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kuwait: kuwait Health Profile 2012

2012/03/14

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Kuwait Health Profile 2012

The Ministry of Health (MOH), located in the Capital region is responsible for planning, financing, resource allocation, regulation, monitoring and evaluation as well as health care service delivery. The Ministry of Health is the third largest public-sector employer after the ministries of education and interior. During the Iraqi invasion, most medical facilities were devastated and reduced to shambles. One of the Government's primary tasks after liberation was to bring health care system back on rails in the shortest possible time.
The Ministry of Health operates through an administrative and a technical workforce and has an extensive central organizational structure, headed by the Minister. (MOH organizational chart is attached as annex 1). The Minister of Health is assisted by the Undersecretary and twelve Assistant Undersecretaries. Central departments under the direct supervision of the Undersecretary include; Technical department, legal advisor, planning and follow up, public relations, treatment abroad, medical council and department of medical services. The Secretary General, Kuwait institute of medical specialization report directly to the Minister.
The Assistant Under-Secretaries are administratively responsible for public health affairs, dental health, health services, blood transfusion and laboratories, nutrition and drug control, drugs and medical supplies, financial affairs, administrative affairs, legal affairs,  quality control affairs, and newly established health regions and private health services & licensing department. The MOH overall structure therefore consists of twelve functional divisions embracing 42 central departments and offices at the central level. A ministerial council, headed by the minister with Under Secretary and Assistant under Secretaries as its members, meets on a weekly basis to discuss all issues related to the health system. The health regions are represented by the newly appointed Assistant Under secretary of health regions.
Currently, the Ministry of health is in the process of revising its organizational structure. Few new departments have been added, like department of health regions, central department of medial services and private health services and licensing department. Few other departments have been either abolished or merged with others. Earlier eight departments along with all the health regions were reporting directly to the undersecretary. Recently, through a ministerial declaration, two separate departments have been created, including a department of health regions, therefore shifting some authority from the under secretary to the newly appointed assistant under secretaries.
Generally the organizational structure of the ministry is heavy at the top with some evidence of duplication of roles and responsibilities between different departments. In addition, there is a significant variation in distribution of responsibilities among assistant under secretaries. The number of departments supervised by them varies from one toeight departments leading to overburden in some cases. Roles and functions of each department is clearly defined in the ministerial decrees issued at the time of establishing new departments although in practice there is some overlap and duplication of work. There is a need to organize the structure of MOH with a view to minimize the overlap among various tasks and functions and with clear and equitable sharing of departmental responsibilities. There is good working relationship and coordination between different departments in the ministry, evident by number of committees that meet regularly to discuss and resolves issues of mutual interest. The council of assistant under secretaries that meet on weekly basis is another forum to improve coordination between various departments. Likewise, the links with other ministries including ministries of planning and finance are  well established and smooth. Recently established council of undersecretaries facilitates this process. However, there seems to be a gap between the central departments in Ministry of health and the health regions in terms of coordination, communication, technical supervision and information sharing.
Administrative and financial rules and procedures in MOH are written down, clearly defined and available. Job descriptions of all the staff are developed at the time of creation of new positions and these are available within the ministry but not widely distributed and most of the staff is not aware of their existence. There is good system of performance evaluation of staff. Performance of all staff is assessed on annual basis by the respective supervisor and graded based on defined criteria into excellent, good or weak. There is a separate budget allocated for excellent performing staff, which gets a bonus based on the recommendation of supervisor. Sometimes promotions are also based on performance in addition to other considerations like certificates from continuing medical education department. Weak performers are recommended for refresher training and other administrative action if required. There are examples of actions taken, including termination from service, for the staff found guilty of negligence. Despite the computerization initiative, the communication processes are still based on traditional paper based exchanges and all official correspondence and documents are maintained as hard copies. There is no inter-departmental networking in place at the ministry or its related departments. There is no central login-based intranet for access to ministry documents, training materials, or other resources to facilitate efficient
communication.

Primary Health Centres
There are 72 primary health centres spread over the country. The services offered by them include general practitioner services and childcare, family medicine, maternity care, diabetes patient care, dentistry, preventive medical care, nursing care and pharmaceuticals.
Secondary Health Centres
Secondary healthcare services are provided by the six major hospitals: Sabah hospital,Amiri hospital, Adan hospital, Farwaniya hospital, Mubarak Al-Kabeer hospital and Jahra hospital.
The structure of each one of this hospital include a general hospital, a health centre specialised clinics and dispensaries. The policy of each hospital is to provide the best  possible healthcare to all citizens and residents.

Modern, for-profit
Despite the comprehensive services provided by the Ministry of health, private hospitals and clinics thrive in Kuwait. Private sector providers focus on curative services, and have little role in preventive interventions. There are 5 private hospitals in Kuwait with a total bed capacity of 427. Total number of doctors in these hospitals is 254 and number of nurses 707. In 2004, total number of outpatient visits in private hospitals was 798,985 (compared to 1.75 million in public sector hospitals). Data is not available on exact number of private clinics. Most of the private hospitals and clinics are concentrated in central and commercial areas like Farwania, Hawalli and the capital region and provide secondary and tertiary curative care. MOH is regulating the construction of new private hospitals to be built in other regions to ensure that they are equally distributed. Private  ealth services are generally perceived to be of better quality and mainly accessed and utilized by the better-off Kuwaiti population.


Modern, not-for-profit
Oil companies’ hospitals include
- Ahmadi Hospital
- Texaco Hospital
- Kuwait National Petroleum Company (KNPC) hospital

Kuwait has one of the most modern health care infrastructures in the region. The health system consists of both public and private sectors. More than 80% of all health services are provided by the public sector, mainly by the Ministry of health. Other than MOH,  Ministry of defence and Kuwait Oil Company have separate hospitals for their employees. Ministry of social affairs through its hospital provide health services to the handicapped and elderly. Private sector is small but rapidly expanding.

At present, the healthcare network in Kuwait is the best in the Gulf region and among the finest in the world. Kuwaitis receive medical services at government clinics and hospitals free of charge. Public healthcare is maintained by an intricate network of primary and secondary health centres and specialised hospitals and research institutions. There are 72 primary health centres spread over the country. The services offered by them include general practitioner services and childcare, family medicine, maternity care, diabetes patient care, dentistry, preventive medical care, nursing care and
pharmaceuticals. Secondary healthcare services are provided by six major hospitals: Sabah hospital, Amiri hospital, Adan hospital, Farwaniya hospital, Mubarak Al-Kabeer hospital and Jahra hospital. The structure of each one of this hospital include a general hospital, a health centre, specialised clinics and dispensaries.
Despite the excellent comprehensive services provided by the public health service, private hospitals and clinics thrive in Kuwait. The MPH regulates standards and the fees they may charge. The private hospitals and clinics have their own pharmacies. Most of them are general hospitals with some specialist departments. Some have limited equipment, such as ICUs, or specialists and refer patients to government hospitals for special procedures.
Private clinics are usually staffed by doctors of a particular specialty. There are several private dentists and dental clinics providing services to international standards. Orthodontics is only available to expatriates through these dentists and clinics. The Ministry of Health has approved the applications of 35 private companies to set up private hospitals in Kuwait. A decision is also issued allowing cooperative societies, private hospitals and Kuwaiti doctors to open private clinics for general practice in residential areas.

With a distinguished history in terms of health care, Kuwait rapidly built up its infrastructure in the 1960s and 1970s. However, since 1981, development has slowed and the country’s population growth has begun to put pressure on its existing health care capacity. The government is now taking measures to address this situation, with a number of capacity-building initiatives to increase bed inventories, improve human resources and encourage private sector development in the works. In 2007 the government unveiled a $173m plan to increase bed capacity, followed by a July 2008 announcement to spend $3.1bn on eight new hospitals.

The first stage of the new plan will see the construction of the $1.2bn Jaber Al Ahmed Al Sabah Hospital, followed by the three-phase construction of eight additional hospitals with varied specialisations, which are expected to be operational in 2015-16. Retaining qualified staff in the public sector is also a priority, with salary raises introduced in February 2008 expected to help in this regard. Funding to the sector continues to increase. By 2008, total health care expenditure accounted for 3.7% of the country’s GDP. In March 2009, the minister of health requested a budget of KD962m ($3.42bn) for the fiscal year 2009/10.

This expansion in funding will be used to offer additional health care services, with the Ministry of Health (MoH) planning to open 19 new health centres and support the private sector. The government is looking to expand the role of the private sector, with indications that it could enlist its help in building a national health insurance scheme.

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