Dissertations / Theses on the topic 'Public health Saudi Arabia'

Rising worldwide rates of noncommunicable diseases (NCDs) in the Middle East, principally Saudi Arabia, have put an increasing load on the health system and employers. Middle Eastern organizations have been slow to develop targeted health programs, which include an emphasis on employee productivity. The purpose of this study was to determine the relationship, if any, between employee lifestyle and workplace productivity. Productivity is the amount of work produced based on the time and cost required to do so. The underlying theoretical foundations of this research were the socioecological health model and the human capital model. The quantitative, ex post facto design relied on secondary data from Saudi Aramco. Lifestyle data were collected from a health risk assessment including the Stanford Presenteeism Scale. Data analysis consisted of both a correlational and multiple regression analysis. Correlational results indicated that exercise, tobacco use, body mass index (BMI), and nutrition were significantly related to workplace productivity. Exercise and nutrition had a significant positive correlation with workplace productivity, while tobacco use and increasing BMI were negatively correlated with workplace productivity. Multiple regression analysis results explained 21% of the variance in the dependent variable, a sizable percentage with such a large sample. Overall, these results suggest a strong influence of health choices on productivity. Since this research was the first to explore the unique cultural context and draw attention to the increasing NCD burden, the results are notable. Implications of this research should resonate with organizational leaders in the Middle East, and provide a clear opportunity to improve organization and human performance.

Introduction Community pharmacy in Saudi Arabia faces many challenges. There is a lack of empirical research about medication safety in community pharmacy from the perspective of different stakeholders. A holistic approach is needed to identify medication safety problems. Aim To explore factors associated with medication safety in this setting. Methods Three empirical studies were undertaken. Focus groups explored medication safety problems using the Human Factors Framework and a Delphi exercise prioritised these problems. Interviews were conducted with pharmacy users to explore their willingness to share information with pharmacists during consultations using the Self-Regulatory Model. Results Four focus groups and four interviews (n=35 participants) identified seven main themes: commercialism; illegal supply of medication; lack of enforcement of regulations; the healthcare system; self-medication; trust in pharmacists; and communication and information exchange. Consensus was achieved with 28/84 items identified during the Delphi study. The top five priorities were: lack of pharmacy facilities; pharmacists' communication between pharmacists and physicians; patient databases; post-registration education; and pharmacists' long working hours. The interview study (n=21) identified that trust in pharmacists was the main enabler in sharing information. Barriers were pharmacists' perceived attitudes towards counselling, workload, lack of motivation, patient proxies, type of questions asked, gender and lack of privacy. Both the focus group study and the interview study highlighted pharmacy users' consumerist behaviour. Conclusion This research has shown that community pharmacy is a complex system involving many interacting factors. Multifactorial interventions are needed at individual (patient, pharmacist), pharmacy and organisational level. The effect of consumerist behaviour that pharmacy users exercise in purchasing medication without utilising the pharmacist's expertise and not engaging in dialogue on patient safety should be studied. Further research is needed to analyse pharmacy users' interactions with pharmacists to identify the factors that encourage communication and sharing of all relevant information with pharmacists.

Rising worldwide rates of noncommunicable diseases (NCDs) in the Middle East, principally Saudi Arabia, have put an increasing load on the health system and employers. Middle Eastern organizations have been slow to develop targeted health programs, which include an emphasis on employee productivity. The purpose of this study was to determine the relationship, if any, between employee lifestyle and workplace productivity. Productivity is the amount of work produced based on the time and cost required to do so. The underlying theoretical foundations of this research were the socioecological health model and the human capital model. The quantitative, ex post facto design relied on secondary data from Saudi Aramco. Lifestyle data were collected from a health risk assessment including the Stanford Presenteeism Scale. Data analysis consisted of both a correlational and multiple regression analysis. Correlational results indicated that exercise, tobacco use, body mass index (BMI), and nutrition were significantly related to workplace productivity. Exercise and nutrition had a significant positive correlation with workplace productivity, while tobacco use and increasing BMI were negatively correlated with workplace productivity. Multiple regression analysis results explained 21% of the variance in the dependent variable, a sizable percentage with such a large sample. Overall, these results suggest a strong influence of health choices on productivity. Since this research was the first to explore the unique cultural context and draw attention to the increasing NCD burden, the results are notable. Implications of this research should resonate with organizational leaders in the Middle East, and provide a clear opportunity to improve organization and human performance.

Infectious disease management system area is considered as an emerging field of modern healthcare in the Gulf region. Significant technical and clinical progress and advanced technologies can be utilized to enhance the performance and ubiquity of such systems. Effective infectious disease management (IDM) can be achieved by analysing the disease management issues from the perspectives of healthcare personnel and patients. Hence, it is necessary to identify the needs and requirements of both healthcare personnel and patients for managing the infectious disease. The basic idea behind the proposed mobile IDM system in this thesis is to improve the healthcare processes in managing infectious diseases more effectively. For this purpose, internet and mobile technologies are integrated with social networking, mapping and IDM applications to improve the processes efficiency. Hence, the patients submit their health related data through their devices remotely using our application to our system database (so-called SAIF). The main objective of this PhD project was the design and development of a novel web based architecture of next-generation infectious disease management system embedding the concept of social networking tailored for Saudi patients. Following a detailed literature review which identifies the current status and potential impact of using infectious diseases management system in KSA, this thesis conducts a feasibility user perspective study for identifying the needs and the requirements of healthcare personnel and the patients for managing infectious diseases. Moreover, this thesis proposes a design and development of a novel architecture of next-generation web based infectious disease management system tailored for Saudi patients (i.e., called SAIF – infectious diseases management framework for Saudi Arabia). Further, this thesis introduces a usability study for the SAIF system to validate the acceptability of using mobile technologies amongst infected patient in KSA and Gulf region. The preliminary results of the study indicated general acceptance of the patients in using the system with higher usability rating in high affected patients. In general, the study concluded that the concept of SAIF system is considered acceptable tool in particularly with infected patients.

Background: the aims of this study were to assess the outpatients needs among 155 patients at Al-Amal Complex for Mental Health in Riyadh, Saudi Arabia, and identifying the demographic variables that are associated with these needs. Method: the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) was used to assess the needs and the demographic questionnaire was used to identify the patient’s demographic variables includes gender, age, income and level of education. Results: patient who meets any one of these criteria; being elderly, poor, and the uneducated are more likely to have higher total number of needs. Men and women are more likely to report similar met needs, but women are more likely expressed more unmet needs.

This study explores public attitudes towards healthcare in the Eastern Province of KSA. It employs a sequential mixed-method design. Semi-structured focus group discussions (FGDs) were conducted with fifty-four participants in the Eastern Province. The qualitative arm of the study used a framework thematic analysis. A questionnaire was constructed from evidence-based items from four sources: an international performance assessment framework, literature review, systematic review, and the FGDs. The questionnaire was administered to 813 participants using on-site and online recruitment modes. Two qualitative validity assessments and quantitative construct validity and reliability tests were then carried out for the questionnaire. The FGDs indicate a public sense of pride in the Saudi health system. However, some concerns emerged from the FDGs-most notably, access barriers to the government health sector including the referral system from primary to secondary care and the necessity of personal connections, or 'wasta', to access timely care. Access barriers also emerged in the private health sector, namely the affordability of care and health insurance companies' delays in responding to medical claims. Participants also considered their inability to discuss treatment plans and to be involved in decision-making processes with their doctors as issues in both the public and private sectors. Participants were also concerned about the Ministry of Health (MOH) monitoring and regulating both sectors. This affected participant attitudes towards health service provisions. The questionnaire demonstrated qualitative validity and good psychometric properties in construct validity and internal reliability. Participants perceived doctor-patient communication as the most positive aspect of the Saudi health system while they perceived MOH monitoring of the private sector and affordability of care as the most negative aspects. Socio-demographic characteristics were considered as strong predictors of participants' attitudes towards the health system, and nationality and insurance status were identified as the most frequent predictors of satisfaction. Recommendations include implementing policies that monitor pricing in the private sector, fairer access to government healthcare, and patient involvement in decision-making processes. Future research should investigate the relationship between public attitudes towards the Saudi health system and health-related decisions to ensure better use of healthcare services in KSA.

Background: The Kingdom of Saudi Arabia faces one of the highest prevalence rates of type 2 diabetes mellitus (T2DM) in the world. However, there are no credible local data on the trends and future projections of the disease, and the relevant international studies underestimated the true prevalence rates. This thesis used epidemiological modelling to study the trends in T2DM prevalence in Saudi Arabia, predicted its future levels, and quantified the impact of reducing some risk factors on the disease prevalence trends. Methods: This thesis developed and validated the “Saudi IMPACT Diabetes Forecast Model”, which integrates data on the population, obesity and smoking prevalence trends in Saudis aged ≥25 years to estimate the trends in T2DM prevalence (1992-2022) using a Markov modelling approach. The model considers different reasonable scenarios of future trends in obesity prevalence, and incorporates a number of parameters to model the disease epidemiology. These parameters include the estimated diabetes incidence, case-fatality, total mortality, relative risk of diabetes if obese, and relative risk of diabetes if a smoker. The model data inputs and parameters were obtained from different sources, including local departments, medical literature and assumptions. The model results were validated against local data from the STEPwise survey in 2005, and against the model of the Global Burden of Disease study, where the model produced reasonably close results to both of these studies. Results: The prevalence of T2DM among the Saudi population aged ≥25 years was estimated to rise substantially during the 30-year period of 1992-2022 from 8.5% to 39.5%, assuming some levelling off of obesity trends (capping), or to 44.1%, assuming uncapped increasing obesity trends. In men, T2DM prevalence was estimated to increase from 8.7% to 39.2% with capped obesity trends, or to 41.3% with continuing linear increase in obesity trends. In women, T2DM prevalence was estimated to increase from 8.2% to 39.8% with capping of obesity trends, or to 47.7% without such a capping. The model showed that if the trends in obesity start to decline by 10% in 12 years (2010-2022), a relative reduction of 13% in diabetes prevalence could be achieved. If the prevalence of obesity was halted at the 2010 levels, a 10% relative reduction in diabetes prevalence could be attained by 2022. ii Conclusion: T2DM is currently a major public health challenge in Saudi Arabia, and this thesis predicted that its burden will increase substantially in the next decade. Intensive and aggressive preventive measures directed to reduce the levels of risk factors, particularly obesity and smoking, can result in reasonable reduction of the disease prevalence, and therefore should be an urgent action.

Background: Saudi Arabia is one of the Gulf Cooperative Council (GCC) countries which have common characteristics such as high-income governments, dominant expatriate populations, and under-developed healthcare systems, including healthcare financing. The dominance of the expatriate working population raises the question of how to find a mechanism that ensures expatriates have appropriate access to medical care whilst the employers bear the responsibility of healthcare expenses. Saudi Arabia is one of the few GCC countries to have reformed its private healthcare system through a Compulsory Employment-Based Health Insurance (CEBHI). The CEBHI was designed to mitigate some of the disadvantages of the Employment Sponsored Insurance scheme previously implemented in the United States; and this is the first study to investigate the impact of this form of private health insurance on access to medical care, in a country such as Saudi Arabia. The main aim of the study was to explore the influence of health insurance on access to medical care, in order to assist the Saudi Government in their deliberations about making CEBHI compulsory for all people (citizens and expatriates) within Saudi Arabia. This aim was investigated through the following objectives: 1) to review health financing in Saudi Arabia and compare it with other GCC countries and elsewhere in the world; 2) to compare the access to medical care of insured and uninsured expatriates in Saudi Arabia; 3) to develop a framework for understanding the complex relationship of health insurance and access to healthcare, 4) to make policy-relevant recommendations regarding the key question as to whether compulsory health insurance in Saudi Arabia should be expanded. Methods: Two methods were used to tackle the study objectives. Firstly, a framework for country-level analysis of healthcare financing arrangements was used to compare and analyse the national expenditure on healthcare within the GCC and other developing/developed countries. Secondly, a logistic regression analysis of data from a cross-sectional survey was undertaken to investigate the impact of health insurance on access to medical care, considering the main workplace and personal characteristics of the expatriates. Three access measures, access to usual medical care (Access 1), inability to access medical care (Access 2), and utilization of medical care (Access 3), were used to evaluate access to medical care for the expatriate population. Prior to the implementation of CEBHI the expatriate population accessed medical care through a variety of different avenues. These modes of access were used as classification of the expatriate population into four groups. Two of these groups were insured but had a different Previous Method of Paying for Healthcare (PMPHC) (Group B=insured, not paid, and Group D=insured and paid) and two groups were not insured but also had different PMPHC (Group A=not insured, not paid and Group C=not insured, but paid). A multistage stratified cluster sampling was used, and a sample selected from each sector and company size proportionately. The total sample size was 3,278. A simple conceptual framework for studying access to medical care was developed to guide the multi-variate regression techniques, and greatly assisted interpretation of the results. Results: The GCC characteristics impact on the healthcare financing strategies of GCC countries in three ways. First, GCC governments provide the majority share of the health budget, similar to high-income countries. Second, GCC countries use different strategies to control expatriates costs, but some of these strategies lead to increased out-of-pocket expenses, which is a characteristic of low-income countries. Third, health care financing systems in GCC countries are still being developed as they finance most of their public services, including health care services, with revenue from natural resources (i.e. oil or gas). Additionally, some of their health care indicators are identifiable with those from below upper-middle income countries. In addition, after CEBHI, private expenditure did not change but remained around 22.4%, which does not reflect the huge number of people having access to medical care though private sector only. However, there was a shift in the means of private sector expenditure from Out Of Pocket payments to private insurance expenditure. OOP expenditure decreased from 32.3% in 2006 to 28.4% in 2008, and private insurance expenditure increased as a percentage of private sector expenditure from 26.2% in 2006 to 36.7% in 2008. Analysis of the data from the survey demonstrates that health insurance is strongly associated with access to medical care, as measured by the three different access measures). Compared to uninsured workers, being enrolled in CEBHI increased the possibility of an expatriate’s access to usual medical care and utilisation of medical care by more than 10 (8.709-12.299, 95%), and 2.3 (1.946-2.750, 95%) respectively. However, the influence of PMPHC is greater than the influence of insurance alone on reducing the inability to access medical care (health insurance reduced the inability to access medical services by 42% (0.515-0.995, 95%), whereas PMPHC reduced the inability to access medical services by more than 65.% (0.273-0.436, 95%)).Therefore, the impact of health insurance on access to medical care is much greater for those expatriates previously having had healthcare costs met by their employer, than for those who had not. These impacts remained, when the odds ratios were adjusted for both workplace and personal characteristics. Conclusion: CEBHI has a clear positive impact on reducing out of pocket payments and increasing private insurance expenditure. However, overall, private healthcare expenditure has increased insignificantly. This indicates that the main impact of CEBHI on private expenditure, is the change in the mode of payment from out of pocket payments to private insurance expenditure. However, the actual impact on private sector expenditure is still minor. Access to medical care is influenced by health insurance. In addition, it is also influenced by PMPHC as a contributory role to play in the influence of health insurance on access to medical care. Workplace and personal characteristics play a small part in mediating the influence of health insurance on access to medical care. A framework was developed for understanding the complex relationship of health insurance and access to healthcare, which will be useful for further investigations regarding the influence of health insurance on access to medical care. Both long and short-term recommendations are proposed for increasing the expatriate population’s access to medical care, whilst reducing the burden on healthcare financing.

My main thesis is that Saudi culture, in the context of the field of Molecular Genetics Epidemiology (MGE) research, poses many challenges to the currently used biomedical research regulations developed by the Saudi National Committee of Bioethics (NCBE). The NCBE regulations are informed by selected international research ethics guidelines, and they are influenced by a set of assumptions about how we ought to think about ethics. The overall focus is on a version of liberalism, where there is a strong commitment to autonomy, there is a significant focus on informed consent, the harm principle guides the justification of action, and paternalism is seen as something that is to be avoided. There are no specific guidelines that regulate MGE research in Saudi Arabia. Therefore, it was important as a first step in the thesis to analyse the relevant regulations (both the Saudi and the selected international ones) and explore the related normative issues. One of the main empirical findings was an observed and reported lack of adherence to the requirements of the NCBE regulations. In this thesis I argued that the problem emerges from a mismatch between the liberal international guidelines and the nature of the Saudi context. One possible way to address this tension is to formulate a set of guidelines and research practices that build upon the nature of Saudi social relations and norms. This may result in a focus on what we can call trust-based, rather than the currently promoted autonomy-based, bioethics.

The current study projects the third-person perception phenomenon into the area of emergency management, specifically regarding risk communication in the context of religious gatherings. This study utilized the Umrah religious gathering in Makkah, Saudi Arabia, during summer 2019 as a case study (N = 257). This study aimed to investigate whether pilgrims perceive there was a greater effect of health information on others than on themselves. Survey results were translated and then coded and analyzed statistically using SPSS software. The findings indicated that third-person perception existed among pilgrims. Specifically, the perception of pilgrims that the influence of news about MERS-CoV, believed to be undesirable in its effect on themselves, was greater on others than on themselves was found statistically significant. Further, the findings indicated that the more pilgrims watched, listened to, or read news about MERS-CoV, the larger the effect of the news they perceived on themselves and others was. Thus, exposure to MERS-CoV news did not increase, but rather decreased the perception of difference between self and others. Also, the empirical findings indicated that pilgrims who were knowledgeable about MERS-CoV could relate to the coverage. Moreover, if pilgrims believed they were affected by MERS-CoV news, they believed that the MERS-CoV news had a similar or greater effect on other pilgrims. The findings indicated socio-demographics had a partial effect on third-person perception, Finally, the stronger the perceived effect of MERS-CoV news on oneself, the more likely these pilgrims were to take protective actions against the MERS-CoV epidemic. However, the third-person perception anticipated in the use of impersonal communication (pamphlets, television, radio, newspapers, Internet, social media, text message, health clinics, mosques messages, public events, and billboards) and of interpersonal communication (friends, family member, or others you know) was not found significant. Moreover, the perceived effects of MERS-CoV news on others did not show third-person perception regarding behavior intention or consequences. These findings have implications for risk communication and its governance during religious gatherings as well as for the prepared individuals to promote preparation for risk and actions toward risk mitigation.

This research utilised a multi-method approach to investigate risk factors that could lead to the development of psychopathology in institutionalised children in Saudi Arabia. Chapter 1 provided a cultural context for understanding reasons that lead to institutionalisation and attitudes towards these children. Chapter 2 outlined previous research that considered the negative impact of institutionalisation on development and Chapter 3 considered several frameworks that could explain adverse outcomes in this population. Chapter 4 presented a qualitative study that highlighted, following interviews with institutionalised children and their carers, that symptoms linked to externalising and internalising difficulties, as well as reports of behaviours to conceal their social status, were evident in children. The subsequent empirical chapters explored the presence of symptoms of psychopathology in institutionalised children compared to non-institutionalised peers, after having translated key questionnaires (linked to measurements of externalising and internalising symptoms, as well as self-concept, shame, stigma, and aggressive behaviours (Chapter 5)). Chapter 6 found some evidence for perceptions of stigma in children, their carers, their teachers, and other teachers who had less familiarity of working with these groups of children. Chapters 7 and 8 used theoretical frameworks to demonstrate that children’s reported perceptions of stigma were associated with symptoms of depression and anger, and that this relationship was mediated for depression and anger by children’s reports of their feelings of shame (Chapter 7). In addition, it showed that social information processing models had some utility in understanding links between elevated reports of aggressive behaviours in children with endorsements of hostile behavioural response to hypothetical peers via increased interpretations of ambiguous (benign/hostile) hypothetical actions as hostile (Chapter 8). Chapter 9 summarised how these findings fit with and extend previous research. In addition, it suggested how the findings could be used to intervene to deliver educational interventions to reduce the negative attitudes towards the institutionalised children and to provide specialised training for individuals who work with children and adolescents in institutional care, and society more broadly.

Current statistics on Health and Safety (H&S) outcomes the Kingdom of Saudi Arabia (KSA) public construction sector demonstrate the need for academic and practical assessment of the current environment for the purpose of improving outcomes. Even though the construction public sector in Saudi Arabia has been rapidly expanding, the H&S record of this industry remains considerably poor, as evidenced by the rising figures of injuries and deaths. The purpose of this research is to assess the current use of H&S technologies and, therefore, possibilities for the use of building information modelling (BIM) in the industry. The research aims to enhance H&S management in Saudi public sector construction projects by exploring integrated approaches to project design and delivery using BIM-based technologies and processes This research uses a mixed method approach to assess the current H&S environment to develop a framework suitable for the unique environment aimed at improving the current outcomes. The data collected through a survey and interviews with subject matter experts has been analysed to outline the major issues facing the implementation of innovative technologies to improve current business processes and provide a roadmap to enhance the predominant H&S policies and activities in Saudi Arabia. Challenges identified through these efforts include the Saudi environment as having high levels of fragmentation, a low skilled, multilingual and multi-ethnic workforce and inefficient use of BIM technologies being made. Based on these findings, a framework, which incorporates BIM to include automated hazard identification and correction during design and during construction, has been developed. The framework is initially devised based on a synthesis of the literature and further refined based on findings from questionnaires. The result of this research is the identification of 18 factors impacting H&S. The framework is developed and validated using interpretive structural modelling (ISM). Through these methods, the key driving factors for improving H&S outcomes in the public construction sector in KSA are identified. Among these, better enforcement of regulations and laws is identified as the key factor needed for improving outcomes. The study concludes with a discussion of the applications of the proposed framework and recommendations for future research. Specifically, this research advocates for the inclusion of BIM technologies in H&S frameworks as a method of addressing the specific challenge of communicating with a predominately migrant workforce. This new approach for H&S analysis during construction focuses on the integration of construction simulation, 3D/4D/5D construction management and safety analysis through the incorporation of technology for both planning and communication.

Recent health care reforms within Saudi Arabia have advocated use of economic evaluation in health care decision making. Little research has, however, considered the use of economic evaluation to set priorities in rentier state settings. This thesis explores the nature of the rentier state and the basis of health care priority setting, and conducts a systematic review of the use of economic evaluation in priority setting. The thesis uses in-depth qualitative research to explore health care priority setting and use of economic evaluation in Saudi Arabia. Qualitative data comprised 22 in-depth interviews with decision makers at the national and district levels, 3 focus groups, and one meeting observation. Data collection and analysis were conducted iteratively using constant comparison. Findings show that contextual factors have a great influence on the decision making process and that the use of economic evaluation is still very limited. There appeared to be two types of barriers to the use of economic evaluation: decision context-related barriers and barriers relating to the production of economic evaluation data. Incorporating economic evaluation into the health care decision making process in Saudi Arabia is proving to be complex and contextual factors have more influence on priority decisions than economic evaluation.

Despite the existence of breast cancer screening that could promote early diagnosis and survival of breast cancer, high mortality rates of breast cancer persist among Filipino women. The purpose of the qualitative study was to describe the perceptions, beliefs, and behaviors of Filipino women working as Overseas Filipino Workers (OFWs) in Saudi Arabia. Face-to-face interviews were conducted with 20 Filipino women between the ages of 40 to 60 years who were recruited voluntarily using purposeful sampling technique. Guided by the structures of health belief model (HBM), the study used an inductive coding technique to elicit common themes from the raw data. The study established that the participants' screening behaviors were influenced by family history of breast cancer, the financial and emotional burden of the disease and its treatment, the benefit of early detection, mobility to participate, culture and language barriers, and the social media. The study also demonstrated that the desire to participate in breast cancer screening is influenced by the participants' perception of susceptibility and perception of severity to breast cancer. The findings of the study could create a positive social change as it may inform the practice of public health providers, influence the drafting of informed policies for comprehensive breast health care, and improve access to preventive health services for Filipino women OFWs. Furthermore, the study could empower Filipino women in their personal health decision making, especially when working in other countries where good health is the working capital and a precondition for survival.

In global terms, Saudi Arabia is a rapidly developing country. As such, its food industries have yet to fully implement the food safety management systems common in the EU. In the hospitals sector, the Ministry of Health intends to implement Hazard Analysis Critical Control Points (HACCP) system to provide safe meals for patients, staff and hospital visitors. The aim of this study was to evaluate the readiness of the Saudi Arabian hospitals to implement HACCP by assessing the pre-requisites programmes in their foodservices departments. An audit form was used in four hospitals in Riyadh. Questionnaires were also used to assess self-reported behaviour, knowledge and attitudes of 300 foodservices staff. Lack of training was known to be a major omission in the pre-requisite programs (PRP’s) of all hospitals. Therefore a bespoke food safety training program was developed and delivered to food handlers in the participating hospitals. An assessment was then made to determine whether this intervention had any effect on their knowledge, attitude to food safety and self-reported behaviour. The results show that, the prerequisite programs were not implemented properly in the participating hospitals. Also, foodservices staff had a poor knowledge with regard to food safety. However, staff knowledge was significantly improved following the training (p. value < 0.05) and their level of knowledge remained stable after six months. Participants’ behaviours and attitudes also improved after the training. This indicates that, training has a positive impact on food handlers knowledge, practices and attitude.

Despite increased awareness about patient safety and quality of care, errors and adverse outcomes occur frequently in clinical practice. An estimated 10% of the 35.1 million U.S. hospital patients suffered injuries caused by medical errors; the most common were medication errors, which accounted for more than 50% of all medical errors. Work-related stress is associated with medication errors for health care professionals (HCP) in Saudi Arabia (SA) hospitals; however, the specific types of stressors and their effect on the level of medication errors have not been studied in SA. The purpose of this quantitative correlational study was to examine the relationship between the overall level and sources of work-related stress using the job stress scale on the level of medication errors for a group of 269 HCPs working at King Abdul-Aziz Hospital (KAH) in SA. The theoretical framework for this research was the Donabedian patient safety model, which relates healthcare quality to personal, environmental, and organizational factors. Binary logistic regression analyses indicated there was no relationship between overall levels of stress and medication errors. However, specific sources of work related stress such as disruption to home life, excessive workload, and night/weekend call duties were associated with a significant increase in the medication error rate, while pressure to meet deadlines and difficulties with colleagues was associated with a significant decrease in the medication error rate. Positive social change implications include how understanding the impact of work-related stress on medication errors by SA HCPs may lead to specific interventions to reduce medication errors and improve patient care.

ANTECEDENTES: Después del hogar, la escuela representa el segundo entorno en el que se desatrrolla la vida de los niños. Su capacidad de aprendizaje está estrechamente relacionada con su bienestar y salud. Los estudiantes saludables asisten a clase con mayor asiduidad y son capaces de concentrarse mejor en las tareas escolares (Murray, 2007). Los enfermeros escolares desempeñan múltiples funciones en la protección y la promoción de la salud de los estudiantes. OBJETIVOS: A) General: ldentificar los factores que dificultan la implantación de la figura de la enfermera escolar en Jeddah, Arabia Saudi. b) Especificos: 1- Explorar las percepciones de las enfermeras que trabajan en centros escolares sobre las ventajas e inconvenientes de sus funciones en el ambito escolar. 2- Explorar las percepciones de los directores y profesores sobre la necesidad de las enfermeras escolares. 3- ldentificar las opiniones de los gestores sobre la necesidad de mcorporar enfermeras escolares en los centros educativos. · 4- Conocer la opinion de los directores, maestros y padres sobre el papel de la enfermera escolar. METODOLOGIA: Metodología cualitativa. Se diseñó un estudio fenomenológico interpretativo. Para la recogida de informaci6n se reaiizaron entrevistas en profundidad a educadores, enfermeros, directores, padres de aiumnos. RESULTADOS: Los resultados confirmaron la necesidad de tener una enfermera escoiar en los colegios de Arabia Saudí. Tanto los participantes de los colegios que disponen de la figura de una enfermera escolar como los que no la tienen, apoyan el rol de la enfermera escolar. Todos los informantes tienen coincidencias en el significado y funciones que ha de tener una enfermera escolar y todos consideran que la enfermera escolar tiene un impacto positivo tanto en los estudiantes como en el profesorado y en las familias; en los estudiantes, mediante su contribución a la promoción de la salud, la prevención de problemas de salud, el cuidado sistematico y a su formación en educación para la salud, al profesorado y dirección de las escuelas les genera seguridad y confianza lo cual les proporciona mayor libertad para realizar su trabajo docente y en las familias genera tranquilidad respecto al cuidado integral en salud de sus hijos. Los problemas que dificultan la inclusion de la enfermera escolar en los colegios son estructurales. CONCLUSIÓN: Los resultados de este estudio proporcionan información relevante sobre las percepciones y expectativas que las madres, profesoras, directoras y enfermeras escolares tienen respecto a las enfermeras escolares. Estos resultados abren las puertas a investigaciones adicionales en esta area en Arabia Saudí. Este estudio ha hecho una contribuci6n positiva y exclusiva para investigar mas sobre las enfermeras escolares, y por tanto tiene un impacto potencialmente positivo sobre el desarrollo en el establecimiento de la figura de una enfermera escolar en Arabia Saudi. El studio. mostró que todas las mujeres participantes que tuvieron experiencia de primera mano con enfermeras escolares reconocieron únanimemente la importancia del papel de las enfermeras escolares. Todas las participantes identificaron los primeros auxilios y tratar con las emergencias, accidentes o enfermedades y la dispensación de medicamentos corno las principales funciones de las enferrneras escolares, especialmente en las escuelas primarias donde los niños más pequeños tienen niveles más altos de hiperactividad y, por lo tanto, existe un mayor riesgo de lesión. Las enfermeras escolares mencionaron muchos beneficios de tener una enfermera en la escuela y ninguna desventaja. Los temas que surgen al abordar estas cuestiones fueron especialmente valiosos en terminos prácticos para los directores de las escuelas saudíes que desean emplear a una enfermera de alta calidad. El tema principal "empleando enfermeras escolares" identificó dos facilitadores de empleo de enfermeras escolares, a saber, la conciencia cultural / idioma y el horario laboral, micntras que surgieron varias barreras económicas para emplear a enfermeras escolares según se tratara de escuelas públicas o privadas.
BACKGROUND: The school is the second environment, after the home, where children develop their lives. Their learning capacity is widely related to their health and wellness. Healthy children attend classes more regularly and are capable to concentrate more in school activities (Murray, 2007). School nurses play multiple roles with regards to the protection and health awareness of the students. The aim of this project is to explore the perspectives directors, tutors and parents have of school nurses, and to find out what they think the role of a nurse consists of in a school environment. OBJECTIVES: General: to identify the factors that hinder the implantation of a school nurse figure in Jeddah, Saudi Arabia. Specific: I.Explore the perceptions of the nurses that work in schools regarding the advantages and disadvantages of their functions in that environment 2. Explore the perceptions of directors and teachers about the need of having a school nurse 3. Identify the opinions of managers about the need to include school nurses in education centres 4. Get to know the opinion of directors, teachers and parents with regards to the role of a school nurse. METHODOLOGY: Qualitative methodology, specifically with an interpretive phenomenological study. For the data collection, interviews will be held in depth with educators, · nurses, directors, parents and students. RESULTS: The findings confirmed the need for a nurse to be present in schools in Saudi Arabia. By comparing participants with and without a school nurse was possible to see that support for the role of school nurse was to be found in both groups. All the informants have coincidences in the meaning and functions that a school nurse must have and all consider that the school nurse has a positive impact on students, teachers and families; In the students, through their contribution to the promotion of health, prevention of health problems, systematic care and training in health education, for teaching staff and school managers generates security and confidence, which provides greater Freedom to carry out their teaching work and in families generates peace of mind regarding the comprehensive health care of their children. The problems that hinder the inclusion of the school nurse in schools are structural. CONCLUSION: The results of this study provide relevant information about the perceptions and expectations that mothers, teachers; principals and school nurses have regarding nurses. These results open the door to further research in this area in Saudi Arabia. This study has made a positive and exclusive contribution to further research on school nurses, and thus has a potentially positive impact on development in establishing a school nurse figure in Saudi Arabia. This study has made a positive and exclusive contribution to further research on school nurses, and therefore has a potentially positive impact on development in establishing a school nurse figure in Saudi Arabia. The study showed that all participating women who had firsthand experience with school nurses unanimously recognized the importance of the role of school nurses. All participants identified first aid and deal with emergencies, accidents or illnesses and dispensing medications as the main functions of school nurses, especially in primary schools w.here younger children have higher levels of.hyperactivity and, therefore, there is an increased risk of injury. School nurses mentioned many benefits of having a nurse at school and no disadvantages. The issues raised in addressing these issues were especially valuable in practical terms for the principals of Saudi schools who wish to employ a high-quality nurse. The main theme "employing school nurses" identified two facilitators of school nurse employment, namely cultural awareness / language and working hours, while several economic barriers emerged to employ school nurses as public or private schools.
ANTECEDENTS: Després de la llar, l'escola representa el segon entorn en que es desenvolupa la vida dels nens. La seva capacitat d'aprenentatge està estretament relacionada amb el seu benestar i salut. Els estudiants saludables assisteixen a classe amb mes assiduïtat i són capaços de concentrar-se millor en les tasques escolars (Murray, 2007). Els infermers escolars exerceixen múltiples funcions en la protecció i la promoció de la salut dels estudiants. OBJECTIUS a) General: Identificar els factors que dificulten la implantació de la figura de la infermera escolar a Jeddah, Aràbia Saudita. b) Específics: 1- Explorar les percepcions de les infermeres que treballen en centres escolars. sobre els avantatges i inconvenients de les seves funcions en l'àmbit escolar. 2- Explorar les percepcions dels directors i professors sobre la necessitat de les infermeres escolars. 3- Identificar les opinions dels gestors sobre la necessitat d'incorporar infermeres escolars en els centres educatius. 4- Conèixer l'opinió dels directors, mestres i pares sobre el paper de la infermera escolar. METODOLOGIA: Metodologia qualitativa. Es va dissenyar un estudi fenomenològic interpretatiu. Per a la recollida d'informació es van realitzar entrevistes en profunditat a educadors, infermers, directors, pares d'alumnes. RESULTATS: Els resultats van confirmar la necessitat de tenir una infermera escolar a les escoles d'Aràbia Saudita. Tant els participants dels col·legis que disposen de la figura d'una infermera escolar com els que no la tenen, donen suport al paper de la infermera escolar. Tots els informants tenen coincidències en el significat i funcions que ha de tenir una infermera escolar i tots consideren que la infermera escolar té un impacte positiu tant en els estudiants com en el professorat i en les famílies; en els estudiants, mitjançant la seva contribució a la promoció de la salut, la prevenció de problemes de salut, la cura sistemàtica i a la seva formació en educació per a la salut, al professorat i direcció de les escoles els genera seguretat i confiança la qual cosa els proporciona major llibertat per realitzar-la docent i en les famílies genera tranquil·litat respecte a la cura integral en salut dels seus fills.. CONCLUSIÓ: Els resultats d'aquest estudi proporcionen informació rellevant sobre les percepcions 1 expectatives que les mares, professores, directores i infermeres escolars tenen respecte a les infermeres escolars. Aquests resultats obren les portes a investigacions addicionals en aquesta àrea a l'Aràbia Saudita. Aquest estudi ha fet una contribució positiva i exclusiva per investigar més sobre les infermeres escolars, i per tant té un impacte potencialment positiu sobre el desenvolupament en l'establiment de la figura d'una infermera escolar a l'Aràbia Saudita. L’estudi va mostrar que totes les dones participants que van tenir experiència de primera ma amb infermeres escolars van reconèixer unànimement la importància del paper de les infermeres escolars. Totes les participants van identificar els primers auxilis i tractar amb les emergències, accidents o malalties i la dispensació de medicaments com les principals funcions de les infermeres escolars, especialment a les escoles primaries on els nens més petits tenen nivells més alts d'hiperactivitat i, per tant, hi ha un major risc de lesió. Les infermeres escolars van esmentar molts beneficis de tenir una infermera a l'escola i cap desavantatge. Els temes que sorgeixen en abordar aquestes qüestions van ser especialment valuosos en termes pràctics per als directors de les escoles saudites que volen donar feina a una infermera d'alta qualitat. El tema principal "emprant infermeres escolars" identificar dos facilitadors d'ocupació d'infermeres escolars, és a dir, la consciència cultural / idioma i l'horari laboral, mentre que van sorgir diverses barreres econòmiques per donar feina a infermeres escolars segons es tractés d'escoles públiques o privades.

Globally, the responsibilities of Food Safety Inspectors have dramatically evolved in recent times. The major change is the shift from a diagnostic and traditional food safety assessment role to a proactive and risk-based evaluation, resulting in better protection from foodborne illnesses. The aim of this study was to investigate the knowledge and skills required by food inspectors in Riyadh, Saudi Arabia, that will enable continuous improvement to food safety inspection practices by using proactive and risk-based evaluation methods. The result being that the implementation of more effective food inspection practices will result in the provision of safer food for consumers.

In Saudi Arabia, medical errors are at an alarming level. Lack of a Health Information Exchange (HIE) system is one the greatest reasons for medical errors in the Kingdom. Health care in many countries has evolved with the invention of electronic health information exchange system, henceforth HIE. This research paper purposes to implement HIE in Saudi Arabia, which entirely does not have a system of the sort. It is imperative instill HIE in the health care system in Saudi to allow physicians, nurses, health care facilities as well as patients to electronically share medical information in a safe and secure manner. Many countries such as United States, New Zealand and Germany have had great success with the HIE system and have reported vast benefits. Benefits of HIE are such as reduction of health care cost as well as decreasing medical errors. For Saudi Arabia to reach the same heights, many stakeholders will be involved in the triumph of the HIE system in the Kingdom of Saudi Arabia. The biggest contributor will be the Ministry of Health, which will be in charge of implementing as well as making the system mandatory in the main four hospitals in the country: Shomasy, Kind Saud University Hospital, Ministry of interior Hospital and Ministry of Defense Hospital. Each hospital having their own current medical information recording system, will now have one universal system that is made sure to be secure and safe for patients as well as other participating organizations who have access to the HIE system. The main concentration of the HIE system in Saudi Arabia will be in the emergency care of these four hospitals. It is crucial to have an organized and controlled way of recording as well as accessing patient medical records electronically, in a fast and effective way. This paper proposes that an HIE system in Saudi Arabia will reduce the cost of medical care and decrease medical errors. Through the use of Lean thinking and the use of quality tools, the HIE system will be able to change and increase the reliably as well as effectiveness of Urgent Care in the country and therefore have consequent benefits as well. Also, understanding who is going to play a great role in the triumph of the HIE system, such as the Ministry of Health and knowing what stakeholders will need to be affiliated and contribute will lead the project to a better success.

Saudi Arabia is struggling to provide quality healthcare services in light of the growing population, rapid spread of chronic diseases, and limited resources available. In addition to these obstacles, the Saudi society is a highly conservative one, and certain traditions may sometimes limit how healthcare services can be offered. This work examines the impact of a Telecare solution on the healthcare system at the National Guard Health Affairs (NGHA). It focuses on diabetes, and the challenges faced by both the healthcare officials at NGHA, and the patients. These challenges also include social factors that may pose at obstacle in delivering healthcare services. The ‘Telecare for Managing Diabetes – TeMaD’ system is designed and developed using the Soft Systems Methodology. It was then integrated into the hospital information systems at King Abdulaziz Medical City in the Central Region, and consisted of 52 participating patients, and four involved Diabetic Educators. HbA1c levels of all patients were recorded prior to commencement of the study. Patients were required to use TeMaD for a 3-month period, then, had their HbA1c levels recorded again after completion of the study. Overall observation of the results showed a reduction in the HbA1c levels of 83% of the patients. Participating patients expressed their acceptance of the system, indicating that TeMaD allowed them to overcome some obstacles such as lack of transportation. It also assisted the majority of participants to better manage their diabetes and ease communication with their diabetic educators. Most patients requested that the system be offered permanently at the clinic. Diabetic educators were in favour of integrating TeMaD into the current healthcare system at NGHA, and they were enthusiastic about its numerous benefits. Telecare solutions can be used to enhance the quality of healthcare services, meet current demands, and address obstacles faced by the healthcare system in Saudi Arabia, including social factors that are unique. They can be adopted by neighbouring Gulf States which share common obstacles in healthcare.

This thesis investigates the features of common health risk behaviours (HRBs), namely, violent behaviours, sexual behaviours, smoking, drug use and unhealthy dietary behaviours, and patterns of engagement with these HRBs, among students at a Saudi university. The study includes a literature review covering the underlying reasons and consequences of HRBs, and explores existing theoretical models of HRBs in order to construct an appropriate theoretical model which underpins and guides this investigation. A mixed methods research methodology was used; quantitative data was collected using a questionnaire-based survey administered to 722 respondents, and qualitative data was collected using a series of interviews with 17 students. The elaborated theoretical model developed from the findings of the study may offer a more accurate understanding of HRBs amongst students at this Saudi university. In addition, the theoretical model may help to inform HRB-related research more widely across universities in Saudi Arabia and beyond. Key findings point to high levels of smoking, risky driving and violent behaviours, moderate levels of alcohol and illegal drug consumption, and physical inactivity and unhealthy diet. Students did not report serious sexual risk behaviours. Furthermore, such HRBs are influenced by traditional practices, gender, age, influence of other HRBs, the current legal system, globalisation, and lack of awareness. These practices are well-aligned to three major levels of influence: the intra-personal, public engagement and socio-cultural. Policy and practice implications arising from the findings are discussed.

This research has taken the form of a field study to gather empirical evidence capable of providing an overview of current initial public offerings OPOs) in Saudi Arabia. The main thrusts of this thesis are: to identify empirically the motivations for going public in Saudi Arabia; to find the barriers to going public in the Kingdom; to investigate the effects of IPOs on the performance of companies; to investigate the relationship between an increase in the number of IPOs and economic performance; to find which kind of companies are more likely to go public in the country, and to identify some suggestions which could increase the number of IPOs in Saudi Arabia. To answer the research questions, the researcher undertook three studies. Firstly, data was collected through a case study of a single company that had made an IPO in the Kingdom. Financial ratio analysis was employed to capture the changes in the financial Statements before and after the IFO, and two in-depth interviews were conducted with the company's CEO and financial manager to discuss the financial changes and other IDPO issues. Secondly, more data was gathered through a comprehensive questionnaire. The sample studied in the questionnaire was taken from the top management of the 500 largest companies in Saudi Arabia. A total of 145 companies from 7 different business sectors in Saudi Arabia participated in the study. This represented a response rate in excess of 29%. Thirdly, extra data was obtained from personal interviews with three well-experienced and educated businessmen who have taken their companies public. The results obtained from the single case study, the questionnaire, and the interviews showed firstly, that companies in Saudi Arabia are motivated to go public in order to use the money raised for more expansion and growth, to be more competitive, and to separate the company's life from that of the previous owners. Secondly, with regard to the most important barriers to going public in the Kingdom, the study finds that private fin-ns are reluctant to go public because of the failure of many joint stock companies listed on the Saudi Stock Market to generate profit; because of the possible loss of control; and because of the lengthy procedure for going public. Thirdly, this research also discovers that whereas most of the questionnaire survey participants believed that IPO performance would decline after the transition, and also confmned by the results from the case study, the interviewees thought that performance would improve after the IPO. Fourthly, with regard to the effect of IPOs on economic conditions, there is a great consensus between the questionnaire participants and all the interviewees on that an increased number of IPOs in Saudi Arabia would have a favourable, effect on economic welfare. An increase in joint stock companies in the Kingdom would improve several economic factors, such as the growth rate, foreign investment, the balance of trade, and the unemployment rate. Fifthly, this research also finds that while most of the questionnaire survey respondents thought that companies owned by more than one investor and large companies (in terms of size) are more likely to go public, most of the interviewees believed that companies working in industrial sector are more probably to seek public equity. Sixthly, this research finds that the rate of going public in Saudi Arabia could be improved if the government creates a complete financial system, prepares clear guidelines that explained the procedures for going public, and eases the procedures for IPOs. The rate of going public in Saudi Arabia also could be improved if the decision makers in private firms separate management from ownership and hire professional personnel to lead the companies. In conclusion, the study suggests that since going public would add many advantages to firms, like strengthening financial position, increasing public trust, and attracting well qualified personal, the flotation decision could solve some of the problems that the Saudi private sector has, such as severe competition, poor management, constraints of finance, and generation shift (lock of family succession and control). Nevertheless, the study also confirms that IPOs would create new problems, especially that of more restrictions on private transactions.

The aim of this research is to study and compare the use of social media by public relations departments in the Saudi Telecommunications Company (STC) and The Saudi Ministry of Commerce and Industry (Saudi MCI). An integration of cross-sectional and archival research designs was implemented using both secondary and primary data. Qualitative primary data was collected through face-to-face semi-structured interviews, with 12 purposively selected senior public relations and communications’ officials PR and communication practitioners working at STC (n= 7) and Saudi MCI (n= 5). Quantitative primary data was collected through web-administered surveys designed using Google survey Forms (N= 511) and whose links were placed in the STC (n= 262) and Saudi MCI (n= 249) with Facebook pages and Twitter handles. Quantitative data was analysed using SPSS version 21, after data preparation and arrangement in Microsoft Excel 2013 Interview and archival data were analysed using inductive content and thematic analysis, which led to the development of thematic maps. The findings showed that both STC and Saudi MCI use social media to publicise their activities through public information, lobby public support for their positions, enhance information quality and provide a question and answer platform for their publics. Findings show that both STC and Saudi MCI were ethical in their PR practices. The usage of Facebook and Twitter changed the way STC and MCI PR practitioners engage with their publics and stakeholders by easing contacts between the organisation and the public, allowing the public access to important information and enabling the public a voice in the engagement especially through criticising the organisation. The findings also showed that the private and public organisations in Saudi Arabia exploit the social media affordances comprising visibility, editability, persistence, and association.

In Riyadh City, as an effort to reduce the excess dependency on private vehicles, in 2012 city’s authorities have approved the construction of a public transport system and travel demand management strategies. On this basis, this study question is “what are the procedures and approaches that have to be undertaken to ensure public transport uptake in Riyadh City?” To answer the study question, a relevant literature has been reviewed in order to identify major successes of public transport services around the world. In addition, two empirical studies were conducted in Riyadh during the study course include a series of semi-structured interviews with local stakeholders and a web-based-general-public survey. The study findings were consolidated and discussed to provide concrete answers to the study question. The study found considerable support by stakeholders and the general-public for introducing public transport services and reshaping the existing travel strategies. It was also found that the future planning of the public transport system in Riyadh City has to pay considerable attention to social and cultural perspectives of its citizens; for safety and separate family carriages. The study also found that improving infrastructure to enhance accessibility to and from transit stations, selecting appropriate TOD sites, parking charges are effective strategies. Finding from a stated preference experiment showed that the likelihood of shifting people from private cars to public transport in Riyadh City would increase by a reduction in public transport cost, number of changes, and increase in the service frequency. Most importantly, there are cultural aspects involving perceptions towards public transport that play an important role in people’s intention to use public transport. For example, it found that highly qualified individuals were more likely to perceive public transport as a 'taking a step down into the World' and this is a point in which public transport authorities need to focus in order to ease this perception. Finally, this is the first time to derive estimates of the value of travel time savings for Riyadh City.

Application of Health Informatics (HI) is becoming more pervasive in the Saudi Arabian health organisations (SAHOs) with the aim of exploiting its potential for better healthcare delivery. Yet, to date, the management of HI has not been fully digested in the Saudi health environment. Therefore, adoption of imported models has become a common practice for managing HI. Consequently, most implemented systems fall short of meeting objectives or tackling key existing issues. The aim of the study is to develop a model for HI management that not only deals with key prevailing issues but also should be compatible with the Saudi Arabian health environment. The research contends that the key to success in exploiting the potential of HI is the use of appropriate local models that fully integrate with the Saudi Arabian health environment. The research design was mainly guided by pragmatic philosophy which incorporated both quantitative and qualitative research. It was inductive in nature and used a field research methodology to accomplish the research objectives. Empirical data was collected via questionnaires and interviews in the collaborating health organisations. Literature review, data analyses of the questionnaires and interviews yielded the initial framework for the Health Informatics Management Model (HIMM). A first round evaluation of the HIMM was conducted yielding a revised version. Later, data was also gathered from participants in a second round of evaluating the HIMM. The second round was to reassess the compatibility of HIMM with the Saudi Arabian health organisations, and to update the model in order to match the current application of HI in these organisations. The analysis of the data gleaned from the second stage evaluation yielded a revised (and final) HIMM, contemplated by participants. Based on the above empirical data, the research study introduces the HIMM, the first holistic and systematic HI framework that should enable the Saudi health providers and managers to better comprehend the multi-faceted perspectives that form the HI management paradigm, and guide them in its management. It can allow them to decide how best to manage HI projects in a way that ensures an optimum use of HI resources for effective and efficient delivery of healthcare and services. This work is of considerable utility in the Kingdom of Saudi Arabia and the Gulf States, where HI management and its application are regarded as an area of high priority.

Study aim: This study was conducted to describe how women and health care professionals perceive sexual health and services that are currently provided in Saudi Arabia. Background: At present, the worldwide health authority, in the form of the World Health Organisation (WHO) has drawn great attention to the importance of improving women's sexual health globally. It is increasingly concerned about women's sexual health and permanently works to shed light on the innovative approaches that are needed to raise women's awareness of risky behaviour, and to help them access the advice and treatment they need to avoid negative health outcomes that would impact on their future lives. Research into women's sexual health in Saudi Arabia will help in identifying possible causes of poor sexual health care that could be used as preventive tools in that, or similar cultures. In addition, it helps to meet women's physiological, emotional and educational needs, which is essential to support good sexual health. Methods and data: The researcher adopted an exploratory, qualitative method to conduct the study with an ethnographic design. It was undertaken in two governmental hospitals in Jeddah city, namely King Abdulaziz University Hospital and Maternity and Children Hospital. The duration of data collection was two months in each hospital. Women, doctors, nurses, and clinic managers all were participated in the study. Observational notes, document analysis and in-depth interviews were used for data collection. Detailed field notes were recorded of observations in the setting, clinical consultations and the participant's behaviours and interactions. 40 Interviews were conducted (21 with female patients and 19 with Health care professionals) and 74 consultations were observed. The data analysis was conducted using the framework identified by Holloway and Todres (2006, p. 219), for use in ethnographic research. Findings: Female participants reported experiencing more difficulties in talking about sexual matters generally, and specifically those that related to sexual intercourse. They also delayed seeking sexual health care as a result of the influence of Saudi social norms around women's sexuality. Plus, appointment issues, long waiting times, low quality of care provided and being dependent upon husbands for transportation were also barriers to accessing sexual health care or advice. Health care professionals tended to avoid initiating discussions about sexual matters in their clinical practices, to respect the cultural norms and avoid offending the patient. Many other barriers to talking about sexual topics in the clinic were also reported by the health care professionals in the current study. Sexual health care and services in Saudi Arabia are limited, lack integration to sexual health education and centre on reproductive health through the provision of obstetrics and gynecology care and contraception. Discussion: Using the Theory of Reasoned action as a theoretical framework to discuss the findings of the study this chapter sets out how the social norm pressures that are embedded in Saudi culture particularly those related to women and sex significantly influence both health care professionals and women's attitudes and behaviour towards sexual health care. The effect of Islamic guidance on Saudi culture and in participants' lives was very strong and clear. Adopting the concept of holistic sexual health explicitly in Saudi Arabia would be difficult and problematic. Missing the opportunity to talk about sexual issues in general, and in consultations in particular, put women at the possible risk of poor sexual health. Conclusion: Multifaceted interventions and programs are necessary to improve the quality of services that provide women sexual health care in Saudi Arabia. Efforts to influence social norms, empower women, enhance health care professionals' roles and functions and more research into women's sexual health is required.

The increasing demands of efficiency and effectiveness in the public sector encourage political leaders and policy makers to adopt and apply advanced techniques and solutions to overcome flaws in public organizational performance. Entrepreneurship was introduced in several Western countries as a way to improve their processes and management through adopting private sector management principles and market-oriented techniques. In 2015, Saudi Arabia announced its 2030 vision, which introduced hundreds of innovative and creative initiatives aiming to overcome issues of the turbulent environment, future oil depletion, budgetary pressures, and public demands for efficiency and effectiveness. Building on interdisciplinary perspectives, this study investigates entrepreneurial orientation among Saudi public employees from all administrative regions across the country. Building on McClelland's theory of motivation, this study hypothesizes that the motives of need for achievement, need for affiliation, and need for power are positively associated with entrepreneurial behavior. It also hypothesizes that excessive organizational hierarchy, formalization, and lack of autonomy constrain employees' entrepreneurial activities. Moreover, this study adopts a sociological perspective in proposing solutions for facilitating entrepreneurial orientation among public employees by hypothesizing that human and social capital promote an entrepreneurial orientation. Multiple regression analysis reveals that Saudi public employees with a higher level of need for achievement and need for power tend to be more entrepreneurial, while need for affiliation fails to predict entrepreneurial orientation. Furthermore, the findings suggest that a high level of hierarchy and formalization in public organizations is negatively associated to entrepreneurial orientation, while a high level of autonomy is positively associated with entrepreneurial orientation. Finally, the study finds that employees with a high level of breadth and depth of experience (human capital) are more likely to be entrepreneurial, while a high level of bonding social capital and bridging social capital promote a negative and a positive entrepreneurial orientation, respectively.

Saudi Arabia has witnessed rapid development in economic, cultural and social aspects since the discovery of oil a few decades ago. This development involves all the governmental sectors including national parks. The need for national parks has become inevitable. Asir National Park was established to provide recreational sites and to preserve the unique natural and cultural features of the park. Research evaluated the impact of human activities of logging, grazing, hunting, land development and elimination and negligence of traditional architecture on Asir National Park features. A questionnaire, interviews and field observations were conducted to investigate the impact of these activities on Asir National Park. Asir National Park suffers a great deal of pressures from human activities. The local population depends on the park as their source of livelihood and as a traditional habit. The study illustrates the most affected zones where action should be taken to preserve park features.

Saudi Arabia faces a universally acknowledged need to diversify beyond hydrocarbons. The Saudi Arabian government has outlined a strategy to achieve diversification through its Vision 2030 reform plan. Contrary to the Vision 2030 plan, the Saudi government should allow for entrepreneurs and market signals to determine diversification when considering what sectors should receive investment, with the exception of broad infrastructure investments contributing to the overall enabling environment. Government lending for private-sector investments need to have plausibly high projected rates of return, and meet minimum standards of environmental and social responsibility, requiring participation by multiple government ministries sufficiently insulated from the government.

This study examines health services in Medina in relation to the delivery system, the spatial distribution of health services, accessibility and effectiveness of utilization, including satisfaction with the services. A total of 500 patient questionnaires and 31 face-to-face interviews with key decision makers were used in addressing the research questions. Despite many positive aspects to the health services in Medina, such as the ratios of physicians and beds/population compared to the whole Kingdom's average, there are some problems that need to be overcome. The provision of primary health care centres (PHCCs) is very far from the health ministry target, which is one PHCC to serve 5,000 to 10,000 people and they are unevenly distributed. The capacity of state hospitals is almost full, and needs to be expanded by building another general hospital in the east part of Medina to help remedy the current balance in spatial distribution. The lack of a clear spatial distribution policy for Medina's health services is evident in the concentration of general hospitals on one side of the city. Most private hospitals and clinics (doctors) and groups of clinics are concentrated south and south west of the city centre, in a circle of about two kilometres in diameter. Demographic and socio-economic factors appear to be influential in explaining differences in utilization, access, and preference between types of health services (private/state/traditional healers). Accessibility issues had little effect in making health care users switch to private hospitals. It seems that perceptions of accessibility were influenced by the widespread ownership and use of cars. It appears that consumers' satisfaction with accessibility and quality was higher for private health services than state ones in the study area. However public and private provisions are intercalated in complex ways. Overall, the study shows that, given Saudi's expanding population and growing wealth, there is growing demand for new health facilities and access is stile a major planning issue, although it needs to be reconceptualization in the light of car ownership. New agendas are set for service planning, and for medical geography in the Saudi Arabia.

Saudi Arabia is in the process of implementing Electronic Patient Records (EPR) throughout its National Health services. One of the key challenges during the adoption process is the security of EPR. This thesis investigates the current state of EPR security in Saudi Arabia’s National Health Services (SA NHS) both from a policy perspective and with regard to its implementation in SA NHS’s information systems. To facilitate the analysis of EPR security, an EPR model has been developed that captures the information that is stored as part of the electronic record system in conjunction with stated security requirements. This model is used in the analysis of policy consistency and to validate operational reality against stated policies at various levels within the SA NHS. The model is based on a comprehensive literature survey and structured interviews which established the current state of practice with respect to EPRs in a representative Saudi Arabian hospital. The key contribution of this research is the development and evaluation of a structured and model-based analysis approach to EPR security at the early adoption stage in SA, based on types of information present in EPRs and the needs of the users of EPRs. The key findings show that the SA EPR adoption process is currently proceeding without serious consideration for security policy to protect EPR and a lack of awareness amongst hospital staff.

This study was conducted to describe how women and health care professionals perceive sexual health and services that are currently provided in Saudi Arabia. Background At present, the worldwide health authority, in the form of the World Health Organisation (WHO) has drawn great attention to the importance of improving women's sexual health globally. It is increasingly concerned about women's sexual health and permanently works to shed light on the innovative approaches that are needed to raise women's awareness of risky behaviour. and to help them access the advice and treatment they need to avoid negative health outcomes that would impact on their future lives. Research into women's sexual health in Saudi Arabia will help in identifying possible causes of poor sexual health care that could be used as preventive tools in that, or similar cultures. In addition, it helps to meet women's physiological, emotional and educational needs, which is essential to support good sexual health.

More than half the population of Saudi Arabia has access to the Internet and social media, which are considered to be the fastest growing methods of communication in the region. The Saudi Ministry of Health encourages health-care providers, health professionals, and health organizations to accept and actively engage in using technology for improving health practices. Despite their increasing importance, there is little published literature on social media use and acceptance among health educators in Saudi Arabia. The purpose of the present study was to better understand the factors that determine the use and acceptance of social media. The theoretical framework consisted of the unified theory of acceptance and use of technology (UTAUT) as well as an extension to that theory. Through this lens, the study investigated how personal innovativeness in information technology and level of education may influence behavioral intention or use of social media among health educators in Saudi Arabia. A cross-sectional design was employed to determine the relationships among the specified factors. The participants included 320 health educators who filled out an online survey that had been constructed and validated in the literature. Findings indicated that performance expectancy, social influence, and personal innovativeness have a significant positive influence on behavioral intention. Facilitating conditions were negatively significant to user behavior. As anticipated, age and level of education were successfully shown to be a moderator. The study also discussed social media usage patterns among health educators in Saudi Arabia for personal and health-education purposes.

This study examined the perception of managers in the Institute of Public Administration (IPA), Riyadh, Saudi Arabia as to the way public relations is practiced within Saudi Arabia based on a comparison with Grunig's four models of public relations. Out of a population of 38 directors and director generals, 30 participated in a personal interview for a 79 percent response rate.A Q-sort analysis revealed two perceptions of public relations performance in the Institute. Perceptions differed based on educational experience, and managerial levels. Top managers with Ph.Ds tended to view performance as related to Grunig's Press Agentry and One-Way Information models. Fewer level employees saw performance related to the Two-Way Asymmetrical and Symmetrical models. The researcher concluded that the more higher educated level managers had a better understanding of the reality of performance of public relations in IPA. Main attitudes from the sorts of the participants showing a significantly and different attitude in how directors generals and directors perceived public relations was being practiced in the IPA. The directors generals and directors strongly held different views concerning the practice of public relations in the IPA.
Department of Journalism

This thesis examines public relations in Saudi Arabia as an occupational group. The thesis investigates the knowledge public relations practitioners possess, and how Saudi culture and public communication factors affect public relations practitioners. The thesis offers insights into the cultural background of the country, public communication and public relations practice in Saudi Arabia. Moreover, it provides an analysis of theories of the profession and the relationship between the profession and public relations occupation. For the purposes of this research, in-depth unstructured interviews were used to collect data from 27 practitioners. A constructivist paradigm was utilised to examine the Saudi practitioners’ perceptions of knowledge, culture, public communication. Moreover, the thesis has followed a socio-cultural approach and theories of the profession to investigate the empirical data. The thesis has several contributions to knowledge. Firstly, it brings an understanding of the role of the state in the process of professionalization. Using Vygotsky’s theories the thesis has found that educational institutions influence PR practice and this results in lack of progress and limited opportunities for change, learning and career movement. Secondly, the thesis found that there is disconnection between theories that are taught in universities with PR programmes and PR practices. The thesis found that there is a problematic nature of abstract knowledge, which determines the disconnection between communication theories and PR practice. Moreover, there is a disconnection between the practice immersed in culture and that cultural practices are stronger than professional practice. Finally, the thesis has contributed to the literature by finding out that ethics in Western countries are regarded as something that is developed by a professional body in a way that relates to society, however in Saudi Arabia the Muslim values and ethics are implemented directly in the work context and ethics is not developed by a professional body.

An Electronic Medical Record (EMR) is a system that has been embraced by healthcare providers worldwide. However, the implementation success of EMRs has varied widely. Studies have identified both barriers to and facilitators for implementing EMRs within healthcare organisations. In Saudi Arabia (SA), the majority of healthcare providers manage patient records manually. As public hospitals are a major provider of health services in SA and have been shown to face more EMR implementation barriers than private hospitals, there is a need for an implementation framework to guide EMR implementation in Saudi public hospitals. This doctoral project therefore aimed to develop an evidence-based EMR implementation framework for public hospitals in SA informed by those who work at the micro-implementation level and the macro-implementation level and the extant literature sensitive to the cultural, resource-related, and technological, organisational, and environmental issues of SA.

Since the day Saudi Arabia was founded, its highly centralised and paramilitary police organisation remained immune to scrutiny, and police performance and their relationship with the public have remained uncharted territories.  But lately, in response to leaking reports about rising crime levels and an escalating social control crisis, writers affiliated to the police organisation were quick to deny that a real crime problem exists.  However, some of those writers do admit that a serious social disorder problem is now brewing, and they find an urgent need to address the crisis.  According to them, any effective response requires a community orientated policing strategy to be applied immediately, even without debate or planning. The statement above raises three important questions.  First, does a social control problem really exist? Secondly, if yes, would a community policing (CP) approach address it?  And third, are the police and the public ready for change? To answer those questions, quantitative and qualitative data have been collected from a wide range of sources.  Results obtained from the data show clearly that the police are not the effective crime fighters they claim they are.  Further, although it has been found that the Saudi policing system is not without problems, a community policing approach, at least in the sense it is understood in the west, is incompatible with the Saudi culture.  Reasons for this incompatibility have been examined, and suggestions to improve the Saudi police performance have been made.

This thesis describes and analyses the development of the health care system in Saudi Arabia, particularly in the period since 1970. Two major differences between Saudi Arabia and most other countries have to be isolated. First, as a result of its oil wealth, Saudi Arabia has experienced extremely rapid economic growth over the last twenty years. Second, a very strong value system, Islam, has a persuasive effect upon Saudi society, including the organization of its health care system. The Basic Needs approach, which is favoured here, defines 'economic development' a the satisfaction of certain basic material human needs. Health care is important because it is one such basic need. The principal characteristics of health and health care in poor countries are examined. Patterns of mortality and morbidity are discussed as are the different health systems, and financial and health care planning arrangements, which are to be found. Trends in mortality, morbidity and life expectancy in Saudi Arabia are then discussed, bringing together data not previously assembled. The framework of the Saudi health sector is described. For the first time, the roles of health service providers, other than the Ministry of Health itself, are comprehensively documented. Regression contributions of rising living standards and the development of the health services to improvements in health status. Although some positive results are obtained, inadequate data prevent firm conclusions from being drawn. This crucial issue is therefore pursued on a more analytical level, employing comparative evidence on the experience of other countries. The final judgement is that economic growth, rather than the expansion of the health services, is the principal explanation of better standards of health in Saudi Arabia.

The provision of health services to all the population is one of the highest priorities in many governments' agenda, because the health system, education and social security are important indicators of the level of development of a state. However, the provision of health services to cover all the population is not easy, particularly in many developing counnies, which lack human and financial resources. In 1978, at Alma - Ata WHO and UNICEF jointly declared the primacy of the primary health care ( PHC) approach for achieving the WHO's social goal, " health for all the people by the year 2000". Since then, PHC has become a major concern on national and international levels. Saul Arabia one of the countries which has adopted and implemented the PHC approach.This study explores the implementation of the PHC approach, the utilisation of health services delivered at the health centres and health awareness in Jeddah, a major urban centre in Saudi Arabia, where public and private health services co-exist and compete, and where traditional medicine is still used and practised. A sample comprising both utilisers of the PHC centres and non- utilisers were questioned about their health practices, beliefs and attitudes, and an attempt was made to determine whether socio- economic and demographic characteristics were significantly related to utilisation and health awareness. No single pattern of attitude or behaviour was found to be consistently related to socio-economic or demographic characteristics. However, the findings indicate the general significance of education.The nature of service provision was found to affect satisfaction and a need was found to improve the quality of the health service and to remove bureaucratic barriers which impede utilisation. Although many aspects of PHC are successfully implemented, there is evidence of misunderstandings of the approach by both consumers and providers, which limits both utilisation and satisfaction. In particular providers and users still prioritises curative above preventive medicine, health education is still neglected, and the potential of the media in this respect is under-exploited.Finally, traditional medicine was found to be used and practised, but the finding; indicate there is not necessarily a conflict between the two systems. They appear to be used in a complementary way, and them may be scope for integration.