The public healthcare system and primary care services in Saudi Arabia: a system in transition

Background: Saudi Arabia has invested heavily in its health care system by establishing health care infrastructures to improve health of the nation. However, it remains to be seen whether it is efficient and effective in providing health care services needed. Primary health care, which is the basis of universal health coverage, needs to be assessed on its performance, challenges and future opportunities to serve the Saudi Arabian population. Aims: This review aimed to identify challenges within the Saudi Arabian health care system with a focus on primary health care services, and to analyse the interrelated factors in order to suggest remedial reforms to further strengthen and improve the health care system. Methods: A narrative review of previous studies and governmental reports was undertaken to extract, analyse, synthesize and report the findings. Results: The review found a number of key areas for improvement in the primary health care system. These areas include: the scope, structure, infrastructure, financing, increased demand, increased costs and workforce capacity. Other critical challenges include inequitable access to health services, quality and safety of services, the growing burden of chronic diseases, lack of an effective information system, management and leadership issues, and gaps in the referral system. Conclusion: The Saudi Arabian health care system needs comprehensive reform with a focus on primary health care. Keywords: delivery of health care, health services, primary health care, Saudi Arabia