Rebuilding Iraq society

18 January 2011

Investing in education to boost skill levels and revamping the healthcare system is essential to Iraq’s recovery

Key Iraq fact

About 5,000 new primary and secondary schools are due to be built within the next five years in Iraq

Source: MEED

As Prime Minister Nouri al-Maliki begins the reconstruction of Iraq, development of the country’s energy sector and increasing oil exports will be his top priority.

But while the natural resources are in place, a local skills base to exploit them is absent. Iraq suffers from a large gap between market needs and its human resource capacity. Foreign firms looking to invest in the country currently need to relocate employees there, which some are reluctant to do, while others demand huge compensation.

The government is keen to diversify the economy and increase self-sufficiency, but this will require heavy investment in the education sector and other social infrastructure. 

Poor education in Iraq

“The quality of Iraqi graduates is not high enough to compare well to foreign graduates,” says Dlawer Ala’Aldeen, the Kurdistan Regional Government (KRG) minister for higher education and scientific research. “Iraq needs hundreds of thousands of skilled and qualified workers to attract foreign investment.”

The quality of Iraqi graduates is not high enough to compare well to foreign graduates

Dlawer Ala’Aldeen, KRG minister for higher education and scientific research

Although Iraq has traditionally led the region in terms of educational standards, the quality of teaching has fluctuated according to political circumstances and financial constraints. Current graduates are a product of the old, rote-style learning, with little access to modern resources.

“Iraq has been isolated for far too long and academia has suffered as a result. The sector requires repair. You cannot rely entirely on a generation brought up in isolation for reform,” says Ala’Aldeen.

Throughout the country, educational institutions suffer from a lack of funding, which has resulted in poor quality of teaching, minimal research activity and no competition to raise standards. Infrastructure deteriorated during the years of conflict and ethnic violence, and, as a result, most schools are overcrowded. Student numbers have been rising steadily over the past few years, particularly at the secondary school level. Recognising the scale of the challenge, Baghdad has allocated five per cent of its $186bn national development budget for 2010-14 to develop and improve the education sector.

Iraq unemployment  (percentage)
Source: National Development Plan

The planning ministry is targeting a 6.9 per cent increase in secondary enrolment in its national development plan. To support this, some 5,000 new primary and secondary schools are due to be built within the next five years.

This rise will in turn drive demand for higher education. But universities are ill-prepared to cope with additional student numbers at present and so investment will need to be directed in this area as well.

Historically, the higher education sector in Iraq has been fully state-funded. Universities do not need to compete for funding, which results in a lack of competition, stunts innovation and increases the potential for corruption. State universities also admit 100 per cent of applicants, leading to high teacher-to-student ratios and inevitably impacting on the quality of education delivered.

Our first priority is to reform the healthcare system … The second is to improve existing facilities

Majid Hamad Amin, health minister

The private sector has been able to benefit from the underperformance of state-owned schools and universities. There are currently 12 private universities in the Kurdish region and eight in the rest of Iraq. The KRG has also received 18 applications from investors interested in setting up their own private education institutes. Most are from the US and Europe, along with some Arab countries such as Egypt.

Iraq higher education spending budget*
Iraqi dinars (million)
*=Except Kurdistan
Source: National Development Plan

But these institutions are also troubled by low educational standards. From December 2009 to March 2010, the Kurdish ministry for higher education and scientific research closed down two dentistry and three pharmaceutical colleges at three different universities for failing to meet the required standards.

Following this, a teacher quality assurance programme (TQA) was set in place. The scheme empowers students by giving them a right to assess the quality of education delivered to them. New committees have been set up to monitor the progress of students and teachers alike. Academics are now obliged to take part in regular training and development, including maintaining contact with their counterparts worldwide to keep them updated with new trends and practices.

Raising education standards in Iraq

“We want investors to bring us experience,” says Ala’Aldeen. “We do not need them to bring money and establish institutions that suffer the same problems as government-owned universities. Teachers are now being held accountable through TQA and so universities have to become providers of quality education and not think like rapid-profit-making businesses.”

So far the majority of reforms that have taken place in the higher education sector have been in the Kurdistan region. The KRG has set aside $400m for scholarships to send students abroad to help raise local standards to international norms. Funding for state universities is now performance-led and schemes have been put in place to encourage them to generate income for themselves.

Iraq key health statistics, 2008
Total doctors16,721
Total dentists3,859
Total nurses7,307
Doctors per 1,000 people0.6
Nurses per 1,000 people1.2
Total hospitals221
Total public clinics334
Source: National Development Plan

But Baghdad has shown strong interest in applying the same measures. With the reforms that are taking place, the country hopes to regain its reputation as a centre for educational excellence within the next 20 years.

“If everything goes to plan we’ll see international students, particularly from the Middle East coming to Iraq to study,” says Ala’Aldeen.

While other governments in the region are investing in technology to enhance their education sector, Iraq is attempting to establish the principles of quality by reforming the current system. 

Healthcare provision in Iraq

The government is looking to establish the same principles in the healthcare sector. Before the sanctions were imposed on the country, Iraq’s health sector was the outstanding example in the Middle East. A substantial proportion of doctors completed their training abroad and many health centres in Baghdad provided specialised services for neighbouring countries.

But since the 1980s, a lack of investment has allowed the sector to deteriorate so much that it is now considered one of the worst in the region. National expenditure on health decreased from 3.72 per cent of gross domestic product (GDP) in 1990 to 0.81 per cent in 1997.

Between 2002-06, the government only allocated 4.9 per cent of its budget to healthcare, far below the recommendations from the Switzerland-based World Health Organisation (WHO). Years of under-funding have left Iraq’s healthcare sector severely outdated and the health of the population has declined accordingly. One fifth of Iraqi families are deprived of basic health services, with rural areas even worse off.

“The major issue in the healthcare system is access,” says Syed Jaffar Hussain, WHO country representative for Iraq. “This is not just geographical, it is also economical and social.”

Decades of conflict have further exacerbated the situation, with damage caused to infrastructure and the loss of equipment and supplies. Migration has also put pressure on the sector. It is estimated that to date 8,000 Iraqi doctors have fled the country to escape the violence, almost a third of the total workforce. The country has been left with manifold health problems, including rising mortality rates and infectious diseases and an increase in psychological problems. The poor health of the local population is also impacting the efficiency and productivity of the labour force across the entire country.

“Iraq has a double burden of disease. The threat of communicable diseases still exists, as well as chronic diseases, such as diabetes,” says Hussain. According to the Brussels-headquartered International Diabetes Federation, 10.2 per cent of Iraq’s population suffered with diabetes in 2010. The new government has announced a budget of $5.2bn for the next five years to improve the country’s healthcare sector.

“Our first priority is to reform the healthcare system, which is a tough task,” says Majid Hamad Amin, Iraq’s health minister. “The second is to improve existing facilities and to employ better practice across the healthcare [sector].”

Improving access to healthcare in Iraq

The ministry is the main provider of health services in Iraq and as such the sector is heavily centralised. “The decisions that need to be made at local level cannot be made swiftly,” says Hussain.

The poor quality of healthcare provision is the cause of much discontent and an overhaul of the sector is crucial if the government is to retain the support of the voting public.

“The public has lost trust in the national health service,” says another health ministry official. “The system is chaotic. Conditions and management are so bad you go into the hospital to get treated for one condition and come out with five different infections.”

Demand for private healthcare has risen as a result, but these services are currently unregulated. “During Saddam Hussein’s dictatorship there were feared consequences if standards were not met, but now private doctors have nothing to worry about and can get away with ripping people off,” says the official. 

There is also strong speculation that public money has been used to fund private surgeries and services. The WHO is currently undertaking a study to gauge the level of corruption in the private healthcare sector in Iraq.

Construction of hospitals will dominate the health ministry’s investment budget. Twenty-five tenders have already been issued to build 10 teaching hospitals, 10 maternity and paediatric hospitals and five general hospitals, all valued at $140m each. The KRG health ministry is also planning to build eight more public hospitals within the next five years and is looking at introducing private health insurance.

Investment in energy projects is essential for Baghdad to fund its rebuilding programme, but it is spending on social infrastructure that will make most difference to the average citizen and as such should be given equal priority.

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