Khaled Yassin

Khaled Yassin (Arabic: خالد ياسين) is a German-Egyptian scholar in public health and management of health systems. He served as an expert for several international organizations, advancing efforts for modernization of health systems and development of medical and public health education around the globe. He contributed to the establishment of medical colleges and schools of public health in Pakistan, Yemen, Syria and Palestine. He has an excellent record of research papers published in international academic journals and authored more than 37 books, some of them are considered references in the field. Currently, he is director of the European Institute of Health Sciences (Institut Européen des Sciences de la Santé) in Casablanca, Morocco.

He was born on April 17, 1969 in Al Sharqia Governorate in Egypt, where his family had been forced to migrate from Ismaïlia as a result of the Six-Day War in June 1967. In January 1974 he returned with his family to Ismaïlia, just three months after a cease-fire was concluded between Egypt and Israel in October 1973. Between 3 and 5 he went to Al Kottab for learning the holy Quran, a factor that contributed to his mastery of Arabic at a very young age. When he showed signs of high intelligence in primary school, the headmaster devised for him a special program, in which he had to learn solo, carrying out extra assignments in Arabic language, literature and Islamic studies. He moved onward to the class of excelling pupils in Taha Hussein Preparatory School and thereafter to the same class in Muhammad Anwar El Sadat Secondary School. He was awarded the prize of the ideal student several times between 1981 and 1986 and was twice elected president of the student union of Ismailia governorate.

He studied medicine at the Suez Canal University between 1987 and 1993. He demonstrated talent in medical research and public health to the extent that he was appointed as a researcher at the end of his first year in medical college. By the third year, he became the field coordinator of the National Schistosomiasis Research Project, a large project that was financed jointly by the World Bank and USAID and implemented by the Suez Canal University and the University of Maryland. He continued to work in medical research while studying and when he graduated in 1993 he had six major research projects in stock.

After graduating from the medical college he migrated to Germany, where he obtained a Master of Public Health degree from Bielefeld University and a doctorate in epidemiology and medical research from the University of Münster. He further obtained a second doctorate degree in health system management from the University of Bielefeld. In the three degrees he obtained the highest academic grade in German universities and became one of the youngest members of the German academic elites with two doctoral degrees.

He is married to Mina Housni, a Moroccan German specialist in health communication, and they have three children (two daughters and one son). He has a passion for music and fine arts. He wrote seven plays in Egypt, two of which were directed by Wael Ihssan.

Deductive pragmatism

One of his major contributions to the development of research methods is his invention of the deductive pragmatism methodology. Deductive pragmatism is a research method aiming at helping researchers communicate qualitative assumptions about cause-effect relationships, elucidate the ramifications of such assumptions and drive causal inferences from a combination of assumptions, experiments, observations and case studies. This unique methodology couples the affirmative nature of causal effects tracing measures (such as correlational studies) with the interpretive nature of process tracing schemes usually found in case studies and other qualitative methods. Furthermore, it bridges the gap between the academic interests of research and the prescriptive demands of policy-making. Deductive pragmatism responds basically to the fact that conventional epidemiological models for causation have serious limitations as a source of causal inference. This is particularly true for complex and complicated situations such as the impact of structural adjustment on health, the research for which he invented this methodology. Such an issue involves several reciprocally interacting variables that cannot be accurately accounted for by conventional correlational approaches. Furthermore, a big part of the literature on the impact of structural adjustment encompasses subjective and qualitative assumptions, which lack a sound empirical base in most of the cases. Deductive pragmatism consists of three basic steps; 1) hypotheization of causal relations, 2) verification of causal effects, and 3) tracing of causal processes. The following sections explains each component in details. The invention of this new methodology represented a watershed for research in complicated public health issuesIt liberated public health research from medical and clinical research methods that have been restricted to situations of single or few etiological factors and single. And it has, therefore, opened the door wide for public health research to conveniently and accurately assess the complexities of health-related phenomenon and dilemmas.

Applications of the burden of disease methodology

He made significant contributions to widening the scope of utilization of the burden of disease methodology in public health and health system research. The burden of disease methodology was developed by the World Health Organization in collaboration with the Harvard School of Public Health mainly for the Global Burden of Disease Study. His added-value to this methodology stemmed basically from his unique approaches to data analysis that made the methodology more flexible and applicable to a wide variety of issues. Through these additions, the burden of disease methodology could be more easily utilized for support of health planning, impact assessment, policy development and epidemiological assessment. Among his contributions to this methodology, perhaps, the most significant was his study in 2000 on the burden of liver disease in Egypt. In this study, he assessed the impact of three liver diseases prevalent in the countries, which are hepatitis C infection, hepatitis B infection and Schistosoma mansoni. The study provided, for the first time, an empirical evidence that hepatitis c infection is the leading cause of liver-related mortality and morbidity through liver cirrhosis and hepatocellular carcinoma. His study settled the debate in political and academic circles in Egypt that used to incline towards the assumption that schistosomaisis was the leading liver disease. A subsequent array of epidemiological studies has thereafter proven the conclusion of his study. He also utilized the burden of disease methodology to study and compare health disparities in Europe at the level of municipalities. Furthermore, he used the methodology for projecting future public health impact of cerebral stroke and myocardial infarction in Germany and for comparing the public health effectiveness and cost benefits of various modalities of treatment of hepatitis C disease in Europe. These applications have inspired researchers in various countries to retrace his footsteps in utilizing the burden of disease methodology in public health and health system research.

Methodologies for targeting the poor in health planning

He invented an innovative methodological approach for narrow geographic targeting of the poor in health planning. His invention came when he was requested by the World Bank and Government of Egypt to take the serious decision of deciding on the villages/municipalities in three selected governorates to which 400 million US dollars of investment in health infrastructure should be channeled. He constructed the so-called socioeconomic vulnerability index (SVI), calculated the SVI for all villages/municipalities and ranked them into four quartiles (poorest, lower middle, upper middle and well-off). The result of his work was a fascinating inventory of villages/municipalities ranked according to their socioeconomic situation. The ministry of health requested him to apply his methodology to the whole country and prioritized the poorest villages/municipalities in its health plans.

The statistical analysis for the Socio-economic Vulnerability Index (SVI) had two parts: In the first part, a prediction model for household income was estimated, using the household data of the Egypt’s Demographic and Health Survey (DHS). The DHS included data about household’s income and several socio-economic characteristics for a sample of 1586 households selected from several Governorates in Egypt. The explanatory socio-economic variables in that model were selected so that only variables for which the Central Agency for Public Mobilization and Statistics (CAPMAS) collects data for all villages in the census were included. In the second part, the prediction model was used to calculate the SVI for all villages in Menoufia, using the village-level data of the explanatory variables from the census.

Faculty of Health and Medical Sciences in Pakistan

He was responsible, with financial support from the German government, for the establishment of the Faculty of Health and Medical Sciences within the University of Azad Jammu and Kashmir in Pakistan. The faculty consists of four sections: College of medicine, College of Nursing, College of Medical Technology, and School of Public Health. He worked as the founding dean for five years between 2008 and 2012. The faculty currently provides educational programs at undergraduate and graduate level as well as a wide scope of clinical specialization programs for doctors and nurses.

European Master of Public Health

Yassin worked on the academic team representing German schools of public health in the project for the development of the European Master of Public Health. The project was undertaken under the umbrella of the Association of Schools of Public Health in the European Region with support from the European Union. The project encompassed two components. The first component included studies of the curricula, pedagogical approaches, evaluation systems and graduation criteria of the offered master of public health programs in Europe. The goal of this component was to build consensus among European institutions on a framework for accreditation and mutual recognition of degrees and courses. The second component comprised the development of a new master program that responds to the needs and requirements of the European health systems and incorporates at least 40% of its curricula for European health issues. Currently, the European Master of Public Health is being offered in several European universities and students can complete courses in any of these universities.

Strengthening public health education in South Eastern Europe

He provided significant contributions for the strengthening of public health education and research in south-eastern Europe through his work as a deputy of the project. The project was financed through the Stability Pact of the European Commission and the University of Bielefeld was in charge of the coordination and technical support. The beneficiaries of the support activities included the following institutions: Andrija Stampar School of Public Health, Zagreb, Croatia, Faculty of Medicine, Belgrade, Yugoslavia, Faculty of Medicine, Ljubljana, Slovenia, Faculty of Medicine and Institute of Public Health, Novi Sad, Yugoslavia, School of Public Health, Pristina, Kosovo, Faculty of Medicine, Sarajevo, Bosnia-Herzegovina, Faculty of Medicine, Skopje, Macedonia, School of Public Health, Sofia, Bulgaria, Faculty of Medicine and National Institute of Public Health, Tirana, Albania, and Faculty of Medicine, Varna, Bulgaria.

Support of epidemiology training in Eastern Europe

He supported epidemiology training in Eastern Europe, particularly in Bulgaria, Romania, Poland and the Baltic states, through initiatives of the German Academic Exchange Service and the European Union. His contribution focused on improving the curricular structure and contents as well on modernizing the learning methodologies. His contribution placed a special emphasis on transforming teaching into learning and static pedagogical approaches into more interactive and applied ones.

Center for Strategic Health Studies in Syria

He contributed to the establishment of the Center for Strategic Health Studies in Damascus, Syria that was financed by the European Union. As an EU expert he contributed to the needs assessment, prefeasibility and feasibility studies, strategic and business planning and curricular planning. Currently, the center provides four master programs in public health, health system management, hospital management and health economics. In addition, the center provides a large scope of short courses these four domains.

National Diploma in Health Administration in Yemen

He assisted the Ministry of Health in the Republic of Yemen in establishing the National Diploma in Health Administration. The country was in need for such a training program due to the extreme paucity of qualified health managers at all levels of care. The diploma was financed by the European Union. To plan the diploma program, he first of all started with a need assessment and a rationalization plan for human resources in health services and public health programs. He convinced then the Ministry of Health to amend the nomenclature of management posts and proposed a more practical scheme for adoption. For each of the management posts, he developed a job description including responsibilities, activities, a profile of required competencies and a performance appraisal scheme. Based on these prerequisites he developed the curriculum of the national diploma and detailed the syllabi for each module. He then surveyed the teaching institutions in the country and selected four institutions to deliver the diploma program which include 1) Amin Nashir Institute in Aden, Higher institute for public health in Sanaa, the National Management Development Institute in Sanaa and the Health Institute in Taez. He executed then the training of the teaching faculty in the four institution and supervised the delivery of the program. The program has been running successfully since 2003 and has had a significant role in bridging the gap in health care manager.

Support of School of Public Health at Al-Quds University in Palestine

He contributed to the establishment of the School of Public Health at Al-Quds University in Palestine. He supported the efforts to design and operate the master of public health program, contributed to the teaching faculty development programs, participated in supervision and evaluation of master theses and participated in qualifying Palestinian students at the doctoral level at the University of Bielefeld.

Moreover, he supported the research projects of the Ministry of Health of the Palestinian National Authority. His contribution focused on planning of research, development of study design and statistical analysis.

His contribution to development and reform of health systems is tremendous and worldwide. His portfolio of projects covers 28 countries and exceeded in value 1.2 billion US dollar. He focused on providing technical solutions for the inherited health system problems of underfinancing and lack of resources in developing countries. He supported a strong but rational role of the state in health care provision and committed himself for inventing tools for enhancing efficiency, relevance and transparency of health services. He opposed vertical approaches to health system, cost-recovery schemes as well as over emphasizing primary health care. He advocates the so-called tailored approaches for problem-solving of health sector-wide problems.

Books

• Impact of structural adjustment policies on health in developing countries.
• Management of Child Health Programs in Developing Countries
• Strategy and the 10th Five-Year Plan of the Health Sector in the Syrian Arab Republic.
• Atlas of Health and Health Care in Daraa Governorate.
• Local Patterns of Mortality in Daraa: Spatial Differences, Leading Causes and Years of Life Lost.
• Development of a Diploma Course in Management of Health Services.
• Assessment of Health Needs in Syria: A Qualitative Perspective from Daraa.
• Evaluation of The Diploma Course in Management of Health Services.
• Diagnostic Radiology Technology.
• Anesthesia Technology.
• Surgical Technology.
• Emergency Medical Technology.
• Respiratory Therapy Technology.
• Physical Therapy Technology.
• Dialysis Technology.
• Cardiovascular Technology.
• Female genital mutilation, between science and superstition.
• Menoufia Governorate’s Master Plan For Facility-Based Health Services.
• Sohag Governorate’s Master Plan For Facility-Based Health Services.
• Hospital Care Supply in Syria: Adequacy, Appropriateness and Future Needs.
• Primary Health Care in Syria: Critical Review and Reform Potentials.
• Structural adjustment and health: The truth and the myth.
• Inequalities in Health as assessed by the Burden of Disease Methodology.
• Norms and Standards for Primary Health Care Facilities in Syria.
• Cost and Efficiency of Primary Health Care in Syria: Review of Daraa Governorate.
• Master of Science in Epidemiology and Biostatistics.
• Unraveling the Mystery of Liver Diseases in Egypt.

Papers published in scientific journals

• Levels and Determinants of Caesarean Deliveries in Egypt: Pathways to Rationalization.
• Factors That Predict Demand For Perinatal Care Among Egyptian Women: A Multivariate Logistic Regression Analysis.
• Direct costs for care and glycaemic control in patients with type 2 diabetes in Sudan.
• Quality assurance of the knowledge exchange process: a factor in the success of child health programs in developing countries. International Journal of Health Care Quality.
• The burden of infections and child health in Iraq.
• Decline in the child health indicators: assessing the impact of war in five south-eastern European countries.
• Maternal morbidity in rural upper Egypt: levels, determinants, and care seeking.
• Urging health system research: identifying gaps and fortifying tuberculosis control in Pakistan.
• Prevalence and risk factors of HBsAg in Gaza: implications for prevention and control.
• The epidemiology of hepatitis A infection in Palestine: a universal vaccination programme is not yet needed.
• A zero prevalence of anti-HIV in blood donors in Gaza: how can it be sustained?
• Morbidity and risk factors of diarrheal diseases among under-five children in rural Upper Egypt.
• Incidence and socioeconomic determinants of abortion in rural Upper Egypt.
• Indices and sociodemographic determinants of childhood mortality in rural Upper Egypt.
• Family Planning in Egypt: Inconsistencies between attitudes and practices.
• Decline in maternal mortality ratio in Menoufia, Egypt: An impressive success or a statistical artefact?
• Morbidity, Risk Factors and Home Management of Acute Respiratory Infections among U5 Children in Rural Upper Egypt.
• Patterns and Determinants of Mothers’ Use of Oral Rehydration Solution for Childhood Diarrhea in Rural Upper Egypt.
• Hepatitis C infection in Egypt: Decoupling epidemiology from policy.
• The burden of liver diseases in Egypt: Hepatitis C and not schistosomiasis is the leasing cause.
• Prevalence of Hepatitis C Infection in the General Population and Blood Donors in Palestine.
• Provider choice for maternal care in Egypt: Implications for health system reform.
• Utilization of Antenatal Care in Egypt: Arial Differences and Socioeconomic Determinants.