10 September is World Suicide Prevention Day—a day dedicated specifically to raising awareness about suicide and how we can work towards creating a world where fewer people die this way.

Each year, suicide ranks in the top 20 leading causes of fatality across the world for people of all ages, and it is responsible for more than 700,000 deaths—translating to one suicide every 40 seconds. These statistics aren’t just numbers; they are friends, members of a family, partners, parents, sons, and daughters.

But when we consider statistics, there is a significant difference between genders. The number of suicides is much higher among males than females across all age groups in the world. In the UK, men are three times more likely to die by suicide than women.

The toxicity in toxic masculinity

Toxic masculinity, is, unfortunately, a term we’ve all come across. The concept has been around for a while, but now it is discussed pretty much everywhere. And for good reason.

Toxic masculinity is essentially a ‘macho’ and ‘red-blooded’ culture where men are expected to be tough and carry typical ‘masculine’ characteristics. Researchers defined toxic masculinity by behaviours and beliefs in part as:

•          Suppressing emotions or masking distress

•          Maintaining an appearance of toughness

•          Violence as an indicator of power (e.g., tough-guy behaviour)

In simple terms, toxic masculinity is the result of decades, perhaps centuries, of society teaching boys that they can’t and shouldn’t express emotion openly and that if they do, then they are weak and ‘feminine’. These boys then internalise these feelings and grow into men who have been taught that they can’t be anything less than ‘masculine’.

According to the American Psychological Association, these norms integrated into our culture has been linked to aggression and violence, resulting in men at “disproportionate risk for school discipline, academic challenges, and health disparities,” including cardiovascular problems, substance abuse, and suicide.

As well as toxic masculinity, there is also a massive stigma around mental health that is in the process of being deconstructed. Due to mass conversation on social media around the world, more and more of us are understanding the importance of mental health and being able to open up, although there is a long way to go. So, let’s do the same with toxic masculinity.

Toxic masculinity is a barrier to mental health treatment

Sadly, men who have internalised traditional views of masculinity are not only less likely to go to see their doctor, but they are also less likely to be honest about their health history and symptoms.

It can be incredibly daunting reaching out for medical advice, particularly about something so private. But if you need help, contact your GP to discuss how you’re feeling. Everything discussed will be confidential, so you don’t have to worry about anyone finding out. They can recommend medication, lifestyle changes, therapies, and support to help. Here is a helpful guide to prepare for a doctor’s appointment about mental health.

If you struggle reaching out and are reluctant about making the first step, you can access online doctor appointments through healthcare apps that allow you to speak to your doctor via video call, providing your GP surgery supports this technology. This can be particularly important for those who are held back by feelings of discomfort, offering a degree of discretion. Not only accessing medical advice virtually, but you can also order prescriptions, access your medical records, and mental health services. With toxic masculinity and general mental health stigma holding many people back from seeking help, research suggests that technology can help improve access to services.

What can the rest of us do?

Masculinity can be redeemed. It’s time to reclaim the meaning of masculinity and creating it as a concept of compassion and care. Here are some tips to help build trust with those in need and encourage the men you love to be more comfortable sharing their emotions.

Avoid trivialising men’s mental health.

Probably one of the most important and effective points to consider. Avoid saying things that invalidate a man’s feelings—for example, “you sound like a woman”, “stop being a girl”, “man up”, and “why are you being so emotional?”. Instead, acknowledge their feelings, show empathy, and provide support. Finding the right words can be difficult, and nobody is expecting you to provide high-quality counselling. If you find that you don’t know what to say, even listening without judgment is the best thing you can do.

Check up on your friends and family

Dropping in, whether it is by their house or in their texts, shows that you’re there for them and they can rely on you for support. Feeling alone is a huge symptom of depression, so let them know they’re not.

Encourage men to help them express emotions

Expressing emotion and crying are normal reactions for all people, regardless of gender. Don’t associate crying or stereotypically feminine traits with being weak. Processing emotions make us human—encourage the men in your life to acknowledge this.

Feeling and displaying your emotions aren’t bad things. Both femininity and masculinity can encompass compassion, empathy, and care, and shouldn’t be mutually exclusive. Please seek medical advice if you’re in need.

Article provided by myGP

Alzheimer’s disease is a progressive disorder, with symptoms including mild memory loss that may progress to a loss of the ability to interact with the environment and maintain a conversation. According to the U.S. Centre for Disease Control (CDC), Alzheimer’s disease is the most prevalent type of dementia. Recent reports have highlighted that dementia is going to affect one in three children born today, costs US$500 billion globally every year, and the cost of treatment is expected to reach US$2 trillion globally by 2030.

Early diagnosis of dementia has the potential to save US$118,000 per patient. To help achieve this, Cognetivity, a Cambridge University start-up founded by Dr Sina Habibi and Dr Seyed-Mahdi Khaligh-Razavi, uses Artificial Intelligence (AI) and human response to animals to detect dementia 10-15 years before outward signs would typically occur.

The simple five-minute test, administered via an iPad, is non-invasive, and results aren’t impacted by practice effect or any language, cultural or educational bias. Instead, it uses the human genetic response to animals to stimulate large brain areas in a single task. Users are asked to respond to a series of split-second images, some of which contain animals. Speed and accuracy data of responses is then analysed via the AI engine, and the user’s risk of having early signs of dementia are flagged.

In an interview with Omnia Health Magazine, Dr Habibi shared that the story of Cognetivity, which started in 2013, where, as a mechanical engineer, he was finishing his PhD in nanobiotechnology and started collaborating with co-founder Dr Khaligh-Razavi, a computational neuroscientist.

At that time, Dr Khaligh-Razavi was trying to understand the human vision and how the brain forms images. When we look around ourselves, our eyes work as a camera and keeps taking pictures. And the brain works like a computer to make sense of what’s happening inside those images. Thanks to the latest breakthroughs in neuroimaging, particularly in functional MRIs, one can discover what happens in the brain by giving patients or participants visual tasks. When they are put in MRI machines, the activated brain parts can be seen. During this work, Dr Khaligh-Razavi realised a specific response to natural images where animals are present. Through years of evolution, humans have become sensitive to pictures or scenarios where animals are present.

Dr Habibi explained: “Some call it the “food or fear” phenomenon – either those animals were our food, so we had to run after them, to hunt and eat them, or they were coming after us, so we needed to run away. When we see animals, we get wired and respond sensitively. So, we started using that phenomenon and created a code where we tested our friends. It’s like a game, and when they completed this task, we looked at their performance. We found an interesting correlation between their age and performance. As they got older, their performance dropped, but we observed healthy and active individuals between the ages of 18 to 35. That was quite an interesting observation. Because we know that for dementia, a major risk factor is age. So, we had a tool that can be correlated with age, and we know that dementia is correlated with age. Therefore, we put the two together and started building the technology.”

When you have a medical breakthrough, you have to back it up with data. Hence, the duo started the process of putting the hypothesis to test through different clinical trials. It took them almost six years to get the solution fully validated through multiple clinical trials. The last one was in the UK, where 10 National Health Services (NHS) trusts were involved. Each NHS Trust manages various hospitals and clinics, so they were able to test the efficacy widely. As a result, the test was confirmed to have superior performance, because of which Cognetivity got regulatory approval, which enabled bringing the product to market.

Recently, Cognetivity announced its partnership with InterSystems to use the company’s advanced data capabilities of the IRIS for Health platform to achieve integration with the NHS IT systems.

“We are now in commercial use in the NHS. We have plans to get U.S. Food and Drug Administration (FDA) approvals later this year,” he highlighted. “Because the technology is culture, language, and education agnostic, we are looking at various export markets.”

Dr Sina Habibi

Patient pathway

Usually, when a patient presents with a memory complaint to General Practitioners (GPs), a cognitive test is taken based on certain time-tested methodologies. If the patient scores below a certain level, they are referred to secondary care, where specialists carry out additional assessments such as MRI, CT scan and blood tests. After observing these different parameters, the doctors will come to the clinical conclusion of whether the patient has dementia or not. If the diagnosis happens at the later stages of the disease, where the memory symptoms are severe, the patient will be required to take medicines to help tackle the disease symptoms.

“That’s where we come in,” explained Dr Habibi. “Our technology is tuned to pick up very early stages of the disease. You can do a lot more at an earlier stage, especially in terms of adapting your lifestyle to postpone and delay the onset of symptoms. Some people have managed to prevent the onset completely by making the right lifestyle choices. In the past, people didn’t want to diagnose dementia in the early stages because nothing could be done. But now, it’s been proven that it can help patients delay the onset. Around 150 clinical trials are going on around the world on new treatments for Alzheimer’s. Recently, the U.S. FDA even approved a drug targeted at mild cognitive impairment (MCI). For the first time, they have managed to slow down and reverse the disease. It’s almost similar to cancer treatments. If you diagnose it in stage four, you probably have no chance. But if you pick it up earlier, your treatment might be more effective.”

Also, due to COVID-19, doctor visits had stopped entirely, which caused a delay in diagnosis. The ability to assess the patient and give them the right direction has not been there due to the pandemic. “We are working hard with NHS partners to make our technology completely remotely accessible. Because it’s a very simple five-minute test – the patient needs to tap right and left if they’ve seen an animal. It has simple instructions and no language barriers. Due to these various benefits, we are well-positioned to characterise, assess and monitor our patients. If the situation is getting worse, our AI can pick and highlight that over the last six months, every other month, this person has taken the test, and every test shows that there is a decline, so they need to pay attention to their health. They need to stay healthy by eating healthy and improve their sleep, exercise, and socialising patterns.”

He concluded: “We are looking at potential partnerships in the UAE. Our technologies are geared towards prevention, and the UAE is one of the few countries that look at prevention as an important act against long-term diseases.” 

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

A good night’s sleep is essential for the successful functioning of the immune system, physical health and helps fight depression and anxiety. Studies show that getting high-quality sleep can positively affect energy, activity, mood, and weight. However, COVID-19 created several challenges for those who previously didn’t have problems falling asleep. The uncertainty created by the pandemic has increased stress levels and had a definite impact on sleep and mental health.

According to a report published in the U.S. National Library of Medicine, around four in 10 people in the U.S. have reported trouble sleeping during the pandemic. Facing “Coronasomnia” myself, I started wearing Fitbit’s latest wearable, Luxe, to track my sleep and build good sleep hygiene practices. Unlike bulky wearables, Luxe is a dainty fitness tracker that proved to be a comfortable device to wear to bed.

Related: Omnia Health Magazine August – September 2021

While we are asleep each night, the body goes through several sleep cycles that last an average of 90 minutes. The sleep cycles include REM (Rapid Eye Movement) sleep, which is associated with vivid dreams, light sleep, and deep sleep, where there is less brain activity than REM sleep. Light sleep makes up most of the night’s sleep and promotes mental and physical restoration. REM is vital for memory and mood, while deep sleep helps with physical recovery and aspects of memory and learning and leaves one feeling refreshed.

Related: Snorers who suffer from sleep apnoea at increased risk of Type 2 diabetes

The device gives a detailed sleep score, sleep duration, sleep stage breakdown, resting heart rate, and skin temperature variation at night. A Fitbit Premium membership provides even more detailed sleep and health insights. The sleep log includes detailed charts showing fluctuations between sleep stages, trends over time, and estimated oxygen variation overnight. The deviations are marked in a different colour to draw attention to potential irregularities in breathing.

The tracker can estimate sleep stages using a combination of movement and heart rate patterns. The wearable tracks beat-to-beat changes in the heart rate, known as heart rate variability (HRV), which fluctuates as one transitions between the different sleep stages. REM or deep sleep can’t be controlled, but adopting good sleep habits can help achieve the ideal stages.

Moreover, the tracker gives a sleep score out of 100 in the morning that considers the quality of the rest. These insights provide a better sense of the current state of health and fitness level.

Sleep coach

Along with the tracker, the Fitbit app acts as a much-needed health coach and provides detailed insights along with important tips. For instance, one of the first myths the app breaks is that getting eight hours of sleep isn’t for everyone. Instead, experts recommend at least 6.5 hours of sleep, but beyond those, individual needs vary.

The app also offers a ‘Get More Sleep’ guided programme, an easy-to-follow guide that helps get more sleep with guidance from sleep experts. First, you have to complete a survey that asks general questions such as “how much energy do you have when you wake up?” among others and sets a schedule accordingly.

The weekly guided sleep goal, based on sleep data, helps to improve sleep score. For example, my score for August varied between 72 to 80. I am hoping that I can bring it to 80 and above over time with good sleep habits.

The feature also helps set up a bedtime routine that involves relaxing 15 minutes before bed, which can help one fall and stay asleep. These activities can include reading, listening to music and taking a warm shower which can calm the mind and help unwind. In addition, certain relaxation tools are offered in the app library, such as meditation sessions, soothing music pieces like the piano and bansuri flute, and a guided session on gazing upon the night sky to experience more restful sleep.

Moreover, the guided body scan session focuses on deep breathing exercises that help to relax the body and drift off to sleep. For instance, breathing in and out of the nose is a technique that brings more oxygen and is proven to lower stress cortisol that will leave the mind peaceful and quiet.

In conclusion, the Fitbit Luxe packs a lot in a small package! Luxe tracks steps, sleep, and nudges to keep moving during the day as a standard fitness band. It is a sleek and stylish device, unlike the cumbersome fitness trackers in the market. It scores high on functionality with robust battery life and is perfect for those looking to get a general overview of their health. Personally, it has helped me become more mindful of my sleep patterns and is assisting me in following a consistent sleep schedule. 

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Over the last 12 months, it has become more evident than ever before just how critical our healthcare systems and providers are. Perhaps more so than other industries, we are seeing the sector evolve at warp-speed to keep up with heightened demand. Whether its operations, tech or data, healthcare institutions have been forced to mature through a rapid digital transformation that the world was not prepared for.

There have been waves of transformation before, although not adopted everywhere. Take CIGNA in the U.S. and other global markets, and Nuffield in the UK, for example – both companies have been taking an approach to nurturing wellbeing with their customers for more than a decade. CIGNA has been involved in encouraging community participation in sport, in addition to offering health insurance. Nuffield has bought gyms, and dedicated resources to curating insights and information, all while managing its network of hospitals. In the Middle East, we’ve recently seen the ‘Saudi German Hospital’ rebrand to encompass a far broader offering, with ‘Saudi German Health’ now including everything from education to community medical care in its operations and customer offerings.

Related: Digitalisation of healthcare in GCC

One trend that has significantly increased over the last year is higher digital engagement with customers. Specifically for the healthcare sector, telehealth is on the rise in many countries, allowing accessibility to physicians that many patients would not otherwise have access to during the pandemic. A recent survey by vHealth says that more than half of expats in the UAE are likely to use telehealth services. A report by the U.S. Centers for Disease Control and Prevention (CDC) states there was a 154 per cent increase in telehealth visits during the last week of March 2020, compared with the same period in 2019 in the U.S.

Along with the innovation in operations and tech, the role that data plays is exponentially growing in the industry. New innovation to manage and adapt to demand using a ‘predict and prescribe’ methodology to plan based on trends is being utilised. Healthcare providers – and their procurement departments – are increasingly using data to deliver efficiencies and cost savings throughout their facilities. In addition, more efficient data and information management is helping to speed up decision making at all levels of organisations. Finally, we have seen more secure and systematic methods for managing and sharing patient data.

Related: How digitisation is helping the Gulf achieve its healthcare ambitions

Healthcare providers have access to data and as the world increasingly embraces digitalisation, providers will have access to more and more information. Managing patient data comes with sensitivities that are enforced by Government ministries, so data needs to be held safely and securely, accessed and stored in line with regulations.

In the same way that leading providers are moving towards a prevention – not cure approach – behind the scenes, patient data is increasingly being managed in a way that offers protection and prevention. The healthcare industry is transforming before our eyes, with the help of technology and data. The onus is now on healthcare providers, as much as regulators, to ensure this is being done safely and securely.

Samer Kamal

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Digital’ and ‘healthcare’ are terms that are becoming increasingly intertwined in the 21st century. The separation of the physical place from the delivery of healthcare services has become all the more pertinent as a result of the COVID-19 pandemic, with many healthcare organisations unable to treat both COVID and non-COVID patients in the same place.

Expanding access to quality healthcare services is a key global policy initiative, linked to Sustainable Development Goal 3: “Ensure healthy lives and promote wellbeing for all, at all ages.” This is particularly the case among the GCC countries, with each one making healthcare a cornerstone of both their national development strategies and their investment attraction agendas.

But what do we mean by digital healthcare? It’s a nebulous term that covers patient-facing and back-office elements that are increasingly touching our lives.

The GCC has generally embraced the innovation and technological advances of the Fourth Industrial Revolution, and this is prevalent in the healthcare sector too. Over the next 10 years, digital infrastructure virtual care, remote patient monitoring, and Artificial Intelligence will account for 30 per cent of hospital investments in the region. Much of this activity will come through private players; over the last 10 years, there were at least 74 VC investments into digital health related innovations targeting the Middle East Market, including Okadoc, an appointment booking platform, which secured the largest health tech Series A funding in the Middle East.

Innovation is already here; the UAE and Saudi Arabia in particular, are harnessing digital health solutions across the healthcare value chain to provide better services to patients.

In the UAE, more than 50 per cent of hospitals use IoT-based solutions and 90 per cent of doctors use smartphones and medical apps to provide services to their patients. The UAE will also likely become the regional hub for robotic surgery by 2030.

Saudi Arabia, powered by the Vision 2030 strategic plan and a growing population, is investing SR250 billion on healthcare infrastructure by 2030 – up to 50 per cent is expected to be in digital solutions and there is an expectation of increasing private sector involvement.

Even the smaller GCC countries know this is a key area of growth. Bahrain’s Economic Development Board, for example, lists foreign direct investment in healthcare (including digital health solutions) as a priority sector, and its medical devices market will increase by 25 per cent to 30 per cent in 2021 as the number of elective surgical procedures increases. Healthcare digitisation spending will likely reach US$600 million by 2025.

This is all driven by evolving patient attitudes and expectations of the type of care they receive. Virtual care, enabled by telehealth, is expected to become the ‘new normal’ in this region. Companies like the UAE’s Health at Hand, which connects patients with regional doctors through virtual consultations, are being actively integrated into the supply chain.

While healthcare spending in the region has traditionally been dominated by governments, privatisation will increase. Couple this with ongoing efforts to digitise the healthcare value chain, and there is ample opportunity for innovative private players to thrive in the GCC.

Ricky Shah

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Healthcare design is a complex business in the construction industry. Unlike hotels, education institutes or shopping malls, hospitals must follow a defining entity of medical industry requirement, i.e., control parameters to minimise infections. This can be achieved by adhering to good design practices in space development and all other electro-mechanical design requirements such as Heating, ventilation, and air conditioning (HVAC), plumbing, drainage and electrical supplies and its redundancy requirement for life-saving equipment usage and performance.

 To cater to this stringent need, Dr Vivek Desai founded HOSMAC in 1996 with an aim to create a holistic service platform for healthcare management models and spaces. HOSMAC Middle East was established in the year 2007. However, the firm ventured into the Middle East market in 2003. The company is headquartered in India and has an office in Dubai. Some of their projects in the Middle East include Emirates Hospital, Dubai, Prime Hospital, Dubai, Gulf Medical University, Ajman and Trauma Hospital, Sharjah, among others.

Related: Resilient design paramount for patient safety

Dr Vivek Desai

Related: Achieving Net Zero Energy for Hospital Buildings

After completing his MBBS, Desai realised that he was more inclined towards other aspects of healthcare rather than general practice. He found that there were significant gaps in hospital management, and hence there was immense scope for improvement. That’s when he decided to quit medicine, where he was working as an intensivist, and entered consultancy. During the last 25 years, Desai has had the opportunity to work as an advisor to renowned organisations such as the World Bank, United States Agency for International Development (USAID), Indian Ministry of Health and Family Welfare, among others.

 In an interview with Omnia Health Magazine, Desai, who also serves as the Managing Director of HOSMAC, shared: “We provide end-to-end healthcare solutions right from conceptualisation to commissioning of the medical facility. Our team comprises over 120 members, including doctors, hospital administrators, medical planners, architects, civil and MEP engineers, interior designers, biomedical engineers, chartered accountants, IT specialists and communication experts. Having designed over two million square feet of healthcare space in India, Middle East and Africa, HOSMAC aims to be a one-stop solution for healthcare consultancy in these regions and beyond.”

Planning ahead

When asked about the state of the Middle East’s healthcare construction industry, Uday Kumar Alaham, Managing Director, HOSMAC Middle East, highlighted that the industry is very well structured and complies with international standards of healthcare infrastructure. It covers all regulatory approvals such as civil defence, nuclear radiation, fire and life safety, among others. These approvals help any healthcare facility owner to obtain international accreditation from recognised boards without any challenges.

Uday Kumar Alaham

He said: “To give you an example, almost all of the healthcare facilities in the UAE, which are more than six months into operations, have obtained an accreditation board certification or are in the process of getting themselves accredited to attract international patients, with international health insurance cover.”

One of the significant challenges faced by the healthcare industry in the UAE and other Middle Eastern countries at present is that they don’t have clear pre-qualified and approved healthcare construction groups, stressed Alaham. This impacts the duration of construction of healthcare facilities, which has a significant impact on project budget and cost escalation.

“If the regulatory bodies of healthcare construction industry establish a norm of having pre-qualified healthcare infrastructure developing groups, I am sure that the planning, procurement and implementation of complex healthcare infrastructure development will be more efficiently handled and completed within a pre-set timeframe and cost,” he added.

Furthermore, he explained that healthcare design should not be limited to design inputs for the present need but also must have a plan for the expanding and demanding healthcare industry while keeping in mind the decades to come. Facilities that undergo organic growth face the challenge of infrastructure collapse and can be detrimental for patients and staff working in such facilities. “Due to increased healthcare demand, we need to plan well so that a modular addition of departments, sections or new features can be merged with existing facilities with minimal interruption to their operation,” he said

HOSMAC Middle East has executed several healthcare projects in the UAE and other Gulf and Middle Eastern countries. One such project was the Emirates Hospital in Jumeira, Dubai.

Alaham said that the project was challenging due to two reasons – the first being the proximity to the sea and the second due to the height restriction of the building.

“We were able to come out successfully with two basement floors car park facility and a spacious 50-bed hospital in above three ground floors. Our scope of services for Emirates Hospital included turnkey design, project management and equipment planning,” he said.

Latest trends in hospital design

According to Desai, something as essential as indoor air quality, which was neglected earlier, has become a paramount factor to monitor in hospitals.

“Globally, we have realised that the fundamentals have to be in place to have a successful healthcare infrastructure,” he stressed. “The future of hospital designing will be focused on how hospital buildings can be more flexible at the time of disasters, such as the pandemic we are facing currently. The tiniest of details will come into action at such times. For example, the way the services have been laid out in a hospital should make the process seamless and quick; air conditioning must be adequate and so on.”

In addition, he added, there will be an increased emphasis on how technology can replace the human interface in both diagnoses and treatment. As a result, services and features like artificial intelligence and virtual consultation will see more traction in healthcare.

Commenting on HOSMAC’s future plans, Desai emphasised that the firm is predominantly looking into two areas for the future.

The first is to partner with construction companies, where joint expertise can help design and build quality hospitals. This synergy will utilise the strengths of both partners. For example, HOSMAC can provide design, engineering, clinical department construction management support, and equipment planning services, whereas construction entities can handle the procurement and built aspects.

“Second, HOSMAC intends to get into retainer management contracts, i.e., operate hospitals for promoters. Having 25 years of experience in management consultancy, we believe our application of best practices and leanings can help enhance operations of any facility,” he concluded.

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

In Vitro Fertilization (IVF) was pioneered by biologist Robert Edwards who, with gynaecologist Patrick Steptoe, fertilised the first human egg in a Cambridge laboratory in 1969. Louise Brown, the first test-tube baby was born on 25 July 1978, at Oldham General Hospital in England.

The International Committee Monitoring Assisted Reproductive Technologies (ICMART) estimates that globally, in the last 40 years, over 8 million babies have been born using IVF or other assisted reproduction techniques. Today, around the world, over half a million babies are born each year using IVF or other assisted reproduction techniques with over two million treatment cycles performed every year.

The World Health Organisation (WHO) estimates that globally over 10 per cent of women are classified as infertile and require assistance to enable conception. The current global IVF market, based on various studies, is estimated to be between US$ 10 billion to US$ 13.7 billion.

Whilst there is no definitive accurate data available for the Middle East, the estimated IVF market size drawn from a number of cycles by Colliers is roughly US$ 200 million for UAE, US$ 300 million for the Kingdom of Saudi Arabia (KSA) and US$ 500 million for Egypt.

This article provides an in-depth analysis as to why despite an overall high population growth rate in the MENA region, IVF remains so popular. The paper also identifies opportunities and challenges for operators and investors.

What is infertility?

Medically, infertility is generally recognised as the failure to establish a clinical pregnancy after trying over a 12-month period.

Infertility in the MENA region

In the MENA region, the population has increased from just over 100 million in 1950 to 500 million in 2020 and is expected to increase to 700 million by 2050. However, overall fertility rates have decreased from 7 children per woman in 1960 to less than 3 in 2020.

There are several reasons for the decline in family size, including socio-economic factors, such as an increase in female literacy rate, an aspiration to be economically independent, evolution and increase in the use of contraception and changes in cultural norms.

In addition, men are also choosing to start families later in life plus the rise in lifestyle diseases (diabetes and obesity) especially in the Arab countries has also increased the demand for infertility treatments.

Many studies, including those published by the Global Diabetes Community, has shown a direct and indirect link between diabetes and obesity on both male and female infertility. Based on Collier's research and interviews with industry experts, compared to 10 per cent worldwide, the infertility rate in the region is 15 per cent or even higher.

Infertility is split approximately 50 per cent male to female across the Middle East region. The growth in the UAE IVF sector stems not only from domestic demand but also from the success of the UAE, particularly Dubai, in promoting medical tourism and the availability of infertility treatment centres, which are of international standards.

IVF market sizing

Why the Middle East is a growing market?

1. Shift from a taboo to cultural acceptability: With the passage of time, the stigma attached to infertility treatment has faded. Men also accept male infertility as taboo and seek IVF treatment
2. Fragmented market: Despite increased interest and investments, the fertility market in the Middle East remains relatively fragmented. The market is served mostly by individual clinics and as hospitals unit. Thus, offering opportunities for M&A.
3. Gender Selection/Family Balancing: The UAE is one of the few countries in the world, allowing gender selection giving an opportunity to the parents for “Family Balancing”.
4. Growth of home-grown brands: There are several centres affiliated with international brands. A number of home-grown brands also provide high quality and high success ratio, therefore, a lack of international brands is not hindering the growth of the sector.
5. Ease of entry: Over the years, many regional countries, notability the UAE, has relaxed tourist/medical visa eligibility and many countries can get visas on arrival. KSA has also embarked on a policy to attract tourists other than for religious purposes. The ease of entry has positively impacted the regional IVF sector.

 

Declining fertility in the MENA region

Across the globe and in the MENA region, fertility rates are decreasing due to several factors, which are summarised below. Female empowerment directly influences a woman’s choice of when to enter the family planning cycle. Moreover, although individually, males and females account for an equal percentage of infertility cases, however, in around 3/4th of the couples seeking IVF treatment, male fertility is either a primary factor or a co-factor. The factors contributing to male infertility include lifestyle, environmental, diabetes, obesity, hypertension, and genetics.

1. Increase in literacy rates: The overall literacy rate for both men and women in the Arab World has increased from 46 per cent in 1980 to over 73 per cent in 2019, with Saudi Arabia, UAE and Lebanon having above 90 per cent literacy rate and Egypt just over 70 per cent. Whilst the female literacy rate has increased from 32 per cent in 1980 to over 66 per cent in 2019.
2. Increase in the female labour force participation: Based on the latest data available from the International Labour Organization (ILO), the overall female labour force participation rate in the Arab world has increased from 16 per cent in 1990 to over 18 per cent in 2019. Most of the GCC countries made significant improvements such as in the UAE, the ratio increased from 28 per cent to 52 per cent, KSA (15 per cent to 22 per cent), Oman (21 per cent to 36 per cent), while the ratio in Egypt decreased from 22 per cent to 19 per cent.

 

Sources: World Development Indicators, UNESCO, International Labour Organization, Colliers Research 2021

UAE, Saudi Arabia, and Egypt: the regional “hot-spot”

Cost of IVF treatment/cycle

Due to the high success rates and quality of treatment offered, the UAE is in the best position to become the regional hub in IVF. Pregnancy rates in the UAE are higher than the average of IVF centres in Europe or the U.S. and are comparable with the success rates of the best centres in the world.

The higher cost of treatment as compared to other countries in the UAE is considered the major limiting factor for more patients coming from abroad. However, based on Colliers’s discussions with major providers in the UAE, “high success rates and quality are directly related to the significant investments made in this sector both in equipment and staff. If treatment fees for IVF are substantially reduced, it will have an impact on the UAE’s ability to retain that talent. Failure to do so can jeopardise the quality of treatment that is being currently offered”.

It is expected that the focus of the UAE will remain on attracting medical tourism willing to pay a premium for “high quality - high success rate”.

Impact of COVID

Like most elective procedures, IVF activity took a hit at the beginning of the pandemic. Embryo transfers slowed as the sector awaited guidelines from the Dubai Health Authority (DHA). To restart the embryo transfer, clinics adopted COVID-safe protocols. Fertility clinics, as with much of the healthcare industry, increasingly turned to telehealth in 2020.

Attractive returns

The IVF market in the MENA region is quite a lucrative investment. A mid-size premium facility set-up cost ranges from US$2.5 million to US$3.5 million excluding rent or construction cost. Earnings before interest, tax, depreciation, and amortization (EBITDA) margins for efficiently run clinics at optimal capacity typically range between 25 per cent to 40 per cent. Project investment returns (IRR) typically range from 18 per cent to 25 per cent.

Changing IVF laws

The new changes in IVF laws are also expected to further boost the IVF market. One of the most fundamental changes introduced by the new IVF law for fertility patients relates to the freezing of human embryos as well as unfertilised eggs and sperm.

The new IVF law also introduces a framework for intragovernmental consultation and decision making, and allows limited scientific research, in the field of fertility treatments. These changes are in line with the UAE’s National Agenda 2021 and the UAE Centennial 2071 project, which aim to elevate the UAE’s position in the global community and are especially important as the UAE positions itself as the go-to medical hub in the region.

Market growth potential

The IVF market in the UAE is relatively stable with a total number of 15,000–16,000 cycles performed per year. The growth of the market will be driven primarily by population expansion, but other factors that could amplify demand include increases in the incidence of infertility due to lifestyle changes and a rebound in IVF medical tourism — once the travel restrictions are lifted — particularly given the better quality, infrastructure, and success rates in Emirates.

Moreover, it is expected that the new IVF law will provide more options to couples who are looking IVF as a means to conceive babies. Moreover, the new law also will further establish UAE as a key destination for couples seeking IVF treatments regionally and internationally.

Mansoor Ahmed

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

The COVID-19 pandemic has sent shockwaves through hospitals and other healthcare institutions, which have had to continuously adapt to rapidly changing conditions. Many have also recently had to shift from providing emergency triage for an onslaught of coronavirus cases – on top of the common emergencies and illnesses they already deal with – to proactively support national vaccination rollouts.

The result of the need to make continuous adjustments as the crisis has developed has been that the requirements for communication technologies to help healthcare facilities adjust have been greater than ever. Systems such as track and trace via smartphone apps along with the management of vaccination schedules for entire populations have highlighted the potential for digital tools to deliver effective communication across entire hospital and healthcare services – and the communities they serve. To effectively deal with individuals who still require treatment at hospitals and clinics worldwide amid ongoing social distancing requirements and other restrictions, many healthcare providers are finding new ways to interact with visitors and patients through innovative IPTV and digital signage technologies.

Case in point: keeping everyone informed

Related: Omnia Health Magazine August – September 2021

The TOBB University of Technology and Economics (ETÜ) Hospital in Turkey serves as an excellent example of how IPTV can be used to keep all personnel and visitors on-site informed efficiently. TOBB ETÜ Hospital installed an IP video system in patient rooms, clinic waiting areas, visitor waiting rooms, and its on-site restaurants and cafes. The system facilitates the delivery of broadcast programming – including the news – and educational material to 85 patient rooms, six public areas and 28 staff desktops.

Access to local and international channels can help ensure patients are abreast of the pandemic’s latest news and developments. The IP video system also delivers prepared presentations and training videos to enable staff to access medical information or refresh their training at their convenience from a desktop computer.

Related: IT automation and healthcare: a golden union

TOBB ETÜ is one of many hospitals around the world that had already deployed IPTV prior to the pandemic, an increasingly useful tool for mass communications that can help reduce the amount of face-to-face exposure. The ability to display health-related communication in multiple languages and graphical representations offer a powerful tool – especially when dealing with multi-ethnic and culturally diverse populations.

Reaching people with dynamic tools

Although many digital signage implementations are seen as a form of one-way communication, a growing number of interactive systems can be used to greet visitors at the facility’s entrance and streamline ‘check-in’ processes through touchscreens and kiosks. Digital signage can be utilised to inform visitors where and how to begin the ‘check-in’ process and can include a range of other useful messages for those entering a hospital, including visitation hours, queue management information and wayfinding directions to departments and facilities like vending machines and restrooms. These digital signage applications help improve the overall visitor experiences while minimising interaction with staff by allowing visitors to check themselves in and find their way to their appointment.

In addition to the impact felt by frontline staff, in-patient stays can also benefit from enhanced communication tools and bedside TV entertainment. For example, at Qatar’s Hamad Medical Corporation, IPTV and digital signage technologies are employed to help patients feel connected to the outside world. Deployed throughout the hospital and in individual patient rooms at the specialist Tertiary Communicable Disease Centre, the IPTV system facilitates the delivery of 120 live and Video on Demand (VoD) channels to inform, entertain and support the patients, guests, and visitors while they are being treated, waiting or visiting the hospital campus. The digital signage solution also enables the hospital to create, manage and display dynamic signage across the site, communicating important updates on COVID-19 safety-compliant measures.

Technology that’s fit for purpose

These tools are also being increasingly used behind the scenes to overcome communication hurdles. Many healthcare providers use ward notice boards and internal electronic emailing methods, which in the midst of an ‘all hands to the pump’ crisis are sometimes problematic. With the impact of COVID-19, time available to ward staff to update static boards and check emails may be severely limited – and many staff, such as cleaners and other contractors, may have no access to email at all. To get around these issues, an increasing number of facilities use digital signage to efficiently update staff throughout large-scale facilities and across various locations, which can include break rooms, patient rooms and admission areas. These displays can quickly distribute critical information like policy changes, patient information, staff rosters, operation schedules, ongoing training opportunities, human resources information and, perhaps most critically, patient intake statuses.

By linking digital signage to hospital management systems, these critical updates can be dynamically created and displayed on defined screens with little human interaction – saving time and effort to support busy healthcare professionals. With the healthcare profession running at full capacity, digital signage and IP video have also been used to display necessary training and work protocols for staff, including instructions on cleaning communal equipment; observing new procedures for deliveries; and using cafeterias, kitchens and other facilities shared by frontline staff. Additional benefits of digital signage include adding more screens anywhere on the network easily and the ability to update signage screens remotely in real-time. Vitally, they can also be used to trigger emergency alerts and emergency messaging across the hospital staff screens.

The need to remain vigilant

IPTV and digital signage technology have proven itself invaluable during the recent pandemic. Moving forward, the lesson learnt around how to manage the dual requirements of minimising contact while still providing outstanding healthcare services will lead to more innovative use cases. Although vaccination programmes are being rolled out in countries around the world, the prospect of a new variant changing circumstances, or another type of outbreak, means that being prepared to adjust and deploy communications to staff, patients and others who are on-site will remain of critical importance to hospitals and other medical facilities. Indeed, the ability of healthcare providers to once again step into the breach means that exploring innovative new technologies to foster better digital communication should remain on the agenda of senior leaders throughout the industry.

Colin Farquhar

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

At Medlab Middle East 2021, Becton, Dickinson and Company (BD), a medical technology firm that manufactures medical devices, instrument systems, and reagents, highlighted its BD Biosciences business and BD Life Sciences – Integrated Diagnostic Solutions as well as its medication management solution.

On the sidelines of the show, Maher ElHassan, Vice President & General Manager, MENAT, BD, told us that the region’s healthcare industry was undergoing an unprecedented transformation, especially in the field of medical technology (MedTech). He said: “This is our first participation in a physical show since the pandemic began, and we are proud to be present and support the region.”

Related: Millennials set to reorder healthcare and medical laboratory testing

To provide continued support and expertise, BD has been working closely with stakeholders in the industry to understand their challenges and meet their needs by bringing the latest innovations to market. “We are looking to bring MedTech innovation in the areas of infection prevention and control, as well as rapid diagnostics, laboratory automation and cutting-edge research. This aligns with our mission of enhancing patient care and safety.”

BD Biosciences displayed products such as flow cytometry instruments for single-cell analysis for clinical and research applications at the show.

Related: New ‘lab on wheels’ mobile testing stations soon to be norm in MENA

Mohamad Kurdi, PhD, Clinical Affairs Manager, Middle East & North Africa, BD Biosciences, said: “For clinical application, we have the latest generation of flow cytometry, which can be used alone or in combination with a pre-analytical system. Its main application is in the haematological laboratory, for instance, in the application for the diagnosis of lymphoma or leukaemia. The instrument was designed to respond to the needs of the clinical laboratory, especially in terms of standardisation and accreditation, which is mandatory in most countries. Moreover, it makes the life of a laboratory professional very easy as it’s fully automated and simple to use.”

While BD’s Integrated Diagnostic Solutions business provides assessment and management of microbiology solutions and it offers completely automated solutions for different clinical laboratory needs, right from blood culture to sepsis management. “We provide solutions that completely transform the microbiology laboratory,” said Dewanand Mahto, Clinical Development Manager, BD.

For example, when a sample comes to the laboratory, several steps must be carried out manually. But today, artificial intelligence (AI) is being used to read culture plates that can automatically tell if a result is positive or negative.

“We have molecular instruments with different assays that provide rapid and reliable results within two to three hours depending on the different solutions right from women’s health and cancer to tuberculosis,” Mahto explained.

Furthermore, for antimicrobial resistance (AMR), the company has specific solutions such as antibiotic panels that are being used only in this region. These offer rapid and reliable results and decrease the patient length of stay and reduce the cost of antibiotics.

“We are continuously working on improving the way we partner with the authorities and our existing distributors to offer the best solutions and cutting-edge technology to the market,” ElHassan concluded.

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Towards the end of 2019, Dr Anton Decker was appointed as the President of Mayo Clinic International. He came into this new role just before the pandemic hit, and in a recent interview with Omnia Health Magazine, he shared that Mayo Clinic was prepared to face this challenge head-on.

“There’s a saying that goes, “you should expect the unexpected”,” said Dr Decker. “So, when the unexpected happened, thanks to Mayo Clinic’s deep expertise and resources, we were ready in every aspect to face the situation.”

Related: Sustaining a COVID-free medical facility during the world’s worst pandemic

The organisation had clinical protocols in place. It had enough people and expertise to deal with rare events like this, ranging from biologists, epidemiologists, pulmonologists, and intensivists. It had the equipment, technology, and supply chain protocols to tackle such situations. “So, when COVID-19 struck, as unfortunate as it was, we activated all of our protocols to deal with the unforeseen event,” he added.

At the same time, he stressed, Mayo Clinic tried to reach out to the rest of the world to share their knowledge while continuously learning about the new virus. As a result, there were several successful efforts in sharing vital information, which led to the acceleration of treatment protocols. Moreover, the institution continued to treat people for their chronic and other acute conditions during the pandemic.

Related: Omnia Health Magazine August – September 2021

Dr Anton Decker

Destination medical centre

Mayo Clinic is a global healthcare organisation, and patients from over 130 countries visit their facilities in the U.S. every year. People visit Mayo Clinic for definitive answers, treatment, and hope, particularly when they have severe or complex conditions, said Dr Decker. The organisation’s fundamental value is that the needs of the patient come first, above everything else. As times are changing and technology has improved, Mayo Clinic has strived to bring its model of care closer to the patient.

He emphasised that the most crucial aspect of choosing a partner to reach more patients is to find someone who shares the same values. “As we looked for potential partners, we viewed our connection with the Middle East, and specifically the UAE, as we go back a long way. Therefore, it became easy to form a partnership with the UAE and SEHA, the Abu Dhabi Health Services Company, which led to the creation of our joint venture, the Sheikh Shakhbout Medical City (SSMC) Abu Dhabi. Together, we are committed to turning it into a. ‘Destination Medical Centre’.”

Mayo Clinic has three such centres in the U.S., and the SSMC is its fourth and only international destination medical centre. “One of the most delightful things about the journey is how much we are also learning. Not a day goes by that we don’t also learn something from the UAE, that we bring back home to help us,” he added.

A destination medical centre is where a patient goes to receive definitive care for severe and complex conditions. Recently, Dr Decker shared that a patient from Africa contacted Mayo Clinic for a recurrent tumour in their parotid gland. The patient had heard that there was a doctor in Arizona who knew how to treat the condition. “We did a virtual visit with the patient, and they are now coming to Arizona for the surgery,” he shared. “There are other such patients who we have been able to help increasingly in SSMC Abu Dhabi or in London, where we also have a clinic. So, we try and treat the patient where its most convenient for them and send them to the U.S. if necessary.”

SSMC has 50 expert physicians, nurses, and administrators from the U.S. The number is growing to help accelerate the journey for SSMC to become a destination medical centre. According to Dr Decker, SSMC’s priority is to create a definitive place to treat Emiratis. But the goal is to also attract patients from the broader region for medical tourism.

“SSMC is one of the most modern hospitals in the world. We are working together with the UAE on making sure that the processes and technology inside of it match the grandeur of the facility,” he added.

Connecting the dots

The pandemic has accelerated the adoption of telemedicine and forced the world to adapt very quickly. At SSMC, the number of telemedicine visits grew over 300 per cent compared to before the pandemic and made it easier for patients to get access to the “Mayo level of care”, highlighted Dr Decker. In addition, telemedicine was beneficial in providing remote intensive care services from the U.S. The acceleration also helped triage patients virtually first and determined the appropriate place for physical care, if needed.

When asked if the transition to telemedicine was challenging for physicians, he said they have become a lot more comfortable using the technology. In some cases, it has helped them develop a better relationship with a patient and is more accessible for follow-ups. It also allows physicians to see the patients sooner than they usually would, as it cuts down travel time. Moreover, there was a robust infrastructure around the physicians to support adoption.

He concluded: “We have a wonderful partnership with the UAE and are delighted that Mayo Clinic is building a definitive destination here for the entire region.” 

Coordinated care

When one is unwell, the last thing they need to worry about is how to go about making an appointment and finding the right doctor. Recently, SSMC launched the Inflammatory Bowel Disease (IBD) Centre and the Adolescent Clinic to provide a coordinated care approach so that patients don’t need to go to several different places to solve a problem. For instance, at the IBD Centre, patients can consult with a surgeon, gastroenterologist, or a dietitian, in one place, which makes the process easier. SSMC has plans to launch more of these dedicated centres in the near future.

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.