Schedule Delay in Saudi Arabia Road Construction Projects: Size, Estimate, Determinants and Effects

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1 International Journal of Architecture, Engineering and Construction Vol 6, No 3, September 2017, Schedule Delay in Saudi Arabia Road Construction : Size, Estimate, Determinants and Effects Ibrahim Mahamid* Civil Engineering Department, Hail University, Hail, P.O Box 2440, Saudi Arabia Abstract: This study aims at addressing schedule delay in road construction projects in Saudi Arabia. The evaluation of the progress reports of 55 road projects constructed during the period in Saudi Arabia concluded that delays are extensive: the average ratio of planned contract duration to the actual completion time is 58.24%, ranging from 2% to 172%. The study also investigated the main factors and effects of schedule delay in road construction projects through a questionnaire survey. 70 contractors working in road construction completed a structured questionnaire survey. 34 identified factors were ranked according to their levels of severity, frequency, and importance. Results indicated that the top five important factors affecting schedule delay in road construction projects are: improper planning, poor labor productivity, additional works, rework, and lack of contractor experience. The study concluded that the main effects of schedule delay in road construction projects as assessed by contractors are: cost overrun, disputes, arbitration, litigation, and poor quality. Based on the study findings, the following recommendations were formulated: Managerial skills of construction parties should be improved, Labors motivation system should be developed, More communication between construction parties should be done at the early project stages to minimize late changes during construction phase, Policy of contract awarding should be improved: resources and capabilities of bidders should be checked carefully. Keywords: Schedule delay, time overrun, public construction, road construction, road management DOI: 1 INTRODUCTION Schedule delay is defined as the time difference between the actual completion time and the estimated completion time, agreed by and between the client and the contractor during signing of the contract(mahamid et al. 2012). (Stumpf 2000)defined delay as "an act or event that extends the time required to perform the tasks under a contract. It usually shows up as additional days of work or as a delayed start of an activity". (Al-Najjar 2008) defined schedule delay as "the time increase to complete the project after the planned date which is caused by internal and external factors of the project". Roads are of high importance for community and people; they are constructed to connect places with each other and so to make the movement of people and their goods easy. Road construction can be categorized as a heavy construction which is publicly owned and therefore financed either through bonds or taxes. This category of construction is characterized by a high degree of mechanization, which has gradually replaced some labor intensive operations. The engineers and builders engaged in road construction projects are usually highly specialized (Holm et al. 2004). Cost, time, and quality are primary measures of a project s success. This is true, especially for public projects in developing countries, because public construction projects in these countries are executed with limited financial resources (Nega 2008). However, the history of the construction industry is full of projects that were completed with significant schedule delay(ameh et al. 2010). According to (Faridi and El-Sayegh 2006), construction delay is considered to be one of the most recurring problems in the construction industry and it has an adverse impact on project success in terms of time, cost, quality and safety. In Saudi Arabia, a construction boom has been experienced during the past three decades. According to the Saudi Ministry of Planning, the construction industry contributed between 30% to 40% of the non-oil productive sectors at the end of each National Development Plan from 1980 to 2000 (Cordesman and Burke 2002). The Statistical Year Books (2000) showed that the Saudi Arabia Government spent nearly $234 billion on infrastructure projects during 1990 to However, schedule delay in public construction projects is considered to be one of the main problems in the Saudi construction industry (Faridi and El-Sayegh 2006). Assaf and Al-Hejji (2006) found that only 30% of building construction projects in Saudi Arabia were completed within the scheduled completion dates and that the average time delay was between 10% and 30%. Thus, it appears that the problem of schedule delay in public construction projects in Saudi Arabia is critical and should be studied more to alleviate this problem in the future. One of the major infrastructure projects in Saudi Arabia is road construction. According to the statistics of Saudi Ministry of Municipal and Rural, the to- * i.mahamid@uoh.edu.sa 51

2 tal lengths of the constructed roads in Saudi Arabia in 2015 was 165,004 km. This reflects the high volume of road construction projects and its high importance. Therefore, this study will assist in addressing schedule delay in road construction projects in Saudi Arabia in terms of causes, effects, size and estimate. This paper aims at investigating the time performance in such an important sector in order to avoid and control any related delay problems and to improve it. This knowledge can support the Government (owners) in planning, designing, and improving the regulations to meet the construction market needs, contractors in taking risks when scheduling projects, consultants in providing comprehensive and clear contract information, and workers in conducting their day-to-day activities. It is hoped that these findings will guide efforts to enhance time performance in construction industry in Saudi Arabia and other developing countries. 2 OBJECTIVES The main objectives of this study include the following: 1. To investigate the size of schedule delay in road construction projects in Saudi Arabia; 2. To develop mathematical models that relates the actual completion date with planned date in road construction projects; 3. To identify the causes of schedule delay in road construction projects in Saudi Arabia; 4. To identify the severity, frequency and importance of delay causes in road construction projects from contractors perspective; 5. To identify the main effects of schedule delay in road construction projects from contractors perspective. 3 LITERATURE REVIEW 3.1 Size of Schedule Delay in Construction Researches on construction projects in some developing countries indicated that by the time a project is completed, the actual duration exceeds the original contract duration by about 30 % (Al-Momani 1996). In Saudi Arabia, Al-Khalil and (Al-Khalil and Al-Ghafly 1999) found that 45 out of 76 water and sewage projects in the Eastern Province of Saudi Arabia were completed with extensive schedule delay during the period Moreover, from 20 randomly selected delayed projects, the extent of delay was 110%. Battaineh (1999) evaluated the progress reports of 164 building and 28 highway projects constructed during the period in Jordan. He found that the average ratio of actual completion time to the planned time is 160% for road construction projects and 120% for building projects. Mahamid et al. (2012) investigated delay in highway projects constructed during the period in Palestine. They found that 75% of the projects have average delay between 10% and 30% of the original project duration, and 20% of the projects have 30-50% delay compared to the origin specified duration. Omoregie and Radford (2006) reported that the average delay in Nigerian construction projects is 188%. 3.2 Factors Affecting Schedule Delay in Construction Many studies have been conducted all over the world to examine the schedule delay causes in construction projects. In the Middle East countries, several researches were conducted to address the factors affecting construction delay. Mahamid et al. (2012) identified delay causes in road construction projects in the West Bank in Palestine. They concluded that the top five delay causes from contractors view are: segmentation of the West Bank and limited movement between areas, political situation, progress payments delay by owner, delays in decision making by owner, and low productivity of labors. Odeh and Battaineh (2002) examined delay causes in Jordanian construction projects. They found that the top delay causes are: owner interference, inadequate contractor experience, financing and payments, labor productivity, slow decision making, improper planning, and incompetence of subcontractors. In the West Bank in Palestine, Mahamid (2011) concluded that the most affecting delay factors in road construction projects are: poor communication between construction parties, poor resource management, delay in commencement, insufficient inspectors, and rework. Al-Momani (2000) examined the delay causes in 130 public building projects constructed in Jordan during the period of The study concluded that factors related to designer, user changes, weather, site conditions, late deliveries, economic conditions and increase in quantity were the main delay causes. Koushki et al. (2005) conducted a study in Kuwait to rank the main time and cost overrun causes in construction projects. The study revealed that the factors affecting schedule delay are: changing orders, owners financial constraints, and owners lack of experience. Faridi and El-Sayegh (2006) conducted a study in UAE to investigate schedule delay in construction projects. They found that 50% of the construction projects encounter delays and were not completed on time. The top significant causes of construction delays are approval of drawings, inadequate early planning and slowness of the owners decision-making process. In Africa, many researched have been conducted to analyze the delay causes in construction projects. In Ghana, a questionnaire survey conducted by (Frimpong et al. 2003) to identify the significant causes contributing to delay and cost overruns in groundwater construction projects. They concluded that the main contributors to delay and cost overruns were: monthly payment difficulties from agencies; poor contractor management; material procurement; poor technical performance, and escalation of material prices. The schedule delays in Zambian road construction projects were studied by (Kaliba et al. 2009) who found that the critical factors were: delayed payments, financial processes and difficulties on the part of contractors and clients, contract modification, problems in national economy, materials procurement, changes in drawings, staffing problems, equipment unavailability, poor supervision, construction mistakes, poor coordination on site, changes in specifications and labor disputes and strikes. Similar studies were conducted in Southeast Asia. Sambasivan and Soon (2007) conducted a study in Malaysia to identify delay causes in construction projects. They found that top ten delay causes in Malaysian construction industry are: contractor s improper planning, contractor s poor site management, inadequate contractor experience, inadequate client s finance and payments for completed work, incompetence of subcontractors, shortage in material, labor supply, equipment availability and failure, lack of communication between parties, and mistakes during the construction stage. They also found that the six main effects of delay are: schedule delay, cost overrun, disputes, arbitration, 52

3 litigation, and total abandonment. Memon et al. (2014) investigated the significant factors causing schedule delay in Malaysian construction industry through a questionnaire survey carried out in central and southern parts of Malaysian among the respondents from the perspective of client, consultant and contractors. The feedback was received from 75 respondents against 300 companies contacted. They concluded that cash flow and financial difficulties faced by contractor, poor site management and supervision, incompetent subcontractor, shortage of workers and financial difficulties of the owner are major contributors of schedule delay. In order to get a general view about the causes of schedule delay, 6 major causes are examined in 10 previous studies as shown in Table 1. The selected studies have been done in 7 countries. Although these studies are not definitely similar about the purpose and methods of survey, the summary is useful for understanding the problems of construction projects. 3.3 Effects of Schedule Delay in Construction Table 2 summarizes the main effects of time delay in construction projects as presented in 6 selected previous studies. The table shows that the most common effects of schedule delay in construction projects are: cost overrun (100% of studies), litigation (66% of studies), disputes (66% of studies), and arbitration (66% of studies). Overall, a great deal of information concerned with delay in construction projects may be found in the literature. The increased interest in construction overrun is due to efforts by project participants to reduce construction delays. This study conducted to analyze schedule delay in road construction projects in Saudi Arabia. 4 RESEARCH METHOD The following steps were followed in order to achieve the objectives of this study: 1. Collecting field data to analyze schedule delay in road construction projects; 2. Conducting a questionnaire survey to identify and rank factors and effects of schedule delay in road construction projects. These steps are detailed in the subsequent sections. 4.1 Investigating of Schedule Delay in Road Construction The progress reports of 55 road projects constructed during the period in Saudi Arabia were randomly selected. The progress reports were analyzed for the following purposes: (1) to reveal the size of schedule delay in road construction projects, (2) to test the relation between actual and planned project duration, (3) to test the relation between schedule delay and planned project duration. During data collection, two important points were taken into consideration: (1) to have, approximately, an equal number of implemented projects in each year over the years (Table 3) (2) to have, approximately, an equal number of projects based on project duration (Table 4). Based on the collected data, the discrepancies between actual and estimated duration were studied and used to derive the magnitude and direction of the ratio λ of divergence defined as: λ i = ((κ ε) /ε) i i = 1... n (1) where κ is the actual duration and ε is the estimated duration. Table 1. Main causes of schedule delay in construction projects through previous studies Author (Al-Momani 2000) (Odeh and Battaineh 2002) (Frimpong et al. 2003) (Koushki et al. 2005) (Faridi and El-Sayegh 2006) (Sambasivan and Soon 2007) (Kaliba et al. 2009) (Mahamid 2011) (Mahamid et al. 2012) (Memon et al. 2014) Cause Incompetent contractors Labors related matters Payment delay Improper planning Material related matters Political situation Table 2. Main predictable effects of schedule delay in construction projects through previous studies Effect Author Less profit to Less profit Cost overrun Arbitration Disputes Litigation Poor quality contractor to client (Aibinu and Jagboro 2002) (Ahmed et al. 2003) (Faridi and El-Sayegh 2006) (Sambasivan and Soon 2007) (Al-Kharashi and Skitmore 2009) (Al-Khalil and Al-Ghafly 1999) 53

4 Table 3. Frequency of projects based on year of implementation Year # of projects Table 4. Frequency of projects based on project duration Duration (months) # of projects Duration (months) # of projects Model Development Once the variables to be included in the proposed models have been identified, a series of mathematical models were developed using linear regression techniques. Linear regression model was selected to find the linear combination of independent variable which best correlates with dependent variables. Regression models are well established and widely used. They are effective due to a well-defined mathematical, as well as being able to explain the significance of each variable and relationship between independent variables (Sodikov 2005). Excel statistical tools were employed to perform regression analysis and to test model significance. The regression equation is expressed as follows: Y = C + b 1 X 1 (2) C: regression constant; b 1 : regression estimates; X 1 : independent variables; Y : dependent variable. 4.2 Identifying and Ranking of Delay Factors and Effects in Road Construction 34 factors that might affect schedule delay in road construction projects in Saudi Arabia and 6 effects of schedule delay have been compiled through making interviews with some local construction experts (contractors, engineers, supervisors, consultants and owners), and by reviewing some related previous studies.the identified factors and effects are tabulated in a questionnaire form. The questionnaire was developed in order to evaluate the severity, frequency, and importance of the identified factors and the importance of the identified effects. Data gathered through a field survey, analyzed by using severity index, frequency index, and importance index, taking in the view of contractors Questionnaire Design The collected factors and effects were used in developing a questionnaire with the objective of investigating the main factors and effects of schedule delay in road construction projects in Saudi Arabia. The questionnaire is divided into three main parts. Part I is related to general information for the company. The surveyed contractors were further requested to answer questions pertaining to their experience in the construction industry. Part II includes the list of the identified factors affecting schedule delay in road construction projects. For each factor two questions were asked: (1) What is the frequency of occurrence for this factor? (2) What is the degree of severity of this factor on project delay? Both frequency of occurrence and severity were categorized on a five-point scale. Frequency of occurrence was categorized as follows: always, often, sometimes, rarely, very rarely (on 5 to 1 point scale). Similarly, degree of severity was categorized as follows: very high, high, moderate, low and very low (on 5 to 1 point scale). Part III includes the list of the identified effects of schedule delay in road construction projects. The respondents are asked to identify the severity degree of each identified effect using a five-point scale as shown above. Then, the designed questionnaire was sent to some local construction experts to check its content and its validation. Some amendments were conducted that improved the questionnaire, prior to sending it to the representative research sample Data Analysis The collected data were analyzed and ranked through the following indices: Frequency index: A formula is used to rank factors affecting schedule delay in public construction based on frequency of occurrence as identified by the participants: F requency Index (F.I) (%) = a (n/n) 100/5 (3) where, a is the constant expressing weighting given to each response (ranges from 1 for very rarely, to 5 for always), n is the frequency of the responses, and N is total number of responses. Severity index: A formula is used to rank the identified factors based on their severity as indicated by the participants: Severity Index (S.I) (%) = a (n/n) 100/5 (4) where, a is the constant expressing weighting given to each response (ranges from 1 for very low, to 5 for very high), n is the frequency of the responses, and N is total number of responses. Importance index: The importance index of each factor is calculated as a function of both frequency index and severity index, as follow: Importance Index (IMP.I) (%) = [(F.I) (%) (S.I) (%)] /100 5 RESULTS AND DISCUSSION 5.1 Analysis of Schedule Delay in Road Construction Size of Schedule Delay in Road Construction For the collected data of 55 road construction projects, a statistical analysis for schedule delay was done, the results are: % of projects face schedule delay; 2. The average of schedule delay is 58.24%, ranging from 2% to 172% Classification of Schedule Delay in Road Construction Figure 1 illustrates frequency of schedule delay in 55 road construction projects. It illustrates the followings: (1) less than (5) 54

5 4% of the investigated projects have schedule delay of value less than 10% of the estimated duration, (2) about 24% of the investigated projects have schedule delay between 10% - 30% of the estimated duration, (3) 20% of the investigated projects have schedule delay between 30% - 50%, (4) 40% of the investigated projects have schedule delay between 50% - 100% of the estimated duration, (5)about 13% of the projects have schedule delay greater than 100% of the estimated duration, (6) 73% of the investigated projects have schedule delay higher than 30% of the estimated duration. Results indicate the followings: 1. The correlation between estimated and actual project duration is high as the coefficient of determination R 2 = 0.81 (close to 1); 2. The equation is valid for minimum X (the estimated project duration) value of 2 months. Otherwise, the equation will give unreasonable values of actual duration (negative values). 3. The analysis of variance test confirmed the statistical significance of the equation at a significance level of Schedule Delay Versus Estimated Duration in Road Construction The correlation between schedule delay and estimated project duration was tested using regression analysis techniques. Results (Table 5) indicate a good linear relation between schedule delay and estimated project duration with R 2 value of The relation between them is as follow: Y = 0.76X (7) Figure 1. Schedule delay in 55 road construction projects Actual Duration Versus Estimated Duration in Road Construction Figure 2 illustrates a linear relation between estimated and actual duration of road construction projects. Regression technique was used to develop the relation, the result is: Y = 2.20X 3.88 (6) where, Y is actual project duration (months), and X is estimated project duration (months). where, Y is schedule delay in months, and X is estimated project duration (months). The above analyses indicate that the problem of schedule delay in road construction projects in Saudi Arabia is alarming and should be studied more to alleviate this problem in the future. 5.2 Factors Affecting Schedule Delay in Road Construction In this study, 34 factors affecting schedule delay in road construction projects in Saudi Arabia have been identified and ranked by measurement of severity index, frequency index, and importance index according to equation (3), equation (4), and equation (5) Participants The target population in this study are the contractors working in road construction in the Northern Province of Saudi Arabia. Simple random sampling was used. The questionnaire was sent out to a total of 83 contractors asking them to rank the identified 34 factors in terms of severity and frequency using an ordinal scale. A total of 70 contractors filled the questionnaire. The response rate by the contractors is 84%. On average, the respondents have an experience of more than 10 years in public construction projects. Figure 2. Actual duration versus estimated duration in 55 road construction projects Factors Ranking Table 6 illustrates the indexes values (importance index, severity index and frequency index) and ranking of 34 factors affect- Table 5. The correlation between schedule delay and estimated project duration Regression Statistics Independent variables Coefficients t Stat P-value Multiple R 0.86 Intercept R Square 0.74 Estimated duration Observations 55 F

6 ing schedule delay in road construction projects in Saudi Arabia from contractors view. The table illustrates that the top five severe factors affecting schedule delay in road construction projects are: bid award for lowest price, poor labor productivity, improper planning, additional work, and lack of contractor experience (with severity index of value 79.12, 78.69, 76.13, 75.67, and respectively). While the top five frequent factors are: rework, improper planning, changes in material types and specifications during construction, poor contract management, and poor resource management (with frequency index of value 65.88, 64.28, 62.10, 62.00, and respectively). Results show that the top five important factors affecting schedule delay in road construction projects in Saudi Arabia are: 1. Improper planning: proper planning is one of the main keys for project success. It includes managing of natural and human project resources from its early stages up to project closeout. Thus, it is obvious that improper planning negatively affects project progress and leads to project delay. Interviews indicated that local contractors often fail to come out with a well planned work program at the initial planning stage due to lack of systematic site management and lack of contractor s experience. This result is in line with Sambasivan and Soon (2007) and Faridi and El-Sayegh (2006). 2. Poor labor productivity: labor productivity affects the activity duration and consequently the total project duration. Poor productivity increases the actual time of a specific activity to be completed. Accordingly, the project will delay. Labor productivity could be affected by many factors such as: motivations, relation between labors and management team, relations among labors, payment delay, wages,..etc. Interviews with number of contractors in the studied sample illustrate that low labor wages in Table 6. Ranking of factors affecting schedule delay in road construction projects Factor S.I F.I IMP.I Rank Improper planning Poor labor productivity Additional work Rework Lack of contractor experience Poor resource management Poor contract management Bid award for lowest price Changes in material types and specifications during construction Duration of contract period Inflationary pressure Frequent changes in design Lack of adequate manpower Payments delay Long period between design and time of implementation Unreasonable project time frame Late design work Inadequate production of raw materials by the country Lack of coordination between design and contractors Mistakes in design Poor financial control on site Poor relationship between managers and labors Economic instability Disputes on site Manipulation of suppliers Level of competitors Number of projects going at the same time Number of competitors Contractual procedure Government policies High interest rates by bankers Project location Effects of weather Social and cultural impacts

7 construction projects in Saudi Arabia (less than $200 per month) affects their motivation to work which leads to poor productivity. This result is in line with Mahamid et al. (2012). 3. Additional work: it can be defined as a deviation from an agreed upon well-defined scope and schedule. In general, initiation of additional work could be summarized as follows: owner may request a change, engineer may originate a change because of differing site condition or new governmental regulation, and contractor may initiate a change due to design errors or field requirement. Thus, additional work requires adding or removing of construction items that affects project duration. This result is in line with Koushki et al. (2005). 4. Rework: it can be simply defined as redoing the same activity for more than one time. It might be as a result of many reasons such as improper planning, additional works, poor workmanship, poor material quality, late changes, scope changes, mistakes in design,..etc. It is clear that redoing the same duty again and again will lead to project delay. This result is supported by Mahamid (2011). 5. Lack of contractor experience: it is established fact from learning effect that if you do the same task more than one time, you will control it better with less time and cost. Interviews with number of contractors in the studied sample illustrate that the road construction projects are awarded by the owner (i.e. Governmental Departments) to the bidder with lowest price who are, in general, not technically and financially sound. This affects contractor ability to do his job properly and to complete the project on time as agreed on. This result is in line with Odeh and Battaineh (2002). 5.3 Effects of Schedule Delay in Road Construction The primary data collected from the third part of the questionnaire was analyzed from the perspective of contractors. The calculation of S.I and ranking of the identified 5 effects of schedule delay in road construction projects were done according to equation (5). Results reveal the following order (Table 7): cost overrun (S.I = 81.22), dispute (S.I = 73.16), arbitration (S.I = 66.75), litigation (S.I = 58.13), and poor quality (S.I = 55.05), respectively. Table 7. Ranking of effects of schedule delay in road construction projects Effect S.I Rank Cost overrun Disputes Arbitration Litigation Poor quality Results illustrate that cost overrun was ranked in position 1 by the respondents. Project delay can lead to cost and schedule delays. Delay and cost increase can lead to disputes between project participants as to who should bear the responsibility and the cost. These disputes often lead to an arbitration process by third party. If the arbitration process fails, litigation, where the disputes are settled by the court, is resulted. Moreover, project delay may lead to poor quality of works. The contractors might accelerate the work to minimize project delay; consequently poor quality will be the result. 6 CONCLUSION This study was conducted to recognize schedule delay in road construction projects in Saudi Arabia. The evaluation of the progress reports of 55 road projects constructed during the period in Saudi Arabia concluded that delays are extensive: the average ratio of actual completion time to the planned contract duration is 58.24%, ranging from 2% to 172%. The analyses indicate high correlation between schedule delay and project duration in road construction projects. The study also investigates the main factors and effects of schedule delay in road construction projects in Saudi Arabia through a questionnaire survey. 70 contractors working in road construction completed a structured questionnaire survey. 34 identified factors were ranked according to their levels of severity, frequency, and importance. Results show that the top five important factors affecting schedule delay in road construction projects are: improper planning, poor labor productivity, additional works, rework, and lack of contractor experience. Contractors input indicates that the top five severe factors affecting schedule delay are: bid award for lowest price, poor labor productivity, improper planning, additional work, and lack of contractor experience. While the top five frequent factors are: rework, improper planning, changes in material types and specifications during construction, poor contract management, and poor resource management.the study concludes that the main effects of schedule delay in road construction projects as assessed by contractorsare: cost overrun, disputes, arbitration, litigation, and poor quality. The following conclusions derived from the statistical analyses of the data: (1) The minimum severity index is 41%, (2) the minimum frequency index is 37%, (3) No factor was ruled out by any of the respondents. These all indicate that the identified factors are highly relevant to the problem of schedule delay in public construction projects in Saudi Arabia. Based on the study findings, the following points are recommended to minimize schedule delay in public construction projects: 1. Managerial skills of construction parties should be improved; 2. Labors motivation system should be developed; 3. More communication between construction parties should be done at the early project stages to minimize late changes during construction phase; 4. Policy of contract awarding should be improved: resources and capabilities of bidders should be checked carefully. 7 IMPLICATIONS AND FUTURE RESEARCH AND DEVELOPMENTS This study has investigated the time performance in road construction projects in Saudi Arabia. The results have clear implications for the construction projects (public and private) in Saudi Arabia and the construction industry at large. This study 57

8 provides a fresh view on an old problem in construction industry by testing the relation between estimated and actual project duration, and ranking the different delay causes and effects from the perspectives of contractors. This study has provided evidence on the schedule delay in road construction projects in Saudi Arabia in terms of causes, effects, size and estimate. It is hoped that the results of this study can be of immense help to the key project participants (owners, contractors and consultants) and academicians. The findings can support the owners in planning, contractors in better understanding of delay causes and effects and how to control it, consultants in applying comprehensive contract information, and workers in conducting their day-to-day activities. Finally, although this study is related to views for respondents from Saudi Arabia, other developing countries could benefit from the results of this study. 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