Qualitative Saudi focus groups reveal mixed experiences of primary healthcare reforms

Patients participating in 11 focus groups across four regions of Saudi Arabia reported mixed experiences with primary healthcare reforms, including easier appointment booking, medication access and specialist referrals, alongside persistent problems involving digital access, continuity of care, communication between services and availability of dental and mental health support. The qualitative study recruited 44 patients through purposive sampling and examined their experiences in four domains: accessibility, continuity, coordination and comprehensiveness. Investigators used thematic analysis with both inductive and deductive coding to identify recurring patterns in participants’ accounts. The findings, published as an open-access research article in BMC Health Services Research, reflect reported experiences rather than measured changes in population-wide health outcomes.

Access to appointments and medicines was among the areas in which participants described improvements. Many said the “Mawid: My Appointment” system made it easier to book primary-care appointments, while “Wasfaty: My Prescription” improved access to medications for some users. These reported benefits did not extend uniformly across the patient population. Older adults and people with limited digital literacy or poor internet connectivity encountered additional barriers when using the digital services. Participants also raised practical concerns about limited parking, restricted appointment flexibility and long travel distances to obtain medications in some areas. The study therefore documents a combination of reported gains and continuing access problems, rather than a uniform experience of reform.

Patients emphasized the importance of relational continuity in primary care. They valued seeing the same physician over time and associated repeated contact with a familiar clinician with trust and familiarity. Frequent physician turnover was reported to weaken that continuity. Electronic medical records provided a different form of support by supporting informational continuity across providers, allowing patient information to remain available when care involved different clinicians. The focus-group findings distinguish these two aspects of continuity: participants appreciated both the transfer of clinical information and the personal familiarity developed through an enduring physician-patient relationship.

Coordination between primary and secondary care also showed a mixed picture. Participants reported that the “Ehalati: My Referral” system improved the speed of referrals and access to specialist care. Communication gaps between primary and secondary care providers nevertheless remained common. In primary health care centres, participants acknowledged greater availability of laboratory, X-ray, dental and mental health services, indicating improvements in the comprehensiveness of care available at this level. Availability within primary care centres did not mean that access was consistently straightforward. Long waiting times and limited appointment availability remained major concerns in dental care, while mental health services were described as less visible and inconsistently available.

As a qualitative focus-group study, the research cannot establish how common these experiences were among all Saudi patients or measure changes in service use, health outcomes or equity over time. The sample comprised 44 purposively recruited participants in 11 focus groups spanning four Saudi regions, and the conclusions are based on the themes that emerged from their accounts. Within that scope, the study documents how structural expansion and digital services coexist with uneven access, interruptions in continuity, communication failures between care levels and gaps in specialized services. The authors concluded that successful primary healthcare transformation requires more than structural and technological change, with sustained attention needed for equitable access, stable patient-provider relationships and integration across services.

Subject of Research: Patient experiences of primary healthcare reforms in Saudi Arabia

Article Title: Patients’ perspectives on primary healthcare reforms in Saudi Arabia: a qualitative focus group study

Article References: Mubarky, A., Almalki, M., Hulme, C., Valderas, J. M., Porter, I., Moafa, H. N., & Pitchforth, E. (2026). Patients’ perspectives on primary healthcare reforms in Saudi Arabia: a qualitative focus group study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15518-7

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15518-7

Keywords: Saudi Arabia, primary healthcare, healthcare reform, patient perspectives, focus groups, qualitative research, digital health, care continuity, referral coordination, healthcare access, Patients, perspectives