Chronic Disease Management Program in Primary Health Care in Saudi Arabia - Case Study Example

Chronic disease management program in primary health care in Saudi Arabia Introduction Globally, chronic diseases and their management have and are among major agendas and issues that global economies seek to address. Chronic ailments have increased tremendously over the last century. Majority of the chronic ailments are, attributed to poor diets, unhealthy and disoriented lifestyles and comes with old age. However, recent studies indicate a rise in the number of young people who have contracted these diseases (Ewles, 2005). The concern for provision and establishing sustainable chronic disease management programs and infrastructures is a concern for many nations, and is such in Saudi Arabia (Louis, et al., 2004). This report therefore, candidly reviews the performance of chronic disease management programs with respect to its availability, affordability and its appropriateness to Saudi nationals. The report will also highlight the successes and the challenges facing the chronic disease management programs in Saudi and what are the elements that have influenced its success or poor performance. An analysis of the implications for PHC providers, consumers and general health care systems and equity will be, covered. In addition, the report will seek to establish whether there are opportunities for change and offer a few recommendations on how to improve on performance of chronic disease management programs. Accessibility of Chronic disease management programs in Saudi Arabia Chronic disease management infrastructures in Saudi Arabia have been developing over the past couple of years (Qatari & Haran, 1999). However, the Kingdom has been undergoing problems arising from increasing need for health care services, increased costs to offer and receive health care services and the growing demand from the public to have better quality, efficient and effective health care services and programs. Chronic ailments prevalent in Saudi Arabia include chronic respiratory diseases, Diabetes, Cancer, Obesity, and HIV among others. More than 70% of all deaths in Saudi Arabia around the year 2000, were attributed to chronic ailments, although minimally, have gradually reduced over the years. Although other primary health services such as management of disease outbreak, maternal healthcare services and immunization have easy access, and are affordable to ordinary Saudi national, accessibility, affordability, effectiveness and availability of chronic disease health care has been, impeded (Qatari & Haran, 1999). This patterns in poor availability, effectiveness and affordability of chronic disease management programs and health care services has been replicated across neighboring regions such as in the Arabian Gulf, South East Asian nations, parts of sub Saharan African nations and in Australia (Louis, et al., 2004). In Saudi Arabia, chronic disease management programs have been slow paced as more and more patients complain of disintegrated medical care structures which translate to long waiting duration of time to consult and receive treatment, poor conditions of primary care providers/ facilities, lack of comprehensive and appropriate opening hours, and constant delays to procure medical care and services (Ewles, 2005). This consequently leads to inability of patients with chronic ailments to access specialists care. However, the Saudi Arabian Ministry of Health has been in the forefront mobilizing for reform in primary health care systems, which include issuing chronic patients with appointment systems, health care facilities having medical registers and establishing record keeping and developing appropriate, efficient and effective follow up and referral systems (Ahmadi & Roland, 2005). Currently, these variables are undergoing integration into medical care systems and therefore, considerable improvement has been, noted in chronic disease management programs and systems (Ministry of Health, 2002). Effective-wise however, chronic disease systems in Saudi are impaired by lack of professional skills and knowledge by care providers who offer wrong diagnosis for chronic cases, offer ineffective management and treatment of the diseases and have problems in giving prescriptions. In recent research findings, majority of chronic ailment programs in Saudi Arabia, chronic patients are over prescribed or under prescribed, or receive inappropriate prescriptions (Qatari & Haran, 1999). Inefficiency on part of care providers, limit chronic ailments programs as chronic patients are not educated on issues of drug interactions and dosage. Ineffectiveness is also, evidenced in unstructured and insufficient diagnosis and referral systems (Ahmadi & Roland, 2005). Communication and cultural barriers have been evident as care providers are non-Saudis, and therefore, communication breakdown, since majority of patients communicate in Arabic (Louis, et al., 2004). Factors that contribute to success or poor performance in chronic disease programs in Saudi The success in chronic disease programs in Saudi although dismal has been, achieved. This is, facilitated by improved management and supervisory structures. more and more of Saudi study to be medical professionals. By so doing, management in chronic ailment programs have improved, as they move from the traditional practice of solving problems to offering services that not only offer quality and efficiency, but also are patient centered (Jarallah et al., 1998). Continuous training of medical professionals has enhanced teamwork and professionalism in service and care deliveries (Ministry of Health, 2002). Presently, chronic disease programs in Saudi have also improved due to an increase in staffing, record keeping, registration systems, referral and follow up systems (Ministry of Health, 2002). This has ensured decreased delays, quick treatment, improved attitude of health care by patients and easy access to specialists care (Ahmadi & Roland, 2005). Organization cultures in Saudi have elicited the need for creating close relationship between chronic patients, care providers and management (Louis, et al., 2004). In addition, promoting team building, positive attitude towards healthcare improvement through mobilization, training and establishment of evidence based health care provision. Nevertheless, poor performance in chronic ailment programs has been associated with poor leadership as leaders in primary care centers lack the ability to make independent decisions and choices, lack efficient and appropriate up to date information, lack accountability for chronic patients/ issues and lack the necessarily skills and knowledge (Jarallah et al., 1998). Lack of conducive working environment, poor community collaboration, brain drain of medical personnel in Saudi, and poor synchronization among health-associated sectors have resulted in poor performance of chronic management programs (Al-Ansary & Khoja, 2002). Among other factors contributing to poor performance of chronic management programs are under developed information frameworks, increased medical worker turnover, overworking for health personnel and reduced resources to facilitate successful implementation of the programs (Ahmadi & Roland, 2005). Deficiency in use of evidence based management and treatment of chronic diseases that arise from poor diffusion of guidelines, reduced attentiveness by staff of chronic disease journals, review publications and records has added to the poor performance of chronic management programs (Ministry of Health, 2002). Implications for PHC providers, consumers and general health care systems and equity As it stands, the PHC providers, consumers and the general health care systems have influenced the slow pace to success of chronic disease management systems heavily. Patients feel they do not receive value for money, their needs are not, addressed as efficiently as is required and are unable to afford, access appropriate management and treatment of their chronic ailments (Al-Khaldi, 2002). They blame this inadequacy on the care providers, and the environment of primary care provision centers. PHC providers on the other feel unmotivated, unappreciated, overworked, receive poor incentives, and are subjected to poor working conditions (Jarallah et al., 1998). Chronic patients exert so much pressure on them and limited knowledge of important and critical aspects of primary care provision such as increased prevalence of chronic diseases and costs of procuring treatment. The government has therefore; invested in ensuring resource allocation in promoting service delivery at the primary care level, which more often than not, act as the first contact point between patients and the health care system (Al-Khaldi, 2002). Motivating and training medical staff has been crucial to making workers feel empowered, hence, improving on success of chronic management programs and infrastructures (Jarallah et al., 1998). Equity can be a reality within chronic management programs if only the concerned stakeholders, develop, implement and monitor mechanisms and intervention frameworks that are patient centered, promotes interpersonal care, improved follow-up and referral road maps, and sustainable continuous and efficient exchange of information between related health care sectors (Al-Ansary & Khoja, 2002). Opportunities for change There are opportunities for change in chronic management programs in Saudi Arabia. The opportunities lie in both preventive and curative programs (W.H.O., 2005). In preventive of chronic ailment programs, it entails educating the Saudi population the importance of leading healthy lifestyles by eating the right balanced diets, regular physical exercising, and avoiding elements that leads to unhealthy conditions such as over indulgence in alcohol, foods and smoking (Al-Ansary & Khoja, 2002). This because majority of chronic ailments and cases are lifestyle based or induced (W.H.O., 2005). In the curative programs, integration of technological solutions will enhance record keeping, creating registers, improve treatment of chronic diseases that require machines such as radiographies (Diane Publishing, 2010). All this enhance follow up and referral systems, which forms the basis to success in chronic disease management programs and services (Ministry of Health, 2002). In addition, an opportunity to succeed in the programs lies in implementing health care strategies that involve a variety of population- wide advances coupled with intervention for individual chronic patients (Al-Ansary & Khoja, 2002). Continuous training of medical staff in matters pertaining to offering evidence based medical care propels the chronic disease management programs to new height where chronic patients receive effective, efficient, affordable care and right diagnosis, prescription, management and treatment of their conditions (Jarallah et al., 1998). Recommendations Since the chronic disease management programs in Saudi Arabia require a lot in order to succeed, this report offers two recommendations that will seek to ensure this is so. This includes The stakeholders in health care systems in Saudi to invest in Quality management. This entail workers easily and efficiently accessing and becoming aware of medical issues and using evidence based medical policies and guidelines. Integrating technological solutions in matters relating to record keeping and chronic patient registration in order to monitor prevalence rates, follow up of chronic patients and swift referral systems (Diane Publishing, 2010). Conclusion Chronic disease management programs are a critical issue across the globe. In Saudi Arabia, the programs have slightly indicated improvement but a lot need to be, done. Among challenges arising in Saudi includes poor medical infrastructures, lack in efficient leadership, brain drain of medical workers, lack of skilled and knowledgeable staff who can make use of evidence-based guidelines. In addition, is the low morale of workers arising from poor working conditions and increased pressure from chronic patients. Negative attitude about medical care by patients does not help matters. As highlighted in the report however, there are opportunities for change. References Qatari G, & Haran D.1999. Determinants of users’ satisfaction with primary healthcare settings and services in Saudi Arabia. International Journal of Quality Health Care vol 11: 523–531. Ewles, L. 2005. Key topics in public health: essential briefings on prevention and health promotion. London: Elsevier Health Sciences. Al-Ansary L. & Khoja T. 2002. The place of evidence-based medicine among primary healthcare physicians in Riyadh region, Saudi Arabia. Family Practice; 19: 537–542. Louis, A.M.P., Akala, F.A., & Karam, H.S. 2004. Public health in the Middle East and North Africa: meeting the challenges of the twenty-first century. Geneva: World Bank Publications, 2004 Jarallah J, Khoja T, Mirdad S. 1998. Continuing medical education and primary healthcare physicians in Saudi Arabia: perception of needs and problems faced. SMJ 1998; 19: 720–727 Ahmadi, H.A. & Roland, M. 2005. 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