Conclusion

it is important to note that information on the quality of care is not systematically available, and thus additional dimensions of productivity cannot be assessed. in particular, the quality of care (for example, accuracy of diagnoses and treatment, patient-centeredness, follow-up and continuity of care) is also critically important for yielding positive health outcomes. Thus, in relative terms, higher productivity can also reflect the ability to provide higher quality of care per patient for the same number of health workers—aspects of performance that cannot be investigated with the available data.

CONCLUSION

The current density of health workers in Saudi Arabia—about 9 physicians and nurses per 1,000 population across various data sources—exceeds the WHO global benchmark (4.5 physicians and nurses per 1,000 population) for achieving UHC. However, further analysis of the current composition of health workers in Saudi Arabia highlights areas in which further policies are needed to strengthen the health workforce and shape its strategic growth to meet national transformation objectives. first, Saudi Arabia’s health system relies heavily on foreign workers and lesser trained and experienced diploma nurses. Saudi nationals comprise only one-third of all physicians and nurses, among whom the vast majority of practicing Saudi nurses (nearly 80 percent) are diploma nurses with only two years of education. These diploma nurses are not “nurses” in the strictest sense. Hence, the real number of Saudi nurses (those with a bachelor’s degree or advanced master’s or PhD degree) available for patient care is much lower than often assumed.

Within the Saudi health workforce, additional imbalances by cadre and type of training, facility type, and gender exist. Saudi physicians and nurses are predominantly employed in hospital settings (72 percent) rather than primary care facilities. The large majority of Saudi physicians are men (63 percent), whereas nurses are largely women (68 percent among diploma nurses and 71 percent among bachelor and advanced nurses). Among Saudi physicians, two-thirds are specialists, of which 68 percent are men; women are more represented among generalist physicians (at 45 percent).

Saudi physicians and nurses are further concentrated in urban areas and practice within the MOH. About 95 percent of the workforce is located in urban areas. even when adjusting for population size, the imbalance is still large (0.8 per 1,000 population in rural areas compared with 1.8 per 1,000 population in urban areas, including diploma nurses). There are more physicians for every bachelor and advanced nurse in urban areas and more diploma nurses to bachelor and advanced nurses in rural areas, showing a high dependency on diploma nurses in rural areas. Saudi physicians are also predominantly employed within the MOH (70 percent), followed by the Ministry of Defense (9 percent) and private sector employers (7 percent). Saudi bachelor and advanced nurses are mainly working within the MOH (73 percent), followed by the private sector (10 percent) and the national Guard (6.5 percent), which hires no diploma nurses.

An examination of the relative productivity of Saudi health workers is inconclusive. from the limited information available, the data suggest that the number of inpatient and outpatient visits is not related to the number of hospital health workers. no data on the quality of care are available to further assess worker