Date of Award

11-2016

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Medical Education

First Advisor

Dr. Iain Blair

Second Advisor

Dr. Tom Loney

Third Advisor

Michal Grivna

Abstract

An optimal functioning health system delivers quality, timely, and efficient services to all individuals in a convenient and accessible location. The United Arab Emirates (UAE) is a rapidly developing country hosting a multinational population with emerging health issues and needs that are influencing the growth and direction of the health system. This study offers a comprehensive review and appraisal of the structure and function of the UAE health system using the Health Systems in Transition (HiT) framework.

A two-stage mixed-methods research design was used; stage one, included completing each chapter of the HiT framework using published and unpublished data; stage two entailed convening three focus group discussions with participants selected from key stakeholder groups including managers, service providers, and patients of the UAE health system to further explore the health system challenges and gaps identified after completing the HiT. Focus group discussions were taped, transcribed verbatim, and thematically analyzed.

Study findings revealed that the UAE health system includes the majority of the World Health Organization's components of a well-functioning health system. Specifically, governmental leaders are committed to good health and service, a wide range of accredited health care services are available, the UAE population has universal healthcare coverage, and the system is well-resourced in terms of infrastructure, financing, and human resources. However, the study highlighted a number of challenges and potential areas of health reform including: health sector fragmentation; rising costs and uncertain outcomes; proper regulation of the fast expanding private sector; shortage of national health human resources coupled with difficulty in retaining and supporting career advancement of expatriate human resources; population growth and increased levels of chronic disease risk factors.

The UAE health system has developed on an impressive trajectory since the country's formation in 1971. Despite significant achievements, several challenges have emerged affecting the costs and quality of health services. Recommended solutions to address such challenges include setting up independent national-level institutes for healthcare planning, improvement, quality and outcomes monitoring, enhancing workforce planning, and strengthening public health. In addition, there is a need to improve the integration between health systems and raise levels of health literacy in the population. Finally, the study recommends setting up national academic centers of excellence to avoid duplication and ensure high quality services. The study offers a valuable contribution to the health systems research in the UAE and allows international comparisons and benchmarking with other countries.

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