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      The future of integrative health and medicine in Saudi Arabia

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          Abstract

          Saudi Arabia is witnessing a healthcare transformation to face the challenges of the increased burden of noncommunicable diseases and to maintain the quality of healthcare services. However, in Saudi Arabia, where low back and neck pain, depressive disorders, migraine, diabetes, and anxiety disorders cause the most disability, a broader way of integrative health approach is needed to foster healthy lives and promote well-being for all ages. In the presence of the advanced modern medicine healthcare system in Saudi Arabia, the traditional medicine healing system is being used by a substantial proportion of Saudis but like a shadow healthcare system. This phenomenon of using two healthcare systems reflects a need for an integrative healthcare system. Integrative medicine or approach is about bringing traditional, complementary, and modern medicine in a harmonized system of healthcare which can give a high return and save cost. The rationale behind integrative medicine is to include the best practices of both conventional and complementary therapy, uniting these practices into an integrative approach. Pain management, care of cancer patients, and behavior change are among the leading areas of integration models that should be included in healthcare transformation in Saudi Arabia. Investment in behavior change and well-being outside the boundaries of the healthcare system in the Saudi 2030 vision will have more impact on health and wellness of the Saudi citizen in the face of the epidemics of the lifestyle diseases. Models of integrative medicine during the healthcare transformation can be developed, evaluated, and replicated.

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          Health care system in Saudi Arabia: an overview.

          The government of Saudi Arabia has given high priority to the development of health care services at all levels: primary, secondary and tertiary. As a consequence, the health of the Saudi population has greatly improved in recent decades. However, a number of issues pose challenges to the health care system, such a shortage of Saudi health professionals, the health ministry's multiple roles, limited financial resources, changing patterns of disease, high demand resulting from free services, an absence of a national crisis management policy, poor accessibility to some health care facilities, lack of a national health information system, and the underutilization of the potential of electronic health strategies. This paper reviews the historical development and current structure of the health care system in Saudi Arabia with particular emphasis on the public health sector and the opportunities and challenges confronting the Saudi health care system.
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            Prevalence of physical activity and inactivity among Saudis aged 30-70 years. A population-based cross-sectional study.

            To assess physical activity levels among Saudi adults, and to examine the relationships of physical activity with body mass index (BMI), waist circumference (WC) and obesity prevalence. Data taken from the Coronary Artery Disease in Saudis Study which is a National Epidemiological Health Survey carried out between 1995 and 2000. Participants included 17395 Saudi males and females aged 30-70 years, selected randomly using a multistage stratified cluster sampling technique. Leisure-type and sport-related physical activities including walking were assessed using an interviewed-administered questionnaire. The activities were classified into five intensity categories and assigned metabolic equivalents (MET) according to the compendium of physical activity. Based on the intensity, duration and frequency of physical activity, subjects were classified into active or inactive category. Inactivity prevalence (96.1%) was very high. There were significantly (p<0.001)) more inactive females (98.1%) than males (93.9%). Inactivity prevalence increases with increasing age category, especially in males, and decreases with increasing education levels. Inactivity was the highest in the central region (97.3%; 95% CI = 96.8-97.8%) and the lowest in the southern region of Saudi Arabia (94.0%; 95% CI = 93.2-94.8%). Further, active individuals exhibited lower values of BMI and WC. These findings reveal the sedentary nature of Saudi population. The overwhelming majority of men and women did not reach the recommended physical activity levels necessary for promoting health and preventing diseases. The high prevalence of inactivity among Saudis represents a major public health concern.
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              The changing face of healthcare in Saudi Arabia

              Many countries now struggle to provide cost-effective, quality healthcare services to their citizens. Saudi Arabia has experienced high costs along with concerns about quality of care in its public facilities. To address these issues the country is currently restructuring their healthcare system to privatize public hospitals and introduce insurance coverage for both foreign workers and citizens. The changes provide an interesting and insightful case for the challenges in radically changing a country’s healthcare system. The situation also demonstrates a unique case in the Middle East for greater reliance of the private sector to address rapidly escalating healthcare costs and deteriorating quality. The complexity of changing a healthcare system is discussed with the many challenges associated with the change.
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                Author and article information

                Contributors
                Journal
                Integr Med Res
                Integr Med Res
                Integrative Medicine Research
                Elsevier
                2213-4220
                2213-4239
                23 June 2018
                December 2018
                23 June 2018
                : 7
                : 4
                : 316-321
                Affiliations
                [1 ]National Center for Complementary and Alternative Medicine, Ministry of Health, Riyadh, Saudi Arabia
                [2 ]College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
                Author notes
                [* ] Corresponding author at: National Center for Complementary and Alternative Medicine, P.O. Box 88300, Riyadh 11662, Saudi Arabia. statkhl@ 123456hotmail.com m.khalil@ 123456nccam.gov.sa
                Article
                S2213-4220(18)30169-0
                10.1016/j.imr.2018.06.004
                6303372
                30591884
                adadff12-fb22-43f1-baf1-d2137cd691cc
                © 2018 Korea Institute of Oriental Medicine. Published by Elsevier.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 27 May 2018
                : 13 June 2018
                : 15 June 2018
                Categories
                Review Article

                cupping,integrative medicine,saudi arabia,healthcare transformation

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