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Abstract
BackgroundThe United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population. To achieve this it has implemented extensive health system reforms in the past 10 years. The nature, extent and success of these reforms has not recently been comprehensively reviewed. In this paper we review the progress and outcomes of health systems reform in the UAE.MethodsWe searched relevant databases and other sources to identify published and unpublished studies and other data available between 01 January 2002 and 31 March 2016. Eligible studies were appraised and data were descriptively and narratively synthesized.ResultsSeventeen studies were included covering the following themes: the UAE health system, population health, the burden of disease, healthcare financing, healthcare workforce and the impact of reforms. Few, if any, studies prospectively set out to define and measure outcomes. A central part of the reforms has been the introduction of mandatory private health insurance, the development of the private sector and the separation of planning and regulatory responsibilities from provider functions. The review confirmed the commitment of the UAE to build a world class health system but amongst researchers and commentators opinion is divided on whether the reforms have been successful although patient satisfaction with services appears high and there are some positive indications including increasing coverage of hospital accreditation. The UAE has a rapidly growing population with a unique age and sex distribution, there have been notable successes in improving child and maternal mortality and extending life expectancy but there are high levels of chronic diseases. The relevance of the reforms for public health and their impact on the determinants of chronic diseases have been questioned.ConclusionsFrom the existing research literature it is not possible to conclude whether UAE health system reforms are working. We recommend that research should continue in this area but that research questions should be more clearly defined, focusing whenever possible on outcomes rather than processes.
Highlights
The United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population
The purpose of this paper is to describe the main healthcare challenges and public health issues in the UAE and review the progress and outcomes of health systems reform
MEDLINE, EMBASE and PsycINFO electronic databases were searched covering the period from 2002 to April 2016 using a combination of the following MESH terms, free-text words, and entry terms: UAE; United Arab Emirates; Dubai; Abu Dhabi; healthcare quality, access and evaluation; healthcare reform, health system reform, health sector reform
Summary
The United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population To achieve this it has implemented extensive health system reforms in the past 10 years. The United Arab Emirates (UAE) is a young nation, established in 1971 as a federation of seven Emirates: Abu Dhabi, Dubai, Ajman, Umm Al Quwain, Sharjah, Fujairah and Ras Al Khaimah (Fig. 1). This newness has allowed its leaders to deliberately plan for the development of UAE society in order to strengthen national unity, promote continuous economic growth and personal health and wellbeing [1]. Healthcare in the UAE has benefited from rapid economic growth and there has been a significant increase in the number of healthcare facilities and healthcare professionals and in levels of service use
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