How do we strengthen the health workforce in a rapidly developing high-income country? A case study of Abu Dhabi's health system in the United Arab Emirates

Marília Silva Paulo,Luís Velez Lapão,Tom Loney

doi:10.1186/s12960-019-0345-9

Abstract

BackgroundThe United Arab Emirates (UAE) is a rapidly developing high-income country that was formed from the union of seven emirates in 1971. The UAE has experienced unprecedented population growth coupled with increased rates of chronic diseases over the past few decades. Healthcare workers are the core foundation of the health system, especially for chronic care conditions, and the UAE health workforce needs to be fully prepared for the increased rates of chronic diseases in the adult population. Abu Dhabi is the largest emirate in terms of land mass and population size, and the purpose of this paper was to assess how the health system has been using the Chronic Care Model to improve its capacity to reach out to all patients in the population.Case presentationThe Abu Dhabi health workforce has twice the number of doctors (52.4 vs. 23.2 per 10 000 population) and nurses (134.7 vs. 50.4 per 10 000 population) compared to the entire UAE health workforce. In addition to an overreliance on expatriate workers, there is an excess of some specializations such as general medicine and gynecology and a severe undersupply of other specialties including trauma and injury, and medical oncology. The digital infrastructure and skills of the health workforce need to be improved to minimize the proportion of the appointment time required to complete administrative tasks for a health insurance system and maximize the doctor-patient face-to-face interaction time for consultation and lifestyle counseling.ConclusionsA greater emphasis needs to be placed on developing self-management support strategies using a combination of nurse health educators and community-based patient-led health programs. The UAE Vision 2021 includes developing a world-class healthcare system, and full implementation of the Chronic Care Model seems to facilitate the detailed planning and preparation of healthcare services and workers required to achieve this goal.

Highlights

The United Arab Emirates (UAE) is a rapidly developing high-income country that was formed from the union of seven emirates in 1971
The Eastern Mediterranean Region (EMR) countries have been divided into three groups according to the specific needs of their health workforce
The primary aim of this paper is to contribute to improving the capacity of healthcare workers to reach out to chronic patients through the identified gaps of the Chronic Care Model (CCM) in the primary healthcare system of Abu Dhabi

Summary

Introduction

The United Arab Emirates (UAE) is a rapidly developing high-income country that was formed from the union of seven emirates in 1971. Strategies to achieve Universal Health Coverage and the Sustainable Development Goals have been the main themes for discussion and allocation of resources among healthcare policymakers Both of these initiatives target the organization and associated costs of healthcare services required to reach the entire population of a specific (2019) 17:9 specific framework of action for health workforce development in the Eastern Mediterranean Region (EMR) [3]. This region is facing major challenges regarding the capacity and composition of the health workforce with an “overall shortage of qualified workers with suboptimal and imbalanced overall production and availability in the region” [3]. This group has major issues related to a shortage of national health workers, a high reliance on expatriate staff, limited professional production capacity, and a high turnover of expatriate staff [3]

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