Abstract
It is essential for people to understand the importance of a Health Care Delivery System (HCDS). Some people develop misconceptions regarding such a system, and some have quite a vague knowledge about it. A health care delivery system is designed to meet every individual's health care needs whether you are a parent who is worried about your children's health, or an employer who needs to offer insurance to his employees.
Throughout this report we will cast a spot light on the Health Care Delivery System in the United Arab Emirates. We aim to clarify misunderstandings that people usually develop, and spread public awareness to the readers.
Introduction:
The United Arab Emirates is a small, high-income country with rich natural resources. In comparison with other countries in the world, the level of health care in the UAE is considered good for many reasons. First of all, diseases associated with poverty are minimal since most families have acceptable income and a residence. Moreover, infections associated with deprived, unsafe water systems or poor sewage disposal are minimal too because of the country's modern infrastructure. Health institutions like hospitals, health centers and dental clinics are all clean and well quipped, not to mention that UAE has one of the highest ratios of beds per population. (Kronfol, 1999, ¶ 11, 12)
UAE uses WHO's definition of health for all health strategies: "Health is a state of complete physical, social and mental well-being, and not merely the absence of diseases and infirmity". UAE's government is committed to WHO's constitution, which insists that health is a basic human right and an ultimate objective for social and economical development. (WHO, 2006, Introduction, ¶ 2)
Challenges:
Morbidity and mortality rates
According to national data, cardiovascular diseases are the leading causes of death, representing a percentage of 28. Cerebrovascular disease 16.2%, hypertensive disease 13.0%, and ischaemic heart disease 12.3% of mortality. Across all age groups, death resulted by cardiovascular diseases are reported more among males than females, and mostly at the age of 45 years. (WHO, 2006, Morbidity and Mortality trends, ¶ 8)
Second leading causes of deaths in the UAE are car accidents which correspond to a percentage of 15%. Cancer has been ranked as the third leading cause of death in the UAE representing a percentage of 8.6. Congenital anomalies are the fourth leading cause of death, representing a percentage of 4.7 which arises due to consanguinity. Diabetes mellitus is a significant cause of mortality and morbidity. Deaths attributed to diabetes accounted for 2-3%. (WHO, 2006, Morbidity and Mortality trends, ¶ 9, 10, 11, 12)
Health care infrastructure:
Health care system in UAE is delivered through levels of health care, which are:
Primary health care: This represents the first level of health care; it's where patients undergo their first interaction with the health care system. This level provides preventive, curative, and promotive health care. Patients who have non-serious injuries usually refer to the primary health care facilities, because it provides a straightforward treatment; minor cuts, flu, and non-serious bone break and other minor forms of injuries are dealt with at this level. Adding to that, the cost of treatment at this level is usually low. (Scarborough, 2010)
Secondary Health Care: This is the intermediate level of health care, it's based on referral services (advising) given by a health consultant to the patients, it's where the medical condition of the patient is examined through medical imaging such as X-Ray and other laboratory tests. Then the result of the test is examined by the consultant and a decision is made about whether to send the patients to a higher level of health care. (Scarborough, 2010)
Tertiary Health Care: This is the final level of health care, it's provided by large hospitals, and involves specialist doctors. It deals with serious conditions through surgeries and operations. Moreover, the medical cost at this level is the highest. (Scarborough, 2010)
Specialization level increases
Health care providers:
Ministry of Health (MOH)
Introduction
MOH is a federal authority responsible for six emirates: Sharjah, Dubai, Ajman, Umm al-Quwain, Ras al Khaimah, and Fujairah.
Goals:
MOH has set strategic goals to work on. First and foremost, they aim to unify the health policies in the country. Secondly, develop a nationwide health service. Thirdly, ensure the accessibility of health services across the country. Last but not least, encourage all heath providers to reach excellent high standards. (MOH, 2008, Goals, ¶ 1, 2)
Achievements:
Rules in action: Part of the plans that MOH has made is a set of laws and regulations which have already showed good results. They follow Sharjah laws and take into account ethical considerations:(Al Budoor, UAE Ministry of Health, 2010, ¶ 4, 5)
Smoking: In January Ministry of health announced the plans for limiting smoking in the UAE and this includes both shisha and tobacco use. The law comprises full ban on smoking in public areas and plans are to print graphic health warnings on cigarette packets leading
to a major reduction in health implications of smoking in the inhabitants. (UAE Yearbook, 2010, Major changes in health system, ¶ 2, 3)
Driving legislations: In February the director of the federal traffic department, Brig Gen Ghaith Al Zaabi said seat belts for those above 6 years and child seats for children under 6 would be obligatory by 2011 as a consequence of the surge in road traffic accidents, one of the country's major public health concerns. (UAE Yearbook, 2010, Major changes in health system, ¶ 6)
Organ Transplants: Another huge accomplishment for the UAE was in May when a law that allowed organs to be donated from dead patients thus making an enormous difference to people who are in need of organ transplants such as kidney or heart and this law is considered a great medical advance in UAE history. (UAE Yearbook, 2010, Major changes in health system, ¶ 4,5)
Breast cancer awareness campaign: According to WHO statistics and studies, breast cancer forms a modern health challenge for health systems globally which requires continuous cooperation of all parties to face it. The program was spread in the UAE emirates by year 2006 with an expansion of 7 more early detection units, and a screening plan to fight the diseases in all the medical districts in the UAE to reduce breast cancer mortality and improve the lives of affected women. On Thursday, 14, October 2010 the annual awareness campaign to all women in the UAE was held, information was provided about early detection and treatment including breast self examination. (MOH, 2010, Minister of Health Opens Breast Cancer Awareness Campaign, ¶ 6, 8)
Federal Health Authority (FHA):
A group of board directors from the MOH have been selected to run the FHA. The aim of this new authority is to coordinate with local health authorities, colleges, universities, and international hospitals to build up a more professional and successful medical system in the UAE, within an allocated budget. (Al Budoor, UAE Ministry of Health, 2010, ¶)
The FHA will help accredit about 14 public hospitals across Dubai and Northern Emirates under the UAE MOH. It will also supervise and establish new hospitals across the UAE. FHA enables the provision of health services for people in agreement with international standards under the supervision of MOH. It performs laws and regulations that include rules and practices in all areas of the health sector. (Al Budoor, UAE Ministry of Health, 2010, ¶ 9)
FHA's aim is to help hospitals and health centers in different locations reach self-sufficiency. This is why Sharjah has been chosen as the headquarters, because of its location within the northern emirates. (Al Budoor, UAE Ministry of Health, 2010, ¶ 10)
MOH of transferred administrative, technical and medical staff to ensure all medical services in the northern emirates in a structure that holds a new independent, financial and administrative system. (Al Budoor, UAE Ministry of Health, 2010, ¶ 11)
One of the new strategies that MOH aims for is connecting all medical facilities by creating a health information system "Wareed" which is to be part of the FHA. The aim of this system is to achieve accuracy, speed and privacy of medical information for each individual who gets treatment in medical facilities; including 14 hospitals and more than 67 medical centers in the UAE. This huge project will decrease the consumption of time for the medical, administrative and technical staff, not to mention also the patients themselves. (Al Budoor, UAE Ministry of Health, 2010, ¶ 12)
Every individual receiving treatment will have a single electronic file that is easily accessed when needed. This file will include the patient's check-ups, medical reports, medical history and previous treatments. This strategy will assist the personnel to deal with each case in a specific way depending on precise and reliable data. This project will help in linking health care providers in the UAE with MOH, so that all treatment, medical and preventive services work in harmony together to achieve national health goals in the UAE. (Al Budoor, UAE Ministry of Health, 2010, ¶ 13)
Health Authority of Abu Dhabi (HAAD):
Introduction:
In 1970 there were only two hospitals in the UAE, now there are 14 hospitals only in its capital Abu Dhabi! The medical facilities belong either to the private sector or to the public sector. The General Authority for Health Services (GHAs) controlled most of the government hospitals in Abu Dhabi, but in 2007 the government decided to break it into two units the first unit is the Health Authority of Abu Dhabi (HAAD) and the second unit is Abu Dhabi health service company (SEHA). (Oxford Business Group (OBG), 2009, The business of taking care section, ¶ 2)
HAAD is the regulator of the health care sector whose function is to access the health care system in AD, and to monitor the population health status, it also works in spreading the health awareness among the citizens in AD. (OBG, 2009, The business of taking care section, ¶ 2)
Goals:
To provide an outstanding health care services of high standards to the community.
Providing a health service which is affordable by all the residents in Abu Dhabi.
(HAAD, 2010, About HAAD, ¶ 1, 2, 4)
Achievements:
Hosting conferences: On March 2010 HAAD hosted the first international diabetes congress (ADDC) in Abu Dhabi, this conference included many experts in the field of diabetes, and the main aim was to clarify the main factors causing diabetes and to outline the preventive measures which should be undertaken against this disease which affects about 25% of the UAE nationals each year. (AME Info, 2010, ¶ 2, 3, 4, 5 )
Improvements:
Since HAAD formed in 2007 many improvements took place in order to upgrade and maximize the health standards in AD, the most significant improvements took place in the following fields:
Obesity and Diabetes: In May health and education authorities united together to control the rising problem of childhood obesity and diabetes; 12% of country's children are overweight and 25% of the population is diabetic. HAAD, the Abu Dhabi Education Council and the Abu Dhabi Food Control Authority devised a School Health Strategy in order to fix this situation and it includes measures to perk up nutrition and promote exercise. (UAE Yearbook, 2010, Major changes in health system, ¶ 12)
National statistics: Lack of national health statistics is one of the widely recognized challenges for the UAE in terms of future planning; however when the Health Authority-Abu Dhabi (HAAD) made public its comprehensive figures for 2009 it provided everyone with an idea of the successes and challenges in the sector.
In hospitals:
Due to the increasing population many of the hospitals are going to undergo some changes. Firstly, more hospital beds are going to be added to each hospital. Secondly, the hospital rooms are going to expand in size and number. Thirdly, trauma and psychiatric centers are to be opened. Finally, a new clinic called "Cleveland clinic Abu Dhabi" will open in 2012 carrying with it advanced technologies in imaging and surgery (OBG, 2009, The business of taking care section, ¶ 7)
In preventive measures:
On March 2009 (HA-AD) announced launching a newborn screening program, this program will screen new born against many various diseases mostly inherited diseases such as cystic fibrosis, the main aim of this program is to reduce the number of diseases in the capital and to provide early treatment against detected diseases. (AME info, 2010, ¶ 1, 2)
In consumer service:
All of these changes in the medical sector were aiming to increase the trust of the patients in this health care system they are experiencing. In addition, on 2005 his highness Sheik Khalifa Bin Zayed implemented "The Health Insurance law" which states that employers should provide health insurance for their employees; the employer should insure his employee plus his wife and 3 of his children under the age of 18. (HAAD, 2010, Health insurance section, ¶ 10)
SEHA Company:
Introduction:
Was formed in December 2007, SEHA is an independent public joint stock company (PJSC) its main function is to operate and manage the medical facilities in AD which are being regulated by (HAAD); it now operates 12 hospitals and more than 40 health care clinics. (OBG, 2009, The business of taking care section, ¶ 1).
Goals:
To provide a recognized and trusted health care service to the community,
To attract the best health care providers through the process of partnership.
(SEHA, 2010, SEHA's Beliefs, ¶ 1, 2)
Achievements:
Since it was formed SEHA completely turned over the performance of the government controlled medical facilities, it consequently managed and secured contracts with the best leading health care providers in the world like:
Cleveland clinic's which now manages Sheik Khalifa Medical City.
John Hopkins which manages Tawam Hospital in AL-Ain.
Bumrungrad manages Al-Mafraq Hospital.
Medical University of Vienna manages Al-Ain Hospital.
New England Center for children (Centre for autism).
(OBG, The business of taking care section, ¶ 3, 4).
The main aim for this partnership was to develop and nourish the health care system provided by the public sector; it was beneficial in upgrading the quality of health care in Abu Dhabi. (Eder, 2009, The business of taking care, ¶ 3)
Sheik Khalifa Medical City (SKMC): is the largest public hospital in AD, it's owned by SEHA and it's under the private management of Cleveland clinic. Since Cleveland clinic took control over SKMC it contributed to many changes that took SKMC to a new level; it brought with it experienced staff, new medical devices, and the latest technologies. Moreover it constructed a new Diabetes center, and led to the expansion of SKMC. Now SKMC is composed of:
A main campus (located downtown) with core units specialized for Tertiary care (surgeries).
Two dental clinics
Six family medical centers (FHC's) specialized for primary care
Three urgent care centers (UCC's) specialized for primary care
SKMC has a total of 683 physicians most of them are foreign. g is a list of the specialties and medical services available in SKMC:
(Sheikh Khalifa Medical City, 2010, medical services)
(OBG, 2009, Capital City, ¶ 2, 3, 5)
Dubai Health Authority (DHA):
Introduction:
In 2007 the DHA was formed under the directives of H. H. Sheikh Mohammed bin Rashid Al Maktoum, Ruler of Dubai. DHA acts as a regulatory body for healthcare in Dubai regulating services related to public, private, Free Zone and Ministry of Health facilities. (DHA, 2010, Our history, ¶ 12) (DHA, 2010, Strategic Goals, ¶ 2)
Dubai is already recognized to be one of the top tourism destinations in the world and over the past few years the number of patients who had visited Dubai for treatment have surged indicating remarkable potential therefore DHA is further building its healthcare capabilities, policies and regulations to ensure that Dubai enjoys the same position as a healthcare destination. (DHA, 2010, DHA strengthens its medical tourism strategy for 2011, ¶ 8)
Goals:
The DHA's main objectives and areas of strategic focus are:
Health Planning and Investment Promotion: DHA's main objective is to attract private investment in Dubai and guiding it through a long-term plan; this will inevitably lead to improved healthcare access by people and more reliance on the private sector for providing healthcare services in Dubai. (DHA, 2010, Strategic Goals, ¶ 1)
Health Information Systems and Standards: The Objective is improving the healthcare quality by facilitating the flow of information among patients and healthcare providers whilst encouraging transparency and competition. Consumers should have full access to information on health and healthcare in Dubai. Evidence-based decision-making by should be implemented by collecting and publishing high-quality data and statistics. (DHA, 2010, Strategic Goals, ¶ 2)
Health Regulation: Ensuring quality, constancy and accessibility and efficiency of health care professionals in Dubai by regulating the services of hospitals and clinics in Dubai. Consumers rights are also protected through complaints procedures. (DHA, 2010, Strategic Goals, ¶ 3)
Health Insurance and Funding: Build an inclusive healthcare funding policy that improves the available resources without hampering business competitiveness and guaranteeing basic coverage of appropriate healthcare services to all residents in Dubai. (DHA, 2010, Strategic Goals, ¶ 4)
Health promotion and Public Health: DHA's Public Health and Safety Department is responsible for the establishment and implementation of policies and strategies that will improve the well-being of Dubai's population. This is achieved by various projects and campaigns such as "Tobacco Control" in addition to partnership with public and private sectors. (DHA, 2010, Strategic Goals, ¶ 5)
Medical Education and Research: Is a key strategic objective in which healthcare professionals in Dubai are kept up-to-date with the technologies worldwide and the postgraduate supply is of superior quality. Moreover, research on key health issues in Dubai is encouraged by DHA. (DHA, 2010, Strategic Goals, ¶ 6)
Service Delivery at DHA Healthcare Facilities - Current Services and Planned Projects: Following the strategies of DHA, new healthcare projects are being under construction whilst maintaining the international standards and specific health requirements of the people living in Dubai. (DHA, 2010, Strategic Goals, ¶ 7)
Facilities:
DHA controls and supervises 3 hospitals, 12 Primary Health Centres and 8 Specialty Centres spread over the emirate to ensure their accessibility to all of Dubai's population. Specialty Centres include: Dubai Blood Donation Centre, Dubai Cord Blood, Thalassemia Centre, Elderly Center, Dental, Trauma Center, Genetics Center and finally the Fertility Center.
(DHA, 2010, Facilities)
Achievements:
DHA begins campaign for World Heart Day 2010: On the 27th of September, 2010 the DHA began its World Heart Day 2010 campaign with an awareness initiative held at the DHA headquarters. This aroused from the strong beliefs of DHA that such campaigns help in educating people on essential health issues about lifestyle related diseases such as diabetes and heart diseases that can be prevented by exercise and proper nutrition. During all awareness campaigns cardiologists are going to be present to provide consultation and advice people on how to pursue a lifestyle that is heart-friendly. (DHA, 2010, DHA begins campaign for World Heart Day 2010 , ¶ 1, 3, 5)
DHA strengthens its medical tourism strategy for 2011: On the 28th of September, 2010 the Dubai Health Authority recently signed a Memorandum of Understanding (MOU) with the Medical Tourism Association at the World Medical Tourism and Global Health Congress which took place in Los Angeles from 22nd to 24th September 2010. With the signing of this MOU, both parties will work towards further strengthening and improving the medical tourism sector in the Emirate of Dubai. (DHA, 2010, DHA strengthens its medical tourism strategy for 2011, ¶ 1)
National statistics: Dubai has also contributed to gather more comprehensive statistics on the state of the emirate's health this year. Along with the Dubai Statistics Centre, the Dubai Health Authority (DHA) has just completed a survey of more than 5,000 people aged above 18 years living in the emirate. Initial result emphasized on a need for the authorities to deal with underperformances in health insurance and as a consequence DHA stated that this would be a priority for 2010 and 2011 and new obligations would be announced to solve this issue. (UAE Yearbook, 2010, Major changes in health system, ¶ 7, 8, 9)
Dubai Health Care City (DHCC):
Introduction
In year 2002, Dubai Healthcare City (DHCC) - the world's first healthcare free zone was founded by H.H. Sheikh Mohammed Bin Rashid AlMaktoum. DHCC is 100% tax free with a 100% foreign ownership. It has no customs duty or restrictions on capital, trade barriers or quotes. Competitive prices are ensured by DHCC with full clinical purchase options. (DHCC, 2009)
DHCC is directed by Centre for Healthcare Planning and quality (CPQ), which is known for its high international standards of healthcare delivery through its professional licensing, facilities, and clinical planning. (DHCC, 2008)
Goals:
DHCC aims to create an internationally recognized location of excellent clinical and wellness services, medical education, research and high quality of healthcare. It also aims to be one of the leading healthcare providers to improve the lives of others. (DHCC, 2008)
Achievements:
DHCC tends to lead awareness campaigns of diseases that dominate in the society such as diabetes, heart disease and breast cancer. A major breast cancer awareness campaign was held by DHCC at the end of 2007. DCHH decided to raise public awareness and launch a fundraising program which included the creation of the largest pink Breast Cancer ribbon, which entered the Guinness Book of World Records. The money raised from the campaign was donated to the Emirates Breast Cancer Foundation, a local research organization. (DHCC, 2008)
In 2008, DHCC organized yearly blood donation campaign, in partnership with the Department of Health and Medical Services (DOHMS), to support DOHMS' Thalassemia Center's urgent need for blood. (DHCC, 2008)
DHCC supports non-profit organizations that are committed to specific diseases and causes, like the Dubai Autism Centre and the Emirates Arthritis Foundation. (DHCC, 2008)
Facilities:
DHCC is the center of important national and global healthcare brands; it offers all the medical expertise in one location. It is also the World's largest healthcare development with more than 80 clinics and 2 internationally accredited hospitals and 1,700 licensed healthcare providers speaking more than 40 languages. (DHCC, 2009)
Group Reflection
First and foremost, the triple jump exam experience was one of a kind to all our group members. Regardless of the bunch of challenges and dilemmas that we faced we were able to find a way to overcome them and achieve our aims.
As a group we faced a lot of difficulties from different angles. Solo players hampered us in this experience. Some of us like to do their work alone on their own way with their own rules and this affected the group in many ways; it led to clashing of ideas and work strategies. Also, cultural differences created an obstacle for some members to adapt and work effectively. Some members tended to create a barrier between them and others; this resulted in weak communication between us. Time coordinating and management between us was an obstacle too. The timings we set for our meetings did not always suit all the members, thus most of our group meetings were unproductive.
We faced hard times, but our dynamic spirits helped us over come all the barriers. Enthusiasm and the willingness to work were the key elements. Each one of us seeked self improvement and learned new skills. In addition to that we accomplished one of our major goals, which is creating harmony between us as a group.
