The geography of health care in Saudi Arabia : provision and use of primary health facilities in Al-Qassim region

This study provides a geographical contribution to the understanding of the use of health services in Saudi Arabia, a country which has experienced enormous economic and social development, including its health care, over the last two decades. It now has a level of health provision almost equal, in quantitative terms, to that in some advanced countries. The first part of the thesis examines the main features of the health care delivery system in Saudi Arabia, its recent development, and the variation in health provision and utilisation between the country's 14 health regions. The second and main part attempts to examine the provision and use of the health facilities, and the possible factors that influence the people's use of primary care, in one region, Al-Qassim, in the central part of the country. The analysis is based upon a sample of several health centres selected from five parts of the region and from interviews with 1375 users of the primary services. The analysis has indicated that the demographic and socio-economic characteristics of the users varied significantly between the five areas. The ailments people use the services for are related particularly to age, social type, and level of education. Patterns of illness also varied between urban, rural and desert areas with gastric and chest complaints the most frequent cause for visits to health centres. Rates of visits to primary health services appeared to be high amongst all categories of the sample. Age level of education, social type, nationality, mobility and distance to centres explain these differences in use rates. Age, social type, and level of education are also important influences on attitudes towards use of folk healers. While the standard of primary care still varies between urban and rural areas, accessibility to health care is generally good, and individual factors of age, education and environment probably explain varying levels of use and standard of health. More research is needed on people's use of health facilities at the local community level. Several recommendations are made for further research.