In 1993, Egypt's population was estimated at 60 million, which is expected to rise to 64 million by the year 2000. The majority of the population is crowded into the Nile Delta and Valley. Nearly half of the population lives in cities.
The nutrition situation in Egypt up to 1990 was described in the ACC/SCN's Second Report on the World Nutrition Situation (ACC/SCN, 1993, p.45-50), and in a case study entitled "Review of Trends, Policies and Programs Affecting Nutrition and Health in Egypt (1970-1990)", (Nassar, 1992). The information here updates these earlier reports.
Recent Trends in Nutrition
Recent nutrition trends in Egypt can be assessed from two nationally representative anthropometric surveys - one carried out in 1990 by the PAPCHILD project of the Arab League and the other carried out in 1992 in collaboration with DHS, with both sources of data reporting comparable sampling procedures and age categories.
The national averages for the two surveys showed that the level underweight improved from 10.4% in 1990 to about 9.4% in 1992. Most of the gains were made in the rural sector of Upper Egypt where the prevalence of underweight improved from 18% in 1990 to 12% in 1992 (see Figure 1), and in the urban part of Lower Egypt (from about 8% to 4%).
In the 1992 survey, anthropometric measurements of women were also included for the first time. These revealed that only around 1.5% of Egyptian women of reproductive age are underweight (below 18.5 BMI). However, the prevalence of obesity is high, with about 29% of women with BMI of 29 or greater.
In the same survey, the proportion of women with height below 145 cm (a cut-off for obstetric risk) was estimated at about 1.3%, while those who had weights below 50 kg were estimated at only 8.9%, which is very low compared to many other developing countries.
Figure 1. Egypt: Prevalence of Underweight Children (1-59 months) by Region, 1990-1992
Source: Egypt National Population Council/DHS (1993)
EGYPT
(Estimates in 1993)
|
Population |
: 56 million |
|
Population Density |
: 53 per sq. km. |
|
Population Growth Rate |
: 2.4% per annum |
|
Urban Population |
: 44% |
|
IMR |
: 46 |
|
GNP US$ (Per Capita) |
: 660 |
|
PPP estimates of GDP |
: 3600 |
Underweight preschool children (Percent below -2 s.d. weight for age)
Infant mortality rate (Per 1,000 live births)
ECONOMICS
GDP per capita (1987 Mkt. prices, Pounds / capita)
Debt service ratio (Debt service/exports)
FOOD
Food production index (Per caput, 1979-81=100)
Dietary energy supply (Kcals/caput/day)
Consumer price index (1980=100)
FPI/CPI ratio (1980=100)
HEALTH
Immunization coverage (Percent)
Access to local health care (Percent)
PUBLIC EXPENDITURES
Education and health expenditures (US $ per capita)
Education and health expenditures (Percent of government expenditures)
Factors Affecting Trends in Nutrition
Economic Growth. In 1993, per capita GNP was estimated to be U.S.$660. Per capita GDP remained virtually constant between 1986 and 1993.
During the 1980s Egypt did not adjust its economy to adverse external shocks, such as the decline in oil prices and increase in interest rates, resulting in massive fiscal and current account deficits, and unsustainable debt accumulation. Economic growth slowed due to substantial reduction in capital inflows and a large accumulation of unmet debt obligations.
The government adopted a comprehensive economic reform package and a structural adjustment programme (ERSAP) in March of 1990. This programme is designed to correct structural weaknesses of the economy and achieve macroeconomic stability. Under this programme the government reduced expenditures on food subsidies, public payrolls, and defense. These expenditures then increased in FY91 due to increases in defense spending and food subsidies related to the Gulf crisis and the return of large numbers of workers from Gulf area. Government expenditures then fell again in FY92 mainly due to a significant reduction in subsidies and the level of public investment.
As a result of increase in government revenues to 35% of GDP in 1992, the overall fiscal deficit (including public enterprises) fell to 6.4% of GDP in FY92. This was mainly due to increased tax rates, improved tax administration, reformed custom duties and higher prices for energy, electricity, and other goods and services. Inflation rose from 19.8% in FY91 to 21% in FY92, mainly reflecting high energy prices and tax rate.
Recent analysis of the impact of the structural adjustment measures on poverty in Egypt indicates that the level of poverty rose between 1982 and 1991.
Food Security. The Egyptian food subsidy system is one of the most extensive in the world. Virtually everyone (90%) of the population has access to direct food subsidies. The food subsidy program is one of the largest single components of the national government budget, estimated at around 10% (about US$1 billion, in 1992). Thus, food security in Egypt is affected directly by policies such as food rationing, food subsidies, and aid. In order to reduce the rising food gap and high food dependency ratio, which adds an extra burden to Egypt's balance of payments and exhausts the resources needed for capital imports, serious efforts have been made to improve the performance of the agriculture sector since the early 1980s.
Despite the high inflation rate (13.6% in 1992 and 21.3% in 1989), food consumption of the average Egyptian has remained virtually unchanged. The calorie supply per capita remained among the highest in the developing world, in excess of 3300 kcals/person/day.
For the period between 1990 and 1992, the policy of large food subsidies remained in place for wheat and flour, edible oils, and sugar, which are sold through a system of ration shops, government retail stores, and cooperatives. The subsidized price of bread was last increased in 1988. But for other items, the government has allowed the subsidized price to rise for rationed rice, regular sugar, rationed oil, and regular oil since 1992. Since flour (in the form of bread) is the largest source of calories in the Egyptian diet, increases in prices of other foods have not generally caused a decline in per capita calorie consumption.
Increases in the subsidized price of rice, sugar, rationed oil, and regular oil in 1992 were not matched by increases in wages. It is likely, therefore, that the impact of these increases may have hurt the poor.
The trends of the ratio of the food price index to the consumer price index has been declining since the last increase in the price of subsidized bread in 1988. The ratio in 1993 is nearly 100, which implies that the overall price of food has not been growing faster than other items in household's budgets.
Health, Population. In the area of child immunization, considerable gains have been made. Two DHS surveys (1988 and 1992), which are comparable in sampling procedures, provide a good basis for understanding these trends. The proportion of infants 12-23 months of age who were immunized against BCG increased from 56% in 1988 to 88% in 1992; while those with at least 3 DPT shots increased from 50% to 73% in the same period.
The rate of population growth has dropped from 3% in 1985 to 2.3% in 1993, probably resulting in part from intensive family planning programmes. Crude birth rate as put by the state statistics agency (CAP-MAS) in 1993 is at 29 per thousand, and life expectancy of around 60 years. The total fertility rates based on the DHS surveys declined from 4.4 births per woman in 1986-88 period to 3.9 in 1990-92.
