Transcript 4 main hsksa SV (2)

Health System
in Saudi Arabia
CHP300:
Community Health Program-l
Mohamed M. B. Alnoor
Health System in Saudi Arabia
Lecture Objectives
•
•
•
•
•
•
•
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
Health System in Saudi Arabia
Lecture Objectives
Why 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
Health System in Saudi Arabia
Health System
Definitions
What is Health:
“Health is a state of complete physical,
mental and social well-being and not
merely the absence of disease or infirmity”
(WHO) 1948
Health System in Saudi Arabia
Health System
Definitions
What is a System ?
A SET OF INTERRELATED AND
INDEPENDENT PARTS DESIGNED TO
ACHIEVE A SET OF GOALS.
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 in Saudi Arabia
Health System Needs
A health system provides services
that are:
 Responsive,
 Financially fair,
 Treating people decently.
(WHO)
Health System in Saudi Arabia
Health System Components
 Financing Resources
 Legislative Authorities
 Health Regulators
 Health Care Providers
 Human Resources
 Medical supplies providers
 Pharmaceutical producers
 Judiciary Services
Health System in Saudi Arabia
Health System: Components
Financing Resources:
Governmental
5.9% of GNP in 2006.
 Out of pocket.
 Charity.
 Donation.
Health System in Saudi Arabia
Health System: Components
Legislative Authorities:
The Royal Cabinet:
 Al Shora Council
 The Bureau of Experts
Health System in Saudi Arabia
Health System: Components
Health Regulators:
The National Organizations:
 The National Health Council
 Ministry of health
The Saudi Commission for Health
Specialties
 Council of Co-operative Health
Insurance
 The Saudi Food and Drug Authority
Health System in Saudi Arabia
Health System Components
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 System in Saudi Arabia
Health System Components
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
cont.
Health System in Saudi Arabia
Health System: Components
Health Care Providers:
Hospital Beds distribution according to sectors
Private Sector 23
%
20%
Other
Governmental
Sectors 18.7%
20%
MOH 58.5%
60%
Source: MOH Annual report 2007
Health System in Saudi Arabia
Health System: Components
Health Care Providers:
1409
1427
# OF
HOSPI
TALS
# OF
BEDS
# OF
HOSPI
TALS
# OF
BEDS
MINISTRY
of HEALTH
162
25 918
220
31 877
OTHER
GOVERNM.
30
6 592
39
10 257
PRIVATE
SECTOR
61
6 445
127
12 590
TOTAL
253
38 955
386
54724
SECTOR
Health System in Saudi Arabia
Health System: Components
Health Care Providers:
Level of Care
>2000
Around 400
PRIMARY HEALTH CARE
SECONDARY
HEALTH CARE
TERIEARY
HEALTH
CARE
Health System in Saudi Arabia
Health System: Components
Human Resources:




Professionals
Nationalities
Gender
Cultural Backgrounds
Health System in Saudi Arabia
Health System: Components
Medical supplies providers:
•Medical supplies (consumables)
• Medical Equipment
• Medical Instruments
• Medical Devices
Around 30 Medical Supplies
Factories in KSA
Health System in Saudi Arabia
Health System: Components
Pharmaceutical Producers:
• Medications
• Medical Solutions
• Immunizations
Health System in Saudi Arabia
Health System Components
Judiciary Services
 Committee for Private sector
violations
 Medico-legal committee.
 Health Insurance Violation
Committee
Health System in Saudi Arabia
Ministry of Health Organizational Chart
‫‪Health System in Saudi Arabia‬‬
‫‪Ministry of Health Organizational Chart‬‬
‫الوزير‬
‫وكيل الوزارة‬
‫للتخطيط و التطوير‬
‫وكيل الوزارة‬
‫للشئون التنفيذية‬
‫وكيل‬
‫الوزارة‬
‫المساعد‬
‫للطب‬
‫الوقائى‬
‫وكيل‬
‫الوزارة‬
‫المساعد‬
‫للطب‬
‫العالجى‬
‫وكيل‬
‫الوزارة‬
‫المساعد‬
‫العداد‬
‫و تطوير‬
‫القوى‬
‫العاملة‬
‫وكيل‬
‫الوزارة‬
‫المساعد‬
‫للتخطيط‬
‫و البحوث‬
Health System in Saudi Arabia
Distribution of Provinces (13)
Health System in Saudi Arabia
Province Organizational Chart
‫‪Health System in Saudi Arabia‬‬
‫‪Province Organizational Chart‬‬
‫المدير العام للشئون الصحية‬
‫المساعد للتخطيط‬
‫و التطوير‬
‫اللجنة الطبية الشرعية‬
‫ادارة المتابعة الفنية‬
‫ادارة االعالم و التوعية الصحية‬
‫المساعد للتخطيط‬
‫و التطوير‬
‫المساعد للرعاية‬
‫الصحية األولية‬
‫المستشارين االدارى و الفنى‬
‫لجنة المخلفات الطبية‬
‫ادارة ضمان الجودة‬
‫المساعد‬
‫للمستشفيات‬
‫المساعد‬
‫المالى‬
‫واالدارى‬
‫المساعد‬
‫للتموين‬
‫الطبى‬
Health System in Saudi Arabia
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
Health System in Saudi Arabia
STRENGTHS AND WEAKNESSES OF THE
CURRENT HEALTH SYSTEM
Strengths:
• Universal (covers everybody) (NHS)
• Accessible
• Comprehensive
( primary, secondary and tertiary)
• Safe
• Equitable
Health System in Saudi Arabia
STRENGTHS AND WEAKNESSES OF THE
CURRENT HEALTH SYSTEM
Weaknesses:
 Single source financing dependent
 Multi - sectoral:
o Duplication of services among
Providers
o Difficult to Co-ordinate
o Waste of resources
Health System in Saudi Arabia
CHALLENGES FACING
THE CURRENT HEALTH SYSTEM
Financial
Budget allocated to the health sector
by the Ministry of Health :
1956: 39.549.458 SR
1958: 68.480.000 SR
1960: 116.395.000 SR
2009: 40.43 billion SR
2010: 61.20 billion SR
2011: 68.70 billion SR
Health System in Saudi Arabia
CHALLENGES FACING
THE CURRENT HEALTH SYSTEM
Financial
Data for decision-making/policy-making .
Manpower
Population:
 Growth
 Aging
 Demanding
Changes in Disease patterns (NCD)
 New medical technologies and
new medications
Health System in Saudi Arabia
HIGH COST OF HAELTH CARE





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
Health System in Saudi Arabia
HIGH COST OF HAELTH CARE
A delivery system that prevents
abuse and excessive use
a managed health care model,
under the
Cooperative Health Insurance
Health System in Saudi Arabia
Health Insurance
The Cooperative Health Insurance in KSA
Islamic Cooperative Insurance (Takaful)
Sudan in 1979 and Malaysia in 1984
Followed by :
Indonesia
Brunei
Saudi Arabia
Bahrain
Qatar.
Recently, UAE, Kuwait, Egypt and
Bangladesh
Health System in Saudi Arabia
Health Insurance
The Cooperative Health Insurance in KSA(Takaful)
Act and Laws
1985 : Royal Decree No (M/5)
Based on Islamic ‘Takaful’
1999, Cooperative Health Insurance Act .
Aimed at covering ultimately the whole Saudi
and non Saudi population.
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
Health System in Saudi Arabia
Health Insurance
The Cooperative Health Insurance in KSA(Takaful)
Pros and Cons
Pros
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. certified
Future : 2011-2020: up to 40,000 job opportunities .
Cons
2016: will be worth US$18 Billion.
Continuous increase of health care cost
Lack of compliance with the Shariaa laws
Health System in Saudi Arabia
Future changes in the Saudi
Health System Strategy
Proposed Health Reforms
1] Sectoral coordination:
(National Health Services Council )
2] Health manpower
(Labor Force Council )
3] Financing health care
Health System in Saudi Arabia
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
Health System in Saudi Arabia
Future changes in the Saudi
Health System Strategy
Proposed Health Reforms
1] Sectoral coordination:
(National Health Services Council )
1- Coordinating and integrating all health system elements
2- Optimal utilization of facilities and resources
3- Alternatives for the operation and financing services.
4- Specific criteria for new health facilities.
5- Ensuring regional balance
6- Selecting adequate health insurance alternatives.
7- Health services studies and research.
Health System in Saudi Arabia
Future changes in the Saudi
Health System Strategy
Proposed Health Reforms
2] Health manpower (Labor Force Council )
1- Private colleges.
2- Hospitals own training centers.
3- Expand on the postgraduate
4- Strengthen the role of the SCFHS
3] Financing health care
1- Cooperative HIS.
2- Private sector :financing, construction and management
3- Better coordination and integration between government
health agencies
Health System in Saudi Arabia
Future changes in the Saudi
Health System Strategy
Proposed Health Reforms
4] The function of the Ministry of Health
1- Regulations and control rules.
2- Public health services and PHC
3- Disadvantaged access to health care.
4- Strategies and general plans..
5] Relevant Data and Statistics
All Sectors should:
1- Promote evidence based policy-making.
2- Combining/coordinating the multiple systems and the private.
3- Quality : facilities and manpower.
Health System in Saudi Arabia
Future changes in the Saudi
Health System Strategy
Proposed Health Reforms
6] Improve the Pharmaceutical Sector
1- List of essential medicines.
2- Substitute or generic medicine.
3- Training physicians on logical use of medicines
4- Develop medicine-pricing system
5- Storage and distribution.