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Saudi Arabia Health Care System and Hospital Administration

by Suleman
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Table of Contents

  • Introduction
  • Saudi Arabia
  • Health Care System in Saudi Arabia
  • Health care policies
  • Hospital Administration in Saudi Arabia
  • Conclusion
  • References
  • Bibliography

Introduction

Health of the citizens is one of the key factors for the development of any country. It is a common formula that healthy citizens make a healthy country. But citizens from different country have different health condition. Main reason behind this variance in the health condition is different country has different health care system. It is quite obvious that developed countries have advanced health care system and hence better health condition, but countries, especially from Africa and Asia, which are undeveloped having poor health care condition. Health care system of any country is heavily influenced by the health care policy adopted by that particular country. Hospital administration is an important component of a country’s health care system. Hospital administration generally refers to management of hospital in a particular country. It is actually the key component of any health agencies and/or institutions’ management. Hospital administration is the narrow form of health administration. This paper includes a detailed overview of health care system, health care policy and hospital administration of Saudi Arabia.

Saudi Arabia

Saudi Arabia, formally known as kingdom of Saudi Arabia, was founded by ABD AL-AZIZ bin Abd al-Rahman AL SAUD (Ibn Saud) in 1932. Saudi Arabia is renowned as the birth place of the religion ‘Islam’. The country is also the home of two holiest place in the Islam religion, Mecca and Medina.  Saudi Arabia is a Middle East country with the population of approximately 28 million among which 5.6 million are foreigners. Population growth rate in Saudi Arabia is approximately 1.9%. Capital of Saudi Arabia is Riyadh where almost 3.6 million people live. There are still monarchy type of government exist in Saudi Arabia. Almost 82% of total population of the country live in urban area. Average life expectancy of total population in Saudi Arabia is 76.3 years and almost 78.8% people in the country are officially educated.[1]

Saudi Arabia’s economy is mainly oil based. Almost 20% of total petroleum reserves in world are possessed by Saudi Arabia. Saudi Arabia holds the number one position as far as the export of petroleum is concerned. In 2008, Saudi Arabia’s GDP was $527 billion, 45% of this GDP come form petroleum sector. Saudi Arabia plays an important role in OPEC as it is the largest petroleum exporter. Entire economy is controlled by the Saudi government. In 2008 country’s annual growth rate was approximately 6.1%.[2]

Saudi Arabia Health Care System and Hospital Administration

Health Care System in Saudi Arabia

Health of the citizens is one of the major concerns for any country’s government. It is necessary for any country to have an efficient and effective health care system in order to provide proper health care facilities. A perfect health care system would include everything and everyone starting from the person who is ill, the doctor who will be take care of that illness, the surgeon who will be performing the surgeries, the hospital and/or nursing homes where sick people would be admitted and the department of health of the government who will be taking measures in order to enhance the health care service. Government would also be responsible for deciding upon various health care policies and monitoring the entire health care system of the country.

In the Kingdom of Saudi Arabia various private organization and government agencies operate several hospitals and other primary health care institutions. Saudi Arabia’s ministry of health is the main government agency that provides sufficient health care service for the citizens of the country in order to cure, prevent and rehabilitate.

There is a long history of health care system in Saudi Arabia. In 1926 health care system first started in organized form in the kingdom of Saudi Arabia. A health department was founded by king Abdulaziz. This department was responsible for setting up clinics and hospitals in various cities like Jeddah, Mekkah, Medina and Taif. The first nursing school was established in 1926. Then in 1927 school of health and emergencies was set up. In the same year name of the health department was changed to “General  Directorate for Health and Aid”. It was associated to the Bureau of Attorney General. Under this attorney general a health council was established. This health council included director of health, director of quarantine, the inspector general, Mekkah police commander, mayor of the city, director of endowment and the Eid Zubaidah commission chairman. This council was supposed to meet once in a month and study all the reports coming from different cities and districts. Council used to take actions Based on this study. Main purpose of these activities was improving the quality of health care of the country by protecting people form various epidemics and diseases. Director of health was mainly responsible for implementing and monitoring all the decisions taken by the council. Director was also supposed to provide all the information to the government regarding the health of the people in the country. Since at time there were not enough funds available, the growth of health care was very disappointing.  Till 1946 there were only 300 hospital beds in the entire country. Situation slightly improved after the economic progression that took place after 1946. By 1950 there were hospitals in different major cities like Mekkah, Medina, Riyadh, Taif, jeddah and Al Hassa. Number of clinics was also improved. Total number hospital beds increased form 300 to 1000 and number of physicians increased to 111. In spite of these significant improvements, facilities were not sufficient to serve a large portion of the Saudi population.  

In 1951 a full fledged health ministry was first established under the leadership of King Abdullah Al-Faisal. Actually “General Directorate for Health and Aid” was converted into the ministry of health. Separate health directorates were formed for taking care of clinics, hospitals, equipment and administration in several parts of the country. Since the inception of this ministry of health, Saudi Arabia’s health care system has dramatically improved. By 1973, there were almost 2,900 doctors and 84 hospitals in Saudi Arabia.

Apart from ministry of health other organizations which provide health care service in Saudi Arabia are Saudi Red Crescent society, National Guard, ministry of interior and armed forces. Saudi Red Crescent society is a part of international Red Crescent society and it was formed in 1935 with objective of providing emergency health services. Saudi National Guard started to provide medical services from 1962 after the prince Abdullah bin Abdulaziz came into the power. Saudi national guard, today, own four major hospitals. All the four hospitals are named as King Abdulaziz Medical City and they are located in four major cities in Saudi Arabia namely Riyadh, Jeddah, Dammam, Al Ahsa.  

Saudi armed forces started to provide medical services since 1950. Today there are almost 5000 hospital beds, 6000 nurses and 2500 doctors under the General Department of Armed Forces Medical Services (AFMS). Saudi armed forces provide military services through military hospitals. But these hospitals generally made for armed force members and their family members. Saudi Arabia’s ministry of interior began providing medical services since 1968 with a small dispensary in the capital Riyadh. In 1972 ministry of interior made their first hospital and till then it is continuing to provide medical services to Saudi people.    

Saudi Arabia’s health care system consists of three tiers; primary, secondary and tertiary. In the first tier there are primary health care clinics and centers for providing emergency, prenatal, preventive and mobile clinics for the people who are living in rural areas of Saudi Arabia. In the network of second tier there are hospitals that mainly serve people of urban areas of Saudi Arabia. Tertiary tier consists of specialized hospitals.  

In 1978 World Health Organization issued ‘Alma Ata Declaration’ in which it stated that primary health care should be the key for providing minimum health care for all by 2000. As per this declaration Saudi Arabia’s ministry of health started to build primary health care centers. Today there are almost 1787 primary care centers and each of these centers is providing health care service to 8727 people.[3]

Almost 11.5% of country’s total number of physicians is working in primary health care centers.[4] In Saudi Arabia primary health care is considered as the foundation of health care service and it has been found that most of patients need primary health care. Almost 83% of all the patients need primary health care. Primary health care services can be classified into three different types according to their capacity. Generally primary health care centers cater to three main capacities, 500, 5000, 25000. Large number of primary care centers is evenly distributed in the country to provide medical services to the people living in both rural and urban areas. Saudi ministry of health mainly controls all these primary care services. It is quite clear from these statistics that primary care system in Saudi Arabia has managed to attain success within few years from its implementation. 

In Saudi Arabia all the hospitals and other special treatment providing institutes are part of the secondary care or second tier. Hospitals are mainly run by the ministry of health. Almost 63% of all hospital beds are ministry of health controlled. 2002 estimates say that there are almost 2.3 beds, and 1.5 doctors per 1000 Saudi people. It has also been found that 95% of Saudi population can access clean water for their daily activities and most significantly almost entire Saudi population can access to essential drugs which are affordable. Apart from ministry of health there are other government agencies which run hospitals in the country. In 1993 there were almost 74 hospitals run by the private sector and another 32 hospitals run by other government agencies, whereas there were 174 hospitals which were run by the ministry of health of the country. Major private sector run hospitals are Saudi German Hospital in Jeddah, Saudi ARAMCO Hospital in Dhahran, Social Insurance Hospital in Riyadh, SAAD Medical Centre, in Al Khobar etc.[5]

Today health care system of Saudi Arabia is quite comparable to that of health care systems in developed nations. People of Saudi Arabia today do not go out side of the country in order to get medical services. Government of Saudi Arabia has made several facilities in order to train health professionals so that no human resources shortage situation arises. Today major objectives of health care system in the Kingdom of Saudi Arabia are detection as well as treatments of patients, proper delivery of medicines, improving of diagnostic, treatment facilities and health education. Major challenges faced by health care system of Saudi Arabia are inadequate epidemiologic studies, diversity in the environments of living in rural and urban areas.[6]  

Saudi Arabia Health Care Policies

Ministry of health is responsible for designing various effective health care policies in order to improve the quality of health care in the country. There is a Planning and Development Unit which look after all the aspects of health care planning and its implementation. Generally this unit is led by a deputy minister who is helped by an assistant minister. These two ministers along with a director general look after all the planning, man power development and research. This planning and development unit and the ministry of planning plays important role in designing the five years development plan for the purpose of improving the health of Saudi citizens.

In 1970 country’s first ‘five years health plan’ was developed. But before 1970 there was no such strategic plan to improve the quality of health of Saudi Arabians. Since 1970, every five year plan was made by taking into account the future plans and previous years’ uncompleted plans.

When the first five-year development plan was made, Saudi Arabia was not in a financially strong position. As a result objectives were quite modest as compared to consequent plans. Major objectives of the first five-year plans include improving the standards of diet and sanitation, expanding preventive health service. Government took the policy of increasing the number of professionals in health care and these human resources with more effectiveness. Various studies were undertaken to review the policies so that the future strategies could be made in a more scientific way and the ultimate aim of this study was to the reduction of mortality and morbidity resulted from nutritional deficiencies and various infectious diseases.

In the second five-year plans (1975-1980) main focus was on building health infrastructure. Moreover in this period kingdom was getting financially strong as a result more number of hospitals was built. But this created a huge problem in terms of human resources. There were not sufficient health professionals to run all the health institutes properly. To deal with the problem of manpower shortage ‘The Inter Ministerial Health Manpower Planning Control’ was created. This government body was comprised with ministers of health, planning and higher education and the main objective was to find out strategies to deal with the problem.

The third five-year development plans (1980-1985) were also focused on infrastructure and facilities development. Major objectives of the third five-year plans were to increase the number of health care professionals and improve the administrations of the health care institutions.

During the period of fourth-year development plan (1985-1990) focus was shifted from building infrastructure to maintenance, strengthening and co-ordination. In this period government encouraged private sector to take initiatives in health care industry.      

Fifth development plan (1990-1995) was made to address some new issues which came out in previous years plans. These new issues included problems of new health conditions like chronic health conditions, urban-related and industrial health conditions. Moreover pressure was mounting on government as the spending on health infrastructure was rising. There were also lack of health related data and information. The Fifth development plan was prepared in order to tackle all these problems.

Major issues of sixth development plan (1995-2000) were saudization of human resources in health care, financing health care services and maintaining regional balance in primary health care service distribution.[7]

The seventh five year development plans were expected to be quite similar to that of the sixth development plan. Major issues that were supposed to be addressed in the seventh five year development plan, were efficiency in the utilization of services and reduction of government’s financial burdens.   

As per the Saudi government’s information each and every citizen of Saudi Arabia has access to free and unlimited health care services. Saudi government spends huge amount of money in health care infrastructure building. In 2006 Saudi government allocated 13% of its budget to the health care and social services.[8]

Saudi Arabia’s ministry of health has its own mission which says that it wants to provide integrative and comprehensive health care at all therapeutic, protective, rehabilitation levels in such a way that is not disrespectful to the Islamic principles as well as medical ethics and moreover that would realize various aspects of patient satisfaction. Ministry of health wants to do it by improving the health awareness, promoting the health systems and service levels, even distribution of health care services as well as taking care of Ministry of Health staffs through encouragement, regular training and qualifying.[9]

 Saudi Arabia’s Ministry of health has taken general vision for 2020. According to the information provided in the ministry of health’s own website, general vision for 2020 is to achieve best and maximum possible health condition for the citizens of Saudi Arabia. Ministry of health’s main vision is to form a basic body in order to determine the health policies, to include the services regarding health insurance. Ministry of health also wants to adopt a general health strategy for the entire nation. This strategy would focus on the main causes of diseases which include nutrition, AIDS, smoking, injuries and accidents. General vision also includes formation of such a method in the health care system which would be effectively measuring the associated risks as well as the advantages.[10]

Hospital Administration in Saudi Arabia

Prior to 1946 there were hardly any hospitals in the Kingdom of Saudi Arabia which is reflecting the poor health care system of the country. Till 1946 total number of beds in all the hospitals of the country was only 300. But after 1946 an economic development was seen in the Kingdom of Saudi Arabia and this had a significant effect in the health care system in the country. By 1950 there were hospitals in different major cities like Mekkah, Medina, Riyadh, Taif, jeddah and Al Hassa. As a consequence there was significant rise in the number of hospitals bed which increased form 300 to 1000 and number of physicians increased to 111. Number of primary health care clinics was also increased significantly. Situations really improved when a full fledged ministry of health was appointed in the country to look after all the health related issues of Saudi citizens. By 1973, there were almost 2,900 doctors and 84 hospitals in Saudi Arabia.[11] Since the creation of the ministry of health, it is the main controller of most of the hospitals in the country. It has been found that almost 63% of hospitals in the Kingdom of Saudi Arabia are run by the ministry of health. Apart from ministry of health there are other government agencies and various private organizations that operate several hospitals in the country. National Guard and the Armed forces of Kingdom of Saudi Arabia run some hospitals which mainly serve the members of respective organizations and their families. Major private sector run hospitals are Saudi German Hospital in Jeddah, Saudi ARAMCO Hospital in Dhahran, Social Insurance Hospital in Riyadh, SAAD Medical Centre, in Al Khobar etc.

According to the information given by the ministry of health of Saudi government, increase in number of hospitals from the year 1989 to the year 1993 is quite significant. Following table provides a clear view about the situation of hospitals in the country. 

1409/1410H. 1413/1414H INCREASE PERCETN
-1989 -1993 (number)
(number) (number)
Hospitals
Ministry of Health 162 174 12 7.4
Other Government Agencies 30 32 2 6.7
Private Sector 61 75 14 22.9
Total 253 281 28 11.1
Hospital Beds :
Ministry of Health 25,918 26,974 1,076 4.1
Other Government Agencies 6,592 7,338 746 11.3
Private Sector 6,445 7,477 1,032 16
Total 38,955 41,789 2,834 7.3
Primary Health Centers of 1,640 1,707 67 4.1

It is quite clear from the above figure that in 1989 there were 25,918 beds in 162 ministry of health operated hospitals whereas in 1993 number of beds raised to 26,974 as the number of hospitals raised to 174. It is also found that private sector played an important role in the country’s health care as in 1993 there were almost 75 private sector hospitals consisting of 7,477 beds. [12]

In the Kingdom of Saudi Arabia each and every hospital has its own board that control and monitor the entire operation of the hospital. Hospital board is the top body in the hospital administration. Apart from hospital board there are hospital super, doctors, nurses and other supporting stuffs in the hospital administration. Recently Saudi Arabia government has decided that all the existing boards of those specialized hospitals that are operated by the ministry of health, are going to be changed. Government is actually planning to replace these boards of administration by a single board. This new board will be in action for next three years under the leadership of the minister of health.[13]  

Conclusion

“Healthy citizen, healthy nation” this is supposed to be the ultimate objective of the health care policy of any country’s government which is concerned about the condition of the health of its citizens. Kingdom of Saudi Arabia is found to be quite concerned regarding the health issues. Ministry of health is the top government authority that looks after the entire health care system of the country. It forms various policies and strategies in order to improve the overall health condition of the country. Like any other countries in Saudi Arabia also hospitals are the main health care service providers but there are large numbers of primary health care centers. Finally it can be concluded that in Saudi Arabia health care system and the policies adopted by the government are likely to lead the overall health condition to a satisfactory level in the upcoming years.

References:
  • Background Note: Saudi Arabia, (January 2009). U.S. Department of State, [online]. [Cited on October 13, 2009] available from World Wide Web: http://www.state.gov/r/pa/ei/bgn/3584.htm
  • Cavendish, M. (2006), World and Its Peoples: The Middle East, Western Asia, and Northern Africa, Marshall Cavendish.
  • Country Profile: Saudi Arabia, (September 2006). Library of Congress – Federal Research Division, [online]. [Cited on October 13, 2009] available from World Wide Web: http://www.unhcr.org/refworld/pdfid/46f913560.pdf
  • Engel, J. Pedley, T. A. Aicardi, J. Dichter, M. A. (2007), Epilepsy: A Comprehensive Textbook, Volume 1, Lippincott Williams & Wilkins
  • General Vision for the Year 2020, (January 15, 2007). Ministry of Health, [online]. [Cited on October 13, 2009] available from World Wide Web: http://www.moh.gov.sa/en/modules/mysections/article.php?lid=4
  • Jones, R. (2004), Oxford textbook of primary medical care, Volume 1, Oxford University Press
  • MOH Mission, (January 2007). Ministry of Health, [online]. [Cited on October 13, 2009] available from World Wide Web: http://www.moh.gov.sa/en/modules/mysections/article.php?lid=3
  • Mufti, M. H. (2000), Healthcare development strategies in the Kingdom of Saudi Arabia, Springer
  • Quality of primary health care in Saudi Arabia: a comprehensive review, (2005). Hanan Al-Ahmadi, Martin Roland, [online]. [Cited on October 13, 2009] available from World Wide Web: http://intqhc.oxfordjournals.org/cgi/reprint/mzi046v1.pdf
  • Saudi Arabia to Restructure Hospital Boards, (August 25, 2009). Hospital Management.net, [online]. [Cited on October 13, 2009] available from World Wide Web: http://www.hospitalmanagement.net/news/news62821.html
  • Saudi Arabia Health Services, (No Date). The Saudi Network, [online]. [Cited on October 13, 2009] available from World Wide Web: http://www.the-saudi.net/saudi-arabia/health-services.htm
  • The world Fact Book, (September 30,2009). Central Intelligence Agency, [online]. [Cited on October 13, 2009] available from World Wide Web: https://www.cia.gov/library/publications/the-world-factbook/geos/sa.html
  • The Healthcare System of Saudi Arabia, (No Date). Helen Zeigler & Associates, [online]. [Cited on October 13, 2009] available from World Wide Web: http://www.hziegler.com/locations/middle-east/saudi-arabia/articles/healthcare-system-of-saudi-arabia.html

Bibliography;
  • Akhter, R. (2002), Urban health in the third world, APH Publishing
  • Federal Research Division, (2004), Saudi Arabia A Country Study, Kessinger Publishing
  • Ham, A. Shams, M. B. Madden, A. (2004), Saudi Arabia, Lonely Planet
  • [1] The world Fact Book, Central Intelligence Agency, (September 30,2009).
  • [2] Background Note: Saudi Arabia, U.S. Department of State, (January 2009).
  • [3] Quality of primary health care in Saudi Arabia: a comprehensive review, Hanan Al-Ahmadi, Martin Roland, (2005).
  • [4] Roger Jones, Oxford textbook of primary medical care, Volume 1, (Oxford University Press, 2004)
  • [5] The Healthcare System of Saudi Arabia, Helen Zeigler & Associates
  • [6] Jerome Engel, Timothy A. Pedley, Jean Aicardi, Marc A Dichter, Epilepsy: A Comprehensive Textbook, Volume 1 (Lippincott Williams & Wilkins, 2007)
  • [7] Mohammed H. Mufti, Healthcare development strategies in the Kingdom of Saudi Arabia, (Springer, 2000).
  • [8] Country Profile: Saudi Arabia, Library of Congress – Federal Research Division, (September 2006).
  • [9] MOH Mission, Ministry of Health, (January 2007).
  • [10] General Vision for the Year 2020, Ministry of Health, (January 15, 2007).
  • [11] Marshall Cavendish, World and Its Peoples: The Middle East, Western Asia, and Northern Africa, (Marshall Cavendish, 2006).
  • [12] Saudi Arabia Health Services, The Saudi Network,
  • [13] Saudi Arabia to Restructure Hospital Boards, Hospital Management.net, (August 25, 2009).

 

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