The health care and education systems in Bahrain have improved significantly over the last six decades. The kingdom brought forth basic compulsory education in 1919 and a health-for-all policy in 1959, which expanded the two sectors substantially. The government introduced a universal health insurance scheme, set to be launched in early 2025, which will further extend coverage and support service improvements. Greater funding will enhance coordination across the public and private sectors, as well as support the digitalisation of services and medical records. Meanwhile, the implementation of innovative education policies is improving learning outcomes, supported by advances in education technology (edtech) and a focus on closing the skills gap between education and the labour market.
Health Oversight
The Supreme Council of Health sets the national strategy, administers Bahrain’s medical services and manages the implementation of national health policies, while the National Health Regulatory Authority (NHRA) directs the private health care sector. The Ministry of Health (MoH) is an essential component of the Supreme Council of Health. The MoH is involved in all the duties and tasks of the Council and has an essential role in the issuance of decisions and policies related to health financing, as it is the executive body of the Supreme Council of Health in the field of quality, planning and training in line with the vision of the kingdom of Bahrain 2030. The MoH also focuses on providing and organising public health services, health promotion and raising awareness through education programmes that aim to control communicable and non-communicable diseases. Furthermore, it provides mental health services and health care for the elderly in hospitals that are not subject to health insurance.
Bahrain relies on imported medicines since it lacks local production capabilities. Medications, medicine factories and pharmacies are licensed under the NHRA. Approval for any medication necessities is granted by the NHRA. For some generic medicines, manufacturers need to provide a bioequivalence study, which should match with the GCC bioequivalence guideline.
The government has developed several policies to improve Bahrain’s health care. Bahrain Economic Vision 2030, launched in 2008, states that all Bahraini nationals and residents have access to quality health care. The blueprint aims for the country to be a leading centre for modern medicine, offering high-quality and financially sustainable health care in the region. Patients will have a choice of public and private providers that meet international standards for health care provision.
The MoH’s National Health Plan 2016-25 incorporates health objectives set out in Bahrain Economic Vision 2030, engages all health agencies in Bahrain and addresses the main challenges in the health system. This is complemented by several other policies, including the Government Plan 2023-26, the Health Improvement Strategy 2015-18 and the 2022-26 Telecommunications, ICT and Digital Economy Sector Strategy.
In May 2018 the government launched Law No. 23 – known as the Health Insurance Law – making health insurance obligatory for all citizens, residents and visitors. The law was due to come into effect in 2019 but was delayed until 2024 due to the Covid-19 pandemic.
In 2023 government expenditure on health care represented 8.7% of total government expenditure and contributed 60.6% of Bahrain’s health care GDP. Much of this investment went towards the treatment of non-communicable diseases (NCDs), including the prevention and treatment of cardiovascular diseases, chronic respiratory diseases and diabetes.
General Health Indicators
Health care in Bahrain has improved considerably in recent decades, which has contributed to life expectancy increasing from 75 years in 2000 to 77.9 years in 2020. Meanwhile, the infant mortality rate has significantly decreased over time. In 2000 it was an average of 8.5 per 1000 live births and by 2020 it had further dropped to 6.8 per 1000 live births. This improvement is largely due to the fact that 100% of live births are now attended by skilled health staff. Immunisation rates stand at 100% for both diphtheria and measles.
The disease burden has shifted in recent years as the prevalence of NCDs has risen, linked largely to poor nutrition, and overweight and obesity levels. Another major factor is the prevalence of smoking in Bahrain, with around 15% of the adult population engaging in daily tobacco consumption in 2018, according to a WHO STEP wise approach to risk factor surveillance (STEPS) survey conducted in Bahrain in 2018. In addition, the capital city of Manama suffers from considerable levels of air pollution – around six times higher than the World Health Organisation’s (WHO’s) recommended limit. Nevertheless, Manama and the metropolis of Um Alhassam have earned the WHO Healthy City designation due to their commitment to enhancing health care.
Overweight and obesity rates have risen in recent years, with an average of 70.8% of the population registered as either overweight or obese in 2018. Approximately 15% of the population aged over 18 had diabetes in 2018. Meanwhile, cardiovascular disease was responsible for around 49% of NCD-related deaths in 2020, with cancer and diabetes accounting for 18% and 3%, respectively.
Initiatives
Bahrain, through the MoH, has implemented initiatives to improve public health and reduce premature deaths from chronic NCDs, in line with the 2030 UN Sustainable Development Goals. Efforts include nutrition improvements, such as adopting the International Code of Marketing of Breast Milk Substitutes, salt reduction regulations and excise taxes on energy drinks. Bahrain also fortified flour with iron and folate to reduce anaemia and birth defects. The kingdom promotes physical activity through initiatives like the 2024 ISF Gymnasiade and Bahrain Sports Day, and was awarded the WHO Award for Healthy Cities. Additionally, Bahrain supports health research and hosted the 2021 Bahrain Obesity Academy to train doctors in obesity management.
As in many parts of the world, the prevalence of NCDs and their associated costs are on the rise. According to estimates from a February 2023 UN Development Programme report on Bahrain, the government spent BD162.1m ($430.1m) on four major NCDs, accounting for 47.4% of total health expenditure. Private health care costs for these diseases were BD120.9m ($320.7m), bringing the total direct cost to BD283m ($750.7m). Diabetes accounted for the largest share at BD119.7m ($317.5m), followed by cardiovascular diseases at BD88.5m ($234.8m). Chronic respiratory diseases and cancers each accounted for BD37.4m ($99.2m).
In contrast, the incidence of communicable diseases have decreased in recent years, with tuberculosis cases per 100,000 people falling from 29 in 2002 to 15 in 2022, supported by vaccination programmes. MoH-operated primary health care centres coordinate with schools to ensure vaccine compliance and run immunisation campaigns for tetanus, diphtheria and hepatitis.
The government has responded to Bahrain’s ageing population by prioritising several social support programmes including a cost of living allowance for Bahraini retirees and social security for widows and the elderly, among other subsidies. Between 2010 and 2023 the percentage of the population aged 65 and above increased from 2% to 4%, while birth rates fell from 28 to 18 per 1000 people between 2010 and 2023.
Additionally, there has been a heightened focus on psychological well-being in recent years, marked by the establishment of specialised clinics under the Towards a Better Mental Health programme. Mental health has become more integrated into primary care since the launch of the National Mental Health Strategy 2016-20. Bahrain has integrated school mental health clinics for children aged six to 18, with increased utilisation from 1054 in 2017 to 1364 in 2019. There is a training programme for family physicians to provide mental health services in health centres, and four regional clinics are covered by psychiatrists.
Referrals to adult mental health clinics have also increased. The government continues to update mental health guidelines and aims to regulate the relationship between patients and stakeholders through the Mental Health Law. Plans are underway to establish Bahrain’s first psychiatric hospital for children. These initiatives, along with awareness campaigns and new traffic laws, have contributed to improved public health.
Health Insurance
Health coverage in Bahrain has increased in recent decades due to improved public policies, and increased spending on both infrastructure and training. In 2000 Bahrain had a universal health coverage effective coverage index of 60, which rose to 76 in 2021. The MoH has traditionally provided free medical coverage to all Bahrainis at medical centres and Salmaniya Hospital. Fees apply to non-Bahraini patients not enrolled in the primary health care scheme. The new Sehati programme will maintain free services for Bahrainis, offering various packages that include primary health care, inpatient-outpatient services and emergency care. Additional services like IVF, medicines, medical tests and treatments abroad will be available under certain conditions. Expatriates will also have access to these packages, funded by employers, and offered in both government and private facilities. Most expatriate workers were registered under the MoH basic cover system, paying an annual health insurance fee of $191 through the Labour Market regulatory Authority. Visitors to Bahrain required independent health insurance to access services.
In 2018 the government approved the National Social Health Insurance Programme (Sehati) in an effort to provide free health care coverage to Bahraini citizens and expatriate workers in the country. Under Sehati, employer enrolment is mandatory to provide insurance for expatriate employees. Scheduled for launch in early 2025, the programme will issue Sehati cards to residents, enabling access to primary health care services. The MoH will provide the majority of care, while other government health institutions and the private sector will also contribute to health care provision.
There was a rise in gross insurance premium in the first half of 2023, which amounted to $402m. This represented a 3.1% increase compared to the same period in 2022. General insurance, including medical insurance, accounted for 90% of gross premium, according to the Central Bank of Bahrain (see Insurance chapter).
Public & Private Provision
The NHRA regulates the provision of health care in the private sector in Bahrain, according to national policy. In 2023, 84% of hospitals across Bahrain met NHRA core standards of compliance. The same year NHRA issued 85 new medical facility licences and renewed 843 facility licences that year, increasing the number of health facilities to 924. In the pharmaceutical segment, there were 434 licensed pharmacies and 4211 registered medicines as of end-2023. The NHRA also reviewed applications for 12,636 new medical devices and approved 11,388 in 2023.
In November 2023 the MoH became the first entity in the Middle East to acquire the latest human genome sequencing machine, NovaSeqTM X Plus. This move supports Bahrain’s National Genome Project, which was launched in 2018. The MoH hopes to engage 50,000 participants by 2024 to enhance genome research.
Infrastructure
Hospitals are largely concentrated in the capital, Manama, with five public and 17 private hospitals. There are a further two public hospitals in the southern region of Bahrain and two in Muharraq, as well as three private hospitals in the southern region, three in the northern region and one in Muharraq. By 2023 there were 31 registered government health centres in Bahrain and 329 private health centres.
The largest ongoing health care infrastructure project is the multi-phase King Abdullah Bin Abdulaziz Medical City, valued at BD1bn ($2.7bn). This facility will feature 300 beds, a range of outpatient clinics, 15 operating rooms and high-quality support services, including advanced laboratories and a pharmacy. The total area of the medical city is estimated at 70,000 sq metres. Another development under way, the Hussain Ali Yateem Health Centre in Salman City in the Northern Governorate, broke ground in December 2023. The complex spans 12,218 sq miles and will include facilities for emergency treatment, physical therapy, maternity and childcare, consultancy clinics and dentistry. Once complete, it is expected to serve 31,000 people.
There is a total of 2816 hospital beds across Bahrain, with 1464 public hospital beds and 476 private beds in Manama, 805 public and 108 private beds in the southern region, 547 public and 21 private beds in Muharraq and 157 private hospital beds in the northern region. The number of private hospital beds has risen significantly in recent years, from 542 in 2021 to 762 in 2023, according to the 2023 NHRA annual report.
Regulatory developments include the introduction of GCC unified standards for health professional classification and registration, a completed health care sector skills report and progress towards the completion of guidelines for classifying medical products in collaboration with the Gulf Health Council.
The health sector has made strides in digitalisation, with the NHRA offering regulatory e-services. It completed phase one of its digitalisation plan for the period 2021-22, developing several new systems, and launched phase two in 2023, which will be expanded in the coming years. Health care digitalisation efforts in Bahrain echo those taking place elsewhere in the Gulf region.
The MoH launched the National Health Information System (I-SEHA) in 2014, under its ICT strategy. It provides electronic health services, such as patient appointments, laboratory and X-ray results and birth and death registration. The Sehati platform enables users consult with health care providers remotely. During the pandemic, the MoH also launched the mobile app BeAware Bahrain to enhance telemedicine services.
The MoH is working to improve data collection systems and the Digital Health Integration System (DHIS) is anticipated to launch in 2025. It is a unified platform for health data in Bahrain, helping government agencies and health care providers to store and share data. The system is set to help monitor and control the spread of infectious diseases. At the time of writing, 80 health facilities have received DHIS training.
Medical Staff
The NHRA issued 3602 new licences and renewed 8759 licences for medical professionals in 2023, bringing the total to 22,060. As of end-2023, there were 4723 physicians, 9914 nurses, 1172 dentists, 1923 pharmacists and 4328 allied health professionals registered in Bahrain. The number of registered nurses increased by 207% from 3225 to a total of 9914 in 2023.
Owing to the large expatriate population in Bahrain, a large proportion of staff in the health sector are foreign – around 66% Bahraini compared to 34% non-Bahraini. However, approximately 64% of all nurses are foreign and 69% of total nurses working in the public sector. The percentage of male medical professionals was 46%, compared to 54% female, demonstrating a high level of gender parity in health care in Bahrain.
Bahrain offers several international training schemes for medical students and has partnerships with institutions like the Heersink School of Medicine at the University of Birmingham, Alabama, the UK’s Keele University and Royal College of Surgeons in Ireland. In early 2024, Bahrain and Saudi Arabia signed a memorandum of understanding (MoU) to boost cooperation in medical training between their health ministries.
Education Oversight
Several education directorates oversee Bahrain’s school system, including the MoE, which establishes and implements education policies in Bahrain. The Directorate of Curricula develops, reviews and adapts the public-school curricula and textbooks. The Education and Training Quality Authority (BQA) sets performance standards and conducts reviews of educational institutions. The Higher Education Council (HEC), established in 2005, oversees education at the tertiary level.
The government has introduced several policies to improve Bahrain’s education system, such as Bahrain Economic Vision 2030. This initiative and other policies aim to enhance Bahrain’s education system by empowering individuals to reach their potential in business, government and society. It endeavours to develop future leaders, and equip Bahrainis with the skills and values needed for high-value positions.
The Government Plan 2023-26 was inspired by the Constitution, the National Action Charter and Bahrain Economic Vision 2030. It sets forward four strategic goals in education: quality instruction, improving the efficiency of human resources, optimising administrative services, and developing educational and digital infrastructure. Education policies are influenced by the National Research Strategy (NRS) 2014-24 – which seeks to promote knowledge and innovation – and the National Higher Education Strategy (NHES) 2014-24.
To facilitate gender equality, the Supreme Council for Women and the National Plan for the Advancement of Bahraini Women 2023-26 promote female representation in education and the workforce. In 2022, 75% of primary school teachers were female. In 2019 females made up 49.1% of primary, 49.4% of intermediate, 49.1% of secondary school students and 51.7% of higher education students in 2022/23.
Additionally, in 2022, women represented 22.5% of the total workforce, with 18% in the public sector and 82% in the private sector. Furthermore, Bahrain ranks first globally in literacy rate and enrolment in secondary and tertiary education, according to the World Economic Forum’s Gender Gap 2023 Report. It also ranks first in the GCC and third globally for women with degrees, as per the IMD: World Competitiveness Ranking 2023, and first in the Arab world for the percentage of females in the labour force, based on the 2023 IMD World Talent Ranking.
In 2023 the government spent around 4% of Bahrain’s GDP on education. The government has earmarked $312m for new schools from 2024-30, with plans to build 18 new schools and 24 academic buildings across the kingdom’s four governorates. The MoE will collaborate with the Ministry of Works to make the buildings suitable for vertical or horizontal expansion.
Sector Breakdown
The modern public school system in Bahrain was established in 1919 and women gained access to education in 1928. The school system expanded in the 1960s and 1970s – supported by the Education Act of 1975 – which made basic education compulsory. The literacy rate among the population aged 15 to 24 was 99.2% as of 2022, according to the most recent data from the World Bank.
Schooling in Bahrain is compulsory and free from the age of six to 15. The system includes basic education for students aged six to 15, followed by three years of secondary school, from grades nine to 12. Secondary education offers the choice of a unified academic track of scientific, literary and commercial studies, and a technical and vocational education and training (TVET) track. Graduates from secondary school receive a general secondary certificate for each subject completed.
In 2021 the then minister of education, Majid bin Ali Al Nuaimi, announced plans to restructure the school system in line with Bahrain Economic Vision 2030. New staff positions were created, including specialists in quality of life, language, digital empowerment and counselling. The MoE updated the curriculum to include digital economy, business sciences and artificial intelligence. The geography curriculum now includes Gulf region and globalisation studies, and history covers contemporary world history. Updated English books were introduced, and global developments, sustainable development goals, 21st-century skills and enhanced critical thinking were integrated into the curriculum.
In 2023 Mohammed bin Mubarak Juma, the minister of education, announced new school hours to improve the school-life balance: primary schools finish at 12.30pm, middle schools at 1.15pm and secondary schools at 1.45pm. He also announced plans to improve English proficiency through qualifications such as International English Language Testing System and Test of English as a Foreign Language. Juma attended the 2023 Education Ministerial Meeting at the COP28 UN Conference on Climate Change in Dubai, highlighting the role of education in raising environmental awareness.
Public & Private Sector Education
There were 209 government schools with some 155,000 students, as stated by Nawal Ibrahim Al Khater, policies, strategies and performance undersecretary at the Ministry of Education during an August 2023 press conference chaired by the minister of education. Private schools are licensed by the Directorate of Licensing and Follow-up of Private Schools. These institutions are categorised into national, foreign and foreign community schools. The curricula and textbooks in private schools must be approved by the Directorate of Curricula. The schools must also teach the MoE-approved national curriculum and textbooks for Arabic language for Arab students, Islamic studies for Muslim students and the history and geography of Bahrain for all students.
Staffing
The Directorate of Training and Career Development works with the Directorate of Educational Supervision and the Directorate of Curriculum to provide teacher training. Teacher training programmes are centralised and are taught at the Bahrain Teachers College. Students can study for a Bachelor of Education Degree or pursue a Postgraduate Diploma after completing a bachelor’s degree in another subject.
The government has sought to increase the proportion of Bahraini nationals working in certain sectors in recent years. As of the second quarter of 2023, foreigners make up around 84% of Bahrain’s workforce. In February 2024 the Parliament and the Shura Council approved proposed legislation that would restrict expatriates from working in six professions – accounting, aviation, banking, education, legal and medicine. MPs have previously tried to push Bahrainisation initiatives, such as the ban on the recruitment of expatriates across 35 professions proposed in 2019. As of writing, it is uncertain whether the initiative will be approved.
Tertiary Education
Bahrain has 14 private higher education institutions out of 18 total universities and colleges. Tertiary education follows the National Higher Education Strategy (NHES) and National Research Strategy (NRS) 2014-24, focusing on quality enhancement, bridging the skills gap, expanding STEM courses, improving accreditation, advancing technology in education and promoting entrepreneurship.
Several universities have formed partnerships with international institutions to expand opportunities. The University of Bahrain signed an MoU with the UK’s Lancaster University in March 2024 for dual degrees and staff-student exchanges. The HEC also partnered with the British Council to offer research training for 125 students. Additionally, the UK’s University of Strathclyde opened an Innovation, Research and Education centre in Bahrain in September 2024. Other collaborations include a dual law degree program with London South Bank University and partnerships for applied research with India’s Chandigarh University and student exchanges with EKLYA School of Business.
Professional & Vocational Training
As of April 2021 around 6500 students were enrolled in secondary TVET institutions, making up 3.6% of the secondary student population, with 8.1% female. The Directorate of Continuous Education and the Directorate of Technical and Vocational Education design TVET programs for both youth and adults, covering areas like auto mechanics, book classification, computer literacy, e-commerce and more. The Bahrain Training Institute offers various short and long TVET courses, while the Supreme Council for Vocational Training develops industrial sector training to enhance labour market skills. The National Authority for Qualifications and Quality Assurance oversees guidelines, examinations and quality reviews for training institutions.
EdTech
Bahrain has been recognised for its excellence in global edtech, ranking first in the GCC for digital skills in the IMD World Competitiveness Ranking 2023. Bahrain has also achieved significant strides in digital inclusion, excelling in areas such as national female e-inclusion policies, female digital skills training and STEM education plans, and support for digital literacy, as measured by Meta’s Inclusive Internet Index 2022. Further, the success of General Assembly in winning the award for Excellence in Learning and Development Initiative at the Global Higher Education Exhibition held in the kingdom in 2023 is a testament to Bahrain’s burgeoning reputation as a global edtech centre. Internet penetration in Bahrain is high across all segments of society.
The Information & eGovernment Authority and the Ministry of Labour’s Technical Development Programme have jointly committed to help boost sustainability, fairness and competitiveness, optimise government spending and create job opportunities for young, qualified Bahrainis. The Bank of Bahrain and Kuwait, and the Bahrain Institute for Banking and Finance launched a programme in November 2020 aimed at building the digital capabilities of Bahraini women to promote equal access to eGovernment services, online schooling, e-banking and e-payments. The programme endeavours to train 100 stay-at-home Bahraini women above 20 years of age to overcome societal barriers.
Outlook
The government has expanded education and health care services in recent decades to achieve universal participation in both systems. Bahrain’s education system has become highly competitive at the regional level, supported by strong edtech that has enhanced digital literacy among students. The rollout of a new curriculum in line with Bahrain Economic Vision 2030 has also helped to close the skills gap between the education system and the labour market, as well as provide students with critical thinking skills.
Meanwhile, the new health insurance scheme is expected to boost coverage for Bahraini nationals and expatriate workers. The plan is expected to enhance cooperation between public and private health care providers by introducing digital systems, and encouraging information sharing and reporting on diseases. School vaccine drives have led to a reduction in communicable diseases and educational awareness campaigns are expected to help drive down NCDs among youth.
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