The kingdom of Saudi Arabia is a relatively young nation compromising of 13 provinces and one of the largest countries in the Middle East at 2.4 million square kilometres (WHO, 2004). Saudi Arabia enjoys a vast oil reserve in the world. Oil affluence has led to an increased improvement in socio-economic cycle in recent years causing a remarkable impact on wellbeing and lifestyle (AL-Dossary et al, 2008). Latest population figures show that the kingdom has reached a population of 24,573,000, with 10,690 being under the age of 18 years.
Health services are provided by the Ministry of health, other entities in the government sector, and the private health sectors. The structure of a health system is different from one nation to another and even within the same nation. It also varies over time as nations expand and adjust their health systems to accommodate new health requirements within the limits of socio-cultural and economic indicators and population expectations. Therefore, this essay aims to present an overview of current health care systems in Saudi Arabia.
According to Sebai (1985), Saudi Arabia has the largest health care sector in the Middle East with complex organisations that are in a constant process of change and evolution. Dentistry is one of the very small component of the wider health care system, which is itself part of the overall social welfare system within society (Littlewood & Yousuf, 2000). The Saudi Arabian government has committed enormous recourses to improve the health care, with the ultimate goal of providing free and accessible health care services for every Saudi citizen and expatriate working within the public sector. On the other hand, workers in private sectors are sponsored by their employers. Health care financing in Saudi Arabia is provided primarily from the government budget, which is largely based on oil and gas revenues (AL-Yousuf et al, 2002). The total expenditure on health is 3.8 % of GDP, with 77.1% from government and 22.9 % from private expenditure (WHO, 2005). Health services are provided by three health sectors: ministry of health, other government sector, and private sectors. The Ministry of Health provides 60% of the healthcare services, the other governmental agencies and the private sector provide the remaining 40% (Abu-Zinadah, 2006).In this regard, the following section provides a brief description of each sector in the kingdom of Saudi Arabia.
Ministry of Health
The Ministry of Health was established by King Saud in1950. The ministry is the biggest provider of health care in Saudi Arabia; it serves a population of around 20 million (MOH, 1999). It provides primary health care through a system of fundamental healthcare centres in the whole country and with a referral system to severe and advanced health care through a broad base of common and specialist hospitals. Additionally, each region has dental clinic that acts as a referral centres for the dental clinics attached to the health centres and hospitals. Furthermore, the ministry is also responsible for strategic planning, formulating health policies, supervising, and monitoring all health related programmes in the country.
There exist five chest health centers that offer inpatient services for people with chest problems and three tuberculosis centers that deal with case detection, follow-up healthcare, and rehabilitation by the help of outpatient services. Rehabilitation centers are concerned with speech and hearing treatment, repair of accident related injuries, and physiotherapy; these centers are eight in number. Five central laboratories act as complementary health centers in the range of hospital laboratories. Moreover, catering for smokers is an essential requirement in the health sector and thus ant-smoking clinics offer counseling, education, and rehabilitation (MOH, 1999).
A Regional Director General of Health Services is assigned to each of the 19 health regions. The director directly reports to the Deputy Minister concerned with Health for Executive Affairs. Each health regional directorate has several health departments. Each health department control at least one general hospital and several health centers, school health services, health offices, and the private health sector within its domain. The strategies, plans, and developments of the MOH are constituted through this facet. The directorates are sensibly independent in regards to employee selection and recruitment, training, and evaluation. However, some liabilities are shared with the MOH when necessary. Links to other health-related sectors (e.g. education, agriculture, municipal and rural affairs) are maintained through departmental coordinators.
Other Government Sectors
Other governments sectors such as Ministry of Defense and Aviation, the Ministry of National Guard, universities (and affiliated teaching hospitals), large multinational corporations such as Saudi Armco Oil Company, and some specialist hospitals also deliver health care directly to their employees. Furthermore, the Ministry of education offers both protective and remedial fundamental care by means of school health centers, integrating dental examinations with referral to the resultant level. As a requirement, these services are not offered to members of neighboring communities, and where such groups of people are lacking services, it is the duty of the MOH to offer them. Similarly, other government sectors provide the same services as MOH with regard to ambulatory and inpatient care.
Private sectors comprise health centers such as dental clinics, dispensaries, and pharmacies. These amenities are typically situated in urban centers. Additionally, health services in private sectors differ from basic medical and dental care to highly organized specialist (AL-Yousuf et al, 2002). Health care in the private sectors has dramatically increased in the kingdom and is coordinated within the referral network that includes hospitals, clinics, dispensaries and pharmacies (AL-Yousuf et al, 2002; United Nation, 2007).
Weaknesses in the Health System
Despite the previously mentioned widespread and free healthcare in every area in Saudi Arabia, some chronic health problems are noticeably rising among people such as dental caries. This is due to minimal efforts placed on avoidance and public health. For example, dentist and hygienist do not get rewards for prevention, so they do not put effort on any prevention program. Another weakness we can observe in health services is that many professionals, especially who work in primary care clinics are not allowed to have Educational leave, and even face difficulties getting permission to attend conferences or seminars. Besides, they do not have internet to access medical journals, thus not enough facilities for the workers to update their knowledge. This has contributed to improper diagnosis, inadequate management of a wide range of medical conditions and inappropriate clinical decisions.
Proper health care can be achieved when there are enough finances to support the costly diagnostic tests and processes, and lengthy stays for inpatients. The structure of the Saudi health system comprises of the Ministry of Health, other government sectors, and private health sectors. However, there exists some sort of duplication of services among the key players in the health system. This could be dealt with through proper and feasible control of health services. In addition, effectiveness in distribution and utilization of health facilities should be increased. Lastly, the outreach services of the PHCC should be adjusted to meet the health requirements. The people, and the people’s health ‘wants’ which reflect their socio-cultural background should be given attention in health planning. These measures will additionally improve the functioning of the health care system in Saudi Arabia and thus enhance the people’s welfare.