Critical Review Of The Performance Of A Primary Health Care Service In

Critical Review Of The Performance Of A Primary Health Care Service In Critical Review Of The Performance Of A Primary Health Care Service In A Saudi Arabia Against The â€" Essay Example > Critical review of the performance of a primary health care service in a Saudi Arabia against the key functions of primary health care. IntroductionSaudi Arabia, as signatory to the 1978 Alma Ata declaration of Health For All by the year 2000 of the WHO, had identified the development primary health care as the important strategy for the purpose, with the result the country now has 1787 primary health care centres each serving an average population of 8727 people as in 2005 (MOH, 2002). Quality of health care has been defined as a combination of access to health care and effectiveness of health care. While access refers to health structures and processes available, effectiveness refers to clinical care and interpersonal care that deliver the desired results (Campbell, Roland, Buetow, 2000). PHC systemThough health for all by 2000 could not be achieved, the PHC system has contributed significantly towards improvement of health conditions for those who are economically deprived. Bei ng the flagship of the country’s health care system, all the PHCs are closely linked to the respective general hospitals which are linked to the tertiary care services through referral and feedback system. PHCs are also expected implement various facets of health care at the primary level and they carry out population and family census in the respective areas, maintain health files of the patients, conduct surveys at schools and routine home visits besides maintaining “health friends committees’ Their services are thus comprehensive in that they are promotional, preventive, curative and rehabilitative. They are owned by the Ministry of Health and wherever necessary PHC health care delivery is done through private dispensaries also. (Heath Systems Profile-Saudi Arabia) Present status of PHC system in Saudi Arabia As per the WHO report, the country has three types of PHCs catering to populations of 500, 5,000 and 25,000. Some, which are in cities, are liable to be overloaded t o serve 100,000 people. And that additionally 900 PHCs are required to deliver an equitable health care service especially in remote areas. (WHO Report). Focus on Maternal Health Care Donabedian (1966), an authority on health care evaluation has suggested three levels of evaluation of a health service in terms of structure, process and outcome. While structure relates manpower, facilities and equipment, process involves assessment of the manner in which resources are used. Resources refer to health workers, procedures and techniques used to achieve the objectives. Outcome refers to evaluation of patient satisfaction, recovery rates and morbidity and mortality rates. Donabedian has opined that it would be ideal to adopt more than one of the three levels for evaluation to avoid misleading results. A study by Mansour (1996), cautions that people of Saudi Arabia are very polite and would not complain of poor services probably because they feel that the expatriate health workers would b e harmed if complaints are made. The same study says that people of Saudi Arabia are generally content with low standards of care. Access to prenatal health careThe study by Al-Ahamadi and Rolland (2005), which analysed 128 studies and selected 31 out of them, found access to prenatal health care was 67-95% which is considered good. (Al-Ahamadi and Rolland, 2005). There has been a steady decline in maternal mortality from 18 per 100,000 births in 1993 to 14 in 2003. 91 % of the births have been attended by skilled professionals, 86 % of whom were from public facilities. 86 % of pregnant mothers were fully immunised with tetanus toxoid. 90% of pregnant mothers received at least one antenatal check by a skilled profession. 21 % used contraceptives out of which 69% used pills and 24 % IUDs. Fertility rates fell from 6.5% in 1993 to 4.3 in 2003. Mean marriage age for females was 21.7 while for males it was 25.6 (WHO Report). However one report says that female mortality rates was 12 pe r 100,000 in 2000 (Health System Profile, 2006). A comparative figure of maternal mortality of 500,000 globally every year is noteworthy here. In Indonesia alone the rate is 20,000 every year (Healthcare Industry Today, 2010).