Saudi Arabia Health Profile 2012

Brief History of the Health Care System
A public health department was established in 1925, by a Royal decree from King Abdel- Aziz Al-Saud, based in Makka AlMukrma, with branches in provinces, followed by establishment of dispensaries, hospitals, and laboratories. This was the beginning of emphasis on prevention and environmental health. The first school of nursing was opened in 1926, followed by the school of heath and emergences in 1927.
In 1951, the Ministry of Health was established. From that date the health services expanded. From 1970 to 1980, health services were predominantly curative as most health personnel had received their formative training in patient-oriented, hospital-based medical institutes. Furthermore, there was a general population expectation of curative care. This care was delivered through a network of hospitals and dispensaries, while preventive care was delivered by health offices and to some extent through maternal and child health care centers. Disease control activities, such as for malaria, tuberculosis, leprosy, schistosomiasis and leishmaniasis, were handled by vertical programs. Episodic outbreak control activities were managed through the health offices.
In the early 1980s, the concept of primary health care (PHC) became popular, with the WHO slogan ‘Health For All’ (HFA) gaining recognition. A ministerial decree in 1980, led to the establishment of the health centers, administratively integrating the existing dispensaries, health offices and maternal and child health (MCH) centers into one unit. At the same time, health posts were upgraded to health centers, thus paving the way for the delivery of integrated health services, i.e. initiation of the PHC approach. Currently there are 1848 PHC centers, and 200 hospitals run by Ministry of Health. The MOH budget increased from 2,8% of the total National budget in 1970 to 6,4% in 2004. The Saudi health system was established by a Royal decree in 2002, aimed to insure the provision of comprehensive and integrate health care to all inhabitants in Saudi Arabia in an equitable, affordable and organized manner. This will be done through the Council of Health Services headed by the Minster of Health and composed of representatives of governmental and private health sectors.

Key organizational changes over last 5 years in the public system, and consequences
There are 13 health regions, each led by a Regional Director General for Health Services, who is directly responsible to the Deputy Minister of Health for Executive Affairs and Deputy Minister for Planning and development. Each health regional general directorate supervises one or more of health provinces through provincial health directorate. Each provincial health directorate supervises and manages at least one general hospital and a number of health centers, and supervises private health sector. The policies, plans and programs of the MOH are implemented through this structure. The health directorates are reasonably autonomous in terms of staff recruitment and welfare, training, discipline, supervision and evaluation. However, some responsibilities are shared with the MOH when necessary. Links to other health-related sectors (e.g. military, education, agriculture, municipal and rural affairs) are maintained through sectoral coordinators . A health area policy will soon be introduced to provide greater decentralization of health services throughout the country. The MOH is the biggest provider of health care, providing health services (more than 60% of health services, the rest provided by other governmental and non governmental sectors) . Each region has a dental centre that acts as a referral centre for the dental clinics attached to the health centers and hospitals. There are medical rehabilitation centers for speech and hearing therapy, accident injury repair and physiotherapy. Central laboratories serve as reference laboratories for the  health centre and hospital laboratories. Quarantine centers located along the border with neighboring countries conduct health check up and vaccinations and provide chemoprophylaxis as needed. Smoking is a serious problem in Saudi Arabia and there is at least one anti-smoking clinic in each health directorate for counseling, health  education and rehabilitation. Under ‘other government’ sectors are grouped the health facilities of the military, National Guard, universities (and affiliated teaching hospitals), large multinational corporations such as Saudi Aramco oil company, and a number of specialist hospitals. Apart from the specialist hospitals, the health facilities in this sector are primarily designed to serve the workers of the different establishments and members of their families. As a rule, services are not extended to members of adjoining communities, and where such communities are lacking services, it is the responsibility of the MOH to provide them. The ‘other government’ facilities carry out similar functions to those of the MOH with respect to ambulatory care and inpatient care.

Private Health Care System
Modern, for-profit
The private health sector includes private hospitals, clinics, dispensaries and pharmacies. The facilities are mostly located in urban centers. The private sector has grown rapidly in recent years. Health services vary from basic medical care to highly organized specialist services.

Traditional
There is a recently established traditional medicine department in MOH to supervise and control traditional medicine in the market.

Key changes in private sector organization
MOH fully cooperates, and coordinates with the private health sector, either directly or through the medical units in chambers of commerce and industry in the kingdom.

Public/private interactions (Institutional),

• Participation in joint committees.
• Plays a major role in cooperative health insurance system.
• Privatization and corporatization projects.

Public/private interactions (Individual),
Under-development.