Background: Out-of-pocket (OOP) health expenditure is a pressing issue in Egypt and far exceeds half of Egypt’s total health spending, threatening the economic viability, and long-term sustainability of Egyptian households. Targeting households at risk of catastrophic health payments based on their characteristics is an obvious pathway to mitigate the impoverishing impacts of OOP health payments on livelihoods. This study was conducted to identify the risk factors of incurring catastrophic health payments hoping to formulate appropriate policies to protect households against financial catastrophes. Methods: Using data derived from the Egyptian Household Income, Expenditure, and Consumption Survey (HIECS), a multiplicative heteroskedastic probit model is applied to account for heteroskedasticity and avoid biased and inconsistent estimates. Results: Accounting for heteroskedasticity induces notable differences in marginal effects and demonstrates that the impact of some core variables is underestimated and insignificant and in the opposite direction in the homoscedastic probit model. Moreover, our results demonstrate the principal factors besides health status and socioeconomic characteristics responsible for incurring catastrophic health expenditure, such as the use of health services provided by the private sector, which has a dramatic effect on encountering catastrophic health payments. Conclusions: The marked differences between estimates of probit and heteroskedastic probit models emphasize the importance of investigating homoscedasticity assumption to avoid policies based on incorrect evidence. Many policies can be built upon our findings, such as enhancing the role of social health insurances in rural areas, expanding health coverage for poor households and chronically ill household heads, and providing adequate financial coverage for households with a high proportion of elderly, sick members, and females. Also, there is an urgent need to limit OOP health payments absorbed by private sector to achieve an acceptable level of fair financing.

The COVID-19 pandemic has significantly altered employment and income distribution, impacting women and men differently. This study investigates the negative effects of COVID-19 on the labour market, focusing on the gender gap in five countries in the Middle East and North Africa (MENA) region. The study indicates whether women are more susceptible to losing their jobs, either temporarily or permanently, switching their primary occupation, and experiencing decreased working hours and income compared to men during the COVID-19 outbreak. The study utilizes a multivariate Probit model to estimate the relationship between gender and adverse labour outcomes controlling for correlations among outcomes. Data are obtained from the Combined COVID-19 MENA Monitor Household Survey, covering Egypt, Tunisia, Morocco, Jordan, and Sudan. The findings of this study offer empirical evidence of the gender gap in labour market outcomes during the pandemic. Women are more likely than men to experience negative work outcomes, such as permanent job loss and change in their main job. The increased childcare and housework responsibilities have significantly impacted women's labour market outcomes during the pandemic. However, the availability of telework has reduced the likelihood of job loss among women. The study's results contribute to a better understanding of the impact of COVID-19 on gender inequality in understudied MENA countries. Mitigation policies should focus on supporting vulnerable women who have experienced disproportionate negative effects of COVID-19.

COVID-19 has caused a global health crisis and severe economic and social consequences. Unprecedented economic disruption and high unemployment are the pronounced impacts of the pandemic. The current study is primarily concerned with the effects of COVID-19-induced labour market outcomes on workers' subjective wellbeing in four MENA countries using the Combined COVID-19 MENA Monitor Household Survey. The study documented that COVID-19-induced labour market changes negatively affected workers' subjective wellbeing after controlling for work characteristics, risks, social distancing, and socio-demographic variables. Job loss, income reduction, and wage delay were the most significant labour changes that deteriorated workers' subjective wellbeing. Our findings underscore the need for policy responses that reduce workers' vulnerability and sustain their livelihoods. Mental health services and income support policies are important tools to enhance subjective wellbeing of economically affected workers.