2015年-世界发展银行全球_Shaping_Healthier_Societies_and_Building_Higher_Performing_Health_Systems_in_the_GCC_Countries_17页_844kb

Summary of SHAPING HEALTHIER SOCIETIES AND BUILDING HIGHER PERFORMING HEALTH SYSTEMS IN THE GCC COUNTRIES

Core Content

This policy note provides an overview of the health sector trends and challenges in the Gulf Cooperation Council (GCC) countries, which include Saudi Arabia, Kuwait, Bahrain, the United Arab Emirates (UAE), Oman, and Qatar. It highlights the progress made in improving health outcomes and the ongoing challenges that need to be addressed to build more efficient and responsive health systems.

Main Trends and Challenges in the GCC Health Sector

• Health Status Improvements: The GCC countries have made significant progress in improving health outcomes over the past few decades, particularly in reducing child mortality and increasing life expectancy. In 1970, life expectancy in the GCC was close to the global average, and by 2012, it had surpassed that of upper-middle-income countries and was only slightly below high-income countries.
• Non-Communicable Diseases (NCDs) and Injuries: The rising prevalence of NCDs and injuries, such as cardiovascular diseases, diabetes, and road traffic injuries, is a major challenge. These conditions are increasingly contributing to the disease burden and are expected to account for 81% of all deaths in MENA and 87% in the GCC by 2030.
• Obesity and Diabetes: The GCC countries have the highest prevalence of obesity and diabetes among high-income nations, with some countries like Saudi Arabia and Qatar reporting rates significantly above the OECD average.
• Road Traffic Injuries: Road traffic fatalities are also alarmingly high in the GCC, with some countries exceeding the global average by a large margin.
• Health Service Delivery: The current health service delivery systems face challenges including inefficient management, lack of autonomy for public sector facilities, and inadequate post-acute care infrastructure.
• Health Financing: The GCC health systems are under financial pressure due to reliance on hydrocarbon revenues, increasing costs from new technologies and treatments, and a social contract that guarantees access to health services.

Key Observations and Findings

• Financial Protection: The GCC countries provide a relatively high level of financial protection, with out-of-pocket (OOP) health spending as a percentage of total health spending below 21% in all six countries.
• Primary Care Focus: There is a growing need to shift the focus of health systems from tertiary care to primary care to manage NCDs more effectively.
• Innovation in Payment Systems: The introduction of new mandatory health insurance initiatives has prompted some GCC countries to experiment with innovative payment systems such as global budgeting and capitation.
• Quality of Care: The lack of a unified quality of care framework across the public and private sectors is a challenge for continuous improvement in healthcare services.
• Autonomy for Public Sector: The centralized nature of public sector health management in the GCC has led to a lack of incentives for performance and innovation, prompting discussions on granting greater autonomy to health facilities.

World Bank Engagement in GCC Health Sector

The World Bank is engaged in three main clusters of activities to support health sector reform in the GCC:

1. Developing Multi-Layered Solutions for NCDs and Road Safety

   • Analyzing economic burden of NCDs and RTIs
   • Examining cost-effectiveness of multi-sectoral interventions
   • Assessing supply-side readiness of health systems
   • Providing evidence on global best practices for addressing NCD risk factors
   • Designing pay-for-performance schemes for NCD screening
   • Assessing the quality of NCD healthcare services

2. Health System Strengthening

   • Developing and assessing health strategies
   • Benchmarking health system performance
   • Analyzing health financing systems and expenditure trends
   • Supporting implementation of reforms, including public expenditure reviews and health accounts

3. Integrating Health Policy within Institutional Frameworks

   • Aligning health policies with broader institutional and legal frameworks
   • Promoting cooperation and harmonization of health policies among GCC member states

Outlook

The GCC countries are at a critical juncture in their health sector development. While they have achieved significant improvements in health outcomes, the rising burden of NCDs and injuries, along with the need for more efficient and equitable health financing and service delivery, presents a major challenge. Sustained and coordinated policy actions are essential to address these issues and ensure that the GCC health systems continue to evolve and meet the needs of their populations.