Kuwait: health system review

In 2017 the London School of Economics and Political Science (LSE Health) was engaged by the Kuwait Foundation for the Advancement of Sciences (KFAS) to undertake two interconnected tasks: first, a review of the Kuwait healthcare system and, second, to develop a public health strategy for the country. This report represents findings from the first task by outlining and assessing governance, financing, workforce, IT, service provision and public health arrangements within Kuwait’s healthcare system

The diabetes-obesity-hypertension nexus in Qatar: evidence from the World Health Survey

Background: As countries develop economically, an “epidemiological transition” occurs whereby a set of chronic diseases increasingly becomes a country’s health challenge. Against this background, this paper examines the most common conditions associated with the prevalence of diabetes in Qatar, with a specific focus on the diabetes-obesity-hypertension nexus. Methods: We analyzed data from the World Health Organization’s World Health Survey conducted in the State of Qatar in 2006. The survey included demographic, anthropometric, and blood chemistry measurements. Using multivariate logistical regression analysis, we assessed the most common conditions associated with diabetes, using both objective and subjective measures of diabetes. The objective measures relied on random blood sugar tests, and the subjective measure included respondents who affirmatively answered the question on diabetes diagnosis. We repeated our analysis on respondents who had blood glucose levels high enough to be considered diabetic/glucose intolerant but did not answer affirmatively on the question of diabetes diagnosis. Results: When using the objective measure of diabetes, the following conditions appeared significant: obesity (OR = 1.5, 95% CI = 1.2 – 1.9), higher income (OR = 1.4, 95% CI = 1.0 – 1.9), high cholesterol (OR = 1.4, 95% CI = 1.0 – 1.9), having Qatari origin (OR = 1.3, 95% CI = 1.0 – 1.7), and increasing systolic blood pressure (SBP) 120–139 mmHg (OR = 1.5, 95% CI = 1.2 – 2.0), SBP 140–159 mmHg (OR = 2.2, 95% CI = 1.6 – 3.1), SBP > 160 mmHg (OR = 3.2, 95% CI = 2.0 – 5.3). Similar results were obtained using the subjective measure of diabetes as a dependent variable. When applied to the group of respondents that included pre-diabetics and those who did not know they were diabetic, obesity and hypertension appeared as the only statistically significant explanatory variables. Conclusion: High prevalence of diabetes, hypertension, and especially obesity is documented among residents of Qatar. Further steps are required to tackle the most common conditions associated with the rising diabetes epidemic in the country, which might also pose significant fiscal challenges in the future

Structural equation model for estimating risk factors in type 2 diabetes mellitus in a Middle Eastern setting: evidence from the STEPS Qatar.

AIMS: Understanding type 2 diabetes mellitus is critical for designing effective diabetes prevention policies in Qatar and the Middle East. METHODS: Using the Qatar 2012 WHO STEPwise approach to surveillance survey, a subsample of 1224 Qatari participants aged 18-64 years was selected. Subjects had their fasting blood glucose levels tested, had not been diagnosed with or treated for diabetes, had a fasting time >12 hours and were not pregnant. We applied a hypothesized structural equation model (SEM) to assess sociodemographic, behavioral, anthropometric and metabolic variables affecting persons with type 2 diabetes mellitus. RESULTS: There is a direct effect of triglyceride levels (0.336) and body mass index (BMI) (0.164) on diabetes status. We also found that physical activity levels negatively affect BMI (-0.148) and positively affect high-density lipoprotein (HDL) (0.106); sociodemographic background negatively affects diet (-0.522) and BMI (-0.352); HDL positively affects total cholesterol (0.230) and has a negative effect on BMI (-0.108), triglycerides (-0.128) and waist circumference (-0.104). Diet has a positive effect on triglycerides (0.281) while family history of diabetes negatively affects total cholesterol (-0.104). BMI has a positive effect on waist circumference (0.788) and mediates the effects of physical activity over diabetes status (-0.028). BMI also mediates the effects that sociodemographic factors (-0.058) and physical activity (-0.024) have on diabetes status. BMI and HDL (-0.002) together mediate the effect of physical activity on diabetes status and similarly HDL and tryglycerides (-0.005) also mediate the effect of physical activity on diabetes status. Finally diet and tryglycerides mediate the effects that sociodemographic factors have on diabetes status (-0.049). CONCLUSIONS: This study's main finding is that triglyceride levels and BMI are the main variables directly affecting diabetes status in the Qatari population

Satisfaction and responsiveness with health-care services in Qatar - evidence from a survey

Satisfaction and responsiveness with health care are some of the main outcome variables of a health system. Although health outcomes have been studied in countries with different levels of economic development, there is limited information on the health provision/satisfaction/responsiveness nexus in countries where rapid transitions from middle to high-income status have occurred

The prevalence and predictors of diabetes in a private health insurance scheme: An analysis of three million beneficiaries in Saudi Arabia

BACKGROUND: Noncommunicable diseases (NCDs) are a leading threat to population health in Saudi Arabia. Addressing NCDs is a priority for health-care transformation, and understanding the current disease prevalence is crucial. The prevalence in other settings is unknown because studies have relied on data from households or public health-care institutions. This study aims to investigate the prevalence and predictors of diabetes in the privately insured population. MATERIALS AND METHODS: This retrospective study explored the prevalence and predictors of diabetes in beneficiaries aged 15 years or older who sought medical care in 2022. Data were sourced from the National Platform for Health and Insurance Exchange Services, a unified health insurance claim platform. We used the International Classification of Disease-10 to capture the condition. To identify predictors of diabetes, we employed a backward selection approach for logistic regression. RESULTS: Over 3.3 million beneficiaries sought medical care during the study. The population was relatively young aged 26–39 years, (47.5%) and two-thirds of males. The prevalence of diabetes was 11.0% and varied across regions, with the highest in Bahah (18.4%) and the lowest in Jizan (9.5%). Age, gender, nationality, insurance company size, body mass index, region, hypertension, and coronary heart disease were significant predictors of diabetes. Hypertensive patients were over five times more likely to have diabetes than those without hypertension (odds ratio OR = 5.08; 95% confidence interval CI = 5.02–5.24). Saudis were 30% more likely to have diabetes than other nationalities (OR = 1.3; 95% CI = 1.28–1.31). CONCLUSION: We found a higher prevalence of diabetes in privately insured beneficiaries than the recent national estimate. This necessitates population health management strategies at all levels (primary, secondary, and tertiary) to mitigate the burden of diabetes in privately insured individuals. This study provides valuable baseline data for the prevalence of diabetes in this population and emphasizes the urgent need for targeted interventions, especially in regions with a higher prevalence