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. 2024 Jun 8;14(6):e079332.
doi: 10.1136/bmjopen-2023-079332.

Economics of primary healthcare: cost estimation of clinical services at primary care facilities in the six countries of the Gulf Cooperation Council

Khalifa Elmusharaf  1 , Sébastien Poix  2 , Daniel Grafton  3 , Johanna S Jung  4 , Rebecca Gribble  5 , Rachael Stanton  4 , Lamia Mahmoud  6 , Deena Hamza Al Asfoor  6 , Tayba Alawadi  7 , Mohammed Mustafa  7 , Lulwa Shuwaiter  8 , Mohammed S Alsuwaidan  9 , Zahir Al-Abri  10 , Sultana Al-Sabahi  10 , Sherif Fadda  11 , Hassan Raza Syed  11 , Muneera Almutairi  12 , Yahya M Al-Farsi  13 , Nicholas Banatvala  14 , Dudley Tarlton  5
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Economics of primary healthcare: cost estimation of clinical services at primary care facilities in the six countries of the Gulf Cooperation Council

Khalifa Elmusharaf et al. BMJ Open. .

Abstract

Objective: While the Gulf Cooperation Council (GCC) countries have demonstrated a strong commitment to strengthening primary healthcare (PHC), the costs of delivering these services in this region remain relatively unexplored. Understanding the costs of PHC delivery is essential for effective resource allocation and health system efficiency.

Design: We used an ingredient-based method to estimate the cost of delivering a selection of services at PHC facilities in the six GCC countries in 2019. Services were categorised into eight programmes: immunisation; non-communicable diseases (NCDs); oral and dental care; child health; nutrition; mental health; reproductive, maternal, neonatal and child health and general practice. The cost estimation focused on two key ingredients: the costs of drugs and supplies and the healthcare workforce cost. The coverage rates of specific types of health services, including screening and mental health services, were also estimated. Data for the analysis were obtained from ministries of health, health statistics reports, online databases, national surveys and scientific literature.

Results: The estimated costs of delivering the selected services at public PHC facilities in the six GCC countries totalled US$5.7 billion in 2019, representing 0.34% of the combined 2019 GDP. The per capita costs varied from US$69 to US$272. General practice and NCD programmes constituted 79% of the total costs modelled while mental health ranged between 0.0% and 0.3%. Over 8 million individuals did not receive NCD screening services, and over 30 million did not receive needed mental health services in public PHC facilities across the region.

Conclusions: To our knowledge, this is the first study to estimate the costs of services delivered at PHC facilities in the GCC countries. Identifying the main cost drivers and the services which individuals did not receive can be used to help strengthen PHC to improve efficiency and scale up needed services for better health outcomes.

Keywords: HEALTH ECONOMICS; Health policy; PUBLIC HEALTH; Primary Health Care.

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Conflict of interest statement

Competing interests: The authors alone are responsible for the views expressed in this article, and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated.

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