Iraq's Healthcare System: Organisation, Access for a Foreigner, Emergencies and Health Risks

According to the World Health Organization, the federal Ministry of Health, based in Baghdad, oversees 16 provincial directorates that run the secondary and tertiary hospitals and the primary care services. The Kurdistan region has its own Ministry of Health, which follows national policies while remaining operationally independent, but depends on federal funding. The Ministry of Health is the main provider of curative and preventive care. The private sector coexists: public practice is licensed by the ministry, private practice by the unions of physicians, dentists and pharmacists.

Primary care rests on two levels: large centres, located mainly in the large cities for more than 10,000 inhabitants, and sub-centres in the outskirts and rural areas for 3,000 to 10,000 inhabitants. The count varies depending on sources: about 2,700 centres. For hospitals, a WHO evaluation cites nearly 300 public hospitals spread across 20 governorates and more than 150 registered private hospitals, mostly in the large cities. The WHO describes a system long centred on the hospital, which the ministry is seeking to shift towards primary care and family medicine.

Ministry of Health facilities provide almost all services free of charge, according to the WHO; primary healthcare centres ask for a small registration fee and charges for some diagnostic tests, and medicines are free when available. The WHO also notes that patients often pay out of pocket and that user fees have been introduced; an evaluation by the Organization puts this direct spending at about 45% in the private sector, or on average USD 91 per person per year.

The WHO writes that there is no national health insurance system; only small programmes cover the employees of certain companies and of three ministries. A bill was submitted to Parliament in 2014, and a WHO evaluation indicates that a 2021 law created a voluntary scheme for catastrophic health expenditure; its level of implementation was not confirmed for this page. More recently, the social security law of 17 May 2023 provides for health insurance with public, cooperative and private providers, according to the ILO. A foreigner’s access to this scheme, like its cost, should be confirmed with the employer and the social security directorate. No access conditions for a foreign resident are presented in the France Diplomatie pages.

France Diplomatie names no hospital. It states that insurers can direct their clients to reference hospitals in Baghdad or in the region, which offer life-saving emergency care at standards presented as comparable to those of France and Europe, and that medical evacuations to Dubai or France remain possible. The choice of doctor and facility is therefore made with the assistance provider or the insurer, who knows the approved facilities in the city of residence.

The France Diplomatie Health page lists no Iraqi emergency number: the only emergency number cited is 15, the French SAMU (emergency medical service), for what to do after a stay (the case of fever and breathing difficulties in the context of the MERS coronavirus). On the spot, the emergency call number is obtained from the employer, the assistance provider or the French embassy in Baghdad (+964 790 191 23 65); the consulate general in Erbil shows no telephone number on the page. The road is a risk in itself: France Diplomatie reports frequent and often fatal accidents, which justifies choosing a trusted carrier for medical journeys.

The French ministry recommends taking only the strictly necessary medicines, in their original packaging, with a prescription giving the names as international non-proprietary names, and checking that they are permitted in Iraq. It advises putting together the first-aid kit and treatments for chronic diseases in France, because counterfeit medicines are widespread, and not buying anything from street vendors.

Tap water is not drinkable anywhere in Iraq: poisonings are regularly reported. Water from a sealed bottle or water made safe by filtration, boiling or disinfectant should be preferred, and fruit and vegetables peeled or washed with safe water.

France Diplomatie recommends checking the French vaccination schedule (diphtheria, tetanus, poliomyelitis, whooping cough, measles), then discussing with the doctor or an international vaccination centre hepatitis A, typhoid, meningococcal ACWY (in the dry season, or in the event of a reported epidemic), rabies (young children, rural stay), hepatitis B for frequent or prolonged stays and mpox where there is a risk of exposure.

• Malaria: protection against mosquitoes and, if the doctor advises it, preventive treatment; prompt consultation in the event of fever, including in the weeks following return.
• Cholera: cases have been reported in the Kurdistan region, in particular in the governorate of Sulaymaniyah; prevention through water and food hygiene and, on medical advice, vaccination.
• MERS-CoV coronavirus: no vaccine; hand hygiene, avoiding contact with dromedaries and their meat or milk, and large gatherings.
• Crimean-Congo haemorrhagic fever: transmitted by ticks or contact with the blood and tissues of infected animals; no vaccine.
• Typhoid, meningococcal meningitis, poliomyelitis and avian influenza: prevention through hygiene and vaccination where available.

Because a foreigner’s access to care relies largely on assistance, the contract should be read methodically. Four points deserve a written check:

• Zone covered: the whole of Iraq, or only certain regions; the exclusions linked to the zones advised against by France Diplomatie.
• Network: the reference hospitals in Baghdad or in the region to which the insurer directs, and the possibility of direct settlement rather than an advance of costs.
• Evacuation: the possible destinations (Dubai or France), the conditions for triggering it and the time needed to carry it out.
• Chronic diseases and medical history: acceptance of the risk, the limits and the medicines covered, bearing in mind that the French ministry advises buying chronic treatments in France.

For a stay of several years, the combination of international insurance with evacuation and, depending on status, the French scheme or the CFE (Caisse des Français de l’étranger, the voluntary social security fund for French nationals abroad) meets these requirements better than relying on public facilities alone.

France has no social security agreement with Iraq (CLEISS list; CLEISS is the French Centre for European and International Social Security Liaison): the carte Vitale is not used on the spot. An assistance or insurance contract covering all medical costs, surgery, hospitalisation and medical repatriation is presented by France Diplomatie as essential: without it, access to care can be refused, even in a life-threatening emergency, and the embassy does not pay these costs. Before taking out a contract, check that it covers Iraq and the city of residence, and whether the country or the zone of residence leads to exclusions or surcharges. See the page repatriation and assistance, the guide healthcare reimbursement in Iraq and the page living in Iraq.