HEALTH MANPOWER IN SAUDI ARABIA: WHICH WAY FORWARD?
In the year 1974, I published a paper entitled “Projected Needs for Health Manpower in Saudi Arabia”. In the paper, I stated that Saudi-born doctors constituted 20% of the total number of the doctors working in the country. In the years 1980 and 1982, I published two more papers as a reminder of the shortage of Saudi health personnel and the need to relate medical curricula to our needs. Today, more than 30 years after the publication of that first paper, despite the increase in the number of Saudi doctors, the percentage stands at 22%, an increase of only 2%. The reason, it seems is the lack of strategic planning.
Let us take a look at the present state of the Health Manpower in KSA, (doctors and para- medicals) and make a projection to the year 2035, 28 years from now when the population is expected to double from what it is now.
In order to cope with this phenomenal increase in the population by the year 2035, the number of doctors in Saudi Arabia must be doubled from the present figure of 35000 to 70000. If our aim is to ensure that 60% of the doctors at post are Saudis, then the number of Saudis need to increase from the current 7700, to 42000. It is expected that many of the Saudi doctors working at present will have left the service by the end of the next three decades for various reasons including retirement or change of careers leaving only 70% which is about 5000. This means that in the next 28 years, at least 37000 Saudi doctors have to be trained. Considering that it has taken 40 years to train only 7700 doctors, 10 – 15 colleges of medicine at least need to be established in addition to the 10 already in existence in order to meet the challenge.
To operate an efficient health team, 6-8 para-medicals are required for every doctor. These include all nursing staff as well as health assistants in such areas as the laboratories, x-rays, anesthesia, nutrition, rehabilitation, public health, health management etc. With 70,000 doctors in the year 2035, we should have at least 420,000 para-medicals. If our plan is to ensure that 60% of them are Saudis, that would give us 252,000 Saudi para-medicals. In the last 50 years we have managed to train only 35,000 Saudi Para-medicals. Only 25,000 of them will still be working by the year 2035. That means that 227,000 Saudi Para-medicals should be trained in the coming 28 years. Is this possible? What are the alternatives? Who should bear the responsibility of this training; the government, the private sector or both?
There are many challenges, to say the least, besides that of increasing the number of Saudi health personnel to the desired level. These challenges include the following:
· To improve the quality of education and training and make them relevant to the needs of the community.
· To aim at an efficient utilization of the health manpower.
· To have an equitable geographic distribution.
· To reach a judicious balance between curative, preventive, promotive and rehabilitative services. This should be reflected in the training scheme and curriculum design.
· To improve the relationship between primary, secondary and tertiary care.
· To strengthen the role of the private sector in education and training of Health Manpower.
The improvement of the condition of Health Manpower in Saudi Arabia with regard to number, quality of training, efficiency and distribution, requires strategic planning. This should be accomplished along with an efficient system of follow- up, evaluation and feed back. It is my hope that when we look back from the year 2035 we would be able to say that we did it right.
1. Sebai Z. A. Baker T. D. Projected Needs for Health Manpower in Saudi Arabia, 1974-1990: Medical Education 1976;10:359-361.
2. Sebai ZA. Planning for Medical Education, Proceedings of the 4th Saudi Medical Meeting, King Faisal University, Dammam, 1980;342-344.
3. Sebai ZA. Health Manpower; The Problem Facing Saudi Arabia. Saudi Medical Journal 1982;3:217-221.
Zohair A. Sebai
Professor of Family and Community Medicine
President, Sebai Institute
Jeddah, Saudi Arabia