Health Inequalities Among Women in KSA: A Systematic Review

Running head: HEALTH MANAGEMENT: RESEARCH PROPOSAL
Health Management: Research Proposal
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HEALTH MANAGEMENT: RESEARCH PROPOSAL
Background of the problem
According to the reports published by the WHO (2017), Kingdom of Saudi Arabia
(KSA)) has a total population of 32,276,000 as reported in the year 2016. The life-expectancy
of the KSA at the time of birth is 74/76 (male/female). The probability of death under five
years of age per 1000 liver birth in the year 2017 is 7. Probability of dying among 15 to 60
years of age per 1000 population is 97/78 (male/female). The total expenditure on health per
capita during the year 2014 is $2,466 and total cost on health as % of GDP during the year
2014 is 4.7. Thus the above statistics highlight that the there exists a health inequality
between men and women between 15 to 60 years. The life expectancy of women is higher
than the males. This is mainly attributed to the improvements in the healthcare system made
by the government of KSA. During the tenure of 1990 to 2012, the maternal mortality rates
have decreased from 15.7% of 7.0% per 100,000 live births along with an increase in the life
expectancy from 74.7 to 80.8 among the women. However, women with longer life span
experiences poor health conditions due to the high burden of the non-communicable diseases
(NCDs) (Daoud et al., 2015). The national survey done in the KSA during the year 2013 in
order to evaluate the health status of the Saudi Arabian women and associated healthcare
challenges highlighted that women required improving their health behaviours to decrease the
burden of chronic diseases in KSA. The Saudi women also need to get involved in design and
subsequent implementation of the disease prevention strategies and effective health
promotion programs (Daoud et al., 2015). The systematic review conducted by Alshaikhet al.
(2017) highlighted similar results like (Daoud et al., 2015). Alshaikhet al. (2017) are of the
opinion that there is a high prevalence of lifestyle related diseases among the women in the
gulf countries like the KSA. A prompt change in the political and the social structure is
important to improve the health status and the health inequalities among the women in KSA.

HEALTH MANAGEMENT: RESEARCH PROPOSAL
Literature review
To understand the current status of the health related inequality prevalent in the KSA,
a detailed literature review must be conducted. The review will help in understanding the
main health inequalities prevalent among the women in the KSA and the whether any
government policies are framed for addressing this health inequalities. The literature review
will also highlight the population health related outcomes in KSA and other public health
interventions (PHI) targeted towards addressing this health inequalities. The review of the
literature will be done within the last five years in other to ascertain the current health
inequality data in KSA.
Alshammari et al. (2018) conducted a cross-sectional study to determine the oral
health of the people residing in the KSA. The focus was the people who are above 60 years of
age. The oral health assessment is done as per the guidelines stated in the Geriatric Oral
Health Assessment Index (GOHAI-Ar). The analysis of the data accumulated from October
2017 to December 2017 from five different regions of Hafar Al-Batin and Saudi Arabia
stated that the older adults mainly the women suffer from poor oral health condition. The lack
of proper dental hygiene along with increased rate of substance abuse is the reason behind the
poor oral health among KSA women. The people who are residing in the rural or the remote
areas are the main victims of the poor oral health condition (Alshammari et al., 2018). The
national survey conducted by Daoud et al. (2018) the women who are residing in KSA are
victims of the ischemic heart diseases, diabetes and other cardiovascular complications. The
elevated body mass index, unhealthy lifestyle habits, untreated blood glucose level and
elevated blood pressure are the reason behind the high rate of occurrence of the NCD among
the women in KSA. The survey highlighted that the largest group of women who are aware
of the health related challenges belong to the age group of 15 to 24 years. The women who
are older than 30 years of age or women who are married with child are not aware of the

HEALTH MANAGEMENT: RESEARCH PROPOSAL
health impact and its associated lifestyle changes. The gap in the knowledge about the health
related awareness due to gap in the education. The majority of the women residing in KSA
have attained education up to the elementary school (46.2%). Thus gap in education creates a
lack of understanding about their health status and thus generating poor quality of life of the
women in KSA (Daoud et al., 2018). Khalifa (2013) stated proper implementation of the
electronic medical records (EMRs) is KSA is not possible due to numerous human barriers
and financial barriers. The financial barriers include lack of proper funding to implement
EHR under hospital settings and to provide internet connection in hospitals located in the
remote areas. The personal barriers include lack of trained IT professionals along with gap in
the knowledge of the nurses to adopt the concept of using EHR for documentation of the
patients’ information. In the absence of the EHR, the exact percentage and the reasons for the
health inequalities in women and men cannot be traced in KSA. The government of KSA
make require funding for healthcare organization. The findings reveal that lack of proper risk
management is rated as most important factor behind for projects relate to infrastructure.
Budget overruns and poor communication by the management are other reasons that prevent
comprehensive utilization of government funding in improving the healthcare sectors. The
prevailing corruption and ignorance towards designing health policies for the women are
some of the reasons that might be responsible for health inequalities among women in KSA
(Ikediashi, Ogunlana and Alotaibi 2014). Oil revenues finance the public sector healthcare
system in Saudi Arabia and “free at point of delivery” is coming under high strain because of
escalating expenditure and an expanding volatile market of oil and is most probably
unsuitable in long-term medium. The evidences showed few dissatisfaction with the quality
and provision of present public health sector services like lack of proper availability of the
appointments, increased waiting times and lack of proper availability of drugs. The
households of KSA are willing to give funds to national insurance scheme, conditional upon