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Rethinking staff health and retention in Dubai and Abu Dhabi

The UAE has made the dreams of many ambitious organisations and professionals come true.

Yet, these days, many businesses are struggling to attract and retain talent as expats fail to make their life overseas work long-term — often due to work pressures, rising living costs and insufficient health and wellness support from their employers.

This article explores the challenges faced by employees in the UAE, and what companies can do to ensure successful assignments.

The cost of living the dream

In 2018, Guardian Wealth Management reported that rising costs of living in the Emirates was the “single biggest factor” for expats assessing their future in the UAE. When it comes to school fees, for example, one father in the report stated that school fees for his sons came to $43,000 per year. Add to this the fact that, according to a survey by consultancy Aon, the cost of medical care worldwide is expected to increase 8% in 2018, more than double the general inflation rate of 3%.

Mercer reports that Dubai is the second most expensive city in the Middle East (behind Tel Aviv), and Abu Dhabi is third.

The challenges businesses in the UAE face today include a new VAT regime and a need to maintain fast, sustainable growth. Staff turnover in the UAE is higher than the global average with 56% of employees looking to switch in the next 12 months if benefits don’t add up. In fact, the UAE is seeing a decline in its expat population, as countries like Saudi Arabia and Qatar are attracting more and more foreign investors.

Some organisations are coming to realise that limited health and wellness benefits might offer upfront cost savings but can often leave employees vulnerable to ill health and the company vulnerable to low staff productivity and retention and costly replacements.

There are ways to reduce poor health and failed assignments and this article will help employers ensure the good health, happiness and productivity of employees in the UAE.

First, a hypothetical story that illustrates how poor health care can impact employees and bring failure to businesses recruiting expats in the UAE.   

Once upon a time…

Your new hire is a 40-something expat with local industry experience and with an established family life in the Emirates. Your new hire is highly capable, experienced, driven and brimming with positive energy.

Due to increased focus on your bottom line and subsequent cuts in various areas, the organisation’s health care benefits package is the least expensive — and most basic — but your new employee seems fit and healthy.

Female computer programmer resting her eyes in front of her computer Female computer programmer resting her eyes in front of her computer

Not so happily ever after

After a few months you notice increased absences and overhear senior management complaining about the employee’s reduced productivity. By the one-year anniversary the decision is made to put the employee under probation due to continued failure to hit targets, increased absences, reduced productivity and complaints from colleagues about attitude.

The employee breaks down and explains they’ve decided to return to their home country — they just can’t cope anymore. This is a financial blow to the organisation as it means you must begin the recruiting, training and settling-in processes all over again.

What went wrong?

Behind the smart office attire, best intentions and convincing mask of professionalism was crumbling mental health due to increased job pressure, high cost of living and its impact on family life. A significant annual rise in school fees put the household budget under increasing strain, and without any family in the country to lean on for support, the employee’s spouse became unhappy and isolated.

The employee’s company didn’t offer appropriate psychological support services and the effects began to impact the employee’s ability to perform at work.

This is a sad story, but one that’s not uncommon.

Tell a different story

While there is a human cost, business owners know all too well the financial impact of failed assignments in Dubai or Abu Dhabi. 

Multi-ethnic business meeting occurring outdoors in a city Multi-ethnic business meeting occurring outdoors in a city

While no specific figures for the UAE exist, reports suggest employers in the UK pay between $14,500 to $36,900 to recruit and train talent and this figure can be higher for C-suite and managerial positions where recruitment commissions can skyrocket. A 2017 report suggests that a poor hire at mid-manager level with a salary of £42,000 ($53,9221) can cost a business more than £132,000 ($175,0002).

It is harder still to measure the impact to the business of those who remain on the job, but whose performance continues to decline. As well as their own productivity, they may affect those around them, potentially putting the organisation’s reputation at risk.

How can businesses ensure the success of appointments and avoid the costs of reduced productivity and replacement?

Rethinking health care in Dubai and Abu Dhabi

If you’re hiring expats in Dubai or Abu Dhabi, there is a better approach to help ensure job role success and reduce the impact on your bottom line. The approach focuses on the positive well-being of the individual — a healthy workforce makes it easier to acquire and, more importantly, retain talent, as well as boost productivity.

Arabic female doctor in hijab posing in a pediatrician's office Arabic female doctor in hijab posing in a pediatrician's office

1. Managing risk

Managing the risk to an employee’s mental and physical health is essential for role success.


As mentioned above, any risk assessment should take the specific situation, as well as employee nationalities and cultural norms, into consideration when choosing health care plans.


By ensuring the ongoing good health of your employees you ensure that claims for stress, anxiety and behavioural therapy are kept in check.

Proactive employers can work with their international private medical insurance (iPMI) providers to predict, prevent and intervene in their employees’ medical issues, leading to better health outcomes for individuals and more cost-effective results for employers.

  • Review and lower utilisation rates including medical management negotiations
  • Manage high-dollar claims
  • Respond to critical conditions through data and risk analysis
  • Predict costs and create strategies to maintain a desired state


Low productivity of individuals can affect a business’s reputation, create rumours of a high-stress work environment and cause a high staff turnover. For many businesses, the people are the product, so it’s essential that your employees show the business in the best light and don’t endanger key relationships through poor performance, absenteeism and ill-advised behaviour such as aggression, poor lifestyle choices and negativity. By ensuring your staff are happy and healthy, you are mitigating the risk of damage to reputation by the behaviours brought on by poor well-being.

2. Remuneration

Many people move to the UAE for the opportunities — including higher salaries and excellent standards of living. Most employers know that salary isn’t a silver bullet for employee happiness, but its impact on quality of life and work/life balance can affect relationships, mental health and even decisions about remaining in the country. This is more pertinent as reported predictions that salaries would drop in 2018 as inflation grow faster than wages. compare several product and service costs from cities around the world. It’s an invaluable tool to work out the cost of living in different countries.  

Arabic mother preparing her young son for a graduation ceremony. Arabic mother preparing her young son for a graduation ceremony.

3. Invest in health and wellness

Choosing the lowest level of health insurance for a workforce may help contain costs in the short term, but with reduced productivity and the risk of failure, it’s a costly long-term strategy. Invest in health and wellness for your international employees and you can protect your company from damaging assignment failures.

Studies show that productivity is related to employee health and well-being. This includes everything from physical fitness and diet to good sleep patterns. Many employers have incorporated or built health and wellness initiatives to reap the rewards of a healthier, happier workforce. For example, LinkedIn CEO Jeff Weiner said: “In my opinion, four fundamental pillars to being productive at work start with wellness: sleep, nutrition, fitness and mindfulness.”

A couple listening to music while running through downtown Dubai A couple listening to music while running through downtown Dubai

One Dubai-based expat in our 2018 What Is Wellness? survey said: “Health is obviously first priority for you, but health care is a bit of a sideshow because it’s an ‘if it happens’ not a ‘when it happens’ thing, not like those other things (housing, schools).” This is an opportunity for employers to do more than just organise the mandatory health insurance but support their employees’ families in this important but neglected field. Waqas Javed, a Pakistani living with his wife and child in Dubai said: “Do a bit of research, make an initial visit and analyse the situation first. And make sure you can actually afford it! If you can’t support yourself then there’s no way you’ll be able to afford to support a family.”

The Dubai Chamber of Commerce is an organisation that supports the health and happiness goals of its employees. President and CEO, Dubai Chamber HE Hamad Buamim said: “We firmly support our staff in setting positive goals for their lives, as we know that healthy, happy staff are crucial to the success of the Chamber and the happiness of our customers.” As part of their wellness programme, staffs committed to (and achieved) doing 10,000 steps per day and were also offered health club memberships.

Is it worth it? Looking at a broader mix of strategies designed to focus on employee well-being, three in four companies are actively pursuing strategies to improve employee well-being by introducing flexible working hours, learning and development and more innovative workspaces. The correlation between employee wellness and happiness with productivity and retention is becoming more ingrained in corporate culture in the UAE.

What can businesses do?

  • Embed a quality medical insurance policy into the benefits package that covers mental health and helps build healthier lifestyles — and doesn’t just fix people when they get sick
  • Instil a culture of tolerance around mental and physical health conditions, where it is acceptable to ask for help/support around mental and physical health concerns when it is needed
  • Educate the workforce around the need for people to look after and be champions of their own health and well-being. Sweeping concerns under the proverbial carpet will only lead to greater complications in the future
  • Build processes where people can flag concerns about others’ well-being
  • Ensure that there are healthy food options available in the workplace
  • Instil a culture that enables people to go home on time free from scrutiny, where possible, and to switch off during out-of-hours: no emails, phone calls
  • Offer a subsidised gym membership
  • Encourage peer-led well-being initiatives such as running clubs, yoga, meditation and reading groups

4. Talent acquisition and retention

With increasing pressure on businesses to cut costs while improving performance, finding and keeping the skilled, talented personnel is key. More than 50% of all organisations globally have difficulty retaining some of their most valued employee groups.

Many employers are reacting to the demands of this talent through a variety of staff benefits, from flexible working hours and locations to well-being schemes. 

Young businesspeople talking as they walk through a city Young businesspeople talking as they walk through a city

A 2018 research revealed that of the businesses surveyed, 78% offered an employee assistance program (EAP), 89% offered private medical insurance and 64% offered occupational health services.

And the initiatives are bearing fruit: Gallup found that employees who were ‘highly engaged’ in their job and had ‘high well-being’ were 59% less likely to look for a job with a different organisation in the next 12 months.

Young woman and her toddler son looking out the window of the Burj Khalifa in Dubai. Young woman and her toddler son looking out the window of the Burj Khalifa in Dubai.


By investing in health and wellness benefits solutions for their employees, employers can keep health care costs down by retaining talent and keeping them healthier and more productive.

Aetna International understands the challenges faced by employers when it comes to maintaining a healthy workforce and healthy finances. With teams in the United Arab Emirates, they support companies, big and small, to be able to provide their expat employees with the tools to build a healthy life. The services we offer include:

  • Mental health and work-life balance support: Read more about iConnectYou here.
  • Finding and accessing quality health care: Watch this video on virtual care to find out how it could help you bring convenient, confidential doctor care to your employees when and where they need it most.
  • Building a healthy life and keeping well
  • Onsite education and health screenings
  • Providing the right care, in the right place, at the right time for everyday health concerns as well as medical emergencies
  • Seamless coordination of care services and treatment
  • Cultural awareness and security services: Watch this video to find out about the available safety and security services here.  

If you want to talk to us about any of these aspects of ensuring international assignment success, speak to one of our experts — find Aetna International in your region or read more about our plans and services here.

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