Primary Healthcare Needs Analysis in the UAE - Case Study Example

Primary Healthcare Needs Analysis in UAE Name: Course: Instructor: Institution: Date of Submission Primary Healthcare Needs Analysis in UAE The Background Primary Health Care, which is often abbreviated as ‘PHC’, is the essential health care that is based on socially acceptable, scientifically sound and practical methods that have to be accessed by all families and individuals in the community (Thomas-MacLean et al., 2009). It aims at full participation of every member of the country or community in health care, so that the aspect of health becomes equity producing social policy. It is important to note that PHC involves all areas that are crucial in health such as environment, lifestyle and accessibility to health services. This model (of PHC) came into being after the announcement of the International Conference on Primary Health Care in Alma Ata in 1978, and has by then become the core goal of WHO to attain the objective of “Health for All” (Ministry of Health (UAE), 2014b; WHO, 2014). The United Arab Emirates (UAE) is composed of seven emirates (Ajman, Abu Dhabi, Fujairah, Dubai, Ras Al Khaimah, Umm Al-Quwain and Sharjah). Due to the booming oil industry, the country has been experiencing significant industrial and economic growth; spear headed by aviation, petroleum, construction, maritime and health care industries. Consequently, the population of the country has been increasing steadily, for the past four decades due to the immigration of workers because of massive recruitments of expatriates from abroad by the UAE industries (WHO, 2006). In fact, this immigration has complicated the population structure of the whole country: only 11 % of the population represents UAE citizens while the rest is represented by varying nationalities. In this regard, therefore one should expect the whole multinational population to have portions that vary in educational backgrounds, cultural practices and religious beliefs, which pose challenges to the Primary Health Care strategies (Yeboa, 2007). Being a country where temperatures can reach 50C, foreign nationals are likely to encounter common health problems such as sunburn, heatstroke and dehydration. Respiratory problems are likely to be aggravated by dust and sand within the air because of the ongoing construction projects. The government has also put it clear that swine flu threat remains a problem, and therefore visitors need checks of updates regarding areas where they are located. The other problem is that the government is privatizing its health sector and it is even encouraging private players to open more primary health care centers. This has caused medical bills go up, to a standard that analysts say is comparable to the European one (Expert Health, 2014). This is likely to be quite expensive to foreigners, especially those that come from relatively poor countries. Although some emirates like Dubai and the country as a whole have been emphasizing very much on the importance of the PHC programs, many UAE nationals and white collar expatriates are bypassing them and going to health specialists for care. Therefore this report will try to explain the challenges the country’s PHC system faces, so that necessary solutions can be drawn to maintain the balance between service demand and supply for efficiency and quality assurance (Ministry of Health (UAE), 2014a). Methods of Study and Materials The research used the following methods to obtain secondary data from journal articles and government agencies’ reports and health related organizations such as World Health Organization: Searching published literature using key words Systematic searches from reports and publications by government agencies, authorities and local hospitals The Current Situation The UAE Population From the figure above, the UAE’s population is increasing steadily (United Arab Emirates, 2014). The Country’s estimated population in 2014 is 9, 368,283. It is also estimated to be having the highest immigration rate in the world at 21.71%; any expatriate who has worked in the country for 20 years can apply for citizenship. Moreover, the number of daily visitors in the country has increased to 1,041,705. UAE manifests the highest gender inequality, as the male/female ratio is 2.2. It has been projected that by 2020, 85% of the whole population will be living in urban areas (Sophia, 2014). Therefore, as one can see, there are greater challenges regarding the increasing population size and varying population distribution and composition (Yeboa, 2007). Impacts of the Population Variables on the PHC Provision Increase in population size has led to the increased demand of the healthcare medical services. The country’s public hospitals have increased to 40, compared to only seven in 1970. Moreover, the UAE is undertaking multi-million projects that will see itself having state-of- the-art medical facilities for expatriates and wealthy Emiratis. Nonetheless, the country is also being forced to train more workers in this sector to offer highly standardized services. Going hand in hand with government initiative have been the development of private owned hospitals. As already stated, the government has been encouraging private initiatives to set up private hospitals for widening its health sector (Yeboa, 2007). Needless to account, the number of health centers have been increasing, with Dubai alone having over 20 of them. Health Services Offered by UAE PHC Sector (Ministry of Health (UAE), 2014b) Child health services School health services Mental health services Care of handicapped and elderly Nutritional and dietary services Epidemiological services School health services Oral and dental health services Social services Port health services Specialist clinics services Travelers’ health services Laboratory services Pharmaceutical services Radiological services PHC Utilization Comparison: Nationals versus Non-Nationals in Dubai Category Public PHC visits Private PHC/ Clinic visits Total visits Nationals 530,280 76,594 606,874 Non-Nationals 182,746 554,821 737,567 Total 713,026 631,415 1,344,441 Per Capita PHC Visits/Year 3.6 visits/year 0.4 visits/year 0.7 visits/year Source: Dubai Health Authority (DHA) (2011) Key Messages from the Table The UAE nationals strongly demand national PHC facilities, when they have the option of using private PHC facilities Non-nationals on the other hand prefer using private PHC services. UAE nationals paint a good picture of visiting the PHC facilities. However, the situation becomes worsened for non-nationals at only 0.4 visits/year. This is because the services may be expensive, they may not afford the medical services or facilities (Government of Dubai, 2014). PHC Consumer Service Demands 56% More dental clinics 46% Imaging services 22% More lab Services 22% Specialized doctors 14% More staff 14% Availability of drugs 4% More ultrasound units 2% More concern to health education 2% Management of chronic diseases 2% Expansion nutrition services Source: Dubai Health Authority (DHA) (2011) Priority According Health Providers 40% Diabetes Mellitus 39% Hypertension 26% Dental & Oral problems 25% Bronchial asthma 17.5% Chronic disease 12.5% Obesity 9% Respiratory diseases 4% Mental disorders Source: Dubai Health Authority (DHA) (2011) Physicians and Nurses in UAE According to the 2012 Abu Dhabi Health statistics report, it has been estimated that the whole of the UAE has around 5,528 physicians, 12,375 nurses, 969 dentists and 4,319 allied health professionals. Nonetheless, it has 1,993 pharmacists working in about 1,508 licensed facilities. All of the above professionals work in 40 hospitals with over 4,226 beds, 856 centers and clinics and 454 pharmacies. However, the country still needs more health professionals for the increasing demand of Primary Health Care Program. It has been estimated that 6,500 nurses and 5,000 more doctors will be required by the year 2019. According to the Gulf News both public and private health practitioners acknowledge that the process of recruiting health professionals is quite tedious and long (Health Authority Abu Dhabi, 2013; Ministry of Health (UAE), 2014a). Capacity Gaps in PHC Services for the Growing Population As already discussed, the number of trained and licensed health professionals in the country is required to be improved. At present, the country lacks specialist physicians in oncology, histopathology, infectious diseases and occupational medicine. There is robust immigration, infectious diseases are much likely to be encountered and therefore, there should Primary Health Care professionals in this area (Health Authority Abu Dhabi, 2013). The other gap, which is related to the previous one, is the lack of training facilities such as universities and colleges to take care of students wishing to continue with their education in clinical and public health specialties. They are these specialties that will produce health promotion and health education specialists that are essential to make campaigns that focus on healthy lifestyles become successful (UAE Report, 2014). The other gap has been lack of proper monitoring and surveillance of the PHC programs for effective planning. It can be noticed that nearly all emirates are doing their programs independently, and therefore, there is no proper coordination of national data sets to realize better results. The other challenge that makes the PHC program not effective is that due to lack of health insurance and financial access, many people especially the immigrants are not willing to seek the PHC services; In this regard, they would wait for their health status to worsen to seek emergence treatment which is offered for free. On the other side, wealthy Emiratis and foreign expatriates consider PHC facilities and services to be much inferior, and therefore they would prefer seeking specialists’ services directly (UAE Report, 2014). Conclusion The supply and demand of the Primary Health Care services is being determined by the impact of the population variables such as composition, distribution and size. The rising population has increased the demand for Primary Health Care services. Although the UAE has a good per capita income, which has led it to respond well in some areas, it lags behind in some aspects (Health Authority Abu Dhabi, 2013; Margolis & Reed, 2003). The major reasons why the population is not considering the PHC services is that its quality is inferior and that it is expensive for the majority of immigrants who have to pay for themselves because they have not purchased health insurance. However, the government also needs to consider integrating its services nationally for clear coordination of efforts to attain better results. Nonetheless, there is a general lack of trained health professionals in this area and it seems that what hospitals prioritize as emergence cases in PHC do not match those consumers. Recommendations While planning, to prioritize those condition the PHC program considers important, the government should engage all stakeholders, especially the consumers. This will be much important in promoting the buy-in commitment. Therefore, they will have to be asked about what they really want to be achieved, including how such a process will be monitored and evaluated (UNDP, 2009). This will avoid a scenario whereby priorities of the consumers and providers of the PHC services do not match. Many people are now visiting the UAE and that the immigrant population forms over 80% of the population, it will be important if the spread of communicable diseases and injuries from industries, as consumers list, become top priorities. In this process too, of planning, the government should be able to realize the number and the kind of facilities the program would require to become successful, due to the steady population increase (Health Authority Abu Dhabi, 2013). Although, it is important that local communities get involved, the process should be controlled and managed by the government at national level.Therefore all programs that happen in all emirates regarding the Primary Health Care should be governed under similar UAE federal legislations. In this regard, all awareness programs and health education should be administered by these legislations. Currently, it seems the government has not instituted Health and Safety programs at work places, and therefore they need to be incorporated in planning (UNDP, 2009).The government will also need to increase the number of trained professionals in the PHC sector so that infectious diseases can be prevented due to widespread education and knowledge from them (UAE Report, 2014). The next aspect, of improving the Emirati PHC sector will be monitoring the quality of its services (UNDP, 2009). Apparently, the white collar expatriates prefer private clinics while the UAE nationals strongly want to get medical services from the superior government facilities. In both cases, they consider the quality of the public PHC to be inferior. The other aspect on the likeability of the system should also emanate from monitoring its affordability. Most immigrants would prefer delaying to seek the PHC services until their conditions worsen and become serious to get care under emergency interventions, because they cannot afford them. In the long run it will be more expensive because an individual will have to seek hospital care which is expensive and it may increase the general health expenditure, on the government and on himself. The solution for this should be the introduction of mandatory health insurance schemes, whereby insurance companies, making the PHC services affordable (UAE Report, 2014), will cover most of medical costs. Conclusion The next aspect of managing the PHC program will be continued evaluation. Evaluation is key in determining the development of the project as it will enable the managers to make informed decisions, making them to plan strategically. In this regard, they will be in a position to know where things went wrong and why, and propose informed solutions to correct the situation. Evaluation is also important in building knowledge for wider and more generalized applications. Nonetheless, sponsors wait for evaluations outcome to gauge the standards of accountability. When evaluation is carried out effectively, physicians will be able to realize conditions that affect the community very much so that they can prioritize well. In this case, evaluation will enable the Ministry of Health to be aware about how individuals are responding to the PHC program and reasons that affect their responses. This will be dealt with easily so that the next program can become successful. Nonetheless, the country will be able to tell how portions of the UAE population that varies in educational backgrounds, cultural practices and religious beliefs are responding differently, so that appropriate measures can be taken for improvement. References Dubai Health Authority (DHA). (2011). Primary Healthcare in Dubai Capacity Requirements and Project. Dubai: DHA. Expert Health. 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Retrieved on 06 September 2014 from http://gulfbusiness.com/2014/09/dubais-population-grow-5-2014/#.VAq4BFdicwo Thomas-MacLean, R. et al. (2009). Short Definition of Primary Health Care. Ontario: University of Western Ontario. Retrieved on 06 September 2014 from http://www.uwo.ca/fammed/csfm/tutor-phc/documentation/trainingpapers/TUTOR_Definitio_%20of_primar_%20health_care.pdf non-nationals/ UAE Report. (2014).An analysis of the health status of the United Arab Emirates: the ‘Big 4’ public health issues. Middle East Health. Retrieved on 06 September 2014 from http://www.middleeasthealthmag.com/cgi-bin/index.cgi?http://www.middleeasthealthmag.com/sep2013/feature5.ht UNDP. (2009). Handbook on Planning. New York: UNDP. United Arab Emirates. (2014). fanack.com. Retrieved on 06 September 2014 from http://fanack.com/en/countries/uae/population/ethnic-and-religious-groups/ WHO. (2014). Primary health care. 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