Ad

H.H.
Sheikh Khalifa Bin Zayed Al Nahyan

President of the UAE and Ruler of Abu Dhabi
H.H. General Sheikh Mohammed Bin Zayed Al Nahyan
Crown Prince of Abu Dhabi and Deputy Supreme Commander
of the UAE Armed Forces
Contents
8 Vision, Mission, Values
12 Chairman’s Message
14 CEO’s Message
18 About HAAD
22 Health System at a Glance

Health System Improvements
Public Health Highlights
Investor Highlights
Patients Satisfaction
Key Performance Indicators
28 Strategic Plan 2010 - 2014

Strategic Plan Priorities
Delivering HAAD's Strategic Priorities: Our Achievements 2009
34 Organization
Public Health & Policy Division
Health Regulation Division
Health System Compliance Division
Emergency & Disaster Management Department
Corporate Affairs Department
Corporate Support Services Department
56 Facing the Challenges of Emirati Health

Breast Cancer Awareness
62 H1N1 Pandemic
66 Sustainability
7 Contents HAAD Annual Report 2009

Shared Vision For
The Health System
• Everyone has access to healthcare

• World-class quality care and outcomes
Vision • Full spectrum services

• Quality regularly monitored and published
• Predominantly independent and private
providers
• Mandatory health insurance
• Flexible and efficient financial system
'Everyone has access

to healthcare'
9 Vision HAAD Annual Report 2009

Mission Values
Ensure reliable excellence in
• We believe in fostering the development
of creative, leading edge solutions and
implementing technologies that enhance
services and improve productivity
healthcare for the community 3. Respect & Compassion

• We believe that all people have the right to be
treated with dignity
• We care about the individuals and communities
we serve
4. Integrity
• We believe in honest, ethical and professional
behaviour
• We believe in being sincere, open and truthful,
fostering trust in relationships
• We make decisions based on sound, ethical
principles
1. Commitment to the Community We Serve
• We honour our obligations
• We recognize our responsibility to the
community in which we reside and serve
5. Accountability
• We are committed to promoting wellness,
preventing illness and fostering development of • We believe in regularly reporting our performance
programmes and services appropriate to the to our stakeholders
community we serve
• We are committed to providing the highest 6. Collective Wisdom of Teamwork &
standard of care delivered in a learning Collaboration
environment
• We believe that communication, teamwork and
Role of Regulator partnership is essential
Regulatory Authority • Encourage adoption of world-class quality & 2. Pursuit of Excellence and Continuous • We believe that collaboration with our partners
performance targets Improvement will achieve positive results
• Ensure excellent quality healthcare for the
community • Plan capacities and service levels • We believe that exemplary, effective and • We work towards common goals through open
accessible services are developed and achieved communication, mutual support and win-win
• Define the strategy for the health system and set • Drive programmes to improve societal health through research, education and the application attitudes
Public Private Partnership roadmap of best evidence-based practice
• Define minimum standards for health service • We respect our differences and build on our
• Monitor & analyze the health status of the providers and health professionals strengths
population and performance of the system
• Regulate scope of services and premiums &
• Shape regulatory framework for the health system reimbursement rates of providers and payors
• Inspect against regulations and enforce standards
HAAD Annual Report 2009 Mission 10 11 Values HAAD Annual Report 2009
The Health Authority – Abu Dhabi continues to implement our Strategic Plan for the development of the
Abu Dhabi Health System, in alignment with the Government of Abu Dhabi policy agenda. Based on
the vision of the late Sheikh Zayed Bin Sultan Al Nahyan (God bless him) and greatly supported by His
Highness the President Sheikh Khalifa Bin Zayed Al Nahyan, and His Highness General Sheikh Mohammed
Bin Zayed Al Nahyan, Crown Prince of Abu Dhabi, we continue to build on the foundation established over
the past 3 years.
Our major accomplishments of 2008 were focused on defining HAAD’s role as the regulator which included the
launch of THIQA - our comprehensive health insurance plan for all Abu Dhabi nationals, as well as establishing
quality standards for regulation of healthcare facilities and professionals. On reflection of our achievements in
2009, we have fully implemented these initiatives with >95% of nationals living/working in the Emirate of Abu Dhabi
Chairman’s enrolled in THIQA and >95% of expatriates legally living/working in the Emirate enrolled in health insurance plans
with licensed providers. Using the established standards for regulating the system has resulted in tangible benefits
for patients as these requirements are applied through regular HAAD quality audits of all healthcare facilities, and
Message
examination and licensure of healthcare professionals with over 90% of health professionals practicing in the
Emirate of Abu Dhabi registered in HAAD.
Having our base firmly established in 2008, our focus in 2009 was on further improving medical outcomes
and public health. Mammography screening rates increased from 16% in 2008 to 67% in 2009, nearing the
international best practice rate of 72%. Key activities to improve the public health of the population included
improvements in development of programs to address Metabolic Syndrome, Road Safety, Breast Cancer
Awareness, Occupational Health and Infectious Diseases, with implementation of community plans for H1N1
prevention and containment.
I would like to take this opportunity to thank our partners and staff who have worked collaboratively and diligently
to bring our strategic vision closer to reality. We look forward to continuing our development of a strong,
sustainable healthcare system for the population of Abu Dhabi.
Dr. Ahmed M. Al Mazrouei

H.E. Dr. Ahmed Mubarak Al Mazrouei Chairman
Chairman, Health Authority - Abu Dhabi
'We look forward to

continuing our development
of a strong, sustainable
healthcare system for the
population of Abu Dhabi.'
13 Chairman’s Message HAAD Annual Report 2009

Since its formation in 2007, the Health Authority – Abu Dhabi (HAAD) has set ambitious priorities for executing
health system reform within the Emirate of Abu Dhabi. These priorities are clearly defined in our five-year strategic
plan and are fully aligned with the Abu Dhabi Government 2010-2030 Strategy Map. They have also been reflected
in our balanced scorecard, which further translates and operationalizes our vision and strategy into ambitious
targets we hold ourselves accountable for to our stakeholders. The HAAD corporate balanced scorecard guides
all of our external reporting and internal performance management and defines the outcomes (access, customer
satisfaction and better health) and the internal processes needed to achieve those outcomes.
Looking back at the year 2009, I am happy to tell you that we have made significant progress against those
priorities and targets.
CEO’s
The outcome which we want to achieve is a system in which everyone has full access to healthcare (access)
resulting in a healthy population (better health) trusting the system (customer satisfaction).
Providing Affordable Access: Together with our partner DAMAN, we have completed the enrolment of all Nationals
Message into the Thiqa programme in 2009. The addition of special programmes for orphans, the handicapped and
prisoners have completed our universal health insurance programme so without exception everyone in the Emirate
has access to quality healthcare.
Improving Health: In managing the first renewal for Thiqa, we have expanded the Weqaya programme to now
include screening programmes for groups at high risk for breast cancer. The screening programme has not only
been embraced by our people, the media and even the arts (a film documenting the tales of survivors of breast
cancer prepared by HAAD was screened at the Middle Eastern Film Festival) but has already started to save lives
by earlier detection and better treatment. It therefore contributed to improving people’s health.
This past year has also provided new and unexpected challenges for the Health Authority. The international H1N1
pandemic serves as a reminder that new health challenges will continue to emerge. Our swift response to this
challenge, whilst continuing our broad range of activities, illustrates our increasing level of maturity as an Authority
and our level of preparedness and flexibility.
H.E. Zaid Al Siksek

Chief Executive Officer, Health Authority-Abu Dhabi
'The H1N1 pandemic

serves as a reminder that
new health challenges will
continue to emerge.'
15 CEO’s Message HAAD Annual Report 2009

CEO's
Message Scorecard
Satisfying Residents: In the end, patients need to trust the care that they receive. To monitor patient satisfaction,
we have administered two comprehensive surveys across public and private providers in the Emirate, including the
largest health satisfaction survey to date in order to develop baseline and recommended actions.
In order to deliver the desired improvements in outcomes, we need to start with ourselves and improve the service
delivery of the Health Authority having, more customer friendly processes and developing and nurturing our people.
We have a strong internal performance management system on all of our initiatives in the strategic plan.
Processes: To improve our processes in 2009, we launched our completely redesigned new service area which
creates a single customer interface for all of your dealings with the Health Authority. We have successfully
automated some of the most important customer facing processes for faster and easier service and better data
capture, examples of which are the new and electronic visa screening and death notification forms.
Employees: Our employees at the Health Authority are our most valuable asset as they create these processes
and deliver the services to our stakeholders. I am happy to say that our heavy investments in training such as
the innovative leadership programme we started in collaboration with Johns Hopkins School of Public Health to
properly plan for succession to the next generation of leaders in healthcare is already bearing fruit. We will continue
to strive for recruiting the best and offering them attractive and long-term career prospects.
Looking ahead, I am personally excited about continuing the journey towards building a truly world-class health
system guided by our strategic plan together with the support of our employees, our dedicated partners to the
government in insurance and healthcare provision, existing and new investors from the private sector, and last but
not least all healthcare professionals who are delivering the care to the patient. In closing, I wish to express my
gratitude to our customers, partners, and employees for their unwavering commitment; our accomplishments past,
present, and future are only made possible through their collaborative efforts.
Zaid Al Siksek
Chief Executive Officer, Health Authority-Abu Dhabi
The balanced scorecard is a strategic planning and management system used to align business activities with
the vision, mission and strategy. Used extensively in business and government, it allows management to improve
internal and external communications, and monitor performance against strategic goals. It is a performance
measurement framework that adds strategic non-financial performance measures to traditional financial metrics to
give managers and executives a more 'balanced' view of organizational performance.
HAAD Annual Report 2009 CEO’s Message 16 17 CEO’s Message HAAD Annual Report 2009
• Define the strategy for the health system and set public private partnership roadmap
• Monitor & analyze the health status of the population and performance of the system
HAAD’s Role • Shape regulatory framework for the health system

• Inspect against regulations and enforce standards
as a Regulator • Encourage adoption of world-class quality & performance targets
About
• Plan capacities and service levels
& Policy Maker • Drive programmes to improve societal health
• Define minimum standards for health service providers and health professionals
HAAD
• Regulate scope of services and premiums & reimbursement rates of providers and payers
The Health Authority-Abu Dhabi (HAAD) is the

government regulatory authority for health services
sector in the Emirate of Abu Dhabi. Established in
February 2007, The Health Authority-Abu Dhabi
develops the strategy for the health system of the
Emirate based on the directives of the Chairman of the
Health Authority and the Abu Dhabi Government.
HAAD is responsible for the licensing and inspection of

all health professionals and healthcare facilities (public
and private) in the Emirate. It regulates all hospitals,
clinics and primary healthcare facilities, as well as health
insurance providers.
HAAD also drives programmes to increase awareness

and adoption of healthy living standards among the
residents of the Emirate in addition to regulating the
scope of services, premiums and reimbursement rates
of the health system.
19 About HAAD HAAD Annual Report 2009

Our Organizational
People Chart
'We are here to serve

your health needs'
HAAD Annual Report 2009 About HAAD 20 21 About HAAD HAAD Annual Report 2009
Health System
Overview 2009
Health
System
at a Glance Source: WHO Statistical Information System/World Health Statistics 2009, Public Health Department, and Health Facility Database.
Population Encounter
• 1.9m residents, 21% Nationals • 11.6 million encounters
• Median age 19 for Nationals and 30 for Expatriates – 2% inpatient (179’948)
• 29’068 births and 2’988 deaths – 42% by Nationals
• Life expectancy 74.4 for men, 74.8 for women – 43% by hospitals
Provider Financing
• 5’142 doctors, 8’142 nurses and5’630 allied health • There are now more insurance contracts (2.2m) than
professionals in 1’077 licensed facilities: residents
– 39 hospitals (3’621 beds)
– 572 centers and clinics Claim
– 467 pharmacies and stores • 9.1 Million claims processed
• 98.8% of claims for outpatients
Payer
• 33 licensed insurers compete for members
23 Health System
at a Glance
HAAD Annual Report 2009
Public Health Investor
Highlights Highlights
• Injuries: Abu Dhabi has one of the world’s highest additional doctors and 6,500 nurses will be required
rates of injuries due to road traffic collisions. They by 2019. If churn rates remain at their 2009 level,
account for 14.4% of all deaths and are the leading this will require some 1,600 doctors and almost
cause of death amongst young males. Fines for 1,800 nurses to be recruited annually. There are
speeding, mandated use of seat belts and traffic productivity reserves within existing facilities, with
safety education programmes are some of the average physician productivity in most hospitals
actions being taken by government agencies to lower than the US average. Demand for inpatient
counter this problem. services may require up to 2’000 additional beds
within ten years beyond the current 3,660 beds.
• Communicable diseases Rates of childhood 57 hospitals with temporary licenses suggests there
communicable diseases are very low, due to is likely to be significant future development and
immunization programs targeting children aged <5 investment in this area.
years. Expatriates are screened for communicable
diseases before acquiring residence status. • Capacity gaps: Overall bed occupancy rates
vary significantly by facility, but have not increased
• Non-Communicable diseases The Emirate has in aggregate. Bed occupancy in ICU, NICU and
very high rates of chronic diseases related to lifestyle PICU was consistently above optimal level of 75%
including obesity, diabetes, and cardiovascular throughout 2009.
• Population Abu Dhabi has grown rapidly in previous disease. WHO reports obesity rates of 25.6% for • Population The population is largely on or nearby
years, with likely temporary consolidation in 2009. males and 39.9% for females for UAE residents over Abu Dhabi island. Areas of growth in the short • Reimbursement HAAD sets prices for the Basic
1 in 5 residents are Nationals of whom 2/3 are under 15-years-of-age. Without major changes, these rates to medium term are expected to be just off the product uniformly, adapted from the US-Medicare
30 and half under 19. Most expatriates are aged are set to increase further as the population ages. island (Khalifa City A, Mohammed Bin Zayed City, structure. Providers negotiate prices with Payers
between 20 and 40. Cardiovascular diseases already accounted for a the islands adjacent to Abu Dhabi island) and the for Enhanced plans, generally as a multiple of up
quarter of recorded deaths in 2009, our biggest killer. oldest city Al Ain. At the end of 2009 there were
to twice Basic product rates. Thiqa is reimbursed
• Expatriates are overwhelmingly male and of Adult Nationals were screened for cardiovascular risk 0.4m National Thiqa members, 0.9m government-
at the level of Daman’s most generous Enhanced
Asian origin. A significant share are employed in factors in 2008 as a condition for enrolment in Thiqa subsidised Basic members and 0.86m Enhanced
plan. Price levels are weighted towards outpatient
construction and accommodated in labour camps. insurance. Individuals thought to be at high risk of members.
care. In line with this, demand growth has been in
The introduction of mandatory health insurance in cardiovascular disease are now being followed up.
ER and outpatient services whilst inpatient service
2007 provided all residents in Abu Dhabi access • Demand for health services in the Emirate stabilised
• Cancer caused 13% of all recorded deaths in the levels have remained relatively stable from 2007-
to high quality care. Residence status is generally in 2009 – with the exception of ER encounters
Emirate in 2009. Breast cancer is the dominant 09 accounting for <2% of all encounters. DRGs,
contingent on being employed, so there are very few – following significant increases in 2007 due to
cancer in Abu Dhabi. Late detection of breast anticipated in 2010, will likely increase inpatient
retirement age or unemployed expatriates. the introduction of mandatory health insurance
cancer has historically lead to significant increases reimbursement.
for Expatriates and Thiqa for Nationals in 2008.
• Mortality rates have also declined steadily over in mortality. Female adult Nationals aged 40-69 are Significant growth in demand for services relating to
the past years. Infant mortality is now comparable being screened for breast cancer as part of their chronic diseases, e.g. diabetes, is expected, with • Provider market Government-subsidized SEHA
with most other developed countries and the WHO Thiqa insurance renewal. Education and awareness larger volume increases in outpatient settings. It is, facilities provided 89% of all critical care bed
recently reported a decrease in the under 5 mortality campaigns plus subsidized screening have increased however, estimated that there will also be aggressive days, treated 58% of all inpatients and 36% of all
rate from 15 to 8 per 1’000 live births between 1990 screening rates for all nationalities. growth in inpatient services relating to both diabetes outpatients.
and 2007 across the UAE. In 2009, the diseases and cancer.
of Circulatory System are the number one cause • Respiratory infections are the most common non- • Payer market Mandatory eClaims for all from
of death, accounting for 24% of all death cases life threatening condition in the Emirate, accounting • Supply Despite growth in the number of doctors January 2010 (www.haad.ae/DataDictionary) created
registered in the Abu Dhabi Emirate. External Causes for over 18% of all encounters across all healthcare available to residents, it is estimated that up to 5,000 a market for eClaims software.
of morbidity and mortality and Neoplasms are the facilities. Respiratory infections impact workforce
second and third highest cause of death. productivity and quality of life.
HAAD Annual Report 2009 Health System

at a Glance
24 25 Health System
at a Glance
Patients Key Performance
Satisfaction Indicators
Key Performance Indicators (KPI) Baseline Actual Target Success

2009 Overall Outpatient Department Satisfaction Indicators
Service Delivery % of all Nationals living/working in the Emirate of Abu
50% >95% 90%
Dhabi enrolled in comprehensive health insurance plan
Overall outpatient satisfaction 83% % of all Expats legally living/working in the Emirate of
Abu Dhabi enrolled in health insurance plan with licensed 90% >95% 94%
health insurer
Willingness to revisit the hospital 92%
% mortality data collected by major diagnostic categories
25% 90% 60%
& adjusted for comparability
Willingness to recommend the hospital 94% % of all hospitals beds managed by internationally
>40% 70 >40%
experienced hospital groups
Waiting Time (In Waiting Room/Area) 75.0% Service Delivery % Satisfied Customers (Outpatient) 64% 83% 70%
Process &
Technology % of Nationals in workforce 21% 34% 22%
Time Spent (Physician) 80.0% % of services/processes automated 10% 80% 70%
% of total initiatives executed as planned N/A 86% 80%
Attention of Physician 81.9% % of outsourced services with SLA 100% 100% 100%
People % Satisfied employees 70% 73% 73%
Clarity of Communication 81.9% Development
# of high level managers in the leadership programme N/A 25% 15%
Explanation of Medical Condition (Physician) 81.7%
Nationals have
95% 95%
Explanation of Test / Treatment 82.0% Expatriates have
Comprehensive Health Insurance
Provision of Translation / Interpreter Services 84.0% Health Insurance
Privacy 82.3%
Satisfied Internal
83% 80%
Instructions Provided 82.2%
Customers Processes
(Outpatient) Automated
100%
Source: Survey of 3133 outpatients from 8 public hospitals within the Emirate of Abu Dhabi
Facilities
Audited
HAAD Annual Report 2009 Health System

at a Glance
26 27 Health System
at a Glance
Strategic Plan
Priorities
Strategic
Plan
2010-2014 1. Fill Critical Gaps in Capacity and Insurance Coverage
2. Improve Medical Outcomes
3. Inspect & Control for quality
4. Improve Health Professional Education
5. Increase Emiratisation of Health Sector
6. Improve Public Health
7. Create Customer Transparency
8. Pay-for-Quality
9. Increase in Private Sector Investment
10. Be Prepared for Emergencies
11. Automate Internal Processes
12. Develop Quality Workforce & Plan Succession
Strategic Plan
29 2010-2014
Delivering HAAD’s Our Achievements
Strategic Priorities 2009
Priority 3: Inspect & Control for quality
• 1,310 audits conducted by Health Audit, Hospital
& Clinics Section
• 1,061 audits conducted by Health Audit,
Pharmacy Section
• Successfully conducted audit visits to all of the
facilities under the management of SEHA
• 70 ambulances and medical transport units were
approved this year (This includes new applications
and renewals)
Priority 4: Improve Health Professional

Education
• 265 continuing medical education (CME) activities;
10,655 attendees to HAAD sponsored CME
events; 2,012.75 accredited CME hours
• 4,866 candidates sat for written and oral exams
Priority 1: Fill Critical Gaps in Capacity and • Introduction of online examination Center
Insurance Coverage
• 1st Abu Dhabi International Nursing Conference
• Following the introduction of Thiqa, more than
95% of Nationals living or working in the Emirate
are enrolled in a comprehensive health insurance Priority 5: Increase Emiratisation of Health
plan Sector
• Equally, more than 95% of all Expatriates legally • Critical gap still exists for clinical staff but
living/working in the Emirate are enrolled in a increasing capacity for training should improve
direction over coming years
health insurance plan with a licensed health insurer
• For non-clinical/management staff, start of
healthcare leadership programme (Dr.Ph-MPH) for
Priority 2: Improve Medical Outcomes 25 Nationals with Johns Hopkins School of Public
Health
• 9,327 Health professionals in the Emirate are
registered with HAAD, approximately 90% of those • Ongoing promotion campaigns to recruit talented
practicing in the Emirate Nationals
• Established a follow up system for diabetics

identified through Weqaya. A telephone invitation, Priority 6: Improve Public Health
call Center and appointment booking system has
'Following the introduction of Thiqa, more than 95% been established for those screening positive for
diabetes, resulting in over 7,000 appointments and
Metabolic syndrome:
• Over 180,000 Adult Nationals from Abu Dhabi
of Nationals living or working in the Emirate are 3,000 visits for newly diagnosed diabetics screened for cardiovascular (CVD) risk factors
enrolled in a comprehensive health insurance plan.' • 5 Memorandums of Understanding (MOU's)

signed
• Link of Thiqa to mandatory screening showed over
70% of adults to have at least one CVD risk factor
Strategic Plan
HAAD Annual Report 2009 Strategic Plan
30 31 2010-2014
2010-2014
Delivering HAAD’s Our Achievements
Strategic Priorities 2009
Policy & Standards Priority 10: Be Prepared for Emergencies • Establishment of systems for electronic notification
and certification of births, deaths and diseases
• Completed a comprehensive review of all • Formation of HAAD Incident Command system
HAAD Policies & Standards and Definitions, in and Major Incident Plan. Incident Plan for external • Fully automated insurance product approval process
incidents via internet
collaboration with a U.S. accreditation body, and
national and international specialist law firms • Health Information System (HIS) link to Operations • Automation of HAAD back office processes
Center providing live patient information
• Minimum standards for healthcare facilities (policies,
codes of practice, guideline, etc) developed in • Geographic Information System (GIS) mapping Priority 12: Develop Quality Workforce & Plan
conjunction with a U.S. accreditation body link with Abu Dhabi Systems & Information Center Succession
(ADSIC)
• Completed a review of the Terms of Reference for Quality Workforce:
Medical Boards and produced a revised policy as
part of HAAD Policy Manuals Priority 11: Automate Internal Processes • Investing in and improving the training of all staff
through a comprehensive training catalogue linked to
• Launch of Visa Screening System, setting standards employee personal development plans
Priority 7: Create Customer Transparency for the Visa Screening process
Succession Planning:
• Defined the data standards for all relevant quality • Public Health Notifications for Births, Deaths,
Infectious Diseases, Injury & School Health • Launched formal planning effort to identify critical
data and created the processes and incentives, for
• Development of school canteen guidelines (in Screening/Vaccinations developed and piloted with business roles and development needs for both
collaboration with Abu Dhabi Food Control Authority a continuous, and reliable, data flow
healthcare facilities incumbents and potential successors in these roles
& Abu Dhabi Education Council (ADFCA & ADEC) • Regular mandatory patient satisfaction surveys by
focusing on healthy eating
HAAD successfully introduced
Road Safety: • Prospective patients are able to map the locations
• Launched Emirate-wide road safety campaign of our healthcare facilities around the Emirate
including in-depth crash investigation of more than through the ‘Find a Doctor/Clinic tool’ located on
200 fatal and severe road crashes in the Emirate the HAAD website
Breast Cancer Awareness Improved Outcomes:

Priority 8: Pay-for-Quality
• 98 breast cancers detected earlier through screening
during 2009 • Increase transparency on levels of pay through
standardized new basic price list implemented in
Occupational Environment: Q1, 2001
• Launched Emirate-wide heat management
• Planned introduction of Pay-for-Quality through
campaign: 465 Companies, 4,460 work sites,
Diagnosis Related Groups in August 2010
815,000 heat-exposed workers, more than
1,794 labour camps covered, more than 77,600 • 33 licensed insurers compete in an open market
educational items distributed
Infectious Disease: Priority 9: Increase in Private Sector Investment

• Launched GCC-leading H1N1 campaign for
community and schools and managed roll out of • Total increase of 88 new private facilities
H1N1 vaccine campaign for Hajj Pilgrims, pregnant • HAAD Winner of Best Healthcare Management
woman and healthcare professionals
Service Strategy Award at Hospital Build 2009
• Vaccination Programme: Introduction of new vaccine and Highly Recommended for Best Facilities
to the Expanded Programme on Immunization (EPI) Management Service Strategy Award at Hospital
schedule (Hexavalent vaccine) at age of two months Build 2009
Strategic Plan
HAAD Annual Report 2009 Strategic Plan
32 33 2010-2014
2010-2014
Congenital malformations, deformations
7% and chromosomal abnormalities Injury, poisoning and cetain other
2% consquences of external causes
Other causes
7% Endocrine, nutritional
and metabolic diseases 25% or unknown
Public Health &

Policy Division 13% Neoplasms
Organization
Disease of the
24% circulatory system
22% External causes of
morbidity and mortality
Leading causes of death 2009
Mission
The mission of the Public Health and Policy Division (PHPD) is to
improve public health increasing the length and quality of life of the
population of Abu Dhabi. The Division does this by insuring effective
regulation of the health system, by driving the health agenda in non-
health sectors, and by driving the safe and rational use of drugs and
medical devices.
Responsibilities
PHPD seeks to deliver measurable improvements in length and
quality of life across the entire population of Abu Dhabi. This is done
through health promotion and disease prevention programmes
and a broad range of evidence based interventions. Continuous
surveillance of vital statistics and regular screening provide HAAD
with world class epidemiological data which is routinely analyzed to
drive public health intervention and health system reform. Disease
prevention programmes drive for measurable health impact through
the targeted use of public health interventions such as vaccination
and screening, and the consistent promotion of healthy lifestyle
choices. All public health programmes are monitored against clear
targets to drive for impact and continuous improvement.
In collaboration with relevant stakeholders, PHPD formulates

health policies to help ensure reliable excellence in healthcare. This
includes ensuring the safety and effectiveness of drugs and medical
products, and traditional, complementary and alternative medicine.
35 Organization HAAD Annual Report 2009

Public Health & Public Health &
Policy Division Policy Division
The scope of work includes: External causes of mortality 2009
• Identification and prioritization of public health needs through rigorous surveillance
• Implementation of evidence-based programmes to address these priorities 12% Occupational Injury
• Development, perpetuation and evaluation of best practices in disease control, occupational and
environmental health, and family and school health 8% Home Injury Category 2009 2008 2007
Road Traffic Injury (RTI) 430 422 427
• Enhancement of knowledge in order to permanently change behaviour and attitude through effective health
promotion 8% Suicide Occupational Injury 82 68 66
• Formalisation of the research regulatory framework in collaboration with other UAE regulators, and Home 57 34 10
development of a funding process to promote and sponsor research into Abu Dhabi’s disease priorities in a 4% Occupational
RTI Suicide 51 66 39
safe and sustainable research environment
• Coordination with external stakeholders in the planning and implementation of public health interventions
3% Other Occupational RTI 26 8 34
Drowning 13 13 22
• Monitoring and evaluation of results to ensure continuous improvement 2% Drowning Other 21 12 23
Road Traffic
The Public Health & Policy Division has four departments:
63% Injuries (RTI)
Total 680 623 621
• Public Health and Research

• Pharma/Medicines
• Policy and Standards
• Zayed Complex for Herbal Research
Gender and age By Nationality

Changes vs. Changes vs.
Leading causes of death 2008 2008
1 (-1)
Causes 2001 2002 2003 2004 2005 2006 2007 2008 2009
UAE 139 (20%) (1)
7 (3)
Diseases of the circulatory system 622 778 624 413 424 378 506 697 726
20 1 (11) Pakistan 137 (20%) (50)
External causes of morbidity and mortality 464 645
600 614 574 563 565 503 621 60 1 (14)
India 118 (17%) (-26)
Injury, poisoning, and certain other consequences of
85 61
external causes 103 9 (5)
Bangladesh 63 (9%) (-7)
Neoplasm 252 289 276 298 294 315 370 360 399 146 12 (15)
218 18 (21) Egypt 40 (6%) (8)

Congenital malformations, deformations and
190 199 152 146 156 131 177 120 208
chromosomal abnormalities
30 9 (-11) Other 183 (27%) (31)
Endocrine, nutritional and metabolic diseases 65 73 103 126 133 130 201 79 212
26 16 (3)
Other causes or unknown 845 664 763 943 874 993 867 1144 737
1 (-2)
Total 2574 2617 2492 2489 2446 2450 2742 2949 2968
Source: Public Health and Policies, Health Statistics Analysis
Note: Changes in reporting procedures may account for some differences between years.
Source: Preventive Medicine Department reports, Public Health & Policy; Health Statistics Analysis.
HAAD Annual Report 2009 Organization 36 37 Organization HAAD Annual Report 2009
Public Health & Research Department

Current Public Health priority areas (2008 - 2009)
Based on the leading causes of death, the Division devised 10 priority areas.
Road Safety Safety In Heat
1- ‘Achievable impact’ combines number of patients affected, how serious the condition is, gap between current UAE performance and international The HAAD ‘DRIVE SAFE – SAVE LIVES’ road safety Road traffic injury was the second-leading cause of
best practice, and availability of evidence based intervention.
campaign in 2009 focused on speeding and the use of death in the Emirate in 2008. Up to November 2009
2- Extended Programme for Immunization.
seatbelts, specifically targeting young male drivers. there were 401 road traffic fatalities, mostly young
adults, with UAE Nationals accounting for one out of
Instead of using the standard ‘scare and fear’ tactics four of them (25%). Speed and failure to use a seat
HAAD addressed six of these priority areas with major health promotion seen in many other injury prevention campaigns, the belt or child safety seat were identified as the leading
HAAD Road Safety message was positive and inspiring
campaigns, here are two examples using World Rally car driver, Sheikh Khalid Al Qassimi,
causes for fatal and severe road traffic injuries.
as the spokesperson. The message encouraged

Road Death:
common sense rather than creating emotional pressure Occupational Accident:
The HAAD Road Safety Programme is focusing on: as a way of changing behaviour.
HAAD Heat Management Programme: ‘Safety In Heat’
• Improving road traffic injury data by utilizing HAAD recognized that changing driver behaviour is was divided at over 465 companies, employing more
and improving health and surveillance data and a long challenging process and can’t be achieved than 800,000 workers at over 4,500 worksites and
conducting, or facilitating, targeted surveys and by campaigns and education alone - proper law
research to close knowledge gaps 1,800 labour camp sites.
enforcement and good road engineering is necessary
• Increasing awareness and educating high- to improve road safety in a significantly shorter period The campaign, carried out in collaboration with the
risk populations, and the community, about of time. Ministry of Labour, aimed to increase employer and
the dangers of risky driving behaviours and worker awareness of heat stress and the need to
promoting safe driving practices HAAD’s efforts in changing driver behaviour were prevent heat illness. The programme included the
recognized at the Gulf Traffic Conference where it free distribution of training packs, DVD videos, over
• Supporting, planning and implementing was awarded Gulf Traffic Award 2009 in the category
road safety initiatives with proven or likely 63,000 worker and supervisors pamphlets, over 13,000
‘Road Safety – Changing Driver Behaviour Award posters in five different languages, and HAAD water
effectiveness, e.g. child car seat initiatives and
(Campaigns)’ for the campaign. The award recognized coolers for smaller companies. An online Thermal Work
use of seat belts
that the campaign addressed the most pressing issues, Limit calculator and training workshops were also
• Working in partnerships with all concerned speeding and seatbelt usage, and built a broader provided. All materials were made available to any
stakeholders to improve road safety in the awareness of the importance of driving safely and the company that registered at www.haad-safe.ae.
Emirate value of human lives.
An evaluation of the programme amongst company representatives and HSE personnel indicated a 79.6%,
‘very good’ to excellent level of satisfaction. They rated the response to the programme in the ‘good, very good
Pharma/Medicines Department
or excellent’ categories at 93.9% for management and business owners, 95.5% for HSE personnel and 93.8% Poison and Drug Information Center
for workers. Statistics from two large companies indicated a significant decrease in heat related cases in 2009
compared with 2008: Company A had a 79.5% decrease in cases (from 15.3 to 1.16 cases/1000 workers) and
Company B had a 50% reduction in serious cases (from 0.08 to 0.04 cases/100,000 work hours). The Poison and Drug Information Center (PDIC) improves pharmaceutical care by providing accurate and easily
accessible, poison and drug information to the general public and the healthcare community.
The campaign will be repeated annually in the lead upto summer. Subsequent campaigns will repeat the core
content, but evolve the materials to maintain interest. They will include graphics from additional sectors, and will be The number of enquiries in the general public increased in 2009. This can be attributed to the following reasons:
issued in additional languages. • The Center produced 13 brochures, in Arabic and English, addressing important health issues
• The Center launched a new website in June 2009
E-Notifications Systems for Birth, Death, Intrauterine Fetal Death (IUFD), Infectious Diseases: • In co-operation with SEHA, the Center’s toll free number was distributed to the public through a SEHA
Using Online Tools to Improve Services medication safety campaign
As part of our effort to improve the quality of data and to enhance and streamline the data capture process,
the Division developed web-based applications to capture Birth, Death, Intrauterine Fetal Death and Infectious One of the most important tasks of the division is to improve medication safety awareness among healthcare
Diseases Data. professionals in order to promote rational, and safe, use of medicines.
The system was developed to increase the speed of data collection, mitigate reporting errors, and improve In 2009, the number of safety issues communicated to healthcare professionals increased due to our continuous,
communication between healthcare workers and HAAD. daily, monitoring of international regulatory agencies, such as the Food and Drug Administration (FDA) and Center
for Disease Control (CDC) in the USA, the Medicines and Healthcare products Regulatory Agency (MHRA) in the
The system performed very efficiently during the H1N1 pandemic. Where the previous manual reporting UK and Therapeutic Goods Administration of Australia (TGA), amongst others. Safety information from these
mechanism had a considerable time lag, the E-Notification system enabled healthcare workers to log on from any agencies is filtered according to relevance and then communicated to healthcare professionals in the following
location and upload data immediately. ways:
• Increased validation resulting in improved quality control • Email for safety alerts
• Enforced coding and standardization • Toxic Drug Info (quarterly newsletter)
• Improved customer services • Web/fax for Health Advisories
• Real time data analysis
Medication Safety Issues Communicated to Healthcare Professionals

250
   
214
200
153
150
100
46
50
0
2006 2007 2008 2009
requirements across the full spectrum of health
In an effort to improve patient safety and prevent harm from exposure to toxic agents, the Center conducted three services. They will include the requirements for facilities,
surveys covering a wide variety of agents presenting potential risks for toxic exposure or abuse. These included: clinicians, health insurance provider and all other health
• cough and cold services in the Emirate.
• household products A major part of this review was completed in 2009 with
• herbal weight reduction products three policy manuals delivered. A fourth manual will
be finalized in January 2010. Public and stakeholder
110 locally available cough and cold products were screened for the appropriateness of the package (outer and consultations are planned for early 2010, with
inner), the correctness of the label information and the safety of ingredients. Two products were withdrawn from implementation workshops to be held from February to
the UAE market. April 2010.
Key ingredients in the most commonly available household products were assessed. The Center is creating a The revised policies and standards in the manuals
referral database and developing guidelines for packaging. reflect global best practice, assuring that HAAD
policies are transparent, evidence and risk based, able
to be complied with and most importantly that they
will remain relevant and effective over time. They will
Quality Control encourage the healthcare sector to deliver world-class
Quality Control is the regulation section for pharmaceutical medicines and medical products. care.
It is responsible for setting policy standards and guidelines for pharmaceuticals used in the Emirate and running a
variety of related programmes and initiatives. 2009 activities Zayed Complex for Herbal
Quality Control is involved in the listing of medical devices for all government subsidiary programmes in the During 2009, work on the rational medicine use Research
insurance scheme. Section representatives sit on many committees, including vaccine committees and the programme continued through outreach with various
hospitals, medical Centers and clinics. The Research Center was conceived by the late Sheikh
Continuing Pharmacy Education committee.
Zayed Bin Sultan Al Nahyan, the founder of the United
A reporting mechanism covering adverse reactions Arab Emirates. His Highness felt that, in spite of all
and medication errors was launched and the PV recent modern healthcare developments, there was
programme collaborated with the Federal Ministry of a need for a Research Center to study herbal and
Pharmacovigilance programme
Health on a unified, UAE-wide reporting system. traditional therapies.
The Pharmacovigilance programme (PV), launched in
Partnerships with international drug regulatory agencies The ‘Zayed Complex for Herbal Research and
2008, assesses the benefits, harm, effectiveness and Hospitals in PV Programme were forged so that information on drug safety Traditional Medicine’ (ZCHRTM) was established in
risk of medical products and encourages their safe,
monitoring could be shared. 1996. The Complex is unique in that, under one roof,
rational and more effective use. Private
it has traditional systems of medicine examined with
Public HAAD Quality Control Laboratory modern scientific research tools and methodology.
PV safety monitoring covers HAAD is establishing a Quality Control Laboratory for Using the work of the Complex, the Health Authority-
drugs in Abu Dhabi. Construction has begun and the Abu Dhabi is taking a leading role in the world wide
• Conventional medicines (prescription & non-
laboratory is expected to be operational by the middle investigation of herbal medicines. The Zayed Complex
prescription)
of 2010. is actively involved in generating knowledge about new
• Herbal and Traditional medicines herbal treatments and verifying old traditions regarding
• Vitamins and Minerals
Policy & Standards the therapeutic properties of local medicinal herbs.
• Biotechnology products i.e. vaccines, serums and These discoveries are made available for clinical use
blood derived products Department and further research for validation and documentation.
• Medical devices A comprehensive review of all HAAD Policies and Researchers from the Zayed Complex have been
Standards was initiated, in partnership with a U.S. involved in many seminars on the advancement of the
In 2009, the PV programme was extended to include all accreditation body, leading healthcare providers in the science of herbal and traditional medicine, and their
private hospitals in Abu Dhabi and Al Ain. Emirate and national and international specialist law cooperation has been sought by different international
firms. This review aims to produce consolidated and agencies.
integrated policy manuals that spell out the regulatory
Health Regulation Health Regulation
Division Division
• To provide objective, efficient and timely processes

for addressing allegations involving health Health Professionals Licensing Department
professionals licensed by the Authority and develop
proactive policies and procedures designed to Professionals Licensed 2009
address issues of concern
Alternative Clinical Support Physicians &
Total Nursing Pharmacy
• To promote continuous development of health Medicine Services Dentist
professionals to address current and emerging
issues of the healthcare industry Total 13530 59 1647 3434 2034 6347
Hospital 7258 9 833 2516 0 3899
• To provide the public with information and Clinic 497 1 21 152 0 322
educational resources regarding the licensing, Polyclinic 1387 17 153 369 0 845
regulation and practice standards of health
Rehabilitation Center 379 25 337 7 0 10
professions
Center 1837 7 235 381 0 1211
• To collaborate with stakeholders to explore issues Diagnostic Center 113 0 66 0 0 47
impacting the supply, training and employment of Provision of Health
25 0 2 9 0 13
healthcare professionals Service
Office 21 0 0 0 21 0
• To protect the public by promoting quality care
Mission through programmes, to license and certify
healthcare professionals, facilities and providers
Pharmacy
Store
1862
151
0
0
0
0
0
0
1862
151
0
0
To ensure the provision of quality healthcare and

protect and preserve the health, safety and welfare of • To identify and promote professional standards for
the population of the Emirate. The Division implements the highest quality healthcare
health policies, laws, regulations and standards for Professionals Licensed 2007-2009
healthcare facilities, professionals and health insurance • To determine acceptable internationally recognized
companies, and also manages the treatment of UAE standards for the services of Health Insurance
Providers and to implement these standards 15000
nationals abroad.
• To set the general rules for reimbursement between
Responsibilities providers and insurance companies, and the prices
2009
at which providers get reimbursed for the basic 12000
The division promotes the provision of quality and insurance product
2008
safe healthcare by ensuring the highest standards
as it manages all licensed activities of healthcare The Health Regulation Division (HRD) has four 2007
professionals, healthcare facilities and health insurance departments: 9000
entities operating in the Emirate.
• Health Professionals Licensing Department
The scope of work for this division includes:
• International Patient Care (IPC) 6000
• To provide fair, consistent and timely processes
for those applying for a license or registration • Health Insurance Regulation Department
and maintain accurate records of licences and
registrations issued • Health Facilities Licensing Department
3000
0 Total Hospitals Clinic Center Office Pharmacy Store
Source: Public Health Department & Health Facility database
Health Regulation Health Regulation
Division Division
Total Accredited CME Hours
Continuous Medical Education and Professional
Development:
Health Facilities Licensing Department
To ensure the quality of healthcare professionals
working in the Emirate is world class and to secure
reliably high standards of healthcare services, HAAD ALL FACILITIES 1130 All Facilities Licensed 2009
requires, as a condition of their license renewal, all
physicians, dentists, pharmacists and nurses to Hospital 40
undertake continuous education. Similar conditions will
in the near future, be applied to all other members of
Center 107
98 Rehabilitation 61Store
Center 107Center
healthcare teams. Polyclinic 187
11 Provision of
Health Service
Clinic 201
Pharmacy 407
Provision of Health Service 11

201Clinic
International Patient Care (IPC)
Diagnostic
187 Polyclinic 13 Center
Store 61
IPC is responsible for ensuring appropriate international care is provided to UAE Nationals who are unable to find 40 Hospital
suitable care within the Emirate. It refers patients for treatment abroad or to private hospitals and medical centers Office 5 5 Office
in other Emirates.
Rehabilitation Center 98
407 Pharmacy
Applications for international treatment are considered by the Medical Committee which bases assessments on a
thorough knowledge of the services available within the Emirate and abroad. Diagnostic Center 13
When a patient is sent abroad IPC manages the arrangement of tickets, transportation and accommodation for the
patient and a legal escort. If necessary an ambulance aircraft is provided to transport the patient to the country of During 2009 Health Facilities Licensing began licensing new medical services including: Mobile Health Unit (single
treatment. and multiple), Dialysis Center, Provision of Health Services (Health consulting services & hospital management,
Employing/Transferring medical staff, Home Care Services, Medical Professional Development, Medical Transport
service and Patient Escort services).
Health Insurance Regulation Department: Facilities Licensed 2007-2009

Insured Population
2500000 1200
2009
Thiqa
1000 2008
2000000 Basic
Enhanced 2007
800
1500000
600
1000000
400
500000
200
0
Dec 2006 Dec 2007 Dec 2008 Dec 2009
0
Note: Some numbers may be inflated, as cancellations during the year are not reflected. Total Center Clinic Hospitals Pharmacy Store
Source: Payer submissions; some insurance data not available. Source: Public Health Department & Health Facility submissions
Health System Health System
Compliance Division Compliance Division
The Division’s scope of work covers all public and
private healthcare institutions and providers in the
Emirate of Abu Dhabi. It monitors compliance with all
Clinics & Hospitals Audited 2009
Ad Hoc
Ad Hoc
applicable healthcare regulations and standards which Audit Type – (Incl Adhoc & Pending (Private)
(Public) New
includes but is not limited to: Number 5%
5% Licensing
Results) 11%
• Maintaining effective auditing and monitoring New Licensing 148

Ad Hoc
systems and protocols to evaluate compliance with Audit
Licensing Renewal 534
federal laws, HAAD rules and regulations, other 42%
international standards Follow up Audit 499
• Facilitating and building patient satisfaction and trust Ad Hoc (Private) 68

in the healthcare system
Ad Hoc (Public) 61
• Clinical reviews/investigations and complaints Total Audit Visits 1310

Follow up Licensing
Audit Renewal
management to investigate, respond to and 38% 41%
prevent identified compliance problems, including
Mission establishing appropriate and coordinated corrective

action measures
The Health System Compliance Division safeguards the • Establishing and maintaining communication
health and safety of the public by ensuring that legal feedback process to disseminate findings
requirements and professional standards of practice are
maintained by healthcare providers. • Developing disciplinary guidance and appropriate
criteria to respond to improper or illegal activities in
Responsibilities healthcare facilities, and to carry out enforcement
actions against facilities that have violated laws,
regulations, and healthcare programme requirements
The Division enforces rules and regulations for
and approved standards
healthcare providers (HCPs) and healthcare facilities
(HCFs) to ensure that healthcare is provided in an
ethical and professional manner, and in compliance with The Health System Compliance Division has two
approved standards. HSCD audits healthcare facilities Areas:
to monitor compliance with applicable rules and
• Health Quality Audit Department
regulations and conformance to approved standards.
• Clinical Reviews and Investigation Section
It also investigates complaints about health care
providers’ compliance and violations.
Top 5 reasons for classifying healthcare facilities as ‘disapproved’:

Health Quality Audit Department 1. Infection prevention standards and control practices guidelines were not met
Auditing public and private facilities 2. No maintenance of the medical equipment or quality control and calibration materials
During 2009 the Health Quality Audit Department focused on the public sector and conducted audit visits to all of 3. Improper medical records keeping
the facilities under the management of SEHA. 4. Clinical practice guidelines not met
The Department conducted ten audits of Primary Healthcare facilities to ensure that Weqaya screenings were 5. Not performing facility regular and preventive maintenance, and not observing fire and safety standards in
implemented and that they met all nominated criteria. In 2010 the focus will be on the private sector. the facility
Health System
Compliance Division
Health System
Special Projects
Compliance Division
Audit Visits to Assess H1N1 Preparedness the auditing of visa screening Centers. All SEHA
operated Centers were audited and detailed reports
The Division was heavily involved in the H1N1
provided.
Pharmaceutical Facilities Audited 2009 assessment for all healthcare facilities and many
New
Follow up Facility 6%
unannounced visits were conducted to assess the
Audit Type (Incl Adhoc & Pending Licensing situation. An intensive programme of visits to public Prescription Only Medicine Campaign
Number 13%
schools was undertaken with 31 visits in just one
results) The campaign aimed to educate the public about
month. These visits were made to ensure H1N1 Prescription only Medicine (POM), warn of the dangers
New facility 63 preparedness in schools. of self medication and convince people to see a
physician before taking prescription only medicines.
Licensing Renewal 417
Checklist Approval Follow-up auditing revealed a decrease in POM
violations to 30%.
Ad Hoc Audit 441 The Health Quality Department developed new
checklists for healthcare facilities which are being
Follow up Licensing 140 tested. The Department is organizing a workshop with Publishing an Awareness Raising Booklet
Licensing
Ad Hoc all healthcare facilities to discuss these new checklists.
Audit
Renewal In 2009 HSCD published a guide for parents on the
Total Audit Visits 1061 39%
42% rational use of antibiotics: The ‘Do Bugs Need Drugs’
Standards booklet combined:
The introduction of Hospital Standards, Continuum of 1. Material prepared by ‘Do Bugs Need Drugs®-
Care Standards and Ambulatory Care Standards to the Canada’ which is a community education
healthcare sector has driven enhanced compliance. programme to address the problem of antibiotic
HAAD standards and regulations are being widely resistance in Canada.
implemented by HCFs.
2. Artwork painted by students in Abu Dhabi schools.
Visa Screening The chosen pictures were all drawn by UAE
nationals.
In addition to the regular Audits, on the request of the
Public Health Division, the Health Audit team undertook
Clinical Review and Investigations Section

A proactive campaign to increase public awareness about the complaint system and why it is important to lodge
complaints, was conducted using 800800 posters in healthcare facilities and pharmacies.
To shorten the review time for complaints and to obtain Calls Received
unbiased decisions in clinical reviews, the Clinical
Reviews and Investigation team signed two contracts
with international consultancy companies. The
maximum review time is now between 10 and 20 days.
Local reviews, conducted with consultants, used to

Top 5 reasons for classifying pharmaceutical care facilities as ‘disapproved’ : take between six and eight weeks. Now, due to the
systematic approach learned from the international
1. Cleanliness and neatness companies, typical reviews only take ten days.
2. Inappropriate storage of medicines In line with our continuous efforts to ensure the quality
3. Contravention of laws, regulations, or policies of care in the Emirate of Abu Dhabi, cases of medical
negligence are reviewed by an external committee,
4. Incorrect handling of controlled drugs and there is an established system to refer these
5. Damaged or expired items cases to the newly formed Disciplinary Committee for
appropriate action.
Emergency & Disaster Corporate
Management Department Affairs Department
• Build sufficient capacity to handle critical patients in and structures by which HAAD is directed, controlled
emergencies and held to account. It defines the governance
framework, specifying key governance bodies,
• Test personnel, plans and capabilities periodically;
reporting arrangements and an authority matrix. This
• Establish clear emergency communication structure determines how HAAD works, and is directed,
protocols day to day.
When Emergencies occur The Department also delivered the Code of Conduct,
which sets out the core standards of conduct expected
In the event of an emergency, healthcare providers, of all HAAD staff whether at the corporate office or in
blood banks, mortuaries must comply with all HAAD the regions. It provides staff with a systematic guide on
directives, provide treatment, prophylactic measures, how they should approach their work and the decisions
provide assistance and advice as requested by HAAD. they have to make.
During 2009 HAAD coordinated the response for one
A third major document, The Organization Function
major biological incident, the H1N1 flu pandemic,
Manual describes the organizational relationships within
and 39 other incidents – including serious road traffic
HAAD and the principles underlying its structure. The
accidents, airport incident standbys, fires and other
objective is to establish clarity of purpose for each
emergencies. It also took part in nine multi-agency
drills. organizational unit, and provide guidance to each unit
One of HAAD’s most important roles is to ensure that The Corporate Affairs Department provides on how to undertake their roles and responsibilities.
the Emirate’s health sector is properly prepared for During these incidents and drills the efforts of almost all organizational development, manpower resource Each unit’s role is clearly defined with activities and
emergencies, disasters and other high risk events such major hospitals and health care centers in the Emirate planning, and change management support. It also responsibilities detailed.
as epidemics. To fulfil this role HAAD has an Incident were coordinated. Multi-agency coordination and develops and maintains management tools and
Command structure modelled on similar systems in the cooperation included drills with the Ministry of Health systems, including relevant manuals. The nature of relations between the different
U.S. and UK. (MOH), the Abu Dhabi National Oil Company (ADNOC), organizational units within HAAD are also described
the Abu Dhabi Health Services Company (SEHA), the In 2009 the Department delivered the Corporate to ensure smooth and effective channels of
To ensure preparedness HAAD maintains stockpiles Governance Manual which describes the processes communication.
National Crisis and Emergency Management Authority
of drugs and vaccines at strategic sites and
(NCEMA), the Abu Dhabi Airports Company (ADAC),
maintains surveillance systems to detect and monitor
the Abu Dhabi Systems & Information Center (ADSIC),
emergencies. It monitors all healthcare resources to
and the Environment Agency.
ensure sufficient capacity to cope with emergencies
and maintains a communications network linking During the year capabilities were added to the physical
frontline services. These include emergency infrastructure:
departments, ambulance services, search and rescue
and hazmat teams, voluntary agencies and other • The Incident Management System was linked to
relevant facilities including mortuaries. Hospital Information Systems for live, real-time,
information
During an emergency, HAAD’s Incident Command
team, using the 24-hour Operations Center, mobilizes • A Geo-spatial Information System, with the use
health resources, prioritizes patient management, and of digital mapping for managing incidents and
coordinates healthcare facilities, medical responses and planning, was activated
public communications.
Training of medical disaster management administrators
Ensuring proper preparations continued throughout 2009.
Healthcare facilities comply with HAAD’s Standard for HAAD signed a service level agreement with the
Emergency & Disaster Management and Business Abu Dhabi Systems and Information Center (ADSIC)
Continuity. They are required to: to facilitate the sharing of geo-spatial data among
government agencies and other stakeholders.
• Be designed, constructed or retro-fitted to be
disaster-resilient The SLA fulfilled HAAD’s commitment to the Abu Dhabi
• Conduct a Hazard Vulnerability Analysis (HVA) and Spatial Data Infrastructure (AD-SDI), an initiative of the
plan to overcome vulnerabilities government of Abu Dhabi, administered within the
Abu Dhabi Systems and Information Center (ADSIC)
• Develop a plan for managing critical operations and e-government programme.
ensure operational continuity
Corporate Support Corporate Support
Services Department Services Department
• Planning and coordinating the supply,
commissioning, preparation and maintenance of Employee Feedback
information technology resources and services
In line with HAAD’s commitment to creating an open and desirable working environment, CSS conducted a year
• Providing services and technical support to end Satisfaction Survey and a mid-year PULSE survey. The improvement recorded across many key sections
manage shared data demonstrated HAAD’s willingness to listen and take action. The Satisfaction Survey covered work questions and the 6
Core Values of HAAD. Overall satisfaction reached 81% with more than 85% safisfied with HAAD Values. In addition to
• Ensuring the security of IT systems and data –
the marked improvement in satisfaction ratings, there was a decrease in overall dissatisfaction from 11% to 7%.
right people having the right access to the right
programs and data
The Corporate Support Services Department has three

Pulse VS YE Survey
sections: Largest Improvements from PULSE Survey
95.00% YE
• Human Resources +30.74%
Pulse
90.00%
• IT Services +12.51%
85.00% +25.86%
• Procurement and General Services
80.00%
2009 saw a number of HR initiatives and programs
demonstrating HAAD’s commitment to its employees. 75.00%
+15.04%
Mission Events
70.00%
65.00%
Corporate Support Services engages in a continuous
cycle of action and analysis to deliver innovative HAAD participated in the three-day NAJAH Exhibition, 60.00%
support to the Health Authority with the goal of providing hundreds of potential employees with 55.00%
providing for all Human Capital needs from day-to- information about HAAD and the opportunities
day job requirements (IT & Procurement/General available. This event also allovwed HAAD to for share its 50.00%
Overall Satisfaction I receive regular and I am comfortable My supervisor
Services) to attracting and developing competent highly messages on Breast Cancer Awareness, Road Safety Question timely feedback on my raising and issue recognizes when i do
productive employees (HR). and other public health programs. job performance with my team if I feel a good job
strongly about it
Responsibilities An employee recognition program, Mumtaz/Bravo,

was launched, recognizing the contributions of two Top 3 Scoring Questions from PULSE vs. YE Scores
outstanding employees each month. Awards are given
Corporate Support Services supports operational
at bi-monthly staff meetings which also feature CEO 94.00%
excellence by developing performance measurement +6.71%
briefings and presentations from Section Heads. YE
processes that drive continuous improvement and 92.00%
effective use of the potential of information technology. Pulse
Developement 90.00%
Its scope includes:
• Providing expertise on human resource issues and 88.00% +1.9%
In pursuit of excellence and continuous improvement,
meaningful analysis and reporting for management Human Resources revised rating criteria in appraisal +2.64%
86.00%
decision-making forms and processes and included a mid-year appraisal
• Developing programs and services that empower to supplement year-end evaluation. 84.00%
employees and involve them in the business In addition to its programme of job specific training, 82.00%
• Developing and implementing best practice HAAD offered two special training opportunities
80.00%
services in HR, IT, Procurement and General to all employees, ‘Mind Mapping’ and ‘Emotional
Service Intelligence’. Mind Mapping helps employees sort 78.00%
out complex issues and participate in brainstorming My immediate manager treats I can see the relationship My immdiate manager
• Ensuring equitable and competitive terms and me with respect & dignity between what I do and the listen to my concerns and
sessions. Emotional Intelligence helps facilitate better goals of where I work suggestions
conditions of employment, assisting in the effective
interactions between colleagues and customers.
management of resources and supporting
institutional compliance and customer service Human Resources completed a review and update of Demographics
• Managing timely, efficient and cost effective all job descriptions, changing remuneration including
basic salaries, supplemental allowances and housing In 2009 HAAD’s staff turnover remained below 10%. In line with HAAD’s commitment to a diverse workplace, the
provision of critical support services (procurement, number of male employees remained constant while the number of females increased. At the end of the year,
inventory management, office services and housing allowances. This was undertaken to ensure that HAAD
remained competitive in the labor market. HAAD employed 143 UAE Nationals, representing 35% of the total employees.
services)
1. The problem
Breast cancer is the leading cause of cancer death in much of the developed world. One in eight women will
develop breast cancer during their lifetime. Every year in Abu Dhabi, over 130 women develop breast cancer and
Emirati Health: many do not seek treatment until it is too late. As a result 44% of cases in Abu Dhabi are fatal within 5 years of
first diagnosis compared with 15-20% in best-practice countries. In order to reduce the number of fatal cases we
are using the most effective means of detecting breast cancer, mammogram screening. In 2007 the mammogram
Breast Cancer screening rate for women over 40 was just 12% compared with around 70-80% in best practice countries.
Awareness In 2007 HAAD set up a breast cancer programme to increase screening and reduce breast cancer mortality. The
Global Initiative for Breast Cancer Awareness was launched in Abu Dhabi in November 2007 in partnership with
Facing the Susan G. Komen for the Cure® and the Institute of International Education, under the auspices of the National
Higher Committee for Breast Cancer and the patronage of HH Sheikha Fatima Bint Mubarak.
Challenges of The Initiative brought Komen’s proven Course for the Cure™ to Abu Dhabi.
Emirati Health
Overview
1. The problem
2. The team
3. The initiatives
4. The achievements
5. The future
57 Facing the
Challenges
Emirati Health Emirati Health
Breast Cancer Awareness Breast Cancer Awareness
2. The Team Enforcement included making screening a systematic part of the health checks undertaken for the National
Health insurance program 'Thiqa'.
HAAD drove the programme, working with SEHA and other healthcare providers to provide facilities, equipment,
staff and training. HAAD’s approach, based on global best practice, is simple and practical, yet rigorous: The HAAD team worked intensively with healthcare providers, including them in the online appointment booking
engine which increased usage of otherwise under-utilised facilities. Healthcare providers were given regular
a. Driving uptake: Women across the Emirate are encouraged to screen (including Breast Self Examination, feedback with a newsletter. Training of healthcare professionals on all aspects of screening as well as treatment
Clinical Breast Examination and Mammograms). HAAD covered and or subsidized the cost of screening with and post-surgical care was undertaken and monthly data from healthcare providers collated in the Breast Imaging
health insurance and government revenues. Reporting and Data System (BIRADS).
b. Delivering world-class capacity: New screening facilities, providing world-class equipment, staff and training,
were supplied.
HAAD set up programme teams in each of the Emirate’s three regions with the goal of raising awareness and
training volunteers from local communities.
3. The Initiatives
The teams began work in mid 2008, encouraging, enabling and enforcing women, communities and healthcare
providers to take action.
Encouragement included opportunistic screening. For example when mother took her child for a vaccination,
she was invited to have a screening or given information on the benefits of screening, breast examination or
book a mammogram. A documentary “Healing & Hope”® was made using local survivors telling their own stories
(www.simplycheck.ae). A television advertisement was also made and shown.
Enabling included a website through which women could book screenings or Email for information. It also hosts
Snapshot of HAAD breast cancer website and appointment booking system: found at www.simplycheck.ae
videos for survivors and self examination stories. Nationals who had not been screened were also telephoned
and invited to come in to be screened. A call center was also set up at the number 800 61116. A series of health
promotion campaigns were also undertaken.
®®
Any trademarks featured remain the property of their respective owners
HAAD Annual Report 2009 Facing the

Challenges 58 59 Facing the
Challenges
Emirati Health Emirati Health
Breast Cancer Awareness Breast Cancer Awareness
4. The Achievements
Mammogram Screening rate
The mammogram screening rate was the key performance indicator used by the breast cancer team. We saw an
increase in the screening rate from 12% in 2007 to 16% in 2008 and, to date, a screening rate of 67% in 2009,
comparable with the rates seen in best practice countries.
Number of Mammogram Screenings
The Breast Journal Award

• Education & Awareness Campaign
• Breast Cancer Team Initiatives

Earlier discovery
• Website & Mini Campaign - April 2009
The number of late stage cancers discovered declined from 64% of total discoveries in 2007 to 56% in 2008,
an indication that problems were being discovered earlier. With the significant increase in screening rates, it is
• Healthcare provider regular communication - January 2009 expected that late stage detection will reduce significantly in coming years. As a result the proportion who can
have breast conserving treatment is expected to increase.
• Community Awareness - December 2008
Mortality from breast cancer
• October Campaign 2008 Changes in overall mortality rates take years to appear. We can predict that of the 88 lives predicted to be lost
from breast cancer every year in Abu Dhabi, 40 lives (45% of the total) will be saved due to increased screening
and early detection. These are 40 mothers, sisters and daughters who will be able to spend many more years with
• October Campaign 2007 their families.
Recognition
The work of the HAAD breast cancer team has been presented at International Conferences including the
American Public Health Association meeting in Philadelphia, and the 15th Multidisciplinary Symposium on Breast
Cancer, where it received the prestigious Breast Journal Award. The team has been invited to present at future
meetings of the Global Initiatives to tackle breast cancer.
5. The Future
Over the next year, the breast cancer team will be working to: increase screening rates, ensure consistently
excellent care and Centers of excellence in Abu Dhabi and developing standards and care pathways.
In our campaign to raise screening rates we will focus on improving services in remote areas. This will be achieved
through a mobile unit operating from Tawam Hospital in Al Ain and a new screening facility in Al Gharbiya Region.
HAAD Annual Report 2009 Facing the

Challenges 60 61 Facing the
Challenges
1. The Challenge
Pandemics, the spread of infectious diseases throughout the world, have existed throughout history. Today due to
easy international travel, they can spread quickly. Aware of the threat, HAAD has made preparations.
H1N1 An influenza outbreak in Veracruz, Mexico, was identified as a new strain of H1N1 influenza virus in April. It
rapidly spread around the world and, in June, the World Health Organization (WHO) declared the outbreak to be a
Response pandemic.
H1N1 is typically contracted by person to person transmission through respiratory droplets. Those with more
H1N1 severe symptoms or those in an at risk group may benefit from antivirals.
Overview
1. The challenge
2. Preparation undertaken
3. New virus identified
4. Pandemic phase
5. Achievements
6. The future
63 H1N1
Response
H1N1 H1N1
Response Response
2. Preparations Undertaken Hospitals were instructed to implement their pandemic 4. Pandemic Phase 5. Achievements
flu plans and a website provided H1N1 information
HAAD’s preparations included a response network for healthcare workers and the public. Educational On June 11, WHO declared H1N1 to be the first global The overall handling of the H1N1 pandemic was widely
and a stock of antiviral drugs. In collaboration with materials were prepared and distributed. pandemic of the 21st Century. praised. There were no shortages of supplies, adequate
international authorities, training sessions were facilities were available at all times, and there were no
HAAD immediately put all health care facilities on high
held. Hospitals were instructed in pandemic flu Increasing the level of surveillance, health care teams public panics.
alert, activated hospital plans, stepped up surveillance
preparedness. were deployed in ports of entry and thermal scanners
and increased laboratory capacity. The effectiveness of HAAD’s public information efforts
were placed in airports. Passengers arriving from
Receiving hospitals in all regions were identified, a were recognised by the Middle East Public Relations
infected countries were screened and screening cards Daily reporting on critical cases admitted to ICUs began
management plan was put in place, and a stockpile of Association (MEPRA) which highly commended the
were distributed to airlines. and training for healthcare workers, school nurses
antiviral drugs was created. A network of stakeholders and safety officers, was accelerated. On June 14 a effectiveness of the campaign.
was established and a capacity building plan drawn up. The Sheikh Khalifa Medical City (SKMC) laboratory was public awareness campaign began with information
designated as the diagnostic center, and health care in the media and campaigns in malls, government
personnel were given special training. All suspected departments and mosques. 6. The Future
3. New Virus Identified
cases were hospitalized, isolated and managed as The process of handling the H1N1 pandemic has
A dedicated vaccination campaign for the Haj was
When the new virus was identified in April, HAAD inpatients. Front line personnel at ports of entry, those strengthened the capacities of the Emirate’s health care
conducted and HAAD, working with the Abu Dhabi
alerted all hospitals. A command team was established working in emergency medical services, airports and Education Council (ADEC) launched an education system. HAAD has carefully documented this process
and the HAAD Operation Center was put on 24/7 high airlines were also trained and educational materials programme for parents, students and teachers in the and is in an excellent position to contribute to the
alert. were produced and distributed. Emirate’s schools. control of any future pandemics.
HAAD Annual Report 2009 H1N1

Response 64 65 H1N1
Response
Environmental HAAD began environmental conservation initiatives in 2008 taking a variety of measures to reduce the use of
energy, fuel, water, and paper. The results of these activities are still being quantified, therefore 2009 data will be
Sustainability the baseline for measuring HAAD’s environmental footprint in future reports.
Sustainability
HAAD added 86 employees in 2009, taking

the total number of staff to 285. Despite that
increase significant improvements were made in
consumption levels. HAAD’s 2009 conservation
achievements include:
Successfully reduced electricity use by 34.5 %.

• Utility meters to measure water and electricity
use installed
• Separate AC for computer server room
installed. This reduced the need to cool the
entire building
• Signs above all electricity switches to remind
staff to turn lights off
• Conservation campaign displayed on LCDs
throughout HAAD offices, encourages
staff to reduce water, electricity, and paper
consumption
• Carpooling in HAAD vehicles whenever
possible. Drivers reminded to turn off engines
while waiting
• Disconnect/lower the ACs, and all lights
switched off, after business hours.
67 Sustainability HAAD Annual Report 2009

Sustainability Sustainability
2008 2009 Initial Performance

Environmental Overall 2008 Overall 2009 Difference Initial Social KPI 2009 Targets
Consumption Consumption Difference Target Achievements
KPI Consumption Consumption /Staff Achievements 2008 2009 % change
/Staff /Staff /Staff
Electricity UAE National employment 21 % 36.2 % + 15.2 % 22 %

5,490,256 27,589 5,148,230 18,064 381,713 -9,525 -10% -7% -34.5%
use (KW)
UAE Women employment 32 % 22.90 % - 9.1 % 34 %
Water use
19,468,350 97,830 22,306,281 78,255 28,377 -19,575 -10% +14.5% -16%
(Litres) Employee Satisfaction N/A 73 % N/A 75 %
Printer/
Copier 1980 9.94 2179 7.64 199 -2.30 -10% +10% -20%
paper (Kg) Social sustainability initiatives at HAAD:
• A training assessment programme to increase the skills and knowledge of all HAAD employees.
Printer/
This programme is designed to target specific needs of individual employees based on their current
Copier 50 .25 55 .19 5 -0.06 -10% +10% -24%
competencies and future objectives
Cartridges
• An annual employee satisfaction survey is conducted to identify opportunities to increase employee
Note: 4.5 Litres equals 1 gallon
retention
• Provision of the 9 Essential Public Health Services to staff to reduce the burdens caused by chronic illness,
Planned environmental initiatives: infectious disease, or injuries
• Green building standards for new buildings. HAAD plans to build four new buildings in the near future: a
training Center, a data Center, a vaccine store, and a new mortuary
• Improved mileage tracking of HAAD's vehicles in order to measure and reduce vehicle emissions of 1. Monitor health status to identify community health
greenhouse gases. HAAD's vehicle data will appear in the HAAD 2010 annual report problems.
• Reduced paper consumption. Guidelines for circulating ‘electronic copies only’ and limiting printouts 2. Diagnose and investigate health problems and
• HAAD began recycling paper in July 2009. Paper recycling is being tracked and will be compared with total health hazards in the community.
paper use
3. Inform, educate and empower people about health
issues.
4. Mobilize community partnerships to identify and

solve health problems.
5. Develop policies and plans that support individual

and community health efforts.
6. Enforce laws and regulations that protect and

ensure safety.
7. Assure a competent public health and personal

healthcare workforce.
8. Evaluate effectiveness, accessibility, and quality of

personal and population-based health services.
9. Research for new insights and innovative solutions

to health problems.
HAAD Annual Report 2009 Sustainability 68 69 Sustainability HAAD Annual Report 2009
Call Free: 800 800
www.haad.ae

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H.H.

Sheikh Khalifa Bin Zayed Al Nahyan

8 Vision, Mission, Values

22 Health System at a Glance

28 Strategic Plan 2010 - 2014

56 Facing the Challenges of Emirati Health

7 Contents HAAD Annual Report 2009

• Everyone has access to healthcare

Vision • Full spectrum services

'Everyone has access

9 Vision HAAD Annual Report 2009

healthcare for the community 3. Respect & Compassion

• Inspect against regulations and enforce standards

Dr. Ahmed M. Al Mazrouei

'We look forward to

13 Chairman’s Message HAAD Annual Report 2009

H.E. Zaid Al Siksek

'The H1N1 pandemic

15 CEO’s Message HAAD Annual Report 2009

HAAD’s Role • Shape regulatory framework for the health system

The Health Authority-Abu Dhabi (HAAD) is the

HAAD is responsible for the licensing and inspection of

HAAD also drives programmes to increase awareness

19 About HAAD HAAD Annual Report 2009

'We are here to serve

HAAD Annual Report 2009 Health System

Key Performance Indicators (KPI) Baseline Actual Target Success

Explanation of Medical Condition (Physician) 81.7%

HAAD Annual Report 2009 Health System

2. Improve Medical Outcomes

3. Inspect & Control for quality

4. Improve Health Professional Education

5. Increase Emiratisation of Health Sector

6. Improve Public Health

7. Create Customer Transparency

9. Increase in Private Sector Investment

10. Be Prepared for Emergencies

11. Automate Internal Processes

12. Develop Quality Workforce & Plan Succession

Priority 4: Improve Health Professional

• Established a follow up system for diabetics

enrolled in a comprehensive health insurance plan.' • 5 Memorandums of Understanding (MOU's)

Breast Cancer Awareness Improved Outcomes:

Infectious Disease: Priority 9: Increase in Private Sector Investment

Public Health &

Leading causes of death 2009

In collaboration with relevant stakeholders, PHPD formulates

35 Organization HAAD Annual Report 2009

• Public Health and Research

Gender and age By Nationality

218 18 (21) Egypt 40 (6%) (8)

Public Health & Research Department

Road Safety Safety In Heat

as the spokesperson. The message encouraged

Medication Safety Issues Communicated to Healthcare Professionals

• To provide objective, efficient and timely processes

To ensure the provision of quality healthcare and

0 Total Hospitals Clinic Center Office Pharmacy Store

Source: Public Health Department & Health Facility database

Provision of Health Service 11

Health Insurance Regulation Department: Facilities Licensed 2007-2009

• Maintaining effective auditing and monitoring New Licensing 148