The first country in the Gulf region to establish Family Medicine was in Bahrain. And the first residency program started during 1983

1. WONCA Emro region Meeting,
Wonca Emro Conference Abu Dhabi, March 2017
Prof Faisal Abdul Latif Alnasir
FPC, FRCGP, MICGP, PhD
Senior Lecturer; Imperial College. London
Member of Anti-smoking International Alliances
General Secretary & Treasures; International Society
For The History Of Islamic Medicine
Chairman; Home Health Care Center
Temp Advisor: WHO Emro
Former Chairman: Dept Of Family & Community Medicine
Former Vice President: Arabian Gulf University
Former President: Scientific Council Family & Com. Medicine
Bahrain
F. Alnasir 2017

2. Demographics of Bahrain
Population: 1.3Million
Total area: 765.3 km²
Ethnicity: Arab, Asian, European
Unemployment rate: 3.7%
Life expectancy:76.54 years (2012)
F. Alnasir 2017

3. • The Health services are provided to the
population mainly by the Ministry of Health.
• There are three levels; Primary, Secondary
and Tertiary care.
• PHC are provided through 25 PHC centres
that are distributed on the Island
geographically.
• People are attached to the health centres
according to their residential address.
• Health insurance is a new topic under
discussion by the government to be
implemented shortly.
Structure primary health care
F. Alnasir 2017

4. • Each PHC centre consist of:
 Family Physicians
 GPs
 Nurses
 Axillary
 Community Health
 Midwives
 Health Educators
 Pharmacist
 Radiologist
 Lab Technician
 Dentist
 Hygienist
Disciplines working in primary
health care in the community
•PHC and Family
Medicine discipline is
available in all the
health centres around
the country which easy
accessible to the public
F. Alnasir 2017

5. Proportion of general practices
integrated in PHC team
• Each FP has a list of families that
are registered under his/her
domain.
• He takes care of all family members
from birth to death.
• All the medical facility in the PHC
are provided to the patients on
doctor’s instruction.
The allied health heath
service are:
• Childcare
• Ante, Post Natal
• Health education
• Community health
• Social workers
• Laboratory
• Radiology
• Dental
F. Alnasir 2017

6. Community based primary
health care in Bahrain
The services are multidisciplinary.
The doctor patient ratio is still high
which stands at 1 to 3500.
F. Alnasir 2017

7. Relation of primary health
care with other community
services
Community Council that has leaders
representations.
FP are members in many:
•Community committees
•Social Societies
•Medical Societies
F. Alnasir 2017

8. Impact on patient care
A study which was done by Alnasir, F in
2015, Reported that PHC is a very cost
effective service and showed that :
Heath center visit cost US$ 14-19
Hospital OPD visit cost US$ 130
Admission per night cost US$ 530- 660
Admission intensive care US$ 1300
Since the implementation of PHC services and the
development FPRP, the health services have
improved and the patients’ health awareness has
increased F. Alnasir 2017

9. What are the benefits?
• Patients are now resenting to being sent to
secondary care because they feel lost over there.
• FPs are appointed as part-timers in the
medical colleges to teach and train medical
students.
• Family Practice Residency Program is held in the
PHC were the FPs are involved in teaching and
training of residents.
F. Alnasir 2017

10. What barriers are encountered?
The most serious barrier is shortage of FPs in the
country leading to high doctor (FP) to patients ratio
(1 to 3500).
Causes are:
• Decrease in the program intake capacity (16-20
/year). The country’s immediate need is more than
830 FDs (around 400 currently available);
• FM is not a priority among the policy makers
• New graduates prefer other specialty as it is more
financially rewarding.
F. Alnasir 2017

11. How teams support or impede
response to community needs
• PHC team are close to the community and
considered their family friends
• They are easily accessible (within the locality)
• Short appointment system
• Home visits for certain cases
• Respond to the needs (material, social ,
psychological)
F. Alnasir 2017

12. Lessons for other countries
What works well in a community based PHC:
• Continuity of care
• FP taking care of the whole family
• Family Folder
• Easy accessible Locations
What does not work well are mainly due to
shortage of FP:
• Goals can’t be achieved
• FP are overloaded and they have no time to plan for
the better health of their patients, just perform the
daily demand
F. Alnasir 2017