Introduction to Health Systems and Saudi Health System PDF

Introduction to Health Systems and Introduction to Saudi Health System LECTURE OBJECTIVES • To understand what is a health system • To know the components of a health system • To Know the strengths and weaknesses of the current Saudi health system LECTURE OBJECTIVES • To know the challenges fac...

Introduction to Health Systems and Introduction to Saudi Health System LECTURE OBJECTIVES • To understand what is a health system • To know the components of a health system • To Know the strengths and weaknesses of the current Saudi health system LECTURE OBJECTIVES • To know the challenges facing the current Saudi health system • To know the future changes in the Saudi Health System Strategy 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 What is a Health System ? • A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. • This includes efforts to influence determinants of health as well as more direct health-improving activities. A health system is therefore more than the pyramid of publicly owned facilities that deliver personal health services. (WHO) WHAT IS A HEALTH SYSTEM? CONTINUED It includes, for example, a mother caring for a sick child at home; private providers; behaviour change programmes; health insurance organizations; occupational health and safety legislation. It includes inter-sectoral action by health staff,  For example, encouraging the Ministry of Education to promote female education, a well known determinant of better health. THE SIX BUILDING BLOCKS OF A HEALTH SYSTEMS (WHO) 1. Health services are those which deliver effective, safe, quality personal. And non-personal health interventions to those who need them, when, and where needed. With minimum waste of resources. 2. A well-performing health workforce is one which works in a ways that are responsive, fair, and efficient to achieve the best health outcomes possible, given available resources and circumstances. i.e. There are sufficient numbers and mix staff, fairly distributed, they are competent, responsive, and productive. THE SIX BUILDING BLOCKS OF A HEALTH SYSTEMS (WHO) 3. A well functioning health information system is one that ensures the production, analysis, dissemination, and use of reliable and timely information on health determinants, health systems performance, and health status. 4. A well-functioning system ensures equitable, access to essential medical products vaccines and technologies of assured quality safely, efficacy, and const effectiveness, and their scientifically sound and cost-effective use. THE SIX BUILDING BLOCKS OF A HEALTH SYSTEMS (WHO) 5. A good health financing system raises adequate funds for health, in way that ensure people can use needed services, and protected from financial catastrophe or impoverishment associated with having to pay them. 6. Leadership and governance involves ensuring strategic policy frameworks exist and are combined with effective oversight, coalition building , the provision of appropriate regulations and incentives attention to system-design, and accountability. HEALTH SYSTEM CONTROL KNOBS (THE WORLD BANK)  Financing Where does funding for the Health System come from? How are the funds pooled? How are they allocated and spent?  Payment How are providers (hospitals, clinics, managers, physicians, nurses, etc.) paid? HEALTH SYSTEM CONTROL KNOBS (THE WORLD BANK)  Organization and Service Delivery Who delivers health care and in what settings? How are those facilities organized? Where do people go for care and why?  Regulation How are different actors in the health system -- insurers, producers of inputs, providers, and facilities regulated? HEALTH SYSTEM CONTROL KNOBS (THE WORLD BANK)  Persuasion How does personal behavior of providers and patients influence both individual interaction with the health system and individual health?  Politics How can health system reformers mobilize the political support need to bring about positive change?  Ethics and Values How do national health systems reflect the country's and community's values? HEALTH SYSTEM: COMPONENTS  Financing Resources  Legislative Authorities  Health Regulators  Health Care Providers  Human Resources  Medical supplies providers  Pharmaceutical producers  Judiciary Services 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: COMPONENTS HEALTH CARE PROVIDERS 1. Public healthcare Services:  Ministry of Health  Ministry of Defense and Aviation  National Guards  Ministry of Interior  Specialized Hospitals (KFSH, KKESH)  Universities (Ministry of Higher Education) HEALTH SYSTEM: COMPONENTS HEALTH CARE PROVIDERS 2. Non-profit and Charity:  Ministry of Social Welfare  Charity Health Providers: Prince Fahad Bin Salman Charity Association For Renal Failure Patients Care Charity Zamzam Association for Health Services volunteers The Saudi Red Crescent 3. For Profit healthcare providers HEALTH SYSTEM: COMPONENTS HEALTH CARE PROVIDERS Hospital Beds distribution according to sectors Private Sector 22 % MOH 60% Other Governmental Sectors 18% Source: MOH Annual report 2007 HEALTH SYSTEM: COMPONENTS HUMAN RESOURCES  Physicians  nurses  other healthcare professions Leaders and admins HOSPITAL BEDS PER 10,000 POPULATION Hospital beds (per 10 000 population) GCC Countries and World Bank Income Groups 70 59 60 50 36 40 29 30 20 18 20 22 25 22 19 18 13 10 0 Bahrain Kuwait Oman Saudi Arabia Qatar UAE Low income Lower middle income Upper middle income High income Global Note: Data is based on the WHO database for available yearly data: Bahrain -2009, Kuwait- 2009, Oman-2009, Saudi Arabia-2009, Qatar-2007, UAE-2008, World Bank Income Groups available data for year 2005 HEALTH WORKFORCE DENSITY PER 10,000 POPULATION Physicians density Nursing and midwifery personnel density 80 73.70 71.00 70 60 50 45.50 41.10 40 27.57 30 20 40.90 37.30 17.93 26.00 21.00 19.01 19.30 15.00 14.42 9.39 10 28.00 28.00 17.00 14.00 8.00 5.00 2.00 0 Bahrain Kuwait Oman Qatar Saudi Arabia UAE Low income Lower middleUpper middle High income income income Global Note: Data is based on the WHO database for available yearly data: Bahrain -2008, Kuwait- 2009, Oman-2008, Saudi Arabia-2008, Qatar-2006, UAE-2007, World Bank Income Groups available data for year 2007 HEALTH SYSTEM: COMPONENTS MEDICAL SUPPLIES PROVIDERS Medical supplies (consumables)  Medical Equipment  Medical Instruments  Medical Devices Around 30 Medical Supplies Factories in KSA HEALTH SYSTEM: COMPONENTS PHARMACEUTICAL PRODUCERS • Medications • Medical Solutions • Immunizations HEALTH SYSTEM: COMPONENTS JUDICIARY SERVICES  Committee for Private Sector Violations  Medico-legal Committee  Health Insurance Violation Committee 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 Healthcare Financing Charts: Total Expenditure on Health as Percentage of Gross Domestic Product Country 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Bahrain 4.6 4.6 4.7 4.7 4.7 3.9 4.3 4.4 4.2 3.9 3.8 3.6 3.6 4.1 4.5 4.3 3.8 Kuwait 3.9 3.5 3.7 4.4 3.7 2.5 3.6 3.6 3.2 2.8 2.4 2.3 2.1 1.9 3.8 2.6 2.7 Oman 3.6 3.6 3.4 3.7 3.5 3.1 3.1 3.2 3.2 3.0 2.6 2.3 2.5 2.1 3.0 2.7 2.3 Qatar 3.7 3.6 3.2 3.4 2.9 2.3 2.6 2.7 4.1 3.6 3.0 2.6 2.3 1.9 2.5 2.1 1.9 Saudi Arabia 3.0 3.0 3.1 3.3 4.1 4.3 4.5 4.3 4.0 3.7 3.5 3.7 3.7 3.1 4.1 4.0 3.7 United Arab Emirates 2.8 2.5 2.5 2.6 2.5 2.2 2.5 2.7 2.6 2.5 2.3 2.3 2.5 3.0 4.4 3.7 3.3 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