Analysis of national health indicators

Between Saudi Arabia and France

Student: ………………….

ID: ………………………..

Research presented within the requirements of the course of the Healthcare

Economics

HSAE 603

supervision of Dr: Talaat Al-demerdash Ibrahim

KING ABDULAZIZ UNIVERSITY

Faculty of Economics and Management
Health Services and Hospitals Administration Department
Jeddah-Saudi Arabia

second Semester
2023
 CONTENTS

Introduction ...................................................................................................... 2

Chapter 1 ........................................................................................................... 4

Health Indicators of Saudi Arabia2019-2021 .................................................... 4

Chapter 2 ........................................................................................................... 8

Health Indicators of France2019-2021 .............................................................. 8

Chapter 3 ......................................................................................................... 12

Comparison between Saudi Arabia and France in 2021 ................................. 12

Conclusion ....................................................................................................... 16

References ....................................................................................................... 16

1
 Introduction
Health indictors are important metrics in determine what going on about the

health issues in specific countries. Disease status such for example needed to

determine the correct plane for future treatments. Every Saudi citizen has

access to healthcare thanks to the ministry of health in the country. Since King

Abdul Aziz Bin Abdul Rahman Al Saud established Saudi Arabia, disease

management and prevention have risen to the top of the government's list of

objectives. A comprehensive framework for healthcare services encompassing

the entire kingdom is provided by the ministry of health, which is the kingdom's

representative. Citizens of Saudi Arabia have free access to all health care

services offered by the kingdom in all kingdom regions, which has led to an

improvement in public health in recent years. Health indicators are metrics

created to compile information about how well healthcare institutions are

performing.

On the other hand, France care about the health of its individuals and this

increased greatly during covid 19 pandemic disease. The French system is a

social health insurance system in which all legal residents must register with the

public health insurance program (sickness insurance funds) and provides

universal population coverage. The universal coverage is given, first, on the

professional/ occupational basis and secondly, since 2000, based on residence.

Spending on health per capita and as a share of GDP has been greater in France
2
than the EU average for many years. Until 2020, spending on health was growing

at around the same rate as the economy, but it increased more rapidly in

response to the COVID-19 pandemic, while GDP fell by 8 %.

In this research we will talk about the health indictors in both countries, Saudi

Arabia and French including demographic, economic , disease, immunization

indictors and health resources, the final chapter gives a comparison between

the both countries in this five health indictors to give a hint about the most

apparent differences.

3
 Chapter 1
Health Indicators of Saudi Arabia
2019-2021
Preface:
This chapter includes health indicators in Saudi Arabia. The fifth common
health indicators described in this chapter are demographic, health resources,
disease, immunization, and economic indicators over the 2019 2020 2021
three years.
1: Saudi Health Demographic Indicators
Saudi Arabia
Demographic Indicators
2019 2020 2021
Population (Total) 35,827.362 35,997,107 35,950,396
Population growth(annual%) 2.3 .5 -0.1
% of population <15 years 24.5 24.4 24.5
% of population >65 years 2 2 3
Birth rate, crude (per10.000 people) 180 180 180
Crude Death rate per 10000 inhabitants 30 30 30
Mortality rate, adult, female (per 10,000
810 880 880
adult females)
Mortality rate, adult, male (per 10000
1010 1080 1080
adult male)
Mortality rate for those under the age of 5
70 70 70
(per 10000 live birth)
Infant mortality rate per 10000 live births 60 60 60
Fertility rate, total (births per women) 2.5 2.5 2.6
life expectancy at birth 77 76 76
life expectancy at birth for Females 79 78 78
life expectancy at birth for Males 76 75 75

Saudi Arabia saw a 0.5% increase in the population during 2020, but -0.1
decreased in the total population in 2021. The proportion of the population over
65 increased by 1% in 2021. Crude mortality and birth rates continue over the

4
three years. The mortality rate for both sexes increased by 70 people in 2021
compared to 2020 and 2019. The infant mortality rate and the under-5 mortality
rate almost persist with unnoticeable variation. The rate of fever has increased
in the past few years with an increase in life expectancy with a slight decline in
2021.
2: Saudi Health Economic Indicators
Economic Indicators Saudi Arabia
2019 2020 2021
Percentage of expenditure on health care from GDP 5.69% 5.75% 5.78%
Current health expenditure per capita (US$) 1.316$ 1.316$ 1316$
Out of pocket expenditure per capita (current US$) 217.18$ 217.18$ 219.5$
Out-of-pocket expenditure (% of current health
16.5% 16.5% 17.3%
expenditure)
Domestic general government health expenditure per
910.52$ 910.52$ 911.52$
capita (current US$)
Domestic general government health expenditure (% of
3.93% 3.39% 4.1%
GDP)
Current health expenditure (% of GDP) 5.69% 5.69% 5.49
Domestic general government health expenditure (% of
69.17% 49.1% 49.3%
current health expenditure)
Domestic general government health expenditure (% of
11.05% 11.05% 11.05
general government expenditure)

Percentage of expenditure on health care increased through years to achieve

the goals and vision of Saudi Arabia. Current health expenditure per capita had
small variation. Domestic general government health expenditure (% of general
government expenditure) equal 11.05. Out-of-pocket expenditure (% of current
health expenditure) increased through years by 0.8%. Domestic general
government health expenditure per capita (current US$) was 910$ and
increased by 1$ in 2021.

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3: Health resources Indicators
Saudi Arabia
Indicators of health resources
2019 2020 2021
Number of beds per 10,000 inhabitants 22.5 22.4 22.6
Number of medical doctors per 10,000 inhabitants 33.1 32.8 35.9
Number of pharmacists per 10,000 inhabitants 9.3 7.9 9
The number of nursing per 10,000 inhabitants 55.55 54.64 56.05
Medical doctor number 94,333 95,336 100,247
Pharmacist number 31,872 27,529 30,840
Nurses' numbers 194,907 196,701 196,795

The number of beds decreased in 2020 by0.1 and again increased by0.2 in 2021
compared to 2019. The number of doctors increased in 2021 and the same
condition for nurses and pharmacists. According to data provided for 2020,
there have been many declines in health resources that are unparalleled from
other years that may be linked to the epidemic coronavirus.

4: Saudi Disease Indicators

Saudi Arabia
Disease Indicators
2019 2020 2021
Malaria cases 0 0 0
Tuberculosis incidence rate (per 10,000) 0.9 0.8 0.8
Cases of measles (10,000) 0.299 0.01 0.096
Diabetes Prevalence % population (20-79 y) 17.9 18.2 18.7
Neonatal Mortality rate per 10000 life birth 35.7% 34.1 32.7
Prevalence of anemia among children under 5y (%) 21.8% 22.1% 23%
Cause of death, by communicable diseases and maternal, 7% 7% 7%
prenatal and nutrition conditions (% of total)
Cause of death, by non-communicable diseases (% of total) 73% 73% 73%

There is no malaria during these three years, and the incidence of tuberculosis
decreased by 0.1 in 2021. Measles cases enjoy a good preview that has fallen
below 0.1% in 2021. The prevalence rate of diabetes% of the population (20-79
6
y) has 0.3 increase in 2020 with 0.7 increase in 2021. Neonatal mortality
decreased by 1.6% in 2020 and 1.4% in 2021. The prevalence of anemia has
increased over the years. Non-communicable diseases responsible for large
deaths compared to infectious diseases due to good immunization coverage.
The causes of death from infectious diseases, maternal diseases, prenatal
conditions, nutrition (percentage of total) and cause of death from non-
communicable diseases (percentage of total) vary slightly over the years.

5: Immunization indicators
Immunization indicators Saudi Arabia
2019 2020 2021
Immunization for measles prevention for children 12-23 months 95 96 98
Polio (Pol3) immunization coverage among 1-year-olds (%) 97 95 97
Immunization, DPT (%of children ages 12-23 months) 96 95 97
Immunization, HepB3(% of one-year children) 96 95 97
BCG vaccination 52 95 94.1
Hib (Hib3) immunization coverage among 1-year-olds (%) 96 98 98
Pneumococcal conjugate vaccines (PCV3) immunization
97 97 97
coverage among 1-year-olds (%)

The range for immunization and vaccination in the Kingdome of Saudi Arabia
reach above 98%, it's a good indication of communicable disease control and
prevention. Immunization for measles, polio, Hib3 and pneumococcal
conjugate vaccine all reach 98% in 2021.

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 Chapter 2
Health Indicators of France2019-2021
Preface:
This chapter included the fifth common health indicators in France from
demographic indicators (mortality rate, total population, fertility rate, crude
mortality rate) to immunization indicators during 2019 through 2021.
1: Health Demographic Indicators

Demographic Indicators France

2019 2020 2021
Population (Total) 67,388,001 67,571,107 67,749,632
Population growth(annual%) 0.3 0.3 0.3
% of population <15 years 18 18 17
% of population >65 years 21 21 21
Birth rate, crude (per10,000 people) 110 110 110
Crude Death rate per 10,000 inhabitants 90 100 100
Mortality rate, adult, female (per 10,000
adult females) No data available about this period, data available
Mortality rate, adult, male (per 10000 only for 2018 and pervious years
adult male)
Mortality rate for those under the age of 40 40 40
5 (per 10,000 live birth)
Infant mortality rate per 10,000 live 30 30 30
births
Fertility rate, total (births per women) 1.9 1.8 1.83
life expectancy at birth 83 82 82
life expectancy at birth for Females 86 85 85
life expectancy at birth for Males 80 79 79

There's an annual growth through these three years by 0.3%. Percentage of

population over 65 years old higher than percentage of population lower than
15 years old. Crude birth rate sustained while crude death rate increased

8
through 2021 and 2020. Mortality rate for both males and females increased but
the data is not available on world bank. Infants' mortality rate sustained and the
same case for those under 5 years old. Fertility rate decreased through 2020 and
increased by0.03 in 2021. Life expectency had no changes. Life expectency for
males was 86 years in 2019 while in 2020 decreased by one year and the same
case for life expectency for males but the main life age for males lower than
females.

2: Health Economic Indicators

Economic Indicators France
2019 2020 2021
Percentage of expenditure on health care from GDP 11.1% 12.4% 12.5%
Current health expenditure per capita (US$) 4,491$ 4,769$ 6,115
Out of pocket expenditure per capita (current US$) 415.98$ 426.3$ 489.3$
Out-of-pocket expenditure (% of current health 9.26% 8.94% 9%
expenditure)
Domestic general government health expenditure per
3,389$ 3,659$ 3,710$
capita (current US$)
Domestic general government health expenditure (% of 8.33% 9.36% 9.2%
GDP)
Current health expenditure (% of GDP) 11.06% 12.21% 12.8%
Domestic general government health expenditure (% of 75.31% 76.72% 77.75%
current health expenditure)
Domestic general government health expenditure (% of 15.06% 15.19% 15.5%
general government expenditure)

Economic health indictors in continuous increasing through these three years.

This appears from the data presented above. Expenditure on health care from
GDP increased in 2020 incombered to 2019. Current health expenditure per
capita (US$) also increased by 200$ in 2019 and by about 1,500$ in 2021.
Domestic general government health expenditure (% of current health

9
expenditure) had small variation in this period and the same case for Domestic
general government health expenditure (% of GDP).

3: Health resources Indicators

Indicators of health resources France
2019 2020 2021
Number of beds per 10,000 inhabitants 57.3 57 58
Number of medical doctors per 10,000 inhabitants 33.11 33.24 32.5
Number of pharmacists per 10,000 inhabitants 10.73 10.64 11.3
The number of nursing per 10,000 inhabitants 122.2 119.2 120.1
Medical doctor number 213,201 214,315 214,200
Pharmacist number 68,621 69,078 70,100
Nurses number 744,307 764,260 785,240

Number of beds increased in 2021 but with small decrease in 2019 by about 0.3.
number of medical doctors increased by 0.13 in 2020 but decreased again in
2021 by 1.26% in 2021. Number of pharmacists in continues increasing and
number of nurses but number of medical doctors decreased in 2021
incomparable to 2020.
4: Disease Indicators
Disease Indicators France
2019 2020 2021
Incidence of malaria (per 10,000 population at risk) No, Malaria
Tuberculosis incidence rate (per 10,000) 0.91 0.83 0.77
Cases of measles 2637 240 16
Diabetes Prevalence % population (20-79 y) 5.3% 5.3% 5.3%

Neonatal Mortality rate per 10,000 life birth 30 30 30

Prevalence of anemia among children under 5y (%) 14.7% 14% 13%
Cause of death, by communicable diseases and maternal, 6% 6% 6%
prenatal and nutrition conditions (% of total)
Cause of death, by non-communicable diseases (% of total) 87% 87% 87%

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The data presented that there's no malaria cases anymore with very small
number of cases of tuberculosis, the measles cases decreased to its lowest value
in 2021. Neonatal mortality rate sustained over years. Non communicable cause
of deaths is higher than deaths occur due to communicable. Prevalence of
anemia decreased to 13% in 2021.

5: Immunization indicators
Immunization indicators France
2019 2020 2021
Immunization for measles prevention for children 12-23
92% 92% 92%
months
Polio (Pol3) immunization coverage among 1-year-olds (%) 96% 96% 96%
Immunization, DPT (%of children ages 12-23 months) 96% 96% 96%
Immunization, HepB3(% of one-year children) 91% 91% 91%
BCG vaccination for infants till one year of age 95% 80% 80%
Hib (Hib3) immunization coverage among 1-year-olds (%) 95% 95% 95%
Pneumococcal conjugate vaccines (PCV3) immunization 92% 92% 92%
coverage among 1-year-olds (%)

Immunization coverage is good arranged from 91% to 96% with only BCG
coverage 80% in 2020 and 2021. Immunization, DPT and polio reach 96% in 2021
while Hib3 95%. The coverage range nearly sustained through years.

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 Chapter 3
Comparison between Saudi Arabia and France in 2021
Preface:
This chapter included comparison between France and Saudi Arabia in the
common fifth health indictors (demographic, health resources, disease,
immunization, and economic indicators).

Demographic Indicators Saudi Arabia France

Population (Total) 35,950,396 67,749,632
Population growth(annual%) -0.1 0.3
% of population <15 years 24.5% 17
% of population >65 years 3% 21
Birth rate, crude (per1.000 people) 180 110
Crude Death rate per 1000 inhabitants 30 100
Mortality rate, adult, female (per 1,000 adult 880
females) No data
Mortality rate, adult, male (per 1000 adult male) 1080
Mortality rate for those under the age of 5 (per 70 40
1000 live birth)
Infant mortality rate per 1000 live births 60 30
Fertility rate, total (births per women) 2.6 1.83
life expectancy at birth 76 82
life expectancy at birth for Females 78 85
life expectancy at birth for Males 75 79

Total population of Saudi Arabia is double total population of France.

Percentage of Population lower than 15 years old higher in Saudi Arabia while
total population above 65 higher in France than Saudi Arabia. Fertility rate in
Saudi Arabia is good than fertility rate of France so crude birth rate is higher. Life
expectency in France is higher than life expectency in Saudi Arabia.

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 Economic Indicators Saudi France
Arabia
Percentage of expenditure on health care from GDP 5.78% 12.5%

Percentage of expenditure on health care (private

1316$ 6,115
sector) of total expenditure on health
Current health expenditure per capita (US$) 219.5$ 489.3$

Out of pocket expenditure per capita (current US$) 17.3% 9%

Out-of-pocket expenditure (% of current health

911.52$ 3,710$
expenditure)
Domestic general government health expenditure
4.1% 9.2%
per capita (current US$)
Domestic general government health expenditure (%
5.49 12.8%
of GDP)
Current health expenditure (% of GDP) 49.3% 77.75%

Domestic general government health expenditure (%

11.05 15.5%
of current health expenditure)
Domestic general government health expenditure (%
5.78% 12.5%
of general government expenditure)

All percentages of economic health indictor of France higher than those in Saudi
Arabia except Out-of-pocket expenditure per capita (current US$). Out-of-
pocket expenditure (% of current health expenditure) shows great difference
between France and Saudi Arabia, in France equal 3710 while in Saudi Arabia
equal 911 dollars.

13
 Indicators of health resources Saudi Arabia France
Number of beds per 10,000 inhabitants 22.6 58
Number of doctors per 10,000 inhabitants 35.9 32.5
Number of pharmacists per 10,000 inhabitants 9 11.3
The number of nursing per 10,000 inhabitants 56.05 120.1
Medical doctor number 100,247 214,200

Pharmacist number 30,840 70,100

Nurses' numbers 196,795 785,240

Indictors here with great difference between both countries as the data
presented above, such for example total number of medical doctors in France
double the number exist in Saudi Arabi. Nursing personal number about 5 times
more than those in Saudi Arabia.

Disease Indicators Saudi Arabia France

Malaria cases 0 0
Tuberculosis incidence rate (per 100,000) 0.9 0.77
Cases of measles (100,000) 0.299 16
Diabetes Prevalence % population (20-79 y) 17.9 5.3%
Neonatal Mortality rate per 1000 life birth 35.7% 30
Prevalence of anemia among children under 5y (%) 21.8% 13%
Cause of death, by communicable diseases and 7% 6%
maternal, prenatal and nutrition conditions (% of
total)
Cause of death, by non-communicable diseases (% 73% 87%
of total)

Saudi Arabia has delightful indicators leading to all indicators of diseases such as
malaria, measles, tuberculosis and the (cause of death, due to infectious
diseases, maternal and prenatal conditions and nutrition (% of the total)), which

14
is also the same for France, but France has been very good at managing diabetes
with only about 5% prevalence. Measles cases are lower than those in France.

Immunization indicators Saudi Arabia France

Immunization for measles prevention for children 12-23
98 92%
months
Immunization of children's polio vaccine for 12-23
97 96%
months
Immunization, DPT (%of children ages 12-23 months) 97 96%
Immunization, HepB3(% of one-year children) 97 91%
BCG vaccination 94.1 80%
Pneumococcal Conjugate Vaccine (PCV) 98 95%
Hib (Hib3) immunization coverage among 1-year-olds
97 92%
(%)

Vaccination had a good preview in both countries but better in Saudi Arabia.
where vaccinations reach approximately 98%. For example, measles vaccination
reached 98%. Both countries have a good control on the prevalence of
communicable disease.

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Conclusion
We included all the information's that related to the health indictors in both

countries starting from demographic indictors till the immunization indictors.

The results in both countries differ through years and some points had small

variations. Total population in France more than those in Saudi Arabia by about

30 million. Economic health indictors in France were higher at all direction and

more than Saudi Arabia, both with good immunization coverage and disease

control but the non-communicable disease still need more attention. Diabetes

prevalence in France is very low and this is good according to country like France.

Health indictors needs more attention for future recommendation and disease

control.

References
1. Sokoya T, Zhou Y. As Measures of Individual Health Status and Their Public
Perspectives: Cross-sectional Survey Study. J Med Internet Res. 2022 Jun
21;24(6):e38099. doi: 10.2196/38099. PMID: 35623051; PMCID: PMC9257608.

2. https://www.moh.gov.sa/en/Ministry/Statistics/book/Pages/default.asp
x
3. the global economy.com.
4. State of Health in the EU France Country Health Profile 2021.
https://www.theglobaleconomy.com/rankings/hospital_beds_per_1000
_people/
5. World bank. Health indictors. https://data.worldbank.org/topic/8
6. WHO. Indictors. https://www.who.int/data/gho/data/indicators

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