The evaluation and development of a model for primary health care in the United Arab Emirates
The results of the literature review and survey show that tremendous changes have taken place in the United Arab Emirates both in its economic as well as in the provision of health care, since its independence in 1971. The country has extensive primary health care services that are easily accessible. The range of services provided includes health promotion, preventive, curative and maternity and child health services. However, the philosophy of primary health care is not generally accepted and the emphasis remains on providing a curative service and the use of high technology medicine. There are many other difficulties with the current system including a shortage of manpower; poor co-ordination between primary care and hospital based services; rising cost of health care provision; inadequate provision of health education programmes; inadequately or inappropriately resourced primary health centres; and the lack of reliable and good quality data on primary health care. Several recommendations are made: 1. Creating a task force dedicated to primary health care and involving all stakeholders in order to identify gaps and deficiencies, make recommendations for improvement and ensure that the recommendations are being implemented. 2. Emphasising the importance of primary health care in the overall provision of health care. 3. Establishing a correct balance and a better co-ordination between primary, secondary and tertiary levels of care. This should include an improvement in the referral and feedback system between primary care and hospitals. 4. Ensuring the establishment of an effective health education programme aimed at emphasising the value of primary health care, simple low-cost technology, health promotion and prevention services so minimising the dependence on the use of hospitals and high technology medicine. This should take into account the different cultural, religious and social backgrounds of both the expatriate community as well as local inhabitants. 5. Improving the provision of maternal child health care, screening, health promotion, prevention services and the availability of equipment, facilities and resources to enable primary care health professionals to carry out the assessment and management of most common and treatable conditions. 6. Producing doctors, nurses and other health professionals who will promote health for all people and meet the needs of the society they serve. This will require a greater collaboration and partnership between medical schools and the Ministry of Health. 7. Developing a system of continuing professional development with staff training programmes for health professionals, to ensure the maintenance of their competence. 8. Forming a professional organisation, such as a College or Institute of general practice, in order to identify the professional needs of general practitioners, to represent the specialty on professional matters and on all relevant medical decision making bodies, and to promote professional development at both national and international levels.