Country profiles

Qatar

Overview

Qatar has a surface area of 11 427 km². The country is flat except for some hills and high ground to the northwest. The population was 700 000 in 1996. According to national sources, the entire population is considered to be residing in urban areas. The population percentages below 15 years of age and above 65 years of age, in 1996, were 27.8% and 1.1%, respectively. In 1995, the total adult literacy rate and the female adult literacy rate were estimated at 79% and 80%, respectively. Based on the most recent statistics, the infant mortality rate was estimated at 12 per 1000 live births in 1996. Also in 1996, the under-5 mortality rate was estimated at 14.6 per 1000 live births, the average life expectancy at birth was calculated at 74.3 years, the crude birth rate was estimated at 14.9 per 1000 population and the maternal mortality rate was 1 per 10 000 live births. The leading causes of mortality in 1989 were as follows: diseases of the circulatory system (45.6%); injury and poisoning (30.9%); neoplasms (13.5%); congenital anomalies (6.6%) and infectious and parasitic diseases (3.4%). The mortality pattern resembles that of developed countries, with highest mortality rates accounted for by chronic diseases The per capita gross domestic product in 1991 was US$ 14 760.

Health care is provided free to all residents of Qatar, whether national or non-national. No formal health strategy exists as such, and the responsible officials believe that the goal of health for all has already been achieved in Qatar. This is mainly due to the fact that the country has a small population and abundant financial resources. Qatar’s health services are somewhat different from other countries of the Eastern Mediterranean Region in that almost all hospital services are controlled by a private medical corporation-the Hamad Medical Corporation. The primary health care services and peripheral health clinics are, however, run by the Ministry of Health. The majority of the population (89%) live in the capital, Doha, and the immediate suburbs.

In recent years, in addition to establishing new health centres, the following steps have been taken to reorient services towards primary health care:

• school health services have become the responsibility of the Ministry of Health and form part of the activities of the Directorate of Primary Health Care

• a new Division for Childhood Immunization has been established in the Ministry of Health to cover immunization against the six diseases of childhood targeted by the expanded programme on vaccination: diphtheria, measles, mumps, pertussis, poliomyelitis and tetanus

• health education has become part of health centres’ activities; the necessary health promotion leaflets have been prepared for their use

• the licensing commission for private clinics has been reorganized in such a way that it enables the public sector to play a supervisory role over private sector activities, especially where primary health care services are delivered.

Recently, a planning committee, comprising representatives of the various departments of the Ministry of Health, as well as of hospitals, was established as a nucleus for a national planning committee for health development.

The per capita Ministry of Health expenditure was US$ 463, which is among the highest in the Region. The Ministry’s expenditure represented 12.3% and 15.8% of the government total and recurrent expenditures. In 1989, there were 729 physicians, 102 dentists and 1739 nurses. The respective rates per 10 000 population were 18.2, 2.6 and 43.5. Of the physicians employed by the Ministry of Health, 46% were working in primary health care delivery. Similarly, 30% of nurses were working in primary health care services. A nursing college has recently been established in Qatar, and Ministry of Health employees are sent abroad on fellowships.

With respect to physical resources, in 1989, there were 29 health centres providing maternal and child health services, school health services, family planning, preventive services, environmental control, and health education. There were also three hospitals: two general hospitals and one maternity hospital. The total number of beds was 1069; thus, there were 27 beds per 10 000 population in 1989. There is no unit responsible for health research at the Ministry of Health, and no health research policy based on priorities has yet been established.

MENTAL HEALTH

A psychiatric service was first established in Qatar in 1971, soon after the country’s independence. In 1983, the Department of Psychiatry moved to Rumaillah Hospital as a part of Hamad Medical Corporation. This opened the door for establishment of a modern psychiatric unit, which included both inpatient and outpatient facilities and was staffed by two consultants and five junior doctors.

Over the years, the Department has been working hard to maintain the multidisciplinary approach to psychiatry, and for this reason, two social workers were employed in 1982 and a psychology section was established in 1984. In Rumaillah Hospital, the Department had 18 beds for male patients and 12 for female patients.

At that time, most of the treatment activities were centred around general psychiatry and liaison psychiatry.

As the number of patients and public awareness regarding psychological problems increased, , the Department moved to its current premises,a purposely renovated inpatient unit of 56 beds (44 male and 16 female) in 1994 .It also has an outpatient department, and an occupational therapy unit.The latter section is run by two qualified occupational therapists.

In 1993 a community nursing service, a day care hospital programme and a drug treatment and rehabilitation unit were set up.

At present time, all inpatient admissions are informal; and a 24-hour telephone line for patients and families, is planned.

The national mental health programme was introduced in 1990 and stresses those areas related to the community care system in mental health. This will include action plans to be implemented in the following areas:

• Legislation. Establishment of legislation where not available and amendment if needed.

• Family involvement. Inpatient care, early detection of morbidity through awareness and lastly, tolerance of mental illness.

• Primary health care. Upgrading of family health physicians through ongoing periodical courses on mental health.

• Counselling programme. In school health with the aim of dealing with psychosocial problems and scholastic failures. Special education and teacher training is also included.

The central psychiatric facility is located at the Rumaillah Hospital (220 beds). This facility houses the Department of Psychiatry, Rehabilitation, Mental Retardation, Special Education and Geriatric Medicine, including psychogeriatric services. The Department of Psychiatry, besides providing mental health care to the whole country, also works with three other psychiatric services, those of school health, the armed forces and the police force.

The Department is staffed by three consultants (two Qatari), one Qatari senior specialist, one specialist and seven residents (one Qatari, as well as nursing staff (some Qatari). The medical staff regularly attend regional and international scientific conferences relevant to the speciality. It is an integral part of policy to encourage Qatari staff to take senior positions. The Department is also looking forward to getting a child psychiatrist and a psychogeriatrician.

There are 5 psychiatrists, 7 residents in psychiatry, 10 social workers, 8 psychologists, 43 nurses and one counsellor as part of the mental health care system.

Since its establishment, the Department has given special consideration to research, and many papers have been published in reputable periodicals. At present, four research projects are in progress.

The Department of Psychiatry has been accredited to the Arab Board Training Programme since 1993. Seven doctors are enrolled in this active training programme, and four of them recently obtained their qualification after passing the final exam. Besides the Arab Board Training Programme, the Department also receives trainees from the University of Qatar who are studying for the diploma in psychological counselling. The Department also takes physicians from the primary health care and dermatology department as part of their internship training programme.

The Department of Psychiatry cooperates very closely, through its child psychiatry ambulatory outpatient clinic, with the psychiatric services of school health.

The team consists of a consultant and two residents with a social worker, nurse and psychologist. The principles on which the programme is based are derived from a behavioural modification model with stress on a doctor-patient compliance contract. Preventive and educational measures include education via the press, television and radio and direct family patient education.

Day care:

It is headed by a psychiatrist as coordinator and staffed by two psychiatric nurses, a social worker, psychologist, occupational therapist, mental health technologist and volunteers.

The main theme of the educational a programme is to arouse awareness in the community about mental illness in order to: eliminate bias and stigma; facilitate reintegration of the mental patient back into society; promote early detection; establish a true image of mental illness as scientifically treatable; develop the concept that mental health is an integral part of general health in the community; and convince the community that prevention of mental illness is feasible and that the community is a major participant in policies and measures to that end.

There is no formal mental health act in Qatar as yet. It is therefore left to the discretion of the civil or religious courts to arbitrate in consultation with psychiatrists when controversy arises. Psychiatry, in turn, plays only an advisory role with recommendations on the matter with no well-established criteria for decision-making. It is planned to establish a mental health act for Qatar.