Prof. Dr. Reda Khalil
1 Executive Summary
Located in the southwest corner of Asia, the Kingdom is at the crossroads of Europe, Asia and Africa. It is surrounded by the Red Sea on the West, by Yemen and Oman on the South, the Arabian Gulf and the United Arab Emirates and Qatar on the East, and Jordan ,Iraq and Kuwait on the North. The climate of the Kingdom is arid, with great extremes of temperature in the interior; humidity and temperature are both high along the coast.
The healthcare system in Saudi Arabia can be classified as a national health care system in which the government provides health care services through a number of government agencies. In the meantime, there is a growing role and increased participation from the private sector .
The Ministry provides primary health care (PHC) services through a network of health care centers (comprising 2037) throughout the kingdom.
It also adopts the referral system which provides curative care for all members of society from the level of general practitioners at primary health centers to advanced specialist curative services through a broad base of general and specialist hospitals (224 Public hospitals). The MOH is considered the lead Government agency responsible for the management, planning, financing and regulating of the health care sector.
The Ministry is seeking to implement a new reform project of integrated & comprehensive health care system . On project completion, the proposed program would reflect an integrated system of healthcare facilities and a well-coordinated organizational structure across all healthcare levels.
The proposed project leans upon strengthening and restructuring of the health facilities affiliated with the MOH, focusing on the needs of beneficiaries and the service quality rather than a hospital-based health system With encouragement from the public sector, the private sector has contributed to the provision of health services through:
- the provision of curative services through 145hospitals with 11833 beds, or 22 percent of all hospital beds in the Kingdom;
- the provision of health care through 1944 dispensaries and 217 clinics;
- the provision of drugs and medicines through 6022 pharmacies with a rate of one pharmacy per / 4213 people;
Through the implementation of the health insurance scheme to expatriates, the private sector provided 21% of total hospital-bed capacity, compared with 20.6% in 2004; 30.1% of total physicians, and 22.5% of the total nursing staff, compared with 21.5% in 2004. In the same year, the private health sector comprised 125 hospitals, with a total of 11,833 beds1944 dispensaries and clinics 6022 pharmacies; and 398 drug warehouses.
The integration of services is applied through implementation of referral system among primary, secondary and tertiary care levels. But, more integration is needed through adopting an integrated health information system.
The curative care constitute 65,7% of the total health expenditure , while primary health care expenditure reached 30,8% in 2008.
Provision and Saudization of medical and health employment have been a central themes in the MOH policy. In 2008 - 2010, the share of Saudi nationals in medical and health employment was 21.6% for physicians, 28.8% for nursing staff, and 59.1% for ancillary medical workers. Clearly, indigenization of jobs in health are still low, especially for physicians and nursing staff.
As for Access of care of health services at the Kingdom, there are 2037 primary health centers distributed all over the Kingdom and belong to the MOH in 2009. The number of hospitals in MOH is 244 and the number of beds available all over the Kingdom is 5932 ,where 59,4 % are public and belongs to MOH.
The utilization pattern for using these services showed that
- The total number of visits to health centers , private clinics, and hospitals , of different health sectors in the Kingdom was about 131 million visits in 2009 with an average of 524732 visit / day.
- The average rate of visits to all health facilities ( governmental and nongovernmental ) people / year was 5,2 visit / individual / year.
The total number in inpatients in the hospitals of all sectors in the Kingdom was 3,042,465 , 54,4 % of them were in the MOH hospitals. While the rate of beds / people is 2,2 beds . this means that there is one bed for 454 people.
A new standard was set for PHC centers to have one centre per 7,000 Saudis is envisaged by 2014 with introducing family doctor approach in all PHC centers and having a family doctor / 2000 Saudis.
This will be done through:
a Integrated system of health facilities including:
- 2836 health center
- 14 peripheral Hospital (a)
- 104 peripheral hospital (b)
- 120 general hospital
- 62 central hospital
- 5 medical cities
All the aforementioned facilities are to be fairly distributed over the cities and villages of KSA.