Health Insurance and Access to Care in Southern Area of Riyadh City

This report provides a comprehensive literature review on health insurance and access to care in the southern area of Riyadh City, Saudi Arabia. It begins with an introduction highlighting the importance of healthcare access and the role of health insurance, especially in the context of Sustainable Development Goals (SDGs). The significance of the study emphasizes the importance of Riyadh's healthcare system and identifies challenges, such as accessibility issues. The literature review explores the importance of health insurance, the current health services provided, and access to healthcare during the pilgrimage season. It also discusses the evolution of health insurance in Riyadh, including the establishment of the Council for Cooperative Health Insurance. The report references various studies and findings, offering a detailed overview of the healthcare landscape in Riyadh, including the challenges and developments in the healthcare sector.

Running head: HEALTH INSURANCE AND ACCESS TO CARE IN SOUTHERN AREA
OF RIYADH CITY, SAUDI ARABIA
Health Insurance and Access to Care in Southern Area of Riyadh City, Saudi Arabia
Name of the Student:
Name of the University:
Author note:

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Table of Contents
Introduction................................................................................................................................2
Significance of the Study...........................................................................................................2
Literature Review.......................................................................................................................3
Importance of Health Insurance and access to health care....................................................3
The current health services provided to Riyadh population...................................................4
Access to health services in the season of pilgrimage...........................................................6
Health Insurance in Riyadh....................................................................................................6
References:.................................................................................................................................8

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Introduction
There is an increasing awareness of the fact that ill-health or illness keeps conserve
poverty. Access to quality and comprehensive health care services is very important for the
promotion and maintenance of health while preventing the occurrence of disease and
managing it. The first step in this process is gaining an entry into the health care system,
which is usually done through the health insurance coverage. It is to mention that one of the
key aims of SDGs (Sustainable Development Goals) is providing all the people throughout
the world with equal and unbiased access to PHCS (Primary Health Care Services) (Alfaqeeh
et al., 2017). There are many developing nations such as Tanzania, Kenya, Ghana, Thailand
etc. who are been implementing different forms of health insurance schemes in recent times
(Amu et al., 2018). The primary objective behind this is to ensure that everyone in the
country, especially the poor, have effective access to health care. One of such countries is
Saudi Arabia. There is a high demand for providing better healthcare facilities to the rapidly
increasing population of Saudi Arabia. The lack of trained healthcare professionals and high
dependability on the foreign workers are two of the most notable aspects that the
policymakers of the country have to deal with. Riyadh is the capital city of Saudi Arabia and
is well known for its readiness and availability of manpower in the healthcare system.
This paper shall elaborate on presenting a literature review on the health insurance
and access to care in Southern Areas of Riyadh City, Saudi Arabia. It shall assess the works
and studies of multiple researchers on the topic highlighting the current scenario of the place.
Significance of the Study
It is to note that the Saudi Arabian health care services have been given a significant
priority by the government. Promotion of good and quality has always been a key part of
health care programs in Saudi Arabia (Aldosari et al., 2018). For this reason, the health care

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system in the country has been greatly improved in the recent decades. Notwithstanding this
fact, a huge number of issues pose challenges to the country’s health care system. These
issues range from shortage of professionals in certain parts of Saudi Arabia, multiple roles of
health ministry, very limited financial resources, high demands for care, change in disease
patterns, and absence of national health information system etc. Hence, despite of the fact
that the health system of Riyadh is a comprehensive one, which covers all the citizens,
studies have found that the access to health care is not as convenient as it is expected. This
calls for attention as the degree of accessibility to the health system is the direct indicator of
its responsiveness. The study shall highlight the gaps in the process of accessing health
insurance and health care facility in Riyadh, Saudi Arabia.
Literature Review
Importance of Health Insurance and access to health care
According to Davis Giardina et al. (2014), access to health services is all about “the
timely use of personal health services to achieve the best health outcomes”. The primary step
in this process is gaining an entry into the health care system, which is usually done through
the health insurance coverage and then accessing a particular location where the required
health care services is provided (the geographic availability). As per World Health
Organisation (2018), access to the health care services impacts the mental, social and
physical well-being of an individual. It also affects the quality of life he or she is living.
There are many barriers to health services including lack of service availability, high cost of
care, lack of insurance coverage and shortage of culturally competent care. It is to mention
that health insurance is one of the types of insurance coverage, which pays for surgical,
medical and sometimes, dental expenses that are incurred by the insured. It is of great help
for the insured as it can either reimburse him or her for expenses that are incurred from the

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illness or the injury or can directly pay the care provider. It is to mention that citizens of
Saudi Arabia have free access to all types of public health care services that are available in
the country (Alkhamis, 2017). Due to this reason, just a decade ago, Saudi Arabia was facing
high costs along with significant concerns regarding the quality of care given in the public
facilities. However, the non-Saudis who live within the country also have the access to health
care system and facilities, but they need to maintain private insurance for accessing the
private facilities and the public facilities free of cost.
The current health services provided to Riyadh population
According to Mansuri et al. (2015), the health services in Riyadh have developed and
improved significantly in the recent decades. At present, Ministry of Health (MOH) is the
key government provider and financer of the health care services in Riyadh, with a total of 49
hospitals in total within the city (Al Otaibi, 2017). Some of the well-known hospitals in the
city are- National Care Hospital, Diaverum PMAC 9003, King Faisal Specialist Hospital and
Research Centre, Specialised Medical Cener Tower 1 etc. The other governmental bodies
operating within the city include the referral hospitals such as the King Faisal Specialist
Hospital and Research Centre, National Guard Health Affairs, Army Forces Medical
Services, Security Forces Medical Services, the Red Crescent Society, ARAMCO Hospitals,
the Royal Commission for Jubail and Yanbu Health Services etc. (Alumran et al., 2020).
Among these governmental agencies, except the Red Crescent Society and the referral
hospitals, each one of them provides health care services only to a defined population of the
country who are usually the employees and their dependants.
A recent study conducted by Assiri et al. (2014) have examined the different factors
that have influenced the access to and use of public health care centres in the rural and urban
areas of the country. Findings have revealed some vital differences among the rural and urban

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populations, with the factors for the patients from rural regions including cleanliness of the
public health care centres, distance to reach to the public health care centres and accessibility
of health prevention services. It is to mention that the Ministry of Health (MOH) in Saudi
Arabia has developed a four year project for improving the “health” in the health care
institutions and facilities. Notwithstanding this fact, the strategy was implemented in the year
2011 in the hospitals of the major cities of the country including Riyadh. Lee et al. (2015)
have conducted a study for the identification of information needs and the behaviour of
information seeking of the primary care physicians in the country. The findings of the study
have revealed that there is absence of electronic health care system and it was the key
contributor to the weakness of the public health centre services and infrastructure in many
cities. There was no updates patient information for the primary health care physicians also;
there was shortage of high quality computing services like clinical decision making support
tools and electronic health records that are important for ensuring quality healthcare service
for the general population.
Along with the advancement in the health services in the city, combined with the
other different factors like improved and accessible public education, increased level of
health awareness among the general public in the city and better life conditions have aided to
the notable improvements in the health indicators. The study by Jamal et al. (2015) has noted
revealed that despite of the municipality of health service professionals and providers, there is
lack of coordination and lack of clear channels of communication among them and this is
resulting in the waste of resources within the health care system of Riyadh and Saudi Arabia
as a whole.

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Access to health services in the season of pilgrimage
It is of no doubt that Saudi Arabia does hold a unique position in the world of Islam.
It is due to the fact that the country embraces two holiest cities of Islam- the Mecca and
Medina. About two millions of global pilgrims every year perform hajj. In the year 2019,
about 2.5 millions of pilgrims gathered in place and among them, majority were from foreign
countries (Yezli et al., 2019). Hosting such events every year becomes a challenge for the
country as it calls for a well-planned and well-organised efforts across different departments
and agencies to make sure that there is ample of essential services in place like that of
housing, safety and health care (Yezli et al., 2019). Being the capital city of Saudi Arabia,
Riyadh is a hub for some well-known Saudi Arabian health professionals and quality health
cares. Pilgrims too approach to these health care institutions as they provide with curative and
preventive care for all the pilgrims, regardless of their caste and nationality. Riyadh
comprises of 49 hospitals, which is the highest number in the entire country with a minimum
of 3500 beds and 200 beds for emergency admissions (Aldabahi et al., 2020). In the year
2017, on an average, each physician in Riyadh treated about 242 pilgrims and each nurses
treated about 187.
Health Insurance in Riyadh
It is to mention that funding the health care services in Riyadh is the key challenges
faced by the Ministry of Health (Al-Hanawi et al., 2018). The total expenditure in the country
on public health services comes from the part of government and all the services are free of
cost. For this reason, there is a significant pressure of cost on the Saudi Arabian government,
especially in light of the rapidly growing population, rising price of new technologies and
increasing awareness of common public about their health and diseases. For meeting the
demands of the rising population in the country, including the city of Riyad, and for ensuring
equal services are provided to every members of the community, the Council for Cooperative

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Health Insurance was established in the year 1999 by the Saudi Arabian government
(Alharbi, 2019). In this regard, the main role of the council is introducing, regulating and
supervising the strategy of health insurance for the health care market of the country.
Furthermore, it is also to mention that the market for cooperative health insurance
scheme in Saudi Arabia started with one company in the year 2004 (Aldosari et al., 2014). At
present, there are about twenty five companies. Introduction of the scheme in Riyadh is
intended towards decreasing the financial burden on the city and the country as a whole
because of the costs associated with giving free health care services to the population. With
the same, it also gives the Riyadh population with an opportunity of choosing the health
services that they need.

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Amu, H., Dickson, K. S., Kumi-Kyereme, A., & Darteh, E. K. M. (2018). Understanding
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