻠﻎ ﺍﻟﺪﻋﻢ‬
‫ﺍﳌﺎﱄ ﺍﳊﻜﻮﻣﻲ ﻟﻜﻞ ﺳﺮﻳﺮ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ‪ ٥,٨‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﻭ‪ ١١,٥‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﳉﺎﻣﻌﻴﺔ ﻭ‪ ١٩,١‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﰲ ‪.١٩٩٥‬‬
‫‪ .٣‬ﺍﻟﺘﺪﻫﻮﺭ ﰲ ﺧﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ :‬ﻟﻘﺪ ﺃﺩﻯ ﺍﻟﺘﻤﻮﻳﻞ ﻏﲑ ﺍﻟﻜﺎﰲ ﳋﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺇﱃ ﻧﻘﺺ‬
‫ﺍﳌﺴﺘﻠﺰﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﺍﳌﻄﻠﻮﺑﺔ ﻟﻠﻌﻤﻠﻴﺎﺕ ﺍﻟﻄﺒﻴﺔ ﻭﻧﻘﺺ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ .‬ﻭﻟﻘﺪ ﺍﺯﺩﺍﺩﺕ ﻫﺬﻩ‬

‫‪١١٠‬‬
‫ﺍﳌﺸﻜﻼﺕ ﺑﺴﺒﺐ ﺍﻟﺰﻳﺎﺩﺓ ﺍﳍﺎﺋﻠﺔ ﰲ ﺍﻷﺳﻌﺎﺭ ﺍﻟﻌﺎﳌﻴﺔ ﻟﻠﻤﻨﺘﺠﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ .‬ﻭﻟﻘﺪ ﺃﺩﻯ ﻋﺪﻡ ﺍﻟﺮﺿﺎ‬
‫ﺑﺎﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺇﱃ ﻧﻘﺺ ﻋﺪﺩ ﺍﳌﺮﺿﻰ ﺍﳌﺘﺮﺩﺩﻳﻦ ﺇﱃ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺭﺟﻴﺔ ﰲ‬
‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﻨﺴﺒﺔ ‪ %٢٣‬ﺧﻼﻝ ﻓﺘﺮﺓ ﻋﺎﻡ ‪-١٩٨٢‬ﻋﺎﻡ ‪ ١٩٩٣‬ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺯﻳﺎﺩﺓ‬
‫ﺧﺪﻣﺎﺕ ﻭﺗﺴﻬﻴﻼﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰲ ﻫﺬﻩ ﺍﻟﻔﺘﺮﺓ ﺑﻨﺴﺒﺔ ‪.%٣٣‬ﺃﻣﺎ ﺍﻵﻥ ﻓﻠﻘﺪ ﺍﳔﻔﻀﺖ ﻣﻌﺪﻻﺕ‬
‫ﺇﺷﻐﺎﻝ ﺍﻷﺳﺮﺓ ﻣﻦ ‪ %٦٠‬ﰲ ﻋﺎﻡ ‪ ١٩٨٢‬ﺇﱃ ‪ % ٤٥‬ﰲ ﻋﺎﻡ ‪١٩٩٥‬ﻭ ﻗﻠﺖ ﻧﺴﺒﺔ ﺳﺮﻳﺮ ‪ ١٠٠٠ /‬ﻣﻮﺍﻃﻦ‬
‫ﰲ ﺍﻟﻌﻘﺪ ﺍﻷﺧﲑ ﰲ ﺧﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﻦ ‪ ١٤,٤‬ﰲ ﻋﺎﻡ ‪ ١٩٧٩‬ﺇﱃ ‪ ١١,٦٤‬ﰲ ﻋﺎﻡ ‪.١٩٩٥‬ﻳﻌﻜﺲ‬
‫ﻫﺬﺍ ﺍﻟﻨﻘﺺ ﺍﳌﻮﻗﻒ ﺍﳌﺎﱄ ﺍﳊﺮﺝ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺬﻱ ﻳﻮﻓﺮ ﺃﻋﻠﻰ ﻧﺴﺒﺔ ﻣﻦ ﺍﻷﺳﺮﺓ ﰲ ﻣﺼﺮ‬
‫)‪ .(٥٩,٧‬ﻛﺬﻟﻚ ﻓﺈﻥ ﻫﻨﺎﻙ ﺍﺧﺘﻼﻓﺎﺕ ﻭﺍﺿﺤﺔ ﰲ ﺍﻹﻧﻔﺎﻕ ﺍﻟﻴﻮﻣﻲ ﳋﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﲔ‬
‫ﳐﺘﻠﻒ ﺍﳍﻴﺌﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ ،‬ﺃﺳﺮﺓ ﻭﺯﺍﺭﺓ ﺍﻟﺘﺮﺑﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﺃﺳﺮﺓ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ‪.‬‬
‫‪ .٤‬ﺍﺳﺘﻤﺮﺍﺭﻳﺔ ﻭﺟﻮﺩ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻟﻔﻘﺮ‪ :‬ﻳﻨﻔﻖ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﻣﺒﺎﻟﻎ ﻗﻠﻴﻠﺔ ﺟﺪﺍﹰ‬
‫ﻋﻠﻰ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﺋﻴﺴﻴﺔ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺍﻟﺼﻮﺭﺓ ﺍﻹﳚﺎﺑﻴﺔ ﺍﳌﺬﻛﻮﺭﺓ ﺳﺎﺑﻘﺎﹰ ﻟﻠﺸﺒﻜﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﳌﺼﺮﻳﺔ ﺫﺍﺕ ﺍﻟﺘﻐﻄﻴﺔ ﺍﳌﻨﺎﺳﺒﺔ ﻭﺇﺗﺎﺣﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻣﺮﺍﺽ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﻟﻔﻘﺮ‪،‬‬
‫ﻓﺈﻥ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻮﺑﺎﺋﻴﺔ ﻣﺎﺯﺍﻟﺖ ﲤﺜﻞ ﺍﳌﺸﻜﻠﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪ ،‬ﺍﻷﻛﺜﺮ ﺧﻄﻮﺭﺓ ﻫﻲ ﺍﻷﻣﺮﺍﺽ‬
‫ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﳌﻌﺪﺓ ﻭﺍﻷﻣﻌﺎﺀ ﻭﺍﳌﻨﺘﺸﺮﺓ ﻋﻠﻰ ﻧﻄﺎﻕ ﻭﺍﺳﻊ ﺑﲔ ﺳﻜﺎﻥ ﺍﻟﺮﻳﻒ ﻭﳏﺪﻭﺩﻱ ﺍﻟﺪﺧﻞ ﰲ‬
‫ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺍﳔﻔﺎﺽ ﻧﺴﺒﺔ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ‪ ،‬ﻓﺈ‪‬ﺎ ﻻ ﺗﺰﺍﻝ ﻣﻮﺟﻮﺩﺓ‪ .‬ﻭﲤﺜﻞ‬
‫ﺃﻣﺮﺍﺽ ﺍﻹﺳﻬﺎﻝ ﻭﺍﺣﺪﺓ ﻣﻦ ﺃﻛﺜﺮ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ‪ .‬ﻭﺗﻌﺘﱪ ﺍﻷﻧﻴﻤﻴﺎ )ﻓﻘﺮ ﺍﻟﺪﻡ( ﺃﻳﻀﺎﹰ‬
‫ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺫﺍﺕ ﺍﻻﻧﺘﺸﺎﺭ ﺍﻟﻮﺍﺳﻊ ﺑﲔ ﺍﻟﻔﻘﺮﺍﺀ‪ .‬ﻭﻣﺎﺯﺍﻝ ﻣﺮﺽ ﺍﻟﺘﺮﺍﻛﻮﻣﺎ )ﺍﻟﺮﻣﺪ ﺍﳊﺒﻴﱯ( ﻣﻨﺘﺸﺮﺍﹸ‬
‫ﲟﻌﺪﻻﺕ ﻣﺮﺗﻔﻌﺔ ﻧﺴﺒﻴﺎﹰ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭﺗﻌﺪ ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﻣﺜﻞ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﺮﺋﻮﻱ‬
‫ﻭﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﺸﻌﱯ ﺃﺣﺪ ﺍﻷﺳﺒﺎﺏ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻠﻮﻓﺎﺓ ﰲ ﻣﺼﺮ‪ .‬ﻭﳚﺐ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺃﻧﻪ ﻣﺎﺯﺍﻟﺖ ﻋﺪﻭﻯ‬
‫ﺑﻌﺾ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ ﻣﺜﻞ ﺍﻟﺴﻞ ﻭﺍﻷﻣﺮﺍﺽ ﺍﻟﻄﻔﻴﻠﻴﺔ ﺗﻨﺘﺸﺮ ﺑﲔ ﺍﻟﻔﺌﺎﺕ ﺍﻷﻛﺜﺮ ﻓﻘﺮﺍﹰ ﻣﻦ‬
‫ﺍﻟﺴﻜﺎﻥ‪.‬‬
‫ﻭﻳﻮﺟﺪ ﻧﻮﻋﺎﻥ ﻣﻦ ﺍﻟﺒﻠﻬﺎﺭﺳﻴﺎ ﺇﻛﻠﻴﻨﻴﻜﻴﺎ ﰲ ﻣﺼﺮ‪ :‬ﺍﻟﻨﻮﻉ ﺍﻷﻭﻝ ﻫﻮ ﺑﻠﻬﺎﺭﺳﻴﺎ ﺍ‪‬ﺎﺭﻱ ﺍﻟﺒﻮﻟﻴﺔ‬
‫)‪ (Schistosomiasis Haematobia‬ﲟﻌﺪﻝ ﺍﻧﺘﺸﺎﺭ ‪ %٧,٣‬ﰲ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‪ ،‬ﻭﺍﻟﺒﻠﻬﺎﺭﺳﻴﺎ ﺍﳌﻌﻮﻳﺔ‬
‫)‪ (Schistosomiasis Mansoni‬ﲟﻌﺪﻝ ﺍﻧﺘﺸﺎﺭ ﻣﺮﺗﻔﻊ ﺟﺪﺍﹰ ﰲ ﺍﻟﺪﻟﺘﺎ‪ :‬ﻣﻦ ‪ %٢٠‬ﺇﱃ ‪ %٥٣‬ﻭﻓﻘﺎ‬
‫ﻟﻠﻤﺤﺎﻓﻈﺔ‪ .‬ﺃﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻻﻧﺘﺸﺎﺭ ﻣﺮﺽ ﺍﳉﺰﺍﻡ ﻓﻬﻮ ﺑﺼﻮﺭﺓ ﺃﻛﺜﺮ ﻧﺴﺒﻴﺎﹰ ﰲ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ ﺍﻟﱵ‬
‫ﺗﺴﺠﻞ ﺃﺩﱏ ﻣﺆﺷﺮﺍﺕ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﻜﻞ ﻣﻦ ﻣﺼﺮ ﺍﻟﺴﻔﻠﻰ ﺃﻭ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‪.‬‬
‫‪ .٥‬ﺍﳔﻔﺎﺽ ﻣﺴﺘﻮﻯ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻣﻬﺎﺕ ﻭﺍﻷﻃﻔﺎﻝ‪ :‬ﺇﻥ ﺃﺣﺪ ﺃﻫﻢ ﺍﻟﻨﻘﺎﻁ ﺍﳊﺮﺟﺔ ﰲ ﺍﻟﺼﺤﺔ‬
‫ﲟﺼﺮ ﻫﻲ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻣﻬﺎﺕ ﻭﺍﻷﻃﻔﺎﻝ‪ .‬ﻓﺒﺎﻟﺮﻏﻢ ﻣﻦ ﺍﻟﺘﺤﺴﻴﻨﺎﺕ ﺍﳍﺎﺋﻠﺔ ﰲ ﻣﺸﺮﻭﻉ‬
‫ﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺑﻘﺎﺀ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻓﺈﻥ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ )‪ (IMR‬ﻣﺎ ﺯﺍﻝ ﻣﺮﺗﻔﻌﺎﹰ ﻭﺃﺳﻮﺃ ﻧﺴﺒﻴﺎﹰ‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﳌﻌﻈﻢ ﺩﻭﻝ ﺍﻟﺸﺮﻕ ﺍﻷﻭﺳﻂ ﻭﴰﺎﻝ ﺇﻓﺮﻳﻘﻴﺎ‪.‬ﻭﲜﺎﻧﺐ ﺇﺳﻬﺎﻝ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻫﻨﺎﻙ ﺃﻣﺮﺍﺽ‬
‫ﺃﺧﺮﻯ ﻣﺜﻞ ﺍﳊﺼﺒﺔ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﻐﺪﺓ ﺍﻟﻨﻜﺎﻓﻴﺔ‪ ،‬ﺍﻟﺴﻌﺎﻝ ﺍﻟﺪﻳﻜﻰ‪ ،‬ﺍﳉﺪﻳﺮﻱ ﺍﳌﺎﺋﻲ ﻭﺍﳊﺼﺒﺔ ﺍﻷﳌﺎﻧﻴﺔ‬
‫ﻭﺍﻟﱵ ﺗﻮﺟﺪ ﺑﻨﺴﺒﺔ ﺣﺪﻭﺙ ﻣﺘﻮﺳﻄﺔ ﻟﻜﻦ ﻋﺎﺩﺓ ﰲ ﺃﺷﻜﺎﻝ ﻭﺑﺎﺋﻴﺔ‪.‬‬

‫‪١١١‬‬
 ‫‪ .٦‬ﺍﻟﺘﺒﺎﻳﻦ ﰲ ﺗﻜﻠﻔﺔ ﺍﻟﻮﺣﺪﺓ‪ :‬ﺗﻮﺿﺢ ﺍﻟﻨﺘﺎﺋﺞ ﺍﻟﺘﻤﻬﻴﺪﻳﺔ ﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﺘﻜﺎﻟﻴﻒ ﺍﻟﺼﺤﻴﺔ ﺃﻧﻪ ﻳﻮﺟﺪ‬
‫ﻧﻘﺺ ﺟﻮﻫﺮﻱ ﰲ ﻓﻌﺎﻟﻴﺔ ﺧﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺣﻴﺚ ﺗﺘﻨﻮﻉ ﺗﻜﺎﻟﻴﻒ ﺍﻟﻮﺣﺪﺍﺕ ﰲ ﺍﳋﺪﻣﺎﺕ ﺫﺍﺕ‬
‫ﺍﳊﺠﻢ ﺍﳌﻤﺎﺛﻞ ﺑﺼﻮﺭﺓ ﻛﺒﲑﺓ‪ .‬ﻭﺗﺘﺮﺍﻭﺡ ﺍﻟﺘﻜﻠﻔﺔ ﻟﻜﻞ ﻣﺮﻳﺾ ﺧﺎﺭﺟﻲ ﰲ ﺍﻟﻮﺣﺪﺓ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ‬
‫ﻣﻦ ‪ ٥‬ﺟﻨﻴﻬﺎﺕ ﻣﺼﺮﻳﺔ ﺇﱃ ‪ ٨٠‬ﺟﻨﻴﻬﺎﹰ ﻣﺼﺮﻳﺎﹰ‪ .‬ﰲ ﺣﲔ ﺗﺘﺮﺍﻭﺡ ﺍﻟﺘﻜﻠﻔﺔ ﺑﲔ ‪ ٢٥‬ﺇﱃ ‪ ٥٧٥‬ﺟﻨﻴﻬﺎﹰ‬
‫ﻣﺼﺮﻳﺎﹰ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﺍﺧﺘﻼﻑ ﺍﻟﺘﻜﺎﻟﻴﻒ ﻗﺪ ﻳﻔﺴﺮ ﺑﻌﺪﺓ ﻋﻮﺍﻣﻞ ﻣﺘﻀﻤﻨﺔ‬
‫ﺍﺧﺘﻼﻑ ﺍﳊﺎﻟﺔ ﺍﳌﺮﺿﻴﺔ ﻭﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﺪﺧﻮﻝ‪ ،‬ﻓﺈ‪‬ﺎ ﺗﺸﲑ ﺃﻳﻀﺎ ﺇﱃ ﺍﺧﺘﻼﻓﺎﺕ ﰲ ﻧﻮﻋﻴﺔ ﺍﳋﺪﻣﺔ‬
‫ﻭﻋﺪﻡ ﺍﻟﻜﻔﺎﺀﺓ ﰲ ﺗﻮﺯﻳﻊ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺣﺴﺐ ﻧﻮﻉ ﺍﳋﺪﻣﺔ‪.‬‬
‫ﻭﺗﺒﻠﻎ ﻣﺘﻮﺳﻂ ﺗﻜﻠﻔﺔ ﺍﻟﺴﺮﻳﺮ ﰲ ﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ‪ ٧٠٣١‬ﺟﻨﻴﻬﺎﹰ ﻣﺼﺮﻳﺎﹰ ﻓﻘﻂ‪ ،‬ﺑﻴﻨﻤﺎ‬
‫ﻫﻲ ‪ ٢١٧٨٩‬ﺟﻨﻴﻬﺎﹰ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﻴﺔ‪ ،‬ﻭ‪ ٤٦٤٧٤‬ﺟﻨﻴﻬﺎﹰ ﰲ ﻣﺴﺘﺸﻔﻴﺎﺕ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ‬
‫ﺍﻟﺼﺤﻲ ﻭ‪ ١٧٢٣١‬ﺟﻨﻴﻪ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳋﺎﺻﺔ‪ .‬ﻭﻳﻨﻌﻜﺲ ﺫﻟﻚ ﻋﻠﻰ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﰲ ﻛﻞ‬
‫ﻣﺆﺳﺴﺔ‪.‬‬
‫‪ .٧‬ﺗﻜﺪﺱ ﺍﻟﻘﻮﺓ ﺍﻟﻌﺎﻣﻠﺔ ﺍﻟﻄﺒﻴﺔ‪ :‬ﺗﺸﲑ ﺍﳌﻘﺎﺭﻧﺎﺕ ﺍﻟﻌﺎﳌﻴﺔ ﺇﱃ ﻭﺟﻮﺩ ﻋﺪﺩ ﻛﺒﲑ ﻧﺴﺒﻴﺎﹰ ﻣﻦ ﺍﻷﻃﺒﺎﺀ‬
‫ﲟﺼﺮ‪ .‬ﻓﻌﻠﻰ ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ ﻓﺈﻥ ﺍﳌﺮﺿﻰ ﺍﳌﺘﺮﺩﺩﻳﻦ ﻋﻠﻰ ﺍﻟﻄﺒﻴﺐ ﰲ ﺍﻟﻴﻮﻡ ﺍﻟﻮﺍﺣﺪ ﻳﺘﺮﺍﻭﺡ ﺑﲔ ‪٠,١٧‬‬
‫ﺇﱃ ‪ ٣,٠٤‬ﰲ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭﻫﻰ ﻣﻌﺪﻻﺕ ﻣﻨﺨﻔﻀﺔ ﺑﺸﺪﺓ ﺑﺎﻟﻨﺴﺒﺔ ﻟﺴﺒﻊ‬
‫ﺳﺎﻋﺎﺕ ﻋﻤﻞ ﻳﻮﻣﻴﺎﹰ‪ .‬ﻭﻳﺮﺟﻊ ﺫﻟﻚ ﻟﺴﻮﺀ ﺗﻮﺯﻳﻊ ﺍﻟﻌﻤﺎﻟﺔ ﺍﻟﻄﺒﻴﺔ ﺑﲔ ﺍﳊﻀﺮ‪.‬‬
‫‪ .٨‬ﺍﳔﻔﺎﺽ ﻣﻌﺪﻻﺕ ﺍﻻﺳﺘﺨﺪﺍﻡ ﻟﻠﻮﺣﺪﺓ ﺍﻟﺼﺤﻴﺔ‪ :‬ﻭﻧﺘﻴﺠﺔ ﻟﻘﻠﺔ ﺍﳉﻮﺩﺓ ﰲ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ‬
‫ﻭﺣﺪﺍﺕ ﻣﻌﻴﻨﺔ ﰲ ﺍﻟﺮﻳﻒ ﻭﰲ ﺍﳌﺪﻥ‪ ،‬ﻓﺈﻥ ﻣﻌﺪﻻﺕ ﺍﻻﺳﺘﻔﺎﺩﺓ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﺎ ﰲ ﺍﻟﺸﻜﻞ ﺭﻗﻢ ‪٢٠‬‬
‫ﺗﻮﺿﺢ ﺃﻧﻪ ﰲ ﻛﻞ ‪ ٣٠‬ﻗﺴﻤﺎﹰ ﻟﻠﻤﺮﺿﻰ ﺍﳌﻘﻴﻤﲔ‪ ،‬ﻓﻘﻂ ‪ ٤‬ﺃﻗﺴﺎﻡ ﻟﺪﻳﻬﺎ ﻣﻌﺪﻝ ﺇﺷﻐﺎﻝ ﺃﻛﺜﺮ ﻣﻦ‬
‫‪ . ،%٨٠‬ﻭﰱ ‪ %٥٤‬ﻣﻦ ﺃﻗﺴﺎﻡ ﺍﳌﺮﺿﻰ ﺍﳌﻘﻴﻤﲔ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺟﺪﺕ ﺯﻳﺎﺩﺓ ﰲ ﺇﺗﺎﺣﺔ ﺍﻷﺳﺮ‪‬ﺓ‪،‬‬
‫ﻭﻧﺴﺒﺔ ﺇﺷﻐﺎﻝ ﺃﻗﻞ ﻣﻦ ‪ %٦٠‬ﻭﻣﻌﺪﻝ ﲢﻮﻝ ﺃﻗﻞ ﻣﻦ ‪ ٣٢‬ﻣﺮﻳﻀﺎﹰ ﻟﻠﺴﺮﻳﺮ ﻛﻞ ﺳﻨﺔ‪.‬‬

‫ﺷﻜﻞ )‪ :(٢٠-٤‬ﻣﻌﺪﻻﺕ ﺍﻻﺳﺘﻔﺎﺩﺓ ﻟﻠﻤﺮﺿﻰ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ‬

‫‪80‬‬

‫‪70‬‬

‫‪60‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪(%‬‬

‫‪50‬‬

‫‪40‬‬

‫‪30‬‬

‫‪20‬‬

‫‪10‬‬

‫‪0‬‬

‫‪1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994‬‬

‫ﻣﻌﺪﻝ ﺍﻹﺷﻐﺎﻝ ﺍﻷﺳﺮ‪‬ﺓ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬

‫ﺍﳊﻜﻮﻣﻴﺔ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺟﺪﻭﻝ ‪ ١٩‬ﺑﺎﳌﻠﺤﻖ ﺍﻹﺣﺼﺎﺋﻲ‬

‫‪١١٢‬‬
‫‪ .٩‬ﺍﳔﻔﺎﺽ ﺍﻷﺟﻮﺭ ﺍﻟﻔﻌﻠﻴﺔ‪ :‬ﺇﻥ ﺍﻟﺴﺒﺐ ﰲ ﳑﺎﺭﺳﺔ ﺍﻷﻋﻤﺎﻝ ﺍﳋﺎﺻﺔ ﳌﻌﻈﻢ ﻣﻮﻇﻔﻲ ﺍ‪‬ﺎﻝ ﺍﻟﻄﱯ‬
‫ﻫﻮ ﺃ‪‬ﻢ ﻳﺘﻘﺎﺿﻮﻥ ﺃﺟﻮﺭ ﻣﻨﺨﻔﻀﺔ ﻛﻤﻮﻇﻔﲔ ﺣﻜﻮﻣﻴﲔ‪.‬‬
‫‪ .١٠‬ﺳﻮﺀ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﳍﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ :‬ﺗﻮﺍﺟﻪ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻋﺪﺩﺍﹰ ﻣﻦ‬
‫ﺍﳌﺸﺎﻛﻞ ﻣﺜﻞ‪ :‬ﺍﳔﻔﺎﺽ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ‪ ،‬ﺍﳔﻔﺎﺽ ﺍﻟﺘﻐﻄﻴﺔ‪ ،‬ﻓﺠﻮﺓ ﻋﺠﺰ ﻭﺍﺿﺤﺔ ﰲ ﻣﻴﺰﺍﻧﻴﺘﻬﺎ‬
‫ﺍﳌﻘﺪﺭﺓ‪ .‬ﻭﻋﻠﻰ ﺍﳉﺎﻧﺐ ﺍﻵﺧﺮ‪ ،‬ﲡﻤﻊ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻣﺴﺎﻋﺪﺍﺕ ﻣﺘﻮﺍﺿﻌﺔ ﻣﻦ ﻣﻮﻇﻔﻲ‬
‫ﺍﳊﻜﻮﻣﻲ ﺍﳌﺘﻤﺘﻌﲔ ﺑﺘﻐﻄﻴﺘﻬﺎ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻟﺪﺧﻞ ﺍﳊﻜﻮﻣﻲ ﻣﻦ ﺍﳌﺒﻴﻌﺎﺕ‪ .‬ﻭﰱ ﺍﻟﻮﻗﺖ ﻧﻔﺴﻪ‬
‫ﺗﺮﺗﺒﻂ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺑﺒﻌﺾ ﺍﻟﺘﻌﺎﻗﺪﺍﺕ ﻣﻊ ﺍﳋﺪﻣﺎﺕ ﺍﳋﺎﺭﺟﻴﺔ ﻭﺍﳌﻤﻮﻟﲔ ﻋﻠﻰ ﺃﺳﺎﺱ‬
‫ﺍﳌﺼﺮﻭﻓﺎﺕ ﻣﻘﺎﺑﻞ ﺍﳋﺪﻣﺎﺕ‪ .‬ﻭﺗﺘﻠﻘﻰ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﲤﻮﻳﻠﻬﺎ ﺍﻷﺳﺎﺳﻲ ﻣﻦ ﺍﻷﻗﺴﺎﻁ‬
‫ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﺍﳌﺪﻓﻮﻋﺔ ﳍﻴﺌﺔ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﻭﺍﳌﻌﺎﺷﺎﺕ ﺑﻮﺍﺳﻄﺔ ﺍﳊﻜﻮﻣﺔ‪،‬‬
‫ﺍﳌﻮﻇﻔﲔ ﻭﺍﻟﻘﺎﺋﻤﲔ ﻋﻠﻰ ﺍﻟﺘﻮﻇﻴﻒ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺫﻟﻚ ﻣﻦ ﻣﻌﺪﻝ ﺍﻻﺳﺘﻔﺎﺩﺓ ﺍﳌﻘﺪﻡ ﻣﻦ ﻗﺒﻞ‬
‫ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻳﻌﺘﱪ ﻛﺒﲑﺍﹰ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻸﻗﺴﺎﻁ ﺍﻟﺴﻨﻮﻳﺔ ﺍﻟﱵ ﺗﺘﺮﺍﻭﺡ ﺑﲔ ‪ ٨٠-٤٢‬ﺟﻨﻴﻬﺎﹰ‬
‫ﻣﺼﺮﻳﺎﹰ )‪ ( ١٩٩٥/٩٤‬ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺠﻤﻮﻋﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﺍﻟﱵ ﻳﺘﻢ ﺗﻐﻄﻴﺘﻬﺎ‪ ،‬ﺑﻴﻨﻤﺎ ﻣﻌﺪﻝ ﺍﻹﻧﻔﺎﻕ‬
‫ﻟﻜﻞ ﻣﺴﺘﻔﻴﺪ ﻳﻌﺘﱪ ﺿﺌﻴﻼﹰ ﺑﻨﺴﺒﺔ ‪ ٨١‬ﺟﻨﻴﻬﺎﹰ ﻣﺼﺮﻳﺎﹰ ﰲ ﺍﻟﺴﻨﺔ ﺍﳌﺎﻟﻴﺔ ‪ .١٩٩٢‬ﻭﻗﺪ ﻧﺘﺞ ﻋﻦ‬
‫ﺫﻟﻚ ﺭﺩﺍﺀﺓ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻭﲟﺎ ﺃﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺗﻐﻄﻲ ﻣﻮﻇﻔﻲ ﺍﳊﻜﻮﻣﺔ ﺑﺸﻜﻞ ﺃﺳﺎﺳﻲ ﻭﺍﻟﻌﻤﺎﻝ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺮﲰﻲ‪،‬‬
‫ﻓﺈ‪‬ﺎ ﺗﺘﺮﻙ ﻣﻌﻈﻢ ﺍﻟﻔﻘﺮﺍﺀ ﺍﻟﺬﻳﻦ ﻳﻌﻤﻠﻮﻥ ﰲ ﳎﺎﻝ ﺍﻟﺰﺭﺍﻋﺔ ﺃﻭ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﻏﲑ ﺍﻟﺮﲰﻲ‪.‬‬
‫ﻭﻻ ﲢﻈﻰ ﺍﻟﻨﺴﺎﺀ ﺑﻨﻔﺲ ﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﱵ ﳛﻈﻰ ‪‬ﺎ ﺍﻟﺮﺟﺎﻝ‪ ،‬ﻭﺫﻟﻚ ﻷﻥ ﻧﺴﺒﺔ ﻛﺒﲑﺓ ﻣﻨﻬﻢ ﺗﻌﻤﻞ‬
‫ﰲ ﺍﻟﻘﻄﺎﻉ ﻏﲑ ﺍﻟﺮﲰﻲ ﻣﻘﺎﺭﻧﺔ ﺑﺎﻟﺮﺟﺎﻝ ﺣﻴﺚ ﺃﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﻻ ﺗﻐﻄﻰ ﻛﺎﻓﺔ ﺍﳌﻨﺘﻔﻌﲔ‪.‬‬
‫ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻧﻪ ﻛﺎﻥ ﻣﻦ ﺍﳌﺘﻮﻗﻊ ﺃﻥ ﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻠﻄﻼﺏ ﺳﻮﻑ ﻳﺴﺎﻋﺪ ﰲ ﺗﻮﺳﻴﻊ‬
‫ﺗﻐﻄﻴﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻠﻜﺜﲑ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻔﻘﺮﺍﺀ‪ ،‬ﻓﺈﻥ ﻫﻨﺎﻙ ﻋﺪﺩﺍﹰ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻷﻛﺜﺮ ﻓﻘﺮﺍﹰ‬
‫ﻟﻦ ﻳﺘﻢ ﺗﻐﻄﻴﺘﻬﻢ ‪‬ﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ ﻃﺎﳌﺎ ﺃ‪‬ﻢ ﱂ ﻳﻠﺘﺤﻘﻮﺍ ﺑﺎﳌﺪﺍﺭﺱ ﺃﺻﻼ‪ .‬ﻭﺗﺴﺘﻔﻴﺪ ﺍﻟﻔﺘﻴﺎﺕ‪،‬‬
‫ﺧﺎﺻﺔ ﺍﻟﻼﰐ ﻳﻨﺘﻤﲔ ﺇﱃ ﻋﺎﺋﻼﺕ ﻓﻘﲑﺓ ﺍﺳﺘﻔﺎﺩﺓ ﺃﻗﻞ ﻣﻦ ﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﺄﻣﲔ ﺍﳌﺪﺭﺳﻲ ﻋﻦ ﺍﻟﻄﻼﺏ‬
‫ﺍﻟﺬﻛﻮﺭ‪ ،‬ﻭﺫﻟﻚ ﻷﻥ ‪ %٤١‬ﻓﻘﻂ ﻣﻦ ﺍﻟﻔﺘﻴﺎﺕ ﻗﺪ ﺍﺳﺘﻜﻤﻠﻦ ﺗﻌﻠﻴﻤﻬﻦ ﺍﻻﺑﺘﺪﺍﺋﻲ‪ ،‬ﻣﻘﺎﺭﻧﺔ ﺑﻨﺴﺒﺔ‬
‫‪ %٧٥‬ﻟﻸﻭﻻﺩ‪ .‬ﺗﻮﺿﺢ ﺃﻳﻀﺎﹰ ﺑﻴﺎﻧﺎﺕ ﺗﻘﺮﻳﺮ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﻌﺎﻡ ‪ ١٩٩٥/٩٤‬ﺃﻥ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﰲ‬
‫ﻣﺼﺮ ﻳﺴﺘﻔﻴﺪ ﻣﻨﻪ ﺳﻜﺎﻥ ﺍﳊﻀﺮ ﺃﻛﺜﺮ ﻣﻦ ﺳﻜﺎﻥ ﺍﻟﺮﻳﻒ‪ .‬ﻓﻠﻘﺪ ﺗﺒﲔ ﺃﻥ ﻧﺼﻒ ﻋﺪﺩ ﺭﺑﺎﺕ ﺍﳌﻨﺎﺯﻝ‬
‫ﺫﺍﺕ ﺍﻟﺪﺧﻞ ﺍﳌﻨﺨﻔﺾ ﻟﺪﻳﻬﻦ ﻧﻮﻉ ﻣﻦ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻔﺮﺩ ﻭﺍﺣﺪ ﻣﻦ ﺍﻷﺳﺮﺓ ﻋﻠﻰ ﺍﻷﻗﻞ ﻋﻨﺪ‬
‫ﻣﻘﺎﺭﻧﺘﻬﻢ ﺑﺜﻼﺛﺔ ﺃﺭﺑﺎﻉ ﺭﺑﺎﺕ ﺍﳌﻨﺎﺯﻝ ﰲ ﺍﻷﺳﺮ ﻣﻦ ﺫﻭﺍﺕ ﺍﻟﺪﺧﻞ ﺍﳌﺘﻮﺳﻂ ﻭﺍﻟﺪﺧﻞ ﺍﳌﺮﺗﻔﻊ‪) .‬ﺗﻘﺮﻳﺮ‬
‫ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ‪.(١٩٩٥/٩٤‬‬

‫‪ – ٣‬ﺇﺻﻼﺡ ﲤﻮﻳﻞ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ‬

‫ﻋﻨﺪ ﺗﺼﻤﻴﻢ ﺧﺮﻳﻄﺔ ﺇﺻﻼﺡ ﺍﻹﻧﻔﺎﻕ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻧﻮﺍﺟﻪ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫ﻧﻘﺺ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻋﻦ ﻧﻈﺎﻡ ﺍﻹﻧﻔﺎﻕ ﻭﺍﻟﺘﻤﻮﻳﻞ ﺍﳌﻮﺟﻮﺩ‪.‬‬ ‫‪-‬‬
‫ﻧﻘﺺ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻋﻦ ﺗﻮﻇﻴﻒ ﺍﻟﻨﻈﺎﻡ ﺍﳌﻮﺟﻮﺩ ﰲ ﻛﻞ ﻣﻦ ﺍﻟﻘﻄﺎﻋﲔ ﺍﳋﺎﺹ ﻭﺍﻟﻌﺎﻡ‪.‬‬ ‫‪-‬‬

‫‪١١٣‬‬
 ‫ﻧﻘﺺ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻋﻦ ﺗﺄﺛﲑ ﺇﺻﻼﺡ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﲨﻴﻊ ﻓﺌﺎﺕ ﺍﳌﺴﺘﺨﺪﻣﲔ‪.‬‬ ‫‪-‬‬
‫ﻭﻣﻊ ﺫﻟﻚ ﻓﺈﻥ ﺍﻗﺘﺮﺍﺣﺎﺕ ﺍﻹﺻﻼﺡ ﻫﻲ ﻛﺎﻵﰐ‪) :‬ﻋﺪﻡ ﺍﳊﺼﺎﻧﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻹﺻﻼﺡ ﺍﻟﺼﺤﻲ‪ ،‬ﻳﻮﻧﻴﻮ‬
‫‪.(١٩٩٦‬‬
‫‪ .١‬ﺇﻋﺎﺩﺓ ﲣﺼﻴﺺ ﻣﻴﺰﺍﻧﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻭﺯﻳﺎﺩﺓ ﻣﺴﺎﳘﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰲ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﻟﺼﺤﻴﺔ‪:‬‬
‫ﻣﻨﺬ ﻣﻨﺘﺼﻒ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺯﻳﺎﺩﺓ ﻧﺼﻴﺐ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ﻣﻦ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﻟﻘﻮﻣﻴﺔ‬
‫)ﺑﺎﺳﺘﺜﻨﺎﺀ ﺧﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ(‪ ،‬ﺗﻘﻞ ﺣﺼﺔ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻮﺟﻬﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ .‬ﻭﳍﺬﺍ‬
‫ﻓﺈﻧﻪ ﳚﺐ ﺗﻮﺟﻴﻪ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻔﻘﺮﺍﺀ‪ .‬ﳝﻜﻦ ﺍﻟﺘﻮﺻﻞ ﺇﱃ ﺫﻟﻚ ﻣﻦ ﺧﻼﻝ‬
‫ﺗﻘﻠﻴﻞ ﻣﻴﺰﺍﻧﻴﺔ ﺍﻻﺳﺘﺜﻤﺎﺭ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳉﺪﻳﺪﺓ ﻭﺍﻟﺘﻮﻗﻒ ﻋﻦ ﺍﳋﺪﻣﺎﺕ ﻏﲑ ﺍﻟﻔﻌﺎﻟﺔ ﰲ‬
‫ﺷﻜﻞ ﻣﻌﺪﻻﺕ ﺍﻷﺷﻐﺎﻝ ﺍﳌﻨﺨﻔﻀﺔ‪.‬‬
‫‪ .٢‬ﺇﻋﺎﺩﺓ ﲝﺚ ﺑﺮﻧﺎﻣﺞ ﺍﺳﺘﻌﺎﺩﺓ ﺍﻹﻧﻔﺎﻕ‪ ،‬ﳉﻌﻠﻪ ﺃﻛﺜﺮ ﻓﺎﻋﻠﻴﺔ ﰲ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺇﻧﻔﺎﻕ ﻟﺘﻤﻮﻳﻞ ﺃﺳ‪‬ﺮﺓ‬
‫ﳎﺎﻧﻴﺔ ﻟﻠﻔﻘﺮﺍﺀ‪ ،‬ﻭﻫﻜﺬﺍ ﳚﺐ ﺃﻥ ﻳﻜﻮﻥ ﻫﺪﻑ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ ﲪﺎﻳﺔ ﺍﻟﺴﻜﺎﻥ ﺍﻟﻔﻘﺮﺍﺀ ﻣﻦ ﺍﻷﺿﺮﺍﺭ‬
‫ﺍﻟﻨﺎﲡﺔ ﻋﻦ ﺗﻄﺒﻴﻖ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ ﻣﻦ ﺧﻼﻝ ﺗﻮﺟﻴﻪ ﻓﻌﺎﻝ ﳚﺐ ﺃﻥ ﻳﻜﻮﻥ ﺟﺰﺀﺍﹰ ﺃﺳﺎﺳﻴﺎﹰ ﻣﻦ ﺗﺼﻤﻴﻢ‬
‫ﺍﻟﱪﻧﺎﻣﺞ‪ .‬ﻭﻋﻠﻰ ﺻﺎﻧﻌﻲ ﺍﻟﺴﻴﺎﺳﺔ ﺍﳋﺎﺻﺔ ﺑﺘﻨﻔﻴﺬ ﺍﻟﱪﻧﺎﻣﺞ ﺍﻻﺧﺘﻴﺎﺭ ﺑﲔ ﺍﻟﺘﻮﺟﻪ ﺍﳉﻐﺮﺍﰲ‬
‫ﻭﺗﻘﻨﻴﺎﺕ ﺃﺧﺮﻯ ﻣﺜﻞ ﺍﺧﺘﺒﺎﺭ ﺍﻟﻮﺳﺎﺋﻞ ‪ means testing‬ﺑﺎﺳﺘﺨﺪﺍﻡ ﺍﻟﺒﺎﺣﺜﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ‬
‫ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﻣﻌﻠﻮﻣﺎﺕ ﻋﻦ ﻣﺴﺘﻮﻯ ﺩﺧﻞ ﺍﳌﺮﺿﻰ ﺍﳌﻮﺟﻮﺩﻳﻦ ﺿﻤﻦ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻓﺎﻷﻭﻝ ﳝﺘﺎﺯ ﺑﺈﻧﻔﺎﻕ ﺇﺩﺍﺭﻱ ﻣﻨﺨﻔﺾ ﻭﻣﺴﺘﻮﻯ ﻣﺮﺗﻔﻊ ﻟﻠﺘﺴﺮﺏ ﺑﻴﻨﻤﺎ ﳝﺘﺎﺯ ﺍﻵﺧﺮ ﺑﺈﻧﻔﺎﻕ ﺇﺩﺍﺭﻱ‬
‫ﻣﺮﺗﻔﻊ ﻭﻣﺴﺘﻮﻯ ﻣﻨﺨﻔﺾ ﻟﻠﺘﺴﺮﺏ‪.‬‬
‫ﻭﻗﺪ ﻳﻜﻮﻥ ﺍﻟﺘﻮﺟﻪ ﺍﳉﻐﺮﺍﰲ ﻣﻨﺎﺳﺒﺎﹰ ﻟﻠﻤﺠﺘﻤﻊ ﺍﻟﻔﻘﲑ ﰲ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‪ ،‬ﺑﻴﻨﻤﺎ ﳝﻜﻦ ﺃﻥ ﻳﻜﻮﻥ‬
‫ﺍﺧﺘﺒﺎﺭ ﺍﻟﻮﺳﺎﺋﻞ ﻫﻮ ﺍﻷﻓﻀﻞ ﰲ ﺍﻟﻘﺎﻫﺮﺓ‪ ،‬ﺣﻴﺚ ﻗﻄﺎﻉ ﺍﻟﺘﻮﻇﻴﻒ ﺍﻟﺮﲰﻲ ﻭﻏﲑ ﺍﻟﺮﲰﻲ ﺃﻛﺜﺮ‬
‫ﺷﻴﻮﻋﺎﹰ‪ ،‬ﻭﺑﺬﻟﻚ ﻓﺈﻥ ﺍﻟﻘﺪﺭﺓ ﻋﻠﻰ ﲢﺪﻳﺪ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﺪﺧﻞ ﺗﻜﻮﻥ ﺃﻛﱪ‪.‬‬
‫ﻛﺬﻟﻚ ﳚﺐ ﻋﺪﻡ ﺗﻄﺒﻴﻖ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ‪ ،‬ﺣﻴﺚ ﺗﻘﻞ ﺍﻟﺮﻏﺒﺔ ﰲ ﺍﻟﺪﻓﻊ‬
‫ﺧﺎﺻﺔ ﺑﺎﻟﻨﺴﺒﺔ ﳍﺬﻩ ﺍﳋﺪﻣﺎﺕ ﻭﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ ﻟﻠﻔﻘﺮﺍﺀ‪ .‬ﻭﳍﺬﺍ ﳚﺐ ﺃﻥ ﺗﺴﺘﻤﺮ ﻫﺬﻩ‬
‫ﺍﳋﺪﻣﺎﺕ ﰲ ﺗﻠﻘﻰ ﺇﻋﺎﻧﺎﺕ ﻣﺎﻟﻴﺔ ﺃﺳﺎﺳﻴﺔ ﻟﻜﻲ ﺗﺰﻳﺪ ﻣﻦ ﻓﺮﺻﺔ ﺍﺳﺘﻐﻼﳍﺎ ﻣﻦ ﺟﺎﻧﺐ ﺍﻟﻔﻘﺮﺍﺀ‪.‬‬
‫ﻛﺬﻟﻚ ﻓﺈﻧﻪ ﻳﺘﻀﻤﻦ ﺗﻘﻴﻴﻢ ﺇﺻﻼﺡ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ﻭﻣﺘﺎﺑﻌﺔ ﺑﺮﺍﳎﻪ ﻭﺗﻘﻴﻴﻢ ﺑﺮﻧﺎﻣﺞ ﺍﺳﺘﻌﺎﺿﺔ‬
‫ﺍﻟﺘﻜﺎﻟﻴﻒ ﺑﺼﻮﺭﺓ ﻣﺴﺘﻤﺮﺓ‪ .‬ﻭﺗﺴﺘﺨﺪﻡ ﺍﳌﺘﺎﺑﻌﺔ ﻟﺘﺤﺪﻳﺪ ﻣﺪﻯ ﺗﻨﺎﻭﻝ ﺍﻟﱪﻧﺎﻣﺞ ﺑﺸﻜﻞ ﺟﻴﺪ ﻋﻠﻰ‬
‫ﻣﺴﺘﻮﻳﺎﺕ ﳐﺘﻠﻔﺔ ﻭﺍﱃ ﻣﺪﻯ ﻓﻌﺎﻟﻴﺔ ﺍﻟﱪﻧﺎﻣﺞ ﰲ ﲢﻘﻴﻖ ﺃﻫﺪﺍﻓﻪ‪ .‬ﻭﻳﻘﻴﺲ ﺃﺛﺮ ﺍﻟﺘﻘﻴﻴﻢ ﺍﳊﺪ ﺍﻟﺬﻱ‬
‫ﳝﻜﻦ ﺃﻥ ﺗﻨﺨﻔﺾ ﻓﻴﻪ ﺍﻻﺧﺘﻼﻓﺎﺕ ﰲ ﺍﺳﺘﻐﻼﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﺍﻟﻨﺎﺗﺞ ﺍﻟﺼﺤﻲ ﻭﺍﻹﻧﻔﺎﻕ‬
‫ﺑﺎﻟﱪﻧﺎﻣﺞ‪ .‬ﻭﻣﻦ ﻧﺎﺣﻴﺔ ﻣﺘﺎﺑﻌﺔ ﺍﻟﱪﻧﺎﻣﺞ‪ ،‬ﻓﺈﻥ ﺍﻟﻘﺎﺋﻤﲔ ﻋﻠﻰ ﺍﻟﱪﻧﺎﻣﺞ ﳚﺐ ﺃﻥ ﻳﻮﻓﺮﻭﺍ ﻣﻘﻴﺎﺳﺎ‬
‫ﻻﺧﺘﻴﺎﺭ ﻣﺆﺷﺮﺍﺕ ﻣﻨﺎﺳﺒﺔ ﻟﻠﺘﻘﻴﻴﻢ‪ ،‬ﻟﻠﺘﻌﺮﻳﻒ ﺑﺎﳌﺼﺎﺩﺭ ﺍﳌﻮﺟﻮﺩﺓ ﻭﺍﻟﻜﺎﻣﻨﺔ ﻟﻠﺒﻴﺎﻧﺎﺕ ﻟﺘﻄﻮﻳﺮ‬
‫ﺗﻨﻔﻴﺬ ﺍﳋﻄﺔ‪ ،‬ﻭﻟﺘﺤﻠﻴﻞ ﺍﻟﻨﺘﺎﺋﺞ ﻭﺩﻣﺞ ﻧﺘﺎﺋﺞ ﺍﻟﺘﻘﻴﻴﻢ ﺑﺎﻟﺘﺨﻄﻴﻂ ﺍﻹﺳﺘﺮﺍﺗﻴﺠﻲ ﻭﺑﺘﺼﻤﻴﻢ‬
‫ﺍﻟﱪﻧﺎﻣﺞ‪ .‬ﻭﻣﻦ ﻧﺎﺣﻴﺔ ﺃﺛﺮ ﺍﻟﺘﻘﻴﻴﻢ‪ ،‬ﳚﺐ ﺃﻥ ﲢﺪﺩ ﺍﻷﻫﺪﺍﻑ ﺇﺫﺍ ﻣﺎ ﻛﺎﻧﺖ ﺍﻟﺘﻐﲑﺍﺕ ﰲ ﺍﳌﺆﺷﺮﺍﺕ ﻧﺎﲡﺔ‬
‫ﻋﻦ ﺍﺧﺘﻼﻑ ﻋﺪﺩ ﺍﻟﺴﻜﺎﻥ ﻣﺮﺗﺒﻄﺔ ﺑﻌﻮﺍﻣﻞ ﺃﺧﺮﻯ‪.‬‬

‫‪١١٤‬‬
‫‪ .٣‬ﺍﻟﺘﻨﺴﻴﻖ ﺍﻷﻣﺜﻞ ﺑﲔ ﻣﻮﻓﺮﻱ ﺍﻟﺼﺤﺔ ﺍﻷﺳﺎﺳﻴﺔ ﰲ ﻣﺼﺮ ﺣﱴ ﻳﻜﻮﻧﻮﺍ ﻗﺎﺩﺭﻳﻦ ﻋﻠﻰ ﺧﺼﺨﺼﺔ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﱵ ﺗﻮﻓﺮ ﻟﻠﻤﻮﺍﻃﻨﲔ ﻣﻴﺴﻮﺭﻱ ﺍﳊﺎﻝ ﻭﺿﻤﺎﻥ ﺧﺪﻣﺎﺕ ﺻﺤﻴﺔ ﳎﺎﻧﻴﺔ ﰲ ﺍﻟﻘﻄﺎﻉ‬
‫ﺍﳋﺎﺹ ﻣﺜﻞ ﲢﺪﻳﺪ ﻧﺴﺒﺔ ﺍﻷﺳﺮﺓ ﺑﻜﻞ ﻣﺴﺘﺸﻔﻰ‪ ،‬ﻭﺑﺎﻟﺘﺎﱄ ﳒﺪ ﺃﻥ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ﺍﳋﺎﺹ ﳝﻜﻦ ﺃﻥ‬
‫ﻳﺴﺎﻋﺪ ﰲ ﲢﺴﲔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻔﻘﺮﺍﺀ ﰲ ﻭﺣﺪﺍﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻛﺠﺰﺀ ﻣﻦ ﻣﺴﺌﻮﻟﻴﺘﻪ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ .‬ﻭﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﳊﻜﻮﻣﻲ ﻓﺈﻥ ﺍﻟﺘﻮﻓﻴﻖ ﺍﻷﻣﺜﻞ ﻳﻌﲎ ﲡﻨﺐ ﺍﺯﺩﻭﺍﺝ ﺍﳋﺪﻣﺎﺕ‪ ،‬ﻭﻧﻈﺎﻡ‬
‫ﻣﺮﺟﻌﻲ ﺟﻴﺪ‪ ،‬ﲜﺎﻧﺐ ﺇﺩﺍﺭﺓ ﻋﻠﻰ ﻗﺪﺭ ﻛﺒﲑ ﻣﻦ ﺍﻟﻜﻔﺎﺀﺓ‪ ،‬ﻭﺧﻠﻖ ﻧﻈﺎﻡ ﺗﻌﺎﻗﺪ ﳑﺘﺪ ﻟﻠﻨﻈﻢ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫‪ .٤‬ﺯﻳﺎﺩﺓ ﺣﺼﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﳌﻮﺟﻬﺔ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺗﻌﺰﻳﺰ ﺩﻭﺭ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰲ‬
‫ﺗﻮﻓﲑ ﺧﺪﻣﺎﺕ ﺻﺤﻴﺔ ﺃﺳﺎﺳﻴﺔ‪ :‬ﻛﻤﺎ ﲤﺖ ﺍﻹﺷﺎﺭﺓ ﺳﺎﺑﻘﺎﹰ ﻓﺈﻥ ﺍﻷﳕﺎﻁ ﺍﳊﺎﻟﻴﺔ ﻟﺘﻮﺯﻳﻊ ﺍﳌﻮﺍﺭﺩ ﻭﺗﻮﻓﲑ‬
‫ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻻ ﺗﺘﻮﺍﻓﻖ ﻣﻊ ﺣﺎﺟﺎﺕ ﺍﻷﻓﺮﺍﺩ ﻏﲑ ﺍﶈﺼﻨﲔ ﺍﺟﺘﻤﺎﻋﻴﺎﹰ‪ .‬ﻭﻟﺘﺤﺴﲔ‬
‫ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻳﻘﺘﺮﺡ ﺍﻵﰐ‪:‬‬
‫ﳚﺐ ﺃﻥ ﻳﺰﻳﺪ ﺍﺳﺘﻐﻼﻝ ﺍﳋﺪﻣﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﻟﻠﻤﺮﺿﻰ ﺍﳋﺎﺭﺟﻴﲔ ﺧﺎﺻﺔ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‬
‫ﻭﻳﺘﻄﻠﺐ ﺫﻟﻚ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺫﻟﻚ ﻣﻦ ﺧﻼﻝ‪ :‬ﺗﺄﻣﲔ ﺍﻟﺘﺨﺼﻴﺺ‬
‫ﺍﻟﻜﺎﰲ ﻣﻦ ﺍﻹﻣﺪﺍﺩﺍﺕ ﺍﻟﺒﺸﺮﻳﺔ ﻟﻸﺩﻭﻳﺔ ﻭﺍﳌﻌﺪﺍﺕ ﻭﺍﻟﺘﻮﺳﻊ ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ‪/‬‬
‫ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻸﻃﺒﺎﺀ ﻭﺍﳌﻤﺮﺿﺎﺕ ﻛﺠﺰﺀ ﻣﻦ ﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻄﱯ‬
‫ﺍﳌﺴﺘﻤﺮ‪ ،‬ﻭﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻮﺳﺎﺋﻞ ﺍﻹﻋﻼﻣﻴﺔ ﲜﺎﻧﺐ ﺍﻟﺘﺪﺭﻳﺐ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﺼﺤﻲ ﺍﻟﻌﻤﻠﻲ ﻟﻄﻠﺒﺔ‬
‫ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ‪.‬‬
‫‪ .٥‬ﺍﳊﺎﺟﺔ ﺇﱃ ﺿﻮﺍﺑﻂ ﺍﳌﻤﺎﺭﺳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﳋﺎﺻﺔ‪ :‬ﻭﺫﻟﻚ ﻟﺘﻔﺎﺩﻯ ﺗﻔﻮﻕ ﺍﳍﻴﺌﺎﺕ ﺍﳋﺎﺻﺔ ﻋﻠﻰ ﺍﻟﻌﺎﻣﺔ‬
‫ﻭﺫﻟﻚ ﻷﻥ ﻣﻌﻈﻢ ﺍﻷﻃﺒﺎﺀ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﻟﺪﻳﻬﻢ ﺃﻋﻤﺎﻝ ﺧﺎﺻﺔ‪ ،‬ﻭﻗﺪ ﻳﺴﺘﺨﺪﻣﻮﻥ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ ﰲ ﺑﻌﺾ ﺃﻋﻤﺎﳍﻢ ﺍﳋﺎﺻﺔ‪ ،‬ﻛﻤﺎ ﳛﺪﺙ ﰲ ﺑﻌﺾ ﺍﳌﻨﺎﻃﻖ‬
‫ﺍﻟﺮﻳﻔﻴﺔ‪.‬‬
‫‪ .٦‬ﺇﻋﺎﺩﺓ ﲣﺼﻴﺺ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺎﺩﻳﺔ ﻭﺍﻟﺒﺸﺮﻳﺔ ﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ :‬ﺇﻥ ﺇﻋﺎﺩﺓ ﺗﻮﺯﻳﻊ ﻣﻮﺍﺭﺩ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻭﺧﺎﺻﺔ ﺍﻟﻌﺎﻣﻠﲔ ﺇﱃ ﺍﳌﻨﺎﻃﻖ ﺍﻟﱵ ﲢﺘﺎﺝ ﺇﱃ ﺭﻋﺎﻳﺔ ﺻﺤﻴﺔ‪ ،‬ﻭﺍﻟﱵ ﲤﺘﺎﺯ ﺃﻳﻀﺎ ﲟﺆﺷﺮﺍﺕ‬
‫ﺣﺎﻟﺔ ﺻﺤﻴﺔ ﻣﻨﺨﻔﻀﺔ‪ ،‬ﻭﻫﻮ ﺃﻣﺮ ﺿﺮﻭﺭﻱ‪ .‬ﻭﻫﻨﺎﻙ ﻃﺮﻳﻘﺘﺎﻥ ﳏﺪﺩﺗﺎﻥ ﻟﻺﺻﻼﺡ‪ :‬ﺗﻮﻓﲑ ﺣﻮﺍﻓﺰ‬
‫ﻟﻠﻌﺎﻣﻠﲔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﻌﺎﻣﻠﲔ ﺍﻵﺧﺮﻳﻦ )ﻣﺘﻀﻤﻨﲔ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ( ﰲ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‬
‫ﻭﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪ .‬ﻭﺍﻷﺧﺮﻯ ﻫﻲ ﺗﻮﻓﲑ ﺗﺪﺭﻳﺐ ﺑﻌﺾ ﺍﻟﺴﻜﺎﻥ ﺍﳌﺘﻄﻮﻋﲔ ﰲ ﻫﺬﻩ ﺍﳌﻨﺎﻃﻖ ﻋﻠﻰ‬
‫ﺃﻋﻤﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ‪.‬‬
‫‪ .٧‬ﲣﻔﻴﺾ ﻋﺪﺩ ﺍﻟﻌﺎﻣﻠﲔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ :‬ﺇﻥ ﻧﺼﻒ ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ ﺍﻟﻮﺯﺍﺭﺓ ﻭ‪ %٦٠‬ﻣﻦ ﺇﻧﻔﺎﻗﻬﺎ ﺍﳉﺎﺭﻱ‬
‫ﻣﻮﺟﻪ ﻟﻸﺟﻮﺭ‪ ،‬ﻭﻫﻨﺎﻙ ﺳﻴﺎﺳﺘﺎﻥ ﻟﻺﺻﻼﺡ ﻫﺪﻓﻬﻤﺎ ﲣﻔﻴﺾ ﻋﺪﺩ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻟﺬﻱ‬
‫ﻳﺆﺩﻯ ﺇﱃ ﲣﻔﻴﺾ ﰲ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ .‬ﻭﳘﺎ ﺗﻘﻠﺺ ﺍﻟﺘﻮﻇﻴﻒ ﺍﳊﻜﻮﻣﻲ ﳋﺮﳚﻲ ﻣﺪﺍﺭﺱ‬
‫ﺍﻟﻄﺐ ﺍﳉﺪﺩ‪ ،‬ﻭﺍﻵﻟﻴﺔ ﺍﻷﺧﺮﻯ ﻫﻲ ﻋﺪﻡ ﺍﺳﺘﺒﺪﺍﻝ ﺍﻟﻌﻤﺎﻝ ﺍﳌﺘﻘﺎﻋﺪﻳﻦ‪.‬‬
‫‪ .٨‬ﺍﻟﺘﻮﺳﻊ ﰲ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ :‬ﺇﻥ ﺍﻷﺷﺨﺎﺹ ﺍﳌﺘﻤﺘﻌﲔ ﺑﺎﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻫﻢ ﺃﻛﺜﺮ ﻣﻦ ﻳﻄﻠﺒﻮﻥ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻦ ﻫﺆﻻﺀ ﺍﻟﺬﻳﻦ ﻻ ﻳﺘﻤﺘﻌﻮﻥ ﺑﺬﻟﻚ ﺍﻟﺘﺄﻣﲔ‪ .‬ﻭﻋﻠﻰ ﺍﻷﺧﺺ ﻓﺈﻥ ﻋﺪﺩ ﺯﻳﺎﺭﺍﺕ‬
‫ﺍﳌﺮﺿﻰ ﻟﻠﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺭﺟﻴﺔ ﻟﻠﻔﺮﺩ ﺍﻟﻮﺍﺣﺪ ﰲ ﺍﻟﺴﻨﺔ ﺍﻟﻮﺍﺣﺪﺓ ﰲ ﺗﻘﺮﻳﺮ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻛﺎﻧﺖ‬

‫‪١١٥‬‬
‫ﺃﻋﻠﻰ ﺑﻨﺴﺒﺔ ‪ %٢٨‬ﺿﻤﻦ ﺍﻷﻓﺮﺍﺩ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﻢ ﻋﻦ ﻫﺆﻻﺀ ﻏﲑ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﻢ )‪ ٤,٨٣‬ﺿﺪ ‪(٣,٧٧‬‬
‫)‪ .(Berman 1995‬ﻭﺗﻮﻓﲑ ﺍﻟﺘﻐﻄﻴﺔ ﺍﻟﻌﺎﻣﺔ ﳚﺐ ﺃﻥ ﻳﻘﻠﻞ ﺍﻟﻔﺠﻮﺓ ﰲ ﺍﺳﺘﻐﻼﻝ ﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺧﺎﺻﺔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺪﺍﺧﻠﻴﺔ ﻣﺎ ﺑﲔ ﺍﻟﻔﻘﺮﺍﺀ ﻭﺍﻷﻳﺴﺮ ﺣﺎﻻﹰ‪ .‬ﻭﺑﲔ ﻗﺎﻃﲏ ﺍﻟﺮﻳﻒ ﻭﺍﳊﻀﺮ‬
‫ﻭﺑﲔ ﺍﻟﻨﺴﺎﺀ ﻭﺍﻟﺮﺟﺎﻝ‪.‬‬
‫ﻭﻳﺘﻢ ﺗﺄﻣﲔ ﻓﺎﻋﻠﻴﺔ ﺧﺪﻣﺎﺕ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻋﻦ ﻃﺮﻳﻖ ﺗﻘﻠﻴﻞ ﺍﻟﻌﺠﺰ‪ ،‬ﻭﻋﻦ ﻃﺮﻳﻖ ﺍﻟﺘﻌﺎﻗﺪ‬
‫ﻭﺍﻟﺴﻤﺎﺡ ﻟﻠﻤﺴﺘﻔﻴﺪﻳﻦ ﺃﻥ ﳜﺘﺎﺭﻭﺍ ﳑﻮﻟﻴﻬﻢ‪ ،‬ﻭﻫﺬﺍ ﳚﺐ ﺃﻥ ﻳﻜﻮﻥ ﺧﻄﻮﺓ ﺿﺮﻭﺭﻳﺔ ﻗﺒﻞ ﺃﻥ ﺗﺒﺪﺃ‬
‫ﺍﳊﻜﻮﻣﺔ ﰲ ﺑﺮﻧﺎﻣﺞ ﻣﺮﺗﻔﻊ ﻭﻋﺎﱄ ﺍﻟﺘﻜﻠﻔﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻡ‪ .‬ﻭﻟﻜﻲ ﺗﺘﻢ ﲪﺎﻳﺔ ﺍﻟﻔﻘﺮﺍﺀ‬
‫ﳚﺐ ﺃﻥ ﺗﻀﻢ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻭﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﶈﻠﻰ ﻧﻈﺎﻡ ﺇﻋﻔﺎﺀﺍﺕ ﻣﻦ‬
‫ﺍﻷﻗﺴﺎﻁ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﻣﻊ ﺗﻔﺎﻭﺕ ﺍﻟﺪﻋﻢ ﺣﺴﺐ ﻣﺴﺘﻮﻯ ﺍﻟﺪﺧﻞ‪ .‬ﻭﻣﺜﻞ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﳚﺐ ﺃﻥ ﻳﺸﻤﻞ‬
‫ﺩﻓﻊ ﺃﻗﺴﺎﻁ ﺗﺄﻣﻴﻨﻴﺔ ﻣﺮﺗﻔﻌﺔ ﻓﻮﻕ ﺍﻟﺘﻜﺎﻟﻴﻒ ﻟﻠﻤﻨﺘﻔﻌﲔ ﺍﻷﻛﺜﺮ ﺛﺮﺍﺀ‪ .‬ﻭﺗﻄﺎﻟﺐ ﻫﺬﻩ‬
‫ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺃﻳﻀﺎﹰ ﺑﻔﺼﻞ ﺍﻟﺘﻤﻮﻳﻞ ﻋﻦ ﺗﻮﻓﲑ ﺍﻟﺮﻋﺎﻳﺔ ﻣﻦ ﺧﻼﻝ ﻧﻈﺎﻡ ﺍﻟﺘﻌﺎﻗﺪ ﻋﻠﻰ ﺑﺮﺍﻣﺞ‬
‫ﳐﺘﻠﻔﺔ ﻟﻠﺘﺄﻣﲔ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻟﺴﻤﺎﺡ ﻟﻠﻤﺴﺘﻔﻴﺪﻳﻦ ﺑﺎﻻﺧﺘﻴﺎﺭ ﺑﲔ ﺍﳌﻤﻮﻟﲔ‪.‬‬

‫‪١١٦‬‬
 ‫‪23 01‬‬
‫ﺍﳉﺪﻭﻝ )‪ :(١‬ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ) ﺑﺎﻷﺳﻌﺎﺭ ﺍﳉﺎﺭﻳﺔ ﻭﺍﻷﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ ﻣﻦ ﺳﻨﺔ ‪(١٩٩٦ – ١٩٩٠‬‬
‫ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ‬
‫ﺍﳌﻴﺰﺍﻧﻴﺔ‬ ‫ﺍﻟﺮﻗﻢ‬ ‫ﻣﻌﺪﻝ‬ ‫ﺍﳌﻴﺰﺍﻧﻴﺔ‬
‫ﺍﻟﺴﻨﻮﻳﺔ ﰲ‬
‫ﺑﺄﺳﻌﺎﺭ‬ ‫ﺍﻟﻘﻴﺎﺳﻲ‬ ‫ﺍﻟﺰﻳﺎﺩﺓ‬ ‫ﺑﺎﻷﺳﻌﺎﺭ‬ ‫ﺍﻟﺴﻨﺔ‬
‫ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﳊﻘﻴﻘﻴﺔ‬
‫ﻋﺎﻡ ‪١٩٩٠‬‬ ‫ﻟﻸﺳﻌﺎﺭ‬ ‫ﺍﻟﺴﻨﻮﻳﺔ ‪%‬‬ ‫ﺍﳉﺎﺭﻳﺔ )‪(٠٠٠‬‬
‫‪%‬‬
‫‪٠,٠‬‬ ‫‪٦٥٢٢٩٣,٨‬‬ ‫‪٣٧,١‬‬ ‫‪٤٠,١‬‬ ‫‪٢٤٢٠٠١‬‬ ‫‪٨٢/٨١‬‬
‫‪٥,٧‬‬ ‫‪٦٨٩٥١٩,٥‬‬ ‫‪٤٣,٥‬‬ ‫‪٢٣,٩‬‬ ‫‪٢٩٩٩٤١‬‬ ‫‪٨٣/٨٢‬‬
‫‪٣,٤-‬‬ ‫‪٦٦٦٢٠٤,٨‬‬ ‫‪٥٠,٠‬‬ ‫‪١١,١‬‬ ‫‪٣٣٣١٠٢,٤‬‬ ‫‪٨٤/٨٣‬‬
‫‪٦,٩‬‬ ‫‪٧١١٩٣٢,٩‬‬ ‫‪٥٢,٦‬‬ ‫‪١٢,٤‬‬ ‫‪٣٧٤٤٧٦,٧‬‬ ‫‪٨٥/٨٤‬‬
‫‪٢,٦‬‬ ‫‪٧٣,٦٢٨,٥‬‬ ‫‪٥٥,١‬‬ ‫‪٧,٥‬‬ ‫‪٤٠٢٥٧٦,٣‬‬ ‫‪٨٦/٨٥‬‬
‫‪٩,٢-‬‬ ‫‪٦٦٣٠٤٩,٦‬‬ ‫‪٦٢,٧‬‬ ‫‪٣,٣‬‬ ‫‪٤١٥٧٣٢,١‬‬ ‫‪٨٧/٨٦‬‬
‫‪٠,٤-‬‬ ‫‪٦٦٠١٩٦,١‬‬ ‫‪٧١,١‬‬ ‫‪١٢,٩‬‬ ‫‪٤٦٩٣٩٩,٤‬‬ ‫‪٨٨/٨٧‬‬
‫‪٥,٣-‬‬ ‫‪٦٢٥٠٨٥,٦‬‬ ‫‪٨٤,٥‬‬ ‫‪١٢,٥‬‬ ‫‪٥٢٨١٩٧,٣‬‬ ‫‪٨٩/٨٨‬‬
‫‪٢,٥‬‬ ‫‪٦٤٠٥١٣,٨‬‬ ‫‪١٠٠,٠‬‬ ‫‪٢١,٣‬‬ ‫‪٦٤٠٥١٣,٨‬‬ ‫‪٩٠/٨٩‬‬
‫‪١,٢‬‬ ‫‪٦٤٨١٠٧,٩‬‬ ‫‪١١٤,٥‬‬ ‫‪١٥,٩‬‬ ‫‪٧٤٢٠٨٣,٥‬‬ ‫‪٩١/٩٠‬‬
‫‪٠,٣-‬‬ ‫‪٦٤٦٣٩٧,٢‬‬ ‫‪١٣٧,١‬‬ ‫‪١٩,٤‬‬ ‫‪٨٨٦٢١٠,٥‬‬ ‫‪٩٢/٩١‬‬
‫‪٦,١‬‬ ‫‪٦٨٥٨٩٠١,٥‬‬ ‫‪١٥٠,٧‬‬ ‫‪١٦,٦‬‬ ‫‪١٠٣٣٦٥٣,٥‬‬ ‫‪٩٣/٩٢‬‬
‫‪٦,٤‬‬ ‫‪٧٢٩٨٣٦,٧‬‬ ‫‪١٦١,٣‬‬ ‫‪١٣,٩‬‬ ‫‪١١٧٧٢٢٦,٦‬‬ ‫‪٩٤/٩٣‬‬
‫‪٦,٢‬‬ ‫‪٧٧٥٢٠٧,٥‬‬ ‫‪١٨٠,٧‬‬ ‫‪١٩,٠‬‬ ‫‪١٤٠٠٨٠٠‬‬ ‫‪٩٥/٩٤‬‬
‫‪١٢,٥‬‬ ‫‪١٥٧٦٠٠٠‬‬ ‫‪٩٦/٩٥‬‬
‫* ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ – ﻗﺴﻢ ﺍﻹﺣﺼﺎﺀ‬

‫ﺍﳉﺪﻭﻝ )‪ :(٢‬ﻣﺘﻮﺳﻂ ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﺍﻟﻔﺮﺩ ) ﺃﺳﻌﺎﺭ ‪(١٩٩٠‬‬

‫ﻣﻌﺪﻝ‬ ‫ﻧﺼﻴﺐ ﺍﻟﻔﺮﺩ ﻣﻦ‬
‫ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺰﻳﺎﺩﺓ‬ ‫ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺴﻜﺎﻥ‬ ‫ﺍﻟﺼﺤﺔ ﺍﻹﲨﺎﻟﻴﺔ‬ ‫ﺍﻟﺴﻨﺔ‬
‫ﺍﻟﺴﻨﻮﻳﺔ‬ ‫ﺍﻟﺼﺤﺔ‬
‫ﺑﺄﺳﻌﺎﺭ‪١٩٩٠‬‬
‫‪%‬‬ ‫)ﺃﺳﻌﺎﺭ‪(١٩٩٠‬‬
‫‪-‬‬ ‫‪١٤,٦‬‬ ‫‪٤٤٥٠٦‬‬ ‫‪٦٥٢٢٩٣,٨‬‬ ‫‪٨٢/٨١‬‬
‫‪٣,٤‬‬ ‫‪١٥,١‬‬ ‫‪٤٥٧٢١‬‬ ‫‪٦٨٩٥١٩,٥‬‬ ‫‪٨٣/٨٢‬‬
‫‪٠,٦-‬‬ ‫‪١٤,٢‬‬ ‫‪٤٦٩٩٠‬‬ ‫‪٦٦٦٢٠٤,٨‬‬ ‫‪٨٤/٨٣‬‬
‫‪٣,٥‬‬ ‫‪١٤,٧‬‬ ‫‪٤٨٣٤٩‬‬ ‫‪٧١١٩٣٢,٩‬‬ ‫‪٨٥/٨٤‬‬
‫‪٠,٧-‬‬ ‫‪١٤,٦‬‬ ‫‪٤٩٩١٢‬‬ ‫‪٧٣,٦٢٨,٥‬‬ ‫‪٨٦/٨٥‬‬
‫‪١١,٦-‬‬ ‫‪١٢,٩‬‬ ‫‪٥١٣٩٨‬‬ ‫‪٦٦٣,٤٩,٦‬‬ ‫‪٨٧/٨٦‬‬
‫‪٣,١-‬‬ ‫‪١٢,٥‬‬ ‫‪٥٢٨٧٦‬‬ ‫‪٦٦,١٩٦,١‬‬ ‫‪٨٨/٨٧‬‬
‫‪٠,٨-‬‬ ‫‪١١,٥‬‬ ‫‪٥٤٢٥٩‬‬ ‫‪٦٢٥٠٨٥,٦‬‬ ‫‪٨٩/٨٨‬‬
‫‪٠,٠‬‬ ‫‪١,٥‬‬ ‫‪٥٥٦٣٥‬‬ ‫‪٦٤٠٥١٣,٨‬‬ ‫‪٩٠/٨٩‬‬
‫‪٠,٩-‬‬ ‫‪١١,٤‬‬ ‫‪٥٦٩٢٢‬‬ ‫‪٦٤٨١٠٧,٩‬‬ ‫‪٩١/٩٠‬‬
‫‪٢,٦-‬‬ ‫‪١١,١‬‬ ‫‪٥٨١٠٣‬‬ ‫‪٦٤٦٣٩٧,٢‬‬ ‫‪٩٢/٩١‬‬
‫‪٤,٥‬‬ ‫‪١١,٦‬‬ ‫‪٥٩٢٣٠‬‬ ‫‪٦٨٥٩٠١,٥‬‬ ‫‪٩٣/٩٢‬‬
‫‪٤,٣‬‬ ‫‪١٢,١‬‬ ‫‪٦٠٥٤٠‬‬ ‫‪٧٢٩٨٣٦,٧‬‬ ‫‪٩٤/٩٣‬‬
‫‪٣,٣‬‬ ‫‪١٢,٥‬‬ ‫‪٦١٩٠‬‬ ‫‪٧٧٥٢٠٧,٥‬‬ ‫‪٩٥/٩٤‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻗﺴﻢ ﺍﻹﺣﺼﺎﺀ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺑﻴﺎﻧﺎﺕ ﺍﻟﺘﻨﺒﺆ ﺑﺎﻟﺴﻜﺎﻥ ﻟﻠﺠﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ‪.‬‬

‫‪١١٧‬‬
 ‫ﺍﳉﺪﻭﻝ )‪ :(٣‬ﻧﺴﺒﺔ ﺇﻧﻔﺎﻕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ‬
‫ﺇﲨﺎﱄ‬ ‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫‪% ١ :٢‬‬ ‫ﺍﻟﺴﻨﺔ‬
‫ﺍﻹﻧﻔﺎﻕ )‪(٢‬‬ ‫ﺑﺎﳌﻠﻴﻮﻥ ﺣﻴﻨﻪ )‪(١‬‬
‫‪٢,٨‬‬ ‫‪٨٥٥٩٦٢٧‬‬ ‫‪٢٤٢٠٠١‬‬ ‫‪٨٢/٨١‬‬
‫‪٢,٥‬‬ ‫‪١٢٠٨١٣٣٦‬‬ ‫‪٢٩٩٩٤١‬‬ ‫‪٨٣/٨٢‬‬
‫‪٢,٥‬‬ ‫‪١٣٣٧٢٣٦٥‬‬ ‫‪٣٣٣١٠٢,٤‬‬ ‫‪٨٤/٨٣‬‬
‫‪٢,٥‬‬ ‫‪١٥١٧٩٣٥٦‬‬ ‫‪٣٧٤٤٧٦,٧‬‬ ‫‪٨٥/٨٤‬‬
‫‪٢,٥‬‬ ‫‪١٦٣٨٦٦٧٨‬‬ ‫‪٤٠٢٥٧٦,٣‬‬ ‫‪٨٦/٨٥‬‬
‫‪٢,٥‬‬ ‫‪١٦٩٠١٥٠١‬‬ ‫‪٤١٥٧٣٢,١‬‬ ‫‪٨٧/٨٦‬‬
‫‪٢,٤‬‬ ‫‪١٩٤٧١٠٨٢‬‬ ‫‪٤٦٩٣٩٩,٤‬‬ ‫‪٨٨/٨٧‬‬
‫‪٢,٢‬‬ ‫‪٢٣٦٥٦٢٢٩‬‬ ‫‪٥٢٨١٩٧,٣‬‬ ‫‪٨٩/٨٨‬‬
‫‪٢,٤‬‬ ‫‪٢٧١٩٥٠٩٤‬‬ ‫‪٦٤٠٥١٣,٨‬‬ ‫‪٩٠/٨٩‬‬
‫‪٢,٠‬‬ ‫‪٣٧٩١٨٠٦٨‬‬ ‫‪٧٤٢٠٨٣,٥‬‬ ‫‪٩١/٩٠‬‬
‫‪١,٧‬‬ ‫‪٥٠٨٤٤٩٠١‬‬ ‫‪٨٨٦٢١٠,٥‬‬ ‫‪٩٢/٩١‬‬
‫‪١,٨‬‬ ‫‪٥٧٨٨٦٥٠٢‬‬ ‫‪١٠٣٣٦٥٣,٥‬‬ ‫‪٩٣/٩٢‬‬
‫‪٢,٠‬‬ ‫‪٦٠٠٠٦١٧٨‬‬ ‫‪١١٧٧٢٢٦,٦‬‬ ‫‪٩٤/٩٣‬‬
‫‪٢,١‬‬ ‫‪٦٥٠٤٧٣٠٠‬‬ ‫‪١٤٠٠٨٠٠‬‬ ‫‪٩٥/٩٤‬‬
‫‪٢,٢‬‬ ‫‪٧١٦٨١٩٠٠‬‬ ‫‪١٥٧٦٠٠٠‬‬ ‫‪٩٦/٩٥‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ – ﻗﺴﻢ ﺍﻹﺣﺼﺎﺀ‬

‫ﺍﳉﺪﻭﻝ )‪ :(٤‬ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﰲ ﻧﺼﻴﺐ ﻛﻞ ﻓﺮﺩ ﰲ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺑﺎﻷﺳﻌﺎﺭ ﺍﻟﺜﺎﺑﺘﺔ‪.‬‬

‫ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ‬
‫ﰲ ﻧﺼﻴﺐ‬ ‫ﻧﺼﻴﺐ ﻛﻞ‬
‫ﺍﻟﻔﺮﺩ ﰲ‬ ‫ﻓﺮﺩ ﰲ‬ ‫ﻧﺼﻴﺐ‬
‫ﺍﻟﺴﻨﺔ‬
‫ﺍﻻﺳﺘﺜﻤﺎﺭ‬ ‫ﺍﻻﺳﺘﺜﻤﺎﺭ‬ ‫ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﰲ‬ ‫ﺍﻟﻔﺮﺩ ﰲ‬ ‫ﺇﲨﺎﱄ‬
‫ﺑﺎﻷﺳﻌﺎﺭ‬ ‫ﺑﺎﻷﺳﻌﺎﺭ‬ ‫ﺍﻟﺮﻗﻢ‬ ‫ﻧﺼﻴﺐ ﺍﻟﻔﺮﺩ ﻣﻦ‬ ‫ﺍﻻﺳﺘﺜﻤﺎﺭ‬ ‫ﻋﺪﺩ‬ ‫ﺍﻻﺳﺘﺜﻤﺎﺭ‬
‫ﺍﻟﺜﺎﺑﺘﺔ‬ ‫ﺍﻟﺜﺎﺑﺘﺔ‬ ‫ﺍﻟﻘﻴﺎﺳﻲ‬ ‫ﺍﻻﺳﺘﺜﻤﺎﺭ )‪(%‬‬ ‫ﺍﻟﺼﺤﻲ‬ ‫ﺍﻟﺴﻜﺎﻥ‬ ‫ﺍﻟﺼﺤﻲ‬
‫‪-‬‬ ‫‪٤,٢٨‬‬ ‫‪٤٣,٥‬‬ ‫‪-‬‬ ‫‪١,٨٦‬‬ ‫‪٤٥,٧٢١‬‬ ‫‪٨٥,١‬‬ ‫‪٨٣/٨٢‬‬
‫‪٠,٥-‬‬ ‫‪٤,٢٦‬‬ ‫‪٥٠,٠‬‬ ‫‪١٤,٥‬‬ ‫‪٢,١٣‬‬ ‫‪٤٦,٩٩٠‬‬ ‫‪١٠٠,٢‬‬ ‫‪٨٤/٨٣‬‬
‫‪١١,٣-‬‬ ‫‪٣,٧٨‬‬ ‫‪٥٢,٦‬‬ ‫‪٦,٥-‬‬ ‫‪١,٩٩‬‬ ‫‪٤٨,٣٤٩‬‬ ‫‪٩٦,٤‬‬ ‫‪٨٥/٨٤‬‬
‫‪١٩,٦‬‬ ‫‪٤,٥٢‬‬ ‫‪٥٥,١‬‬ ‫‪٢٥,١‬‬ ‫‪٢,٤٩‬‬ ‫‪٤٩,٩١٢‬‬ ‫‪١٢٤,٤‬‬ ‫‪٨٦/٨٥‬‬
‫‪-٥٤,٩‬‬ ‫‪٧,٠‬‬ ‫‪٦٢,٧‬‬ ‫‪٧٦,٣‬‬ ‫‪٤,٣٩‬‬ ‫‪٥١,٣٩٨‬‬ ‫‪٢٢٥,٤‬‬ ‫‪٨٧/٨٦‬‬
‫‪١٠,٠‬‬ ‫‪٦,٣‬‬ ‫‪٧١,١‬‬ ‫‪٢,٧‬‬ ‫‪٤,٥١‬‬ ‫‪٥٢,٨٧٦‬‬ ‫‪٢٣٨,٥٣‬‬ ‫‪٨٨/٨٧‬‬
‫‪٤,٨‬‬ ‫‪٦,٦‬‬ ‫‪٨٤,٥‬‬ ‫‪٢٣,٩‬‬ ‫‪٥,٥٩‬‬ ‫‪٥٤,٢٥٩‬‬ ‫‪٣٠٣,١‬‬ ‫‪٨٩/٨٨‬‬
‫‪٨,٩-‬‬ ‫‪٦,٠١‬‬ ‫‪١٠٠,٠‬‬ ‫‪٧,٥‬‬ ‫‪٦,٠١‬‬ ‫‪٥٥,٦٣٥‬‬ ‫‪٢٣٤,٣‬‬ ‫‪٩٠/٨٩‬‬
‫‪٣٥,١-‬‬ ‫‪٣,٩‬‬ ‫‪١١٤,٥‬‬ ‫‪٢٦,٣-‬‬ ‫‪٤,٤٣‬‬ ‫‪٥٦,٩٢٢‬‬ ‫‪٢٥٢,٠‬‬ ‫‪٩١/٩٠‬‬
‫‪٤١,٠‬‬ ‫‪٥,٥‬‬ ‫‪١٣٧,٥‬‬ ‫‪٦٩,٨‬‬ ‫‪٧,٥٢‬‬ ‫‪٥٨١,١٠٣‬‬ ‫‪٤٣٧,٠‬‬ ‫‪٩٢/٩١‬‬
‫‪٢٤,٢‬‬ ‫‪٦,٨٣‬‬ ‫‪١٥٠,٧‬‬ ‫‪٣٧,٠‬‬ ‫‪١٠,٣‬‬ ‫‪٥٩,٢٣٠‬‬ ‫‪٦٠٨,٠‬‬ ‫‪٩٣/٩٢‬‬
‫‪٨,٣‬‬ ‫‪٧,٤‬‬ ‫‪١٦١,٣‬‬ ‫‪١٥,٥‬‬ ‫‪١١,٩‬‬ ‫‪٦٠,٥٤٠‬‬ ‫‪٧٢١,٠‬‬ ‫‪٩٤/٩٣‬‬
‫‪٥,٤‬‬ ‫‪٧,٨‬‬ ‫‪١٨٠,٧‬‬ ‫‪١٨,٥‬‬ ‫‪١٤,١‬‬ ‫‪٦١,٩٠٠‬‬ ‫‪٨٧٥,٠‬‬ ‫‪٩٥/٩٤‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ – ﻗﺴﻢ ﺍﻹﺣﺼﺎﺀ‪.‬‬

‫‪١١٨‬‬
 ‫ﺍﳉﺪﻭﻝ )‪ :(٥‬ﺍﻟﺘﻮﺯﻳﻊ ﺍﻟﻨﺴﱯ ﻟﻼﺳﺘﺜﻤﺎﺭ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ ‪١٩٩٧-٨٢‬‬
‫ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﳋﺎﺹ ‪%‬‬ ‫ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﻌﺎﻡ ‪%‬‬ ‫ﺍﻟﺴﻨﺔ‬
‫‪١٠,٥‬‬ ‫‪٨٩,٥‬‬ ‫‪٨٣/١٩٨٢‬‬
‫‪١٧,٣‬‬ ‫‪٨٢,٧‬‬ ‫‪٨٤/١٩٨٣‬‬
‫‪٢٧,٢‬‬ ‫‪٧٢,٨‬‬ ‫‪٨٥/١٩٨٤‬‬
‫‪٢٠,٥‬‬ ‫‪٧٩,٥‬‬ ‫‪٨٦/١٩٨٥‬‬
‫‪١٦‬‬ ‫‪٤٨‬‬ ‫‪٨٧/١٩٨٦‬‬
‫‪١٨,٣‬‬ ‫‪٨١,٧‬‬ ‫ﺍﳋﻄﺔ ﺍﳋﻤﺴﻴﺔ ﺍﻷﻭﱃ‬
‫‪١٥,٩‬‬ ‫‪٨٤,١‬‬ ‫‪٨٨/١٩٨٧‬‬
‫‪١٣,٤‬‬ ‫‪٨٦,٦‬‬ ‫‪٨٩/١٩٨٨‬‬
‫‪١٣,٢‬‬ ‫‪٨٦,٨‬‬ ‫‪٩٠/١٩٨٩‬‬
‫‪١٩‬‬ ‫‪٨١‬‬ ‫‪٩١/١٩٩٠‬‬
‫‪١٠,٣‬‬ ‫‪٨٩,٧‬‬ ‫‪٩٢/١٩٩١‬‬
‫‪١٣,٩‬‬ ‫‪٨٦,١‬‬ ‫ﺍﳋﻄﺔ ﺍﳋﻤﺴﻴﺔ ﺍﻟﺜﺎﻧﻴﺔ‬
‫‪١٩,١‬‬ ‫‪٨٠,٩‬‬ ‫‪٩٣/١٩٩٢‬‬
‫‪١٠,٥‬‬ ‫‪٨٠,٥‬‬ ‫‪٩٤/١٩٩٣‬‬
‫‪١٣,٨‬‬ ‫‪٨٦,٢‬‬ ‫‪٩٥/١٩٩٤‬‬
‫‪١١,٣‬‬ ‫‪٨٨,٧‬‬ ‫‪٩٦/١٩٩٥‬‬
‫‪١١,٢‬‬ ‫‪٨٨,٨‬‬ ‫‪٩٧/١٩٩٦‬‬
‫‪١٢,٨‬‬ ‫‪٨٧,٢‬‬ ‫ﺍﳋﻄﺔ ﺍﳋﻤﺴﻴﺔ ﺍﻟﺜﺎﻟﺜﺔ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﳎﻠﺲ ﺍﻟﺸﻮﺭﻯ ﺍﳋﻄﺔ ﺍﻟﻘﻮﻣﻴﺔ ‪.١٩٩٨ / ٩٧‬‬

‫ﺍﳉﺪﻭﻝ )‪ :(٦‬ﻧﺴﺒﺔ ﺍﻻﺳﺘﺜﻤﺎﺭ ﺍﻟﺼﺤﻲ ﺇﱃ ﺇﲨﺎﱄ ﺍﻟﻨﺎﺗﺞ ﺍﶈﻠﻲ ‪١٩٩٥/٩٤-١٩٨٧/٨٦‬‬

‫‪% ١ :٢‬‬ ‫ﺇﲨﺎﱄ ﺍﻟﻨﺎﺗﺞ ﺍﶈﻠﻲ ﺑﺎﳌﻠﻴﻮﻥ ﺣﻴﻨﻪ )‪(٢‬‬ ‫ﺍﻻﺳﺘﺜﻤﺎﺭ ﺑﺎﳌﻠﻴﻮﻥ ﺣﻴﻨﻪ )‪(١‬‬ ‫ﺍﻟﺴﻨﺔ‬
‫‪٠,٥٥‬‬ ‫‪٤٠٨٨٤,٧‬‬ ‫‪٢٢٥,٨‬‬ ‫‪٨٧/٨٦‬‬
‫‪٠,٣٧‬‬ ‫‪٩١٥٧٥‬‬ ‫‪٣٣٤,٣‬‬ ‫‪٩٠/٨٩‬‬
‫‪٠,٢٣‬‬ ‫‪١٠٨٧٤٠‬‬ ‫‪٢٥٢‬‬ ‫‪٩١/٩٠‬‬
‫‪٠,٣٣‬‬ ‫‪١٣١٠٥٧‬‬ ‫‪٤٣٧‬‬ ‫‪٩٢/٩١‬‬
‫‪٠,٤٢‬‬ ‫‪١٤٦١٦٠‬‬ ‫‪٦٠٨‬‬ ‫‪٩٣/٩٢‬‬
‫‪٠,٤٤‬‬ ‫‪١٦٢٩٦٧‬‬ ‫‪٧٢١‬‬ ‫‪٩٤/٩٣‬‬
‫‪٠,٤٦‬‬ ‫‪١٩١٠١٠‬‬ ‫‪٨٧٥‬‬ ‫‪٩٥/٩٤‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻗﺴﻢ ﺍﻹﺣﺼﺎﺀ‪ ،‬ﺑﻴﺎﻧﺎﺕ ﻏﲑ ﻣﻨﺸﻮﺭﺓ‬

‫ﺍﳉﺪﻭﻝ )‪ :(٧‬ﻣﻴﺰﺍﻧﻴﺔ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ﺇﱃ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﻹﲨﺎﻟﻴﺔ ‪١٩٩٨/٩٥-١٩٨١/٨٠‬‬

‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ‬ ‫ﺍﳌﻴﺰﺍﻧﻴﺔ‬ ‫ﺇﻧﻔﺎﻕ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ‬ ‫ﺍﻟﺴﻨﺔ‬
‫ﺍﻟﺼﺤﻲ ﺍﳊﻜﻮﻣﻲ ﺇﱃ‬ ‫ﺍﻹﲨﺎﻟﻴﺔ‬ ‫ﺍﳊﻜﻮﻣﻲ ﺑﺎﳌﻠﻴﻮﻥ‬
‫ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﻌﺎﻡ‬ ‫ﺑﺎﳌﻠﻴﻮﻥ ﺟﻨﻴﻪ‬ ‫ﺟﻨﻴﻪ‬
‫‪٢,٩‬‬ ‫‪٦٨٠١,٧‬‬ ‫‪١٩٦,٥‬‬ ‫‪٨١/٨٠‬‬
‫‪٢,٨‬‬ ‫‪٦٠٠٠٦,٢‬‬ ‫‪١٦٦٢,١‬‬ ‫‪٩٤/٩٣‬‬
‫‪٣,٢‬‬ ‫‪٧١٦٨١,٩‬‬ ‫‪٢٢٥٢,٦‬‬ ‫‪٩٦/٩٥‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻗﺴﻢ ﺍﻹﺣﺼﺎﺀ‪ ،‬ﺑﻴﺎﻧﺎﺕ ﻏﲑ ﻣﻨﺸﻮﺭﺓ‬

‫‪١١٩‬‬
 ‫ﺍﳉﺪﻭﻝ )‪ :(٨‬ﺍﻷﺷﺨﺎﺹ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﻢ ﺣﺴﺐ ﻃﺒﻴﻌﺘﻬﻢ‪(١٩٩٦/٩٥).‬‬
‫‪%‬‬ ‫ﺍﻟﻌﺪﺩ‬ ‫ﺍﻟﺒﻨﺪ‬
‫‪٢٤,٩‬‬ ‫‪٤,٨٨٣‬‬ ‫ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ‬
‫‪٣,٢‬‬ ‫‪٠,٦٢٠‬‬ ‫ﺍﻷﺭﺍﻣﻞ ﻭﺍﳌﻌﺎﺷﺎﺕ‬
‫‪٧١,٩‬‬ ‫‪١٤,٠٨٦‬‬ ‫ﺍﻟﻄﻼﺏ‬
‫‪١٠٠‬‬ ‫‪١٩,٥٩٢‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﻭﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ‪١٩٩٦/٩٥‬‬

‫ﺍﳉﺪﻭﻝ )‪ :(٩‬ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺣﺴﺐ ﻧﻮﻋﻪ)‪(١٩٩٥/٩٤‬‬

‫ﺑﻨﻮﺩ ﺍﻹﻧﻔﺎﻕ ‪%‬‬
‫‪% ٥٤‬‬ ‫ﺍﻷﺩﻭﻳﺔ‬
‫‪% ٣٦‬‬ ‫ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺭﺟﻴﺔ‬
‫‪% ١٠‬‬ ‫ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺪﺍﺧﻠﻴﺔ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺣﺴﺒﺖ ﻣﻦ ﺑﻴﺎﻧﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﺑﻴﺎﻧﺎﺕ ﺇﻧﻔﺎﻕ ‪.١٩٩٥/٩٤ ،DDM‬‬

‫ﺍﳉﺪﻭﻝ )‪ :(١٠‬ﺗﻮﺯﻳﻊ ﺍﺳﺘﺜﻤﺎﺭ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ )‪(١٩٩٧/٩٦‬‬

‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ‪%‬‬ ‫ﺍﻹﲨﺎﱄ‬ ‫ﺍﳌﺸﺮﻭﻉ‬
‫‪٥٧,٨‬‬ ‫‪١٢٢٢١٨٦‬‬ ‫ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻼﺟﻴﺔ‬
‫‪٢١,٢‬‬ ‫‪٤٤٧١٩٤‬‬ ‫ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻷﺳﺎﺳﻴﺔ‬
‫‪٢,٨٩‬‬ ‫‪٦١٢٣٧‬‬ ‫ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ‬
‫‪٠,٣٦‬‬ ‫‪٢٨٨٩٣‬‬ ‫ﻗﺴﻢ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻭﺍﻷﲝﺎﺙ‬
‫‪٨,٠٣‬‬ ‫‪١٦٩٧٣٦‬‬ ‫ﻗﻄﺎﻉ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﺍﻟﺴﻜﺎﻥ‬
‫‪٦,٢٩‬‬ ‫‪١٣٣٠٥٦‬‬ ‫ﺍﳊﻤﺎﻳﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻮﺑﺎﺋﻴﺔ‬
‫‪٠,١٧‬‬ ‫‪٢٤٧٨‬‬ ‫ﻗﻄﺎﻉ ﺍﻷﻣﺮﺍﺽ ﺍﻟﺒﺎﻃﻨﺔ‬
‫‪٢,٨٤‬‬ ‫‪٦٠٠٧‬‬ ‫ﻗﻄﺎﻉ ﻃﺐ ﺍﻷﺳﻨﺎﻥ‬
‫‪٢,٠٥‬‬ ‫‪٤٢٧٣٧‬‬ ‫ﻗﻄﺎﻉ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ‬
‫‪٢١١٣٥٢٤‬‬ ‫ﺃﲨﺎﱄ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫‪٦٢٩٠٠٥‬‬ ‫ﺃﲨﺎﱄ ﺍﳍﻴﺌﺎﺕ ﻭﺍﳌﺆﺳﺴﺎﺕ‬
‫‪٢٧٤٢٥٢٩‬‬ ‫ﺃﲨﺎﱄ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻗﺴﻢ ﺍﻟﺘﺨﻄﻴﻂ‪ ،‬ﺑﻴﺎﻧﺎﺕ ﻏﲑ ﻣﻨﺸﻮﺭﺓ‪١٩٩٨ ،‬‬

‫ﺍﳉﺪﻭﻝ )‪ :(١١‬ﺗﻮﺯﻳﻊ ﻣﻴﺰﺍﻧﻴﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺎﳌﻠﻴﻮﻥ ﺟﻨﻴﻪ )‪(١٩٩٨/٩٧‬‬

‫‪١٩٩٨/٩٧‬‬
‫ﺍﻹﲨﺎﱄ‬ ‫ﺍﻹﻣﺪﺍﺩﺍﺕ‬ ‫ﺍﻷﺟﻮﺭ ﻭﺍﳌﺮﺗﺒﺎﺕ‬
‫‪٤٠٩٠١٣‬‬ ‫‪٣٧١٨٦٦‬‬ ‫‪٣٧١٤٧‬‬ ‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫‪١١٩٨٠٩٤‬‬ ‫‪٢٤٨٧٣٥‬‬ ‫‪٩٤٩٣٥٩‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ‬
‫‪٦٢٠٦٠١‬‬ ‫‪٩٨٦٥٠٦‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻗﺴﻢ ﺍﻹﺣﺼﺎﺀ‪ ،‬ﺑﻴﺎﻧﺎﺕ ﻏﲑ ﻣﻨﺸﻮﺭﺓ‪١٩٩٨ ،‬‬

‫‪١٢٠‬‬
 ‫ﺍﳉﺪﻭﻝ )‪١٢‬ﺃ(‪ :‬ﻣﺘﻮﺳﻂ ﺍﻹﻧﻔﺎﻕ ﻭﻣﺘﻮﺳﻂ ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻟﻠﻤﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﺣﺴﺐ ﻓﺌﺎﺕ ﺍﻹﻧﻔﺎﻕ‬
‫ﺍﻟﺮﻳﻒ‬
‫ﻣﺘﻮﺳﻂ‬
‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ‬ ‫ﺍﻹﻧﻔﺎﻕ‬ ‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ‬ ‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ‬
‫ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ‬ ‫ﺍﻟﺼﺤﻲ‬ ‫ﻣﺘﻮﺳﻂ‬ ‫ﻋﻠﻰ ﺍﻟﺼﺤﺔ‬ ‫ﺍﻹﲨﺎﱄ ﻟﻜﻞ‬ ‫ﻓﺌﺎﺕ ﺍﻹﻧﻔﺎﻕ‬
‫ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ ﻛﻞ‬ ‫ﺣﺴﺐ‬ ‫ﺍﻷﻧﻔﺎﻕ‬ ‫ﺇﱃ ﺇﲨﺎﱄ‬ ‫ﻓﺌﺔ ﺇﱃ ﺇﲨﺎﱄ‬
‫ﻓﺌﺔ ﻣﻦ ﻓﺌﺎﺕ‬ ‫ﻓﺌﺎﺕ ﺍﻟﺪﺧﻞ‬ ‫ﺍﻹﲨﺎﱄ‬ ‫ﺇﻧﻔﺎﻕ ﺍﻟﺼﺤﺔ‬ ‫ﺍﻹﻧﻔﺎﻕ‬
‫ﺍﻟﺪﺧﻞ ‪%‬‬ ‫ﺍﳌﺨﺘﻠﻔﺔ‬ ‫ﺑﺎﳉﻨﻴﻪ‬ ‫)ﺗﺮﺍﻛﻤﻲ ‪(%‬‬ ‫)ﺗﺮﺍﻛﻤﻲ‪(%‬‬
‫‪٤,٣٦٦‬‬ ‫‪٧٩,٢٠٠‬‬ ‫‪١٨١٤,٠١٧‬‬ ‫‪٤,٠٠٨‬‬ ‫‪٣,١٧٦‬‬ ‫‪%١٠‬‬
‫‪٣,٥٥٦‬‬ ‫‪١٠٦,٥٠٢‬‬ ‫‪٢٩٩٤,٦٤٧‬‬ ‫‪٩,٣٩٧‬‬ ‫‪٨,٤١٩‬‬ ‫‪%٢٠‬‬
‫‪٣,٣١٤‬‬ ‫‪١١٩,٦٨٩‬‬ ‫‪٣٦١١,١٩٥‬‬ ‫‪١٥,٤٥٤‬‬ ‫‪١٤,٧٤١‬‬ ‫‪%٣٠‬‬
‫‪٣,٢٧٥‬‬ ‫‪١٤٤,٤٨٩‬‬ ‫‪٤٤١٢,٢٨٢‬‬ ‫‪٢٢,٧٦٦‬‬ ‫‪٢٢,٤٦٦‬‬ ‫‪%٤٠‬‬
‫‪٣,١٤٤‬‬ ‫‪١٥٤,١٠٢‬‬ ‫‪٤٩٠١,٨٦٤‬‬ ‫‪٣٠,٥٦٤‬‬ ‫‪٣١,٠٤٨‬‬ ‫‪%٥٠‬‬
‫‪٣,١٠٣‬‬ ‫‪١٦٨,٨٢٩‬‬ ‫‪٥٤٤٠,٨٠٦‬‬ ‫‪٣٩,١٠٧‬‬ ‫‪٤٠,٥٧٢‬‬ ‫‪%٦٠‬‬
‫‪٣,١٦٩‬‬ ‫‪١٩٥,٤٣٨‬‬ ‫‪٦١٦٦,٨٠٦‬‬ ‫‪٤٨,٩٩٧‬‬ ‫‪٥١,٣٦٨‬‬ ‫‪%٧٠‬‬
‫‪٣,١١٨‬‬ ‫‪٢١٥,٢٢٠‬‬ ‫‪٦٩٠٣,٥٧٣‬‬ ‫‪٥٩,٨٨٨‬‬ ‫‪٦٣,٤٥٥‬‬ ‫‪%٨٠‬‬
‫‪٣,٢٨١‬‬ ‫‪٢٧٠,٥٠٣‬‬ ‫‪٨٢٤٤,٣٠٠‬‬ ‫‪٧٣,٥٧٧‬‬ ‫‪٧٧,٨٨٨‬‬ ‫‪%٩٠‬‬
‫‪٤,١٣٤‬‬ ‫‪٥٢٢,١٥٦‬‬ ‫‪١٢٦٢٩,٧٨٩‬‬ ‫‪١٠٠,٠٠‬‬ ‫‪١٠٠,٠٠٠‬‬ ‫‪%١٠٠‬‬
‫‪٨١٨٣‬‬ ‫ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ‬
‫‪٤٦٧٤٠٠٩٤‬‬ ‫ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺑﺎﳉﻨﻴﻪ‬
‫‪١٦١٧٠٦٥‬‬ ‫ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺣﺴﺒﺖ ﻣﻦ ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻹﻧﻔﺎﻕ ﻟﻠﺠﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪ ٩٦/ ١٩٩٥‬ﺑﻮﺍﺳﻄﺔ ﻫﺒﺔ ﺍﻟﻠﻴﺜﻲ‬

‫ﺍﳉﺪﻭﻝ )‪١٢‬ﺏ(‪ :‬ﻣﺘﻮﺳﻂ ﺍﻹﻧﻔﺎﻕ ﻭﻣﺘﻮﺳﻂ ﺇﻧﻔﺎﻕ ﺍﻟﺼﺤﺔ ﻟﻠﻤﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﺣﺴﺐ ﻓﺌﺎﺕ ﺍﻹﻧﻔﺎﻕ‬
‫ﺍﳊﻀﺮ‬
‫ﻣﺘﻮﺳﻂ‬ ‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ‬
‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ‬ ‫ﺍﻹﻧﻔﺎﻕ‬ ‫ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ‬ ‫ﺍﻹﲨﺎﱄ ﻟﻜﻞ‬
‫ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ‬ ‫ﺍﻟﺼﺤﻲ‬ ‫ﻣﺘﻮﺳﻂ‬ ‫ﻋﻠﻰ ﺍﻟﺼﺤﺔ‬ ‫ﻓﺌﺔ ﺇﱃ‬ ‫ﻓﺌﺎﺕ ﺍﻹﻧﻔﺎﻕ‬
‫ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ‬ ‫ﺣﺴﺐ ﻓﺌﺎﺕ‬ ‫ﺍﻷﻧﻔﺎﻕ‬ ‫ﺇﱃ ﺇﲨﺎﱄ‬ ‫ﺇﲨﺎﱄ‬
‫ﻛﻞ ﻓﺌﺔ ﻣﻦ ﻓﺌﺎﺕ‬ ‫ﺍﻟﺪﺧﻞ‬ ‫ﺍﻹﲨﺎﱄ‬ ‫ﺇﻧﻔﺎﻕ ﺍﻟﺼﺤﺔ‬ ‫ﺍﻹﻧﻔﺎﻕ‬
‫ﺍﻟﺪﺧﻞ‬ ‫ﺍﳌﺨﺘﻠﻔﺔ‬ ‫ﺑﺎﳉﻨﻴﻪ‬ ‫)ﺗﺮﺍﻛﻤﻲ ‪(%‬‬ ‫)ﺗﺮﺍﻛﻤﻲ‪(%‬‬
‫‪٥,٧٩٩‬‬ ‫‪١٣٣,٨٦٦‬‬ ‫‪٢٣٠٨,٣٧٥‬‬ ‫‪٤,٣٠٤‬‬ ‫‪٢,٩٤٩‬‬ ‫‪%١٠‬‬
‫‪٤,٥٦٣‬‬ ‫‪١٦٣,٣٣٣‬‬ ‫‪٣٥٧٩,٤٦٢‬‬ ‫‪٩,٥٥٥‬‬ ‫‪٧,٥٢١‬‬ ‫‪%٢٠‬‬
‫‪٤,٧٧١‬‬ ‫‪٢١٤,٢٠٤‬‬ ‫‪٤٤٨٩,٥٦٧‬‬ ‫‪١٦,٤٤٢‬‬ ‫‪١٣,٢٥٦‬‬ ‫‪%٣٠‬‬
‫‪٤,١٠٦‬‬ ‫‪٢١٦,٥٦٤‬‬ ‫‪٥٢٧٤,٠٧٥‬‬ ‫‪٢٣,٤٠٥‬‬ ‫‪١٩,٩٩٣‬‬ ‫‪%٤٠‬‬
‫‪٤,٢١٤‬‬ ‫‪٢٦٠,٥١٣‬‬ ‫‪٦١٨١,٦٢٤‬‬ ‫‪٢٧,٥٩٣‬‬ ‫‪٢٣,٤٠٥‬‬ ‫‪%٤٥‬‬
‫‪٤,٢١٤‬‬ ‫‪٢٦٠,٥٧٧‬‬ ‫‪٦١٨٣,٤٩١‬‬ ‫‪٣١,٧٨٣‬‬ ‫‪٢٧,٨٩٢‬‬ ‫‪%٥٠‬‬
‫‪٤,١١٥‬‬ ‫‪٢٨٤,١٣٤‬‬ ‫‪٦٩٠٥,١٣٧‬‬ ‫‪٤٠,٩١٨‬‬ ‫‪٣٦,٧١٢‬‬ ‫‪%٦٠‬‬
‫‪٣,٩٦٠‬‬ ‫‪٣٢٠,١٧٠‬‬ ‫‪٨٠٨٥,٠٠٩‬‬ ‫‪٥١,٢١١‬‬ ‫‪٤٧,٠٤٠‬‬ ‫‪%٧٠‬‬
‫‪٣,٨٧٥‬‬ ‫‪٣٥٤,٧٨٢‬‬ ‫‪٩١٥٦,٢١٨‬‬ ‫‪٦٢,٦١٨‬‬ ‫‪٥٨,٧٣٦‬‬ ‫‪%٨٠‬‬
‫‪٣,٩٧٤‬‬ ‫‪٤٦٣,٥١٨‬‬ ‫‪١١٦٦٤,٤١٤‬‬ ‫‪٧٧,٥٢٠‬‬ ‫‪٧٣,٦٣٥‬‬ ‫‪%٩٠‬‬
‫‪٣,٣٨٨‬‬ ‫‪٦٩٩,١٩١‬‬ ‫‪٢٠٦٣٩,٥٨٣‬‬ ‫‪١٠٠,٠٠٠‬‬ ‫‪١٠٠,٠٠٠‬‬ ‫‪%١٠٠‬‬
‫‪٦٦٢٢‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫‪٥١٨٤٠٥٤٦‬‬ ‫ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﺋﻠﻲ‬
‫‪٢٠٥٩٦٦٦‬‬ ‫ﺇﲨﺎﱄ ﺍﻟﺼﺤﺔ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺣﺴﺒﺖ ﻣﻦ ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻹﻧﻔﺎﻕ ﻟﻠﺠﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪ ١٩٩٦/ ٩٥‬ﺑﻮﺍﺳﻄﺔ ﻫﺒﺔ ﺍﻟﻠﻴﺜﻲ‪.‬‬

‫‪١٢١‬‬
‫ﺍﳉﺪﻭﻝ )‪ :(١٣‬ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﻟﻌﺎﻡ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﻌﺎﻡ ﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ ‪-١٩٨٢/٨١‬‬
‫‪١٩٩١/٩٠‬ﻭ‪(%)١٩٩٦/٩٥‬‬
‫ﺍﳊﻀﺮ‬ ‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﻟﺴﻨﺔ‬
‫‪١,٨‬‬ ‫‪١,٨‬‬ ‫‪٨٢/١٩٨١‬‬
‫‪٣,٣‬‬ ‫‪٣,٥‬‬ ‫‪٩١/١٩٩٠‬‬
‫‪٤,٦٩٠٦‬‬ ‫‪٣,٥٣١‬‬ ‫‪٩٦/١٩٩٥‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻹﻧﻔﺎﻕ ﻟﻠﺠﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ‪.‬‬

‫ﺍﳉﺪﻭﻝ )‪ :(١٤‬ﺍﻟﺰﻳﺎﺭﺓ ﺍﻷﺧﲑﺓ ﻟﻠﻤﺮﺿﻰ ﺣﺴﺐ ﻓﺌﺎﺕ ﺍﻟﺪﺧﻞ ‪١٩٩٥/٩٤‬‬

‫ﻣﺴﺘﻮﻯ ﺍﻹﻧﻔﺎﻕ‬
‫ﺍﳌﺮﻓﻖ ﺍﻟﺼﺤﻲ‬
‫ﻣﺮﺗﻔﻊ‪%‬‬ ‫ﻣﺘﻮﺳﻂ ‪%‬‬ ‫ﳏﺪﻭﺩﻭ ﺍﻟﺪﺧﻞ ‪%‬‬
‫‪%٥٦,١‬‬ ‫‪%٧٠,٤‬‬ ‫‪%٧٧,٨‬‬ ‫ﺍﳊﻜﻮﻣﺔ‬
‫‪%١٢,٣‬‬ ‫‪%١٤,٨‬‬ ‫‪%١٢,٨‬‬ ‫ﻋﺎﻡ‬
‫‪%٢٧,٨‬‬ ‫‪%١٣,٧‬‬ ‫‪%٧,٧‬‬ ‫ﺧﺎﺹ‬
‫‪%٣,٩‬‬ ‫‪%١,١‬‬ ‫‪%١,٦‬‬ ‫ﺃﺧﺮﻯ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺣﺴﺒﺖ ﻣﻦ ﺑﻴﺎﻧﺎﺕ ﺇﺣﺼﺎﺀ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‪.DDM & CDC ١٩٩٥/ ٩٤ ،‬‬

‫ﺍﳉﺪﻭﻝ )‪١٥‬ﺃ(‪ :‬ﻣﺘﻮﺳﻂ ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ ﺍﳌﺮﺿﻰ ﺍﳌﻘﻴﻤﲔ ﺣﺴﺐ ﻓﺌﺎﺕ ﺍﻟﺪﺧﻞ ‪١٩٩٥/٩٤‬‬
‫ﻣﺴﺘﻮﻯ ﺍﻷﻧﻔﺎﻕ‬
‫ﺍﳌﺮﻓﻖ ﺍﻟﺼﺤﻲ‬
‫ﻣﺮﺗﻔﻊ‬ ‫ﻣﺘﻮﺳﻂ‬ ‫ﻗﻠﻴﻞ‬
‫‪٢٣١,٥‬‬ ‫‪٩٧,٥‬‬ ‫‪١٢٠,٥‬‬ ‫ﺍﳊﻜﻮﻣﺔ‬
‫‪٨٦٤,٥‬‬ ‫‪١٣٦,٥‬‬ ‫‪٤٦‬‬ ‫ﻋﺎﻡ‬
‫‪٩١٨,٢٥‬‬ ‫‪٢٢١,٥‬‬ ‫‪٢٤٤,٢٥‬‬ ‫ﺧﺎﺹ‬
‫‪٢٢٢‬‬ ‫‪١٩٤‬‬ ‫‪٣٠‬‬ ‫ﺃﺧﺮﻯ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺣﺴﺒﺖ ﻣﻦ ﺑﻴﺎﻧﺎﺕ ﺇﺣﺼﺎﺀ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‪.DDM & CDC ١٩٩٥/ ٩٤ ،‬‬

‫ﺍﳉﺪﻭﻝ )‪١٥‬ﺏ(‪ :‬ﻣﺘﻮﺳﻂ ﺇﲨﺎﱄ ﺇﻧﻔﺎﻕ ﺍﳌﺮﺿﻰ ﻣﻦ ﺍﳋﺎﺭﺝ ﺣﺴﺐ ﻓﺌﺎﺕ ﺍﻟﺪﺧﻞ ‪١٩٩٥/٩٤‬‬
‫ﻣﺴﺘﻮﻯ ﺍﻷﻧﻔﺎﻕ ﺑﺎﳉﻨﻴﻪ‬
‫ﻣﻜﺎﻥ ﺍﳌﺮﺿﻰ ﻣﻦ ﺍﳋﺎﺭﺝ‬
‫ﻣﺮﺗﻔﻊ‬ ‫ﻣﺘﻮﺳﻂ‬ ‫ﻗﻠﻴﻞ‬
‫‪١٦,٨٣‬‬ ‫‪١١‬‬ ‫‪٩‬‬ ‫ﺍﳊﻜﻮﻣﺔ‬
‫‪٨‬‬ ‫‪٤‬‬ ‫‪٤‬‬ ‫ﻋﺎﻡ‬
‫‪٣٩‬‬ ‫‪١٦,٧٥‬‬ ‫‪١٢,٧٥‬‬ ‫ﺧﺎﺹ‬
‫‪٢٣‬‬ ‫‪٢٠‬‬ ‫‪١٣‬‬ ‫ﻭﺣﺪﺍﺕ ﺍﻟﺼﺤﺔ ﺑﺎﳌﺴﺠﺪ ﻭﺍﻟﻜﻨﻴﺴﺔ‬
‫‪٦١‬‬ ‫‪١٥‬‬ ‫‪٣٠‬‬ ‫‪DK‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺣﺴﺒﺖ ﻣﻦ ﺑﻴﺎﻧﺎﺕ ﺇﺣﺼﺎﺀ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‪.DDM&CDC ١٩٩٥/ ٩٤ ،‬‬

‫‪١٢٢‬‬
‫ﺍﳉﺪﻭﻝ ﺭﻗﻢ )‪ :(١٦‬ﺍﻟﺘﻜﻠﻔﺔ ﻛﺴﺒﺐ ﻟﻌﺪﻡ ﺍﻟﺮﺿﺎ ﻋﻦ ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺣﺴﺐ ﻓﺌﺎﺕ ﺍﻟﺪﺧﻞ‬
‫ﺍﳌﺨﺘﻠﻔﺔ‬
‫ﻣﺴﺘﻮﻯ ﺍﻷﻧﻔﺎﻕ‬
‫ﺍﳌﺮﻓﻖ ﺍﻟﺼﺤﻲ‬
‫ﻣﺮﺗﻔﻊ‪%‬‬ ‫ﻣﺘﻮﺳﻂ ‪%‬‬ ‫ﻗﻠﻴﻞ ‪%‬‬
‫ﻣﻜﺎﻥ ﺍﳌﺮﺿﻰ ﺍﳋﺎﺭﺟﲔ‬
‫‪%٤٠,٠‬‬ ‫‪%٥١,٨‬‬ ‫‪%٨٣,٣‬‬ ‫ﺣﻜﻮﻣﺔ‬
‫‪%٠,٠‬‬ ‫‪%٣,٧‬‬ ‫‪%٠,٠‬‬ ‫ﻋﺎﻡ‬
‫‪%٦٠,٠‬‬ ‫‪%٢٩,٦‬‬ ‫‪%١٦,٧‬‬ ‫ﺧﺎﺹ‬
‫‪%٠,٠‬‬ ‫‪%١١,١‬‬ ‫‪%٠,٠‬‬ ‫ﻭﺣﺪﺍﺕ ﺍﻟﺼﺤﺔ ﺑﺎﳌﺴﺠﺪ ﻭﺍﻟﻜﻨﻴﺴﺔ‬
‫ﻣﻜﺎﻥ ﺍﳌﺮﺿﻰ ﺍﳌﻘﻴﻤﲔ‬
‫‪%١٠٠,٠‬‬ ‫‪%٨٠,٠‬‬ ‫‪%٦٦,٧‬‬ ‫ﺣﻜﻮﻣﺔ‬
‫‪%٠,٠‬‬ ‫‪%٢٠,٠‬‬ ‫‪%١٦,٧‬‬ ‫ﻋﺎﻡ‬
‫‪%٠,٠‬‬ ‫‪%٠,٠‬‬ ‫‪%١٦,٧‬‬ ‫ﺧﺎﺹ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺣﺴﺒﺖ ﻣﻦ ﺑﻴﺎﻧﺎﺕ ﺇﺣﺼﺎﺀ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‪.DDM & CDC ١٩٩٥/ ٩٤ ،‬‬

‫ﺍﳉﺪﻭﻝ )‪ :(١٧‬ﺍﻟﺘﻮﺯﻳﻊ ﺍﻹﻗﻠﻴﻤﻲ ﻷﺳﺮﺓ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ )‪(١٩٩٨/٩٧‬‬

‫‪%‬‬ ‫ﻋﺪﺩ ﺍﻟﺴﻜﺎﻥ‬ ‫‪%‬‬ ‫ﻋﺪﺩ ﺍﻷﺳﺮﺓ‬ ‫ﺍﶈﺎﻓﻈﺔ‬
‫‪١١,٨‬‬ ‫‪٦٩٥٥‬‬ ‫‪١١,٢‬‬ ‫‪٩٢٨٨‬‬ ‫ﺍﻟﻘﺎﻫﺮﺓ‬
‫‪٥,٨‬‬ ‫‪٣٤٣١‬‬ ‫‪١٢,٤‬‬ ‫‪١٠٣٥٩‬‬ ‫ﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬
‫‪٠,٨‬‬ ‫‪٤٦٧‬‬ ‫‪٢,٠‬‬ ‫‪١٦٨٢‬‬ ‫ﺑﻮﺭ ﺳﻌﻴﺪ‬
‫‪٠,٧‬‬ ‫‪٤١١‬‬ ‫‪١,١‬‬ ‫‪٩١١‬‬ ‫ﺍﻟﺴﻮﻳﺲ‬
‫‪١٩,١‬‬ ‫‪١١٢٦٤‬‬ ‫‪٢٦,٧‬‬ ‫‪٢٢٢٤٠‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪١,٥‬‬ ‫‪٨٩٨‬‬ ‫‪٢,٩‬‬ ‫‪٢٤٣٩‬‬ ‫ﺩﻣﻴﺎﻁ‬
‫‪٧,٢‬‬ ‫‪٤٢٢٦‬‬ ‫‪٥,٥‬‬ ‫‪٤٦٢٤‬‬ ‫ﺍﻟﺪﻗﻬﻠﻴﺔ‬
‫‪٧,١‬‬ ‫‪٤٢٢٠‬‬ ‫‪٤,٢‬‬ ‫‪٣٥٠٩‬‬ ‫ﺍﻟﺸﺮﻗﻴﺔ‬
‫‪٥,٢‬‬ ‫‪٣٠٤٥‬‬ ‫‪٩,١‬‬ ‫‪٧٥٦٨‬‬ ‫ﺍﻟﻘﻠﻴﻮﺑﻴﺔ‬
‫‪٣,٨‬‬ ‫‪٢٢٦٦‬‬ ‫‪٢,٩‬‬ ‫‪٢٤٢٣‬‬ ‫ﻛﻔﺮ ﺍﻟﺸﻴﺦ‬
‫‪٥,٨‬‬ ‫‪٣٤٣٧‬‬ ‫‪٨,٢‬‬ ‫‪٦٨٣٥‬‬ ‫ﺍﻟﻐﺮﺑﻴﺔ‬
‫‪٤,٥‬‬ ‫‪٢٦٧٢‬‬ ‫‪٤,١‬‬ ‫‪٣٤١٠‬‬ ‫ﺍﳌﻨﻮﻓﻴﺔ‬
‫‪٦,٧‬‬ ‫‪٣٩٦٨‬‬ ‫‪٤,٣‬‬ ‫‪٣٥٤٦‬‬ ‫ﺍﻟﺒﺤﲑﺓ‬
‫‪١,٢‬‬ ‫‪٦٨١‬‬ ‫‪١,٦‬‬ ‫‪١٣٦١‬‬ ‫ﺍﻹﲰﺎﻋﻴﻠﻴﺔ‬
‫‪٤٣‬‬ ‫‪٢٥٤١٣‬‬ ‫‪٤٢,٨‬‬ ‫‪٣٥٧١٥‬‬ ‫ﻣﺼﺮ ﺍﻟﺴﻔﻠﻲ‬
‫‪٧,٧‬‬ ‫‪٤٥٢٥‬‬ ‫‪٥,٥‬‬ ‫‪٤٥٩٥‬‬ ‫ﺍﳉﻴﺰﺓ‬
‫‪٣,١‬‬ ‫‪١٨٣٦‬‬ ‫‪١,٩‬‬ ‫‪١٦٠٤‬‬ ‫ﺑﲎ ﺳﻮﻳﻒ‬
‫‪٣,٤‬‬ ‫‪١٩٩٥‬‬ ‫‪٢,٣‬‬ ‫‪١٨٩٦‬‬ ‫ﺍﻟﻔﻴﻮﻡ‬
‫‪٥,٧‬‬ ‫‪٣٣٧٢‬‬ ‫‪٥,٤‬‬ ‫‪٤٥٣٦‬‬ ‫ﺍﳌﻨﻴﺎ‬
‫‪٤,٨‬‬ ‫‪٢٨٤٣‬‬ ‫‪٥,٥‬‬ ‫‪٤٦١٨‬‬ ‫ﺃﺳﻴﻮﻁ‬
‫‪٥,٣‬‬ ‫‪٣١٣٦‬‬ ‫‪٤,٠‬‬ ‫‪٣٣٣١‬‬ ‫ﺳﻮﻫﺎﺝ‬
‫‪٤,٧‬‬ ‫‪٢٧٦٦‬‬ ‫‪٢,٠‬‬ ‫‪١٦٦٥‬‬ ‫ﻗﻨﺎ‬
‫‪٠,٢‬‬ ‫‪١٥٩‬‬ ‫‪٠,٤‬‬ ‫‪٢٨٦‬‬ ‫ﺍﻷﻗﺼﺮ‬
‫‪١,٨‬‬ ‫‪١٠٤٢‬‬ ‫‪١,٧‬‬ ‫‪١٤٢٣‬‬ ‫ﺃﺳﻮﺍﻥ‬
‫‪٣٦,٧‬‬ ‫‪٢١٦٧٤‬‬ ‫‪٢٨,٧‬‬ ‫‪٢٣٩٥٤‬‬ ‫ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‬
‫‪٠,٢‬‬ ‫‪١٢٠‬‬ ‫‪٠,٣‬‬ ‫‪٢٥٠‬‬ ‫ﺍﻟﺒﺤﺮ ﺍﻷﲪﺮ‬
‫‪٠,٢‬‬ ‫‪١٣٦‬‬ ‫‪٠,٥‬‬ ‫‪٤٣٠‬‬ ‫ﺍﻟﻮﺍﺩﻱ ﺍﳉﺪﻳﺪ‬
‫‪٠,٣‬‬ ‫‪١٨٦‬‬ ‫‪٠,٤‬‬ ‫‪٣٤٤‬‬ ‫ﻣﻄﺮﻭﺡ‬
‫‪٠,٤‬‬ ‫‪٢١٩‬‬ ‫‪٠,٤‬‬ ‫‪٣٥١‬‬ ‫ﴰﺎﻝ ﺳﻴﻨﺎﺀ‬

‫‪١٢٣‬‬
 ‫‪%‬‬ ‫ﻋﺪﺩ ﺍﻟﺴﻜﺎﻥ‬ ‫‪%‬‬ ‫ﻋﺪﺩ ﺍﻷﺳﺮﺓ‬ ‫ﺍﶈﺎﻓﻈﺔ‬
‫‪٠,١‬‬ ‫‪٣٥‬‬ ‫‪٠,٢‬‬ ‫‪١٣٧‬‬ ‫ﺟﻨﻮﺏ ﺳﻴﻨﺎﺀ‬
‫‪١,٢‬‬ ‫‪٦٩٦‬‬ ‫‪١,٨‬‬ ‫‪١٥١٢‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ‬
‫‪١٠٠‬‬ ‫‪٥٩٠٤٧‬‬ ‫‪١٠٠‬‬ ‫‪٨٣٤٢١‬‬ ‫ﻣﺼﺮ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ ﻭﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪.‬‬

‫ﺍﳉﺪﻭﻝ )‪ :(١٨‬ﺗﻮﺯﻳﻊ ﺍﺳﺘﺜﻤﺎﺭ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻋﻠﻰ ﳏﺎﻓﻈﺎﺕ ﺍﳉﻤﻬﻮﺭﻳﺔ )‪-١٩٩٨/٩٧‬‬
‫‪(٢٠٠٢/٢٠٠١‬‬
‫ﺗﻮﺯﻳﻊ ﺍﻟﺴﻜﺎﻥ‬ ‫ﺍﻻﺳﺘﺜﻤﺎﺭ )‪(٠٠٠‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ‬
‫‪١٩,٨‬‬ ‫‪٤١٥٤٠٠‬‬ ‫ﺍﻟﻘﺎﻫﺮﺓ‬
‫‪٤‬‬ ‫‪٨٤٥٦٥‬‬ ‫ﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬
‫‪١,٧‬‬ ‫‪٣٥٣٨٠‬‬ ‫ﺑﻮﺭ ﺳﻌﻴﺪ‬
‫‪١,٥‬‬ ‫‪٣١٢٤٥‬‬ ‫ﺍﻟﺴﻮﻳﺲ‬
‫‪٢٧‬‬ ‫‪٥٦٦٥٩٠‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪٤,٨‬‬ ‫‪٩٩٧٩٥‬‬ ‫ﺩﻣﻴﺎﻁ‬
‫‪٣,٨‬‬ ‫‪٨٠٤٢٥‬‬ ‫ﺍﻟﺪﻗﻬﻠﻴﺔ‬
‫‪٦‬‬ ‫‪١٢٤٩٥٥‬‬ ‫ﺍﻟﺸﺮﻗﻴﺔ‬
‫‪٦‬‬ ‫‪١٢٥٣٧٥‬‬ ‫ﺍﻟﻘﻠﻴﻮﺑﻴﺔ‬
‫‪١,٩‬‬ ‫‪٣٩٤٩٠‬‬ ‫ﻛﻔﺮ ﺍﻟﺸﻴﺦ‬
‫‪٢‬‬ ‫‪٤٢١٨٥‬‬ ‫ﺍﻟﻐﺮﺑﻴﺔ‬
‫‪٤,٦‬‬ ‫‪٩٥٤٢٥‬‬ ‫ﺍﳌﻨﻮﻓﻴﺔ‬
‫‪٤,١‬‬ ‫‪٨٦٣٢٥‬‬ ‫ﺍﻟﺒﺤﲑﺓ‬
‫‪٣,٦‬‬ ‫‪٧٦٨١٥‬‬ ‫ﺍﻹﲰﺎﻋﻴﻠﻴﺔ‬
‫‪٣٦,٨‬‬ ‫‪٧٧٠٧٩٠‬‬ ‫ﻣﺼﺮ ﺍﻟﺴﻔﻠﻲ‬
‫‪١٢,٥‬‬ ‫‪٢٦٢٦٠٥‬‬ ‫ﺍﳉﻴﺰﺓ‬
‫‪١,٤‬‬ ‫‪٢٨٨١٠‬‬ ‫ﺑﲎ ﺳﻮﻳﻒ‬
‫‪١,٥‬‬ ‫‪٣١٦٠٠‬‬ ‫ﺍﻟﻔﻴﻮﻡ‬
‫‪٢,١‬‬ ‫‪٤٣٠٦٥‬‬ ‫ﺍﳌﻨﻴﺎ‬
‫‪٢‬‬ ‫‪٤٢٢٠٠‬‬ ‫ﺃﺳﻴﻮﻁ‬
‫‪٢,٩‬‬ ‫‪٦١٤٣٥‬‬ ‫ﺳﻮﻫﺎﺝ‬
‫‪٢,٢‬‬ ‫‪٤٥١٧٥‬‬ ‫ﻗﻨﺎ‬
‫‪١,٣‬‬ ‫‪٢٧٤٠٠‬‬ ‫ﺍﻷﻗﺼﺮ‬
‫‪١,٢‬‬ ‫‪٢٤٨٧٥‬‬ ‫ﺃﺳﻮﺍﻥ‬
‫‪٢٧,١‬‬ ‫‪٥٦٧١٦٥‬‬ ‫ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‬
‫‪١,٦‬‬ ‫‪٣٣٣٤٠‬‬ ‫ﺍﻟﺒﺤﺮ ﺍﻷﲪﺮ‬
‫‪١,٤‬‬ ‫‪٢٩١٥٠‬‬ ‫ﺍﻟﻮﺍﺩﻱ ﺍﳉﺪﻳﺪ‬
‫‪١,٤‬‬ ‫‪٢٨٨٦٠‬‬ ‫ﻣﻄﺮﻭﺡ‬
‫‪١,١‬‬ ‫‪٢٣٤٨٠‬‬ ‫ﺳﻴﻨﺎﺀ ﺍﻟﺸﻤﺎﻟﻴﺔ‬
‫‪٣,٦‬‬ ‫‪٧٦٢٧٥‬‬ ‫ﺳﻴﻨﺎﺀ ﺍﳉﻨﻮﺑﻴﺔ‬
‫‪٩,١‬‬ ‫‪١٩١١٠٥‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ‬
‫‪١٠٠‬‬ ‫‪٢٠٩٥٦٥٠‬‬ ‫ﻣﺼﺮ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﻟﺘﺨﻄﻴﻂ )‪.(١٩٩٧‬‬

‫‪١٢٤‬‬
 ‫ﺍﳉﺪﻭﻝ )‪ :(١٩‬ﻣﻌﺪﻻﺕ ﺍﻻﺳﺘﺨﺪﺍﻡ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻭﺍﳌﺮﻛﺰﻳﺔ‬
‫ﻣﻌﺪﻝ ﺍﻹﺷﻐﺎﻝ ﻟﻸﺳﺮ‪‬ﺓ‬ ‫ﻣﻌﺪﻝ ﺍﻹﺷﻐﺎﻝ ﺍﻷﺳﺮ‪‬ﺓ ﰲ‬
‫ﺍﻟﺴﻨﺔ‬ ‫ﺍﻟﺴﻨﺔ‬
‫ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ‬ ‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ‬
‫‪٥٦,٩٦‬‬ ‫‪١٩٨٨‬‬ ‫‪٥٠,١٥‬‬ ‫‪١٩٨١‬‬
‫‪٤٧,٩٦‬‬ ‫‪١٩٨٩‬‬ ‫‪٦٢‬‬ ‫‪١٩٨٢‬‬
‫‪٤٨,٤٩‬‬ ‫‪١٩٩٠‬‬ ‫‪٦٩‬‬ ‫‪١٩٨٣‬‬
‫‪٤٩,١٧‬‬ ‫‪١٩٩١‬‬ ‫‪٦٣‬‬ ‫‪١٩٨٤‬‬
‫‪٤٢,٨٧‬‬ ‫‪١٩٩٢‬‬ ‫‪٥٤,٩٥‬‬ ‫‪١٩٨٥‬‬
‫‪٤٣,٩٤‬‬ ‫‪١٩٩٣‬‬ ‫‪٦٣,٣٣‬‬ ‫‪١٩٨٦‬‬
‫‪٤٢,٢٨‬‬ ‫‪١٩٩٤‬‬ ‫‪٥٣,٣٩‬‬ ‫‪١٩٨٧‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﺑﻴﺎﻧﺎﺕ ﻏﲑ ﻣﻨﺸﻮﺭﺓ‪.‬‬

‫‪١٢٥‬‬

1
‫ ﺑﺎﻟﻠﻐﺔ ﺍﻟﻌﺮﺑﻴﺔ‬:‫ﺃﻭﻻ‬
.١٩٩٦ .‫ﺎﻟﺲ ﺍﻟﻘﻮﻣﻴﺔ ﺍﳌﺘﺨﺼﺼﺔ‬‫ ﺍ‬.١
.‫ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ‬.١٩٩٨ .‫ ﳎﻠﺲ ﺍﻟﺸﻮﺭﻯ‬.٢
.١٩٩٨/٩٧ ‫ ﺍﳋﻄﺔ ﺍﻟﻘﻮﻣﻴﺔ‬.١٩٩٨ .‫ ﻭﺯﺍﺭﺓ ﺍﻟﺘﺨﻄﻴﻂ‬.٣

‫ ﺑﺎﻟﻠﻐﺔ ﺍﻹﳒﻠﻴﺰﻳﺔ‬:‫ﺛﺎﻧﻴﺎ‬
1. Berman, Peter. 1995. The Financing of Health Services in Egypt, DDM-
Data for Decision Making. Egypt: Strategies for Health Sector, Change,
Harvard University, USAID.
2. Des Rochers. 1996. Health Care Financing, Egypt’s. World Bank’s Health
Sector Reconnaissance Mission.
3. Human Research Center for AID Egypt. 1996. "Social Vulnerability and
Health Reform” Abt Associates, University Research Cooperation.
4. Institute National Planning (INP). 1996. Human Development Report, Egypt.
5. Kemprecos, L. 1993. Health Care Financing in Egypt, Cost Recovery For
Health Project, Cambridge Consulting Cooperation.
6. Nassar, H. 1995. Health and Development. INP Egypt Human
Development Background Paper.

١٢٦
 ‫
 
‪:‬‬
‫ 
    
 
 ‬
‫‪" # $%& .! .‬‬

‫ﻟﻦ ﻧﺴﺘﻔﻴﺾ ﰲ ﺍﳊﺪﻳﺚ ﻋﻦ ﺃﳘﻴﺔ ﺍﳌﻌﻠﻮﻣﺎﺕ ﰲ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭ ﺍﻟﺮﺷﻴﺪ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ‪،‬‬
‫ﻓﻘﺪ ﺃﺻﺒﺤﺖ ﻫﺬﻩ ﺍﳊﻘﻴﻘﺔ ﻣﻦ ﺍﻷﻣﻮﺭ ﺍﳌﺴﻠﻢ ‪‬ﺎ ﻋﻠﻰ ﻧﻄﺎﻕ ﻭﺍﺳﻊ‪ .‬ﻭﻳﺒﺪﻭ ﺃﻥ ﺇﺩﺭﺍﻙ ﻗﻴﻤﺔ ﺍﳌﻌﻠﻮﻣﺎﺕ‬
‫ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻟﻴﺲ ﺑﺎﻷﻣﺮ ﺍﳌﺴﺘﺤﺪﺙ ﻛﻤﺎ ﻗﺪ ﻳﻈﻦ ﺍﻟﺒﻌﺾ‪ ،‬ﻭﻟﻜﻨﻪ ﻭﺍﻛﺐ ﺗﻄﻮﺭ ﻭﳕﻮ ﻧﻈﺎﻡ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳊﺪﻳﺚ ﰲ ﻣﺼﺮ ﻣﻨﺬ ﻧﺸﺄﺗﻪ ﰲ ﻣﻄﻠﻊ ﺍﻟﻘﺮﻥ ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ‪ ،‬ﻛﻤﺎ ﺳﻴﺘﻀﺢ ﻣﻦ‬
‫ﺍﳌﻮﺟﺰ ﺍﻟﺘﺎﺭﳜﻲ ﺍﻟﻮﺍﺭﺩ ﰲ ﻫﺬﺍ ﺍﻟﻔﺼﻞ‪.‬‬

‫!) 
( 
'‬
‫ﻫﻨﺎﻙ ﻣﺼﺪﺭﺍﻥ ﺭﺋﻴﺴﻴﺎﻥ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ ﻭﳘﺎ‪ :‬ﺍﻟﺴﺠﻼﺕ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ ﻭﺍﳌﺴﻮﺡ ﺍﳋﺎﺻﺔ‪.‬‬
‫ﻭﺍﻟﺴﺠﻼﺕ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ ﻧﻌﲏ ‪‬ﺎ ﺍﻟﺴﺠﻼﺕ ﺍﻟﱵ ﺗﻘﺘﻀﻲ ﺍﻟﻘﻮﺍﻧﲔ ﻭﺍﻟﻠﻮﺍﺋﺢ ﺍﳌﻨﻈﻤﺔ ﻟﻠﻌﻤﻞ‬
‫ﺍﺳﺘﻴﻔﺎﺀﻫﺎ ﺑﺸﻜﻞ ﻣﻨﺘﻈﻢ ﻭﺫﻟﻚ ﳋﺪﻣﺔ ﺃﻏﺮﺍﺽ ﻣﻌﻠﻮﻣﺎﺗﻴﺔ ﻭﺃﻏﺮﺍﺽ ﺃﺧﺮﻯ )ﻗﺎﻧﻮﻧﻴﺔ‪ ،‬ﺇﺩﺍﺭﻳﺔ‪ ،‬ﺍﱁ‪.(....‬‬
‫ﻭﻻ ﺗﻌﲏ ﻛﻠﻤﺔ "ﺭﻭﺗﻴﻨﻴﺔ" ﺍﳌﻌﲎ ﺍﻟﺴﻠﱯ ﺍﻟﺬﻱ ﺍﻟﺘﺼﻖ ‪‬ﺎ ﰲ ﳎﺘﻤﻌﻨﺎ ﻣﻦ ﲨﻮﺩ ﻭﺗﻌﻮﻳﻖ‬
‫ﻭﺳﻄﺤﻴﺔ ﻭﻣﻈﻬﺮﻳﺔ ﺍﻫﺘﻤﺎﻡ ﺑﺎﻟﺸﻜﻞ ﻋﻠﻰ ﺣﺴﺎﺏ ﺍﳉﻮﻫﺮ ﻭﺍﳌﻀﻤﻮﻥ ﻭﺑﺎﻟﺘﺎﱄ ﻋﺪﻡ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ‬
‫ﺻﺪﻕ ﻭﺩﻗﺔ ﺍﻟﺒﻴﺎﻧﺎﺕ ﰲ ﺍ‪‬ﺎﻝ ﺍﳌﻌﻠﻮﻣﺎﰐ ﻣﺎ ﺩﺍﻡ ﺍﻟﺸﻜﻞ ﻣﺴﺘﻮﰲ ﻃﺒﻘﺎﹰ ﻟﻠﺘﻌﻠﻴﻤﺎﺕ‪.‬‬
‫ﻭﺍﻟﺴﺠﻼﺕ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ ﰲ ﻛﺎﻓﺔ ﺩﻭﻝ ﺍﻟﻌﺎﱂ ﻫﻲ ﻣﺼﺪﺭ ﺭﺋﻴﺴﻲ )ﺑﻞ ﺍﳌﺼﺪﺭ ﺍﻟﺮﺋﻴﺴﻲ( ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﰲ‬
‫ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ‪ .‬ﻓﻬﺬﻩ ﺍﻟﺴﺠﻼﺕ ﺍﻟﱵ ﺗﺘﻀﻤﻦ ﺗﺴﺠﻴﻼﹰ ﻣﻨﺘﻈﻤﺎﹰ ﻟﻠﻤﻮﺍﻟﻴﺪ ﻭﺍﻟﻮﻓﻴﺎﺕ ﻭﻭﻗﺎﺋﻊ ﺣﺪﻭﺙ‬
‫ﺍﳌﺮﺽ )ﺃﻣﺮﺍﺽ ﻣﻌﺪﻳﺔ – ﺃﻣﺮﺍﺽ ﻏﲑ ﻣﻌﺪﻳﺔ – ﺇﺻﺎﺑﺎﺕ( ﻭﻧﺸﺎﻁ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﻌﻤﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﻭﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺘﺤﻜﻤﺔ ﰲ ﺣﺪﻭﺙ ﺍﳌﺮﺽ ﻭﺍﻟﻮﻓﺎﺓ‪ ،‬ﻛﺎﻧﺖ ﻭﺳﺘﻈﻞ ﻣﺼﺪﺭﺍﹰ ﳑﺘﺎﺯﺍﹰ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﰲ ﺍﻟﻘﻄﺎﻉ‬
‫ﺍﻟﺼﺤﻲ‪ .‬ﻭﺇﺫﺍ ﻗﺎﺭﻧﺎﻫﺎ ﺑﺎﳌﺼﺪﺭ ﺍﻟﺮﺋﻴﺴﻲ ﺍﻵﺧﺮ ﻭﻫﻮ ﺍﳌﺴﻮﺡ ﺍﳋﺎﺻﺔ‪ ،‬ﻓﺈ‪‬ﺎ ﺗﻨﻔﺮﺩ ﺑﻌﺪﺓ ﻣﺰﺍﻳﺎ ﻣﻨﻬﺎ ﻣﺎ‬
‫ﻳﻠﻲ‪:‬‬
‫ﺃﻭﻻﹰ‪ :‬ﺍﻟﺸﻤﻮﻝ‪ ،‬ﻓﻬﻲ ﺗﺸﻤﻞ )ﺃﻭ ﻣﻔﺘﺮﺽ ﺃﻥ ﺗﺸﻤﻞ( ﻛﺎﻓﺔ ﺍﻟﻮﻗﺎﺋﻊ ﰲ ﺍ‪‬ﺎﻝ ﻣﻮﺿﻊ ﺍﻟﺘﺴﺠﻴﻞ ﻭﻟﻴﺲ‬
‫ﻋﻴﻨﺔ ﻣﻦ ﻫﺬﻩ ﺍﻟﻮﻗﺎﺋﻊ‪ .‬ﺃﻣﺎ ﺍﳌﺴﻮﺡ ﻓﻬﻲ ﻋﺎﺩﺓ ﺗﺘﻢ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻌﻴﻨﺔ‪ ،‬ﳑﺎ ﻳﻄﺮﺡ ﺩﺍﺋﻤﺎﹰ ﳎﺎﻻﹰ ﻟﻠﺘﺴﺎﺅﻝ‬
‫ﻋﻦ ﺩﻗﺔ ﲤﺜﻴﻞ ﺍﻟﻌﻴﻨﺔ ﻭﺑﺎﻟﺘﺎﱄ ﺇﻣﻜﺎﻧﻴﺔ ﺍﻟﺘﻌﻤﻴﻢ ﻣﻦ ﻧﺘﺎﺋﺠﻬﺎ ﻟﻠﻤﺠﺘﻤﻊ ﺑﺄﻛﻤﻠﻪ ﻭﻛﺬﻟﻚ ﻛﻔﺎﻳﺔ‬
‫ﺣﺠﻢ ﺍﻟﻌﻴﻨﺔ ﻭﺑﺎﻟﺘﺎﱄ ﻣﺪﻯ ﻫﺎﻣﺶ ﺍﳋﻄﺄ ﰲ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ‪.‬‬
‫ﺛﺎﻧﻴﺎﹰ‪ :‬ﺍﻻﺳﺘﻤﺮﺍﺭﻳﺔ ﺍﻟﺰﻣﻨﻴﺔ – ﻓﺎﳉﻤﻊ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﺴﺠﻼﺕ ﻳﺘﻢ ﺑﺸﻜﻞ ﺩﺍﺋﻢ‪ ،‬ﻳﺴﻤﺢ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﲔ‬
‫ﻓﺘﺮﺍﺕ ﺯﻣﻨﻴﺔ ﳐﺘﻠﻔﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﺍﳌﺴﻮﺡ ﺗﺘﻢ ﻋﻨﺪ ﻣﻘﻄﻊ ﺯﻣﲏ ﻣﻌﲔ ﺃﻭ ﻋﻨﺪ ﻣﻘﺎﻃﻊ ﺯﻣﻨﻴﺔ ﻣﻌﻴﻨﺔ‪،‬‬

‫‪١٢٧‬‬
‫ﺗﺴﻤﺢ ﺑﺎﳌﻘﺎﺭﻧﺔ ﻓﻘﻂ ﻋﻨﺪ ﻫﺬﻩ ﺍﳌﻘﺎﻃﻊ ﺍﻟﺰﻣﻨﻴﺔ‪ ،‬ﺃﻣﺎ ﻣﺎ ﺑﻴﻨﻬﺎ ﻓﺎﻷﻣﺮ ﻣﺘﺮﻭﻙ ﻟﻼﺳﺘﻨﺘﺎﺝ ﺍﻟﺮﻳﺎﺿﻲ‬
‫ﺑﺄﺳﺎﻟﻴﺐ ﳐﺘﻠﻔﺔ‪.‬‬
‫ﺛﺎﻟﺜﺎﹸ‪ :‬ﲢﻤﻴﻞ ﺍﻟﺘﻜﻠﻔﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻋﻠﻰ ﺍﻟﺒﻨﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻠﻤﺆﺳﺴﺔ – ﺍﺳﺘﻴﻔﺎﺀ‬
‫ﺍﻟﺴﺠﻼﺕ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ ﻳﻘﻮﻡ ﺑﻪ ﻋﺎﺩﺓ ﻋﺎﻣﻠﻮﻥ ﺑﺎﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺿﻤﻦ ﺃﻧﺸﻄﺘﻬﻢ ﺍﳌﻌﺘﺎﺩﺓ ﺍﻟﻴﻮﻣﻴﺔ‬
‫ﻭﺑﺸﺄﻥ ﻫﺬﻩ ﺍﻷﻧﺸﻄﺔ ﳑﺎ ﳜﻔﺾ ﺗﻜﻠﻔﺔ ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ‪ .‬ﻛﻤﺎ ﺃﻥ ﲨﻊ ﻫﺬﻩ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻟﻴﺲ ﻓﻘﻂ‬
‫ﻟﻸﻏﺮﺍﺽ ﺍﳌﻌﻠﻮﻣﺎﺗﻴﺔ ﺑﻞ ﺇﻧﻪ ﳜﺪﻡ ﺃﻏﺮﺍﺿﺎﹰ ﺃﺧﺮﻯ ﻛﺎﳊﻔﺎﻅ ﻋﻠﻰ ﺣﻘﻮﻕ ﻗﺎﻧﻮﻧﻴﺔ ﺃﻭ ﺇﺩﺍﺭﻳﺔ ﻟﻠﻤﺆﺳﺴﺔ ﺃﻭ‬
‫ﻟﻸﻓﺮﺍﺩ ﺍﻟﻌﺎﻣﻠﲔ ‪‬ﺎ ﺃﻭ ﺍﻷﻓﺮﺍﺩ ﺍﳌﻨﺘﻔﻌﲔ ﲞﺪﻣﺎ‪‬ﺎ ﳑﺎ ﻳﻌﻈﻢ ﻣﻦ ﻋﺎﺋﺪ ﺗﻜﻠﻔﺔ ﲨﻊ ﺍﻟﺒﻴﺎﻥ‪ ،‬ﺑﻴﻨﻤﺎ‬
‫ﺍﳌﺴﻮﺡ ﲢﺘﺎﺝ ﻟﺘﺼﻤﻴﻢ ﺧﺎﺹ ﻭﺗﻨﻈﻴﻢ ﺧﺎﺹ ﻭﺑﺎﻟﺘﺎﱄ ﺗﻜﻠﻔﺔ ﻭﺍﻋﺘﻤﺎﺩﺍﺕ ﻣﺎﻟﻴﺔ ﺇﺿﺎﻓﻴﺔ‪.‬‬
‫ﺭﺍﺑﻌﺎﹰ‪ :‬ﲣﺼﺺ ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﺳﺘﻴﻔﺎﺀ ﺍﻟﺴﺠﻼﺕ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ – ﻓﺎﻟﺒﻴﺎﻧﺎﺕ ﻳﺘﻢ ﲨﻌﻬﺎ ﺑﻮﺍﺳﻄﺔ‬
‫ﻋﺎﻣﻠﲔ ﰲ ﳎﺎﻝ ﻧﺸﺎﻃﻬﻢ ﺍﻟﻴﻮﻣﻲ ﺍﻟﺬﻱ ﻣﺎﺭﺳﻮﻩ ﻟﻔﺘﺮﺓ ﻃﻮﻳﻠﺔ ﻭﻳﺄﻟﻔﻮﻧﻪ ﲤﺎﻣﺎﹰ‪ ،‬ﺑﻴﻨﻤﺎ ﺍﳌﺴﻮﺡ ﺗﺘﻢ‬
‫ﺑﻮﺍﺳﻄﺔ ﺃﻓﺮﺍﺩ ﻳﺘﻢ ﺗﺪﺭﻳﺒﻬﻢ ﺧﺼﻴﺼﺎﹰ ﳍﺬﺍ ﺍﻟﻐﺮﺽ ﻭﺭﲟﺎ ﻳﻜﻮﻥ ﺍ‪‬ﺎﻝ ﺟﺪﻳﺪﺍﹰ ﲤﺎﻣﺎﹰ ﺑﺎﻟﻨﺴﺒﺔ ﳍﻢ‪.‬‬
‫ﻛﻤﺎ ﺃﻥ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﳌﺆﺳﺴﺔ ﻋﻨﺪ ﺍﺳﺘﻴﻔﺎﺋﻬﻢ ﻟﻠﺴﺠﻼﺕ ﻳﺸﻌﺮﻭﻥ )ﺃﻭ ﻳﻨﺒﻐﻲ ﺃﻥ ﻳﺸﻌﺮﻭﺍ( ﺃﻥ ﻣﺎ‬
‫ﳚﻤﻌﻮﻧﻪ ﻭﻳﺴﺠﻠﻮﻧﻪ ﻣﻦ ﺑﻴﺎﻧﺎﺕ ﺳﻴﻔﻴﺪﻫﻢ ﺷﺨﺼﻴﺎﹰ ﰲ ﺗﻄﻮﻳﺮ ﺃﺩﺍﺋﻬﻢ ﺍﻟﻮﻇﻴﻔﻲ ﻭﺃﺩﺍﺀ ﻣﺆﺳﺴﺎ‪‬ﻢ‪،‬‬
‫ﻭﺍﻷﻣﺮ ﳐﺘﻠﻒ ﺑﺎﻟﻨﺴﺒﺔ ﳌﻦ ﻳﻌﻤﻞ ﰲ ﻣﺴﺢ ﻣﻦ ﺍﳌﺴﻮﺡ ﻟﻔﺘﺮﺓ ﻣﻌﻴﻨﺔ ﳊﺴﺎﺏ ﻣﺆﺳﺴﺔ ﻣﻌﻴﻨﺔ ﻭﻟﻦ‬
‫ﺗﺘﺎﺡ ﻟﻪ ﺷﺨﺼﻴﺎﹰ ﻓﺮﺻﺔ ﺍﻻﺳﺘﻔﺎﺩﺓ ﻣﻦ ﻧﺘﺎﺋﺞ ﺍﳌﺴﺢ‪ ،‬ﻭﺑﺎﻟﺘﺎﱄ ﻳﻘﻞ ﻋﻨﺪﻩ ﺍﳊﺎﻓﺰ ﺍﻟﺸﺨﺼﻲ‪.‬‬
‫ﺧﺎﻣﺴﺎﹰ‪ :‬ﺗﻘﺒﻞ ﺍﻷﻓﺮﺍﺩ ﺍﻟﺬﻳﻦ ﻳﺘﻢ ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻣﻨﻬﻢ ﳍﺬﺍ ﺍﻹﺟﺮﺍﺀ – ﻳﺘﻢ ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ‬
‫ﺑﺸﻜﻞ ﺗﻠﻘﺎﺋﻲ ﻟﻠﺴﺠﻼﺕ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ‪ ،‬ﻓﺎﳌﻮﺍﻃﻦ ﻳﻘﺪﻡ ﺑﻨﻔﺴﻪ ﻟﻺﺑﻼﻍ ﻋﻦ ﺣﺎﻻﺕ ﺍﳌﻴﻼﺩ ﻭﺍﻟﻮﻓﺎﺓ‪ ،‬ﻛﻤﺎ ﺃﻥ‬
‫ﺍﳌﺮﻳﺾ ﻳﺮﻯ ﺃﻧﻪ ﻣﻦ ﺍﳌﻨﻄﻘﻲ ﺍﻹﺟﺎﺑﺔ ﻋﻦ ﺃﻳﺔ ﺃﺳﺌﻠﺔ ﺗﻮﺟﻪ ﺇﻟﻴﻪ ﺑﺸﺄﻥ ﺣﺎﻟﺘﻪ‪ ،‬ﻭﺍﻟﻌﺎﻣﻠﻮﻥ ﺑﺎﳌﺆﺳﺴﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﻳﺮﻭﻥ ﺃﻧﻪ ﻣﻦ ﺍﻟﻄﺒﻴﻌﻲ ﺃﻥ ﻳﻘﺪﻣﻮﺍ ﺃﻳﺔ ﺑﻴﺎﻧﺎﺕ ﺗﻄﻠﺒﻬﺎ ﺟﻬﺔ ﻋﻤﻠﻬﻢ ﻣﻨﻬﻢ‪ ،‬ﺑﻴﻨﻤﺎ ﰲ‬
‫ﺍﳌﺴﻮﺡ ﺑﺎﻟﻌﻴﻨﺔ ﳛﺘﺎﺝ ﺍﻷﻣﺮ ﳉﻬﺪ ﻹﻗﻨﺎﻉ ﺍﳌﺴﺘﺠﻴﺐ ﲟﱪﺭﺍﺕ ﺍﻟﺒﺤﺚ ﻭﻓﻮﺍﺋﺪﻩ‪ ،‬ﻭﳌﺎﺫﺍ ﻭﻗﻊ ﻋﻠﻴﻪ ﺍﻻﺧﺘﻴﺎﺭ‬
‫ﻫﻮ ﺷﺨﺼﻴﺎﹰ ﺩﻭﻥ ﻏﲑﻩ ﻟﺘﻮﺟﻴﻪ ﺍﻷﺳﺌﻠﺔ ﻋﻠﻴﻪ ﳑﺎ ﻗﺪ ﻳﺆﺛﺮ ﻋﻠﻰ ﺗﻘﺒﻠﻪ ﻟﻼﺳﺘﺠﺎﺑﺔ ﲟﺎ ﻳﺘﺮﺍﻭﺡ ﻣﻦ ﻋﺪﻡ‬
‫ﺍﻻﻛﺘﺮﺍﺙ ﺇﱃ ﺣﺠﺐ ﺑﻌﺾ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺇﱃ ﺍﻟﺮﻓﺾ ﺍﻟﺼﺮﻳﺢ ﻟﻠﺘﻌﺎﻭﻥ‪.‬‬
‫ﻭﻣﻦ ﻧﺎﺣﻴﺔ ﺃﺧﺮﻯ‪ ،‬ﻓﻬﻨﺎﻙ ﻣﺰﺍﻳﺎ ﻟﻠﻤﺴﻮﺡ ﺍﳋﺎﺻﺔ ﻋﻠﻰ ﺍﻟﺴﺠﻼﺕ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ‪) ،‬ﺑﻞ ﺇﻥ ﺑﻌﺾ ﻣﺰﺍﻳﺎ‬
‫ﺍﻟﺴﺠﻼﺕ ﻗﺪ ﺗﻨﻘﻠﺐ ﰲ ﺣﺎﻻﺕ ﻣﻌﻴﻨﺔ ﺇﱃ ﻋﻴﻮﺏ(‪ .‬ﻭﳒﻤﻞ ﻣﺰﺍﻳﺎ ﺍﳌﺴﺢ ﻛﻤﺪﺧﻞ ﳉﻤﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻓﻴﻤﺎ‬
‫ﻳﻠﻲ‪:‬‬
‫ﺃﻭﻻﹰ‪ :‬ﲨﻊ ﺑﻴﺎﻧﺎﺕ ﻏﲑ ﻣﺘﻀﻤﻨﺔ ﺑﺎﻟﺴﺠﻼﺕ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ – ﻓﺎﻟﺴﺠﻼﺕ ﺍﻟﺮﻭﺗﻴﻨﻴﺔ ﻻ ﺗﺘﻀﻤﻦ‬
‫ﻋﺎﺩﺓ ﺇﻻ ﻋﺪﺩﺍﹰ ﳏﺪﻭﺩﺍﹰ ﻣﻦ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﺣﱴ ﻳﺘﺴﲎ ﲨﻌﻬﺎ ﻣﻦ ﺍﻟﻜﺎﻓﺔ‪ .‬ﻭﻫﻲ ﻋﺎﺩﺓ ﺑﻴﺎﻧﺎﺕ ﻻ‬
‫ﺗﺘﻄﻠﺐ ﻣﻬﺎﺭﺓ ﻛﺒﲑﺓ ﰲ ﲨﻌﻬﺎ‪.‬‬
‫ﺛﺎﻧﻴﺎﹰ‪ :‬ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺑﻜﻔﺎﺀﺓ ﺃﻛﱪ ﻭﺩﻗﺔ ﺃﻋﻠﻰ – ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﻋﻴﻨﺔ ﳏﺪﺩﺓ ﻣﻦ ﺍ‪‬ﺘﻤﻊ ﻳﺴﻤﺢ‬
‫ﲜﻮﺩﺓ ﺑﻴﺎﻧﺎﺕ ﻋﺎﻟﻴﺔ ﺍﳉﻮﺩﺓ ﺑﻮﺍﺳﻄﺔ ﺃﻓﺮﺍﺩ ﻣﺪﺭﺑﲔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻋﺎﻝ ﻭﲢﺖ ﺇﺷﺮﺍﻑ ﺩﻗﻴﻖ ﻭﺿﺒﻂ ﳉﻮﺩﺓ‬
‫ﺍﻷﺩﺍﺀ )ﳝﻜﻨﻨﺎ ﺍﳌﻘﺎﺭﻧﺔ ﻣﺜﻼﹰ ﺑﲔ ﺩﻗﺔ ﺍﻟﻘﻴﺎﺳﺎﺕ ﺍﻷﻧﺜﺮﻭﺑﻮﻣﺘﺮﻳﺔ ﻣﻦ ﻃﻮﻝ ﻭﻭﺯﻥ ﻭﺧﻼﻓﻪ ﺍﻟﱵ ﻳﺘﻢ ﲨﻌﻬﺎ‬
‫ﰲ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﳌﺴﺤﻴﺔ ﺍﳋﺎﺻﺔ ﻣﺜﻞ ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺪﳝﻮﺟﺮﺍﰲ )‪ (DHS‬ﻭﺗﻠﻚ ﺍﻟﱵ ﻳﺘﻢ ﲨﻌﻬﺎ‬
‫ﺑﺸﻜﻞ ﺭﻭﺗﻴﲏ ﰲ ﻣﺮﺍﻛﺰ ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ ﺃﻭ ﺑﺮﺍﻣﺞ ﺍﻟﺼﺤﺔ ﺍﳌﺪﺭﺳﻴﺔ(‪ .‬ﻓﺮﻏﻢ ﺃﻥ ﺗﻜﺮﺍﺭ ﺍﳉﻤﻊ‬

‫‪١٢٨‬‬
‫ﻟﻨﻔﺲ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻳﻜﺴﺐ ﺟﺎﻣﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺧﱪﺓ‪ ،‬ﻓﺈﻧﻪ ﻗﺪ ﻳﺼﺎﺏ ﺑﺎﳌﻠﻞ ﻣﻊ ﻃﻮﻝ ﺍﻟﺰﻣﻦ ﻭﻳﻔﻘﺪ ﺍﳊﻤﺎﺱ‪،‬‬
‫ﺧﺼﻮﺻﺎﹰ ﺇﺫﺍ ﱂ ﻳﻜﻦ ﻳﺮﻯ ﻣﺮﺩﻭﺩﺍﹰ ﻭﺍﺿﺤﺎﹰ ﳉﻬﺪﻩ‪ .‬ﻭﺇﺫﺍ ﻛﺎﻥ ﻧﺸﺎﻁ ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻭﺗﺴﺠﻴﻠﻬﺎ ﻳﺘﻢ ﻋﻠﻰ‬
‫ﺣﺴﺎﺏ ﺃﻧﺸﻄﺔ ﺃﺧﺮﻯ ﻗﺪ ﻳﺮﺍﻫﺎ ﺃﻛﺜﺮ ﺃﳘﻴﺔ ﻭﺃﻗﺮﺏ ﺻﻠﺔ ﺑﺘﺨﺼﺼﻪ ﺍﳌﻬﲏ‪ ،‬ﻓﻘﺪ ﻳﺘﺮﺍﺟﻊ ﻣﺴﺘﻮﻯ‬
‫ﺍﻟﺪﻗﺔ ﻭﺍﻹﺗﻘﺎﻥ ﰲ ﺃﺩﺍﺋﻪ‪ ،‬ﺑﻴﻨﻤﺎ ﻣﻦ ﳚﻤﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﰲ ﻣﺸﺮﻭﻋﺎﺕ ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﻗﺪ ﻳﺮﻯ ﺃﻧﻪ ﻣﻘﺒﻞ‬
‫ﻋﻠﻰ ﺧﱪﺓ ﺟﺪﻳﺪﺓ ﻓﻴﻤﺎﺭﺱ ﻋﻤﻠﻪ ﺑﺸﻐﻒ ﻭﲪﺎﺱ ﻭﺭﻏﺒﺔ ﰲ ﲢﻘﻴﻖ ﺍﻟﺬﺍﺕ ﳑﺎ ﻳﺮﻓﻊ ﻣﺴﺘﻮﻯ ﺃﺩﺍﺋﻪ‪.‬‬
‫ﺛﺎﻟﺜﺎﹰ‪ :‬ﺍﻹﺟﺎﺑﺔ ﻋﻠﻰ ﺗﺴﺎﺅﻻﺕ ﳏﺪﺩﺓ ﺃﻭ ﻣﻮﺍﺟﻬﺔ ﻣﺸﻜﻠﺔ ﳏﺪﺩﺓ ﺗﺜﲑ ﺍﻫﺘﻤﺎﻡ‬
‫ﺍﳌﺨﻄﻄﲔ ﻭﺻﻨﺎﻉ ﺍﻟﻘﺮﺍﺭ ﻭﻳﺘﻢ ﲣﻄﻴﻂ ﺍﳌﺴﺢ ﺧﺼﻴﺼﺎﹰ ﻟﺒﺤﺜﻬﺎ‪.‬‬

‫
‪ * +),‬‬
‫ﻋﻨﺪﻣﺎ ﻧﺘﺤﺪﺙ ﻋﻦ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ‪ ،‬ﻓﺈﻥ ﺃﻭﻝ ﻣﺎ ﻳﺘﺒﺎﺩﺭ ﻟﺬﻫﻦ ﺍﻟﺒﻌﺾ ﻫﻮ ﻣﺼﺎﺩﺭ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻭﻫﻢ‬
‫ﳏﻘﻮﻥ ﰲ ﺫﻟﻚ ﺇﱃ ﺣﺪ ﻛﺒﲑ‪ ،‬ﻓﻼ ﺗﻮﺟﺪ ﻓﺎﺋﺪﺓ ﻣﻦ ﺃﻱ ﻧﻈﺎﻡ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﻣﺎ ﱂ ﻳﻜﻦ ﻣﺆﺳﺴﺎﹰ ﻋﻠﻰ‬
‫ﺑﻴﺎﻧﺎﺕ ﺩﻗﻴﻘﺔ ﻭﻣﻌﻠﻮﻣﺎﺕ ﺻﺤﻴﺤﺔ‪ .‬ﻭﻟﻜﻦ ﻳﻨﺒﻐﻲ ﺃﻥ ﻧﺘﺬﻛﺮ ﺃﻥ ﺍﳌﻌﻠﻮﻣﺔ ﻣﻦ ﺧﻼﻝ ﻣﻨﻈﻮﺭ ﺩﻳﻨﺎﻣﻴﻜﻲ‬
‫ﻣﺘﺤﺮﻙ ﻻ ﺍﳌﻨﻈﻮﺭ ﺍﻻﺳﺘﺎﺗﻴﻜﻲ ﺍﻟﺜﺎﺑﺖ‪ .‬ﻓﻬﻨﺎﻙ ﺩﻭﺭﺓ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﺗﺸﺒﻪ ﺩﻭﺭﺓ ﺍﳊﻴﺎﺓ ﻟﻠﻜﺎﺋﻦ ﺍﳊﻲ ﻭﳝﻜﻦ‬
‫ﺗﺼﻮﺭﻫﺎ ﻛﻤﺎ ﻳﻠﻲ‪:‬‬
‫‪ .١‬ﺍﻟﺘﺨﻄﻴﻂ ﺍﳌﻌﻠﻮﻣﺎﰐ‪ :‬ﻟﺘﺤﺪﻳﺪ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳌﻄﻠﻮﺏ ﲨﻌﻬﺎ ﻟﺪﻋﻢ ﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭ‪.‬‬
‫‪ .٢‬ﺍﻹﻋﺪﺍﺩ ﳉﻤﻊ ﺍﳌﻌﻠﻮﻣﺔ )ﻣﻦ ﺗﺼﻤﻴﻢ ﳕﺎﺫﺝ ﻭﺗﺪﺭﻳﺐ ﻭﺇﻋﻼﻡ‪ ،‬ﺍﱁ‪.(..‬‬
‫‪ .٣‬ﲨﻊ ﺍﳌﻌﻠﻮﻣﺔ )ﲟﺎ ﰲ ﺫﻟﻚ ﻋﻤﻠﻴﺎﺕ ﺿﺒﻂ ﺍﳉﻮﺩﺓ ﻭﺍﳌﺮﺍﺟﻌﺔ ﻭﺍﻟﺘﺪﻗﻴﻖ(‪.‬‬
‫‪ .٤‬ﲢﻠﻴﻞ ﺍﳌﻌﻠﻮﻣﺔ )ﺇﺩﺧﺎﻝ ﺑﻴﺎﻧﺎﺕ‪ ،‬ﲢﻠﻴﻞ ﺇﺣﺼﺎﺋﻲ‪ ،‬ﺍﱁ‪.(....‬‬
‫‪ .٥‬ﺍﺳﺘﻘﺮﺍﺀ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻭﺍﳋﻠﻮﺹ ﺑﺎﻻﺳﺘﻨﺘﺎﺟﺎﺕ‪.‬‬
‫‪ .٦‬ﻋﺮﺽ ﺍﻟﻨﺘﺎﺋﺞ ﻭﺗﻮﻓﲑﻫﺎ ﻟﺼﻨﺎﻉ ﺍﻟﻘﺮﺍﺭ ﻭﻏﲑﻫﻢ ﻣﻦ ﺍﳌﻬﺘﻤﲔ‪.‬‬
‫‪ .٧‬ﺗﺮﺷﻴﺪ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﻭﺍﻷﺳﺎﻟﻴﺐ ﺍﻟﺘﻨﻔﻴﺬﻳﺔ ﰲ ﺿﻮﺀ ﻣﺎ ﺗﻮﺍﻓﺮ ﻣﻦ ﻣﻌﻠﻮﻣﺎﺕ‪.‬‬
‫‪ .٨‬ﺗﻘﻴﻴﻢ ﺗﺄﺛﲑ ﺍﻟﺘﻌﺪﻳﻞ ﺍﻟﺬﻱ ﰎ ﰲ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻷﺳﺎﻟﻴﺐ ﺍﻟﺘﻨﻔﻴﺬﻳﺔ‪ ،‬ﻭﰲ ﺿﻮﺀ ﻫﺬﺍ ﺍﻟﺘﻘﻴﻴﻢ‬
‫ﻳﺘﻢ ﲢﺪﻳﺪ ﺟﺪﻳﺪ ﻟﻼﺣﺘﻴﺎﺟﺎﺕ ﺍﳌﻌﻠﻮﻣﺎﺗﻴﺔ ﳌﻮﺍﺟﻬﺔ ﺍﻟﻔﺠﻮﺍﺕ ﻭﺍﻟﺜﻐﺮﺍﺕ ﺍﻟﱵ ﻳﻈﻬﺮﻫﺎ‬
‫ﺍﻟﺘﻘﻴﻴﻢ‪ ،‬ﺃﻱ ﺃﻧﻨﺎ ﻧﻌﻮﺩ ﺛﺎﻧﻴﺔ ﻟﻠﺨﻄﻮﺓ ﺍﻷﻭﱃ ﻟﺘﺒﺪﺃ ﺍﻟﺪﻭﺭﺓ ﺍﳌﻌﻠﻮﻣﺎﺗﻴﺔ ﻣﻦ ﺟﺪﻳﺪ‪.‬‬
‫ﻭﺑﻌﺪ ﻫﺬﺍ ﺍﻟﺘﻘﺪﱘ ﻓﺈﻧﻨﺎ ﺳﻨﺘﻨﺎﻭﻝ ﰲ ﻫﺬﺍ ﺍﻟﻔﺼﻞ ﺑﺈﳚﺎﺯ ﺍﳌﻮﺿﻮﻋﺎﺕ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫‪ .١‬ﺗﻄﻮﺭ ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ‪.‬‬
‫‪ .٢‬ﺇﻋﺪﺍﺩ ﺍﻟﻜﻮﺍﺩﺭ ﺍﻟﺒﺸﺮﻳﺔ ﻟﻠﻌﻤﻞ ﰲ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ ﰲ ﻣﺼﺮ‪.‬‬
‫‪ .٣‬ﺍﳌﺴﻮﺡ ﺍﻟﺼﺤﻴﺔ ﻛﻤﺼﺎﺩﺭ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﰲ ﻣﺼﺮ‪.‬‬
‫‪ .٤‬ﺍﲡﺎﻫﺎﺕ ﺍﳌﺴﺘﻘﺒﻞ ﰲ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺼﺮ‪.‬‬

‫‪١٢٩‬‬
 ‫*)   
'  ‪-‬‬
‫ﻻ ﻳﻨﻔﺼﻞ ﺗﻄﻮﺭ ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻋﻦ ﺗﻄﻮﺭ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﻧﻔﺴﻪ‪ ،‬ﻭﻳﺘﺄﺛﺮ ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﰲ ﻛﻞ‬
‫ﻣﺮﺣﻠﺔ ﺑﺎﻟﻔﻠﺴﻔﺔ ﻭﺍﻟﻔﻜﺮ ﺍﳊﺎﻛﻤﲔ ﳍﺬﻩ ﺍﳌﺮﺣﻠﺔ‪ .‬ﻭﺍﳌﺼﺎﺩﺭ ﻗﻠﻴﻠﺔ ﻭﻣﻌﻈﻤﻬﺎ ﻏﲑ ﻣﻨﺸﻮﺭ ﺃﻭ ﻏﲑ‬
‫ﻣﺘﻮﺍﻓﺮ ﻟﻜﺘﺎﺑﺔ ﺗﺎﺭﻳﺦ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﲟﺼﺮ‪ ،‬ﻭﻟﻜﻦ ﰲ ﺣﺪﻭﺩ ﻣﺎ ﺃﻣﻜﻨﻨﺎ ﺍﻟﺘﻮﺻﻞ ﺇﻟﻴﻪ ﻣﻦ‬
‫ﺗﻘﺎﺭﻳﺮ ﻭﻣﺮﺍﺟﻊ ﻓﺈﻧﻨﺎ ﻧﻮﺟﺰ ﻫﺬﺍ ﺍﻟﺘﻄﻮﺭ ﻓﻴﻤﺎ ﻳﻠﻲ‪:‬‬
‫‪ -‬ﰲ ﻋﺼﺮ ﺍﻟﻮﺍﱄ ﳏﻤﺪ ﻋﻠﻲ ﺻﺪﺭﺕ ﻻﺋﺤﺔ ﺑﻘﻴﺪ ﺍﳌﻮﺍﻟﻴﺪ ﻭﺍﻟﻮﻓﻴﺎﺕ )ﻋﺎﻡ ‪.(١٨٣٨‬‬
‫‪ -‬ﰲ ﻋﺎﻡ ‪ ١٨٥١‬ﺃﻧﺸﺌﺖ ﺩﻓﺎﺗﺮ ﻟﻘﻴﺪ ﺍﳌﻄﻌﻤﲔ )ﺿﺪ ﺍﳉﺪﺭﻱ( ﰲ ﻣﻜﺎﺗﺐ ﺻﺤﺔ ﺍﻟﻘﺎﻫﺮﺓ‪.‬‬
‫‪ -‬ﰲ ﻋﺎﻡ ‪) ١٨٧٠‬ﺑﺘﺎﺭﻳﺦ ‪ ٢٢‬ﻣﺎﺭﺱ( ﻧﺸﺮﺕ ﺟﺮﻳﺪﺓ ﺍﻟﻮﻗﺎﺋﻊ ﺍﳌﺼﺮﻳﺔ ﺍﻟﺮﲰﻴﺔ ﺃﻭﻝ ﺇﺣﺼﺎﺀ ﻟﻠﻤﻮﺍﻟﻴﺪ‬
‫ﻭﺍﻟﻮﻓﻴﺎﺕ ﻭﻋﺪﺩ ﺍﻟﺬﻳﻦ ﻟﻘﺤﻮﺍ ﺿﺪ ﺍﳉﺪﺭﻱ ﻭﻋﺪﺩ ﺍﻟﺬﻳﻦ ﻋﻮﳉﻮﺍ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ )ﻛﺎﻥ ﻋﺪﺩ ﺍﳌﻮﺍﻟﻴﺪ‪:‬‬
‫‪ ١٩٥٢٢٤‬ﻣﻨﻬﻢ ‪ ١٠٢٩٢٨‬ﻣﻦ ﺍﻟﺬﻛﻮﺭ ﻭ‪ ٩٢٢٩٦‬ﻣﻦ ﺍﻹﻧﺎﺙ‪ ،‬ﻭﻋﺪﺩ ﺍﻟﻮﻓﻴﺎﺕ‪ ١١٥٦٦٣ :‬ﻣﻨﻬﻢ ‪٦٢٢٠٨‬‬
‫ﻣﻦ ﺍﻟﺬﻛﻮﺭ ﻭ‪ ٥٣٤٥٥‬ﻣﻦ ﺍﻹﻧﺎﺙ ﻭﻋﺪﺩ ﺍﳌﻄﻌﻤﲔ ‪ ١٣٥٥٩٠‬ﻣﻨﻬﻢ ‪ ٧١٠٥٧‬ﻣﻦ ﺍﻟﺬﻛﻮﺭ ﻭ‪ ٦٤٨٩٣‬ﻣﻦ‬
‫ﺍﻹﻧﺎﺙ(‪.‬‬
‫‪ -‬ﻋﺎﻡ ‪ ١٨٨٤‬ﺃﻧﺸﺌﺖ ﺇﺩﺍﺭﺓ ﳌﺼﺎﱀ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻮﻣﻴﺔ ﺗﺎﺑﻌﺔ ﻟﻨﻈﺎﺭﺓ )ﻭﺯﺍﺭﺓ( ﺍﻟﺪﺍﺧﻠﻴﺔ‪ .‬ﻭﰲ ﻋﺎﻡ‬
‫‪ ١٩٢٠‬ﺗﻘﺮﺭ ﺭﻓﻊ ﺩﺭﺟﺔ ﺭﺋﻴﺲ ﻣﺼﻠﺤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻮﻣﻴﺔ ﺣﻴﻨﺬﺍﻙ ﻟﺘﺸﻤﻞ ﺃﺭﺑﻌﺔ ﺃﻗﺴﺎﻡ ﻓﻨﻴﺔ‬
‫ﻣﻨﻬﺎ "ﻗﺴﻢ ﺍﳌﺴﺎﺋﻞ ﺍﻟﺼﺤﻴﺔ" ﻭﻛﺎﻥ ﳍﺬﺍ ﺍﻟﻘﺴﻢ ﻋﺪﺓ ﺍﺧﺘﺼﺎﺻﺎﺕ ﻣﻨﻬﺎ ﺍﻹﺣﺼﺎﺀ‬
‫ﻭﺍﻟﺘﺨﻄﻴﻂ‪.‬‬
‫‪ -‬ﰲ ﻋﺎﻡ ‪ ،١٩٣٦‬ﺃﻧﺸﺌﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻮﻣﻴﺔ ﻭﺍﺳﺘﻘﻠﺖ ﻋﻦ ﻭﺯﺍﺭﺓ ﺍﻟﺪﺍﺧﻠﻴﺔ‪.‬‬
‫‪ -‬ﰲ ﻋﺎﻡ ‪ ١٩٥٩‬ﺻﺪﺭ ﻗﺮﺍﺭ ﲨﻬﻮﺭﻱ ﺑﺈﻋﺎﺩﺓ ﺗﻨﻈﻴﻢ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻮﻣﻴﺔ ﻭﺃﻧﺸﺌﺖ ﺇﺩﺍﺭﺓ‬
‫ﻟﻺﺣﺼﺎﺀ ﻭﺍﻟﺘﻨﻈﻴﻢ ﺗﺸﻤﻞ ﺃﺭﺑﻌﺔ ﺃﻗﺴﺎﻡ )ﺍﻟﺘﺨﻄﻴﻂ – ﻣﺘﺎﺑﻌﺔ ﺍﳌﺸﺮﻭﻋﺎﺕ – ﺍﻹﺣﺼﺎﺀ –‬
‫ﺍﻟﺘﻨﻈﻴﻢ(‪.‬‬
‫‪ -‬ﻧﺺ ﻗﺮﺍﺭ ﻭﺯﺍﺭﻱ ﻻﺣﻖ ﰲ ﻧﻔﺲ ﺍﻟﻌﺎﻡ ﻋﻠﻰ ﺃﻥ ﺍﺧﺘﺼﺎﺹ ﻗﺴﻢ ﺍﻹﺣﺼﺎﺀ ﺑﺈﺩﺍﺭﺓ ﺍﻹﺣﺼﺎﺀ‬
‫ﻭﺍﻟﺘﻨﻈﻴﻢ ﻫﻮ ﺃﻋﻤﺎﻝ ﺍﻹﺣﺼﺎﺀ ﺍﻟﺼﺤﻲ ﻟﻮﺣﺪﺍﺕ ﺍﻟﻮﺯﺍﺭﺓ ﻭﲢﻠﻴﻞ ﺍﻹﺣﺼﺎﺋﻴﺎﺕ ﻭﺗﺒﻮﻳﺒﻬﺎ‬
‫ﻭﺍﺳﺘﻘﺮﺍﺀ ﺍﻟﻨﺘﺎﺋﺞ ﻭﺇﻋﺪﺍﺩ ﺍﻟﺮﺳﻮﻡ ﺍﻟﺒﻴﺎﻧﻴﺔ ﻭﺍﻻﺷﺘﺮﺍﻙ ﻣﻊ ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﻌﺎﻣﺔ ﺍﳌﺨﺘﺼﺔ ﰲ ﺗﻘﺪﱘ‬
‫ﺍﳌﻘﺘﺮﺣﺎﺕ ﺍﻟﻼﺯﻣﺔ ﰲ ﻫﺬﺍ ﺍﻟﺸﺄﻥ ﻋﻠﻰ ﺿﻮﺀ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺎﺕ‪.‬‬
‫ﻭﻧﻼﺣﻆ ﻫﻨﺎ ﺃﻣﺮﻳﻦ ﻻﻓﺘﲔ ﻟﻠﻨﻈﺮ ﻭﳘﺎ‪ :‬ﻭﺿﻮﺡ ﺍﻟﺮﺅﻳﺔ ﻟﺪﻯ ﺻﻨﺎﻉ ﺍﻟﻘﺮﺍﺭ ﰲ ﻫﺬﺍ ﺍﻟﻮﻗﺖ ﺍﳌﺒﻜﺮ ﺑﺸﺄﻥ‬
‫ﺍﺭﺗﺒﺎﻁ ﺍﻹﺣﺼﺎﺀ ﻭﺍﳌﻌﻠﻮﻣﺎﺕ ﺑﺸﻜﻞ ﻭﺛﻴﻖ ﺑﺎﻟﺘﺨﻄﻴﻂ‪ ،‬ﺣﱴ ﺃ‪‬ﻤﺎ ﻗﺪ ﲨﻌﺎ ﰲ ﺇﺩﺍﺭﺓ ﻭﺍﺣﺪﺓ‪ ،‬ﻭﻛﺬﻟﻚ‬
‫ﺍﻹﺩﺭﺍﻙ ﺍﻟﻮﺍﺿﺢ ﻷﳘﻴﺔ ﺍﻻﺷﺘﺮﺍﻙ ﻣﻊ ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﻌﺎﻣﺔ ﺍﳌﺨﺘﺼﺔ )ﻭﻟﻴﺲ ﳎﺮﺩ ﺍﻟﺘﻨﺴﻴﻖ( ﻟﻮﺿﻊ‬
‫ﺧﻄﺔ ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻭﻟﻼﺳﺘﻔﺎﺩﺓ ﻣﻨﻬﺎ )ﲟﺎ ﻳﺘﻄﺎﺑﻖ ﻣﻊ ﻣﻔﻬﻮﻡ ﺍﻟﺪﻭﺭﺓ ﺍﳌﻌﻠﻮﻣﺎﺗﻴﺔ(‪.‬‬
‫‪ -‬ﺍﺭﺗﻘﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻮﻇﻴﻔﻲ ﻟﻘﺴﻢ ﺍﻹﺣﺼﺎﺀ ﺑﻌﺪ ﺫﻟﻚ ﻟﻴﺼﺒﺢ ﺇﺩﺍﺭﺓ ﻣﺴﺘﻘﻠﺔ ﰒ ﺇﺩﺍﺭﺓ ﻋﺎﻣﺔ‬
‫ﻟﻺﺣﺼﺎﺀ‪.‬‬
‫‪ -‬ﰲ ﻋﺎﻡ ‪ ١٩٨١‬ﺻﺪﺭ ﻗﺮﺍﺭ ﺍﻟﺴﻴﺪ ﺭﺋﻴﺲ ﺍﳉﻤﻬﻮﺭﻳﺔ ﺭﻗﻢ ‪ ٦٢٧‬ﻟﺴﻨﺔ ‪ ١٩٨١‬ﺑﺸﺄﻥ ﺇﻧﺸﺎﺀ ﻣﺮﺍﻛﺰ‬
‫ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﻭﺍﻟﺘﻮﺛﻴﻖ ﰲ ﻛﺎﻓﺔ ﺍﻟﻮﺯﺍﺭﺍﺕ ﻭﺍﳍﻴﺌﺎﺕ ﻭﺑﻨﺎﺀ ﻋﻠﻴﻪ ﺻﺪﺭ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺑﺄﻥ ﺗﺘﺤﻮﻝ‬

‫‪١٣٠‬‬
‫ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻺﺣﺼﺎﺀ ﺑﺎﻟﻮﺯﺍﺭﺓ ﺇﱃ ﻣﺮﻛﺰ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﻭﺍﻟﺘﻮﺛﻴﻖ‪ .‬ﻭﰎ ﺍﻻﺗﻔﺎﻕ ﻣﻊ ﺍﳌﺮﻛﺰ ﺍﻟﻘﻮﻣﻲ‬
‫ﻟﻺﺣﺼﺎﺀﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺑﺎﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ ﺍﻷﻣﺮﻳﻜﻴﺔ ‪ NCHS‬ﻟﺘﺒﺎﺩﻝ ﺍﳋﱪﺓ ﺍﻟﻔﻨﻴﺔ ﻟﺘﻄﻮﻳﺮ‬
‫ﺍﻟﻌﻤﻞ ﲟﺮﻛﺰ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻭﺍﻟﺘﻮﺛﻴﻖ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﳌﺼﺮﻳﺔ ﻭﰎ ﺇﺩﺧﺎﻝ ﺍﳊﺎﺳﺒﺎﺕ ﺍﻟﺪﻗﻴﻘﺔ‬
‫)ﺍﳌﻴﻜﺮﻭﻛﻮﻣﺒﻴﻮﺗﺮ( ﺑﺸﻜﻞ ﲡﺮﻳﱯ ﰲ ﻣﺪﻳﺮﻳﺔ ﺍﻟﺼﺤﺔ ﺑﺎﻟﻔﻴﻮﻡ‪ ،‬ﰒ ﺑﺎﻹﲰﺎﻋﻴﻠﻴﺔ‪ ،‬ﰒ ﰎ ﺗﻌﻤﻴﻤﻬﺎ‬
‫ﲜﻤﻴﻊ ﺍﶈﺎﻓﻈﺎﺕ‪.‬‬
‫ﻭﻛﺎﻧﺖ ﻣﺼﻠﺤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻮﻣﻴﺔ ﲢﺮﺹ ﻋﻠﻰ ﺇﺻﺪﺍﺭ ﺗﻘﺮﻳﺮ ﺳﻨﻮﻱ‪ ،‬ﺑﻪ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﳌﻌﻠﻮﻣﺎﺕ‬
‫ﺍﳌﻔﻴﺪﺓ‪ ،‬ﻭﺃﻗﺪﻡ ﺗﻘﺮﻳﺮ ﻣﻦ ﻫﺬﺍ ﺍﻟﻨﻮﻉ ﲤﻜﻨﺎ ﻣﻦ ﺍﻹﻃﻼﻉ ﻋﻠﻴﻪ ﻫﻮ ﺍﻟﺘﻘﺮﻳﺮ ﺍﳋﺎﺹ ﺑﻌﺎﻡ ‪ ،١٩١٦‬ﻭﻫﻮ ﺗﻘﺮﻳﺮ‬
‫ﳎﻠﺪ ﻣﻄﺒﻮﻉ ﻃﺒﺎﻋﺔ ﺟﻴﺪﺓ ﻳﻘﻊ ﰲ ‪ ٩٥‬ﺻﻔﺤﺔ ﺑﻠﻐﺔ ﺇﳒﻠﻴﺰﻳﺔ ﺭﺍﻗﻴﺔ ﺻﺎﺩﺭ ﻋﻦ ﻣﺼﻠﺤﺔ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﻌﻤﻮﻣﻴﺔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺪﺍﺧﻠﻴﺔ ﺍﳌﺼﺮﻳﺔ ﻭﻣﺘﺎﺡ ﻟﻠﺒﻴﻊ ﲟﺒﻠﻎ ﻗﺪﺭﻩ ﻋﺸﺮﻭﻥ ﻗﺮﺷﺎﹰ ﻣﻦ ﻣﻜﺘﺐ ﺍﳌﻄﺒﻮﻋﺎﺕ‬
‫ﺍﳊﻜﻮﻣﻴﺔ‪ ،‬ﻭﻳﺸﻤﻞ ﻋﺸﺮﺓ ﺃﺑﻮﺍﺏ ﻛﻞ ﻣﻨﻬﺎ ﻳﺸﻤﻞ ﻋﺪﺓ ﻓﺼﻮﻝ‪ .‬ﻭﻗﺪ ﻳﻜﻮﻥ ﻣﻦ ﺍﳌﻔﻴﺪ ﺍﺳﺘﻌﺮﺍﺽ‬
‫ﺑﻌﺾ ﺍﻟﻌﻨﺎﻭﻳﻦ ﺍﻟﱵ ﺍﺷﺘﻤﻞ ﻋﻠﻴﻬﺎ ﺍﻟﺘﻘﺮﻳﺮ ﻓﻤﻨﻬﺎ ﻋﻠﻰ ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ‪ :‬ﺍﻹﺣﺼﺎﺀﺍﺕ ﺍﳊﻴﻮﻳﺔ )ﻣﻦ ﺗﻌﺪﺍﺩ‬
‫ﻟﻠﺴﻜﺎﻥ ﻭﻣﻮﺍﻟﻴﺪ ﻭﻭﻓﻴﺎﺕ ﻭﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﳉﻤﻴﻊ ﺍﶈﺎﻓﻈﺎﺕ ﻭﺍﳌﺪﻳﺮﻳﺎﺕ ﻣﺼﻨﻔﲔ ﺇﱃ ﻣﺼﺮﻳﲔ ﻭﺃﺟﺎﻧﺐ(‪،‬‬
‫ﻭﺍﻟﻔﺤﻮﺹ ﺍﻟﻄﺒﻴﺔ ﺍﻟﺸﺮﻋﻴﺔ‪ ،‬ﻭﺍﻷﻣﺎﻛﻦ ﺍﳌﻠﻮﺛﺔ ﻟﻠﺒﻴﺌﺔ‪ ،‬ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ )ﻋﺪﺩ ﺍﻷﺳﺮﺓ‪ ،‬ﻭﻋﺪﺩ‬
‫ﺍﳌﺮﺿﻰ ﺑﺎﻟﻘﺴﻢ ﺍﳋﺎﺭﺟﻲ ﻭﺍﻟﻘﺴﻢ ﺍﻟﺪﺍﺧﻠﻲ‪ ،‬ﻭﻣﻌﺪﻝ ﻭﻓﺎﺓ ﺍﳌﺮﺿﻰ‪ ،‬ﻭﻋﺪﺩ ﺃﻳﺎﻡ ﺍﻟﻌﻼﺝ‪ ،‬ﻭﻋﺪﺩ ﺍﻟﻌﻤﻠﻴﺎﺕ‬
‫ﺍﳉﺮﺍﺣﻴﺔ‪ ،‬ﻭﺍﻟﺘﻜﻠﻔﺔ‪ ،‬ﻭﺍﻟﺪﺧﻞ‪ ،‬ﻭﺫﻟﻚ ﳉﻤﻴﻊ ﺍﶈﺎﻓﻈﺎﺕ ﺑﺎﻹﺿﺎﻓﺔ ﻟﺘﺼﻨﻴﻒ ﺍﳌﺮﺿﻰ ﻃﺒﻘﺎﹰ‬
‫ﻟﻠﺘﺸﺨﻴﺺ(‪ ،‬ﻭﺍﻹﺣﺼﺎﺀﺍﺕ ﺍﳋﺎﺻﺔ ﺑﺎﳌﺴﺘﻮﺻﻔﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ‪ ،‬ﻭﻣﺴﺘﻮﺻﻔﺎﺕ ﺭﻋﺎﻳﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ‪،‬‬
‫ﻭﻣﺪﺍﺭﺱ ﺍﳌﻮﻟﺪﺍﺕ )ﺍﻟﺪﺍﻳﺎﺕ(‪ ،‬ﻭﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺮﻣﺪ‪ ،‬ﻭﺍﳊﻤﻴﺎﺕ‪ ،‬ﻭﺍﳊﺞ‪ ،‬ﻭﺍﳌﻮﺍﻟﺪ‪ ،‬ﻭﺣﻼﻗﻲ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﺍﳊﺠﺮ‬
‫ﺍﻟﺼﺤﻲ‪ ،‬ﻭﺍﳌﻌﺎﻣﻞ )ﺑﻜﺘﺮﻳﻮﻟﻮﺟﻴﺔ‪ ،‬ﻛﻴﻤﻴﺎﺋﻴﺔ‪ ،‬ﲢﻠﻴﻞ ﻣﻴﺎﻩ‪ ،‬ﻟﻘﺎﺣﺎﺕ‪ ،‬ﺍﱁ(‪ ،‬ﻭﺃﻋﻤﺎﻝ ﺍﻟﻘﻮﻣﺴﻴﻮﻧﺎﺕ‬
‫ﺍﻟﻄﺒﻴﺔ‪ ،‬ﻭﺍﻟﺼﻴﺪﻟﻴﺎﺕ‪ ،‬ﻭﺍﳌﺨﺎﺯﻥ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ ،‬ﻭﻣﻴﺰﺍﻧﻴﺔ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﺍﻟﻌﺎﻣﻠﻮﻥ ‪‬ﺎ‪ ،‬ﻭﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﻭﺳﺎﺋﺮ‬
‫ﺍﳌﻬﻦ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺼﺎﺩﺭﺓ ﺧﻼﻝ ﺍﻟﻌﺎﻡ‪ ،‬ﻭﻻ ﻳﺴﻌﻨﺎ ﺳﻮﻯ ﺇﺑﺪﺍﺀ ﺍﻹﻋﺠﺎﺏ ‪‬ﺬﺍ‬
‫ﺍﳉﻬﺪ ﰲ ﺫﻟﻚ ﺍﻟﻮﻗﺖ ﺭﻏﻢ ﻋﺪﻡ ﺗﻮﺍﻓﺮ ﺍﻹﻣﻜﺎﻧﻴﺎﺕ ﺍﳊﺪﻳﺜﺔ ﻣﻦ ﺣﺎﺳﺒﺎﺕ ﺁﻟﻴﺔ ﻭﻭﺳﺎﺋﻞ ﺍﺗﺼﺎﻝ ﻣﺘﻘﺪﻣﺔ‪.‬‬
‫ﻭﻛﺎﻧﺖ ﻣﺼﺮ ﺳﺒﺎﻗﺔ ﻛﺬﻟﻚ ﰲ ﺍﻷﺧﺬ ﺑﻨﻈﺎﻡ ﺍﻟﺘﺼﻨﻴﻒ ﺍﻟﺪﻭﱄ ﻟﻸﻣﺮﺍﺽ‪ ،‬ﻭﻫﻮ ﻧﻈﺎﻡ ﻟﻮﺿﻊ ﺭﻣﻮﺯ‬
‫ﻣﻮﺣﺪﺓ ﺩﻭﻟﻴﺎﹰ ﻟﻸﻣﺮﺍﺽ ﻭﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ‪ ،‬ﺪﻑ ﺗﻴﺴﲑ ﺍﳌﻘﺎﺭﻧﺔ ﺑﲔ ﺇﺣﺼﺎﺀﺍﺕ ﺍﻟﺪﻭﻝ ﺍﳌﺨﺘﻠﻔﺔ ﻭﻟﺴﻨﻮﺍﺕ‬
‫ﳐﺘﻠﻔﺔ ﺩﻭﻥ ﲣﻮﻑ ﻣﻦ ﺣﺪﻭﺙ ﺃﺧﻄﺎﺀ ﺑﺴﺒﺐ ﺍﻹﺷﺎﺭﺓ ﻟﻨﻔﺲ ﺍﳌﺮﺽ ﺑﺄﲰﺎﺀ ﳐﺘﻠﻔﺔ ﺃﻭ ﺍﺳﺘﻌﻤﺎﻝ‬
‫ﻧﻔﺲ ﺍﻻﺳﻢ ﻟﻺﺷﺎﺭﺓ ﻷﻣﺮﺍﺽ ﳐﺘﻠﻔﺔ‪ .‬ﻭﻫﺬﺍ ﺍﻟﺘﺼﻨﻴﻒ ﺗﺼﺪﺭﻩ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ﻣﻨﺬ‬
‫ﺗﺄﺳﻴﺴﻬﺎ ﺑﻌﺪ ﺍﳊﺮﺏ ﺍﻟﻌﺎﳌﻴﺔ ﺍﻟﺜﺎﻧﻴﺔ )ﻭﻛﺎﻧﺖ ﺗﺼﺪﺭﻩ ﻋﺼﺒﺔ ﺍﻷﻣﻢ ﻗﺒﻞ ﺫﻟﻚ( – ﻓﺎﻋﺘﺒﺎﺭﺍﹰ ﻣﻦ ﻋﺎﻡ‬
‫‪ ١٩٥٠‬ﻗﺮﺭﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻮﻣﻴﺔ ﺗﻌﻤﻴﻢ ﺍﺳﺘﻌﻤﺎﻝ ﺍﻟﺘﺼﻨﻴﻒ ﺍﻟﺪﻭﱄ ﻟﻸﻣﺮﺍﺽ‪ ،‬ﻭﻗﺎﻣﺖ ﺑﺈﻋﺪﺍﺩ‬
‫ﺩﻟﻴﻞ ﺇﺭﺷﺎﺩﻱ ﻟﻸﻃﺒﺎﺀ‪ ،‬ﻟﻜﺘﺎﺑﺔ ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ ﻣﺼﻨﻔﺔ ﻃﺒﻘﺎﹰ ﻟﻠﺪﻟﻴﻞ ﺍﻟﺪﻭﱄ‪.‬‬
‫ﻭﱂ ﻳﻘﺘﺼﺮ ﻧﺸﺮ ﺍﻹﺣﺼﺎﺀﺍﺕ ﺫﺍﺕ ﺍﻷﳘﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻓﻘﺴﻢ ﺍﻹﺣﺼﺎﺀ ﺑﺎﻹﺩﺍﺭﺓ‬
‫ﺍﻟﻌﺎﻣﺔ ﻟﻠﺼﺤﺔ ﺍﳌﺪﺭﺳﻴﺔ ﺑﻮﺯﺍﺭﺓ ﺍﳌﻌﺎﺭﻑ ﺍﻟﻌﻤﻮﻣﻴﺔ ﻛﺎﻥ ﻳﻨﺸﺮ ﺗﻘﺎﺭﻳﺮ ﺳﻨﻮﻳﺔ ﺧﺎﺻﺔ ‪‬ﺎ )ﻛﺎﻧﺖ‬
‫ﺍﻟﺼﺤﺔ ﺍﳌﺪﺭﺳﻴﺔ ﺗﺘﺒﻊ ﻭﺯﺍﺭﺓ ﺍﳌﻌﺎﺭﻑ "ﺍﻟﺘﺮﺑﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻢ" ﻟﻔﺘﺮﺍﺕ ﻃﻮﻳﻠﺔ(‪ .‬ﻭﺍﻟﺘﻘﺮﻳﺮ ﺍﳋﺎﺹ ﺑﺎﻟﻌﺎﻡ‬
‫ﺍﻟﺪﺭﺍﺳﻲ ‪ ١٩٤٩ – ١٩٤٨‬ﻳﻘﻊ ﰲ ﺃﻛﺜﺮ ﻣﻦ ‪ ١٠٠‬ﺻﻔﺤﺔ‪ ،‬ﻭﻣﻦ ﳏﺘﻮﻳﺎﺗﻪ ﺍﻟﻘﻴﻤﺔ ﺟﺪﺍﻭﻝ ﺧﺎﺻﺔ‬

‫‪١٣١‬‬
‫ﲟﺘﻮﺳﻄﺎﺕ ﺍﻷﻭﺯﺍﻥ ﻭﺍﻷﻃﻮﺍﻝ ﻭﻧﺴﺐ ﺍﻹﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ‪ ،‬ﻟﻮ ﺗﻮﺍﻓﺮ ﺍﻟﺒﺎﺣﺜﻮﻥ ﻋﻠﻰ ﺩﺭﺍﺳﺘﻬﺎ ﻭﻣﻘﺎﺭﻧﺘﻬﺎ‬
‫ﻟﺴﻨﻮﺍﺕ ﳐﺘﻠﻔﺔ ﻟﺒﻴﻨﺖ ﺗﻄﻮﺭ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻄﺎﻟﺐ ﺍﳌﺼﺮﻱ ﻋﱪ ﺍﻟﺴﻨﲔ‪.‬‬
‫ﻭﻛﺎﻧﺖ ﻣﺼﻠﺤﺔ ﻋﻤﻮﻡ ﺍﻹﺣﺼﺎﺀ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﳌﺎﻟﻴﺔ ﺗﺼﺪﺭ ﻧﺸﺮﺓ ﺳﻨﻮﻳﺔ ﻋﻦ ﺍﳌﻮﺍﻟﻴﺪ ﻭﺍﻟﻮﻓﻴﺎﺕ‬
‫ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ‪ ،‬ﻭﻛﺎﻧﺖ ﻫﺬﻩ ﺍﻟﻨﺸﺮﺓ ﺑﺎﻟﻐﺔ ﺍﻟﺘﻔﺼﻴﻞ )ﻧﺸﺮﺓ ﻋﺎﻡ ‪ ١٩٢٢‬ﺗﻘﻊ ﰲ ﺃﻛﺜﺮ ﻣﻦ ‪٧٠‬‬
‫ﺻﻔﺤﺔ‪ ،‬ﻭﲢﺘﻮﻱ ﺍﻟﺘﻔﺎﺻﻴﻞ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻷﻗﺴﺎﻡ ﻭﺍﳌﺮﺍﻛﺰ ﻭﻟﻴﺲ ﻓﻘﻂ ﺍﶈﺎﻓﻈﺎﺕ ﻭﺍﳌﺪﻳﺮﻳﺎﺕ(‪.‬‬
‫ﻭﻻ ﺗﻔﻮﺗﻨﺎ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺍﻟﺘﻘﺮﻳﺮ ﺍﻹﺣﺼﺎﺋﻲ ﺍﻟﺴﻨﻮﻱ ﺍﻟﺬﻱ ﺻﺪﺭ ﻋﺎﻡ ‪ ١٩٧٢‬ﰲ ﻋﻬﺪ ﺍﻟﺴﻴﺪ ﺍﻟﻮﺯﻳﺮ‬
‫ﺍﻟﺪﻛﺘﻮﺭ ﳏﻤﻮﺩ ﳏﻔﻮﻅ ﻭﺍﻟﺬﻱ ﺻﺪﺭ ﰲ ﺷﻜﻞ ﳎﻠﺪ ﻛﺒﲑ ﺗﺰﻳﺪ ﺻﻔﺤﺎﺗﻪ ﻋﻦ ‪ ٣٥٠‬ﺻﻔﺤﺔ‪،‬‬
‫ﻭﻳﺘﻀﻤﻦ ﺿﻤﻦ ﻣﺎ ﻳﺘﻀﻤﻦ ﻷﻭﻝ ﻣﺮﺓ‪ ،‬ﺗﻘﺮﻳﺮﺍﹰ ﻣﻄﻮﻻﹰ ﻋﻦ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ ﻣﺆﻛﺪﺍﹰ ﺑﺬﻟﻚ ﺇﳝﺎﻥ‬
‫ﺍﻟﻮﺯﺍﺭﺓ ﺑﺄﻥ ﺍﻹﺣﺼﺎﺀﺍﺕ ﻫﻲ ﺍﻷﺳﺎﺱ ﺍﻟﺬﻱ ﺗﺒﲎ ﻋﻠﻴﻪ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬

‫
‪./
 
  '
 01-2
'
3 45‬‬
‫ﺃﻧﺸﺊ ﺍﳌﺮﻛﺰ ﺍﻟﻘﻮﻣﻲ ﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﻘﺮﺍﺭ ﻭﺯﺍﺭﻱ ﰲ ﻳﻮﻟﻴﻮ ‪ ١٩٩٨‬ﺗﺎﺑﻌﺎﹰ ﻣﺒﺎﺷﺮﺓ ﻟﻘﻄﺎﻉ‬
‫ﻣﻜﺘﺐ ﺍﻟﻮﺯﻳﺮ‪ ،‬ﻭﰎ ﺍﻻﺳﺘﻔﺎﺩﺓ ﲟﺒﻠﻎ ﻳﻘﺎﺭﺏ ﺍﳌﻠﻴﻮﻥ ﺩﻭﻻﺭ ﻣﻦ ﺍﳌﻌﻮﻧﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ﺍﳌﺨﺼﺼﺔ ﻟﻮﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻟﺘﻄﻮﻳﺮ ﺃﺣﺪ ﻣﺒﺎﱐ ﺍﻟﻮﺯﺍﺭﺓ ﻟﻴﻜﻮﻥ ﻣﻘﺮﺍﹰ ﳍﺬﺍ ﺍﳌﺮﻛﺰ ﺑﺎﻹﺿﺎﻓﺔ ﻹﺩﺍﺭﺓ ﺍﻟﺘﺨﻄﻴﻂ‪ ،‬ﺇﺫ‬
‫ﻳﺸﻐﻞ ﺍﳌﺮﻛﺰ ﺛﻼﺛﺔ ﺃﺩﻭﺍﺭ ﻣﻦ ﺍﳌﺒﲎ‪ ،‬ﻭﺗﺸﻐﻞ ﺇﺩﺍﺭﺓ ﺍﻟﺘﺨﻄﻴﻂ ﺩﻭﺭﺍﹰ ﻭﺍﺣﺪﺍﹰ‪ .‬ﻭﺭﻭﻋﻲ ﺃﻥ ﻳﻀﻢ ﻣﺒﲎ ﻭﺍﺣﺪ‬
‫ﻛﻼ ﺍﻟﻨﺸﺎﻃﲔ )ﺍﳌﻌﻠﻮﻣﺎﺕ ﻭﺍﻟﺘﺨﻄﻴﻂ( ﺗﺄﻛﻴﺪﺍﹰ ﻋﻠﻰ ﺍﻻﺭﺗﺒﺎﻁ ﺍﻟﻌﻀﻮﻱ ﺑﻴﻨﻬﻤﺎ‪ ،‬ﻭﻻ ﻧﻨﺴﻰ ﺃ‪‬ﻤﺎ ﻛﺎﻧﺎ‬
‫ﻳﺘﺒﻌﺎﻥ ﺇﺩﺍﺭﺓ ﻭﺍﺣﺪﺓ ﺣﱴ ﻗﺮﺏ ‪‬ﺎﻳﺔ ﺍﳋﻤﺴﻴﻨﻴﺎﺕ‪.‬‬
‫ﻭﻗﺎﻡ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺑﺎﻓﺘﺘﺎﺡ ﺍﳌﺮﻛﺰ ﺑﻌﺪ ﺗﻄﻮﻳﺮﻩ ﻳﻮﻡ ‪ ١‬ﺩﻳﺴﻤﱪ ‪ ١٩٩٨‬ﲝﻀﻮﺭ ﻭﺯﻳﺮﺓ ﺍﻟﺼﺤﺔ‬
‫ﺍﻷﻣﺮﻳﻜﻴﺔ ﰲ ﺫﻟﻚ ﺍﻟﻮﻗﺖ )ﺩﻭﻧﺎ ﺷﻼﻻ(‪.‬‬
‫ﻭﻳﻀﻢ ﺍﳌﺮﻛﺰ ﲬﺲ ﺇﺩﺍﺭﺍﺕ‪ :‬ﺍﳊﺎﺳﺒﺎﺕ‪ ،‬ﺍﻹﺣﺼﺎﺀﺍﺕ ﻭﺍﳌﻌﻠﻮﻣﺎﺕ‪ ،‬ﺍﻟﻨﺸﺮ‪ ،‬ﺍﻟﺘﻮﺛﻴﻖ ﻭﺍﳌﻜﺘﺒﺎﺕ‪ ،‬ﺩﻋﻢ ﺍﲣﺎﺫ‬
‫ﺍﻟﻘﺮﺍﺭ‪.‬‬
‫ﻛﻤﺎ ﺃﻥ ﺑﺎﳌﺮﻛﺰ ﺑﺮﺍﻣﺞ ﻭﻭﺣﺪﺍﺕ ﻭﺃﻧﺸﻄﺔ ﻣﻨﻬﺎ‪ :‬ﺍﻟﺘﺪﺭﻳﺐ ﰲ ﳎﺎﻝ ﺍﳌﻌﻠﻮﻣﺎﺕ )ﻭﻗﺪ ﺃﻗﻴﻢ ﳍﺬﺍ ﺍﻟﻐﺮﺽ‬
‫ﻣﺮﻛﺰ ﺗﺪﺭﻳﺐ ﻣﺘﻘﺪﻡ ﻣﻘﺮﻩ ﻣﺴﺘﺸﻔﻰ ﺍﳌﻨﲑﺓ ﺑﺎﻟﻘﺮﺏ ﻣﻦ ﺍﻟﻮﺯﺍﺭﺓ(‪ ،‬ﺍﻟﺴﺠﻞ ﺍﻟﻘﻮﻣﻲ ﻟﻠﺴﺮﻃﺎﻥ‪ ،‬ﺷﺒﻜﺔ‬
‫ﺍﻹﻧﺘﺮﻧﺖ ﺑﺎﻟﻮﺯﺍﺭﺓ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪ ،‬ﺍﻟﺘﺨﻄﻴﻂ ﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ ﺇﺩﺍﺭﺓ ﺍﳌﻌﻠﻮﻣﺎﺕ‪ ،‬ﺷﺒﻜﺔ ﻣﻌﻠﻮﻣﺎﺕ ﺑﻨﻮﻙ‬
‫ﺍﻟﺪﻡ‪ ،‬ﺍﱁ‪.‬‬
‫ﻭﻃﺒﻘﺎﹰ ﻟﺘﻮﺻﻴﻒ ﺍﳌﺮﻛﺰ ﺿﻤﻦ ﺍﳍﻴﻜﻞ ﺍﻟﺘﻨﻈﻴﻤﻲ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪ ،‬ﻓﺈﻥ ﺍﳌﺮﻛﺰ‪:‬‬
‫‪ -‬ﻳﻌﺘﱪ ﻭﺣﺪﺓ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﰲ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬
‫‪ -‬ﻳﻜﻮﻥ ﻣﺴﺌﻮﻻﹰ ﻋﻦ ﺗﻄﻮﻳﺮ ﻭﺍﺳﺘﻤﺮﺍﺭﻳﺔ ﺇﺩﺍﺭﺓ ﻧﺸﺎﻁ ﺗﻜﻨﻮﻟﻮﺟﻴﺎ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬
‫‪ -‬ﻳﻜﻮﻥ ﻣﺴﺌﻮﻻﹰ ﻋﻦ ﻛﺎﻓﺔ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻭﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻘﻮﻣﻲ‪.‬‬
‫‪ -‬ﻋﻠﻴﻪ ﺍﻟﺘﻌﺎﻭﻥ ﻣﻊ ﻛﺎﻓﺔ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﰲ ﺳﺒﻴﻞ ﺍﺳﺘﻜﻤﺎﻝ‬
‫ﻭﺗﻜﺎﻣﻞ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬

‫‪١٣٢‬‬
 ‫ﻭﺑﻨﺎﺀً ﻋﻠﻴﻪ ﰎ ﻭﺿﻊ ﻣﻌﺎﻳﲑ ﳏﺪﺩﺓ ﻟﻌﻤﻞ ﺍﳌﺮﻛﺰ ﺗﺘﻤﺜﻞ ﻓﻴﻤﺎ ﻳﻠﻲ‪:‬‬
‫‪ .١‬ﺍﻋﺘﺒﺎﺭ ﺍﳌﺮﻛﺰ ﻫﻮ ﺍﻟﻮﺣﺪﺓ ﺍﳌﺮﻛﺰﻳﺔ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻨﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻟﻜﺎﻓﺔ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻠﻮﺯﺍﺭﺓ‪.‬‬
‫‪ .٢‬ﺍﻟﺘﻌﺎﻭﻥ ﰲ ﺗﺼﻤﻴﻢ ﻭﺗﻄﻮﻳﺮ ﻧﻈﺎﻡ ﻣﺘﻜﺎﻣﻞ ﻓﻌﺎﻝ ﻟﻨﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻲ ﺍﻟﻘﻮﻣﻲ‪.‬‬
‫‪ .٣‬ﺇﺗﺎﺣﺔ ﻛﺎﻓﺔ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﺪﻋﻢ ﻭﺗﻨﻔﻴﺬ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻜﺎﻓﺔ ﺍﻹﺩﺍﺭﺍﺕ ﺍﳊﺎﻟﻴﺔ‬
‫ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﻣﺎ ﻳﺴﺘﺠﺪ ﻣﻦ ﻫﺬﻩ ﺍﻹﺩﺍﺭﺍﺕ‪.‬‬
‫‪ .٤‬ﺃﻥ ﻳﻜﻮﻥ ﻣﺴﺌﻮﻻﹰ ﻋﻦ ﺇﳚﺎﺩ ﻭﲢﺪﻳﺪ ﺳﺒﻞ ﺍﻟﺘﻌﺎﻭﻥ ﻣﻊ ﻣﺮﺍﻛﺰ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻣﺪﻳﺮﻳﺎﺕ‬
‫ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﻭﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻭﲢﺪﺩﺕ ﻣﺴﺌﻮﻟﻴﺎﺕ ﺍﳌﺮﻛﺰ ﻋﻠﻰ ﺃ‪‬ﺎ‪:‬‬
‫‪ -‬ﲣﻄﻴﻂ ﻭﺗﺼﻤﻴﻢ ﻭﺗﻄﺒﻴﻖ ﻭﺩﻋﻢ ﻛﺎﻓﺔ ﻣﻌﺎﻳﲑ ﻧﻈﻢ ﻭﺗﻜﻨﻮﻟﻮﺟﻴﺎ ﺍﳌﻌﻠﻮﻣﺎﺕ‪.‬‬
‫‪ -‬ﻭﺿﻊ ﻣﻌﺎﻳﲑ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳋﺎﺻﺔ ﺑﻨﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻲ ﻟﻠﻮﺯﺍﺭﺓ‪.‬‬
‫‪ -‬ﺗﺪﺭﻳﺐ ﳑﺜﻠﻲ ﻣﺮﺍﻛﺰ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﻭﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﻄﺒﻴﺔ ﻋﻠﻰ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﻣﻊ ﺗﻄﺒﻴﻖ ﺍﳌﻌﺎﻳﲑ ﺍﳋﺎﺻﺔ ﺑﺬﻟﻚ‪.‬‬
‫‪ -‬ﺗﺼﻤﻴﻢ ﻭﺗﻄﻮﻳﺮ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﻘﻴﺎﺩﻳﺔ ﺍﻟﱵ ﺗﺴﺘﺨﺪﻡ ﺑﻮﺍﺳﻄﺔ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﻠﻴﺎ‪.‬‬
‫ﻭﲢﺪﺩﺕ ﻭﺳﺎﺋﻞ ﲢﻘﻴﻖ ﺍﳌﻬﺎﻡ ﻭﺍﳌﺴﺌﻮﻟﻴﺎﺕ ﻛﻤﺎ ﻳﻠﻲ‪:‬‬
‫‪ -‬ﲡﻤﻴﻊ ﻭﻣﻌﺎﳉﺔ ﻭﺗﺪﻗﻴﻖ ﻭﲢﻠﻴﻞ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻜﺎﻓﺔ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﺳﻮﺍﺀ ﰲ ﺍﻟﺪﻳﻮﺍﻥ ﺍﻟﻌﺎﻡ ﻟﻠﻮﺯﺍﺭﺓ ﺃﻡ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ ﺃﻡ ﺍﻹﺩﺍﺭﺍﺕ ﺃﻡ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﺑﻜﺎﻓﺔ ﺃﻧﻮﺍﻋﻬﺎ‪.‬‬
‫‪ -‬ﺇﻧﺸﺎﺀ ﻧﻈﺎﻡ ﺗﺪﺭﻳﱯ ﺫﻱ ﻛﻔﺎﺀﺓ ﻋﺎﻟﻴﺔ ﻭﺩﻳﻨﺎﻣﻴﻜﻴﺔ ﻟﺘﻨﻔﻴﺬ ﺫﻟﻚ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﻌﺎﻣﻠﲔ ﺑﻮﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﺃﻭ ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﶈﺎﻓﻈﺎﺕ‪.‬‬
‫‪ -‬ﺍﻟﺘﻌﺎﻭﻥ ﺍﳍﻴﻜﻠﻲ ﺍﻟﻔﻌﺎﻝ ﺑﲔ ﻛﺎﻓﺔ ﻭﺣﺪﺍﺕ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺑﺪﺀﺍﹰ ﻣﻦ ﺍﳌﺴﺘﻮﻯ ﺍﳌﺮﻛﺰﻱ ﺣﱴ ﻣﺴﺘﻮﻯ‬
‫ﺍﶈﺎﻓﻈﺎﺕ ﻭﺍﳌﺮﺍﻛﺰ ﻭﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫‪ -‬ﺃﻥ ﻳﻜﻮﻥ ﺍﳌﺮﻛﺰ ﻫﻮ ﺑﻨﻚ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺫﻟﻚ ﻋﻦ ﻃﺮﻳﻖ ﺗﻨﻈﻴﻢ ﻭﺇﻧﺸﺎﺀ ﻣﻜﺘﺒﺔ ﻗﻮﻣﻴﺔ‬
‫ﻋﺼﺮﻳﺔ ﻟﻜﺎﻓﺔ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﺃﺣﺪﺙ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺔ ﺍﳌﺘﺎﺣﺔ‪.‬‬

‫ﺇﺗﺎﺣﺔ ﻛﺎﻓﺔ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺴﻤﻮﺡ ‪‬ﺎ ﳌﻦ ﳛﺘﺎﺟﻬﺎ‬

‫ﻭﺫﻟﻚ ﺑﺎﺳﺘﺨﺪﺍﻡ ﺍﻟﻮﺳﺎﺋﻞ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫‪ -‬ﺍﳌﻄﺒﻮﻋﺎﺕ ﺍﻹﺩﺍﺭﻳﺔ‪.‬‬
‫‪ -‬ﺇﻧﺸﺎﺀ ﻣﻮﻗﻊ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﺷﺒﻜﺔ ﺍﳌﻌﻠﻮﻣﺎﺕ )ﺍﻹﻧﺘﺮﻧﺖ(‪.‬‬
‫‪ -‬ﺍﳊﻤﻼﺕ ﺍﻹﻋﻼﻣﻴﺔ ﺍﳌﺮﺋﻴﺔ ﻭﺍﳌﺴﻤﻮﻋﺔ ﻭﻏﲑﻫﺎ ﻣﻦ ﺍﻟﻮﺳﺎﺋﻞ‪.‬‬

‫‪١٣٣‬‬
‫ﻭﻳﺼﺪﺭ ﺍﳌﺮﻛﺰ ﺗﻘﺮﻳﺮﺍﹰ ﺳﻨﻮﻳﺎﹰ ﻣﻄﻮﻻﹰ ﻭﻛﺬﻟﻚ ﻧﺸﺮﺓ ﳐﺘﺼﺮﺓ ﻳﺘﻨﺎﻭﻝ ﻓﻴﻬﺎ ﺍﳌﻌﺪﻻﺕ ﺍﻟﺴﻜﺎﻧﻴﺔ‬
‫ﻭﺍﻟﺼﺤﻴﺔ ﻭﺑﻴﺎﻧﺎﺕ ﻋﻦ ﺍﻟﻮﺣﺪﺍﺕ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺃﻧﺸﻄﺘﻬﺎ ﻭﺑﻴﺎﻧﺎﺕ ﻋﻦ‬
‫ﺍﻟﻌﻤﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ )ﺃﻃﺒﺎﺀ ﻭﲤﺮﻳﺾ ﻭﻏﲑ ﺫﻟﻚ(‪.‬‬

‫
‪Health Information System  
 2
'
 6‬‬
‫ﰲ ﳏﺎﻭﻟﺔ ﻟﺘﻮﺣﻴﺪ ﻭﲢﺪﻳﺚ ﻧﻈﻢ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﰲ ﺍﳉﻬﺎﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﰎ‬
‫ﺗﺼﻤﻴﻢ ﺍﻟﻨﻈﺎﻡ ﺍﻟﻘﻮﻣﻲ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﻫﻮ ﻧﻈﺎﻡ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﻣﺘﻌﺪﺩ ﺍﳌﺴﺘﻮﻳﺎﺕ‬
‫ﻭﻣﺴﺘﻮﻳﺎﺗﻪ ﻫﻲ‪:‬‬
‫‪ .١‬ﺍﳌﺴﺘﻮﻯ ﺍﻟﻘﺎﻋﺪﻱ )ﻣﺴﺘﻮﻯ ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻣﻦ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ(‪.‬‬
‫‪ .٢‬ﻣﺴﺘﻮﻯ ﺍﻹﺩﺍﺭﺓ ﺍﻟﺼﺤﻴﺔ )ﺗﻘﺎﺑﻞ ﺍﳌﺮﻛﺰ ﺃﻭ ﺍﳊﻲ(‪.‬‬
‫‪ .٣‬ﻣﺴﺘﻮﻯ ﺍﳌﺪﻳﺮﻳﺔ )ﺗﻘﺎﺑﻞ ﺍﶈﺎﻓﻈﺔ(‪.‬‬
‫‪ .٤‬ﺍﳌﺴﺘﻮﻯ ﺍﳌﺮﻛﺰﻱ )ﻣﺮﻛﺰ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺑﺪﻳﻮﺍﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ(‪.‬‬
‫ﻭﻳﻬﺪﻑ ﺍﻟﻨﻈﺎﻡ ﺍﻟﻘﻮﻣﻲ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺇﱃ‪:‬‬
‫‪ .١‬ﲢﻮﻳﻞ ﲨﻴﻊ ﺍﻷﻧﺸﻄﺔ ﺍﳋﺎﺻﺔ ﺑﺎﳌﻌﻠﻮﻣﺎﺕ ﻣﻦ ﺍﻟﻨﻈﺎﻡ ﺍﻟﻴﺪﻭﻱ ﺇﱃ ﺍﻟﻨﻈﺎﻡ ﺍﳊﺎﺳﻮﰊ‬
‫)ﺍﻟﻜﻮﻣﺒﻴﻮﺗﺮ( ﻭﺫﻟﻚ ﺑﺪﺀﺍﹰ ﻣﻦ ﻣﺴﺘﻮﻯ ﺍﻹﺩﺍﺭﺓ ﺍﻟﺼﺤﻴﺔ ﻓﺄﻋﻠﻰ‪.‬‬
‫‪ .٢‬ﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳉﻐﺮﺍﰲ )‪.(GIS‬‬
‫‪ .٣‬ﺇﻧﺸﺎﺀ ﻗﺎﻋﺪﺓ ﺑﻴﺎﻧﺎﺕ ﻣﺮﻛﺰﻳﺔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬
‫‪ .٤‬ﲨﻊ ﺑﻴﺎﻧﺎﺕ ﺻﺤﻴﺤﺔ ﻭﻣﺴﺘﻮﻓﺎﺓ ﻣﻦ ﲨﻴﻊ ﺍﶈﺎﻓﻈﺎﺕ‪.‬‬
‫‪ .٥‬ﺍﺳﺘﺨﺮﺍﺝ ﺍﳌﺆﺷﺮﺍﺕ ﻭﺗﻮﺯﻳﻌﻬﺎ‪.‬‬
‫‪ .٦‬ﺍﻟﺘﻨﺴﻴﻖ ﻣﻊ ﻛﺎﻓﺔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﻭﺍﳌﺸﺎﺭﻳﻊ ﳌﻨﻊ ﺍﻟﺘﻜﺮﺍﺭ ﰲ ﲨﻊ ﺍﳌﻌﻠﻮﻣﺎﺕ‪.‬‬
‫ﻭﻳﻐﻄﻲ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﻛﺎﻓﺔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﻣﻦ ﻭﻗﺎﺋﻴﺔ ﻭﻋﻼﺟﻴﺔ ﻭﺭﻋﺎﻳﺔ ﺻﺤﻴﺔ ﺃﻭﻟﻴﺔ‪.‬‬
‫ﻭﻳﻬﺪﻑ ﺍﻟﻨﻈﺎﻡ ﻛﺬﻟﻚ ﺇﱃ ﺍﻟﺘﻮﺣﻴﺪ ﺍﻟﻘﻴﺎﺳﻲ ﰲ ﳎﺎﻝ ﲨﻊ ﺍﳌﻌﻠﻮﻣﺎﺕ‪ ،‬ﻟﺬﻟﻚ ﻓﻘﺪ ﺣﺪﺩ ‪ ١٨‬ﻣﻦ ﻧﻈﻢ‬
‫ﺍﻷﻛﻮﺍﺩ ﺍﳌﻮﺣﺪﺓ ﻣﻨﻬﺎ ﻣﺎ ﻫﻮ ﺩﻭﱄ‪ :‬ﻛﻨﻈﺎﻡ ﺗﻜﻮﻳﺪ ﺍﻟﻌﻘﺎﻗﲑ ﺃﻭ ﻧﻈﺎﻡ ﻟﺘﻜﻮﻳﺪ ﺍﻷﻣﺮﺍﺽ )ﺍﻟﺘﺼﻨﻴﻒ‬
‫ﺍﻟﺪﻭﱄ ﻟﻸﻣﺮﺍﺽ – ﺍﳌﺮﺍﺟﻌﺔ ﺍﻟﻌﺎﺷﺮﺓ( ﻭﻣﻨﻬﺎ ﻣﺎ ﻫﻮ ﳏﻠﻲ ﻣﺜﻞ ﻧﻈﻢ ﺗﻜﻮﻳﺪ ﺍﻟﺘﺨﺼﺼﺎﺕ ﺍﳌﻬﻨﻴﺔ ﺃﻭ‬
‫ﺃﻧﻮﺍﻉ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻭﺍﻟﻐﺎﻳﺔ ﻣﻦ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﺩﻋﻢ ﻣﻘﺪﺭﺓ ﻣﺘﺨﺬ ﺍﻟﻘﺮﺍﺭ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ ﻋﻠﻰ ﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭ ﺍﻷﻓﻀﻞ ﻭﺍﻷﻛﺜﺮ‬
‫ﻓﻌﺎﻟﻴﺔ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ‪.‬‬

‫*)&@ ?‪9:  

 ;<  2
&-=>
 )!/
 !,‬ء 
‪7‬‬
‫ﻣﻦ ﺍﻟﺒﺪﻳﻬﻴﺎﺕ ﺃﻥ ﻣﺴﺘﻮﻯ ﺍﳌﻌﻠﻮﻣﺎﺕ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ ﻻ ﳝﻜﻦ ﺃﻥ ﻳﻜﻮﻥ ﺃﻓﻀﻞ ﻣﻦ ﻣﺴﺘﻮﻯ ﺍﻟﺒﻴﺎﻧﺎﺕ‬
‫ﺍﻷﻭﻟﻴﺔ ﺍﻟﱵ ﰎ ﲨﻌﻬﺎ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻄﺮﰲ ﻛﺄﺳﺎﺱ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ‪ .‬ﻓﺎﳊﺎﺳﺒﺎﺕ ﺍﻵﻟﻴﺔ ﺍﳌﺘﻘﺪﻣﺔ‬

‫‪١٣٤‬‬
‫ﻭﺍﻟﱪﺍﻣﺞ ﺍﳌﺘﻄﻮﺭﺓ ﻻ ﳝﻜﻨﻬﺎ ﺇﻧﺘﺎﺝ ﺑﻴﺎﻧﺎﺕ ﻋﺎﻟﻴﺔ ﺍﳉﻮﺩﺓ ﻣﺎ ﱂ ﺗﻜﻦ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻷﻭﻟﻴﺔ ﺍﻟﻄﺮﻓﻴﺔ ﺻﺤﻴﺤﺔ‬
‫ﻭﺩﻗﻴﻘﺔ‪ ،‬ﻟﺬﻟﻚ ﻓﻼ ﳝﻜﻦ ﺇﻗﺎﻣﺔ ﻧﻈﺎﻡ ﻣﻌﻠﻮﻣﺎﺕ ﺻﺤﻲ ﻣﻔﻴﺪ ﻣﺎ ﱂ ﺗﻜﻦ ﻫﻨﺎﻙ ﻛﻮﺍﺩﺭ ﺑﺸﺮﻳﺔ ﻣﺪﺭﺑﺔ‬
‫ﺗﺪﺭﻳﺒﺎﹰ ﺟﻴﺪﺍﹰ ﺑﺎﻟﻮﺣﺪﺍﺕ ﺍﻟﻄﺮﻓﻴﺔ ﳉﻤﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ‪.‬‬
‫ﻭﻻ ﻳﻘﺘﺼﺮ ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻋﻠﻰ ﺃﻓﺮﺍﺩ ﻣﻌﻴﻨﲔ ﺑﺎﻟﺬﺍﺕ‪ ،‬ﻓﺎﻷﻃﺒﺎﺀ ﻭﺃﻓﺮﺍﺩ ﻫﻴﺌﺔ ﺍﻟﺘﻤﺮﻳﺾ ﻭﺍﻹﺩﺍﺭﻳﻮﻥ‬
‫ﻭﻏﲑﻫﻢ‪ ،‬ﻫﻢ ﺟﺎﻣﻌﻮﻥ ﻭﻣﺴﺠﻠﻮﻥ ﻟﻠﺒﻴﺎﻧﺎﺕ‪ ،‬ﻭﻟﻜﻦ ﺍﻷﻣﺮ ﳛﺘﺎﺝ ﺑﺎﻹﺿﺎﻓﺔ ﺍﱃ ﺫﻟﻚ ﻷﻓﺮﺍﺩ ﻳﻜﻮﻥ‬
‫ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ ﻫﻮ ﺷﺎﻏﻠﻬﻢ ﺍﻷﺳﺎﺳﻲ ﻭﻧﺸﺎﻃﻬﻢ ﺍﻟﺮﺋﻴﺴﻲ ﻭﻟﻴﺲ ﳎﺮﺩ ﻣﻬﻤﺔ ﺇﺿﺎﻓﻴﺔ ﳝﺎﺭﺳﻬﺎ‬
‫ﺍﻟﺒﻌﺾ ﺭﲟﺎ ﺩﻭﻥ ﺍﻗﺘﻨﺎﻉ ﺃﻭ ﲪﺎﺱ‪ .‬ﻭﻻ ﻳﻌﲎ ﻫﺬﺍ ﺍﻻﺳﺘﻐﻨﺎﺀ ﻋﻦ ﺩﻭﺭ ﺍﻟﻔﺌﺎﺕ ﺍﻷﺧﺮﻯ ﰱ ﻋﻤﻠﻴﺔ‬
‫ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ‪ ،‬ﻓﻬﻮ ﺩﻭﺭ ﻻ ﳝﻜﻦ ﺍﻻﺳﺘﻐﻨﺎﺀ ﻋﻨﻪ‪ ،‬ﻓﻤﻦ ﻏﲑ ﺍﻟﻄﺒﻴﺐ ﻣﺜﻼﹰ ﳝﻜﻨﻪ ﻗﻴﺪ ﺑﻴﺎﻧﺎﺕ ﺃﺳﺒﺎﺏ‬
‫ﺍﻟﻮﻓﺎﺓ ﺑﺸﻜﻞ ﺻﺤﻴﺢ ﺑﺸﻬﺎﺩﺓ ﺍﻟﻮﻓﺎﺓ ﺃﻭ ﻛﺘﺎﺑﺔ ﺗﺸﺨﻴﺺ ﺍﳌﺮﺽ ﺑﺘﺬﻛﺮﺓ ﺍﳌﺮﻳﺾ‪ .‬ﻭﻟﻚ ﻻﺑﺪ ﻣﻦ ﻭﺟﻮﺩ‬
‫ﻓﲎ ﻟﻠﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ ﻟﻠﺘﺄﻛﺪ ﻣﻦ ﺃﻥ ﻛﻞ ﻓﺮﺩ ﻣﻜﻠﻒ ﺑﺘﺴﺠﻴﻞ ﺑﻴﺎﻧﺎﺕ ﻣﺎ‪ ،‬ﻗﺪ ﺃﺩﻯ ﺩﻭﺭﻩ ﺑﺎﻟﻔﻌﻞ‬
‫ﺑﺸﻜﻞ ﻣﺘﻘﻦ ﻭﻋﻠﻴﻪ ﻛﺬﻟﻚ ﺃﻥ ﻳﻘﻮﻡ ﲜﺪﻭﻟﺔ ﻭﻓﻬﺮﺳﺔ ﻫﺬﻩ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻭﺍﺳﺘﺨﺮﺍﺝ ﺍﳌﺆﺷﺮﺍﺕ ﻣﻨﻬﺎ ﰒ‬
‫ﺗﺼﻌﻴﺪﻫﺎ ﻟﻠﻤﺴﺘﻮﻳﺎﺕ ﺍﻷﻋﻠﻰ ﺑﺎﻹﺩﺍﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ ﰒ ﺍﳌﺪﺭﻳﺎﺕ ﰒ ﻣﺮﻛﺰ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺑﺎﻟﻮﺯﺍﺭﺓ‪.‬‬
‫ﻭﻋﻠﻰ ﻓﲏ ﺍﻟﺘﺴﺠﻴﻞ ﻧﺸﺮ "ﺛﻘﺎﻓﺔ ﺍﻟﺘﺴﺠﻴﻞ" ﺑﲔ ﻛﺎﻓﺔ ﺍﻟﻌﺎﻣﻠﲔ‪ ،‬ﺃﻱ ﺗﺒﺼﲑﻫﻢ ﺑﺄﳘﻴﺔ ﺍﻟﺘﺴﺠﻴﻞ‬
‫ﻭﺗﺰﻭﻳﺪﻫﻢ ﺑﺎﻟﺒﻴﺎﻧﺎﺕ ﻭﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﱵ ﲤﻜﻨﻬﻢ ﻣﻦ ﺗﻄﻮﻳﺮ ﺃﺩﺍﺋﻬﻢ ﺣﱴ ﻻ ﻳﻔﻘﺪﻭﻥ ﲪﺎﺳﻬﻢ ﻟﺪﻗﺔ‬
‫ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺇﺫ ﺷﻌﺮﻭﺍ ﺃﻥ ﻣﺎ ﻳﺒﺬﻟﻮﻧﻪ ﻣﻦ ﺟﻬﺪ ﰲ ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻻ ﻳﺆﺩﻯ ﻟﻔﺎﺋﺪﺓ ﻭﺍﺿﺤﺔ ﳍﻢ‬
‫ﻭﻟﻠﻤﺆﺳﺴﺔ ﺍﻟﱵ ﻳﻌﻤﻠﻮﻥ ‪‬ﺎ‪.‬‬
‫ﻭﺍﺳﺘﺸﻌﺎﺭﺍﹰ ﻣﻦ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻷﳘﻴﺔ ﻭﺟﻮﺩ ﻛﻮﺍﺩﺭ ﻓﻨﻴﺔ ﻣﺘﺨﺼﺼﺔ ﰲ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ‬
‫ﻭﺍﻹﺣﺼﺎﺀ‪ ،‬ﻗﺎﻣﺖ ﺑﺈﻧﺸﺎﺀ ﺷﻌﺒﺔ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ ﻭﺍﻹﺣﺼﺎﺀ ﺑﺎﳌﻌﺎﻫﺪ ﺍﻟﻔﻨﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﻗﺪ‬
‫ﺃﻧﺸﺌﺖ ﻷﻭﻝ ﻣﺮﺓ ﺑﺎﳌﻌﻬﺪ ﺍﻟﻔﲏ ﺍﻟﺼﺤﻲ ﺑﺈﻣﺒﺎﺑﺔ ﻋﺎﻡ ‪ ،١٩٧٢‬ﰒ ﺗﺘﺎﺑﻊ ﺇﻧﺸﺎﺀ ﺍﻟﺸﻌﺒﺔ ﰲ ﻛﺎﻓﺔ‬
‫ﺍﳌﻌﺎﻫﺪ ﺍﻟﺼﺤﻴﺔ ﺣﱴ ﺃﺻﺒﺤﺖ ﻣﺜﻠﻪ ﰲ ﲨﻴﻊ ﺍﳌﻌﺎﻫﺪ ﺍﻟﻔﻨﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺑﺎﳉﻤﻬﻮﺭﻳﺔ )ﺃﺣﺪ ﻋﺸﺮ‬
‫ﻣﻌﻬﺪﺍﹰ ﺣﱴ ﺍﻵﻥ( ﻭﺍﳉﺪﻭﻝ ﺭﻗﻢ )‪ (١‬ﻳﻮﺿﺢ ﺗﺎﺭﻳﺦ ﺇﻧﺸﺎﺀ ﺷﻌﺒﺔ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ ﻭﺍﻹﺣﺼﺎﺀ ﺑﺎﳌﻌﺎﻫﺪ‬
‫ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(١-٥‬ﺗﺎﺭﻳﺦ ﺇﻧﺸﺎﺀ ﺷﻌﺒﺔ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ ﻭﺍﻹﺣﺼﺎﺀ ﺑﺎﳌﻌﺎﻫﺪ ﺍﻟﻔﻨﻴﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﺗﺎﺭﻳﺦ ﺇﻧﺸﺎﺀ ﺷﻌﺒﺔ‬
‫ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ‬ ‫ﺍﳌﻌﻬﺪ ﺍﻟﻔﲎ ﺍﻟﺼﺤﻰ‬
‫ﻭﺍﻹﺣﺼﺎﺀ‬
‫‪١٩٧٢‬‬ ‫ﺇﻣﺒﺎﺑﺔ‬
‫‪١٩٧٣‬‬ ‫ﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬
‫‪١٩٧٥‬‬ ‫ﺍﻟﺰﻗﺎﺯﻳﻖ‬
‫‪١٩٨٠‬‬ ‫ﺃﺳﻴﻮﻁ‬
‫‪١٩٨٠‬‬ ‫ﺍﳌﻨﺼﻮﺭﺓ‬
‫‪١٩٨١‬‬ ‫ﻃﻨﻄﺎ‬
‫‪١٩٩١‬‬ ‫ﺑﲎ ﺳﻮﻳﻒ‬
‫‪١٩٩٢‬‬ ‫ﺳﻮﻫﺎﺝ‬
‫‪١٩٩٣‬‬ ‫ﺑﻮﺭ ﺳﻌﻴﺪ‬
‫‪١٩٩٤‬‬ ‫ﺑﻨﻬﺎ‬
‫‪١٩٩٥‬‬ ‫ﺍﻹﲰﺎﻋﻴﻠﻴﺔ‬

‫‪١٣٥‬‬
‫ﻭﻛﺎﻥ ﻋﺪﺩ ﺧﺮﳚﻲ ﺍﻟﺸﻌﺒﺔ ﳏﺪﺩﺍﹰ ﰲ ﺑﺎﺩﺉ ﺍﻷﻣﺮ ﻭﻟﻜﻨﻪ ﺗﺰﺍﻳﺪ ﺑﺴﺮﻋﺔ‪ ،‬ﻻ ﺳﻴﻤﺎ ﰲ ﻋﻘﺪ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ‬
‫)ﻛﻤﺎ ﻫﻮ ﻣﻮﺿﺢ ﰲ ﺟﺪﻭﻝ ‪.(٢-٥‬‬
‫ﻭﻳﺒﺪﻭ ﺃﻥ ﺍﻟﺘﻮﺳﻊ ﰲ ﺍﻟﻘﺒﻮﻝ ﱂ ﻳﻮﺍﻛﺒﻪ ﺗﺼﻮﺭ ﻭﺍﺿﺢ )ﺃﻭ ﺍﻗﺘﻨﺎﻉ ﻭﺍﺿﺢ( ﲞﺼﻮﺹ ﺍﻻﺳﺘﻔﺎﺩﺓ ﻣﻦ‬
‫ﺍﳋﺮﳚﲔ )ﺭﻏﻢ ﺍﳊﺎﺟﺔ ﺍﻟﺸﺪﻳﺪﺓ ﳍﺬﺍ ﺍﻟﺘﺨﺼﺺ(‪ .‬ﳑﺎ ﺃﺩﻯ ﻟﺘﻮﺯﻳﻊ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳋﺮﺟﲔ ﰲ ﻣﻮﺍﻗﻊ ﻻ ﲤﺖ‬
‫ﺑﺼﻠﺔ ﻟﻌﻤﻠﻬﻢ‪ ،‬ﻛﺎﻟﻌﻤﻞ ﻛﻜﺘﺒﺔ ﻋﻠﻰ ﺍﻵﻻﺕ ﺍﻟﻜﺎﺗﺒﺔ ﺃﻭ ﰲ ﺃﻋﻤﺎﻝ ﺍﻟﺴﻜﺮﺗﺎﺭﻳﺔ ﺃﻭ ﺍﻷﻋﻤﺎﻝ ﺍﻹﺩﺍﺭﻳﺔ‬
‫ﻭﺍﳌﺎﻟﻴﺔ ﻭﺍﳌﺨﺰﻧﻴﺔ‪ ،‬ﳑﺎ ﺳﺒﺐ ﺷﻌﻮﺭﺍﹰ ﺑﺎﻹﺣﺒﺎﻁ ﺑﲔ ﺍﳋﺮﺟﲔ ﺑﻞ ﺣﱴ ﺑﲔ ﺍﻟﻄﻼﺏ ﺍﻟﺬﻳﻦ ﻣﺎ ﺯﺍﻟﻮﺍ ﻳﺪﺭﺳﻮﻥ‬
‫ﺑﺎﻟﺸﻌﺒﺔ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٢-٥‬ﻋﺪﺩ ﺧﺮﳚﻲ ﺷﻌﺒﺔ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ ﻭﺍﻹﺣﺼﺎﺀ ﺑﺎﳌﻌﺎﻫﺪ ﺍﻟﻔﻨﻴﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﳌﺘﻮﺳﻂ ﺍﻟﺴﻨﻮﻱ‬ ‫ﻋﺪﺩ ﺍﳋﺮﳚﲔ‬ ‫ﺍﻟﻔﺘﺮﺓ ﺍﻟﺰﻣﻨﻴﺔ‬
‫‪١٩٠‬‬ ‫‪٩٤٨‬‬ ‫‪١٩٨٥-١٩٨١‬‬
‫‪٢٨١‬‬ ‫‪١٤٠٦‬‬ ‫‪١٩٩٠-١٩٨٦‬‬
‫‪٥٣٦‬‬ ‫‪١٩٩٢‬‬
‫‪٦٣٧‬‬ ‫‪١٩٩٣‬‬
‫‪٣١٧‬‬ ‫‪١٩٩٤‬‬
‫‪٤٠٠‬‬ ‫‪١٩٩٥‬‬
‫‪٥١٩‬‬ ‫‪١٩٩٦‬‬
‫ﻭﻗﺪ ﺗﺰﺍﻳﺪ ﻋﺪﺩ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ ﻓﻨﻴﻲ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ )ﺳﻮﺍﺀ ﻛﺎﻧﻮﺍ ﻳﻌﻤﻠﻮﻥ ﰲ ﳎﺎﻝ‬
‫ﲣﺼﺼﻬﻢ ﺃﻡ ﻏﲑﻩ ﻣﻦ ﺍ‪‬ﺎﻻﺕ(‪ ،‬ﻓﺒﻴﻨﻤﺎ ﻛﺎﻥ ﻋﺪﺩﻫﻢ ﺑﺎﻟﻮﺯﺍﺭﺓ ‪ ١٣٠‬ﻓﻨﻴﺎﹰ ﻓﻘﻂ ﻋﺎﻡ ‪ ،١٩٨٢‬ﺑﻠﻎ ﻋﺪﺩﻫﻢ‬
‫ﰲ ﺃﻭﻝ ﻳﻨﺎﻳﺮ ‪ ٢٨٦٢ ،١٩٩٧‬ﻓﲏ ﺗﺴﺠﻴﻞ ﻃﱯ ﻗﺎﺋﻤﺎﹰ ﺑﺎﻟﻌﻤﻞ ﻓﻌﻼﹰ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﳊﻮﺍﱄ ‪ ٤٠٠‬ﻋﻠﻰ ﻗﻮﺓ‬
‫ﺍﻟﻮﺯﺍﺭﺓ ﻭﻟﻜﻦ ﻏﲑ ﻗﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ )ﺇﻋﺎﺭﺍﺕ‪ ،‬ﺇﺟﺎﺯﺍﺕ‪ ،‬ﺭﻋﺎﻳﺔ ﻃﻔﻞ‪ ،‬ﺍﱁ(‪ ،‬ﺃﻱ ﺃﻧﻪ ﰲ ‪ ١٥‬ﻋﺎﻣﺎﹰ ﺗﻀﺎﻋﻒ‬
‫ﺍﻟﻌﺪﺩ ﺃﻛﺜﺮ ﻣﻦ ‪ ٢٢‬ﻣﺮﺓ‪ ،‬ﻭﺑﺘﺎﺭﻳﺦ ﺃﻭﻝ ﻳﻨﺎﻳﺮ ‪ ٢٠٠١‬ﻛﺎﻥ ﻋﺪﺩ ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ ﻣﻦ ﻓﻨﻴﻲ ﺍﻟﺘﺴﺠﻴﻞ‬
‫ﺍﻟﻄﱯ ‪ ،٤٢٥٦‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺣﻮﺍﱄ ‪ ٥٠٠‬ﻋﻠﻰ ﻗﻮﺓ ﺍﻟﻮﺯﺍﺭﺓ ﻏﲑ ﻗﺎﺋﻤﲔ ﺑﺎﻟﻌﻤﻞ‪ .‬ﻭﻻ ﻧﺮﻯ ﺃﻧﻪ ﻳﻮﺟﺪ ﻓﺎﺋﺾ‪،‬‬
‫ﻓﻠﻮ ﺍﻓﺘﺮﺿﻨﺎ ﺃﻥ ﻛﻞ ﻭﺣﺪﺓ ﺻﺤﻴﺔ ﺃﻭ ﻣﺴﺘﺸﻔﻰ ﳛﺘﺎﺝ ﺇﱃ ﻓﲏ ﺗﺴﺠﻴﻞ ﻃﱯ ﻭﺍﺣﺪ ﻓﻘﻂ ﻟﺘﺒﲔ ﻟﻨﺎ‬
‫ﺃﻥ ﺍﻟﻌﺪﺩ ﺍﳌﺘﺎﺡ ﺃﻗﻞ ﻣﻦ ﺍﳌﻄﻠﻮﺏ‪ ،‬ﻭﻟﻜﻦ ﻻﺑﺪ ﻣﻦ ﺳﻴﺎﺳﺔ ﺭﺷﻴﺪﺓ ﰲ ﺍﻟﺘﻮﺯﻳﻊ‪ ،‬ﻟﻮﺿﻊ ﺍﻟﺮﺟﻞ ﺍﳌﻨﺎﺳﺐ ﰲ‬
‫ﺍﳌﻜﺎﻥ ﺍﳌﻨﺎﺳﺐ‪.‬‬

‫ﻧﻈﺎﻡ ﺍﻟﺪﺭﺍﺳﺔ‬
‫ﻳﺘﻢ ﻗﺒﻮﻝ ﺍﻟﻄﻼﺏ ﻣﻦ ﲪﻠﺔ ﺷﻬﺎﺩﺓ ﺍﻟﺜﺎﻧﻮﻳﺔ ﺍﻟﻌﺎﻣﺔ ﺃﻭ ﺍﻟﺜﺎﻧﻮﻳﺔ ﺍﻟﺘﺠﺎﺭﻳﺔ )ﻭﺍﻟﻐﺎﻟﺒﻴﺔ ﺑﺎﻟﻔﻌﻞ ﳛﻤﻠﻮﻥ‬
‫ﺩﺑﻠﻮﻡ ﺍﻟﺜﺎﻧﻮﻳﺔ ﺍﻟﺘﺠﺎﺭﻳﺔ(‪ .‬ﻭﺗﺸﻜﻞ ﺍﻟﻄﺎﻟﺒﺎﺕ ﺍﻷﻏﻠﺒﻴﺔ )ﰲ ﻋﺎﻡ ‪ ١٩٩٥‬ﻛﺎﻥ ‪ %٥٧‬ﻣﻦ ﺧﺮﳚﻲ ﺍﻟﺸﻌﺒﺔ‬
‫ﻣﻦ ﺍﻹﻧﺎﺙ‪ ،‬ﻋﻠﻰ ﻋﻜﺲ ﲨﻴﻊ ﺍﻟﺸﻌﺒﺎﺕ ﺍﻷﺧﺮﻯ ﺑﺎﳌﻌﺎﻫﺪ ﺍﻟﻔﻨﻴﺔ‪ ،‬ﺣﻴﺚ ﺷﻜﻞ ﺍﻟﻄﺎﻟﺒﺎﺕ ‪ %١٤‬ﻓﻘﻂ‬
‫ﻣﻦ ﺍﳋﺮﺟﲔ(‪.‬‬
‫ﻭﺗﺴﺘﻤﺮ ﺍﻟﺪﺭﺍﺳﺔ ﻋﻠﻰ ﻣﺪﻯ ﺳﻨﺘﲔ ﺩﺭﺍﺳﻴﺘﲔ ﺑﻮﺍﻗﻊ ‪ ٢٧‬ﺃﺳﺒﻮﻋﺎﹰ ﰲ ﺍﻟﺴﻨﺔ ﺍﻷﻭﱃ ﻭ‪ ٣٠‬ﺃﺳﺒﻮﻋﺎﹰ ﰲ‬
‫ﺍﻟﺴﻨﺔ ﺍﻟﺜﺎﻧﻴﺔ‪ ،‬ﻭﻳﺘﺨﻠﻞ ﺍﻟﻌﺎﻣﲔ ﺗﺪﺭﻳﺐ ﺻﻴﻔﻲ ﻣﺪﺗﻪ ‪ ٤‬ﺃﺳﺎﺑﻴﻊ ﺑﻮﺍﻗﻊ ‪ ٣٠‬ﺳﺎﻋﺔ ﺃﺳﺒﻮﻋﻴﺎﹰ‪.‬‬
‫ﻭﻳﻌﺘﻤﺪ ﺍﻟﺘﺪﺭﻳﺲ ﺇﱃ ﺣﺪ ﻛﺒﲑ ﻋﻠﻰ ﻧﻈﺎﻡ ﺍﻻﻧﺘﺪﺍﺏ ﻣﻦ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﻭﻣﻦ ﻛﺒﺎﺭ ﺍﻟﻌﺎﻣﻠﲔ ﺑﻮﺯﺍﺭﺓ‬
‫ﺍﻟﺼﺤﺔ ﻭﻏﲑﻫﺎ ﻣﻦ ﺍﳍﻴﺌﺎﺕ‪ .‬ﻭﺟﺰﺀ ﻛﺒﲑ ﻣﻦ ﺳﺎﻋﺎﺕ ﺍﻟﺘﺪﺭﻳﺲ ﳐﺼﺺ ﻟﻠﺠﻮﺍﻧﺐ ﺍﻟﻌﻤﻠﻴﺔ‬
‫ﺍﻟﺘﻄﺒﻴﻘﻴﺔ‪.‬‬

‫‪١٣٦‬‬
 ‫ﺍﳌﻘﺮﺭﺍﺕ‬
‫ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻋﺎﻡ ‪ ١٩٩٥‬ﲟﺒﺎﺩﺭﺓ ﻟﺘﻄﻮﻳﺮ ﻣﻘﺮﺭﺍﺕ ﺷﻌﺒﺔ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ ﻭﺍﻹﺣﺼﺎﺀ‬
‫ﺑﺎﳌﻌﺎﻫﺪ ﺍﻟﻔﻨﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺫﻟﻚ ﻟﺘﻮﺍﻛﺐ ﺍﳌﺘﻐﲑﺍﺕ ﺍﳊﺪﻳﺜﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﺍﻟﺴﺮﻳﻊ ﺍﻟﺘﻄﻮﺭ‪ .‬ﻭﺻﺪﺭ ﺍﻟﻘﺮﺍﺭ‬
‫ﺍﻟﻮﺯﺍﺭﻱ ﺭﻗﻢ )‪ (٧٩‬ﻟﺴﻨﺔ ‪ ١٩٩٦‬ﻣﺸﺘﺮﻛﺎﹰ ﻣﻦ ﻭﺯﻳﺮﻱ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻌﺎﱄ ﻭﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻣﺘﻀﻤﻨﺎﹰ‬
‫ﺍﻟﺘﻌﺪﻳﻼﺕ ﺍﳌﻘﺘﺮﺣﺔ ﻭﲣﺮﺟﺖ ﰲ ﺷﻬﺮ ﺃﻏﺴﻄﺲ ‪ ١٩٩٧‬ﺃﻭﻝ ﺩﻓﻌﺔ ﻣﻦ ﺍﻟﺸﻌﺒﺔ ﻃﺒﻘﺎﹰ ﻟﻼﺋﺤﺔ ﺍﳌﻄﻮﺭﺓ‪.‬‬
‫ﻭﺗﻀﻤﻦ ﺍﻟﺘﻄﻮﻳﺮ ﺇﺩﺧﺎﻝ ﻣﻘﺮﺭﺍﺕ ﺧﺎﺻﺔ ﺑﺎﳊﺎﺳﺐ ﺍﻵﱄ ﻭﺍﻟﺘﺼﻨﻴﻒ ﺍﻟﺪﻭﱄ ﻟﻸﻣﺮﺍﺽ ﻭﻧﻈﻢ ﺍﻹﺩﺍﺭﺓ‬
‫ﺍﻟﺼﺤﻴﺔ ﻣﻊ ﺯﻳﺎﺩﺓ ﻣﻜﻮﻥ ﺍﻟﺘﺪﺭﻳﺐ ﺍﻟﻌﻤﻠﻲ ﺍﳌﻴﺪﺍﱐ ﰲ ﺍﳌﻘﺮﺭﺍﺕ‪.‬‬
‫ﻭﺑﺎﻹﺿﺎﻓﺔ ﻟﺬﻟﻚ ﻳﺪﺭﺱ ﺍﻟﻄﺎﻟﺐ ﻋﻠﻰ ﻣﺪﺍﺭ ﺍﻟﻌﺎﻣﲔ ﻣﻘﺮﺭﺍﺕ ﰲ ﺍﻹﺣﺼﺎﺀ ﺍﻟﺘﻄﺒﻴﻘﻲ ﻭﺍﳌﺼﻄﻠﺤﺎﺕ‬
‫ﺍﻟﻄﺒﻴﺔ ﺑﺎﻟﻠﻐﺔ ﺍﻹﳒﻠﻴﺰﻳﺔ ﻭﺍﶈﺎﺳﺒﺔ ﺍﳌﺎﻟﻴﺔ‪ .‬ﻫﺬﺍ ﺑﺎﻟﻄﺒﻊ ﲜﺎﻧﺐ ﲣﺼﺼﻪ ﺍﻷﺳﺎﺳﻲ ﰲ ﺍﻟﺘﺴﺠﻴﻞ‬
‫ﺍﻟﻄﱯ ﺣﻴﺚ ﻳﻘﻮﻡ ﺑﺪﺭﺍﺳﺔ ﻛﺎﻓﺔ ﺍﻟﻨﻤﺎﺫﺝ ﺍﻹﺣﺼﺎﺋﻴﺔ ﺍﳌﻄﺒﻘﺔ ﺑﺎﻟﻮﺯﺍﺭﺓ ﻭﺍﻟﱵ ﰎ ﲨﻌﻬﺎ ﰲ ﻧﻈﺎﻡ‬
‫ﻣﻮﺣﺪ‪.‬‬

‫‪2
)!21  ,  A‬‬
‫ﺭﻏﻢ ﻛﻞ ﺍﳉﻬﻮﺩ ﺍﳌﺒﺬﻭﻟﺔ ﻟﺘﺤﺴﲔ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﻄﱯ‪ ،‬ﻓﻼ ﺯﺍﻟﺖ ﻫﻨﺎﻙ ﻣﺸﺎﻛﻞ ﻛﱪﻯ ﺧﺎﺻﺔ‬
‫ﺑﺎﺳﺘﻜﻤﺎﻝ ﺍﻟﺘﺴﺠﻴﻞ ﻭﻧﻮﻋﻴﺘﻪ‪ .‬ﻓﺎﻹﺑﻼﻍ ﻋﻦ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﻳﻌﺘﺮﻳﻪ ﻗﺼﻮﺭ ﻛﺒﲑ ﻻ ﺳﻴﻤﺎ ﺑﺎﻟﻨﺴﺒﺔ‬
‫ﻟﻮﻓﻴﺎﺕ ﺍﻟﺸﻬﺮ ﺍﻷﻭﻝ‪ ،‬ﻗﺪ ﻗﺪﺭﺕ ﺑﻌﺾ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻧﺴﺒﺔ ﻫﺬﺍ ﺍﻟﻘﺼﻮﺭ ﰲ ﺑﻌﺾ ﺍﶈﺎﻓﻈﺎﺕ ﲝﻮﺍﱄ ‪.%٦٠‬‬
‫ﻭﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻳﺘﻢ ﺍﻹﺑﻼﻍ ﻋﻨﻬﺎ ﺑﺼﻔﺔ ﻋﺎﻣﺔ‪ ،‬ﻭﻟﻜﻦ ﻧﺘﻴﺠﺔ ﺍﻟﺘﻘﺼﲑ ﰲ ﺇﻳﻀﺎﺡ ﺃﻥ ﺳﺒﺐ ﺍﻟﻮﻓﺎﺓ‬
‫ﺭﺍﺟﻊ ﻟﻸﻣﻮﻣﺔ )ﺍﳊﻤﻞ‪ ،‬ﺍﻟﻮﻻﺩﺓ‪ ،‬ﺍﻟﻨﻔﺎﺱ( ﻓﺈﻥ ﺗﻘﺪﻳﺮ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻋﻠﻰ ﺃﺳﺎﺱ ﺍﻟﺴﺠﻼﺕ‬
‫ﻳﻜﻮﻥ ﺩﻭﻥ ﺍﻟﻮﺍﻗﻊ‪ .‬ﻓﻌﻠﻰ ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ‪ ،‬ﻳﺘﻢ ﺗﺴﺠﻴﻞ ﻭﻓﺎﺓ ﺍﻷﻡ ﻋﻠﻰ ﺃﻥ ﺳﺒﺒﻬﺎ "ﺻﺪﻣﺔ ﺑﺎﳉﻬﺎﺯ ﺍﻟﻘﻠﱯ‬
‫ﺍﻟﺪﻭﺭﻱ ﺑﺴﺒﺐ ﺍﻟﱰﻑ" ﺩﻭﻥ ﺇﻳﻀﺎﺡ ﺃﻥ ﺍﻟﱰﻑ ﻛﺎﻥ ﻣﻦ ﺍﻟﺮﺣﻢ ﺃﺛﻨﺎﺀ ﺍﻟﻮﻻﺩﺓ‪.‬‬
‫ﻭﻭﺍﺿﺢ ﺃﻥ ﺍﻟﻘﺼﻮﺭ ﺇﻣﺎ ﺭﺍﺟﻊ ﻟﻨﻘﺺ ﻭﻋﻲ ﺍﳌﻮﺍﻃﻦ ﺍﻟﺬﻱ ﻗﺪ ﻳﺘﺮﺍﺧﻰ ﰲ ﺍﻹﺑﻼﻍ ﻋﻦ ﺍﻟﻮﻗﺎﺋﻊ ﺍﻟﻮﺍﺟﺒﺔ‬
‫ﺍﻟﺘﺒﻠﻴﻎ‪ ،‬ﻣﺜﻞ ﺍﳌﻮﺍﻟﻴﺪ ﺃﻭ ﺍﻟﻮﻓﻴﺎﺕ ﺃﻭ ﺑﻌﺾ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ‪ ،‬ﺃﻭ ﻟﻘﺼﻮﺭ ﰲ ﺍﻷﺩﺍﺀ ﺍﻟﻔﲏ ﻟﻠﻄﺒﻴﺐ ﺍﻟﺬﻱ‬
‫ﻳﻘﻮﻡ ﺑﺎﺳﺘﻴﻔﺎﺀ ﺑﻴﺎﻧﺎﺕ ﺍﻟﺘﺸﺨﻴﺺ ﺃﻭ ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ ﺃﻭ ﻏﲑﻫﺎ ﻣﻦ ﺍﻟﺒﻴﺎﻧﺎﺕ‪ .‬ﻭﳑﺎ ﻻ ﺷﻚ ﻓﻴﻪ ﺃﻥ‬
‫ﻟﻠﺘﺪﺭﻳﺐ ﻭﺍﳌﺘﺎﺑﻌﺔ ﻭﺍﻹﺷﺮﺍﻑ ﺍﳌﻨﻀﺒﻂ ﺩﻭﺭﺍﹰ ﰲ ﺗﺼﺤﻴﺢ ﻫﺬﻩ ﺍﻷﻭﺿﺎﻉ ﻭﻟﻜﻦ ﺳﻴﻈﻞ ﺍﻟﻘﺼﻮﺭ ﻣﻮﺟﻮﺩﺍﹰ‬
‫ﻭﺑﺎﻟﺘﺎﱄ ﻫﻨﺎﻙ ﺧﻄﻮﺭﺓ ﰲ ﺃﻥ ﺗﺮﺳﻢ ﺳﻴﺎﺳﺎﺕ ﺻﺤﻴﺔ ﺑﻨﺎﺀ ﻋﻠﻰ ﻣﺆﺷﺮﺍﺕ ﺇﺣﺼﺎﺋﻴﺔ ﻏﲑ ﺩﻗﻴﻘﺔ‬
‫ﻣﺴﺘﻤﺪﺓ ﻣﻦ ﺑﻴﺎﻧﺎﺕ ﻳﺸﻮ‪‬ﺎ ﺍﻟﻘﺼﻮﺭ‪.‬‬
‫ﻭﺍﳊﻞ ﺍﳌﻜﻤﻞ )ﻭﻻ ﻧﻘﻮﻝ ﺍﻟﺒﺪﻳﻞ( ﻫﻮ ﺍﳌﺴﻮﺡ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻴﺪﺍﻧﻴﺔ‪ ،‬ﻓﻌﻦ ﻃﺮﻳﻘﻬﺎ ﳝﻜﻦ ﻣﻌﺮﻓﺔ ﻧﺴﺒﺔ‬
‫ﻗﺼﻮﺭ ﺍﻟﺘﺴﺠﻴﻞ ﻭﺗﺼﺤﻴﺢ ﺍﳌﺆﺷﺮﺍﺕ ﺇﱃ ﺣﺪ ﻛﺒﲑ‪.‬‬
‫ﻭﺍﳌﺴﻮﺡ ﺍﳌﻴﺪﺍﻧﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻧﺸﻄﺔ ﲟﺼﺮ ﻭﺗﺘﺮﺍﻭﺡ ﺑﲔ ﻣﺴﻮﺡ ﻗﻮﻣﻴﺔ ﺿﺨﻤﺔ ﻋﻠﻰ ﻋﻴﻨﺎﺕ ﻋﺸﻮﺍﺋﻴﺔ‬
‫ﳐﺘﺎﺭﺓ ﻋﻠﻰ ﺃﺳﺎﺱ ﻋﻠﻤﻲ ﺩﻗﻴﻖ ﻟﺘﻤﺜﻞ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺼﺮﻱ ﺇﱃ ﻣﺴﻮﺡ ﺻﻐﲑﺓ ﻋﻠﻰ ﻋﻴﻨﺎﺕ ﻋﻤﺪﻳﺔ ﰲ‬
‫ﻣﻨﺎﻃﻖ ﺟﻐﺮﺍﻓﻴﺔ ﳏﺪﻭﺩﺓ‪ .‬ﻭﺍﻟﻜﺜﲑ ﻣﻦ ﲝﻮﺙ ﺍﻟﺪﻛﺘﻮﺭﺍﻩ ﻭﺍﳌﺎﺟﺴﺘﲑ ﰲ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﻭﺍﻟﺘﻤﺮﻳﺾ‬
‫ﻭﻏﲑﻫﺎ ﻣﻦ ﺍﻟﻜﻠﻴﺎﺕ ﺗﺸﺘﻤﻞ ﻋﻠﻰ ﻣﺴﻮﺡ ﻣﻴﺪﺍﻧﻴﺔ ﻭﻛﺬﻟﻚ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺸﺎﺭﻳﻊ ﺍﻟﺒﺤﺜﻴﺔ ﻭﺍﳋﺪﻣﻴﺔ‪.‬‬

‫‪١٣٧‬‬
‫ﻭﻟﻸﺳﻒ ﻓﺈﻥ ﺍﻟﻜﺜﲑ ﻣﻦ ﻧﺘﺎﺋﺞ ﻫﺬﻩ ﺍﳌﺴﻮﺡ ﻏﲑ ﻣﻨﺸﻮﺭ ﺃﻭ ﻣﺘﻮﺍﻓﺮ ﻓﻘﻂ ﰲ ﺷﻜﻞ ﺗﻘﺎﺭﻳﺮ ﻏﲑ ﻣﺘﺎﺣﺔ‬
‫ﻋﻠﻰ ﻧﻄﺎﻕ ﻭﺍﺳﻊ‪ ،‬ﺑﻞ ﻗﺪ ﻻ ﻳﻌﺮﻑ ﺑﻮﺟﻮﺩﻫﺎ ﺃﺳﺎﺳﺎﹰ ﺍﻟﻜﺜﲑﻭﻥ ﻣﻦ ﺍﳌﻬﺘﻤﲔ ﲟﻮﺿﻮﻉ ﺍﳌﺴﺢ‪.‬‬
‫ﺳﻨﻜﺘﻔﻲ ﻫﻨﺎ ﺑﺈﻋﻄﺎﺀ ﺛﻼﺛﺔ ﺃﻣﺜﻠﺔ ﳌﺴﻮﺡ ﻗﻮﻣﻴﺔ ﻫﺎﻣﺔ‪:‬‬

‫ﺃ‪ -‬ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﺍﻟﺪﳝﻮﺟﺮﺍﰲ‬

‫ﻃﺒﻖ ﻫﺬﺍ ﺍﳌﺴﺢ ﻷﻭﻝ ﻣﺮﺓ ﰲ ﻣﺼﺮ ﻋﺎﻡ ‪ ،١٩٨٨‬ﰒ ﺗﻜﺮﺭ ﰲ ﺃﻋﻮﺍﻡ ‪ ١٩٩٢‬ﻭ‪ ١٩٩٥‬ﻭ‪ ،٢٠٠٠‬ﺑﺎﻹﺿﺎﻓﺔ‬
‫ﳌﺴﺤﲔ ﳏﺪﻭﺩﻱ ﺍﳊﺠﻢ ﻧﺴﺒﻴﺎﹰ ﻷﻋﻮﺍﻡ ‪ ١٩٩٧‬ﻭ‪ .١٩٩٨‬ﻭﻗﺪ ﺍﻛﺘﺴﺐ ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﺍﻟﺪﳝﻮﺟﺮﺍﰲ‬
‫ﺻﻔﺔ ﺍﳌﺮﺟﻌﻴﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﺪﻳﺪ ﻣﻦ ﺍﳍﻴﺌﺎﺕ ﺍﶈﻠﻴﺔ ﻭﺍﻟﺪﻭﻟﻴﺔ ﻭﺫﻟﻚ ﻟﻸﺳﺒﺎﺏ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫‪ .١‬ﻛﱪ ﺣﺠﻢ ﺍﻟﻌﻴﻨﺔ‪ ،‬ﻓﺎﳌﺴﺢ ﺍﻷﺧﲑ ﻟﻌﺎﻡ ‪ ٢٠٠٠‬ﰎ ﻋﻠﻰ ﺣﻮﺍﱄ ‪ ١٦٠٠٠‬ﺃﺳﺮﺓ‪.‬‬
‫‪ .٢‬ﺍﻟﺘﻤﺜﻴﻞ ﺍﻟﻘﻮﻣﻲ‪ ،‬ﺣﻴﺚ ﻳﺘﻢ ﲤﺜﻴﻞ ﻛﺎﻓﺔ ﻣﻨﺎﻃﻖ ﻭﳏﺎﻓﻈﺎﺕ ﺍﳉﻤﻬﻮﺭﻳﺔ‪.‬‬
‫‪ .٣‬ﺍﺧﺘﻴﺎﺭ ﺍﻟﻌﻴﻨﺔ ﻋﻠﻰ ﺃﺳﺎﺱ ﻋﻠﻤﻲ ﺑﻮﺍﺳﻄﺔ ﺧﱪﺍﺀ ﻣﺘﺨﺼﺼﲔ‪ ،‬ﻟﺘﻜﻮﻥ ﻋﻴﻨﺔ ﻋﺸﻮﺍﺋﻴﺔ‬
‫ﳑﺜﻠﺔ ﺑﺪﻗﺔ ﻟﻠﻤﺠﺘﻤﻊ ﺍﳌﺼﺮﻱ‪.‬‬
‫‪ .٤‬ﺍﳌﺴﺢ ﻳﺘﻢ ﳊﺴﺎﺏ ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻠﺴﻜﺎﻥ ﻭﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﻫﻲ ﻫﻴﺌﺎﺕ ﺭﲰﻴﺔ‬
‫ﻭﻳﺘﻢ ﺍﻟﺘﻨﻔﻴﺬ ﺍﻟﻔﲏ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﺘﻌﺎﻗﺪ ﻣﻊ ﺟﻬﺎﺕ ﻣﺘﺨﺼﺼﺔ ﺫﺍﺕ ﺧﱪﺓ ﻓﻨﻴﺔ ﻃﻮﻳﻠﺔ‪.‬‬
‫‪ .٥‬ﺍﳌﺴﺢ ﻳﺘﻮﺍﻓﺮ ﻟﻪ ﺍﻟﺘﻤﻮﻳﻞ ﺍﻟﻜﺎﰲ ﻭﺗﺘﻢ ﺑﻪ ﻋﻤﻠﻴﺎﺕ ﻟﻀﺒﻂ ﺟﻮﺩﺓ ﺍﻷﺩﺍﺀ‪.‬‬
‫‪ .٦‬ﺍﳌﺴﺢ ﻳﺸﻤﻞ ﺑﻴﺎﻧﺎﺕ ﻋﻦ ﺍﻟﺘﺮﻛﻴﺒﺔ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻭﺍﳋﺼﻮﺑﺔ ﻭﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﻭﺻﺤﺔ ﺍﻟﻄﻔﻞ‬
‫ﻭﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﺘﻌﻠﻴﻢ ﻭﳎﺎﻻﺕ ﺃﺧﺮﻯ‪ ،‬ﻭﺍﻟﺒﻴﺎﻧﺎﺕ ﺗﺘﺎﺡ ﻋﻠﻰ ﺷﺒﻜﺔ ﺍﻹﻧﺘﺮﻧﺖ ﲟﺎ ﻳﺴﻤﺢ‬
‫ﻟﻠﺒﺎﺣﺜﲔ ﺑﺈﺟﺮﺍﺀ ﲢﻠﻴﻼﺕ ﺇﺣﺼﺎﺋﻴﺔ ﻣﺒﺘﻜﺮﺓ ﻟﻠﺮﺑﻂ ﺑﲔ ﺍﳌﺘﻐﲑﺍﺕ ﰲ ﳎﺎﻻﺕ ﳐﺘﻠﻔﺔ‪.‬‬
‫‪ .٧‬ﺗﺘﻮﺍﻓﺮ ﻧﺘﺎﺋﺞ ﺍﻟﺒﺤﺚ ﺧﻼﻝ ﻓﺘﺮﺓ ﻗﺼﲑﺓ ﻧﺴﺒﻴﺎﹰ ﻣﻦ ﺍﻧﺘﻬﺎﺀ ﺍﻟﻌﻤﻞ ﺍﳌﻴﺪﺍﱐ ﲟﺎ ﻳﺴﻤﺢ‬
‫ﺑﺎﻻﺳﺘﻔﺎﺩﺓ ﻣﻦ ﻫﺬﻩ ﺍﻟﻨﺘﺎﺋﺞ ﻟﺮﺳﻢ ﺍﻟﺴﻴﺎﺳﺎﺕ‪ ،‬ﻋﻜﺲ ﻣﺴﻮﺡ ﺃﺧﺮﻯ ﱂ ﺗﺘﻮﺍﻓﺮ ﺑﻴﺎﻧﺎ‪‬ﺎ ﺇﻻ‬
‫ﺑﻌﺪ ﺳﻨﻮﺍﺕ ﺗﻜﻮﻥ ﺃﺣﻮﺍﻝ ﺍ‪‬ﺘﻤﻊ ﻗﺪ ﺗﻐﲑﺕ ﺧﻼﳍﺎ ﻭﻳﻔﻘﺪ ﺍﻟﺒﺤﺚ ﺃﻳﺔ ﻗﻴﻤﺔ ﻟﻪ ﺑﺸﺄﻥ‬
‫ﺍﳌﺴﺎﻋﺪﺓ ﰲ ﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭ ﻭﺗﺒﻘﻰ ﻟﻪ ﻓﻘﻂ ﺍﻷﳘﻴﺔ ﺍﻟﺘﺎﺭﳜﻴﺔ‪.‬‬

‫ﺏ‪ -‬ﺍﳌﺴﺢ ﺍﻟﻘﻮﻣﻲ ﻟﻠﻤﺮﺍﻫﻘﲔ ﺍﳌﺼﺮﻳﲔ‬

‫ﺃﺟﺮﻱ ﻋﺎﻡ ‪ ١٩٩٧‬ﻭﴰﻞ ‪ ٩١٢٨‬ﻣﻦ ﺍﳌﺮﺍﻫﻘﲔ ﻭﺍﳌﺮﺍﻫﻘﺎﺕ ﻭﺃﺳﺮﻫﻢ ﻭﺍﺷﺘﺮﻛﺖ ﰲ ﺇﺟﺮﺍﺋﻪ ﲬﺲ ﺟﻬﺎﺕ‬
‫ﻋﻠﻤﻴﺔ )ﻣﻨﻬﺎ ﺛﻼﺙ ﺟﺎﻣﻌﺎﺕ( ﻭﴰﻞ ﲨﻴﻊ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ )ﻋﺪﺍ ﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ(‪ .‬ﻭﺳﺪ ﻫﺬﺍ‬
‫ﺍﳌﺴﺢ ﻓﺮﺍﻏﺎﹰ ﻣﻌﻠﻮﻣﺎﺗﻴﺎﹰ ﻛﺒﲑﺍﹰ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺸﺮﳛﺔ ﺍﻟﻌﻤﺮﻳﺔ ‪ ١٩ – ١٠‬ﺳﻨﺔ‪ ،‬ﻷﻥ ﻣﻌﻈﻢ ﺍﳌﺴﻮﺡ‬
‫ﻛﺎﻧﺖ ﺗﺮﻛﺰ ﰲ ﺍﻟﻌﺎﺩﺓ ﻋﻠﻰ ﻣﺮﺣﻠﺔ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ‪ .‬ﻭﴰﻞ ﺍﳌﺴﺢ ﺑﻴﺎﻧﺎﺕ ﺧﺎﺻﺔ ﺑﺎﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﻨﻤﻮ‬
‫ﻭﻣﺮﺍﺣﻞ ﺍﻟﺒﻠﻮﻍ ﻭﺍﻟﻌﺎﺩﺍﺕ ﺍﻟﻐﺬﺍﺋﻴﺔ ﻭﺍﻟﺘﺪﺧﲔ ﻭﺍﻹﻋﺎﻗﺔ ﻭﺍﺳﺘﻌﻤﺎﻝ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺗﺄﻣﲔ ﺻﺤﻲ‬
‫ﻣﺪﺭﺳﻲ ﻭﻏﲑﻫﺎ‪ ،‬ﴰﻞ ﻛﺬﻟﻚ ﺍﳉﻮﺍﻧﺐ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﲟﺎ ﰲ ﺫﻟﻚ ﺍﻟﻨﻮﺍﺣﻲ ﺍﻟﻨﻔﺴﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﰲ‬
‫ﺍﳊﻴﺎﺓ ﺍﳌﺪﺭﺳﻴﺔ‪ .‬ﻭﺗﻨﺎﻭﻝ ﺍﳌﺴﺢ ﺃﻳﻀﺎﹰ ﺑﻴﺎﻧﺎﺕ ﻋﻦ ﺍﻟﻌﻤﻞ ﻭﺍﳌﻌﺎﻣﻠﺔ ﺍﻷﺳﺮﻳﺔ ﻭﳑﺎﺭﺳﺔ ﺍﻟﺮﻳﺎﺿﺔ ﻭﻭﺳﺎﺋﻞ‬
‫ﺍﻟﺘﺮﻓﻴﻪ ﻭﺍﻟﺘﻌﺮﺽ ﻟﻺﻋﻼﻡ ﻭﻭﺟﻬﺎﺕ ﺍﻟﻨﻈﺮ ﺑﺸﺄﻥ ﺍﻟﺰﻭﺍﺝ ﻭﺗﻘﺎﺳﻢ ﺍﳌﺴﺌﻮﻟﻴﺎﺕ ﰲ ﺍﳊﻴﺎﺓ ﺍﻷﺳﺮﻳﺔ ﻭﻏﲑ‬
‫ﺫﻟﻚ ﻣﻦ ﺍﻟﺒﻴﺎﻧﺎﺕ‪.‬‬

‫‪١٣٨‬‬
‫ﻭﻧﻼﺣﻆ ﻫﻨﺎ ﺃﻥ ﻫﺬﺍ ﺍﳌﺴﺢ ﻛﻤﺼﺪﺭ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﻳﺘﻤﻴﺰ ﺑﺸﻤﻮﻟﻪ ﻟﺒﻴﺎﻧﺎﺕ ﺻﺤﻴﺔ ﻣﺒﺎﺷﺮﺓ ﻭﺑﻴﺎﻧﺎﺕ ﰲ‬
‫ﳎﺎﻻﺕ ﺃﺧﺮﻯ ﻛﺎﻟﺘﻌﻠﻴﻢ ﻭﺍﳊﻴﺎﺓ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ ،‬ﳑﺎ ﳝﻜﻦ ﺍﻟﺒﺎﺣﺜﲔ ﻣﻦ ﺍﻟﺮﺑﻂ ﺑﲔ ﺍﳉﻮﺍﻧﺐ ﺍﻟﺼﺤﻴﺔ ﻭﻫﺬﻩ‬
‫ﺍ‪‬ﺎﻻﺕ ﺍﻟﱵ ﺃﺻﺒﺢ ﻣﻦ ﺍﳌﺴﻠﻢ ﺑﻪ ﺃﻥ ﺩﻭﺭﻫﺎ ﰲ ﺍﻟﺼﺤﺔ ﺩﻭﺭ ﺟﻮﻫﺮﻱ ﻣﺆﺛﺮ ﻟﻠﻐﺎﻳﺔ‪.‬‬

‫ﺝ‪ -‬ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ‪٢٠٠٠‬‬

‫ﻫﻲ ﺛﺎﱐ ﺩﺭﺍﺳﺔ ﻗﻮﻣﻴﺔ ﻣﻦ ﻧﻮﻋﻬﺎ ﺇﺫ ﺃﻥ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻷﻭﱃ ﺃﺟﺮﻳﺖ ﰲ ﻋﺎﻣﻲ ‪ .١٩٩٣ /١٩٩٢‬ﻭﻗﺪ ﺃﺟﺮﺕ ﻛﻠﺘﺎ‬
‫ﺍﻟﺪﺭﺍﺳﺘﲔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ – ﻗﻄﺎﻉ ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ ﺑﺘﻤﻮﻳﻞ ﻣﻦ ﻫﻴﺌﺔ ﺍﳌﻌﻮﻧﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ‪.‬‬
‫ﻭﺍﻋﺘﻤﺪﺕ ﺍﻟﺪﺭﺍﺳﺔ ﻋﻠﻰ ﻣﻘﺎﺑﻠﺔ ﺃﺳﺮ ﺍﻟﺴﻴﺪﺍﺕ ﺍﻟﻼﰐ ﺗﻮﻓﲔ ﺧﻼﻝ ﻋﺎﻡ ‪ ٢٠٠٠‬ﻭﻛﺎﻧﺖ ﺃﻋﻤﺎﺭﻫﻦ ﺗﺘﺮﺍﻭﺡ‬
‫ﺑﲔ ‪ ١٥‬ﺳﻨﺔ ﻭ‪ ٤٩‬ﺳﻨﺔ‪ ،‬ﻟﻠﺘﺤﻘﻖ ﻣﻦ ﺳﺒﺐ ﺍﻟﻮﻓﺎﺓ‪ .‬ﺇﺫ ﺃﻧﻪ ﻣﻦ ﺍﳌﻌﻠﻮﻡ‪ ،‬ﻛﻤﺎ ﺳﺒﻖ ﺍﻟﺬﻛﺮ‪ ،‬ﺃﻥ ﺍﻟﻮﻓﻴﺎﺕ ﰲ‬
‫ﻫﺬﻩ ﺍﻟﺸﺮﳛﺔ ﺍﻟﻌﻤﺮﻳﺔ ﻳﻨﺪﺭ ﺃﻻ ﻳﺘﻢ ﺍﻹﺑﻼﻍ ﻋﻨﻬﺎ‪ ،‬ﺃﻱ ﺃﻥ ﻧﺴﺒﺔ ﺍﻹﺑﻼﻍ ﺗﻜﺎﺩ ﺗﻜﻮﻥ ﻛﺎﻣﻠﺔ‪ ،‬ﻭﻟﻜﻦ ﰲ‬
‫ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻴﺎﻥ ﻻ ﻳﺘﻢ ﺗﺴﺠﻴﻞ ﺳﺒﺐ ﺍﻟﻮﻓﺎﺓ ﺑﺎﻟﺘﻔﺼﻴﻞ ﺍﻟﻜﺎﰲ‪ ،‬ﻓﻼ ﻳﺬﻛﺮ ﺃﻥ ﺍﻟﻮﻓﺎﺓ ﺍﺭﺗﺒﻄﺖ ﺑﺎﳊﻤﻞ‬
‫ﺃﻭ ﺍﻟﻮﻻﺩﺓ ﺃﻭ ﺍﻟﻨﻔﺎﺱ‪ ،‬ﺃﻱ ﺃﻥ ﺍﻟﻮﻓﺎﺓ ﺗﺴﺠﻞ ﻛﻮﻓﺎﺓ ﻭﻟﻜﻦ ﻟﻴﺲ ﻛﻮﻓﺎﺓ ﺃﻣﻮﻣﺔ‪ .‬ﻭﻃﺮﻳﻘﺔ ﺍﳌﻘﺎﺑﻠﺔ ﺍﳌﺒﺎﺷﺮﺓ‬
‫ﺗﺘﻴﺢ ﺍﻟﻔﺮﺻﺔ ﻟﻠﺘﻌﺮﻑ ﻋﻠﻰ ﻣﻼﺑﺴﺎﺕ ﺍﻟﻮﻓﺎﺓ ﺑﺎﻟﺘﻔﺼﻴﻞ ﻭﻫﻞ ﻫﻲ ﻣﺮﺗﺒﻄﺔ ﺑﺎﻷﻣﻮﻣﺔ ﺃﻡ ﻻ‪ ،‬ﳑﺎ ﻳﺴﻤﺢ‬
‫ﺑﺎﳊﺼﻮﻝ ﻋﻠﻰ ﺗﻘﺪﻳﺮﺍﺕ ﺩﻗﻴﻘﺔ ﳌﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‪ .‬ﻭﻗﺪ ﺗﻮﺻﻞ ﺍﳌﺴﺢ ﺇﱃ ﺃﻥ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ‬
‫ﺍﻷﻣﻬﺎﺕ ﻟﻌﺎﻡ ‪ ٢٠٠٠‬ﻛﺎﻥ ‪ ٨٤‬ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﺃﻣﻬﺎﺕ ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ‪ .‬ﻭﻫﻮ ﺭﻗﻢ ﻳﺰﻳﺪ ﻛﺜﲑﺍﹰ ﻋﻦ‬
‫ﺍﻟﺮﻗﻢ ﺍﻟﺬﻱ ﺗﻈﻬﺮﻩ ﺍﻟﺴﺠﻼﺕ ﺍﻟﻌﺎﺩﻳﺔ‪ .‬ﻭﺭﻏﻢ ﻫﺬﺍ ﻓﻬﻮ ﻳﻘﻞ ﻛﺜﲑﺍﹰ ﻋﻦ ﺍﻟﺮﻗﻢ ﺍﻟﺬﻱ ﺃﻇﻬﺮﻩ ﻣﺴﺢ ‪١٩٩٢‬‬
‫– ‪ ١٩٩٣‬ﻭﺍﻟﺬﻱ ﻛﺎﻥ ‪ ١٧٤‬ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﺃﻣﻬﺎﺕ ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ‪ ،‬ﺃﻱ ﺃﻥ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ‬
‫ﺍﳔﻔﺾ ﲝﻮﺍﱄ ﺍﻟﻨﺼﻒ ﺗﻘﺮﻳﺒﺎﹰ ﺧﻼﻝ ‪ ٨‬ﺳﻨﻮﺍﺕ‪ .‬ﻭﺗﻨﺎﻭﻝ ﺍﳌﺴﺢ ﻛﺬﻟﻚ ﺗﺒﺎﻳﻦ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‬
‫ﻃﺒﻘﺎﹰ ﻷﻗﺎﻟﻴﻢ ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ ﻭﺗﺒﻌﺎﹰ ﻟﺴﻦ ﺍﻷﻡ ﻭﻋﺪﺩ ﺃﻃﻔﺎﳍﺎ ﻭﺗﺮﺩﺩﻫﺎ ﻋﻠﻰ ﺧﺪﻣﺎﺕ ﺭﻋﺎﻳﺔ ﺍﳊﻤﻞ‬
‫ﻭﻋﻮﺍﻣﻞ ﺃﺧﺮﻯ‪ .‬ﻭﺗﻨﺎﻭﻟﺖ ﺍﻟﺪﺭﺍﺳﺔ ﻛﺬﻟﻚ ﺃﺳﺒﺎﺏ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻭﻫﻞ ﻛﺎﻥ ﳝﻜﻦ ﺗﻔﺎﺩﻳﻬﺎ ﺃﻡ ﻻ‪.‬‬
‫ﻭﻧﻜﺘﻔﻲ ‪‬ﺬﻩ ﺍﻷﻣﺜﻠﺔ‪ ،‬ﺣﻴﺚ ﺇﻥ ﻏﺮﺿﻨﺎ ﻟﻴﺲ ﺇﻋﻄﺎﺀ ﺑﻴﺎﻥ ﺑﺎﳌﺴﻮﺡ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﻭﻟﻜﻦ ﺇﻳﻀﺎﺡ‬
‫ﺃﳘﻴﺘﻬﺎ ﻛﻤﺼﺪﺭ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﻻ ﻏﲎ ﻋﻨﻪ‪.‬‬

‫‪ > +-‬‬

‫ﻫﻨﺎﻙ ﻣﺆﺷﺮﺍﺕ ﺇﳚﺎﺑﻴﺔ ﻗﺪ ﺗﺒﺸﺮ ﺑﺘﻄﻮﺭ ﰲ ﳎﺎﻝ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺃﻫﻢ ﻫﺬﻩ ﺍﳌﺆﺷﺮﺍﺕ ﻫﻮ ﺍﻧﺘﺸﺎﺭ‬
‫ﺍﻟﻘﻨﺎﻋﺔ ﻋﻠﻰ ﻧﻄﺎﻕ ﻭﺍﺳﻊ ﺑﺄﻥ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻟﻴﺴﺖ ﺗﺮﻓﺎﹰ ﻭﻟﻜﻨﻬﺎ ﺃﺳﺎﺱ ﻟﻠﻘﺮﺍﺭ ﺍﻟﺮﺷﻴﺪ‪ .‬ﻛﻤﺎ ﺃﻥ‬
‫ﺍﳊﺎﺳﺒﺎﺕ ﺍﻵﻟﻴﺔ ﻗﺪ ﺍﳔﻔﺾ ﲦﻨﻬﺎ ﻭﺗﻮﺍﻓﺮﺕ ﻋﻠﻰ ﻧﻄﺎﻕ ﻭﺍﺳﻊ‪ ،‬ﻭﻛﺬﻟﻚ ﺯﺍﺩ ﻋﺪﺩ ﻣﻦ ﳚﻴﺪﻭﻥ ﺍﺳﺘﻌﻤﺎﳍﺎ‬
‫ﺑﻌﺪ ﺗﺒﺴﻴﻂ ﻧﻈﻢ ﺗﺸﻐﻴﻠﻬﺎ ﺗﺒﺴﻴﻄﺎﹰ ﻛﺒﲑﺍﹰ‪ ،‬ﻭﺃﺻﺒﺢ ﺍ‪‬ﺘﻤﻊ ﺑﺄﺳﺮﻩ ﻳﺪﺭﻙ ﺃﻥ ﺍﻟﻌﺎﱂ ﻳﻌﻴﺶ ﺍﻵﻥ‬
‫"ﻋﺼﺮ ﺍﳌﻌﻠﻮﻣﺎﺕ"‪.‬‬
‫ﻭﻟﻜﻦ ﻻ ﺯﺍﻟﺖ ﻫﻨﺎﻙ ﺑﻌﺾ ﺍﻟﺴﻠﺒﻴﺎﺕ ﰲ ﳎﺎﻝ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺗﻌﻮﻕ ﺍﻻﺳﺘﻔﺎﺩﺓ ﺍﻟﻜﺎﻣﻠﺔ ﻣﻦ‬
‫ﺍﻻﺳﺘﺜﻤﺎﺭﺍﺕ ﺍﻟﻜﺒﲑﺓ ﺍﻟﱵ ﺃﺗﺎﺣﺘﻬﺎ ﺍﻟﺪﻭﻟﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻣﻦ ﲡﻬﻴﺰﺍﺕ ﻭﻣﺒﺎﻥ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﻮﺯﺍﺭﺓ ﻭﻋﻠﻰ‬
‫ﻣﺴﺘﻮﻯ ﺍﶈﺎﻓﻈﺎﺕ‪ ،‬ﻭﻣﻦ ﺗﺪﺭﻳﺐ ﻟﻸﻓﺮﺍﺩ ﺩﺍﺧﻞ ﻭﺧﺎﺭﺝ ﻣﺼﺮ‪ ،‬ﻭﻣﻦ ﺗﻮﻓﲑ ﺍﳋﱪﺍﺀ ﺍﻟﺪﻭﻟﻴﲔ ﻭﺍﶈﻠﻴﲔ‪ ،‬ﻭﻣﻦ‬
‫ﺃﻣﺜﻠﺔ ﻫﺬﻩ ﺍﻟﺴﻠﺒﻴﺎﺕ‪:‬‬

‫‪١٣٩‬‬
‫‪ .١‬ﻋﺪﻡ ﺩﻗﺔ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻟﻮﺍﺭﺩﺓ ﻣﻦ ﺍﳌﺼﺪﺭ ﺍﻷﺻﻠﻲ ﻟﻠﺒﻴﺎﻥ‪ .‬ﻓﻜﺎﺗﺐ ﺍﻟﻮﺣﺪﺓ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ‬
‫ﺑﺈﺣﺪﻯ ﺍﻟﻘﺮﻯ ﺍﻟﻨﺎﺋﻴﺔ‪ ،‬ﻗﺪ ﻻ ﻳﻜﻮﻥ ﺇﺩﺭﺍﻛﻪ ﻷﳘﻴﺔ ﺍﻟﺒﻴﺎﻥ ﺍﻟﺬﻱ ﻳﺮﺳﻠﻪ ﳑﺎﺛﻼﹰ ﻹﺩﺭﺍﻙ ﻛﺒﺎﺭ‬
‫ﺍﳌﺴﺌﻮﻟﲔ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ ﺍﻟﺬﻳﻦ ﻳﻌﻠﻤﻮﻥ ﺃﻥ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻫﻲ ﻋﺼﺐ ﻋﻤﻠﻴﺔ ﺻﻨﻊ ﺍﻟﻘﺮﺍﺭ‪.‬‬
‫‪ .٢‬ﺍﻟﺘﺄﺧﲑ ﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ ﰲ ﲡﻬﻴﺰ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻭﺇﺗﺎﺣﺘﻬﺎ ﻟﺼﺎﻧﻊ ﺍﻟﻘﺮﺍﺭ ﰲ ﺍﻟﻮﻗﺖ ﺍﳌﻨﺎﺳﺐ‪ ،‬ﳑﺎ‬
‫ﻳﻘﻠﻞ ﻣﻦ ﻗﻴﻤﺘﻬﺎ ﰲ ﺩﻋﻢ ﺍﻟﻘﺮﺍﺭ‪.‬‬
‫‪ .٣‬ﺍﳍﻴﺌﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﳋﺎﺻﺔ ﺍﻟﱵ ﻻ ﺗﺘﺒﻊ ﻣﺒﺎﺷﺮﺓ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻗﺪ‬
‫ﺗﺘﻘﺎﻋﺲ ﻋﻦ ﺗﺰﻭﻳﺪ ﻣﺮﻛﺰ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺑﺎﻟﻮﺯﺍﺭﺓ ﺑﺒﻴﺎﻧﺎﺕ ﺗﻔﺼﻴﻠﻴﺔ ﺩﻗﻴﻘﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﻛﺎﻥ ﺍﳍﺪﻑ ﻣﻦ‬
‫ﺇﻧﺸﺎﺀ ﻫﺬﺍ ﺍﳌﺮﻛﺰ ﺃﻥ ﻳﻜﻮﻥ ﻣﺴﺘﻘﺮﺍﹰ ﻣﺮﻛﺰﻳﺎﹰ ﻗﻮﻣﻴﺎﹰ ﳉﻤﻴﻊ ﺑﻴﺎﻧﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﺑﻐﺾ ﺍﻟﻨﻈﺮ ﻋﻦ ﺍﻟﺘﺒﻌﻴﺔ ﺍﻹﺩﺍﺭﻳﺔ ﻟﻠﻮﺯﺍﺭﺓ ﻣﻦ ﻋﺪﻣﻪ‪.‬‬
‫ﻭﻧﺄﻣﻞ ﺃﻥ ﻳﺆﺩﻱ ﺗﺰﺍﻳﺪ ﺍﻟﻮﻋﻲ ﺍﳌﻌﻠﻮﻣﺎﰐ ﰲ ﺍ‪‬ﺘﻤﻊ ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻭﺑﲔ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ‬
‫ﺑﺼﻔﺔ ﺧﺎﺻﺔ ﺇﱃ ﺍﻟﺰﻭﺍﻝ ﺍﻟﺘﺪﺭﳚﻲ ﳍﺬﻩ ﺍﻟﺴﻠﺒﻴﺎﺕ ﺣﱴ ﳝﻜﻦ ﲢﻘﻴﻖ ﺍﻻﺳﺘﻔﺎﺩﺓ ﺍﻟﻘﺼﻮﻯ ﻣﻦ‬
‫ﺍﳌﻌﻠﻮﻣﺎﺕ ﻟﻠﻮﺻﻮﻝ ﺇﱃ ﺃﻓﻀﻞ ﻣﺴﺘﻮﻯ ﺻﺤﻲ ﻟﻠﻤﻮﺍﻃﻦ ﺍﳌﺼﺮﻱ‪.‬‬

‫‪١٤٠‬‬
 ‫
 
‪:‬‬
‫   ء‬
‫‪  . .‬‬

‫‬
‫ﻟﻘﺪ ﺃﺿﺤﻰ ﺗﻄﺒﻴﻖ ﻧﻈﻢ ﺍﳉﻮﺩﺓ ﰲ ﳎﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺍﻟﻀﺮﻭﺭﺍﺕ ﺍﳌﻠﺤﺔ ﰲ ﺍﻟﻌﻘﺪﻳﻦ‬
‫ﺍﻷﺧﲑﻳﻦ ﻭﺧﺎﺻﺔ ﰲ ﺩﻭﻝ ﺍﻟﻌﺎﱂ ﺍﻟﻨﺎﻣﻲ ﺣﻴﺚ ﺗﺰﺩﺍﺩ ﺍﳊﺎﺟﺔ ﺇﱃ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻇﻞ ﺍﺭﺗﻔﺎﻉ‬
‫ﻣﺴﺘﻤﺮ ﰲ ﺗﻜﻠﻔﺔ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ ﻭﺃﻳﻀﺎ ﰲ ﻭﺟﻮﺩ ﺗﺒﺎﻳﻦ ﻛﺒﲑ ﰲ ﻣﺮﺩﻭﺩ ﻭﻧﺘﺎﺋﺞ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﰲ‬
‫ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺘﻤﺎﺛﻠﺔ ﳑﺎ ﻳﺒﺰ ﺍﳊﺎﺟﺔ ﺇﱃ ﺍﺗﺒﺎﻉ ﻣﻌﺎﻳﲑ ﻗﻴﺎﺳﻴﺔ ﰲ ﺍﻷﺩﺍﺀ ﺍﻟﻄﱯ ﻭﺍﺗﺒﺎﻉ‬
‫ﺑﺮﻭﺗﻮﻛﻮﻻﺕ ﻣﺒﻨﻴﺔ ﻋﻠﻰ ﺃﺩﻟﺔ ﻋﻠﻤﻴﺔ‪.‬‬

‫‬ ‫‪!"#‬‬
‫ﻟﻘﺪ ﻋﺮ‪‬ﻑ ﺍﻟﺮﺳﻮﻝ ﺍﻟﻜﺮﱘ )ﺻﻠﻮﺍﺕ ﺍﷲ ﻋﻠﻴﻪ ﻭﺳﻼﻣﻪ( ﺍﳉﻮﺩﺓ ﻣﻨﺬ ﺃﺭﺑﻌﺔ ﻋﺸﺮ ﻗﺮﻧﺎ ﻣﻦ ﺍﻟﺰﻣﺎﻥ ﰲ‬
‫ﺣﺪﻳﺜﻪ ﺍﻟﺸﺮﻳﻒ " ﺇﻥ ﺍﷲ ﳛﺐ ﺇﺫﺍ ﻋﻤﻞ ﺃﺣﺪﻛﻢ ﻋﻤﻼ ﺃﻥ ﻳﺘﻘﻨﻪ"‪.‬‬
‫ﺇﺫﺍ ﻓﺎﳉﻮﺩﺓ ﻫﻲ ﺇﺗﻘﺎﻥ ﺍﻟﻌﻤﻞ ﻭﲟﻌﲎ ﺁﺧﺮ ﺍﳉﻮﺩﺓ ﻫﻲ ﺃﻥ ﺗﻘﻮﻡ ﺑﺎﻹﺟﺮﺍﺀ ﺍﻟﺼﺤﻴﺢ ﺑﻄﺮﻳﻘﺔ ﺳﻠﻴﻤﺔ ﻭﻣﻦ‬
‫ﺃﻭﻝ ﻣﺮﺓ ﺑﻞ ﻭﻛﻞ ﻣﺮﺓ )‪.(Doing right thing right, first time and every time‬‬
‫ﻭﻣﻦ ﻧﺎﺣﻴﺔ ﺃﺧﺮﻯ ﳝﻜﻦ ﺭﺅﻳﺔ ﺍﳉﻮﺩﺓ ﻣﻦ ﺛﻼﺙ ﺯﻭﺍﻳﺎ ﳐﺘﻠﻔﺔ‪.‬‬
‫ﺣﻴﺚ ﳝﻜﻦ ﺗﻘﻴﻴﻤﻬﺎ ﺑﻄﺮﻳﻘﺔ ﻣﻮﺿﻮﻋﻴﺔ ﻭﺫﻟﻚ ﲟﺪﻯ ﻣﺴﺎﻳﺮ‪‬ﺎ‬ ‫ﺟﻮﺩﺓ ﻗﻴﺎﺳﻴﺔ‪:‬‬
‫ﻟﻠﻤﻌﺎﻳﲑ ﺍﻟﻘﻴﺎﺳﻴﺔ‪.‬‬
‫ﻭﻫﻰ ﻣﺪﻯ ﺍﻟﺘﻔﻮﻕ ﻭﺍﻻﻣﺘﻴﺎﺯ ﺍﻟﺬﻱ ﻳﻘﺪﺭﻩ ﻣﻘﺪﻣﻮ ﺍﳋﺪﻣﺔ ﺃﻭ ﳎﻤﻮﻋﺔ ﻣﻦ‬ ‫ﺟﻮﺩﺓ ﺗﻘﺪﻳﺮﻳﺔ‪:‬‬
‫ﺍﳋﱪﺍﺀ ﻭﺍﻷﻃﺒﺎﺀ ﺍﳌﻬﺮﺓ ﻭﻫﻰ ﺑﺬﻟﻚ ﺗﻜﻮﻥ ﺃﺑﻌﺪ ﻣﻦ ﳎﺮﺩ ﻣﻄﺎﺑﻘﺔ ﺃﻭ‬
‫ﻣﺴﺎﻳﺮﺓ ﺑﻌﺾ ﺍﳌﻌﺎﻳﲑ‪.‬‬
‫ﻭﻫﻰ ﻣﺪﻯ ﺍﻟﺘﻔﻮﻕ ﺍﻟﺬﻱ ﻳﺪﺭﻛﻪ ﺃﻭ ﳝﻴﺰﻩ ﺍﳌﺴﺘﻔﻴﺪﻭﻥ ﻣﻦ ﺍﳋﺪﻣﺔ‪.‬‬ ‫ﺟﻮﺩﺓ ﻣﺪﺭﻛﺔ‪:‬‬
‫ﻭﻣﻦ ﻫﻨﺎ ﻳﺄﰐ ﺃﺣﻴﺎﻧﺎ ﺍﻻﺧﺘﻼﻑ ﰲ ﺗﻘﻴﻴﻢ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﻭﺟﻬﺔ ﻧﻈﺮ ﻛﻞ ﻣﻦ ﻣﻘﺪﻡ ﺍﳋﺪﻣﺔ‬
‫ﻭﺍﳌﺴﺘﻔﻴﺪ ﻣﻦ ﺍﳋﺪﻣﺔ ﻭﻣﺎﻟﻚ ﺃﻭ ﻣﺪﻗﻖ ﺍﳋﺪﻣﺔ‪ ,‬ﻭﻟﺬﻟﻚ ﻓﻘﺪ ﺃﺿﺎﻑ ﺍﻟﻌﺎﱂ ﺍﳌﻌﺮﻭﻑ ﺟﻮﺭﺍﻥ )‪(١٩٨٩‬‬
‫ﺑﻌﺪﺍ ﺟﺪﻳﺪﺍ ﻟﺘﻌﺮﻳﻒ ﺍﳉﻮﺩﺓ ﺃﻻ ﻭﻫﻮ ﺇﺭﺿﺎﺀ ﺍﻟﻌﻤﻴﻞ )ﺃﻭ ﺍﳌﻨﺘﻔﻌﲔ ﻣﻦ ﺍﳋﺪﻣﺔ( ﺣﻴﺚ ﻋﺮ‪‬ﻑ ﺍﳉﻮﺩﺓ ﻋﻠﻰ‬
‫ﺃ‪‬ﺎ ﺧﺪﻣﺔ )ﻣﻨﺘﺞ( ﺧﺎﻝٍ ﻣﻦ ﺍﻟﻌﻴﻮﺏ ﺃﻭ ﺍﻷﺧﻄﺎﺀ ﻭﺫﻭ ﻣﻈﻬﺮ ﺟﻴﺪ‪ ،‬ﲟﺎ ﻳﻌﲎ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ ﺗﻘﺪﱘ‬
‫ﺧﺪﻣﺔ ﺧﺎﻟﻴﺔ ﻣﻦ ﺍﻟﻌﻴﻮﺏ )ﻣﺜﻞ ﺍﻟﺘﻬﺎﺏ ﺍﳉﺮﺡ ﺑﻌﺪ ﺍﳉﺮﺍﺣﺔ ﺃﻭ ﻃﻮﻝ ﺍﻧﺘﻈﺎﺭ ﺍﳌﺮﻳﺾ ﰲ ﺍﻟﻌﻴﺎﺩﺓ ﺍﳋﺎﺭﺟﻴﺔ‬
‫ﺃﻭ ﺿﻴﺎﻉ ﻧﺘﺎﺋﺞ ﺍﻟﺘﺤﺎﻟﻴﻞ ﻣﻦ ﺍﳌﻠﻒ … ﻭﻏﲑﻫﺎ( ﻭﻛﺬﻟﻚ ﺫﻭ ﻣﻈﻬﺮ ﻻﺋﻖ )ﻣﺜﻞ ﻏﺮﻓﺔ ﺍﻧﺘﻈﺎﺭ ﻣﻨﺎﺳﺒﺔ‬
‫ﻭﺍﺳﺘﺨﺪﺍﻡ ﺍﳊﺎﺳﻮﺏ ﰲ ﺍﻟﺴﺠﻼﺕ ﺍﻟﻄﺒﻴﺔ ﻭﻏﲑﻫﺎ( ﻭﻧﻼﺣﻆ ﻫﻨﺎ ﺃﻥ ﺗﻘﺪﱘ ﺧﺪﻣﺔ ﺧﺎﻟﻴﺔ ﻣﻦ ﺍﻟﻌﻴﻮﺏ‬

‫‪١٤١‬‬
‫ﻳﺰﻳﺪ ﻣﻦ ﺭﺿﺎﺀ ﺍﳌﺮﻳﺾ ﻭﺍﻟﻌﻤﻼﺀ ﻭﺑﺬﻟﻚ ﻳﺰﻳﺪ ﻣﻦ ﺩﺧﻞ ﺍﳌﺆﺳﺴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺃﻣﺎ ﺍﳌﺒﺎﻟﻐﺔ ﰲ ﲢﺴﲔ‬
‫ﻣﻈﻬﺮ ﺍﳋﺪﻣﺔ ﺃﻭ ﺍﳌﻨﺘﺞ ﻳﺰﻳﺪ ﻣﻦ ﺍﻟﺘﻜﻠﻔﺔ ﻭﻟﺬﻟﻚ ﻳﺮﺍﻋﻰ ﰲ ﺍﻟﺘﺨﻄﻴﻂ ﻟﻠﺨﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻈﻬﺮ‬
‫ﺍﻟﻼﺋﻖ ﺑﺎﳋﺪﻣﺔ ﻣﻊ ﻣﺮﺍﻋﺎﺓ ﺍﻟﺘﻜﻠﻔﺔ‪.‬‬

‫) ( ‪&'#‬ء ‪(Customers of Health Care)   $ %‬‬

‫‪‬ﺘﻢ ﺍﳉﻮﺩﺓ ﺑﺸﻜﻞ ﻛﺒﲑ ﺑﺘﻠﺒﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻭﺗﻮﻗﻌﺎﺕ ﺍﻟﻌﻤﻴﻞ ﻭﻟﺬﻟﻚ ﳚﺐ ﺃﻥ ﻧﻮﺿﺢ ﻫﻨﺎ ﻣﺎ ﺍﳌﻘﺼﻮﺩ‬
‫ﺑﺎﻟﻌﻤﻼﺀ ﰲ ﳎﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺣﻴﺚ ﳝﻜﻦ ﺗﻘﺴﻴﻤﻬﻢ ﺇﱃ ﳎﻤﻮﻋﺘﲔ‪:‬‬
‫ﻋﻤﻼﺀ ﺧﺎﺭﺟﻴﲔ‪ :‬ﻭﻫﻢ ﻳﺘﻌﺎﻣﻠﻮﻥ ﻣﻊ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻭﻟﻜﻨﻬﻢ ﻣﻦ ﺧﺎﺭﺝ ﺍﳌﺆﺳﺴﺔ ﺍﻟﺼﺤﻴﺔ ﻣﺜﻞ‬
‫ﺍﳌﺮﺿﻰ ﻭﺍﻷﺳﺮ ﻭﺍﻷﻓﺮﺍﺩ ﻭﻛﺬﻟﻚ ﻣﻦ ﻳﺪﻓﻊ ﻧﻔﻘﺎﺕ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻣﺜﻞ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻭﺍﻟﻨﻘﺎﺑﺎﺕ‬
‫ﺍﳌﻬﻨﻴﺔ ﻭﺍﻟﺸﺮﻛﺎﺕ ﻭﻏﲑﻫﻢ‪.‬‬
‫ﻋﻤﻼﺀ ﺩﺍﺧﻠﻴﲔ‪ :‬ﺇﻱ ﻣﻦ ﺩﺍﺧﻞ ﺍﳌﺆﺳﺴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﻳﺘﺄﺛﺮ ﻋﻤﻠﻬﻢ ﲜﻮﺩﺓ ﺍﻟﻌﻤﻞ ﺑﺎﳌﺆﺳﺴﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﻣﺜﻞ ﺃﻓﺮﺍﺩ ﺍﻟﻔﺮﻳﻖ ﺍﻟﺼﺤﻲ ﻭﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﻟﺼﻴﺪﻟﻴﺔ ﻭﺍﳌﻌﺎﻣﻞ ﻭﺍﻷﺷﻌﺔ ﻭﻏﲑﻫﻢ‪ ،‬ﺃﻱ ﺃﻥ ﺍﻟﻌﺎﻣﻠﲔ‬
‫ﺑﺎﳌﺆﺳﺴﺔ ﺍﻟﺼﺤﻴﺔ ﻳﻌﺘﱪﻭﻥ ﻋﻤﻼﺀ ﺑﻌﻀﻬﻢ ﻟﺒﻌﺾ ﺣﻴﺚ ﺇﻥ ﺗﻠﺒﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻭﺗﻮﻗﻌﺎﺕ ﺍﻟﻌﻤﻴﻞ‬
‫ﺍﳋﺎﺭﺟﻲ ﺗﺘﻄﻠﺐ ﺃﻭﻻ ﺗﻠﺒﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻭﺗﻮﻗﻌﺎﺕ ﺍﻟﻌﻤﻴﻞ ﺍﻟﺪﺍﺧﻠﻲ ﻭﻣﺜﺎﻝ ﺫﻟﻚ‪ :‬ﻋﻨﺪ ﻛﺘﺎﺑﺔ ﻭﺻﻔﺔ ﺩﻭﺍﺀ‬
‫ﳌﺮﻳﺾ ﻣﻨﻮﻡ ﺑﺎﳌﺴﺘﺸﻔﻰ ﻓﺈﻥ ﳑﺮﺿﺔ ﺍﻟﻘﺴﻢ ﺗﻌﺘﱪ ﻋﻤﻴﻼﹰ ﺩﺍﺧﻠﻴﺎﹰ ﻟﻠﺼﻴﺪﻟﻴﺔ ﻭﳍﺎ ﺍﺣﺘﻴﺎﺟﺎﺕ ﳚﺐ‬
‫ﺗﻠﺒﻴﺘﻬﺎ ﻣﺜﻞ ﺻﺮﻑ ﺍﻟﺪﻭﺍﺀ ﰲ ﺍﻟﻮﻗﺖ ﺍﳌﻨﺎﺳﺐ ﻭﺑﺎﳉﺮﻋﺔ ﺍﻟﺼﺤﻴﺤﺔ ﻭﺍﻟﺸﻜﻞ ﺍﳌﻄﻠﻮﺏ ﻭﻟﻜﻲ ﺗﺘﻢ‬
‫ﺗﻠﺒﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﳌﺮﻳﺾ )ﺍﻟﻌﻤﻴﻞ ﺍﳋﺎﺭﺟﻲ( ﻻﺑﺪ ﺃﻭﻻ ﻣﻦ ﺗﻠﺒﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﻌﻤﻴﻞ ﺍﻟﺪﺍﺧﻠﻲ )ﺍﳌﻤﺮﺿﺔ(‬

‫*‪ #‬‬
‫ﻭﳝﺘﺪ ﻣﻔﻬﻮﻡ ﺍﳉﻮﺩﺓ ﻟﻴﺸﻤﻞ ﺃﺑﻌﺎﺩﺍ ﳐﺘﻠﻔﺔ ﰲ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺳﻮﻑ ﻧﺘﻨﺎﻭﻝ ﺑﺎﳌﻨﺎﻗﺸﺔ ﻫﻨﺎ ﺃﻫﻢ‬
‫ﻫﺬﻩ ﺍﻷﺑﻌﺎﺩ‪:‬‬
‫‪ -١‬ﺍﳌﻼﺀﻣﺔ )‪ :(Appropriateness‬ﻭﻫﻰ ﺩﺭﺟﺔ ﻣﻼﺀﻣﺔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﳌﻘﺪﻣﺔ ﻟﻠﻤﺮﻳﺾ ﻻﺣﺘﻴﺎﺟﺎﺗﻪ‬
‫ﺍﻟﺼﺤﻴﺔ )ﻣﻊ ﻣﺮﺍﻋﺎﺓ ﺃﺣﺪﺙ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ( ﻭﺑﺬﻟﻚ ﻳﻬﺘﻢ ﻫﺬﺍ ﺍﻟﺒﻌﺪ ﺑﺎﺧﺘﻴﺎﺭ ﺍﻹﺟﺮﺍﺀ ﺍﻟﺼﺤﻴﺢ ﺃﻭ‬
‫ﺍﳌﻨﺎﺳﺐ )‪.(Doing right thing‬‬
‫‪ -٢‬ﺳﻬﻮﻟﺔ ﺍﻟﻮﺻﻮﻝ ﺇﱃ ﺍﳋﺪﻣﺔ )‪ :(Accessibility‬ﻫﻲ ﺩﺭﺟﺔ ﺗﻮﺍﻓﺮ ﺍﳋﺪﻣﺔ ﳌﻘﺎﺑﻠﺔ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﻷﻓﺮﺍﺩ ﺍ‪‬ﺘﻤﻊ ﺩﻭﳕﺎ ﻋﺎﺋﻖ ﺟﻐﺮﺍﰲ ﺃﻭ ﺍﻗﺘﺼﺎﺩﻱ ﺃﻭ ﺍﺟﺘﻤﺎﻋﻲ ﺃﻭ ﺣﱴ ﺛﻘﺎﰲ‪.‬‬
‫‪ -٣‬ﺍﻟﺘﺴﻠﺴﻞ ﻭﺍﻟﺘﻨﺴﻴﻖ )‪ :(Continuity‬ﻭﻫﻰ ﺩﺭﺟﺔ ﺍﻟﺘﻨﺴﻴﻖ ﰲ ﺗﻘﺪﱘ ﻣﺮﺍﺣﻞ ﺍﳋﺪﻣﺔ‬
‫ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻤﺮﻳﺾ ﺃﻭ ﲟﻌﲎ ﺁﺧﺮ ﺃﻥ ﳛﺼﻞ ﺍﳌﺮﻳﺾ ﻋﻠﻰ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺘﺎﻣﺔ ﺍﻟﱵ ﳛﺘﺎﺟﻬﺎ‬
‫ﲟﺮﺍﺣﻠﻬﺎ ﺍﳌﺨﺘﻠﻔﺔ ﺩﻭﻥ ﻧﻘﺺ ﺃﻭ ﺗﻜﺮﺍﺭ‪.‬‬
‫‪ -٤‬ﺍﻟﻔﻌﺎﻟﻴﺔ )‪ :(Effectiveness‬ﻭﻫﻰ ﺩﺭﺟﺔ ﻓﻌﺎﻟﻴﺔ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﻨﺘﺎﺋﺞ ﺍﳌﺮﺟﻮﺓ‬
‫ﺃﻱ ﺃﻥ ﻫﺬﺍ ﺍﻟﺒﻌﺪ ﻳﻬﺘﻢ ﺑﺄﻥ ﻳﺘﻢ ﺍﻹﺟﺮﺍﺀ ﺑﻄﺮﻳﻘﺔ ﺻﺤﻴﺤﺔ )‪.(doing things right‬‬

‫‪١٤٢‬‬
‫‪ -٥‬ﺍﻟﻜﻔﺎﺀﺓ )‪ :(Efficiency‬ﻭﺗﻌﲎ ﺗﻘﺪﱘ ﺃﻓﻀﻞ ﺧﺪﻣﺔ ﰲ ﻇﻞ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺘﺎﺣﺔ ﺃﻱ ﺃﻥ ﻫﺬﺍ ﺍﻟﺒﻌﺪ‬
‫ﻳﻬﺘﻢ ﺑﺎﻟﻌﻼﻗﺔ ﺑﲔ ﻣﺮﺩﻭﺩ ﺍﳋﺪﻣﺔ ﻭﺍﻟﺘﻜﻠﻔﺔ‪.‬‬
‫‪ -٦‬ﺍﻟﻔﻌﺎﻟﻴﺔ ﺍﳌﺜﺎﻟﻴﺔ )‪ :(Efficacy‬ﻫﻲ ﻗﺪﺭﺓ ﺍﻟﺘﺪﺧﻼﺕ ﺍﻟﻄﺒﻴﺔ ﻋﻠﻰ ﲢﺴﲔ ﺻﺤﺔ ﺍﳌﺴﺘﻔﻴﺪﻳﻦ‬
‫ﻭﺫﻟﻚ ﺑﺎﺳﺘﺨﺪﺍﻡ ﺍﻟﺘﺪﺧﻼﺕ ﺍﻟﻄﺒﻴﺔ ﺍﻟﱵ ﺗﻘﻮﻡ ﻋﻠﻰ ﺃﺩﻟﺔ ﻋﻠﻤﻴﺔ )‪.(Evidence based medicine‬‬
‫‪ -٧‬ﺍﳌﻬﺎﺭﺓ )ﺍﳉﺪﺍﺭﺓ( )‪ :(Competency‬ﻭﺗﻌﲎ ﺩﺭﺟﺔ ﺍﻟﺘﺰﺍﻡ ﺍﻷﻃﺒﺎﺀ ﻭﺍﻟﻔﺮﻳﻖ ﺍﻟﺼﺤﻲ ﲟﻌﺎﻳﲑ ﺍﻷﺩﺍﺀ‬
‫ﻭﻟﺬﻟﻚ ﻳﻬﺘﻢ ﻫﺬﺍ ﺍﻟﺒﻌﺪ ﲟﻬﺎﺭﺍﺕ ﻭﻗﺪﺭﺍﺕ ﻭﺍﻷﺩﺍﺀ ﺍﻟﻔﻌﻠﻲ ﻟﻠﻔﺮﻳﻖ ﺍﻟﺼﺤﻲ ﻭﺍﻹﺩﺍﺭﻱ ﻭﺍﳋﺪﻣﺎﺕ ﺍﳌﺴﺎﻧﺪﺓ‪.‬‬
‫‪ -٨‬ﺍﻻﺣﺘﺮﺍﻡ ﺍﳌﺘﺒﺎﺩﻝ )‪ : (Respect and caring‬ﺩﺭﺟﺔ ﻣﺸﺎﺭﻛﺔ ﺍﳌﺮﻳﺾ ﰲ ﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭ ﻭﻛﺬﻟﻚ ﺭﺩ‬
‫ﻓﻌﻞ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳌﺮﻳﺾ ﻭﺗﻮﻗﻌﺎﺗﻪ‪.‬‬
‫‪ -٩‬ﺍﻟﺴﻼﻣﺔ )‪ :(Safety‬ﻭﻫﻰ ﺩﺭﺟﺔ ﺧﻠﻮ ﺑﺒﻴﺌﺔ ﺍﳌﺆﺳﺴﺔ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺍﳌﺨﺎﻃﺮ‪ ،‬ﺃﻱ ﺃﻥ ﻫﺬﺍ ﺍﻟﺒﻌﺪ‬
‫ﻳﻬﺘﻢ ﺑﺘﻘﻠﻴﻞ ﺍﳌﺨﺎﻃﺮ ﺍﻟﻨﺎﲡﺔ ﻋﻦ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﻭﺫﻟﻚ ﻟﻜﻞ ﻣﻦ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﻭﺍﳌﺴﺘﻔﻴﺪﻳﻦ ﻣﻨﻬﺎ‪.‬‬
‫‪ -١٠‬ﺍﻟﺘﻮﻗﻴﺖ )‪ :(Timeliness‬ﻭﻳﻘﺼﺪ ﺑﻪ ﺍﻟﻘﺪﺭﺓ ﻋﻠﻰ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﻟﻮﻗﺖ ﺍﳌﻨﺎﺳﺐ‬
‫ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﻨﺘﺎﺋﺞ ﺍﳌﺮﺟﻮﺓ‪.‬‬

‫‪ +
 ,-‬‬
‫ﻭﺍﳊﺪﻳﺚ ﻋﻦ ﺗﻄﻮﺭ ﻣﻔﻬﻮﻡ ﺍﳉﻮﺩﺓ ﻳﺴﺘﻮﺟﺐ ﻣﻨﺎﻗﺸﺔ ﺑﻌﺾ ﺍﻟﺘﻔﺎﺻﻴﻞ ﻋﻦ ﻣﻔﻬﻮﻡ ﺍﳉﻮﺩﺓ ﰲ ﺍﻟﺼﻨﺎﻋﺔ ﰒ‬
‫ﻧﻨﺪﺭﺝ ﺇﱃ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ ﺣﱴ ﻧﺘﻤﻜﻦ ﻣﻦ ﺇﺩﺭﺍﻙ ﺗﻄﻮﺭ ﻣﻔﻬﻮﻡ ﺍﳉﻮﺩﺓ ﻋﻠﻰ ﻣﺮ ﺍﻟﻌﺼﻮﺭ‪ ،‬ﻓﻘﺒﻞ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ‬
‫ﻛﺎﻧﺖ ﺍﳉﻮﺩﺓ ﰲ ﺍﻟﺼﻨﺎﻋﺔ ﺗﻌﲎ ﻓﺮﺯ ﺍﳌﻨﺘﺞ‪ ،‬ﻭﺑﻌﺪ ﺍﳊﺮﺏ ﺍﻟﻌﺎﳌﻴﺔ ﺍﻟﺜﺎﻧﻴﺔ ﻗﺎﻡ ﺍﻟﻴﺎﺑﺎﻧﻴﻮﻥ ﺑﺜﻮﺭﺓ ﰲ ﺟﻮﺩﺓ ﺍﻟﺼﻨﺎﻋﺔ‬
‫ﺣﻴﺚ ﰎ ﺗﻄﺒﻴﻖ ﺍﻟﺮﻗﺎﺑﺔ ﺍﻹﺣﺼﺎﺋﻴﺔ )‪ (Statistical Process Control‬ﻻﻛﺘﺸﺎﻑ ﻧﻘﺎﻁ ﺍﻟﻀﻌﻒ ﻭﺍﳋﻠﻞ ﺃﺛﻨﺎﺀ‬
‫ﺇﺟﺮﺍﺀ ﺍﻟﻌﻤﻠﻴﺎﺕ ﻭﲟﻌﲎ ﺁﺧﺮ ﺍﻟﻮﺻﻮﻝ ﺇﱃ ﺍﳌﻌﻴﺐ ﻣﻦ ﺍﳌﺼﺪﺭ )‪ (Catching Defects at the Source‬ﰒ ﺗﻄﻮﺭ‬
‫ﺍﳌﻔﻬﻮﻡ ﺇﱃ ﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ )ﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﺍﳉﻮﺩﺓ( )‪ (Quality Assurance‬ﻟﻠﺘﺄﻛﺪ ﻣﻦ ﻣﻼﺀﻣﺔ‬
‫ﺍﻟﺴﻠﻌﺔ ﻷﻭﺟﻪ ﺍﺳﺘﻌﻤﺎﳍﺎ )‪ (Fitness Use‬ﺣﻴﺚ ﻳﻜﻮﻥ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺟﻮﺩﺓ ﺍﳌﻄﺎﺑﻘﺔ ﻟﻠﻤﻮﺍﺻﻔﺎﺕ‬
‫)‪ (Quality of Conformance‬ﲟﺎ ﻳﻀﻤﻦ ﺍﻟﻮﺻﻮﻝ ﻟﻠﻌﻤﻴﻞ ﺍﻟﺼﺤﻴﺢ ﻣﻦ ﺃﻭﻝ ﻣﺮﺓ ﰒ ﺃﺻﺒﺤﺖ‬
‫ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺍﻟﻜﻠﻴﺔ )‪ (Total Quality Management TQM‬ﺍﻟﱵ ﺗﺮﺗﻜﺰ ﻋﻠﻰ ﺍﻟﺘﺤﺴﲔ ﺍﳌﺴﺘﻤﺮ‬
‫ﻟﻠﺠﻮﺩﺓ )‪ (Continuous Quality Improvement‬ﻫﻲ ﺍﻟﺸﻌﺎﺭ ﻟﻌﺪﺩ ﻛﺒﲑ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﺍﻟﺼﻨﺎﻋﻴﺔ ﻭﺍﻟﺘﺠﺎﺭﻳﺔ ﺍﻵﻥ‪.‬‬

‫‪١٤٣‬‬
 ‫ﺷﻜﻞ )‪ :(١-٦‬ﺗﻄﻮﺭ ﻣﻔﻬﻮﻡ ﺍﳉﻮﺩﺓ‬

‫ﺇﺩﺭﺍﺓ ﺍﳉﻮﺩﺓ ﺍﻟﻜﻠﻴﺔ‬

‫ﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ‬

‫ﺿﺒﻂ ﺍﳉﻮﺩﺓ‬

‫ﺍﻟﻔﺮﺯ‬

‫‪Inspection‬‬

‫‪Quality control‬‬

‫‪Quality assurance‬‬

‫‪Total quality management‬‬

‫ﺃﻣﺎ ﰲ ﳎﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ :‬ﻓﻘﺪ ﻛﺎﻧﺖ ﺟﻬﻮﺩ ﺍﳉﻮﺩﺓ ﻛﻠﻬﺎ ﺗﺮﻛﺰ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ‬
‫ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﻛﺎﻧﺖ ﻋﻼﻗﺔ ﺍﻟﻄﺒﻴﺐ ﺑﺎﳌﺮﻳﺾ ﻫﻲ ﳏﻮﺭ ﺍﳉﻮﺩﺓ ﰎ ﺗﻄﻮﺭ ﻫﺬﺍ ﺍﳌﻔﻬﻮﻡ ﺣﱴ ﺃﺻﺒﺢ‬
‫ﻋﻼﻗﺔ ﺍﳋﺪﻣﺔ ﻛﻜﻞ ﺑﺎﳌﺮﻳﺾ ﲟﺎ ﻳﻌﲎ ﺑﺮﻭﺯ ﺃﳘﻴﺔ ﺩﻭﺭ ﺑﺎﻗﻲ ﺃﻓﺮﺍﺩ ﺍﻟﻔﺮﻳﻖ ﺍﻟﺼﺤﻲ ﻭﺍﻹﺩﺍﺭﻱ ﻭﺍﳋﺪﻣﺎﺕ‬
‫ﺍﳌﺴﺎﻧﺪﺓ ﰲ ﺍﳉﻮﺩﺓ‪ ،‬ﻓﻤﺜﻼ ﳝﻜﻦ ﳉﺮﺍﺡ ﺫﻱ ﻛﻔﺎﺀﺓ ﻋﺎﻟﻴﺔ ﺇﺟﺮﺍﺀ ﺟﺮﺍﺣﺔ ﻧﺎﺟﺤﺔ ﻭﻟﻜﻦ ﻧﻈﺮﺍ ﻟﻀﻌﻒ‬
‫ﺍﳋﺪﻣﺔ ﺍﻟﺘﻤﺮﻳﻀﻴﺔ ﺑﻌﺪ ﺍﻟﻌﻤﻠﻴﺔ ﲢﺪﺙ ﻣﻀﺎﻋﻔﺎﺕ ﺗﺆﺛﺮ ﻋﻠﻰ ﺍﻟﻨﺘﺎﺋﺞ ﺍﻟﻨﻬﺎﺋﻴﺔ ﻟﻠﺠﺮﺍﺣﺔ ﻭﺑﺎﻟﺘﺎﱄ‬
‫ﺟﻮﺩﺓ ﺍﳋﺪﻣﺔ‪.‬‬
‫ﻭﳝﻜﻦ ﺗﻠﺨﻴﺺ ﺗﻄﻮﺭ ﻣﻔﻬﻮﻡ ﺍﳉﻮﺩﺓ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ ﰲ ﺍﻟﻨﻘﺎﻁ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫ﺍﺗﺴﻊ ﺍﻟﻐﺮﺽ ﻣﻦ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻴﺸﻤﻞ ﲢﺴﲔ ﺍﳋﺪﻣﺔ ﳉﻤﻴﻊ ﺃﻓﺮﺍﺩ ﺍ‪‬ﺘﻤﻊ‬ ‫‪-‬‬
‫ﻭﲨﻴﻊ ﺍﻟﻌﻤﻼﺀ ﻭﻟﻴﺲ ﻓﻘﻂ ﺍﳌﺮﺿﻰ‪.‬‬
‫ﺍﻣﺘﺪ ﳎﺎﻝ ﺍﳉﻮﺩﺓ ﻟﻴﻐﻄﻰ ﲨﻴﻊ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﺘﻌﺰﻳﺰﻳﺔ ﻭﻟﻴﺲ ﻓﻘﻂ ﺍﳋﺪﻣﺎﺕ‬ ‫‪-‬‬
‫ﺍﻟﺴﺮﻳﺮﻳﺔ‪.‬‬
‫ﺗﻄﻮﺭ ﻣﻔﻬﻮﻡ ﺍﻟﻘﻴﺎﺩﺓ ﻟﻴﺸﻤﻞ ﺃﻳﻀﺎ ﺩﻭﺭ ﺍﻟﻘﻴﺎﺩﺍﺕ ﺍﻹﺩﺍﺭﻳﺔ ﻭﺍ‪‬ﺘﻤﻌﻴﺔ ﺑﺎﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ‬ ‫‪-‬‬
‫ﺍﻧﺘﻘﻞ ﺍﻟﺘﺮﻛﻴﺰ ﻣﻦ ﺍﻟﻔﺮﺯ ﺃﻭ ﺍﻟﺘﻔﺘﻴﺶ ﻻﻛﺘﺸﺎﻑ ﺍﻟﻨﺘﺎﺋﺞ ﻏﲑ ﺍﳌﺮﺿﻴﺔ )ﻭﻣﺎ ﻳﺘﺒﻌﻬﺎ ﻣﻦ‬ ‫‪-‬‬
‫ﺗﺼﻠﻴﺢ ﺃﻭ ﺇﻋﺎﺩﺓ ﺍﳋﺪﻣﺔ ﻣﻊ ﺇﻫﺪﺍﺭ ﻟﻠﻮﻗﺖ ﻭﺍﳌﺎﻝ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻵﺛﺎﺭ ﺍﻟﻨﻔﺴﻴﺔ ﻭﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻟﺴﻴﺌﺔ ﻋﻠﻰ ﺍﳌﺮﻳﺾ( ﺇﱃ ﺍﻟﺘﺤﺴﲔ ﺍﳌﺴﺘﻤﺮ ﻟﻺﺟﺮﺍﺀﺍﺕ ﺍﻟﱵ ﺗﺘﻢ ﺃﺛﻨﺎﺀ ﺍﳋﺪﻣﺔ ﲟﺎ ﻳﻀﻤﻦ ﺃﻭ‬
‫ﳝﻨﻊ ﺣﺪﻭﺙ ﺍﻷﺧﻄﺎﺀ‪.‬‬

‫‪١٤٤‬‬
‫ﺑﺪﺃ ﺍﺳﺘﺨﺪﺍﻡ ﺃﺩﻭﺍﺕ ﺍﳉﻮﺩﺓ ﻟﺘﺤﺴﲔ ﺍﳋﺪﻣﺔ ﻭﺗﻄﻮﺭ ﻟﻴﺸﻤﻞ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻌﺼﻒ ﺍﻟﺬﻫﲏ‬ ‫‪-‬‬
‫ﻭﻣﺼﻔﻮﻓﺔ ﺍﻷﻭﻟﻮﻳﺎﺕ ﻭﺍﻟﺮﺳﻮﻣﺎﺕ ﺍﻟﺘﻮﺿﻴﺤﻴﺔ ﻭﺍﻟﺒﻴﺎﻧﻴﺔ ﻭﻏﲑﻫﺎ ﻣﻦ ﺍﻷﺩﻭﺍﺕ‪.‬‬
‫ﺃﺻﺒﺢ ﻫﻨﺎﻙ ﻣﻌﺎﻳﲑ ﻟﻠﺨﺪﻣﺔ ﻳﺸﺎﺭﻙ ﰲ ﻭﺿﻌﻬﺎ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳌﻬﻨﻴﲔ‪ ،‬ﺍﳌﺴﺘﻔﻴﺪﻭﻥ ﻣﻦ‬ ‫‪-‬‬
‫ﺍﳋﺪﻣﺔ ﻭﺑﺎﻗﻲ ﺍﻟﻌﻤﻼﺀ ﻭﺫﻟﻚ ‪‬ﺪﻑ ﺍﻟﺘﺤﺴﲔ ﺍﳌﺴﺘﻤﺮ ﻟﻠﺨﺪﻣﺔ‪.‬‬
‫ﺍﻧﺘﺸﺮ ﻣﻔﻬﻮﻡ ﺭﻭﺡ ﺍﻟﻔﺮﻳﻖ ﻭﺃﺻﺒﺢ ﺃﺩﺍﺀ ﻛﻞ ﻓﺮﺩ ﻭﻋﺎﻣﻞ ﰲ ﺍﳌﺆﺳﺴﺔ ﺍﻟﺼﺤﻴﺔ ﻣﻬﻤﺎﹰ ﻭﻳﺆﺛﺮ‬ ‫‪-‬‬
‫ﻋﻠﻰ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺔ‪.‬‬

‫‪(TQM) ./  ,0‬‬

‫ﻟﻘﺪ ﺗﻌﺪﺩﺕ ﺗﻌﺎﺭﻳﻒ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺍﻟﻜﻠﻴﺔ ﻓﻬﻨﺎﻙ ﻣﻦ ﻳﻌﺮﻓﻬﺎ ﺑﺄ‪‬ﺎ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺗﻨﻈﻴﻤﻴﺔ ﻭﺃﺳﺎﻟﻴﺐ‬
‫ﺇﺩﺍﺭﻳﺔ ﺗﺆﺩﻯ ﺇﱃ ﺧﺪﻣﺔ ﺫﺍﺕ ﺟﻮﺩﺓ ﻋﺎﻟﻴﺔ ﺗﺮﺿﻰ ﺍﻟﻌﻤﻼﺀ‪ ,‬ﻭﻫﻨﺎﻙ ﺗﻌﺮﻳﻒ ﺁﺧﺮ ﻳﻨﺺ ﻋﻠﻰ ﺃ‪‬ﺎ ﺷﻜﻞ‬
‫ﺗﻌﺎﻭﱐ ﻷﺩﺍﺀ ﺍﻟﻌﻤﻞ ﻳﻌﺘﻤﺪ ﻋﻠﻰ ﺍﻟﻘﺪﺭﺍﺕ ﺍﳌﺸﺘﺮﻛﺔ ﻟﻜﻞ ﻣﻦ ﺍﻹﺩﺍﺭﺓ ﻭﺍﻟﻌﺎﻣﻠﲔ ‪‬ﺪﻑ ﲢﺴﲔ ﻭﺯﻳﺎﺩﺓ‬
‫ﺍﻹﻧﺘﺎﺟﻴﺔ ﺑﺼﻔﺔ ﻣﺴﺘﻤﺮﺓ ﻣﻦ ﺧﻼﻝ ﻓﺮﻳﻖ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﻭﻗﺪ ﲣﺘﻠﻒ ﺍﻟﺘﻌﺎﺭﻳﻒ ﺍﳋﺎﺻﺔ ﺑﺈﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺍﻟﻜﻠﻴﺔ )‪ (TQM‬ﻭﻟﻜﻦ ﳚﺐ ﺃﻥ ﳛﺘﻮﻯ ﺍﻟﺘﻌﺮﻳﻒ ﻋﻠﻰ‬
‫ﺍﻟﻨﻘﺎﻁ ﺍﳍﺎﻣﺔ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫‪ .١‬ﺿﺮﻭﺭﺓ ﺃﻥ ﺗﺘﺸﻜﻞ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﻠﻴﺎ ﰒ ﺗﻨﺘﺸﺮ ﰲ ﺍﳌﺆﺳﺴﺔ ﲝﻴﺚ‬
‫ﺗﺼﺒﺢ ﺍﳉﻮﺩﺓ ﺍﻟﻜﻠﻴﺔ ﻫﻲ ﺍﻟﻘﻴﻢ ﺍﻟﺜﻘﺎﻓﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﱵ ﺗﺆﻣﻦ ‪‬ﺎ ﺍﳌﺆﺳﺴﺔ ﺍﻟﺼﺤﻴﺔ ﻣﻦ‬
‫ﺃﺟﻞ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ‪.‬‬
‫‪ .٢‬ﺃﻥ ﺃﺳﺎﻟﻴﺐ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺍﻟﻜﻠﻴﺔ ‪ TQM‬ﺗﺘﺮﺍﻭﺡ ﺑﲔ ﺍﻷﺳﺎﻟﻴﺐ ﺍﻟﺘﻘﻠﻴﺪﻳﺔ ﺍﳌﺒﻨﻴﺔ ﻋﻠﻰ ﺍﻟﺘﻔﺘﻴﺶ‬
‫)ﺍﻟﻔﺮﺯ( ﻭﺍﻟﺮﻗﺎﺑﺔ ﺍﻹﺣﺼﺎﺋﻴﺔ ﺇﱃ ﺍﻷﺳﺎﻟﻴﺐ ﺍﳊﺪﻳﺜﺔ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺈﺩﺍﺭﺓ ﺍﳌﻮﺍﺭﺩ ﺍﻟﺒﺸﺮﻳﺔ ﻭﻓﺮﻕ ﺍﻹﺩﺍﺭﺓ‬
‫ﺍﻟﺬﺍﺗﻴﺔ‪.‬‬
‫‪ .٣‬ﺗﺘﻢ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﻣﻦ ﺧﻼﻝ ﺍﻟﻌﻤﻼﺀ ﻓﺎﳋﺪﻣﺔ ﳚﺐ ﺃﻥ ﺗﻠﱮ ﺃﻭ ﺗﺰﻳﺪ ﻋﻦ ﺗﻮﻗﻌﺎﺕ ﺍﻟﻌﻤﻼﺀ‪.‬‬
‫‪ .٤‬ﳚﺐ ﺃﻻ ﺗﻜﻮﻥ ﺍﳉﻮﺩﺓ ﳎﺮﺩ ﺷﻌﺎﺭﺍﺕ ﻣﻜﺘﻮﺑﺔ ﺑﻞ ﳚﺐ ﺃﻥ ﺗﻜﻮﻥ ﺷﻴﺌﺎﹰ ﻣﻠﻤﻮﺳﺎﹰ ﻳﺪﺭﻛﻪ ﺍﻟﻌﻤﻴﻞ‬
‫)ﺍﻟﺪﺍﺧﻠﻲ ﻭﺍﳋﺎﺭﺟﻲ( ﺑﺎﻟﻔﻌﻞ‪.‬‬
‫‪ .٥‬ﻻ ﻳﻘﺼﺪ ﺑﺎﻟﻌﻤﻼﺀ ﳎﺮﺩ ﻣﺴﺘﺨﺪﻣﻲ ﺍﳋﺪﻣﺔ ﺑﻞ ﻳﺘﻀﻤﻦ ﺃﻳﻀﺎ ﺍﻟﻌﻤﻼﺀ ﺍﻟﺪﺍﺧﻠﻴﲔ ﺑﺎﳌﺆﺳﺴﺔ‬
‫ﻭﻟﺬﻟﻚ ﳒﺪ ﺃﻥ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺍﻟﻜﻠﻴﺔ ﺗﺘﻀﻤﻦ ﻛﻞ ﺍﻷﻓﺮﺍﺩ ﺩﺍﺧﻞ ﻭﺧﺎﺭﺝ ﺍﳌﻨﻈﻤﺔ ﻭﺍﻟﺬﻳﻦ ﻳﺮﺗﺒﻄﻮﻥ‬
‫ﺑﺎﳋﺪﻣﺔ‪.‬‬
‫ﻭﳑﺎ ﺳﺒﻖ ﻳﺘﻀﺢ ﺃﻥ ﻓﻠﺴﻔﺔ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺍﻟﻜﻠﻴﺔ ﺗﺮﺗﻜﺰ ﻋﻠﻰ ﺛﻼﺛﺔ ﳏﺎﻭﺭ ﻫﺎﻣﺔ‪:‬‬
‫ﺇﺭﺿﺎﺀ ﺍﻟﻌﻤﻴﻞ‪.‬‬ ‫ﺃﻭﻻ‪:‬‬
‫ﺛﻘﺎﻓﺔ ﺍﳉﻮﺩﺓ‪.‬‬ ‫ﺛﺎﻧﻴﺎ‪:‬‬
‫ﻗﻴﺎﺱ ﺍﳉﻮﺩﺓ‪.‬‬ ‫ﺛﺎﻟﺜﺎ‪:‬‬

‫‪١٤٥‬‬
 ‫‪  3$ % 
4‬‬
‫ﻟﻘﺪ ﺃﺻﺒﺢ ﻗﻴﺎﺱ ﺍﳉﻮﺩﺓ ﻭﺍﺳﺘﺨﺪﺍﻡ ﺍﻷﺩﻭﺍﺕ ﺍﻹﺣﺼﺎﺋﻴﺔ ﰲ ﺍﻟﺘﺤﺴﲔ ﺍﳌﺴﺘﻤﺮ ﻟﻠﺠﻮﺩﺓ ﺿﺮﻭﺭﺓ ﻣﻠﺤﺔ‬
‫ﻭﻻ ﺳﺒﻴﻞ ﺇﱃ ﲡﺎﻫﻠﻬﺎ ﻭﻟﻜﻦ ﻋﻨﺪ ﺍﺧﺘﻴﺎﺭ ﺍﻟﻘﻴﺎﺳﺎﺕ ﺍﳌﻨﺎﺳﺒﺔ ﳚﺐ ﺃﻥ ﻳﺆﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﻋﻮﺍﻣﻞ ﻋﺪﺓ‬
‫ﻣﻨﻬﺎ‪:‬‬
‫ﳌﺎﺫﺍ ﻧﻘﻴﺲ ﺃﻭ ﻣﺎ ﺍﻟﻐﺮﺽ ﻣﻦ ﻗﻴﺎﺱ ﺍﳉﻮﺩﺓ؟‬ ‫‪-‬‬
‫ﻣﺎ ﻫﻲ ﺃﻧﻮﺍﻉ ﺍﻟﻘﻴﺎﺳﺎﺕ؟‬ ‫‪-‬‬
‫ﻣﺎ ﻫﻲ ﺃﻧﻮﺍﻉ ﺍﳌﺘﻐﲑﺍﺕ ﺍﻟﱵ ﺳﻮﻑ ﻧﻘﻴﺴﻬﺎ؟‬ ‫‪-‬‬

‫ﺃﻭﻻ‪ :‬ﺍﻟﻐﺮﺽ ﻣﻦ ﻗﻴﺎﺱ ﺍﳉﻮﺩﺓ‬

‫‪ .١‬ﺗﻘﻴﻴﻢ ﺍﻷﺩﺍﺀ )‪(Assessment of Performance‬‬
‫‪ .٢‬ﲢﺴﲔ ﺍﻹﺟﺮﺍﺀﺍﺕ )‪(Improve Processes‬‬
‫‪ .٣‬ﺿﺒﻂ ﺍﻹﺟﺮﺍﺀﺍﺕ )‪(Control Processes‬‬
‫ﻭﻧﻮﺩ ﺃﻥ ﻧﺸﺪﺩ ﻫﻨﺎ ﻋﻠﻰ ﺃﻧﻪ ﺭﻏﻢ ﺃﻥ ﻛﻞ ﺍﳌﻘﺎﻳﻴﺲ ﺗﺼﻠﺢ ﻟﻠﺘﻘﻴﻴﻢ‪ ،‬ﻓﺈﻧﻪ ﻫﻨﺎﻙ ﺑﻌﺾ ﺍﳌﻘﺎﻳﻴﺲ ﺗﻔﻴﺪ‬
‫ﺍﻛﺜﺮ ﰲ ﲢﺴﲔ ﺍﻹﺟﺮﺍﺀﺍﺕ ﺃﻭ ﺿﺒﻂ ﺍﻹﺟﺮﺍﺀﺍﺕ‪.‬‬

‫ﺛﺎﻧﻴﺎﹰ‪ :‬ﺃﻧﻮﺍﻉ ﺍﻟﻘﻴﺎﺳﺎﺕ‬

‫ﻭﻣﻦ ﺍﳌﻔﻴﺪ ﺃﻥ ﻧﻔﺮﻕ ﻫﻨﺎ ﺑﲔ ﺛﻼﺛﺔ ﺃﻧﻮﺍﻉ ﻣﻦ ﺍﻟﻘﻴﺎﺳﺎﺕ‬
‫‪ .١‬ﻗﻴﺎﺳﺎﺕ ﻟﻠﺒﻨﻴﺔ )‪ :(Measurement of structure‬ﻣﺜﻞ ﺍﳌﻮﺍﺭﺩ ﺍﻟﺒﺸﺮﻳﺔ ﻭﺍﻷﺟﻬﺰﺓ ﻭﺍﻹﻣﺪﺍﺩﺍﺕ‪.‬‬
‫‪ .٢‬ﻗﻴﺎﺳﺎﺕ ﺍﻹﺟﺮﺍﺀﺍﺕ )‪ :(Measurement of processes‬ﻣﺜﻞ ﻗﻴﺎﺱ ﺇﺟﺮﺍﺀﺍﺕ ﺭﻋﺎﻳﺔ ﺍﳊﻮﺍﻣﻞ ﻣﻦ‬
‫ﺗﻐﻄﻴﺔ ﺑﺎﳋﺪﻣﺔ ﻭﻋﺪﺩ ﺍﳊﻮﺍﻣﻞ ﺍﻟﻼﰐ ﺭﺍﺟﻌﻦ ﺃﻛﺜﺮ ﻣﻦ ﲬﺲ ﺯﻳﺎﺭﺍﺕ ﺃﺛﻨﺎﺀ ﻓﺘﺮﺓ ﺍﳊﻤﻞ ﻭﻣﺪﺓ‬
‫ﺍﻧﺘﻈﺎﺭ ﺍﳌﺮﻳﺾ ﰲ ﺍﻟﻌﻴﺎﺩﺓ ﺍﳋﺎﺭﺟﻴﺔ ﻭﻏﲑﻫﺎ‪.‬‬
‫‪ .٣‬ﻗﻴﺎﺳﺎﺕ ﺍﻟﻨﺘﺎﺋﺞ )‪ :(Measurement of outcomes‬ﻣﺜﻞ ﺍﻟﻮﻓﻴﺎﺕ ﻭﺍﳌﻌﺪﻻﺕ ﺍﳌﺮﺿﻴﺔ ﻭﺩﺭﺟﺔ‬
‫ﺭﺿﺎﺀ ﺍﻟﻌﻤﻴﻞ ﻋﻦ ﺍﳋﺪﻣﺔ ﻭﻏﲑﻫﺎ‪.‬‬
‫ﻭﻻﺑﺪ ﺃﻥ ﻧﻮﺿﺢ ﻫﻨﺎ ﺃﻥ ﺍﻻﻫﺘﻤﺎﻡ ﺑﻘﻴﺎﺱ ﺍﻟﻨﺘﺎﺋﺞ ﺩﻭﻥ ﻣﻨﺎﻇﺮﺓ ﺍﻹﺟﺮﺍﺀﺍﺕ ﻻ ﻳﺴﺎﻋﺪ ﻋﻠﻰ ﺍﻟﺘﺤﺴﲔ‬
‫ﺍﳌﺴﺘﻤﺮ ﻟﻠﺠﻮﺩﺓ ﻭﻟﺬﺍ ﳚﺐ ﺍﺧﺘﻴﺎﺭ ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﻟﻘﻴﺎﺳﺎﺕ ﺍﻟﱵ ﺗﻐﻄﻰ ﺍﻷﻧﻮﺍﻉ ﺍﻟﺜﻼﺛﺔ ﻣﻦ ﺍﻟﻘﻴﺎﺳﺎﺕ‪،‬‬
‫ﻭﺫﻟﻚ ﺣﺴﺐ ﺍﻟﻐﺮﺽ ﻣﻦ ﺍﻟﻘﻴﺎﺳﺎﺕ ﻓﻘﻴﺎﺱ ﺍﻟﻨﺘﺎﺋﺞ ﻳﺴﺘﺨﺪﻡ ﻏﺎﻟﺒﺎ ﺑﻐﺮﺽ ﺗﻘﻴﻴﻢ ﺍﻷﺩﺍﺀ ﺑﻴﻨﻤﺎ ﻗﻴﺎﺱ‬
‫ﺍﻹﺟﺮﺍﺀﺍﺕ ﻭﺍﻟﺒﻨﻴﺔ ﻳﺴﺘﺨﺪﻡ ﺑﻐﺮﺽ ﲢﺴﲔ ﻭﺿﺒﻂ ﺍﻹﺟﺮﺍﺀﺍﺕ‪.‬‬

‫ﺛﺎﻟﺜﺎﹰ‪ :‬ﺃﻧﻮﺍﻉ ﺍﳌﺘﻐﲑﺍﺕ‬

‫ﻭﺍﳌﺘﻐﲑ ﻫﻮ ﺻﻔﺔ ﺃﻭ ﺧﺎﺻﻴﺔ ﺗﺄﺧﺬ ﻗﻴﻤﺎﹰ ﳐﺘﻠﻔﺔ ﰲ ﳐﺘﻠﻒ ﺍﳌﺸﺎﻫﺪ‪ ،‬ﻭﺭﻏﻢ ﺃﻧﻨﺎ ﻟﻦ ﳔﻮﺽ ﰲ‬
‫ﺗﻔﺎﺻﻴﻞ ﺃﻧﻮﺍﻉ ﺍﳌﺘﻐﲑﺍﺕ ﻫﻨﺎ ﻭﻟﻜﻦ ﺳﻨﺬﻛﺮ ﻋﻠﻰ ﺍﺳﺘﻌﺠﺎﻝ ﺍﻷﻧﻮﺍﻉ ﺍﻟﺘﺎﻟﻴﺔ ﻭﻋﻼﻗﺘﻬﺎ ﺑﻘﻴﺎﺱ ﺍﳉﻮﺩﺓ‪:‬‬
‫ﻣﺘﻐﲑﺍﺕ ﻭﺻﻔﻴﺔ‪ :‬ﻣﺜﻞ ﺍﻟﻨﻮﻉ‪ ،‬ﻓﺼﻴﻠﺔ ﺍﻟﺪﻡ‪ ،‬ﺍﻟﺘﺪﺧﲔ‪ ..‬ﻭﻏﲑﻫﺎ‪.‬‬ ‫‪-‬‬

‫‪١٤٦‬‬
‫ﻣﺘﻐﲑﺍﺕ ﻭﺻﻔﻴﺔ ﻃﺒﻘﻴﺔ‪ :‬ﻣﺜﻞ ﻣﺴﺘﻮﻯ ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﻭﺍﳌﺴﺘﻮﻯ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ ،‬ﻭﺷﺪﺓ ﺍﳌﺮﺽ‬ ‫‪-‬‬
‫ﻭﻏﲑﻫﺎ‪.‬‬
‫ﻣﺘﻐﲑﺍﺕ ﻛﻤﻴﺔ ﻋﺪﺩﻳﺔ‪ :‬ﻣﺜﻞ ﻋﺪﺩ ﺍﳌﺮﺿﻰ‪ ،‬ﻋﺪﺩ ﺍﻷﻭﻻﺩ‪ ،‬ﻋﺪﺩ ﻣﺮﺍﺕ ﺍﻹﺟﻬﺎﺽ‪ ،‬ﻋﺪﺩ ﺃﻓﻼﻡ‬ ‫‪-‬‬
‫ﺍﻷﺷﻌﺔ ﻭﻏﲑﻫﺎ‪.‬‬
‫ﻣﺘﻐﲑﺍﺕ ﻛﻤﻴﺔ ﻣﺘﺼﻠﺔ) ﻗﻴﺎﺳﻴﺔ(‪ :‬ﻣﺜﻞ ﺍﻟﻮﻗﺖ‪ ،‬ﻭﺍﻟﻨﻘﻮﺩ‪ ،‬ﻭﺍﻟﻘﻴﺎﺳﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻀﻐﻂ‬ ‫‪-‬‬
‫ﺍﻟﺪﻡ ﻭﺍﳊﺮﺍﺭﺓ ﻭﺍﻟﻄﻮﻝ ﻭﺍﻟﻮﺯﻥ ﻭﻏﲑﻫﺎ‪.‬‬
‫ﻭﳚﺐ ﺃﻥ ﻧﻮﺿﺢ ﻫﻨﺎ ﺃﻥ ﺍﳌﺘﻐﲑﺍﺕ ﺍﻟﻌﺪﺩﻳﺔ ﺗﺼﻠﺢ ﰲ ﺗﻘﻴﻴﻢ ﺍﻷﺩﺍﺀ ﰲ ﺣﲔ ﺃﻥ ﺍﳌﺘﻐﲑﺍﺕ ﺍﻟﻘﻴﺎﺳﻴﺔ‬
‫ﺗﺼﻠﺢ ﰲ ﲢﺴﲔ ﺍﻹﺟﺮﺍﺀﺍﺕ ﺃﻭ ﺿﺒﻂ ﺍﻹﺟﺮﺍﺀﺍﺕ‪.‬‬
‫ﻭﻫﻨﺎﻙ ﻧﻘﺎﻁ ﺃﺧﺮﻯ ﳚﺐ ﻣﺮﺍﻋﺎ‪‬ﺎ ﻋﻨﺪ ﻗﻴﺎﺱ ﺍﳉﻮﺩﺓ ﻣﺜﻞ‪:‬‬
‫ﺳﻬﻮﻟﺔ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺒﻴﺎﻧﺎﺕ ﳍﺬﻩ ﺍﻟﻘﻴﺎﺳﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﻣﺪﻯ ﺍﻟﻔﺎﺋﺪﺓ ﻣﻦ ﺍﻟﻘﻴﺎﺱ ﰲ ﻣﻘﺎﺑﻞ ﺗﻜﻠﻔﺔ ﺍﻟﻘﻴﺎﺱ‪.‬‬ ‫‪-‬‬
‫ﺩﺭﺟﺔ ﺍﻋﺘﻤﺎﺩﻳﺔ )‪ (Reliability‬ﻫﺬﻩ ﺍﻟﻘﻴﺎﺳﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﺩﺭﺟﺔ ﺻﺪﻕ ﺍﻟﻘﻴﺎﺳﺎﺕ )‪.(Validity‬‬ ‫‪-‬‬
‫ﻭﺃﺧﲑﺍﹰ ﻻﺑﺪ ﺃﻥ ﻳﻜﻮﻥ ﻫﻨﺎﻙ ﻧﻈﺎﻡ ﻹﺩﺍﺭﺓ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺑﺎﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﲢﺪﺩ ﻓﻴﻪ ﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﻟﻔﻌﻠﻴﺔ‬
‫ﳉﻤﻊ ﻭﺗﻮﺯﻳﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻣﻊ ﺗﻮﺿﻴﺢ ﺍﻵﰐ‪:‬‬
‫ﻣﻦ ﻫﻢ ﰲ ﺣﺎﺟﺔ ﺇﱃ ﻫﺬﻩ ﺍﳌﻌﻠﻮﻣﺎﺕ ) ﻣﺪﻳﺮﻭ ﺍﻟﻮﺣﺪﺍﺕ ﻭﺃﻋﻀﺎﺀ ﳎﻠﺲ ﺍﻹﺩﺍﺭﺓ ﻭﺍﻷﻃﺒﺎﺀ‬ ‫‪-‬‬
‫ﻭﻏﲑﻫﻢ(‪.‬‬
‫ﻣﺎ ﻫﻲ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﱵ ﳛﺘﺎﺟﻬﺎ ﻛﻞ ﻣﻨﻬﻢ ﺣﱴ ﻳﺴﺘﻄﻴﻊ ﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺘﺤﺴﲔ‬ ‫‪-‬‬
‫ﺍﳉﻮﺩﺓ؟‬
‫ﻭﻳﺮﺍﻋﻰ ﰲ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ ﻭﺻﻮﻝ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﺼﺤﻴﺤﺔ ﺇﱃ ﺍﻟﺸﺨﺺ ﺍﳌﻨﺎﺳﺐ ﻭﰱ ﺍﻟﻮﻗﺖ‬ ‫‪-‬‬
‫ﺍﳌﻨﺎﺳﺐ ﻭﺑﺎﻟﻄﺮﻳﻘﺔ ﺍﳌﻨﺎﺳﺒﺔ‪.‬‬

‫‪"  % 5 67 !8‬‬ ‫‪98‬‬

‫ﺭﻏﻢ ﺃﻧﻨﺎ ﻧﻌﺘﻘﺪ ﺃﻥ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻗﺪ ﻻﻗﺖ ﺍﻻﻫﺘﻤﺎﻡ ﺍﳉﺪﻳﺮ ‪‬ﺎ ﺧﻼﻝ ﻋﺼﻮﺭ ﺍﺯﺩﻫﺎﺭ ﺍﳊﻀﺎﺭﺓ‬
‫ﺍﻟﻔﺮﻋﻮﻧﻴﺔ ﻭﺍﻟﻘﺒﻄﻴﺔ ﻭﺍﻹﺳﻼﻣﻴﺔ ﲟﺼﺮ‪ ،‬ﺇﻻ ﺃﻧﻨﺎ ﺳﻨﺮﻛﺰ ﰲ ﻫﺬﺍ ﺍﻟﺘﻘﺮﻳﺮ ﻋﻠﻰ ﻭﺻﻒ ﻭﺗﻘﻮﱘ ﺍﻟﻮﺿﻊ‬
‫ﺍﳊﺎﱄ‪ ،‬ﻓﻘﺪ ﺑﺪﺃ ﺍﻻﻫﺘﻤﺎﻡ ﲜﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﻟﻌﺼﺮ ﺍﳊﺪﻳﺚ ﻣﻨﺬ ﻭﻗﺖ ﻣﺒﻜﺮ ﰲ ﳎﺎﻻﺕ‬
‫ﺍﳌﻨﺘﺠﺎﺕ ﺍﻟﺼﻴﺪﻻﻧﻴﺔ ﻭﺍﻟﻔﺤﻮﺹ ﺍﳌﻌﻤﻠﻴﺔ ﻭﻣﺮﺍﻗﺒﺔ ﺍﻷﻏﺬﻳﺔ ﻭﺍﻟﺒﻴﺌﺔ‪ ،‬ﻭﺫﻟﻚ ﺑﺎﺗﺒﺎﻉ ﻣﻌﺎﻳﲑ ﻭﺇﺟﺮﺍﺀﺍﺕ‬
‫ﻣﺮﺍﻗﺒﺔ ﺍﳉﻮﺩﺓ ﺍﻟﻌﺎﳌﻴﺔ‪ ،‬ﻛﻤﺎ ﺍﻧﻪ ﰲ ﻣﻨﺘﺼﻒ ﺍﻟﺴﺘﻴﻨﻴﺎﺕ ﻣﻦ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ ﻗﺎﻣﺖ ﺍﻟﻌﺪﻳﺪ ﻣﻦ‬
‫ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﻔﻨﻴﺔ ﺑﺈﻋﺪﺍﺩ ﺃﺩﻟﺔ ﻋﻤﻞ ﺗﻮﺿﺢ ﺍﳌﻮﺍﺭﺩ ﺍﻟﻨﻤﻄﻴﺔ ﻭﺇﺟﺮﺍﺀﺍﺕ ﺍﻟﻌﻤﻞ‪ .‬ﻭﻧﻈﺮﺍﹰ ﻟﺘﻌﺪﺩ ﺍﻷﻧﻈﻤﺔ‬
‫ﺍﻟﱵ ﺗﻘﺪﻡ ﻣﻦ ﺧﻼﳍﺎ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﲟﺼﺮ ﻓﺴﻮﻑ ﻧﺴﺘﻌﺮﺽ ﰲ ﺇﳚﺎﺯ ﺟﻬﻮﺩ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﰲ ﺑﻌﺾ‬
‫ﻫﺬﻩ ﺍﻷﻧﻈﻤﺔ‪.‬‬

‫‪١٤٧‬‬
 ‫ﺃﻭﻻ‪ :‬ﰲ ﳎﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‬
‫ﺑﺪﺃ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳉﻮﺩﺓ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻣﻨﺬ ﻣﻨﺘﺼﻒ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ ﺣﻴﺚ ﻗﺎﻣﺖ ﺛﻼﺛﺔ ﺑﺮﺍﻣﺞ ﻗﻮﻣﻴﺔ ﻫﻲ‬
‫ﺍﻟﺘﻄﻌﻴﻤﺎﺕ ﻭﻣﻜﺎﻓﺤﺔ ﺃﻣﺮﺍﺽ ﺍﻹﺳﻬﺎﻝ ﻭﻣﻜﺎﻓﺤﺔ ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﺍﳊﺎﺩﺓ‪ ،‬ﺑﺎﺗﺒﺎﻉ ﻭﺗﻄﻮﻳﺮ ﻣﻌﺎﻳﲑ‬
‫ﻭﺇﺟﺮﺍﺀﺍﺕ ﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ ﺍﻟﺬﻱ ﺃﻋﺪﺗﻪ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ﰲ ﻫﺬﻩ ﺍ‪‬ﺎﻻﺕ‪ .‬ﻭﰱ ﺃﻭﺍﺋﻞ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﰎ‬
‫ﺇﻋﺪﺍﺩ ﻭﺗﻄﺒﻴﻖ ﻣﻌﺎﻳﲑ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺻﺪﻳﻘﺔ ﺍﻟﻄﻔﻞ ﻟﺘﺸﺠﻴﻊ ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﻛﻤﺎ ﺗﺒﲎ ﺑﺮﻧﺎﻣﺞ‬
‫ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻧﻈﺎﻡ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﰲ ﲨﻴﻊ ﻭﺣﺪﺍﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺪﺀًﺍ ﻣﻦ ﻋﺎﻡ ‪ ١٩٩٢‬ﺣﻴﺚ ﰎ ﻭﺿﻊ ‪١٠١‬‬
‫ﻣﻌﻴﺎﺭ ﻟﻠﺨﺪﻣﺔ ‪‬ﺬﻩ ﺍﻟﻮﺣﺪﺍﺕ ﻭﲤﻨﺢ ﺍﻟﻨﺠﻤﺔ ﺍﻟﺬﻫﺒﻴﺔ ﻟﻠﻮﺣﺪﺓ ﺍﻟﱵ ﺗﺘﻄﺎﺑﻖ ﻣﻊ ﻫﺬﻩ ﺍﳌﻌﺎﻳﲑ‪ .‬ﻭﰱ ﺳﻨﺔ‬
‫‪ ١٩٩٣‬ﻗﺎﻡ ﻣﺸﺮﻭﻉ ﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺣﻴﺎﺓ ﺍﻟﻄﻔﻞ )‪ Child Survival Project (CSP‬ﺑﺘﻜﻮﻳﻦ ﻓﺮﻳﻖ ﺿﺒﻂ‬
‫ﺍﳉﻮﺩﺓ ﺍﳌﺮﻛﺰﻱ ﺍﻟﺬﻱ ﻗﺎﻡ ﺑﻮﺿﻊ ﺧﻄﺔ ﻋﻤﻞ ﻟﱪﻧﺎﻣﺞ ﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺣﻴﺎﺓ ﺍﻟﻄﻔﻞ ﻣﻦ ﺧﻼﻝ ﻣﺮﺍﻛﺰ‬
‫ﳕﻮﺫﺟﻴﺔ )‪ (CSP Model Clinic Program‬ﻭﻗﺪ ﺍﻋﺘﻤﺪ ﺍﻟﱪﻧﺎﻣﺞ ﻋﻠﻰ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫‪ .١‬ﺍﺳﺘﺨﺪﺍﻡ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺔ ﻟﺘﺤﺴﲔ ﺍﻷﺩﺍﺀ ﺍﻟﻔﲏ ﻭﺍﻹﺩﺍﺭﻱ‪.‬‬
‫‪ .٢‬ﺗﻄﻮﻳﺮ ﻣﺮﺍﻛﺰ ﳕﻮﺫﺟﻴﺔ‪.‬‬
‫‪ .٣‬ﺍﻟﺘﻮﺳﻊ ﰲ ﺍﺳﺘﺨﺪﺍﻡ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺔ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﺘﺪﺭﺝ ﺇﱃ ﺍﻟﻼﻣﺮﻛﺰﻳﺔ ﰲ ﺍﻟﺘﻄﺒﻴﻖ‪.‬‬
‫ﻭﺑﻨﺎﺀ ﻋﻠﻰ ﺫﻟﻚ ﰎ ﺇﻋﺪﺍﺩ ﻛﺘﻴﺒﺎﺕ ﻟﺘﺤﺪﻳﺪ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺔ ﻟﱪﻧﺎﻣﺞ ﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺣﻴﺎﺓ ﺍﻟﻄﻔﻞ ﴰﻠﺖ‬
‫ﻣﻌﺎﻳﲑ ﺧﺪﻣﺎﺕ ﻛﻞ ﻣﻦ‪:‬‬
‫‪EPI‬‬ ‫ﺍﻟﱪﻧﺎﻣﺞ ﺍﳌﻮﺳﻊ ﻟﻠﺘﻄﻌﻴﻤﺎﺕ‬ ‫‪-‬‬
‫‪MCH‬‬ ‫ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ‬ ‫‪-‬‬
‫‪ARI‬‬ ‫ﻣﻜﺎﻓﺤﺔ ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ‬ ‫‪-‬‬
‫‪DDC‬‬ ‫ﻣﻜﺎﻓﺤﺔ ﺃﻣﺮﺍﺽ ﺍﻹﺳﻬﺎﻝ‬ ‫‪-‬‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﺎﻣﺔ ﺑﺎﳌﺮﺍﻛﺰ ﺍﻟﺼﺤﻴﺔ‬ ‫‪-‬‬
‫ﻛﻤﺎ ﰎ ﺇﻋﺪﺍﺩ ﻗﺎﺋﻤﺔ ﻣﺮﺍﺟﻌﻪ ﻟﺘﺴﻬﻴﻞ ﺍﺳﺘﺨﺪﺍﻡ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺔ ﻭﺗﻘﻴﻴﻢ ﺍﻷﺩﺍﺀ‪.‬‬
‫ﻭﲢﺘﻮﻯ ﻣﻌﺎﻳﲑ ﺍﻟﱪﺍﻣﺞ ﺍﻟﻔﻨﻴﺔ ﻋﻠﻰ ﺍﳉﺰﺋﻴﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺘﻘﺪﱘ ﺍﳋﺪﻣﺔ ﻭﻫﻰ‪:‬‬
‫ﺍﳌﺮﺍﻓﻖ‪.‬‬ ‫‪-‬‬
‫ﺍﻷﺛﺎﺙ‪.‬‬ ‫‪-‬‬
‫ﺍﻹﻣﺪﺍﺩﺍﺕ ﻭﺍﳌﺴﺘﻠﺰﻣﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﻟﻔﻨﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﺘﺜﻘﻴﻒ ﺍﻟﺼﺤﻲ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﺴﺠﻼﺕ ﻭﺍﻟﺘﻘﺎﺭﻳﺮ ﻭﺍﻟـﻤﺆﺷﺮﺍﺕ‪.‬‬ ‫‪-‬‬
‫ﻛﻤﺎ ﲢﺘﻮﻯ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻤﺮﻛﺰ ﻋﻠﻰ ﺍﳉﺰﺋﻴﺎﺕ ﺍﻟﻀﺮﻭﺭﻳﺔ ﻻﺳﺘﻜﻤﺎﻝ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﻭﺍﻟﱵ ﺗﺴﺎﻫﻢ ﰲ ﺇﺭﺿﺎﺀ ﺍﳌﺘﺮﺩﺩﻳﻦ ﻋﻠﻰ ﺍﳋﺪﻣﺔ ﻭﻫﻰ‪:‬‬
‫ﺍﳌﺮﺍﻓﻖ‪.‬‬ ‫‪-‬‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﳌﺴﺎﻋﺪﺓ‪.‬‬ ‫‪-‬‬

‫‪١٤٨‬‬
 ‫ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ‪.‬‬ ‫‪-‬‬
‫ﺇﺟﺮﺍﺀﺍﺕ ﻣﻜﺎﻓﺤﺔ ﺍﻟﻌﺪﻭﻯ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﺼﻴﺪﻟﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﳌﻌﻤﻞ‪.‬‬ ‫‪-‬‬
‫ﺻﻴﺎﻧﺔ ﺍﳌﺒﺎﱐ ﻭﺍﳌﻌﺪﺍﺕ‪.‬‬ ‫‪-‬‬
‫ﺇﺭﺿﺎﺀ ﺍﳌﺘﺮﺩﺩﻳﻦ‪.‬‬ ‫‪-‬‬
‫ﻭﻗﺪ ﻗﺎﻡ ﺍﳌﺸﺮﻭﻉ ﺑﺘﻄﺒﻴﻖ ﻫﺬﻩ ﺍﳌﻌﺎﻳﲑ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﺑﺎﳌﺮﺍﻛﺰ ﺍﳊﻀﺮﻳﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﺍﻟﱵ ‪‬ﺎ‬
‫ﻛﻠﻴﺎﺕ ﻟﻠﻄﺐ ﻛﻤﺮﺣﻠﺔ ﲡﺮﻳﺒﻴﺔ ﻭﺫﻟﻚ ﻣﻦ ﻋﺎﻡ ‪ ١٩٩٣‬ﻭﺣﱴ ﻋﺎﻡ ‪ ١٩٩٥‬ﺣﻴﺚ ﺃﺛﺒﺘﺖ ﺍﻟﺘﺠﺮﺑﺔ ﺃﻥ‬
‫ﺍﺳﺘﺨﺪﺍﻡ ﻫﺬﻩ ﺍﳌﻌﺎﻳﲑ ﻳﺆﺩﻯ ﺇﱃ ﺍﻛﺘﺸﺎﻑ ﺃﻭﺟﻪ ﺍﻟﻘﺼﻮﺭ ﰲ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ ﻭﺍﲣﺎﺫ ﺍﻹﺟﺮﺍﺀﺍﺕ‬
‫ﺍﻟﺘﺼﺤﻴﺤﻴﺔ ﺍﳌﻄﻠﻮﺑﺔ ﻟﺮﻓﻊ ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺔ ﻭﺭﻏﻢ ﺃﻥ ﻫﺬﻩ ﺍﳌﺮﺣﻠﺔ ﺍﺳﺘﻬﺪﻓﺖ ﺍﶈﺎﻓﻈﺎﺕ ﺍﻟﱵ ‪‬ﺎ‬
‫ﻛﻠﻴﺎﺕ ﻃﺐ ﺣﱴ ﻳﺘﻢ ﺗﺪﺭﻳﺐ ﺍﻟﻄﻠﺒﺔ ﺑﺎﳌﺮﺍﻛﺰ ﺍﻟﻨﻤﻮﺫﺟﻴﺔ ﺇﻻ ﺃﻥ ﺑﻌﺾ ﺍﳉﺎﻣﻌﺎﺕ ﺍﺳﺘﺠﺎﺑﺖ ﻭﺍﻟﺒﻌﺾ‬
‫ﺍﻵﺧﺮ ﺗﻘﺎﻋﺲ ﻋﻦ ﺍﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍﳌﺸﺮﻭﻉ‪.‬‬
‫ﰒ ﺩﺧﻠﺖ ﺟﻬﻮﺩ ﲢﺴﲔ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻣﺮﺣﻠﺔ ﺟﺪﻳﺪﺓ ﻣﻊ ﺑﺪﺀ ﻣﺸﺮﻭﻉ ﺻﺤﺔ ﺍﻷﻡ‬
‫ﻭﺍﻟﻄﻔﻞ ﻋﺎﻡ ‪ ١٩٩٦‬ﺣﻴﺚ ﺗﺒﲎ ﻫﺬﺍ ﺍﳌﺸﺮﻭﻉ ﺍﻷﻫﺪﺍﻑ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫‪ .١‬ﲢﺴﲔ ﺍﳌﻬﺎﺭﺍﺕ ﺍﻹﺩﺍﺭﻳﺔ ﻭﺍﻹﺷﺮﺍﻓﻴﺔ ﳌﺪﻳﺮﻱ ﺍﻹﺩﺍﺭﺍﺕ ﺑﺎﺳﺘﺨﺪﺍﻡ ﻗﺎﺋﻤﺔ ﻣﺮﺍﺟﻌﺎﺕ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺔ‪.‬‬
‫‪ .٢‬ﺯﻳﺎﺩﺓ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺧﺎﺻﺔ ﺧﺪﻣﺎﺕ ﺭﻋﺎﻳﺔ ﺍﳊﻮﺍﻣﻞ‪.‬‬
‫‪ .٣‬ﺯﻳﺎﺩﺓ ﻋﺪﺩ ﺍﳌﺮﺍﻛﺰ ﺍﻟﻨﻤﻮﺫﺟﻴﺔ ﻟﺘﺸﻤﻞ ‪ % ١٠‬ﻣﻦ ﻣﺮﺍﻛﺰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﺑﻜﻞ ﺍﶈﺎﻓﻈﺎﺕ‬
‫ﻭﺗﺸﻤﻞ ‪ % ٤٠‬ﻣﻦ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳌﺴﺘﻬﺪﻓﺔ‪.‬‬
‫‪ .٤‬ﺩﻋﻢ ﺍﻟﻼﻣﺮﻛﺰﻳﺔ ﰲ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺘﻨﻔﻴﺬ ﻭﺍﳌﺘﺎﺑﻌﺔ )ﺍﻹﺷﺮﺍﻑ(‬
‫ﻭﻣﻦ ﰒ ﰎ ﺗﻄﻮﻳﺮ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺎﺕ ﺣﱴ ﺗﺘﻼﺀﻡ ﰲ ﺗﻄﺒﻴﻘﻬﺎ ﻣﻊ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺼﻐﲑﺓ ﰲ ﺍﻟﺮﻳﻒ‬
‫ﺍﳌﺼﺮﻱ‪ ،‬ﻛﻤﺎ ﰎ ﺗﻄﻮﻳﺮ ﻗﺎﺋﻤﺔ ﺍﳌﺘﺎﺑﻌﺔ‪ ،‬ﻭﻗﺪ ﺑﺪﺃ ﺗﻄﺒﻴﻖ ﺍﻟﱪﻧﺎﻣﺞ ﰲ ﳏﺎﻓﻈﺔ ﺑﲎ ﺳﻮﻳﻒ ﻛﺪﺭﺍﺳﺔ‬
‫ﺍﺳﺘﺮﺷﺎﺩﻳﺔ ﺣﻴﺚ ﰎ ﺗﺪﺭﻳﺐ ﻛﻞ ﺍﻷﻃﺒﺎﺀ ﰲ ﻣﺮﺍﻛﺰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﺑﺎﶈﺎﻓﻈﺔ ﻋﻠﻰ ﺍﺳﺘﺨﺪﺍﻡ‬
‫ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺔ ﻭﺍﻟﺘﻘﻮﱘ ﺍﻟﺬﺍﰐ ﻭﺣﻞ ﺍﳌﺸﻜﻼﺕ‪ ،‬ﻛﻤﺎ ﰎ ﺗﺪﺭﻳﺐ ﻓﺮﻳﻖ ﺇﺷﺮﺍﰲ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳌﺪﻳﺮﻳﺔ ﻭﺁﺧﺮ‬
‫ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻛﻞ ﺇﺩﺍﺭﺓ ﺻﺤﻴﺔ ﰒ ﺍﻣﺘﺪ ﺗﻄﺒﻴﻖ ﺍﻟﱪﻧﺎﻣﺞ ﻟﻴﺸﻤﻞ ﺃﺭﺑﻊ ﻋﺸﺮﺓ ﳏﺎﻓﻈﺔ ﺣﱴ ﺍﻵﻥ ﻭﻫﻰ‬
‫ﻣﻦ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‪ :‬ﺑﲎ ﺳﻮﻳﻒ ‪ -‬ﻗﻨﺎ ‪ -‬ﺍﻷﻗﺼﺮ ‪ -‬ﺃﺳﻮﺍﻥ ‪ -‬ﺍﻟﻔﻴﻮﻡ ‪ -‬ﺳﻮﻫﺎﺝ ‪ -‬ﺍﳌﻨﻴﺎ‪ -‬ﺃﺳﻴﻮﻁ‪ ،‬ﻭﻣﻦ‬
‫ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‪ :‬ﺍﻟﺒﺤﲑﺓ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ ‪ -‬ﺑﻮﺭ ﺳﻌﻴﺪ ‪ -‬ﺍﻟﻮﺍﺩﻱ ﺍﳉﺪﻳﺪ‪ -‬ﴰﺎﻝ ﺳﻴﻨﺎﺀ‬
‫ﻭﺟﻨﻮﺏ ﺳﻴﻨﺎﺀ‪.‬‬

‫‪١٤٩‬‬
 ‫ﻛﻴﻔﻴﺔ ﺗﻘﻮﱘ ﺟﻮﺩﺓ ﺍﻷﺩﺍﺀ ﺑﺎﻟﱪﻧﺎﻣﺞ‪:‬‬
‫ﺗﻘﻮﱘ ﺫﺍﰐ‪ :‬ﻳﺴﺘﺨﺪﻡ ﻓﺮﻳﻖ ﺍﻟﻮﺣﺪﺓ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻌﺎﻳﲑ ﻭﻗﺎﺋﻤﺔ ﺍﳌﺘﺎﺑﻌﺔ ﰲ ﺗﻘﻮﱘ ﻣﺪﻯ ﺗﻮﺍﻓﻖ ﺍﻟﻮﺣﺪﺓ ﻣﻊ‬
‫ﺍﳌﻌﺎﻳﲑ‪ ،‬ﰒ ﲢﺪﻳﺪ ﺍﳌﺸﺎﻛﻞ ﰒ ﺣﻞ ﺍﳌﺸﺎﻛﻞ ﻟﺰﻳﺎﺩﺓ ﻧﺴﺒﺔ ﺍﻟﺘﻮﺍﻓﻖ‪.‬‬
‫ﺗﻘﻮﱘ ﺇﺷﺮﺍﰲ ﻣﻦ ﺍﻹﺩﺍﺭﺓ ﺍﻟﺼﺤﻴﺔ‪ :‬ﻳﺴﺘﺨﺪﻡ ﻓﺮﻳﻖ ﺍﻹﺩﺍﺭﺓ ﺍﳌﻌﺎﻳﲑ ﻭﻗﺎﺋﻤﺔ ﺍﳌﺘﺎﺑﻌﺔ ﰲ ﺗﻘﻮﱘ ﻋﺪﺩ ‪١٠‬‬
‫ﻭﺣﺪﺍﺕ ﺷﻬﺮﻳﺎﹰ ﻭﻣﻨﺎﻗﺸﺔ ﺃﻃﺒﺎﺀ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﻟﻨﻘﺎﻁ ﻏﲑ ﺍﳌﺘﻮﺍﻓﻘﺔ ﻣﻊ ﺍﳌﻌﺎﻳﲑ ﻭﺇﻋﻄﺎﺀ‬
‫ﺍﻟﺘﻮﺟﻴﻬﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺰﻳﺎﺩﺓ ﻧﺴﺒﺔ ﺍﻟﺘﻮﺍﻓﻖ‪.‬‬
‫ﺗﻘﻮﱘ ﻣﺘﺎﺑﻌﺔ ﻣﻦ ﺍﳌﺪﻳﺮﻳﺔ‪ :‬ﻳﺴﺘﺨﺪﻡ ﻓﺮﻳﻖ ﺍﳌﺘﺎﺑﻌﺔ ﺍﳌﻌﺎﻳﲑ ﻭﻗﺎﺋﻤﺔ ﺍﳌﺘﺎﺑﻌﺔ ﰲ ﺗﻘﻮﱘ ﻋﺪﺩ )‪ (٢‬ﻭﺣﺪﺓ ﰲ‬
‫ﻛﻞ ﺇﺩﺍﺭﺓ ﺻﺤﻴﺔ ﳌﺘﺎﺑﻌﺔ ﻋﻤﻞ ﺍﻹﺩﺍﺭﺓ ﺍﻟﺼﺤﻴﺔ ﻭﻣﺴﺎﻋﺪﺓ ﺍﻟﻮﺣﺪﺍﺕ ﰲ ﺣﻞ ﺑﻌﺾ ﺍﳌﺸﻜﻼﺕ ﺍﻟﱵ‬
‫ﲢﺘﺎﺝ ﺗﺪﺧﻞ ﺍﳌﺪﻳﺮﻳﺔ‪.‬‬
‫ﺗﻘﻮﱘ ﻣﺘﺎﺑﻌﺔ ﻣﺮﻛﺰﻱ‪ :‬ﻳﺴﺘﺨﺪﻡ ﺍﻟﻔﺮﻳﻖ ﺍﳌﺮﻛﺰﻱ ﺍﳌﻌﺎﻳﲑ ﻭﻗﺎﺋﻤﺔ ﺍﳌﺘﺎﺑﻌﺔ ﻟﺘﻄﺒﻴﻖ ﺍﻟﻨﻈﺎﻡ ﻭﺇﻋﻄﺎﺀ‬
‫ﺍﻟﺘﻮﺟﻴﻬﺎﺕ ﺍﻟﻼﺯﻣﺔ ﲟﺸﺎﺭﻳﻊ ﲢﺴﲔ ﺍﳉﻮﺩﺓ‪.‬‬
‫ﻭﻳﺘﻜﻮﻥ ﺍﻟﻔﺮﻳﻖ ﺍﻹﺷﺮﺍﰲ ﰲ ﺍﳌﺪﻳﺮﻳﺔ ﻣﻦ‪:‬‬
‫ﻣﺪﻳﺮ ﻋﺎﻡ ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ‪.‬‬ ‫‪-‬‬
‫ﻣﺪﻳﺮﺓ ﺍﻟﺘﻤﺮﻳﺾ‪.‬‬ ‫‪-‬‬
‫ﻣﺮﺍﻗﺐ ﺻﺤﻲ ﺃﻭﻝ ﺍﳌﺪﻳﺮﻳﺔ‪.‬‬ ‫‪-‬‬
‫ﻭﻳﺘﻜﻮﻥ ﻓﺮﻳﻖ ﺍﻹﺷﺮﺍﻑ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻹﺩﺍﺭﺓ ﻣﻦ‪:‬‬
‫ﻣﺴﺎﻋﺪ ﻣﺪﻳﺮ ﺍﻹﺩﺍﺭﺓ‪.‬‬ ‫‪-‬‬
‫ﻣﻔﺘﺸﺔ ﺍﻟﺘﻤﺮﻳﺾ‪.‬‬ ‫‪-‬‬
‫ﻣﺮﺍﻗﺐ ﺻﺤﻲ ﺃﻭﻝ ﺍﻹﺩﺍﺭﺓ‪.‬‬ ‫‪-‬‬
‫ﻭﻗﺪ ﻗﺎﻡ ﺍﻟﱪﻧﺎﻣﺞ ﺑﺘﺪﺭﻳﺐ ﺍﻟﻔﺮﻳﻖ ﺍﻹﺷﺮﺍﰲ ﺑﺎﳌﺪﻳﺮﻳﺔ ﻭﺍﻹﺩﺍﺭﺍﺕ ﰲ ﺃﺭﺑﻊ ﻭﲦﺎﻧﲔ ﺇﺩﺍﺭﺓ ﺻﺤﻴﺔ ﺗﺘﺒﻊ ﺃﺭﺑﻊ‬
‫ﻋﺸﺮﺓ ﻣﺪﻳﺮﻳﺔ ﺻﺤﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﺍﻟﺴﺎﺑﻖ ﺫﻛﺮﻫﺎ‪ .‬ﻭﻗﺪ ﺃﲦﺮﺕ ﻫﺬﻩ ﺍﳉﻬﻮﺩ ﻋﻦ ﻗﻴﺎﻡ ﺃﻃﺒﺎﺀ ﻭﺣﺪﺍﺕ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺑﺘﺤﺴﲔ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﰲ ﳎﺎﻻﺕ ﺭﻋﺎﻳﺔ ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ ﻭﻗﻴﺎﻡ‬
‫ﻋﺪﺩ ﻣﻦ ﺍﻟﻮﺣﺪﺍﺕ ﺑﻌﻤﻞ ﻣﺸﺮﻭﻋﺎﺕ ﻟﺘﺤﺴﲔ ﻣﺆﺷﺮﺍﺕ ﺍﻟﻌﻤﻞ ﰲ ﺍﻟﻮﺣﺪﺍﺕ‪ .‬ﻭﻗﺪ ﺑﻠﻐﺖ ﻫﺬﻩ‬
‫ﺍﳌﺸﺮﻭﻋﺎﺕ ﺣﱴ ﺍﻵﻥ ‪ ١٥٣‬ﻣﺸﺮﻭﻋﺎ ﰎ ﺗﻘﻴﻴﻢ ﻋﺪﺩ ‪ ٨٨‬ﻣﺸﺮﻭﻋﺎ ﻭﺟﺎﺭ ﺗﻘﻴﻴﻢ ﺍﻟﺒﺎﻗﻲ‪ ،‬ﻭﻳﻈﻬﺮ ﰲ ﺍﳌﻠﺤﻖ‬
‫ﺍﳋﺎﺹ ‪‬ﺬﺍ ﺍﻟﻔﺼﻞ ﻧﺘﺎﺋﺞ ﻫﺬﻩ ﺍﳌﺸﺮﻭﻋﺎﺕ ﰲ ﳏﺎﻓﻈﱵ ﺑﲎ ﺳﻮﻳﻒ ﻭﺍﻹﺳﻜﻨﺪﺭﻳﺔ‪.‬‬
‫ﰲ ﻋﺎﻡ ‪ ١٩٩٨‬ﻗﺎﻡ ﻣﺸﺮﻭﻉ ﺭﻓﻊ ﺍﻟﻜﻔﺎﺀﺓ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ﺑﺈﺻﺪﺍﺭ ﺩﻟﻴﻞ ﺿﻤﺎﻥ‬
‫ﺍﳉﻮﺩﺓ ﻟﺘﻮﺣﻴﺪ ﺍﻟﻨﻈﺎﻡ‪ ،‬ﳛﺘﻮﻯ ﻋﻠﻰ ﺍﺛﻨﱵ ﻋﺸﺮﺓ ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﳌﻌﺎﻳﲑ ﺗﻐﻄﻰ ﻧﺸﺎﻁ ﻭﺣﺪﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻛﻤﺎ ﰎ ﻭﺿﻊ ﻣﺆﺷﺮﺍﺕ ﻟﻠﺠﻮﺩﺓ ﻭﰎ ﺗﻄﺒﻴﻖ ﺍﻟﻨﻈﺎﻡ ﰲ ‪ ٦‬ﳏﺎﻓﻈﺎﺕ ﻣﻌﻈﻤﻬﺎ ﰲ ﻭﺟﻪ‬
‫ﲝﺮﻱ ﻭﻫﻰ ﺍﳌﻨﻮﻓﻴﺔ ﻭﺍﻟﺸﺮﻗﻴﺔ ﻭﺍﻟﺒﺤﲑﺓ ﻭﻛﻔﺮ ﺍﻟﺸﻴﺦ ﻭﺍﳌﻨﻴﺎ ﻭﺳﻮﻫﺎﺝ‪.‬‬
‫ﻭﻗﺪ ﺍﻧﺘﻘﻞ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳉﻮﺩﺓ ﺇﱃ ﻣﺮﺣﻠﺔ ﺃﺧﺮﻯ ﺟﺪﻳﺪﺓ ﺑﻌﺪ ﺇﻧﺸﺎﺀ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺑﺎﳍﻴﻜﻞ ﺍﻟﺘﻨﻈﻴﻤﻲ ﻟﺪﻳﻮﺍﻥ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﺳﻨﺔ ‪ ١٩٩٨‬ﻛﺄﺣﺪ ﻣﺘﻄﻠﺒﺎﺕ ﻣﺸﺮﻭﻉ ﺇﺻﻼﺡ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ‪ Health Sector Reform Program‬ﺣﻴﺚ‬
‫ﻗﺎﻣﺖ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺑﺈﻋﺪﺍﺩ ﺃﺩﻟﺔ ﺍﻟﻌﻤﻞ ﺍﻹﻛﻠﻴﻨﻴﻜﻲ ﳊﺰﻣﺔ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﺑﻮﺣﺪﺍﺕ ﻭﻣﺮﺍﻛﺰ ﻃﺐ‬

‫‪١٥٠‬‬
‫ﺍﻷﺳﺮﺓ ﻣﺴﺘﻌﻴﻨﺔ ﲟﺎ ﰎ ﺇﻋﺪﺍﺩﻩ ﻣﺴﺒﻘﺎﹰ ﻋﻦ ﻃﺮﻳﻖ ﺍﳌﺸﺮﻭﻋﺎﺕ ﺍﻟﻘﻮﻣﻴﺔ ﻭﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ ،‬ﻛﻤﺎ‬
‫ﻗﺎﻣﺖ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺑﺈﻋﺪﺍﺩ ﺃﺩﺍﺓ ﻻﻋﺘﻤﺎﺩ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍ‪‬ﺎﻻﺕ ﺍﻵﺗﻴﺔ‪:‬‬
‫ﺣﻘﻮﻕ ﺍﳌﺮﺿﻰ‪.‬‬ ‫‪-‬‬
‫ﺭﻋﺎﻳﺔ ﺍﳌﺮﺿﻰ ﻭﺗﺸﻤﻞ ﺍﻟﺘﺸﺨﻴﺺ ﻭﺍﻟﻌﻼﺝ ﻭﺭﻋﺎﻳﺔ ﺍﳊﻮﺍﻣﻞ ﻭﺍﻟﺘﻄﻌﻴﻤﺎﺕ ﻭﺗﻨﻈﻴﻢ‬ ‫‪-‬‬
‫ﺍﻷﺳﺮﺓ ﻭﺧﺪﻣﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺘﻜﺎﻣﻠﺔ ﻭﻣﺘﺎﺑﻌﺔ ﻣﺮﺿﻰ ﺍﻟﺴﻜﺮﻱ ﻭﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ‪.‬‬
‫ﺍﻷﻣﻦ ﻭﺍﻟﺴﻼﻣﺔ ﻭﺗﺸﻤﻞ ﺳﻼﻣﺔ ﺍﻟﺒﻴﺌﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﻹﻛﻠﻴﻨﻴﻜﻴﺔ )ﲣﺘﺺ ﺑﺎﻟﺘﻌﻘﻴﻢ‬ ‫‪-‬‬
‫ﻭﻣﻜﺎﻓﺤﺔ ﺍﻟﻌﺪﻭﻯ( ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻟﻠﻌﺎﻣﻠﲔ‪.‬‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﳌﺴﺎﻋﺪﺓ‪ :‬ﻭﺗﻨﻘﺴﻢ ﺇﱃ ﺍﻹﻛﻠﻴﻨﻴﻜﻴﺔ ﻭﺗﺸﻤﻞ ﺍﻟﺼﻴﺪﻟﺔ ﻭﺍﳌﻌﻤﻞ ﻭﺍﻷﺷﻌﺔ)ﺇﻥ‬ ‫‪-‬‬
‫ﻭﺟﺪﺕ( ﻭﻏﲑ ﺍﻹﻛﻠﻴﻨﻴﻜﻴﺔ ﻭﺗﺸﻤﻞ ﺇﺩﺍﺭﺓ ﺍﳌﻤﺘﻠﻜﺎﺕ ﻭﺗﺄﻣﲔ ﺍﻟﺘﺠﻬﻴﺰﺍﺕ ﻭﺧﺪﻣﺎﺕ ﺍﳌﻐﺴﻠﺔ‬
‫ﻭﺍﳌﻄﺒﺦ )ﺇﻥ ﻭﺟﺪ(‪.‬‬
‫ﺇﺩﺍﺭﺓ ﺍﳌﻌﻠﻮﻣﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﺃﻧﺸﻄﺔ ﺍﻟﺘﺤﺴﲔ ﺍﳌﺴﺘﻤﺮ ﻟﻠﺠﻮﺩﺓ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﳌﺘﻜﺎﻣﻠﺔ‪ :‬ﻧﻈﺎﻡ ﻃﺐ ﺍﻷﺳﺮﺓ‪.‬‬ ‫‪-‬‬
‫ﺍﻹﺩﺍﺭﺓ‪.‬‬ ‫‪-‬‬
‫ﻭﺗﻌﺘﻤﺪ ﺃﺩﺍﺓ ﺍﻻﻋﺘﻤﺎﺩ ﰲ ﻛﻞ ﻣﻦ ﺍ‪‬ﺎﻻﺕ ﺍﻟﺴﺎﺑﻘﺔ ﻋﻠﻰ‪:‬‬
‫ﺍﳌﻼﺣﻈﺔ ﺑﺎﺳﺘﺨﺪﺍﻡ ﻗﺎﺋﻤﺔ ﺍﳌﺮﺍﺟﻌﺔ‪.‬‬ ‫‪-‬‬
‫ﻣﺮﺍﺟﻌﺔ ﻋﺪﺩ ﻋﺸﺮﺓ ﻣﻠﻔﺎﺕ ﻣﺮﺿﻰ‪.‬‬ ‫‪-‬‬
‫ﺍﳌﻘﺎﺑﻠﺔ ﺍﻟﺸﺨﺼﻴﺔ ﻟﻌﺪﺩ ﻋﺸﺮﺓ ﻣﻦ ﺍﳌﺮﺿﻰ ﺍﳌﺘﺮﺩﺩﻳﻦ ﻋﻠﻰ ﺍﻟﻮﺣﺪﺓ‪.‬‬ ‫‪-‬‬
‫ﺍﳌﻘﺎﺑﻠﺔ ﺍﻟﺸﺨﺼﻴﺔ ﻟﻠﻌﺎﻣﻠﲔ ﺑﺎﻟﻮﺣﺪﺓ ﻭﺗﺸﻤﻞ ﻣﺪﻳﺮ ﺍﻟﻮﺣﺪﺓ ﻭﲬﺴﺔ ﻣﻦ ﺍﻷﻃﺒﺎﺀ ﻭﻛﺬﻟﻚ‬ ‫‪-‬‬
‫ﲬﺴﺔ ﳑﺮﺿﺎﺕ ﻭﻋﺪﺩ ﺍﺛﻨﲔ ﻣﻦ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﳌﻐﺴﻠﺔ ﻭﺍﺛﻨﲔ ﻣﻦ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺈﺩﺍﺭﺓ ﺍﳌﻤﺘﻠﻜﺎﺕ‬
‫ﻭﺗﺄﻣﲔ ﺍﻟﺘﺠﻬﻴﺰﺍﺕ ﻭﺃﺣﺪ ﺍﳌﺴﺌﻮﻟﲔ ﲟﻜﺎﻓﺤﺔ ﺍﻟﻌﺪﻭﻯ‪.‬‬
‫ﻫﺬﺍ ﻭﻗﺪ ﻗﺎﻣﺖ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺣﱴ ﺍﻵﻥ ﺑﺘﺪﺭﻳﺐ ‪ ٤٥‬ﻣﻦ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﺍﳌﺴﺘﻬﺪﻓﺔ ﻟﻠﻌﻤﻞ ﰲ ﳉﺎﻥ‬
‫ﺍﻻﻋﺘﻤﺎﺩ ﻭﰎ ﺍﻋﺘﻤﺎﺩ ﺛﻼﺛﲔ ﻭﺣﺪﺓ ﻭﻣﺮﻛﺰ ﻟﻄﺐ ﺍﻷﺳﺮﺓ ﰲ ﺛﻼﺙ ﳏﺎﻓﻈﺎﺕ ﻫﻲ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ ﻭﺍﳌﻨﻮﻓﻴﺔ‬
‫ﻭﺳﻮﻫﺎﺝ‪.‬‬
‫ﻭﺗﻨﻘﺴﻢ ﺍﻟﻮﺣﺪﺍﺕ ﻃﺒﻘﺎﹰ ﻷﺩﺍﺓ ﺍﻻﻋﺘﻤﺎﺩ ﺇﱃ ﺛﻼﺙ ﻓﺌﺎﺕ ﺣﺴﺐ ﻧﺴﺐ ﺗﻄﺎﺑﻘﻬﺎ ﻣﻊ ﺍﳌﺘﻄﻠﺒﺎﺕ ﻭﻫﻰ‪:‬‬
‫ﻭﺣﺪﺍﺕ ﺗﺘﻄﺎﺑﻖ ﺑﻨﺴﺒﺔ ﺍﻛﺜﺮ ﻣﻦ ‪ % ٨٠‬ﻭﲤﻨﺢ ﺍﻋﺘﻤﺎﺩﺍﹰ ﳌﺪﺓ ﺳﻨﺘﲔ ﻳﻌﺎﺩ ﺑﻌﺪﻩ ﺗﻘﻴﻴﻤﻬﺎ‬ ‫‪-‬‬
‫ﻭﺍﻋﺘﻤﺎﺩﻫﺎ‪.‬‬
‫ﻭﺣﺪﺍﺕ ﺗﺘﻄﺎﺑﻖ ﺑﻨﺴﺒﺔ ﺑﲔ ‪ % ٨٠ ،٥٠‬ﻭﲤﻨﺢ ﺍﻋﺘﻤﺎﺩﺍﹰ ﳌﺪﺓ ﺳﻨﺔ ﻭﺍﺣﺪﺓ ﻋﻠﻰ ﺃﻥ ﺗﺴﺘﻜﻤﻞ‬ ‫‪-‬‬
‫ﺍﳌﺘﻄﻠﺒﺎﺕ ﺧﻼﻝ ﻫﺬﻩ ﺍﻟﺴﻨﺔ ﻹﻋﺎﺩﺓ ﺍﻋﺘﻤﺎﺩﻫﺎ‪.‬‬
‫ﻭﺣﺪﺍﺕ ﺗﺘﻄﺎﺑﻖ ﺑﻨﺴﺒﺔ ﺍﻗﻞ ﻣﻦ ‪ % ٥٠‬ﻭﻻ ﲤﻨﺢ ﺍﻋﺘﻤﺎﺩﺍﹰ ﺑﻞ ﲤﻨﺢ ﻣﻬﻠﺔ ‪ ٦‬ﺷﻬﻮﺭ ﻟﺘﺤﺴﲔ‬ ‫‪-‬‬
‫ﺍﻷﺩﺍﺀ ﺣﱴ ﺗﺘﻮﺍﻓﻖ ﻣﻊ ﺍﳌﺘﻄﻠﺒﺎﺕ ﻭﻳﻌﺎﺩ ﺗﻘﻴﻴﻤﻬﺎ‪.‬‬
‫ﻭﻗﺪ ﻗﺎﻣﺖ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﱵ ﻣﻨﺤﺖ ﺍﻻﻋﺘﻤﺎﺩ ﺑﻌﻤﻞ ﺳﺒﻌﲔ ﻣﺸﺮﻭﻋﺎ ﻟﺘﺤﺴﲔ ﺍﳉﻮﺩﺓ ﺣﱴ ﺍﻵﻥ ﰎ ﺗﻮﺛﻴﻖ‬
‫ﲬﺴﲔ ﻣﻨﻬﺎ‪.‬‬

‫‪١٥١‬‬
‫ﻭﺗﻘﻮﻡ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺣﺎﻟﻴﺎﹰ ﺑﺈﻋﺪﺍﺩ ﻫﻴﻜﻞ ﺗﻨﻈﻴﻤﻲ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﶈﺎﻓﻈﺎﺕ ﻳﺸﻤﻞ ﻣﺪﻳﺮﺍﹰ ﻟﻠﺠﻮﺩﺓ ﻋﻠﻰ‬
‫ﻣﺴﺘﻮﻯ ﺍﳌﺪﻳﺮﻳﺔ ﻭﳉﻨﺔ ﻟﻠﺠﻮﺩﺓ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳌﺪﻳﺮﻳﺔ ﻭﳉﺎﻧﺎﹰ ﻟﻠﺠﻮﺩﺓ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻹﺩﺍﺭﺍﺕ ﻭﻓﺮﻕ ﺟﻮﺩﺓ‬
‫ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺗﺴﺘﻬﺪﻑ ﺍﳋﻄﺔ ﺍﳌﺴﺘﻘﺒﻠﻴﺔ ﻹﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺍﻋﺘﻤﺎﺩ ‪ ٥٠٠‬ﻭﺣﺪﺓ‬
‫ﻭﻣﺮﻛﺰ ﻟﻄﺐ ﺍﻷﺳﺮﺓ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻘﻮﻣﻲ‪.‬‬

‫ﺛﺎﻧﻴﺎﹰ‪ :‬ﰲ ﳎﺎﻝ ﺧﺪﻣﺎﺕ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬

‫ﻟﻌﻞ ﻫﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻫﻲ ﺃﻭﻝ ﻣﻦ ﺑﺪﺃ ﺍﻻﻫﺘﻤﺎﻡ ﲜﻮﺩﺓ ﺍﻷﺩﺍﺀ ﰲ ﳎﺎﻝ ﺧﺪﻣﺎﺕ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺣﻴﺚ‬
‫ﻗﺎﻣﺖ ﰲ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ ﺑﺈﻋﺪﺍﺩ ﺃﺩﻟﺔ ﺍﻟﻌﻤﻞ ﰲ ﺑﻌﺾ ﺍ‪‬ﺎﻻﺕ ﺍﻹﻛﻠﻴﻨﻴﻜﻴﺔ ‪‬ﺪﻑ ﲢﺴﲔ ﺃﺩﺍﺀ ﺍﻷﻃﺒﺎﺀ ﻭﲢﺴﲔ‬
‫ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻷﻏﺮﺍﺽ ﺗﻌﻠﻴﻤﻴﺔ ﻭﺍﻗﺘﺼﺎﺩﻳﺔ ﺇﻻ ﺃﻧﻪ ﱂ ﻳﺘﻢ ﺗﻄﺒﻴﻖ ﺑﺮﻧﺎﻣﺞ ﻣﺘﻜﺎﻣﻞ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪ ،‬ﻭﰱ ﻋﺎﻡ‬
‫‪ ١٩٩٣‬ﻗﺎﻡ ﻣﺸﺮﻭﻉ ﺍﺳﺘﺮﺩﺍﺩ ﺗﻜﺎﻟﻴﻒ ﺍﻟﻌﻼﺝ )‪ (Cost Recovery for Health Project‬ﺑﺘﻨﻔﻴﺬ ﲡﺮﺑﺔ‬
‫ﲢﺴﲔ ﺍﳋﺪﻣﺎﺕ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ ﻣﻦ ﺧﻼﻝ ﺇﻋﺪﺍﺩ ﺃﺩﻟﻪ ﺍﻟﻌﻤﻞ ﻭﺇﺟﺮﺍﺀﺍﺕ ﻗﻴﺎﺳﻴﺔ ﰲ ﳎﺎﻻﺕ ﻣﻜﺎﻓﺤﺔ‬
‫ﺍﻟﻌﺪﻭﻯ ﻭﺳﲑ ﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻹﺩﺍﺭﻳﺔ ﻭﺍﳌﺎﻟﻴﺔ‪.‬‬
‫ﻭﺍﺳﺘﻬﺪﻑ ﺑﺮﻧﺎﻣﺞ ﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ ﲟﺸﺮﻭﻉ ﺍﺳﺘﺮﺩﺍﺩ ﺗﻜﺎﻟﻴﻒ ﺍﻟﻌﻼﺝ ﺗﻄﺒﻴﻖ ﺑﺮﻧﺎﻣﺞ ﻋﻤﻠﻲ ﻭﻓﻌﺎﻝ‬
‫ﻟﻀﻤﺎﻥ ﺍﳉﻮﺩﺓ ﻭﰎ ﺍﺧﺘﻴﺎﺭ ﻛﻞ ﻣﻦ ﻣﺴﺘﺸﻔﻰ ‪ ١٥‬ﻣﺎﻳﻮ ﺑﺎﻟﻘﺎﻫﺮﺓ ﻭﻣﺴﺘﺸﻔﻰ ﺍﻟﻘﻨﻄﺮﺓ ﻏﺮﺏ‬
‫ﺑﺎﻹﲰﺎﻋﻴﻠﻴﺔ ﻛﺘﺠﺮﺑﺔ ﺍﺳﺘﺮﺷﺎﺩﻳﺔ ﻭﰎ ﺑﺎﻟﻔﻌﻞ ﻭﺿﻊ ﺧﻄﺔ ﻋﻤﻞ ﳌﺴﺘﺸﻔﻰ ‪ ١٥‬ﻣﺎﻳﻮ ﺗﻀﻤﻨﺖ‬
‫ﺍﻟﺮﺅﻳﺔ ﺍﳌﺴﺘﻘﺒﻠﻴﺔ ﻭﺭﺳﺎﻟﺔ ﺍﳌﺴﺘﺸﻔﻰ ﻭﺍﻟﻐﺎﻳﺎﺕ ﺍﻵﺗﻴﺔ‪:‬‬
‫‪‬ﻴﺌﺔ ﺍﳌﻨﺎﺥ ﺍﻟﻌﺎﻡ ﻭﺷﺤﻦ ﺍﻟﻄﺎﻗﺎﺕ ﺍﳉﻤﺎﻋﻴﺔ ﳋﻠﻖ ﺍﲡﺎﻩ ﺇﳚﺎﰊ ﳓﻮ ﺑﺮﻧﺎﻣﺞ ﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ‪.‬‬ ‫‪-‬‬
‫ﺍﺳﺘﻜﻤﺎﻝ ﺍﻟﺒﻨﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﻼﺯﻣﺔ ﻟﺘﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺯﻳﺎﺩﺓ ﻋﺪﺩ ﺍﳌﺘﺮﺩﺩﻳﻦ ﻋﻦ ﻃﺮﻳﻖ ﺭﻓﻊ ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺔ‪.‬‬ ‫‪-‬‬
‫ﲢﻘﻖ ﺭﺿﺎﺀ ﺍﳌﺮﺿﻰ ﻭﺍﻟﻌﺎﻣﻠﲔ ﻭﺍ‪‬ﺘﻤﻊ‪.‬‬ ‫‪-‬‬
‫ﻭﻗﺪ ﰎ ﻭﺿﻊ ﺃﻫﺪﺍﻑ ﳏﺪﺩﻩ ﻟﻜﻞ ﻏﺎﻳﺔ ﻭﺍﻷﺳﺎﻟﻴﺐ ﺍﳌﺨﺘﻠﻔﺔ ﻟﺘﺤﻘﻴﻖ ﺍﻷﻫﺪﺍﻑ ﻭﺑﻨﺎﺀ ﻋﻠﻰ ﺫﻟﻚ ﰎ‬
‫ﺗﺸﻜﻴﻞ ﳉﻨﺔ ﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ ﺑﺎﳌﺴﺘﺸﻔﻰ ﻣﻊ ﲢﺪﻳﺪ ﺻﻼﺣﻴﺎﺕ ﻭﻭﺍﺟﺒﺎﺕ ﺍﻟﻠﺠﻨﺔ‪ ،‬ﻛﻤﺎ ﰎ ﺍﺧﺘﻴﺎﺭ‬
‫ﻣﻨﺴﻖ ﻟﻠﱪﻧﺎﻣﺞ ﻭﲢﺪﻳﺪ ﻣﻬﺎﻣﻪ‪ .‬ﻭﻳﻼﺣﻆ ﺃﻧﻪ ﰎ ﺇﻋﺎﺩﺓ ﺻﻴﺎﻏﺔ ﻭﺗﻨﺴﻴﻖ ﺧﻄﺔ ﺍﻟﻌﻤﻞ ﻋﺪﺓ ﻣﺮﺍﺕ ﻋﻠﻰ‬
‫ﻓﺘﺮﺍﺕ ﻭﻗﺎﻡ ﺍﻟﻔﺮﻳﻖ ﺑﺮﺻﺪ ﺍﻟﻌﻘﺒﺎﺕ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫ﺿﻌﻒ ﺍﻟﺘﺰﺍﻡ ﺍﻹﺩﺍﺭﺓ ﲡﺎﻩ ﺍﻟﻠﺠﻨﺔ‪.‬‬ ‫‪-‬‬
‫ﻋﺪﻡ ﺷﺮﻋﻴﺔ ﳉﻨﺔ ﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ‪.‬‬ ‫‪-‬‬
‫ﺻﻌﻮﺑﺔ ﺍﻟﺘﺴﻮﻳﻖ ﳌﻔﻬﻮﻡ ﺍﳉﻮﺩﺓ‪.‬‬ ‫‪-‬‬
‫ﻧﻘﺺ ﺍﻟﺘﺄﻫﻴﻞ ﺍﻟﻼﺯﻡ ﻷﺩﺍﺀ ﻋﻤﻞ ﺍﻟﻠﺠﻨﺔ‪.‬‬ ‫‪-‬‬
‫ﻧﻘﺺ ﺍﳌﻮﺍﺭﺩ‪.‬‬ ‫‪-‬‬
‫ﻋﺪﻡ ﻭﺟﻮﺩ ﻧﻈﺎﻡ ﺛﺎﺑﺖ ﻟﻌﻤﻞ ﺍﻟﻠﺠﻨﺔ‪.‬‬ ‫‪-‬‬
‫ﻭﻗﺪ ﺍﻧﺘﻬﻰ ﺍﻟﱪﻧﺎﻣﺞ ﻋﺎﻡ ‪ ١٩٩٥‬ﺩﻭﻥ ﻧﺘﺎﺋﺞ ﻣﺮﺿﻴﺔ‪.‬‬

‫‪١٥٢‬‬
‫ﻭﺗﻘﻮﻡ ﺣﺎﻟﻴﺎﹰ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺑﺎﻟﻮﺯﺍﺭﺓ ﺑﺈﻋﺪﺍﺩ ﺑﺮﻧﺎﻣﺞ ﻟﺘﻘﻴﻴﻢ ﺃﺩﺍﺀ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ )ﺃﺩﺍﺓ ﺍﻋﺘﻤﺎﺩ( ﻣﺒﲎ ﻋﻠﻰ‬
‫ﻗﻴﺎﺱ ﻣﻌﺎﻳﲑ ﺍﻷﺩﺍﺀ ﻭﲡﺮﺑﺘﻬﺎ ﻣﻴﺪﺍﻧﻴﺎﹰ‪.‬‬
‫ﺃﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﻴﺔ ﻓﻘﺪ ﺑﺪﺃﺕ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳉﻮﺩﺓ ﰲ ﻭﻗﺖ ﻣﺘﺄﺧﺮ ﻧﺴﺒﻴﺎﹰ ﺣﻴﺚ‬
‫ﺣﺼﻞ ﻣﺴﺘﺸﻔﻰ ﻋﲔ ﴰﺲ ﺍﻟﺘﺨﺼﺼﻲ ﺍﳉﺎﻣﻌﻲ ﻋﻠﻰ ﺷﻬﺎﺩﺓ ﺃﻻﻳﺰﻭ ‪ ١٩٩٤/٩٠٠٠‬ﻋﺎﻡ ‪،١٩٩٨‬‬
‫ﻛﻤﺎ ﺣﺼﻞ ﻗﺼﺮ ﺍﻟﻌﻴﲏ ﺍﳉﺪﻳﺪ ﻋﻠﻰ ﺷﻬﺎﺩﺓ ﺍﻷﻳﺰﻭ ‪ ٢٠٠٠/ ٩٠٠٠‬ﻋﺎﻡ ‪ ٢٠٠٢‬ﻭﺣﱴ ﺍﻵﻥ ﻓﺈﻥ ﺍﳉﻬﻮﺩ‬
‫ﺍﳌﺒﺬﻭﻟﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﻴﺔ ﺗﻌﺘﱪ ﳏﺪﻭﺩﺓ ﻭﻣﺘﻔﺮﻗﺔ ﻭﻏﺎﻟﺒﺎﹰ ﻣﺎ ﺗﻘﺘﺼﺮ ﻋﻠﻰ‬
‫ﻭﺣﺪﺍﺕ ﺍﻟﻌﻼﺝ ﺑﺄﺟﺮ‪.‬‬
‫ﻭﺇﺫﺍ ﻣﺎ ﺍﻧﺘﻘﻠﻨﺎ ﺇﱃ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﳒﺪ ﺃﻥ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳉﻮﺩﺓ ﺑﺪﺃ ﺣﺪﻳﺜﺎﹰ ﺣﻴﺚ‬
‫ﺣﺼﻞ ﻣﺴﺘﺸﻔﻰ ﺃﲪﺪ ﻣﺎﻫﺮ ﺍﻟﺘﻌﻠﻴﻤﻲ ﻋﻠﻰ ﺷﻬﺎﺩﺓ ﺃﻻﻳﺰﻭ ‪ ٩٠٠٠‬ﺳﻨﺔ‪ ،٢٠٠١‬ﻭﻫﻨﺎﻙ ﺟﻬﻮﺩ ﺣﺜﻴﺜﺔ‬
‫ﺑﺎﳍﻴﺌﺔ ﻟﻼﺳﺘﻔﺎﺩﺓ ﻣﻦ ﲡﺮﺑﺔ ﻣﺴﺘﺸﻔﻰ ﺃﲪﺪ ﻣﺎﻫﺮ ﰲ ﺑﺎﻗﻲ ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﳍﻴﺌﺔ‪ .‬ﺃﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ‬
‫ﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﻓﻠﻦ ﻳﺘﺴﻊ ﺍ‪‬ﺎﻝ ﻟﻨﺨﻮﺽ ﰲ ﺗﻔﺎﺻﻴﻞ ﲡﺮﺑﺔ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳋﺎﺻﺔ‬
‫ﺣﻴﺚ ﻳﺘﻄﻠﺐ ﺫﻟﻚ ﺩﺭﺍﺳﺔ ﻣﻨﻔﺼﻠﺔ ﺗﺮﺻﺪ ﺍﻟﻮﺍﻗﻊ ﻭﺗﻘﻴﻤﻪ ﻭﲢﻠﻠﻪ ﺑﻌﻤﻖ‪.‬‬

‫ﺛﺎﻟﺜﺎﹰ‪ :‬ﺩﻭﺭ ﺍﳉﻤﻌﻴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﻭﺍﳌﺆﺳﺴﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ‬

‫ﰲ ﻋﺎﻡ ‪ ١٩٩٥‬ﺗﺄﺳﺴﺖ ﺍﳉﻤﻌﻴﺔ ﺍﳌﺼﺮﻳﺔ ﳉﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ )‪Egyptian Society of Quality (ESQua‬‬
‫‪‬ﺪﻑ‪:‬‬
‫ﻧﺸﺮ ﺍﻟﻮﻋﻲ ﰲ ﺍ‪‬ﺘﻤﻊ ﻭﺑﲔ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺣﻘﻞ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻦ ﺿﻤﺎﻥ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ‬ ‫‪-‬‬
‫ﺍﻟﺼﺤﻴﺔ ﻭﲢﺴﻨﻬﺎ ﺍﳌﺴﺘﻤﺮ‪.‬‬
‫ﺗﺮﺳﻴﺦ ﻣﻔﻬﻮﻡ ﺃﻥ ﺍﳌﺴﺘﻔﻴﺪ ﻣﻦ ﺍﳋﺪﻣﺔ ﻫﻮ ﺣﺠﺮ ﺍﻟﺰﺍﻭﻳﺔ ﳉﻤﻴﻊ ﺧﻄﻂ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬ ‫‪-‬‬
‫ﻭﻟﺬﺍ ﻳﻠﺰﻡ ﺍﻟﻌﻤﻞ ﺍﳌﺴﺘﻤﺮ ﻟﺘﺤﻘﻴﻖ ﺍﺣﺘﻴﺎﺟﺎﺗﻪ ﻭﺗﻮﻗﻌﺎﺗﻪ‪.‬‬
‫ﺍﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍﳉﻬﺎﺕ ﺍﳌﻌﻨﻴﺔ ﻟﺘﻌﺒﺌﺔ ﻭﺗﻨﻤﻴﺔ ﻭﺗﻄﻮﻳﺮ ﺍﳌﻮﺍﺭﺩ ﺍﻟﺒﺸﺮﻳﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﺘﻨﺴﻴﻖ ﻣﻊ ﺍﳉﻬﺎﺕ ﺍﳌﻌﻨﻴﺔ ﻭﺍﳉﻤﻌﻴﺎﺕ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﻟﻄﺒﻴﺔ ﻟﻮﺿﻊ ﻣﻌﺎﻳﲑ ﺍﳉﻮﺩﺓ ﲟﺎ ﻳﻮﺍﻛﺐ‬ ‫‪-‬‬
‫ﺍﳌﻌﺎﻳﲑ ﺍﻟﻌﺎﳌﻴﺔ ﻭﻳﺘﻨﺎﺳﺐ ﻣﻊ ﺍﻟﺒﻴﺌﺔ ﺍﶈﻠﻴﺔ‪.‬‬
‫ﻭﻗﺪ ﻗﺎﻣﺖ ﺍﳉﻤﻌﻴﺔ ﺑﺘﻨﻈﻴﻢ ﻣﺆﲤﺮﻳﻦ ﻗﻮﻣﻴﲔ ﻋﺎﻣﻲ ‪ ١٩٩٩ ،١٩٩٥‬ﺷﺎﺭﻙ ﻓﻴﻬﻤﺎ ﺍﻟﻜﺜﲑ ﻣﻦ ﺧﱪﺍﺀ‬
‫ﺍﳉﻮﺩﺓ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﶈﻠﻰ ﻭﺍﻟﻌﺎﳌﻲ‪ ،‬ﻛﻤﺎ ﺷﺎﺭﻛﺖ ﺍﳉﻤﻌﻴﺔ ﰲ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﻨﺪﻭﺍﺕ ﻭﺍﻟﺪﻭﺭﺍﺕ‬
‫ﺍﻟﺘﺪﺭﻳﺒﻴﺔ‪ .‬ﻛﺬﻟﻚ ﺗﺄﺳﺴﺖ ﺃﻳﻀﺎ ﲨﻌﻴﺔ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺘﻤﺮﻳﻀﻴﺔ ﻭﺍﻟﺒﺤﻮﺙ ‪‬ﺪﻑ ﲢﻘﻴﻖ ﺭﻋﺎﻳﺔ‬
‫ﲤﺮﻳﻀﻴﺔ ﺫﺍﺕ ﺟﻮﺩﺓ ﻋﺎﻟﻴﺔ ﻣﻦ ﺧﻼﻝ ﺭﺑﻂ ﺍﻟﺒﺤﻮﺙ ﺍﻟﺘﻄﺒﻴﻘﻴﺔ ﺑﺎﻷﺩﺍﺀ ﺍﻟﺘﻤﺮﻳﻀﻲ ﺑﻜﺎﻓﺔ ﲣﺼﺼﺎﺗﻪ‪.‬‬
‫ﻭﻳﻼﺣﻆ ﺃﻧﻪ ﺑﺪﺃ ﺣﺪﻳﺜﺎﹰ ﺍﻫﺘﻤﺎﻡ ﺑﻌﺾ ﺍﳉﻤﻌﻴﺎﺕ ﺍﻟﻌﻠﻤﻴﺔ ﺍﻟﻄﺒﻴﺔ ﺍﻟﺘﺨﺼﺼﻴﺔ ﺑﺈﻋﺪﺍﺩ ﺃﺩﻟﺔ ﺍﻟﻌﻤﻞ‬
‫ﺍﻹﻛﻠﻴﻨﻴﻜﻲ ﰲ ﳎﺎﻝ ﺍﻟﺘﺨﺼﺺ ﻭﻣﺜﺎﻝ ﺫﻟﻚ ﻣﺎ ﻗﺎﻣﺖ ﺑﻪ ﺍﳉﻤﻌﻴﺔ ﺍﳌﺼﺮﻳﺔ ﻟﺪﺭﺍﺳﺔ ﺃﻣﺮﺍﺽ ﺍﻟﻜﺒﺪ‬
‫ﻭﺍﳉﻬﺎﺯ ﺍﳍﻀﻤﻲ ﺣﻴﺚ ﺃﻋﺪﺕ ﺩﻟﻴﻞ ﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﻹﻛﻠﻴﻨﻴﻜﻴﺔ ﻷﻣﺮﺍﺽ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻘﻮﻟﻮﻥ ‪ ,‬ﻭﻻﺑﺪ ﻫﻨﺎ ﻣﻦ‬
‫ﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﺃﳘﻴﺔ ﺩﻭﺭ ﻫﺬﻩ ﺍﳉﻤﻌﻴﺎﺕ ﻭﺇﺷﺮﺍﻛﻬﺎ ﰲ ﻭﺿﻊ ‪ /‬ﻣﺮﺍﺟﻌﺔ ﺍﳌﻌﺎﻳﲑ ﻭﺇﻋﺪﺍﺩ ﺃﺩﻟﺔ ﺍﻟﻌﻤﻞ‬
‫ﻭﻳﺘﻌﲔ ﺇﳚﺎﺩ ﺁﻟﻴﺔ ﻟﺘﻔﻌﻴﻞ ﺩﻭﺭ ﻫﺬﻩ ﺍﳉﻤﻌﻴﺎﺕ ﻭﺗﻨﺴﻴﻖ ﺍﻟﻌﻤﻞ ﻣﻌﻬﺎ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪.‬‬

‫‪١٥٣‬‬
‫ﻭﻻ ﻳﻔﻮﺗﻨﺎ ﻫﻨﺎ ﺍﻹﺷﺎﺭﺓ ﺇﱄ ﺍﳉﻬﻮﺩ ﺍﻟﱵ ﺗﺒﺬﳍﺎ ﻧﻘﺎﺑﺔ ﺍﻷﻃﺒﺎﺀ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﺣﻴﺚ ﻗﺎﻣﺖ ﺑﺘﻜﻮﻳﻦ ﳉﻨﺔ‬
‫ﻗﻮﻣﻴﺔ ﻟﻠﺠﻮﺩﺓ ﻣﻦ ﺍﳋﱪﺍﺀ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ‪‬ﺪﻑ ﻭﺿﻊ ﻣﻌﺎﻳﲑ ﻭﺃﺩﻟﺔ ﺍﻟﻌﻤﻞ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﻭﻟﻜﻦ ﺗﻌﺜﺮ‬
‫ﻋﻤﻞ ﺍﻟﻠﺠﻨﺔ ﺑﻌﺪ ﻋﺪﺩ ﳏﺪﻭﺩ ﻣﻦ ﺍﻻﺟﺘﻤﺎﻋﺎﺕ ﻧﻈﺮﺍﹰ ﻟﻌﺪﻡ ﺗﻔﺮﻍ ﺃﻋﻀﺎﺋﻬﺎ ﻟﻠﻤﻬﺎﻡ ﺍﳌﻨﻮﻃﺔ ‪‬ﻢ‪.‬‬
‫ﻭﲡﺪﺭ ﺍﻹﺷﺎﺭﺓ ﻫﻨﺎ ﺇﱃ ﺃﻧﻪ ﰎ ﺣﺪﻳﺜﺎ ﺗﺄﺳﻴﺲ ﺭﺍﺑﻄﺔ ﻋﺮﺑﻴﺔ ﳉﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﺘﻮﺣﻴﺪ ﺟﻬﻮﺩ ﺍﻟﺪﻭﻝ‬
‫ﺍﻟﻌﺮﺑﻴﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻭﺟﺎﺭ ﺍﲣﺎﺫ ﺑﺎﻗﻲ ﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺘﻔﻌﻴﻞ ﺩﻭﺭ ﻫﺬﻩ ﺍﻟﺮﺍﺑﻄﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪.‬‬
‫ﻭﻻ ﻳﻔﻮﺗﻨﺎ ﰲ ﻫﺬﺍ ﺍﳌﻘﺎﻡ ﺃﻥ ﻧﺬﻛﺮ ﺍﳉﻬﻮﺩ ﺍﳊﺜﻴﺜﺔ ﺍﻟﱵ ﻳﺒﺬﳍﺎ ﺣﺎﻟﻴﺎ ﺍﳌﻜﺘﺐ ﺍﻹﻗﻠﻴﻤﻲ ﻟﺸﺮﻕ ﺍﳌﺘﻮﺳﻂ‬
‫ﺍﻟﺘﺎﺑﻊ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ﺍﻟﺬﻱ ﻗﺎﻡ ﻣﺆﺧﺮﺍ ﺑﻮﺿﻊ ﺩﻟﻴﻞ ﺍﻋﺘﻤﺎﺩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻟﺪﻭﻝ ﺍﻹﻗﻠﻴﻢ‬
‫ﻭﺟﺎﺭﻯ ﻣﺮﺍﺟﻌﺘﻪ ﺣﺎﻟﻴﺎ ﺑﻮﺍﺳﻄﺔ ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﳋﱪﺍﺀ‪ ،‬ﻭﻳﺘﻤﻴﺰ ﻫﺬﺍ ﺍﻟﺪﻟﻴﻞ ﲟﺮﺍﻋﺎﺓ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‬
‫ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﻭﺫﻟﻚ ﺑﻮﺿﻊ ﺍﳌﻌﺎﻳﲑ ﻋﻠﻰ ﺛﻼﺛﺔ ﻣﺴﺘﻮﻳﺎﺕ‪ ،‬ﻭﻻ ﲤﻨﺢ ﺍﳌﺴﺘﺸﻔﻰ ﺍﻋﺘﻤﺎﺩﺍ ﲟﺴﺘﻮﻯ‬
‫ﻣﻌﲔ ﺇﻻ ﺇﺫﺍ ﺗﻄﺎﺑﻘﺖ ﻛﻞ ﺍﻟﻮﻇﺎﺋﻒ ﻭﺍﻹﺟﺮﺍﺀﺍﺕ ﻓﻴﻪ ﻣﻊ ﻣﻌﺎﻳﲑ ﻫﺬﺍ ﺍﳌﺴﺘﻮﻯ‪ .‬ﻭﻳﻬﺪﻑ ﺗﺒﲎ ﻫﺬﻩ‬
‫ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺇﱃ ﺗﺸﺠﻴﻊ ﻛﻞ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻋﻠﻰ ﺍﺧﺘﻼﻑ ﻣﺴﺘﻮﻳﺎ‪‬ﺎ ﻭﺳﻌﺘﻬﺎ ﺍﻟﺴﺮﻳﺮﺓ ﰲ ﳐﺘﻠﻒ‬
‫ﺩﻭﻝ ﺍﻹﻗﻠﻴﻢ ﺍﻻﺷﺘﺮﺍﻙ ﰲ ﺑﺮﻧﺎﻣﺞ ﺍﻻﻋﺘﻤﺎﺩ ﻭﺍﻻﻟﺘﺰﺍﻡ ﺑﺎﳌﻌﺎﻳﲑ‪ .‬ﻛﻤﺎ ﻗﺎﻣﺖ ﺍﳌﻨﻈﻤﺔ ﺃﻳﻀﺎ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ‬
‫ﻭﺣﺪﺓ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺑﻜﻠﻴﺔ ﻃﺐ ﻋﲔ ﴰﺲ ﻹﻋﺪﺍﺩ ﻛﺘﻴﺐ ﺗﺪﺭﻳﱯ ﰲ ﳎﺎﻝ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ‬
‫ﺑﺎﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻛﺬﻟﻚ ﺗﻨﻔﻴﺬ ﺛﻼﺙ ﺩﻭﺭﺍﺕ ﺗﺪﺭﻳﺒﻴﺔ ﻟﺘﺄﻫﻴﻞ ﺍﻟﻘﻴﺎﺩﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺑﺪﻭﻝ ﺍﻹﻗﻠﻴﻢ‬
‫ﻟﺘﻄﺒﻴﻖ ﻭﻗﻴﺎﺩﺓ ﺑﺮﺍﻣﺞ ﺍﳉﻮﺩﺓ ﺑﺎﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺑﺎﳌﻨﻄﻘﺔ‪.‬‬

‫ﺭﺍﺑﻌﺎﹰ‪ :‬ﺍﻟﺘﺪﺭﻳﺐ ﻭﺍﻟﺘﻌﻠﻴﻢ ﰲ ﳎﺎﻝ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‬

‫ﻟﻘﺪ ﺻﺎﺣﺐ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺘﻄﺒﻴﻖ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍ‪‬ﺎﻻﺕ ﺍﻟﺴﺎﺑﻘﺔ ﺍﻟﺬﻛﺮ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻟﺪﻭﺭﺍﺕ‬
‫ﺍﻟﺘﺪﺭﻳﺒﻴﺔ ﻭﺣﻠﻘﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺧﺎﺻﺔ ﻣﻦ ﺧﻼﻝ ﺍﻟﱪﺍﻣﺞ ﺍﻟﻘﻮﻣﻴﺔ ﻭﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻛﺬﻟﻚ‬
‫ﺳﺎﻋﺪﺕ ﺍﳌﺆﲤﺮﺍﺕ ﺍﻟﻘﻮﻣﻴﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻋﻠﻰ ﺗﺮﻭﻳﺞ ﻓﻜﺮﺓ ﺿﻤﺎﻥ ﺍﳉﻮﺩﺓ ﻭﺍﻟﺘﺤﺴﲔ ﺍﳌﺴﺘﻤﺮ ﺑﲔ‬
‫ﺑﻌﺾ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ‪.‬‬
‫ﻛﺬﻟﻚ ﻗﺎﻡ ﻣﻌﻬﺪ ﺍﳉﻮﺩﺓ ﺑﺎﳉﺎﻣﻌﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ﺑﺘﺼﻤﻴﻢ ﻭﻋﻘﺪ ﻋﺪﺓ ﺩﻭﺭﺍﺕ ﺗﺪﺭﻳﺒﻴﺔ ﰲ ﳎﺎﻝ ﺟﻮﺩﺓ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﰒ ﰎ ﺗﻄﻮﻳﺮﻫﺎ ﺇﱃ ﺩﺭﺟﺔ ﺩﺑﻠﻮﻡ ﰲ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻛﺬﻟﻚ ﺃﻧﺸﺌﺖ ﻭﺣﺪﺓ‬
‫ﳉﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺑﻜﻠﻴﺔ ﺍﻟﻄﺐ ﺟﺎﻣﻌﺔ ﻋﲔ ﴰﺲ ﻋﺎﻡ ‪ ١٩٩٩‬ﺗﻌﻤﻞ ﰲ ﳎﺎﻻﺕ ﺍﻟﺘﺪﺭﻳﺐ‬
‫ﻭﺍﻟﺒﺤﻮﺙ ﻭﺍﳋﺪﻣﺎﺕ ﺍﻻﺳﺘﺸﺎﺭﻳﺔ ﰲ ﳎﺎﻝ ﺍﻟﺘﺤﺴﲔ ﺍﳌﺴﺘﻤﺮ ﻟﻠﺠﻮﺩﺓ ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻛﻤﺎ‬
‫ﻗﺎﻣﺖ ﺍﻟﻮﺣﺪﺓ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍﳉﻤﻌﻴﺔ ﺍﳌﺼﺮﻳﺔ ﳉﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺑﺎﲣﺎﺫ ﺍﻹﺟﺮﺍﺀﺍﺕ ﺍﻟﻼﺯﻣﺔ‬
‫ﻟﻠﻤﻮﺍﻓﻘﺔ ﻋﻠﻰ ﻋﻘﺪ ﺍﻣﺘﺤﺎﻥ ﺍﻟﺒﻮﺭﺩ ﺍﻷﻣﺮﻳﻜﻲ ﰲ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺑﻜﻠﻴﺔ ﺍﻟﻄﺐ ﺟﺎﻣﻌﺔ ﻋﲔ‬
‫ﴰﺲ ﺑﺪﺀًﺍ ﻣﻦ ﻋﺎﻡ ‪ ٢٠٠٠‬ﻡ ﻭﰎ ﻋﻘﺪ ﻫﺬﺍ ﺍﻻﻣﺘﺤﺎﻥ ﺍﻟﻌﺎﳌﻲ ﲟﺼﺮ ﰲ ﺍﻷﻋﻮﺍﻡ ﺍﻟﺜﻼﺛﺔ ﺍﻷﺧﲑﺓ‪ ,‬ﻛﻤﺎ‬
‫ﻗﺎﻣﺖ ﻛﻠﻴﺔ ﺍﻟﻄﺐ ﲜﺎﻣﻌﺔ ﻋﲔ ﴰﺲ ﺑﺎﻟﺘﻘﺪﻡ ﺑﺈﻧﺸﺎﺀ ﺩﺭﺟﺔ ﺩﺑﻠﻮﻡ ﰲ ﺇﺩﺍﺭﺓ ﺟﻮﺩﺓ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﻭﰎ ﺇﻋﺪﺍﺩ ﻻﺋﺤﺔ ﺗﻔﺼﻴﻠﻴﺔ ﻟﻠﺘﺪﺭﻳﺲ ﻭﺍﻟﺘﻘﻮﱘ ﻭﲤﺖ ﺍﳌﻮﺍﻓﻘﺔ ﻋﻠﻴﻬﺎ ﻣﻦ ﻗﺒﻞ ﳎﻠﺲ ﺍﳉﺎﻣﻌﺔ ﻭﺭﻓﻌﻬﺎ‬
‫ﻟﻠﻌﺮﺽ ﻋﻠﻰ ﺍ‪‬ﻠﺲ ﺍﻷﻋﻠﻰ ﻟﻠﺠﺎﻣﻌﺎﺕ ﺍﻟﺬﻱ ﻭﺍﻓﻖ ﻣﺆﺧﺮﺍ ﻋﻠﻰ ﺗﻀﻤﲔ ﻫﺬﻩ ﺍﻟﺪﺭﺟﺔ ﺿﻤﻦ ﺧﻄﺔ‬
‫ﺗﻄﻮﻳﺮ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﻌﻠﻴﺎ ﺑﻜﻠﻴﺔ ﺍﻟﻄﺐ ﺟﺎﻣﻌﺔ ﻋﲔ ﴰﺲ‪ .‬ﻭﻻ ﻳﻔﻮﺗﻨﺎ ﺃﻥ ﻧﻨﻮﻩ ﻫﻨﺎ ﻋﻦ ﺟﻬﻮﺩ ﺍﳌﻌﻬﺪ‬
‫ﺍﻟﻌﺎﱄ ﻟﻠﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﺑﺎﻹﺳﻜﻨﺪﺭﻳﺔ ﰲ ﺍﻟﺘﺪﺭﻳﺐ ﻭﺍﻟﺘﺪﺭﻳﺲ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪.‬‬

‫‪١٥٤‬‬
 ‫
<‪"!-. 3:;8 3‬‬
‫ﻳﺘﻀﺢ ﳑﺎ ﺳﺒﻖ ﻋﺮﺿﻪ ﺃﻥ ﻫﻨﺎﻙ ﺟﻬﻮﺩﺍﹰ ﺣﺜﻴﺜﺔ ﰲ ﺍﻟﻌﻘﺪﻳﻦ ﺍﻷﺧﺮﻳﻦ ﻟﻀﻤﺎﻥ ﻭﲢﺴﲔ ﺟﻮﺩﺓ ﺍﻷﺩﺍﺀ ﰲ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﲟﺼﺮ ﻭﺧﺎﺻﺔ ﰲ ﺧﺪﻣﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪ ،‬ﻭﻟﻜﻦ ﺟﺎﺀﺕ ﻫﺬﻩ ﺍﳉﻬﻮﺩ‬
‫ﻣﺘﻔﺮﻗﺔ ﻣﻦ ﺧﻼﻝ ﺍﻟﱪﺍﻣﺞ ﻭﺍﳌﺸﺮﻭﻋﺎﺕ ﺍﻟﻘﻮﻣﻴﺔ ﺣﻴﺚ ﻳﻌﻤﻞ ﻛﻞ ﻣﻨﻬﻢ ﺑﺎﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﳐﺘﻠﻔﺔ ﻭﺩﻭﻥ‬
‫ﺗﻨﺴﻴﻖ ﻭﺗﻜﺎﻣﻞ ﻣﻊ ﺑﺎﻗﻲ ﺍﻟﱪﺍﻣﺞ ﳑﺎ ﺗﺴﺒﺐ ﰲ ﺗﺸﺘﻴﺖ ﺍﳉﻬﻮﺩ ﻭﺍﳌﻮﺍﺭﺩ‪ .‬ﻭﻣﺒﻌﺚ ﻗﻠﻘﻨﺎ ﺍﳊﻘﻴﻘﻲ ﻫﻮ‬
‫ﺍﺣﺘﻤﺎﻝ ﺍﻧﺘﻬﺎﺀ ﺟﻬﻮﺩ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﻭﺍﻟﻌﻤﻞ ﺑﺎﳌﻌﺎﻳﲑ ﻣﻊ ﺍﻧﺘﻬﺎﺀ ﻫﺬﻩ ﺍﳌﺸﺮﻭﻋﺎﺕ ﻭﺍﻟﱪﺍﻣﺞ‪ .‬ﻭﻟﻜﻦ ﺗﺒﻘﻰ‬
‫ﻫﻨﺎﻙ ﺑﺎﺭﻗﺔ ﺃﻣﻞ ﰲ ﺍﺳﺘﻤﺮﺍﺭ ﺍﳉﻬﻮﺩ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻣﻦ ﺧﻼﻝ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‬
‫ﻭﺧﺎﺻﺔ ﺑﻌﺪ ﺗﻔﻌﻴﻞ ﺍﳍﻴﻜﻞ ﺍﻟﺘﻨﻈﻴﻤﻲ ﻹﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﶈﺎﻓﻈﺎﺕ ﻭﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﺣﻴﺚ ﺇﻥ ﺍﻟﻀﻤﺎﻥ ﺍﻟﻮﺣﻴﺪ ﻻﺳﺘﻤﺮﺍﺭ ﺃﻧﺸﻄﺔ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﻫﻮ ﺗﻀﻤﲔ ﻫﺬﻩ ﺍﻷﻧﺸﻄﺔ ﰲ ﺍﻟﱪﺍﻣﺞ‬
‫ﺍﻷﻓﻘﻴﺔ ﺑﺎﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﰲ ﻫﺬﺍ ﺍﻹﻃﺎﺭ ﻳﺘﻌﲔ ﺇﳚﺎﺩ ﺁﻟﻴﺔ ﻟﻠﺘﻨﺴﻴﻖ ﺑﲔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﻭﺍﻟﱪﺍﻣﺞ‬
‫ﺍﳌﺨﺘﻠﻔﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻛﻤﺎ ﻳﺘﻌﲔ ﺇﳚﺎﺩ ﺁﻟﻴﺔ ﺃﻛﺜﺮ ﻓﻌﺎﻟﻴﺔ ﻟﺘﻘﻴﻴﻢ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﻊ ﺗﻮﺣﻴﺪ‬
‫ﺍﻟﻨﻤﺎﺫﺝ ﺍﳌﺴﺘﺨﺪﻣﺔ ﰲ ﺫﻟﻚ‪.‬‬
‫ﻭﻻﺑﺪ ﺃﻥ ﻧﻘﺮ ﻫﻨﺎ ﺑﺼﻌﻮﺑﺔ ﺍﻟﺘﺤﺪﻳﺎﺕ ﺍﻟﱵ ﺗﻮﺍﺟﻪ ﺑﺮﺍﻣﺞ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﰲ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ‬
‫ﺍﻟﻘﺎﺋﻤﺔ ﰲ ﻣﺼﺮ ﰲ ﻇﻞ ﻣﺎ ﺭﺳﺦ ﻓﻴﻬﺎ ﻣﻦ ﳑﺎﺭﺳﺎﺕ ﻭﺛﻘﺎﻓﺎﺕ ﺇﺩﺍﺭﻳﺔ ﻣﺘﻮﺍﺭﺛﺔ ﻋﱪ ﺍﻷﺟﻴﺎﻝ‪ .‬ﻭﻫﻨﺎﻙ‬
‫ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﳌﻌﻮﻗﺎﺕ ﺍﻟﱵ ﺗﻌﺮﻗﻞ ﻣﺴﺎﻋﻲ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﰲ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺣﻴﺚ ﻳﺘﺼﺪﺭ ﻫﺬﻩ‬
‫ﺍﳌﻌﻮﻗﺎﺕ ﻋﺪﻡ ﺍﻟﺘﺰﺍﻡ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﻠﻴﺎ ﺑﺘﻄﺒﻴﻖ ﻧﻈﻢ ﺍﳉﻮﺩﺓ ﻭﻋﺪﻡ ﺍﻧﺘﺸﺎﺭ ﺛﻘﺎﻓﺔ ﺍﳉﻮﺩﺓ ﺑﲔ ﻛﻞ ﻣﻦ‬
‫ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﺍﻟﺼﺤﻴﺔ ﻭﻛﺬﻟﻚ ﺍﳌﺴﺘﻔﻴﺪﻳﻦ ﻣﻦ ﺍﳋﺪﻣﺔ ﻭﺍ‪‬ﺘﻤﻊ ﻛﻜﻞ ﻭﻣﺎ ﻳﺘﺮﺗﺐ ﻋﻠﻰ ﺫﻟﻚ ﻣﻦ‬
‫ﺻﻌﻮﺑﺔ ﰲ ﺗﺴﻮﻳﻖ ﻣﻔﻬﻮﻡ ﺍﳉﻮﺩﺓ ﺑﲔ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ‪ .‬ﻛﺬﻟﻚ ﻧﺪﺭﺓ ﺍﻟﻜﻮﺍﺩﺭ ﺍﻟﺒﺸﺮﻳﺔ‬
‫ﺍﳌﺆﻫﻠﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻭﺍﻟﻘﺎﺩﺭﺓ ﻋﻠﻰ ﻗﻴﺎﺩﺓ ﺑﺮﺍﻣﺞ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﰲ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﺃﻳﻀﺎ ﺿﻌﻒ‬
‫ﺍﳌﺨﺼﺼﺎﺕ ﺍﳌﺎﻟﻴﺔ ﺣﻴﺚ ﺇﻧﻪ ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﳛﺪ ﻣﻦ ﺍﻟﻔﺎﻗﺪ ﰲ ﺍﳌﻮﺍﺭﺩ ﻭﻳﺰﻳﺪ ﻣﺮﺩﻭﺩ‬
‫ﺍﳋﺪﻣﺔ ﻋﻠﻰ ﺍﳌﺪﻯ ﺍﻟﺒﻌﻴﺪ‪ ،‬ﻓﺈﻥ ﺑﺪﺍﻳﺔ ﺍﻟﺘﻄﺒﻴﻖ ﳛﺘﺎﺝ ﺇﱃ ﺩﻋﻢ ﺍﻟﺒﻨﻴﺔ ﺍﻟﺘﺤﺘﻴﺔ‪ .‬ﻭﺭﲟﺎ ﳛﺘﺎﺝ ﺍﻷﻣﺮ ﰲ‬
‫ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ ﺇﱃ ﺩﻋﻢ ﺳﻴﺎﺳﻲ ﻗﻮﻯ‪ ،‬ﻛﺬﻟﻚ ﺗﻮﻓﲑ ﳕﻮﺫﺝ ﻋﻤﻠﻲ ﻣﻄﺒﻖ ﻭﻧﺎﺟﺢ ﳝﻜﻦ ﺗﻌﻤﻴﻤﻪ‪.‬‬
‫ﻭﻧﺮﻯ ﺃﻧﻪ ﻣﻦ ﺍﳌﻘﻠﻖ ﺗﻄﻠﻊ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﻭﺍﳋﺎﺻﺔ ﺇﱃ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺷﻬﺎﺩﺓ ﺍﻷﻳﺰﻭ‬
‫ﺍﻟﻌﺎﳌﻴﺔ ﰲ ﺍﳉﻮﺩﺓ‪ ،‬ﺣﻴﺚ ﺇﻥ ﻟﻨﺎ ﲢﻔﻈﺎﺕ ﻋﻠﻰ ﺻﻼﺣﻴﺔ ﻫﺬﻩ ﺍﳌﻮﺍﺻﻔﺔ ﻟﻠﻤﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﺭﲟﺎ‬
‫ﻳﺮﺟﻊ ﺫﻟﻚ ﺇﱃ ﻏﻴﺎﺏ ﻧﻈﻢ ﺃﺧﺮﻯ ﰲ ﻣﺼﺮ ﲡﻴﺰ ﺃﻭ ﲤﻴﺰ ﻣﺴﺘﻮﻯ ﺍﳉﻮﺩﺓ ﺑﺎﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﻧﺄﻣﻞ ﰲ‬
‫ﺍﳌﺴﺘﻘﺒﻞ ﺍﻟﻘﺮﻳﺐ ﺇﱃ ﺗﺄﺳﻴﺲ ﻫﻴﺌﺔ ﻣﺼﺮﻳﺔ ﻣﺴﺘﻘﻠﺔ ﺃﻭ ﻛﻴﺎﻥ ﻣﺴﺘﻘﻞ ﻻﻋﺘﻤﺎﺩ ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﺗﻘﻮﻡ ﺑﻮﺿﻊ ﺍﳌﻌﺎﻳﲑ ﺍﻟﻘﻮﻣﻴﺔ ﻭﻣﺮﺍﺟﻌﺘﻬﺎ ﻭﲢﺪﻳﺜﻬﺎ ﻛﻞ ﻓﺘﺮﺓ ‪ ,‬ﻛﺬﻟﻚ ﺍﻋﺘﻤﺎﺩ ﺍﳌﺮﺍﺟﻌﲔ‬
‫ﻭﲢﺪﻳﺪ ﻣﻮﺍﺻﻔﺎ‪‬ﻢ ﻭﺍﳌﻬﺎﻡ ﺍﳌﻨﻮﻃﺔ ‪‬ﻢ‪ .‬ﻭﻳﺮﺍﻋﻰ ﺃﻥ ﻳﺘﻢ ﺍﻻﻋﺘﻤﺎﺩ ﺑﻨﻔﻘﺎﺕ ﻣﻘﺒﻮﻟﺔ ﺗﻀﻤﻦ‬
‫ﺍﺳﺘﻤﺮﺍﺭﻳﺔ ﺍﻟﺘﻮﺍﻓﻖ ﻣﻊ ﺍﳌﻌﺎﻳﲑ ﻹﻋﺎﺩﺓ ﺍﻻﻋﺘﻤﺎﺩ ﺑﻌﺪ ﺍﻧﺘﻬﺎﺀ ﺍﳌﺪﺓ ﺍﳌﻘﺮﺭﺓ‪ .‬ﻭﺭﻏﻢ ﺃﻧﻨﺎ ﻧﻘﺪﺭ ﺟﻬﻮﺩ ﺇﺩﺍﺭﺓ‬
‫ﺍﳉﻮﺩﺓ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻟﻠﺒﺪﺀ ﰲ ﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﺍﻻﻋﺘﻤﺎﺩ ﲟﺮﺍﻛﺰ ﻃﺐ ﺍﻷﺳﺮﺓ ﻭﺍﻟﻌﻤﻞ ﻋﻠﻰ‬
‫ﺇﻋﺪﺍﺩ ﺃﺩﺍﺓ ﺍﻻﻋﺘﻤﺎﺩ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ‪ ،‬ﺇﻻ ﺃﻧﻨﺎ ﻧﻔﻀﻞ ﺃﻥ ﺗﺒﻘﻰ ﺟﻬﻮﺩ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﻹﻋﺪﺍﺩ ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﺍﻟﺘﺎﺑﻌﺔ ﳍﺎ ﻟﻼﻋﺘﻤﺎﺩ ﻭﺇﻋﺎﺩﺓ ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺃﻥ ﳝﻨﺢ ﺍﻻﻋﺘﻤﺎﺩ ﻫﻴﺌﺔ ﻗﻮﻣﻴﺔ ﺃﻭ ﺟﻬﺔ ﻣﺴﺘﻘﻠﺔ‪.‬‬

‫‪١٥٥‬‬
‫ﻭﻣﻦ ﺍﻟﻐﺮﻳﺐ ﺃﻥ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﺑﺎﳉﺎﻣﻌﺎﺕ ﺍﳌﺼﺮﻳﺔ ‪ -‬ﻭﺍﳌﺸﻬﻮﺩ ﳍﺎ ﺩﺍﺋﻤﺎﹰ ﺑﺎﻟﺴﺒﻖ ﰲ ﺍﻟﻌﺪﻳﺪ ﻣﻦ‬
‫ﺍ‪‬ﺎﻻﺕ ‪ -‬ﺗﺒﺎﻃﺄﺕ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﺣﱴ ﺇﻧﻪ ﱂ ﻳﺘﻢ ﺣﱴ ﺍﻵﻥ ﺗﻀﻤﲔ ﺍﳌﻨﺎﻫﺞ ﺍﻟﺪﺭﺍﺳﻴﺔ ﺃﻱ ﺗﻨﻮﻳﻪ ﻋﻦ‬
‫ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﻟﻮﻻ ﺟﻬﻮﺩ ﻣﺘﻮﺍﺿﻌﺔ ﺑﺪﺃ‪‬ﺎ ﻛﻠﻴﺔ ﻃﺐ ﻋﲔ ﴰﺲ ﻭﻛﻠﻴﺔ ﻃﺐ‬
‫ﻗﻨﺎﺓ ﺍﻟﺴﻮﻳﺲ ﻟﻠﺘﻨﻮﻳﻪ ﻋﻦ ﻣﻔﻬﻮﻡ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺿﻤﻦ ﻣﻨﻬﺞ ﻃﺐ ﺍ‪‬ﺘﻤﻊ ﻟﻘﻠﻨﺎ ﺇﻥ‬
‫ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﲣﻠﻔﺖ ﻋﻦ ﺍﻟﺮﻛﺐ ‪ ,‬ﻭﻧﺄﻣﻞ ﰲ ﺍﳌﺴﺘﻘﺒﻞ ﺍﻟﻘﺮﻳﺐ ﺃﻥ ﻳﻠﻘﻰ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﺍﻻﻫﺘﻤﺎﻡ ﺍﳉﺪﻳﺮ ﺑﻪ‬
‫ﻭﺃﻥ ﺗﺘﻌﺎﻭﻥ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﻣﻊ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﱪﺍﻣﺞ ﺍﻟﻘﻮﻣﻴﺔ ﻟﺘﺪﺭﻳﺐ ﻃﻠﺒﺔ ﻛﻠﻴﺔ ﺍﻟﻄﺐ‬
‫ﻋﻠﻰ ﺍﺳﺘﺨﺪﺍﻡ ﻣﻌﺎﻳﲑ ﺍﳋﺪﻣﺔ ﻭﻗﺎﺋﻤﺔ ﺍﳌﺮﺍﺟﻌﺎﺕ ﻭﻣﻬﺎﺭﺍﺕ ﺣﻞ ﺍﳌﺸﺎﻛﻞ ﻭﺃﺩﻭﺍﺕ ﲢﺴﲔ ﺍﳉﻮﺩﺓ ﻭﺫﻟﻚ‬
‫ﺃﺛﻨﺎﺀ ﺍﻟﺘﺪﺭﻳﺐ ﺍﻟﻌﻤﻠﻲ ﻭﺍﻟﺰﻳﺎﺭﺍﺕ ﺍﳌﻴﺪﺍﻧﻴﺔ ﳌﺮﺍﻛﺰ ﻭﻭﺣﺪﺍﺕ ﻃﺐ ﺍﻷﺳﺮﺓ ﺿﻤﻦ ﻣﻨﻬﺞ ﺍﻟﺘﺪﺭﻳﺐ ﺍﻟﻌﻤﻠﻲ‬
‫ﳌﺎﺩﺓ ﻃﺐ ﺍ‪‬ﺘﻤﻊ‪.‬‬
‫ﻭﲡﺪﺭ ﺍﻹﺷﺎﺭﺓ ﻫﻨﺎ ﺃﻥ ﻣﻨﺎﻫﺞ ﺑﺮﻧﺎﻣﺞ ﺍﻟﺰﻣﺎﻟﺔ ﺍﳌﺼﺮﻳﺔ ﺍﻟﺘﺎﺑﻊ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﲣﻠﻮ ﻣﻦ ﺃﻱ ﳏﺘﻮﻯ ﰲ‬
‫ﺇﺩﺍﺭﺓ ﺟﻮﺩﺓ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﳓﺐ ﺃﻥ ﻧﺸﺪﺩ ﻫﻨﺎ ﻋﻠﻰ ﺃﳘﻴﺔ ﺗﻀﻤﲔ ﻫﺬﺍ ﺍﳉﺰﺀ ﰲ ﺑﺮﺍﻣﺞ ﺍﻟﺰﻣﺎﻟﺔ‬
‫ﺍﳌﺼﺮﻳﺔ ﻭﺧﺎﺻﺔ ﺯﻣﺎﻟﺔ ﻃﺐ ﺍﻷﺳﺮﺓ‪ .‬ﻛﻤﺎ ﳚﺐ ﻋﻠﻰ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﱵ ﻳﺘﻢ ‪‬ﺎ ﺍﻟﺘﺪﺭﻳﺐ ﻟﱪﻧﺎﻣﺞ‬
‫ﺍﻟﺰﻣﺎﻟﺔ ﺃﻥ ﺗﻨﺸﺊ ﻧﻈﺎﻡ ﺟﻮﺩﺓ ﻣﻮﺛﻘﺎﹰ ﻭﻣﻄﺒﻘﺎﹰ ﺑﻔﺎﻋﻠﻴﺔ ﻭﳚﺐ ﻋﻠﻰ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﻠﻴﺎ ‪‬ﺬﻩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺃﻥ ﺗﻮﻓﺮ ﺃﺩﻟﺔ ﻋﻠﻰ ﺍﻟﺘﺰﺍﻣﻬﺎ ﺑﺘﻄﻮﻳﺮ ﻭﺗﻄﺒﻴﻖ ﻧﻈﺎﻡ ﺇﺩﺍﺭﺓ ﺍﳉﻮﺩﺓ‪.‬‬
‫ﻭﰱ ﺍﻟﻨﻬﺎﻳﺔ ﻓﺈﻧﻨﺎ ﻧﺘﻄﻠﻊ ﰲ ﺍﻟﻘﺮﻳﺐ ﺍﻟﻌﺎﺟﻞ ﺇﱃ ﺇﺻﺪﺍﺭ ﻭﺛﻴﻘﺔ ﻗﻮﻣﻴﺔ ﻟﺴﻴﺎﺳﺔ ﺍﳉﻮﺩﺓ ﰲ ﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺗﻮﺿﺢ ﺍﻟﺮﺅﻳﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻭﺍﻷﻫﺪﺍﻑ ﺍﻷﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻭﺍﳋﻄﻮﺍﺕ ﺍﻟﻌﻤﻠﻴﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻭﺗﻜﻮﻥ‬
‫ﲟﺜﺎﺑﺔ ﻣﻴﺜﺎﻕ ﺗﺘﻄﻠﻊ ﺇﻟﻴﻪ ﻛﻞ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﲟﺼﺮ‪.‬‬

‫‪١٥٦‬‬
‫‪!?" 3:*  @A 3?8"B 648 ) 3"CDE F#* :(1) =.‬‬
‫   ‪GG‬‬
‫ﺃﻭﻻﹰ‪ :‬ﳏﺎﻓﻈﺔ ﺑﲏ ﺳﻮﻳﻒ‬
‫ﻣﺆﺷﺮ ‪ :١‬ﻣﺘﻮﺳﻂ ﺗﺮﺩﺩ ﺍﳊﺎﻣﻞ‬
‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬ ‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬
‫ﺗﺎﺭﻳﺦ ﺑﺪﺍﻳﺔ ﺍﳌﺸﺮﻭﻉ‬ ‫ﺍﺳﻢ ﺍﻟﻮﺣﺪﺓ‬ ‫ﻡ‬
‫ﺑﻌﺪ ﻟﺘﺤﺴﲔ‬ ‫ﻗﺒﻞ ﺍﻟﺘﺤﺴﲔ‬
‫ﺃ‪ .‬ﻣﺸﺮﻭﻋﺎﺕ ﺣﻘﻘﺖ ﻧﺘﺎﺋﺞ ﻭﻣﺎﺯﺍﻝ ﺍﻟﺘﺤﺴﲔ ﻣﺴﺘﻤﺮﺍ‬
‫‪٤,٥‬‬ ‫‪٠,٦‬‬ ‫ﻓﱪﺍﻳﺮ ‪٢٠٠١‬‬ ‫ﺑﻴﻠﻴﻔﻴﺎ‬ ‫‪١‬‬
‫‪٣,٩‬‬ ‫‪٠,٩‬‬ ‫ﻳﻮﻧﻴﻮ ‪٢٠٠١‬‬ ‫ﺍﺑﺴﻮﺝ‬ ‫‪٢‬‬
‫‪٣‬‬ ‫‪١,٣‬‬ ‫ﺃﻛﺘﻮﺑﺮ ‪٢٠٠١‬‬ ‫ﺃﻧﻔﺴﻂ‬ ‫‪٣‬‬
‫‪٣,٣‬‬ ‫‪٠,٩‬‬ ‫ﺃﻛﺘﻮﺑﺮ ‪٢٠٠١‬‬ ‫ﺍﳌﻤﺎﻟﻴﻚ‬ ‫‪٤‬‬
‫‪٣‬‬ ‫‪١,١‬‬ ‫ﺩﻳﺴﻤﱪ ‪٢٠٠١‬‬ ‫ﺍﻟﻨﻮﻳﺮﺓ‬ ‫‪٥‬‬
‫‪٣,٣‬‬ ‫‪٠,٥‬‬ ‫ﺩﻳﺴﻤﱪ ‪٢٠٠١‬‬ ‫ﺗﻠﺖ‬ ‫‪٦‬‬
‫‪٤,٢‬‬ ‫‪١‬‬ ‫ﻳﻨﺎﻳﺮ ‪٢٠٠٢‬‬ ‫ﻧﺰﻟﺔ ﺍﳌﺸﺎﺭﻗﺔ‬ ‫‪٧‬‬
‫‪٢,٦‬‬ ‫‪٠,٨‬‬ ‫ﻳﻨﺎﻳﺮ ‪٢٠٠٢‬‬ ‫ﻣﻨﺸﺄﺓ ﺍﻷﻣﺮﺍﺀ‬ ‫‪٨‬‬
‫‪٤,٤‬‬ ‫‪٠,٨‬‬ ‫ﻓﱪﺍﻳﺮ ‪٢٠٠٢‬‬ ‫ﺑﺮﺍﻭﺓ‬ ‫‪٩‬‬
‫‪٢,٥‬‬ ‫‪١,٤‬‬ ‫ﻣﺎﺭﺱ ‪٢٠٠٢‬‬ ‫ﻧﺰﻟﺔ ﺣﻨﺎ‬ ‫‪١٠‬‬
‫‪٢,٧‬‬ ‫‪٠,٩‬‬ ‫ﻳﻮﻟﻴﻪ ‪٢٠٠٢‬‬ ‫ﻧﻨﺎ‬ ‫‪١١‬‬
‫‪٣,٩‬‬ ‫‪٠,٩‬‬ ‫ﻳﻮﻟﻴﻪ ‪٢٠٠٢‬‬ ‫ﻛﻮﻡ ﺃﺩﺭﳚﺔ‬ ‫‪١٢‬‬
‫‪٣,٤‬‬ ‫‪٠,٨‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫ﺏ‪ -‬ﻣﺸﺮﻭﻋﺎﺕ ﱂ ﲢﻘﻖ ﻧﺘﺎﺋﺞ ﺃﻭ ﺗﻮﻗﻒ ﺍﻟﻌﻤﻞ ‪‬ﺎ‬
‫‪٢,٣‬‬ ‫‪٢,٧‬‬ ‫ﻳﻨﺎﻳﺮ ‪٢٠٠٢‬‬ ‫ﺍﻟﻌﻮﺍﻭﻧﺔ‬ ‫‪١‬‬
‫‪٢,٣‬‬ ‫‪٢,٧‬‬ ‫ﺍﻹﲨﺎﱄ‬

‫ﻣﺆﺷﺮ ‪ :٢‬ﻧﺴﺒﺔ ﺗﻐﻄﻴﺔ ﻓﺤﺺ ﺍﳍﻴﻤﻮﺟﻠﻮﺑﲔ ﰲ ﻋﻤﺮ ﺳﻨﺔ‬

‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬ ‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬
‫ﺗﺎﺭﻳﺦ ﺑﺪﺍﻳﺔ ﺍﳌﺸﺮﻭﻉ‬ ‫ﺍﺳﻢ ﺍﻟﻮﺣﺪﺓ‬ ‫ﻡ‬
‫ﺑﻌﺪ ﺍﻟﺘﺤﺴﲔ‬ ‫ﻗﺒﻞ ﺍﻟﺘﺤﺴﲔ‬
‫ﺃ‪ .‬ﻣﺸﺮﻭﻋﺎﺕ ﺣﻘﻘﺖ ﻧﺘﺎﺋﺞ ﻭﻣﺎﺯﺍﻝ ﺍﻟﺘﺤﺴﲔ ﻣﺴﺘﻤﺮﺍ‬
‫‪%٩٠,٧‬‬ ‫ﺻﻔﺮ‪%‬‬ ‫ﺃﻏﺴﻄﺲ ‪٢٠٠٢‬‬ ‫ﻃﻨﺴﺎ ﺑﲏ ﻣﺎﻟﻮ‬ ‫‪١‬‬
‫‪%٩٠,٧‬‬ ‫ﺻﻔﺮ‪%‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫ﺏ‪ .‬ﻣﺸﺮﻭﻋﺎﺕ ﱂ ﲢﻘﻖ ﻧﺘﺎﺋﺞ ﺃﻭ ﺗﻮﻗﻒ ﺍﻟﻌﻤﻞ ‪‬ﺎ‬
‫‪%٢٦,١‬‬ ‫ﺻﻔﺮ‪%‬‬ ‫ﻓﱪﺍﻳﺮ‪٢٠٠٢‬‬ ‫ﺃﺑﺴﻮﺝ‬ ‫‪١‬‬
‫‪%٢٦,١‬‬ ‫ﺻﻔﺮ‪%‬‬ ‫ﺍﻹﲨﺎﱄ‬

‫‪١٥٧‬‬
 ‫ﻣﺆﺷﺮ ‪ :٣‬ﻧﺴﺒﺔ ﺗﻐﻄﻴﺔ ﺍﻟﻮﻻﺩﺍﺕ ﻟﻠﺤﻮﺍﻣﻞ ﺍﳉﺪﺩ‬
‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬ ‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬
‫ﺗﺎﺭﻳﺦ ﺑﺪﺍﻳﺔ ﺍﳌﺸﺮﻭﻉ‬ ‫ﺍﺳﻢ ﺍﻟﻮﺣﺪﺓ‬ ‫ﻡ‬
‫ﺑﻌﺪ ﺍﻟﺘﺤﺴﲔ‬ ‫ﻗﺒﻞ ﺍﻟﺘﺤﺴﲔ‬
‫‪%٣٥‬‬ ‫‪%٢١,٤‬‬ ‫ﻳﻨﺎﻳﺮ‪٢٠٠٢‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﻧﺎﺻﺮ‬ ‫‪١‬‬
‫‪%٣٥‬‬ ‫‪%٢١,٣‬‬ ‫ﺍﻹﲨﺎﱄ‬

‫ﺛﺎﻧﻴﺎﹰ‪ :‬ﳏﺎﻓﻈﺔ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬

‫ﻣﺆﺷﺮ ‪ :١‬ﻣﺘﻮﺳﻂ ﺗﺮﺩﺩ ﺍﳊﺎﻣﻞ‬
‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬
‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬ ‫ﺗﺎﺭﻳﺦ ﺑﺪﺍﻳﺔ‬
‫ﺑﻌﺪ ﺍﻟﺘﺤﺴﲔ‬ ‫ﺍﺳﻢ ﺍﻟﻮﺣﺪﺓ‬ ‫ﻡ‬
‫ﻗﺒﻞ ﺍﻟﺘﺤﺴﲔ‬ ‫ﺍﳌﺸﺮﻭﻉ‬
‫ﺩﻳﺴﻤﱪ ‪٢٠٠٢‬‬
‫‪٥٠١‬‬ ‫‪١٠٧‬‬ ‫ﺇﺑﺮﻳﻞ ‪٢٠٠٠‬‬ ‫ﻣﺮﻛﺰ ﻃﱯ ﺍﻟﻘﺒﺎﺭﻱ‬ ‫‪١‬‬
‫‪٣,٨‬‬ ‫‪١,٦‬‬ ‫ﻣﺎﻳﻮ‪٢٠٠٠‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﻛﺮﻣﻮﺯ‬ ‫‪٢‬‬
‫‪٣,٩‬‬ ‫‪١,٩‬‬ ‫ﻳﻮﻧﻴﻮ ‪٢٠٠١‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﳏﺮﻡ ﺑﻚ‬ ‫‪٣‬‬
‫‪٣‬‬ ‫‪١,٩‬‬ ‫ﻳﻮﻟﻴﻮ ‪٢٠٠١‬‬ ‫ﺑﺮﺝ ﺍﻟﻌﺮﺏ‬ ‫‪٤‬‬
‫‪٣,٢‬‬ ‫‪١,٥‬‬ ‫ﻳﻮﻟﻴﻮ‪٢٠٠١‬‬ ‫ﺍﳌﻨﺘﺰﺓ ﺍﻟﺮﻳﻔﻴﺔ‬ ‫‪٥‬‬
‫‪٤,١‬‬ ‫‪٢,٩‬‬ ‫ﺩﻳﺴﻤﱪ ‪٢٠٠١‬‬ ‫ﻣﺮﻛﺰ ﻃﱯ ﺑﺎﻛﻮﺱ‬ ‫‪٦‬‬
‫‪٣,٢‬‬ ‫‪٢,٥‬‬ ‫ﻳﻨﺎﻳﺮ ‪٢٠٠٢‬‬ ‫ﻣﺮﻛﺰ ﻃﱯ ﺩﻧﺎ‬ ‫‪٧‬‬
‫‪٢,٦‬‬ ‫‪٢,٣‬‬ ‫ﻳﻨﺎﻳﺮ ‪٢٠٠٢‬‬ ‫ﻭﺣﺪﺓ ﻃﻮﻣﺴﻮﻥ‬ ‫‪٨‬‬
‫‪٣,١‬‬ ‫‪٢,٩‬‬ ‫ﻳﻨﺎﻳﺮ ‪٢٠٠٢‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﺃﺑﻮ ﻗﲑ‬ ‫‪٩‬‬
‫‪٣,٩‬‬ ‫‪٣,٦‬‬ ‫ﻳﻨﺎﻳﺮ ‪٢٠٠٢‬‬ ‫ﺭﻋﺎﻳﺔ ﺍﻷﻣﻮﻣﺔ ﺑﺎﳊﻀﺮﺓ‬ ‫‪١٠‬‬
‫‪٢,٦‬‬ ‫‪١,٩‬‬ ‫ﻓﱪﺍﻳﺮ ‪٢٠٠٢‬‬ ‫ﻭﺣﺪﺓ ﻛﻴﻨﺞ ﻣﺮﻳﻮﻁ‬ ‫‪١١‬‬
‫‪٣,٨‬‬ ‫‪٢,٤‬‬ ‫ﻓﱪﺍﻳﺮ ‪٢٠٠٢‬‬ ‫ﻭﺣﺪﺓ ‪‬ﻴﺞ‬ ‫‪١٢‬‬
‫‪٣,١‬‬ ‫‪١,٨‬‬ ‫ﻓﱪﺍﻳﺮ ‪٢٠٠٢‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﺍﳍﺎﻧﻮﻓﻴﻞ‬ ‫‪١٣‬‬
‫‪٣,٤‬‬ ‫‪٢,٥‬‬ ‫ﻣﺎﺭﺱ ‪٢٠٠٢‬‬ ‫ﻭﺣﺪﺓ ﺃﺑﻮ ﺻﲑ‬ ‫‪١٤‬‬
‫‪٣,٨‬‬ ‫‪٢,٤‬‬ ‫ﺍﻹﲨﺎﱄ‬

‫ﻣﺆﺷﺮ ‪ :٢‬ﻧﺴﺒﺔ ﺗﻐﻄﻴﺔ ﺭﻋﺎﻳﺔ ﺍﻟﻄﻔﻞ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‬

‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬
‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬ ‫ﺗﺎﺭﻳﺦ ﺑﺪﺍﻳﺔ‬
‫ﺑﻌﺪ ﺍﻟﺘﺤﺴﲔ‬ ‫ﺍﺳﻢ ﺍﻟﻮﺣﺪﺓ‬ ‫ﻡ‬
‫ﻗﺒﻞ ﺍﻟﺘﺤﺴﲔ‬ ‫ﺍﳌﺸﺮﻭﻉ‬
‫ﺩﻳﺴﻤﱪ‪٢٠٠٢‬‬
‫‪%٦٩,٥‬‬ ‫‪%٣٤,٤‬‬ ‫ﺩﻳﺴﻤﱪ‪٢٠٠٠‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﻛﺮﻣﻮﺯ‬ ‫‪١‬‬
‫‪%٨٦,٤‬‬ ‫‪%٧,٢‬‬ ‫ﺃﻏﺴﻄﺲ‪٢٠٠١‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﺍﻟﻌﺎﻣﺮﻳﺔ‬ ‫‪٢‬‬
‫‪%٩٢,٢‬‬ ‫‪%٥٨,٦‬‬ ‫ﻳﻨﺎﻳﺮ‪٢٠٠٢‬‬ ‫ﻭﺣﺪﺓ ﺍﻟﻮﺭﺩﻳﺎﻥ‬ ‫‪٣‬‬
‫‪%٦٤,٥‬‬ ‫‪%٦٢,١‬‬ ‫ﻓﱪﺍﻳﺮ‪٢٠٠٢‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﺃﺑﻮ ﻗﻴﲑ‬ ‫‪٤‬‬
‫‪%٨٧,٣‬‬ ‫‪%٥٣,١‬‬ ‫ﺍﻹﲨﺎﱄ‬

‫‪١٥٨‬‬
 ‫ﻧﺴﺒﺔ ﺗﻐﻄﻴﺔ ﺍﳊﻮﺍﻣﻞ ﺍﳉﺪﺩ ﲞﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ‬
‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ ﺑﻌﺪ‬ ‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ ﻗﺒﻞ‬ ‫ﺗﺎﺭﻳﺦ ﺑﺪﺍﻳﺔ‬
‫ﺍﺳﻢ ﺍﻟﻮﺣﺪﺓ‬ ‫ﻡ‬
‫ﺍﻟﺘﺤﺴﲔ‬ ‫ﺍﻟﺘﺤﺴﲔ‬ ‫ﺍﳌﺸﺮﻭﻉ‬
‫‪%٥٥,٣‬‬ ‫‪%٥٥,٣‬‬ ‫ﻳﻮﻧﻴﻮ ‪٢٠٠١‬‬ ‫ﻣﺮﻛﺰ ﻃﱯ ﲰﻮﺣﺔ‬ ‫‪١‬‬
‫‪%٥٤,٦‬‬ ‫‪%٣٣,٤‬‬ ‫ﺩﻳﺴﻤﱪ ‪٢٠٠١‬‬ ‫ﺍﳉﻤﺮﻙ‬ ‫‪٢‬‬
‫‪%٧٠٣٤‬‬ ‫‪%٣٣,٢‬‬ ‫ﺩﻳﺴﻤﱪ ‪٢٠٠١‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﺍﻟﻠﺒﺎﻥ‬ ‫‪٣‬‬
‫‪%٦٠,٢‬‬ ‫‪%٤٠,٦‬‬ ‫ﺍﻹﲨﺎﱄ‬

‫ﻣﺆﺷﺮ ‪ :٣‬ﻧﺴﺒﺔ ﺗﻐﻄﻴﺔ ﺍﻟﻮﻻﺩﺍﺕ ﻟﻠﺤﻮﺍﻣﻞ ﺍﳉﺪﺩ‬

‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬ ‫ﻣﺘﻮﺳﻂ ﺍﻟﻨﺴﺒﺔ‬ ‫ﺗﺎﺭﻳﺦ ﺑﺪﺍﻳﺔ‬
‫ﺍﺳﻢ ﺍﻟﻮﺣﺪﺓ‬ ‫ﻡ‬
‫ﺑﻌﺪ ﺍﻟﺘﺤﺴﲔ‬ ‫ﻗﺒﻞ ﺍﻟﺘﺤﺴﲔ‬ ‫ﺍﳌﺸﺮﻭﻉ‬
‫‪%٣٠,٧‬‬ ‫‪%٢١,٦‬‬ ‫ﻳﻮﻧﻴﻪ‪٢٠٠١‬‬ ‫ﺍﳉﻤﺮﻙ‬ ‫‪١‬‬
‫‪%٢٨,٢‬‬ ‫‪%١٦,٣‬‬ ‫ﻳﻮﻧﻴﻪ‪٢٠٠١‬‬ ‫ﺍﻟﻘﺒﺎﺭﻱ‬ ‫‪٢‬‬
‫‪%٣٧‬‬ ‫‪%٣٥,١‬‬ ‫ﺩﻳﺴﻤﱪ ‪٢٠٠١‬‬ ‫ﻣﺮﻛﺰ ﻃﱯ ﺑﺎﻛﻮﺱ‬ ‫‪٣‬‬
‫‪%١١,٤‬‬ ‫‪%٩,٦‬‬ ‫ﻣﺎﻳﻮ ‪٢٠٠٢‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﺍﻟﻌﺎﻣﺮﻳﺔ‬ ‫‪٤‬‬
‫‪%٢٠,٧‬‬ ‫‪%٢٠,١‬‬ ‫ﻳﻮﻧﻴﻮ ‪٢٠٠٢‬‬ ‫ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﳏﺮﻡ ﺑﻚ‬ ‫‪٥‬‬
‫‪%٢٥,٧‬‬ ‫‪%٢٠,٥‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫ﻣﻠﺤﻮﻇﺔ‪ :‬ﻭﺍﺟﻪ ﻫﺬﺍ ﺍﳌﺆﺷﺮ ﺻﻌﻮﺑﺎﺕ ﻛﺒﲑﺓ ﻧﺘﻴﺠﺔ ﳊﺪﻭﺙ ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﰲ ﺭﻋﺎﻳﺔ ﻃﻔﻞ ﻛﺮﻣﻮﺯ ﳑﺎ ﺃﺛﺮ ﻋﻠﻰ ﲨﻴﻊ ﺣﺎﻻﺕ‬
‫ﺍﻟﻮﻻﺩﺓ ﰲ ﺩﻭﺭ ﺍﻟﻮﻻﺩﺓ ﺑﺎﶈﺎﻓﻈﺔ‪.‬‬

‫‪١٥٩‬‬
 @ @@
@ @
@ @@
 ‫ء‬

  
  
@ @
@ @‹—€€ß@À@ò€î€€z€€—€€Ûa@òÛb€€€z€€€€Ûa@pa‹€€€€’ûß@ZÉibÛa@Ý—ÐÛa@•
@ @
 ‫
 
‪:‬‬
‫      ‬
‫     ‬

‫ﳛﺎﻭﻝ ﻫﺬﺍ ﺍﻟﻔﺼﻞ ﻣﻦ ﺍﻟﺘﻘﺮﻳﺮ ﺇﻟﻘﺎﺀ ﺍﻟﻀﻮﺀ ﻋﻠﻰ ﺣﺎﻟﺔ ﺍﻟﺼﺤﺔ ﰲ ﻣﺼﺮ ﻣﻦ ﺧﻼﻝ ﻋﺮﺽ ﻋﺪﺩ ﻣﻦ‬
‫ﺍﳌﺆﺷﺮﺍﺕ ﺍﳌﺨﺘﺎﺭﺓ ﻭﺍﻟﱵ ﺗﺘﻌﻠﻖ ﺑﺎﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻤﻮﺍﻃﻨﲔ‪ ،‬ﺃﻭ ﲟﺤﺪﺩﺍﺕ ﺣﺎﻛﻤﺔ ﻟﻠﺤﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﻭﻣﻘﺎﺭﻧﺘﻬﺎ ﲟﺆﺷﺮﺍﺕ ﺑﻌﺾ ﺍﻟﺪﻭﻝ ﺍﻷﺧﺮﻯ ﺍﳌﺨﺘﺎﺭﺓ‪ .‬ﰎ ﺍﺧﺘﻴﺎﺭ ﻫﺬﻩ ﺍﳌﺆﺷﺮﺍﺕ ﺑﺎﻻﺳﺘﻌﺎﻧﺔ ﺑﺘﻘﺴﻴﻢ‬
‫ﺍﳌﺆﺷﺮﺍﺕ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪ ،(WHO‬ﻣﻊ ﺇﺟﺮﺍﺀ ﺑﻌﺾ ﺍﻟﺘﻌﺪﻳﻼﺕ ﻭﻓﻘﺎﹰ ﻟﺘﻮﻓﺮ ﺍﻟﺒﻴﺎﻧﺎﺕ ﻋﻦ‬
‫ﺍﻟﻮﺍﻗﻊ ﺍﳌﺼﺮﻱ‪ .‬ﻭﳝﻜﻦ ﺗﺼﻨﻴﻒ ﺍﳌﺆﺷﺮﺍﺕ ﺍﻟﱵ ﰎ ﺍﺧﺘﻴﺎﺭﻫﺎ ﻛﻤﺎ ﻳﻠﻲ‪:‬‬

‫‪    !"  .1‬‬

‫ﺃ‪ .‬ﺗﻮﺯﻳﻊ ﺍﳌﻮﺍﺭﺩ‬
‫ﺃ‪ :١-‬ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ )ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ(‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(١-١‬ﺗﻄﻮﺭ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻲ ﺍﻟﺼﺤﺔ ﰲ ﻣﺼﺮ ﻭﺫﻟﻚ ﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ )‪ (٩٩/٢٠٠٠-١٩٩١/٩٠‬ﺑﺎﳌﻠﻴﻮﻥ‬
‫ﺟﻨﻴﻪ‬
‫ﺍﻻﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‬
‫)ﺑﺎﳌﻠﻴﻮﻥ ﺟﻨﻴﻪ(‬ ‫ﻋﺎﻡ‬
‫‪742.1‬‬ ‫‪١٩٩١/١٩٩٠‬‬
‫‪886.2‬‬ ‫‪١٩٩٢/١٩٩١‬‬
‫‪1033.7‬‬ ‫‪١٩٩٣/١٩٩٢‬‬
‫‪1197.2‬‬ ‫‪١٩٩٤/١٩٩٣‬‬
‫‪1400.8‬‬ ‫‪١٩٩٥/١٩٩٤‬‬
‫‪1576.3‬‬ ‫‪١٩٩٦/١٩٩٥‬‬
‫‪1993.7‬‬ ‫‪١٩٩٧/١٩٩٦‬‬
‫‪2129.6‬‬ ‫‪١٩٩٨/١٩٩٧‬‬
‫‪2512.9‬‬ ‫‪١٩٩٩/١٩٩٨‬‬
‫‪3106.5‬‬ ‫‪٢٠٠٠/١٩٩٩‬‬
‫ﺍﳌﻮﺍﺯﻧﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺪﻭﻟﺔ ‪١٩٩٩‬‬

‫‪١٦١‬‬
 ‫ﺃ‪ :٢-‬ﻧﺴﺒﺔ ﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺇﱃ ﺇﲨﺎﱄ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ )‪(%‬‬
‫ﺟﺪﻭﻝ )‪ :(٢-١‬ﻧﺴﺒﺔ ﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﺇﱃ ﺇﲨﺎﱄ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ )‪ (%‬ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ‬
‫ﺃﺧﺮﻯ‪.‬‬
‫‪٢٠٠٠‬‬ ‫‪١٩٩٩‬‬ ‫‪١٩٩٨‬‬ ‫‪١٩٩٧‬‬ ‫‪١٩٩٦‬‬ ‫‪١٩٩٥‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪٨,٣‬‬ ‫‪٧,٩‬‬ ‫‪٧,٥‬‬ ‫‪٧,٥‬‬ ‫‪٧,٤‬‬ ‫‪٧,٢‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪٥,٣‬‬ ‫‪٥,١‬‬ ‫‪٤,٧‬‬ ‫‪٤,٥‬‬ ‫‪٤,٢‬‬ ‫‪٣,٩‬‬ ‫ﺍﻟﺼﲔ‬
‫‪٦,٨‬‬ ‫‪٦,٩‬‬ ‫‪٦,٤‬‬ ‫‪٦,٣‬‬ ‫‪٥,٨‬‬ ‫‪٥,٧‬‬ ‫ﻛﻮﺑﺎ‬
‫‪٣,٨‬‬ ‫‪٣,٩‬‬ ‫‪٤‬‬ ‫‪٣,٩‬‬ ‫‪٣,٨‬‬ ‫‪٣,٧‬‬ ‫ﻣﺼﺮ‬
‫‪٤,٩‬‬ ‫‪٥,١‬‬ ‫‪٥‬‬ ‫‪٥,٣‬‬ ‫‪٥,٢‬‬ ‫‪٥‬‬ ‫ﺍﳍﻨﺪ‬
‫‪١٠,٩‬‬ ‫‪١٠,٩‬‬ ‫‪١٠‬‬ ‫‪١٠,١‬‬ ‫‪١٠,٢‬‬ ‫‪٩,٩‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪٧,٨‬‬ ‫‪٧,٤‬‬ ‫‪٧,١‬‬ ‫‪٧,٢‬‬ ‫‪٧‬‬ ‫‪٧‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪٨,٣‬‬ ‫‪٨,٤‬‬ ‫‪٨,٤‬‬ ‫‪٨,٣‬‬ ‫‪٨,١‬‬ ‫‪٨,١‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪٦‬‬ ‫‪٥,٦‬‬ ‫‪٥,١‬‬ ‫‪٥‬‬ ‫‪٤,٩‬‬ ‫‪٤,٧‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪٥,٣‬‬ ‫‪٥,٦‬‬ ‫‪٥,٩‬‬ ‫‪٥,٨‬‬ ‫‪٥,٤‬‬ ‫‪٥,٥‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪٥,٣‬‬ ‫‪٥,٤‬‬ ‫‪٥,٧‬‬ ‫‪٥,١‬‬ ‫‪٥,١‬‬ ‫‪٥,٣‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪٨,٨‬‬ ‫‪٨,٨‬‬ ‫‪٨,٧‬‬ ‫‪٩‬‬ ‫‪٩,٢‬‬ ‫‪٨,٤‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪٧‬‬ ‫‪٧‬‬ ‫‪٦,٨‬‬ ‫‪٦,٤‬‬ ‫‪٦,٦‬‬ ‫‪٦,٨‬‬ ‫ﺗﻮﻧﺲ‬
‫‪٧,٣‬‬ ‫‪٧,١‬‬ ‫‪٦,٨‬‬ ‫‪٦,٨‬‬ ‫‪٧‬‬ ‫‪٧‬‬ ‫ﺇﳒﻠﺘﺮﺍ‬
‫‪١٣‬‬ ‫‪١٣‬‬ ‫‪١٢,٩‬‬ ‫‪١٣‬‬ ‫‪١٣,٢‬‬ ‫‪١٣,٣‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ – ‪٢٠٠٢‬‬

‫ﺃ‪ :٣-‬ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﳋﺎﺹ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨـﺎﱄ ﺍﻹﻧﻔـﺎﻕ ﺍﻟـﺼﺤﻲ )‪ (%‬ﰲ ﻣـﺼﺮ‬
‫ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٣-١‬ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﳋﺎﺹ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ )‪ (%‬ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ‬
‫ﺑﺪﻭﻝ ﺃﺧﺮﻱ‪.‬‬
‫‪٢٠٠٠‬‬ ‫‪١٩٩٩‬‬ ‫‪١٩٩٨‬‬ ‫‪١٩٩٧‬‬ ‫‪١٩٩٦‬‬ ‫‪١٩٩٥‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪٥٩,٢‬‬ ‫‪٥٧,٢‬‬ ‫‪٥٦‬‬ ‫‪٥٦,٥‬‬ ‫‪٥٩,٦‬‬ ‫‪٥٧,٣‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪٦٣,٤‬‬ ‫‪٦٢‬‬ ‫‪٦١‬‬ ‫‪٦٠‬‬ ‫‪٥٧,٨‬‬ ‫‪٥٣,٣‬‬ ‫ﺍﻟﺼﲔ‬
‫‪١٠,٨‬‬ ‫‪١١,٤‬‬ ‫‪١٢,٤‬‬ ‫‪١٢,٥‬‬ ‫‪١٠,٥‬‬ ‫‪٩,٨‬‬ ‫ﻛﻮﺑﺎ‬
‫‪٥٣,٩‬‬ ‫‪٥٣,٦‬‬ ‫‪٥٤‬‬ ‫‪٥٤,١‬‬ ‫‪٥٥,٤‬‬ ‫‪٥٦,١‬‬ ‫ﻣﺼﺮ‬
‫‪٨٢,٢‬‬ ‫‪٨٢,١‬‬ ‫‪٨١,٦‬‬ ‫‪٨٤,٣‬‬ ‫‪٨٤,٤‬‬ ‫‪٨٣,٨‬‬ ‫ﺍﳍﻨﺪ‬
‫‪٢٤,١‬‬ ‫‪٢٢,٣‬‬ ‫‪٢٣‬‬ ‫‪٢١,٣‬‬ ‫‪٢١,٤‬‬ ‫‪٢٥,٦‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪٢٣,٣‬‬ ‫‪٢٢‬‬ ‫‪٢٢,٦‬‬ ‫‪٢٠,٥‬‬ ‫‪١٩,٧‬‬ ‫‪٢١,٨‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪٧٧,٨‬‬ ‫‪٧٣,٥‬‬ ‫‪٧٣,٨‬‬ ‫‪٧٣,٨‬‬ ‫‪٧٢,٧‬‬ ‫‪٧٣,٤‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪٥٥,٩‬‬ ‫‪٥٦,٩‬‬ ‫‪٥٣,٨‬‬ ‫‪٥٩‬‬ ‫‪٦١,٢‬‬ ‫‪٦٣,٥‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪٢٧,٥‬‬ ‫‪٣٥,٣‬‬ ‫‪٣١,١‬‬ ‫‪٢٧,١‬‬ ‫‪٢١,٩‬‬ ‫‪١٨,٥‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪٢٠,٩‬‬ ‫‪٢٠,٧‬‬ ‫‪٢٠,٩‬‬ ‫‪٢١,٥‬‬ ‫‪٢٢‬‬ ‫‪٢١,٣‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪٥٧,٨‬‬ ‫‪٥٧,٤‬‬ ‫‪٥٧,٦‬‬ ‫‪٥٣,٩‬‬ ‫‪٥٣,١‬‬ ‫‪٥١,٣‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪٢١,٨‬‬ ‫‪٢١,٢‬‬ ‫‪٢٠,٩‬‬ ‫‪٢٢,٣‬‬ ‫‪٣٢,٥‬‬ ‫‪٤٣,٩‬‬ ‫ﺗﻮﻧﺲ‬
‫‪١٩‬‬ ‫‪١٩,٨‬‬ ‫‪٢٠,١‬‬ ‫‪٢٠,١‬‬ ‫‪١٧,١‬‬ ‫‪١٦,١‬‬ ‫ﺇﳒﻠﺘﺮﺍ‬
‫‪٥٥,٧‬‬ ‫‪٥٥,٧‬‬ ‫‪٥٥,٥‬‬ ‫‪٥٤,٨‬‬ ‫‪٥٤,٥‬‬ ‫‪٥٤,٧‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ‪٢٠٠٢ -‬‬

‫‪١٦٢‬‬
 ‫ﺃ‪ :٤-‬ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ )‪.(%‬‬
‫ﺟﺪﻭﻝ )‪ :(٤-١‬ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ )‪ (%‬ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ‬
‫ﺑﺪﻭﻝ ﺃﺧﺮﻱ‪.‬‬
‫‪٢٠٠٠‬‬ ‫‪١٩٩٩‬‬ ‫‪١٩٩٨‬‬ ‫‪١٩٩٧‬‬ ‫‪١٩٩٦‬‬ ‫‪١٩٩٥‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪40.8‬‬ ‫‪42.8‬‬ ‫‪44‬‬ ‫‪43.5‬‬ ‫‪40.4‬‬ ‫‪42.7‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪36.6‬‬ ‫‪38‬‬ ‫‪39‬‬ ‫‪40‬‬ ‫‪42.2‬‬ ‫‪46.7‬‬ ‫ﺍﻟﺼﲔ‬
‫‪89.2‬‬ ‫‪88.6‬‬ ‫‪87.6‬‬ ‫‪87.5‬‬ ‫‪89.5‬‬ ‫‪90.2‬‬ ‫ﻛﻮﺑﺎ‬
‫‪46.1‬‬ ‫‪46.4‬‬ ‫‪46‬‬ ‫‪45.9‬‬ ‫‪44.6‬‬ ‫‪43.9‬‬ ‫ﻣﺼﺮ‬
‫‪17.8‬‬ ‫‪17.9‬‬ ‫‪18.4‬‬ ‫‪15.7‬‬ ‫‪15.6‬‬ ‫‪16.2‬‬ ‫ﺍﳍﻨﺪ‬
‫‪75.9‬‬ ‫‪77.7‬‬ ‫‪77‬‬ ‫‪78.7‬‬ ‫‪78.6‬‬ ‫‪74.4‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪76.7‬‬ ‫‪78‬‬ ‫‪77.4‬‬ ‫‪79.5‬‬ ‫‪80.3‬‬ ‫‪78.2‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪22.2‬‬ ‫‪26.5‬‬ ‫‪26.2‬‬ ‫‪26.2‬‬ ‫‪27.3‬‬ ‫‪26.6‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪44.1‬‬ ‫‪43.1‬‬ ‫‪46.2‬‬ ‫‪41‬‬ ‫‪38.8‬‬ ‫‪36.5‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪72.5‬‬ ‫‪64.7‬‬ ‫‪68.9‬‬ ‫‪72.9‬‬ ‫‪78.1‬‬ ‫‪81.5‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪79.1‬‬ ‫‪79.3‬‬ ‫‪79.1‬‬ ‫‪78.5‬‬ ‫‪78‬‬ ‫‪78.7‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪42.2‬‬ ‫‪42.6‬‬ ‫‪42.4‬‬ ‫‪46.1‬‬ ‫‪46.9‬‬ ‫‪48.7‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪78.2‬‬ ‫‪78.8‬‬ ‫‪79.1‬‬ ‫‪77.7‬‬ ‫‪67.5‬‬ ‫‪56.1‬‬ ‫ﺗﻮﻧﺲ‬
‫‪81‬‬ ‫‪80.2‬‬ ‫‪79.9‬‬ ‫‪79.9‬‬ ‫‪82.9‬‬ ‫‪83.9‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪44.3‬‬ ‫‪44.3‬‬ ‫‪44.5‬‬ ‫‪45.2‬‬ ‫‪45.5‬‬ ‫‪45.3‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ – ‪٢٠٠٢‬‬

‫ﺃ‪ :٥-‬ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ )‪.(%‬‬
‫ﺟﺪﻭﻝ )‪ :(٥-١‬ﻧﺴﺒﺔ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺇﲨﺎﱄ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ )‪ (%‬ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ‬
‫ﺑﺪﻭﻝ ﺃﺧﺮﻱ‪.‬‬
‫‪٢٠٠٠‬‬ ‫‪١٩٩٩‬‬ ‫‪١٩٩٨‬‬ ‫‪١٩٩٧‬‬ ‫‪١٩٩٦‬‬ ‫‪١٩٩٥‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪8.4‬‬ ‫‪9.3‬‬ ‫‪9‬‬ ‫‪9.1‬‬ ‫‪8.3‬‬ ‫‪8.3‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪11‬‬ ‫‪12‬‬ ‫‪13.7‬‬ ‫‪14.7‬‬ ‫‪15.2‬‬ ‫‪15.5‬‬ ‫ﺍﻟﺼﲔ‬
‫‪13.5‬‬ ‫‪11.8‬‬ ‫‪10.3‬‬ ‫‪10‬‬ ‫‪9.3‬‬ ‫‪8‬‬ ‫ﻛﻮﺑﺎ‬
‫‪6.5‬‬ ‫‪6.2‬‬ ‫‪6.5‬‬ ‫‪5.9‬‬ ‫‪5.2‬‬ ‫‪4.8‬‬ ‫ﻣﺼﺮ‬
‫‪5.3‬‬ ‫‪5.7‬‬ ‫‪5.6‬‬ ‫‪4.7‬‬ ‫‪4.7‬‬ ‫‪4.7‬‬ ‫ﺍﳍﻨﺪ‬
‫‪15.7‬‬ ‫‪15.9‬‬ ‫‪14.3‬‬ ‫‪14.6‬‬ ‫‪16.8‬‬ ‫‪15.7‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪15.4‬‬ ‫‪15.3‬‬ ‫‪13.2‬‬ ‫‪16.2‬‬ ‫‪15.2‬‬ ‫‪15.1‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪8.1‬‬ ‫‪8.1‬‬ ‫‪8.1‬‬ ‫‪8‬‬ ‫‪7.2‬‬ ‫‪6.6‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪11.2‬‬ ‫‪10.2‬‬ ‫‪9.6‬‬ ‫‪9.4‬‬ ‫‪9.1‬‬ ‫‪8.6‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪14.5‬‬ ‫‪11.9‬‬ ‫‪12.3‬‬ ‫‪10.6‬‬ ‫‪10.4‬‬ ‫‪11.7‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪14.6‬‬ ‫‪13.9‬‬ ‫‪11.1‬‬ ‫‪12.2‬‬ ‫‪14‬‬ ‫‪13.3‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪11.2‬‬ ‫‪11.1‬‬ ‫‪11.3‬‬ ‫‪12.4‬‬ ‫‪12.6‬‬ ‫‪12.6‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪17.2‬‬ ‫‪17.3‬‬ ‫‪16.9‬‬ ‫‪15.7‬‬ ‫‪13.5‬‬ ‫‪11.5‬‬ ‫ﺗﻮﻧﺲ‬
‫‪14.9‬‬ ‫‪14.6‬‬ ‫‪13.7‬‬ ‫‪13.2‬‬ ‫‪13.5‬‬ ‫‪13.1‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪16.7‬‬ ‫‪16.7‬‬ ‫‪16.8‬‬ ‫‪17.2‬‬ ‫‪17‬‬ ‫‪16.8‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ‪٢٠٠٢ -‬‬

‫‪١٦٣‬‬
‫ﺃ‪ :٦-‬ﻧــﺴﺒﺔ ﺍﳌــﺼﺎﺩﺭ ﺍﳋﺎﺭﺟﻴــﺔ ﻟﻺﻧﻔــﺎﻕ ﻋﻠــﻰ ﺍﻟــﺼﺤﺔ ﺇﱃ ﺍﻹﻧﻔــﺎﻕ ﺍﳊﻜــﻮﻣﻲ ﻋﻠــﻰ‬
‫ﺍﻟﺼﺤﺔ )‪.(%‬‬
‫ﺟﺪﻭﻝ )‪ :(٦-١‬ﻧﺴﺒﺔ ﺍﳌﺼﺎﺩﺭ ﺍﳋﺎﺭﺟﻴﺔ ﻟﻺﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ )‪ (%‬ﰲ‬
‫ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻱ‪.‬‬
‫‪٢٠٠٠‬‬ ‫‪١٩٩٩‬‬ ‫‪١٩٩٨‬‬ ‫‪١٩٩٧‬‬ ‫‪١٩٩٦‬‬ ‫‪١٩٩٥‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪1‬‬ ‫‪1.2‬‬ ‫‪1.2‬‬ ‫‪0.8‬‬ ‫‪0.4‬‬ ‫‪0.4‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪0.6‬‬ ‫‪0.7‬‬ ‫‪0.5‬‬ ‫‪0.7‬‬ ‫‪0.7‬‬ ‫‪0.8‬‬ ‫ﺍﻟﺼﲔ‬
‫‪0.2‬‬ ‫‪0.3‬‬ ‫‪0.1‬‬ ‫‪0.2‬‬ ‫‪0‬‬ ‫‪0.1‬‬ ‫ﻛﻮﺑﺎ‬
‫‪3.8‬‬ ‫‪3.8‬‬ ‫‪4.5‬‬ ‫‪4.2‬‬ ‫‪5.8‬‬ ‫‪5.7‬‬ ‫ﻣﺼﺮ‬
‫‪12.4‬‬ ‫‪12.5‬‬ ‫‪13.1‬‬ ‫‪14.8‬‬ ‫‪12.8‬‬ ‫‪13.2‬‬ ‫ﺍﳍﻨﺪ‬
‫‪0.4‬‬ ‫‪0.3‬‬ ‫‪0‬‬ ‫‪1.4‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪38.3‬‬ ‫‪32.3‬‬ ‫‪29.8‬‬ ‫‪26.9‬‬ ‫‪26.1‬‬ ‫‪32.3‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪4.4‬‬ ‫‪5.8‬‬ ‫‪1.7‬‬ ‫‪0.5‬‬ ‫‪0.4‬‬ ‫‪0.3‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪0.2‬‬ ‫‪0.2‬‬ ‫‪0.2‬‬ ‫‪0.2‬‬ ‫‪0.2‬‬ ‫‪0.1‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪0.7‬‬ ‫‪0.6‬‬ ‫‪0.7‬‬ ‫‪0.9‬‬ ‫‪0.9‬‬ ‫‪1.2‬‬ ‫ﺗﻮﻧﺲ‬
‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ – ‪٢٠٠٢‬‬

‫ﺃ‪ :٧-‬ﻧﺴﺒﺔ ﺇﻧﻔﺎﻕ ﺍﻷﻣﺎﻥ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ )‪.(%‬‬
‫ﺟﺪﻭﻝ )‪ :(٧-١‬ﻧﺴﺒﺔ ﺇﻧﻔﺎﻕ ﺍﻷﻣﺎﻥ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺇﱃ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﻋﻠﻰ ﺍﻟﺼﺤﺔ )‪ (%‬ﰲ‬
‫ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻱ‪.‬‬
‫‪٢٠٠٠‬‬ ‫‪١٩٩٩‬‬ ‫‪١٩٩٨‬‬ ‫‪١٩٩٧‬‬ ‫‪١٩٩٦‬‬ ‫‪١٩٩٥‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪50.7‬‬ ‫‪51.4‬‬ ‫‪53‬‬ ‫‪58‬‬ ‫‪60‬‬ ‫‪62.1‬‬ ‫ﺍﻟﺼﲔ‬
‫‪10.6‬‬ ‫‪11‬‬ ‫‪19.4‬‬ ‫‪20.9‬‬ ‫‪13‬‬ ‫‪17.7‬‬ ‫ﻛﻮﺑﺎ‬
‫‪29.5‬‬ ‫‪29.5‬‬ ‫‪28.4‬‬ ‫‪28‬‬ ‫‪28.3‬‬ ‫‪27.9‬‬ ‫ﻣﺼﺮ‬
‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﺍﳍﻨﺪ‬
‫‪25.8‬‬ ‫‪24.3‬‬ ‫‪26.3‬‬ ‫‪25.6‬‬ ‫‪24.9‬‬ ‫‪23.8‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪89.1‬‬ ‫‪84‬‬ ‫‪84.8‬‬ ‫‪89‬‬ ‫‪84.4‬‬ ‫‪84.7‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪15.2‬‬ ‫‪12.8‬‬ ‫‪13.1‬‬ ‫‪13.3‬‬ ‫‪13‬‬ ‫‪13.4‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪77.3‬‬ ‫‪75.2‬‬ ‫‪74.5‬‬ ‫‪71.9‬‬ ‫‪71‬‬ ‫‪69.6‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪24.5‬‬ ‫‪36.9‬‬ ‫‪36.3‬‬ ‫‪33.8‬‬ ‫‪31.5‬‬ ‫‪28.1‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪47.6‬‬ ‫‪47.8‬‬ ‫‪47.1‬‬ ‫‪45.3‬‬ ‫‪42.2‬‬ ‫‪37.2‬‬ ‫ﺗﻮﻧﺲ‬
‫‪11.2‬‬ ‫‪11.6‬‬ ‫‪12.2‬‬ ‫‪11.9‬‬ ‫‪11.3‬‬ ‫‪11.3‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪33.7‬‬ ‫‪33.3‬‬ ‫‪33.4‬‬ ‫‪32.2‬‬ ‫‪32.8‬‬ ‫‪32.1‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ‪٢٠٠٢ -‬‬

‫‪١٦٤‬‬
 ‫ﺏ‪ .‬ﻋﺪﺍﻟﺔ ﺍﻟﺘﻮﺯﻳﻊ‬
‫ﺏ‪ :١-‬ﻣﻌﺪﻝ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﻠﻔﺮﺩ )ﺑﺎﻟﺪﻭﻻﺭ ﺍﻷﻣﲑﻛﻲ(‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٨-١‬ﻣﻌﺪﻝ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺼﺤﻲ ﻟﻠﻔﺮﺩ )ﺑﺎﻟﺪﻭﻻﺭ ﺍﻷﻣﲑﻛﻲ( ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻱ‪.‬‬
‫‪٢٠٠٠‬‬ ‫‪١٩٩٩‬‬ ‫‪١٩٩٨‬‬ ‫‪١٩٩٧‬‬ ‫‪١٩٩٦‬‬ ‫‪١٩٩٥‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪267‬‬ ‫‪248‬‬ ‫‪351‬‬ ‫‪365‬‬ ‫‪355‬‬ ‫‪319‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪45‬‬ ‫‪40‬‬ ‫‪36‬‬ ‫‪33‬‬ ‫‪28‬‬ ‫‪22‬‬ ‫ﺍﻟﺼﲔ‬
‫‪169‬‬ ‫‪157‬‬ ‫‪138‬‬ ‫‪131‬‬ ‫‪121‬‬ ‫‪112‬‬ ‫ﻛﻮﺑﺎ‬
‫‪51‬‬ ‫‪52‬‬ ‫‪48‬‬ ‫‪46‬‬ ‫‪41‬‬ ‫‪36‬‬ ‫ﻣﺼﺮ‬
‫‪23‬‬ ‫‪23‬‬ ‫‪22‬‬ ‫‪23‬‬ ‫‪21‬‬ ‫‪20‬‬ ‫ﺍﳍﻨﺪ‬
‫‪2021‬‬ ‫‪1888‬‬ ‫‪1767‬‬ ‫‪1819‬‬ ‫‪1823‬‬ ‫‪1653‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪2908‬‬ ‫‪2631‬‬ ‫‪2213‬‬ ‫‪2467‬‬ ‫‪2594‬‬ ‫‪2950‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪28‬‬ ‫‪29‬‬ ‫‪33‬‬ ‫‪31‬‬ ‫‪27‬‬ ‫‪27‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪584‬‬ ‫‪486‬‬ ‫‪354‬‬ ‫‪523‬‬ ‫‪568‬‬ ‫‪508‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪92‬‬ ‫‪71‬‬ ‫‪112‬‬ ‫‪167‬‬ ‫‪153‬‬ ‫‪126‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪448‬‬ ‫‪394‬‬ ‫‪387‬‬ ‫‪411‬‬ ‫‪408‬‬ ‫‪397‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪255‬‬ ‫‪269‬‬ ‫‪275‬‬ ‫‪322‬‬ ‫‪324‬‬ ‫‪318‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪145‬‬ ‫‪155‬‬ ‫‪145‬‬ ‫‪133‬‬ ‫‪142‬‬ ‫‪137‬‬ ‫ﺗﻮﻧﺲ‬
‫‪1747‬‬ ‫‪1753‬‬ ‫‪1657‬‬ ‫‪1531‬‬ ‫‪1422‬‬ ‫‪1357‬‬ ‫ﺇﳒﻠﺘﺮﺍ‬
‫‪4499‬‬ ‫‪4252‬‬ ‫‪4068‬‬ ‫‪3905‬‬ ‫‪3762‬‬ ‫‪3621‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ – ‪٢٠٠٢‬‬

‫ﺏ‪ :٢-‬ﻣﻌﺪﻝ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﺍﻟﺼﺤﻲ ﻟﻠﻔﺮﺩ )ﺑﺎﻟﺪﻭﻻﺭ ﺍﻷﻣﲑﻛﻲ(‪.‬‬

‫ﺟﺪﻭﻝ )‪ :(٩-١‬ﻣﻌﺪﻝ ﺍﻹﻧﻔﺎﻕ ﺍﳊﻜﻮﻣﻲ ﺍﻟﺼﺤﻲ ﻟﻠﻔﺮﺩ )ﺑﺎﻟﺪﻭﻻﺭ ﺍﻷﻣﲑﻛﻲ( ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻱ‪.‬‬
‫‪٢٠٠٠‬‬ ‫‪١٩٩٩‬‬ ‫‪١٩٩٨‬‬ ‫‪١٩٩٧‬‬ ‫‪١٩٩٦‬‬ ‫‪١٩٩٥‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪257‬‬ ‫‪243‬‬ ‫‪234‬‬ ‫‪231‬‬ ‫‪203‬‬ ‫‪203‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪75‬‬ ‫‪67‬‬ ‫‪60‬‬ ‫‪54‬‬ ‫‪48‬‬ ‫‪44‬‬ ‫ﺍﻟﺼﲔ‬
‫‪166‬‬ ‫‪161‬‬ ‫‪144‬‬ ‫‪139‬‬ ‫‪126‬‬ ‫‪112‬‬ ‫ﻛﻮﺑﺎ‬
‫‪64‬‬ ‫‪61‬‬ ‫‪58‬‬ ‫‪55‬‬ ‫‪49‬‬ ‫‪44‬‬ ‫ﻣﺼﺮ‬
‫‪13‬‬ ‫‪13‬‬ ‫‪12‬‬ ‫‪10‬‬ ‫‪9‬‬ ‫‪9‬‬ ‫ﺍﳍﻨﺪ‬
‫‪1776‬‬ ‫‪1699‬‬ ‫‪1515‬‬ ‫‪1527‬‬ ‫‪1510‬‬ ‫‪1321‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪1540‬‬ ‫‪1443‬‬ ‫‪1343‬‬ ‫‪1455‬‬ ‫‪1365‬‬ ‫‪1277‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪26‬‬ ‫‪31‬‬ ‫‪31‬‬ ‫‪30‬‬ ‫‪30‬‬ ‫‪28‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪401‬‬ ‫‪330‬‬ ‫‪294‬‬ ‫‪271‬‬ ‫‪238‬‬ ‫‪196‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪293‬‬ ‫‪245‬‬ ‫‪263‬‬ ‫‪284‬‬ ‫‪277‬‬ ‫‪300‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪541‬‬ ‫‪542‬‬ ‫‪576‬‬ ‫‪512‬‬ ‫‪506‬‬ ‫‪536‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪280‬‬ ‫‪272‬‬ ‫‪262‬‬ ‫‪294‬‬ ‫‪296‬‬ ‫‪271‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪369‬‬ ‫‪348‬‬ ‫‪316‬‬ ‫‪280‬‬ ‫‪234‬‬ ‫‪186‬‬ ‫ﺗﻮﻧﺲ‬
‫‪1437‬‬ ‫‪1340‬‬ ‫‪1223‬‬ ‫‪1184‬‬ ‫‪1179‬‬ ‫‪1103‬‬ ‫ﺇﳒﻠﺘﺮﺍ‬
‫‪1992‬‬ ‫‪1883‬‬ ‫‪1810‬‬ ‫‪1767‬‬ ‫‪1714‬‬ ‫‪1639‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ – ‪٢٠٠٢‬‬

‫‪١٦٥‬‬
 ‫ﺏ‪ :٣-‬ﺗﻮﺯﻳﻊ ﻓﺮﻳﻖ ﺍﻟﻌﻤﻞ ﺑﺎﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(١٠-١‬ﺗﻮﺯﻳﻊ ﻓﺮﻳﻖ ﺍﻟﻌﻤﻞ ﺑﺎﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﲟﻨﺎﻃﻖ ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ )ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻓﻘﻂ(‬
‫ﻟﻜﻞ ‪ ١٠٠‬ﺁﻟﻒ ﻧﺴﻤﺔ‪.‬‬
‫ﲤﺮﻳﺾ‬ ‫ﺃﻃﺒﺎﺀ‬ ‫ﺍﻟﻨﻄﺎﻕ ﺍﳉﻐﺮﺍﰲ‬
‫‪99‬‬ ‫‪99‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪143‬‬ ‫‪67.4‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪89‬‬ ‫‪56‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫‪212‬‬ ‫‪110‬‬ ‫ﺍﳊﺪﻭﺩ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٩/١٩٩٨‬‬

‫ﺟﺪﻭﻝ )‪ :(١١-١‬ﺗﻮﺯﻳﻊ ﻓﺮﻳﻖ ﺍﻟﻌﻤﻞ ﺑﺎﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﲟﺼﺮ ﻟﻜﻞ ‪ ١٠٠‬ﺁﻟﻒ ﻧﺴﻤﺔ )‪– ١٩٨٠‬‬
‫‪.(١٩٩٨‬‬
‫ﻣﻼﺣﻈﺎﺕ‬ ‫ﺍﳌﺼﺪﺭ‬ ‫ﲤﺮﻳﺾ‬ ‫ﺃﻃﺒﺎﺀ‬ ‫ﺍﻟﻌﺎﻡ‬
‫‪١‬‬ ‫‪..‬‬ ‫‪110‬‬ ‫‪١٩٨٠‬‬
‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻓﻘﻂ‬ ‫‪2‬‬ ‫‪91‬‬ ‫‪54‬‬ ‫‪١٩٨٢‬‬
‫‪3‬‬ ‫‪125‬‬ ‫‪125‬‬ ‫‪١٩٨٤‬‬
‫‪٤‬‬ ‫‪128.2‬‬ ‫‪129.8‬‬ ‫‪١٩٨٤-١٩٨٩‬‬
‫‪١‬‬ ‫‪..‬‬ ‫‪160‬‬ ‫‪١٩٩٠-١٩٩٩‬‬
‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻓﻘﻂ‬ ‫‪٢‬‬ ‫‪86‬‬ ‫‪65‬‬ ‫‪١٩٩٤‬‬
‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻓﻘﻂ‬ ‫‪٥‬‬ ‫‪116‬‬ ‫‪69‬‬ ‫‪١٩٩٨‬‬
‫‪ ..‬ﱂ ﻳﺬﻛﺮ‬
‫‪ .٣‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻌﺎﳌﻲ )‪.(١٩٩٠‬‬ ‫‪ .٢‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٦‬‬ ‫‪ .١‬ﻣﺆﺷﺮﺍﺕ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﻌﺎﳌﻴﺔ – ﺍﻟﺒﻨﻚ ﺍﻟﺪﻭﱄ )‪(٢٠٠٢‬‬
‫‪ .٥‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(٢٠٠١‬‬ ‫‪ .٤‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻌﺎﳌﻲ )‪.(١٩٩٣‬‬

‫ﺟﺪﻭﻝ )‪ :(١٢-١‬ﺗﻮﺯﻳﻊ ﻓﺮﻳﻖ ﺍﻟﻌﻤﻞ ﺑﺎﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﻣﻊ ﺩﻭﻝ ﺃﺧﺮﻯ ﻟﻜﻞ ‪ ١٠٠‬ﺃﻟﻒ‬
‫ﻧﺴﻤﺔ‪.‬‬
‫ﺃﻃﺒﺎﺀ‬ ‫ﺃﻃﺒﺎﺀ‬
‫ﺍﻟﺪﻭﻟﺔ‬
‫ﻋﺎﻡ‬ ‫ﺻﻴﺎﺩﻟﺔ‬ ‫ﻋﺎﻡ‬ ‫ﺃﺳﻨﺎﻥ‬ ‫ﻋﺎﻡ‬ ‫ﻗﺎﺑﻼﺕ‬ ‫ﻋﺎﻡ‬ ‫ﲤﺮﻳﺾ‬ ‫ﻋﺎﻡ‬ ‫ﺑﺸﺮﻳﲔ‬
‫…‬ ‫…‬ ‫‪1996‬‬ ‫‪85.1‬‬ ‫…‬ ‫…‬ ‫‪1996‬‬ ‫‪41.3‬‬ ‫‪1996‬‬ ‫‪127.2‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫…‬ ‫…‬ ‫…‬ ‫…‬ ‫‪1998‬‬ ‫‪3.9‬‬ ‫‪1998‬‬ ‫‪98.6‬‬ ‫‪1998‬‬ ‫‪161.7‬‬ ‫ﺍﻟﺼﲔ‬
‫…‬ ‫…‬ ‫‪1997‬‬ ‫‪84.5‬‬ ‫…‬ ‫…‬ ‫‪1997‬‬ ‫‪677.6‬‬ ‫‪1997‬‬ ‫‪530.4‬‬ ‫ﻛﻮﺑﺎ‬
‫‪1996‬‬ ‫‪56‬‬ ‫‪1996‬‬ ‫‪25‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪1996‬‬ ‫‪233‬‬ ‫‪1996‬‬ ‫‪202‬‬ ‫ﻣﺼﺮ‬
‫…‬ ‫…‬ ‫…‬ ‫…‬ ‫…‬ ‫…‬ ‫‪1992‬‬ ‫‪45‬‬ ‫‪1992‬‬ ‫‪48‬‬ ‫ﺍﳍﻨﺪ‬
‫‪1998‬‬ ‫‪60.5‬‬ ‫‪1998‬‬ ‫‪116‬‬ ‫‪1998‬‬ ‫‪18.6‬‬ ‫‪1998‬‬ ‫‪613‬‬ ‫‪1998‬‬ ‫‪385‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫…‬ ‫…‬ ‫‪1996‬‬ ‫‪68.6‬‬ ‫‪1996‬‬ ‫‪18.9‬‬ ‫‪1996‬‬ ‫‪744.9‬‬ ‫‪1996‬‬ ‫‪193.2‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫…‬ ‫…‬ ‫‪1995‬‬ ‫‪2.2‬‬ ‫…‬ ‫…‬ ‫‪1995‬‬ ‫‪90.1‬‬ ‫‪1995‬‬ ‫‪13.2‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫…‬ ‫…‬ ‫‪1997‬‬ ‫‪33.4‬‬ ‫…‬ ‫…‬ ‫‪1997‬‬ ‫‪291.2‬‬ ‫‪1997‬‬ ‫‪136.1‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪1998‬‬ ‫‪6.2‬‬ ‫‪1998‬‬ ‫‪32.2‬‬ ‫‪1998‬‬ ‫‪62.5‬‬ ‫‪1998‬‬ ‫‪821‬‬ ‫‪1998‬‬ ‫‪421‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪1997‬‬ ‫‪21‬‬ ‫‪1997‬‬ ‫‪16‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪1997‬‬ ‫‪330‬‬ ‫‪1997‬‬ ‫‪166‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫…‬ ‫…‬ ‫‪1996‬‬ ‫‪17.8‬‬ ‫…‬ ‫…‬ ‫‪1996‬‬ ‫‪471.8‬‬ ‫‪1996‬‬ ‫‪56.3‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬

‫‪١٦٦‬‬
 ‫ﺃﻃﺒﺎﺀ‬ ‫ﺃﻃﺒﺎﺀ‬
‫ﺍﻟﺪﻭﻟﺔ‬
‫ﻋﺎﻡ‬ ‫ﺻﻴﺎﺩﻟﺔ‬ ‫ﻋﺎﻡ‬ ‫ﺃﺳﻨﺎﻥ‬ ‫ﻋﺎﻡ‬ ‫ﻗﺎﺑﻼﺕ‬ ‫ﻋﺎﻡ‬ ‫ﲤﺮﻳﺾ‬ ‫ﻋﺎﻡ‬ ‫ﺑﺸﺮﻳﲔ‬
‫‪1997‬‬ ‫‪17‬‬ ‫‪1997‬‬ ‫‪13‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪1997‬‬ ‫‪286‬‬ ‫‪1997‬‬ ‫‪70‬‬ ‫ﺗﻮﻧﺲ‬
‫‪1992‬‬ ‫‪58.2‬‬ ‫‪1992‬‬ ‫‪39.8‬‬ ‫‪1989‬‬ ‫‪43.3‬‬ ‫‪1989‬‬ ‫‪497‬‬ ‫‪1993‬‬ ‫‪164‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫…‬ ‫…‬ ‫‪1996‬‬ ‫‪59.8‬‬ ‫…‬ ‫…‬ ‫‪1996‬‬ ‫‪972‬‬ ‫‪1995‬‬ ‫‪279‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻹﺣﺼﺎﺋﻲ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(WHOSIS‬‬

‫‪$% "& '(")  .2‬‬

‫ﺃ‪.‬ﻣﻌﺪﻻﺕ ﺍﻟﻨﻤﻮ ﺍﻟﺴﻜﺎﱐ )ﻣﻌﺪﻻﺕ ﺍﳌﻮﺍﻟﻴﺪ – ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ – ﻣﻌﺪﻝ‬
‫ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ(‬
‫ﺟﺪﻭﻝ )‪ :(١-٢‬ﻣﻌﺪﻻﺕ ﺍﳌﻮﺍﻟﻴﺪ ﻭﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ ﻭﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ ﲟﻨﺎﻃﻖ ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ ﻋﺎﻡ‬
‫‪١٩٩٨‬‬
‫ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ‬ ‫ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ‬ ‫ﻣﻌﺪﻝ ﺍﳌﻮﺍﻟﻴﺪ‬
‫ﺍﻟﻨﻄﺎﻕ ﺍﳉﻐﺮﺍﰲ )ﻋﺎﻡ ‪(١٩٩٨‬‬
‫)‪(%‬‬ ‫)ﻟﻜﻞ ‪ ١٠٠٠‬ﻧﺴﻤﺔ(‬ ‫)ﻟﻜﻞ ‪ ١٠٠٠‬ﻧﺴﻤﺔ(‬
‫‪1.66‬‬ ‫‪6.7‬‬ ‫‪23.3‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪1.99‬‬ ‫‪5.9‬‬ ‫‪25.8‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪2.44‬‬ ‫‪7.2‬‬ ‫‪31.6‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫‪2.62‬‬ ‫‪4.2‬‬ ‫‪30.4‬‬ ‫ﺍﳊﺪﻭﺩ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٩/١٩٩٨‬‬

‫ﺟﺪﻭﻝ )‪ :(٢-٢‬ﻣﻌﺪﻻﺕ ﺍﳌﻮﺍﻟﻴﺪ ﻭﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ ﻭﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ ﲟﺼﺮ )‪.(٢٠٠١ -١٩٦٠‬‬
‫ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ‬ ‫ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ‬ ‫ﻣﻌﺪﻝ ﺍﳌﻮﺍﻟﻴﺪ‬
‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﻟﻌﺎﻡ‬
‫ﺍﻟﻄﺒﻴﻌﻴﺔ )‪(%‬‬ ‫)ﻟﻜﻞ ‪ ١٠٠٠‬ﻧﺴﻤﺔ( )ﻟﻜﻞ ‪ ١٠٠٠‬ﻧﺴﻤﺔ(‬
‫‪١‬‬ ‫‪2.4‬‬ ‫‪21‬‬ ‫‪45‬‬ ‫‪١٩٦٠‬‬
‫‪١‬‬ ‫‪2.3‬‬ ‫‪17‬‬ ‫‪40‬‬ ‫‪١٩٧٠‬‬
‫‪١‬‬ ‫‪2.1‬‬ ‫‪10‬‬ ‫‪31‬‬ ‫‪١٩٩١‬‬
‫‪٢‬‬ ‫‪2‬‬ ‫‪8‬‬ ‫‪28‬‬ ‫‪١٩٩٥‬‬
‫‪٣‬‬ ‫‪2‬‬ ‫‪7‬‬ ‫‪27‬‬ ‫‪١٩٩٦‬‬
‫‪٤‬‬ ‫‪1.9‬‬ ‫‪7‬‬ ‫‪26‬‬ ‫‪١٩٩٧‬‬
‫‪٥‬‬ ‫‪1.9‬‬ ‫‪7‬‬ ‫‪26‬‬ ‫‪١٩٩٨‬‬
‫‪٦‬‬ ‫‪1.9‬‬ ‫‪7‬‬ ‫‪26‬‬ ‫‪١٩٩٩‬‬
‫‪٧‬‬ ‫‪1.8‬‬ ‫‪6‬‬ ‫‪24‬‬ ‫‪٢٠٠١‬‬
‫‪ .٣‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٨‬‬ ‫‪ .٢‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٧‬‬ ‫‪ .١‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٣‬‬
‫‪ .٦‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠١‬‬ ‫‪ .٥‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠٠‬‬ ‫‪ .٤‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٩‬‬
‫‪ .٧‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠٣‬‬

‫‪١٦٧‬‬
 ‫ﺟﺪﻭﻝ )‪ :(٣-٢‬ﻣﻌﺪﻻﺕ ﺍﳌﻮﺍﻟﻴﺪ ﻭﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ ﻭﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ ﲟﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ‪.‬‬
‫ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ‬ ‫ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ‬ ‫ﻣﻌﺪﻝ ﺍﳌﻮﺍﻟﻴﺪ‬
‫)‪(%‬‬ ‫)ﻟﻜﻞ ‪ ١٠٠٠‬ﻧﺴﻤﺔ(‬ ‫)ﻟﻜﻞ ‪ ١٠٠٠‬ﻧﺴﻤﺔ(‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪2001‬‬ ‫‪1997‬‬ ‫‪1970‬‬ ‫‪2001‬‬ ‫‪1997‬‬ ‫‪1970‬‬ ‫‪2001‬‬ ‫‪1997‬‬ ‫‪1970‬‬
‫‪1.4‬‬ ‫‪1.4‬‬ ‫‪2‬‬ ‫‪6‬‬ ‫‪6‬‬ ‫‪7‬‬ ‫‪20‬‬ ‫‪20‬‬ ‫‪27‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪1.2‬‬ ‫‪1.3‬‬ ‫‪2.4‬‬ ‫‪7‬‬ ‫‪7‬‬ ‫‪11‬‬ ‫‪19‬‬ ‫‪20‬‬ ‫‪35‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪3‬‬ ‫‪3‬‬ ‫‪3‬‬ ‫‪4‬‬ ‫‪4‬‬ ‫‪18‬‬ ‫‪34‬‬ ‫‪34‬‬ ‫‪48‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪0.1‬‬ ‫‪0.2‬‬ ‫‪1.2‬‬ ‫‪8‬‬ ‫‪8‬‬ ‫‪7‬‬ ‫‪9‬‬ ‫‪10‬‬ ‫‪19‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪1.1‬‬ ‫‪1.8‬‬ ‫‪2.6‬‬ ‫‪7‬‬ ‫‪6‬‬ ‫‪14‬‬ ‫‪18‬‬ ‫‪24‬‬ ‫‪40‬‬ ‫ﺗﻮﻧﺲ‬
‫‪1‬‬ ‫‪2.2‬‬ ‫‪2.4‬‬ ‫‪15‬‬ ‫‪8‬‬ ‫‪14‬‬ ‫‪25‬‬ ‫‪30‬‬ ‫‪38‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪0.7‬‬ ‫‪0.9‬‬ ‫‪2.2‬‬ ‫‪6‬‬ ‫‪6‬‬ ‫‪9‬‬ ‫‪13‬‬ ‫‪15‬‬ ‫‪31‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪2.2‬‬ ‫‪2.6‬‬ ‫‪3.5‬‬ ‫‪13‬‬ ‫‪11‬‬ ‫‪17‬‬ ‫‪35‬‬ ‫‪37‬‬ ‫‪52‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪1.8‬‬ ‫‪1.9‬‬ ‫‪2.3‬‬ ‫‪6‬‬ ‫‪7‬‬ ‫‪17‬‬ ‫‪24‬‬ ‫‪26‬‬ ‫‪40‬‬ ‫ﻣﺼﺮ‬

‫ﺏ‪ .‬ﻣﺆﺷﺮﺍﺕ ﺍﻗﺘﺼﺎﺩﻳﺔ‬

‫ﺏ‪ :١-‬ﺇﲨﺎﱄ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ ﻭﻧﺼﻴﺐ ﺍﻟﻔﺮﺩ ﻣﻦ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٤-٢‬ﺇﲨﺎﱄ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ )ﺑﻠﻴﻮﻥ ﺩﻭﻻﺭ ﺃﻣﲑﻛﻲ( ﻭﻧﺼﻴﺐ ﺍﻟﻔﺮﺩ ﻣﻦ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ )ﺩﻭﻻﺭ‬
‫ﺃﻣﲑﻛﻲ( ﲟﺼﺮ ﻋﺎﻡ ‪ ٢٠٠٠‬ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ‬
‫ﻧﺼﻴﺐ ﺍﻟﻔﺮﺩ ﻣﻦ ﺍﻟﺪﺧﻞ‬ ‫ﺇﲨﺎﱄ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ )ﺑﻠﻴﻮﻥ‬
‫ﺍﻟﺪﻭﻟﺔ‬
‫ﺍﻟﻘﻮﻣﻲ‬ ‫ﺩﻭﻻﺭ ﺃﻣﲑﻛﻲ( )‪(٢٠٠٠‬‬
‫‪34,142‬‬ ‫‪9,837.4‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫‪26,755‬‬ ‫‪4,841.6‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪23,509‬‬ ‫‪1,414.6‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪20,131‬‬ ‫‪110.4‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪17,380‬‬ ‫‪457.2‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪8,377‬‬ ‫‪251.1‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪11,367‬‬ ‫‪173.3‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪7,625‬‬ ‫‪595.5‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪3,976‬‬ ‫‪1,080.0‬‬ ‫ﺍﻟﺼﲔ‬
‫‪6,363‬‬ ‫‪19.5‬‬ ‫ﺗﻮﻧﺲ‬
‫‪9,401‬‬ ‫‪125.9‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪3,635‬‬ ‫‪98.7‬‬ ‫ﻣﺼﺮ‬
‫‪2,358‬‬ ‫‪457.0‬‬ ‫ﺍﳍﻨﺪ‬
‫‪1,022‬‬ ‫‪10.4‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(٢٠٠٢‬‬

‫‪١٦٨‬‬
 ‫ﺏ‪ :٢-‬ﺃﻭﻟﻮﻳﺎﺕ ﺃﻧﻔﺎﻕ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٥-٢‬ﺃﻭﻟﻮﻳﺎﺕ ﺃﻧﻔﺎﻕ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ ﲟﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ‪.‬‬
‫ﺍﻻﻧﻔﺎﻕ ﺍﻟﻌﺎﻡ ﻋﻠﻰ‬ ‫ﺍﻻﻧﻔﺎﻕ ﺍﻟﻌﺎﻡ ﻋﻠﻰ‬
‫‪Total debt‬‬
‫‪service‬‬ ‫ﺍﻻﻧﻔﺎﻕ ﺍﻟﻌﺴﻜﺮﻱ )‪%‬‬ ‫ﺍﻟﺼﺤﺔ )‪ %‬ﻣﻦ ﺍﻟﺪﺧﻞ‬ ‫ﺍﻟﺘﻌﻠﻴﻢ )‪ %‬ﻣﻦ ﺍﻟﺪﺧﻞ‬
‫ﺍﻟﺪﻭﻟﺔ‬
‫)‪(as % or GDP‬‬ ‫ﻣﻦ ﺍﻟﺪﺧﻞ ﺍﻟﻘﻮﻣﻲ(‬ ‫ﺍﻟﻘﻮﻣﻲ(‬ ‫ﺍﻟﻘﻮﻣﻲ(‬
‫‪2000‬‬ ‫‪1990‬‬ ‫‪2000‬‬ ‫‪1990‬‬ ‫‪1998‬‬ ‫‪1990‬‬ ‫‪١٩٩٧-١٩٩٥ ١٩٨٧-١٩٨٥‬‬
‫‪..‬‬ ‫‪..‬‬ ‫‪3.1‬‬ ‫‪5.3‬‬ ‫‪5.7‬‬ ‫‪4.7‬‬ ‫‪5.4‬‬ ‫‪5.0‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪1.0‬‬ ‫‪0.9‬‬ ‫‪5.7‬‬ ‫‪4.6‬‬ ‫‪3.6‬‬ ‫‪..‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪2.5‬‬ ‫‪3.9‬‬ ‫‪5.8‬‬ ‫‪5.1‬‬ ‫‪5.3‬‬ ‫‪4.8‬‬ ‫ﺇﳒﻠﺘﺮﺍ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪8.0‬‬ ‫‪12.2‬‬ ‫‪6.0‬‬ ‫‪3.8‬‬ ‫‪7.6‬‬ ‫‪6.7‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪5.1‬‬ ‫‪3.3‬‬ ‫‪2.8‬‬ ‫‪3.7‬‬ ‫‪2.4‬‬ ‫‪1.8‬‬ ‫‪3.7‬‬ ‫‪3.8‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪4.9‬‬ ‫‪6.7‬‬ ‫‪6.8‬‬ ‫ﻛﻮﺑﺎ‬
‫‪4.6‬‬ ‫‪2.0‬‬ ‫‪4.0‬‬ ‫‪12.3‬‬ ‫‪..‬‬ ‫‪2.5‬‬ ‫‪3.5‬‬ ‫‪3.4‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪11.6‬‬ ‫‪12.8‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪7.5‬‬ ‫‪7.4‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪10.5‬‬ ‫‪1.8‬‬ ‫‪1.3‬‬ ‫‪1.9‬‬ ‫‪2.9‬‬ ‫‪3.0‬‬ ‫‪5.1‬‬ ‫‪4.7‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪2.0‬‬ ‫‪2.0‬‬ ‫‪2.1‬‬ ‫‪2.7‬‬ ‫‪2.1‬‬ ‫‪2.2‬‬ ‫‪2.3‬‬ ‫‪2.3‬‬ ‫ﺍﻟﺼﲔ‬
‫‪9.8‬‬ ‫‪11.6‬‬ ‫‪1.7‬‬ ‫‪2.0‬‬ ‫‪2.2‬‬ ‫‪3.0‬‬ ‫‪7.7‬‬ ‫‪6.2‬‬ ‫ﺗﻮﻧﺲ‬
‫‪3.1‬‬ ‫‪..‬‬ ‫‪1.5‬‬ ‫‪3.8‬‬ ‫‪3.3‬‬ ‫‪3.1‬‬ ‫‪7.6‬‬ ‫‪6.1‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪1.8‬‬ ‫‪7.1‬‬ ‫‪2.3‬‬ ‫‪3.5‬‬ ‫‪..‬‬ ‫‪1.8‬‬ ‫‪4.8‬‬ ‫‪4.5‬‬ ‫ﻣﺼﺮ‬
‫‪2.2‬‬ ‫‪2.6‬‬ ‫‪2.4‬‬ ‫‪2.7‬‬ ‫‪..‬‬ ‫‪0.9‬‬ ‫‪3.2‬‬ ‫‪3.2‬‬ ‫ﺍﳍﻨﺪ‬
‫‪4.6‬‬ ‫‪9.3‬‬ ‫‪1.8‬‬ ‫‪2.9‬‬ ‫‪2.4‬‬ ‫‪2.4‬‬ ‫‪6.5‬‬ ‫‪7.1‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(٢٠٠٢‬‬

‫ﺟـ‪ .‬ﻣﺆﺷﺮﺍﺕ ﺍﻟﺘﻌﻠﻴﻢ‬

‫ﺟﺪﻭﻝ )‪ :(٦-٢‬ﻣﻌﺪﻻﺕ ﺗﻌﻠﻴﻢ ﺍﻟﺒﺎﻟﻐﲔ )ﺍﻛﱪ ﻣﻦ ‪ ١٥‬ﻋﺎﻣﺎﹰ( ﲟﻨﺎﻃﻖ ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ ﻋﺎﻡ ‪.١٩٩٨‬‬
‫‪١٩٩٩-١٩٩٨‬‬ ‫ﺍﻟﻨﻄﺎﻕ ﺍﳉﻐﺮﺍﰲ‬

‫‪75‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬

‫‪57‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬

‫‪47.8‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬

‫‪70.1‬‬ ‫ﺍﳊﺪﻭﺩ‬

‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٩‬‬

‫ﺟﺪﻭﻝ )‪ :(٧-٢‬ﻣﻌﺪﻻﺕ ﺃﻣﻴﺔ ﺍﻟﺒﺎﻟﻐﲔ )ﺍﻛﱪ ﻣﻦ ‪ ١٥‬ﻋﺎﻣﺎﹰ( ﰲ ﻣﺼﺮ )‪.(٢٠٠٠ – ١٩٧٠‬‬

‫ﻋﺪﺩ ﺍﻷﻓﺮﺍﺩ ﺍﻷﻣﻴﲔ )‪(١٠٠٠‬‬ ‫ﻧﺴﺒﺔ ﺍﻷﻣﻴﲔ )‪(%‬‬
‫ﺍﻟﻌﺎﻡ‬
‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﻛﻠﻲ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﻛﻠﻲ‬
‫‪8,617‬‬ ‫‪5,533‬‬ ‫‪14,150‬‬ ‫‪83.2‬‬ ‫‪53.6‬‬ ‫‪68.4‬‬ ‫‪١٩٧٠‬‬
‫‪9,909‬‬ ‫‪6,154‬‬ ‫‪16,063‬‬ ‫‪75.3‬‬ ‫‪46.3‬‬ ‫‪60.7‬‬ ‫‪١٩٨٠‬‬
‫‪11,116‬‬ ‫‪6,752‬‬ ‫‪17,866‬‬ ‫‪66.4‬‬ ‫‪39.6‬‬ ‫‪52.9‬‬ ‫‪١٩٩٠‬‬
‫‪11,669‬‬ ‫‪7,025‬‬ ‫‪18,687‬‬ ‫‪61.5‬‬ ‫‪36.5‬‬ ‫‪48.9‬‬ ‫‪١٩٩٥‬‬
‫‪12,253‬‬ ‫‪7,374‬‬ ‫‪19,613‬‬ ‫‪56.2‬‬ ‫‪33.4‬‬ ‫‪44.7‬‬ ‫‪٢٠٠٠‬‬
‫ﻣﻮﻗﻊ ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻟﻴﻮﻧﺴﻜﻮ )‪.(www.uis.unesco.org‬‬

‫‪١٦٩‬‬
 ‫ﺟﺪﻭﻝ )‪ :(٨-٢‬ﻣﻌﺪﻻﺕ ﺃﻣﻴﺔ ﺍﻟﺒﺎﻟﻐﲔ )ﺍﻛﱪ ﻣﻦ ‪ ١٥‬ﻋﺎﻣﺎﹰ( ﰲ ﻣﺼﺮ ﻣﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ )ﻋﺎﻡ ‪(٢٠٠٠‬‬
‫ﻋﺪﺩ ﺍﻷﻓﺮﺍﺩ ﺍﻷﻣﻴﲔ )‪(١٠٠٠‬‬ ‫ﻧﺴﺒﺔ ﺍﻷﻣﻴﲔ )‪(%‬‬
‫ﺍﻟﺪﻭﻟﺔ‬
‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﻛﻠﻲ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﻛﻠﻲ‬
‫‪8,195‬‬ ‫‪7,690‬‬ ‫‪15,885‬‬ ‫‪13.2‬‬ ‫‪13.0‬‬ ‫‪13.1‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪103,499‬‬ ‫‪38,424‬‬ ‫‪141,903‬‬ ‫‪22.1‬‬ ‫‪7.9‬‬ ‫‪14.8‬‬ ‫ﺍﻟﺼﲔ‬
‫‪153‬‬ ‫‪141‬‬ ‫‪294‬‬ ‫‪3.4‬‬ ‫‪3.2‬‬ ‫‪3.3‬‬ ‫ﻛﻮﺑﺎ‬
‫‪12,253‬‬ ‫‪7,374‬‬ ‫‪19,613‬‬ ‫‪56.2‬‬ ‫‪33.4‬‬ ‫‪44.7‬‬ ‫ﻣﺼﺮ‬
‫‪177,689‬‬ ‫‪109,367‬‬ ‫‪286,951‬‬ ‫‪54.6‬‬ ‫‪31.6‬‬ ‫‪42.8‬‬ ‫ﺍﳍﻨﺪ‬
‫‪162‬‬ ‫‪64‬‬ ‫‪225‬‬ ‫‪7.3‬‬ ‫‪3.0‬‬ ‫‪5.2‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪2,102‬‬ ‫‪954‬‬ ‫‪3,049‬‬ ‫‪24.0‬‬ ‫‪11.1‬‬ ‫‪17.6‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪673‬‬ ‫‪159‬‬ ‫‪831‬‬ ‫‪3.6‬‬ ‫‪0.9‬‬ ‫‪2.2‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪376‬‬ ‫‪159‬‬ ‫‪535‬‬ ‫‪0.6‬‬ ‫‪0.3‬‬ ‫‪0.4‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪1,723‬‬ ‫‪1,092‬‬ ‫‪2,760‬‬ ‫‪33.1‬‬ ‫‪17.0‬‬ ‫‪23.8‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪2,260‬‬ ‫‪1,956‬‬ ‫‪4,217‬‬ ‫‪15.4‬‬ ‫‪14.0‬‬ ‫‪14.8‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪1,307‬‬ ‫‪621‬‬ ‫‪1,928‬‬ ‫‪39.4‬‬ ‫‪18.6‬‬ ‫‪29.0‬‬ ‫ﺗﻮﻧﺲ‬
‫ﻣﻮﻗﻊ ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻟﻴﻮﻧﺴﻜﻮ )‪.(www.uis.unesco.org‬‬

‫‪+   ,-.  .3‬‬

‫ﺃ‪ .‬ﺍﳌﻴﺎﻩ ﺍﻟﻨﻘﻴﺔ ﻭﺍﻟﺼﺮﻑ ﺍﻟﺼﺤﻲ‬
‫ﺟﺪﻭﻝ )‪ :(١-٣‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻮﺣﺪﺍﺕ ﺍﻟﺴﻜﻨﻴﺔ ﺍﳌﺘﺼﻠﺔ ﺑﺎﳌﻴﺎﻩ ﻧﻘﻴﺔ ﻭﺍﻟﺼﺮﻑ ﺍﻟﺼﺤﻲ ﰲ ﻣﻨﺎﻃﻖ‬
‫ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ ﻋﺎﻡ ‪.٢٠٠١‬‬
‫ﺍﻟﻮﺣﺪﺍﺕ ﺍﳌﺘﺼﻠﺔ ﺑﺎﻟﺼﺮﻑ‬ ‫ﺍﻟﻮﺣﺪﺍﺕ ﺍﳌﺘﺼﻠﺔ ﲟﻴﺎﻩ‬
‫ﺍﻟﺼﺤﻲ )‪(%‬‬ ‫ﻧﻘﻴﺔ )‪(%‬‬ ‫ﺍﻟﻨﻄﺎﻕ ﺍﳉﻐﺮﺍﰲ‬
‫‪99.9‬‬ ‫‪99.8‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪98.2‬‬ ‫‪89.6‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪84.9‬‬ ‫‪85.9‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫‪91.6‬‬ ‫‪90‬‬ ‫ﺍﳊﺪﻭﺩ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(٢٠٠٣‬‬
‫ﺟﺪﻭﻝ )‪ :(٢-٣‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻮﺣﺪﺍﺕ ﺍﻟﺴﻜﻨﻴﺔ ﺍﳌﺘﺼﻠﺔ ﺑﺎﳌﻴﺎﻩ ﻧﻘﻴﺔ ﻭﺍﻟﺼﺮﻑ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ‬
‫)‪(٢٠٠١-١٩٨٠‬‬
‫ﺍﻟﻮﺣﺪﺍﺕ ﺍﳌﺘﺼﻠﺔ‬ ‫ﺍﻟﻮﺣﺪﺍﺕ ﺍﳌﺘﺼﻠﺔ ﲟﻴﺎﻩ‬
‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﻟﻌﺎﻡ‬
‫ﺑﺎﻟﺼﺮﻑ ﺍﻟﺼﺤﻲ )‪(%‬‬ ‫ﻧﻘﻴﺔ )‪(%‬‬
‫‪١‬‬ ‫‪70‬‬ ‫‪75‬‬ ‫‪١٩٨٠‬‬
‫‪٢‬‬ ‫‪54‬‬ ‫‪86‬‬ ‫‪١٩٩٠-١٩٨٨‬‬
‫‪١‬‬ ‫‪..‬‬ ‫‪86‬‬ ‫‪١٩٩٣‬‬
‫‪٣‬‬ ‫‪84.3‬‬ ‫‪83.3‬‬ ‫‪١٩٩٥‬‬
‫‪٤‬‬ ‫‪45.1‬‬ ‫‪82.6‬‬ ‫‪١٩٩٦‬‬
‫‪٥‬‬ ‫‪94.5‬‬ ‫‪87.4‬‬ ‫‪١٩٩٩‬‬
‫‪٦‬‬ ‫‪93.6‬‬ ‫‪91.3‬‬ ‫‪٢٠٠١‬‬
‫‪ .٣‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٦‬‬ ‫‪ .٢‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(١٩٩٣‬‬ ‫‪ .١‬ﻣﺆﺷﺮﺍﺕ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﻌﺎﳌﻴﺔ – ﺍﻟﺒﻨﻚ ﺍﻟﺪﻭﱄ )‪(١٩٩٦‬‬
‫‪ .٦‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(٢٠٠٣‬‬ ‫‪ .٥‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٩‬‬ ‫‪ .٤‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٧‬‬

‫‪١٧٠‬‬
‫ﺟﺪﻭﻝ )‪ :(٣-٣‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﺴﻜﺎﻥ ﺍﻟﺬﻳﻦ ﻳﺼﻠﻬﻢ ﻣﻴﺎﻩ ﻧﻘﻴﺔ ﻭﺻﺮﻑ ﺻﺤﻲ ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ‬
‫ﺑﺪﻭﻝ ﺍﺧﺮﻯ )ﻋﺎﻡ ‪.(٢٠٠٠‬‬
‫ﻧﺴﺒﺔ ﺍﻟﺴﻜﺎﻥ ﺍﻟﺬﻳﻦ‬ ‫ﻧﺴﺒﺔ ﺍﻟﺴﻜﺎﻥ ﺍﻟﺬﻳﻦ‬
‫ﺍﻟﺪﻭﻟﺔ‬
‫ﻳﺴﺘﺨﺪﻣﻮﻥ ﳌﺎﺀ ﻧﻘﻲ )‪(%‬‬ ‫ﻳﺴﺘﺨﺪﻣﻮﻥ ﺻﺮﻑ ﺻﺤﻲ )‪(%‬‬
‫‪87‬‬ ‫‪77‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪75‬‬ ‫‪38‬‬ ‫ﺍﻟﺼﲔ‬
‫‪95‬‬ ‫‪95‬‬ ‫ﻛﻮﺑﺎ‬
‫‪95‬‬ ‫‪94‬‬ ‫ﻣﺼﺮ‬
‫‪88‬‬ ‫‪31‬‬ ‫ﺍﳍﻨﺪ‬
‫‪..‬‬ ‫‪..‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪..‬‬ ‫‪..‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪49‬‬ ‫‪86‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪92‬‬ ‫‪63‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪99‬‬ ‫‪..‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪95‬‬ ‫‪100‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪86‬‬ ‫‪86‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪..‬‬ ‫‪..‬‬ ‫ﺗﻮﻧﺲ‬
‫‪100‬‬ ‫‪100‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪100‬‬ ‫‪100‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(٢٠٠٢‬‬

‫ﺏ‪ .‬ﺍﻟﺘﻄﻌﻴﻢ‬
‫ﺟﺪﻭﻝ )‪ :(٤-٣‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻸﻃﻔﺎﻝ ﺍﻛﱪ ﻣﻦ ﺳﻨﺔ ﻭﺗﻠﻘﻮﺍ ﻛﺎﻓﺔ ﺍﻟﺘﻄﻌﻴﻤﺎﺕ ﲟﻨﺎﻃﻖ ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ‪.‬‬
‫‪) %‬ﻋﺎﻡ ‪(١٩٩٨‬‬ ‫ﺍﻟﻨﻄﺎﻕ ﺍﳉﻐﺮﺍﰲ‬
‫‪97.3‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪82.4‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪81.2‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫‪..‬‬ ‫ﺍﳊﺪﻭﺩ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٩/١٩٩٨‬‬

‫ﺟﺪﻭﻝ )‪ :(٥-٣‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﺘﻄﻌﻴﻢ ﺍﻷﻃﻔﺎﻝ ﺍﻛﱪ ﻣﻦ ﺳﻦ ﻋﺎﻡ ﻣﻨﺬ ‪ ١٩٨٧‬ﻭﺣﱴ ‪.٢٠٠١‬‬
‫ﺗﻠﻘﻮﺍ ﺍﻟﺘﻄﻌﻴﻢ‬ ‫ﺗﻠﻘﻮﺍ ﺍﻟﺘﻄﻌﻴﻢ‬ ‫ﺗﻠﻘﻮﺍ ﻛﺎﻓﺔ‬
‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﻟﻌﺎﻡ‬
‫ﺿﺪ ﺍﳊﺼﺒﺔ )‪(%‬‬ ‫ﺿﺪ ﺍﻟﺪﺭﻥ )‪(%‬‬ ‫ﺍﻟﺘﻄﻌﻴﻤﺎﺕ )‪(%‬‬
‫‪..‬‬ ‫‪..‬‬ ‫‪1‬‬ ‫‪85‬‬ ‫‪١٩٨٧‬‬
‫‪..‬‬ ‫‪..‬‬ ‫‪2‬‬ ‫‪87‬‬ ‫‪١٩٩١-١٩٨٩‬‬
‫‪٣‬‬ ‫‪93‬‬ ‫‪٣‬‬ ‫‪93‬‬ ‫‪..‬‬ ‫‪١٩٩١-١٩٩٠‬‬
‫‪٤‬‬ ‫‪90‬‬ ‫‪٤‬‬ ‫‪95‬‬ ‫‪..‬‬ ‫‪١٩٩٥-١٩٩٢‬‬
‫‪٥‬‬ ‫‪77‬‬ ‫‪٥‬‬ ‫‪91‬‬ ‫‪..‬‬ ‫‪١٩٩٦-١٩٩٥‬‬
‫‪٦‬‬ ‫‪92‬‬ ‫‪٦‬‬ ‫‪98‬‬ ‫‪..‬‬ ‫‪١٩٩٧-١٩٩٥‬‬
‫‪٧‬‬ ‫‪98‬‬ ‫‪٧‬‬ ‫‪97‬‬ ‫‪..‬‬ ‫‪١٩٩٨-١٩٩٥‬‬

‫‪١٧١‬‬
 ‫‪٨‬‬ ‫‪97‬‬ ‫‪٨‬‬ ‫‪99‬‬ ‫‪..‬‬ ‫‪١٩٩٩-١٩٩٧‬‬
‫‪..‬‬ ‫‪..‬‬ ‫‪٩‬‬ ‫‪84.3‬‬ ‫‪١٩٩٨‬‬
‫‪١٠‬‬ ‫‪95‬‬ ‫‪١٠‬‬ ‫‪99‬‬ ‫‪..‬‬ ‫‪١٩٩٩‬‬
‫‪..‬‬ ‫‪..‬‬ ‫‪٩‬‬ ‫‪97.9‬‬ ‫‪٢٠٠١‬‬
‫‪ .٣‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٣‬‬ ‫‪ .٢‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(١٩٩٣‬‬ ‫‪ .١‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(١٩٩٠‬‬
‫‪ .٦‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ –ﺍﻟﻌﺎﱂ )‪.(١٩٩٩‬‬ ‫‪ .٥‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٨‬‬ ‫‪ .٤‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٧‬‬
‫‪ .٩‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(٢٠٠٣‬‬ ‫‪ .٨‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ –ﺍﻟﻌﺎﱂ )‪.(٢٠٠١‬‬ ‫‪ .٧‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ –ﺍﻟﻌﺎﱂ )‪.(٢٠٠٠‬‬
‫‪ .١٠‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ –ﺍﻟﻌﺎﱂ )‪.(٢٠٠٢‬‬

‫ﺟﺪﻭﻝ )‪ :(٦-٣‬ﻋﺪﺩ ﺣﺎﻻﺕ ﺍﻹﺻﺎﺑﺔ ﺍﳌﺴﺠﻠﺔ ﺑﺎﻣﺮﺍﺽ ﻳﺘﻢ ﺍﻟﺘﻄﻌﻴﻢ ﺿﺪﻫﺎ ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ‬
‫ﺃﺧﺮﻯ )ﻋﺎﻡ ‪.(٢٠٠٠‬‬
‫ﺗﻴﺘﺎﻧﻮﺱ‬
‫ﺍﳊﻤﻰ‬ ‫ﳎﻤﻮ‬ ‫ﺷﻠﻞ‬ ‫ﺍﻟﺴﻌﺎﻝ‬
‫ﺣﺪﻳﺜﻲ‬ ‫ﺣﺼﺒﺔ‬ ‫ﺩﻓﺘﺮﻳﺎ‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫ﺍﻟﺼﻔﺮﺍﺀ‬ ‫ﺍﻟﺘﻴﺘﺎﻧﻮﺱ‬ ‫ﺍﻻﻃﻔﺎﻝ‬ ‫ﺍﻟﺪﻳﻜﻲ‬
‫ﺍﻟﻮﻻﺩﺓ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪1‬‬ ‫ﺃ‬ ‫‪0‬‬ ‫‪434‬‬ ‫‪0‬‬ ‫‪33‬‬ ‫‪0‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪85‬‬ ‫‪447‬‬ ‫‪0‬‬ ‫‪1044‬‬ ‫‪40‬‬ ‫‪38‬‬ ‫‪48‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫ﺃ‬ ‫‪0‬‬ ‫ﺃ‬ ‫‪19‬‬ ‫ﺃ‬ ‫‪0‬‬ ‫ﺃ‬ ‫‪11‬‬ ‫ﺏ‬ ‫‪10‬‬ ‫ﺃ‬ ‫‪2815‬‬ ‫ﺃ‬ ‫‪0‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪0‬‬ ‫‪5561‬‬ ‫‪3230‬‬ ‫‪71093‬‬ ‫‪19‬‬ ‫ﺍﻟﺼﲔ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪6694‬‬ ‫‪265‬‬ ‫‪27851‬‬ ‫‪1679‬‬ ‫‪22236‬‬ ‫‪3094‬‬ ‫ﺍﳍﻨﺪ‬
‫‪0‬‬ ‫‪26‬‬ ‫‪0‬‬ ‫‪6755‬‬ ‫‪0‬‬ ‫‪81‬‬ ‫‪4‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫‪0‬‬ ‫‪90‬‬ ‫‪0‬‬ ‫‪3787‬‬ ‫‪0‬‬ ‫‪22497‬‬ ‫‪1‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪2‬‬ ‫ﺏ‬ ‫‪0‬‬ ‫‪866‬‬ ‫‪0‬‬ ‫‪104‬‬ ‫‪2‬‬ ‫ﺇﳒﻠﺘﺮﺍ‬
‫‪..‬‬ ‫‪..‬‬ ‫‪5‬‬ ‫‪0‬‬ ‫‪1‬‬ ‫‪2‬‬ ‫‪47‬‬ ‫‪0‬‬ ‫ﺗﻮﻧﺲ‬
‫‪0‬‬ ‫‪11‬‬ ‫‪0‬‬ ‫‪8‬‬ ‫‪11‬‬ ‫‪1459‬‬ ‫‪2‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪..‬‬ ‫‪..‬‬ ‫ﺃ‬ ‫‪49‬‬ ‫ﺏ‬ ‫‪0‬‬ ‫ﺃ‬ ‫‪22222‬‬ ‫ﺏ‬ ‫‪40‬‬ ‫ﺃ‬ ‫‪7428‬‬ ‫ﺃ‬ ‫‪838‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪0‬‬ ‫‪1‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫‪0‬‬ ‫ﻛﻮﺑﺎ‬
‫ﺏ‬ ‫‪0‬‬ ‫‪6‬‬ ‫ﺏ‬ ‫‪0‬‬ ‫‪28‬‬ ‫ﺃ‬ ‫‪0‬‬ ‫‪32088‬‬ ‫ﺏ‬ ‫‪0‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪0‬‬ ‫‪628‬‬ ‫‪0‬‬ ‫‪424‬‬ ‫‪1278‬‬ ‫‪21002‬‬ ‫‪15‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫ﺃ‬ ‫‪0‬‬ ‫‪597‬‬ ‫‪4‬‬ ‫‪3‬‬ ‫‪321‬‬ ‫‪2633‬‬ ‫‪0‬‬ ‫ﻣﺼﺮ‬
‫‪ ..‬ﱂ ﻳﺬﻛﺮ‬ ‫ﺏ‪ .‬ﻋﺎﻡ ‪١٩٩٨‬‬ ‫ﺃ‪ .‬ﻋﺎﻡ ‪١٩٩٩‬‬
‫ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻹﺣﺼﺎﺋﻲ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(WHOSIS‬‬

‫‪١٧٢‬‬
 ‫‪+     .4‬‬
‫ﺃ‪ .‬ﺍﻟﻮﻓﻴﺎﺕ‬
‫ﺃ‪ :١-‬ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﺩﻭﻥ ﺳﻦ ﻋﺎﻡ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(١-٤‬ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﺩﻭﻥ ﺳﻦ ﻋﺎﻡ ﲟﻨﺎﻃﻖ ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ ﻋﺎﻡ ‪ ٢٠٠١‬ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ‪.‬‬
‫ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ )ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬ ‫ﺍﻟﻨﻄﺎﻕ ﺍﳉﻐﺮﺍﰲ‬
‫‪22.2‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪25.9‬‬ ‫ﺍﳊﺪﻭﺩ‬
‫‪35.7‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫‪36.6‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(٢٠٠٣‬‬

‫ﺟﺪﻭﻝ )‪ :(٢-٤‬ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﺩﻭﻥ ﺳﻦ ﻋﺎﻡ ﲟﺼﺮ )ﻋﺎﻡ ‪ (٢٠٠١-١٩٩٠‬ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ‪.‬‬
‫ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ )ﻟﻜﻞ‬ ‫ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ )ﻟﻜﻞ‬ ‫ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ )ﻟﻜﻞ‬
‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﳌﺼﺪﺭ‬
‫‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬ ‫‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬ ‫‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬ ‫ﺍﻟﻌﺎﻡ‬
‫‪٢‬‬ ‫‪62‬‬ ‫‪١‬‬ ‫‪76‬‬ ‫‪١٩٩٠‬‬
‫‪3‬‬ ‫‪59‬‬ ‫‪١٩٩١‬‬
‫‪4‬‬ ‫‪62‬‬ ‫‪١٩٩٢‬‬
‫‪6‬‬ ‫‪37‬‬ ‫‪5‬‬ ‫‪82‬‬ ‫‪2‬‬ ‫‪66.1‬‬ ‫‪١٩٩٣‬‬
‫‪7‬‬ ‫‪40‬‬ ‫‪١٩٩٥‬‬
‫‪9‬‬ ‫‪34‬‬ ‫‪٨‬‬ ‫‪57‬‬ ‫‪١٩٩٦‬‬
‫‪١١‬‬ ‫‪54‬‬ ‫‪١٠‬‬ ‫‪54‬‬ ‫‪١٩٩٧‬‬
‫‪13‬‬ ‫‪29.8‬‬ ‫‪٢‬‬ ‫‪43.5‬‬ ‫‪١٢‬‬ ‫‪51‬‬ ‫‪١٩٩٨‬‬
‫‪١٤‬‬ ‫‪41‬‬ ‫‪١٩٩٩‬‬
‫‪1‬‬ ‫‪37‬‬ ‫‪٢٠٠٠‬‬
‫‪١٦‬‬ ‫‪30‬‬ ‫‪15‬‬ ‫‪35‬‬ ‫‪٢٠٠١‬‬
‫‪ .٢‬ﺍﳌﺴﺢ ﺍﻟﺪﳝﻮﺟﺮﺍﰲ ﻭﺍﻟﺼﺤﻲ – ﻣﺼﺮ )‪.(٢٠٠٠‬‬ ‫‪ .١‬ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻟﻴﻮﻧﺴﻴﻒ )‪.(www.childinfo.org‬‬
‫‪ .٤‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٣‬‬ ‫‪ .٣‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻌﺎﳌﻲ )‪.(١٩٩٣‬‬
‫‪ .٦‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻌﺎﳌﻲ )‪.(١٩٩٦‬‬ ‫‪ .٥‬ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(١٩٩٥‬‬
‫‪ .٨‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٨‬‬ ‫‪ .٧‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٧‬‬
‫‪ .١٠‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٩‬‬ ‫‪ .٩‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻌﺎﳌﻲ )‪.(١٩٩٧‬‬
‫‪ .١٢‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠٠‬‬ ‫‪ .١١‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻌﺎﳌﻲ )‪.(١٩٩٩‬‬
‫‪ .١٤‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠١‬‬ ‫‪ .١٣‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ‪ -‬ﻣﺼﺮ )‪.(١٩٩٩‬‬
‫‪ .١٦‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ‪ -‬ﻣﺼﺮ )‪.(٢٠٠٣‬‬ ‫‪ .١٥‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠٣‬‬

‫ﺟﺪﻭﻝ )‪ :(٣-٤‬ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﺩﻭﻥ ﺳﻦ ﻋﺎﻡ ﲟﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ) ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‪.‬‬
‫‪٢٠٠٠‬‬ ‫‪١٩٩٥‬‬ ‫‪١٩٩٠‬‬ ‫‪١٩٨٠‬‬ ‫‪١٩٧٠‬‬ ‫‪١٩٦٠‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪32‬‬ ‫‪41‬‬ ‫‪50‬‬ ‫‪70‬‬ ‫‪95‬‬ ‫‪115‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪32‬‬ ‫‪37‬‬ ‫‪38‬‬ ‫‪49‬‬ ‫‪85‬‬ ‫‪150‬‬ ‫ﺍﻟﺼﲔ‬

‫‪١٧٣‬‬
 ‫‪٢٠٠٠‬‬ ‫‪١٩٩٥‬‬ ‫‪١٩٩٠‬‬ ‫‪١٩٨٠‬‬ ‫‪١٩٧٠‬‬ ‫‪١٩٦٠‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪7‬‬ ‫‪9‬‬ ‫‪12‬‬ ‫‪22‬‬ ‫‪34‬‬ ‫‪39‬‬ ‫ﻛﻮﺑﺎ‬
‫‪37‬‬ ‫‪56‬‬ ‫‪76‬‬ ‫‪119‬‬ ‫‪157‬‬ ‫‪189‬‬ ‫ﻣﺼﺮ‬
‫‪69‬‬ ‫‪74‬‬ ‫‪84‬‬ ‫‪113‬‬ ‫‪127‬‬ ‫‪146‬‬ ‫ﺍﳍﻨﺪ‬
‫‪6‬‬ ‫‪7‬‬ ‫‪10‬‬ ‫‪16‬‬ ‫‪24‬‬ ‫‪32‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪4‬‬ ‫‪4‬‬ ‫‪5‬‬ ‫‪8‬‬ ‫‪14‬‬ ‫‪31‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪77‬‬ ‫‪73‬‬ ‫‪63‬‬ ‫‪73‬‬ ‫‪96‬‬ ‫‪122‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪5‬‬ ‫‪6‬‬ ‫‪8‬‬ ‫‪16‬‬ ‫‪43‬‬ ‫‪90‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪18‬‬ ‫‪18‬‬ ‫‪21‬‬ ‫‪28‬‬ ‫‪29‬‬ ‫‪48‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪24‬‬ ‫‪27‬‬ ‫‪34‬‬ ‫‪65‬‬ ‫‪118‬‬ ‫‪170‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪55‬‬ ‫‪50‬‬ ‫‪45‬‬ ‫‪65‬‬ ‫‪80‬‬ ‫‪89‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪22‬‬ ‫‪29‬‬ ‫‪41‬‬ ‫‪72‬‬ ‫‪135‬‬ ‫‪170‬‬ ‫ﺗﻮﻧﺲ‬
‫‪6‬‬ ‫‪6‬‬ ‫‪8‬‬ ‫‪12‬‬ ‫‪18‬‬ ‫‪23‬‬ ‫ﺇﳒﻠﺘﺮﺍ‬
‫‪7‬‬ ‫‪8‬‬ ‫‪9‬‬ ‫‪13‬‬ ‫‪20‬‬ ‫‪26‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻟﻴﻮﻧﺴﻴﻒ )‪.(www.childinfo.org‬‬

‫ﺃ‪ :٢-‬ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ ﲬﺴﺔ ﺃﻋﻮﺍﻡ‪.‬‬

‫ﺟﺪﻭﻝ )‪ :(٤-٤‬ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ ﲬﺴﺔ ﺃﻋﻮﺍﻡ ﲟﻨﺎﻃﻖ ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ ﻋﺎﻡ ‪ ١٩٩٨‬ﻟﻜﻞ ‪١٠٠٠‬‬
‫ﻃﻔﻞ ﺩﻭﻥ ﺳﻦ ﺍﳋﺎﻣﺴﺔ‪.‬‬
‫ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ ﲬﺴﺔ ﺃﻋﻮﺍﻡ‬
‫)ﻟﻜﻞ ‪ ١٠٠٠‬ﻃﻔﻞ ﺩﻭﻥ ﺳﻦ ﺍﳋﺎﻣﺴﺔ(‬ ‫ﺍﻟﻨﻄﺎﻕ ﺍﳉﻐﺮﺍﰲ‬
‫‪٣٠,٧‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪٣١,٢‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪٤١,٣‬‬ ‫ﺍﳊﺪﻭﺩ‬
‫‪٥٨,٧‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٩‬‬

‫ﺟﺪﻭﻝ )‪ :(٥-٤‬ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ ﲬﺴﺔ ﺃﻋﻮﺍﻡ ﲟﺼﺮ ﻟﻜﻞ ‪ ١٠٠٠‬ﻃﻔﻞ ﺩﻭﻥ ﺳﻦ ﺍﳋﺎﻣﺴﺔ‪.‬‬
‫ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ‬ ‫ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ‬
‫ﲬﺴﺔ ﺃﻋﻮﺍﻡ ﲟﺼﺮ ﻟﻜﻞ‬ ‫ﲬﺴﺔ ﺃﻋﻮﺍﻡ ﲟﺼﺮ ﻟﻜﻞ‬
‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﻟﻌﺎﻡ‬
‫‪ ١٠٠٠‬ﻃﻔﻞ ﺩﻭﻥ ﺳﻦ‬ ‫‪ ١٠٠٠‬ﻃﻔﻞ ﺩﻭﻥ ﺳﻦ‬
‫ﺍﳋﺎﻣﺴﺔ‬ ‫ﺍﳋﺎﻣﺴﺔ‬
‫‪1‬‬ ‫‪300‬‬ ‫‪١٩٦٠‬‬
‫‪2‬‬ ‫‪243‬‬ ‫‪١٩٦٧‬‬
‫‪3‬‬ ‫‪235‬‬ ‫‪١٩٧٠‬‬
‫‪٢‬‬ ‫‪238‬‬ ‫‪١٩٧٢‬‬
‫‪٢‬‬ ‫‪203‬‬ ‫‪١٩٧٦‬‬
‫‪٢‬‬ ‫‪191‬‬ ‫‪١٩٧٧‬‬
‫‪٢‬‬ ‫‪157‬‬ ‫‪١٩٨٠‬‬
‫‪٢‬‬ ‫‪167‬‬ ‫‪١٩٨١‬‬
‫‪٢‬‬ ‫‪139‬‬ ‫‪١٩٨٣‬‬

‫‪١٧٤‬‬
 ‫ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ‬ ‫ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ‬
‫ﲬﺴﺔ ﺃﻋﻮﺍﻡ ﲟﺼﺮ ﻟﻜﻞ‬ ‫ﲬﺴﺔ ﺃﻋﻮﺍﻡ ﲟﺼﺮ ﻟﻜﻞ‬
‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﻟﻌﺎﻡ‬
‫‪ ١٠٠٠‬ﻃﻔﻞ ﺩﻭﻥ ﺳﻦ‬ ‫‪ ١٠٠٠‬ﻃﻔﻞ ﺩﻭﻥ ﺳﻦ‬
‫ﺍﳋﺎﻣﺴﺔ‬ ‫ﺍﳋﺎﻣﺴﺔ‬
‫‪٢‬‬ ‫‪130‬‬ ‫‪١٩٨٥‬‬
‫‪٢‬‬ ‫‪102‬‬ ‫‪١٩٨٦‬‬
‫‪1‬‬ ‫‪125‬‬ ‫‪٢‬‬ ‫‪103‬‬ ‫‪١٩٨٨‬‬
‫‪٢‬‬ ‫‪85‬‬ ‫‪١٩٩٠‬‬
‫‪4‬‬ ‫‪85‬‬ ‫‪١٩٩١‬‬
‫‪٢‬‬ ‫‪81‬‬ ‫‪١٩٩٣‬‬
‫‪5‬‬ ‫‪51‬‬ ‫‪١٩٩٥‬‬
‫‪٧‬‬ ‫‪34‬‬ ‫‪٦‬‬ ‫‪78‬‬ ‫‪١٩٩٦‬‬
‫‪3‬‬ ‫‪73‬‬ ‫‪٨‬‬ ‫‪73‬‬ ‫‪١٩٩٧‬‬
‫‪9‬‬ ‫‪69‬‬ ‫‪٢‬‬ ‫‪54‬‬ ‫‪١٩٩٨‬‬
‫‪١١‬‬ ‫‪52‬‬ ‫‪10‬‬ ‫‪52‬‬ ‫‪١٩٩٩‬‬
‫‪12‬‬ ‫‪45‬‬ ‫‪٢٠٠٠‬‬
‫‪١٤‬‬ ‫‪39.1‬‬ ‫‪١٣‬‬ ‫‪41‬‬ ‫‪٢٠٠١‬‬
‫‪ .٢‬ﺍﳌﺴﺢ ﺍﻟﺪﳝﻮﺟﺮﺍﰲ ﻭﺍﻟﺼﺤﻲ – ﻣﺼﺮ )‪ .٣ .(٢٠٠٠‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻌﺎﳌﻲ )‪.(١٩٩٩‬‬ ‫‪ .١‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٠‬‬
‫‪ .٦‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٨‬‬ ‫‪ .٥‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٧‬‬ ‫‪ .٤‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٣‬‬
‫‪ .٩‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠٠‬‬ ‫‪ .٨‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٩‬‬ ‫‪ .٧‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ‪ -‬ﺍﻟﻌﺎﳌﻲ )‪.(١٩٩٧‬‬
‫‪ .١١‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ‪ -‬ﺍﻟﻌﺎﳌﻲ )‪.(٢٠٠١‬‬ ‫‪ .١٠‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠١‬‬
‫‪ .١٣‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠٣‬‬ ‫‪ .١٢‬ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻟﻴﻮﻧﺴﻴﻒ )‪.(www.childinfo.org‬‬
‫‪ .١٤‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(٢٠٠٣‬‬

‫ﺟﺪﻭﻝ )‪ :(٦-٤‬ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ ﲬﺴﺔ ﺃﻋﻮﺍﻡ ﲟﺼﺮ ﻟﻜﻞ ‪ ١٠٠٠‬ﻃﻔﻞ ﺩﻭﻥ ﺳﻦ ﺍﳋﺎﻣﺴﺔ ﲟﺼﺮ‬
‫ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ‪.‬‬
‫‪٢٠٠١‬‬ ‫‪٢٠٠٠‬‬ ‫‪١٩٩٥‬‬ ‫‪١٩٩٠‬‬ ‫‪١٩٨٠‬‬ ‫‪١٩٧٠‬‬ ‫‪١٩٦٠‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫‪36‬‬ ‫‪38‬‬ ‫‪48‬‬ ‫‪60‬‬ ‫‪92‬‬ ‫‪135‬‬ ‫‪177‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪39‬‬ ‫‪40‬‬ ‫‪46‬‬ ‫‪49‬‬ ‫‪64‬‬ ‫‪120‬‬ ‫‪225‬‬ ‫ﺍﻟﺼﲔ‬
‫‪9‬‬ ‫‪9‬‬ ‫‪10‬‬ ‫‪13‬‬ ‫‪22‬‬ ‫‪43‬‬ ‫‪54‬‬ ‫ﻛﻮﺑﺎ‬
‫‪41‬‬ ‫‪45‬‬ ‫‪71‬‬ ‫‪104‬‬ ‫‪175‬‬ ‫‪235‬‬ ‫‪282‬‬ ‫ﻣﺼﺮ‬
‫‪93‬‬ ‫‪95‬‬ ‫‪104‬‬ ‫‪123‬‬ ‫‪173‬‬ ‫‪202‬‬ ‫‪242‬‬ ‫ﺍﳍﻨﺪ‬
‫‪6‬‬ ‫‪6‬‬ ‫‪7‬‬ ‫‪12‬‬ ‫‪19‬‬ ‫‪27‬‬ ‫‪39‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪5‬‬ ‫‪5‬‬ ‫‪6‬‬ ‫‪6‬‬ ‫‪11‬‬ ‫‪21‬‬ ‫‪40‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪122‬‬ ‫‪120‬‬ ‫‪111‬‬ ‫‪97‬‬ ‫‪115‬‬ ‫‪156‬‬ ‫‪205‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪5‬‬ ‫‪5‬‬ ‫‪6‬‬ ‫‪9‬‬ ‫‪18‬‬ ‫‪54‬‬ ‫‪127‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪21‬‬ ‫‪21‬‬ ‫‪22‬‬ ‫‪21‬‬ ‫‪35‬‬ ‫‪36‬‬ ‫‪64‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪28‬‬ ‫‪29‬‬ ‫‪34‬‬ ‫‪44‬‬ ‫‪85‬‬ ‫‪185‬‬ ‫‪250‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪71‬‬ ‫‪70‬‬ ‫‪65‬‬ ‫‪60‬‬ ‫‪90‬‬ ‫‪115‬‬ ‫‪130‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪27‬‬ ‫‪28‬‬ ‫‪37‬‬ ‫‪52‬‬ ‫‪100‬‬ ‫‪201‬‬ ‫‪254‬‬ ‫ﺗﻮﻧﺲ‬
‫‪7‬‬ ‫‪7‬‬ ‫‪7‬‬ ‫‪10‬‬ ‫‪14‬‬ ‫‪23‬‬ ‫‪27‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪8‬‬ ‫‪9‬‬ ‫‪9‬‬ ‫‪10‬‬ ‫‪15‬‬ ‫‪26‬‬ ‫‪30‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﻟﻴﻮﻧﺴﻴﻒ )‪.(www.childinfo.org‬‬

‫‪١٧٥‬‬
 ‫ﺃ‪ :٣-‬ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٧-٤‬ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﲟﻨﺎﻃﻖ ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ ) ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‪.‬‬
‫ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﲟﻨﺎﻃﻖ ﻣﺼﺮ ﺍﳉﻐﺮﺍﻓﻴﺔ ) ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬
‫ﺍﻟﻨﻄﺎﻕ ﺍﳉﻐﺮﺍﰲ‬
‫)‪٢٠٠١ (٣‬‬ ‫)‪٢٠٠٠ (٢‬‬ ‫‪(١) ١٩٩٣-١٩٩٢‬‬
‫‪41.8‬‬ ‫‪93‬‬ ‫‪132‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪50.3‬‬ ‫‪120‬‬ ‫‪..‬‬ ‫ﺍﳊﺪﻭﺩ‬
‫‪61.8‬‬ ‫‪89‬‬ ‫‪217‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫‪88.9‬‬ ‫‪48‬‬ ‫‪233‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪ .١‬ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ )‪.(١٩٩٣‬‬
‫‪ .٢‬ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ )‪.(٢٠٠٠‬‬
‫‪ .٣‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(٢٠٠٣‬‬

‫ﺟﺪﻭﻝ )‪ :(٨-٤‬ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﲟﺼﺮ ) ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ( )‪.(٢٠٠١-١٩٧٩‬‬

‫ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﲟﺼﺮ‬
‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﻟﻌﺎﻡ‬
‫) ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬
‫‪١‬‬ ‫‪78‬‬ ‫‪١٩٧٩‬‬
‫‪٢‬‬ ‫‪320‬‬ ‫‪١٩٨٧-١٩٨٠‬‬
‫‪3‬‬ ‫‪300‬‬ ‫‪١٩٨٨‬‬
‫‪4‬‬ ‫‪170‬‬ ‫‪١٩٩٠‬‬
‫‪5‬‬ ‫‪170‬‬ ‫‪١٩٩٧-١٩٩٠‬‬
‫‪1‬‬ ‫‪174‬‬ ‫‪١٩٩٣-١٩٩٢‬‬
‫‪4‬‬ ‫‪170‬‬ ‫‪١٩٩٥‬‬
‫‪6‬‬ ‫‪96‬‬ ‫‪١٩٩٨‬‬
‫‪7‬‬ ‫‪84‬‬ ‫‪٢٠٠٠‬‬
‫‪٨‬‬ ‫‪60.7‬‬ ‫‪٢٠٠١‬‬
‫‪ .٢‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(١٩٩٠‬‬ ‫‪ .١‬ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ )‪.(١٩٩٣‬‬
‫‪ .٤‬ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻹﺣﺼﺎﺋﻲ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(WHOSIS‬‬ ‫‪ .٣‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(١٩٩٣‬‬
‫‪ .٦‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(١٩٩٩‬‬ ‫‪ .٥‬ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(٢٠٠٠‬‬
‫‪ .٨‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(٢٠٠٣‬‬ ‫‪ .٧‬ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ )‪.(٢٠٠٠‬‬

‫ﺟﺪﻭﻝ )‪ :(٩-٤‬ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﲟﺼﺮ ) ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ( ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ‪.‬‬
‫ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ) ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬
‫ﺍﻟﺪﻭﻟﺔ‬
‫‪١٩٩٥‬‬ ‫‪١٩٩٠‬‬
‫‪260‬‬ ‫‪220‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪60‬‬ ‫‪95‬‬ ‫ﺍﻟﺼﲔ‬
‫‪24‬‬ ‫‪95‬‬ ‫ﻛﻮﺑﺎ‬
‫‪170‬‬ ‫‪170‬‬ ‫ﻣﺼﺮ‬
‫‪440‬‬ ‫‪570‬‬ ‫ﺍﳍﻨﺪ‬
‫‪8‬‬ ‫‪7‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪12‬‬ ‫‪18‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬

‫‪١٧٦‬‬
 ‫ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ) ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻮﻟﻮﺩ ﺣﻲ(‬
‫ﺍﻟﺪﻭﻟﺔ‬
‫‪١٩٩٥‬‬ ‫‪١٩٩٠‬‬
‫‪1300‬‬ ‫‪650‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪75‬‬ ‫‪75‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪23‬‬ ‫‪130‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪340‬‬ ‫‪230‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪70‬‬ ‫‪170‬‬ ‫ﺗﻮﻧﺲ‬
‫‪10‬‬ ‫‪9‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪12‬‬ ‫‪12‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻹﺣﺼﺎﺋﻲ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(WHOSIS‬‬

‫ﺏ‪ .‬ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ‬

‫ﺟﺪﻭﻝ )‪ :(١٠-٤‬ﺗﻄﻮﺭ ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﰲ ﻣﺼﺮ )‪(٢٠٠١-١٩٧٦‬‬
‫ﺍﳌﺼﺪﺭ‬ ‫ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ‬ ‫ﺍﻟﻌﺎﻡ‬
‫‪1‬‬ ‫‪55‬‬ ‫‪١٩٧٦‬‬
‫‪2‬‬ ‫‪56‬‬ ‫‪١٩٨٠‬‬
‫‪٣‬‬ ‫‪62‬‬ ‫‪١٩٨٧‬‬
‫‪4‬‬ ‫‪61‬‬ ‫‪١٩٨٨‬‬
‫‪5‬‬ ‫‪60.3‬‬ ‫‪١٩٩٠‬‬
‫‪٦‬‬ ‫‪61‬‬ ‫‪١٩٩١‬‬
‫‪٧‬‬ ‫‪64‬‬ ‫‪١٩٩٣‬‬
‫‪٨‬‬ ‫‪66.7‬‬ ‫‪١٩٩٤‬‬
‫‪9‬‬ ‫‪65‬‬ ‫‪١٩٩٥‬‬
‫‪10‬‬ ‫‪65‬‬ ‫‪١٩٩٦‬‬
‫‪11‬‬ ‫‪66‬‬ ‫‪١٩٩٧‬‬
‫‪١٢‬‬ ‫‪67‬‬ ‫‪١٩٩٨‬‬
‫‪١٣‬‬ ‫‪67‬‬ ‫‪١٩٩٩‬‬
‫‪14‬‬ ‫‪67‬‬ ‫‪٢٠٠٠‬‬
‫‪15‬‬ ‫‪68‬‬ ‫‪٢٠٠١‬‬
‫‪ .٢‬ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(٢٠٠٠‬‬ ‫‪ .١‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(٢٠٠٣‬‬
‫‪ .٤‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٠‬‬ ‫‪ .٣‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(١٩٩٠‬‬
‫‪ .٦‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٣‬‬ ‫‪ .٥‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(١٩٩٣‬‬
‫‪ .٨‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﻣﺼﺮ )‪.(١٩٩٦‬‬ ‫‪ .٧‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(١٩٩٥‬‬
‫‪ .١٠‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٨‬‬ ‫‪ .٩‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٧‬‬
‫‪ .١٢‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠٠‬‬ ‫‪ .١١‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(١٩٩٩‬‬
‫‪ .١٤‬ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ – ﺍﻟﻌﺎﱂ )‪.(٢٠٠٢‬‬ ‫‪ .١٣‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠١‬‬
‫‪ .١٥‬ﺗﻘﺮﻳﺮ ﺣﺎﻟﺔ ﺃﻃﻔﺎﻝ ﺍﻟﻌﺎﱂ )‪.(٢٠٠٣‬‬

‫‪١٧٧‬‬
 ‫ﺟﺪﻭﻝ )‪ :(١١-٤‬ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ )‪.(٢٠٠١‬‬
‫ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ‬
‫ﺍﻟﺪﻭﻟﺔ‬
‫ﺍﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﻛﻞ ﺍﻟﺴﻜﺎﻥ‬
‫‪84.7‬‬ ‫‪77.9‬‬ ‫‪81.4‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪80.9‬‬ ‫‪76.1‬‬ ‫‪78.5‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪78.7‬‬ ‫‪71.2‬‬ ‫‪74.9‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪73.5‬‬ ‫‪69‬‬ ‫‪71.1‬‬ ‫ﺗﻮﻧﺲ‬
‫‪73.5‬‬ ‫‪68.4‬‬ ‫‪70.5‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪72‬‬ ‫‪65.5‬‬ ‫‪68.7‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪67.8‬‬ ‫‪65.3‬‬ ‫‪66.5‬‬ ‫ﻣﺼﺮ‬
‫‪50.3‬‬ ‫‪47.7‬‬ ‫‪49‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪49.6‬‬ ‫‪48.2‬‬ ‫‪48.9‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪72.3‬‬ ‫‪58.9‬‬ ‫‪65.2‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪72.7‬‬ ‫‪69.8‬‬ ‫‪71.2‬‬ ‫ﺍﻟﺼﲔ‬
‫‪79.9‬‬ ‫‪75.1‬‬ ‫‪77.5‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪79.5‬‬ ‫‪74.3‬‬ ‫‪77‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫‪79.2‬‬ ‫‪74.7‬‬ ‫‪76.9‬‬ ‫ﻛﻮﺑﺎ‬
‫‪60.7‬‬ ‫‪60‬‬ ‫‪60.8‬‬ ‫ﺍﳍﻨﺪ‬
‫ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻹﺣﺼﺎﺋﻲ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(WHOSIS‬‬

‫ﺝ‪ .‬ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﺑﺪﻭﻥ ﻋﻠﺔ )‪.(Healthy life expectancy at birth‬‬
‫ﺟﺪﻭﻝ )‪ :(١٢-٤‬ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﺑﺪﻭﻥ ﻋﻠﺔ ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺃﺧﺮﻯ )‪.(٢٠٠١‬‬
‫ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﺑﺪﻭﻥ ﻋﻠﺔ‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫ﺍﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﻛﻞ ﺍﻟﺴﻜﺎﻥ‬
‫‪75.8‬‬ ‫‪71.4‬‬ ‫‪73.6‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪70.8‬‬ ‫‪68‬‬ ‫‪69.4‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪70.3‬‬ ‫‪64.5‬‬ ‫‪67.4‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪63.7‬‬ ‫‪58.9‬‬ ‫‪61.3‬‬ ‫ﺗﻮﻧﺲ‬
‫‪62.5‬‬ ‫‪57.4‬‬ ‫‪60‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪57‬‬ ‫‪56.4‬‬ ‫‪56.7‬‬ ‫ﻣﺼﺮ‬
‫‪61.1‬‬ ‫‪52.2‬‬ ‫‪56.7‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪42.7‬‬ ‫‪40‬‬ ‫‪41.3‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪42.1‬‬ ‫‪39.5‬‬ ‫‪40.8‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪61.9‬‬ ‫‪51.5‬‬ ‫‪56.7‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪64.3‬‬ ‫‪62‬‬ ‫‪63.2‬‬ ‫ﺍﻟﺼﲔ‬
‫‪70.4‬‬ ‫‪68.4‬‬ ‫‪69.6‬‬ ‫ﺇﳒﻠﺘﺮﺍ‬
‫‪68.8‬‬ ‫‪66.4‬‬ ‫‪76.6‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫‪68.5‬‬ ‫‪64.7‬‬ ‫‪66.6‬‬ ‫ﻛﻮﺑﺎ‬
‫‪51.3‬‬ ‫‪51.5‬‬ ‫‪51.4‬‬ ‫ﺍﳍﻨﺪ‬
‫ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻹﺣﺼﺎﺋﻲ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(WHOSIS‬‬

‫‪١٧٨‬‬
 ‫ﺩـ‪ .‬ﺍﻟﺴﻨﻮﺍﺕ ﺍﳌﺘﻮﻗﻊ ﻓﻘﺪﻫﺎ ﻣﻦ ﺍﻟﻌﻤﺮ ﺑﺴﺒﺐ ﺍﻟﻌﻠﺔ ﻋﻨﺪ ﺍﳌﻴﻼﺩ‬
‫)‪(Expected lost health years at birth‬‬
‫ﺟﺪﻭﻝ )‪ :(١٣-٤‬ﺍﻟﺴﻨﻮﺍﺕ ﺍﳌﺘﻮﻗﻊ ﻓﻘﺪﻫﺎ ﻣﻦ ﺍﻟﻌﻤﺮ ﺑﺴﺒﺐ ﺍﻟﻌﻠﺔ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ‬
‫ﺃﺧﺮﻯ )‪.(٢٠٠١‬‬
‫ﺍﻟﺴﻨﻮﺍﺕ ﺍﳌﺘﻮﻗﻊ ﻓﻘﺪﻫﺎ ﻣﻦ ﺍﻟﻌﻤﺮ ﺑﺴﺒﺐ ﺍﻟﻌﻠﺔ ﻋﻨﺪ‬
‫ﺍﳌﻴﻼﺩ‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫ﺍﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬
‫‪11.0‬‬ ‫‪13.3‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪8.4‬‬ ‫‪7.7‬‬ ‫ﺍﻟﺼﲔ‬
‫‪10.8‬‬ ‫‪10.0‬‬ ‫ﻛﻮﺑﺎ‬
‫‪10.8‬‬ ‫‪8.9‬‬ ‫ﻣﺼﺮ‬
‫‪10.4‬‬ ‫‪8.4‬‬ ‫ﺍﳍﻨﺪ‬
‫‪10.0‬‬ ‫‪8.1‬‬ ‫ﺍﺳﺮﺍﺋﻴﻞ‬
‫‪8.9‬‬ ‫‪6.5‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪7.5‬‬ ‫‪8.7‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪8.4‬‬ ‫‪6.7‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪10.4‬‬ ‫‪7.4‬‬ ‫ﺭﻭﺳﻴﺎ‬
‫‪11.0‬‬ ‫‪10.9‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪7.6‬‬ ‫‪7.7‬‬ ‫ﺟﻨﻮﺏ ﺍﻓﺮﻳﻘﻴﺎ‬
‫‪9.8‬‬ ‫‪10.1‬‬ ‫ﺗﻮﻧﺲ‬
‫‪9.0‬‬ ‫‪6.6‬‬ ‫ﺍﳒﻠﺘﺮﺍ‬
‫‪10.7‬‬ ‫‪8.0‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﻧﻈﺎﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻹﺣﺼﺎﺋﻲ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪.(WHOSIS‬‬

‫ﻫـ‪ .‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻻﺣﺘﻤﺎﻻﺕ ﺍﳊﻴﺎﺓ ﺣﱴ ﺳﻦ ‪ ٦٥‬ﻋﺎﻣﺎﹰ )ﻋﻨﺪ ﺍﳌﻴﻼﺩ(‪.‬‬

‫ﺟﺪﻭﻝ )‪ :(١٤-٤‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻻﺣﺘﻤﺎﻻﺕ ﺍﳊﻴﺎﺓ ﺣﱴ ﺳﻦ ‪ ٦٥‬ﻋﺎﻣﺎﹰ )ﻋﻨﺪ ﺍﳌﻴﻼﺩ( ﰲ ﻣﺼﺮ ﺑﺎﳌﻘﺎﺭﻧﺔ‬
‫ﺑﺪﻭﻝ ﺃﺧﺮﻯ )‪.(٢٠٠٠-١٩٩٥‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻻﺣﺘﻤﺎﻻﺕ ﺍﳊﻴﺎﺓ ﺣﱴ ﺳﻦ ‪٦٥‬‬
‫ﻋﺎﻣﺎﹰ )ﻋﻨﺪ ﺍﳌﻴﻼﺩ(‪.‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫ﺫﻛﻮﺭ‬ ‫ﺇﻧﺎﺙ‬
‫‪59.3‬‬ ‫‪75.4‬‬ ‫ﺍﻟﱪﺍﺯﻳﻞ‬
‫‪70.9‬‬ ‫‪79.4‬‬ ‫ﺍﻟﺼﲔ‬
‫‪78.1‬‬ ‫‪84.1‬‬ ‫ﻛﻮﺑﺎ‬
‫‪63.9‬‬ ‫‪72.8‬‬ ‫ﻣﺼﺮ‬
‫‪59.9‬‬ ‫‪64.7‬‬ ‫ﺍﳍﻨﺪ‬
‫‪85.1‬‬ ‫‪89.7‬‬ ‫ﺇﺳﺮﺍﺋﻴﻞ‬
‫‪84.0‬‬ ‫‪92.1‬‬ ‫ﺍﻟﻴﺎﺑﺎﻥ‬
‫‪38.5‬‬ ‫‪43.6‬‬ ‫ﻛﻴﻨﻴﺎ‬
‫‪72.1‬‬ ‫‪87.5‬‬ ‫ﻛﻮﺭﻳﺎ‬
‫‪46.4‬‬ ‫‪77.0‬‬ ‫ﺭﻭﺳﻴﺎ‬

‫‪١٧٩‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻻﺣﺘﻤﺎﻻﺕ ﺍﳊﻴﺎﺓ ﺣﱴ ﺳﻦ ‪٦٥‬‬
‫ﻋﺎﻣﺎﹰ )ﻋﻨﺪ ﺍﳌﻴﻼﺩ(‪.‬‬ ‫ﺍﻟﺪﻭﻟﺔ‬
‫ﺫﻛﻮﺭ‬ ‫ﺇﻧﺎﺙ‬
‫‪73.4‬‬ ‫‪78.4‬‬ ‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪40.2‬‬ ‫‪53.7‬‬ ‫ﺟﻨﻮﺏ ﺇﻓﺮﻳﻘﻴﺎ‬
‫‪70.6‬‬ ‫‪75.8‬‬ ‫ﺗﻮﻧﺲ‬
‫‪81.5‬‬ ‫‪88.3‬‬ ‫ﺇﳒﻠﺘﺮﺍ‬
‫‪77.4‬‬ ‫‪85.7‬‬ ‫ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‬
‫ﺗﻘﺮﻳﺮ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻌﺎﱂ ‪ -‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )‪(٢٠٠٢‬‬

‫‪١٨٠‬‬
 @ @@
@ @
@ @
 ‫ء‬
   !"#
@ @
@ @pbîÜjÔn¾aë@Êbšëþa@N@N‹—ß@À@õaë‡Ûa@ZåßbrÛa@Ý—ÐÛa@•
@ @݀€€€€€€€€€Ð€€€€€€€Đ€€€€€€€€€Ûa@ò€€€€z€€€€€€–@ZɎbnÛa@Ý—ÐÛa@•
@ @ñc‹€€€€€€€€€€à€€€€€€€€€Ûa@ò€€€€€z€€€€€€–@Z‹’bÈÛa@Ý—ÐÛa@•
@ @ò€€î€€ä€€è€€à€€€€Ûa@ò€€€€z€€€€—€€€€Ûa@Z‹“Ç@ð†b¨a@Ý—ÐÛa@•
@ @ò€€î€€€€Ð€€€ä€€€€Ûa@ò€€€€€€€z€€€€—€€€Ûa@Z‹“Ç@ïãbrÛa@Ý—ÐÛa@•
@ @
 ‫
 
‪:‬‬
‫ء  ‪  ..‬‬
‫‬ ‫‪! "# . .‬ء‬

‫ ‪ :%$‬ء – * )( '&‬

‫ﺗﻌﺮﻳﻒ‬
‫ﻳﻌﺮﻑ ﺍﻟﺪﻭﺍﺀ ﺑﺄﻧﻪ "ﺃﻱ ﻣﺎﺩﺓ ﻣﺪﺭﺟﺔ ﰲ ﺩﺳﺘﻮﺭ ﻟﻸﺩﻭﻳﺔ ‪ Pharmacopoeia‬ﺃﻭ ﻣﻮﺟﻮﺩﺓ ﰲ ﻣﻨﺘﺞ ﺻﻴﺪﱄ‬
‫ﻭﻳﻜﻮﻥ ﻣﻦ ﺷﺎﻥ ﺍﺳﺘﺨﺪﺍﻣﻬﺎ ﺗﻐﻴﲑ ﺃﻭ ﺍﺳﺘﻜﺸﺎﻑ ﻧﻈﻢ ﻓﺴﻴﻮﻟﻮﺟﻴﺔ ﺃﻭ ﺣﺎﻻﺕ ﻣﺮﺿﻴﺔ ﻟﺼﺎﱀ‬
‫ﻣﺘﻠﻘﻴﻬﺎ"‪.‬‬

‫ﺧﺼﻮﺻﻴﺎﺕ ﺭﺋﻴﺴﻴﺔ‬
‫ﻫﺬﺍ‪ ،‬ﻭﻟﻠﺪﻭﺍﺀ ﺛﻼﺙ ﺧﺼﻮﺻﻴﺎﺕ ﺭﺋﻴﺴﻴﺔ ﺟﻌﻠﺖ ﻟﻪ ﺃﺑﻌﺎﺩﺍﹰ ﻏﲑ ﻋﺎﺩﻳﺔ‪ .‬ﺃﻣﺎ ﻋﻦ ﺍﳋﺼﻮﺻﻴﺎﺕ ﻓﻬﻲ‬
‫ﻛﺎﻟﺘﺎﱄ‪:‬‬
‫ﺍﳋﺼﻮﺻﻴﺔ ﺍﻷﻭﱃ ﻫﻲ ﺃﻥ ﺍﻟﺪﻭﺍﺀ ﺳﻠﻌﺔ ﻻ ﳝﻜﻦ ﳌﻦ ﳛﺘﺎﺟﻬﺎ ﺃﻥ ﻳﺴﺘﻐﲏ ﻋﻨﻬﺎ‪.‬‬ ‫‪-‬‬
‫ﺍﳋﺼﻮﺻﻴﺔ ﺍﻟﺜﺎﻧﻴﺔ ﻫﻲ ﺃﻥ ﺍﻟﺪﻭﺍﺀ ﺳﻠﻌﺔ ﺗﻮﺟﺪ ﻋﻠﻰ ﺍﻟﺪﻭﺍﻡ ﻣﻨﺬ ﻋﺮﻓﻬﺎ ﺍﻹﻧﺴﺎﻥ ﻭﱂ ﺗﺘﻮﻗﻒ‬ ‫‪-‬‬
‫ﺍﳊﺎﺟﺔ ﺇﻟﻴﻬﺎ ﻗﻂ‪ ،‬ﻭﻫﻲ ﺗﺘﻄﻮﺭ ﺑﺎﺳﺘﻤﺮﺍﺭ ﻟﺰﻭﻡ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﻋﻼﺝ ﺃﺣﺴﻦ‪ ،‬ﻭﻛﺬﻟﻚ ﻟﺰﻭﻡ‬
‫ﺍ‪‬ﺎ‪‬ﺔ ﺍﻟﻌﻼﺟﻴﺔ ﳌﺴﺘﺠﺪﺍﺕ ﻣﺮﺿﻴﺔ ﺟﺪﻳﺪﺓ‪.‬‬
‫ﺍﳋﺼﻮﺻﻴﺔ ﺍﻟﺜﺎﻟﺜﺔ ﻫﻲ ﺃﻥ ﺍﻻﺑﺘﻜﺎﺭ ﺍﻟﺪﻭﺍﺋﻲ ﻳﻌﺘﻤﺪ ﻋﻠﻰ ﺍﻟﺒﺤﺚ ﺍﻟﻌﻠﻤﻲ ﺍﻟﻌﻤﻴﻖ‬ ‫‪-‬‬
‫ﻭﺍﳌﺘﻮﺍﺻﻞ‪ ،‬ﻭﻫﻮ ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﺟﻌﻞ ﻟﱪﺍﺀﺍﺕ ﺍﻻﺧﺘﺮﺍﻉ ﰲ ﺍ‪‬ﺎﻻﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻗﻴﻤﺔ ﻛﺒﲑﺓ‪.‬‬

‫ﺃﺑﻌﺎﺩ ﻗﻀﺎﻳﺎ ﺍﻟﺪﻭﺍﺀ‬

‫ﻟﻘﺪ ﺗﺴﺒﺒﺖ ﻫﺬﻩ ﺍﳋﺼﻮﺻﻴﺎﺕ ﰲ ﺗﻮﻟﻴﺪ ﻭﺗﻄﻮﻳﺮ ﺃﺑﻌﺎﺩﺍﹰ ﻏﲑ ﻋﺎﺩﻳﺔ ﺗﺮﺗﺒﻂ ﺑﺎﻟﺪﻭﺍﺀ‪ ،‬ﻭﻏﺎﻟﺒﺎﹰ ﱂ ﺗﻨﺸﺄ‬
‫ﺃﺑﻌﺎﺩﺍﹰ ﳑﺎﺛﻠﺔ ﳍﺎ ﰲ ﺍﻷﳘﻴﺔ ﻭﺍﻟﺘﻌﺪﺩ ﻭﺍﻟﺘﻌﻘﺪ ﲞﺼﻮﺹ ﺃﻳﺔ ﺳﻠﻌﺔ ﺃﺧﺮﻯ ﻋﺮﻓﻬﺎ ﺍﻹﻧﺴﺎﻥ‪ .‬ﻭﳝﻜﻦ‬
‫ﺍﻹﺷﺎﺭﺓ – ﻓﻴﻤﺎ ﻳﻠﻲ – ﺇﱃ ﺃﻫﻢ ﻫﺬﻩ ﺍﻷﺑﻌﺎﺩ‪:‬‬
‫‪ .١‬ﺷﻴﻮﻉ ﺍﺭﺗﺒﺎﻁ ﺍﺳﺘﺨﺪﺍﻡ ﻣﺼﻄﻠﺢ "ﻣﺎﻓﻴﺎ" ﺑـ "ﺍﻟﺪﻭﺍﺀ"‪ ،‬ﻭﻫﻮ ﻣﺼﻄﻠﺢ ﱂ ﻳﺸﻊ ﺍﺳﺘﺨﺪﺍﻣﻪ‬
‫ﻋﺎﳌﻴﺎﹰ ﰲ ﻏﲑ ﺍﳌﺨﺪﺭﺍﺕ ﻭﺍﻟﺴﻼﺡ ﻭﺍﻟﺪﻭﺍﺀ‪ .‬ﻭﺇﺫﺍ ﻛﺎﻥ ﻣﻦ ﺍﳌﻔﻬﻮﻡ ﺍﺭﺗﺒﺎﻁ ﻫﺬﺍ ﺍﳌﺼﻄﻠﺢ ﺑﺎﳌﺨﺪﺭﺍﺕ‬
‫ﻭﺑﺎﻟﺴﻼﺡ‪ ،‬ﺣﻴﺚ ﻟﻜﻞ ﻣﻨﻬﻤﺎ ﺍﺳﺘﺨﺪﺍﻣﺎﺕ ﺑﻐﻴﻀﺔ ﻣﻌﺎﺩﻳﺔ ﻟﻺﻧﺴﺎﻧﻴﺔ‪ ،‬ﻓﺈﻥ ﺍﺭﺗﺒﺎﻃﻪ ﺑﺎﻟﺪﻭﺍﺀ ﻗﺪ‬
‫ﻳﻜﻮﻥ ﺃﻣﺮﺍﹰ ﻏﺮﻳﺒﺎﹰ ﻳﺒﻌﺚ ﻋﻠﻰ ﺍﻟﺘﺴﺎﺅﻝ‪ ،‬ﳌﺎﺫﺍ ﺑﺰﻍ ﻭﺷﺎﻉ ﺍﺳﺘﺨﺪﺍﻡ ﻣﺼﻄﻠﺢ "ﻣﺎﻓﻴﺎ" ﻣﻊ ﺍﻟﺪﻭﺍﺀ‬
‫ﺑﺎﻟﺬﺍﺕ ﺩﻭﻥ ﺑﻘﻴﺔ ﺍﻟﺴﻠﻊ ﺍﳌﻔﻴﺪﺓ ﻟﻠﺒﺸﺮ‪ .‬ﺭﲟﺎ ﻳﻜﻤﻦ ﺟﺰﺀ ﻛﺒﲑ ﻣﻦ ﺍﻹﺟﺎﺑﺔ ﰲ ﺣﻘﻴﻘﺔ ﺃﻥ ﺍﻟﺪﻭﺍﺀ‬
‫ﻳﺘﻤﻴﺰ ﺑﻘﻴﻤﺔ ﻣﻀﺎﻓﺔ ﻫﺎﺋﻠﺔ‪ ،‬ﻫﻲ ﺍﻷﻋﻠﻰ ﻣﻘﺎﺭﻧﺔ ﺑﺄﻳﺔ ﺳﻠﻊ ﻣﺸﺮﻭﻋﺔ ﺃﺧﺮﻯ‪.‬‬

‫‪١٨١‬‬
‫‪ .٢‬ﺍﺭﺗﺒﺎﻁ ﺍﻟﺪﻭﺍﺀ ﺑﺎﺣﺘﻴﺎﺟﺎﺕ ﺗﻨﻤﻮﻳﺔ ﻣﺒﺎﺷﺮﺓ‪ ،‬ﻣﻦ ﺃﺑﺮﺯﻫﺎ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺒﺸﺮﻳﺔ )ﻣﻦ ﺧﻼﻝ ﻣﻜﺎﻧﺔ‬
‫ﺍﻟﺪﻭﺍﺀ ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ(‪ ،‬ﻭﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ )ﻋﱪ ﺍﻟﻘﻴﻤﺔ ﺍﳌﻀﺎﻓﺔ ﺍﻟﻌﺎﻟﻴﺔ(‪ ،‬ﺫﻟﻚ‬
‫ﻓﻀﻼﹰ ﻋﻦ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﺟﺘﻤﺎﻋﻴﺔ ﺳﻴﺎﺳﻴﺔ )ﻣﻦ ﻣﻨﻈﻮﺭ ﺍﻟﺪﻭﺭ ﺍﻟﺮﺋﻴﺴﻲ ﻟﺘﻠﺒﻴﺔ ﺍﳊﺎﺟﺎﺕ ﰲ ﺻﻨﻊ‬
‫ﺍﻻﺳﺘﻘﺮﺍﺭ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺇﻣﻜﺎﻧﺎﺕ ﺍﳊﺲ ﺍﻟﺪﳝﻘﺮﺍﻃﻲ(‪.‬‬
‫‪ .٣‬ﲤﻴﺰ "ﺍﻟﺪﻭﺍﺀ" ﺑﺎﺭﺗﺒﺎﻁ ﻋﺎﻝٍ ﺑﺎﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳊﺮﻛﻴﺎﺕ "ﻋﱪ ﺍﻟﻮﻃﻨﻴﺔ" ‪ .Transnational‬ﻓﻴﻤﺎ ﻳﻠﻲ ﺃﺑﺮﺯ‬
‫ﻫﺬﻩ ﺍﳊﺮﻛﻴﺎﺕ‪- :‬‬
‫ﺃ‪ .‬ﺍﻟﺘﺤﺎﻟﻔﺎﺕ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺑﲔ ﺍﻟﺸﺮﻛﺎﺕ ﻭﺑﻌﻀﻬﺎ ﺍﻟﺒﻌﺾ ﺃﻭ ﺑﲔ ﺍﻟﺸﺮﻛﺎﺕ ﻭﻣﻌﺎﻫﺪ‬
‫ﺍﻟﺒﺤﻮﺙ‪.‬‬
‫ﺏ‪ .‬ﺍﻻﻧﺪﻣﺎﺝ ﺑﲔ ﺷﺮﻛﺎﺕ ﻋﺎﳌﻴﺔ ﻛﱪﻯ ﻭﻗﻴﺎﻡ ﺷﺮﻛﺎﺕ ﻛﱪﻯ ﺑﺸﺮﺍﺀ ﺷﺮﻛﺎﺕ ﺃﺧﺮﻯ ﺃﺻﻐﺮ ﻣﻨﻬﺎ‪.‬‬
‫ﺝ‪ .‬ﻧﺸﺎﻁ ﻣﻜﺜﻒ ‪‬ﺪﻑ ﺗﻮﺍﻓﻖ ﺍﳌﻮﺍﺻﻔﺎﺕ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻋﺎﳌﻲ‪ ،‬ﻭﺍﻟﺬﻱ ﻳﺮﻯ ﻓﻴﻪ ﺍﻟﺒﻌﺾ ﻗﺪﺭﺍﹰ ﻣﻦ‬
‫ﺍﻟﺘﻬﺪﻳﺪ ﻟﻠﻤﻨﺘﺠﲔ ﻭﺍﻟﺪﻭﻝ ﺍﻷﻗﻞ ﳕﻮﺍﹰ‪ ،‬ﺣﻴﺚ ﳝﺜﻞ ﺑﺎﻟﻨﺴﺒﺔ ﳍﻢ ‪،Harmon –Imperialism‬‬
‫ﺃﻭ ﺍﺳﺘﻌﻤﺎﺭﺍﹰ ﻗﺎﺋﻤﺎﹰ ﻋﻠﻰ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻮﺍﻓﻖ ﰲ ﺍﳌﻮﺍﺻﻔﺎﺕ‪ ،‬ﺣﻴﺚ ﻣﻦ ﺍﳌﺘﻮﻗﻊ – ﻋﻠﻰ ﺍﻟﺪﻭﺍﻡ –‬
‫ﺍﺭﺗﻘﺎﺀ ﺍﳌﻮﺍﺻﻔﺎﺕ ﻃﺒﻘﺎﹰ ﻻﺳﺘﻴﻌﺎﺏ ﻭﲤﻜﻦ ﺍﻟﻼﻋﺒﲔ ﺍﻟﻜﺒﺎﺭ )ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﻌﺎﳌﻴﺔ ﺍﻟﻜﱪﻯ(‪.‬‬
‫ﺩ‪ .‬ﺑﺰﻭﻍ ﺍﺗﻔﺎﻗﻴﺔ ﺣﻘﻮﻕ ﺍﳌﻠﻜﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ ‪ TRIPs‬ﻛﻮﺍﺣﺪﺓ ﻣﻦ ﺍﺗﻔﺎﻗﻴﺎﺕ ﺍﳉﺎﺕ ﻣﻦ ﺧﻼﻝ ‪ -‬ﻋﻠﻰ‬
‫ﻭﺟﻪ ﺍﳋﺼﻮﺹ – ﻗﻮﺓ ﺩﻓﻊ ﻣﻦ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺫﺍﺕ ﺍﻟﻨﺸﺎﻁ ﺍﻟﺪﻭﱄ‪.‬‬
‫ﻩ‪ .‬ﺗﻜﺮﺍﺭ ﺍﻧﻜﺸﺎﻑ ﳑﺎﺭﺳﺎﺕ ﺳﻠﺒﻴﺔ ﰲ ﺍﻟﺒﻴﺌﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﺪﻭﻟﻴﺔ‪ .‬ﻣﻦ ﻫﺬﻩ ﺍﳌﻤﺎﺭﺳﺎﺕ ﺍﻻﺩﻋﺎﺀ‬
‫ﺑﺘﻜﺎﻟﻴﻒ ﻣﻐﺎﻝ ﻓﻴﻬﺎ ﺑﺸﺪﺓ ﺑﺸﺄﻥ ﺍﻟﺒﺤﻮﺙ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ ،‬ﺣﻴﺚ ﻳﻈﻦ ﺃﻥ ﺩﺭﺟﺔ ﺍﳌﻐﺎﻻﺓ ﺗﺼﻞ ﺇﱃ‬
‫ﺣﻮﺍﱄ ﻋﺸﺮﺓ ﺃﻣﺜﺎﻝ ﺍﳊﻘﻴﻘﺔ‪ ،‬ﻭﻣﻦ ﻫﺬﻩ ﺍﳌﻤﺎﺭﺳﺎﺕ ﺃﻳﻀﺎﹰ ﺍﺳﺘﺨﺪﺍﻡ ﻧﺸﺮﺍﺕ ﺩﻭﺍﺋﻴﺔ ﺇﻋﻼﻣﻴﺔ‬
‫ﻣﻌﻴﺒﺔ‪ ،‬ﻭﺗﻘﺪﱘ ﺭﺷﺎﻭﻯ ﳌﺴﺌﻮﻟﲔ ﺣﻜﻮﻣﻴﲔ ﻣﻦ ﺃﺟﻞ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﻣﻌﺎﻣﻼﺕ ﺗﻔﺼﻴﻠﻴﺔ ﰲ‬
‫ﻋﻄﺎﺀﺍﺕ ﲣﺘﺺ ﺑﺎﻹﻣﺪﺍﺩ ﺍﻟﺪﻭﺍﺋﻲ‪ .‬ﻟﻘﺪ ﺑﻠﻐﺖ ﻫﺬﻩ ﺍﻟﺴﻠﺒﻴﺎﺕ ﺣﺪ ﺇﻧﺘﺎﺝ ﻋﺒﻮﺍﺕ ﻣﻦ ﺩﻭﺍﺀ ﳌﻨﻊ‬
‫ﺍﳊﻤﻞ )ﺑﻮﺍﺳﻄﺔ ﺷﺮﻛﺔ ﻓﺮﻋﻴﺔ ﻹﺣﺪﻯ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﻌﺎﳌﻴﺔ ﰲ ﺍﻟﱪﺍﺯﻳﻞ( ﻻ ﳛﺘﻮﻱ ﻋﻠﻰ ﺍﳌﺎﺩﺓ‬
‫ﺍﻟﻔﻌﺎﻟﺔ‪.‬‬

‫ﺑﺰﻭﻍ ﺍﳊﺎﺟﺔ ﻟﺴﻴﺎﺳﺎﺕ ﺩﻭﺍﺋﻴﺔ ﻣﻌﻠﻨﺔ‬

‫ﻭﻫﻜﺬﺍ‪ ،‬ﻧﺘﻴﺠﺔ ﻟﺘﻔﺮﺩ "ﺍﻟﺪﻭﺍﺀ" ﺑﺎﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳋﺼﻮﺻﻴﺎﺕ ﻭﺍﻟﻘﻀﺎﻳﺎ ﺍﳌﺘﺪﺍﺧﻠﺔ ﺑﻮﺿﻮﺡ ﻣﻊ ﺍﳌﺼﺎﱀ‬
‫ﺍﻹﻧﺴﺎﻧﻴﺔ ﺍﳌﺒﺎﺷﺮﺓ ﻋﻠﻰ ﻣﺴﺘﻮﻳﺎﺕ ﳐﺘﻠﻔﺔ )ﺍﻟﻔﺮﺩ – ﺍﳉﻤﺎﻋﺔ – ﺍﻟﺪﻭﻟﺔ – ﺍﻟﻌﺎﱂ(‪ ،‬ﺑﺰﻏﺖ ﺍﳊﺎﺟﺔ‬
‫ﻟﺼﻴﺎﻏﺔ ﻭﺗﻄﺒﻴﻖ ﺳﻴﺎﺳﺎﺕ ﻗﻮﻣﻴﺔ ﻟﻠﺪﻭﺍﺀ ‪ ،National Drug Policies‬ﺳﻴﺎﺳﺎﺕ ﻳﻜﻮﻥ ﻣﻦ ﺷﺄ‪‬ﺎ‬
‫ﺗﻨﻈﻴﻢ ﺍﻷﺩﺍﺀ ﺍﻟﺪﻭﺍﺋﻲ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ‪ ،‬ﻭﺗﺮﺷﻴﺪ ﺍﻟﺘﻌﺎﻣﻼﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻋﱪ ﺍﻟﺪﻭﻝ‪ .‬ﻟﻘﺪ ﺑﺪﺃﺕ‬
‫ﺍﻻﻫﺘﻤﺎﻣﺎﺕ ﺍﳌﻠﺤﻮﻇﺔ ﺑﺎﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺗﺘﻄﻮﺭ ﺩﻭﻟﻴﺎﹰ ﻣﻦ ﺧﻼﻝ ﺇﺻﺪﺍﺭ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ‬
‫ﻟﻨﻤﻮﺫﺝ ﻗﺎﺋﻤﺔ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻋﺎﻡ ‪ ،١٩٧٧‬ﰒ ﻣﻦ ﺧﻼﻝ ﺍﻋﺘﺒﺎﺭ ﺇﺗﺎﺣﺔ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻛﺄﺣﺪ‬
‫ﺍﻟﻌﻨﺎﺻﺮ ﺍﻟﺮﺋﻴﺴﻴﺔ ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ )ﺑﻮﺍﺳﻄﺔ ﺍﳌﺆﲤﺮ ﺍﳌﺸﺘﺮﻙ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﻌﺎﳌﻴﺔ ﻭﺍﻟﻴﻮﻧﻴﺴﻴﻒ ‪ -‬ﻋﺎﻡ ‪ .(١٩٧٨‬ﺑﻌﺪ ﺫﻟﻚ ﺗﺄﺳﺲ ﺑﺮﻧﺎﻣﺞ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ﻟﻸﺩﻭﻳﺔ‬
‫ﺍﻷﺳﺎﺳﻴﺔ ﻋﺎﻡ ‪ .١٩٧٩‬ﻭﺗﺼﺎﻋﺪ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺄﻣﻮﺭ ﺳﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺀ ﺑﺎﻧﻌﻘﺎﺩ ﻣﺆﲤﺮ ﺧﱪﺍﺀ ﺍﻻﺳﺘﺨﺪﺍﻡ‬

‫‪١٨٢‬‬
‫ﺍﻟﺴﻠﻴﻢ ﻟﻠﺪﻭﺍﺀ ﰲ ﻧﲑﻭﰊ ﻋﺎﻡ ‪ ،١٩٨٥‬ﻭﺍﻟﺬﻱ ﺍﻋﺘﻤﺪﺕ ﺗﻮﺻﻴﺎﺗﻪ ﰲ ﺍﻟﻌﺎﻡ ﺍﻟﺘﺎﱄ ﺑﻮﺍﺳﻄﺔ ﳎﻠﺲ‬
‫ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ‪ .‬ﻟﻘﺪ ﺃﺩﺕ ﻫﺬﻩ ﺍﻷﻧﺸﻄﺔ ﻭﺍﳌﺒﺎﺩﺭﺍﺕ ﺍﳌﺘﺘﺎﻟﻴﺔ ﺇﱃ ﺍﻧﻌﻘﺎﺩ ﺍﺟﺘﻤﺎﻉ ﺧﺎﺹ ﻟﻠﺨﱪﺍﺀ ﻣﻦ‬
‫ﺧﻼﻝ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )ﻋﺎﻡ ‪ (١٩٨٦‬ﻟﻮﺿﻊ ﺇﺭﺷﺎﺩﺍﺕ ﻋﻤﻠﻴﺔ ﻳﻜﻮﻥ ﻣﻦ ﺷﺄ‪‬ﺎ ﻣﺴﺎﻋﺪﺓ‬
‫ﺍﻟﺪﻭﻝ ﺍﻷﻋﻀﺎﺀ ﻋﻠﻰ ﺻﻴﺎﻏﺔ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ‪ ،‬ﻭﻗﺪ ﺻﺪﺭﺕ ﻫﺬﻩ ﺍﻹﺭﺷﺎﺩﺍﺕ ﻋﺎﻡ ‪ ١٩٨٨‬ﰲ‬
‫ﺗﻘﺮﻳﺮ )ﺃﻭ ﻛﺘﻴﺐ( ﺑﻌﻨﻮﺍﻥ ‪ .Guidelines For Developing National Drug Policies‬ﻭﻛﻨﺘﻴﺠﺔ‬
‫ﳍﺬﻩ ﺍﳉﻬﻮﺩ‪ ،‬ﻭﺍﺳﺘﺠﺎﺑﺔ ﻟﻠﺤﺎﺟﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ ﻟﺘﻨﻈﻴﻢ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﻗﻀﺎﻳﺎ ﺍﻟﺪﻭﺍﺀ‪ ،‬ﺗﺼﺎﻋﺪ ﻋﺪﺩ ﺍﻟﺪﻭﻝ‬
‫ﺍﻟﱵ ﺍﻋﺘﻤﺪﺕ ﺳﻴﺎﺳﺎﺕ ﻭﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ ﻣﻦ ﻋﺪﺩ ‪ ١٤‬ﺩﻭﻟﺔ ﻋﺎﻡ ‪ ١٩٨٩‬ﺇﱃ ﻋﺪﺩ ‪ ٦٦‬ﺩﻭﻟﺔ ﻋﺎﻡ ‪ ،١٩٩٩‬ﺫﻟﻚ‬
‫ﺑﻴﻨﻤﺎ ﻭﺻﻞ ﻋﺪﺩ ﺍﻟﺪﻭﻝ ﺍﻟﱵ ﺗﻨﻈﻢ ﺣﺎﺟﺎ‪‬ﺎ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻣﻦ ﺧﻼﻝ ﻗﺎﺋﻤﺔ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺇﱃ ﻋﺪﺩ‬
‫‪ ١٥٦‬ﺩﻭﻟﺔ‪ ،‬ﰲ ﻧﻔﺲ ﺍﻟﻌﺎﻡ‪.‬‬
‫ﻭﺑﺎﺧﺘﺼﺎﺭ ﺷﺪﻳﺪ ﳝﻜﻦ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺃﻥ ﺍﳊﺎﺟﺔ ﺇﱃ ﻭﺟﻮﺩ ﺳﻴﺎﺳﺔ ﺩﻭﺍﺋﻴﺔ ﻗﻮﻣﻴﺔ ‪National Drug Policy‬‬
‫ﰲ ﻇﻞ ﺗﻌﻘﻴﺪﺍﺕ )ﻭﺗﻌﺪﺩ ﺟﻮﺍﻧﺐ( ﻗﻀﺎﻳﺎ ﺍﻟﺪﻭﺍﺀ ﺗﻌﻮﺩ ﺇﱃ ﺃﺳﺒﺎﺏ ﻋﺪﻳﺪﺓ‪ ،‬ﻓﻴﻤﺎ ﻳﻠﻲ ﺇﺷﺎﺭﺓ ﺇﱃ ﺃﳘﻬﺎ‪:‬‬
‫‪ .١‬ﺗﻘﺪﱘ ﺗﻮﺿﻴﺢ ﻣﻮﺛﻖ ﻟﻠﻘﻴﻢ ﻭﺍﻟﻄﻤﻮﺣﺎﺕ ﻭﺍﻷﻫﺪﺍﻑ ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﻭﺍﻻﻟﺘﺰﺍﻣﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ )ﻣﺘﻮﺳﻄﺔ‬
‫ﻭﻃﻮﻳﻠﺔ ﺍﳌﺪﻯ( ﲞﺼﻮﺹ ﻗﻀﺎﻳﺎ ﺍﻟﺪﻭﺍﺀ‪.‬‬
‫‪ .٢‬ﲢﺪﻳﺪ ﺍﻷﻫﺪﺍﻑ ﻭﺍﳌﻘﺎﺻﺪ ﻭﺍﻷﻭﻟﻮﻳﺎﺕ ﺍﳌﻨﻮﻃﺔ ﺇﱃ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺪﻭﺍﺋﻲ‪.‬‬
‫‪ .٣‬ﲢﺪﻳﺪ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﳌﻄﻠﻮﺑﺔ ﻟﺘﺤﻘﻴﻖ ﺍﻷﻫﺪﺍﻑ ﻭﺍﳌﻘﺎﺻﺪ ﻭﺍﻷﻭﻟﻮﻳﺎﺕ‪ ،‬ﻭﻛﺬﻟﻚ ﲢﺪﻳﺪ‬
‫ﺍﳌﺴﺌﻮﻟﻴﺎﺕ ﻭﺍﳌﺴﺌﻮﻟﲔ ﲞﺼﻮﺹ ﺗﻄﺒﻴﻖ ﺍﻟﺴﻴﺎﺳﺔ‪.‬‬
‫‪ .٤‬ﺗﺄﺳﻴﺲ ﻣﻨﺘﺪﻯ ‪ Forum‬ﻟﻠﻤﻨﺎﻗﺸﺎﺕ ﺍﻟﻘﻮﻣﻴﺔ ﲞﺼﻮﺹ ﻗﻀﺎﻳﺎ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‪.‬‬
‫ﻫﺬﺍ‪ ،‬ﻭﳚﺪﺭ ﺍﻻﻧﺘﺒﺎﻩ ﺇﱃ ﺃﻥ ﺍﳌﻘﺎﺻﺪ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻜﺎﻓﺔ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ ﺗﺘﻀﻤﻦ ﺍﳌﺴﺎﻭﺍﺓ ﰲ‬
‫ﺇﺗﺎﺣﺔ ﺍﻟﺪﻭﺍﺀ ﳌﻦ ﳛﺘﺎﺟﻪ‪ ،‬ﻭﺿﻤﺎﻥ ﺟﻮﺩﺓ ﺍﻟﺪﻭﺍﺀ‪ ،‬ﻭﺍﺳﺘﺨﺪﺍﻣﻪ ﺍﺳﺘﺨﺪﺍﻣﺎﹰ ﺳﻠﻴﻤﺎﹰ‪ .‬ﻭﻋﻦ ﻫﺬﻩ ﺍﳌﻘﺎﺻﺪ‬
‫ﻭﻏﲑﻫﺎ )ﻣﻦ ﻣﻘﺎﺻﺪ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ( ﻓﺈﻥ ﲢﺪﻳﺪﻫﺎ )ﻭﲢﺪﻳﺪ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺘﺤﻘﻴﻘﻬﺎ(‬
‫ﻳﻌﺘﻤﺪ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‪ ،‬ﻭﻋﻠﻰ ﻗﻴﻢ ﻭﺧﻴﺎﺭﺍﺕ ﺳﻴﺎﺳﻴﺔ‪ ،‬ﻛﻤﺎ ﻳﻌﺘﻤﺪ ﻛﺬﻟﻚ ﻋﻠﻰ‬
‫ﻋﻮﺍﻣﻞ ﺛﻘﺎﻓﻴﺔ ﻭﺗﺎﺭﳜﻴﺔ‪.‬‬

‫‪  -. -)/0 :$+,‬‬

‫ﺍﳌﻨﻈﻮﻣﺔ ﻫﻲ ﺍﻹﻃﺎﺭ )ﺃﻭ ﺍﻟﻜﻴﺎﻥ( ﺍﻟﺬﻱ ﲡﺮﻯ ﺩﺍﺧﻠﻪ ﺍﻟﻌﻤﻠﻴﺎﺕ ﻭﺍﻟﺘﻔﺎﻋﻼﺕ ﺍﳋﺎﺻﺔ ﺑﺘﺤﺪﻳﺪ ﺍﻷﻫﺪﺍﻑ‪،‬‬
‫ﻭﺑﺎﻟﺘﺸﻐﻴﻞ‪ ،‬ﻭﺍﻟﺘﻨﺴﻴﻖ ﻭﺍﳌﺘﺎﺑﻌﺔ‪ ،‬ﻭﻫﻲ ﺍﻟﱵ ﺗﻘﻮﻡ ﻣﻦ ﺧﻼﻝ ﺣﺮﻛﻴﺎ‪‬ﺎ ﺍﻟﺪﺍﺧﻠﻴﺔ ﺑﺎﺳﺘﻴﻌﺎﺏ‬
‫ﺍﻟﺘﺤﺪﻳﺎﺕ ﻭﺍﳌﺪﺧﻼﺕ‪ ،‬ﻭﲢﻮﻳﻠﻬﺎ ﲨﻴﻌﺎﹰ ﺇﱃ ﳐﺮﺟﺎﺕ ﲢﺎﻓﻆ ‪‬ﺎ ﻋﻠﻰ ﺍﺳﺘﻤﺮﺍﺭ ﻭﺟﻮﺩﻫﺎ ﻭﻋﻠﻰ ﺇﳒﺎﺯ‬
‫ﺗﻘﺪﻣﻬﺎ‪ .‬ﺇﻥ ﺍﳌﻜﻮﻧﺎﺕ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻠﻤﻨﻈﻮﻣﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ ﺗﺘﻀﻤﻦ ﺍﳉﻬﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳊﻜﻮﻣﻴﺔ‪،‬‬
‫ﻛﻤﺎ ﺗﺘﻀﻤﻦ ﻣﺆﺳﺴﺎﺕ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ .‬ﻫﺬﺍ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺟﻬﺎﺕ ﺃﺧﺮﻯ ﻣﺘﻌﺪﺩﺓ ﺗﻌﺘﻤﺪ ﰲ‬
‫ﻋﻤﻠﻬﺎ – ﺇﱃ ﺣﺪ ﻛﺒﲑ ‪ -‬ﻋﻠﻰ ﺍﳌﻜﻮﻧﺎﺕ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﺎ‪ .‬ﺇﻧﻨﺎ ﻧﻌﲏ ﻫﻨﺎ )ﰲ ﺛﺎﻧﻴﺎﹰ( ﺑﺎﳉﻬﺎﺕ‬
‫ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳊﻜﻮﻣﻴﺔ ﻭﺁﻟﻴﺎﺕ ﻋﻤﻠﻬﺎ‪ .‬ﰲ ﻫﺬﺍ ﺍﻹﻃﺎﺭ ﻧﺸﲑ ﺇﱃ ﺃﻥ ﺍﳉﻬﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳊﻜﻮﻣﻴﺔ ﺗﺘﺒﻊ‬
‫ﲨﻴﻌﻬﺎ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺗﺘﻜﻮﻥ ﺑﺸﻜﻞ ﺃﺳﺎﺳﻲ ﻣﻦ‪:‬‬
‫‪ .١‬ﺍﻹﺩﺍﺭﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﺸﺌﻮﻥ ﺍﻟﺼﻴﺪﻟﺔ‪.‬‬

‫‪١٨٣‬‬
 ‫‪ .٢‬ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺮﻗﺎﺑﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺍﻟﺪﻭﺍﺋﻴﺔ‪.‬‬
‫‪ .٣‬ﻣﺮﻛﺰ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‪.‬‬
‫ﻭﻓﻴﻤﺎ ﻳﻠﻲ ﻧﺸﲑ ﺇﱃ ﺍﳌﻬﺎﻡ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﳌﻨﻮﻃﺔ ‪‬ﺬﻩ ﺍﳉﻬﺎﺕ‪.‬‬

‫‪ -١‬ﺍﻹﺩﺍﺭﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﺸﺌﻮﻥ ﺍﻟﺼﻴﺪﻟﺔ‬

‫ﺗﺘﺤﻤﻞ ﺍﻹﺩﺍﺭﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﺸﺌﻮﻥ ﺍﻟﺼﻴﺪﻟﺔ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺴﺌﻮﻟﻴﺎﺕ ﺍﻹﺩﺍﺭﻳﺔ ﺍﳍﺎﻣﺔ ﺑﺸـﺄﻥ ﺍﻟﺘﻴﺴﲑ‬
‫ﺍﻹﺩﺍﺭﻱ ﻭﺍﻟﻔﲏ ﻟﺸﺌﻮﻥ ﺍﻟﺪﻭﺍﺀ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻘﻮﻣﻲ‪ ،‬ﻭﻳﻌﻮﺩ ﺇﻟﻴﻬﺎ ﺍﻻﺧﺘﺼﺎﺹ ﰲ ﻫﺬﻩ ﺍﻷﻣﻮﺭ ﻣﻦ ﺧﻼﻝ‬
‫ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﻬﺎﻡ ﺍﳌﻮﻛﻠﺔ ﺇﻟﻴﻬﺎ ﻭﻣﻦ ﺃﳘﻬﺎ ﻣﺎ ﻳﻠﻲ‪:‬‬
‫ﺍﻹﺷﺮﺍﻑ ﻋﻠﻰ ﺗﻨﻔﻴﺬ ﺃﺣﻜﺎﻡ ﻗﺎﻧﻮﻥ ﻣﺰﺍﻭﻟﺔ ﻣﻬﻨﺔ ﺍﻟﺼﻴﺪﻟﺔ ﻭﻗﺎﻧﻮﻥ ﺍﳌﺨﺪﺭﺍﺕ ﻭﺍﻟﻘﻮﺍﻧﲔ‬ ‫‪-‬‬
‫ﺍﳌﻌﺪﻟﺔ ﻟﻪ‪ ،‬ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﳌﻨﻔﺬﺓ ﳍﻤﺎ‪.‬‬
‫ﺍﻟﺘﺮﺧﻴﺺ ﺑﻔﺘﺢ ﻣﺼﺎﻧﻊ ﺍﻷﺩﻭﻳﺔ ﻭﺍﳌﺴﺘﻮﺩﻋﺎﺕ ﻭﺍﳌﺨﺎﺯﻥ ﺍﻟﺘﺎﺑﻌﺔ ﳍﺎ‪.‬‬ ‫‪-‬‬
‫ﺗﺴﺠﻴﻞ ﺍﻷﺩﻭﻳﺔ ﺍﶈﻠﻴﺔ ﻭﺍﻷﺟﻨﺒﻴﺔ‪ ،‬ﻭﺍﻟﺮﻗﺎﺑﺔ ﻋﻠﻰ ﺍﻷﺩﻭﻳﺔ ﻭﺍﻟﻜﻴﻤﺎﻭﻳﺎﺕ ﺍﳌﺴﺘﻮﺭﺩﺓ ﻭﺍﳌﺼﻨﻌﺔ‬ ‫‪-‬‬
‫ﳏﻠﻴﺎﹰ ﻭﺍﳌﺼﺪﺭﺓ‪.‬‬
‫ﻣﺘﺎﺑﻌﺔ ﺍﻷﺩﺍﺀ ﺍﻟﺼﻴﺪﱄ ﰲ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻠﻮﺯﺍﺭﺓ ﻣﺮﻛﺰﻳﺎ‪ ،‬ﻭﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺸﺌﻮﻥ ﺍﻟﺼﺤﻴﺔ‬ ‫‪-‬‬
‫ﺑﺎﶈﻠﻴﺎﺕ‪.‬‬
‫ﺍﻟﺮﻗﺎﺑﺔ ﻋﻠﻰ ﺗﻮﻓﲑ ﺍﻷﺩﻭﻳﺔ ﻟﻠﻮﺣﺪﺍﺕ ﺍﳊﻜﻮﻣﻴﺔ ﻭﻭﺣﺪﺍﺕ ﺍﻟﻘﻄﺎﻋﲔ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ ﻃﺒﻘ ﹰﺎ‬ ‫‪-‬‬
‫ﻟﻠﺨﻄﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻘﻮﻣﻲ‪ ،‬ﻭﻭﺿﻊ ﺍﳋﻄﻂ ﻭﺍﻟﱪﺍﻣﺞ ﺍﻟﱵ ‪‬ﺪﻑ ﺇﱃ ﺗﺮﺷﻴﺪ‬
‫ﺍﺳﺘﻬﻼﻙ ﺍﻟﺪﻭﺍﺀ ﻭﻣﺘﺎﺑﻌﺘﻬﺎ‪.‬‬
‫ﻫﺬﺍ‪ ،‬ﻭﺗﻨﺠﺰ ﺍﻹﺩﺍﺭﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﺸﺌﻮﻥ ﺍﻟﺼﻴﺪﻟﺔ ﻣﻬﺎﻣﻬﺎ ﻣﻦ ﺧﻼﻝ ﻋﺪﺩ ﻣﻦ ﺍﻹﺩﺍﺭﺍﺕ ﺍﻟﻌﺎﻣﺔ )ﲣﺘﺺ‬
‫ﺑﺎﻟﺘﻔﺘﻴﺶ ﻭﺍﻟﺘﺴﺠﻴﻞ ﻭﺍﻟﺘﺮﺧﻴﺺ ﻭﺍﻟﺪﺭﺍﺳﺎﺕ‪ ..‬ﺍﱁ(‪ ،‬ﻛﻤﺎ ﺃ‪‬ﺎ ﺗﺘﻌﺎﻭﻥ ﰲ ﺃﺩﺍﺀ ﻣﻬﺎﻣﻬﺎ ﻣﻊ ﺍﳉﻬﺘﲔ‬
‫ﺍﻷﺧﺮﻳﲔ )ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺮﻗﺎﺑﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻭﻣﺮﻛﺰ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ(‪.‬‬

‫‪ -٢‬ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺮﻗﺎﺑﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺍﻟﺪﻭﺍﺋﻴﺔ‬

‫ﰎ ﺇﻧﺸﺎﺀ ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺮﻗﺎﺑﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻋﺎﻡ ‪ ،١٩٧٦‬ﻭﺫﻟﻚ ﺑﺪﻣﺞ ﻛﻞ ﻣﻦ ﻣﻌﺎﻣﻞ ﺍﻟﺮﻗﺎﺑﺔ‬
‫ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﻣﺮﻛﺰ ﺍﻷﲝﺎﺙ ﻭﺍﻟﺮﻗﺎﺑﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ ،‬ﻭﺗﻌﺘﱪ ﻫﻴﺌﺔ ﻋﻠﻤﻴﺔ‪ ،‬ﻭﺗﺘﺤﺪﺩ ﻣﻬﺎﻡ ﻫﺬﻩ‬
‫ﺍﳍﻴﺌﺔ )ﲞﺼﻮﺹ ﺍﻟﺪﻭﺍﺀ( ﰲ ﺃﺩﺍﺀ ﻣﺎ ﻳﻠﻲ‪:‬‬
‫ﺍﻟﻘﻴﺎﻡ ﺑﺎﻷﻋﻤﺎﻝ ﺍﻟﺮﻗﺎﺑﻴﺔ ﻋﻠﻰ ﺍﳌﺴﺘﺤﻀﺮﺍﺕ ﻭﻣﻮﺍﺩﻫﺎ ﺍﳋﺎﻡ ﻭﺍﺳﺘﺤﺪﺍﺙ ﺍﻟﻮﺳﺎﺋﻞ ﻭﺍﻟﻄﺮﻕ‬ ‫‪-‬‬
‫ﺍﻟﺮﻗﺎﺑﻴﺔ ﲟﺎ ﻳﺘﻔﻖ ﻭﺍﻟﺘﻘﺪﻡ ﺍﻟﻌﻠﻤﻲ‪.‬‬
‫ﺇﺟﺮﺍﺀ ﺍﻟﺘﺤﺎﻟﻴﻞ ﻭﺍﻟﻔﺤﻮﺹ ﻭﺍﻟﺪﺭﺍﺳﺎﺕ ﻋﻠﻰ ﺍﳌﺴﺘﺤﻀﺮﺍﺕ ﺍﳌﺴﺘﺠﺪﺓ ﻭﺍﳌﻌﺪﺓ ﻟﻠﺘﺴﺠﻴﻞ ﺃﻭ‬ ‫‪-‬‬
‫ﺍﻟﱵ ﺗﺪﻋﻮ ﺍﳊﺎﺟﺔ ﺇﱃ ﺗﻘﻴﻴﻤﻬﺎ ﺃﻭ ﺇﻋﺎﺩﺓ ﺍﻟﻨﻈﺮ ﰲ ﺗﻘﻴﻴﻤﻬﺎ‪ ،‬ﻭﺫﻟﻚ ‪‬ﺪﻑ ﺿﻤﺎﻥ ﻣﻄﺎﺑﻘﺘﻬﺎ‬
‫ﻟﻠﻤﻮﺍﺻﻔﺎﺕ‪ ،‬ﻭﻓﺎﻋﻠﻴﺘﻬﺎ‪ ،‬ﻭﺧﻠﻮﻫﺎ ﻣﻦ ﺍﻷﺿﺮﺍﺭ‪.‬‬
‫ﺇﻗﺮﺍﺭ ﺍﳌﻮﺍﺻﻔﺎﺕ ﺍﻟﺮﻗﺎﺑﻴﺔ ﻟﻠﻤﺴﺘﺤﻀﺮﺍﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﻨﻬﻮﺽ ﺑﺎﳌﺴﺘﻮﻯ ﺍﻟﻌﻠﻤﻲ ﰲ ﳎﺎﻝ ﺍﻟﺮﻗﺎﺑﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‪.‬‬ ‫‪-‬‬
‫‪١٨٤‬‬
‫ﺗﻘﺪﱘ ﺍﳌﺸﻮﺭﺓ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﻟﺪﺭﺍﺳﺎﺕ ﻟﻠﺠﻬﺎﺕ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺇﺟﺮﺍﺀ ﺍﻷﲝﺎﺙ ﺍﻟﻌﻠﻤﻴﺔ ﰲ ﳎﺎﻻﺕ‬ ‫‪-‬‬
‫ﺍﻟﺮﻗﺎﺑﺔ ﻭﺍﻟﺘﻘﻴﻴﻢ ﺍﻟﺪﻭﺍﺋﻲ‪.‬‬
‫ﺇﺑﺪﺍﺀ ﺍﻟﺮﺃﻱ ﰲ ﺍﳌﻀﻤﻮﻥ ﺍﻟﻌﻠﻤﻲ ﻟﻠﻨﺸﺮﺍﺕ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﻹﻋﻼﻧﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻋﻦ ﺍﳌﻮﺍﺩ‬ ‫‪-‬‬
‫ﻭﺍﳌﺴﺘﺤﻀﺮﺍﺕ ﺍﻟﻌﻼﺟﻴﺔ‪.‬‬
‫ﺇﺻﺪﺍﺭ ﺍﻟﻨﺸﺮﺍﺕ ﺍﻹﻋﻼﻣﻴﺔ ﻋﻦ ﺍﻷﺩﻭﻳﺔ ﺍﳉﺪﻳﺪﺓ ﺃﻭ ﺍﻷﺩﻭﻳﺔ ﺍﻟﱵ ﻳﺒﻄﻞ ﺍﺳﺘﻌﻤﺎﳍﺎ‪ ،‬ﻭﻋﻦ‬ ‫‪-‬‬
‫ﺍﻟﺘﺄﺛﲑﺍﺕ ﺍﳉﺎﻧﺒﻴﺔ ﺍﻟﱵ ﺗﻨﺘﺞ ﻋﻦ ﺍﻷﺩﻭﻳﺔ‪.‬‬
‫ﺍﻟﺘﺼﺮﻳﺢ ﺑﺈﺟﺮﺍﺀ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻹﻛﻠﻴﻨﻴﻜﻴﺔ ﺍﻟﱵ ‪‬ﺪﻑ ﺇﱃ ﺗﻘﻴﻴﻢ ﺗﺄﺛﲑ ﺍﻷﺩﻭﻳﺔ ﰲ ﺍﻹﻧﺴﺎﻥ‪.‬‬ ‫‪-‬‬
‫ﻣﺰﺍﻭﻟﺔ ﺍﻻﺧﺘﺼﺎﺻﺎﺕ ﻭﺍﻟﺴﻠﻄﺎﺕ ﺍﻷﺧﺮﻯ ﺍﻟﱵ ﻛﺎﻧﺖ ﺗﺒﺎﺷﺮﻫﺎ ﺍﳉﻬﺎﺕ ﺍﻟﱵ ﻧﻘﻠﺖ ﺇﻟﻴﻬﺎ‬ ‫‪-‬‬
‫)ﺧﺎﺻﺔ ﲝﻮﺙ ﻭﺗﻄﻮﻳﺮ ﺍﻷﺩﻭﻳﺔ(‪.‬‬
‫ﻫﺬﺍ‪ ،‬ﻭﺗﺘﻜﻮﻥ ﺍﳍﻴﺌﺔ ﻣﻦ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺸﻌﺐ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﳌﻌﺎﻣﻞ ﻭﺍﳌﺮﺍﻛﺰ ﺍﳌﺘﺨﺼﺼﺔ ﰲ ﺍ‪‬ﺎﻻﺕ‬
‫ﺍﳌﺨﺘﻠﻔﺔ ﻟﺮﻗﺎﺑﺔ ﻭﲝﻮﺙ ﺍﻟﺪﻭﺍﺀ )ﺍﻟﻜﻴﻤﻴﺎﺀ – ﺍﻟﻨﺒﺎﺕ – ﺍﳌﻴﻜﺮﻭﺑﻴﻮﻟﻮﺟﻴﺎ – ﺍﻟﻨﺒﺎﺗﺎﺕ ﺍﻟﻄﺒﻴﺔ –‬
‫ﺍﻟﻔﺎﺭﻣﺎﻛﻮﻟﻮﺟﻴﺎ ﻭﺍﻟﺴﻤﻮﻡ – ﺍﻟﻜﻴﻤﻴﺎﺀ ﺍﳊﻴﻮﻳﺔ – ﺍﳌﻌﻠﻮﻣﺎﺗﻴﺔ – ﺍﻹﺗﺎﺣﺔ ﺍﳊﻴﻮﻳﺔ ﻟﻸﺩﻭﻳﺔ‪ ..‬ﺍﱁ(‪.‬‬

‫‪ -٣‬ﻣﺮﻛﺰ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‬

‫ﻧﺸﺄ ﻫﺬﺍ ﺍﳌﺮﻛﺰ ﰲ ﺍﻟﺒﺪﺍﻳﺔ ﺑﺎﺳﻢ ﳉﻨﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻋﺎﻡ )‪ ،(١٩٩٢‬ﰒ ﺗﻐﲑ ﺍﻻﺳﻢ ﻋﺎﻡ ‪ ١٩٩٥‬ﺇﱃ‬
‫ﻣﺴﻤﻰ ﻣﺮﻛﺰ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ ،‬ﻭﺇﻥ ﻛﺎﻧﺖ ﺍﳌﻬﺎﻡ ﱂ ﺗﺘﻐﲑ‪ .‬ﻭﻳﺘﻮﱃ ﻫﺬﺍ ﺍﳌﺮﻛﺰ ﺍﻟﻘﻴﺎﻡ‬
‫ﲟﺎ ﻳﻠﻲ‪:‬‬
‫ﺇﻋﺪﺍﺩ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻭﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻟﻼﺯﻣﺔ ﻟﺘﺴﻌﲑ ﻣﻨﺘﺠﺎﺕ ﺷﺮﻛﺎﺕ ﺍﻷﺩﻭﻳﺔ‪.‬‬ ‫‪-‬‬
‫ﺗﺪﻋﻴﻢ ﺍﻹﻋﻼﻡ ﺍﻟﺪﻭﺍﺋﻲ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﺴﻌﻲ ﺇﱃ ﲢﻘﻴﻖ ﻣﺎ ﻳﻜﻔﻞ ﺗﻮﻓﲑ ﺍﻟﺪﻭﺍﺀ ﻭﺍﺳﺘﻜﻤﺎﻝ ﻧﻮﺍﻗﺼﻪ‪.‬‬ ‫‪-‬‬
‫ﺩﻋﻢ ﺍﻟﺒﺤﻮﺙ ﺍﻟﻌﻠﻤﻴﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻭﺗﺪﺍﻭﻝ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﻟﺘﻨﻈﻴﻤﻴﺔ ﺍﳌﺘﻌﻠﻘـﺔ ﺑﺎﻟﺪﻭﺍﺀ‪.‬‬ ‫‪-‬‬
‫ﻣﺒﺎﺷﺮﺓ ﺍﳌﻬﺎﻡ ﺍﻟﱵ ﻛﺎﻧﺖ ﺗﻘﻮﻡ ‪‬ﺎ ﻫﻴﺌﺔ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﻟﻸﺩﻭﻳﺔ ﻭﺍﻟﻜﻴﻤﺎﻭﻳﺎﺕ ﻭﺍﳌﺴﺘﻠﺰﻣﺎﺕ‬ ‫‪-‬‬
‫ﺍﻟﻄﺒﻴﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺘﺴﺠﻴﻞ ﺍﻷﺩﻭﻳﺔ )ﻣﻠﺤﻮﻇﺔ‪ :‬ﺍﳍﻴﺌﺔ ﺍﳌﺬﻛﻮﺭﺓ ﺃﻟﻐﻴﺖ ﻣﻦ ﺧﻼﻝ ﲢﻮﳍﺎ‬
‫ﺇﱃ ﺷﺮﻛﺔ ﻗﺎﺑﻀﺔ ﰲ ﻗﻄﺎﻉ ﺍﻷﻋﻤﺎﻝ(‪.‬‬
‫ﺍﳉﺪﻳﺮ ﺑﺎﻹﺷﺎﺭﺓ ﺃﻥ ﻛﻼ ﻣﻦ ﺍﻹﺩﺍﺭﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﺸﺌﻮﻥ ﺍﻟﺼﻴﺪﻟﺔ ﻭﻣﺮﻛﺰ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‬
‫ﳝﺎﺭﺳﺎ ﺃﻋﻤﺎﳍﻤﺎ ﰲ ﺇﻃﺎﺭ ﻋﺪﺩ ﻣﻦ ﺍﻟﻘﻮﺍﻧﲔ ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﳌﺮﺟﻌﻴﺔ ﻭﺍﻟﱵ ﺗﻀﻢ – ﰲ ﺍﻷﺳﺎﺱ – ﻣﺎ ﻳﻠﻲ‪:‬‬
‫ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ١٢٧‬ﻟﺴﻨﺔ ‪ ١٩٥٥‬ﰲ ﺷﺄﻥ ﻣﺰﺍﻟﺔ ﻣﻬﻨﺔ ﺍﻟﺼﻴﺪﻟﺔ‪.‬‬ ‫‪-‬‬
‫ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٢١٢‬ﻟﺴﻨﺔ ‪ ١٩٦٠‬ﺑﺸﺄﻥ ﺗﻨﻈﻴﻢ ﲡﺎﺭﺓ ﺍﻷﺩﻭﻳﺔ ﻭﺍﳌﺴﺘﻠﺰﻣﺎﺕ ﻭﺍﻟﻜﻴﻤﺎﻭﻳﺎﺕ‬ ‫‪-‬‬
‫ﺍﻟﻄﺒﻴﺔ‪ ،‬ﻭﺍﻟﻘﻮﺍﻧﲔ ﺍﳌﻌﺪﻟﺔ ﻟﻪ‪.‬‬
‫ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ١١٨‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﰲ ﺷﺄﻥ ﺍﻻﺳﺘﲑﺍﺩ ﻭﺍﻟﺘﺼﺪﻳﺮ‪.‬‬ ‫‪-‬‬
‫ﻗﺮﺍﺭ ﺭﺋﻴﺲ ﺍﳉﻤﻬﻮﺭﻳﺔ ﺭﻗﻢ ‪ ٩٦‬ﻟﺴﻨﺔ ‪ ١٩٧٨‬ﺑﺈﻧﺸﺎﺀ ﺻﻨﺪﻭﻕ ﻟﺘﺤﺴﲔ ﺍﳋﺪﻣﺔ ﻭﺩﻋﻢ ﺍﻟﺒﺤﻮﺙ‬ ‫‪-‬‬
‫ﺍﳌﺸﺘﺮﻛﺔ ﺑﺎﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‪.‬‬

‫‪١٨٥‬‬
‫ﻗﺮﺍﺭ ﳎﻠﺲ ﺍﻟﻮﺯﺭﺍﺀ ﺍﻟﺼﺎﺩﺭ ﲜﻠﺴﺘﻪ ﺍﳌﻌﻘﻮﺩﺓ ﺑﺘﺎﺭﻳﺦ ‪ ١٩٨٩/٩/٣٠‬ﰲ ﺷﺄﻥ ﺗﺴﻌﲑ ﻣﻨﺘﺠﺎﺕ‬ ‫‪-‬‬
‫ﺷﺮﻛﺎﺕ ﺍﻷﺩﻭﻳﺔ ﺍﳋﺎﺿﻌﺔ ﻟﻘﺎﻧﻮﻥ ﺍﻻﺳﺘﺜﻤﺎﺭ‪.‬‬
‫ﻫﺬﺍ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻋﺪﺩ ﻣﻦ ﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﻟﻮﺯﺍﺭﻳﺔ‪.‬‬ ‫‪-‬‬
‫ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳉﻬﺎﺕ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﻟﺜﻼﺙ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﺎ ﺗﻮﺟﺪ ﻛﻴﺎﻧﺎﺕ ﺃﺧﺮﻯ ﺗﺘﺼﻞ ﻣﻬﺎﻣﻬﺎ‬
‫ﻭﺍﻫﺘﻤﺎﻣﺎ‪‬ﺎ ﺑﺸﻜﻞ ﺃﻭ ﺁﺧﺮ ﺑﺎﳌﻨﻈﻮﻣﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ‪ .‬ﻭﻣﻦ ﺃﻫﻢ ﻫﺬﻩ ﺍﻟﻜﻴﺎﻧﺎﺕ ﻧﺸﲑ ﺇﱃ‪:‬‬
‫ﻏﺮﻓﺔ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺑﺎﲢﺎﺩ ﺍﻟﺼﻨﺎﻋﺎﺕ‪.‬‬ ‫‪-‬‬
‫ﺷﻌﺒﺔ ﲝﻮﺙ ﺍﻟﺪﻭﺍﺀ ﲟﺠﻠﺲ ﺍﻟﺒﺤﻮﺙ ﺍﻟﻄﺒﻴﺔ ﺑﺄﻛﺎﺩﳝﻴﺔ ﺍﻟﺒﺤﺚ ﺍﻟﻌﻠﻤﻲ‪.‬‬ ‫‪-‬‬
‫ﺷﻌﺒﺔ ﺍﻟﺪﻭﺍﺀ ﲟﺠﻠﺲ ﺍﳋﺪﻣﺎﺕ ﺑﺎ‪‬ﺎﻟﺲ ﺍﻟﻘﻮﻣﻴﺔ ﺍﳌﺘﺨﺼﺼﺔ‪.‬‬ ‫‪-‬‬
‫ﻭﲡﺪﺭ ﺍﻹﺷﺎﺭﺓ ﺃﻳﻀﺎﹰ ﺇﱃ ﻭﺟﻮﺩ ﳉﺎﻥ ﻋﻠﻤﻴﺔ ﺗﺴﺎﻫﻢ ﺑﺎﻟﺮﺃﻱ ﰲ ﻗﺮﺍﺭﺍﺕ ﺗﺴﺠﻴﻞ ﺍﻷﺩﻭﻳﺔ‪ .‬ﺗﻀﻢ ﻫﺬﻩ‬
‫ﺍﻟﻠﺠﺎﻥ ﳉﻨﺔ ﺍﻟﻔﺎﺭﻣﺎﻛﻮﻟﻮﺟﻴﺎ ﻭﳉﺎﻥ ﻃﺒﻴﺔ ﻣﺘﺨﺼﺼﺔ ﰲ ﺷﱴ ﻓﺮﻭﻉ ﺍﻟﻄﺐ‪ ،‬ﻛﻤﺎ ﺗﺘﻢ ﺍﳌﻮﺍﻓﻘﺔ‬
‫ﺍﻟﻨﻬﺎﺋﻴﺔ ﻋﻠﻰ ﺗﺴﺠﻴﻞ ﺃﻭ ﻋﺪﻡ ﺗﺴﺠﻴﻞ ﺍﻟﺪﻭﺍﺀ ﺑﻮﺍﺳﻄﺔ ﺍﻟﻠﺠﻨﺔ ﺍﻟﻔﻨﻴﺔ ﳌﺮﺍﻗﺒﺔ ﺍﻷﺩﻭﻳﺔ‪ .‬ﻫﺬﺍ‪ ،‬ﻭﺗﻮﺟﺪ‬
‫ﳉﻨﺔ ﺧﺎﺻﺔ ﺑﻘﺎﺋﻤﺔ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ‪.‬‬
‫ﻭﺍﳉﺪﻳﺮ ﺑﺎﻟﺬﻛﺮ ﺃﻧﻪ ﻗﺪ ﻧﺸﺄ ﻣﺆﺧﺮﺍﹰ ﳎﻠﺲ ﻟﺘﺤﺪﻳﺚ ﻭﺗﻄﻮﻳﺮ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﻭﺍﳌﺴﺘﻠﺰﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ‬
‫ﳜﺘﺺ ﺃﻳﻀﺎﹰ ﺑﺎﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺘﺴﻌﲑ‪ ،‬ﻭﺫﻟﻚ ﺑﻘﺮﺍﺭ ﺭﺋﻴﺲ ﳎﻠﺲ ﺍﻟﻮﺯﺭﺍﺀ ﺭﻗﻢ ‪ ١٢١٦‬ﻟﺴﻨﺔ ‪ ٢٠٠٢‬ﻭﻳﺘﻌﻠﻖ‬
‫ﻫﺬﺍ ﺍ‪‬ﻠﺲ ﻃﺒﻘﺎﹰ ﻟﻘﺮﺍﺭ ﺇﻧﺸﺎﺋﻪ ﺑﻮﺿﻊ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﲞﺼﻮﺹ ﲢﺪﻳﺚ ﺍﻟﺼﻨﺎﻋﺔ‪،‬‬
‫ﻭﺇﻋﺪﺍﺩ ﺍﻟﺘﺨﻄﻴﻂ ﻟﻠﺘﺴﻌﲑ ﺍﻟﻌﺎﺩﻝ‪ ،‬ﻭﺍﻟﺘﺮﻭﻳﺞ ﻟﻼﺳﺘﺜﻤﺎﺭﺍﺕ ﰲ ﳎﺎﱄ ﺍﳋﺎﻣﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ ،‬ﻭﺍﳌﺴﺘﻠﺰﻣﺎﺕ‬
‫ﺍﻟﻄﺒﻴﺔ ﻭﺗﻨﺸﻴﻂ ﺍﻟﺼﺎﺩﺭﺍﺕ ﺍﳌﺼﺮﻳﺔ‪ ،‬ﻭﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺗﻮﻓﲑ ﺍﻷﺩﻭﻳﺔ ﻭﺍﳌﺴﺘﻠﺰﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﶈﺪﻭﺩﻱ‬
‫ﺍﻟﺪﺧﻞ‪ ..‬ﺍﱁ‪ .‬ﻭﳝﺎﺭﺱ ﺍ‪‬ﻠﺲ ﻣﻬﺎﻣﻪ ﺑﺮﺋﺎﺳﺔ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬

‫‪-1  -. -2 3 :$,‬‬

‫ﻗﺒﻞ ﺗﻨﺎﻭﻝ ﺣﺎﻝ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ ﰲ ﻣﺼﺮ ﻓﺈﻧﻪ ﲡﺪﺭ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺍﻻﻋﺘﺒﺎﺭﺍﺕ ﺍﳌﻨﻄﻘﻴﺔ‬
‫ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫ﺍﻻﻋﺘﺒﺎﺭ ﺍﻷﻭﻝ‪ :‬ﺃﻥ ﻭﺟﻮﺩ ﺳﻴﺎﺳﺔ ﺩﻭﺍﺋﻴﺔ ﻭﻃﻨﻴﺔ ﺃﻣﺮ ﻳﻌﲏ ﻭﺟﻮﺩ ﺍﻟﺘﺰﺍﻡ ‪‬ﺪﻑ )ﺃﻭ ﺑﺄﻫﺪﺍﻑ(‪ ،‬ﻭﻳﻌﲏ‬
‫ﺃﻳﻀﺎﹰ ﻭﺟﻮﺩ ﺗﺼﻮﺭ ﺍﺳﺘﺮﺷﺎﺩﻱ ﻟﻠﺘﻄﺒﻴﻖ‪.‬‬
‫ﺍﻻﻋﺘﺒﺎﺭ ﺍﻟﺜﺎﱐ‪ :‬ﺃﻧﻪ ﰲ ﻋﺪﻡ ﻭﺟﻮﺩ ﻭﺛﻴﻘﺔ ﻟﻠﺴﻴﺎﺳﺔ )ﺃﻱ ﰲ ﻏﻴﺒﺔ ﺳﻴﺎﺳﻴﺔ ﻣﻜﺘﻮﺑﺔ( ﻓﺈﻧﻪ ﻣﻦ‬
‫ﺍﻟﺼﻌﺐ )ﺃﻭ ﻣﻦ ﺍﳌﺴﺘﺤﻴﻞ( ﺍﻟﻘﻮﻝ ﺑﻮﺟﻮﺩ ﺍﻟﺘﺰﺍﻡ ‪‬ﺪﻑ )ﺃﻭ ﺑﺄﻫﺪﺍﻑ(‪ ،‬ﺃﻭ ﺑﻮﺟﻮﺩ ﺗﺼﻮﺭ‬
‫ﺍﺳﺘﺮﺷﺎﺩﻱ ﻟﻠﺘﻄﺒﻴﻖ‪.‬‬
‫ﺍﻻﻋﺘﺒﺎﺭ ﺍﻟﺜﺎﻟﺚ‪ :‬ﺃﻥ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻮﺻﻞ ﺇﱃ ﺳﻴﺎﺳﺔ ﺩﻭﺍﺋﻴﺔ ﻭﻃﻨﻴﺔ )ﲟﺎ ﺗﺘﻀﻤﻨﻪ ﻣﻦ ﺗﺼﻮﺭﺍﺕ‬
‫ﻭﺍﺳﺘﺸﺎﺭﺍﺕ ﻭﻣﻨﺎﻗﺸﺎﺕ ﻭﺩﺭﺍﺳﺎﺕ‪ ..‬ﺍﱁ( ﺗﺘﻜﺎﻓﺄ ﰲ ﺍﻷﳘﻴﺔ ﻣﻊ ﻣﺴﺄﻟﺔ ﻭﺟﻮﺩ‬
‫ﺍﻟﺴﻴﺎﺳﺔ ﻛﻮﺛﻴﻘﺔ‪ .‬ﻭﺑﺎﻟﺘﺎﱄ ﻓﺈﻧﻪ ﰲ ﻏﻴﺒﺔ ﻋﻤﻠﻴﺔ ‪ Process‬ﻛﻔﺌﺔ ﻟﻠﺘﻮﺻﻞ ﺇﱃ‬
‫ﺳﻴﺎﺳﺔ ﻓﺈﻥ ﺍﻟﻮﺛﻴﻘﺔ ﺍﻟﻨﺎﲡﺔ ﺳﺘﻜﻮﻥ ﻭﺛﻴﻘﺔ ﻏﲑ ﻛﻔﺌﺔ‪.‬‬

‫‪١٨٦‬‬
‫ﺍﻻﻋﺘﺒﺎﺭ ﺍﻟﺮﺍﺑﻊ‪ :‬ﺃﻥ ﻭﺟﻮﺩ ﺳﻴﺎﺳﺔ ﺩﻭﺍﺋﻴﺔ ﺩﻭﻥ ﻭﺟﻮﺩ ﺧﻄﺔ ﻟﻠﺘﻄﺒﻴﻖ ﺃﻣﺮ ﻳﻌﲏ ﺃﻥ ﺍﻟﺴﻴﺎﺳﺔ ﳎﺮﺩ‬
‫ﻭﺛﻴﻘﺔ ﻣﻴﺘﺔ‪.‬‬
‫ﻭﻫﻜﺬﺍ‪ ،‬ﺑﺎﻷﺧﺬ ﰲ ﺍﳊﺴﺒﺎﻥ ﻟﻼﻋﺘﺒﺎﺭﺍﺕ ﺍﻷﺭﺑﻌﺔ ﺍﻟﺴﺎﺑﻘﺔ ﺗﺘﺠﺴﻢ ﺍﻟﺮﺅﻳﺔ ﺍﻟﺘﻘﻮﳝﻴﺔ ﳊﺎﻝ ﺍﻟﺴﻴﺎﺳﺔ‬
‫ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ ﰲ ﻣﺼﺮ‪ .‬ﻓﺒﺎﻟﺮﻏﻢ ﻣﻦ ﻭﺟﻮﺩ ﺑﲏ ‪ Structures‬ﺩﻭﺍﺋﻴﺔ ﺿﺨﻤﺔ ﻭﻋﺮﻳﻘﺔ )ﻛﻤﺎ ﻭﺿﺢ‬
‫ﰲ ﺍﳉﺰﺀ ﺍﻟﺴﺎﺑﻖ "ﺛﺎﻧﻴﺎﹰ( ﻣﻘﺎﺭﻧﺔ ﺑﺎﻟﺒﲏ ﺍﳌﺜﻴﻠﺔ ﰲ ﻛﺎﻓﺔ ﺩﻭﻝ ﺍﳌﻨﻄﻘﺔ ﻭﻣﻌﻈﻢ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ‪ ،‬ﺇﻻ ﺃﻥ‬
‫ﻫﺬﻩ ﺍﻟﺒﲎ )ﲟﺎ ﺗﻀﻢ ﻣﻦ ﻣﻮﺍﺭﺩ ﺑﺸﺮﻳﺔ ﻣﺸﻬﻮﺩ ﳍﺎ ﺑﺎﻟﻜﻔﺎﺀﺓ( ﻛﺎﻧﺖ – ﻭﺭﲟﺎ ﻻ ﺯﺍﻟﺖ – ﺗﻔﺘﻘﺪ ﺇﱃ‬
‫ﺍﻟﻄﺮﻳﻖ ﺍﻷﻣﺜﻞ ﻟﻸﺩﺍﺀ ﺍﻟﻜﻒﺀ ﻭﺍﳌﺘﻄﻮﺭ ﺩﺍﺋﻤﺎﹰ‪ ،‬ﻭﺫﻟﻚ ﺑﺴﺒﺐ ﻏﻴﺒﺔ ﺍﻟﻌﻤﻞ ﰲ ﺇﻃﺎﺭ ﺍﻋﺘﺒﺎﺭﺍﺕ ﺍﳌﻨﻈﻮﻣﺔ‬
‫‪ ،System‬ﻭﺩﻳﻨﺎﻣﻴﻜﻴﺎ‪‬ﺎ ﺍﻟﻔﺎﻋﻠﺔ ‪ ،Active Mechanisms‬ﻭﺍﻟﺸﻔﺎﻓﺔ‪ ،‬ﻭﺍﳌﺘﻄﻮﺭﺓ ﺑﺎﺳﺘﻤﺮﺍﺭ‪ .‬ﺇﻥ ﻫﺬﻩ‬
‫ﺍﻟﻮﺿﻌﻴﺔ ﺗﺘﺠﺴﻢ ﻛﺤﻘﻴﻘﺔ ﰲ ﺿﻌﻒ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ‪ ،‬ﻭﺫﻟﻚ ﺳﻮﺍﺀ ﻗﺒﻞ ﺻﺪﻭﺭ‬
‫ﺍﻟﻮﺛﻴﻘﺔ ﺍﳌﻌﻨﻮﻧﺔ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ )ﻋﺎﻡ ‪ ،(٢٠٠١‬ﺃﻡ ﺑﻌﺪ ﺻﺪﻭﺭ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ‪.‬‬
‫ﺇﻥ ﻣﺆﺷﺮﺍﺕ ﻫﺬﺍ ﺍﻟﻀﻌﻒ ﻣﺘﻌﺪﺩﺓ‪ ،‬ﻧﺸﲑ ﻓﻴﻤﺎ ﻳﻠﻲ ﺇﱃ ﺍﻟﺒﻌﺾ ﻣﻨﻬﺎ‪:‬‬
‫‪ .١‬ﺃﻧﻪ ﰲ ﺳﺒﺘﻤﱪ ‪ ،١٩٨٨‬ﻭﰲ ﻟﻘﺎﺀ ﻋﺎﻡ ﳜﺘﺺ ﲟﻮﺿﻮﻉ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ ﰲ ﻣﺼﺮ‪ 1‬ﻧﻔﻰ‬
‫ﺍﳌﺘﺤﺪﺛﻮﻥ ﻧﻴﺎﺑﺔ ﻋﻦ ﺍﳊﻜﻮﻣﺔ ﺍﳊﺎﺟﺔ ﺍﳌﻠﺤﺔ ﻟﺘﻄﻮﻳﺮ ﺃﻭﺿﺎﻉ ﻭﺳﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺀ‪ ،‬ﻭﺫﻟﻚ ﺑﺘﺄﻛﻴﺪﺍﺕ‬
‫ﻗﺎﻃﻌﺔ ﺑﺄﻥ ﻫﺬﻩ ﺍﻷﻭﺿﺎﻉ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﻫﻲ ﺍﻷﺣﺴﻦ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻛﺎﻓﺔ ﺩﻭﻝ ﺍﳌﻨﻄﻘﺔ‪ ،‬ﻭﺃﻥ ﺃﻳﺔ‬
‫ﺭﺅﻯ ﺃﻭ ﲢﻠﻴﻼﺕ ﺗﻘﻀﻲ ﺇﱃ ﻏﲑ ﺫﻟﻚ ﻫﻲ ﺭﺅﻯ ﺃﻭ ﲢﻠﻴﻼﺕ ﻏﲑ ﺳﻠﻴﻤﺔ ﻣﻄﻠﻘﺎﹰ ﻭ)؟!(‪.‬‬
‫ﺍﳌﻔﺎﺟﺌﺔ )ﺃﻭ ﺍﳌﺸﻜﻠﺔ( ﺃﻥ ﻭﺿﻌﻴﺔ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﻣﺼﺮ ﻗﺪ ﺍﺗﻀﺤﺖ ﺑﻌﺪ ﺫﻟﻚ ﻣﻦ‬
‫ﺧﻼﻝ ﺍﺳﺘﻘﺮﺍﺀ ﺑﻴﺎﻧﺎﺕ ﻫﺎﻣﺔ ﺻﺪﺭﺕ ﰲ ‪‬ﺎﻳﺔ ﻋﺎﻡ ‪ ١٩٨٨‬ﰲ ﺷﻜﻞ ﺗﻘﺮﻳﺮ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﻌﺎﳌﻴﺔ ﺑﻌﻨﻮﺍﻥ ﻭﺿﻌﻴﺔ ﺍﻟﺪﻭﺍﺀ ﰲ ﺍﻟﻌﺎﱂ ‪.Drug Situation in the world – 1988‬‬
‫ﻟﻘﺪ ﻭﺻﻔﺖ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ﺍﻷﻭﺿﺎﻉ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﺑﻠﺪﺍﻥ ﺍﻟﻌﺎﱂ ﻣﻦ ﺧﻼﻝ ﺃﺣﺪ ﻋﺸﺮ‬
‫ﻣﺆﺷﺮﺍﹰ ‪ Indicator‬ﺗﺘﻌﻠﻖ ﺑﺎﻟﺘﺸﺮﻳﻊ ﻭﺍﻹﻧﺘﺎﺝ ﻭﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺍﳌﻌﻠﻮﻣﺎﺗﻴﺔ ﻭﺍﻟﺮﻗﺎﺑﺔ ﻭﺍﻟﺘﻮﺯﻳﻊ‬
‫ﻭﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ﻭﺍﻟﺘﺮﺷﻴﺪ ﺍﻟﺪﻭﺍﺋﻲ‪ ..‬ﺍﱁ‪ ،‬ﻭﺫﻟﻚ ﺑﺎﺳﺘﻌﻤﺎﻝ ﻣﺪﻯ ﻣﻦ ﺍﻟﺪﺭﺟﺎﺕ ﻟﻜﻞ ﻣﺆﺷﺮ‬
‫ﻳﺼﻒ ﺣﺎﻟﺔ ﺍﻟﺒﻠﺪﺍﻥ ﻓﻴﻤﺎ ﳜﺘﺺ ﺑﺄﻭﺿﺎﻋﻬﺎ ﺍﳌﺘﻌﻠﻘﺔ ‪‬ﺬﺍ ﺍﳌﺆﺷﺮ‪ .‬ﻭﺑﻔﺤﺺ ﺃﻭﺿﺎﻉ ﺍﻟﺪﻭﺍﺀ ﰲ‬
‫ﺍﻟﻌﺎﱂ ﺣﺴﺐ ﻣﺆﺷﺮﺍﺕ ﻭﺑﻴﺎﻧﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ‪ ،‬ﻭﺑﺎﻟﻜﺸﻒ ﻋﻠﻰ ﻋﺪﺩ ﺍﳌﺆﺷﺮﺍﺕ ﺍﻟﱵ ﲢﻘﻖ‬
‫ﻓﻴﻬﺎ ﺍﻟﺒﻠﺪﺍﻥ ﺍﳌﺨﺘﻠﻔﺔ ﺍﳊﺪ ﺍﻷﻋﻠﻰ ﻣﻦ ﺍﻟﺪﺭﺟﺎﺕ‪ ،‬ﻳﺘﻀﺢ ﻟﻨﺎ ﺃﻥ ﻣﺮﺗﺒﺔ ﻣﺼﺮ ﰲ ﺍﻟﺴﻴﺎﺳﺔ‬
‫ﺍﻟﺪﻭﺍﺋﻴﺔ ﻋﺎﻡ ‪ ١٩٨٨‬ﻛﺎﻧﺖ ﻣﻜﺎﻧﺔ ﻣﻨﺨﻔﻀﺔ ﺟﺪﺍﹰ‪ ،‬ﻭﻻ ﺗﺘﻨﺎﺳﺐ ﺃﺑﺪﺍﹰ ﻣﻊ ﺗﺎﺭﳜﻬﺎ ﻭﺇﻣﻜﺎﻧﻴﺎ‪‬ﺎ‪.‬‬
‫ﻟﻘﺪ ﻛﺎﻥ ﻣﺴﺘﻮﻯ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﻣﺼﺮ ﺣﺴﺐ ﺍﳌﻌﻴﺎﺭ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻪ ﻻ ﻳﺴﺒﻖ ﻣﻦ ﺍﻟﺪﻭﻝ‬
‫ﺍﻟﻌﺮﺑﻴﺔ ﻏﲑ ﻣﻮﺭﻳﺘﺎﻧﻴﺎ ﻭﺍﻟﺼﻮﻣﺎﻝ‪ ،‬ﻭﻻ ﻳﺴﺒﻖ ﻣﻦ ﺩﻭﻝ ﳎﻤﻮﻋﺔ ﺍﻟـ ‪ ١٥‬ﻏﲑ ﻧﻴﺠﲑﻳﺎ ﻭﺍﻟﺴﻨﻐﺎﻝ‬
‫ﻭﺯﳝﺒﺎﺑﻮﻱ‪ ،‬ﺫﻟﻚ ﺑﻴﻨﻤﺎ ﻛﺎﻧﺖ ﺍﻟﻌﺮﺍﻕ ﲢﻘﻖ ﺃﻋﻠﻰ ﻣﺴﺘﻮﻯ ﰲ ﳎﻤﻮﻋﺔ ﺍﻟﺒﻠﺪﺍﻥ ﺍﻟﻌﺮﺑﻴﺔ )ﺗﻠﻴﻬﺎ‬

‫‪ 1‬ﻋﻘﺪ ﻫﺬﺍ ﺍﻟﻠﻘﺎﺀ ﺑﺮﻋﺎﻳﺔ ﺍﻟﻨﻘﺎﺑﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺼﻴﺎﺩﻟﺔ ﰲ ﻣﺼﺮ‪ ،‬ﻭﻛﺎﻥ ﻳﺘﻜﻮﻥ ﻣﻦ ﳏﺎﺿﺮﺓ ﻟﻜﺎﺗﺐ ﻫﺬﻩ ﺍﻟﺴﻄﻮﺭ ﺑﻌﻨﻮﺍﻥ "ﳓﻮ ﺳﻴﺎﺳﺔ ﺩﻭﺍﺋﻴﺔ‬
‫ﺃﻛﺜﺮ ﺗﻜﺎﻣﻼﹰ"‪ ،‬ﻳﻌﻘﺒﻬﺎ ﺗﻌﻠﻴﻘﺎﺕ ﺭﺋﻴﺴﻴﺔ ﻣﻦ ﺍﻟﺴﺎﺩﺓ ﺭﺅﺳﺎﺀ ﺍﻹﺩﺍﺭﺓ ﺍﳌﺮﻛﺰﻳﺔ ﻟﺸﺌﻮﻥ ﺍﻟﺼﻴﺪﻟﺔ‪ ،‬ﻭﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺮﻗﺎﺑﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺍﻟﺪﻭﺍﺋﻴﺔ‪،‬‬
‫ﻭﻫﻴﺌﺔ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﻟﻸﺩﻭﻳﺔ‪ ،‬ﻭﻗﺪ ﺃﺩﺍﺭ ﺍﳊﻮﺍﺭ ﻧﻘﻴﺐ ﺻﻴﺎﺩﻟﺔ ﻣﺼﺮ ﻭﻗﺘﻬﺎ ﺍﳌﺮﺣﻮﻡ ﺃ‪ .‬ﺩ‪ .‬ﻳﻮﺳﻒ ﻋﺰ ﺍﻟﺪﻳﻦ ﲪﻮﺩﺓ‪ .‬ﺍﻧﻈﺮ ﺃﻳﻀﺎﹰ ﻣﻘﺎﻝ "ﺍﻟﺴﻴﺎﺳﺔ‬
‫ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﻔﻘﻮﺩﺓ" – ﺍﻷﻫﺮﺍﻡ ‪.١٩٨٨ / ٣ / ٢١‬‬

‫‪١٨٧‬‬
‫ﺍﳉﺰﺍﺋﺮ(‪ ،!!..‬ﻭﻛﺎﻧﺖ ﺍﳉﺰﺍﺋﺮ )ﺑﺎﻻﺷﺘﺮﺍﻙ ﻣﻊ ﺍﻟﱪﺍﺯﻳﻞ ﻭﺷﻴﻠﻲ ﻭﺇﻧﺪﻭﻧﻴﺴﻴﺎ ﻭﺍﳌﻜﺴﻴﻚ( ﲢﻘﻖ ﺃﻋﻠﻰ‬
‫ﻣﺴﺘﻮﻯ ﺑﲔ ﳎﻤﻮﻋﺔ ﺩﻭﻝ ﺍﻟـ ‪) ١٥‬ﺍﻧﻈﺮ ﺍﳉﺪﻭﻟﲔ "‪.("٢-٨" ،"١-٨‬‬
‫ﺫﻟﻚ ﻛﻠﻪ ﰲ ﺍﻟﻮﻗﺖ ﺍﻟﺬﻱ ﻛﺎﻧﺖ ﺍﻟﺪﻭﻟﺔ ﰲ ﻣﺼﺮ ﳑﺜﻠﺔ ﰲ ﺍﻟﻘﻴﺎﺩﺍﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺴﺌﻮﻟﺔ ﺗﺮﻓﺾ‬
‫)ﻭﻻ ﺗﺒﺎﱄ ﺑـ( ﻧﺪﺍﺀﺍﺕ ﻭﺩﺭﺍﺳﺎﺕ ﻭﻃﻨﻴﺔ ﺗﻨﺒﻪ ﻭﲢﺬﺭ ﲞﺼﻮﺹ ﺿﻌﻒ ﻣﺴﺘﻮﻯ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﻮﻃﻨﻴﺔ‬
‫ﻟﻠﺪﻭﺍﺀ‪ .‬ﻭﺍﳉﺪﻳﺮ ﺑﺎﻻﻧﺘﺒﺎﻩ ﻫﻨﺎ ﺃﻥ ﺍﻟﺴﻴﺪ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻛﺎﻥ ﻗﺪ ﺗﻔﻀﻞ ﻋﺎﻡ ‪ ١٩٩٢‬ﺑﺎﻟﺘﺮﺣﻴﺐ‬
‫ﺑﺎﻗﺘﺮﺍﺡ ﺑﺈﻧﺸﺎﺀ ﳎﻠﺲ ﺃﻋﻠﻰ ﻟﻠﺪﻭﺍﺀ )ﻧﺸﺮ ﰲ ﺍﻷﻫﺮﺍﻡ – ‪ (١٩٩٢/٣/١٢‬ﻣﻦ ﺃﺟﻞ ﻭﺿﻊ ﺳﻴﺎﺳﺔ‬
‫ﻭﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ‪ ،‬ﻭﻣﺘﺎﺑﻌﺔ ﺗﻨﻔﻴﺬﻫﺎ ﻭﺗﻄﻮﻳﺮﻫﺎ‪ .‬ﻏﲑ ﺃﻥ ﺍﻟﻜﻴﺎﻥ ﺍﻟﺬﻱ ﺃﻧﺸﺊ ﺑﻌﺪ ﺫﻟﻚ ﺑﺎﻟﻔﻌﻞ ﻛﺎﻥ –‬
‫ﻭﻻ ﻳﺰﺍﻝ – ﳜﺘﺺ ﺑﺄﻋﻤﺎﻝ ﺇﺟﺮﺍﺋﻴﺔ‪ ،‬ﻭﻗﺪ ﺃﻃﻠﻖ ﻋﻠﻴﻪ "ﳉﻨﺔ ﺍﳋﺪﻣﺎﺕ"‪ ،‬ﰒ ﺗﻐﲑ ﻣﺴﻤﺎﻩ ﺑﻌﺪ ﺫﻟﻚ ﺇﱃ‬
‫ﻣﺮﻛﺰ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‪.‬‬

‫ﺟﺪﻭﻝ )‪ :(١-٨‬ﺗﺮﺗﻴﺐ ﺩﻭﻝ ﳎﻤﻮﻋﺔ ﺍﻟـ ‪ ١٥‬ﺣﺴﺐ ﻋﺪﺩ ﻣﺆﺷﺮﺍﺕ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﱵ ﲢﻘﻖ‬
‫ﻓﻴﻬﺎ ﺍﻟﺪﻭﻟﺔ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ‪.‬‬
‫ﺃﻭﻻﹰ‪ :‬ﺩﻭﻝ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ "‪ "٥‬ﻣﺆﺷﺮﺍﺕ‪ :‬ﺍﳉﺰﺍﺋﺮ – ﺍﻟﱪﺍﺯﻳﻞ – ﺷﻴﻠﻲ – ﺇﻧﺪﻭﻧﻴﺴﻴﺎ – ﺍﳌﻜﺴﻴﻚ‬
‫ﺛﺎﻧﻴﺎﹰ‪ :‬ﺩﻭﻝ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ "‪ "٣‬ﻣﺆﺷﺮﺍﺕ‪ :‬ﺍﻷﺭﺟﻨﺘﲔ – ﺍﳍﻨﺪ – ﻣﺎﻟﻴﺰﻳﺎ‬
‫ﺛﺎﻟﺜﺎﹰ‪ :‬ﺩﻭﻝ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ ﻣﺆﺷﺮ ﻭﺍﺣﺪ‪ :‬ﻣﺼﺮ – ﺟﺎﻣﻴﻜﺎ – ﻓﱰﻭﻳﻼ‬
‫ﺭﺍﺑﻌﺎﹰ‪ :‬ﺩﻭﻝ ﻻ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ ﺃﻱ ﻣﺆﺷﺮﺍﺕ‪ :‬ﻧﻴﺠﲑﻳﺎ – ﺍﻟﺴﻨﻐﺎﻝ ‪ -‬ﺯﳝﺒﺎﺑﻮﻱ‬
‫* ﺍﳌﺮﺟﻊ‪ :‬ﻡ‪.‬ﺭ‪ :.‬ﺣﺎﻣﺪ ﳏﺎﺿﺮﺓ ﺃﻣﺎﻡ ﺍﺟﺘﻤﺎﻉ ﺧﱪﺍﺀ ﳎﻤﻮﻋﺔ ﺍﻟـ ‪ ١٥‬ﰲ ﺍﳌﻌﺎﻳﲑ ﻭﺍﳉﻮﺩﺓ – ﻧﻴﻮﺩﳍﻲ – ﻳﻨﺎﻳﺮ ‪.١٩٩٨‬‬

‫ﺟﺪﻭﻝ )‪ :(٢-٨‬ﺗﺮﺗﻴﺐ ﺍﻟﺪﻭﻝ ﺍﻟﻌﺮﺑﻴﺔ ﺣﺴﺐ ﻋﺪﺩ ﻣﺆﺷﺮﺍﺕ ﺍﻟﱵ ﲢﻘﻖ ﻓﻴﻬﺎ ﺍﻟﺪﻭﻟﺔ ﺍﻟﺪﺭﺟﺎﺕ‬
‫ﺍﻷﻋﻈﻢ‬
‫ﺃﻭﻻﹰ‪ :‬ﺩﻭﻝ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ "‪ "٨‬ﻣﺆﺷﺮﺍﺕ‪ :‬ﺍﻟﻌﺮﺍﻕ‬
‫ﺛﺎﻧﻴﺎﹰ‪ :‬ﺩﻭﻝ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ "‪ "٥‬ﻣﺆﺷﺮﺍﺕ‪ :‬ﺍﳉﺰﺍﺋﺮ‬
‫ﺛﺎﻟﺜﺎﹰ‪ :‬ﺩﻭﻝ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ "‪ "٤‬ﻣﺆﺷﺮﺍﺕ‪ :‬ﻟﻴﺒﻴﺎ ‪ -‬ﺳﻮﺭﻳﺎ‬
‫ﺭﺍﺑﻌﺎﹰ‪ :‬ﺩﻭﻝ ﻻ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ "‪ "٣‬ﻣﺆﺷﺮﺍﺕ‪ :‬ﺍﻟﻜﻮﻳﺖ‬
‫ﺧﺎﻣﺴﺎﹰ‪ :‬ﺩﻭﻝ ﻻ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ ﻣﺆﺷﺮﻳﻦ ﻓﻘﻂ‪ :‬ﺍﻟﺒﺤﺮﻳﻦ – ﺍﻷﺭﺩﻥ – ﺟﻴﺒﻮﰐ‬
‫ﺳﺎﺩﺳﺎﹰ‪ :‬ﺩﻭﻝ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ ﻣﺆﺷﺮ ﻭﺍﺣﺪ‪ :‬ﻣﺼﺮ – ﺍﻟﻴﻤﻦ ﺍﻟﺪﳝﻘﺮﺍﻃﻲ – ﻋﻤﺎﻥ – ﻟﺒﻨﺎﻥ – ﺍﻟﺴﻮﺩﺍﻥ –‬
‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫ﺳﺎﺑﻌﺎﹰ‪ :‬ﺩﻭﻝ ﻻ ﲢﻘﻖ ﺍﻟﺪﺭﺟﺎﺕ ﺍﻷﻋﻈﻢ ﰲ ﺃﻱ ﻣﺆﺷﺮ‪ :‬ﺍﻟﺼﻮﻣﺎﻝ ‪ -‬ﻣﻮﺭﻳﺘﺎﻧﻴﺎ‬
‫* ﺍﳌﺮﺟﻊ‪ :‬ﻡ‪.‬ﺭ‪ .‬ﺣﺎﻣﺪ‪ :‬ﳏﺎﺿﺮﺓ ﺃﻣﺎﻡ ﺍﻻﺟﺘﻤﺎﻉ ﺍﻻﺳﺘﺸﺎﺭﻱ ﰲ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ – ﳎﻤﻮﻋﺔ ﺩﻭﻝ ﺷﺮﻕ ﺍﳌﺘﻮﺳﻂ – ﻣﻨﻈﻤﺔ‬
‫ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ – ﺍﻹﺳﻜﻨﺪﺭﻳﺔ – ﺇﺑﺮﻳﻞ ‪.١٩٩٨‬‬

‫‪ .٢‬ﺃﻥ ﻭﺛﻴﻘﺔ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ‪ ،‬ﻭﺍﻟﱵ ﺻﺪﺭﺕ ﻋﻦ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻋﺎﻡ ‪ ،٢٠٠١‬ﻗﺪ ﺟﺎﺀﺕ‬
‫ﻋﻠﻰ ﺍﺳﺘﺤﻴﺎﺀ )ﻛﻤﺎ ﻳﺒﺪﻭ ﻣﻦ ﳏﺘﻮﻳﺎ‪‬ﺎ( ﻭﰲ ﻋﺠﺎﻟﺔ ﺷﺪﻳﺪﺓ ﺃﻭ ﻛﺮﺩ ﻓﻌﻞ ﺃﺩﺍﺋﻲ ﲡﺎﻩ ﺍﻟﺮﺃﻱ‬
‫ﺍﻟﻌﺎﻡ ﺍﳌﻄﺎﻟﺐ ﺑﺴﻴﺎﺳﺔ ﺩﻭﺍﺋﻴﺔ ﻗﻮﻣﻴﺔ )ﻣﻨﺬ ﻣﻨﺘﺼﻒ ﲦﺎﻧﻴﻨﻴﺎﺕ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ(‪ .‬ﻭﳑﺎ ﻳﻠﻔﺖ‬
‫ﺍﻻﻧﺘﺒﺎﻩ ﺑﺸﺄﻥ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ ﻣﺎ ﻳﻠﻲ‪:‬‬

‫‪١٨٨‬‬
‫ﺃ‪ .‬ﺍﻧﻪ‪ ،‬ﻭﺇﻥ ﻛﺎﻧﺖ ﺍﻟﻮﺛﻴﻘﺔ ﺑﻌﻨﻮﺍﻥ "ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ"‪ ،‬ﺇﻻ ﺃﻧﻪ ﻣﻦ ﺍﻟﺜﺎﺑﺖ ﻣﻦ‬
‫ﳏﺘﻮﻳﺎ‪‬ﺎ‪ ،‬ﻭﻣﻦ ﺗﺸﻜﻴﻞ ﳉﻨﺔ ﺇﻋﺪﺍﺩﻫﺎ ﻭﳉﻨﺔ ﺻﻴﺎﻏﺘﻬﺎ‪ ،‬ﺃﻥ ﻣﺮﻛﺰ ﺍﻟﺘﺨﻄﻴﻂ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ‬
‫ﺍﻟﺪﻭﺍﺋﻴﺔ ﱂ ﻳﺸﺎﺭﻙ ﺭﲰﻴﺎﹰ ﰲ ﺍﻟﺘﻮﺻﻞ ﺇﱃ ﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ‪ ،‬ﻭﻫﻮ ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﳒﺬﺏ ﺍﻻﻧﺘﺒﺎﻩ‬
‫ﺇﻟﻴﻪ‪ ،‬ﻟﻴﺲ ﻣﻦ ﻣﻨﻈﻮﺭ ﻛﻔﺎﺀﺓ ﺍﻟﻮﺛﻴﻘﺔ ﻭﻣﺼﺪﺍﻗﻴﺘﻬﺎ‪ ،‬ﻭﻟﻜﻦ ﻣﻦ ﻣﻨﻈﻮﺭ ﺻﺤﺔ ﺍﻟﺒﲎ‬
‫ﻭﺍﻟﻌﻼﻗﺎﺕ ﺍﳌﻨﻈﻮﻣﻴﺔ ﺍﳌﻮﻟﺪﺓ ﳍﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ‪ ،‬ﺃﻭ ﻷﻱ ﻣﻦ ﺃﻧﺸﻄﺔ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‬
‫ﺍﻟﻮﻃﻨﻴﺔ‪.‬‬
‫ﺏ‪ .‬ﺃﻥ ﺍﻟﻮﺛﻴﻘﺔ ﰲ ﺑﻨﺎﺋﻬﺎ ﻭﳏﺘﻮﻳﺎ‪‬ﺎ ﻭﺻﻴﺎﻏﺘﻬﺎ ﱂ ﺗﻌﺘﻤﺪ ﻋﻠﻰ ﻣﻨﻬﺞ ﻋﻠﻤﻲ ‪Scientific‬‬
‫‪ method‬ﻣﻨﺎﺳﺐ‪ ،‬ﺳﻮﺍﺀ ﺑﺎﺳﺘﺨﺪﺍﻡ ﻣﺆﺷﺮﺍﺕ ﻣﻌﻴﺎﺭﻳﺔ ‪ Standardized indicators‬ﺃﻡ‬
‫ﺭﺅﻯ ﻭﺗﻘﻴﻴﻤﺎﺕ ﺳﻴﺎﺳﻴﺔ‪ ..‬ﺍﱁ‪.‬‬
‫ﺝ‪ .‬ﺃﻥ ﺍﻟﻮﺛﻴﻘﺔ ﻗﺪ ﺧﻠﺖ ﻣﻦ ﺃﻳﺔ ﺗﻮﺻﻴﻔﺎﺕ ﺃﻭ ﺇﺷﺎﺭﺍﺕ ﻟﻠﻮﺍﻗﻊ ﻭﳌﺸﻜﻼﺗﻪ‪.‬‬
‫ﺩ‪ .‬ﺃﻧﻪ ﻣﻦ ﺍﻟﻄﺒﻴﻌﻲ ﰲ ﺇﻃﺎﺭ ﺍﳌﻼﺑﺴﺎﺕ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﺎ ﰲ "ﺃ"‪ ،‬ﻭ"ﺏ"‪ ،‬ﻭ"ﺝ" ﺃﻥ ﲤﻴﻞ ﺍﻟﻮﺛﻴﻘﺔ ﺇﱃ‬
‫ﺍﻹﻓﺮﺍﻁ ﰲ ﺍﻟﻌﻤﻮﻣﻴﺔ ﻭﺃﻥ ﲣﻠﻮ ﻣﻦ ﺍﻷﺑﻌﺎﺩ ﻭﺍﻟﺘﻨﺎﻭﻻﺕ ﺍﻟﺴﻴﺎﺳﻴﺔ ﻭﺍﻟﺘﺨﻄﻴﻄﻴﺔ ﻭﺍﻟﺘﻌﺎﻭﻧﻴﺔ‬
‫ﺍﳌﺘﻮﻗﻌﺔ ﻣﻨﻬﺎ‪.‬‬
‫‪ .٣‬ﺃﻥ ﺍﳌﻼﻣﺢ ﺍﳊﻘﻴﻘﻴﺔ ﻟﻸﻭﺿﺎﻉ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ ﺗﺘﻀﻤﻦ ﻣﺆﺷﺮﺍﺕ ﺿﻌﻒ ﺗﺪﻓﻊ ﺇﱃ ﺿﺮﻭﺭﺓ‬
‫ﺍﻟﺪﻋﻮﺓ ﻟﻌﻤﻞ ﺳﻴﺎﺳﺔ ﺩﻭﺍﺋﻴﺔ "ﺣﻘﻴﻘﻴﺔ" ﺇﻧﻨﺎ ﻫﻨﺎ ﻧﻜﺘﻔﻲ – ﻓﻘﻂ – ﺑﺎﻹﺷﺎﺭﺓ ﺑﻘﺪﺭ ﻣﻦ‬
‫ﺍﻟﺘﻔﺼﻴﻞ ﺇﱃ ﻣﺜﺎﻝ ﻭﺍﺣﺪ ﻟﻨﻤﺎﺫﺝ ﻣﺆﺷﺮﺍﺕ ﺍﻟﻀﻌﻒ‪ ،‬ﻭﺍﻟﺬﻱ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺘﻔﺎﻭﺕ ﺍﻟﻀﺨﻢ ﰲ ﺗﻮﺯﻳﻊ‬
‫ﻗﻴﻢ ﺍﺳﺘﻬﻼﻙ ﺍﻟﺪﻭﺍﺀ ﰲ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ‪ ،‬ﺣﻴﺚ ﳒﺪ ﺃﻥ ﺍﻟﺘﻔﺎﻭﺕ ﰲ ﻣﺘﻮﺳﻂ ﻧﺼﻴﺐ ﺍﻟﻔﺮﺩ ﺑﲔ‬
‫ﳏﺎﻓﻈﺔ ﻭﺃﺧﺮﻯ ﻳﺼﻞ ﺇﱃ ﻗﺪﺭ ﻳﺰﻳﺪ ﻋﻠﻰ ﺍﻷﺭﺑﻌﺔ ﺃﻣﺜﺎﻝ‪ ،‬ﻭﺃﻥ ﻫﻨﺎﻙ ﺗﻔﺎﻭﺗﺎﺕ ﻛﺒﲑﺓ ﺑﲔ ﺗﻮﺯﻳﻊ ﻗﻴﻢ‬
‫ﺍﺳﺘﻬﻼﻙ ﺍﻟﺪﻭﺍﺀ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ‪ ،‬ﻣﻘﺎﺭﻧﺔ ﺑﺘﻮﺯﻳﻊ ﺍﻟﺴﻜﺎﻥ‪ .‬ﻣﻦ ﺍﻷﻣﺜﻠﺔ ﺍﻟﺼﺎﺭﺧﺔ‬
‫ﻋﻠﻰ ﺍﻟﺘﻔﺎﻭﺗﺎﺕ ﳒﺪ ﺃﻥ ﻣﺘﻮﺳﻂ ﻧﺼﻴﺐ ﺍﻟﻔﺮﺩ ﻳﺒﻠﻎ ﰲ ﳏﺎﻓﻈﺎﺕ ﺩﻣﻴﺎﻁ ﻭﺍﻟﻘﺎﻫﺮﺓ )ﺑﺎﳉﻨﻴﻪ( ‪،٩٩‬‬
‫ﻭ‪ ،٩٠‬ﻋﻠﻰ ﺍﻟﺘﺮﺗﻴﺐ ﺑﻴﻨﻤﺎ ﻫﻮ ﰲ ﺣﺪﻭﺩ ‪ ٢١‬ﺇﱃ ‪ ٢٥‬ﺟﻨﻴﻬﺎﹰ ﰲ ﳏﺎﻓﻈﺎﺕ ﺃﺳﻴﻮﻁ ﻭﺍﻟﻮﺍﺩﻱ ﺍﳉﺪﻳﺪ‪،‬‬
‫ﻭﺍﻟﻔﻴﻮﻡ ﻭﺑﲏ ﺳﻮﻳﻒ‪ ،‬ﻭﺍﳌﻨﻴﺎ‪ ،‬ﻭﺳﻮﻫﺎﺝ‪ ،‬ﻭﺍﻟﺒﺤﲑﺓ )ﺍﻧﻈﺮ ﺟﺪﻭﻝ "‪.("٣-٨‬‬

‫ﺟﺪﻭﻝ ﺭﻗﻢ )‪ :(٣-٨‬ﻗﻴﻢ ﺍﺳﺘﻬﻼﻙ ﺍﻟﺪﻭﺍﺀ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﳏﺎﻓﻈﺎﺕ ﻣﺼﺮ )ﻋﺎﻡ ‪(١٩٩٦‬‬
‫ﻣﺘﻮﺳﻂ ﻧﺼﻴﺐ‬ ‫ﺍﺳﺘﻬﻼﻙ ﺍﻟﺪﻭﺍﺀ‬ ‫ﺍﻟﺴﻜــــﺎﻥ‬
‫ﺍﶈﺎﻓﻈﺔ‬
‫ﺍﻟﻔﺮﺩ ﺑﺎﳉﻨﻴﻪ‬ ‫‪%‬‬ ‫ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ‬ ‫)‪(%‬‬ ‫ﻣﻠﻴﻮﻥ ﻧﺴﻤﺔ‬
‫‪٩٠‬‬ ‫‪٢٢,٥‬‬ ‫‪٦١٧,٣‬‬ ‫‪١١,٧‬‬ ‫‪٦,٩‬‬ ‫ﺍﻟﻘﺎﻫﺮﺓ‬
‫‪٦١‬‬ ‫‪١٠,٧‬‬ ‫‪٢٩٢,٠٠‬‬ ‫‪٨,٢‬‬ ‫‪٤,٨‬‬ ‫ﺍﳉﻴﺰﺓ‬
‫‪٧٧‬‬ ‫‪١١,١‬‬ ‫‪٢٧٦,٨‬‬ ‫‪٦,٢‬‬ ‫‪٣,٦‬‬ ‫ﺍﻹﺳﻜﻨﺪﺭﻳﺔ ﻭﻣﻄﺮﻭﺡ‬
‫‪٢٤‬‬ ‫‪٣,٥‬‬ ‫‪٩٤,٥‬‬ ‫‪٦,٦‬‬ ‫‪٣,٩‬‬ ‫ﺍﻟﺒﺤﲑﺓ‬
‫‪٤٠‬‬ ‫‪٣,٢‬‬ ‫‪٨٨,٥‬‬ ‫‪٣,٨‬‬ ‫‪٢,٢‬‬ ‫ﻛﻔﺮ ﺍﻟﺸﻴﺦ‬
‫‪٥٦‬‬ ‫‪٦,٩‬‬ ‫‪١٩٠,٠٠‬‬ ‫‪٥,٨‬‬ ‫‪٣,٤‬‬ ‫ﺍﻟﻐﺮﺑﻴﺔ‬
‫‪٣٨‬‬ ‫‪٣,٧‬‬ ‫‪١٠٢,٥‬‬ ‫‪٤,٦‬‬ ‫‪٢,٧‬‬ ‫ﺍﳌﻨﻮﻓﻴﺔ‬
‫‪٢٧‬‬ ‫‪٢,٩‬‬ ‫‪٧٩,٨‬‬ ‫‪٥,١‬‬ ‫‪٣,٠٠‬‬ ‫ﺍﻟﻘﻠﻴﻮﺑﻴﺔ‬
‫‪٩٩‬‬ ‫‪٣,٣‬‬ ‫‪٨٩,٠٠‬‬ ‫‪١,٥‬‬ ‫‪٠,٩‬‬ ‫ﺩﻣﻴﺎﻁ‬
‫‪٤٣‬‬ ‫‪٦,٦‬‬ ‫‪١٨١,٠٠‬‬ ‫‪٧,٢‬‬ ‫‪٤,٢‬‬ ‫ﺍﻟﺪﻗﻬﻠﻴﺔ‬

‫‪١٨٩‬‬
 ‫ﻣﺘﻮﺳﻂ ﻧﺼﻴﺐ‬ ‫ﺍﺳﺘﻬﻼﻙ ﺍﻟﺪﻭﺍﺀ‬ ‫ﺍﻟﺴﻜــــﺎﻥ‬
‫ﺍﶈﺎﻓﻈﺔ‬
‫ﺍﻟﻔﺮﺩ ﺑﺎﳉﻨﻴﻪ‬ ‫‪%‬‬ ‫ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ‬ ‫)‪(%‬‬ ‫ﻣﻠﻴﻮﻥ ﻧﺴﻤﺔ‬
‫‪٤٦‬‬ ‫‪٧,٠٠‬‬ ‫‪١٩٢,٧‬‬ ‫‪٧,٢‬‬ ‫‪٤,٢‬‬ ‫ﺍﻟﺸﺮﻗﻴﺔ‬
‫‪٦٢‬‬ ‫‪٢,٨‬‬ ‫‪٧٤,٥‬‬ ‫‪٢,٠٠‬‬ ‫‪١,٢‬‬ ‫ﺍﻹﲰﺎﻋﻴﻠﻴﺔ ﻭﺑﻮﺭﺳﻌﻴﺪ ﻭﺳﻴﻨﺎ‬
‫‪٢٩‬‬ ‫‪٠,٧‬‬ ‫‪٢٠,٢‬‬ ‫‪١,٢‬‬ ‫‪٠,٧‬‬ ‫ﺍﻟﺴﻮﻳﺲ ﻭﺳﻴﻨﺎﺀ ﺍﻟﺸﻤﺎﻟﻴﺔ‬
‫‪٢٢‬‬ ‫‪٢,٩‬‬ ‫‪٨١,٥‬‬ ‫‪٦,٥‬‬ ‫‪٣,٨‬‬ ‫ﺍﻟﻔﻴﻮﻡ ﻭﺑﲏ ﺳﻮﻳﻒ‬
‫‪٢٥‬‬ ‫‪٣,٠٠‬‬ ‫‪٨٢,١‬‬ ‫‪٥,٦‬‬ ‫‪٣,٣‬‬ ‫ﺍﳌﻨﻴﺎ‬
‫‪٢١‬‬ ‫‪٢,٣‬‬ ‫‪٦٣,٨‬‬ ‫‪٥,١‬‬ ‫‪٣,٠٠‬‬ ‫ﺃﺳﻴﻮﻁ ﻭﺍﻟﻮﺍﺩﻱ ﺍﳉﺪﻳﺪ‬
‫‪٢٥‬‬ ‫‪٢,٩‬‬ ‫‪٨٠,٢‬‬ ‫‪٥,٥‬‬ ‫‪٣,٢‬‬ ‫ﺳﻮﻫﺎﺝ‬
‫‪٣٨‬‬ ‫‪٤,٩‬‬ ‫‪١٣٤,٧‬‬ ‫‪٦,٢‬‬ ‫‪٣,٦‬‬ ‫ﻗﻨﺎ ﻭﺃﺳﻮﺍﻥ ﻭﺍﻟﺒﺤﺮ ﺍﻷﲪﺮ‬
‫‪٤٧‬‬ ‫‪١٠٠‬‬ ‫‪٢٧٤١,١‬‬ ‫‪١٠٠‬‬ ‫‪٥٨,٦‬‬ ‫ﺍﻹﲨﺎﱄ‬

‫‪ .٤‬ﺃﻥ ﻣﺆﺷﺮﺍﺕ ﺿﻌﻒ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺗﺘﻀﻤﻦ ﺃﻣﺜﻠﺔ ﻭﺍﻗﻌﻴﺔ ﺃﺧﺮﻯ ﻧﺸﲑ ﺇﱃ ﺑﻌﻀﻬﺎ ﺑﺈﳚﺎﺯ‪،‬‬
‫ﻛﻤﺎ ﻳﻠﻲ‪:‬‬
‫ﺃ‪ .‬ﻧﺪﺭﺓ )ﺃﻭ ﻏﻴﺒﺔ( ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﳌﻴﺪﺍﻧﻴﺔ )ﺃﻭ ﺩﺭﺍﺳﺎﺕ ﺍﳊﺎﻟﺔ( ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺄﻭﺿﺎﻉ ﻭﺇﺷﻜﺎﻟﻴﺎﺕ‬
‫ﻭﺗﻄﻮﺭﺍﺕ ﻋﻤﻠﻴﺎﺕ ﺇﺗﺎﺣﺔ ﻭﺗﻮﺯﻳﻊ ﻭﻭﺻﻒ ﻭﺍﺳﺘﺨﺪﺍﻡ ﺍﻷﺩﻭﻳﺔ‪ ،‬ﻭﻛﺬﻟﻚ ﻋﻤﻠﻴﺎﺕ ﻣﺘﺎﺑﻌﺔ‬
‫ﺍﺣﺘﻤﺎﻟﻴﺎﺕ ﻭﺟﻮﺩ ﺁﺛﺎﺭ ﺿﺎﺭﺓ ﺑﻌﺪ ﺍﻻﺳﺘﺨﺪﺍﻡ ‪.Pharmacovigillance‬‬
‫ﺏ‪ .‬ﻓﻘﺪﺍﻥ ﺍﻻﻫﺘﻤﺎﻡ ﺍﻟﻌﻤﻠﻲ ﺑﻀﺒﻂ ﺻﺮﻑ ﺍﻟﻌﺒﻮﺍﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ ،‬ﲝﻴﺚ ﻳﺘﻢ ﺻﺮﻑ ﺭﺷﻴﺪ‬
‫ﻟﻠﺠﺮﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﻘﺮﺭﺓ‪ ،‬ﺑﺎﻟﻘﺪﺭ ﺍﳌﻮﺻﻮﻑ‪ ،‬ﻻ ﺃﻛﺜﺮ ﻭﻻ ﺃﻗﻞ‪ ،‬ﻭﻛﺬﻟﻚ ‪‬ﺪﻑ ﺗﻘﻠﻴﻞ ﺍﻟﻔﺎﻗﺪ‪،‬‬
‫ﻭﰲ ﻧﻔﺲ ﺍﻟﻮﻗﺖ ﺿﻤﺎﻥ ﻋﺪﻡ ﻭﺟﻮﺩ ﻗﺼﻮﺭ ﺃﻭ ﻧﻘﺺ ﰲ ﺍﻟﻌﻼﺝ ﺑﺎﳉﺮﻋﺎﺕ ﺍﻟﻜﺎﻣﻠﺔ‪ ،‬ﺣﻴﺚ‬
‫ﻳﺆﺩﻱ ﻫﺬﺍ ﺍﻟﻨﻘﺺ ﺇﱃ ﺃﺿﺮﺍﺭ ﻋﺪﻳﺪﺓ ﻣﻦ ﺃﺷﺪﻫﺎ ﺍﻧﺘﺸﺎﺭ ﺣﺎﻻﺕ ﻣﻘﺎﻭﻣﺔ ﺍﳌﻴﻜﺮﻭﺑﺎﺕ ﻟﻠﻌﻼﺝ‬
‫‪.Resistance‬‬
‫ﺝ‪ .‬ﻭﺟﻮﺩ ﻣﻐﺎﻻﺓ ﰲ ﻫﺎﻣﺶ ﺍﻟﺮﺑﺢ ﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ‪ ،‬ﻭﻫﻮ ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﻳﻈﻬﺮ ﰲ ﺗﺒﺎﻳﻨﺎﺕ ﻛﺒﲑﺓ ﰲ‬
‫ﺃﺳﻌﺎﺭ ﺑﻌﺾ ﺍﳌﺴﺘﺤﻀﺮﺍﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺧﺎﺭﺝ ﻭﺩﺍﺧﻞ ﺍﳌﻨﺎﻗﺼﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ‪ ،‬ﻛﻤﺎ ﻳﻈﻬﺮ ﺃﻳﻀﺎﹰ‬
‫ﰲ ﺑﻌﺾ ﺳﻠﻮﻛﻴﺎﺕ ﺍﻟﺒﻴﻊ ﻭﺍﻟﺪﻋﺎﻳﺔ ﻟﺒﻌﺾ ﺍﻟﺸﺮﻛﺎﺕ‪ .‬ﻭﺍﻟﻐﺮﻳﺐ ﺃﻥ ﺫﻟﻚ ﳛﺪﺙ ﰲ ﺫﺍﺕ‬
‫ﺍﻟﻮﻗﺖ ﺍﻟﺬﻱ ﲡﺎﺑﻪ ﻓﻴﻪ ﺑﻌﺾ ﺍﻟﺸﺮﻛﺎﺕ ﺻﻌﻮﺑﺎﺕ ﰲ ﺇﻧﺘﺎﺝ ﺑﻌﺾ ﺍﻷﺩﻭﻳﺔ ﺍﳌﻬﻤﺔ ﻣﺘﺪﻧﻴﺔ‬
‫ﺍﻟﺴﻌﺮ‪ ،‬ﻭﺍﻟﱵ ﱂ ﺗﺘﺤﺮﻙ ﺃﺳﻌﺎﺭﻫﺎ ﻣﻨﺬ ﺳﻨﻮﺍﺕ ﻋﺪﻳﺪﺓ ﺭﻏﻢ ﺍﻟﺘﻌﺮﺽ ﻟﻠﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺘﻐﲑﺍﺕ‬
‫ﺍﻟﻨﻘﺪﻳﺔ ﺍﳌﺆﺛﺮﺓ ﰲ ﺍﻷﺳﻌﺎﺭ ﺑﺸﻜﻞ ﻋﺎﻡ‪.‬‬
‫ﺩ‪ .‬ﺍﻓﺘﻘﺎﺩ ﺗﻌﻤﻴﻢ ﺗﻄﺒﻴﻖ ﺍﳌﻔﺎﻫﻴﻢ ﻭﺍﻟﺘﻮﺟﻬﺎﺕ ﺍﳊﺪﻳﺜﺔ ﺍﳋﺎﺻﺔ ﺑﺘﺮﺷﻴﺪ ﺍﺳﺘﺨﺪﺍﻣﺎﺕ‬
‫)ﻭﺍﻗﺘﺼﺎﺩﻳﺎﺕ( ﺍﻷﺩﻭﻳﺔ‪ ،‬ﻭﺫﻟﻚ ﻣﺜﻞ ﻣﻔﻬﻮﻡ "ﻗﺎﺋﻤﺔ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ" )ﻣﻦ ﺣﻴﺚ ﺍﺳﺘﻴﻌﺎﺑﻪ‬
‫ﻭﺗﻄﺒﻴﻘﻪ ﻋﻠﻰ ﻣﺴﺘﻮﻳﺎﺕ ﳐﺘﻠﻔﺔ‪ ،‬ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺘﺼﻨﻴﻊ ﺍﻟﺪﻭﺍﺋﻲ ﻭﺑﻌﻤﻠﻴﺎﺕ ﺍﻟﻮﺻﻒ‬
‫ﺍﻟﺪﻭﺍﺋﻲ ﰲ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﺗﺒﺎﻳﻦ ﺃﻧﻮﺍﻋﻬﺎ(‪.‬‬
‫ﻫﺬﺍ‪ ،‬ﻭﺇﺫﺍ ﻛﻨﺎ ﻗﺪ ﺃﻛﺪﻧﺎ ﻋﻠﻰ ﺿﻌﻒ ﺃﻭﺿﺎﻉ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ‪ ،‬ﻓﺈﻧﻪ ﳛﺴﺐ ﻟﻠﻘﻴﺎﺩﺍﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻟﻘﻮﻣﻴﺔ ﺍﳌﺘﺘﺎﻟﻴﺔ )ﻧﻘﺼﺪ ﺍﻟﺴﺎﺩﺓ ﻭﺯﺭﺍﺀ ﺍﻟﺼﺤﺔ ﻭﻣﻌﺎﻭﻧﻴﻬﻢ( ﲤﺴﻜﻬﻢ – ﺑﻘﺪﺭ ﺍﻹﻣﻜﺎﻥ –‬
‫ﺑﺎﻟﻌﻤﻞ ﻋﻠﻰ ﺗﻮﻓﲑ ﺍﻷﺩﻭﻳﺔ ﻭﻣﻘﺎﻭﻣﺔ ﺭﻓﻊ ﺃﺳﻌﺎﺭﻫﺎ‪ ،‬ﻏﲑ ﺃﻥ ﺍﺳﺘﻤﺮﺍﺭ ﺍﻷﻭﺿﺎﻉ ﺍﳉﺎﺭﻳﺔ )ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ‬

‫‪١٩٠‬‬
‫ﺑﺎﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ( ﻋﻠﻰ ﻣﺎ ﻫﻲ ﻋﻠﻴﻪ‪ ،‬ﻳﻌﲏ ﺍﺳﺘﻤﺮﺍﺭ ﻭﺟﻮﺩ ﻓﺎﻗﺪ ﻛﺒﲑ ﰲ ﺍﳌﻤﻜﻨﺎﺕ‬
‫ﻭﺍﻟﻔﺮﺹ‪ ،‬ﻭﻳﻌﲏ ﻛﺬﻟﻚ ﺍﺭﺗﻔﺎﻉ ﺍﺣﺘﻤﺎﻟﻴﺔ ﺍﻟﺘﻌﺮﺽ ﻟﻠﺼﻌﻮﺑﺎﺕ ﻭﺍﳌﻔﺎﺟﺌﺎﺕ ﻭﺍﻷﺯﻣﺎﺕ‪.‬‬

‫!'&‪-1  -. -40  3 :$‬‬

‫ﺗﻘﺪﻡ ﺻﻨﺎﻋﺔ ﺍﻟﺪﺍﺀ ﺍﳌﺼﺮﻳﺔ ﳕﻮﺫﺟﺎﹰ ﻓﺮﻳﺪﺍﹰ ﰲ "ﻫﺪﺭ ﺍﻹﻣﻜﺎﻧﻴﺔ"‪ ،‬ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺍﳌﻮﺍﺭﺩ ﺍﻟﺒﺸﺮﻳﺔ ﺍﻟﻜﺜﻴﻔﺔ‬
‫ﺍﳌﻮﺟﻮﺩﺓ ﺩﺍﺧﻞ ﻣﺆﺳﺴﺎﺕ ﻫﺬﻩ ﺍﻟﺼﻨﺎﻋﺔ ﻭﻛﺬﻟﻚ ﺧﺎﺭﺟﻬﺎ ﰲ ﻣﻌﺎﻫﺪ ﻭﻣﺮﺍﻛﺰ ﺍﻟﺒﺤﺚ ﺍﻟﻌﻠﻤﻲ ﻋﻠﻰ‬
‫ﺍﳌﺴﺘﻮﻯ ﺍﻟﻮﻃﲏ‪ ،‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﻫﺬﻩ ﺍﻟﺼﻨﺎﻋﺔ ﻛﺎﻧﺖ ﻫﻲ ﺍﻟﺮﺍﺋﺪﺓ ﻭﺍﻟﻘﺎﺋﺪﺓ ﻭﺍﳌﻌﻠﻤﺔ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻳﺎﺕ‬
‫ﺍﻹﻗﻠﻴﻤﻴﺔ ﰲ ﺯﻣﻦ ﺳﺎﺑﻖ‪ ،‬ﺇﻻ ﺃ‪‬ﺎ ﺗﻌﺎﱐ ﺣﺎﻟﻴﺎﹰ ﻣﻦ ﺗﺄﺧﺮ ﻧﺴﱯ ﻭﺍﺿﺢ‪ ،‬ﻭﺫﻟﻚ ﺑﺎﻷﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ‬
‫ﻟﻺﻣﻜﺎﻧﻴﺎﺕ ﻭﺍﳌﻮﺍﺭﺩ ﺍﻟﺬﺍﺗﻴﺔ‪ ،‬ﻭﺃﻳﻀﺎﹰ ﺑﺎﳌﻘﺎﺭﻧﺔ ﻣﻊ ﺣﺎﻝ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﺩﻭﻝ ﺍﳌﻨﻄﻘﺔ ﻭﰲ ﺍﻟﻌﺪﻳﺪ‬
‫ﻣﻦ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ‪ ،‬ﻭﺃﻳﻀﺎﹰ ﺑﺎﻟﻨﻈﺮ ﺇﱃ ﺇﻳﻘﺎﻉ ﺗﻘﺪﻡ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﺪﻭﱄ‪ .‬ﻭﰲ‬
‫ﺗﻘﺪﻳﺮﻧﺎ‪ ،‬ﳝﻜﻦ ﺍﻟﺘﻌﺮﻑ ﻋﻠﻰ "ﺃﻭﺿﺎﻉ ﺳﻴﺎﺳﺔ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﰲ ﻣﺼﺮ" ﻣﻦ ﺧﻼﻝ ﺍﻟﺘﻨﺎﻭﻝ ﺍﳌﻮﺟﺰ ﻟﺒﻌﺾ‬
‫ﺧﻠﻔﻴﺎ‪‬ﺎ ﺍﻟﻌﺎﻣﺔ‪ ،‬ﻭﻟﻠﻤﺸﻜﻼﺕ ﺍﻟﺬﺍﺗﻴﺔ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﻟﻜﺎﻣﻨﺔ ﻓﻴﻬﺎ‪ ،‬ﻭﻟﻸﺧﻄﺎﺀ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﱵ‬
‫ﺃﺿﻌﻔﺖ ﻣﺴﲑ‪‬ﺎ ﻋﻠﻰ ﻣﺪﻯ ﺍﻟﻌﻘﻮﺩ ﺍﻟﺜﻼﺛﺔ ﺍﳌﺎﺿﻴﺔ‪.‬‬

‫ﺃ‪ -‬ﺧﻠﻔﻴﺎﺕ ﻋﺎﻣﺔ‬

‫‪ .١‬ﺗﻌﺘﱪ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﰲ ﻣﺼﺮ ﺻﻨﺎﻋﺔ ﻋﺮﻳﻘﺔ‪ ،‬ﺣﻴﺚ ﻫﻲ ﺍﻷﻭﱃ ﻣﻦ ﺣﻴﺚ ﺍﻟﻨﺸﺄﺓ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ‬
‫ﺍﻹﻗﻠﻴﻤﻲ )ﺍﻹﻓﺮﻳﻘﻲ – ﺍﻟﻌﺮﰊ – ﺍﻟﺸﺮﻕ ﺃﻭﺳﻄﻲ(‪.‬‬
‫‪ .٢‬ﺍﺳﺘﻄﺎﻋﺖ ﻫﺬﻩ ﺍﻟﺼﻨﺎﻋﺔ ﺃﻥ ﲢﻘﻖ ﺍﳍﺪﻑ ﺍﻟﺘﻘﻠﻴﺪﻱ ﻟﻠﺘﻨﻤﻴﺔ ﰲ ﻓﺘﺮﺓ ﺍﳋﻤﺴﻴﻨﻴﺎﺕ‬
‫ﻭﺍﻟﺴﺘﻴﻨﻴﺎﺕ ﻣﻦ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ‪ ،‬ﻭﻫﻮ "ﺍﻹﺣﻼﻝ ﳏﻞ ﺍﻟﻮﺍﺭﺩﺍﺕ"‪.‬‬
‫‪ .٣‬ﻓﻘﺪﺕ ﻫﺬﻩ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻣﻜﺎﻧﺘﻬﺎ ﺍﻟﻘﻴﺎﺩﻳﺔ ﺑﲔ ﺩﻭﻝ ﺍﻟﻌﺎﱂ ﺍﻟﺜﺎﻟﺚ ﺗﺪﺭﳚﻴﺎﹰ ﻣﻨﺬ‬
‫ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ‪ ،‬ﺣﻴﺚ ﺗﻘﺪﻣﺖ ﻋﻠﻴﻬﺎ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﰲ ﺩﻭﻝ ﻛﺜﲑﺓ ﻣﺜﻞ ﺍﳍﻨﺪ ﻭﺍﻷﺭﺟﻨﺘﲔ ﻭﺍﻟﱪﺍﺯﻳﻞ‬
‫ﻭﺍﻟﺼﲔ ﻭﻛﻮﺭﻳﺎ ﺍﳉﻨﻮﺑﻴﺔ‪.‬‬
‫ﺷﻜﻞ )‪ :(١-٨‬ﺗﻄﻮﺭ ﻧﺼﻴﺐ ﺍﻹﻧﺘﺎﺝ ﺍﻟﻮﻃﲏ ﻣﻦ ﺍﳌﺴﺘﺤﻀﺮﺍﺕ ﺍﻟﺼﻴﺪﻟﻴﺔ ﰲ ﲨﻠﺔ ﺍﻻﺳﺘﻬﻼﻙ ﺍﶈﻠﻲ )‪(%‬‬

‫‪100‬‬
‫‪90‬‬
‫ﻧﺴﺒﺔ ﻗﻴﻤﺔ ﺍﻻﻧﺘﺎﺝ ﻣﻦ ﺍﲨﺎﱄ ﺍﻻﺳـﺘﻬﻼﻙ )‪(%‬‬

‫‪80‬‬
‫‪70‬‬
‫‪60‬‬
‫‪50‬‬
‫‪40‬‬
‫‪30‬‬
‫‪20‬‬
‫‪10‬‬
‫‪0‬‬
‫‪1950‬‬ ‫‪1960‬‬ ‫‪1970‬‬ ‫‪1980‬‬ ‫‪1990‬‬ ‫‪1995‬‬
‫ﺍ ﻟﺴﻨﻮﺍﺕ‬

‫‪١٩١‬‬
‫‪ .٤‬ﺑﻠﻐﺖ ﺑﻌﺾ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻨﺎﺷﺌﺔ ﰲ ﺑﻌﺾ ﺍﻟﺒﻠﺪﺍﻥ ﺍﻟﻌﺮﺑﻴﺔ ﻧﻔﺲ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻨﻮﻋﻲ‬
‫ﻟﻠﺼﻨﺎﻋﺔ ﺍﳌﺼﺮﻳﺔ )ﰲ ﳎﺎﻝ ﺍﻟﺘﺸﻜﻴﻞ ﺍﻟﺼﻴﺪﱄ(‪ ،‬ﻭﺃﺣﻴﺎﻧﺎﹰ ﺗﻔﻮﻗﺖ ﻋﻠﻴﻬﺎ‪ ،‬ﻭﻗﺪ ﺗﻔﻮﻗﺖ ﺍﻷﺭﺩﻥ‬
‫ﺑﺸﻜﻞ ﻭﺍﺿﺢ ﰲ ﳎﺎﻝ ﺍﻟﺘﺼﺪﻳﺮ )ﺣﻴﺚ ﺗﺼﺪﺭ ﺃﻛﺜﺮ ﻣﻦ ﺿﻌﻒ ﻣﺎ ﺗﺼﺪﺭﻩ ﻣﺼﺮ(‪.‬‬
‫‪ .٥‬ﻭﺻﻠﺖ ﺍﻟﻘﺪﺭﺓ ﺍﻟﻮﻃﻨﻴﺔ ﰲ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﻣﻨﺬ ﺑﺪﺍﻳﺔ ﺳﺒﻌﻴﻨﻴﺎﺕ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ ﺇﱃ ﺳﻘﻒ‬
‫ﻣﻨﺤﲏ ﺗﻄﻮﺭﻫﺎ ﰲ ﺇﻃﺎﺭ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻵﻟﻴﺎﺕ ﺍﻟﻘﺎﺋﻤﺔ )ﺍﻧﻈﺮ ﺍﻟﺸﻜﻞ "‪.("١-٨‬‬

‫ﺏ‪ -‬ﺍﳌﺸﻜﻼﺕ )ﺃﻭ ﺍﻟﺴﻠﺒﻴﺎﺕ( ﺍﻟﺬﺍﺗﻴﺔ‬

‫‪ .١‬ﻋﺪﻡ ﻭﺟﻮﺩ ﺳﻴﺎﺳﺔ ﺩﻭﺍﺋﻴﺔ ﻭﻃﻨﻴﺔ ﻣﺘﻜﺎﻣﻠﺔ‪ ،‬ﻭﻛﺬﻟﻚ ﻋﺪﻡ ﻭﺟﻮﺩ ﳐﻄﻂ ﺍﺳﺘﺮﺍﺗﻴﺠﻲ ﻟﺘﻄﻮﻳﺮ‬
‫ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‪.‬‬
‫‪ .٢‬ﻋﺪﻡ ﺍﺳﺘﻴﻌﺎﺏ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺍﻟﻮﻃﻨﻴﺔ ﻣﻦ ﺧﻼﻝ ﻣﻨﻈﻮﻣﺘﻬﺎ ﺍﻟﻘﺎﺋﻤﺔ ﻟﻄﺒﻴﻌﺔ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ‬
‫ﺑﺎﻋﺘﺒﺎﺭﻫﺎ ﻣﻦ ﻧﻮﻉ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﱵ ﻳﻌﺘﻤﺪ ﻓﻴﻬﺎ ﺍﻟﺘﻘﺪﻡ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻲ – ﰲ ﺍﻷﺳﺎﺱ – ﻋﻠﻰ‬
‫ﺃﻧﺸﻄﺔ ﺍﻟﺒﺤﺚ ﻭﺍﻟﺘﻄﻮﻳﺮ‪ .‬ﻫﻨﺎ ﳒﺬﺏ ﺍﻻﻧﺘﺒﺎﻩ ﺇﱃ ﺃﻥ ﻧﺴﺒﺔ ﺍﻟﺼﺮﻑ ﻋﻠﻰ ﺃﻧﺸﻄﺔ ﺍﻟﺒﺤﺚ‬
‫ﻭﺍﻟﺘﻄﻮﻳﺮ )ﻣﻘﺎﺭﻧﺔ ﺑﺎﳌﺒﻴﻌﺎﺕ( ﰲ ﺍﻟﺸﺮﻛﺎﺕ ﺍﳌﺼﺮﻳﺔ ﺗﻜﺎﺩ ﻻ ﺗﺘﻌﺪﻯ ‪ ،%٢,٥‬ﻳﺼﺮﻑ ﺃﻛﺜﺮ ﻣﻦ‬
‫ﻧﺼﻔﻬﺎ ﻋﻠﻰ ﺍﻷﺟﻮﺭ‪ ،‬ﺫﻟﻚ ﺑﻴﻨﻤﺎ ﺗﺮﺗﻔﻊ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﰲ ﺷﺮﻛﺎﺕ ﺍﻟﺪﻭﺍﺀ ﺍﻟﱵ ﺗﻘﻮﻡ ﺑﻨﺸﺎﻁ ﲝﺜﻲ‬
‫ﺗﻄﻮﻳﺮﻱ ﺣﻘﻴﻘﻲ ﺇﱃ ﺃﻛﺜﺮ ﻣﻦ ‪.%١٥‬‬
‫‪ .٣‬ﺗﺪﻫﻮﺭ ﺍﳌﻌﺎﻳﲑ ﺍﳋﺎﺻﺔ ﺑﺘﻘﻴﻴﻢ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻭﳐﺮﺟﺎ‪‬ﺎ‪ ،‬ﺣﻴﺚ ﺗﺮﺗﻜﺰ ﻫﺬﻩ ﺍﳌﻌﺎﻳﲑ – ﺣﱴ‬
‫ﺍﻵﻥ – ﻋﻠﻰ ﺣﺠﻢ ﺗﻐﻄﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺴﻮﻕ ﺍﶈﻠﻲ‪ ،‬ﻛﻤﺎ ﺗﺘﺪﺍﺧﻞ ﺍﻋﺘﺒﺎﺭﺍﺕ ﻭﺗﻮﺟﻬﺎﺕ ﺫﺍﺗﻴﺔ‬
‫)ﺗﺘﻤﺜﻞ ﰲ ﺍﻟﺮﺅﻯ ﺍﻟﺸﺨﺼﻴﺔ ﻭﻏﻠﺒﺔ "ﺍﻟﱪﻭﺑﺎﺟﻨﺪﺍ"( ﻣﻊ ﺃﻱ ﺟﻬﻮﺩ ﻟﺘﻘﻮﱘ ﻫﺬﻩ ﺍﳌﻌﺎﻳﲑ‪.‬‬
‫‪ .٤‬ﻏﻴﺒﺔ ﺍﻟﺘﺤﺎﻟﻔﺎﺕ ﻭﺍﻟﺘﻜﺘﻼﺕ ﺍﻟﻮﻃﻨﻴﺔ ﺍﻟﺘﻄﻮﻳﺮﻳﺔ ﺍﻟﻔﻌﺎﻟﺔ ﰲ ﺍ‪‬ﺎﻻﺕ ﺍﻟﺒﺤﺜﻴﺔ ﻭﺍﻟﺘﺴﻮﻳﻘﻴﺔ‬
‫ﻭﺍﻟﺘﺠﺎﺭﻳﺔ‪.‬‬
‫‪ .٥‬ﻭﺟﻮﺩ ﺣﺎﺟﺰ ﻧﻔﺴﻲ ﺃﻣﺎﻡ ﺍﻻﺑﺘﻜﺎﺭ ﺍﻟﺪﻭﺍﺋﻲ ﺍﻟﻮﻃﲏ‪ .‬ﻭﺗﻌﻮﺩ ﺃﺳﺒﺎﺏ ﻫﺬﺍ ﺍﳊﺎﺟﺰ ﺍﻟﻨﻔﺴﻲ ﺇﱃ‬
‫ﺳﻠﺒﻴﺘﲔ ﺭﺋﻴﺴﺘﲔ‪ .‬ﺍﻟﺴﻠﺒﻴﺔ ﺍﻷﻭﱃ ﺗﺘﻌﻠﻖ ﺑﻀﻌﻒ ﻗﺪﺭﺓ ﺍﻷﺟﻬﺰﺓ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻘﺎﺋﻤﺔ )ﰲ‬
‫ﺍﻟﺼﻨﺎﻋﺔ ﻭﺍﻟﺒﺤﻮﺙ( ﻋﻠﻰ ﺍﺳﺘﻘﺮﺍﺀ ﻭﻓﻬﻢ ﺳﻴﺎﺳﺎﺕ ﻭﺍﻗﺘﺼﺎﺩﻳﺎﺕ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﻟﻌﺎﳌﻴﺔ ﰲ ﺻﻨﺎﻋﺔ‬
‫ﺍﻟﺪﻭﺍﺀ‪ .‬ﻭﺃﻣﺎ ﺍﻟﺴﻠﺒﻴﺔ ﺍﻟﺜﺎﻧﻴﺔ ﻓﺘﺘﻌﻠﻖ ﺑﺴﻮﺀ ﺣﺎﻝ ﺇﺩﺍﺭﺓ ﺃﻧﺸﻄﺔ ﺍﻟﺒﺤﺚ ﻭﺍﻟﺘﻄﻮﻳﺮ ﺍﻟﺪﻭﺍﺋﻲ ﰲ‬
‫ﻣﺼﺮ‪ ،‬ﻭﻛﺬﻟﻚ ﺿﻌﻒ ﻗﺪﺭﺓ ﺍﻟﻘﻴﺎﺩﺍﺕ ﻭﺍﻷﻧﻈﻤﺔ ﺍﻟﻘﺎﺋﻤﺔ )ﰲ ﻣﺆﺳﺴﺎﺕ ﺍﻟﺪﻭﺍﺀ( ﲞﺼﻮﺹ‬
‫ﺍﺳﺘﻴﻌﺎﺏ ﻭﺗﺴﻴﲑ ﺍﻹﻣﻜﺎﻧﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ‪ .‬ﻫﻨﺎ ﳚﺪﺭ ﺟﺬﺏ ﺍﻻﻧﺘﺒﺎﻩ ﺇﱃ ﺃﻥ ﺍﻟﺴﻠﺒﻴﺘﲔ ﺍﳌﺬﻛﻮﺭﺗﲔ‬
‫ﺃﻋﻼﻩ ﺗﺼﻔﺎ ﺍﻟﻮﺿﻊ ﺍﻟﻌﺎﻡ‪ ،‬ﻭﺍﻟﺬﻱ ﺗﻮﺟﺪ – ﺑﺎﻟﻘﻄﻊ – ﺍﺳﺘﺜﻨﺎﺀﺍﺕ ﻓﺮﺩﻳﺔ ﳐﺎﻟﻔﺔ ﻟﻪ‪.‬‬
‫ﻫﺬﺍ‪ ،‬ﻭﻗﺪ ﻧﺘﺞ ﻋﻦ ﺍﳌﺸﻜﻼﺕ )ﺃﻭ ﺍﻟﺴﻠﺒﻴﺎﺕ( ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﺎ ﻣﺎ ﻳﻠﻲ‪:‬‬
‫ﻫﺪﺭ ﺇﻣﻜﺎﻧﻴﺎﺕ ﺍﻟﺒﺤﺚ ﻭﺍﻟﺘﻄﻮﻳﺮ ﺍﻟﺪﻭﺍﺋﻲ ﰲ ﻣﺆﺳﺴﺎﺕ ﺍﻟﺪﻭﻟﺔ )ﺍﳉﺎﻣﻌﺎﺕ ﻭﻣﺮﺍﻛﺰ ﺍﻟﺒﺤﻮﺙ(‪.‬‬ ‫‪-‬‬
‫ﺗﺄﺧﺮ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺍﳌﺼﺮﻳﺔ )ﻛﻤﺎ ﺃﺷﺮﻧﺎ ﻣﻦ ﻗﺒﻞ(‪ ،‬ﻭﺣﻴﺚ ﺗﻌﺘﻤﺪ ﻋﻠﻰ ﺑﺸﻜﻞ ﺷﺒﻪ ﻛﻠﻲ‬ ‫‪-‬‬
‫ﻋﻠﻰ ﺍﺳﺘﲑﺍﺩ ﺍﳌﻮﺍﺩ ﺍﳋﺎﻡ ﻭﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ‪ ،‬ﻭﺃﻳﻀﺎﹰ – ﺇﱃ ﺣﺪ ﻛﺒﲑ – ﺍﺳﺘﲑﺍﺩ ﻣﻮﺍﺩ ﺍﻟﺘﻌﺒﺌﺔ‪.‬‬
‫ﺗﺄﺧﺮ ﺇﻧﺸﺎﺀ ﺑﻨﻴﺔ ﺃﺳﺎﺳﻴﺔ ﻟﻠﺘﻜﻨﻮﻟﻮﺟﻴﺎ ﺍﳊﻴﻮﻳﺔ ﺩﺍﺧﻞ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ‪ ،‬ﻭﺫﻟﻚ ﰲ‬ ‫‪-‬‬
‫ﻇﻞ ﺍﺳﺘﻤﺮﺍﺭ ﻏﻴﺎﺏ ﺭﺅﻳﺔ ﻗﻮﻣﻴﺔ‪ ،‬ﻭﺟﻬﺪ ﻭﻃﲏ ﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺗﻜﻨﻮﻟﻮﺟﻴﺎ‪.‬‬

‫‪١٩٢‬‬
‫ﺩﺧﻮﻝ ﺑﻌﺾ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﻌﺎﳌﻴﺔ ﻟﺸﺮﺍﺀ ﺷﺮﻛﺎﺕ ﻗﺎﺋﻤﺔ‪ ،‬ﺣﻴﺚ ﳚﺮﻯ ﺫﻟﻚ ﰲ ﺇﻃﺎﺭ ﺗﻮﺟﻪ ﳜﺘﺺ‬ ‫‪-‬‬
‫‪ -‬ﰲ ﺍﻷﺳﺎﺱ ‪ -‬ﺑﺎﻻﺳﺘﺤﻮﺍﺫ ﻋﻠﻰ ﺍﻟﺴﻮﻕ ﺍﶈﻠﻲ ﺃﻛﺜﺮ ﳑﺎ ﳜﺘﺺ ﺑﻨﻘﻞ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ‬
‫)ﻣﻠﺤﻮﻇﺔ‪ :‬ﻳﺴﺘﺤﻮﺫ ﻓﺮﻉ ﺷﺮﻛﺔ ﺟﻼﻛﺴﻮ ﺍﻟﻌﺎﳌﻴﺔ ﰲ ﻣﺼﺮ ﻋﻠﻰ ﺃﻛﺜﺮ ﻣﻦ ‪ %٩‬ﻣﻦ ﺣﺠﻢ‬
‫ﺍﻟﺴﻮﻕ ﺍﳌﺼﺮﻳﺔ(‪.‬‬
‫ﻭﰲ ﻏﻤﺎﺭ ﺍﻟﺘﻌﺮﺽ ﻟﻠﻤﺸﻜﻼﺕ )ﺃﻭ ﺍﻟﺴﻠﺒﻴﺎﺕ( ﺍﻟﺬﺍﺗﻴﺔ ﰲ ﻗﻄﺎﻉ ﺍﻟﺪﻭﺍﺀ‪ ،‬ﲡﺪﺭ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﻭﺟﻮﺩ ﻧﺸﺎﻁ‬
‫ﻣﻠﺤﻮﻅ ﻭﻣﺘﺰﺍﻳﺪ ﰲ ﳎﺎﻝ ﺍﻷﻣﺼﺎﻝ ﻭﺍﻟﻠﻘﺎﺣﺎﺕ )ﺧﺎﺻﺔ ﻣﻊ ﲢﻮﻝ ﻫﻴﺌﺔ ﺍﻷﻣﺼﺎﻝ ﻭﺍﻟﻠﻘﺎﺣﺎﺕ ﺇﱃ‬
‫ﺷﺮﻛﺔ ﻗﺎﺑﻀﺔ(‪ ،‬ﻭﻫﻮ ﺃﻣﺮ ﳛﺘﺎﺝ ﺇﱃ ﺗﻘﻴﻴﻢ ﻧﻮﻋﻲ ﻭﻛﻤﻲ‪.‬‬

‫ﺝ‪ -‬ﺍﻷﺧﻄﺎﺀ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﱵ ﺃﺿﻌﻔﺖ ﻣﺴﲑﺓ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺍﻟﻮﻃﻨﻴﺔ‬

‫‪ .١‬ﺍﻻﻗﺘﺼﺎﺭ ﻋﻠﻰ ﺍﻟﺘﻄﻮﺭ ﺍﻷﻓﻘﻲ‪ ،‬ﲟﻌﲎ ﺯﻳﺎﺩﺓ ﻋﺪﺩ ﺍﳌﺼﺎﻧﻊ ﺩﻭﻥ ﺍﻻﻧﺘﺒﺎﻩ ﺇﱃ ﺍﻟﺘﻄﻮﺭ ﺍﻟﺮﺃﺳﻲ )ﺗﻄﻮﺭ‬
‫ﺍﳌﻨﺘﺠﺎﺕ ﻭﺍﻟﻌﻤﻠﻴﺎﺕ ﺍﻹﻧﺘﺎﺟﻴﺔ ﻭﺍﳋﺪﻣﻴﺔ ﻭﻗﺪﺭﺍﺕ ﺍﻟﺒﺤﺚ ﻭﺍﻟﺘﻄﻮﻳﺮ(‪ ،‬ﻭﺫﻟﻚ ﺑﻴﻨﻤﺎ ﺍﻟﺘﻄﻮﺭ‬
‫ﺍﻟﺮﺃﺳﻲ ﰲ ﺻﻨﺎﻋﺔ ﺗﻌﺘﻤﺪ ﻋﻠﻰ ﺍﻟﻌﻠﻢ ﻣﺜﻞ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ‪ ،‬ﻫﻮ ﺍﻟﻄﺮﻳﻖ ﺍﻟﺮﺋﻴﺴﻲ ﻟﺘﻨﻈﻴﻢ‬
‫ﺍﻟﻘﻴﻤﺔ ﺍﳌﻀﺎﻓﺔ ﻭﺍﻟﻨﻤﻮ ﻭﺍﻟﺘﻨﺎﻓﺴﻴﺔ‪.‬‬
‫‪ .٢‬ﻏﻴﺒﺔ ﺩﻭﺭ ﺇﳚﺎﰊ ﻟﻠﺤﻜﻮﻣﺎﺕ ﺍﳌﺼﺮﻳﺔ ﺍﳌﺘﻌﺎﻗﺒﺔ )ﺭﲟﺎ ﻣﻨﺬ ﺃﻭﺍﺧﺮ ﺳﺘﻴﻨﻴﺎﺕ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ( ﲡﺎﻩ‬
‫ﺿﺮﻭﺭﺍﺕ ﺍﻟﺘﻄﻮﺭ ﺍﻟﺮﺃﺳﻲ ﻟﻠﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ .‬ﻟﻘﺪ ﺭﻛﺰﺕ ﺍﳊﻜﻮﻣﺎﺕ ﺍﳌﺼﺮﻳﺔ ﻃﻠﺒﺎ‪‬ﺎ ﻣﻦ‬
‫ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﺍﻟﺪﻭﺍﺋﻲ )ﰒ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﺑﻌﺪ ﺫﻟﻚ( ﰲ ﺗﻐﻄﻴﺔ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﶈﻠﻴﺔ‪ ،‬ﻭﱂ ﺗﺸﺄ ﺃﻱ‬
‫ﻣﻨﻬﺎ )ﺃﻱ ﺍﳊﻜﻮﻣﺎﺕ( ﲢﻤﻞ ﻣﺴﺌﻮﻟﻴﺔ ﺍﻟﺘﺮﺷﻴﺪ ﺍﻹﳚﺎﰊ ﺃﻭ ﺇﺩﺍﺭﺓ ﺍﻟﺪﻓﺔ ﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺍﳌﺼﺮﻳﺔ‬
‫ﻣﻦ ﺧﻼﻝ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻵﻟﻴﺎﺕ ﺍﳌﺎﻟﻴﺔ ﻭﺍﻟﺘﺸﺮﻳﻌﻴﺔ ﻭﺍﻻﺳﺘﺜﻤﺎﺭﻳﺔ ﺍﳌﻨﺎﺳﺒﺔ ﻣﻦ ﺃﺟﻞ ﺩﻓﻊ ﻫﺬﻩ‬
‫ﺍﻟﺼﻨﺎﻋﺔ ﺇﱃ ﺍﻟﺘﻄﻮﺭ ﺍﻟﺮﺃﺳﻲ )ﺍﻟﺘﻄﻮﺭ ﺍﻟﻘﺎﺋﻢ ﻋﻠﻰ ﺃﻧﺸﻄﺔ ﺍﻟﺒﺤﺚ ﻭﺍﻟﺘﻄﻮﻳﺮ(‪ ،‬ﻭﰲ ﺍﳌﻘﺎﺑﻞ ﻓﻘﺪ‬
‫ﻗﺎﻣﺖ )ﻭﺗﻘﻮﻡ( ﺣﻜﻮﻣﺎﺕ ﺍﻟﺪﻭﻝ ﺍﳌﺘﻘﺪﻣﺔ ﻭﺍﻟﻼﺣﻘﺔ – ﻋﻠﻰ ﺍﻟﺴﻮﺍﺀ – ﺑﺄﺩﻭﺍﺭ ﺇﳚﺎﺑﻴﺔ ﻫﺎﻣﺔ ﰲ‬
‫ﺗﺮﺷﻴﺪ ﻭﺗﻄﻮﻳﺮ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ‪.‬‬
‫‪ .٣‬ﻧﺸﺄﺓ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﺍﻟﺪﻭﺍﺋﻲ – ﰲ ﺍﻷﺳﺎﺱ – ﻛﺎﻣﺘﺪﺍﺩ ﻣﻮﺍﺯٍ )ﻭﺭﲟﺎ ﺑﺪﻳﻞ( ﻟﻠﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﺍﻟﺪﻭﺍﺋﻲ‬
‫ﳑﺎ ﺣﺼﺮ ﺍﳌﻨﺎﻓﺴﺔ ﰲ ﺇﻃﺎﺭ ﳏﻠﻲ‪ ،‬ﻭﲢﺖ ﺳﻘﻒ ﻣﺴﺘﻮﻳﺎﺕ ﺗﻜﻨﻮﻟﻮﺟﻴﺔ ﻣﺘﺸﺎ‪‬ﺔ ﺇﱃ ﺣﺪ ﻛﺒﲑ‪.‬‬
‫ﻭﻧﺘﻴﺠﺔ ﻟﺬﻟﻚ ﱂ ﺗﺘﻄﻮﺭ ﺍﻟﻘﺪﺭﺍﺕ ﺍﻟﻨﻮﻋﻴﺔ ﺍﻟﻨﺴﺒﻴﺔ ﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺍﳌﺼﺮﻳﺔ )ﻭﻻ ﺍﻟﻘﺪﺭﺍﺕ‬
‫ﺍﻹﺩﺍﺭﻳﺔ ﻟﻘﻴﺎﺩﺍ‪‬ﺎ( ﻋﻦ ﺃﻭﺿﺎﻉ ﻣﺎ ﻗﺒﻞ ﺍﳋﺼﺨﺼﺔ ﺃﻭ ﺍﻟﻌﻮﳌﺔ‪ ،‬ﺑﻞ ﱂ ﺗﺘﻄﻮﺭ ﻛﺜﲑﺍﹰ ﻋﻦ ﺃﻭﺿﺎﻉ‬
‫ﺳﺘﻴﻨﻴﺎﺕ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ‪.‬‬
‫ﻭﻫﻜﺬﺍ‪ ،‬ﻳﺘﻀﺢ ﺃﻥ ﺍﻷﺧﻄﺎﺀ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﺜﻼﺛﺔ ﺍﻟﺴﺎﺑﻖ ﺫﻛﺮﻫﺎ ﺗﺸﺘﺮﻙ ﰲ ﺟﻮﻫﺮ ﺭﺋﻴﺴﻲ ﻭﺍﺣﺪ‪ ،‬ﻭﻫﻮ‬
‫ﻋﺪﻡ ﺍﻻﻧﺘﺒﺎﻩ ﺇﱃ ﺍﻟﺘﻄﻮﺭ ﺍﻟﺮﺃﺳﻲ ﺍﳌﻌﺘﻤﺪ ﻋﻠﻰ ﺃﻧﺸﻄﺔ ﺍﻟﺒﺤﺚ ﻭﺍﻟﺘﻄﻮﻳﺮ ﻭﺍﻟﺘﺴﻮﻳﻖ‪.‬‬
‫ﻟﻘﺪ ﺃﺩﻯ ﺫﻟﻚ ﺇﱃ ﺗﻌﻄﻴﻞ ﻣﺴﲑﺓ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺍﳌﺼﺮﻳﺔ ﻋﻦ ﺍﳌﺴﲑﺍﺕ ﺍﳌﻨﺎﻇﺮﺓ ﰲ ﺩﻭﻝ ﺑﺪﺃﺕ ﻣﻌﻬﺎ‬
‫)ﻣﺜﻞ ﺍﳍﻨﺪ(‪ ،‬ﻛﻤﺎ ﳊﻘﺖ ‪‬ﺎ ﺻﻨﺎﻋﺎﺕ ﺣﺪﻳﺜﺔ ﺍﻟﻨﺸﺄﺓ )ﻣﺜﻞ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺪﻭﻝ‬
‫ﺍﻟﻌﺮﺑﻴﺔ‪ ،‬ﻛﺘﻠﻚ ﰲ ﺍﻷﺭﺩﻥ ﻭﺍﻹﻣﺎﺭﺍﺕ ﻭﻓﻠﺴﻄﲔ ﻭﺳﻮﺭﻳﺎ ﻭﺍﳌﻐﺮﺏ(‪ .‬ﺫﻟﻚ ﻓﻀﻼﹰ ﻋﻦ ﺍﻟﺴﺒﻖ ﺍﻟﺬﻱ ﺣﻘﻘﺘﻪ‬
‫ﻛﻴﺎﻧﺎﺕ ﺩﻭﺍﺋﻴﺔ ﺣﺪﻳﺜﺔ ﱂ ﺗﻜﻦ ﻣﻮﺟﻮﺩﺓ ﻋﻨﺪﻣﺎ ﺑﺪﺃﺕ ﻣﺼﺮ ﺻﻨﺎﻋﺘﻬﺎ ﺍﻟﺪﻭﺍﺋﻲ )ﻧﻘﺼﺪ ﺍﻟﺼﻨﺎﻋﺔ‬
‫ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻹﺳﺮﺍﺋﻴﻠﻴﺔ(‪ .‬ﻭﺑﻴﻨﻤﺎ ﻗﻴﺎﺩﺍﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺪﻭﺍﺀ ﰲ ﻣﺼﺮ ﺗﺘﻤﺴﻚ ﲟﻌﻴﺎﺭ ﺗﻐﻄﻴﺔ ﺍﻻﺳﺘﻬﻼﻙ‬

‫‪١٩٣‬‬
‫ﺍﶈﻠﻲ ﻛﺪﻟﻴﻞ ﻗﻮﺓ ﳍﺬﻩ ﺍﻟﺼﻨﺎﻋﺔ )ﻭﻫﻮ ﻣﻌﻴﺎﺭ ﺧﺎﻃﺊ ﰲ ﺻﻨﺎﻋﺔ ﺗﻌﺘﻤﺪ ﻋﻠﻰ ﺍﻟﻌﻠﻢ ﻣﺜﻞ ﺻﻨﺎﻋﺔ‬
‫ﺍﻟﺪﻭﺍﺀ(‪ ،‬ﺣﻴﺚ ﺩﺃﺑﺖ ﻫﺬﻩ ﺍﻟﻘﻴﺎﺩﺍﺕ ﻋﻠﻰ ﺍﻹﻋﻼﻥ ﺑﺄﻥ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺍﻟﻮﻃﻨﻴﺔ ﺗﻐﻄﻲ ‪ %٩٥‬ﻣﻦ‬
‫ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﶈﻠﻴﺔ )ﻛﺪﻟﻴﻞ ﻗﻮﺓ ﳍﺬﻩ ﺍﻟﺼﻨﺎﻋﺔ(‪ ،‬ﻓﺈﻥ ﺗﻘﺮﻳﺮ ﺣﺪﻳﺚ ﻗﺪ ﺻﺪﺭ ﻣﻦ ﺍﲢﺎﺩ ﺍﻟﺼﻨﺎﻋﺎﺕ ﻗﺪ‬
‫ﺃﻭﺿﺢ ﺃﻥ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﻗﺪ ﺍﳔﻔﻀﺖ ﻣﺆﺧﺮﺍﹰ ﺇﱃ ‪ .%٨٥‬ﻭﰲ ﺗﻘﺪﻳﺮﻧﺎ ﺃﻥ ﺍﺭﺗﻔﺎﻉ ﺃﻭ ﺍﳔﻔﺎﺽ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ‬
‫ﻟﻴﺲ ﻟﻪ ﻋﻼﻗﺔ ﻣﺒﺎﺷﺮﺓ ﺑﺘﻔﻮﻕ ﺍﻟﻘﺪﺭﺍﺕ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺔ ﺍﻷﺻﻴﻠﺔ ﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺍﳊﺪﻳﺜﺔ‬
‫)ﻣﻠﺤﻮﻇﺔ‪ :‬ﺻﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺀ ﰲ ﺑﻠﺪﺍﻥ ﻣﺜﻞ ﺳﻮﻳﺴﺮﺍ ﻭﺇﳒﻠﺘﺮﺍ ﻻ ﺗﻐﻄﻲ ﺃﻛﺜﺮ ﻣﻦ ‪ %٦٠‬ﻣﻦ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ‬
‫ﺍﶈﻠﻴﺔ ﺑﻴﻨﻤﺎ ﳍﺎ ﺃﻧﺼﺒﺔ ﻛﺒﲑﺓ ﰲ ﺍﻟﺴﻮﻕ ﺍﻟﻌﺎﳌﻲ(‪.‬‬

‫‪  -.  64 - -7

8% 29&+ :$5‬‬
‫ﺗﺸﻜﻞ ﺍﺗﻔﺎﻗﻴﺎﺕ ﻣﻨﻈﻤﺔ ﺍﻟﺘﺠﺎﺭﺓ ﺍﻟﻌﺎﳌﻴﺔ ﺍﻟﻘﻮﺓ ﺍﻟﺮﺋﻴﺴﻴﺔ )ﻭﺭﲟﺎ ﺍﻟﻜﻠﻴﺔ( ﰲ ﺍﻟﺘﺄﺛﲑ ﻋﻠﻰ ﺍﻷﻭﺿﺎﻉ‬
‫ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﻣﺼﺮ‪ ،‬ﻭﰲ ﺗﻘﺪﻳﺮﻧﺎ ﺳﺘﻜﻮﻥ ﺍﻷﻭﻟﻮﻳﺔ ﰲ ﺍﻟﺘﺄﺛﲑﺍﺕ ﺭﺍﺟﻌﺔ ﻵﻟﻴﺎﺕ ﺛﻼﺙ‪:‬‬
‫‪ .١‬ﺍﻟﻨﻔﺎﺫﻳﺔ ﻟﻸﺳﻮﺍﻕ‪.‬‬
‫‪ .٢‬ﺍﻻﻟﺘﺰﺍﻡ ﺑﺎﳌﻮﺍﺻﻔﺎﺕ ﺍﳌﻘﺒﻮﻟﺔ ﻋﺎﳌﻴﺎﹰ‪..‬‬
‫‪ .٣‬ﲪﺎﻳﺔ ﺍﳌﻠﻜﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ‪.‬‬
‫ﺇﻥ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﻫﺬﻩ ﺍﻵﻟﻴﺎﺕ ﺗﺄﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﳎﻤﻞ ﺍﺗﻔﺎﻗﻴﺎﺕ ﺍﳉﺎﺕ‪ ،‬ﻭﻟﻴﺲ ﻓﻘﻂ ﺍﺗﻔﺎﻗﻴﺔ "ﺣﻘﻮﻕ‬
‫ﺍﳌﻠﻜﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﻟﺘﺠﺎﺭﺓ" ‪ ،TRIPs‬ﻭﺇﻥ ﻛﺎﻧﺖ ﻫﺬﻩ ﺍﻷﺧﲑﺓ ﻫﻲ ﺍﻷﻛﺜﺮ ﻭﺿﻮﺣﺎﹰ ﰲ ﺍﻟﺘﺄﺛﲑ‬
‫ﺍﳌﺒﺎﺷﺮ‪.‬‬
‫ﺍﳉﺪﻳﺮ ﺑﺎﻻﻧﺘﺒﺎﻩ ﺃﻥ ﺍﺗﻔﺎﻗﻴﺔ ﺗﺮﻳﺒﺲ ‪ TRIPs‬ﺗﺆﺛﺮ ﻋﻠﻰ ﺍﻷﻭﺿﺎﻉ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻋﺎﻣﺔ ﻣﻦ ﺧﻼﻝ ﺍﻟﻌﺪﻳﺪ ﻣﻦ‬
‫ﺍﳉﻮﺍﻧﺐ‪ ،‬ﻧﺬﻛﺮ ﻣﻨﻬﺎ ﻫﻨﺎ ﺟﺎﻧﺒﲔ ﺭﺋﻴﺴﻴﲔ‪ ،‬ﻭﳘﺎ ﺗﻐﻄﻴﺔ ﺑﺮﺍﺀﺓ ﺍﻻﺧﺘﺮﺍﻉ ﻟﻜﻞ ﻣﻦ ﺍﻟﻌﻤﻠﻴﺔ ﺍﻻﺑﺘﻜﺎﺭﻳﺔ‬
‫‪ ،Process‬ﻭﺍﳌﻨﺘﺞ ‪ ،Product‬ﻭﺫﻟﻚ ﺑﻌﺪ ﺃﻥ ﻛﺎﻥ ﺍﻟﻮﺿﻊ ﺍﻟﺪﺍﺭﺝ ﰲ ﻗﻮﺍﻧﲔ ﺍﻟﺪﻭﻝ ﻫﻮ ﻣﻨﺢ ﺍﻟﱪﺍﺀﺓ ﻋﻠﻰ‬
‫ﺍﻟﻌﻤﻠﻴﺔ ﺍﻻﺑﺘﻜﺎﺭﻳﺔ ﻓﻘﻂ‪ ،‬ﺫﻟﻚ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺟﻌﻞ ﻓﺘﺮﺓ ﲪﺎﻳﺔ ﺑﺮﺍﺀﺓ ﺍﻻﺧﺘﺮﺍﻉ ﲤﺘﺪ ﺇﱃ ﻋﺸﺮﻳﻦ ﻋﺎﻣﺎﹰ‬
‫ﻋﻠﻰ ﺍﻷﻗﻞ‪.‬‬
‫ﺇﻥ ﺗﻘﻴﻴﻢ ﺍﻻﻧﻌﻜﺎﺳﺎﺕ ﺍﳌﻤﻜﻨﺔ ﳍﺬﻩ ﺍﻻﺗﻔﺎﻗﻴﺔ ﻋﻠﻰ ﺍﻷﻭﺿﺎﻉ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻳﻨﺒﻐﻲ ﺃﻥ ﻳﺄﺧﺬ ﰲ ﺍﳊﺴﺒﺎﻥ‪،‬‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳉﺎﻧﺒﲔ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﻤﺎ‪ ،‬ﺍﻋﺘﺒﺎﺭﺍﺕ ﺃﺧﺮﻯ ﺗﻨﺘﺞ ﰲ ﳎﻤﻠﻬﺎ ﻣﻦ ﻛﺎﻓﺔ ﺑﻨﻮﺩ ﻫﺬﻩ ﺍﻻﺗﻔﺎﻗﻴﺔ‪،‬‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳌﺴﺘﺠﺪﺍﺕ ﺍﳋﺎﺻﺔ ﺑﺒﻘﻴﺔ ﺍﺗﻔﺎﻗﻴﺎﺕ ﺍﳉﺎﺕ )ﻭﻫﻲ ﺍﻻﺗﻔﺎﻗﻴﺎﺕ ﺍﻟﱵ ﺗﺮﻋﺎﻫﺎ ﻣﻨﻈﻤﺔ‬
‫ﺍﻟﺘﺠﺎﺭﺓ ﺍﻟﻌﺎﳌﻴﺔ ﻣﻨﺬ ﻳﻨﺎﻳﺮ ‪ ،(١٩٩٥‬ﻭﺧﺎﺻﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﻔﺾ ﺍﻟﱰﺍﻋﺎﺕ‪ ،‬ﻭﺍﻻﺳﺘﺜﻤﺎﺭ‪ ،‬ﻭﺍﳋﺪﻣﺎﺕ‪،‬‬
‫ﻭﺍﻻﻋﺘﺒﺎﺭﺍﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﺫﻟﻚ ﻛﻠﻪ )ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻭﺿﻌﻴﺔ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺑﺎﻋﺘﺒﺎﺭﻫﺎ ﺻﻨﺎﻋﺔ ﺗﻌﺘﻤﺪ‬
‫ﻋﻠﻰ ﺍﻟﺒﺤﺚ ﺍﻟﻌﻠﻤﻲ ‪ Research – Driven Industry‬ﻳﻌﲏ ﰲ ﺗﻘﺪﻳﺮﻧﺎ ﺃﻥ ﺍﻻﻧﻌﻜﺎﺳﺎﺕ ﺍﻟﺮﺋﻴﺴﻴﺔ‬
‫ﳍﺬﻩ ﺍﻻﺗﻔﺎﻗﻴﺔ ﺗﻜﻮﻥ – ﺃﺳﺎﺳﺎﹰ – ﰲ ﺍﲡﺎﻫﲔ‪:‬‬
‫ﺍﻻﲡﺎﻩ ﺍﻷﻭﻝ‪ :‬ﺯﻳﺎﺩﺓ ﻗﻮﺓ ﺍﳉﻬﺔ ﺻﺎﺣﺒﺔ ﺍﻻﺧﺘﺮﺍﻉ ﺍﻟﺪﻭﺍﺋﻲ‪ ،‬ﻭﺫﻟﻚ ﻣﻦ ﺣﻴﺚ ﺳﻄﻮ‪‬ﺎ ﰲ ﲪﺎﻳﺔ‬
‫ﻣﻨﺘﺠﻬﺎ‪ ،‬ﻭﺍﻛﺘﺴﺎﺏ ﺭﻳﻊ ﻋﻨﻪ ﻟﻔﺘﺮﺓ ﻃﻮﻳﻠﺔ ﺟﺪﺍﹰ‪ .‬ﺫﻟﻚ ﻓﻀﻼﹰ ﻋﻦ ﳏﺎﻭﻟﺘﻬﺎ ﲤﺪﻳﺪ ﻓﺘﺮﺓ‬
‫ﺍﻟﱪﺍﺀﺓ‪ ،‬ﻣﻦ ﺧﻼﻝ ﺇﺩﺧﺎﻝ ﺗﻌﺪﻳﻼﺕ ﻃﻔﻴﻔﺔ ﰲ ﺍﳌﻨﺘﺞ‪.‬‬

‫‪١٩٤‬‬
‫ﺍﻻﲡﺎﻩ ﺍﻟﺜﺎﱐ‪ :‬ﺍﻹﺑﻄﺎﺀ ﻣﻦ ﺳﺮﻋﺔ ﳕﻮ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻨﺎﺷﺌﺔ ﰲ ﺍﻟﺒﻠﺪﺍﻥ ﺍﻟﻨﺎﻣﻴﺔ‪،‬‬
‫ﻭﺗﻘﻠﻴﺺ ﺇﻣﻜﺎﻧﻴﺎﺕ ﺗﻄﻮﺭﻫﺎ ﺍﳌﺴﺘﻘﺒﻠﻲ‪ ،‬ﲝﻴﺚ ﻳﺼﻌﺐ ﻗﻴﺎﻣﻬﺎ ﺑﺈﻧﺘﺎﺝ ﺃﺩﻭﻳﺔ ﻏﲑ ﺗﻠﻚ‬
‫ﺍﻟﱵ ﺯﺍﻟﺖ ﻋﻨﻬﺎ ﺑﺮﺍﺀﺍﺕ ﺍﻻﺧﺘﺮﺍﻉ )ﻭﺍﳌﺴﻤﺎﺓ ﺑﺎﻷﺩﻭﻳﺔ ﺍﳉﻨﻴﺴﺔ ‪.(Generics‬‬
‫ﻫﺬﺍ‪ ،‬ﻭﳑﺎ ﻳﺰﻳﺪ ﻣﻦ ﺍﺣﺘﻤﺎﻟﻴﺔ ﺗﻘﻠﻴﺺ ﻗﺪﺭﺍﺕ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﺍﻟﺒﻠﺪﺍﻥ ﺍﻟﻨﺎﻣﻴﺔ )ﻭﻣﻨﻬﺎ ﻣﺼﺮ(‬
‫ﻋﻠﻰ ﺍﻟﻨﻤﻮ‪ ،‬ﺯﻳﺎﺩﺓ ﺍﻟﺘﻨﺎﻓﺴﻴﺔ ﺑﲔ ﻫﺬﻩ ﺍﻟﺒﻠﺪﺍﻥ ﲞﺼﻮﺹ ﺍﻷﺩﻭﻳﺔ ﺍﻟﱵ ﺯﺍﻟﺖ ﻋﻨﻬﺎ ﻓﺘﺮﺍﺕ ﲪﺎﻳﺔ ﺑﺮﺍﺀﺍﺕ‬
‫ﺍﺧﺘﺮﺍﻋﻬﺎ )ﺃﻱ ﺗﻠﻚ ﺍﻟﱵ ﺃﺻﺒﺤﺖ ﰲ ﺣﻴﺰ ﺍﳌﻠﻚ ﺍﻟﻌﺎﻡ ‪ .(Public domain‬ﺫﻟﻚ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﲡﺎﻩ‬
‫ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﻌﺎﳌﻴﺔ ﺍﻟﻜﱪﻯ ﺇﱃ ﺇﻧﺸﺎﺀ ﺷﺮﻛﺎﺕ ﺻﻐﲑﺓ ﺗﺎﺑﻌﺔ ﳍﺎ ﻟﺘﻘﻮﻡ ﺑﺈﻧﺘﺎﺝ ﺍﻷﺩﻭﻳﺔ ﺍﳉﻨﻴﺴﺔ ﻣﻦ‬
‫ﻧﻔﺲ ﺍﳌﻨﺘﺠﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺎﻟﺸﺮﻛﺎﺕ ﺍﻷﻡ‪ ،‬ﻭﺑﻨﻔﺲ ﺍﻷﲰﺎﺀ ﺍﻟﺘﺠﺎﺭﻳﺔ ‪ Brand names‬ﺍﻟﱵ ﺍﺷﺘﻬﺮﺕ‬
‫‪‬ﺎ‪.‬‬
‫ﺧﻼﺻﺔ ﻣﺎ ﺳﺒﻖ ﻫﻮ ﺃﻥ ﺗﺄﺛﲑ ﺍﺗﻔﺎﻗﻴﺔ "ﺗﺮﻳﺒﺲ" ﻋﻠﻰ ﺃﻭﺿﺎﻉ ﺍﻟﺪﻭﺍﺀ ﰲ ﻣﺼﺮ ﻳﺘﺮﻛﺰ ﰲ ﳎﺎﻟﲔ‪ ،‬ﳘﺎ‬
‫"ﺍﻷﺳﻌﺎﺭ"‪ ،‬ﻭ"ﻣﺼﲑ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ"‪.‬‬
‫ﻭﻋﻠﻴﻪ‪ ،‬ﻓﺒﺎﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﻣﺼﺮ ﻧﺸﲑ ﺇﱃ ﻣﺎ ﻳﻠﻲ‪:‬‬

‫ﺃ‪ -‬ﺑﺎﻟﻨﺴﺒﺔ ﻟﻸﺳﻌﺎﺭ‬

‫‪ .١‬ﻧﻈﺮﺍﹰ ﻷﻥ ﻣﻌﻈﻢ ﺍﻷﺩﻭﻳﺔ ﺍﳌﺘﺪﺍﻭﻟﺔ ﰲ ﺍﻟﺴﻮﻕ ﺍﳌﺼﺮﻳﺔ )‪ %٩٥ – ٩٠‬ﻋﻠﻰ ﺍﻷﻗﻞ( ﻫﻲ ﺃﺩﻭﻳﺔ‬
‫ﺳﻘﻄﺖ ﺑﺮﺍﺀﺍ‪‬ﺎ ﰲ ﺍﳌﻠﻚ ﺍﻟﻌﺎﻡ‪ ،‬ﻓﺈﻥ ﺃﺳﻌﺎﺭﻫﺎ ﻟﻦ ﺗﺘﺄﺛﺮ ﺳﻠﺒﻴﺎﹰ ﺑﺘﻄﺒﻴﻖ ﺍﻻﺗﻔﺎﻗﻴﺔ‪ .‬ﺑﻞ ﻳﺘﻮﻗﻊ ﺃﻥ‬
‫ﻳﻜﻮﻥ ﻫﻨﺎﻙ ﺍﳔﻔﺎﺽ ﰲ ﺃﺳﻌﺎﺭﻫﺎ ﻧﺘﻴﺠﺔ ﺍﻟﺘﻨﺎﻓﺴﻴﺔ ﺑﲔ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ‪،‬‬
‫ﺣﻴﺚ ﻧﺘﻮﻗﻊ ﺃﻥ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﺑﻌﺾ ﻫﺬﻩ ﺍﻟﺒﻠﺪﺍﻥ )ﻣﺜﻞ ﺍﳍﻨﺪ ﻭﺍﻟﱪﺍﺯﻳﻞ( ﺳﺘﻜﻮﻥ ﻋﻠﻰ‬
‫ﻗﺪﺭﺓ ﺃﻛﱪ ﲞﺼﻮﺹ ﺗﻮﻓﲑ ﻫﺬﻩ ﺍﻷﺩﻭﻳﺔ ﺑﺄﺳﻌﺎﺭ ﺃﻗﻞ‪.‬‬
‫‪ .٢‬ﻭﻣﻊ ﻣﻼﺣﻈﺔ ﺃﻥ ﺣﻮﺍﱄ ‪ %٤٠‬ﻣﻦ ﺍﻷﺩﻭﻳﺔ ﺍﳌﺼﺮﻳﺔ ﺗﻨﺘﺞ ﺑﺘﺮﺧﻴﺺ ‪ license‬ﻣﻦ ﺷﺮﻛﺎﺕ ﺃﺟﻨﺒﻴﺔ‬
‫)ﺭﻏﻢ ﺃﻥ ﺟﺰﺀﺍﹰ ﻗﻠﻴﻼﹰ ﻣﻨﻬﺎ ﻫﻮ ﻓﻘﻂ ﺍﳋﺎﺿﻊ ﻟﻠﻤﻠﻚ ﺍﳋﺎﺹ‪ -‬ﺃﻱ ﳊﻤﺎﻳﺔ ﺑﺮﺍﺀﺓ ﺍﻻﺧﺘﺮﺍﻉ(‪ ،‬ﻓﺈﻥ‬
‫ﺃﺳﻌﺎﺭ ﻫﺬﻩ ﺍﻷﺩﻭﻳﺔ ﻟﻦ ﺗﺘﺄﺛﺮ ﺑﺘﻄﺒﻴﻖ ﺍﻻﺗﻔﺎﻗﻴﺔ‪ ،‬ﺑﻞ ﳝﻜﻦ ﺃﻥ ﺗﻨﺨﻔﺾ‪.‬‬
‫‪ .٣‬ﻭﺃﻣﺎ ﺍﻷﺩﻭﻳﺔ ﺍﳋﺎﺿﻌﺔ ﺣﺎﻟﻴﺎﹰ ﳊﻤﺎﻳﺔ ﺑﺮﺍﺀﺓ ﺍﻻﺧﺘﺮﺍﻉ‪ ،‬ﻭﻫﻲ ﲤﺜﻞ ﰲ ﺣﺪﻭﺩ ‪ %١٠ – ٥‬ﻣﻦ ﺍﻷﺩﻭﻳﺔ ﺍﳌﻮﺟﻮﺩﺓ‬
‫ﰲ ﺍﻟﺴﻮﻕ ﺍﳌﺼﺮﻳﺔ‪ ،‬ﻓﺈﻥ ﺟﺰﺀﺍﹰ ﻣﻨﻬﺎ ﻳﺴﺘﻮﺭﺩ ﻣﻦ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻷﺟﻨﺒﻴﺔ ﺍﻷﻡ ‪،Mother Companies‬‬
‫ﻭﺑﺎﻟﺘﺎﱄ ﻓﺈﻥ ﻫﺬﺍ ﺍﳉﺰﺀ ﻟﻦ ﺗﺮﺗﻔﻊ ﺃﺳﻌﺎﺭﻩ ﺑﺘﻄﺒﻴﻖ ﺍﻻﺗﻔﺎﻗﻴﺔ‪ .‬ﻭﺃﻣﺎ ﺍﳉﺰﺀ ﺍﻵﺧﺮ ﻭﺍﻟﺬﻱ ﻳﺼﻨﻊ‬
‫ﺑﻮﺍﺳﻄﺔ ﺷﺮﻛﺎﺕ ﻣﺼﺮﻳﺔ‪ ،‬ﺃﻭ ﻳﺴﺘﻮﺭﺩ ﻣﻦ ﺷﺮﻛﺎﺕ ﺃﺟﻨﺒﻴﺔ ﻏﲑ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻷﻡ‪ ،‬ﻓﻬﻮ ﺟﺰﺀ ﻗﻠﻴﻞ‬
‫ﺟﺪﺍﹰ )ﳝﺜﻞ ﺟﺰﺀﺍﹰ ﻣﻦ ﺍﻟـ ‪ ،(%١٠-٥‬ﻭﻫﻮ ﻋﺮﺿﺔ ﻻﺭﺗﻔﺎﻉ ﰲ ﺍﻟﺴﻌﺮ ﻋﻨﺪ ﺗﻄﺒﻴﻖ ﺍﻻﺗﻔﺎﻗﻴﺔ )ﺇﺫﺍ ﻣﺎ‬
‫ﻛﺎﻥ ﺣﻴﻨﺌﺬ ﻻ ﻳﺰﺍﻝ ﻣﺘﻤﺘﻌﺎﹰ ﺑﺎﳊﻤﺎﻳﺔ(‪ .‬ﻭﺣﱴ ﻋﻨﺪﺋﺬ ﻓﻤﻦ ﺍﶈﺘﻤﻞ ﺃﻥ ﻻ ﻳﺘﺄﺛﺮ ﺗﺴﻌﲑ ﺑﻌﺾ ﻫﺬﻩ‬
‫ﺍﻷﺩﻭﻳﺔ‪ ،‬ﺣﻴﺚ ﺳﻴﻜﻮﻥ ﻟﻠﺸﺮﻛﺎﺕ ﺍﻷﺟﻨﺒﻴﺔ ﺍﻷﻡ ﺑﻌﺾ ﺍﳌﺼﻠﺤﺔ ﰲ ﲡﻨﺐ ﺍﻹﺳﺎﺀﺓ ﺇﱃ ﺻﻮﺭ‪‬ﺎ‬
‫ﺍﻟﺬﻫﻨﻴﺔ ﻋﻨﺪ ﲨﻬﻮﺭ ﻳﻜﻮﻥ ﻗﺪ ﺗﻌﻮﺩ ﻋﻠﻰ ﺍﻗﺘﻨﺎﺀ ﺍﻟﺪﻭﺍﺀ ﺑﺄﺳﻌﺎﺭ ﻣﻨﺨﻔﻀﺔ )ﺧﺎﺻﺔ ﺃﺩﻭﻳﺔ‬
‫ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ(‪.‬‬

‫‪١٩٥‬‬
‫‪ .٤‬ﺗﺄﺗﻰ ﺍﳌﺸﻜﻠﺔ ﰲ ﺍﻟﺴﻌﺮ ﺃﻛﺜﺮ ﻭﺿﻮﺣﺎﹰ ﻣﻊ ﺍﻷﺩﻭﻳﺔ ﺍﳉﺪﻳﺪﺓ ﺧﺎﺻﺔ ﺗﻠﻚ ﺍﻟﱵ ﺳﻴﻜﻮﻥ ﺇﻧﺘﺎﺟﻬﺎ‬
‫ﻣﻦ ﺧﻼﻝ ﺗﻜﻨﻮﻟﻮﺟﻴﺎ ﺭﺍﻗﻴﺔ ﻧﺴﺒﻴﺎﹰ‪ ،‬ﻭﺇﻥ ﺃﺳﻌﺎﺭ ﻫﺬﻩ ﺍﻷﺩﻭﻳﺔ ﺳﺘﻜﻮﻥ ﻣﺮﺗﻔﻌﺔ ﻟﻠﻐﺎﻳﺔ ﺑﺎﻟﻨﺴﺒﺔ‬
‫ﳌﺘﻮﺳﻄﻲ ﺍﻟﺪﺧﻞ )ﻭﻣﻨﻬﻢ ﻛﺒﺎﺭ ﻣﻮﻇﻔﻲ ﺍﻟﺪﻭﻟﺔ( ﻭﻣﻦ ﺩﻭ‪‬ﻢ‪.‬‬
‫‪ .٥‬ﻭﺍﳉﺪﻳﺮ ﺑﺎﻟﺘﻮﻗﻒ ﻭﺍﻻﻧﺘﺒﺎﻩ ﻫﻮ ﺃﻧﻪ ﻣﻊ ﻣﺮﻭﺭ ﺍﻟﺰﻣﻦ ﺳﺘﺰﺩﺍﺩ ﻧﺴﺒﺔ ﺍﻷﺩﻭﻳﺔ ﺍﳉﺪﻳﺪﺓ ﺍﳋﺎﺿﻌﺔ‬
‫ﻟﱪﺍﺀﺍﺕ ﺍﺧﺘﺮﺍﻉ ﲡﻌﻠﻬﺎ ﺧﺎﺿﻌﺔ ﻟﻠﻤﻠﻜﻴﺔ ﺍﳋﺎﺻﺔ‪ ،‬ﻭﺃﻳﻀﺎﹰ ﺳﺘﻜﻮﻥ ﻫﺬﻩ ﺍﻷﺩﻭﻳﺔ ﺃﻛﺜﺮ ﺗﻔﻮﻗﺎﹰ ﰲ‬
‫ﺍﻟﻜﻔﺎﺀﺓ ﺍﻟﻌﻼﺟﻴﺔ ﻣﻘﺎﺭﻧﺔ ﺑﺎﻷﺩﻭﻳﺔ ﺍﻟﱵ ﺳﺘﻜﻮﻥ ﰲ ﺍﳌﻠﻚ ﺍﻟﻌﺎﻡ‪ ،‬ﺣﻴﺚ ﺳﺘﻜﻮﻥ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺣﺪﺙ‬
‫ﺃﻛﺜﺮ ﲤﻴﺰﺍﹰ )ﰲ ﺍﻟﻔﻌﺎﻟﻴﺔ ﻭﺍﳌﺄﻣﻮﻧﻴﺔ( ﻣﻦ ﺧﻼﻝ ﲤﻜﻦ ﺍﳌﺴﺘﺤﻀﺮ ﺍﻟﺪﻭﺍﺋﻲ ﻣﻦ ﺇﳒﺎﺯ ﺍﻟﻌﻼﺝ ﺍﻟﺪﻗﻴﻖ‬
‫ﻟﻠﺠﺰﺀ ﺍﳌﺼﺎﺏ ﻣﻦ ﺍﳉﺴﻢ ‪ ،Drug Targeting‬ﻭﺫﻟﻚ ﺑﺎﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺍﳌﻌﺎﺭﻑ ﻭﺍﻟﺘﻄﺒﻴﻘﺎﺕ‬
‫ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺔ ﺍﻷﺣﺪﺙ )ﺍﳍﻨﺪﺳﺔ ﺍﻟﻮﺭﺍﺛﻴﺔ – ﺍﳌﻮﺍﺩ ﺍﳉﺪﻳﺪﺓ – ﺍﻟﺘﺸﻜﻴﻞ ﺍﻟﺪﻭﺍﺋﻲ‬
‫ﺍﳌﺘﻄﻮﺭ ﺟﺪﺍﹰ‪ ..‬ﺍﱁ(‪.‬‬
‫‪ .٦‬ﺫﻟﻚ ﻳﻌﲏ ﺃﻥ ﻣﺸﻜﻠﺔ ﺍﻷﺳﻌﺎﺭ ﻟﻦ ﺗﺒﺰﻍ ﺑﺎﻟﻔﻌﻞ ﺑﺸﻜﻞ ﻛﺒﲑ ﻭﺣﻘﻴﻘﻲ ﺇﻻ ﺑﻌﺪ ﺳﻨﻮﺍﺕ‪،‬‬
‫ﻭﻟﻜﻨﻬﺎ ﻋﻨﺪﺋﺬ ﺳﺘﺘﻔﺎﻗﻢ ﺑﻌﺠﻠﺔ ﻣﺘﺴﺎﺭﻋﺔ‪.‬‬

‫ﺏ‪ -‬ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺼﻨﺎﻋﺔ‬

‫ﻫﻨﺎ ﳝﻜﻦ ﺍﻟﻘﻮﻝ ﺇﻥ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ )ﺑﻮﺟﻪ ﻋﺎﻡ( ﻻ ﲤﻠﻚ – ﺣﺎﻟﻴﺎﹰ – ﻗﺪﺭﺓ ﺗﻨﺎﻓﺴﻴﺔ ﰲ‬
‫ﳎﺎﻝ ﺃﻧﺸﻄﺔ ﺍﻟﺒﺤﺚ ﻭﺍﻟﺘﻄﻮﻳﺮ )ﻭﺇﻥ ﻛﺎﻧﺖ ﲤﻠﻚ ﺇﻣﻜﺎﻧﻴﺎﺕ ﻣﺎﻟﻴﺔ ﻭﺑﺸﺮﻳﺔ ﻣﺪﻓﻮﻧﺔ ﻏﲑ ﻣﻮﻇﻔﺔ‪ ،‬ﻭﺇﺫﺍ‬
‫ﺍﺳﺘﻤﺮﺕ ﺑﻮﺿﻌﻬﺎ ﺍﳊﺎﱄ ﺩﻭﻥ ﺣﺪﻭﺙ ﺗﻌﺪﻳﻼﺕ ﻋﺎﺩﻳﺔ ﻭﺟﺬﺭﻳﺔ ﰲ ﺇﺩﺍﺭ‪‬ﺎ ﻭﰲ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎ‪‬ﺎ‪ ،‬ﻓﺈ‪‬ﺎ‬
‫ﺳﺘﻮﺍﺟﻪ ﺑﺘﻨﺎﻓﺴﻴﺔ ﻋﺎﻟﻴﺔ ﻣﻦ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ ﺍﳌﺘﻄﻮﺭﺓ ﺩﻭﺍﺋﻴﺎﹰ ﰲ ﳎﺎﻝ ﺇﻧﺘﺎﺝ ﺃﺩﻭﻳﺔ ﺟﻨﻴﺴﺔ‬
‫‪ Generics‬ﺑﻜﻔﺎﺀﺓ ﻋﻼﺟﻴﺔ ﻋﺎﻟﻴﺔ ﻭﺃﺳﻌﺎﺭ ﻣﻨﺨﻔﻀﺔ‪ .‬ﺇﻥ ﻫﺬﻩ ﺍﻟﺘﻨﺎﻓﺴﻴﺔ )ﰲ ﺇﻃﺎﺭ ﺍﺗﻔﺎﻗﻴﺎﺕ ﺍﻟﺘﺠﺎﺭﺓ‬
‫ﺍﻟﻌﺎﳌﻴﺔ( ﳝﻜﻦ ﺃﻥ ﺗﺆﺛﺮ ﺳﻠﺒﺎﹰ ﻋﻠﻰ ﻗﺪﺭﺓ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﺍﳌﺼﺮﻳﺔ‪ ،‬ﻟﻴﺲ ﻓﻘﻂ ﲞﺼﻮﺹ ﺍﳌﻨﺎﻓﺴﺔ ﰲ‬
‫ﺍﻷﺳﻮﺍﻕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺩﺍﺧﻞ ﺍﻟﺒﻠﺪﺍﻥ ﺍﻟﻌﺮﺑﻴﺔ ﻭﺳﺎﺋﺮ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ‪ ،‬ﻭﻟﻜﻦ ﺃﻳﻀﺎﹰ ﲞﺼﻮﺹ ﺍﳌﻨﺎﻓﺴﺔ ﺩﺍﺧﻞ‬
‫ﺍﻟﺴﻮﻕ ﺍﳌﺼﺮﻳﺔ ﺫﺍ‪‬ﺎ‪.‬‬
‫ﻭﺇﺫﺍ ﻣﺎ ﻛﺎﻧﺖ ﺍﻟﺘﺄﺛﲑﺍﺕ ﺍﳌﺒﺎﺷﺮﺓ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺗﺘﺮﻛﺰ ﰲ "ﺍﻷﺳﻌﺎﺭ" ﻭ"ﻣﺼﲑ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ"‪،‬‬
‫ﻓﺈﻥ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻌﺎﳌﻴﺔ ﺫﺍﺕ ﺍﻟﻨﺸﺎﻁ ﺍﻟﺪﻭﱄ )ﺃﻭ ﻣﺘﻌﺪﻳﺔ ﺍﳉﻨﺴﻴﺔ( ﻭﺣﻜﻮﻣﺎﺕ ﺍﻟﺒﻠﺪﺍﻥ ﺍﻟﱵ‬
‫ﺗﻨﺘﻤﻲ ﺇﻟﻴﻬﺎ ﺗﺴﻌﻰ ﺑﺎﺳﺘﻤﺮﺍﺭ ﻭﺑﻜﺜﺎﻓﺔ ﺇﱃ ﺗﻌﻄﻴﻞ ﺍﻻﻧﺘﺒﺎﻩ ﺇﱃ ﺍﻹﻣﻜﺎﻧﻴﺎﺕ ﺍﻟﻜﺎﻣﻨﺔ ﻭﺍﳌﻤﻜﻨﺔ ﰲ‬
‫ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ )ﺧﺎﺻﺔ ﰲ ﺍﻟﺒﻠﺪﺍﻥ ﺍﻟﱵ ﲤﻠﻚ ﺇﻣﻜﺎﻧﺎﺕ ﺑﺸﺮﻳﺔ ﻛﺎﻣﻨﺔ ﻭﺍﻋﺪﺓ ﻣﺜﻞ‬
‫ﻣﺼﺮ(‪ ،‬ﻭﻫﻲ ﺗﻨﺘﻬﺞ ﻫﺬﺍ ﺍﻟﻨﻬﺞ ﻣﻦ ﺧﻼﻝ ﺍﻻﺭﺗﻜﺎﺯ ﻋﻠﻰ ﺑﻌﺾ ﻣﻮﺍﺩ ﺍﺗﻔﺎﻗﻴﺔ ﺗﺮﻳﺒﺲ ﻣﻦ ﺃﺟﻞ ﺗﻘﻴﻴﺪ‬
‫ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ ﻟﻠﻔﺘﺮﺓ ﺍﻻﻧﺘﻘﺎﻟﻴﺔ ﻭﺍﻟﱵ ﺗﻨﺘﻬﻲ ﺑﻨﻬﺎﻳﺔ ﻋﺎﻡ ‪ ،٢٠٠٤‬ﻭﺫﻟﻚ ﻛﻤﺎ‬
‫ﺣﺪﺙ ﲞﺼﻮﺹ ﻃﻠﺐ ﳎﻤﻮﻋﺔ ﺷﺮﻛﺎﺕ ﺃﺟﻨﺒﻴﺔ )ﻣﻌﻈﻤﻬﺎ ﻳﻨﺘﻤﻲ ﺇﱃ ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ( ﺇﻳﻘﺎﻑ ﺇﻧﺘﺎﺝ‬
‫ﺃﻛﺜﺮ ﻣﻦ ﻣﺎﺋﺔ ﻣﻨﺘﺞ ﺩﻭﺍﺋﻲ ﳏﻠﻲ ﲝﺠﺔ ﺣﺼﻮﻝ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ ﻋﻠﻰ ﻣﻌﻠﻮﻣﺎﺕ ﻏﲑ ﻣﺘﺎﺣﺔ‬
‫ﻟﻠﻤﻠﻚ ﺍﻟﻌﺎﻡ )ﻭﺫﻟﻚ ﺍﻋﺘﻤﺎﺩﺍﹰ ﻋﻠﻰ ﻧﺺ ﺍﳌﺎﺩﺓ ‪ ٣٩‬ﻣﻦ ﺍﺗﻔﺎﻗﻴﺔ ﺗﺮﻳﺒﺲ(‪ ،‬ﻭﻛﺬﻟﻚ ﻣﻄﺎﻟﺒﺔ ﺑﻌﺾ‬
‫ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻌﺎﳌﻴﺔ ﻻﻛﺘﺴﺎﺏ ﺣﻖ ﺍﻟﺘﺴﻮﻳﻖ ﺍﻻﺳﺘﺌﺜﺎﺭﻱ ﻷﺩﻭﻳﺔ ﻣﻌﻴﻨﺔ‪.‬‬

‫‪١٩٦‬‬
‫ﻭﻣﻊ ﺍﻷﺧﺬ ﺑﻀﺮﻭﺭﺓ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ‪‬ﺞ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﻌﺎﳌﻴﺔ ﰲ ﻣﺜﻞ ﺍﻟﺘﺼﺮﻓﺎﺕ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﺎ ﺃﻋﻼﻩ‪ ،‬ﻣﻦ‬
‫ﺧﻼﻝ ﻣﻨﻈﻮﺭ ﺳﻴﺎﺳﻲ ﻭﺟﻬﺪ ﻧﻀﺎﱄ ﻣﻨﻈﻮﻣﻲ ﻋﻠﻤﻲ ﻣﻜﺜﻒ‪ ،‬ﺇﻻ ﺃﻥ ﺫﻟﻚ ﻳﻨﺒﻐﻲ ﺃﻥ ﳛﻔﺰ )ﻭﻻ ﻳﻌﻄﻞ(‬
‫ﺑﻨﺎﺀ ﻭﺗﻄﺒﻴﻖ ﺭﺅﻳﺔ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻟﺘﻄﻮﻳﺮ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ‪.‬‬
‫ﺇﻥ ﻣﺜﻞ ﻫﺬﺍ ﺍﻻﻋﺘﺒﺎﺭ ﻳﺮﻗﻰ ﻷﻥ ﻳﻜﻮﻥ ﲢﺬﻳﺮﺍﹰ ﺳﻴﺎﺳﻴﺎﹰ ﻭﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﹰ‪ ،‬ﻭﺫﻟﻚ ﻋﻨﺪ ﺍﻷﺧﺬ ﰲ ﺍﳊﺴﺒﺎﻥ‬
‫ﻟﻠﺠﻬﺪ ﺍﳊﺎﺩ ﺍﻟﺬﻱ ﺗﺒﺬﻟﻪ ﺍﻟﺮﺍﺑﻄﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ﳌﺼﻨﻌﻲ ﺍﻷﺩﻭﻳﺔ ‪ PHRMA‬ﰲ ﲢﺠﻴﻢ ﺍﺳﺘﻔﺎﺩﺓ ﻋﺪﺩ ﻣﻦ‬
‫ﺍﻟﺒﻠﺪﺍﻥ ﺍﻟﻨﺎﻣﻴﺔ ﻋﻠﻰ ﺭﺃﺳﻬﺎ ﺍﳍﻨﺪ ﻭﺍﻟﺼﲔ ﻭﻣﺼﺮ ﻭﺍﻟﱪﺍﺯﻳﻞ ﻣﻦ ﺑﻌﺾ ﻣﻜﺘﺴﺒﺎﺕ ﺇﻋﻼﻥ ﺍﻟﺪﻭﺣﺔ‪.‬‬
‫)ﻭﺑﺎﻟﺘﺤﺪﻳﺪ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﳌﺮﻭﻧﺎﺕ ﺍﳌﻘﺮﺭﺓ ﲞﺼﻮﺹ ﺍﻻﺳﺘﻔﺎﺩﺓ ﻣﻦ ﻣﺒﺪﺃ ﺍﻟﺘﺮﺧﻴﺺ ﺍﻹﺟﺒﺎﺭﻱ(‪.‬‬
‫ﻫﺬﺍ‪ ،‬ﻭﰲ ‪‬ﺎﻳﺔ ﻫﺬﺍ ﺍﻟﻌﺮﺽ ﲞﺼﻮﺹ ﺍﻧﻌﻜﺎﺳﺎﺕ ﺍﻻﺗﻔﺎﻗﻴﺎﺕ ﺍﻟﺪﻭﻟﻴﺔ ﻋﻠﻰ ﺃﻭﺿﺎﻉ ﺍﻟﺪﻭﺍﺀ ﰲ ﻣﺼﺮ‪،‬‬
‫ﳒﺬﺏ ﺍﻻﻧﺘﺒﺎﻩ ﺇﱃ ﺃﻥ ﺍﺗﻔﺎﻗﻴﺔ ﺍﳌﺸﺎﺭﻛﺔ ﺍﳌﺼﺮﻳﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ‪ ،‬ﺭﲟﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺪﻭﺍﺀ ﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ‪ ،‬ﻻ‬
‫ﺗﺄﰐ ﲜﺪﻳﺪ ﺭﺋﻴﺴﻲ ﻳﻀﺎﻑ ﺇﱃ ﺍﻧﻌﻜﺎﺳﺎﺕ ﺍﺗﻔﺎﻗﻴﺎﺕ ﺍﻟﺘﺠﺎﺭﺓ ﺍﻟﻌﺎﳌﻴﺔ )ﻭﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ ﺍﺗﻔﺎﻗﻴﺔ‬
‫ﺗﺮﻳﺒﺲ(‪ ،‬ﺣﻴﺚ ﺗﻨﺺ ﺍﺗﻔﺎﻗﻴﺔ ﺍﳌﺸﺎﺭﻛﺔ ﺍﳌﺼﺮﻳﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﰲ ﺍﳌﺎﺩﺓ ‪ ٢٦‬ﻣﻨﻬﺎ ﻋﻠﻰ ﻋﺪﻡ ﺗﻌﺮﺽ ﺍﻻﺗﻔﺎﻕ‬
‫ﳊﻤﺎﻳﺔ ﺣﻘﻮﻕ ﺍﳌﻠﻜﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ‪.‬‬

‫‪- ;/+ ..-0: -

7 :$22‬‬
‫ﰲ ﻇﻞ ﻣﺎ ﻳﻜﻮﻥ ﻗﺪ ﻭﺿﺢ ﰲ ﺍﻷﺟﺰﺍﺀ ﺍﻟﺴﺎﺑﻘﺔ ﻣﻦ ﻫﺬﺍ ﺍﻟﻔﺼﻞ ﲞﺼﻮﺹ ﻣﺎ ﻫﻮ ﺣﺎﺩﺙ ﰲ ﻣﺼﺮ ﻣﻦ‬
‫ﻫﺪﺭ ﻣﺰﻣﻦ ﻟﻺﻣﻜﺎﻧﻴﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ ﻭﺍﳌﺎﺩﻳﺔ ﻭﺍﻟﺘﺎﺭﳜﻴﺔ ﰲ ﺳﻴﺎﺳﺎﺕ ﻭﳎﺎﻻﺕ ﺍﻟﺪﻭﺍﺀ‪ ،‬ﻓﺈﻧﻪ ﻳﺘﻌﺬﺭ‬
‫– ﻣﻦ ﺍﻟﻨﺎﺣﻴﺔ ﺍﳌﻨﻄﻘﻴﺔ – ﺍﻻﻧﺘﻘﺎﻝ ﺇﱃ ﻋﻤﻞ ﻧﻈﺮﺓ ﻣﺴﺘﻘﺒﻠﻴﺔ ﺩﻭﻥ ﺇﺟﺮﺍﺀ "ﻭﻗﻔﺔ ﻭﻃﻨﻴﺔ" ﻟﻠﺘﻤﻌﻦ ﰲ‬
‫ﺍﻟﻮﺍﻗﻊ ﻭﺃﻳﻀﺎﹰ ﲟﺎ ﻓﻴﻪ ﻣﻦ ﻇﺮﻭﻑ ﻣﻌﺮﻗﻠﺔ ﻷﻳﺔ ﺗﻮﺟﻬﺎﺕ ﻟﻠﺘﻘﺪﻡ‪ ،‬ﻭﺃﻳﻀﺎﹰ ﲟﺎ ﻓﻴﻪ ﻣﻦ ﻇﺮﻭﻑ ﻭﻋﻮﺍﻣﻞ‬
‫ﻳﻜﻮﻥ ﻣﻦ ﺷﺄﻥ ﺍﻻﻧﺘﺒﺎﻩ ﺇﻟﻴﻬﺎ ﻭﺗﻮﻇﻴﻔﻬﺎ ﺇﺗﺎﺣﺔ ﻓﺮﺹ ﻟﻠﺨﺮﻭﺝ ﻣﻦ ﺷﺮﻧﻘﺔ "ﳏﻠﻚ ﺳﺮ" ﺍﳉﺎﺭﻳﺔ ﻭﺇﳒﺎﺯ‬
‫ﺗﻘﺪﻡ ﻭﻃﲏ ﺣﻘﻴﻘﻲ‪.‬‬
‫ﺇﻥ "ﺍﻟﻮﻗﻔﺔ ﺍﻟﻮﻃﻨﻴﺔ" ﺍﳌﻄﻠﻮﺑﺔ ﲤﺜﻞ "ﺍﻟﻌﺘﺒﺔ" ﺍﻟﱵ ﻻ ﻣﻨﺎﺹ ﻣﻦ ﻋﺒﻮﺭﻫﺎ‪ ،‬ﺑﺎﻋﺘﺒﺎﺭﻫﺎ – ﰲ ﺗﻘﺪﻳﺮﻧﺎ –‬
‫ﺍﻟﻄﺮﻳﻖ ﺍﻟﻮﺣﻴﺪ ﻟﺼﻴﺎﻏﺔ ﺭﺅﻯ ﻭﺳﻴﺎﺳﺎﺕ ﻭﺑﺮﺍﻣﺞ ﻣﺴﺘﻘﺒﻠﻴﺔ ﺗﻜﻮﻥ ﺑﺎﻟﻔﻌﻞ ﻋﻠﻰ ﺩﺭﺟﺔ ﻣﻘﺒﻮﻟﺔ ﻣﻦ‬
‫ﺍﻟﻔﻌﺎﻟﻴﺔ‪ .‬ﺫﻟﻚ ﻳﻌﲏ ﺍﳊﺎﺟﺔ ﻷﻥ ﲤﺎﺭﺱ ﻫﺬﻩ ﺍﻟﻮﻗﻔﺔ ﺑﻮﺍﺳﻄﺔ ﻣﺎ ﳝﻜﻦ ﺃﻥ ﻳﻄﻠﻖ ﻋﻠﻴﻪ "ﺍﻟﻌﻘﻞ‬
‫ﺍﳉﻤﺎﻋﻲ ﺍﻟﺪﻭﺍﺋﻲ ﺍﻟﻮﻃﲏ"‪ ،‬ﻭﺍﻟﺬﻱ ﻳﺘﺸﻜﻞ ﻣﻦ ﻣﻔﻜﺮﻳﻦ ﻭﺧﱪﺍﺀ ﻭﳑﺜﻠﲔ ﻟﻠﻤﺼﺎﱀ ﺍ‪‬ﺘﻤﻌﻴﺔ ﺍﳌﺘﻌﻠﻘﺔ‬
‫ﺑﺎﻟﺪﻭﺍﺀ‪ ،‬ﻭﻟﻴﺲ ﻓﻘﻂ ﳑﺜﻠﻮ ﺍﳉﻬﺎﺕ ﺍﻟﺘﻨﻔﻴﺬﻳﺔ ﺍﳌﻌﻨﻴﺔ‪ .‬ﺍﳌﺴﺄﻟﺔ ﺇﺫﻥ ﺃﻧﻪ ﻳﺴﺘﺤﻴﻞ ﺇﺟﺮﺍﺀ ﻭﻗﻔﺔ ﻭﻃﻨﻴﺔ‬
‫ﺣﻘﻴﻘﻴﺔ ﻭﻣﺴﺌﻮﻟﺔ ﻣﻦ ﻣﻨﻈﻮﺭ ﺑﲑﻭﻗﺮﺍﻃﻲ ﺗﻘﻠﻴﺪﻱ‪ ،‬ﺃﻭ ﻣﻦ ﻣﻨﻈﻮﺭ ﻓﺮﺩﻱ‪ .‬ﻭﻋﻠﻴﻪ‪ ،‬ﻓﺈﻥ ﻣﺎ ﳝﻜﻨﻨﺎ ﺗﻘﺪﳝﻪ‬
‫ﻫﻨﺎ ﻻ ﻳﻌﺪﻭ ﳎﺮﺩ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺍﻋﺘﺒﺎﺭﺍﺕ ﻋﺎﻣﺔ ﻧﻈﻦ ﺑﺈﻣﻜﺎﻥ ﻣﺴﺎﳘﺘﻬﺎ ﻛﻤﺪﺧﻞ ﻟﻌﻤﻞ ﲨﺎﻋﻲ‬
‫ﻣﺴﺌﻮﻝ ﰲ ﺷﺄﻥ "ﺍﻟﻮﻗﻔﺔ ﺍﻟﻮﻃﻨﻴﺔ" ﻭ"ﺍﻟﻨﻈﺮﺓ ﺍﳌﺴﺘﻘﺒﻠﻴﺔ"‪.‬‬

‫ﺃ‪ -‬ﺍﻋﺘﺒﺎﺭﺍﺕ ﻋﺎﻣﺔ ﲞﺼﻮﺹ ﺍﻟﻮﻗﻔﺔ ﺍﻟﻮﻃﻨﻴﺔ‬

‫ﺗﺮﻛﺰ ﺍﻻﻋﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺎﻟﻴﺔ ﻋﻠﻰ ﺍﻟﻨﻘﺎﻁ ﺍﻟﻜﻔﻴﻠﺔ ﺑﺈﺟﺮﺍﺀ ﻭﻗﻔﺔ ﻭﻃﻨﻴﺔ ﺷﺎﻣﻠﺔ ﻭﻣﺆﺛﺮﺓ‪:‬‬
‫‪ .١‬ﺍﳊﺎﺟﺔ ﻟﻜﺸﻒ "ﺗﻀﺎﺭﻳﺲ" ﺍﻟﻀﻌﻒ ﺍﳉﺎﺭﻱ ﰲ ﻛﻞ ﻣﻦ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻭﺃﺣﻮﺍﻝ‬
‫ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ‪ ،‬ﻭﺇﺩﺭﺍﻙ ﺣﻘﻴﻘﺔ ﻭﻓﺪﺍﺣﺔ ﻏﻴﺒﺔ ﺭﺅﻯ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻟﺘﻄﻮﻳﺮﳘﺎ‪.‬‬

‫‪١٩٧‬‬
‫‪ .٢‬ﺍﳊﺎﺟﺔ ﺇﱃ ﻗﻴﺎﺱ "ﻓﺠﻮﺓ ﺍﻻﺳﺘﻨﻬﺎﺽ ﺍﻟﺪﻭﺍﺋﻲ ﺍﻟﻮﻃﲏ"‪ .‬ﻭﳝﻜﻦ ﺗﻌﺮﻳﻒ ﻫﺬﻩ ﺍﻟﻔﺠﻮﺓ ﺑﺄ‪‬ﺎ‬
‫ﺍﻟﻔﺎﺭﻕ )ﺍﻻﻗﺘﺼﺎﺩﻱ ﻭﺍﳌﺆﺳﺴﺎﰐ ﻭﺍﳌﻌﺮﰲ( ﺑﲔ ﺣﺎﻟﺔ ﳏﻠﻚ ﺳﺮ ﺍﻟﻘﺎﺋﻤﺔ ﻣﻨﺬ ﺳﻨﻮﺍﺕ ﻃﻮﻳﻠﺔ )ﰲ‬
‫ﳎﺎﻻﺕ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻭﺍﻟﺴﻴﺎﺳﻴﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ(‪ ،‬ﻭﺣﺎﻟﺔ ﺍﻟﺘﻘﺪﻡ ﺍﻟﱵ ﳝﻜﻦ ﺃﻥ ﺗﺘﺤﻘﻖ‬
‫ﺑﺎﻟﺘﻔﻌﻴﻞ ﺍﻷﻣﺜﻞ ﻟﻺﻣﻜﺎﻧﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ )ﺍﻟﺒﺸﺮﻳﺔ ﻭﺍﳌﺎﺩﻳﺔ(‪.‬‬
‫‪ .٣‬ﺍﳊﺎﺟﺔ ﻟﻠﺘﻔﺎﻋﻞ ﺍﻹﳚﺎﰊ ﻣﻊ ﻇﺮﻭﻑ ﺍﻟﺒﻴﺌﺔ ﺍﻟﺪﻭﻟﻴﺔ‪ ،‬ﻭﺫﻟﻚ ﻣﻦ ﻣﻨﻈﻮﺭﻳﻦ‪:‬‬
‫ﺍﳌﻨﻈﻮﺭ ﺍﻷﻭﻝ‪ :‬ﺍﻛﺘﺸﺎﻑ ﻭﻗﻴﺎﺱ ﻭﺍﺳﺘﺸﺮﺍﻑ "ﺍﻟﺘﺤﺪﻳﺎﺕ" ﺍﻟﻮﺍﻗﻌﺔ ﺃﻭ ﺍﻟﱵ ﳝﻜﻦ ﺃﻥ ﺗﻘﻊ ﻋﻠﻴﻨﺎ )ﻭﻋﻠﻰ‬
‫ﺍﳌﻨﻄﻘﺔ( ﻣﻦ ﺍﻟﺒﻴﺌﺔ ﺍﻟﺪﻭﻟﻴﺔ‪ ،‬ﻭﺭﺳﻢ ﺳﻴﻨﺎﺭﻳﻮﻫﺎﺕ )ﻣﺘﻮﺳﻄﺔ ﻭﻃﻮﻳﻠﺔ ﺍﳌﺪﻯ(‬
‫ﻟﻠﺘﻌﺎﻣﻞ ﻣﻊ ﻫﺬﻩ ﺍﻟﺘﺤﺪﻳﺎﺕ ﻣﻦ ﺧﻼﻝ ﺍﻻﺳﺘﻌﺪﺍﺩ ﻭﺍﻟﺘﻮﻇﻴﻒ ﻭﺩﺭﺀ ﺍﻟﺴﻠﺒﻴﺎﺕ‪ .‬ﻭﻣﻦ‬
‫ﺃﻣﺜﻠﺔ ﻫﺬﻩ ﺍﻟﺘﺤﺪﻳﺎﺕ ﳝﻜﻦ ﺍﻹﺷﺎﺭﺓ ﺇﱃ‪:‬‬
‫ﺗﻮﺟﻬﺎﺕ ﻭﺁﻟﻴﺎﺕ ﻭﺃﺩﻭﺍﺕ ﺍﻟﺸﻤﺎﻝ ﺍﳌﺘﻘﺪﻡ )ﻣﻦ ﺷﺮﻛﺎﺕ ﻭﺣﻜﻮﻣﺎﺕ( ﺑﺸﺄﻥ ﺗﻮﻛﻴﺪ‬ ‫
‬
‫ﺍﻻﺣﺘﻜﺎﺭ‪.‬‬
‫ﺗﺴﺎﺭﻉ ﺁﻟﻴﺎﺕ ﻭﺗﻘﻨﻴﺎﺕ ﺭﺳﻢ ﻭﺗﻄﺒﻴﻖ ﻭﺗﻄﻮﻳﺮ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ‪.‬‬ ‫
‬
‫ﺍﳌﻨﻈﻮﺭ ﺍﻟﺜﺎﱐ‪ :‬ﺍﻟﺘﺒﻜﲑ ﰲ ﺍﳊﺲ ﺑﺒﺰﻭﻍ ﺃﺣﺪﺍﺙ ﻭﺭﺅﻯ )ﺃﻭ ﻣﻔﺎﻫﻴﻢ( ﻳﻜﻮﻥ ﻣﻦ ﺷﺄ‪‬ﺎ ﺇﺗﺎﺣﺔ ﻭ‪/‬ﺃﻭ ﺗﻮﻟﻴﺪ‬
‫ﻓﺮﺹ ﻟﱪﺍﻣﺞ ﻭﺗﻐﻴﲑﺍﺕ ﺗﺴﺎﻫﻢ ﰲ ﺗﺴﺮﻳﻊ ﺇﳒﺎﺯ ﺍﻟﺘﻘﺪﻡ ﺍﻟﺪﻭﺍﺋﻲ ﺍﻟﻮﻃﲏ‪ .‬ﻣﻦ ﺃﻣﺜﻠﺔ‬
‫ﻫﺬﻩ ﺍﻷﺣﺪﺍﺙ ﻭﺍﻟﺮﺅﻯ )ﺃﻭ ﺍﳌﻔﺎﻫﻴﻢ( ﳝﻜﻦ ﺍﻹﺷﺎﺭﺓ ﺇﱃ‪:‬‬
‫ﺗﺼﺎﻋﺪ ﰲ ﺍﻻﲡﺎﻩ ﺍﻟﻌﺎﳌﻲ ﺑﺎﻋﺘﺒﺎﺭ ﺃﻥ ﻣﻦ ﺷﺎﻥ ﺍﺗﻔﺎﻗﻴﺔ ﺣﻘﻮﻕ ﺍﳌﻠﻜﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ‬ ‫
‬
‫"ﺗﺮﻳﺒﺲ" ﺑﺄﻭﺿﺎﻋﻬﺎ ﺍﻟﺮﺍﻫﻨﺔ ﻋﺮﻗﻠﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﰲ ﺍﻟﺒﻠﺪﺍﻥ ﺍﻟﻨﺎﻣﻴﺔ‪ ،‬ﻭﻣﻦ‬
‫ﺍﳌﻌﺎﱂ ﺍﻟﺮﺋﻴﺴﻴﺔ ﳍﺬﺍ ﺍﻟﺘﺼﺎﻋﺪ ﻣﺎ ﻳﻠﻲ‪:‬‬
‫ﺍﳌﻌﺎﺭﺿﺎﺕ ﺍﻟﺸﻌﺒﻴﺔ ﻭﺍﳊﻜﻮﻣﻴﺔ ﻗﺒﻞ ﺍﻧﻌﻘﺎﺩ ﻣﺆﲤﺮ ﺍﻟﻮﺯﺭﺍﺀ ﺍﻟﺮﺍﺑﻊ ﳌﻨﻈﻤﺔ ﺍﻟﺘﺠﺎﺭﺓ‬ ‫‪o‬‬
‫ﺍﻟﻌﺎﳌﻴﺔ ﰲ ﺍﻟﺪﻭﺣﺔ )ﻧﻮﻓﻤﱪ ‪.(٢٠٠١‬‬
‫ﺍﻟﺘﻮﻛﻴﺪ ﺍﻟﺬﻱ ﺟﺎﺀ ﰲ ﺇﻋﻼﻧﺎﺕ ﻣﺆﲤﺮ ﺍﻟﺪﻭﺣﺔ ﲞﺼﻮﺹ ﺣﻖ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ ﰲ‬ ‫‪o‬‬
‫ﺍﻻﺳﺘﻔﺎﺩﺓ ﻭﺍﻟﺘﻤﺘﻊ ﲟﺮﻭﻧﺎﺕ ﺍﻻﺗﻔﺎﻗﻴﺔ‪.‬‬
‫ﺻﺪﻭﺭ ﺗﻘﺮﻳﺮ ﻋﻦ ﳉﻨﺔ ﺩﻭﻟﻴﺔ ﻣﺸﻜﻠﺔ ﺑﻮﺍﺳﻄﺔ ﺍﳊﻜﻮﻣﺔ ﺍﻟﱪﻳﻄﺎﻧﻴﺔ ﺑﺸﺄﻥ ﺣﻘﻮﻕ‬ ‫‪o‬‬
‫ﺍﳌﻠﻜﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ )‪ ،(٢٠٠٢‬ﻳﻘﻒ ﰲ ﺻﻒ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ ﺑﺸﺄﻥ ﺍﻟﺘﻤﺘﻊ ﺑﺎﻟﻌﺪﻳﺪ ﻣﻦ‬
‫ﺍﳌﺮﻭﻧﺎﺕ ﻭﺍﳊﻘﻮﻕ ﺑﺸﺄﻥ ﺍﳌﻠﻜﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ ﻭﺍﻟﺪﻭﺍﺀ‪ ،‬ﻭﺫﻟﻚ ﺑﺮﻏﻢ ﺍﻟﺼﻠﻒ ﺍﳌﺘﻮﺍﺻﻞ‬
‫ﻣﻦ ﺷﺮﻛﺎﺕ ﻭﺩﻭﻝ ﻛﱪﻯ‪.‬‬
‫ﻇﻬﻮﺭ ﲢﻠﻴﻼﺕ ﻭﺍﻋﺘﺒﺎﺭﺍﺕ ﺣﺪﻳﺜﺔ ﺗﺆﻛﺪ ﻋﻠﻰ ﺗﻨﺎﻣﻲ ﻗﺪﺭﺓ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ‬ ‫
‬
‫ﺍﻟﺼﻐﲑﺓ ﻭﺍﳌﺘﻮﺳﻄﺔ ﺍﳊﺠﻢ ‪ Small and medium-sized companies‬ﻋﻠﻰ‬
‫ﺗﻮﻟﻴﺪ ﺍﻟﻘﻴﻤﺔ ‪ ،Value Creation Potential‬ﲤﺎﻣﺎﹰ ﺑﻨﻔﺲ ﺍﻟﻘﺪﺭﺓ ﺍﻟﻨﺴﺒﻴﺔ‬
‫ﻟﻠﺸﺮﻛﺎﺕ ﺍﻟﻜﺒﲑﺓ‪ ،‬ﻭﺫﻟﻚ ﺑﺎﺗﺒﺎﻉ ﺃﺩﻭﺍﺕ ﻭﺗﻮﺟﻬﺎﺕ ﺍﻗﺘﺼﺎﺩﻳﺔ ﺇﺩﺍﺭﻳﺔ ﺟﺪﻳﺪﺓ‪.‬‬

‫‪١٩٨‬‬
 ‫ﺏ‪ -‬ﺍﻋﺘﺒﺎﺭﺍﺕ ﻋﺎﻣﺔ ﲞﺼﻮﺹ ﺍﻟﻨﻈﺮﺓ ﺍﳌﺴﺘﻘﺒﻠﻴﺔ‬
‫ﺇﺫﺍ ﻛﺎﻥ ﻣﻦ ﺷﺄﻥ "ﺍﻟﻮﻗﻔﺔ ﺍﻟﻮﻃﻨﻴﺔ" ﺍﳉﻴﺪﺓ )ﻣﻦ ﺣﻴﺚ ﺃﺩﻭﺍ‪‬ﺎ ﻭﺷﻔﺎﻓﻴﺘﻬﺎ( ﺃﻥ ﲤﻜﹶّﻦ ﻣﻦ ﺍﻟﻘﺪﺭﺓ ﻋﻠﻰ‬
‫ﺇﺣﺪﺍﺙ ﻗﻔﺰﺍﺕ ﰲ ﺍﻟﺘﻘﺪﻡ ﺍﻟﺪﻭﺍﺋﻲ‪ ،‬ﻓﺈﻥ ﻣﻦ ﺷﺄﻥ ﺍﻟﻨﻈﺮﺓ ﺍﳌﺴﺘﻘﺒﻠﻴﺔ ﺃﻥ ﺗﺴﺘﻜﺸﻒ ﺃﺳﺲ ﻭﺃﺩﻭﺍﺕ‬
‫ﻭﺁﻓﺎﻕ ﺍﻟﺘﻄﻮﺭ ﺍﻟﺪﻭﺍﺋﻲ ﺍﳌﺴﺘﻘﺒﻠﻲ‪.‬‬
‫ﻣﻦ ﻫﺬﺍ ﺍﳌﻨﻈﻮﺭ ﻧﺸﲑ ﺇﱃ ﺍﻻﻋﺘﺒﺎﺭﺍﺕ )ﻭﺍﻻﺣﺘﻴﺎﺟﺎﺕ( ﺍﻟﺴﻴﺎﺳﻴﺔ ﻭﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﺘﺎﻟﻴﺔ‪ ،‬ﻛﻤﺪﺧﻞ‬
‫ﻟﻠﻨﻈﺮﺓ ﺍﳌﺴﺘﻘﺒﻠﻴﺔ‪:‬‬
‫‪ .١‬ﺿﺮﻭﺭﺓ ﺍﻟﺘﻌﺎﻣﻞ ﺑﻮﺿﻮﺡ ﻭﺷﻔﺎﻓﻴﺔ ﻣﻊ ﺛﻼﺛﺔ ﺃﻧﻮﺍﻉ ﻣﻦ ﺍﻟﻌﻼﻗﺎﺕ ﺑﲔ ﺍﻟﺴﻴﺎﺳــــﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‬
‫ﺍﻟﻮﻃﻨﻴﺔ ﻣﻦ ﺟﻬﺔ‪ ،‬ﻭﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ ﻣﻦ ﺟﻬﺔ ﺃﺧﺮﻯ )ﺍﻧﻈﺮ ﺷﻜﻞ ‪:(٢-٨‬‬
‫‪ :١-١‬ﻋﻼﻗﺎﺕ ﲣﺘﺺ ﺑﻨﻘﺎﻁ ﺗﻼﻗﻲ‪:‬‬
‫ﺗﻠﺘﻘﻲ ﻛﻞ ﻣﻦ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻭﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ ﰲ ﻫﺪﻑ ﲪﺎﻳﺔ ﺍﻹﻧﺴﺎﻥ‪ ،‬ﻟﻴﺲ ﻓﻘﻂ‬
‫ﺑﺘﻮﻓﲑ ﺍﻷﺩﻭﻳﺔ ﺍﳌﻔﻴﺪﺓ ﻟﻪ‪ ،‬ﺑﻞ ﻭﲪﺎﻳﺘﻪ ﻣﻦ ﺃﻱ ﳑﺎﺭﺳﺎﺕ ﻗﺪ ﻳﺴﺘﻐﻞ ﻓﻴﻬﺎ ﺍﻹﻧﺴﺎﻥ ﺑﻘﺼﺪ ﺃﻭ ﺩﻭﻥ ﻗﺼﺪ‪.‬‬
‫ﻭﰲ ﻫﺬﺍ ﺍﻹﻃﺎﺭ ﺗﻠﺘﻘﻲ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻣﻊ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺍﻋﺘﺒﺎﺭﺍﺕ ﺃﺳﺎﺳﻴﺔ‪،‬‬
‫ﻣﻦ ﺃﳘﻬﺎ ﻣﺎ ﻳﻠﻲ‪:‬‬
‫ﺃﺧﻼﻗﻴﺎﺕ ﻃﻴﺒﺔ – ﻏﲑ ﻣﻌﻴﺒﺔ – ﰲ ﺗﺮﻭﻳﺞ ﺍﻷﺩﻭﻳﺔ‪.‬‬ ‫ﺃ‪.‬‬
‫ﺿﻮﺍﺑﻂ ﲡﺮﻳﺐ ﺍﻷﺩﻭﻳﺔ ﻋﻠﻰ ﺍﻹﻧﺴﺎﻥ‪.‬‬ ‫ﺏ‪.‬‬
‫ﻣﺘﺎﺑﻌﺔ ﺍﻵﺛﺎﺭ ﺍﻟﻄﻴﺒﺔ ﻭﺍﻟﺴﻠﺒﻴﺔ ﻟﻠﺪﻭﺍﺀ ﺑﻌﺪ ﺗﺴﻮﻳﻘﻪ‪.‬‬ ‫ﺝ‪.‬‬
‫ﺍﻟﺘﺴﻌﲑ ﺍﳌﻨﺎﺳﺐ‪.‬‬ ‫ﺩ‪.‬‬
‫ﺍﻟﺘﻔﺘﻴﺶ ﻭﺍﻟﺮﻗﺎﺑﺔ ﻋﻠﻰ ﺟﻮﺩﺓ ﺍﻷﺩﻭﻳﺔ‪.‬‬ ‫ﻩ‪.‬‬
‫‪ :٢-١‬ﻋﻼﻗﺎﺕ ﲣﺘﺺ ﺑﻨﻘﺎﻁ ﺗﻜﺎﻣﻞ‪:‬‬
‫ﺗﺘﻜﺎﻣﻞ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻣﻊ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ ﻣﻦ ﺧﻼﻝ ﲢﻘﻴﻖ ﺍﻟﺘﻄﺒﻴﻖ ﺍﳌﻨﺎﺳﺐ ﳌﻔﺎﻫﻴﻢ ﻣﻬﻤﺔ‬
‫ﻣﺜﻞ‪ :‬ﻣﻔﻬﻮﻡ ﺍﻷﺩﻭﻳﺔ ﺍﳉﻨﻴﺴﺔ )ﺃﻭ ﺍﻟﻨﻮﻋﻴﺔ( ‪ ،Generic drugs‬ﻭﻣﻔﻬﻮﻡ ﺍﻷﺩﻭﻳﺔ ﺍﻷﺳﺎﺳﻴﺔ ‪،Essential drugs‬‬
‫ﻭﻛﺬﻟﻚ ﻣﻔﻬﻮﻡ ﺍﻗﺘﺼﺎﺩﻳﺎﺕ ﺍﻟﻌﻼﺝ ﺍﻟﺪﻭﺍﺋﻲ ‪ ،Pharmaco - Economics‬ﻭﺫﻟﻚ ﻣﻦ ﺧﻼﻝ ﺍﻟﺘﻮﺍﻓﻖ ﺑﲔ ﺁﻟﻴﺎﺕ‬
‫ﳐﺘﻠﻔﺔ ﰲ ﺍﻟﺼﻨﺎﻋﺔ‪ ،‬ﻭﰲ ﺍﳌﺆﺳﺴﺎﺕ ﺍﳌﻌﻨﻴﺔ ﺑﺎﻟﻨﻈﻢ ﺍﻟﺪﻭﺍﺋﻴﺔ ‪ ،Drug Regulations‬ﻭﻛﺬﻟﻚ ﰲ ﻣﺆﺳﺴﺎﺕ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﻣﻦ ﻧﺎﺣﻴﺔ ﺃﺧﺮﻯ ﻳﻜﻮﻥ ﻋﻠﻰ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﺮﺷﻴﺪﺓ ﺃﻥ ﺗﺄﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺇﻧﻌﺎﺵ ﻭﲢﻔﻴﺰ‬
‫ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻮﻃﻨﻴﺔ‪ ،‬ﻣﻦ ﺧﻼﻝ ﺿﺒﻂ ﺍﻷﻫﺪﺍﻑ ﺍﻵﻧﻴﺔ ﻭﺑﻌﻴﺪﺓ ﺍﳌﺪﻯ ﻭﺧﻠﻖ ﺍﳌﻨﺎﺥ ﺍﻻﻗﺘﺼﺎﺩﻱ‬
‫ﻭﺍﻟﺘﺸﺮﻳﻌﻲ ﺍﳌﻨﺎﺳﺐ ﻟﺘﺤﻘﻴﻖ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻷﻫﺪﺍﻓﻬﺎ‪.‬‬
‫‪ :٣-١‬ﻋﻼﻗﺎﺕ ﲣﺘﺺ ﺑﻨﻘﺎﻁ ﺗﺒﺎﻋﺪ ﺃﻭ ﲝﺪﻭﺩ ﻓﺎﺻﻠﺔ‪:‬‬
‫ﻣﻦ ﺃﻫﻢ ﻫﺬﻩ ﺍﻟﻨﻘﺎﻁ ﺍﺳﺘﻘﻼﻟﻴﺔ ﺃﺟﻬﺰﺓ ﺍﻟﺘﻨﻈﻴﻢ ﺍﻟﺪﻭﺍﺋﻲ ﻭﺍﻟﺮﻗﺎﺑﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‪ ،‬ﻣﻦ ﻧﺎﺣﻴﺔ‪ ،‬ﻋﻦ ﺃﺟﻬﺰﺓ‬
‫ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻣﻦ ﻧﺎﺣﻴﺔ ﺃﺧﺮﻯ‪ ،‬ﲝﻴﺚ ﻻ ﻳﻜﻮﻥ ﻫﻨﺎﻙ ﺗﺪﺍﺧﻞ ﰲ ﺍﳌﺼﺎﱀ ‪Conflict of Interests‬‬
‫ﰲ ﺍﻷﻫﺪﺍﻑ ﺍﳉﺰﺋﻴﺔ ﻟﻜﻞ ﻣﻨﻬﻤﺎ‪ ،‬ﺃﻭ ﰲ ﺍﳌﺼﺎﱀ ﺍﻟﺸﺨﺼﻴﺔ ﺍﳋﺎﺻﺔ ﺑﺎﻟﻘﺎﺋﻤﲔ ﻋﻠﻴﻬﻤﺎ‪ .‬ﻫﻨﺎ ﲡﺪﺭ‬
‫ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺃﻥ ﺃﺟﻬﺰﺓ ﺍﻟﺮﻗﺎﺑﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﻋﺎﺩﺓ ﻣﺎ ﺗﻔﺮﺽ ﻋﻠﻴﻬﺎ ﻣﻬﺎﻣﻬﺎ ﺍﲣﺎﺫ ﻣﻮﻗﻒ ﺍﳊﻜﻢ ﺑﲔ ﺃﻃﺮﺍﻑ‬
‫ﺻﻨﺎﻋﻴﺔ ﳐﺘﻠﻔﺔ‪ ،‬ﻣﺜﻠﻤﺎ ﺣﺪﺙ ﰲ ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ ﰲ ﺗﺴﻌﻴﻨﻴﺎﺕ ﺍﻟﻘﺮﻥ ﺍﻟﻌﺸﺮﻳﻦ‪ ،‬ﻋﻨﺪﻣﺎ ﺍﺿﻄﺮﺕ‬

‫‪١٩٩‬‬
‫ﻫﻴﺌﺔ ﺍﻷﻏﺬﻳﺔ ﻭﺍﻷﺩﻭﻳﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ‪ FDA‬ﺇﱃ ﺇﺻﺪﺍﺭ ﺑﻴﺎﻥ ﳌﻮﺍﺟﻬﺔ ﺷﺎﺋﻌﺎﺕ ﺗﺮﻭﺟﻬﺎ ﺑﻌﺾ ﺍﻟﺸﺮﻛﺎﺕ‬
‫ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻜﱪﻯ ﺿﺪ ﺷﺮﻛﺎﺕ ﺍﳌﺴﺘﺤﻀﺮﺍﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳉﻨﻴﺴﺔ ‪ .Generics‬ﻭﻏﲏ ﻋﻦ ﺍﻟﺒﻴﺎﻥ ﻫﻨﺎ ﺃﻥ‬
‫ﺍﳌﺘﻐﲑﺍﺕ ﺍﻟﺘﻘﺎﻧﻴﺔ ﻭﺍﻟﺘﺠﺎﺭﻳﺔ ﺍﳌﺼﺎﺣﺒﺔ ﻟﻠﻌﻮﳌﺔ ﺗﺘﻄﻠﺐ ﺃﻥ ﺗﻜﻮﻥ ﺍﻷﺟﻬﺰﺓ ﺍﳌﺨﺘﺼﺔ ﺑﺘﻨﻈﻴﻢ ﺷﺌﻮﻥ‬
‫ﺍﻟﺪﻭﺍﺀ ﻭﺭﻗﺎﺑﺘﻪ ﺃﺟﻬﺰﺓ ﻗﻮﻳﺔ "ﺩﺍﺋﻤﺔ ﺍﻟﺘﻄﻮﺭ ﺍﻟﺬﺍﰐ"‪ ،‬ﲝﻴﺚ ﺗﻘﺪﺭ ﻋﻠﻰ ﲪﺎﻳﺔ ﻣﺼﺎﱀ ﻛﺎﻓﺔ ﺍﻷﻃﺮﺍﻑ‬
‫)ﻣﺜﻞ‪ :‬ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ – ﺍﳌﺴﺘﻬﻠﻜﲔ – ﺍﻗﺘﺼﺎﺩ ﺍﻟﺪﻭﻟﺔ(‪ ،‬ﻭﺫﻟﻚ ﺑﺴﺤﺐ ﺍﻷﺩﻭﻳﺔ ﻏﲑ ﺍﳌﻄﺎﺑﻘﺔ‪،‬‬
‫ﻭﺗﺼﺤﻴﺢ ﺃﻳﺔ ﺣﻴﻮﺩ ﻟﻠﺸﺮﻛﺎﺕ ﰲ ﺃﺳﺎﻟﻴﺐ ﺍﻟﺘﺮﻭﻳﺞ ﻭﺍﻟﺪﻋﺎﻳﺔ‪ ،‬ﻭﻛﺬﻟﻚ ﺍﺗﺒﺎﻉ ﺍﳌﻤﺎﺭﺳﺎﺕ ﺍﳉﻴﺪﺓ ﰲ‬
‫ﺍﻟﺘﺼﻨﻴﻊ ﺍﻟﺪﻭﺍﺋﻲ ﺃﻭ ﰲ ﺍﻻﺧﺘﺒﺎﺭﺍﺕ ﺍﳌﻌﻤﻠﻴﺔ‪ ،‬ﺃﻭ ﰲ ﺍﻟﺘﺠﺮﻳﺐ ﺍﻟﺪﻭﺍﺋﻲ ﻋﻠﻰ ﺍﻹﻧﺴﺎﻥ‪ ..‬ﺍﱁ‪ ،‬ﻣﻊ ﺍﻟﺪﻓﻊ‬
‫ﻋﻠﻰ ﺍﻟﺘﺤﺴﲔ ﺍﳌﺘﻮﺍﺻﻞ ﻷﺳﺎﻟﻴﺐ ﺍﻹﻧﺘﺎﺝ ﻭﺃﺳﺎﻟﻴﺐ ﺍﻟﺮﻗﺎﺑﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺍﻟﺪﻭﺍﺋﻴﺔ‪.‬‬

‫ﺍﻟﺼﻨﺎﻋﺔ‬ ‫ﺍﻟﺴﻴﺎﺳﺔ‬
‫ﺍﻟﻮﻃﻨﻴﺔ‬ ‫ﺍﻟﺴﻴﺎﺳﺔ‬ ‫ﺍﻟﺼﺤﻴﺔ‬
‫ﻟﻠﺪﻭﺍﺀ‬ ‫ﺍﻟﻮﻃﻨﻴﺔ‬
‫ﻟﻠﺪﻭﺍﺀ‬

‫‪ .٢‬ﺃﻥ ﺗﺼﺎﻍ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ ﲟﻨﻬﺞ ﻋﻠﻤﻲ‪ ،‬ﻭﺃﻥ ﺗﺴﺘﻨﺪ ﺻﻴﺎﻏﺘﻬﺎ ﻋﻠﻰ "ﻣﻌﻠﻮﻣﺎﺕ‬
‫ﻭﻣﻌﺎﺭﻑ" ﺗﺘﻀﻤﻦ ﺗﻘﻴﻴﻢ ﺍﻷﺩﺍﺀ‪ ،‬ﻭﲢﻠﻴﻞ ﺃﺳﺒﺎﺏ ﺍﻟﻨﺠﺎﺡ ﻭﺍﻟﻔﺸﻞ‪ ،‬ﻭﺍﻗﺘﺮﺍﺣﺎﺕ ﳏﺪﺩﺓ‬
‫ﺑﺎﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﻟﻠﺘﺤﺴﲔ‪ .‬ﺫﻟﻚ ﻋﻠﻰ ﺃﻥ ﺗﻌﺘﻤﺪ ﻣﺴﺎﺭﺍﺕ ﺍﻟﺘﻄﺒﻴﻖ ﻋﻠﻰ ﺍﻟﺘﺤﺪﻳﺪ ﻭﺍﻟﻮﺿﻮﺡ‬
‫ﺑﺸﺄﻥ ﺍﻷﻭﻟﻮﻳﺎﺕ‪ ،‬ﻭﺍﳋﻄﻂ‪ ،‬ﻭﺍﳌﺴﺌﻮﻟﻴﺎﺕ‪ ،‬ﻭﺍﳌﻮﺍﺭﺩ‪ ،‬ﻭﺃﻫﺪﺍﻑ ﻭﻣﻴﻜﺎﻧﻴﺰﻣﺎﺕ ﻭﺁﻓﺎﻕ ﺍﻟﺘﻌﺎﻭﻥ ﻋﻠﻰ‬
‫ﺍﳌﺴﺘﻮﻳﲔ‪ ،‬ﺍﻹﻗﻠﻴﻤﻲ ﻭﺍﻟﺪﻭﱄ‪.‬‬
‫‪ .٣‬ﺃﻥ ﺗﻘﻮﻡ ﺍﳊﻜﻮﻣﺔ ﺑﺎﻟﺪﻭﺭ ﺍﳌﺄﻣﻮﻝ ﻣﻨﻬﺎ‪ ،‬ﻭﺍﻟﺬﻱ ﻻ ﳝﻜﻦ ﺃﻥ ﺗﺘﻌﻬﺪ ﺑﺮﻋﺎﻳﺘﻪ ﺟﻬﺔ )ﺃﻭ ﺟﻬﺎﺕ( ﺃﺧﺮﻯ‬
‫ﻏﲑﻫﺎ‪ ،‬ﻭﻫﻮ ﺩﻭﺭ ﺇﺩﺍﺭﺓ ﺩﻓﺔ ﺍﻟﺘﻘﺪﻡ ﺍﻟﺪﻭﺍﺋﻲ ﺍﻟﻮﻃﲏ‪ ،‬ﻭﺗﺘﺤﺪﺩ ﻣﻌﺎﳌﻪ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻓﻴﻤﺎ ﻳﻠﻲ‪:‬‬
‫‪ :١-٣‬ﺻﻴﺎﻏﺔ ﺍﻟﺴﻴﺎﺳﺎﺕ‪.‬‬
‫‪ :٢-٣‬ﺭﻋﺎﻳﺔ ﺗﺼﻤﻴﻢ ﻭﺗﻄﺒﻴﻖ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﻟﻘﻮﻣﻴﺔ )ﺍﻟﺼﻨﺎﻋﻴﺔ ﻭﻏﲑ‬
‫ﺍﻟﺼﻨﺎﻋﻴﺔ(‪.‬‬
‫‪ :٣-٣‬ﲢﺪﻳﺚ ﻫﻴﻜﻞ ﺍﳌﻨﻈﻮﻣﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ‪.‬‬
‫ﻣﻠﺤﻮﻇﺔ‪ :‬ﻏﲎ ﻋﻦ ﺍﻟﺒﻴﺎﻥ ﺃﻥ ﻗﻴﺎﻡ ﺍﳊﻜﻮﻣﺔ ﺑﺪﻭﺭ ﺇﺩﺍﺭﺓ ﺍﻟﺪﻓﺔ ﻳﻌﲏ ﻭﺟﻮﺩ ﺃﺩﻭﺍﺭ ﻣﺴﺎﻋﺪﺓ‬
‫ﻟﻜﺎﻓﺔ ﺃﺻﺤﺎﺏ ﺍﳌﺼﻠﺤﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﰲ ﻛﺎﻓﺔ ﺍﻟﻘﻄﺎﻋﺎﺕ(‪.‬‬

‫‪٢٠٠‬‬
‫‪ .٤‬ﺃﻥ ﺗﻘﻮﻡ ﻋﻨﺎﺻﺮ ﻣﻨﻈﻮﻣﺔ ﺍﻟﺼﻨﺎﻋﺔ )ﺑﻘﻮﺓ ﺩﻓﻊ ﻭﺑﺮﻋﺎﻳﺔ ﻣﻦ ﺍﳊﻜﻮﻣﺔ( ﺑﻮﺿﻊ ﺭﺅﻳﺔ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ‬
‫ﻳﻜﻮﻥ ﻣﻦ ﺷﺎ‪‬ﺎ ﺇﺣﺪﺍﺙ "ﲢﻮﻝ" ﺇﳚﺎﰊ ﰲ ﻣﺴﺎﺭ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ‪ ،‬ﻋﻠﻰ ﺃﻥ ﺗﻌﺘﻤﺪ‬
‫ﺻﻴﺎﻏﺔ ﻫﺬﻩ ﺍﻟﺮﺅﻳﺔ ﻋﻠﻰ ﺩﺭﺍﺳﺎﺕ ﻋﻠﻤﻴﺔ‪ ،‬ﻭﺃﻥ ﺗﻘﻮﻡ ﻋﻠﻰ ﺁﻟﻴﺎﺕ ﻣﺒﺘﻜﺮﺓ ﺗﺮﺗﻜﺰ – ﺃﺳﺎﺳﺎﹰ – ﻋﻠﻰ‬
‫ﺍﳋﺼﻮﺻﻴﺎﺕ ﺍﻟﻘﻮﻣﻴﺔ‪ ،‬ﻭﺗﺄﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﻟﻠﻈﺮﻭﻑ ﻭﺍﻟﺘﺤﺪﻳﺎﺕ ﺍﻹﻗﻠﻴﻤﻴﺔ ﻭﺍﻟﺪﻭﻟﻴﺔ‪ .‬ﻫﺬﺍ‪،‬‬
‫ﻭﻧﻜﺘﻔﻲ ﻫﻨﺎ ﺑﺄﻥ ﻧﻮﺭﺩ – ﰲ ﺇﳚﺎﺯ ﺷﺪﻳﺪ – ﺃﻣﺜﻠﺔ ﻵﻟﻴﺎﺕ ﳝﻜﻦ ﻣﻦ ﺧﻼﻝ ﺗﻮﺍﻓﻘﻬﺎ ﻭﺍﺗﺰﺍ‪‬ﺎ )ﰲ‬
‫ﺇﻃﺎﺭ ﺣﺰﻣﺔ ﻣﻦ ﺍﻟﻮﺳﺎﺋﻞ( ﺃﻥ ﺗﺴﺎﻫﻢ ﰲ ﺇﺩﺍﺭﺓ ﲢﻮﻝ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﰲ ﻣﺼﺮ )ﺍﻧﻈﺮ ﳌﺰﻳﺪ ﻣﻦ‬
‫ﺍﻟﺘﻔﺎﺻﻴﻞ )‪ (١‬ﻣﻘﺎﻝ "ﲢﺎﻟﻒ ﺍﺳﺘﺮﺍﺗﻴﺠﻲ ﻭﻃﲏ ﰲ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ"‪ .‬ﺍﻷﻫﺮﺍﻡ ﺍﻻﻗﺘﺼﺎﺩﻱ –‬
‫‪ (٢) ،١٩٩٣/١٢/٧‬ﻛﺘﺎﺏ "ﺍﻟﻮﻃﻨﻴﺔ ﰲ ﻣﻮﺍﺟﻬﺔ ﺍﻟﻌﻮﳌﺔ" – ﺳﻠﺴﻠﺔ ﺍﻗﺮﺃ – ﺩﺍﺭ ﺍﳌﻌﺎﺭﻑ – ‪١٩٩٩‬‬
‫– ﺹ ‪:(٢٠٤‬‬
‫‪ :١-٤‬ﺗﺼﺤﻴﺢ ﻣﻌﺎﻳﲑ ﺗﻘﻴﻴﻢ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ‪.‬‬
‫‪ :٢-٤‬ﺗﺼﻨﻴﻒ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﻘﺎﺋﻤﺔ ﺇﱃ ﻣﺴﺘﻮﻳﲔ‪ ،‬ﺃﺣﺪﳘﺎ ﺧﺎﺹ ﺑﺼﻨﺎﻋﺔ ﺍﻷﺩﻭﻳﺔ ﺍﳉﻨﻴﺴﺔ‬
‫‪ ،Generics‬ﻭﺍﻵﺧﺮ ﺧﺎﺹ ﺑﺼﻨﺎﻋﺔ ﺗﻘﻮﻡ ﻋﻠﻰ ﺍﻟﺘﻄﻮﻳﺮ ﺍﻟﻌﻠﻤﻲ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻲ ﺍﳌﺒﺎﺷﺮ‪،‬‬
‫ﻣﻊ ﻣﺎ ﻳﺘﺮﺗﺐ ﻋﻠﻰ ﺫﻟﻚ ﻣﻦ ﺗﺒﺎﻳﻦ ﰲ ﻭﺳﺎﺋﻞ ﻭﺇﺟﺮﺍﺀﺍﺕ ﺍﻟﺘﺸﺠﻴﻊ ﻭﺍﻟﺘﺤﻔﻴﺰ‪.‬‬
‫‪ :٣-٤‬ﺇﺩﺧﺎﻝ ﺇﺩﺍﺭﺓ ﺍﻟﺘﻐﻴﲑ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻲ ﺇﱃ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ‪.‬‬
‫‪ :٤-٤‬ﺍﺳﺘﻴﻌﺎﺏ ﺍﳌﺘﻐﲑﺍﺕ ﺍﻟﻌﺎﳌﻴﺔ ﰲ ﺇﺩﺍﺭﺓ ﻭﺍﻗﺘﺼﺎﺩﻳﺎﺕ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ )ﻣﺜﻞ ﺍﻟﻌﻤﻠﻘﺔ‬
‫ﻭﺍﻟﺘﺤﺎﻟﻒ ﻭﺍﻟﺘﻜﺘﻼﺕ ﻭﺷﺒﻜﺎﺕ ﺍﻟﺒﺤﻮﺙ(‪.‬‬
‫‪ :٥-٤‬ﺍﻻﻟﺘﻔﺎﻑ ﺍﻹﳚﺎﰊ ﺣﻮﻝ ﻗﺎﻧﻮﻥ ﲪﺎﻳﺔ ﺍﳌﻠﻜﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ ﺑﻮﺍﺳﻄﺔ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ‬
‫ﺍﻟﺘﻄﻮﻳﺮﺍﺕ ﺍﻟﺒﺴﻴﻄﺔ ﺍﳌﺘﺼﺎﻋﺪﺓ ‪.Incremental changes‬‬
‫‪ :٦-٤‬ﺍﻟﺘﻮﺍﺻﻞ ﺍﻷﻓﻘﻲ ﻣﻊ ﺍﳌﻮﺍﺭﺩ ﺍﶈﻠﻴﺔ ﻭﺍﻹﻗﻠﻴﻤﻴﺔ ﺍﻟﻘﺎﺋﻤﺔ )ﻣﻦ ﻣﻨﺘﺠﺎﺕ ﻃﺒﻴﻌﻴﺔ‬
‫ﻭﺻﻨﺎﻋﺎﺕ(‪.‬‬
‫‪ :٧-٤‬ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﻌﻠﻴﺎ ﻛﺂﻟﻴﺔ ﺭﺋﻴﺴﻴﺔ ﰲ ﺍﻟﺘﻐﻴﲑ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻲ ﺍﻟﺪﻭﺍﺋﻲ‪.‬‬
‫‪ :٨-٤‬ﲢﻔﻴﺰ ﺍﻹﻋﺎﺭﺓ ﺍﳌﺘﺒﺎﺩﻟﺔ ﺑﲔ ﺷﺮﻛﺎﺕ ﺍﻟﺪﻭﺍﺀ ﻣﻦ ﻧﺎﺣﻴﺔ‪ ،‬ﻭﺍﻟﻜﻠﻴﺎﺕ ﺍﻟﻌﻤﻠﻴﺔ ﻣﻦ ﻧﺎﺣﻴﺔ‬
‫ﺃﺧﺮﻯ‪.‬‬
‫‪ :٩-٤‬ﺇﻧﺸﺎﺀ ﺷﺮﻛﺔ ﻣﺴﺎﳘﺔ ﻣﺼﺮﻳﺔ )ﻗﻄﺎﻉ ﺧﺎﺹ( ﰲ ﺷﻜﻞ ﻣﺮﻛﺰ ﲝﺜﻲ ﻋﻤﻼﻕ‪ ،‬ﻳﺘﺤﺎﻟﻒ‬
‫ﰲ ﺇﻗﺎﻣﺘﻪ ﺍﻟﺒﻨﻮﻙ ﻭﺷﺮﻛﺎﺕ ﺍﻟﺪﻭﺍﺀ ﻭﺍﳌﺴﺘﺜﻤﺮﻭﻥ‪ ،‬ﻭﺗﻜﻮﻥ ﻣﻬﻤﺘﻪ ﺑﻨﺎﺀ ﻗﺪﺭﺍﺕ ﲝﺜﻴﺔ‬
‫ﺗﺘﻤﻜﻦ ﻣﻦ ﺍﺧﺘﺮﺍﻕ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺔ ﻭﺗﻘﺪﱘ ﻣﻨﺘﺠﺎﺕ ﻭﻋﻤﻠﻴﺎﺕ‬
‫ﺇﻧﺘﺎﺟﻴﺔ ﺟﺪﻳﺪﺓ ﲢﺘﻜﺮﻫﺎ ﺍﻟﺸﺮﻛﺎﺕ ﺍﳌﺼﺮﻳﺔ )ﻭﻫﻮ ﺍﻗﺘﺮﺍﺡ ﻗﺪﻣﻨﺎﻩ ﻣﻔﺼﻞ ﻋﺎﻡ ‪١٩٩٣‬‬
‫ﻭﻟﻘﻲ ﻣﻮﺍﻓﻘﺔ ﺃﺣﺪ ﺍﻟﺒﻨﻮﻙ ﺍﻟﻮﻃﻨﻴﺔ ﺍﻟﻜﱪﻯ‪ ،‬ﺑﻴﻨﻤﺎ ﻗﻮﺑﻞ ﺑﻌﺪﻡ ﺍﻛﺘﺮﺍﺙ )ﺃﻭ ﺑﺮﻓﺾ( ﻣﻦ‬
‫ﻗﻴﺎﺩﺍﺕ ﺩﻭﺍﺋﻴﺔ ﻋﻠﻴﺎ(‪.‬‬
‫‪ .٥‬ﺍﳊﺮﺹ ﻋﻠﻰ ﺗﺸﻴﻴﺪ ﻭﺍﺑﺘﻜﺎﺭ ﺗﺂﺯﺭ )ﺃﻭ ﺩﻳﺎﻟﻜﺘﻴﻚ ﺇﳚﺎﰊ( ﺑﲔ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﺪﻭﺍﺀ ﻣﻦ ﺟﻬﺔ‬
‫ﻭﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ ﻣﻦ ﺟﻬﺔ ﺃﺧﺮﻯ‪ ،‬ﻭﺫﻟﻚ ﺣﱴ ﳝﻜﻦ ﺍﳊﻔﺎﻅ ﻋﻠﻰ ﺇﻣﻜﺎﻧﻴﺔ ﺗﻮﻟﻴﺪ ﺃﻛﱪ‬
‫ﺍﺳﺘﻔﺎﺩﺓ ﳑﻜﻨﺔ ﻣﻦ ﻇﺮﻭﻑ ﺍﺗﻔﺎﻗﻴﺎﺕ ﺍﻟﺘﺠﺎﺭﺓ ﺍﻟﻌﺎﳌﻴﺔ‪ ،‬ﻭﺍﻟﱵ ﻫﻲ ﻋﺮﺿﺔ ﻟﻠﺘﻄﻮﺭ ﺑﺎﺳﺘﻤﺮﺍﺭ‪.‬‬

‫‪٢٠١‬‬
‫‪ .٦‬ﺗﻄﺒﻴﻖ ﺍﻻﺳﺘﺨﺪﺍﻡ ﺍﳊﻜﻮﻣﻲ ﻟﻸﺩﻭﻳﺔ ﺍﶈﻤﻴﺔ ﺑﱪﺍﺀﺍﺕ ﺍﺧﺘﺮﺍﻉ ﺑﻌﻴﺪﺍﹰ ﻋﻦ ﺍﳌﻨﻔﻌﺔ ﺍﻟﺘﺠﺎﺭﻳﺔ‪ ،‬ﻭﻫﻮ‬
‫ﺃﻣﺮ ﻣﺴﻤﻮﺡ ﺑﻪ ﺩﻭﻟﻴﺎﹰ‪ ،‬ﻭﺫﻟﻚ ﰲ ﺇﻃﺎﺭ ﺗﻮﻓﲑ ﺍﻟﺪﻭﺍﺀ ﶈﺘﺎﺟﻴﻪ ﳑﻦ ﻻ ﻳﻘﺪﺭﻭﻥ ﻋﻠﻰ ﺷﺮﺍﺋﻪ ﺑﺄﺳﻌﺎﺭ‬
‫ﺍﻟﺴﻮﻕ‪.‬‬
‫‪ .٧‬ﺍﻻﺳﺘﺨﺪﺍﻡ ﺍﻟﺒﺤﺜﻲ ﻟﻸﺩﻭﻳﺔ ﺍﶈﻤﻴﺔ‪.‬‬
‫ﻭﻛﺨﺎﲤﺔ ﻻﺑﺪ ﻣﻦ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺃﻥ ﻃﺒﻴﻌﺔ "ﺍﻟﺪﻭﺍﺀ" ﻛﺴﻠﻌﺔ ﺳﺮﻳﻌﺔ ﺍﻟﺘﻄﻮﺭ ﻣﻦ ﺷﺄ‪‬ﺎ ﺟﻌﻞ ﻛﺎﻓﺔ‬
‫ﺷﺌﻮﻥ ﺍﻟﺪﻭﺍﺀ )ﰲ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻟﺼﻨﺎﻋﺔ( ﺷﺪﻳﺪﺓ ﺍﳊﺴﺎﺳﻴﺔ ﻟﻀﻌﻒ ﺃﻭ ﺗﺂﺧﺮ "ﺍﻹﺩﺍﺭﺓ"‪ ،‬ﻭﻫﻮ ﺍﻷﻣﺮ ﺍﻟﺬﻱ‬
‫ﻳﻌﲏ ﰲ ﳎﻤﻠﻪ ﺃﻥ ﺍﻟﻌﺒﻮﺭ ﺇﱃ ﺃﻭﺿﺎﻉ ﻭﺁﻓﺎﻕ ﺃﻛﺜﺮ ﺇﳚﺎﺑﻴﺔ ﰲ ﺃﺣﻮﺍﻝ ﻭﺳﻴﺎﺳﺎﺕ ﺍﻟﺪﻭﺍﺀ ﰲ ﻣﺼﺮ ﺃﻣﺮ‬
‫ﻣﺮﻫﻮﻥ – ﺇﱃ ﺣﺪ ﻛﺒﲑ – ﺑﻘﺪﺭ ﺟﻮﺩﺓ ﺍﻟﺘﻐﻴﲑ ﻭﺍﻟﺸﻔﺎﻓﻴﺔ ﰲ ﺍﳌﻨﻈﻮﻣﺔ ﺍﻟﺪﻭﺍﺋﻴﺔ ﺍﳌﺼﺮﻳﺔ‪ ،‬ﺩﺍﺧﻞ‬
‫ﺍﳊﻜﻮﻣﺔ ﻭﺧﺎﺭﺟﻬﺎ‪.‬‬

‫>= "<‪(

 1‬‬
‫‪ .١‬ﻡ‪ .‬ﺭ‪ .‬ﺣﺎﻣﺪ‪ :‬ﻣﺴﺘﻘﺒﻞ ﺻﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ ﰲ ﻣﺼﺮ ﻭﺍﳌﻨﻄﻘﺔ ﺍﻟﻌﺮﺑﻴﺔ – ﻛﺮﺍﺳﺎﺕ ﻣﺴﺘﻘﺒﻠﻴﺔ –‬
‫ﺍﳌﻜﺘﺒﺔ ﺍﻷﻛﺎﺩﳝﻴﺔ – ﺍﻟﻘﺎﻫﺮﺓ – ‪.١٩٩٧‬‬
‫‪ .٢‬ﻡ‪ .‬ﺭ‪ .‬ﺣﺎﻣﺪ‪ :‬ﺍﻻﺳﺘﻨﻬﺎﺽ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻲ ﻟﺼﻨﺎﻋﺔ ﺍﻟﺪﻭﺍﺀ – ﰲ‪ :‬ﺑﺪﻳﻞ ﻟﻠﺘﻘﺪﻡ – ﲢﺮﻳﺮ ﺩ‪ .‬ﳏﻤﺪ‬
‫ﺍﻟﺴﻴﺪ ﺳﻌﻴﺪ – ﻣﺮﻛﺰ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ – ﺍﻷﻫﺮﺍﻡ – ‪.١٩٩٨‬‬
‫‪ .٣‬ﻡ‪ .‬ﺭ‪ .‬ﺣﺎﻣﺪ‪ :‬ﺛﻮﺭﺓ ﺍﻟﺪﻭﺍﺀ‪ ..‬ﺍﳌﺴﺘﻘﺒﻞ ﻭﺍﻟﺘﺤﺪﻳﺎﺕ – ﺳﻠﺴﻠﺔ ﺍﻗﺮﺃ – ﺩﺍﺭ ﺍﳌﻌﺎﺭﻑ ‪.٢٠٠١‬‬
‫‪ .٤‬ﳏﻤﺪ ﻋﺒﺪﻩ ﺑﺪﺭ ﺍﻟﺪﻳﻦ – ﺇﻧﺘﺎﺝ ﺍﻷﺩﻭﻳﺔ ﻭﺍﺳﺘﻬﻼﻛﻬﺎ ﰲ ﻣﺼﺮ – ﺩﺭﺍﺳﺔ ﰲ ﺍﳉﻐﺮﺍﻓﻴﺎ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‬
‫– ﺭﺳﺎﻟﺔ ﺩﻛﺘﻮﺭﺍﻩ – ﻛﻠﻴﺔ ﺍﻵﺩﺍﺏ – ﺟﺎﻣﻌﺔ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ – ‪.٢٠٠١‬‬
‫‪ .٥‬ﻡ‪ .‬ﺭ‪ .‬ﺣﺎﻣﺪ‪ :‬ﺣﻘﻮﻕ ﺍﳌﻠﻜﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ – ﺭﺅﻳﺔ ﺟﻨﻮﺑﻴﺔ ﻣﺴﺘﻘﺒﻠﻴﺔ – ﻛﺮﺍﺳﺎﺕ ﻣﺴﺘﻘﺒﻠﻴﺔ –‬
‫ﺍﳌﻜﺘﺒﺔ ﺍﻷﻛﺎﺩﳝﻴﺔ – ﺍﻟﻘﺎﻫﺮﺓ – ‪.٢٠٠٢‬‬
‫‪National Drug Policy, WHO, 2001 .٦‬‬

‫‪٢٠٢‬‬
 ‫
 
‪:‬‬
‫ 
‬
‫‪    . .‬‬

‫‪%& .‬ء ‪   !"#‬‬

‫')(' ‬
‫ﻟﻘﺪ ﻃﻠﺐ ﻣﺆﲤﺮ ﺍﻟﻘﻤﺔ ﺍﻟﻌﺎﳌﻲ ﻣﻦ ﺃﺟﻞ ﺍﻟﻄﻔﻞ ﺇﱄ ﲨﻴﻊ ﺍﻟﺸﻌﻮﺏ ﺃﻥ ﺗﺴﺘﺮﺷﺪ ﲟﺒﺪﺃ "ﺍﻷﻃﻔﺎﻝ‬
‫ﺃﻭﻻﹰ"‪ ،‬ﺍﻟﺬﻱ ﻳﻨﺎﺩﻱ ﺑﻀﺮﻭﺭﺓ ﺇﻋﻄﺎﺀ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻷﺳﺎﺳﻴﺔ ﺃﻭﻟﻮﻳﺔ ﻋﻠﻴﺎ ﻋﻨﺪ ﲣﺼﻴﺺ ﺍﳌﻮﺍﺭﺩ‪،‬‬
‫ﺳﻮﺍﺀ ﰲ ﺃﻭﻗﺎﺕ ﺍﻟﺮﺧﺎﺀ ﺃﻭ ﺍﻟﺸﺪﺓ‪ ،‬ﻭﻋﻠﻰ ﻛﺎﻓﺔ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ ﻭﺍﻟﺪﻭﻟﻴﺔ‪ ،‬ﻭﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻷﺳﺮﺓ‬
‫ﻧﻔﺴﻬﺎ‪ .‬ﺇﻥ ﻣﺒﺪﺃ "ﺍﻷﻃﻔﺎﻝ ﺃﻭﻻ" ﱂ ﻳﱭ ﻋﻠﻰ ﺍﻟﺮﻣﺎﻝ ﺍﻟﻌﺎﺻﻔﺔ ﻭﺍﻷﺣﺎﺳﻴﺲ‪ ،‬ﺫﻟﻚ ﺃﻥ ﳕﻮ ﺍﻟﻄﻔﻞ‬
‫ﺍﻟﻌﻘﻠﻲ ﻭﺍﳉﺴﺪﻱ ﳛﺪﺙ ﻣﻌﻈﻤﻪ ﺧﻼﻝ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻷﻭﱄ ﻣﻦ ﺍﻟﻌﻤﺮ‪ .‬ﻭﳍﺬﺍ ﻓﺈﻥ ﻫﺬﻩ ﺍﻟﺴﻨﻮﺍﺕ ﻫﻲ‬
‫ﻓﺮﺻﺔ ﺍﻟﻄﻔﻞ ﺍﻷﻭﱄ ﻭﺍﻟﻮﺣﻴﺪﺓ ﻟﻜﻲ ﻳﻨﻤﻮ ﻋﻘﻠﻴﺎ ﻭﺟﺴﺪﻳﺎ‪ ،‬ﻭﳛﻘﻖ ﻃﺎﻗﺎﺗﻪ ﺍﻟﻮﺭﺍﺛﻴﺔ ﻛﺎﻣﻠﺔ‪ .‬ﻭﺇﺫﺍ ﱂ‬
‫ﺗﻜﺘﻤﻞ ﺍﳌﺮﺍﺣﻞ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻨﻤﻮ ﰲ ﺍﻟﻮﻗﺖ ﺍﳌﻼﺋﻢ‪ ،‬ﻓﺈﻥ ﺗﻠﻔﺎ ﺩﺍﺋﻤﺎ ﺳﻴﻠﺤﻖ ﲟﺠﻤﻞ ﻋﻤﻠﻴﺎﺕ ﺍﻟﻨﻤﻮ‪ ،‬ﻭﻟﻦ‬
‫ﺗﻜﻮﻥ ﻫﻨﺎﻙ ﻓﺮﺻﺔ ﺃﺧﺮﻯ ﻹﺻﻼﺡ ﺍﳋﻠﻞ‪ .‬ﻋﻠﻰ ﺃﺭﺿﻴﺔ ﻫﺬﻩ ﺍﳊﻘﻴﻘﺔ ﺍﻟﻔﺴﻴﻮﻟﻮﺟﻴﺔ‪ ،‬ﰎ ﺑﻨﺎﺀ ﻋﻠﻰ ﻣﺒﺪﺃ‬
‫"ﺍﻷﻃﻔﺎﻝ ﺃﻭﻻ"‪ .‬ﻭﳍﺬﺍ ﻓﺈﻥ ﻫﺬﺍ ﺍﳌﺒﺪﺃ ﻳﻄﺎﻟﺐ ﺑﺈﻳﻼﺀ ﺃﳘﻴﺔ ﺧﺎﺻﺔ ﳊﻤﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻭﻳﻨﺎﺩﻱ ﺑﻌﺪﻡ‬
‫ﺍﳌﺴﺎﺱ ‪‬ﺎ‪ ،‬ﺣﱴ ﰲ ﺃﺣﻠﻚ ﺍﻟﻈﺮﻭﻑ ﻭﺍﻷﻭﻗﺎﺕ‪ .‬ﻛﻤﺎ ﻳﻄﺎﻟﺐ ﺑﺎﻹﺑﻘﺎﺀ ﻋﻠﻴﻬﺎ ﻛﺂﺧﺮ ﻋﻨﺼﺮ ﰲ ﺍﳊﻤﺎﻳﺔ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ ،‬ﺑﺪﻻ ﻣﻦ ﺟﻌﻠﻬﺎ ﺍﻟﻀﺤﻴﺔ ﺍﻷﻭﱄ ﻷﻱ ﺗﻐﻴﲑ‪.‬‬
‫ﻭﻳﻨﺒﻐﻲ ﻋﻠﻰ ﻛﻞ ﺍ‪‬ﺘﻤﻌﺎﺕ ﺃﻥ ﺗﻠﺘﺰﻡ ﺑﺘﻮﻓﲑ ﺍﳌﻘﻮﻣﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻨﻤﻮ ﺍﻟﻄﻔﻞ‪ ،‬ﲟﺎ ﰲ ﺫﻟﻚ ﺍﳊﺐ‬
‫ﻭﺍﻻﻫﺘﻤﺎﻡ ﺍﳌﻨﺎﺳﺐ ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﳊﺎﻧﻴﺔ ﻭﺃﻥ ﺗﻀﻤﻦ ﻟﻪ ﺍﻟﻨﻤﻮ ﺍﳉﺴﺪﻱ ﺍﻟﺴﻮﻱ‪ ،‬ﻭﺍﻟﺘﺤﺼﲔ ﺿﺪ ﺍﻷﻣﺮﺍﺽ‪،‬‬
‫ﻭﺃﻥ ﺗﻮﻓﺮ ﻟﻪ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﻓﺮﺻﺔ ﺍﻻﻟﺘﺤﺎﻕ ﺑﺎﳌﺪﺍﺭﺱ‪ ،‬ﰲ ﺃﻭﻗﺎﺕ ﺍﻟﺮﺧﺎﺀ ﻭﺍﻟﺸﺪﺓ‪ .‬ﻫﺬﺍ‬
‫ﺍﻻﻟﺘﺰﺍﻡ ﳚﺐ ﺃﻻ ﻳﻀﻌﻒ ﰲ ﺃﻭﻗﺎﺕ ﺍﻟﺮﻛﻮﺩ ﺍﻻﻗﺘﺼﺎﺩﻱ‪ ،‬ﻭﻻ ﺃﻣﺎﻡ ﺍﳌﺘﻄﻠﺒﺎﺕ ﺍﻟﻘﺼﲑﺓ ﺍﻷﻣﺪ ﻟﱪﺍﻣﺞ‬
‫ﺍﻟﺘﻜﻴﻒ ﺍﳍﻴﻜﻠﻴﺔ‪ .‬ﻛﻤﺎ ﻳﻨﺒﻐﻲ ﺃﻥ ﻻ ﳜﻀﻊ ﻫﺬﺍ ﺍﻻﻟﺘﺰﺍﻡ ﻟﻠﻀﻐﻮﻁ ﺍﻟﱵ ﳝﺎﺭﺳﻬﺎ ﺃﺻﺤﺎﺏ ﺍﳌﺼﺎﱀ‬
‫ﺍﳋﺎﺻﺔ‪ ،‬ﻭﻻ ﺃﻥ ﻳﺘﻘﻠﺐ ﻭﻓﻘﺎ ﻷﻫﻮﺍﺀ ﺃﺣﺰﺍﺏ ﺳﻴﺎﺳﻴﺔ ﻣﻌﻴﻨﺔ‪ ،‬ﻭﻳﻨﺒﻐﻲ ﺃﻻ ﻳﺘﺰﻋﺰﻉ ﰲ ﺃﻭﻗﺎﺕ ﺍﻻﺿﻄﺮﺍﺑﺎﺕ‬
‫ﺃﻭ ﺃﺛﻨﺎﺀ ﺍﻟﻔﺘﺮﺍﺕ ﺍﻻﻧﺘﻘﺎﻟﻴﺔ‪ ،‬ﻭﺃﻻ ﻳﻌﺘﻤﺪ ﻋﻠﻲ ﺃﻳﺔ ﺃﻳﺪﻳﻮﻟﻮﺟﻴﺔ ﺳﻴﺎﺳﻴﺔ‪ ،‬ﻭﺃﻻ ﳚﻤﺪ ﰲ ﺃﻭﻗﺎﺕ ﺍﳊﺮﻭﺏ ﺃﻭ‬
‫ﺍﻟﺼﺮﺍﻋﺎﺕ ﺍﻷﻫﻠﻴﺔ‪.‬‬
‫ﰎ ﺗﺄﺳﻴﺲ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﻋﻠﻰ ﺍﳌﺒﺪﺃ ﺍﻷﺳﺎﺳﻲ ﳊﻖ ﺍﻟﻄﻔﻞ ﺍﳌﻜﺘﺴﺐ ﰲ ﺍﻟﻌﻴﺶ ﻭﺍﻟﺒﻘﺎﺀ‬
‫ﻭﺍﻟﻨﻤﻮ‪ ,‬ﺇﻻ ﺇﻧﻪ ﰲ ﺃﻏﻠﺐ ﺍﻷﺣﻴﺎﻥ ﻳﺘﻌﺮﺽ ﻛﺜﲑ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﳋﻄﺮ ﻋﺪﻡ ﺍﻣﺘﻼﻛﻬﻢ ﻧﻔﺲ ﺍﻟﻔﺮﺹ ﻹﺩﺭﺍﻙ‬
‫ﺗﻠﻚ ﺍﳊﻘﻮﻕ‪ .‬ﻭﰲ ﺃﺣﻴﺎﻥ ﻛﺜﲑﺓ‪ ،‬ﺗﺘﻔﺎﻋﻞ ﻇﺮﻭﻑ ﺳﻴﺎﺳﻴﺔ ﻭﺍﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻗﺘﺼﺎﺩﻳﺔ ﻭﺑﻴﺌﻴﺔ ﻭﺑﻴﻮﻟﻮﺟﻴﺔ ﰲ‬
‫ﺟﻌﻞ ﻓﺌﺎﺕ ﻋﺪﻳﺪﺓ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﻭﺿﻊ ﻳﻀﺮ ﻭﻳﻬﻤﺶ ﻣﻦ ﺩﻭﺭﻫﻢ ﰲ ﺍ‪‬ﺘﻤﻊ‪ .‬ﻭﺫﻟﻚ ﺇﻣﺎ ﻳﻌﺮﺽ‬
‫ﺣﻴﺎ‪‬ﻢ ﻭﺑﻘﺎﺀﻫﻢ ﻟﻠﺨﻄﺮ ﻭ‪/‬ﺃﻭ ﻳﻌﺮﻗﻞ ﳕﻮﻫﻢ‪ .‬ﻟﺬﻟﻚ ﻓﻘﺪ ﺃﻛﺪ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﻋﻠﻰ ﺩﻭﺭ ﺍﻟﺪﻭﻟﺔ‬
‫ﻭﺍ‪‬ﺘﻤﻊ ﺑﺄﻛﻤﻠﻪ ﰲ ﺿﻤﺎﻥ ﲪﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﺍﻟﻈﺮﻭﻑ ﺍﻟﱵ ﻗﺪ ﺗﻨﺘﻬﻚ ﺗﻠﻚ ﺍﳊﻘﻮﻕ‪ .‬ﻛﺬﻟﻚ ﻳﺸﺘﻤﻞ‬

‫‪٢٠٣‬‬
‫ﻣﻔﻬﻮﻡ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﻋﻠﻰ ﻣﻘﺎﻳﻴﺲ ﻭﻗﺎﺋﻴﺔ ﻭﺗﻌﺰﻳﺰﻳﺔ‪ ،‬ﻭﺑﺎﻟﺘﺎﱄ ﻳﺘﺨﻄﻰ ﻭﺍﺟﺐ ﺍﻟﺪﻭﻟﺔ ﻭﺍ‪‬ﺘﻤﻊ‬
‫ﻟﻠﻤﻬﺎﻡ ﺍﻟﻌﻼﺟﻴﺔ ﻟﻴﻤﺘﺪ ﺩﻭﺭﻫﺎ ﺇﱃ ﺩﻭﺭ ﺳﺎﺑﻖ ﻟﺬﻟﻚ ﻭﻫﻮ ﻋﻼﺝ ﺍﻷﺳﺒﺎﺏ ﺍﳉﺬﺭﻳﺔ ﺍﻟﱵ ﺗﻌﺮﻗﻞ ﻭ‪‬ﺪﺩ ﳕﻮ‬
‫ﺍﻟﻄﻔﻞ‪ ،‬ﲜﺎﻧﺐ ﺗﻮﻓﲑ ﺍﻟﺒﻴﺌﺔ ﺍﻟﻼﺯﻣﺔ ﺍﻟﱵ ﲤﻜﻦ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﺗﻨﻤﻴﺔ ﻛﻞ ﻗﺪﺍﺭ‪‬ﻢ ﺍﻟﻜﺎﻣﻨﺔ‪.‬‬
‫ﱂ ﺗﻜﻦ ﻣﺼﺮ ﳎﺮﺩ ﺇﺣﺪﻯ ﺍﻟﺪﻭﻝ ﺍﳌﻮﻗﻌﺔ ﻋﻠﻰ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ‪ ،‬ﻭﻟﻜﻨﻬﺎ ﻟﻌﺒﺖ ﺃﻳﻀﺎﹰ ﺩﻭﺭﺍﹰ ﻗﻴﺎﺩﻳ ﹰﺎ‬
‫ﰲ ﺗﻌﺰﻳﺰ ﻭﺗﺄﻳﻴﺪ ﺣﻘﻮﻕ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﺑﺎﻷﺧﺺ ﺍ‪‬ﻤﻮﻋﺎﺕ ﺍﳌﻌﺮﺿﺔ ﻭﺍﶈﺮﻭﻣﲔ‪ .‬ﻭﻗﺪ ﺷﻬﺪ ﺍﻟﻌﻘﺪ ﺍﳌﺎﺿﻲ‪،‬‬
‫ﺧﺎﺻﺔ ﺁﺧﺮ ﲬﺲ ﺳﻨﻮﺍﺕ‪ ،‬ﺗﻨﻤﻴﺎﺕ ﻫﺎﻣﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﻭﺗﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ‬
‫ﲜﺎﻧﺐ ﺍﻟﻮﻋﻲ ﺍﻟﻌﺎﻡ ﳊﻘﻮﻕ ﺍﻟﻄﻔﻞ‪ .‬ﻓﻌﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﺴﻴﺎﺳﺎﺕ‪ ،‬ﻭﺻﻞ ﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﻣﺴﺄﻟﺔ ﲪﺎﻳﺔ‬
‫ﺍﻟﻄﻔﻞ ﺫﺭﻭﺓ ﺟﺪﻳﺪﺓ ﰎ ﺇﺛﺒﺎ‪‬ﺎ ﺑﺎﻟﺘﺼﺮﻳﺢ ﺑﺄﻥ ﺍﻟﺴﻨﻮﺍﺕ ﻣﻦ ‪ ١٩٨٩‬ﺇﱃ ‪ ١٩٩٩‬ﻫﻮ ﻋﻘﺪ ﲪﺎﻳﺔ ﺍﻟﻄﻔﻞ‬
‫ﺍﳌﺼﺮﻱ‪ .‬ﻛﻤﺎ ﺳﺎﳘﺖ ﻣﺼﺮ ﰲ ﺻﺪﻭﺭ ﺩﺳﺘﻮﺭ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﺍﻟﻌﺮﰊ‪ ،‬ﻭﺍﻟﺬﻱ ﻳﻌﺘﱪ ﳎﻬﻮﺩﺍﹰ ﻣﺸﺘﺮﻛﺎﹰ‬
‫ﺑﲔ ﻛﻞ ﺍﻟﺪﻭﻝ ﺍﻟﻌﺮﺑﻴﺔ )‪.(A-Wahdan, 1999‬‬
‫ﻭﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﺘﺸﺮﻳﻌﻲ ﻟﻌﺎﻡ ‪ ،١٩٩٦‬ﰎ ﺇﺻﺪﺍﺭ ﺃﻭﻝ ﺗﺸﺮﻳﻊ ﺷﺎﻣﻞ ﳜﺺ ﺍﻟﻄﻔﻞ ﺍﳌﺼﺮﻱ‪ .‬ﻓﻸﻭﻝ ﻣﺮﺓ‬
‫ﰲ ﺗﺎﺭﻳﺦ ﻣﺼﺮ‪ ،‬ﰎ ﲨﻊ ﻛﻞ ﺍﻟﻘﻮﺍﻧﲔ ﺍﳋﺎﺻﺔ ﲝﻤﺎﻳﺔ ﺍﻟﻄﻔﻞ ﰲ ﺗﺸﺮﻳﻊ ﻭﺍﺣﺪ‪ ،‬ﻫﻮ ﻗﺎﻧﻮﻥ ﺭﻗﻢ ‪١٢‬‬
‫ﻟﺴﻨﺔ ‪ .١٩٩٦‬ﺇﺫ ﻳﺘﻀﻤﻦ ﺍﻟﺘﺸﺮﻳﻊ ﺍﳋﺎﺹ ﺑﺎﻟﻄﻔﻞ ﻓﺼﻮﻻﹰ ﳐﺼﺼﺔ ﻟﺼﺤﺔ ﺍﻟﻄﻔﻞ‪ ،‬ﻭﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ ،‬ﻭﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﻭﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻭﻏﲑ ﺍﻟﻘﺎﺩﺭﻳﻦ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺣﻘﻮﻗﻬﻢ ﺍﻟﺜﻘﺎﻓﻴﺔ‪ .‬ﻭﻗﺪ‬
‫ﺍﺣﺘﻠﺖ ﺍﻟﺒﻨﻮﺩ ﺍﳋﺎﺻﺔ ﲟﻌﺎﻗﺒﺔ ﺍﻷﻃﻔﺎﻝ ﻓﺼﻼﹰ ﻭﺍﺣﺪﺍﹰ ﻓﻘﻂ ﻣﻦ ﺍﻟﺘﺸﺮﻳﻊ‪ .‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻫﺬﺍ‪ ،‬ﻓﺈﻥ‬
‫ﺍﻹﻃﺎﺭ ﺍﻟﻌﺎﻡ ﻟﻸﻃﻔﺎﻝ ﺍﻟﻮﺍﻗﻌﲔ ﲢﺖ ﺍﳌﻌﺎﻗﺒﺔ ﺍﻟﻘﺎﻧﻮﻧﻴﺔ‪ ،‬ﻫﻮ ﺍﻟﺘﺮﻛﻴﺰ ﺍﻷﻛﱪ ﻋﻠﻰ ﺍﳊﻤﺎﻳﺔ ﻭﺍﻹﺻﻼﺡ‬
‫ﺃﻛﺜﺮ ﻣﻦ ﺍﳌﻌﺎﻗﺒﺔ ﻭﺍﻟﺘﺠﺮﱘ‪ .‬ﻭﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺎﺕ‪ ،‬ﻓﻘﺪ ﺷﻬﺪﺕ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﺍﻟﻈﻬﻮﺭ ﻭﺍﻟﺘﻜﺎﺛﺮ‬
‫ﺍﻟﺴﺮﻳﻊ ﻟﻠﱪﺍﻣﺞ ﻭﺍﳌﺸﺮﻭﻋﺎﺕ ﺍﻟﱵ ﲣﺎﻃﺐ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻭﺣﻘﻮﻕ ﺍﻷﻃﻔﺎﻝ ﺍﶈﺮﻭﻣﲔ ﰲ ﻛﻞ ﻣﻦ ﺍﳍﻴﺌﺎﺕ‬
‫ﺍﳊﻜﻮﻣﻴﺔ ﻭﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ‪.‬‬
‫ﰲ ﺍﻟﻮﻗﺖ ﻧﻔﺴﻪ‪ ،‬ﱂ ﺗﻜﻦ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﻟﱵ ﻃﺮﺃﺕ ﻋﻠﻰ ﺍﳌﻨﻈﻤﺎﺕ ﺍﳌﻬﺘﻤﺔ ﺑﺎﺣﺘﻴﺎﺟﺎﺕ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﶈﺮﻭﻣﲔ ﰲ ﺍﻟﻜﻢ ﻓﻘﻂ ﻭﻟﻜﻨﻬﺎ ﰲ ﺍﻟﻜﻴﻒ ﺃﻳﻀﺎﹰ‪ .‬ﺇﺫ ﻋﻜﺴﺖ ﺍﻟﺘﻄﻮﺭﺍﺕ ﲢﻮﻻ ﻛﺒﲑﺍ ﻣﻦ ﺍﻹﺷﻔﺎﻕ‬
‫ﻭﺗﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ ﻭﺍﻟﻌﻨﺎﻳﺔ ﺇﱃ ﺩﻭﺭ ﻧﺸﻂ ﺃﻛﺜﺮ ﻓﺎﻋﻠﻴﺔ ﰲ ﺗﺄﻳﻴﺪ ﻭﺩﻋﻢ ﺣﻘﻮﻕ ﻫﺆﻻﺀ ﺍﻷﻃﻔﺎﻝ‪ .‬ﱂ ﺗﻜﻦ‬
‫ﺗﻠﻚ ﺍﻟﻔﺘﺮﺓ ﺷﺎﻫﺪﺓ ﻓﻘﻂ ﻋﻠﻰ ﺇﻧﺸﺎﺀ ﻭﺗﻄﻮﻳﺮ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﻨﻈﻤﺎﺕ ﺍﳌﻬﺘﻤﺔ ﲝﻘﻮﻕ ﺍﻷﻃﻔﺎﻝ ﺑﺸﻜﻞ‬
‫ﻋﺎﻡ ﻭﺍﶈﺮﻭﻣﲔ ﻣﻨﻬﻢ ﺧﺎﺻﺔ‪ ،‬ﻭﻟﻜﻦ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ ﺗﺒﻨﺖ ﺃﻧﻮﺍﻉ ﻣﻦ ﺍﳌﻨﻈﻤﺎﺕ ﺍﻟﱵ ﺗﻮﻓﺮ ﺍﳋﺪﻣﺔ‬
‫ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺘﻘﻠﻴﺪﻳﺔ ﺃﺩﻭﺍﺭﺍﹰ ﺟﺪﻳﺪﺓ ﻟﺘﺄﻳﻴﺪ ﻭﺩﻋﻢ ﺣﻘﻮﻕ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻭﰲ ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻴﺎﻥ‪ ،‬ﺗﻌﻤﻞ ﺍﳌﻨﻈﻤﺎﺕ‬
‫ﻋﻠﻰ ﺍﳉﻤﻊ ﺑﲔ ﺗﻮﻓﲑ ﺍﳋﺪﻣﺔ ﻭﺗﺄﻳﻴﺪ ﻭﺩﻋﻢ ﺣﻘﻮﻕ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻭﺃﺧﲑﺍﹰ‪ ،‬ﻓﻘﺪ ﺃﺩﻯ ﺍﻹﺩﺭﺍﻙ ﺍﻷﻓﻀﻞ ﳊﻘﻮﻕ‬
‫ﺍﻟﻄﻔﻞ ﰲ ﺍﻟﺘﻌﺒﲑ ﻭﺍﻻﺟﺘﻤﺎﻉ‪ ،‬ﺇﱃ ﻋﻤﻞ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﳌﻨﻈﻤﺎﺕ ﻣﻊ ﺍﻷﻃﻔﺎﻝ ﻟﺘﻄﻮﻳﺮ ﺍﳌﻨﺎﺑﺮ ﺍﻟﱵ ﻓﻴﻬﺎ‬
‫ﳝﻜﻦ ﻟﻸﻃﻔﺎﻝ ﻭﺍﻟﺸﺒﺎﺏ ﺇﺑﺪﺍﺀ ﺁﺭﺍﺋﻬﻢ ﻭﺍﻟﺘﻌﺒﲑ ﻭﺍﻟﺪﻓﺎﻉ ﻋﻦ ﺍﺣﺘﻴﺎﺟﺎ‪‬ﻢ‪ ،‬ﻭﻟﺬﻟﻚ ﰎ ﺇﻧﺸﺎﺀ ﺍﺋﺘﻼﻑ‬
‫ﻟﻠﻤﻨﻈﻤﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ ﺧﺎﺹ ﲝﻘﻮﻕ ﺍﻟﻄﻔﻞ‪ .‬ﲜﺎﻧﺐ ﺫﻟﻚ‪ ،‬ﺗﻮﻓﺮ ﺍﳌﻨﺎﺑﺮ ﺍﻟﻔﺮﺹ ﻟﻸﻃﻔﺎﻝ ﻭﺍﻟﺸﺒﺎﺏ‬
‫ﻟﻠﻤﺮﺓ ﺍﻷﻭﱃ ﻛﻤﻤﺜﻠﲔ ﺇﳚﺎﺑﻴﲔ ﰲ ﻫﺬﻩ ﺍﳌﻨﻈﻤﺎﺕ ﻭﺍ‪‬ﺘﻤﻌﺎﺕ ﺍﻟﱵ ﻳﻌﻤﻠﻮﻥ ‪‬ﺎ ﻭﻟﻴﺴﻮﺍ ﻓﻘﻂ‬
‫ﻛﻤﺘﻠﻘﲔ‪.‬‬
‫ﺇﻻ ﺇﻧﻪ ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﻹﳚﺎﺑﻴﺔ ﺍﻟﱵ ﺳﺒﻖ ﺫﻛﺮﻫﺎ‪ ،‬ﻳﻠﻘﻲ ﻫﺬﺍ ﺍﻟﺘﺤﻠﻴﻞ ﺍﻟﻀﻮﺀ ﻋﻠﻰ‬
‫ﺍﻟﻔﺠﻮﺍﺕ ﺍﻟﱵ ﰲ ﺣﺎﺟﺔ ﻣﺎﺳﺔ ﻟﻠﻌﻼﺝ ﻭﺫﻟﻚ ﺇﺫﺍ ﺃﺩﺭﻙ ﻛﻞ ﺍﻷﻃﻔﺎﻝ ﺍﳌﺼﺮﻳﲔ ﺣﻘﻮﻗﻬﻢ ﰲ ﺍﳊﻴﺎﺓ‬

‫‪٢٠٤‬‬
‫ﻭﺍﻟﺒﻘﺎﺀ ﻭﺍﻟﺘﻨﻤﻴﺔ‪ .‬ﻭﰲ ﳏﺎﻭﻟﺔ ﻹﻳﻘﺎﺩ ﺷﻌﻠﺔ ﻣﺒﺪﺃ "ﺍﻷﻃﻔﺎﻝ ﺃﻭﻻ"‪ ،‬ﻳﺴﺘﻄﻴﻊ ﺍﻟﻌﺎﱂ ﺍﻵﻥ ﺍﻹﻓﺎﺩﺓ ﻣﻦ‬
‫ﺍﻻﺗﻔﺎﻕ ﺍﻟﺪﻭﱄ ﺍﳊﺎﱄ ﻋﻠﻰ ﺍﳊﺪ ﺍﻷﺩﱏ ﻣﻦ ﺍﳊﻤﺎﻳﺔ ﺍﻟﻮﺍﺟﺐ ﺗﻮﻓﲑﻫﺎ ﻟﻸﻃﻔﺎﻝ‪ .‬ﻭﺗﺸﻤﻞ ﺃﻫﺪﺍﻑ ﻣﺆﲤﺮ‬
‫ﺍﻟﻘﻤﺔ ﺍﻟﻌﺎﳌﻲ ﻣﻦ ﺃﺟﻞ ﺍﻟﻄﻔﻞ ﻭﺑﻨﻮﺩ ﺍﻻﺗﻔﺎﻗﻴﺔ ﺍﻟﺪﻭﻟﻴﺔ ﳊﻘﻮﻕ ﺍﻟﻄﻔﻞ‪ ،‬ﻋﻠﻰ ﻣﻌﺎﻳﲑ ﺩﻧﻴﺎ ﻣﺘﻔﻘﺎ‬
‫ﻋﻠﻴﻬﺎ ﳊﻤﺎﻳﺔ ﺑﻘﺎﺀ ﺍﻷﻃﻔﺎﻝ ﻭﺻﺤﺘﻬﻢ ﻭﺗﻌﻠﻴﻤﻬﻢ‪ .‬ﻛﻤﺎ ﺗﺸﻤﻞ ﻋﻠﻰ ﺍﳊﺪ ﺍﻷﺩﱏ ﻣﻦ ﺍﳌﻌﺎﻳﲑ ﺍﳌﺘﻔﻖ‬
‫ﻋﻠﻴﻬﺎ ﻟﺘﻮﻓﲑ ﺍﳊﻤﺎﻳﺔ ﻟﻜﻞ ﺍﻷﻃﻔﺎﻝ ﰲ ﳐﺘﻠﻒ ﺃﻣﺎﻛﻦ ﺗﻮﺍﺟﺪﻫﻢ ﻣﻦ ﺍﻻﺳﺘﻐﻼﻝ ﻭﺳﻮﺀ ﺍﻻﺳﺘﺨﺪﺍﻡ‪،‬‬
‫ﺳﻮﺍﺀ ﰲ ﺃﻭﻗﺎﺕ ﺍﳊﺮﻭﺏ ﺃﻡ ﰲ ﺍﻟﻌﻤﻞ ﺃﻡ ﺍﳌﱰﻝ‪ .‬ﻭﳍﺬﺍ‪ ،‬ﻓﺈﻥ ﺍﻟﻌﺎﱂ ﻗﺪ ﻭﺿﻊ ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﳌﻌﺎﻳﲑ ﺍﳌﺘﻔﻖ‬
‫ﻋﻠﻴﻬﺎ ﺩﻭﻟﻴﺎ ﳊﻤﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻭﺗﺴﺘﻄﻴﻊ ﺃﻱ ﺩﻭﻟﺔ ﻣﻦ ﺩﻭﻝ ﺍﻟﻌﺎﱂ ﺃﻥ ﺗﻘﻴﺲ ﻣﺪﻯ ﺍﻟﺘﻘﺪﻡ ﺍﻟﻌﻤﻠﻲ ﺍﻟﺬﻱ‬
‫ﺃﺣﺮﺯﺗﻪ ﻋﻠﻰ ﺻﻌﻴﺪ ﺇﻗﺎﻣﺔ ﻧﻈﺎﻡ ﺟﺪﻳﺪ ﻟﻸﻃﻔﺎﻝ‪ ،‬ﰲ ﺿﻮﺀ ﻫﺬﻩ ﺍﳌﻌﺎﻳﲑ‪.‬‬

‫‪ ' * +
,-   .  )/‬‬
‫ﻫﻨﺎﻙ ﻋﺪﺓ ﻣﻌﺎﻳﲑ ﰎ ﻭﺿﻌﻬﺎ ﻋﺎﳌﻴﺎ ﻟﺘﻘﻴﻴﻢ ﺣﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻭﻛﺎﻧﺖ ﻣﺼﺮ ﻣﻦ ﺍﻟﺪﻭﻝ ﺍﻟﱵ ﻭﺍﻓﻘﺖ ﻋﻠﻲ‬
‫ﻫﺬﻩ ﺍﳌﻌﺎﻳﲑ‪ .‬ﻭﻋﻨﺪ ﺗﻘﻴﻴﻢ ﺣﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ ﳝﻜﻦ ﺍﺳﺘﺨﺪﺍﻡ ﻫﺬﻩ ﺍﳌﻌﺎﻳﲑ‪ ،‬ﻭﻟﻜﻦ ﺗﻜﻤﻦ ﻣﺸﻜﻠﺔ‬
‫ﺍﻟﺘﻘﻴﻴﻢ ﰲ ﻣﺼﺎﺩﺭ ﺍﻟﺒﻴﺎﻧﺎﺕ‪ .‬ﻭﰲ ﻣﺼﺮ‪ ،‬ﻛﻤﻌﻈﻢ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ‪ ،‬ﻳﻌﺘﻤﺪ ﺗﻘﻴﻴﻢ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻲ‬
‫ﻃﺮﻕ ﻏﲑ ﻣﺒﺎﺷﺮﺓ ﻣﺜﻞ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﱵ ﲢﺪﺩ ﻣﺪﻯ ﺍﻧﺘﺸﺎﺭ ﺑﻌﺾ ﺍﻷﻣﺮﺍﺽ ﻭﻋﻠﻰ ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﻴﺎﺕ‬
‫ﻧﺘﻴﺠﺔ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ‪ .‬ﻭﳌﺘﺎﺑﻌﺔ ﻭﺗﻘﻴﻴﻢ ﺍﻹﳒﺎﺯﺍﺕ ﰲ ﳎﺎﻝ ﺍﻟﺘﻨﻤﻴﺔ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ ﳚﺐ ﺍﻻﻋﺘﻤﺎﺩ‬
‫ﻋﻠﻰ ﺑﻴﺎﻧﺎﺕ ﻣﻮﺛﻮﻕ ‪‬ﺎ‪ .‬ﻭﻗﺪ ﰎ ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺗﻘﻴﻴﻢ ﺣﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ‪ ،‬ﰲ ﻫﺬﺍ ﺍﻟﺘﻘﺮﻳﺮ‪ ،‬ﻋﻠﻲ‬
‫ﺑﻴﺎﻧﺎﺕ ﻣﻮﺛﻘﺔ ﺩﻭﻟﻴﺎ ﻭﻋﻠﻲ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﶈﻠﻴﺔ ﻭﺍﻟﱵ ﻗﺪ ﻭﺟﺪ ﺃﻧﻪ ﻳﻮﺟﺪ ﺗﺒﺎﻳﻦ ﺑﻴﻨﻬﺎ‪.‬‬
‫ﻭﺍﳉﺪﻭﻝ ﺍﻟﺘﺎﱄ ﻳﻮﺿﺢ ﺩﺭﺟﺔ ﺍﻹﳒﺎﺯ ﰲ ﻣﺼﺮ ﳓﻮ ﲢﺴﲔ ﺣﺎﻝ ﺍﻷﻃﻔﺎﻝ ‪‬ﺎ ﻭﺍﻟﱵ ﰎ ﺗﻘﻴﻴﻤﻬﺎ ﺣﺴﺐ‬
‫ﻗﺎﺋﻤﺔ ﺍﻷﻫﺪﺍﻑ ﺍﻟﱵ ﻭﺿﻌﺖ ﺑﻮﺍﺳﻄﺔ ﻣﺆﲤﺮ ﺍﻟﻘﻤﺔ ﺍﻟﻌﺎﳌﻲ ﻣﻦ ﺃﺟﻞ ﺍﻟﻄﻔﻞ ﺍﻟﺬﻱ ﻋﻘﺪ ﰲ ‪٣٠‬‬
‫ﺳﺒﺘﻤﱪ ‪ ١٩٩٠‬ﻭﺍﻟﺬﻱ ﻭﻗﻌﺖ ﻋﻠﻴﻪ ﻣﺼﺮ‪ ،‬ﻭﻫﺬﻩ ﺍﻷﻫﺪﺍﻑ ﻳﻨﺒﻐﻲ ﲢﻘﻴﻘﻬﺎ ﲝﻠﻮﻝ ﻋﺎﻡ ‪ .٢٠٠٠‬ﻭﺑﺬﻟﻚ‬
‫ﳝﻜﻦ ﺗﻘﻴﻴﻢ ﺍﻹﳒﺎﺯ ﺍﻟﺬﻱ ﺣﻘﻘﺘﻪ ﻣﺼﺮ ﺧﻼﻝ ﺍﻟﻌﻘﺪ ﺍﻟﺴﺎﺑﻖ‪ .‬ﻭﻗﺪ ﰎ ﺍﻻﻋﺘﻤﺎﺩ ﰲ ﺍﻟﺘﻘﻴﻴﻢ ﻋﻠﻲ ﺑﻴﺎﻧﺎﺕ‬
‫ﻣﺘﻮﻓﺮﺓ ﻋﻦ ﻣﺼﺮ ﻣﻦ ﻣﺼﺪﺭ ﻭﺍﺣﺪ ﻟﻜﻞ ﻣﺆﺷﺮ ﳌﺮﺍﻋﺎﺓ ﺗﻮﺣﻴﺪ ﺍﻟﻘﻴﺎﺱ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(١-٩‬ﺃﻫﺪﺍﻑ ﻋﺎﻡ ‪ ٢٠٠٠‬ﺍﳋﺎﺻﺔ ﻣﺒﺎﺷﺮﺓ ﺑﺎﻷﻃﻔﺎﻝ )ﻳﻮﻧﻴﺴﻒ‪(١٩٩٢ ،‬‬
‫ﺩﺭﺟﺔ ﺍﻹﳒﺎﺯ‬ ‫ﺍﳌﻌﺪﻝ ﺳﻨﺔ‬ ‫ﺍﳌﻌﺪﻝ ﺳﻨﺔ‬
‫ﺍﻷﻫﺪﺍﻑ‬
‫ﰲ ﻣﺼﺮ‬ ‫‪٢٠٠٠- ١٩٩٥‬‬ ‫‪١٩٩٢-١٩٩٠‬‬
‫ﺍﻷﻫﺪﺍﻑ ﺍﻟﺸﺎﻣﻠﺔ ‪٢٠٠٠-١٩٩٠‬‬
‫ﲣﻔﻴﺾ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ ﺑﻨﺴﺒﺔ ﺍﻟﺜﻠﺚ )ﺃﻭ‬
‫ﲢﻘﻖ‬ ‫‪٥٤‬‬ ‫‪٨٥‬‬
‫ﲣﻔﻴﻀﻬﺎ ﺇﱄ ﻣﺎ ﺩﻭﻥ ‪ ٧٠‬ﻭﻓﺎﺓ ﻟﻜﻞ ‪ ١٠٠٠‬ﻭﻻﺩﺓ ﺣﻴﺔ ‪ -‬ﺃﻳﻬﻤﺎ ﺃﻗﻞ(‪#‬‬
‫ﲣﻔﻴﺾ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ ﺇﱄ ﻣﺎ ﺩﻭﻥ ‪ ٥٠‬ﻭﻓﺎﺓ ﻟﻜﻞ ‪١٠٠٠‬‬
‫ﲢﻘﻖ‬ ‫‪٤٤‬‬ ‫‪٦٢‬‬
‫ﻭﻻﺩﺓ ﺣﻴﺔ‪#‬‬
‫‪٢٤‬‬ ‫‪٣٣‬‬ ‫ﲣﻔﻴﺾ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ ﺇﱄ ﻣﺎ ﺩﻭﻥ‬
‫ﺍﻟﺘﻌﻠﻴﻢ‪:‬‬
‫ﺗﻮﻓﲑ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﻟﻜﻞ ﺍﻷﻃﻔﺎﻝ )‪ ١٥-٦‬ﺳﻨﺔ ﻣﻦ‬ ‫
‬
‫‪٨٤,٤‬‬ ‫ﺍﻟﻌﻤﺮ( )‪ %‬ﺍﳌﻠﺘﺤﻘﲔ ﺑﺎﳌﺪﺍﺭﺱ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ ﺣﺎﻟﻴﺎ(‪#‬‬
‫ﱂ ﻳﺘﺤﻘﻖ‬ ‫‪٨٤,٣‬‬
‫ﺍﻟﺘﻌﻠﻴﻢ ﺍﻻﺑﺘﺪﺍﺋﻲ ﺍﻟﻜﺎﻣﻞ ﻟـ ‪ %٨٠‬ﻋﻠﻲ ﺍﻷﻗﻞ ﻣﻦ ﺍﻷﻃﻔﺎﻝ‬ ‫
‬
‫‪٤٧,٠‬‬ ‫ﻣﺎ ﺑﲔ ‪ ١٥-٦‬ﺳﻨﺔ ﻣﻦ ﺍﻟﻌﻤﺮ‪#.‬‬

‫‪٢٠٥‬‬
 ‫ﺩﺭﺟﺔ ﺍﻹﳒﺎﺯ‬ ‫ﺍﳌﻌﺪﻝ ﺳﻨﺔ‬ ‫ﺍﳌﻌﺪﻝ ﺳﻨﺔ‬
‫ﺍﻷﻫﺪﺍﻑ‬
‫ﰲ ﻣﺼﺮ‬ ‫‪٢٠٠٠- ١٩٩٥‬‬ ‫‪١٩٩٢-١٩٩٠‬‬
‫ﺍﻟﺘﻐﺬﻳﺔ‬
‫ﲣﻔﻴﺾ ﻋﺪﺩ ﺍﻟﻮﻻﺩﺍﺕ ﺑﻮﺯﻥ ﻣﻨﺨﻔﺾ ﺃﻗﻞ ﻣﻦ ‪ ٢,٥‬ﻛﺠﻢ ﺇﱄ ﻣﺎ ﻳﻘﻞ ﻋﻦ‬
‫‪١٠‬‬ ‫‪١٠‬‬
‫‪**.%١٠‬‬
‫ﲣﻔﻴﺾ ﺣﺎﻻﺕ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﺍﳊﺎﺩﺓ ﻭﺍﳌﻌﺘﺪﻟﺔ ﺇﱄ ﺍﻟﻨﺼﻒ ﺑﲔ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﻟﺬﻳﻦ ﻫﻢ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ‪.‬‬
‫‪١٢‬‬ ‫‪٩‬‬
‫ﺗﻔﺎﻗﻤﺖ‬ ‫ﺍﳔﻔﺎﺽ ﺍﻟﻮﺯﻥ*‬ ‫
‬
‫‪٦‬‬ ‫‪٣‬‬
‫ﺍﳌﺸﻜﻠﺔ‬ ‫ﺍﳍﺰﺍﻝ*‬ ‫
‬
‫‪٢٥‬‬ ‫‪٢٤‬‬
‫ﺍﻟﺘﻘﺰﻡ*‬ ‫
‬
‫ﺍﻟﻘﻀﺎﺀ ﻛﻠﻴﺎ ﻋﻠﻲ ﺍﻹﺿﺮﺍﺑﺎﺕ ﺍﻟﻨﺎﲡﺔ ﻋﻦ ﻧﻘﺺ ﻓﻴﺘﺎﻣﲔ ﺃ ﻭﺍﻟﻴﻮﺩ‪.‬‬
‫‪ %‬ﺍﻷﻃﻔﺎﻝ )‪ ٢٣-١٢‬ﺷﻬﺮﺍ( ﺣﺼﻠﻮﺍ ﻋﻠﻲ ﻓﻴﺘﺎﻣﲔ ﺃ‬ ‫
‬
‫‪٢٢,٧‬‬ ‫ﱂ ﻳﺒﺪﺃ‬
‫ﺍﻟﺘﻜﻤﻴﻠﻲ‪#‬‬
‫‪٥٥,٩‬‬ ‫‪--‬‬
‫‪ %‬ﺍﺳﺘﻬﻼﻙ ﺃﻓﺮﺍﺩ ﺍﻟﻌﺎﺋﻠﺔ ﳌﻠﺢ ﺍﻟﻴﻮﺩ‪#‬‬ ‫
‬
‫ﻧﺸﺮ ﺍﳌﻌﺮﻓﺔ ﺑﲔ ﺍﻟﻌﺎﺋﻼﺕ ﲨﻴﻌﻬﺎ ﻋﻦ ﺃﳘﻴﺔ ﺗﻘﺪﱘ ﺍﻟﺪﻋﻢ ﻟﻠﻤﺮﺃﺓ ﰲ‬
‫ﻋﻤﻠﻴﺔ ﺇﺭﺿﺎﻉ ﺍﻟﻄﻔﻞ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﺜﺪﻱ ﺧﻼﻝ ﺃﻭﻝ ‪٦-٤‬ﺃﺷﻬﺮ ﻣﻦ ﺣﻴﺎﺓ‬
‫ﺗﻔﺎﻗﻤﺖ‬ ‫‪٥٣‬‬ ‫‪٦٨‬‬ ‫ﺍﻟﻄﻔﻞ‪.‬‬
‫ﺍﳌﺸﻜﻠﺔ‬ ‫‪٣٧‬‬ ‫‪٥٢‬‬ ‫‪ %‬ﺍﻷﻃﻔﺎﻝ ﻳﺮﺿﻌﻮﻥ ﺭﺿﺎﻋﺔ ﻃﺒﻴﻌﻴﺔ ﻓﻘﻂ )‪ ٣-٠‬ﺷﻬﻮﺭ(*‬ ‫
‬
‫ﻳﺘﻨﺎﻭﻟﻮﻥ ﺃﻏﺬﻳﺔ ﻣﻜﻤﻠﺔ ﳊﻠﻴﺐ ﺍﻷﻡ )‪ ٩-٦‬ﺷﻬﻮﺭ(*‬ ‫
‬
‫ﺍﻷﻧﻴﻤﻴﺎ‬
‫‪٢٩,٩‬‬ ‫ﺍﻧﺘﺸﺎﺭ ﺍﻷﻧﻴﻤﻴﺎ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻌﻤﺮ ‪ ٥٩-٦‬ﺷﻬﺮ‪#‬‬ ‫
‬
‫‪٢٩,٧‬‬ ‫ﺍﻧﺘﺸﺎﺭ ﺍﻷﻧﻴﻤﻴﺎ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻌﻤﺮ ‪ ١٩-١١‬ﻋﺎﻣﺎ‪#‬‬ ‫
‬
‫ﺻﺤﺔ ﺍﻟﻄﻔﻞ‬
‫ﺍﻟﻘﻀﺎﺀ ﻋﻠﻲ ﺷﻠﻞ ﺍﻷﻃﻔﺎﻝ‪.‬‬
‫ﱂ ﻳﺘﺤﻘﻖ‬ ‫‪٩٦‬‬ ‫‪٩١‬‬ ‫ﻧﺴﺒﺔ ﺍﶈﺼﻨﲔ ﲢﺼﻴﻨﺎ ﻛﺎﻣﻼ*‬ ‫
‬
‫ﺃﻣﺮﺍﺽ ﺍﻹﺳﻬﺎﻝ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ‬
‫ﲢﻘﻖ‬ ‫‪٧,١‬‬ ‫‪١٥,٩‬‬ ‫ﲣﻔﻴﺾ ﻧﺴﺒﺔ ﺣﺪﻭﺙ ﺍﻷﻣﺮﺍﺽ ﺍﻹﺳﻬﺎﻟﻴﺔ ﺑﻨﺴﺒﺔ ‪#%٢٥‬‬ ‫
‬
‫ﺍﻻﻟﺘﻬﺎﺑﺎﺕ ﺍﻟﺘﻨﻔﺴﻴﺔ ﺍﳊﺎﺩﺓ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ‬
‫ﱂ ﻳﺘﺤﻘﻖ‬ ‫‪٩,٥‬‬ ‫‪٢٣,٢‬‬ ‫ﲣﻔﻴﺾ ﻧﺴﺒﺔ ﺣﺪﻭﺙ ﺍﻻﻟﺘﻬﺎﺑﺎﺕ ﺍﻟﺘﻨﻔﺴﻴﺔ ﲟﻘﺪﺍﺭ ﺍﻟﺜﻠﺚ‪#‬‬ ‫
‬
‫** ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ )‪(٢٠٠٠‬‬ ‫‪ #‬ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ‬ ‫* ﺍﻟﻴﻮﻧﻴﺴﻴﻒ‬

‫ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ‬

‫ﻭﺟﺪ ﺃﻥ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ ﻣﻦ ﺍﻟﻌﻤﺮ ﰲ ﺧﻼﻝ ﺍﳋﻤﺲ ﺳﻨﻮﺍﺕ ﺍﻟﺴﺎﺑﻘﺔ ﻟﻠﻤﺴﺢ‬
‫ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ )ﻣﺼﺮ ‪ (٢٠٠٠‬ﻫﻮ ‪ ٥٤‬ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ‪ .‬ﻭﻋﻨﺪ ﻫﺬﺍ ﺍﳌﺴﺘﻮﻯ‪ ،‬ﻓﺈﻥ ﻫﻨﺎﻙ‬
‫ﻃﻔﻞ ﻣﻦ ﺑﲔ ﻛﻞ ‪ ٢٠‬ﻃﻔﻼ ﻣﺼﺮﻳﺎ ﺳﻮﻑ ﻳﺘﻮﰱ ﻗﺒﻞ ﺑﻠﻮﻏﻪ ﺍﻟﺴﻨﺔ ﺍﳋﺎﻣﺴﺔ ﻣﻦ ﺍﻟﻌﻤﺮ‪ .‬ﻛﻤﺎ ﺃﻥ‬
‫ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ )ﺧﻼﻝ ﺍﻟﻌﺎﻡ ﺍﻷﻭﻝ ﻣﻦ ﺍﻟﻌﻤﺮ( ﻫﻮ ‪ ٤٤‬ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ‪ ،‬ﺃﻣﺎ ﻣﻌﺪﻝ‬
‫ﻭﻓﻴﺎﺕ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ )ﺧﻼﻝ ﺍﻟﺸﻬﺮ ﺍﻷﻭﻝ ﻣﻦ ﺍﻟﻌﻤﺮ( ﻓﻬﻮ ‪ ٢٤‬ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ‪ .‬ﻭﻳﻮﺿﺢ‬
‫ﻫﺬﺍ ﺃﻥ ‪ %٨٠‬ﻣﻦ ﻭﻓﻴﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ ﰲ ﻣﺼﺮ ﲢﺪﺙ ﻗﺒﻞ ﺑﻠﻮﻍ ﺍﻟﻄﻔﻞ ﺍﻟﺴﻨﺔ ﺍﻷﻭﱄ ﻣﻦ ﺍﻟﻌﻤﺮ‪،‬‬
‫ﻭﺃﻛﺜﺮ ﻣﻦ ‪ %٤٠‬ﻣﻦ ﺍﻟﻮﻓﻴﺎﺕ ﲢﺪﺙ ﺧﻼﻝ ﺍﻟﺸﻬﺮ ﺍﻷﻭﻝ ﻣﻦ ﺍﻟﻌﻤﺮ‪.‬‬
‫ﳝﻜﻦ ﺩﺭﺍﺳﺔ ﺗﻄﻮﺭ ﻭﻓﻴﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ ﰲ ﻣﺼﺮ ﻭﺫﻟﻚ ﲟﻘﺎﺭﻧﺔ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﻣﻦ ﻣﺴﻮﺡ ﺃﺟﺮﻳﺖ ﰲ‬
‫ﻓﺘﺮﺍﺕ ﺯﻣﻨﻴﺔ ﳐﺘﻠﻔﺔ )ﺍﻟﺪﻭﺭﺍﺕ ﺍﻷﺭﺑﻊ ﺍﳋﺎﺻﺔ ﺑﺎﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ﰲ ﻣﺼﺮ ﻭﻣﺴﺢ ﺍﳋﺼﻮﺑﺔ‬

‫‪٢٠٦‬‬
‫ﺍﳌﺼﺮﻱ ‪ .(١٩٨٠‬ﻭﺗﻐﻄﻲ ﻫﺬﻩ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﻣﻊ ﺑﻌﻀﻬﺎ ﺍﻟﺒﻌﺾ ﻓﺘﺮﺓ ﲬﺴﺔ ﻭﺛﻼﺛﲔ ﻋﺎﻣﺎ ﺑﲔ ‪١٩٦٥‬‬
‫ﻭﺣﱴ ﻋﺎﻡ ‪ .٢٠٠٠‬ﺗﺆﻛﺪ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﺃﻥ ﻭﻓﻴﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ ﻗﺪ ﺍﳔﻔﻀﺖ ﺍﳔﻔﺎﺿﺎ ﻣﻠﺤﻮﻇﺎ ﰲ‬
‫ﻣﺼﺮ ﺧﻼﻝ ﺍﻟﻌﻘﻮﺩ ﺍﻟﺜﻼﺛﺔ ﺍﻟﺴﺎﺑﻘﺔ‪ .‬ﺣﻴﺚ ﺑﻠﻎ ﺍﺣﺘﻤﺎﻝ ﻭﻓﺎﺓ ﺍﻟﻄﻔﻞ ﻗﺒﻞ ﺑﻠﻮﻏﻪ ﺳﻦ ﺍﳋﺎﻣﺴﺔ ﰲ‬
‫ﻣﻨﺘﺼﻒ ﺍﻟﺴﺘﻴﻨﻴﺎﺕ ﲬﺴﺔ ﺃﺿﻌﺎﻑ ﻧﻈﲑﻩ ﰲ ‪‬ﺎﻳﺔ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ‪ .‬ﻛﻤﺎ ﺗﺆﻛﺪ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﺍﻟﺘﻐﲑ ﰲ‬
‫ﺍﻟﻨﻤﻂ ﺍﻟﻌﻤﺮﻱ ﻟﻠﻮﻓﻴﺎﺕ ﺑﲔ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﺣﻴﺚ ﺗﻨﺎﻗﺼﺖ ﺍﳌﻌﺪﻻﺕ ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻭﺗﺮﻛﺰﺕ ﺍﻟﻮﻓﻴﺎﺕ ﺑﺸﻜﻞ‬
‫ﻣﺘﺰﺍﻳﺪ ﰲ ﺍﻟﺸﻬﻮﺭ ﺍﻷﻭﱄ ﻣﻦ ﺍﳊﻴﺎﺓ‪ .‬ﻓﻔﻲ ﻣﻨﺘﺼﻒ ﺍﻟﺴﺘﻴﻨﻴﺎﺕ ﺣﺪﺛﺖ ‪ %٤٠‬ﻣﻦ ﺍﻟﻮﻓﻴﺎﺕ ﺑﻌﺪ ﺑﻠﻮﻍ‬
‫ﺍﻟﻄﻔﻞ ﻋﺎﻣﻪ ﺍﻷﻭﻝ ﻭﰲ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﺣﺪﺛﺖ ‪ %٢٠‬ﻓﻘﻂ ﻣﻦ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ ﻣﻦ ﺍﻟﻌﻤﺮ‬
‫ﺑﻌﺪ ﺃﻥ ﺃﰎ ﺍﻟﻄﻔﻞ ‪ ١٢‬ﺷﻬﺮﺍ ﻣﻦ ﺣﻴﺎﺗﻪ‪.‬‬
‫ﻛﻤﺎ ﻭﺟﺪ ﺃﻥ ﻫﻨﺎﻙ ﺗﺒﺎﻳﻨﺎﺕ ﰲ ﻭﻓﻴﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ ﺣﺴﺐ ﺍﳋﺼﺎﺋﺺ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ‬
‫ﻭﺍﻟﺪﳝﻮﺟﺮﺍﻓﻴﺔ‪ .‬ﻓﺈﻥ ﺍﺣﺘﻤﺎﻝ ﺍﻟﻮﻓﺎﺓ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﳊﻀﺮ‪ ،‬ﰲ ﺃﻱ ﻣﺮﺣﻠﺔ ﻣﻦ ﻣﺮﺍﺣﻞ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ‬
‫ﺃﻗﻞ ﻣﻨﻪ ﻟﺪﻯ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﺮﻳﻒ‪ .‬ﻭﻫﻨﺎﻙ ﺗﺒﺎﻳﻨﺎﺕ ﺣﺴﺐ ﳏﻞ ﺍﻹﻗﺎﻣﺔ‪ ،‬ﺣﻴﺚ ﺗﻮﺟﺪ ﺃﻗﻞ ﻣﻌﺪﻻﺕ‬
‫ﻟﻠﻮﻓﻴﺎﺕ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﻭﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ‪ ،‬ﺑﻴﻨﻤﺎ ﺗﻮﺟﺪ ﺃﻋﻠﻰ ﻫﺬﻩ ﺍﳌﻌﺪﻻﺕ ﰲ ﺭﻳﻒ ﺍﻟﻮﺟﻪ‬
‫ﺍﻟﻘﺒﻠﻲ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﺍﻟﻮﻓﻴﺎﺕ ﰲ ﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ ﺃﻋﻠﻲ ﻟﻜﻞ ﺍﻷﻋﻤﺎﺭ ﻣﻦ ﺍﻟﻮﻓﻴﺎﺕ ﰲ ﺭﻳﻒ ﺍﻟﻮﺟﻪ‬
‫ﺍﻟﺒﺤﺮﻱ‪ ،‬ﺇﻻ ﺃﻥ ﺍﻟﺘﺒﺎﻳﻨﺎﺕ ﺍﻟﻜﺒﲑﺓ ﰲ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﻣﺎ ﺑﻌﺪ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ ﺑﺼﻔﺔ ﺧﺎﺻﺔ ﺗﺜﲑ ﺍﻻﻧﺘﺒﺎﻩ‪.‬‬
‫ﺇﻥ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﻣﺎ ﺑﻌﺪ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ )ﺍﻟﻔﺮﻕ ﺑﲔ ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﻭﻭﻓﻴﺎﺕ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ( ﰲ ﺭﻳﻒ‬
‫ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ ﺿﻌﻒ ﺍﳌﻌﺪﻝ ﰲ ﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ )‪ ٤٢‬ﻭ‪ ٢١‬ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ(‪ .‬ﻛﺬﻟﻚ‬
‫ﻓﺈﻥ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﰲ ﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ ﺃﻋﻠﻲ ﺑﻨﺴﺒﺔ ‪ %٦٤‬ﻋﻦ ﺍﳌﻌﺪﻝ ﰲ ﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫)‪ ٧٧‬ﻭ‪ ٤٧‬ﺣﺎﻟﺔ ﻭﻓﺎﺓ ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻮﻟﻮﺩ(‪ .‬ﻭﺑﺎﻟﻨﻈﺮ ﺇﱃ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‪ ،‬ﺗﻌﺘﱪ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﻮﻓﻴﺎﺕ ﺃﻋﻠﻰ‬
‫ﺑﻜﺜﲑ ﰲ ﺣﻀﺮ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ ﻋﻨﻬﺎ ﰲ ﺣﻀﺮ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ ﺃﻭ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﺣﻴﺚ ﺗﺮﺟﻊ ﺃﻏﻠﺐ‬
‫ﻫﺬﻩ ﺍﻟﺘﺒﺎﻳﻨﺎﺕ ﺇﱃ ﺍﺭﺗﻔﺎﻉ ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ‪ .‬ﺑﻴﻨﻤﺎ ﺗﻌﺘﱪ ﺍﻟﻔﺠﻮﺓ ﰲ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺑﲔ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‬
‫ﺍﻟﺜﻼﺙ ﺃﻗﻞ ﺑﻜﺜﲑ‪.‬‬
‫ﻭﻛﻤﺎ ﻫﻮ ﻣﺒﲔ ﰲ ﻣﺴﻮﺡ ﺳﺎﺑﻘﺔ‪ ،‬ﻫﻨﺎﻙ ﺃﺛﺮ ﺫﻭ ﻣﻌﻨﻮﻳﺔ ﺇﺣﺼﺎﺋﻴﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻡ ﺧﻼﻝ ﻓﺘﺮﺓ‬
‫ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ ﻋﻠﻰ ﳐﺎﻃﺮ ﻭﻓﻴﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ‪ .‬ﺣﻴﺚ ﺗﻌﺘﱪ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﻮﻓﻴﺎﺕ ﺧﻼﻝ ﻣﺮﺣﻠﺔ‬
‫ﺍﻟﻌﺎﻡ ﺍﻷﻭﻝ ﺃﻗﻞ ﻟﻠﻤﻮﺍﻟﻴﺪ ﺍﻟﺬﻳﻦ ﺣﺼﻠﺖ ﺃﻣﻬﺎ‪‬ﻢ ﻋﻠﻰ ﻛﻞ ﻣﻦ ﺭﻋﺎﻳﺔ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ ﻣﻦ ﻣﻘﺪﻡ‬
‫ﺧﺪﻣﺔ ﻃﱯ ﻣﺘﻤﺮﺱ ﻣﻘﺎﺭﻧﺔ ﺑﺎﳌﻮﺍﻟﻴﺪ ﺍﻟﺬﻳﻦ ﺣﺼﻠﺖ ﺃﻣﻬﺎ‪‬ﻢ ﻋﻠﻰ ﺭﻋﺎﻳﺔ ﺍﳊﻤﻞ ﻓﻘﻂ ﺃﻭ ﱂ ﳛﺼﻠﻦ‬
‫ﻋﻠﻰ ﺃﻱ ﺭﻋﺎﻳﺔ‪ .‬ﻛﻤﺎ ﺃﻭﺿﺤﺖ ﺍﻷﲝﺎﺙ ﻭﺟﻮﺩ ﻋﻼﻗﺔ ﻗﻮﻳﺔ ﺑﲔ ﺃﳕﺎﻁ ﺍﻹﳒﺎﺏ ﻟﻸﻣﻬﺎﺕ ﻭﺍﺣﺘﻤﺎﻟﻴﺔ ﺍﻟﺒﻘﺎﺀ‬
‫ﻋﻠﻲ ﻗﻴﺪ ﺍﳊﻴﺎﺓ‪ .‬ﻭﺗﺰﺩﺍﺩ ﺧﻄﻮﺭﺓ ﺍﻟﻮﻓﺎﺓ ﰲ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ ﳌﻮﺍﻟﻴﺪ ﺍﻷﻣﻬﺎﺕ ﺍﻟﺼﻐﲑﺍﺕ ﺟﺪﺍ ﺃﻭ‬
‫ﺍﻟﻜﺒﲑﺍﺕ ﺟﺪﺍ ﰲ ﺍﻟﺴﻦ )ﺃﻗﻞ ﻣﻦ ‪ ١٨‬ﻭﺃﻛﱪ ﻣﻦ ‪ ٣٤‬ﺳﻨﺔ( ﻭﻟﻸﻃﻔﺎﻝ ﺍﳌﻮﻟﻮﺩﻳﻦ ﺑﻌﺪ ﻓﺘﺮﺓ ﻣﺒﺎﻋﺪﺓ ﻗﺼﲑﺓ‬
‫)ﺃﻗﻞ ﻣﻦ ‪ ٢٤‬ﺷﻬﺮﺍ ﻣﻦ ﺍﻟﻮﻻﺩﺓ ﺍﻟﺴﺎﺑﻘﺔ( ﻭﺫﻭﻱ ﺍﻟﺘﺮﺗﻴﺐ ﺍﻟﻌﺎﱄ )ﺍﻟﺘﺮﺗﻴﺐ ﺍﻟﺮﺍﺑﻊ ﺃﻭ ﺃﻋﻠﻲ(ﻋﻨﺪ ﺍﻹﳒﺎﺏ‪.‬‬
‫ﻛﻤﺎ ﺗﺒﻠﻎ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﻮﻓﻴﺎﺕ ﺃﺩﻧﺎﻫﺎ ﻟﻠﻤﻮﺍﻟﻴﺪ ﻷﻣﻬﺎﺕ ﺃﻋﻤﺎﺭﻫﻦ ﺑﲔ ‪ ٢٩-٢٠‬ﺳﻨﺔ‪ .‬ﻭﺗﺸﲑ ﻧﺘﺎﺋﺞ ﺍﳌﺴﺢ‬
‫ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ‪ ٢٠٠٠‬ﺇﱃ ﺃﻥ ‪ %٤٨‬ﻣﻦ ﺍﳌﻮﺍﻟﻴﺪ ﰲ ﺍﳋﻤﺲ ﺳﻨﻮﺍﺕ ﺍﻟﺴﺎﺑﻘﺔ ﻋﻠﻰ ﺍﳌﺴﺢ ﻛﺎﻧﻮﺍ ﰲ‬
‫ﻓﺌﺔ ﻭﺍﺣﺪﺓ ﻋﻠﻰ ﺍﻷﻗﻞ ﻣﻦ ﻓﺌﺎﺕ ﺍﳋﻄﺮ ﺍﻟﻌﺎﱄ ﺍﶈﺪﺩﺓ ﻭ‪ %١٥‬ﻛﺎﻧﻮﺍ ﻋﺮﺿﺔ ﻟﻌﺎﻣﻠﲔ ﺃﻭ ﺃﻛﺜﺮ ﻣﻦ ﻋﻮﺍﻣﻞ‬
‫ﺍﳋﻄﺮ ﺍﻟﻌﺎﱄ‪ .‬ﻛﺬﻟﻚ ﺗﻌﺘﱪ ﻗﺼﺮ ﺍﻟﻔﺘﺮﺓ ﺑﲔ ﺍﳌﻮﺍﻟﻴﺪ ﻭﺗﺮﺗﻴﺐ ﺍﳌﻮﻟﻮﺩ ﺍﻷﻋﻠﻰ ﺃﻛﺜﺮ ﻋﻮﺍﻣﻞ ﺍﳋﻄﺮ ﺍﳌﺮﺗﻔﻊ‬
‫ﺍﻟﺸﺎﺋﻌﺔ‪ .‬ﻭﻳﺼﻞ ﺧﻄﺮ ﺍﻟﻮﻓﺎﺓ ﻟﻠﻄﻔﻞ ﺍﻟﺬﻱ ﻳﻘﻊ ﰲ ﺃﻱ ﻓﺌﺔ ﻣﻦ ﻓﺌﺎﺕ ﺍﳋﻄﺮ ﺍﻟﻌﺎﱄ ﺇﱃ ‪ ١،٩‬ﻣﺮﺓ ﳋﻄﺮ‬

‫‪٢٠٧‬‬
‫ﺍﻟﻄﻔﻞ ﺍﻟﺬﻱ ﻻ ﻳﻘﻊ ﰲ ﺃﻱ ﻓﺌﺔ ﻣﻦ ﻓﺌﺎﺕ ﺍﳋﻄﺮ ﺍﻟﻌﺎﱄ‪ .‬ﻭﺑﺼﻔﺔ ﻋﺎﻣﺔ‪ ،‬ﻓﺈﻥ ﻏﺎﻟﺒﻴﺔ ﺍﻟﺴﻴﺪﺍﺕ‬
‫ﺍﳌﺘﺰﻭﺟﺎﺕ ﺣﺎﻟﻴﺎ )‪ (%٧٦‬ﻟﺪﻳﻬﻦ ﻣﻘﻮﻣﺎﺕ ﺇﳒﺎﺏ ﻃﻔﻞ ﺑﻨﺴﺐ ﳐﺎﻃﺮ ﻋﺎﻟﻴﺔ ﻟﻠﻮﻓﺎﺓ‪ .‬ﻓﺤﻮﺍﱄ ﺳﻴﺪﺓ‬
‫ﻭﺍﺣﺪﺓ ﻣﻦ ﺑﲔ ﻛﻞ ﺛﻼﺙ ﺳﻴﺪﺍﺕ ﳝﻜﻦ ﺃﻥ ﺗﻨﺠﺐ ﻃﻔﻼ ﺑﻔﺌﺔ ﺧﻄﺮ ﻭﺍﺣﺪﺓ ﻣﺮﺗﻔﻌﺔ )ﺃﺳﺎﺳﺎ ﺗﺮﺗﻴﺐ‬
‫ﺃﻋﻠﻲ ﻟﻠﻤﻮﻟﻮﺩ( ﺑﻴﻨﻤﺎ ﺣﻮﺍﱄ ﺳﻴﺪﺓ ﻭﺍﺣﺪﺓ ﻣﻦ ﺑﲔ ﻛﻞ ﲦﺎﱐ ﺳﻴﺪﺍﺕ ﳝﻜﻦ ﺃﻥ ﺗﻨﺠﺐ ﻃﻔﻼ ﺑﻔﺌﺔ‬
‫ﳐﺎﻃﺮ ﻣﺘﻌﺪﺩﺓ )ﺃﺳﺎﺳﺎ ﻛﱪ ﺍﻟﻌﻤﺮ ﻋﻨﺪ ﺍﻹﳒﺎﺏ ﻭﺍﻟﺘﺮﺗﻴﺐ ﺍﻟﻌﺎﱄ ﻟﻠﻤﻮﻟﻮﺩ(‪.‬‬

‫ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﻭﺍﻷﻏﺬﻳﺔ ﺍﳌﻜﻤﻠﺔ‬

‫ﺇﻥ ﳕﻂ ﺗﻐﺬﻳﺔ ﺍﻟﺮﺿﻊ ﻟﻪ ﺗﺄﺛﲑ ﻫﺎﻡ ﻋﻠﻲ ﺻﺤﺔ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻛﺬﻟﻚ ﺗﻌﺘﱪ ﺍﻟﻌﺎﺩﺍﺕ ﺍﻟﻐﺬﺍﺋﻴﺔ ﺍﶈﺪﺩ‬
‫ﺍﻟﺮﺋﻴﺴﻲ ﻟﻠﺤﺎﻟﺔ ﺍﻟﺘﻐﺬﻭﻳﺔ ﻟﻸﻃﻔﺎﻝ ﺍﻟﺼﻐﺎﺭ‪ ،‬ﻓﻠﻘﺪ ﺛﺒﺖ ﺃﻥ ﺳﻮﺀ ﺍﳊﺎﻟﺔ ﺍﻟﻐﺬﺍﺋﻴﺔ ﺗﺰﻳﺪ ﻣﻦ ﳐﺎﻃﺮ‬
‫ﺍﻟﺘﻌﺮﺽ ﻟﻠﻤﺮﺽ ﻭﺍﻟﻮﻓﺎﺓ ﺑﲔ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻛﻤﺎ ﺃﻥ ﳑﺎﺭﺳﺔ ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﳍﺎ ﺗﺄﺛﲑ ﻋﻠﻲ ﺧﺼﻮﺑﺔ‬
‫ﺍﻷﻡ‪.‬‬
‫ﺃﻭﺿﺤﺖ ﻧﺘﺎﺋﺞ ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ‪ -‬ﻣﺼﺮ ‪ ٢٠٠٠‬ﺃﻧﻪ ﰎ ﻭﺿﻊ ‪ %٥٧‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻋﻠﻲ ﺛﺪﻱ ﺍﻷﻡ‬
‫ﺧﻼﻝ ﺳﺎﻋﺔ ﻣﻦ ﺍﻟﻮﻻﺩﺓ ﻭ‪ %٨٨‬ﺭﺿﻌﻮﺍ ﺭﺿﺎﻋﺔ ﻃﺒﻴﻌﻴﺔ ﺧﻼﻝ ﺍﻟﻴﻮﻡ ﺍﻷﻭﻝ‪ .‬ﻛﻤﺎ ﺃﻥ ‪ %٥٤‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻗﺪ‬
‫ﺗﻨﺎﻭﻟﻮﺍ ﺃﻏﺬﻳﺔ ﻗﺒﻞ ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﻭﺫﻟﻚ ﺧﻼﻝ ﺍﻟﺜﻼﺛﺔ ﺃﻳﺎﻡ ﺍﻷﻭﱄ ﺑﻌﺪ ﺍﳌﻴﻼﺩ‪.‬‬
‫ﺗﻌﺘﱪ ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﺍﳌﻄﻠﻘﺔ ﻟﻴﺴﺖ ﻇﺎﻫﺮﺓ ﻋﺎﻣﺔ ﰲ ﺍﻟﻄﻔﻮﻟﺔ ﺍﳌﺒﻜﺮﺓ ﰲ ﻣﺼﺮ‪ ،‬ﻓﺈﻥ ﻗﻠﺔ ﻣﻦ‬
‫ﺍﻷﻃﻔﺎﻝ ﻳﺮﺿﻌﻮﻥ ﺭﺿﺎﻋﺔ ﻃﺒﻴﻌﻴﺔ ﻣﻄﻠﻘﺔ ﺧﻼﻝ ﺍﻟﺴﺘﺔ ﺃﺷﻬﺮ ﺍﻷﻭﱄ ﻣﻦ ﺍﻟﻌﻤﺮ‪ .‬ﻓﻘﺪ ﻭﺟﺪ ﺃﻥ ‪%٧٩‬‬
‫ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ ﻭﻋﻤﺮﻫﻢ ﺃﻗﻞ ﻣﻦ ﺷﻬﺮﻳﻦ ﻳﺘﻨﺎﻭﻟﻮﻥ ﻟﱭ ﺍﻟﺜﺪﻱ ﻓﻘﻂ‪ .‬ﰒ ﺗﻨﺨﻔﺾ ﻧﺴﺒﺔ ﻣﻦ‬
‫ﻳﺮﺿﻌﻮﻥ ﺭﺿﺎﻋﺔ ﻃﺒﻴﻌﻴﺔ ﻣﻄﻠﻘﺔ ﺇﱄ ‪ %٦٠‬ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﻋﻨﺪ ﺍﻟﻌﻤﺮ ‪ ٣-٢‬ﺃﺷﻬﺮ ﻭ‪ %٣٤‬ﺑﲔ ﺍﻷﻃﻔﺎﻝ‬
‫ﻋﻨﺪ ﺍﻟﻌﻤﺮ ‪ ٥-٤‬ﺃﺷﻬﺮ‪ .‬ﻭﻣﻊ ﺫﻟﻚ ﻓﻌﻨﺪ ﺍﻟﻌﻤﺮ ﻣﻦ ‪ ٩-٨‬ﺷﻬﻮﺭ ﻓﺈﻥ ﺣﻮﺍﱄ ﻭﺍﺣﺪ ﻣﻦ ﺑﲔ ﻛﻞ ﺳﺘﺔ‬
‫ﺃﻃﻔﺎﻝ ﱂ ﻳﺘﻨﺎﻭﻝ ﺃﻱ ﺃﻏﺬﻳﺔ ﺻﻠﺒﺔ ﺃﻭ ﺷﺒﻪ ﺻﻠﺒﺔ ﺃﻭ ﻟﱭ ﺁﺧﺮ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﻟﱭ ﺍﻟﺜﺪﻱ‪ .‬ﻭﻋﻨﺪ ﺍﻟﻌﻤﺮ ﻣﻦ‬
‫‪ ١١-١٠‬ﺷﻬﺮﺍ‪ ،‬ﻓﺈﻥ ﻭﺍﺣﺪﺍ ﻣﻦ ﺑﲔ ﻛﻞ ﻋﺸﺮﺓ ﺃﻃﻔﺎﻝ ﱂ ﻳﺘﻨﺎﻭﻝ ﺃﻱ ﺃﻏﺬﻳﺔ ﺃﺧﺮﻱ ﺃﻭ ﻟﱭ‪ .‬ﻭﻗﺪ ﻭﺟﺪ ﺃﻥ‬
‫ﺃﻛﺜﺮ ﻣﻦ ‪ %٨٠‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻌﻤﺮ ‪ ١٣-١٢‬ﺷﻬﺮﺍﹰ ﻳﺮﺿﻌﻮﻥ ﺭﺿﺎﻋﺔ ﻃﺒﻴﻌﻴﺔ ﻭﺣﻮﺍﱄ ﻧﺼﻒ ﺍﻷﻃﻔﺎﻝ‬
‫ﰲ ﺍﻟﻌﻤﺮ ‪ ١٩-١٨‬ﺷﻬﺮﺍ ﻣﺴﺘﻤﺮﻭﻥ ﰲ ﺍﻟﺮﺿﺎﻋﺔ‪ .‬ﻭﻗﺪ ﻭﺟﺪ ﺃﻥ ﺃﻗﻞ ﻣﻦ ﻭﺍﺣﺪ ﻣﻦ ﺑﲔ ﻛﻞ ﺳﺘﺔ ﺃﻃﻔﺎﻝ‬
‫ﻻﺯﺍﻟﻮﺍ ﻳﺮﺿﻌﻮﻥ ﻣﻦ ﺍﻟﺜﺪﻱ ﰲ ﺍﻟﻌﻤﺮ ‪ ٢٥-٢٤‬ﺷﻬﺮﺍ‪.‬‬

‫ﻧﻘﺺ ﻭﺯﻥ ﺍﳌﻮﺍﻟﻴﺪ‬

‫ﻳﻌﺮﻑ ﻭﺯﻥ ﺍﻟﻮﻻﺩﺓ ﺍﳌﻨﺨﻔﺾ ﺑﺎﻟﻮﺯﻥ ﻋﻨﺪ ﺍﻟﻮﻻﺩﺓ ﺃﻗﻞ ﻣﻦ ‪ ٢٥٠٠‬ﺟﻢ ﺑﺼﺮﻑ ﺍﻟﻨﻈﺮ ﻋﻦ ﻋﻤﺮ ﺍﳊﻤﻞ‪.‬‬
‫ﻭﻳﻌﺪ ﻭﺯﻥ ﺍﻟﻮﻻﺩﺓ ﺍﳌﻨﺨﻔﺾ ﺃﺣﺪ ﺍﶈﺪﺩﺍﺕ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻠﺤﻔﺎﻅ ﻋﻠﻲ ﺣﻴﺎﺓ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ ﰲ ﺍﻟﺸﻬﺮ‬
‫ﺍﻷﻭﻝ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ ﻭﳌﺮﺍﺿﺘﻪ ﺑﻌﺪ ﺫﻟﻚ‪ .‬ﰲ ﺍﳌﺪﺓ ﻣﻦ ‪ ،١٩٩٧-١٩٩٥‬ﺃﺟﺮﻳﺖ ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ ﻟﺪﺭﺍﺳﺔ‬
‫ﻣﺸﻜﻠﺔ ﻭﺯﻥ ﺍﻟﻮﻻﺩﺓ ﺍﳌﻨﺨﻔﺾ ﰲ ﻣﺼﺮ‪ .‬ﻭﻗﺪ ﴰﻠﺖ ﻋﻴﻨﺔ ﺍﻟﺒﺤﺚ ﳏﺎﻓﻈﺎﺕ ﲨﻬﻮﺭﻳﺔ ﻣﺼﺮ‬
‫ﺑﺎﺳﺘﺜﻨﺎﺀ ﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ‪ .‬ﻭﻗﺪ ﺳﺠﻠﺖ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ ﻣﻌﺪﻝ ﻭﻻﺩﺓ ﺃﻃﻔﺎﻝ ﻧﺎﻗﺼﻲ ﺍﻟﻮﺯﻥ ﺑﲔ ﺍﳌﻮﺍﻟﻴﺪ‬
‫ﺍﻷﺣﻴﺎﺀ ﻫﻮ ‪ %١٢,٩‬ﻭﻳﺘﺮﺍﻭﺡ ﻫﺬﺍ ﺍﳌﻌﺪﻝ ﺑﲔ ‪ %٧,٤‬ﰲ ﺑﻮﺭﺳﻌﻴﺪ ﻭ‪ %٨,١‬ﰲ ﺍﻟﺒﺤﲑﺓ ﻟﻴﺼﻞ ﺇﱄ ‪ %١٤,٤‬ﰲ‬
‫ﺍﻟﺪﻗﻬﻠﻴﺔ ﻭ‪ %١٧,١‬ﰲ ﺍﻟﻘﺎﻫﺮﺓ‪ .‬ﻭﺗﻌﺘﱪ ﻫﺬﻩ ﺍﳌﻌﺪﻻﺕ ﻋﺎﻟﻴﺔ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺎﳌﻘﺎﻳﻴﺲ ﺍﻟﻌﺎﳌﻴﺔ‪ ،‬ﺣﻴﺚ ﺇﻥ ﻫﺬﺍ‬

‫‪٢٠٨‬‬
‫ﺍﳌﻌﺪﻝ ﳚﺐ ﺃﻥ ﻳﻘﻞ ﻋﻦ ‪ .%١٠‬ﻛﻤﺎ ﺃﻇﻬﺮﺕ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ ‪ %٣١,٦‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻧﺎﻗﺼﻲ ﺍﻟﻮﺯﻥ ﻛﺎﻧﻮﺍ ﰲ‬
‫ﺍﺣﺘﻴﺎﺝ ﻟﺪﺧﻮﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﳌﺮﻛﺰﺓ ﻭﺃﻥ ﻧﺴﺒﺔ ﺍﻟﻮﻓﺎﺓ ﺑﻴﻨﻬﻢ ﻭﺻﻠﺖ ﺇﱄ ‪.%٢‬‬

‫ﻣﻘﺎﻳﻴﺲ ﺍﳊﺎﻟﺔ ﺍﻟﻐﺬﺍﺋﻴﺔ‬

‫ﻫﻨﺎﻙ ﺛﻼﺙ ﻣﺆﺷﺮﺍﺕ ﻗﻴﺎﺳﻴﺔ ﻟﻠﻨﻤﻮ ﺍﻟﻄﺒﻴﻌﻲ ﳝﻜﻦ ﻣﻦ ﺧﻼﳍﺎ ﺗﺼﻨﻴﻒ ﺍﳊﺎﻟﺔ ﺍﻟﻐﺬﺍﺋﻴﺔ ﻟﻸﻃﻔﺎﻝ‬
‫ﺍﻟﻄﻮﻝ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﻤﺮ‪.‬‬ ‫
‬
‫ﺍﻟﻮﺯﻥ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻄﻮﻝ‪.‬‬ ‫
‬
‫ﺍﻟﻮﺯﻥ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﻤﺮ‪.‬‬ ‫
‬
‫ﻳﻘﻴﺲ ﻛﻞ ﻣﺆﺷﺮ ﻣﻦ ﻫﺬﻩ ﺍﳌﺆﺷﺮﺍﺕ ﻣﻔﺎﻫﻴﻢ ﳐﺘﻠﻔﺔ ﻟﻠﺤﺎﻟﺔ ﺍﻟﻐﺬﺍﺋﻴﺔ‪ .‬ﻓﻤﻘﻴﺎﺱ ﺍﻟﻄﻮﻝ ﺑﺎﻟﻨﺴﺒﺔ‬
‫ﻟﻠﻌﻤﺮ ﻫﻮ ﻣﺆﺷﺮ ﻟﻠﻘﺼﻮﺭ ﻋﻦ ﺧﻂ ﺍﻟﻨﻤﻮ )ﺍﻟﺘﻘﺰﻡ(‪ .‬ﻭﺍﻟﺘﻘﺰﻡ ﰲ ﳕﻮ ﺍﻷﻃﻔﺎﻝ ﻳﻜﻮﻥ ﻧﺘﻴﺠﺔ ﻟﻌﺪﻡ‬
‫ﺣﺼﻮﻝ ﺍﻟﻄﻔﻞ ﻋﻠﻲ ﺍﻟﻐﺬﺍﺀ ﺍﳌﺘﻮﺍﺯﻥ ﳌﺪﺓ ﺯﻣﻨﻴﺔ ﻃﻮﻳﻠﺔ ﺃﻭ ﻧﺘﻴﺠﺔ ﻟﺘﻜﺮﺍﺭ ﺍﻟﻌﺪﻭﻯ ﺃﻭ ﺍﻹﺻﺎﺑﺔ ﲟﺮﺽ‬
‫ﻣﺰﻣﻦ‪ .‬ﻭﺑﺎﻟﺘﺎﱄ ﻓﺈﻥ ﻣﻘﻴﺎﺱ ﺍﻟﻄﻮﻝ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﻤﺮ ﳝﺜﻞ ﻧﺎﺗﺞ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﰲ ﳎﺘﻤﻊ ﻋﻠﻲ ﻣﺪﺍﺭ‬
‫ﻓﺘﺮﺓ ﺯﻣﻨﻴﺔ ﻃﻮﻳﻠﺔ ﻭﻻ ﻳﺘﻐﲑ ﻛﺜﲑﺍ ﺣﺴﺐ ﻓﺼﻞ ﲨﻊ ﺍﻟﺒﻴﺎﻧﺎﺕ‪ .‬ﺃﻣﺎ ﻣﻘﻴﺎﺱ ﺍﻟﻮﺯﻥ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻄﻮﻝ‬
‫ﻳﻘﻴﺲ ﻛﺘﻠﺔ ﺍﳉﺴﻢ ﻭﻋﻼﻗﺘﻬﺎ ﺑﺎﻟﻄﻮﻝ‪ .‬ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﺗﻜﻮﻥ ﻣﻘﺎﻳﻴﺲ ﺍﻟﻮﺯﻥ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻄﻮﻝ ﺃﻗﻞ ﻣﻦ‬
‫ﻭﺳﻴﻂ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺮﺟﻌﻲ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﳓﺎﻓﺔ‪ .‬ﻭﺗﻨﺘﺞ ﻫﺬﻩ ﺍﻟﻨﺤﺎﻓﺔ ﻋﻦ ﻓﺸﻞ ﺣﺼﻮﻝ ﺍﻟﻄﻔﻞ ﻋﻠﻲ‬
‫ﺍﻟﻐﺬﺍﺀ ﺍﻟﻜﺎﰲ ﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ ﺍﻟﺴﺎﺑﻘﺔ ﻣﺒﺎﺷﺮﺓ ﻟﻠﻤﺴﺢ ﻭﺍﻟﱵ ﺗﻜﻮﻥ ﻧﺘﻴﺠﺔ ﻹﺻﺎﺑﺔ ﺍﻟﻄﻔﻞ ﺑﺴﻠﺴﻠﺔ‬
‫ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﻌﺎﻗﺒﺔ ﺃﻭ ﺑﺴﺒﺐ ﻧﻘﺺ ﺗﻮﺍﻓﺮ ﺍﻟﻐﺬﺍﺀ‪ .‬ﻭﻳﻌﺘﱪ ﻣﻘﻴﺎﺱ ﺍﻟﻮﺯﻥ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﻤﺮ ﻣﺆﺷﺮﺍ‬
‫ﻣﺮﻛﺒﺎ ﻟﻜﻞ ﻣﻦ ﺍﻟﻄﻮﻝ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﻤﺮ ﻭﺍﻟﻮﺯﻥ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻄﻮﻝ‪ .‬ﻭﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﻳﻜﻮﻥ ﻣﻘﻴﺎﺱ‬
‫ﻭﺯ‪‬ﻢ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻌﻤﺮﻫﻢ ﺃﻗﻞ ﻣﻦ ﻭﺳﻴﻂ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺮﺟﻌﻲ ﻳﻌﺘﱪﻭﻥ ﻣﺼﺎﺑﲔ ﺑﻨﻘﺺ ﺍﻟﻮﺯﻥ ﺑﺎﻟﻨﺴﺒﺔ‬
‫ﻟﻠﻌﻤﺮ‪ .‬ﻭﳝﻜﻦ ﺃﻥ ﻳﻜﻮﻥ ﺍﻟﻄﻔﻞ ﻧﺎﻗﺺ ﺍﻟﻮﺯﻥ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻌﻤﺮﻩ ﺑﺴﺒﺐ ﺍﻟﺘﻘﺰﻡ )ﻗﺼﺮ ﺍﻟﻘﺎﻣﺔ( ﺃﻭ‬
‫ﺍﻟﻨﺤﺎﻓﺔ ﺃﻭ ﺑﺴﺒﺐ ﺃﻧﻪ ﻗﺼﲑ ﺍﻟﻘﺎﻣﺔ ﻭﳓﻴﻒ ﰲ ﻧﻔﺲ ﺍﻟﻮﻗﺖ‪.‬‬
‫ﻳﺘﻀﺢ ﻣﻦ ﻧﺘﺎﺋﺞ ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ‪ -‬ﻣﺼﺮ ‪ ٢٠٠٠‬ﻭﺟﻮﺩ ﺳﻮﺀ ﺗﻐﺬﻳﺔ ﻣﺰﻣﻦ ﺑﲔ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﳌﺼﺮﻳﲔ‪ .‬ﺑﺼﻔﺔ ﻋﺎﻣﺔ‪ ،‬ﻓﺈﻥ ‪ %١٩‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺳﻦ ﺍﳋﺎﻣﺴﺔ ﻣﻦ ﺍﻟﻌﻤﺮ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺍﻟﺘﻘﺰﻡ )ﻗﺼﺮ‬
‫ﺍﻟﻘﺎﻣﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﻤﺮ( ﻭ‪ %٦‬ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﻗﺼﺮ ﻗﺎﻣﺔ ﺣﺎﺩ‪ .‬ﻭﻫﻨﺎﻙ ﺍﺭﺗﺒﺎﻁ ﺑﲔ ﻋﻤﺮ ﺍﻟﻄﻔﻞ ﻭﺍﻟﺘﻘﺰﻡ‪.‬‬
‫ﻓﻘﺼﺮ ﺍﻟﻘﺎﻣﺔ ﻳﺰﻳﺪ ﺑﺴﺮﻋﺔ ﻣﻊ ﺍﻟﻌﻤﺮ ﻣﻦ ‪ %١١‬ﻓﻘﻂ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﺃﻗﻞ ﻣﻦ ‪ ٦‬ﺃﺷﻬﺮ ﻣﻦ ﺍﻟﻌﻤﺮ ﺇﱄ‬
‫‪ %٢٤‬ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﻣﺎ ﺑﲔ ‪ ٢٣-١٢‬ﺷﻬﺮﺍ‪ ،‬ﻗﺒﻞ ﺃﻥ ﺗﻨﺨﻔﺾ ﺇﱄ ‪ %١٨‬ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﻋﻨﺪ ﺳﻦ ‪ ٤‬ﺳﻨﻮﺍﺕ‬
‫ﻓﺄﻛﱪ‪ .‬ﻛﻤﺎ ﳒﺪ ﺃﻥ ‪ %٣‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﳌﺼﺮﻳﲔ ﻣﺼﺎﺑﻮﻥ ﺑﺎﻟﻨﺤﺎﻓﺔ‪ .‬ﻭﺍﻟﻨﺤﺎﻓﺔ ﺃﻛﺜﺮ ﺍﻧﺘﺸﺎﺭﺍ ﺑﲔ ﺍﻷﻃﻔﺎﻝ‬
‫ﺃﻗﻞ ﻣﻦ ﻋﺎﻣﲔ ﻋﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻷﻛﱪ ﻋﻤﺮﺍ‪ .‬ﻛﺬﻟﻚ ‪ %٤‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺃﻗﻞ ﻣﻦ ‪ ٥‬ﺳﻨﻮﺍﺕ ﻟﺪﻳﻬﻢ ﻧﻘﺺ ﰲ‬
‫ﺍﻟﻮﺯﻥ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﻤﺮ‪.‬‬

‫ﺍﻧﺘﺸﺎﺭ ﺍﻷﻧﻴﻤﻴﺎ ﺑﲔ ﺍﻷﻃﻔﺎﻝ‬

‫ﺻﻐﺎﺭ ﺍﻷﻃﻔﺎﻝ )‪ ٥٩-٦‬ﺷﻬﺮﺍﹰ(‪ :‬ﺑﺼﻔﺔ ﻋﺎﻣﺔ‪ ،‬ﻳﻌﺎﱐ ﺛﻼﺛﺔ ﻣﻦ ﺑﲔ ﻛﻞ ﻋﺸﺮﺓ ﺃﻃﻔﺎﻝ ﻣﻦ ﺩﺭﺟﺔ ﻣﺎ ﻣﻦ‬
‫ﺍﻷﻧﻴﻤﻴﺎ‪ .‬ﺗﻌﺘﱪ ﺍﻷﻧﻴﻤﻴﺎ ﺑﺴﻴﻄﺔ ﰲ ﺣﺎﻻﺕ ﻋﺪﻳﺪﺓ‪ .‬ﻓﻘﺪ ﻭﺟﺪ ﺃﻥ ‪ %١١‬ﻣﻦ ﺻﻐﺎﺭ ﺍﻷﻃﻔﺎﻝ ﻟﺪﻳﻬﻢ ﺃﻧﻴﻤﻴﺎ‬
‫ﻣﺘﻮﺳﻄﺔ )‪ ٩،٩-٧‬ﺟﻢ‪ /‬ﺩﻳﺴﻴﻠﺘﺮ( ﻭﻧﺴﺒﺔ ﺻﻐﲑﺓ )ﺃﻗﹲﻞ ﻣﻦ ‪ (%١‬ﰎ ﺗﺼﻨﻴﻔﻬﻢ ﺑﺄﻥ ﻟﺪﻳﻬﻢ ﺃﻧﻴﻤﻴﺎ‬

‫‪٢٠٩‬‬
‫ﺣﺎﺩﺓ )ﺃﻗﻞ ﻣﻦ ‪ ٧‬ﺟﻢ‪ /‬ﺩﻳﺴﻴﻠﺘﺮ( )ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ‪ -‬ﻣﺼﺮ ‪ .(٢٠٠٠‬ﻭﻳﺰﺩﺍﺩ ﺍﺣﺘﻤﺎﻝ ﺇﺻﺎﺑﺔ‬
‫ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﻟﺜﺎﻧﻴﺔ ﻣﻦ ﺍﻟﻌﻤﺮ ﺑﺎﻷﻧﻴﻤﻴﺎ ﻋﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻷﻛﱪ ﻋﻤﺮﺍ‪ .‬ﻛﻤﺎ ﺗﺰﺩﺍﺩ ﺍﺣﺘﻤﺎﻝ ﺇﺻﺎﺑﺔ ﺍﻷﻃﻔﺎﻝ‬
‫ﰲ ﺍﻟﺮﻳﻒ ﺑﺎﻷﻧﻴﻤﻴﺎ ﻋﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﳊﻀﺮ )‪ %٣٤‬ﻭ‪ %٢٤‬ﻋﻠﻲ ﺍﻟﺘﺮﺗﻴﺐ( ﻭﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ ﻭﳏﺎﻓﻈﺎﺕ‬
‫ﺍﳊﺪﻭﺩ )‪.(%٣٨‬‬
‫ﺍﻷﻃﻔﺎﻝ )‪ ١٩-١١‬ﺳﻨﺔ(‪ :‬ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻓﺈﻥ ﺣﻮﺍﱄ ﺛﻼﺛﺔ ﻣﻦ ﺑﲔ ﻋﺸﺮﺓ ﺃﻓﺮﺍﺩ ﰲ ﺍﻟﻌﻤﺮ ‪ ١٩-١١‬ﻟﺪﻳﻬﻢ‬
‫ﺃﻧﻴﻤﻴﺎ‪ .‬ﻭﺗﻌﺘﱪ ﺍﻷﻧﻴﻤﻴﺎ ﻟﺪﻯ ﺍﻟﻐﺎﻟﺒﻴﺔ ﻣﻨﻬﻢ ﺑﺴﻴﻄﺔ ﺑﻴﻨﻤﺎ ﰎ ﺗﺼﻨﻴﻒ ‪ %٢‬ﺑﺄﻥ ﻟﺪﻳﻬﻢ ﺃﻧﻴﻤﻴﺎ‬
‫ﻣﺘﻮﺳﻄﺔ ﻭﻧﺴﺒﺔ ﻗﻠﻴﻠﺔ ﺟﺪﺍ ﻛﺎﻧﺖ ﻟﺪﻳﻬﻢ ﺃﻧﻴﻤﻴﺎ ﺣﺎﺩﺓ‪.‬‬

‫ﻓﻴﺘﺎﻣﲔ "ﺃ" ﺍﻟﺘﻜﻤﻴﻠﻲ‬

‫ﺗﺘﺒﲎ ﻣﺼﺮ ﺑﺮﻧﺎﳎﺎ ﻟﻔﻴﺘﺎﻣﲔ "ﺃ" ﺍﻟﺘﻜﻤﻴﻠﻲ ﻟﻜﻞ ﻣﻦ ﺍﻷﻣﻬﺎﺕ ﺍﳉﺪﺩ ﻭﻟﻸﻃﻔﺎﻝ ﺍﺑﺘﺪﺍﺀ ﻣﻦ ﻋﻤﺮ ‪٩‬‬
‫ﺷﻬﻮﺭ‪ .‬ﻭﻳﺸﺘﻤﻞ ﺍﻟﱪﻧﺎﻣﺞ ﻋﻠﻲ ﻋﻨﺼﺮﻳﻦ‪ .‬ﺃﻭﻻ‪ ،‬ﻳﺘﻢ ﺇﻋﻄﺎﺀ ﻛﺒﺴﻮﻟﺔ ﻓﻴﺘﺎﻣﲔ "ﺃ" ﻟﻸﻣﻬﺎﺕ ﺧﻼﻝ‬
‫ﺍﻟﺸﻬﺮﻳﻦ ﺍﻷﻭﻟﲔ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ ‪‬ﺪﻑ ﺣﺼﻮﻝ ﺍﻟﺮﺿﻴﻊ ﻋﻠﻲ ﻛﻤﻴﺔ ﻛﺎﻓﻴﺔ ﻣﻦ ﺍﻟﻌﻨﺎﺻﺮ ﺍﻟﻐﺬﺍﺋﻴﺔ‬
‫ﺍﻟﺪﻗﻴﻘﺔ ﻟﻀﻤﺎﻥ ﺍﻟﻨﻤﻮ ﺍﻟﺴﻠﻴﻢ ﻣﻦ ﺧﻼﻝ ﻟﱭ ﺍﻷﻡ‪ .‬ﺛﺎﻧﻴﺎ‪ ،‬ﺍﺑﺘﺪﺍﺀ ﻣﻦ ﺍﻟﺸﻬﺮ ﺍﻟﺘﺎﺳﻊ ﻟﻠﻄﻔﻞ )ﺍﻟﻮﻗﺖ‬
‫ﺍﻟﺬﻱ ﻳﺘﻢ ﻓﻴﻪ ﻋﺎﺩﺓ ﺃﺧﺬ ﺗﻄﻌﻴﻢ ﺍﳊﺼﺒﺔ( ﻳﺘﻢ ﺇﻋﻄﺎﺀ ﺍﻟﻄﻔﻞ ﻛﺒﺴﻮﻟﺔ ﻓﻴﺘﺎﻣﲔ "ﺃ" )‪ ١٠٠٠٠٠‬ﻭﺣﺪﺓ‬
‫ﺩﻭﻟﻴﺔ( ﻛﻤﺎ ﻳﺘﻢ ﺇﻋﻄﺎﺀ ﺍﻟﻄﻔﻞ ﻛﺒﺴﻮﻟﺘﲔ ﺇﺿﺎﻓﻴﺘﲔ )‪ ٢٠٠٠٠٠‬ﻭﺣﺪﺓ( ﰲ ﺍﻟﻌﻤﺮ ‪ ١٨‬ﺷﻬﺮﺍﹰ ﻣﻊ ﺍﳉﺮﻋﺔ‬
‫ﺍﳌﻨﺸﻄﺔ ﻟﻠﺸﻠﻞ‪ .‬ﺗﺒﲔ ﻣﻦ ﺧﻼﻝ ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ‪ -‬ﻣﺼﺮ ‪ ٢٠٠٠‬ﺃﻥ ‪ %١١‬ﻓﻘﻂ ﻣﻦ ﺍﻷﻣﻬﺎﺕ‬
‫ﺣﺼﻠﻦ ﻋﻠﻲ ﻓﻴﺘﺎﻣﲔ "ﺃ" ﺍﻟﺘﻜﻤﻴﻠﻲ ﰲ ﺍﻟﻔﺘﺮﺓ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ‪ .‬ﻛﻤﺎ ﺣﺼﻞ ﺣﻮﺍﱄ ﲬﺲ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﳌﺼﺮﻳﲔ ﻋﻠﻲ ﺍﻷﻗﻞ ﻋﻠﻲ ﻛﺒﺴﻮﻟﺔ ﻭﺍﺣﺪﺓ ﻣﻦ ﻓﻴﺘﺎﻣﲔ "ﺃ"‪.‬‬

‫ﺍﺳﺘﺨﺪﺍﻡ ﺍﳌﻠﺢ ﺍﳌﻌﺎﰿ ﺑﺎﻟﻴﻮﺩ‬

‫ﻟﻘﺪ ﺗﺒﻨﺖ ﻣﺼﺮ ﺑﺮﻧﺎﳎﺎ ﳌﻌﺎﳉﺔ ﺍﳌﻠﺢ ﺑﺎﻟﻴﻮﺩ ﻟﻠﺘﻐﻠﺐ ﻋﻠﻲ ﻧﻘﺺ ﺍﻟﻴﻮﺩ ﺑﺎﳉﺴﻢ‪ .‬ﺑﺼﻔﺔ ﻋﺎﻣﺔ‪ ،‬ﻓﺈﻥ‬
‫‪ %٥٦‬ﻣﻦ ﺍﻷﺳﺮ ﺗﺴﺘﺨﺪﻡ ﺍﳌﻠﺢ ﺍﳌﻌﺎﰿ ﺑﺎﻟﻴﻮﺩ‪ ،‬ﺑﻴﻨﻤﺎ ﺍﳌﻠﺢ ﺍﳌﺴﺘﺨﺪﻡ ﰲ ‪ %٤٤‬ﻣﻦ ﺍﻷﺳﺮ ﱂ ﻳﻜﻦ‬
‫ﳛﺘﻮﻱ ﻋﻠﻲ ﺍﻟﻴﻮﺩ‪ .‬ﻛﻤﺎ ﻭﺟﺪ ﺃﻥ ﺍﻷﺳﺮ ﺍﳌﻌﻴﺸﻴﺔ ﰲ ﺍﳊﻀﺮ ﺃﻛﺜﺮ ﺍﺳﺘﺨﺪﺍﻣﺎ ﳌﻠﺢ ﳝﻜﻦ ﺍﻋﺘﺒﺎﺭﻩ ﻣﻌﺎﰿ‬
‫ﺑﻨﺴﺒﺔ ﻛﺎﻓﻴﺔ ﻣﻦ ﺍﻟﻴﻮﺩ ﻋﻦ ﺍﻷﺳﺮ ﺍﳌﻌﻴﺸﻴﺔ ﰲ ﺍﻟﺮﻳﻒ‪ ،‬ﺣﻴﺚ ﱂ ﻳﻌﺎﰿ ﺍﳌﻠﺢ ﺑﺎﻟﻴﻮﺩ ﰲ ﺃﻛﺜﺮ ﻗﻠﻴﻼ ﻣﻦ‬
‫ﻧﺼﻒ ﺍﻷﺳﺮ ﺍﳌﻌﻴﺸﻴﺔ ﰲ ﺍﻟﺮﻳﻒ ﻭﺛﻠﺚ ﺍﻷﺳﺮ ﺍﳌﻌﻴﺸﻴﺔ ﰲ ﺍﳊﻀﺮ‪ .‬ﺃﻣﺎ ﺣﺴﺐ ﳏﻞ ﺍﻹﻗﺎﻣﺔ ﻓﺘﺘﺮﺍﻭﺡ‬
‫ﻧﺴﺒﺔ ﺍﻷﺳﺮ ﺍﳌﻌﻴﺸﻴﺔ ﺍﻟﱵ ﺗﺴﺘﺨﺪﻡ ﻣﻠﺤﺎﹰ ﻏﲑ ﻣﻌﺎﰿ ﺑﺎﻟﻴﻮﺩ ﻣﻦ ‪ %٢٢‬ﰲ ﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ ﺇﱄ ‪%٥٧‬‬
‫ﰲ ﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‪.‬‬

‫ﺍﻹﺳﻬﺎﻝ‬
‫ﻳﻌﺘﱪ ﺍﳉﻔﺎﻑ ﺍﻟﻨﺎﺟﻢ ﻋﻦ ﺍﻹﺳﻬﺎﻝ ﺍﳊﺎﺩ ﻣﻦ ﺃﻫﻢ ﺃﺳﺒﺎﺏ ﺍﳌﺮﺽ ﻭﺍﻟﻮﻓﺎﺓ ﺑﲔ ﺻﻐﺎﺭ ﺍﻷﻃﻔﺎﻝ‪ .‬ﺑﲔ‬
‫ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ‪ -‬ﻣﺼﺮ ‪ ٢٠٠٠‬ﺃﻥ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ ﻣﻦ ﺍﻟﻌﻤﺮ ﺍﻟﺬﻳﻦ ﺃﺻﻴﺒﻮﺍ‬
‫ﺑﺎﻹﺳﻬﺎﻝ ﰲ ﺃﻱ ﻭﻗﺖ ﺧﻼﻝ ﻓﺘﺮﺓ ﺍﻷﺳﺒﻮﻋﲔ ﺍﻟﺴﺎﺑﻘﲔ ﻋﻠﻲ ﺍﳌﺴﺢ‪ .‬ﻭﲟﺎ ﺃﻥ ﻫﻨﺎﻙ ﺍﺧﺘﻼﻓﺎﺕ ﻣﻮﲰﻴﺔ‬
‫ﰲ ﺃﳕﺎﻁ ﺍﻹﺻﺎﺑﺔ ﺑﺎﻹﺳﻬﺎﻝ‪ ،‬ﻓﺈﻧﻪ ﳚﺐ ﺗﺬﻛﺮ ﺃﻥ ﻭﻗﺖ ﺇﺟﺮﺍﺀ ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ‪ -‬ﻣﺼﺮ ‪٢٠٠٠‬‬
‫ﻛﺎﻥ ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﺎ ﺑﲔ ﻓﱪﺍﻳﺮ‪-‬ﻣﺎﺭﺱ ‪ .٢٠٠٠‬ﻭﺟﺪ ﺃﻥ ‪ %٧‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ ﻗﺪ ﺃﺻﻴﺒﻮﺍ ﺑﺎﻹﺳﻬﺎﻝ‬
‫ﺧﻼﻝ ﺍﻷﺳﺒﻮﻋﲔ ﺍﻟﺴﺎﺑﻘﲔ ﻋﻠﻲ ﺍﳌﺴﺢ‪ .‬ﻭﻣﻊ ﺍﻷﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺍﻟﺘﺒﺎﻳﻨﺎﺕ ﰲ ﻣﺴﺘﻮﻱ ﺍﻹﺳﻬﺎﻝ ﺣﺴﺐ‬

‫‪٢١٠‬‬
‫ﺍﻟﻌﻤﺮ‪ ،‬ﻓﺈﻥ ﺍﻟﻨﺘﺎﺋﺞ ﺗﻮﺿﺢ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻌﻤﺮ ‪ ٢٣-٦‬ﺷﻬﺮﺍ ﺃﻛﺜﺮ ﻋﺮﺿﺔ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻹﺳﻬﺎﻝ ﻣﻦ‬
‫ﻏﲑﻫﻢ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻷﻛﱪ ﺃﻭ ﺍﻷﺻﻐﺮ ﺳﻨﺎ‪ .‬ﻭﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺨﺼﺎﺋﺺ ﺍﳋﻠﻔﻴﺔ ﺍﻷﺧﺮﻯ‪ ،‬ﻓﻘﺪ ﻟﻮﺣﻆ ﺃﻛﱪ‬
‫ﺗﺒﺎﻳﻦ ﺑﲔ ﺍﳌﻨﺎﻃﻖ ﺍﳉﻐﺮﺍﻓﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ‪ .‬ﺣﻴﺚ ﺗﺘﻔﺎﻭﺕ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﺃﺻﻴﺒﻮﺍ ﺑﺎﻹﺳﻬﺎﻝ ﺧﻼﻝ‬
‫ﻓﺘﺮﺓ ﺍﻷﺳﺒﻮﻋﲔ ﺍﻟﺴﺎﺑﻘﲔ ﻟﻠﻤﺴﺢ ﻣﺎ ﺑﲔ ‪ %٥‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﻭ‪ %١٠‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ‬
‫ﰲ ﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‪ .‬ﻭﻗﺪ ﻭﺟﺪ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﻷﻣﻬﺎﺕ ﻳﻌﻤﻠﻦ ﻣﻘﺎﺑﻞ ﻋﺎﺋﺪ ﻧﻘﺪﻱ )‪ (%٩١‬ﻛﺎﻧﻮﺍ ﺃﻛﺜﺮ‬
‫ﺣﺼﻮﻻ ﻋﻠﻲ ﺭﻋﺎﻳﺔ ﺃﻭ ﻋﻼﺝ ﺧﻼﻝ ﻓﺘﺮﺓ ﺍﻹﺻﺎﺑﺔ ﺑﺎﻹﺳﻬﺎﻝ‪ ،‬ﺑﻴﻨﻤﺎ ﺍﻷﻃﻔﺎﻝ ﺍﳌﻘﻴﻤﻮﻥ ﰲ ﺭﻳﻒ ﺍﻟﻮﺟﻪ‬
‫ﺍﻟﻘﺒﻠﻲ )‪ (%٧٠‬ﻛﺎﻧﻮﺍ ﺃﻗﻞ ﺣﺼﻮﻻ ﻋﻠﻲ ﺭﻋﺎﻳﺔ ﻟﻌﻼﺝ ﺍﻹﺳﻬﺎﻝ‪ .‬ﻭﻗﺪ ﰎ ﺍﳊﺼﻮﻝ ﻋﻠﻲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬
‫ﺃﻛﺜﺮ ﻟﻸﻃﻔﺎﻝ ﺃﻗﻞ ﻣﻦ ﻋﺎﻡ ﻭﺍﻷﻃﻔﺎﻝ ﺍﳌﻘﻴﻤﲔ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‪ .‬ﻭﻛﺎﻥ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﺮﻳﻒ ﺃﻛﺜﺮ‬
‫ﺣﺼﻮﻻ ﻋﻠﻲ ﳏﻠﻮﻝ ﻟﻌﻼﺝ ﺍﳉﻔﺎﻑ ﺃﻭ ﺯﻳﺎﺩﺓ ﺍﻟﺴﻮﺍﺋﻞ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﳊﻀﺮ‪ .‬ﻭﻭﺟﺪ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ‬
‫ﺗﻘﻞ ﺃﻋﻤﺎﺭﻫﻢ ﻋﻦ ﺳﺘﺔ ﺃﺷﻬﺮ ﺃﻭ ﺍﻟﺬﻳﻦ ﻳﻘﻴﻤﻮﻥ ﰲ ﺍﳊﻀﺮ ﺧﺎﺻﺔ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‪ ،‬ﺃﻗﻞ‬
‫ﺍﺣﺘﻤﺎﻻ ﻟﺰﻳﺎﺩﺓ ﺍﻟﺴﻮﺍﺋﻞ ﳍﻢ ﺧﻼﻝ ﻓﺘﺮﺓ ﺇﺻﺎﺑﺘﻬﻢ ﺑﺎﻹﺳﻬﺎﻝ‪ .‬ﻛﻤﺎ ﺃﻥ ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻲ ﺍﳌﻀﺎﺩﺍﺕ ﺍﳊﻴﻮﻳﺔ‬
‫ﺃﻭ ﺃﻱ ﻋﻘﺎﺭ ﺁﺧﺮ ﻟﻌﻼﺝ ﺍﻹﺳﻬﺎﻝ ﺃﻛﺜﺮ ﺷﻴﻮﻋﺎ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻋﻨﻪ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪ .‬ﻋﻠﻤﺎ ﺑﺄﻧﻪ‬
‫ﻻ ﻳﻨﺼﺢ ﺑﺎﺳﺘﺨﺪﺍﻡ ﺍﳌﻀﺎﺩﺍﺕ ﺍﳊﻴﻮﻳﺔ ﻭﻣﻀﺎﺩﺍﺕ ﺍﻹﺳﻬﺎﻝ ﰲ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺼﻐﺎﺭ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺫﻟﻚ‪،‬‬
‫ﺗﺒﲔ ﺍﻟﻨﺘﺎﺋﺞ ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﺃﻧﻪ ﰎ ﺇﻋﻄﺎﺀ ﺍﳌﻀﺎﺩﺍﺕ ﺍﳊﻴﻮﻳﺔ ﻝ ‪ %٢٤‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﳌﺼﺎﺑﲔ ﺑﺎﻹﺳﻬﺎﻝ‬
‫ﺑﻴﻨﻤﺎ ﺗﻠﻘﻲ ‪ %٣١‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻋﻼﺟﺎ ﺁﺧﺮ‪.‬‬

‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﺍﳊﺎﺩﺓ‬

‫ﺗﻌﺘﱪ ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﻭﺧﺼﻮﺻﺎ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﺮﺋﻮﻱ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﺍﻹﺳﻬﺎﻝ‪ ،‬ﻣﻦ ﺍﻷﺳﺒﺎﺏ‬
‫ﺍﻟﺸﺎﺋﻌﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﻭﺻﻐﺎﺭ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻓﺎﻟﺘﺸﺨﻴﺺ ﺍﳌﺒﻜﺮ ﻭﺍﻟﻌﻼﺝ ﺑﺎﳌﻀﺎﺩﺍﺕ ﺍﳊﻴﻮﻳﺔ ﳝﻜﻦ ﺃﻥ‬
‫ﳝﻨﻊ ﻧﺴﺒﺔ ﻛﺒﲑﺓ ﻣﻦ ﺍﻟﻮﻓﻴﺎﺕ ﺑﺴﺒﺐ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﺮﺋﻮﻱ‪ .‬ﰎ ﺗﻘﺪﻳﺮ ﺍﻧﺘﺸﺎﺭ ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ‬
‫ﻟﻸﻃﻔﺎﻝ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ ﺑﺴﻌﺎﻝ ﻣﺼﺤﻮﺏ ﺑﺘﻨﻔﺲ ﻗﺼﲑ ﻭﺳﺮﻳﻊ )ﺃﻋﺮﺍﺽ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﺮﺋﻮﻱ( ﰲ ﻓﺘﺮﺓ‬
‫ﺍﻷﺳﺒﻮﻋﲔ ﺍﻟﺴﺎﺑﻘﲔ ﻋﻠﻲ ﺍﳌﺴﺢ‪ .‬ﻭﺟﺪ ﺃﻥ ﻧﺴﺒﺔ ﺍﻧﺘﺸﺎﺭ ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﻟﻸﻃﻔﺎﻝ ﺩﻭﻥ‬
‫ﺍﳋﺎﻣﺴﺔ ﰲ ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ‪ -‬ﻣﺼﺮ ‪ ٢٠٠٠‬ﻛﺎﻥ ‪ .%١٠‬ﻭﺃﻳﻀﺎ ﻛﻤﺎ ﻫﻮ ﺍﳊﺎﻝ ﰲ ﺃﻣﺮﺍﺽ‬
‫ﺍﻹﺳﻬﺎﻝ‪ ،‬ﺗﺘﻔﺎﻭﺕ ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﺣﺴﺐ ﺍﳌﻮﺳﻢ‪ .‬ﻭﻗﺪ ﻭﺟﺪ ﺃﻥ ﺍﻟﺘﺒﺎﻳﻨﺎﺕ ﰲ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﳌﺼﺎﺑﲔ ﺑﺄﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﺍﳊﺎﺩﺓ ﺻﻐﲑﺓ‪ .‬ﻭﻗﺪ ﻟﻮﺣﻆ ﺃﻛﱪ ﺗﺒﺎﻳﻦ ﺣﺴﺐ ﻋﻤﺮ ﺍﻟﻄﻔﻞ ﺣﻴﺚ ﺇﻥ‬
‫ﺃﻛﱪ ﻧﺴﺒﺔ ﺃﺻﻴﺒﺖ ﻛﺎﻧﺖ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻌﻤﺮ ‪ ٢٣-٦‬ﺷﻬﺮﺍﹰ‪ .‬ﻛﻤﺎ ﺃﻥ ‪ %٦٦‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﳌﺮﺿﻲ ﻗﺪ‬
‫ﺗﻠﻘﻮﺍ ﻧﺼﻴﺤﺔ ﺃﻭ ﻋﻼﺝ ﻣﻦ ﻣﻘﺪﻡ ﺧﺪﻣﺔ ﺻﺤﻲ‪ .‬ﻭﻗﺪ ﰎ ﺍﺳﺘﺸﺎﺭﺓ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ‬
‫ﺃﻛﺜﺮ ﻣﻦ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﰲ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳊﻜﻮﻣﻴﺔ )‪ %٤٣‬ﻭ‪ %٢٥‬ﻋﻠﻲ ﺍﻟﺘﺮﺗﻴﺐ(‪ .‬ﻭﺃﻥ ‪ %٧٥‬ﻣﻦ‬
‫ﺍﻷﻃﻔﺎﻝ ﺍﳌﺼﺎﺑﲔ ﻗﺪ ﰎ ﺍﺳﺘﻌﻤﺎﻝ ﺍﳌﻀﺎﺩﺍﺕ ﺍﳊﻴﻮﻳﺔ ﻟﻌﻼﺟﻬﻢ‪.‬‬

‫ﺗﻄﻌﻴﻤﺎﺕ ﺍﻷﻃﻔﺎﻝ‬
‫ﺗﺒﻨﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﰲ ﻣﺼﺮ ﺇﺭﺷﺎﺩﺍﺕ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ﺍﳋﺎﺻﺔ ﺑﺘﻄﻌﻴﻤﺎﺕ‬
‫ﺍﻟﻄﻔﻮﻟﺔ ﻭﺫﻟﻚ ﺑﺄﻥ ﳛﺼﻞ ﲨﻴﻊ ﺍﻷﻃﻔﺎﻝ ﺧﻼﻝ ﺍﻟﻌﺎﻡ ﺍﻷﻭﻝ ﻣﻦ ﺍﻟﻌﻤﺮ ﻋﻠﻲ ﺗﻄﻌﻴﻢ ﺿﺪ ﺍﻟﺪﺭﻥ )ﰊ‬
‫ﺳﻲ ﺟﻲ( ﻭﺛﻼﺙ ﺟﺮﻋﺎﺕ ﻣﻦ ﻃﻌﻢ ﺍﻟﺜﻼﺛﻲ ﻟﻠﺤﻤﺎﻳﺔ ﻣﻦ ﺍﻟﺪﻓﺘﲑﻳﺎ ﻭﺍﻟﺴﻌﺎﻝ ﺍﻟﺪﻳﻜﻰ ﻭﺍﻟﺘﻴﺘﺎﻧﻮﺱ‪،‬‬
‫ﻭﺛﻼﺙ ﺟﺮﻋﺎﺕ ﻣﻦ ﻃﻌﻢ ﺷﻠﻞ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻭﺟﺮﻋﺔ ﻣﻦ ﻃﻌﻢ ﺍﳊﺼﺒﺔ‪ .‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﻫﺬﻩ ﺍﻟﺘﻄﻌﻴﻤﺎﺕ‬

‫‪٢١١‬‬
‫ﺍﻷﺳﺎﺳﻴﺔ‪ ،‬ﻓﻘﺪ ﺃﻭﺻﻲ ﺍﻟﱪﻧﺎﻣﺞ ﺍﳌﺼﺮﻱ ﻟﺘﻄﻌﻴﻤﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ ﺑﺄﻥ ﻳﺄﺧﺬ ﺍﻷﻃﻔﺎﻝ ﺛﻼﺙ ﺟﺮﻋﺎﺕ ﻣﻦ‬
‫ﻃﻌﻢ ﺍﻟﻜﺒﺪ ﺍﻟﻮﺑﺎﺋﻲ‪ .‬ﰲ ﺃﺛﻨﺎﺀ ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ﺍﻷﺧﲑ ‪ ،٢٠٠٠‬ﻛﺎﻧﺖ ﺷﻬﺎﺩﺓ ﺍﳌﻴﻼﺩ ﻭ‪/‬ﺃﻭ‬
‫ﺍﻟﺒﻄﺎﻗﺔ ﺍﻟﺼﺤﻴﺔ ﻣﺘﺎﺣﺔ ﰲ ‪ %٧٠‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻌﻤﺮ ‪ ٢٣-١٢‬ﺷﻬﺮﺍ‪ .‬ﺃﻣﺎ ﺍﻟﻨﺴﺒﺔ ﺍﻟﺒﺎﻗﻴﺔ ﻣﻦ‬
‫ﺍﻷﻃﻔﺎﻝ ﻓﺈﻥ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻋﻦ ﺍﻟﺘﻄﻌﻴﻤﺎﺕ ﺗﻌﺘﻤﺪ ﻋﻠﻲ ﻣﺎ ﺫﻛﺮﺗﻪ ﺍﻷﻡ‪ .‬ﻭﻣﻦ ﺍﳌﻬﻢ ﺃﻥ ﻧﺘﺬﻛﺮ ﺃﻥ ﺍﻹﺟﺮﺍﺀﺍﺕ‬
‫ﺍﻟﱵ ﺍﺳﺘﺨﺪﻣﺖ ﰲ ﺇﳚﺎﺩ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ‪ ،‬ﺍﻓﺘﺮﺿﺖ ﺃﻥ ﻧﺴﺒﺔ ﻣﻦ ﺍﻟﺘﻄﻌﻴﻤﺎﺕ ﺍﻟﱵ ﰎ ﺇﻋﻄﺎﺅﻫﺎ ﺧﻼﻝ‬
‫ﺍﻟﺴﻨﺔ ﺍﻷﻭﱄ ﻣﻦ ﺍﻟﻌﻤﺮ ﻟﻸﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﰎ ﺍﳊﺼﻮﻝ ﻋﻠﻲ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳋﺎﺻﺔ ‪‬ﻢ ﻭﻓﻘﺎ ﳌﺎ ﺫﻛﺮﺗﻪ ﺍﻷﻡ‬
‫ﻣﺜﻞ ﺣﺎﻟﺔ ﺍﻟﺬﻳﻦ ﻟﺪﻳﻬﻢ ﺷﻬﺎﺩﺓ ﻣﻴﻼﺩ‪/‬ﺑﻄﺎﻗﺔ ﺻﺤﻴﺔ ﻣﺴﺠﻞ ﻓﻴﻬﺎ ﺗﻮﺍﺭﻳﺦ ﳐﺘﻠﻒ ﺍﻟﺘﻄﻌﻴﻤﺎﺕ‪.‬‬
‫ﻭﻣﻦ ﺍﻟﻮﺍﺿﺢ ﺃﻥ ﻫﺬﺍ ﺍﻻﻓﺘﺮﺍﺽ ﺃﻛﺜﺮ ﻣﺼﺪﺍﻗﻴﺔ ﺇﺫﺍ ﻛﺎﻧﺖ ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﱵ ﺍﻋﺘﻤﺪﺕ‬
‫ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳋﺎﺻﺔ ‪‬ﻢ ﻋﻠﻲ ﻣﺎ ﺫﻛﺮﺗﻪ ﺍﻷﻡ ﺻﻐﲑﺓ‪.‬‬
‫ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻭﺟﺪ ﺃﻥ ‪ %٩٢‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﻓﺌﺔ ﺍﻟﻌﻤﺮ ‪ ٢٣-١٢‬ﺷﻬﺮﺍ ﻗﺪ ﺃﺧﺬﻭﺍ ﲨﻴﻊ ﺍﻟﺘﻄﻌﻴﻤﺎﺕ‬
‫)ﺿﺪ ﺍﻟﺪﺭﻥ‪ ،‬ﺛﻼﺙ ﺟﺮﻋﺎﺕ ﻣﻦ ﻛﻞ ﻣﻦ ﻃﻌﻢ ﺍﻟﺜﻼﺛﻲ ﻭﺷﻠﻞ ﺍﻷﻃﻔﺎﻝ(‪ .‬ﻭﺃﻥ ﺃﻛﱪ ﺗﻐﻄﻴﺔ ﻟﻠﺘﻄﻌﻴﻤﺎﺕ ﰲ‬
‫ﻫﺬﻩ ﺍﻟﻔﺌﺔ ﺍﻟﺴﻨﻴﺔ ﻛﺎﻧﺖ ﻟﺘﻄﻌﻴﻢ ﺍﻟﺪﺭﻥ ﺣﻴﺚ ﺑﻠﻐﺖ ﺍﻟﻨﺴﺒﺔ ‪ ،%٩٩،٣‬ﻳﻠﻴﻪ ﺗﻄﻌﻴﻢ ﺍﳊﺼﺒﺔ ﺣﻴﺚ‬
‫ﺑﻠﻐﺖ ﺍﻟﻨﺴﺒﺔ ‪ %٩٦،٩‬ﻭﺭﲟﺎ ﻳﺮﺟﻊ ﺫﻟﻚ ﺃﻥ ﺍﻟﺘﻄﻌﻴﻢ ﺿﺪ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ ﻳﺘﻜﻮﻥ ﻣﻦ ﺟﺮﻋﺔ ﻭﺍﺣﺪﺓ‪ .‬ﺃﻣﺎ‬
‫ﻋﻨﺪ ﺗﻘﻴﻴﻢ ﻧﺴﺐ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﰎ ﺗﻄﻌﻴﻤﻬﻢ ﻗﺒﻞ ﺑﻠﻮﻏﻬﻢ ﺍﻟﺴﻨﺔ ﺍﻷﻭﱄ ﻣﻦ ﺍﻟﻌﻤﺮ ﻛﻤﺎ ﻳﻮﺻﻲ‬
‫ﺑﺬﻟﻚ‪ ،‬ﺑﺼﻔﺔ ﻋﺎﻣﺔ‪ ،‬ﻓﺈﻥ ‪ %٨٨‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻌﻤﺮ ‪ ٢٣-١٢‬ﺷﻬﺮﺍ ﻗﺪ ﺣﺼﻠﻮﺍ ﻋﻠﻲ ﺍﻟﺘﻄﻌﻴﻤﺎﺕ‬
‫ﺍﳌﻄﻠﻮﺑﺔ )ﺑﺎﺳﺘﺜﻨﺎﺀ ﺍﻟﻜﺒﺪ ﺍﻟﻮﺑﺎﺋﻲ( ﺑﺒﻠﻮﻏﻬﻢ ﺍﻟﺴﻨﺔ ﺍﻷﻭﱄ ﻣﻦ ﺍﻟﻌﻤﺮ‪ .‬ﻭﻗﺪ ﰎ ﺇﺩﺧﺎﻝ ﺗﻄﻌﻴﻢ ﺍﻟﻜﺒﺪ‬
‫ﺍﻟﻮﺑﺎﺋﻲ ﺿﻤﻦ ﺍﻟﱪﻧﺎﻣﺞ ﺍﳌﺼﺮﻱ ﻟﺘﻄﻌﻴﻤﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ ﻣﻨﺬ ﻣﻨﺘﺼﻒ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ‪ .‬ﻭﺗﺒﲔ ﺍﻟﻨﺘﺎﺋﺞ ﺃﻥ‬
‫‪ %٩٢‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻗﺪ ﺣﺼﻠﻮﺍ ﻋﻠﻲ ﺍﳉﺮﻋﺔ ﺍﻟﺜﺎﻟﺜﺔ ﻣﻦ ﻃﻌﻢ ﺍﻟﻜﺒﺪ ﺍﻟﻮﺑﺎﺋﻲ ﻗﺒﻞ ﺑﻠﻮﻏﻬﻢ ﺍﻟﺴﻨﺔ‬
‫ﺍﻷﻭﱄ ﻣﻦ ﺍﻟﻌﻤﺮ‪ ،‬ﻛﻤﺎ ﻳﻮﺻﻲ ﺑﺬﻟﻚ‪ .‬ﻭﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻓﺈﻥ ‪ %٨٧‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻗﺒﻞ ﺑﻠﻮﻏﻬﻢ ﺍﻟﺴﻨﺔ ﺍﻷﻭﱄ‬
‫ﻣﻦ ﺍﻟﻌﻤﺮ ﻗﺪ ﺣﺼﻠﻮﺍ ﻋﻠﻲ ﺗﻄﻌﻴﻢ ﻛﺎﻣﻞ ﺿﺪ ﺍﻟﻜﺒﺪ ﺍﻟﻮﺑﺎﺋﻲ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﺍﻟﺴﺒﻌﺔ ﺃﻣﺮﺍﺽ ﺍﻷﺧﺮﻯ‬
‫ﺍﻟﱵ ﳝﻜﻦ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻨﻬﺎ‪.‬‬
‫ﻭﻫﻜﺬﺍ‪ ،‬ﻣﻦ ﺍﺳﺘﻌﺮﺍﺽ ﺍﳌﺆﺷﺮﺍﺕ ﺍﻟﺴﺎﺑﻘﺔ‪ ،‬ﻳﺘﺒﲔ ﺃﻥ ﻫﻨﺎﻙ ﲢﺴﻨﺎﹰ ﰲ ﺍﻷﺣﻮﺍﻝ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻄﻔﻞ‬
‫ﺍﳌﺼﺮﻱ‪ ،‬ﺇﻻ ﺃﻥ ﻫﺬﺍ ﺍﻟﺘﺤﺴﻦ ﱂ ﻳﺒﻠﻎ ﺍﻷﻫﺪﺍﻑ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﱵ ﺳﺒﻖ ﻭﺿﻌﻬﺎ‪ .‬ﻭﺑﻌﺪ ﺍﺳﺘﻌﺮﺍﺽ‬
‫ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻃﻔﺎﻝ ﰲ ﻣﺼﺮ‪ ،‬ﻫﻨﺎﻙ ﻗﻀﻴﺘﺎﻥ ﻣﺮﺗﺒﻄﺘﺎﻥ ﺑﻮﺿﻊ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ‪ ،‬ﺍﻹﻋﺎﻗﺔ‬
‫ﻭﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻭﳌﺎ ﻛﺎﻧﺖ ﻫﺎﺗﺎﻥ ﺍﻟﻘﻀﻴﺘﺎﻥ ﻣﻦ ﺍﻷﳘﻴﺔ‪ ،‬ﻛﺎﻥ ﳚﺐ ﺃﻥ ﻧﻠﻘﻲ ﺍﻟﻀﻮﺀ ﻋﻠﻴﻬﻤﺎ ﰲ ﻫﺬﺍ‬
‫ﺍﻟﺘﻘﺮﻳﺮ‪ .‬ﻭﺗﺄﰐ ﺃﳘﻴﺔ ﻫﺎﺗﲔ ﺍﻟﻘﻀﻴﺘﲔ ﳌﺎ ﳍﻤﺎ ﻣﻦ ﺃﺑﻌﺎﺩ ﳐﺘﻠﻔﺔ ﻭﻭﺍﺳﻌﺔ ﺳﻮﻑ ﺗﺴﺎﻋﺪ ﻋﻨﺪ‬
‫ﻋﺮﺿﻬﻤﺎ ﻋﻠﻲ ﺗﻔﻬﻢ ﺃﻛﺜﺮ ﻭﺿﻮﺣﺎ ﳊﺎﻝ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ‪.‬‬

‫‪ 0&1‬‬
‫ﺗﺸﻜﻞ ﺍﻹﻋﺎﻗﺔ ﰲ ﻣﺼﺮ ﻣﻌﻮﻗﺎ ﻫﺎﻣﺎ ﻟﻠﺘﻨﻤﻴﺔ‪ ،‬ﻭﺫﻟﻚ ﳌﺎ ﳍﺎ ﻣﻦ ﺁﺛﺎﺭ ﺳﻠﺒﻴﺔ ﺻﺤﻴﺔ ﻭﻧﻔﺴﻴﺔ‬
‫ﻭﺍﺟﺘﻤﺎﻋﻴﺔ ﻋﻠﻲ ﺍﻷﺷﺨﺎﺹ ﺍﳌﻌﺎﻗﲔ ﺃﻧﻔﺴﻬﻢ ﻭﺃﺳﺮﻫﻢ ﻭﳎﺘﻤﻌﺎ‪‬ﻢ ﺍﶈﻠﻴﺔ ﻭﻋﻠﻲ ﺍﻟﻮﻃﻦ ﻛﻠﻪ‪.‬‬
‫ﻣﻨﺬ ﺍﻟﺒﺪﺍﻳﺔ ﻧﻮﺩ ﺃﻥ ﻧﻮﺿﺢ ﺻﻌﻮﺑﺔ ﺍﻟﻮﺻﻮﻝ ﺇﱄ ﺗﻘﺪﻳﺮﺍﺕ ﺩﻗﻴﻘﺔ ﳊﺴﺎﺏ ﻧﺴﺒﺔ ﺍﻧﺘﺸﺎﺭ ﺍﻹﻋﺎﻗﺔ ﺑﲔ‬
‫ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ ﻭﻫﺬﺍ ﻳﺮﺟﻊ ﺇﱄ ﻋﺪﻡ ﻭﺟﻮﺩ ﺗﻮﺣﻴﺪ ﻗﻴﺎﺳﻲ ﻟﺘﻌﺮﻳﻒ ﻭﺗﺼﻨﻴﻒ ﺍﻹﻋﺎﻗﺔ ﻭﻧﺪﺭﺓ ﺍﻟﺒﻴﺎﻧﺎﺕ‬

‫‪٢١٢‬‬
‫ﺍﻟﺴﻨﻮﻳﺔ ﺍﻟﱵ ﳝﻜﻦ ﺍﻟﺮﺟﻮﻉ ﺇﻟﻴﻬﺎ‪ .‬ﻫﺬﺍ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﺃﻥ ﻧﺘﺎﺋﺞ ﺍﻟﺒﺤﻮﺙ ﺍﻟﺴﺎﺑﻘﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﺟﺎﺀﺕ‬
‫ﻣﺘﺒﺎﻳﻨﺔ ﺇﱄ ﺣﺪ ﻛﺒﲑ‪ .‬ﻓﺒﻴﻨﻤﺎ ﳒﺪ ﺃﻥ ﻧﺴﺒﺔ ﺍﻹﻋﺎﻗﺔ ﰲ ﺗﻌﺪﺍﺩ ﺍﻟﺴﻜﺎﻥ ﻟﺴﻨﺔ ‪ ١٩٧٦‬ﻻ ﺗﺘﻌﺪﻯ ‪%٣‬‬
‫ﳒﺪﻫﺎ ﺗﺼﻞ ﺇﱄ ‪ %١١،٨‬ﰲ ﺩﺭﺍﺳﺔ ﻗﺎﻡ ‪‬ﺎ ﻣﻌﻬﺪ ﺷﻠﻞ ﺍﻷﻃﻔﺎﻝ ﰲ ‪ ٦‬ﻗﺮﻯ ﻭ‪ ١٨‬ﻣﺪﺭﺳﺔ ﲟﻨﻄﻘﺔ‬
‫ﺇﻣﺒﺎﺑﺔ ﰲ ﳏﺎﻓﻈﺔ ﺍﳉﻴﺰﺓ )‪ .(١٩٨٨‬ﺃﻣﺎ ﺍﻟﺪﺭﺍﺳﺔ ﺍﳋﺎﺻﺔ ﺑﺼﺤﺔ ﺍﻟﻄﻔﻞ ﻓﻠﻢ ﺗﺘﻌﺪ ﺍﻟﻨﺴﺒﺔ ﻓﻴﻬﺎ‬
‫‪ .(١٩٩٢) %١،٥٤‬ﻭﻛﺬﻟﻚ ﺍﳋﺮﻳﻄﺔ ﺍﻟﺼﺤﻴﺔ ﳌﺼﺮ ﻭﺻﻠﺖ ﺍﻟﻨﺴﺒﺔ ﻓﻴﻬﺎ ﺇﱄ ‪ .(١٩٨٧) %١،٥٢‬ﻭﰲ ﻋﺎﻡ‬
‫‪ ١٩٩٤‬ﻗﺎﻡ ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻸﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ ﺑﺪﺭﺍﺳﺔ ﰲ ﺛﻼﺙ ﳏﺎﻓﻈﺎﺕ ﻭﻫﻲ ﺍﳉﻴﺰﺓ ﻭﻛﻔﺮ ﺍﻟﺸﻴﺦ‬
‫ﻭﺃﺳﻮﺍﻥ‪ ،‬ﻭﺍﻋﺘﻤﺪﺕ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﻋﻠﻲ ﺍﳌﻨﻬﺞ ﺍﳌﺴﺘﺨﺪﻡ ﰲ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﺪﻭﻟﻴﺔ ﻟﻮﺑﺎﺋﻴﺎﺕ ﺍﻹﻋﺎﻗﺔ ﺑﲔ‬
‫ﺍﻷﻃﻔﺎﻝ‪ .‬ﻭﻗﺪ ﺑﻴﻨﺖ ﺩﺭﺍﺳﺔ ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻠﻄﻔﻮﻟﺔ ﺃﻥ ﻧﺴﺒﺔ ﺍﻹﻋﺎﻗﺔ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﺳﻦ ﺻﻔﺮ ﺇﱄ‬
‫ﺳﻦ ‪ ١٥‬ﺳﻨﺔ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﻟﺜﻼﺛﺔ ﻛﺎﻧﺖ ﻛﺎﻵﰐ‪ :‬ﺍﳉﻴﺰﺓ ﺑﻨﺴﺒﺔ ‪ - %١،٢‬ﻛﻔﺮ ﺍﻟﺸﻴﺦ ﺑﻨﺴﺒﺔ ‪- %١،٩‬‬
‫ﺃﺳﻮﺍﻥ ﺑﻨﺴﺒﺔ ‪ .%٤،٥‬ﻭﰲ ﻧﻔﺲ ﺍﻟﻌﺎﻡ )‪ (١٩٩٤‬ﺗﻌﺎﻭﻧﺖ ﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﻴﺌﻴﺔ ﻭﺍﻟﺼﺤﻴﺔ ﻣﻊ‬
‫ﻣﻨﻈﻤﺔ ﺍﻟﻴﻮﻧﻴﺴﻴﻒ ﰲ ﺩﺭﺍﺳﺔ ﻣﺴﺤﻴﺔ ﲟﻨﻄﻘﺔ ﻋﲔ ﺣﻠﻮﺍﻥ ﻋﻠﻲ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﺳﻦ ‪ ٢‬ﺇﱄ ‪ ١٥‬ﺳﻨﺔ‬
‫ﻭﻭﺻﻠﺖ ﺍﻟﻨﺘﺎﺋﺞ ﰲ ﺗﻠﻚ ﺍﻟﺪﺭﺍﺳﺔ ﺇﱄ ﻧﺴﺒﺔ ‪ .%٥،٧‬ﻭﺃﺧﲑﺍ ﻭﺿﺤﺖ ﻧﺘﺎﺋﺞ ﺍﳌﺴﺢ ﺍﻟﺴﻜﺎﱐ ﺍﻟﺼﺤﻲ ‪-‬‬
‫ﻣﺼﺮ ‪ ٢٠٠٠‬ﺃﻥ ﻧﺴﺐ ﺍﻹﻋﺎﻗﺔ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﺗﺼﻞ ﺇﱄ ‪ %٨‬ﻋﻠﻤﺎ ﺑﺄﻥ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﺗﺸﻤﻞ ﺍﻟﺪﺭﺟﺔ‬
‫ﺍﻟﺒﺴﻴﻄﺔ ﻣﻦ ﺍﻹﻋﺎﻗﺔ ﺍﻟﺒﺼﺮﻳﺔ ﻭﺇﺫﺍ ﺍﺳﺘﺒﻌﺪﺕ ﻫﺬﻩ ﺍﻟﻔﺌﺔ ﺗﺼﻞ ﻧﺴﺐ ﺍﻹﻋﺎﻗﺔ ﺇﱄ ‪ .%٣،٤‬ﻭﺗﺮﺟﻊ ﻫﺬﻩ‬
‫ﺍﻻﺧﺘﻼﻓﺎﺕ ﺇﱄ ﻋﺪﺩ ﻣﻦ ﺍﻷﺳﺒﺎﺏ ﺃﳘﻬﺎ ﻭﺟﻮﺩ ﺗﻌﺮﻳﻒ ﻣﻮﺣﺪ ﳌﻔﻬﻮﻡ ﺍﻹﻋﺎﻗﺔ‪ ،‬ﻭﻣﻌﻈﻢ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ‬
‫ﺍﳋﺎﺻﺔ ﺑﺎﻹﻋﺎﻗﺔ ﺟﺎﺀﺕ ﻣﻦ ﺧﻼﻝ ﺩﺭﺍﺳﺎﺕ ﻋﺎﻣﺔ ﳏﺪﻭﺩﺓ‪ ،‬ﻭﺍﻟﺼﻌﻮﺑﺎﺕ ﺍﳌﻨﻬﺠﻴﺔ ﻟﻠﺪﺭﺍﺳﺎﺕ ﺍﻟﱵ‬
‫ﺗﻌﺮﺿﺖ ﳌﻔﻬﻮﻡ ﺍﻹﻋﺎﻗﺔ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﻏﻴﺎﺏ ﺍﻟﺘﺴﺠﻴﻞ ﺍﻟﺪﻗﻴﻖ ﰲ ﻣﻌﻈﻢ ﺍﳉﻬﺎﺕ ﺍﻟﱵ ﺗﺘﻌﺎﻣﻞ ﻣﻦ‬
‫ﺍﻹﻋﺎﻗﺔ‪.‬‬
‫ﻭﻟﻮ ﺍﻟﺘﺰﻣﻨﺎ ﺑﺎﻟﻨﺴﺐ ﺍﻟﱵ ﺣﺪﺩ‪‬ﺎ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ﻭﺍﻟﱵ ﲢﺪﺩ ﻧﺴﺒﺔ ﺍﻹﻋﺎﻗﺔ ﰲ ﺍﻟﺒﻼﺩ‬
‫ﺍﻟﺼﻨﺎﻋﻴﺔ ﺑﻨﺴﺒﺔ ‪ %١٠‬ﻭﰲ ﺍﻟﺒﻼﺩ ﺍﻟﻨﺎﻣﻴﺔ ﺑﻨﺴﺒﺔ ‪ ،%١٣-١٢‬ﻓﺴﻮﻑ ﳝﻜﻨﻨﺎ ﺃﻥ ﳓﺪﺩ ﻋﺪﺩ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﳌﺼﺎﺑﲔ ﺑﺈﻋﺎﻗﺎﺕ ﰲ ﻣﺼﺮ ﺑﲔ ﺳﻦ ﺻﻔﺮ ﺇﱄ ‪ ١٥‬ﺳﻨﺔ ﲝﻮﺍﱄ ‪ ٢،٤‬ﻣﻠﻴﻮﻥ ﻃﻔﻞ ﻭﻃﻔﻠﺔ ﻧﺼﻔﻬﻢ‬
‫ﻋﻠﻲ ﺍﻷﻗﻞ ﻣﺼﺎﺑﻮﻥ ﺑﺄﻛﺜﺮ ﻣﻦ ﺇﻋﺎﻗﺔ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﺃﻥ ﺍﻹﻋﺎﻗﺎﺕ ﺗﺼﻴﺐ ﺍﻟﺬﻛﻮﺭ ﻭﺍﻹﻧﺎﺙ ﺑﺸﻜﻞ ﻣﺘﻘﺎﺭﺏ‬
‫ﻛﻤﺎ ﺃﻇﻬﺮﺕ ﺑﻌﺾ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﱵ ﺃﺟﺮﻳﺖ ﰲ ﳎﺘﻤﻌﺎﺕ ﳏﻠﻴﺔ ﺇﻻ ﺃﻥ ﺍﻟﻮﺍﺿﺢ ﺃﻥ ﺍﻷﺳﺮ ﻭﺍ‪‬ﺘﻤﻊ‬
‫ﺑﺸﻜﻞ ﻋﺎﻡ ﻳﻬﺘﻢ ﺑﺎﻹﻋﺎﻗﺎﺕ ﻟﺪﻯ ﺍﻟﺬﻛﻮﺭ ﺑﺸﻜﻞ ﺃﻛﱪ ﻭﻣﻦ ﰒ ﻳﻈﻬﺮ ﺣﺠﻢ ﺍﻹﻋﺎﻗﺔ ﻟﺪﻳﻬﻢ ﻭﻛﺬﺍ‬
‫ﺍﺳﺘﺨﺪﺍﻣﻬﻢ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺘﺄﻫﻴﻠﻴﺔ ﺃﻛﺜﺮ ﻣﻦ ﺍﻹﻧﺎﺙ‪.‬‬
‫ﻭﺗﺸﲑ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﻘﻠﻴﻠﺔ ﺍﻟﱵ ﺃﺟﺮﻳﺖ ﻋﻦ ﺃﻫﻢ ﺍﻷﺳﺒﺎﺏ ﻭﻋﻮﺍﻣﻞ ﺍﳋﻄﻮﺭﺓ ﺍﳌﺮﺗﺒﻄﺔ ﲝﺪﻭﺙ ﺍﻹﻋﺎﻗﺔ ﺇﱄ‬
‫ﺃﻥ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ ﻭﺍﳊﻮﺍﺩﺙ ﻻ ﺗﺰﺍﻝ ﺗﺸﻜﻞ ﺍﻷﺳﺒﺎﺏ ﺍﻷﻛﺜﺮ ﺷﻴﻮﻋﺎ‪ ،‬ﻭﻫﻲ ﺑﻄﺒﻴﻌﺘﻬﺎ ﺃﺳﺒﺎﺏ ﻣﺮﺗﺒﻄﺔ‬
‫ﺑﺎﻷﻭﺿﺎﻉ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻟﺜﻘﺎﻓﻴﺔ ﻭﳝﻜﻦ ﺍﻟﺘﻐﻠﺐ ﻋﻠﻴﻬﺎ ﻭﲡﻨﺒﻬﺎ ﻣﻦ ﺧﻼﻝ ﺗﻄﺒﻴﻖ ﺑﺮﺍﻣﺞ‬
‫ﻭﻗﺎﺋﻴﺔ ﻭﺑﺘﻨﻤﻴﺔ ﺍ‪‬ﺘﻤﻊ ﻭﲢﺴﲔ ﺍﻟﻈﺮﻭﻑ ﺍﳌﻌﻴﺸﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ ﺑﺸﻜﻞ ﻋﺎﻡ‪.‬‬
‫ﺃﻣﺎ ﺍﳋﺪﻣﺎﺕ ﺍﳌﺘﺎﺣﺔ ﻓﻼ ﲣﺪﻡ ﺃﻛﺜﺮ ﻣﻦ ‪ %١٠‬ﻣﻦ ﻫﺬﺍ ﺍﻟﻌﺪﺩ ﻋﻠﻲ ﺃﻛﺜﺮ ﺗﻘﺪﻳﺮ‪ .‬ﻫﺬﺍ ﺇﱄ ﺟﺎﻧﺐ ﻏﻴﺎﺏ‬
‫ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻗﻮﻣﻴﺔ ﻭﺍﺿﺤﺔ ﻭﻣﺒﻠﻮﺭﺓ ﳌﻮﺍﺟﻬﺔ ﻗﻀﻴﺔ ﺍﻹﻋﺎﻗﺔ ﻋﻠﻲ ﻣﺴﺘﻮﻳﺎ‪‬ﺎ ﺍﳌﺨﺘﻠﻔﺔ ﻣﻊ ﺳﻴﺎﺩﺓ‬
‫ﺍﻟﻨﻈﺮﺓ ﺍﳌﺆﺳﺴﻴﺔ ﺍﻟﻄﺒﻴﺔ ﺍﳉﺰﺋﻴﺔ ﰲ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﻹﻋﺎﻗﺔ‪ ،‬ﻭﻋﺠﺰﻫﺎ ﻋﻦ ﺍﻻﺳﺘﺠﺎﺑﺔ ﻻﺣﺘﻴﺎﺟﺎﺕ‬
‫ﺍﻹﻧﺴﺎﻥ ﺍﳌﻌﺎﻕ ﻭﺃﺳﺮﺗﻪ‪ ،‬ﺑﻞ ﻧﺘﺎﺋﺠﻬﺎ ﺍﻟﻀﺎﺭﺓ ﰲ ﺗﻜﺮﻳﺲ ﻋﺰﻟﺔ ﺍﳌﻌﺎﻕ ﻭﺃﺳﺮﺗﻪ‪.‬‬

‫‪٢١٣‬‬
‫ﺗﺸﺎﺭﻙ ﺛﻼﺛﺔ ﻗﻄﺎﻋﺎﺕ ﺭﺋﻴﺴﻴﺔ ﰲ ﲢﻤﻞ ﺧﺪﻣﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﳌﻌﺎﻗﲔ‪ ،‬ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﻗﻄﺎﻉ ﺍﻟﺘﻌﻠﻴﻢ‪،‬‬
‫ﻭﻗﻄﺎﻉ ﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ ،‬ﻭﻋﺪﺩ ﻣﻦ ﺍﳌﻨﻈﻤﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ ﺑﺘﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﳍﺬﻩ ﺍﻟﻔﺌﺔ ﻣﻦ‬
‫ﺍﻷﻃﻔﺎﻝ‪ .‬ﻛﻤﺎ ﻳﻘﻮﻡ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﺃﻳﻀﺎ ﺑﺒﻌﺾ ﺍﳋﺪﻣﺎﺕ ﰲ ﺍ‪‬ﺎﻝ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺘﻌﻠﻴﻤﻲ ﻭﻟﻜﻦ ﻧﺴﺒﺔ‬
‫ﺍﳌﺴﺘﻔﻴﺪﻳﻦ ﻣﻦ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ ﳏﺪﻭﺩﺓ ﻟﻠﻐﺎﻳﺔ‪ .‬ﻛﻤﺎ ﺃﻥ ﻏﻴﺎﺏ ﺍﻟﺘﻜﺎﻣﻞ ﻭﺍﻟﺘﺮﺍﺑﻂ ﺑﲔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﻣﻦ‬
‫ﺟﻬﺔ‪ ،‬ﻭﺩﺍﺧﻞ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻮﺍﺣﺪ ﻣﻦ ﺟﻬﺔ ﺃﺧﺮﻱ‪ ،‬ﻳﺆﺩﻱ ﺇﱄ ﺇﺿﻌﺎﻑ ﻗﺪﺭﺓ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ ﰲ ﺍﻻﺳﺘﺠﺎﺑﺔ‬
‫ﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳌﻌﺎﻗﲔ ﻭﺃﺳﺮﻫﻢ ﺇﱄ ﺃﻗﺼﻰ ﺍﳊﺪﻭﺩ‪ .‬ﻭﻫﻮ ﻣﺎ ﻳﺆﺩﻱ ﺇﱄ ﻣﻀﺎﻋﻔﺔ ﺍﻷﻋﺒﺎﺀ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‬
‫ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻋﻠﻲ ﻫﺆﻻﺀ ﺍﻷﺷﺨﺎﺹ ﻭﺃﺳﺮﻫﻢ‪.‬‬
‫ﻭﻧﻈﺮﺍ ﻟﻸﳘﻴﺔ ﺍﻟﻮﺍﺿﺤﺔ ﻭﺍﻟﺘﺄﺛﲑ ﺍﻟﻜﺒﲑ ﻟﻘﻀﻴﺔ ﺍﻹﻋﺎﻗﺔ ﻓﻘﺪ ﺍﻫﺘﻤﺖ ‪‬ﺎ ﻛﺎﻓﺔ ﺍﻷﻃﺮﺍﻑ ﺍﳌﻌﻨﻴﺔ‪ ،‬ﳑﺎ‬
‫ﺃﺩﻯ ﺇﱄ ﺣﺪﻭﺙ ﺗﻄﻮﺭﺍﺕ ﻫﺎﻣﺔ ﻋﻠﻲ ﻛﺎﻓﺔ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻌﻬﺎ ﺧﻼﻝ ﺍﻟﻌﻘﺪ ﺍﳌﺎﺿﻲ "ﻋﻘﺪ‬
‫ﺍﳌﻌﺎﻗﲔ" ﻭﻋﻠﻲ ﺍﻷﺧﺺ ﺧﻼﻝ ﺍﳋﻤﺲ ﺳﻨﻮﺍﺕ ﺍﳌﺎﺿﻴﺔ‪ .‬ﻓﻌﻠﻲ ﻣﺴﺘﻮﻱ ﺍﳌﻔﺎﻫﻴﻢ ﻭﺍﲡﺎﻫﺎﺕ ﺍﻟﺘﺄﻫﻴﻞ‪،‬‬
‫ﻇﻬﺮﺕ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ ﰲ ﺍﻟﻨﺼﻒ ﺍﻟﺜﺎﱐ ﻣﻦ ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ ﻣﺘﺰﺍﻣﻨﺔ‬
‫ﻭﻣﺘﻮﺍﻓﻘﺔ ﻣﻊ ﳕﻮ ﺍﳌﻔﻬﻮﻡ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻟﻠﺼﺤﺔ ﺑﺸﻜﻠﻬﺎ ﺍﻟﺸﺎﻣﻞ ﻭﺍﻟﺘﻌﺎﻣﻞ ﻣﻌﻬﺎ ﻋﻠﻲ ﳏﺎﻭﺭ‬
‫ﺍﳌﺴﺎﻭﺍﺓ ﻭﺍﻟﻌﺪﺍﻟﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺗﻌﺪﺩ ﺍﻟﻘﻄﺎﻋﺎﺕ ﻭﺍﳌﺸﺎﺭﻛﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﻣﻦ ﺧﻼﻝ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻭﻣﻨﻬﺞ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺣﻘﻮﻕ ﺍﻟﻔﺌﺎﺕ ﺍﳋﺎﺻﺔ ﻛﺠﺰﺀ ﻻ ﻳﺘﺠﺰﺃ ﻣﻦ ﺣﻘﻮﻕ ﺍﻹﻧﺴﺎﻥ‪ .‬ﻭﻗﺪ ﺗﻄﻮﺭﺕ‬
‫ﳕﺎﺫﺝ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ ﻭﺯﻳﺎﺩﺓ ﺍﻧﺘﺸﺎﺭ ﲨﻌﻴﺎﺕ ﺍﳌﻌﺎﻗﲔ ﺃﻧﻔﺴﻬﻢ ﻭﺃﺳﺮﻫﻢ ﰲ ﻣﺼﺮ‪ ،‬ﻣﻨﺬ‬
‫ﻣﻨﺘﺼﻒ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ ﻭﺧﺎﺻﺔ ﰲ ﻋﻘﺪ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ‪ .‬ﻭﻇﻬﺮﺕ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺒﺎﺩﺭﺍﺕ ﰲ ﺍﳋﻤﺲ ﺳﻨﻮﺍﺕ‬
‫ﺍﻷﺧﲑﺓ ﻣﺜﻞ ﺗﺸﻜﻴﻞ ﳉﻨﺔ ﺍﳊﺪ ﻣﻦ ﺍﻹﻋﺎﻗﺔ ﰲ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺗﺒﲏ ﻭﺯﺍﺭﺓ ﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻣﻨﻬﺞ‬
‫ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ ﻭﺍﻟﻌﻤﻞ ﻋﻠﻲ ﻧﺸﺮﻩ ﺑﲔ ﺍﳉﻤﻌﻴﺎﺕ‪ ،‬ﻭﺗﺄﺳﻴﺲ ﺃﻛﺜﺮ ﻣﻦ ‪ ٣٠‬ﻣﺸﺮﻭﻋﺎﹰ‬
‫ﻟﻠﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ ﲜﺎﻧﺐ ﺗﺒﲏ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﲨﻌﻴﺎﺕ ﺍﻟﺘﻨﻤﻴﺔ ﻣﻔﻬﻮﻡ ﺍﻹﻋﺎﻗﺔ ﻛﻤﻜﻮﻥ‬
‫ﺃﺳﺎﺳﻲ ﻣﻦ ﻣﻜﻮﻧﺎﺕ ﺍﻟﺘﻨﻤﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ‪ .‬ﻛﻤﺎ ﰎ ﰲ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻷﺧﲑﺓ ﳕﻮ ﺣﻘﻴﻘﻲ ﻣﻦ ﺣﻴﺚ ﺍﻟﻜﻢ‬
‫ﻭﺍﻟﻜﻴﻒ ﰲ ﺍﻫﺘﻤﺎﻡ ﺍﻹﻋﻼﻡ ﺑﻘﻀﻴﺔ ﺍﻹﻋﺎﻗﺔ ﻭﺍﳌﻌﺎﻗﲔ ﺣﻴﺚ ﺍﺯﺩﺍﺩ ﻋﺪﺩ ﺍﻟﱪﺍﻣﺞ ﺍﻟﺘﻠﻴﻔﺰﻳﻮﻧﻴﺔ ﺃﻛﺜﺮ ﻣﻦ‬
‫ﲬﺴﺔ ﺃﺿﻌﺎﻑ ﻭﺍﻧﺘﺸﺮﺕ ﺍﳌﻘﺎﻻﺕ ﺍﻟﱵ ﺗﺘﻨﺎﻭﻝ ﻗﻀﻴﺔ ﺍﻹﻋﺎﻗﺔ ﰲ ﳐﺘﻠﻒ ﺍﻟﺼﺤﻒ ﻭﺍ‪‬ﻼﺕ‬
‫ﺍﻟﻘﻮﻣﻴﺔ ﻭﺍﶈﻠﻴﺔ‪.‬‬
‫ﺃﻣﺎ ﻋﻠﻲ ﻣﺴﺘﻮﻱ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻟﺘﺸﺮﻳﻌﺎﺕ‪ ،‬ﻓﻘﺪ ﺗﻨﺎﻣﻲ ﺍﻫﺘﻤﺎﻡ ﺻﺎﻧﻌﻲ ﺍﻟﻘﺮﺍﺭ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﺑﻘﻀﻴﺔ‬
‫ﺍﻹﻋﺎﻗﺔ‪ ،‬ﳑﺎ ﺣﺴﻦ ﻣﻦ ﻣﻮﻗﻌﻬﺎ ﻋﻠﻲ ﺳﻠﻢ ﺃﻭﻟﻮﻳﺎﺕ ﺟﺪﻭﻝ ﺍﻟﻌﻤﻞ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺍﻟﺘﻨﻤﻮﻱ ﰲ ﻣﺼﺮ‪ .‬ﻛﻤﺎ‬
‫ﻇﻬﺮﺕ ﻋﺪﺓ ﻗﻮﺍﻧﲔ ﻭﻣﺸﺎﺭﻳﻊ ﻗﻮﺍﻧﲔ ﺟﺪﻳﺪﺓ ﺗﺸﻜﻞ ﺃﺭﺿﻴﺔ ﻫﺎﻣﺔ ﺇﺫﺍ ﻣﺎ ﰎ ﺗﻔﻌﻴﻠﻬﺎ‪ .‬ﻭﻣﻨﻬﺎ ﻗﺎﻧﻮﻥ‬
‫ﺍﻟﻄﻔﻞ ﻋﺎﻡ ‪ ١٩٩٦‬ﻭﻻﺋﺤﺘﻪ ﺍﻟﺘﻨﻔﻴﺬﻳﺔ ﻋﺎﻡ ‪ ١٩٩٧‬ﻭﺍﻟﺬﻱ ﺃﻓﺮﺩ ﺑﺎﺑﺎ ﻛﺎﻣﻼ ﳊﻘﻮﻕ ﺍﻟﻄﻔﻞ ﺍﳌﻌﺎﻕ ﻷﻭﻝ ﻣﺮﺓ‪.‬‬
‫ﻭﻗﺎﻧﻮﻥ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻌﺎﻡ ‪ ١٩٩٨‬ﺍﻟﺬﻱ ﻣﺪ ﻣﻈﻠﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﺘﺸﻤﻞ ﻛﺎﻓﺔ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﳌﻮﻟﻮﺩﻳﻦ ﺑﻌﺪ ﻫﺬﺍ ﺍﻟﻌﺎﻡ ﻟﺘﻮﺳﻴﻊ ﺍﳌﻈﻠﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﻭﻟﺘﻮﻓﲑ ﺍﻷﺟﻬﺰﺓ ﻭﺍﳌﻌﺪﺍﺕ ﺍﳌﻌﻴﻨﺔ ﻟﻸﻃﻔﺎﻝ‬
‫ﺍﳌﻌﺎﻗﲔ ﺍﻟﺬﻳﻦ ﱂ ﻳﺸﻤﻠﻬﻢ ﺫﻟﻚ ﻣﻦ ﻗﺒﻞ‪ .‬ﻛﻤﺎ ﻇﻬﺮﺕ ﻋﺪﺓ ﻣﺒﺎﺩﺭﺍﺕ ﻫﺎﻣﺔ ﰲ ﺍﲡﺎﻩ ﺑﻠﻮﺭﺓ‬
‫ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﻗﻮﻣﻴﺔ ﳌﻮﺍﺟﻬﺔ ﻣﺸﻜﻠﺔ ﺍﻹﻋﺎﻗﺔ ﻣﻦ ﺃﺑﺮﺯﻫﺎ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺍﻟﻘﻮﻣﻴﺔ ﲟﺒﺎﺩﺭﺓ ﻣﻦ ﻣﺮﻛﺰ‬
‫ﺍﳌﻌﻠﻮﻣﺎﺕ ﻟﺪﻋﻢ ﺍﲣﺎﺫ ﺍﻟﻘﺮﺍﺭ ﺍﻟﺘﺎﺑﻊ ‪‬ﻠﺲ ﺍﻟﻮﺯﺭﺍﺀ ﲢﺖ ﻣﻈﻠﺔ ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻸﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ‪.‬‬

‫‪٢١٤‬‬
‫ﺃﻣﺎ ﻋﻠﻲ ﻣﺴﺘﻮﻯ ﺍﻟﺘﻨﺴﻴﻖ ﻭﺍﻟﺘﻜﺎﻣﻞ ﺑﲔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﻗﺪ ﺣﺪﺛﺖ ﻃﻔﺮﺓ ﻫﺎﻣﺔ ﰲ ﺍﻟﺘﻨﺴﻴﻖ‬
‫ﻭﺍﻟﺘﻜﺎﻣﻞ ﺑﲔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﻣﻦ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺎﺕ ﰲ ﳎﺎﻝ ﺍﻹﻋﺎﻗﺔ ﺧﺎﺻﺔ ﰲ ﺍﳋﻤﺲ ﺳﻨﻮﺍﺕ‬
‫ﺍﻷﺧﲑﺓ‪ ،‬ﻓﺒﺠﺎﻧﺐ ﺍﻟﺪﻭﺭ ﺍﻟﺬﻱ ﻳﻠﻌﺒﻪ ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻸﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ ﰲ ﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﻣﻘﺪﻣﻲ‬
‫ﺍﳋﺪﻣﺎﺕ ﻭﺻﺎﻧﻌﻲ ﺍﻟﻘﺮﺍﺭ ﰲ ﳎﺎﻝ ﺇﻋﺎﻗﺎﺕ ﺍﻟﻄﻔﻮﻟﺔ‪ ،‬ﻗﺎﻣﺖ ﻋﺪﺓ ﻣﺒﺎﺩﺭﺍﺕ ﻟﺘﺄﺳﻴﺲ ﺷﺒﻜﺎﺕ ﻟﻠﺘﻌﺎﻭﻥ‬
‫ﻋﻠﻲ ﻣﺴﺘﻮﻯ ﺍﳌﺮﺍﻛﺰ ﻭﺍﶈﺎﻓﻈﺎﺕ ﲨﻌﺖ ﺑﲔ ﺍﳉﻤﻌﻴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﻭﺍ‪‬ﺎﻟﺲ ﺍﶈﻠﻴﺔ ﻭﺇﺩﺍﺭﺍﺕ ﺍﻟﻮﺯﺍﺭﺍﺕ‬
‫ﺍﳌﺨﺘﻠﻔﺔ ﰲ ﻋﺪﺩ ﻣﻦ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳌﺼﺮﻳﺔ‪.‬‬
‫ﻭﻋﻠﻲ ﻣﺴﺘﻮﻯ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪ ،‬ﻗﺎﻣﺖ ﺍﻟﻮﺯﺍﺭﺓ ﺑﺒﻠﻮﺭﺓ ﺍﻟﱪﻧﺎﻣﺞ ﺍﻟﻘﻮﻣﻲ ﻟﻠﺤﺪ ﻣﻦ ﺍﻹﻋﺎﻗﺔ‬
‫ﻭﺍﻟﺬﻱ ﺣﺪﺩ ﺍﻟﻮﻗﺎﻳﺔ ﻭﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻭﺍﻟﺘﺪﺧﻞ ﺍﳌﺒﻜﺮ ﺑﺎﻟﻌﻼﺝ ﻭﺍﻟﺘﺄﻫﻴﻞ ﻛﺜﻼﺛﺔ ﳏﺎﻭﺭ ﺭﺋﻴﺴﻴﺔ‬
‫ﻟﻠﻮﺯﺍﺭﺓ ﰲ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﻗﻀﻴﺔ ﺍﻹﻋﺎﻗﺔ‪ .‬ﻣﻊ ﺗﻄﺒﻴﻖ ﻋﺪﺓ ﻣﺒﺎﺩﺭﺍﺕ ﻟﻨﻤﺎﺫﺝ ﻟﻼﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻭﺍﻟﺘﺄﻫﻴﻞ‬
‫ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ ﰲ ﻋﺪﺩ ﻣﻦ ﺍ‪‬ﺘﻤﻌﺎﺕ ﺍﶈﻠﻴﺔ ﻭﺍﶈﺎﻓﻈﺎﺕ ﻋﻠﻲ ﻣﺴﺘﻮﻯ ﻣﺼﺮ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ‬
‫ﺍﳉﻤﻌﻴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﻭﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻷﺧﺮﻯ‪ .‬ﻛﻤﺎ ﰎ ﺗﻨﻔﻴﺬ ﻋﺪﺓ ﺑﺮﺍﻣﺞ ﻟﻼﺭﺗﻘﺎﺀ ﺑﻜﻔﺎﺀﺓ ﺃﻓﺮﺍﺩ ﺍﻟﻔﺮﻳﻖ‬
‫ﺍﻟﺼﺤﻲ ﰲ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﻗﻀﻴﺔ ﺍﻹﻋﺎﻗﺔ ﻋﻠﻲ ﻋﺪﺓ ﻣﺴﺘﻮﻳﺎﺕ ﺑﺪﺍﻳﺔ ﻣﻦ ﺍﻟﺘﺜﻘﻴﻒ ﺍﻟﺼﺤﻲ‬
‫ﻭﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻭﺍﻟﻌﻼﺝ ﻭﺇﺟﺮﺍﺀ ﺍﻟﺘﺤﻮﻳﻼﺕ ﺍﳌﻼﺋﻤﺔ‪ .‬ﻭﻗﺪ ﰎ ﺗﺸﻜﻴﻞ ﺍﻟﻠﺠﻨﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺤﺪ ﻣﻦ‬
‫ﺍﻹﻋﺎﻗﺔ ﰲ ﻋﺎﻡ ‪ ١٩٩٧‬ﺍﻟﱵ ﴰﻠﺖ ﻋﺪﺩﺍ ﻣﻦ ﺍﻟﻮﺯﺍﺭﺍﺕ ﺍﳌﻌﻨﻴﺔ ﻭﺍﳉﻤﻌﻴﺎﺕ‪ .‬ﻭﺗﺸﺮﻑ ﺍﻟﻠﺠﻨﺔ ﺣﺎﻟﻴﺎ ﻋﻠﻲ‬
‫ﺗﻨﻔﻴﺬ ﳕﺎﺫﺝ ﳌﻮﺍﺟﻬﺔ ﻣﺸﻜﻠﺔ ﺍﻹﻋﺎﻗﺔ ﺑﺸﻜﻞ ﻣﺘﻜﺎﻣﻞ ﻋﻠﻲ ﺃﺳﺲ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ ﰲ ‪٤‬‬
‫ﳏﺎﻓﻈﺎﺕ ﻭﺫﻟﻚ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻷﺧﺮﻯ ﻭﺍﻟﻌﻤﻞ ﺍﻷﻫﻠﻲ ﻭﺍﳌﻌﺎﻗﲔ ﻭﺃﺳﺮﻫﻢ‪ .‬ﻭﻗﺪ ﰎ ﺗﺸﻜﻴﻞ‬
‫ﺇﺩﺍﺭﺓ ﺧﺎﺻﺔ ﺑﺎﻹﻋﺎﻗﺔ ‪‬ﻴﺌﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺗﺸﺮﻑ ﻋﻠﻲ ﻛﺎﻓﺔ ﳎﺎﻻﺕ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﻭﺗﻄﻮﻳﺮﻫﺎ‪.‬‬
‫ﻛﻤﺎ ﰎ ﺩﺧﻮﻝ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻛﻄﺮﻑ ﺃﺳﺎﺳﻲ ﰲ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﰲ ﳎﺎﻝ ﺍﻹﻋﺎﻗﺔ‪ ،‬ﻭﺗﺸﻤﻞ ﻫﺬﻩ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻜﺸﻮﻑ ﺍﻟﻄﺒﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ ﻋﻠﻲ ﲨﻴﻊ ﻃﻼﺏ ﺍﳌﺪﺍﺭﺱ ﻭﺗﻮﻓﲑ ﺧﺪﻣﺎﺕ ﺍﻟﺘﻘﻴﻴﻢ ﻭﺍﻟﺘﻮﺟﻴﻪ‬
‫ﻭﺗﺄﻫﻴﻞ ﺍﻟﺘﺨﺎﻃﺐ ﻭﺍﻟﻌﻼﺝ ﺍﻟﻄﺒﻴﻌﻲ ﻣﻦ ﺧﻼﻝ ﻣﺮﺍﻛﺰﻩ ﺍﳌﻨﺘﺸﺮﺓ‪.‬‬
‫ﻋﻠﻲ ﻣﺴﺘﻮﻯ ﻭﺯﺍﺭﺓ ﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ ،‬ﰎ ﺍﻟﺘﻮﺳﻊ ﰲ ﻣﻨﺎﻓﺬ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺑﺈﻧﺸﺎﺀ ﺃﻛﺜﺮ ﻣﻦ ‪٢٣‬‬
‫ﻣﻜﺘﺐ ﺗﺄﻫﻴﻞ ﺍﺟﺘﻤﺎﻋﻲ ﺟﺪﻳﺪﺍﹰ ﻟﻠﻤﺴﺎﳘﺔ ﰲ ﺗﻐﻄﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﳌﻌﺎﻗﲔ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﶈﺮﻭﻣﺔ‬
‫ﻭﺍﻟﻨﺎﺋﻴﺔ ﺑﺼﻮﺭﺓ ﺧﺎﺻﺔ ﻭﺍﻟﺘﻮﺳﻊ ﰲ ﺗﺄﺳﻴﺲ ﺣﻀﺎﻧﺎﺕ ﺍﳌﻌﺎﻗﲔ‪ .‬ﻛﻤﺎ ﻋﻤﻠﺖ ﺍﻟﻮﺯﺍﺭﺓ ﻋﻠﻲ ﲡﺮﻳﺐ‬
‫ﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﱰﱄ )ﺑﻮﺭﺗﻴﺪﺝ( ﰲ ﻋﺪﺩ ﻣﻦ ﺍﳌﺮﺍﻛﺰ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﺍ‪‬ﻠﺲ ﺍﻟﻌﺮﰊ ﻟﻠﻄﻔﻮﻟﺔ ﻭﺍﻟﻌﻤﻞ‬
‫ﻋﻠﻲ ﺗﻄﻮﻳﺮ ﺑﺮﺍﻣﺞ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﻬﲏ‪ .‬ﻛﻤﺎ ﻗﺎﻣﺖ ﺍﻟﻮﺯﺍﺭﺓ ﺑﺪﻋﻢ ﻋﺪﺩ ﻭﺍﺳﻊ ﻣﻦ ﺍﳉﻤﻌﻴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﰲ ﻫﺬﺍ‬
‫ﺍ‪‬ﺎﻝ‪.‬‬
‫ﻋﻠﻲ ﻣﺴﺘﻮﻯ ﻭﺯﺍﺭﺓ ﺍﻟﺘﺮﺑﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﰎ ﺍﻟﺒﺪﺀ ﰲ ﺑﺮﻧﺎﻣﺞ ﻟﺘﻄﻮﻳﺮ ﺁﻓﺎﻕ ﺍﻟﺘﺮﺑﻴﺔ ﺍﻟﻔﻜﺮﻳﺔ ﻣﻦ ﺧﻼﻝ ﳕﺎﺫﺝ‬
‫ﲡﺮﻳﺒﻴﺔ ﻣﺘﺰﺍﻳﺪﺓ‪ .‬ﻛﻤﺎ ﰎ ﺍﻟﺘﻮﺳﻊ ﰲ ﺍﻟﺘﻐﻄﻴﺔ ﺍﳉﻐﺮﺍﻓﻴﺔ ﻟﻠﻤﺪﺍﺭﺱ ﻭﺍﻟﻔﺼﻮﻝ ﺍﳌﻠﺤﻘﺔ )‪ (٢٤٤‬ﻟﺘﺸﻤﻞ‬
‫ﺍﳌﺮﺍﻛﺰ ﻭﺍﻟﻘﺮﻯ ﺍﻟﻨﺎﺋﻴﺔ ﺑﻌﺪ ﺃﻥ ﻛﺎﻧﺖ ﺗﺘﺮﻛﺰ ﺗﻘﺮﻳﺒﺎ ﰲ ﺍﳌﺪﻥ‪ .‬ﻛﻤﺎ ﳚﺮﻱ ﺣﺎﻟﻴﺎ ﺍﺳﺘﺤﺪﺍﺙ ﻣﺮﺣﻠﺔ ﺭﻳﺎﺽ‬
‫ﺍﻷﻃﻔﺎﻝ ﻭﺍﻟﱵ ﱂ ﺗﻜﻦ ﻣﻮﺟﻮﺩﺓ ﻣﻦ ﻗﺒﻞ ﻭﺍﻻﲡﺎﻩ ﳓﻮ ﺩﻣﺞ ﺍﻷﻃﻔﺎﻝ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﰲ‬
‫ﺍﳌﺪﺍﺭﺱ ﺍﻟﻌﺎﻣﺔ‪.‬‬

‫‪٢١٥‬‬
 ‫ﻓﺠﻮﺍﺕ ﳚﺐ ﺍﻟﺘﻐﻠﺐ ﻋﻠﻴﻬﺎ‬
‫ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﻛﻞ ﻫﺬﻩ ﺍﻟﺘﻄﻮﺭﺍﺕ ﺍﳍﺎﻣﺔ‪ ،‬ﻓﻤﺎ ﺯﺍﻟﺖ ﻫﻨﺎﻙ ﻓﺠﻮﺍﺕ ﻛﺒﲑﺓ ﺑﲔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻣﻮﺍﺟﻬﺔ‬
‫ﺍﳌﺸﻜﻠﺔ ﻣﻦ ﺟﺎﻧﺐ ﻭﺍﻟﺘﺪﺧﻼﺕ ﺍﻟﻘﺎﺋﻤﺔ ﻣﻦ ﺟﺎﻧﺐ ﺁﺧﺮ‪ .‬ﺇﻥ ﺭﺻﺪ ﻫﺬﻩ ﺍﻟﻔﺠﻮﺍﺕ ﻳﺴﺎﻋﺪ ﻭﻻﺷﻚ ﰲ‬
‫ﲢﺪﻳﺪ ﺍ‪‬ﺎﻻﺕ ﺍﻟﱵ ﻣﺎﺯﺍﻟﺖ ﲢﺘﺎﺝ ﺇﱄ ﺗﻄﻮﺭ ﻭﺑﺎﻟﺘﺎﱄ ﺍﻷﻫﺪﺍﻑ ﻭﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﻭﺍﻟﺘﺪﺧﻼﺕ ﺍﳌﻄﻠﻮﺏ‬
‫ﺍﻟﻘﻴﺎﻡ ‪‬ﺎ‪.‬‬
‫ﺃﻭﻻ‪ :‬ﰲ ﳎﺎﻝ ﺍﳌﻔﺎﻫﻴﻢ ﻭﺍﲡﺎﻫﺎﺕ ﺍﻟﺘﺄﻫﻴﻞ‪ :‬ﻋﺪﻡ ﺍﻟﻮﺻﻮﻝ ﺇﱄ ﺍﺗﻔﺎﻕ ﻭﺍﺿﺢ ﺣﻮﻝ ﺗﻌﺮﻳﻒ ﻭﺗﺼﻨﻴﻒ‬
‫ﻭﻃﺮﻕ ﺭﺻﺪ ﺍﻹﻋﺎﻗﺔ ﻭﻣﻮﺍﺟﻬﺘﻬﺎ‪ ،‬ﻣﻊ ﺗﺒﺎﻳﻨﺎﺕ ﰲ ﻃﺮﻕ ﺍﳌﻮﺍﺟﻬﺔ ﻭﺃﻭﻟﻮﻳﺘﻬﺎ ﻭﰲ ﻣﺪﻱ ﻭﻋﻤﻖ ﺗﺒﲏ‬
‫ﻭﺗﻄﺒﻴﻖ ﻣﻨﻬﺞ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ‪ ،‬ﻭﺍﺳﺘﻤﺮﺍﺭ ﺍﻋﺘﻤﺎﺩ ﻣﻌﻈﻢ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺘﺄﻫﻴﻠﻴﺔ ﻋﻠﻲ‬
‫ﺍﳌﺮﺍﻛﺰ ﻭﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﱵ ﺗﺘﺒﻊ ﺃﺳﻠﻮﺏ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﺆﺳﺴﻲ ﺍﻟﺬﻱ ﻳﻌﺎﱐ ﻣﻦ ﺳﻠﺒﻴﺎﺕ ﻫﺎﻣﺔ ﰲ ﻣﻘﺪﻣﺘﻬﺎ‬
‫ﻋﺪﻡ ﺍﻟﻜﻔﺎﻳﺔ ﻭﻋﺪﻡ ﺍﻟﻌﺪﺍﻟﺔ ﻭﺍﻻﺑﺘﻌﺎﺩ ﻋﻦ ﺍﻟﺪﻣﺞ ﻭﺍﳋﺮﻭﺝ ﻣﻦ ﺇﻃﺎﺭ ﺍﻟﺘﻨﻤﻴﺔ ﻭﻧﻘﺺ ﺍﳌﺸﺎﺭﻛﺔ‬
‫ﺍ‪‬ﺘﻤﻌﻴﺔ‪.‬‬
‫ﺛﺎﻧﻴﺎ‪ :‬ﰲ ﳎﺎﻝ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻟﺘﺸﺮﻳﻌﺎﺕ‪ :‬ﺍﺳﺘﻤﺮﺍﺭ ﺍﻻﺣﺘﻴﺎﺝ ﻟﻠﻤﺰﻳﺪ ﻣﻦ ﺗﻮﺣﻴﺪ ﺍﻟﺮﺅﻯ ﻭﺍﻟﺴﻴﺎﺳﺎﺕ ﺑﲔ‬
‫ﺍﻷﻃﺮﺍﻑ ﺍﳌﻌﻨﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ ﻭﻃﺮﻕ ﲢﻮﻳﻠﻬﺎ ﺇﱄ ﺗﺪﺧﻼﺕ ﳏﺪﺩﺓ ﻋﻠﻲ ﺍﳌﺴﺘﻮﻳﲔ ﺍﶈﻠﻲ ﻭﺍﻟﻘﻮﻣﻲ‪ ،‬ﻭﺗﻘﻠﻴﻞ‬
‫ﺍﳌﺴﺎﻓﺔ ﺑﲔ ﺍﳋﻄﻂ ﻭﺍﻟﱪﺍﻣﺞ ﺍﻟﻔﻌﻠﻴﺔ ﰲ ﺍﻟﻘﺪﺭﺓ ﻋﻠﻲ ﺍﻟﺘﺼﺪﻱ ﻟﻸﺑﻌﺎﺩ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻤﺸﻜﻠﺔ‬
‫ﻭﺍﺳﺘﻴﻌﺎﺏ ﺍﻷﻃﺮﺍﻑ ﺍﳌﻌﻨﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ ﻭﺗﻐﻄﻴﺔ ﺍﻷﻗﺎﻟﻴﻢ ﺍﳉﻐﺮﺍﻓﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﺛﺎﻟﺜﺎ‪ :‬ﰲ ﳎﺎﻝ ﺍﻟﺘﻨﺴﻴﻖ ﻭﺍﻟﺘﻜﺎﻣﻞ‪ :‬ﺍﺳﺘﻤﺮﺍﺭ ﻣﺸﻜﻠﺔ ﻧﻘﺺ ﺍﻟﺘﻨﺴﻴﻖ ﻭﺍﻟﺘﻜﺎﻣﻞ ﺑﲔ ﺍﻟﻘﻄﺎﻋﺎﺕ‬
‫ﺍﳌﺨﺘﻠﻔﺔ ﻭﺑﲔ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺎﺕ ﻛﻈﺎﻫﺮﺓ ﻋﺎﻣﺔ ﻋﻠﻲ ﺃﺭﺽ ﺍﻟﻮﺍﻗﻊ‪ ،‬ﳑﺎ ﻳﺆﺩﻱ ﺇﱄ ﺇﻫﺪﺍﺭ ﻟﻠﻤﻮﺍﺭﺩ ﻭﺇﱄ‬
‫ﺇﺿﺎﻓﺔ ﺃﻋﺒﺎﺀ ﻣﺎﻟﻴﺔ ﻭﺍﺟﺘﻤﺎﻋﻴﺔ ﺑﺎﻫﻈﺔ‪ .‬ﻓﻬﻨﺎﻙ ﻗﺼﻮﺭ ﰲ ﲢﺪﻳﺪ ﺍﻷﺩﻭﺍﺭ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻸﻃﺮﺍﻑ ﺍﳌﻌﻨﻴﺔ‬
‫ﻭﺍﻻﺗﻔﺎﻕ ﻋﻠﻴﻬﺎ ﻭﺍﻹﻟﺰﺍﻡ ‪‬ﺎ ﻭﺍﺳﺘﻤﺮﺍﺭﻫﺎ ﻣﻦ ﺃﺟﻞ ﺗﻌﻤﻴﻖ ﺗﻜﺎﻣﻠﻬﺎ ﻭﲡﺎﻭﺯ ﺗﻜﺮﺍﺭﻫﺎ‪ ،‬ﻛﻤﺎ ﺃﻥ ﻫﻨﺎﻙ‬
‫ﻗﺼﻮﺭﺍﹰ ﰲ ﺁﻟﻴﺎﺕ ﻭﺃﺩﻭﺍﺕ ﲢﻘﻴﻖ ﺍﻟﺘﻜﺎﻣﻞ ﻭﺍﻟﺘﻌﺎﻭﻥ ﺑﲔ ﺍﻷﻃﺮﺍﻑ ﺍﳌﻌﻨﻴﺔ ﻋﻠﻲ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﺭﺍﺑﻌﺎ‪ :‬ﰲ ﳎﺎﻝ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ‪ :‬ﺍﺳﺘﻤﺮﺍﺭ ﻭﺟﻮﺩ ﻧﻘﺺ ﺣﺎﺩ ﰲ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻘﺎﺋﻤﺔ ﻣﻘﺎﺭﻧﺔ ﺑﺎﻻﺣﺘﻴﺎﺟﺎﺕ‪ ،‬ﺇﺫ‬
‫ﺗﻐﻄﻲ ﻣﺎ ﻳﻘﺮﺏ ﻣﻦ ‪ %٥-٣‬ﻓﻘﻂ ﰲ ﺑﻌﺾ ﺍﳉﻮﺍﻧﺐ‪ ،‬ﻛﻤﺎ ﻻ ﺗﺰﺍﻝ ﻓﻌﻠﻴﺎ ﺻﻌﺒﺔ ﺍﳌﻨﺎﻝ ﺧﺎﺻﺔ ﺑﺎﻟﻨﺴﺒﺔ‬
‫ﻟﻠﻔﻘﺮﺍﺀ ﻭﻟﻘﺎﻃﲏ ﺍﻟﺮﻳﻒ ﻭﺍﳌﻨﺎﻃﻖ ﺍﻟﻨﺎﺋﻴﺔ‪ ،‬ﻭﻣﺎ ﺯﺍﻟﺖ ﻳﻐﻠﺐ ﻋﻠﻴﻬﺎ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﻷﻋﺮﺍﺽ ﻭﻟﻴﺲ‬
‫ﺍﻷﺳﺒﺎﺏ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ ﺍﳌﺆﺩﻳﺔ ﳍﺎ‪ .‬ﻭﺗﻔﺘﻘﺪ ﺍﻟﺘﻜﺎﻣﻞ ﻭﺗﺘﻌﺎﻣﻞ ﻣﻊ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ‬
‫ﻭﺃﺳﺮﻫﻢ ﺑﺎﻋﺘﺒﺎﺭﻫﻢ ﻣﺘﻠﻘﲔ ﻟﻠﺨﺪﻣﺔ ﻭﻟﻴﺴﻮﺍ ﺷﺮﻛﺎﺀ ﰲ ﺍﻟﻘﻀﻴﺔ‪ ،‬ﳑﺎ ﻳﻌﻤﻖ ﺍﻻﻋﺘﻤﺎﺩﻳﺔ ﻋﻨﺪ ﲨﻬﻮﺭ‬
‫ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﻭﻳﻘﻠﻞ ﻣﻦ ﻗﺪﺭﺓ ﺍﳋﺪﻣﺎﺕ ﻋﻠﻲ ﺍﻟﺘﺼﺪﻱ ﻻﺣﺘﻴﺎﺟﺎ‪‬ﻢ ﺍﳊﻘﻴﻘﻴﺔ‪.‬‬
‫ﺧﺎﻣﺴﺎ‪ :‬ﻓﺠﻮﺍﺕ ﺧﺎﺻﺔ‪:‬‬
‫ﰲ ﳎﺎﻝ ﺍﻟﻮﻗﺎﻳﺔ ﻭﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ‪ :‬ﺍﺳﺘﻤﺮﺍﺭ ﻧﻘﺺ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳌﺘﻮﺍﻓﺮﺓ ﻋﻦ ﺃﺳﺒﺎﺏ ﺍﻹﻋﺎﻗﺔ ﰲ ﻣﺼﺮ‬
‫ﻭﻋﻮﺍﻣﻞ ﺍﳋﻄﺮ ﺍﳌﺆﺩﻳﺔ ﳍﺎ ﳑﺎ ﻳﻀﻌﻒ ﻭﺿﻊ ﺍﻷﻭﻟﻮﻳﺎﺕ ﻭﺍﻟﺘﺨﻄﻴﻂ‪ ،‬ﻭﻭﺟﻮﺩ ﻗﺼﻮﺭ ﰲ ﻧﻈﻢ ﻭﺃﺩﻭﺍﺕ‬
‫ﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻟﻺﻋﺎﻗﺔ ﻭﺍﻻﺗﻔﺎﻕ ﻋﻠﻴﻬﺎ ﻭﺗﻌﻤﻴﻤﻬﺎ ﻋﻠﻲ ﻣﻨﺎﻓﺬ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻼﺋﻤﺔ ﻭﺍﻟﻘﺎﺩﺭﺓ ﻋﻠﻲ‬
‫ﺍﻟﺘﻌﺮﻑ ﻭﺍﻛﺘﺸﺎﻑ ﺍﻹﻋﺎﻗﺔ ﺑﲔ ﺍﳌﻮﺍﻃﻨﲔ ﻣﻦ ﳐﺘﻠﻒ ﺍﻷﻋﻤﺎﺭ ﺧﺎﺻﺔ ﺳﻦ ﻣﺎ ﻗﺒﻞ ﺍﳌﺪﺭﺳﺔ‪.‬‬

‫‪٢١٦‬‬
‫ﰲ ﳎﺎﻝ ﺍﻟﺘﺸﺨﻴﺺ ﻭﺍﻟﺘﻘﻴﻴﻢ‪ :‬ﺍﺳﺘﻤﺮﺍﺭ ﺍﻟﻘﺼﻮﺭ ﰲ ﺗﻮﻓﺮ ﻓﺮﻕ ﺍﻟﻌﻤﻞ ﻣﺘﻌﺪﺩﺓ ﺍﻟﺘﺨﺼﺼﺎﺕ ﻭﺿﻌﻒ‬
‫ﻃﺮﻳﻘﺔ ﻋﻤﻠﻬﺎ ﻛﻔﺮﻳﻖ ﻣﺘﻜﺎﻣﻞ‪ ،‬ﳑﺎ ﻳﺆﺩﻱ ﺇﱄ ﲡﺰﺋﺔ ﺧﺪﻣﺎﺕ ﺍﻟﺘﺸﺨﻴﺺ ﻭﺍﻟﺘﻘﻴﻴﻢ ﺑﲔ ﺍﳌﻬﻨﻴﲔ‬
‫ﺍﳌﺨﺘﻠﻔﲔ‪ ،‬ﻭﺻﻌﻮﺑﺔ ﺍﻟﻮﺻﻮﻝ ﺇﱄ ﺗﺸﺨﻴﺺ ﻭﺗﻘﻴﻴﻢ ﻣﺘﻜﺎﻣﻞ ﻳﺴﺘﺠﻴﺐ ﻟﻼﺣﺘﻴﺎﺟﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‬
‫ﻟﻠﺸﺨﺺ ﺍﳌﻌﺎﻕ ﺑﺼﻮﺭﺓ ﻣﺘﻜﺎﻣﻠﺔ‪.‬‬
‫ﰲ ﳎﺎﻝ ﺗﻌﻠﻴﻢ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ‪ :‬ﺍﺳﺘﻤﺮﺍﺭ ﻭﺟﻮﺩ ﻧﻘﺺ ﻛﺒﲑ ﰲ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻭﰲ ﻭﻋﻲ ﺍﻷﺳﺮ ﺑﺄﳘﻴﺔ ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﺗﻨﻌﻜﺲ ﻋﻠﻲ ﻋﺪﻡ ﻭﺻﻮﻝ ﻗﻄﺎﻋﺎﺕ ﻭﺍﺳﻌﺔ ﻣﻦ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﳌﻌﺎﻗﲔ ﰲ ﺳﻦ ﺍﻟﺘﻌﻠﻴﻢ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪ ،‬ﺧﺎﺻﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻘﺎﻃﲏ ﺍﻟﺮﻳﻒ ﻭﺍﳌﻨﺎﻃﻖ ﺍﻟﻨﺎﺋﻴﺔ‬
‫ﻭﳌﺘﻌﺪﺩﻱ ﺍﻹﻋﺎﻗﺔ ﻭﻛﺬﻟﻚ ﻣﺘﻮﺳﻄﻲ ﻭﺷﺪﻳﺪﻱ ﺍﻹﻋﺎﻗﺎﺕ ﺍﻟﺬﻫﻨﻴﺔ‪.‬‬
‫ﰲ ﳎﺎﻝ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﻬﲏ‪ :‬ﺍﺳﺘﻤﺮﺍﺭ ﻧﻘﺺ ﺇﻣﻜﺎﻧﻴﺎﺕ ﻭﻓﺮﺹ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﻬﲏ ﻭﳕﻄﻴﺔ ﺃﺳﺎﻟﻴﺒﻪ ﺍﻟﻘﺎﺋﻤﺔ‬
‫ﻭﻋﺪﻡ ﺗﻮﺍﻓﻘﻬﺎ ﻣﻊ ﻗﺪﺭﺍﺕ ﺍﳌﻌﺎﻕ ﻭﺭﻏﺒﺎﺕ ﻭﺇﻣﻜﺎﻧﺎﺕ ﺍﻷﺳﺮ ﻭﻋﺪﻡ ﲡﺎﻭ‪‬ﺎ ﻣﻊ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳊﻘﻴﻘﺔ‬
‫ﻟﺴﻮﻕ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﰲ ﳎﺎﻝ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺘﺸﻐﻴﻞ‪ :‬ﺗﻨﻌﻜﺲ ﺍﻟﺴﻠﺒﻴﺎﺕ ﺍﻟﻘﺎﺋﻤﺔ ﰲ ﳎﺎﻝ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﻬﲏ ﻣﻦ ﺟﺎﻧﺐ ﻭﺗﻐﲑﺍﺕ‬
‫ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺴﻮﻕ ﻭﺗﻔﺎﻋﻠﻬﺎ ﻣﻊ ﺳﻴﺎﺩﺓ ﺍﻟﺘﻮﺟﻬﺎﺕ ﺍﻟﺴﻠﺒﻴﺔ ﻟﺼﺎﺣﱯ ﺍﻷﻋﻤﺎﻝ ﰲ ﻭﺿﻊ ﺻﻌﻮﺑﺎﺕ‬
‫ﻭﻋﺮﺍﻗﻴﻞ ﺣﻘﻴﻘﻴﺔ ﲡﺎﻩ ﻋﻤﻞ ﻭﺗﺸﻐﻴﻞ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ‪.‬‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﺍﳋﺎﺻﺔ ﲝﺠﻢ ﺍﳌﺸﻜﻠﺔ ﻭﺃﺳﺒﺎ‪‬ﺎ‪ :‬ﻣﺎ ﺯﺍﻟﺖ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺳﻮﺍﺀ ﺗﻠﻚ ﺍﳌﺘﻌﻠﻘﺔ‬
‫ﺑﺄﺳﺒﺎﺏ ﺍﳌﺸﻜﻠﺔ ﺃﻭ ﺃﻧﻮﺍﻋﻬﺎ ﻣﺘﺒﺎﻳﻨﺔ ﰲ ﺃﺣﻴﺎﻥ ﻛﺜﲑﺓ‪ ،‬ﻭﻳﺘﻢ ﺍﻟﻮﺻﻮﻝ ﺇﻟﻴﻬﺎ ﻭﻓﻘﺎ ﳌﻌﺎﻳﲑ ﻭﻃﺮﻕ ﻭﺃﺩﻭﺍﺕ‬
‫ﳐﺘﻠﻔﺔ‪ .‬ﰲ ﻇﻞ ﻏﻴﺎﺏ ﻧﻈﺎﻡ ﻣﻮﺣﺪ ﻟﺘﺴﺠﻴﻞ ﺍﻹﻋﺎﻗﺔ ﻋﻨﺪ ﺍﻛﺘﺸﺎﻓﻬﺎ ﰲ ﺍﳌﺮﺍﺣﻞ ﺍﻟﺴﻨﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ‬
‫ﻭﻓﻘﺎ ﳌﻌﺎﻳﲑ ﳏﺪﺩﺓ ﻭﻟﺮﺑﻂ ﻣﻨﺎﻓﺬ ﺍﻟﺘﺴﺠﻴﻞ ﲟﺮﻛﺰ ﻗﻮﻣﻲ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ‪ ،‬ﻛﻤﺎ ﻻ ﻳﺰﺍﻝ ﺗﻮﺛﻴﻖ ﺍﻟﺘﺠﺎﺭﺏ‬
‫ﻭﺍﻟﻘﻀﺎﻳﺎ ﻭﺍﻷﲝﺎﺙ ﺍﳌﺨﺘﻠﻔﺔ ﻭﺇﺗﺎﺣﺔ ﻫﺬﻩ ﺍﻟﻮﺛﺎﺋﻖ ﻟﺼﺎﻧﻌﻲ ﺍﻟﻘﺮﺍﺭ ﻭﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻬﺘﻤﲔ ﺑﺘﻠﻚ‬
‫ﺍﻟﻘﻀﻴﺔ ﻏﲑ ﻛﺎﻑ ﺑﺸﻜﻞ ﻛﺒﲑ‪.‬‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﺪﻭﺭ ﺍﻹﻋﻼﻡ‪ :‬ﻣﺎ ﺗﺰﺍﻝ ﺍﻟﺮﺳﺎﻟﺔ ﺍﻹﻋﻼﻣﻴﺔ ﺗﺼﻮﺭ ﺍﳌﻌﺎﻕ ﰲ ﺍﻷﻏﻠﺐ ﺑﺸﻜﻞ ﻏﲑ ﻣﻮﺿﻮﻋﻲ ﻭﻏﲑ‬
‫ﺣﻘﻴﻘﻲ ﻳﺪﻋﻮ ﺇﱄ ﺍﻟﺸﻔﻘﺔ ﺃﻭ ﻳﻬﻮﻝ ﻣﻦ ﺇﻣﻜﺎﻧﻴﺎﺗﻪ‪ ،‬ﻭﻣﺎ ﺯﺍﻟﺖ ﺍﻟﱪﺍﻣﺞ ﺍﻟﱵ ﺗﺘﻨﺎﻭﻝ ﻗﻀﻴﺔ ﺍﻹﻋﺎﻗﺔ ﰲ‬
‫ﺍﻷﻏﻠﺐ ﺑﺮﺍﻣﺞ ﺧﺎﺻﺔ ﻏﲑ ﺟﺬﺍﺑﺔ‪ ،‬ﻻ ﺗﻌﺮﺽ ﺍﳌﻌﺎﻗﲔ ﻛﺠﺰﺀ ﻃﺒﻴﻌﻲ ﻣﻦ ﻧﺴﻴﺞ ﺍ‪‬ﺘﻤﻊ ﻭﻻ ﺗﺮﻛﺰ ﻋﻠﻲ‬
‫ﻣﺸﺎﺭﻛﺔ ﺍﻷﺷﺨﺎﺹ ﺍﳌﻌﺎﻗﲔ ﻭﺃﺳﺮﻫﻢ ﰲ ﺍﳊﻴﺎﺓ ﺍﻟﻄﺒﻴﻌﻴﺔ‪.‬‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻘﻄﺎﻉ ﺍﻷﻫﻠﻲ‪ :‬ﻻ ﺗﺰﺍﻝ ﻣﺴﺎﳘﺔ ﻫﺬﺍ ﺍﻟﻘﻄﺎﻉ ﺗﻌﺎﱐ ﻣﻦ ﻧﻘﺺ ﺍﻹﻣﻜﺎﻧﻴﺎﺕ ﻭﺍﳌﻮﺍﺭﺩ ﻭﺧﺎﺻﺔ‬
‫ﺍﳌﻮﺍﺭﺩ ﺍﻟﺪﺍﺧﻠﻴﺔ‪ ،‬ﻛﻤﺎ ﻳﺮﻛﺰ ﻋﻤﻞ ﺃﻏﻠﺒﻴﺔ ﺍﳉﻤﻌﻴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﰲ ﺍﳌﺪﻥ ﺩﻭﻥ ﺍﻟﺮﻳﻒ ﻭﺍﳌﻨﺎﻃﻖ ﺍﻟﻨﺎﺋﻴﺔ‪ ،‬ﻛﻤﺎ‬
‫ﻳﻮﺟﺪ ﺿﻌﻒ ﲤﺜﻴﻞ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﻭﺃﺳﺮﻫﻢ ﺑﺸﻜﻞ ﻋﺎﻡ ﰲ ﺇﺩﺍﺭﺍﺕ ﻫﺬﻩ‬
‫ﺍﳍﻴﺌﺎﺕ‪.‬‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﺪﻭﺭ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﻭﺃﺳﺮﻫﻢ‪ :‬ﻻ ﻳﺰﺍﻝ ﺩﻭﺭ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ‬
‫ﺍﳋﺎﺻﺔ ﻭﺃﺳﺮﻫﻢ ﳏﺪﻭﺩﺍ ﻭﻏﲑ ﻣﻨﻈﻢ‪ .‬ﻭﻣﺎ ﺯﺍﻟﺖ ﺃﻏﻠﺒﻴﺔ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﰲ ﻣﻮﻗﻊ‬
‫ﺍﳌﺘﻠﻘﻲ ﻟﻠﺨﺪﻣﺔ ﻭﻟﻴﺲ ﺍﻟﻌﻨﺼﺮ ﺍﻟﻔﺎﻋﻞ ﻭﺍﻟﻘﺎﺋﺪ ﻟﻠﺘﻄﻮﻳﺮ‪ .‬ﻭﻣﺎ ﺯﺍﻝ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺃﺳﺮ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ‬
‫ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﺗﺸﻮ‪‬ﺎ ﺍﻟﺴﻠﺒﻴﺔ ﲡﺎﻩ ﺍﳌﻌﺎﻗﲔ ﺧﺎﺻﺔ ﺍﻹﻧﺎﺙ‪ ،‬ﻭﺗﺘﺮﺍﻭﺡ ﺍﻟﺘﻮﺟﻬﺎﺕ ﻣﻦ ﺍﳋﺠﻞ‬
‫ﻭﺍﻟﺸﻔﻘﺔ ﻋﻠﻴﻬﻢ ﺇﱄ ﻋﺰﳍﻢ ﻋﻦ ﺍﳌﺸﺎﺭﻛﺔ ﰲ ﺣﻴﺎﺓ ﺍﻷﺳﺮﺓ ﻭﺗﺸﺠﻴﻌﻬﻢ ﻟﻼﻧﺪﻣﺎﺝ ﰲ ﺍ‪‬ﺘﻤﻊ‪ .‬ﻭﻣﺎ‬

‫‪٢١٧‬‬
‫ﺯﺍﻟﺖ ﺍﳍﻴﺌﺎﺕ ﺍﻟﱵ ﺗﺸﻜﻠﺖ ﻣﻦ ﻗﺒﻞ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﻭﺃﺳﺮﻫﻢ ﺗﻨﺘﻤﻲ ﰲ ﺍﻷﻏﻠﺐ‬
‫ﺍﻷﻋﻢ ﺇﱄ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﳌﻴﺴﻮﺭﺓ ﻭﻻ ﲤﺜﻞ ﺻﻮﺕ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻷﻭﺳﻊ ﻣﻦ ﺍﳌﻌﺎﻗﲔ ﻭﺃﺳﺮﻫﻢ‪ ،‬ﻭﻣﺎ ﺯﺍﻟﺖ‬
‫ﺗﺮﻛﺰ ﻋﻠﻲ ﺗﺄﺳﻴﺲ ﺧﺪﻣﺎﺕ ﺗﻌﻠﻴﻤﻴﺔ ﻭﺗﺄﻫﻴﻠﻴﺔ ﻣﺘﻘﺪﻣﺔ ﻏﲑ ﻗﺎﺑﻠﺔ ﻟﻠﺘﻌﻤﻴﻢ ﻭﺍﻟﺘﻜﺮﺍﺭ ﰲ ﺣﲔ ﺗﻔﺘﻘﺪ‬
‫ﺇﱄ ﺍﻟﺮﺅﻳﺔ ﺍﳋﺎﺻﺔ ﺑﻀﺮﻭﺭﺓ ﺗﻄﻮﻳﺮ ﺍﻟﻮﻋﻲ ﺍ‪‬ﺘﻤﻌﻲ ﻭﺗﻐﻴﲑ ﺍﻟﺘﻮﺟﻬﺎﺕ ﺍﻟﺴﻠﺒﻴﺔ ﰲ ﺍ‪‬ﺘﻤﻊ ﻭﺍﻟﺘﻌﺒﺌﺔ‬
‫ﻭﺍﻟﺪﻓﺎﻉ ﻋﻦ ﺣﻘﻮﻕ ﺍﳌﻌﺎﻗﲔ‪.‬‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﺘﻮﺟﻬﺎﺕ ﺍ‪‬ﺘﻤﻊ ﲡﺎﻩ ﻗﻀﻴﺔ ﺍﻹﻋﺎﻗﺔ ﻭﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ‪ :‬ﻻ ﺗﺰﺍﻝ‬
‫ﺍﻟﺘﻮﺟﻬﺎﺕ ﺍﻟﺴﺎﺋﺪﺓ ﻳﺸﻮ‪‬ﺎ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻟﺴﻠﺒﻴﺎﺕ‪ ،‬ﺇﺫ ﺗﺘﺮﺍﻭﺡ ﻧﻈﺮﺓ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﻮﺍﻃﻨﲔ ﲡﺎﻩ‬
‫ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﻣﻦ ﺍﻟﺸﻔﻘﺔ ﺇﱄ ﺍﳋﻮﻑ ﺑﻞ ﻭﺍﻻﴰﺌﺰﺍﺯ ﺃﺣﻴﺎﻧﺎ‪ ،‬ﳑﺎ ﻳﻨﻌﻜﺲ ﻋﻠﻲ‬
‫ﺍﻟﺒﻴﺌﺔ ﺍﻟﻔﻴﺰﻳﻘﻴﺔ ﻟﻠﻤﺠﺘﻤﻊ ﻭﺍﻟﱵ ﻻ ﺗﻀﻊ ﰲ ﺣﺴﺒﺎ‪‬ﺎ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ ﺍﻹﻋﺎﻗﺎﺕ‪ ،‬ﻓﺎﻟﻄﺮﻕ‬
‫ﻭﺍﳌﻮﺍﺻﻼﺕ ﻭﺍﻷﻣﺎﻛﻦ ﺍﻟﻌﺎﻣﺔ ﰲ ﺍﻷﻏﻠﺐ ﻏﲑ ﻣﺘﺎﺣﺔ ﳍﻢ‪ ،‬ﻭﻳﺆﺛﺮ ﺫﻟﻚ ﻋﻠﻲ ﻋﻤﻠﻴﺔ ﺍﻹﻋﺎﻗﺔ ﻭﺍﻟﱵ ﺗﺆﺩﻱ‬
‫ﺇﱄ ﺍﻟﻌﺠﺰ ﺭﲟﺎ ﺃﻛﺜﺮ ﻣﻦ ﺍﻷﺳﺒﺎﺏ ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺔ ﺍﻷﺻﻠﻴﺔ‪.‬‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﱪﺍﻣﺞ ﺍﻟﻘﺎﺋﻤﺔ ﰲ ﳎﺎﻝ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ‪ :‬ﻓﻼ ﺗﻮﺟﺪ ﺧﻄﺔ ﻗﻮﻣﻴﺔ ﻟﺪﻋﻢ‬
‫ﺍﳌﺒﺎﺩﺭﺍﺕ ﻭﺍﳌﺸﺮﻭﻋﺎﺕ ﺍﶈﻠﻴﺔ ﻟﻠﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ‪ .‬ﻛﻤﺎ ﺃﻥ ﻫﻨﺎﻙ ﻧﻘﺼﺎﹰ ﰲ ﴰﻮﻟﻴﺔ ﺍﻷﻧﺸﻄﺔ‬
‫ﺍﶈﻠﻴﺔ ﻟﻠﻔﺌﺎﺕ ﺍﻟﻌﻤﺮﻳﺔ ﻭﻧﻮﻋﻴﺎﺕ ﺍﻹﻋﺎﻗﺔ ﺍﳌﺨﺘﻠﻔﺔ ﻭﻋﺪﻡ ﻛﻔﺎﻳﺔ ﻣﺸﺎﺭﻛﺔ ﺍﻷﺷﺨﺎﺹ ﺫﻭﻱ‬
‫ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ ﻭﺃﺳﺮﻫﻢ ﻭﻋﻨﺎﺻﺮ ﺍ‪‬ﺘﻤﻊ ﺍﶈﻠﻲ‪ .‬ﻛﻤﺎ ﺃﻥ ﻫﻨﺎﻙ ﺻﻌﻮﺑﺔ ﰲ ﺗﻮﻓﲑ ﺍﻟﺘﻤﻮﻳﻞ ﺍﻟﻼﺯﻡ‬
‫ﻟﻠﻤﺸﺮﻭﻋﺎﺕ ﻭﺿﻌﻒ ﻋﻮﺍﻣﻞ ﺍﻻﺳﺘﻤﺮﺍﺭﻳﺔ ﻭﺑﻂﺀ ﺍﻧﺘﺸﺎﺭ ﺍﳌﺸﺮﻭﻋﺎﺕ ﻭﺍﻟﺘﻮﺳﻊ ﻓﻴﻬﺎ‪.‬‬
‫ﰲ ﻋﺎﻡ ‪ ٢٠٠٢‬ﺑﺪﺃ ﺍﻟﻌﻤﻞ ﰲ ﺑﺮﻧﺎﻣﺞ ﺗﻄﻮﻳﺮ ﻣﺸﺮﻭﻋﺎﺕ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ ﻭﺍﻟﺬﻱ ﺗﺘﻌﺎﻭﻥ ﻓﻴﻪ‬
‫ﺍﻟﻠﺠﻨﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺤﺪ ﻣﻦ ﺍﻹﻋﺎﻗﺔ ﻭﻭﺯﺍﺭﰐ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﻫﻴﺌﺎﺕ ﺍﻟﻴﻮﻧﺴﻴﻒ ﻭﺇﻧﻘﺎﺫ‬
‫ﺍﻟﻄﻔﻮﻟﺔ ﺍﻟﱪﻳﻄﺎﻧﻴﺔ‪ ،‬ﻣﻊ ﻣﺮﻛﺰ ﺳﻴﱵ )‪ (CARITAS-EGYPT‬ﻭﺍﳍﻴﺌﺔ ﺍﻟﻘﺒﻄﻴﺔ ﺍﻹﳒﻴﻠﻴﺔ ﻟﻠﺨﺪﻣﺎﺕ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ )‪ (CEOSS‬ﻭﲨﻌﻴﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ )‪ (AHED‬ﻛﺠﻤﻌﻴﺎﺕ ﻣﺴﺎﻧﺪﺓ‪،‬‬
‫ﻭﲨﻌﻴﺎﺕ ﺍﻟﺘﺄﻫﻴﻞ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺑﻜﻞ ﻣﻦ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ ﻭﻗﻨﺎ ﻭﲨﻌﻴﺔ ﺗﻨﻤﻴﺔ ﺍ‪‬ﺘﻤﻊ ﺍﶈﻠﻲ ﺍﻟﺴﻼﻡ ﺛﺎﱐ‬
‫ﺑﺎﻟﻘﺎﻫﺮﺓ ﻛﺠﻤﻌﻴﺎﺕ ﳏﻠﻴﺔ ﻣﻨﻔﺬﺓ ﺃﺳﺎﺳﻴﺔ ﺗﺘﻌﺎﻭﻥ ﻣﻊ ﲨﻌﻴﺎﺕ ﺗﻨﻤﻴﺔ ﻭﻣﻜﺎﺗﺐ ﺗﺄﻫﻴﻞ ﳏﻠﻴﺔ ﰲ‬
‫ﻣﻮﺍﻗﻊ ﺍﳌﺸﺮﻭﻋﺎﺕ ﲟﺤﺎﻓﻈﺎﺕ ﺍﻟﻘﺎﻫﺮﺓ ﻭﺍﻹﺳﻜﻨﺪﺭﻳﺔ ﻭﻗﻨﺎ‪.‬‬

‫&‪+
,2 3‬‬
‫ﺑﺪﺍﺧﻞ ﺍﻹﻃﺎﺭ ﺍﻟﻌﺎﻡ ﳊﻘﻮﻕ ﺍﻟﻄﻔﻞ‪ ،‬ﳚﺐ ﺃﻥ ﻳﺸﻤﻞ ﻣﻌﲎ ﺍﳊﻤﺎﻳﺔ ﺍﻵﰐ‪:‬‬
‫‪ .١‬ﺍﳊﻤﺎﻳﺔ ﻣﻦ ﻛﻞ ﺃﺷﻜﺎﻝ ﺍﻟﻌﻨﻒ ﻭﺍﻹﻳﺬﺍﺀ ﻭﺇﺳﺎﺀﺓ ﺍﳌﻌﺎﻣﻠﺔ‪ ،‬ﻭﺍﻹﳘﺎﻝ ﻭﺍﻻﺳﺘﻐﻼﻝ‪ ...‬ﲜﺎﻧﺐ‪،‬‬
‫‪ .٢‬ﲪﺎﻳﺔ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ‪.‬‬
‫ﺑﺎﻟﺘﺎﱄ ﻓﻘﺪ ﺗﺒﲎ ﳕﻮﺫﺝ ﺍﳊﻤﺎﻳﺔ ﺍﳋﺎﺹ ﲟﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ ﻭﻟﻴﺲ ﻓﻘﻂ ﺩﻧﻮ‬
‫ﺑﺴﻴﻂ ﻣﻨﻬﺎ‪ ،‬ﻭﻫﻮ ﺑﺬﻟﻚ ﻳﺴﻬﻢ ﰲ ﺗﻨﻤﻴﺔ ﺍﻷﻃﻔﺎﻝ ﺍﳌﻌﺮﺿﲔ‪.‬‬

‫‪٢١٨‬‬
 ‫ﻧ‪‬ﻈﻢ ﻗﺎﻧﻮﻧﻴﺔ‬
‫ﻳﻌﺘﱪ ﺳﻦ ﺍﻟﺮﺍﺑﻌﺔ ﻋﺸﺮﺓ ﺍﳊﺪ ﺍﻷﺩﱏ ﺍﻟﻘﺎﻧﻮﱐ ﻟﻜﻞ ﻓﺌﺎﺕ ﺍﻟﻌﻤﻞ‪ .‬ﻭﺑﺎﻻﺗﻔﺎﻕ ﻣﻊ ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ ﳝﻜﻦ‬
‫ﻟﺮﺅﺳﺎﺀ ﺍﳊﻜﻮﻣﺎﺕ ﺍﻟﺴﻤﺎﺡ ﺑﻌﻤﻞ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﺳﻦ ‪ ١٤ – ١٢‬ﻋﺎﻣﺎﹰ ﰲ ﺃﻋﻤﺎﻝ ﻣﻮﲰﻴﺔ ﻏﲑ ﺿﺎﺭﺓ‬
‫ﺑﺎﻟﺼﺤﺔ ﺃﻭ ﻣﻌﻄﻠﺔ ﻟﻠﺤﻀﻮﺭ ﺍﳌﺪﺭﺳﻲ‪ .‬ﻛﻤﺎ ﰎ ﻣﻨﻊ ﺍﻷﻋﻤﺎﻝ ﺍﳋﻄﲑﺓ ﳌﻦ ﻫﻢ ﺃﻗﻞ ﻣﻦ ‪ ١٧‬ﻋﺎﻣﺎﹰ‪ ،‬ﲜﺎﻧﺐ‬
‫ﺇﺭﺳﺎﺀ ﺍﻟﻘﻮﺍﻧﲔ ﺍﳌﻨﻈﻤﺔ ﳌﻮﺍﻋﻴﺪ ﺍﻟﻌﻤﻞ ﻭﺷﺮﻭﻃﻪ‪ .‬ﻋﻠﻰ ﺃﻥ ﻳﺘﻢ ﺗﻌﺮﺽ ﺍﻟﻌﺎﻣﻠﲔ ﻏﲑ ﺍﳌﻠﺘﺰﻣﲔ ‪‬ﺬﻩ‬
‫ﺍﻟﻘﻮﺍﻧﲔ ﺇﱃ ﻏﺮﺍﻣﺔ ﻣﺎﻟﻴﺔ ﺗﺼﻞ ﺇﱃ ‪ ٥٠٠ – ١٠٠‬ﺟﻨﻴﻪ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺗﻌﺮﺽ ﻫﺆﻻﺀ ﺍﻟﺬﻳﻦ ﻳﻌﻴﻘﻮﻥ‬
‫ﻋﻤﻠﻴﺔ ﺗﻌﻠﻴﻢ ﺍﻟﻄﻔﻞ ﺇﱃ ﺳﺠﻦ ﳌﺪﺓ ﺷﻬﺮ ﺃﻭ ﻏﺮﺍﻣﺔ ﻣﺎﻟﻴﺔ ﺗﺼﻞ ﺇﱃ ‪ ٥٠٠ – ٢٠٠‬ﺟﻨﻴﻪ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ‬
‫ﻛﻞ ﻫﺬﻩ ﺍﻟﻘﻮﺍﻧﲔ ﺇﻻ ﺃﻥ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻣﺎﺯﺍﻟﺖ ﻣﺴﺘﻤﺮﺓ‪.‬‬

‫ﻧﺴﺒﺔ ﺍﻧﺘﺸﺎﺭ ﻇﺎﻫﺮﺓ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ‬

‫ﻫﻨﺎﻙ ﺗﻌﺪﺩ ﰲ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﺍﳋﺎﺻﺔ ﺑﺘﺤﺪﻳﺪ ﻣﺪﻱ ﺍﻧﺘﺸﺎﺭ ﻫﺬﻩ ﺍﻟﻈﺎﻫﺮﺓ‪ ،‬ﻓﻘﺪ ﻗﺪﺭ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ‬
‫ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ ﰲ ﻣﺼﺮ )‪ (CAPMAS‬ﻧﺴﺒﺔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ )ﻣﺎ ﺑﲔ ‪ ١٤ – ٦‬ﻋﺎﻣﺎﹰ( ﺧﻼﻝ‬
‫ﻣﻨﺘﺼﻒ ﺍﻟﺴﺒﻌﻴﻨﻴﺎﺕ‪ ،‬ﲝﻮﺍﱄ ‪ ،% ١٠‬ﻟﺘﺼﻞ ﺍﻟﻨﺴﺒﺔ ﺇﱃ ‪ %١٢‬ﰲ ﻋﺎﻡ ‪ ،١٩٨٨‬ﰒ ﺗﺒﻌﻬﺎ ﺍﳔﻔﺎﺽ ﺣﺎﺩ‬
‫ﺧﻼﻝ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﻭﻳﺼﻞ ﺇﱃ ‪ %٢,٦‬ﰲ ﻋﺎﻡ ‪ .١٩٩٥‬ﻏﲑ ﺃﻥ ﺩﺭﺍﺳﺎﺕ ﻣﻴﺪﺍﻧﻴﺔ ﺃﺧﺮﻯ ﻗﺪ ﺃﻇﻬﺮﺕ ﺗﻘﺪﻳﺮﺍﺕ‬
‫ﳐﺘﻠﻔﺔ ﻋﻤﺎ ﺳﺒﻖ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٢-٩‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﳎﻤﻮﻉ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﺳﻦ ‪ ١٤ – ٦‬ﻋﺎﻣﺎ‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻸﻃﻔﺎﻝ‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻸﻃﻔﺎﻝ‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ‬
‫ﻣﺼﺪﺭ‬
‫ﺍﻟﻌﺎﻣﻠﲔ ﺑﻼ ﺃﺟﺮ ﻣﻦ ﺑﲔ‬ ‫ﺍﳉﺎﻣﻌﲔ ﺑﲔ ﺍﻟﺪﺭﺍﺳﺔ ﻭﺍﻟﻌﻤﻞ‬ ‫ﻟﻸﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ‬ ‫ﺍﻟﻌﺎﻡ‬
‫ﺍﻟﺒﻴﺎﻧﺎﺕ‬
‫ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‬ ‫ﻣﻦ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‬ ‫ﻋﻤﺮ ‪ ١٤ – ٦‬ﻋﺎﻣﺎﹰ‬
‫)‪(١‬‬
‫‪٤٤,٠‬‬ ‫‪٣٥,٤‬‬ ‫‪١٢‬‬ ‫‪١٩٨٨‬‬ ‫‪LFSS‬‬
‫)‪(١‬‬
‫‪-‬‬ ‫‪-‬‬ ‫‪٢,٦‬‬ ‫‪١٩٩٥‬‬ ‫‪LFSS‬‬
‫)‪(٢‬‬
‫‪٢٤,٠‬‬ ‫‪٩,٨‬‬ ‫‪٣,٦‬‬ ‫‪١٩٩٥‬‬ ‫‪DHS‬‬
‫)‪(٣‬‬
‫‪٧٢,٦‬‬ ‫‪٦٥,٨‬‬ ‫‪١١,٩‬‬ ‫‪١٩٩٦‬‬ ‫‪EMICS‬‬
‫)‪(٤‬‬
‫‪٧٣,٠‬‬ ‫‪٦٥‬‬ ‫‪١٤,٧‬‬ ‫‪١٩٩٧‬‬ ‫‪ASCE‬‬
‫)‪(٥‬‬
‫‪-‬‬ ‫‪٣٦,٤‬‬ ‫‪٦,٣‬‬ ‫‪١٩٩٨‬‬ ‫‪ELMS‬‬
‫‪ .١‬ﻣﺴﺢ ﻗﻮﺓ ﺍﻟﻌﻤﻞ‬
‫‪ .٢‬ﻣﺴﺢ ﺩﳝﻮﺟﺮﺍﰱ ﻭﺻﺤﻲ‪.‬‬
‫‪ .٣‬ﺍﳌﺴﺢ ﺍﻟﻌﻨﻘﻮﺩﻱ ﳌﺆﺷﺮﺍﺕ ﻣﺘﻌﺪﺩﺓ ﰲ ﻣﺼﺮ‪.‬‬
‫‪ .٤‬ﺍﻷﻭﺿﺎﻉ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻹﳒﺎﺯ ﺍﻟﺪﺭﺍﺳﻲ ﻟﻠﻤﺮﺍﻫﻘﲔ ﰲ ﻣﺼﺮ‪.‬‬
‫‪ .٥‬ﻣﺴﺢ ﻋﻦ ﺳﻮﻕ ﺍﻟﻌﻤﺎﻟﺔ ﺍﳌﺼﺮﻳﺔ‪) .‬ﺩﺭﺍﺳﺔ ﺧﺎﺻﺔ ﻟﺘﻘﻴﻴﻢ ﺍﻟﺘﻐﲑ ﰲ ﺍﻻﻧﺘﺸﺎﺭ ﻣﻦ ﺑﲔ ﻋﺎﻣﻲ ‪ ١٩٩٨ – ١٩٨٨‬ﺑﺘﺒﲏ ﻧﻔﺲ‬
‫ﺍﳌﻨﻬﺞ ﺍﻟﻌﻠﻤﻲ(‪.‬‬
‫ﺇﻥ ﺗﻀﺎﺭﺏ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﺍﳌﺨﺘﻠﻘﺔ ﺍﻟﻮﺍﺭﺩﺓ ﰲ ﺍﳉﺪﻭﻝ ﺍﻟﺴﺎﺑﻖ ﻭﺍﺿﺤﺔ‪ ،‬ﻭﻫﺬﺍ ﻧﺎﺗﺞ ﻋﻦ ﺍﻻﺧﺘﻼﻓﺎﺕ ﰲ‬
‫ﺍﻟﺘﻌﺮﻳﻔﺎﺕ ﻭﺍﳌﻨﺎﻫﺞ ﺍﳌﺴﺘﺨﺪﻣﺔ ﰲ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻣﻮﲰﻴﺔ ﻋﻤﻞ ﺍﻷﻃﻔﺎﻝ‪.‬‬

‫ﺗﻔﻬﻢ ﻇﺎﻫﺮﺓ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‬

‫ﺇﻥ ﺗﻔﻬﻢ ﻃﺒﻴﻌﺔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻭﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﺳﺘﻤﺮﺍﺭﻳﺘﻬﺎ ﺷﺮﻁ ﺃﺳﺎﺳﻲ ﻟﻮﺿﻊ‬
‫ﺍﻟﺴﻴﺎﺳﺎﺕ‪ ،‬ﺇﺫ ﻛﺎﻧﺖ ﺍﻟﺘﻘﻴﻴﻤﺎﺕ ﺍﳋﺎﺻﺔ ﺑﻈﺎﻫﺮﺓ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﳌﺎﺿﻲ ﻣﺘﺄﺛﺮﺓ ﺑﺘﻔﺴﲑﺍﺕ‬

‫‪٢١٩‬‬
‫ﺍﻧﻄﺒﺎﻋﻴﺔ ﻭﻧﺰﻋﺎﺕ ﻣﻔﺎﻫﻴﻤﻴﺔ‪ .‬ﻭﻣﻦ ﻫﻨﺎ ﺃﺟﺮﻳﺖ ﺩﺭﺍﺳﺎﺕ ﻋﺪﺓ ﰲ ﺍﻟﻘﺎﻫﺮﺓ ﺍﻟﻜﱪﻯ ﺣﻮﻝ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‬
‫ﻭﻗﺪ ﺃﺛﺒﺘﺖ ﺑﻄﻼﻥ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻻﻋﺘﻘﺎﺩﺍﺕ ﺍﳋﺎﻃﺌﺔ‪.‬‬
‫‪ .١‬ﺍﺩﻋﺖ ﺍﻟﺘﻔﺴﲑﺍﺕ ﺍﻟﺴﺎﺑﻘﺔ ﺃﻥ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺗﺮﺗﺒﻂ‪ ،‬ﺑﻞ ﻏﺎﻟﺒﺎﹰ ﺗﻨﺘﺞ ﻋﻦ ﺍﻻ‪‬ﻴﺎﺭ ﺍﻷﺳﺮﻱ‬
‫)‪ .(NCSCR,1991‬ﻭﻟﻜﻦ ﺍﻟﻌﻜﺲ ﺻﺤﻴﺢ‪ ,‬ﺇﺫ ﻛﺸﻒ ﳎﺎﻝ ﺍﻟﺒﺤﺚ ﻋﻦ ﻭﺟﻮﺩ ﺍﺭﺗﺒﺎﻁ ﻭﺗﻀﺎﻣﻦ‬
‫ﻭﺛﻴﻖ ﺑﲔ ﺃﻓﺮﺍﺩ ﻋﺎﺋﻼﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪ ،‬ﻭﺇﻥ ﺍﻻ‪‬ﻴﺎﺭ ﺍﻷﺳﺮﻱ ﺍﻟﻨﺎﺗﺞ ﻋﻦ ﺍﻟﻄﻼﻕ ﻭﻓﻘﺪﺍﻥ ﺃﺣﺪ‬
‫ﺍﻵﺑﺎﺀ ﻻ ﺗﺘﻌﺪﻯ ﻧﺴﺒﺘﻪ ‪ %١,٩‬ﻣﻦ ﺃﺳﺮ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪.‬‬
‫‪ .٢‬ﻛﻤﺎ ﰎ ﺇﺛﺒﺎﺕ ﻋﺪﻡ ﺩﻗﺔ ﺍﻻﺩﻋﺎﺀﺍﺕ ﺍﻟﻘﺎﺋﻠﺔ ﺇﻥ ﺍﳍﺠﺮﺓ ﻣﻦ ﺍﻟﺮﻳﻒ ﺇﱃ ﺍﳌﺪﻥ ﺗﺆﺩﻱ ﺇﱃ ﺍﺭﺗﻔﺎﻉ ﻧﺴﺒﺔ‬
‫ﺍﻟﻌﻤﺎﻟﺔ ﺑﲔ ﺍﻷﻃﻔﺎﻝ )‪ .(Al Heneidi, 1986‬ﺇﺫ ﺃﺷﺎﺭﺕ ﺍﻟﺪﺍﺭﺳﺔ ﺇﱃ ﺃﻥ ‪ %٥٢‬ﻣﻦ ﻋﺎﺋﻼﺕ‬
‫ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻫﻢ ﰲ ﺍﻷﺳﺎﺱ ﻣﻦ ﺳﻜﺎﻥ ﺍﻟﻘﺎﻫﺮﺓ‪ ،‬ﻭﺃﻥ ‪ %٤٨‬ﻗﺪ ﻫﺎﺟﺮﻭﺍ ﺇﱃ ﺍﻟﻘﺎﻫﺮﺓ ﻣﻨﺬ ﺃﻛﺜﺮ‬
‫ﻣﻦ ‪ ١٥ – ١٠‬ﻋﺎﻣﺎﹰ ﻣﻀﻰ‪.‬‬
‫‪ .٣‬ﺁﺧﺮﻭﻥ ﻗﺪ ﺍﺩﻋﻮﺍ ﺃﻥ ﺍﳌﺴﺘﻮﻯ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻲ ﺍﳌﺘﺪﱐ ﻟﻠﺰﺍﺭﻋﺔ ﻭﺍﻟﺼﻨﺎﻋﺔ ﻳﻌﺪ ﻋﺎﻣﻼﹰ ﻣﺴﺒﺒﺎﹰ ﻟﻈﺎﻫﺮﺓ‬
‫ﺍﻟﻌﻤﺎﻟﺔ ﺑﲔ ﺍﻷﻃﻔﺎﻝ‪ .‬ﺇﻻ ﺃﻧﻪ ﻣﻦ ﺍﻟﻀﺮﻭﺭﻱ ﺍﻟﺘﻔﺮﻗﺔ ﺑﲔ ﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺴﺒﺒﺔ ﻭﺍﻷﺣﺪﺍﺙ ﻭﺍﻟﻈﺮﻭﻑ‬
‫ﺍﻟﱵ ﺗﻌﻤﻞ ﻋﻠﻰ "ﺗﺴﻬﻴﻞ" ﻭﺟﻮﺩ ﺍﻟﻈﺎﻫﺮﺓ ﺑﻞ ﻭﺗﻮﻓﺮ ﺍﻟﺒﻴﺌﺔ ﺍﳌﻨﺎﺳﺒﺔ ﻻﻧﺘﺸﺎﺭﻫﺎ‪ .‬ﻛﻤﺎ ﺃﻧﻪ ﻣﻦ‬
‫ﺍﻟﻀﺮﻭﺭﻱ ﺇﺩﺭﺍﻙ ﺃﻥ ﺍﻟﺘﻔﺸﻲ ﺍﻟﻮﺍﺿﺢ ﻟﻈﺎﻫﺮﺓ ﺃﻭ ﻣﺸﻜﻠﺔ ﻣﺎ‪ ،‬ﻣﺎ ﻫﻮ ﺇﻻ ﺟﺮﺱ ﺇﻧﺬﺍﺭ ﻳﻌﻠﻦ ﻋﻦ‬
‫ﻭﺟﻮﺩ ﺍﳌﺸﻜﻠﺔ ﻭﻟﻴﺲ ﻫﻮ ﲟﺴﺒﺒﻬﺎ‪.‬‬
‫ﻟﺬﻟﻚ ﻓﺈﻥ ﺍﻟﺘﻔﻬﻢ ﺍﳊﻘﻴﻘﻲ ﻟﺘﻠﻚ ﺍﻟﻈﺎﻫﺮﺓ ﻳﺴﺘﻠﺰﻡ ﲢﺪﻳﺪ ﻣﺎ ﻳﻠﻲ‪:‬‬
‫ﻃﺒﻴﻌﺔ ﺍﻟﻈﺎﻫﺮﺓ ﺑﺪﺍﺧﻞ ﳏﻴﻄﻬﺎ ﺍﻻﺟﺘﻤﺎﻋﻲ‪.‬‬ ‫
‬
‫ﺍﻟﺘﺮﺍﺑﻂ ﺍﳉﺬﺭﻱ ﻟﻌﺪﺓ ﻋﻮﺍﻣﻞ ﺗﺴﺎﻋﺪ ﻋﻠﻰ ﻭﺟﻮﺩ ﻭﺍﺳﺘﻤﺮﺍﺭ ﻇﺎﻫﺮﺓ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪.‬‬ ‫
‬
‫ﺗﻀﺎﺭﺏ ﻭﺗﻀﺎﻣﻦ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺗﺄﺛﲑﻫﺎ ﻋﻠﻰ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪.‬‬ ‫
‬

‫ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻭﻣﺎ ﻳﺘﺒﻌﻬﺎ ﻣﻦ ﺁﺛﺎﺭ ﺳﻠﺒﻴﺔ‬

‫ﻏﺎﻟﺒﺎﹰ ﻣﺎ ﺗﻜﻮﻥ ﺍﳌﺸﻜﻼﺕ ﺍﻟﱵ ﻳﻮﺍﺟﻬﻬﺎ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﻳﻌﻤﻠﻮﻥ ﻣﺆﺷﺮﺍﹰ ﻟﻠﺤﺮﻣﺎﻥ ﺃﻭ ‪ /‬ﻭﺗﺆﺛﺮ‬ ‫
‬
‫ﺳﻠﺒﺎ ﻋﻠﻲ ﺩﺭﺍﺳﺘﻬﻢ ﻭﺭﺍﺣﺘﻬﻢ ﻭﻣﺘﻌﺘﻬﻢ‪ .‬ﻭﻗﺪ ﺃﺷﺎﺭﺕ ﻧﺘﺎﺋﺞ ﺍﻟﺒﺤﻮﺙ ﺇﱃ ﻭﺟﻮﺩ ﺍﺭﺗﺒﺎﻁ‬
‫ﻭﺍﺿﺢ ﺑﲔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻭﺍﳊﺮﻣﺎﻥ ﺍﻟﺬﻱ ﻳﺘﻌﺮﺿﻮﻥ ﺇﻟﻴﻪ‪ ،‬ﻭﻫﻮ ﰲ ﺍﻟﻮﻗﻊ ﺣﺮﻣﺎﻥ ﻣﻦ‬
‫ﺣﻘﻮﻗﻬﻢ ﺍﻷﺳﺎﺳﻴﺔ‪ .‬ﻣﺜﺎﻝ ﻟﺬﻟﻚ ﻣﺎ ﻛﺸﻔﻪ ﺍﳌﺴﺢ ﺍﻟﺪﳝﻮﺟﺮﺍﰲ ﻭﺍﻟﺼﺤﻲ ﺍﳌﺼﺮﻱ‬
‫)‪ (EDHS, 1992‬ﻋﻦ ﻭﺟﻮﺩ ﻋﻼﻗﺔ ﺛﻼﺛﻴﺔ ﺍﻷﺑﻌﺎﺩ ﺑﲔ ﺍﻟﻔﻘﺮ ﻭﺍﳊﺮﻣﺎﻥ ﺍﻟﺘﺮﺑﻮﻱ ﻭﻋﻤﺎﻟﺔ‬
‫ﺍﻷﻃﻔﺎﻝ‪.‬‬
‫ﻛﺬﻟﻚ ﻳﺘﻄﻠﺐ ﺗﻔﻬﻢ ﺍﻟﻈﺎﻫﺮﺓ ﺑﺪﺍﺧﻞ ﳏﻴﻄﻬﺎ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ ،‬ﻣﻊ ﺍﻷﺧﺬ ﺑﻌﲔ ﺍﻻﻋﺘﺒﺎﺭ‬ ‫
‬
‫ﺍﳋﻠﻔﻴﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻟﻸﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺧﺼﺎﺋﺼﻬﻢ‪.‬‬
‫‪ .١‬ﺧﻠﻔﻴﺔ ﻋﻦ ﺃﺳﺮ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‬
‫ﻳﺄﰐ ﺍﻟﻐﺎﻟﺒﻴﺔ ﺍﻟﻌﻈﻤﻰ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ ﺧﻠﻔﻴﺎﺕ ﺫﺍﺕ ﻣﺴﺘﻮﻯ ﺍﺟﺘﻤﺎﻋﻲ‬
‫ﻭﺍﻗﺘﺼﺎﺩﻱ ﻣﺘﺪﻥ‪.‬‬

‫‪٢٢٠‬‬
‫)‪ (١‬ﻛﺸﻒ ﻣﺴﺢ ﺃﺟﺮﺍﻩ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪ CAPMAS‬ﰲ ﻣﺼﺮ ﻋﻠﻰ‬
‫ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ )ﻋﺎﻡ ‪ (١٩٨٨‬ﺃﻥ ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻸﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻣﺮﺗﻔﻌﺔ ﲟﻌﺪﻝ ‪%٨٦‬‬
‫ﰲ ﺛﻼﺙ ﻓﺌﺎﺕ ﻣﻦ ﺍﻷﺳﺮ ﺫﺍﺕ ﺍﻟﺪﺧﻞ ﺍﳌﻨﺨﻔﺾ )‪ %٢٨‬ﰲ ﺍﻷﺳﺮ ﺍﻟﱵ ﻳﺼﻞ ﻣﻜﺴﺒﻬﺎ‬
‫ﺍﻟﺴﻨﻮﻱ ﺃﻗﻞ ﻣﻦ ‪ ١٠٠٠‬ﺟﻨﻴﻪ‪ %٣٢ ،‬ﰲ ﺍﻷﺳﺮ ﺍﻟﱵ ﻳﺼﻞ ﻣﻜﺴﺒﻬﺎ ﺍﻟﺴﻨﻮﻱ ﻣﺎ ﺑﲔ‬
‫‪ ١٠٠٠‬ﺇﱃ ‪ ١٩٩٩‬ﺟﻨﻴﻬﺎﹰ‪ ،‬ﻭ‪ %٢٦‬ﰲ ﺍﻷﺳﺮ ﺍﻟﱵ ﻳﺼﻞ ﻣﻜﺴﺒﻬﺎ ﺍﻟﺴﻨﻮﻱ ﻣﺎ ﺑﲔ ‪ ٢٠٠٠‬ﺇﱃ‬
‫‪ ٢٩٩٩‬ﺟﻨﻴﻬﺎﹰ ﺳﻨﻮﻳﺎﹰ(‪.‬‬
‫ﻭﻗﺪ ﺃﺳﻔﺮﺕ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﱵ ﺃﺟﺮﺍﻫﺎ ﺍﳌﺴﺢ ﺍﻟﺪﳝﻮﺟﺮﺍﰲ ﺍﻟﺼﺤﻲ ﺍﳌﺼﺮﻱ ‪DHS‬‬
‫)‪ (1992‬ﻋﻦ ﻧﺘﺎﺋﺞ ﻣﻄﺎﺑﻘﺔ ﻭﺍﻟﱵ ﺗﺴﺘﺨﻠﺺ ﰲ ﲨﻠﺘﻬﺎ ﺃﻥ ﺍﳌﺴﺘﻮﻯ ﺍﻻﺟﺘﻤﺎﻋﻲ‬
‫ﻭﺍﻻﻗﺘﺼﺎﺩﻱ ﻷﺳﺮ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺃﻗﻞ ﻣﻦ ﻣﺴﺘﻮﻯ ﺍﻷﺳﺮ ﺍﻟﱵ ﻻ ﺗﻀﻢ ﺃﻃﻔﺎﻻﹰ‬
‫ﻋﺎﻣﻠﲔ‪.‬‬
‫ﻛﻤﺎ ﺃﻛﺪﺕ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﱵ ﺃﺟﺮ‪‬ﺎ ‪ (١٩٩١) NCSCR‬ﻋﻠﻰ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﻟﻘﺎﻫﺮﺓ‬
‫ﺍﻟﻜﱪﻯ ﻋﻦ ﻭﺟﻮﺩ ﻋﻼﻗﺔ ﻭﺛﻴﻘﺔ ﺑﲔ ﺍﳊﺮﻣﺎﻥ ﺍﻻﻗﺘﺼﺎﺩﻱ ﻭﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻣﺸﲑﺓ ﺇﱃ ﺃﻥ‬
‫ﻣﻜﺎﺳﺐ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﲤﺜﻞ ﰲ ﺍﳌﺘﻮﺳﻂ ﻣﺎ ﺑﲔ ‪) %٢٣‬ﻋﻠﻰ ﺣﺴﺐ ﺗﻘﺪﻳﺮ‬
‫ﺍﻷﻣﻬﺎﺕ( ﻭ‪) %٣١‬ﻋﻠﻰ ﺣﺴﺐ ﺗﻘﺪﻳﺮ ﺍﻷﻃﻔﺎﻝ( ﻣﻦ ﺍﻟﺪﺧﻞ ﺍﻟﺸﻬﺮﻱ ﻟﻸﺳﺮﺓ‪ .‬ﰲ ﺍﻟﻮﻗﺖ‬
‫ﺍﻟﺬﻱ ﺑﻴﻨﺖ ﻓﻴﻪ ﺩﺭﺍﺳﺔ ﺣﺪﻳﺜﺔ ﺑﺎﻟﻘﺎﻫﺮﺓ ﺍﻟﻜﱪﻯ )‪ (Nassar,1999‬ﺑﺄﻥ ‪ %٦٨‬ﻣﻦ ﺍﻷﻭﻻﺩ‬
‫ﺍﻟﻌﺎﻣﻠﲔ ﻭ‪ %١٠٠‬ﻣﻦ ﺍﻟﻔﺘﻴﺎﺕ ﺍﻟﻌﺎﻣﻼﺕ ﻳﻮﻓﺮﻭﻥ ﺍﳌﺴﺎﻋﺪﺓ ﺍﳌﺎﺩﻳﺔ ﻷﺳﺮﻫﻢ‪.‬‬
‫)‪ (٢‬ﻛﺬﻟﻚ ﺗﺸﲑ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺃﻥ ﺍﳊﺎﻟﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻟﻮﻇﻴﻔﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻟﻌﺎﺋﻞ ﻫﺬﻩ‬
‫ﺍﻷﺳﺮ ﻣﺘﺪﻥ‪:‬‬
‫ﻣﺴﺘﻮﻱ ﺗﻌﻠﻴﻢ ﺭﺏ ﺍﻷﺳﺮﺓ‪ :‬ﺃﺷﺎﺭ ﺍﳌﺴﺢ ﺍﻟﺪﳝﻮﺟﺮﺍﰲ ﺍﻟﺼﺤﻲ )‪ EDHS (1995‬ﺃﻥ‬
‫ﺃﺭﺑﺎﺏ ﺍﻷﺳﺮ ﺍﻟﺬﻛﻮﺭ ﺑﺪﺍﺧﻞ ﺃﺳﺮ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﳛﻈﻮﻥ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺗﻌﻠﻴﻤﻲ‬
‫ﻣﺘﺪﻥ‪ %٨٤ :‬ﻣﻨﻬﻢ ﱂ ﳛﺼﻠﻮﺍ ﻋﻠﻰ ﺃﻱ ﻗﺴﻂ ﻣﻦ ﺍﻟﺘﻌﻠﻴﻢ ﺃﻭ ﱂ ﻳﻜﻤﻠﻮﺍ ﺗﻌﻠﻴﻤﻬﻢ‬
‫ﺍﻻﺑﺘﺪﺍﺋﻲ‪ ،‬ﺑﻴﻨﻤﺎ ‪ %٧,٧‬ﺃﻛﻤﻠﻮﺍ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻻﺑﺘﺪﺍﺋﻲ‪ .‬ﰲ ﺍﻟﻮﻗﺖ ﻧﻔﺴﻪ ﺃﺷﺎﺭﺕ ﺗﻠﻚ‬
‫ﺍﻟﺪﺭﺍﺳﺔ ﺇﱃ ﺃﻥ ‪ %٣,٣‬ﱂ ﻳﻜﻤﻠﻮﺍ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﺜﺎﻧﻮﻱ‪ ،‬ﻭﻓﻘﻂ ‪ %١,٩‬ﺃﻛﻤﻠﻮﺍ ﺗﻌﻠﻴﻤﻬﻢ‬
‫ﺍﻟﺜﺎﻧﻮﻱ‪.‬‬
‫ﻃﺒﻴﻌﺔ ﻋﻤﻞ ﺭﺏ ﺍﻷﺳﺮﺓ‪ :‬ﻛﺸﻔﺖ ﺩﺭﺍﺳﺔ ﺃﺟﺮ‪‬ﺎ ‪ NCSCR‬ﺣﻮﻝ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ‬
‫ﺍﻟﻘﺎﻫﺮﺓ ﺍﻟﻜﱪﻯ ﰲ ﻋﺎﻡ ‪ ١٩٩١‬ﻋﻦ ﺃﻥ ﺁﺑﺎﺀ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﻣﻌﻈﻢ ﺍﳊﺎﻻﺕ ﻳﺸﻐﻠﻮﻥ‬
‫ﻭﻇﺎﺋﻒ ﻣﺘﺪﻧﻴﺔ ﺃﻭ ﺑﺴﻴﻄﺔ ﺇﺫ ﺗﺼﻞ ﻧﺴﺒﺔ ﺍﻟﻌﻤﺎﻝ ﺑﻴﻨﻬﻢ ﺇﱃ )‪ (%٣٤‬ﻭﺍﳋﺪﺍﻡ )‪(%٢٥‬‬
‫ﻭﺍﻟﺒﺎﺋﻌﲔ )‪ ،(%١٤‬ﲜﺎﻧﺐ ﺃﻋﻤﺎﻝ ﺃﺧﺮﻯ ﻣﺸﺎ‪‬ﺔ‪.‬‬
‫ﻧﺴﺒﺔ ﺑﻄﺎﻟﺔ ﻋﺎﺋﻞ ﺍﻷﺳﺮﺓ‪ :‬ﺃﺷﺎﺭﺕ ﻧﺘﺎﺋﺞ ﺍﳌﺴﺢ ﺍﻟﺪﳝﻮﺟﺮﺍﰲ ﺍﻟﺼﺤﻲ )‪ (1995‬ﺃﻥ‬
‫ﻧﺴﺒﺔ ﺑﻄﺎﻟﺔ ﺭﺏ ﺍﻷﺳﺮﺓ ﺗﺼﻞ ﺇﱃ ‪ ،%٩‬ﰲ ﺍﻟﻮﻗﺖ ﺍﻟﺬﻱ ﺗﺼﻞ ﻓﻴﻪ ﻧﺴﺒﺔ ﺭﺑﺎﺕ ﺍﻷﺳﺮﺓ‬
‫ﺍﻟﻼﰐ ﻻ ﻳﻌﻤﻠﻦ ﺇﱃ ‪ .%٨٠‬ﺗﻌﺪ ﺗﻠﻚ ﺍﻟﻨﺘﺎﺋﺞ ﻣﺆﺷﺮﺍﹰ ﺇﺿﺎﻓﻴﺎﹰ ﻟﻠﺤﺮﻣﺎﻥ ﻭﺍﳌﻌﺎﻧﺎﺓ ﺍﻟﱵ‬
‫ﺗﻮﺍﺟﻬﻬﺎ ﺗﻠﻚ ﺍﻷﺳﺮ‪.‬‬

‫‪٢٢١‬‬
 ‫‪ .٢‬ﺧﺼﺎﺋﺺ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪:‬‬
‫ﺃ‪ .‬ﻧﺴﺒﺔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺍﳊﻀﺮﻳﺔ‪:‬‬
‫ﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺍﻟﺘﺎﱄ ﻧﺴﺐ ﺗﻮﺯﻳﻊ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﲝﺴﺐ ﺍﻹﻗﺎﻣﺔ )ﺍﻟﺮﻳﻒ ‪ /‬ﺍﳌﺪﻳﻨﺔ(‬
‫ﰲ ﺩﺭﺍﺳﺎﺕ ﳐﺘﻠﻔﺔ‪ ،‬ﻭﺇﱃ ﺃﻥ ﺍﻧﺘﺸﺎﺭ ﻇﺎﻫﺮﺓ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺃﻛﱪ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٣-٩‬ﻧﺴﺒﺔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ )‪ (%‬ﺣﺴﺐ ﳏﻞ ﺍﻹﻗﺎﻣﺔ ﰲ ﺛﻼﺛﺔ ﻣﺴﻮﺡ ﳐﺘﻠﻔﺔ‬
‫‪ELMS – 98‬‬ ‫‪EMICS - 96‬‬ ‫‪LFSS – 88‬‬
‫‪٢,٥‬‬ ‫‪٣,٨‬‬ ‫‪٥,٣‬‬ ‫ﺍﳌﺪﻳﻨﺔ‬
‫‪٨,٧‬‬ ‫‪١٣,٦‬‬ ‫‪١٥,٦‬‬ ‫ﺍﻟﺮﻳﻒ‬
‫‪٦,٣‬‬ ‫‪١٠,٤‬‬ ‫‪١١,٦‬‬ ‫ﺍ‪‬ﻤﻮﻉ‬
‫ﻭﻏﺎﻟﺒﺎﹰ ﻣﺎ ﻳﺘﻢ ﺗﺸﻐﻴﻞ ﺍﻷﻃﻔﺎﻝ ﰲ ﺃﻧﺸﻄﺔ ﺯﺭﺍﻋﻴﺔ ﻣﺜﻞ ﺟﲏ ﺍﻟﻘﻄﻦ‪ ،‬ﺇﻻ ﺃﻧﻪ ﻣﻦ‬
‫ﺍﻟﻀﺮﻭﺭﻱ ﺍﻷﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺃﻥ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﳎﺎﻝ ﺍﻟﺰﺭﺍﻋﺔ ﲣﺘﻠﻒ ﻋﻠﻰ‬
‫ﻣﺪﺍﺭ ﺍﻟﻌﺎﻡ‪ ،‬ﺫﻟﻚ ﻷﻥ ﻋﻤﻞ ﺍﻷﻃﻔﺎﻝ ﻏﺎﻟﺒﺎﹰ ﻣﺎ ﻳﻜﻮﻥ ﻣﻮﲰﻴﺎ‪.‬‬
‫ﺏ‪ .‬ﺍﻟﺴﻦ ﻭﺍﻟﻨﻮﻉ‪:‬‬
‫ﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺍﻟﺘﺎﱄ ﻧﺴﺒﺔ ﺍﻧﺘﺸﺎﺭ ﻇﺎﻫﺮﺓ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻃﺒﻘﺎ ﻟﻔﺌﺎﺕ ﺍﻟﻌﻤﺮ‬
‫ﺍﳌﺨﺘﻠﻔﺔ‪:‬‬
‫ﺟﺪﻭﻝ )‪ :(٣-٩‬ﻧﺴﺒﺔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ )‪ (%‬ﺣﺴﺐ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ ﰲ ﺛﻼﺛﺔ ﻣﺴﻮﺡ ﳐﺘﻠﻔﺔ‬
‫‪ELMS - 98‬‬ ‫‪EMICS – 96‬‬ ‫‪LFSS – 88‬‬ ‫ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ‬
‫‪٣,٤‬‬ ‫‪٦,٩‬‬ ‫‪٧,٢‬‬ ‫‪١١ - ٦‬‬
‫‪١١,٤‬‬ ‫‪١٧,٣‬‬ ‫‪٢٠,٧‬‬ ‫‪١٤ – ١٢‬‬
‫‪٦,٣‬‬ ‫‪١٠,٤‬‬ ‫‪١١,٦‬‬ ‫‪١٤ - ٦‬‬
‫ﻳﺸﲑ ﺍﳉﺪﻭﻝ ﺇﱃ ﺍﺭﺗﻔﺎﻉ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ ﻣﻦ ‪ ١٤ – ١٢‬ﺳﻨﺔ‬
‫ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺎﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ ‪ ١١ – ٦‬ﺳﻨﺔ‪ .‬ﻭﻗﺪ ﰎ ﺗﺄﻛﻴﺪ ﺗﻠﻚ ﺍﻟﻨﺘﺎﺋﺞ ﰲ‬
‫ﺍﻟﺜﻼﺛﺔ ﻣﺴﻮﺣﺎﺕ‪ ،‬ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﻭﺟﻮﺩ ﺗﺒﺎﻳﻦ ﰲ ﺍﻟﻨﺘﺎﺋﺞ‪ .‬ﻛﻤﺎ ﺗﺸﲑ ﺍﻟﻨﺘﺎﺋﺞ ﺃﻳﻀﺎ ﺇﱄ‬
‫ﺍﺭﺗﻔﺎﻉ ﻫﺬﻩ ﺍﻟﻨﺴﺐ ﺑﲔ ﺍﻹﻧﺎﺙ ﻣﻘﺎﺭﻧﺔ ﺑﺎﻟﺬﻛﻮﺭ ﻭﺧﺎﺻﺔ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪.‬‬
‫ﺝ‪ .‬ﺍﻟﺘﻌﻠﻴﻢ‪:‬‬
‫ﻋﻴﻨﺖ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﱵ ﺃﺟﺮ‪‬ﺎ ‪ LFSS – 88‬ﺍﳌﺴﺘﻮﻯ ﺍﻟﺘﻌﻠﻴﻤﻲ ﻟﻸﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪،‬‬ ‫‪o‬‬
‫ﻭﻗﺪ ﻛﺸﻒ ﺍﳌﺴﺢ ﻋﻦ ﻭﺟﻮﺩ ‪ %١٨,٤‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﲢﺖ ﺳﻦ ﺍﻟﻌﺎﺷﺮﺓ‪،‬‬
‫ﻭ‪ %٤٩,٧‬ﻏﲑ ﻣﺘﻌﻠﻤﲔ‪ ،‬ﻭ‪ %١٩,٣‬ﻣﻦ ﺍﳌﺘﻌﻠﻤﲔ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ‪ %١٢,٦‬ﲢﺖ ﺍﳌﺴﺘﻮﻯ‬
‫ﺍﳌﺘﻮﺳﻂ‪ .‬ﻟﺘﺮﺗﻔﻊ ﻧﺴﺒﺔ ﺍﻷﻣﻴﺔ ﺑﲔ ﺍﻹﻧﺎﺙ ﺇﱃ )‪ (%٥٢‬ﻭﺑﲔ ﺍﻟﺬﻛﻮﺭ ﺇﱄ )‪.(%٣٠,٥‬‬
‫ﻛﻤﺎ ﻃﻠﺒﺖ ﺩﺭﺍﺳﺔ ﺃﺟﺮ‪‬ﺎ ‪ EMICS – 1996‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺃﻥ ﳛﺪﺩﻭﺍ‬ ‫‪o‬‬
‫ﺍﻟﺴﻨﺔ ﺍﻟﺪﺭﺍﺳﻴﺔ ﺍﻟﱵ ﻭﺻﻠﻮﺍ ﺇﻟﻴﻬﺎ‪ .‬ﻭﻛﺸﻔﺖ ﺍﻟﻨﺘﺎﺋﺞ ﺇﱃ ﺃﻥ ‪ %٣٣‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﻟﻌﺎﻣﻠﲔ ﻻ ﻳﺬﻫﺒﻮﻥ ﺇﱃ ﺍﳌﺪﺍﺭﺱ )‪ %٢٢,١‬ﻣﻦ ﺍﻟﺬﻛﻮﺭ ﻭ‪ %٥٥,٣‬ﻣﻦ ﺍﻹﻧﺎﺙ(‪ .‬ﻭﺗﺼﻞ‬
‫ﻧﺴﺒﺔ ﺍﻟﺬﻳﻦ ﻭﺻﻠﻮﺍ ﺇﱃ ﺍﻟﺼﻒ ﺍﳋﺎﻣﺲ ﳌﺎ ﻓﻮﻕ ‪ %١٢,١‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪.‬‬

‫‪٢٢٢‬‬
‫ﻛﺬﻟﻚ ﻛﺸﻔﺖ ﻧﺘﺎﺋﺞ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﺴﺎﺑﻘﺔ ﺃﻥ ‪ %٤٤,٢‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‬ ‫‪o‬‬
‫ﻣﻮﺍﻇﺒﻮﻥ ﻋﻠﻰ ﺍﻟﺪﺭﺍﺳﺔ ﰲ ﻭﻗﺖ ﺍﳌﺴﺢ )‪ %٩٠‬ﻣﻨﻬﻢ ﻣﻦ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‪ ،‬ﻭ‪%١٠‬‬
‫ﻣﻦ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪(.‬‬
‫ﻛﺸﻔﺖ ﺍﻟﺪﺍﺭﺳﺔ ﺍﻟﱵ ﺃﺟﺮ‪‬ﺎ ‪ EDHS – 95‬ﺃﻥ ‪ %١٢‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﱂ‬ ‫‪o‬‬
‫ﻳﺴﺘﻜﻤﻠﻮﺍ ﻋﺎﻣﻬﻢ ﺍﻷﻭﻝ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻻﺑﺘﺪﺍﺋﻲ‪ ،‬ﻭﻫﻲ ﻧﺴﺒﺔ ﺗﺼﻞ ﺇﱃ ‪ %١٥,٧‬ﰲ‬
‫ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭ‪ %١٠,٤‬ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‪ ،‬ﻭﻣﻊ ﺍﺧﺘﻼﻑ ﻧﻮﻉ ﺍﻟﻄﻔﻞ ﻓﺈﻥ‬
‫‪ %١٣,٢‬ﻣﻦ ﺍﻟﺬﻛﻮﺭ ﻭ‪ %٣٣,٣‬ﻣﻦ ﺍﻹﻧﺎﺙ ﺍﻟﺬﻳﻦ ﻳﻌﻤﻠﻮﻥ ﻛﺎﻧﻮﺍ ﻣﻨﺘﻈﻤﲔ ﰲ ﺍﻟﺪﺭﺍﺳﺔ‪.‬‬

‫ﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺴﺎﻫـﻤﺔ ﰲ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‬

‫ﺇﻥ ﺍﻟﺘﻔﺸﻲ ﺍﻟﻮﺍﺿﺢ ﻟﻈﺎﻫﺮﺓ ﻣﻌﻴﻨﺔ ﻫﻮ ﻏﺎﻟﺒﺎﹰ ﺍﻟﱪﻳﻖ ﺍﻟﺬﻱ ﻳﺴﺒﻖ ﺑﻘﺎﺅﻫﺎ ﻭﺳﺒﺒﻬﺎ‪) .‬ﺍﻟﻴﻮﻧﺴﻴﻒ‪،‬‬
‫‪ .(١٩٩٦‬ﻟﺬﻟﻚ ﳚﺐ ﺃﻥ ﻧﺘﻔﻬﻢ ﻇﺎﻫﺮﺓ ﻣﺜﻞ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻋﻠﻰ ﺃ‪‬ﺎ ﻋ‪َ‬ﺮ‪‬ﺽ ﳌﻮﻗﻒ ﺃﻛﺜﺮ ﻋﻤﻘﺎﹰ‬
‫ﻭﺗﻌﻘﻴﺪﺍﹰ ﺑﺪﺍﺧﻞ ﻧﻄﺎﻕ ﺍﺟﺘﻤﺎﻋﻲ ﳏﺪﺩ‪.‬‬
‫‪ .١‬ﺃﺳﺒﺎﺏ ﻣﺘﻌﻠﻘﺔ ﺑﺎﻟﻌﻤﻞ‬
‫ﺗﺪﻋﻲ ﻣﻌﻈﻢ ﺍﻟﺒﺤﻮﺙ ﺃﻥ ﺃﺳﺒﺎﺏ ﺍﻟﺘﻮﻗﻒ ﻋﻦ ﺍﻟﺪﺭﺍﺳﺔ ﻏﺎﻟﺒﺎﹰ ﻣﺎ ﺗﻘﻮﺩ ﺇﱃ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪ .‬ﺇﻻ ﺃﻥ‬
‫ﻫﺬﺍ ﺍﻻﺩﻋﺎﺀ ﳝﻜﻦ ﺃﻥ ﻳﻜﻮﻥ ﻣﻀﻠﻼﹰ‪ .‬ﻓﻘﺪ ﺃﻇﻬﺮﺕ ﺩﺭﺍﺳﺔ ﺣﺪﻳﺜﺔ ﺣﻮﻝ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺃﻥ ﺍﻷﺳﺒﺎﺏ‬
‫ﺍﻟﺮﺋﻴﺴﺔ ﻟﻠﺘﺴﺮﺏ ﻣﻦ ﺍﳌﺪﺍﺭﺱ ﻫﻲ ﺃﺳﺒﺎﺏ ﻣﺎﻟﻴﺔ ﲜﺎﻧﺐ ﺍﻧﻌﺪﺍﻡ ﺍﻟﺮﻏﺒﺔ ﰲ ﺍﻻﺳﺘﻤﺮﺍﺭ ﰲ ﺍﻟﺘﻌﻠﻴﻢ‪.‬‬
‫)ﺭﺍﺟﻊ ﺍﳉﺰﺀ ﺍﳋﺎﺹ ﺑﻌﻤﺎﻟﺔ ﺍﻟﻄﻔﻞ ﻭﺍﻟﺘﻌﻠﻴﻢ(‪ .‬ﻭﻣﻦ ﻧﺎﺣﻴﺔ ﺃﺧﺮﻯ‪ ،‬ﺃﺷﺎﺭﺕ ﺩﺭﺍﺳﺔ ﺣﻮﻝ ﻋﻤﺎﻟﺔ‬
‫ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻘﺎﻫﺮﺓ ﺍﻟﻜﱪﻯ ﻋﺎﻡ ‪ ١٩٩١‬ﻋﻠﻲ ﻋﻴﻨﺔ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺇﱃ ﺃﻥ ﺃﺳﺒﺎﺏ ﺍﻟﻌﻤﻞ‬
‫ﻫﻲ ﻛﻤﺎ ﻳﻠﻲ‪:‬‬
‫ﺟﺪﻭﻝ )‪ :(٤-٩‬ﺃﺳﺒﺎﺏ ﺍﻟﻌﻤﻞ ﺣﺴﺐ ﺍﻟﻨﻮﻉ‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻣﻦ‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻣﻦ‬ ‫ﺍﻟﺴﺒﺐ *‬
‫ﺍﻹﻧﺎﺙ‬ ‫ﺍﻟﺬﻛﻮﺭ‬
‫‪١٨,٩‬‬ ‫‪٥٢,٦‬‬ ‫ﻓﺸﻞ ﰲ ﺍﻟﺘﻌﻠﻴﻢ‬
‫‪١٨,٩‬‬ ‫‪٤٧,٨‬‬ ‫ﺗﻌﻠﻢ ﻣﻬﻨﺔ‬
‫‪٦٦‬‬ ‫‪٤٣,٣‬‬ ‫ﺍﳌﺴﺎﳘﺔ ﰲ ﺩﺧﻞ ﺍﻷﺳﺮﺓ‬
‫‪٥٨,٥‬‬ ‫‪٣٤,٥‬‬ ‫ﻛﺴﺐ ﻣﺎﻝ ﺧﺎﺹ‬
‫‪١٨,٩‬‬ ‫‪٥,٥‬‬ ‫ﺃﺳﺒﺎﺏ ﺃﺧﺮﻯ‬
‫* ﰎ ﺍﻟﺴﻤﺎﺡ ﻟﻠﻤﺠﻴﺒﲔ ﺫﻛﺮ ﺃﻛﺜﺮ ﻣﻦ ﺳﺒﺐ‪.‬‬

‫ﺍﻟﻔﺸﻞ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻟﺮﻏﺒﺔ ﰲ ﺗﻌﻠﻢ ﺣﺮﻓﺔ ﻣﺎ‪ ،‬ﻛﺎﻧﺎ ﻣﻦ ﺃﻫﻢ ﺍﻷﺳﺒﺎﺏ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺬﻛﻮﺭ‪ .‬ﺃﻣﺎ‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻺﻧﺎﺙ‪ ،‬ﻓﻜﺎﻧﺖ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻣﻦ ﺃﻛﺜﺮ ﺍﻷﺳﺒﺎﺏ ﺍﶈﻔﺰﺓ ﻋﻠﻰ ﺍﻟﻌﻤﻞ‪ .‬ﻭﻗﺪ‬
‫ﺍﺳﺘﻨﻜﺮ ﺑﻌﺾ ﺍﻵﺑﺎﺀ‪ ،‬ﰲ ﻣﻘﺎﺑﻼﺕ ﺷﺨﺼﻴﺔ ﺇﺫﺍ ﻣﺎ ﻛﺎﻥ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﻛﺎﻓﻴﺎﹰ ﳌﺪ ﺃﻭﻻﺩﻫﻢ ﲟﺎ‬
‫ﳛﺘﺎﺟﻮﻧﻪ ﻟﻜﺴﺐ ﺍﳋﱪﺓ‪ .‬ﰲ ﺍﻟﻮﻗﺖ ﺍﻟﺬﻱ ﺍﺷﺘﻜﻰ ﻓﻴﻪ ﺍﻟﺒﻌﺾ ﻣﻦ ﺃﻋﺒﺎﺀ ﺗﻜﺎﻟﻴﻒ ﺍﳌﺪﺭﺳﺔ‪ .‬ﻛﻤﺎ‬
‫ﺃﻇﻬﺮﺕ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﻀﻐﻮﻁ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺍﻟﱵ ﺗﺘﻌﺮﺽ ﳍﺎ ﺍﻷﺳﺮ ﻟﻸﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪ ،‬ﺇﺫ ﺃﺷﺎﺭﺕ‬
‫ﺍﻟﻨﺘﺎﺋﺞ ﺃﻥ ﻣﺴﺎﳘﺔ ﺍﻟﻄﻔﻞ ﰲ ﻣﻴﺰﺍﻧﻴﺔ ﺍﻷﺳﺮﺓ ﳝﺜﻞ ﰲ ﺍﳌﺘﻮﺳﻂ ﻓﻴﻤﺎ ﺑﲔ ‪) %٢٢,٨‬ﺣﺴﺐ ﺗﻘﺪﻳﺮ‬
‫ﺍﻷﻣﻬﺎﺕ( ﻭ‪) %٣٠,٧‬ﺣﺴﺐ ﺗﻘﺪﻳﺮ ﺍﻷﻃﻔﺎﻝ(‪ .‬ﻭﻏﺎﻟﺒﺎﹰ ﻣﺎ ﺗﻜﻮﻥ ﺭﺑﺔ ﺍﻷﺳﺮﺓ ﻣﻦ ﺃﻛﺜﺮ ﺍﻟﻔﺌﺎﺕ ﻗﻬﺮﺍﹰ‪،‬‬

‫‪٢٢٣‬‬
‫ﻭﺑﺎﻟﺘﺎﱄ ﳒﺪﻫﺎ ﺗﻌﺘﻤﺪ ﺑﻘﺪﺭ ﻛﺒﲑ ﻋﻠﻰ ﻋﻤﺎﻟﺔ ﺍﻟﻄﻔﻞ ﻛﻤﺼﺪﺭ ﻟﻠﺪﺧﻞ‪ .‬ﻭﻗﺪ ﺃﻇﻬﺮﺕ ﺗﻠﻚ ﺍﻟﻨﺘﺎﺋﺞ‬
‫ﺇﱃ ﺍﳌﻌﺎﻧﺎﺓ ﺍﻟﱵ ﺗﻌﻴﺸﻬﺎ ﺭﺑﺔ ﺍﻷﺳﺮﺓ‪ ،‬ﺗﻠﻚ ﺍﳊﻘﻴﻘﺔ ﺍﻟﱵ ﺗﺪﻋﻮ ﺇﱃ ﺃﺧﺬ ﺗﻠﻚ ﺍﻟﻈﺎﻫﺮﺓ ﺑﻌﲔ‬
‫ﺍﻻﻋﺘﺒﺎﺭ ﻗﻲ ﻭﺿﻊ ﺇﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺷﺎﻣﻠﺔ ﳊﻤﺎﻳﺔ ﺗﻠﻚ ﺍﻟﻔﺌﺎﺕ ﺍﳌﹸُﻌﺬﺑﺔ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٥-٩‬ﺃﺳﺒﺎﺏ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ ﺃﹸﺳﺮ ﻣﻜﻮﻧﺔ ﻣﻦ ﺃﺑﻮﻳﻦ ﻭﺃﺳﺮ ﺫﺍﺕ ﻋﺎﺋﻞ ﻭﺍﺣﺪ‬
‫‪ %‬ﻟﻸﻃﻔﺎﻝ ﺑﺪﺍﺧﻞ ﺃﺳﺮ‬ ‫‪ %‬ﻷﻃﻔﺎﻝ ﺑﺪﺍﺧﻞ ﺃﺳﺮ‬
‫ﺍﻟﺴﺒﺐ *‬
‫ﻳﻌﻮﳍﺎ ﺍﻷﺑﻮﺍﻥ‬ ‫ﺗﻌﻮﳍﺎ ﺭﺑﺔ ﺍﳌﱰﻝ‬
‫‪٣٩,٩‬‬ ‫‪٦١,٨‬‬ ‫ﻳﺴﺎﻫﻢ ﰲ ﺩﺧﻞ ﺍﻷﺳﺮﺓ‬
‫‪٣٣‬‬ ‫‪٤٣,٦‬‬ ‫ﻳﻜﺴﺐ ﻣﺎﻟﻪ ﺍﳋﺎﺹ‬
‫‪٤٩,٦‬‬ ‫‪٤٢,٣‬‬ ‫ﻓﺸﻞ ﰲ ﺍﻟﺪﺭﺍﺳﺔ‬
‫‪٤٥,٢‬‬ ‫‪٣٨,٥‬‬ ‫ﺗﻌﻠﻢ ﺣﺮﻓﺔ‬
‫‪٦,٧‬‬ ‫‪٥,١‬‬ ‫ﺃﺳﺒﺎﺏ ﺃﺧﺮﻯ‬
‫* ﰎ ﺍﻟﺴﻤﺎﺡ ﻟﻠﻤﺠﻴﺒﲔ ﺑﺬﻛﺮ ﺃﻛﺜﺮ ﻣﻦ ﺳﺒﺐ‬

‫‪ .٢‬ﺍﻟﻔﻘﺮ ﻭﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‬

‫ﻳﻮﺟﺪ ﰲ ﻣﺼﺮ ﺗﻔﺎﻭﺕ ﻭﺍﺳﻊ ﰲ ﺍﻟﺜﺮﻭﺍﺕ‪ ،‬ﺣﻴﺚ ﻗﻴﻢ ﺍﻟﺒﻨﻚ ﺍﻟﺪﻭﱄ ﺇﻥ ﺃﻏﲎ ‪ %٢٠‬ﻣﻦ ﻣ‪‬ﻼﻙ‬
‫ﺍﻷﺭﺍﺿﻲ ﳛﻈﻮﻥ ﺑـ ‪ %٧٩‬ﻣﻦ ﺍﻷﺭﺍﺿﻲ ﺍﻟﺰﺭﺍﻋﻴﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﳛﻈﻰ ﺃﻓﻘﺮ ‪ %٢٠‬ﺑـ ‪ %١٥‬ﻓﻘﻂ ﻣﻦ ﺍﻷﺭﺍﺿﻲ‬
‫ﺍﻟﺰﺭﺍﻋﻴﺔ‪ .‬ﻭﻗﺪ ﺗﺒﻨﺖ ﺍﳊﻜﻮﻣﺔ‪ ،‬ﻣﺘﺄﺛﺮﺓ ﺑﺎﻟﺘﻴﺎﺭﺍﺕ ﺍﻟﻌﺎﳌﻴﺔ‪ ،‬ﺳﻴﺎﺳﺔ "ﺍﻟﺒﺎﺏ ﺍﳌﻔﺘﻮﺡ" ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﰲ‬
‫ﻋﺎﻡ ‪ ١٩٧٤‬ﻭﺍﻟﱵ ﺃﺩﺕ ﺇﱃ ﺍﻟﻨﻤﻮ ﰲ ﺍﻟﺘﺠﺎﺭﺓ‪ ،‬ﺧﺎﺻﺔﹰ ﰲ ﺑﻀﺎﺋﻊ ﺍﳌﺴﺘﻬﻠﻜﲔ‪ ،‬ﻭﺫﻟﻚ ﺃﺩﻯ ﺑﺎﻟﻨﻔﻊ‬
‫ﻋﻠﻰ ﻓﺌﺔ ﳏﺪﺩﺓ ﻣﻦ ﺭﺟﺎﻝ ﺍﻷﻋﻤﺎﻝ‪ .‬ﻭﻛﺎﻥ ﻟﻠﻌﺠﺰ ﰲ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﻟﺴﻨﻮﻳﺔ‪ ،‬ﲜﺎﻧﺐ ﺛﻘﹼﻞ ﺍﻟﺪﻳﻮﻥ ﺍﶈﻠﻴﺔ‬
‫ﻭﺍﻟﺪﻭﻟﻴﺔ ﺗﺄﺛﲑﻩ ﻋﻠﻰ ﺍﻻﻗﺘﺼﺎﺩ‪ .‬ﻟﺬﻟﻚ ﻓﻘﺪ ﺗﺒﻨﺖ ﻣﺼﺮ ﰲ ﻋﺎﻡ ‪ ١٩٨٦‬ﺳﻴﺎﺳﺎﺕ ﺍﻹﺻﻼﺡ‬
‫ﺍﻻﻗﺘﺼﺎﺩﻱ‪ ،‬ﻓﺎﻧﺘﻬﺠﺖ ﺳﻴﺎﺳﺔ ﺍﳊﺪ ﻣﻦ ﺍﻹﻧﻔﺎﻕ ﺍﻟﻌﺎﻡ ﲜﺎﻧﺐ ﺯﻳﺎﺩﺓ ﰲ ﻣﻌﺪﻻﺕ ﺍﳌﺎﺀ ﻭﺍﻟﻜﻬﺮﺑﺎﺀ‪،‬‬
‫ﻭﻛﺬﻟﻚ ﺍﳊﺪ ﻣﻦ ﻓﺮﺹ ﺍﻟﺘﻮﻇﻴﻒ‪ .‬ﻭﻗﺪ ﻗﺪﺭ ﺍﻟﺒﻨﻚ ﺍﻟﺪﻭﱄ ﰲ ﺑﺪﺍﻳﺔ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﺃﻥ ﻣﺎ ﺑﲔ ‪– ٢٠‬‬
‫‪ %٢٥‬ﻣﻦ ﻋﺪﺩ ﺍﻟﺴﻜﺎﻥ ﻳﻌﻴﺸﻮﻥ ﲢﺖ ﺧﻂ ﺍﻟﻔﻘﺮ ﻭﺃﻥ ‪ %١٣ – ١٠‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ ﻳﻌﻴﺸﻮﻥ ﺃﺷﻜﺎﻝ‬
‫ﻗﺼﻮﻯ ﻣﻦ ﺍﻟﻔﻘﺮ)ﺍﻟﺒﻨﻚ ﺍﻟﺪﻭﱄ‪.(١٩٩٠ ،‬‬
‫ﻭﺃﻛﺜﺮ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﺍﳊﺪﻳﺜﺔ ﺣﻮﻝ ﻗﻀﻴﺔ ﺍﻟﻔﻘﺮ ﺗﻘﻮﻡ ﻋﻠﻰ ﺃﺳﺎﺱ ﻣﺴﺢ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ‬
‫ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪ (١٩٩٦ – ١٩٩٥) CAPMAS‬ﺣﻮﻝ ﺩﺧﻞ ﺍﻷﺳﺮﺓ ﻭﺍﻹﻧﻔﺎﻕ ﻟﻴﻘﺪﺭ ﺃﻥ ﺧﻂ ﺍﻟﻔﻘﺮ‬
‫ﺍﻟﻘﺎﺋﻢ ﻋﻠﻰ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻲ ﺍﳌﺄﻛﻞ ﻓﻘﻂ ﻳﺼﻞ ﺇﱃ ‪ ٣١٤٨‬ﺟﻨﻴﻬﺎﹰ ﻟﻸﺳﺮﺓ ﺃﻭ ﺃﻗﻞ ﺃﻭ ‪ ٥٩٤‬ﺟﻨﻴﻬﺎﹰ‬
‫ﻟﻠﻔﺮﺩ‪ .‬ﺗﺒﺎﻋ‪‬ﺎ‪ ،‬ﻓﻘﺪ ﻗﻴﻤﺖ ﻣﺆﺳﺴﺔ ﺍﻟﺘﺨﻄﻴﻂ ﺍﻟﻘﻮﻣﻲ )‪ (INP‬ﺃﻥ ‪ %٢٤‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ ﻳﻌﻴﺸﻮﻥ‬
‫ﲢﺖ ﺧﻂ ﺍﻟﻔﻘﺮ‪ ،‬ﻛﻤﺎ ﰎ ﺍﻋﺘﺒﺎﺭ ﺧ‪‬ﻤﺲ ﺍﻟﺴﻜﺎﻥ ﻳﻌﻴﺸﻮﻥ ﰲ "ﻓﻘﺮ ﻧﺴﱯ"‪ .‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ‬
‫ﻓﻘﺪ ﺃﺷﺎﺭﺕ ﻧﺘﺎﺋﺞ ﺍﻟﺒﺤﺚ ﺃﻥ ‪ %٤٢‬ﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ ﻳﻌﻴﺸﻮﻥ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭ‪ %٥٨‬ﰲ ﺍﳌﻨﺎﻃﻖ‬
‫ﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭﻭﻓﻘﺎﹰ ﻟﻸﻗﺎﻟﻴﻢ‪ ،‬ﻳﻌﻴﺶ ‪ %٣٦‬ﻣﻨﻬﻢ ﰲ ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ ﻭ‪ %٨‬ﰲ ﻣﺼﺮ ﺍﻟﻌﻠﻴﺎ‪.‬‬
‫)‪.(INP, 1996‬‬
‫ﻭﻗﺪ ﺃﺷﺎﺭ ﻣﺴﺢ ﺁﺧﺮ )‪ (Nagi, 1995‬ﺇﱃ ﺃﻥ ﺍﳌﻌﲎ ﺍﳌﻄﻠﻖ ﻟﻠﻔﻘﺮ ﰲ ﻣﺼﺮ ﻳﺘﺮﺍﻭﺡ ﻓﻴﻤﺎ ﺑﲔ‬
‫‪ %٣٢,٦‬ﺇﱄ ‪ %٣٧,٢‬ﺇﺫﺍ ﺃﺧﺬﻧﺎ ﻧﺼﻒ ﺃﻭ ﺛﻠﺜﻲ ﻣﺴﺘﻮﻱ ﺍﻹﻧﻔﺎﻕ ﺍﻟﺴﺎﺑﻖ ﺫﻛﺮﻩ ﻛﺤﺪ ﳌﺴﺘﻮﻱ ﺍﻟﻔﻘﺮ‬
‫ﺑﺎﻟﺘﺮﺗﻴﺐ‪ .‬ﻛﻤﺎ ﺃﻭﺿﺤﺖ ﺫﺍﺕ ﺍﻟﺪﺭﺍﺳﺔ ﺇﱄ ﺃﻥ ﺍﻟﺪﺧﻞ ﺍﻟﺸﻬﺮﻱ ﻟـ ‪ %٨٢,٨‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ ﺃﻗﻞ ﻣﻦ ‪٥٠٠‬‬
‫ﺟﻨﻴﻪ ﻭ‪ %٢٨,٣‬ﻳﻘﻞ ﺩﺧﻠﻬﻢ ﺍﻟﺸﻬﺮﻱ ﻋﻦ ‪ ٢٠٠‬ﺟﻨﻴﻪ‪ .‬ﻛﻤﺎ ﻛﺸﻒ ﻫﺬﺍ ﺍﳌﺴﺢ ﺃﻳﻀﺎ ﻋﻦ ﺃﻥ ﺍﻟﻔﻘﺮ‬

‫‪٢٢٤‬‬
‫ﺃﻛﺜﺮ ﺗﻔﺸﻴﺎﹰ ﺑﲔ ﺍﻟﺴﻴﺪﺍﺕ ﺍﳌﻌﻴﻼﺕ ﻟﻸﺳﺮﺓ ﺑﻨﺴﺒﺔ ‪ ،%٤٣,٢‬ﻣﻘﺎﺭﻧﺔ ﺑﺎﻟﺮﺟﺎﻝ ﺍﻟﱵ ﺗﺼﻞ ﺍﻟﻨﺴﺒﺔ‬
‫ﺑﻴﻨﻬﻢ ﺇﱃ ‪.%٣٤,٣‬‬
‫ﺃﺷﺎﺭﺕ ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ ﰎ ﺇﺟﺮﺍﺅﻫﺎ ﰲ ﳏﺎﻓﻈﺔ ﺳﻮﻫﺎﺝ )‪ (INP, 1996‬ﺇﱃ ﺃﻥ ﺍﻟﻘﺮﻭﻳﲔ ﺍﻟﺬﻳﻦ ﻻ‬
‫ﳝﻠﻜﻮﻥ ﺃﺭﺍﺿﻲ ﺯﺭﺍﻋﻴﺔ ﻳﻌﺪﻭﻥ ﻣﻦ ﺃﻛﺜﺮ ﺍﻟﻔﻘﺮﺍﺀ ﻣﻌﺎﻧﺎﺓﹰ‪ ،‬ﺇﺫ ﺃ‪‬ﻢ ﻳﻌﺘﻤﺪﻭﻥ ﻋﻠﻰ ﺍﻟﻌﻤﻞ ﺍﳌﻮﲰﻲ‬
‫ﺍﻟﺬﻱ ﻳﻘﺪ‪‬ﺭ ﻋﻠﻰ ﳓﻮ ﻣﻦ ‪ ١٠ – ٨‬ﺃﻳﺎﻡ ﰲ ﺍﻟﺸﻬﺮ‪ .‬ﻭﻗﺪ ﺃﺷﺎﺭ ﺍﳌﺴﺢ ﺇﱃ ﺃﻥ ﻫﺬﻩ ﺍﻟﻔﺌﺔ ﻏﲑ ﻗﺎﺩﺭﺓ ﻋﻠﻰ‬
‫ﺇﺑﻘﺎﺀ ﺃﺑﻨﺎﺋﻬﺎ ﰲ ﺍﳌﺪﺍﺭﺱ‪ .‬ﰲ ﺣﲔ ﻳﺴﺘﻄﻴﻊ ﺍﳌﺴﺘﺄﺟﺮﻭﻥ ﺍﻟﺒﺴﻄﺎﺀ ﻭﻣ‪‬ﻼﻙ ﺍﻷﺭﺍﺿﻲ )ﺃﻗﻞ ﻣﻦ ﻓﺪﺍﻥ‬
‫ﻭﺍﺣﺪ( ﺃﻥ ﻳﻮﻓﺮﻭﺍ ﺍﺣﺘﻴﺎﺟﺎ‪‬ﻢ ﺍﻷﺳﺎﺳﻴﺔ ﳌﺪﺓ ﺷﻬﺮﻳﻦ ﺃﻭ ﺛﻼﺛﺔ ﻟﻴﺠﺪﻭﺍ ﺃﻧﻔﺴﻬﻢ ﰲ ﺣﺎﺟﺔ ﺇﱃ‬
‫ﺍﻟﺒﺤﺚ ﻋﻦ ﻋﻤﻞ ﻳﻜﻔﻴﻬﻢ ﻟﺒﻘﻴﺔ ﺍﻷﺷﻬﺮ‪ .‬ﺫﻟﻚ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻋﺪﻡ ﺗﻮﻓﺮ ﺃﻱ ﻣﻮﺍﺭﺩ ﺃﺧﺮﻯ ﻟﺘﻌﻠﻴﻢ‬
‫ﺍﻷﻃﻔﺎﻝ‪ .‬ﻭﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ‪ ،‬ﻳﻌﺪ ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﺍﳌﻼﺫ ﺍﻷﺳﺎﺳﻲ ﻟﻠﻔﻘﺮﺍﺀ‪ ،‬ﺇﺫ ﳚﺘﺬﺏ ﺍﻟﻨﺴﺎﺀ‬
‫ﻭﺍﻷﻃﻔﺎﻝ ﻟﺸﻐﻞ ﺃﺩﱐ ﺣﺪﻭﺩ ﺍﻷﻧﺸﻄﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ )‪.(INP, 1996‬‬
‫ﻭﻷﻭﺟﻪ ﻣﻌﺎﻧﺎﺓ ﺍﻟﻔﻘﺮﺍﺀ ﻣﻈﺎﻫﺮ ﻋﺪﺓ‪ .‬ﻓﻘﺪ ﻛﺸﻒ ﻣﺴﺢ )‪ (Nagi, 1995‬ﺃﻥ ‪ %٢٩,٧‬ﻣﻦ ﺍﻷﺳﺮ‬
‫ﺍﻟﱵ ﰎ ﺇﺟﺮﺍﺀ ﺍﻟﺪﺭﺍﺳﺔ ﻋﻠﻴﻬﺎ ﺗﻮﺍﺟﻪ ﺻﻌﻮﺑﺎﺕ ﰲ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﲦﻦ ﺍﻟﻄﻌﺎﻡ‪ ،‬ﻭ‪ %٣٥,٣‬ﻣﻦ ﺍﻷﺳﺮ‬
‫ﺗﻮﺍﺟﻪ ﺻﻌﻮﺑﺔ ﰲ ﲢﻤﻞ ﺗﻜﻠﻔﺔ ﺍﳌﺄﻛﻞ ﻭﺍﳌﻠﺒﺲ‪ ،‬ﻭ‪ %١٣,٦‬ﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ ﺍﻟﺬﻳﻦ ﻫﻢ ﰲ ﺣﺎﺟﺔ ﺇﱃ‬
‫ﺭﻋﺎﻳﺔ ﻃﺒﻴﺔ ﻻ ﳛﻈﻮﻥ ‪‬ﺎ‪ ،‬ﻭﻓﻘﻂ ‪ %١١,٩‬ﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ ﺗﺼﻠﻬﻢ ﻣﻌﻮﻧﺔ ﻣﺎﺩﻳﺔ‪ .‬ﺑﻮﺟﻪ ﻋﺎﻡ‪ ،‬ﻓﻘﺪ‬
‫ﻭﺟﺪ ﺃﻥ ﺍﳋﺪﻣﺎﺕ ﻭﺍﻟﻘﺮﻭﺽ ﺍﳌﺨﺼﺼﺔ ﻟﻠﻔﻘﺮﺍﺀ ﻗﻠﻴﻠﺔ ﻭﻣﺘﻔﺮﻗﺔ‪ .‬ﻛﺬﻟﻚ ﻓﻘﺪ ﻛﺸﻔﺖ ﺷﻮﺍﻫﺪ‬
‫ﻗﻮﻳﺔ ﺃﻥ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﻻ ﳛﻀﺮﻭﻥ ﺍﳌﺪﺍﺭﺱ ﰲ ﺯﻳﺎﺩﺓ ﻣﺴﺘﻤﺮﺓ ﺑﺴﺒﺐ ﺍﳔﻔﺎﺽ ﻣﻌﺪﻻﺕ‬
‫ﺩﺧﻮﻝ ﺍﻷﺳﺮ‪ .‬ﻭﻗﺪ ﺃﺷﺎﺭﺕ ﺩﺭﺍﺳﺔ ﺃﺧﺮﻱ ﺇﱃ ﺃﻥ ﺩﺧﻞ ﺍﻟﻄﻔﻞ ﺍﻟﻌﺎﻣﻞ ﳝﺜﻞ ‪ %٢٣‬ﻣﻦ ﺩﺧﻞ ﺍﻷﺳﺮﺓ‪.‬‬
‫)ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻘﺎﻫﺮﺓ ﺍﻟﻜﱪﻯ‪.(١٩٩١ ،‬‬
‫ﺟﺪﻭﻝ )‪ :(٦-٩‬ﺍﻷﻃﻔﺎﻝ )ﺑﲔ ﺳﻦ ‪ (١٥ – ٦‬ﺍﻟﺬﻳﻦ ﻻ ﳛﻀﺮﻭﻥ ﺍﳌﺪﺭﺳﺔ ﻭﺩﺧﻞ ﺍﻷﺳﺮﺓ‬
‫ﺍﻟﺪﺧﻞ ﺍﻟﺴﻨﻮﻱ ﺑﺎﳉﻨﻴﻪ‬
‫ﻋﺪﺩ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﻻ‬
‫ﺍ‪‬ﻤﻮﻉ‬ ‫‪٨٤٠٠+‬‬ ‫‪٨٣٩٩ -٢٤٠٠‬‬ ‫)<‪(٢٣٩٩-١٢٢٠‬‬
‫ﳛﻀﺮﻭﻥ ﺍﳌﺪﺭﺳﺔ‬
‫‪N = 3696‬‬ ‫‪N = 221‬‬ ‫‪N = 2537‬‬ ‫‪N = 939‬‬
‫‪%٧٠,٥‬‬ ‫‪%٨٤,٢‬‬ ‫‪%٧٤,٢‬‬ ‫‪%٥٧,١‬‬ ‫ﻻ ﺃﺣﺪ‬
‫‪%١٨,٣‬‬ ‫‪%١٠,٩‬‬ ‫‪%١٦,٤‬‬ ‫‪%٢٥,٥‬‬ ‫ﻭﺍﺣﺪ‬
‫‪%٦,٤‬‬ ‫‪%٣,٦‬‬ ‫‪%٥,٣‬‬ ‫‪%١٠,١‬‬ ‫ﺍﺛﻨﺎﻥ‬
‫‪%٤,٨‬‬ ‫‪%١,٤‬‬ ‫‪%٤,٢‬‬ ‫‪%٧,٢‬‬ ‫ﺛﻼﺛﺔ ﺃﻭ ﺃﻛﺜﺮ‬
‫‪%١٠٠,٠‬‬ ‫‪%١٠٠,٠‬‬ ‫‪%١٠٠,٠‬‬ ‫‪%١٠٠,٠‬‬ ‫ﺍ‪‬ﻤﻮﻉ‬
‫* ﻣﻠﺤﻮﻇﺔ‪ :‬ﻳﻘﺘﺼﺮ ﺍﻟﺘﺤﻠﻴﻞ ﻋﻠﻰ ﺍﻷﺳﺮ ﺍﻟﱵ ﺗﻀﻢ ‪ -‬ﻋﻠﻰ ﺍﻷﻗﹲﻞ ‪ -‬ﻃﻔﻼﹰ ﻭﺍﺣﺪﺍﹰ ﰲ ﻋﻤﺮ ﻣﺎ ﺑﲔ )‪ ١٥ – ٦‬ﺳﻨﺔ(‬
‫)‪.(Nagi, 1995‬‬

‫‪ .٣‬ﺍﻟﺘﻌﻠﻴﻢ ﻭﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‬

‫ﻳﻨﺺ ﺍﻟﻘﺎﻧﻮﻥ ﺍﳌﺼﺮﻱ ﻋﻠﻰ ﺃﻥ ﺍﻟﺘﻌﻠﻴﻢ ﻫﻮ ﺣﻖ ﺗﻀﻤﻨﻪ ﺍﻟﺪﻭﻟﺔ )ﺑﻨﺪ ‪ (١٨‬ﳎﺎﻧﺎﹰ ﰲ ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﺍﳊﻜﻮﻣﻴﺔ )ﺑﻨﺪ ‪ (٢٠‬ﻭﺇﺟﺒﺎﺭﻱ ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺃﻥ ﺍﻟﺪﻭﻟﺔ ﺗﻌﻤﻞ ﳌﺪ‬
‫ﺇﺟﺒﺎﺭﻳﺔ ﺍﻟﺘﻌﻠﻴﻢ ﻟﺘﺸﻤﻞ ﺍﳌﺮﺍﺣﻞ ﺍﻷﺧﺮﻯ )ﺑﻨﺪ ‪ .(١٨‬ﻭﰲ ﺍﻟﻮﻗﺖ ﺍﳊﺎﱄ‪ ،‬ﺗﻀﻢ ﺍﳌﺮﺣﻠﺔ ﺍﻹﺟﺒﺎﺭﻳﺔ‬
‫ﲬﺲ ﺳﻨﻮﺍﺕ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻻﺑﺘﺪﺍﺋﻲ‪ ،‬ﻭﺛﻼﺙ ﺳﻨﻮﺍﺕ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻹﻋﺪﺍﺩﻱ‪ .‬ﻋﻤﻠﻴﺎﹰ‪ ،‬ﻳﻮﺍﺟﻪ ﻧﻈﺎﻡ ﺍﻟﺘﻌﻠﻴﻢ‬
‫ﺻﻌﻮﺑﺎﺕ ﺫﺍﺕ ﻣﻀﺎﻋﻔﺎﺕ ﻋﻠﻰ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻔﻘﺮﺍﺀ‪.‬‬

‫‪٢٢٥‬‬
‫ﻃﺒﻘﺎﹰ ﻟﻺﺣﺼﺎﺋﻴﺎﺕ ﺍﻟﺮﲰﻴﺔ‪ ،‬ﺗﺼﻞ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﻓﺌﺔ ﺳﻦ ) ‪ ٨ – ٦‬ﺳﻨﻮﺍﺕ( ﺍﳌﺴﺠﻠﲔ ﰲ‬
‫ﻣﺮﺍﺣﻞ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻴﺔ )ﻟﻌﺎﻡ ‪ (١٩٩٣‬ﺇﱃ ‪ .%٩١,٩‬ﺇﻻ ﺃﻧﻪ ﻳﻮﺟﺪ ﺗﺒﺎﻳﻦ ﻭﺍﺿﺢ ﺑﲔ ﺍﶈﺎﻓﻈﺎﺕ‬
‫)ﺗﺼﻞ ﻧﺴﺒﺔ ﺍﻟﻘﻴﺪ ﺇﱃ ‪ %١٠٠‬ﰲ ﳏﺎﻓﻈﺎﺕ ﻣﺜﻞ ﺍﻹﲰﺎﻋﻴﻠﻴﺔ ﻭﺩﻣﻴﺎﻁ‪ ،‬ﰲ ﺍﻟﻮﻗﺖ ﺍﻟﺬﻱ ﺗﺼﻞ‬
‫ﻓﻴﻪ ﺍﻟﻨﺴﺒﺔ ﺑﲔ ‪ %٨٦ – ٧٢‬ﰲ ﺳﻮﻫﺎﺝ ﻭﻛﻔﺮ ﺍﻟﺸﻴﺦ ﻭﺃﺳﻴﻮﻁ ﻭﺑﲏ ﺳﻮﻳﻒ ﻭﺍﻟﻔﻴﻮﻡ( )ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺘﻌﻠﻴﻢ‪.(١٩٩٣ ،‬‬
‫ﻭﰲ ﻣﺴﺢ ﺣﺪﻳﺚ ﺃﺟﺮﺗﻪ )‪ (Datt et al, 1997‬ﰲ ‪ ٢٠‬ﳏﺎﻓﻈﺔ ﺣﻮﻝ "ﺃﻭﺟﻪ ﺍﻟﻔﻘﺮ ﰲ ﻣﺼﺮ"‪ ،‬ﰎ‬
‫ﺍﻟﺘﺤﺮﻱ ﻋﻦ ﺍﻷﺳﺒﺎﺏ ﺍﻟﱵ ﺃﺩﱃ ‪‬ﺎ ﺃﻓﺮﺍﺩ ﰲ ﺳﻦ ‪ ١٥‬ﻋﺎﻣﺎﹰ ﺃﻭ ﺃﻛﺜﺮ ﺣﻮﻝ ﻋﺪﻡ ﺫﻫﺎ‪‬ﻢ ﻟﻠﻤﺪﺍﺭﺱ‬
‫‪‬ﺎﺋﻴﺎﹰ‪ .‬ﻭﻛﺎﻥ ﺍﻟﺴﺒﺒﺎﻥ ﺍﻟﺮﺋﻴﺴﻴﺎﻥ ﺍﻟﻠﺬﺍﻥ ﺣﻈﻴﺎ ﻋﻠﻰ ﺃﻋﻠﻰ ﻧﺴﺒﺔ ﻣﺌﻮﻳﺔ ﻟﺪﻯ ﺍ‪‬ﻴﺒﲔ ﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ‬
‫ﻭﻏﲑ ﺍﻟﻔﻘﺮﺍﺀ ﳘﺎ‪ :‬ﺃﺳﺒﺎﺏ ﻣﺎﺩﻳﺔ‪ ،‬ﻭﻗﻠﺔ ﺍﻟﺮﻏﺒﺔ ﰲ ﺍﻟﺘﻌﻠﻴﻢ‪.‬‬
‫ﺍﻟﺘﺴﺮﺏ ﺍﳌﺪﺭﺳﻲ‬
‫ﻗﺪﺭﺕ ﻧﺴﺒﺔ ﺍﻟﺘﺴﺮﺏ ﺍﳌﺪﺭﺳﻲ ﻣﻦ ﺍﻟﺼﻒ ﺍﳋﺎﻣﺲ ﻟﻠﺘﻌﻠﻴﻢ ﺍﻻﺑﺘﺪﺍﺋﻲ ﺧﻼﻝ ﻓﺘﺮﺓ ﺍﻟﻌﺸﺮﺓ‬ ‫
‬
‫ﺃﻋﻮﺍﻡ ‪ ١٩٧٩/١٩٧٨‬ﺣﱴ ‪ ١٩٨٩/١٩٨٨‬ﺑﲔ ‪) % ١١ – ١٠‬ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﺍﻟﺘﻌﻠﻴﻢ ﻟﻠﺠﻤﻴﻊ‪،‬‬
‫‪.(١٩٩٣‬‬
‫ﻭﰲ ﺗﻘﻴﻴﻢ ﺁﺧﺮ ﻟﻠﺘﺴﺮﺏ ﺍﳌﺪﺭﺳﻲ ﻋﻠﻲ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﺍﻟﺘﺤﻘﻮﺍ ﺑﺎﻟﺼﻒ ﺍﻷﻭﻝ ﻣﻦ ﺍﻟﺘﻌﻠﻴﻢ‬ ‫
‬
‫ﺍﻻﺑﺘﺪﺍﺋﻲ ﰲ ‪ ،٨٨-١٩٨٧‬ﻭﻋﻦ ﺇﲤﺎﻣﻬﻢ ﺍﳌﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ ﰲ ‪ ،١٩٩٢/١٩٩١‬ﻭﺟﺪ ﺃﻥ ‪ %٢٠‬ﻣﻦ‬
‫ﻫﺆﻻﺀ ﺍﻷﻃﻔﺎﻝ ﺗﺮﻛﻮﺍ ﺍﻟﺘﻌﻠﻴﻢ )ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﺍﻟﺘﻌﻠﻴﻢ ﻟﻠﺠﻤﻴﻊ‪.(١٩٩٣ ،‬‬
‫ﻛﺬﻟﻚ ﻓﺈﻥ ﻧﺴﺒﺔ ﺍﳌﺘﺴﺮﺑﲔ ﻣﻦ ﺍﳌﺮﺣﻠﺔ ﺍﻹﻋﺪﺍﺩﻳﺔ ﻟﻠﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﻗﺪ ﻭﺟﺪﺕ ﻋﺎﻟﻴﺔ‪،‬‬ ‫
‬
‫ﻓﻔﻲ ﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ ﺑﲔ ‪ ١٩٩٢/١٩٩١‬ﺇﱃ ‪ ١٩٩٤/١٩٩٣‬ﻭﺟﺪ ﺃﻥ ﻧﺴﺒﺔ ﺍﻟﺘﺴﺮﺏ ﻣﻦ ﺍﻟﺼﻒ‬
‫ﺍﻷﻭﻝ ﻟﻠﺘﻌﻠﻴﻢ ﺍﻹﻋﺪﺍﺩﻱ ﺗﺼﻞ ﺇﱃ ‪ %٩,١‬ﻭﻣﻦ ﺍﻟﺼﻒ ﺍﻟﺜﺎﱐ ﺗﺼﻞ ﺇﱄ ‪ .%٧,٢‬ﻛﻤﺎ ﺃﺷﺎﺭﺕ‬
‫ﻧﻔﺲ ﺍﻟﺪﺭﺍﺳﺔ ﺇﱃ ﺃﻥ ﻫﺬﻩ ﺍﳌﻌﺪﻻﺕ ﺃﻋﻠﻰ ﰲ ﺍﻟﻘﺎﻫﺮﺓ‪ ،‬ﺑﻨﺴﺒﺔ ‪ %١٦,٨‬ﻣﻦ ﺍﻟﺼﻒ ﺍﻷﻭﻝ‬
‫ﻭ‪ %١٧,٢‬ﻣﻦ ﺍﻟﺼﻒ ﺍﻟﺜﺎﱐ ) ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﺍﻟﺘﻌﻠﻴﻢ ﻟﻠﺠﻤﻴﻊ‪.( ١٩٩٣ ،‬‬
‫ﻭﻋﻨﺪ ﺍﻷﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﻧﺴﺐ ﺍﳌﻠﺘﺤﻘﲔ ﻭﻧﺴﺐ ﺍﳌﺘﺴﺮﺑﲔ‪ ،‬ﺃﻇﻬﺮﺕ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ ﺧﻼﻝ‬ ‫
‬
‫ﺍﻟﻔﺼﻞ ﺍﻟﺪﺭﺍﺳﻲ ‪ ١٩٩٣/١٩٩٢‬ﺗﺼﻞ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ ﺍﳊﺎﺿﺮﻳﻦ ﻟﻠﻤﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ‬
‫ﻟﻠﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﺇﱃ ‪ %٧٧,٥‬ﻣﻦ ﺍ‪‬ﻤﻮﻉ ﺍﻟﻜﻠﻲ ﻟﻸﻃﻔﺎﻝ ﰲ ﻫﺬﻩ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ‪ ،‬ﻭﺃﻥ‬
‫ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻹﻋﺪﺍﺩﻳﺔ ﳝﺜﻠﻮﻥ ‪ %٨٢,٩‬ﻣﻦ ﳎﻤﻮﻉ ﺍﻷﻃﻔﺎﻝ ﰲ ﻫﺬﻩ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ‪.‬‬
‫ﺑﺬﻟﻚ ﰎ ﺗﻘﺪﻳﺮ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﺃﲤﻮﺍ ﻣﺮﺣﻠﺔ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﺑـ ‪ ) %٨١‬ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﺍﻟﺘﻌﻠﻴﻢ ﻟﻠﺠﻤﻴﻊ‪.(١٩٩٣ ،‬‬
‫ﻭﻗﺪ ﺳﻌﺖ ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ )‪ (Datt etal.1997‬ﺃﻗﻴﻤﺖ ﰲ ‪ ٢٠‬ﳏﺎﻓﻈﺔ ﻟﺘﺤﺪﻳﺪ "ﺃﻭﺟﻪ‬ ‫
‬
‫ﺍﻟﻔﻘﺮ ﰲ ﻣﺼﺮ" ﺇﱃ ﺗﻘﻴﻴﻢ ﺳﻨﻮﺍﺕ ﺍﻟﺪﺭﺍﺳﺔ ﻭﻧﺴﺐ ﺃﻣﻴﺔ ﺍ‪‬ﻴﺒﲔ ﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ ﻭﻏﲑ ﺍﻟﻔﻘﺮﺍﺀ‬
‫ﺧﻼﻝ ﺃﻛﺜﺮ ﻣﻦ ‪ ١٥‬ﻋﺎﻣﺎﹰ‪ .‬ﺇﺫ ﻋﻴﻨﺖ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ ﻣﺘﻮﺳﻂ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻟﺪﺭﺍﺳﻴﺔ ﻟﻔﺌﺔ "ﻏﲑ‬
‫ﺍﻟﻔﻘﺮﺍﺀ" ﺗﻌﺪ ‪ ٧,٢‬ﻋﺎﻡ‪ ،‬ﰲ ﻣﻘﺎﺑﻞ ‪ ٤,٤‬ﻋﺎﻡ ﻟﻔﺌﺔ "ﺍﻟﻔﻘﺮﺍﺀ"‪ ،‬ﻭﻓﻘﻂ ‪ ٣,١٤‬ﻋﺎﻡ ﻟﻠﺬﻳﻦ ﰎ‬
‫ﺍﻋﺘﺒﺎﺭﻫﻢ "ﺃﻛﺜﺮ ﻓﻘﺮﺍﹰ"‪ .‬ﻭﻛﺬﻟﻚ ﺳﺠﻠﺖ ﺍﻟﺪﺭﺍﺳﺔ ﻭﺟﻮﺩ ﻫﻮﺓ ﺑﲔ ﺍﻟﻔﻘﺮﺍﺀ ﻭﻏﲑ ﺍﻟﻔﻘﺮﺍﺀ ﰲ‬
‫ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭﺑﲔ ﺍﻟﺬﻛﻮﺭ ﻭﺍﻹﻧﺎﺙ‪ .‬ﻛﻤﺎ ﻛﺸﻒ ﺍﻟﺒﺤﺚ ﻋﻠﻲ ﻧﺴﺐ ﺍﻷﻣﻴﺔ‬

‫‪٢٢٦‬‬
‫ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻮﻃﲏ‪ ،‬ﻓﻘﺪ ﺑﻠﻐﺖ ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻘﺎﺩﺭﻳﻦ ﻋﻠﻰ ﺍﻟﻘﺮﺍﺀﺓ ﻣﻦ ﻏﲑ ﺍﻟﻔﻘﺮﺍﺀ‬
‫‪ %٦٦,٥‬ﻭﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ ‪ .%٤٨,٤‬ﻛﻤﺎ ﺑﻠﻐﺖ ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻘﺎﺩﺭﻳﻦ ﻋﻠﻰ ﺍﻟﻜﺘﺎﺑﺔ ﻣﻦ ﻏﲑ‬
‫ﺍﻟﻔﻘﺮﺍﺀ ‪ %٦٥,٦‬ﻭﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ ‪.%٤٧,٣‬‬
‫ﺃﺳﺒﺎﺏ ﺍﻟﺘﺴﺮﺏ ﻣﻦ ﺍﳌﺪﺭﺳﺔ‬
‫ﺳﻌﺖ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻭﺍﳌﺴﻮﺡ ﻟﺘﺤﺪﻳﺪ ﺍﻷﺳﺒﺎﺏ ﺍﻟﱵ ﺗﺴﺎﻫﻢ ﰲ ﺯﻳﺎﺩﺓ ﻧﺴﺐ ﺍﻟﺘﺴﺮﺏ‬
‫ﻣﻦ ﺍﳌﺪﺍﺭﺱ‪ ،‬ﻭﻳﻌﺪ ﺫﻟﻚ ﺍﻟﺘﻘﻴﻴﻢ ﺫﺍ ﺻﻠﺔ ﻭﺛﻴﻘﺔ ﺑﺘﻔﻬﻢ ﻗﻀﻴﺔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٧-٩‬ﺃﺳﺒﺎﺏ ﺗﺮﻙ ﺍﳌﺪﺭﺳﺔ ﲝﺴﺐ ﺍﻟﻘﻄﺎﻉ ﻭﺍﻟﻨﻮﻉ* )‪(%‬‬
‫ﱂ ﻳﺘﻢ‬
‫ﻋﺪﺩ‬ ‫ﺃﺳﺒﺎﺏ‬ ‫ﻋﺪﻡ ﺍﻟﺮﻏﺒﺔ‬ ‫ﺃﺳﺒﺎﺏ‬ ‫ﺇ‪‬ﺎﺀ‬
‫ﺍﻻﻟﺘﺤﺎﻕ‬
‫ﺍﳌﻼﺣﻈﺎﺕ‬ ‫ﺃﺧﺮﻯ‬ ‫ﰲ ﺍﻻﺳﺘﻤﺮﺍﺭ‬ ‫ﻣﺎﺩﻳﺔ‬ ‫ﺍﻟﺪﺭﺍﺳﺔ‬
‫ﺑﺎﳌﺪﺭﺳﺔ‬
‫ﺍﳌﺪﻳﻨﺔ‬
‫‪٤١٣‬‬ ‫‪١,٧٩‬‬ ‫‪٢٥,٨١‬‬ ‫‪٣١,٠١‬‬ ‫‪٠٠,٠٠‬‬ ‫‪٤١,٣٩‬‬ ‫ﻓﻘﲑ‬
‫‪١,٨٥٦‬‬ ‫‪٥,٤٥‬‬ ‫‪١٤,٠١‬‬ ‫‪١٥,٠٦‬‬ ‫‪٠,٣٧‬‬ ‫‪٦٥,١١‬‬ ‫ﻏﲑ ﻓﻘﲑ‬
‫‪٢,٢٦٩‬‬ ‫‪٤,٧٦‬‬ ‫‪١٦,٢٣‬‬ ‫‪١٨,٠٦‬‬ ‫‪٠,٣٠‬‬ ‫‪٦٠,٦٥‬‬ ‫ﻛﻼﳘﺎ‬
‫ﺍﻟﺮﻳﻒ‬
‫‪٤٠٨‬‬ ‫‪٢,١١‬‬ ‫‪٢٩,٣٩‬‬ ‫‪٣١,٩١‬‬ ‫‪٢,٣١‬‬ ‫‪٣٤,٢٨‬‬ ‫ﻓﻘﲑ‬
‫‪١,٦٧٥‬‬ ‫‪٥,٢٠‬‬ ‫‪٢١,٠٢‬‬ ‫‪٢٥,٨١‬‬ ‫‪١,٣٨‬‬ ‫‪٤٦,٥٩‬‬ ‫ﻏﲑ ﻓﻘﲑ‬
‫‪٢,٠٨٣‬‬ ‫‪٤,٦٠‬‬ ‫‪٢٢,٦٦‬‬ ‫‪٢٧,٠٠‬‬ ‫‪١,٥٧‬‬ ‫‪٤٤,١٨‬‬ ‫ﻛﻼﳘﺎ‬
‫ﺫﻛﻮﺭ‬
‫‪٥١٧‬‬ ‫‪٠,٤٧‬‬ ‫‪٢٥,٠١‬‬ ‫‪٣٥,٤٨‬‬ ‫‪١,١٣‬‬ ‫‪٣٧,٩٠‬‬ ‫ﻓﻘﲑ‬
‫‪٢,٠٨٨‬‬ ‫‪٠,٩٦‬‬ ‫‪١٩,٨٤‬‬ ‫‪٢٢,٢٤‬‬ ‫‪٠,٨٠‬‬ ‫‪٥٨,١٧‬‬ ‫ﻏﲑ ﻓﻘﲑ‬
‫‪٢,٦٠٥‬‬ ‫‪٠,٨٦‬‬ ‫‪١٩,٢٨‬‬ ‫‪٢٤,٨٨‬‬ ‫‪٠,٨٦‬‬ ‫‪٥٤,١١‬‬ ‫ﻛﻼﳘﺎ‬
‫ﺇﻧﺎﺙ‬
‫‪٣٠٤‬‬ ‫‪٤,٣١‬‬ ‫‪٣١,٣٣‬‬ ‫‪٢٤,٨٥‬‬ ‫‪٠,٩٠‬‬ ‫‪٣٨,٦٢‬‬ ‫ﻓﻘﲑ‬
‫‪١,٤٤٣‬‬ ‫‪١١,٥٢‬‬ ‫‪١٦,٠٥‬‬ ‫‪١٦,٣٤‬‬ ‫‪٠,٨٤‬‬ ‫‪٥٥,٢٦‬‬ ‫ﻏﲑ ﻓﻘﲑ‬
‫‪١,٧٤٧‬‬ ‫‪١٠,٢٣‬‬ ‫‪١٨,٧٨‬‬ ‫‪١٧,٨٦‬‬ ‫‪٠,٨٥‬‬ ‫‪٥٢,٢٨‬‬ ‫ﻛﻼﳘﺎ‬
‫ﰲ ﻛﻞ ﻣﺼﺮ‬
‫‪١٩٩‬‬ ‫‪١,٨٠‬‬ ‫‪٣٢,٥٦‬‬ ‫‪٤٠,٧٨‬‬ ‫‪٠,٩١‬‬ ‫‪٢٣,٩٥‬‬ ‫ﻓﻘﲑ‬
‫‪٨٢١‬‬ ‫‪١,٩٣‬‬ ‫‪٢٧,٤٣‬‬ ‫‪٣١,٤٢‬‬ ‫‪١,٠٤‬‬ ‫‪٣٨,١٨‬‬ ‫ﻏﲑ ﻓﻘﲑ‬
‫‪٣,٥٣١‬‬ ‫‪٥,٢٤‬‬ ‫‪١٧,١٠‬‬ ‫‪١٩,٧٩‬‬ ‫‪٠,٨٢‬‬ ‫‪٥٦,٩٦‬‬ ‫ﻛﻼﳘﺎ‬
‫‪٤,٣٥٢‬‬ ‫‪٤,٩٦‬‬ ‫‪١٩,٠٨‬‬ ‫‪٢٢,٠١‬‬ ‫‪٠,٨٦‬‬ ‫‪٥٣,٣٦‬‬
‫)‪* Datt et al (1997‬‬
‫ﻧﻔﺖ ﺗﻠﻚ ﺍﻟﻨﺘﺎﺋﺞ ﺍﻻﺩﻋﺎﺀﺍﺕ ﺍﻟﻘﺎﺋﻠﺔ ﺑﻌﺪﻡ ﺍﻻﻟﺘﺤﺎﻕ ﺑﺎﳌﺪﺍﺭﺱ ﺑﺴﺒﺐ ﺑﻌﺪ ﺍﳌﺴﺎﻓﺔ ﺃﻭ ﻋﺪﻡ ﺗﻮﻓﺮ‬
‫ﺍﳌﺪﺍﺭﺱ‪ .‬ﻭﻛﻤﺎ ﻫﻮ ﻭﺍﺿﺢ‪ ،‬ﻓﻘﺪ ﻣﺜﻠﺖ ﺍﻷﺳﺒﺎﺏ ﺍﳌﺎﺩﻳﺔ ﺍﻷﺳﺒﺎﺏ ﺍﻟﺮﺋﻴﺴﻴﺔ ﻟﻠﺘﺴﺮﺏ ﺍﳌﺪﺭﺳﻲ‬
‫)‪ %٢٠‬ﻣﻦ ﻏﲑ ﺍﻟﻔﻘﺮﺍﺀ‪ %٣١ ،‬ﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ(‪ .‬ﻭﻳﺘﻤﺜﻞ ﺍﻟﺴﺒﺐ ﺍﻵﺧﺮ ﺍﳌﺘﺼﻞ ﺑﺎﻟﻘﻀﻴﺔ ﰲ ﻋﺪﻡ‬
‫ﺍﻟﺮﻏﺒﺔ ﰲ ﺍﺳﺘﻜﻤﺎﻝ ﺍﻟﺘﻌﻠﻴﻢ )‪ %١٧‬ﻣﻦ ﻏﲑ ﺍﻟﻔﻘﺮﺍﺀ‪ %٢٧ ،‬ﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ(‪ .‬ﻛﺬﻟﻚ ﺗﺆﻛﺪ ﺩﺭﺍﺳﺔ‬
‫ﻣﻴﺪﺍﻧﻴﺔ ﺃﺧﺮﻯ )‪ (Nagi, 1995‬ﺗﻠﻚ ﺍﻟﻨﺘﺎﺋﺞ ﻣﺸﲑﺓ ﺇﱃ ﺃﻥ ﻋﺪﺩ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﻻ ﳛﻀﺮﻭﻥ‬
‫ﺍﳌﺪﺍﺭﺱ ﰲ ﺗﺰﺍﻳﺪ ﻭﺍﺿﺢ ﻣﻊ ﺗﺪﱐ ﺩﺧﻮﻝ ﺍﻷﺳﺮ )ﺍﻧﻈﺮ ﺇﱃ ﺍﳉﺰﺀ ﺍﳋﺎﺹ ﺑﺎﻟﻔﻘﺮ ﻭﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪.(.‬‬

‫‪٢٢٧‬‬
 ‫ﺗﻜﻠﻔﺔ ﺍﻟﺘﻌﻠﻴﻢ‬
‫ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﺍﻟﺘﻌﻠﻴﻢ ﰲ ﺍﳌﺆﺳﺴﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﰲ ﻣﺒﺪﺋﻪ ﳎﺎﻧﺎﹰ‪ ،‬ﺇﻻ ﺃﻥ ﻗﺎﻧﻮﻥ ﺍﻟﺘﻌﻠﻴﻢ )ﺭﻗﻢ‬
‫‪ (١٩٨١/١٤٦‬ﻳﺸﺮﻉ ﻧﻔﻘﺎﺕ ﺧﺎﺻﺔ ﻟـ "ﺧﺪﻣﺎﺕ ﺇﺿﺎﻓﻴﺔ" ﻭﺗﺄﻣﲔ ﻋﻠﻰ ﺍﺳﺘﻌﻤﺎﻝ ﺃﺩﻭﺍﺕ ﺍﳌﺪﺭﺳﺔ‬
‫)ﺑﻨﺪ ‪ .(٣‬ﻛﺬﻟﻚ ﻗﺪﻡ ﻗﺮﺍﺭ ﻭﺯﺍﺭﻱ )ﺭﻗﻢ ‪ (١٩٨٦/١٤٨‬ﻧﻈﺎﻡ ﻟﺮﺳﻮﻡ ﺍ‪‬ﻤﻮﻋﺎﺕ ﺍﳋﺎﺻﺔ ﻻﺳﺘﻜﻤﺎﻝ‬
‫ﺩﺭﻭﺱ ﺍﳌﺪﺭﺳﺔ ﻭﻣﻘﺎﻭﻣﺔ ﺍﻟﺮﺳﻮﻡ ﺍﳋﺎﺻﺔ‪ ،‬ﺑﺬﻟﻚ ﲣﺘﻠﻒ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﺣﻮﻝ ﺗﻜﻠﻔﺔ ﺍﻟﺘﻌﻠﻴﻢ‪.‬‬
‫ﻭﰲ ﺩﺭﺍﺳﺔ ﺣﻮﻝ ﺗﻜﻠﻔﺔ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﱵ ﺗﺘﺤﻤﻠﻬﺎ ﺍﻷﺳﺮ ﻣﻦ ﺍﻟﺪﺧﻞ ﺍﻟﺴﻨﻮﻱ ﻻ ﻳﺘﻌﺪﻯ ‪٣٦٠٠‬‬
‫ﺟﻨﻴﻪ‪ ،‬ﻗﺪﺭﺕ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ ﺗﻜﻠﻔﺔ ﺍﻟﺘﻌﻠﻴﻢ ﲢﻈﻰ ﺑـ ‪ %١٠‬ﻣﻦ ﺩﺧﻞ ﺍﻷﺳﺮﺓ ﰲ ﺍﳌﺮﺍﺣﻞ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ‬
‫ﻣﻦ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﻭ‪ %١٢,٥‬ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻹﻋﺪﺍﺩﻳﺔ ﻣﻦ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ‪estimated by ) .‬‬
‫‪ .(El Leithy H, quoted by Nassar H., 1995.‬ﻛﺬﻟﻚ ﺃﺷﺎﺭﺕ ﺩﺭﺍﺳﺔ ﺃﺧﺮﻯ ﺃﺟﺮ‪‬ﺎ ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺘﻌﻠﻴﻢ ﰲ ‪ ١٩٩٣‬ﺇﱃ ﺃﻥ ﺍﻷﺳﺮ ﺍﻟﱵ ﻻ ﻳﺰﻳﺪ ﺩﺧﻠﻬﺎ ﺍﻟﺸﻬﺮﻱ ﻋﻦ ‪ ٥٠٠‬ﺟﻨﻴﻪ‪ ،‬ﺗﻨﻔﻖ ﰲ ﺍﳌﺘﻮﺳﻂ‬
‫‪ ٢٦٠‬ﺟﻨﻴﻬﺎﹰ ﺳﻨﻮﻳﺎﹰ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻻﺑﺘﺪﺍﺋﻲ ﻭ‪ ٣٥٦‬ﺟﻨﻴﻬﺎﹰ ﺳﻨﻮﻳﺎﹰ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻹﻋﺪﺍﺩﻱ )ﻭﺯﺍﺭﺓ‬
‫ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﺍﻟﺘﻌﻠﻴﻢ ﻟﻠﺠﻤﻴﻊ‪ .(١٩٩٣ ،‬ﻭﻗﺪ ﺍﺣﺘﻮﺕ ﻧﺘﺎﺋﺞ ﺍﻟﺒﺤﺚ ﺩﻻﺋﻞ ﻋﻠﻰ ﻋﺪﻡ ﻗﺪﺭﺓ ﺍﻷﺳﺮ‬
‫ﺍﻟﻔﻘﲑﺓ ﻟﺘﺤﻤﻞ ﺗﻜﻠﻔﺔ ﺍﻟﺘﻌﻠﻴﻢ‪ .‬ﺇﺫ ﺃﺷﺎﺭﺕ ﺩﺭﺍﺳﺔ ﺣﻮﻝ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ ﻋﺎﻡ ‪ ١٩٩١‬ﺇﱄ‬
‫ﺃﻥ ‪ %٤٢‬ﻣﻦ ﺃﺳﺮ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻳﺆﻣﻨﻮﻥ ﺑﺄﻥ ﺗﻜﻠﻔﺔ ﺍﳌﺪﺭﺳﺔ ﺗﻌﺘﱪ ﻋﺒﺌﺎﹰ ﺛﻘﻴﻼﹰ‪ .‬ﻛﻤﺎ ﺃﻇﻬﺮﺕ‬
‫ﺩﺭﺍﺳﺔ ﺃﺧﺮﻯ ﺃﻥ ‪ %٥٦,٢‬ﻣﻦ ﺃﺳﺮ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻻ ﻳﺴﺘﻄﻴﻌﻮﻥ ﲢﻤﻞ ﺩﻓﻊ ﻣﺼﺎﺭﻳﻒ ﺍ‪‬ﻤﻮﻋﺎﺕ‬
‫ﺍﳋﺎﺻﺔ‪.‬‬
‫ﺟﻮﺩﺓ ﺍﻟﺘﻌﻠﻴﻢ‬
‫ﺗﻌﺪ ﺟﻮﺩﺓ ﺍﻟﺘﻌﻠﻴﻢ ﻗﻀﻴﺔ ﺃﻛﺜﺮ ﺗﻌﻘﻴﺪﺍ‪ . ،‬ﻓﻬﻲ ﺗﺮﺗﺒﻂ ﺑﺒﻴﺌﺔ ﺍﳌﺪﺭﺳﺔ‪ ،‬ﻭﺍﻟﺘﺴﻬﻴﻼﺕ ﺍﻟﺘﺮﺑﻮﻳﺔ‪،‬‬
‫ﻭﺍﳌﻨﺎﻫﺞ ﻭﺍﻷﺳﺎﻟﻴﺐ‪ ،‬ﻭﺍﳌﻬﺎﺭﺍﺕ ﺍﳌﹸﻘﺪﻣﺔ‪ .‬ﻭﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ‪ ،‬ﻳﺘﻄﻠﺐ ﺍﻟﻌﺠﺰ ﰲ ﺍﻟﺘﺴﻬﻴﻼﺕ ﺇﱃ‬
‫ﺍﺳﺘﺨﺪﺍﻡ ﻧﻔﺲ ﺍﳌﺒﲎ ﻟﻔﺘﺮﺗﲔ ﺃﻭ ﺃﻛﺜﺮ‪(Nagi, 1995) .‬‬
‫ﻭﻗﺪ ﺃﺷﺎﺭ ﺗﻘﻴﻴﻢ ﺍﳌﻬﺎﺭﺍﺕ ﺍﻷﺳﺎﺳﻴﺔ ﺑﺪﺍﺧﻞ ﺃﻋﻀﺎﺀ ﺍﻷﺳﺮﺓ ﻟﻔﺌﺔ ﺳﻦ ﻣﺎ ﺑﲔ ‪ ١٧ –١٠‬ﻋﺎﻣﺎﹰ‪ ،‬ﺇﱃ‬
‫ﻣﺴﺘﻮﻳﺎﺕ ﻣﻨﺨﻔﻀﺔ‪ ،‬ﺧﺎﺻﺔﹰ ﰲ ﺍﻟﺮﻳﺎﺿﻴﺎﺕ‪ ،‬ﺇﺫ ﱂ ﻳﺘﻌﺪ ﻣﺘﻮﺳﻂ ﺍﻟﻌﻼﻣﺎﺕ ﺛﻠﺚ ﺍﻟﻜﻔﺎﺀﺓ‬
‫ﺍﳌﺘﻮﻗﻌﺔ‪ ،‬ﺃﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻘﺮﺍﺀﺓ ﻭﺍﻟﻜﺘﺎﺑﺔ‪ ،‬ﻓﻘﺪ ﻫﺒﻂ ﻣﺘﻮﺳﻂ ﺍﻟﻌﻼﻣﺎﺕ ﺇﱃ ﺃﻗﻞ ﻣﻦ ‪ ،%٥٠‬ﻭﻛﺎﻧﺖ‬
‫ﺃﺳﻮﺃ ﺍﻟﻨﺘﺎﺋﺞ ﻟﻸﺳﺮ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﻔﻘﲑﺓ )‪ .(Fergani, 1995‬ﻭﻗﺪ ﺃﺛﺎﺭﺕ ﻫﺬﻩ ﺍﻟﻨﺘﺎﺋﺞ ﻣﺆﺧﺮﺍﹰ‬
‫ﻗﻀﺎﻳﺎ ﻋﺪﻳﺪﺓ ﻷﺧﺬ ﺳﻴﺎﺳﺔ ﺍﻟﺘﻌﻠﻴﻢ ﺑﻌﲔ ﺍﻻﻋﺘﺒﺎﺭ‪ ،‬ﻣﺜﻞ ﻣﺴﺘﻮﻯ ﺍﻟﺘﺪﺭﻳﺲ‪ ،‬ﺃﺳﺎﻟﻴﺐ ﺍﳌﺪﺭﺳﲔ‪،‬‬
‫ﺗﺮﺍﺑﻂ ﺍﳌﻨﺎﻫﺞ‪ ..‬ﺍﱁ‪ ،‬ﻛﻞ ﻫﺬﺍ ﻷﻗﻞ ﻗﻄﺎﻋﺎﺕ ﺍ‪‬ﺘﻤﻊ ﺍﺳﺘﻔﺎﺩﺓ‪ .‬ﻭﺃﺷﺎﺭ ﺗﻘﺮﻳﺮ ﺍﻟﻴﻮﻧﺴﻜﻮ ﺇﱃ ﺃﻧﻪ‬
‫ﻏﺎﻟﺒﺎﹰ ﻣﺎ ﻳﻜﻮﻥ ﺍﳌﻨﺎﻫﺞ ﺑﻌﻴﺪﺓ ﺍﻟﺼﻠﺔ ﺑﺎﻷﺳﺮ ﺫﺍﺕ ﺍﻟﺪﺧﻮﻝ ﺍﳌﻨﺨﻔﻀﺔ ﻭﳋﱪﺓ ﺍﻷﻃﻔﺎﻝ ﺍﳊﻴﺎﺗﻴﺔ‪.‬‬
‫ﻭﰲ ﺩﺭﺍﺳﺔ ﻣﺒﺪﺋﻴﺔ ﻟﺘﻘﻴﻴﻢ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﰲ ﻣﺼﺮ‪ ،‬ﺃﻗﺮ ﺣﻮﺍﱄ ﻧﺼﻒ ﺍﻵﺑﺎﺀ ﺇﱃ ﺃﻥ ﺍﻟﺘﻌﻠﻴﻢ‬
‫ﻻ ﻳﻀﻤﻦ ﻭﺟﻮﺩ ﺍﻟﻮﻇﻴﻔﺔ‪ ،‬ﻛﻤﺎ ﻳﺆﻣﻨﻮﺍ ﺑﺄﻥ ﺍﻟﺘﻌﻠﻴﻢ ﻻ ﻳﻮﻓﺮ ﺍﳌﻜﺴﺐ ﺍﻟﻜﺎﰲ )‪.(Fergani, 1995‬‬
‫ﺗﻮﺍﻓﺮ ﺍﳌﺼﺎﺩﺭ‬
‫ﻗﺴ‪‬ﻢ ﺍﻟﻴﻮﻧﺴﻴﻒ ﺍﳌﺼﺎﺩﺭ ﺍﻟﻼﺯﻣﺔ ﻟﺘﻄﺒﻴﻖ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﺇﱃ ﺛﻼﺙ ﻓﺌﺎﺕ ﺃﺳﺎﺳﻴﺔ‪:‬‬
‫ﻣﺼﺎﺩﺭ ﺇﻧﺴﺎﻧﻴﺔ‪ ،‬ﻭﺍﻗﺘﺼﺎﺩﻳﺔ‪ ،‬ﻭﺗﻨﻈﻴﻤﻴﺔ‪.‬‬

‫‪٢٢٨‬‬
‫ﰲ ﺍﳌﺎﺿﻲ‪ ،‬ﻛﺎﻧﺖ ﻣﻴﺰﺍﻧﻴﺔ ﺍﳊﻜﻮﻣﺔ ﺍﳌﺼﺮﻳﺔ ﺍﳌﺨﺼﺼﺔ ﻟﻠﺘﻌﻠﻴﻢ ﳏﺪﻭﺩﺓ‪ ،‬ﻭﻛﺎﻥ ﻟﺬﻟﻚ ﺗﺄﺛﲑ‬
‫ﺩﺍﺋﻢ ﻋﻠﻰ ﺟﻮﺩﺓ ﺍﻟﺘﻌﻠﻴﻢ‪ .‬ﻭﻣﺆﺧﺮﺍ‪ ،‬ﺑﺪﺃﺕ ﺣﺼﺺ ﺍﳌﻴﺰﺍﻧﻴﺔ ﺍﳌﺨﺼﺼﺔ ﻟﻠﺘﻌﻠﻴﻢ ﰲ ﺍﺯﺩﻳﺎﺩ‪ .‬ﺇﺫ ﰎ‬
‫ﲣﺼﻴﺺ ﻣﺎ ﻳﺘﻌﺪﻯ ﺍﻟـ ‪ ١٤‬ﺑﻠﻴﻮﻥ ﺟﻨﻴﻪ ﳍﺬﺍ ﺍﻟﻌﺎﻡ‪ ,‬ﺗﻠﻚ ﺍﻟﺰﻳﺎﺩﺓ ﺍﻟﱵ ﻻ ﺷﻚ ﺳﻮﻑ ﺗﻘﻮﺩ ﺇﱃ‬
‫ﲢﺴﻴﻨﺎﺕ ﰲ ﺍﻟﺒﻨﻴﺔ ﺍﻟﺘﺤﺘﻴﺔ ﺍﳌﻨﻬﻜﺔ ﻭﺍﳋﺪﻣﺎﺕ ﰲ ﺍﻟﻮﻗﺖ ﺍﳊﺎﱄ‪.‬‬
‫ﻭﺍﻟﺘﺤﺴﲔ ﻣﻄﻠﻮﺏ ﰲ ﺟﻬﺎﺕ ﻋﺪﺓ‪:‬‬
‫ﺇﻣﻜﺎﻧﻴﺎﺕ ﺍﳌﺪﺭﺳﲔ‪ :‬ﻃﺒﻘﺎﹰ ﻹﺣﺼﺎﺋﻴﺎﺕ ﻋﺎﻡ ‪ ،١٩٩٧‬ﺗﻌﺪ ﻧﺴﺒﺔ ﺍﳌﻌﻠﻤﲔ ﰲ ﺍﳌﺪﺍﺭﺱ‬ ‫
‬
‫ﺍﳊﺎﺻﻠﲔ ﻋﻠﻰ ﺷﻬﺎﺩﺓ ﺟﺎﻣﻌﻴﺔ ﻭﻣﺆﻫﻼﺕ ﺗﺮﺑﻮﻳﺔ ‪ %١١‬ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ ﻭ‪ %٦,٣‬ﰲ‬
‫ﺍﳌﺮﺣﻠﺔ ﺍﻹﻋﺪﺍﺩﻳﺔ‪ .‬ﻛﻤﺎ ﺗﺼﻞ ﻧﺴﺒﺔ ﺍﳊﺎﺻﻠﲔ ﻋﻠﻰ ﺷﻬﺎﺩﺓ ﺟﺎﻣﻌﻴﺔ ﻭﻟﻜﻦ ﺑﺪﻭﻥ ﺗﺄﻫﻴﻞ‬
‫ﻋﻠﻰ ﺍﻟﺘﺪﺭﻳﺲ ﺇﱃ ‪ %٦,٢‬ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ ﻭ‪ %٢٤,٤‬ﰲ ﺍﻹﻋﺪﺍﺩﻳﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﺗﺼﻞ ﻧﺴﺒﺔ‬
‫ﺍﳌﺪﺭﺳﲔ ﻏﲑ ﺍﳊﺎﺻﻠﲔ ﻋﻠﻰ ﺷﻬﺎﺩﺍﺕ ﺟﺎﻣﻌﻴﺔ ﺇﱃ ‪ %٨٥,٧‬ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ ﻭ‪ %٦٩,٣‬ﰲ‬
‫ﺍﻟﺘﻌﻠﻴﻢ ﺍﻹﻋﺪﺍﺩﻱ )ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ‪.(١٩٩٧ ،‬‬
‫ﻛﺜﺎﻓﺔ ﺍﻟﻔﺼﻞ‪ :‬ﺇﻥ ﻣﺘﻮﺳﻂ ﻋﺪﺩ ﺍﻟﻄﻼﺏ ﰲ ﺍﻟﻔﺼﻞ ﻳﺼﻞ ﺇﱃ ‪ ٤٤‬ﻃﺎﻟﺒﺎﹰ‪ ،‬ﻭﻣﻊ ﺫﻟﻚ‬ ‫
‬
‫ﻓﺎﻷﻋﺪﺍﺩ ﻣﺘﺰﺍﻳﺪﺓ ﰲ ﺑﻌﺾ ﺍﶈﺎﻓﻈﺎﺕ ﻟﺘﺼﻞ ﺇﱃ ‪ ٦٠‬ﻃﺎﻟﺒﺎﹰ ﰲ ﺑﻌﺾ ﺍﳊﺎﻻﺕ )ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ‪،‬‬
‫‪.(١٩٩٧‬‬
‫ﻳﺘﻢ ﺗﻮﻓﲑ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻼﺯﻣﺔ )ﺧﺎﺻﺔ ﺍﻟﺒﺴﻜﻮﻳﺖ ﺍﳉﺎﻫﺰ( ﺇﱃ ﺃﻛﺜﺮ ﻣﻦ ‪ ٥‬ﻣﻼﻳﲔ ﻣﻦ ﺃﻃﻔﺎﻝ‬ ‫
‬
‫ﺍﳌﺪﺍﺭﺱ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺍﳊﻀﺮﻳﺔ ﺍﻟﻔﻘﲑﺓ ﻭﻳﻜﻮﻥ ﻫﺬﺍ ﻛﺎﻓﻴﺎﹸ )ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ‪(١٩٩٩ ،‬‬
‫ﺍﳉﻤﻊ ﺑﲔ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺘﻌﻠﻴﻢ‬
‫ﺗﻌﺪ ﻗﻀﻴﺔ ﺇﻣﻜﺎﻧﻴﺔ ﺍﳉﻤﻊ ﺑﲔ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺘﻌﻠﻴﻢ ﻟﻸﻃﻔﺎﻝ ﺍﻟﺼﻐﺎﺭ ﻗﻀﻴﺔ ﻣﺜﲑﺓ ﻟﻠﺠﺪﻝ‪ ،‬ﺇﻻ ﺃﻥ‬
‫ﺑﻌﺾ ﺍﳌﺴﻮﺡ ﻗﺪ ﺃﻣﺪﺗﻨﺎ ﺑﻨﻈﺮﻳﺎ‪‬ﺎ ﺍﳌﺘﻌﻤﻘﺔ ﰲ ﻫﺬﻩ ﺍﻟﻘﻀﻴﺔ‪:‬‬
‫ﺃﺷﺎﺭﺕ ﺩﺭﺍﺳﺔ ﺣﺪﻳﺜﺔ )‪ (Zibani, 1999‬ﺇﱃ ﺃﻥ ﺍﻷﻏﻠﺒﻴﺔ ﺍﻟﻌﻈﻤﻰ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻻ ﳚﻤﻌﻮﻥ ﺑﲔ‬
‫ﺍﻟﻌﻤﻞ ﻭﺍﻟﺪﺭﺍﺳﺔ‪ ،‬ﺧﺎﺻﺔﹰ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﺑﲔ ﺍﻟﺬﻛﻮﺭ‪ .‬ﻭﺃﻥ ﺍﻟﻨﺴﺒﺔ ﺍﻷﻋﻠﻰ ﻣﻦ ﺃﻭﻟﺌﻚ ﺍﻟﺬﻳﻦ‬
‫ﳚﻤﻌﻮﻥ ﺑﲔ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺘﻌﻠﻴﻢ ﻓﺘﻜﻮﻥ ﻣﻦ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﺍﳌﺘﺮﺍﻭﺡ ﺃﻋﻤﺎﺭﻫﻢ ﺑﲔ )‪ ١٤ – ١٢‬ﻋﺎﻣﺎﹰ( ﰲ‬
‫ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭﻫﺬﺍ ﻳﻌﺪ ﻣﻨﻄﻘﻴﺎﹰ‪ ،‬ﺇﺫ ﺇﻥ ﺍﻟﻌﻤﻞ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﻋﻤﻞ ﻣﺮﻥ ﻭﻣﻮﲰﻲ‪،‬‬
‫ﺧﺎﺻﺔﹰ ﰲ ﻧﻄﺎﻕ ﺍﻟﻌﻤﻞ ﺍﳋﺎﺹ ﺑﺎﻷﺳﺮﺓ‪.‬‬

‫‪٢٢٩‬‬
 ‫ﺟﺪﻭﻝ )‪ :(٨-٩‬ﻧﺸﺎﻃﺎﺕ ﺍﻷﻃﻔﺎﻝ ﲝﺴﺐ ﺍﻟﻨﻮﻉ ﻭﺍﻟﻌﻤﺮ ﻭﺍﳌﻮﻗﻊ )ﺍﻟﺮﻳﻒ ‪ /‬ﺍﳌﺪﻳﻨﺔ( ﻟﻌﺎﻡ ‪١٩٩٨‬‬
‫‪١٤-٦‬‬ ‫‪١٤-١٢‬‬ ‫‪١١-٦‬‬
‫ﰲ‬ ‫ﰲ‬ ‫ﰲ‬ ‫ﰲ‬ ‫ﰲ‬ ‫ﰲ‬
‫ﺍ‪‬ﻤﻮﻉ‬ ‫ﺍ‪‬ﻤﻮﻉ‬ ‫ﺍ‪‬ﻤﻮﻉ‬
‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﳌﺪﻳﻨﺔ‬ ‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﳌﺪﻳﻨﺔ‬ ‫ﺍﻟﺮﻳﻒ‬ ‫ﺍﳌﺪﻳﻨﺔ‬
‫ﺍﻟﺬﻛﻮﺭ‬
‫‪٩١,٤‬‬ ‫‪٨٩,٥‬‬ ‫‪٩٤,٦‬‬ ‫‪٨٥,٨‬‬ ‫‪٨٢,٢‬‬ ‫‪٩٢,١‬‬ ‫‪٩٤,٥‬‬ ‫‪٩٣,٦‬‬ ‫‪٩٦,١‬‬ ‫ﰲ ﺍﳌﺪﺭﺳﺔ‬
‫‪٢,٩‬‬ ‫‪٣,٥‬‬ ‫‪١,٨‬‬ ‫‪٦,٦‬‬ ‫‪٨,٠‬‬ ‫‪٤,٢‬‬ ‫‪٠,٨‬‬ ‫‪١,٠‬‬ ‫‪٠,٤‬‬ ‫ﰲ ﺍﻟﻌﻤﻞ‬
‫‪٠,٨‬‬ ‫‪١,٠‬‬ ‫‪٠,٥‬‬ ‫‪١,٩‬‬ ‫‪٢,٧‬‬ ‫‪٠,٥‬‬ ‫‪٠,٢‬‬ ‫‪٠,١‬‬ ‫‪٠,٤‬‬ ‫ﻛﻼﳘﺎ ﻣﻌﺎﹰ‬
‫‪٤,٩‬‬ ‫‪٦,٠‬‬ ‫‪٣,٢‬‬ ‫‪٥,٧‬‬ ‫‪٧,١‬‬ ‫‪٣,٢‬‬ ‫‪٤,٥‬‬ ‫‪٥,٣‬‬ ‫‪٣,١‬‬ ‫ﻻﻫﺬﺍ ﻭﻻ ﺫﺍﻙ‬
‫ﺍﻹﻧﺎﺙ‬
‫‪٨٢,٠‬‬ ‫‪٧٥,٤‬‬ ‫‪٩١,٨‬‬ ‫‪٧٥,٢‬‬ ‫‪٦٦,٢‬‬ ‫‪٨٧,١‬‬ ‫‪٨٦,٢‬‬ ‫‪٨٠,٦‬‬ ‫‪٩٥,٠‬‬ ‫ﰲ ﺍﳌﺪﺭﺳﺔ‬
‫‪٤,٣‬‬ ‫‪٦,٥‬‬ ‫‪١,٠‬‬ ‫‪٧,٠‬‬ ‫‪١١,٣‬‬ ‫‪١,٥‬‬ ‫‪٢,٦‬‬ ‫‪٣,٨‬‬ ‫‪٠,٧‬‬ ‫ﻑ ﺍﻟﻌﻤﻞ‬
‫‪٣,٩‬‬ ‫‪٥,٧‬‬ ‫‪١,٢‬‬ ‫‪٥,٦‬‬ ‫‪٨,٣‬‬ ‫‪٢,٠‬‬ ‫‪٢,٨‬‬ ‫‪٤,٢‬‬ ‫‪٠,٧‬‬ ‫ﻛﻼﳘﺎ ﻣﻌﺎﹰ‬
‫‪٩,٨‬‬ ‫‪١٢,٥‬‬ ‫‪٥,٩‬‬ ‫‪١٢,٢‬‬ ‫‪١٤,٢‬‬ ‫‪٩,٤‬‬ ‫‪٨,٤‬‬ ‫‪١١,٥‬‬ ‫‪٣,٦‬‬ ‫ﻻﻫﺬﺍ ﻭﻻ ﺫﺍﻙ‬
‫)‪*Zibani (1999‬‬

‫ﻛﺬﻟﻚ ﻓﻘﺪ ﺣﺪﺩﺕ ﺩﺭﺍﺳﺔ ﺃﺧﺮﻯ )‪ (SRC, 1996‬ﺍﳊﺎﻟﺔ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻭﺍﳌﻬﻨﻴﺔ ﻟﺪﻯ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﻟﻌﺎﻣﻠﲔ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(٩-٩‬ﺗﻮﺯﻳﻊ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ ﻓﺌﺔ ﺳﻦ ‪ ١٤ – ٦‬ﲝﺴﺐ ﺍﳊﺎﻟﺔ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻭﺍﳌﻬﻨﻴﺔ ﻭﲝﺴﺐ‬
‫ﺍﻟﻌﻤﺮ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﺍﻟﺮﻳﻔﻴﺔ – ‪١٩٩٦‬‬
‫‪١٤ - ٦‬‬ ‫‪١٤ - ١٢‬‬ ‫‪١١-٦‬‬
‫ﺍ‪‬ﻤﻮﻉ‬ ‫ﺑﻼ‬ ‫ﺑﺄﺟﺮ‬ ‫ﺍ‪‬ﻤﻮﻉ‬ ‫ﺑﻼ‬ ‫ﺑﺄﺟﺮ‬ ‫ﺍ‪‬ﻤﻮﻉ‬ ‫ﺑﻼ‬ ‫ﺑﺄﺟﺮ‬
‫ﺃﺟﺮ‬ ‫ﻣﺪﻓﻮﻉ‬ ‫ﺃﺟﺮ‬ ‫ﻣﺪﻓﻮﻉ‬ ‫ﺃﺟﺮ‬ ‫ﻣﺪﻓﻮﻉ‬
‫‪١٠٠,٠‬‬ ‫‪٨٩,٧‬‬ ‫‪١٠,٣‬‬ ‫‪١٠٠,٠‬‬ ‫‪٨٤,١‬‬ ‫‪١٥,٩‬‬ ‫‪١٠٠,٠‬‬ ‫‪٩٤,٦‬‬ ‫‪٥,٤‬‬ ‫ﺍﳌﹸﺴﺠﻠﲔ‬
‫‪١٠٠,٠‬‬ ‫‪٤٢,٩‬‬ ‫‪٥٧,١‬‬ ‫‪١٠٠,٠‬‬ ‫‪٤٢,٣‬‬ ‫‪٥٧,٧‬‬ ‫‪١٠٠,٠‬‬ ‫‪٤٤,٧‬‬ ‫‪٥٥,٣‬‬ ‫ﻏﲑ ﺍﳌﹸﺴﺠﻠﲔ‬
‫‪٧٣,٧‬‬ ‫‪٧٣,٧‬‬ ‫‪٢٦,٣‬‬ ‫‪١٠٠,٠‬‬ ‫‪٦٣,٩‬‬ ‫‪٣٦,١‬‬ ‫‪١٠٠,٠‬‬ ‫‪٨٧,٨‬‬ ‫‪١٢,٢‬‬ ‫ﺍ‪‬ﻤﻮﻉ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺸﺮﻭﻉ ﺍﻻﺭﺗﻘﺎﺀ ﺑﺎﻟﻄﻔﻞ ﰲ ﻣﺼﺮ ‪SRC‬‬

‫ﺃﺷﺎﺭ ﺍﳌﺴﺢ ﺇﱃ ﺍﻟﻨﺘﺎﺋﺞ ﺍﳍﺎﻣﺔ ﺍﻟﺘﺎﻟﻴﺔ‪ :‬ﺇﻥ ﺍﻟﻐﺎﻟﺒﻴﺔ ﺍﻟﻌﻈﻤﻰ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺍﻟﺬﻳﻦ ﳚﻤﻌﻮﻥ‬
‫ﺑﲔ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺪﺭﺍﺳﺔ‪ ،‬ﻳﻌﻤﻠﻮﻥ ﺑﻼ ﺃﺟﺮ )‪ %٩٤,٦‬ﻓﻴﻤﺎ ﺑﲔ ‪ ١١ – ٦‬ﻋﺎﻣﺎﹰ‪ %٨٤,١ ،‬ﻓﻴﻤﺎ ﺑﲔ ‪ ١٤ – ١٢‬ﻋﺎﻣﺎﹰ‪،‬‬
‫‪ %٨٩,٧‬ﺑﺎﻟﻨﺴﺒﺔ ﳉﻤﻴﻊ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺑﻼ ﺃﺟﺮ ﻓﻴﻤﺎ ﺑﲔ ‪ ١٤ - ٦‬ﻋﺎﻣﺎﹰ(‪ .‬ﻛﻤﺎ ﺃﻥ ﺃﻛﺜﺮ ﻣﻦ ﻧﺼﻒ‬
‫ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻏﲑ ﺍﳌﺴﺠﻠﲔ ﺑﺎﻟﺘﻌﻠﻴﻢ‪ ،‬ﳛﺼﻠﻮﻥ ﻋﻠﻰ ﺃﺟﻮﺭ‪ ،‬ﲟﻌﲎ ﺃﻥ ﻧﺴﺒﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‬
‫ﺑﺄﺟﻮﺭ ﺗﺼﻞ ﺇﱃ )‪ %٥٣‬ﻓﻴﻤﺎ ﺑﲔ ‪ ١١ – ٦‬ﻋﺎﻣﺎﹰ‪ %٥٧,٧ ،‬ﻓﻴﻤﺎ ﺑﲔ ‪ ١٤ – ١٢‬ﻋﺎﻣﺎﹰ‪ %٥٧,١ ،‬ﺑﺎﻟﻨﺴﺒﺔ ﳉﻤﻴﻊ‬
‫ﺍﻷﻃﻔﺎﻝ ﻓﻴﻤﺎ ﺑﲔ ‪ ١٤ – ٦‬ﻋﺎﻣﺎﹰ(‬
‫ﻭﻗﺪ ﻭﻓﺮﺕ ﺗﻠﻚ ﺍﻟﻨﺘﺎﺋﺞ ﻧﻈﺮﺓ ﺩﻗﻴﻘﺔ ﻫﺎﻣﺔ‪ .‬ﻭﻳ‪‬ﻨﺼﺢ ﺃﻥ ﺗﺄﺧﺬ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﳌﺴﺘﻘﺒﻠﻴﺔ ﺍﳋﺎﺻﺔ ﺑﻌﻤﺎﻟﺔ‬
‫ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺍﻟﺘﺮﺩﺩﺍﺕ ﺍﳌﻮﲰﻴﺔ ﺍﻟﱵ ﺗﺮﺗﺒﻂ ﺍﺭﺗﺒﺎﻃﺎﹰ ﻭﺛﻴﻘﺎﹰ ﺟﺪﺍﹰ ‪‬ﺬﻩ ﺍﻟﻈﺎﻫﺮﺓ‪ .‬ﰲ ﺍﻟﻮﻗﺖ‬
‫ﻧﻔﺴﻪ‪ ،‬ﺍﲣﺬﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺘﻌﻠﻴﻢ ﺃﻭﻟﻮﻳﺎﺕ ﻟﺘﻄﻮﻳﺮ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﻭﲢﺪﻳﺚ ﺍﳌﻨﺎﻫﺞ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ‬
‫ﲢﺴﲔ ﺃﺳﺎﻟﻴﺐ ﺍﻟﺘﺪﺭﻳﺲ‪ ،‬ﻭﻣﻊ ﺫﻟﻚ ﻳﻌﺪ ﺗﺰﺍﻳﺪ ﻏﲑ ﺍﳌﹸﺴﺠﻠﲔ ﺑﺎﳌﺪﺍﺭﺱ ﻭﺍﳌﺘﺴﺮﺑﲔ ﻣﻨﻬﺎ ﲢﺪﻳﺎﹰ ﺧﻄﲑﺍﹰ‪.‬‬
‫ﻟﺬﻟﻚ ﳚﺐ ﺃﻥ ﻳﻮﺍﺯﻱ ﺗﻠﻚ ﺍﳉﻬﻮﺩ ﺍﳌﺒﺬﻭﻟﺔ ﻟﺘﻄﻮﻳﺮ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺮﲰﻲ ﻟﻠﻤﺪﺍﺭﺱ ﺃﻥ ﺗﻮﻓﺮ ﺍﻟﱪﺍﻣﺞ‬
‫ﺍﳊﻜﻮﻣﻴﺔ ﺍﻷﺧﺮﻯ ﻓﺮﺻﺎﹰ ﺑﺪﻳﻠﺔ ﳍﺆﻻﺀ ﺍﻟﺬﻳﻦ ﱂ ﻳﺘﻢ ﺗﺴﺠﻴﻠﻬﻢ ﰲ ﺍﳌﺪﺍﺭﺱ ﺃﻭ ﺍﳌﺘﺴﺮﺑﲔ ﻣﻨﻬﺎ ﻗﺒﻞ‬
‫ﺇﲤﺎﻡ ﺩﺭﺍﺳﺘﻬﻢ‪.‬‬

‫‪٢٣٠‬‬
‫ﺗﺴﻌﻲ ﺍﻟﺪﻭﻟﺔ ﺇﱄ ﻣﻌﺎﳉﺔ ﻗﻀﻴﺔ ﺍﻟﺘﺴﺮﺏ ﺍﳌﺪﺭﺳﻲ ﻋﻦ ﻃﺮﻳﻖ ﺑﺮﺍﻣﺞ ﻏﲑ ﺗﻘﻠﻴﺪﻳﺔ‪ ،‬ﻭﺗﺸﻤﻞ ﺑﺮﻧﺎﻣﺞ‬
‫ﺍﳌﺪﺍﺭﺱ ﺍﳌﺸﺘﺮﻛﺔ ﺫﺍﺕ ﺍﻟﻔﺼﻞ ﺍﻟﻮﺍﺣﺪ‪ ،‬ﻭﺍﻟﺘﻌﻠﻴﻢ ﻏﲑ ﺍﻟﺮﲰﻲ‪ ،‬ﻭﻣﺪﺍﺭﺱ ﺍﻟﺘﻜﻮﻳﻦ ﺍﳌﻬﲏ‪ .‬ﻳﻬﺪﻑ‬
‫ﺑﺮﻧﺎﻣﺞ ﺍﳌﺪﺍﺭﺱ ﺍﳌﺸﺘﺮﻛﺔ ﺫﺍﺕ ﺍﻟﻔﺼﻞ ﺍﻟﻮﺍﺣﺪ ﺇﱃ ﺇﻧﺸﺎﺀ ‪ ٣٠٠‬ﻣﺪﺭﺳﺔ ﺫﺍﺕ ﻓﺼﻞ ﻭﺍﺣﺪ‪ ،‬ﻛﻤﺎ ﻳﺴﻌﻰ‬
‫ﺇﱃ ﺧﻔﺾ ﺍﻟﺘﺒﺎﻳﻨﺎﺕ ﺑﲔ ﺍﳌﺪﺍﺭﺱ ﺍﻟﱵ ﺗﻀﻢ ﳎﻤﻮﻋﺎﺕ ﺫﺍﺕ ﺍﻟﺴﻦ ﺍﻟﻮﺍﺣﺪ‪ ،‬ﻫﺬﺍ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻣﻌﺎﳉﺔ‬
‫ﻗﻀﻴﺔ ﺍﻟﺘﺴﺮﺏ ﺍﳌﺪﺭﺳﻲ‪ .‬ﺃﻣﺎ ﺍﻟﺘﻌﻠﻴﻢ ﻏﲑ ﺍﻟﺮﲰﻲ ﰲ ﻣﺮﻛﺰ ﺗﻌﻠﻴﻢ ﺍﻟﻜﺒﺎﺭ ﰲ ﺣﻠﻮﺍﻥ ﻓﻴﻮﻓﺮ ﺩﻭﺭﺍﺕ‬
‫ﺗﻌﻠﻴﻤﻴﺔ ﻟﻠﻤﺘﺴﺮﺑﲔ ﻣﻦ ﺍﳌﺪﺍﺭﺱ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺗﺪﺭﻳﺐ ﻣﻬﲏ‪ ،‬ﻛﻤﺎ ﺃﻥ ﺑﻌﺾ ‪ NGO‬ﺗﻮﻓﺮ ﺗﻌﻠﻴﻤﺎﹰ ﻏﲑ‬
‫ﺭﲰﻲ ﰲ ﺃﺟﺰﺍﺀ ﻣﺘﻔﺮﻗﺔ ﻣﻦ ﺍﻟﺪﻭﻟﺔ‪ .‬ﻭﺃﺧﲑﺍ‪ ،‬ﺳﺎﳘﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﰲ ﻣﻌﺎﳉﺔ ﻣﺸﻜﻠﺔ‬
‫ﺍﻟﺘﺴﺮﺏ ﺍﳌﺪﺭﺳﻲ ﻣﻦ ﺧﻼﻝ ﻣﺪﺍﺭﺱ ﺍﻟﺘﻜﻮﻳﻦ ﺍﳌﻬﲏ‪ ،‬ﻓﻘﺪ ﺃﻧﺸﺊ ‪ ٥٦‬ﻣﺮﻛﺰﺍﹰ ﻟﻠﺘﺪﺭﻳﺐ ﺍﳌﻬﲏ‪ ،‬ﻭﺻﻞ‬
‫ﻋﺪﺩ ﺍﳌﻨﺘﻔﻌﲔ ‪‬ﺎ ﰲ ﻋﺎﻡ ‪ ١٩٩٦‬ﺇﱃ ‪ ٤٤٢٧‬ﻣﺮﺍﻫﻘﺎﹰ‪.‬‬

‫ﺗﺄﺛﲑ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‬

‫ﺷﺮﻭﻁ ﺍﻟﻌﻤﻞ‬
‫ﻳﻨﻈﻢ ﺍﻟﻘﺎﻧﻮﻥ ﺍﳌﺼﺮﻱ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻭﺫﻟﻚ ﺑﺎﻟﺴﻤﺎﺡ ﻟﻸﻃﻔﺎﻝ ﺑﺎﻟﻌﻤﻞ ﺳﺖ ﺳﺎﻋﺎﺕ ﻓﻘﻂ ﰲ ﺍﻟﻴﻮﻡ‬
‫ﻋﻠﻰ ﺃﻥ ﻳﻜﻮﻥ ﳍﻢ ﻋﻠﻰ ﺍﻷﻗﹲﻞ ﺳﺎﻋﺔ ﺭﺍﺣﺔ‪ ،‬ﻭﻏﲑ ﻣﺴﻤﻮﺡ ﳍﻢ ﺃﻥ ﻳﻌﻤﻠﻮﺍ ﺃﻛﺜﺮ ﻣﻦ ﺃﺭﺑﻊ ﺳﺎﻋﺎﺕ‬
‫ﻣﺘﻮﺍﺻﻠﺔ‪.‬‬
‫ﺇﻻ ﺃﻥ ﻣﻌﻈﻢ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺃﻭﺿﺤﺖ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﻳﻌﻤﻠﻮﻥ ﻟﻌﺪﺩ ﺳﺎﻋﺎﺕ ﺃﻃﻮﻝ ﻣﻦ ﺍﶈﺪﺩﺓ‪ .‬ﻓﻔﻲ ﺩﺭﺍﺳﺔ‬
‫ﺃﺟﺮ‪‬ﺎ ‪ NCSCR‬ﰲ ﻋﺎﻡ ‪ ،١٩٩١‬ﺃﺷﺎﺭﺕ ﺇﱃ ﺃﻥ ﻣﺘﻮﺳﻂ ﺳﺎﻋﺎﺕ ﺍﻟﻌﻤﻞ ﻟﺪﻯ ﺍﻷﻃﻔﺎﻝ ﻛﺎﻥ ﺣﻮﺍﱄ ‪١١‬‬
‫ﺳﺎﻋﺔ ﰲ ﺍﻟﻴﻮﻡ‪ .‬ﻳﻌﻤﻞ ﻧﺴﺒﺔ ‪ %١٣,٦‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺑﺸﻜﻞ ﻣﺘﻮﺍﺻﻞ ﺑﺪﻭﻥ ﻓﺘﺮﺓ ﺭﺍﺣﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﳛﺼﻞ‬
‫‪ %٣٤,٦‬ﻣﻨﻬﻢ ﻋﻠﻰ ﻧﺼﻒ ﺳﺎﻋﺔ ﺭﺍﺣﺔ ﻓﻘﻂ‪ ،‬ﻭﺑﻌﺾ ﺍﻷﻃﻔﺎﻝ ﻋﻠﻴﻬﻢ ﺍﻟﻌﻤﻞ ﻟﻮﻗﺖ ﻣﺘﺄﺧﺮ ﰲ ﺍﻟﻠﻴﻞ‪،‬‬
‫ﻭﺁﺧﺮﻭﻥ ﻋﻠﻴﻬﻢ ﺍﻟﻌﻤﻞ ﳌﺪﺓ ﻓﺘﺮﺗﲔ ﻣﺘﻮﺍﺻﻠﺘﲔ‪ .‬ﻛﻤﺎ ﺃﻛﺪﺕ ﺩﺭﺍﺳﺎﺕ ﺃﺧﺮﻯ ﺗﻠﻚ ﺍﻟﻨﺘﺎﺋﺞ ﺑﺎﺧﺘﻼﻓﺎﺕ‬
‫ﻃﻔﻴﻔﺔ‪ ،‬ﺇﺫ ﺃﻭﺿﺤﺖ ﺩﺭﺍﺳﺔ ﺃﺟﺮﺍﻫﺎ ‪ Rashad‬ﰲ ﻋﺎﻡ ‪ ١٩٩٣‬ﺃﻥ ﻣﺘﻮﺳﻂ ﺳﺎﻋﺎﺕ ﺍﻟﻌﻤﻞ ﻳﺼﻞ ﺇﱃ ‪٩,٤‬‬
‫ﺳﺎﻋﺔ ﰲ ﺍﻟﻴﻮﻡ‪ ،‬ﻭﺃﻥ ‪ %٧٣,٦‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻳﻌﻤﻠﻮﻥ ﳌﺪﺓ ﺃﻃﻮﻝ ﻣﻦ ‪ ٨‬ﺳﺎﻋﺎﺕ ﰲ ﺍﻟﻴﻮﻡ‪ .‬ﻛﺬﻟﻚ ﺃﻛﺪﺕ‬
‫ﺩﺭﺍﺳﺎﺕ ﺃﺧﺮﻯ ﺃﻛﺜﺮ ﺣﺪﺍﺛﺔ ﻋﻤﻞ ﺍﻷﻃﻔﺎﻝ ﻟﺴﺎﻋﺎﺕ ﺃﻃﻮﻝ ﳑﺎ ﺃﺛﺒﺘﺘﻪ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﺴﺎﺑﻘﺔ‪ .‬ﺃﺷﺎﺭﺕ ﺩﺭﺍﺳﺔ‬
‫ﺃﺟﺮﺍﻫﺎ ‪ Abdel Gawad‬ﰲ ﻋﺎﻡ ‪ ١٩٩٧‬ﻋﻠﻰ ‪ ١٠٠‬ﻃﻔﻞ ﻋﺎﻣﻞ ﰲ ﺷﺮﻕ ﺍﻟﻘﺎﻫﺮﺓ ﺇﱃ ﺃﻥ ﺍﻷﻃﻔﺎﻝ‬
‫ﻳﻌﻤﻠﻮﻥ ﰲ ﺍﳌﺘﻮﺳﻂ ﳌﺪﺓ ‪ ١٢‬ﺳﺎﻋﺔ ﰲ ﺍﻟﻴﻮﻡ‪ .‬ﻭﰲ ﺩﺭﺍﺳﺔ ﲢﺖ ﺇﺷﺮﺍﻑ ‪ NCSCR‬ﻋﻠﻰ ‪ ١٠٠‬ﻃﻔﻞ‬
‫ﻋﺎﻣﻞ ﺃﺷﺎﺭﺕ ﺍﻟﻨﺘﺎﺋﺞ ﺃﻥ ‪ %٤١‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻳﻌﻤﻠﻮﻥ ﳌﺪﺓ ‪ ١٢‬ﺳﺎﻋﺔ ﰲ ﺍﻟﻴﻮﻡ )‪.(NCSCR, 1999‬‬
‫ﻻ ﻳﻌﻤﻞ ﺍﻷﻃﻔﺎﻝ ﻋﺪﺩ ﺳﺎﻋﺎﺕ ﻃﻮﻳﻠﺔ ﻓﻘﻂ‪ ،‬ﻭﻟﻜﻨﻬﻢ ﻻ ﳛﺼﻠﻮﻥ ﺃﻳﻀﺎﹰ ﻋﻠﻲ ﻓﺘﺮﺍﺕ ﺭﺍﺣﺔ ﻛﺎﻓﻴﺔ‬
‫ﺧﻼﻝ ﻋﻤﻠﻬﻢ‪ .‬ﻭﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ ﻻ ﳛﺼﻠﻮﻥ ﻋﻠﻰ ﺃﻱ ﺭﺍﺣﺔ ﻣﻄﻠﻘﺎﹰ‪ .‬ﻓﻔﻲ ﺩﺭﺍﺳﺔ ﺃﺟﺮ‪‬ﺎ ‪NCSCR‬‬
‫)‪ ،(1991‬ﻛﺸﻔﺖ ﺍﻟﻨﺘﺎﺋﺞ ﺃﻥ ‪ %١٣,٦‬ﻻ ﳛﺼﻠﻮﻥ ﻋﻠﻰ ﺭﺍﺣﺔ ﻣﻄﻠﻘﺎﹰ‪ ،‬ﺑﻴﻨﻤﺎ ﳛﺼﻞ ‪ %٣٤,٦‬ﻋﻠﻰ ﻧﺼﻒ‬
‫ﺳﺎﻋﺔ‪ ،‬ﻭ‪ %٣٤,٤‬ﻋﻠﻰ ﺳﺎﻋﺔ ﺭﺍﺣﺔ ﻭﺍﺣﺪﺓ‪ .‬ﺑﻴﻨﻤﺎ ﺃﺷﺎﺭ ‪ Abdel Gawad‬ﰲ ﻋﺎﻡ ‪ ١٩٩٧‬ﺃﻥ ‪ %٤٢‬ﻣﻦ‬
‫ﺍﻷﻃﻔﺎﻝ ﻻ ﳛﺼﻠﻮﻥ ﻋﻠﻰ ﺭﺍﺣﺔ ﻣﻄﻠﻘﺎ‪ ،‬ﺑﻴﻨﻤﺎ ‪ %٢٤‬ﳛﺼﻠﻮﻥ ﻋﻠﻰ ﻧﺼﻒ ﺳﺎﻋﺔ ﻓﻘﻂ ﻭ‪ %١٧‬ﻋﻠﻰ‬
‫ﺳﺎﻋﺔ ﺭﺍﺣﺔ‪ .‬ﻭﻳﺮﺟﻊ ﺫﻟﻚ ﺍﻻﺧﺘﻼﻑ ﺇﱃ ﺗﺒﺎﻳﻦ ﺍ‪‬ﺘﻤﻌﺎﺕ ﻭﺃﻧﻮﺍﻉ ﺍﻟﻨﺸﺎﻃﺎﺕ‪ .‬ﻭﺍﳌﺸﻜﻠﺔ ﻻ ﺗﻘﺘﺼﺮ ﻓﻘﻂ‬
‫ﻋﻠﻰ ﺗﻮﻇﻴﻒ ﺍﻷﻃﻔﺎﻝ ﲢﺖ ﺍﻟﺴﻦ ﺍﻟﻘﺎﻧﻮﻧﻴﺔ ﻭﺇﺟﺒﺎﺭﻫﻢ ﻋﻠﻰ ﺍﻟﻌﻤﻞ ﳌﺪﺓ ﺳﺎﻋﺎﺕ ﺃﻛﺜﺮ ﻣﻦ ﺍﳌﺪﺓ‬
‫ﺍﻟﻘﺎﻧﻮﻧﻴﺔ‪ ،‬ﻭﻟﻜﻦ ﳝﻜﻦ ﺃﻳﻀﺎﹰ ﺩﻣﺞ ﻛﻞ ﻫﺬﺍ ﺑﺎﻷﺟﻮﺭ ﺍﻟﻈﺎﳌﺔ ﻭﺍﻟﻌﻤﻞ ﺫﻱ ﺍﻟﻄﺎﺑﻊ ﺍﳋﻄﺮ‪.‬‬

‫‪٢٣١‬‬
‫ﻛﺬﻟﻚ ﻛﺸﻔﺖ ﺩﺭﺍﺳﺔ ﺃﺟﺮ‪‬ﺎ ‪ NCSCR, 1991‬ﺃﻥ ﺍﻷﻭﺿﺎﻉ ﰲ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ ﺑﺼﻮﺭﺓ ﻋﺎﻣﺔ ﻏﲑ‬
‫ﻣﻼﺋﻤﺔ‪ .‬ﺇﺫ ﻳﻔﺘﻘﺮ ﻣﻜﺎﻥ ﺍﻟﻌﻤﻞ ﻟﻠﺘﺴﻬﻴﻼﺕ ﺍﻷﺳﺎﺳﻴﺔ ﻣﺜﻞ ﺇﻣﻜﺎﻧﻴﺔ ﺷﺮﺏ ﺍﳌﺎﺀ )‪ ،(%٣٨‬ﺗﻮﻓﺮ ﺩﻭﺍﺭﺍﺕ‬
‫ﺍﳌﻴﺎﻩ )‪ ،(%٥٠‬ﲜﺎﻧﺐ ﺃﻧﻮﺍﻉ ﺍﻟﺘﻠﻮﺙ ﺍﳌﺨﺘﻠﻔﺔ ﺑﺪﺍﺧﻞ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ ﻛﺎﻟﻐﺒﺎﺭ ﻭﺍﻟﻀﻮﺿﺎﺀ ﻭﺍﻟﺮﺍﺋﺤﺔ‬
‫ﺍﻟﻜﺮﻳﻬﺔ‪ .‬ﻫﺬﺍ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻋﺪﻡ ﺗﻮﻓﺮ ﺃﺩﻭﺍﺕ ﺍﻟﻄﻮﺍﺭﺉ ﻭﺍﻷﻣﺎﻥ‪ ،‬ﺑﻴﻨﻤﺎ ﺗﺘﻮﻓﺮ ﺣﻘﺎﺋﺐ ﺍﻹﺳﻌﺎﻓﺎﺕ ﺍﻷﻭﻟﻴﺔ‬
‫ﻓﻘﻂ ﰲ ‪ %٥٠‬ﻣﻦ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ‪ ،‬ﰲ ﺍﻟﻮﻗﺖ ﺍﻟﺬﻱ ﻓﻴﻪ ﻳﺮﺗﺪﻱ ‪ %٨,٦٦‬ﻓﻘﻂ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﳌﻼﺑﺲ ﺍﻟﻮﺍﻗﻴﺔ‪.‬‬
‫ﻭﰲ ﺩﺭﺍﺳﺔ ﻷﺑﻌﺎﺩ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻋﻠﻲ ﺍﻟﺼﺤﺔ‪ ،‬ﺃﻛﺪ ‪ Youssef, 1995‬ﻭﺟﻮﺩ ﺃﺷﻐﺎﻝ ﺧﻄﺮﺓ‪ ،‬ﺇﺫ‬
‫ﻳﺘﻌﺮﺽ ﺍﻷﻃﻔﺎﻝ ﻟﻀﻮﺿﺎﺀ ﻭﺣﺮﺍﺭﺓ ﻋﺎﻟﻴﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﳐﺎﻃﺮ ﻣﻬﻨﻴﺔ ﻣﺜﻞ ﺍﻟﺘﻌﺎﻣﻞ ﺑﺎﻟﻜﻴﻤﺎﻭﻳﺎﺕ ﺃﻭ‬
‫ﺍﳌﺎﻛﻴﻨﺎﺕ‪ .‬ﻫﺬﺍ ﻭﻗﺪ ﺃﻛﺪﺕ ﺩﺭﺍﺳﺎﺕ ﺃﺧﺮﻯ ﻋﻦ ﻧﻘﺺ ﻣﻴﺎﻩ ﺍﻟﺸﺮﺏ ﺍﻟﻨﻈﻴﻔﺔ ﻭﺍﻟﺘﻌﺮﺽ ﻟﺪﺭﺟﺎﺕ ﺣﺮﺍﺭﺓ‬
‫ﻋﺎﻟﻴﺔ ﲜﺎﻧﺐ ﻏﻴﺎﺏ ﺃﺩﻭﺍﺕ ﺍﻷﻣﺎﻥ‪.‬‬
‫ﺇﻥ ﻃﺒﻴﻌﺔ ﺍﳋﺪﻣﺔ ﺍﳌﱰﻟﻴﺔ ﲝﺪ ﺫﺍ‪‬ﺎ ﺗﻌﲏ ﺃﻥ ﺃﻭﻟﺌﻚ ﺍﻟﻘﺎﺋﻤﲔ ‪‬ﺎ ﺑﻌﻴﺪﻭﻥ ﲤﺎﻣﺎ ﻋﻦ ﺃﻧﻈﺎﺭ ﺍﻟﻌﺎﱂ‬
‫ﺍﳋﺎﺭﺟﻲ‪ ،‬ﻭﻻ ﺗﺘﻮﺍﻓﺮ ﳍﻢ ﺃﻳﺔ ﲪﺎﻳﺔ ﻣﻦ ﺍﻹﺳﺎﺀﺍﺕ‪ .‬ﺇﻥ ﻫﺬﻩ ﺍﻟﻌﺰﻟﺔ ﲡﻌﻞ ﻣﻦ ﺍﻟﺼﻌﺐ ﺍﻟﺘﻮﺻﻞ ﺇﱄ‬
‫ﺗﻘﺪﻳﺮﺍﺕ ﺻﺤﻴﺤﺔ ﺣﻮﻝ ﻋﺪﺩ ﺍﻷﻃﻔﺎﻝ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪ .‬ﻭﻣﻊ ﻫﺬﺍ ﻓﻴﻤﻜﻦ ﻟﻠﻤﺴﻮﺣﺎﺕ ﺍﶈﻠﻴﺔ ﺃﻥ ﺗﻌﻄﻴﻨﺎ‬
‫ﻓﻜﺮﺓ‪ ،‬ﻭﻟﻮ ﺑﺴﻴﻄﺔ‪ ،‬ﻋﻦ ﺣﺠﻢ ﻫﺬﻩ ﺍﳌﺸﻜﻠﺔ ﻭﺃﺑﻌﺎﺩﻫﺎ‪.‬‬
‫ﻋﻠﻲ ﻋﻜﺲ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳋﺪﻣﺔ ﺍﳌﱰﻟﻴﺔ‪ ،‬ﻳﻌﻤﻞ ﺍﻷﻃﻔﺎﻝ ﰲ ﺃﻣﺎﻛﻦ ﻇﺎﻫﺮﺓ ﻟﻠﺠﻤﻴﻊ ﲤﺎﻣﺎ‪ ،‬ﰲ‬
‫ﺍﻟﺸﻮﺍﺭﻉ‪ .‬ﺗﺮﺍﻫﻢ ﰲ ﻛﻞ ﻣﻜﺎﻥ‪ ،‬ﻳﻨﺎﺩﻭﻥ ﻋﻠﻲ ﺑﻀﺎﻋﺘﻬﻢ ﰲ ﺍﻷﺳﻮﺍﻕ‪ ،‬ﻳﺘﺪﺍﻓﻌﻮﻥ ﰲ ﻭﺳﻂ ﺯﲪﺔ ﺣﺮﻛﺔ‬
‫ﺍﳌﺮﻭﺭ‪ ،‬ﻳﻌﺮﺿﻮﻥ ﺑﻀﺎﻋﺘﻬﻢ ﰲ ﺍﳊﺎﻓﻼﺕ ﻭﺍﻟﻘﻄﺎﺭﺍﺕ‪ ،‬ﻭﺃﻣﺎﻡ ﺍﻟﻔﻨﺎﺩﻕ ﻭﺍﶈﻼﺕ ﺍﻟﺘﺠﺎﺭﻳﺔ‪ .‬ﻭﻳﺮﻱ ﻛﺜﲑ ﻣﻦ‬
‫ﺍﻟﻜﺒﺎﺭ ﻫﺆﻻﺀ ﺍﻷﻃﻔﺎﻝ ﻣﺼﺪﺭﺍ ﻟﻺﺯﻋﺎﺝ‪ ،‬ﺇﻥ ﱂ ﻳﻜﻮﻧﻮﺍ ﳎﺮﻣﲔ ﺻﻐﺎﺭﺍ ﺧﻄﺮﻳﻦ‪ .‬ﻭﰲ ﻭﺍﻗﻊ ﺍﳊﺎﻝ‪ ،‬ﻓﺈﻥ ﻣﺎ‬
‫ﻳﻔﻌﻠﻪ ﻫﺆﻻﺀ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﺸﻮﺍﺭﻉ ﻫﻮ ﻧﻮﻉ ﻣﻦ ﺃﻧﻮﺍﻉ ﺍﻟﻌﻤﻞ‪ .‬ﻳﻌﻤﻞ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﺸﻮﺍﺭﻉ ﰲ ﺗﻠﻤﻴﻊ‬
‫ﺍﻷﺣﺬﻳﺔ ﻭﻏﺴﻞ ﺍﻟﺴﻴﺎﺭﺍﺕ ﻭﺣﺮﺍﺳﺘﻬﺎ‪ ،‬ﻭﲪﻞ ﺍﻷﻣﺘﻌﺔ‪ ،‬ﻭﺑﻴﻊ ﺍﻟﺰﻫﻮﺭ‪ ،‬ﻛﻤﺎ ﻳﺒﺘﺪﻋﻮﻥ ﺁﻻﻑ ﺍﻟﻄﺮﻕ‬
‫ﻟﻠﺤﺼﻮﻝ ﻋﻠﻲ ﺍﻟﻨﻘﻮﺩ‪ .‬ﻭﻣﻊ ﺃﻥ ﻣﺎ ﳚﻤﻌﻮﻧﻪ ﻣﻦ ﻧﻘﻮﺩ ﺭﲟﺎ ﻛﺎﻥ ﻗﻠﻴﻼ‪ ،‬ﺇﻻ ﺃﻧﻪ ﻳﺰﻳﺪ ﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ ﻋﻦ‬
‫ﺍﻷﺟﺮ ﺍﻟﺬﻱ ﳝﻜﻦ ﺃﻥ ﻳﺘﻠﻘﻮﻩ ﻣﻦ ﻋﻤﻠﻬﻢ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺮﲰﻲ‪.‬‬
‫ﺗﻌﻮﺩ ﺍﻟﻐﺎﻟﺒﻴﺔ ﺍﻟﻌﻈﻤﻰ ﻣﻦ ﻫﺆﻻﺀ ﺍﻷﻃﻔﺎﻝ ﺇﱄ ﺃﻫﻠﻬﻢ ﻛﻞ ﻟﻴﻠﺔ‪ .‬ﻓﻬﻢ ﻳﻌﻤﻠﻮﻥ ﰲ ﺍﻟﺸﻮﺍﺭﻉ ﻭﻟﻜﻨﻬﻢ‬
‫ﻟﻴﺴﻮﺍ ﺃﻃﻔﺎﻝ ﺷﻮﺍﺭﻉ‪ .‬ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺫﻟﻚ‪ ،‬ﻓﻐﺎﻟﺒﺎ ﻣﺎ ﺗﻜﻮﻥ ﺍﳊﻴﺎﺓ ﺑﺎﻟﻨﺴﺒﺔ ﳍﻢ ﳏﻔﻮﻓﺔ ﺑﺎﳌﺨﺎﻃﺮ‬
‫ﻭﺗﻨﺬﺭ ﺑﺎﻟﻌﻨﻒ‪ ،‬ﻭﻏﲑ ﺻﺤﻴﺔ ﻭﻣﻊ ﺃﻥ ﺑﻌﻀﻬﻢ ﻳﺴﺘﻄﻴﻌﻮﻥ ﺍﳉﻤﻊ ﺑﲔ ﺍﻟﺪﺭﺍﺳﺔ ﻭﺍﻟﻌﻤﻞ ﰲ ﺍﻟﺸﺎﺭﻉ‪ ،‬ﺇﻻ‬
‫ﺃﻥ ﺍﻟﻜﺜﲑﻳﻦ ﻣﻨﻬﻢ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺍﻻﺳﺘﻐﻼﻝ‪ ،‬ﻭﻣﻦ ﺍﺣﺘﻴﺎﻝ ﺍﻟﻜﺒﺎﺭ‪ .‬ﻛﻤﺎ ﻳﻌﺎﱐ ﺍﻟﻜﺜﲑﻭﻥ ﻣﻦ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ‬
‫ﻭﺍﻷﻣﺮﺍﺽ‪ .‬ﻭﻏﺎﻟﺒﺎ ﻣﺎ ﺗﻜﻮﻥ ﺛﻘﺘﻬﻢ ﺑﺄﻧﻔﺴﻬﻢ ﺿﻌﻴﻔﺔ ﺑﺎﻟﺮﻏﻢ ﳑﺎ ﳛﺎﻭﻟﻮﻥ ﺗﺼﻨﻌﻪ ﻣﻦ ﺛﻘﺔ ﻣﺒﺎﻟﻎ‬
‫‪‬ﺎ ﺑﺎﻟﻨﻔﺲ ﻹﻇﻬﺎﺭ ﺑﺮﺍﻋﺘﻬﻢ ﰲ ﺍﻟﺸﻮﺍﺭﻉ‪ .‬ﻭﻣﻦ ﺍﶈﺘﻢ ﰲ ﻣﺜﻞ ﻫﺬﻩ ﺍﳊﺎﻟﺔ ﺃﻥ ﻳﺼﺒﺢ ﻫﺆﻻﺀ ﻋﺮﺿﺔ‬
‫ﻟﻼﳔﺮﺍﻁ ﰲ ﺍﻷﻋﻤﺎﻝ ﺍﳍﺎﻣﺸﻴﺔ ﻭﻏﲑ ﺍﳌﺸﺮﻭﻋﺔ‪ ،‬ﻛﺎﻟﺘﺴﻮﻝ ﻭﺍﻟﻨﺸﻞ‪ .‬ﻛﻤﺎ ﻳﻨﺠﺮ ﺍﻟﻜﺜﲑﻭﻥ ﻣﻨﻬﻢ ﺇﱄ‬
‫ﺗﺮﻭﻳﺞ ﺍﳌﺨﺪﺭﺍﺕ‪ .‬ﺇﻥ ﺍﻟﺜﻘﺎﻓﺔ ﺍﳋﺎﺻﺔ ﺍﻟﱵ ﻳﻨﻐﻤﺲ ﻓﻴﻬﺎ ﻫﺆﻻﺀ ﺍﻷﻃﻔﺎﻝ ﻻ ﺗﻌﺮﻑ ﺳﻮﻱ ﺍﻟﻌﺪﻭﺍﻧﻴﺔ‬
‫ﻭﺍﻹﺳﺎﺀﺓ‪.‬‬
‫ﺃ – ﺍﻷﺛﺮ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‬
‫ﺗﺆﺛﺮ ﻋﻨﺎﺻﺮ ﻋﺪﺓ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺑﺼﻮﺭﺓ ﺧﻄﲑﺓ ﻋﻠﻰ ﺻﺤﺔ ﺍﻷﻃﻔﺎﻝ ﻣﻨﻬﺎ ﺍﻻﻧﻀﻤﺎﻡ ﺇﱃ ﺳﻮﻕ‬
‫ﺍﻟﻌﻤﻞ ﰲ ﺳﻦ ﺻﻐﲑ‪ ،‬ﺍﻟﻌﻤﻞ ﳌﺪﺓ ﺳﺎﻋﺎﺕ ﻃﻮﻳﻠﺔ‪ ،‬ﺇﳒﺎﺯ ﻣﻬﺎﻡ ﺛﻘﻴﻠﺔ‪ ،‬ﲜﺎﻧﺐ ﺍﻟﻌﻤﻞ ﰲ ﺑﻴﺌﺔ ﻗﺎﺳﻴﺔ‪.‬‬

‫‪٢٣٢‬‬
‫ﻭﺍﻷﻛﺜﺮ ﻣﻦ ﺫﻟﻚ‪ ،‬ﻓﻘﺪ ﺃﺷﺎﺭﺕ ﻧﺘﺎﺋﺞ )‪ Badran (١٩٩٥‬ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﺑﺎﻹﺿﺎﻓﺔ‬
‫ﺇﱃ ﺗﻌﺮﺿﻬﻢ ﻷﺧﻄﺎﺭ ﺗﻨﺎﻭﻝ ﺍﻷﻃﻌﻤﺔ ﺍﳌﻠﻮﺛﺔ ﻭﺍﻟﻔﺎﺳﺪﺓ‪ .‬ﻭﻫﺬﺍ ﻳﻌﻮﺩ ﺑﺂﺛﺎﺭ ﺳﻠﺒﻴﺔ ﻋﻠﻰ ﺻﺤﺘﻬﻢ‬
‫ﻭﳕﻮﻫﻢ‪ .‬ﻭﰲ ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻴﺎﻥ ﻳﺴﺘﻤﺮ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻌﻤﻞ ﺧﻼﻝ ﻣﺮﺿﻬﻢ‪ ،‬ﻭﺫﻟﻚ ﻷ‪‬ﻢ ﳏﺮﻭﻣﻮﻥ ﻣﻦ‬
‫ﺍﻟﺪﻭﺍﺀ ﺍﳌﻼﺋﻢ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﺍﻟﱵ ﻳﻠﺠﺌﻮﻥ ﺇﻟﻴﻬﺎ ﻟﻠﻌﻼﺝ‪.‬‬
‫ﻭﻗﺪ ﺍﺧﺘﱪﺕ ﺩﺭﺍﺳﺔ ﺃﺟﺮ‪‬ﺎ ‪ NCSCR, 1991‬ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻟﺘﻘﻴﻴﻢ ﺍﳊﺎﻻﺕ‬
‫ﺍﻟﱵ ﺗﺘﻌﺮﺽ ﻷﻭﺿﺎﻉ ﺍﻟﻌﻤﻞ ﺍﳋﻄﲑﺓ‪ ،‬ﻭﻗﺪ ﻭﺟﺪﺕ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺃﻣﺮﺍﺽ ﳐﺘﻠﻘﺔ ﻣﺜﻞ‬
‫ﺍﻟﺒﻠﻬﺎﺭﺳﻴﺎ ﺑﻨﺴﺒﺔ ‪ ،%٢١,٨‬ﻭﺃﻧﻮﺍﻉ ﳐﺘﻠﻘﺔ ﻣﻦ ﺍﻹﺳﻬﺎﻝ ﺑﻨﺴﺒﺔ ‪ ،%٢٢,٨‬ﻛﻤﺎ ﻳﻌﺎﱐ ‪ %٢١,٩‬ﻣﻦ‬
‫ﻣﺸﺎﻛﻞ ﺧﻄﲑﺓ ﰲ ﺍﳍﻀﻢ‪ ،‬ﻭ‪ %١‬ﻟﺪﻳﻬﻢ ﻣﺸﺎﻛﻞ ﳍﺎ ﻋﻼﻗﺔ ﺑﺄﻣﺮﺍﺽ ﺍﻟﻘﻠﺐ‪ .‬ﻫﺬﺍ ﲜﺎﻧﺐ ﻭﺟﻮﺩ‬
‫ﺍﺧﺘﻼﻑ ﻭﺍﺿﺢ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻭﺍﻷﻃﻔﺎﻝ ﻏﲑ ﺍﻟﻌﺎﻣﻠﲔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺴﻌﺔ ﺭﺋﺘﻬﻢ‪ .‬ﺗﻠﻚ ﺍﻟﻨﺘﺎﺋﺞ‬
‫ﺍﻟﺴﻠﺒﻴﺔ ﻇﻬﺮﺕ ﺑﻮﺿﻮﺡ ﰲ ﺻﻨﺎﻋﺎﺕ ﺍﻟﻨﺴﻴﺞ ﻭﺍﻟﺰﺟﺎﺝ ﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ‪ .‬ﻛﻤﺎ ﺃﻭﺿﺤﺖ ﺍﻟﻨﺘﺎﺋﺞ‬
‫ﺇﱃ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺗﻠﻚ ﺍﻟﺼﻨﺎﻋﺎﺕ ﻟﺪﻳﻬﻢ ﺍﳔﻔﺎﺽ ﰲ ﻣﺘﻮﺳﻂ ﺳﺮﻋﺔ ﺇﺧﺮﺍﺝ ﺍﳍﻮﺍﺀ‬
‫ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺎﳊﺎﻻﺕ ﺍﻟﻌﺎﺩﻳﺔ‪.‬‬
‫ﺇﻥ ﺳﺎﻋﺎﺕ ﺍﻟﻌﻤﻞ ﺍﻟﻄﻮﻳﻠﺔ ﻭﻇﺮﻭﻑ ﺍﻟﻌﻤﻞ ﺍﻟﻘﺎﺳﻴﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻟﻈﺮﻭﻑ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺴﻴﺌﺔ ﻛﻞ‬
‫ﻫﺬﺍ ﺟﻌﻞ ﺍﻷﻃﻔﺎﻝ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺣﻮﺍﺩﺙ ﰲ ﺍﻟﻌﻤﻞ ﻭﺇﺻﺎﺑﺎﺕ ﻣﻬﻨﻴﺔ‪ .‬ﻭﻗﺪ ﺃﻭﺿﺤﺖ ﺩﺭﺍﺳﺔ ﺃﺟﺮ‪‬ﺎ‬
‫‪ NCSCR,1991‬ﺃﻥ ‪ %٤٣,١١‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺃﺻﻴﺒﻮﺍ ﺃﺛﻨﺎﺀ ﺍﻟﻌﻤﻞ ﻭﺛﻠﺜﻬﻢ ﻗﺪ ﺃﺻﻴﺐ ﺃﻛﺜﺮ ﻣﻦ ﻣﺮﺓ‪.‬‬
‫ﺑﻴﻨﻤﺎ ﻛﺸﻔﺖ ﻧﺘﺎﺋﺞ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﱵ ﻗﺎﻡ ‪‬ﺎ )‪ Abdel Gawad (1997‬ﺃﻥ ‪ %٦٢‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻳﻌﺎﻧﻮﻥ‬
‫ﻣﻦ ﺇﺻﺎﺑﺎﺕ ﺃﺛﻨﺎﺀ ﺍﻟﻌﻤﻞ‪ ،‬ﻭﺇﻥ ﺃﻛﺜﺮ ﻣﻦ ﻧﺼﻔﻬﻢ ﺃﺻﻴﺒﻮﺍ ﺃﻛﺜﺮ ﻣﻦ ﻣﺮﺓ‪ ،‬ﺗﻠﻚ ﺍﻟﻨﺴﺒﺔ ﺍﻟﻌﺎﻟﻴﺔ ﻣﻦ‬
‫ﺍﻹﺻﺎﺑﺎﺕ ﰎ ﺗﻔﺴﲑﻫﺎ ﺑﺴﺒﺐ ﺻﻐﺮ ﺳﻦ ﺍﻷﻃﻔﺎﻝ ﻭﺍﻓﺘﻘﺎﺭﻫﻢ ﻟﻠﺨﱪﺓ‪ .‬ﻭﳑﺎ ﺯﺍﺩ ﻣﻦ ﻧﺴﺒﺔ ﺍﻹﺻﺎﺑﺎﺕ‬
‫ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ ﺍﻟﺒﺪﺍﺋﻴﺔ ﻭﺃﻳﻀﺎﹰ ﺇﺭﻫﺎﻕ ﺍﻷﻃﻔﺎﻝ ﺑﺄﻋﻤﺎﻝ ﺛﻘﻴﻠﺔ‪ .‬ﻛﺬﻟﻚ ﲢﺮﻯ ‪Abdel Gawad‬‬
‫ﻋﻦ ﺭﺩﻭﺩ ﺃﻓﻌﺎﻝ ﺃﺻﺤﺎﺏ ﺍﻟﻌﻤﻞ ﲡﺎﻩ ﺇﺻﺎﺑﺎﺕ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻓﻮﺟﺪ ﺃﻥ ‪ %٣٨‬ﻣﻦ ﺍﳊﺎﻻﺕ ﻻ ﻳﻔﻌﻞ ﺃﺻﺤﺎﺏ‬
‫ﺍﻟﻌﻤﻞ ﺃﻱ ﺷﻲﺀ ﲡﺎﻫﻬﺎ‪ ،‬ﻭﺗﻘﺮﻳﺒﺎ ﺭ‪‬ﺑﻊ ﺍﳊﺎﻻﺕ ﻳﺄﺧﺬ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ ﺍﻟﻄﻔﻞ ﺇﱃ ﺍﳌﺴﺘﺸﻔﻰ‪ ،‬ﺑﻴﻨﻤﺎ ﻳﺘﻢ‬
‫ﻋﻼﺝ ﺍﻹﺻﺎﺑﺎﺕ ﺍﻟﺒﺴﻴﻄﺔ ﰲ ﳏﻞ ﺍﻟﻌﻤﻞ )ﺭ‪‬ﺑﻊ ﺍﳊﺎﻻﺕ( ﺃﻭ ﻋﻨﺪ ﺻﻴﺪﱄ ﻗﺮﻳﺐ )‪.(%١٣‬‬
‫ﺏ – ﺍﻷﺛﺮ ﺍﻻﻗﺘﺼﺎﺩﻱ ﻭﺍﻻﺟﺘﻤﺎﻋﻲ‬
‫ﻳﺆﺩﻱ ﺍﻻﻟﺘﺤﺎﻕ ﺑﺴﻮﻕ ﺍﻟﻌﻤﻞ ﰲ ﺳﻦ ﺻﻐﲑﺓ ﺇﱃ ﺣﺮﻣﺎﻥ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﺣﻘﻬﻢ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻟﺘﻤﺘﻊ‬
‫ﺑﻄﻔﻮﻟﺘﻬﻢ ﻭﺍﻟﻌﻴﺶ ﰲ ﺑﻴﺌﺔ ﺻﺤﻴﺔ‪ ،‬ﻛﻤﺎ ﳛﺪ ﺃﻳﻀﺎﹰ ﻣﻦ ﻓﺮﺹ ﺗﻨﻤﻴﺔ ﻗﺪﺭﺍ‪‬ﻢ ﺍﻟﻌﻘﻠﻴﺔ ﻭﻳﺆﺫﻱ‬
‫ﺻﺤﺘﻬﻢ‪ .‬ﻛﻞ ﻫﺬﺍ ﻳﺼﺒﺢ ﻋﺎﺋﻘﺎﹰ ﻟﻨﻤﻮﻫﻢ ﺍﳉﺴﺪﻱ ﻭﺍﻟﻌﻘﻠﻲ ﻭﺍﻟﻨﻔﺴﻲ‪ .‬ﻭﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ ﳚﻤﻊ‬
‫ﺍﻷﻃﻔﺎﻝ ﺑﲔ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺪﺭﺍﺳﺔ‪ ،‬ﻭﰲ ﺗﻠﻚ ﺍﳊﺎﻻﺕ ﻳﺘﺪﺍﺧﻞ ﺍﻟﻌﻤﻞ ﺍﻟﺸﺎﻕ ﻣﻊ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻌﻠﻴﻢ ﻭﳚﻌﻠﻬﺎ‬
‫ﻏﲑ ﻣﺆﺛﺮﺓ ﺇﺫ ﺃﻧﻪ ﻳﻘﻠﻞ ﻣﻦ ﺗﺮﻛﻴﺰ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﻟﻔﺼﻮﻝ ﻭﳛﺪ ﻣﻦ ﺍﻟﻮﻗﺖ ﺍﻟﻜﺎﰲ ﻟﻠﻮﺍﺟﺒﺎﺕ ﺍﳌﺪﺭﺳﻴﺔ‬
‫)‪.(Abdel-Gawad, 1997‬‬
‫ﻛﺬﻟﻚ ﳝﻜﻦ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺃﻥ ﺗﺆﺛﺮ ﻋﻠﻰ ﺍﳊﻴﺎﺓ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻟﻠﻄﻔﻞ ﺑﺪﺍﺧﻞ ﺃﺳﺮﺗﻪ ﻭﺍ‪‬ﺘﻤﻊ ﺍﻷﻭﺳﻊ‪.‬‬
‫ﻭﰲ ﻣﻘﺎﺑﻞ ﺍﻟﻨﺘﺎﺋﺞ ﺍﻟﺴﻠﺒﻴﺔ ﺍﳋﻄﲑﺓ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‪ ،‬ﱂ ﺗﺸﺮ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺇﱃ ﺍﻟﺘﺄﺛﲑﺍﺕ‬
‫ﺍﻟﺴﻠﺒﻴﺔ ﺍﳊﻘﻴﻘﻴﺔ ﺍﻟﱵ ﺗﺆﺛﺮ ﻋﻠﻰ ﺍﻟﻌﻼﻗﺔ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﻭﻋﺎﺋﻼ‪‬ﻢ‪ .‬ﺇﺫ ﺃﻭﺿﺤﺖ ﻧﺘﺎﺋﺞ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﱵ‬
‫ﺃﺟﺮ‪‬ﺎ ‪ NCSCR, 1993‬ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﻳﻘﻀﻮﻥ ﻣﻌﻈﻢ ﻭﻗﺘﻬﻢ ﺧﺎﺭﺝ ﺍﻟﺒﻴﺖ ﺗﻜﻮﻥ ﻋﻼﻗﺘﻬﻢ‬

‫‪٢٣٣‬‬
‫ﺑﺄﺳﺮ‪‬ﻢ ﻗﻮﻳﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﺷﺘﻴﺎﻗﻬﻢ ﻟﻠﺘﺠﻤﻊ ﻣﻊ ﻋﺎﺋﻠﺘﻬﻢ ﻟﻠﻌﺸﺎﺀ ﺃﻭ ﻣﺸﺎﻫﺪﺓ ﺍﻟﺘﻠﻔﺎﺯ‪ .‬ﻭﻭﻓﻘ ﹰﺎ‬
‫ﻵﺭﺍﺀ ﺍﻷﻣﻬﺎﺕ‪ ،‬ﺗﺘﺼﻒ ﻋﻼﻗﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺄﺧﻮ‪‬ﻢ ﺑﺎﶈﺒﺔ ﻭﺍﻟﺘﻔﺎﻫﻢ ﻭﺍﻟﺘﻌﺎﻭﻥ‪ ،‬ﻭﻫﺬﺍ ﻳﻌﲏ ﻋﺪﻡ‬
‫ﻭﺟﻮﺩ ﻧﺘﺎﺋﺞ ﺳﻠﺒﻴﺔ ﺗﺆﺛﺮ ﻋﻠﻰ ﻋﻼﻗﺔ ﺍﻟﻄﻔﻞ ﺑﺎﻷﺳﺮﺓ ﺑﺴﺒﺐ ﻋﻤﻠﻪ‪ .‬ﺑﻞ ﺑﺎﻟﻌﻜﺲ‪ ،‬ﺇﺫ ﺗﻘﻞ ﺍﳌﺸﺎﻛﻞ ﻣﻊ‬
‫ﺍﻷﺧﻮﺓ ﺑﻌﺪ ﺍﻟﻌﻤﻞ‪ .‬ﻛﻤﺎ ﺃﺑﺪﺕ ﺫﺍﺕ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻧﻪ ﰲ ‪ %٥٦‬ﻣﻦ ﺍﳊﺎﻻﺕ ﻳﺸﺘﺎﻕ ﺃﻋﻀﺎﺀ ﺍﻷﺳﺮﺓ ﺇﱃ‬
‫ﺍﻻﺟﺘﻤﺎﻉ ﻣﻌﺎﹰ ﻟﺘﻨﺎﻭﻝ ﻭﺟﺒﺎ‪‬ﻢ ﺧﺼﻮﺻﺎﹰ ﰲ ﺍﻟﻌﻄﻼﺕ‪ .‬ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺫﻟﻚ‪ ،‬ﻓﺈﻥ ﻗﻀﺎﺀ ﺳﺎﻋﺎﺕ ﻋﻤﻞ‬
‫ﻃﻮﻳﻠﺔ ﰲ ﺍﻟﻌﻤﻞ ﳛﺮﻡ ﺍﻷﻃﻔﺎﻝ ﰲ ﺣﻘﻬﻢ ﰲ ﺍﻻﺳﺘﻤﺘﺎﻉ ﺑﻄﻔﻮﻟﺘﻬﻢ‪ .‬ﻭﰲ ﺇﺟﺎﺑﺔ ﻟﺴﺆﺍﻝ ﻋﻦ ﻣﺎﺫﺍ‬
‫ﻳﻔﻌﻠﻮﻥ ﻋﻨﺪﻣﺎ ﻳﻌﻮﺩﻭﻥ ﺇﱃ ﺍﳌﱰﻝ ﺑﻌﺪ ﺍﻟﻌﻤﻞ ﺃﺟﺎﺏ ‪ %٦٩‬ﺇ‪‬ﻢ ﻳﺘﻨﺎﻭﻟﻮﻥ ﺍﻟﻌﺸﺎﺀ ﻭﳜﻠﺪﻭﻥ ﻟﻠﻨﻮﻡ‪ ،‬ﺑﻴﻨﻤﺎ‬
‫ﺫﻛﺮ ‪ %٢٢‬ﻣﻨﻬﻢ ﺃ‪‬ﻢ ﻳﻠﻌﺒﻮﻥ ﻣﻊ ﺍﻹﺧﻮﺓ ﻭﺍﻷﺧﻮﺍﺕ‪ ،‬ﻭﻗﺎﻝ ‪ %٩‬ﺇ‪‬ﻢ ﻳﺘﺤﺪﺛﻮﻥ ﻋﻦ ﻣﺸﻜﻼ‪‬ﻢ ﻣﻊ‬
‫ﺑﺎﻗﻲ ﺃﻓﺮﺍﺩ ﺍﻷﺳﺮﺓ‪.‬‬
‫ﻛﻤﺎ ﻳﺸﺘﺮﻙ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﻮﻥ ﻣﻊ ﺃﺳﺮﻫﻢ ﰲ ﺍﳌﺴﺌﻮﻟﻴﺎﺕ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‪ ،‬ﻓﻘﺪ ﺃﻭﺿﺤﺖ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﱵ‬
‫ﺃﺟﺮ‪‬ﺎ ‪ NCSCR, 1991‬ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﻳﺴﺎﳘﻮﻥ ﺑﻮﺿﻮﺡ ﰲ ﺩﺧﻞ ﺍﻷﺳﺮﺓ‪ ،‬ﺇﺫ ﻳﺴﺎﻫﻢ ‪ %٦٦,٤‬ﻣﻨﻬﻢ‬
‫ﺑﺄﺟﺮﻩ ﻛﺎﻣﻼﹰ‪ ،‬ﻭﻳﺴﺎﻫﻢ ‪ %١٨,٤‬ﺑﺜﻼﺛﺔ ﺃﺭﺑﺎﻉ ﺍﺟﺮﻩ‪ ،‬ﺑﻴﻨﻤﺎ ﻳﺴﺎﻫﻢ ‪ %٦,٥‬ﺑﻨﺼﻒ ﺃﺟﺮﻩ‪ ،‬ﰲ ﺣﲔ ﺃﻧﻪ ‪%٥‬‬
‫ﻓﻘﻂ ﻻ ﻳﺴﺎﻋﺪﻭﻥ ﺃﺳﺮﻫﻢ‪ .‬ﻭﺗﺘﺮﺍﻭﺡ ﻧﺴﺒﺔ ﺍﳌﺴﺎﳘﺔ ﻓﻴﻤﺎ ﺑﲔ ‪ %٢٢,٨‬ﻭ‪ %٣٠,٨‬ﻣﻦ ﺩﺧﻞ ﺍﻷﺳﺮﺓ‪ ،‬ﺇﺫ‬
‫ﺍﻋﺘﱪ ‪ %٨١‬ﻣﻦ ﺃﻣﻬﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺃﻥ ﻣﺴﺎﳘﺔ ﺍﻷﻃﻔﺎﻝ ﺿﺮﻭﺭﻳﺔ ﰲ ﻣﻴﺰﺍﻧﻴﺔ ﺍﻷﺳﺮﺓ‪ .‬ﻛﻤﺎ‬
‫ﺃﻭﺿﺤﺖ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﺘﺎﻟﻴﺔ ‪ NCSCR, 1993‬ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻳﺴﺎﳘﻮﻥ ﰲ ﺍﳌﺘﻮﺳﻂ ﰲ ﺣﺪﻭﺩ‬
‫ﺭﺑﻊ ﺩﺧﻞ ﺍﻷﺳﺮﺓ‪.‬‬
‫ﻛﺬﻟﻚ ﺃﻛﺪﺕ ﺩﺭﺍﺳﺎﺕ ﺃﻛﺜﺮ ﺣﺪﺍﺛﺔ ﻣﺴﺎﳘﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺩﺧﻞ ﺃﺳﺮﻫﻢ‪ .‬ﺇﺫ ﻗﺪﺭ ‪Abdel-‬‬
‫‪ Gawad, 1997‬ﺃﻥ ﳎﻤﻮﻉ ﺩﺧﻞ ﺍﻟﻄﻔﻞ )ﺍﻷﺟﺮ ﻭﺍﻟﺒﻘﺸﻴﺶ( ﻳﺼﻞ ﰲ ﺍﳌﺘﻮﺳﻂ ﺇﱃ ‪ ١٥,٥‬ﺟﻨﻴﻪ ﰲ‬
‫ﺍﻷﺳﺒﻮﻉ‪ ،‬ﻛﻤﺎ ﻳﺴﺎﻫﻢ ﺣﻮﺍﱄ ‪ %٩٧‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﺩﺧﻞ ﺍﻷﺳﺮﺓ ﲟﻌﺪﻻﺕ ﳐﺘﻠﻔﺔ‪ %٥٧ :‬ﻣﻨﻬﻢ‬
‫ﻳﺴﺎﳘﻮﻥ ﺑﺎﻷﺟﺮ ﻛﻠﻪ‪ ،‬ﻭ‪ %٢٣‬ﺑﺜﻼﺛﺔ ﺃﺭﺑﺎﻉ ﺃﺟﻮﺭﻫﻢ‪ ،‬ﻭ‪ %١١‬ﺑﻨﺼﻒ ﺍﻷﺟﺮ ﻭ‪ %٦‬ﲟﻌﺪﻻﺕ ﳐﺘﻠﻔﺔ‪ .‬ﻟﺬﻟﻚ‪،‬‬
‫ﻓﺈﻥ ﻭﺍﺣﺪﺍﹰ ﻣﻦ ﺃﻫﻢ ﺍﻟﺘﺄﺛﲑﺍﺕ ﺍﻹﳚﺎﺑﻴﺔ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻫﻮ ﺍﳌﺴﺎﳘﺔ ﰲ ﻣﻴﺰﺍﻧﻴﺔ ﺍﻷﺳﺮﺓ‪ ،‬ﺫﻟﻚ ﻷﻥ‬
‫ﻣﻌﻈﻢ ﺃﺳﺮ ﻫﺆﻻﺀ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﺍﻟﻔﻘﺮﺍﺀ‪ .‬ﺃﻳﻀﺎﹰ ﻳﺴﺎﻋﺪ ﺫﻟﻚ ﻋﻠﻰ ﺭﻓﻊ ﺗﻘﺪﻳﺮ ﺍﻟﻄﻔﻞ ﻟﻨﻔﺴﻪ‪ ،‬ﻫﺬﺍ‬
‫ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﳝﻜﻨﻪ ﺃﻥ ﻳﻀﻤﺪ ﺃﻱ ﻧﺘﺎﺋﺞ ﻋﺎﻃﻔﻴﺔ ﺳﻠﺒﻴﺔ ﺃﺧﺮﻯ‪ ،‬ﺇﺫ ﺇﻥ ‪ %٩٧‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺳﻌﺪﺍﺀ ﻭﺭﺍﺿﻮﻥ‬
‫ﳌﺴﺎﳘﺘﻬﻢ ﰲ ﺩﺧﻞ ﺍﻷﺳﺮﺓ‪ .‬ﻭﺳﺒﺐ ﺫﻟﻚ ﻫﻮ ﻣﺎ ﻳﻠﻲ‪ %٤٧ :‬ﻣﻨﻬﻢ ﻳﺸﻌﺮﻭﻥ ﺑﺎﻟﻔﺨﺮ ﻭﺍﺣﺘﺮﺍﻡ ﺍﻟﺬﺍﺕ‪،‬‬
‫‪ %٢٥‬ﻣﻨﻬﻢ ﳜﺘﱪﻭﻥ ﻣﺸﺎﻋﺮ ﺍﻟﻨﻀﺞ ﻭﲢﻤﻞ ﺍﳌﺴﺌﻮﻟﻴﺔ‪ %١٨ ،‬ﻳﻜﻔﻮﻥ ﺣﺎﺟﺘﻬﻢ ﺍﳌﺎﺩﻳﺔ‪ ،‬ﻭ‪ %٦‬ﻳﺪﺧﺮ‬
‫ﺃﺳﺮﻫﻢ ﳍﻢ ﺍﻟﻨﻘﻮﺩ‪ ،‬ﺑﻴﻨﻤﺎ ﻳﺸﻌﺮ ‪ %٤‬ﻣﻨﻬﻢ ﺃﻥ ﺃﺳﺮﻫﻢ ﺗﻘﺪﺭ ﺩﻭﺭﻫﻢ‪.‬‬
‫ﺝ ‪ -‬ﺍﻟﻨﺘﺎﺋﺞ ﺍﻟﻨﻔﺴﻴﺔ ﺍﳌﺘﺮﺗﺒﺔ ﻋﻠﻰ ﻋﻤﺎﻟﺔ ﺍﻟﻄﻔﻞ‬
‫ﺍﻫﺘﻤﺖ ﺩﺭﺍﺳﺎﺕ ﻗﻠﻴﻠﺔ ﺑﺎﻵﺛﺎﺭ ﺍﻟﺴﻠﺒﻴﺔ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻋﻠﻰ ﻧﻔﺴﻴﺔ ﺍﻟﻄﻔﻞ ﻭﺻﺤﺘﻪ ﺍﻟﻌﻘﻠﻴﺔ‪ ،‬ﻓﻘﺪ‬
‫ﺍﻫﺘﻤﺖ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻟﱵ ﺃﺟﺮ‪‬ﺎ ‪ Fathi, 1994‬ﺑﺼﻮﺭﺓ ﺍﻷﺳﺮﺓ ﻛﻤﺎ ﻳﺮﺍﻫﺎ ﺍﻟﻄﻔﻞ ﺍﻟﻌﺎﻣﻞ ﻭﳑﻴﺰﺍﺕ‬
‫ﺷﺨﺼﻴﺘﻪ‪ .‬ﺇﺫ ﺗﺒﻨﺖ ﺍﻟﺪﺭﺍﺳﺔ ﻣﻨﻬﺞ ﻗﺎﺭﻧﺖ ﻓﻴﻪ ﺑﲔ ﻋﻴﻨﺔ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻏﲑ ﺍﻟﻌﺎﻣﻠﲔ ﻭﻋﻴﻨﺘﲔ ﻣﻦ‬
‫ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪ ،‬ﻭﰎ ﺍﺧﺘﻴﺎﺭ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﳎﺎﻟﲔ ﻋﻤﻞ ﳐﺘﻠﻔﺘﲔ‪ ،‬ﺃﺣﺪﳘﺎ ﺧﻄﺮ ﻭﺍﻵﺧﺮ‬
‫ﻋﻤﻞ ﺑﺴﻴﻂ‪ .‬ﻭﻛﺎﻥ ﻫﻨﺎﻙ ﺍﺧﺘﻼﻓﺎﺕ ﻭﺍﺿﺤﺔ ﺑﲔ ﻫﺆﻻﺀ ﺍﻟﺬﻳﻦ ﻳﻌﻤﻠﻮﻥ ﰲ ﺃﺷﻐﺎﻝ ﺧﻄﺮﺓ ﻭﻫﺆﻻﺀ ﺍﻟﺬﻳﻦ‬
‫ﻳﻌﻤﻠﻮﻥ ﰲ ﺃﺷﻐﺎﻝ ﺑﺴﻴﻄﺔ‪ .‬ﻓﺎﻷﻃﻔﺎﻝ ﺍﻟﺬﻳﻦ ﻳﻌﻤﻠﻮﻥ ﰲ ﺃﻋﻤﺎﻝ ﺑﺴﻴﻄﺔ ﻟﺪﻳﻬﻢ ﻋﻼﻗﺎﺕ ﺃﻛﺜﺮ ﻭﺛﺎﻗﺔ‬

‫‪٢٣٤‬‬
‫ﺑﻌﺎﺋﻼ‪‬ﻢ‪ ،‬ﻓﻜﻼ ﺍﻟﺬﻛﻮﺭ ﻭﺍﻹﻧﺎﺙ ﺍﻟﻌﺎﻣﻠﲔ ﻟﺪﻳﻬﻢ ﺇﺣﺴﺎﺱ ﻣﺘﺴﺎﻭٍ ﺑﺎﻻﻟﺘﺰﺍﻡ ﲡﺎﻩ ﻋﺎﺋﻼ‪‬ﻢ‪ .‬ﺃﻣﺎ‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﻤﻴﺰﺍﺕ ﺍﻟﺸﺨﺼﻴﺔ‪ ،‬ﻓﻮﺟﺪ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺃﻛﺜﺮ ﺍﺳﺘﻘﻼﻻﹰ ﻣﻦ ﻏﲑ ﺍﻟﻌﺎﻣﻠﲔ‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺗﺄﺛﲑﻫﻢ ﺍﻟﻮﺍﺿﺢ‪ ،‬ﺇﺫ ﳝﻜﻦ ﻭﺻﻔﻬﻢ ﺑﺎﶈﺎﺭﺑﲔ‪ ،‬ﺇﻻ ﺃ‪‬ﻢ ﺃﻛﺜﺮ ﻋﺪﻭﺍﻧﻴﺔ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻏﲑ‬
‫ﺍﻟﻌﺎﻣﻠﲔ‪.‬‬
‫ﻭﻣﻦ ﻧﺎﺣﻴﺔ ﺃﺧﺮﻯ‪ ،‬ﻗﺎﺩ ‪ El-Garhi, 1994‬ﺩﺭﺍﺳﺔ ﻋﻠﻰ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺰﺭﺍﻋﻲ ﻭﻋﻴﻨﺔ‬
‫ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻏﲑ ﺍﻟﻌﺎﻣﻠﲔ‪ ،‬ﻟﺘﺄﰐ ﺍﻟﻨﺘﺎﺋﺞ ﻣﻮﺿﺤﺔ ﺍﺧﺘﻼﻓﺎﺕ ﻫﺎﻣﺔ ﺑﲔ ﺍﻟﻔﺮﻳﻘﲔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺘﻮﺍﻓﻖ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺍﻟﺸﺨﺼﻲ‪ .‬ﻭﻛﺎﻧﺖ ﺍﻟﻨﺘﻴﺠﺔ ﰲ ﺻﺎﱀ ﺍﻷﻃﻔﺎﻝ ﻏﲑ ﺍﻟﻌﺎﻣﻠﲔ ﺍﻟﺬﻳﻦ ﺍﻟﺘﺤﻘﻮﺍ ﺑﺎﳌﺪﺍﺭﺱ‪،‬‬
‫ﻣﻮﺿﺤﺎﹰ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﻣﺴﺘﻮﻳﺎﺕ ﻣﻨﺨﻔﻀﺔ ﻣﻦ ﺍﻟﺘﻮﺍﻓﻖ ﺍﳌﻬﲏ ﻭﺍﻟﺼﺤﻲ‬
‫ﻭﺍﻻﺟﺘﻤﺎﻋﻲ ﺍﻟﺸﺨﺼﻲ‪.‬‬
‫ﻭﻗﺪ ﻋﻴﻨﺖ ﺩﺭﺍﺳﺔ ﺷﺎﻣﻠﺔ ‪ NCSCR, 1991‬ﻋﻠﻰ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻨﺘﺎﺋﺞ ﺍﻟﻨﻔﺴﻴﺔ ﺍﳌﺘﺮﺗﺒﺔ ﻋﻠﻰ‬
‫ﺩﺧﻮﻝ ﺍﻷﻃﻔﺎﻝ ﺳﻮﻕ ﺍﻟﻌﻤﻞ ﰲ ﺳﻦ ﻣﺒﻜﺮﺓ‪ .‬ﻛﻤﺎ ﲝﺜﺖ ﺍﻟﺪﺭﺍﺳﺔ ﻋﻴﻨﺔ ﻣﻜﻮﻧﺔ ﻣﻦ ‪ ٥٦٦‬ﻃﻔﻼﹰ ﻋﺎﻣﻼﹰ‪،‬‬
‫ﺃﺿﻴﻒ ﺇﻟﻴﻬﻢ ‪ ١٨‬ﺁﺧﺮﻭﻥ ﻟﺪﺭﺍﺳﺔ ﺍﳊﺎﻻﺕ ﺍﻷﻛﺜﺮ ﺗﻌﻘﻴﺪﺍﹰ‪ .‬ﻓﻔﻲ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ‪ ،‬ﺍﺩﻋﻰ ‪ Ramzi‬ﺃﻥ ﺩﺧﻮﻝ‬
‫ﺳﻮﻕ ﺍﻟﻌﻤﻞ ﰲ ﺳﻦ ﻣﺒﻜﺮﺓ ﳛﺪ ﻣﻦ ﻓﺮﺹ ﺍﻷﻃﻔﺎﻝ ﰲ ﺗﻨﻤﻴﺔ ﻣﻬﺎﺭﺍ‪‬ﻢ ﻭﻳﻘﻠﻞ ﻣﻦ ﻗﺪﺭ‪‬ﻢ ﻋﻠﻰ‬
‫ﺍﻟﺘﻮﺍﻓﻖ‪ .‬ﻭﻗﺪ ﺃﻛﺪﺕ ﺍﻟﺪﺭﺍﺳﺔ ﻋﻠﻰ ﺍﳊﺎﺟﺔ ﺇﱃ ﺍﺳﺘﻘﺼﺎﺀ ﺍﳌﺘﻐﲑﺍﺕ ﺍﻟﱵ ﺗﺮﺗﺒﻂ ﺍﺭﺗﺒﺎﻃﺎﹰ ﻭﺛﻴﻘﺎ ﺑﻈﺎﻫﺮﺓ‬
‫ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻣﺜﻞ ﺍﻟﺬﻛﺎﺀ ﻭﺍﻟﺘﻮﺍﻓﻖ ﺍﻟﺸﺨﺼﻲ ﻭﺍﻟﺘﻮﺍﻓﻖ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺍﻟﺘﻮﺍﻓﻖ ﺍﻟﻌﺎﻡ‪ .‬ﻓﺒﺎﻟﻨﺴﺒﺔ‬
‫ﻟﻠﺬﻛﺎﺀ‪ ،‬ﰎ ﺍﻻﺩﻋﺎﺀ ﺑﺄﻥ ﻣﺴﺘﻮﻯ ﺫﻛﺎﺀ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺘﺎﺭﻛﲔ ﻟﻠﻤﺪﺭﺳﺔ ﻣﻨﺨﻔﺾ ﻭﰲ ﺍﻟﻮﻗﺖ ﻧﻔﺴﻪ ﺗﺮﻙ‬
‫ﺍﳌﺪﺭﺳﺔ ﱂ ﻳﻮﻓﺮ ﳍﻢ ﺍﻟﻔﺮﺻﺔ ﻟﺘﻨﻤﻴﺔ ﺫﻛﺎﺋﻬﻢ‪ .‬ﺇﻥ ﺍﻟﺘﻮﺍﻓﻖ ﺍﻟﺸﺨﺼﻲ ﻳﺘﻢ ﺗﻜﻮﻳﻨﻪ ﻋﻠﻰ ﺃﺳﺎﺱ ﻣﻦ‬
‫ﺍﻟﺸﻌﻮﺭ ﺑﺎﻷﻣﻦ ﻭﻳﻌﻜﺲ ﺍﺳﺘﻘﻼﻟﻴﺔ ﻭﺍﺣﺘﺮﺍﻣﺎﹰ ﻟﻠﻨﻔﺲ‪ ،‬ﺃﻣﺎ ﺍﻟﺘﻮﺍﻓﻖ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻓﻴﺘﻮﻟﺪ ﻋﻨﺪﻣﺎ ﻳﺸﻌﺮ‬
‫ﺍﻟﻄﻔﻞ ﺑﺎﻫﺘﻤﺎﻡ ﻭﺍﺣﺘﺮﺍﻡ ﺍﻵﺧﺮﻳﻦ ﻟﻪ‪ ،‬ﻭﳛﺘﺮﻡ ﻫﻮ ﺍﻟﻘﻮﺍﻧﲔ ﻭﺍﻟﻘﻮﺍﻋﺪ‪ .‬ﺇﻥ ﺍﻟﺘﻮﺍﻓﻖ ﺍﻟﻌﺎﻡ ﻫﻮ ﻧﺘﻴﺠﺔ‬
‫ﺍﻟﺘﻮﺍﻓﻖ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺍﻟﺸﺨﺼﻲ‪ ،‬ﻓﻬﻮ ﻳﻌﻜﺲ ﻗﺪﺭﺓ ﺍﻟﺘﻮﺍﻓﻖ ﻣﻊ ﺍﻵﺧﺮﻳﻦ ﰲ ﳐﺘﻠﻒ ﺍﳌﻮﺍﻗﻒ‪.‬‬
‫ﻭﻗﺪ ﺗﺒﲎ )‪ ( Ramzi ١٩٩٨‬ﻣﻨﻬﺠﺎﹰ ﻗﺎﺭﻥ ﻓﻴﻪ ﻋﻴﻨﺔ ﺛﺎﻧﻮﻳﺔ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺑﻌﻴﻨﺔ ﻣﻦ ﺍﻷﻃﻔﺎﻝ‬
‫ﻏﲑ ﺍﻟﻌﺎﻣﻠﲔ ﺍﳌﻠﺘﺤﻘﲔ ﺑﺎﳌﺪﺍﺭﺱ‪ .‬ﻭﻛﺸﻔﺖ ﺍﻟﻨﺘﺎﺋﺞ ﻋﻦ ﺍﺭﺗﻔﺎﻉ ﻣﺴﺘﻮﻯ ﺍﻟﺬﻛﺎﺀ ﻟﺪﻯ ﺍﻷﻃﻔﺎﻝ ﰲ‬
‫ﺍﳌﺪﺍﺭﺱ ﻋﻦ ﺫﻭﻳﻬﻢ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪ .‬ﻭﻗﺪ ﺃﻛﺪﺕ ﺗﻠﻚ ﺍﻟﻨﺘﺎﺋﺞ ﺃﻥ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻛﺜﺮ ﺗﺄﺛﲑﺍﹰ ﰲ ﺍﻷﻃﻔﺎﻝ‬
‫ﻣﻦ ﺍﻟﻌﻤﻞ ﺇﺯﺍﺀ ﺗﻄﻮﻳﺮ ﻣﻌﺎﻣﻞ ﺍﻟﺬﻛﺎﺀ ﻟﺪﻯ ﺍﻟﻄﻔﻞ‪ .‬ﻛﻤﺎ ﺃ‪‬ﺎ ﺗﻨﻤﻲ ﺍﻟﻘﺪﺭﺍﺕ ﺍﻟﻼﺯﻣﺔ ﻟﻜﺴﺐ ﺍﳌﻌﻴﺸﺔ‪،‬‬
‫ﺇﻻ ﺃﻥ ﻣﻌﻈﻢ ﺍﻷﻃﻔﺎﻝ ﳝﺎﺭﺳﻮﻥ ﺃﻋﻤﺎﻻﹰ ﻳﺪﻭﻳﺔ ﲢﺘﺎﺝ ﺇﱃ ﻣﺴﺘﻮﻳﺎﺕ ﻣﺘﻮﺳﻄﺔ ﻣﻦ ﺍﻟﺬﻛﺎﺀ ﻛﻤﺎ ﺇ‪‬ﺎ‬
‫ﺗﻮﻓﺮ ﻓﺮﺻﺎﹰ ﺃﻗﻞ ﻟﺘﺪﺭﻳﺐ ﻣﺴﺘﻮﻳﺎﺕ ﻋﻠﻴﺎ ﻣﻦ ﺍﻟﻘﺪﺭﺍﺕ ﺍﻟﻌﻘﻠﻴﺔ ﺫﻟﻚ ﻷﻥ ﺍﻟﻘﺪﺭﺍﺕ ﺍﻟﱵ ﺗﻨﻤﻲ ﺍﳌﻘﺪﺭﺓ‬
‫ﺍﳌﻌﺮﻓﻴﺔ ﻭﺍﻟﺬﻛﺎﺀ ﺗﻜﻮﻥ ﺃﻛﺜﺮ ﻓﺎﻋﻠﻴﺔ ﻣﻦ ﺧﻼﻝ ﻧﻈﺎﻡ ﻣﺪﺭﺳﻲ ﻓﻌﺎﻝ‪.‬‬
‫ﻛﻤﺎ ﻛﺸﻔﺖ ﺍﻟﻨﺘﺎﺋﺞ ﻋﻦ ﻣﺘﻐﲑﺍﺕ ﻫﺎﻣﺔ ﺑﲔ ﳎﻤﻮﻋﺘﲔ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻭﻏﲑ ﺍﻟﻌﺎﻣﻠﲔ ﻓﻴﻤﺎ‬
‫ﻳﺘﻌﻠﻖ ﺑﺎﻟﺘﻮﺍﻓﻖ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺍﻟﻌﺎﻡ‪ ،‬ﺇﻻ ﺃﻧﻪ ﻻ ﻳﻮﺟﺪ ﻣﺘﻐﲑﺍﺕ ﻓﻌﺎﻟﺔ ﺑﲔ ﺍﻟﻌﻴﻨﺘﲔ ﻓﻴﻢ ﳜﺘﺺ ﺑﺎﻟﺘﻔﺎﻋﻞ‬
‫ﺍﻟﺬﺍﰐ‪ .‬ﻭﳝﻜﻦ ﺷﺮﺡ ﻫﺬﺍ ﰲ ﺿﻮﺀ ﺍﻟﻨﺘﺎﺋﺞ ﺍﻟﱵ ﺗﻜﺸﻒ ﺃﻥ ‪ %٩١,٦‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻳﺴﺎﳘﻮﻥ ﰲ‬
‫ﺩﺧﻞ ﺍﻷﺳﺮﺓ ﳑﺎ ﻳﻜﻮﻥ ﻟﺪﻳﻬﻢ ﺍﻹﺣﺴﺎﺱ ﺑﺎﻟﺮﺿﺎ ﺑﺎﻟﻨﻔﺲ ﻭﺍﻟﺘﺄﺛﲑ ﻭﻫﺬﺍ ﻳﻨﻌﻜﺲ ﻋﻠﻰ ﺗﻮﺍﻓﻘﻬﻢ ﺍﻟﺬﺍﰐ‬
‫)‪ .(NCSCR,1991‬ﺇﻻ ﺃﻥ ﺫﻟﻚ ﻏﲑ ﻛﺎﻑ ﻟﺘﻌﻮﻳﺾ ﺍﻹﺣﺴﺎﺱ ﺑﺎﻟﻘﻬﺮ ﻭﺍﻟﻈﻠﻢ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺫﻟﻚ‬
‫ﲟﻘﺎﺭﻧﺔ ﺃﻧﻔﺴﻬﻢ ﺑﺎﻷﻃﻔﺎﻝ ﺍﻵﺧﺮﻳﻦ ﰲ ﻧﻔﺲ ﺍﳌﺮﺣﻠﺔ ﺍﻟﻌﻤﺮﻳﺔ‪ .‬ﻛﺬﻟﻚ ﻳﻌﺎﱐ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﻮﻥ ﻣﻦ‬

‫‪٢٣٥‬‬
‫ﺗﻀﺎﺭﺏ ﻣﺸﺎﻋﺮﻫﻢ ﻣﻊ ﻣﻬﺎﻣﻬﻢ‪ ،‬ﻓﻔﻲ ﺍﻟﻮﻗﺖ ﺍﻟﺬﻱ ﻳﺪﺭﻛﻮﻥ ﻓﻴﻪ ﺃﳘﻴﺔ ﺩﻭﺭﻫﻢ ﰲ ﺍﻷﺳﺮﺓ ﻭﻛﺬﻟﻚ‬
‫ﺃﳘﻴﺔ ﺇﺳﻬﺎﻣﻬﻢ ﺍﳌﺎﺩﻱ‪ ،‬ﺇﻻ ﺃ‪‬ﻢ ﻳﺘﻄﻠﻌﻮﻥ ﻟﻠﻌﻴﺶ ﻣﻌﻴﺸﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﱵ ﲤﻜﻨﻬﻢ ﻣﻦ ﺍﻟﻠﻌﺐ‬
‫ﻭﺍﻻﺳﺘﻤﺘﺎﻉ‪.‬‬
‫ﻭﻗﺪ ﲝﺚ ‪ Abdel-Gawad, 1997‬ﺍﻟﻌﻼﻗﺔ ﺑﲔ ﺍﻟﺮﺿﺎ ﺍﻟﻨﺎﺗﺞ ﻋﻦ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺘﻔﺎﻋﻞ ﺍﻟﻨﻔﺴﻲ‪ ،‬ﻟﻴﺠﺪ‬
‫ﺃﻥ ﻫﺬﺍ ﺍﻟﺮﺿﺎ ﻫﻮ ﻧﺘﻴﺠﺔ ﲢﻮﻝ ﻧﻈﺮﺓ ﺍﻟﻄﻔﻞ ﻟﻠﻌﻤﻞ ﻭﻗﻴﻤﺘﻪ‪ .‬ﻭﻫﺬﺍ ﻧﺘﻴﺠﺔ ﻟﻠﻤﺘﻐﲑﺍﺕ ﺍﳌﺨﺘﻠﻔﺔ‬
‫ﺍﳌﺘﺼﻠﺔ ﺑﺎﻟﺒﻴﺌﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ ﺍﶈﻴﻄﺔ ﺑﺎﻟﻌﻤﻞ ﻭﺍﻟﻌﻼﻗﺔ ﺑﺎﻟﺰﻣﻼﺀ ﻭﺃﺻﺤﺎﺏ ﺍﻟﻌﻤﻞ ﻭﺍﻷﺟﺮ ﻭﻧﻮﻉ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﻛﻤﺎ ﻳﺘﺄﺛﺮ ﺍﻟﺮﺿﺎ ﺍﻟﻨﺎﺗﺞ ﻋﻦ ﺍﻟﻌﻤﻞ ﺑﺒﻌﺾ ﺍﳌﺘﻐﲑﺍﺕ ﺍﻟﺜﻘﺎﻓﻴﺔ ﻭﺍﻟﺘﺮﺑﻮﻳﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ‬
‫ﻭﺃﻳﻀﺎﹰ ﺍﻟﻨﻔﺴﻴﺔ‪ .‬ﻭﻗﺪ ﺍﺳﺘﺨﺪﻡ ‪ Abdel-Gawad‬ﻧﻔﺲ ﻣﻘﺎﻳﻴﺲ ﺍﻟﺘﻔﺎﻋﻞ ﺍﻟﺬﺍﰐ ﻭﺍﻟﻨﻔﺴﻲ ﺍﻟﱵ‬
‫ﺃﺭﺳﺎﻫﺎ ‪ .Ramzi‬ﺇﺫ ﺃﻭﺿﺤﺖ ﺍﻟﺪﺭﺍﺳﺔ ﻭﺟﻮﺩ ﻋﻼﻗﺔ ﻣﺘﻮﺳﻄﺔ ﺑﲔ ﺍﻟﺮﺿﺎ ﺍﻟﻨﺎﺗﺞ ﻋﻦ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺘﻔﺎﻋﻞ‬
‫ﺍﻟﻨﻔﺴﻲ ﰲ ﺃﺑﻌﺎﺩﻩ ﺍﻟﺬﺍﺗﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪.‬‬

‫‪ 45)' 6‬‬

‫ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﺍﻟﱵ ﻳﻌﺎﱐ ﻣﻨﻬﺎ ﺍﻷﻃﻔﺎﻝ‬
‫ﻫﻨﺎﻙ ﳎﺎﻻﺕ ﳏﺪﺩﺓ ﳚﺐ ﻋﻠﻲ ﺍﳊﻜﻮﻣﺔ ﻭﻛﻞ ﺍﻷﻃﺮﺍﻑ ﺍﳌﻌﻨﻴﺔ ﻭﺿﻌﻬﺎ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﻋﻨﺪ ﻭﺿﻊ‬
‫ﺍﻟﺴﻴﺎﺳﺎﺕ‪:‬‬
‫
ﻋﺪﻡ ﺍﻻﻋﺘﻤﺎﺩ ﻛﻠﻴﺎ ﻋﻠﻲ ﺍﻟﻨﻈﻢ ﺍﻟﺘﻘﻠﻴﺪﻳﺔ ﰲ ﺍﻟﺘﺴﺠﻴﻞ ﻭﺍﻹﺣﺼﺎﺀ‪ ،‬ﻭﻟﻜﻦ ﳚﺐ ﺩﻋﻢ ﻫﺬﻩ‬
‫ﺍﻹﺣﺼﺎﺋﻴﺎﺕ ﲟﺴﻮﺡ ﻣﻴﺪﺍﻧﻴﺔ ﰲ ﺇﻃﺎﺭ ﺳﻴﺎﺳﺔ ﲝﺜﻴﺔ ﻗﻮﻣﻴﺔ‪.‬‬
‫
ﺗﻘﻠﻴﻞ ﺍﻟﻔﺠﻮﺓ ﰲ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻃﻔﺎﻝ ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭﺑﲔ ﳏﺎﻓﻈﺎﺕ‬
‫ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ ﻭﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‪.‬‬
‫
ﻣﺎﺯﺍﻟﺖ ﻣﺸﺎﻛﻞ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﺑﲔ ﺍﻷﻃﻔﺎﻝ ﻣﻨﺘﺸﺮﺓ ﻭﳚﺐ ﻋﻠﻲ ﲨﻴﻊ ﺍﳉﻬﺎﺕ ﻭﺍﻟﻮﺯﺍﺭﺍﺕ‬
‫ﺍﳌﻌﻨﻴﺔ ﺍﻟﺘﺼﺪﻱ ﳍﺎ ﺑﺴﻴﺎﺳﺔ ﻣﺘﻜﺎﻣﻠﺔ‪ .‬ﻫﺬﺍ ﳚﺐ ﺃﻥ ﻳﺘﻀﻤﻦ ﺳﻴﺎﺳﺔ ﻟﻸﻣﻦ ﺍﻟﻐﺬﺍﺋﻲ‪ ،‬ﺑﺮﺍﻣﺞ‬
‫ﺗﺪﻋﻴﻤﻴﺔ ﳌﻨﻊ ﻭﻋﻼﺝ ﺃﻣﺮﺍﺽ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻨﺎﲡﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ‪ ،‬ﻭﻣﻮﺍﺟﻬﺔ ﺍﻷﺳﺎﻟﻴﺐ‬
‫ﺍﻟﻐﺬﺍﺋﻴﺔ ﺍﳋﺎﻃﺌﺔ‪.‬‬
‫
ﺍﻟﻌﻤﻞ ﻋﻠﻲ ﺗﻜﺜﻴﻒ ﺟﻬﻮﺩ ﺍﳌﻨﻈﻤﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ ﰲ ﺍﻟﺘﺼﺪﻱ ﻟﺒﻌﺾ ﺍﳌﺸﺎﻛﻞ ﻭﺧﺎﺻﺔ ﰲ‬
‫ﺍﻷﻣﺎﻛﻦ ﺍﶈﺮﻭﻣﺔ ﻣﺜﻞ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪ ،‬ﻭﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‪ ،‬ﻭﺍﳌﻨﺎﻃﻖ ﺍﻟﻌﺸﻮﺍﺋﻴﺔ‬
‫ﻭﺍﶈﺮﻭﻣﺔ‪.‬‬

‫ﺳﻴﺎﺳﺔ ﺍﻹﻋﺎﻗﺔ ﺑﺪﺍﺧﻞ ﻣﻔﻬﻮﻡ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ‬

‫ﺍﻟﻮﺳﺎﺋﻞ ﺍﳌﻘﺘﺮﺣﺔ ﻟﻌﻼﺝ ﺍﻟﻘﻀﻴﺔ ﻭﺑﻨﺎﺀ ﻋﻠﻰ ﺍﻻﺣﺘﻤﺎﻻﺕ ﺍﻹﳚﺎﺑﻴﺔ ﺍﻟﱵ ﰎ ﺗﻄﻮﻳﺮﻫﺎ ﺧﻼﻝ ﺍﻟﺴﻨﻮﺍﺕ‬
‫ﺍﳌﺎﺿﻴﺔ‪ ،‬ﻓﻘﺪ ﺭﻛﺰ ﺍﻟﺘﺤﻠﻴﻞ ﻋﻠﻰ ﺍﶈﺎﻭﺭ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫
ﺗﻜﻮﻳﻦ ﺭﺅﻳﺔ ﻗﻮﻣﻴﺔ ﻣﻮﺣﺪﺓ ﻭﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﻟﻌﻼﺝ ﻗﻀﻴﺔ ﺍﻹﻋﺎﻗﺔ ﻋﺎﻣﺔ‪ ،‬ﻭﻗﻀﻴﺔ ﺇﻋﺎﻗﺔ ﺍﻷﻃﻔﺎﻝ‬
‫ﺑﺸﻜﻞ ﺧﺎﺹ‪ ،‬ﻗﺎﺋﻤﺔ ﻋﻠﻰ ﻣﻔﺎﻫﻴﻢ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﻭﲪﺎﻳﺔ ﺍﻟﻄﻔﻞ ﻣﻊ ﺇﺩﻣﺎﺝ ﻃﺎﻗﺎﺕ‬
‫ﺍﻷﻓﺮﺍﺩ ﺍﳌﻌﺎﻗﲔ ﻭﺃﺳﺮﻫﻢ‪.‬‬

‫‪٢٣٦‬‬
 ‫
ﺗﺸﺠﻴﻊ ﺍﻟﺘﺄﻫﻴﻞ ﺍﳌﺮﺗﻜﺰ ﻋﻠﻲ ﺍ‪‬ﺘﻤﻊ ﳌﻌﺎﳉﺔ ﺍﻟﻘﻀﻴﺔ ﺑﺪﺍﺧﻞ ﺇﻃﺎﺭ ﺗﻨﻤﻴﺔ ﺍ‪‬ﺘﻤﻊ ﺑﺄﻛﻤﻠﻪ‪.‬‬
‫
ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﺘﺠﻤﻴﻊ ﻭﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﺍﳌﻘﺘﺮﺣﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﺍﻟﻘﺎﺋﻤﺔ ﻋﻠﻰ ﺗﻜﺮﺍﺭ ﻭﺍﻣﺘﺪﺍﺩ ﺍﳋﱪﺍﺕ‬
‫ﺍﻹﳚﺎﺑﻴﺔ ﻟﻠﻨﻤﺎﺫﺝ ﺍﻟﻨﺎﺟﺤﺔ ﺍﻟﻜﺜﲑﺓ‪ ،‬ﻓﻀﻼﹰ ﻋﻦ ﺑﻨﺎﺀ ﳕﺎﺫﺝ ﺟﺪﻳﺪﺓ‪.‬‬

‫ﺳﻴﺎﺳﺔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺑﺪﺍﺧﻞ ﻣﻔﻬﻮﻡ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ‬

‫ﺗﺸﲑ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﺴﺎﺑﻘﺔ ﻟﻘﻀﻴﺔ ﻋﻤﻞ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ‪ ،‬ﺇﱃ ﺃﻥ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻫﻲ ﰲ ﺍﻷﺳﺎﺱ‬
‫ﻭﺟﻪ ﻭﺍﺣﺪ ﻣﻦ ﺃﻭﺟﻪ ﺍﳊﺮﻣﺎﻥ ﺍﻟﻌﺪﻳﺪﺓ ﺍﻟﱵ ﻳﺘﻌﺮﺽ ﳍﺎ ﺍﻟﻄﻔﻞ‪ .‬ﻓﻘﺪ ﻛﺸﻔﺖ ﻧﺘﺎﺋﺞ ﺍﻟﺒﺤﻮﺙ ﺃﻥ‬
‫ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﺮﺋﻴﺴﻴﺔ ﺍﳌﺆﺩﻳﺔ ﺇﱃ ﻋﻤﺎﻟﺔ ﺍﻟﻄﻔﻞ ﻫﻲ ﰲ ﺗﻌﺎﺭﺽ ﻣﻊ ﺣﻖ ﺍﻟﻄﻔﻞ ﰲ ﺍﻟﻌﻴﺶ ﰲ ﻣﺴﺘﻮﻯ‬
‫ﻣﻼﺋﻢ )ﺑﻨﺪ ‪ .(CRC ٢٨‬ﻭﻏﺎﻟﺒﺎ ﻣﺎ ﺗﺰﻳﺪ ﻋﻤﺎﻟﺔ ﺍﻟﻄﻔﻞ ﻓﺮﺹ ﺍﻟﺘﻌﺮﺽ ﻟﻼﺳﺘﻐﻼﻝ ﻭ‪/‬ﺃﻭ ﺍﻟﺘﻌﺮﺽ ﻷﻋﻤﺎﻝ‬
‫ﺧﻄﺮﺓ‪ ،‬ﺍﻟﱵ ﳝﻜﻦ ﺃﻥ ﺗﻜﻮﻥ ﺿﺎﺭﺓ ﻷﻣﻦ ﺍﻟﻄﻔﻞ ﻭﺻﺎﳊﻪ‪ .‬ﺇﻥ ﻣﻀﻤﻨﺎﺕ ﻣﻔﺎﻫﻴﻢ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ‬
‫ﻭﺍﻻﻗﺘﺮﺍﺏ ﻣﻦ ﻣﻌﺎﳉﺔ ﻗﻀﻴﺔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺳﻮﻑ ﻳﺴﺘﻠﺰﻡ ﺳﻴﺎﺳﺔ ﺷﺎﻣﻠﺔ ﺗﺴﻌﻰ ﻟﺘﺤﻘﻴﻖ‬
‫ﻫﺪﻓﲔ‪:‬‬
‫
ﻣﻌﺎﳉﺔ ﺍﳌﻮﻗﻒ ﺍﻟﺮﺍﻫﻦ ﺍﻟﺬﻱ ﻳﺸﲑ ﺇﱃ ﻭﺟﻮﺩ ﺃﻋﺪﺍﺩ ﻛﺒﲑﺓ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺍﻟﺸﺎﻏﻠﲔ‬
‫ﻭﻇﺎﺋﻒ ﳐﺘﻠﻔﺔ ﰲ ﻛﻞ ﻣﻦ ﺍﳌﻨﺎﻃﻖ ﺍﳊﻀﺮﻳﺔ ﻭﺍﻟﺰﺭﺍﻋﻴﺔ‪ ،‬ﺑﺪﻭﻥ ﲪﺎﻳﺔ ﻛﺎﻓﻴﺔ‪.‬‬
‫
ﺍﻟﺘﻮﺟﻪ ﺇﱃ ﺍﻷﺳﺒﺎﺏ ﺍﳉﺬﺭﻳﺔ ﻟﻌﻤﺎﻟﺔ ﺍﻟﻄﻔﻞ‪ ،‬ﻭﻧﻘﺼﺪ ﺑﺬﻟﻚ ﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺴﺒﺒﺔ ﺍﻟﱵ ﺗﻨﺘﻬﻚ‬
‫ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺗﺴﺎﻫﻢ ﰲ ﺍﻟﺘﺪﻓﻖ ﺍﳌﺴﺘﻤﺮ ﻟﻸﻋﺪﺍﺩ ﺍﳉﺪﻳﺪﺓ ﻣﻦ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪.‬‬
‫ﻭﳝﻜﻦ ﻣﻌﺎﳉﺔ ﻇﺎﻫﺮﺓ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻋﻠﻲ ﻣﺮﺣﻠﺘﲔ‪ ،‬ﻣﺮﺣﻠﺔ ﺍﻧﺘﻘﺎﻟﻴﺔ ﻭﻣﺮﺣﻠﺔ ﺑﻌﻴﺪﺓ ﺍﳌﺪﻯ‪.‬‬

‫ﺍﳌﺮﺣﻠﺔ ﺍﻻﻧﺘﻘﺎﻟﻴﺔ ﰲ ﲪﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‬

‫ﻛﺸﻔﺖ ﺍﳋﱪﺍﺕ ﺍﳌﻘﺎﺭﻧﺔ ﰲ ﺍﻟﺒﻠﺪﺍﻥ ﺍﳌﺨﺘﻠﻔﺔ ﺃﻥ ﳏﺎﻭﻻﺕ ﺍﻟﺘﺨﻠﺺ ﻣﻦ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺑﺎﻟﻘﻮﺓ ﻭﺍﳌﻨﻊ‬
‫ﻗﺪ ﻓﺸﻠﺖ‪ .‬ﻭﰲ ﺑﻌﺾ ﺍﳊﺎﻻﺕ‪ ،‬ﻣﺜﻼﹰ ﰲ ﺑﻨﺠﻼﺩﺵ‪ ،‬ﺗﻌﺮﺽ ﺍﻷﻃﻔﺎﻝ ﻷﺷﻜﺎﻝ ﻣﺘﻄﺮﻓﺔ ﻣﻦ ﺍﳊﺮﻣﺎﻥ‬
‫ﻭﺍﻻﺳﺘﻐﻼﻝ‪ .‬ﺇﻻ ﺇﻧﻪ ﺑﺎﻟﻨﻈﺮ ﺇﱃ ﺍﻟﻄﺒﻴﻌﺔ ﺍﳌﻌﻘﺪﺓ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻳﻜﻮﻥ ﻣﻦ ﺍﳌﻨﻄﻘﻲ ﺗﻮﻗﻊ‬
‫ﺍﺳﺘﻤﺮﺍﺭﻫﺎ ﻃﺎﳌﺎ ﺍﺳﺘﻤﺮﺕ ﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺆﺩﻳﺔ ﺇﱃ ﺑﻘﺎﺋﻬﺎ‪ .‬ﻭﰲ ﺧﻼﻝ ﺍﳌﺮﺣﻠﺔ ﺍﻻﻧﺘﻘﺎﻟﻴﺔ‪ ،‬ﻻ ﳝﻜﻦ ﲡﺎﻫﻞ‬
‫ﺍﳌﻮﻗﻒ ﺍﳊﺎﱄ ﻟﻸﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪ ،‬ﻭﻫﺬﺍ ﻳﺪﻋﻮ ﺇﱃ ﺃﺧﺬ ﺑﻌﲔ ﺍﻻﻋﺘﺒﺎﺭ ﻣﺎ ﻳﻠﻲ ﰲ ﺗﻠﻚ ﺍﻟﺴﻴﺎﺳﺔ‪:‬‬
‫‪ .١‬ﺍﳊﻤﺎﻳﺔ ﺍﻟﻘﺎﻧﻮﻧﻴﺔ‪ :‬ﻛﻤﺎ ﺳﺒﻖ ﺃﻥ ﺫﻛﺮﻧﺎ‪ ،‬ﻳﻮﺟﺪ ﻣﺒﺎﺩﺉ ﻗﺎﻧﻮﻧﻴﺔ ﲤﻨﻊ ﻋﻤﻞ ﺍﻟﻄﻔﻞ ﻗﺒﻞ ﺳﻦ‬
‫‪ ١٤‬ﻋﺎﻣﺎﹰ ﲜﺎﻧﺐ ﻣﻨﻊ ﺷﻐﻠﻪ ﰲ ﺍﻟﻮﻇﺎﺋﻒ ﺍﳋﻄﲑﺓ ﺣﱴ ﺳﻦ ﺍﻟـ ‪ ١٧‬ﻋﺎﻣﺎ‪ .‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺷﺮﻁ‬
‫ﲪﺎﻳﺘﻪ ﻣﻦ ﻇﺮﻭﻑ ﺍﻟﻌﻤﻞ ﺍﳋﻄﲑﺓ ﻭﺍﻟﻀﺎﺭﺓ‪ .‬ﺇﻻ ﺃﻥ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺍﳌﺆﺩﻳﺔ‬
‫ﻟﻌﻤﺎﻟﺔ ﺍﻟﻄﻔﻞ ﻣﻨﺘﺸﺮﺓ ﻭﻣ‪‬ﺒﻄﻠﺔ ﻟﻔﺎﻋﻠﻴﺔ ﺍﳊﻤﺎﻳﺔ ﺍﻟﻘﺎﻧﻮﻧﻴﺔ‪.‬‬
‫‪ .٢‬ﺍﻟﺼﺤﺔ ﻭﺍﻷﻣﻦ ﺍﻟﺼﻨﺎﻋﻲ‪ :‬ﻳﺘﻢ ﺗﻨﻈﻴﻤﻪ ﺑﻘﺎﻧﻮﻥ ﻭﺃﻥ ﻳﻜﻮﻥ ﻣﻀﻤﻮﻧﺎﹰ ﻣﻦ ﺧﻼﻝ ﻣﻔﺘﺸﲔ‬
‫ﻋﻠﻰ ﺍﻟﻌﻤﺎﻟﺔ ﻣﻌﻴﻨﲔ ﻣﻦ ﻗِﺒﻞ ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﳍﺠﺮﺓ )‪ .(MOMM‬ﺇﻻ ﺃﻥ ﻋﻤﻠﻴﺔ‬
‫ﺍﻟﺘﻔﺘﻴﺶ ﻏﲑ ﻣﻨﺘﻈﻤﺔ ﻭﻟﻴﺲ ﳍﺎ ﺃﻱ ﺃﺛﺮ‪ ،‬ﲜﺎﻧﺐ ﺃ‪‬ﺎ ﻻ ﺗﺘﻀﻤﻦ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺰﺭﺍﻋﻲ‪ .‬ﻟﺬﻟﻚ ﳚﺐ‬
‫ﺗﺼﻮﺭ ﺩﻭﺭ ﺟﺪﻳﺪ ﻟﻠﻤﻔﺘﺸﲔ ﺧﻼﻝ ﺍﳌﺮﺣﻠﺔ ﺍﻻﻧﺘﻘﺎﻟﻴﺔ‪ ،‬ﺇﺫ ﺇﻥ ﺩﻭﺭ ﺍﳌﻔﺘﺸﲔ ﳚﺐ ﺃﻥ ﻳﻜﻮﻥ ﺃﻗﺮﺏ ﺇﱃ‬
‫ﺷﺨﺺ ﻭﺍﺳﻊ ﺍﻷﻓﻖ‪ ،‬ﻣ‪‬ﻨﻈﻢ ﻟﻠﺠﻤﺎﻋﺔ ﻭﻗﺎﺩﺭ ﻋﻠﻰ ﺍﻟﻘﻴﺎﻡ ﺑﻌﻤﻞ ﺗﺮﺑﻮﻱ‪ ،‬ﻛﻤﺎ ﺗﻮﻓﺮ ﺍﻟﱪﺍﺯﻳﻞ‬
‫ﲪﺎﻳﺔ ﳏﻠﻴﺔ ﻣﻦ ﺧﻼﻝ ﳎﺎﻟﺲ ﲪﺎﻳﺔ ﺍﻟﻄﻔﻞ )‪.(Bequele and Myers, 1995‬‬

‫‪٢٣٧‬‬
‫‪ .٣‬ﺑﺮﺍﻣﺞ ﲡﻤﻊ ﺑﲔ ﺍﳊﻤﺎﻳﺔ ﻭﺍﻟﺘﻨﻤﻴﺔ‪ :‬ﺇﺫ ﺇﻥ ﺍﳍﺪﻑ ﺍﻟﺬﻱ ﻳﺴﻌﻰ ﺇﻟﻴﻪ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ‬
‫ﻫﻮ ﺿﻤﺎﻥ ﺍﻟﺘﻨﻤﻴﺔ ﺍﳌﺘﺠﺎﻧﺴﺔ ﻟﻜﻞ ﻃﻔﻞ‪ .‬ﻟﺬﻟﻚ ﳚﺐ ﺃﻥ ﺗﺘﻀﻤﻦ ﺍﻟﱪﺍﻣﺞ ﺍﳋﺎﺻﺔ ﲝﻤﺎﻳﺔ‬
‫ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻋﻨﺼﺮ ﺍﻟﺘﻨﻤﻴﺔ‪ .‬ﺍﻋﺘﻤﺎﺩﺍ ﻋﻠﻲ ﻫﺬﺍ ﺍﳌﺒﺪﺃ‪ ،‬ﻓﻘﺪ ﺃﺳﺲ ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ‬
‫ﻟﻠﻄﻔﻮﻟﺔ ﻭﺍﻷﻣﻮﻣﺔ‪ NCCM‬ﻣﺸﺮﻭﻋﺎ ﺷﺎﻣﻼﹰ ﰲ ﻣﺪﻳﻨﺔ ﺍﳊﺮﻓﻴﲔ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﻣﺸﺮﻭﻋﲔ‬
‫ﺁﺧﺮﻳﻦ ﺃﻧﺸﺄ‪‬ﻤﺎ ﺍﻟﻴﻮﻧﺴﻴﻒ )ﰲ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ( ﻭﻣﻨﻈﻤﺔ ﺍﻟﻌﻤﻞ ﺍﻟﺪﻭﻟﻴﺔ )‪) (ILO‬ﰲ ﺷﱪﺍ‬
‫ﺍﳋﻴﻤﺔ(‪ .‬ﻟﺬﻟﻚ ﳚﺐ ﺗﻘﻴﻴﻢ ﺗﻠﻚ ﺍﳌﺸﺮﻭﻋﺎﺕ ﺍﻟﻨﺎﺟﺤﺔ ﺍﻟﺮﺍﺋﺪﺓ ﻭﺗﻘﺪﱘ ﳕﺎﺫﺝ ﳑﺎﺛﻠﺔ ﳍﺎ‪ .‬ﻫﺬﺍ ﻭﻗﺪ‬
‫ﻭﻗﻌﺖ ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﳍﺠﺮﺓ ‪ MOMM‬ﺍﺗﻔﺎﻗﻴﺔ ﻣﻊ ﻣﻨﻈﻤﺔ ﺍﻟﻌﻤﻞ ﺍﻟﺪﻭﻟﻴﺔ ‪IPEC-‬‬
‫‪ ILO‬ﰲ ‪ ١٩٩٦‬ﻹﻧﺸﺎﺀ ﺑﺮﺍﻣﺞ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ‪ ،‬ﻭﻟﻜﻦ ﺣﱴ ﺍﻵﻥ ﱂ ﻳﺘﱭ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ‬
‫ﺳﻴﺎﺳﺔ ﺷﺎﻣﻠﺔ ﶈﺎﺭﺑﺔ ﺃﻭ ﺍﻟﻘﻀﺎﺀ ﻋﻠﻰ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪.‬‬
‫ﻛﻤﺎ ﺃﻥ ﻫﻨﺎﻙ ﻣﻮﺿﻮﻋﺎﺕ ﻋﺪﺓ ﳚﺐ ﺁﺧﺬﻫﺎ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﻋﻨﺪ ﺭﺳﻢ ﺍﻟﺴﻴﺎﺳﺔ ﺍﳋﺎﺻﺔ ﺑﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪:‬‬
‫
ﻓﻄﺒﻘﺎﹰ ﳌﻴﺜﺎﻕ ﻣﻨﻈﻤﺔ ﺍﻟﻌﻤﻞ ﺍﻟﺪﻭﻟﻴﺔ )‪ (ILO‬ﺭﻗﻢ ‪ ،١٩٩٩/١٨٢‬ﳚﺐ ﻋﺪﻡ ﺇِﺟﺎﺯﺓ ﺍﻷﺷﻐﺎﻝ‬
‫ﺍﳋﻄﺮﺓ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺗﻮﻓﲑ ﺑﺪﺍﺋﻞ ﻟﻠﻄﻔﻞ ﻭﺍﻷﺳﺮﺓ ﻣﺜﻞ ﺍﳉﻤﻊ ﺑﲔ ﺍﻟﻔﺮﺹ‬
‫ﺍﻟﺘﺪﺭﻳﺒﻴﺔ ﻭﺍﻟﺘﺮﺑﻮﻳﺔ‪ ،‬ﻭﺗﻮﻓﲑ ﻣﺎ ﻳﻀﻤﻦ ﻟﻸﺟﻴﺎﻝ ﺍﻟﻘﺎﺩﻣﺔ ﺑﺪﺍﺋﻞ ﻟﻌﻤﻞ ﺍﻷﻃﻔﺎﻝ‪.‬‬
‫
ﻛﺬﻟﻚ ﻳﺘﻢ ﺗﻮﻓﲑ ﺩﻭﺭﺍﺕ ﺗﺪﺭﻳﺐ ﻣﻬﲏ ﻟﻸﻃﻔﺎﻝ ﺍﳌﺘﺴﺮﺑﲔ ﻣﻦ ﺍﳌﺪﺍﺭﺱ ﻣﻦ ﺧﻼﻝ ‪ ٥٦‬ﻣﺮﻛﺰﺍﹰ ﲢﺖ‬
‫ﺇﺷﺮﺍﻑ ﻭﺯﺍﺭﺓ ﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ ،‬ﺇﻻ ﺃﻥ ﺍﻟﺘﺪﺭﻳﺐ ﻳﻘﺘﺼﺮ ﻋﻠﻰ ﺍﻷﻋﻤﺎﻝ ﺍﻟﺘﻘﻠﻴﺪﻳﺔ ﻣﺜﻞ ﺍﻟﻨﺠﺎﺭﺓ‬
‫ﻭﺍﻟﻠﺤﺎﻡ ﻭﺍﻟﻨﺴﻴﺞ‪ ...‬ﺍﱁ‪ ،‬ﻋﻠﻰ ﺃﻥ ﻳﺘﻢ ﺍﻟﺘﻮﺳﻊ ﰲ ﺍﻟﱪﺍﻣﺞ ﺍﳌﻬﻨﻴﺔ ﻟﺘﻮﻓﺮ ﻓﺮﺹ ﺗﺪﺭﻳﺐ ﻟﻸﻃﻔﺎﻝ‬
‫ﺍﻟﻌﺎﻣﻠﲔ ﻭﻹﻋﺎﺩﺓ ﺗﻮﻇﻴﻒ ﻫﺆﻻﺀ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺃﻋﻤﺎﻝ ﺧﻄﲑﺓ ﻷﻋﻤﺎﻝ ﺃﻛﺜﺮ ﺃﻣﻨﺎﹰ ﻭﻣﻼﺀﻣﺔ‬
‫)ﳎﻤﻮﻋﺔ ﻋﻤﻞ ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﳍﺠﺮﺓ ‪ MOMM‬ﲞﺼﻮﺹ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ(‪.‬‬
‫
ﻭﰲ ﺍﻟﻮﻗﺖ ﺍﳊﺎﱄ‪ ،‬ﻳﺘﻢ ﺣﺮﻣﺎﻥ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻟﻘﺎﺻﺮ ﻋﻠﻰ ﺍﻷﻃﻔﺎﻝ‬
‫ﺍﳌﻠﺘﺤﻘﲔ ﺑﺎﳌﺪﺍﺭﺱ‪ .‬ﻟﺬﻟﻚ ﳚﺐ ﻋﻠﻲ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﻮﺍﻗﻌﻴﺔ ﺍﳌﺘﺪﺭﺟﺔ ﻭﺍﳌﺘﻘﺪﻣﺔ ﰲ ﺍﻟﺘﺨﻠﺺ ﻣﻦ‬
‫ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻣﻊ ﻋﺪﻡ ﺇﻏﻔﺎﻝ ﺗﻮﻓﲑ ﺍﳊﻤﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺧﻼﻝ ﺍﳌﺮﺣﻠﺔ‬
‫ﺍﻻﻧﺘﻘﺎﻟﻴﺔ‪.‬‬
‫
ﻛﺬﻟﻚ ﳚﺐ ﺇﻧﺸﺎﺀ ﻧﻈﺎﻡ ﻣﺮﺍﻗﺒﺔ ﳌﻨﻊ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﻭﲪﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ‬
‫ﺍﳌﻨﻄﻘﺔ ﺍﶈﻠﻴﺔ‪ .‬ﻓﻘﺪ ﰎ ﺇﻧﺸﺎﺀ ﻣﺸﺮﻭﻉ ﺍﺳﺘﻜﺸﺎﰲ ﳌﺮﺍﻗﺒﺔ ﺍﻷﻃﻔﺎﻝ ﺍﳌﻌﺮﺿﲔ ﳌﺨﺎﻃﺮ ﺍﻟﻌﻤﻞ‬
‫ﻭﺫﻟﻚ ﲢﺖ ﺇﺷﺮﺍﻑ ﺍﳍﻼﻝ ﺍﻷﲪﺮ ﻭﲨﻌﻴﺔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﳌﺘﻜﺎﻣﻠﺔ‪.‬‬

‫ﺳﻴﺎﺳﺔ ﺑﻌﻴﺪﺓ ﺍﳌﺪﻯ‬

‫ﺇﻥ ﺍﳌﺮﺣﻠﺔ ﺍﻻﻧﺘﻘﺎﻟﻴﺔ ﻭﺍﳋﻄﻮﺍﺕ ﺍﻟﻼﺯﻣﺔ ﳊﻤﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺿﺮﻭﺭﻳﺎﻥ ﳌﻌﺎﳉﺔ ﺍﻟﻮﺿﻊ ﺍﻟﺮﺍﻫﻦ‪ ،‬ﺇﻻ‬
‫ﺃﻥ ﻫﺬﻩ ﺍﳋﻄﻮﺍﺕ ﻻ ﺗﺘﻌﺎﻣﻞ ﻣﻊ ﺍﻷﺳﺒﺎﺏ ﺍﳉﺬﺭﻳﺔ ﺍﻟﱵ ﺗﺴﺎﻫﻢ ﰲ ﺍﺳﺘﻤﺮﺍﺭﻳﺔ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻟﺬﺍ ﻓﺈﻥ‬
‫ﺍﻟﺘﻔﻬﻢ ﺍﳊﻘﻴﻘﻲ ﳌﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﻳﺴﺘﻠﺰﻡ ﺗﺒﲏ ﳕﻮﺫﺝ ﻟﻠﺘﻨﻤﻴﺔ ﻋﻦ ﺗﺒﲏ ﳕﻮﺫﺝ ﺛﺎﻧﻮﻱ ﺍﺟﺘﻤﺎﻋﻲ‪.‬‬
‫ﺇﻥ ﲪﺎﻳﺔ ﺍﻟﻄﻔﻞ ﻻ ﺗﻘﺘﺼﺮ ﻋﻠﻰ ﺍﻟﻮﻗﺎﻳﺔ ﻭﻣﻌﺎﳉﺔ ﻟﻜﻞ ﺃﺷﻜﺎﻝ "ﺍﻷﺫﻯ" ﺍﻟﱵ ﺗﻘﻊ ﻋﻠﻰ ﺍﻷﻃﻔﺎﻝ‪ .‬ﺫﻟﻚ‬
‫ﻷﻥ ﺍﳊﻤﺎﻳﺔ‪ ،‬ﻛﻤﺎ ﻳﺮﺍﻫﺎ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ‪ ،‬ﻫﻲ ﲪﺎﻳﺔ ﳊﻘﻮﻕ ﺍﻟﻄﻔﻞ‪ ،‬ﻭﻫﻲ ﺑﺬﻟﻚ ﺗﺴﻬﻢ ﰲ ﺗﻨﻤﻴﺔ‬

‫‪٢٣٨‬‬
‫ﺍﻷﻃﻔﺎﻝ ﺍﶈﺮﻭﻣﲔ ﻭﺍﳌﻌﺬﺑﲔ‪ .‬ﰲ ﻧﻄﺎﻕ ﻫﺬﻩ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ‪ ،‬ﻫﻨﺎﻙ ﺑﻌﺾ ﺍﻟﻘﻀﺎﻳﺎ ﳚﺐ ﺃﻥ ﺗﺆﺧﺬ ﰲ‬
‫ﺍﻻﻋﺘﺒﺎﺭ ﻋﻨﺪ ﺭﺳﻢ ﺍﻟﺴﻴﺎﺳﺔ‪.‬‬
‫‪ (١‬ﺍﻟﺘﻮﺟﻴﻪ ﻭﺍﳌﺴﺎﻋﺪﺓ ﺍﻟﺘﻘﻨﻴﺔ ﰲ ﺗﺮﺑﻴﺔ ﺍﻟﻄﻔﻞ‬
‫
ﺃﺩﺭﻙ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﺍﳌﺒﺪﺃ ﺍﳋﺎﺹ ﺑﺄﻥ ﻛﻼ ﻣﻦ ﺍﻷﺑﻮﻳﻦ ﻟﺪﻳﻬﻤﺎ ﻣﺴﺌﻮﻟﻴﺎﺕ ﻣﺸﺘﺮﻛﺔ ﰲ‬
‫ﺗﺮﺑﻴﺔ ﺍﻟﻄﻔﻞ ﻭﺗﻨﻤﻴﺘﻪ‪ ،‬ﻭﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ ﳝﻜﻦ ﺃﻥ ﻳﻜﻮﻥ ﺍﻵﺑﺎﺀ ﻏﲑ ﻗﺎﺩﺭﻳﻦ ﻋﻠﻰ ﺃﺩﺍﺀ‬
‫ﻣﺴﺌﻮﻟﻴﺘﻬﻢ ﺑﺎﻟﺸﻜﻞ ﺍﻟﻜﺎﰲ‪ .‬ﻟﺬﻟﻚ ﻓﻌﻠﻰ ﺃﺣﺰﺍﺏ ﺍﻟﺪﻭﻟﺔ ﰲ ﺗﻠﻚ ﺍﻷﺣﻴﺎﻥ ﺃﻥ ﺗﻘﺪﻡ ﺍﳌﺴﺎﻋﺪﺓ‬
‫ﺍﳌﻨﺎﺳﺒﺔ ﻟﻶﺑﺎﺀ ﻭﺃﻭﻟﻴﺎﺀ ﺍﻷﻣﻮﺭ ﰲ ﺃﺩﺍﺀ ﻣﺴﺌﻮﻟﻴﺘﻬﻢ ﰲ ﺗﺮﺑﻴﺔ ﺍﻟﻄﻔﻞ‪ ،‬ﻛﺬﻟﻚ ﳚﺐ ﺿﻤﺎﻥ ﺗﻨﻤﻴﺔ‬
‫ﺍﳌﺆﺳﺴﺎﺕ ﻭﺍﻟﺘﺴﻬﻴﻼﺕ ﻭﺍﳋﺪﻣﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺮﻋﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ )ﺑﻨﺪ ‪(١٨‬‬
‫
ﻭﻳﻘﺪﻡ ﰲ ﺍﻟﻮﻗﺖ ﺍﳊﺎﺿﺮ ‪ ٩٣‬ﻣﻜﺘﺒﺎﹰ ﻟﻠﻤﺸﻮﺭﺓ ﻭﺍﳌﺴﺎﻋﺪﺓ ﺍﻷﺳﺮﻳﺔ ﲢﺖ ﺭﻋﺎﻳﺔ ﻭﺯﺍﺭﺓ ﺍﻟﺸﺌﻮﻥ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ )‪ (MOSA‬ﺍﻟﻨﺼﻴﺤﺔ ﻭﺍﳌﺴﺎﻋﺪﺓ ﻟﻠﻌﺎﺋﻼﺕ ﳊﻞ ﻣﺸﺎﻛﻠﻬﻢ ﻭﺧﻼﻓﺎ‪‬ﻢ‪ .‬ﻭﲣﺘﺺ‬
‫ﺃﻏﻠﺐ ﺍﳊﺎﻻﺕ ﺑﺎﳋﻼﻓﺎﺕ ﺍﻷﺳﺮﻳﺔ ﻭﺍﻟﱰﺍﻋﺎﺕ ﺍﳌﺪﻧﻴﺔ‪ ،‬ﻭﻟﻜﻦ ﻻ ﻳﻘﺪﻡ ﺃﻱ ﻣﺸﻮﺭﺓ ﺃﻭ ﻣﺴﺎﻋﺪﺓ ﰲ‬
‫ﺗﺮﺑﻴﺔ ﺍﻷﻃﻔﺎﻝ‪ .‬ﻟﺬﻟﻚ ﻫﻨﺎﻙ ﺍﳊﺎﺟﺔ ﻟﺘﻮﻓﲑ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﳌﺘﺪﺭﺑﲔ ﻟﺘﻮﻓﲑ ﺗﻠﻚ ﺍﳋﺪﻣﺔ‪.‬‬
‫
ﰲ ﺣﺎﻟﺔ ﺗﻌﺮﺽ ﺍﻟﻄﻔﻞ ﻷﺫﻯ ﻋﻘﻠﻲ ﺃﻭ ﺟﺴﺪﻱ‪ ،‬ﳚﺐ ﺃﻥ ﻳﺘﻢ ﺗﻮﻓﲑ ﻭﺳﺎﺋﻞ ﺍﳊﻤﺎﻳﺔ ﻟﻪ ﻣﺘﻀﻤﻨﺔ‬
‫ﺇﻧﺸﺎﺀ ﺑﺮﺍﻣﺞ ﺍﻟﺪﻋﻢ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻟﻠﻄﻔﻞ ﻭﻟﻜﻞ ﺍﳌﻬﺘﻤﲔ ﺑﻪ )ﺑﻨﺪ ‪.(١٩‬‬
‫‪ (٢‬ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﻟﺼﺤﺔ‬
‫ﰲ ﺍﻵﻭﻧﺔ ﺍﻷﺧﲑﺓ‪ ،‬ﺍﲣﺬﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺧﻄﻮﺍﺕ ﺇﳚﺎﺑﻴﺔ ﲡﺎﻩ ﺗﻮﻓﲑ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻸﻃﻔﺎﻝ ﰲ‬
‫ﺍﳌﺪﺍﺭﺱ‪ .‬ﺇﻻ ﺃﻧﻪ ﰲ ﺣﺎﻟﺔ ﺍﻟﺘﺴﺮﺏ ﺍﳌﺪﺭﺳﻲ‪ ،‬ﻻ ﻳﻮﺟﺪ ﺭﺑﻂ ﺑﲔ ﺍﻟﻄﻔﻞ ﻭﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ ،‬ﺇﺫ ﺃﻭﺿﺤﺖ‬
‫ﺍﻟﺪﺭﺍﺳﺎﺕ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﳝﻜﻦ ﺃﻻ ﳚﺪﻭﺍ ﺃﻱ ﻋﻼﺝ ﰲ ﺣﺎﻟﺔ ﻣﺮﺿﻬﻢ )‪ .(Badran, 1995‬ﻭﰲ‬
‫ﺣﺎﻟﺔ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ‪ ،‬ﲡﺪ ﺃﺳﺮﺓ ﺍﻟﻄﻔﻞ ﺃﻥ ﺍﻟﻌﻼﺝ ﻳﻔﻮﻕ ﺇﻣﻜﺎﻧﻴﺎ‪‬ﺎ‪ .‬ﻟﺬﻟﻚ ﳚﺐ ﻋﻠﻰ ﺍﻟﺴﻴﺎﺳﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺃﻥ ﺗﺄﺧﺬ ﺑﻌﲔ ﺍﻻﻋﺘﺒﺎﺭ ﺗﻮﻓﲑ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻜﻞ ﺍﻷﻃﻔﺎﻝ ﻭﲞﺎﺻﺔ ﻟﻠﺤﺎﻻﺕ ﺍﳌﺰﻣﻨﺔ‪.‬‬
‫‪ (٣‬ﺍﻟﻀﻤﺎﻥ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺍﻻﻗﺘﺼﺎﺩﻱ‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻳﺮﺗﺒﻂ ﺍﻟﻔﻘﺮ ﺍﺭﺗﺒﺎﻃﺎﹰ ﻭﺛﻴﻘﺎﹰ ﲟﻌﺎﻧﺎﺓ ﺍﻟﻄﻔﻞ‪ .‬ﻟﺬﻟﻚ ﺗﺒﻨﺖ ﺳﻴﺎﺳﺔ ﺍﻟﺪﻭﻟﺔ‬
‫ﺑﺮﺍﻣﺞ ﻟﻠﺤﺪ ﻣﻦ ﺍﻟﻔﻘﺮ‪ ،‬ﺇﺫ ﻳﻮﺟﺪ ﺑﺮﻧﺎﳎﺎﻥ ﺭﺋﻴﺴﻴﺎﻥ ﺫﻱ ﺃﳘﻴﺔ ﺧﺎﺻﺔ ﻳﺘﻄﻠﺒﺎ ﺃﺧﺬﳘﺎ ﰲ ﺍﻻﻋﺘﺒﺎﺭ‪:‬‬
‫‪ .١-٣‬ﻳﻮﻓﺮ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻟﻠﻔﻘﺮﺍﺀ ﻣﻌﺎﺷﺎ ﺷﻬﺮﻳﺎ‪ ،‬ﻭﺻﻞ ﻣﺆﺧﺮﺍﹰ ﺇﱃ ‪ ٥٠‬ﺟﻨﻴﻬﺎ‪ ،‬ﻟﻔﺌﺎﺕ‬
‫ﳏﺪﺩﺓ ﻣﻦ ﺍﻟﻌﺎﻃﻠﲔ‪ ،‬ﻣﻦ ﺃﻣﺜﺎﻝ ﻛﺒﺎﺭ ﺍﻟﺴﻦ ﻭﺍﻷﻳﺘﺎﻡ ﻭﺍﳌﻄﻠﻘﺎﺕ ﲜﺎﻧﺐ ﻓﺌﺎﺕ ﺃﺧﺮﻯ‪ .‬ﻭﻗﺪ ﻗﻴﻤﺖ‬
‫ﻣﺆﺳﺴﺔ ﺍﻟﺘﺨﻄﻴﻂ ﺍﻟﻘﻮﻣﻲ ﰲ ﻋﺎﻡ ‪ ٨١٤ ،١٩٩٦‬ﺟﻨﻴﻬﺎ ﻛﻤﺠﻤﻮﻉ ﺳﻨﻮﻱ ﻻﺯﻡ ﻟﻀﻤﺎﻥ ﺃﻗﻞ‬
‫ﻣﺴﺘﻮﻯ ﻟﻠﻤﻌﻴﺸﺔ ﻟﻠﻔﺮﺩ )‪ .(INP, 1996‬ﻭﻳﻌﺪ ﻫﺬﺍ ﺍﳌﻮﺿﻮﻉ ﻣﻬﻤﺎﹰ ﻋﻨﺪ ﻭﺿﻊ ﺍﻟﺴﻴﺎﺳﺎﺕ‬
‫ﺍﳌﺴﺘﻘﺒﻠﻴﺔ‪.‬‬
‫‪ .٢-٣‬ﺗﻔﻀﻞ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﳊﺎﻟﻴﺔ ﻟﻠﺤﺪ ﻣﻦ ﺍﻟﻔﻘﺮ ﺗﻮﻓﲑ ﻣﺎ ﻳﻀﻤﻦ ﻟﻠﻔﺮﺩ ﺍﻟﻔﻘﲑ ﺗﺄﺳﻴﺲ ﻣﺸﺮﻭﻋﺎﺕ‬
‫ﺍﻷﺳﺮ ﺍﳌﻨﺘﺠﺔ ﻭﺫﻟﻚ ﻛﺒﺪﻳﻞ ﳌﻌﺎﺷﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ .‬ﻭﻣﺎ ﻳﺘﻮﻓﺮ ﻣﻦ ﻣﻌﻠﻮﻣﺎﺕ ﻋﻦ‬
‫ﻓﺎﻋﻠﻴﺔ ﻭﺗﺄﺛﲑ ﺗﻠﻚ ﺍﳌﺸﺮﻭﻋﺎﺕ ﳏﺪﻭﺩ‪.‬‬

‫‪٢٣٩‬‬
‫ﻳﻮﻓﺮ ﺍﻟﺼﻨﺪﻭﻕ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻟﻠﺘﻨﻤﻴﺔ )‪ (SFD‬ﻧﻈﺎﻣ ﹰﺎ ﻳﺘﻀﻤﻦ ﻣﺸﺮﻭﻋﺎﺕ ﺗﻨﻤﻴﺔ ﺍ‪‬ﺘﻤﻊ‪،‬‬ ‫
‬
‫ﻭﻗﺪ ﰎ ﺗﻘﻴﻴﻢ ﻓﺎﻋﻠﻴﺔ ﺍﻟﻘﺮﻭﺽ ﰲ ﳏﺎﻓﻈﺎﺕ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ ﻭﺍﻟﺸﺮﻗﻴﺔ ﻭﺃﺳﻴﻮﻁ‬
‫)‪.(El Leithy, 1999‬‬
‫ﻭﺣﱴ ‪ ٣٠‬ﻣﺎﻳﻮ ‪ ،١٩٩٨‬ﻭﺯﻉ ﺑﺮﻧﺎﻣﺞ ﺗﻨﻤﻴﺔ ﺍ‪‬ﺘﻤﻊ ﺣﻮﺍﱄ ﲬﺴﺔ ﻣﻼﻳﲔ ﻭﻧﺼﻒ ﺍﳌﻠﻴﻮﻥ‬ ‫
‬
‫ﺟﻨﻴﻪ ﻋﻠﻰ ﺍﻟﻨﺸﺎﻃﺎﺕ ﺍﻟﻘﺎﺋﻤﺔ ﻋﻠﻰ ﺍﻟﻀﻤﺎﻧﺎﺕ ﻟـ ‪ ٤٢,٩٦٦‬ﻣﺸﺮﻭﻋﺎﹰ ﺻﻐﲑﺍﹰ‪ ،‬ﺑﻌﺪﺩ‬
‫ﻣﺴﺘﻔﻴﺪﻳﻦ ﻳﺼﻞ ﺇﱃ ‪ ،٤٣,٠٥١‬ﲟﺘﻮﺳﻂ ﺣﺠﻢ ﻗﺮﺽ ﻳﺼﻞ ﺇﱃ ‪ ١,٢٨٨‬ﺟﻨﻴﻬﺎ ﻟﻠﻤﺸﺮﻭﻉ‪.‬‬
‫ﻫﺪﻑ ﺑﺮﻧﺎﻣﺞ ﺗﻨﻤﻴﺔ ﺍ‪‬ﺘﻤﻊ ﻫﺬﺍ ﻫﻮ ﺍﳊﺪ ﻣﻦ ﺍﻟﻔﻘﺮ ﻭﺭﻓﻊ ﺍﳌﺴﺘﻮﻯ ﺍﳌﻌﻴﺸﻲ ﻟﻠﻘﻄﺎﻋﺎﺕ ﺍﻷﻛﺜﺮ ﻓﻘﺮ ﹰﺍ‬
‫ﻣﻦ ﺍﻟﺴﻜﺎﻥ‪ .‬ﻭﻛﺎﻥ ﺍﻟﺘﺮﻛﻴﺰ ﰲ ﺛﻼﺙ ﳏﺎﻓﻈﺎﺕ ﻋﻠﻰ ﺻﻨﺎﻋﺎﺕ ﺍﳉﱭ‪ ،‬ﻭﺗﺮﺑﻴﺔ ﺍﳊﻴﻮﺍﻧﺎﺕ ﻭﺧﺪﻣﺔ‬
‫ﺍﻟﺘﻮﺻﻴﻞ ﻟﻠﻤﻨﺎﺯﻝ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻷﻋﻤﺎﻝ ﺍﻟﻴﺪﻭﻳﺔ ﻭﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺼﻐﲑﺓ‪ ،‬ﻟﺘﺼﻞ ﻧﺴﺒﺔ ﺍﻟﻔﺎﺋﺪﺓ ﻓﻴﻤﺎ‬
‫ﺑﲔ ‪.%٩-٨‬‬
‫‪ (٤‬ﺍﻟﺘﻌﻠﻴﻢ‬
‫ﻳﻮﻓﺮ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﺍﳋﻄﻮﻁ ﺍﻷﺳﺎﺳﻴﺔ ﻟﺘﻮﻓﲑ ﺍﻟﺘﻌﻠﻴﻢ ﻋﻠﻰ ﺃﺳﺎﺱ ﻣﻦ ﺗﻮﺍﻓﻖ ﺍﻟﻔﺮﺹ )ﺑﻨﺪ‬
‫‪ .(٢٨‬ﻭﻗﺪ ﺃﺷﺎﺭﺕ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺇﱃ ﺃﻥ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻔﻘﺮﺍﺀ ﻗﺪ ﻭﺍﺟﻬﻮﺍ ﻋﻮﺍﺋﻖ ﻋﺪﺓ ﺳﺎﳘﺖ ﰲ ﻋﺪﻡ‬
‫ﺍﻟﺘﺤﺎﻗﻬﻢ ﺑﺎﳌﺪﺍﺭﺱ ﺃﻭ ﺗﺴﺮ‪‬ﻢ ﻣﻨﻬﺎ ﻗﺒﻞ ﺇﲤﺎﻣﻬﻢ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ‪ .‬ﻛﻤﺎ ﰎ ﻣﻨﺎﻗﺸﺔ ﺗﻠﻚ‬
‫ﺍﳌﺸﻜﻼﺕ ﻻﺣﻘﺎ ﳑﺎ ﺁﺛﺎﺭ ﻗﻀﺎﻳﺎ ﻋﺪﺓ ﳚﺐ ﺃﺧﺬﻫﺎ ﺑﻌﲔ ﺍﻻﻋﺘﺒﺎﺭ ﻋﻨﺪ ﻭﺿﻊ ﺍﻟﺴﻴﺎﺳﺎﺕ‪.‬‬
‫‪ .١-٤‬ﻋﺪﻡ ﺍﻹﻣﻜﺎﻧﻴﺔ‪ :‬ﺗﺘﺤﻤﻞ ﺍﻷﺳﺮ ﺍﻟﻔﻘﲑﺓ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺗﻜﺎﻟﻴﻒ ﺍﳌﺪﺍﺭﺱ‪ .‬ﻭﰲ ﺍﻵﻭﻧﺔ ﺍﻷﺧﲑﺓ‬
‫ﺃﺻﺒﺤﺖ ﻣﺼﺮﻭﻓﺎﺕ ﺍﻟﺪﺭﻭﺱ ﺍﳋﺼﻮﺻﻴﺔ ﺷﺒﻪ ﺇﺟﺒﺎﺭﻳﺔ ﺇﺫ ﻣﺜﻠﺖ ﻣﺼﺎﺭﻳﻒ ﺇﺿﺎﻓﻴﺔ ﳚﺐ ﺃﻥ‬
‫ﻳﺘﻢ ﺩﻓﻌﻬﺎ ﺷﻬﺮﻳﺎﹰ ﻟﻜﻞ ﻣﺎﺩﺓ ﺩﺭﺍﺳﻴﺔ‪ .‬ﻭﻗﺪ ﻗﺎﻣﺖ ﺩﺭﺍﺳﺔ ﺍﺳﺘﻜﺸﺎﻓﻴﺔ ﺃﺟﺮ‪‬ﺎ ﻣﻨﻈﻤﺔ ﻏﲑ‬
‫ﺣﻜﻮﻣﻴﺔ ﰲ ﺍﻟﻘﺎﻫﺮﺓ‪ ،‬ﺑﺪﻓﻊ ‪ ٣٧‬ﺟﻨﻴﻬﺎ ﺷﻬﺮﻳﺎ ﻟﻜﻞ ﻃﻔﻞ ﳛﻀﺮ ﳎﻤﻮﻋﺔ ﲟﺼﺮﻭﻓﺎﺕ ﰲ‬
‫ﺍﳌﺮﺣﻠﺔ ﺍﻹﻋﺪﺍﺩﻳﺔ ﻣﻦ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ‪ ،‬ﻭﻗﺪ ﻛﺸﻔﺖ ﻧﺘﺎﺋﺞ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ ﺍﻷﺳﺮ ﺍﻟﻔﻘﲑ ﻏﲑ‬
‫ﻗﺎﺩﺭﺓ ﻋﻠﻰ ﲢﻤﻞ ﺍﳌﺼﺎﺭﻳﻒ ﺍﳌﺪﺭﺳﻴﺔ ﻭﺃﻥ ﻫﺬﺍ ﺍﻟﻌﺎﻣﻞ ﻳﻌﺪ ﺳﺒﺒﺎﹰ ﺭﺋﻴﺴﻴﺎﹰ ﻟﻠﺘﺴﺮﺏ ﺍﳌﺪﺭﺳﻲ‪.‬‬
‫ﺗﻠﻚ ﺍﻟﻘﻀﻴﺔ ﺍﻟﱵ ﳚﺐ ﺩﺭﺍﺳﺘﻬﺎ ﻣﻦ ﻗِﺒﻞ ﺍﳊﻜﻮﻣﺔ‪.‬‬
‫‪ .٢-٤‬ﺍﳌﻼﺀﻣﺔ‪ :‬ﺗﻌﺪ ﻗﻀﻴﺔ ﻣﻼﺀﻣﺔ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﻟﻸﻃﻔﺎﻝ ﺍﳌﹸﻌﺪﻣﲔ ﻭﺃﺳﺮﻫﻢ ﻗﻀﻴﺔ ﻗﺪ ﺁﺛﺎﺭﻫﺎ‬
‫ﺃﻭﻟﻴﺎﺀ ﺃﻣﻮﺭ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ‪ ،‬ﻣﻌﱪﻳﻦ ﻋﻦ ﺇﳝﺎ‪‬ﻢ ﺑﻀﺮﻭﺭﺓ ﺃﻥ ﻳﺸﻤﻞ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ‬
‫ﺩﻭﺭﺍﺕ ﻣﻬﻨﻴﺔ ﻟﺘﺤﻀﲑ ﺍﻷﻃﻔﺎﻝ ﻟﻠﺤﻴﺎﺓ ﺍﻟﻌﻤﻠﻴﺔ ﻭﺍﻟﺘﻮﻇﻴﻒ‪ .‬ﻛﻤﺎ ﺫﻛﺮﺕ ﻧﺴﺒﺔ ﳑﺎﺛﻠﺔ‬
‫ﻟﻸﻃﻔﺎﻝ ﺍﳌﺘﺴﺮﺑﲔ ﻣﻦ ﺍﳌﺪﺭﺳﺔ ﺃ‪‬ﻢ ﻳﺄﻣﻠﻮﻥ ﰲ ﺗﻌﻠﻢ ﺣﺮﻓﺔ‪.‬‬
‫ﺟﻌﻞ ﺍﳌﻨﻬﺞ ﻣﻼﺋﻤﺎﹰ ﻟﻠﺒﻴﺌﺎﺕ ﻭﺍ‪‬ﺘﻤﻌﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‪ .‬ﻭﻗﺪ ﺳﺒﻖ ﺃﻥ ﺩﻋﺎ ﺍ‪‬ﻠﺲ ﺍﻷﻋﻠﻰ‬ ‫
‬
‫ﻟﻠﺘﻌﻠﻴﻢ ﺃﻥ ﺗﻜﻮﻥ ﺍﳌﻨﺎﻫﺞ ﻣﺘﻜﻴﻔﺔ ﻣﻊ ﺍﻟﻈﺮﻭﻑ ﺍﳌﺨﺘﻠﻔﺔ )ﺍ‪‬ﻠﺲ ﺍﻷﻋﻠﻰ ﻟﻠﺘﻌﻠﻴﻢ‪،‬‬
‫‪.(١٩٧٤‬‬
‫ﺗﻘﺪﱘ ﻣﻬﺎﺭﺍﺕ ﻣﻬﻨﻴﺔ ﻭﻋﻤﻠﻴﺔ ﻣﺘﻤﺎﺷﻴﺔ ﻣﻊ ﺍﻟﻈﺮﻭﻑ ﺍﻟﺴﺎﺋﺪﺓ ﰲ ﺍ‪‬ﺘﻤﻌﺎﺕ‪.‬‬ ‫
‬
‫ﻭﻗﺪ ﺗﺒﻨﺖ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺪﻭﻝ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﻋﺪﺓ ﰲ ﺣﺪﻭﺩ ﺍﻷﻭﻟﻮﻳﺎﺕ ﺍﻟﺮﲰﻴﺔ ﻭﻏﲑ‬
‫ﺍﻟﺮﲰﻴﺔ ﻟﺘﻮﻓﲑ ﳎﺎﻝ ﻟﻼﺧﺘﻴﺎﺭ ﻭﺍﻟﻔﺮﺹ ﻟﻸﻃﻔﺎﻝ ﺍﶈﺮﻭﻣﲔ‪ .‬ﻭﰲ ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻮﺍﻝ ﻳﺘﻢ‬

‫‪٢٤٠‬‬
‫ﺗﻜﻤﻠﺔ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﺑﺘﺪﺭﻳﺐ ﻣﺎ ﻗﺒﻞ ﺍﳌﻬﲏ ﻭﺍﳌﻬﲏ ﻭﻓﻘﺎﹰ ﻟﺴﻦ ﺍﻟﻄﻔﻞ )ﻛﻤﺎ‬
‫ﳛﺪﺙ ﰲ ﺍﳍﻨﺪ(‪ ،‬ﲣﺼﻴﺺ ﻓﺘﺮﺓ ﺍﳌﺴﺎﺀ ﻟﺘﻌﻠﻴﻢ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ )ﰲ ﺍﻟﱪﺍﺯﻳﻞ(‪ ،‬ﺗﻮﺟﻴﻪ‬
‫ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﻇﺮﻭﻑ ﺧﻄﲑﺓ ﻟﱪﺍﻣﺞ ﺗﻌﻠﻴﻢ ﻭﻛﺴﺐ )ﺍﻟﻔﻠﺒﲔ(‪ ،‬ﺗﻮﻓﲑ ﺣﻮﺍﻓﺰ‬
‫ﺍﻗﺘﺼﺎﺩﻳﺔ ﻭﺿﻤﺎﻥ ﻟﻸﺳﺮ ﺍﻟﻔﻘﲑﺓ ﻋﻠﻰ ﺷﺮﻁ ﺃﻥ ﳛﻀﺮ ﺍﻟﻄﻔﻞ ﺍﳌﺪﺭﺳﺔ )ﺍﻟﱪﺍﺯﻳﻞ(‬
‫)‪(Azer and Saad, 1998‬‬
‫‪ .٣-٤‬ﺍﳌﺮﺍﻗﺒﺔ‪ :‬ﻳﻔﺘﻘﺮ ﺍﶈﻴﻂ ﺍﳌﺪﺭﺳﻲ ﻟﻠﺨﺪﻣﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻟﻨﻔﺴﻴﺔ‪ ،‬ﺇﺫ ﻻ ﻳﺘﻢ ﻣﺮﺍﻗﺒﺔ ﺃﻭ‬
‫ﻣﺴﺎﻧﺪﺓ ﺍﻷﻃﻔﺎﻝ ﰲ ﺍﳌﺪﺍﺭﺱ ﺍﻟﺬﻳﻦ ﻳﻮﺍﺟﻬﻮﻥ ﻣﺸﺎﻛﻞ ﺃﻭ ﺍﻟﺬﻳﻦ ﻻ ﳛﻀﺮﻭﻥ ﺍﳌﺪﺭﺳﺔ ﺑﺎﻧﺘﻈﺎﻡ ﺃﻭ‬
‫ﺍﳌﺘﺴﺮﺑﲔ ﻣﻨﻬﺎ‪ .‬ﻟﺬﻟﻚ ﳚﺐ ﺇﺭﺳﺎﺀ ﻧﻈﺎﻡ ﻣﻼﺋﻢ ﻭﳑﺘﺪ ﻟﻠﻤﺮﺍﻗﺒﺔ ﻭﺍﳌﺘﺎﺑﻌﺔ ﻭﺫﻟﻚ ﻟﻌﻼﺝ ﻗﻀﻴﺔ‬
‫ﺍﻟﺘﺴﺮﺏ ﻣﻦ ﺍﳌﺪﺭﺳﺔ‪.‬‬
‫‪ (٥‬ﺳﻴﺎﺳﺎﺕ ﻣﺘﻜﺎﻣﻠﺔ‬
‫ﺗﻔﺘﻘﺮ ﻭﺳﺎﺋﻞ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺍﳊﺎﻟﻴﺔ ﻟﻠﺘﻜﺎﻣﻞ ﻭﺍﻟﺘﻨﺴﻴﻖ‪ .‬ﺇﺫ ﻛﺸﻔﺖ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻟﺸﻮﺍﻫﺪ‬
‫ﻋﻦ ﺍﳊﺎﺟﺔ ﺇﱃ ﺍﻟﺘﻨﺴﻴﻖ‪ :‬ﻓﺎﻟﺘﻌﻘﻴﺪﺍﺕ ﺑﲔ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻟﺜﻘﺎﻓﺔ‪ ،‬ﺑﲔ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻟﺼﺤﺔ‪ ،‬ﺑﲔ ﻭﺳﺎﺋﻞ ﺍﳊﺪ‬
‫ﻣﻦ ﺍﻟﻔﻘﺮ‪ ،‬ﻭﺍﻷﻣﻦ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳊﻤﺎﻳﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻟﻸﻃﻔﺎﻝ ﺍﶈﺮﻭﻣﲔ –‬
‫ﻛﻠﻬﺎ ﺃﻣﻮﺭ ﺗﺘﻄﻠﺐ ﺍﻋﺘﺒﺎﺭﺍﺕ ﺳﻴﺎﺳﻴﺔ ﺗﻀﻤﻦ ﺗﻨﻤﻴﺔ ﻣﻨﺎﺳﺒﺔ ﺷﺎﻣﻠﺔ ﻟﻜﻞ ﻃﻔﻞ‪.‬‬

‫ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﱵ ﺣﺮﻡ ﻓﻴﻬﺎ ﺍﻷﻃﻔﺎﻝ ﻣﻦ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﺳﺮﻳﺔ‬

‫ﻭﺳﺎﺋﻞ ﻣﻘﺘﺮﺣﺔ ﻟﻌﻼﺝ ﺍﻟﻘﻀﻴﺔ‪:‬‬
‫
ﺍﺑﺘﻜﺎﺭ ﺍﻗﺘﺮﺍﺣﺎﺕ ﻣﻨﻔﺮﺩﺓ ﻟﻠﻘﻀﺎﺀ ﻋﻠﻰ ﻋﺰﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻀﺎﻟﲔ ﻭﺍﻟﻠﻘﻄﺎﺀ ﺑﺪﻭﻥ ﺃﻱ ﺗﻌﻘﻴﺪﺍﺕ‬
‫ﻗﺎﻧﻮﻧﻴﺔ‪.‬‬
‫
ﺗﻘﺪﱘ ﻭﺗﻌﺰﻳﺰ ﺑﺮﺍﻣﺞ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻟﻌﻼﺝ ﻗﻀﻴﺔ ﺃﻃﻔﺎﻝ ﺍﻟﺸﻮﺍﺭﻉ ﺑﺪﻻ ﻣﻦ ﺍﻟﻨﻤﺎﺫﺝ‬
‫ﺍﳌﺆﺳﺴﻴﺔ ﻭﺍﻟﱵ ﻣﻨﻴﺖ ﺑﺎﻟﻔﺸﻞ‪.‬‬
‫
ﻣﻌﺎﳉﺔ ﺍﻷﺳﺒﺎﺏ ﺑﺪﺍﺧﻞ ﺍﻷﺳﺮﺓ ﺍﳌﺆﺩﻳﺔ ﺇﱃ ﺗﺮﻙ ﺍﻟﻄﻔﻞ ﻷﺳﺮﺗﻪ‪ ،‬ﲟﺎ ﰲ ﺫﻟﻚ ﺍﻟﺘﺤﺪﻳﺪ ﻭﺍﻟﺘﺪﺧﻞ‬
‫ﺍﳌﺒﻜﺮ ﻭﺍﻟﻔﻌﺎﻝ ﻣﻊ ﺃﻃﻔﺎﻝ ﺍﻟﺸﻮﺍﺭﻉ ﳌﻨﻊ ﺃﻱ ﺳﻠﻮﻙ ﻣﻨﺤﺮﻑ‪.‬‬

‫‪ %7‬‬
‫ﻭﰲ ﺍﻟﻨﻬﺎﻳﺔ‪ ،‬ﻋﻠﻲ ﺍﻟﺮﻏﻢ ﻣﻦ ﺍﻹﳒﺎﺯﺍﺕ ﻭﺍﻟﻜﻢ ﺍﳍﺎﺋﻞ ﻣﻦ ﺍﳌﻘﺘﺮﺣﺎﺕ ﰲ ﻣﺼﺮ ﳓﻮ ﲢﻘﻴﻖ ﺍﳊﻤﺎﻳﺔ‬
‫ﺍﻟﻜﺎﻣﻠﺔ ﻟﻸﻃﻔﺎﻝ‪ ،‬ﻫﻨﺎﻙ ﺑﻌﺾ ﺍﻟﺘﺪﺧﻼﺕ ﺍﳍﺎﻣﺔ ﻭﺍﻷﺳﺎﺳﻴﺔ ﻭﺍﻟﱵ ﳚﺐ ﺃﻥ ﺗﺆﺧﺬ ﺑﻌﲔ ﺍﻻﻋﺘﺒﺎﺭ ﰲ‬
‫ﺍﳌﺮﺣﻠﺔ ﺍﻟﻘﺎﺩﻣﺔ‪:‬‬
‫‪ .١‬ﺍﻻﺣﺘﻴﺎﺝ ﺇﱄ ﺭﺅﻳﺔ ﻭﺳﻴﺎﺳﺎﺕ ﻣﻨﺪﳎﺔ ﻭﻣﺘﻜﺎﻣﻠﺔ ﺗﻮﺍﺟﻪ ﺍﻷﺳﺒﺎﺏ ﺍﳉﺬﺭﻳﺔ ﻟﺘﻬﻤﻴﺶ ﺑﻌﺾ‬
‫ﺍﻟﻔﺌﺎﺕ ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻭﺣﺮﻣﺎ‪‬ﻢ ﻣﻦ ﺍﳊﻘﻮﻕ ﺍﻷﺳﺎﺳﻴﺔ‪.‬‬
‫‪ .٢‬ﺍﻻﺣﺘﻴﺎﺝ ﻟﺘﻜﻮﻳﻦ ﻧﻈﺎﻡ ﻣﺮﺍﻗﺒﺔ ﻣﺴﺘﻤﺮ ﻟﻸﻃﻔﺎﻝ ﺑﻐﺮﺽ ﺍﻟﺘﺤﺪﻳﺪ ﺍﳌﺒﻜﺮ ﻟﻸﻃﻔﺎﻝ ﺍﳌﻌﺮﺿﲔ‬
‫ﻭﺍﶈﺮﻭﻣﲔ ﻭﺍﻟﺘﻮﺻﻴﺔ ﺑﺎﻟﺘﺪﺧﻼﺕ ﺍﳌﻨﺎﺳﺒﺔ ﻋﻠﻲ ﻣﺴﺘﻮﻱ ﺍ‪‬ﺘﻤﻌﺎﺕ ﺍﶈﻠﻴﺔ ﻭﺍﻟﻮﻃﻨﻴﺔ‪.‬‬

‫‪٢٤١‬‬
‫ ﺍﻻﺣﺘﻴﺎﺝ ﺇﱄ ﺗﻜﺎﻣﻞ ﻭﺗﻌﺎﻭﻥ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﰲ ﳎﺎﻝ ﺣﻘﻮﻕ ﺍﻟﻄﻔﻞ ﺷﺎﻣﻠﺔ ﺍﳉﻬﺎﺕ‬.٣
.‫ﺍﳊﻜﻮﻣﻴﺔ ﻭﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ ﻭﻋﻠﻲ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﶈﻠﻴﺔ ﻭﺍﻹﻗﻠﻴﻤﻴﺔ ﻭﺍﻟﻮﻃﻨﻴﺔ‬

89
1. Abdallah, Ahmed. Child Labor in Egypt: Leather Tanning Industry in Cairo.
In Assefa Bequelle and Jo Boyden (eds). Combating Child Labor. ILO
Geneva, 1988.
2. Abdel Gawad, Muhamed. A Study or the Relationship between Work
Satisfaction and Psychological Adjustment of Working Children. Institute
of Childhood Studies. Ain Shams University. Master dissertation, Cairo,
1997.
3. Abdel Gawad, M. Social Dimensions of Child Labor in Egypt. Paper
represented 10 workshop on Convention No. 138 of 1973 Concerning the
Minimum Age for Employment. 20-22 Oct. 1997. Ministry of Labor Force
and ILO. Cairo, 1997.
4. Azer, A, Training and Welfare of Working Children in Shubra El Kheima:
A Pre-Project Survey. The National Center for Social and Criminological
Research in Collaboration with ILO, Cairo. 1993.
5. Azer, A. and Ramzi, N. Child Labor in Egypt, The National Center for
Social and Criminological Research, in collaboration wilh UNICEF. Cairo,
1991,
6. Azer, A. Modalities of the Best Interests Principle in Education.
7. Azer, A. and Saad, M. The Interfce Between Child Labor and Education
Within the Framework of the Child Rights Convention. UNICEF, Egypt,
May 1998.
8. Badran, A,, Health Care of Children in Difficult Circumstances, Unicef,
Cairo, 1995 (Report Not Published).
9. Bequele, A. and Myers, W.B., First Things First in Child Labor, Unicef,
1995.
10. Datt, G. et. al. A Profile of Poverty in Egypt: 1997. Ministry of Agriculture
and Land Reclamation, and the Ministry of Trade and Supply. March
31,1998.
11. El-Deeb, B. Size and Charactcristica of Child Labor in Egypt. Paper
presented in the workshop on "Reducing Child Labor in Egypt, organized
by the Ministry of Manpower and Migration. Cairo, 1995.

٢٤٢
12. Ei-Gai-hl, Hassan. Psychological Adjustment and Self- Respect of Working
Child and School Child. Ain Shams University, Master Dissertation, Cairo,
1994.
13. El Leithy, H. et al., Social and Economic Impact Assessment of Loans
Provided by the Social Fund for Development Through the Enterprise
Development Program and the Community Development Program, Cairo,
May 1999.
14. Bl-Tawila, S. & et. al. Transition to Adulthood, A National Survey of
Egyptian Adolescents. The Population Council, New York, 1999.
15. Fathi, Randa. "Family Image as Conceived by the Working Child", Ain
Shams University. Master Dissertation. Cairo, 1994.
16. Fcrgany, N. Survey of Access to Primary Education and Acquisition to
Basic Literacy Skills in Three Govemorates in Egypt. Cairo, UNICEF, 1995.
17. Heneidi, Abdel Salam, Child Labor. Paper Presented in the Symposium on
Child Labor. The National Center for Social and Criminological Research.
Cairo, 1986.
18. High Council of Education, the National Specialized Councils (NSC),
Repcm No. 103. Vol. 6 Cairo. NSC, 1974.
19. Institute of National Planning, Egypt Human Development Report, Cairo,
1996.
20. Ministry of Education (MOB), "Al Taaleem Lilgamea*'. (Education for All).
Meeting of Nine Countries on Education for All, MOE, Cairo, 1993.
21. Ministry of Education (MOE). Pre-University Education Statistics. Cairo,
1997.
22. Nagi, S. In Pursuit of Progress - An Agenda for Social Development.
Report presented to the Ministry of" Insurance and Social Affairs, and
UNDP. Cairo, 1998.
23. Nassar, H. The Economic Aspects of Children's Vulnerability in Egypt.
Cairo, UNICEF. 1995.
24. Nassar, H. Survey on Socio-Economic Conditions of Work in Greater
Cairo. The American University in Cairo (AUC), 1999.
25. National Center, (NCSCR) Symposium on Child Labor. The National
Center for Social and Criminological Research and UNICEF, Cairo, 1986.
26. NCSCR. Training and welfare of Working Children in Shoubra El-Kheima:
Pre-Project Survey. NCSCR & ILO. Cairo. 1993.
27. NCSCR. Working. Children in Urban Areas. Cairo" NCSCR. Cairo, 1999.

٢٤٣
28. Ramzi, Nahed "Child Labor Phenomenon in Arab Countries; Towards an
Arab Strategy to Face the Phenomenon, Cairo" Arab Council for
Childhood and Development, Cairo, 1998.
29. Rashad, Nadia. Child Labor in Relation to Psychological Adjustment:
Empirical Study on Working Children in Industrial Workshops. Cairo Am
Shams University. Master Dissertation, Cairo, 1993.
30. UNESCO, Final Report of the International Consultative Forum on
Education for All. Paris, UNESCO. 1991.
31. Youssef, Zainab, Health and Child Labor. Workshop on Combating Child
Labor in Egypt. Ministry of Labor force and ILO. Cairo, 1995.
32. Zibani, N. Children's Work and Schooling in Egypt, Trends of Change
Between 1988 and 1998. A Paper Presented for the Conference on Labor
Market and Human Resources Development in Egypt, Cairo, 1999.
33. Abu Zeid, Samira. Pre-school Programs and Educational Techniques for
the Disabled Child. Cairo: Zahraa El Sharq Bookstore, 1998. (Arabic)
34. Alien, Louise R (preparation) The Situation of Children in Upper Egypt.
Capmas and Unicef, November 19S9.
35. Boylan, Esther, (preparation) Women and Disability. London and New
Jersey: Zed Books Ltd, 1991.
36. Campbell, Jane and Mike Oliver. Disability Politics: Understanding our
past, changing our future. London and New York: Routledge, 1996.
37. Cartwright, F.F. A Social History in Medicine. London and New York:
Longman, 1977.
38. Child Law and its internal regulations. Published by the Organization of
Protecting the Rights of the Child, Cairo - Egypt.
39. Childhood and Handicap: concepts and strategies. Proceedings of the
seminar held at the French Cultural Center. Published in collaboration
between the Ministry of Health and Population, UNDP and the French
Embassy: the French cultural center. Egypt" Cairo: FOTIADIS Press, 1997.
40. Disability, Handicap and Society. Vol. 8, No. 4. Journals Oxford Ltd,
1993.
41. Disability. Chapter 5 in die Oxfam Handbook of Development and Relief,
vol. 1& 2. Oxfam (UK & Ireland): UK, 1995,
42. Persons with Special Needs and the 21st Century in the Arab World.
Researches, Studies and Recommendations. Seventh National Conference

٢٤٤
 for the Union of Organizations for the Care of Groups with Special Needs
and Disabled Persons. Egypt, Cairo; Dec. 1998. (Arabic)
43. El Deeb, Bothayna ei al. (preparation) The Stare of Egyptian Children.
CAPMAS and Unicef, June 1988.
44. Future Visions for Educational Manuals in the Arab World, The Third
Scientific Conference, Published by the Egyptian Association for Manuals
and Educational Techniques. Alexandria, 1991. (Arabic)
45. Gaff, Angela. The Human Rights of persons with Disabilities. Al Hag:
West Bank Affiliate of the International Commission of Jurists, 1994. Uver,
Michael. The Politics of Disablement. London: Macmillan Press Ltd, 1990.
46. Guide to organizations caring and rehabilitating disabled persons in Egypt.
The International Year of Disability 1981. published by the Union of
Organizations for the Care of Groups with Special Needs and Disabled
Persons, 1982. (Arabic)
47. Laws and Legislations regarding the Rehabilitation of Disabled Persons.
Ministry of Social Affairs (MOSA). Cairo: Amireya Press, 1985.
48. Mandl, P.E. (editor) The Disabled Child; a new approach to prevention
and rehabilitation. Assignment children - a journal concerned with
children, women and youth in development. 53/54. Unicef, spring 1981.
49. NGO Coalition on the Rights of the Child, NGOs Report on the Rights of
the Child in Egypt. Egypt, June 2000.
50. Normal Life is a Right for the Disabled, a periodical issued by the Union
of Organizations for the Care of Groups with Special Needs and Disabled
Persons. No. 58-62 for the year June 99 - June 2000. (Arabic)
51. Pinet, Genevieve. (coordination) Is the Law Fair to the Disabled? A
European survey. "WHO regional Publications, European Series,
No.29.1990.
52. Shukrallah, Alaa and Ahmed Fathi (preparation). The DHS Childhood
Disability Survey Report (second Draft). April 2000.
53. Shukrallah, Alaa and Manal Abaza (editing). The Disability Services in the
Ismailia Governorate, Field Study, second phase. North-South INSERM
Network. Cairo, April 1999.
54. Shukrallah. Alaa et aL The Current State of the Disability Question in
Egypt. Preliminary study. North-South INSERM Network- April, 1997.

٢٤٥
55. Shukrallah, Alaa. "Prevention, Early Detection and Rehabilitation of
Children with Special Needs" Scaling up the Childhood Disability Project.
November 1997.
56. Shukrallah, Alaa. Final Progress Report on Childhood Disability Project
presented to Unicef. Cairo: AHED, January 1997.
57. Statistical Indicators. Ministry of Social Affairs (MOSA) and the Information
and Decision Support Center (IDSC). Cairo. 1997.
58. Towards a Better Future for the Disabled, Reports. Researches, Studies and
Recommendations. The Sixth Conference for the Union of Organizations
for the Care of Groups with Special Needs and Disabled Persons Egypt,
Cairo; March 1994. (Arabic)
59. Towards a Unified Egyptian National Strategy in the Area of Childhood
Disability; common needs, obstacles and strategic issues, Workshop
Report organized by Unicef-AHED. January 1995.
60. UN. Convention on the Rights of the Child. Egypt: Elias Modem Press,
1989.
61. WHO, Intel-national Classification of Impairments, Disabilities, and
Handicaps. WHO Geneva, 1980.
62. World Declaration on Education for all and Framework for Action to Meet
Basic learning Needs. World Conference on Education for All. WCEPA.
New York, April 1990-Hurst, Rachel, (editing) Are Disabled People
Included? Published by Disability Awareness in Action. Printed by
Freeways Print.

٢٤٦
 ‫
 
‪:‬‬
‫ 
‬
‫ ‪  . .‬‬

‫‪ !" # .‬‬

‫!‪!"$‬‬
‫ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺪﻭﻝ ﺍﻟﻌﺎﱂ ﺍﻟﺜﺎﻟﺚ ﻓﺈﻥ ﻣﺼﺮ ﲤﺘﻠﻚ ﺷﺒﻜﺔ ﺧﺪﻣﺎﺕ ﺻﺤﻴﺔ ﳑﺘﺪﺓ ﻋﱪ ﺍﻟﻘﻄﺮ ﻛﻠﻪ‪ ،‬ﻣﻊ ﺃﻧﻪ‬
‫ﻻ ﻳﺰﺍﻝ ﻳﻮﺟﺪ ﺍﻟﻔﺮﻕ ﺍﻟﻮﺍﺿﺢ ﺑﲔ ﺗﻠﻚ ﺍﳋﺪﻣﺎﺕ ﻭﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﺣﺪﻳﺜﻲ ﺍﻟﺘﺨﺮﺝ ﺳﻨﻮﻳﺎﹰ‪ ،‬ﺣﻮﺍﱄ ‪٥٠٠٠‬‬
‫ﻃﺒﻴﺐ‪ ،‬ﻭﺗﻮﺟﺪ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﺍﻟﱵ ﺗﻮﻓﺮﻫﺎ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰲ ﻣﺪﻯ ‪ ٥‬ﻛﻴﻠﻮﻣﺘﺮﺍﺕ ﻣﻦ ﺍﳌﺮﺍﻛﺰ‬
‫ﺍﻟﺼﺤﻴﺔ ﻟـ ‪ %٩٥‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ‪ .‬ﻭﻣﻊ ﺫﻟﻚ ﻓﺈﻥ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻌﺎﻡ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻣﺘﺪﻥ‪ .‬ﻭﻫﻨﺎﻙ ﻗﻠﺔ ﰲ‬
‫ﻋﺪﺩ ﺍﳌﻤﺮﺿﺎﺕ)‪ .(١‬ﻭﻛﺬﻟﻚ ﻓﺈﻥ ﻣﺆﺷﺮﺍﺕ ﺍﻟﺼﺤﺔ ﻣﺜﻞ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻭﺍﳌﻮﺍﻟﻴﺪ ﻻ ﺗﺰﺍﻝ ﳑﺎﺛﻠﺔ‬
‫ﻟﺘﻠﻚ ﺍﳌﻌﺪﻻﺕ ﰲ ﺑﻠﺪﺍﻥ ﺍﻟﻌﺎﱂ ﺍﻟﺜﺎﻟﺚ ﺍﻟﻔﻘﲑ‪ .‬ﻓﻤﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ‪ ٨٤‬ﻟﻜﻞ ﻣﺎﺋﺔ ﺃﻟﻒ ﻣﻮﻟﻮﺩ ﺣﻲ‬
‫)ﺳﻨﺔ ‪) (٢٠٠٠‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ( ﻭﻫﻮ ﻳﻌﺘﱪ ﻣﻌﺪﻻﹰ ﻣﻨﺨﻔﻀﺎﹰ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺎﻟﺮﻗﻢ ﺍﻟﺴﺎﺑﻖ ﰲ ﻣﺼﺮ ﻟﻌﺎﻡ‬
‫‪ ١٩٩٢‬ﻭﻫﻮ ‪١٧٤‬ﻟﻜﻞ ﻣﺎﺋﺔ ﺃﻟﻒ‪ %٣٧ .‬ﱂ ﻳﻨﺎﻟﻮﺍ ﻣﺘﺎﺑﻌﺔ ﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ‪ .‬ﻭ‪ %٦٠‬ﻣﻦ ﺍﻟﻮﻻﺩﺍﺕ ﻛﺎﻧﺖ ﻋﻦ ﻃﺮﻳﻖ‬
‫ﻣﺴﺎﻋﺪﺓ ﺍﻟﺪﺍﻳﺔ)‪.(٢‬‬
‫ﻳﻮﺟﺪ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﱵ ﺗﺸﺎﺭﻙ ﰲ ﻫﺬﺍ ﺍﻟﻮﺿﻊ ﺗﺄﰐ ﻋﻠﻰ ﺭﺃﺳﻬﺎ ﺍﳊﺎﻟﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‪ ،‬ﺣﻴﺚ‬
‫ﳝﺜﻞ ﺍﻹﻧﻔﺎﻕ ﻋﻠﻰ ﻗﻄﺎﻉ ﺍﻟﺼﺤﺔ ‪ %١,٧‬ﻣﻦ ﺍﳌﻮﺍﺯﻧﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺪﻭﻟﺔ ﻭﺍﻟﺬﻱ ﻇﻞ ﺛﺎﺑﺘﺎﹰ ﻋﻠﻰ ﻣﺪﺍﺭ ﺍﻟﺴﻨﻮﺍﺕ‬
‫ﺍﻟﺴﺎﺑﻘﺔ ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺎﻹﻧﻔﺎﻕ ﻋﻠﻰ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﺬﻱ ﺯﺍﺩ ﻣﻦ ‪ %٤,١‬ﺇﱃ ‪ %٥,٦‬ﻣﻦ ﺍﳌﻮﺍﺯﻧﺔ ﺍﻟﻌﺎﻣﺔ ﺑﲔ ﻋﺎﻣﻲ‬
‫)‪ ،(١٩٩٩ – ١٩٩١‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳓﻴﺎﺯ ﺍﻹﻧﻔﺎﻕ ﺑﻨﺴﺒﺔ ﺗﻘﺘﺮﺏ ﻣﻦ ﺍﻟﺜﻠﺜﲔ ﻧﺎﺣﻴﺔ ﺍﻟﻄﺐ ﺍﻟﻌﻼﺟﻲ ﻋﻠﻰ‬
‫ﺣﺴﺎﺏ ﺍﻟﻄﺐ ﺍﻟﻮﻗﺎﺋﻲ ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﻷﻭﻟﻴﺔ‪ ،‬ﻭﻛﺬﻟﻚ ﻫﻨﺎﻙ ﺍﳓﻴﺎﺯ ﺇﱃ ﺍﳌﻨﺎﻃﻖ ﺍﳌﺪﻧﻴﺔ ﻋﻠﻰ ﺣﺴﺎﺏ‬
‫ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ‪.‬‬
‫ﻋﻨﺪﻣﺎ ﻧﺘﺤﺪﺙ ﻋﻦ ﺻﺤﺔ ﺍﳌﺮﺃﺓ‪ ،‬ﻓﺈﻧﻨﺎ ﻧﺘﺤﺪﺙ ﻋﻦ ﻗﻄﺎﻉ ﻳﺸﻜﻞ ﻛﻤﻴﺎﹰ ﻧﺼﻒ ﻋﺪﺩ ﺍﻟﺴﻜﺎﻥ‪.‬‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ‪ ،‬ﻓﺈﻥ ﺃﻭﺿﺎﻉ ﺍﳌﺮﺃﺓ ﺧﺎﺻﺔ ﲡﻌﻠﻬﺎ ﺟﺪﻳﺮﺓ ﺑﺎﻟﺪﺭﺍﺳﺔ – ﻟﻴﺲ ﻓﻘﻂ ﻣﻦ ﻭﺍﻗﻊ ﺃﻥ ﻟﻠﻤﺮﺃﺓ‬
‫ﺍﺣﺘﻴﺎﺟﺎﺕ ﺧﺎﺻﺔ ‪‬ﺎ ﻣﻦ ﺍﻟﻨﺎﺣﻴﺔ ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺔ‪ ،‬ﻭﻟﻜﻦ ﻳﻮﺟﺪ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺸﻜﻼﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳋﺎﺻﺔ‬
‫ﺑﺎﳌﺮﺃﺓ ﻭﺍﻟﱵ ﻳﺸﻜﻠﻬﺎ ﺩﻭﺭﻫﺎ ﰲ ﺍ‪‬ﺘﻤﻊ ﺃﻭ ﻣﺎ ﻳﺴﻤﻰ ﺑﺎﻟﻨﻮﻉ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ ،‬ﻭﺍﻟﱵ ﺗﻌﱪ ﻋﻦ ﻧﻔﺴﻬﺎ ﻣﻦ‬
‫ﺧﻼﻝ ﺍﻟﺘﻔﺮﻗﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﺑﲔ ﺍﳉﻨﺴﲔ ﰲ ﺍﳊﻘﻮﻕ ﻭﺍﳌﻮﺍﺭﺩ ﳑﺎ ﻳﺆﺩﻱ ﺇﱃ ﻋﺪﻡ ﺍﻟﺘﻤﺎﺛﻞ ﰲ ﺍﻟﻌﺐﺀ ﺍﻟﺬﻱ ﻳﻘﻊ‬
‫ﻋﻠﻰ ﻛﻞ ﻣﻦ ﺍﻟﻨﻮﻋﲔ ﰲ ﺍ‪‬ﺘﻤﻊ ﻭﻣﻨﻬﺎ ﻋﺐﺀ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻓﻔﻲ ﺍﻟﻮﺍﻗﻊ ﻳﻮﺟﺪ ﺗﺪﺍﺧﻞ ﻛﺒﲑ ﻳﺼﻌﺐ ﺍﻟﻔﺼﻞ – ﰲ ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ – ﺑﲔ ﻣﻔﻬﻮﻡ ﺍﻟﺼﺤﺔ ﻭﺍﳉﻨﺲ‬
‫)ﺫﻛﺮ ﺃﻭ ﺃﻧﺜﻰ(‪ ،‬ﻭﺑﲔ ﺍﻟﺼﺤﺔ ﻭﺍﻟﻨﻮﻉ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ .‬ﻓﻌﻠﻰ ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ ﻓﺈﻥ ﺍﻟﻮﻇﺎﺋﻒ ﺍﻹﳒﺎﺑﻴﺔ ﻟﻠﻤﺮﺃﺓ‬
‫ﻟﺘﻌﺮﺿﻬﺎ ﻟﻠﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺸﻜﻼﺕ ﺍﻟﺼﺤﻴﺔ ﻣﺜﻞ ﺯﻳﺎﺩﺓ ﺍﻧﺘﺸﺎﺭ ﺍﻷﻧﻴﻤﻴﺎ ﺑﲔ ﺍﻟﻨﺴﺎﺀ ﻋﻨﻬﺎ ﺑﲔ ﺍﻟﺮﺟﺎﻝ‬

‫‪٢٤٧‬‬
‫)ﻭﺍﻟﱵ ﻳﻌﺰﻯ ﺳﺒﺒﻬﺎ ﳊﺪﻭﺙ ﺍﻟﺪﻭﺭﺓ ﺍﻟﺸﻬﺮﻳﺔ( ﺇﱃ ﻣﻮﺍﺟﻬﺔ ﺃﺧﻄﺎﺭ ﻗﺪ ﺗﺆﺩﻱ ﺇﱃ ﺍﳌﻮﺕ ﺃﺛﻨﺎﺀ ﺍﻟﻮﻻﺩﺓ‪.‬‬
‫ﻭﻣﺜﻞ ﻫﺬﻩ ﺍﻷﺷﻴﺎﺀ ﻭﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺸﻜﻼﺕ ﺍﻷﺧﺮﻯ ﻗﺪ ﺗﺒﺪﻭ ﺃﻥ ﳏﺪﺩﺍ‪‬ﺎ ﺑﻴﻮﻟﻮﺟﻴﺔ ﻓﻘﻂ‪ ،‬ﻭﻟﻜﻦ ﻳﺰﻳﺪ‬
‫ﻣﻦ ﻣﻌﺪﻻ‪‬ﺎ ﺍﻟﺴﻴﺎﻕ ﺍ‪‬ﺘﻤﻌﻲ ﻭﺍﻟﺜﻘﺎﰲ ﺍﻟﺬﻱ ﻳﺰﻳﺪ ﻣﻦ ﺗﻌﺮﺽ ﺍﻟﻨﺴﺎﺀ ﻟﺒﻌﺾ ﺍﻷﻣﺮﺍﺽ ﻭﳛﺪﺩ ﺍﳌﻮﺍﺭﺩ‬
‫ﺍﻟﱵ ﺗﺴﻤﺢ ﳍﻦ ﺑﺎﻟﺘﻌﺎﻣﻞ ﺍﻟﺴﻠﻴﻢ ﻣﻊ ﻣﺸﻜﻼ‪‬ﻦ ﺍﻟﺼﺤﻴﺔ ﻭﲢﺪ ﻣﻦ ﻭﺻﻮﳍﻦ ﺇﱃ ﻣﺮﺍﻛﺰ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﻻ ﳜﻔﻰ ﻋﻠﻰ ﺃﺣﺪ ﺣﻘﻴﻘﺔ ﺃﻥ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﺗﻌﻜﺲ ﺍﻟﻔﺮﻕ ﺍﻟﻜﺒﲑ ﺑﲔ ﺍﻟﺒﻠﺪﺍﻥ‬
‫ﺍﻟﻨﺎﻣﻴﺔ ﻭﺍﻟﺒﻠﺪﺍﻥ ﺍﳌﺘﻘﺪﻣﺔ ﰲ ﻣﺆﺷﺮﺍﺕ ﺍﻟﺘﻄﻮﺭ ﺍﻹﻧﺴﺎﱐ‪ .‬ﻭﻳﻌﺘﱪ ﻫﺬﺍ ﻣﺜﻼﹰ ﻭﺍﺿﺤﺎﹰ ﻋﻠﻰ ﻛﻴﻔﻴﺔ‬
‫ﺍﻟﺘﻔﺎﻋﻞ ﺑﲔ ﺍﻟﻨﻮﻉ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﻓﺮﻭﻕ ﺍﳉﻨﺲ ﻭﺗﺄﺛﲑ ﺫﻟﻚ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‪.‬‬
‫ﻟﻘﺪ ﺗﺰﺍﻳﺪ ﺍﻻﻫﺘﻤﺎﻡ ﰲ ﺍﻟﻌﻘﺪﻳﻦ ﺍﻷﺧﲑﻳﻦ ﺑﺼﺤﺔ ﺍﳌﺮﺃﺓ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻌﺎﳌﻲ ﺑﺴﺒﺐ ﺍﳉﻬﻮﺩ ﺍﻟﱵ‬
‫ﺗﺒﺬﳍﺎ ﺍﳊﺮﻛﺔ ﺍﻟﻨﺴﺎﺋﻴﺔ ﻭﺩﻋﺎﺓ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺸﺎﻣﻠﺔ ﻭﺍﳉﻤﻌﻴﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ ﻭﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺪﻭﻟﻴﺔ‬
‫ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺘﻨﻤﻴﺔ‪ .‬ﻭﻗﺪ ﺗﻜﺜﻒ ﻫﺬﺍ ﺍﳉﻬﺪ ﺇﺑﺎﻥ ﺍﻧﻌﻘﺎﺩ ﻣﺆﲤﺮ ﺍﻟﻘﺎﻫﺮﺓ ﺍﻟﺪﻭﱄ‬
‫ﻟﻠﺴﻜﺎﻥ )‪ (ICPD‬ﰲ ﺳﺒﺘﻤﱪ ‪ ١٩٩٤‬ﻭﻣﺎ ﺻﺪﺭ ﻋﻨﻪ ﻣﻦ ﻭﺛﺎﺋﻖ ﻭﻣﺎ ﺍﻧﺒﺜﻖ ﻋﻨﻪ ﻣﻦ ﲡﻤﻌﺎﺕ ﻋﻤﻞ‬
‫ﻭﺑﺮﺍﻣﺞ ﻣﺜﻞ ﻣﺆﲤﺮ ﺑﻜﲔ ‪ .١٩٩٥‬ﻭﻗﺪ ﺗﺒﻨﺖ ﺍﻟﺴﻴﺎﺳﺎﺕ ﻭﺍﻟﱪﺍﻣﺞ ﺍﻟﺴﻜﺎﻧﻴﺔ ﻣﻔﻬﻮﻡ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ‬
‫ﺑﺪﻻﹰ ﻣﻦ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ؛ ﺣﻴﺚ ﺇﻥ ﺫﻟﻚ ﺍﳌﻔﻬﻮﻡ ﻳﻌﺘﱪ ﺃﻛﺜﺮ ﺇﻧﺴﺎﻧﻴﺔ؛ ﻓﻬﻮ ﻳﺴﺘﺠﻴﺐ ﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﻔﺮﺩ‬
‫ﻭﻳﺸﻜﻞ ﻓﻌﺎﻟﻴﺔ ﺃﻛﺜﺮ ﰲ ﺇﺑﻄﺎﺀ ﺍﻟﻨﻤﻮ ﺍﻟﺴﻜﺎﱐ ﻣﻦ ﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﻘﺪﱘ ﺍﻟﺬﻱ ﺍﺭﺗﻜﺰ ﻋﻠﻰ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪.‬‬
‫ﻭﰲ ﻣﺼﺮ ﺗﺰﺍﻳﺪ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺼﺤﺔ ﺍﳌﺮﺃﺓ ﻭﺗﻨﺎﻣﻲ ﻋﺪﺩ ﺍﳉﻤﻌﻴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﺍﻟﱵ ﺗﻌﻤﻞ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﺳﻮﺍﺀ‬
‫ﺑﺘﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﳌﺒﺎﺷﺮﺓ ﺃﻭ ﺍﻟﺘﺜﻘﻴﻒ ﻭﺍﻟﺘﻮﻋﻴﺔ ﻭﺍﻟﺘﻤﻜﲔ‪ .‬ﻛﺬﻟﻚ ﺍﻫﺘﻤﺖ ﺍﻟﺪﻭﻟﺔ ﳑﺜﻠﺔ ‪-‬ﺃﺳﺎﺳﺎﹰ‪ -‬ﰲ‬
‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺍﳍﻴﺌﺎﺕ ﺍﻟﻘﻮﻣﻴﺔ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﳎﺎﻻﺕ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﺍﻷﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ‬
‫ﺑﺈﺑﺮﺍﺯ ﻗﻀﻴﺔ ﺻﺤﺔ ﺍﻟﻨﺴﺎﺀ ﻛﻘﻀﻴﺔ ﻧﻮﻋﻴﺔ ﻭﺗﺰﺍﻳﺪ ﺍﻟﺴﻌﻲ ﻟﺘﻜﺜﻴﻒ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﻟﻠﻤﺮﺃﺓ ﺑﺸﻜﻞ‬
‫ﺧﺎﺹ‪.‬‬
‫ﻭﻗﺪ ﺳﺎﳘﺖ ﺟﻬﻮﺩ ﻣﺆﺳﺴﺎﺕ ﺍﻷﻣﻢ ﺍﳌﺘﺤﺪﺓ ﻭﺍﳉﻤﻌﻴﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ ﻭﻫﻴﺌﺎﺕ ﺍﻟﺘﻤﻮﻳﻞ ﺍﻟﺪﻭﻟﻴﺔ ﰲ‬
‫ﺩﻋﻢ ﺍﳉﻬﻮﺩ ﺍﳌﺼﺮﻳﺔ ﻭﺩﻓﻌﻬﺎ ﳓﻮ ﺍﻟﺘﺒﻠﻮﺭ ﻭﺍﻟﺘﻨﺴﻴﻖ ﻭﺍﻟﻔﻌﺎﻟﻴﺔ‪ ،‬ﻏﲑ ﺃﻥ ﺍﻟﻜﺜﲑ ﻣﻦ ﻫﺬﻩ ﺍﳉﻬﻮﺩ ﻇﻠﺖ‬
‫ﳏﺼﻮﺭﺓ ﰲ ﺇﻃﺎﺭ ﻟﺼﺤﺔ ﺍﳌﺮﺃﺓ ﻳﻌﲏ ﺃﺳﺎﺳﺎﹰ ﺑﺎﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺗﻨﻈﻴﻢ ﺍﳋﺼﻮﺑﺔ )ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ(‪.‬‬
‫ﻭﺭﻏﻢ ﺃﻥ ﻫﺬﺍ ﺍﻟﺘﻮﺟﻪ ﻟﻌﺐ ﺩﻭﺭﺍﹰ ﻣﻬﻤﺎﹰ ﰲ ﺗﺴﻠﻴﻂ ﺍﻟﻀﻮﺀ ﻋﻠﻰ ﻗﻀﻴﺔ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﺇﻻ ﺃﻧﻪ ﺃﺩﻯ ﺇﱃ ﻃﺒﻊ‬
‫ﻣﻔﻬﻮﻣﻨﺎ ﻋﻨﻬﺎ ﰲ ﺣﺪﻭﺩ ﺍﻟﺪﻭﺭ ﺍﻹﳒﺎﰊ ﻭﰲ ﺍﻟﻨﻄﺎﻕ ﺍﻟﻌﻤﺮﻱ ﻣﺎ ﺑﲔ ‪ ٤٥-١٥‬ﺳﻨﺔ‪ .‬ﻭﻣﻊ ﺃﻥ ﺍﳌﻔﻬﻮﻡ ﻗﺪ‬
‫ﺑﺪﺃ ﻳﺘﺴﻊ ﰲ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻷﺧﲑﺓ ﻟﻴﺸﻤﻞ ﺍﻷﻣﻮﻣﺔ ﺍﻵﻣﻨﺔ ﰒ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ؛ ﺇﻻ ﺃﻧﻪ ﻣﺎﺯﺍﻟﺖ ﻫﻨﺎﻙ‬
‫ﺟﻮﺍﻧﺐ ﻋﺪﻳﺪﺓ ﻭﻫﺎﻣﺔ ﻏﲑ ﻣﻄﺮﻭﺣﺔ ﻭﻏﲑ ﻣﻌﺮﻭﻓﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺼﺤﺔ ﺍﳌﺮﺃﺓ‪.‬‬
‫ﻭﻟﻌﻞ ﺃﻭﻝ ﻣﺎ ﻳﻮﺍﺟﻪ ﺍﻟﺒﺎﺣﺚ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻫﻮ ﻏﻴﺎﺏ ﺗﻌﺮﻳﻒ ﳏﺪﺩ ﻭﻭﺍﺿﺢ ﳌﺎ ﻳﺸﺘﻤﻞ ﻋﻠﻴﻪ ﺗﻌﺒﲑ‬
‫ﺻﺤﺔ ﺍﳌﺮﺃﺓ‪ .‬ﻓﻼ ﻳﻮﺟﺪ ﰲ ﺍﻷﺩﺑﻴﺎﺕ ﺳﻮﻯ ﻋﺪﺩ ﳏﺪﻭﺩ ﻧﺴﺒﻴﺎﹰ ﻣﻦ ﺍﶈﺎﻭﻻﺕ ﻟﻮﺿﻊ ﺗﻌﺮﻳﻒ ﻭﺍﺿﺢ‪،‬‬
‫ﻭﳛﺘﻮﻯ ﺃﻏﻠﺒﻬﺎ ﻋﻠﻰ ﺩﺭﺟﺔ ﻣﻦ ﺍﻟﺘﺪﺍﺧﻞ ﻣﻊ ﺗﻌﺮﻳﻔﺎﺕ ﻟﻠﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﺃﻭ ﺻﺤﺔ ﺍﻷﻡ)‪.(٣‬‬
‫ﻭﰲ ﺇﻃﺎﺭ ﺍﳌﻔﻬﻮﻡ ﺍﻟﺸﻤﻮﱄ ﻭﺍﻹﳚﺎﰊ ﻟﻠﺼﺤﺔ ﺍﻟﺬﻱ ﺍﻋﺘﻤﺪﺗﻪ ﺩﻭﻝ ﺍﻟﻌﺎﱂ ﻛﻠﻬﺎ ﰲ ﻣﻴﺜﺎﻕ ﻣﻨﻈﻤﺔ‬
‫ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ)‪ (٤‬ﺑﺎﻋﺘﺒﺎﺭﻫﺎ "ﺣﺎﻟﺔ ﻣﻦ ﺍﻛﺘﻤﺎﻝ ﺍﻟﺮﻓﺎﻫﺔ ﺍﻟﺒﺪﻧﻴﺔ ﻭﺍﻟﻌﻘﻠﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﻟﻴﺴﺖ‬
‫ﳎﺮﺩ ﺍﻟﺴﻼﻣﺔ ﻣﻦ ﺍﳌﺮﺽ ﺃﻭ ﺍﻹﻋﺎﻗﺔ" ﻓﺈﻧﻪ ﳚﺪﺭ ﺗﺒﲏ ﻣﻔﻬﻮﻡ ﻟﺼﺤﺔ ﺍﳌﺮﺃﺓ ﻳﺘﻌﺪﻯ ﺩﻭﺭﻫﺎ ﺍﻹﳒﺎﰊ ﺇﱃ‬
‫ﺍﻷﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻣﺎ ﻗﺒﻞ ﻭﻣﺎ ﺑﻌﺪ ﻫﺬﻩ ﺍﳌﺮﺣﻠﺔ ﻣﻦ ﺩﻭﺭﺓ ﺣﻴﺎ‪‬ﺎ‪ ،‬ﻭﻳﺄﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺃﻥ ﻛﺜﲑ‪،‬‬

‫‪٢٤٨‬‬
‫ﻣﻦ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﳊﻴﺎﺓ ﺍﻟﻨﺴﺎﺀ ﺍﻟﱵ ﺗﺆﺛﺮ ﻋﻠﻰ ﺻﺤﺘﻬﻦ‪ ،‬ﻭﻟﻌﻞ ﺃﻗﺮﺏ ﺍﻟﺘﻌﺮﻳﻔﺎﺕ ﳍﺬﺍ ﺍﳌﻔﻬﻮﻡ‬
‫ﻫﻮ ﺍﻟﺬﻱ ﻃﺮﺣﻪ "ﻓﺎﻥ ﺩﻳﺮ ﻛﻮﺍﻙ" ﺳﻨﺔ ‪ (٥)١٩٩١‬ﻋﻠﻰ ﺍﻟﻨﺤﻮ ﺍﻟﺘﺎﱄ‪" :‬ﺇﻥ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﻫﻲ ﺭﻓﺎﻫﻴﺘﻬﺎ‬
‫ﺍﻟﻜﻠﻴﺔ ﺍﻟﱵ ﻻ ﲢﺪﺩﻫﺎ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺔ ﻭﺍﻹﳒﺎﺑﻴﺔ ﻭﺣﺴﺐ؛ ﺇﳕﺎ ﺗﺘﺤﺪﺩ ﺃﻳﻀﺎﹰ ﺑﺘﺄﺛﲑﺍﺕ ﻋﺐﺀ ﺍﻟﻌﻤﻞ‬
‫ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺘﻮﺗﺮ ﻭﺍﳊﺮﻳﺔ ﻭﺍﳍﺠﺮﺍﺕ ﻣﻦ ﺑﲔ ﻋﻮﺍﻣﻞ ﺃﺧﺮﻯ"‪ .‬ﻭﳝﻜﻨﻨﺎ ﺃﻥ ﻧﻀﻴﻒ ﺇﱃ ﻫﺬﻩ ﺍﻟﻌﻮﺍﻣﻞ ﺃﻳﻀﺎﹰ‬
‫ﻭﺿﻊ ﺍﳌﺮﺃﺓ ﰲ ﺍ‪‬ﺘﻤﻊ‪ ،‬ﻭﺗﻌﻠﻴﻤﻬﺎ ﻭﺍﺳﺘﻘﻼﳍﺎ ﺍﻻﻗﺘﺼﺎﺩﻱ ﻭﺍﻟﻘﻴﻢ ﺍﻟﺜﻘﺎﻓﻴﺔ ﺍﻟﺒﺎﻟﻴﺔ ﺍﻟﱵ ﲤﻴﺰ ﺿﺪﻫﺎ ﺃﻭ‬
‫ﺗﻀﻄﻬﺪﻫﺎ‪ .‬ﻭﺑﻌﺒﺎﺭﺓ ﺃﺧﺮﻯ ﻛﻤﺎ ﻳﻘﻮﻝ "ﺃﻭﺭ")‪" :(٦‬ﺇﻥ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ‪-‬ﻭﻣﻊ ﺍﻷﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺣﻘﺎﺋﻖ ﺩﻭﺭ‬
‫ﺍﻟﻨﺴﺎﺀ ﰲ ﺍﻹﳒﺎﺏ ﻭﺍﻟﺘﻨﺸﺌﺔ‪ -‬ﺗﺄﺧﺬ ﻣﻨﻈﻮﺭﺍﹰ ﺃﻭﺳﻊ ﳊﻴﺎﺓ ﺍﳌﺮﺃﺓ ﻭﲡﻌﻞ ﻣﺘﻄﻠﺒﺎ‪‬ﺎ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﱵ‬
‫ﺗﻠﱯ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﻨﺴﺎﺀ ﻛﻜﻞ ﻣﺸﺮﻭﻋﺔ ﺑﺼﺮﻑ ﺍﻟﻨﻈﺮ ﻋﻦ ﺍﻟﺴﻦ ﺃﻭ ﺍﻟﻮﺿﻊ ﺍﻻﺟﺘﻤﺎﻋﻲ"‪ .‬ﻭﺭﻏﻢ‬
‫ﺍﻷﳘﻴﺔ ﺍﻟﻘﺼﻮﻯ ﳍﺬﻩ ﺍﻟﺘﻌﺮﻳﻔﺎﺕ ﺍﻟﻌﺮﻳﻀﺔ ﺍﻟﱵ ﺗﻐﻠﺐ ﺍﳌﻔﻬﻮﻡ ﺍﻹﳚﺎﰊ ﻭﺍﻟﺸﻤﻮﱄ ﻟﻠﺼﺤﺔ ﻋﻠﻰ‬
‫ﺍﳌﻔﺎﻫﻴﻢ ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺔ ﺍﻟﻀﻴﻘﺔ ﻭﺍﻟﱵ ﺗﻌﺮﻑ ﺍﻟﺼﺤﺔ ﺳﻠﺒﻴﺎﹰ ﺑﻐﻴﺎﺏ ﺍﳌﺮﺽ‪ ،‬ﺭﻏﻢ ﺃﳘﻴﺘﻬﺎ ﰲ ﻓﻬﻢ‬
‫ﺍﻟﺼﺤﺔ ﻛﻘﻀﻴﺔ ﺗﻨﻤﻮﻳﺔ ﻭﻓﺘﺢ ﺍ‪‬ﺎﻝ ﺃﻣﺎﻡ ﻣﺸﺎﺭﻛﺔ ﺍ‪‬ﺘﻤﻌﺎﺕ ﰲ ﲢﺪﻳﺪ ﺃﻭﻟﻮﻳﺎ‪‬ﺎ ﻭﺩﻓﻊ ﺍﳍﻴﺌﺎﺕ‬
‫ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ ﳓﻮ ﺻﻴﺎﻏﺔ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ ﺑﺪﻳﻠﺔ ﻣﻦ ﺃﺟﻞ ﺗﻮﺯﻳﻊ ﺃﻛﺜﺮ ﻋﺪﻻﹰ ﳌﺪﺧﻼﺕ ﺍﻟﺘﻨﻤﻴﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﻭﺭﻓﻊ ﻛﻔﺎﺀ‪‬ﺎ ﻭﻛﻔﺎﻳﺘﻬﺎ؛ ﺇﻻ ﺃﻥ ﻫﺬﻩ ﺍﻟﺘﻌﺮﻳﻔﺎﺕ ﺗﻮﺍﺟﻪ ﺑﺼﻌﻮﺑﺎﺕ ﺷﺪﻳﺪﺓ ﻋﻨﺪ ﳏﺎﻭﻟﺔ‬
‫ﻭﺿﻊ ﺗﻌﺮﻳﻔﺎﺕ ﻛﻠﻴﺔ ﻟﻘﻴﺎﺱ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻭﲢﺪﻳﺪ ﺍﳌﺆﺷﺮﺍﺕ ﺍﳌﻄﻠﻮﺑﺔ ﻟﺮﺳﻢ ﺍﳋﺮﻳﻄﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻭﻟﻌﻞ ﺃﻫﻢ ﻫﺬﻩ ﺍﻟﺼﻌﻮﺑﺎﺕ ﺗﺘﻠﺨﺺ ﰲ ﺍﻟﻨﻘﺎﻁ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬
‫ﺍﺳﺘﺒﺪﺍﻝ ﻣﻔﻬﻮﻡ "ﺍﻟﺼﺤﺔ" ﺍﳍﻼﻣﻲ ﲟﻔﻬﻮﻡ ﻣﻄﺎﻃﻲ ﻫﻮ "ﺍﻟﺮﻓﺎﻫﺔ" ﻳﺼﻌﺐ ﻗﻴﺎﺳﻪ ﺃﻳﻀﺎﹰ‪.‬‬ ‫‪-‬‬
‫ﻭﺿﻊ ﺍﻟﺼﺤﺔ ﻛﻬﺪﻑ ﻣﺜﺎﱄ ﳝﻜﻦ ﺍﻟﺘﻮﺟﻪ ﳓﻮﻩ ﻭﻟﻜﻦ ﻻ ﳝﻜﻦ ﲢﻘﻴﻘﻪ ﺑﺎﻟﻜﺎﻣﻞ‪.‬‬ ‫‪-‬‬
‫ﺍﺣﺘﻮﺍﺀ ﻇﺎﻫﺮﺓ ﺍﻟﺼﺤﺔ ﻋﻠﻰ ﻋﺪﺩ ﻏﲑ ﳏﺪﻭﺩ ﻣﻦ ﺍﻷﺑﻌﺎﺩ ﻭﺍﳌﺪﺧﻼﺕ‪.‬‬ ‫‪-‬‬
‫ﺗﺄﺛﺮ ﺍﻟﻘﻴﺎﺱ ﻭﺍﻟﺘﻘﻴﻴﻢ ﻟﻠﺼﺤﺔ ﰲ ﺇﻃﺎﺭ ﻫﺬﻩ ﺍﳌﻔﺎﻫﻴﻢ ﺑﺎﳌﺮﺟﻌﻴﺔ ﺍﻟﺘﻨﻤﻮﻳﺔ ﻭﺍﻟﺜﻘﺎﻓﻴﺔ ﻟﻠﻤﻘﻴﻢ‬ ‫‪-‬‬
‫ﺫﺍﺗﻪ‪.‬‬
‫ﳍﺬﺍ ﻓﻘﺪ ﺍﲡﻪ ﺍﻟﺒﺎﺣﺜﻮﻥ ﺇﱃ ﺍﺧﺘﻴﺎﺭ ﻣﺆﺷﺮﺍﺕ ﳏﺪﺩﺓ ﻟﺮﺳﻢ ﺍﳋﺮﻳﻄﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻤﺠﺘﻤﻌﺎﺕ ﺃﻭ‬
‫ﻗﻄﺎﻋﺎﺕ ﳏﺪﺩﺓ ﻣﻨﻬﺎ ﻛﻤﺎ ﻳﻘﻮﻝ "ﻫﺎﻧﺴﻠﻮﻛﺎ")‪" :(٧‬ﺇﺫﺍ ﺍﻋﺘﱪﻧﺎ ﺃﻥ ﺍﻟﺼﺤﺔ ﻃﻴﻒ ﻣﻦ ﺍﻷﺣﻮﺍﻝ ﺗﻘﻊ ﰲ‬
‫ﺃﺣﺪ ﺣﺪﻭﺩﻫﺎ ﺍﻟﻘﺼﻮﻯ ﺣﺎﻟﺔ ﺍﻛﺘﻤﺎﻝ ﺍﻟﺼﺤﺔ‪ ،‬ﻓﺈﻧﻪ ﻳﺒﺪﻭ ﺃﻛﺜﺮ ﺳﻬﻮﻟﺔ ﲢﻠﻴﻠﻴﺎﹰ ﻭﺃﻛﺜﺮ ﺩﻻﻟﺔ ﻋﻤﻠﻴﺎﹰ ﰲ‬
‫ﺁﻥ ﻭﺍﺣﺪ ﺃﻥ ﻳﺘﻢ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻷﺣﻮﺍﻝ ﺍﻟﺒﻴﻨﻴﺔ ﻭﻋﻠﻰ ﺍﻟﺘﺤﺴﻴﻨﺎﺕ ﻋﻮﺿﺎﹰ ﻋﻦ ﺍﳊﺎﻟﺔ ﺍﻟﻘﺼﻮﻯ ﺫﺍ‪‬ﺎ‬
‫ﻭﺍﻟﱵ ﻗﺪ ﺗﻜﻮﻥ ﻏﲑ ﻗﺎﺑﻠﺔ ﻟﻠﺘﺤﻘﻖ ﺃﻭ ﺣﱴ ﻏﲑ ﻣﺘﺨﻴﻠﺔ"‪ .‬ﻭﻋﻠﻴﻪ ﻓﻴﻤﻜﻨﻨﺎ ﺃﻥ ﳒﻤﻞ ﺃﻧﻪ ﻻ ﻳﻮﺟﺪ ﺣﱴ‬
‫ﺍﻵﻥ ﳕﻮﺫﺝ ﳏﺪﻭﺩ ﻭﻭﺍﺿﺢ ﻟﺪﺭﺍﺳﺔ ﻭﺗﻮﺻﻴﻒ "ﺻﺤﺔ ﺍﳌﺮﺃﺓ" ﻓﻤﺎ ﺯﻟﻨﺎ ﺣﱴ ﺍﻵﻥ ﰲ ﺍﳌﺮﺍﺣﻞ ﺍﻷﻭﻟﻴﺔ‬
‫ﻟﺘﻌﺮﻳﻒ ﻭﻗﻴﺎﺱ ﻣﺎ ﺍﻟﺬﻱ ﻳﺘﻀﻤﻨﻪ ﻣﻔﻬﻮﻡ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﻭﻛﻴﻒ ﳝﻜﻦ ﻗﻴﺎﺳﻪ‪.‬ﻭﻣﻊ ﺫﻟﻚ ﻓﻬﻨﺎﻙ ﺑﻌﺾ‬
‫ﺍﻻﺟﺘﻬﺎﺩﺍﺕ ﺍﻟﱵ ﺑﺪﺃﺕ ﺗﺘﺒﻠﻮﺭ ﻭﺗﺼﻞ ﺇﱃ ﺍﻗﺘﺮﺍﺣﺎﺕ ﻣﻘﺒﻮﻟﺔ ﻣﻦ ﺍﻟﺒﺎﺣﺜﲔ ﻭﺍﻟﻌﺎﻣﻠﲔ ﰲ ﳎﺎﻝ ﺍﳌﺮﺃﺓ‪.‬‬
‫ﻭﻗﺪ ﺣﺎﻭﻟﺖ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻋﺘﻤﺎﺩ ﺑﻌﺾ ﺍﳌﻔﺎﻫﻴﻢ ﺍﻟﱵ ﺑﺪﺃﺕ ﺗﺘﺮﺳﺦ ﰲ ﺩﺭﺍﺳﺎﺕ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﻭﻣﻨﻬﺎ‪:‬‬
‫ﻣﻔﻬﻮﻡ ﺩﻭﺭﺓ ﺍﳊﻴﺎﺓ )ﺷﻜﻞ‪ (١‬ﺍﻟﺬﻱ ﻳﺴﺘﻮﺟﺐ ﺍﻟﻨﻈﺮ ﺇﱃ ﺍﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﻨﺴﺎﺀ ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺔ‬ ‫‪-‬‬
‫ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﰲ ﻛﻞ ﻣﺮﺣﻠﺔ ﻋﻤﺮﻳﺔ‪ .‬ﺇﻥ ﺍﻟﻨﻈﺮ ﺇﱃ ﺍﻟﻨﺴﺎﺀ ﻛﻘﻄﺎﻉ ﻭﺍﺣﺪ ﻳﺆﺩﻱ ﺇﱃ ﻃﻤﺲ‬
‫ﺣﻘﺎﺋﻖ ﻫﺎﻣﺔ ﻭﺍﺣﺘﻴﺎﺟﺎﺕ ﳏﺪﺩﺓ ﻟﻜﻞ ﻣﺮﺣﻠﺔ ﻣﻦ ﻣﺮﺍﺣﻞ ﺍﻟﻌﻤﺮ‪ ،‬ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﻳﺆﺩﻱ ﺇﱃ ﺻﻌﻮﺑﺔ‬

‫‪٢٤٩‬‬
‫ﻣﻘﺎﺭﻧﺔ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺑﲔ ﺍ‪‬ﺘﻤﻌﺎﺕ ﻭﺑﲔ ﺍﻟﺬﻛﻮﺭ ﻭﺍﻹﻧﺎﺙ‪ .‬ﻓﻀﻼﹰ ﻋﻦ ﺫﻟﻚ ﻓﺈﻥ ﻫﺬﺍ ﺍﳌﻔﻬﻮﻡ ﻳﺆﻛﺪ‬
‫ﻋﻠﻰ ﺗﻮﺳﻴﻊ ﻧﻄﺎﻕ "ﺻﺤﺔ ﺍﳌﺮﺃﺓ" ﲟﺎ ﻳﺘﻌﺪﻯ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ‪.‬‬
‫ﺇﻃﺎﺭ ﳏﺪﺩﺍﺕ ﺍﻟﺼﺤﺔ ﺍﻟﺬﻱ ﻳﺪﻋﻮ ﺇﱃ ﺍﻟﻨﻈﺮ ﺇﱃ ﺍﻟﻮﺍﻗﻊ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻟﻠﻤﺮﺃﺓ ﻭﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺆﺛﺮﺓ ﰲ‬ ‫‪-‬‬
‫ﺣﺎﻟﺘﻬﺎ ﺍﻟﺼﺤﻴﺔ ﺑﻨﻔﺲ ﺍﻟﻘﺪﺭ ﺍﻟﺬﻱ ﻳﻨﻈﺮ ﺑﻪ ﺇﱃ ﺗﺒﺪﻳﺎﺕ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﺫﺍ‪‬ﺎ ﻭﺗﻘﺴﻴﻢ ﻫﺬﻩ‬
‫ﺍﶈﺪﺩﺍﺕ ﺇﱃ ﻣﺴﺘﻮﻳﺎﺕ‪ .‬ﻳﺄﰐ ﰲ ﺍﳌﺴﺘﻮﻯ ﺍﻷﻗﺮﺏ ﺇﱃ ﺍﳊﺎﻟﺔ ﺍﳌﺮﺿﻴﺔ ﺫﺍ‪‬ﺎ ﳏﺪﺩ ﺍﻟﺘﻌﺮﺽ‬
‫ﻟﻠﻤﺮﺽ ﺃﻭ ﻋﻮﺍﻣﻞ ﺍﳌﺨﺎﻃﺮﺓ ﺍﳌﺒﺎﺷﺮﺓ‪ .‬ﺃﻣﺎ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻮﺳﻴﻂ ﻓﻴﺘﻀﻤﻦ ﺃﳕﺎﻁ ﺍﳊﻴﺎﺓ‬
‫ﻭﺍﻟﺴﻠﻮﻛﻴﺎﺕ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻟﺼﺤﺔ ﻭﺍﺳﺘﺨﺪﺍﻡ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﺃﻣﺎ ﺍﳌﺴﺘﻮﻯ ﺍﻷﺑﻌﺪ ﻓﻴﺤﺘﻮﻱ‬
‫ﻋﻠﻰ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺘﺎﺣﺔ ﻟﻠﻔﺮﺩ ﰲ ﺍ‪‬ﺘﻤﻊ )ﺷﻜﻞ ‪.(٢‬‬
‫ﻣﻔﻬﻮﻡ ﺍﻟﻌﺐﺀ ﺍﻟﻜﻠﻲ ﻟﻠﻤﺮﺽ ﻭﺍﻟﺬﻱ ﻳﺄﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﻋﺐﺀ ﺍﳌﺮﺍﺿﺔ ‪ Morbidity‬ﺇﱃ ﺟﺎﻧﺐ‬ ‫‪-‬‬
‫ﻋﺐﺀ ﺍﻟﻮﻓﺎﺓ ‪ Mortality‬ﻋﻨﺪ ﲢﺪﻳﺪ ﺃﻭﻟﻮﻳﺎﺕ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻓﻔﻲ ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻴﺎﻥ ﻻ‬
‫ﺗﻌﻜﺲ ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﺎﺓ ﻭﻻ ﺣﱴ ﺳﻨﻮﺍﺕ ﺍﻟﻌﻤﺮ ﺍﳌﻔﻘﻮﺩﺓ ﺑﺎﻟﻮﻓﺎﺓ ﻣﻦ ﻣﺮﺽ ﻣﻌﲔ ﻣﺪﻯ ﺍﻟﻌﺐﺀ‬
‫ﺍﻟﻜﻠﻲ ﻛﻤﺎ ﻳﺘﻀﺢ ﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ ﰲ ﺣﺎﻻﺕ ﺍﻹﻋﺎﻗﺔ ﺍﻟﺒﺪﻧﻴﺔ ﻭﺍﻟﻌﻘﻠﻴﺔ ﻭﺳﻮﺀ‬
‫ﺍﻟﺘﻐﺬﻳﺔ)‪.(٨‬‬
‫ﺷﻜﻞ )‪ :(١-١٠‬ﻣﺸﻜﻼﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﱵ ﺗﺆﺛﺮ ﺑﺪﺭﺟﺔ ﳏﺪﻭﺩﺓ ﺃﻭ ﺑﺪﺭﺟﺔ ﻛﺒﲑﺓ ﻋﻠﻰ ﺻﺤﺔ ﺍﳌﺮﺃﺓ‬

‫ﻣﺮﺣﻠﺔ ﺍﻟﻄﻔﻮﻟﺔ ﲟﺎ ﻓﻴﻬﺎ ﺍﻟﺴﻨﺔ ﺍﻷﻭﱃ‬

‫ﻣﻦ ﺍﻟﻌﻤﺮ )ﺻﻔﺮ ‪ 9 -‬ﺳﻨﻮﺍﺕ(‬
‫‪ -‬ﺍﺧﺘﻴﺎﺭ ﺍﻟﻨﻮﻉ‬
‫‪ -‬ﺍﳋﺘﺎﻥ‬
‫‪ -‬ﺍﻟﺘﻤﻴﻴﺰ ﰲ ﺍﻟﺘﻐﺬﻳﺔ‬
‫‪ -‬ﺍﻟﺘﻤﻴﻴﺰ ﰲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬

‫ﻣﺮﺣﻠﺔ ﺍﳌﺮﺍﻫﻘﺔ‬
‫ﻣﺮﺣﻠﺔ ﻣﺎ ﺑﻌﺪ ﺍﻹﳒﺎﺏ‬ ‫ﺍﳌﺸﻜﻼﺕ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ‬ ‫) ‪ 19 - 10‬ﺳﻨﺔ(‬
‫) ‪ 45‬ﺳﻨﺔ ﻭﻣﺎ ﺑﻌﺪﻫﺎ(‬ ‫ﻣﺪﻯ ﺍﻟﻌﻤﺮ‬ ‫‪ -‬ﺍﳊﻤﻞ ﺍﳌﺒﻜﺮ‬
‫‪ -‬ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺪﻭﺭﻱ‬ ‫‪ -‬ﺍﻟﻌﻨﻒ ﺍﳌﺘﻌﻠﻖ ﺑﺎﻟﻨﻮﻉ‬ ‫‪ -‬ﺍﻹﺟﻬﺎﺽ‬
‫‪ -‬ﺃﻭﺭﺍﻡ‬ ‫ﺍﻻﺟﺘﻤﺎﻋﻲ‬ ‫‪ -‬ﺍﻷﻣﺮﺍﺽ ﺍﻟﱵ ﺗﻨﺘﻘﻞ ﻋﻦ‬
‫‪ -‬ﻫﺸﺎﺷﺔ ﺍﻟﻌﻈﺎﻡ‬ ‫‪ -‬ﺑﻌﺾ ﺍﳌﺸﻜﻼﺕ ﺍﳌﺘﻌﻠﻘﺔ‬ ‫ﻃﺮﻳﻖ ﺍﳉﻨﺲ ﻭﺍﻹﻳﺪﺯ‬
‫‪ -‬ﺍﻟﺘﻬﺎﺑﺎﺕ ﺍﻟﻌﻈﺎﻡ‬ ‫ﺑﺎﻟﺼﺤﺔ ﺍﻟﺒﻴﺌﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‬ ‫‪ -‬ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ‬
‫‪ -‬ﺍﻟﺴﻜﺮ‬ ‫‪ -‬ﺍﻻﻛﺘﺌﺎﺏ‬ ‫‪ -‬ﺗﺰﺍﻳﺪ ﻣﻌﺪﻻﺕ ﺍﻻﺳﺘﻐﻼﻝ‬

‫ﻣﺮﺣﻠﺔ ﺍﻹﳒﺎﺏ ) ‪ 44 - 20‬ﺳﻨﺔ(‬

‫ﺍﳊﻤﻞ ﻏﲑ ﺍﳌﺮﻏﻮﺏ‬ ‫‪-‬‬
‫ﺍﻷﻣﺮﺍﺽ ﺍﻟﱵ ﺗﻨﺘﻘﻞ ﻋﻦ ﻃﺮﻳﻖ ﺍﳉﻨﺲ ﻭﺍﻹﻳﺪﺯ‬ ‫‪-‬‬
‫ﺍﻹﺟﻬﺎﺽ‬ ‫‪-‬‬
‫ﻣﻀﺎﻋﻔﺎﺕ ﺍﳊﻤﻞ‬ ‫‪-‬‬
‫ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﻭﺧﺎﺻﺔ ﻧﻘﺺ ﺍﳊﺪﻳﺪ‬ ‫‪-‬‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪World Bank 1994: A New Agenda for Women's Health & Nutrition :‬‬

‫‪٢٥٠‬‬
 ‫ﺷﻜﻞ )‪ :(٢-١٠‬ﳏﺪﺩﺍﺕ ﺍﳌﺮﺍﺿﺔ ﺍﻹﳒﺎﺑﻴﺔ‬

‫ﻋﻮﺍﻣﻞ‬
‫ﺍﳌﺮﺍﺿﺔ‬ ‫ﺍﻟﻌﻮﺍﻣﻞ‬ ‫ﺍﳌﻮﺍﺭﺩ‬
‫ﺍﳌﺨﺎﻃﺮﺓ‬
‫ﺍﻹﳒﺎﺑﻴﺔ‬ ‫ﺍﻟﻮﺳﻴﻄﺔ‬ ‫ﺍﳌﺘﺎﺣﺔ‬
‫ﺍﻟﻄﺒﻴﺔ‬

‫ﺳﻮﺀ‬ ‫ﺍﻟﺸﺨﺼﻴﺔ‬
‫ﺍﳌﺮﺍﺿﺔ‬ ‫ﳕﻂ ﺍﻹﳒﺎﺏ‬
‫ﺍﻟﺘﻐﺬﻳﺔ‬
‫ﻣﻦ ﺍﳊﻤﻞ‬
‫ﻭﺍﻟﻮﻻﺩﺓ‬
‫ﺍﻷﺳﺮﺓ‬
‫ﺍﻟﻘﺎﺑﻠﻴﺔ‬ ‫ﺍﺳﺘﺨﺪﺍﻡ‬
‫ﳊﺪﻭﺙ‬ ‫ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﳌﺮﺽ‬ ‫ﺍﻟﺼﺤﻴﺔ‬
‫ﺍ‪‬ﺘﻤﻊ‬
‫ﺍﳌﺮﺍﺿﺔ‬
‫ﻣﻦ ﺃﻣﺮﺍﺽ‬ ‫ﺍﻟﺴﻠﻮﻛﻴﺎﺕ‬
‫ﺍﻟﻨﺴﺎﺀ‬ ‫ﺍﻟﻌﺪﻭﻯ‬ ‫ﺍﳌﺘﻌﻠﻘﺔ‬ ‫ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﺑﺎﻟﺼﺤﺔ‬ ‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪(Huda Zurayk. Women's Reproductive Health In The Arab World. Cairo, Egypt: :‬‬
‫)‪The Population Council Regional Office for West Asia and North Africa, 1994‬‬

‫‪%&' ()*+‬‬
‫ﺗﻮﻗﻊ ﺍﳊﻴﺎﺓ ﻋﻨﺪ ﺍﳌﻴﻼﺩ‬
‫ﻳﻘﺪﺭ ﺗﻮﻗﻊ ﺍﳊﻴﺎﺓ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﺑـ ‪ ٦٦‬ﺳﻨﺔ ﻟﻠﺴﻜﺎﻥ ﰲ ﻣﺼﺮ ﻋﺎﻡ ‪ ١٩٩٧‬ﺑﻨﺴﺒﺔ ‪ %١٠٤‬ﻟﻺﻧﺎﺙ ﺑﺎﻟﻨﺴﺒﺔ‬
‫ﻟﻠﺬﻛﻮﺭ)‪ ،(٩‬ﻭﻃﺒﻘﺎﹰ ﻟﺒﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ﻓﺈﻥ ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﻫﻮ‬
‫‪ ٦٩‬ﺳﻨﺔ ﻟﻺﻧﺎﺙ ﻭ‪ ٦٥,٠١‬ﺳﻨﺔ ﻟﻠﺬﻛﻮﺭ ﺳﻨﺔ ‪ (٩)١٩٩٦‬ﺑﻨﺴﺒﺔ ‪ %١٠٦‬ﻟﻺﻧﺎﺙ ﻣﻘﺎﺭﻧﺔ ﺑﺎﻟﺬﻛﻮﺭ‪ .‬ﻳﺘﻀﺢ ﻣﻦ‬
‫ﺗﻄﻮﺭ ﺗﻮﻗﻊ ﺍﳊﻴﺎﺓ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﰲ ﻣﺼﺮ ﰲ ﺳﻨﺔ ‪ ١٩٦٠‬ﺇﱃ ‪ ١٩٩٦‬ﺃﻥ ﺗﻮﻗﻊ ﺍﳊﻴﺎﺓ ﻟﻺﻧﺎﺙ ﻗﺪ ﺯﺍﺩ ‪ ٥,٨‬ﺳﻨﺔ‬
‫)‪ (%١٠‬ﺑﲔ ﺳﻨﺔ ‪ ٨٦-٧٦‬ﻭ‪ ٥,٥‬ﺳﻨﺔ )‪ (%٨,٧‬ﺑﲔ ﺳﻨﺔ ‪ ٩٦-٨٦‬ﻣﻘﺎﺭﻧﺔ ﺑـ ‪ ٧,٨‬ﺳﻨﺔ )‪ (%١٤,٩‬ﻭ‪ ٤,٦‬ﺳﻨﺔ‬
‫)‪ (%٧,٧‬ﻟﻠﺬﻛﻮﺭ ﰲ ﻧﻔﺲ ﺍﻟﻔﺘﺮﺍﺕ‪) .‬ﺟﺪﻭﻝ ‪.(١-١٠‬‬

‫ﺟﺪﻭﻝ )‪ :(١-١٠‬ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻮﻟﺪ ﻭﻓﻘﺎﹰ ﻟﻠﻨﻮﻉ‬

‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺍﻟﺴﻨﺔ‬
‫‪٥٣,٨‬‬ ‫‪٥١,٦‬‬ ‫‪١٩٦٠‬‬
‫‪٥٧,٧‬‬ ‫‪٥٢,٧‬‬ ‫‪١٩٧٦‬‬
‫‪٦٣,٥‬‬ ‫‪٦٠,٥‬‬ ‫‪١٩٨٦‬‬
‫‪٦٦,٤‬‬ ‫‪٦٢,٨‬‬ ‫‪١٩٩١‬‬
‫‪٦٩,٠‬‬ ‫‪٦٥,١‬‬ ‫‪١٩٩٦‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪١٩٩٨‬‬

‫‪٢٥١‬‬
‫ﻭﻗﺪ ﺯﺍﺩ ﺗﻮﻗﻊ ﺍﳊﻴﺎﺓ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﻟﻺﻧﺎﺙ ﻭﺍﻟﺬﻛﻮﺭ ﰲ ﺍﻟﻌﺎﱂ ﻛﻠﻪ ﻭﻣﻊ ﺫﻟﻚ ﻓﻤﺎ ﺯﺍﻟﺖ ﺍﻟﻔﺮﻭﻕ ﻛﺒﲑﺓ ﺑﲔ‬
‫ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ )ﻭﻣﻦ ﺑﻴﻨﻬﺎ ﻣﺼﺮ( ﻭﺍﻟﺪﻭﻝ ﺍﳌﺘﻘﺪﻣﺔ‪ .‬ﻭﻳﻨﺨﻔﺾ ﺗﻮﻗﻊ ﺍﳊﻴﺎﺓ ﻓﻴﻤﺎ ﻳﺘﺮﺍﻭﺡ ﺑﲔ ‪٥-٣‬‬
‫ﺳﻨﻮﺍﺕ ﰲ ﺍﳌﺘﻮﺳﻂ ﰲ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ ﻛﻤﺎ ﻫﻮ ﺍﳊﺎﻝ ﰲ ﻣﺼﺮ‪ ،‬ﳑﺎ ﻳﻌﻜﺲ ﺇﻫﺪﺍﺭﺍﹰ ﳉﺰﺀ ﻣﻦ ﺍﳌﺰﻳﺔ‬
‫ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺔ ﺍﻟﱵ ﻣﻨﺤﺘﻬﺎ ﺍﻟﻄﺒﻴﻌﺔ ﻟﻠﻤﺮﺃﺓ‪ ،‬ﺑﺴﺒﺐ ﺍﻟﺘﻤﻴﻴﺰ ﺿﺪﻫﺎ ﺃﻭ ﺑﺴﺒﺐ ﺍﳉﻬﺪ ﺍﻟﺰﺍﺋﺪ ﺍﻟﺬﻱ‬
‫ﺗﺘﺤﻤﻠﻪ ﰲ ﺍﳊﻴﺎﺓ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﺭﺗﻔﺎﻉ ﻣﻌﺪﻻﺕ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ ﻭﻣﺎ ﻳﻨﺘﺞ ﻋﻨﻬﺎ ﻣﻦ ﳐﺎﻃﺮ ﻋﻠﻰ‬
‫ﺍﳊﻴﺎﺓ)‪ (١٠‬ﻭﻣﻊ ﺇﻥ ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻋﻨﺪ ﺍﳌﻴﻼﺩ ﰲ ﻣﺼﺮ ﻳﻨﺘﻈﺮ ﺃﻥ ﻳﺼﻞ ﺇﱃ ‪ ٧٤‬ﺳﻨﺔ ﺑﻨﻬﺎﻳﺔ ﻋﺎﻡ ‪٢٠٢٥‬‬
‫ﻭﻫﻮ ﻣﺎ ﻳﻘﺎﺭﺏ ﻓﻘﻂ ﻣﺎ ﻛﺎﻥ ﻋﻠﻴﻪ ﰲ ﺍﻟﺪﻭﻝ ﺍﳌﺘﻘﺪﻣﺔ ﰲ ﺃﻭﺍﺧﺮ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ ﺇﻻ ﺃﻧﻪ ﳚﺐ ﺃﻥ ﻳﺆﺧﺬ ﰲ‬
‫ﺍﻻﻋﺘﺒﺎﺭ ﻋﻨﺪ ﺍﻟﺘﺨﻄﻴﻂ ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻲ ﻟﺼﺤﺔ ﺍﳌﺮﺃﺓ ﺃﻥ ﻧﺴﺒﺔ ﺍﻟﻨﺴﺎﺀ ﰲ ﺍﻷﻋﻤﺎﺭ ﺍﻷﻛﱪ ﺁﺧﺬﺓ ﰲ‬
‫ﺍﻟﺰﻳﺎﺩﺓ ﲟﺎ ﲢﻤﻠﻪ ﻣﻦ ﻣﺸﻜﻼﺕ ﻫﺬﻩ ﺍﳌﺮﺣﻠﺔ ﻣﻦ ﺩﻭﺭﺓ ﺍﳊﻴﺎﺓ‪.‬‬
‫ﺷﻜﻞ )‪ :(٣-١٠‬ﺗﻄﻮﺭ ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﺍﻟﻌﺎﻡ‬

‫‪13‬‬

‫‪12‬‬

‫‪11‬‬
‫ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﺍﻟﻌﺎﻡ )ﻟﻜﻞ ﺃﻟﻒ(‬

‫‪10‬‬

‫‪9‬‬

‫‪8‬‬

‫‪7‬‬

‫‪6‬‬

‫‪5‬‬
‫‪1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996‬‬
‫ﺳﻨﻮﺍﺕ‬
‫ﺫﻛﻮﺭ‬ ‫ﺇﻧﺎﺙ‬ ‫ﳎﻤﻮﻉ‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪١٩٩٨‬‬

‫ﺍﻟﻮﻓﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻟﻺﻧﺎﺙ‬

‫ﻳﺘﺮﺍﻭﺡ ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺴﻜﺎﻥ ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪ ١٩٩٧-١٩٩٠‬ﺑﲔ ‪ ٧,١‬ﻭ‪ ٦,٤‬ﻭﻓﺎﺓ ﻟﻜﻞ ﺃﻟﻒ ﻣﻦ‬
‫ﺍﻟﺴﻜﺎﻥ ﰲ ﻣﺼﺮ)‪ (٩‬ﻭﻳﺒﲔ ﺍﻟﺸﻜﻞ )‪ (٣-١٠‬ﺗﻄﻮﺭ ﺍﳔﻔﺎﺽ ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﺍﻟﻌﺎﻡ ﻟﻺﻧﺎﺙ ﻭﺍﻟﺬﻛﻮﺭ‬
‫ﻭﺍﻹﲨﺎﱄ ﻣﻦ ﺳﻨﺔ ‪ ١٩٧٧‬ﺇﱃ ‪ .١٩٩٦‬ﻭﻳﺘﻀﺢ ﻣﻨﻪ ﺃﻥ ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﻟﻺﻧﺎﺙ ﻭﺍﻟﺬﻛﻮﺭ ﻗﺪ ﺍﳔﻔﺾ ﻣﻦ‬
‫‪ ١١,٨‬ﰲ ﺍﻷﻟﻒ ﺇﱃ ‪ ٦,٣‬ﰲ ﺍﻷﻟﻒ )‪ %٥٠‬ﺗﻘﺮﻳﺒﺎﹰ( ﻭﻗﺪ ﺍﺣﺘﻔﻈﺖ ﺍﻹﻧﺎﺙ ﲟﻌﺪﻝ ﺃﻗﻞ ﻗﻠﻴﻼﹰ ﻣﻦ ﺍﻟﺮﺟﺎﻝ ﺧﻼﻝ‬
‫ﻫﺬﻩ ﺍﻟﻔﺘﺮﺓ ﻳﺘﺮﺍﻭﺡ ﺑﲔ ‪ ٠,١‬ﻭ‪ ٢,٦‬ﰲ ﺍﻷﻟﻒ ﻭﻛﺎﻥ ﺣﻮﺍﱄ ‪ %٢٠‬ﻣﻦ ﻫﺬﺍ ﺍﻻﳔﻔﺎﺽ ﰲ ﺍﻟﻌﺸﺮ ﺳﻨﻮﺍﺕ‬
‫ﺍﻷﻭﱄ ﻭﺣﻮﺍﱄ ‪ %٣٠‬ﰲ ﺍﻟﻌﺸﺮ ﺳﻨﻮﺍﺕ ﺍﻟﺘﺎﻟﻴﺔ‪ .‬ﻭﻣﻦ ﺍﳌﻬﻢ ﺃﻥ ﻧﺬﻛﺮ ﻫﻨﺎ ﺃﻳﻀﺎﹰ ﺃﻥ ﻣﻌﻈﻢ ﻫﺬﺍ ﺍﻟﺘﻐﲑ‬
‫ﻧﺎﺗﺞ ﻋﻦ ﺍﳔﻔﺎﺽ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﻭﺍﻷﻃﻔﺎﻝ ﺧﻼﻝ ﻧﻔﺲ ﺍﻟﻔﺘﺮﺓ‪ .‬ﻭﻳﺒﲔ ﺷﻜﻞ )‪ (٤-١٠‬ﺃﻥ ﺃﻋﻠﻰ‬
‫ﻣﻌﺪﻝ ﻟﻮﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ ﰲ ﻣﺼﺮ ﻫﻮ ﰲ ﺻﻌﻴﺪ ﻣﺼﺮ ﺗﻠﻴﻬﺎ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﰒ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬

‫‪٢٥٢‬‬
‫ﻓﺎﶈﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩﻳﺔ‪ .‬ﻭﻳﻼﺣﻆ ﺃﻳﻀﺎﹰ ﰲ ﺍﻟﺸﻜﻞ ﺃﻥ ﺃﻋﻠﻰ ﻣﺰﻳﺔ ﻧﺴﺒﻴﺔ ﻟﻺﻧﺎﺙ ﻣﻦ ﺣﻴﺚ ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺮﺟﺎﻝ ﻫﻮ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﺑﻴﻨﻤﺎ ﺗﺘﺪﱏ ﻫﺬﻩ ﺍﳌﺰﻳﺔ ﻟﺘﺼﻞ ﺇﱃ ﺃﻗﻞ ﻣﻌﺪﻻ‪‬ﺎ ﰲ‬
‫ﳏﺎﻓﻈﺎﺕ ﺍﻟﺼﻌﻴﺪ ﻭﺗﻌﻜﺲ ﻫﺬﻩ ﺍﻟﺼﻮﺭﺓ ﻣﺪﻯ ﺗﺪﱐ ﺍﻷﻭﺿﺎﻉ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻟﻨﺴﺎﺀ ﺍﻟﻮﺟﻪ‬
‫ﺍﻟﻘﺒﻠﻲ ﻋﻠﻰ ﻭﺟﻪ ﺍﳋﺼﻮﺹ‪.‬‬

‫ﺷﻜﻞ )‪ :(٤-١٠‬ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﺍﻟﻌﺎﻡ ﻭﻓﻘﺎﹰ ﻟﻠﻨﻮﻉ ﻭﳏﻞ ﺍﻹﻗﺎﻣﺔ‬

‫‪9‬‬
‫‪7.95‬‬
‫‪8‬‬
‫‪7.14‬‬ ‫‪7.05‬‬
‫‪6.76 6.91‬‬ ‫‪6.79‬‬
‫‪7‬‬ ‫‪6.29‬‬ ‫‪6.47‬‬
‫‪6.13‬‬ ‫‪6.13‬‬
‫‪5.87‬‬
‫‪6‬‬ ‫‪5.60‬‬
‫ﻣﻌﺪﻝ ﺍﻟﻮﻓﻴﺎﺕ ﻟﻜﻞ ﺃﻟﻒ‬

‫‪4.86‬‬
‫‪5‬‬ ‫‪4.37‬‬
‫‪3.82‬‬
‫‪4‬‬

‫‪3‬‬

‫‪2‬‬

‫‪1‬‬

‫‪0‬‬
‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬ ‫ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻯ‬ ‫ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻰ‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ‬ ‫ﳎﻤﻮﻉ‬

‫ﳏﻞ ﺍﻻﻗﺎﻣﺔ‬

‫ﺫﻛﻮﺭ‬ ‫ﺇﻧﺎﺙ‬ ‫ﳎﻤﻮﻉ‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪١٩٩٨‬‬

‫ﺃﺳﺒﺎﺏ ﻭﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ‬

‫ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺩﻗﺔ ﺗﺴﺠﻴﻞ ﺍﻟﻮﻓﻴﺎﺕ ﺇﱃ ﺣﺪ ﻛﺒﲑ ﰲ ﻣﺼﺮ ﻧﻈﺮﺍﹰ ﻻﺣﺘﻴﺎﺝ ﺍﳌﻮﺍﻃﻨﲔ ﺇﱃ ﺗﻮﺛﻴﻖ ﺣﺪﻭﺙ‬
‫ﺍﻟﻮﻓﺎﺓ‪ ،‬ﺇﻻ ﺃﻥ ﺗﺴﺠﻴﻞ ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ ﻳﺸﻮﺑﻪ ﺍﻟﻜﺜﲑ ﻣﻦ ﻋﺪﻡ ﺍﻟﺪﻗﺔ ﺑﺴﺒﺐ ﺻﻌﻮﺑﺎﺕ ﺗﺸﺨﻴﺺ ﺍﳌﺮﺽ‬
‫ﺍﻷﺻﻠﻲ ﺍﳌﺘﺴﺒﺐ ﰲ ﺍﻟﻮﻓﺎﺓ ﻭﺍﳋﻠﻂ ﺑﻴﻨﻪ ﻭﺑﲔ ﺍﻟﺴﺒﺐ ﺍﻟﻨﻬﺎﺋﻲ ﻭﻋﺪﻡ ﺍﻻﻟﺘﺰﺍﻡ ﺑﺎﻟﺘﺼﻨﻴﻒ ﺍﻟﺪﻭﱄ‬
‫ﻟﻸﻣﺮﺍﺽ‪ ،‬ﻓﻀﻼﹰ ﻋﻦ ﺫﻟﻚ ﻓﺈﻥ ﺑﻴﺎﻧﺎﺕ ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ ﻻ ﺗﺼﺪﺭ ﺑﺎﻟﺴﺮﻋﺔ ﺍﳌﻨﺎﺳﺒﺔ ﻭﻳﺼﻌﺐ ﺍﳊﺼﻮﻝ‬
‫ﻋﻠﻴﻬﺎ ﻣﻦ ﻣﺼﺎﺩﺭﻫﺎ ﺃﺣﻴﺎﻧﺎﹰ؛ ﻟﺬﻟﻚ ﻓﻘﺪ ﳉﺄﻧﺎ ﰲ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﳌﻘﺎﺭﻧﺔ ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ‬
‫ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ﻣﻊ ﻧﺘﺎﺋﺞ ﺑﻌﺾ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﳌﻴﺪﺍﻧﻴﺔ ﺍﻟﱵ ﺃﻣﻜﻦ ﺍﳊﺼﻮﻝ ﻋﻠﻴﻬﺎ‪ .‬ﻭﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ‬
‫)‪ (٢-١٠‬ﺑﻌﺾ ﺍﻟﺘﺒﺎﻳﻦ ﰲ ﻣﻌﺪﻻﺕ ﺍﻟﻮﻓﺎﺓ ﺑﲔ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ﻭﻋﺪﺩ ﻣﻦ ﻫﺬﻩ‬
‫ﺍﻟﺪﺭﺍﺳﺎﺕ ﻭﺑﲔ ﺑﻌﻀﻬﺎ ﺍﻟﺒﻌﺾ‪.‬‬

‫‪٢٥٣‬‬
‫ﺭﻏﻢ ﻫﺬﺍ ﺍﻟﺘﺒﺎﻳﻦ ﻓﺈﻥ ﻫﻨﺎﻙ ﺍﺗﻔﺎﻗﺎﹰ ﺑﲔ ﺍﳌﺼﺎﺩﺭ ﺍﳌﺨﺘﻠﻔﺔ ﻋﻠﻰ ﺃﻥ ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺪﻭﺭﻱ ﻭﺍﻟﻘﻠﺐ ﻫﻲ‬
‫ﺍﳌﺴﺒﺐ ﺍﻷﻭﻝ ﻟﻠﻮﻓﻴﺎﺕ ﺑﲔ ﺍﻹﻧﺎﺙ ﰲ ﲨﻴﻊ ﺍﳌﺮﺍﺣﻞ ﺍﻟﻌﻤﺮﻳﺔ ﺑﻌﺪ ﻣﺮﺣﻠﺔ ﺍﻟﻄﻔﻮﻟﺔ ﺍﻷﻗﻞ ﻣﻦ ﲬﺲ‬
‫ﺳﻨﻮﺍﺕ‪ .‬ﻭﺗﺘﻀﻤﻦ ﻫﺬﻩ ﺍ‪‬ﻤﻮﻋﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ ﻭﺍﻟﺬﲝﺔ ﺍﻟﺼﺪﺭﻳﺔ ﻭﻗﺼﻮﺭ ﺍﻟﺸﺮﺍﻳﲔ‬
‫ﺍﻟﺘﺎﺟﻴﺔ ﻭﺟﻠﻄﺎﺕ ﺍﳌﺦ ﻭﺗﺼﻠﺐ ﺍﻟﺸﺮﺍﻳﲔ؛ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳊﻤﻰ ﺍﻟﺮﻭﻣﺎﺗﻴﺰﻣﻴﺔ ﻭﺃﻣﺮﺍﺽ ﺻﻤﺎﻣﺎﺕ‬
‫ﺍﻟﻘﻠﺐ ﺍﻟﻨﺎﲡﺔ ﻋﻨﻬﺎ‪ .‬ﻭﺍﳉﺪﻳﺮ ﺑﺎﳌﻼﺣﻈﺔ ﺃﻥ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ ﺑﺸﻜﻞ ﻋﺎﻡ ﻣﻦ ﲨﻠﺔ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ‬
‫)‪ (%٤٩‬ﻫﻮ ﺃﻋﻠﻰ ﻣﻨﻪ ﻋﻨﺪ ﺍﻟﺬﻛﻮﺭ )‪ .∗(%٤٦‬ﻭﻣﻦ ﺍﳌﻬﻢ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺍﺣﺘﻤﺎﻝ ﺍﳌﺒﺎﻟﻐﺔ ﰲ ﺗﺴﺠﻴﻞ ﺳﺒﺐ‬
‫ﺍﻟﻮﻓﺎﺓ ﻋﻠﻰ ﺃﻧﻪ ﺿﻤﻦ ﻫﺬﻩ ﺍ‪‬ﻤﻮﻋﺔ ﺣﻴﺚ ﺇﻥ ﺍﻟﺴﺒﺐ ﺍﻟﻨﻬﺎﺋﻲ ﻟﻠﻮﻓﺎﺓ ﰲ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﻷﺧﺮﻯ‬
‫ﻳﻜﻮﻥ ﻧﺘﻴﺠﺔ ﻓﺸﻞ ﺍﻟﻘﻠﺐ ﻭﺍﻟﺪﻭﺭﺓ ﺍﻟﺪﻣﻮﻳﺔ‪.‬‬
‫ﻭﲤﺜﻞ ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺒﻮﱄ ﻭﺍﻟﺘﻨﺎﺳﻠﻲ ﺃﻳﻀﺎﹰ ﻣﺮﺗﺒﺔ ﻋﺎﻟﻴﺔ ﰲ ﺗﺮﺗﻴﺐ ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﺑﲔ‬
‫ﺍﻟﻨﺴﺎﺀ ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﻫﺬﻩ ﺍ‪‬ﻤﻮﻋﺔ ﻻ ﺗﺘﻀﻤﻦ ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ ﺍﻟﻨﺎﲡﺔ ﻋﻦ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ‪ ،‬ﻛﻤﺎ ﻻ‬
‫ﺗﺘﻀﻤﻦ ﺃﻳﻀﺎﹰ ﺃﻭﺭﺍﻡ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ ﺍﳋﺒﻴﺜﺔ ﻭﻻ ﺃﻭﺭﺍﻡ ﺍﳉﻬﺎﺯ ﺍﻟﺒﻮﱄ‪ .‬ﻭﺭﻏﻢ ﻫﺬﺍ ﻓﺈﻥ ﺍﻹﻧﺎﺙ ﺃﻛﺜﺮ ﻋﺮﺿﺔ‬
‫ﻗﻠﻴﻼﹰ ﻟﻠﻮﻓﺎﺓ ﺑﺴﺒﺐ ﻫﺬﻩ ﺍ‪‬ﻤﻮﻋﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ )‪ (%١١‬ﻋﻦ ﺍﻟﺬﻛﻮﺭ )‪.(٩)(%١٠‬‬
‫ﻭﻣﺎ ﺯﺍﻟﺖ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ ﻭﺍﻟﻄﻔﻴﻠﻴﺔ ﺗﺸﻜﻞ ﻋﺒﺌﺎﹰ ﻫﺎﻣﺎﹰ ﻟﻠﻮﻓﻴﺎﺕ ﻭﺇﻥ ﻛﺎﻥ ﻣﻌﻈﻤﻬﺎ ﳛﺪﺙ ﰲ ﻣﺮﺣﻠﺔ‬
‫ﺍﻟﻄﻔﻮﻟﺔ ﻭﺍﳌﺮﺍﻫﻘﺔ‪ ،‬ﻭﺗﻈﻞ ﺇﲨﺎﱄ ﻭﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ ﺑﺴﺒﺐ ﻫﺬﻩ ﺍ‪‬ﻤﻮﻋﺔ )‪ (%٦‬ﺃﻋﻠﻰ ﻣﻦ ﻧﺴﺒﺘﻬﺎ ﰲ‬
‫ﺍﻟﺬﻛﻮﺭ ﲟﻌﺪﻝ )‪ (%١‬ﺃﻳﻀﺎﹰ ﻭﻳﺄﰐ ﺑﻌﺪ ﺫﻟﻚ ﰲ ﺗﺮﺗﻴﺐ ﺍﻷﳘﻴﺔ ﺃﻣﺮﺍﺽ ﺍﻟﻐﺪﺩ ﺍﻟﺼﻤﺎﺀ ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﳉﻬﺎﺯ‬
‫ﺍﳍﻀﻤﻲ ﻭﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﺣﻴﺚ ﲤﺜﻞ ﻛﻞ ﻣﻨﻬﺎ ‪ %٤-٣‬ﻣﻦ ﺃﺳﺒﺎﺏ ﻭﻓﻴﺎﺕ ﺍﻟﻨﺴﺎﺀ‪ ،‬ﻛﻤﺎ ﺃﻥ ﻧﺴﺐ‬
‫ﻭﻓﻴﺎﺕ ﺍﻟﺮﺟﺎﻝ ﻣﻨﻬﺎ ﺃﻋﻠﻰ ﻗﻠﻴﻼﹰ ﻣﻦ ﺍﻹﻧﺎﺙ ﻣﺎ ﻋﺪﺍ ﳎﻤﻮﻋﺔ ﺍﻟﻐﺪﺩ ﺍﻟﺼﻤﺎﺀ ﻭﺍﻟﺘﻐﺬﻳﺔ‪.‬‬

‫ﳚﺐ ﻣﻼﺣﻈﺔ ﺃﻥ ﺍﳌﻘﺎﺭﻧﺔ ﺑﲔ ﺍﻟﺬﻛﻮﺭ ﻭﺍﻹﻧﺎﺙ ﻫﻨﺎ ﻫﻲ ﰲ ﻧﺴﺒﺔ ﺍﻟﺴﺒﺐ ﺇﱃ ﺇﲨﺎﱄ ﺍﻟﻮﻓﻴﺎﺕ ﺩﺍﺧﻞ ﻛﻞ ﻧﻮﻉ ﻭﻻ ﺗﻌﱪ ﻋﻦ ﺍﻟﻌﺪﺩ ﺍﳌﻄﻠﻖ‬ ‫∗‬

‫ﻟﻠﻮﻓﻴﺎﺕ ﺩﺍﺧﻞ ﻛﻞ ﻧﻮﻉ ﻭﻻ ﺗﻌﱪ ﻋﻦ ﺍﻟﻌﺪﺩ ﺍﳌﻄﻠﻖ ﻟﻠﻮﻓﻴﺎﺕ ﻣﻦ ﻫﺬﺍ ﺍﻟﺴﺒﺐ ﰲ ﻛﻞ ﻧﻮﻉ‪.‬‬

‫‪٢٥٤‬‬
 ‫ﺟﺪﻭﻝ )‪ :(٢-١٠‬ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ ﰲ ﺍﻟﺴﻴﺪﺍﺕ ﻣﻦ ﺳﻦ ‪ ٤٥ - ١٤‬ﺳﻨﺔ‬
‫ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ‬
‫ﺍﳌﺮﻛﺰﻱ‬ ‫ﺩﺭﺍﺳﺔ‬ ‫ﺩﺭﺍﺳﺔ‬ ‫ﺍﻟﺪﺭﺍﺳﺔ‬
‫ﻟﻠﺘﻌﺒﺌﺔ‬ ‫ﻭﻓﻴﺎﺕ‬ ‫ﻭﻓﻴﺎﺕ‬ ‫ﺍﻟﻘﻮﻣﻴﺔ‬ ‫ﺍﻟﺴﺒﺐ‬
‫ﺍﻟﻌﺎﻣﺔ‬ ‫ﺍﻷﻣﻬﺎﺕ‬ ‫ﺍﻷﻣﻬﺎﺕ‬ ‫ﻟﻮﻓﻴﺎﺕ‬
‫ﻭﺍﻹﺣﺼﺎﺀ ‪%‬‬ ‫ﺑﺒﻮﺭﺳﻌﻴﺪ ‪%‬‬ ‫ﺑﺎﳌﻨﻮﻓﻴﺔ ‪%‬‬ ‫ﺍﻷﻣﻬﺎﺕ ‪%‬‬
‫‪٣,٦‬‬ ‫‪٢,٧‬‬ ‫‪٧,٣‬‬ ‫‪٣,٨‬‬ ‫ﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ ﻭﺍﻟﻄﻔﻴﻠﻴﺎﺕ‬
‫‪٨,٥‬‬ ‫‪١٣,٨‬‬ ‫‪٧,٧‬‬ ‫‪١٤,١‬‬ ‫ﺍﻷﻭﺭﺍﻡ‬
‫‪٢‬‬ ‫‪٠٠‬‬ ‫‪٠٠‬‬ ‫‪٣,٦‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﻟﻐﺪﺩ ﺍﻟﺼﻤﺎﺀ‪ ،‬ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺘﻤﺜﻴﻞ ﺍﻟﻐﺬﺍﺋﻲ‬
‫‪١‬‬ ‫‪٠٠‬‬ ‫‪٠٠‬‬ ‫‪٠,٦‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﻟﺪﻡ‬
‫‪٠٠‬‬ ‫‪٠٠‬‬ ‫‪٠٠‬‬ ‫‪٠,٤‬‬ ‫ﺃﻣﺮﺍﺽ ﻋﻘﻠﻴﺔ‬
‫‪٢‬‬ ‫‪٠٠‬‬ ‫‪٠٠‬‬ ‫‪٤,٧‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﻌﺼﱯ‬
‫‪٤١,٣‬‬ ‫‪٣٩,٥‬‬ ‫‪٢٨,١‬‬ ‫‪٢٩,٨‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺪﻭﺭﻱ‬
‫‪٦,٢‬‬ ‫‪٥,١‬‬ ‫‪٣‬‬ ‫‪٥‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ‬
‫‪٦,١‬‬ ‫‪٤,٦‬‬ ‫‪٤,٦‬‬ ‫‪١٢,١‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﳍﻀﻤﻲ‬
‫‪٧‬‬ ‫‪٥,٨‬‬ ‫‪٣,٦‬‬ ‫‪٩,٧‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺒﻮﱄ ﻭﺍﻟﺘﻨﺎﺳﻠﻲ‬
‫‪٣,٣‬‬ ‫‪١,٩‬‬ ‫‪٢٢,٨‬‬ ‫‪٠٠‬‬ ‫ﻣﻀﺎﻋﻔﺎﺕ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ‬
‫‪٠٠‬‬ ‫‪٠٠‬‬ ‫‪٠٠‬‬ ‫‪٠٠‬‬ ‫ﺃﻣﺮﺍﺽ ﻭﺭﺍﺛﻴﺔ‬
‫‪٠٠‬‬ ‫‪٠,٥‬‬ ‫‪٥,٢‬‬ ‫‪٠,٢‬‬ ‫ﻏﲑ ﳏﺪﺩ‬
‫‪١٢‬‬ ‫‪١٠,٥‬‬ ‫‪١٤,١‬‬ ‫‪١٦,١‬‬ ‫ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻟﺘﺴﻤﻢ‬
‫‪٠٠‬‬ ‫‪١١,٣‬‬ ‫‪٣,٣‬‬ ‫‪٠٠‬‬ ‫ﺃﺧﺮﻯ‬
‫ﺍﳌﺼﺎﺩﺭ‪:‬‬
‫‪ - ١‬ﻣﺘﺮﺟﻢ ﻋﻦ‪(National Maternal Mortality Study: Egypt, 1992-1993 Findings & Conclusions. :‬‬
‫)‪Ministry of Health - Child Survival Project In Cooperation with USAID, 1994‬‬
‫‪ - ٢‬ﺳﻨﻴﺔ ﺻﺎﱀ ﻭﺁﺧﺮﻭﻥ‪ .‬ﺃﺳﺒﺎﺏ ﻭﻓﻴﺎﺕ ﺍﻟﺴﻴﺪﺍﺕ ﰲ ﺳﻦ ﺍﻹﳒﺎﺏ ‪ -‬ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ ﰲ ﳏﺎﻓﻈﺔ ﺍﳌﻨﻮﻓﻴﺔ‪ .‬ﻣﺮﻛﺰ ﺍﻟﺒﺤﻮﺙ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ‪ -‬ﺍﳉﺎﻣﻌﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ﺑﺎﻟﻘﺎﻫﺮﺓ‪.١٩٨٧ ،‬‬
‫‪ - ٣‬ﻣﺘﺮﺟﻢ ﻋﻦ‪(Ghoneim H.1990, Study of Maternal Mortality in Port Said during the period of :‬‬
‫‪1989 - 1993).‬‬
‫‪ - ٤‬ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻯ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ‪.١٩٩٣ ،‬‬

‫ﻭﺭﻏﻢ ﺃﳘﻴﺔ ﺍﺳﺘﻌﺮﺍﺽ ﻧﺴﺐ ﻣﺴﺎﳘﺔ ﲨﻠﺔ ﺍﻷﺳﺒﺎﺏ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ ﻭﻣﻘﺎﺭﻧﺘﻬﺎ‬
‫ﺑﺎﻟﻨﺴﺐ ﺍﳋﺎﺻﺔ ﺑﺎﻟﺬﻛﻮﺭ ﻟﻠﺘﻌﺮﻑ ﻋﻠﻰ ﻋﺐﺀ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ ﺍﻟﱵ ﺗﺘﻌﺮﺽ ﳍﺎ ﺍﻟﻨﺴﺎﺀ‬
‫ﰲ ﺍ‪‬ﺘﻤﻊ ﺑﺸﻜﻞ ﻋﺎﻡ ﺇﻻ ﺃﻥ ﺍﻟﻨﺴﺐ ﺍﻹﲨﺎﻟﻴﺔ ﲣﻔﻲ ﰲ ﻃﻴﺎ‪‬ﺎ ﻣﻔﺎﺭﻗﺎﺕ ﻫﺎﻣﺔ ﻭﻣﻌﻠﻮﻣﺎﺕ ﺃﺳﺎﺳﻴﺔ‬
‫ﻻﺯﻣﺔ ﻟﻘﻴﺎﺱ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻨﺴﺎﺀ ﰲ ﺍﳌﺮﺍﺣﻞ ﺍﳌﺨﺘﻠﻔﺔ ﻣﻦ ﺍﻟﻌﻤﺮ‪.‬‬
‫ﺃﻭﱃ ﻫﺬﻩ ﺍﳌﻔﺎﺭﻗﺎﺕ ﻫﻲ ﺃﻥ ﻧﺴﺒﺔ ‪ %١٥‬ﻣﻦ ﺇﲨﺎﱄ ﻭﻓﻴﺎﺕ ﺍﻟﻨﺴﺎﺀ ﺗﻘﻊ ﰲ ﳎﻤﻮﻋﺔ ﻣﺎ ﻳﺴﻤﻰ ﺑـ‬
‫"ﺍﻷﻋﺮﺍﺽ ﻭﺍﻷﺳﺒﺎﺏ ﻏﲑ ﺍﶈﺪﺩﺓ" ﻭﻫﻲ ﺃﻋﻠﻰ ﻣﻨﻬﺎ ﻋﻨﺪ ﺍﻟﺬﻛﻮﺭ ﲟﻘﺪﺍﺭ ‪ .%٣‬ﻭﺭﻏﻢ ﺃﻥ ﻫﺬﻩ ﺍ‪‬ﻤﻮﻋﺔ ﻭﺍﺭﺩﺓ‬
‫ﰲ ﻛﻞ ﺗﺼﻨﻴﻒ ﻷﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ ﺇﻻ ﺃﻥ ﺍﺭﺗﻔﺎﻉ ﻧﺴﺒﺘﻬﺎ ﻭﺧﺎﺻﺔ ﺑﲔ ﺍﻟﻨﺴﺎﺀ ﺗﻌﻜﺲ ﻋﺪﻡ ﺩﻗﺔ‬
‫ﻭﻣﺼﺪﺍﻗﻴﺔ ﺗﺴﺠﻴﻞ ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﺎﺓ ﻣﻦ ﻧﺎﺣﻴﺔ‪ .‬ﻭﻣﻦ ﻧﺎﺣﻴﺔ ﺃﺧﺮﻯ ﺗﺸﲑ ﺇﱃ ﺍﺣﺘﻤﺎﻝ ﺗﻌﺪﺩ ﺍﻷﻋﺮﺍﺽ‬
‫ﻭﺍﻟﻈﻮﺍﻫﺮ ﺍﳌﺮﺿﻴﺔ ﻟﺪﻯ ﺑﻌﺾ ﺍﻟﺴﻴﺪﺍﺕ ﺧﺎﺻﺔ ﻛﺒﺎﺭ ﺍﻟﺴﻦ ﺑﺴﺒﺐ ﺍﻟﺘﻌﺮﺽ ﺍﳌﺴﺘﻤﺮ ﻷﻋﺒﺎﺀ ﺍﳊﻴﺎﺓ‬
‫ﻭﺍﻷﺩﻭﺍﺭ ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺔ ﻭﻋﺪﻡ ﺗﻠﺒﻴﺔ ﺣﺎﺟﺎ‪‬ﻦ ﺍﻟﺼﺤﻴﺔ ﻋﱪ ﻣﺮﺍﺣﻞ ﺩﻭﺭﺓ ﺍﳊﻴﺎﺓ‪.‬‬

‫‪٢٥٥‬‬
‫ﺃﻣﺎ ﺍﳌﻔﺎﺭﻗﺔ ﺍﻟﺜﺎﻧﻴﺔ ﻓﻬﻲ ﻋﺪﻡ ﻭﺿﻮﺡ ﺃﳘﻴﺔ ﺍﳊﻮﺍﺩﺙ ﻭﺍﻟﺘﺴﻤﻢ ﻭﺍﻟﻌﻨﻒ ﰲ ﺍﻟﻨﺴﺒﺔ ﺍﻹﲨﺎﻟﻴﺔ‬
‫ﻟﻮﻓﻴﺎﺕ ﺍﻟﻨﺴﺎﺀ )‪ %٢‬ﻓﻘﻂ( ﺭﻏﻢ ﺍﺭﺗﻔﺎﻉ ﻧﺴﺒﺔ ﻫﺬﻩ ﺍ‪‬ﻤﻮﻋﺔ ﺑﺪﺭﺟﺔ ﻛﺒﲑﺓ ﰲ ﻣﺮﺍﺣﻞ ﻣﻌﻴﻨﺔ ﻣﻦ‬
‫ﺍﻟﻌﻤﺮ ﻛﻤﺎ ﺳﻮﻑ ﻳﺘﻀﺢ ﻻﺣﻘﺎﹰ‪.‬‬
‫ﻭﺍﳌﻔﺎﺭﻗﺔ ﺍﻟﺜﺎﻟﺜﺔ ﺍﳍﺎﻣﺔ ﻫﻲ ﻋﺪﻡ ﺣﺼﻮﻝ ﳎﻤﻮﻋﺔ ﻣﻀﺎﻋﻔﺎﺕ ﻣﺎ ﺣﻮﻝ ﺍﻟﻮﻻﺩﺓ )ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ(‬
‫ﻋﻠﻰ ﺃﻳﺔ ﻧﺴﺒﺔ ﻣﻦ ﲨﻠﺔ ﺍﻟﻮﻓﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻟﻺﻧﺎﺙ ﻧﻈﺮﺍﹰ ﻟﻀﺂﻟﺔ ﻋﺪﺩ ﺍﻟﻮﻓﻴﺎﺕ ‪‬ﺬﺍ ﺍﻟﺴﺒﺐ ﺇﱃ ﲨﻠﺔ‬
‫ﺍﻟﻮﻓﻴﺎﺕ ﺭﻏﻢ ﺧﻄﻮﺭﺓ ﻫﺬﻩ ﺍﳌﺸﻜﻠﺔ ﻭﺭﻏﻢ ﺃﻥ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﰲ ﻣﺼﺮ ﻳﻌﺘﱪ ﻣﺮﺗﻔﻌﺎﹰ ﻛﻤﺎ‬
‫ﺳﻴﺘﻀﺢ ﻻﺣﻘﺎﹰ‪.‬‬
‫ﻭﻳﺒﲔ ﺍﻟﺸﻜﻞ )‪ (٥-١٠‬ﺍﻟﻮﺯﻥ ﺍﻟﻨﺴﱯ ﻷﺳﺒﺎﺏ ﺍﻟﻮﻓﻴﺎﺕ ﻟﻺﻧﺎﺙ ﰲ ﻛﻞ ﻣﺮﺣﻠﺔ ﻣﻦ ﻣﺮﺍﺣﻞ ﺍﻟﻌﻤﺮ ﻃﺒﻘﺎﹰ‬
‫ﻟﺒﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ﻟﺴﻨﺔ ‪.١٩٩٦‬‬

‫‪٢٥٦‬‬
 ‫ﺷﻜﻞ )‪ :(٥-١٠‬ﺃﺳﺒﺎﺏ ﺍﻟﻮﻓﻴﺎﺕ ﻋﻨﺪ ﺍﻟﻨﺴﺎﺀ‬

‫‪60‬‬
‫‪60‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺪﻭﺭﻱ‬

‫ﻏﲑ ﳏﺪﺩ‬
‫‪50‬‬
‫‪43‬‬
‫ﺃﻭﺭﺍﻡ‬

‫‪40‬‬
‫ﺣﻮﺍﺩﺙ‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻮﻓﻴﺎﺕ‬ ‫‪34‬‬
‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ‬

‫‪30‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺒﻮﱄ ﻭﺍﻟﺘﻨﺎﺳﻠﻲ‬

‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﳍﻀﻤﻲ‬

‫‪18‬‬
‫‪20‬‬ ‫‪17‬‬
‫ﺃﻣﺮﺍﺽ ﻣﻌﺪﻳﺔ‬

‫‪٢٥٧‬‬
‫‪12‬‬ ‫‪12‬‬ ‫‪12‬‬
‫‪10‬‬
‫ﻣﺎ ﺣﻮﻝ ﺍﻟﻮﻻﺩﺓ‬
‫‪10‬‬ ‫‪6‬‬
‫‪7‬‬
‫‪6‬‬ ‫‪6‬‬ ‫‪6‬‬
‫‪5‬‬ ‫‪5‬‬
‫‪4‬‬ ‫‪4‬‬ ‫‪4‬‬
‫‪2‬‬
‫‪3‬‬ ‫‪3‬‬
‫‪2‬‬ ‫‪2‬‬
‫‪3‬‬ ‫‪3‬‬ ‫‪3‬‬ ‫ﺃﻣﺮﺍﺽ ﻋﺼﺒﻴﺔ‬
‫‪1‬‬ ‫‪1‬‬ ‫‪1‬‬ ‫‪1‬‬
‫‪0‬‬ ‫‪0‬‬
‫‪0‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﻟﻐﺪﺩ ﺍﻟﺼﻤﺎﺀ‬
‫‪10 to 15‬‬ ‫‪15 to 45‬‬ ‫‪45-‬‬
‫ﺍﻟﻔﺌﺎﺕ ﺍﻟﻌﻤﺮﻳﺔ‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﺑﻴﺎﻧﺎﺕ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ‪١٩٩٨‬‬

 ‫ ‪
,‬‬
‫ﻧﺎﻟﺖ ﺻﺤﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻫﺘﻤﺎﻣﺎﹰ ﻭﺍﺳﻌﺎﹰ ﰲ ﻣﺼﺮ ﺧﻼﻝ ﺍﻟﻌﻘﻮﺩ ﺍﻷﺧﲑﺓ ﺑﺪﺍﻳﺔ ﻣﻦ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﻟﺘﻄﻌﻴﻢ‪،‬‬
‫ﻭﺍﻟﻌﻼﺝ ﲟﺤﻠﻮﻝ ﻣﻌﺎﳉﺔ ﺍﳉﻔﺎﻑ‪ ،‬ﻭﺑﺮﻧﺎﻣﺞ ﻋﺪﻭﻯ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﻔﺴﻲ ﺍﳊﺎﺩﺓ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﲪﻼﺕ‬
‫ﺗﺸﺠﻴﻊ ﺍﻟﺮﺿﺎﻋﺔ ﺍﻟﻄﺒﻴﻌﻴﺔ‪.‬‬
‫ﻭﻗﺪ ﺻﺎﺣﺒﺖ ﻫﺬﻩ ﺍﳌﺒﺎﺩﺭﺍﺕ‪ ،‬ﻣﺒﺎﺩﺭﺍﺕ ﺃﺧﺮﻯ ﻟﺘﺤﺴﲔ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﻭﺻﺤﺔ ﺍﻷﻡ‪ ،‬ﻭﺑﺎﻷﺧﺺ ﺑﺮﺍﻣﺞ‬
‫ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﺍﻷﻣﻮﻣﺔ ﺍﻵﻣﻨﺔ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﳉﻬﻮﺩ ﺍﳌﻜﺜﻔﺔ ﻟﺘﺤﺴﲔ ﻭﺯﻳﺎﺩﺓ ﺍﻟﺒﻨﻴﺔ ﺍﻟﺘﺤﺘﻴﺔ‬
‫ﻟﻠﻌﻴﺎﺩﺍﺕ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﳏﺎﻭﻻﺕ ﻟﺘﻘﻮﻳﺔ ﻗﻄﺎﻉ ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻷﻭﻟﻴﺔ ﻛﺠﺰﺀ ﻣﻦ ﺍﳌﺸﺮﻭﻉ ﻃﻮﻳﻞ‬
‫ﺍﳌﺪ ﻹﺻﻼﺡ ﺍﻟﻘﻄﺎﻉ ﺍﻟﺼﺤﻲ‪ .‬ﻭﺑﺸﻜﻞ ﻋﺎﻡ‪ ،‬ﻳﺒﺪﻭ ﺃﻥ ﺻﺤﺔ ﺍﻟﻄﻔﻠﺔ ﰲ ﻣﺼﺮ ﺗﺴﺘﺠﻴﺐ ﳉﻬﻮﺩ‬
‫ﺍﻟﺘﻄﻮﺭ ﻛﻤﺎ ﻳﻈﻬﺮ ﰲ ﺍﳉﺪﻭﻝ )‪.(٣-١٠‬‬

‫ﺟﺪﻭﻝ )‪ :(٣-١٠‬ﺗﻄﻮﺭ ﻣﻌﺪﻝ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ‪ ،‬ﻭﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‪ ،‬ﻭﻣﺎ ﺑﻌﺪ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‪ ،‬ﻭﺍﻷﻃﻔﺎﻝ‬
‫ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ‬
‫ﻣﻦ ‪٤-١‬‬ ‫ﻣﺎ ﺑﻌﺪ‬ ‫ﺍﻷﻃﻔﺎﻝ‬
‫ﺣﺪﻳﺜﻮ ﺍﻟﻮﻻﺩﺓ‬
‫ﺳﻨﻮﺍﺕ‬ ‫ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ‬ ‫ﺍﻟﺮﺿﻊ‬ ‫ﺍﳌﺴﺢ‬ ‫ﺍﻟﺴﻨﺔ‬
‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬
‫‪١٦,١‬‬ ‫‪١٤,٦‬‬ ‫‪٢٩,٣‬‬ ‫‪٢٢,٤‬‬ ‫‪٢٥,٢‬‬ ‫‪٣٢,٦‬‬ ‫‪٥٤,٥‬‬ ‫‪٥٥,٠‬‬ ‫ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺪﳝﺠﺮﺍﰲ ‪٢٠٠٠‬‬ ‫‪٢٠٠٠ – ١٩٩٠‬‬
‫‪٢٨,١‬‬ ‫‪٢١,٧‬‬ ‫‪٤١,٨‬‬ ‫‪٢٩,٩‬‬ ‫‪٣١,٥‬‬ ‫‪٤٢,٦‬‬ ‫‪٧٣,٣‬‬ ‫‪٧٢,٥‬‬ ‫ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺪﳝﺠﺮﺍﰲ ‪١٩٩٥‬‬ ‫‪١٩٩٥ – ١٩٨٥‬‬
‫‪٣٦,١‬‬ ‫‪٢٤,٦‬‬ ‫‪٣٩,٢‬‬ ‫‪٣٦,٠‬‬ ‫‪٣٦,١‬‬ ‫‪٤٨,٤‬‬ ‫‪٧٥,٣‬‬ ‫‪٨٤,٤‬‬ ‫ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺪﳝﺠﺮﺍﰲ ‪١٩٩٢‬‬ ‫‪١٩٩٢ – ١٩٨٢‬‬
‫‪٤٦,٢‬‬ ‫‪٣٨,١‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪..‬‬ ‫‪٩٣,٤‬‬ ‫‪٩٥,١‬‬ ‫ﺍﳌﺴﺢ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺪﳝﺠﺮﺍﰲ ‪١٩٨٨‬‬ ‫‪١٩٨٨ – ١٩٧٨‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺍﻟﺰﻧﺎﰐ ﻭﻭﺍﻱ – ‪ – ٢٠٠١‬ﺟﺪﻭﻝ ‪ ،٤-١٠‬ﺍﻟﺰﻧﺎﰐ ﻭﺁﺧﺮﻭﻥ – ‪ – ١٩٩٦‬ﺟﺪﻭﻝ ‪ ،٤-٩‬ﺍﻟﺰﻧﺎﰐ ﻭﺁﺧﺮﻭﻥ – ‪ – ١٩٩٣‬ﺟﺪﻭﻝ ‪،٤-١٠‬‬
‫ﺳﻴﺪ ﻭﺃﺧﺮﻭﻥ – ‪ – ١٩٨٩‬ﺟﺪﻭﻝ ‪٨-٨‬‬

‫ﲟﻼﺣﻈﺔ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻟﻮﺍﺭﺩﺓ ﰲ ﺍﳉﺪﻭﻝ ﺍﻟﺴﺎﺑﻖ‪ ،‬ﳒﺪ ﺃﻥ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺣﺪﻳﺜﻲ ﺍﻟﻮﻻﺩﺓ ﺗﻌﻜﺲ ﺍﳌﺰﻳﺔ‬
‫ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺔ ﻟﻺﻧﺎﺙ‪ ،‬ﻭﻟﻜﻦ ﺗﺰﺩﺍﺩ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ ﰲ ﻣﺮﺣﻠﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ ﻭﻣﺮﺣﻠﺔ ﺍﻟﻄﻔﻮﻟﺔ‪.‬‬

‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻄﻔﻠﺔ‬

‫ﺗﻘﺪﻡ ﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳌﺴﺘﻤﺪﺓ ﻣﻦ ﺍﳌﺴﻮﺡ ﺍﻟﻘﻮﻣﻴﺔ ﺍﻟﱵ ﻗﺎﻡ ‪‬ﺎ ﻣﺸﺮﻭﻉ ﺍﻟﺘﻄﻌﻴﻢ ﰲ ﻣﺼﺮ ﻣﻘﺎﺭﻧﺔ ﺑﲔ‬
‫ﺍﻟﺬﻛﻮﺭ ﻭﺍﻹﻧﺎﺙ ﰲ ﻃﻠﺐ ﺍﻟﻌﻼﺝ ﻭﺯﻳﺎﺭﺓ ﺍﻷﻃﺒﺎﺀ‪ .‬ﻭﺗﻮﺿﺢ ﻫﺬﻩ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻟﺘﻤﻴﻴﺰ ﺿﺪ ﺍﻹﻧﺎﺙ ﰲ ﺍﻟﺬﻫﺎﺏ‬
‫ﺇﱃ ﺍﻟﻄﺒﻴﺐ‪ ،‬ﺧﺎﺻﺔ ﰲ ﺻﻌﻴﺪ ﻣﺼﺮ‪ ،‬ﻭﰲ ﺍ‪‬ﺘﻤﻌﺎﺕ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺍﳌﻨﺎﻃﻖ ﺍﻟﻌﺸﻮﺍﺋﻴﺔ ﺍﳊﻀﺮﻳﺔ‬
‫ﺍﻟﻔﻘﲑﺓ)‪.(١١‬‬

‫‪٢٥٨‬‬
 ‫ﺟﺪﻭﻝ )‪ :(٤-١٠‬ﺃﻫﻢ ﺍﳌﺆﺷﺮﺍﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻃﻔﺎﻝ‬
‫ﻧﺴﺒﺔ ﺍﻟﻘﻴﺪ‬ ‫‪ %‬ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ‬
‫‪ %‬ﻷﻱ‬
‫ﺍﻹﲨﺎﱄ ﰲ‬ ‫ﻟﻸﻃﻔﺎﻝ ﺩﻭﻥ‬ ‫ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ‬
‫ﺭﺿﺎﻋﺔ‬ ‫ﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ‬
‫ﺍﻟﺘﻌﻠﻴﻢ‬ ‫ﺍﳋﺎﻣﺴﺔ )ﺍﻟﻄﻮﻝ‬ ‫ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ‬
‫ﻃﺒﻴﻌﻴﺔ‬
‫ﺍﻷﺳﺎﺳﻲ ﻟﻺﻧﺎﺙ‬ ‫‪ /‬ﺍﻟﺴﻦ( –‪SD٢‬‬
‫‪١٩,٨‬‬ ‫‪٩٥,١‬‬ ‫ﺫﻛﺮ‬
‫‪١٨,٤‬‬ ‫‪٩٥,٩‬‬ ‫ﺃﻧﺜﻰ‬
‫‪١٠٤,٥‬‬ ‫‪٨,٥‬‬ ‫‪٤٤,٩‬‬ ‫‪٣٧,٤‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪٩٤,٨‬‬ ‫‪١٦,٠‬‬ ‫‪٥٨,٦‬‬ ‫‪٤٥,٣‬‬ ‫ﻭﺟﻪ ﲝﺮﻱ‬
‫‪١٣,٧‬‬ ‫‪٥١,٩‬‬ ‫‪٤٠,٣‬‬ ‫ﺣﻀﺮ‬ ‫‪-‬‬
‫‪١٦,٨‬‬ ‫‪٦٠,٨‬‬ ‫‪٤٧,٠‬‬ ‫ﺭﻳﻒ‬ ‫‪-‬‬
‫‪٨٠,٥‬‬ ‫‪٢٥,٨‬‬ ‫‪٨٩,٦‬‬ ‫‪٧١,٢‬‬ ‫ﻭﺟﻪ ﻗﺒﻠﻲ‬
‫‪٢١,٩‬‬ ‫‪٦٥,٢‬‬ ‫‪٥٤,٣‬‬ ‫ﺣﻀﺮ‬ ‫‪-‬‬
‫‪٢٧,٢‬‬ ‫‪٩٨,٥‬‬ ‫‪٧٧,٣‬‬ ‫ﺭﻳﻒ‬ ‫‪-‬‬
‫‪٩٠,٨‬‬ ‫‪١٦,٧‬‬ ‫‪٤٦,٢‬‬ ‫‪٣٧,٣‬‬ ‫ﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ‬
‫‪٩٠,٨‬‬ ‫‪١٨,٧‬‬ ‫‪٦٩,٢‬‬ ‫‪٥٤,٧‬‬ ‫ﺇﲨﺎﱄ ‪٢٠٠٠‬‬
‫‪٢٦,٠‬‬ ‫‪٨٥,٠‬‬ ‫‪٦٢,٠‬‬ ‫ﺇﲨﺎﱄ ‪١٩٩٢‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺍﳌﺴﺢ ﺍﻟﺪﳝﺠﺮﺍﰲ ﻭﺍﻟﺼﺤﻲ ‪٢٠٠٠‬‬

‫ﻧﻼﺣﻆ ﺃﻥ ﺍﻟﻔﺠﻮﺓ ﺑﲔ ﺍﻟﺮﻳﻒ ﻭﺍﳊﻀﺮ ﻓﻴﻤﺎ ﳜﺺ ﻭﻓﻴﺎﺕ ﺍﻷﻃﻔﺎﻝ ﺍﻟﺮﺿﻊ ﻗﺪ ﺗﺼﻞ ﺇﱃ ﺍﻟﻀﻌﻒ ﺑﲔ‬
‫ﺍﳌﻨﺎﻃﻖ ﺍﳉﻐﺮﺍﻓﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ؛ ﻓﺘﺼﻞ ﺃﻋﻠﻰ ﻣﻌﺪﻻ‪‬ﺎ ﰲ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ ﻭﺃﻗﻠﻬﺎ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫ﻭﳏﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩ‪.‬‬
‫ﻭﻳﺪﻟﻞ ﺍﳉﺪﻭﻝ ﺍﻟﺴﺎﺑﻖ ﻋﻠﻰ ﺃﻥ ﻫﻨﺎﻙ ﲤﻴﻴﺰﺍﹰ ﺿﺪ ﺍﻟﻄﻔﻠﺔ ﰲ ﻣﻨﺎﺡ ﺃﺧﺮﻯ ﺗﻨﺪﺭﺝ ﲢﺖ ﳏﺪﺩﺍﺕ ﺍﻟﺼﺤﺔ‬
‫ﻣﻨﻬﺎ ﻧﺴﺒﺔ ﺍﻟﻘﻴﺪ ﰲ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻷﺳﺎﺳﻲ ﺣﻴﺚ ﺗﺼﻞ ﺍﻟﻔﺠﻮﺓ ﺑﲔ ﺍﻟﺬﻛﻮﺭ ﻭﺍﻹﻧﺎﺙ ﺇﱃ ‪INP, ) %٨٥‬‬
‫‪ .(1999‬ﻛﻤﺎ ﻭﺟﺪ ﺃﻥ ﻧﺴﺒﺔ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﳏﺴﻮﺑﺔ )ﺍﻟﻄﻮﻝ ‪ /‬ﺍﻟﺴﻦ(‪ ،‬ﻭﻫﻲ ﺃﻛﺜﺮ ﺍﻧﺘﺸﺎﺭﺍﹰ ﰲ ﺍﻟﻮﺟﻪ‬
‫ﺍﻟﻘﺒﻠﻲ ﺗﻠﻴﻪ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﰒ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‪ ،‬ﻭﳒﺪ ﺃ‪‬ﺎ ﺃﻋﻠﻰ ﰲ ﺍﻟﺮﻳﻒ ﻋﻨﻪ ﰲ ﺍﳊﻀﺮ‪.‬‬

‫ﺟﺪﻭﻝ )‪ :(٥-١٠‬ﺍﻷﻧﻴﻤﻴﺎ ﰲ ﺍﻷﻃﻔﺎﻝ‬

‫ﺑﺴﻴﻄﺔ )‪-١٠‬‬ ‫ﻣﺘﻮﺳﻄﺔ )‪٩,٩-٧‬‬ ‫ﺑﺴﻴﻄﺔ )‪١٠,٩-١٠‬‬ ‫ﻣﺘﻮﺳﻄﺔ )‪٩,٩-٧‬‬
‫‪ ١٠,٩‬ﺟﻢ‪/‬ﺩﻝ(‬ ‫ﺟﻢ‪/‬ﺩﻝ(‬ ‫ﺟﻢ‪/‬ﺩﻝ(‬ ‫ﺟﻢ‪/‬ﺩﻝ(‬
‫‪٢٩,٥‬‬ ‫‪٠,٧‬‬ ‫‪١٧,٥‬‬ ‫‪١٢,١‬‬ ‫ﺫﻛﺮ‬
‫‪٢٦,١‬‬ ‫‪٢,٨‬‬ ‫‪١٩,٦‬‬ ‫‪١٠,٣‬‬ ‫ﺃﻧﺜﻰ‬
‫‪٢٧,٩‬‬ ‫‪١,٧‬‬ ‫‪١٨,٥‬‬ ‫‪١١,٢‬‬ ‫ﺇﲨﺎﱄ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺍﳌﺴﺢ ﺍﻟﺪﳝﺠﺮﺍﰲ ﻭﺍﻟﺼﺤﻲ ‪٢٠٠٠‬‬

‫ﻳﻌﺎﱐ ‪ %٣١,٦‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﰲ ﻣﺼﺮ ﻣﻦ ﺃﻧﻴﻤﻴﺎ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻭﺗﺄﰐ ﺍﻟﻨﺴﺐ ﺍﻷﻋﻠﻰ ﰲ ﳏﺎﻓﻈﺎﺕ‬
‫ﺍﳊﺪﻭﺩ ﺗﻠﻴﻬﺎ ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ ﰒ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﰒ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‪ .‬ﻭﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻓﺈﻥ‬
‫ﻧﺴﺐ ﺳﻮﺀ ﺍﻷﻧﻴﻤﻴﺎ ﰲ ﺍﻟﺮﻳﻒ ﺃﻋﻠﻰ ﻣﻨﻬﺎ ﰲ ﺍﳊﻀﺮ)‪.(١٢‬‬

‫‪٢٥٩‬‬
‫ﻭﺗﻌﺘﱪ ﺍﻟﺘﻔﺮﻗﺔ ﺑﲔ ﺍﻟﻄﻔﻞ ﻭﺍﻟﻄﻔﻠﺔ ﰲ ﺍﻟﺘﻨﺸﺌﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻣﻦ ﺃﺣﺪ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﱵ ﺗﺆﺛﺮ ﻋﻠﻰ‬
‫ﺍﻟﺼﺤﺔ‪ ،‬ﻓﻨﺠﺪ ﺃﻥ ﻣﺘﻮﺳﻂ ﻣﺪﺓ ﺇﺭﺿﺎﻉ ﺍﻟﻄﻔﻞ )‪ ١٩‬ﺷﻬﺮﺍﹰ( ﻳﺰﻳﺪ ﻋﻨﻪ ﰲ ﺍﻟﻄﻔﻠﺔ )‪ ١٧,٧‬ﺷﻬﺮ(‪ ،‬ﺣﻴﺚ‬
‫ﻳﺴﻮﺩ ﺍﳌﻌﺘﻘﺪ ﺇﺭﺿﺎﻉ ﺍﻟﻄﻔﻠﺔ ﳌﺪﺓ ﺃﻛﱪ "ﻳﻘﻮﻳﻬﺎ"‪ ،‬ﻭﺑﺎﻟﺘﺎﱄ ﻳﺘﻢ ﺇﻳﻘﺎﻑ ﺭﺿﺎﻋﺘﻬﺎ ﻣﺒﻜﺮﺍﹰ‪ .‬ﻭﻭﺟﺪ ﺃﻥ‬
‫‪ %٩٢,٢‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻳﺘﻢ ﺇﺭﺿﺎﻋﻬﻢ‪ ،‬ﺑﻼ ﻓﺮﻭﻕ ﻛﺒﲑﺓ ﺑﲔ ﺍﻟﻮﺟﻬﲔ ﺍﻟﻘﺒﻠﻲ ﻭﺍﻟﺒﺤﺮﻱ ﺃﻭ ﺑﲔ ﺍﻟﺮﻳﻒ‬
‫ﻭﺍﳊﻀﺮ‪ ،‬ﺇﻻ ﺃﻥ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﺗﻘﻞ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﻟﺘﺼﻞ ﺇﱃ ‪ .(EDHS-2000) %٨٤,٧‬ﻭﰲ‬
‫ﺑﻌﺾ ﺍﻷﺳﺮ ﻭﺟﺪ ﺃﻥ ﺍﻟﺮﺟﻞ ﰒ ﺍﻻﺑﻦ ﳛﺼﻼﻥ ﻋﻠﻰ ﺃﻓﻀﻞ ﺍﻟﻄﻌﺎﻡ ﰲ ﺍﻷﺳﺮﺓ ﻳﻠﻴﻬﻤﺎ ﺍﳌﺮﺃﺓ ﻭﺍﻻﺑﻨﺔ‪،‬‬
‫ﻭﳛﺪﺙ ﻫﺬﺍ ﺑﺎﻷﺧﺺ ﰲ ﺍﻟﻐﺬﺍﺀ ﺫﻱ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻐﺬﺍﺋﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ‪.‬‬
‫ﻭﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺤﻮﺍﺩﺙ ﺍﳌﱰﻟﻴﺔ‪ ،‬ﳒﺪ ﺃﻥ ﺍﻟﺒﻨﺎﺕ ﺃﻛﺜﺮ ﻋﺮﺿﺔ ﻟﻺﺻﺎﺑﺔ ﺑﺎﳊﺮﻭﻕ ﻭﺍﳉﺮﻭﺡ ﳌﻌﺎﻭﻧﺘﻬﻦ ﰲ‬
‫ﺍﻟﻄﻬﻲ ﻭﺍﻷﻋﻤﺎﻝ ﺍﳌﱰﻟﻴﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﻳﻜﻮﻥ ﺍﻟﺒﻨﻮﻥ ﺃﻛﺜﺮ ﻋﺮﺿﺔ ﻟﻠﻜﺴﻮﺭ ﻏﺎﻟﺒﺎﹰ ﺑﺴﺒﺐ ﺍﻟﻠﻬﻮ ﺧﺎﺭﺝ ﺍﳌﱰﻝ‪.‬‬

‫ﺧﺘﺎﻥ ﺍﻹﻧﺎﺙ‬
‫ﳝﺜﻞ ﻃﻘﺲ ﺧﺘﺎﻥ ﺍﻹﻧﺎﺙ ﰲ ﻣﺼﺮ ﻇﺎﻫﺮﺓ ﺃﺧﺮﻯ ﻟﻠﻘﻴﻢ ﺍ‪‬ﺘﻤﻌﻴﺔ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻟﻨﻮﻉ‪ .‬ﻓﺎﻟﱪﻏﻢ ﻣﻦ ﻧﻔﻲ‬
‫ﻋﻼﻗﺘﻪ ﺑﺎﻷﺩﻳﺎﻥ‪ ،‬ﺇﻻ ﺃﻧﻪ ﻋﺎﺩﺓ ﻣﻮﺭﻭﺛﺔ ﲢﻤﻞ ﺑﲔ ﻃﻴﺎ‪‬ﺎ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺮﺳﺎﺋﻞ ﳍﺎ ﺗﺄﺛﲑ ﺳﻠﱯ ﻭﻧﺘﺎﺋﺞ‬
‫ﺳﻠﺒﻴﺔ ﻋﻘﻠﻴﺔ ﻭﺟﺴﺪﻳﺔ ﻭﳎﺘﻤﻌﻴﺔ‪ .‬ﺗﺼﻞ ﻧﺴﺒﺔ ﺍﻧﺘﺸﺎﺭ ﻫﺬﻩ ﺍﻟﻌﺎﺩﺓ ‪ -‬ﻛﻤﺎ ﻳﺸﲑ ﺗﻘﺮﻳﺮ ﺍﳌﺴﺢ‬
‫ﺍﻟﺪﳝﺠﺮﺍﰲ ﻭﺍﻟﺼﺤﻲ ‪ – ٢٠٠٠‬ﺇﱃ ‪ %٨٠‬ﺑﲔ ﺍﳌﺘﺰﻭﺟﺎﺕ ﻣﻦ ﺳﻦ )‪ ٤٥ – ١٥‬ﺳﻨﺔ(‪ .‬ﻭﱂ ﺗﺘﺤﺴﻦ ﻫﺬﻩ‬
‫ﺍﻟﻨﺴﺒﺔ ﻛﺜﲑﺍﹰ ﰲ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻷﺧﲑﺓ)‪.(١٢‬‬
‫ﻣﻦ ﺍﳌﻼﺣﻆ ﺃﻥ ﻧﺴﺒﺔ ﻋﻤﻠﻴﺎﺕ ﺍﳋﺘﺎﻥ ﺍﻟﱵ ﻳﻘﻮﻡ ‪‬ﺎ ﺍﻷﻃﺒﺎﺀ ﻭﺍﳌﻤﺮﺿﺎﺕ ﻗﺪ ﺍﺯﺩﺍﺩﺕ ﻟﺘﺼﻞ ﻋﻠﻰ ﺣﻮﺍﱄ‬
‫‪ %٥٥,١‬ﻣﻦ ﺍﻟﻌﻤﻠﻴﺎﺕ ﺍﻟﱵ ﺃﺟﺮﻳﺖ ﻟﻔﺘﻴﺎﺕ ﰲ ﻓﺘﺮﺓ ﺍﳌﺮﺍﻫﻘﺔ‪ ،‬ﺧﺎﺻﺔ ﺑﻌﺪ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻟﻠﺴﻤﺎﺡ‬
‫ﻟﻸﻃﺒﺎﺀ ﻓﻘﻂ ﺑﺈﺟﺮﺍﺀ ﻫﺬﻩ ﺍﻟﻌﻤﻠﻴﺎﺕ ﺑﻘﺼﺪ ﺍﳊﺪ ﻣﻦ ﺍﳌﺨﺎﻃﺮ ﺍﳉﺴﺪﻳﺔ ﺍﻟﱵ ﻗﺪ ﻳﺴﺒﺒﻬﺎ ﺍﳋﺘﺎﻥ‪ .‬ﳑﺎ‬
‫ﻳﺸﲑ ﺇﱃ ﺃﳘﻴﺔ ﺗﺜﻘﻴﻒ ﺍﻷﻃﺒﺎﺀ ﺇﺫ ﻻ ﺗﻮﺟﺪ ﻗﻮﺍﻋﺪ ﺻﺤﻴﺔ ﺗﱪﺭ ﺇﺟﺮﺍﺀ ﺗﻠﻚ ﺍﻟﻌﻤﻠﻴﺔ)‪.(١٢‬‬
‫ﻭﻣﺎﺯﺍﻝ ﻣﻮﺿﻮﻉ ﺧﺘﺎﻥ ﺍﻹﻧﺎﺙ ﰲ ﻣﺼﺮ ﰲ ﺣﺎﺟﺔ ﺇﱃ ﺍﳌﺰﻳﺪ ﻣﻦ ﺍﳉﻬﻮﺩ ﻟﻮﻗﻒ ﺗﻠﻚ ﺍﳌﻤﺎﺭﺳﺔ ﺍﻟﻀﺎﺭﺓ‪.‬‬
‫ﻭﺣﻴﺚ ﺇﻥ ﻫﺬﻩ ﺍﻟﻘﻀﻴﺔ ﻣﻌﻘﺪﺓ ﻭﲤﺘﺰﺝ ﺑﺎﳌﻌﺘﻘﺪﺍﺕ ﺍ‪‬ﺘﻤﻌﻴﺔ‪ ،‬ﻓﺎﻟﺘﺄﺛﲑ ﻓﻴﻬﺎ ﻟﻦ ﻳﻜﻮﻥ ﺑﺒﺴﺎﻃﺔ ﻹﻋﺪﺍﺩ‬
‫ﳎﻤﻮﻋﺎﺕ ﻟﻠﺘﺜﻘﻴﻒ ﻭﺍﻟﺘﻮﻋﻴﺔ‪ ،‬ﻭﺇﳕﺎ ﳛﺘﺎﺝ ﺍﻷﻣﺮ ﺇﱃ ﻣﻨﻈﻮﻣﺔ ﺗﻨﻤﻮﻳﺔ ﻛﺎﻣﻠﺔ‪ .‬ﻭﻳﻌﺪ ﻣﺜﺎﻝ ﻗﺮﻳﺔ‬
‫"ﺍﻟﱪﺷﺔ" ﳕﻮﺫﺟﺎﹰ ﺣﻴﺎﹰ ﻳﱪﻫﻦ ﻋﻠﻰ ﺫﻟﻚ‪ .‬ﻓﻔﻲ ﻗﺮﻳﺔ ﺗﺒﻠﻎ ﻓﻴﻬﺎ ﻧﺴﺒﺔ ﺍﻷﻣﻴﺔ ‪ ،%٧٥‬ﺗﻀﺎﻓﺮﺕ ﺟﻬﻮﺩ‬
‫ﺗﻨﻤﻮﻳﺔ ﳐﺘﻠﻔﺔ ﻣﻦ ﺧﻼﻝ ﺇﺷﺮﺍﻙ ﺍ‪‬ﺘﻤﻊ ﻭﺍﻟﻘﻴﺎﺩﺍﺕ ﺃﺩﺕ ﰲ ﺍﻟﻨﻬﺎﻳﺔ ﺇﱃ ﺍﺧﺘﻔﺎﺀ ﺗﻠﻚ ﺍﻟﻌﺎﺩﺓ ﻣﻦ‬
‫ﺍﻟﻘﺮﻳﺔ‪ ،‬ﳑﺎ ﳚﻌﻠﻬﺎ ﲡﺮﺑﺔ ﺭﺍﺋﺪﺓ ﰲ ﻣﺼﺮ )ﺁﻣﺎﻝ ﻋﺒﺪ ﺍﳍﺎﺩﻱ – ‪.(١٣)(١٩٩٨‬‬

‫ﺟﺪﻭﻝ )‪ :(٦-١٠‬ﺍﻟﻨﺴﺐ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻔﺘﻴﺎﺕ ﰲ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ ‪ ١٩-١٣‬ﻋﺎﻣﺎﹰ ﺍﻟﻼﰐ ﰎ ﺧﺘﺎ‪‬ﻦ‪ ،‬ﺣﺴﺐ‬
‫ﺧﺼﺎﺋﺺ ﻣﺘﺼﻠﺔ ﺑﺎﳋﻠﻔﻴﺔ )ﺍﻟﻌﺪﺩ = ‪:(٧٨٩‬‬
‫ﺍﻻﻧﺘﺸﺎﺭ‬
‫‪٨٦,٠‬‬ ‫ﺍﻻﻧﺘﺸﺎﺭ ﺍﻟﻜﻠﻲ‬
‫ﺍﳊﺎﻟﺔ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﻟﻠﻜﺒﺎﺭ‬
‫‪٩٢,٥‬‬ ‫ﱂ ﻳﻠﺘﺤﻘﻦ ﺑﺎﻟﺘﻌﻠﻴﻢ‬
‫‪٩٧,٤‬‬ ‫ﱂ ﻳﻜﻤﻠﻦ ﺍﳌﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ‬
‫‪٨٤,٤‬‬ ‫ﺃﻛﻤﻠﻦ ﺍﳌﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ ‪ /‬ﱂ ﻳﻜﻤﻠﻦ ﺍﳌﺮﺣﻠﺔ ﺍﻹﻋﺪﺍﺩﻳﺔ‬

‫‪٢٦٠‬‬
 ‫‪٦٨,٤‬‬ ‫ﺛﺎﻧﻮﻱ ‪ /‬ﻣﺆﻫﻞ ﻓﻮﻕ ﺍﳌﺘﻮﺳﻂ‬
‫‪٤٧,٩‬‬ ‫ﺛﺎﻧﻮﻱ ﻓﺄﻋﻠﻰ‬
‫ﺍﳊﺎﻟﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ‪ /‬ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‬
‫‪٩١,٠‬‬ ‫ﻣﻨﺨﻔﻀﺔ‬
‫‪٩٠,٨‬‬ ‫ﻣﺘﻮﺳﻄﺔ‬
‫‪٧٤,٨‬‬ ‫ﻣﺮﺗﻔﻌﺔ‬
‫ﺍﻟﺘﻮﺯﻳﻊ ﺍﳉﻐﺮﺍﰲ‬
‫‪٦٩,٤‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪٨٢,٨‬‬ ‫ﻭﺟﻪ ﲝﺮﻱ‬
‫‪٨٨,٢‬‬ ‫ﻭﺟﻪ ﻗﺒﻠﻲ‬
‫ﺣﻀﺮ ‪ /‬ﺭﻳﻒ‬
‫‪٨٢,٤‬‬ ‫ﺣﻀﺮ‬
‫‪٩٣,٥‬‬ ‫ﺭﻳﻒ‬
‫* ﻣﺴﺘﻮﻯ ﺍﳌﻌﻨﻮﻳﺔ ﻻﺧﺘﺒﺎﺭﺍﺕ ﺍﻟﻔﺮﻭﻕ ﺍﻟﻔﺮﺩﻳﺔ ﺑﲔ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﻟﺪﺍﺧﻠﻴﺔ ﻟﻜﻞ ﻣﺘﻐﲑ ﻣﻦ ﺍﳌﺘﻐﲑﺍﺕ ﺍﳋﻠﻔﻴﺔ >‪٠,٠٠١‬‬
‫ﺍﳌﺼﺪﺭ‪) :‬ﺳﺤﺮ ﺍﻟﻄﻮﻳﻠﺔ ﻭﺁﺧﺮﻭﻥ‪ .‬ﺍﻻﻧﺘﻘﺎﻝ ﺇﱃ ﻣﺮﺣﻠﺔ ﺍﻟﻨﻀﺞ ‪ -‬ﻣﺴﺢ ﻗﻮﻣﻰ ﺣﻮﻝ ﺍﻟﻨﺶﺀ ﰲ ﻣﺼﺮ‪.‬ﺍﻟﻘﺎﻫﺮﺓ‪ :‬ﳎﻠﺲ‬
‫ﺍﻟﺴﻜﺎﻥ ﺍﻟﺪﻭﱃ‪.(١٩٩٩ ،‬‬

‫ﺷﻜﻞ )‪ :(٦-١٠‬ﺍﻻﺣﺘﻤﺎﻝ ﺍﻟﺘﺮﺍﻛﻤﻲ ﳋﺘﺎﻥ ﺍﻹﻧﺎﺙ ﻗﺒﻞ ﺑﻠﻮﻍ ‪ ١٥‬ﻋﺎﻣﺎﹰ ‪‬ﻤﻮﻋﺘﲔ ﻋﻤﺮﻳﺘﲔ ﳐﺘﻠﻔﺘﲔ‬

‫‪100%‬‬
‫‪90%‬‬
‫‪80%‬‬
‫ﻧﺴﺒﺔ ﺍﻻﻃﻔﺎﻝ ﺍﻟﻼﰐ ﰎ ﺧﺘﺎ‪‬ﻦ‬

‫‪70%‬‬
‫‪60%‬‬
‫‪50%‬‬
‫‪40%‬‬
‫‪30%‬‬
‫‪20%‬‬
‫‪10%‬‬
‫‪0%‬‬

‫‪3‬‬ ‫‪4‬‬ ‫‪5‬‬ ‫‪6‬‬ ‫‪7‬‬ ‫‪8‬‬ ‫‪9‬‬ ‫‪10‬‬ ‫‪11‬‬ ‫‪12‬‬ ‫‪13‬‬ ‫‪14‬‬ ‫‪15‬‬ ‫‪16‬‬ ‫‪17‬‬ ‫‪18‬‬
‫ﺍﻟﻌﻤﺮ ﺑﺎﻟﺴﻨﻮﺍﺕ‬

‫ﺍﳌﺼﺪﺭ‪) :‬ﺳﺤﺮ ﺍﻟﻄﻮﻳﻠﺔ ﻭﺁﺧﺮﻭﻥ‪ .‬ﺍﻻﻧﺘﻘﺎﻝ ﺇﱃ ﻣﺮﺣﻠﺔ ﺍﻟﻨﻀﺞ ‪ -‬ﻣﺴﺢ ﻗﻮﻣﻰ ﺣﻮﻝ ﺍﻟﻨﺶﺀ ﰲ ﻣﺼﺮ‪.‬ﺍﻟﻘﺎﻫﺮﺓ‪ :‬ﳎﻠﺲ‬
‫ﺍﻟﺴﻜﺎﻥ ﺍﻟﺪﻭﱃ‪.(١٩٩٩ ،‬‬

‫‪٢٦١‬‬
 ‫ﺟﺪﻭﻝ )‪ :(٧-١٠‬ﻣﻀﺎﻋﻔﺎﺕ ﺍﳋﺘﺎﻥ‬
‫ﻏﲑ ﺍﳌﺨﺘﻨﺎﺕ‬ ‫ﺍﳌﺨﺘﻨﺎﺕ‬
‫ﺍﻟﻨﺴﺒﺔ‬ ‫ﺍﻟﻌﺪﺩ‬ ‫ﺍﻟﻨﺴﺒﺔ‬ ‫ﺍﻟﻌﺪﺩ‬
‫ﺍﳌﻀﺎﻋﻔﺎﺕ ﺍﻟﻌﺎﺟﻠﺔ‬
‫‪-‬‬ ‫‪-‬‬ ‫‪٥١,٣‬‬ ‫‪١٠٣‬‬ ‫ﺍﻷﱂ‬
‫‪-‬‬ ‫‪-‬‬ ‫‪١٦,٥‬‬ ‫‪٣٣‬‬ ‫ﺍﻟﱰﻳﻒ‬
‫‪-‬‬ ‫‪-‬‬ ‫‪٤٣,٠‬‬ ‫‪٨٦‬‬ ‫ﺍﻻﻟﺘﻬﺎﺏ‬
‫‪-‬‬ ‫‪-‬‬ ‫‪٩,٥‬‬ ‫‪١٩‬‬ ‫ﺗﺸﻮﻩ ﺧﺎﺭﺟﻲ‬
‫ﺍﳌﻀﺎﻋﻔﺎﺕ ﺍﻵﺟﻠﺔ‬
‫‪٥,٢‬‬ ‫‪٥٢‬‬ ‫‪٦٨,٥‬‬ ‫‪١٣٧‬‬ ‫ﺃﱂ ﺍﻟﺪﻭﺭﺓ‬
‫‪٨,٠‬‬ ‫‪٨‬‬ ‫‪١٥,٥‬‬ ‫‪٢١‬‬ ‫ﺍﻟﻌﻘﻢ ﺍﻷﻭﱄ‬
‫‪١٣,٥‬‬ ‫‪١٣‬‬ ‫‪١٨,٥‬‬ ‫‪٣٧‬‬ ‫ﺍﻟﻌﻘﻢ ﺍﻟﺜﺎﻧﻮﻱ‬
‫‪٢٩,٠‬‬ ‫‪٢٩‬‬ ‫‪٤١,٥‬‬ ‫‪٨٣‬‬ ‫ﺃﱂ ﺃﺛﻨﺎﺀ ﺍﳉﻤﺎﻉ‬
‫‪٢٣,٠‬‬ ‫‪٢٣‬‬ ‫‪٦٢,٠‬‬ ‫‪١٢٤‬‬ ‫ﺿﻌﻒ ﺍﻟﺮﻏﺒﺔ ﺍﳉﻨﺴﻴﺔ‬
‫‪٥٤,٠‬‬ ‫‪٥٤‬‬ ‫‪٦٨,٩‬‬ ‫‪١٣٦‬‬ ‫ﺿﻌﻒ ﺍﻻﺳﺘﻤﺘﺎﻉ ﺍﳉﻨﺴﻲ‬
‫‪٢٩,٠‬‬ ‫‪٢٩‬‬ ‫‪٤١,٥‬‬ ‫‪٨٣‬‬ ‫ﻓﻘﺪ ﺍﻷﻭﺭﺟﺎﺯﻡ‬
‫ﺍﳌﺼﺪﺭ‪Adel Ali Sakr. M.Sc. Thesis in Obst & Guyn. A Study of Female Circumssion in Ismailia :‬‬
‫‪City, Suez Canal University, 1995‬‬

‫
‪$#
+ -.  /
! 0 ()1‬‬
‫ﻳﺒﻠﻎ ﻋﺪﺩ ﺍﻟﺴﻜﺎﻥ ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻟﻌﻤﺮﻳﺔ ﻣﻦ ‪ ١٩-١٠‬ﺳﻨﺔ ﰲ ﻣﺼﺮ ‪ ١٤,٥‬ﻣﻠﻴﻮﻥ ﺷﺎﺏ ﻭﻓﺘﺎﺓ ﳝﺜﻠﻮﻥ ‪%٢٢‬‬
‫ﻣﻦ ﺍﻟﺴﻜﺎﻥ‪ ،‬ﻭﻳﻌﲏ ﻫﺬﺍ ﺃﻥ ﻧﺴﺒﺔ ﺍﻟﻔﺘﻴﺎﺕ ﰲ ﻫﺬﻩ ﺍﳌﺮﺣﻠﺔ ﺗﺼﻞ ﺇﱃ ﺃﻛﺜﺮ ﻣﻦ ‪ %١٠‬ﻣﻦ ﺍﻟﺴﻜﺎﻥ‬
‫)ﺣﻮﺍﱄ ‪ ٧,٥‬ﻣﻠﻴﻮﻥ ﻓﺘﺎﻩ(‪ .‬ﻭﺗﺒﻠﻎ ﻧﺴﺒﺔ ﺍﻟﻔﺘﻴﺎﺕ ﺑﲔ ‪ ١٩-١٥‬ﺳﻨﺔ ‪ ٣,٣‬ﻣﻠﻴﻮﻥ ﺷﺎﺑﺔ)‪ .(٩‬ﻭﻻ ﺗﺘﻌﺪﻯ ﻧﺴﺒﺔ‬
‫ﺍﳊﺎﺻﻼﺕ ﻋﻠﻰ ‪ ٧‬ﺳﻨﻮﺍﺕ ﺩﺭﺍﺳﻴﺔ ﺃﻭ ﺃﻛﺜﺮ ﻧﺼﻒ ﺍﻟﻔﺘﻴﺎﺕ ﰲ ﻫﺬﻩ ﺍﳌﺮﺣﻠﺔ ﺍﻟﻌﻤﺮﻳﺔ )‪ ،(%٤٩‬ﺑﻴﻨﻤﺎ ﻻ‬
‫ﺗﺰﻳﺪ ﻧﺴﺒﺔ ﺍﳊﺎﺻﻼﺕ ﻋﻠﻰ ﺃﻛﺜﺮ ﻣﻦ ‪ ١٠‬ﺳﻨﻮﺍﺕ ﺩﺭﺍﺳﻴﺔ ﻋﻦ ﺍﻟﺮﺑﻊ )‪ (%٢٣‬ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﻣﻦ ﺳﻦ ‪١٩-١٨‬‬
‫ﺳﻨﺔ‪.‬‬
‫ﺃﻣﺎ ﻧﺴﺒﺔ ﺍﻟﻌﻤﺎﻟﺔ ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﻣﻦ ‪ ١٩-١٥‬ﺳﻨﺔ‪ ،‬ﻓﻬﻲ ‪ %٨‬ﻭﻧﺴﺒﺔ ﺍﳌﺘﺰﻭﺟﺎﺕ ﻣﻨﻬﻦ ﺣﻮﺍﱄ ‪%١٤‬‬
‫ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺜﻼﺛﺔ ﺑﺎﳌﺎﺋﺔ ﻓﻘﻂ ﺑﲔ ﺍﻟﺬﻛﻮﺭ ﰲ ﻧﻔﺲ ﺍﻟﺴﻦ‪ .‬ﻭﻳﺮﺗﺒﻂ ﺍﻟﺰﻭﺍﺝ ﺍﳌﺒﻜﺮ ﻟﻠﺒﻨﺎﺕ ﺑﺎﻻﻧﻘﻄﺎﻉ ﻋﻦ‬
‫ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﻓﺎﺣﺘﻤﺎﻝ ﺍﻟﺰﻭﺍﺝ ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﺍﳊﺎﺻﻼﺕ ﻋﻠﻰ ﺃﻗﻞ ﻣﻦ ‪ ٧‬ﺳﻨﻮﺍﺕ ﺩﺭﺍﺳﻴﺔ ‪ ٨‬ﺃﻣﺜﺎﻝ ﺍﳊﺎﺻﻼﺕ‬
‫ﻋﻠﻰ ﻋﺪﺩ ﺃﻛﱪ ﻣﻦ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻟﺪﺭﺍﺳﻴﺔ )‪ %٤٩‬ﻣﻘﺎﺑﻞ ‪ .(%٦‬ﻭﰲ ﻛﻞ ﻋﺎﻡ ﺗﻨﺠﺐ ﺣﻮﺍﱄ ‪ %٦‬ﻣﻦ ﺍﻟﺸﺎﺑﺎﺕ‬
‫ﰲ ﺳﻦ ‪ ١٩-١٥‬ﺳﻨﺔ ﻣﻮﺍﻟﻴﺪ ﺟﺪﺩﺍﹰ‪ ،‬ﻓﻔﻲ ﺳﻨﺔ ‪ ١٩٩٧‬ﺃﳒﱭ ‪ ٢٠٨,٨٠٠‬ﻣﻮﻟﻮﺩ)‪.(١٤‬‬

‫ﺗﻘﻴﻴﻢ ﺍﻟﻨﻤﻮ ﻭﺍﳊﺎﻟﺔ ﺍﻟﻐﺬﺍﺋﻴﺔ‬

‫ﻳﻌﺘﱪ ﺗﻘﻴﻴﻢ ﺍﻟﻨﻤﻮ ﻭﺍﳊﺎﻟﺔ ﺍﻟﻐﺬﺍﺋﻴﺔ ﰲ ﻣﺮﺣﻠﺔ ﺍﳌﺮﺍﻫﻘﺔ ﻣﻦ ﺍﳌﺆﺷﺮﺍﺕ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻠﺼﺤﺔ‪ .‬ﺃﻭ ﹰ‬
‫ﻻ‬
‫ﻟﺘﺄﺛﲑﻫﺎ ﺍﳌﺒﺎﺷﺮ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺍﻟﺒﺪﻧﻴﺔ ﻭﺍﻟﻨﻔﺴﻴﺔ ﻭﺍﻟﻘﺪﺭﺓ ﻋﻠﻰ ﺍﻟﺘﺤﺼﻴﻞ ﻭﺍﻹﻧﺘﺎﺝ ﰲ ﻫﺬﻩ ﺍﳌﺮﺣﻠﺔ‪،‬‬
‫ﻭﺛﺎﻧﻴﺎﹰ ﻻﻣﺘﺪﺍﺩ ﺃﺛﺮﻫﺎ ﻋﻠﻰ ﺇﻋﺪﺍﺩ ﺍﻟﻔﺘﺎﺓ‪ ،‬ﺧﺼﻮﺻﺎﹰ ﻟﻠﻤﺮﺣﻠﺔ ﺍﻟﻼﺣﻘﺔ ﻣﻦ ﺩﻭﺭﺓ ﺣﻴﺎ‪‬ﺎ ﻭﻋﻠﻰ ﺃﺑﻨﺎﺋﻬﺎ ﰲ‬
‫ﺍﳌﺴﺘﻘﺒﻞ‪.‬‬

‫‪٢٦٢‬‬
‫ﻓﺎﻟﻄﻔﻠﺔ ﺍﻟﱵ ﺗﻌﺎﱐ ﰲ ﻓﺘﺮﺓ ﺍﻟﻨﻀﻮﺝ ﻣﻦ ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﻭﻓﻘﺮ ﺍﻟﺪﻡ ﺑﺴﺒﺐ ﺳﻮﺀ ﺍﻷﻭﺿﺎﻉ‬
‫ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﻗﺼﻮﺭ ﺍﳌﻌﺮﻓﺔ ﻭﺍﻷﻣﻴﺔ ﻭﺍﻟﺘﻤﻴﻴﺰ ﺿﺪﻫﺎ ﰲ ﺻﺎﱀ ﺍﻟﺬﻛﻮﺭ‪ ،‬ﻫﻲ ﺃﻛﺜﺮ‬
‫ﻋﺮﺿﺔ ﰲ ﺫﺍﺕ ﺍﻟﻮﻗﺖ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻟﻄﻔﻴﻠﻴﺎﺕ ﻭﺍﻟﱰﻻﺕ ﺍﳌﻌﻮﻳﺔ ﻭﺍﻻﻟﺘﻬﺎﺑﺎﺕ ﺍﻟﺼﺪﺭﻳﺔ ﺍﻟﱵ ﺗﻨﻬﻚ ﻗﻮﺍﻫﺎ‬
‫ﻭﺗﻀﻌﻒ ﻗﺪﺭ‪‬ﺎ ﻋﻠﻰ ﻭﻗﺎﻳﺔ ﻧﻔﺴﻬﺎ ﻣﻦ ﺍﳊﻤﻞ ﺍﳌﺒﻜﺮ ﺟﺪﺍﹰ ﺍﻟﺬﻱ ﺑﺪﻭﺭﻩ ﻳﻌﺮﺿﻬﺎ ﻭﻃﻔﻠﺘﻬﺎ ﻟﻠﻤﺨﺎﻃﺮ‬
‫ﺍﻟﺼﺤﻴﺔ ﺧﺎﺻﺔ ﰲ ﺣﺎﻟﺔ ﻋﺪﻡ ﺗﻮﺍﻓﺮ ﺭﻋﺎﻳﺔ ﺻﺤﻴﺔ ﻣﻨﺎﺳﺒﺔ ﻭﻓﻌﺎﻟﺔ ﺃﺛﻨﺎﺀ ﻓﺘﺮﺓ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ‪ ،‬ﻓﻬﻲ‬
‫ﻗﺪ ﺗﺘﻌﺮﺽ ﳌﻀﺎﻋﻔﺎﺕ ﺍﻟﻮﻻﺩﺓ ﺑﺴﺒﺐ ﺗﻘﺰﻣﻬﺎ ﺃﻭ ﳓﺎﻓﺘﻬﺎ ﺃﻭ ﺍﻻﺛﻨﲔ ﻣﻌﺎﹰ‪ ،‬ﳑﺎ ﻋﻨﻪ ﻳﻨﺘﺞ ﻋﻨﻬﺎ ﻭﻻﺩﺓ‬
‫ﻣﺘﻌﺴﺮﺓ ﺃﻭ ﺍﻧﻔﺠﺎﺭ ﰲ ﺍﻟﺮﺣﻢ ﺃﻭ ﲪﻰ ﻧﻔﺎﺱ ﻗﺪ ﺗﻮﺩﻱ ﲝﻴﺎ‪‬ﺎ‪ .‬ﻓﺈﺫﺍ ﳒﺤﺖ ﰲ ﺇﻛﻤﺎﻝ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ‬
‫ﻓﺈﻥ ﻃﻔﻠﺘﻬﺎ ﰲ ﻣﻌﻈﻢ ﺍﻷﺣﻮﺍﻝ ﻻ ﺗﻜﻮﻥ ﻋﻠﻰ ﺍﻟﺪﺭﺟﺔ ﺍﳌﺜﻠﻰ ﻣﻦ ﺍﻛﺘﻤﺎﻝ ﺍﻟﻨﻤﻮ ﻭﺍﻟﺼﺤﺔ ﻋﻨﺪ ﺍﳌﻴﻼﺩ‪.‬‬
‫ﻭﲟﺎ ﺃﻥ ﺍﻷﻡ ﻧﻔﺴﻬﺎ ﺗﺼﺒﺢ ﺃﻛﺜﺮ ﺿﻌﻔﺎﹰ ﻭﺍﻋﺘﻼﻻﹰ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ ﻓﺈ‪‬ﺎ ﺗﻜﻮﻥ ﺃﻗﻞ ﻗﺪﺭﺓ ﻋﻠﻰ ﺭﻋﺎﻳﺔ‬
‫ﺍﻟﻄﻔﻠﺔ ﳑﺎ ﻳﻌﺮﺿﻬﺎ ﻟﺰﻳﺎﺩﺓ ﺍﺣﺘﻤﺎﻻﺕ ﺍﻟﻮﻓﺎﺓ ﻗﺒﻞ ﺍﻟﻮﺻﻮﻝ ﺇﱃ ﺳﻦ ﺍﳋﺎﻣﺴﺔ ﻭﺇﺫﺍ ﻛﺘﺐ ﳍﺎ ﺍﻟﻌﻤﺮ‬
‫ﻓﺈ‪‬ﺎ ﺗﻈﻞ ﰲ ﺣﺎﻟﺔ ﺻﺤﻴﺔ ﺃﻗﻞ ﻣﻦ ﺍﳌﺴﺘﻮﻯ ﺍﳌﻨﺸﻮﺩ ﻭﻫﻜﺬﺍ ﺗﺘﻜﺮﺭ ﺣﻠﻘﺎﺕ ﺍﻟﺪﺍﺋﺮﺓ ﺍﳌﻔﺮﻏﺔ ﻻﻋﺘﻼﻝ‬
‫ﺍﻟﺼﺤﺔ ﻋﱪ ﺍﻷﺟﻴﺎﻝ ﺑﲔ ﺍﻟﺒﻨﺎﺕ ﻭﺍﻟﻔﺘﻴﺎﺕ ﻭﺍﻷﻣﻬﺎﺕ )ﺷﻜﻞ ‪.(٧-١٠‬‬
‫ﻭﺗﻔﻴﺪ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺃﻥ ﻧﺴﺒﺔ ﻟﻴﺴﺖ ﻗﻠﻴﻠﺔ ﻣﻦ ﺍﻟﻔﺘﻴﺎﺕ ﰲ ﺳﻦ ﺍﳌﺮﺍﻫﻘﺔ ﻳﻌﺎﻧﲔ ﻣﻦ ﻣﺸﻜﻼﺕ ﰲ ﺍﻟﻨﻤﻮ‬
‫ﺍﳉﺴﺪﻱ‪ .‬ﻓﻘﺪ ﺑﻴﻨﺖ ﺩﺭﺍﺳﺔ "ﺍﻟﻨﺶﺀ ﻭﺍﻟﺘﻄﻮﺭ ﺍﻻﺟﺘﻤﺎﻋﻲ ﰲ ﻣﺼﺮ ‪ (١٥)"١٩٩٩‬ﺃﻥ ﻧﺴﺒﺔ ﺍﻟﺘﻘﺰﻡ ﺗﺘﺮﺍﻭﺡ‬
‫ﺑﲔ ‪ %٢١,٢‬ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﻣﻦ ‪ ١١-١٠‬ﺳﻨﺔ ﺇﱃ ‪ %٨‬ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﺍﻷﻛﱪ ﻣﻦ ‪ ١٦‬ﺳﻨﺔ ﺑﻨﺴﺒﺔ ﺇﲨﺎﻟﻴﺔ‬
‫‪ %١٤,٥‬ﻭﻫﻲ ﺃﻗﻞ ﻗﻠﻴﻼﹰ ﻣﻦ ﻧﺴﺒﺔ ﺍﻟﺘﻘﺰﻡ ﺍﻹﲨﺎﻟﻴﺔ ﺑﲔ ﺍﻟﻔﺘﻴﺎﻥ ﰲ ﻧﻔﺲ ﺍﳌﺮﺣﻠﺔ ﺍﻟﻌﻤﺮﻳﺔ )‪.(%١٨,٩‬‬
‫ﻭﲟﻘﺎﺭﻧﺔ ﻣﺘﻮﺳﻂ ﺍﻟﻄﻮﻝ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺴﻦ ﻟﻠﻔﺘﻴﺎﺕ ﺍﳌﺼﺮﻳﺎﺕ ﻣﻊ ﺍﻟﻌﻴﻨﺔ ﺍﳌﺮﺟﻌﻴﺔ ﺍﳌﻨﺘﻘﺎﺓ ﻣﻦ ﺍﳌﺮﻛﺰ‬
‫ﺍﻟﻘﻮﻣﻲ ﺍﻷﻣﺮﻳﻜﻲ ﻟﻺﺣﺼﺎﺀ ﻭﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ )ﻭﻫﻲ ﻋﻴﻨﺔ ﲤﺜﻞ ﺷﺮﳛﺔ ﺳﻜﺎﻧﻴﺔ ﺗﺘﻤﺘﻊ‬
‫ﺑﺘﻐﺬﻳﺔ ﺟﻴﺪﺓ( ﺗﺒﲔ ﺃﻧﻪ ﺃﻗﻞ ﰲ ﲨﻴﻊ ﺍﻟﻔﺌﺎﺕ ﺍﻟﻌﻤﺮﻳﺔ ﻣﻦ ‪ ١٩-١٠‬ﺳﻨﺔ ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﺍﳌﺼﺮﻳﺎﺕ‪.‬‬
‫ﺃﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻨﺤﺎﻓﺔ ﻓﻘﺪ ﺗﺮﺍﻭﺣﺖ ﻧﺴﺒﺘﻬﺎ ﺑﲔ ‪ %٩,١‬ﰲ ﺍﻟﻔﺘﻴﺎﺕ ﺍﻷﺻﻐﺮ )‪ ١١-١٠‬ﺳﻨﺔ( ﻭ‪%٣,٥‬‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻔﺘﻴﺎﺕ ﺍﻷﻛﱪ )‪ ١٨-١٦‬ﺳﻨﺔ( ﺑﻨﺴﺒﺔ ﺇﲨﺎﻟﻴﺔ ‪ %٦,٣‬ﻭﻫﻲ ﺃﻳﻀﺎﹰ ﺃﻗﻞ ﻣﻦ ﻧﺴﺒﺔ ﺍﻟﻨﺤﺎﻓﺔ‬
‫ﺑﲔ ﺍﻟﻔﺘﻴﺎﻥ ﰲ ﻧﻔﺲ ﺍﳌﺮﺣﻠﺔ ﺍﻟﻌﻤﺮﻳﺔ )‪) (%١٢,٥‬ﺟﺪﻭﻝ ‪ .(١‬ﻭﻳﺮﺟﻊ ﻫﺬﺍ ﺇﱃ ﺃﻥ ﻧﺴﺒﺔ ﺍﳌﻌﺮﺿﺎﺕ ﻟﻠﺒﺪﺍﻧﺔ‬
‫ﻭﺍﳌﺼﺎﺑﺎﺕ ‪‬ﺎ )‪ ٥,١ %١٤,١‬ﻭ‪ %‬ﻋﻠﻰ ﺍﻟﺘﻮﺍﱄ( ﻫﻲ ﺃﻋﻠﻰ ﻣﻦ ﻣﺜﻴﻼ‪‬ﺎ ﺑﲔ ﺍﻟﻔﺘﻴﺎﻥ )‪ %٥,٠‬ﻭ‪ % ٣,٢‬ﻋﻠﻰ‬
‫ﺍﻟﺘﻮﺍﱄ(‪ .‬ﻭﻗﺪ ﻛﺎﻧﺖ ﻣﻌﺪﻻﺕ ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﳉﺴﻢ ‪ BMI‬ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﺍﳌﺼﺮﻳﺎﺕ ﺃﻗﻞ ﻣﻦ ﺍﻟﻌﻴﻨﺔ‬
‫ﺍﳌﺮﺟﻌﻴﺔ ﺣﱴ ﺳﻦ ‪ ١٣‬ﺳﻨﺔ‪ ،‬ﰒ ﺗﺄﺧﺬ ﰲ ﺍﻟﺰﻳﺎﺩﺓ ﺑﻌﺪ ﻫﺬﻩ ﺍﻟﺴﻦ ﺣﱴ ﺳﻦ ‪ ١٩‬ﺳﻨﺔ ﻟﺘﺼﻞ ﻧﺴﺒﺔ‬
‫ﺍﳌﻌﺮﺿﺎﺕ ﻟﻠﺒﺪﺍﻧﺔ ﺇﱃ ‪ %٢٠,٩‬ﰲ ﺍﻟﻔﺘﻴﺎﺕ ﺑﲔ ‪ ١٩-١٦‬ﺳﻨﺔ )ﺃﻱ ﺿﻌﻒ ﺍﻟﻨﺴﺒﺔ ﺍﳌﺘﻮﻗﻌﺔ ﻣﻘﺎﺭﻧﺔ‬
‫ﺑﺎﻟﻌﻴﻨﺔ ﺍﳌﺮﺟﻌﻴﺔ( )ﺷﻜﻞ ‪ .(٨-١٠‬ﻛﻤﺎ ﺗﺼﻞ ﻧﺴﺒﺔ ﺍﻟﺒﺪﻳﻨﺎﺕ ﻓﻌﻼﹰ ﺇﱃ ‪ .%٦,٦‬ﻭﻗﺪ ﺑﺮﺭﺕ ﺍﻟﺪﺭﺍﺳﺔ‬
‫ﺍﻧﺘﺸﺎﺭ ﺍﻟﺒﺪﺍﻧﺔ ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﺑﺎﻟﻘﻴﻮﺩ ﺍﻟﱵ ﻛﺜﲑﺍﹰ ﻣﺎ ﺗﻔﺮﺽ ﻋﻠﻰ ﺣﺮﻛﺔ ﺍﻟﻔﺘﻴﺎﺕ ﻭﻧﺸﺎﻃﻬﻦ ﺍﻟﺒﺪﱐ‬
‫ﻓﻀﻼﹰ ﻋﻦ ﺗﻨﺎﻗﺺ ﺣﺠﻢ ﻭﻗﺖ ﺍﻟﻔﺮﺍﻍ ﺍﻟﺬﻱ ﳝﻜﻦ ﲣﺼﻴﺼﻪ ﻟﻸﻧﺸﻄﺔ ﺍﻟﺒﺪﻧﻴﺔ ﺑﺴﺒﺐ ﺯﻳﺎﺩﺓ ﺃﻋﺒﺎﺋﻬﻦ‬
‫ﺍﳌﱰﻟﻴﺔ ﻣﻊ ﺗﻘﺪﻡ ﺍﻟﻌﻤﺮ‪.‬‬
‫ﻣﻦ ﺍﳌﻬﻢ ﺍﻻﻧﺘﺒﺎﻩ ﺇﱃ ﺍﻟﻔﺮﻭﻕ ﺍﻟﻜﺒﲑﺓ ﰲ ﻫﺬﻩ ﺍﳌﺆﺷﺮﺍﺕ ﺣﺴﺐ ﺍﳊﺎﻟﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﳏﻞ‬
‫ﺍﻹﻗﺎﻣﺔ‪ ،‬ﺣﻴﺚ ﺗﺼﻞ ﻧﺴﺒﺔ ﺍﻧﺘﺸﺎﺭ ﺍﻟﺘﻘﺰﻡ ﻭﺍﻟﻨﺤﺎﻓﺔ ﺇﱃ ﺃﻗﻞ ﻗﻠﻴﻼﹰ ﻣﻦ ﺿﻌﻒ ﻣﺴﺘﻮﺍﻫﺎ ﺑﲔ ﺍﻟﻨﺶﺀ‬
‫ﻣﻦ ﺍﻟﻔﺌﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺍﻟﺪﻧﻴﺎ )‪ %٢٠,٢‬ﻭ‪ %١٣,٢‬ﻋﻠﻰ ﺍﻟﺘﻮﺍﱄ( ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺎﻟﻔﺌﺔ ﺍﻟﻌﻠﻴﺎ‬

‫‪٢٦٣‬‬
‫)‪ %١١,٧‬ﻭ‪ %٧,٨‬ﻋﻠﻲ ﺍﻟﺘﻮﺍﱄ(‪ ،‬ﺑﻴﻨﻤﺎ ﻋﻠﻰ ﺍﻟﻌﻜﺲ ﻣﻦ ﺫﻟﻚ ﻓﺈﻥ ﻣﻌﺪﻝ ﺍﻟﺒﺪﺍﻧﺔ ﺑﲔ ﺍﻟﻨﺶﺀ ﻣﻦ ﺍﻟﻔﺌﺎﺕ‬
‫ﺍﻟﻌﻠﻴﺎ )‪ (%٧,١‬ﺿﻌﻒ ﺍﳌﻌﺪﻝ ﰲ ﺍﻟﻔﺌﺎﺕ ﺍﻟﺪﻧﻴﺎ )‪ (%٣٠,١‬ﻛﻤﺎ ﺗﺰﺩﺍﺩ ﻣﻌﺪﻻﺕ ﺍﻟﺘﻘﺰﻡ ﻭﺍﻟﻨﺤﺎﻓﺔ ﺑﺸﻜﻞ‬
‫ﻣﻠﺤﻮﻅ ﰲ ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ )‪ (%١٦,٣ ،%٢٣,٢‬ﻋﻨﻬﺎ ﰲ ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ )‪%١٣,٩‬‬
‫ﻭ‪ (%٦,٢‬ﻭﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ )‪ .(%٣,٧) ،(%٩,٠‬ﺑﻴﻨﻤﺎ ﳛﺪﺙ ﺍﻟﻌﻜﺲ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺒﺪﺍﻧﺔ ﺍﻟﱵ ﺗﺰﻳﺪ ﰲ‬
‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ )‪ (%٧,٠١‬ﻋﻦ ﻛﻞ ﻣﻦ ﳏﺎﻓﻈﺎﺕ ﺍﻟﻮﺟﻬﲔ ﺍﻟﺒﺤﺮﻱ )‪ (%٤,٤‬ﻭﺍﻟﻘﺒﻠﻲ )‪.(%٢,٨‬‬
‫ﻭﻳﺆﻛﺪ ﺍﳌﺴﺢ ﺍﻟﺪﳝﻮﺟﺮﺍﰲ ﻭﺍﻟﺼﺤﻲ ﳌﺼﺮ ‪ (١٦)١٩٩٥‬ﺃﺛﺮ ﺍﻟﺘﻐﺬﻳﺔ ﰲ ﻣﺮﺣﻠﺔ ﺍﳌﺮﺍﻫﻘﺔ‪ ،‬ﺣﻴﺚ ﺗﺒﲔ ﺃﻥ‬
‫ﻣﺘﻮﺳﻂ ﻃﻮﻝ ﺍﻷﻣﻬﺎﺕ ‪ ١٥٨‬ﺳﻢ ﻭﺗﻘﻊ ﺣﻮﺍﱄ ‪ %١٠‬ﻣﻨﻬﻦ ﰲ ﻣﺴﺘﻮﻯ ﻃﻮﻝ ﺃﺩﱏ ﻣﻦ ﺍﳊﺪ ﺍﻟﺬﻱ ﻳﻌﺘﱪ‬
‫ﺁﻣﻨﺎﹰ ﻣﻦ ﳐﺎﻃﺮ ﺍﻟﻮﻻﺩﺓ ﺍﳌﺘﻌﺜﺮﺓ )‪١٥٠-١٤٠‬ﺳﻢ(‪ ،‬ﻛﻤﺎ ﺗﺒﲔ ﺃﻥ ‪ %٢‬ﻣﻦ ﺍﻷﻣﻬﺎﺕ ﺃﻗﺼﺮ ﻣﻦ ‪١٤٥‬ﺳﻢ‬
‫ﻭ‪ %٩‬ﻣﺎ ﺑﲔ ‪١٤٩-١٤٥‬ﺳﻢ‪ .‬ﻭﻣﻊ ﺫﻟﻚ ﻳﺘﻀﺢ ﻣﻦ ﺍﻟﻨﺘﺎﺋﺞ ﺃﻥ ﻧﺴﺒﺔ ﺍﻷﻣﻬﺎﺕ ﺍﻷﻗﻞ ﻣﻦ ‪ ١٤٥‬ﺳﻢ ﺗﻘﻞ‬
‫ﻋﱪ ﺍﻷﺟﻴﺎﻝ ﺣﻴﺚ ﺗﺒﻠﻎ ﺍﻟﻨﺴﺒﺔ ‪ %٢,٣‬ﺑﲔ ﺍﻷﻣﻬﺎﺕ ﺍﻷﻛﱪ ﺳﻨﺎﹰ )‪ ٤٩-٣٥‬ﺳﻨﺔ(‪ ،‬ﺑﻴﻨﻤﺎ ﺗﻘﻞ ﺇﱃ ‪ %٨‬ﰒ‬
‫‪ %١,٦‬ﺑﲔ ﺍﻷﻣﻬﺎﺕ ﺍﻷﺻﻐﺮ ﺳﻨﺎﹰ )‪ ٢٤-٢٠‬ﺳﻨﺔ(‪ ١٩-١٥) ،‬ﺳﻨﺔ( ﻋﻠﻰ ﺍﻟﺘﻮﺍﱄ‪.‬‬
‫ﻭﺗﺒﲔ ﻧﻔﺲ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ ﻣﺘﻮﺳﻂ ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﳉﺴﻢ ﻟﺪﻯ ﺍﻷﻣﻬﺎﺕ ﺍﳌﺼﺮﻳﺎﺕ ﻫﻮ )‪ (٢٦,٣‬ﻭﺃﻥ ‪%٢‬‬
‫ﻣﻨﻬﻦ ﻓﻘﻂ ﻳﻘﻌﻦ ﰲ ﻣﺴﺘﻮﻯ ﺃﻗﻞ ﻣﻦ ﺍﳌﺴﺘﻮﻯ ﺍﻟﺬﻱ ﻳﻌﺘﱪ ﺣﺪﺍﹰ ﺃﺩﱏ ﻟﻠﺪﻻﻟﺔ ﻋﻠﻰ ﻧﻘﺺ ﺍﻟﻄﺎﻗﺔ‬
‫ﺍﻟﻐﺬﺍﺋﻴﺔ ﺍﳌﺰﻣﻦ )‪ .(١٨,٥‬ﻭﺍﳌﻠﻔﺖ ﻟﻠﻨﻈﺮ ﺃﻥ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ‪-‬ﻋﻠﻰ ﻋﻜﺲ ﻣﺎ ﻫﻮ ﺣﺎﺩﺙ ﺑﺎﻟﻨﺴﺒﺔ ﻟﺘﻄﻮﺭ‬
‫ﺍﻟﻄﻮﻝ‪ -‬ﺁﺧﺬﺓ ﰲ ﺍﻟﺰﻳﺎﺩﺓ ﻋﱪ ﺍﻷﺟﻴﺎﻝ ﺣﻴﺚ ﺗﺼﻞ ﺇﱃ ‪ %٢,٣‬ﺑﲔ ﺍﻷﻣﻬﺎﺕ ﻣﻦ ‪ ١٩-١٥‬ﺳﻨﺔ ﻭﺗﻨﺨﻔﺾ‬
‫ﺇﱃ ‪ %١,١‬ﺑﲔ ﺍﻷﻣﻬﺎﺕ ﻣﻦ ‪ ٤٩-٣٥‬ﺳﻨﺔ‪.‬‬

‫ﺷﻜﻞ )‪ :(٧-١٠‬ﺍﻟﺪﺍﺋﺮﺓ ﺍﳌﻔﺮﻏﺔ ﻻﻋﺘﻼﻝ ﺍﻟﺼﺤﺔ ﻋﱪ ﺍﻷﺟﻴﺎﻝ‬

‫ﺍﻋﺘﻼﻝ ﺍﻟﺼﺤﺔ ﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ‬

‫)ﺳﻮﺀ ﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﻌﺪﻭﻯ(‬

‫ﻗﺼﻮﺭ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﳌﻨﺎﺳﺒﺔ ﲟﺎ‬
‫ﰲ ﺫﻟﻚ ﺧﺪﻣﺎﺕ‬ ‫ﺭﺿﻊ ﻣﻌﺘﻠﻮ‬
‫ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‬ ‫ﺍﻟﺼﺤﺔ ﻋﻨﺪ ﺍﻟﻮﻻﺩﺓ‬

‫ﺍﳔﻔﺎﺽ ﺍﻟﻄﺎﻗﺔ ﻭﺍﻹﻣﻜﺎﻧﺎﺕ‬

‫ﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﻔﻞ‬
‫ﺍﳔﻔﺎﺽ ﻣﺴﺘﻮﻯ‬
‫ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻟﻮﺿﻊ‬ ‫ﺍﻋﺘﻼﻝ ﺻﺤﺔ ﺍﻟﻨﺴﺎﺀ‬
‫ﺍﻻﻗﺘﺼﺎﺩﻯ ﻭﺍﻻﺟﺘﻤﺎﻋﻰ‬ ‫ﺍﻟﺘﻤﻴﻴﺰ ﺿﺪ ﺍﻟﻄﻔﻠﺔ ﰲ‬
‫ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﻐﺬﺍﺀ‬

‫ﺿﻌﻒ ﺍﻟﻄﺎﻗﺔ ﻭﺍﻹﻣﻜﺎﻧﺎﺕ‬

‫ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‬

‫ﺍﺧﺘﻼﻝ ﺍﻟﻨﻤﻮ ﻭﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ‬

‫ﻟﻠﺒﻨﺎﺕ ﻭﺍﻟﺸﺎﺑﺎﺕ‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪Winikoff B., Women's Health in the Developing Countries. In Koblisky et al :‬‬
‫‪eds.: The Health of Women: A global perspective. Boulder, Westview press, 1993. Ch. 16 pp‬‬
‫‪168-190.‬‬

‫‪٢٦٤‬‬
‫ﺟﺪﻭﻝ )‪ :(٨-١٠‬ﺗﻮﺯﻳﻊ ﺍﻟﻔﺘﻴﺎﺕ ﻭﺍﻟﻔﺘﻴﺎﻥ ﺍﳌﺼﻨﻔﲔ ﻛﻨﺎﻗﺼﻲ ﺗﻐﺬﻳﺔ ﻭﻓﻘﺎﹰ ﻟﻠﻄﻮﻝ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺴﻦ ﻭﺩﻟﻴﻞ‬
‫ﻛﺘﻠﺔ ﺍﳉﺴﻢ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺴﻦ )ﺑﺎﻟﻨﺴﺐ ﺍﳌﺌﻮﻳﺔ( ﺣﺴﺐ ﺧﺼﺎﺋﺺ ﳐﺘﺎﺭﺓ‬
‫ﻧﺴﺒﺔ‬ ‫ﻧﺴﺒﺔ‬ ‫ﻧﺴﺒﺔ‬
‫ﻧﺴﺒﺔ‬
‫ﺇﲨﺎﱄ‬ ‫ﺍﳌﻌﺮﺿﲔ‬ ‫ﺍﳌﺼﺎﺑﲔ‬ ‫ﺇﲨﺎﱄ‬ ‫ﺍﻟﺘﻘﺰﻡ‬
‫ﺍﳌﺼﺎﺑﲔ‬ ‫ﺍﻟﻌﻤﺮ‬
‫ﺍﻟﻌﺪﺩ‬ ‫ﻟﻠﺴﻤﻨﺔ‬ ‫ﺑﺎﻟﻨﺤﺎﻓﺔ‬ ‫ﺍﻟﻌﺪﺩ‬ ‫)ﺍﻋﺘﻼﻻﺕ‬
‫ﺑﺎﻟﺴﻤﻨﺔ‬
‫ﺍﻟﻨﻤﻮ(‬
‫‪١٩٦٨‬‬ ‫‪٤,٢‬‬ ‫‪١٠,١‬‬ ‫‪٩,٣‬‬ ‫‪١٦٥٨‬‬ ‫‪١٦,٦‬‬ ‫ﺍﻹﲨﺎﱄ‬

‫‪٩٥٧‬‬ ‫‪٣,٣‬‬ ‫‪٥,٩‬‬ ‫‪١٢,٥‬‬ ‫‪٨٠١‬‬ ‫‪١٨,٩‬‬ ‫ﺍﻟﻔﺘﻴﺎﻥ‬

‫‪١٠١١‬‬ ‫‪٥,١‬‬ ‫‪١٤,١‬‬ ‫‪٦,٣‬‬ ‫‪٨٥٧‬‬ ‫‪١٤,٥‬‬ ‫ﺍﻟﻔﺘﻴﺎﺕ‬

‫ﺍﻟﻔﺘﻴﺎﻥ‬
‫‪٣٨١‬‬ ‫‪٢,٨‬‬ ‫‪٨,٠‬‬ ‫‪١٦,١‬‬ ‫‪٣٦٥‬‬ ‫‪١٩,٣‬‬ ‫‪١٢-١٠‬‬
‫‪٣٠٥‬‬ ‫‪٤,١‬‬ ‫‪٣,٧‬‬ ‫‪١٣,٦‬‬ ‫‪٢٨٨‬‬ ‫‪١٩,٨‬‬ ‫‪١٥-١٣‬‬
‫‪٢٧١‬‬ ‫‪٢,٩‬‬ ‫‪٥,٦‬‬ ‫‪٦,١‬‬ ‫‪١٤٨‬‬ ‫‪١٥,٨‬‬ ‫‪+١٦‬‬

‫ﺍﻟﻔﺘﻴﺎﺕ‬
‫‪٣٩٩‬‬ ‫‪٤,٠‬‬ ‫‪٦,١‬‬ ‫‪٩,١‬‬ ‫‪٣٨٠‬‬ ‫‪٢١,٢‬‬ ‫‪١٢-١٠‬‬
‫‪٣٣٢‬‬ ‫‪٥,٣‬‬ ‫‪١٨,٤‬‬ ‫‪٥,١‬‬ ‫‪٣١٩‬‬ ‫‪٩,٦‬‬ ‫‪١٥-١٣‬‬
‫‪٢٨٠‬‬ ‫‪٦,٦‬‬ ‫‪٣٠,٩‬‬ ‫‪٣,٥‬‬ ‫‪١٥٨‬‬ ‫‪٨,٠‬‬ ‫‪+١٦‬‬

‫ﺍﻟﻮﺿﻊ‬
‫ﺍﻻﻗﺘﺼﺎﺩﻱ‪/‬ﺍﻻﺟﺘﻤﺎﻋﻲ‬
‫‪٥٥١‬‬ ‫‪٣,١‬‬ ‫‪٧,٧‬‬ ‫‪١٣,٢‬‬ ‫‪٤٧٤‬‬ ‫‪٢٠,٢‬‬ ‫ﻣﻨﺨﻔﺾ‬
‫‪٦٣٢‬‬ ‫‪٢,٨‬‬ ‫‪١١,٠‬‬ ‫‪٧,١‬‬ ‫‪٥٥٢‬‬ ‫‪١٥,٦‬‬ ‫ﻣﺘﻮﺳﻂ‬
‫‪٥٨٢‬‬ ‫‪٧,٠‬‬ ‫‪١٠,٨‬‬ ‫‪٧,٨‬‬ ‫‪٤٨٦‬‬ ‫‪١١,٧‬‬ ‫ﻣﺮﺗﻔﻊ‬
‫‪٤١٧‬‬ ‫‪٣,٣‬‬ ‫‪٨,٥‬‬ ‫‪١٢,١‬‬ ‫‪٣٥٥‬‬ ‫‪١٨,٢‬‬ ‫ﱂ ﻳﻠﺘﺤﻘﻮﺍ ﻣﻄﻠﻘﺎﹰ ‪ /‬ﱂ ﻳﻜﻤﻠﻮﺍ‬
‫ﺍﳌﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ‬
‫‪٨٤٥‬‬ ‫‪٣,٢‬‬ ‫‪٧,١‬‬ ‫‪١١,٥‬‬ ‫‪٧٨١‬‬ ‫‪١٩,٢‬‬ ‫ﺍﺑﺘﺪﺍﺋﻲ ‪ /‬ﱂ ﻳﻜﻤﻞ ﺍﻹﻋﺪﺍﺩﻱ‬
‫‪٤٦١‬‬ ‫‪٦,٢‬‬ ‫‪١٣,٨‬‬ ‫‪٦,٥‬‬ ‫‪٤١١‬‬ ‫‪١٢,٠‬‬ ‫ﺇﻋﺪﺍﺩﻱ‪ /‬ﱂ ﻳﻜﻤﻞ ﺛﺎﻧﻮﻱ‬
‫‪١٧٦‬‬ ‫‪٥,٧‬‬ ‫‪١٧,٦‬‬ ‫‪٢,٧‬‬ ‫‪٩١‬‬ ‫‪١٠,٨‬‬ ‫ﺛﺎﻧﻮﻱ‬
‫‪٦٩‬‬ ‫‪٥,٩‬‬ ‫‪١٢,٩‬‬ ‫‪٢,٠‬‬ ‫‪٢٠‬‬ ‫‪١٠,٠‬‬ ‫ﻓﻮﻕ ﻣﺘﻮﺳﻂ ‪ /‬ﺟﺎﻣﻌﺔ‬

‫‪٦٧٧‬‬ ‫‪٧,٩‬‬ ‫‪١٤,٧‬‬ ‫‪٤,٩‬‬ ‫‪٥٥٧‬‬ ‫‪١٢,٧‬‬ ‫ﺣﻀﺮ‬

‫‪١٢٩١‬‬ ‫‪٢,٥‬‬ ‫‪٧,٩‬‬ ‫‪١١,٥‬‬ ‫‪١١٠١‬‬ ‫‪١٨,١‬‬ ‫ﺭﻳﻒ‬

‫‪٣٢٨‬‬ ‫‪٧,١‬‬ ‫‪١٧,٠‬‬ ‫‪٣,٧‬‬ ‫‪٢٦١‬‬ ‫‪٩,٠‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬

‫‪٩٦٧‬‬ ‫‪٤,٤‬‬ ‫‪١٠,٨‬‬ ‫‪٦,٢‬‬ ‫‪٨١٦‬‬ ‫‪١٣,٩‬‬ ‫ﻭﺟﻪ ﲝﺮﻱ‬
‫‪٦٧٣‬‬ ‫‪٢,٨‬‬ ‫‪٦,١‬‬ ‫‪١٦,٢‬‬ ‫‪٥٨١‬‬ ‫‪٢٣,٢‬‬ ‫ﻭﺟﻪ ﻗﺒﻠﻲ‬
‫* ﻣﻼﺣﻈﺔ‪ :‬ﰎ ﺍﺳﺘﺒﻌﺎﺩ ‪ %٤‬ﻣﻦ ﺍﳌﺸﺎﻫﺪﺍﺕ‪ .‬ﺃﻳﻀﺎﹰ ﰎ ﺍﺳﺘﺒﻌﺎﺩ ﺍﻟﻨﺶﺀ ﺃﻛﱪ ﻣﻦ ‪ ١٨‬ﺳﻨﺔ ﻧﻈﺮﺍﹰ ﻷﻥ ﺍ‪‬ﺘﻤﻊ ﺍﳌﻌﻴﺎﺭﻱ ﻳﺘﻀﻤﻦ‬
‫ﻓﻘﻂ ﺍﻟﻨﺶﺀ ﰲ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ ﻣﻦ ‪ ١٨ -١٠‬ﺳﻨﺔ‪.‬‬
‫ﺍﳌﺼﺪﺭ‪) :‬ﺳﺤﺮ ﺍﻟﻄﻮﻳﻠﺔ ﻭﺁﺧﺮﻭﻥ‪ .‬ﺍﻻﻧﺘﻘﺎﻝ ﺇﱃ ﻣﺮﺣﻠﺔ ﺍﻟﻨﻀﺞ ‪ -‬ﻣﺴﺢ ﻗﻮﻣﻲ ﺣﻮﻝ ﺍﻟﻨﺶﺀ ﰲ ﻣﺼﺮ‪.‬ﺍﻟﻘﺎﻫﺮﺓ‪ :‬ﳎﻠﺲ‬
‫ﺍﻟﺴﻜﺎﻥ ﺍﻟﺪﻭﱄ‪.(١٩٩٩ ،‬‬

‫‪٢٦٥‬‬
 ‫ﺷﻜﻞ )‪ :(٨-١٠‬ﻣﻘﺎﺭﻧﺔ ﺩﻟﻴﻞ ﻛﺘﻠﺔ ﺍﳉﺴﻢ ﻟﻠﻔﺘﻴﺎﺕ ﺍﳌﺼﺮﻳﺎﺕ ﺑﺎﻟﺒﻴﺎﻧﺎﺕ ﺍﳌﺮﺟﻌﻴﺔ ﳌﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﻌﺎﳌﻴﺔ ‪ /‬ﺍﳌﺮﻛﺰ ﺍﻟﻘﻮﻣﻲ ﺍﻷﻣﺮﻳﻜﻲ ﻟﻺﺣﺼﺎﺀﺍﺕ ﺍﻟﺼﺤﻴﺔ‬

‫‪32‬‬
‫‪ 95‬ﺑﺎﳌﺎﺋﺔ‬
‫‪30‬‬

‫‪28‬‬

‫‪26‬‬

‫‪24‬‬
‫ﻛﺘﻠﺔ ﺍﳉﺴﻢ‬

‫‪22‬‬

‫‪20‬‬
‫‪ 50‬ﺑﺎﳌﺎﺋﺔ‬
‫‪18‬‬

‫‪16‬‬
‫‪ 5‬ﺑﺎﳌﺎﺋﺔ‬
‫‪14‬‬

‫‪12‬‬

‫‪10‬‬
‫‪10‬‬ ‫‪11‬‬ ‫‪12‬‬ ‫‪13‬‬ ‫‪14‬‬ ‫‪15‬‬ ‫‪16‬‬ ‫‪17‬‬ ‫‪18‬‬ ‫‪19‬‬
‫ﺍ‪‬ﺘﻤﻊ ﺍﳌـﺼﺮﻱ‬ ‫ﺍﻟﻌﻤﺮ ﺑﺎﻟﺴﻨﻮﺍﺕ‬
‫ﺍ‪‬ﺘﻤﻊ ﺍﳌﺮﺟﻌﻲ‬

‫ﺍﳌﺼﺪﺭ‪) :‬ﺳﺤﺮ ﺍﻟﻄﻮﻳﻠﺔ ﻭﺁﺧﺮﻭﻥ‪ .‬ﺍﻻﻧﺘﻘﺎﻝ ﺇﱃ ﻣﺮﺣﻠﺔ ﺍﻟﻨﻀﺞ ‪ -‬ﻣﺴﺢ ﻗﻮﻣﻲ ﺣﻮﻝ ﺍﻟﻨﺶﺀ ﰲ ﻣﺼﺮ‪.‬ﺍﻟﻘﺎﻫﺮﺓ‪ :‬ﳎﻠﺲ‬
‫ﺍﻟﺴﻜﺎﻥ ﺍﻟﺪﻭﱄ‪.(١٩٩٩ ،‬‬

‫ﻓﻘﺮ ﺍﻟﺪﻡ )ﺍﻷﻧﻴﻤﻴﺎ(‬

‫ﻟﻌﻠﻪ ﻣﻦ ﺍﳌﻌﺮﻭﻑ ﺃﻥ ﺍﻷﻧﻴﻤﻴﺎ ﻫﻲ ﺇﺣﺪﻯ ﺍﳌﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻛﺜﺮ ﺍﻧﺘﺸﺎﺭﺍﹰ ﺑﲔ ﺍﻟﻨﺴﺎﺀ ﰲ ﻣﺼﺮ‬
‫ﺑﺸﻜﻞ ﻋﺎﻡ ﻭﺧﺎﺻﺔ ﺑﲔ ﺍﳊﻮﺍﻣﻞ ﻭﺍﳌﺮﺿﻌﺎﺕ‪ ،‬ﻛﻤﺎ ﺃﻥ ﺍﻵﺛﺎﺭ ﺍﻟﻀﺎﺭﺓ ﳍﺎ ﻋﻠﻰ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ ﻟﻴﺴﺖ‬
‫ﺧﺎﻓﻴﺔ ﻭﺳﻮﻑ ﻳﺘﻢ ﺍﻹﺷﺎﺭﺓ ﺇﻟﻴﻬﺎ ﺗﻔﺼﻴﻼﹰ ﻋﻨﺪ ﺍﳊﺪﻳﺚ ﻋﻦ ﺍﳌﺮﺣﻠﺔ ﺍﻹﳒﺎﺑﻴﺔ ﻭﻟﻜﻦ ﻣﻦ ﺍﳌﻬﻢ ﺍﻟﺘﺄﻛﻴﺪ‬
‫ﻋﻠﻰ ﺃﻥ ﻫﺬﻩ ﺍﳌﺸﻜﻠﺔ ﺗﺒﺪﺃ ﺃﺻﻮﳍﺎ ﻣﻨﺬ ﺍﳌﺮﺍﺣﻞ ﺍﻷﻭﱃ ﻟﻠﻨﻤﻮ ﻭﺍﻟﻨﻀﺞ ﰲ ﺍﳌﺮﺍﻫﻘﺔ‪ .‬ﻓﻘﺪ ﺃﺛﺒﺖ ﻣﺴﺢ‬
‫"ﺍﻟﻨﺶﺀ ﻭﺍﻟﺘﻄﻮﺭ ﺍﻻﺟﺘﻤﺎﻋﻲ ﰲ ﻣﺼﺮ" ﺃﻥ ﺣﻮﺍﱄ ‪ %٤٥,٦‬ﻣﻦ ﺍﻟﻔﺘﻴﺎﺕ ﻳﻌﺎﻧﲔ ﻣﻦ ﺩﺭﺟﺔ ﺃﻭ ﺃﺧﺮﻯ ﻣﻦ‬
‫ﺍﻷﻧﻴﻤﻴﺎ‪ .‬ﻭﻗﺪ ﺻﻨﻔﺖ ﺩﺭﺟﺔ ﺍﻷﻧﻴﻤﻴﺎ ﻋﻠﻰ ﺃ‪‬ﺎ ﺿﻌﻴﻔﺔ ﰲ ‪ %٨٣‬ﻣﻨﻬﻦ )‪ ١٢-١٠‬ﺟﺮﺍﻣﺎﹰ‬
‫ﻫﻴﻤﻮﺟﻠﻮﺑﲔ‪١٠٠/‬ﻣﻠﻞ(‪ ،‬ﻭﻣﺘﻮﺳﻄﺔ ﰲ ‪٩,٩-٧) %١٦,٥‬ﺟﺮﺍﻡ‪١٠٠/‬ﻣﻠﻞ( ﻭﺷﺪﻳﺪﺓ ﰲ ‪) %٠,٤‬ﺃﻗﻞ ﻣﻦ‬
‫‪٧‬ﺟﻢ‪١٠٠/‬ﻣﻠﻞ( ﻭﱂ ﻳﻜﻦ ﻫﻨﺎﻙ ﻓﺮﻕ ﻭﺍﺿﺢ ﰲ ﻫﺬﻩ ﺍﻟﻨﺴﺐ ﺍﻹﲨﺎﻟﻴﺔ ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﻭﺍﻟﻔﺘﻴﺎﻥ‪ .‬ﺇﻻ ﺃﻥ‬
‫ﻫﻨﺎﻙ ﺍﺧﺘﻼﻓﺎﹰ ﻭﺍﺿﺤﺎﹰ ﰲ ﻧﺴﺐ ﺍﻧﺘﺸﺎﺭ ﺍﻷﻧﻴﻤﻴﺎ ﺣﺴﺐ ﺍﻟﺴﻦ ﺑﲔ ﺍﻟﻨﻮﻋﲔ‪ ،‬ﻓﺒﻴﻨﻤﺎ ﺗﺰﺩﺍﺩ ﻣﻌﺪﻻﺕ‬
‫ﺍﻧﺘﺸﺎﺭ ﺍﻷﻧﻴﻤﻴﺎ ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﺗﺪﺭﳚﻴﺎﹰ ﺑﺪﺍﻳﺔ ﻣﻦ ‪ ١٤‬ﺳﻨﺔ ﺣﱴ ﺗﺼﻞ ﺇﱃ ﺃﻋﻠﻰ ﻣﻌﺪﻻ‪‬ﺎ )ﺣﻮﺍﱄ ‪(%٦٠‬‬
‫ﻋﻨﺪ ﺳﻦ ‪ ١٩‬ﺳﻨﺔ‪ ،‬ﻓﺈﻥ ﻣﻌﺪﻻﺕ ﺍﻻﻧﺘﺸﺎﺭ ﺗﻘﻞ ﺑﺸﻜﻞ ﻣﻄﺮﺩ ﺑﲔ ﺍﻟﻔﺘﻴﺎﻥ ﺣﱴ ﺗﺼﻞ ﺇﱃ ﺃﻗﻞ‬
‫ﻣﻌﺪﻻ‪‬ﺎ ﻋﻨﺪ ﺳﻦ ‪ ١٩‬ﺳﻨﺔ )ﺣﻮﺍﱄ ‪ (%٢٠‬ﺑﺎﺳﺘﺜﻨﺎﺀ ﺍﺭﺗﻔﺎﻉ ﻣﺆﻗﺖ ﻋﻨﺪ ﺳﻦ ‪ ١٦‬ﺳﻨﺔ ﺗﻘﺮﻳﺒﺎﹰ‪ .‬ﻭﺗﻌﺰﻯ‬

‫‪٢٦٦‬‬
‫ﻫﺬﻩ ﺍﻟﺰﻳﺎﺩﺓ ﺍﳌﻄﺮﺩﺓ ﻟﻸﻧﻴﻤﻴﺎ ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ ﺇﱃ ﻋﺪﻡ ﻛﻔﺎﻳﺔ ﺍﻟﻐﺬﺍﺀ ﻭﺧﺎﺻﺔ ﻋﻨﺼﺮﻱ ﺍﳊﺪﻳﺪ ﻭﲪﺾ‬
‫ﺍﻟﻔﻮﻟﻴﻚ ﻟﺘﻠﺒﻴﺔ ﺍﻻﺣﺘﻴﺎﺝ ﺍﳌﺘﺰﺍﻳﺪ ﻣﻊ ﺑﺪﺍﻳﺔ ﺍﻟﻄﻤﺚ ﻭﻓﻘﺪﺍﻥ ﺍﻟﺪﻡ ﺍﳌﺴﺘﻤﺮ‪.‬‬
‫ﺗﺆﺛﺮ ﺍﻷﻧﻴﻤﻴﺎ ‪ -‬ﻛﻤﺎ ﻫﻮ ﻣﻮﺿﺢ ﰲ ﺍﳉﺪﻭﻝ ﺭﻗﻢ )‪ - (٩-١٠‬ﻋﻠﻰ ﺛﻠﺚ ﺃﻃﻔﺎﻝ ﻣﺼﺮ ﻣﻦ ‪ ١٩ – ١١‬ﺳﻨﺔ‬
‫ﻭﺃﻋﻠﻰ ﺑﻘﻠﻴﻞ ﺑﲔ ﺍﻟﺬﻛﻮﺭ ﻋﻦ ﺍﻹﻧﺎﺙ‪.‬‬

‫ﺟﺪﻭﻝ )‪ :(٩-١٠‬ﺍﻧﺘﺸﺎﺭ ﺍﻷﻧﻴﻤﻴﺎ ﺑﲔ ﺍﳌﺮﺍﻫﻘﲔ‬

‫‪ASCE 1997‬‬ ‫‪DHS 2000‬‬
‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬
‫‪٠,٢‬‬ ‫‪٠,٢‬‬ ‫‪٠,١‬‬ ‫‪٠,١‬‬ ‫ﺣﺎﺩﺓ‬
‫‪٧,٥‬‬ ‫‪٧,١‬‬ ‫‪٢,٨‬‬ ‫‪٠,٧‬‬ ‫ﻣﺘﻮﺳﻄﺔ‬
‫‪٣٧,٩‬‬ ‫‪٤٠,٤‬‬ ‫‪٢٦,١‬‬ ‫‪٢٩,٥‬‬ ‫ﺧﻔﻴﻔﺔ‬
‫‪٤٥,٦‬‬ ‫‪٤٧,٧‬‬ ‫‪٢٩,٠‬‬ ‫‪٣٠,٣‬‬ ‫ﺍ‪‬ﻤﻮﻉ‬
‫‪El-Zanaty and Way, 2001, table 13.3‬‬ ‫ﺍﳌﺼﺪﺭ‪:‬‬
‫‪El-Tawila et al., 2000, table 4.4 and figure 4.3‬‬

‫ﻭﻓﻴﺎﺕ ﻭﻣﺮﺍﺿﺔ ﺍﳌﺮﺍﻫﻘﺎﺕ‬

‫ﰲ ﻣﺼﺮ‪ :‬ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ ﻣﻨﺨﻔﻀﺔ ﻭﰲ ﺍﻟﺬﻛﻮﺭ ﺃﻋﻠﻰ ﻣﻨﻬﺎ ﰲ ﺍﻹﻧﺎﺙ‪ .‬ﺃﻣﺎ ﺍﳌﺮﺍﺿﺔ ﻓﻬﻲ ﻣﺘﺴﺎﻭﻳﺔ‬
‫ﺗﻘﺮﻳﺒﺎﹰ‪ .‬ﻭﺗﻮﺟﺪ ﺯﻳﺎﺩﺓ ﻃﻔﻴﻔﺔ ﰲ ﺍﻹﺻﺎﺑﺎﺕ ﺍﻟﻄﻔﻴﻠﻴﺔ ﺑﲔ ﺍﻹﻧﺎﺙ)‪.(١٥‬‬

‫ﺍﻟﺼﺤﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ‬
‫ﺍﻟﺰﻭﺍﺝ ﺍﳌﺒﻜﺮ ﻭﺍﻹﳒﺎﺏ ﺍﳌﺒﻜﺮ‬
‫ﻳﺴﺒﺐ ﺍﻟﺰﻭﺍﺝ ﺍﳌﺒﻜﺮ ﳐﺎﻃﺮ ﺻﺤﻴﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺃﻧﻪ ﳛﻤﻞ ﺍﻧﺘﻬﺎﻛﺎﹰ ﳊﻘﻮﻕ ﺍﻹﻧﺴﺎﻥ ﺍﳋﺎﺻﺔ‬
‫ﺑﺎﻟﻔﺘﻴﺎﺕ‪ .‬ﻓﺎﻟﻔﺘﻴﺎﺕ ﺍﳌﺘﺰﻭﺟﺎﺕ ﺻﻐﲑﺍﺕ ﰲ ﺍﻟﺴﻦ ﻳﻮﺍﺟﻬﻦ ﳐﺎﻃﺮ ﻣﺮﺗﻔﻌﺔ ﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ ﻣﻦ‬
‫ﻭﻓﻴﺎﺕ ﻭﻣﺮﺍﺿﺔ‪ .‬ﻭﻳﻜﻦ ﻋﻠﻰ ﺍﻷﻏﻠﺐ ﻻ ﺩﻭﺭ ﳍﻦ ﰲ ﺍﺧﺘﻴﺎﺭ ﺍﻟﺰﻭﺝ‪ .‬ﺃﻗﻞ ﺣﻈﺎﹰ ﻣﻦ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺃﻗﻞ ﻣﻌﺮﻓﺔ‬
‫ﻓﻴﻤﺎ ﳜﺺ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﻭﺍﳉﻨﺴﻴﺔ‪ .‬ﻭﻻ ﻳﺰﺍﻝ ﺍﻟﺰﻭﺍﺝ ﺍﳌﺒﻜﺮ ﰲ ﻣﺼﺮ ﻳﺸﻜﻞ ﲢﺪﻳﺎﹰ ﻛﺒﲑﺍﹰ‪ .‬ﻛﻤﺎ‬
‫ﻳﻮﺿﺢ ﺟﺪﻭﻝ )‪ :(١٠-١٠‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻨﺴﺎﺀ ﺍﳊﻮﺍﻣﻞ ﻣﺎ ﺑﲔ ﺳﻦ ‪.١٩ – ١٥‬‬

‫‪٢٦٧‬‬
‫ﺟﺪﻭﻝ )‪ :(١٠-١٠‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻨﺴﺎﺀ ﺍﳊﻮﺍﻣﻞ ﻣﻦ ﺳﻦ ‪ ١٩-١٥‬ﺳﻨﺔ ﻭﺍﻟﻼﺋﻰ ﺑﺪﺃﻥ ﲪﻠﻬﻦ ﰲ ﺃﻭﻝ‬
‫ﻃﻔﻞ ﻭﻓﻘﺎﹰ ﻟﻠﺨﺼﺎﺋﺺ ﺍﻟﺪﳝﺠﺮﺍﻓﻴﺔ ﳍﻦ )‪.(DHS 2000‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ‬
‫ﻟﻠﻤﺮﺍﻫﻘﺎﺕ ﺍﻟﻼﰐ‬ ‫ﺍﻟﺴﻤﺎﺕ ﺍﻟﺪﳝﺠﺮﺍﻓﻴﺔ‬
‫ﺑﺪﺃﻥ ﲪﻠﻬﻦ‬
‫ﺍﻟﺴﻦ‬
‫‪٠,٦‬‬ ‫‪ ١٥‬ﺳﻨﺔ‬
‫‪٢,٧‬‬ ‫‪ ١٦‬ﺳﻨﺔ‬
‫‪٧,٣‬‬ ‫‪ ١٧‬ﺳﻨﺔ‬
‫‪١٢,٣‬‬ ‫‪ ١٨‬ﺳﻨﺔ‬
‫‪٢٠,٤‬‬ ‫‪ ١٩‬ﺳﻨﺔ‬
‫ﺍﻹﻗﻠﻴﻢ ﺍﳉﻐﺮﺍﰲ‬
‫‪٤,٦‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪٥,٥‬‬ ‫ﺣﻀﺮ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪٩,٣‬‬ ‫ﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪٦,٢‬‬ ‫ﺣﻀﺮ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫‪١٣,٠‬‬ ‫ﺭﻳﻒ ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫ﺃﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺗﻌﻠﻴﻤﻲ‬
‫‪١٦,٩‬‬ ‫ﻏﲑ ﻣﺘﻌﻠﻤﲔ‬
‫‪١٦,٣‬‬ ‫ﱂ ﻳﻜﻤﻠﻮﺍ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻻﺑﺘﺪﺍﺋﻲ‬
‫‪٤,٩‬‬ ‫ﺃﻛﻤﻠﻮﺍ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻻﺑﺘﺪﺍﺋﻲ ﻭﺑﻌﺾ ﺍﻹﻋﺪﺍﺩﻱ‬
‫‪٦,٥‬‬ ‫ﺃﻛﻤﻠﻮﺍ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻹﻋﺪﺍﺩﻱ ﻭﻣﺎ ﻗﺪ ﻳﻜﻮﻥ ﺃﻋﻠﻰ‬
‫‪٨,٥‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫ﺍﳌﺼﺪﺭ‪El-Zanaty and Way, 2001, table 4.10 :‬‬

‫ﺍﳌﻌﺮﻓﺔ ﺑﺎﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ‬

‫ﺃﻭﺿﺤﺖ ﺩﺭﺍﺳﺔ ﺣﺪﻳﺜﺔ ﻧﻘﺺ ﰲ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻋﻦ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﺑﲔ ﺍﻟﻔﺘﻴﺎﺕ‪ .‬ﻓﻌﻨﺪ ﺳﺆﺍﻝ‬
‫ﳎﻤﻮﻋﺔ ﻣﻦ ﺍﻟﻔﺘﻴﺎﺕ ﻣﻦ ‪ ١٩ – ١٦‬ﺳﻨﺔ ﻋﻦ ﻓﺘﺮﺓ ﺍﳋﺼﻮﺑﺔ‪ .‬ﺃﺟﺎﺑﺖ ‪ %١٥‬ﻓﻘﻂ ﻣﻨﻬﻦ ﺇﺟﺎﺑﺔ‬
‫ﺻﺤﻴﺤﺔ‪ .‬ﺃﻣﺎ ﻋﻦ ﻭﺳﺎﺋﻞ ﻣﻨﻊ ﺍﳊﻤﻞ‪ %٥ ،‬ﻓﻘﻂ ﻛﻦ ﻳﻌﺮﻓﻦ ﺍﻟﻮﺍﻗﻲ ﺍﻟﺬﻛﺮﻱ‪ .‬ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑـ ‪ %١٤‬ﺑﲔ‬
‫ﺍﻟﺬﻛﻮﺭ)‪.(١٥‬‬
‫ﺃﻣﺎ ﻋﻦ ﺍﳌﻌﺮﻓﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﳌﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎﹰ ﻓﻜﺎﻧﺖ ﺃﻳﻀﺎﹰ ﺿﻌﻴﻔﺔ ‪ %٣٠‬ﻛﻦ ﻻ ﻳﻌﺮﻓﻦ ﺃﻥ ﻫﻨﺎﻙ ﺃﻣﺮﺍﺿﺎﹰ‬
‫ﺗﻨﺘﻘﻞ ﻋﻦ ﻃﺮﻳﻖ ﺍﳉﻨﺲ‪ .‬ﻭ‪ %٦‬ﻓﻘﻂ ﻛﻦ ﻳﻌﺮﻓﻦ ﺃﻥ ﻫﻨﺎﻙ ﺃﻣﺮﺍﺿﺎﹰ ﺃﺧﺮﻯ ﺗﻨﺘﻘﻞ ﻋﻦ ﻃﺮﻳﻖ ﺍﳉﻨﺲ ﻏﲑ‬
‫ﻣﺮﺽ ﺍﻹﻳﺪﺯ )‪.(AIDS‬‬
‫ﻭﻗﺪ ﺃﺑﺪﻯ ﺟﺰﺀ ﻛﺒﲑ ﻣﻦ ﺍﻟﻔﺘﻴﺎﺕ ﺭﻏﺒﺘﻬﻦ ﰲ ﻣﺪﻫﻦ ﲟﻌﻠﻮﻣﺎﺕ ﻋﻦ ﺍﻟﺘﻐﲑﺍﺕ ﺍﻟﻔﻴﺰﻳﺎﺋﻴﺔ ﺑﺄﺟﺴﺎﺩﻫﻦ‬
‫ﻭﻟﻜﻨﻬﻦ ﺭﻏﱭ ﺑﻨﺴﺒﺔ ﺃﻗﻞ ﻣﻦ ﺍﻟﺬﻛﻮﺭ ﻋﻦ ﻣﻌﺮﻓﺔ ﻣﻌﻠﻮﻣﺎﺕ ﻋﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻨﻘﻮﻟﺔ ﻋﻦ ﻃﺮﻳﻖ‬
‫ﺍﳉﻨﺲ)‪.(١٥‬‬

‫‪٢٦٨‬‬
 ‫
‪)23' /‬‬
‫ﺇﻥ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳌﺮﺣﻠﺔ ﺍﻹﳒﺎﺑﻴﺔ ﻟﻠﻤﺮﺃﺓ ﺣﺪﻳﺜﺎﹰ ﻧﺴﺒﻴﺎﹰ‪ .‬ﻭﻗﺪ ﻧﺸﺄ ﻫﺬﺍ ﺍﻻﻫﺘﻤﺎﻡ ﻧﺘﻴﺠﺔ ﳌﻼﺣﻈﺔ ﺍﻟﻨﺴﺒﺔ‬
‫ﺍﻟﻌﺎﻟﻴﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‪ .‬ﻭﻗﺪ ﻛﺎﻥ ﺍﻟﺘﺮﻛﻴﺰ ﰲ ﺍﻷﺳﺎﺱ ﻋﻠﻰ ﺑﺮﺍﻣﺞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﺍﻟﱵ ﻃﻤﺴﺖ‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﲝﺎﺟﺎﺕ ﺍﻟﻨﺴﺎﺀ ﻭﻣﺘﻄﻠﺒﺎ‪‬ﻦ ﻭﲡﺎﻫﻠﺖ ﺍﻟﻌﺐﺀ ﺍﻟﻘﺎﺳﻲ ﺍﻟﺬﻱ ﲢﻤﻠﻪ ﺍﻟﻨﺴﺎﺀ‪.‬‬

‫ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ‬
‫ﺗﻌﺮﻑ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﺑﺄ‪‬ﺎ "ﻭﻓﺎﺓ ﺍﳌﺮﺃﺓ ﺃﺛﻨﺎﺀ ﲪﻠﻬﺎ ﺃﻭ ﺧﻼﻝ ‪ ٤٢‬ﻳﻮﻣﺎﹰ ﻣﻦ ﺍﻧﺘﻬﺎﺀ ﺍﳊﻤﻞ ‪-‬ﺑﺼﺮﻑ ﺍﻟﻨﻈﺮ‬
‫ﻋﻦ ﻣﺪﺓ ﺍﳊﻤﻞ ﻭﻣﻮﺿﻌﻪ‪ -‬ﻷﻱ ﺳﺒﺐ ﻣﻦ ﺍﻷﺳﺒﺎﺏ ﺍﻟﱵ ﺗﺘﻌﻠﻖ ﺑﺎﳊﻤﻞ ﺃﻭ ﺗﺘﻔﺎﻗﻢ ﺑﺴﺒﺒﻪ ﻭﻟﻜﻦ ﻻ‬
‫ﺗﻌﺪ ﺿﻤﻦ ﺫﻟﻚ ﺍﳊﻮﺍﺩﺙ ﻭﺍﻷﺳﺒﺎﺏ ﺍﻟﻌﺮﺿﻴﺔ ﺍﻟﱵ ﻳﺘﺼﺎﺩﻑ ﺣﺪﻭﺛﻬﺎ ﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ")‪ .(١٧‬ﻭﺗﺸﲑ ﺑﻴﺎﻧﺎﺕ‬
‫ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ ﺇﱃ ﺍﳔﻔﺎﺽ ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﰲ ﻣﺼﺮ ﻣﻦ ‪ ٦٠‬ﻟﻜﻞ‬
‫ﻣﺎﺋﺔ ﺃﻟﻒ ﻣﻮﻟﻮﺩ ﰲ ﺳﻨﺔ ‪ ١٩٨٦‬ﺇﱃ ‪ ٥٠‬ﻟﻜﻞ ﻣﺎﺋﺔ ﺃﻟﻒ ﰲ ﺳﻨﺔ ‪ ١٩٩٠‬ﰒ ﺇﱃ ‪ ٣٠‬ﻟﻜﻞ ﻣﺎﺋﺔ ﺃﻟﻒ ﰲ‬
‫ﺳﻨﺔ ‪ .١٩٩٥‬ﻏﲑ ﺃﻧﻪ ﻣﻦ ﺍﳌﻌﻠﻮﻡ ﺃﻥ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﺍﳌﺴﺘﺨﻠﺼﺔ ﻣﻦ ﺳﺠﻼﺕ ﺍﻟﻮﻓﻴﺎﺕ‬
‫ﺍﻟﺮﲰﻴﺔ ﻋﺎﺩﺓ ﻣﺎ ﺗﻘﺪﺭ ﻧﺴﺒﺘﻬﺎ ﺑﺄﻗﻞ ﻣﻦ ﻗﺪﺭﻫﺎ ﺍﳊﻘﻴﻘﻲ ﺣﱴ ﰲ ﺍﻟﺪﻭﻝ ﺍﳌﺘﻘﺪﻣﺔ ﺻﻨﺎﻋﻴﺎﹰ؛ ﻟﺬﻟﻚ‬
‫ﻳﻠﺠﺄ ﺍﳌﺨﻄﻄﻮﻥ ﻭﺍﻟﺒﺎﺣﺜﻮﻥ ﺇﱃ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺗﻘﺪﻳﺮﺍﺕ ﺃﻗﺮﺏ ﺇﱃ ﺍﻟﺪﻗﺔ ﻣﻦ ﺧﻼﻝ ﺩﺭﺍﺳﺎﺕ ﻭﻓﻴﺎﺕ‬
‫ﺍﻷﻣﻬﺎﺕ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺃﻭ ﰲ ﺍﻟﺒﺤﻮﺙ ﺍﳌﻴﺪﺍﻧﻴﺔ‪ .‬ﻭﻳﻌﺮﺽ ﺍﳉﺪﻭﻝ )‪ (١١-١٠‬ﻋﺪﺩﺍﹰ ﻣﻦ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺎﺕ‬
‫ﺍﻟﱵ ﲤﺖ ﰲ ﻣﺼﺮ ﺧﻼﻝ ﺍﻟﻌﻘﺪﻳﻦ ﺍﻷﺧﲑﻳﻦ ﻭﺭﻏﻢ ﺃﻥ ﺍﻟﻨﺴﺐ ﺗﺘﺒﺎﻳﻦ ﺑﲔ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺑﺴﺒﺐ ﺍﺧﺘﻼﻑ‬
‫ﻣﻨﺎﻫﺞ ﺍﻟﺒﺤﻮﺙ ﺍﳌﺴﺘﺨﺪﻣﺔ ﻭﺃﻣﺎﻛﻨﻬﺎ ﺇﻻ ﺃ‪‬ﺎ ﲨﻴﻌﺎﹰ ﺗﺸﲑ ﺇﱃ ﺃﻥ ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﰲ ﻣﺼﺮ‬
‫ﺃﻋﻠﻰ ﺑﻜﺜﲑ ﻣﻦ ﺍﻟﺘﻘﺪﻳﺮﺍﺕ ﺍﻟﺮﲰﻴﺔ‪.‬‬

‫ﺟﺪﻭﻝ )‪ :(١١-١٠‬ﻧﺴﺐ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﰲ ﺩﺭﺍﺳﺎﺕ ﳐﺘﻠﻔﺔ‬

‫ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‬ ‫ﺍﻟﺘﺎﺭﻳﺦ‬ ‫ﺍﳌﻜﺎﻥ‬ ‫ﻧﻮﻉ ﺍﻟﺪﺭﺍﺳﺔ‬
‫‪١٩٠‬‬ ‫‪١٩٨٣ - ١٩٨١‬‬ ‫ﺍﳌﻨﻮﻓﻴﺔ‬ ‫ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ‬
‫‪٤٥٠‬‬ ‫‪١٩٨٥ - ١٩٨١‬‬ ‫ﺍﻟﺪﻗﻬﻠﻴﺔ‬ ‫ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ‬
‫‪١٥٠‬‬ ‫‪١٩٨٦ - ١٩٨٥‬‬ ‫ﺍﳉﻴﺰﺓ‬ ‫ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ‬
‫‪٣٦٨‬‬ ‫‪١٩٨٨ - ١٩٨٧‬‬ ‫ﺃﺳﻴﻮﻁ ﻭ‪ ٣‬ﻗﺮﻯ‬ ‫ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ‬
‫‪٢٠٧‬‬ ‫‪١٩٩٠ - ١٩٨٩‬‬ ‫ﻗﻨﺎ‬ ‫ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ‬
‫‪١٧٤‬‬ ‫‪١٩٩٣ - ١٩٩٢‬‬ ‫ﻗﻮﻣﻴﺔ‬ ‫ﺩﺭﺍﺳﺔ ﻣﻴﺪﺍﻧﻴﺔ‬
‫‪٢٠٩‬‬ ‫‪١٩٨٦ - ١٩٨١‬‬ ‫ﺩﺭﺍﺳﺔ ﰲ ﻣﺴﺘﺸﻔﻰ )ﻗﺼﺮ ﺍﻟﻌﻴﲎ(‬
‫‪٢٩٧‬‬ ‫‪١٩٩٥ - ١٩٩٢‬‬ ‫ﺩﺭﺍﺳﺔ ﰲ ﻣﺴﺘﺸﻔﻰ )ﻗﺼﺮ ﺍﻟﻌﻴﲎ(‬
‫‪) ١٠١‬ﻋﲔ ﴰﺲ(‬
‫‪١٩٩٣ - ١٩٩٠‬‬ ‫ﺩﺭﺍﺳﺔ ﰲ ﻣﺴﺘﺸﻔﻰ )ﻋﲔ ﴰﺲ ‪ -‬ﺍﻷﺯﻫﺮ(‬
‫‪) ٦٤‬ﺍﻷﺯﻫﺮ(‬

‫‪٢٦٩‬‬
 ‫ﺟﺪﻭﻝ )‪ :(١٢-١٠‬ﻭﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ ﻭﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻭﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﺣﺴﺐ ﳏﻞ ﺍﻟﺴﻜﻦ‬
‫ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‬
‫ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻦ‬ ‫ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‬ ‫ﻭﻓﻴﺎﺕ‬ ‫ﻭﻓﻴﺎﺕ‬ ‫ﺍﳌﻮﺍﻟﻴﺪ‬
‫ﺍﳌﻮﺍﻟﻴﺪ ﺍﻷﺣﻴﺎﺀ‬ ‫‪ /‬ﻭﻓﻴﺎﺕ ﺍﻹﻧﺎﺙ ‪%‬‬ ‫ﺍﻷﻣﻬﺎﺕ‬ ‫ﺍﻹﻧﺎﺙ‬ ‫ﺃﺣﻴﺎﺀ‬
‫‪٢٣٣‬‬ ‫‪٨,٣‬‬ ‫‪١٤٢‬‬ ‫‪١٧٠٢‬‬ ‫‪٦٠٨٨٢‬‬ ‫ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ‬
‫‪١٣٢‬‬ ‫‪٨,٨‬‬ ‫‪٣١٤‬‬ ‫‪٣٥٦٤‬‬ ‫‪٢٣٧٠٠٦‬‬ ‫ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫‪٢١٧‬‬ ‫‪١٤,٢‬‬ ‫‪٣١٦‬‬ ‫‪٢٢٢١‬‬ ‫‪١٤٥٣٦٠‬‬ ‫ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫‪١٧٤‬‬ ‫‪١٠,٣‬‬ ‫‪٧٧٢‬‬ ‫‪٧٤٨٧‬‬ ‫‪٤٤٣٢٤٨‬‬ ‫ﺍ‪‬ﻤﻮﻉ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪(National Maternal Mortality Study: Egypt, 1992-1993 Findings & Conclusions. :‬‬
‫)‪Ministry of Health - Child Survival Project In Cooperation with USAID, 1994‬‬

‫ﺍﻟﻌﺎﱂ ﺍﻟﺜﺎﻟﺚ )‪ .(١٧)(%٣٠-٢٥‬ﻭﻳﻌﺰﻱ ﻫﺬﺍ ﺇﱃ ﺃﻥ ﺍﳔﻔﺎﺽ ﺍﳋﺼﻮﺑﺔ ﰲ ﻣﺼﺮ ﻗﺪ ﺃﺩﻯ ﺇﱃ ﺍﳔﻔﺎﺽ ﰲ‬

‫ﺃﻋﺪﺍﺩ ﺍﳊﻮﺍﻣﻞ ﻭﺑﺎﻟﺘﺎﱄ ﻋﺪﺩ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﻭﻧﺴﺒﺘﻬﺎ ﺇﱃ ﺇﲨﺎﱄ ﺍﻟﻮﻓﻴﺎﺕ ﰲ ﻫﺬﻩ ﺍﳌﺮﺣﻠﺔ ﺍﻟﻌﻤﺮﻳﺔ‪،‬‬
‫ﻭﺗﻈﻞ ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﻋﺎﻟﻴﺔ ﺣﻴﺚ ﻻ ﺗﺘﺄﺛﺮ ﺑﺎﳔﻔﺎﺽ ﻋﺪﺩ ﺍﳊﻮﺍﻣﻞ ﻷ‪‬ﺎ ﺗﻨﺴﺐ ﺇﱃ ﺍﳌﻮﺍﻟﻴﺪ‬
‫ﺍﻷﺣﻴﺎﺀ‪ .‬ﻭﻳﻌﲏ ﻫﺬﺍ ﺃﻥ ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﺗﻌﻜﺲ ﻓﻘﻂ ﺍﳌﺸﻜﻼﺕ ﺍﻟﱵ ﺗﻘﺪﻡ ﻟﻠﻨﺴﺎﺀ ﺍﳊﻮﺍﻣﻞ‬
‫ﻭﺻﻮﺭﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ ﳍﻦ ﻭﻟﻴﺴﺖ ﳉﻤﻠﺔ ﺍﻟﻨﺴﺎﺀ‪.‬‬
‫ﻭﻳﺒﲔ ﺍﻟﺸﻜﻼﻥ )‪ (١٠-١٠ ،٩-١٠‬ﺃﻫﻢ ﻋﻨﺎﺻﺮ ﺍﳌﺨﺎﻃﺮﺓ ﺍﻟﱵ ﺗﺴﺎﻫﻢ ﰲ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻭﻫﻲ "ﻋﻤﺮ‬
‫ﺍﻷﻡ ﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ" ﻭ"ﻋﺪﺩ ﻣﺮﺍﺕ ﺍﳊﻤﻞ ﺍﻟﺴﺎﺑﻘﺔ" ﺣﻴﺚ ﺗﻜﻮﻥ ﻧﺴﺐ ﺍﻟﻮﻓﻴﺎﺕ ﰲ ﺃﻗﻞ ﻣﻌﺪﻻ‪‬ﺎ ﺑﲔ ‪٢٠‬‬
‫ﻭ‪ ٣٠‬ﺳﻨﺔ‪ ،‬ﺑﻴﻨﻤﺎ ﺗﻜﻮﻥ ﻋﺎﻟﻴﺔ ﻗﺒﻞ ﺳﻦ ﺍﻟﻌﺸﺮﻳﻦ ﻭﻣﺘﺰﺍﻳﺪﺓ ﺑﻌﺪ ﺳﻦ ‪ ٣٠‬ﺣﱴ ﺗﺼﻞ ﻷﻋﻠﻰ ﻣﻌﺪﻻ‪‬ﺎ‬
‫ﻳﻌﺪ ﺳﻦ ‪ ٤٥‬ﺳﻨﺔ‪ ،‬ﻛﻤﺎ ﺗﺰﻳﺪ ﻣﻌﺪﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﺍﻃﺮﺍﺩﻳﺎﹰ ﺑﺰﻳﺎﺩﺓ ﻋﺪﺩ ﻣﺮﺍﺕ ﺍﳊﻤﻞ‪.‬‬
‫ﻭﻳﺒﲔ ﺍﻟﺸﻜﻼﻥ )‪ (١٢-١٠ ،١١-١٠‬ﺍﻟﻮﺯﻥ ﺍﻟﻨﺴﱯ ﻟﻸﺳﺒﺎﺏ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﺣﻴﺚ ﻳﺘﻀﺢ ﺃﻥ‬
‫ﺃﻫﻢ ﺍﻷﺳﺒﺎﺏ ﺍﳌﺒﺎﺷﺮﺓ ﺍﻟﱵ ﲢﺪﺙ ﺑﺴﺒﺐ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ ﺃﻭ ﺍﻟﺘﺪﺧﻼﺕ ﺍﳌﺼﺎﺣﺒﺔ ﳍﺎ ﻫﻲ ﺍﻟﱰﻑ ﻣﺎ‬
‫ﻗﺒﻞ ﺍﻟﻮﻻﺩﺓ )ﺣﻮﺍﱄ ‪ (%١١‬ﻭﺍﻟﱰﻑ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ )‪ (%٣٥‬ﻭﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ ﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ )‪ (%٢٣‬ﻭﺗﻘﻴﺢ‬
‫ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ )‪ (%١٢‬ﻭﺗﺴﺎﻫﻢ ﻋﻤﻠﻴﺎﺕ ﺍﻟﻮﻻﺩﺓ ﺍﻟﻘﻴﺼﺮﻳﺔ ﲝﻮﺍﱄ ‪ %٩‬ﻣﻦ ﺍﻷﺳﺒﺎﺏ ﺍﳌﺒﺎﺷﺮﺓ‪ .‬ﺃﻣﺎ‬
‫ﺍﻷﺳﺒﺎﺏ ﻏﲑ ﺍﳌﺒﺎﺷﺮﺓ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ )ﺍﻟﻨﺎﲡﺔ ﻋﻦ ﺃﻣﺮﺍﺽ ﻣﻮﺟﻮﺩﺓ ﺃﺻﻼﹰ ﻗﺒﻞ ﺍﳊﻤﻞ ﺃﻭ ﺣﺪﺛﺖ ﺃﺛﻨﺎﺀ‬
‫ﺍﳊﻤﻞ ﻭﻟﻴﺴﺖ ﺑﺴﺒﺐ ﺍﳊﻤﻞ ﺫﺍﺗﻪ ﻭﻟﻜﻨﻬﺎ ﺗﻔﺎﻗﻤﺖ ﺑﺴﺒﺒﻪ( ﻓﺈﻥ ﺃﳘﻬﺎ ﺃﻣﺮﺍﺽ ﺍﻟﻘﻠﺐ ﻭﺍﻷﻭﻋﻴﺔ‬
‫ﺍﻟﺪﻣﻮﻳﺔ ﻭﺍﻟﱵ ﲤﺜﻞ ﺃﻗﻞ ﻗﻠﻴﻼﹰ ﻣﻦ ﻧﺼﻒ ﺍﻷﺳﺒﺎﺏ ﻏﲑ ﺍﳌﺒﺎﺷﺮﺓ‪.‬‬
‫ﻭﻟﻌﻞ ﺍﳌﺄﺳﺎﺓ ﺍﻟﻜﱪﻯ ﰲ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﺃﻥ ﻏﺎﻟﺒﻴﺘﻬﺎ ﺍﻟﻌﻈﻤﻰ ﳝﻜﻦ ﲡﻨﺒﻬﺎ‪ .‬ﻭﻗﺪ ﻭﺟﺪﺕ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ‬
‫ﺣﻮﺍﱄ ‪ %٨‬ﻓﻘﻂ ﻣﻦ ﺍﻟﻮﻓﻴﺎﺕ ﺑﺴﺒﺐ ﻋﻮﺍﻣﻞ ﻻ ﳝﻜﻦ ﲡﻨﺒﻬﺎ‪ ،‬ﺑﻴﻨﻤﺎ ﻛﺎﻧﺖ ﺃﻫﻢ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﱵ ﳝﻜﻦ‬
‫ﲡﻨﺒﻬﺎ ﻫﻲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻷﻗﻞ ﻣﻦ ﺍﳌﺴﺘﻮﻯ ﺍﳌﻄﻠﻮﺏ ﻣﻦ ﻓﺮﻳﻖ ﺇﺧﺼﺎﺋﻴﻲ ﺍﻟﺘﻮﻟﻴﺪ ﰲ ‪ %٤٧‬ﻣﻦ ﺍﳊﺎﻻﺕ‬
‫ﻭﺿﻌﻒ ﺟﻮﺩﺓ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻣﺘﺎﺑﻌﺔ ﺍﳊﻤﻞ ‪ %٣٣‬ﻭﺍﻟﺘﺄﺧﺮ ﰲ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺍﳋﺪﻣﺔ ﺍﻟﻄﺒﻴﺔ ﻣﻦ‬
‫ﺟﺎﻧﺐ ﺍﻟﺴﻴﺪﺓ ﺃﻭ ﺃﺳﺮ‪‬ﺎ ﰲ ‪ %٤٤‬ﻣﻦ ﺍﳊﺎﻻﺕ)‪.(١٨‬‬

‫‪٢٧٠‬‬
 ‫ ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻭﻓﻘﺎﹰ ﻟﻠﻤﺠﻤﻮﻋﺎﺕ ﺍﻟﻌﻤﺮﻳﺔ ﻟﻠﻨﺴﺎﺀ‬:(٩-١٠) ‫ﺷﻜﻞ‬

600

500

100000 ‫ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻻﻣﻬﺎﺕ ﻟﻜﻞ‬

400

300

200

100

0
0 20 25 30 35 40 45+
‫ﺍﻟﻌﻤﺮ ﺑﺎﻻﻋﻮﺍﻡ‬

(National Maternal Mortality Study: Egypt, 1992-1993 Findings & Conclusions. :‫ ﻣﺘﺮﺟﻢ ﻋﻦ‬:‫ﺍﳌﺼﺪﺭ‬
Ministry of Health - Child Survival Project In Cooperation with USAID, 1994)

‫ ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻭﻓﻘﺎﹰ ﻟﻌﺪﺩ ﻣﺮﺍﺕ ﺍﳊﻤﻞ‬:(١٠-١٠)‫ﺷﻜﻞ‬

1400
100000 ‫ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻻﻣﻬﺎﺕ ﻟﻜﻞ‬

1200
1000
800
600
400
200
0
0 1 2 3 4 5 6 7 8 9 10
‫ﻋﺪﺩ ﻣﺮﺍﺕ ﺍﳊﻤﻞ‬

(National Maternal Mortality Study: Egypt, 1992-1993 Findings & Conclusions. :‫ ﻣﺘﺮﺟﻢ ﻋﻦ‬:‫ﺍﳌﺼﺪﺭ‬
Ministry of Health - Child Survival Project In Cooperation with USAID, 1994)

٢٧١
 ‫ﺷﻜﻞ)‪ :(١١-١٠‬ﺍﻷﺳﺒﺎﺏ ﺍﳌﺒﺎﺷﺮﺓ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‬

‫ﻧﺰﻳﻒ ﻣﺎ ﻗﺒﻞ ﺍﻟﻮﻻﺩﺓ‬

‫ﻧﺰﻳﻒ ﻣﺎ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ‬

‫ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ‬

‫ﺍﻟﺘﻬﺎﺑﺎﺕ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳـﻠﻰ‬

‫ﺍﻹﺟﻬﺎﺽ ﺍﻟﺘﻠﻘﺎﺋﻰ‬

‫ﺍﻹﺟﻬﺎﺽ ﺍﳌﺘﻌﻤﺪ‬

‫ﺍﳊﻤﻞ ﺧﺎﺭﺝ ﺍﻟﺮﺣﻢ‬

‫ﺍﻧﻔﺠﺎﺭ ﺍﻟﺮﺣﻢ‬

‫ﺍﻟﻮﻻﺩﺓ ﺍﳌﺘﻌﺜﺮﺓ‬

‫ﺍﻟﻮﻻﺩﺓ ﺍﻟﻘﻴﺼﺮﻳﺔ‬

‫ﺍﻟﺘﺨﺪﻳﺮ‬

‫ﺍﳉﻠﻄﺔ ﺍﻟﺮﺋﻮﻳﺔ‬

‫ﺃﺧﺮﻯ‬

‫‪0‬‬ ‫‪5‬‬ ‫‪10‬‬ ‫‪15‬‬ ‫‪20‬‬ ‫‪25‬‬ ‫‪30‬‬

‫ﺷﻜﻞ)‪ :(١٢-١٠‬ﺍﻷﺳﺒﺎﺏ ﻏﲑ ﺍﳌﺒﺎﺷﺮﺓ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‬

‫ﺍﻷﻧﻴﻤﻴﺎ‬

‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺪﻭﺭﻯ‬

‫ﺍﻷﻣﺮﺍﺽ ﺍﻟﻌﺼﺒﻴﺔ‬

‫ﺍﻟﻌﺪﻭﻯ ﻭﺍﻻﻟﺘﻬﺎﺑﺎﺕ‬

‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﳍﻀﻤﻰ‬

‫ﺃﻣﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺒﻮﱃ ﻭﺍﻟﺘﻨﺎﺳـﻠﻰ‬

‫ﺍﻷﻭﺭﺍﻡ‬

‫ﻣﺮﺽ ﺍﻟﺒﻮﻝ ﺍﻟﺴﻜﺮﻯ‬

‫ﺃﺧﺮﻯ‬

‫‪0‬‬ ‫‪5‬‬ ‫‪10‬‬ ‫‪15‬‬ ‫‪20‬‬ ‫‪25‬‬ ‫‪30‬‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪(National Maternal Mortality Study: Egypt, 1992-1993 Findings & Conclusions. :‬‬
‫)‪Ministry of Health - Child Survival Project In Cooperation with USAID, 1994‬‬

‫‪٢٧٢‬‬
‫ﻭﻗﺪ ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺑﺪﺭﺍﺳﺘﲔ ﻗﻮﻣﻴﺘﲔ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻭﺫﻟﻚ ﰲ ﺑﺪﺍﻳﺔ ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﻭﺍﻷﺧﺮﻯ ﰲ‬
‫ﻋﺎﻡ ‪ ٢٠٠٠‬ﻭﻗﺪ ﺃﻋﻠﻨﺖ ﺑﺄﻣﺎﻧﺔ ﺍﳌﺴﺌﻮﻟﻴﺔ ﻋﻠﻰ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻷﻃﺒﺎﺀ‪ .‬ﺑﻌﺪﻡ ﻛﻔﺎﺀ‪‬ﻢ‬
‫ﰲ ﻣﻨﻊ ﺍﻷﺳﺒﺎﺏ ﺍﻟﱵ ﳝﻜﻦ ﺍﻟﻮﻗﺎﻳﺔ ﺑﺼﺪﺩ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‪.‬‬
‫ﳝﺜﻞ ﺍﳉﺪﻭﻝ )‪ (١٣-١٠‬ﺍﻻﳔﻔﺎﺽ ﺍﳌﻠﺤﻮﻅ ﰲ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﰲ ﻣﺼﺮ‪ .‬ﻭﺍﳊﺎﺟﺔ ﺇﱃ ﺍﳌﺰﻳﺪ ﻣﻦ ﺍﳉﻬﺪ‬
‫ﳋﻔﺾ ﺍﻟﺮﻗﻢ ﺍﻟﺬﻱ ﻻ ﻳﺰﺍﻝ ﻣﺮﺗﻔﻌﺎﹰ ﻟﻮﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‪.‬‬
‫ﻭﻻ ﺗﺰﺍﻝ ﺍﳊﺎﺟﺔ ﺇﱃ ﲢﺴﲔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺩﺍﺧﻞ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺗﻠﻌﺐ ﺩﻭﺭﺍﹰ ﺭﺋﻴﺴﻴﺎﹰ ﰲ ﺗﻔﺎﺩﻱ ﻭﻓﻴﺎﺕ‬
‫ﺍﻷﻣﻬﺎﺕ‪ .‬ﻓﻼ ﻳﺰﺍﻝ ﺩﻭﺭ ﺇﺧﺼﺎﺋﻴﻲ ﺍﻟﻨﺴﺎﺀ ﻭﺍﻟﺘﻮﻟﻴﺪ ﰲ ﺍﻟﺘﺸﺨﻴﺺ ﻭﺍﻟﻌﻼﺝ ﻟﻠﺤﺎﻻﺕ ﺍﳌﺨﺘﻠﻔﺔ ﳝﺜﻞ ﺃﻛﱪ‬
‫ﺳﺒﺐ ﳝﻜﻦ ﺃﻥ ﳝﻨﻊ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‪ .‬ﻭﺃﻳﻀﺎﹰ ﺍﻟﺮﻋﺎﻳﺔ ﺩﻭﻥ ﺍﳌﺴﺘﻮﻯ ﺍﳌﻘﺪﻣﺔ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ‪%٢٦‬‬
‫ﺑﺎﳌﻘﺎﺭﻧﺔ ﺑﺎﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ ‪ .(DHS 2000) %٢٢‬ﺃﻳﻀﺎﹰ ﺍﳌﻤﺎﺭﺳﻮﻥ ﺍﻟﻌﻤﻮﻡ ﻳﺸﺎﺭﻛﻮﻥ ﺑﺪﻭﺭﻫﻢ ﰲ‬
‫ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ﻋﻦ ﻃﺮﻳﻖ ﺗﺄﺧﲑ ﺍﻟﺘﺤﻮﻳﻞ ﺇﱃ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺇﺳﺎﺀﺓ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻷﺩﻭﻳﺔ ﺍﶈﻔﺰﺓ ﻟﻠﺮﺣﻢ‬
‫ﺃﺛﻨﺎﺀ ﺍﻟﻮﻻﺩﺓ‪.‬‬
‫ﻭﻋﻠﻰ ﺍﻟﻨﻘﻴﺾ‪ ،‬ﻓﻘﺪ ﻗﺎﻣﺖ ﺍﻟﺪﺍﻳﺎﺕ ﻭﺍﳌﻮﻟﺪﺍﺕ ﲟﺸﺎﺭﻛﺔ ﺇﳚﺎﺑﻴﺔ ﻓﻴﻤﺎ ﻋﺪﺍ ﺯﻳﺎﺩﺓ ﻋﺪﺩ ﺍﻟﻮﻓﻴﺎﺕ ﻣﻦ ﺗﻌﻔﻦ‬
‫ﺍﻟﺪﻡ ﻣﻌﻬﻦ ﺃﻛﺜﺮ ﻣﻦ ﺍﻷﻃﺒﺎﺀ‪.‬‬

‫ﺟﺪﻭﻝ )‪ :(١٣-١٠‬ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ*‬

‫‪٢٠٠٠‬‬ ‫‪٩٣ – ١٩٩٢‬‬
‫ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‬
‫‪٨٤‬‬ ‫‪١٧٤‬‬ ‫ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻣﺼﺮ‬
‫‪٤٨‬‬ ‫‪٢٣٣‬‬ ‫ﺍﻟﻌﺎﺻﻤﺔ‬
‫‪٨٩‬‬ ‫‪٢١٧‬‬ ‫ﺍﻟﻮﺟﻪ ﺍﻟﻘﺒﻠﻲ‬
‫‪٩٣‬‬ ‫‪١٣٢‬‬ ‫ﺍﻟﻮﺟﻪ ﺍﻟﺒﺤﺮﻱ‬
‫ﺍﻷﺳﺒﺎﺏ ﺍﳌﺒﺎﺷﺮﺓ ﻭﻏﲑ ﺍﳌﺒﺎﺷﺮﺓ ﻟﻠﻮﻓﺎﺓ‬
‫‪٣٢‬‬ ‫‪٥٦‬‬ ‫ﻧﺰﻳﻒ‬
‫‪١٨‬‬ ‫‪٢٨‬‬ ‫ﺃﻣﺮﺍﺽ ﻧﺎﲡﺔ ﻋﻦ ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ‬
‫‪٧‬‬ ‫‪١٤‬‬ ‫ﺃﻣﺮﺍﺽ ﺻﺪﻳﺪﻳﺔ‬
‫‪٧‬‬ ‫‪١٢‬‬ ‫ﺍﻧﻔﺠﺎﺭ ﺍﻟﺮﺣﻢ‬
‫‪١١‬‬ ‫‪٢٣‬‬ ‫ﺃﻣﺮﺍﺽ ﺍﻟﻘﻠﺐ ﻭﺍﻷﻭﻋﻴﺔ ﺍﻟﺪﻣﻮﻳﺔ‬
‫ﺍﻟﺘﻌﺮﻑ ﻋﻠﻰ ﺍﳌﺸﻜﻠﺔ ﻭﺍﻟﺘﺄﺧﲑ ﰲ ﳏﺎﻭﻟﺔ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ‬
‫‪٢٥‬‬ ‫‪٧٣‬‬ ‫ﺍﻟﻮﻓﺎﺓ ﻧﺘﻴﺠﺔ ﺍﻟﺘﺄﺧﲑ ﰲ ﺍﻟﺘﻌﺮﻑ ﻋﻠﻰ ﺍﳌﺸﻜﻠﺔ ﻭﻃﻠﺐ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ‬
‫ﻭﺳﺎﺋﻞ ﺍﻟﻨﻘﻞ ﺇﱃ ﺍﻷﻣﺎﻛﻦ ﺍﻟﻄﺒﻴﺔ‬
‫‪٤‬‬ ‫‪٧‬‬ ‫ﺍﳌﻮﺕ ﻧﺘﻴﺠﺔ ﻗﻠﺔ ﻭﺳﺎﺋﻞ ﺍﻟﻨﻘﻞ ﻟﻸﻣﺎﻛﻦ ﺍﻟﻄﺒﻴﺔ‬
‫ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺔ‬
‫ﺍﳋﺪﻣﺎﺕ ﺩﻭﻥ ﺍﳌﺴﺘﻮﻯ ﻣﻦ‪:‬‬
‫‪٣٦‬‬ ‫‪٨٢‬‬ ‫ﺃﻃﺒﺎﺀ ﺍﻟﻨﺴﺎﺀ ﻭﺍﻟﺘﻮﻟﻴﺪ‬
‫‪٩‬‬ ‫‪٢١‬‬ ‫ﺍﳌﻤﺎﺭﺳﻮﻥ ﺍﻟﻌﻤﻮﻡ‬
‫‪٧‬‬ ‫‪٢١‬‬ ‫ﺍﻟﺪﺍﻳﺎﺕ‬
‫* ﻧﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ = ﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ ‪ ١٠٠٠٠٠ /‬ﻣﻮﻟﻮﺩ ﺣﻲ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ – ‪.٢٠٠١‬‬

‫‪٢٧٣‬‬
 ‫ﺍﳌﺮﺍﺿﺔ ﺍﻹﳒﺎﺑﻴﺔ‬
‫ﺭﻏﻢ ﺃﳘﻴﺔ ﻭﺧﻄﻮﺭﺓ ﻭﻓﻴﺎﺕ ﺍﻷﻣﻮﻣﺔ ﺇﻻ ﺃ‪‬ﺎ ﺗﺸﻜﻞ ﻓﻘﻂ ﻗﻤﺔ ﺟﺒﻞ ﺍﳉﻠﻴﺪ ﻣﻦ ﺣﺠﻢ ﺍﻟﻌﺐﺀ‬
‫ﺍﳌﺮﺿﻲ ﻟﻠﻨﺴﺎﺀ ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻹﳒﺎﺑﻴﺔ‪ .‬ﻭﺗﺴﺘﺪﻋﻲ ﺍﻟﻨﻈﺮﺓ ﺍﻟﺸﻤﻮﻟﻴﺔ ﻟﻠﺼﺤﺔ ﺩﺭﺍﺳﺔ ﺍﻷﺣﻮﺍﻝ ﺍﳌﺮﺿﻴﺔ‬
‫ﻭﺍﻷﻋﺮﺍﺽ ﺍﻟﱵ ﺗﺸﻜﻮ ﻣﻨﻬﺎ ﺍﻟﻨﺴﺎﺀ ﻭﺗﺆﺛﺮ ﻋﻠﻰ ﺣﻴﺎ‪‬ﻦ‪ ،‬ﺑﻞ ﺇ‪‬ﺎ ﻗﺪ ﺗﺸﻜﻞ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺠﺘﻤﻊ‬
‫ﻛﻜﻞ ﺍﳊﺠﻢ ﺍﻷﻛﱪ ﻣﻦ ﺳﻨﻮﺍﺕ ﺍﻟﻌﻤﺮ ﺍﳌﻔﻘﻮﺩﺓ ﺑﺴﺒﺐ ﺍﻋﺘﻼﻝ ﺍﻟﺼﺤﺔ‪.‬‬
‫ﻭﺗﺸﻤﻞ ﺃﺳﺒﺎﺏ ﺍﳌﺮﺍﺿﺔ ﺍﻹﳒﺎﺑﻴﺔ ﺗﻠﻚ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ ﻭﺍﻟﻨﻔﺎﺱ؛ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻷﻣﺮﺍﺽ‬
‫ﺍﻟﻨﺴﺎﺋﻴﺔ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ ﻏﲑ ﺍﳌﺮﺗﺒﻄﺔ ﲝﻤﻞ ﳏﺪﺩ ﻣﺜﻞ ﺍﻻﻟﺘﻬﺎﺑﺎﺕ ﻭﺍﻟﺘﻐﲑﺍﺕ ﰲ ﻋﻨﻖ‬
‫ﺍﻟﺮﺣﻢ ﻭﺗﺪﱄ ﺃﺟﺰﺍﺀ ﻣﻦ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ ﻭﺍﻟﻌﻘﻢ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺑﻌﺾ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﻟﻨﺴﺎﺀ ﻣﺜﻞ‬
‫ﺍﻟﺘﻬﺎﺑﺎﺕ ﺍﳉﻬﺎﺯ ﺍﻟﺒﻮﱄ ﻭﺍﻷﻧﻴﻤﻴﺎ ﻭﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ ﻭﺍﻟﺒﺪﺍﻧﺔ)‪.(١٩‬‬
‫ﻭﺗﻌﺘﱪ ﺑﻴﺎﻧﺎﺕ ﺍﳌﺮﺍﺿﺔ ﻣﻦ ﺗﻠﻚ ﺍﻟﱵ ﻳﺼﻌﺐ ﺍﳊﺼﻮﻝ ﻋﻠﻴﻬﺎ ﺣﻴﺚ ﻻ ﻳﺘﻢ ﺗﺴﺠﻴﻠﻬﺎ ﰲ ﺍﻟﺴﺠﻼﺕ‬
‫ﺍﻟﺮﲰﻴﺔ ﻭﺇﺫﺍ ﺗﻮﻓﺮﺕ ﰲ ﺳﺠﻼﺕ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻓﺈ‪‬ﺎ ﰲ ﺍﻷﻏﻠﺐ ﺗﻜﻮﻥ ﻏﲑ ﺩﻗﻴﻘﺔ‪ ،‬ﻓﻀﻼﹰ ﻋﻦ ﻋﺪﻡ‬
‫ﲤﺜﻴﻞ ﺍﳌﺘﺮﺩﺩﺍﺕ ﻋﻠﻰ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ‪‬ﻤﻮﻉ ﺍﻟﻨﺴﺎﺀ ﰲ ﺍ‪‬ﺘﻤﻊ‪.‬‬
‫ﻭﻗﺪ ﺃﺟﺮﻳﺖ ﰲ ﻣﺼﺮ ﰲ ﺍﻟﻌﻘﺪ ﺍﻷﺧﲑ ﺩﺭﺍﺳﺘﺎﻥ ﻫﺎﻣﺘﺎﻥ ﻟﻠﺘﻌﺮﻑ ﻋﻠﻰ ﺣﺠﻢ ﺍﳌﺮﺍﺿﺔ ﺍﻹﳒﺎﺑﻴﺔ‪ ،‬ﺍﻷﻭﱃ‬
‫ﻫﻲ ﺩﺭﺍﺳﺔ ﰲ ﺇﺣﺪﻯ ﻗﺮﻯ ﳏﺎﻓﻈﺔ ﺍﳉﻴﺰﺓ‪ .‬ﻭﺍﻟﺜﺎﻧﻴﺔ ﴰﻠﺖ ﳏﺎﻓﻈﺎﺕ ﺃﺳﻴﻮﻁ ﻭﺳﻮﻫﺎﺝ ﻭﻗﻨﺎ)‪ .(٢٠‬ﻭﻗﺪ‬
‫ﺍﺳﺘﺨﺪﻣﺖ ﺍﻟﺪﺭﺍﺳﺘﺎﻥ ﺍﻻﺳﺘﺒﻴﺎﻥ ﻟﺴﺆﺍﻝ ﺍﻟﻨﺴﺎﺀ ﻋﻦ ﻣﺸﻜﻼ‪‬ﻦ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺼﺎﺣﺒﺔ ﻵﺧﺮ ﲪﻞ‪،‬‬
‫ﻛﻤﺎ ﺃﺟﺮﺕ ﺍﻟﺪﺭﺍﺳﺔ ﺍﻷﻭﱃ ﻓﺤﺼﺎﹰ ﻃﺒﻴﺎﹰ ﻭﺑﻌﺾ ﺍﻟﺘﺤﺎﻟﻴﻞ ﻟﻠﺘﻌﺮﻑ ﻋﻠﻰ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﺴﺎﺋﻴﺔ‪.‬‬
‫ﻭﻳﺒﲔ ﺍﳉﺪﻭﻝ )‪ (١٤-١٠‬ﺃﻫﻢ ﺍﳌﺸﻜﻼﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ ﰲ ﺍﻟﺪﺭﺍﺳﺘﲔ‪ .‬ﻭﻳﺘﻀﺢ ﻣﻦ‬
‫ﺍﻟﺪﺭﺍﺳﺘﲔ ﺃﻥ ﺃﻫﻢ ﺃﺳﺒﺎﺏ ﺍﳌﺮﺍﺿﺔ ﺑﺴﺒﺐ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ ﻫﻲ ﺍﻟﱰﻑ ﻭﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ ﻭﺍﻟﺘﺸﻨﺠﺎﺕ‬
‫ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻟﺜﺎﻟﺜﺔ ﻣﻦ ﺍﳊﻤﻞ ﻧﻈﺮﺍﹰ ﳋﻄﻮﺭﺓ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ‪.‬‬
‫ﺃﻣﺎ ﺃﻛﺜﺮﻫﺎ ﺷﻴﻮﻋﺎﹰ ﻓﻬﻲ ﺍﻟﺼﺪﺍﻉ ﻭﺍﻹﻓﺮﺍﺯﺍﺕ ﺍﳌﻬﺒﻠﻴﺔ ﻭﺁﻻﻡ ﺍﳊﻮﺽ ﻭﺍﳊﻤﻰ )ﺧﺎﺻﺔ ﻓﻴﻤﺎ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ(‬
‫ﻭﻣﺸﻜﻼﺕ ﺍﻟﺜﺪﻱ‪ .‬ﻭﲡﺪﺭ ﺍﻹﺷﺎﺭﺓ ﺇﱃ ﺃﻥ ﻧﺴﺒﺔ ﺣﺪﻭﺙ ﺍﳌﺸﻜﻼﺕ ﺃﺛﻨﺎﺀ ﺍﻟﻮﻻﺩﺓ ﺗﺘﺮﺍﻭﺡ ﺑﲔ ‪ %١٧‬ﻭ‪%٤٣‬‬
‫ﻋﻠﻤﺎﹰ ﺑﺄﻥ ﻛﻠﺘﺎ ﺍﻟﺪﺭﺍﺳﺘﲔ ﺃﻛﺪﺗﺎ ﻋﻠﻰ ﺃﻥ ﺃﻏﻠﺒﻴﺔ ﺍﻟﻮﻻﺩﺍﺕ ﺑﺎﳌﱰﻝ )‪.(%٨٦-%٧٧‬‬
‫ﺟﺪﻭﻝ )‪ :(١٤-١٠‬ﺍﳌﺮﺍﺿﺔ ﺃﺛﻨﺎﺀ ﺍﳊﻤﻞ ﻭﺃﺛﻨﺎﺀ ﻭﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ‬
‫ﺩﺭﺍﺳﺔ ﳎﻠﺲ‬ ‫ﺩﺭﺍﺳﺔ ﺍﳉﻤﻌﻴﺔ‬
‫ﺍﻟﺴﻜﺎﻥ ﺍﻟﺪﻭﱄ‬ ‫ﺍﳌﺼﺮﻳﺔ ﻟﺮﻋﺎﻳﺔ‬
‫ﺍﳊﺎﻟﺔ‬
‫)ﺍﳉﻴﺰﺓ(‬ ‫ﺍﳋﺼﻮﺑﺔ‬
‫‪%‬‬ ‫‪%‬‬
‫ﺧﻼﻝ ﺍﳊﻤﻞ‬
‫‪٩‬‬ ‫‪٧‬‬ ‫ﻧﺰﻳﻒ‬
‫‪٤٥‬‬ ‫‪٣٧‬‬ ‫ﺇﻓﺮﺍﺯﺍﺕ ﺃﻭ ﻫﺮﺵ ﺑﺎﳌﻬﺒﻞ‬
‫‪٢١‬‬ ‫‪٢٦‬‬ ‫ﺍﺭﺗﻔﺎﻉ ﰲ ﺩﺭﺟﺔ ﺍﳊﺮﺍﺭﺓ‬
‫‪٥٩‬‬ ‫‪--‬‬ ‫ﺻﺪﺍﻉ‬
‫‪٢٠‬‬ ‫‪٢٤‬‬ ‫ﺗﻮﺭﻡ ﺑﺎﻟﻘﺪﻣﲔ‬
‫‪٢٧‬‬ ‫‪٢١‬‬ ‫ﻣﺸﻜﻼﺕ ﺑﻮﻟﻴﺔ‬
‫‪١١‬‬ ‫‪١٠‬‬ ‫ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ‬
‫‪٢‬‬ ‫‪٥‬‬ ‫ﺗﺸﻨﺠﺎﺕ ﰲ ﺍﻟﺜﻠﺚ ﺍﻷﺧﲑ ﻣﻦ ﺍﳊﻤﻞ‬

‫‪٢٧٤‬‬
 ‫ﺩﺭﺍﺳﺔ ﳎﻠﺲ‬ ‫ﺩﺭﺍﺳﺔ ﺍﳉﻤﻌﻴﺔ‬
‫ﺍﻟﺴﻜﺎﻥ ﺍﻟﺪﻭﱄ‬ ‫ﺍﳌﺼﺮﻳﺔ ﻟﺮﻋﺎﻳﺔ‬
‫ﺍﳊﺎﻟﺔ‬
‫)ﺍﳉﻴﺰﺓ(‬ ‫ﺍﳋﺼﻮﺑﺔ‬
‫‪%‬‬ ‫‪%‬‬
‫‪--‬‬ ‫‪٢٠‬‬ ‫ﻗﻲﺀ ﺷﺪﻳﺪ‬
‫‪--‬‬ ‫‪--‬‬ ‫ﳎﻤﻮﻉ‬
‫ﺧﻼﻝ ﺍﻟﻮﻻﺩﺓ‬
‫‪--‬‬ ‫‪١٧‬‬ ‫ﻭﻻﺩﺓ ﺍﺳﺘﻤﺮﺕ < ‪ ١٨‬ﺳﺎﻋﺔ‬
‫‪--‬‬ ‫‪٢‬‬ ‫ﺗﺸﻨﺠﺎﺕ‬
‫‪--‬‬ ‫‪٧‬‬ ‫ﻧﺰﻳﻒ ﺷﺪﻳﺪ‬
‫‪--‬‬ ‫‪٩‬‬ ‫ﻓﻘﺪ ﺍﻟﻮﻋﻲ‬
‫‪--‬‬ ‫‪١‬‬ ‫ﺍﻧﻔﺠﺎﺭ ﺍﻟﺮﺣﻢ‬
‫‪--‬‬ ‫‪١٠‬‬ ‫ﻗﻄﻊ ﻣﻬﺒﻠﻲ‬
‫‪١٧‬‬ ‫‪--‬‬ ‫ﳎﻤﻮﻉ‬
‫ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ‬
‫‪١٠‬‬ ‫‪٦‬‬ ‫ﻧﺰﻳﻒ‬
‫‪٣٠‬‬ ‫‪١٢‬‬ ‫ﺇﻓﺮﺍﺯﺍﺕ ﺃﻭ ﺍﻟﺘﻬﺎﺑﺎﺕ ﻣﻬﺒﻠﻴﺔ‬
‫‪٣٠‬‬ ‫‪٢٢‬‬ ‫ﺍﺭﺗﻔﺎﻉ ﰲ ﺩﺭﺟﺔ ﺍﳊﺮﺍﺭﺓ‬
‫‪١٤‬‬ ‫‪٢١‬‬ ‫ﺍﻛﺘﺌﺎﺏ‬
‫‪--‬‬ ‫‪٦‬‬ ‫ﻓﻘﺪ ﺍﻟﻮﻋﻲ‬
‫‪--‬‬ ‫‪٢‬‬ ‫ﺗﺸﻨﺠﺎﺕ‬
‫‪--‬‬ ‫‪٥٦‬‬ ‫ﺁﻻﻡ ﰲ ﺍﳊﻮﺽ‬
‫‪--‬‬ ‫‪٢٢‬‬ ‫ﻣﺸﻜﻼﺕ ﰲ ﺍﻟﺜﺪﻱ‬
‫‪--‬‬ ‫‪١٢‬‬ ‫ﺣﺮﻗﺎﻥ ﰲ ﺍﻟﺒﻮﻝ‬
‫‪--‬‬ ‫‪--‬‬ ‫ﳎﻤﻮﻉ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪:‬‬
‫‪1.‬‬ ‫‪The Egyptian Fertility Care Society 1996, Community-Based Survey of Maternal Mortality‬‬
‫‪in Assuit Sohag, and Qena Governorates – Final Report.‬‬
‫‪2.‬‬ ‫‪Zurayk H., Khattab H., Younis N., El-Mouelhy M., and Fadle M., 1993. Concepts and‬‬
‫‪Measures of Reproductive Health – Health Traditions Review Vol.3.‬‬

‫ﻭﻳﺒﲔ ﺍﳉﺪﻭﻝ )‪ (١٥-١٠‬ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﺴﺎﺋﻴﺔ ﻏﲑ ﺍﳌﺮﺗﺒﻄﺔ ﲝﻤﻞ ﺃﻭ ﻭﻻﺩﺓ ﰲ ﺩﺭﺍﺳﺔ ﺍﳉﻴﺰﺓ‪ ،‬ﻭﻳﺘﻀﺢ ﻣﻦ‬
‫ﺍﳉﺪﻭﻝ ﺍﳊﺠﻢ ﺍﻟﻜﺒﲑ ﻟﻠﻌﺐﺀ ﺍﳌﺮﺿﻲ ﳍﺬﻩ ﺍ‪‬ﻤﻮﻋﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺣﻴﺚ ﻳﺒﻠﻎ ﻣﻌﺪﻝ ﺍﻧﺘﺸﺎﺭ ﺍﻟﺘﻬﺎﺑﺎﺕ‬
‫ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ ﺣﻮﺍﱄ ‪ %٥٠‬ﺑﲔ ﺍﻟﻨﺴﺎﺀ ﺗﻘﺮﻳﺒﺎﹰ ﺑﺼﺮﻑ ﺍﻟﻨﻈﺮ ﻋﻦ ﺍﻟﺴﻦ‪ ،‬ﻭﻳﺒﻠﻎ ﻣﻌﺪﻝ ﺍﻧﺘﺸﺎﺭ ﺗﺪﱄ‬
‫ﺃﺟﺰﺍﺀ ﻣﻦ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ ‪ %٦٥‬ﻭﺗﺘﺰﺍﻳﺪ ﺍﻟﻨﺴﺒﺔ ﻣﻊ ﺯﻳﺎﺩﺓ ﺍﻟﻌﻤﺮ ﺑﺴﺒﺐ ﺗﺰﺍﻳﺪ ﻣﺮﺍﺕ ﺍﳊﻤﻞ ﻭﺍﻟﻮﻻﺩﺓ‪،‬‬
‫ﻭﲢﺘﻞ ﺍﻷﻧﻴﻤﻴﺎ ﻣﺮﺗﺒﺔ ﻫﺎﻣﺔ ﺣﻴﺚ ﻳﺒﻠﻎ ﻣﻌﺪﻝ ﺍﻻﻧﺘﺸﺎﺭ ‪.%٦٣‬‬

‫‪٢٧٥‬‬
 ‫ﺟﺪﻭﻝ )‪ :(١٥-١٠‬ﺍﻧﺘﺸﺎﺭ ﺃﻣﺮﺍﺽ ﺍﻟﻨﺴﺎﺀ‬
‫ﺍﻟﻔﺌــــﺔ ﺍﻟﻌﻤﺮﻳﺔ‬
‫ﳎﻤﻮﻉ‬ ‫‪+٤٥‬‬ ‫‪٤٤-٣٥‬‬ ‫‪٣٤-٢٥‬‬ ‫‪٢٤-٢٠‬‬ ‫‪١٩-١٤‬‬ ‫ﺍﳊﺎﻟﺔ‬
‫‪%‬‬ ‫‪%‬‬ ‫‪%‬‬ ‫‪%‬‬ ‫‪%‬‬ ‫‪%‬‬
‫‪٥٠‬‬ ‫‪٤١‬‬ ‫‪٥٦‬‬ ‫‪٤٩‬‬ ‫‪٥٤‬‬ ‫‪٤٣‬‬ ‫ﺍﻟﺘﻬﺎﺑﺎﺕ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ‬
‫‪٥٦‬‬ ‫‪٦٣‬‬ ‫‪٧٤‬‬ ‫‪٦٥‬‬ ‫‪٤٣‬‬ ‫‪٢٤‬‬ ‫ﺗﺪﱄ ﺃﺟﺰﺍﺀ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ‬
‫‪١٤‬‬ ‫‪٢٥‬‬ ‫‪١٦‬‬ ‫‪١١‬‬ ‫‪١٢‬‬ ‫‪١٣‬‬ ‫ﺍﻟﺘﻬﺎﺑﺎﺕ ﻗﻨﺎﺓ ﳎﺮﻯ ﺍﻟﺒﻮﻝ‬
‫‪٦٣‬‬ ‫‪٤٩‬‬ ‫‪٥٥‬‬ ‫‪٦٦‬‬ ‫‪٦٣‬‬ ‫‪٧٦‬‬ ‫ﺍﻷﻧﻴﻤﻴﺎ‬
‫‪٤٣‬‬ ‫‪٦١‬‬ ‫‪٥٩‬‬ ‫‪٤٤‬‬ ‫‪٣٢‬‬ ‫‪٢١‬‬ ‫ﺍﻟﺴﻤﻨﺔ‬
‫‪١٨‬‬ ‫‪٥٥‬‬ ‫‪٣٠‬‬ ‫‪١٣‬‬ ‫‪٨‬‬ ‫‪٧‬‬ ‫ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ‬
‫‪٥٠٥‬‬ ‫‪٤٤‬‬ ‫‪١١٥‬‬ ‫‪١٧٤‬‬ ‫‪٩٤‬‬ ‫‪٧٨‬‬ ‫ﻣﺘﻮﺳﻂ ﻋﺪﺩ ﺍﻟﻨﺴﺎﺀ‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪Zurayk H., Khattab H., Younis N., El-Mouelhy M., and Fadle M., 1993. :‬‬
‫‪Concepts and Measures of Reproductive Health – Health Traditions Review Vol.3.‬‬

‫ﻭﺭﻏﻢ ﺃﳘﻴﺔ ﻭﺧﻄﻮﺭﺓ ﻛﻞ ﻣﺮﺽ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺒﻴﻨﺔ ﺑﺎﳉﺪﻭﻝ ﻋﻠﻰ ﺣﺪﺓ‪ ،‬ﻓﻘﺪ ﺃﺛﺒﺘﺖ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ‬
‫ﺣﻮﺍﱄ ‪ %٥‬ﻣﻦ ﺍﻟﺴﻴﺪﺍﺕ ﺍﳌﺒﺤﻮﺛﺎﺕ ﻓﻘﻂ ﻛﻦ ﻳﻌﺎﻧﲔ ﻣﻦ ﻣﺮﺽ ﻭﺍﺣﺪ ﻓﻘﻂ ﻣﻦ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ‪ ،‬ﻭﺃﻥ ﺃﻛﺜﺮ‬
‫ﻣﻦ ﻧﺼﻒ ﺍﻟﺴﻴﺪﺍﺕ ﻛﻦ ﻳﻌﺎﻧﲔ ﻣﻦ ﺛﻼﺛﺔ ﺃﻭ ﺃﻛﺜﺮ ﻣﻦ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ ﰲ ﻧﻔﺲ ﺍﻟﻮﻗﺖ‪ .‬ﻭﻳﺮﺗﻔﻊ ﺗﻌﺪﺩ‬
‫ﺍﻷﻣﺮﺍﺽ ﺍﻟﱵ ﺗﺸﻜﻮ ﻣﻨﻬﺎ ﺍﻟﺴﻴﺪﺍﺕ ﻣﻊ ﺯﻳﺎﺩﺓ ﺍﻟﻌﻤﺮ‪.‬‬

‫ﺍﻹﺟﻬﺎﺽ‬
‫ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺍﻻﻧﻄﺒﺎﻉ ﺍﻟﺴﺎﺋﺪ ﺃﻥ ﺍﻹﺟﻬﺎﺽ ﻏﲑ ﻣﻨﺘﺸﺮ ﰲ ﻣﺼﺮ ﺇﻻ ﺃﻥ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺗﺸﲑ ﺇﱃ ﺃﻥ‬
‫)‪(٢١‬‬
‫ﺍﻟﻨﺴﺎﺀ ﻳﻠﺠﺄﻥ ﺇﱃ ﺍﻹﺟﻬﺎﺽ ﰲ ﺃﺣﻮﺍﻝ ﻛﺜﲑﺓ‪ ،‬ﻭﺃﻧﻪ ﻣﻨﺘﺸﺮ ﺣﱴ ﰲ ﺍﻟﺮﻳﻒ‪ .‬ﻓﻘﺪ ﺃﺟﺮﻳﺖ ﺩﺭﺍﺳﺔ‬
‫ﺑﺎﺳﺘﺨﺪﺍﻡ ﺍﻟﻄﺮﻕ ﺍﻟﻜﻤﻴﺔ )ﺍﻻﺳﺘﻘﺼﺎﺀ( ﻭﺍﻟﻜﻴﻔﻴﺔ )ﳎﻤﻮﻋﺎﺕ ﻧﻘﺎﺵ ﺑﺆﺭﻳﺔ‪ ،‬ﻭﻣﻼﺣﻈﺔ ﺑﺎﳌﺸﺎﺭﻛﺔ‪،‬‬
‫ﻭﻣﻘﺎﺑﻼﺕ ﻣﺘﻌﻤﻘﺔ( ﰲ ﺇﺣﺪﻯ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﻟﻠﺘﻌﺮﻑ ﻋﻠﻰ ﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺆﺛﺮﺓ ﰲ ﺍﻹﺟﻬﺎﺽ ﺍﻟﻌﻤﺪﻱ ﰲ‬
‫ﻣﺼﺮ‪ ،‬ﻓﺘﻘﻮﻝ ﺍﻟﺪﺭﺍﺳﺔ ﺇﻥ ‪ %١٤‬ﻣﻦ ﺍﳌﺒﺤﻮﺛﺎﺕ ﺑﺎﻻﺳﺘﻘﺼﺎﺀ ﻗﺪ ﳉﺄﻥ ﺇﱃ ﺍﻹﺟﻬﺎﺽ ﻣﺮﺓ ﻭﺍﺣﺪﺓ ﻋﻠﻰ‬
‫ﺍﻷﻗﻞ ﻃﻮﺍﻝ ﺣﻴﺎ‪‬ﻦ ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﺍﻟﻨﺘﺎﺋﺞ ﺗﺸﲑ ﺇﱃ ﺍﻧﺘﺸﺎﺭ ﺃﻛﱪ ﻣﻦ ﺫﻟﻚ‪ .‬ﻭﺗﻠﺠﺄ ﺍﻟﻨﺴﺎﺀ ﻋﻠﻰ ﺍﻷﻏﻠﺐ‬
‫ﻟﻺﺟﻬﺎﺽ ﻟﻨﻔﺲ ﺍﻷﺳﺒﺎﺏ ﺍﻟﱵ ﻳﻠﺠﺄﻥ ﻓﻴﻬﺎ ﺇﱃ ﻭﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﺃﻭ ﻟﺘﻐﻄﻴﺔ ﻓﺸﻞ ﻫﺬﻩ‬
‫ﺍﻟﻮﺳﺎﺋﻞ‪.‬‬
‫ﻭﻣﻦ ﺍﻷﺳﺒﺎﺏ ﺍﻟﺸﺎﺋﻌﺔ ﻟﻺﺟﻬﺎﺽ ﻭﺟﻮﺩ ﺃﺑﻨﺎﺀ ﻛﺒﺎﺭ ﺃﻭ ﻣﺘﺰﻭﺟﲔ ﻟﺪﻯ ﺍﻟﺴﻴﺪﺓ‪ ،‬ﻛﻤﺎ ﻛﺸﻔﺖ ﺍﻟﺪﺭﺍﺳﺔ‬
‫ﻋﻦ ﺃﻥ ﺣﺪﻭﺙ "ﲪﻞ ﺧﺎﺭﺝ ﻋﻼﻗﺔ ﺯﻭﺟﻴﺔ ﺷﺮﻋﻴﺔ" ﻫﻮ ﺃﺣﺪ ﺃﺳﺒﺎﺏ ﺍﻟﻠﺠﻮﺀ ﺇﱃ ﺍﻹﺟﻬﺎﺽ ﺍﻵﺧﺬﺓ ﰲ‬
‫ﺍﻻﺯﺩﻳﺎﺩ‪ .‬ﻭﻳﺰﺩﺍﺩ ﺍﻟﻠﺠﻮﺀ ﺇﱃ ﺍﻹﺟﻬﺎﺽ ﻣﻊ ﺯﻳﺎﺩﺓ ﺍﻟﺴﻦ ﻭﻣﺪﺓ ﺍﻟﺰﻭﺍﺝ ﻭﻋﺪﺩ ﺍﻷﻭﻻﺩ ﻭﺿﻌﻒ ﺗﻌﻠﻴﻢ ﺍﻟﺰﻭﺝ‪.‬‬
‫ﺑﻴﻨﻤﺎ ﱂ ﻳﻜﻦ ﻫﻨﺎﻙ ﺍﺭﺗﺒﺎﻁ ﺑﲔ ﺍﻹﺟﻬﺎﺽ ﻭﻣﺴﺘﻮﻯ ﺗﻌﻠﻴﻢ ﺍﻟﺴﻴﺪﺓ ﻭﻋﻤﻠﻬﺎ ﺃﻭ ﺍﳌﺴﺘﻮﻯ ﺍﻻﻗﺘﺼﺎﺩﻱ‬
‫ﻭﺍﻻﺟﺘﻤﺎﻋﻲ‪ .‬ﻭﺑﻴﻨﺖ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ ﺍﻹﺟﻬﺎﺽ ﺍﻟﻄﱯ ﺍﻵﻣﻦ ﻣﺘﻮﺍﻓﺮ ﻭﺳﻬﻞ ﺍﳊﺼﻮﻝ ﻋﻠﻴﻪ ﳌﻦ ﺗﺴﺘﻄﻴﻊ‬
‫ﺩﻓﻊ ﺍﻟﺜﻤﻦ ﺍﻟﻐﺎﱄ‪ .‬ﺃﻣﺎ ﻣﻦ ﻟﻴﺲ ﻟﺪﻳﻬﻦ ﺍﻟﻘﺪﺭﺓ ﻓﻴﻠﺠﺄﻥ ﺇﱃ ﺍﻷﺳﺎﻟﻴﺐ ﻏﲑ ﺍﻟﻄﺒﻴﺔ ﺍﻟﱵ ﺗﺮﺍﻭﺣﺖ ﺑﲔ‬
‫ﺍﺳﺘﺨﺪﺍﻡ ﺍﻷﺩﻭﺍﺕ ﺍﳉﺮﺍﺣﻴﺔ ﺃﻭ ﺍﻷﺩﻭﻳﺔ ﺃﻭ ﺍﻟﻠﺠﻮﺀ ﺇﱃ ﺑﺬﻝ ﳎﻬﻮﺩ ﺯﺍﺋﺪ )ﻛﺎﻟﻘﻔﺰ ﻣﻦ ﺃﻣﺎﻛﻦ ﻋﺎﻟﻴﺔ ﺃﻭ‬
‫ﲪﻞ ﺃﲪﺎﻝ ﺛﻘﻴﻠﺔ ﺃﻭ ﻗﻔﺰ ﺍﻷﻃﻔﺎﻝ ﻓﻮﻕ ﺑﻄﻦ ﺍﳌﺮﺃﺓ ﺍﳊﺎﻣﻞ( ﺃﻭ ﺍﻟﻮﺳﺎﺋﻞ ﺍﳌﻴﻜﺎﻧﻴﻜﻴﺔ ﻋﻦ ﻃﺮﻳﻖ ﺇﺩﺧﺎﻝ‬

‫‪٢٧٦‬‬
‫ﺟﺰﺀ ﻣﻦ ﺑﻌﺾ ﺍﻟﻨﺒﺎﺗﺎﺕ ﺃﻭ ﺭﻳﺶ ﺍﻟﻄﻴﻮﺭ ﺃﻭ ﺃﺳﻴﺎﺥ ﻣﻌﺪﻧﻴﺔ ﺩﺍﺧﻞ ﺍﻟﺮﺣﻢ‪ .‬ﻭﺗﺆﻛﺪ ﺍﻟﺪﺭﺍﺳﺔ ﺗﻌﺪﺩ‬
‫ﺍﻟﻮﺳﺎﺋﻞ ﻭﺍﳌﻌﻠﻮﻣﺎﺕ ﺍﳌﻨﺘﺸﺮﺓ ﻋﻦ ﺃﻥ ﺍﻹﺟﻬﺎﺽ ﻟﻴﺲ ﻇﺎﻫﺮﺓ ﺣﺪﻳﺜﺔ‪ ،‬ﻭﺃﻥ ﻟﻪ ﺟﺬﻭﺭﺍﹰ ﻗﺪﳝﺔ ﰲ ﺍ‪‬ﺘﻤﻊ‪.‬‬
‫ﻭﻳﻮﺿﺢ ﺍﻟﺸﻜﻞ )‪ (١٣-١٠‬ﺃﻥ ﻧﺴﺒﺔ ﺣﺎﻻﺕ ﺍﻹﺟﻬﺎﺽ ﺑﲔ ﺍﻟﻨﺴﺎﺀ ﺍﶈﺠﻮﺯﺍﺕ ﰲ ﺃﻗﺴﺎﻡ ﺃﻣﺮﺍﺽ ﺍﻟﻨﺴﺎﺀ‬
‫ﻭﺍﻟﺘﻮﻟﻴﺪ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻭﺍﳉﺎﻣﻌﻴﺔ ﰲ ﻣﺼﺮ ﲤﺜﻞ ‪ %١٩‬ﻣﻦ ﺍ‪‬ﻤﻮﻉ‪ ،‬ﻭﺃﻥ ﻧﺴﺒﺔ ﺍﻹﺟﻬﺎﺽ ﻏﲑ‬
‫ﺍﻟﻌﻤﺪﻱ ﺑﲔ ﻫﺬﻩ ﺍﳊﺎﻻﺕ ﲤﺜﻞ ‪ %٣٥‬ﻓﻘﻂ‪ ،‬ﺑﻴﻨﻤﺎ ‪ %٦٠‬ﻣﻦ ﺍﳊﺎﻻﺕ ﺑﺴﺒﺐ ﺍﻹﺟﻬﺎﺽ ﺍﻟﻌﻤﺪﻱ ﺃﻭ ﺍﶈﺪﺙ‪،‬‬
‫ﻭ‪ %٥‬ﻓﻘﻂ ﻣﻦ ﺍﳌﺆﻛﺪ ﺃ‪‬ﺎ ﳏﺪﺛﺔ‪.‬‬
‫ﻭﺗﺘﺮﻛﺰ ﻣﻌﻈﻢ ﺣﺎﻻﺕ ﺍﻹﺟﻬﺎﺽ ﺍﻟﱵ ﺗﺪﺧﻞ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﻟﻌﻤﺮﻳﺔ ﺑﲔ ‪ ٢٠‬ﺇﱃ ‪ ٣٠‬ﺳﻨﺔ‬
‫)‪ (%٣٥‬ﻭﻟﻜﻦ ﻳﻼﺣﻆ ﺃﻥ ‪ %٨,٥‬ﻣﻦ ﺍﳊﺎﻻﺕ ﻫﻲ ﻣﻦ ﺳﻦ ‪ ١٩-١٥‬ﺳﻨﺔ‪ .‬ﻛﻤﺎ ﺃﻥ ﺃﻛﺜﺮ ﻣﻦ ‪ %٦٠‬ﻣﻦ ﻫﺬﻩ‬
‫ﺍﳊﺎﻻﺕ ﻣﻦ ﺍﻟﻨﺴﺎﺀ ﻏﲑ ﺍﳌﺘﻌﻠﻤﺎﺕ‪ .‬ﻭﺗﻘﻞ ﺍﻟﻨﺴﺒﺔ ﻛﻠﻤﺎ ﺍﺭﺗﻔﻊ ﻣﺴﺘﻮﻯ ﺍﻟﺘﻌﻠﻴﻢ‪.‬‬

‫ﺷﻜﻞ )‪ :(١٣-١٠‬ﺣﺎﻻﺕ ﺍﻟﺪﺧﻮﻝ ﺑﻘﺴﻢ ﺍﻟﻨﺴﺎﺀ ﻭﺍﻟﻮﻻﺩﺓ ﺧﻼﻝ ‪ ٣٠‬ﻳﻮﻣﺎﹰ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ‬

‫ﺍﻟﻮﻻﺩﺓ )‪(%60‬‬ ‫ﺇﺟﻬﺎﺽ ﻣﺘﻌﻤﺪ ﻣﺆﻛﺪ‬

‫)‪(5%‬‬

‫ﳛﺘﻤﻞ ﺃﻧﻪ ﻣﺘﻌﻤﺪ‬

‫ﻣﺎ ﺑﻌﺪ ﺍﻻﺟﻬﺎﺽ‬ ‫)‪(58%‬‬
‫)‪(19%‬‬

‫ﺇﺟﻬﺎﺽ ﻏﲑ ﻣﺘﻌﻤﺪ‬
‫)‪(35%‬‬

‫ﻳﻌﺘﻘﺪ ﺃﻧﻪ ﻣﺘﻌﻤﺪ‬

‫ﺃﻣﺮﺍﺽ ﺍﻟﻨﺴﺎﺀ )‪(%21‬‬ ‫)‪(2%‬‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪(The Egyptian Fertility Care Society 1997, Postabortion Case Load Study in :‬‬
‫)‪Egyptian Public Sector Hospitals - Final Report.‬‬

‫ﻭﺑﺎﻟﻨﺴﺒﺔ ﻟﻌﺪﺩ ﻣﺮﺍﺕ ﺍﳊﻤﻞ ﻓﺈﻥ ﺃﻏﻠﺐ ﺍﳊﺎﻻﺕ ﻗﺪ ﺳﺒﻖ ﳍﻦ ﺍﳊﻤﻞ ﻣﻦ‪ ٥-١‬ﻣﺮﺍﺕ‪ ،‬ﻭﻟﻜﻦ ﲡﺪﺭ ﺍﻹﺷﺎﺭﺓ‬
‫ﺇﱃ ﺃﻥ ‪ %١٦,١‬ﱂ ﻳﻜﻦ ﺣﻮﺍﻣﻞ ﻣﻦ ﻗﺒﻞ‪.‬‬
‫ﻭﻳﺒﲔ ﺍﻟﺸﻜﻞ )‪ (١٤-١٠‬ﺃﻧﻮﺍﻉ ﺍﻹﺟﻬﺎﺽ ﺍﳌﺨﺘﻠﻔﺔ ﻭﻧﺴﺒﻬﺎ ﻭﻃﻮﻝ ﻣﺪﺓ ﺍﻟﺒﻘﺎﺀ ﺑﺎﳌﺴﺘﺸﻔﻰ ﻟﻜﻞ ﻣﻨﻬﺎ‪.‬‬
‫ﻭﻗﺪ ﻛﺎﻧﺖ ﺃﻫﻢ ﺍﳌﻀﺎﻋﻔﺎﺕ ﺍﳌﺼﺎﺣﺒﺔ ﻟﻺﺟﻬﺎﺽ ﻋﻨﺪ ﺩﺧﻮﻝ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻫﻲ ﺍﻟﱰﻑ ﰲ ‪ %٨٦‬ﻣﻦ‬
‫ﺍﳊﺎﻻﺕ ﻭﺍﻟﱰﻑ ﺍﻟﺸﺪﻳﺪ ﰲ ‪ %١٤‬ﻣﻦ ﺍﳊﺎﻻﺕ ﻭﺻﺪﻣﺔ ﺍﳉﻬﺎﺯ ﺍﻟﺪﻭﺭﻱ ﰲ ‪ %٥‬ﻣﻦ ﺍﳊﺎﻻﺕ ﻭﺍﻻﻟﺘﻬﺎﺑﺎﺕ ﰲ ‪%٥‬‬
‫ﻭﺍﻹﺻﺎﺑﺎﺕ ﰲ ‪ %١‬ﺗﻘﺮﻳﺒﺎﹰ )ﺍﻟﺸﻜﻞ ‪.(١٥-١٠‬‬
‫ﻭﻗﺪ ﺗﺮﺍﻭﺣﺖ ﻧﺴﺒﺔ ﺍﻟﻮﻓﻴﺎﺕ ﻣﻦ ﺍﻹﺟﻬﺎﺽ ﺑﻌﺪ ﺩﺧﻮﻝ ﺍﳌﺴﺘﺸﻔﻰ ﺑﲔ ‪ %٢٣‬ﰲ ﺑﻌﺾ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬
‫ﺍﻟﻌﺎﻣﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﺍﳊﺪﻭﺩﻳﺔ ﺇﱃ ﻣﺎ ﺑﲔ ‪ %١١,١‬ﺇﱃ ‪ %٢,٣‬ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﻭﺍﳌﺮﻛﺰﻳﺔ ﰲ ﺍﻟﻮﺟﻬﲔ‬
‫ﺍﻟﺒﺤﺮﻱ ﻭﺍﻟﻘﺒﻠﻲ ﺇﱃ ‪ %١,٣‬ﰲ ﺃﺣﺪ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳉﺎﻣﻌﻴﺔ‪.‬‬

‫‪٢٧٧‬‬
‫ﺷﻜﻞ )‪ :(١٤-١٠‬ﻣﺪﺓ ﺍﻹﻗﺎﻣﺔ ﰲ ﺍﳌﺴﺘﺸﻔﻰ ﻭﻓﻘﺎﹰ ﻟﻨﻮﻉ ﺍﻹﺟﻬﺎﺽ ﺍﻟﺬﻱ ﰎ ﺗﺸﺨﻴﺼﻪ ﻋﻨﺪ ﺍﻟﺪﺧﻮﻝ‬

‫ﻣﻨﺬﺭ‬

‫ﻋﻔﻦ‬
‫ﺍﻧﻮﺍﻉ ﺍﻻﺟﻬﺎﺽ‬

‫ﻛﺎﻣﻞ‬

‫ﻏﲑ ﻛﺎﻣﻞ‬

‫‪0‬‬ ‫‪5‬‬ ‫‪10‬‬ ‫‪15‬‬ ‫‪20‬‬ ‫‪25‬‬ ‫‪30‬‬ ‫‪35‬‬ ‫‪40‬‬ ‫‪45‬‬ ‫‪50‬‬

‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ‬

‫ﻣﻨﺬﺭ‬

‫ﻋﻔﻦ‬
‫ﺍﻧﻮﺍﻉ ﺍﻻﺟﻬﺎﺽ‬

‫ﻛﺎﻣﻞ‬

‫ﻏﲑ ﻛﺎﻣﻞ‬

‫‪0‬‬ ‫‪2‬‬ ‫‪4‬‬ ‫‪6‬‬ ‫‪8‬‬ ‫‪10‬‬ ‫‪12‬‬ ‫‪14‬‬ ‫‪16‬‬ ‫‪18‬‬ ‫‪20‬‬

‫ﻣﺘﻮﺳﻂ ﻣﺪﺓ ﺍﻻﻗﺎﻣﺔ‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪(The Egyptian Fertility Care Society 1997, Postabortion Case Load Study in :‬‬
‫)‪Egyptian Public Sector Hospitals - Final Report.‬‬

‫‪٢٧٨‬‬
 ‫ﺷﻜﻞ )‪ :(١٥-١٠‬ﺍﳌﻀﺎﻋﻔﺎﺕ ﺑﲔ ﺍﻟﺴﻴﺪﺍﺕ ﺑﻌﺪ ﺍﻹﺟﻬﺎﺽ ﻋﻨﺪ ﺩﺧﻮﳍﻦ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‬

‫‪100‬‬
‫‪86.4‬‬
‫‪80‬‬

‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪(%‬‬

‫‪60‬‬

‫‪40‬‬

‫‪13.6‬‬
‫‪20‬‬
‫‪5.2‬‬ ‫‪5‬‬
‫‪0.7‬‬
‫‪0‬‬
‫ﻧﺰﻳﻒ‬ ‫ﻧﺰﻳﻒ ﺷﺪﻳﺪ‬ ‫ﺻﺪﻣﺔ‬ ‫ﺇﺻﺎﺑﺎﺕ‬ ‫ﺍﻟﺘﻬﺎﺑﺎﺕ‬

‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪(The Egyptian Fertility Care Society 1997, Postabortion Case Load Study in :‬‬
‫)‪Egyptian Public Sector Hospitals - Final Report.‬‬

‫ﺍﻷﻣﺮﺍﺽ ﺍﳌﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎﹰ ﻭﺍﻹﻳﺪﺯ‬

‫ﲤﺜﻞ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻨﻘﻮﻟﺔ ﻋﻦ ﻃﺮﻳﻖ ﺍﳉﻨﺲ ﺳﺒﺒﺎﹰ ﻣﻬﻤﺎﹰ ﻣﻦ ﺃﺳﺒﺎﺏ ﺍﳌﺮﺽ ﰲ ﻣﺼﺮ‪ .‬ﻧﺘﺎﺋﺞ ﻣﺴﺢ ﻗﺪ‬
‫ﺃﺟﺮﻱ ﰲ ﺍﻟﻘﺎﻫﺮﺓ ﺃﻛﺪ ﺃﻥ ﻫﻨﺎﻙ ﻧﺴﺒﺔ ﻣﺮﺗﻔﻌﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻨﻘﻮﻟﺔ ﻋﻦ ﻃﺮﻳﻖ ﺍﳉﻨﺲ ﺍﻟﻘﺎﺑﻠﺔ‬
‫ﻟﻠﺸﻔﺎﺀ ﺗﺼﻞ ﺇﱃ ‪ %٣٦,٥٥‬ﺑﲔ ﺍﳌﻤﺎﺭﺳﺎﺕ ﻟﻠﺠﻨﺲ ﺍﻟﺘﺠﺎﺭﻱ ﻭ‪ %٢٢,٨‬ﺑﲔ ﺍﻟﺮﺟﺎﻝ ﺍﻟﺬﻳﻦ ﳝﺎﺭﺳﻮﻥ ﺍﳉﻨﺲ‬
‫ﻣﻊ ﺍﻟﺮﺟﺎﻝ‪ %٨,٣ .‬ﺑﲔ ﺍﻟﻨﺴﺎﺀ ﺍﳌﺘﺮﺩﺩﺍﺕ ﻋﻠﻰ ﻋﻴﺎﺩﺍﺕ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭ‪ %٥,٣٥‬ﺑﲔ ﺍﳌﺪﻣﻨﲔ)‪.(٢٢‬‬
‫ﻣﻊ ﺗﺒﲏ ﻣﺼﻄﻠﺢ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﰲ ﺍﳌﺆﲤﺮ ﺍﻟﺪﻭﱄ ﻟﻠﺴﻜﺎﻥ ﻭﺍﻟﺘﻨﻤﻴﺔ ﻋﺎﻡ ‪ ١٩٩٤‬ﺍﻗﺘﺮﺡ ﺍﺳﻢ‬
‫"ﻋﺪﻭﻯ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ" ﺑﺪﻻﹰ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎﹰ‪ .‬ﻭﻗﺪ ﻗﺎﻣﺖ ﺑﺎﻟﺘﺮﻛﻴﺰ ﺃﺳﺎﺳﺎﹰ ﻋﻠﻰ‬
‫ﺍﻟﻨﺴﺎﺀ‪ .‬ﻭﻛﺎﻧﺖ ﺍﻷﲝﺎﺙ ﺍﻟﱵ ﺃﺟﺮﻳﺖ ﰲ ﻣﺼﺮ ﺑﻌﺪ ﺫﻟﻚ ﺗﻌﺘﻤﺪ ﻋﻠﻰ ﻓﺤﺺ ﺍﻟﻨﺴﺎﺀ ﺃﺳﺎﺳﺎﹰ ﰲ‬
‫ﺍﻟﻌﻴﺎﺩﺍﺕ ﺃﻭ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪ ،‬ﳑﺎ ﺃﺩﻯ ﺇﱃ ﺃﺭﻗﺎﻡ ﻭﺗﻘﺪﻳﺮﺍﺕ ﺃﻗﻞ ﳑﺎ ﻫﻮ ﻋﻠﻴﻪ ﺍﳊﺎﻝ ﰲ ﺍ‪‬ﺘﻤﻊ‪ .‬ﻭﻛﺎﻥ ﺍﻟﺴﺒﺐ‬
‫ﰲ ﺗﻘﺪﻳﺮ ﻣﻌﻈﻢ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﱵ ﺃﺟﺮﻳﺖ ﻋﻠﻰ ﻫﺬﺍ ﺍﳌﻮﺿﻮﻉ ﻋﻠﻰ ﻋﺪﻡ ﻛﻔﺎﻳﺔ ﺍﳌﻌﻠﻮﻣﺎﺕ )ﻭﻣﻨﻬﺎ‬
‫ﺩﺭﺍﺳﺔ ﺍﳉﻴﺰﺓ‪ ،‬ﻫﻨﺪ ﺧﻄﺎﺏ ﻭﺁﺧﺮﻭﻥ( ﺑﺴﺒﺐ ﺍﻋﺘﺒﺎﺭ ﺍﻟﻨﺴﺎﺀ ﺃﻥ ﺗﻠﻚ ﺍﻷﻣﺮﺍﺽ ﲤﺜﻞ ﻋﺎﺭﺍﹰ ﺍﺟﺘﻤﺎﻋﻴﺎﹰ‪.‬‬
‫ﻭﻛﺬﻟﻚ ﺃﺭﺟﻌﺖ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻋﺪﻡ ﺫﻛﺮ ﺍﻟﻨﺴﺎﺀ ﻟﻜﺜﲑ ﻣﻦ ﺍﻷﻋﺮﺍﺽ ﻭﺍﺭﺗﺒﺎﻛﻬﻦ ﻧﺘﻴﺠﺔ‬
‫ﻟﻠﻤﻌﺎﻣﻠﺔ ﺍﻟﺴﻴﺌﺔ ﻣﻦ ﺍﻷﻃﺒﺎﺀ‪.‬‬
‫ﻭﻛﺎﻧﺖ ﻧﺘﺎﺋﺞ ﺩﺭﺍﺳﺔ ﺃﺟﺮﻳﺖ ﻋﻠﻰ ﺍﻟﻨﺴﺎﺀ ﺩﺍﺧﻞ ﺑﻴﻮ‪‬ﻦ ﺃﻥ ‪ %٥‬ﻓﻘﻂ ﻣﻦ ﺍﻟﻨﺴﺎﺀ ﻛﻦ ﻻ ﻳﻌﺎﻧﲔ ﻣﻦ ﺃﻱ‬
‫ﺃﻣﺮﺍﺽ ﺧﺎﺻﺔ ﺑﺎﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ‪ .‬ﻧﺼﻒ ﺍﻟﻨﺴﺎﺀ ﻛﻦ ﻳﻌﺎﻧﲔ ﻣﻦ ﻣﺮﺿﲔ ﰲ ﻧﻔﺲ ﺍﻟﻮﻗﺖ‪ ،‬ﻭﲬﺲ‬
‫ﺍﻟﻨﺴﺎﺀ ﻛﻦ ﻳﻌﺎﻧﲔ ﻣﻦ ﺛﻼﺛﺔ ﺃﻣﺮﺍﺽ ﺃﻭ ﺃﻛﺜﺮ‪ .‬ﻧﺼﻒ ﺍﻟﻨﺴﺎﺀ ﻳﻌﺎﻧﲔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻨﻘﻮﻟﺔ ﻋﻦ ﻃﺮﻳﻖ‬
‫ﺍﳉﻨﺲ‪ %٤٤ :‬ﺍﻟﺘﻬﺎﺑﺎﺕ ﰲ ﺍﳌﻬﺒﻞ )ﺑﺴﺒﺐ ﺍﻟﺒﻜﺘﲑﻳﺎ ‪ ،%٢٢‬ﺑﺴﺒﺐ ﺍﻟﺘﺮﺍﻳﻜﻮﻣﻮﻧﺲ ‪ %١٨‬ﺑﺴﺒﺐ ﺍﻟﻜﺎﻧﺪﻳﺪﺍ‬
‫‪ .( %١١‬ﻭ‪ %١٥‬ﻳﻌﺎﻧﲔ ﻣﻦ ﺍﻟﺘﻬﺎﺏ ﺑﻌﻨﻖ ﺍﻟﺮﺣﻢ؛ ‪ %٩‬ﻣﻨﻬﻦ ﺑﺴﺒﺐ ﺍﻟﻜﻼﻣﻴﺪﻳﺎ‪.‬‬
‫ﻭﻛﺬﻟﻚ ﻓﺈﻥ ﺛﻠﺜﻲ ﺍﻟﻨﺴﺎﺀ ﻛﻦ ﻳﻌﺎﻧﲔ ﻣﻦ ﺳﻘﻮﻁ ﰲ ﺍﳉﻬﺎﺯ ﺍﻟﺘﻨﺎﺳﻠﻲ)‪.(٢٣‬‬

‫‪٢٧٩‬‬
‫ﻭﻗﺪ ﻗﺎﻣﺖ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﳌﺼﺮﻳﺔ ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﻭﺍﻷﺳﺮﺓ ﺍﻟﺪﻭﻟﻴﺔ ﺑﺒﺤﺚ )ﻛﻤﺎ ﺳﺒﻖ‬
‫ﺫﻛﺮﻩ( ﺃﻇﻬﺮﺕ ﻓﻴﻪ ﺃﻥ ‪ %٧,٩‬ﻣﻦ ﺍﳌﺸﺎﺭﻛﺎﺕ ﻛﻦ ﻣﺼﺎﺑﺎﺕ ﺑﺄﻣﺮﺍﺽ ﺗﻨﻘﻞ ﻋﻦ ﻃﺮﻳﻖ ﺍﳉﻨﺲ‪ ،‬ﻭﻛﺎﻧﺖ‬
‫ﺍﻟﻨﺴﺒﺔ ‪ %٨,٣‬ﻣﻦ ﺑﲔ ﺍﳌﺘﺮﺩﺩﺍﺕ ﻋﻠﻰ ﻋﻴﺎﺩﺍﺕ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪ ،‬ﻭ‪ %٤‬ﻣﻦ ﺍﻟﻨﺴﺎﺀ ﺍﳌﺘﺮﺩﺩﺍﺕ ﻋﻠﻰ ﻋﻴﺎﺩﺍﺕ‬
‫ﻣﺘﺎﺑﻌﺔ ﺍﳊﻤﻞ‪ .‬ﻭﻗﺪ ﺃﻭﺻﺖ ﺍﻟﺪﺭﺍﺳﺔ ﺑﺎﻗﺘﺮﺍﺡ ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﻟﻠﺴﻴﻄﺮﺓ ﻋﻠﻰ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎﹰ‬
‫ﰲ ﻣﺼﺮ ﻭﻫﻲ ﺗﺸﻤﻞ‪ :‬ﺍﻷﲝﺎﺙ ﻭﺍﳌﺴﻮﺡ‪ ،‬ﻛﺬﻟﻚ ﻋﻤﻞ ﻭﺗﻄﻮﻳﺮ ﺃﺩﻟﺔ ﻟﻠﺘﺸﺨﻴﺺ ﻭﺍﻟﻌﻼﺝ ﻟﻸﻃﺒﺎﺀ‬
‫ﻭﺍﻟﻌﺎﻣﻠﲔ ﺍﻟﺼﺤﻴﲔ‪ .‬ﻭﻳﻌﻜﺲ ﻫﺬﺍ ﺍﻟﺘﻄﻮﺭ ﻣﻦ ﺍﳌﻮﻗﻒ ﺍﻟﺴﺎﺑﻖ ﺍﻟﺮﺍﻓﺾ ﺑﺪﻭﻥ ﺑﻴﻨﺔ ﻭﺍﻟﺬﻱ ﻳﻨﻜﺮ ﻭﺟﻮﺩ‬
‫ﺍﳉﻨﺲ ﺍﻟﺘﺠﺎﺭﻱ ﰲ ﻣﺼﺮ ﻭﻛﺬﻟﻚ ﺍﳉﻨﺴﻴﺔ ﺍﳌﺜﻠﻴﺔ ﺑﲔ ﺍﻟﺬﻛﻮﺭ)‪.(٢٤‬‬
‫ﰲ ﻋﺎﻡ ‪ ١٩٨٦‬ﰎ ﺇﻗﺎﻣﺔ ﺍﻟﱪﻧﺎﻣﺞ ﺍﻟﻮﻃﲏ ﻟﻠﺘﺤﻜﻢ ﰲ ﺍﻹﻳﺪﺯ‪ .‬ﻭﰲ ﻋﺎﻡ ‪ ١٩٩٦‬ﻗﺎﻡ ﺍﻟﱪﻧﺎﻣﺞ ﺍﻟﻮﻃﲏ‬
‫ﲟﻌﺎﻭﻧﺔ ﻣﺆﺳﺴﺔ ﻓﻮﺭﺩ ﺑﺈﻗﺎﻣﺔ ﺍﳋﻂ ﺍﻟﺴﺎﺧﻦ ﻭﺫﻟﻚ ﳏﺎﻭﻟﺔ ﻟﻠﺘﻌﺮﻑ ﻋﻠﻰ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﻭﺍﳌﻌﻠﻮﻣﺎﺕ‬
‫ﺍﻟﱵ ﻳﺼﻌﺐ ﺍﳊﺼﻮﻝ ﻋﻠﻴﻬﺎ ﳌﺎ ﳛﻴﻂ ﺑﺎﻹﺻﺎﺑﺔ ﺑﺎﻹﻳﺪﺯ ﻣﻦ ﺍﻟﻌﺎﺭ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ ،‬ﻭﻗﺪ ﳒﺢ ﻫﺬﺍ ﺍﻟﱪﻧﺎﻣﺞ‬
‫ﰲ ﺍﻹﺟﺎﺑﺔ ﻋﻠﻰ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻷﺳﺌﻠﺔ ﺍﳊﺴﺎﺳﺔ ﻋﻦ ﻃﺮﻳﻖ ﻧﻘﻞ ﺍﻟﻌﺪﻭﻯ ﻭﺍﻟﻌﻼﺝ ﻭﺍﳌﻤﺎﺭﺳﺎﺕ ﺍﳉﻨﺴﻴﺔ‬
‫ﺍﻟﺼﺤﻴﺤﺔ؛ ﻣﺜﻞ ﻫﻞ ﻳﻘﻮﻡ ﺍﻟﻨﺎﻣﻮﺱ ﺑﻨﻘﻞ ﺍﳌﺮﺽ؟)‪.(٢٥‬‬
‫ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪ ٢٠٠١ – ١٩٨٦‬ﻛﺎﻥ ﺃﻛﺜﺮ ﻣﻦ ﲬﺴﺔ ﻣﻼﻳﲔ ﻣﺼﺮﻱ ﻗﺪ ﰎ ﻓﺤﺼﻬﻢ‪ .‬ﻭﻗﺪ ﰎ ﺍﻛﺘﺸﺎﻑ‬
‫‪ ١٥٨٤‬ﺣﺎﻟﺔ ‪ AIDS‬ﻭ‪ HIV‬ﻛﺎﻥ ﻣﻨﻬﻢ ‪ ٥٤٠‬ﺣﺎﻟﺔ ﺃﺟﺎﻧﺐ‪ %٥٩ ،‬ﻣﻦ ﺍﳊﺎﻻﺕ ﻛﺎﻧﻮﺍ ﻣﻦ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ ﺑﲔ‬
‫‪ ٢٠‬ﻭ‪ ٣٩‬ﺳﻨﺔ ﻭﻣﺜﻞ ﺍﻟﺬﻛﻮﺭ ‪ %٨٩‬ﻣﻦ ﺇﲨﺎﱄ ﺍﳊﺎﻻﺕ‪ .‬ﻭﻛﺎﻥ ﻣﻌﺪﻝ ﺍﻧﺘﺸﺎﺭ ﺍﳊﺎﻻﺕ ﺑﲔ ﺍﻟﻨﺎﺱ ‪%٠,٠٣‬‬
‫ﻭﻣﻊ ﻫﺬﻩ ﺍﻟﻨﺴﺐ ﺗﺒﻘﻰ ﻣﺼﺮ ﻣﻦ ﺍﻟﺒﻠﺪﺍﻥ ﺍﻷﻗﻞ ﰲ ﺍﻧﺘﺸﺎﺭ ﻣﺮﺽ ﺍﻹﻳﺪﺯ)‪.(٢٦‬‬

‫ﺍﻟﺼﺤﺔ ﺍﳉﻨﺴﻴﺔ ﻟﻠﺴﻴﺪﺍﺕ ﰲ ﻣﺼﺮ‬

‫ﺇﻥ ﺍﻷﻃﺒﺎﺀ ﰲ ﻣﺼﺮ ﻏﲑ ﻣﺪﺭﺑﲔ ﻋﻠﻰ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﳌﺸﺎﻛﻞ ﺍﳉﻨﺴﻴﺔ ﻟﻠﺴﻴﺪﺍﺕ‪ .‬ﻓﺈﻥ ﻣﻨﻬﺞ ﺍﻟﺘﻌﻠﻴﻢ‬
‫ﺍﻟﻄﱯ ﰲ ﻣﻌﻈﻢ ﺍﳉﺎﻣﻌﺎﺕ ﻻ ﻳﺸﻤﻞ ﺍﻟﺼﺤﺔ ﺍﳉﻨﺴﻴﺔ‪ .‬ﻓﻘﻂ ﺃﻇﻬﺮﺕ ﺩﺭﺍﺳﺔ ﺣﻮﻝ ﻣﻮﻗﻒ ﺍﻷﻃﺒﺎﺀ‬
‫ﺣﻮﻝ ﻣﻨﺎﻗﺸﺔ ﺍﳌﺸﺎﻛﻞ ﺍﳉﻨﺴﻴﺔ ﻣﻊ ﺍﳌﺘﺮﺩﺩﺍﺕ ﻋﻠﻰ ﻋﻴﺎﺩﺍﺕ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﺃﻥ ﺍﻷﻃﺒﺎﺀ ﳛﺠﻤﻦ ﻋﻦ‬
‫ﻣﻨﺎﻗﺸﺔ ﺗﻠﻚ ﺍﻷﻣﻮﺭ ﺧﻮﻓﺎﹰ ﻣﻦ ﺍﻟﺘﺴﺒﺐ ﰲ ﺇﺣﺮﺍﺝ ﺍﳌﺘﺮﺩﺩﺍﺕ‪ .‬ﻭﻋﻠﻰ ﺍﻟﻨﻘﻴﺾ ﺃﻋﻠﻨﺖ ﺍﻟﺴﻴﺪﺍﺕ ﺭﻏﺒﺘﻬﻦ‬
‫ﰲ ﻣﻨﺎﻗﺸﺔ ﻣﺸﺎﻛﻠﻬﻦ ﺍﳉﻨﺴﻴﺔ ﺍﳌﺘﻌﻠﻘﺔ ﺑﻮﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻣﻊ ﻣﻘﺪﻣﻲ ﺍﳋﺪﻣﺔ ﻭﻟﻜﻨﻬﻦ ﻻ‬
‫ﻳﺮﻏﱭ ﺃﻥ ﻳﻜﻦ ﻫﻦ ﺍﻟﺒﺎﺩﺋﺎﺕ ﺑﺎﳌﻨﺎﻗﺸﺔ)‪.(٢٧‬‬
‫ﻛﺬﻟﻚ ﻓﺈﻥ ﺍﻟﻨﻈﺎﻡ ﺍﻟﺼﺤﻲ ﻏﲑ ﻣﻌﺪ ﻟﻠﺘﻌﺎﻣﻞ ﻣﻊ ﺿﺤﺎﻳﺎ ﺍﻟﻌﻨﻒ ﺍﳉﻨﺴﻲ )ﺍﻻﻏﺘﺼﺎﺏ( ﻭﻻ ﺗﻮﺟﺪ‬
‫ﺑﺮﻭﺗﻮﻛﻮﻻﺕ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺗﻮﺿﺢ ﻃﺮﻳﻘﺔ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺿﺤﺎﻳﺎ ﺍﻟﻌﻨﻒ ﻣﺜﻞ ﺍﳌﺸﻮﺭﺓ ﻭﺍﻟﻌﻼﺝ‬
‫ﺍﻟﻨﻔﺴﻲ‪ .‬ﺍﺧﺘﺒﺎﺭ ﺍﻧﺘﻘﺎﻝ ﺍﻟﻌﺪﻭﻯ ﻋﻦ ﻃﺮﻳﻖ ﺍﳉﻨﺲ ﻭﻛﺬﻟﻚ ﺗﻘﺪﱘ ﺍﻟﻮﺳﻴﻠﺔ ﺍﳌﻨﺎﺳﺒﺔ ﳌﻨﻊ ﺍﳊﻤﻞ‪.‬‬

‫ﻋﺪﻡ ﺍﻹﳒﺎﺏ )ﺍﻟﻌﻘﻢ(‬

‫ﻟﻸﳘﻴﺔ ﺍﻟﻜﱪﻯ ﺍﳌﻌﻄﺎﺓ ﻷﺩﻭﺍﺭ ﺍﳌﺮﺃﺓ ﺍﻹﳒﺎﺑﻴﺔ ﰲ ﻣﺼﺮ ﻭﺍﻟﻘﻴﻤﺔ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺈﳒﺎﺏ ﺍﻷﻃﻔﺎﻝ ﳝﺜﻞ ﺍﻟﻌﻘﻢ‬
‫ﻣﺸﻜﻠﺔ ﺧﻄﲑﺓ ﰲ ﻣﺼﺮ ﳍﺎ ﻧﺘﺎﺋﺞ ﻫﺎﻣﺔ ﻋﻠﻰ ﺍﳌﺮﺃﺓ ﻭﺃﺳﺮ‪‬ﺎ‪ .‬ﻓﻴﺒﺪﺃ ﺍﻟﻀﻐﻂ ﻋﻠﻰ ﺇﳒﺎﺏ ﺍﻟﻄﻔﻞ‬
‫ﺍﻷﻭﻝ ﺑﻌﺪ ﻓﺘﺮﺓ ﻗﺼﲑﺓ ﻣﻦ ﺍﻟﺰﻭﺍﺝ‪ .‬ﻓﻌﻠﻰ ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ ﰎ ﺗﻘﺪﻳﺮ ﺛﻼﲦﺎﺋﺔ ﺃﻟﻒ ﺣﺎﻟﺔ ﻣﻦ ﺍﻟﻨﺴﺎﺀ ﺗﺄﺧﺮ‬
‫ﲪﻠﻬﻦ ﻋﻠﻰ ﺍﻷﻗﻞ ‪ ٢٤‬ﺷﻬﺮﺍﹰ‪ .‬ﻭﻳﺘﺒﻊ ﻫﺬﺍ ﺍﻟﺘﺄﺧﲑ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻟﻘﻠﻖ ﻭﺍﳋﻮﻑ ﻭﺍﺗﺒﺎﻉ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻟﻄﻘﻮﺱ‬

‫‪٢٨٠‬‬
‫ﺍﻟﺸﻌﺒﻴﺔ ﻭﺍﻟﻄﻘﻮﺱ ﺍﻟﻀﺎﺭﺓ ﻭﺍﻻﺳﺘﺨﺪﺍﻡ ﺍﳌﺒﻜﺮﺓ ﻟﻠﻮﺳﺎﺋﻞ ﺍﻟﻄﺒﻴﺔ ﻟﻌﻼﺝ ﺍﳋﺼﻮﺑﺔ ﻭﻛﻞ ﺗﻠﻚ‬
‫ﺍﻟﻌﺠﻠﺔ ﲡﻌﻞ ﺍﳌﺮﺃﺓ ﻭﺟﻬﺎﺯﻫﺎ ﺍﻟﺘﻨﺎﺳﻠﻲ ﰲ ﺣﺎﻟﺔ ﺃﻛﺜﺮ ﺳﻮﺀﺍﹰ)‪.(٢٨‬‬

‫ﻓﻘﺪ ﺍﻷﺟﻨﺔ‬
‫ﺟﺎﻧﺐ ﺁﺧﺮ ﻣﻦ ﺟﻮﺍﻧﺐ ﺍﻟﺼﺤﺔ ﺍﻹﳒﺎﺑﻴﺔ ﺍﳌﻬﻤﺔ ﻭﻫﻮ ﺍﳌﻌﺪﻻﺕ ﺍﳌﺮﺗﻔﻌﺔ ﻟﻔﻘﺪ ﺍﻷﺟﻨﺔ ﻭﻣﺎ ﻳﻨﺘﺞ ﻋﻨﻪ‬
‫ﻣﻦ ﻣﺸﺎﻛﻞ ﻧﻔﺴﻴﺔ ﻭﺟﺴﺪﻳﺔ‪ .‬ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻗﺪ ﺃﺟﺮﻳﺖ ﻭﺃﻭﺿﺤﺖ ﺍﻟﻌﺐﺀ ﺍﳌﺮﺗﻔﻊ ﻟﺪﻯ‬
‫ﺍﻟﺴﻴﺪﺍﺕ ﻣﻦ ﻓﻘﺪ ﺍﻷﺟﻨﺔ )‪ %١٣ (٢٩‬ﻣﻦ ﺍﻷﲪﺎﻝ ﺗﻔﻘﺪ‪.‬‬
‫ﺟﺪﻭﻝ )‪ :(١٦-١٠‬ﻣﻘﺎﻳﻴﺲ ﻓﻘﺪﺍﻥ ﺍﳊﻤﻞ ﺑﲔ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻼﰐ ﺳﺒﻖ ﳍﻦ ﺍﻟﺰﻭﺍﺝ )‪ ٤٩– ١٥‬ﺳﻨﺔ(‬
‫ﺍﻟﻨﺴﺎﺀ ﻣﻦ ‪٤٠‬‬
‫ﻛﻞ ﺍﻟﻨﺴﺎﺀ‬
‫ﺳﻨﺔ ﺃﻭ ﺃﻛﺜﺮ‬
‫‪٩٩‬‬ ‫‪٦٢‬‬ ‫ﻣﻌﺪﻝ ﻓﻘﺪﺍﻥ ﺍﳊﻤﻞ )‪(١‬‬
‫‪٤١,٢‬‬ ‫‪٢٩,٧‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻨﺴﺎﺀ ﺍﻟﻼﺋﻰ ﺳﺒﻖ ﳍﻦ ﲡﺮﺑﺔ ﻓﻘﺪ ﺍﳊﻤﻞ‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻨﺴﺎﺀ ﺍﻟﻼﺋﻰ ﺟﺮﺑﻦ ﻓﻘﺪ ﺍﳊﻤﻞ ‪ ٣‬ﻣﺮﺍﺕ ﺃﻭ ﺃﻛﺜﺮ‬
‫ﻓﻘﺪﺍﻥ ﺍﳊﻤﻞ ﺑﲔ ﻣﻦ ﺳﺒﻖ ﳍﻦ ﺍﳊﻤﻞ‬
‫ﻓﻘﺪﺍﻥ ﺍﳊﻤﻞ ﻭﻓﻘﺎﹰ ﻟﻨﻮﻉ ﻓﻘﺪﺍﻧﻪ‬
‫‪٢٠,٢‬‬ ‫ﺇﺟﻬﺎﺽ‬
‫‪١٥,٩‬‬ ‫ﻣﻮﺍﻟﻴﺪ ﺃﺣﻴﺎﺀ‬
‫‪٢٣,٧‬‬ ‫ﺃﻱ ﻧﻮﻉ‬

‫ﻣﺸﻜﻼﺕ ﺻﺤﻴﺔ ﺃﺧﺮﻯ‬

‫ﺍﻟﺒﻠﻬﺎﺭﺳﻴﺎ‪ :‬ﻣﺮﺽ ﻳﻨﺘﻘﻞ ﻋﻦ ﻃﺮﻳﻖ ﺍﳌﺎﺀ ﻭﳝﺜﻞ ﻗﻀﻴﺔ ﺻﺤﺔ ﻋﺎﻣﺔ ﻫﺎﻣﺔ ﲟﺼﺮ ﻭﻳﻨﺘﺸﺮ ﺍﳌﺮﺽ ﺑﲔ‬
‫ﺍﻟﺬﻛﻮﺭ ﺑﻨﺴﺒﺔ ﺃﻋﻠﻰ ﻣﻦ ﺍﻹﻧﺎﺙ؛ ﻓﻴﺼﻞ ﺍﻧﺘﺸﺎﺭ ﺍﻟﺒﻠﻬﺎﺭﺳﻴﺎ ﺍﳌﻌﻮﻳﺔ ﺇﱃ ‪ %٣١,٤‬ﺑﲔ ﺍﻹﻧﺎﺙ ﻭ‪ %٤١,٥‬ﺑﲔ‬
‫ﺍﻟﺬﻛﻮﺭ‪ .‬ﺃﻣﺎ ﺍﻧﺘﺸﺎﺭ ﺑﻠﻬﺎﺭﺳﻴﺎ ﺍ‪‬ﺎﺭﻱ ﺍﻟﺒﻮﻟﻴﺔ ﻓﻴﺼﻞ ﺇﱃ ‪ %٥,٦‬ﺑﲔ ﺍﻹﻧﺎﺙ‪ ،‬ﻭ‪ %١٠,١‬ﺑﲔ ﺍﻟﺬﻛﻮﺭ)‪.(٣٠‬‬
‫ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﺍﻟﻨﺴﺒﺔ ﺃﻋﻠﻰ ﺑﲔ ﺍﻟﺬﻛﻮﺭ ﺇﻻ ﺃﻥ ﻋﻼﺝ ﺍﻟﺒﻠﻬﺎﺭﺳﻴﺎ ﰲ ﺣﺎﺟﺔ ﺇﱃ ﺣﺴﺎﺳﻴﺔ ﺧﺎﺻﺔ ﲡﺎﻩ‬
‫ﺍﻟﻨﻮﻉ‪ .‬ﺣﻴﺚ ﺇﻥ ﺍﻟﻌﻼﺝ ﰲ ﺍﻷﺳﺎﺱ ﻳﻜﻮﻥ ﻣﻦ ﺧﻼﻝ ﺍﳌﺪﺭﺳﺔ‪ ،‬ﻭﻧﺴﺒﺔ ﺍﻹﻧﺎﺙ ﺧﺎﺭﺝ ﺍﳌﺪﺭﺳﺔ ﺃﻋﻠﻰ ﻭﻻ‬
‫ﻳﺘﻠﻘﲔ ﺍﻟﻌﻼﺝ‪ ،‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺫﻟﻚ ﻓﺈﻥ ﺍﻟﺴﻴﺪﺍﺕ ﺍﳊﻮﺍﻣﻞ ﻻ ﻳﺄﺧﺬﻥ ﺍﻟﻌﻼﺝ‪.‬‬
‫ﻛﺜﺮﺓ ﺍﻹﳒﺎﺏ‪ :‬ﻳﻘﺪﺭ ﻣﻌﺪﻝ ﺍﳋﺼﻮﺑﺔ ﰲ ﻣﺼﺮ ﺑـ ‪ ،٣,٥‬ﻭﻳﺘﺮﺍﻭﺡ ﻣﺎ ﺑﲔ ‪ ٢,٨٩‬ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﺍﳊﻀﺮﻳﺔ ﺇﱃ‬
‫‪ ٤,٦٦‬ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﺑﺼﻌﻴﺪ ﻣﺼﺮ )ﺍﳌﺴﺢ ﺍﻟﺪﳝﺠﺮﺍﰲ ﻭﺍﻟﺼﺤﻲ – ﻣﺼﺮ ‪ .(٢٠٠٠‬ﻭﻭﻓﻖ‬
‫ﺇﺣﺼﺎﺀﺍﺕ ﺍﳌﺴﺢ ﺍﻟﺪﳝﺠﺮﺍﰲ ﻭﺍﻟﺼﺤﻲ – ﻣﺼﺮ ‪ ،٢٠٠٠‬ﻓﺈﻥ ‪ %١٩,٢‬ﻣﻦ ﺍﻟﻨﺴﺎﺀ ﺍﳌﺘﺰﻭﺟﺎﺕ ﻟﺪﻳﻬﻦ ‪٦‬‬
‫ﻣﻮﺍﻟﻴﺪ ﺃﺣﻴﺎﺀ‪ ،‬ﻭ‪ %١١,٣‬ﻣﻦ ﺍﳌﻮﺍﻟﻴﺪ ﺍﳊﺪﻳﺜﺔ ﻗﺪ ﺣﺪﺛﺖ ﺑﻌﺪ ﺃﻗﻞ ﻣﻦ ‪ ١٨‬ﺷﻬﺮﺍﹰ ﻣﻨﺬ ﺁﺧﺮ ﻭﻻﺩﺓ‪.‬‬
‫ﻭﻻ ﺗﺰﺍﻝ ﻣﻌﺪﻻﺕ ﺍﻹﳒﺎﺏ ﺍﻟﻌﺎﻟﻴﺔ ﰲ ﻣﺼﺮ ﻗﻀﻴﺔ ﻫﺎﻣﺔ‪ ،‬ﻭﺧﻔﺾ ﺗﻠﻚ ﺍﳌﻌﺪﻻﺕ ﻫﺪﻑ ﻣﻦ ﺍﻷﻫﺪﺍﻑ‬
‫ﺍﻟﺘﻨﻤﻮﻳﺔ‪ .‬ﻭﻣﺎ ﺯﺍﻟﺖ ﺗﻮﺟﺪ ﺍﻟﺒﻴﻨﺔ ﻋﻠﻰ ﺇﻣﻜﺎﻧﻴﺔ ﺧﻔﺾ ﺗﻠﻚ ﺍﳌﻌﺪﻻﺕ ﻋﻦ ﻃﺮﻳﻖ ﺗﻠﺒﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ‬
‫ﺍﻷﻓﺮﺍﺩ‪ .‬ﻓﺄﺭﻗﺎﻡ ﺍﳊﻤﻞ ﻏﲑ ﺍﳌﺮﻏﻮﺏ ﻓﻴﻪ ﰲ ﺗﻘﺪﻳﺮ)‪ (١٢‬ﻛﺎﻧﺖ ‪ %١٣,٤‬ﻛﻤﺎ ﻳﻮﺿﺢ ﺫﻟﻚ ﺃﻳﻀﺎﹰ ﺗﺰﺍﻳﺪ ﺃﻋﺪﺍﺩ‬
‫ﺍﳊﻤﻞ ﺍﻟﺴﺮﻱ‪ ،‬ﺣﻴﺚ ﳝﺜﻞ ﺍﳊﻤﻞ ﻏﲑ ﺍﳌﺮﻏﻮﺏ ﻓﻴﻪ ﻋﺒﺌﺎﹰ ﻧﻔﺴﻴﺎﹰ ﻭﺟﺴﺪﻳﺎﹰ ﻋﺎﱄ ﻋﻠﻰ ﺍﳌﺮﺃﺓ ﻭﺍﻟﻄﻔﻞ‬
‫ﺃﻳﻀﺎﹰ‪.‬‬

‫‪٢٨١‬‬
‫ﻭﻳﻮﺟﺪ ﻃﺮﻳﻖ ﻭﺍﺣﺪ ﳋﻔﺾ ﻣﻌﺪﻻﺕ ﺍﳊﻤﻞ ﺍﻟﻐﲑ ﻣﺮﻏﻮﺏ ﻓﻴﻪ ﻭﻫﻮ‪ :‬ﺗﻠﺒﻴﺔ ﺍﻟﺮﻏﺒﺔ ﻏﲑ ﺍﳌﻠﺒﺎﺓ ﻟﻠﻨﺴﺎﺀ‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻮﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪ .‬ﻭﺗﻔﺎﺩﻱ ﻓﺸﻞ ﺍﺳﺘﺨﺪﺍﻡ ﻭﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪ .‬ﻭﺗﻘﺎﺱ ﺍﻟﺮﻏﺒﺔ ﻏﲑ‬
‫ﺍﳌﻠﺒﺎﺓ ﺑﻨﺴﺒﺔ ﺍﻟﻨﺴﺎﺀ ﺍﳌﻌﺮﺿﺎﺕ ﻟﻠﺤﻤﻞ‪ ،‬ﻭﻟﻜﻦ ﻻ ﻳﺴﺘﺨﺪﻣﻦ ﻭﺳﺎﺋﻞ ﻟﺘﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‪.‬‬
‫ﻭﺣﺴﺐ ﺇﺣﺼﺎﺀﺍﺕ)‪ (١٢‬ﻓﺈﻥ ‪ %١١,٢‬ﻣﻦ ﺍﻟﻨﺴﺎﺀ ﺍﳌﺘﺰﻭﺟﺎﺕ ﻟﺪﻳﻬﻦ ﺭﻏﺒﺔ ﻏﲑ ﻣﻠﺒﺎﺓ ﰲ ﺍﺳﺘﺨﺪﺍﻡ ﻭﺳﺎﺋﻞ‬
‫ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﻳﺮﺗﻔﻊ ﻫﺬﺍ ﺍﻟﻌﺪﺩ ﺇﱃ ‪ %١٨,٧‬ﰲ ﺭﻳﻒ ﺻﻌﻴﺪ ﻣﺼﺮ‪ %١٤ ،‬ﻟﻠﻨﺴﺎﺀ ﻏﲑ ﺍﳌﺘﻌﻠﻤﺎﺕ‪.‬‬
‫ﻭﻣﻦ ﺍﳌﺜﲑ ﺃﻥ ﻫﺬﺍ ﺍﻟﺮﻗﻢ ﻣﺮﺗﻔﻊ ﻧﺴﺒﻴﺎﹰ ﻟﻠﻨﺴﺎﺀ ﺍﳌﺘﻌﻠﻤﺎﺕ ﻭﺍﻟﻼﰐ ﻳﻌﻤﻠﻦ ﻟﻠﻜﺴﺐ ‪ %٧,٤‬ﻟﻜﻞ‬
‫ﳎﻤﻮﻋﺔ‪.‬‬
‫ﻭﻛﻤﺎ ﻳﻈﻬﺮ ﺑﺎﻟﺒﻴﻨﺔ ﺃﻧﻪ ﰲ ﻣﺼﺮ ﺗﻮﺟﺪ ﻧﺴﺒﺔ ﻋﺎﻟﻴﺔ ﻟﻠﺮﻏﺒﺎﺕ ﻏﲑ ﺍﳌﻠﺒﺎﺓ ﰲ ﺍﺳﺘﺨﺪﺍﻡ ﻭﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ‬
‫ﺍﻷﺳﺮﺓ‪ ،‬ﻭﻣﻌﺪﻝ ﻋﺎﻝٍ ﻟﻠﺘﻮﻗﻒ ﰲ ﺍﺳﺘﺨﺪﺍﻡ ﻭﺳﺎﺋﻞ ﻣﻨﻊ ﺍﳊﻤﻞ‪ ،‬ﺍﻟﻌﺪﺩ ﺍﻟﻜﺒﲑ ﻣﻦ ﺍﻟﻮﻻﺩﺍﺕ ﻏﲑ ﺍﳌﺨﻄﻂ‬
‫ﳍﺎ‪ ،‬ﻛﻞ ﻫﺬﺍ ﻳﺴﺘﺪﻋﻲ ﻭﺟﻮﺩ ﺧﻄﻂ ﻭﺍﺳﺘﺮﺍﺗﻴﺠﻴﺎﺕ ﻟﺘﺒﲏ ﻃﺮﻕ ﳐﺘﻠﻔﺔ ﺭﲟﺎ ﺗﻜﻮﻥ ﺃﻛﺜﺮ ﺣﺴﺎﺳﻴﺔ‬
‫ﻟﻠﻨﻮﻉ ﰲ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﻣﺸﺎﻛﻞ ﺍﻟﻨﺴﺎﺀ ﺍﻹﳒﺎﺑﻴﺔ‪.‬‬

‫ﺍﺳﺘﺨﺪﺍﻡ ﻭﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ‬

‫ﻛﻤﺎ ﻫﻮ ﻣﺘﻮﻗﻊ ﻓﻘﺪ ﻛﺎﻥ ﻣﻮﺿﻮﻉ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﻭﺳﺎﺋﻠﻪ ﻫﻮ ﺍﻷﻛﺜﺮ ﺣﻈﺎﹰ ﻣﻦ ﺍﻟﺒﺤﺚ ﺧﻼﻝ‬
‫ﺍﻟﻌﻘﺪﻳﻦ ﺍﳌﺎﺿﻴﲔ‪ .‬ﻭﺳﻮﻑ ﻧﻠﺨﺺ ﻓﻴﻤﺎ ﻳﻠﻲ ﺑﻌﺾ ﺍﳌﻌﻠﻮﻣﺎﺕ ﻭﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻷﺳﺎﺳﻴﺔ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﳊﺎﻟﺔ‬
‫ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﺗﺸﲑ ﺃﺣﺪﺙ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺇﱃ ﺃﻥ ﺣﻮﺍﱄ ‪ %٦٠-٥٠‬ﻣﻦ ﺍﻟﺴﻴﺪﺍﺕ ﺍﳌﺘﺰﻭﺟﺎﺕ ﻳﺴﺘﺨﺪﻣﻦ ﺍﻟﻮﺳﺎﺋﻞ ﺍﳊﺪﻳﺜﺔ‬
‫ﳌﻨﻊ ﺍﳊﻤﻞ‪ ،‬ﻭﺃﻥ ﻧﺴﺒﺔ ﺿﺌﻴﻠﺔ ﺗﺒﻠﻎ ﺣﻮﺍﱄ ‪ %٢‬ﻣﺎ ﺯﻟﻦ ﻳﺴﺘﺨﺪﻣﻦ ﺍﻟﻮﺳﺎﺋﻞ ﺍﻟﺘﻘﻠﻴﺪﻳﺔ‪ .‬ﻭﻗﺪ ﺗﻀﺎﻋﻒ‬
‫ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻮﺳﺎﺋﻞ ﺧﻼﻝ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻟﻌﺸﺮﻳﻦ ﺍﻷﺧﲑﺓ‪ .‬ﻭﻋﻠﻰ ﺍﻷﺧﺺ ﻓﻘﺪ ﺯﺍﺩ ﺍﻧﺘﺸﺎﺭ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻠﻮﻟﺐ‬
‫ﺑﺸﻜﻞ ﻣﻄﺮﺩ ﻣﻦ ‪ %٤‬ﺇﱃ ‪ %٣٠‬ﰲ ﺧﻼﻝ ﻫﺬﻩ ﺍﻟﻔﺘﺮﺓ ﲝﻴﺚ ﺃﺻﺒﺢ ﺍﺳﺘﺨﺪﺍﻣﻪ ﻳﺼﻞ ﺇﱃ ﺛﻼﺛﺔ ﺃﺿﻌﺎﻑ‬
‫ﺃﻗﺮﺍﺹ ﻣﻨﻊ ﺍﳊﻤﻞ ﺍﻟﱵ ﻗﻞ ﺍﺳﺘﺨﺪﺍﻣﻬﺎ ﺑﺸﻜﻞ ﻣﻠﺤﻮﻅ‪.‬‬
‫ﻭﻳﺒﻠﻎ ﺍﺳﺘﺨﺪﺍﻡ ﻭﺳﻴﻠﺔ ﻣﻨﻊ ﺍﳊﻤﻞ ﺑﺎﳊﻘﻦ ﺣﻮﺍﱄ ‪ %٢,٥‬ﺑﻴﻨﻤﺎ ﻳﺴﺘﺨﺪﻡ ﺍﻟﻮﺍﻗﻲ ﺍﻟﺬﻛﺮﻱ ﺑﻨﺴﺒﺔ ‪%١,٥‬‬
‫ﻓﻘﻂ‪.‬‬
‫ﻭﻗﺪ ﻛﺎﻥ ﻣﻌﺪﻝ ﺍﻟﺰﻳﺎﺩﺓ ﰲ ﺍﺳﺘﺨﺪﺍﻡ ﻭﺳﺎﺋﻞ ﻣﻨﻊ ﺍﳊﻤﻞ ﻣﺮﺗﻔﻌﺎﹰ ﺧﻼﻝ ﺍﻟﺜﻤﺎﻧﻴﻨﻴﺎﺕ‪ ،‬ﻭﻟﻜﻨﻪ ﻗﻞ ﰲ‬
‫ﺍﻟﺘﺴﻌﻴﻨﻴﺎﺕ ﺣﱴ ﻭﺻﻞ ﺇﱃ ﺩﺭﺟﺔ ﻣﻦ ﺍﻟﺜﺒﺎﺕ ﺗﻘﺮﻳﺒﺎﹰ)‪.(٣٥-٣١-١٦‬‬
‫ﻭﻳﺒﲔ ﺍﻟﺸﻜﻞ )‪ (١٧-١٠‬ﺍﻷﺳﺒﺎﺏ ﺍﻟﱵ ﺗﺆﺩﻱ ﺇﱃ ﺗﻮﻗﻒ ﺍﻟﺴﻴﺪﺍﺕ ﺍﳌﺘﺰﻭﺟﺎﺕ ﻋﻦ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻮﺳﺎﺋﻞ‬
‫ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﻭﻗﺪ ﺑﻴﻨﺖ ﺇﺣﺪﻯ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺃﺳﺒﺎﺏ ﻋﺪﻡ ﺭﺿﺎﺀ ﺍﻟﺴﻴﺪﺍﺕ ﺍﻟﱵ ﺗﺆﺩﻱ ﺇﱃ ﺗﻮﻗﻔﻬﻦ ﻋﻦ‬
‫ﺍﻻﺳﺘﺨﺪﺍﻡ ﻭﻛﺎﻥ ﺃﳘﻬﺎ ﺍﻟﱰﻑ ﻭﺍﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﺪﻭﺭﺓ ﺍﻟﺸﻬﺮﻳﺔ )‪ (%٤٧‬ﻭﺍﻟﺼﺪﺍﻉ ﻭﺍﻟﺰﻏﻠﻠﺔ )‪(%٣٣‬‬
‫ﻭﺍﻻﻟﺘﻬﺎﺑﺎﺕ ﻭﺍﻹﻓﺮﺍﺯﺍﺕ )‪ (%٦‬ﻭﺗﻐﲑ ﺍﻟﻮﺯﻥ )‪ (%٣‬ﻭﻓﻘﺪﺍﻥ ﺍﻻﺳﺘﻤﺘﺎﻉ ﺍﳉﻨﺴﻲ )‪ (%٣‬ﻭﺃﻋﺮﺍﺽ ﺍﳉﻬﺎﺯ ﺍﻟﺒﻮﱄ‬
‫)‪.(%٤‬‬
‫ﻭﻻ ﻳﻌﺮﻑ ﺣﺠﻢ ﺍﳌﻀﺎﻳﻘﺎﺕ ﺍﻟﱵ ﺗﺘﺤﻤﻠﻬﺎ ﺍﻟﺴﻴﺪﺍﺕ ﺍﻟﻼﰐ ﻳﺴﺘﻤﺮﻥ ﰲ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻮﺳﺎﺋﻞ‪ .‬ﻭﻟﻜﻦ‬
‫ﻣﻦ ﺍﳌﻌﺘﻘﺪ ﺃ‪‬ﺎ ﻣﻦ ﺑﲔ ﺍﻷﺳﺒﺎﺏ ﺍﻟﱵ ﺗﺆﺩﻱ ﺇﱃ ﺗﻜﺮﺍﺭ ﺍﻟﺸﻜﻮﻯ ﻣﻦ ﺍﻷﻋﺮﺍﺽ ﺍﳌﺨﺘﻠﻔﺔ ﺑﲔ ﺍﻟﺴﻴﺪﺍﺕ‬
‫ﻭﺍﻟﺘﺮﺩﺩ ﻋﻠﻰ ﻋﻴﺎﺩﺍﺕ ﺍﻷﻃﺒﺎﺀ‪.‬‬

‫‪٢٨٢‬‬
 ‫ﺷﻜﻞ )‪ :(١٦-١٠‬ﺗﻄﻮﺭ ﺍﺳﺘﺨﺪﺍﻡ ﻭﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﰲ ﻣﺼﺮ ‪١٩٩٥ - ١٩٨٠‬‬

‫‪60‬‬ ‫ﻛﻞ ﺍﻟﻮﺳﺎﺋﻞ‬

‫ﺣﺒﻮﺏ ﻣﻨﻊ ﺍﳊﻤﻞ‬

‫‪50‬‬ ‫ﺍﻟﻠﻮﻟﺐ‬ ‫‪48‬‬ ‫‪47‬‬ ‫‪48‬‬

‫‪40‬‬ ‫‪38‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪(%‬‬

‫‪30‬‬ ‫‪30‬‬
‫‪30‬‬ ‫‪28‬‬
‫‪24‬‬ ‫‪24‬‬

‫‪20‬‬ ‫‪17‬‬ ‫‪17‬‬ ‫‪16‬‬ ‫‪16‬‬

‫‪13‬‬
‫‪10‬‬
‫‪8‬‬ ‫‪15‬‬
‫‪10‬‬
‫‪4‬‬

‫‪0‬‬
‫‪1978‬‬ ‫‪1980‬‬ ‫‪1982‬‬ ‫‪1984‬‬ ‫‪1986‬‬ ‫‪1988‬‬ ‫‪1990‬‬ ‫‪1992‬‬ ‫‪1994‬‬ ‫‪1996‬‬

‫)‪EFS (1980), ECPS (1984), DHS (1988), EMCHS (1991), EDHS (1992), EDHS (1995‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻣﺘﺮﺟﻢ ﻋﻦ‪(National Population Council, Demographic and Health Survey 1995.) :‬‬

‫ﺷﻜﻞ )‪ :(١٧-١٠‬ﻣﻌﺪﻻﺕ ﺍﻟﺘﻮﻗﻒ ﻋﻦ ﺍﺳﺘﺨﺪﺍﻡ ﻭﺳﺎﺋﻞ ﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻭﻓﻘﺎﹰ ﻟﻠﺴﺒﺐ ﻭﺍﻟﻄﺮﻳﻘﺔ‬
‫ﺍﳌﺴﺘﺨﺪﻣﺔ‬

‫‪60‬‬

‫‪50‬‬

‫‪40‬‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ )‪(%‬‬

‫‪30‬‬

‫‪20‬‬

‫‪10‬‬

‫‪0‬‬
‫ﺣﺒﻮﺏ ﻣﻨﻊ ﺍﳊﻤﻞ‬ ‫ﺍﻟﻠﻮﻟﺐ‬ ‫ﺍﳊﻘﻦ‬
‫ﻓﺸﻞ ﺍﻟﻄﺮﻳﻘﺔ‬ ‫ﻣﻦ ﺃﺟﻞ ﺍﻹﳒﺎﺏ‬ ‫ﺃﻋﺮﺍﺽ ﺟﺎﻧﺒﻴﺔ‬ ‫ﺃﺧﺮﻯ‬

‫‪٢٨٣‬‬
 ‫ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ‬
‫ﻟﻘﺪ ﺣﺎﻭﻟﻨﺎ ﰲ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺩﺭﺍﺳﺎﺕ ﺃﻭ ﺑﻴﺎﻧﺎﺕ ﻋﻦ ﺍﳌﺮﺍﺿﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ ﻣﺜﻞ‬
‫ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ ﻭﺍﻟﺒﻮﻝ ﺍﻟﺴﻜﺮﻱ ﻭﺍﻷﻭﺭﺍﻡ ﻭﺍﻷﻣﺮﺍﺽ ﺍﻟﺮﻭﻣﺎﺗﻴﺰﻣﻴﺔ…‪.‬ﺍﱁ‪ .‬ﻭﻗﺪ ﺗﻮﺻﻠﻨﺎ ﺇﱃ ﻋﺪﺩ ﻣﻦ‬
‫ﳏﺪﻭﺩ ﻣﻦ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻋﻦ ﺑﻌﺾ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ ﻭﻛﺎﻧﺖ ﻣﻌﻈﻤﻬﺎ ﻣﻦ ﺭﺳﺎﺋﻞ ﺍﳌﺎﺟﺴﺘﲑ ﻭﺍﻟﺪﻛﺘﻮﺭﺍﻩ ﰲ‬
‫ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﻭﻟﻜﻦ ﻳﻼﺣﻆ ﻋﻠﻰ ﻣﻌﻈﻢ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺃﻥ ﻋﻴﻨﺎﺕ ﺍﻷﻓﺮﺍﺩ ﺍﳌﺒﺤﻮﺛﲔ‬
‫ﳏﺪﻭﺩﺓ ﻭﻻ ﲤﺜﻞ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺼﺮﻱ ﺃﻭ ﺣﱴ ﻗﻄﺎﻋﺎﹰ ﻣﻨﻪ ﻧﻈﺮﺍﹰ ﺇﱃ ﺃ‪‬ﺎ ﺗﺘﻢ ﰲ ﺇﻃﺎﺭ ﻣﺴﺘﺸﻔﻰ ﻣﻌﲔ‪.‬‬
‫ﻭﺛﺎﻧﻴﺎﹰ ﰲ ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻴﺎﻥ ﻻ ﻳﺆﺧﺬ ﻋﺎﻣﻞ ﺍﻟﻨﻮﻉ ﺑﺸﻜﻞ ﻭﺍﺿﺢ ﺿﻤﻦ ﲢﻠﻴﻞ ﺍﻟﻨﺘﺎﺋﺞ‪ ،‬ﻭﺃﺧﲑﺍﹰ ﻓﺈﻥ ﺃﻏﻠﺐ‬
‫ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺎﺕ ﻛﺎﻧﺖ ﺗﻌﲏ ﺑﻘﻀﺎﻳﺎ ﺑﻌﻴﺪﺓ ﺇﱃ ﺣﺪ ﻣﺎ ﻋﻦ ﳎﺎﻝ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﻭﻓﻬﻢ ﺍﳌﺸﻜﻠﺔ ﰲ‬
‫ﺇﻃﺎﺭ ﺍ‪‬ﺘﻤﻊ‪.‬‬
‫ﻭﻗﺪ ﻛﺎﻥ ﺍﳌﺮﺽ ﺍﻟﻮﺣﻴﺪ ﺍﻟﺬﻱ ﺟﺮﻯ ﲞﺼﻮﺻﻪ ﻣﺴﺢ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻘﻮﻣﻲ ﻫﻮ ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ‬
‫ﺍﻟﺪﻡ)‪ .(٣٢‬ﻭﺗﺒﲔ ﻧﺘﺎﺋﺞ ﻫﺬﺍ ﺍﻟﺒﺤﺚ ﺃﻥ ﺃﻛﺜﺮ ﻣﻦ ﺭﺑﻊ ﺍﻟﻨﺴﺎﺀ ﰲ ﻣﺼﺮ ﻣﺼﺎﺑﺎﺕ ﺑﺎﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ‬
‫)‪ (%٢٧‬ﻭﻳﺰﻳﺪ ﺍﻧﺘﺸﺎﺭ ﻫﺬﺍ ﺍﳌﺮﺽ ﺍﻃﺮﺍﺩﻳﺎﹰ ﻋﻨﺪ ﺍﻟﻨﺴﺎﺀ ﻣﻊ ﺍﻟﻌﻤﺮ ﻣﻦ ‪ %٤,٦‬ﻋﻨﺪ ﺍﻟﻨﺴﺎﺀ ﺑﲔ ‪ ٣٤-٢٥‬ﺳﻨﺔ‬
‫ﺇﱃ ‪ %٦٥‬ﻋﻨﺪ ﺍﻟﻨﺴﺎﺀ ﺍﻷﻛﱪ ﻣﻦ ‪ ٧٠‬ﺳﻨﺔ‪ ،‬ﻭﺗﺰﻳﺪ ﻧﺴﺒﺔ ﺍﳌﺮﺽ ﰲ ﺍﻟﻨﺴﺎﺀ ﻋﻦ ﺍﻟﺮﺟﺎﻝ ﺑﻌﺪ ﺳﻦ ‪ ٤٥‬ﺳﻨﺔ‬
‫ﺑﻨﺴﺒﺔ ﺗﺘﺮﺍﻭﺡ ﺑﲔ ‪ %٥‬ﻭ‪ %١٧‬ﰲ ﺍﳌﺮﺍﺣﻞ ﺍﻟﻌﻤﺮﻳﺔ ﺍﻟﺘﺎﻟﻴﺔ )ﺟﺪﻭﻝ ‪.(١٧-١٠‬‬
‫ﺟﺪﻭﻝ )‪ :(١٧-١٠‬ﺗﻘﺪﻳﺮﺍﺕ ﻣﻌﺪﻻﺕ ﺍﻻﻧﺘﺸﺎﺭ ﺍﻟﻘﻮﻣﻴﺔ ﻻﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ ﻭﺍﻟﻌﻼﺝ ﺍﳌﺴﺘﺨﺪﻡ ﻟﻪ ﻭﻓﻘﺎﹰ‬
‫ﻟﻠﻔﺌﺎﺕ ﺍﻟﻌﻤﺮﻳﺔ‬
‫ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻌﻼﺝ‬ ‫ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ‬
‫ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ‬
‫ﳎﻤﻮﻉ ‪%‬‬ ‫ﻧﺴﺎﺀ ‪%‬‬ ‫ﺭﺟﺎﻝ ‪%‬‬ ‫ﳎﻤﻮﻉ ‪%‬‬ ‫ﻧﺴﺎﺀ ‪%‬‬ ‫ﺭﺟﺎﻝ ‪%‬‬
‫‪٠,٨‬‬ ‫‪١,٠‬‬ ‫‪٠,٥‬‬ ‫‪٧,٨‬‬ ‫‪٤,٦‬‬ ‫‪١١,٠‬‬ ‫‪ ٣٤-٢٥‬ﺳﻨﺔ‬
‫‪٣,٦‬‬ ‫‪٤,٧‬‬ ‫‪٢,٥‬‬ ‫‪١٨,٦‬‬ ‫‪١٦,٩‬‬ ‫‪٢٠‬؟‪٤‬‬ ‫‪ ٤٤-٣٥‬ﺳﻨﺔ‬
‫‪١٠,٠‬‬ ‫‪١٣,٨‬‬ ‫‪٥,٨‬‬ ‫‪٣٧,٥‬‬ ‫‪٤٠,٨‬‬ ‫‪٣٤,٠‬‬ ‫‪ ٥٤-٤٥‬ﺳﻨﺔ‬
‫‪١٤,١‬‬ ‫‪١٧,٦‬‬ ‫‪١٠,٥‬‬ ‫‪٤٨,٢‬‬ ‫‪٥٥,٣‬‬ ‫‪٤٠,٩‬‬ ‫‪ ٦٤-٥٥‬ﺳﻨﺔ‬
‫‪١٥,٠‬‬ ‫‪١٧,٨‬‬ ‫‪١٢,٥‬‬ ‫‪٥٩,٤‬‬ ‫‪٦٤,٨‬‬ ‫‪٥٤,٤‬‬ ‫‪ ٧٤-٦٥‬ﺳﻨﺔ‬
‫‪١٣,٤‬‬ ‫‪٢٠,٣‬‬ ‫‪٦,٢‬‬ ‫‪٥٦,٦‬‬ ‫‪٦٥,٠‬‬ ‫‪٤٨,٠‬‬ ‫‪ +٧٥‬ﺳﻨﺔ‬
‫‪٦,٣‬‬ ‫‪٨,٢‬‬ ‫‪٤,٣‬‬ ‫‪٢٦,٣‬‬ ‫‪٢٦,٩‬‬ ‫‪٢٥,٧‬‬ ‫ﺍﻟﺘﻘﺪﻳﺮ ﺍﻟﻘﻮﻣﻲ‬
‫ﺍﳌﺼﺪﺭ‪Ibrahim M. et al. Hypertension Prevalence, Awareness, Treatment and Control in Egypt :‬‬
‫‪NHP)–(Results from the Egyptian National Hypertension Project‬‬

‫ﻭﻣﻊ ﺫﻟﻚ ﺗﺒﲔ ﺍﻟﺪﺭﺍﺳﺔ ﺃﻥ ﺣﻮﺍﱄ ‪ %٦‬ﻓﻘﻂ ﻣﻦ ﺍﻟﻨﺴﺎﺀ ﻳﺘﻨﺎﻭﻟﻦ ﻋﻼﺟﺎﹰ ﻟﻠﻀﻐﻂ‪ .‬ﻭﻛﺎﻧﺖ ﻫﺬﻩ ﺍﻟﻨﺴﺒﺔ‬
‫ﺃﻗﻞ ﻋﻨﺪ ﺍﻟﻨﺴﺎﺀ ﻣﻨﻬﺎ ﻋﻨﺪ ﺍﻟﺮﺟﺎﻝ ﰲ ﻛﻞ ﺍ‪‬ﻤﻮﻋﺎﺕ ﺍﻟﺴﻨﻴﺔ ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﻧﺴﺒﺔ ﺃﻛﱪ ﻣﻦ‬
‫ﺍﻟﻨﺴﺎﺀ ﻛﻦ ﻳﻌﻠﻤﻦ ﺃ‪‬ﻦ ﻣﺼﺎﺑﺎﺕ ﺑﺎﳌﺮﺽ )‪ (%٤٧‬ﻣﻘﺎﺑﻞ )‪ (%٢٨‬ﻣﻦ ﺍﻟﺮﺟﺎﻝ‪.‬‬
‫ﻭﻗﺪ ﺃﺧﺬﻧﺎ ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﻟﻠﻌﺮﺽ ﻫﻨﺎ ﻋﻠﻰ ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ ﻟﺒﻴﺎﻥ ﺃﳘﻴﺔ ﺑﻌﺾ ﺍﻷﻣﺮﺍﺽ ﻏﲑ ﺍﻹﳒﺎﺑﻴﺔ‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺮﺃﺓ‪ .‬ﻭﻋﻠﻰ ﺃﻳﺔ ﺣﺎﻝ ﻓﺈﻥ ﲢﻠﻴﻞ ﺑﻴﺎﻧﺎﺕ ﻭﻓﻴﺎﺕ ﺍﻟﻨﺴﺎﺀ ﺣﺴﺐ ﺍﳌﺮﺣﻠﺔ ﺍﻟﻌﻤﺮﻳﺔ ﺍﳌﻌﺮﻭﺽ‬
‫ﺳﺎﺑﻘﺎﹰ ﻳﺪﻝ ﻋﻠﻰ ﺍﻷﻭﺯﺍﻥ ﺍﻟﻨﺴﺒﻴﺔ ﻟﺒﻌﺾ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ ﻭﺃﻭﻟﻮﻳﺎ‪‬ﺎ‪ ،‬ﻭﺇﻥ ﻛﺎﻥ ﻻ ﻳﻐﲏ ﻋﻦ ﺩﺭﺍﺳﺔ‬
‫ﺍﳌﺮﺍﺿﺔ ﻟﺘﺤﺪﻳﺪ ﺍﻟﻌﺐﺀ ﺍﻟﻜﻠﻲ‪ .‬ﻭﻟﻌﻞ ﻫﺬﺍ ﺍﻷﻣﺮ ﻳﺘﻄﻠﺐ ﺩﺭﺍﺳﺔ ﺧﺎﺻﺔ‪.‬‬

‫‪٢٨٤‬‬
 ‫
 ‪4)5 6,$& "2 ! /
! 0‬‬
‫ﺇﻥ ﺍﻟﻨﺴﺒﺔ ﺍﻟﻌﻈﻤﻰ ﻟﻠﺴﻜﺎﻥ ﰲ ﻣﺼﺮ‪ .‬ﺗﻌﺘﱪ ﺻﻐﲑﺓ ﺍﻟﺴﻦ‪ ،‬ﻓﻴﻤﺜﻞ ﻋﺪﺩ ﺍﻟﺴﻜﺎﻥ ﰲ ﺳﻦ ﺍﻟـ ‪٦٠‬‬
‫ﻓﻴﻤﺎ ﻓﻮﻕ ﻓﻘﻂ ‪ %٦‬ﻣﻦ ﳎﻤﻮﻉ ﺍﻟﺴﻜﺎﻥ‪.‬‬
‫ﻭﺣﻴﺚ ﺇﻥ ﻧﺴﺒﺔ ﺍﻹﻧﺎﺙ ﻟﻠﺬﻛﻮﺭ ﻣﺘﺸﺎ‪‬ﺔ ﺇﻻ ﺃﻧﻪ ﻳﻮﺟﺪ ﻓﺮﻕ ﻛﺒﲑ ﰲ ﺍﳋﺼﺎﺋﺺ‪ ،‬ﻓﺈﻥ ‪ ٣/٢‬ﻣﻦ ﺍﻹﻧﺎﺙ‬
‫ﺃﺭﺍﻣﻞ ﰲ ﻣﻘﺎﺑﻞ ‪ %٨٧‬ﻣﻦ ﺍﻟﺬﻛﻮﺭ ﻣﺘﺰﻭﺟﻮﻥ‪ .‬ﻭ‪ %١٢‬ﻓﻘﻂ ﺃﺭﺍﻣﻞ‪ .‬ﻭﻛﺬﻟﻚ ﻓﺈﻥ ﺍﻟﻔﺮﻕ ﺍﻟﻨﻮﻋﻲ ﰲ ﺍﳊﺎﻟﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺑﻌﺪ ﻫﺎﻡ ﺁﺧﺮ‪ ،‬ﻓﻔﻲ ﺍﻟﻮﻗﺖ ﺍﻟﺬﻱ ﻳﻔﻮﻕ ﻓﻴﻪ ﻣﻌﺪﻝ ﻋﻤﺮ ﺍﻹﻧﺎﺙ ﻋﻤﺮ ﺍﻟﺬﻛﻮﺭ ﺇﻻ ﺃﻥ ﻣﺮﺍﺿﺔ‬
‫ﺍﻟﻨﺴﺎﺀ ﰲ ﻫﺬﻩ ﺍﻟﻌﻤﺮ ﺗﻔﻮﻕ ﻣﺮﺍﺿﺔ ﺍﻟﺬﻛﻮﺭ)‪.(٩‬‬
‫ﺟﺪﻭﻝ )‪ :(١٨-١٠‬ﻣﺴﺘﻮﻳﺎﺕ ﺍﻹﺣﺴﺎﺱ ﺍﻟﺸﺨﺼﻲ ﺑﺎﳌﺮﺍﺿﺔ ﻭﺍﳋﱪﺓ ﻣﻊ ﺍﳌﺮﺽ ﻛﺒﺎﺭ ﺍﻟﺴﻦ ﻣﻦ ﺍﳌﺼﺮﻳﲔ‬
‫ﻣﻘﺴﻤﺔ ﺗﺒﻌﺎﹰ ﻟﻠﺠﻨﺲ‬
‫ﺍ‪‬ﻤﻮﻉ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺍﳌﺮﺍﺿﺔ‬
‫ﺍﻟﺘﻘﻴﻴﻢ ﺍﻟﺸﺨﺼﻲ ﻟﻺﺣﺴﺎﺱ ﺑﺎﻟﺼﺤﺔ‬
‫ﳑﺘﺎﺯﺓ‬
‫ﺟﻴﺪﺓ‬
‫‪٤,٥‬‬ ‫‪٢,٦‬‬ ‫‪٦,٤‬‬ ‫ﻣﺘﻮﺳﻄﺔ‬
‫‪٣٣,٥‬‬ ‫‪٢٩,٢‬‬ ‫‪٣٧,٧‬‬ ‫ﺿﻌﻴﻔﺔ‬
‫‪٥٠,٤‬‬ ‫‪٥٧,٢‬‬ ‫‪٤٣,٩‬‬ ‫ﺍﳌﺴﺘﻮﻯ ﺍﻟﺼﺤﻲ ﻣﻘﺎﺭﻧﺎﹰ ﺑﺎﻵﺧﺮﻳﻦ ﰲ ﻧﻔﺲ ﺍﻟﻌﻤﺮ‬
‫‪١١,٦‬‬ ‫‪١١,١‬‬ ‫‪١٢,٠‬‬ ‫ﺃﻓﻀﻞ‬
‫‪١٦,٦‬‬ ‫‪١١,٣‬‬ ‫‪٢١,٨‬‬ ‫ﺗﻘﺮﻳﺒﺎﹰ ﻧﻔﺲ ﺍﳌﺴﺘﻮﻯ‬
‫‪٥٢,٨‬‬ ‫‪٥٥,٨‬‬ ‫‪٥٠,٠‬‬ ‫ﺃﺳﻮﺃ‬
‫‪١٣,٥‬‬ ‫‪١٥,٥‬‬ ‫‪١١,٦‬‬ ‫ﻻ ﺃﺳﺘﻄﻴﻊ ﺍﻟﺘﺤﺪﻳﺪ‬
‫‪١٧,٠‬‬ ‫‪١٧,٤‬‬ ‫‪١٦,٦‬‬ ‫ﺍﻟﺘﺠﺎﺭﺏ ﺍﳌﺮﺿﻴﺔ ﺍﻟﺴﺎﺑﻘﺔ‬
‫‪١٧,٢‬‬ ‫‪٢٢,٤‬‬ ‫‪١٢,٣‬‬ ‫ﺿﻐﻂ ﺍﻟﺪﻡ ﺍﳌﺮﺗﻔﻊ‬
‫‪١٠,٢‬‬ ‫‪١٣,٤‬‬ ‫‪٧,٠‬‬ ‫ﺃﺯﻣﺔ ﻗﻠﺒﻴﺔ‬
‫‪٦,٩‬‬ ‫‪٧,٥‬‬ ‫‪٦,٤‬‬ ‫ﺃﻳﺔ ﻣﺸﺎﻛﻞ ﺃﺧﺮﻯ ﰲ ﺍﻟﻘﻠﺐ‬
‫‪٢٤,٤‬‬ ‫‪٣٢,٥‬‬ ‫‪١٦,٦‬‬ ‫ﺭﻭﻣﺎﺗﻴﺰﻡ‬
‫‪٢,٨‬‬ ‫‪١,٩‬‬ ‫‪٣,٦‬‬ ‫ﺟﻠﻄﺔ ﺃﻭ ﺷﻠﻞ‬
‫‪٧,٥‬‬ ‫‪٨,٢‬‬ ‫‪٦,٨‬‬ ‫ﺳﻜﺮ‬
‫‪٠,٥‬‬ ‫‪٠,٥‬‬ ‫‪٠,٥‬‬ ‫ﺳﺮﻃﺎﻥ‬
‫‪٣,٩‬‬ ‫‪٢,٨‬‬ ‫‪٥,٠‬‬ ‫ﻛﺴﻮﺭ ﺃﻭ ﺷﺮﻭﺥ ﺑﺎﻟﻌﻈﺎﻡ‬
‫‪١٣,٩‬‬ ‫‪١١,٨‬‬ ‫‪١٥,٩‬‬ ‫ﻫﺒﻮﻁ‬
‫‪٠,٦‬‬ ‫‪٠,٢‬‬ ‫‪٠,٩‬‬ ‫ﺃﻣﺮﺍﺽ ﺭﺋﻮﻳﺔ ﻣﺜﻞ ﺍﻟﺮﺑﻮ‬
‫‪٠,٥‬‬ ‫‪٠,٢‬‬ ‫‪٠,٧‬‬ ‫ﺣﺮﻭﻕ‬
‫‪٦,٥‬‬ ‫‪٧,٨‬‬ ‫‪٥,٢‬‬ ‫ﺩﺭﻥ‬
‫‪٢,٨‬‬ ‫‪٣,٥‬‬ ‫‪٢,٠‬‬ ‫ﻣﺸﺎﻛﻞ ﰲ ﺍﻟﻘﺪﻣﲔ‬
‫‪٢,١‬‬ ‫‪٢,٤‬‬ ‫‪١,٨‬‬ ‫ﻗﺮﺣﺔ ﰲ ﺍﳌﻌﺪﺓ‬
‫‪٣,٢‬‬ ‫‪٢,٨‬‬ ‫‪٣,٦‬‬ ‫ﻣﺮﺽ ﻣﻌﺪٍ ﺃﻭ ﻃﻔﻴﻠﻲ‬
‫‪١٠,٢‬‬ ‫‪١٠,٨‬‬ ‫‪٩,٥‬‬ ‫ﺃﻣﺮﺍﺽ ﺃﺧﺮﻯ‬
‫‪٣٩,٣‬‬ ‫‪٣١,٣‬‬ ‫‪٤٧,٠‬‬ ‫ﻋﺪﺩ ﺍﻷﻣﺮﺍﺽ ﺍﻟﱵ ﺃﺻﺒﺖ ‪‬ﺎ ﺧﻼﻝ ﺍﻟـ ‪ ١٢‬ﺷﻬﺮ ﺍﳌﺎﺿﻴﺔ‬
‫‪٥٥,٩‬‬ ‫‪٦٣,٥‬‬ ‫‪٤٨,٤‬‬ ‫ﺻﻔﺮ‬
‫‪٤,٨‬‬ ‫‪٥,٢‬‬ ‫‪٤,٦‬‬ ‫‪٣–١‬‬
‫‪١,١٧‬‬ ‫‪١,٣٢‬‬ ‫‪١,٠٢‬‬ ‫‪+٤‬‬
‫‪١,٤٤‬‬ ‫‪١,٤٤‬‬ ‫‪١,٤٢‬‬ ‫ﻋﺪﺩ ﺍﻷﻣﺮﺍﺽ ﺍﻟﱵ ﺃﺻﺒﺖ ‪‬ﺎ ﺧﻼﻝ ﺍﻟـ ‪ ١٢‬ﺷﻬﺮ ﺍﳌﺎﺿﻴﺔ‬
‫ﺍﳌﺘﻮﺳﻂ‬
‫ﺍﻻﳓﺮﺍﻑ ﺍﳌﻌﻴﺎﺭﻱ‬
‫‪٨٦٥‬‬ ‫‪٤٢٥‬‬ ‫‪٤٤٠‬‬ ‫ﺍ‪‬ﻤﻮﻉ‬
‫ﺍﳌﺼﺪﺭ‪Khadr, 2002. Table1. :‬‬

‫‪٢٨٥‬‬
 ‫ﺟﺪﻭﻝ )‪ :(١٩-١٠‬ﻣﺴﺘﻮﻳﺎﺕ ﺍﻹﻋﺎﻗﺔ ﻭﻗﻴﻮﺩ ﺍﳊﺮﻛﺔ ﺑﲔ ﻛﺒﺎﺭ ﺍﻟﺴﻦ ﺍﳌﺼﺮﻳﲔ ﻭﻓﻘﺎﹰ ﻟﻠﺠﻨﺲ‬
‫ﺇﲨﺎﱄ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺍﳌﻘﺎﻳﻴﺲ‬
‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﳌﻦ ﻟﺪﻳﻬﻢ ﺻﻌﻮﺑﺔ ﰲ ﺃﻭ ﻋﺪﻡ ﻗﺪﺭﺓ ﻋﻠﻰ‪:‬‬
‫‪٥٢,٠‬‬ ‫‪٦٤,٠‬‬ ‫‪٤٠,٥‬‬ ‫ﺍﻟﺴﻔﺮ ﻭﺍﻟﺘﺠﻮﺍﻝ ﻭﺍﻟﺘﺴﻮﻕ‬
‫‪٥٥,٤‬‬ ‫‪٥٠,٤‬‬ ‫‪٦٠,٢‬‬ ‫ﺇﻋﺪﺍﺩ ﺍﻟﻄﻌﺎﻡ‬
‫‪٤٦,٠‬‬ ‫‪٥٦,٥‬‬ ‫‪٣٥,٩‬‬ ‫ﺩﻓﻊ ﻭﺟﺮ ﺍﻷﺷﻴﺎﺀ ﺍﻟﻜﺒﲑﺓ‬
‫‪٣٢,٨‬‬ ‫‪٣٨,٤‬‬ ‫‪٢٧,٥‬‬ ‫ﺍﳌﺸﻲ‬
‫‪٤٨,٤‬‬ ‫‪٥٧,٦‬‬ ‫‪٣٩,٥‬‬ ‫ﺍﻻﳓﻨﺎﺀ ﻭﺍﻟﺮﻛﻮﻉ‬
‫‪٤٧,٩‬‬ ‫‪٦٠,٠‬‬ ‫‪٣٦,١‬‬ ‫ﲪﻞ ﺃﺷﻴﺎﺀ ﻳﺘﺨﻄﻰ ﻭﺯ‪‬ﺎ ‪ ٥‬ﻛﺠﻢ‬
‫‪٤٣,٢‬‬ ‫‪٤٣,١‬‬ ‫‪٢٥,٧‬‬ ‫ﺛﲏ ﻭﻓﺮﺩ ﺍﻟﺬﺭﺍﻉ‬
‫‪٣٠,٣‬‬ ‫‪٣٩,١‬‬ ‫‪٢١,٨‬‬ ‫ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺃﻭ ﻣﺴﻚ ﺃﺷﻴﺎﺀ ﺻﻐﲑﺓ ﺑﺎﻷﺻﺎﺑﻊ‬
‫ﻋﺪﺩ ﺍﻷﻧﺸﻄﺔ ﺍﻟﱵ ﻳﺘﻢ ﻓﻌﻠﻬﺎ ﺑﺪﺭﺟﺔ ﻣﻦ ﺍﻟﺼﻌﻮﺑﺔ‬
‫‪٢٦,١‬‬ ‫‪٢٠,٥‬‬ ‫‪٣١,٦‬‬ ‫ﺻﻔﺮ‬
‫‪٢٩,٨‬‬ ‫‪٢٦,٦‬‬ ‫‪٣٣,٠‬‬ ‫‪٣-١‬‬
‫‪١٧,٦‬‬ ‫‪١٨,٨‬‬ ‫‪١٦,٣‬‬ ‫‪٦-٤‬‬
‫‪٢٦,٥‬‬ ‫‪٣٤,١‬‬ ‫‪١٩,١‬‬ ‫‪٨-٧‬‬
‫‪٣,٤٧‬‬ ‫‪٤,٠٨‬‬ ‫‪٢,٨٧‬‬ ‫ﻣﺘﻮﺳﻂ ﻋﺪﺩ ﺍﻷﻧﺸﻄﺔ‬
‫‪٣,٠٩‬‬ ‫‪٣,١٢‬‬ ‫‪٢,٩٥‬‬ ‫ﺍﻻﳓﺮﺍﻑ ﺍﳌﻌﻴﺎﺭﻱ‬
‫‪٣٩,٥‬‬ ‫‪٤٢,٨‬‬ ‫‪٣٦,٤‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﳌﻦ ﻟﺪﻳﻬﻢ ﻣﺸﻜﻼﺕ ﺑﺼﺮﻳﺔ‬
‫‪٢٤,٥‬‬ ‫‪٢٧,٨‬‬ ‫‪٢١,٤‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﳌﻦ ﳛﺘﺎﺟﻮﻥ ﺇﱃ ﻧﻈﺎﺭﺍﺕ ﻭﻻ ﻳﺘﺤﻤﻠﻮﻥ ﺷﺮﺍﺀﻫﺎ‬
‫‪١٣,٢‬‬ ‫‪١٤,١‬‬ ‫‪١٢,٣‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﳌﻦ ﻟﺪﻳﻬﻢ ﻣﺸﻜﻼﺕ ﲰﻌﻴﺔ‬
‫‪٤,٧‬‬ ‫‪٦,٦‬‬ ‫‪٨,٢‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﳌﻦ ﳛﺘﺎﺟﻮﻥ ﺇﱃ ﻣﻌﻴﻨﺎﺕ ﺍﻟﺴﻤﻊ ﻭﻻ ﻳﺘﺤﻤﻠﻮﻥ ﺷﺮﺍﺀﻫﺎ‬
‫ﺍﻟﺴﻠﻮﻛﻴﺎﺕ ﺫﺍﺕ ﺍﳋﻄﻮﺭﺓ‬
‫‪٢١,٣‬‬ ‫‪٠,٧‬‬ ‫‪٤١,١‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻤﺪﺧﻨﲔ ﺣﺎﻟﻴﺎﹰ‬
‫‪٨٦٥‬‬ ‫‪٤٢٥‬‬ ‫‪٤٤٠‬‬ ‫ﺍ‪‬ﻤﻮﻉ‬

‫ﺟﺪﻭﻝ )‪ :(٢٠-١٠‬ﺍﳋﺼﺎﺋﺺ ﺍﻟﺪﳝﺠﺮﺍﻓﻴﺔ ﻛﺒﺎﺭ ﺍﻟﺴﻦ ﰲ ﻣﺼﺮ ﻭﻓﻘﺎﹰ ﻟﻠﻨﻮﻉ – ﺗﻌﺪﺍﺩ ‪١٩٩٦‬‬
‫ﺇﲨﺎﱄ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺍﻟﺴﻤﺎﺕ‬
‫‪٥,٧‬‬ ‫‪٥,٧‬‬ ‫‪٥,٨‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻜﺒﺎﺭ ﺍﻟﺴﻦ‬
‫ﺍﻟﻌﻤﺮ )ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ(‬
‫‪٤١,٠‬‬ ‫‪٤٢,٢‬‬ ‫‪٣٩,٩‬‬ ‫‪٦٤-٦٠‬‬
‫‪٢٧,٣‬‬ ‫‪٢٥,٨‬‬ ‫‪٢٨,٧‬‬ ‫‪٦٩-٦٥‬‬
‫‪١٨,١‬‬ ‫‪١٨,٤‬‬ ‫‪١٧,٨‬‬ ‫‪٧٤-٧٠‬‬
‫‪١٣,٦‬‬ ‫‪١٣,٧‬‬ ‫‪١٣,٦‬‬ ‫‪+٧٥‬‬
‫‪٦٧,٧‬‬ ‫‪٦٧,٧‬‬ ‫‪٦٧,٨‬‬ ‫ﺍﳌﺘﻮﺳﻂ‬
‫‪٤٤,٩‬‬ ‫‪٤٢,٨‬‬ ‫‪٤٧,٠‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﰲ ﺍﳊﻀﺮ‬
‫ﺍﳊﺎﻟﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ )‪(%‬‬
‫‪٠,٩‬‬ ‫‪١,٠‬‬ ‫‪٠,٧‬‬ ‫ﱂ ﻳﺘﺰﻭﺝ ﻣﻄﻠﻘﺎﹰ )‪(%‬‬
‫‪٦٠,٨‬‬ ‫‪٣٢,٥‬‬ ‫‪٨٧,١‬‬ ‫ﻣﺘﺰﻭﺝ )‪(%‬‬
‫‪٣٧,٧‬‬ ‫‪٥٦,٥‬‬ ‫‪١١,٨‬‬ ‫ﺃﺭﻣﻞ )‪(%‬‬
‫‪٠,٦‬‬ ‫‪٠,٩‬‬ ‫‪٠,٤‬‬ ‫ﻣﻄﻠﻖ )‪(%‬‬
‫‪٧٤,٣‬‬ ‫‪٨٨,٦‬‬ ‫‪٦١,٠‬‬ ‫ﺍﻷﻣﻴﻮﻥ )‪(%‬‬
‫‪٢٠,٧‬‬ ‫‪١,٤‬‬ ‫‪٣٨,٠‬‬ ‫ﺍﻟﻌﺎﻣﻠﻮﻥ )‪(%‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ‬

‫‪٢٨٦‬‬
 ‫ﺟﺪﻭﻝ )‪ :(٢١-١٠‬ﺍﳌﺮﺍﺿﺔ ﺍﻹﳒﺎﺑﻴﺔ ﺍﳌﺸﺨﺼﺔ* ﰲ ﺩﺭﺍﺳﺔ ﳎﺘﻤﻌﻴﺔ ﺑﺎﻟﻔﻴﻮﻡ‬
‫ﺃﻣﺮﺍﺽ ﺍﻟﻨﺴﺎﺀ‬
‫‪ -١‬ﻋﺪﻭﻯ ﺍﻟﻘﻨﺎﺓ ﺍﻟﺘﻨﺎﺳﻠﻴﺔ ﺍﻟﺴﻔﻠﻰ‬
‫‪%٣٩,٥‬‬ ‫ﺍﻟﺘﻬﺎﺑﺎﺕ ﻣﻬﺒﻠﻴﺔ‬
‫‪%٧٥,٦‬‬ ‫ﺍﻟﺘﻬﺎﺑﺎﺕ ﻋﻨﻖ ﺍﻟﺮﺣﻢ ﺍﳌﺰﻣﻨﺔ‬
‫‪ -٢‬ﻋﺪﻭﻯ ﺍﻟﻘﻨﺎﺓ ﺍﻟﺘﻨﺎﺳﻠﻴﺔ ﺍﻟﻌﻠﻴﺎ‬
‫‪%٩,٣‬‬ ‫ﺍﻟﺘﻬﺎﺑﺎﺕ ﺍﳊﻮﺽ‬
‫‪%٥٣,٥‬‬ ‫‪ -٣‬ﺳﻘﻮﻁ ﺍﻷﻋﻀﺎﺀ ﺍﻟﺘﻨﺎﺳﻠﻴﺔ‬
‫‪%٢٣,٤‬‬ ‫‪ -٤‬ﺗﺂﻛﻞ ﻋﻨﻖ ﺍﻟﺮﺣﻢ‬
‫‪ -٥‬ﺗﻐﲑﺍﺕ ﰲ ﺍﳋﻼﻳﺎ ﺗﺪﻋﻮ ﻟﻠﺸﻚ‬
‫‪-٦‬‬
‫ﺃﻣﺮﺍﺽ ﺫﺍﺕ ﻋﻼﻗﺔ )ﻋﺪﺩ= ‪(١٢٦‬‬
‫‪%١٥,١‬‬ ‫‪ -١‬ﺗﻀﺨﻢ ﰲ ﺍﻟﻜﺒﺪ ﺃﻭ ﺍﻟﻄﺤﺎﻝ‬
‫‪%١١,٩‬‬ ‫‪ ٢‬ﲰﻨﺔ‬
‫‪%٢٨,٦‬‬ ‫‪ -٣‬ﺍﺭﺗﻔﺎﻉ ﺿﻐﻂ ﺍﻟﺪﻡ )ﺿﻐﻂ ﺍﻟﺪﻡ ﺍﻻﻧﺒﺴﺎﻃﻲ < ‪(٩٠‬‬
‫‪%٦,٤‬‬ ‫‪٩٩ -٩٠‬‬
‫‪%٢٢,٢‬‬ ‫‪+ ١٠٠‬‬
‫‪%٧٦,٧‬‬ ‫‪ -٤‬ﻋﺪﻭﻯ ﺍﻟﻘﻨﺎﺓ ﺍﻟﺒﻮﻟﻴﺔ‬
‫‪%٤٦,٢‬‬ ‫‪ -٥‬ﺃﻳﻨﻤﻴﺎ‬
‫‪%٢٥,٦‬‬ ‫‪ -٦‬ﺍﻟﺘﺮﻳﻜﻮﻣﻮﻧﺎﺱ‬
‫‪%١٦,٧‬‬ ‫‪ -٧‬ﻋﺪﻭﻯ ﺑﻠﻬﺎﺭﺳﻴﺎ ﺍ‪‬ﺎﺭﻯ ﺍﻟﺒﻮﻟﻴﺔ‬
‫)*( ﻳﺮﺗﻜﺰ ﺍﻟﺘﺸﺨﻴﺺ ﻋﻠﻰ ﻓﺤﺺ ﻋﺪﺩ ﻣﻦ ﺍﻟﻨﺴﺎﺀ ﻳﺘﺮﺍﻭﺡ ﺑﲔ ‪١٢٦ – ٨٦‬‬
‫ﺍﳌﺼﺪﺭ‪ :‬ﻃﻠﻌﺖ‪ .٢٠٠١ ،‬ﺟﺪﻭﻝ )‪ ٧‬ﻭ‪(٨‬‬

‫‪٢٨٧‬‬
 ‫‪)7$18! 9:‬‬
‫ﻻ ﺷﻚ ﺃﻥ ﻣﺆﺷﺮﺍﺕ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﻗﺪ ﲢﺴﻨﺖ ﰲ ﺍﻟﻌﻘﺪﻳﻦ ﺍﻷﺧﲑﻳﻦ‪ ،‬ﺇﻻ ﺃﻥ ﺍﻟﻮﻋﻲ ﺍﻟﺼﺤﻲ ﻣﺎ ﺯﺍﻝ ﰲ‬
‫ﺣﺎﺟﺔ ﺇﱃ ﺍﻻﺭﺗﻘﺎﺀ ﺳﻮﺍﺀ ﻟﻠﺤﻔﺎﻅ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺃﻭ ﲢﺴﻴﻨﻬﺎ‪ ،‬ﻭﳚﺐ ﺃﻥ ﻳﺸﺎﺭﻙ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺪﱐ‬
‫ﲟﺆﺳﺴﺎﺗﻪ ﻭﲨﻌﻴﺎﺗﻪ ﺍﻷﻫﻠﻴﺔ ﻭﺃﻓﺮﺍﺩﻩ ﻟﻠﻨﻬﻮﺽ ‪‬ﺬﺍ ﺍﻟﻮﻋﻲ ﳊﻴﺎﺓ ﺃﻓﻀﻞ‪.‬‬
‫‪ -١‬ﺇﻥ ﺍﻟﺸﺮﺍﻛﺔ ﺑﲔ ﺍ‪‬ﺘﻤﻊ ﺍﳌﺪﱐ ﻭﺍﳊﻜﻮﻣﺔ ﻭﺍ‪‬ﺘﻤﻊ ﺍﶈﻠﻲ ﺿﺮﻭﺭﺓ‪ ،‬ﻓﻼ ﻳﻜﻔﻲ ﺃﻥ ﻧﻄﻌﻢ ﺍﻷﻃﻔﺎﻝ‬
‫ﻭﺍﻷﻣﻬﺎﺕ‪ ،‬ﻓﺄﻛﺜﺮ ﺍﻷﻣﺮﺍﺽ ﻟﻴﺲ ﳍﺎ ﺗﻄﻌﻴﻢ ﻭﺃﺳﻠﻮﺏ ﺍﳌﻌﻴﺸﺔ ﻳﺆﺛﺮ ﻓﻴﻬﺎ‪ ،‬ﻭﺗﻐﲑ ﺍﻟﺴﻠﻮﻙ ﺇﱃ‬
‫ﺳﻠﻮﻙ ﺻﺤﻲ ﻳﺘﻄﻠﺐ ﺳﻨﻮﺍﺕ ﻋﺪﻳﺪﺓ‪ .‬ﺍﻻﺟﺘﻤﺎﻋﺎﺕ ﺍﻟﺪﻭﺭﻳﺔ ﺑﲔ ﺍ‪‬ﺘﻤﻊ ﺍﶈﻠﻲ ﻭﺍﳉﻬﺎﺕ ﺍﻟﺮﲰﻴﺔ‬
‫ﻭﺍ‪‬ﺘﻤﻊ ﺍﳌﺪﱐ ﺿﺮﻭﺭﺓ ﻻﺭﺗﻘﺎﺀ ﻣﺴﺘﻮﻯ ﺍﻟﺼﺤﺔ‪ .‬ﻓﻤﺎ ﺩﻭﺭ ﻛﻞ ﻣﻦ ﺍﻷﻃﺮﺍﻑ ﺍﻟﺜﻼﺛﺔ ﺣﱴ ﺗﺘﺤﻘﻖ‬
‫ﻃﺮﻳﻘﺔ ﻣﻌﻴﺸﺔ ﺻﺤﻴﺔ ﻟﻠﻤﺠﺘﻤﻊ ﺍﶈﻠﻲ؟‬

‫ﺍ‪‬ﺘﻤﻊ ﺍﳌﺪﱐ‬ ‫ﺍﳉﻬﺎﺕ ﺍﻟﺮﲰﻴﺔ‬

‫)ﺍﳉﻤﻌﻴﺔ ‪ -‬ﺟﻬﺎﺕ‬ ‫)ﻣﺜﻞ ﺍﻟﺼﺤﺔ ‪ -‬ﺍﳊﻜﻢ‬
‫ﻣﻬﺘﻤﺔ‪ ...‬ﺍﱁ(‬ ‫ﺍﶈﻠﻲ ‪ -‬ﺍﻟﺘﻌﻠﻴﻢ‪ ...‬ﺍﱁ(‬

‫ﺍ‪‬ﺘﻤﻊ ﺍﶈﻠﻲ‬

‫‪ -٢‬ﻟﻼﺭﺗﻘﺎﺀ ﲟﺴﺘﻮﻯ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﻓﺈﻥ ﺍﻟﺘﻌﺎﻭﻥ ﺑﲔ ﺍﳉﻬﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ – ﻣﺘﻀﻤﻨﺎﹰ ﺍﻹﻋﻼﻡ ‪-‬‬
‫ﻭﺍﳉﻤﻌﻴﺎﺕ ﺍﻷﻫﻠﻴﺔ ﺿﺮﻭﺭﺓ ﰲ ﺇﻃﺎﺭ ﺍﺗﻔﺎﻗﻴﺎﺕ ﺍﻟﻘﻀﺎﺀ ﻋﻠﻰ ﲨﻴﻊ ﺃﺷﻜﺎﻝ ﺍﻟﺘﻤﻴﻴﺰ ﺿﺪ ﺍﳌﺮﺃﺓ‪.‬‬
‫ﺍﻻﺭﺗﻘﺎﺀ ﺑﺼﺤﺔ ﺍﳌﺮﺃﺓ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺗﻮﻋﻴﺘﻬﺎ ﺑﺄﳘﻴﺔ ﺍﻟﻮﻗﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﳍﺎ ﻭﻷﺳﺮ‪‬ﺎ‬ ‫
‬
‫ﻭﺍﻻﻋﺘﻨﺎﺀ ﺑﻨﻈﺎﻓﺔ ﺍﻟﺒﻴﺌﺔ ﰲ ﺇﻃﺎﺭ ﻣﺘﻜﺎﻣﻞ ﲟﺸﺎﺭﻛﺔ ﺍ‪‬ﺘﻤﻊ‪.‬‬
‫ﻣﺸﺎﺭﻛﺔ ﺍﳌﺮﺃﺓ ﻣﻦ ﺍ‪‬ﺘﻤﻊ ﺍﶈﻠﻲ ﺳﻮﻑ ﻳﻮﺿﺢ ﺍﳌﻌﻮﻗﺎﺕ ﻭﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺼﺤﻴﺔ ﳍﺎ‪.‬‬ ‫
‬
‫‪ -٣‬ﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻟﺼﺤﻴﺔ ﰲ ﻧﻔﺲ ﺍﳌﻨﻄﻘﺔ ﺿﺮﻭﺭﻱ ﺣﱴ ﻳﺴﺘﻄﻴﻊ ﺍﳌﺮﻳﺾ ﺍﻻﺳﺘﻔﺎﺩﺓ‬
‫ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﳌﻘﺪﻣﺔ‪ ،‬ﻭﺣﱴ ﻻ ‪‬ﺪﺭ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺘﺎﺣﺔ‪.‬‬
‫‪ -٤‬ﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﻘﻄﺎﻋﺎﺕ ﺍﻷﺧﺮﻯ ﻣﺜﻞ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻟﺰﺭﺍﻋﺔ ﻭﺍﻟﺮﻱ ﻭﺍﻹﻋﻼﻡ‬
‫ﻭﻏﲑﻫﺎ ﺿﺮﻭﺭﻱ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳊﻲ‪ ،‬ﺣﱴ ﳝﻜﻦ ﺣﻞ ﻣﺸﺎﻛﻞ ﺍ‪‬ﺘﻤﻊ ﺍﶈﻠﻲ‪.‬‬
‫‪ -٥‬ﺍﻻﺭﺗﻘﺎﺀ ﲟﺴﺘﻮﻯ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﻭﺗﻮﻓﲑ ﺍﳌﻮﺍﺭﺩ ﺍﻟﻼﺯﻣﺔ‪.‬‬
‫‪ -٦‬ﺃﻣﺎ ﲞﺼﻮﺹ ﻓﺮﻳﻖ ﺍﻟﻌﻤﻞ ﺍﻟﺼﺤﻲ‪:‬‬
‫ﺍﻟﺘﺪﺭﻳﺐ ﺍﳌﺴﺘﻤﺮ ﻟﻸﻃﺒﺎﺀ ﻭﺍﳌﻤﺮﺿﺎﺕ ﻟﺘﺤﺴﲔ ﺃﺩﺍﺅﻫﻢ ﻟﻠﺨﺪﻣﺔ‪.‬‬ ‫
‬
‫ﻣﺘﺎﺑﻌﺔ ﻋﻤﻠﻬﻢ ﻭﺃﺩﺍﺋﻬﻢ‪.‬‬ ‫
‬

‫‪٢٨٨‬‬
‫‪ -٧‬ﺃﳘﻴﺔ ﺍﻟﺘﻮﻋﻴﺔ ﺍﻟﻐﺬﺍﺋﻴﺔ ﻭﻧﻈﺎﻓﺔ ﺍﻟﻐﺬﺍﺀ ﻭﺍﻟﺘﻮﻋﻴﺔ ﻋﻦ ﻃﺮﻕ ﺍﻧﺘﺸﺎﺭ ﺍﻟﻌﺪﻭﻯ ﻟﻠﻤﺮﺃﺓ ﻭﺑﺎﻷﺧﺺ‬
‫ﺍﳌﺮﺃﺓ ﺍﻷﻣﻴﺔ ﳋﻔﺾ ﻧﺴﺒﺔ ﺍﻧﺘﺸﺎﺭ ﺍﻷﻧﻴﻤﻴﺎ ﻭﺍﻟﻄﻔﻴﻠﻴﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻌﺪﻳﺔ ﺑﻴﻨﻬﻦ ﻭﺑﲔ ﺃﻃﻔﺎﳍﻦ‬
‫ﻭﺃﺳﺮﻫﻦ‪.‬‬
‫‪ -٨‬ﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﺍﳉﻤﻌﻴﺎﺕ ﰲ ﳎﺎﻻﺕ ﺍﻟﺘﻮﻋﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ ﻭﺗﺒﺎﺩﻝ ﺍﳋﱪﺍﺕ ﺑﻴﻨﻬﺎ‪.‬‬
‫‪ -٩‬ﺛﺒﺖ ﺃﻥ ﻟﻠﺸﺒﺎﺏ ﺩﻭﺭﺍﹰ ﻫﺎﻣﺎﹰ ﰲ ﺍﻟﺘﻄﻮﻉ ﻭﺑﺚ ﺍﻟﺮﺳﺎﺋﻞ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺒﻴﺌﻴﺔ)‪.(٣٣‬‬
‫‪ -١٠‬ﳏﺎﻭﻻﺕ ﺗﺪﺭﻳﺐ ﺍﻷﻃﺒﺎﺀ ﰲ ﳎﺎﻻﺕ ﺍﻟﺘﻮﻋﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻻﺗﺼﺎﻝ ﻭﺗﻨﻈﻴﻢ ﺍﻷﺳﺮﺓ ﻋﻠﻴﻬﺎ ﺃﻥ ﺗﺒﺪﺃ‬
‫ﺃﺛﻨﺎﺀ ﺩﺭﺍﺳﺔ ﺍﻟﻄﺐ ﻭﻟﻴﺴﺖ ﻓﻘﻂ ﺑﻌﺪﻫﺎ‪.‬‬
‫‪ -١١‬ﻋﻠﻰ ﺍﻟﺪﻭﻟﺔ ﻭﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﺃﻥ ﺗﻌﻄﻲ ﻣﺴﺌﻮﻟﻴﺔ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺮﻳﻔﻴﺔ ﺇﱃ‬
‫ﺍ‪‬ﺘﻤﻊ ﺍﶈﻠﻲ ﻭﻋﻠﻴﻬﺎ ﺍﻹﺷﺮﺍﻑ ﺍﻟﻔﲏ ﻭﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻷﻣﺮﺍﺽ‪.‬‬
‫‪ -١٢‬ﻋﻤﻞ ﺗﺄﻣﲔ ﺻﺤﻲ ﻟﺮﺑﺔ ﺍﳌﱰﻝ‪.‬‬
‫ﻣﻊ ﺍﻧﺘﺸﺎﺭ ﺍﻟﻌﻮﳌﺔ ﻣﻦ ﺍﳌﺘﻮﻗﻊ ﺃﻥ ﺗﻨﺸﺄ ﺑﺎﳌﺪﻥ ﻣﺴﺘﺸﻔﻴﺎﺕ ﻋﺎﳌﻴﺔ ﻋﻠﻰ ﺃﺭﻗﻰ ﻣﺴﺘﻮﻯ‪ ،‬ﺗﺘﻴﺢ ﺍﻟﻌﻤﻞ‬
‫ﻟﻸﻃﺒﺎﺀ ﻭﺍﳌﻤﺮﺿﺎﺕ ﺍﻷﺟﺎﻧﺐ‪ ،‬ﻳﺴﺘﻄﻴﻊ ﺍﺳﺘﺨﺪﺍﻣﻬﺎ ﺍﻷﺟﺎﻧﺐ ﻭﺍﻷﻏﻨﻴﺎﺀ‪ ،‬ﺃﻣﺎ ﺍﻟﻐﺎﻟﺒﻴﺔ ﺍﻟﻌﻈﻤﻰ ﻣﻦ‬
‫ﺍﻟﻨﺎﺱ‪ ،‬ﻓﻠﻦ ﺗﺴﺘﻄﻴﻊ ﺃﻥ ﺗﺴﺪﺩ ﺗﻜﻠﻔﺔ ﺍﳌﺮﺽ‪ ،‬ﺇﺫﺍ ﱂ ﻳﺸﺘﺮﻛﻮﺍ ﰲ ﺃﻱ ﻧﻮﻉ ﻣﻦ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ .‬ﺣﻴﺚ‬
‫ﺃﻧﻪ ﻣﻦ ﺍﳌﺘﻮﻗﻊ ﺍﻧﺘﺸﺎﺭ ﺧﺼﺨﺼﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬
‫ﻟﻦ ﺗﻜﻮﻥ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻣﺘﺎﺣﺔ ﻟﻸﻏﻠﺒﻴﺔ ﺍﻟﻌﻈﻤﻰ ﻣﻦ ﺍﻟﻨﺎﺱ‪ ،‬ﺧﺼﻮﺻﺎﹰ ﺑﻌﺪ ‪٢٠٠٥‬‬ ‫
‬
‫ﻣﻊ ﻧﻔﺎﺫ ﺍﺗﻔﺎﻗﻴﺔ ‪ ،TRIPS‬ﻓﺘﻜﻠﻔﺔ ﺍﻟﺪﻭﺍﺀ ﻟﻦ ﻳﻘﺪﺭ ﻋﻠﻴﻬﺎ ﺳﻮﺍﺩ ﺍﻟﺸﻌﺐ‪.‬‬
‫ﺳﻮﻑ ﳝﻮﺕ ﺍﳌﺮﺿﻰ ﺍﻟﻔﻘﺮﺍﺀ ﻷ‪‬ﻢ ﻻ ﳝﻠﻜﻮﻥ ﺗﻜﻠﻔﺔ ﺍﻟﻌﻼﺝ‪.‬‬ ‫
‬
‫ﺳﻮﻑ ﺗﻠﺠﺄ ﺍﳌﺮﺃﺓ ﻏﲑ ﺍﳌﻘﺘﺪﺭﺓ ﻣﺮﺓ ﺃﺧﺮﻯ ﺇﱃ ﺍﻟﻄﺐ ﺍﻟﺸﻌﱯ‪.‬‬ ‫
‬
‫ﻭﺗﺘﺪﻫﻮﺭ ﻣﺆﺷﺮﺍﺕ ﺍﻟﻌﻤﺮ ﺍﳌﺘﻮﻗﻊ ﻭﻭﻓﻴﺎﺕ ﺍﻟﺮﺿﻊ ﻭﺍﻷﻃﻔﺎﻝ ﻭﻭﻓﻴﺎﺕ ﺍﻷﻣﻬﺎﺕ‪.‬‬ ‫
‬
‫ﺑﻞ ﻫﺬﺍ ﺳﻴﻨﺎﰲ ﺍﳌﺎﺩﺓ ‪ ٢١‬ﻭ‪ ٢٥‬ﳊﻘﻮﻕ ﺍﻹﻧﺴﺎﻥ‪ ،‬ﻭﻛﺬﻟﻚ ﺍﳌﺎﺩﺓ ‪ ١٢‬ﻻﺗﻔﺎﻗﻴﺔ ﺍﻟﻘﻀﺎﺀ ﻋﻠﻰ‬ ‫
‬
‫ﻛﺎﻓﺔ ﺃﺷﻜﺎﻝ ﺍﻟﺘﻤﻴﻴﺰ ﺿﺪ ﺍﳌﺮﺃﺓ‪.‬‬

‫‪٢٨٩‬‬
 ;

1- Health Action (May – December 1998) P. 5.
2- Maternal Montality in Egypt (Ministry of Health) 2000.
3- Graham, Kobinsky M. A. Campbello. M. R. & Halow S.D. In. Koblinsky
M, Timyan J & Gay J. The Health of Women: A Global Prespective 1993.
West View Press.
.(‫ – ﺟﻨﻴﻒ‬٣٥ ‫ )ﺍﻟﻮﺛﺎﺋﻖ ﺍﻷﺳﺎﺳﻴﺔ – ﺍﻟﻄﺒﻌﺔ‬١٩٨٥ ‫ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ‬-٤
5- Van Der Kwaak et al 1991. Women and Health. Vena Journal 3(1): 233
quated in Koblinsky et al 1993.
6- Orr J. 1987. Women’s Health in the community. London: John Wiley.
7- Hansluwka, H. 1985. Measuring the Health of Populations: Indicators and
Interpretations. Social Science and Medicine 20, 12: 1207-1224.
8- Zuirayk. H. Women’s Reproductive Health in the Arab World. The
Population Council. West Asia and North Africa, Regional Paper No. 39
pp 14-22.
‫ )ﻳﻮﻧﻴﻮ‬١٩٩٧-١٩٩٢ ‫ ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ – ﺍﻟﻜﺘﺎﺏ ﺍﻹﺣﺼﺎﺋﻲ ﺍﻟﺴﻨﻮﻱ‬-٩
.(١٩٩٨
10- Haider R, 1996: Gender and Development: Women and Demographic
Dynamics. The American University in Cairo Press, pp: 76-78.
11- El-Zanati et al 1996. Egypt Demographic and Health Survey 1995.
12- El Zanaty, Fatma and Ann A. Way. 2001. Egypt Demographic and Health
survey 2000. Calverton, Maryland (USA); Ministry of Health and
population (Egypt), National Population Council.
13- Abdel-Hadi, Amal 1998.
– ‫ ﺍﳊﻴﺎﺓ ﺍﳉﻨﺴﻴﺔ ﻭﺍﻹﳒﺎﺑﻴﺔ ﻟﻠﻨﺴﺎﺀ ﻭﺍﻟﺸﺎﺑﺎﺕ )ﻧﻴﻮﻳﻮﺭﻙ‬:‫ ﳓﻮ ﻋﺎﱂ ﺟﺪﻳﺪ‬:‫ ﻣﻌﻬﺪ ﺁﻻﻥ ﺟﺸﻤﺎﺧﺮ‬-١٤
.(١٩٩٨ ‫ﻣﺎﻳﻮ‬
15- El Tawila, Saher, Barbra Ibrahim, Sunny Sallam, Omaima El Eibaly and
Firat El sahn. 2000. Transition to Adulthood – A national survey of Egypt.
Population council – regional office for west Asia and Africa, Social
Research center – the American University in Cairo.
16- Egypt Demographic and Health Survey 1995.
17- Royton E and Armtrong S. 1989, Preventing Maternal mortality. WHO,
Geneva.
18- National Maternal Mortality Study: Egypt, 1992-1993 Findings &
Conclusions. Ministry of Health - Child Survival Project In Cooperation
with USAID, 1994)

٢٩٠
19- Zurayk H, Khattab H, Younis N, El-Moulhy M and Fadie M. 1993.
Concepts and Measures of Reproductive Health. Health Transition
Review, Vol. 3. No. 17-40.
20- The Egyptian Fertility Care Society 1996. Community Based Survey of
Maternal Morbidity in Assuit, sohag and Qena Governorates – Final
Report, Cairo.
‫ – ﺍﺗﺼﺎﻝ ﺷﺨﺼﻲ‬١٩٩٨ ‫ ﺃﲪﺪ ﺭﺟﺎﺋﻲ ﺭﺟﺐ‬-٢١
22- Egyptian National Aids Program and Family Health International, 2001.
23- Younis, Nabil, Etal. Learning about Gynecological Health of Women. The
policy series in Reproductive Health no. 2. population council regional
office for west Asia and North Africa. Cairo, 1994.
24- Evaluation of selected reproductive health infections in various Egyptian
population groups in greater Cairo, 1998 – 2000 (executive summary)
released 2002.
25- Annual AIDS hotline report. Ministry of Health, National AIDS program,
2001.
26- HIV/AIDS prevention and control in Egypt. Report by Ministry of Health
and population, National AIDS control program, 2001
27- Abd El Tawab, Naltla, RH. M. magazine, volume number.
28- Greenhalgh, S. 1995. Marcio C. Inhorn. Guest for conception: gender,
infertility, and Egyptian medical tradition: in Book Reviews, population
and development review, 21 (2): 431.
29- El Sasani, S. M. 1998. Infertility, Pregnancy loss and their precipitating
Factors, Social Research Center, the American University in Cairo.
30- American Journal of Tropical Medicine, 2000.
31- Ragab A. R. A., Ankoman A., Ford N. J. and Powell R. A. 1996.
Understanding the Pattern of Contraceptive Use and Un-met Need among
Egyptian Married Women. In Powell RA, Mwegen EA and Ankomak A
(eds) Population Dynamics: Some Past and Energing Issue, Institute of
Population Studies – University of Exeter.
32- Ibrahim M. M., Rizk H, Appel LJ et al. 1995, Hypertension Prevalence
Awareness, Treatment and Control in Egypt. Results from the Egyptian
National Hypertension Project (NHP). Hypertension vol 26, No 6, pp 886-
890.
‫ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ‬،‫ ﻃﻠﺒﺔ ﺍﻟﻄﺐ ﻛﺪﻋﺎﺓ ﻟﻠﺼﺤﺔ ﻭﺍﻟﺒﻴﺌﺔ‬:(١٩٩٧) ‫ ﺳﻠﻤﻰ ﺟﻼﻝ‬-٣٣
.‫ﺑﺎﳌﺘﻮﺳﻂ‬

٢٩١
 ‫ﻣﺮﺍﺟﻊ ﻭﻣﺼﺎﺩﺭ ﺃﺧﺮﻯ‬
‫ ﺻﺤﺔ ﺍﻷﻡ ﻭﺍﻟﻄﻔﻞ – ﺩﺍﺭ ﻗﺒﺎﺀ‬:(١٩٩٨) ‫ ﺳﻠﻤﻰ ﺟﻼﻝ‬-٣٤
.١٩٩٣ ،‫ ﺍﻟﺘﻘﺮﻳﺮ ﺍﻹﺣﺼﺎﺋﻲ ﺍﻟﺴﻨﻮﻱ ﻟﻮﺍﻗﻊ ﺍﻟﻄﻔﻞ ﺍﻟﻌﺮﰊ‬:‫ﻠﺲ ﺍﻟﻌﺮﰊ ﻟﻠﻄﻔﻮﻟﺔ ﻭﺍﻟﺘﻨﻤﻴﺔ‬‫ ﺍ‬-٣٥
.‫ ﺻﺤﺔ ﺍﳌﺮﺃﺓ ﺍﳌﺼﺮﻳﺔ ﻣﻦ ﻧﲑﻭﰊ ﺇﱃ ﺑﻜﲔ‬:(١٩٩٤) ‫ ﺳﻠﻤﻰ ﺟﻼﻝ‬-٣٦
.١٩٩٨ ،‫ ﻣﻌﻬﺪ ﺍﻟﺘﺨﻄﻴﻂ ﺍﻟﻘﻮﻣﻲ‬،‫ ﻣﺼﺮ – ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ‬-٣٧
.١٩٩٩ ،‫ ﻣﻌﻬﺪ ﺍﻟﺘﺨﻄﻴﻂ ﺍﻟﻘﻮﻣﻲ‬،‫ ﻣﺼﺮ – ﺗﻘﺮﻳﺮ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺒﺸﺮﻳﺔ‬-٣٨
‫ ﺍﳌﻌﺎﻧﺎﺓ ﺍﻟﺼﺎﻣﺘﺔ – ﺟﻮﺍﻧﺐ ﻣﻦ ﺍﻟﻈﺮﻭﻑ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺍﶈﻴﻄﺔ ﺑﺼﺤﺔ‬:‫ ﻫﻨﺪ ﺃﺑﻮ ﺍﻟﺴﻌﻮﺩ ﺧﻄﺎﺏ‬-٣٩
.١٩٩٢ ،‫ﺍﳌﺮﺃﺓ ﺍﻹﳒﺎﺑﻴﺔ ﰲ ﺭﻳﻒ ﻣﺼﺮ – ﺍﻟﻴﻮﻧﻴﺴﻴﻒ‬
.١٩٩٦ ،‫ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ – ﻭﺣﺪﺓ ﺍﻹﺣﺼﺎﺋﻴﺎﺕ‬-٤٠
41- Alma Ata Declaration, WHO/ UNICEF (1978)
42- CEDAW
43- Declaration of Human Rights
44- EDHS 1998
45- EDHS 2000
46- El Gueneidy,M.,E.Abd El Kader & N.Mahgoub, Prevalence of female
circumcision among preparatory school girls in Alexandria, The First
Intern. Scientific Nursing Congress, High Institute of Nursing, May, 1990
47- El-Guindy,A., paper prepared for the World Summit on Environment,
(1992)
48- Galal, S. The role of pharmacies in the promotion of community health
services, The Egyptian Journal of Community Medicine, Vol 4, No3, 189-
200 (1988)
49- Galal,S., G.Ayoub, S.El-Mallah, A case control study on toxoplasmosis,
The Egyptian Journal of Community Medicine, Dec (1992)
50- MOH,Egyptian Experience in Primary Health Care, (1977)
51- MOH/DANIDA/Carl Bro/ Galal/DTRC, (1991)
52- UNDP, Human Development Report, 1998
53- UNDP, Human Development Report, 1994
54- UNDP & Arab Fund for Economic and Social Development, Arab Human
Development Report 2002, Jordan
55- El Kassas, M 1994. National Maternal mortality study: Egypt, 1992 – 1993.
Findings and conclusions, Cairo: Ministry of Health.
56- The situation of Egyptian children and women, UNICEF 2000, P. 55.

٢٩٢
 ‫ 
 
‪:‬‬
‫  ‬
‫‪
   . .‬‬

‫ ‬
‫ﳝﺜﻞ ﺍﻹﻧﺴﺎﻥ ﺍﻟﻌﺎﻣﻞ ﺍﻟﻠﺒﻨﺔ ﺍﻷﻭﱃ ﰲ ﻃﺮﻳﻖ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ .‬ﻭﻣﻊ ﻧﺸﺄﺓ ﺍﻟﺼﻨﺎﻋﺔ‬
‫ﻭﺗﻄﻮﺭﻫﺎ ﰲ ﺍﻟﺪﻭﻝ ﺍﻟﺼﻨﺎﻋﻴﺔ ﺑﺪﺍ ﻭﺍﺿﺤﺎ ﺃﻧﻪ – ﻭﺇﻥ ﻛﺎﻥ ﺍﻟﻌﻤﻞ ﺑﺎﻟﻨﺴﺒﺔ ﺇﱃ ﺍﻹﻧﺴﺎﻥ ﺇﺣﺪﻯ ﺿﺮﻭﺭﺍﺕ‬
‫ﺍﳊﻴﺎﺓ – ﺇﻻ ﺃﻥ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ﰲ ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻴﺎﻥ ﲢﺘﻮﻯ ﻋﻠﻰ ﻋﻮﺍﻣﻞ ﻣﺘﺒﺎﻳﻨﺔ ﺗﺸﻜﻞ ﺧﻄﻮﺭﺓ ﻋﻠﻰ‬
‫ﺻﺤﺔ ﺍﻟﻌﺎﻣﻠﲔ ﻭﺭﻓﺎﻫﻴﺘﻬﻢ‪.‬‬
‫ﻭﻗﺪ ﻻﺣﻆ ﺃﺑﻮﻗﺮﺍﻁ ﻣﻨﺬ ﺯﻣﻦ ﺑﻌﻴﺪ ﺃﻧﻪ – ﻟﻜﻲ ﻳﺼﻞ ﺍﻟﻄﺒﻴﺐ ﺇﱃ ﺍﻟﺘﺸﺨﻴﺺ ﺍﻟﺼﺤﻴﺢ ﰲ ﻛﺜﲑ ﻣﻦ‬
‫ﺍﻷﺣﻴﺎﻥ – ﳚﺐ ﻋﻠﻴﻪ ﺃﻥ ﻳﺘﻌﺮﻑ ﻋﻠﻰ ﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺨﺘﻠﻔﺔ ﺍﻟﱵ ﲢﻴﻂ ﺑﺎﳌﺮﻳﺾ ﰲ ﻣﻜﺎﻥ ﻋﻤﻠﻪ)‪.(١‬‬
‫ﻭﰱ ﺍﻟﻘﺮﻥ ﺍﻟﺜﺎﻣﻦ ﻋﺸﺮ ﺃﻟﻒ ﺍﻟﻌﺎﱂ ﺍﻹﻳﻄﺎﱄ ﺍﻟﺸﻬﲑ ﺏ‪ .‬ﺭﺍﻣﺎﺯﻳﲎ ‪ Bernardino Ramazzini‬ﻛﺘﺎﺑﻪ‬
‫ﺍﻟﺸﻬﲑ ﻋﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﰲ ﺍﳌﻬﻦ ﺍﳌﺨﺘﻠﻔﺔ)‪.(٢‬‬
‫ﻭﻗﺪ ﻧﺸﺄ ﻋﻠﻢ ﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻣﻮﺍﻛﺒﺎ ﻟﺘﻄﻮﺭ ﺍﻟﺼﻨﺎﻋﺔ‪ ،‬ﻭﻛﺎﻥ ﺍﳍﺪﻑ ﺍﻟﺮﺋﻴﺴﻲ ﻫﻮ ﺗﻮﻓﲑ ﺑﻴﺌﺔ‬
‫ﺍﻟﻌﻤﻞ ﺍﻵﻣﻨﺔ ‪ Safe work environment‬ﻭﻭﻗﺎﻳﺔ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ ﳐﺎﻃﺮ ﺍﳌﻬﻨﺔ‪.‬‬
‫ﻭﻗﺪ ﻋﺮﻓﺖ ﺍﻟﻠﺠﻨﺔ ﺍﳌﺸﺘﺮﻛﺔ ﻣﻦ ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﳌﻴﺔ ﻭﻣﻨﻈﻤﺔ ﺍﻟﻌﻤﻞ ﺍﻟﺪﻭﻟﻴﺔ ﰲ ﺍﺟﺘﻤﺎﻋﻬﺎ‬
‫ﺳﻨﺔ ‪ (٣)١٩٥٠‬ﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﺄ‪‬ﺎ ﺍﻷﻧﺸﻄﺔ ﺍﻟﱵ ‪‬ﺪﻑ ﺇﱃ ﲢﺴﲔ ﻭﺍﻻﺣﺘﻔﺎﻅ ﺑﺄﻋﻠﻰ ﺩﺭﺟﺎﺕ‬
‫ﺍﻟﺮﻓﺎﻫﻴﺔ ﺍﻟﺒﺪﻧﻴﺔ ﻭﺍﻟﻨﻔﺴﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻟﻠﻌﺎﻣﻠﲔ ﰲ ﲨﻴﻊ ﺍﳌﻬﻦ ‪Promotion and‬‬
‫‪maintenance of the highest degree of physical, mental and social well being of‬‬
‫‪ workers in all occupations‬ﻭﺫﻟﻚ ﻋﻦ ﻃﺮﻳﻖ ﲪﺎﻳﺘﻬﻢ ﻣﻦ ﺃﺧﻄﺎﺭ ﺍﳌﻬﻨﺔ ﻭﻣﻦ ﻛﺎﻓﺔ ﺍﳌﺆﺛﺮﺍﺕ‬
‫ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﰲ ﻣﻜﺎﻥ ﺍﻟﻌﻤﻞ ﻭﻭﺿﻊ ﺍﻟﻌﺎﻣﻞ ﰲ ﻣﻜﺎﻥ ﺍﻟﻌﻤﻞ ﺍﻟﺬﻱ ﻳﺘﻨﺎﺳﺐ ﻣﻊ ﻗﺪﺭﺍﺗﻪ ﺍﻟﺒﺪﻧﻴﺔ‬
‫ﻭﺍﻟﺬﻫﻨﻴﺔ ﻭﺍﻟﻨﻔﺴﻴﺔ‪ .‬ﻭﺟﺪﻳﺮ ﺑﺎﻟﺬﻛﺮ ﺃﻥ ﻫﺬﻩ ﺍﳌﻬﻦ ﻻ ﺗﺸﻤﻞ ﺍﳌﻬﻦ ﺍﻟﺼﻨﺎﻋﻴﺔ ﻓﺤﺴﺐ ﺑﻞ ﺗﺸﻤﻞ‬
‫ﺃﻳﻀﺎ ﺍﻟﺰﺭﺍﻋﺔ ﻭﺍﻟﺘﺠﺎﺭﺓ ﻭﺍﻷﻋﻤﺎﻝ ﺍﻟﻜﺘﺎﺑﻴﺔ ﻭﺍﻹﺩﺍﺭﺓ ﻭﻏﲑ ﺫﻟﻚ‪.‬‬
‫ﻭﺗﺸﲑ ﺇﺣﺼﺎﺋﻴﺎﺕ ﻣﻨﻈﻤﺔ ﺍﻟﻌﻤﻞ ﺍﻟﺪﻭﻟﻴﺔ ﺇﱃ ﺃﻥ ﺍﳋﺴﺎﺋﺮ ﺑﺴﺒﺐ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﰲ ﺇﳒﻠﺘﺮﺍ ﺧﻼﻝ‬
‫ﺳﻨﻮﺍﺕ ﺍﳊﺮﺏ ﺍﻟﻌﺎﳌﻴﺔ ﺍﻟﺜﺎﻧﻴﺔ ﺑﻠﻐﺖ ﺛﻼﺛﺔ ﺃﺿﻌﺎﻑ ﺧﺴﺎﺋﺮ ﺍﳊﺮﺏ‪ ،‬ﻭﺃﻥ ﻫﺬﻩ ﺍﳋﺴﺎﺋﺮ ﰲ ﺍﻟﻮﻻﻳﺎﺕ‬
‫ﺍﳌﺘﺤﺪﺓ ﺑﻠﻐﺖ ﺃﻛﺜﺮ ﻣﻦ ﺳﺒﻌﺔ ﺃﺿﻌﺎﻑ ﺧﺴﺎﺋﺮ ﺍﳊﺮﺏ‪ .‬ﻭﰲ ﺳﻨﺔ ‪ ١٩٤٤‬ﻛﺎﻧﺖ ﻫﻨﺎﻙ ﰲ ﺍﻟﻮﻻﻳﺎﺕ‬
‫ﺍﳌﺘﺤﺪﺓ ﺃﻛﺜﺮ ﻣﻦ ﺳﺘﺔ ﻣﻼﻳﲔ ﺇﺻﺎﺑﺔ ﻋﻤﻞ ﻭﺃﻛﺜﺮ ﻣﻦ ﻧﺼﻒ ﻣﻠﻴﻮﻥ ﺣﺎﻟﺔ ﻣﺮﺽ ﻣﻬﲏ‪ .‬ﻭﰱ ﻧﻔﺲ‬
‫ﺍﻟﻌﺎﻡ ﺃﻧﻔﻘﺖ ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ ‪ ١٢١‬ﺑﻠﻴﻮﻥ ﺩﻭﻻﺭ ﺑﺴﺒﺐ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻣﺎ ﺑﲔ ﺗﻜﻠﻔﺔ ﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ‬
‫ﻭﺧﺴﺎﺋﺮ ﺍﻹﻧﺘﺎﺝ ﻭﺗﻜﺎﻟﻴﻒ ﺍﻟﻌﻼﺝ ﻭﺍﳌﺼﺮﻭﻓﺎﺕ ﺍﻹﺩﺍﺭﻳﺔ)‪ .(٤‬ﻭﺟﺪﻳﺮ ﺑﺎﻟﺬﻛﺮ ﺃﻧﻪ ﰲ ﺍﻟﺪﻭﻝ ﺍﻟﻨﺎﻣﻴﺔ ﻳﻜﻮﻥ‬
‫ﺣﺠﻢ ﻣﺸﻜﻠﺔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﺃﻛﱪ ﺑﻜﺜﲑ ﻣﻨﻪ ﰲ ﺍﻟﺪﻭﻝ ﺍﳌﺘﻘﺪﻣﺔ ﻭﺃﻛﺜﺮ ﺗﻜﻠﻔﺔ‪.‬‬

‫‪٢٩٣‬‬
‫ﻭﳍﺬﺍ ﺍﻫﺘﻤﺖ ﺍﻟﺪﻭﻝ ﺍﻟﺼﻨﺎﻋﻴﺔ ﺍﻟﻜﱪﻯ ﲝﻤﺎﻳﺔ ﺍﻟﻌﺎﻣﻞ ﻭﺗﺄﻣﲔ ﺳﻼﻣﺘﻪ ﻭﻇﻬﺮ ﺷﻌﺎﺭ "ﺍﻟﺴﻼﻣﺔ ﺃﻭﻻﹰ"‬
‫‪ Safety first‬ﻭﻟﻴﺲ ﺍﻹﻧﺘﺎﺝ ﺃﻭﻻﹰ‪.‬‬
‫ﻭﻗﺪ ﻇﻬﺮ ﺃﻭﻝ ﻗﺎﻧﻮﻥ ﳊﻤﺎﻳﺔ ﺍﻟﻌﺎﻣﻠﲔ ﺳﻨﺔ ‪ ١٨٠٢‬ﰲ ﺇﳒﻠﺘﺮﺍ ﻭﰱ ﺳﻨﺔ ‪ ١٨٣٠‬ﺃﻧﺸﺌﺖ ﺃﻭﻝ ﻫﻴﺌﺔ‬
‫ﻟﻠﺘﻔﺘﻴﺶ ﻋﻠﻰ ﺍﳌﺼﺎﻧﻊ ﰒ ﻇﻬﺮﺕ ﺗﺸﺮﻳﻌﺎﺕ ﻟﻠﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﺳﻨﺔ ‪ ١٨٤٠‬ﰲ ﺳﻮﻳﺴﺮﺍ‬
‫ﻭﺍﻟﺪﺍﳕﺎﺭﻙ‪ ،‬ﻭﰲ ‪ ١٨٧٧‬ﰲ ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ ﻭﺗﻼﻫﺎ ﺳﻦ ﻗﻮﺍﻧﲔ ﻣﺸﺎ‪‬ﺔ ﰲ ﻛﺜﲑ ﻣﻦ ﺍﻟﺪﻭﻝ ﺍﻷﺧﺮﻯ‪.‬‬
‫ﺃﻣﺎ ﰲ ﻣﺼﺮ)‪ (٥‬ﻓﻘﺪ ﺻﺪﺭ ﻷﻭﻝ ﻣﺮﺓ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٦٤‬ﻟﺴﻨﺔ ‪ ١٩٣٦‬ﻟﻠﺘﺄﻣﲔ ﺿﺪ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﻛﺎﻥ‬
‫ﻋﻠﻰ ﺍﻟﻌﺎﻣﻞ ﺃﻥ ﻳﺜﺒﺖ ﺧﻄﺄ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ ﺣﱴ ﻳﻜﻮﻥ ﻟﻪ ﺣﻖ ﺍﻟﺘﻌﻮﻳﺾ ﻋﻦ ﺍﻹﺻﺎﺑﺔ‪ ،‬ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﻛﺎﻥ‬
‫ﻣﻦ ﺍﻟﺼﻌﻮﺑﺔ ﲟﻜﺎﻥ‪ .‬ﻭﰲ ﺳﻨﺔ ‪ ١٩٤٢‬ﺻﺪﺭ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٨٦‬ﺑﺸﺄﻥ ﺍﻟﺘﺄﻣﲔ ﺍﻹﺟﺒﺎﺭﻱ ﺿﺪ ﺇﺻﺎﺑﺎﺕ‬
‫ﺍﻟﻌﻤﻞ ﻟﻀﻤﺎﻥ ﺣﻘﻮﻕ ﺍﻟﻌﺎﻣﻠﲔ ﻭﺗﻮﻟﺖ ﺷﺮﻛﺎﺕ ﺍﻟﺘﺄﻣﲔ ﻫﺬﻩ ﺍﳌﻬﻤﺔ ﺣﱴ ﺳﻨﺔ ‪ ١٩٥٢‬ﺣﻴﺚ ﺃﻧﺸﺌﺖ‬
‫ﻣﺆﺳﺴﺔ ﺍﻟﺘﺄﻣﲔ ﻭﺍﻻﺩﺧﺎﺭ ﺍﻟﱵ ﲢﻮﻟﺖ ﺑﻌﺪ ﺫﻟﻚ ﺇﱃ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ .‬ﻭﺗﻄﻮﺭ‬
‫ﺗﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻣﻦ ﺧﻼﻝ ﺗﻌﺪﻳﻼﺕ ﻋﺪﻳﺪﺓ ﻓﺄﺿﻴﻔﺖ ﺃﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ ﺇﱃ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﺳﻨﺔ‬
‫‪) ١٩٥٠‬ﻗﺎﻧﻮﻥ ﺭﻗﻢ ‪ (١١٧‬ﻭﺍﻧﺘﻬﺖ ﺍﻟﺘﻌﺪﻳﻼﺕ ﺍﳌﺨﺘﻠﻔﺔ ﺇﱃ ﺍﻟﻘﺎﻧﻮﻥ ﺍﳊﺎﱄ ﺭﻗﻢ ‪ ٧٩‬ﻟﺴﻨﺔ ‪١٩٧٥‬‬
‫ﻭﺗﻌﺪﻳﻼﺗﻪ ﺍﻟﺬﻱ ﺍﻋﺘﱪ ﺃﻥ ﺇﺻﺎﺑﺔ ﺍﻟﻌﻤﻞ ﻫﻲ ﻛﻞ ﺇﺻﺎﺑﺔ ﺗﻘﻊ ﺃﺛﻨﺎﺀ ﺍﻟﻌﻤﻞ ﺃﻭ ﺑﺴﺒﺒﻪ ﲟﺎ ﰲ ﺫﻟﻚ ﺇﺻﺎﺑﺎﺕ‬
‫ﺍﻟﻄﺮﻳﻖ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﺎﲨﺔ ﻋﻦ ﺍﻹﺟﻬﺎﺩ ﻭﺍﻹﺭﻫﺎﻕ‪.‬‬
‫ﻭﰱ ﺳﻨﺔ ‪ ١٩٥٩‬ﺻﺪﺭ ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﺭﻗﻢ ‪ ٩١‬ﻭﺍﻟﺬﻱ ﺍﺧﺘﺺ ﺍﻟﺒﺎﺏ ﺍﳋﺎﻣﺲ ﻣﻨﻪ ﺑﺮﻋﺎﻳﺔ ﺻﺤﺔ ﺍﻟﻌﺎﻣﻠﲔ‬
‫ﻭﺗﻨﻈﻴﻢ ﺇﺟﺮﺍﺀﺍﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ‪ .‬ﻭﻗﺪ ﰎ ﺗﻌﺪﻳﻠﻪ ﻓﻴﻤﺎ ﺑﻌﺪ ﺑﺎﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ١٣٧‬ﻟﺴﻨﺔ‬
‫‪.١٩٨١‬‬

‫ﺍﳋﺴﺎﺋﺮ ﺑﺴﺒﺐ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‬

‫ﰲ ﺗﻘﺮﻳﺮ ﻟﺸﻌﺒﺔ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺎ‪‬ﺎﻟﺲ ﺍﻟﻘﻮﻣﻴﺔ ﺍﳌﺘﺨﺼﺼﺔ ﺳﻨﺔ ‪ ١٩٩٣‬ﻭﺑﻨﺎﺀ ﻋﻠﻰ ﺗﻘﺮﻳﺮ ﺍﻹﺩﺍﺭﺓ‬
‫ﺍﻟﻌﺎﻣﺔ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺳﻨﺔ ‪ (٦)١٩٨٣‬ﻭﺭﺩﺕ ﺍﳊﻘﺎﺋﻖ ﺍﻟﺘﺎﻟﻴﺔ ﻟﻠﺪﻻﻟﺔ‬
‫ﻋﻠﻰ ﺣﺠﻢ ﺍﳋﺴﺎﺋﺮ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺑﺴﺒﺐ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺃﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ ﺧﻼﻝ ﻋﺎﻡ ‪:١٩٨٣‬‬
‫ﻋﺎﻣﻞ‬ ‫‪١٣٠٥٩٣٠٠‬‬ ‫ﻋﺪﺩ ﺍﻟﻌﺎﻣﻠﲔ‬
‫ﺟﻨﻴﻪ‬ ‫‪٤,٠٦٠‬‬ ‫ﻣﺘﻮﺳﻂ ﺍﻷﺟﺮ ﺍﻟﻴﻮﻣﻲ )ﲝﺴﺎﺏ ﺳﻨﺔ ‪(١٩٨٣‬‬
‫ﻳﻮﻣﺎ‬ ‫‪٢٢٢٤٠٩٩٣‬‬ ‫ﻋﺪﺩ ﺍﻷﻳﺎﻡ ﺍﻟﻀﺎﺋﻌﺔ ﺑﺴﺒﺐ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ‬
‫ﺟﻨﻴﻬﺎﹰ‬ ‫‪٩٠٢٩٨٤٣١‬‬ ‫ﺗﻜﺎﻟﻴﻒ ﺃﻳﺎﻡ ﺍﻻﻧﻘﻄﺎﻉ ﺑﺴﺒﺐ ﺍﻹﺻﺎﺑﺔ‬
‫ﺟﻨﻴﻬﺎﹰ‬ ‫‪٩٣٨٨٣٤٤‬‬ ‫ﺍﻟﺘﻌﻮﻳﻀﺎﺕ ﺍﻟﻨﺎﲨﺔ ﻋﻦ ﺍﻹﺻﺎﺑﺔ ﻭﺍﻟﻮﻓﺎﺓ‬
‫ﺟﻨﻴﻬﺎﹰ‬ ‫‪٣٥٨٥٨٦٣‬‬ ‫ﺗﻜﺎﻟﻴﻒ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ )ﺍﻷﻳﺎﻡ ﺍﳌﻔﻘﻮﺩﺓ(‬
‫ﺟﻨﻴﻬﺎﹰ‬ ‫‪٦٩٩٤٦٧٤٦‬‬ ‫ﺗﻜﺎﻟﻴﻒ ﺍﻟﻌﻼﺝ ﻟﻺﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‬
‫ﺟﻨﻴﻬﺎﹰ‬ ‫‪١٧١٢١٩٣٨٤‬‬ ‫ﳎﻤﻮﻉ ﺍﳋﺴﺎﺋﺮ ﺍﳌﺒﺎﺷﺮﺓ‬
‫ﻓﺈﺫﺍ ﺍﻋﺘﱪﻧﺎ ﺃﻥ ﺍﳋﺴﺎﺋﺮ ﻏﲑ ﺍﳌﺒﺎﺷﺮﺓ )ﺍﳊﺪ ﺍﻷﺩﱏ( ﺗﺴﺎﻭﻯ ﲬﺴﺔ ﺃﺿﻌﺎﻑ ﺍﳋﺴﺎﺋﺮ ﺍﳌﺒﺎﺷﺮﺓ ﻟﺘﺒﲔ ﻟﻨﺎ‬
‫ﺃﻥ ﳎﻤﻮﻉ ﺍﳋﺴﺎﺋﺮ ﺍﳌﺒﺎﺷﺮﺓ ﻭﻏﲑ ﺍﳌﺒﺎﺷﺮﺓ ﻳﺘﻌﺪﻯ ﺍﳌﻠﻴﺎﺭ ﺟﻨﻴﻪ ﺳﻨﻮﻳﺎ ﺑﺘﻘﺪﻳﺮ ﺳﻨﺔ ‪ .١٩٨٣‬ﻭﻻ ﺷﻚ‬

‫‪٢٩٤‬‬
‫ﺃﻧﻪ ﻣﻨﺬ ﺫﻟﻚ ﺍﻟﺘﺎﺭﻳﺦ ﺯﺍﺩﺕ ﳎﺎﻻﺕ ﺍﻟﻌﻤﺎﻟﺔ ﻭﺯﺍﺩﺕ ﺍﻷﺟﻮﺭ ﻭﺗﻜﺎﻟﻴﻒ ﺍﻟﻌﻼﺝ‪ ،‬ﻭﺯﺍﺩﺕ ﺑﻨﺎﺀ ﻋﻠﻰ ﺫﻟﻚ‬
‫ﺍﳋﺴﺎﺋﺮ ﺍﻟﻨﺎﲨﺔ ﻋﻦ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺃﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ‪.‬‬

‫ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ‬

‫‪‬ﺪﻑ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﺇﱃ ﺗﻮﻓﲑ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ﺍﻵﻣﻨﺔ ﻭﺍﳊﻔﺎﻅ ﻋﻠﻰ‬
‫ﺻﺤﺔ ﻭﺳﻼﻣﺔ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺃﻋﻠﻰ ﺩﺭﺟﺎﺕ ﺍﻟﻠﻴﺎﻗﺔ‪ ،‬ﻭﺗﻮﻓﲑ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﱵ ﺗﻀﻤﻦ ﺍﻻﻛﺘﺸﺎﻑ‬
‫ﺍﳌﺒﻜﺮ ﻟﻸﻣﺮﺍﺽ ﻭﺍﻹﺻﺎﺑﺎﺕ ﺍﳌﻬﻨﻴﺔ ﻭﻋﻼﺟﻬﺎ ﻭﻣﻨﻊ ﺃﻭ ﺍﻟﺘﻘﻠﻴﻞ ﻣﻦ ﺍﻟﻌﺠﺰ ﺍﻟﻨﺎﺗﺞ ﻋﻨﻬﺎ‪ ،‬ﻭﺗﻌﻮﻳﺾ‬
‫ﺍﻟﻌﺎﻣﻞ ﰲ ﺣﺎﻟﺔ ﺍﻟﻌﺠﺰ ﻋﻦ ﺍﻟﻌﻤﻞ‪ ،‬ﻭﺍﻟﻌﻤﻞ ﻋﻠﻰ ﻭﺿﻊ ﺍﻟﻌﺎﻣﻞ ﺍﳌﻨﺎﺳﺐ ﰲ ﺍﻟﻌﻤﻞ ﺍﳌﻨﺎﺳﺐ‪.‬‬
‫ﻭﺍﻟﺘﺸﺮﻳﻊ ﺍﻷﺳﺎﺳﻲ ﰲ ﳎﺎﻝ ﺍﻟﻌﻤﻞ ﻫﻮ ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﺭﻗﻢ ‪ ١٣٧‬ﻟﺴﻨﺔ ‪ ١٩٨١‬ﻭﺍﻟﺬﻱ ﻳﻨﻈﻢ ﺍﻟﻌﻼﻗﺎﺕ‬
‫ﺍﳋﺎﺻﺔ ﺑﺘﺸﻐﻴﻞ ﺍﻟﻌﺎﻣﻠﲔ‪ :‬ﻋﻘﺪ ﺍﻟﻌﻤﻞ ﺍﻟﻔﺮﺩﻱ ﻭﺗﻨﻈﻴﻢ ﺗﺸﻐﻴﻞ ﺍﻟﻌﺎﻣﻠﲔ ﻭﺳﺎﻋﺎﺕ ﺍﻟﻌﻤﻞ‬
‫ﻭﺍﻹﺟﺎﺯﺍﺕ ﻭﺣﻘﻮﻕ ﺍﻟﻌﺎﻣﻠﲔ ﻭﺍﻷﺟﻮﺭ ﻭﺍﳌﻜﺎﻓﺂﺕ ﻭﺍﳉﺰﺍﺀﺍﺕ ﻭﻏﲑ ﺫﻟﻚ ﻣﻦ ﻣﻮﺿﻮﻋﺎﺕ ﺍﻟﻌﻤﺎﻟﺔ‪ .‬ﻭﳛﺘﻮﻯ‬
‫ﺍﻟﻘﺎﻧﻮﻥ ﰲ ﺍﻟﺒﺎﺏ ﺍﳋﺎﻣﺲ ﻋﻠﻰ ﻛﺎﻓﺔ ﺍﳉﻮﺍﻧﺐ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﲟﺎ ﰲ ﺫﻟﻚ ﻭﺳﺎﺋﻞ‬
‫ﻭﻗﺎﻳﺔ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ ﺍﳌﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ ﻭﺗﻮﻓﲑ ﻭﺳﺎﺋﻞ ﺍﻹﺳﻌﺎﻓﺎﺕ ﺍﻷﻭﻟﻴﺔ ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﻭﺗﻨﻈﻴﻢ‬
‫ﺍﻷﺟﻬﺰﺓ ﺍﳌﺸﺮﻓﺔ ﻋﻠﻰ ﺻﺤﺔ ﻭﺳﻼﻣﺔ ﺍﻟﻌﺎﻣﻠﲔ‪ .‬ﻭﻗﺪ ﺻﺪﺭ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ١٣٧‬ﻟﺴﻨﺔ ‪ ١٩٨١‬ﻣﻌﺪﻻ‬
‫ﻟﻘﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﺭﻗﻢ ‪ ٩١‬ﺍﻟﺼﺎﺩﺭ ﰲ ﺳﻨﺔ ‪.١٩٥٩‬‬
‫ﻭﳌﺎ ﻟﺼﻨﺎﻋﺔ ﺍﻟﺘﻌﺪﻳﻦ ﻣﻦ ﻭﺿﻊ ﺧﺎﺹ ﻣﻦ ﺣﻴﺚ ﻗﺴﻮﺓ ﻇﺮﻭﻑ ﺍﻟﻌﻤﻞ ﻭﺍﳌﺨﺎﻃﺮ ﺍﻟﱵ ﻳﺘﻌﺮﺽ ﳍﺎ‬
‫ﺍﻟﻌﺎﻣﻠﻮﻥ ﻓﻘﺪ ﺻﺪﺭ ﰲ ﺳﻨﺔ ‪ ١٩٨١‬ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٢٧‬ﺍﳋﺎﺹ ﺑﺘﺸﻐﻴﻞ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳌﻨﺎﺟﻢ ﻭﺍﶈﺎﺟﺮ‪.‬‬
‫ﻭﻳﻨﻈﻢ ﺍﻟﻘﺎﻧﻮﻥ – ﻋﻠﻰ ﻏﺮﺍﺭ ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ – ﻋﻼﻗﺎﺕ ﺍﻟﻌﻤﻞ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﻌﻤﻞ ﰲ ﺗﻠﻚ ﺍﻟﺼﻨﺎﻋﺎﺕ‪،‬‬
‫ﻭﻗﺪ ﺍﺣﺘﻮﻯ ﺃﻳﻀﺎ ﻋﻠﻰ ﻣﻮﺍﺩ ﺧﺎﺻﺔ ﺑﺎﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﰲ ﺻﻨﺎﻋﺔ ﺍﻟﺘﻌﺪﻳﻦ‪.‬‬
‫ﻭﻫﺬﺍﻥ ﺍﻟﻘﺎﻧﻮﻧﺎﻥ ﻳﻨﻈﻤﺎﻥ ﺑﺼﻔﺔ ﺃﺳﺎﺳﻴﺔ ﺍﻟﻨﻮﺍﺣﻲ ﺍﻟﻮﻗﺎﺋﻴﺔ ﰲ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ ﻭﺍﻟﱵ ﺗﺸﻜﻞ ﺍﻫﺘﻤﺎﻣﺎ‬
‫ﺭﺋﻴﺴﻴﺎ ﻟﻠﻤﺘﺨﺼﺼﲔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪.‬‬
‫ﻭﰱ ﻣﺮﺣﻠﺔ ﺍﻟﺘﺮﺧﻴﺺ ﺑﺈﻧﺸﺎﺀ ﺍﶈﺎﻝ ﺍﻟﺼﻨﺎﻋﻴﺔ ﻭﺍﻟﺘﺠﺎﺭﻳﺔ ﻭﻏﲑﻫﺎ ﺗﺮﺍﻋﻰ ﺍﺷﺘﺮﺍﻃﺎﺕ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻼﻣﺔ ﻟﻠﻌﺎﻣﻠﲔ ﻭﺍﳉﻤﻬﻮﺭ ﻭﻳﺸﺘﺮﻙ ﰲ ﺇﺻﺪﺍﺭ ﺍﻟﺘﺮﺍﺧﻴﺺ ﳉﻨﺔ ﻳﺸﺎﺭﻙ ﻓﻴﻬﺎ ﻣﺴﺌﻮﻟﻮ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﺍﶈﻠﻴﺎﺕ‪ .‬ﻭﻳﻨﻈﻢ ﻋﻤﻠﻴﺔ ﺇﺻﺪﺍﺭ ﺍﻟﺘﺮﺍﺧﻴﺺ ﻭﻣﺮﺍﻋﺎﺓ ﺍﺷﺘﺮﺍﻃﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ‬
‫ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٤٥٣‬ﻟﺴﻨﺔ ‪ ١٩٥٤‬ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﳌﻨﻔﺬﺓ ﻟﻪ ﻭﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﺍﳌﺘﻌﻠﻘﺔ ﺑﻪ‪.‬‬
‫ﻭﻣﻬﻤﺎ ﺑﻠﻐﺖ ﺍﻷﻧﺸﻄﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻣﻦ ﺍﻟﻜﻤﺎﻝ ﻓﺈﻥ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺃﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ ﺗﻈﻞ ﺃﻣﺮﺍ ﳏﺘﻤﻞ‬
‫ﺍﳊﺪﻭﺙ‪ .‬ﻭﱂ ﺗﻐﻔﻞ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﺍﳌﺼﺮﻳﺔ ﺗﺄﻣﲔ ﺍﻟﻌﺎﻣﻠﲔ ﺿﺪ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ‪ ،‬ﻭﻗﺪ ﺗﻄﻮﺭﺕ ﺣﱴ‬
‫ﺍﻧﺘﻬﺖ ﺇﱃ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٧٩‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﻭﺗﻌﺪﻳﻼﺗﻪ ﻭﺍﻟﺬﻱ ﻳﺘﻨﺎﻭﻝ ﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ‬
‫ﻭﻳﻮﻓﺮ ﺍﻟﻌﻼﺝ ﻭﺍﻟﺘﺄﻫﻴﻞ ﻭﺍﻟﺘﻌﻮﻳﺾ ﻋﻦ ﺍﻟﻌﺠﺰ ﰲ ﺣﺎﻻﺕ ﺍﻹﺻﺎﺑﺔ ﻭﺍﳌﺮﺽ ﺍﳌﻬﲏ‪ ،‬ﻭﺫﻟﻚ ﻋﻦ ﻃﺮﻳﻖ ﺗﺄﻣﲔ‬
‫ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ‪ .‬ﻭﻳﺸﻤﻞ ﻫﺬﺍ ﺍﻟﻘﺎﻧﻮﻥ ﺃﻳﻀﺎ ﺗﻨﻈﻴﻢ ﺇﺟﺮﺍﺀﺍﺕ ﺍﳋﺪﻣﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻟﻸﻣﺮﺍﺽ ﻏﲑ ﺍﳌﻬﻨﻴﺔ‬
‫ﻋﻦ ﻃﺮﻳﻖ ﺗﺄﻣﲔ ﺍﳌﺮﺽ )ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ(‪.‬‬
‫ﻭﻳﻼﺣﻆ ﺃﻥ ﺍﻟﻘﺎﻧﻮﻥ ‪ ٧٩‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﻳﺘﻨﺎﻭﻝ ﺍﳉﻮﺍﻧﺐ ﺍﻟﻌﻼﺟﻴﺔ ﺳﻮﺍﺀ ﻟﻸﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﺃﻡ ﻏﲑ ﺍﳌﻬﻨﻴﺔ‪.‬‬

‫‪٢٩٥‬‬
‫ﻭﻫﻨﺎﻙ ﺑﻌﺾ ﺗﺸﺮﻳﻌﺎﺕ ﺃﺧﺮﻯ ﻣﻜﻤﻠﺔ ﻟﻠﻘﻮﺍﻧﲔ ﺍﻟﱵ ﺗﺘﻨﺎﻭﻝ ﺍﳉﻮﺍﻧﺐ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺫﻟﻚ ﰲ ﺣﺎﻻﺕ ﺧﺎﺻﺔ‬
‫ﻣﺜﻞ ﺍﻟﺘﻌﺮﺽ ﻟﻺﺷﻌﺎﻋﺎﺕ ﺍﳌﺆﻳﻨﺔ ﻭﺗﺪﺍﻭﻝ ﺍﳌﺒﻴﺪﺍﺕ ﻭﺍﺳﺘﻌﻤﺎﻝ ﺍﻵﻻﺕ ﺍﳊﺮﺍﺭﻳﺔ ﻭﺍﳌﺮﺍﺟﻞ ﺍﻟﺒﺨﺎﺭﻳﺔ‪.‬‬
‫ﻭﻳﺘﻨﺎﻭﻝ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٤‬ﻟﺴﻨﺔ ‪ ١٩٩٤‬ﺍﳌﺴﺎﺋﻞ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻟﺒﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ‪ ،‬ﻭﺑﻪ ﺍﻟﻘﻠﻴﻞ ﻣﻦ ﺍﳌﻮﺍﺩ ﺍﻟﱵ‬
‫ﺗﺘﻨﺎﻭﻝ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ﻭﲢﺘﻮﻯ ﺍﻟﻼﺋﺤﺔ ﺍﻟﺘﻨﻔﻴﺬﻳﺔ ﻋﻠﻰ ﺍﳌﻌﺎﻳﲑ ﻭﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﺘﻌﺮﺽ ﺍﳌﺴﻤﻮﺡ ‪‬ﺎ‪.‬‬
‫ﻭﺗﺸﻤﻞ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﻣﺎ ﻳﺄﰐ‪:‬‬
‫‪ – ١‬ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﺭﻗﻢ ‪ ١٣٧‬ﻟﺴﻨﺔ ‪ ١٩٨١‬ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﻟﻮﺯﺍﺭﻳﺔ ﺍﳌﻨﻔﺬﺓ ﻟﻪ‪:‬‬
‫ﻭﻳﻌﺘﱪ ﺍﻟﻘﺎﻧﻮﻥ ﺍﻟﺮﺋﻴﺴﻲ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ‪ ،‬ﻭﻓﻴﻤﺎ ﻳﻠﻲ ﺍﻷﺟﺰﺍﺀ ﺍﳋﺎﺻﺔ ﺑﻪ‪:‬‬
‫ﺍﻟﺒﺎﺏ ﺍﳋﺎﻣﺲ‪ :‬ﺧﻼﻓﺎ ﻟﺒﻘﻴﺔ ﻣﻮﺍﺩ ﺍﻟﻘﺎﻧﻮﻥ ﻓﺈﻥ ﻫﺬﺍ ﺍﻟﺒﺎﺏ ﻳﻨﻄﺒﻖ ﻋﻠﻰ ﲨﻴﻊ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ ﺩﻭﻥ‬
‫ﺍﺳﺘﺜﻨﺎﺀ )ﺍﻟﻘﻄﺎﻉ ﺍﻟﻌﺎﻡ ﻭﺍﻟﻘﻄﺎﻉ ﺍﳋﺎﺹ ﻭﻗﻄﺎﻉ ﺍﻷﻋﻤﺎﻝ ﺍﻟﻌﺎﻡ ﻭﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﳍﻴﺌﺎﺕ ﺍﳊﻜﻮﻣﻴﺔ(‪.‬‬
‫ﺍﻟﻔﺼﻞ ﺍﻟﺜﺎﱐ‪ :‬ﻳﺘﻨﺎﻭﻝ ﺍﺧﺘﻴﺎﺭ ﺍﳌﻮﻗﻊ ﻭﺇﺟﺮﺍﺀﺍﺕ ﺍﻟﺘﺮﺧﻴﺺ ﻭﻓﻘﺎ ﻟﻠﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٤٥٣‬ﻟﺴﻨﺔ ‪١٩٥٤‬‬
‫ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﻟﻮﺯﺍﺭﻳﺔ ﺍﳌﻨﻔﺬﺓ ﻟﻪ‪.‬‬
‫ﻭﻳﺘﻨﺎﻭﻝ ﺍﻟﻔﺼﻞ ﺍﻟﺜﺎﻟﺚ ﺗﻮﻓﲑ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ﺍﻵﻣﻨﺔ )ﺍﳌﻮﺍﺩ ‪ (١٢٠– ١١٥‬ﺣﻴﺚ ﻳﻜﻮﻥ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ‬
‫ﻣﺴﺌﻮﻻ ﻋﻦ ﺫﻟﻚ ﻭﻛﺬﻟﻚ ﻋﻦ ﺗﻌﺮﻳﻒ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺄﺧﻄﺎﺭ ﺍﳌﻬﻨﺔ ﻭﺗﻮﻓﲑ ﻭﺳﺎﺋﻞ ﺍﻟﻮﻗﺎﻳﺔ ﳍﻢ ﲟﺎ ﰲ ﺫﻟﻚ‬
‫ﻭﺳﺎﺋﻞ ﺍﻟﻮﻗﺎﻳﺔ ﺍﻟﺸﺨﺼﻴﺔ ﻭﺗﺪﺭﺑﻴﻬﻢ ﻋﻠﻰ ﺍﺳﺘﻌﻤﺎﳍﺎ ﻭﺻﻴﺎﻧﺘﻬﺎ‪.‬‬
‫ﻭﻳﻮﺿﺢ ﺍﻟﻘﺮﺍﺭ ﺍﻟﻮﺯﺍﺭﻱ ﺭﻗﻢ ‪ ٥٥‬ﻟﺴﻨﺔ ‪ ١٩٨٣‬ﺗﻔﺎﺻﻴﻞ ﻭﺳﺎﺋﻞ ﺍﻟﻮﻗﺎﻳﺔ ﲟﺎ ﰲ ﺫﻟﻚ ﺳﻼﻣﺔ ﺍﳌﺒﲎ‬
‫ﻭﺍﺣﺘﻴﺎﻃﺎﺕ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﳊﺮﻳﻖ ﻭﻛﺬﻟﻚ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﳌﺨﺎﻃﺮ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ ﻭﺍﳌﻴﻜﺎﻧﻴﻜﻴﺔ ﻭﺍﻟﻄﺒﻴﻌﻴﺔ‬
‫ﻭﺍﳌﺨﺎﻃﺮ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺄﻋﻤﺎﻝ ﺍﳌﻘﺎﻭﻻﺕ‪ .‬ﻭﻗﺪ ﺃﳊﻖ ‪‬ﺬﺍ ﺍﻟﻘﺮﺍﺭ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﳌﺄﻣﻮﻧﺔ ﻟﻠﻮﻃﺄﺓ ﺍﳊﺮﺍﺭﻳﺔ ﻭﺷﺪﺓ‬
‫ﺍﻹﺿﺎﺀﺓ ﻭﺍﻟﻀﻮﺿﺎﺀ ﻭﺗﺮﻛﻴﺰ ﺍﳌﻮﺍﺩ ﺍﻟﻀﺎﺭﺓ ﻣﺜﻞ ﺍﻟﻐﺎﺯﺍﺕ ﻭﺍﻷﺗﺮﺑﺔ ﺍﳌﺴﻤﻮﺡ ‪‬ﺎ ﰲ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﻭﺗﻨﺺ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﻋﻠﻰ ﺃﻧﻪ ﳚﻮﺯ ﻟﻠﺠﻬﺔ ﺍﻹﺩﺍﺭﻳﺔ ﺍﻷﻣﺮ ﺑﺈﻏﻼﻕ ﺍﳌﻨﺸﺄﺓ ﻛﻠﻴﺎ ﺃﻭ ﺟﺰﺋﻴﺎ ﺇﺫﺍ ﱂ ﺗﺘﺒﻊ‬
‫ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﳌﻨﺼﻮﺹ ﻋﻠﻴﻬﺎ ﰲ ﺍﻟﻘﺮﺍﺭ ﺇﺫﺍ ﻛﺎﻥ ﺫﻟﻚ ﻳﺸﻜﻞ ﺧﻄﺮﺍ ﻋﻠﻰ ﺍﻟﺼﺤﺔ‪.‬‬
‫ﻭﺗﺆﻛﺪ ﺍﳌﺎﺩﺓ ‪ ١١٦‬ﻣﻦ ﺍﻟﻘﺎﻧﻮﻥ ﻋﻠﻰ ﺿﺮﻭﺭﺓ ﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻻﺑﺘﺪﺍﺋﻲ ﻟﻠﻌﺎﻣﻠﲔ ﺑﻮﺍﺳﻄﺔ ﺍﳍﻴﺌﺔ‬
‫ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ .‬ﻭﲢﻘﻴﻘﺎ ﳌﺒﺪﺃ ﻭﺿﻊ ﺍﻟﻌﺎﻣﻞ ﺍﳌﻨﺎﺳﺐ ﰲ ﺍﻟﻌﻤﻞ ﺍﳌﻨﺎﺳﺐ ﻓﻘﺪ ﺻﺪﺭ ﻗﺮﺍﺭ‬
‫ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺭﻗﻢ ‪ ١٣٣‬ﻟﺴﻨﺔ ‪ ١٩٨٣‬ﺑﺘﺤﺪﻳﺪ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﻠﻴﺎﻗﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻋﻤﺎﻝ ﺍﳌﺨﺘﻠﻔﺔ‪ .‬ﻭﻗﺪ ﺃﻛﺪ‬
‫ﺍﻟﻘﺮﺍﺭ ﻋﻠﻰ ﺿﺮﻭﺭﺓ ﺇﺟﺮﺍﺀ ﺑﻌﺾ ﺍﻟﻔﺤﻮﺹ ﺍﻟﻄﺒﻴﺔ ﺍﳋﺎﺻﺔ ﻟﻠﻌﺎﻣﻠﲔ ﺍﳌﻌﺮﺿﲔ ﻟﻠﻤﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ‬
‫ﺍﳌﺨﺘﻠﻔﺔ – ﺃﺛﻨﺎﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻻﺑﺘﺪﺍﺋﻲ‪ -‬ﺣﱴ ﳝﻜﻦ ﺃﻥ ﺗﺴﺘﻌﻤﻞ ﻧﺘﺎﺋﺞ ﻫﺬﻩ ﺍﻟﻔﺤﻮﺹ ﻟﻠﻤﻘﺎﺭﻧﺔ‬
‫ﻋﻨﺪ ﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ‪‬ﺪﻑ ﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻟﻸﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‪ ،‬ﻭﺇﻥ ﻛﺎﻧﺖ ﻫﺬﻩ‬
‫ﺍﻟﻔﺤﻮﺹ ﻗﻠﻤﺎ ﲡﺮﻱ ﺃﺛﻨﺎﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻻﺑﺘﺪﺍﺋﻲ‪.‬‬
‫ﻭﻳﺘﻨﺎﻭﻝ ﺍﻟﻔﺼﻞ ﺍﻟﺮﺍﺑﻊ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﻭﻭﺳﺎﺋﻞ ﺍﻹﺳﻌﺎﻑ ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻹﺳﻜﺎﻥ ﻭﺍﳌﻮﺍﺻﻼﺕ ﻛﻤﺎ ﻳﻨﺺ‬
‫ﻋﻠﻰ ﺃﻥ ﺗﻠﺘﺰﻡ ﺍﳌﻨﺸﺄﺓ ﺑﺈﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻟﻠﻌﺎﻣﻠﲔ ﺍﳌﻌﺮﺿﲔ ﻟﻠﻤﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ ﻭﺫﻟﻚ‬
‫ﺑﻮﺍﺳﻄﺔ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪.‬‬
‫ﻭﻳﺘﻨﺎﻭﻝ ﺍﻟﻔﺼﻞ ﺍﳋﺎﻣﺲ ﺃﻣﻮﺭ ﺍﻟﺘﻔﺘﻴﺶ ﻋﻠﻰ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ ﻟﻠﺘﺄﻛﺪ ﻣﻦ ﺗﻨﻔﻴﺬ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪١٣٧‬‬
‫ﻟﺴﻨﺔ ‪ ١٩٨١‬ﻭﻛﺬﻟﻚ ﻟﻠﺘﺄﻛﺪ ﻣﻦ ﺗﻨﻔﻴﺬ ﺍﺷﺘﺮﺍﻃﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﺍﻟﱴ ﺗﻨﺺ ﻋﻠﻴﻬﺎ‬

‫‪٢٩٦‬‬
‫ﺑﻌﺾ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﺍﻷﺧﺮﻯ ﻣﺜﻞ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٤٥٣‬ﻟﺴﻨﺔ ‪ .١٩٥٤‬ﻭﻳﺘﻢ ﺍﻟﺘﻔﺘﻴﺶ ﺑﺼﻔﺔ ﺩﻭﺭﻳﺔ ﺑﻮﺍﺳﻄﺔ‬
‫ﺃﻓﺮﺍﺩ ﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﺍﻟﺘﺎﺑﻊ ﻟﻮﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﳌﻜﻮﻥ ﻣﻦ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ‬
‫ﺍﳌﻬﻨﻴﺔ ﻭﻣﻜﺎﺗﺐ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﲟﺪﻳﺮﻳﺎﺕ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‪ .‬ﻭﻳﺒﻠﻎ ﻋﺪﺩ ﺃﻓﺮﺍﺩ‬
‫ﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳉﻤﻬﻮﺭﻳﺔ ‪ ٩٦٦‬ﻓﺮﺩﺍ ﺑﲔ ﻛﻴﻤﻴﺎﺋﻲ ﻭﻣﻬﻨﺪﺱ ﻭﻃﺒﻴﺐ‪ ،‬ﳍﻢ ﺻﻔﺔ‬
‫ﺍﻟﻀﺒﻄﻴﺔ ﺍﻟﻘﻀﺎﺋﻴﺔ‪ ،‬ﻭﻳﺘﻢ ﺗﺪﺭﻳﺒﻬﻢ ﺩﻭﺭﻳﺎ ﻟﺮﻓﻊ ﻣﺴﺘﻮﻯ ﺍﻷﺩﺍﺀ ﻭﻛﺬﻟﻚ ﺗﺰﻭﻳﺪﻫﻢ ﺑﺄﺟﻬﺰﺓ ﻭﻣﻌﺪﺍﺕ‬
‫ﻟﻘﻴﺎﺱ ﺍﳌﺨﺎﻃﺮ ﻭﺗﻘﻴﻴﻢ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ‪ .‬ﻭﻷﻓﺮﺍﺩ ﺍﳉﻬﺎﺯ ﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﻮﺹ ﺍﻟﺒﻴﺌﻴﺔ ﻭﺍﻟﻄﺒﻴﺔ ﰲ ﺍﳌﻨﺸﺂﺕ‬
‫ﻟﻠﺘﺄﻛﺪ ﻣﻦ ﺳﻼﻣﺔ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ﻭﻛﺬﻟﻚ ﻟﻔﺤﺺ ﺃﻳﺔ ﺷﻜﻮﻯ ﻣﻦ ﺍﳌﻮﺍﻃﻨﲔ ﺃﻭ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺸﺄﻥ ﻣﺸﺎﻛﻞ‬
‫ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﻭﳜﺘﺺ ﺍﻟﻔﺼﻞ ﺍﻟﺴﺎﺩﺱ ﻭﺍﻟﻘﺮﺍﺭ ﺍﻟﻮﺯﺍﺭﻱ ﺭﻗﻢ ‪ ١١٦‬ﻟﺴﻨﺔ ‪ ١٩٩١‬ﺑﺈﻧﺸﺎﺀ ﻭﺗﻜﻮﻳﻦ ﻭﺗﺸﻜﻴﻞ ﻭﺗﺪﺭﻳﺐ‬
‫ﺃﺟﻬﺰﺓ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﺎﳌﻨﺸﺂﺕ ﻭﺍﺧﺘﻴﺎﺭ ﻭﻋﺪﺩ ﻭﻣﺆﻫﻼﺕ ﺃﻓﺮﺍﺩﻫﺎ ﻭﻛﺬﻟﻚ ﲢﺪﻳﺪ ﺟﻬﺎﺕ‬
‫ﺗﺪﺭﻳﺒﻬﻢ‪ .‬ﻛﻤﺎ ﺗﻄﺮﻕ ﺍﻟﺘﺸﺮﻳﻊ ﺇﱃ ﺇﻧﺸﺎﺀ ﳉﺎﻥ ﻟﻸﻣﻦ ﺍﻟﺼﻨﺎﻋﻲ ﰲ ﺍﳌﻨﺸﺂﺕ ﻭﲢﺪﻳﺪ ﺍﺧﺘﺼﺎﺻﺎ‪‬ﺎ‬
‫ﻭﺗﻜﻮﻳﻨﻬﺎ‪.‬‬
‫ﻭﻳﻠﺰﻡ ﺍﻟﻘﺮﺍﺭ ﺍﻟﻮﺯﺍﺭﻱ ﺭﻗﻢ ‪ ٧٥‬ﻟﺴﻨﺔ ‪ ١٩٩٣‬ﺍﳌﻨﺸﺂﺕ ﺑﺈﺧﻄﺎﺭ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻋﻦ ﺍﻷﻣﺮﺍﺽ‬
‫ﻭﺍﻹﺻﺎﺑﺎﺕ ﺍﳌﻬﻨﻴﺔ ﻭﺍﳊﻮﺍﺩﺙ ﺍﳉﺴﻴﻤﺔ ﻭﻛﺬﻟﻚ ﺍﻷﻣﺮﺍﺽ ﻏﲑ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ ﺇﺫﺍ ﻛﺎﻥ ﻋﺪﺩ‬
‫ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳌﻨﺸﺄﺓ ‪ ٥٠‬ﻋﺎﻣﻼ ﻓﺄﻛﺜﺮ‪.‬‬
‫ﻭﻳﻨﺺ ﺍﻟﻔﺼﻞ ﺍﻟﺴﺎﺑﻊ ﻋﻠﻰ ﺃﻥ ﻳﻨﺸﺄ ﺑﻘﺮﺍﺭ ﻣﻦ ﺭﺋﻴﺲ ﺍﳉﻤﻬﻮﺭﻳﺔ " ﺍ‪‬ﻠﺲ ﺍﻻﺳﺘﺸﺎﺭﻱ ﺍﻷﻋﻠﻰ‬
‫ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ " ﺑﺮﺋﺎﺳﺔ ﻭﺯﻳﺮ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﻳﻀﻢ ﳑﺜﻠﲔ ﻋﻦ ﺍﳉﻬﺎﺕ ﺍﳌﻌﻨﻴﺔ ﻭﳜﺘﺺ‬
‫ﺑﺮﺳﻢ ﺍﻟﺴﻴﺎﺳﺎﺕ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻭﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﺍﳉﻬﺎﺕ ﺍﻟﻌﺎﻣﻠﺔ ﻓﻴﻪ )ﻗﺮﺍﺭ ﺭﺋﻴﺲ ﺍﳉﻤﻬﻮﺭﻳﺔ ﺭﻗﻢ ‪١١٤‬‬
‫ﻟﺴﻨﺔ ‪ ،(١٩٨٤‬ﻛﻤﺎ ﻧﺺ ﺍﻟﻘﺎﻧﻮﻥ ﻋﻠﻰ ﺗﺸﻜﻴﻞ ﳉﺎﻥ ﺍﺳﺘﺸﺎﺭﻳﺔ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﰲ‬
‫ﺍﶈﺎﻓﻈﺎﺕ‪.‬‬
‫ﻭﻳﻨﻈﻢ ﺍﻟﺒﺎﺏ ﺍﻟﺴﺎﺑﻊ ﺗﺸﻐﻴﻞ ﺍﻷﺣﺪﺍﺙ‪ ،‬ﻭﻗﺪ ﺻﺪﺭﺕ ﰲ ﻫﺬﺍ ﺍﻟﺸﺄﻥ ﻗﺮﺍﺭﺍﺕ ﻭﺯﻳﺮ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺭﻗﻢ‬
‫‪ ١٢‬ﻟﺴﻨﺔ ‪ ،١٩٨٢‬ﻭ‪ ١٣‬ﻟﺴﻨﺔ ‪ ،١٩٨٣‬ﻭ‪ ١٤‬ﻟﺴﻨﺔ ‪ .١٩٨٢‬ﻭﻛﺬﻟﻚ ﻳﻨﻈﻢ ﻫﺬﺍ ﺍﻟﺒﺎﺏ ﺗﺸﻐﻴﻞ ﺍﻟﻨﺴﺎﺀ‬
‫ﻭﻣﻨﺤﻬﻦ ﺇﺟﺎﺯﺓ ﻭﺿﻊ ﻣﺪﻓﻮﻋﺔ ﺍﻷﺟﺮ‪ ،‬ﻭﺇﻧﺸﺎﺀ ﺩﻭﺭ ﺣﻀﺎﻧﺔ‪ ،‬ﻭﻗﺪ ﺻﺪﺭﺕ ‪‬ﺬﺍ ﺍﻟﺸﺄﻥ ﻗﺮﺍﺭﺍﺕ ﻭﺯﻳﺮ ﺍﻟﻘﻮﻯ‬
‫ﺍﻟﻌﺎﻣﻠﺔ ﺭﻗﻢ ‪ ٢٣‬ﻟﺴﻨﺔ ‪ ،١٩٨٢‬ﻭ‪ ٣٠‬ﻟﺴﻨﺔ ‪.١٩٨٢‬‬
‫ﻭﰲ ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺇﺩﺍﺭﺓ ﻟﻌﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﺗﻘﻮﻡ ﲝﺼﺮ ﻟﻸﺣﺪﺍﺙ ﺍﻟﻌﺎﻣﻠﲔ‪ .‬ﻭﻳﻘﻮﻡ ﻣﻔﺘﺸﻮ‬
‫ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﲟﺮﺍﻗﺒﺔ ﺗﻨﻔﻴﺬ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺎﻷﺣﺪﺍﺙ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﻟﻮﺭﺵ‬
‫ﺍﻟﺼﻐﲑﺓ‪.‬‬
‫ﻭﰲ ﳎﺎﻝ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻸﻃﻔﺎﻝ‪ ،‬ﻓﻘﺪ ﺍﺣﺘﻮﻯ ﻗﺎﻧﻮﻥ ﺍﻟﻄﻔﻞ ﺭﻗﻢ ‪ ١٢‬ﻟﺴﻨﺔ ‪ ١٩٩٦‬ﻋﻠﻰ ﻣﻮﺍﺩ‬
‫ﺗﻌﲎ ﺑﺘﻘﺪﱘ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﳍﻢ ﲟﺎ ﰲ ﺫﻟﻚ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ‪ .‬ﻭﻛﺬﻟﻚ ﻳﺘﻢ ﺇﻋﻔﺎﺅﻫﻢ ﻣﻦ‬
‫ﺩﻓﻊ ﺃﻳﺔ ﺭﺳﻮﻡ ﻋﻨﺪ ﺍﺳﺘﺨﺪﺍﻡ ﻣﺮﺍﻛﺰ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺳﺎﺳﻴﺔ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ – ﺑﻨﺎﺀً ﻋﻠﻰ‬
‫ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬
‫ﻭﻳﺘﻢ ﰲ ﳎﺎﻝ ﺭﻋﺎﻳﺔ ﺍﻷﻃﻔﺎﻝ ﺍﻟﻌﺎﻣﻠﲔ ﺍﻟﺘﻨﺴﻴﻖ ﺑﲔ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ )ﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻷﺳﺎﺳﻴﺔ( ﻭﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻸﻣﻮﻣﺔ ﻭﺍﻟﻄﻔﻮﻟﺔ‪.‬‬

‫‪٢٩٧‬‬
‫ﻭﻳﺪﻋﻢ ﺃﻋﻤﺎﻝ ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ " ﺍﳌﺮﻛﺰ ﺍﻟﻘﻮﻣﻲ ﻟﺪﺭﺍﺳﺎﺕ ﺍﻷﻣﻦ ﺍﻟﺼﻨﺎﻋﻲ " ﺍﳌﻨﺸﺄ ﺑﺎﻟﻘﺮﺍﺭ‬
‫ﺍﳉﻤﻬﻮﺭﻱ ﺭﻗﻢ ‪ ٩٣٢‬ﻟﺴﻨﺔ ‪ ١٩٦٩‬ﻭﻳﺘﺒﻊ ﻭﺯﻳﺮ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻣﺒﺎﺷﺮﺓ ﻭﳜﺘﺺ ﺑﺎﻟﺪﺭﺍﺳﺎﺕ ﻭﺍﻟﺒﺤﻮﺙ‬
‫ﻭﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻴﺪﺍﻧﻴﺔ ﻭﺍﻟﺘﺪﺭﻳﺐ ﺫﻱ ﺍﳌﺴﺘﻮﻯ ﺍﻟﻌﺎﱄ ﻭﺍﻟﺘﺨﺼﺼﻲ‪.‬‬
‫‪ -٢‬ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٢٧‬ﻟﺴﻨﺔ ‪ ١٩٨١‬ﺑﺸﺄﻥ ﺗﺸﻐﻴﻞ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳌﻨﺎﺟﻢ ﻭﺍﶈﺎﺟﺮ‪:‬‬
‫ﻭﻳﻨﺺ ﺍﻟﻘﺎﻧﻮﻥ ﻣﻦ ﺑﲔ ﻣﻮﺍﺩﻩ ﻋﻠﻰ ﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻻﺑﺘﺪﺍﺋﻲ ﻟﻠﻌﺎﻣﻠﲔ ﻭﻛﺬﺍ ﻓﺤﺺ ﺍﻟﺼﺪﺭ‬
‫ﺑﺎﻷﺷﻌﺔ ﻛﻞ ‪٦‬ﺷﻬﻮﺭ ﻟﻠﻤﻌﺮﺿﲔ ﺑﺼﻔﺔ ﻣﺒﺎﺷﺮﺓ ﺃﻭ ﻏﲑ ﻣﺒﺎﺷﺮﺓ ﻟﻸﺗﺮﺑﺔ‪ ،‬ﻛﻤﺎ ﻳﻮﺿﺢ ﺇﺟﺮﺍﺀﺍﺕ ﺍﻷﻣﻦ‬
‫ﺍﻟﺼﻨﺎﻋﻲ ﻭﻳﺘﻨﺎﻭﻝ ﺃﻣﻮﺭ ﺍﻹﺳﻜﺎﻥ ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﻟﻌﻤﺎﻝ ﺍﳌﻨﺎﺟﻢ ﻭﺍﶈﺎﺟﺮ‪ .‬ﻭﻳﻼﺣﻆ ﺃﻥ‬
‫ﺍﻟﻼﺋﺤﺔ ﺍﻟﺘﻨﻔﻴﺬﻳﺔ ﻟﻠﻘﺎﻧﻮﻥ ﱂ ﺗﺼﺪﺭ ﺑﻌﺪ‪.‬‬
‫‪ -٣‬ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٤٥٣‬ﻟﺴﻨﺔ ‪ ١٩٥٤‬ﺑﺸﺄﻥ ﺗﺮﺍﺧﻴﺺ ﺍﶈﺎﻝ ﺍﻟﺼﻨﺎﻋﻴﺔ ﻭﺍﻟﺘﺠﺎﺭﻳﺔ ﻭﻏﲑﻫﺎ‬
‫ﻣﻦ ﺍﶈﺎﻝ ﺍﳌﻘﻠﻘﺔ ﻟﻠﺮﺍﺣﺔ ﻭﺍﳌﻀﺮﺓ ﺑﺎﻟﺼﺤﺔ ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﳌﺘﻌﻠﻘﺔ ﺑﻪ‪:‬‬
‫ﻳﻨﻈﻢ ﺍﻟﻘﺎﻧﻮﻥ ﺑﺼﻔﺔ ﻋﺎﻣﺔ ﺇﺟﺮﺍﺀﺍﺕ ﺗﺮﺧﻴﺺ ﺍﶈﺎﻝ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﺎ ﻭﳛﺘﻮﻯ ﻋﻠﻰ ﺍﺷﺘﺮﺍﻃﺎﺕ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ‪ .‬ﻭﻗﺪ ﺻﺪﺭ ﺃﻳﻀﺎ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﺍﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ ﺭﻗﻢ ‪ ٩٩١‬ﻟﺴﻨﺔ ‪ ١٩٧٦‬ﺑﺸﺄﻥ‬
‫ﺇﺟﺮﺍﺀﺍﺕ ﺍﻷﻣﻦ ﺍﻟﺼﻨﺎﻋﻲ ﰲ ﻫﺬﻩ ﺍﶈﺎﻝ‪ .‬ﻭﺗﺮﺍﻋﻰ ﻫﺬﻩ ﺍﻻﺷﺘﺮﺍﻃﺎﺕ ﻋﻨﺪ ﺍﻟﺘﺮﺧﻴﺺ ﻟﻠﻤﺤﺎﻝ ﺑﻮﺍﺳﻄﺔ‬
‫ﳑﺜﻠﻲ ﻭﺯﺍﺭﺍﺕ ﺍﻹﺳﻜﺎﻥ ﻭﺍﻟﺼﺤﺔ ﻭﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﶈﻠﻰ‪.‬‬
‫ﻭﻗﺪ ﻧﺺ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻹﺳﻜﺎﻥ ﺭﻗﻢ ‪ ٣٨٠‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﻋﻠﻰ ﺍﺷﺘﺮﺍﻃﺎﺕ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﰲ‬
‫ﺃﻧﻮﺍﻉ ﻣﺘﻌﺪﺩﺓ ﻣﻦ ﺍﳌﻨﺸﺂﺕ ﲟﺎ ﰲ ﺫﻟﻚ ﻣﻮﺍﺩ ﺍﻟﺒﻨﺎﺀ ﻭﺍﻷﺭﺿﻴﺎﺕ ﻭﺍﺭﺗﻔﺎﻉ ﺍﳌﺒﲎ ﻭﺍﻟﺴﻘﻒ ﻭﺍﻟﺘﻬﻮﻳﺔ‬
‫ﻭﺍﻹﺿﺎﺀﺓ ﻭﺍﳌﺮﺍﻓﻖ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺘﻮﺻﻴﻼﺕ ﺍﻟﻜﻬﺮﺑﺎﺋﻴﺔ ﻭﺍﺣﺘﻴﺎﻃﺎﺕ ﺍﳊﺮﻳﻖ ﻭﻏﲑ ﺫﻟﻚ‪ .‬ﻭﻗﺪ ﴰﻠﺖ‬
‫ﺍﳉﺪﺍﻭﻝ ﺍﳌﺮﻓﻘﺔ ﺑﺎﻟﻘﺮﺍﺭ ﺣﻮﺍﱄ ‪ ١٨٠‬ﻧﺸﺎﻃﺎ ﻣﻬﻨﻴﺎ‪.‬‬
‫‪ -٤‬ﻗﺎﻧﻮﻥ ﺍﻟﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺭﻗﻢ ‪ ٧٩‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﺍﳌﻌﺪﻝ ﺑﺎﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٢٥‬ﻟﺴﻨﺔ‬
‫‪ ١٩٧٧‬ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﳌﻨﻔﺬﺓ ﻟﻪ‪:‬‬
‫ﻭﻳﺸﻤﻞ ﺍﻟﻘﺎﻧﻮﻥ ‪ -‬ﺇﱃ ﺟﺎﻧﺐ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺍﻷﺧﺮﻯ‪ -‬ﺗﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪.‬‬
‫ﻭﻳﺸﻤﻞ ﺗﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﲨﻴﻊ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳊﻜﻮﻣﺔ ﻭﺍﻟﻌﺎﻣﻠﲔ ﺍﻟﺬﻳﻦ ﻳﻨﻄﺒﻖ ﻋﻠﻴﻬﻢ ﻗﺎﻧﻮﻥ‬
‫ﺍﻟﻌﻤﻞ ﻭﺍﻟﺬﻳﻦ ﺑﻠﻐﻮﺍ ﻣﻦ ﺍﻟﻌﻤﺮ ‪ ١٨‬ﻋﺎﻣﺎ ﻓﺄﻛﺜﺮ – ﻣﻊ ﺑﻌﺾ ﺍﻻﺳﺘﺜﻨﺎﺀﺍﺕ‪ .‬ﻭﳝﻮﻝ ﺗﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ‬
‫ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ‪ .‬ﻭﻳﻮﻓﺮ ﺍﻟﺘﺄﻣﲔ ﺧﺪﻣﺎﺕ ﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻟﻸﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﻋﻼﺝ ﻫﺬﻩ ﺍﻷﻣﺮﺍﺽ‬
‫ﻭﺍﻹﺻﺎﺑﺎﺕ ﺍﳌﻬﻨﻴﺔ ﻭﺗﻌﻮﻳﺾ ﺍﻷﺟﺮ ﰲ ﺣﺎﻟﺔ ﺍﻟﻌﺠﺰ ﺍﳌﺆﻗﺖ ﻭﻛﺬﻟﻚ ﺍﻟﺘﻌﻮﻳﺾ ﰲ ﺣﺎﻟﺔ ﺍﻟﻌﺠﺰ ﺍﳌﺴﺘﺪﱘ‬
‫ﻭﺍﻟﻮﻓﺎﺓ ﺃﻭ ﺍﻟﺘﻘﺎﻋﺪ ﻷﺳﺒﺎﺏ ﻣﻬﻨﻴﺔ ﻭﻛﺬﻟﻚ ﺧﺪﻣﺎﺕ ﺍﻟﺘﺄﻫﻴﻞ‪.‬‬
‫ﻭﻣﻠﺤﻖ ﺑﺎﻟﻘﺎﻧﻮﻥ ﺟﺪﻭﻝ ﺃﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ ﻭﺍﻟﺬﻱ ﳛﺘﻮﻯ – ﻋﻠﻰ ﺳﺒﻴﻞ ﺍﳊﺼﺮ – ‪ ٢٩‬ﺗﻌﺮﺿﺎ ﻣﻬﻨﻴﺎ ﻭﳝﻜﻦ‬
‫ﺗﻌﺪﻳﻠﻪ ﺑﺎﻟﺰﻳﺎﺩﺓ ﺑﻘﺮﺍﺭ ﻣﻦ ﻭﺯﻳﺮ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ‪ .‬ﻭﺍﻟﻌﺎﻣﻠﻮﻥ ﺍﳌﻌﺮﺿﻮﻥ ﳍﺬﻩ ﺍﻟﺘﻌﺮﺿﺎﺕ ﳚﺮﻯ ﻓﺤﺼﻬﻢ ﺩﻭﺭﻳﺎ‬
‫ﺑﻐﺮﺽ ﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻟﻸﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‪ ،‬ﻭﻳﻨﻈﻢ ﺇﺟﺮﺍﺀﺍﺕ ﺍﻟﻔﺤﺺ ﻭﺩﻭﺭﻳﺘﻪ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺭﻗﻢ‬
‫‪ ٢١٨‬ﻟﺴﻨﺔ ‪ ١٩٧٧‬ﺍﳌﻌﺪﻝ ﺑﺎﻟﻘﺮﺍﺭ ﺭﻗﻢ ‪ ٧٨‬ﻟﺴﻨﺔ ‪ .٧٨‬ﻭﺗﺘﻮﱃ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺇﺟﺮﺍﺀ‬
‫ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻭﺍﻛﺘﺸﺎﻑ ﻭﻋﻼﺝ ﻭﺗﺄﻫﻴﻞ ﺍﳌﺮﺿﻰ ﻭﺍﳌﺼﺎﺑﲔ ﻭﺗﻘﺪﻳﺮ ﻧﺴﺐ ﺍﻟﻌﺠﺰ ﻭﻣﻨﺢ‬
‫ﺍﻹﺟﺎﺯﺍﺕ ﺍﳌﺮﺿﻴﺔ‪.‬‬

‫‪٢٩٨‬‬
‫ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺪﺭﺟﺔ ﰲ ﺟﺪﻭﻝ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻓﺈﻥ ﺍﻷﻣﺮﺍﺽ ﺍﳌﺘﺴﺒﺒﺔ ﻋﻦ ﺍﻹﺟﻬﺎﺩ‬
‫ﻭﺍﻹﺭﻫﺎﻕ ﳝﻜﻦ ﺍﻋﺘﺒﺎﺭﻫﺎ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﲢﺖ ﻇﺮﻭﻑ ﻣﻌﻴﻨﺔ ﺗﻨﻈﻤﻬﺎ ﻗﺮﺍﺭﺍﺕ ﻭﺯﻳﺮ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺭﻗﻢ‬
‫‪ ٢٣٩‬ﻟﺴﻨﺔ ‪ ١٩٧٧‬ﻭﺍﳌﻌﺪﻝ ﺑﺎﻟﻘﺮﺍﺭﺍﺕ ﺭﻗﻢ ‪ ١٣٦‬ﻟﺴﻨﺔ ‪ ١٩٨٠‬ﻭﺭﻗﻢ ‪ ٣٦‬ﻟﺴﻨﺔ ‪ ١٩٨٢‬ﻭﺭﻗﻢ ‪ ١٦١‬ﻟﺴﻨﺔ‬
‫‪.١٩٨٢‬‬
‫ﻭﳝﻮﻝ ﺧﺪﻣﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ ﻭﺍﻟﻌﺎﻣﻞ ﺑﻨﺴﺐ ﳏﺪﺩﺓ ﻭﺗﻘﺪﻡ ﺍﳋﺪﻣﺔ ﺍﻟﻄﺒﻴﺔ ﺍ‪‬ﺎﻧﻴﺔ‬
‫ﰲ ﺍﻷﻏﻠﺐ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﳌﻨﺸﺄﺓ ﺑﺎﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ ﺭﻗﻢ ‪ ١٢٠٩‬ﻟﺴﻨﺔ ‪ ١٩٦٤‬ﻭﺫﻟﻚ‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻻﺑﺘﺪﺍﺋﻲ ﻭﺍﻟﺪﻭﺭﻱ‪ .‬ﻭﻳﺸﺮﻑ ﻋﻠﻰ ﺃﻋﻤﺎﻝ ﺍﳍﻴﺌﺔ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻜﺎﻥ‪.‬‬
‫ﻭﻗﺪ ﺃﺟﺎﺯ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺭﻗﻢ ‪ ٣٩٣‬ﻟﺴﻨﺔ ‪ ١٩٧٧‬ﻟﻠﻤﻨﺸﺂﺕ – ﲢﺖ ﻇﺮﻭﻑ ﻣﻌﻴﻨﺔ – ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ‬
‫ﺍﻟﺘﺄﻣﲔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻸﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﻏﲑ ﺍﳌﻬﻨﻴﺔ ﺷﺮﻳﻄﺔ ﺃﻥ ﺗﻜﻮﻥ ﺍﳋﺪﻣﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺗﺮﺿﻰ ﻋﻨﻪ‬
‫ﺍﳍﻴﺌﺔ‪.‬‬
‫ﻭﻳﺘﻴﺢ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٣٢‬ﻟﺴﻨﺔ‪ ١٩٧٥‬ﻟﻠﻌﺎﻣﻠﲔ ﰲ ﺍﳊﻜﻮﻣﺔ ﻭﻭﺣﺪﺍﺕ ﺍﻹﺩﺍﺭﺓ ﺍﶈﻠﻴﺔ ﻭﺍﳍﻴﺌﺎﺕ ﺍﻟﻌﺎﻣﺔ‬
‫ﻭﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻌﺎﻣﺔ ﺍﻻﻧﺘﻔﺎﻉ ﺑﻨﻈﺎﻡ ﺍﻟﻌﻼﺝ ﺍﻟﺘﺄﻣﻴﲏ ﺍﻟﺬﻱ ﻳﺘﻴﺤﻪ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٧٩‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﻋﻠﻰ‬
‫ﺃﻥ ﻳﺪﻓﻊ ﺍﳌﻨﺘﻔﻊ ﺍﺷﺘﺮﺍﻛﺎ ﳐﻔﻀﺎ )‪ (%٠,٥‬ﺑﺎﻹﺿﺎﻓﺔ ﺇﱃ ﺭﺳﻢ ﺭﻣﺰﻱ ﻳﺆﺩﻳﻪ ﻋﻨﺪ ﺍﻻﻧﺘﻔﺎﻉ ﺑﺎﳋﺪﻣﺔ‪.‬‬
‫ﻭﻫﻨﺎﻙ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﻘﻮﺍﻧﲔ ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﻟﻮﺯﺍﺭﻳﺔ ﻭﻗﺮﺍﺭﺍﺕ ﺭﺅﺳﺎﺀ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫ﺍﳌﻨﻈﻤﺔ ﳋﺪﻣﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻭﺗﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ‪.‬‬
‫‪ -٥‬ﺍﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ ﺭﻗﻢ ‪ ٥٩‬ﻟﺴﻨﺔ ‪ ١٩٦٠‬ﺑﺸﺄﻥ ﺍﺳﺘﻌﻤﺎﻝ ﺍﻹﺷﻌﺎﻋﺎﺕ ﺍﳌﺆﻳﻨﺔ‬
‫ﻭﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺃﺧﻄﺎﺭﻫﺎ‪:‬‬
‫ﻳﻨﻔﺬ ﻫﺬﺍ ﺍﻟﻘﺎﻧﻮﻥ ﺍﻟﺬﻱ ﲡﺎﻭﺯ ﻋﻤﺮﻩ ﺍﻷﺭﺑﻌﲔ ﻋﺎﻣﺎ "ﺍﳌﻜﺘﺐ ﺍﻟﺘﻨﻔﻴﺬﻱ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻹﺷﻌﺎﻋﺎﺕ ﺍﳌﺆﻳﻨﺔ"‬
‫ﺍﻟﺘﺎﺑﻊ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ‪ ،‬ﻭﺍﻟﺬﻱ ﻳﻌﺎﱏ ﻣﻦ ﻧﻘﺺ ﰲ ﻋﺪﺩ ﻭﺗﺪﺭﻳﺐ ﺍﻟﻌﺎﻣﻠﲔ ﺑﻪ‪ .‬ﻭﳜﺘﺺ ﺍﳌﻜﺘﺐ‬
‫ﺑﺎﻟﺘﺮﺧﻴﺺ ﻭﺗﻨﻈﻴﻢ ﺍﺳﺘﻌﻤﺎﻝ ﻣﺼﺎﺩﺭ ﺍﻹﺷﻌﺎﻋﺎﺕ ﺍﳌﺆﻳﻨﺔ ﻭﻳﻌﻄﻰ ﻫﺬﺍ ﺍﻻﺧﺘﺼﺎﺹ ﳍﻴﺌﺔ ﺍﻟﻄﺎﻗﺔ‬
‫ﺍﻟﻨﻮﻭﻳﺔ ﻓﻴﻤﺎ ﳜﺘﺺ ﺑﺎﳌﺼﺎﺩﺭ ﺍﳌﻔﺘﻮﺣﺔ ﻭﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻓﻴﻤﺎ ﳜﺘﺺ ﺑﺎﳌﺼﺎﺩﺭ ﺍﳌﻐﻠﻘﺔ ﻭﺃﺟﻬﺰﺓ‬
‫ﺍﻷﺷﻌﺔ‪ .‬ﻭﻳﻨﻈﻢ ﺍﳌﻜﺘﺐ ﻋﻤﻠﻴﺎﺕ ﺍﻟﺘﺮﺧﻴﺺ ﺑﺎﻻﺳﺘﲑﺍﺩ ﻟﻸﻓﺮﺍﺩ ﻭﺍﳌﺆﺳﺴﺎﺕ ﻭﳛﺪﺩ ﻣﺆﻫﻼﺕ ﻭﺗﺪﺭﻳﺐ‬
‫ﺍﻷﻓﺮﺍﺩ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻭﻳﺆﻛﺪ ﻋﻠﻰ ﺍﺳﺘﻌﻤﺎﻝ ﻭﺳﺎﺋﻞ ﺍﻟﻮﻗﺎﻳﺔ‪ .‬ﻭﻳﻘﻮﻡ ﺍﻟﻌﺎﻣﻠﻮﻥ ﰲ ﺍﳌﻜﺘﺐ‬
‫ﺑﺎﻟﺘﻔﺘﻴﺶ ﻭﺣﻔﻆ ﺍﳌﻠﻔﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺎﳌﺼﺎﺩﺭ ﻭﺍﻟﺘﺄﻛﺪ ﻣﻦ ﺭﻋﺎﻳﺔ ﺻﺤﺔ ﺍﻟﻌﺎﻣﻠﲔ ﻭﺍﳉﻤﻬﻮﺭ ﻭﻣﻦ‬
‫ﺍﻟﺘﺨﻠﺺ ﺍﻵﻣﻦ ﻣﻦ ﺗﻠﻚ ﺍﳌﺼﺎﺩﺭ ﺃﻭ ﺇﻋﺎﺩﺓ ﺗﺼﺪﻳﺮﻫﺎ‪.‬‬
‫‪ -٦‬ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺭﻗﻢ ‪ ١٧٤‬ﻟﺴﻨﺔ ‪ ١٩٨٦‬ﺑﺸﺄﻥ ﺍﻟﺘﺮﺧﻴﺺ ﻟﻠﻤﻨﺸﺂﺕ ﺍﳌﻌﺪﺓ‬
‫ﳌﻘﺎﻭﻣﺔ ﺍﻵﻓﺎﺕ‪:‬‬
‫ﻳﻨﻈﻢ ﺍﻟﻘﺮﺍﺭ ﻋﻤﻠﻴﺔ ﺍﻟﺘﺮﺧﻴﺺ ﻟﻸﺷﺨﺎﺹ ﻭﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﳎﺎﻝ ﻣﻘﺎﻭﻣﺔ ﺍﻵﻓﺎﺕ ﻭﺍﳌﺆﻫﻼﺕ‬
‫ﺍﳌﻄﻠﻮﺑﺔ ﻟﻠﻌﺎﻣﻠﲔ ‪‬ﺬﻩ ﺍﻷﻋﻤﺎﻝ ﻭﺍﻟﺸﺮﻭﻁ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻮﺍﺟﺐ ﺗﻮﺍﻓﺮﻫﺎ ﻭﺇﺟﺮﺍﺀﺍﺕ ﺍﻟﺴﻼﻣﺔ‪.‬‬
‫‪ -٧‬ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٥٥‬ﻟﺴﻨﺔ ‪ ١٩٧٧‬ﺑﺸﺄﻥ ﺇﻗﺎﻣﺔ ﻭﺇﺩﺍﺭﺓ ﺍﻵﻻﺕ ﺍﳊﺮﺍﺭﻳﺔ ﻭﺍﳌﺮﺍﺟﻞ ﺍﻟﺒﺨﺎﺭﻳﺔ‪:‬‬
‫ﻳﻮﺿﺢ ﺍﻟﻘﺎﻧﻮﻥ ﺍﻻﺷﺘﺮﺍﻃﺎﺕ ﺍﻟﻮﺍﺟﺐ ﺗﻮﺍﻓﺮﻫﺎ ﰲ ﻫﺬﻩ ﺍﻵﻻﺕ ﻭﺍﳌﺮﺍﺟﻞ ﻟﺘﺤﻘﻴﻖ ﺍﻟﺴﻼﻣﺔ ﻟﻠﻌﺎﻣﻠﲔ‪.‬‬

‫‪٢٩٩‬‬
 ‫ﻭﻳﻘﻮﻡ ﺑﺎﻟﺘﻔﺘﻴﺶ ﻋﻠﻰ ﺗﻨﻔﻴﺬ ﻫﺬﺍ ﺍﻟﻘﺎﻧﻮﻥ ﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﺍﻟﺘﺎﺑﻊ ﻟﻮﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ‪.‬‬
‫‪ -٨‬ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٤‬ﻟﺴﻨﺔ ‪ ١٩٩٤‬ﺑﺸﺄﻥ ﲪﺎﻳﺔ ﺍﻟﺒﻴﺌﺔ ﻭﻻﺋﺤﺘﻪ ﺍﻟﺘﻨﻔﻴﺬﻳﺔ ﺍﻟﺼﺎﺩﺭﺓ‬
‫ﺑﻘﺮﺍﺭ ﺭﺋﻴﺲ ﳎﻠﺲ ﺍﻟﻮﺯﺭﺍﺀ ﺭﻗﻢ ‪ ٣٣٨‬ﻟﺴﻨﺔ ‪:١٩٩٥‬‬
‫ﻳﻨﺺ ﺍﻟﻘﺎﻧﻮﻥ ﰲ ﻣﺎﺩﺗﻪ ﺍﻷﻭﱃ ﻋﻠﻰ ﺃﻥ ﻳﻌﻤﻞ ﺑﺄﺣﻜﺎﻣﻪ ﻣﻊ ﻣﺮﺍﻋﺎﺓ ﺍﻟﻘﻮﺍﻋﺪ ﻭﺍﻷﺣﻜﺎﻡ ﺍﻟﻮﺍﺭﺩﺓ ﰲ‬
‫ﺍﻟﻘﻮﺍﻧﲔ ﺍﳋﺎﺻﺔ‪ ،‬ﻭﰲ ﺍﳌﺎﺩﺓ ﺍﻟﺜﺎﻧﻴﺔ ﺃﻭﻛﻞ ﺇﱃ ﺍﻟﻮﺯﺭﺍﺀ‪ ،‬ﻛﻞ ﻓﻴﻤﺎ ﳜﺼﻪ‪ ،‬ﺇﺻﺪﺍﺭ ﺍﳌﻌﺪﻻﺕ ﻭﺍﻟﻨﺴﺐ‬
‫ﺍﻟﻼﺯﻣﺔ ﻟﺘﻨﻔﻴﺬ ﺃﺣﻜﺎﻡ ﺍﻟﺒﺎﺏ ﺍﻟﺜﺎﱐ ﻣﻦ ﺍﻟﻘﺎﻧﻮﻥ‪.‬‬
‫ﻭﺗﺘﻨﺎﻭﻝ ﻣﻌﻈﻢ ﻣﻮﺍﺩ ﺍﻟﻘﺎﻧﻮﻥ ﺍﻷﻣﻮﺭ ﺍﻟﱵ ﺗﻀﻤﻦ ﻋﺪﻡ ﺗﻠﻮﺙ ﺍﻟﺒﻴﺌﺔ ﺍﳋﺎﺭﺟﻴﺔ‪ .‬ﻭﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺒﻴﺌﺔ‬
‫ﺍﻟﻌﻤﻞ ﻓﻬﻨﺎﻙ ﺑﻌﺾ ﺍﳌﻮﺍﺩ ﺍﻟﱵ ﺗﻨﺎﻭﻟﺖ ﻫﺬﺍ ﺍﳉﺎﻧﺐ‪:‬‬
‫ﻣﺎﺩﺓ ‪ :٣٨‬ﺗﺘﻨﺎﻭﻝ ﺍﻟﺸﺮﻭﻁ ﻭﺍﻟﻀﻮﺍﺑﻂ ﻭﺍﻟﻀﻤﺎﻧﺎﺕ ‪ -‬ﻋﻨﺪ ﺍﺳﺘﺨﺪﺍﻡ ﻣﺒﻴﺪﺍﺕ ﺍﻵﻓﺎﺕ ﺃﻭ ﺃﻱ ﻣﺮﻛﺒﺎﺕ‬
‫ﻛﻴﻤﻴﺎﺋﻴﺔ ﺃﺧﺮﻯ ﻷﻱ ﻏﺮﺽ – ﺍﻟﱵ ﺗﻜﻔﻞ ﻋﺪﻡ ﺗﻌﺮﺽ ﺍﻹﻧﺴﺎﻥ ﺃﻭ ﺍﳊﻴﻮﺍﻥ ﺃﻭ ﺍﻟﻨﺒﺎﺕ ﺃﻭ ﳎﺎﺭﻯ ﺍﳌﻴﺎﻩ‪.‬‬
‫ﻣﺎﺩﺓ ‪ :٤٠‬ﻋﻨﺪ ﺣﺮﻕ ﺍﻟﻮﻗﻮﺩ ﳚﺐ ﺃﻥ ﺗﻜﻮﻥ ﺍﳌﻠﻮﺛﺎﺕ ﺍﻟﻨﺎﲡﺔ ﰲ ﺍﳊﺪﻭﺩ ﺍﳌﺴﻤﻮﺡ ‪‬ﺎ‪.‬‬
‫ﻣﺎﺩﺓ ‪ :٤٢‬ﺗﻨﺺ ﻋﻠﻰ ﻋﺪﻡ ﲡﺎﻭﺯ ﺷﺪﺓ ﺍﻟﺼﻮﺕ ﺍﻟﻨﺎﺗﺞ ﻣﻦ ﻣﻌﺪﺍﺕ ﺍﻹﻧﺘﺎﺝ ﺍﳊﺪﻭﺩ ﺍﳌﺴﻤﻮﺡ ‪‬ﺎ‪.‬‬
‫ﻣﺎﺩﺓ ‪ :٤٣‬ﻋﻠﻰ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ ﺍﲣﺎﺫ ﺍﻻﺣﺘﻴﺎﻃﺎﺕ ﻟﻌﺪﻡ ﺗﺴﺮﺏ ﺃﻭ ﺍﻧﺒﻌﺎﺙ ﻣﻠﻮﺛﺎﺕ ﺍﳍﻮﺍﺀ ﺩﺍﺧﻞ ﻣﻜﺎﻥ‬
‫ﺍﻟﻌﻤﻞ ﺇﻻ ﰲ ﺍﳊﺪﻭﺩ ﺍﳌﺴﻤﻮﺡ ‪‬ﺎ ﻭﺃﻥ ﻳﻮﻓﺮ ﺳﺒﻞ ﺍﳊﻤﺎﻳﺔ ﻟﻠﻌﺎﻣﻠﲔ ﺗﻨﻔﻴﺬﺍ ﻟﺸﺮﻭﻁ‬
‫ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪.‬‬
‫ﻣﺎﺩﺓ ‪ :٤٤‬ﺪﻑ ﺇﱃ ﺍﶈﺎﻓﻈﺔ ﻋﻠﻰ ﺩﺭﺟﱵ ﺍﳊﺮﺍﺭﺓ ﻭﺍﻟﺮﻃﻮﺑﺔ ﺩﺍﺧﻞ ﻣﻜﺎﻥ ﺍﻟﻌﻤﻞ ﰲ ﺍﳊﺪﻭﺩ ﺍﳌﺴﻤﻮﺡ‬
‫‪‬ﺎ‪.‬‬
‫ﻣﺎﺩﺓ ‪ :٤٥‬ﺗﺘﻨﺎﻭﻝ ‪‬ﻮﻳﺔ ﺍﻷﻣﺎﻛﻦ ﺍﳌﻐﻠﻘﺔ ﻭﺷﺒﻪ ﺍﳌﻐﻠﻘﺔ‪.‬‬
‫ﻣﺎﺩﺓ ‪ :٤٦‬ﻣﻨﻊ ﺍﻟﺘﺪﺧﲔ ﰲ ﺍﻷﻣﺎﻛﻦ ﺍﳌﻐﻠﻘﺔ‪.‬‬
‫ﻣﺎﺩﺓ ‪ :٤٧‬ﲢﺪﻳﺪ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﺘﻌﺮﺽ ﻟﻠﻨﺸﺎﻁ ﺍﻹﺷﻌﺎﻋﻲ‪.‬‬
‫ﻭﻗﺪ ﺍﺣﺘﻮﺕ ﺍﻟﻼﺋﺤﺔ ﺍﻟﺘﻨﻔﻴﺬﻳﺔ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﳌﺴﻤﻮﺡ ‪‬ﺎ ﻟﻠﻮﻃﺄﺓ ﺍﳊﺮﺍﺭﻳﺔ ﻭﺍﻟﻀﻮﺿﺎﺀ ﻭﺍﳌﻠﻮﺛﺎﺕ‬
‫ﰲ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ‪.‬‬

‫ﺍﳉﻬﺎﺕ ﻭﺍﳍﻴﺌﺎﺕ ﺍﳌﻌﻨﻴﺔ ﺑﺘﻨﻔﻴﺬ ﻭﻣﺮﺍﻗﺒﺔ ﺗﺸﺮﻳﻌﺎﺕ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ‬

‫ﺍﳌﻬﻨﻴﺔ‬
‫‪ .١‬ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﳍﺠﺮﺓ ﻭﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﺍﶈﺎﻓﻈﺎﺕ‪:‬‬
‫ﻭﺗﻘﻮﻡ ﲟﺮﺍﻗﺒﺔ ﺗﻨﻔﻴﺬ ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﻭﻗﺎﻧﻮﻥ ﺗﺸﻐﻴﻞ ﺍﻟﻌﺎﻣﻠﲔ ﺑﺎﳌﻨﺎﺟﻢ ﻭﺍﶈﺎﺟﺮ ﻭﺍﻟﺘﻔﺘﻴﺶ ﺍﻟﺪﻭﺭﻱ ﻋﻠﻰ‬
‫ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ‪ .‬ﻛﻤﺎ ﻳﻘﻮﻡ ﻣﻔﺘﺸﻮ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺃﻳﻀﺎ ﲟﺮﺍﻗﺒﺔ ﺗﻨﻔﻴﺬ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ‬
‫ﺍﻷﺧﺮﻯ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻣﺜﻞ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٤٥٣‬ﻟﺴﻨﺔ‪ ١٩٥٤‬ﻭﺍﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ‬
‫ﺭﻗﻢ ‪ ٩٩١‬ﻟﺴﻨﺔ ‪ ١٩٧٦‬ﻭﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻹﺳﻜﺎﻥ ﺭﻗﻢ ‪ ٣٨٠‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﻭﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٥٥‬ﻟﺴﻨﺔ ‪.١٩٧٧‬‬
‫ﻭﻳﺮﺍﻗﺐ ﻣﻔﺘﺸﻮ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻛﺬﻟﻚ ﺃﻋﻤﺎﻝ ﳉﺎﻥ ﻭﺃﺟﻬﺰﺓ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﰲ‬
‫ﺍﳌﻨﺸﺂﺕ‪.‬‬

‫‪٣٠٠‬‬
‫ﻭﻳﺘﺒﻊ ﻭﺯﻳﺮ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﳍﺠﺮﺓ ﺍﳌﺮﻛﺰ ﺍﻟﻘﻮﻣﻲ ﻟﺪﺭﺍﺳﺎﺕ ﺍﻷﻣﻦ ﺍﻟﺼﻨﺎﻋﻲ ﺍﳌﻨﺸﺄ ﺑﺎﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ‬
‫ﺭﻗﻢ ‪ ٩٣٢‬ﻟﺴﻨﺔ ‪ .١٩٦٩‬ﻭﳜﺘﺺ ﺍﳌﺮﻛﺰ ﺑﺎﻟﺪﺭﺍﺳﺎﺕ ﻭﺍﻟﺒﺤﻮﺙ ﻭﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻴﺪﺍﻧﻴﺔ ﻭﺍﻟﺘﺪﺭﻳﺐ‪.‬‬
‫ﻭﻳﺮﺃﺱ ﻭﺯﻳﺮ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺍ‪‬ﻠﺲ ﺍﻻﺳﺘﺸﺎﺭﻱ ﺍﻷﻋﻠﻰ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺍﳌﻨﺸﺄ – ﺗﻄﺒﻴﻘﺎ‬
‫ﻟﻘﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ – ﺑﺎﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ ﺭﻗﻢ ‪ ١١٤‬ﻟﺴﻨﺔ ‪ .١٩٨٤‬ﻭﳜﺘﺺ ﺍ‪‬ﻠﺲ ﺑﺎﻟﺘﻨﺴﻴﻖ ﺑﲔ ﺍﻟﻮﺯﺍﺭﺍﺕ‬
‫ﻭﺍﳍﻴﺌﺎﺕ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﳎﺎﻝ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪ .‬ﻛﺬﻟﻚ ﻧﺺ ﺍﻟﻘﺎﻧﻮﻥ ﻋﻠﻰ ﺇﻧﺸﺎﺀ ﳎﺎﻟﺲ‬
‫ﺍﺳﺘﺸﺎﺭﻳﺔ ﻣﺸﺘﺮﻛﺔ ﰲ ﺍﶈﺎﻓﻈﺎﺕ‪.‬‬
‫‪ .٢‬ﻭﺯﺍﺭﺓ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ – ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪:‬‬
‫ﻭﺗﻘﻮﻡ ﺑﺘﻨﻔﻴﺬ ﻗﺎﻧﻮﻥ ﺍﻟﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺭﻗﻢ ‪ ٧٩‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﻭﺗﻌﺪﻳﻼﺗﻪ ﻓﻴﻤﺎ ﳜﺘﺺ ﺑﺘﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ‬
‫ﺍﻟﻌﻤﻞ ﻭﺍﻟﻌﻼﺝ ﻭﺍﻟﺘﺄﻫﻴﻞ ﻭﺍﻟﺘﻌﻮﻳﺾ ﻋﻦ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ‪.‬‬
‫ﻭﺗﺘﻮﱃ ﺍﳍﻴﺌﺔ ﺃﺳﺎﺳﺎ ﺍﳉﻮﺍﻧﺐ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﳊﻘﻮﻕ ﺍﳌﺎﺩﻳﺔ ﻭﺗﺘﻮﱃ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‬
‫ﺍﻟﻨﻮﺍﺣﻲ ﺍﻟﻄﺒﻴﺔ‪.‬‬
‫‪ .٣‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪:‬‬
‫ﺗﻘﻮﻡ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻭﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﺑﺒﺤﺚ ﺷﻜﺎﻭﻯ ﺍﳌﻨﺸﺂﺕ‬
‫ﻭﺍﳌﻮﺍﻃﻨﲔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺄﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ ﻭﻋﻤﻞ ﺍﻟﺒﺤﻮﺙ ﺍﳌﻴﺪﺍﻧﻴﺔ ﻭﺇﻋﻄﺎﺀ ﺍﻟﺘﻮﺻﻴﺎﺕ ﻭﺗﺪﺭﻳﺐ ﺍﻟﻜﻮﺍﺩﺭ‬
‫ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪.‬‬
‫ﻛﻤﺎ ﻳﻘﻮﻡ ﻣﺮﻛﺰ ﺍﻟﺮﺻﺪ ﺍﻟﺒﻴﺌﻲ ﻭﺩﺭﺍﺳﺎﺕ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ﺍﳌﻨﺸﺄ ﺑﻘﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺭﻗﻢ ‪ ٤٩‬ﻟﺴﻨﺔ ‪١٩٩٠‬‬
‫ﺑﺈﺟﺮﺍﺀ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﳌﻴﺪﺍﻧﻴﺔ ﻭﲝﺚ ﻣﺸﻜﻼﺕ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﻭﻳﺸﺮﻑ ﺍﳌﻜﺘﺐ ﺍﻟﺘﻨﻔﻴﺬﻱ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻹﺷﻌﺎﻋﺎﺕ ﺍﳌﺆﻳﻨﺔ ﻋﻠﻰ ﺗﻨﻔﻴﺬ ﺍﻟﻘﺮﺍﺭ ﺭﻗﻢ ‪ ٥٩‬ﻟﺴﻨﺔ ‪.١٩٦٠‬‬
‫ﻭﻳﺸﺮﻑ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻋﻠﻰ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻟﱵ ﲣﺘﺺ ﲟﺎ ﻳﺄﰐ‪:‬‬
‫‪ -‬ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻻﺑﺘﺪﺍﺋﻲ ﻟﻠﻌﺎﻣﻠﲔ ﺑﺎﻟﺪﻭﻟﺔ ﻭﺗﻄﺒﻴﻖ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﻠﻴﺎﻗﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻮﺍﺭﺩﺓ ﺑﻘﺮﺍﺭ‬
‫ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺭﻗﻢ ‪ ١٣٣‬ﻟﺴﻨﺔ ‪.١٩٨٣‬‬
‫‪ -‬ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻟﻠﻌﺎﻣﻠﲔ ﺍﳌﻌﺮﺿﲔ ﻟﻠﻤﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ ﺍﻟﻮﺍﺭﺩﺓ ﰲ ﺟﺪﻭﻝ ﺃﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ‬
‫ﺍﳌﻠﺤﻖ ﺑﻘﺎﻧﻮﻥ ﺍﻟﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ‪.‬‬
‫‪ -‬ﺍﻟﺘﺸﺨﻴﺺ ﻭﺍﻟﻌﻼﺝ ﻭﺍﻟﺘﺄﻫﻴﻞ ﻭﺗﻘﺪﻳﺮ ﻧﺴﺐ ﺍﻟﻌﺠﺰ ﻟﻺﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‪.‬‬
‫‪ -‬ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻠﻌﺎﻣﻠﲔ‪ .‬ﻭﺍﳍﻴﺌﺔ ﻣﺮﺧﺺ ﳍﺎ ﺑﺄﺩﺍﺀ ﺧﺪﻣﺎﺕ ﻃﺒﻴﺔ ﺑﺄﺟﺮ‬
‫ﲟﻘﺘﻀﻰ ﻗﺮﺍﺭ ﺭﺋﻴﺲ ﺍﳉﻤﻬﻮﺭﻳﺔ ﺭﻗﻢ ‪ ٢٣٢٣‬ﻟﺴﻨﺔ ‪.١٩٦٧‬‬
‫‪ .٤‬ﻭﺯﺍﺭﺓ ﺍﻹﺳﻜﺎﻥ ﻭﺍﳌﺮﺍﻓﻖ‪:‬‬
‫ﻭﺗﻘﻮﻡ – ﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ﻭﺯﺍﺭﺍﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﳊﻜﻢ ﺍﶈﻠﻰ – ﺑﺘﻨﻔﻴﺬ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ‬
‫‪ ٤٥٣‬ﻟﺴﻨﺔ ‪ ١٩٥٤‬ﺑﺸﺄﻥ ﺍﻟﺘﺮﺧﻴﺺ ﺑﺈﻧﺸﺎﺀ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﺼﻨﺎﻋﻴﺔ ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﻷﺧﺮﻯ ﺍﳌﺘﻌﻠﻘﺔ‬
‫ﺑﺎﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪.‬‬

‫‪٣٠١‬‬
 ‫‪ .٥‬ﻭﺯﺍﺭﺓ ﺍﻟﺰﺭﺍﻋﺔ‪:‬‬
‫ﺗﺸﺎﺭﻙ ﻣﻌﻬﺎ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰲ ﺍﻟﻠﺠﻨﺔ ﺍﻟﻌﻠﻴﺎ ﻟﻠﻤﺒﻴﺪﺍﺕ ﻭﺍﻟﱵ ‪‬ﺘﻢ ﺑﺪﺭﺍﺳﺔ ﲰﻴﺔ ﺍﳌﺒﻴﺪﺍﺕ‬
‫ﻭﺍﻟﺘﺄﻛﺪ ﻗﺒﻞ ﺍﻟﺘﺼﺮﻳﺢ ﺑﺎﺳﺘﻌﻤﺎﳍﺎ ﰲ ﺍﻟﺒﻼﺩ ﻣﻦ ﺃﻥ ﺗﺄﺛﲑﻫﺎ ﻋﻠﻰ ﺻﺤﺔ ﺍﻟﻌﺎﻣﻠﲔ ﻭﺍﳉﻤﻬﻮﺭ ﰲ ﺍﳊﺪﻭﺩ‬
‫ﺍﳌﻘﺒﻮﻟﺔ‪.‬‬
‫ﻭﺗﺸﺘﺮﻙ ﻣﻊ ﻭﺯﺍﺭﺍﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﺍﻟﺘﻮﻋﻴﺔ ﺑﺸﺄﻥ ﺍﻟﺘﺪﺍﻭﻝ ﺍﻟﺴﻠﻴﻢ ﻟﻠﻤﺒﻴﺪﺍﺕ‪.‬‬
‫‪ .٦‬ﻭﺯﺍﺭﺓ ﺍﻟﺼﻨﺎﻋﺔ‪:‬‬
‫ﺗﺸﺘﺮﻙ ﻣﻊ ﻭﺯﺍﺭﺍﺕ ﺃﺧﺮﻯ ﻣﻨﻬﺎ ﻭﺯﺍﺭﺍﺕ ﺍﻹﺳﻜﺎﻥ ﻭﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﺍﻹﺷﺮﺍﻑ ﻋﻠﻰ ﺗﻨﻔﻴﺬ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ‬
‫‪ ٥٥‬ﻟﺴﻨﺔ ‪ ١٩٧٨‬ﺑﺸﺄﻥ ﺍﻵﻻﺕ ﺍﳊﺮﺍﺭﻳﺔ ﻭﺍﳌﺮﺍﺟﻞ ﺍﻟﺒﺨﺎﺭﻳﺔ ﻭﻛﺬﻟﻚ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٢٧‬ﻟﺴﻨﺔ ‪ ١٩٨١‬ﺑﺸﺄﻥ‬
‫ﺗﺸﻐﻴﻞ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳌﻨﺎﺟﻢ ﻭﺍﶈﺎﺟﺮ‪.‬‬
‫‪ .٧‬ﻭﺯﺍﺭﺓ ﺍﻟﺪﻭﻟﺔ ﻟﺸﺌﻮﻥ ﺍﻟﺒﻴﺌﺔ ﻭﺟﻬﺎﺯ ﺷﺌﻮﻥ ﺍﻟﺒﻴﺌﺔ ﺑﺮﺋﺎﺳﺔ ﳎﻠﺲ ﺍﻟﻮﺯﺭﺍﺀ‪:‬‬
‫ﺗﻘﻮﻡ ﺑﺘﻨﻔﻴﺬ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٤‬ﻟﺴﻨﺔ ‪ ١٩٩٤‬ﺑﺸﺄﻥ ﲪﺎﻳﺔ ﺍﻟﺒﻴﺌﺔ‪.‬‬
‫‪ .٨‬ﻭﺯﺍﺭﺓ ﺍﻟﺪﺍﺧﻠﻴﺔ‪:‬‬
‫ﺗﺴﺎﻫﻢ ﺍﻟﻮﺯﺍﺭﺓ ﺑﺄﺟﻬﺰ‪‬ﺎ ﺍﳌﺨﺘﻠﻔﺔ ﰲ ﺗﻨﻔﻴﺬ ﻛﺎﻓﺔ ﺍﻟﻘﻮﺍﻧﲔ‪.‬‬
‫ﻭﺗﻘﻮﻡ ﻣﺼﻠﺤﺔ ﺍﻟﺪﻓﺎﻉ ﺍﳌﺪﱐ ﺑﺘﻨﻔﻴﺬ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ١٠٧‬ﻟﺴﻨﺔ ‪ ١٩٨٢‬ﺑﺸﺄﻥ ﺃﺟﻬﺰﺓ ﺍﻟﺪﻓﺎﻉ ﺍﳌﺪﱐ ﰲ‬
‫ﺍﳌﻨﺸﺂﺕ ﺍﻟﺼﻨﺎﻋﻴﺔ‪.‬‬
‫‪ .٩‬ﺃﺟﻬﺰﺓ ﻣﻌﺎﻭﻧﺔ‪:‬‬
‫ﺗﻌﺎﻭﻥ ﰲ ﲢﻘﻴﻖ ﺃﻫﺪﺍﻑ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺍﳉﻬﺎﺕ ﺍﻵﺗﻴﺔ‪:‬‬
‫ﺍﳉﺎﻣﻌﺎﺕ ﻭﺍﳌﺮﺍﻛﺰ ﺍﻟﺒﺤﺜﻴﺔ ﻭﺍﳌﻌﺎﻫﺪ ﺍﻟﻌﻠﻤﻴﺔ‪.‬‬ ‫
‬
‫ﺍﻻﲢﺎﺩ ﺍﻟﻌﺎﻡ ﻟﻨﻘﺎﺑﺎﺕ ﻋﻤﺎﻝ ﻣﺼﺮ ﻭﺑﻪ ﺃﻣﺎﻧﺔ ﻣﺘﺨﺼﺼﺔ ﻟﻸﻣﻦ ﺍﻟﺼﻨﺎﻋﻲ ﻭﻳﺘﺒﻌﻪ‪:‬‬ ‫
‬
‫ﺍﳉﺎﻣﻌﺔ ﺍﻟﻌﻤﺎﻟﻴﺔ ﺑﺸﻌﺒﻬﺎ ﺍﳌﺨﺘﻠﻔﺔ ﻭﻣﻨﻬﺎ ﺷﻌﺒﺔ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‬ ‫‪-‬‬
‫ﺍﳌﺆﺳﺴﺔ ﺍﻟﺜﻘﺎﻓﻴﺔ ﺍﻟﻌﻤﺎﻟﻴﺔ ﻭﻳﺘﺒﻌﻬﺎ ﻣﻌﻬﺪ ﺍﻷﻣﻦ ﺍﻟﺼﻨﺎﻋﻲ ﺍﻟﺬﻱ ﻳﻘﻮﻡ ﺑﺘﺪﺭﻳﺐ‬ ‫‪-‬‬
‫ﺍﻷﺧﺼﺎﺋﻴﲔ ﻭﺍﻟﻔﻨﻴﲔ ﻭﺃﻋﻀﺎﺀ ﳉﺎﻥ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﺎﳌﻨﺸﺂﺕ‪ ،‬ﻭﻫﻮﺍﳉﻬﺔ‬
‫ﺍﳌﻌﺘﻤﺪﺓ ﻣﻦ ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻟﻠﻘﻴﺎﻡ ‪‬ﺬﺍ ﺍﻟﺘﺪﺭﻳﺐ‪.‬‬
‫‪ .١٠‬ﻭﻟﺒﻌﺾ ﺍﻟﻮﺯﺍﺭﺍﺕ ﺍﻷﺧﺮﻯ ﺃﻧﺸﻄﺔ ﳍﺎ ﺍﻧﻌﻜﺎﺳﺎﺕ ﺇﳚﺎﺑﻴﺔ ﻋﻠﻰ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ‬
‫ﺍﳌﻬﻨﻴﺔ ﻣﻨﻬﺎ ﻭﺯﺍﺭﺍﺕ ﺍﻟﺘﻌﻠﻴﻢ ﻭﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻌﺎﱄ ﻭﺍﻟﺒﺤﺚ ﺍﻟﻌﻠﻤﻲ – ﺃﻛﺎﺩﳝﻴﺔ ﺍﻟﺒﺤﺚ ﺍﻟﻌﻠﻤﻲ‬
‫ﻭﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ – ﻭﻭﺯﺍﺭﺓ ﺍﻹﻋﻼﻡ‪.‬‬

‫‪٣٠٢‬‬
 ‫&(' &‪!"#"    $ %‬‬
‫ﺍﳉﺪﻭﻻﻥ ﺭﻗﻢ ‪١‬ﻭ‪ ٢‬ﻳﻮﺿﺤﺎﻥ ﺗﻮﺯﻳﻊ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ ﺳﻦ ‪ ١٥‬ﺳﻨﺔ ﻓﺄﻛﺜﺮ ﺣﺴﺐ ﺍﻟﻨﺸﺎﻁ ﺍﻻﻗﺘﺼﺎﺩﻱ‬
‫ﻭﺍﳌﻬﻨﺔ ﻭﺍﻟﻨﻮﻉ ﰲ ﺭﻳﻒ ﻭﺣﻀﺮ ﲨﻬﻮﺭﻳﺔ ﻣﺼﺮ ﺍﻟﻌﺮﺑﻴﺔ ﻃﺒﻘﺎ ﻟﻨﺘﺎﺋﺞ ﺗﻌﺪﺍﺩ ﺳﻨﺔ ‪.(٧)١٩٩٦‬‬
‫ﻳﺒﲔ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ١‬ﺃﻥ ﻣﻦ ﳎﻤﻮﻉ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ ﺳﻦ ‪ ١٥‬ﺳﻨﺔ ﻓﺄﻛﺜﺮ – ﻭﻋﺪﺩﻫﻢ ﺣﻮﺍﱄ ‪ ١٥،٨‬ﻣﻠﻴﻮﻥ‬
‫ﻋﺎﻣﻞ – ﻓﺈﻥ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳌﻬﻦ ﺍﻟﺰﺭﺍﻋﻴﺔ ﳝﺜﻠﻮﻥ ﺣﻮﺍﱄ ‪ ٤،٩‬ﻣﻠﻴﻮﻥ ﻋﺎﻣﻞ ﺃﻱ ‪ %٣١‬ﻭﺫﻟﻚ ﻣﻊ ﺍﻷﺧﺬ ﰲ‬
‫ﺍﻻﻋﺘﺒﺎﺭ ﺃﻥ ﻋﻤﺎﻟﺔ ﺍﻷﻃﻔﺎﻝ ﲢﺖ ﺳﻦ ‪ ١٥‬ﺳﻨﺔ ﺃﻛﺜﺮ ﺑﺪﺭﺟﺔ ﻛﺒﲑﺓ ﰲ ﺍﻷﻋﻤﺎﻝ ﺍﻟﺰﺭﺍﻋﻴﺔ ﻣﻨﻬﺎ ﰲ ﺍﳌﻬﻦ‬
‫ﺍﻷﺧﺮﻯ‪.‬‬
‫ﻭﲣﺘﻠﻒ ﺩﺭﺟﺔ ﺍﻟﺘﻌﺮﺽ ﻟﻠﻤﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ – ﻭﺧﺎﺻﺔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ – ﻛﻤﺎ ﻳﺘﺒﲔ ﺫﻟﻚ ﻣﻦ ﺣﺴﺎﺑﺎﺕ‬
‫ﻣﻌﺪﻝ ﺍﻟﺘﻜﺮﺍﺭ ﻭﻣﻌﺪﻝ ﺍﻟﺸﺪﺓ ﻟﻺﺻﺎﺑﺎﺕ ﰲ ﺍﳌﻬﻦ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫)ﻣﻌﺪﻝ ﺗﻜﺮﺍﺭ ﺍﳊﻮﺍﺩﺙ = ﻋﺪﺩ ﺍﻹﺻﺎﺑﺎﺕ ﺧﻼﻝ ﻋﺎﻡ × ﻣﻠﻴﻮﻥ ÷ ﻋﺪﺩ ﺍﻟﺴﺎﻋﺎﺕ ﺍﻟﱵ ﻋﻤﻠﻬﺎ ﲨﻴﻊ‬
‫ﺍﻟﻌﺎﻣﻠﲔ ﺧﻼﻝ ﻧﻔﺲ ﺍﻟﻔﺘﺮﺓ ﺍﻟﺰﻣﻨﻴﺔ(‪.‬‬
‫)ﻣﻌﺪﻝ ﺷﺪﺓ ﺍﳊﻮﺍﺩﺙ = ﻋﺪﺩ ﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﺧﻼﻝ ﻋﺎﻡ × ‪ ÷ ١٠٠٠‬ﻋﺪﺩ ﺍﻟﺴﺎﻋﺎﺕ ﺍﻟﱵ ﻋﻤﻠﻬﺎ ﲨﻴﻊ‬
‫ﺍﻟﻌﺎﻣﻠﲔ ﺧﻼﻝ ﻧﻔﺲ ﺍﻟﻔﺘﺮﺓ(‪.‬‬
‫ﻭﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٣‬ﻣﻌﺪﻝ ﺗﻜﺮﺍﺭ ﻭﺷﺪﺓ ﺍﳊﻮﺍﺩﺙ ﰲ ﺑﻌﺾ ﺍﻷﻧﺸﻄﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻣﻦ ﻭﺍﻗﻊ ﻧﺘﺎﺋﺞ‬
‫ﺩﺭﺍﺳﺔ ﺃﺟﺮﻳﺖ ﺑﻮﺍﺳﻄﺔ ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﰲ ﺳﻨﺔ ‪ ١٩٩١‬ﰲ ﺍﳌﻨﺸﺂﺕ ﺍﻟﱵ ﻳﻌﻤﻞ ‪‬ﺎ ‪ ٥٠‬ﻋﺎﻣﻼ‬
‫ﻓﺄﻛﺜﺮ ) ﺟﺪﻭﻝ ﺭﻗﻢ ‪.(١٠‬‬
‫ﻭﻳﺘﺒﲔ ﻣﻦ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٣‬ﺃﻥ ﺃﻋﻠﻰ ﻣﻌﺪﻝ ﻟﺘﻜﺮﺍﺭ ﺍﳊﻮﺍﺩﺙ ﰲ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺘﺤﻮﻳﻠﻴﺔ ﺗﻠﻴﻬﺎ ﺻﻨﺎﻋﺔ‬
‫ﺍﻟﺘﻌﺪﻳﻦ ﻓﺼﻨﺎﻋﺔ ﺍﻟﺒﻨﺎﺀ ﻭﺍﻹﻧﺸﺎﺀﺍﺕ‪ ،‬ﻓﻤﻬﻦ ﺍﻟﺘﺠﺎﺭﺓ ﻭﺍﻟﻔﻨﺎﺩﻕ ﻭﺍﳌﻄﺎﻋﻢ‪ ،‬ﰒ ﺍﻷﻋﻤﺎﻝ ﺍﻟﺰﺭﺍﻋﻴﺔ‪ ،‬ﰲ ﺣﲔ‬
‫ﺃﻥ ﻣﻌﺪﻝ ﺷﺪﺓ ﺍﳊﻮﺍﺩﺙ ﺃﻋﻠﻰ ﰲ ﺻﻨﺎﻋﺔ ﺍﻟﺘﻌﺪﻳﻦ ﰒ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺘﺤﻮﻳﻠﻴﺔ ﰒ ﺍﻟﺒﻨﺎﺀ ﻭﺍﻹﻧﺸﺎﺀﺍﺕ ﻭﻫﻲ‬
‫ﺍﻷﻗﻞ ﰲ ﺍﳌﻬﻦ ﺍﻟﺰﺭﺍﻋﻴﺔ‪.‬‬
‫ﻭﻳﺒﲔ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٢‬ﺗﻮﺯﻳﻊ ﺍﻟﻌﺎﻣﻠﲔ ﺣﺴﺐ ﺍﳌﻬﻦ ﰲ ﺍﻷﻧﺸﻄﺔ ﺍﳌﺨﺘﻠﻔﺔ ﰲ ﺣﻀﺮ ﻭﺭﻳﻒ ﺍﳉﻤﻬﻮﺭﻳﺔ‬
‫ﻭﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻌﺎﻣﻠﲔ ﰲ ﻛﻞ ﻣﻬﻨﺔ‪ .‬ﻭﻳﺘﻀﺢ ﻣﻦ ﺍﳉﺪﻭﻝ ﺃﻥ ﻋﻤﺎﻝ ﺍﻟﺰﺭﺍﻋﺔ ﻫﻢ ﺍﻷﻛﺜﺮ ﻋﺪﺩﺍ ﻳﻠﻴﻬﻢ‬
‫ﺍﳊﺮﻓﻴﻮﻥ ﰒ ﺍﻟﻌﺎﻣﻠﻮﻥ ﰲ ﺍﳌﻬﻦ ﺍﻷﺧﺮﻯ‪.‬‬

‫ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‬
‫ﺗﻌﺘﱪ ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﳌﺼﺪﺭ ﺍﻷﺳﺎﺳﻲ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﺍﳋﺎﺻﺔ ﲝﺎﻻﺕ‬
‫ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺫﻟﻚ ﻣﻦ ﻭﺍﻗﻊ ﻧﺘﺎﺋﺞ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻟﻠﻌﺎﻣﻠﲔ ﺍﳌﻌﺮﺿﲔ ﻟﻠﻤﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ‬
‫ﺍﳌﺨﺘﻠﻔﺔ‪ .‬ﻭﻻ ﳚﺮﻯ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﳉﻤﻴﻊ ﺍﻟﻌﺎﻣﻠﲔ ﺍﳋﺎﺿﻌﲔ ﻟﺘﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﻟﻜﻦ‬
‫ﳛﺪﺩ ﺍﻟﻔﺌﺎﺕ ﺍﳋﺎﺿﻌﺔ ﻟﻠﻔﺤﺺ ﺟﺪﻭﻝ ﺃﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ ﺍﳌﻠﺤﻖ ﺑﻘﺎﻧﻮﻥ ﺍﻟﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺭﻗﻢ ‪٧٩‬‬
‫ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﻭﺍﻟﺬﻱ ﳛﺪﺩ ﻋﻠﻰ ﺳﺒﻴﻞ ﺍﳊﺼﺮ ‪ ٢٩‬ﺗﻌﺮﺿﺎ ﻣﻬﻨﻴﺎ ﻛﻤﺎ ﲢﺪﺩ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﺃﻳﻀﺎ ﺩﻭﺭﻳﺔ‬
‫ﺍﻟﻔﺤﺺ ﻟﻔﺌﺎﺕ ﺍﻟﻌﺎﻣﻠﲔ ﺍﳌﻌﺮﺿﲔ ﺣﺴﺐ ﻧﻮﻉ ﺍﻟﺘﻌﺮﺽ ﻭﺩﺭﺟﺔ ﺧﻄﻮﺭﺗﻪ‪ .‬ﻭﺗﺘﺮﺍﻭﺡ ﺩﻭﺭﻳﺔ ﺍﻟﻔﺤﺺ ﻣﻦ‬
‫ﺳﺘﺔ ﺷﻬﻮﺭ ﺇﱃ ﺳﻨﺔ ﺇﱃ ﺳﻨﺘﲔ‪ .‬ﻭﳚﺐ ﺃﻥ ﻳﺆﺧﺬ ﰲ ﺍﻻﻋﺘﺒﺎﺭ ﺃﻥ ﻗﻠﻴﻼﹰ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻜﱪﻯ ‪-‬‬

‫‪٣٠٣‬‬
‫ﺑﺎﳌﺨﺎﻟﻔﺔ ﻟﻠﻘﻮﺍﻧﲔ – ﺗﺮﻓﺾ ﺍﻟﺴﻤﺎﺡ ﻷﻃﺒﺎﺀ ﺍﻟﺘﺎﻣﲔ ﺍﻟﺼﺤﻲ ﺑﺈﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﻟﻠﻌﺎﻣﻠﲔ ‪‬ﺎ‪،‬‬
‫ﻭﻫﻨﺎﻙ ﺃﻳﻀﺎ ﺑﻌﺾ ﺍﳌﻨﺸﺂﺕ ﺍﻟﱵ ﺗﺘﻬﺮﺏ ﻷﺳﺒﺎﺏ ﺷﱴ ﻣﻦ ﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ‪ .‬ﻭﻣﻦ ﰒ ﻓﺈﻥ ﺗﻘﺪﻳﺮﺍﺕ‬
‫ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻹﺻﺎﺑﺎﺕ ﻗﺪ ﺗﻜﻮﻥ ﺃﻛﺜﺮ ﳑﺎ ﻳﻈﻬﺮ ﰲ ﺇﺣﺼﺎﺋﻴﺎﺕ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪.‬‬
‫ﻭﻳﺒﲔ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٤‬ﺃﻋﺪﺍﺩ ﺍﻟﻌﻤﺎﻝ ﺍﳌﻨﺘﻔﻌﲔ ﺑﺘﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﻋﺪﺩ ﺍﻟﻌﻤﺎﻝ ﺍﳌﻌﺮﺿﲔ ﻟﻠﻤﺨﺎﻃﺮ‬
‫ﺍﳌﻬﻨﻴﺔ ﰲ ﺍﻟﻔﺮﻭﻉ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻬﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻣﻮﺯﻋﲔ ﺣﺴﺐ ﺩﻭﺭﻳﺔ ﺍﻟﻔﺤﺺ ﰲ‬
‫ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪ ١٩٩٩/١/١‬ﺇﱃ ‪ (٨)٢٠٠٠/١٢/٣١‬ﻭﻳﻼﺣﻆ ﺃﻥ ﻋﺪﺩ ﺍﻟﻌﻤﺎﻝ ﺍﳋﺎﺿﻌﲔ ﻟﻠﻔﺤﺺ ﺍﻟﻄﱯ‬
‫ﺍﻟﺪﻭﺭﻱ ﳝﺜﻞ ‪ %٥,٩‬ﻣﻦ ﺇﲨﺎﱄ ﻋﺪﺩ ﺍﳌﻨﺘﻔﻌﲔ ﻣﻨﻬﻢ ‪ %٢,٩‬ﻳﺘﻢ ﻓﺤﺼﻬﻢ ﻛﻞ ﺳﺘﺔ ﺃﺷﻬﺮ ﻭ‪ %٦٣‬ﻳﺘﻢ‬
‫ﻓﺤﺼﻬﻢ ﻛﻞ ﺳﻨﺔ ﻭ‪ %٣٤,١‬ﻳﺘﻢ ﻓﺤﺼﻬﻢ ﻛﻞ ﺳﻨﺘﲔ‪.‬‬
‫ﻛﻤﺎ ﻳﺒﲔ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٥‬ﺃﻋﺪﺍﺩ ﺍﻟﻌﻤﺎﻝ ﺍﳌﻌﺮﺿﲔ ﻟﻠﻤﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ ﺍﻟﱵ ﻧﺘﺠﺖ ﻋﻨﻬﺎ‬
‫ﺃﻣﺮﺍﺽ ﻣﻬﻨﻴﺔ ﻭﻋﺪﺩ ﺣﺎﻻﺕ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﺍﳌﻜﺘﺸﻔﺔ ﻭﻧﺴﺒﺔ ﺍﻹﺻﺎﺑﺔ ﺑﲔ ﺍﳌﻌﺮﺿﲔ ﻭﺫﻟﻚ ﰲ‬
‫ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪ ١٩٩٩/١/١‬ﺇﱄ ‪.(٨)٢٠٠٠/١٢/٣١‬‬
‫ﻭﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٦‬ﻋﺪﺩ ﺣﺎﻻﺕ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﺍﳌﻜﺘﺸﻔﺔ ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪ ٢٠٠٠/١/١‬ﺇﱄ‬
‫‪ ٢٠٠٠/١٢/٣١‬ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻬﻴﺌﺔ)‪.(٨‬‬
‫ﻭﻳﻼﺣﻆ ﺍﻟﺘﻔﺎﻭﺕ ﺍﻟﻜﺒﲑ ﰲ ﻋﺪﺩ ﺍﳊﺎﻻﺕ ﻭﻧﺴﺐ ﺍﻹﺻﺎﺑﺔ ﻭﺫﻟﻚ ﻧﻈﺮﺍ ﻻﺧﺘﻼﻑ ﻋﺪﺩ ﺍﻟﻌﻤﺎﻝ ﺍﳌﻌﺮﺿﲔ‬
‫ﻭﻃﺒﻴﻌﺔ ﺍﻟﻨﺸﺎﻁ ﺍﳌﻬﲏ ﻭﺍﺧﺘﻼﻑ ﺃﻧﻮﺍﻉ ﺍﻟﺘﻌﺮﺿﺎﺕ ﻭﺷﺪ‪‬ﺎ ﻭﺃﻧﻮﺍﻉ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺑﲔ ﺍﳌﻨﺎﻃﻖ ﺍﳌﺨﺘﻠﻔﺔ‪.‬‬
‫ﻭﻗﺪ ﺗﻜﻮﻥ ﻫﻨﺎﻙ ﺃﺳﺒﺎﺏ ﺃﺧﺮﻯ ﻻﺧﺘﻼﻑ ﻧﺴﺐ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﰲ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ‬
‫ﻭﰲ ﺍﻟﺼﻨﺎﻋﺔ ﺍﻟﻮﺍﺣﺪﺓ ﰲ ﺍﳌﻮﺍﻗﻊ ﺍﳌﺨﺘﻠﻔﺔ‪ .‬ﻭﻗﺪ ﻳﻜﻮﻥ ﻣﻦ ﺍﳌﻔﻴﺪ ﺃﻥ ﺗﻘﻮﻡ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ‬
‫ﺍﻟﺼﺤﻲ ﺑﺎﻻﺷﺘﺮﺍﻙ ﻣﻊ ﺍﳉﺎﻣﻌﺎﺕ ﻭﻣﺮﺍﻛﺰ ﺍﻟﺒﺤﻮﺙ ﺑﺈﺟﺮﺍﺀ ﺩﺭﺍﺳﺎﺕ ﻟﻠﻜﺸﻒ ﻋﻦ ﺃﺳﺒﺎﺏ ﺍﺭﺗﻔﺎﻉ ﻧﺴﺐ‬
‫ﺍﻹﺻﺎﺑﺔ ﰲ ﺍﳌﻮﺍﻗﻊ ﺍﳌﺨﺘﻠﻔﺔ ﳑﺎ ﻳﺴﺎﻋﺪ ﻋﻠﻰ ﲣﻄﻴﻂ ﺍﻷﻧﺸﻄﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻋﻠﻰ ﺃﺳﺎﺱ ﻋﻠﻤﻲ ﺳﻠﻴﻢ‪.‬‬
‫ﻭﻳﺘﺒﲔ ﻣﻦ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٥‬ﺃﻥ ﺃﻋﻠﻰ ﻧﺴﺒﺔ ﺇﺻﺎﺑﺔ ﻫﻲ ﺑﲔ ﺍﳌﻌﺮﺿﲔ ﻟﻐﺒﺎﺭ ﺍﻟﺴﻠﻴﻜﺎ )‪ (%١٣‬ﻛﻤﺎ ﻳﺒﲔ‬
‫ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٦‬ﺃﻥ ﻧﺴﺒﺔ ﺍﻹﺻﺎﺑﺔ ﲟﺮﺽ ﺍﻟﺴﻠﻴﻜﻮﺯﺱ ﺑﲔ ﺍﳌﻌﺮﺿﲔ ﲣﺘﻠﻒ ﻣﻦ ﻣﻨﻄﻘﺔ ﺇﱄ ﺃﺧﺮﻯ ﻓﻬﻲ‬
‫ﺗﺘﺮﺍﻭﺡ ﻣﻦ ‪ %١٤,٤‬ﰲ ﻭﺳﻂ ﻭﺟﻨﻮﺏ ﺍﻟﺼﻌﻴﺪ ﺇﱄ ‪ %١٢‬ﰲ ﻣﻨﻄﻘﺔ ﺍﻟﻘﻨﺎﻝ ﺇﱄ ‪ %١٠,٣‬ﰲ ﺷﺮﻕ ﺍﻟﺪﻟﺘﺎ ﺇﱄ‬
‫‪ %٧,٤‬ﰲ ﴰﺎﻝ ﻏﺮﺏ ﺍﻟﺪﻟﺘﺎ ﺇﱄ ‪ %٧,١‬ﰲ ﴰﺎﻝ ﺍﻟﺼﻌﻴﺪ ﺇﱄ ‪ %٠,٤٩‬ﰲ ﺍﻟﻘﺎﻫﺮﺓ‪.‬‬
‫ﻭﺗﺒﻠﻎ ﻧﺴﺒﺔ ﺍﻹﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﻟﱵ ﺗﻨﺸﺄ ﻋﻦ ﺍﻟﺘﻌﺮﺽ ﻟﻠﻬﺮﻣﻮﻧﺎﺕ ﺑﲔ ﺍﳌﻌﺮﺿﲔ ﳍﺎ ‪ %٣,٨‬ﻭﺇﻥ ﻛﺎﻥ‬
‫ﻋﺪﺩ ﺍﳌﻌﺮﺿﲔ ﳍﺎ ﺃﻗﻞ ﻛﺜﲑﺍ ﻣﻦ ﺍﳌﻌﺮﺿﲔ ﻟﻠﺘﻌﺮﺿﺎﺕ ﺍﻷﺧﺮﻯ ﻭﻳﺘﺮﻛﺰ ﺍﻟﺘﻌﺮﺽ ﰲ ﻣﻨﻄﻘﺔ ﻭﺍﺣﺪﺓ‬
‫ﻫﻲ ﴰﺎﻝ ﺍﻟﺼﻌﻴﺪ )ﺻﻨﺎﻋﺔ ﺍﻷﺩﻭﻳﺔ( )ﺟﺪﻭﻝ ‪ .(٥‬ﻭﻛﺬﻟﻚ ﺗﺒﻠﻎ ﻧﺴﺒﺔ ﺍﻹﺻﺎﺑﺔ ﺑﺎﻟﺼﻤﻢ ﺍﳌﻬﲏ ﺑﲔ‬
‫ﺍﳌﻌﺮﺿﲔ ﻟﻠﻀﻮﺿﺎﺀ ‪ %١,٤‬ﻣﻦ ﺇﲨﺎﱄ ﻋﺪﺩ ﺍﳌﻌﺮﺿﲔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳉﻤﻬﻮﺭﻳﺔ )ﺟﺪﻭﻝ ﺭﻗﻢ ‪.(٥‬‬
‫ﻭﺍﳊﺎﻻﺕ ﺍﻟﻮﺍﺭﺩﺓ ﰲ ﺟﺪﻭﱄ ﺭﻗﻢ ‪ ٥‬ﻭ‪ ٦‬ﲢﺖ "ﺍﻟﺘﺴﻤﻢ ﺑﺎﻟﻔﻮﺳﻔﻮﺭ" ﻫﻲ ﺣﺎﻻﺕ ﺗﺴﻤﻢ ﺑﺎﳌﺒﻴﺪﺍﺕ‬
‫ﺍﻟﻔﺴﻔﻮﺭﻳﺔ ﺍﻛﺘﺸﻔﺖ ﺃﺛﻨﺎﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻟﻔﺌﺎﺕ ﺍﻟﻌﻤﺎﻝ ﺍﳌﻨﺘﻈﻤﲔ ﺍﳌﻌﺮﺿﲔ ﻭﻫﻢ ﻋﻤﺎﻝ‬
‫ﻣﺼﺎﻧﻊ ﺍﳌﺒﻴﺪﺍﺕ ﻭﺍﻟﻌﺎﻣﻠﻮﻥ ﰲ ﺍﳉﻤﻌﻴﺎﺕ ﺍﻟﺰﺭﺍﻋﻴﺔ ﻭﻳﺘﻌﺮﺽ ﻟﻠﻤﺒﻴﺪﺍﺕ ﺃﻳﻀﺎ ﻋﻤﺎﻝ ﺍﻟﺰﺭﺍﻋﺔ ﻭﻻ ﻳﺴﻠﻢ‬
‫ﻣﻦ ﺍﻟﺘﻌﺮﺽ ﻣﻦ ﻫﻢ ﺩﻭﻥ ﺍﳋﺎﻣﺴﺔ ﻋﺸﺮﺓ‪ .‬ﻭﺇﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻟﻌﻤﺎﻝ ﺍﻟﺰﺭﺍﻋﺔ ﺍﳌﻌﺮﺿﲔ‬
‫ﻟﻠﻤﺒﻴﺪﺍﺕ ﺗﻘﺎﺑﻠﻪ ﻣﺼﺎﻋﺐ ﲨﺔ‪ ،‬ﻓﺮﺵ ﺍﳌﺒﻴﺪﺍﺕ ﰲ ﺍﳊﻘﻮﻝ ﻭﺍﻟﺒﺴﺎﺗﲔ ﻋﻤﻠﻴﺔ ﻣﻮﲰﻴﺔ ﻗﺪ ﻻ ﻳﺪﺭﻛﻬﺎ‬
‫ﺍﻟﻔﺤﺺ ﺍﻟﺪﻭﺭﻱ ﻛﻤﺎ ﺃﻥ ﺃﻋﺪﺍﺩﺍ ﻫﺎﺋﻠﺔ ﻣﻦ ﺍﳌﺰﺍﺭﻋﲔ ﻻ ﻳﺸﻤﻠﻬﻢ ﺗﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ )ﻷ‪‬ﻢ ﻣﻼﻙ‬

‫‪٣٠٤‬‬
‫ﺍﻷﺭﺽ ﺃﻭ ﺃﻓﺮﺍﺩ ﺍﻟﻌﺎﺋﻠﺔ ﺃﻭ ﻋﻤﺎﻝ ﻣﻮﲰﻴﲔ ﺻﻐﺎﺭ ﺍﻟﺴﻦ ﻳﺘﻬﺮﺏ ﺍﳌﻘﺎﻭﻝ ﺍﻟﺬﻱ ﻳﺴﺘﺨﺪﻣﻬﻢ ﻣﻦ ﺩﻓﻊ‬
‫ﺍﻟﺘﺄﻣﻴﻨﺎﺕ(‪ ،‬ﻭﻟﺬﻟﻚ ﻓﺈﻥ ﺍﻟﻔﺤﺺ ﺍﻟﺪﻭﺭﻱ ﻳﺸﻤﻞ ﳎﻤﻮﻋﺔ ﳏﺪﻭﺩﺓ ﻣﻨﻬﻢ‪.‬‬
‫ﻭﻫﻨﺎﻙ ﺣﺎﻻﺕ ﻣﻦ ﺍﻟﺘﺴﻤﻢ ﺍﳊﺎﺩ ﲢﺪﺙ ﻟﻌﻤﺎﻝ ﺍﻟﺰﺭﺍﻋﺔ ﻋﻨﺪ ﺍﻟﺘﻌﺮﺽ ﻟﻠﻤﺒﻴﺪﺍﺕ ﺃﺛﻨﺎﺀ ﺍﻟﻌﻤﻞ ﻭﺗﻌﺎﰿ ﰲ‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺃﻭ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﻻ ﺗﺒﻠﻎ ﻫﺬﻩ ﺍﳊﺎﻻﺕ ﻋﺎﺩﺓ ﺇﱃ ﺍﳍﻴﺌﺔ‬
‫ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺃﻭ ﺇﱃ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﻻ ﺗﻮﺟﺪ ﰲ ﺍﻟﻮﻗﺖ ﺍﳊﺎﺿﺮ ﺇﺣﺼﺎﺋﻴﺎﺕ‬
‫ﺣﺪﻳﺜﺔ ﻭﺩﻗﻴﻘﺔ ﻋﻦ ﺣﺠﻢ ﺍﳌﺸﻜﻠﺔ‪.‬‬

‫ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ‪ -‬ﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﻭﺍﻟﻮﻓﻴﺎﺕ ﻭﺍﳋﺴﺎﺋﺮ ﺍﳌﺎﺩﻳﺔ‬

‫ﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٧‬ﻋﺪﺩ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﰲ ﺍﻟﻔﺮﻭﻉ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻬﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺧﻼﻝ‬
‫ﻋﺎﻡ ‪ ٢٠٠٠ -١٩٩٩‬ﻣﻊ ﺑﻴﺎﻥ ﺍﳊﺎﻻﺕ ﺍﻟﱵ ﺍﺣﺘﺎﺟﺖ ﺇﱄ ﺍﺳﺘﺸﺎﺭﺓ ﺍﻷﺧﺼﺎﺋﻲ ﺃﻭ ﺩﺧﻠﺖ ﺍﳌﺴﺘﺸﻔﻰ ﻭﻋﺪﺩ‬
‫ﺍﳊﺎﻻﺕ ﺍﻟﱵ ﺷﻔﻴﺖ ﻭﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ)‪ .(٩‬ﻭﻳﺘﺒﲔ ﻣﻦ ﺍﳉﺪﻭﻝ ﺍﺧﺘﻼﻑ ﻣﻌﺪﻝ ﺣﺪﻭﺙ ﺍﻹﺻﺎﺑﺔ ﻟﻜﻞ ‪١٠٠٠‬‬
‫ﻭﻣﻌﺪﻝ ﺃﻳﺎﻡ ﺍﻻﻧﻘﻄﺎﻉ ﻟﻜﻞ ‪ ١٠٠٠٠٠‬ﻣﻨﺘﻔﻊ ﺑﲔ ﺍﻟﻔﺮﻭﻉ ﺍﳌﺨﺘﻠﻔﺔ ﺣﻴﺚ ﺑﻠﻎ ﻣﻌﺪﻝ ﺣﺪﻭﺙ ﺍﻹﺻﺎﺑﺔ‬
‫‪ ٤١,٧‬ﰲ ﻭﺳﻂ ﺍﻟﺪﻟﺘﺎ ﻭ‪ ١٠,٩‬ﰲ ﺍﻟﻘﺎﻫﺮﺓ ﻭ‪ ٠,٦‬ﰲ ﺃﺳﻴﻮﻁ ﻭﻭﺳﻂ ﺍﻟﺼﻌﻴﺪ ﺑﻴﻨﻤﺎ ﻛﺎﻥ ﻣﻌﺪﻝ ﺃﻳﺎﻡ‬
‫ﺍﻻﻧﻘﻄﺎﻉ ﰲ ﺍﻟﻘﺎﻫﺮﺓ ﺃﻋﻠﻰ ﻣﻨﻪ ﰲ ﺍﻟﻔﺮﻭﻉ ﺍﻷﺧﺮﻯ‪.‬‬
‫ﻭﻗﺪ ﻛﺎﻥ ﻣﻦ ﺍﳌﺘﻮﻗﻊ ‪ -‬ﻣﻊ ﻣﺎ ﻳﺘﻢ ﻣﻦ ﲢﺪﻳﺚ ﻟﻠﻌﻤﻠﻴﺎﺕ ﺍﻟﺼﻨﺎﻋﻴﺔ ﻭﺗﻘﺪﻡ ﺗﻜﻨﻮﻟﻮﺟﻴﺎﺕ ﺍﻟﺘﺤﻜﻢ ﰲ‬
‫ﺍﳌﺨﺎﻃﺮ‪ ،‬ﻭﺍﻫﺘﻤﺎﻡ ﺍﳌﺴﺌﻮﻟﲔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻣﻮﺍﻗﻊ ﺍﻟﻌﻤﻞ ﻭﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﳊﻜﻮﻣﻲ ‪ -‬ﺃﻥ ﺗﺘﻨﺎﻗﺺ‬
‫ﻣﻌﺪﻻﺕ ﺣﺪﻭﺙ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ‪ .‬ﻭﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٨‬ﺃﻋﺪﺍﺩ ﺍﻟﻮﻓﻴﺎﺕ ﻭﺣﺎﻻﺕ‬
‫ﺍﻟﻌﺠﺰ ﻧﺘﻴﺠﺔ ﺍﻹﺻﺎﺑﺔ ﻭﺗﻮﺯﻳﻊ ﺍﳌﻌﺎﺷﺎﺕ ﺍﳌﻨﺼﺮﻓﺔ ﻟﻠﻮﻓﺎﺓ ﺍﻹﺻﺎﺑﻴﺔ ﻭﺍﻟﻌﺠﺰ ﺧﻼﻝ ﺳﻨﻮﺍﺕ ‪– ١٩٩٦‬‬
‫‪ ٢٠٠١‬ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ‪ .‬ﻭﻣﻦ ﺍﳉﺪﻭﻝ ﻳﻼﺣﻆ ﺃﻥ ﻫﻨﺎﻙ ﺗﺰﺍﻳﺪﺍ ﻣﺴﺘﻤﺮﺍ ﰲ ﻋﺪﺩ ﺍﻟﻮﻓﻴﺎﺕ ﺑﺴﺒﺐ‬
‫ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﻛﺬﻟﻚ ﰲ ﺣﺎﻻﺕ ﺍﻟﻌﺠﺰ‪ .‬ﻭﺑﺎﻟﺘﺎﱄ ﻓﻘﺪ ﺯﺍﺩﺕ ﻗﻴﻤﺔ ﺍﳌﻌﺎﺷﺎﺕ ﺍﳌﻨﺼﺮﻓﺔ ﻛﺘﻌﻮﻳﺾ ﻋﻦ‬
‫ﺍﻟﻮﻓﺎﺓ ﻭﺍﻟﻌﺠﺰ ﺍﻹﺻﺎﰊ )ﺑﺴﺒﺐ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻹﺻﺎﺑﺎﺕ ﺍﻟﻨﺎﲡﺔ ﻋﻦ ﺍﳊﻮﺍﺩﺙ()‪ .(١٠‬ﻭﺟﺪﻳﺮ ﺑﺎﻟﺬﻛﺮ ﺃﻧﻪ‬
‫ﻣﻦ ﺍﳌﺘﻮﻗﻊ ﺃﻥ ﺗﻜﻮﻥ ﻣﻌﺪﻻﺕ ﺣﺪﻭﺙ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻹﺻﺎﺑﺎﺕ ﰲ ﺍﻟﻘﻄﺎﻋﲔ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ ﺃﻋﻠﻰ‬
‫ﻣﻨﻬﺎ ﰲ ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ‪.‬‬
‫ﻭﻗﺪ ﻗﺎﻣﺖ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﻮﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺪﺭﺍﺳﺔ ﻋﻦ ﺇﺻﺎﺑﺎﺕ‬
‫ﺍﻟﻌﻤﻞ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ‪ .١٩٩١– ١٩٨٦‬ﻭﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ٩‬ﻋﺪﺩ ﺍﻟﻌﺎﻣﻠﲔ ﺧﻼﻝ‬
‫ﺍﻟﺴﻨﻮﺍﺕ ‪ ١٩٨٦‬ﺇﱄ ‪ ١٩٩٠‬ﻭﻋﺪﺩ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻟﻮﻓﻴﺎﺕ ﻭﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﻭﻛﺬﻟﻚ ﻋﺪﺩ ﺣﺎﻻﺕ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‬
‫ﻭﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﺑﺴﺒﺒﻬﺎ‪.‬‬
‫ﻳﺘﺒﲔ ﻣﻦ ﺍﳉﺪﻭﻝ ﺃﻧﻪ ﻛﺎﻧﺖ ﻫﻨﺎﻙ ﺣﻮﺍﱄ ‪ ٢٠٠‬ﻭﻓﺎﺓ ﺳﻨﻮﻳﺎ ﺑﺴﺒﺐ ﺍﻹﺻﺎﺑﺎﺕ ﺧﻼﻝ ﺗﻠﻚ ﺍﻟﻔﺘﺮﺓ‪.‬‬
‫ﻭﺗﺮﺍﻭﺣﺖ ﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﺧﻼﻝ ﻧﻔﺲ ﺍﻟﻔﺘﺮﺓ – ﺑﺴﺒﺐ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ – ﺑﲔ‪ ٠,٩٥‬ﺇﱄ ‪١,٢‬‬
‫ﻣﻠﻴﻮﻥ ﻳﻮﻡ‪.‬‬
‫ﻛﻤﺎ ﻳﻮﺿﺢ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ١٠‬ﻋﺪﺩ ﺍﳌﻨﺸﺂﺕ ﺍﻟﱵ ﻳﻌﻤﻞ ‪‬ﺎ ‪ ٥٠‬ﻋﺎﻣﻼ ﻓﺄﻛﺜﺮ ﻭﻋﺪﺩ ﻋﻤﺎﳍﺎ ﻭﻋﺪﺩ‬
‫ﺍﻹﺻﺎﺑﺎﺕ ﻭﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﻧﺘﻴﺠﺔ ﺍﻹﺻﺎﺑﺔ ﰲ ﺍﻷﻧﺸﻄﺔ ﺍﳌﺨﺘﻠﻔﺔ ﺧﻼﻝ ﻋﺎﻡ ‪.١٩٩١‬‬

‫‪٣٠٥‬‬
‫ﻭﻳﺘﺒﲔ ﻣﻦ ﺍﳉﺪﻭﻝ ﺃﻧﻪ ﻛﺎﻧﺖ ﻫﻨﺎﻙ ‪ ٥٤٣‬ﺇﺻﺎﺑﺔ ﺧﻼﻝ ﺫﻟﻚ ﺍﻟﻌﺎﻡ ﲣﻠﻒ ﻋﻨﻬﺎ ﻋﺠﺰ‪ ،‬ﻣﻨﻬﺎ ‪ ٣٥٥‬ﰲ‬
‫ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺘﺤﻮﻳﻠﻴﺔ ﻭ‪ ٧٥‬ﰲ ﺻﻨﺎﻋﺔ ﺍﻟﺒﻨﺎﺀ ﻭﺍﻟﺘﺸﻴﻴﺪ ﻭ‪ ٤٨‬ﰲ ﺻﻨﺎﻋﺔ ﺍﻟﻨﻘﻞ ﻭﺍﻻﺗﺼﺎﻻﺕ ﻭﺍﻟﺘﺨﺰﻳﻦ‪.‬‬
‫ﻛﻤﺎ ﺣﺪﺛﺖ ﰲ ﻧﻔﺲ ﺍﻟﻌﺎﻡ ‪ ١٩٢‬ﻭﻓﺎﺓ ﻣﻨﻬﺎ ‪ ٩١‬ﰲ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺘﺤﻮﻳﻠﻴﺔ ﻭ‪ ٣٠‬ﰲ ﺍﻟﺒﻨﺎﺀ ﻭﺍﻟﺘﺸﻴﻴﺪ ﻭ‪٢٤‬‬
‫ﰲ ﻗﻄﺎﻉ ﺍﻟﻜﻬﺮﺑﺎﺀ ﻭﺍﳌﻴﺎﻩ ﻭﺍﻟﻐﺎﺯ ﻭ‪ ١٩‬ﰲ ﺻﻨﺎﻋﺔ ﺍﻟﻨﻘﻞ ﻭﺍﻻﺗﺼﺎﻻﺕ ﻭﺍﻟﺘﺨﺰﻳﻦ‪.‬‬
‫ﻭﺗﻔﻴﺪ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻟﻮﺍﺭﺩﺓ ﻣﻦ ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺘﺄﻣﻴﻨﺎﺕ ﺑﺄﻥ ﻋﺪﺩ ﺍﻟﻮﻓﻴﺎﺕ ﻭﺍﻹﺻﺎﺑﺎﺕ ﺍﻟﱵ ﲣﻠﻒ ﻋﻨﻬﺎ‬
‫ﻋﺠﺰ ﻗﺪ ﺯﺍﺩﺕ ﺧﻼﻝ ﺳﻨﻮﺍﺕ ‪ ١٩٩١ – ١٩٨١‬ﺑﻨﺴﺒﺔ ‪ % ٦٠‬ﻭﺃﻥ ﻣﺎ ﺩﻓﻌﺘﻪ ﺍﳍﻴﺌﺔ ﻛﺘﻌﻮﻳﺾ ﻋﻦ ﺇﺻﺎﺑﺎﺕ‬
‫ﺍﻟﻌﻤﻞ ﻭﻣﺎ ﲣﻠﻒ ﻋﻨﻬﺎ ﻗﺪ ﺯﺍﺩ ﺧﻼﻝ ﻧﻔﺲ ﺍﻟﻔﺘﺮﺓ ﺑﻨﺴﺒﺔ ‪ %٦٥٤‬ﻭﺃﻥ ﻗﻴﻤﺔ ﺍﻟﺘﻌﻮﻳﻀﺎﺕ ﰲ ﺳﻨﺔ ‪١٩٨٩‬‬
‫ﻛﺎﻧﺖ ‪ ١١٢٩٦٠٠٠‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‪.‬‬

‫&(' &‪!"#"  )* $ %‬‬

‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻌﺎﻣﻠﲔ – ﺷﺄ‪‬ﺎ ﺷﺄﻥ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻟﻜﺎﻓﺔ ﺍﳌﻮﺍﻃﻨﲔ – ﺗﻨﻘﺴﻢ ﺇﱄ‬
‫ﺧﺪﻣﺎﺕ ﻋﻼﺟﻴﺔ ﻭﺧﺪﻣﺎﺕ ﻭﻗﺎﺋﻴﺔ‪ .‬ﻭﻟﻜﻨﻬﺎ ﺗﺘﻤﻴﺰ ﺑﺒﻌﺾ ﺍﳋﻮﺍﺹ ﺍﻟﱵ ﲡﻌﻞ ﳍﺎ ﻃﺎﺑﻌﺎ ﻣﺘﻤﻴﺰﺍ‪.‬‬
‫ﻓﻤﺠﻤﻮﻋﺎﺕ ﺍﻟﻌﺎﻣﻠﲔ ﳎﻤﻮﻋﺎﺕ ﻣﻨﺘﻈﻤﺔ ﳝﻜﻦ ﺍﻟﻮﺻﻮﻝ ﺇﻟﻴﻬﺎ ﰲ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ ﺑﻄﺮﻳﻘﺔ ﻣﻨﻈﻤﺔ‬
‫ﻭﺗﺘﺒﻊ ﺍﳊﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺗﺴﺠﻴﻠﻬﺎ ﻭﺗﻘﺪﱘ ﺧﺪﻣﺔ ﻃﺒﻴﺔ ﻋﻼﺟﻴﺔ ﺫﺍﺕ ﻃﺎﺑﻊ ﻣﻮﺣﺪ ﻣﻦ ﺣﻴﺚ ﻣﺴﺘﻮﻯ‬
‫ﺍﳋﺪﻣﺔ‪ .‬ﻭﰲ ﻏﲑ ﺳﺎﻋﺎﺕ ﺍﻟﻌﻤﻞ ﻳﺘﻤﺘﻊ ﺍﻟﻌﺎﻣﻠﻮﻥ ﺑﺎﳋﺪﻣﺎﺕ ﺍﻟﱵ ﺗﺆﺩﻯ ﺇﱃ ﻛﺎﻓﺔ ﺍﳌﻮﺍﻃﻨﲔ ﺑﺎﻹﺿﺎﻓﺔ‬
‫ﺇﱄ ﻣﺎ ﺗﻘﺪﻣﻪ ﺃﻧﻈﻤﺔ ﺍﻟﻌﻼﺝ ﺍﳋﺎﺻﺔ ‪‬ﻢ ﻭﺍﻟﱵ ﳝﻮﳍﺎ ﰲ ﺃﻏﻠﺐ ﺍﻷﺣﻴﺎﻥ ﻧﻈﺎﻡ ﺗﺄﻣﻴﲏ ﺃﻭ ﺻﺎﺣﺐ‬
‫ﺍﻟﻌﻤﻞ‪.‬‬
‫ﺃﻣﺎ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻓﺈﻥ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺃﻣﺎﻛﻦ ﻋﻤﻠﻬﻢ ﻳﺴﺘﻔﻴﺪﻭﻥ ﻣﻦ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﺍﻟﱵ ﺗﻮﻓﺮﻫﺎ‬
‫ﺍﻟﺪﻭﻟﺔ ﻟﻠﻤﻮﺍﻃﻨﲔ ﻛﺎﻓﺔ ﻭﺫﻟﻚ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﺍﻟﻨﻮﻋﻴﺔ ﺍﻟﱵ ﻳﺘﻄﻠﺒﻬﺎ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ‬
‫ﺍﳌﺨﺎﻃﺮ ﺍﳌﺨﺘﻠﻔﺔ ﺍﻟﱵ ﻗﺪ ﺗﻮﺟﺪ ﰲ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ﻭﻫﻰ ﺍﻷﻧﺸﻄﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﺍﻟﱵ ﺗﻨﺪﺭﺝ ﲢﺖ ﻣﺴﻤﻰ‬
‫"ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ"‪.‬‬

‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ‬
‫ﺃﻟﺰﻣﺖ ﺍﻟﺪﻭﻟﺔ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ ﺑﺘﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﻟﻠﻌﺎﻣﻠﲔ ﺑﺎ‪‬ﺎﻥ‪ .‬ﻓﻘﺪ ﻧﺺ ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﺭﻗﻢ‬
‫‪ ١٣٧‬ﻟﺴﻨﺔ ‪ ١٩٨١‬ﰲ ﺍﳌﺎﺩﺓ ‪ ١٢١‬ﻋﻠﻰ ﺃﻥ‪:‬‬
‫ﺗﻠﺘﺰﻡ ﺍﳌﻨﺸﺄﺓ ﺑﺄﻥ ﺗﻮﻓﺮ ﻟﻠﻌﺎﻣﻠﲔ ‪‬ﺎ ﻭﺳﺎﺋﻞ ﺍﻹﺳﻌﺎﻑ ﺍﻟﻄﺒﻴﺔ‪.‬‬ ‫
‬
‫ﻭﺇﺫﺍ ﺯﺍﺩ ﻋﺪﺩ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﻣﻜﺎﻥ ﻭﺍﺣﺪ ﺃﻭ ﺑﻠﺪ ﻭﺍﺣﺪ ﺃﻭ ﰲ ﺩﺍﺋﺮﺓ ﻧﺼﻒ ﻗﻄﺮﻫﺎ ﲬﺴﺔ ﻋﺸﺮ‬ ‫
‬
‫ﻛﻴﻠﻮﻣﺘﺮﺍ ﻋﻦ ﲬﺴﲔ ﻋﺎﻣﻼ ﺗﻠﺘﺰﻡ ﺍﳌﻨﺸﺄﺓ ﺑﺄﻥ ﺗﺴﺘﺨﺪﻡ ﳑﺮﺿﺎ ﻣﻠﻤﺎ ﺑﻮﺳﺎﺋﻞ ﺍﻹﺳﻌﺎﻑ‬
‫ﺍﻟﻄﺒﻴﺔ ﳜﺼﺺ ﻟﻠﻘﻴﺎﻡ ‪‬ﺎ‪ .‬ﻭﺃﻥ ﺗﻌﻬﺪ ﺇﱄ ﻃﺒﻴﺐ ﺑﻌﻴﺎﺩ‪‬ﻢ ﰲ ﺍﳌﻜﺎﻥ ﺍﻟﺬﻱ ﺗﻌﺪﻩ ﳍﺬﺍ ﺍﻟﻐﺮﺽ‪،‬‬
‫ﻭﺃﻥ ﺗﻘﺪﻡ ﳍﻢ ﺍﻷﺩﻭﻳﺔ ﺍﻟﻼﺯﻣﺔ ﻭﺫﻟﻚ ﻛﻠﻪ ﺑﺪﻭﻥ ﻣﻘﺎﺑﻞ‪.‬‬
‫ﻓﺈﺫﺍ ﺯﺍﺩ ﻋﺪﺩ ﺍﻟﻌﺎﻣﻠﲔ ﺍﻟﺬﻳﻦ ﺗﺴﺘﺨﺪﻣﻬﻢ ﺍﳌﻨﺸﺄﺓ ﻭﻟﻮ ﰲ ﻓﺮﻭﻉ ﻣﺘﻌﺪﺩﺓ ﳍﺎ ﻋﻠﻰ ﺛﻼﲦﺎﺋﺔ ﻋﺎﻣﻞ‬ ‫
‬
‫ﻭﺟﺐ ﻋﻠﻴﻬﺎ ﻓﻀﻼ ﻋﻦ ﺫﻟﻚ ﺃﻥ ﺗﻮﻓﺮ ﳍﻢ ﲨﻴﻌﺎ ﻭﺳﺎﺋﻞ ﺍﻟﻌﻼﺝ ﺍﻷﺧﺮﻯ ﰲ ﺍﳊﺎﻻﺕ ﺍﻟﱵ ﻳﺘﻄﻠﺐ‬

‫‪٣٠٦‬‬
‫ﻋﻼﺟﻬﺎ ﺍﻻﺳﺘﻌﺎﻧﺔ ﺑﺄﻃﺒﺎﺀ ﺃﺧﺼﺎﺋﻴﲔ ﺃﻭ ﺍﻟﻘﻴﺎﻡ ﺑﻌﻤﻠﻴﺎﺕ ﺟﺮﺍﺣﻴﺔ ﺃﻭ ﻏﲑﻫﺎ ﻭﻛﺬﻟﻚ ﺍﻷﺩﻭﻳﺔ‬
‫ﺍﻟﻼﺯﻣﺔ ﻭﺫﻟﻚ ﻛﻠﻪ ﺑﺎ‪‬ﺎﻥ‪.‬‬
‫ﻭﻗﺒﻞ ﺻﺪﻭﺭ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ١٣٧‬ﻟﺴﻨﺔ ‪ ١٩٨١‬ﻛﺎﻥ ﻫﻨﺎﻙ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٩١‬ﻟﺴﻨﺔ ‪ ١٩٥٩‬ﻭﺍﻟﺬﻱ ﻧﺺ ﺃﻳﻀﺎ‬
‫ﻋﻠﻰ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﻟﻠﻌﺎﻣﻠﲔ‪.‬‬
‫ﰲ ﺳﻨﺔ ‪ ١٩٦٤‬ﺻﺪﺭ ﺍﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ ﺭﻗﻢ ‪ ١٢٠٩‬ﺑﺸﺄﻥ ﺇﻧﺸﺎﺀ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻭﺍﻟﱵ‬
‫ﲣﺘﺺ ﺑﺎﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )ﺗﺄﻣﲔ ﺍﳌﺮﺽ( ﻋﻠﻰ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳊﻜﻮﻣﺔ ﻭﻭﺣﺪﺍﺕ ﺍﻹﺩﺍﺭﺓ ﺍﶈﻠﻴﺔ ﻭﺍﳍﻴﺌﺎﺕ‬
‫ﺍﻟﻌﺎﻣﺔ ﻭﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻌﺎﻣﺔ‪.‬‬
‫ﻭﻗﺪ ﺃﻭﺿﺢ ﻗﺎﻧﻮﻥ ﺍﻟﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺭﻗﻢ ‪ ٧٩‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﰲ ﺍﳌﺎﺩﺓ ‪ ٤٧‬ﳎﺎﻻﺕ ﺍﻟﻌﻼﺝ ﻭﺍﻟﺮﻋﺎﻳﺔ‬
‫ﺍﻟﻄﺒﻴﺔ ﺍﻟﱵ ﻳﻘﺪﻣﻬﺎ ﺗﺄﻣﲔ ﺍﳌﺮﺽ ﻭﺗﺘﻠﺨﺺ ﻓﻴﻤﺎ ﻳﺄﰐ‪:‬‬
‫‪ .١‬ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﺍﻟﱵ ﻳﺆﺩﻳﻬﺎ ﺍﳌﻤﺎﺭﺱ ﺍﻟﻌﺎﻡ‪.‬‬
‫‪ .٢‬ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻷﺧﺼﺎﺋﻴﻮﻥ ﲟﺎ ﰲ ﺫﻟﻚ ﺃﺧﺼﺎﺋﻴﻲ ﺍﻷﺳﻨﺎﻥ‪.‬‬
‫‪ .٣‬ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﺍﳌﱰﻟﻴﺔ ﻋﻨﺪ ﺍﻻﻗﺘﻀﺎﺀ‪.‬‬
‫‪ .٤‬ﺍﻟﻌﻼﺝ ﻭﺍﻹﻗﺎﻣﺔ ﰲ ﺍﳌﺴﺘﺸﻔﻰ ﺃﻭ ﺍﳌﺼﺢ ﺃﻭ ﺍﳌﺮﻛﺰ ﺍﻟﻄﱯ ﺍﳌﺘﺨﺼﺺ‪.‬‬
‫‪ .٥‬ﺍﻟﻌﻤﻠﻴﺎﺕ ﺍﳉﺮﺍﺣﻴﺔ ﻭﺃﻧﻮﺍﻉ ﺍﻟﻌﻼﺝ ﺍﻷﺧﺮﻯ ﺣﺴﺐ ﻣﺎ ﻳﻠﺰﻡ‪.‬‬
‫‪ .٦‬ﺍﻟﻔﺤﺺ ﺑﺎﻷﺷﻌﺔ ﻭﺍﻟﺒﺤﻮﺙ ﺍﳌﻌﻤﻠﻴﺔ )ﺍﳌﺨﱪﻳﺔ( ﺍﻟﻼﺯﻣﺔ ﻭﻏﲑﻫﺎ ﻣﻦ ﺍﻟﻔﺤﻮﺹ ﺍﻟﻄﺒﻴﺔ‬
‫ﻭﻣﺎ ﰲ ﺣﻜﻤﻬﺎ‪.‬‬
‫‪ .٧‬ﺻﺮﻑ ﺍﻷﺩﻭﻳﺔ ﺍﻟﻼﺯﻣﺔ ﰲ ﲨﻴﻊ ﺍﳊﺎﻻﺕ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﺎ‪.‬‬
‫‪ .٨‬ﺗﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺘﺄﻫﻴﻠﻴﺔ ﻭﺗﻘﺪﱘ ﺍﻷﻃﺮﺍﻑ ﻭﺍﻷﺟﻬﺰﺓ ﺍﻟﺼﻨﺎﻋﻴﺔ ﻭﺍﻟﺘﻌﻮﻳﻀﻴﺔ‪.‬‬
‫ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﺣﺼﺔ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ ﻳﺆﺩﻯ ﺍﻟﻌﺎﻣﻠﻮﻥ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﻢ ﺍﺷﺘﺮﺍﻛﺎ ﻳﺴﺎﻭﻯ ‪ %١‬ﻣﻦ ﺍﻷﺟﺮ‬
‫ﻧﻈﲑ ﺍﻻﻧﺘﻔﺎﻉ ﲞﺪﻣﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﳌﻨﺼﻮﺹ ﻋﻠﻴﻬﺎ ﺑﺎﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٧٩‬ﻟﺴﻨﺔ ‪ .١٩٧٥‬ﺃﻣﺎ ﻣﻦ‬
‫ﻳﻨﻄﺒﻖ ﻋﻠﻴﻬﻢ ﻧﻈﺎﻡ ﺍﻟﻌﻼﺝ ﺍﻟﺘﺄﻣﻴﲏ ﺍﻟﺼﺎﺩﺭ ﺑﺎﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٣٢‬ﻟﺴﻨﺔ ‪ ١٩٧٥‬ﻓﻴﺆﺩﻯ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻪ‬
‫ﺍﺷﺘﺮﺍﻛﺎ ﻳﺴﺎﻭﻯ ‪ % ٠,٥‬ﻣﻦ ﻣﺮﺗﺒﻪ ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﺭﺳﻢ ﺭﻣﺰﻱ ﻳﺪﻓﻌﻪ ﻋﻨﺪ ﺍﻻﻧﺘﻔﺎﻉ ﺑﺎﳋﺪﻣﺔ ﻭﻧﺴﺒﺔ ﻣﻦ‬
‫ﲦﻦ ﺍﻷﺩﻭﻳﺔ ﻭﺗﻜﺎﻟﻴﻒ ﺍﻟﻌﻼﺝ ﻭﺍﻟﻔﺤﻮﺹ ﺍﳌﻌﻤﻠﻴﺔ ﻭﺍﻷﺷﻌﺔ‪.‬‬
‫ﻭﻗﺪ ﺻﺪﺭ ﻗﺮﺍﺭ ﺭﺋﻴﺲ ﳎﻠﺲ ﺇﺩﺍﺭﺓ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺭﻗﻢ ‪ ٦١٤‬ﻟﺴﻨﺔ ‪ ٦٧‬ﺑﺸﺄﻥ ﺗﻨﻈﻴﻢ‬
‫ﺇﺟﺮﺍﺀﺍﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ ﻟﻠﻤﻨﺘﻔﻌﲔ ﺑﺄﺣﻜﺎﻡ ﻗﻮﺍﻧﲔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﰲ ﻛﺎﻓﺔ ﻣﺮﺍﺣﻠﻬﺎ‪.‬‬
‫ﻛﻤﺎ ﺻﺪﺭ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺭﻗﻢ ‪ ١٤٠‬ﻟﺴﻨﺔ ‪ ١٩٧٦‬ﺑﺎﳊﺪ ﺍﻷﺩﱏ ﳌﺴﺘﻮﻳﺎﺕ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﺍﻟﻄﺒﻴﺔ‬
‫ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﻣﻦ ﺣﻴﺚ ﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﻭﻣﻌﺎﻭﻧﻴﻬﻢ ﺑﺎﻟﻨﺴﺒﺔ ﺇﱄ ﻋﺪﺩ ﺍﳌﻨﺘﻔﻌﲔ‪ ،‬ﻭﻣﺆﻫﻼﺕ ﺃﻓﺮﺍﺩ ﺍﻟﻔﺮﻳﻖ‬
‫ﺍﻟﻄﱯ ﻭﺍﻟﺘﻮﺯﻳﻊ ﺍﳉﻐﺮﺍﰲ ﻟﻠﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺸﺎﻣﻠﺔ ﻭﺧﺪﻣﺎﺕ ﺍﳌﻤﺎﺭﺱ ﻭﺧﺪﻣﺎﺕ‬
‫ﺍﻷﺧﺼﺎﺋﻲ ﻭﺍﻟﺘﺨﺼﺼﺎﺕ ﺍﳌﻄﻠﻮﺏ ﺗﻮﺍﻓﺮﻫﺎ ﻭﺣﻔﻆ ﻣﻠﻔﺎﺕ ﺍﳌﺮﺿﻰ ﻭﲡﻬﻴﺰﺍﺕ ﺍﻟﻮﺣﺪﺍﺕ ﻭﺍﻟﻌﻴﺎﺩﺍﺕ‬
‫ﺍﻟﻄﺒﻴﺔ ﺍﳌﺨﺘﻠﻔﺔ‪ .‬ﻭﺃﻭﺿﺢ ﻛﺬﻟﻚ ﺍﳋﺪﻣﺎﺕ ﺍﻟﱵ ﺗﺆﺩﻯ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﻟﺘﺠﻬﻴﺰﺍﺕ ﺍﳌﻄﻠﻮﺑﺔ ﻭﺍﻷﻓﺮﺍﺩ‬
‫ﻭﺃﻋﺪﺍﺩﻫﻢ ﻭﲣﺼﺼﺎ‪‬ﻢ‪ .‬ﻛﻤﺎ ﺗﻨﺎﻭﻝ ﺃﻳﻀﺎ ﺍﻟﻌﻼﺝ ﺧﺎﺭﺝ ﺍﳉﻤﻬﻮﺭﻳﺔ ﻭﺷﺮﻭﻃﻪ‪.‬‬

‫‪٣٠٧‬‬
‫ﻭﻛﺬﻟﻚ ﺻﺪﺭ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺭﻗﻢ ‪ ١٤١‬ﻟﺴﻨﺔ ‪ ١٩٧٦‬ﰲ ﺷﺄﻥ ﺷﺮﻭﻁ ﻭﺃﻭﺿﺎﻉ ﺗﻮﻓﲑ ﺍﳋﺪﻣﺎﺕ‬
‫ﺍﻟﺘﺄﻫﻴﻠﻴﺔ ﻭﺗﻘﺪﱘ ﺍﻷﻃﺮﺍﻑ ﻭﺍﻷﺟﻬﺰﺓ ﺍﻟﺼﻨﺎﻋﻴﺔ‪.‬‬
‫ﻭﻗﺪ ﺻﺪﺭﺕ ﻣﻦ ﺭﺅﺳﺎﺀ ﳎﻠﺲ ﺇﺩﺍﺭﺓ ﺍﳍﻴﺌﺔ ﻗﺮﺍﺭﺍﺕ ﻣﺘﻌﺪﺩﺓ ﻟﺘﻨﻈﻴﻢ ﺍﻟﻌﻤﻞ ﻭﻭﺿﻊ ﻣﺴﺘﻮﻳﺎﺕ‬
‫ﺍﳋﺪﻣﺔ ﻭﺍﻟﺘﺠﻬﻴﺰﺍﺕ ﻭﺍﻷﻓﺮﺍﺩ ﺑﺎﻟﻮﺣﺪﺍﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻠﻬﻴﺌﺔ‪.‬‬
‫ﻭﻋﻨﺪ ﺇﻧﺸﺎﺀ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺑﺪﺃ ﺍﻟﻌﻤﻞ ﺑﻨﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﰲ ﳏﺎﻓﻈﺔ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ ﻭﰱ‬
‫ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻜﱪﻯ ﻭﺍﻣﺘﺪﺕ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ ﺑﻌﺪ ﺫﻟﻚ ﻟﺘﻐﻄﻰ ﻛﺎﻓﺔ ﺍﶈﺎﻓﻈﺎﺕ ﻭﻛﺎﻓﺔ ﺍﳌﺆﺳﺴﺎﺕ‪.‬‬
‫ﻭﻋﻨﺪﻣﺎ ﺻﺪﺭ ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﺳﻨﺔ ‪ ١٩٨١‬ﱂ ﻳﻜﻦ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻗﺪ ﻏﻄﻰ ﲨﻴﻊ ﺍﳌﻨﺸﺂﺕ‪.‬‬
‫ﻭﰲ ﺳﻨﺔ ‪ ١٩٨١‬ﺻﺪﺭ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﺼﺤﺔ ﺭﻗﻢ ‪ ٨٥٨‬ﺑﺸﺄﻥ ﺳﺮﻳﺎﻥ ﺃﺣﻜﺎﻡ ﺗﺄﻣﲔ ﺍﳌﺮﺽ ﻋﻠﻰ ﺍﻟﻌﺎﻣﻠﲔ‬
‫ﲟﻨﺸﺂﺕ ﺍﻟﻘﻄﺎﻋﲔ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ ﺍﻟﱵ ﻳﻌﻤﻞ ‪‬ﺎ ﻣﻦ ‪ ٤٩٩ – ٥‬ﻋﺎﻣﻼ ﲜﻤﻴﻊ ﳏﺎﻓﻈﺎﺕ ﺍﳉﻤﻬﻮﺭﻳﺔ‪ ،‬ﰒ‬
‫ﺻﺪﺭ ﺍﻟﻘﺮﺍﺭ ﺭﻗﻢ ‪ ٥٥٣‬ﻟﺴﻨﺔ ‪ ١٩٨٣‬ﺑﺸﺄﻥ ﺳﺮﻳﺎﻥ ﺃﺣﻜﺎﻡ ﺗﺄﻣﲔ ﺍﳌﺮﺽ ﻋﻠﻰ ﺍﻟﻌﺎﻣﻠﲔ ﲟﻨﺸﺂﺕ‬
‫ﺍﻟﻘﻄﺎﻋﲔ ﺍﻟﻌﺎﻡ ﻭﺍﳋﺎﺹ ﺍﻟﱵ ﻳﻌﻤﻞ ‪‬ﺎ ﻣﻦ ‪ ٤ – ١‬ﻋﻤﺎﻝ ﰲ ﲨﻴﻊ ﳏﺎﻓﻈﺎﺕ ﺍﳉﻤﻬﻮﺭﻳﺔ‪.‬‬
‫ﻭﻳﺒﲔ ﺍﳉﺪﻭﻝ ﺭﻗﻢ ‪ ١١‬ﺃﻋﺪﺍﺩ ﺍﳌﻨﺘﻔﻌﲔ ﺑﺎﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﰲ ﺍﻟﻔﺮﻭﻉ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻬﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ‬
‫ﺍﻟﺼﺤﻲ ﰲ ‪.(٩)١٩٩٩/٦/٣٠‬‬
‫ﻭﳚﻮﺯ ﻟﻠﻬﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺎﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻟﺘﺼﺮﻳﺢ ﻟﺒﻌﺾ ﺍﳌﻨﺸﺂﺕ ﺑﻌﻼﺝ ﺍﻟﻌﺎﻣﻠﲔ ‪‬ﺎ ﲢﺖ ﻇﺮﻭﻑ‬
‫ﻣﻌﻴﻨﺔ ﺷﺮﻳﻄﺔ ﺃﻥ ﺗﺘﻮﻓﺮ ﻟﺪﻳﻬﺎ ﻣﺴﺘﻮﻳﺎﺕ ﺧﺪﻣﺔ ﻃﺒﻴﺔ ﺗﺮﺿﻰ ﻋﻨﻬﺎ ﺍﳍﻴﺌﺔ‪.‬‬
‫ﻭﻧﺸﺄ ﻋﻦ ﺫﻟﻚ ﻭﺟﻮﺩ ﺷﺮﳛﺔ ﻣﻦ ﺍﳌﻨﺸﺂﺕ ﺗﺘﻮﱃ ﺗﻘﺪﱘ ﺧﺪﻣﺔ ﺍﻟﻌﻼﺝ ﺍﻟﻄﱯ ﻟﻠﻌﺎﻣﻠﲔ ‪‬ﺎ ﻭﻫﻰ ﰲ‬
‫ﺃﻏﻠﺐ ﺍﻷﺣﻴﺎﻥ ﻫﻴﺌﺎﺕ ﺃﻭ ﺷﺮﻛﺎﺕ ﻛﱪﻯ ﺗﻘﺪﻡ ﺧﺪﻣﺎﺕ ﻗﺪ ﺗﺘﻔﻮﻕ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳋﺪﻣﺔ ﺍﻟﺬﻱ ﺗﻘﺪﻣﻪ‬
‫ﺍﳍﻴﺌﺔ‪ .‬ﻭﺗﺆﺩﻯ ﺍﳋﺪﻣﺔ ﻋﻦ ﻃﺮﻳﻖ ﺃﻧﻈﻤﺔ ﳐﺘﻠﻔﺔ ﻓﻤﻨﻬﺎ ﻣﻦ ﻳﺴﺘﺨﺪﻡ ﺃﻃﺒﺎﺀ ﻣﻌﻴﻨﲔ ﻣﺘﺨﺼﺼﲔ‬
‫ﻛﻞ ﺍﻟﻮﻗﺖ ﺃﻭ ﻣﺘﻌﺎﻗﺪﻳﻦ ﻛﻞ ﺃﻭ ﺑﻌﺾ ﺍﻟﻮﻗﺖ ﻭﻣﻨﻬﻢ ﻣﻦ ﻳﺘﻌﺎﻗﺪ ﻣﻊ ﺃﻃﺒﺎﺀ ﰲ ﻋﻴﺎﺩﺍ‪‬ﻢ ﺃﻭ ﰲ‬
‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﻣﻨﻬﻢ ﻣﻦ ﺃﻧﺸﺄ ﻣﺴﺘﺸﻔﻴﺎﺕ ﺧﺎﺻﺔ ‪‬ﻢ ﻣﺜﻞ ﻣﺴﺘﺸﻔﻰ ﺍﻟﺒﺘﺮﻭﻝ ﻭﻣﺴﺘﺸﻔﻰ‬
‫ﺍﻟﻜﻬﺮﺑﺎﺀ ﻭﻣﺴﺘﺸﻔﻰ ﻫﻴﺌﺔ ﺍﻟﺴﻜﻚ ﺍﳊﺪﻳﺪﻳﺔ ﻭﻣﺴﺘﺸﻔﻰ ﻣﺼﺮ ﻟﻠﻄﲑﺍﻥ ﻭﻣﺴﺘﺸﻔﻰ ﺍﻟﺪﻋﺎﺓ‬
‫ﻭﻏﲑﻫﺎ‪.‬‬
‫ﻭﺗﻘﺪﻡ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻟﻠﺸﺮﳛﺔ ﺍﻷﻛﱪ ﻋﺪﺩﺍ ﻣﻦ ﺍﻟﻌﺎﻣﻠﲔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻌﻼﺟﻴﺔ ﺍﳌﺸﺎﺭ‬
‫ﺇﻟﻴﻬﺎ ﻋﻦ ﻃﺮﻳﻖ ﺷﺒﻜﺔ ﻣﻦ ﺍﻟﻮﺣﺪﺍﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻓﻔﻲ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻜﱪﻯ ﻳﻌﻤﻞ ﻃﺒﻴﺐ ﺃﻭ ﺃﻛﺜﺮ ﻛﻞ‬
‫ﺍﻟﻮﻗﺖ ﻭﰱ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻷﺻﻐﺮ ﺣﺠﻤﺎ ﻳﺆﺩﻯ ﺧﺪﻣﺔ ﺍﳌﻤﺎﺭﺱ ﻃﺒﻴﺐ ﺑﻌﺾ ﺍﻟﻮﻗﺖ ﻳﻘﻮﻡ ﺑﺮﻋﺎﻳﺔ ﻋﺪﺩ ﻣﻦ‬
‫ﺍﳌﻨﺸﺂﺕ‪ .‬ﻭﻫﻨﺎﻙ ﻋﻴﺎﺩﺍﺕ ﺍﳌﻤﺎﺭﺱ ﺍﻟﺸﺎﻣﻠﺔ ﻭﻛﺬﻟﻚ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺸﺎﻣﻠﺔ ﺍﻟﱵ ﺗﺆﺩﻯ – ﺇﱄ ﺟﺎﻧﺐ ﺧﺪﻣﺔ‬
‫ﺍﳌﻤﺎﺭﺱ ﺍﻟﻌﺎﻡ ﻟﻠﻤﻨﺸﺂﺕ ﺍﻟﺼﻐﲑﺓ ﻭﻟﻠﺤﺎﻻﺕ ﺍﻟﱵ ﲢﺘﺎﺝ ﺇﱄ ﻫﺬﻩ ﺍﳋﺪﻣﺔ ‪ -‬ﺧﺪﻣﺎﺕ ﺍﻟﻄﺒﻴﺐ‬
‫ﺍﻷﺧﺼﺎﺋﻲ ﰲ ﻓﺮﻭﻉ ﺍﻟﻄﺐ ﺍﳌﺨﺘﻠﻔﺔ‪ ،‬ﻭﻛﺬﻟﻚ ﺧﺪﻣﺔ ﺍﻟﻄﺒﻴﺐ ﺍﻻﺳﺘﺸﺎﺭﻱ‪ .‬ﻭﰲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺼﻨﺎﻋﻴﺔ‬
‫ﻭﺍﳌﺮﺍﻛﺰ ﺍﳊﻀﺮﻳﺔ ﺍﻟﻜﱪﻯ ﻫﻨﺎﻙ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻣﺒﺎﺷﺮﺓ ﻟﻠﻬﻴﺌﺔ‪ ،‬ﻛﻤﺎ ﺗﺸﺘﺮﻯ‬
‫ﺍﳍﻴﺌﺔ ﺍﳋﺪﻣﺔ ﺍﻟﻌﻼﺟﻴﺔ ﻣﻦ ﺑﻌﺾ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺍﳌﺮﺍﻛﺰ ﺍﳌﺘﺨﺼﺼﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻸﻧﺸﻄﺔ ﺍﻟﻌﻼﺟﻴﺔ‬
‫ﺃﻭ ﺍﻟﻔﺤﻮﺹ ﺍﻟﻄﺒﻴﺔ ﺍﻟﱵ ﻻ ﺗﺘﻮﺍﻓﺮ ﰲ ﻭﺣﺪﺍﺕ ﺍﳍﻴﺌﺔ‪.‬‬

‫‪٣٠٨‬‬
‫ﻭﺗﻌﺘﻤﺪ ﺍﳍﻴﺌﺔ ﰲ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﺑﺼﻔﺔ ﺃﺳﺎﺳﻴﺔ ﻋﻠﻰ ﺍﻷﻃﺒﺎﺀ ﺍﳌﻌﻴﻨﲔ ﺍﳌﻤﺎﺭﺳﲔ ﻭﺍﻷﺧﺼﺎﺋﻴﲔ‬
‫ﻭﺍﻷﻓﺮﺍﺩ ﺍﳌﻌﺎﻭﻧﲔ ﳍﻢ ﻭﻟﻜﻨﻬﺎ ﰲ ﻣﻮﺍﻗﻊ ﻛﺜﲑﺓ ﺗﻠﺠﺄ ﺇﱄ ﺍﻟﺘﻌﺎﻗﺪ ﻣﻊ ﺍﻷﻃﺒﺎﺀ ﺍﻷﺧﺼﺎﺋﻴﲔ‬
‫ﻭﺍﻻﺳﺘﺸﺎﺭﻳﲔ ﻭﻏﲑﻫﻢ ﻭﻻﺳﻴﻤﺎ ﰲ ﺍﳌﺪﻥ ﺍﻟﺼﻐﺮﻯ ﻭﺍﳌﻨﺎﻃﻖ ﺍﻟﻨﺎﺋﻴﺔ ﺣﻴﺚ ﻻ ﺗﺘﻮﻓﺮ ﻟﺪﻳﻬﺎ ﻫﺬﻩ‬
‫ﺍﻟﻜﻔﺎﺀﺍﺕ‪.‬‬
‫ﻭﺗﻐﻄﻰ ﺧﺪﻣﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻛﻞ ﺍﶈﺎﻓﻈﺎﺕ ﻭﺗﻘﺪﻡ ﺧﺪﻣﺔ ﻋﻼﺟﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻣﻘﺒﻮﻝ‪،‬‬
‫ﻭﺑﺎﻟﻨﺴﺒﺔ ﻟﺒﻌﺾ ﺍﳋﺪﻣﺎﺕ ﺍﳌﺘﺨﺼﺼﺔ ﻗﺪ ﳛﺘﺎﺝ ﺍﻷﻣﺮ ﺇﱄ ﺃﻥ ﺗﺴﺘﻌﲔ ﺑﻌﺾ ﻭﺣﺪﺍﺕ ﺍﻟﺘﺄﻣﲔ‬
‫ﺍﻟﺼﺤﻲ ﺑﺎﳋﱪﺍﺕ ﺍﳌﺘﻮﻓﺮﺓ ﰲ ﻭﺣﺪﺍﺕ ﺗﺄﻣﻴﻨﻴﺔ ﺃﺧﺮﻯ ﰲ ﺑﻌﺾ ﺍﳌﺪﻥ ﺍﻟﻜﱪﻯ ﺣﻴﺚ ﳛﺘﺎﺝ ﺍﳌﺮﻳﺾ ﺇﱄ‬
‫ﺍﻻﻧﺘﻘﺎﻝ ﺇﱄ ﺍﻟﻮﺣﺪﺓ ﺍﳌﺘﺎﺣﺔ ‪‬ﺎ ﺍﳋﺪﻣﺔ‪.‬‬
‫ﻭﺗﺒﲔ ﺍﳉﺪﺍﻭﻝ ﺭﻗﻢ ‪ ١٢‬ﻭ‪ ١٣‬ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺎﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻣﻦ ﺍﳌﻌﻴﻨﲔ ﻭﺍﳌﺘﻌﺎﻗﺪﻳﻦ‬
‫ﰲ ‪١٩٩٩ /٦/ ٣٠‬ﻭﻛﺬﻟﻚ ﺑﻌﺾ ﺍﳋﺪﻣﺎﺕ ﺍﻟﱵ ﺗﺆﺩﻳﻬﺎ ﺍﳍﻴﺌﺔ ﻭﺗﻜﺎﻟﻴﻔﻬﺎ ﺍﻹﲨﺎﻟﻴﺔ ﺧﻼﻝ ﻋﺎﻡ‬
‫‪.١٩٩٩/١٩٩٨‬‬
‫ﻭﺍﻟﺮﺃﻱ ﺃﻥ ﺍﳌﻨﺘﻔﻌﲔ ﲞﺪﻣﺎﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﳛﺼﻠﻮﻥ ﻋﻠﻰ ﺧﺪﻣﺔ ﺫﺍﺕ ﻣﺴﺘﻮﻯ ﻣﻘﺒﻮﻝ ﺑﺘﻜﺎﻟﻴﻒ‬
‫ﺭﻣﺰﻳﺔ ﻻ ﻳﻌﻴﺒﻬﺎ ﺳﻮﻯ ﺑﻌﺾ ﺗﺼﺮﻓﺎﺕ ﺍﻟﻌﻨﺼﺮ ﺍﻟﺒﺸﺮﻯ ﻋﻨﺪ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﺍ‪‬ﺎﻧﻴﺔ‪ .‬ﻓﻤﻘﺪﻡ ﺍﳋﺪﻣﺔ‬
‫ﻳﺆﺩﻳﻬﺎ ﺑﻄﺮﻳﻘﺔ ﺭﻭﺗﻴﻨﻴﺔ ﻭﻣﺘﻠﻘﻲ ﺍﳋﺪﻣﺔ ﻳﻄﻤﺢ ﺇﱄ ﻣﺰﻳﺪ ﻣﻦ ﺍﻟﺒﺸﺎﺷﺔ ﻭﺣﺴﻦ ﺍﳌﻌﺎﻣﻠﺔ ﻭﺇﱃ ﻣﺰﻳﺪ‬
‫ﻣﻦ ﺍﻟﺪﻭﺍﺀ ﻭﺍﻹﺟﺎﺯﺍﺕ ﺍﻟﱵ ﻳﻄﻠﺒﻬﺎ ﺃﺣﻴﺎﻧﺎ ﺩﻭﻥ ﻭﺟﻪ ﺣﻖ‪.‬‬
‫ﻭﺍﳍﻴﺌﺔ ﻣﺪﻳﻨﺔ ﲟﺒﺎﻟﻎ ﻃﺎﺋﻠﺔ ﺗﺪﻓﻌﻬﺎ ﺇﱄ ﺷﻲﺀ ﻣﻦ ﺍﻟﺘﻘﺸﻒ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺪﻭﺍﺀ‪ ،‬ﻭﻫﻮ ﻟﻴﺲ ﺗﻘﺸﻔﺎ‬
‫ﺟﻮﻫﺮﻳﺎ‪ ،‬ﺇﺫ ﺃﻥ ﺍﳍﻴﺌﺔ ﺗﻘﺪﻡ ﺍﻟﺪﻭﺍﺀ ﺍﻟﻔﻌﺎﻝ ﺍﻷﺭﺧﺺ ﲦﻨﺎ ﰲ ﺃﺿﻴﻖ ﺍﳊﺪﻭﺩ ﺍﳌﻘﺒﻮﻟﺔ‪.‬‬
‫ﻭﻗﺪ ﺑﻠﻎ ﺇﲨﺎﱄ ﻋﺪﺩ ﺷﻜﺎﻭﻯ ﺍﳌﻨﺘﻔﻌﲔ ﺑﺎﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ‪ ٨٠٤٥‬ﺷﻜﻮﻯ ﺧﻼﻝ ﻋﺎﻡ ‪١٩٩٩/١٩٩٨‬‬
‫ﲟﻌﺪﻝ ‪ ٢,٧‬ﺷﻜﻮﻯ ﻟﻜﻞ ‪ ١٠٠٠٠‬ﻣﻨﺘﻔﻊ)‪.(٩‬‬
‫ﻭﰱ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﱵ ﺗﻘﺪﻡ ﺍﳋﺪﻣﺔ ﻟﻠﻌﺎﻣﻠﲔ ‪‬ﺎ ﺗﻜﻮﻥ ﺍﳌﺆﺳﺴﺔ ﰲ ﺃﻏﻠﺐ ﺍﻷﺣﻴﺎﻥ ﺃﻗﻞ ﺗﻘﺸﻔﺎ‬
‫ﻭﺗﻜﻮﻥ ﺍﻟﻌﻼﻗﺎﺕ ﺍﻹﻧﺴﺎﻧﻴﺔ ﺑﲔ ﺍﻟﻔﺮﻳﻖ ﺍﻟﻄﱯ ﻭﺍﳌﺮﻳﺾ ﺃﺣﺴﻦ ﺣﺎﻻ ﻭﻳﻜﻮﻥ ﺭﺿﺎ ﻣﺘﻠﻘﻲ ﺍﳋﺪﻣﺔ ﺃﻛﺜﺮ‬
‫ﻣﻨﻪ ﰲ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﱵ ﺗﻐﻄﻴﻬﺎ ﺍﳍﻴﺌﺔ‪ .‬ﻭﰱ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﱵ ﺗﻘﺪﻡ ﺧﺪﻣﺎ‪‬ﺎ ﻟﻠﻌﺎﻣﻠﲔ ‪‬ﺎ ﻗﺪ‬
‫ﺗﺸﻤﻞ ﺍﻟﱪﺍﻣﺞ ﺍﻟﻌﻼﺟﻴﺔ ﺃﺳﺮ ﺍﻟﻌﺎﻣﻠﲔ‪.‬‬
‫ﻭﻻ ﻧﻨﺴﻰ ﰲ ﻫﺬﺍ ﺍﳌﻘﺎﻡ ﻣﺎ ﺗﻘﺪﻣﻪ ﻧﻘﺎﺑﺎﺕ ﺍﻟﻌﻤﺎﻝ ﻷﻋﻀﺎﺋﻬﺎ ﻣﻦ ﺧﺪﻣﺎﺕ ﻋﻼﺟﻴﺔ ﻣﺘﻮﺍﺿﻌﺔ ﰲ‬
‫ﻋﻴﺎﺩﺍﺕ ﻃﺒﻴﺔ ﺗﻨﺸﺌﻬﺎ ﻣﻦ ﻣﻴﺰﺍﻧﻴﺎ‪‬ﺎ ﺍﳋﺎﺻﺔ‪.‬‬

‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ‬
‫ﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﺍﻟﱵ ﺗﻘﺪﻣﻬﺎ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﻟﻜﺎﻓﺔ ﺍﳌﻮﺍﻃﻨﲔ ﻫﻨﺎﻙ‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻮﻗﺎﺋﻴﺔ ﺍﻟﱵ ‪‬ﺪﻑ ﺃﺳﺎﺳﺎ ﺇﱄ ﺗﻮﻓﲑ ﺑﻴﺌﺔ ﻋﻤﻞ ﺁﻣﻨﺔ ﻭﺇﱃ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﳌﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ‬
‫ﺑﺼﻔﺔ ﺧﺎﺻﺔ‪.‬‬
‫ﻭﻗﺪ ﻛﻔﻠﺖ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﺇﻧﺸﺎﺀ ﺍﻷﺟﻬﺰﺓ ﺍﳌﺴﺌﻮﻟﺔ ﻋﻦ ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﻋﻠﻰ‬
‫ﻛﺎﻓﺔ ﺍﳌﺴﺘﻮﻳﺎﺕ ﻭﻭﺿﻌﺖ ﺍﳌﻌﺎﻳﲑ ﻭﺍﻻﺷﺘﺮﺍﻃﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺘﻨﻔﻴﺬ ﺑﺮﺍﻣﺞ ‪‬ﺪﻑ ﺇﱄ ﲪﺎﻳﺔ ﺍﻟﻌﺎﻣﻞ ﰲ‬
‫ﻣﻜﺎﻥ ﻋﻤﻠﻪ‪.‬‬

‫‪٣٠٩‬‬
 ‫ﻓﻌﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳌﺆﺳﺴﺔ‪:‬‬
‫ﺻﺪﺭ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﻌﻤﻞ ﺭﻗﻢ ‪ ١١٦‬ﻟﺴﻨﺔ ‪ ١٩٩١‬ﺑﺘﺤﺪﻳﺪ ﺍﳌﻨﺸﺂﺕ ﻭﺃﺟﻬﺰﺓ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‬
‫ﻭﺟﻬﺎﺕ ﺍﻟﺘﺪﺭﻳﺐ‪.‬‬
‫ﻭﻳﺴﺮﻯ ﺍﻟﻘﺮﺍﺭ ﻋﻠﻰ ﺍﳌﻨﺸﺂﺕ ﺍﻟﺼﻨﺎﻋﻴﺔ ﻭﻏﲑ ﺍﻟﺼﻨﺎﻋﻴﺔ ﺍﻟﱵ ﺗﺴﺘﺨﺪﻡ ‪ ٥٠‬ﻋﺎﻣﻼ ﻓﺄﻛﺜﺮ ﰲ ﻣﻮﻗﻊ‬
‫ﻭﺍﺣﺪ ﻭﻳﻨﺺ ﻋﻠﻰ ﺃﻥ ﻳﻨﺸﺄ ﰲ ﻛﻞ ﻣﻨﻬﺎ ﺟﻬﺎﺯ ﻭﻇﻴﻔﻲ ﻣﺘﺨﺼﺺ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‬
‫ﻳﺘﻨﺎﺳﺐ ﺣﺠﻤﻪ ﻭﻣﺆﻫﻼﺕ ﺃﻓﺮﺍﺩﻩ ﻭﺗﺪﺭﻳﺒﻬﻢ ﻣﻊ ﻣﺴﺌﻮﻟﻴﺎﺕ ﺍﳌﻨﺸﺄﺓ ﻭﻧﻮﻉ ﺍﻟﻨﺸﺎﻁ ﻭﺣﺠﻢ ﺍﻟﻌﻤﺎﻟﺔ‪.‬‬
‫ﻭﻳﺘﺒﻊ ﺍﳉﻬﺎﺯ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ ﻭﻳﻜﻮﻥ ﻣﺴﺌﻮﻻ ﻋﻦ ﺗﻮﻓﲑ ﺍﺷﺘﺮﺍﻃﺎﺕ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺩﺍﺧﻞ‬
‫ﺍﳌﻨﺸﺄﺓ‪ .‬ﻭﳜﺘﺺ ﺑﺎﻻﺷﺘﺮﺍﻙ ﰲ ﺗﻨﻔﻴﺬ ﺍﻹﻧﺸﺎﺀﺍﺕ ﻭﺍﻟﺘﻮﺳﻌﺎﺕ ﺑﺎﳌﻨﺸﺄﺓ ﻟﺘﻮﻓﲑ ﻭﺳﺎﺋﻞ ﺍﻟﺴﻼﻣﺔ‬
‫ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻭﺇﻋﺪﺍﺩ ﺑﺮﺍﻣﺞ ﺗﺪﺭﻳﺐ ﺍﻟﻌﺎﻣﻠﲔ ﻭﻋﻘﺪ ﺍﺟﺘﻤﺎﻋﺎﺕ ﳉﺎﻥ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‬
‫ﺑﺎﳌﻨﺸﺄﺓ ﻭﺇﻋﺪﺍﺩ ﺧﻄﺔ ﺳﻨﻮﻳﺔ ﺗﻜﻔﻞ ﺍﻟﺘﻔﺘﻴﺶ ﺍﻟﺪﻭﺭﻱ ﻋﻠﻰ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ ﻭﻋﻤﻞ ﺍﻟﻘﻴﺎﺳﺎﺕ ﺍﻟﻼﺯﻣﺔ‬
‫ﻭﻣﻌﺎﻳﻨﺔ ﺍﳊﻮﺍﺩﺙ ﻭﺃﻣﺎﻛﻦ ﺣﺪﻭﺙ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺇﻋﺪﺍﺩ ﺍﻟﺘﻘﺎﺭﻳﺮ ﻭﺍﻹﺣﺼﺎﺋﻴﺎﺕ ﺍﻟﻼﺯﻣﺔ‪.‬‬
‫ﻛﻤﺎ ﻧﺺ ﺍﻟﻘﺮﺍﺭ ﻋﻠﻰ ﺇﻧﺸﺎﺀ ﳉﺎﻥ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﺘﻠﻚ ﺍﳌﻨﺸﺂﺕ ﲣﺘﺺ ﲟﺘﺎﺑﻌﺔ ﺷﺮﻭﻁ‬
‫ﻭﺍﺣﺘﻴﺎﻃﺎﺕ ﺍﻟﻮﻗﺎﻳﺔ ﻭﻣﻨﺎﻗﺸﺔ ﺍﳊﻮﺍﺩﺙ ﻭﺍﻹﺻﺎﺑﺎﺕ ﻭﻣﺘﺎﺑﻌﺔ ﺑﺮﺍﻣﺞ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪.‬‬
‫ﻭﻗﺪ ﺣﺪﺩ ﺍﻟﻘﺮﺍﺭ ﺃﻋﺪﺍﺩ ﻭﻣﺆﻫﻼﺕ ﺃﻓﺮﺍﺩ ﺟﻬﺎﺯ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﺎﳌﻨﺸﺄﺓ ﻭﻛﺬﻟﻚ ﻣﺴﺘﻮﻳﺎﺕ‬
‫ﻭﺟﻬﺎﺕ ﺍﻟﺘﺪﺭﻳﺐ‪.‬‬
‫ﻛﻤﺎ ﺻﺪﺭ ﻗﺮﺍﺭ ﻭﺯﻳﺮ ﺍﻟﻌﻤﻞ ﺭﻗﻢ ‪ ٥٥‬ﻟﺴﻨﺔ ‪ ١٩٨٣‬ﰲ ﺷﺄﻥ ﺍﻻﺷﺘﺮﺍﻃﺎﺕ ﻭﺍﻻﺣﺘﻴﺎﻃﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺘﻮﻓﲑ‬
‫ﻭﺳﺎﺋﻞ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﰲ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ‪ .‬ﻭﺫﻛﺮ ﺍﻟﻘﺮﺍﺭ ﺑﺎﻟﺘﻔﺼﻴﻞ ﻭﺳﺎﺋﻞ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ‬
‫ﺍﳌﺨﺎﻃﺮ ﺍﻟﻄﺒﻴﻌﻴﺔ ﻭﺍﳌﻴﻜﺎﻧﻴﻜﻴﺔ ﻭﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ ﻭﺣﺪﺩ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﳌﺄﻣﻮﻧﺔ ﻟﻠﻮﻃﺄﺓ ﺍﳊﺮﺍﺭﻳﺔ ﻭﺍﻹﺿﺎﺀﺓ‬
‫ﻭﺍﻟﻀﻮﺿﺎﺀ ﻭﺍﳌﻠﻮﺛﺎﺕ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ ﰲ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﻭﺗﻠﺘﺰﻡ ﺍﳌﻨﺸﺂﺕ ﲟﻮﺍﻓﺎﺓ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺈﺣﺼﺎﺋﻴﺎﺕ ﻧﺼﻒ ﺳﻨﻮﻳﺔ ﻋﻦ ﺍﻷﻣﺮﺍﺽ ﻭﺍﻹﺻﺎﺑﺎﺕ‬
‫ﻭﺍﻹﺑﻼﻍ ﻋﻦ ﺍﳊﻮﺍﺩﺙ ﺍﳉﺴﻴﻤﺔ ﺧﻼﻝ ‪ ٢٤‬ﺳﺎﻋﺔ‪.‬‬
‫ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ‪:‬‬
‫ﻧﺼﺖ ﺍﳌﺎﺩﺓ ‪ ١٢٥‬ﻣﻦ ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺇﻋﺪﺍﺩ ﺟﻬﺎﺯ ﻣﺘﺨﺼﺺ ﻳﻘﻮﻡ ﺑﺎﻟﺘﻔﺘﻴﺶ ﺍﻟﺪﻭﺭﻱ ﻋﻠﻰ ﺍﳌﻨﺸﺂﺕ‬
‫ﻟﻠﺘﺤﻘﻖ ﻣﻦ ﺗﻨﻔﻴﺬ ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﻭﺍﻟﻘﺮﺍﺭﺍﺕ ﺍﳌﻨﻔﺬﺓ ﻟﻪ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻭﺃﻥ‬
‫ﺗﺘﻮﻓﺮ ﰲ ﺃﻓﺮﺍﺩ ﺍﳉﻬﺎﺯ ﺍﳌﺆﻫﻼﺕ ﻭﺍﳋﱪﺓ ﺍﻟﻼﺯﻣﺔ ﰲ ﺍﻟﻨﻮﺍﺣﻲ ﺍﻟﻄﺒﻴﺔ ﻭﺍﳍﻨﺪﺳﻴﺔ ﻭﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ ﻭﺃﻥ ﺗﻨﻈﻢ‬
‫ﳍﻢ ﺑﺮﺍﻣﺞ ﺗﺪﺭﻳﺒﻴﺔ ﻣﻨﺎﺳﺒﺔ ﻟﺮﻓﻊ ﻛﻔﺎﺀ‪‬ﻢ‪ ،‬ﻭﺗﺰﻭﻳﺪﻫﻢ ﺑﺄﺟﻬﺰﺓ ﺍﻟﻘﻴﺎﺱ ﺍﻟﻼﺯﻣﺔ ﻷﺩﺍﺀ ﺃﻋﻤﺎﳍﻢ‪ .‬ﻭﻣﻦ‬
‫ﺑﲔ ﺃﻋﻤﺎﻝ ﺃﺟﻬﺰﺓ ﺍﻟﺘﻔﺘﻴﺶ ﻣﺮﺍﻗﺒﺔ ﺃﻋﻤﺎﻝ ﺃﺟﻬﺰﺓ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﰲ ﺍﳌﻨﺸﺂﺕ‪.‬‬
‫ﻭﻳﻌﻤﻞ ﰲ ﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﰲ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻭﰲ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﺣﻮﺍﱄ ﺃﻟﻒ ﻣﻦ‬
‫ﺍﻟﻌﺎﻣﻠﲔ‪ .‬ﻭﻳﻌﺎﱏ ﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﻣﻦ ﻗﻠﺔ ﻋﺪﺩ ﺍﳌﻔﺘﺸﲔ ﻧﺴﺒﺔ ﺇﱄ ﻋﺪﺩ ﺍﳌﻨﺸﺂﺕ ﻭﻣﻦ ﻧﻘﺺ ﰲ ﺑﻌﺾ‬
‫ﺍﻟﺘﺨﺼﺼﺎﺕ ﻣﺜﻞ ﺍﻟﻄﺐ ﻭﺍﳍﻨﺪﺳﺔ‪ ،‬ﻭﻣﻦ ﻧﻘﺺ ﺍﻟﺘﺪﺭﻳﺐ‪ ،‬ﻭﺃﺟﻬﺰﺓ ﺍﻟﻘﻴﺎﺱ‪ ،‬ﻭﻣﻦ ﺻﻌﻮﺑﺔ ﺍﻻﻧﺘﻘﺎﻝ‬
‫ﺇﱄ ﺍﳌﺆﺳﺴﺎﺕ ﺍﳌﺮﺍﺩ ﺍﻟﺘﻔﺘﻴﺶ ﻋﻠﻴﻬﺎ)‪.(١١‬‬

‫‪٣١٠‬‬
 ‫ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳉﻤﻬﻮﺭﻳﺔ‪:‬‬
‫ﺻﺪﺭ ﻗﺮﺍﺭ ﺭﺋﻴﺲ ﺍﳉﻤﻬﻮﺭﻳﺔ ﺭﻗﻢ ‪ ١١٤‬ﻟﺴﻨﺔ ‪ ١٩٨٤‬ﺑﺈﻧﺸﺎﺀ ﺍ‪‬ﻠﺲ ﺍﻻﺳﺘﺸﺎﺭﻱ ﺍﻷﻋﻠﻰ ﻟﻠﺴﻼﻣﺔ‬
‫ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪ .‬ﻭﳜﺘﺺ ﺍ‪‬ﻠﺲ ﺑﺮﺳﻢ ﺍﻟﺴﻴﺎﺳﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻹﺷﺮﺍﻑ‬
‫ﻋﻠﻰ ﺗﻨﺴﻴﻖ ﺍﳉﻬﻮﺩ ﻭﺗﻨﻈﻴﻢ ﺍﻟﺘﻌﺎﻭﻥ ﺑﲔ ﺍﳉﻬﺎﺕ ﺫﺍﺕ ﺍﻟﺼﻠﺔ‪.‬‬
‫ﻛﻤﺎ ﻧﺺ ﺍﻟﻘﺮﺍﺭ ﻋﻠﻰ ﺗﺸﻜﻴﻞ ﳉﺎﻥ ﺍﺳﺘﺸﺎﺭﻳﺔ ﻣﺸﺘﺮﻛﺔ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﻜﻞ ﳏﺎﻓﻈﺔ‬
‫ﳍﺎ ﻧﻔﺲ ﺍﻻﺧﺘﺼﺎﺹ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﶈﻠﻰ‪.‬‬
‫ﻭﺇﺫﺍ ﻧﻈﺮﻧﺎ ﺇﱄ ﺍﳉﺪﺍﻭﻝ ‪ ١٠– ٥‬ﻟﻮﺟﺪﻧﺎ ﺃﻧﻪ – ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﻛﻔﺎﺀﺓ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ – ﻓﺈﻥ ﻣﺸﻜﻼﺕ‬
‫ﺍﻟﺘﻄﺒﻴﻖ ﻭﺍﻟﻨﻈﻢ ﺍﳌﻮﺿﻮﻋﺔ ﻟﻮﻗﺎﻳﺔ ﺍﻟﻌﺎﻣﻠﲔ ﻣﻦ ﺃﺧﻄﺎﺭ ﺍﳌﻬﻨﺔ ﻛﺎﻧﺖ ﺫﺍﺕ ﻧﺘﺎﺋﺞ ﳏﺪﻭﺩﺓ‪ .‬ﻭﺃﻧﻪ ‪-‬‬
‫ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﺇﺩﺍﺭﺍﺕ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﺎﶈﺎﻓﻈﺎﺕ ﻳﺘﻢ ﺇﺧﻄﺎﺭﻫﺎ ﺑﻜﻞ ﺣﺎﻻﺕ ﺍﻹﺻﺎﺑﺎﺕ‬
‫ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‪ ،‬ﻭﺃﻥ ﻋﻠﻰ ﺗﻠﻚ ﺍﻹﺩﺍﺭﺍﺕ ﺗﻨﻔﻴﺬ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ ﺍﳌﺨﺘﻠﻔﺔ ﺍﻟﱵ ‪‬ﺪﻑ ﺇﱄ ﺗﻮﻓﲑ ﺑﻴﺌﺔ ﻋﻤﻞ‬
‫ﺁﻣﻨﺔ – ﺇﻻ ﺃﻥ ﺍﳌﻼﺣﻆ ﻣﻦ ﺟﺪﻭﻝ ‪ ٨‬ﺃﻥ ﺣﺎﻻﺕ ﺍﻟﻮﻓﺎﺓ ﺍﻹﺻﺎﺑﻴﺔ ﻛﺎﻧﺖ ﰲ ﺗﺰﺍﻳﺪ ﻣﺴﺘﻤﺮ ﻣﻨﺬ ﻋﺎﻡ ‪١٩٩٦‬‬
‫ﺣﱴ ﻋﺎﻡ ‪ ،٢٠٠١‬ﻭﺃﻥ ﺣﺎﻻﺕ ﺍﻟﻌﺠﺰ ﺍﻹﺻﺎﰊ ﻗﺪ ﺯﺍﺩﺕ ﻛﺬﻟﻚ ﰲ ﻧﻔﺲ ﺍﻟﻔﺘﺮﺓ‪.‬‬
‫ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﱄ ﺍﻟﺼﻌﻮﺑﺎﺕ ﺍﻟﱵ ﻳﻌﺎﱏ ﻣﻨﻬﺎ ﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﻓﺈﻥ ﺍﻟﻌﻘﻮﺑﺎﺕ ﺍﻟﱵ ﳝﻜﻦ ﺃﻥ ﺗﻮﻗﻊ ﻋﻠﻰ‬
‫ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ ﺍﳌﺨﺎﻟﻒ ﻏﲑ ﺭﺍﺩﻋﺔ‪ .‬ﻭﰲ ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻴﺎﻥ ﻳﻌﺎﱏ ﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﻣﻦ ﻋﺪﻡ ﺗﻌﺎﻭﻥ‬
‫ﺃﺻﺤﺎﺏ ﺍﻷﻋﻤﺎﻝ‪.‬‬
‫ﻭﻳﺘﻔﺎﻭﺕ ﺍﻫﺘﻤﺎﻡ ﺃﺻﺤﺎﺏ ﺍﻷﻋﻤﺎﻝ ﺑﺄﻣﻮﺭ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﳑﺎ ﻳﻨﻌﻜﺲ ﺑﺎﻟﻀﺮﻭﺭﺓ ﻋﻠﻰ ﺃﺩﺍﺀ‬
‫ﺃﺟﻬﺰﺓ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﰲ ﻣﻨﺸﺂ‪‬ﻢ‪ .‬ﻓﻔﻲ ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻴﺎﻥ ﻳﻘﻮﻡ ﺃﻓﺮﺍﺩ ﺍﻟﺴﻼﻣﺔ‬
‫ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ‪‬ﺬﻩ ﺍﻷﻋﻤﺎﻝ ﺇﱄ ﺟﺎﻧﺐ ﺃﻋﻤﺎﳍﻢ ﺍﻷﺻﻠﻴﺔ ﻓﻼ ﻳﺘﺎﺡ ﳍﻢ ﺍﻟﻮﻗﺖ ﺍﻟﻜﺎﰲ ﻷﺩﺍﺋﻬﺎ‪.‬‬
‫ﻭﰱ ﻣﻌﻈﻢ ﺍﻷﺣﻴﺎﻥ ﻻ ﻳﺘﻮﻓﺮ ﳍﻢ ﺍﻟﺘﺪﺭﻳﺐ ﺍﻟﻜﺎﰲ ﻭﻻ ﺃﺟﻬﺰﺓ ﺍﻟﻘﻴﺎﺱ ﺍﻟﻼﺯﻣﺔ ﻟﺘﻘﻴﻴﻢ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﻛﺬﻟﻚ ﻻ ﺗﻨﻌﻘﺪ ﳉﺎﻥ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﺼﻔﺔ ﺩﻭﺭﻳﺔ ﻣﻨﺘﻈﻤﺔ ﻛﻤﺎ ﺗﻨﺺ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ‪،‬‬
‫ﻭﺗﺆﺩﻯ ﺩﻭﺭﻫﺎ ﺑﻄﺮﻳﻘﺔ ﺻﻮﺭﻳﺔ‪ .‬ﻭﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﻣﻦ ﻣﺴﺌﻮﻟﻴﺎﺕ ﻣﻔﺘﺸﻲ ﻣﺪﻳﺮﻳﺎﺕ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ‬
‫ﺍﻟﺘﺄﻛﺪ ﻣﻦ ﺣﺴﻦ ﺳﲑ ﺍﻟﻌﻤﻞ ‪‬ﺬﻩ ﺍﻟﻠﺠﺎﻥ ﺇﻻ ﺃﻥ ﳏﺎﺿﺮ ﺍﳉﻠﺴﺎﺕ ﻛﺜﲑﺍ ﻣﺎ ﺗﺪﻭﻥ ﰲ ﺍﻟﺪﻓﺎﺗﺮ ﺍﳌﻌﺪﺓ‬
‫ﻟﺬﻟﻚ ﺑﺪﻭﻥ ﻋﻘﺪ ﺍﺟﺘﻤﺎﻋﺎﺕ‪.‬‬
‫ﻭﺑﺼﻔﺔ ﻋﺎﻣﺔ ﻓﺈﻧﻪ – ﺑﺎﺳﺘﺜﻨﺎﺀ ﺑﻌﺾ ﺍﳌﻨﺸﺂﺕ ﺍﻟﻜﱪﻯ ﻭﺍﳌﺘﻮﺳﻄﺔ – ﻓﺈﻥ ﺃﺩﺍﺀ ﺃﺟﻬﺰﺓ ﺍﻟﺴﻼﻣﺔ‬
‫ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﰲ ﺍﳌﻨﺸﺂﺕ ﻟﻴﺲ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ ﺍﳌﺄﻣﻮﻝ‪.‬‬

‫‪"+ , -./‬‬

‫ﺇﻥ ﺍﳌﺪﻗﻖ ﰲ ﺍﻹﺣﺼﺎﺋﻴﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﺳﻮﻑ ﻳﺼﺒﺢ ﻋﻠﻰ ﻳﻘﲔ ﻣﻦ ﺃﻥ‬
‫ﺍﻷﻧﺸﻄﺔ ﺍﳌﻮﺟﻬﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﺍﳌﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ ﱂ ﺗﺆﺕ ﺍﻟﻨﺘﺎﺋﺞ ﺍﳌﺮﺟﻮﺓ‪ .‬ﻓﺒﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﺍﻟﺘﺸﺮﻳﻌﺎﺕ‬
‫ﺍﳋﺎﺻﺔ ﺑﺎﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﻋﻠﻰ ﺩﺭﺟﺔ ﻋﺎﻟﻴﺔ ﻣﻦ ﺍﻟﺸﻤﻮﻝ ﺇﻻ ﺃﻥ ﺍﻷﻋﺪﺍﺩ ﺍﻟﻜﺒﲑﺓ ﻭﺍﳌﺘﺰﺍﻳﺪﺓ‬
‫ﻣﻦ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﺗﺸﲑ ﺇﱄ ﺃﻥ ﺍﻟﺘﻨﻔﻴﺬ ﻟﻴﺲ ﻋﻠﻰ ﺩﺭﺟﺔ ﻣﻘﺒﻮﻟﺔ ﻣﻦ ﺍﻟﻜﻔﺎﺀﺓ‪.‬‬

‫‪٣١١‬‬
‫ﻭﺍﻟﺮﺃﻱ ﺃﻥ ﺭﻓﻊ ﺩﺭﺟﺔ ﺍﻟﻮﻋﻲ ﻭﺍﻻﻫﺘﻤﺎﻡ ﻟﺪﻯ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﻠﻴﺎ ﻣﻦ ﻓﺌﺔ ﺃﺻﺤﺎﺏ ﺍﻷﻋﻤﺎﻝ ﺃﻣﺮ ﺟﻮﻫﺮﻱ‬ ‫
‬
‫ﳚﺐ ﺃﻥ ﺗﺘﺠﻪ ﺍﳉﻬﻮﺩ ﺇﱄ ﲢﻘﻴﻘﻪ‪.‬‬
‫ﻭﳋﻠﻖ ﺟﻴﻞ ﻣﻦ ﺍﳌﺪﻳﺮﻳﻦ ﺍﳌﺴﺌﻮﻟﲔ ﰲ ﺍﻟﺼﻨﺎﻋﺔ ﻋﻠﻰ ﻭﻋﻰ ﺑﺄﻣﻮﺭ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﳚﺐ‬
‫ﺃﻥ ﺗﺒﺪﺃ ﺗﻮﻋﻴﺘﻬﻢ ﻭﺗﺪﺭﻳﺒﻬﻢ ﰲ ﻣﺮﺍﺣﻞ ﺍﻟﺘﻌﻠﻴﻢ ﺍﳌﺨﺘﻠﻔﺔ ﻭﻻ ﺳﻴﻤﺎ ﰲ ﺍﳌﺮﺣﻠﺔ ﺍﳉﺎﻣﻌﻴﺔ‪ .‬ﻭﳚﺐ‬
‫ﺃﻥ ﺗﺸﻤﻞ ﺑﺮﺍﻣﺞ ﺗﺪﺭﻳﺐ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﻠﻴﺎ ﻗﺪﺭﺍ ﻛﺒﲑﺍ ﻣﻦ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺼﺤﺔ ﺍﻟﻌﺎﻣﻠﲔ ﻭﺳﻼﻣﺘﻬﻢ‬
‫ﺣﻴﺚ ﺇﻥ ﺫﻟﻚ – ﺑﻜﻞ ﺗﺄﻛﻴﺪ – ﻳﻨﻌﻜﺲ ﻋﻠﻰ ﺟﻮﺩﺓ ﺍﻹﻧﺘﺎﺝ ﻛﻤﺎ ﻭﻛﻴﻔﺎ‪ .‬ﻭﳝﻜﻦ ﺃﻥ ﺗﺴﺎﻫﻢ ﻭﺳﺎﺋﻞ‬
‫ﺍﻹﻋﻼﻡ ﰲ ﻫﺬﻩ ﺍﻟﺘﻮﻋﻴﺔ‪.‬‬
‫ﻓﺈﺫﺍ ﲢﻘﻖ ﺍﻫﺘﻤﺎﻡ ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﻠﻴﺎ ﺑﺄﻣﻮﺭ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﻓﺈﻥ ﺫﻟﻚ ﺳﻴﺆﺩﻯ ﺇﱄ ﻗﻴﺎﻡ‬ ‫
‬
‫ﺃﺟﻬﺰﺓ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﰲ ﺍﳌﻨﺸﺂﺕ ﺑﺪﻭﺭﻫﺎ ﺑﺸﻜﻞ ﺃﻓﻀﻞ‪ .‬ﻭﳚﺐ ﺃﻥ ﺗﻨﻈﺮ ﻋﻨﺪﺋﺬ ﺇﱄ‬
‫ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﺍﻟﱵ ﲢﺪﺙ ﰲ ﺍﳌﻨﺸﺄﺓ ﻋﻠﻰ ﺃ‪‬ﺎ ﺩﻻﻟﺔ ﻋﻠﻰ ﻭﺟﻮﺩ ﻧﻘﺺ ﰲ ﺃﺩﺍﺀ ﻫﺬﻩ‬
‫ﺍﻷﺟﻬﺰﺓ ﻭﺃﻥ ﺗﺒﺬﻝ ﺍﳉﻬﻮﺩ ﳌﻌﺮﻓﺔ ﺃﺳﺒﺎﺏ ﺍﻟﻨﻘﺺ ﻭﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺗﻼﻓﻴﻪ‪.‬‬
‫ﻭﻻ ﻧﻨﺴﻰ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﺃﻥ ﺗﺪﺭﻳﺐ ﻫﺬﻩ ﺍﻷﺟﻬﺰﺓ ﻋﻠﻰ ﺍﻟﺘﻌﺮﻑ ﻋﻠﻰ ﺍﳌﺨﺎﻃﺮ ﰲ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ‬
‫ﻭﻗﻴﺎﺳﻬﺎ ﻭﻣﻘﺎﺭﻧﺘﻬﺎ ﺑﺎﳌﻌﺎﻳﲑ ﺍﳌﺴﻤﻮﺡ ‪‬ﺎ ﻭﺗﻮﻓﲑ ﺃﺟﻬﺰﺓ ﺍﻟﻘﻴﺎﺱ ﺃﻣﺮ ﺷﺪﻳﺪ ﺍﻷﳘﻴﺔ‪ .‬ﻭﳚﺐ ﺃﻻ‬
‫ﻧﻨﺘﻈﺮ ﻭﻗﻮﻉ ﺍﻹﺻﺎﺑﺎﺕ ﺃﻭ ﺣﺪﻭﺙ ﺍﻷﻣﺮﺍﺽ ﻟﻜﻲ ﻧﺘﺨﺬ ﺇﺟﺮﺍﺀﺍﺕ ﺍﻟﻮﻗﺎﻳﺔ ﺑﻞ ﺗﻜﻮﻥ ﺍﻟﻘﻴﺎﺳﺎﺕ ﻫﻲ‬
‫ﺍﳌﺆﺷﺮ ﻋﻠﻰ ﻭﺟﻮﺩ ﺍﳌﺨﺎﻃﺮ ﺍﻟﱵ ﳚﺐ ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺍﻟﺘﺤﻜﻢ ﻓﻴﻬﺎ ﻗﺒﻞ ﺣﺪﻭﺙ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ‪.‬‬
‫ﻭﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﺍﻟﺘﺎﺑﻊ ﻟﻮﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﻣﺪﻳﺮﻳﺎ‪‬ﺎ ﻳﺘﻠﻘﻰ ﻣﻦ ﺍﳌﻨﺸﺂﺕ ﺑﻴﺎﻧﺎﺕ ﺩﻭﺭﻳﺔ ﻋﻦ‬ ‫
‬
‫ﺍﳊﻮﺍﺩﺙ ﻭﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‪ .‬ﻭﺑﺎﻟﻨﻈﺮ ﺇﱄ ﺍﻹﺣﺼﺎﺋﻴﺎﺕ ﺍﳌﺘﺎﺣﺔ ﻟﺪﻳﻨﺎ ﻧﺮﻯ ﺃﻥ ﻫﺬﻩ‬
‫ﺍﻟﺒﻴﺎﻧﺎﺕ ﺗﻌﺎﻣﻞ ﻋﻠﻰ ﺃ‪‬ﺎ ﺃﻣﺮ ﻭﺍﻗﻊ ﻻ ﳝﻜﻦ ﺗﻐﻴﲑﻩ ﻭﻻ ﺗﻠﻔﺖ ﺍﻟﻨﻈﺮ ﺇﱄ ﺍﻷﻭﺿﺎﻉ ﺍﳌﺘﺪﻧﻴﺔ –‬
‫ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ – ﰲ ﺑﻌﺾ ﺃﻣﺎﻛﻦ ﺍﻟﻌﻤﻞ‪ .‬ﻭﻫﻨﺎﻙ ﻋﺪﺓ ﺃﺳﺒﺎﺏ ﳏﺘﻤﻠﺔ ﻻﺳﺘﻤﺮﺍﺭ‬
‫ﺍﻷﻭﺿﺎﻉ ﻋﻠﻰ ﻣﺎ ﻫﻲ ﻋﻠﻴﻪ ﻣﻨﻬﺎ‪:‬‬
‫ﺍﻟﻨﻘﺺ ﰲ ﺍﻹﻣﻜﺎﻧﻴﺎﺕ ﺍﻟﺒﺸﺮﻳﺔ ﻭﺍﻟﺘﺪﺭﻳﺐ ﻭﺍﻷﺟﻬﺰﺓ ﻟﺪﻯ ﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﳑﺎ ﻳﻌﺠﺰﻩ ﻋﻦ‬ ‫‪-‬‬
‫ﺍﻟﻘﻴﺎﻡ ﺑﺪﻭﺭﻩ ﻋﻠﻰ ﺍﻟﻮﺟﻪ ﺍﻷﻛﻤﻞ‪.‬‬
‫ﺍﻟﻼﻣﺒﺎﻻﺓ ﻭﺍﻋﺘﺒﺎﺭ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺃﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ ﻣﺴﺄﻟﺔ ﻣﻘﺒﻮﻟﺔ ﻃﺎﳌﺎ ﳛﺼﻞ ﺍﳌﺼﺎﺏ‬ ‫‪-‬‬
‫ﻋﻠﻰ ﺍﻟﺘﻌﻮﻳﺾ ﺍﻟﻼﺯﻡ‪.‬‬
‫ﺿﻌﻒ ﺍﻟﻌﻘﻮﺑﺎﺕ ﺍﻟﱵ ﻳﻔﺮﺿﻬﺎ ﺍﻟﻘﺎﻧﻮﻥ ﻋﻠﻰ ﺃﺻﺤﺎﺏ ﺍﻟﻌﻤﻞ ﺍﳌﺨﺎﻟﻔﲔ‪.‬‬ ‫‪-‬‬
‫ﻋﺪﻡ ﺍﻫﺘﻤﺎﻡ ﺃﺻﺤﺎﺏ ﺍﻟﻌﻤﻞ ﺑﺄﻣﻮﺭ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ‪.‬‬ ‫‪-‬‬
‫ﺿﻌﻒ ﺍﻹﻣﻜﺎﻧﻴﺎﺕ ﺍﳌﺎﺩﻳﺔ ﻟﺪﻯ ﺻﺎﺣﺐ ﺍﻟﻌﻤﻞ – ﻻﺳﻴﻤﺎ ﰲ ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺼﻐﲑﺓ – ﳑﺎ ﻻ‬ ‫‪-‬‬
‫ﳝﻜﻨﻪ ﻣﻦ ﺍﻟﺘﺤﻜﻢ ﰲ ﺍﳌﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ ﰲ ﺍﳌﻨﺸﺄﺓ‪.‬‬
‫ﻭﻧﺮﻯ ﺃﻥ ﻫﺬﻩ ﺍﻷﻣﻮﺭ – ﳎﺘﻤﻌﺔ – ﺗﺆﺩﻯ ﺇﱄ ﺍﻟﻨﺘﺎﺋﺞ ﺍﳌﺸﺎﺭ ﺇﻟﻴﻬﺎ‪ .‬ﻭﳚﺐ ﺃﻥ ﺗﺘﻮﱃ ﺍﳉﻬﺎﺕ ﺍﳌﺴﺌﻮﻟﺔ‬
‫ﻋﻦ ﻛﻞ ﻣﻨﻬﺎ ﲝﺚ ﺍﻟﺼﻌﻮﺑﺎﺕ ﻭﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺗﺬﻟﻴﻠﻬﺎ‪ .‬ﻭﺃﻥ ﺗﻘﻮﻡ ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺪﻭﺭ ﺭﺍﺋﺪ ﰲ‬
‫ﲢﺴﲔ ﺃﺩﺍﺀ ﺟﻬﺎﺯ ﺍﻟﺘﻔﺘﻴﺶ ﻭﺇﻣﺪﺍﺩﻩ ﺑﺎﻟﻘﻮﻯ ﺍﻟﺒﺸﺮﻳﺔ ﻭﺍﻟﺘﺪﺭﻳﺐ ﻭﺍﻷﺟﻬﺰﺓ ﺍﻟﻼﺯﻣﺔ ﻷﺩﺍﺀ ﻋﻤﻠﻪ ﻋﻠﻰ‬
‫ﺃﺣﺴﻦ ﻭﺟﻪ‪.‬‬

‫‪٣١٢‬‬
‫ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺗﺘﻠﻘﻰ ﺍﺷﺘﺮﺍﻛﺎﺕ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﻢ ﺑﺘﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ‬ ‫
‬
‫ﻭﺗﺘﻜﺪﺱ ﻟﺪﻳﻬﺎ ﺍﻷﻣﻮﺍﻝ‪ ،‬ﺗﻨﻔﻖ ﻣﻨﻬﺎ ﻋﻠﻰ ﺍﻛﺘﺸﺎﻑ ﻭﻋﻼﺝ ﻭﺗﺄﻫﻴﻞ ﻭﺗﻌﻮﻳﺾ ﺍﳌﺼﺎﺑﲔ‪ ،‬ﺩﻭﻥ ﺃﻥ‬
‫ﻳﻜﻮﻥ ﻟﺪﻳﻬﺎ ﺍﻹﺭﺍﺩﺓ – ﺃﻭ ﺍﻻﻟﺘﺰﺍﻡ ﺍﻟﻘﺎﻧﻮﱐ – ﻟﻜﻲ ﺗﺴﺎﻫﻢ ﰲ ﺍﻟﺘﻘﻠﻴﻞ ﻣﻦ ﺍﻟﻔﺎﻗﺪ‪ ،‬ﺍﻷﻣﺮ ﺍﻟﺬﻱ ﻳﻌﻮﺩ‬
‫ﻋﻠﻴﻬﺎ ﺑﺎﻟﻔﺎﺋﺪﺓ – ﺑﻜﻞ ﺗﺄﻛﻴﺪ‪.‬‬
‫ﻭﺗﻘﻮﻡ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺑﺎﻷﻋﻤﺎﻝ ﺍﻟﻄﺒﻴﺔ ﰲ ﳎﺎﻝ ﺗﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ‪ ،‬ﻭﻟﻴﺲ‬
‫ﳍﺎ – ﲝﻜﻢ ﺍﻟﻘﺎﻧﻮﻥ – ﺃﻱ ﺩﻭﺭ ﰲ ﺃﻋﻤﺎﻝ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻓﻴﻤﺎ ﻋﺪﺍ ﺇﺟﺮﺍﺀ‬
‫ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻻﺑﺘﺪﺍﺋﻲ ﻭﺍﻟﺪﻭﺭﻱ‪.‬‬
‫ﻭﻧﺮﻯ ﺃﻥ ﲡﺮﻯ ﺩﺭﺍﺳﺔ ﻫﺬﻩ ﺍﻷﻭﺿﺎﻉ ﻭﺗﻘﻴﻴﻢ ﺍﳉﺪﻭﻯ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻣﻦ ﺍﺷﺘﺮﺍﻙ ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ‬
‫ﻟﻠﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺑﻄﺮﻳﻘﺔ ﺃﻭ ﺑﺄﺧﺮﻯ ﰲ ﺃﻋﻤﺎﻝ ﺍﻟﻮﻗﺎﻳﺔ‬
‫ﻣﻦ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‪.‬‬
‫ﻭﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ﻧﻘﺎﺑﺎﺕ ﺍﻟﻌﻤﺎﻝ ﳍﺎ ﺩﻭﺭ ﻓﻌﺎﻝ ﰲ ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﻣﺰﺍﻳﺎ ﻟﻠﻌﺎﻣﻠﲔ‪ ،‬ﻭﺭﻏﻢ‬ ‫
‬
‫ﺃﻥ ﺍﻟﻨﻘﺎﺑﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻌﻤﺎﻝ ﻣﺼﺮ ‪‬ﺎ ﺃﻣﺎﻧﺔ ﻟﻸﻣﻦ ﺍﻟﺼﻨﺎﻋﻲ‪ ،‬ﺇﻻ ﺃﻧﻪ ‪ -‬ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺃﻣﺎﻛﻦ‬
‫ﺍﻟﻌﻤﻞ – ﻳﺘﺒﻠﻮﺭ ﻧﺸﺎﻁ ﺍﻟﻨﻘﺎﺑﺎﺕ ﰲ ﺍﳌﻄﺎﻟﺒﺔ ﺑﺈﺟﺮﺍﺀ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻭﺍﳊﺼﻮﻝ ﻋﻠﻰ‬
‫ﺣﻘﻮﻕ ﺍﻟﻌﻤﺎﻝ ﺍﳌﺼﺎﺑﲔ ﰲ ﺍﻟﻌﻼﺝ ﻭﺍﻹﺟﺎﺯﺓ ﻭﺍﻟﺘﻌﻮﻳﺾ ﺩﻭﻥ ﺃﻥ ﺗﺒﺬﻝ ﺟﻬﻮﺩﺍ ﺗﺬﻛﺮ ﰲ ﳎﺎﻝ ﺍﻟﻮﻗﺎﻳﺔ‬
‫ﻣﻦ ﺍﳌﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ‪ ،‬ﺇﻻ ﰲ ﺣﺎﻻﺕ ﻧﺎﺩﺭﺓ‪.‬‬
‫ﻣﻦ ﺑﲔ ﺍﺧﺘﺼﺎﺻﺎﺕ ﺍ‪‬ﻠﺲ ﺍﻻﺳﺘﺸﺎﺭﻱ ﺍﻷﻋﻠﻰ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺍﻹﺷﺮﺍﻑ ﻋﻠﻰ‬ ‫
‬
‫ﺗﻨﺴﻴﻖ ﺍﳉﻬﻮﺩ ﻭﺗﻨﻈﻴﻢ ﺍﻟﺘﻌﺎﻭﻥ ﺑﲔ ﺍﳉﻬﺎﺕ ﺫﺍﺕ ﺍﻟﺼﻠﺔ ‪‬ﺪﻑ ﺍﻟﻨﻬﻮﺽ ﲟﺴﺘﻮﻯ ﺃﺩﺍﺋﻬﺎ‪ .‬ﻭﻧﺎﺩﺭﺍ‬
‫ﻣﺎ ﳚﺘﻤﻊ ﺍ‪‬ﻠﺲ‪ .‬ﻭﻟﻴﺴﺖ ﻟﺪﻳﻪ ﺍﻵﻟﻴﺎﺕ ﺍﻟﱵ ﲤﻜﻨﻪ ﻣﻦ ﺇﺣﺪﺍﺙ ﺗﻐﻴﲑ ﰲ ﺃﺳﻠﻮﺏ ﺍﻟﻌﻤﻞ ﲝﻴﺚ‬
‫ﻳﺆﺩﻯ ﺫﻟﻚ ﺇﱄ ﲢﺴﲔ ﺃﺩﺍﺀ ﻫﺬﻩ ﺍﳉﻬﺎﺕ ﻭﲢﻘﻴﻖ ﻭﻗﺎﻳﺔ ﺣﻘﻴﻘﻴﺔ ﻟﻠﻌﺎﻣﻠﲔ‪ .‬ﻭﳛﺘﺎﺝ ﺍﻷﻣﺮ ﺇﱄ ﺗﻌﺪﻳﻞ‬
‫ﺍﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ ﻟﻜﻲ ﻳﻌﻄﻰ ﻟﻠﻤﺠﻠﺲ ﺍﻟﺼﻼﺣﻴﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻭﻛﺬﻟﻚ ﺇﱃ ﺗﻔﻌﻴﻞ ﺩﻭﺭ ﺍﻟﻠﺠﺎﻥ‬
‫ﺍﻻﺳﺘﺸﺎﺭﻳﺔ ﰲ ﺍﶈﺎﻓﻈﺎﺕ ﻭﺇﻋﻄﺎﺋﻬﺎ ﺍﻟﺼﻼﺣﻴﺎﺕ ﺍﻟﻼﺯﻣﺔ ﻟﺘﺄﺩﻳﺔ ﺩﻭﺭﻫﺎ ﻋﻠﻰ ﺍﻟﻮﺟﻪ ﺍﻷﻛﻤﻞ‪.‬‬
‫ﻭﳚﺐ ﺃﻥ ﻳﻘﻮﻡ ﺍ‪‬ﻠﺲ ﻋﻨﺪﺋﺬ ﺑﺈﺟﺮﺍﺀ ﺗﻘﻴﻴﻢ ﺩﻭﺭﻱ ﳊﺎﻟﺔ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﻋﻠﻰ ﺍﳌﺴﺘﻮﻯ‬
‫ﺍﻟﻘﻮﻣﻲ ﻭﺃﻥ ﻳﻜﻮﻥ ﺍﻟﺘﻘﻴﻴﻢ ﻣﺒﻨﻴﺎ ﻋﻠﻰ ﻣﺆﺷﺮﺍﺕ ﻭﺍﻗﻌﻴﺔ ﻣﻦ ﺃﳘﻬﺎ ﻣﻌﺪﻻﺕ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ‬
‫ﺍﳌﻬﻨﻴﺔ‪ ،‬ﻭﻳﺘﻢ ﺑﻨﺎﺀ ﻋﻠﻰ ﻫﺬﺍ ﺍﻟﺘﻘﻴﻴﻢ ﲢﺪﻳﺪ ﻧﻘﺎﻁ ﺍﻟﻀﻌﻒ ﻭﺗﻮﺟﻴﻪ ﺑﺮﺍﻣﺞ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ‬
‫ﺍﳌﻬﻨﻴﺔ ﺍﻟﻮﺟﻬﺔ ﺍﻟﺼﺤﻴﺤﺔ‪ .‬ﻭﻳﺴﺘﻠﺰﻡ ﺫﻟﻚ ﺇﻧﺸﺎﺀ " ﻗﺎﻋﺪﺓ ﺑﻴﺎﻧﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ "‬
‫ﺗﺴﺘﻤﺪ ﺑﻴﺎﻧﺎ‪‬ﺎ ﻣﻦ ﻛﺎﻓﺔ ﺍﳉﻬﺎﺕ ﺍﳌﻌﻨﻴﺔ ﺑﺎﻷﻣﺮ ﻭﺗﻜﻮﻥ ﻣﺘﺎﺣﺔ ﻟﻠﻤﻬﺘﻤﲔ ﻭﺗﺴﺎﻋﺪ ﰲ ﺗﺮﺗﻴﺐ‬
‫ﺃﻭﻟﻮﻳﺎﺕ ﺍﻟﻌﻤﻞ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﻭﺭﺳﻢ ﺍﻟﺴﻴﺎﺳﺎﺕ ﺍﻟﻼﺯﻣﺔ‪.‬‬
‫ﻳﻮﺻﻰ ﺑﺄﻥ ﺗﻘﻮﻡ ﺍﻷﺟﻬﺰﺓ ﺍﻟﻘﺎﺋﻤﺔ ﻋﻠﻰ ﻣﻨﺢ ﺍﻟﺘﺮﺍﺧﻴﺺ ﻟﻠﻤﻨﺸﺂﺕ ﲟﺮﺍﻋﺎﺓ ﺍﻟﺘﺨﻄﻴﻂ ﺍﻟﻌﻤﺮﺍﱐ‬ ‫
‬
‫ﺍﻟﺴﻠﻴﻢ ﻭﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﺍﺳﺘﻌﻤﺎﻝ ﺍﻟﺘﻘﻨﻴﺎﺕ ﺍﻟﺼﻨﺎﻋﻴﺔ ﻏﲑ ﺍﳌﻠﻮﺛﺔ ﻭﻣﺮﺍﻋﺎﺓ ﺍﺷﺘﺮﺍﻃﺎﺕ ﺍﻟﺼﺤﺔ‬
‫ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﻗﺒﻞ ﻣﻨﺢ ﺍﻟﺘﺮﺧﻴﺺ ﺑﺘﺸﻐﻴﻞ ﺍﳌﻨﺸﺄﺓ‪ ،‬ﻭﺃﻥ ﻳﺮﺍﻋﻰ ﺫﻟﻚ ﺑﺼﻔﺔ ﺧﺎﺻﺔ ﰲ‬
‫ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﻌﻤﺮﺍﻧﻴﺔ ﺍﳉﺪﻳﺪﺓ‪.‬‬
‫ﻳﻮﺻﻰ ﺑﻌﻤﻞ ﻣﺮﺍﺟﻌﺔ ﺩﻭﺭﻳﺔ ﻟﻠﺘﺸﺮﻳﻌﺎﺕ ﺍﳋﺎﺻﺔ ﺑﺎﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﺑﻐﺮﺽ ﲢﺪﻳﺜﻬﺎ‬ ‫
‬
‫ﻟﺘﻮﺍﻛﺐ ﺍﻟﺘﻄﻮﺭ ﺍﻟﺘﻘﲏ ﻭﺍﻟﺼﻨﺎﻋﻲ‪ ،‬ﻭﺑﺼﻔﺔ ﺧﺎﺻﺔ‪:‬‬

‫‪٣١٣‬‬
‫ﺟﺪﻭﻝ ﺃﻣﺮﺍﺽ ﺍﳌﻬﻨﺔ ﺍﳌﻠﺤﻖ ﺑﻘﺎﻧﻮﻥ ﺍﻟﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ ﻭﺍﳊﺎﺟﺔ ﺇﱃ ﺗﻌﺪﻳﻠﻪ ﺑﺈﺿﺎﻓﺔ‬ ‫‪-‬‬
‫ﺍﻟﺘﻌﺮﺿﺎﺕ ﺍﳌﻬﻨﻴﺔ ﺍﻟﱵ ﺗﺴﺘﺠﺪ ﻧﺘﻴﺠﺔ ﻟﻠﺘﻄﻮﺭ ﺍﳌﺴﺘﻤﺮ ﰲ ﺍﻟﺼﻨﺎﻋﺔ ﻭﺍﺳﺘﺤﺪﺍﺙ‬
‫ﻋﻤﻠﻴﺎﺕ ﺻﻨﺎﻋﻴﺔ ﻭﺍﺳﺘﻌﻤﺎﻝ ﻛﻴﻤﺎﻭﻳﺎﺕ ﱂ ﺗﻜﻦ ﺗﺴﺘﻌﻤﻞ ﻣﻦ ﻗﺒﻞ‪.‬‬
‫ﺍﻟﻨﺴﺐ ﺍﳌﺴﻤﻮﺡ ﺑﺎﻟﺘﻌﺮﺽ ﳍﺎ ﰲ ﺣﺎﻟﺔ ﻭﺟﻮﺩ ﺍﳌﺨﺎﻃﺮ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ ﻭﺍﻟﻔﻴﺰﻳﺎﺋﻴﺔ ﰲ ﺑﻴﺌﺔ‬ ‫‪-‬‬
‫ﺍﻟﻌﻤﻞ‪.‬‬
‫ﺍﻟﻘﺮﺍﺭ ﺍﳉﻤﻬﻮﺭﻱ ﺭﻗﻢ ‪ ٥٩‬ﻟﺴﻨﺔ ‪ ١٩٦٠‬ﺑﺸﺄﻥ ﺍﺳﺘﻌﻤﺎﻝ ﺍﻹﺷﻌﺎﻋﺎﺕ ﺍﳌﺆﻳﻨﺔ ﻭﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ‬ ‫‪-‬‬
‫ﺃﺧﻄﺎﺭﻫﺎ‪.‬‬
‫ﺗﻐﻠﻴﻆ ﺍﻟﻌﻘﻮﺑﺎﺕ ﻭﺍﻟﻐﺮﺍﻣﺎﺕ ﻋﻠﻰ ﺇﳘﺎﻝ ﻭﺳﺎﺋﻞ ﺍﻟﻮﻗﺎﻳﺔ ﲟﺎ ﻳﺘﻼﺀﻡ ﻣﻊ ﺍﻷﺿﺮﺍﺭ ﺍﻟﻨﺎﲨﺔ ﻋﻦ‬ ‫‪-‬‬
‫ﻫﺬﺍ ﺍﻹﳘﺎﻝ‪.‬‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﺑﺈﺟﺮﺍﺀ ﺩﺭﺍﺳﺔ ﻣﺘﺄﻧﻴﺔ ﻋﻦ ﻛﻴﻔﻴﺔ ﺗﻮﺻﻴﻞ ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﺇﱄ ﻋﻤﺎﻝ‬ ‫
‬
‫ﺍﻟﺰﺭﺍﻋﺔ ﻣﻊ ﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﺩﻭﺭ ﺑﺮﺍﻣﺞ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﺍﻟﻘﺎﺋﻤﺔ ﺣﺎﻟﻴﺎ‪ ،‬ﺑﻌﺪ ﺗﺪﺭﻳﺐ ﺍﻟﻜﻮﺍﺩﺭ‬
‫ﺗﺪﺭﻳﺒﺎ ﻣﻨﺎﺳﺒﺎ‪ .‬ﻭﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﺃﳘﻴﺔ ﺩﻭﺭ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻜﺎﻥ ﰲ ﺗﺄﻣﲔ ﺳﻼﻣﺔ ﺍﺧﺘﻴﺎﺭ‬
‫ﺍﳌﺒﻴﺪﺍﺕ ﺍﻟﱵ ﻳﺼﺮﺡ ﺑﺎﺳﺘﻌﻤﺎﳍﺎ‪ ،‬ﻭﺯﻳﺎﺩﺓ ﺍﻟﺘﻨﺴﻴﻖ ﺑﻴﻨﻬﺎ ﻭﺑﲔ ﻭﺯﺍﺭﺓ ﺍﻟﺰﺭﺍﻋﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪.‬‬
‫ﻳﻮﺻﻰ ﺑﺄﻥ ﻳﻨﺺ ﻗﺎﻧﻮﻥ ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺇﻟﺰﺍﻡ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﱵ ﻳﺰﻳﺪ ﻋﺪﺩ ﻋﻤﺎﳍﺎ ﻋﻦ ‪ ٥٠٠‬ﻋﺎﻣﻞ‬ ‫
‬
‫ﺑﺎﺳﺘﺨﺪﺍﻡ ﻃﺒﻴﺐ )ﻛﻞ ﺍﻟﻮﻗﺖ ﺃﻭ ﺑﻌﺾ ﺍﻟﻮﻗﺖ( ﻣﺘﺨﺼﺺ ﰲ ﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪.‬‬
‫ﲢﺴﲔ ﺍﻷﺩﺍﺀ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻟﻠﻌﺎﻣﻠﲔ ﺍﳌﻌﺮﺿﲔ ﻟﻠﻤﺨﺎﻃﺮ ﺍﳌﻬﻨﻴﺔ ﻭﺫﻟﻚ‬ ‫
‬
‫ﺑﺘﺨﺼﻴﺺ ﺃﻃﺒﺎﺀ ﻣﺴﺘﺪﳝﲔ ﳍﺬﺍ ﺍﻟﻌﻤﻞ ﻭﺗﺪﺭﻳﺒﻬﻢ ﻋﻠﻰ ﺍﻻﻛﺘﺸﺎﻑ ﺍﳌﺒﻜﺮ ﻟﻸﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‪.‬‬
‫ﺍﻟﺘﺪﺭﻳﺐ ﺍﳌﺴﺘﻤﺮ ﻋﻠﻰ ﻛﺎﻓﺔ ﺍﳌﺴﺘﻮﻳﺎﺕ ﻟﻠﻔﺌﺎﺕ ﺍﻵﺗﻴﺔ‪:‬‬ ‫
‬
‫ﺃﻓﺮﺍﺩ ﺃﺟﻬﺰﺓ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﺑﺎﳌﻨﺸﺂﺕ ﻣﻊ ﺍﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﺘﺪﺭﻳﺐ ﺍﻟﻌﻤﻠﻲ ﻋﻠﻰ‬ ‫‪-‬‬
‫ﺍﺳﺘﻌﻤﺎﻝ ﺃﺟﻬﺰﺓ ﺍﻟﻘﻴﺎﺱ‪.‬‬
‫ﻣﻔﺘﺸﻮ ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﲟﺪﻳﺮﻳﺎﺕ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻣﻊ ﺗﻮﻓﲑ ﺃﺟﻬﺰﺓ ﻗﻴﺎﺱ‬ ‫‪-‬‬
‫ﺍﳌﺨﺎﻃﺮ ﻭﺗﺪﺭﻳﺒﻬﻢ ﻋﻠﻴﻬﺎ ﻭﺃﻥ ﺗﻮﻓﺮ ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻟﺒﻌﻀﻬﻢ ﺗﺪﺭﻳﺒﺎ ﻣﺘﻘﺪﻣﺎ ﻋﻦ ﻃﺮﻳﻖ‬
‫ﺑﻌﺜﺎﺕ ﺩﺍﺧﻠﻴﺔ ﻛﻞ ﰲ ﳎﺎﻝ ﲣﺼﺼﻪ‪.‬‬
‫ﺍﻟﺘﺪﺭﻳﺐ ﰲ ﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ ﻷﻃﺒﺎﺀ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﺍﳌﻨﺸﺂﺕ ﺍﻟﺼﻨﺎﻋﻴﺔ‬ ‫‪-‬‬
‫ﻭﺑﺼﻔﺔ ﺧﺎﺻﺔ ﺍﻟﻘﺎﺋﻤﲔ ﺑﺎﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ‪.‬‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ ﰲ ﺑﺮﺍﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻔﲏ ﻭﺍﻟﺘﻌﻠﻴﻢ‬ ‫‪-‬‬
‫ﺍﳉﺎﻣﻌﻲ ﻭﰱ ﺑﺮﺍﻣﺞ ﺍﻟﺘﺪﺭﻳﺐ ﺍﻟﱵ ﺗﻨﻈﻤﻬﺎ ﻧﻘﺎﺑﺎﺕ ﺍﻟﻌﻤﺎﻝ ﻭﺍﳉﺎﻣﻌﺔ ﺍﻟﻌﻤﺎﻟﻴﺔ‪.‬‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﺑﺘﺨﺼﺺ "ﺻﺤﺔ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ‪ ."Industrial hygiene‬ﻭﳝﻜﻦ ﰲ ﺍﻟﻮﻗﺖ ﺍﳊﺎﺿﺮ‬ ‫‪-‬‬
‫ﺍﻻﺳﺘﻌﺎﻧﺔ ﺑﺎﳌﺘﺨﺼﺼﲔ ‪ Industrial hygienists‬ﰲ ﺍﳌﺮﻛﺰ ﺍﻟﻘﻮﻣﻲ ﻟﺪﺭﺍﺳﺎﺕ ﺍﻷﻣﻦ‬
‫ﺍﻟﺼﻨﺎﻋﻲ ﺍﻟﺘﺎﺑﻊ ﻟﻮﺯﻳﺮ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ‪ ،‬ﻭﻛﺬﻟﻚ ﺍﳌﺘﺨﺼﺼﲔ ﰲ ﻣﺮﺍﻛﺰ ﺍﻟﺒﺤﻮﺙ ﻭﺍﳉﺎﻣﻌﺎﺕ‪،‬‬
‫ﻹﺟﺮﺍﺀ ﺍﻟﺘﺪﺭﻳﺐ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪ ،‬ﻭﻋﻠﻰ ﺇﺟﺮﺍﺀ ﺩﺭﺍﺳﺎﺕ ﺻﺤﺔ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ﰲ ﺍﳌﻮﺍﻗﻊ ﺍﳌﺨﺘﻠﻔﺔ‪،‬‬
‫ﻭﻛﺬﻟﻚ ﺣﱴ ﳝﻜﻦ ﺗﻼﰲ ﺣﺪﻭﺙ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻹﺻﺎﺑﺎﺕ ﺃﻭ ﺍﻟﺘﻘﻠﻴﻞ ﻣﻨﻬﺎ‪.‬‬

‫‪٣١٤‬‬
‫ﻳﻮﺻﻰ ﺑﺈﺟﺮﺍﺀ ﺩﺭﺍﺳﺔ ﻣﺘﺄﻧﻴﺔ ‪‬ﺪﻑ ﺇﳚﺎﺩ ﺣﻮﺍﻓﺰ ﺇﳚﺎﺑﻴﺔ ﻭﺳﻠﺒﻴﺔ ﻷﺻﺤﺎﺏ ﺍﻷﻋﻤﺎﻝ ﳊﻔﺰﻫﻢ ﻋﻠﻰ‬ ‫
‬
‫ﺑﺬﻝ ﻣﺰﻳﺪ ﻣﻦ ﺍﳉﻬﺪ ﻟﻠﺘﻘﻠﻴﻞ ﻣﻦ ﻣﻌﺪﻻﺕ ﺣﺪﻭﺙ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‪.‬‬
‫ﺍﻻﺳﺘﻔﺎﺩﺓ ﻣﻦ ﻧﺸﺎﻁ ﺍﳉﻤﻌﻴﺎﺕ ﻏﲑ ﺍﳊﻜﻮﻣﻴﺔ ﰲ ﺩﻋﻢ ﻭﺗﻔﻌﻴﻞ ﺍﻷﻧﺸﻄﺔ ﺍﻟﻮﻗﺎﺋﻴﺔ ﻭﺍﻟﻘﻴﺎﻡ ﺑﺪﻭﺭ‬ ‫
‬
‫ﺇﳚﺎﰊ ﻋﻦ ﻃﺮﻳﻖ ﺇﺑﺮﺍﺯ ﺍﳊﺎﺟﺔ ﺇﱃ ﺇﺟﺮﺍﺀﺍﺕ ﻭﻗﺎﺋﻴﺔ ﰲ ﻣﻮﺍﻗﻊ ﻣﻌﻴﻨﺔ ﻭﺍﻟﻘﻴﺎﻡ ﺑﺎﻟﺪﻭﺭ ﺍﻟﺮﻗﺎﰊ ﺍﻟﺬﻱ‬
‫ﺃﺗﺎﺣﻪ ﺍﻟﻘﺎﻧﻮﻥ ﺭﻗﻢ ‪ ٤‬ﻟﺴﻨﺔ ‪ ،١٩٩٤‬ﻭﻛﺬﻟﻚ ﺗﻮﻋﻴﺔ ﺍﳉﻤﺎﻫﲑ ﳌﻤﺎﺭﺳﺔ ﺍﻟﻀﻐﻂ ﻋﻠﻰ ﺍﻷﺟﻬﺰﺓ‬
‫ﺍﻟﺘﻨﻔﻴﺬﻳﺔ ﻟﺒﺬﻝ ﺍﳌﺰﻳﺪ ﻣﻦ ﺍﳉﻬﺪ‪ ،‬ﻭﺍﻟﻘﻴﺎﻡ ﺑﺪﻭﺭ ﻓﻌﺎﻝ ﰲ ﺗﻮﻋﻴﺔ ﺍﻟﻌﻤﺎﻟﺔ ﻏﲑ ﺍﳌﻨﺘﻈﻤﺔ )ﻣﺜﻞ‬
‫ﻋﻤﺎﻝ ﻗﻄﺎﻉ ﺍﳌﻘﺎﻭﻻﺕ( ﲝﻘﻮﻗﻬﻢ ﺍﻟﺼﺤﻴﺔ ﻭﺍﳌﺎﺩﻳﺔ ﻭﺍﻟﺘﺄﻣﻴﻨﻴﺔ‪.‬‬

‫‪٣١٥‬‬
 ‫ 
‪01‬‬
‫‪١. Hunter D. The Diseases of Occupations. London: Hodder & Stough, ١٩٨٧.‬‬
‫‪٢. Ramazzini B. Diseases of Workers. Translated by Wright W C. In: De‬‬
‫‪Morbis Artificum Diatriba, ١٧١٣. New York: Hofner, ١٩٦٤.‬‬
‫‪٣. World Health Organization. Technical Report Series no. ٦٦. Joint‬‬
‫‪ILO/WHO Committee on Occupational Health. WHO, Geneva, ١٩٥٣.‬‬
‫‪٤. Rom WN. The discipline of environmental and occupational medicine. In:‬‬
‫‪Rom WN ( ed.), Environmental and Occupational Medicine, ٣rd edition.‬‬
‫‪Lippincot-Raven, Philadelphia, New York. ١٩٩٨. PP ٣.‬‬
‫‪ .٥‬ﺍ‪‬ﺎﻟﺲ ﺍﻟﻘﻮﻣﻴﺔ ﺍﳌﺘﺨﺼﺼﺔ – ﺭﺋﺎﺳﺔ ﺍﳉﻤﻬﻮﺭﻳﺔ‪ -‬ﺍ‪‬ﻠﺲ ﺍﻟﻘﻮﻣﻲ ﻟﻠﺨﺪﻣﺎﺕ ﻭﺍﻟﺘﻨﻤﻴﺔ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ – ﺷﻌﺒﺔ ﺍﳋﺪﻣﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ .‬ﺗﻘﺮﻳﺮ ﻋﻦ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺴﻼﻣﺔ ﺍﳌﻬﻨﻴﺔ – ﺭﺅﻳﺔ‬
‫ﻣﺴﺘﻘﺒﻠﻴﺔ‪ .١٩٩٤.‬ﺍﻟﻘﺎﻫﺮﺓ‪.‬‬
‫‪ .٦‬ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ – ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪ .‬ﺍﻟﺘﻘﺮﻳﺮ ﺍﻟﺴﻨﻮﻱ‪.١٩٨٣ .‬‬
‫ﺍﻟﻘﺎﻫﺮﺓ‪.‬‬
‫‪ .٧‬ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ – ﺍﻟﻜﺘﺎﺏ ﺍﻹﺣﺼﺎﺋﻲ ﺍﻟﺴﻨﻮﻱ ‪ -١٩٩٩– ١٩٩٣‬ﻳﻮﻧﻴﻮ‬
‫‪.٢٠٠٠‬‬
‫‪ .٨‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ – ﺍﻟﻠﺠﻨﺔ ﺍﻟﺪﺍﺋﻤﺔ ﻟﻠﺘﺨﻄﻴﻂ ﻭﺍﻹﺷﺮﺍﻑ ﻭﻣﺘﺎﺑﻌﺔ ﺇﺟﺮﺍﺀﺍﺕ‬
‫ﺗﻨﻔﻴﺬ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ _ ﻳﻮﻧﻴﻮ ‪.٢٠٠١‬‬
‫‪ .٩‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ‪ .‬ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻠﻤﻌﻠﻮﻣﺎﺕ ﻭﺍﻟﺘﻮﺛﻴﻖ‪ .‬ﺗﻘﺮﻳﺮ ﺍﳌﺘﺎﺑﻌﺔ ﺍﻟﺴﻨﻮﻱ‬
‫ﻋﻦ ﻧﺸﺎﻁ ﺍﳍﻴﺌﺔ ﺧﻼﻝ ﻋﺎﻡ ‪.١٩٩٩/١٩٩٨‬‬
‫‪ .١٠‬ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ – ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ‪ -‬ﻭﺯﺍﺭﺓ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﻭﺍﻟﺸﺌﻮﻥ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ‪.٢٠٠١‬‬
‫‪ .١١‬ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﳍﺠﺮﺓ – ﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪ .‬ﺍﻟﺘﻔﺘﻴﺶ ﰲ ﳎﺎﻝ‬
‫ﺍﻟﺴﻼﻣﺔ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪.‬ﺗﻘﺮﻳﺮ ﻋﻦ ﺑﻴﺌﺔ ﺍﻟﻌﻤﻞ ﻭﺍﻟﺼﺤﺔ ﺍﳌﻬﻨﻴﺔ‪ .‬ﺍﻟﻮﺍﻗﻊ ﻭﻣﺸﺎﻛﻞ ﺍﻟﺘﻄﺒﻴﻖ‪.‬‬
‫‪.٢٠٠١‬‬

‫‪٣١٦‬‬
 ‫"‪& 1 :1 2‬‬
‫ﺟﺪﻭﻝ )‪ :(١-١١‬ﺗﻮﺯﻳﻊ ﺍﻟﺴﻜﺎﻥ ‪ ١٥‬ﺳﻨﺔ ﻓﺄﻛﺜﺮ ﺣﺴﺐ ﺍﻟﻨﺸﺎﻁ ﺍﻻﻗﺘﺼﺎﺩﻱ ﰲ ﺣﻀﺮ ﻭﺭﻳﻒ ﺍﳉﻤﻬﻮﺭﻳﺔ‬
‫)ﺗﻌﺪﺍﺩ ‪(١٩٩٦‬‬

‫ﲨﻠﺔ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺣﻀﺮ‪ -‬ﺭﻳﻒ‬ ‫ﺍﻟﻨﺸﺎﻁ ﺍﻻﻗﺘﺼﺎﺩﻱ‬

‫‪٥٥٨١٣٦‬‬ ‫‪٢٥٨٤٦‬‬ ‫‪٥٣٢٢٩٠‬‬ ‫ﺣﻀﺮ‬

‫‪٤٣٢٢٧٣٥‬‬ ‫‪٢١٤٣١٨‬‬ ‫‪٤١٠٨٤١٧‬‬ ‫ﺭﻳﻒ‬ ‫ﺯﺭﺍﻋﺔ‪ -‬ﺻﻴﺪ‪ -‬ﻗﻄﻊ ﺃﺧﺸﺎﺏ‬
‫‪٤٨٨٠٨٧١‬‬ ‫‪٢٤٠١٦٤‬‬ ‫‪٤٦٤٠٧٠٧‬‬ ‫ﲨﻠﺔ‬
‫‪٤٢٨٤٥‬‬ ‫‪٢٣١١‬‬ ‫‪٤٠٥٣٤‬‬ ‫ﺣﻀﺮ‬
‫‪٢٠٨٢٥‬‬ ‫‪٤٨٩‬‬ ‫‪٢٠٣٣٦‬‬ ‫ﺭﻳﻒ‬ ‫ﺗﻌﺪﻳﻦ‪ -‬ﻣﻨﺎﺟﻢ‪ -‬ﳏﺎﺟﺮ‬
‫‪٦٣٦٧٠‬‬ ‫‪٢٨٠٠‬‬ ‫‪٦٠٨٧٠‬‬ ‫ﲨﻠﺔ‬
‫‪١٣٨٣٣٧٩‬‬ ‫‪١٤٦٣٦٦‬‬ ‫‪١٢٣٧٠١٣‬‬ ‫ﺣﻀﺮ‬
‫‪٧٩٤٠٥٨‬‬ ‫‪٦٣٢٧١‬‬ ‫‪٧٣٠٧٨٧‬‬ ‫ﺭﻳﻒ‬ ‫ﺻﻨﺎﻋﺎﺕ ﲢﻮﻳﻠﻴﺔ‬
‫‪٢١٧٧٤٣٧‬‬ ‫‪٢٠٩٦٣٧‬‬ ‫‪١٩٦٧٨٠٠‬‬ ‫ﲨﻠﺔ‬
‫‪٩٥٨٥٥‬‬ ‫‪١٢٠٢٠‬‬ ‫‪٨٣٨٣٥‬‬ ‫ﺣﻀﺮ‬
‫‪٦٣٥١٩‬‬ ‫‪٢٢٤٦‬‬ ‫‪٦١٢٧٣‬‬ ‫ﺭﻳﻒ‬ ‫ﻛﻬﺮﺑﺎﺀ‪ -‬ﻏﺎﺯ‪ -‬ﻣﻴﺎﻩ‬
‫‪١٥٩٣٧٤‬‬ ‫‪١٤٢٦٦‬‬ ‫‪١٤٥١٠٨‬‬ ‫ﲨﻠﺔ‬
‫‪٧٥٩٦٧٠‬‬ ‫‪١٦٤٥٥‬‬ ‫‪٧٤٣٢١٥‬‬ ‫ﺣﻀﺮ‬
‫‪٥٢٣١١٠‬‬ ‫‪٤٤٥٢‬‬ ‫‪٥١٨٦٥٨‬‬ ‫ﺭﻳﻒ‬ ‫ﺇﻧﺸﺎﺀﺍﺕ‬
‫‪١٢٨٢٧٨٠‬‬ ‫‪٢٠٩٠٧‬‬ ‫‪١٢٦١٨٧٣‬‬ ‫ﲨﻠﺔ‬
‫‪١٥٦٢٧٧‬‬ ‫‪٨٤٨٨‬‬ ‫‪١٤٧٧٨٩‬‬ ‫ﺣﻀﺮ‬
‫‪٤٩٥٧٥‬‬ ‫‪٢٠٥٩‬‬ ‫‪٤٧٥١٦‬‬ ‫ﺭﻳﻒ‬ ‫ﻣﻄﺎﻋﻢ ﻭﻓﻨﺎﺩﻕ‬
‫‪٢٠٥٨٥٢‬‬ ‫‪١٠٥٤٧‬‬ ‫‪١٩٥٣٠٥‬‬ ‫ﲨﻠﺔ‬
‫‪٥٧٤٨٨٩‬‬ ‫‪٣٩٦٢٢‬‬ ‫‪٥٣٥٢٦٧‬‬ ‫ﺣﻀﺮ‬
‫‪٣٤١٦٠٦‬‬ ‫‪٥٣٢٣‬‬ ‫‪٣٣٦٢٨٣‬‬ ‫ﺭﻳﻒ‬ ‫ﻧﻘﻞ‪ -‬ﺍﺗﺼﺎﻻﺕ‪ -‬ﲣﺰﻳﻦ‬
‫‪٩١٦٤٩٥‬‬ ‫‪٤٤٩٤٥‬‬ ‫‪٧٨١٥٥٠‬‬ ‫ﲨﻠﺔ‬
‫‪٤٥٨٩٥٩‬‬ ‫‪١٣٩٥٧٧‬‬ ‫‪٣١٩٣٨٢‬‬ ‫ﺣﻀﺮ‬
‫‪٢٤٩٦٩٤‬‬ ‫‪٨٥٤٨٦‬‬ ‫‪١٦٤٢٠٨‬‬ ‫ﺭﻳﻒ‬ ‫ﻭﺳﺎﻃﺔ ﻣﺎﻟﻴﺔ‪ -‬ﻋﻘﺎﺭﺍﺕ ﻭﺧﺪﻣﺎﺕ ﺃﻋﻤﺎﻝ‬
‫‪٧٠٨٦٥٣‬‬ ‫‪٢٢٥٠٦٣‬‬ ‫‪٤٨٣٥٩٠‬‬ ‫ﲨﻠﺔ‬
‫‪٢١٣٤٩٧‬‬ ‫‪٣٧٩٢٩‬‬ ‫‪١٧٥٥٦٨‬‬ ‫ﺣﻀﺮ‬
‫‪١٣٥٢١٣‬‬ ‫‪٥٩٦٣‬‬ ‫‪١٢٩٢٥٠‬‬ ‫ﺭﻳﻒ‬ ‫ﺧﺪﻣﺎﺕ ﺍﺟﺘﻤﺎﻋﻴﺔ‪ -‬ﻫﻴﺌﺎﺕ ﺩﻭﻟﻴﺔ‪ -‬ﺧﺪﻣﺎﺕ ﻣﱰﻟﻴﺔ‬
‫‪٣٤٨٧١٠‬‬ ‫‪٤٣٨٩٢‬‬ ‫‪٣٠٤٨١٨‬‬ ‫ﲨﻠﺔ‬
‫‪١٠١٩٩٩٣‬‬ ‫‪٨١٩٦٥‬‬ ‫‪٩٣٨٠٢٨‬‬ ‫ﺣﻀﺮ‬
‫‪٤١٣١٨٩‬‬ ‫‪٣٨٠٥٩‬‬ ‫‪٣٧٥١٣٠‬‬ ‫ﺭﻳﻒ‬ ‫ﲡﺎﺭﺓ ﺍﳉﻤﻠﺔ ﻭﺍﻟﺘﺠﺰﺋﺔ ﻭﺻﻴﺎﻧﺔ ﺍﳌﺮﻛﺒﺎﺕ ﻭﺍﻷﺟﻬﺰﺓ‬
‫‪١٤٣٣١٨٢‬‬ ‫‪١٢٠٠٢٤‬‬ ‫‪١٣١٣١٥٨‬‬ ‫ﲨﻠﺔ‬
‫‪٨٧٧٩٣٣‬‬ ‫‪٢٧٣٦١٤‬‬ ‫‪٦٠٤٣١٩‬‬ ‫ﺣﻀﺮ‬
‫‪٦٥٥٠٢٢‬‬ ‫‪٦٢٨٩٣‬‬ ‫‪٥٩٢١٢٩‬‬ ‫ﺭﻳﻒ‬ ‫ﺇﺩﺍﺭﺓ ﺍﻟﺪﻓﺎﻉ‬
‫‪١٥٣٢٩٥٥‬‬ ‫‪٣٣٦٥٠٧‬‬ ‫‪١١٩٦٤٤٨‬‬ ‫ﲨﻠﺔ‬

‫‪٣١٧‬‬
 ‫ﲨﻠﺔ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺣﻀﺮ‪ -‬ﺭﻳﻒ‬ ‫ﺍﻟﻨﺸﺎﻁ ﺍﻻﻗﺘﺼﺎﺩﻱ‬

‫‪٨٣٥٠٣٢‬‬ ‫‪٤٢٠٨٠٢‬‬ ‫‪٤١٤٢٣٠‬‬ ‫ﺣﻀﺮ‬

‫‪٦٧٥٩٢٤‬‬ ‫‪٢٠٢١٩٣‬‬ ‫‪٤٧٣٧٣١‬‬ ‫ﺭﻳﻒ‬ ‫ﺍﻟﺘﻌﻠﻴﻢ‬
‫‪١٥١٠٩٥٦‬‬ ‫‪٦٢٢٩٩٥‬‬ ‫‪٨٨٧٩٦١‬‬ ‫ﲨﻠﺔ‬
‫‪٢٤١٧١٠‬‬ ‫‪١٣٠٣١٥‬‬ ‫‪١١١٣٩٥‬‬ ‫ﺣﻀﺮ‬
‫‪١٣١٧٩٢‬‬ ‫‪٥٢٣٤٥‬‬ ‫‪٧٩٤٤٧‬‬ ‫ﺭﻳﻒ‬ ‫ﺍﻟﺼﺤﺔ ﻭﺍﻟﻌﻤﻞ ﺍﻻﺟﺘﻤﺎﻋﻲ‬
‫‪٣٧٣٥٠٢‬‬ ‫‪١٨٢٦٦٠‬‬ ‫‪١٩٠٨٤٢‬‬ ‫ﲨﻠﺔ‬
‫‪٩٥٠٦٢‬‬ ‫‪١٥٤٨٨‬‬ ‫‪٧٩٥٧٤‬‬ ‫ﺣﻀﺮ‬
‫‪٧٨٧١٦‬‬ ‫‪١١٤٠٧‬‬ ‫‪٦٧٣٠٩‬‬ ‫ﺭﻳﻒ‬ ‫ﺃﻧﺸﻄﺔ ﻏﲑ ﻛﺎﻣﻠﺔ ﺍﻟﺘﻮﺻﻴﻒ‬
‫‪١٧٣٧٧٨‬‬ ‫‪٢٦٨٩٥‬‬ ‫‪١٤٦٨٨٤‬‬ ‫ﲨﻠﺔ‬
‫‪٧٣١٣٢٣٧‬‬ ‫‪١٣٥٠٧٩٨‬‬ ‫‪٥٩٦٢٤٣٩‬‬ ‫ﺣﻀﺮ‬
‫‪٨٤٥٤٩٧٨‬‬ ‫‪٧٥٠٥٠٤‬‬ ‫‪٧٧٠٤٤٧٤‬‬ ‫ﺭﻳﻒ‬ ‫ﺍﳉﻤﻠﺔ‬
‫‪١٥٧٦٨٢١٥‬‬ ‫‪٢١٠١٣٠٢‬‬ ‫‪١٣٦٦٦٩١٣‬‬ ‫ﲨﻠﺔ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ‪ .‬ﺍﻟﻜﺘﺎﺏ ﺍﻹﺣﺼﺎﺋﻲ ﺍﻟﺴﻨﻮﻱ )‪ ،(١٩٩٩-٩٣‬ﻳﻮﻧﻴﻮ ‪(٧) ٢٠٠٠‬‬

‫ﺟﺪﻭﻝ )‪ :(٢-١١‬ﺗﻮﺯﻳﻊ ﺍﻟﺴﻜﺎﻥ ‪ ١٥‬ﺳﻨﺔ ﻓﺄﻛﺜﺮ ﺣﺴﺐ ﺍﳌﻬﻨﺔ ﻭﺍﻟﻨﻮﻉ ﰲ ﺣﻀﺮ ﻭﺭﻳﻒ ﺍﳉﻤﻬﻮﺭﻳﺔ ﻭﺍﻟﻨﺴﺒﺔ‬
‫ﺍﳌﺌﻮﻳﺔ ﻟﻜﻞ ﻣﻬﻨﺔ )ﺗﻌﺪﺍﺩ ‪(١٩٩٦‬‬
‫‪%‬‬ ‫ﲨﻠﺔ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺣﻀﺮ‪ -‬ﺭﻳﻒ‬ ‫ﺍﳌﻬﻨﺔ‬
‫‪٥٦١٠٣٣‬‬ ‫‪٧٢٧٤١‬‬ ‫‪٤٨٨٢٩٢‬‬ ‫ﺣﻀﺮ‬
‫ﺍﳌﺸﺮﻋﻮﻥ‪-‬ﻛﺒﺎﺭ ﺍﳌﺴﺌﻮﻟﻮﻥ‬
‫‪١٧٨٢٣٧‬‬ ‫‪١٥٩١٨‬‬ ‫‪١٦٢٣١٩‬‬ ‫ﺭﻳﻒ‬
‫ﻭﺍﳌﺪﻳﺮﻭﻥ‬
‫‪٤,٢‬‬ ‫‪٧٣٩٢٧٠‬‬ ‫‪٨٨٦٥٩‬‬ ‫‪٦٥٠٦١١‬‬ ‫ﲨﻠﺔ‬
‫‪١٤٢٢٠٢٨‬‬ ‫‪٤٩٥٩١٢‬‬ ‫‪٩٢٦١١٦‬‬ ‫ﺣﻀﺮ‬
‫ﺍﻟﻌﻠﻤﻴﻮﻥ‬
‫‪٦٥٩٥٢٤‬‬ ‫‪١٥٨٢٢٠‬‬ ‫‪٥٠١٣٠٤‬‬ ‫ﺭﻳﻒ‬
‫‪١٢‬‬ ‫‪٢٠٨١٥٥٢‬‬ ‫‪٦٥٤١٣٢‬‬ ‫‪١٤٢٧٤٢٠‬‬ ‫ﲨﻠﺔ‬
‫‪٩٣٢١٣٣‬‬ ‫‪٢٩٩٠٧٧‬‬ ‫‪٦٣٣٠٥٦‬‬ ‫ﺣﻀﺮ‬
‫‪٦٣٣٢٩٩‬‬ ‫‪١٢٤٦٣٧‬‬ ‫‪٥٠٨٦٦٢‬‬ ‫ﺭﻳﻒ‬ ‫ﻓﻨﻴﻮﻥ ﻭﻣﺴﺎﻋﺪﻭ ﺃﺧﺼﺎﺋﻴﲔ‬
‫‪٩‬‬ ‫‪١٥٦٥٤٣٢‬‬ ‫‪٤٢٣٧١٤‬‬ ‫‪١١٤١٧١٨‬‬ ‫ﲨﻠﺔ‬
‫‪٦٣٢٣٦٣‬‬ ‫‪٢٧٢٥٢٦‬‬ ‫‪٣٥٩٨٣٧‬‬ ‫ﺣﻀﺮ‬
‫‪٤٩٢٨٥١‬‬ ‫‪١٦٤٦٠٧‬‬ ‫‪٣٢٨٢٤٤‬‬ ‫ﺭﻳﻒ‬ ‫ﺃﻋﻤﺎﻝ ﻛﺘﺎﺑﻴﺔ ﻭﻣﺎ ﺇﻟﻴﻬﺎ‬
‫‪٧,١‬‬ ‫‪١٢٢٥٢١٤‬‬ ‫‪٤٣٧١٣٣‬‬ ‫‪٦٨٨٠٨١‬‬ ‫ﲨﻠﺔ‬
‫‪٧٩١٨٨٥‬‬ ‫‪٩٢٥٥٨‬‬ ‫‪٦٩٩٣٢٧‬‬ ‫ﺣﻀﺮ‬
‫‪٦٦٩٥١٤‬‬ ‫‪٣٠٤٣٣‬‬ ‫‪٦٣٩٠٨١‬‬ ‫ﺭﻳﻒ‬ ‫ﺍﳋﺪﻣﺎﺕ ﻭﳏﺎﻝ ﺍﻟﺒﻴﻊ‬
‫‪٨,٤‬‬ ‫‪١٤٦١٣٩٩‬‬ ‫‪١٢٢٩٩١‬‬ ‫‪١٣٣٨٤٠٨‬‬ ‫ﲨﻠﺔ‬
‫‪٥٠٠٠٧٧‬‬ ‫‪١٣٩٢٣‬‬ ‫‪٤٨٦١٥٤‬‬ ‫ﺣﻀﺮ‬
‫‪٤١٨٢٠٣٤‬‬ ‫‪١٩٥٥٢١‬‬ ‫‪٣٩٨٦٥١٣‬‬ ‫ﺭﻳﻒ‬ ‫ﻋﻤﺎﻝ ﺍﻟﺰﺭﺍﻋﺔ ﻭﺍﻟﺼﻴﺪ‬
‫‪٢٧,١‬‬ ‫‪٤٦٨٢١١١‬‬ ‫‪٢٠٩٤٤٤‬‬ ‫‪٤٤٧٢٦٦٧‬‬ ‫ﲨﻠﺔ‬
‫‪١٤٧٨٧٠٣‬‬ ‫‪٣٤٩٢٩‬‬ ‫‪١٤٤٣٧٧٤‬‬ ‫ﺣﻀﺮ‬
‫‪٩٣٠٤٨٥‬‬ ‫‪٢٣٨١٥‬‬ ‫‪٩٠٦٦٧٠‬‬ ‫ﺭﻳﻒ‬ ‫ﺍﳊﺮﻓﻴﻮﻥ ﻭﻣﻦ ﺇﻟﻴﻬﻢ‬
‫‪١٣,٩‬‬ ‫‪٢٤٠٩١٨٨‬‬ ‫‪٥٨٧٤٤‬‬ ‫‪١٣٥٠٤٤٤‬‬ ‫ﲨﻠﺔ‬

‫‪٣١٨‬‬
 ‫‪%‬‬ ‫ﲨﻠﺔ‬ ‫ﺇﻧﺎﺙ‬ ‫ﺫﻛﻮﺭ‬ ‫ﺣﻀﺮ‪ -‬ﺭﻳﻒ‬ ‫ﺍﳌﻬﻨﺔ‬
‫‪٦٠٨٢٩٥‬‬ ‫‪٣١٦٥١‬‬ ‫‪٥٧٦٦٤٤‬‬ ‫ﺣﻀﺮ‬
‫‪٤٦١١١٦‬‬ ‫‪٩٣٦٩‬‬ ‫‪٤٥١٧٤٧‬‬ ‫ﺭﻳﻒ‬ ‫ﻋﻤﺎﻝ ﺗﺸﻐﻴﻞ ﺍﳌﺎﻛﻴﻨﺎﺕ ﻭﺍﳌﺼﺎﻧﻊ ﻭﻋﻤﺎﻝ ﲡﻤﻴﻊ‬
‫‪٦,٢‬‬ ‫‪١٠٦٩٤١١‬‬ ‫‪٤١٠٢٠‬‬ ‫‪١٠٢٨٣٩١‬‬ ‫ﲨﻠﺔ‬
‫‪٢٦٣٩٠٩‬‬ ‫‪١٣٩٢٦‬‬ ‫‪٢٤٩٩٨٣‬‬ ‫ﺣﻀﺮ‬
‫‪١٥٥٢٣٧‬‬ ‫‪١٣٧١٢‬‬ ‫‪١٤١٥٢٥‬‬ ‫ﺭﻳﻒ‬ ‫ﻋﻤﺎﻝ ﺍﳌﻬﻦ ﺍﻟﻌﺎﺩﻳﺔ‬
‫‪٢,٤‬‬ ‫‪٤١٩١٤٦‬‬ ‫‪٢٧٦٣٨‬‬ ‫‪٣٩١٥٠٨‬‬ ‫ﲨﻠﺔ‬
‫‪٧٦٤٢٢٩‬‬ ‫‪٢٦٩١١٨‬‬ ‫‪٤٩٥١١١‬‬ ‫ﺣﻀﺮ‬
‫ﻋﻤﺎﻝ ﻻ ﳝﻜﻦ ﺗﺼﻨﻴﻔﻬﻢ‬
‫‪٩١٢٦٨٢‬‬ ‫‪٢٩٩١٢٧‬‬ ‫‪٦١٤٥٥٥‬‬ ‫ﺭﻳﻒ‬
‫)ﺗﺸﻤﻞ ﻣﺘﻌﻄﻞ ﺣﺪﻳﺚ(‬
‫‪٩,٧‬‬ ‫‪١٦٧٧٩١١‬‬ ‫‪٥٦٨٢٤٥‬‬ ‫‪١١٠٩٦٦٦‬‬ ‫ﲨﻠﺔ‬
‫‪٧٩٥٤٦٥٥‬‬ ‫‪١٥٩٦٣٦١‬‬ ‫‪٦٣٥٨٢٩٤‬‬ ‫ﺣﻀﺮ‬
‫‪٩٢٧٥٩٧٩‬‬ ‫‪١٠٣٥٣٥٩‬‬ ‫‪٨٢٤٠٦٢٠‬‬ ‫ﺭﻳﻒ‬ ‫ﺍﳉﻤﻠﺔ‬
‫‪١٠٠‬‬ ‫‪١٧٢٣٠٦٣٤‬‬ ‫‪٢٦٣١٧٢٠‬‬ ‫‪١٤٥٩٨٩١٤‬‬ ‫ﲨﻠﺔ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳉﻬﺎﺯ ﺍﳌﺮﻛﺰﻱ ﻟﻠﺘﻌﺒﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﻹﺣﺼﺎﺀ‪ .‬ﺍﻟﻜﺘﺎﺏ ﺍﻹﺣﺼﺎﺋﻲ ﺍﻟﺴﻨﻮﻱ )‪ ،(١٩٩٩-٩٣‬ﻳﻮﻧﻴﻮ ‪(٧) ٢٠٠٠‬‬

‫ﺟﺪﻭﻝ )‪ :(٣-١١‬ﺍﻟﻨﺴﺐ ﺍﳌﺌﻮﻳﺔ ﻟﻠﻌﺎﻣﻠﲔ ﰲ ﺍﻷﻧﺸﻄﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺍﳌﺨﺘﻠﻔﺔ ﻭﻣﻌﺪﻻﺕ ﺗﻜﺮﺍﺭ ﻭﺷﺪﺓ‬
‫ﺍﻹﺻﺎﺑﺎﺕ ﰲ ﺑﻌﺾ ﺍﻷﻧﺸﻄﺔ‬
‫ﻣﻌﺪﻝ ﺍﻟﺸﺪﺓ‬ ‫ﻣﻌﺪﻝ ﺍﻟﺘﻜﺮﺍﺭ‬ ‫ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ‬ ‫ﺍﻷﻧﺸﻄﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‬
‫‪.,١٥‬‬ ‫‪٦،٨‬‬ ‫‪٣١‬‬ ‫ﺍﻟﺰﺭﺍﻋﺔ ﻭﺍﻟﺼﻴﺪ‬
‫‪١،١‬‬ ‫‪٢٧،٦‬‬ ‫‪.,٤‬‬ ‫ﺍﻟﺘﻌﺪﻳﻦ‬
‫‪.,٧‬‬ ‫‪٣١،٨‬‬ ‫‪١٣،٨‬‬ ‫ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺘﺤﻮﻳﻠﻴﺔ‬
‫‪.,٥٥‬‬ ‫‪٢٣،٥‬‬ ‫‪٨‬‬ ‫ﺍﻟﺒﻨﺎﺀ ﻭﺍﻹﻧﺸﺎﺀﺍﺕ‬
‫‪.,٢‬‬ ‫‪٧،٥‬‬ ‫‪١،٣‬‬ ‫ﺍﻟﺘﺠﺎﺭﺓ ﻭﺍﳌﻄﺎﻋﻢ ﻭﺍﻟﻔﻨﺎﺩﻕ‬
‫‪٢،٣‬‬ ‫ﺍﻟﺼﺤﺔ ﻭﺍﻟﻌﻤﻞ ﺍﻻﺟﺘﻤﺎﻋﻲ‬
‫‪٩،٥‬‬ ‫ﺍﻟﺘﻌﻠﻴﻢ‬

‫ﺟﺪﻭﻝ )‪ :(٤-١١‬ﺇﲨﺎﱄ ﻋﺪﺩ ﺍﳌﻨﺘﻔﻌﲔ ﺑﺘﺄﻣﲔ ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﻋﺪﺩ ﺍﻟﻌﻤﺎﻝ ﺍﳌﻌﺮﺿﲔ ﻟﻸﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‬
‫ﰲ ﺍﻟﻔﺮﻭﻉ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻬﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻣﻮﺯﻋﲔ ﺣﺴﺐ ﺩﻭﺭﻳﺔ ﺍﻟﻜﺸﻒ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﻣﻦ‬
‫ﺃﻭﻝ ﻳﻨﺎﻳﺮ ‪ ١٩٩٩‬ﺇﱃ ﺁﺧﺮ ﺩﻳﺴﻤﱪ ‪٢٠٠٠‬‬
‫ﺇﲨﺎﱄ ﻋﺪﺩ‬ ‫ﻋﺪﺩ ﺍﻟﻌﻤﺎﻝ ﺍﳌﻌﺮﺿﲔ‬ ‫ﺇﲨﺎﱄ ﻋﺪﺩ‬
‫ﺍﻟﻔﺮﻉ‬
‫ﺍﳌﻌﺮﺿﲔ‬ ‫ﺳﻨﺘﺎﻥ‬ ‫ﺳﻨﺔ‬ ‫ﺳﺘﺔ ﺷﻬﻮﺭ‬ ‫ﺍﳌﻨﺘﻔﻌﲔ‬
‫‪٨٦٠٥٨‬‬ ‫‪٣٥٦٤٨‬‬ ‫‪٤٨٧٩٩‬‬ ‫‪١٦١١‬‬ ‫‪١٧٤٠٠٨٧‬‬ ‫ﴰﺎﻝ ﻏﺮﺏ ﺍﻟﺪﻟﺘﺎ‬
‫‪٢٤٥٨٠٩‬‬ ‫‪٩٢٣٦٩‬‬ ‫‪١٤٤٤٥٠‬‬ ‫‪٨٩٩٠‬‬ ‫‪٢٠٨٣٠٨٥‬‬ ‫ﺍﻟﻘﺎﻫﺮﺓ‬
‫‪٩٦١٧٧‬‬ ‫‪١٣٣٩٢‬‬ ‫‪٨٢٤٢٢‬‬ ‫‪٣٦٣‬‬ ‫‪٨٤٤٦٠٣‬‬ ‫ﺷﺮﻕ ﺍﻟﺪﻟﺘﺎ‬
‫‪٢١٥٩٠‬‬ ‫‪٩٦٥٢‬‬ ‫‪١١٨٢١‬‬ ‫‪١١٧‬‬ ‫‪١٢٩٥٩٧٣‬‬ ‫ﻭﺳﻂ ﺍﻟﺪﻟﺘﺎ‬
‫‪٣١٤٣٢‬‬ ‫‪١٧٦٠٨‬‬ ‫‪١٢٧٢٥‬‬ ‫‪١٠٩٩‬‬ ‫‪٥٩٨٦٥٨‬‬ ‫ﺍﻟﻘﻨﺎﻝ‬
‫‪٦٥٨٦٩‬‬ ‫‪٨٧١٤‬‬ ‫‪٥٦٦٣٦‬‬ ‫‪٥١٩‬‬ ‫‪١٥٧٦٩٤٦‬‬ ‫ﴰﺎﻝ ﺍﻟﺼﻌﻴﺪ‬
‫‪٣٢٨٢٩‬‬ ‫‪٢٤٢٢١‬‬ ‫‪٣٨٠٤‬‬ ‫‪٤٨٠٤‬‬ ‫‪١٣٤٤٧٩٤‬‬ ‫ﻭﺳﻂ ﻭﺟﻨﻮﺏ ﺍﻟﺼﻌﻴﺪ‬
‫‪٢٥٥٢٨‬‬ ‫‪٤٥٢٦‬‬ ‫‪٢٠٨٢٢‬‬ ‫‪١٨٠‬‬ ‫‪٨١٩٦٠٧‬‬ ‫ﴰﺎﻝ ﺷﺮﻕ ﺍﻟﺪﻟﺘﺎ‬
‫‪٦٠٥٢٩٢‬‬ ‫‪٢٠٦١٣٠‬‬ ‫‪٣٨١٤٧٩‬‬ ‫‪١٧٦٨٣‬‬ ‫‪١٠٣٠٣٧٥٣‬‬ ‫ﺇﲨﺎﱄ ﲨﻴﻊ ﺍﻟﻔﺮﻭﻉ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )‪(٨‬‬

‫‪٣١٩‬‬
‫ﺟﺪﻭﻝ )‪ :(٥-١١‬ﺍﻟﻨﺴﺒﺔ ﺍﳌﺌﻮﻳﺔ ﻟﻠﺤﺎﻻﺕ ﺍﻹﳚﺎﺑﻴﺔ ﻟﻌﺪﺩ ﺍﳌﻌﺮﺿﲔ ﻟﻜﻞ ﺗﻌﺮﺽ ﻣﻬﲏ ﺧﻼﻝ ﺍﻟﻔﺘﺮﺓ ﻣﻦ‬
‫‪ ١٩٩٩-١-١‬ﺇﱃ ‪ ٢٠٠٠-١٢-٣١‬ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﳉﻤﻬﻮﺭﻳﺔ *‬
‫ﻧﺴﺒﺔ ﺍﳊﺎﻻﺕ‬ ‫ﺍﳊﺎﻻﺕ‬ ‫ﻋﺪﺩ‬
‫ﺍﳌﺮﺽ ﺍﳌﻬﲏ‬
‫ﻟﻠﻤﻌﺮﺿﲔ ‪%‬‬ ‫ﺍﻹﳚﺎﺑﻴﺔ‬ ‫ﺍﳌﻌﺮﺿﲔ‬
‫‪١٣,٠٠‬‬ ‫‪٥٤٨٢‬‬ ‫‪٤٠٧١٨‬‬ ‫ﺳﻠﻴﻜﻮﺯﺱ‬
‫‪٣,٨٠‬‬ ‫‪٦‬‬ ‫‪١٥٥‬‬ ‫ﺍﻷﻋﺮﺍﺽ ﻭﺍﻷﻣﺮﺍﺽ ﺍﻟﱵ ﺗﻨﺸﺄ ﻋﻦ ﺍﻟﺘﻌﺮﺽ ﻟﻠﻬﺮﻣﻮﻧﺎﺕ ﻭﻣﺸﺘﻘﺎ‪‬ﺎ‬
‫‪٣,٠٠‬‬ ‫‪٢٠‬‬ ‫‪٦٥٣‬‬ ‫ﺍﻟﺘﺴﻤﻢ ﺑﺎﻟﻔﻮﺳﻔﻮﺭ‬
‫‪١,٤٠‬‬ ‫‪١٨٣٨‬‬ ‫‪١٢٦٢١٥‬‬ ‫ﺍﻟﺼﻤﻢ ﺍﳌﻬﲏ‬
‫‪٠,٥٠‬‬ ‫‪١‬‬ ‫‪١٦٨‬‬ ‫ﺍﻟﺘﺴﻤﻢ ﺑﺎﻟﻜﱪﻳﺖ‬
‫‪٠,٢٠‬‬ ‫‪١‬‬ ‫‪٤١٩‬‬ ‫ﺑﺮﻭﺳﻠﻮﺯﺱ‬
‫‪٠,١٠‬‬ ‫‪١١٧‬‬ ‫‪٩٩١٩٣‬‬ ‫ﺍﻛﺰﳝﺎ ﻣﻬﻨﻴﺔ‬
‫‪٠,٣٠‬‬ ‫‪١٤‬‬ ‫‪٤٤٨٦‬‬ ‫ﺍﻟﺘﻬﺎﺏ ﻛﺒﺪﻱ ﻭﺑﺎﺋﻲ ﺳﻲ‬
‫‪٠,٠١‬‬ ‫‪٦‬‬ ‫‪٤٩٨٧٩‬‬ ‫ﻛﺘﺎﺭﺍﻛﺘﺎ ﺧﻠﻔﻴﺔ ﻣﻬﻨﻴﺔ‬
‫‪٠,٠٣‬‬ ‫‪٢‬‬ ‫‪٥٧٨٦‬‬ ‫ﺣﺒﻴﺒﺎﺕ ﺑﺘﺮﻭﻟﻴﺔ‬
‫‪٠,٢٠‬‬ ‫‪٢١‬‬ ‫‪٧٥٩٣‬‬ ‫ﺃﺳﺒﺴﺘﻮﺯﺱ‬
‫‪٠,٠٨‬‬ ‫‪١‬‬ ‫‪١١٢٧‬‬ ‫ﺍﻟﺘﻬﺎﺏ ﻛﺒﺪﻱ ﻭﺑﺎﺋﻲ ﰊ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ)‪(٨‬‬
‫* ﻳﻐﻄﻲ ﻓﺘﺮﺓ ﻋﺎﻣﲔ )ﺩﻭﺭﻳﺔ ﻛﺎﻣﻠﺔ(‬

‫‪٣٢٠‬‬
‫ﺟﺪﻭﻝ )‪ :(٦-١١‬ﻋﺪﺩ ﺍﻟﻌﻤﺎﻝ ﺍﳌﻌﺮﺿﲔ ﻭﻋﺪﺩ ﺍﳊﺎﻻﺕ ﺍﻹﳚﺎﺑﻴﺔ ﻟﻸﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﺍﳌﻜﺘﺸﻔﺔ ﺧﻼﻝ ﺍﻟﻔﺤﺺ ﺍﻟﻄﱯ ﺍﻟﺪﻭﺭﻱ ﰲ ﺍﻟﻔﺘﺮﺓ ﻣﻦ ﺃﻭﻝ ﻳﻨﺎﻳﺮ ‪٢٠٠٠‬ﺍﱃ ﺁﺧﺮ‬
‫ﺩﻳﺴﻤﱪ ‪ ٢٠٠٠‬ﰲ ﺍﳌﻨﺎﻃﻖ ﺍﳌﺨﺘﻠﻔﺔ*‬
‫ﻣﻀﺎﻋﻔﺎﺕ‬ ‫ﺃﻣﺮﺍﺽ ﺍﳊﻤﻴﺎﺕ ﺍﳌﻌﺪﻳﺔ‬ ‫ﺃﻣﺮﺍﺽ ﺍﻟﻐﺒﺎﺭ ﺍﻟﺮﺋﻮﻳﺔ‬ ‫ﻛﺘﺎﺭﺍﻛﺘﺎ‬
‫ﺻﻤﻢ‬ ‫ﺍﻛﺰﳝﺎ‬ ‫ﺣﺒﻴﺒﺎﺕ‬ ‫ﺍﻟﺘﺴﻤﻢ‬
‫ﺍﻟﺘﻌﺮﺽ‬ ‫ﺍﻟﺘﻬﺎﺏ‬ ‫ﺍﻟﺘﻬﺎﺏ ﻛﺒﺪﻯ‬ ‫ﺧﻠﻔﻴﺔ‬ ‫ﺍﳌﺮﺽ‬ ‫ﺍﻟﻔﺮﻉ‬
‫ﻣﻬﲏ‬ ‫ﺑﺮﻭﺳﻠﻮﺯﺱ‬ ‫ﺃﺳﺒﺴﺘﻮﺯﺱ‬ ‫ﺳﻠﻴﻜﻮﺯﺱ‬ ‫ﻣﻬﻨﻴﺔ‬ ‫ﺑﺘﺮﻭﻟﻴﺔ‬ ‫ﺑﺎﻟﻔﺴﻔﻮﺭ‬
‫ﻟﻠﻬﺮﻣﻮﻧﺎﺕ‬ ‫ﻛﺒﺪﻯ‪B‬‬ ‫‪C‬‬ ‫ﻣﻬﻨﻴﺔ‬
‫‪٥٠٠‬‬ ‫‪١٧٩٣‬‬ ‫‪٢٢١٥‬‬ ‫‪٣٣٨٥٣‬‬ ‫ﻣﻌﺮﺽ‬
‫ﴰﺎﻝ ﻏﺮﺏ ﺍﻟﺪﻟﺘﺎ‬
‫‪١٥٦‬‬ ‫‪٣‬‬ ‫‪(٪٧,٤) ١٦٣‬‬ ‫‪٤٠‬‬ ‫ﺇﳚﺎﰊ‬
‫‪٦٣٦٩٥‬‬ ‫‪٧١٦٨‬‬ ‫‪٢١٥٠٦‬‬ ‫ﻣﻌﺮﺽ‬
‫ﺍﻟﻘﺎﻫﺮﺓ‬
‫‪١٨‬‬ ‫‪٣‬‬ ‫‪(٪٠,٤٩) ١٠٧‬‬ ‫ﺇﳚﺎﰊ‬
‫‪٥٠٥٤‬‬ ‫‪٤٩٥‬‬ ‫‪١١٢٧‬‬ ‫‪١١٢٧‬‬ ‫‪٤٨٥٨‬‬ ‫‪١٢٨٨‬‬ ‫‪٤١٠٨٩‬‬ ‫ﻣﻌﺮﺽ‬
‫ﺷﺮﻕ ﺍﻟﺪﻟﺘﺎ‬
‫‪١٤‬‬ ‫‪١‬‬ ‫‪١‬‬ ‫‪١‬‬ ‫‪(٪١٠,٣) ٤٩٨‬‬ ‫‪٢‬‬ ‫‪٤‬‬ ‫ﺇﳚﺎﰊ‬
‫‪١٢٦٣‬‬ ‫‪١٨٤‬‬ ‫‪٥٧٨٦‬‬ ‫‪٥٧٨٦‬‬ ‫‪٦٥٣‬‬ ‫ﻣﻌﺮﺽ‬
‫ﻭﺳﻂ ﺍﻟﺪﻟﺘﺎ‬
‫‪٣‬‬ ‫‪١‬‬ ‫‪٣‬‬ ‫‪٢‬‬ ‫‪١٢‬‬ ‫ﺇﳚﺎﰊ‬
‫‪١٢١٩٩‬‬ ‫‪٣٥٠‬‬ ‫‪٦٥٠٨‬‬ ‫ﻣﻌﺮﺽ‬
‫ﺍﻟﻘﻨﺎﻝ‬
‫‪٤٩٧‬‬ ‫‪١‬‬ ‫‪(٪١٢) ٧٨٩‬‬ ‫ﺇﳚﺎﰊ‬

‫‪٣٢١‬‬
‫‪٢٦١٠‬‬ ‫‪١٥٥‬‬ ‫‪٢١٦‬‬ ‫‪٦٣٢‬‬ ‫‪١٨٤٦٥‬‬ ‫ﻣﻌﺮﺽ‬
‫ﴰﺎﻝ ﺍﻟﺼﻌﻴﺪ‬
‫‪٣٥‬‬ ‫‪٥‬‬ ‫‪٢‬‬ ‫‪(٪٧,١) ٤٥‬‬ ‫‪٣‬‬ ‫ﺇﳚﺎﰊ‬
‫‪٨٤٤٢‬‬ ‫‪٤٢٤٣‬‬ ‫‪٧٥٥‬‬ ‫ﻣﻌﺮﺽ‬
‫ﻭﺳﻂ ﻭﺟﻨﻮﺏ ﺍﻟﺼﻌﻴﺪ‬
‫‪٢٦٧‬‬ ‫‪(٪١٤,٤) ٦١٢‬‬ ‫‪٢‬‬ ‫ﺇﳚﺎﰊ‬
‫‪٤٥٢٦‬‬ ‫ﻣﻌﺮﺽ‬
‫ﴰﺎﻝ ﺷﺮﻕ ﺍﻟﺪﻟﺘﺎ‬
‫‪٣‬‬ ‫ﺇﳚﺎﰊ‬
‫‪٩٨٢٨٩‬‬ ‫‪١٥٥‬‬ ‫‪٤٩٥‬‬ ‫‪١١٢٧‬‬ ‫‪٣٤٨٦‬‬ ‫‪٧١٦٨‬‬ ‫‪٣٩٩٦٢‬‬ ‫‪٢٢٢٧‬‬ ‫‪٩٩١٩٣‬‬ ‫‪٥٧٨٦‬‬ ‫‪٦٥٣‬‬ ‫ﻣﻌﺮﺽ‬
‫ﺍﻹﲨﺎﱄ‬
‫‪٩٩٣‬‬ ‫‪٥‬‬ ‫‪١‬‬ ‫‪١‬‬ ‫‪٧‬‬ ‫‪٣‬‬ ‫‪٢٢١٤‬‬ ‫‪٥‬‬ ‫‪٥٠‬‬ ‫‪٢‬‬ ‫‪١٢‬‬ ‫ﺇﳚﺎﰊ‬
‫‪١,٠‬‬ ‫‪٣,٢‬‬ ‫‪٠,٢٠‬‬ ‫‪٠,٠٩‬‬ ‫‪٠,٢٠‬‬ ‫‪٠,٠٤‬‬ ‫‪٥,٥‬‬ ‫‪٠,٢٢‬‬ ‫‪٠,٠٥‬‬ ‫‪٠,٠٣٤‬‬ ‫‪١,٨‬‬ ‫‪%‬‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )‪(٨‬‬
‫* ﻳﻐﻄﻲ ﻓﺘﺮﺓ ﻋﺎﻡ ﻭﺍﺣﺪ )ﻧﺼﻒ ﺩﻭﺭﻳﺔ( ﻭﳍﺬﺍ ﻳﻼﺣﻆ ﺍﺧﺘﻼﻑ ﺍﻷﺭﻗﺎﻡ ﻭﺍﻟﻨﺴﺐ ﻋﻦ ﻣﺎ ﻭﺭﺩ ﰲ ﺟﺪﻭﻝ ‪٥‬‬
 ‫ﺟﺪﻭﻝ )‪ :(٧-١١‬ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﰲ ﺍﻟﻔﺮﻭﻉ ﺍﳌﺨﺘﻠﻔﺔ ﻟﻠﻬﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺧﻼﻝ ﻋﺎﻡ ‪٢٠٠٠ – ١٩٩٩‬‬
‫ﺃﺳﻴﻮﻁ‬ ‫ﺍﳉﻴﺰﺓ‬
‫ﻗﻨﺎ ﻭﺟﻨﻮﺏ‬ ‫ﴰﺎﻝ ﺷﺮﻕ‬ ‫ﻭﺳﻂ‬ ‫ﴰﺎﻝ ﻏﺮﺏ‬
‫ﺍﻹﲨﺎﱄ‬ ‫ﻭﻭﺳﻂ‬ ‫ﻭﴰﺎﻝ‬ ‫ﺍﻟﻘﺎﻫﺮﺓ‬ ‫ﺍﻟﻘﻨﺎﻝ‬ ‫ﺷﺮﻕ ﺍﻟﺪﻟﺘﺎ‬ ‫ﺍﻟﻔﺮﻭﻉ‬
‫ﺍﻟﺼﻌﻴﺪ‬ ‫ﺍﻟﺪﻟﺘﺎ‬ ‫ﺍﻟﺪﻟﺘﺎ‬ ‫ﺍﻟﺪﻟﺘﺎ‬
‫ﺍﻟﺼﻌﻴﺪ‬ ‫ﺍﻟﺼﻌﻴﺪ‬
‫‪١٠٢٦٤‬‬ ‫‪٦١٣‬‬ ‫‪٧٣٢‬‬ ‫‪١٥٧٧‬‬ ‫‪٢٠٨٣‬‬ ‫‪٥٥٩‬‬ ‫‪٨٢٠‬‬ ‫‪٨٤٤‬‬ ‫‪١٢٩٦‬‬ ‫‪١٧٤٠‬‬ ‫ﻋﺪﺩ ﺍﳌﻨﺘﻔﻌﲔ ﺑﺎﻷﻟﻒ‬
‫‪% ١٠٠‬‬ ‫‪٥,٩‬‬ ‫‪٧,١‬‬ ‫‪١٠,٣‬‬ ‫‪٢٠,٢‬‬ ‫‪٥,٨‬‬ ‫‪٨,٠‬‬ ‫‪٦,٢‬‬ ‫‪١٢,٦‬‬ ‫‪١٦,٩‬‬ ‫ﺍﻟﺘﻮﺯﻳﻊ ﺍﻟﻨﺴﱯ‬
‫‪٦٧٦١٥‬‬ ‫‪٦٨٤‬‬ ‫‪٤٢١‬‬ ‫‪٦٥٢٤‬‬ ‫‪٢٢٦١٩‬‬ ‫‪٢٥٣٤‬‬ ‫‪٨٢٩‬‬ ‫‪٩٥١٧‬‬ ‫‪٢١٥٩‬‬ ‫‪٢٢٣٢٨‬‬ ‫ﺣﺎﻻﺕ ﺍﻹﺻﺎﺑﺔ )ﺟﺪﻳﺪﺓ(‬
‫‪٦,٦‬‬ ‫‪١,١‬‬ ‫‪٠,٦‬‬ ‫‪٤,١‬‬ ‫‪١٠,٩‬‬ ‫‪٤,٢‬‬ ‫‪١‬‬ ‫‪١١,٣‬‬ ‫‪٤١,٧‬‬ ‫‪١٢,٨‬‬ ‫ﻣﻌﺪﻝ ﺍﻹﺻﺎﺑﺔ ﻟﻜﻞ ‪١٠٠٠‬‬
‫‪٣٤٩٥٠‬‬ ‫‪٤٦٣‬‬ ‫‪٥٢٥‬‬ ‫‪٧٩٠٧‬‬ ‫‪٢٧٨٩‬‬ ‫‪٦١١‬‬ ‫‪٢٩٠‬‬ ‫‪١١٦٩١‬‬ ‫‪٥٢٧٧‬‬ ‫‪٥٣٩٧‬‬ ‫ﺍﻟﺘﺤﻮﻳﻞ ﻟﻸﺧﺼﺎﺋﻲ‬
‫‪٤٩٧٠‬‬ ‫‪١٣٥‬‬ ‫‪٤٢‬‬ ‫‪٧٨١‬‬ ‫‪٨١٥‬‬ ‫‪٢٣٧‬‬ ‫‪١١١‬‬ ‫‪١١٧٥‬‬ ‫‪٧٨١‬‬ ‫‪٨٩٣‬‬ ‫ﺩﺧﻮﻝ ﺍﳌﺴﺘﺸﻔﻰ‬
‫‪٦٣٤٧٢‬‬ ‫‪٦٩٦‬‬ ‫‪٤٤١‬‬ ‫‪٥١٨٩‬‬ ‫‪٢١٩١٠‬‬ ‫‪٢٥٩٥‬‬ ‫‪٨٥٠‬‬ ‫‪١٠٠٦٩‬‬ ‫‪٢٠٦٧‬‬ ‫‪١٩٦٥٥‬‬ ‫ﺷﻔﺎﺀ‬
‫‪١٤٥٢٨٣٠‬‬ ‫‪٢١١٧٣‬‬ ‫‪١٤٢٣٦‬‬ ‫‪١٢٥٩٠٠‬‬ ‫‪٥٤٤٣٧٨‬‬ ‫‪٩٠٠٣٩‬‬ ‫‪٢٥٣٨٣‬‬ ‫‪١٨٢٢٧٩‬‬ ‫‪٦٩٠٦٠‬‬ ‫‪٣٨٠٣٩٢‬‬ ‫ﺃﻳﺎﻡ ﺍﻻﻧﻘﻄﺎﻉ‬
‫‪١٤١,٥‬‬ ‫‪٣٤,٥‬‬ ‫‪١٩,٤‬‬ ‫‪٧٩,٨‬‬ ‫‪٢٦١,٣‬‬ ‫‪١٦١,٣‬‬ ‫‪٣٠,٩‬‬ ‫‪٢١٥,٩‬‬ ‫‪٥٣,٣‬‬ ‫‪٢١٨,٦‬‬ ‫ﺃﻳﺎﻡ ﺍﻻﻧﻘﻄﺎﻉ ﻟﻜﻞ ‪ ١٠٠٠‬ﻣﻨﺘﻔﻊ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )‪(٩‬‬

‫‪٣٢٢‬‬
‫ﺟﺪﻭﻝ )‪ :(٨-١١‬ﺃﻋﺪﺍﺩ ﺣﺎﻻﺕ ﺍﻟﻮﻓﺎﺓ ﻭﺍﻟﻌﺠﺰ ﻭﺗﻮﺯﻳﻊ ﺍﳌﻌﺎﺷﺎﺕ ﺍﳌﻨﺼﺮﻓﺔ ﻟﻠﻮﻓﺎﺓ ﺍﻹﺻﺎﺑﺔ ﻭﺍﻟﻌﺠﺰ ﺧﻼﻝ‬
‫ﺳﻨﻮﺍﺕ ‪٢٠٠١-١٩٩٦‬‬
‫ﻋﺠﺰ ﺟﺰﺋﻲ ﻭﻛﻠﻰ ﺇﺻﺎﰊ‬ ‫ﻭﻓﺎﺓ ﺇﺻﺎﺑﺔ ﻋﻤﻞ‬
‫ﺍﻟﺴﻨﺔ‬
‫ﻗﻴﻤﺔ )ﺟﻨﻴﻪ (‬ ‫ﻋﺪﺩ‬ ‫ﻗﻴﻤﺔ )ﺟﻨﻴﻪ (‬ ‫ﻋﺪﺩ‬
‫‪٥٦٦٢٠٩‬‬ ‫‪٣٠٦٦‬‬ ‫‪٢١٤٤٠٨٤‬‬ ‫‪٧٢٣٣‬‬ ‫‪١٩٩٦/١٩٩٧‬‬
‫‪٧٠٤٨٩١‬‬ ‫‪٥٥٤٣‬‬ ‫‪٢٦١٣٤٤٥‬‬ ‫‪٧٨٣٨‬‬ ‫‪١٩٩٧/١٩٩٨‬‬
‫‪٧٦٦٦٢٢‬‬ ‫‪٥٥٣٣‬‬ ‫‪٣٠٨٨٣٨٣‬‬ ‫‪٨٥٠٠‬‬ ‫‪١٩٩٨/١٩٩٩‬‬
‫‪٨٠٩٠٩٨‬‬ ‫‪٥٤١٨‬‬ ‫‪٣٥٥١٣٣٥‬‬ ‫‪٩٠١٦‬‬ ‫‪١٩٩٩/‬‬
‫‪٨٩٩٦٧١‬‬ ‫‪٥٥٥١‬‬ ‫‪٤٠٦٧٥٣٥‬‬ ‫‪٩٤٦٢‬‬ ‫‪٢٠٠٠/٢٠٠١‬‬
‫ﻋﺪﺩ ﺍﳌﻨﺸﺂﺕ = ‪ ٤٣٩٤‬ﻋﺪﺩ ﺍﳌﺆﻣﻦ ﻋﻠﻴﻬﻢ =‪٤٦٩٥١١٥‬‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳍﻴﺌﺔ ﺍﻟﻘﻮﻣﻴﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ .‬ﺍﻟﻘﻄﺎﻉ ﺍﳊﻜﻮﻣﻲ‪ .‬ﻭﺯﺍﺭﺓ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﻭﺍﻟﺸﺌﻮﻥ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ )‪(١٠‬‬

‫ﺟﺪﻭﻝ )‪ :(٩-١١‬ﺇﺻﺎﺑﺎﺕ ﺍﻟﻌﻤﻞ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ ﻭﺍﻟﻮﻓﻴﺎﺕ ﻭﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﺑﺴﺒﺐ ﺍﻹﺻﺎﺑﺔ ﻭﺍﳌﺮﺽ ﺧﻼﻝ‬
‫ﺳﻨﻮﺍﺕ ‪ ٨٦‬ﺇﱃ ‪١٩٩٠‬‬
‫‪١٩٩٠‬‬ ‫‪١٩٨٩‬‬ ‫‪١٩٨٨‬‬ ‫‪١٩٨٧‬‬ ‫‪١٩٨٦‬‬ ‫ﺍﻟﺴﻨﺔ‬
‫‪١٤٢١٨٩٩‬‬ ‫‪١٤١٠١٦٤‬‬ ‫‪١٣١٣٣٠٨‬‬ ‫‪١٢٠٨٦١٣‬‬ ‫‪١٢١٢٩٢٠‬‬ ‫ﻋﺪﺩ ﺍﻟﻌﺎﻣﻠﲔ‬
‫‪٦٣٤٠٨‬‬ ‫‪٦١٩٦٠‬‬ ‫‪٥٨٥٨١‬‬ ‫‪٥٥١٦٣‬‬ ‫‪٥٩٨٢٢‬‬ ‫ﻋﺪﺩ ﺍﻟﻌﺎﻣﻠﲔ ﺍﳌﺼﺎﺑﲔ‬
‫‪٤٥‬‬ ‫‪٤٤‬‬ ‫‪٤٥‬‬ ‫‪٤٦‬‬ ‫‪٤٩‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﰲ ﺍﻷﻟﻒ‬
‫‪٢١٣‬‬ ‫‪٢٢٣‬‬ ‫‪١٨٠‬‬ ‫‪١٩٨‬‬ ‫‪٢٢١‬‬ ‫ﻋﺪﺩ ﺍﻟﻮﻓﻴﺎﺕ ﺑﺴﺒﺐ ﺍﻹﺻﺎﺑﺔ‬
‫‪٠,٣٤‬‬ ‫‪٠,٣٦‬‬ ‫‪٠,٣‬‬ ‫‪٠,٣٦‬‬ ‫‪٠,٣٧‬‬ ‫ﻧﺴﺒﺔ ﺍﻟﻮﻓﻴﺎﺕ ﺇﱃ ﻋﺪﺩ ﺍﻹﺻﺎﺑﺎﺕ ‪%‬‬
‫‪١١٦٧٤٠٧‬‬ ‫‪١٢١٢٣٧٤‬‬ ‫‪١٠٩٢٩٥٩‬‬ ‫‪٩٤٨٤٨٦‬‬ ‫‪١٠١٩٥٣٣‬‬ ‫ﻋﺪﺩ ﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﺑﺴﺒﺐ ﺍﻹﺻﺎﺑﺔ‬
‫‪٧٩٩‬‬ ‫‪١١٢٣‬‬ ‫‪١٥٢١‬‬ ‫‪٦٢٣‬‬ ‫‪١٥٦١‬‬ ‫ﻋﺪﺩ ﺣﺎﻻﺕ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‬
‫‪٠,٥٦‬‬ ‫‪٠,٨‬‬ ‫‪١,٢‬‬ ‫‪٠,٥‬‬ ‫‪١,٣‬‬ ‫ﺍﻟﻨﺴﺒﺔ ﰲ ﺍﻷﻟﻒ‬
‫‪١٦٤١‬‬ ‫‪٦٩٢٤‬‬ ‫‪٣١٦١‬‬ ‫‪٤١١٧‬‬ ‫‪٦١١٠‬‬ ‫ﻋﺪﺩ ﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﺑﺴﺒﺐ ﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‬
‫‪٦٤٢٠٧‬‬ ‫‪٦٣٠٨٣‬‬ ‫‪٦٠١٠٢‬‬ ‫‪٥٥٧٨٦‬‬ ‫‪٦١٣٨٣‬‬ ‫ﻋﺪﺩ ﺣﺎﻻﺕ ﺍﻹﺻﺎﺑﺔ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‬
‫‪١١٦٩٠٤٨‬‬ ‫‪١٢١٩٢٩٨‬‬ ‫‪١٠٩٦١٢٠‬‬ ‫‪٩٥٢٦٠٣‬‬ ‫‪١٠٢٥٦٤٣‬‬ ‫ﻋﺪﺩ ﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ ﺑﺴﺒﺐ ﺍﻹﺻﺎﺑﺎﺕ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﻬﻨﻴﺔ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﻟﺘﺪﺭﻳﺐ‬

‫ﺟﺪﻭﻝ )‪ :(١٠-١١‬ﻋﺪﺩ ﺍﳌﻨﺸﺂﺕ ﺍﻟﱵ ﻳﻌﻤﻞ ‪‬ﺎ ‪ ٥٠‬ﻋﺎﻣﻼ ﻓﺄﻛﺜﺮ ﻭﻋﺪﺩ ﻋﻤﺎﳍﺎ ﻭﺍﻹﺻﺎﺑﺎﺕ ﻭﺃﻳﺎﻡ ﺍﻟﻐﻴﺎﺏ‬
‫ﻭﺍﻟﻮﻓﻴﺎﺕ ﻧﺘﻴﺠﺔ ﺍﻹﺻﺎﺑﺔ ﰲ ﺍﻷﻧﺸﻄﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺍﳌﺨﺘﻠﻔﺔ ﺧﻼﻝ ﻋﺎﻡ ‪١٩٩١‬‬
‫ﻋﺪﺩ‬ ‫ﻋﺪﺩ ﺍﻹﺻﺎﺑﺎﺕ ﺍﻟﱵ‬ ‫ﻋﺪﺩ ﺃﻳﺎﻡ‬ ‫ﻋﺪﺩ‬ ‫ﻋﺪﺩ‬ ‫ﻋﺪﺩ‬
‫ﺍﻷﻧﺸﻄﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‬
‫ﺍﻟﻮﻓﻴﺎﺕ‬ ‫ﲣﻠﻒ ﻋﻨﻬﺎ ﻋﺠﺰ‬ ‫ﺍﻟﻐﻴﺎﺏ‬ ‫ﺍﻹﺻﺎﺑﺎﺕ‬ ‫ﺍﻟﻌﺎﻣﻠﲔ‬ ‫ﺍﳌﻨﺸﺂﺕ‬

‫‪٧‬‬ ‫‪١٢‬‬ ‫‪٩٤٣٥‬‬ ‫‪٤١١‬‬ ‫‪٣٠٤٠١‬‬ ‫‪١٢٧‬‬ ‫ﺍﻟﺰﺭﺍﻋﺔ ﻭﺍﻟﺼﻴﺪ‬

‫‪٩‬‬ ‫‪٨‬‬ ‫‪٥١٨٢١‬‬ ‫‪١٣٢٢‬‬ ‫‪٢٣٩٣٩‬‬ ‫‪٥٥‬‬ ‫ﺍﳌﻨﺎﺟﻢ ﻭﺍﶈﺎﺟﺮ‬
‫‪٩١‬‬ ‫‪٣٥٥‬‬ ‫‪١٠١٤٦٣٢‬‬ ‫‪٤٩٩٠٢‬‬ ‫‪٧٨٣٥٦٨‬‬ ‫‪١٢٤٨‬‬ ‫ﺍﻟﺼﻨﺎﻋﺎﺕ ﺍﻟﺘﺤﻮﻳﻠﻴﺔ‬
‫‪٢٤‬‬ ‫‪١١‬‬ ‫‪٤٣٢٥٢‬‬ ‫‪١١٤٦‬‬ ‫‪٧٦٤٩٣‬‬ ‫‪١٩٨‬‬ ‫ﻛﻬﺮﺑﺎﺀ‪-‬ﻣﻴﺎﻩ‪-‬ﻏﺎﺯ‬
‫‪٣٠‬‬ ‫‪٧٥‬‬ ‫‪١٠١٤٥٢‬‬ ‫‪٤٣٥١‬‬ ‫‪٩٢٥٢٣‬‬ ‫‪٣٠٣‬‬ ‫ﺑﻨﺎﺀ ﻭﺗﺸﻴﻴﺪ‬
‫‪٦‬‬ ‫‪١٦‬‬ ‫‪٣٦٧٩٠‬‬ ‫‪١٤٧٦‬‬ ‫‪٩٧٩٦٣‬‬ ‫‪٤١٤‬‬ ‫ﲡﺎﺭﺓ‪ -‬ﻓﻨﺎﺩﻕ – ﻣﻄﺎﻋﻢ‬
‫‪١٩‬‬ ‫‪٤٨‬‬ ‫‪١٠٤٧٩٣‬‬ ‫‪٤٩٠٥‬‬ ‫‪١٢٢٣٩٤‬‬ ‫‪٢١٥‬‬ ‫ﻧﻘﻞ‪-‬ﺍﺗﺼﺎﻻﺕ‪-‬ﲣﺰﻳﻦ‬

‫‪٣٢٣‬‬
 ‫ﻋﺪﺩ‬ ‫ﻋﺪﺩ ﺍﻹﺻﺎﺑﺎﺕ ﺍﻟﱵ‬ ‫ﻋﺪﺩ ﺃﻳﺎﻡ‬ ‫ﻋﺪﺩ‬ ‫ﻋﺪﺩ‬ ‫ﻋﺪﺩ‬
‫ﺍﻷﻧﺸﻄﺔ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ‬
‫ﺍﻟﻮﻓﻴﺎﺕ‬ ‫ﲣﻠﻒ ﻋﻨﻬﺎ ﻋﺠﺰ‬ ‫ﺍﻟﻐﻴﺎﺏ‬ ‫ﺍﻹﺻﺎﺑﺎﺕ‬ ‫ﺍﻟﻌﺎﻣﻠﲔ‬ ‫ﺍﳌﻨﺸﺂﺕ‬

‫‪٥‬‬ ‫‪٥‬‬ ‫‪٨٩٧٠‬‬ ‫‪١٩١‬‬ ‫‪٦٥٤١٠‬‬ ‫‪٢٢٣‬‬ ‫ﻭﺳﺎﻃﺔ ﻣﺎﻟﻴﺔ‪-‬ﺗﺄﻣﲔ‪-‬ﻋﻘﺎﺭﺍﺕ‬

‫‪١‬‬ ‫‪١٣‬‬ ‫‪١٦٤٠٥‬‬ ‫‪٥٦٤‬‬ ‫‪١٢٠٣٤٥‬‬ ‫‪٢٣٨‬‬ ‫ﺧﺪﻣﺎﺕ ﻋﺎﻣﺔ‬
‫‪١٩٢‬‬ ‫‪٥٤٣‬‬ ‫‪١٣٨٧٥٥٠‬‬ ‫‪٦٤٢٦٨‬‬ ‫‪١٤١٣٠٣٥‬‬ ‫‪٣٠٢١‬‬ ‫ﺍ‪‬ﻤﻮﻉ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﻭﺯﺍﺭﺓ ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﻭﺍﻟﺘﺪﺭﻳﺐ‬

‫ﺟﺪﻭﻝ )‪ :(١١-١١‬ﺍﳌﻨﺘﻔﻌﻮﻥ ﺑﺎﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﰲ ﻓﺮﻭﻉ ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﰲ‪.١٩٩٩/٦/٣٠‬‬
‫ﺍﻹﲨﺎﱄ‬ ‫ﺃﺻﺤﺎﺏ ﺍﳌﻌﺎﺷﺎﺕ‬ ‫ﻗﺎﻧﻮﻥ ‪٧٩/٧٥‬‬ ‫ﻗﺎﻧﻮﻥ ‪٣٢/٧٥‬‬ ‫ﺍﻟﻔﺮﻉ‬
‫‪١٤٢٠٢٩١‬‬ ‫‪٢١٧٥٣٤‬‬ ‫‪٩٨٢٧٨٠‬‬ ‫‪٢١٩٩٧٧‬‬ ‫ﴰﺎﻝ ﻏﺮﺏ ﺍﻟﺪﻟﺘﺎ‬
‫‪١٠١٦٤٢٤‬‬ ‫‪٩٧٣٧٦‬‬ ‫‪٢٤٢٥٤٥‬‬ ‫‪٦٧٦٥٠٣‬‬ ‫ﻭﺳﻂ ﺍﻟﺪﻟﺘﺎ‬
‫‪٦٧٢٤٦٦‬‬ ‫‪٨٧٤٩٤‬‬ ‫‪٢٠٤٨٢٣‬‬ ‫‪٣٨٠١٤٩‬‬ ‫ﺷﺮﻕ ﺍﻟﺪﻟﺘﺎ‬
‫‪٥٠٩٦٧٥‬‬ ‫‪٥١٤٤٩‬‬ ‫‪٨٨٤٣٠‬‬ ‫‪٣٦٩٧٩٦‬‬ ‫ﴰﺎﻝ ﺷﺮﻕ ﺍﻟﺪﻟﺘﺎ‬
‫‪٣٧٥٤١١‬‬ ‫‪٣٨٠٦٣‬‬ ‫‪١٠٦٢٤٨‬‬ ‫‪٢٣١٠٦٤‬‬ ‫ﺍﻟﻘﻨﺎﻝ ﻭﺳﻴﻨﺎﺀ‬
‫‪١٠٤٠٠٢٠‬‬ ‫‪٢٠٩١٢٠‬‬ ‫‪٥٢٦٥٦٧‬‬ ‫‪٣٠٤٣٣٣‬‬ ‫ﺍﻟﻘﺎﻫﺮﺓ‬
‫‪١٠٤٣٧٩٥‬‬ ‫‪١١٩٠٦٥‬‬ ‫‪٣٨٧١٤٩‬‬ ‫‪٥٣٧٥٨١‬‬ ‫ﴰﺎﻝ ﺍﻟﺼﻌﻴﺪ‬
‫‪٤٩٩٣٦٧‬‬ ‫‪٣٩٢٥٦‬‬ ‫‪٧٤٣٤٦‬‬ ‫‪٣٨٥٧٦٥‬‬ ‫ﻭﺳﻂ ﺍﻟﺼﻌﻴﺪ‬
‫‪٣٧٤٤٨٥‬‬ ‫‪٣٢٨٩٢‬‬ ‫‪٨٠٠١٣‬‬ ‫‪٢٦١٥٨٠‬‬ ‫ﺟﻨﻮﺏ ﺍﻟﺼﻌﻴﺪ‬
‫‪٦٩٥١٩٣٤‬‬ ‫‪٨٩٢٢٤٩‬‬ ‫‪٢٦٩٣٩٣٧‬‬ ‫‪٣٣٦٦٧٤٨‬‬ ‫ﺍﻹﲨﺎﱄ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )‪.(٩‬‬

‫ﺟﺪﻭﻝ )‪ :(١٢-١١‬ﺍﻟﻘﻮﻯ ﺍﻟﻌﺎﻣﻠﺔ ﺑﺎﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﰲ ‪١٩٩٩/٦/٣٠‬‬

‫ﺍﳌﻌﻴﻨﻮﻥ‬
‫‪٦٠٩٢‬‬ ‫ﻃﺒﻴﺐ ﺑﺸﺮﻯ‬
‫‪١٥٥٨‬‬ ‫ﻃﺒﻴﺐ ﺃﺳﻨﺎﻥ‬
‫‪٤٢٠‬‬ ‫ﺧﺮﳚﺎﺕ ﻛﻠﻴﺔ ﺍﻟﺘﻤﺮﻳﺾ‬
‫‪١١١٤‬‬ ‫ﺻﻴﺪﱄ‬
‫‪٥٥‬‬ ‫ﺧﺮﻳﺞ ﻋﻠﻮﻡ‬
‫‪١٦٠‬‬ ‫ﺇﺧﺼﺎﺋﻲ ﻋﻼﺝ ﻃﺒﻴﻌﻲ‬
‫‪١٤٤١١‬‬ ‫ﳑﺮﺿﺎﺕ‬
‫‪٤٢٨٨‬‬ ‫ﺯﺍﺋﺮﺍﺕ ﺻﺤﻴﺎﺕ‬
‫‪٨٢‬‬ ‫ﻣﺴﻌﻒ‬
‫‪٤٨٦‬‬ ‫ﻓﲏ ﺃﺷﻌﺔ‬
‫‪١٣٦٢‬‬ ‫ﻓﲏ ﻣﻌﻤﻞ‬
‫‪٦‬‬ ‫ﻓﲏ ﺻﻴﺪﻟﺔ‬
‫‪٢١‬‬ ‫ﻓﲏ ﺑﺼﺮﻳﺎﺕ‬
‫‪٢٠٨‬‬ ‫ﻓﲏ ﺃﺳﻨﺎﻥ‬
‫‪١٦٨٣‬‬ ‫ﻣﺴﺎﻋﺪﺍﺕ ﲤﺮﻳﺾ‬
‫‪٣٦‬‬ ‫ﻣﻼﺣﻆ ﺻﺤﻲ‬
‫‪١٧١٧١‬‬ ‫ﺍﳌﺘﻌﺎﻗﺪﻭﻥ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )‪.(٩‬‬

‫‪٣٢٤‬‬
 ‫ﺟﺪﻭﻝ )‪ :(١٣-١١‬ﻧﺸﺎﻁ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﻋﺎﻡ ‪١٩٩٩/١٩٩٨‬‬
‫ﺍﻷﻋﺪﺍﺩ ﺑﺎﻷﻟﻒ‬ ‫ﺍﻟﻨﺸﺎﻁ‬ ‫ﺍﻷﻋﺪﺍﺩ‬ ‫ﺍﻟﻨﺸﺎﻁ‬
‫ﺑﺎﻷﻟﻒ‬
‫‪٢٨٦‬‬ ‫ﻋﻼﺝ ﺍﻷﺳﻨﺎﻥ‬ ‫‪١٢٥٦٩‬‬ ‫ﺯﻳﺎﺭﺍﺕ ﻟﻠﻤﻤﺎﺭﺱ‬
‫‪٥١٣٦‬‬ ‫ﻓﺤﻮﺹ ﻣﻌﻤﻠﻴﺔ‬ ‫‪١١٨٠٨‬‬ ‫ﺯﻳﺎﺭﺍﺕ ﻟﻸﺧﺼﺎﺋﻲ‬
‫‪١٤٤‬‬ ‫ﻓﺤﻮﺹ ﺃﺧﺮﻯ‬ ‫‪٢٩٨‬‬ ‫ﺩﺧﻮﻝ ﺍﳌﺴﺘﺸﻔﻰ‬
‫‪٣٢‬‬ ‫ﻋﺪﺩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳌﺘﺎﺣﺔ ) ﳑﻠﻮﻛﺔ ﻟﻠﻬﻴﺌﺔ ‪ +‬ﺷﺮﺍﺀ ﺍﳋﺪﻣﺔ (‬
‫‪١٢٦٢٩٢٣‬‬ ‫ﻋﺪﺩ ﺃﻳﺎﻡ ﺍﻹﻗﺎﻣﺔ ﺑﺎﳌﺴﺘﺸﻔﻰ‬ ‫‪٥٤٨٩‬‬ ‫ﻋﺪﺩ ﺍﻷﺳﺮﺓ ﺍﳌﺘﺎﺣﺔ‬
‫‪١٦٦٥٠٦‬‬ ‫ﻋﺪﺩ ﺍﻟﻌﻤﻠﻴﺎﺕ ﺍﳉﺮﺍﺣﻴﺔ‬
‫‪ ٦٢٥٣١٩٤٤‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬ ‫ﺗﻜﻠﻔﺔ ﺍﻟﻐﺴﻴﻞ ﺍﻟﻜﻠﻮﻱ‬ ‫‪٥٢٤٣٠٤‬‬ ‫ﻋﺪﺩ ﺟﻠﺴﺎﺕ ﺍﻟﻐﺴﻴﻞ ﺍﻟﻜﻠﻮﻱ‬
‫‪ ٣٦٥٠٨١٧‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬ ‫ﺗﻜﻠﻔﺔ ﻋﻤﻠﻴﺎﺕ ﺟﺮﺍﺣﺔ ﺍﻟﻘﻠﺐ‬ ‫‪١٦٧٨‬‬ ‫ﻋﺪﺩ ﻋﻤﻠﻴﺎﺕ ﺟﺮﺍﺣﺔ ﺍﻟﻘﻠﺐ‬
‫‪ ١٠٢٠٠٠٠‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬ ‫ﺗﻜﻠﻔﺔ ﻋﻤﻠﻴﺎﺕ ﺯﺭﻉ ﺍﻟﻨﺨﺎﻉ‬ ‫‪١٦‬‬ ‫ﻋﺪﺩ ﻋﻤﻠﻴﺎﺕ ﺯﺭﻉ ﺍﻟﻨﺨﺎﻉ‬
‫‪ ١٦٥٢١٨‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬ ‫ﺗﻜﻠﻔﺔ ﻋﻤﻠﻴﺎﺕ ﺯﺭﻉ ﺍﻟﻜﻠﻰ‬ ‫‪١٨‬‬ ‫ﻋﺪﺩ ﻋﻤﻠﻴﺎﺕ ﺯﺭﻉ ﺍﻟﻜﻠﻰ‬
‫‪ ١٥١٦٤٠٧٥‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬ ‫ﺗﻜﻠﻔﺔ ﻋﻼﺝ ﺣﺎﻻﺕ ﺍﻷﻭﺭﺍﻡ‬ ‫‪٩٤٥٩‬‬ ‫ﻋﺪﺩ ﺣﺎﻻﺕ ﺍﻷﻭﺭﺍﻡ‬
‫‪ ٣٠٦٧٤٤٥‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬ ‫ﺗﻜﻠﻔﺔ ﺍﻟﻌﻼﺝ ﺑﺎﳋﺎﺭﺝ‬ ‫‪٢٥‬‬ ‫ﻋﺪﺩ ﺣﺎﻻﺕ ﺍﻟﻌﻼﺝ ﺑﺎﳋﺎﺭﺝ‬
‫‪ ٣٥٠٤٦٣٨٢٤‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬ ‫ﺗﻜﻠﻔﺔ ﺍﻟﺪﻭﺍﺀ ﺍﳌﻨﺼﺮﻑ ﻣﻦ ﺻﻴﺪﻟﻴﺎﺕ ﳑﻠﻮﻛﺔ ﻟﻠﻬﻴﺌﺔ ﻭﻣﺘﻌﺎﻗﺪﺓ ﻣﻌﻬﺎ‬
‫‪ ٨٦٦٤٨٣٣‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬ ‫ﺇﲨﺎﱄ ﺗﻜﻠﻔﺔ ﺍﻷﺟﻬﺰﺓ ﺍﻟﺘﻌﻮﻳﻀﻴﺔ‬
‫ﺍﳌﺮﺟﻊ‪ :‬ﺍﳍﻴﺌﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ )‪.(٩‬‬

‫‪٣٢٥‬‬
 ‫

 
‪:‬‬
‫

 ‬
‫‪  . .‬‬

‫‬
‫ﰲ ﺍﻟﺴﻨﻮﺍﺕ ﺍﻷﺧﲑﺓ‪ ،‬ﺣﺪﺙ ﺗﻐﻴﲑ ﻛﺒﲑ ﰲ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻲ ﺍﻟﺘﻘﻠﻴﺪﻱ؛ ﺣﻴﺚ ﺃﺩﺭﻛﻨﺎ ﲨﻴﻌﺎﹰ ﺍﻻﻧﺘﺸﺎﺭ‬
‫ﺍﻟﻜﺒﲑ ﻟﻼﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﻨﻔﺴﻴﺔ ﺑﻜﻞ ﺃﺷﻜﺎﳍﺎ‪ ،‬ﻭﺣﲔ ﺃﺩﺭﻛﻨﺎ ﺃﻳﻀﺎ ﺃﻥ ﲢﻘﻴﻖ ﺍﻟﺼﺤﺔ ﻻ ﻳﻌﲏ ﻏﻴﺎﺏ‬
‫ﺍﳌﺮﺽ ﻓﻘﻂ ﺑﻞ ﻳﻌﲏ ﻣﺎ ﻳﺴﻤﻰ ﺍﻵﻥ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻟﻠﻤﺠﺘﻤﻊ ﺑﻜﻞ ﺃﻓﺮﺍﺩﻩ‪.‬‬
‫ﻟﻘﺪ ﺃﺻﺒﺤﺖ ﻫﻨﺎﻙ ﺣﺮﻛﺔ ﰲ ﺍ‪‬ﺘﻤﻌﺎﺕ ﺍﳌﺘﻘﺪﻣﺔ ﺗﺴﻤﻰ ﺣﺮﻛﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ‪ ،‬ﻭﻫﻲ‬
‫ﲤﺜﻞ ﺣﺮﻛﺔ ﻭﻣﻨﻬﺞ ﳐﺘﻠﻒ ﻭﺟﺪﻳﺪ‪ .‬ﻓﻬﻲ ‪‬ﺘﻢ ﺑﺪﻭﺭ ﺍ‪‬ﺘﻤﻊ ﻛﻜﻞ ﲡﺎﻩ ﺃﻓﺮﺍﺩﻩ ﻭﺃﻳﻀﺎﹰ ‪‬ﺘﻢ ﺑﺎﳌﻮﺍﺯﻧﺔ‬
‫ﺑﲔ ﺍﻷﻓﺮﺍﺩ ﻭﺑﲔ ﺍﻟﺒﻴﺌﺎﺕ ﺍﻟﱵ ﻳﻌﻴﺸﻮﻥ ﻓﻴﻬﺎ‪ .‬ﻭﰲ ﺑﺆﺭﺓ ﺍﻫﺘﻤﺎﻡ ﻫﺬﻩ ﺍﳊﺮﻛﺔ ﺍﻟﻌﻼﻗﺎﺕ ﺑﲔ ﺍﻷﻓﺮﺍﺩ ﰲ‬
‫ﺍ‪‬ﺘﻤﻊ ﻭﺍﻟﱵ ﺗﺘﻤﻴﺰ ﺑﺄﻧﻈﻤﺔ ﻣﻦ ﺍﻟﻌﻼﻗﺎﺕ ﺍﻟﺮﲰﻴﺔ ﻭﻏﲑ ﺍﻟﺮﲰﻴﺔ ﺍﳌﻌﻘﺪﺓ‪.‬‬
‫ﻭ‪‬ﺬﺍ ﺍﻟﻔﻬﻢ ﺍﳌﺘﻄﻮﺭ‪ ،‬ﻓﺈﻥ ﺍﻟﺘﺪﺧﻼﺕ ﺍﳋﺎﺻﺔ ﺑﺎﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﻭﺍﻟﱵ ‪‬ﺪﻑ ﺇﱃ ﺗﻄﻮﻳﺮ‬
‫ﻭﺗﻨﻤﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﰲ ﺍ‪‬ﺘﻤﻊ ﺗﺘﺠﺎﻭﺯ ﻣﺴﺘﻮﻯ ﺍﻟﻔﺮﺩ ﻭﺗﻠﻘﻲ ﺑﺎﻫﺘﻤﺎﻣﻬﺎ ﻋﻠﻰ ﺍﻟﻌﻤﻞ ﺍﻟﺴﻴﺎﺳﻲ‬
‫ﻭﺍﻻﺟﺘﻤﺎﻋﻲ‪.‬‬
‫ﻭﻟﻘﺪ ﺭﺻﺪﺕ ﺑﻌﺾ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺑﺪﺍﻳﺎﺕ ﻫﺬﻩ ﺍﳊﺮﻛﺔ ﻭﻇﻬﻮﺭ ﻣﺎ ﻳﺴﻤﻰ ﺑﻌﻠﻢ ﺍﻟﻨﻔﺲ ﻭﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻲ‬
‫ﺍ‪‬ﺘﻤﻌﻲ‪.‬‬
‫ﻓﺘﻌﺘﱪ ﻓﺘﺮﺓ ﺍﻟﺴﺘﻴﻨﻴﺎﺕ ﰲ ﺍﻟﻘﺮﻥ ﺍﳌﺎﺿﻲ ﺃﺣﺪ ﻓﺘﺮﺍﺕ ﺍﻟﻘﻠﻖ ﺍﻟﺸﺪﻳﺪ ﰲ ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ‪ .‬ﻭﰲ ﺳﻨﺔ‬
‫‪ ،١٩٦٠‬ﺗﻜﻮﻧﺖ ﻫﻨﺎﻙ ﺭﺍﺑﻄﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻣﻊ ﻭﺻﻮﻝ ﻛﻴﻨﺪﻱ ﻟﻠﺤﻜﻢ‪ .‬ﻭﻳﻌﺘﱪ ﺍﻟﺒﺎﺣﺜﻮﻥ ﺧﻄﺎﺏ‬
‫ﺍﻟﺮﺋﻴﺲ ﺍﻷﻣﺮﻳﻜﻲ ﺟﻮﻥ ﻛﻴﻨﺪﻱ ﺃﻣﺎﻡ ﺍﻟﻜﻮﳒﺮﺱ ﻋﺎﻡ ‪ ١٩٦٣‬ﻋﻼﻣﺔ ﻓﺎﺭﻗﺔ ﻭﲢﻮﻝ ﺟﺮﻱﺀ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﻨﻔﺴﻴﺔ‪ .‬ﻓﻔﻲ ﻫﺬﺍ ﺍﳋﻄﺎﺏ ﺃﺷﺎﺭ ﻛﻴﻨﺪﻱ ﺇﱃ ﺿﺮﻭﺭﺓ ﺍﻟﻌﻨﺎﻳﺔ ﺑﺎﳌﺮﺿﻰ ﺍﻟﻨﻔﺴﻴﲔ ﻭﺃﻳﻀﺎﹰ ﺇﱃ ﺿﺮﻭﺭﺓ‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﺍﻟﺸﺪﻳﺪ ﺑﺎﻟﻮﻗﺎﻳﺔ ﻭﺍﻻﺭﺗﻘﺎﺀ ﺑﺎﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻟﻠﻤﺠﺘﻤﻊ‪.‬‬
‫ﻭﻣﻊ ﻫﺬﺍ ﺍﳋﻄﺎﺏ‪ ،‬ﻭﻣﻊ ﻭﺟﻮﺩ ﺁﻣﺎﻝ ﻋﺮﻳﻀﺔ ﰲ ﺍ‪‬ﺘﻤﻊ ﺍﻷﻣﺮﻳﻜﻲ ﻹﺣﺪﺍﺙ ﺗﻐﻴﲑ ﰲ ﺃﻭﺿﺎﻉ ﻛﺜﲑﺓ ﺳﻴﺌﺔ‬
‫ﻣﺜﻞ ﺗﺪﱐ ﺍﻷﺟﻮﺭ‪ ،‬ﻭﺳﻮﺀ ﺃﺣﻮﺍﻝ ﺍﻟﺘﻌﻠﻴﻢ‪ ،‬ﻭﺍﻷﺳﺮ ﺍﻟﻔﻘﲑﺓ ﻭﺍﳌﻌﺪﻣﺔ‪ ،‬ﺣﻴﺚ ﺃﻥ ﻫﺬﻩ ﺍﻷﺣﻮﺍﻝ ﺗﺆﺛﺮ‬
‫ﺑﺎﻟﻀﺮﻭﺭﺓ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻟﻸﻓﺮﺍﺩ ﻭﻟﻠﻤﺠﺘﻤﻊ‪.‬‬
‫ﻭﻗﺒﻞ ﺫﻟﻚ ﺑﻘﻠﻴﻞ‪ ،‬ﻭﰲ ﻣﻨﺘﺼﻒ ﺍﳋﻤﺴﻴﻨﻴﺎﺕ‪ ،‬ﰎ ﺍﻛﺘﺸﺎﻑ ﺍﻟﻌﻘﺎﻗﲑ ﺍﻟﻄﺒﻴﺔ )ﺍﳌﻬﺪﺋﺎﺕ ﺍﻟﻜﱪﻯ(‪ ،‬ﻭﺍﻟﱵ‬
‫ﻟﻌﺒﺖ ﺩﻭﺭﺍﹰ ﻛﺒﲑﺍﹰ ﰲ ﺍﻟﺘﺤﻜﻢ ﰲ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻌﻘﻠﻴﺔ ﺍﻟﺸﺪﻳﺪﺓ‪ .‬ﻭﺗﻮﺍﻛﺐ ﻣﻊ ﺫﻟﻚ ﺃﻥ ﺑﻌﺾ ﺍﻟﻌﻠﻤﺎﺀ ‪-‬‬
‫ﻣﺜﻞ ﺳﺎﺯ ‪ -‬ﰲ ﺍﻟﺴﺘﻴﻨﻴﺎﺕ ﻫﺎﲨﻮﺍ ﻣﻔﻬﻮﻡ ﺍﳌﺮﺽ ﺍﻟﻌﻘﻠﻲ ﺍﻟﺸﺎﺋﻊ ﻭﺍﻋﺘﱪﻭﺍ ﻫﺬﺍ ﺍﳌﻔﻬﻮﻡ ﺧﺮﺍﻓﺔ ﺃﻭ‬
‫ﺃﺳﻄﻮﺭﺓ ﻭﻗﺎﻡ ﺳﺎﺯ ﺑﻌﻤﻞ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﳉﻴﺪﺓ ﻹﺛﺒﺎﺕ ﻣﺎ ﻳﻘﻮﻝ ﻣﺆﻛﺪﺍﹰ ﻋﺪﻡ ﻭﺟﻮﺩ ﺃﺩﻟﺔ‬
‫ﻣﻮﺿﻮﻋﻴﺔ ﻟﻔﻬﻢ ﺍﳌﺮﺽ ﺍﻟﻌﻘﻠﻲ ﻭﺗﺸﺨﻴﺼﻪ‪.‬‬

‫‪٣٢٧‬‬
‫ﺷﺎﺭﻙ ﺃﻳﻀﺎﹰ ﰲ ﺫﻟﻚ ﺗﺪﻫﻮﺭ ﺃﻭﺿﺎﻉ ﺍﳌﺼﺤﺎﺕ ﺍﻟﻌﻘﻠﻴﺔ ﺗﻠﻚ ﺍﻟﱵ ﳛﺘﺠﺰ ‪‬ﺎ ﺃﻋﺪﺍﺩ ﻛﺒﲑﺓ ﻣﻦ ﺍﳌﺮﺿﻰ‪،‬‬
‫ﻭﺍﻟﱵ ﻛﺎﻧﺖ ﺗﻌﺎﱐ ﻣﻦ ﺳﻮﺀ ﺃﺣﻮﺍﳍﺎ ﻭﺗﻄﻠﺐ ﺍﻷﻣﺮ ﺇﻋﺎﺩﺓ ﺍﻟﻨﻈﺮ ﰲ ﻧﻈﺎﻡ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻤﺮﺿﻰ‬
‫ﺍﻟﻌﻘﻠﻴﲔ‪.‬‬
‫ﻭﺃﺷﺎﺭﺕ ﺩﺭﺍﺳﺎﺕ ﻋﺪﻳﺪﺓ ﺇﱃ ﺃﻥ ﺯﻳﺎﺩﺓ ﺍﻧﺘﺸﺎﺭ ﻣﻌﺪﻝ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ ﰲ ﺍ‪‬ﺘﻤﻊ ﻭﺍﻟﱵ ﺍﺭﺗﺒﻄﺖ‬
‫ﻣﻌﺪﻻﺕ ﺯﻳﺎﺩﺓ ﺍﻧﺘﺸﺎﺭﻫﺎ ﺑﺄﻭﺿﺎﻉ ﺍﺟﺘﻤﺎﻋﻴﺔ ﺑﻌﻴﻨﻬﺎ‪.‬‬
‫ﺗﺒﻠﻮﺭﺕ ﺃﻳﻀﺎﹰ ﰲ ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ ﺍﻷﻣﺮﻳﻜﻴﺔ ﰲ ﻫﺬﻩ ﺍﻟﻔﺘﺮﺓ ﺍﻷﻓﻜﺎﺭ ﻋﻦ ﳏﺎﺭﺑﺔ ﺍﻟﻔﻘﺮ ﰲ ﺍ‪‬ﺘﻤﻊ‬
‫ﻭﺿﺮﻭﺭﺓ ﺍﲣﺎﺫ ﺇﺟﺮﺍﺀﺍﺕ ﻓﻌﺎﻟﺔ ﰲ ﳎﺎﻝ ﺍﻟﺼﺮﺍﻉ ﺍﻻﺟﺘﻤﺎﻋﻲ‪ ،‬ﻭﺗﻀﻤﻨﺖ ﺃﻳﻀﺎﹰ ﺣﺮﻛﺔ ﺛﻘﺎﻓﻴﺔ ﻋﻤﻴﻘﺔ‬
‫ﻭﺃﺻﻴﻠﺔ ﻣﻀﺎﺩﺓ ﻟﻠﺤﺮﺏ‪ .‬ﻭﻫﺬﻩ ﺍﻷﻓﻜﺎﺭ ﻛﺎﻧﺖ ﺃﺣﺪ ﻣﻨﺎﺑﻊ ﺍﳊﺮﻛﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﺍﳉﺪﻳﺪﺓ‪.‬‬
‫ﻭﺳﻨﺘﻌﺮﺽ ﺑﻌﺪ ﺫﻟﻚ ﳌﻮﺿﻮﻋﲔ ﻫﺎﻣﲔ‪:‬‬
‫ﺍﻷﻭﻝ‪ :‬ﺃﻫﺪﺍﻑ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﻭﻣﺸﻜﻼ‪‬ﺎ‪.‬‬
‫ﺍﻟﺜﺎﱐ‪ :‬ﻣﻔﺎﻫﻴﻢ ﺃﺳﺎﺳﻴﺔ ﳊﺮﻛﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ‪:‬‬
‫ﺃ‪ .‬ﻧﻈﺮﻳﺔ ﺍﻷﺯﻣﺔ؛‬
‫ﺏ‪ .‬ﻣﻔﻬﻮﻡ ﺍﻟﻮﻗﺎﻳﺔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‪.‬‬

‫*
)

 
('&‪ !"#$ %‬‬
‫ﺍﻷﻫﺪﺍﻑ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻟﻠﻤﺠﺘﻤﻊ‬
‫‪ .١‬ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﻔﺮﺩ‬
‫ﺍﻻﻫﺘﻤﺎﻡ ﺑﺘﻘﺪﱘ ﺧﺪﻣﺎﺕ ﻟﻠﻤﺮﺿﻰ ﺧﺎﺭﺝ ﺇﻃﺎﺭ ﺍﳌﺆﺳﺴﺎﺕ ﺍﻟﻘﺎﺋﻤﺔ‪ ،‬ﻭﺑﺎﻟﺬﺍﺕ ﺧﺎﺭﺝ ﺇﻃﺎﺭ‬ ‫
‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ‪.‬‬
‫ﺍﺑﺘﻜﺎﺭ ﻭﺗﻨﻤﻴﺔ ﺧﺪﻣﺎﺕ ﺟﺪﻳﺪﺓ ﻭﻣﺒﺘﻜﺮﺓ ﻟﻠﻤﺮﺿﻰ ﻟﺘﻠﺒﻴﺔ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻓﻌﻠﻴﺔ ﳍﻢ‪.‬‬ ‫
‬
‫ﺍﻻﺑﺘﻌﺎﺩ ﻋﻦ ﺳﻴﺎﺳﺔ ﻋﺰﻝ ﺍﳌﺮﻳﺾ ‪‬ﺪﻑ ﲢﻘﻴﻖ ﻫﺪﻑ ﺷﻔﺎﺋﻲ ﻭﳘﻲ‪ ،‬ﻭﻟﻜﻦ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺘﺪﻋﻴﻢ‬ ‫
‬
‫ﻭﻣﺴﺎﻧﺪﺓ ﺍﻷﻓﺮﺍﺩ ﰲ ﳎﺘﻤﻌﻬﻢ ﺍﶈﻠﻲ‪.‬‬
‫ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺳﺮﻋﺔ ﺇﻋﺎﺩﺓ ﺍﳌﺮﻳﺾ ﺇﱃ ﺍ‪‬ﺘﻤﻊ‪.‬‬ ‫
‬
‫ﻋﻼﺝ ﳎﺘﻤﻌﻲ ﻭﻟﻴﺲ ﻋﻼﺟﺎﹰ ﺇﻛﻠﻴﻨﻴﻜﻴﺎﹰ ﻓﻘﻂ‪.‬‬ ‫
‬
‫‪ .٢‬ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻟﺒﻴﺌﺔ‬
‫ﺍﻟﻘﻴﺎﻡ ﺑﻌﻤﻞ ﺇﺣﺼﺎﺋﻴﺎﺕ ﻟﻠﻀﻐﻂ ﻋﻠﻰ ﺍﻟﻘﺮﺍﺭ ﺍﻟﺴﻴﺎﺳﻲ‪ ،‬ﻭﻋﻠﻰ ﺍﻟﻌﻮﺍﻣﻞ ﺍﳌﺆﺛﺮﺓ ﰲ ﻃﺮﻳﻘﺔ‬ ‫
‬
‫ﺗﻮﺯﻳﻊ ﺍﳌﻮﺍﺭﺩ‪.‬‬
‫ﺿﺮﻭﺭﺓ ﺗﻜﺎﻣﻞ ﻋﻠﻢ ﺍﻟﻨﻔﺲ ﻭﻋﻠﻢ ﺍﻻﺟﺘﻤﺎﻉ ﻭﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻲ‪.‬‬ ‫
‬
‫ﺗﺸﺠﻴﻊ ﺍﻟﻌﻠﻤﺎﺀ ﻋﻠﻰ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﻟﺘﻄﻮﻳﺮ ﺍﻟﻨﻔﺴﻲ ﻟﻺﻧﺴﺎﻥ‪.‬‬ ‫
‬

‫‪٣٢٨‬‬
‫)ﻗﺪ ﳛﺘﺎﺝ ﺍﻷﻣﺮ ﺇﱃ ﻋﻤﻞ ﺍﺟﺘﻤﺎﻋﻲ ﻭﺳﻴﺎﺳﻲ ﻭﺍﻟﺪﺧﻮﻝ ﰲ ﺻﺮﺍﻋﺎﺕ ﻟﻠﺒﺤﺚ ﻋﻦ ﺍﻟﺘﻐﻴﲑ(‪ ،‬ﻭﺑﺎﻟﻄﺒﻊ ﰲ‬
‫ﻫﺬﻩ ﺍﻟﺼﺮﺍﻋﺎﺕ ﻻ ﺗﻮﺟﺪ ﻧﻈﺮﻳﺔ ﻋﻠﻤﻴﺔ ﳏﺪﺩﺓ ﺃﻭ ﺃﺳﺎﺱ ﺇﻣﱪﻳﻘﻲ ﺳﻠﻴﻢ ﻳﻮﺿﺢ ﻣﺎﻫﻴﺔ ﻫﺬﺍ ﺍﻟﻌﻤﻞ‪.‬‬
‫ﻭﺇﺫﺍ ﺍﺳﺘﻌﺮﺿﻨﺎ ﺃﻫﺪﺍﻑ ﻫﺬﺍ ﺍﳌﻔﻬﻮﻡ ﺍﳉﺪﻳﺪ‪ ،‬ﻓﻨﺠﺪ ﺃﻧﻪ ﳜﺘﻠﻒ ﻋﻦ ﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﻄﱯ ﺍﻟﺘﻘﻠﻴﺪﻱ ﰲ ﳎﺎﻝ‬
‫ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻲ ﺍﻟﺬﻱ ﻳﻘﺪﻡ ﺍﳋﺪﻣﺔ ﳌﻦ ﻳﻄﻠﺒﻬﺎ ﻓﻘﻂ‪ ،‬ﻭﺍﻟﺬﻱ ﻗﺪ ﻳﺴﺎﻋﺪ ﻋﻠﻰ ﺗﺜﺒﻴﺖ ﺍﳌﺸﻜﻠﺔ ﺑﺪﻻﹰ‬
‫ﻣﻦ ﺣﻠﻬﺎ؛ ﻷﻥ ﺍﳌﺸﻜﻠﺔ ﻗﺪ ﺗﻜﻮﻥ ﺧﺎﺭﺝ ﺍﻟﻔﺮﺩ ﻭﻗﺪ ﺗﻜﻮﻥ ﻣﺸﻜﻠﺔ ﺗﻜﻴﻒ ﻳﺘﻄﻠﺐ ﺣﻠﻬﺎ ﺧﻠﻖ ﺷﺒﻜﺎﺕ‬
‫ﺍﺟﺘﻤﺎﻋﻴﺔ ﺗﺸﺠﻊ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻔﺮﺩ ﻟﻠﻤﻮﺍﺭﺩ ﺍﳌﺘﺎﺣﺔ‪ .‬ﻭﻫﺬﺍ ﺍﳌﻔﻬﻮﻡ ﺃﻳﻀﺎﹰ ﻳﺪﻋﻮ ﺇﱃ ﻋﺪﻡ ﺿﺮﻭﺭﺓ ﺯﻳﺎﺩﺓ‬
‫ﻋﺪﺩ ﺍﳌﻌﺎﳉﲔ ﺍﳌﺘﺨﺼﺼﲔ‪ .‬ﻭﻳﺆﻛﺪ ﻫﺬﺍ ﺍﳌﻨﻈﻮﺭ ﺑﺎﻥ ﻭﻗﻮﻉ ﺍﻟﻔﺮﺩ ﲢﺖ ﻭﻃﺄﺓ ﺍﳌﺮﺽ ﺍﻟﻨﻔﺴﻲ ﻟﻴﺲ‬
‫ﺣﺘﻤﻴﺎﹰ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﳌﺮﺽ ﺍﻟﻨﻔﺴﻲ ﳑﻜﻨﺔ‪.‬‬

‫ﻣﺸﻜﻼﺕ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ‬

‫ﻻ ﻳﻬﺘﻢ ﻫﺬﺍ ﺍﳌﻨﻬﺞ ﺑﺎﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ ﺍﳌﻌﺮﻭﻓﺔ ﻓﻘﻂ‪ ،‬ﺑﻞ ﻳﺘﻮﺳﻊ ﻟﻼﻫﺘﻤﺎﻡ ﺑﺎﳌﺸﺎﻛﻞ ﺍﻟﻨﻔﺴﻴﺔ‬
‫ﺍﻟﱵ ﻋﺎﺩﺓ ﻻ ﲡﺪﻱ ﻣﻌﻬﺎ ﺍﳋﺪﻣﺎﺕ ﺍﳌﺘﺎﺣﺔ ﻣﺜﻞ‪:‬‬
‫‪ .١‬ﻣﺸﺎﻛﻞ ﺍﻹﺩﻣﺎﻥ‪ :‬ﻣﺸﺎﻛﻞ ﺍﻹﺩﻣﺎﻥ ﰲ ﺍﻟﻌﺎﱂ ﻣﻦ ﺃﺻﻌﺐ ﺍﳌﺸﺎﻛﻞ ﻭﳍﺎ ﺗﺪﺍﻋﻴﺎﺕ ﻭﺁﺛﺎﺭ ﰲ‬
‫ﻛﻞ ﳎﺎﻻﺕ ﺍﳊﻴﺎﺓ‪ .‬ﻭﻫﻲ ﻋﺎﺩﺓ ﲢﺘﺎﺝ ﺇﱃ ﻛﻞ ﺍﳉﻬﻮﺩ ﻣﻦ ﺍﻷﺳﺮﺓ ﺍﻟﺼﻐﲑﺓ ﺇﱃ ﺍﳉﻬﻮﺩ ﺍﻟﺪﻭﻟﻴﺔ‪.‬‬
‫ﻭﻻﺑﺪ ﻣﻦ ﺍﻟﺘﻌﺎﻭﻥ ﺑﲔ ﻛﻞ ﺍﳉﻬﻮﺩ ﻟﻼﺳﺘﻔﺎﺩﺓ ﻣﻦ ﺍﻟﻄﺎﻗﺎﺕ ﺍﳌﺎﺩﻳﺔ ﻭﺍﻟﺒﺸﺮﻳﺔ ﺍﳌﺒﺬﻭﻟﺔ ﰲ ﻫﺬﺍ‬
‫ﺍ‪‬ﺎﻝ‪.‬‬
‫‪ .٢‬ﻣﺸﺎﻛﻞ ﺍﳉﺮﳝﺔ ﻭﺿﺤﺎﻳﺎﻫﺎ‪ :‬ﺗﺘﺰﺍﻳﺪ ﺍﳉﺮﺍﺋﻢ ﻣﺜﻞ ﺟﺮﺍﺋﻢ ﺍﻟﻌﻨﻒ ﻭﺟﺮﺍﺋﻢ ﺍﻻﻏﺘﺼﺎﺏ‪ ،‬ﻭﻗﺪ ﺗﺆﺩﻱ‬
‫ﺧﱪﺓ ﺍﻟﺘﻌﺮﺽ ﻻﻋﺘﺪﺍﺀ ﺇﺟﺮﺍﻣﻲ ﺇﱃ ﻧﺘﺎﺋﺞ ﻧﻔﺴﻴﺔ ﺗﺘﺮﺍﻭﺡ ﺑﲔ ﺍﻹﺣﺴﺎﺱ ﺑﻌﺪﻡ ﺍﻻﺭﺗﻴﺎﺡ ﻟﻔﺘﺮﺓ‬
‫ﻗﺼﲑﺓ ﺇﱃ ﺍﻻﺿﻄﺮﺍﺏ ﺍﻟﺸﺪﻳﺪ ﻃﻮﻳﻞ ﺍﻷﻣﺪ )ﺍﺿﻄﺮﺍﺏ ﻣﺎ ﺑﻌﺪ ﺍﻟﺼﺪﻣﺔ(‪ ،‬ﻭﺍﻟﺬﻱ ﻗﺪ ﻳﺆﺩﻱ‬
‫ﺇﱃ ﺍﻟﻌﺠﺰ ﺍﻟﻜﺎﻣﻞ ﻟﻠﻔﺮﺩ‪ .‬ﻭﺑﺎﻟﺘﺄﻛﻴﺪ ﳝﺘﺪ ﺗﺄﺛﲑ ﺍﳉﺮﳝﺔ ﺇﱃ ﻛﻞ ﺃﻓﺮﺍﺩ ﺃﺳﺮﺓ ﻣﺮﺗﻜﱯ ﺍﳉﺮﺍﺋﻢ‬
‫ﻭﺿﺤﺎﻳﺎﻫﺎ‪.‬‬
‫‪ .٣‬ﻣﺸﻜﻼﺕ ﺍﻟﻄﻔﻮﻟﺔ ﻭﺍﳌﺮﺍﻫﻘﺔ‪ :‬ﻣﺸﻜﻼﺕ ﺍﻟﻄﻔﻮﻟﺔ ﻭﺍﳌﺮﺍﻫﻘﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻛﺜﲑﺓ ﻭﻣﺘﻌﺪﺩﺓ‬
‫ﻭﻧﺎﺩﺭﺍ ﻣﺎ ﺗﺼﻞ ﺇﱃ ﺍﻟﻄﺒﻴﺐ ﺍﻟﻨﻔﺴﻲ ﻣﺜﻞ ﻣﺸﺎﻛﻞ ﺍﻟﺘﻌﻠﻴﻢ ﻭﻣﺸﺎﻛﻞ ﺍﻹﺳﺎﺀﺓ ﺇﱃ ﺍﻷﻃﻔﺎﻝ‬
‫ﻭﺍﻟﻨﺘﺎﺋﺞ ﻭﺍﻟﺘﺪﺍﻋﻴﺎﺕ ﳍﺬﻩ ﺍﳌﺸﺎﻛﻞ‬
‫‪ .٤‬ﺍﳌﺸﺎﻛﻞ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻷﻣﺮﺍﺽ ﺍﳌﺰﻣﻨﺔ ﻭﺍﻹﺻﺎﺑﺎﺕ‪ :‬ﻫﻨﺎﻙ ﺍﻟﻌﺪﻳﺪ ﻡ ﺍﳌﺸﺎﻛﻞ ﰱ ﻫﺬﺍ ﺍ‪‬ﺎﻝ ﺗﺆﺩﻯ‬
‫ﺇﱃ ﻣﺸﺎﻛﻞ ﻧﻔﺴﻴﺔ ﻟﻠﻤﺮﺿﻰ ﻭﻟﻠﻤﺤﻴﻄﲔ ‪‬ﻢ ﻣﺜﻞ )ﻣﺸﺎﻛﻞ ﺍﻟﺴﺮﻃﺎﻥ‪ -‬ﺍﻟﺸﻠﻞ‬
‫ﺍﻟﺪﻣﺎﻏﻰ‪ -‬ﻓﻘﺪ ﺍﻟﺴﻤﻊ‪ -‬ﺍﻟﺼﺮﻉ‪ -‬ﺿﻐﻂ ﺍﻟﺪﻡ‪ -‬ﺗﺼﻠﺐ ﺍﻟﺸﺮﺍﻳﲔ‪ -‬ﺿﻤﻮﺭ ﺍﻟﻌﻀﻼﺕ‪-‬‬
‫ﺍﻟﺮﺑﻮ ﺍﻟﺸﻌﱮ‪ -‬ﺍﻟﺒﻮﻝ ﺍﻟﺴﻜﺮﻯ‪ -‬ﺇﺻﺎﺑﺎﺕ ﺍﻟﺪﻣﺎﻍ‪ -‬ﺍﻟﺘﻬﺎﺏ ﺍﳌﻔﺎﺻﻞ ﻭﺍﻟﺮﻭﻣﺎﺗﻮﻳﺪ‪ -‬ﻣﺸﺎﻛﻞ‬
‫ﺍﻟﺒﺘﺮ‪ -‬ﺍﻷﻣﺮﺍﺽ ﺍﻟﺘﻨﺎﺳﻠﻴﺔ‪ -‬ﻣﺸﺎﻛﻞ ﺍﻟﻌﻘﻢ ﻭﲢﺪﻳﺪ ﺍﻟﻨﺴﻞ(‪.‬‬
‫‪ .٥‬ﺍﻟﻜﻮﺍﺭﺙ‪ :‬ﲢﺪﺙ ﺍﻟﻜﻮﺍﺭﺙ ﺩﺍﺋﻤﺎ ﺇﻣﺎ ﺑﻔﻌﻞ ﺍﻟﻄﺒﻴﻌﺔ ﺃﻭ ﺑﻔﻌﻞ ﺍﻹﻧﺴﺎﻥ ﻣﺜﻞ ﺍﻟﺰﻻﺯﻝ‬
‫ﻭﺍﻟﻔﻴﻀﺎﻧﺎﺕ ﻭﺍﻟﺴﻴﻮﻝ ﻭﺍﳊﺮﺍﺋﻖ ﻭﺍﻷﺟﺴﺎﻡ ﺍﳌﺸﻌﺔ‪ ،‬ﻭﺗﺆﺩﻯ ﺍﻟﻜﻮﺍﺭﺙ ﺇﱃ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺸﺎﻛﻞ‬
‫ﺍﻟﻨﻔﺴﻴﺔ ﺍﻟﱴ ﳚﺐ ﺍﻟﺘﺪﺧﻞ ﻟﻌﻼﺟﻬﺎ ﻭﺍﻟﺘﺨﻔﻴﻒ ﻣﻨﻬﺎ‬

‫‪٣٢٩‬‬
‫‪ .٦‬ﺍﻟﺰﻭﺍﺝ ﻭﺍﻟﻮﺍﻟﺪﻳﺔ‪ :‬ﻫﺬﻩ ﺍﳌﺸﺎﻛﻞ ﺗﺆﺛﺮ ﻋﻠﻰ ﻣﻼﻳﲔ ﺍﻟﺒﺸﺮ ﻣﺜﻞ‪ :‬ﺍﳌﺸﺎﻛﻞ ﺍﻟﺰﻭﺟﻴﺔ‪ -‬ﺍﻹﳒﺎﺏ‬
‫ﻭﻣﺸﺎﻛﻞ ﺍﻹﺟﻬﺎﺽ‪ -‬ﺍﺿﻄﺮﺍﺏ ﻣﺎ ﺑﻌﺪ ﺍﻟﻮﻻﺩﺓ‪ -‬ﺍﳊﻤﻞ ﻏﲑ ﺍﳌﺮﻏﻮﺏ ﻓﻴﻪ‪ -‬ﺍﻟﺼﺮﺍﻉ ﺍﻟﺰﻭﺍﺟﻰ‬
‫ﻭﺍﻧﻌﻜﺎﺳﻪ ﻋﻠﻰ ﺍﻷﻃﻔﺎﻝ‪ -‬ﻣﺸﺎﻛﻞ ﺍﻟﺘﺒﲎ )ﻣﻮﺟﻮﺩﺓ ﰱ ﻣﺼﺮ ﺑﺸﻜﻞ ﳐﺘﻠﻒ( ‪ -‬ﻣﺸﺎﻛﻞ‬
‫ﺍﻟﻄﻼﻕ ﻭﺍﻻﻧﻔﺼﺎﻝ‬
‫‪ .٧‬ﺍﳌﺸﺎﻛﻞ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﻭﻣﺸﺎﻛﻞ ﺍﻟﻌﻤﺎﻟﺔ‪ :‬ﺍﻟﻔﻘﺮ‪ -‬ﺃﺳﺮ ﺗﺮﻋﺎﻫﺎ ﻧﺴﺎﺀ ﻓﻘﲑﺍﺕ ﺃﻭ ﻣﻄﻠﻘﺎﺕ‪-‬‬
‫ﻣﺸﺎﻛﻞ ﰱ ﺍﻟﺴﻜﻦ ﻭﺍﻟﻐﺬﺍﺀ‪ -‬ﺍﻟﺒﻄﺎﻟﺔ ﻭﻧﻮﻉ ﺍﻟﻌﻤﻞ‪ -‬ﺿﻐﻮﻁ ﺍﻟﻌﻤﻞ ﺍﳉﺪﻳﺪ‪ -‬ﺍﳍﺠﺮﺓ ﻣﻦ‬
‫ﺍﻟﺮﻳﻒ ﺇﱃ ﺍﳌﺪﻳﻨﺔ ) ﲤﺜﻞ ﻣﺸﻜﻠﺔ ﰲ ﻣﺼﺮ(‪ -‬ﻓﺸﻞ ﺍﳌﺸﺮﻭﻋﺎﺕ ﺍﻟﺼﻐﲑﺓ‪ -‬ﻋﻤﻞ ﺍﳌﺮﺃﺓ ﻭﺗﻐﲑ‬
‫ﺍﻟﻌﻼﻗﺎﺕ ﺩﺍﺧﻞ ﺍﻷﺳﺮﺓ‪ -‬ﺗﻐﻴﲑ ﻃﺒﻴﻌﺔ ﺍﻟﻌﻤﻞ )ﺯﻳﺎﺩﺓ ﰱ ﺍﻷﻋﻤﺎﻝ ﺍﳋﺪﻣﺔ(‪ -‬ﺍﻟﺘﻘﺎﻋﺪ ﰱ ﺳﻦ‬
‫ﻣﺒﻜﺮﺓ )ﳝﺜﻞ ﻣﺸﻜﻠﺔ ﻛﺒﲑﺓ ﰱ ﻣﺼﺮ ﺣﺎﻟﻴﺎ(‬
‫‪ .٨‬ﺍﳌﻮﺕ ﻭﺍﳊﺪﺍﺩ ﻭﺍﻻﻧﺘﺤﺎﺭ‪ :‬ﺍﻟﻔﻘﺪﺍﻥ ﳝﺜﻞ ﺃﺯﻣﺔ ﻟﻜﻞ ﺍﻷﻓﺮﺍﺩ ﻭﳛﺘﺎﺝ ﺍﻷﻣﺮ ﰱ ﻛﺜﲑ ﻣﻦ ﺍﻷﺣﻴﺎﻥ ﺇﱃ‬
‫ﺍﻟﺘﺪﺧﻞ ﻟﺘﻘﻠﻴﻞ ﻋﺐﺀ ﺍﻟﻔﻘﺪﺍﻥ‬
‫‪ .٩‬ﺍﻟﺸﻴﺨﻮﺧﺔ )ﻋﺘﻪ ﺍﻟﺸﻴﺨﻮﺧﺔ(‪ :‬ﻳﺰﻳﺪ ﺃﻋﺪﺍﺩ ﺍﳌﺴﻨﲔ ﰱ ﺍ‪‬ﺘﻤﻊ ﻭﺗﺰﺩﺍﺩ ﻧﺴﺒﺔ ﺣﺪﻭﺙ ﺍﻟﻌﺘﻪ‬
‫)ﺧﺮﻑ ﺍﻟﺸﻴﺨﻮﺧﺔ( ﺑﺘﺪﺍﻋﻴﺎ‪‬ﺎ ﺍﳌﺆﳌﺔ ﻋﻠﻰ ﺍﳌﺼﺎﺑﲔ ‪‬ﺎ ﻭﻋﻠﻰ ﺍﻟﺮﺍﻋﲔ ﳍﻢ‪.‬‬

‫ *‪%&'(
 

+
,  -‬‬
‫ﻧﻈﺮﻳﺔ ﺍﻷﺯﻣﺔ ﻭﻣﻔﻬﻮﻡ ﺍﻟﻮﻗﺎﻳﺔ‬
‫ﻟﻘﺪ ﻗﺪﻣﺖ ﻟﻨﺎ ﺣﺮﻛﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﻣﻔﻬﻮﻣﲔ ﺃﺳﺎﺳﻴﲔ ﰱ ﻣﻘﺎﺑﻞ ﺍﳌﻔﻬﻮﻡ ﺍﻟﺘﻘﻠﻴﺪﻯ‬
‫ﻟﻠﻤﺮﺽ ﺍﻟﻨﻔﺴﻰ ﻭﳘﺎ ﻣﻔﻬﻮﻡ ﺍﻷﺯﻣﺔ ﻭﻣﻔﻬﻮﻡ ﺍﻟﻮﻗﺎﻳﺔ‪:‬‬
‫‪ .١‬ﻣﻔﻬﻮﻡ )ﻧﻈﺮﻳﺔ( ﺍﻷﺯﻣﺔ‪:‬‬
‫ﺗﻘﺪﻡ ﻧﻈﺮﻳﺔ ﺍﻷﺯﻣﺔ ﳕﻮﺫﺟﺎﹰ ﻣﻔﻴﺪﺍ ﻳﺘﻜﺎﻣﻞ ﻣﻊ ﺍﳌﻨﻈﻮﺭ ﺍﻟﺒﻴﺌﻰ ﻣﺆﺩﺍﻩ ﺃﻧﻪ ﺇﺫﺍ ﻛﺎﻥ ﻗﺪ ﺣﺪﺙ ﻓﺸﻼ ﻣﺎ ﰱ‬
‫ﻋﻤﻠﻴﺔ ﺍﻟﺘﻨﺸﺌﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻟﻠﻔﺮﺩ ﻭﺣﺪﺛﺖ ﻇﺮﻭﻑ ﻗﺎﺳﻴﺔ ﺭﺍﻫﻨﺔ ﻓﻘﺪ ﻳﺴﺘﺠﻴﺐ ﺍﻟﻔﺮﺩ ﲝﺎﻟﺔ ﻣﻦ‬
‫ﺍﳊﺰﻥ ﺍﳌﺆﻗﺖ‪ ،‬ﻭﰱ ﳏﺎﻭﻟﺔ ﺍﻟﻔﺮﺩ ﺍﻟﺘﻐﻠﺐ ﻋﻠﻰ ﻫﺬﻩ ﺍﳊﺎﻟﺔ ﻗﺪ ﻳﻌﺎﱏ ﻣﻦ ﺣﺎﻟﺔ ﻣﺮﺿﻴﺔ ﺳﻴﺌﺔ ﲢﺘﺎﺝ ﺇﱃ‬
‫ﺍﻟﺘﺪﺧﻞ ﺑﺎﻟﺮﻋﺎﻳﺔ ﻭﻗﺪ ﻳﺴﺘﻄﻴﻊ ﺍﻟﻔﺮﺩ ﺍﻟﺘﻐﻠﺐ ﻋﻠﺒﻬﺎ ﻭﺍﻻﺳﺘﻔﺎﺩﺓ ﻣﻨﻬﺎ ﻭﺍﳋﺮﻭﺝ ﺃﻗﻮﻯ ﳑﺎ ﻛﺎﻥ ﻭﻗﺪ ﻻ‬
‫ﻳﺴﺘﻄﻴﻊ‪.‬‬
‫ﻭﻳﻌﺘﱪ ﺍﺧﺘﻼﻑ ﻧﺘﺎﺋﺞ ﺍﻷﺯﻣﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻸﻓﺮﺍﺩ ﺩﻟﻴﻞ ﻋﻠﻰ ﺍﺧﺘﻼﻑ ﺍﻟﺒﻴﺌﺔ ﺍﻟﱴ ﻳﻌﻴﺸﻮﻥ ﻓﻴﻬﺎ ﻭﺍﺧﺘﻼﻑ‬
‫ﻭﺳﺎﺋﻞ ﺍﻟﺪﻋﻢ ﻭﺍﳌﺴﺎﻧﺪﺓ ﺍﳌﻘﺪﻣﺔ ﳍﻢ ﻭﺗﺘﺼﻮﺭ ﻫﺬﻩ ﺍﻟﻨﻈﺮﻳﺔ ﺇﻣﻜﺎﻧﻴﺔ ﺣﺪﻭﺙ ﺗﺘﻄﻮﺭ ﻭﳕﻮ ﻟﻠﻔﺮﺩ‬
‫ﻳﺘﺠﺎﻭﺯ ﺍﻟﻌﻼﺝ ﺍﻟﻨﻔﺴﻰ ﻟﻠﻤﺮﺽ ﺍﳌﻮﺟﻮﺩ‪.‬‬
‫ﻭﰱ ﻫﺬﺍ ﺍﻹﻃﺎﺭ ﻳﺘﻢ ﺗﻌﺮﻳﻒ ﺍﻷﺯﻣﺔ ﻋﻠﻰ ﺃ‪‬ﺎ ﺗﻐﻴﲑ ﺳﺮﻳﻊ ﻳﻀﻊ ﺍﻟﻔﺮﺩ ﰲ ﲢﺪ ﻻ ﳐﺮﺝ ﻣﻨﻪ ﺇﻻ ﻣﻦ ﺧﻼﻝ‬
‫ﺗﻐﻴﲑ ﺃﻭ ﺗﻌﺪﻳﻞ ﰲ ﺳﻠﻮﻛﻪ ﺑﺸﻜﻞ ﻣﺎ‪ -‬ﻭﻣﺼﻄﻠﺢ ﺍﻷﺯﻣﺔ )‪ (Crisis‬ﻳﺮﺟﻊ ﺇﱃ ﺃﺻﻞ ﻳﻮﻧﺎﱐ ﻣﻌﻨﺎﻩ )ﺃﻥ‬
‫ﻳﻘﺮﺭ( ﺃﻱ ﺃﻥ ﺍﻟﻔﺮﺩ ﻳﻮﺍﺟﻪ ﻣﻮﻗﻔﺎ ﳛﺘﺎﺝ ﺇﱃ ﺃﻥ ﻳﺘﺨﺬ ﻗﺮﺍﺭﺍ ﰲ ﺣﻴﺎﺗﻪ ﻹﺣﺪﺍﺙ ﺗﻐﻴﲑ ﰲ ﺣﻴﺎﺗﻪ ﺇﱃ ﺍﻷﻓﻀﻞ‪.‬‬
‫ﻭﻫﻨﺎﻙ ﺃﻭﺟﻪ ﺗﺸﺎﺑﻪ ﻭﺃﻭﺟﻪ ﺍﺧﺘﻼﻑ ﺑﲔ ﻧﻈﺮﻳﺔ ﺍﻷﺯﻣﺔ ﻭﻧﻈﺮﻳﺔ ﺍﻟﻌﺼﺎﺏ ﰲ ﺍﻟﺘﺤﻠﻴﻞ ﺍﻟﻨﻔﺴﻲ ﺣﻴﺚ ﺃﻥ‬
‫ﻧﻈﺮﻳﺔ ﺍﻟﻌﺼﺎﺏ ﺗﻌﺘﱪ ﺍﳌﺸﻜﻼﺕ ﺍﻟﺴﻠﻮﻛﻴﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻧﺘﺎﺟﺎ ﻟﺼﺮﺍﻋﺎﺕ ﱂ ﲢﻞ ﰲ ﺍﳌﺮﺍﺣﻞ ﺍﳌﺒﻜﺮﺓ‬

‫‪٣٣٠‬‬
‫ﻭﺗﻜﻮﻧﺖ ﺩﻓﺎﻋﺎﺕ ﻧﻔﺴﻴﺔ ﻟﻠﻔﺮﺩ ﲢﻮﻝ ﺩﻭﻥ ﺳﻘﻮﻃﻪ ﰲ ﺍﳌﺮﺽ ﺍﻟﻨﻔﺴﻲ ﻭﻃﺎﳌﺎ ﺃﻥ ﻫﺬﻩ ﺍﻟﺪﻓﺎﻋﺎﺕ ﺗﻌﻤﻞ‬
‫ﺑﻜﻔﺎﺀﺓ ﻓﻴﻤﻜﻦ ﻟﻠﻔﺮﺩ ﺃﻥ ﻳﻌﻴﺶ ﰲ ﺃﻣﺎﻥ‪ ،‬ﻭﲢﺪﺙ ﺍﳌﺸﻜﻼﺕ ﺍﻟﺴﻠﻮﻛﻴﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻋﻨﺪﻣﺎ ﺗﻔﺸﻞ‬
‫ﻣﻴﻜﺎﻧﻴﺰﻣﺎﺕ ﺍﻟﺪﻓﺎﻉ ﰲ ﻋﻤﻠﻬﺎ‪ ،‬ﻭﻋﻠﻰ ﺫﻟﻚ ﻓﺎﻥ ﻧﻈﺮﻳﺔ ﺍﻟﺘﺤﻠﻴﻞ ﺍﻟﻨﻔﺴﻲ ﺗﺮﻛﺰ ﻋﻠﻰ ﺍﻟﻔﺮﺩ ﻭﻣﺎﺿﻴﻪ ﻭﻻ‬
‫ﺗﻠﻘﻰ ﺍﻫﺘﻤﺎﻣﺎ ﺇﱃ ﺍﳌﻮﺍﻗﻒ ﺍﳊﺎﻟﻴﺔ‪ ،‬ﰲ ﺣﲔ ﺃﻥ ﺍﻷﺯﻣﺔ ﲢﺪﺙ ﻋﻨﺪﻣﺎ ﻳﻮﺍﺟﻪ ﺍﻟﻔﺮﺩ ﺑﻌﻘﺒﺔ ﺗﺆﺛﺮ ﻋﻠﻰ‬
‫ﺃﻫﺪﺍﻓﻪ ﻭﻻ ﺗﺴﺘﻄﻴﻊ ﺍﻷﺳﺎﻟﻴﺐ ﺍﳌﻌﺘﺎﺩﺓ ﺍﻟﱵ ﻳﺴﺘﺨﺪﻣﻬﺎ ﰲ ﲡﺎﻭﺯ ﻫﺬﻩ ﺍﻟﻌﻘﺒﺔ‪ ،‬ﻭﲣﻞ ﻫﺬﻩ ﺍﻟﻌﻘﺒﺔ‬
‫ﺑﺘﻜﻴﻔﻴﺎﺕ ﺍﻟﻔﺮﺩ ﺍﻟﺴﺎﺑﻖ ﻭﻣﻦ ﰒ ﺗﺘﻄﻠﺐ ﺍﺳﺘﺠﺎﺑﺔ ﻣﻦ ﻧﻮﻉ ﺟﺪﻳﺪ‪ .‬ﻭﻣﻦ ﺍﳌﻔﻴﺪ ﺃﻥ ﻧﺆﻛﺪ ﻫﻨﺎ ﻋﻠﻰ ﺃﻥ‬
‫ﻧﻈﺮﻳﺔ ﺍﻷﺯﻣﺔ ﺗﻨﻈﺮ ﺇﱃ ﺍﻹﻧﺴﺎﻥ ﺑﻨﻈﺮﺓ ﺃﻛﺜﺮ ﺗﻔﺎﺅﻻ ﻓﻬﻲ ﺗﺆﻛﺪ ﻋﻠﻰ ﺇﻣﻜﺎﻧﻴﺔ ﺍﻟﻨﻤﻮ ﻭﺍﻟﺘﻄﻮﺭ ﻟﻠﻔﺮﺩ‬
‫ﺑﺸﻜﻞ ﻻ ‪‬ﺎﺋﻲ ﰲ ﻣﻮﺍﺟﻬﺘﻪ ﻟﻸﺯﻣﺎﺕ ﻭﻫﻰ ﻋﻤﻠﻴﺔ ﺗﺘﺠﺎﻭﺯ ﻋﻼﺝ ﺍﻟﺸﺨﺺ ﻣﻦ ﺍﳌﺸﻜﻼﺕ ﺍﻟﺴﻠﻮﻛﻴﺔ‬
‫ﻭﺍﻟﻨﻔﺴﻴﺔ‪.‬‬
‫ﺍﳌﻼﻣﺢ ﺍﻷﺳﺎﺳﻴﺔ ﻟﻨﻈﺮﻳﺔ ﺍﻷﺯﻣﺔ‬
‫ﺃ‪ .‬ﺣﺪﺙ ﺿﺎﻏﻂ ﺃﻭ ﺃﺣﺪﺍﺙ ﺗﺘﻄﻠﺐ ﺗﻐﻴﲑﺍ‬
‫ﺏ‪ .‬ﺗﺆﺩﻯ ﻃﺒﻴﻌﺔ ﺍﳌﺸﻜﻠﺔ ﺇﱃ ﺇﺭﻫﺎﻕ ﺍﳌﻮﺍﺭﺩ ﺍﳌﺘﺎﺣﺔ ﻟﻠﻔﺮﺩ ﺑﻜﻞ ﺃﻧﻮﺍﻋﻬﺎ ﻧﻔﺴﻴﺎ ﻭﺟﺴﺪﻳﺎ‬
‫ﻭﻣﺎﺩﻳﺎ ﻭﻛﺬﻟﻚ ﻣﻮﺍﺭﺩ ﺃﺳﺮﺗﻪ ﻭﺍﻵﺧﺮﻳﻦ ﺍﻟﺬﻳﻦ ﻳﺸﻜﻠﻮﻥ ﻋﻼﻗﺎﺕ ﺍﻟﺪﻋﻢ ﺍﻻﺟﺘﻤﺎﻋﻰ‬
‫‪ .١‬ﻣﺼﺎﺩﺭ ﺍﻟﻀﻐﻮﻁ‬
‫ﺃ‪ .‬ﺿﻐﻮﻁ ﺑﻴﺌﻴﺔ‬
‫ﺿﻐﻮﻁ ﺍﺟﺘﻤﺎﻋﻴﺔ‪ :‬ﻭﺗﺘﻤﺜﻞ ﰲ ﺍﻟﻔﻘﺮ ﻭﺍﻟﺒﻄﺎﻟﺔ ﻭﺍﻟﻌﺰﻟﺔ ﻭﺍﻟﺘﻐﲑ ﺍﻻﺟﺘﻤﺎﻋﻰ ﻣﻊ ﺍﺭﺗﺒﺎﻁ ﺫﻟﻚ‬ ‫
‬
‫ﲟﻔﺎﻫﻴﻢ ﺍ‪‬ﺘﻤﻊ ﺍﻟﺼﻨﺎﻋﻰ‪ -‬ﺍﻷﻗﻠﻴﺎﺕ‪ -‬ﺍﻟﺘﻐﲑ ﺍ‪‬ﺘﻤﻌﻰ ﺍﻟﺴﺮﻳﻊ‪ -‬ﺿﻐﻮﻁ ﺍﻷﺳﺮﺓ‪ -‬ﻣﻌﺎﻣﻠﺔ‬
‫ﺳﻴﺌﺔ‪ -‬ﺭﻗﺎﺑﺔ ﺷﺪﻳﺪﺓ‪ -‬ﺭﻓﺾ ﺍﻟﻄﻔﻞ ﻭﺍﻧﻌﻜﺎﺱ ﳘﻮﻡ ﺍﻟﻮﺍﻟﺪﻳﻦ ﻋﻠﻰ ﺍﻟﻄﻔﻞ )ﻣﺜﻞ ﺍﳌﻜﺎﻧﺔ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ ،‬ﺍﳌﻤﺘﻠﻜﺎﺕ‪ ،‬ﺍﳌﺮﺽ‪ ،‬ﺍﳊﺎﻟﺔ ﺍﳌﺎﺩﻳﺔ(‪.‬‬
‫ﺿﻐﻮﻁ ﺛﻘﺎﻓﻴﺔ‪ :‬ﺇﺫﺍ ﻛﺎﻥ ﺗﻌﺮﻳﻒ ﺍﻟﺜﻘﺎﻓﺔ ﻫﻮ ﻧﺴﻖ ﻭﺃﺳﺎﻟﻴﺐ ﺍﻟﺘﻔﻜﲑ ﻭﻃﺮﻳﻘﺔ ﺗﻨﺎﻭﻝ ﺍﳌﻮﺍﻗﻒ‬ ‫
‬
‫ﻭﺍﳌﺸﻜﻼﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻟﱴ ﺗﻨﺘﻘﻞ ﻣﻦ ﺟﻴﻞ ﺇﱃ ﺟﻴﻞ ﻓﺎﻥ ﺍﻹﻧﺴﺎﻥ ﻣﻌﺮﺽ ﻟﻀﻐﻮﻁ ﺛﻘﺎﻓﻴﺔ ﺇﺫﺍ‬
‫ﻭﻗﻊ ﻓﺮﻳﺴﺔ ﺑﲔ ﺿﻐﻂ ﻧﺴﻘﲔ ﻣﻦ ﺍﻟﻘﻴﻢ ﺍﳌﺘﺼﺎﺭﻋﺔ )ﺍﳌﺘﻮﺍﺭﺙ ﻭﺍﳊﺪﻳﺚ( ﳑﺎ ﻗﺪ ﻳﺆﺩﻯ ﺇﱃ ﻇﻬﻮﺭ‬
‫ﺃﻋﺮﺍﺽ ﻣﺮﺿﻴﺔ ﻣﺜﻞ ﺍﻟﻘﻠﻖ ﺃﻭ ﺍﳓﺮﺍﻓﺎﺕ ﺳﻠﻮﻛﻴﺔ ﻣﺜﻞ ﺍﳉﺮﳝﺔ ﻭﰱ ﻣﺜﻞ ﻫﺬﻩ ﺍﳊﺎﻻﺕ ﻓﺈﻥ ﺍﻟﺪﻋﻢ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻰ ﻳﺼﺒﺢ ﻟﻪ ﺃﳘﻴﺔ ﻛﺒﲑﺓ ﺣﻴﺚ ﳚﺪ ﺍﻟﻔﺮﺩ ﻧﻔﺴﻪ ﻏﲑ ﻗﺎﺩﺭ ﻋﻠﻰ ﺃﻥ ﻳﺘﻮﺣﺪ ﻣﻊ ﺍﻟﻘﻴﻢ‬
‫ﺍﻟﻮﺍﻟﺪﻳﺔ ﻭﳛﺘﺎﺝ ﳉﻤﺎﻋﺔ ﺧﺎﺭﺟﻴﺔ ﻳﻌﺘﻤﺪ ﻋﻠﻴﻬﺎ ﲝﺜﺎ ﻋﻦ ﺍﻻﺳﺘﻘﺮﺍﺭ ﻭﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻟﺘﻮﺗﺮ‪.‬‬
‫ﺿﻐﻮﻁ ﺍﻗﺘﺼﺎﺩﻳﺔ‪ :‬ﺍﳌﺸﺎﻛﻞ ﺍﳌﺎﺩﻳﺔ )ﻧﻘﺺ ﺍﳌﺎﻝ ﻗﺪ ﻳﻌﻴﻖ ﺍﻟﻜﺜﲑ ﻣﻦ ﻣﺘﻄﻠﺒﺎﺕ ﺍﳊﻴﺎﺓ( ﺍﻟﺘﻐﲑﺍﺕ‬ ‫
‬
‫ﺍﳊﺪﻳﺜﺔ ﺯﺍﺩﺕ ﻣﻦ ﻗﻴﻤﺔ ﺍﳌﺎﻝ ﰱ ﺍ‪‬ﺘﻤﻊ ﻭﺃﺻﺒﺢ ﳝﺜﻞ ﺍﻟﺘﻘﺪﻳﺮ ﻭﺍﻻﻋﺘﺮﺍﻑ ﺑﺎﻟﻔﻀﻞ ﻭﺍﻟﻘﻮﺓ ﻭﺍﻷﻣﺎﻥ‬
‫ﻭﻻﺑﺪ ﻣﻦ ﻣﺴﺎﻳﺮﺓ ﺍﻵﺧﺮﻳﻦ – ﺍﻟﺒﻄﺎﻟﺔ ‪ -‬ﻓﻘﺪﺍﻥ ﺍﻟﻮﻇﻴﻔﺔ‪.‬‬
‫ﺿﻐﻮﻁ ﻣﻬﻨﻴﺔ‪ :‬ﻋﺪﻡ ﻗﺒﻮﻝ ﺍﻟﻌﻤﻞ‪ -‬ﺗﻐﻴﲑ ﻇﺮﻭﻑ ﺍﻟﻌﻤﻞ‪ -‬ﻇﺮﻭﻑ ﺍﻟﻌﻤﻞ ﺍﻟﺴﻠﺒﻴﺔ ﻣﺜﻞ ﺍﻟﻌﻤﻞ‬ ‫
‬
‫ﺍﳌﺮﻫﻖ ﻭﺍﳔﻔﺎﺽ ﺍﳌﻌﻨﻮﻳﺎﺕ ﻭﻋﺪﻡ ﺍﻟﺘﻘﺪﻳﺮ ﻭﺍﻟﺮﻗﺎﺑﺔ ﺍﳌﻬﻨﻴﺔ‪.‬‬
‫ﺿﻐﻮﻁ ﻃﺒﻴﻌﻴﺔ‪ :‬ﻣﺜﻞ ﺍ‪‬ﺎﻋﺎﺕ‪ -‬ﺍﻟﻔﻴﻀﺎﻧﺎﺕ‪ -‬ﺍﻟﺰﻻﺯﻝ‪ -‬ﺍﳊﺮﺍﺋﻖ‪ -‬ﺍﳊﻮﺍﺩﺙ‪ -‬ﺍﻹﺻﺎﺑﺎﺕ‪-‬‬ ‫
‬
‫ﺍﻟﻀﻮﺿﺎﺀ‪.‬‬

‫‪٣٣١‬‬
 ‫ﺏ‪ .‬ﺿﻐﻮﻁ ﺩﺍﺧﻠﻴﺔ )ﻣﻦ ﺩﺍﺧﻞ ﺍﻟﻔﺮﺩ(‪:‬‬
‫ﰱ ﺩﺍﺧﻞ ﻛﻞ ﻓﺮﺩ ﺻﺮﺍﻋﺎﺕ ﻭﻃﻤﻮﺣﺎﺕ ﱂ ﺗﺘﺤﻖ ﻭﻣﺜﲑﺍﺕ ﺃﺧﺮﻯ ﻭﻳﺼﺒﺢ ﻛﻞ ﺫﻟﻚ ﺟﺰﺀﺍ ﻣﻦ ﺑﻨﺎﺀ‬
‫ﺍﻟﺸﺨﺼﻴﺔ ﻭﺃﻳﻀﺎ ﻣﺼﺪﺭﺍ ﻟﻠﻀﻐﻂ ﻻ ﻳﺴﻬﻞ ﲣﻔﻴﻔﻪ ﻭﻗﺪ ﺗﺼﺒﺢ ﻋﻤﻠﻴﺔ ﺍﺳﺘﺪﻣﺎﺝ ﺍﳊﺪﺙ‬
‫ﺍﻟﻀﺎﻏﻂ ﰱ ﺍﻟﻼﺷﻌﻮﺭ ﻋﻤﻠﻴﺔ ﻣﻌﻘﺪﺓ ﻭﻋﺎﺩﺓ ﻣﺎ ﻳﻠﻌﺐ ﺍﻟﻜﺒﺖ ﻭﺍﻟﺘﺸﺮﻳﻂ ﺩﻭﺭﺍ ﻓﻴﻬﺎ‬
‫"ﺍﻟﻜﺒﺖ" ﻫﻮ ﺍﻟﺪﺍﻓﻊ ﺍﻟﻼﺇﺭﺍﺩﻯ ﻟﻠﻤﺜﲑﺍﺕ ﺍﳌﻬﺪﺩﺓ ﻭﺍﳌﺆﳌﺔ ﺇﱃ ﺍﻟﻼﺷﻌﻮﺭ ﻭﺗﺒﻘﻰ ﻓﻴﻪ ﻭﻳﻨﺘﺞ ﻋﻦ ﺫﻟﻚ‬ ‫
‬
‫ﻇﻬﻮﺭ ﺭﻏﺒﺎﺕ ﻭﺃﻓﻜﺎﺭ ﻭﺃﻣﻨﻴﺎﺕ ﻭﻣﺸﺎﻋﺮ ﻻ ﻳﻌﺮﻑ ﺍﻟﺸﺨﺺ ﺷﻴﺌﺎ ﻋﻦ ﻣﻨﺸﺄﻫﺎ‪.‬‬
‫"ﺍﻟﺘﺸﺮﻳﻂ" ﻭﻫﻮ ﻧﻈﺮﻳﺔ ﺑﺎﻓﻠﻮﻑ ﺍﻟﱴ ﺗﺴﺎﻋﺪ ﻋﻠﻰ ﺇﺟﺎﺑﺔ ﻫﺬﺍ ﺍﻟﺴﺆﺍﻝ‪ :‬ﳌﺎﺫﺍ ﻳﺘﻌﺎﻣﻞ ﺍﻟﻨﺎﺱ ﻣﻊ‬ ‫
‬
‫ﻣﺸﺎﻋﺮ ﻭﺃﻓﻜﺎﺭ ﻭﺭﻣﻮﺯ ﻏﲑ ﺣﻘﻴﻘﻴﺔ ﻛﺄ‪‬ﺎ ﺣﻘﻴﻘﻴﺔ؟‬
‫ﻭﳝﻜﻦ ﺗﺼﻨﻴﻒ ﺍﻟﺼﺮﺍﻋﺎﺕ ﻛﻤﺎ ﻳﻠﻰ‪:‬‬
‫ﺻﺮﺍﻉ ﻧﺎﺷﺊ ﻋﻦ ﳏﺎﻭﻟﺔ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺷﺊ ﻭﰱ ﻧﻔﺲ ﺍﻟﻮﻗﺖ ﺍﻟﺮﻏﺒﺔ ﰱ ﲡﻨﺐ ﺍﶈﺎﻭﻟﺔ‬ ‫‪o‬‬
‫"ﺍﻟﺒﺤﺚ ﻋﻦ ﻫﺪﻑ ﺇﳚﺎﰉ ﻭﺍﻟﺒﻌﺪ ﻋﻦ ﻫﺪﻑ ﺳﻠﱮ"‬
‫ﺻﺮﺍﻉ ﻧﺎﺷﺊ ﻋﻦ ﺍﻟﺮﻏﺒﺔ ﰱ ﺍﳊﺼﻮﻝ ﻋﻠﻰ ﺷﺊ ﻣﻊ ﻭﺟﻮﺩ ﺑﺪﻳﻠﲔ ﳍﺬﺍ ﺍﻟﺸﺊ ﺗﺘﺴﺎﻭﻯ ﺍﻟﺮﻏﺒﺔ‬ ‫‪o‬‬
‫ﻓﻴﻬﻤﺎ‬
‫ﺻﺮﺍﻉ ﻧﺎﺷﺊ ﻋﻦ ﲡﻨﺐ ﻣﺰﺩﻭﺝ‪ -‬ﲡﻨﺐ ﺷﻴﺌﲔ ﺳﻴﺌﲔ‬ ‫‪o‬‬
‫‪ .٢‬ﺭﺩﻭﺩ ﺍﻷﻓﻌﺎﻝ ﺍﳌﺮﺗﺒﻄﺔ ﺑﺎﻟﻀﻐﻮﻁ‪:‬‬
‫ﻗﺪ ﺗﺒﺪﻭ ﳏﺎﻭﻻﺕ ﺍﻟﺘﻮﺍﻓﻖ‪ -‬ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺸﺎﻫﺪﻳﻦ ﻣﻦ ﺍﳋﺎﺭﺝ‪ -‬ﻋﻠﻰ ﺃ‪‬ﺎ ﳏﺎﻭﻻﺕ ﻏﲑ ﻓﻌﺎﻟﺔ ﻭﻟﻜﻨﻬﺎ‬
‫ﻟﻠﻔﺮﺩ ﻧﻔﺴﻪ ﻫﻰ ﺃﻓﻀﻞ ﺍﻟﻮﺳﺎﺋﻞ ﺍﳌﺘﺎﺣﺔ ﻟﻪ ﺣﱴ ﻟﻮ ﻛﺎﻧﺖ ﺷﺎﺫﺓ‬
‫ﻭﻟﻼﺳﺘﺠﺎﺑﺔ ﻟﻺﺣﺒﺎﻁ ﳕﻄﲔ ﺃﺳﺎﺳﻴﲔ‪:‬‬
‫* ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻌﺪﻭﺍﻧﻴﺔ )ﻛﺮ ﻭﻗﺘﺎﻝ(‬
‫* ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻻﻧﺴﺤﺎﺑﻴﺔ ) ﻓﺮ ﻭﻫﺮﻭﺏ(‬
‫ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻌﺪﻭﺍﻧﻴﺔ )ﻛﺮ ﻭﻗﺘﺎﻝ(‪ :‬ﻭﻫﻰ ﺍﺳﺘﺠﺎﺑﺔ ﺑﺪﺍﺋﻴﺔ ﺗﻈﻬﺮ ﰱ ﺍﻷﻃﻔﺎﻝ ﻭﻣﻊ ﺍﻟﺰﻣﻦ ﻳﺼﺒﺢ‬
‫ﺍﻹﻧﺴﺎﻥ ﺃﻛﺜﺮ ﺣﺴﺎﺳﻴﺔ ﻟﺮﺩﻭﺩ ﺃﻓﻌﺎﻝ ﺍﻵﺧﺮﻳﻦ‪ .‬ﻭﻗﺪ ﺗﺆﺩﻯ ﻫﺬﻩ ﺍﻻﺳﺘﺠﺎﺑﺔ ﺇﱃ ﺗﻘﻠﻴﻞ ﻣﺸﺎﻋﺮ ﻟﻘﻠﻖ‬
‫ﻭﺍﻟﺘﻌﺐ ﺍﻟﻨﻔﺴﻰ ﻭﻟﻜﻨﻬﺎ ﻻ ﲢﻞ ﺍﳌﺸﻜﻠﺔ ﻭﻻ ﺗﻘﻀﻰ ﻋﻠﻰ ﺍﻟﻀﻐﻂ ﻭﻣﻦ ﺍﳌﻤﻜﻦ ﺃﻥ ﻳﺘﻢ ﺗﻮﺟﻴﻪ ﻫﺬﻩ‬
‫ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻟﻌﺪﻭﺍﻧﻴﺔ ﺇﱃ ﺍﻟﺪﺍﺧﻞ ) ﺇﱃ ﺍﻟﺬﺍﺕ (‬
‫ﺍﻻﺳﺘﺠﺎﺑﺔ ﺍﻻﻧﺴﺤﺎﺑﻴﺔ )ﻓﺮ ﻭﻫﺮﻭﺏ(‪ :‬ﻭﻳﺘﻢ ﺗﻮﺟﻴﻪ ﺍﻟﻐﻀﺐ ﺇﱃ ﺍﻟﺬﺍﺕ ﻭﻳﺸﻌﺮ ﺍﻟﻔﺮﺩ ﺑﺎﻟﻐﻀﺐ‬
‫ﻣﻦ ﺍﻟﺬﺍﺕ ﻭﺍﻻﻛﺘﺌﺎﺏ ﻭﻳﻨﺴﺤﺐ ﺗﺎﺭﻛﺎ ﺍﳌﺸﺎﻛﻞ ﺩﻭﻥ ﺣﻞ‪ ،‬ﻭﻗﺪ ﻳﺆﺩﻯ ﻫﺬﺍ ﺇﱃ ﺃﻣﺮﺍﺽ ﻧﻔﺴﻴﺔ ﺃﻭﻋﻘﻠﻴﺔ ﺃﻭ‬
‫ﻗﺪ ﻳﺆﺩﻯ ﺇﱃ ﻗﻠﻖ ﻧﻔﺴﻰ ﻣﺰﻣﻦ‬
‫ﻭﻳﻨﺘﺞ ﻋﻦ ﺭﺩﻭﺩ ﺍﻷﻓﻌﺎﻝ ﺍﳌﺮﺗﺒﻂ ﺑﺎﻟﻀﻐﻮﻁ ﻋﻠﻰ ﺍﳌﺪﻯ ﺍﻟﺒﻌﻴﺪ‬
‫ﺭﺩﻭﺩ ﺃﻓﻌﺎﻝ ﻣﻨﺤﺮﻓﺔ ﰲ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍ‪‬ﺘﻤﻊ )ﺿﺪ ﺍ‪‬ﺘﻤﻊ (‪.‬‬ ‫‪o‬‬
‫ﺭﺩﻭﺩ ﺃﻓﻌﺎﻝ ﻋﺼﺎﺑﻴﺔ‪ :‬ﻗﺪ ﺗﺆﺩﻯ ﺇﱃ ﺍ‪‬ﻴﺎﺭﺍﺕ ﻋﺼﺒﻴﺔ‪.‬‬ ‫‪o‬‬

‫‪٣٣٢‬‬
‫ﺭﺩﻭﺩ ﺃﻓﻌﺎﻝ ﺫﻫﺎﻧﻴﺔ‪ :‬ﻭﻳﺆﺩﻯ ﺇﱃ ﺍ‪‬ﻴﺎﺭ ﺍﳊﻴﻞ ﺍﻟﺪﻓﺎﻋﻴﺔ ﻭﺍﻻﻧﺴﺤﺎﺏ ﻣﻦ ﺍﻟﻌﺎﱂ ﺍﳊﻘﻴﻘﻰ ﺇﱃ‬ ‫‪o‬‬
‫ﻋﺎﱂ ﺍﳋﻴﺎﻝ ﺍﳉﺎﻣﺢ‪.‬‬
‫ﺭﺩﻭﺩ ﺃﻓﻌﺎﻝ ﻧﻔﺴﻰ ﺟﺴﻤﻴﺔ‪ :‬ﺗﺆﺩﻯ ﺇﱃ ﻇﻬﻮﺭ ﺃﻋﺮﺍﺽ ﺟﺴﺪﻳﺔ ﻭﻳﺸﻌﺮ ﺍﳌﺮﻳﺾ ﺃﻧﻪ ﻳﻌﺎﱏ ﻣﻦ‬ ‫‪o‬‬
‫ﻣﺮﺽ ﻋﻀﻮﻱ؟‬

‫ﺣﻠﻮﻝ ﺍﻷﺯﻣﺔ‬
‫ﺍﻟﺘﻜﻴﻒ‪ -‬ﺍﻟﺘﺼﺪﻱ‬
‫ﺃﻭﻻ‪ :‬ﺍﻟﺘﻜﻴﻒ‬
‫ﻳﻬﺘﻢ ﻋﻠﻢ ﺍﻟﻨﻔﺲ ﺍ‪‬ﺘﻤﻌﻰ ﺑﺎﻟﺴﻌﻰ ﺇﱃ ﻫﺪﻡ ﺍﻟﻌﻤﻠﻴﺔ ﺍﻟﱴ ﻣﻦ ﺧﻼﳍﺎ ﺗﺆﺩﻯ ﺍﻟﻀﻐﻮﻁ ﺍﻟﻨﻔﺴﻴﺔ‬
‫ﺇﱃ ﺃﻣﺮﺍﺽ ﻧﻔﺴﻴﺔ ﻭﺍﻟﺘﻜﻴﻒ ﻫﻮ ﺣﺎﻟﺔ ﻣﺆﻗﺘﺔ ﻭﳏﺪﻭﺩﺓ ﺯﻣﻨﻴﺎ ﻳﺘﻢ ‪‬ﺎ ﺍﳌﻮﺍﺀﻣﺔ ﺑﲔ ﺳﻠﻮﻙ ﺍﻟﻔﺮﺩ‬
‫ﻭﻣﺘﻄﻠﺒﺎﺕ ﳏﺪﺩﺓ ﻭﺗﺘﻀﻤﻦ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻜﻴﻒ ﺃﺑﻌﺎﺩﺍ ﺃﻳﺪﻳﻮﻟﻮﺟﻴﺔ ﻭﺍﺟﺘﻤﺎﻋﻴﺔ ﻭﺩﻻﻻﺕ ﺫﺍﺗﻴﺔ ﻭﻗﻴﻤﻴﻪ‪،‬‬
‫ﻭﻗﺪ ﺗﺸﲑ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻜﻴﻒ ﺃﻳﻀﺎ ﺇﱃ ﺗﻌﺪﻳﻞ ﺳﻠﻮﻙ ﺍﻟﻔﺮﺩ ﺍﺳﺘﺠﺎﺑﺔ ﻟﻈﺮﻭﻑ ﳏﺪﺩﺓ‪ .‬ﻭﻫﺬﺍ ﺍﳌﻌﲎ‬
‫ﻳﺘﻀﻤﻦ ﺍﳋﻀﻮﻉ ﻭﺍﻻﻧﻀﺒﺎﻁ ﻭﻫﻮ ﻣﻦ ﻣﻨﻈﻮﺭ ﺇﻧﺴﺎﱏ ﻭﺛﻮﺭﻯ ﳝﺜﻞ ﻟﻌﻨﺔ ﻋﻠﻰ ﺍﻟﺒﺸﺮﻳﺔ ﺣﻴﺚ ﺍﻧﻪ ﰱ‬
‫ﺑﻌﺾ ﺍﻷﺣﻴﺎﻥ ﻳﻜﻮﻥ ﻗﺒﻮﻝ ﺍﻟﻘﻬﺮ ﻧﻮﻋﺎ ﻣﻦ ﺍﻟﺘﻜﻴﻒ ﻭﻻ ﻧﻌﻲ ﺃﳘﻴﺔ ﺗﻐﻴﲑ ﺍﻟﺒﻴﺌﺔ ﻣﻦ ﺣﻮﻟﻨﺎ ﻛﺤﻞ ﺃﻭ‬
‫ﻛﺒﺪﻳﻞ‪.‬‬
‫)ﻳﺜﺎﺭ ﻫﻨﺎ ﺳﺆﺍﻝ ﻣﻬﻢ ﻭﻫﻮ ﻫﻞ ﳕﺎﺭﺱ ﻣﻊ ﺍﳉﻤﺎﻋﺎﺕ ﺍﻟﻔﻘﲑﺓ ﻭﺍﳌﻬﻤﺸﺔ ﻟﻌﺒﺔ ﺍﻟﺘﻜﻴﻒ ﻣﻊ ﺍﻟﻌﺎﱂ ﻛﻤﺎ‬
‫ﻫﻮ ﺃﻡ ﺍﻷﺟﺪﻯ ﳍﻢ ﻭﻟﻠﻤﺠﺘﻤﻊ ﺃﻳﻀﺎ ﺃﻥ ﳓﺎﻭﻝ ﺩﻓﻌﻬﻢ ﻭﺭﻋﺎﻳﺘﻬﻢ ﻭﺯﻳﺎﺩﺓ ﻭﻋﻴﻬﻢ ﰒ ﻣﺴﺎﻋﺪ‪‬ﻢ‬
‫ﻟﺘﻐﻴﲑ ﺍﻟﻮﺍﻗﻊ ﺍﻟﺒﻴﺌﻰ ﻣﻦ ﺣﻮﳍﻢ ﻭﻫﺬﺍ ﻳﻄﺮﺡ ﻗﻀﻴﺔ ﻣﻬﻤﺔ ﺗﺘﻌﻠﻖ ﺑﻌﺪﻡ ﺍﻟﻘﺪﺭﺓ ﻋﻠﻰ ﺍﻟﺘﻔﻜﲑ ﰱ‬
‫ﻣﻌﻴﺎﺭ ﻟﻠﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻟﻠﻔﺮﺩ ﻭﺍ‪‬ﺘﻤﻊ ﺩﻭﻥ ﺍﻹﺷﺎﺭﺓ ﺑﺸﻜﻞ ﺃﻭ ﺑﺂﺧﺮ ﺇﱃ ﺍﻟﻨﻈﺎﻡ ﺍﻻﺟﺘﻤﺎﻋﻲ(‬
‫ﺛﺎﻧﻴﺎ‪ :‬ﺍﻟﺘﺼﺪﻱ‬
‫ﻭ ﺍﻟﺘﺼﺪﻱ ﻟﻸﺯﻣﺔ ﻳﺘﻀﻤﻦ ﺟﻬﺪﺍ ﻣﻌﺮﻓﻴﺎ ﻭﺳﻠﻮﻛﻴﺎ ﻳﺒﺬﻝ ﻟﻠﺴﻴﻄﺮﺓ ﺃﻭ ﻟﻠﺘﺴﺎﻣﺢ ﻭﻳﻬﺪﻑ ﺇﱃ ﺗﻘﻠﻴﻞ‬
‫ﺍﳌﺘﻄﻠﺒﺎﺕ ﺍﻟﱴ ﺗﺮﻫﻖ ﻭﻗﺪ ﺗﺘﺠﺎﻭﺯ ﻣﻮﺍﺭﺩ ﺍﻟﺸﺨﺺ ﰱ ﻫﺬﻩ ﺍﳌﺮﺣﻠﺔ‪.‬‬
‫ﻭﻳﻮﺍﺟﻪ ﺍﻟﺸﺨﺺ ﻣﺸﻜﻠﺘﲔ‪:‬‬
‫‪ -١‬ﻣﺸﻜﻠﺔ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﻣﺸﺎﻋﺮﻩ ﺍﳋﺎﺻﺔ‪ :‬ﻗﻠﻖ‪ -‬ﺍﻛﺘﺌﺎﺏ‪ -‬ﺗﻮﺗﺮ‪ -‬ﻋﺪﻡ ﺭﺍﺣﺔ‪ -‬ﺷﻚ‬
‫ﰱ ﺍﻟﺬﺍﺕ‪ -‬ﻟﻮﻡ ﺍﻟﺬﺍﺕ‪.‬‬
‫‪ -٢‬ﻣﺸﻜﻠﺔ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﳌﻮﻗﻒ ﺍﳋﺎﺭﺟﻰ‪ :‬ﺿﺮﻭﺭﺓ ﺍﻟﻘﻴﺎﻡ ﺑﻌﻤﻞ ﻣﻨﺎﺳﺐ‪.‬‬
‫ﻭﻻ ﳝﻜﻦ ﺍﻟﻔﺼﻞ ﺑﻴﻨﻬﻤﺎ ) ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﻣﺸﺎﻋﺮ ﺍﻟﺸﺨﺺ ﻭﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﳌﻮﻗﻒ ﺍﳋﺎﺭﺟﻰ( ﻭﺃﻛﺪ ﺑﻌﺾ‬
‫ﺍﻟﻌﻠﻤﺎﺀ ﻋﻠﻰ ﺍﻟﺘﻘﻴﻴﻢ ﺍﳌﻌﺮﰱ ﺍﳌﻮﺿﻮﻋﻰ ﻟﻠﺤﺪﺙ ﺍﻟﻀﺎﻏﻂ ﻭﺗﻨﻘﺴﻢ ﺇﱃ ﻣﺮﺣﻠﺘﲔ‪-‬‬
‫ﺍﳌﺮﺣﻠﺔ ﺍﻷﻭﱃ‪ -‬ﺗﻘﻴﻴﻢ ﺃﻭﱃ ﺑﻴﻮﻟﻮﺟﻰ‪.‬‬
‫ﺍﳌﺮﺣﻠﺔ ﺍﻟﺜﺎﻧﻴﺔ‪ -‬ﺗﻘﻴﻴﻢ ﺛﺎﻧﻮﻯ‪ -‬ﺭﺩ ﺍﻟﻔﻌﻞ ﺍﳌﻄﻠﻮﺏ‬
‫ﻭﺍﻟﺘﻌﻠﻴﻢ ﻗﺪ ﻳﺴﺎﻋﺪ ﻋﻠﻰ ﺇﺩﺭﺍﻙ ﺍﳌﺸﺎﻋﺮ ﻭﺍﻟﺘﺴﺎﻣﺢ ﻣﻌﻬﺎ‬

‫‪٣٣٣‬‬
‫ﻭﻧﻮﺩ ﺃﻥ ﻧﺸﲑ ﻫﻨﺎ ﺇﱃ ﺃﻧﻪ ﺑﻌﺪ ﺍﻟﺴﻴﻄﺮﺓ ﻋﻠﻰ ﺭﺩ ﺍﻟﻔﻌﻞ ﺍﳊﺎﺩ ﻓﻨﺤﻦ ﻧﻨﺘﻘﻞ ﺇﱃ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﳌﻮﻗﻒ‬
‫ﺍﳉﺪﻳﺪ ﻭﻳﺘﻀﻤﻦ ﺫﻟﻚ ﺑﻌﺪﺍ ﺍﻧﻔﻌﺎﻟﻴﺎ ﻳﺘﻄﻠﺐ ﺑﺎﻟﻀﺮﻭﺭﺓ ﺯﻳﺎﺩﺓ ﺍﻷﻣﻞ ) ﺍﻷﻣﻞ ﰲ ﺃﻥ ﻫﺬﺍ ﺍﳌﻮﻗﻒ ﺍﻟﺴﺊ‬
‫ﺳﻴﻨﺘﻬﻰ(‬
‫)ﻭﻋﺎﻃﻔﺔ ﺍﻷﻣﻞ ﻻ ﻧﻌﺮﻑ ﻛﺜﲑﺍ ﻋﻨﻬﺎ‪ -‬ﻣﺎ ﻫﻰ ﺍﻟﻈﺮﻭﻑ ﺍﻟﱴ ﺗﻈﻬﺮ ﻓﻴﻬﺎ؟‪ .‬ﻭﻫﻞ ﲢﺘﺎﺝ ﺇﱃ ﺩﻋﻢ ﻣﻦ‬
‫ﺷﺨﺺ ﺁﺧﺮ؟‪ .‬ﻫﻞ ﻳﺘﻮﻟﺪ ﺍﻷﻣﻞ ﻣﻦ ﺧﻼﻝ ﺍﺳﺘﺪﻋﺎﺀ ﺃﺣﺪﺍﺛﺎ ﺃﺧﺮﻯ ﺍﺳﺘﻄﺎﻉ ﺍﻟﺘﻐﻠﺐ ﻋﻠﻴﻬﺎ ﰲ ﺍﳌﺎﺿﻲ؟‪.‬‬
‫ﻭﻫﻞ ﲤﺜﻞ ﻫﺬﻩ ﺍﻟﻌﺎﻃﻔﺔ ﺟﺰﺀﺍ ﳌﺎ ﻧﻄﻠﻖ ﻋﻠﻴﻪ ﺍﻹﺭﺍﺩﺓ ﺃﻭ ﺍﻟﻌﺰﳝﺔ؟‪ .‬ﻭﻫﻞ ﻫﻨﺎﻙ ﺩﻭﺍﻓﻊ ﻟﻸﻣﻞ ﻣﺜﻞ ﺍﻟﺮﻏﺒﺔ‬
‫ﰱ ﺍﻻﻧﺘﻘﺎﻡ ﺃﻭ ﺍﻟﺮﻏﺒﺔ ﰱ ﺇﺛﺒﺎﺕ ﺷﺊ ﻟﺸﺨﺺ ﺁﺧﺮ ﺍﻷﻣﺮ ﺍﻟﺬﻯ ﻳﺜﲑ ﻣﻌﻪ ﺍﻟﺮﻏﺒﺔ ﰱ ﺑﺬﻝ ﺍﳉﻬﺪ ﻟﻠﺘﻐﻠﺐ‬
‫ﻋﻠﻰ ﺍﳌﺸﻜﻠﺔ؟(‪.‬‬
‫‪ .٢‬ﻣﻔﻬﻮﻡ ﺍﻟﻮﻗﺎﻳﺔ‪:‬‬
‫ﻭﻫﻮ ﳝﺜﻞ ﻣﻔﻬﻮﻡ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ )ﻟﻦ ﻧﻘﻀﻰ ﻋﻠﻰ ﺍﳌﺮﺽ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻌﻼﺝ ﻓﻘﻂ( ﻭﳕﻮﺫﺝ ﺍﻟﺼﺤﺔ‬
‫ﺍﻟﻌﺎﻣﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻳﺘﻀﻤﻦ‪:‬‬
‫ﲢﺴﲔ ﺍﻟﻈﺮﻭﻑ ﺍﻟﺒﻴﺌﻴﺔ‬ ‫‪.١‬‬
‫ﺗﻘﻮﻳﺔ ﺍﻟﻜﺎﺋﻦ ﺿﺪ ﺍﳌﺮﺽ‬ ‫‪.٢‬‬
‫‪ o‬ﲢﺴﲔ ﻧﻮﻋﻴﺔ ﺣﻴﺎﺓ ﺍﻷﻓﺮﺍﺩ‬
‫‪ o‬ﺟﻬﻮﺩ ﻟﺘﻘﻮﻳﺔ ﺍﳉﻮﺍﻧﺐ ﺍﻟﻨﻔﺴﻴﺔ‬
‫ﻭﺭﻏﻢ ﺃﻥ ﻫﺬﺍ ﺍﻟﻨﻤﻮﺫﺝ ﻟﻴﺲ ﲟﻘﺪﻭﺭﻩ ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﻛﺒﲑﺓ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺸﻜﻼﺕ ﺍﻟﻨﻔﺴﻴﺔ‬
‫ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺇﻻ ﺃﻧﻪ ﻣﻔﻴﺪ ﰱ ﻃﺮﻳﻘﺔ ﺍﻟﺘﻔﻜﲑ ﺍﻟﱴ ﺗﻘﺪﻡ ﺃﻃﺮﻭﺣﺎﺕ ﺑﻌﻴﺪﺓ ﻋﻦ ﺍﻟﻨﻤﻮﺫﺝ ﺍﻟﻔﺮﺩﻯ‪.‬‬
‫ﻭﺗﺘﻢ ﺍﻟﻮﻗﺎﻳﺔ ﻗﺒﻞ ﺃﻥ ﻳﺘﻢ ﺗﺴﻤﻴﺔ ﺍﻟﺸﺨﺺ ﻋﻠﻰ ﺃﻧﻪ ﺣﺎﻟﺔ ﻭﺗﺘﻄﻠﺐ ﺍﻟﻮﻗﺎﻳﺔ ﺗﻐﻴﲑ ﻣﻜﺎﻥ ﺍﻟﻌﻤﻞ‬
‫ﺍﻟﺼﺤﻲ ﻟﻴﺼﺒﺢ ﺍﳌﺪﺍﺭﺱ‪ -‬ﻭﺃﺟﻬﺰﺓ ﺍﻹﻋﻼﻡ ‪ -‬ﻭﺃﻣﺎﻛﻦ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ‪ -‬ﺍﻷﺣﺰﺍﺏ‬
‫ﺍﻟﺴﻴﺎﺳﻴﺔ‪.‬‬
‫ﻻﺣﻆ ﺑﻌﺾ ﺍﻟﻌﻠﻤﺎﺀ ﰱ ﺍﻟﻮﻻﻳﺎﺕ ﺍﳌﺘﺤﺪﺓ ﺃﻧﻪ ﺃﺛﻨﺎﺀ ﺍﻟﻔﺘﺮﺓ ﺍﻟﱴ ﻳﺴﻮﺩ ﻓﻴﻬﺎ ﺍﻻﲡﺎﻩ ﺍﶈﺎﻓﻆ ﻳﺘﻐﻠﺐ ﳕﻂ‬
‫ﺍﻟﻌﻼﺝ ﺍﻟﻔﺮﺩﻱ ﻭﺃﺛﻨﺎﺀ ﻓﺘﺮﺍﺕ ﺍﻹﺻﻼﺡ ﻳﺰﺩﺍﺩ ﺍﻻﻫﺘﻤﺎﻡ ﺑﺎﳌﻮﺍﻗﻒ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻏﲑ ﺍﳌﻼﺋﻤﺔ‪.‬‬
‫ﻭﻳﺜﲑ ﻫﺬﺍ ﺍﻟﺘﻮﺟﻪ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻟﺘﺴﺎﺅﻻﺕ ﺍﳉﺪﻳﺪﺓ‪ -‬ﺻﻌﺒﺔ ﺍﻹﺟﺎﺑﺔ ‪ -‬ﺣﻮﻝ ﺍﻟﻘﻴﻢ ﻭﺍﻷﺧﻼﻗﻴﺎﺕ ﰱ‬
‫ﳑﺎﺭﺳﺔ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ ﻛﻤﺎ ﺃﻧﻪ ﻳﺜﲑ ﺍﻟﺘﺴﺎﺅﻝ ﻋﻦ ﻋﺪﻡ ﺣﻴﺪﺓ ﺍﳉﻬﺪ ﺍﻟﻌﻠﻤﻰ ﻭﺗﺄﺛﺮﻩ ﺑﺎﶈﻴﻂ‬
‫ﺍﻻﺟﺘﻤﺎﻋﻰ ﻭﺍﻟﺴﻴﺎﺳﻰ‪.‬‬

‫
‪ 
+/
-3, .'/
0

12/‬‬
‫ﻣﻌﺪﻻﺕ ﺍﻧﺘﺸﺎﺭ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ ﰱ ﻣﺼﺮ ﻣﺜﻞ ﻣﻌﺪﻻﺕ ﺍﻧﺘﺸﺎﺭ ﻛﻞ ﺍﻷﻣﺮﺍﺽ ﻏﲑ ﻣﻌﺮﻭﻓﺔ ﻭﻻ ﺗﻮﺟﺪ‬
‫‪-‬ﻟﻸﺳﻒ‪ -‬ﰱ ﻣﺼﺮ ﺇﺣﺼﺎﺋﻴﺎﺕ ﻳﻌﺘﻤﺪ ﻋﻠﻴﻬﺎ ﰱ ﳎﺎﻝ ﻭﺑﺎﺋﻴﺎﺕ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ ﰱ ﻣﺼﺮ ﻭﻣﻌﻈﻢ‬
‫ﺍﳌﺆﺷﺮﺍﺕ ﺍﻟﱴ ﺳﻨﻌﺮﺿﻬﺎ ﻫﻰ ﺩﺭﺍﺳﺎﺕ ﲤﺖ ﰱ ﺍﳉﺎﻣﻌﺔ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺩﺭﺟﺔ ﻋﻠﻤﻴﺔ ﻭﲤﺖ ﻋﻠﻰ‬
‫ﻋﻴﻨﺎﺕ ﺻﻐﲑﺓ ﻧﺴﺒﻴﺎ‬

‫‪٣٣٤‬‬
 ‫ﺑﺎﻟﻨﺴﺒﺔ ﻻﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﻌﺼﺎﺏ‪:‬‬
‫ﻭﺟﺪ ﺍﻟﺪﻛﺘﻮﺭ ﺃﲪﺪ ﻋﻜﺎﺷﺔ ﺳﻨﺔ ‪ ١٩٦٧‬ﺇﻥ ﺣﻮﺍﱃ ﺛﻠﺚ ﳌﺮﺿﻰ ﺍﻟﺬﻳﻦ ﻳﺬﻫﺒﻮﻥ ﺇﱃ ﺍﳌﻤﺎﺭﺳﲔ‬
‫ﺍﻟﻌﻤﻮﻣﻴﲔ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﻣﺮﺽ ﻧﻔﺴﻰ‪ ،‬ﻛﻤﺎ ﺃﻥ ﺣﻮﺍﱃ ‪ %٢٠‬ﻣﻦ ﺍﳌﺮﺿﻰ ﺍﻟﺬﻳﻦ ﻳﺘﺮﺩﺩﻭﻥ ﻋﻠﻰ ﺍﻟﻌﻴﺎﺩﺓ‬
‫ﺍﳋﺎﺭﺟﻴﺔ ﰱ ﻣﺴﺘﺸﻔﻰ ﺟﺎﻣﻌﻰ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺍﻟﻘﻠﻖ ﺍﻟﻨﻔﺴﻰ ﻭﰱ ﺩﺭﺍﺳﺔ ﺃﺧﺮﻯ ﺃﺛﺒﺖ ﻋﻜﺎﺷﺔ ﺃﻥ‬
‫ﺍﻻﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﺘﺤﻮﻳﻠﻴﺔ ﻣﺎﺯﺍﻟﺖ ﻣﻮﺟﻮﺩﺓ ﰱ ﻣﺼﺮ ﺭﻏﻢ ﺃ‪‬ﺎ ﺍﺧﺘﻔﺖ ﻣﻦ ﺃﻭﺭﻭﺑﺎ ﺗﻘﺮﻳﺒﺎ‪.‬‬

‫ﻭﺑﺎﻟﻨﺴﺒﺔ ﳌﺮﺿﻰ ﺍﻟﻔﺼﺎﻡ‪:‬‬

‫ﻓﺈﻥ ﺇﺣﺪﻯ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺑﻌﺪ ﻣﺘﺎﺑﻌﺔ ‪ ١٠٠٠‬ﻣﺮﻳﺾ ﻣﻦ ﺍﳌﺮﺿﻰ ﺍﳉﺪﺩ ﺍﻟﺬﻳﻦ ﻳﺘﺮﺩﺩﻭﻥ ﻋﻠﻰ ﺍﻟﻌﻴﺎﺩﺓ ﺍﳋﺎﺭﺟﻴﺔ‬
‫ﰱ ﻣﺴﺘﺸﻔﻰ ﺟﺎﻣﻌﻰ ﺧﺎﺻﺔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ ﻭﺍﻟﻌﺼﺒﻴﺔ ﻭﺟﺪﺕ ﺃﻥ ﻧﺴﺒﺔ ﺍﻟﻔﺼﺎﻣﻴﲔ ﺑﲔ‬
‫ﻫﺆﻻﺀ ﺍﳌﺮﺿﻰ ﻫﻲ ‪) %١٥,٣‬ﻋﻜﺎﺷﺔ ‪(١٩٦٧‬‬

‫ﻣﺆﺷﺮﺍﺕ ﻣﺘﺎﺣﺔ ﻋﻦ ﺍﻻﻛﺘﺌﺎﺏ‪:‬‬

‫ﳝﺜﻞ ﺍﻻﻛﺘﺌﺎﺏ ﰱ ﺍ‪‬ﺘﻤﻊ ﻧﺴﺒﺔ ‪%١٥‬‬ ‫
‬
‫‪ %١١‬ﰱ ﺍﳌﺪﻥ‪ ،‬ﻭ‪ %٢٠‬ﰲ ﺍﻟﺮﻳﻒ )ﻋﻜﺎﺷﺔ ‪(١٩٨٤‬‬ ‫
‬
‫ﺩﺭﺍﺳﺔ ﺃﺧﺮﻯ ﻭﺟﺪﺕ ﺃﻥ ﺍﻻﻛﺘﺌﺎﺏ ﳝﺜﻞ ‪ %١٦‬ﻣﻦ ﺍﳌﺮﺿﻰ ﺍﳌﺘﺮﺩﺩﻳﻦ ﻋﻠﻰ ﺍﻟﻌﻴﺎﺩﺓ ﺍﳋﺎﺭﺟﻴﺔ‬ ‫
‬
‫ﻣﻌﻈﻤﻬﻢ )ﻋﺴﺮ ﻣﺰﺍﺝ( ﺃﻱ ﺍﻛﺘﺌﺎﺏ ﻣﺰﻣﻦ‪.‬‬
‫ﻭﰱ ﺩﺭﺍﺳﺔ ﺣﺪﻳﺜﺔ ﻧﺴﺒﻴﺎ ﻟﻠﺪﻛﺘﻮﺭ ﻳﻮﺳﻒ ﻭﺁﺧﺮﻭﻥ ﻭﺟﺪﻭﺍ ﺃﻥ ﻣﻌﺪﻝ ﺍﻧﺘﺸﺎﺭ ﺍﻻﻛﺘﺌﺎﺏ ﻛﺎﻥ ﰱ ﺧﻼﻝ ‪٦‬‬
‫ﺃﺷﻬﺮ‬
‫ﺍﻧﺘﺸﺎﺭ ﺍﻻﻛﺘﺌﺎﺏ ‪%١٨,٦٥‬‬ ‫
‬
‫ﻣﻨﻬﻢ ‪ %٩,٨٧‬ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺍﻻﻛﺘﺌﺎﺏ ﺍﳌﺰﻣﻦ‬ ‫
‬
‫ﻭ ‪ %٣,٤٧‬ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺍﺿﻄﺮﺍﺏ ﺍﻟﺘﺄﻗﻠﻢ ﺍﳌﺼﺤﻮﺏ ﲟﺰﺍﺝ ﺍﻛﺘﺌﺎﰉ‬ ‫
‬
‫ﻭ ‪ %١,٨٥‬ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺍﺿﻄﺮﺍﺏ ﺍﻻﻛﺘﺌﺎﺏ ﻣﻊ ﺍﻟﻘﻠﻖ‬ ‫
‬
‫‪ %١,١٩‬ﺍﻛﺘﺌﺎﺏ ﺛﻨﺎﺋﻰ ﺍﻟﻘﻄﺐ ﺍﻟﻨﻮﻉ ﺍﻷﻭﻝ‬ ‫
‬
‫‪ %٠,١١‬ﺍﻛﺘﺌﺎﺏ ﺛﻨﺎﺋﻰ ﺍﻟﻘﻄﺐ ﺍﻟﻨﻮﻉ ﺍﻟﺜﺎﱏ‬ ‫
‬

‫ﻣﺆﺷﺮﺍﺕ ﺣﻮﻝ ﻣﻌﺪﻻﺕ ﺍﻻﻧﺘﺤﺎﺭ‪:‬‬

‫ﰲ ﺍﻟﺜﻘﺎﻓﺔ ﺍﻹﺳﻼﻣﻴﺔ ﻳﻨﻈﺮ ﻟﻠﻤﻨﺘﺤﺮ ﻋﻠﻰ ﺃﻧﻪ ﻗﺪ ﻓﻘﺪ ﺩﻧﻴﺎﻩ ﻭﺁﺧﺮﺗﻪ ﻭﻫﻮ ﺧﺎﺭﺝ ﻋﻦ ﺍﻟﺪﻳﻦ‪ ،‬ﻭﳍﺬﺍ ﻓﺈﻧﻪ‬
‫ﻧﺎﺩﺭﺍ ﻣﺎ ﻳﺬﻛﺮ ﺍﻻﻧﺘﺤﺎﺭ ﰱ ﺃﻭﺭﺍﻕ ﺭﲰﻴﺔ‪ ،‬ﻭﻏﺎﻟﺒﺎ ﻣﺎ ﻳﺘﻢ ﺍﻟﺘﻐﻄﻴﺔ ﻋﻠﻰ ﻋﻤﻠﻴﺎﺕ ﺍﻻﻧﺘﺤﺎﺭ‪ ،‬ﻭﺍﻹﺣﺼﺎﺋﻴﺎﺕ‬
‫ﺍﻟﺮﲰﻴﺔ ﰱ ﻣﺼﺮ ﺗﺸﲑ ﺍﻻﻧﺘﺤﺎﺭ ﻧﺴﺒﺘﻪ ﻣﻦ ‪ ٦-٤‬ﻟﻜﻞ ﻣﺎﺋﺔ ﺃﻟﻒ ﻣﻮﺍﻃﻦ ﻭﻟﻜﻦ ﺩﺭﺍﺳﺔ ﻃﺐ ﻋﲔ‬
‫ﴰﺲ ﻋﻦ ﺍﻻﻧﺘﺤﺎﺭ ﺃﺷﺎﺭﺕ ﺇﱃ ﺃﻥ ﻣﻌﺪﻝ ﺍﻻﻧﺘﺤﺎﺭ ﰱ ﺍﻟﻘﺎﻫﺮﺓ ﻫﻮ ‪ ٣٨‬ﻟﻜﻞ ﻣﺎﺋﺔ ﺃﻟﻒ ﻣﻮﺍﻃﻦ ﻭﻫﻮ ﺃﻛﺜﺮ‬
‫ﰱ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺮﻳﺔ ﻣﻦ ‪ ١٥‬ﺇﱃ ‪ ٤٤‬ﺳﻨﺔ )ﻋﻜﺎﺷﺔ ‪(١٩٨٤‬‬

‫‪٣٣٥‬‬
 ‫ﺳﻮﺀ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳌﻮﺍﺩ ) ﺍﻹﺩﻣﺎﻥ (‬
‫ﰲ ﺩﺭﺍﺳﺔ ﻟﻌﻜﺎﺷﺔ ﻭﺧﻠﻴﻞ ‪ ١٩٨٢‬ﰱ ﺍﳉﺎﻣﻌﺎﺕ ﻭﺟﺪﻭﺍ ﺃﻥ ‪ %٨‬ﻣﻦ ﺍﻟﻨﺎﺟﺤﲔ ﻳﺘﻌﺎﻃﻮﻥ ﳐﺪﺭﺍﺕ ﻭ‪%٢٨‬‬
‫ﻣﻦ ﺍﻟﺮﺍﺳﺒﲔ ﻳﺘﻌﺎﻃﻮﻥ ﳐﺪﺭﺍﺕ ﻭﻛﺎﻧﺖ ﺍﳌﺨﺪﺭﺍﺕ ﺗﺘﺮﺍﻭﺡ ﺑﲔ ﺍﳊﺸﻴﺶ‪ ،‬ﺍﳌﻨﺒﻬﺎﺕ‪ ،‬ﺍﻟﻜﺤﻮﻝ‪ ،‬ﺍﳌﻨﻮﻣﺎﺕ‬
‫ﻭﺍﳌﻬﻠﻮﺳﺎﺕ‪.‬‬
‫ﻭﰱ ﺩﺭﺍﺳﺔ ﻟﺴﻮﻳﻒ ) ‪ (١٩٨٢‬ﺃﻳﻀﺎ ﻋﻦ ﺳﻮﺀ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳌﻮﺍﺩ ﰱ ﺍﳌﺪﺍﺭﺱ ﺍﻟﺜﺎﻧﻮﻳﺔ ﻭﺟﺪ ﺍﻵﺗﻰ‪:‬‬
‫ﰱ ﺍﳌﺪﺍﺭﺱ ﺍﻟﺜﺎﻧﻮﻳﺔ ﺍﻟﻔﻨﻴﺔ )ﺻﻨﺎﻋﻴﺔ‬ ‫ﰲ ﺍﳌﺪﺍﺭﺱ ﺍﻟﺜﺎﻧﻮﻳﺔ ﺍﻟﻌﺎﻡ‪:‬‬
‫ﻭﲡﺎﺭﻳﺔ(‪:‬‬
‫
‪ %٢٤,٥‬ﻳﺪﺧﻨﻮﻥ ﺑﺎﻧﺘﻈﺎﻡ‬ ‫‪ %١٥‬ﻣﻦ ﺍﻟﻄﻠﺒﺔ ﻳﺪﺧﻨﻮﻥ ﺑﺎﻧﺘﻈﺎﻡ‬ ‫
‬
‫‪ %٤,٦‬ﺟﺮﺑﻮﺍ ﺍﳌﻬﺪﺋﺎﺕ‬ ‫
‬ ‫‪ %٥,٣‬ﺟﺮﺑﻮﺍ ﺍﳌﻬﺪﺋﺎﺕ‬ ‫
‬
‫‪ %٥,٩‬ﺟﺮﺑﻮﺍ ﺍﳌﻨﺒﻬﺎﺕ‬ ‫
‬ ‫‪ %٥,٧‬ﺟﺮﺑﻮﺍ ﺍﳌﻨﺒﻬﺎﺕ‬ ‫
‬
‫‪ %١١,٦‬ﺟﺮﺑﻮﺍ ﺍﻷﺩﻭﻳﺔ ﺍﳌﺨﺪﺭﺓ‬ ‫
‬ ‫‪ %١٠,٥‬ﺟﺮﺑﻮﺍ ﺍﻷﺩﻭﻳﺔ ﺍﳌﺨﺪﺭﺓ‬ ‫
‬
‫‪ %٤,٧‬ﺟﺮﺑﻮﺍ ﺍﳌﻨﻮﻣﺎﺕ‬ ‫
‬ ‫‪ %٤,٧‬ﺟﺮﺑﻮﺍ ﺍﳌﻨﻮﻣﺎﺕ‬ ‫
‬
‫‪ %٩٢,١‬ﺟﺮﺑﻮﺍ ﺍﳊﺸﻴﺶ‬ ‫
‬ ‫‪ %٩٠,٧‬ﺟﺮﺑﻮﺍ ﺍﳊﺸﻴﺶ‬ ‫
‬
‫‪ %٧,٢‬ﺟﺮﺑﻮﺍ ﺍﻷﻓﻴﻮﻥ‬ ‫
‬ ‫‪ %٧,٤‬ﺟﺮﺑﻮﺍ ﺍﻷﻓﻴﻮﻥ‬ ‫
‬
‫‪ %٧,٩‬ﺟﺮﺑﻮﺍ ﺑﺎﻗﻲ ﺍﳌﺨﺪﺭﺍﺕ‬ ‫
‬ ‫‪ %٢‬ﺟﺮﺑﻮﺍ ﺑﺎﻗﻲ ﺍﳌﺨﺪﺭﺍﺕ‬ ‫
‬
‫ﻭﻭﺟﺪ ﺳﻮﻳﻒ ﺃﻳﻀﺎ ﺃﻥ ‪ %٧٣‬ﻣﻦ ﺍﻟﺬﻳﻦ ﻳﺪﺧﻨﻮﻥ ﺍﳊﺸﻴﺶ ﱂ ﻳﻔﻜﺮﻭﺍ ﺃﺑﺪﺍ ﰲ ﺍﻟﺘﻮﻗﻒ‪.‬‬
‫ﻭﺃﺷﺎﺭ ﺍﻟﻌﻘﺒﺎﻭﻯ )‪ (٢٠٠١‬ﺇﱃ ﺍﻧﺘﺸﺎﺭ ﺍﻹﺩﻣﺎﻥ ﰱ ﻣﺼﺮ ﰱ ﺍﻟﺜﻤﺎﻧﻴﻨﺎﺕ ﻛﺎﻥ ‪‬ﺬﺍ ﺍﻟﺘﺮﺗﻴﺐ‪ :‬ﺍﳊﺸﻴﺶ‪-‬‬
‫ﺍﻷﻓﻴﻮﻥ‪ -‬ﺍﳌﻬﺪﺋﺎﺕ‪ -‬ﺍﳍﲑﻭﻳﻦ‪ -‬ﺍﻟﻜﻮﻛﺎﻳﲔ‪.‬‬
‫ﻭﰱ ﺍﻟﺘﺴﻌﻴﻨﺎﺕ ﺍﻧﺘﺸﺮ ﺍﳊﺸﻴﺶ ﺑﺸﻜﻞ ﻛﺒﲑ ﻭﺃﺻﺒﺢ ﻳﺴﻤﻰ ﺍﻟﺒﺎﳒﻮ ﻭﻫﻮ ﳛﺘﻮﻯ ﻋﻠﻰ ﻧﻔﺲ ﺍﳌﺎﺩﺓ‬
‫ﺍﳌﺆﺛﺮﺓ ﻣﺜﻞ ﺍﳊﺸﻴﺶ )ﺗﺘﺮﺍﻫﻴﺪﺭﻭﻛﺎﻧﻴﺒﺎﻧﻮﻝ( ﻭﺃﺻﺒﺢ ﺍﻷﻓﻴﻮﻥ ﻭﺍﳍﲑﻭﻳﻦ ﻧﺎﺩﺭﻳﻦ‬
‫ﻭﺃﺿﺎﻑ ﺍﻟﻌﻘﺒﺎﻭﻯ ﻫﺬﻩ ﺍﻟﻨﺴﺐ ﺑﲔ ﺍﺳﺘﺨﺪﺍﻡ ﻟﻠﺘﺠﺮﺑﺔ ﻭﺇﺳﺎﺀﺓ ﺍﻻﺳﺘﺨﺪﺍﻡ ﻭﺍﻹﺩﻣﺎﻥ ‪) ١ :٤ :١٦‬ﺃﲪﺪ‬
‫ﺷﻮﻗﻲ ﺍﻟﻌﻘﺒﺎﻭﻱ ‪(٢٠٠١‬‬

‫ﺍﻻﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﻨﻔﺴﻴﺔ ﰱ ﺍﻷﻃﻔﺎﻝ ﻭﺍﳌﺮﺍﻫﻘﲔ‬

‫ﳝﺜﻞ ﺍﻧﺘﺸﺎﺭ ﺍﳌﺸﺎﻛﻞ ﺍﻻﻧﻔﻌﺎﻟﻴﺔ ﻭﺍﻟﺴﻠﻮﻛﻴﺔ ﺑﲔ ﺗﻼﻣﻴﺬ ﻣﺎ ﻗﺒﻞ ﺍﳌﺪﺭﺳﺔ ﰱ ﳏﺎﻓﻈﺔ ﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬
‫ﻧﺴﺒﺔ ‪ ) %٢٢,٥‬ﻋﺒﺪ ﺍﻟﻠﻄﻴﻒ ﻭﺍﺧﺮﻭﻥ ‪(١٩٨٩‬‬
‫ﻭﺑﲔ ﺗﻼﻣﻴﺬ ﺍﳌﺮﺣﻠﺔ ﺍﻻﺑﺘﺪﺍﺋﻴﺔ ﲤﺜﻞ ﻫﺬﻩ ﺍﻻﺿﻄﺮﺍﺑﺎﺕ ﻧﺴﺒﺔ ‪) %٤,٧‬ﻗﻮﺭﺓ ‪(١٩٩١‬‬
‫ﻭﻛﺎﻧﺖ ﻧﺴﺒﺔ ﺍﻟﺘﻼﻣﻴﺬ ﰱ ﺍﳌﺪﺍﺭﺱ ﺍﻹﻋﺪﺍﺩﻳﺔ ﺍﻟﺬﻳﻦ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺍﻛﺘﺌﺎﺏ ﰱ ﺇﺣﺪﻯ ﺍﻟﺪﺭﺍﺳﺎﺕ ‪%١٠,٢٥‬‬
‫ﻭﻛﺎﻧﺖ ﺍﻟﻨﺴﺒﺔ ﺃﻛﱪ ﺑﲔ ﺍﻟﺒﻨﺎﺕ )‪ (%٥٦,٢٥‬ﻋﻦ ﺍﻟﺒﻨﲔ ) ‪) (%٤٣,٧٥‬ﺍﺑﻮ ﻧﺎﺯﻝ ‪(١٩٨٩‬‬
‫ﻭﰱ ﺩﺭﺍﺳﺔ ﺃﺧﺮﻯ ﻭﺟﺪ ﺍﺿﻄﺮﺍﺏ ﺍﻟﻘﻠﻖ ﰱ ‪ %١٧‬ﻣﻦ ﺍﳌﺮﺍﻫﻘﲔ ﻭﻛﺎﻥ ﺃﻛﺜﺮ ﺍﻧﺘﺸﺎﺭﺍ ﻋﻨﺪ ﺳﻦ ‪ ١٨‬ﻋﻨﻪ‬
‫ﻋﻨﺪ ﺳﻦ ‪ ) ١٤‬ﻋﻄﻴﻪ ﻭﺁﺧﺮﻭﻥ ‪(١٩٨٨‬‬
‫ﻭﰱ ﺩﺭﺍﺳﺔ ﺇﺑﺮﺍﻫﻴﻢ ﻭﺁﺧﺮﻭﻥ ‪ ١٩٩٩‬ﻭﺟﺪﻭﺍ ﺃﻥ ‪ %٥٩‬ﻣﻦ ﺍﻷﻃﻔﺎﻝ ﻭﺍﳌﺮﺍﻫﻘﲔ ﻣﻦ ﺳﻦ ‪ ١٠‬ﺇﱃ ﺳﻦ ‪ ١٨‬ﺳﻨﺔ‬
‫ﺃﻋﺮﺑﻮﺍ ﻋﻦ ﻣﺸﺎﻋﺮ ﺍﳋﻮﻑ ﻭﺍﻟﻘﻠﻖ‪.‬‬

‫‪٣٣٦‬‬
 ‫ﻣﺸﺎﻋﺮ ﺍﳋﻮﻑ ﻭﺍﻟﻘﻠﻖ ﻛﺎﻧﺖ‬
‫ﺃﻛﺜﺮ ﰱ ﺍﻟﺒﻨﺎﺕ‪.‬‬ ‫
‬
‫ﺃﻛﺜﺮ ﰲ ﺍﳌﺴﺘﻮﻳﺎﺕ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ‪.‬‬ ‫
‬
‫ﺃﻛﺜﺮ ﰲ ﻃﻼﺏ ﺍﳌﺪﺍﺭﺱ ﻋﻨﻬﻢ ﰱ ﻣﻦ ﻻ ﻳﺪﺭﺳﻮﻥ‪.‬‬ ‫
‬
‫ﰲ ﺍﳌﺪﻥ ‪ %٦٣,٢‬ﻭﰱ ﺍﻟﺮﻳﻒ ‪.%٥٥,٧‬‬ ‫
‬
‫ﺃﻛﺜﺮ ﰲ ﻏﲑ ﺍﻟﻌﺎﳌﲔ ﻣﻘﺎﺭﻧﺔ ﺑﺎﻟﻌﺎﻣﻠﲔ‪.‬‬ ‫
‬
‫ﻭﰱ ﺩﺭﺍﺳﺔ ﻣﺴﺤﻴﺔ ﰱ ﺃﻋﻮﺍﻡ ‪ ١٩٨٩ - ١٩٨٥‬ﻭﺟﺪ ﺃﻥ ﺍﻟﺘﺒﻮﻝ ﺍﻟﻼﺇﺭﺍﺩﻯ ﺗﺘﺮﺍﻭﺡ ﻧﺴﺒﺔ ﺣﺪﻭﺛﻪ ﺑﲔ‬
‫ﺍﻷﻃﻔﺎﻝ ﺍﳌﺼﺎﺑﲔ ﺑﺎﺿﻄﺮﺍﺑﺎﺕ ﺳﻠﻮﻛﻴﺔ ﺑﲔ ‪ %٦٣,٩‬ﺇﱃ ‪ ) %٨٢,٥‬ﻗﻮﺭﺓ ﻭﺍﺧﺮﻭﻥ ‪(١٩٩٣‬‬
‫ﰲ ﺧﻼﻝ ﺍﻟﻌﺎﻡ ﺍﻟﺪﺭﺍﺳﻲ )‪ (١٩٩٩ -١٩٩٨‬ﻭﺟﺪ ﰲ ﺍﻷﻃﻔﺎﻝ ﺍﶈﺎﻟﲔ ﺇﱃ ﻋﻴﺎﺩﺍﺕ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻰ ﰱ‬
‫ﺍﳌﺪﺍﺭﺱ ﺃﻱ ﻧﺴﺒﺔ ‪ %٣١,٨‬ﻣﻨﻬﻢ ﰎ ﺗﺸﺨﻴﺼﻬﻢ ﺍﳌﺒﺪﺋﻰ ﻋﻠﻰ ﺃ‪‬ﻢ ﻳﻌﺎﻧﻮﻥ ﻣﻦ ﺍﻟﺘﺨﻠﻒ ﺍﻟﻌﻘﻠﻰ ﻭﺑﻌﺪ‬
‫ﻋﻤﻞ ﺍﻟﺘﻘﻴﻴﻢ ﺍﻟﻜﺎﻣﻞ ﺃﺻﺒﺤﺖ ﺍﻟﻨﺴﺒﺔ ‪ ) %١٨,٩‬ﺗﻘﺮﻳﺮ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ‪(١٩٩٩‬‬
‫ﻭﰱ ‪‬ﺎﻳﺔ ﻫﺬﺍ ﺍﻟﻌﺮﺽ ﻋﻦ ﻣﺆﺷﺮﺍﺕ ﺍﻧﺘﺸﺎﺭ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ ﰲ ﺍ‪‬ﺘﻤﻊ ﻧﺘﻌﺮﺽ ﻟﻸﻋﺪﺍﺩ ﺍﻟﱴ ﺫﻛﺮﻫﺎ‬
‫ﺍﻟﺪﻛﺘﻮﺭ ﺃﲪﺪ ﻋﻜﺎﺷﺔ ﻋﻦ ﺍﳌﺼﺎﺑﲔ ﺑﺎﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ ﰱ ﻣﺼﺮ ﻋﺎﻡ ‪١٩٩٧‬‬
‫ﺍﺿﻄﺮﺍﺑﺎﺕ ﻋﺼﺎﺑﻴﺔ ‪ ١,٥‬ﻣﻠﻴﻮﻥ‬ ‫
‬
‫ﺍﻟﺘﺨﻠﻒ ﺍﻟﻌﻘﻠﻰ ‪ ١,٢‬ﻣﻠﻴﻮﻥ‬ ‫
‬
‫ﺍﻻﻛﺘﺌﺎﺏ ‪ ١‬ﻣﻠﻴﻮﻥ‬ ‫
‬
‫ﺍﻟﺼﺮﻉ ‪ ٠,٥‬ﻣﻠﻴﻮﻥ‬ ‫
‬
‫ﻓﺼﺎﻡ ﻣﺰﻣﻦ ﻭﻋﺘﻪ ‪٠,٢‬ﻣﻠﻴﻮﻥ‬ ‫
‬
‫ﺍ‪‬ﻤﻮﻉ ‪ ٤,٤‬ﻣﻠﻴﻮﻥ‬ ‫
‬
‫ﻭﻫﺬﻩ ﺍﻹﺣﺼﺎﺋﻴﺎﺕ ﰱ ﺃﻏﻠﺒﻬﺎ ﲤﺖ ﰱ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﲤﺖ ‪‬ﺪﻑ ﺭﺻﺪ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ ﻭﻟﻜﻨﻬﺎ ﱂ‬
‫ﺗﺸﺘﻤﻞ ﻋﻠﻰ ﺍﳊﺎﻻﺕ ﺍﻟﱴ ﺗﻌﺎﱏ ﻣﻦ ﺃﻋﺮﺍﺽ ﻧﻔﺴﻴﺔ ﻻ ﺗﺼﻞ ﺇﱃ ﺣﺪ ﺍﳌﺮﺽ ﻛﻤﺎ ﺃ‪‬ﺎ ﻻ ﺗﺘﻌﺎﻣﻞ ﻣﻊ‬
‫ﺍﳌﺸﺎﻛﻞ ﺍﻟﻨﻔﺴﻴﺔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺍﻷﺧﺮﻯ ﻣﺜﻞ ﺿﺤﺎﻳﺎ ﺍﳉﺮﳝﺔ ﻭﺿﺤﺎﻳﺎ ﺍﻟﻈﺮﻭﻑ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺍﻟﺴﻴﺌﺔ‪،‬‬
‫ﻭﺑﺸﻜﻞ ﻋﺎﻡ ﻓﻨﺤﻦ ﻧﻌﺘﻘﺪ ﺃﻥ ﺃﻛﺜﺮ ﻣﻦ ﺭﺑﻊ ﺍﻟﺴﻜﺎﻥ ﻳﻌﺎﱏ ﻣﻦ ﻣﺸﻜﻠﺔ ﻧﻔﺴﻴﺔ ﺑﺸﻜﻞ ﺃﻭ ﺑﺂﺧﺮ‬
‫ﻭﳛﺘﺎﺝ ﻟﻠﻌﻮﻥ ﻣﻦ ﺧﻼﻝ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ ﺍ‪‬ﺘﻤﻌﻴﺔ‪.‬‬

‫
‪
 45 .'/
  67
08‬‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻨﻔﺴﻴﺔ ﰱ ﻣﺼﺮ ﺗﻨﻘﺴﻢ ﺇﱃ ﻗﺴﻤﲔ ﻛﺒﲑﻳﻦ‬
‫‪ .٢‬ﻗﺴﻢ ﺧﺎﺹ‬ ‫‪ .١‬ﻗﺴﻢ ﻋﺎﻡ‬
‫‪ .١‬ﺍﻟﻘﺴﻢ ﺍﻟﻌﺎﻡ‪:‬‬
‫ﻳﻌﺘﻤﺪ ﺃﺳﺎﺳﺎ ﻋﻠﻰ ﺍﳋﺪﻣﺎﺕ ﺍﻟﱴ ﺗﻘﺪﻣﻬﺎ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﻣﻦ ﺧﻼﻝ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﳌﺆﺳﺴﺎﺕ‬
‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﰱ ﺍﳌﺮﺍﻛﺰ ﻭﺍﶈﺎﻓﻈﺎﺕ‬ ‫
‬
‫ﻭﺣﺪﺍﺕ ﺭﻳﻔﻴﺔ ﰱ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﻘﺮﻯ‬ ‫
‬

‫‪٣٣٧‬‬
 ‫ﺍﳌﺆﺳﺴﺔ ﺍﻟﻌﻼﺟﻴﺔ‬ ‫
‬
‫ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‬ ‫
‬
‫ﺍﳌﻌﺎﻫﺪ ﺍﳌﺘﺨﺼﺼﺔ‬ ‫
‬
‫ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻰ‬ ‫
‬
‫ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻰ ﻟﻠﻤﺪﺍﺭﺱ‬ ‫
‬
‫ﻭﻫﻨﺎﻙ ﺃﻳﻀﺎ ﺑﻌﺾ ﺍﳉﻬﺎﺕ ﺍﻟﱴ ﲤﺘﻠﻚ ﻭﺗﺪﻳﺮ ﻣﺴﺘﺸﻔﻴﺎﺕ ﺧﺎﺹ ‪‬ﺎ ﻟﻌﻼﺝ ﺍﻟﻌﺎﻣﻠﲔ ﻣﺜﻞ‬
‫ﻣﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻘﻮﺍﺕ ﺍﳌﺴﻠﺤﺔ ﻭﺍﻟﺸﺮﻃﺔ‬ ‫
‬
‫ﻣﺴﺘﺸﻔﻰ ﺍﻟﻜﻬﺮﺑﺎﺀ‬ ‫
‬
‫ﻣﺴﺘﺸﻔﻰ ﺍﻟﺪﻋﺎﺓ‬ ‫
‬
‫ﻏﲑﻫﺎ‬ ‫
‬
‫‪ .٢‬ﺍﻟﻘﺴﻢ ﺍﳋﺎﺹ‪:‬‬
‫ﻭﻳﺘﻀﻤﻦ ﺍﻟﻌﻴﺎﺩﺍﺕ ﻭﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﳋﺎﺻﺔ‬
‫ﻭﺑﺎﻟﻨﺴﺒﺔ ﳋﺪﻣﺎﺕ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ ﻓﺈﻥ ﺇﺣﺼﺎﺋﻴﺔ ﻋﻜﺎﺷﺔ ﻟﻌﺎﻡ ‪ ١٩٩٨‬ﺃﺷﺎﺭﺕ ﺇﱃ ﺃﻥ ﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ‬
‫ﺍﻟﻨﻔﺴﻴﲔ ﰱ ﻣﺼﺮ ﺣﻮﺍﱃ ‪ ٤٥٠‬ﻃﺒﻴﺎ ﻧﻔﺴﻴﺎ ﺃﻯ ﺃﻥ ﻫﻨﺎﻙ ﻃﺒﻴﺐ ﻧﻔﺴﻰ ﻭﺍﺣﺪ ﻟﻜﻞ ﻣﺎﺋﱴ ﺃﻟﻒ‬
‫ﻣﻮﺍﻃﻦ ‪ ٢٠٠٠٠٠/١‬ﰱ ﺣﲔ ﻳﺒﻠﻎ ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ‪ ٢٥٠‬ﺃﺧﺼﺎﺋﻲ ﻧﻔﺴﻲ ﻭﻫﻨﺎﻙ ﺍﻟﻜﺜﲑ ﻣﻦ‬
‫ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ ﻭﺍﳌﻤﺮﺿﺎﺕ ﻭﻟﻜﻨﻬﻢ ﰱ ﺍﻷﻏﻠﺐ ﱂ ﻳﺘﻌﺮﺿﻮﺍ ﻷﻯ ﻧﻮﻉ ﻣﻦ ﺍﻟﺘﺪﺭﻳﺐ ﰱ ﳎﺎﻝ‬
‫ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ‪ .‬ﻭﺗﻘﺪﻡ ﺧﺪﻣﺎﺕ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ ﻣﻦ ﺧﻼﻝ‬
‫ﺧﺪﻣﺎﺕ ﺍﻷﻗﺴﺎﻡ ﺍﻟﺪﺍﺧﻠﻴﺔ ﺑﺎﳌﺴﺘﺸﻔﻴﺎﺕ‬ ‫
‬
‫ﺧﺪﻣﺎﺕ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﳋﺎﺭﺟﻴﺔ‬ ‫
‬
‫ﻣﺮﺍﻛﺰ ﻋﻼﺝ ﺍﻹﺩﻣﺎﻥ‬ ‫
‬
‫ﻣﺮﺍﻛﺰ ﻣﺘﺨﺼﺼﺔ ﻟﻜﺒﺎﺭ ﺍﻟﺴﻦ‬ ‫
‬
‫ﻳﺒﻠﻎ ﻋﺪﺩ ﺍﻷﺳﺮﺓ ﰱ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻨﻔﺴﻴﺔ ﺍﻟﻌﺎﻣﺔ ﻭﺍﳋﺎﺻﺔ ﺣﻮﺍﱃ ‪ ٨٠٠٠‬ﺳﺮﻳﺮ ﲟﻌﺪﻝ ﺳﺮﻳﺮ ﻟﻜﻞ‬
‫ﺳﺒﻌﺔ ﺁﻻﻑ ﻣﻮﺍﻃﻦ‬
‫ﺗﺘﻤﺮﻛﺰ ﻣﻌﻈﻢ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ ﺍﳌﺘﻌﻠﻘﺔ ﺑﺎﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﰱ ﺍﳌﺪﻥ ﺍﻟﻜﱪﻯ ﻣﺜﻞ ﺍﻟﻘﺎﻫﺮﺓ ﻭﺍﳉﻴﺰﺓ‬
‫ﻭﺍﻹﺳﻜﻨﺪﺭﻳﺔ‬
‫ﻻ ﺗﻮﺟﺪ ﺃﻱ ﻧﻮﻉ ﻣﻦ ﺧﺪﻣﺎﺕ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ ﰱ ﲬﺲ ﳏﺎﻓﻈﺎﺕ ﻣﻦ ‪ ٢٤‬ﳏﺎﻓﻈﺔ ﺍﻟﻮﺍﺩﻯ ﺍﳉﺪﻳﺪ‪،‬‬
‫ﳏﺎﻓﻈﺔ ﴰﺎﻝ ﺳﻴﻨﺎﺀ ﻭﺟﻨﻮﺏ ﺳﻴﻨﺎﺀ‬
‫ﻻ ﺗﻮﺟﺪ ﺧﺪﻣﺎﺕ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ ﻟﻠﻤﺮﻳﺾ ﺍﻟﻨﻔﺴﻰ ﰱ ﻋﺸﺮﺓ ﳏﺎﻓﻈﺎﺕ ﻣﺜﻞ ﺍﻹﲰﺎﻋﻴﻠﻴﺔ‬
‫ﻭﺍﻟﺴﻮﻳﺲ ﻭﺑﻮﺭ ﺳﻌﻴﺪ‬

‫‪٣٣٨‬‬
‫ﺃ‪ .‬ﺗﻮﺟﺪ ﲬﺲ ﻣﺴﺘﺸﻔﻴﺎﺕ ﻟﻠﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺗﺎﺑﻌﺔ ﻟﺪﻳﻮﺍﻥ ﻋﺎﻡ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬
‫ﻭﻫﻰ‪:‬‬
‫ﺍ‪ .‬ﺩﺍﺭ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺑﺎﻟﻌﺒﺎﺳﻴﺔ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺳﺮﺓ ‪‬ﺎ ‪٢٠٧٣‬‬
‫‪ o‬ﻭﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﲔ ‪ ٥٣‬ﻃﺒﻴﺒﺎﹰ‬
‫‪ o‬ﻋﺪﺩ ﺍﳌﻤﺮﺿﲔ ﻭﺍﳌﻤﺮﺿﺎﺕ ‪١٤٦‬‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ‪١٧‬‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ ‪١٨‬‬
‫‪ .٢‬ﻣﺴﺘﺸﻔﻰ ﻣﺼﺮ ﺍﳉﺪﻳﺪﺓ ﻟﻠﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ) ﺍﳌﻄﺎﺭ(‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺳﺮﺓ ‪ ٩٢‬ﺳﺮﻳﺮ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﲔ ‪ ١٤‬ﻃﺒﻴﺐ‬
‫‪ o‬ﻋﺪﺩ ﺍﳌﻤﺮﺿﲔ ‪٣٩‬‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ‪١‬‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ ‪٤‬‬
‫‪ .٣‬ﻣﺴﺘﺸﻔﻰ ﺣﻠﻮﺍﻥ ﻟﻠﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺳﺮﺓ ‪ ٥٢٥‬ﺳﺮﻳﺮ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﲔ ‪ ٤٥‬ﻃﺒﻴﺐ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ‪٤‬‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ ‪٦‬‬
‫‪ .٤‬ﺩﺍﺭ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺑﺎﳋﺎﻧﻜﺔ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺳﺮﺓ ‪ ١٧٩٠‬ﺳﺮﻳﺮ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﲔ ‪ ٢٤‬ﻃﺒﻴﺐ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ‪٢‬‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ ‪٣‬‬
‫‪ o‬ﻋﺪﺩ ﺍﳌﻤﺮﺿﲔ ‪٦٨‬‬
‫‪ .٥‬ﻣﺴﺘﺸﻔﻰ ﺍﳌﻌﻤﻮﺭﺓ ﻟﻠﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺑﺎﻹﺳﻜﻨﺪﺭﻳﺔ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺳﺮﺓ ‪ ٧٥٠‬ﺳﺮﻳﺮ‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﲔ ‪ ٧٤‬ﻃﺒﻴﺐ‬
‫‪ o‬ﻋﺪﺩ ﺍﳌﻤﺮﺿﲔ ‪١٦١‬‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ‪٤‬‬
‫‪ o‬ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ ‪١٢‬‬

‫‪٣٣٩‬‬
‫ﻭﺇﺫﺍ ﰎ ﲡﻤﻴﻊ ﻫﺬﻩ ﺍﻷﻋﺪﺍﺩ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﺪﻳﻮﺍﻥ ﻋﺎﻡ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺃﺻﺒﺢ‬
‫ﺍﻷﺭﻗﺎﻡ ﻛﺎﻟﺘﺎﱃ‪:‬‬
‫ﻋﺪﺩ ﺍﻷﺳﺮﺓ ‪ ٥٢٣٠‬ﺳﺮﻳﺮ‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﲔ ‪ ٢١٠‬ﻃﺒﻴﺐ‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﳌﻤﺮﺿﲔ ‪٥٦٠‬‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ‪٢٨‬‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ ‪٤٣‬‬ ‫‪o‬‬
‫ﺏ‪ .‬ﺇﺣﺪﻯ ﻋﺸﺮ ﻣﺴﺘﺸﻔﻰ ﻟﻠﻄﺐ ﺍﻟﻨﻔﺴﻰ ﺗﺪﺍﺭ ﻣﻦ ﺧﻼﻝ ﺍﶈﻠﻴﺎﺕ‬
‫ﻋﺪﺩ ﺍﻷﺳﺮﺓ ‪‬ﺬﻩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ‪ ٨٠٠‬ﺳﺮﻳﺮ‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﲔ ‪ ٥٩‬ﻃﺒﻴﺐ‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﳌﻤﺮﺿﲔ ‪٢٤٤‬‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ‪٦‬‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﲔ ‪١٣‬‬ ‫‪o‬‬
‫ﻣﻠﺤﻮﻇﺎﺕ‪:‬‬
‫‪ ٨‬ﻣﻦ ﻫﺬﻩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻟﻴﺲ ‪‬ﺎ ﺃﺧﺼﺎﺋﻰ ﻧﻔﺴﻰ ﻭﺍﺣﺪ‬ ‫‪o‬‬
‫‪ ٥‬ﻣﻦ ﻫﺬﻩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻟﻴﺲ ‪‬ﺎ ﺃﺧﺼﺎﺋﻰ ﺍﺟﺘﻤﺎﻋﻰ ﻭﺍﺣﺪ‬ ‫‪o‬‬
‫ﻻ ﺗﺘﻮﺯﻉ ﻫﺬﻩ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺑﺸﻜﻞ ﻣﺘﻮﺍﺯﻥ ﻋﻠﻰ ﲨﻴﻊ ﺍﶈﺎﻓﻈﺎﺕ‬ ‫‪o‬‬
‫ﺝ‪ .‬ﺃﻗﺴﺎﻡ ﻃﺐ ﻧﻔﺴﻲ ﰲ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺎﻣﺔ‬
‫ﻭﻋﺪﺩﻫﺎ ‪ ٨‬ﺃﻗﺴﺎﻡ ‪‬ﺎ ‪ ١٢٤‬ﺳﺮﻳﺮ‬ ‫‪o‬‬
‫ﻭﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﺔ ‪‬ﺎ ‪ ٢٢‬ﻃﺒﻴﺐ‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ‪١‬‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﳌﻤﺮﺿﲔ ‪٢٦‬‬ ‫‪o‬‬
‫ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ ‪٣‬‬ ‫‪o‬‬
‫‪ ٧‬ﻣﻦ ﻫﺬﻩ ﺍﻷﻗﺴﺎﻡ ﻟﻴﺲ ‪‬ﺎ ﺃﺧﺼﺎﺋﻰ ﻧﻔﺴﻰ ﻭﺍﺣﺪ‬ ‫‪o‬‬
‫‪ ٥‬ﻣﻦ ﻫﺬﻩ ﺍﻷﻗﺴﺎﻡ ﻟﻴﺲ ‪‬ﺎ ﺃﺧﺼﺎﺋﻰ ﺍﺟﺘﻤﺎﻋﻰ ﻭﺍﺣﺪ‬ ‫‪o‬‬
‫ﺩ‪ .‬ﺃﺧﺮﻯ‬
‫ﻫﻨﺎﻙ ‪ ٥‬ﻣﺮﺍﻛﺰ ﺗﺎﺑﻌﺔ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺗﻘﻮﻡ ﺑﻌﻼﺝ ﺣﺎﻻﺕ ﺍﻻﺩﻣﺎﻥ ﻭﻫﻰ ﺍﻟﻌﺒﺎﺳﻴﺔ‪،‬‬ ‫‪o‬‬
‫ﺍﳋﺎﻧﻜﺔ‪ ،‬ﺍﳌﻌﻤﻮﺭﺓ‪ ،‬ﺍﻟﻐﺮﺑﻴﺔ ﻭﺃﺳﻮﺍﻥ ﻛﻤﺎ ﻳﻮﺟﺪ ﻣﺮﻛﺰ ﺁﺧﺮ ﺗﺎﺑﻊ ﳉﺎﻣﻌﺔ ﻋﲔ ﴰﺲ‬
‫ﻳﻮﺟﺪ ﺃﺭﺑﻊ ﻣﺮﺍﻛﺰ ﻟﻠﺮﻋﺎﻳﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻟﻜﺒﺎﺭ ﺍﻟﺴﻦ ﻭﻫﻰ ﺗﻮﺟﺪ ﰱ ﺍﻟﻌﺒﺎﺳﻴﺔ‪،‬‬ ‫‪o‬‬
‫ﺍﳋﺎﻧﻜﺔ‪ ،‬ﺣﻠﻮﺍﻥ‪ ،‬ﺍﳌﻌﻤﻮﺭﺓ‪ .‬ﻛﻤﺎ ﻳﻮﺟﺪ ﻣﺮﻛﺰ ﺁﺧﺮ ﺗﺎﺑﻊ ﳉﺎﻣﻌﺔ ﻋﲔ ﴰﺲ ﺑﻪ ﻗﺴﻢ‬
‫ﺩﺍﺧﻠﻰ )‪ ٢٤‬ﺳﺮﻳﺮ(‬

‫‪٣٤٠‬‬
‫ﺧﺪﻣﺎﺕ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ ﺍﻟﱴ ﺗﻘﺪﻣﻬﺎ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﻌﺴﻜﺮﻳﺔ ﺧﺪﻣﺎﺕ ﺍﻟﻌﻴﺎﺩﺓ‬ ‫‪o‬‬
‫ﺍﳋﺎﺭﺟﻴﺔ ﻭﺧﺪﻣﺎﺕ ﺳﺮﻳﺮﻳﻪ ﺣﻮﺍﱃ ﻣﺎﺋﱴ ﺳﺮﻳﺮ‬
‫ﺧﺪﻣﺎﺕ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ ﺍﻟﱴ ﺗﻘﺪﻣﻬﺎ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﺍﳌﺨﺘﻠﻔﺔ‬ ‫‪o‬‬

‫ﺗﻜﺎﻟﻴﻒ ﺧﺪﻣﺎﺕ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ ﰱ ﻣﺼﺮ‬

‫ﻣﻌﻈﻢ ﻫﺬﻩ ﺍﻟﺘﻜﺎﻟﻴﻒ ﺗﻘﻮﻡ ﺑﺘﻐﻄﻴﺘﻬﺎ‬
‫ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ‬ ‫‪o‬‬
‫ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻰ‬ ‫‪o‬‬
‫ﺑﻌﺾ ﻫﺬﻩ ﺍﻟﺘﻜﺎﻟﻴﻒ ﻳﻘﻮﻡ ‪‬ﺎ‬
‫ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ‬ ‫‪o‬‬
‫ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍﻟﻌﺴﻜﺮﻳﺔ‬ ‫‪o‬‬
‫ﺍﻷﺳﺮ ﻭﺍﻷﻓﺮﺍﺩ‬ ‫‪o‬‬
‫ﺍﻟﺘﻜﻠﻔﺔ ﺍﻟﻴﻮﻣﻴﺔ ﻟﻠﻤﺮﻳﺾ ﺩﺍﺧﻞ ﺍﳌﺴﺘﺸﻔﻰ‬
‫ﺑﺎﻟﻨﺴﺒﺔ ﳌﺴﺘﺸﻔﻰ ﺍﻟﻌﺒﺎﺳﻴﺔ ﻭﻫﻰ ﺃﻛﱪ ﻣﺴﺘﺸﻔﻰ ﻟﻠﻄﺐ ﺍﻟﻨﻔﺴﻰ ﰱ ﻣﺼﺮ ﻭﻫﻰ ﺗﻘﻊ ﰱ ﺍﻟﻘﺎﻫﺮﺓ‬
‫ﻭ‪‬ﺎ ‪ ٢٠٣٧‬ﺳﺮﻳﺮ ﻗﺎﻣﺖ ﺑﻌﻤﻞ ﺗﻘﺮﻳﺮ ﺳﻨﺔ ‪ ١٩٩٧‬ﺫﻛﺮﺕ ﺑﻪ‪:‬‬
‫ﻋﺪﺩ ﺍﳌﺮﺿﻰ ﺍﻟﺬﻳﻦ ﰎ ﻋﻼﺟﻬﻢ ‪ ١٦٠٠‬ﻣﺮﻳﺾ‬ ‫
‬
‫ﺍﻟﺘﻜﻠﻔﺔ ﺍﻹﲨﺎﻟﻴﺔ ‪ ١٢‬ﻣﻠﻴﻮﻥ ﺟﻨﻴﻪ ﻣﺼﺮﻯ ﲟﺎ ﻓﻴﻬﺎ ﻣﺮﺗﺒﺎﺕ ﺍﻟﻌﺎﻣﻠﲔ ) ﺣﻮﺍﱃ ‪ ٤‬ﻣﻠﻴﻮﻥ (‬ ‫
‬
‫ﺍﻟﺘﻜﻠﻔﺔ ﺍﻟﺴﻨﻮﻳﺔ ﳌﺮﻳﺾ ﻛﺎﻧﺖ ‪ ٧٥٠٠‬ﺟﻨﻴﻪ ﻣﺼﺮﻯ‬ ‫
‬
‫ﺍﻟﺘﻜﻠﻔﺔ ﺍﻟﻴﻮﻣﻴﺔ ﻟﻜﻞ ﻣﺮﻳﺾ ‪ ٢٠‬ﺟﻨﻴﻪ ﻣﺼﺮﻯ‬ ‫
‬
‫ﻭﻫﺬﺍ ﺍﻟﻌﺮﺽ ﺍﳌﻮﺟﺰ ﻳﻮﺿﺢ ﺃﻥ ﺧﺪﻣﺎﺕ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ ﺗﻜﺎﺩ ﺗﻜﻮﻥ ﻣﻌﺪﻭﻣﺔ ﰱ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺮﻳﻔﻴﺔ ﻭﺃﻥ‬
‫ﻫﻨﺎﻙ ﻧﻘﺺ ﰱ ﻋﺪﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ﻭﺍﻻﺟﺘﻤﺎﻋﻴﲔ ﻭﺍﳌﻤﺮﺿﲔ ﺍﳌﺆﻫﻠﲔ ﻭﺃﻳﻀﺎ ﰱ ﻋﺪﺩ ﺍﻷﻃﺒﺎﺀ‬
‫ﺍﻟﻨﻔﺴﻴﲔ‬
‫ﻻ ﺗﻮﺟﺪ ﺩﺭﺍﺳﺎﺕ ﻋﻦ ﺭﺿﺎ ﻣﺘﻠﻘﻰ ﺧﺪﻣﺎﺕ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻰ ﰱ ﻣﺼﺮ ﻭﺇﻥ ﻛﺎﻥ ﺍﻻﻧﻄﺒﺎﻉ ﺍﻟﻌﺎﻡ ﺃ‪‬ﺎ ﻻ‬
‫ﲣﺘﻠﻒ ﻛﺜﲑﺍ ﻋﻦ ﺍﳋﺪﻣﺎﺕ ﺍﳌﻘﺪﻣﺔ ﰱ ﻓﺮﻭﻉ ﺍﻟﻄﺐ ﺍﻷﺧﺮﻯ‬
‫ﻛﻤﺎ ﺃﻥ ﻛﻔﺎﺀﺓ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﻻ ﳜﺘﻠﻒ ﺃﻳﻀﺎ ﻋﻦ ﻓﺮﻭﻉ ﺍﻟﻄﺐ ﺍﻷﺧﺮﻯ‪.‬‬

‫<; '‪9:‬‬
‫ﺗﻄﻮﻳﺮ ﺑﺮﺍﻣﺞ ﻭﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﰲ ﻣﺼﺮ‬
‫ﺇﺫﺍ ﺣﺎﻭﻟﻨﺎ ﻭﺿﻊ ﺗﺼﻮﺭ ﻟﻠﻤﺴﺘﻘﺒﻞ ﰲ ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻓﻴﺠﺐ ﺃﻥ ﻧﻨﻈﺮ ﺇﱃ ﻃﺒﻴﻌﺔ ﺍﳌﺮﺽ‬
‫ﺍﻟﻨﻔﺴﻲ ﻭﺇﱃ ﺍﻟﻈﺮﻭﻑ ﺍﶈﻴﻄﺔ ﺑﺘﻘﺪﱘ ﻫﺬﻩ ﺍﳋﺪﻣﺎﺕ‪ .‬ﻭﻧﺘﻮﻗﻊ ﰲ ﺍﳌﺴﺘﻘﺒﻞ ﺯﻳﺎﺩﺓ ﺃﻋﺪﺍﺩ ﺍﳌﺮﺿﻰ‬
‫ﺍﻟﻨﻔﺴﻴﲔ ﻧﻈﺮﺍ ﻟﻠﺘﻐﲑ ﺍﻻﺟﺘﻤﺎﻋﻲ ﺍﻟﺴﺮﻳﻊ ﻭﻭﺟﻮﺩ ﺍﻟﻜﺜﲑ ﻣﻦ ﺍﻟﺼﺮﺍﻋﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﰲ ﺍ‪‬ﺘﻤﻌﺎﺕ‬
‫ﺍﻟﺼﻨﺎﻋﻴﺔ ﺍﳊﺪﻳﺜﺔ‬

‫‪٣٤١‬‬
 ‫ﻛﻤﺎ ﺃﻥ ﺯﻳﺎﺩﺓ ﻣﻌﺪﻻﺕ ﺍﳍﺠﺮﺓ ﻣﻦ ﺍﻟﺮﻳﻒ ﺇﱃ ﺍﳌﺪﻥ ﻳﺸﲑ ﺃﻳﻀﺎ ﺇﱃ ﺗﺰﺍﻳﺪ ﻣﻌﺪﻻﺕ ﺍﳌﺮﺽ ﺍﻟﻨﻔﺴﻲ‬
‫ﻭﳛﺪﺙ ﺃﻳﻀﺎ ﰲ ﺍﳌﺴﺘﻘﺒﻞ ﺯﻳﺎﺩﺓ ﰲ ﺃﻋﺪﺍﺩ ﻛﺒﺎﺭ ﺍﻟﺴﻦ ﻭﻫﺬﺍ ﺳﻴﺰﻳﺪ ﺍﻟﻜﺜﲑ ﰲ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ‬
‫ﺍﳌﺮﺗﺒﻄﺔ ﺑﺘﻘﺪﻡ ﺍﻟﻌﻤﺮ‬
‫ﻭﺑﺸﻜﻞ ﻋﺎﻡ ﻓﺈﻥ ﻫﻨﺎﻙ ﻣﺆﺷﺮﺍﺕ ﺗﺪﻝ ﻋﻠﻰ ﺗﺰﺍﻳﺪ ﻣﻌﺪﻻﺕ ﺍﳉﺮﳝﺔ ﻭﺳﻮﺀ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳌﻮﺍﺭﺩ ﲟﺎ ﳍﺎ ﻣﻦ‬
‫ﺗﺒﻌﺎﺕ ﺍﺟﺘﻤﺎﻋﻴﺔ ﻭﻧﻔﺴﻴﺔ‬
‫ﻭﳝﻜﻦ ﺗﻘﺴﻴﻢ ﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﱵ ﺗﻌﻴﻖ ﺗﻘﺪﱘ ﺧﺪﻣﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﰲ ﺍ‪‬ﺘﻤﻊ ﺇﱃ ﺛﻼﺛﺔ ﻋﻮﺍﻣﻞ‪:‬‬
‫ﻋﻮﺍﻣﻞ ﺳﻴﺎﺳﻴﺔ‪:‬‬
‫ﺍﳌﺮﺿﻰ ﺍﻟﻨﻔﺴﻴﻮﻥ ﻟﻴﺲ ﳍﻢ ﺃﻱ ﻭﺯﻥ ﺳﻴﺎﺳﻲ ﻭﻻ ﻳﻬﺘﻢ ‪‬ﻢ ﺍﻟﺴﻴﺎﺳﻴﲔ ﺃﺻﺤﺎﺏ ﺍﻟﻘﺮﺍﺭ‬ ‫‪o‬‬
‫ﺍﻧﺘﺸﺎﺭ ﺍﻟﺜﻘﺎﻓﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ﻭﺳﻴﺎﺩ‪‬ﺎ ﲟﺎ ﻓﻴﻬﺎ ﻣﻦ ﻣﺂﺧﺬ ﺍﺟﺘﻤﺎﻋﻴﺔ ﻭﺛﻘﺎﻓﻴﺔ ﻗﺪ ﺗﺆﺩﻯ ﺇﱃ‬ ‫‪o‬‬
‫ﺯﻳﺎﺩﺓ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ‬
‫ﺯﻳﺎﺩﺓ ﺍﻟﻌﺰﻟﺔ ﻭﺍﻟﻌﺪﻭﺍﻧﻴﺔ ﰲ ﺍ‪‬ﺘﻤﻊ ﻛﻤﺎ ﺃﻥ ﺍﻷﻗﻠﻴﺎﺕ ﺍﻟﻌﺮﻓﻴﺔ ﻭﺍﻟﺪﻳﻨﻴﺔ ﻗﺪ ﺗﺘﻌﺮﺽ ﻟﻠﻤﺰﻳﺪ‬ ‫‪o‬‬
‫ﻣﻦ ﺍﻟﺘﻔﺮﻗﺔ‬
‫ﺯﻳﺎﺩﺓ ﺇﻧﺘﺎﺝ ﻭﲡﺎﺭﺓ ﺍﳌﺨﺪﺭﺍﺕ‬ ‫‪o‬‬
‫ﻏﻴﺎﺏ ﺍﻷﻣﻦ‬ ‫‪o‬‬
‫ﺗﻘﻠﻴﺺ ﺍﳋﺪﻣﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‬ ‫‪o‬‬
‫ﻋﻮﺍﻣﻞ ﺍﻗﺘﺼﺎﺩﻳﺔ‪:‬‬
‫ﺍﳋﺪﻣﺎﺕ ﺍﻟﻄﺐ ﻧﻔﺴﻴﺔ ﻣﻜﻠﻔﺔ ﻭﻋﻠﻰ ﺳﺒﻴﻞ ﺍﳌﺜﺎﻝ ﻓﺎﻥ ﺃﺣﺪ ﺍﻷﺩﻭﻳﺔ ﺍﳊﺪﻳﺜﺔ ﻟﻌﻼﺝ ﺍﻟﻔﺼﺎﻡ‬ ‫‪o‬‬
‫ﲦﻦ ﺍﻟﻌﻠﺒﺔ ﺍﻟﻮﺍﺣﺪﺓ ﻣﻨﻪ ﺃﻛﺜﺮ ﻣﻦ ‪ ٦٠٠‬ﺟﻨﻴﻪ ﻣﺼﺮﻱ‬
‫ﻗﻠﺔ ﺃﻋﺪﺍﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﲔ‬ ‫‪o‬‬
‫ﺍﻟﻨﻈﺎﻡ ﺍﻟﺘﺄﻣﻴﲏ ﺿﻌﻴﻒ ﻛﻤﺎ ﺃﻥ ﺑﻌﺾ ﺃﻧﻈﻤﺔ ﺍﻟﺘﺄﻣﲔ ﺍﻟﺼﺤﻲ ﺗﺴﺘﺒﻌﺪ ﺍﻷﻣﺮﺍﺽ ﻣﻦ‬ ‫‪o‬‬
‫ﺍﳌﻈﻠﺔ ﺍﻟﺘﺄﻣﻴﻨﻴﺔ‬
‫ﺍﻧﺘﺸﺎﺭ ﻭﳑﺎﺭﺳﺔ ﺍﻟﻄﺐ ﺑﺸﻜﻞ ﲡﺎﺭﻯ ﻧﻔﻌﻲ ﺃﻛﺜﺮ ﻣﻦ ﳑﺎﺭﺳﺘﻪ ﺑﺸﻜﻞ ﺇﻧﺴﺎﱐ ﺃﺧﻼﻗﻲ‬ ‫‪o‬‬
‫ﺍﻟﺒﻄﺎﻟﺔ ﻭﺍﻟﺼﻌﻮﺑﺎﺕ ﺍﻻﻗﺘﺼﺎﺩﻳﺔ ﺗﺰﻳﺪ ﻋﺒﺊ ﺍﳌﺮﺽ ﺍﻟﻨﻔﺴﻲ‬ ‫‪o‬‬
‫ﻋﻮﺍﻣﻞ ﻣﺮﺗﺒﻄﺔ ﺑﻄﺒﻴﻌﺔ ﺍﳌﺮﺽ ﺍﻟﻨﻔﺴﻲ‪:‬‬
‫ﺍﺿﻄﺮﺍﺏ ﺍﳌﺰﺍﺝ‬ ‫‪o‬‬ ‫‪ o‬ﺍﻟﻔﺼﺎﻡ‬
‫ﺍﻟﻘﻠﻖ ﻭﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻰ ﺟﺴﻤﻴﺔ‬ ‫‪o‬‬ ‫‪ o‬ﺍﺿﻄﺮﺍﺏ ﺍﻟﻀﻼﻝ ) ﺍﻟﺒﺎﺭﺍﻧﻮﻳﺎ(‬
‫ﺳﻮﺀ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳌﻮﺍﺩ‬ ‫‪o‬‬ ‫‪ o‬ﺍﺿﻄﺮﺍﺏ ﺍﻟﺸﺨﺼﻴﺔ‬
‫‪ o‬ﺍﻷﻋﺮﺍﺽ ﺍﻟﺒﺪﻧﻴﺔ ﺍﳌﺘﻌﺪﺩﺓ‬
‫ﻭﰱ ﺍﻷﻃﻔﺎﻝ ﺃﻳﻀﺎ ﻫﻨﺎﻙ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻷﻣﺮﺍﺽ ﺍﻟﻨﻔﺴﻴﺔ ﺍﻟﱴ ﺗﺼﺒﺢ ﺃﻣﺮﺍﺿﺎ ﻣﺰﻣﻨﺔ ﻣﺜﻞ‬
‫ﻓﺼﺎﻡ ﺍﻟﻄﻔﻮﻟﺔ‬ ‫‪o‬‬ ‫ﺍﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﻨﻤﻮ‬ ‫‪o‬‬
‫ﺍﻟﺘﺨﻠﻒ ﺍﻟﻌﻘﻠﻲ‬ ‫‪o‬‬ ‫ﺍﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﺘﻮﺍﺻﻞ‬ ‫‪o‬‬
‫ﺍﺿﻄﺮﺍﺑﺎﺕ ﺍﳊﺮﻛﺔ‬ ‫‪o‬‬

‫‪٣٤٢‬‬
‫ﻣﺎﺯﺍﻝ ﻫﻨﺎﻙ ﻏﻤﻮﺿﺎ ﰲ ﻧﻮﺍﺡ ﻛﺜﲑﺓ ﻣﺮﺗﺒﻄﺔ ﺑﺎﳋﺪﻣﺎﺕ ﺍﳌﻄﻠﻮﺏ ﺗﻘﺪﳝﻬﺎ ﻟﻠﻤﺮﻳﺾ ﺍﻟﻨﻔﺴﻰ ﻭﻣﺪﻯ‬
‫ﺗﺄﺛﲑﻫﺎ‬
‫ﻳﻌﺎﱏ ﺍﳌﺮﻳﺾ ﻋﺎﺩﺓ ﻣﻦ ﻣﺸﺎﻛﻞ ﺃﺧﺮﻯ ﻏﲑ ﺍﳌﺮﻳﺾ ﻣﺜﻞ‪:‬‬
‫ﺍﻟﺒﻄﺎﻟﺔ‬ ‫‪o‬‬
‫ﺍﻟﻔﻘﺮ‬ ‫‪o‬‬
‫ﻋﺪﻡ ﻭﺟﻮﺩ ﻣﻜﺎﻥ ﺇﻗﺎﻣﺔ‬ ‫‪o‬‬
‫ﺍﻷﻃﺒﺎﺀ ﺣﺪﻳﺜﻰ ﺍﻟﺘﺨﺮﺝ ﻳﻬﺮﺑﻮﻥ ﻣﻦ ﺍﻟﺘﺨﺼﺺ ﰲ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻲ ﻷﺳﺒﺎﺏ ﳐﺘﻠﻔﺔ‬ ‫‪o‬‬

‫ﻣﻘﺘﺮﺣﺎﺕ ﻋﻠﻰ ﺍﳌﺪﻯ ﺍﻟﻘﺼﲑ ﻟﺘﻄﻮﻳﺮ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻲ‬

‫ﺇﺩﺧﺎﻝ ﻣﻔﻬﻮﻡ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﻭﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻲ ﺍ‪‬ﺘﻤﻌﻲ ﰲ ﺍﳌﻤﺎﺭﺳﺔ ﻋﻦ‬ ‫‪o‬‬
‫ﻃﺮﻳﻖ ﻋﻤﻞ ﺩﻭﺭﺍﺕ ﺗﺪﺭﻳﺐ ﻟﻠﻌﺎﻣﻠﲔ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‬
‫ﺍﻟﺒﺪﺀ ﰱ ﺗﻨﻔﻴﺬ ﺑﺮﺍﻣﺞ ﳏﺪﺩﺓ ﰱ ﻣﻨﺎﻃﻖ ﳐﺘﺎﺭﺓ ﻟﻌﻤﻞ ﻓﺮﻳﻖ ﻟﻠﺨﺪﻣﺔ ﺍﻟﻨﻔﺴﻴﺔ ﳌﺮﺍﻋﺎﺓ‬ ‫‪o‬‬
‫ﺍﳌﺮﺿﻰ ﻭﺃﺻﺤﺎﺏ ﺍﳌﺸﺎﻛﻞ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻭﺍﻟﻨﻔﺴﻴﺔ ﻭﺍﻟﺬﻫﺎﺏ ﳍﻢ ﰱ ﺍ‪‬ﺘﻤﻊ ﺑﺪﻻ ﻣﻦ‬
‫ﺍﻧﺘﻈﺎﺭﻫﻢ ﻭﺗﺘﺒﻊ ﺍﳌﺮﺽ ﺑﻌﺪ ﺧﺮﻭﺟﻬﻢ ﻣﻦ ﺍﳌﺴﺘﺸﻔﻴﺎﺕ ﻭﺗﻮﻓﲑ ﺍﻟﻌﻼﺟﺎﺕ ﳍﻢ ﻭﺍﻟﻌﻤﻞ‬
‫ﺑﻌﺪ ﺫﻟﻚ ﻋﻠﻰ ﺗﻮﺳﻴﻊ ﻫﺬﻩ ﺍﳋﺪﻣﺔ‬
‫ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺯﻳﺎﺩﺓ ﺃﻋﺪﺍﺩ ﺍﻷﻃﺒﺎﺀ ﺍﻟﻨﻔﺴﻴﲔ ﺑﺘﻘﺪﱘ ﺑﻌﺾ ﺍﳊﻮﺍﻓﺰ ﳌﻦ ﻳﻌﻤﻞ ﰲ ﻫﺬﺍ ﺍ‪‬ﺎﻝ‬ ‫‪o‬‬
‫ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺗﻐﻄﻴﺔ ﺍﶈﺎﻓﻈﺎﺕ ﺍﶈﺮﻭﻣﺔ ﻣﻦ ﻫﺬﻩ ﺍﳋﺪﻣﺔ ﻭﻗﺪ ﻳﻜﻮﻥ ﻋﻤﻞ ﻋﻴﺎﺩﺍﺕ ﻧﻔﺴﻴﺔ‬ ‫‪o‬‬
‫ﻣﺘﻨﻘﻠﺔ ﺣﻞ ﻣﺆﻗﺖ ﻟﺬﻟﻚ‬
‫ﻋﻤﻞ ﺩﻭﺭﺍﺕ ﺗﺪﺭﻳﺒﻴﺔ ﻟﻸﺧﺼﺎﺋﻴﲔ ﺍﻻﺟﺘﻤﺎﻋﻴﲔ ﺍﻟﻌﺎﻣﻠﲔ ﰲ ﳎﺎﻝ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ‬ ‫‪o‬‬
‫ﺍﻟﻌﻤﻞ ﻋﻠﻰ ﺯﻳﺎﺩﺓ ﺃﻋﺪﺍﺩ ﺍﻷﺧﺼﺎﺋﻴﲔ ﺍﻟﻨﻔﺴﻴﲔ ﻭﺗﺪﺭﻳﺒﻬﻢ‬ ‫‪o‬‬
‫ﺗﻄﻮﻳﺮ ﺗﻌﻠﻴﻢ ﺍﻟﻄﺐ ﺍﻟﻨﻔﺴﻲ ﰲ ﻛﻠﻴﺎﺕ ﺍﻟﻄﺐ ﻭﺇﺩﺧﺎﻝ ﺍﳌﻔﺎﻫﻴﻢ ﺍﳉﺪﻳﺪﺓ‬ ‫‪o‬‬
‫ﺗﺪﺭﻳﺐ ﺃﻃﺒﺎﺀ ﺍﳌﻤﺎﺭﺳﺔ ﺍﻟﻌﺎﻣﺔ ﻋﻠﻰ ﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﻻﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﻨﻔﺴﻴﺔ‬ ‫‪o‬‬

‫ﻋﻠﻰ ﺍﳌﺪﻯ ﺍﻟﺒﻌﻴﺪ‪:‬‬

‫ﻋﻨﺪ ﺗﻨﺎﻭﻝ ﻗﻀﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻨﻔﺴﻴﺔ ﺍ‪‬ﺘﻤﻌﻴﺔ ﻋﻠﻰ ﺍﳌﺪﻯ ﺍﻟﺒﻌﻴﺪ ﻓﺈﻧﻨﺎ ﳒﺪ ﺃﻧﻔﺴﻨﺎ ﻧﺒﺘﻌﺪ ﻋﻦ ﻣﻬﻨﺔ‬
‫ﺍﻟﻄﺐ ﻭﻧﻨﺎﻗﺶ ﺃﻭﺿﺎﻋﺎ ﺍﻗﺘﺼﺎﺩﻳﺔ ﻭﺳﻴﺎﺳﻴﺔ ﻭﺍﺟﺘﻤﺎﻋﻴﺔ ﻣﺘﻌﺪﺩﺓ‪ .‬ﻭﳓﻦ ﻧﺮﻯ ﺃﻥ ﻧﻈﺎﻡ ﺍﳋﺪﻣﺔ‬
‫ﺍﻟﺼﺤﻴﺔ ﺍﻟﻨﻔﺴﻴﺔ ﻟﻠﻤﺠﺘﻤﻊ ﻻ ﳝﻜﻦ ﺃﻥ ﻳﻨﻈﺮ ﺇﻟﻴﻪ ﲟﻌﺰﻝ ﻋﻦ ﺍﻟﻘﻮﻯ ﺍﻟﺴﻴﺎﺳﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻳﺔ‬
‫ﻭﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﺍﻟﱵ ﺗﺸﻜﻞ ﻫﺬﺍ ﺍﻟﻨﻈﺎﻡ‪.‬‬
‫ﻭﺍﻟﺘﺤﺪﻱ ﺍﻟﺬﻱ ﻳﻮﺍﺟﻪ ﺗﻘﺪﱘ ﺍﳋﺪﻣﺔ ﻟﻠﻤﺮﺿﻰ ﺍﻟﻨﻔﺴﻴﲔ ﰲ ﺍﳌﺴﺘﻘﺒﻞ ﻫﻮ ﻗﻀﻴﺔ ﺳﻴﺎﺳﻴﺔ ﺃﻛﺜﺮ‬
‫ﻣﻨﻬﺎ ﻗﻀﻴﺔ ﻓﻨﻴﺔ‪ .‬ﻓﻬﻨﺎﻙ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺘﻘﻨﻴﺎﺕ ﺍﻟﻔﻨﻴﺔ ﺍﻟﱵ ﰎ ﺗﻄﻮﻳﺮﻫﺎ ﻭﲢﺘﺎﺝ ﰲ ﺗﻨﻔﻴﺬﻫﺎ ﺇﱃ‬
‫ﻗﺮﺍﺭﺍﺕ ﺳﻴﺎﺳﻴﺔ‪.‬‬

‫‪٣٤٣‬‬
@ @òî÷îjÛaë@òîz—Ûa@òîàänÛa@òîÈà§@òÃìЫ@ÉjĐÛa@ÖìÔy

‫ﺭﻗﻢ ﺍﻹﻳﺪﺍﻉ ﺑﺪﺍﺭ ﺍﻟﻜﺘﺐ‬

٢٠٠٥ / ٩٢٢٠