CHP300 : Community Health Program-l

Health System in Saudi Arabia

CHP300:CHP300:

Community Health Community Health Program-lProgram-lMohamed M. B. Alnoor


• To know why should a medical student understand the health system• To understand what is a health system• To know the components of a health system • To Know the strengths and weaknesses of the current health system• To Know the Cooperative Health Insurance

in KSA• To know the challenges facing the current Saudi health system• To know the future changes in the Saudi Health System Strategy

Lecture Objectives


Lecture ObjectivesWhy should a medical student understand the health system

•You belong to it (you are part of the system)• To participate in the system’s improvement process• To understand the medico-legal aspects of patient care


What is Health:

Definitions

Health System

(WHO) 1948

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”


Definitions

What is a Health System ?A health system is the sum total of all the organizations, institutions and resources whose primary purpose is to improve health.

Health System

What is a System ?

A SET OF INTERRELATED AND INDEPENDENT PARTS DESIGNED TO ACHIEVE A SET OF GOALS.


A health system needs to provide services that are: Responsive,

Financially fair,

Treating people decently.

(WHO)

Health System Needs


Financing Resources Legislative Authorities Health Regulators Health Care Providers Human Resources Medical supplies providers Pharmaceutical producers Judiciary Services

Health System: Components


Financing Resources:Governmental 5.9% of GNP in 2006. Out of pocket. Charity. Donation.



Legislative Authorities:

The Royal Cabinet:

Al Shora Council

The Bureau of Experts



Health Regulators:

The National Organizations:

The National Health Council Ministry of healthThe Saudi Commission for Health Specialties Council of Co-operative Health Insurance The Saudi Food and Drug Authority



Health Care Providers:• Ministry of Health• Ministry of Defense and Aviation• National Guards• Ministry of Interior• Specialized Hospitals (KFSH, KKESH)• Universities (Ministry of Higher Education)



Health Care Providers:• Ministry of Social welfare• The Private Health Providers • The big Companies: Saudi Aramco, SABIC, Saudi Electric Company, Saudi Airlines • Charity Health Providers• The Saudi Red Crescent



Health Care Providers:

MOH 58.5%

Private Sector 23 %

Other GovernmentalSectors 18.7%

Hospital Beds distribution according to sectors

Source: MOH Annual report 2007



SECTOR

14091427

#OFHOSPITALS

#OFBEDS

#OFHOSPITALS

#OFBED

S

MINISTRYof HEALTH

16225 91822031 877

OTHER GOVERNM.

306 5923910 257

PRIVATE SECTOR

616 44512712 590

TOTAL25338 95538654724





PRIMARY HEALTH CARE

SECONDARY HEALTH CARE

TERIEARY HEALTH

CARE

Level of Care

>2000

Around 400



Human Resources:

Professionals Nationalities Gender Cultural

Backgrounds



Medical supplies providers:•Medical supplies (consumables)• Medical Equipment• Medical Instruments• Medical Devices Around 30 Medical Supplies Factories in KSA



Pharmaceutical Producers:

• Medications

• Medical Solutions

• Immunizations


Judiciary Services

Committee for Private sector violations Medico-legal committee. Health Insurance Violation Committee




Ministry of Health Organizational Chart

Health System in Saudi ArabiaMinistry of Health Organizational Chart

الوزير

وكيل الوزارة

للشئون التنفيذية

الوزارة وكيلو للتخطيط

التطويروكيل

الوزارة المساع

دللطب الوقائ

ى

وكيل الوزار

ة المسا

عدللطب العالج

ى


المساعد العداد

تطوير و القوىالعاملة


المساع

دللتخطي

طو

البحوث


Distribution of Provinces (13)


Province Organizational Chart


Province Organizational Chart

الصحية المدير للشئونالعام

التوعية و االعالم ادارةالصحية

الطبية اللجنةالمتابعة الشرعية ادارةالفنية

و االدارى المستشارينالمخلفات الفنى لجنة

ضمان الطبية ادارةالجودة

المساعد و للتخطيط

التطوير

المساعد للمستش

فيات

المساعد

للتموين

الطبى

المساعد المالى

واالدا رى

المساعد للرعاية الصحية األولية

للتخطيط المساعدالتطوير و


Role of Provincial Health Director

• Manage Patient Care • Supervise the private sector • Supervise reporting of infectious diseases among all health providers • Co-operate with health related agencies • Participate in the health development planning


STRENGTHS AND WEAKNESSES OF THE CURRENT HEALTH SYSTEM

Strengths:

• Universal (covers everybody) (NHS)• Accessible• Comprehensive ( primary, secondary and tertiary)• Safe• Equitable


Weaknesses:

Single source financing dependent Multi - sectoral:

o Duplication of services among Providers

o Difficult to Co-ordinateo Waste of resources

STRENGTHS AND WEAKNESSES OF THE CURRENT HEALTH SYSTEM


CHALLENGES FACING THE CURRENT HEALTH SYSTEMFinancial

1956: 39.549.458 SR1958: 68.480.000 SR1960: 116.395.000 SR

2009: 40.43 billion SR 2010: 61.20 billion SR 2011: 68.70 billion SR

Budget allocated to the health sector by the Ministry of Health :


CHALLENGES FACING THE CURRENT HEALTH SYSTEMFinancial

Data for decision-making/policy-making .ManpowerPopulation:

Growth Aging Demanding

Changes in Disease patterns (NCD) New medical technologies and new medications


The overall development boom Population growth of 3.1% per

annum Expatriate workers ( seven

millions) Increased demand on health

services Rise in the cost of health care

HIGH COST OF HAELTH HIGH COST OF HAELTH CARE CARE


A delivery system that prevents abuse and

excessive use a managed health care model,

under theCooperative Health Insurance

HIGH COST OF HAELTH HIGH COST OF HAELTH CARE CARE


Islamic Cooperative Insurance (Takaful)Sudan in 1979 and Malaysia in 1984Followed by :IndonesiaBruneiSaudi ArabiaBahrain Qatar.

Health InsuranceThe Cooperative Health Insurance in KSA

Recently, UAE, Kuwait, Egypt and Bangladesh


Act and Laws1985 : Royal Decree No

(M/5)1999, Cooperative Health Insurance Act .Based on Islamic ‘Takaful’

Aimed at covering ultimately the whole Saudi and non Saudi population.

Health InsuranceThe Cooperative Health Insurance in KSA(Takaful)

2003: control law of cooperative insurance companies. 2005: compulsory for all non-Saudis(private sector)2008: included Saudis (private sector )

May 2009: bylaws were declared


Pros and ConsPros H.I. became the largest insurance business:By 2011: 8.3 million health insured individuals,

2,147 Health Care Providers accredited 26 Health Ins. Co. certifiedFuture : 2011-2020: up to 40,000 job opportunities . 2016: will be worth US$18 Billion.

Health InsuranceThe Cooperative Health Insurance in KSA(Takaful)

Cons Continuous increase of health care cost Lack of compliance with the Shariaa laws


Proposed Health Reforms 1] Sectoral coordination:(National Health Services Council )2] Health

manpower(Labor Force Council in Saudi Arabia) 3] Financing health

care

Future changes in the Saudi Health System Strategy


Proposed Health Reforms 4] The function of the Ministry of Health 5] Relevant Data and Statistics

6] Improve the Pharmaceutical Sector

Future changes in the Saudi Health System Strategy

CHP300 : Community Health Program-l

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