Download The 8th Five Year Plan for Health Development 2011-2015

MINISTRY OF HEALTH
SULTANATE OF OMAN
THE 8th FIVE - YEAR PLAN
FOR HEALTH DEVELOPMENT
(2011 – 2015)
THE NATIONAL STRATEGIC PLAN
H. M. PHOTO
As it is well known that a healthy mind
is in a healthy body, health should be a right of
every citizen. Since July 1970, we have decided to
attach high priority to the development of health
of the Omani people.
H.M. Qaboos bin Said
Sultan of Oman
Paste Here
Map of Sultanate of Oman
INDEX
Contents
Page
- Foreword …………………………………………………………………............
I
- Introduction ……………………………………………………………………...
III
- Chapter One:
National Health Policy of the Sultanate of Oman …………………............
1
- Chapter Two:
Strategic Directives for Health Development in Oman (2011 – 2015)…....
4
- Chapter three:
Visions, Goals and Objectives of the Eight 5-Year Plan for Health
Development (2011– 2015) …………………………………….....................
10
- Chapter Four:
Domains of the Eight 5-Year Health Development Plan ………………….
19
Vision One: Delivery of High Standards of Health Care to the Community ….
20
▪Domain 1: Primary Health Care ………………………………………………...
21
▪Domain 2: Secondary and Tertiary Health Care ………………………………
28
▪Domain 3: Pharmaceutical Care ………………………………………………...
37
▪Domain 4: Nursing Care …………………………………………………………
50
▪Domain 5: Laboratories ………………………………………………………….
61
▪Domain 6: Blood Services ………………………………………………………..
68
▪Domain 7: X ray Services ………………………………………………………..
74
▪Domain 8: Rehabilitation Services ………………………………………………
80
Vision Two: Quality Assurance of Health Services and Patient Safety ………..
86
▪Domain 9: Quality Assurance / Improvement and Patient Safety……………..
87
Vision Three: Alleviation of Risks Threatening The Public Health …………...
97
Domain 10: Communicable Diseases …………………………………………….
98
▪Domain 11: HIV/AIDS and Sexually Transmitted Infection (STI) ……..…….
114
▪Domain 12: Malaria ……………………………………………………………...
124
▪Domain 13: Non-Communicable Diseases ……………………………………...
129
▪Domain 14: Eye Health …………………………………………………………..
140
▪Domain 15: Ear Health …………………………………………………………..
149
▪Domain 16: Oral and Dental Health …………………………………………….
154
▪Domain 17: Mental Health ………………………………………………………
160
▪Domain 18: Genetic Diseases ………………………………………………….....
169
▪Domain 19: Environmental and Occupational Health ………………………...
178
▪Domain 20: Accidents and Injuries ……………………………………………..
185
Contents
Page
Vision Four: Promoting Woman and Child health & maintaining the health
of elder lies
190
▪ Domain 21: Woman Health
191
▪ Domain 22: Child Health
198
▪ Domain 23: Elderlies care
207
Vision Five: Dissemination of Healthy lifestyles in the Community
214
▪ Domain 24: Health Education and Communication
215
▪ Domain 25: Adolescent and Youth Health
223
▪ Domain 26: School and college health
230
Vision Six: Better Nutrition for All
242
▪ Domain 27: Nutrition
243
Vision Seven: Joint Action for Better Community Health
252
▪ Domain 28: Community Participation
253
Vision Eight: Achieving Excellence in The Managerial Processes
259
▪ Domain 29: Health Management
260
Vision Nine: An Efficient Health Information and Research System to Meet
the Needs of the Health System
265
▪ Domain 30 : Health Information and Statistics
266
▪ Domain 31: Health Studies and Research
272
Vision Ten: Achieving Integrated Digital Environment
283
▪ Domain 32: Information Technology
284
Vision eleven: Availability of Qualified Human Resources in Suitable
Numbers to Work in Health Institutions
295
▪ Domain 33: Human Resources Development and Omanization in the Health
296
▪ Domain 34: Health Educational Institutions in Ministry of Health
308
Vision twelve: Improving the Health services Provided by the Private Health
Sector According to a Health System That is Based on Excellence, Quality
and the Scientific and Practical Efficiency; and to Ensure theRights of
Patients and their Safety.
322
▪ Domain 35: Health services for the Private Health Sector
323
FOREWORD
Since the dawn of the blessed renaissance of the year 1970, the Government of
sultanate of Oman is committed to put the infrastructure of extensive revolution in the country
which results in achieving marked health development for Omani citizen. Since that time up
to today health services in the sultanate achieved a marked significant developments in
quantitative as well as in qualitative terms. The people of Oman are now enjoying state-of -art
medical services provided through a comprehensive and effective health system.
I am pleased to introduce this document on the occasion of the celebration of the
fortieth anniversary of the Omani renaissance. This document presents the general outlines of
the health development programs of the eighth five-year health development plan of Oman
(2011 – 2015).
It may be used as a guide for health workers for performing their duties and
responsibilities with a view to reaching the goal accepted by all of us, which is achieving a
satisfactory level of health for all, as per the directions of his highness the builder of Oman
renaissance.
The ministry of health is committed to make primary health care the first and basic
entry point for achieving health for all, as expressed in the continuation of the world health
organization. At the same time the ministry gives attention to the development of health care
services at secondary (specialist) level and at tertiary (super/ sub-specialty) level. As regards
the mechanism for high quality health care delivery, the ministry has adopted the
decentralization policy for the provision of health services at regional level. The ministry
support the health system at the wilayate level with a view to ensuring equitable distribution
of health services to all segments of the community. Thus all are able to fulfil their health
services needs. The ministry of health has also given special attention to the strategies of
support and development of the national human resources with the goal of enhancing the
Omanization in the ministry of health.
The ministry of health has relentlessly continuously up to date preparing health
development plans every five years starting from 1976 within the framework of the
comprehensive five-year development plans of the sultanate. These plans have led to the
achievement of the health, an economic and social goal which drives Oman to a higher level
of development and welfare throughout years of blessed renaissance. This marked the
beginning of significant developments of health services in Oman in quantitative as well as
qualitative term. The Omani people are now enjoying state-of-the- art medical services
provided through a comprehensive and effective health system.
Eighth five year plan methodology followed the seventh five year plan which adopted
the principles of strategic planning process for national health development which is an
important remarkable methodology in health sector. This methodology follows the principles
of strategic planning which enable us to clearly define our visions, long term goals and
objectives, and help us delineate the strategic directions of work during the next five year
aiming for development of the health system, improvement of the quality of health care and
modernizing various health services components.
Health care support system is a high priority for the Ministry of Health for the next
five years. This includes the administrative process, decentralization and hospital autonomy.
Also, promotion of the primary health care services is high in our work priorities, in addition
to expansion of its coverage to meet the needs of the community comprehensively. The
Ministry will also focus its attention to the dissemination and strengthening of health
promotion with a view to supporting the prevention and control of non-communicable
I
diseases and accidents, and sustaining the achievements in the control of communicable
diseases.
It is well known that policies and strategic plans are of no benefit or value if these are
not translated into operational plans to be implemented, monitored and evaluated. So the
Eighth health plan is characterized by its insistence on the involvement of all concerned
officials at various planning stages, including analysis, prioritization, setting the objectives,
monitoring and evaluation of the alternatives, defining the strategies and activities, provision
of resources and monitoring and evaluation of achievements at the local, regional and central
level.
It was also stressed that supportive local plans should be prepared at Wilayat level
relying on the process of “bottom–up planning” which is used now by the “Wilayat health
committees” in the Sultanate to plan community health projects with the participation and
coordination of the community and health workers.
The 8th Five-Year Plan for Health Development covers 35 specific health fields or
domains to implement the strategic and operational action plans. Each of these domains has a
national comprehensive plan and several operational plans at the regional levels in addition to
supportive plans at Wilayat levels. This specific planning methodology ensures the accuracy
of all the details using several different indicators to evaluate the objectives, strategies and
activities.
I take this opportunity to express my thanks and appreciation for the efforts of all
those who participated in the preparation of this plan.
I do hope that with the blessings of Allah, all concerned will use this document as the
blueprint for their concerted action to achieve all the objectives of this health development
plan.
With the blessings and guidance of Allah
Dr. Ahmed Bin Mohammed AL- Saidi
Minister of Health
II
INTRODUCTION
The Sultanate of Oman started five-year health development planning from the year
of 1976. Since then seven 5- year plans were implemented: (1976-1980), (1981-1985), (19861990), (1991-1995), (1996-2000), (2001-2005), (2006-2010).
The first three plans were generally service extension plans aiming at strengthening
the health services structure. The fourth plan contained detailed programming. It included 23
programs; each one directed to the reduction of one health or health-related problem from the
priority list of problems in the Sultanate. In the same way, the fifth and the sixth plan were
formulated as systematically scientific plans designed mainly to implementing programs;
each of these programs was directed to the reduction of one or more of the priority problems
in the Sultanate.
The policy-makers initiated the preparatory phase of the 7th Five-Year Plan for
Health Development after reviewing its previous experience with the planning process in
meeting the Ministry‟s long-term visions and goals. The central administration concentrated
on the priority health polices based on the information available about the progress in
improving the health level of the Sultanate. Also, the health plan of Oman considered the
National, Local and Regional / GCC directives to enable monitoring and evaluation of our
efforts and comparison of our achievements with that of other nations and regional countries.
The 7th Five-Year Plan for Health Development follows a new planning process and
includes several important health domains, some of which are included for the first time in
the health plan. In addition, several new strategies are presented under related domains
instead of formulating Programs directed to the reduction or control of selected health
problems.
Review and analysis of the previous central, regional and Wilayat health plans
revealed that, the basic activities in each Program were implemented at the level of each
health institution. This was actually a common factor in the entire plan. So when formulating
the new 7th Five-Year Plan for Health Development, we decided to divide and separate the
planning stages to the central and operational levels in order to make the operational plans
extensions not repetitions of the national strategic plan (general outline) relating to each field.
This was supplemented with supportive community plans at Wilayat level. It is well known
that the planning process should proceed step by step. So, in order to prepare the 7th FiveYear Plan for Health Development in a scientific way, we have pursued the same planning
principles and methodology throughout the planning process.
The 8th Five-Year Plan for Health Development follows the same planning principles
and methodology of the 7th Five-Year Plan for Health Development. Preparation of the 8th
Five-Year Plan for Health Development was started at the beginning of 2010, after the
issuance of the Ministerial Decision No. 3 ; year 2010. Thereafter, twenty steps were laid
down to prepare the plan at three levels: central, regional (health regions) and local (Wilayat).
All the steps were scrupulously pursued throughout the following 15 months with the
participation of the responsible officials at all levels.
III
Generally, the 8th Five-Year Plan for Health Development rests on three pillars:
First – National Strategic Plan: This plan is concerned with the visions, goals, general
objectives and strategies at the national level and expected results after implementation using
evidence-based-management philosophy. This helps in focusing on gradual steps to evaluate
the cause-effect relation between the short, intermediate and long-term outcomes and
impacts, resource utilization and activity sharing.
Second – Regional Operational Plans: These “detailed plans” based on the strategic plan to
be implemented by the concerned directorates at the regional or central levels. These plans
include the targets, the operational activities, the needed resources and also the indicators for
monitoring and evaluation and the timetable for implementation.
Third – Local Supportive Plans: These plans will be designed at Wilayat level by the
“Wilayat health committees” to support the regional operational plans. Local Supportive
Plans will be in the form of short-term health projects planned for one year, depending on
community participation and cooperation between the related sectors and using the pyramidal
planning process or “bottom-up-planning” that is used by Wilayat health committees in
Oman since 2003.
Despite the extension of the domains of the 8th Five-Year Plan for Health
Development involving a great number of activities, we hope our efforts will succeed, and the
Sultanate will be able to continue to reach higher levels of achievement in the health field.
Thus, it is hoped, the health conditions of the people of Oman will improve further, and this
will be reflected in our health status indicators.
DR. Ali Bin Talib AL- Hinai
Under Secretary for Planning Affairs
IV
Chapter One
NATIONAL HEALTH POLICY
OF THE SULTANATE OF OMAN
1
Chapter One
National Health Policy of the Sultanate of Oman
In the light of the health situation analysis in the Sultanate, the achievement of the
previous health plans and the assessment of persistent problems and difficulties, the national
health policy for the next five years (2011 – 2015) was formulated as under:
A. The work and activities of the Ministry of Health (MoH) and all other health related
agencies are to be directed for achieving the following goals:
1. Provision of the best levels of primary and specialized health care to the
population of the Sultanate.
2. Reduction of mortality and morbidity rates of different diseases with a view to
attaining life expectancy similar to that of the developed countries.
3. Taking necessary measures for the prevention of infectious and parasitic diseases
aiming at their eradication especially among children and school pupils.
4. Applying the latest methods for the prevention, early case finding and prompt
treatment of chronic diseases aiming at the reduction of their magnitude and
complications.
5. Provision of health care necessary for the elderlies and disabled people.
6. Provision of preventive measures and treatment of all types of accident cases.
7. Development and training of Omani workforce in all health professional
categories in order to achieve high levels of Omanization or self-sufficiency in
health workforce.
8. Development of Information Technology and speed the access to electronic
system data.
B. Steadfastly pursuing the following directives:
1. Considering primary health care the first and basic entry point for all levels of
health care.
2. Improve quality of health services to all the population.
3. Assuring the suitable distribution, accessibility and acceptability of all levels of
health services.
4. Promotion of community involvement in all activities of health care (in a gradual
way).
5. Assuring coordination and good cooperation among the different agencies that
provide health or health related services.
6. Reducing the waste in material and human resources within the health system.
7. Gradual extension of delegation of authority and responsibility to the Wilayat
level.
2
8. Encouraging the private sector to participate effectively in the appropriate aspects
of health work.
C. Directing important attention to the following priorities, and formulating and
implementing suitable plans to manage them:
1. Promotion of primary health care services and ensuring its quality.
2. Prevention and control of non-communicable diseases and accidents involving the
main causes of morbidities, mortalities, and disabilities.
3. Development of comprehensive maternal health and reduction of morbidities and
mortalities of children.
4. To promote the decentralization policy and hospital autonomy initiative.
5. To promote the health awareness of the community and establish a culture of
healthy lifestyle.
3
Chapter Two
STRATEGIC DIRECTIVES
FOR
HEALTH DEVELOPMENT
IN OMAN
(2011 – 2015)
4
Chapter Two
Strategic Directives
For Health Development In Oman
(2011 – 2015)
Since 1970 the Ministry of Health in Sultanate of Oman has been ensuring the
availability of promotive, preventive, curative and rehabilitative health services for all
population aiming to improve the health status of the Omani citizens and residents along the
following lines:
 Provision of comprehensive health services in the field of public health and personal
health considering primary health care as the basic entry point for health care.

Assuring equity in the distribution of health services and burden of health expenditure
to cover all ages, social and economic levels of the community.

Fulfill the health and health related needs and expectations of the people.

Continuation and promotion of all aspects of health development through community
participation and inter-sectoral cooperation.
Health Planning in the Sultanate of Oman:
Since 1976 and the blessed renaissance, the Ministry of Health started its five-year
health development plans, in order to achieve its mission and carry out its responsibilities for
social and economic development through developmental planning. The effect of five-year
health development plans on the development of health services and improvement of the
health status of the people has been observed to be significant. This development reflects the
abiding impact of health planning and management since the dawn of the blessed renaissance
in spreading the health services and provision of health care to all people.
The first stage of the health planning in Sultanate of Oman extended from 1976 to
1990, in which three 5-year plans were implemented. These plans were focused on extension
of the health services infrastructure, since prior to the blessed renaissance there were no
sufficient numbers of health institutions to combat the prevailing unsatisfactory health status.
The second stage of planning started at 1991 and included 3 five-year health plans
(the fourth, fifth and sixth ones), which completed by the end of 2005. This stage was
characterized by several main directions formulated after comprehensive review of the health
system in 1990. “Decentralization in provision of health services” was one of the main
directions, and it was implemented through establishing 10 general health directorates in the
regions, with delegation of financial and administrative authorities according to definite roles
and controls. In 1993 local directorates at Wilayat level was started followed by hospital
autonomy in the year of 2000.
The preparation of plans of the second stage followed “the managerial process for
national health development”. These plans included different Programs each directed to one
priority health or health related problem. The general framework of the 4th, 5th and 6th plans
was prepared at the central level. The 5th and 6th plans included 10 detailed regional plans
while the 6th plan included 19 Wilayat plans, in line with the decentralization policy adopted
by the Ministry of Health.
5
The second stage plans of Ministry of Health were concentrated on qualitative
development besides the quantitative and geographical expansion of health services. The
decentralization policy in health services helped in empowerment of the administrative
machinery and promoted the planning process at the local level. The direct effect of this
policy was observed as the size of health services expanded all over the Sultanate during this
stage (1991 – 2005). During the second stage construction and development of several
hospitals was also undertaken in all the regions in order to provide specialty services mainly
secondary care and limited tertiary health care in each health region. Human resources
development through the establishment of health institutions dealt with the training and
qualification of staff in the field of general nursing, medical laboratories, radiography,
assistant dentists, assistant pharmacists and health inspectors.
The Future Challenges in the Sultanate of Oman:
Despite the significant progress in the field of health throughout the previous 04years, the
health system in Sultanate of Oman is still facing many challenges, like many other health
systems in the world. These challenges may be briefly summarized below:
1. Shortage in the Basic Inputs of the Health System:
The difficult topography and terrain of Oman, the wide dispersal of the population all
over the Sultanate and the importance of providing basic health services to all the people
close to their dwellings pose a great challenge to the stakeholders. The situation can be
comprehended well when you consider that the total population is less than 1000.
Accordingly, special strategies and tools should be adopted to provide suitable and easily
accessible health services to these population settlements. For this situation, the Ministry of
Health started to operate a number of small health centers to serve inhabitants of settlements
with less than 1000 people. This reflects the economic burden to provide the needed health
services to these target groups of people.
The main challenge facing the Ministry is insufficient Omani health workforce. The
problem is aggravated especially because of the recent epidemiological changes in the
Sultanate that has resulted in a tremendous need for highly qualified and specialized
professional doctors. Also, there is increasing difficulties in the recruitment of expatriate staff
particularly physicians and specialists. So, it is necessary to ensure sufficient availability of
qualified medical Omani staff; therefore, supporting Omanization for the highly advanced
specialties is a need.
2. Health Services Expenditure:
The balance between the increasing demand for the health development needs and the
high cost of the health services provided due to continuous progress in the technology of
health care including the advanced information technology, equipment, curative and
diagnostics means, and the chemicals and therapeutics; constitute a great challenge to all
countries without exception. This in turns needs consideration and adoption of alternative
strategies for mobilization of health financial resources in order to prevent undesirable
changes in the health indicators.
It is known that the Ministry of Health is responsible for about 82% of the total health
expenditure in the country constituting the highest such percentage among all GCC countries.
This situation increases the difficulties facing Oman especially with the presence of the
strong governmental commitment to continue such high health expenditure that the entire
burden to achieve the target balance will fall on the government.
6
3. Health Problems:
“The double burden of morbidity” is a significant challenge facing the Sultanate of Oman,
which could be considered a specific characteristic feature of the newly developing countries.
It carries the burden of the present epidemiological changes and the health problems resulting
from unhealthy lifestyles typical of the developed countries. The main diseases resulting due
to these changes are: obesity, cardiac and coronary diseases, hypertension, diabetes, cancers,
chronic kidney diseases, brain stroke, and geriatric diseases. Also, there are groups of
diseases related to the changing age distribution of the population, and to the harmful
practices of the youth, which cause road accidents & injuries, sexually transmitted diseases,
mental health problems and psychiatric disorders and addiction. All these diseases need
expensive treatment for long periods sometimes for entire life. In addition to this group of
diseases, the Ministry of Health should carry the burden of the preceding health problems,
which still persist in varying degrees. These include malnutrition, genetic diseases and
congenital abnormalities, newborns‟ health problems, and also some communicable diseases
such as diarrheal diseases, respiratory infections, viral hepatitis etc.
In spite of the great efforts made in the field of health education, still there is a need for
more education. There is also the need for social marketing for health and health services
with greater coordination between different sectors in order to face the challenges of
unhealthy lifestyles and harmful practices in the Omani community responsible for many
diseases.
Faced with the future challenges:
Faced with the main challenges of the health sector in the Sultanate, the health
planners suggested a set of priorities and strategic alternatives for the next 5 years, which
reflected the urgent need for capacity building. Some of these priories were selected to direct
the available resources for achieving real changes in the present epidemiological situation and
morbidity burden in the Sultanate by using the available and cost-effective mechanisms, as
many health problems such as non-communicable diseases have a negative effect on the
social, economical and health achievements gained during the years of renaissance.
As the selected strategic directions for the 7th - 5 years (2006-2010), the 8th – 5 year
plan (2011 – 2015) take into consideration the good level of health coverage in Oman, the
epidemiological changes in the present and emerging diseases, the national health policies
and the efforts of the Oman Government to achieve high coverage and high quality health
services at affordable costs to all people through supporting and strengthening the inputs of
primary health care in the Sultanate.
Considering the current challenges five strategic objectives were identified in order to
evaluate the success of the health sector in Oman. These strategies help in managing the
impacts of the present transitional period and the expected health and economic changes
resulting from the local, national and regional developments. In addition to the role of the
Ministry of Health in adopting theses strategies, the implementation mechanisms for the
suggested strategies include the support of all partners such as other health related sectors,
non-governmental organizations, educational institutions, the private sector and the national
Government.
7
The identified strategic objectives are:
a. Support of the health system including promotion of the primary health care
services & its quality and supporting the decentralization strategy and hospital
autonomy.
b. Strengthening and support of the prevention and control measures for the noncommunicable diseases and the accidents including the main causes of mortality;
morbidity and disability, and encouraging healthy lifestyles such as proper
nutrition, physical activity, and quitting of smoking, drugs and substance addiction.
c. Strengthening of the links between national health and population policies, and
focusing on reproductive health problems in order to reduce maternal and neonatal
mortalities.
d. Sustaining the significant achievements in the field of communicable diseases and
promotion of the early detection methods for AIDS as well as the surveillance of
diseases that could cause epidemics and enhancing the responsiveness and
preparedness for the emergency cases.
e. Strengthening and spreading the concept of health promotion including
dissemination of health education and promotion of communication means with the
community.
The strategic directions during the period from (2011 – 2015) include:
1. Keeping and improving the present health level through:

The expansion of the primary health care infrastructure.

Adopting effective strategies to reduce the morbidity rates of the priority
health problems.

Continuing the support of the policies and mechanisms aiming at empowering
the women in different fields.


Continuing the efforts of health education to individuals and families.
Promoting cooperation between the Sultanate of Oman and national
organizations especially for program of promotion of healthy lifestyles.

Attaching significant importance to the efforts of health promotion, nutrition
and reproductive health.

Supporting the cooperation with the health related sectors and encouraging the
community based initiatives projects.
2. Improve the cost effectiveness in health expenditure through:
 Improve management and the Redistribution of the hospital‟s beds.
 Early detection and treatment of non-communicable diseases.
 Improving cost measurement and control tools.
8
3. Increase the financial resources through:
 Recover the high costs of some health services such as car accidents through
health insurance system.
 Collecting small or minimum charges from the service clients.
4. Improve self-reliance in the field of human resources through:

Expansion of the education and training Programs for different health sectors.

Rational distribution of manpower in the health institutions.
5. Improve the efficiency of health system through:
 Promotion of decentralization in the health services administration.
 Promotion of hospital autonomy.
 Supporting the management training of health administrators.
 Encouraging scientific studies and health systems research.
6. Improve the cost effectiveness of health services provided through:
 Expansion of primary health care network and restructuring of the hospital
sector.
 Monitoring of the utilization of financial resources.
 Promotion of the referral system, quality assurance, control of costs &
computerized information system.
7. Supporting the private health sector through:
 Provision of soft loans and technical support for the private.
 Privatization of some governmental health services.
9
Chapter Three
VISIONS, GOALS AND OBJECTIVES OF
THE EIGHTH 5 - YEAR PLAN FOR
HEALTH DEVELOPMENT
(2011 – 2015)
10
Chapter Three
Visions, Goals and Objectives
Of The 8 Five Year Plan For Health Development
(2011 – 2015)
th
In the light of identified objectives and strategic directions for health development in
Oman (2011-2015), the first stage of preparatory phases of the 8th five year health
development plan was initiated by reviewing and reformulating the specific health policies
encompassing the key health fields. Also, situation analyses covering all aspects of health
(demographic, social, economic, and environmental), health resources and epidemiological
situation were undertaken. This task was accomplished with the cooperation of senior
responsible staff in the Ministry – HQ and in regions, the supervisors, and central programs
managers and coordinators. This enabled the planners to prepare a comprehensive and
informative document about the Sultanate‟s health profile.
In the second stage of health planning, the work priorities for each health field were
defined. Ranking of the priority problems was done according to its importance with the help
of the specified task forces at central and regional levels. Follow this stage the framework for
the 8th five year health developmental plan (2011-2015) was finalized including the suggested
visions (12 visions) and expected goals.
Visions and Goals and objectives of the 8th five-year plan for Health
Development:
Visions:
1. Delivery of High Standards of Health Care to The Community.
2. Quality Assurance of Health Services and Patient Safety.
3. Alleviation of Risks Threatening The Public Health.
4. Promoting Woman and Child Health and Maintaining the Health of Elderlies.
5. Dissemination of Healthy Lifestyles in the Community.
6. Better Nutrition for All.
7. Joint Action for Better Community Health.
8. Reaching to Distinction in Administrative Practices.
9. An Efficient Health Information and Research System to Meet the Needs of Health
System.
10. Achieving Integrated Digital Environment.
11. Availability of Qualified Human Resources in Suitable Numbers to Work in Health
Institutions.
12. Improving the Health Services Provided by the Private Health Sector According to a
Health System that is Based on Excellence, Quality and the Scientific and Practical
Efficiency; and to Ensure the Rights of Patients and their Safety.
11
Goals:
1. Developing Pillars of The Health System.
2. Provision of High Quality Health Services.
3. Reduction of Mortality and Morbidity Rates of Diseases and Accidents to the Lowest
International Levels.
4. Improving Health Care Provided to Women and Children and Elderlies.
5. Increasing Health Awareness, Correcting Attitudes and Establishing Healthy
Behaviors and Practices in the Community.
6. Improvement of the Nutritional Status of Omani Society.
7. Mobilization of the Community and Health Related Sectors for Health Promotion.
8. Development of Health Administration upon all levels.
9. Strengthening the System of Statistics, Health Information and Research.
10. Facilitate and speed the access to electronic system data.
11. Ensuring the Availability of Adequate Numbers of Suitably Qualified, Trained and
Efficient Workforce.
12. To Support the Private Health Sector in Order to Provide Preventive, Curative and
Promotive Health Services to All Members of Community According to International
Quality Standards and Licensing. And to Supervise the Private Health Establishments
as per the National Legislation and Regulations in Order to Ensure the Efficiency of
Health Services Provided and their Consistency with Government Health Services to
Fulfill the Needs of Community Members.
The strategic plan and the Operational plan:
After defining the visions and health goals for the period (2011- 2015), the general
framework and the strategic plan for the 8th five year health developmental plan (2011-2015)
were completed. This included the formulation of general and direct objectives for each
domain in the plan (35 domains), defining the strategies for achievement of the goals in a
comprehensive and precise scientific manner, and defining the expected results from each
strategy and selecting the indicators of evaluation depending on process of “result- based –
management”.
The third stage included the implementation of the operational plans at the regional level,
which involved the targets and activities to achieve the general objectives of each field as
well as the indicators of monitoring and evaluation, the resources and timetable.
The fourth stage includes the technical revision of the general objectives, the targets,
strategies and the activities at all levels. This stage also included revision of indicators of the
objectives, activities and expected results as well as identification of data needs (research and
studies or other resources). The feasibility of provision of financial and technical resources
needed for its implementation at all levels was also explored and highlighted.
12
Domains and objectives of the 8th five-year plan for health development:
The working groups reviewed all the available information and the evidences from
statistics and scientific studies, and agreed upon selecting 35 domains and their general
objectives. These domains deserve more attention throughout the next 5 years. The domains
and objectives of the 8th five –year plan for Health Development are as follow:
Primary Health Care:
1. To strengthen the PHC infrastructure.
2. To provide high quality PHC services to the community.
Secondary and Tertiary Health Care
1. To develop the infrastructure of the hospitals.
2. To Improve and expand secondary and tertiary health care services.
3. To develop and improve the readiness of hospitals to respond to emergencies and
disasters.
Pharmaceutical Care
1. To assure that patients are provided with safe and effective drugs, at reasonable costs.
2. To ensure the quality of pharmaceutical services provided.
3. To enhance the medication safety programs.
4. To accomplish rational drug use in all institutions.
Nursing Care:
1.
To enhance quality performance of nursing and midwifery services.
2.
To develop nursing and midwifery services in primary health care and community
health.
3.
To develop systems of nursing and midwifery practice so as to protect the recipient
from irresponsible nursing practices.
4.
To develop human resources in the field of nursing and midwifery through focusing on
nursing leadership, continuous education and providing safe and effective working
environment.
Laboratories:
1.
To support and develop laboratories in all health institutions.
2.
To reinforce Laboratory Bio-safety and Bio-security measures.
3.
To insure and improve laboratory quality controls.
13
Blood Services:
1. To increase the number of voluntary blood donors.
2. Optimal use of blood and blood products.
3. To improve and develop the quality of blood transfusion services at the national level.
Radiology Service
1. To enhance the radiology services in the health institutions and improve its quality
assurance.
2. To improve the performance of workers in the field of radiology
Rehabilitation Services:
1. Development of rehabilitation services in all Ministry of Health institutions.
Quality Assurance / Improvement and Patient Safety:
1. To establish and develop quality management and accreditation systems in health care
facilities.
2. To establish patient safety system in health care facilities.
3. To build the qualified national capacity in quality assurance / improvement and patient
safety systems.
Communicable Diseases:
1. Strengthening and maintaining the national capacity for infectious disease, detection
and response through achieving effective preparedness, surveillance and response
system that meet the IHR requirements.
2. Reduction of health care associated infections (HAIs) rates.
3. Maintaining the lowest rates of vaccine-preventable diseases.
4. Achieving the lowest possible rates for other communicable disease.
HIV/AIDS and Sexually Transmitted Infection (STI)
1. To control the spread of HIV/AIDS and STIs in the community in general and in the
most vulnerable groups in particular and stabilizing the current rates of these diseases.
2. To improve health and psychological conditions of patients with HIV/AIDS, reduce the
complications of the disease; reduce mortalities due to opportunistic infections
associated with AIDS, and management of STI as a Syndromic Case Management
Approach (SCMA) with provision of essential medicines in primary health care
institutions.
3. Promotion and support of NGOs who are working with Most At Risk Populations/
those with high risk behavior and People Living With HIV (PLHIV).
14
Malaria Eradication
1. To maintain the incidence of indigenous malaria cases at zero.
2. Prevention of epidemics due to vector borne diseases.
Non- Communicable Diseases:
1. To reduce the risk factors for non-communicable diseases (diabetes, cardiovascular disease,
chronic renal disease, asthma, cancer) associated life style and reduce the steady increase in it.
2. Early diagnosis of non-communicable diseases (diabetes, hypertension, high lipid, chronic renal
disease, stroke, obesity, cancer).
3. Good control of non –communicable disease and reduce complications.
4. To promote researches and studies in the field of non-communicable disease.
Eye Health
1. To control factors leading to blindness in all age groups.
2. To Maintain Trachoma prevalence below WHO recommended standards for elimination of
blinding trachoma.
3. Reorganization of eye care services at all eye care levels specially the secondary and tertiary
levels to improve preventive, curative and rehabilitative eye health services.
Ear Health
1.
Prevention of Hearing loss among all Omani population.
2.
Treatment and rehabilitation of patients with hearing loss.
Oral and Dental Health
1. Improving Oral and Dental Health services provided to priority groups in the community.
Mental Health
1.
To improve the quality of mental health services provided to adults for some of the prevailing
psychiatric disorders (schizophrenia, anxiety, and depression).
2.
To improve the quality of mental health services for psychological, behavioral, and learning
disorders of children and adolescents.
3.
To reduce the incidence of substance dependence and its harmful consequences.
Genetic Diseases
1.
Provision of effective preventive measures and developing Molecular Genetic technology
expertise capable of supporting local effective prevention programs.
2.
Improving the quality of the services provided in the field of genetic health.
3.
Provision & expanding of premarital examination to reduce the prevalence of genetic diseases
and congenital malformation.
4.
To raise the public awareness of genomic technology and its benefits. To continue genomics
education, capacity building and training in new technologies;
15
Environmental and Occupational Health
1.
To reduce the environmental and occupational health morbidity and mortality.
Accidents and Injuries
1.
To decrease morbidity and mortality and disability resulting from the accidents and medical and
public health emergencies.
Woman Health
1.
2.
Expansion in the provision of Reproductive Health services package in the Ministry of Health'
Facilities.
Improving Reproductive practices in the community.
Child Health
1.
2.
3.
To reduce childhood mortality and morbidity rates with focus on neonates, infants and
children less than 5 years of age.
To improve quality of health services provided to children with a focus on:
 Children with special needs.
 Children with chronic illnesses.
 Children victims of maltreatment.
To enhance coordination between different domains related to child health at a central
level.
Elderlies Care
1.
To promote elderlies care service for elderlies population who can reach to PHC institutions and
those who cannot reach to improve their quality of life.
2.
To empower PHC institutions to provide elderlies care services.
3.
To raise the awareness of the community about the importance of elderlies care service to
encourage their contribution in this service.
Health Education and Communication
1.
Developing and improving the health education services.
2.
Developing the skills and building the capacity of MOH staff working in the field of health
education.
3.
Increasing health awareness, targeted at changing unhealthy attitudes and practices and
promoting healthy lifestyles and behaviors in the community.
Adolescent and Youth Health
1. To promote the role of primary health care in providing services appropriate for adolescents and
youth in all regions of the Sultanate.
2. To increase awareness about adolescents and youth issues in order to promote healthy lifestyles
in all regions of the Sultanate.
16
School and College Health
1. To promote healthy lifestyles among all categories of the school community in all regions of the
Sultanate.
2. Development and expansion of efficient, high quality, and comprehensive health services to
all school community in all regions of the Sultanate.
3. To promote the health of students in higher educational institutions in all regions of the
Sultanate.
Nutrition
1. Promotion of food and nutrition policies and strategies.
2. Promotion and management of infant and young child nutrition.
3. Control of micronutrients deficiency among the whole population.
4. Improve nutrition and dietetics services in all health institutes.
5. Support of food safety systems in coordination with other sectors.
Community Participation
1. Implementation of health promotion strategy.
2. Improve the mechanisms of community participation.
Health Management
1. Improvement & activation of performance practices within the health care system.
2. Activation of decentralization.
3. Equal/Balanced distribution of Human and material resources.
Health Information and Statistic
1. Provide comprehensive data and information to meet the needs of the health system.
2. Improve the quality of the health information system outputs.
3. Ensure optimal use of the health information by health workers.
Health Research and Studies
1. Provision of data and information that are required by health system through conducting
researches and studies by the domains.
2. To develop technical capabilities and skills of Health Research Teams on research
design, methodology and other skills.
3. To develop and improve the capacity of research users at different levels to utilize
information as a tool for evidence-based planning and management.
4. To develop and strengthen the infrastructure of Health Research System (HRS) and
ensure its high quality.
17
Information Technology
1. To expand the digital infrastructure in various administrative and health institutes and
consolidate ALSHIFA system among various health institutions.
2. To support IT staff.
3. To activate the electronic communication within the health system.
4. To provide e-services through the website of the Ministry.
5. Access to unified national electronic health records for the patient.
Human Resources Development and Omanization in the Health Field
1. To provide adequate and equitable numbers of trained manpower to all MoH institutions.
2. Accelerate the process of manpower appointing and recruitment.
3. Reduce the number of resignations in all job categories especially in medical and Paramedical job categories.
4. To train Omani health cadres in various health fields.
5. To Develop Continuing Education further in MoH.
6. Development of the learning resources infrastructure.
Health Educational Institutions in Ministry of Health
1. To improve and implement the Quality Assurance schemes in the Health Educational
Institutions.
2. To improve the academic programs to conform with the national frames, standards and
trends of higher education and professional practice.
3. To improve the infrastructure of the Health Educational Institutions, so that it meets the
demands of higher education.
4. To continue developing the capabilities and skills of the teaching staff and the
administrative staff and retain qualified staff.
5. To enhance the capabilities and skills of the teaching staff and students on approach and
methodology of scientific research.
6. To promote the academic and the student relationships with other universities and
colleges, nationally and internationally.
Health Services for the Private Health Sector
1.
Strengthen and enforcing the legislation and laws governing the work of the private
health sector.
2.
Developing the inspection and monitoring system of private health establishments.
The following chapters represent the National Strategic Plan of the 8th
Five-Year Plan for Health Development of Sultanate of Oman for the Year
2011 to 2015.
18
Chapter four
Domains of the Eighth
5-Year Plan for Health Development
(2011 – 2015)
19
Vision One
Delivery of High Standards of Health Care
to the Community
20
Domain One
Primary Health Care
21
Vision: Delivery of High Standards of Health Care to The Community
Goal: Developing Pillars of The Health System
Domain: Primary Health Care
INTRODUCTION:
Primary health care is the first entrance for all levels of health care (secondary and
advanced) and establishes a link between community and health care providers. After Alma
Ata Declaration in 1979, Ministry of Health in the Sultanate committed itself that the primary
health care is the strategy to achieve the goal of health for all and improve the health
indicators which are vital to the Omani society. And also the primary health care services
provided through health centers, polyclinics and local hospitals is the essential foundation for
health care which is an integral part of comprehensive health system, which aims to assist in
the social and economic development of the individuals and society as a whole.
A major development in the infrastructure of primary health care institutions in the
Sultanate during the last five-year plans, where the number of primary health care institutions
by the end of 2010 were 207. Of which (154) health centers and (22) extended health centres
and (31) local hospitals. Out of the ministry's keenness to facilitate access for the individual
and society to provide health care with ease, the ministry adopted through the five-year
plans the establishment of health centers and polyclinics in order to reach, a health center per
10,000 population, and attract these institutions about 85% of the total OPD attendance of the
health system in the Sultanate, reaching visits to primary health care institutions, about 12
million visits during 2010. It has been supported by the existing institutions with the latest
equipment and medical devices and the provision of medical staff, technical, and
administrative requirements to suit the healthy development while providing opportunities for
internal and external training and continuing education for them. As a result of the presence
of various integrated health programs in the primary health care to serve the community has
enhanced the development of quantitative and qualitative primary health care services. The
increase of primary health care institutions with easy access and the implementation of
programs have great impact on the citizens.
With a change in the pattern of disease the method of providing service in these centers
has changed where, it became eligible to provide a comprehensive service for chronic
diseases through the integration of specialist clinics for diseases such as diabetes, blood
pressure, kidney disease and mental health into primary health care services, taking into
account the training of doctors to deal with these diseases.
OBJECTIVES:
1. To strengthen the PHC infrastructure.
2. To provide high quality PHC services to the community.
22
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
0.68
0.75
0.84
4
6
8
0.2
0.35
1
7.9
9
12
0.48
0.6
1
1.57
2.2
3
0.99
2.0
3
0.5
1
1
0.28
0.35
0.75
0.52
0.6
2
First Objective’s Indicators: To strengthen PHC infrastructure
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Rate of health centers per 10000
population.*
Rate of PHC doctors per 10000
population.*
Rate of family physician per 10000
population*.
Rate of PHC nurses per 10000
population.*
Rate of PHC dentists per 10000
population.*
Rate of PHC assistants pharmacists per
10000 population.*
Rate of PHC lab. Technicians per
10000 population.*
Rate of PHC radiographers per 10000
population.*
Rate of PHC dietitians per 10000
population*.
Rate of PHC health educators per
10000 population*.
Second Objective’s Indicators: To provide high quality PHC services to the Community
1.
2.
3.
4.
5.
6.
7.
8.
Percentage of PHC institutions that
implement PHC SOP for general
layout.
Percentage of PHC institutions that
implement PHC SOP for furniture&
equipments.
Percentage of PHC institutions that
have network connection to upper
health care level.
Percentage of PHC institutions that
have network education services.
Percentage of PHC institutions that
have clinical SOP for the management
of emergencies.
Percentage of PHC institutions that
implement staff norms guideline.
Percentage of PHC institutions that
implement
quality
assurance
programme.
Percentage of doctors that have ACLS.
23
NA
15%
60%
15%
60%
22.8%
40%
0
0
50%
NA
NA
NA
NA
60%
NA
15%
60%
20%
75%
90%
NA
2%
20%
Indicators
9.
10.
11.
12.
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
NA
4.6%
55%
NA
5%
50%
10%
15%
50%
7%
30%
60%
Percentage of PHC institutions that
implement elderlies care programme.
Percentage of doctors enrolled in the
GP training programme.
Percentage of PHC institutions that
conduct patient satisfaction surveys.
Percentage of PHC institutions that
conduct staff satisfaction survey.
* MoH institutions only.
* PHC institutions include: health centers, polyclinics and local hospitals.
STRATEGIES:
Strategies to Achieve 1st Objective: To strengthen PHC infrastructure.
1.1 Completion & strengthen PHC services coverage.
Expected results:

Increase in the number of health centers and service users‟ attendance.
1.2 Improve and develop PHC institutions (equipment, laboratory service).
Expected results:

Standard PHC services.
1.3 Determine the catchments’ area for all PHC.
Expected results:

Determination of all catchments‟ area for all PHC institutions.
1.4 Strengthen PHC institute with the required manpower.
Expected results:

PHC institutions covered with the required staff as per (staff Norms).
1.5 Continuing to introduce preventive programmes and early detection of cases (including
chronic diseases) in PHC services.
Expected results:




Proper follow-up of the cases.
Early detection of chronic diseases cases.
Comprehensive and continuous care.
Reducing the expenses of the higher level of care.
1.6 Providing a proper elderlies health care system that meets their health need.
Expected results:


Reduction of the morbidity rates among the elderlies age group.
Early detection of elderlies and senile diseases and their complications.
24
Strategies to Achieve 2nd Objective: To provide high quality PHC services to the
community.
2.1 Revising PHC SOP.
Expected results:

Revised SOPs.
2.2 Reviewing standards of PHC institutes structure & layout.
Expected results:

Specific standards for the PHC structures.
2.3 Revising the standards for the manpower.
Expected results:

Revised Standards for staff norms.
2.4 Revising the standards for the equipments and furniture.
Expected results:

Revised standard list of equipment.
2.5 Implementing effective network connection with the upper health care level.
Expected results:
 Easy transfer of data between the two levels.
 Smooth referral and feedback.
2.6 Training of PHC physicians on family medicine.
Expected results:
 Improved patients‟ satisfaction.
 Enhanced clinical knowledge for PHC physicians.
 Reduces the number of referred cases to upper health care level.
 Reduced re-visits.
2.7 Promoting leadership and administrative skills for all technical staff at PHC institutions.
Expected results:
 PHC staff with leadership and management skills.
 Effective Leaders at the Wilayate and PHC centers level.
2.8 Training PHC staff on communication skills.
Expected results:
 Health care team equipped with communication skills.
2.9 Training of PHC physicians on ACLS.
Expected results:



Competent PHC physicians.
Reduced mortality due to cardiac causes at PHC.
Reduced complication.
25
2.10 Introduce e-learning in primary health care institutes.
Expected results:

Up-to-date guidelines and evidence based in the computer system.
2.11 Conduct patients & staff satisfaction surveys.
Expected results:

Know level of satisfaction.
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Rate of Health Centers per 10000 population.*
Annually
0.75
0.84
1.2a
Percentage of the PHC institutes that have
renewed their equipments.
Annually
25 %
50 %
1.3a
Percentage of Health Centers with active
catchments‟ areas system.
Annually
30 %
60%
1.4a
Percentage of PHC institutes with complete
manpower according to staff norms.
Annually
NA
60%
1.5a
Percentage of PHC institutes that covered 80%
from the total target for the chronic diseases
screening programme (above 40 years)
Annually
37%
70%
1.6a
Percentage of PHC
elderlies care services.
Annually
4.6%
60 %
1.7a
Percentage of PHC institutions that have
completed the equipment and devices.
Annually
Nil
100%
institutions providing
Indicators of Strategies of the 2nd Objective
2.1a
Percentage of PHC institutions that have
updated clinical SOP according to standards.
Annually
NA
40%
2.2a
Percentage of PHC institutions that follow PHC
standard for the general layout.
Annually
15%
60%
2.3a
Percentage of PHC institutions that follow PHC
standard for the equipment.
Annually
20%
60%
26
Indicators
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
2.3b
Percentage of PHC institutions that follow PHC
standard for the furniture.
Annually
20%
55%
2.4a
Percentage of PHC institutions that follow PHC
standard for the staff norms.
Annually
NA
60%
2.5a
Percentage
of
PHC
computerized system.
Annually
83%
96%
2.5b
Percentage of PHC institutions connected by a
network with higher level of care.
Annually
22.8%
40 %
2.6a
Percentage of health centers implementing
family folder.
Annually
15%
50%
2.7a
Percentage of PHC staff trained on leadership
and management.
Annually
20%
60 %
2.7b
Percentage of health workers covered by
Continuous Medical Education (CME).
Annually
30 %
60%
2.8a
Percentage of PHC
communication skills.
Annually
30%
60 %
2.9a
Percentage of physicians trained on ACLS.
Annually
5%
20 %
2.9b
Percentage of physicians trained on SOP for
emergency cases& injury management.
Annually
2%
20 %
2.10a
Percentage of PHC institutions that have
network education services.
Annually
Nil
20%
2.11a
Percentage of the Wilayate that conducted
patient satisfaction survey.
Annually
40%
60%
2.11b
Percentage of the Wilayate that conducted staff
satisfaction survey.
Annually
30%
60%
institutions
staff
with
trained
* MoH PHC institutions only
27
on
Domain Two
Secondary and Tertiary Health Care
28
Vision: Delivery of High Standards of Health Care to The Community
Goal: Developing Pillars of The Health System
Domain: Secondary and Tertiary Health Care
INTRODUCTION:
Ministry of Health has exercised all its efforts to achieve the set objectives of previous
years, through developing and establishing health care plans for curative and preventive
programs, and further developing human resources in the health sector. To achieve its main
objective of provision of optimum level of health care, the Ministry has committed itself and
worked to ensure the appropriate distribution of health facilities for easy / fast access and
respond to its citizens‟ expectations and their health and health related requirements.
Hospitals constitute the critical component of health care delivery system in Oman
and provide secondary and tertiary care services; in addition they also contribute substantially
to primary health care services, either directly or indirectly, with an access to these services.
The health care services have developed considerably over recent years, in 1970 there were
only two small hospitals with 12 inpatient beds, and in 2010 it increased to 50 hospitals with
4692 beds. MoH may adopt new methods and tools in the management of health facilities
with a focus to improve the standards and quality of health services offered in the hospitals,
to keep in pace with the continuous development of health care management and the
provision of health care services. In this context the Ministry of Health launched national
programs to support the hospitals with an aim to reinforce delivery or quality of health
services provided by MoH hospitals, and to facilitate optimum utilization of available
resources of financial, human, information by applying improved management techniques
and tools in planning, organizing, directing and monitoring.
The Ministry also initiated Hospital Autonomy to some of the regional hospitals to
enhance and improve quality in provision of health care services. After years of overall
development and ongoing work and laying the stepping stones on health systems in Sultanate,
it is very obvious that there is a need to assess and evaluate the networking of the specialized
care services and to consider expansion of hospital services to keep in pace with the medical
and technological advancements, and also the increasing population and the growing needs of
the community.
During last few years the Sultanate experienced severe climatic changes, and events
associated with these, affected the infrastructure of health facilities. All efforts to be
exercised to develop, improve and enhance readiness of the Secondary and Tertiary care
health facilities in providing the services seamlessly during such emergencies and crisis and
ensure continuity of provision of health care.
OBJECTIVES:
1. To develop the infrastructure of the hospitals.
2. To Improve and expand secondary and tertiary health care services.
3. To develop and improve the readiness of hospitals to respond to emergencies and
disasters.
29
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To develop the infrastructure for hospitals.
Number of secondary health care
hospitals established during the years
1.
NA
NA
2
of the plan. (Muscat General H.,
Suwaiq H.).
Number of secondary and tertiary
2.
hospitals refurbished / expanded
NA
NA
3
(Khoula H., Samail H., Khasab H.).
3- Number of secondary care hospitals
3.
(Willayat Hosp.), replaced during the
NA
NA
3
years of the plan.
Second Objective’s Indicators: To improve and expand secondary and tertiary health care.
Services
Number of Regional hospitals with the
1.
NA
2
4
availability of tertiary care services.
Number of hospitals in which the
2.
computer systems are upgraded to Al
NA
1
11
Shifa 3+.
Availability of accreditation system in
System
3.
NA
NA
secondary and tertiary care hospitals.
available
Number of Regional hospitals linked
4.
NA
4
8
with tertiary care hospitals.
Third Objective’s Indicators: To develop and improve the readiness of hospitals to respond
to emergencies and disasters.
1.
2.
3.
Number of hospitals with updated plan
for emergencies and disasters response
Availability of a national plan for
emergency and disaster response.
Number of hospitals (Wilayat) in which
emergency departments have been
refurbished (Khoula H., Sinaw H.,
Saham H., Sumail H., Khasab H.).
30
0
8
19
NA
NA
Plan
Available
0
0
5
STRATEGIES:
Strategies to Achieve 1st Objective: To develop the infrastructure of the hospitals
1.1 To establish secondary health care hospitals to cope with the increased demand for
secondary and tertiary care services.
Expected results:

Increase in the number of secondary health care hospitals (Wilayats).
1.2 To refurbish secondary health care hospitals in Wilayats.
Expected results:

Provide good standard health care services in safe and healthy environment.
1.3 To study on the bed occupancy rate in various departments of the hospital.
Expected results:

Identify services for expansion at priority.
1.4 To increase the number of beds in critical care units (ICU, PCU, CCU, SCBU)
Expected results:

Provide better services for patients in critical care areas.
1.5 To conduct an evidenced based study to assess the actual needs for the specialized
health professionals.
Expected results:

Availability of adequate number of specialized health professionals to ensure continuation of
medical services and reduce the work pressure on existing staff.
 Identify deficiencies in the distribution of medical staff to hospitals.
1.6 To develop a plan for each hospital to replace or acquire the medical equipment.
Expected results:
 Speed up the process of replacing / acquiring medical equipment.
 Ensure continuation of medical services requiring the use of medical equipment.
1.7 To provide equipment as per the priorities determined by each hospital.
Expected results:


Availability of resources as per hospital needs.
Delivery of better health care services to patients.
Strategies to Achieve 2nd Objective: To develop and expand health care services secondary
and tertiary.
2.1 To establish National clinical teams / committee for various specialties.
Expected results:

Availability of a reference for various medical specialties.
31
2.2 To provide adequate financial budget for training and education to enhance the skills of
the medical staff in management of patients.
Expected results:
 Availability of medical staff with enhanced skills in delivery of quality health care.
 Improved and enhanced health care services provided to the clientele.
2.3 To expand health care services as per the evidence based by the secondary and tertiary
care hospitals.
Expected results:

Fast / easy access to the specialized health care in secondary and tertiary care health
facilities.
 Increased satisfaction of the clientele in the specialized services provided by the secondary
and tertiary care referral hospitals.
 Reduce the workload on tertiary health care hospitals.
2.4 To provide telemedicine in the regional hospitals.
Expected results:
 Optimal use of available resources in hospitals.
 Use modern technology to enhance delivery of health care services in hospitals.
2.5 Number of wilayat hosptials linked completely with tertiary care hospitals.
Expected results:
 Optimal utilization of available resources.
 Speed up and facilitate transfer of patients and information between hospitals.
 Improve referral feedback between hospitals.
2.6 To develop national standards for patient safety in hospitals.
Expected results:
 Improved patient safety standards in hospitals.
 Improved satisfaction of the patients with the services provided by the hospitals.
 Reduce morbidity related to patient safety in hospitals.
2.7 To launch a campaign targeting community / health workers to build trust / confidence
in the health care services provided by the hospitals.
Expected results:


High level of satisfaction of patients on health care services provided by the hospitals.
Improved confidence of community on the capabilities of the medical staff providing health
care services.
 Improved channels of communication with the community.
2.8 Training of Administrative Leaders in hospitals in the area of strategic management and
planning and resource management.
Expected results:
 Improved management process in hospitals.
 Availability of expert trained and qualified administrators in the basics of hospitals
management and administrative skills.
32
2.9 Training doctors and nurses on the basics of principles of patient safety.
Expected results:
 Availability of medical staff with expertise in principles of patient safety.
Strategies to Achieve 3th Objective: To develop and improve the readiness of hospitals for
emergency and disaster
3.1 To develop a health plan at national level to respond to emergencies and disasters.
Expected results:
 Availability of a national plan to respond to medical emergencies and disasters.
3.2 To develop a plan to respond to emergencies and disasters at the level of secondary and
tertiary care hospitals.
Expected results:
 Availability of a hospital plan to respond to emergencies and disasters.
3.3 Training of medical staff in emergency and other departments on cardio pulmonary
resuscitation (ACLS).
Expected results:

Availability of medical staff in emergency and other departments to manage cardiac patients
efficiently and effectively.
 Better services to cater cardiac patients.
3.4 Training of medical staff in emergency and surgical departments on the management
of Trauma cases (ATLS).
Expected results:

Availability of medical staff in emergency and surgical departments to manage patients with
trauma and accidents efficiently and effectively.
 Availability of medical staff acquired with management of accidents and injuries.
 Better services for the management of accidents and injuries.
3.5 Training health workers on crisis and disaster management programs.
Expected results:
 Availability of qualified staff in hospitals to manage crises and disasters.
3.6 To provide required equipment to respond to emergencies and crisis.
Expected results:
 Enable hospitals to respond effectively and efficiently to emergencies and crisis.
3.7 To establish command centre with provision of all required tools during emergencies
and disasters.
Expected results:

Availability of command centre to manage and liaise with concerned health facilities to
manage emergencies and disasters efficiently and effectively.
33
3.8 To create centralized health information data base to respond during emergencies and
disasters.
Expected results:
 Provide basic information to respond to emergencies and crises.
3.9 To establish trauma centers in priority areas.
Expected results:

Provide better services for the management of injuries and accidents.
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
1.2a
Availability of study on Bed occupancy rate in
specialty departments.
Number of hospitals being renovated during the
plan.
Annually
NA
Study
available
By the
end of the
current
Plan
NA
25% of the
hospitals
1.3a
Availability of study to assess the actual need of Annually
the hospitals for medical professionals.
NA
Study
available
1.4a
Number of critical bed added in (ICU, CCU, Annually
PCU, and SCBU).
NA
25% of the
hospitals
1.5a
Availability of study to assess the actual need of Annually
the hospitals for medical staff.
1.6a
1.6b
NA
Availability of a plan for each hospital to Annually
replace / upgrade or acquire medical equipment.
NA
Percentage of condemned equipment replaced Annually
with new equipment.
NA
Study
available
Availability
of plan for
all hospitals
100%
Indicators of Strategies of the 2nd Objective
2.1a
Availability of clinical teams / committees of Annually
various specialties in hospitals.
1
Availability
of clinical
teams /
committees
2.2a
Availability of adequate financial allocation for Annually
training.
Not
adequate
Adequate
budget
34
Indicators
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
Annually
2
8
0
2
2.3a
Number of hospitals with laparoscopic services.
2.3b
Number of hospitals
catheterization.
2.3c
The number of hospitals with day-care services Annually
devices.
3
All regional
hospitals
2.3d
Number of hospital services providing Pediatric Annually
Surgery.
2
4
2.4a
The number of hospitals with the provision of Annually
telemedicine.
0
8
2.5a
Number of regionals / wilayat hospitals linked
with tertiary care hospitals.
4
All regional
and Wilayat
hospitals
2.5b
Number of Secondary and Tertiary Care Annually
hospitals linked with the primary health care
facilities in the regions.
2
All Regional
hospitals.
NA
Availability
of patient
safety
standards
NA
Availability
of a plan
13%
80%
NA
25%
providing
cardiac Annually
Annually
Annually
2.6a
Availability of national standards for patient
safety in hospitals.
2.7a
Availability of a plan to build trust / confidence Annually
in community on the services in hospitals.
2.8a
2.9b
Percentage of administrative leaders trained in Annually
strategic management, leadership.
Percentage of doctors and nurses trained in the basic Annually
principles of patient safety.
Indicators of Strategies of the 3rd Objective
3.1a
3.2a
3.3a
Percentage of staff trained in the management of Annually
crises and disasters.
Annually
Availability of health Plan at all regional hospitals to
respond to emergencies and disasters.
Percentage of staff trained on CPR programs Annually
(ACLS). (Doctors and nursing staff of emergency
departments and the first on call doctors in other
departments).
35
1.5%
04%
NA
Availability of
the Plan at all
regional
hospitals
17%
50%
Follow
up
timing
Indicators
3.4a
3.5a
3.6a
3.7a
3.8a
3.9a
Percentage of staff trained on management of Annually
trauma
and
injuries
(ATLS)
(Doctors and nursing staff of emergency
departments, Surgical departments and first on call
doctors in other departments).
Annually
Number of staff trained in disaster management.
Availability of National command center for crisis Annually
management operations and disaster equipped with
the required tools.
Availability of command centre in all regional and Annually
tertiary care hospitals equipped with required tools
to manage emergencies and crisis.
Annually
Availability of health information data base for
emergency response and crisis management.
Current
situation
Targeted
situation
2010
2015
< 1%
25%
NA
200
NA
Availability of
the Center
NA
Availability of
the Center
NA
Annually
Availability of trauma centers in priority areas.
36
NA
Availability of
the
information
base
Availability
of the Center
(2)
Domain Three
Pharmaceutical Care
37
Vision: Delivery of High Standards of Health Care to The Community
Goal: Developing Pillars of The Health System
Domain: Pharmaceutical Care
INTRODUCTION:
Pharmaceutical care is a responsible provision of drug therapy to all patients for the
purpose of achieving definite outcomes that improve a patients quality of life, through curing
disease or eliminating / reduction of patient‟s symptoms / arresting or slowing a disease
progression or preventing a disease or symptoms, this will normally be done through setting
and implementing curative & and preventive plans, and monitoring the medication use
outcomes, in order to achieve the set goals, and improve patients quality of life through
rational & cost-effective use of medicines. And to ascertain drug use related problems.
In view of the Sultanate achievements in different health care sectors which make it
important for the pharmacy practice to accompany such development and work in line with
the health system requirements that compliant with changes in methods of providing health
care, which needs qualifying of pharmacists for acquiring the fundamental pharmaceutical
care standards, and caring for patients therapy outcomes and safety, this can be reflected by
provide the patients with safe and effective medications that comply with standard quality &
specification.
In pursuit of Ministry‟s policy towards caring & developing the pharmaceutical care
services the ministry adopted the pharmaceutical care program within the six fifth year health
development plan programs (2001-2005) as pharmaceutical care is considered an essential
and integral element in health care.
One of the positive indicators that show the commitment of the state to make the
financial resources available to meet this vital element is allocation of about 20% of the total
MoH budget towards medicinal expenditure, due to the importance of making available
effective and safe medicines for patients‟ health. With this end in view, MoH has
successfully implemented the procurement system for drugs through, open international and
local tenders and also by participating efficiently in GCC joint tenders. The Executive Board
of GCC Health Ministers Council too has approved certain set of guidelines for drug
procurement policy from generic companies, which helps acquisition of drugs at competitive
rates within the acceptable quality specifications. Another area of consideration was the
establishment of standard warehouses for storage of drugs, in accordance with the required
good storage conditions.
In respect of increased drugs treatment costs and increased number of specialised
medications, which make the participation of pharmacist within the medical team is of vital
importance, for introducing the pharmaceutical care concepts which will assure the quality of
services provided and maintain patient safety through rational utilization of the available
resources, keeping in mind the success of pharmaceutical care program will be reflected
positively on all health care programmes within the five-year plan since the drugs are
considered as a common element in all health and therapy programmes.
Accordingly the support of pharmaceutical manpower in primary care level, as per
service requirements and in secondary & tertiary level, on bed capacity basis, is considered as
the fundamental element to provide an integral and comprehensive pharmaceutical care. This
38
should be reflected positively on all health Programmes within the five-year plan since the
drugs are considered a vital & common element in all these Programmes.
OBJECTIVES:
1.
2.
3.
4.
To assure that patients are provided with safe and effective drugs, at reasonable costs.
To ensure the quality of pharmaceutical services provided.
To enhance the medication safety programs.
To accomplish rational drug use in all institutions.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To assure that patients are provided with safe and effective
drugs, at reasonable costs
Number of the negative reports on
1.
27
20
>10
drug quality.
Number of health institutions with
insufficient storage space and that does
2.
52
42
zero
not
comply
with
required
specifications.
Number of drug batches analyzed by
3.
NA
1075
1200
the central Quality Control Laboratory
for MOH governmental institutions.
Number of drug batches analyzed by
4.
NA
62
400
the central Quality Control Laboratory
for private institutions.
Second Objective’s Indicators: To Ensure the quality of pharmaceutical services provided
1.
2.
3.
4.
5.
6.
Percentage of referral hospitals that
have established Drug Information
System.
Percentage of Government Health
institutions that apply medications
counseling system.
Percentage of the private/community
pharmacy that apply medications
counseling system.
Average number of clinical pharmacy
in hospitals with respect to bed
capacity.
Average Number of Pharmacists in
hospitals with respect to the total
Number of patients.
Average number of pharmacists in
primary healthcare institutions with
respect to the Number of patients.
39
NA
10%
100 %
NA
11%
50%
NA
NA
20 %
1:4542
1:244
1:50
NA
1:109
1:60
1:1300
1:600
1:150
Indicators
Average
number
of
Assistant
pharmacists in primary healthcare
7.
institutions with respect to the Number
of patients.
Percentage of hospitals applying
8. quality assurance standards in
pharmaceutical care.
Percentage of MOH Health institutions
having a comprehensive electronic
system for medicine management,
9.
which covers (prescribing, dispensing,
issuing, and material management
processes).
Percentage of asthmatic patients who
given medication counseling on their
10.
inhalation devices techniques, prior
leaving their health facility.
Number of field visits for each private
11.
pharmacy per year.
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
1:120
1:50
1:30
NA
NA
100%
73%
80%
100%
NA
NA
50 %
Unrecorded
1.2
2
Third Objective’s Indicators: To enhance the medication safety programs
Percentage of health institutions where
medication safety programs are
NA
NA
50 %
applied.
2.
Number of ADRs reports.
320
653
1000
Number of referral hospitals having
guidelines manual, for safe handling of
All referral
3.
NA
NA
dangerous drugs (cytotoxic & radiated
hospitals
isomers).
Fourth Objective’s Indicators: to accomplish rational drug use in all institutions (All
indicators are set to Primary Health Care level)
Average number of drugs per
2.7
< 2.5
< 2.5
1.
prescription.
1.
2.
Percentage of prescription consists of
Antibiotics.
46%
< 30%
< 30%
3.
Percentage of drugs dispensed out of
the prescribed ones.
97%
98%
98%
4.
Percentage of patients who understand
the instruction for the use of their
medications
while
leaving
the
pharmacy.
Unrecorded
72%
85%
5.
Average time for dispensing a
prescription in minutes.
NA
2.23
5
40
STRATEGIES:
Strategies to Achieve 1st Objective: To assure that patients are provided with safe and
effective drugs, at reasonable costs
1.1 Organizing acquainting symposiums for all health professionals with regard to the
drugs quality monitoring programs.
Expected results:
 Ensure quality and efficiency of medicines.
1.2 Training of pharmaceutical manpower to follow scientific methods in forecasting the
requirements, and for inventory control.
Expected results:
 Ensure medicines availability continuously in sufficient quantities at the appropriate timings.
 Minimize overstocking and expiration of drugs.
1.3 Supports drug procurement policy from generic companies as per the required quality
specifications.
Expected results:

Ensure optimum utilization of available financial resources.
1.4 Determine the designs spaces & specification of pharmacies and drug stores at all
health institutions according to the good storage conditions requirements.
Expected results:

Storage of drugs within the required storage conditions to maintain efficacy during the entire
shelf life.
1.5 To make available of all instruments and equipment required for storing medicines
and medical items according to the good storing conditions standards.
Expected results:

Follow-up and monitoring the stored medicines and medical items at all Health institutions to
ensure preserving their efficacy throughout their storing time.
1.6 Linking the central medical stores with the medical stores at health Units via
computerized system and expansion of electronic prescribing.
Expected results:
 Efficient inventory control.
1.7 Establishment of DGMS sub stores at the remaining regions.
Expected results:
 To ensure close availability of medical supplies to all health institutions.
1.8 Set up a national plan for importing biological products.
Expected results:

Ensure procurement of safe and high quality products.
41
Strategies to Achieve 2nd Objective: To ensure the quality of pharmaceutical services
provided
2.1 To setup standards for pharmacy staff requirements at different levels of health
Institution.
Expected results:

Ensure the provision of comprehensive pharmaceutical care services for all targeted
categories.
2.2 Setup an approved training and qualification programs for pharmacy staff in different
pharmaceutical care domains.
Expected results:
 Improved quality of pharmaceutical services provided.
2.3 Establishment and development of drug information services in all referral Hospitals.
Expected results:

Accessible up-to-date efficient drug information for all medical professionals & patients.
2.4 Set up roles & guidelines for drug promotion.
Expected results:

Provision of all medical professionals with unbiased medicine information, which help in
achieving the optimum therapeutic outcomes.
2.5 Prepares and update written manuals, for standard operating procedures for various
issues in pharmacy practices.
Expected results:
 Standardization of operating procedures in all health units.
 Offering a high quality pharmaceutical service.
2.6 Providing medicine-counseling places in pharmacy departments at secondary &
tertiary healthcare levels institutions.
Expected results:

Increase the percentage level of patients acquainted with proper knowledge to use the
prescribed drugs.
 Minimizing the drug related problems for this patient‟s category.
2.7 Determine the hospital pharmaceutical care quality standards.
Expected results:

Identify the quality of pharmaceutical care provided in health institutions.

Ensure the quality of pharmaceutical care provided.
42
2.8 Updating the policies and procedures for dealing with narcotics and controlled drugs at
all healthcare levels.
Expected results:


To ensure safe utilization and disposal for narcotics and controlled drugs.
Exactitude the control of Narcotics other controlled drugs, through monitoring the
implementation of policies and procedures in dealing with this group of drugs & to minimize
their misuse.
2.9 To establish an evaluation standards for profession competencies in pharmacy
practice.
Expected results:

Existence of pharmaceutical manpower with high profession competencies standards at both
government & private sectors.
 Existence of unified standards for the evaluation of professional competencies in pharmacy
practice.
2.10 To Qualify and train pharmacists in the field of pharmaceutical care quality
standards.
Expected results:
 Enhance the concepts quality in pharmaceutical care.
 Presence of qualified pharmaceutical manpower in the field of quality.
 Ensure the quality of pharmaceutical care services provided.
2.11 To Qualify and train pharmacists in the field of patient counseling for the targeted
groups of chronic patients.
Expected results:
 Improve drug therapy outcomes.
 Establish pharmaceutical care concepts awareness among public & Health professional.
2.12 To Qualify and train pharmacists in the field of drug information.
Expected results:
 Existence of qualified pharmaceutical manpower for provision of drug information.
 Accessible up to date efficient drug information for all medical professionals & patients.
2.13 Determine quality standards for assessment of pharmaceutical services quality in
private pharmacies.
Expected results:

Existence of quality standards for assessment of pharmaceutical services quality in private
pharmacies.
2.14 Conduct study to evaluate the performance of pharmaceutical services in the private
pharmaceutical sector by the concern authorities.
Expected results

Strengthen the role of the private pharmaceutical sector in the provision of pharmaceutical
care.
43
Strategies to Achieve 3rd Objective: To enhance the medication safety programs.
3.1 Assessment of the current medication safety situation at health institutions.
Expected results:
 Ascertain the aspects of deficiencies in medication safety functional systems.
 Existence of quality standards for assessment of medication safety in health institutions.
3.2 Establishing the aims and strategies for medication safety programs.
Expected results:
 Minimization of medication errors.
 Promotion of patient medication safety programs.
3.3 Conduct symposiums & orientation meetings about Pharmacovigilance.
Expected results:

Complete awareness of pharmacy staff with concepts of medication safety &
Pharmacovigilance.
3.4 Formation of Medication safety committees at hospitals & regions level.
Expected results:
 Implementation of Medication safety proactive & interactive programs.
3.5 Setup approved standards to ensure the safety of sterile & non-sterile pharmaceutical
preparation.
Expected results:
 Assurance of the quality and safety for sterile & non-sterile pharmaceutical preparation.
3.6 Set a program for monitoring and documenting the medication errors and categorizing
them according to the level of risk.
Expected results:
 Enumeration of medication errors and determination the level of risk.
 Control the incidences of medication errors.
3.7 Organization of training courses in the medication safety scope.
Expected results:
 Boos up the medication safety programs.
3.8 To Qualify and train pharmacists in the field of medication safety.
Expected results:

Acquisitioning the pharmacy staff with the knowledge and skills required for implementing
the medication safety programs.
44
3.9 Reviewing & analyzing the ADRs reports and set up the necessary recommendations to
minimize the adverse effects.
Expected results:


Reduction of adverse effects complications.
Increase the health professional awareness about the importance of monitoring & reporting
ADRs.
3.10 Conducting studies and research in the field of drug use evaluations.
Expected results:


Establish a pharmaceutical research system for conducting research and study in the field of
drug use evaluations.
Updated therapeutic manuals and protocols.
Strategies to Achieve 4th Objective: To accomplish rational drug use in all institutions
4.1 Training all health care providers in the field of rational drug use.
Expected results:



Enhancement of the rational drug use concepts.
Rational prescribing of drugs.
Acquainting the health professionals with required skills to conduct studies in the field of
rational use of drugs.
4.2 Compile and implement strategies and Programs for public health education
concerning the rational drugs use.
Expected results:
 Improve the public awareness about the risks of drug misuse.
 Boosting the positive behavior of public towards the rational use of drugs.
4.3 Preparation of guidelines and advices on medication use to be handed over to patients.
Expected results:
 Acquaintance of patients with guidelines and advices related to medication use.
 Enhance patients‟ compliance to medication use.
4.4 Establishing a system for monitoring the patterns of prescribing in health institution.
Expected results:

Reduction of medication errors.
45
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Number of orientation sessions in quality
reporting program for health care
providers.
Annually
1
10
1.2a
Number of training sessions for
pharmaceutical manpower to follow
scientific method in forecasting and
inventory control.
Annually
2
15
1.3a
Percentage of drugs value purchased
from generic companies compared to that
purchased from patent companies
Annually
43%
55%
Annually
42
Zero
Annually
Manual
available but not
approved
50%
Manual
available and
approved
100%
Annually
2
4
End of
year 2012
Plan NA
Existence of
implemented
plan
1.4a
1.5a
1.6a
1.7a
1.8a
Number of Health units with insufficient
storage space, or with storage area that
not comply with the good storage
specifications, for storing medicine and
medical items.
Existence of a guideline manual for
storing medicines according to good
storage specifications.
Percentage of Health units with
electronic-link to the central stores.
Existence of sub stores at regions &
districts.
Existence of a national plan to regulate
importing of biological products.
End of
year 2012
Indicators of Strategies of the 2nd Objective
Existence of standards for determining
staff requirement at all health care levels.
End of
year 2012
Standards
NA
Existence of
approved
Standards
2.2a
Number of education and training
Pharmaceutical sessions conducted for
pharmaceutical
manpower
in
governmental sector.
Annually
2
10
2.2b
Number of education and training
Pharmaceutical sessions conducted for
pharmaceutical manpower in private
sector.
Annually
4
7
2.1a
46
Indicators
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
2
All referral
Hospitals
2.3a
Number of Referral Hospitals providing
drug information service.
Annually
2.4a
Existence of rules regulating the delivery
of drug information and organizing drug
promotion activities.
End of
year 2012
NA
Existence of
approved rules
& regulations
2.5a
Percentage of referral Hospitals having
implemented Unit Dose system for
inpatients.
Annually
50%
80%.
End of
year 2012
Available but
not completed
Existence of
approved
manuals
2.5c
Percentage of referral Hospitals having
their own drug formulary out of the
approved drug formulary.
Annually
22%
100%.
2.6a
Percentage of Health units offering drugcounselling service for patients at
designated areas.
Annually
71%
100%.
2.7a
Existence of approved assessment tools
for
assessing
the
quality
of
pharmaceutical care at referral hospitals.
End of
year 2012
Not
implemented
Existence of
approved
standards
2.8a
Existence of updated Standard Operating
policies & procedures with regard to
handling Narcotics and Controlled Drugs
at all healthcare levels.
End of
year 2012
Available not
updated
Existence of
updated SOP at
all levels
2.9a
Presence of assessment standards to
evaluate the professional competencies in
pharmacy practice.
Annually
Number of training sessions for
2.10a pharmaceutical manpower in the field of
quality assurance.
2.5b
Presence of pharmacy practice Manuals
for different policies and procedures.
NA
Existence of
approved
Standards
Annually
1
10
Percentage of pharmaceutical manpower
2.10b trained in the field of Quality. in
pharmaceutical services.
Annually
NA
20%
Number of training sessions for
2.11a pharmaceutical manpower in the field of
medication counseling.
Annually
3
10
47
Standards
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
Percentage of pharmaceutical manpower
2.11b trained in the field of medication
counseling.
Annually
4%
20%
Percentage of pharmaceutical manpower
trained in the field of drug information.
Annually
2%
20%
Existence of approved standards to
2.13a evaluate the pharmaceutical services
quality in private sector.
End of
year 2012
NA
Existence of
approved
standards
By the
end of the
current
plan
NA
Existence of
study
Indicators
2.12a
Conduct study to evaluate the
performance of pharmaceutical services
2.14a
in the private pharmaceutical sector.
Indicators of Strategies of the 3rd Objective
Number of health care institution where
medication safety practices have been
evaluated.
End of
year 2013
NA
One study for
each institution
Annually
NA
Existence of
Manual
3.3a
Number
of
orientation
sessions
conducted
in
the
field
of
pharmacovigilance for pharmaceutical
manpower.
Annually
3
25
3.4a
Percentage of Referral Hospitals having
Medication safety committees.
Annually
NA
80%
End of
year 2012
Not
comprehensive
Existence of
comprehensive
Manual
Annually
NA
Existence of
Registers
Annually
426
5000
3.1a
3.2a
3.5a
Existence of Medication safety manual.
Presence of Manual for sterile & nonsterile pharmaceutical preparation.
3.6a
Presence of registers (Forms)
monitoring and documenting
medication errors.
for
the
3.6b
Number of documented pharmaceutical
interventions in treatment therapy.
48
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
3.7a
Existence of manual for safe handling &
disposing
of
Dangerous
Drugs
(Cytotoxic-radiated Isomers).
End of
year 2012
NA
Existence of
Manual
3.7b
Number of training session in the field of
Medication Safety.
Annually
zero
15
3.8a
Percentage of pharmaceutical manpower
trained in field of Medication Safety.
Annually
zero
30%
3.9a
Presence of Medication use evaluation
studies.
Annually
NA
2
Indicators of Strategies of the 4th Objective
Number of training sessions for
pharmaceutical manpower in the field of
rational use of medicines.
Annually
Number of education session for publics
in the field of rational use of medicines.
Annually
4.3a
Number of medicines that have written
advices and use guidelines for patients.
Annually
4.4a
Existence of system for reviewing the
prescribing pattern of drugs at health care
institutions.
4.1a
4.2a
49
Annually
(5) At center
(30) At center
(5) At regions
(100) At regions
(2) At center
(20) At center
(98) At regions
(250) At regions
NA
50
NA
Existence of
drug reviewing
system
Domain Four
Nursing Care
50
Vision: Delivery of High Standards of Health Care to The Community
Goal: Developing Pillars of The Health System
Domain: Nursing Care
INTRODUCTION:
Nursing and Midwifery profession occupies prominent place in the heart of the work of
health institutions therefore Ministry of Health has paid the greatest attention to this
profession in terms of the preparation of national cadres and follow-up and development of
their performance. Health services have witnessed a remarkable development in this
profession during the last decade of the reign of the Sultanate so keep up with modern
developments in the country and meeting the needs of the health system of qualified nursing
staff.
The beginnings were humble in the fifties, where it was relying on the preparation of nurses
through training on the job and on the help of some foreign organizations which had been
present at that time in the Sultanate. The situation continues as it is until the dawn of the
Renaissance when the first School of Nursing was opened at Al-Rahma Hospital in 1970
where a limited number of nurses and nurses aides graduated. Then the nursing program
moved to the Institute of Health Sciences in 1982 and continued until the opening of the
Muscat Nursing Institute in 1993.
In order to speed up development processes, the Ministry has expanded in the establishment
of colleges of nursing in the various governorates and regions to a total of (12) Nursing
Institutes that graduate (7703) nurses up to the year 2010. Thus, the ratio of Omanization
cadres had reached 66% in 2010, but exceeded 95% in some areas. For the sake of the
ministry to continue to develop its human resources, it provides internal or external
scholarships to some of the nursing staff to get diplomas specialist or bachelor's degree or
master's in order to achieve the vision of the ministry and the needs of the required qualified
staff.
Ministry of Health believe in providing better nursing services to those in need regardless
of where they are, consequently it has adopted a home-based care project "palliative" for
patients with cancer and the elderlies with chronic diseases and this program is currently
applied in the governorate of Muscat and some states in other regions. The Ministry has also
adopted the infection control program for the year 2009 with the capacity of accommodating
(25) nurses per academic year.
Moreover, the Ministry has established the Oman Nursing and Midwifery Council under
the Ministerial Decree 67/2001, to perform the functions of regulating the profession of
nursing and midwifery. The Council proceeded to develop a plan of being able to perform all
activities effectively and efficiently.
51
OBJECTIVES:
1. To enhance quality performance of nursing and midwifery services.
2. To develop nursing and midwifery services in primary health care and community
health.
3. To develop systems of nursing and midwifery practice so as to protect the recipient
from irresponsible nursing practices.
4. To develop human resources in the field of nursing and midwifery through focusing
on nursing leadership, continuous education and providing safe and effective working
environment.
OBJECTIVE’S INDICATORS:
Indicators
Past situation
2005
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To enhance quality performance of nursing and midwifery
services.
Availability of new guidelines
for nursing & midwifery
practices.
Available but not
updated
Available but
not updated
Available &
Updated
NA
Started
developing
indicators with
e-reports
Available &
effective
3.
Availability
of
safety
guidelines for patients and
staff.
Available but not
updated
Available but
not updated
Available &
Updated
4.
Number of clinical studies &
researches.
NA
3 (at central
level)
5 (at central
level)
5.
Availability of continues
audits on nursing and
midwifery practices.
Continuous
Continuous
All tools updated
and distributed
to all regions
6 specialized
programs and 4 onjob training
programs
Infection control
program, New
on-job training
programs have
been started in
medical-surgical
nursing.
Start new
programs on
advance nursing
practice and
decentralize
current on-job
programs to
regional
1.
2.
Availability of indicators for
measuring performance of
nursing practices.
Number of new programs in
nursing extended role in
critical specialties.
6.
52
Indicators
Past situation
2005
Current
situation
2010
Targeted
situation
2015
New programs
autonomous
in mental health, institutions.
primary health
care, school
health, and BSN
in primary health
care will start in
September 2011.
Second Objective’s Indicators: To develop nursing and midwifery services in primary health
care and community health.
1.
2.
3.
4.
Number of regions applying
home visits to follow up cases
referred by secondary and
tertiary health institutions.
Number of specialized BSN
nurses in primary health care/
community health.
Availability of guidelines for
nursing services in primary
health care and community
health.
Availability of a new
program in advanced nursing
practitioners in:
- Primary Health Care.
-Advanced
Midwifery
Practice.
Number of on-job training
graduates
in
community
health.
5.
3
3
11
None
None
100 specialized
BSN graduates
Available but not
updated
Available but
not updated
Available &
Updated
-
-
None
Available
28 graduate form on
job training
Program
Developme
nt in
progress.
- Available
- 28 graduate
from on job
training
- None graduates
from specialized
diploma
program.
-Available
- Available
100 graduates
from BSN
program.
The number of graduates in a
specialized
program
in
community health.
100 post basic
diploma
6.
None
None
graduates will be
available
Third Objective’s Indicators: To develop systems of nursing and midwifery practice so as to
protect the recipient from irresponsible nursing practices.
1.
Availability of an updated
system for practicing nursing
and midwifery
Available but not
updated
53
Available but
not updated
Available &
Updated
Indicators
Past situation
2005
Current
situation
2010
Targeted
situation
2015
The proportion of Nurses and
Midwives who obtained a
100%
100%
100%
2. license from the nursing and
Midwifery Council to practice
the profession.
Fourth Objective’s Indicators: To Develop Human Resources in the Field of Nursing and
Midwifery through Focusing on Nursing Leaderships and Continuous Education and Providing
Safe and Effective Working Environment.
1.
2.
3.
4.
5.
6.
7.
Number of Nurses (in the
Ministry of Health) per 10000
of population.
Number of
Omani directors of nursing
and midwifery and heads of
nursing
holding
masters
degrees
in
nursing.
Administration
Availability of guidelines for
developing nursing leadership
according to career structure
in MOH
Number of hours approved
by the Omani Medical
Specialty Board for Nursing
and Midwifery.
Availability
of
criterion
applied for development and
career progression
Availability of an up-to-date
job descriptions for all nursing
categories
Availability of a law for
nursing staff safety in practice
Availability of a tool for
calculating human resources
needs
8.
9.
Availability of a strategy for
motivating
and retaining
nursing
and
midwifery
workforce
30.9
30.7
31.5
2
8
26
Available but not
updated
Available but
not updated
Available &
Updated
None
None
At least 30 hours
for each
specialty.
Available but not
updated
Available but
not updated
Available &
Updated
Available but not
updated
Available but
not updated
Available &
Updated
None
None
Available and
effective
None
A committee has
been formed in
the ministry
level in Jan 2011
and will be
finishing its
tasks in Oct 2011
Available and
effective
None
None
Available
54
Past situation
2005
Current
situation
2010
Targeted
situation
2015
None
Considering a
field study
covering all
health
institutions
4
Masters
5
22
56
Bachelor
10
145
252
Post basic specialty Diploma
850
1700
2500
Indicators
Availability of a study
revealing impact of irregular
10. leaves
on
nursing
performance
Number of Omani
qualified with:
11.
nurses
STRATEGIES:
Strategies to Achieve 1st Objective: To enhance quality performance of nursing and midwifery
services.
1.1 Determining indicators of effectiveness of nursing and midwifery performance
through:

Listing all the indicators associated with the nursing and midwifery practices.

Developing a system to collect data related to indicators.

Conduct studies to determine the level of efficiency in nursing performance.

Raise awareness among all categories of nursing and midwifery of the importance
of monitoring the indicators of the efficiency of services.
Expected Results:
 Existence of Indicators used to assess the efficiency of nursing and midwifery services.
 Existence of a system for collecting data related to indicators.
1.2 Promoting awareness among nursing staff on the importance of quality performance
through:

Promoting a culture of quality performance through lectures and workshops.

Involving all nursing and midwifery categories in promoting quality performance.
Expected Results:

Increase awareness among nursing staff on the importance of quality performance.
55
1.3 Promoting awareness on the importance of researches and its impact on clinical
practices through:

The existence of a working group to identify research priorities for clinical nursing
and midwifery and coordination with the concerned authorities.

Encouraging nursing and midwifery employees to conduct and publish researches.

Preparing nursing and midwifery staff and equipping them to conduct researches
through workshops.

Developing a system for archiving and publishing researches.
Expected Results:


Increase in the number of staff able to conduct researches.
Existence of a system for archiving and publishing researches.
1.4 Strengthening nursing fundamentals in daily practice through:



Promoting awareness among recipients about their rights.
Giving lectures for nursing staff about nursing fundamentals.
Make the subject of a priority in the nursing action plan.
Expected Results:
 Improved nursing performance and patient care.
Strategies to Achieve 2nd Objective: To develop nursing and midwifery services in primary
health care and community health.
2.1 Strengthening nursing services in the area of primary health care and community
health through:

Setting up training programs to promote the performance level of nurses working
in primary health care.

Applying bachelor program in Community Health.
Expected Results:

Increasing efficiency of nurses working in primary health care and community health.
2.2 Promoting awareness on the importance of the role of nursing and primary health care
in the community through:

Establish awareness programs aimed at raising the importance of the role of nursing
and primary health care among members of the community.
Expected Results:


Promoting awareness in the community on the importance of the role of nursing and primary
health care.
The existence of community-based awareness initiatives in partnership between service
providers and recipients.
56
2.3 Introducing a Specialized Advanced Nursing Program and creating a suitable
mechanism to apply the program in primary health care.
Expected Results:
 Existence of Advanced Nursing Practice Program.
Strategies to Achieve 3rd Objective: To Develop Systems for Nursing and Midwifery Practice
so as to Protect the Recipient from Nursing Malpractices.
3.1 Promoting awareness on the importance of Oman Nursing and Midwifery Council in
regulating the practice through:

Activating the role of the Council in coordination with the concerned authorities.

Developing systems to regulate the practice of the profession of nursing and
midwifery.
Expected Results:

Promoting awareness among nursing staff of the Council‟s role.
3.2 Activating the practicing license for nursing and midwifery profession through:

Developing a mechanism to issue and renew licenses to practice the profession of
nursing and midwifery.

Establishing a mechanism to deal with expired licenses.
Expected Results:
 All staff in the field of nursing and midwifery encompasses their own licenses from
Oman Nursing and Midwifery Council.
3.3 Having information exchanged among the Gulf states about the validity of the licenses
granted to nursing staff through:

Establishing a mechanism to exchange information among the Gulf States on
expired licenses.
Expected Results:
 Benefiting from the exchanged information.
 Avoiding contracting with those who committed professional misconduct.
Strategies to Achieve 4th Objective: To Develop Human Resources in the Field of Nursing and
Midwifery through Focusing on Nursing Leadership and Continuous Education and Providing
Safe and Effective Working Environment
4.1 Enhancing the efficiency and capability of Omani nursing leaders through:

Equipping leaders with various scientific and suitable degrees

Enhancing communication between nursing leaders in all regions to exchange
experiences
57

Activating the criterion for selecting leaders in various nursing positions.

Involving leaders in international nursing organizations.
Expected Results:

Omani nursing leaders scientifically qualified with sufficient expertise.

Having a system for exchange information among nursing leaders in Oman and universally.
4.2 Upgrading the knowledge and skills of nursing and midwifery workforce through:

Following up the implementation of the on-the-job training and specialized
programs and setting up new programs based on actual needs.

Increasing the number of programs approved by the Oman Medical Specialties
Board and based on the actual needs of services.
Expected Results:


Nursing staff appropriately qualified, as needed.
All the implemented programs are based on actual needs.
4.3 Developing Plans on scientific bases to identify the needs of nursing departments
through:

Finding a tool to determine the numbers of nurses needed for the health
institutions.

Finding a mechanism to determine the required diversity (Skill Mix) in each
section of the hospitals and health centers to ensure patient’s safety.
Expected results:


Availability of a tool to determine the number of nurses required.
Existence of a mechanism to determine the required diversity in each section of the hospitals
and health centers.
4.4 Developing strategies to assess the unplanned leaves (sick, emergency, maternity)
through:

Availability of a mechanism to assess the magnitude of the impact of unplanned
leaves on nursing performance and workflow.
Expected Results:

Availability of a mechanism to deal with sick leave and its impact on workflow.
4.5
Promoting
the
efficiency
of
newly
appointed
nursing
staff
by:
Giving a sufficient period of time to allow the new graduates to acquire the skill and
experience necessary to enable them to perform their jobs appropriately Working on
improving the mechanism of replacement so as to give the trainee enough time to gain
sufficient
experience.
Expected Results:

Availability of an effective mechanism to provide new graduates with the necessary
expertise.
58
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
1.1b
Availability of indicators used for assessing
Annually
efficiency of nursing and midwifery services.
Availability of a system to collect data related End of the
to indicators.
current
plan
The number of courses held in
None
Being
prepared
nursing
quality of performance.
1.2a
Annually
None
Available
and activated
Available
and
Activated
Available
and
periodical for
all regions in
a national
level.
End of
2012
None
Available
1.3b
Existence of a national committee on the
development of strategies and their
application in the field of research.
Number of qualified nursing staff in
conducting researches.
Annually
26
200
1.3c
Availability of a system for research archiving
and publishing.
End of
2012
None
Available
and activated
1.3a
Indicators of Strategies of the 2nd Objective
The percentage of nurses trained in PHC.
2.1a
2.2a
2.3a
20%
50% +
availability of
OJT Program
Annually
none
All region
Annually
Being
prepared
Available
Annually
The number of governorates that give lectures
to community about importance of PHC.
Availability of an Advanced Nursing Practice
Program.
Indicators of Strategies of the 3rd Objective
Number of governorates that are deliver lectures
to introduce the importance of the role of the
Oman Nursing and Midwifery Council in the
organization of practicing the profession.
3.1a
Annually
59
Lectures are
been
conducted at
many
Governorates
Available
and carried
out on
annual basis
at
governorate
and at
national
level.
Indicators
3.2a
The percentage of nursing and midwifery staff
working in the Ministry of Health and obtained
licenses from the Oman Nursing and Midwifery
Council.
3.3a
Availability of information exchanged between
the Gulf states about the validity of the licenses
granted to nursing staff.
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
Annually
100%
100%
Annually
Available
Available
Indicators of Strategies of the 4th Objective
4.1a
4.2a
Percentage of nursing leaders with masters‟
degree.
Number of continue education programs
accredited by Oman Medical Specialty Board.
Availability of a mechanism for identifying
number of needed nursing staff.
Annually
23
56
Annually
100
1000
End of
2012
4.3a
Availability of a mechanism for identifying
the diversity wanted in each department in all
hospitals and health centers.
4.3b
4.4a
4.5a
Annually
Availability of a mechanism for managing
sick leave and addressing their impact on
workflow.
Availability of a mechanism for equipping
graduates with sufficient experience.
60
Annually
Annually
A committee
has been
formed in the
ministry level
in Jan 2011
and will be
finished in Oct
2011
A committee
has been
formed in the
ministry level
in Jan 2011
and will be
finished in Oct
2011
A
comprehensive
survey is
being
conducted in
all health
institutions
Available
Available
and effective
Available
and effective
Available
Available
Domain Five
Laboratories
61
Vision: Delivery of High Standards of Health Care to The Community
Goal: Developing Pillars of The Health System
Domain: Laboratories
INTRODUCTION:
Before 1974, the numbers of laboratories was small, with limited facilities and
capabilities and were mainly confined to the hospitals. Later on, a Central Public Health
Laboratory was established in Muscat with microbiological and chemical analysis
facilities, followed by the establishment of laboratories in Samail, Nizwa, Salalah, Saham
and Sur polyclinics. In the late 1980s, Regional Public Health Laboratories and Central
Laboratory for Drug Analysis were established. Realizing the importance of the
laboratories, the MoH went further and established high quality laboratories in the
primary, secondary and tertiary health care levels.
In 1994, the Department of Laboratories was restructured to include Microbiology,
Virology, Parasitology, chemical analysis and diagnostic sections. In 2000, QAP section
was established as a part of re-structuring of the department.
In addition to the above, laboratories play a major role in helping to design health care
policies through the provision of vital data in terms of statistics, results and reports.
It is therefore very important that laboratories are supported with highly qualified and
trained human resources (both technical and administrative), as well as equipped with
advanced instruments of good quality and performance, necessary reagents and purpose
built laboratory buildings.
OBJECTIVES:
1. To support and develop laboratories in all health institutions.
2. To reinforce Laboratory Bio-safety and Bio-security measures.
3. To insure and improve laboratory quality controls.
62
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To support and develop laboratories in all health institutions
Number of Laboratories in the ministry
Laboratories
of
Health
Institutes.
available in
1.
169
206
all Health
facilities
Availability of a Central Active Body
2.
NA
NA
Available
within MOH to control laboratories.
Presence of a specialized committee for the
3.
NA
NA
Available
selection of laboratory equipment.
4.
Number of Lab tests added to CPHL.
10
0
15
Percentage of Labs with network
None
None
60%
systems on the central level.
Percentage of Labs using the National
No National
6.
0%
100%
SOP Manuals.
SOP
Second Objective’s Indicators: To reinforce Laboratory Bio-safety and biosecurity measures
Percentage of Lab. technician vaccinated
1.
90%
100%
100%
against Hep. B.
Number of Labs accidents registered
2.
7
0
0
throughout the year.
5.
3.
4.
5.
Presence of a central committee to follow up
on bio-safety and bio-security within the
laboratory.
Availability of legislations and regulations
governing the possession, handling, storage
and transportation of hazardous microorganisms and substances in the Sultanate.
Number of biosafety officers in the regional
hospitals.
NA
NA
Available
NA
NA
Available
0
0
11
Percentage of Labs. following safety
70%
90%
Manual procedures.
Third Objective’s Indicators: To insure and improve laboratory quality controls.
6.
100%
1.
Availability of specialized department to
ensure laboratory quality assurance.
NA
NA
Available
2.
Availability of Laboratory
Assurance Manual and SOP.
NA
NA
Available
0
0
12
N\A
0
0
33%
0
0
3.
4.
5.
Quality
Number of staff trained in laboratory quality
management.
Percentage of errors in the results of
Heamatology according to the quality
assurance program.
Percentage of errors in the results of
microbiology.
63
STRATEGIES:
Strategies to Achieve 1st Objective: To support and develop laboratories in all health
institutions
1.1 Establishment of a Centralized Laboratory Authority.
Expected results:

Ease monitoring and evaluating of laboratory services and quality assurance.
1.2 Construction of Central Public Health Laboratory.
Expected results:



Provision of a specialist reference laboratory at the national level.
More accurate and faster results.
To serve as an appropriate environment for training and research for all OMSB doctors and
other Medical assistant specialties.
1.3 Training of laboratory technicians in reference hospitals on cell tissue examinations.
Expected results:
 Provision of qualified national manpower for cell tissue examinations.
 Reduction of time taken before the release of results.
1.4 Increase the financial incentives for laboratory personnel.
Expected results:
 Higher staff satisfaction.
1.5 Enhance Number and Quality of staff in the labs.
Expected results:
 Provision of specialties as needed.
 Reduce possibilities of technical errors.
1.6 Provision of modern equipment and instruments to perform the required lab. tests.
Expected results:



Quick and accurate results and performance.
Reduced costs over the long term.
Reduced chances of human errors.
Strategies to Achieve 2nd Objective: To reinforce Laboratory Bio-safety and Bio-security
measures
2.1 Prepare Bio-safety programme inside laboratories.
Expected results:




Provision of safety tools and procedures inside the lab (Fire extinguishers, Lab. coats, eye
washer, first-aid kits).
Protection of staff.
Reducing lab. accidents.
Making sure that lab. tests are performed in a safe environment.
64
2.2 To prepare a laboratory waste manual and follow-up implementation.
Expected results:
 To increase the quality of services provided.
 To increase staff knowledge on how to get rid of lab. waste products.
2.3 Training laboratory personnel on safety procedures and waste disposal.
Expected results:

Increase the efficiency of workers.
Strategies to Achieve 3rd Objective: To insure and improve laboratory quality controls.
3.1 To prepare a National Manual for laboratory quality assurance and management.
Expected results:
 To increase the quality of services provided.
3.2 Conduct training courses in laboratory quality assurance for lab workers.
Expected results:
 Increase the efficiency of workers.
 Reduce errors.
3.3 Sending some laboratory workers for scholarships on Laboratory quality management.
Expected results:

Increase the efficiency and capability of workers.
65
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Presence of a Central Active Body within
MOH to control laboratories.
End of the
current
plan
1.2a
Presence of Central Lab. building up to the
standard with all the required specialties.
Annually
1.3a
Number of referral hospitals with at least one
technician
performing
cell
tissue
examination.
Annually
0
All referral
hospitals
1.4a
Availability of incentives for lab workers.
Annually
NA
Available
1.5a
Number of scholarships for lab technician.
Annually
8
12
Annually
6
12
0
4
NA
Available
Old building &
new complex
inconvenient
Number of abroad training courses.
1.5b
- MSc level
- PhD level
1.5c
Number of local training courses.
Annually
35
50
1.6a
Percentage of modern equipment and
instruments in the lab. (Less than 10 years).
Annually
50%
90%
1.6b
Presence
contracts.
Annually
For some
instruments
For all
instruments
of
instruments
maintenance
Indicators of Strategies of the 2nd Objective
2.1a
Presence of Lab. safety manual in the lab.
Annually
Available but
not updated
Available &
updated
2.1b
Percentage of Labs that uses the manual.
Annually
90%
100%
2.2a
Presence of Lab. waste manual.
Annually
None
Available
2.2b
Percentage of laboratories disposing and
transporting their waste safely
Annually
10%
100%
2.3a
Number of training courses on how gets rid
of Lab. waste products.
Annually
None
Twice a Year
66
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 3rd Objective
3.1a
Presence of National Laboratory Quality
management Manual.
Annually
None
Available
3.1b
Number of Laboratories that implement the
national quality manual.
Annually
None
100%
3.2a
Number of training courses on Quality
Assurance, Control and Management.
Annually
None
Twice a Year
3.3a
Number of
Assurance.
Annually
0
2
scholarships
on
quality
67
Domain Six
Blood Services
68
Vision: Delivery of High Standards of Health Care to The Community
Goal: Developing Pillars of The Health System
Domain: Blood Services
INTRODUCTION:
Blood Services in Oman has remained outstanding in provision of safe, efficacious and
high quality blood, blood products and related transfusion services for the benefit of nation
that is sustainable through the generosity of volunteer donors.
The health care services in the Sultanate are ever expanding and to keep the pace with
development there must be proportionate expansion of the blood bank and transfusion
services.
One of the indicators of previous five year health plan that has been achieved successfully
is the increase in the number of blood donors because of the awareness, health education and
initiative from the members of various communities to work for this noble humanitarian
cause.
According to the report of the WHO blood safety there are between 5% - 10% of cases of
HIV infection worldwide that has occurred through the transfusion of contaminated blood
and blood products. In addition, there are many recipients of blood infected with other
viruses such as Hepatitis B and C, and other diseases transmitted through blood transfusion
such as Syphilis and malaria.
Therefore, there is need to activate the policies, programs and plans developed by the
Department of Blood Services to increase the safety of the blood and reduce the probability
of the incidence of these diseases through blood transfusion.
OBJECTIVES:
1. To increase the number of voluntary blood donors.
2. Optimal use of blood and blood products.
3. To improve and develop the quality of blood transfusion services at the national level.
69
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To increase the number of voluntary blood donors
Percentage of voluntary donors among
78 %
67%
(MOH)
1.
the total number of the donors.
(MOH)
95% (MOH)
2.
Percentage of New donors.
47%
35%
Number of staff trained to work in
Donor Affairs Section at the Department
3.
1
0
of Blood Services and Regional Blood
Banks.
Second Objective’s Indicators: Optimal use of Blood and Blood Products
70
Royal Hospital
only
Royal &
Khoula
Hospitals
At least one in
each blood
bank
To be
formulated in
each regional
blood banks
Number of blood units requested by the
Number of
regional referral hospitals.
units issued
should be
2.
proportional
NA
53058
to the actual
requirement
for each
hospital
Number of Blood units gone through
Cross-match
3.
Cross match process.
28922
transfusion
NA
ratio must be
proportionate
Number of blood units transfused to the
Number of
patients.
units
transfused
4.
must be
NA
22805
proportionate
to the number
of units crossmatched.
Third Objective’s Indicators: To improve and develop the Quality of Blood Transfusion
Services at the National Level
Percentage of blood banks that have
1.
implemented
quality
assurance
40%
20%
100%
programme.
Number of staff trained to perform
quality assurance in Department of
Two in each
2.
zero
1
Blood Services and Regional blood
blood bank
banks.
1.
Existence of Hospital Blood Utilization
Committees.
50 %
Indicators
3.
4.
5.
The number of regional blood banks
with specialized laboratory to perform
Nuclear testing for early detection of
disease.
Percentage of leucodepleted blood units.
Percentage of regional Blood Banks
linked with Central Blood bank through
computer network.
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
Zero
zero
10%
zero
50%
Zero
zero
50%
4
STARATEGIES:
Strategies to Achieve 1st Objective: Increase in number of voluntary blood donors
1.1 Develop a plan with community members on the importance of sustainable blood
donations.
Expected results:
 Increase awareness about the importance of safe blood donation.
 Increase the number of blood volunteers and new safe blood donors.
1.2 Train and Employ competent Omani staff at Donor Affairs section in the Dept. of Blood
Services and Regional Blood Banks.
Expected results:
 The presence of Trained Oman Staff.
Strategies to Achieve 2nd Objective: Optimal Use of Blood and Blood Products
2.1 Formulation of Hospital Blood Utilization Committee in every regional Blood Bank.
Expected results:
 Patients receiving proper treatment through optimal use of blood and blood products.
 Rationalization of financial resources.
Strategies to Achieve 3rd Objective: Improve and develop the quality of blood transfusion
services at the national level
3.1 Regional Blood Banks must be separated from the Diagnostic laboratories and should
have separate premises for their function.
Expected results:
 Improve the quality of blood transfusion services at the regional level.
3.2 The Administrative offices at the Dept. of Blood Services must be separated from the
Central Blood Bank laboratories.
Expected results:

Increase quality and safety of blood and blood products.
71
3.3 Provision of Nucleic Acid Testing (NAT) on all blood units.
Expected results:
 Greater security and safety of blood and its components.
3.4 Provision of blood bags with in-line filters for leucodepletion pre-processing once all the
necessary, required tests has been performed or provision of laboratory leucodepletion
filters to hospital for leucodepletion before the unit issued to the ward.
Expected results:
 Reduction in the number of reactions related to White Blood Cells in donated blood.
 Reduction in the transmission of viral diseases such as CMV and other viral diseases.
3.5 Coordination with the Directorate General of Information Technology to implement
Blood Bank Information Management System at the central level that to be integrated as a
network with all the regional blood banks.
Expected results:


Access to all activities related to blood banking and transfusion services at national level.
Effective transportation of blood and blood component.
STRATEGIE’S INDICATORS:
Indicators
Follow
up
timing
Current
situation
Annually
In some
regions
In all regions
2
5
1
16 At the
national level
2010
Indicators of Strategies of the 1st Objective
1.1a
1.1b
1.2a
Presence of a Plan with community members
on the importance of sustainable blood
donations.
Number of health education programs that
have a key role in raising the level of
community knowledge of the importance of
blood donation (at the national level).
Number of qualified staff for specialized
executive services at Dept. of Blood Services
and the regions.
Annually
Annually
Targeted
situation
2015
Indicators of Strategies of the 2nd Objective
2.1a
2.1b
2.1c
2.1d
Proportion of errors in laboratory blood tests.
The proportion of donors who had reactions
during the donation process.
The proportion of patients who develop
transfusion reactions.
The number of hospitals that have hospital
blood utilization committee.
72
Annually
NA
0%
Annually
NA
0%
Annually
NA
0%
4 Hospitals
All the
hospitals
with blood
banks
Annually
Indicators
2.1e
Percentage of trained competent staff in their
field of work.
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
Annually
20%
100%
Indicators of Strategies of the 3rd Objective
3.1a
3.2a
3.3a
3.4a
3.5a
Percentage of regions having specialized
premises for blood bank services.
Administrative offices at the Department of
Blood Services those are separate from the
Central Blood Bank.
Number of regional blood banks equipped with
Nucleic Acid Testing.
Percentage of the usage of in-line filters for
pre-storage leucodepletion.
Percentage of regional blood banks linked to
Central blood bank via network services.
73
Annually
Annually
9%
NA
50%
Available
Annually
Zero
4
Annually
Zero
80%
Annually
Zero
100%
Domain Seven
Radiology Service
74
Vision: Delivery of High Standards of Health Care to The Community
Goal: Developing Pillars of The Health System
Domain: Radiology Service
INTRODUCTION:
During the development of the pillars of the health system for health care, the Ministry
of Health has paid a special attention to five years plans of all the fields of the health care
and radiology is no exception. The field of radiology has participated in the five years
strategy planning for the second time and proven its interest in improving the provided
services in terms of horizontal expansion as well as vertical.
In this arena, the Ministry has paid attention to the Omanization of the human recourse
by locally training the radiographers to a diploma level. For the purpose of improving the
services, the Ministry of Health also initiated a post graduate scheme to upgrade those
diploma holders to BSc. and Msc.
According to statistics the omanization in the radiology departments in Ministry of
Health institutions has reaches to 63%. In addition, a great number of candidates has been
specialized on MRI, CT scan and other specialized modalities.
In terms of the expansion of radiology services, the number of institutions that provide
services for radiology and\or radiography is reaches to 121 divide among tertiary are five,
secondary seven and the balance is primary health service. The offered services by these
institutions are ranged between normal imaging to advanced imaging such as CT, MRI,
etc.
The ministry has paid a special attention to upgrade the old x-ray equipment which
constitutes a significant economic burden on the budget as the life-span of radiology
equipment by default is seven to ten years. Thus continuing to use old equipment requires
intensive service to avoid frequent breakdowns that occur as a result of heavy use and
sometimes needs spear parts that are no longer available. Thus increase the value of the
actual cost of the equipment.
OBJECTIVES:
1. To enhance the radiology services in the health institutions and improve its quality
assurance.
2. To improve the performance of workers in the field of radiology.
75
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To enhance the radiology services in the health institutions and
improve its quality assurance
1.
2.
3.
4.
5.
The
proportion
of
recipients‟
NA
NA
satisfaction from x rays services.
The number of x-rays done per
NA
9.2
radiographer (in primary health care
institutions) per day.
The number of x-rays done per
8.4
9.8
radiographer (in secondary and wilayat
hospitals) per day.
Average number of waiting days for specialized radiological examinations:
12
12
CT scan
NA
75
11
MRI scan
NA
235
23
Ultrasound
NA
75
11
Mammography
NA
75
11
Radionuclide Imaging
NA
NA
23
Percentage of repeated x-rays.
12%
12%
5%
3
3
12
0
0
All health
institutions
0
0
All health
institutions
7.
Number of secondary and tertiary
hospitals
with
digital
radiology
departments.
Number of departments with safety
guide booklet.
8.
Number of departments with operation
protocol.
6.
90%
Second Objective’s Indicators: To improves the performance of workers in the radiology
services.
Number
of
radiologists
with
6
7
24
qualifications or training in specialize
1.
imaging.
Number of radiographers with higher qualifications or training in specialize imaging:
2.
CT scan
1
1
12
MRI scan
2
2
6
Mammography)
3
3
23
76
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
primary health care institutions
NA
NA
12
Secondary and tertiary hospitals
NA
NA
16
2
5
Indicators
Number of patients per radiographer per day:
3.
Number of local training courses per
2
year.
Number of trainees in specialized radiography in local courses:
4.
5.
Ultrasound
20
20
50
Mammography
2
3
20
CT scan
9
12
36
MRI scan
2
2
8
STRATEGIES:
Strategies to Achieve 1st Objective: To enhance the radiology services in the health institutions
and improve its quality assurance.
1.1 Upgrade the radiology departments in line with the volume of services provided through it.
Expected results:
 Faster completion of tests.
 Reduced waiting time for auditors in the Department of Radiology.
 Accurate results and better diagnosis.
1.2 The provision of MRI services in regional hospital.
Expected results:
 Reduced pressure on existing centres (Royal & Khaulah Hospitals).
 Reduced waiting days and therefore faster diagnosis and better service.
1.3 Establish training programs in CT scan and Sonography.
Expected results:


Low proportion of cases transferred to Muscat CT scan centres.
Better utilization of the radiographers in the primary health centres by training them on
obstetric sonography and reduces the patients waiting time.
 High levels of occupational safety.
1.4 Train radiographers in the regional hospital on mammography.
Expected results:

Reduced the number of human errors for mammography and the risk.
77
1.5 Implements quality programs in all radiology departments.
Expected results:
 Low rate of repeated radiograph thus lower radiation dose to patients, staff.
 Reduced running costs of radiology department.
1.6 Replace conventional radiography with digital radiography and PACS in proportion to
the volume of provided services.
Expected results:
 High performance and faster transmission of images.
 Longer storage periods at low cost while maintaining image quality.
 More accurate results with low dose to the patient.
1.7 Standardize the radiology procedures in all departments by establishing (1) standard
protocol for imaging procedures (2) occupational safety.
Expected results:
 Enhance safety measures for the risks of radiation and chemicals.
 Provide adequate protection for patients and society from the hazards of radiation.
Strategies to Achieve 2nd Objective: To improve the performance of workers in the field of
radiology
2.1 Provides sufficient numbers of radiologists and radiographers who are well qualified in
radiology imaging in the regional hospitals.
Expected results:

Reduced the number of patients waiting days for advanced radiology tests such as CT and
ultrasound.
 High quality of service provided.
2.2 Conduct analytical studies to determine the amount of work for radiographer at
different levels of health care.
Expected results:

Identify the volume of work to setup a mechanism for the distribution of radiographers based
on workload.
2.3 Conduct training programmes (CPD) to Enhance the local radiographers\radiologists.
Expected results:


Reduced the number of overseas scholarships.
Enhanced the quality of work.
78
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
1.1b
1.2a
1.3a
1.4a
Number of primary health institutions with
digital radiology departments.
Number of secondary and tertiary hospitals
with digital radiology departments.
Number of MRI units in the Secondary and
tertiary hospitals
Percentage of radiographers with higher
qualifications or training in specialize imaging.
Number of mammographer in the regional
hospitals.
1.5a
Availability of QA
radiology departments.
1.6a
Number of departments which have digital
radiographer systems instead of analogue.
1.7a
1.8a
programmes
in
all
Availability of occupational safety guideline.
Availability of standard operational protocol.
Annually
NA
60% of all
hospitals
Annually
4
All hospitals
Annually
2
6
Annually
14%
90%
Annually
2
20
Annually
No standard
Protocol
standard
Protocol
Annually
NA
All health
institutions
Annually
NA
Provision of
guideline
Annually
NA
Provision of
protocol
Indicators of Strategies of the 2nd Objective
2.1a
Number of radiologists in the radiology
services in regional hospitals.
Annually
55
80
2.1b
Number of radiographers in the radiology
services.
Annually
0
114
2.2a
Analytical studies to determine the amount of
work for radiographer at primary health care.
Annually
NA
availability of
the study
2.2b
Analytical studies to determine the workload
per radiographer at secondary and tertiary
health care.
Annually
NA
availability of
the study
2.3a
Number of local training programmes to
upgrade\update the radiographers.
Annually
0
4
79
Domain Eight
Rehabilitation Services
80
Vision: Delivery of High Standards of Health Care to The Community
Goal: Developing Pillars of The Health System
Domain: Rehabilitation Services
INTRODUCTION:
Health care as a civil service cannot be considered as a complete entity without including
rehabilitation services with all its branches as an important keystone element.
Rehabilitation considered as a young domain here is Oman which has been introduced
recently in our healthcare system providing facilities to secondary and tertiary patient care,
and since rehabilitation effect the patient life style directly to physically, functionally,
socially and mentally, we can sense the need of this service.
Rehabilitation is one of supporting specialty in the medical field which includes a number
of subspecialties which aims toward prevention and compensation of functional lost of a
body part or general health improvement and social integration for the patients in the shortest
possible periods with maximum independence.
Different rehabilitation treatments are used for the aim of providing a high standard of
specialised services including physiotherapy, occupational therapy, language and speech
therapy, orthotics and prosthetics, podiatry, medical social work, rehabilitation nursing as
well as psychotherapy.
Rehabilitation service is considered to be a forefront in prevention, improve patient life
style and functional abilities. There is strong clear evidence for growing demand of
rehabilitation services in the Sultanate of Oman to due improved primary and secondary
health care and surgical techniques that results in improve and prolong average life
expectancy of patients. This is in addition of growing the number of patients who live with
unhealthy lifestyle that can lead to medical conditions such as obesity, ischemic heart disease
or diabetes. Further, it is obvious increased number of road traffic accidents that lead in
serious disabling chronic conditions that sometimes are lives threatening.
In addition of the above, rehabilitation service can not be overlooked and if it is not
adequately provided it will have negative impact on patient physically, psychologically,
functionally and economically and in many situations it increases the burden on government
expenditures as it raises the budget in which the Ministry of Health reflected in increased bed
occupancy with prolonged admissions and complication related to inadequate rehabilitation
services. This includes in increased social security expenditures for depended family
members.
Currently, the Ministry of Health provides acute short term rehabilitation services in some
major tertiary hospitals whereas long term comprehensive rehabilitation services particularly
for chronic disabled patient do almost not exist. Community Based Rehabilitation services is
at large NA in the majority of regions.
Moreover, there is an evident of shortage of human resources within the field of the
rehabilitation services physiotherapy speciality to cover the entire MOH organization, while
specialities such as occupational therapy, speech and language therapy, orthotics and
prosthetics, medical social workers and others are extremely limited in numbers.
81
Regardless of the above mentioned facts, following strategic plans and expert
recommendations from central and the peripheral representative members of different fields
of rehabilitation services should open the door for discussions and exchange of new ideas and
support strategies which will help and succeed the upcoming the ministry's 8th five year plan.
This will be a continuation of what has been achieved during the previous 7th five year
Rehabilitation Service plan.
OBJECTIVES:
1. Development of rehabilitation services in all Ministry of Health institutions.
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: Development of rehabilitation services in all MoH institutions
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Numbers of Physiotherapists.
Numbers of Occupational therapist.
Numbers of Orthotic & Prosthetic
specialists.
Numbers of Orthotic & Prosthetic
technicians.
Number of Speech therapists.
Number of social workers.
Average number of days waiting for the
first appointment in Rehabilitation clinics
(Physiotherapy).
Average number of days waiting for the
first appointment in Rehabilitation clinics
(Occupational therapy).
Average number of days waiting for the
first appointment in Rehabilitation clinics
(Prosthetics & Orthotics) Artificial lower
limb.
Average number of days waiting for the
first appointment in Rehabilitation clinics
(Speech & Language therapy).
Average number of days waiting for the
follow up appointment in Rehabilitation
clinics (Physiotherapy).
Average number of days waiting for the
follow up appointment in Rehabilitation
clinics (Occupational Therapy).
Average number of days waiting for the
follow up appointment in Rehabilitation
clinics (Prosthetics & Orthotics) Artificial
lower limb.
82
122
2
174
8
250
40
2
3
10
10
14
35
5
0
7
5
30
10
Data NA
Data NA
5 days
Data NA
Data NA
2 days
Data NA
9 months
30 days
Data NA
Data NA
1 day
Data NA
Data NA
2 days
Data NA
Data NA
1 day
Data NA
12 months
30 days
Indicators
14.
15.
16.
17.
18.
Average number of days waiting for the
follow up appointment in Rehabilitation
clinics (Speech & Language therapy) .
Patient satisfaction in Rehabilitation
Services (Physiotherapy).
Patient satisfaction in Rehabilitation
Services (Occupational Therapy).
Patient satisfaction in Rehabilitation
Services (Prosthetics & Orthotics).
Patient satisfaction in Rehabilitation
Services (Speech and Language Therapy).
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
Data NA
Data NA
5days
Data NA
Data NA
70%
Data NA
Data NA
70%
Data NA
Data NA
70%
Data NA
Data NA
70%
STRATEGIES:
Strategies to Achieve 1st Objective: Development of rehabilitation services in all MoH
institutions.
1.1 Create an integrated structure for career development of rehabilitation Staff.
Expected results:
 Staff job satisfaction level elevated.
 High level of efficiency and performance in the Rehabilitation services.
1.2 Expansion of the rehabilitation services to include referral hospitals.
Expected results:
 Adequate coverage within the Ministry of Health for Rehabilitation Services.
 Delivering high quality of Rehabilitation Services to all patients.
 Elevated patient‟s satisfaction level in rehabilitation services.
1.3 Continuation of Rehabilitation training programmes nationally and internationally to
optimize national staff coverage in Ministry of Health institutions.
Expected results:
 Increase number of Omani trainees and scholarships for all rehabilitation staff.
 Raising the level of competence of professionals in the field of rehabilitation.
1.4 Establishment of free standing Rehabilitation Services for long term patients who
require treatment.
Expected results:
 Provision of long term care and treatment for patients with special needs.
 Minimizing hospital bed occupancy for long term patients.
1.5 Establishment of community-based rehabilitation services to long term patients after
hospital discharge.
Expected results:

Involvement of the community in the rehabilitation services.
83
 Increase of independency of individuals.
 Easing the burden of hospitalization and long term stay for Ministry of Health.
1.6 Establishment of National Rehabilitation Centre for patients who require long term
Rehabilitation Centre in Muscat Region.
Expected results:


Increased of standard and high quality of Rehabilitation Services for chronic patients.
Reduce number of patients travelling abroad for Rehabilitation Services.
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Implementation of career structure for all
By the end
rehabilitation professionals.
of 2012
1.2a
Percentage of secondary and tertiary health
care institutions providing rehabilitation
services.
1.3a
1.3b
1.3c
1.4a
1.5a
Number of specialized Omani rehabilitation
professionals graduates with Bachelors Degree.
Number of specialized Omani rehabilitation
professionals graduates with Master Degree.
Number of specialized Omani rehabilitation
professionals graduates with Doctorate Degree.
Not existing
existing of
career
structure
15%
80%
Annually
9
15
specialized
cadres
Annually
8
15
Annually
2
Annually
Existing comprehensive Community Based By the end
Rehabilitation (CBR) team.
of the plan
Existing Community Based Rehabilitation
By the end
(CBR) programme.
of the plan
84
0
Within the
Plan
Not existing
Existing of
C.B.R team
Not existing
Existing of
C.B.R
programme
Follow
up
timing
Indicators
1.5b
Number of training programs for long term
patients with chronic disability after hospital
discharge.
Annually
Current
situation
Targeted
situation
2010
2015
Not existing
1 training
programs
annually for
each hospital
Not existing
Existing of
Rehab.
Centre
Presence of Rehabilitation Centre in Muscat.
1.6a
Annually
85
Vision Two
Quality Assurance of Health Services
and Patient Safety
86
Domain Nine
Quality Assurance & Improvement
and Patient Safety
87
Vision: Quality Assurance of Health Services and Patient Safety
Goal: Provision of High Quality Health Services
Domain: Quality Assurance / Improvement and Patient Safety
INTRODUCTION:
The success of the strategy of implementing quality and accreditation systems at health care
institutions requires a clear vision and integrated strategy; ongoing top leadership support for
the strategy to overcome the difficulties facing implementation; developing and carrying out
comprehensive training plans; continued technical support in all phases of implementation;
building and investing in national capacity to ensure continuity and quick execution;
commitment of all employees at all levels to cooperate and actively participate in all activities
and events, in addition to a system of continuous assessment of the strategy to ensure
effectiveness and efficiency of implementation.
The health care delivery system in the Sultanate of Oman has the advantage of solid
infrastructure, well established standards; policies and plans, effective community
participation, availability of sound information network as well as highly committed and
supportive organizational structures and leaderships. All these potentials are considered the
main successful factors for establishing and developing quality and accreditation systems in
health services in the Sultanate.
Safety is one of the fundamental healthcare principles and a vital component of quality
management. Maintaining the citizens` safety and wellness is the main objective of
healthcare. However, medical interventions, combining the technical operations, the use of
complex medical technology and human interactions that shape the delivery of healthcare
system, could inevitably lead to potential medical risks that might do harm to patients and
health care workers.
Patient safety principle draws the full attention of the Ministry of Health. Therefore,
"patient safety" comes on the top priorities of the Ministry agenda. Patient and staff safety
system has been integrated as an essential component within the scope and domains of the
8th strategic plan for Health Development (2011-2015).
The Ministry`s strategic plan includes many activities and operational procedures, that aim
to improve the quality of performance, and to dedicate and apply concepts of patient safety
accredited by the World Health Organization and the World Alliance for Patient Safety in all
health care facilities of the Ministry.
OBJECTIVES:
1. To establish and develop quality management and accreditation systems in health care
facilities.
2. To establish patient safety system in health care facilities.
3. To build the qualified national capacity in quality assurance / improvement and patient
safety systems.
88
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective Indicators: To establish and develop quality management and accreditation
systems in health care facilities
(Calculated separately for primary/secondary/and tertiary care levels)
More than 90%
Number of health care facilities 64 (PHC) , 5
118 (PHC) ,
(PHC) , 12
implementing quality assurance /
regional
10 regional
1.
regional
improvement system.
hospitals
hospitals
hospital
2.
Number of trained health care workers on
basics, concepts and applications of
quality assurance and improvement
programme.
3.
Number of trained health care workers on
communication skills and teamwork.
300
5733
More than 60%
of total health
care workers
4.
Number of qualified auditors to conduct
audit activities on quality systems and
programmes in health care facilities.
240
655
1100
5.
Number of quality improvement projects.
None
22
65
6.
Number of written user complaints (and
their relatives)
NA
309 (PHC) ,
182 (statistics
of 7 regional
hospitals)
Decrease by
25% (total) at
end of 2015
7.
Percentage of patients‟ complaints that
have been resolved.
NA
73%
More than 90%
75% (PHC,
average of
statistics of 4
regions) ,
79% (PHC) ,
61.5%
(average
statistics of 2
regional
hospitals)
More than 75%
(PHC) , more
than 65%
(regional
hospitals)
8.
User satisfaction rate.
2200 (PHC) ,
400 regional
hospitals
7574 (PHC) ,
4159 regional
hospitals
More than 80%
of total health
care workers
56.5%
(average
9.
Staff satisfaction rate
None
89
statistics of one
region and one
regional
hospital)
More than 75%
Past
situation
2005
Indicators
10.
Existence of approved, documented
motivation system to health care staff.
11.
Number of health care facilities that are
preparing for accreditation according to
the National Accreditation System.
None
None
Current
situation
2010
Targeted
situation
2015
4 regions,
Approval and
implementation
of the system
4 regional
hospitals
None
5 regional
hospitals (at
least)
Second Objective Indicators: To establish patient safety system in health care facilities.
(Calculated separately for primary/secondary/and tertiary care levels)
More than 50%
Number of health care workers trained on
1.
None
1600
of total health
basics and concepts of patient safety.
care workers
2.
Number of adverse events reports in
health care facilities.
3.
Number of written user (and their
relatives) complaints related to patient
safety.
4.
Percentage of patients complaints related
to patient safety that have been resolved
according to approved protocols.
NA
Decrease by
25% (total) at
end of 2015
NA
NA
Decrease by
25% (total) at
end of 2015
NA
NA
More than 90%
NA
Third Objective Indicators: To build the qualified national capacity in quality assurance /
improvement and patient safety systems.
Number of Omani heath care providers
participated
in
national
training
Programme or Specialized Diploma
None
21
100
1.
degree
in
quality
assurance
/
improvement and patient safety in health
care.
2.
Number of national cadres has higher
degree
in
quality
assurance
/
improvement in health care. (Local or
international).
90
6
15
25
STRATEGIES:
Strategies to Achieve 1st Objective: To establish and develop quality management and
accreditation systems in health care facilities
1.1 Formulation of the organizational structure for the quality system on the central and
regional levels as well as health care facilities.
Expected results:

Facilitating of implementation of the quality assurance / improvement and patient safety systems
in health care facilities.
1.2 Accomplishing quality management systems in all health care facilities through:

Developing annual quality improvement objectives in health care facilities.

Setting standards and indicators to measure performance in health care facilities.

Implementing quality control/monitoring system.

Implementing quality improvement projects.
Expected results:


Establishing an effective quality control/monitoring system.
Establishing effective approaches to perform follow up and reform the quality system at all
levels.
1.3 Developing skills of health care workers in quality assurance / improvement programme
through:

Executing training programmes for health care workers to build quality culture in
health care facilities.

Executing training programmes for health care workers to develop their
communication skills.

Preparing and training audit teams.

Executing training programmes for health care workers to develop quality
improvement projects.
Expected results:




Raising awareness of health care workers about basics, principles and applications of quality in
health care.
Health care workers shall acquire knowledge and skills that are necessary to improve their
performance.
Qualified and well trained audit teams.
Qualified and well trained teams on quality improvement projects.
1.4 Conducting periodical surveys to assess user's satisfaction.
Expected results:


Provision of the necessary data about user's satisfaction of health care services.
Identifying the weaknesses and strengths and implementing the necessary interventions.
91
1.5 Conducting periodical surveys to evaluate the level of staff satisfaction in health care
facilities.
Expected results:
 Provision of the necessary data about the level of staff satisfaction.
 Identifying the weaknesses and strengths and implementing the necessary interventions.
1.6 Setting and implementing mechanisms to enforce community participation in quality
improvement activities and projects.
Expected results:
 Disseminating quality culture in the community.
 Creating effective community participation that supports the quality system.
1.7 Establishing staff motivation system.
Expected results:
 Improving staff performance.
 Achieving job stability.
1.8 Establishing a National Accreditation System for health care facilities through:

Preparing the manual of national accreditation standard.

Conducting training courses to certify national surveyors for the accreditation system.

Setting and implementing systematic plans to prepare health care facilities to comply
with accreditation standards.

Initiating the formulation of the National Accreditation Council (independent body).
Expected results:

Health care facilities are preparing for accreditation according to the National Accreditation
System.
Strategies to Achieve 2nd Objective: To establish patient safety system in health care facilities.
2.1 Executing training programmes in patient safety for health care workers.
Expected results:
 Raising awareness of health care workers regarding patient safety concepts and principles.
2.2 Executing training programs on root cause analysis for health care workers.
Expected results:

Staff skilled on conducting root causes analysis for sentinel events.
2.3 Establishing a system that ensures patients’ safety of and through:

Setting operational manual of patient safety standards.

Setting standards of patient's rights that take into account the social, ethical and
professional aspects.
92

Establishing a system for patient complaints (and their relatives).
Expected results:

Approval and implementing the operational manual of patient safety policies and procedures in
health care facilities.
 Issuing the document of patients' rights.
 A reduction in the number of written complaints from patients and their relatives.
2.4 Establishing a standardized system for reporting adverse events.
Expected results:
 Increased rates of reported adverse events.
2.5 Implementing patient safety goals/solutions in health care facilities.
Expected results:

Reduced rates of medical errors in health care facilities.
Strategies to Achieve 3rd Objective: To build the qualified national capacity in quality assurance
/ improvement and patient safety systems.
3.1 Developing skills of national cadres in the field of quality and patient safety through:

Conducting central training programmes/ Specialized Diploma to qualify Omani
cadres on quality and patient safety in health care.

Integrating quality and patient safety in the training curricula of health institutions
(belonging to Ministry of Health).

Sending abroad a number of properly selected and distinguished health care workers
to get a higher degree in the field of quality and patient safety.
Expected results:

Qualified and specialized national professionals in total quality management systems to lead
quality assurance/improvement and patient safety systems in their regions.
93
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
Annually
Available
but not
documented
Documented
organizational
structure
Annually
9 regions /
12 regional
hospital
11 regions / all
hospitals
aNumber of organizations that have annual quality
improvement objectives.
Annually
118 (PHC)/ 2
regional
hospitals
More than 70%
1.2.b
Percentage of organizations implementing
approved key performance indicators.
Annually
NA
More than 75%
1.2.c
Number of regions/hospitals that implement
quality audit / monitoring system.
Annually
6 regions
11 regions , all
regional
hospitals
1.2.d
Number of wilayat/ hospitals implementing
quality improvement projects.
Annually
15 wilayat/ ,
one regional
hospital
45 wilayat/ , all
regional
hospitals
1.2.e
Number of regions/hospitals that conduct the
annual top management reviews for quality
systems.
Annually
5 regions/ 2
regional
hospitals
11 regions/ 5
regional
hospitals
320
10 workshops
(at least) for
each region/
hospital during
the plan
1.1.a
Presence of documented organizational structure
for quality system at central level.
1.1.b
Number of regions/hospitals with documented
organizational structure for quality system.
1.2.a
1.3.a
Number of workshops to train health workers
on quality assurance / improvement principles,
concepts and applications.
Annually
1.3.b
Number of workshops to train health workers on
communication skills and teamwork.
Annually
174
10 workshops
(at least) for
each region/
hospital during
the plan
1.3.c
Number of training courses to certify quality
auditors.
Annually
18
35
94
Indicators
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
Annually
5
20
Annually
118 (PHC)/ 7
regional
hospitals
More than 70%
Annually
4 regions/ 4
regional
hospitals
11 regions/ all
regional
hospitals
25
5 workshops
for each region
during the plan
None
Approved
documented
system
None
Approved
documented
manual
None
One central
training course
and one course
for each
hospital
applying the
system
None
5 regional
hospitals (at
least)
None
Fulfillment of
procedures for
formulation of
the council
1.3.d
Number of workshops to train health workers on
the tools and approaches of quality improvement.
1.4
Number of health care facilities that implement
customer satisfaction survey (in primary,
secondary and tertiary care).
1.5
Number of regions/hospitals that implement staff
satisfaction survey.
1.6
Number of workshops to train community
support groups in quality assurance and
improvement.
1.7
Availability of an approved documented
motivation system for health care workers.
Annually
1.8.a
Availability of an approved documented manual
of national accreditation standards
End of
2013
Annually
1.8.b
Number of training courses to train surveyors for
the National Accreditation System.
Annually
1.8.c
Number of organizations that are preparing for
accreditation according to the National
Accreditation System.
2013 2015
1.8.d
Availability of preparatory steps for the
formulation of a National Accreditation Council
(an independent national body).
End of
2013
Indicators of Strategies of the 2nd Objective
2.1a
Number of workshops to train
health care
workers on principles and concepts of patient
safety.
95
Annually
43
5 workshops (at
least) for each
region/ hospital
during the plan
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
2.2a
Number of workshops to train hospital staff on
root cause analysis of sentinel events.
Annually
None
One workshops
for each
regional
hospital
2.3.a
Availability of operational manual of patients‟
safety standards.
2013
Draft
Documented
manual
2.3.b
Availability of approved document regarding
patient‟s right in different levels of health care.
2013
None
Approved
document
2.3.c
Availability of an approved system for patients‟
complaints.
2012
Available in
some regions
All regions
2.4a
Number of organizations that implement the
approved standardized adverse event reporting
system.
NA
More than 50%
(PHC) , all
regional
hospitals
NA
More than 20%
(PHC) , 50%
regional
hospitals
2.5a
Number of organizations that implement patient
safety solutions.
Annually
Annually
Indicators of Strategies of the 3rd Objective
3.1a
Number of central specialized training
programmes/diploma
to
qualify
Omani
professionals in the field of quality and patient
safety.
Annually
1
4
3.2a
Number of educational programmes (in MoH
institutions) that have integrated quality and
patient safety topics in its curriculum.
Annually
3
Not less than
30% of
educational
programmes
3.3a
Number of national cadres who got a
postgraduate degree in quality management in
heath care.
Biennially
15
25
96
Vision Three
Alleviation of Risks Threatening The Public
Health
97
Domain Ten
Communicable Diseases
98
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Communicable Diseases
INTRODUCTION:
Infectious diseases continue to pose a threat to humans despite great progress in their
control and management. Morbidity, disability and mortality attributed to communicable
diseases still constitute a huge burden and challenges worldwide. It is needless to say that
prevention and control of such diseases have got the utmost attention of our wise government,
the Law of Prevention and Control of Communicable Diseases was issued by the Royal
Decree No. 73/92, which regulates the surveillance and control of communicable diseases and
specifies the role of the concerned health organizations in implementing measures and
procedures required to protect the community from communicable diseases. Ministry of
Health (MOH) has adopted policies, strategies and plans to prevent and control communicable
diseases, based on evidence-based science and up-to-date technology. This is also based on
the in-depth analysis and interpretation of epidemiological data generated by the Disease
Surveillance System. These efforts are in line with the initiatives and recommendations of the
concerned international organizations.
Globally, demographic, social and economical changes facilitates the emergence of
new diseases (e.g. AIDS, SARS, Avian Influenza), or emergence of some diseases which
were eradicated (or thought to have been eradicated) or those which were on decline (e.g.
Tuberculosis, West Nile Fever and Dengue Fever). Spread of such diseases has serious
economical, political and health implications. Therefore, the presence of a reliable, effective
and highly sensitive “Disease Surveillance System” is considered an essential prerequisite for
generating the information required for planning and decision making within the (Integrated
Disease Control) framework. In addition, this system functions as an early alert system to
predict outbreaks and epidemics. The “Epidemic Preparedness”, provides the logical basis for
the interventions by Health Authorities.
The Sultanate of Oman has achieved a lot in early diction and prompt treatment of
communicable diseases in the country. The presence of an effective and highly efficient EPI
program enabled Oman to accomplish very high rates of coverage (> 99%) for more than 15
years. The EPI has contributed in reducing the incidence rates of vaccine-preventable
diseases, and averted morbidity and mortality associated with those infections to the lowest
levels, especially in children under five years. MOH is continuously searching for the
adoption most up-to-date technologies in the field of prevention and control of communicable
diseases.
Health care has outstandingly improved over time. This has helped in saving lives and
has brought remarkable benefits to generations of patients and their families. However,
progress in health care delivery is associated with risks. The treatment and care of millions of
99
patients worldwide is complicated by infections acquired during health care. HealthCareassociated infection is a growing as a public health problem. Patients are becoming more
susceptible to infections because of more serious underlying illnesses. Advances in medicine;
new procedures, new treatments, organ transplantation and intensive care are associated with
an increased risk of infection. Moreover, microorganisms become more resistant to treatment
with anti-microbial drugs. Shortage of trained health care workers and increased bed
occupancy rates are among the additional factors that facilitates the spread of these infections
in healthcare settings.
Patient‟s safety is one of the important health priorities for the Ministry of Health of
the Sultanate of Oman. Every patient has the right to receive a clean and safe care. The
ministry of health adapts the evidenced-bases and cost-effective strategies to reduce the
burden of healthcare-associated infection in its plans.
OBJECTIVES:
1. Strengthening and maintaining the national capacity for infectious disease, detection
and response through achieving effective preparedness, surveillance and response
system that meet the IHR requirements.
2. Reduction of health care associated infections (HAIs) rates.
3. Maintaining the lowest rates of vaccine-preventable diseases.
4. Achieving the lowest possible rates for other communicable disease.
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: Strengthening and maintaining the national capacity for infectious
disease detection and response through achieving effective preparedness, surveillance and
response system that meet the IHR requirements.
1.
2.
3.
4.
Number of Borders*that implements the
IHR requirements.
Availability of updated national work
plan which is able to report and respond
to any events that could be a risk to the
public health.
Availability of updated national
Committees which is able to report and
respond to any events that could be a
risk to the public health.
Percentage of the regions that have
developed Epidemic Preparedness Plans
yearly.
100
Nil
Nil
5
N/A
N/A
Updated plan
N/A
Available
Available
80%
90%
100%
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Percentage of the regional Hospital that
0%
10%
100%
5.
have developed Epidemic Preparedness
Plans.
Number of governorate which deal
6
7
11
6.
effectively with e-surveillance.
Second Objective’s Indicators: Reduction of health care associated infections (HAIs) rates.
25%
Incidence rate of reported blood/body
N/A
N/A
decrease of
fluid exposure among healthcare
1.
workers.
the baseline
2.
Percentage of Resisting antimicrobial
isolates (MRSA) among the detected
(Staph).
3.
Percentage of resisting antimicrobial
isolates (MDRO) among the detected
(Acinetobacter).
N/A
N/A
N/A
25%
decrease of
the baseline
N/A
25%
decrease of
the baseline
Third Objective’s Indicators: Maintaining the lowest rates of vaccine-preventable diseases
Percentage Coverage:
1.
2.
3.
 OPV / IPV
>99%
 HBV
>99%
 Diphtheria
>99%
 Pertussis
>99%
 Tetanus
>99%
 Measles
>98%
 Rubella
>98%
 Mumps
>98%
 Hib
>99%
 BCG
>99%
 Pneumococcal Vaccine (PCV)
N/A
 Varecilla
N/A
Incidence rate of AFP per 100,000
children below 15 years.
3,9
Zero
Number of +ve polio cases.
101
>98%
>98%
2,54
More than 2
Zero
Maintaining
Zero
reporting
status
Past
situation
2005
Indicators
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Zero
Number of Diphtheria cases notified.
Current
situation
2010
Targeted
situation
2015
Zero
Maintaining
Zero
reporting
status
Incidence Rate of Neo-Natal Tetanus per
1,000 live births.
Zero
Zero
Maintaining
Zero
reporting
status
Number of Non Neo-Natal Tetanus
cases notified.
Incidence rate of Measles per 1000,000
populations (EMRO initiative of
Measles Elimination by 2010).
Incidence rate of Rubella per 1000,000
populations (EMRO initiative of Rubella
Elimination by 2010).
Number
of
Congenital
Rubella
Syndrome due to Rubella infection per
1,000 live births.
Incidence rate of Mumps per 100,000
populations.
Incidence rate of H. influenza type b
(Hib) infection per 100,000 of children
<5 years.
Number of deaths due to complications
of infection by H. influenza type b.
Incidence rate of pneumococcal diseases
per 100,000 populations.
Number of deaths due to complications
of infection by pneumococcal disease in
children <5 years.
6
2
Zero
0.8
0.9
0.1
0.4
0.9
Zero
0.0004
Zero
Zero
35
20
10
0.04
0.37
Zero
Zero
Zero
Zero
3.9
1,2
1
N/A
Zero
Zero
Fourth Objective’s Indicators: Achieving the lowest possible rates for other communicable
disease
1.
2.
3.
Incidence rate of sputum smear positive
(active pulmonary TB) per 100,000
populations.
Percentage of Cure rate of sputum smear
positive (active pulmonary TB).
Number of new sputum smear positive
(active pulmonary TB) with Multi Drug
Resistance (MDR).
102
5.21
4.86
1.0
93%
94%
95%
0
4
<5
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
0
0
0
0.2
0.1
0.1
N/A
260
50
0.2
0.2
0.1
0
0
0
0.3
0.2
0.2
2
2
1
per
41.8
31.3
20
Incidence rate of Brucellosis per
100,000 of All population.
Incidence rate of Schistosomiasis per
100,000 of Dhofar population.
Incidence rate of acute viral hepatitis A
per 100,000 populations.
4.5
3.9
2
0.6
0.32
0
24.2
13.4
10
Indicators
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Number of new sputum smear positive
(active pulmonary TB) with X Drug
Resistance.
Incidence rate of Leprosy per 10,000
populations
(Leprosy
elimination
initiative).
Incidence rate of Rotavirus infection per
100,000 of children under 5 years. (In
Regional Referral Hospital).
Percentage of Severe dehydration
among all diarrheal.
Number of deaths due to complications
of Diarrheal diseases.
Percentage of Severe ARI (among all
ARI cases in children < 5 years).
Number of deaths due to complications
of ARI diseases.
Incidence rate of Brucellosis
100,000 of Dhofar population.
103
STRATEGIES:
Strategies to Achieve 1st Objective: Strengthening and maintaining the national capacity for
infectious disease detection and response through achieving effective preparedness,
surveillance and response system that meet the IHR requirements.
1.1 Strengthening and maintaining the national capacity for infectious disease detection
and response through achieving effective preparedness, surveillance and response system
that meet the IHR requirements through:

Upgrading the surveillance capacity of the country’s points of entry.

Increasing the capacity of the Public Health Laboratory to appropriately detect
infectious disease.

Finalizing the mapping of potential health risks areas (e.g. vector breeding areas,
animal farms, and industrial zones, petrochemicals and radio-nuclear hazards).

Updating the regional and hospital committees plans for communication,
notification and response to Public Health Event of International Concern
(PHEIC).

Updating the IHR related laws and regulations.

Building the human resources capacities for preparedness, notifications, and
response to public health events of international concerns.

Updating the epidemic preparedness plans.

Implementing simulation & response exercises.
Expected results:







Entry Points are ready to implement IHR standards.
Availability of specific reagent in the Public Health lab for early detection of
emerging/epidemic-prone infections.
Availability Heath Risk Maps (e.g. vector breeding areas, animal farms, and industrial zones,
petrochemical and radio nuclear hazards).
Availability of updated the regional and hospital committees and plans for communication,
notification and response to Public Health Event of International Concern (PHEIC).
Availability of updated IHR-related laws and regulations.
Trained staffs are available to detect, assess and respond to epidemics and reduced the
consequence of severe epidemics.
Availability of updated regional and hospital epidemic preparedness plans and implemented
simulation & response exercises.
Strategies to Achieve 2ndObjective: Reduction of health care associated infections (HAIs)
rates.
2.1 Restructuring the infection prevention & control program through:

Expanding the central infection prevention & control.

Restructure and revitalization of the role of the hospital infection control
committees.

Reporting of the infection control team to the executive director of the hospital.
104

Establishing infection control committee at the regional level.

Appointment of a focal point at the regional level.
Expected results:

Improving efficiency and effectiveness of the structure of the infection control program
2.2 Updating Infection Prevention & Control SOPs & Manuals.
Expected results:

Updated infection prevention & control is available
2.3 Building the capacity& the career of Infection preventionists through:

Continuation of the Infection prevention & control post-basic nursing diploma.

Enrolling post-basic diploma graduates in the Bachelor degree studies.

Granting scholarships for master degree in infection prevention & control for
infection preventionists (nurses).

Granting scholarships for master degree in infection prevention & control for
doctors.

Continually organizing training workshops in infection control.
Expected results:
 Updated Infection prevention & control is available
2.4 Promoting Infection Prevention & Control Principles and Practices among healthcare
workers (HCWs) and in the community through:

Implementing national campaign to promote essential practices of infection
prevention and control, e.g.: Hand hygiene, Injection safety.

Conducting continual training of HCWs on the basic principles and best practice of
infection prevention and control.

Promoting Infection Prevention & Control Principles and Practices among
healthcare workers (HCWs) in the private sector.

Introducing Infection Prevention & Control Principles and Practices among the
community.
Expected results:



Understanding and knowledge of basic principles of infection prevention and control among
healthcare HCWs.
Improvement of Infection prevention and control practices.
Orientation of the community about healthcare associated infections and their prevention.
105
2.5 Improving instruments’ Disinfection & Sterilization processes in healthcare facilities
through:

Building the capacity of staff working in instruments sterilization through
education and continual education.

Developing instruments sterilization manual & SOP.

Proving appropriate sterilization techniques and devices for medical instruments
and equipments.
Expected results:

Improvement of the knowledge and practices of staff working in instruments‟ Disinfection &
Sterilization.

Availability of national standards and procedures on instruments‟ Disinfection &
Sterilization processes.
2.6 providing medical instruments and supplies that have infection prevention and control
features through:

Involving infection prevention and control committees and teams in medical
instrument and equipments evaluation and purchasing decisions.
Expected results:

Availability of medical instruments and supplies that have infection prevention and control
features.
2.7 preventing and controlling infections among health care workers (HCWs) through:

Providing essential HCWs vaccinations (e.g. Hep B, seasonal Influenza, Varicella
and MMR).

Pre employment screening of HCWs against infectious diseases.

Training HCWs on safe practices.

Providing safety-engineered medical instruments to HCWs.

Improving blood/body fluid exposure reporting and follow up system.

Collaboration with agencies involved in occupational health.
Expected results:
 Improving vaccination coverage among HCWs.
 Reducing rates of HCWs occupational infections.
 Follow up of exposed cases.
2.8 Strengthening the surveillance system of healthcare associated infections through:

Updating the surveillance manual related to health services.

Updating the reporting system between different levels of health services.

Establishing electronic database system.
Expected results:

Availability of accurate information on rates and trends of Healthcare associated infections.
106
2.9 Establishing Supervision and monitoring system for infection prevention and control
through:
 Establishing national standards for infection prevention and control.
 Developing national and facility level indicators.
 Developing infection prevention and control audit system.
Expected results:

Availability of national standards and indicators on infection prevention and control
Strategies to Achieve 3rd Objective: Maintaining the lowest rates of vaccine-preventable
diseases
3.1 Upgrading vaccines and updating vaccines target groups in the EPI Program through:

Adding Varicella vaccine to EPI to be given to targeted children starting Jan 2011
for children born in Jan 2010 and after.

Adding Rota vaccine to targeted children

Adding Hexa-valent vaccine (that includes Hib, Hep B, DTP & IPV) to the EPI
program

Providing seasonal influenza vaccine to children > 6 month.

Mass campaign to vaccinate children between 2-5 years with PCV those who didn’t
receive vaccine.
Expected results:

Protecting children against vaccine preventable diseases.
 Expanding vaccination coverage to children.
3.2 Upgrading vaccines and updating vaccines target groups among adults through:

Expanding seasonal influenza vaccine coverage among adults.

Providing Hep B vaccine to adults >30 years of age.

Providing pneumococcal vaccine to high risk groups, e.g. >65 years.
Expected results:
 Protecting adults against vaccine preventable diseases.
 Expanding vaccination coverage among adults.
3.3 Upgrading vaccines and updating vaccines target groups among Healthcare workers
(HCWs) in collaboration with Infection Prevention and control Section through:

Continuation of providing Hep B vaccine to HCWs.

Continuation of providing IPV vaccine to HCWs.

Expanding seasonal influenza vaccine coverage among HCWs.

Providing Varicella vaccines to HCWs.

Providing MMR vaccine to HCWs with no evidence of immunity.
Expected results:

Protecting HCWs against vaccine preventable diseases.

Expanding vaccination coverage among HCWs.
107
3.4 Maintaining the quality of the EPI program performance and the high coverage
percentage through:

Maintaining the efficacy of vaccines in the cold-chain (central / governorate).

Improving the surveillance of adverse effects following immunization (AEFI).

Continuing the vaccine’s defaulter’s retrieval system in the target age group.

Continuing the training and CME activities for all health workers involved in the
implementation of the Programme in the regions.

Continuing the health education activities to the community on the EPI schedule
and diseases targeted by these vaccines.

Improving supervision and monitoring of EPI activities.
Expected results:
 continuation of the quality of the EPI program
Strategies to Achieve 4th Objective: Achieving the lowest possible rates for other
communicable disease.
4.1 Strengthening the epidemiological surveillance and intervention plans for elimination,
control , and eradication of the communicable diseases not targeted by EPI through:

Updating the current SOPs (Leprosy-Tuberculosis-Aids-Communicable Diseases).

Strengthening, upgrading, and updating the disease e-notification system including
web-based surveillance).

Establishing Hepatitis B national registry.

Utilizing the (GIS) applications in communicable diseases.

Improving early warning systems for communicable diseases (.e.g. Severe Acute
Respiratory Illness; SARI).

Upgrading regional surveillance units and providing recourses particularly trained
cadres to them.

Analyzing the current situation of some significant diseases (e.g. HPV, Rota, & Q
fever).
Expected results:






Early detection of communicable diseases other than the vaccine-targeted diseases.
Reduction in the incidence rates of these diseases.
Keeping incidence rates on minimum levels.
Established web-based notification system for communicable disease.
GIS system applied in communicable diseases for central and peripheral level.
Fully prepared regional surveillance units and prepare trained staff for these units.
108
4.2 Strengthening the National TB Program through:

Establishing electronic national reporting system (ENRS).

Strengthening surveillance of anti-microbial resistance of TB.

Improving TB infection prevention and control practices in healthcare facilities.

Continuing to provide DOTS strategy.
Expected results:


Early detection and management of TB cases.
Reduction in the incidence rates of TB particularly among case-close contacts.
STRATEGIE’S INDICATORS:
Follow up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
1.1b
1.1c
1.1d
1.1e
1.1g
Existence of maps up to date on the sources of
risk to public health Risk Mapping, such as
places where the vectors and animal farms and
factories, petrochemical and radio nuclear.
Number of meetings held by Epidemic
Preparedness committee.
Number of staff trained to deal with outbreaks
of a class (public health specialist) annually.
Number of the epidemic preparedness plans
approved and updated annually by the regions.
Percentage of regions / provinces and hospitals
that have implemented a simulation of the
implementation of preparedness and response
plan.
Number of regions / provinces in which the
joint committee up to date with relevant
government agencies.
Annually
NA
Available
Annually
Twice for
each
governorate
Twice for
each
governorate
Annually
2
11
Annually
6
11
Annually
20%
100%
Annually
7
11
Annually
1
5
Annually
1
All hospitals
Annually
0
11
Indicators of Strategies of the 2nd Objective
2.1a
2.1b
2.1c
Number of Employees in infection control
section.
Number of infection control dept established
that reports directly to the Director General/
Hospital Executive Director of hospitals.
Number of regions / provinces with a
committee for the prevention of infections
associated with health care.
109
Follow up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
2.1d
Number of regions / provinces with a focal
point at the regional level for the prevention of
infections associated with health care.
Annually
2
11
2.2a
The existence of Updated National guidelines
for the prevention of infections associated with
health care.
The end of
the current
plan
N/A
Available &
Updated
Continued
Continued
0
25
0
10
3
13
At least one
At least one
N/A
Available
N/A
Available
Annually
65%
At least 90%
The end of
the current
plan
N/A
Available
N/A
Available
N/A
Available
2.3a
2.3b
2.3c
2.3d
2.4a
2.5a
2.6a
2.7a
2.7b
2.8a
2.9a
Continuation of the Post- basic Diploma Annually
course during the years of the plan.
Number of Infection control practitioner study Annually
Bachelor Degree.
Number of Infection control practitioner sent Annually
to study for a Master Degree in prevention of
infections associated with health care.
Number of Doctors sent abroad for a Master Annually
Degree in prevention of infections associated
with health care.
Number of Hand Hygiene audits conducted in Annually
every healthcare facility.
The end of
The existence of guidelines for policies and the current
procedures for sterilization.
plan
The existence of Infection control responsible
in evaluation and purchase committee of tools
and supplies (Infection control equipments).
Percentage of vaccinated HCWs against Viral
Hepatitis type B in every healthcare facility.
The existence of reporting system and
documentation of exposures to blood and body
fluids and acupuncture with sharp tools at
every healthcare facility.
The existence of reporting system and
documentation of infections associated with
health care at every regional and referral
hospital.
The existence of standards for practices,
procedures and prevention and control health
care associated infections at every healthcare
facility.
Annually
Annually
Annually
Indicators of Strategies of the 3rd Objective
3.1a
Coverage of varicella vaccine among target
children.
110
Annually
NA
>98%
Follow up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
3.1b
Availability of Rota Virus Vaccine (severe
diarrhea).
Annually
NA
available
3.1c
Availability of Hexvalent vaccine.
Annually
NA
available
3.1d
Availability of Seasonal Influenza vaccine for
children more than 6 months.
Annually
NA
available
3.1e
Coverage of PCV vaccine among children 2-5
years for those who did not receive vaccine.
Annually
NA
90%
3.2a
Coverage of Seasonal Influenza vaccine
among adult, more than 50 yrs.
Annually
NA
40%
3.2b
Coverage of Hep B vaccine among adult more
than 30 yrs.
Annually
NA
60%
3.2c
Coverage of PCV vaccine among adult – more
than 60 yrs.
Annually
NA
60%
3.3a
Coverage of Influenza vaccine among HCW.
Annually
20%
40%
3.3b
Coverage of varicella vaccine among HCW
those not vaccinated or not exposed by
disease.
Annually
NA
50%
3.3c
Coverage of MMR vaccine among HCW those
not vaccinated or not exposed by disease.
Annually
NA
40%
3.4a
Coverage of vaccine wastage due to cold chain
failure.
Annually
<1%
<1%
3.4b
Rate of Health education sessions per child per
visit.
Annually
Every visit
100%
3.4c
Coverage of defaulters due to vaccination.
Annually
>99%
>99%
3.4d
Coverage of trainees who‟s responsible of EPI
program.
Annually
100%
100%
Available but
needs update
Updating the
3rd edition
Indicators of Strategies of 4th Objective
4.1a
End of the
current plan
The existence of updated manuals for
communicable diseases.
111
Indicators
4.1b
4.1c
4.1d
4.1e
Current
situation
Targeted
situation
2010
2015
Annually
Available in
65% of
Muscat
Governorate
50% of health
institutions of
each region
Annually
Zero
Available
Annually
Zero
8
Follow up
timing
Percentage of Health Care Institutions that
have a monitoring system and electronic
reporting (Web Based Surveillance) of
infectious diseases in each region.
The existence of National Registry for chronic
viral hepatitis (B and C) at the central level.
Number of regions / provinces that have a
geographic information system (GIS) for
priority communicable diseases.
Number of regions / provinces that have
trained units of integrated epidemiological
surveillance
(epidemiologist,
Health
Inspectors and data entry).
The proportion of health centers which have
trained 100% of lab technicians on the use of
the Electronic Reporting System (ENRS) for
TB patient.
The proportion of centers for the examination
of immigrant labour, which have trained at
least 50% of lab technicians on the use of the
Electronic Reporting System (ENRS) for TB
patient.
The proportion of tertiary care hospitals,
which have trained at least 50% of lab
technicians on the use of the Electronic
Reporting System (ENRS) for TB patient.
Number of of regions / provinces that have 4
master trainers on Electronic Reporting
System (ENRS).
Percentage of Health Care Institutions that
have one master trainer on Electronic
Reporting System (ENRS).
The rate of sputum conversion from positive to
negative within 2 to 3 months from the date of
commencement of treatment / all sputum
positive TB patients.
To be
Available
Annually
1 (Dhofar)
In all
Governorates
Annually
NA
70%
Annually
50%
100%
Annually
20%
100%
Annually
NA
11
Annually
NA
50%
Annually
94%
95%
4.2h
The proportion of people with latent TB
(house hold contacts of TB patients) who
completed treatment for 9 months.
Annually
NA
4.2i
The proportion of health institutions that
implement Electronic Reporting System
(ENRS) for TB patient.
Annually
4.2a
4.2b
4.2c
4.2d
4.2e
4.2g
112
At least
80%
NA
70%
Current
situation
Targeted
situation
2010
2015
Annually
NA
70%
Annually
NA
100%
Annually
100%
100%
Annually
90%
100%
Follow up
timing
Indicators
The proportion of health institutions that
4.2j implement Electronic Reporting System
(ENRS) for TB suspect.
The proportion of health institutions that
4.2k implement Electronic Reporting System
(ENRS) in laboratory for TB patients.
The proportion of patients with HIV/AIDS co4.2l infection and receive treatment for both
diseases.
The proportion of TB patients with positive
sputum who are isolated during their
4.2m
admission till their sputum is converted from
positive to negative.
113
Domain Eleven
HIV/AIDS and Sexually Transmitted
Infection (STI)
114
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: HIV/AIDS and Sexually Transmitted Infection (STI)
INTRODUCTION:
Acquired Immune Deficiency Syndrome (AIDS) caused by Human
Immunodeficiency Virus (HIV) is a major health concern facing our world today. Not a
single country in the world is free from HIV/AIDS, and in many countries the epidemic has
escalated and in some it is out of control. The number of people living with HIV / AIDS in
the world at the end of 2009 was estimated to be approximately 33.4 million people, and
around 28 million persons died due to HIV/AIDS in the world during 2009.It is estimated that
the number of people infected with Sexually Transmitted Infections (STIs) each year is
approximately 340 million people in the world.
HIV/AIDS is a major cause of death among young people, especially in the
developing countries where more than 90% of the cases exist. The most affected regions are
Africa, and South East Asia. Oman is located between the two regions and has strong
historical ties with countries in those regions, which increases the need to take certain
precautionary measures to curb the spread of this epidemic, given the rapid social and
economic changes associated with the demographic and epidemiological changes in the
Sultanate.
Although the prevalence rate in Oman remains low, In less than 25 years, the overall
at the end of 2009 cumulative number of reported cases amongst Omanis is 2000 cases, with
total number of people who have died till the end of 2009 is 30% of the total. High-risk
sexual behavior- extramarital relationships and injecting drug use is responsible for more than
90% of all reported cases in Oman, especially in the past 10 years, making it fundamental to
address the issue in a culturally sensitive and pragmatic ways and take all necessary
precautions to halt the spread of the disease further.
There are major factors contributing towards the increase of HIV in Oman; migration
from rural villages to more urban cities in search for jobs and continuing higher education,
the growth of tourism both internal and external, high number of young people who are
seeking jobs. Stigma and discrimination linked with the disease, in addition to its association
with high risk behaviors within the society, also contribute to its increase.
Ever since the reporting of cases in Oman initiated, the Ministry of Health has taken
various measures to face this pandemic, keeping in consideration the importance of the
involvement of all relevant sectors in the fight against HIV/AIDS. A technical committee for
AIDS was established in 1987, which includes representatives from various governmental
health institutions, and aim to develop the regulations and guidelines in the area of diagnosis
and treatment, as well as other technical matters related to HIV/AIDS. It was followed by the
establishment of the National Educational Committee for AIDS in 1990, which was expanded
in 2002 to include a number of representatives from other ministries and relevant
organizations, in addition to the Ministry of Health. The HIV/AIDS control section was
established in 1987 at the Directorate-General of Health Affairs, Ministry of Health in order
to plan, implement and evaluate the prevention and control activities against the disease at
various levels with objectives a) Prevention of HIV transmission including transmission by
way of blood, sexual, injection and perinatal transmission b) Reduction of morbidity and
115
mortality associated with HIV infection and AIDS c) Reduction of the impact of HIV
infection and AIDS on individuals and their families and communities. In 1996, Sexually
Transmitted Infection (STI) was also integrated into the National AIDS Programme (NAP).
In 2007, the National Strategy for HIV/AIDS (2008-2011) was launched with involvement
of thirteen ministries and sectors for the formation of plan of action and development of
strategies to counter HIV/AIDS in Oman. The strategy involved setting clear objectives
where the goal of each sector was to set aside a budget from their respective 5 year plans or
from a special budget specifically for the strategy from the Ministry of Finance. In line with
the initiation of the strategy, the „Lets Talk AIDS‟ Campaign 2009-2010 was launched, with
the goal of increasing awareness among young adults on the prevention of HIV and related
services and to advocate for acceptance and rights of people living with HIV. The campaign
had a strong impact amongst youth in Oman. Moreover, an expansion of the HIV/AIDS/STI
Section took place, increasing its capacity in order to implement its activities to achieve the
goals and follow the policies set out by the Ministry of Health towards combating HIV/AIDS.
OBJECTIVES:
1. To control the spread of HIV/AIDS and STIs in the community in general and in the
most vulnerable groups in particular and stabilizing the current rates of these diseases.
2. To improve health and psychological conditions of patients with HIV/AIDS, reduce the
complications of the disease; reduce mortalities due to opportunistic infections
associated with AIDS, and management of STI as a Syndromic Case Management
Approach (SCMA) with provision of essential medicines in primary health care
institutions.
3. Promotion and support of NGOs who are working with Most At Risk Populations/
those with high risk behavior and People Living With HIV (PLHIV).
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To control the spread of HIV/AIDS and STIs in the
community in general and in the most vulnerable groups in particular and stabilizing the
current rates of these diseases.
Prevalence rate of HIV per 100,000
1.
51
62
86
populations.
Prevalence rate of HIV per 100,000 in
80
90
105
2.
age group 15 – 49 years.
Prevalence rate of STI detected by
3.
laboratory examination per 100,000
67
24
67
populations.
Prevalence rate of STI syndrome per
4.
344
151
344
100,000 populations.
116
Indicators
5.
Number of cases of HIV, Syphilis,
Hepatitis B&C infected through blood
transfusion.
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
0
0
0
Number of newly diagnosed children
infected with HIV through their
4
5
0
mothers.
Second Objective’s Indicators: To improve health and psychological conditions of patients
with HIV/AIDS, reduce the complications of the disease; reduce mortalities due to
opportunistic infections associated with AIDS, and management of STI as a Syndromic
Case Management Approach (SCMA) with provision of essential medicines in primary
health care institutions.
6.
1.
Number of cases receiving ART.
273
481
1000
Percentage of PLHIV receiving
treatment from total of those who are
2.
80%
NA
100%
eligible for treatment (as per the HIV
Management Guidelines).
3.
Number of trained counselors.
85
129
140
Number of Patients receiving Social
4.
25
49
500
Assistance/ welfare.
Number of PLHIV trained as
5.
6
15
19
volunteers work with the NAP.
6.
Annual mortality rate due to AIDS.
4.4%
2.5%
2.5%
Third Objective’s Indicators: Promotion and support of NGOs who are working with Most
At Risk Populations/ those with high risk behaviour and People Living With HIV (PLHIV).
Number of projects supported by
1.
0
0
2-3 annually
Government.
Financial support provided to NGOs.
RO 20002.
NA
NA
5000
annually
STRATEGIES:
Strategies to Achieve 1st objective: To control the spread of HIV/AIDS and STIs in the
community in general and in most at risk population (MARPS) in particular, and
stabilizing the current rates of these diseases
1.1 Expansion of voluntary counseling and testing (VCT) through:

Promotion of VCT particularly for MARPS- injecting drug users (IDUs), men
who have Sex with men (MSM), female sex workers (FSW) and their clients &
STI Patients.

Training of health care workers at primary Health Care (PHC) Levels on VCT.
117
Expected Results:



Raise awareness on prevention methods on HIV.
Address stigma and Discrimination against PLHIV.
Raise awareness of PLHIV and the community at large by enabling them to receive
accurate information on HIV at all times.
 Early detection of a larger number of cases affected by HIV and management of such
cases.
1.2 Elimination of mother to child transmission through screening of all pregnant
women for HIV and taking all preventative measures to avoid vertical transmission.
Expected Results:



Protection of children born from infected mothers.
Reduction in incidence rates among children of infected women.
Detect new cases in the community through screening of contacts of infected pregnant
woman.
1.3 Raise awareness of the community on HIV/AIDS and STI through:

Carry out annual national campaigns to raise the awareness of the community
on risky behaviours associated to HIV, and address the social stigma and
discrimination associated with it.

Support and promote awareness activities directed to young people and women
through the promotion of peer education programmes in collaboration with
ministries, agencies and relevant sectors and institutions.

Address stigma and Discrimination against PLHIV.
Expected Results:



Raise awareness in the community in general and MARPS in particular on HIV and STIs.
Increase participation of government institutions and NGOs in health education on HIV
Involvement of other sectors in peer education programme; Ministry of Education,
Ministry of Higher education, private schools and institutes and Women‟s Associations.
 Eliminate stigma and discrimination against HIV.
1.4 Provision of post-exposure prophylaxis (PEP)to exposed health care workers and
capacity building on management of PEP.
Expected Results:
 Raise knowledge and behavior of health care workers on prevention methods.
 Prevention of health care workers from exposure to HIV.
1.5 Strengthen epidemiological surveillance system to monitor and control the spread of
HIV/AIDS and STI and document future directions for infection and disease.
Expected Results:


Understand in magnitude of problem better so corrective action can be done according to
requirement.
Raise efficiency of health care workers in laboratories and blood banks in order to create
„Qualified Health Care Workers, Better Services‟.
118
Strategies to Achieve 2nd Objective: To improve health and psychological conditions of
patients with HIV/AIDS, reduce the complications of the disease, reduce mortalities due to
opportunistic infections associated with AIDS, and management of STI as a Syndromic
Case Management Approach (SCMA) with provision of essential medicines in primary
health care institutions.
2.1 Care of HIV/AIDS/STI Patients and provision of treatment including anti retroviral
triple therapy, opportunistic infections, preventative treatment and follow up medically
including laboratory monitoring and counseling.
Expected Results:

Improve the health status of those infected with HIV/AIDS/STI and their caregivers.

Reduce numbers of visits of PLHIV to health institutions especially admission in
hospitals.
2.2 Strengthen training of health care workers skills in counseling, management and
care of PLHIV through:

Continuous training of physicians and nurses working in the hospitals and the
counselors through periodic and regular refresher training courses

Strengthen the central unit (National Technical Committee) to supervise the
treatment, follow up and counseling of patients.

Strengthen the regional HIV teams in all treatment facilities/ referral hospitals
(physician, nurse, pharmacist, lab technician) to follow up on treatment and
provide regular refresher training courses for them.
Expected Results:
 Enhance skills of health care workers in management and care of HIV patients.
 Improve follow up of HIV infected patients.
2.3 Management of STI as syndromic case management approach with provision of
treatment in primary health care institutions and training of health care workers in
PHC on treatment of STIs.
Expected Results:
 Early and effective treatment.
 Reduction in incidence rates of these infections.
 Reduction in patient drops out especially during the referral process.
 Offer and provide treatment for partners.
 Provision of condoms.
Strategies to Achieve 3rd objective: Promotion and support of NGOs who are working for
Most At Risk Populations and People Living With HIV (PLHIV)
3.1 Promote and provide financial support to NGOs/ civil society working in the area of
substance abuse and care of those who are substance dependent and those who are HIV
infected and support them in their awareness raising campaigns addressing MARPS.
Expected Results:



Improve NGO and CSOs.
Control the spread of HIV/AIDS.
Raise awareness of MARPS on high risk behavior.
119
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
1.1b
1.1c
1.1d
1.1e
1.1f
1.2a
1.2b
1.2c
1.2d
1.2e
1.2f
1.2g
1.2h
1.2i
1.2k
1.3a
1.3b
Number of Government health institutions
offering voluntary counseling and Testing
(VCT) for HIV with referral system
Number of Private health institutions offering
VCT for HIV with referral system.
Percentage of people tested for HIV and knows
their results.
Percentage of completely filled out counseling
forms and sent to NAP.
Percentage of Omanis who have had at least one
WB after ELISA +.
Percentage of expatriates who have had at least
one WB after ELISA +.
Percentage of Pregnant women tested for HIV
from total numbers registered in ANC.
Percentage of HIV infected pregnant women
who have been followed up during pregnancy
and delivery and receive ART to prevent mother
to child transmission.
Percentage of children born to infected mothers
and
receiving
preventive
treatment
(Antiretroviral Prophylaxis) for at least 6 weeks
after delivery.
Percentage of children born to infected mothers
and received Co-Trimoxazole CTX within 2
months of being born.
Percentage of children born to infected mothers
and tested for antibody or virological tests
within 2 months of being born.
Percentage of HIV infected Pregnant women
who are counseled on artificial feeding.
Percentage of children born to infected mothers
at 18 months who are diagnosed positive for
HIV.
Number of deliveries during which intra-natal
ARV was not administered.
Percentage of infants born to infected mothers‟
breastfed at DPT 3 visit.
Percentage of children born to infected mothers
is tested by ELISA at 18 months.
Number of health education activities during
World AIDS Day.
Number of hits to OmanAIDS website.
120
Annually
0
30
Annually
0
10
Annually
NA
100%
Annually
10%
80%
Annually
100%
100%
Annually
100%
100%
Annually
99.8%
100%
Annually
99%
100%
NA
100%
NA
100%
100%
100%
100%
100%
Annually
3%
2%
Annually
None
None
Annually
NA
0%
Annually
NA
100%
Annually
1129
1312
Annually
NA
50,000
Annually
Annually
Annually
Annually
Indicators
1.3c
1.3d
1.3e
1.3f
1.3g
1.3h
1.3i
1.3j
1.3k
1.3l
1.3m
1.3n
1.4a
1.4b
1.4c
1.4d
1.5a
Number of injecting drug users (IDUs) tested
for HIV and knows their results.
Number of injecting drug users (IDUs) tested
for Hepatitis B, C and knows their results.
Number of persons trained to work with
MARPS.
Percentage
of
government
schools
implementing the peer education project.
Percentage of private schools implementing the
peer education project.
Percentage of government schools that have
HIV integrated within their curriculum starting
from Grade 7.
Percentage of private schools that have HIV
integrated within their curriculum starting from
Grade 7.
Percentage of governmental colleges/ institutes
implementing the peer education project.
Percentage of Private colleges/ institutes
implementing the peer education project.
Number of people age group 15-24 who
completed questionnaire on mode of
transmission and misconceptions on HIV (5 UN
standardized questions).
Percentage of young people age group 15-24
correctly answers all
5 UN standardized
questions on HIV.
Number of condoms distributed in STI clinics,
HIV clinics, ANC clinics for prevention of HIV
and other clinics.
Percentage of government health institutions
that provide post exposure prophylaxis (PEP) or
have a referral system in place with other health
institutions.
Number of cases received PEP after exposure
with HIV source.
Number of reported cases of occupational
exposure to HIV source who are evaluated for
PEP according to national guidelines.
Percentage of private health institutions that
provide PEP or have a referral system in place
with other health institutions.
Percentage of government health institutions
having at least one trained doctor for STI
Syndromic treatment and provide treatment.
121
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
Annually
NA
3000
Annually
NA
3000
Annually
13
25
Annually
NA
40%
Annually
NA
10%
Annually
NA
80%
Annually
NA
30%
Annually
NA
40%
Annually
NA
10%
Annually
NA
5000
Annually
NA
70%
Annually
NA
100,000
Annually
75%
100%
Annually
NA
25
Annually
Annually
Annually
NA
NA
NA
40
100%
80%
Indicators
1.5b
1.5c
1.5d
1.5e
1.5f
1.5g
1.5h
1.5i
1.5j
1.5k
1.5l
Percentage of Omani PLHIV given their
Western Blot reconfirmed test results within
two week of being tested.
Percentage of non- Omani PLHIV who were
given their Western Blot results.
Number of units of donated blood tested for
HIV under external quality assurance.
Number of units of donated blood tested for
HBsAg under external quality assurance.
Number of units of donated blood tested for
Anti-HBc under external quality assurance.
Number of units of donated blood tested for
HCV under external quality assurance.
Number of units of donated blood tested for
TPHA under external quality assurance.
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
Annually
NA
95%
Annually
NA
95%
Annually
100%
100%
Annually
100%
100%
Annually
100%
100%
Annually
100%
100%
Annually
100%
100%
0
3
1
4
NA
150,000
NA
300,000
End of the
current
plan
Number of programmes and interventions Annually
targeting MARPS.
Number of syringes distributed among injecting Annually
drug users.
Number of condoms distributed among Annually
MARPS.
Number of studies targeting (MARPS).
Indicators of Strategies of the 2nd Objective
2.1a
2.1b
2.1c
2.1d
2.1e
2.1f
2.1g
Number of health institutions providing ART
for PLHIV.
Number of health institutions providing follow
up for PLHIV on treatment.
Percentage of PLHIV testing CD4 at least once
a year.
Percentage of PLHIV receiving treatment from
total of those who are eligible for treatment.
Percentage of infected children under 15 who
are on treatment.
Percentage of health institutions that had a stock
out during the last year.
Percentage of TB patients who are HIV + and
on ART treatment.
Annually
15
18
Annually
15
18
Annually
45%
100%
Annually
95%
100%
Annually
100%
100%
Annually
NA
0
Annually
100%
100%
2.1h
Number of PLHIV on INH treatment for
prevention from TB.
Annually
NA
2.1i
Number of PLHIV on TMP-SMX treatment for
prevention from some communicable diseases.
Annually
NA
122
All cases as per
the National
Guidelines
All cases as per
the National
Guidelines
Follow
up
timing
Indicators
2.1j
2.1k
2.1l
2.1m
2.1n
2.1o
2.2a
2.2b
2.2c
2.2d
2.2e
2.2f
2.2g
2.3a
2.3b
Percentage of PLHIV of all groups known to be
Annually
on treatment 12 months after starting of ART.
Percentage of PLHIV of all groups known to be
Annually
on treatment 24 months after starting of ART.
Percentage of PLHIV of all groups known to be Annually
on treatment 36 months after starting of ART.
Percentage of PLHIV of all groups known to be Annually
on treatment 48 months after starting of ART.
Percentage of PLHIV of all groups known to be Annually
on treatment 60 months after starting of ART.
Percentage of PLHIV testing Viral Load at least Annually
once a year.
Number of people trained who have attended at Annually
least one training/ conference on counseling
PLHIV up to the end of 2010.
Number of counselors who completed refresher Annually
training course on counseling PLHIV.
Number of physicians trained on administration Annually
of treatment for PLHIV.
Number of paediatricians trained
on Annually
administration of treatment.
Number of obstetricians/ gynaecologists trained Annually
to deal with infected pregnant women.
Number of pharmacists trained on counseling Annually
and treatment compliance.
Number of people tr who have completed at End of the
least 5 days comprehensive training on HIV/STI
current
counseling during current 5 year plan.
plan
Percentage of PHC physicians trained on Annually
treatment of STI as syndromic case
management approach.
Percentage of government PHC institutions that Annually
provide treatment of STI as syndromic case
management approach.
Current
situation
Targeted
situation
2010
2015
NA
90%
NA
90%
NA
90%
NA
90%
NA
90%
45%
100%
129
NA
NA
120
29
45
9
15
10
30
11
30
0
120
NA
NA
70%
70%
Indicators of Strategies of the 3rd Objective
3.1a
Number of campaigns on HIV conducted in
partnership with substance abuse concerned
NGOs.
3.1b
Number of studies conducted by NGOS that are
supported by Ministry of Health.
3.1c
Financial support provided to NGOs.
123
Annually
End of the
current
Plan
End of the
current
Plan
0
10
0
5
NA
Available
Domain Twelve
Malaria Eradication
124
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Malaria Eradication
INTRODUCTION:
Malaria was one of the major public health problems in Oman. The endemicity reached
its peak in the seventies when about 300,000 clinical cases were recorded annually. Malaria
control strategies were adopted in Oman in eighties but the programme failed to fulfill its
objective to reduce the incidence of malaria therefore the ministry of health decided to
implement an eradication strategy with the main objective to interrupt malaria transmission
and deplete the reservoir of infection. The pilot programme started in Sharquiya governorate
and gradually extended to include all governorates. Excellent results were obtained, the last
indigenous cases were recorded in 1999, and interruption of malaria transmission was
achieved in 2004 and maintained till September 2007 when a focus of local transmission was
detected in Dakhiliya governorate. In 2008 another outbreak of local transmission occurred in
North Batinah governorate.
Presently the available expertise in vector-borne disease prevention and control is mainly
focused on malaria. In the event of future outbreaks of vector-borne diseases (not only
malaria, but also other vector-borne diseases, e.g., leishmaniasis, dengue or West Nile Virus),
it is very important to ensure that this expertise is not lost over the course of time, in order to
deliver a robust and technically sound vector control response to such outbreaks.
Despite of this successful achievement, still there are many challenges the large number of
internationally imported malaria cases from highly endemic countries is a major threat to the
program together with the increased Receptivity may result in resurgence of malaria
transmission in the Omani community whose population has lost their acquired immunity
against malaria. Epidemics of malaria transmission will have serious effects on the health,
economy, tourism and social life of the population.
The suggested strategies in this plan aims to maintain the above achievements in this field by
supporting all activities that lead to prevent malaria transmission.
OBJECTIVES:
1. To maintain the incidence of indigenous malaria cases at zero.
2. Prevention of epidemics due to vector borne diseases.
125
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To maintain the incidence of indigenous malaria cases at zero
1.
Proportion of indigenous cases from
total number of locally transmitted
cases.
0
0
0
2.
Proportion of introduced cases from the
total number of locally transmitted
cases.
0
0
0
3.
Number of deaths due to malaria.
0
2
0
First Objective’s Indicators: Prevention of epidemics due to vector borne diseases.
1.
Number of epidemics due to vectorborne diseases.
NA
0
0
STRATEGIES:
Strategies to Achieve 1st Objective: To maintain the incidence of indigenous malaria cases at
zero
1.1 The use of evidence-based planning through:

Introducing PCR for genotyping of strains, especially where cases occur in clusters
that may be linked to local transmission.

Conduction of studies and experimental field work for evaluation and plan
development.

Monitoring & evaluation of all field activities.
Expected results:
 Detecting all cases and determining the source of infection of each case.
 Early detection & appropriate management of outbreaks.
 The availability of the information needed for planning.
1.2 Early detection and immediate& radical treatment for all the diagnosed cases through:

Activation of the governmental and private health institutions role in the early
detection of malaria cases.
126

Development of the lab technician’s skills in early detection of cases.

Availability of immediate treatment in government health institutions.
Expected results:

Increase the effectiveness of the early case detection strategy in governmental and private
health institutions.
 Improvement in the accuracy of determining the source of infection.
 Availability of treatment to all patients and prevention of the complication.
Strategies to Achieve 2n Objective: Prevention of epidemics due to vector borne diseases
2.1 Using Integrated Preventive measures:

Integrated Vector Control in the high risk areas.

National human resources development in the area of vector biology & control.

Continuous availability of chemoprophylaxis for travelers to highly endemic areas.
Expected results:


Reduction of the vectorial capacity of vector borne diseases.
Availability of qualified & trained national human resource in the area of vector biology &
control.
 Protecting travelers to endemic areas from severe and complicated malaria.
2.2 Enhancement of the health awareness in the community through :

Increase health awareness in the community about the activities of the program
and the risk of ignoring their implementation.

Increase health awareness among the high risk population about the importance of
the early detection in prevention of disease’s complications.
Expected results:

Increase health awareness in the community about the disease, prevention methods and the
importance of early detection.
127
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Number of studies and experiments conducted.
Annually
0
25
1.2a
Percentage of the slides examined in the
private health institutions to the total number
of slides examined.
Annually
21%
100%
1.2b
Percentage of the slides diagnosed correctly to
the total number of slides.
Annually
95%
95%
Number of travelers to high risk area who
received chemoprophylaxis.
Annually
6130
25000
1.2c
Indicators of Strategies of the 2nd Objective
2.1a
Number of epidemics due to vector-borne
diseases.
Annually
0
0
2.1b
Number of National staff
entomology and vector control.
Annually
0
4
2.2a
Number of field visits conducted by the
directorate of malaria eradication for
monitoring and evaluation.
Annually
6
30
2.2b
Number of awareness activities conducted.
Annually
7
55
qualified
128
in
Domain Thirteen
Non- Communicable Diseases
129
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Non- Communicable Diseases
INTRODUCTION:
Non-communicable diseases which are associated with patterns of lifestyle, such as
obesity, diabetes mellitus, hypertension, hyperlipidemia and metabolic syndromes represent a
challenge facing any regional or global health system.
Studies have shown a marked increase in diseases associated with unhealthy lifestyles over
the past ten years which represented by increase in the rate of smoking among males from
8.3% in 2000 to 14.7 in 2008. This reflected on the health sector in the form of an increase in
the prevalence of obesity and overweight, from 48% in 2000 to 52.9% in 2008, as well as an
increase in the prevalence of diabetes from 11.6% in 2000 to 12.3% in 2008. Also, the
prevalence of hypertension has increased from 33% in 2000 to 40.3% in 2008 while the
prevalence of hyperlipidemia has dropped from 40.6% in 2000 to 33.6%.
The complications of the above diseases represented a challenge to the health system, with
increased in the number of deaths due to heart disease during the Seventh Five Year health
Plan (2006-2010) to 220 deaths as well as the number of cases of chronic renal failure (end
stage) to 872 during the same period.
With regard to respiratory diseases bronchial asthma, has recorded the highest rates of
admissions, as well as obstructive airways disease was among the most common disease in
outpatient clinics. In addition, cancer represents the highest mortality rate among overall
mortality (about 250-300) deaths each year.
To face these challenges, the ministry adopted strategies and operational activities for the
prevention and treatment of chronic diseases in particular those associated with lifestyle. The
national strategy for Diet, physical activity and health, has been completed and will be
implement during Eighth Five Year Plan as well as different strategies to implement the
provisions of the Framework Convention for Tobacco Control, that signed by the Sultanate in
2005.
The implementation of early screening program for chronic diseases which was
implemented three years ago, in all primary health care units, is credited with the early
detection of pre-diabetes and hypertension, and subsequently early intervention aiming at
reduction of disease related complications.
The national screening programme has enhanced community awareness about these issues
which resulted in increase percentage of people that know there are diabetic to 63.8% and
high blood pressure to 24.3% in 2008 compared to 37% and 19% in 2000 respectively as well
as to the continued development of health services in the field of chronic diseases.
130
The Ministry of Health has made great strides in the fight against tobacco use. The WHO
Framework Convention on Tobacco Control (FCTC), has ratified by the Sultanate and was
adopted by - Royal Decree No. 20 / 2005.This first application for it was to ban smoking in
enclosed public places since 1st April 2010.
OBJECTIVES:
1. To reduce the risk factors for non-communicable diseases (diabetes, cardiovascular
disease, chronic renal disease, asthma, cancer) associated life style and reduce the
steady increase in it.
2. Early diagnosis of non-communicable diseases (diabetes, hypertension, high lipid,
chronic renal disease, stroke, obesity, cancer).
3. Good control of non –communicable disease and reduce complications.
4. To promote researches and studies in the field of non-communicable disease.
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To reduce the risk factors for non-communicable diseases
(diabetes, cardiovascular disease, chronic renal disease, asthma, cancer) associated life style and
reduce the steady increase in it
1.
Percentage of people over 20 years of
age doing regular physical activity
(more than 2.5 hours per week).
39.7%
52.8%
75%
2.
Percentage of current
cigarettes (males only).
8.7%
14.7%
10%
48%
52.9%
40%
3.
smokers
of
Prevalence of overweight and obesity in
the age group of more than 20 years.
4.
Prevalence of diabetes in the age group
of more 20 years.
11.6%
12.3%
13%
5.
Prevalence of hypertension in the age
group of more than 20 years.
33%
40.3%
35%
6.
Prevalence of high cholesterol in the age
group of more than 20 years.
40.6%
33.6%
30%
7.
Prevalence of chronic kidney disease in
the age group of more than 40 years
according to the index of glomerular
filtration rate (eGFR) in the screening
progamme.
NA
38%
28%
131
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Second Objective’s indicators: Early diagnosis of non-communicable diseases (diabetes,
hypertension, high lipid, chronic renal disease, stroke, obesity, cancer).
1.
Proportion of people who know that
they are diabetic in the age group of
more than 20 years.
37%
63.8%
2.
Proportion of people who know that
they have high blood pressure, in the
age group of more than 20 years.
19%
24.3%
3.
Proportion of people with severely
deranged renal function test (eGFR <30)
among the screened in the national
screening programme.
NA
0.5%
90%
70%
0.25%
Third Objective’s indicators: Good control of non – communicable disease and reduce
complications
Proportion of diabetic patients with
good control of diabetes.
30%
36.1%
45%
2.
Proportion of hypertensive patients with
good control of blood pressure.
42%
48%
55%
3.
Number of patients with chronic renal
failure (end stage) on heamodialysis.
609
872
680
4.
Number of patients with chronic renal
failure (end stage) on peritoneal
dialysis.
NA
22
100
5.
Asthma admissions rate per 10000
populations.
15
14
12
6.
Stroke admission rate of per 10000
populations.
4
5
3
7.
Prevalence of Diabetic foot amputation
rate per 10000 patients.
30
12
5
1.
Forth Objective’s indicators: To promote researches and studies in the field of noncommunicable disease
1.
The presence of an electronic database
for non- communicable diseases at the
national, the governorates and the
regional levels.
NA
NA
Available
2.
Number of studies conducted in the area
of non-communicable diseases.
0
1
3
132
STRATEGIES:
Strategies to Achieve 1st Objective: To reduce the risk factors for non-communicable diseases
(diabetes, cardiovascular disease, chronic renal disease, asthma, cancer) associated life style
and reduce the steady increase in it
1.1 Implementation of the national strategy for diet, physical activity and health and
develop indicators to monitor and evaluate the activating of the Ministry of health in this
regards.
Expected results:
 Reduce the proportion of non-communicable disease related to life style.
 Increasing in the proportion of people doing regular physical activity.
1.2 Activating the Framework Convention for Tobacco Control.
Expected results:

Application of a national plan for tobacco control and work on legislation to reduce tobacco
use.
 Reduction in the number of smokers.
 Increased in trained staff to assist in smoking cessation.
1.3 Activate the national screening programme for non-communicable diseases.
Expected results:

Increased detection of cases in pre stage disease such as obesity, Pre-diabetes, prehypertension.
 Reduction in the incidence of chronic diseases associated with unhealthy lifestyle.
1.4 Increase manpower in nutrition and health education fields and to continue development
of their capacities.
Expected results:
• Increase health awareness in patients on non-communicable diseases.
• Improvement in quality of health care services provided for patients with non-communicable
diseases.
1.5 Expansion of well being clinics in primary health care to be 50 clinics by end of this plan.
Expected results:
Improve the quality of health services provided for diabetes and hypertension.
1.6 Expansion in Healthy Villages and Cities projects in collaboration with other sectors to
include at least one city and village, in each governorate or region.
Expected results:
• Increase number of people doing regular physical activity.
Strategies to achieve 2nd Objective: Early diagnosis of non-communicable diseases (diabetes,
hypertension, high lipid, chronic renal disease, stroke, obesity, cancer).
133
2.1 Strengthens and activates the national non-communicable disease screening program, with
media coverage and solves the medical and administrative problems that prevent coverage of
the target groups and to start awareness campaigns, on the initial symptoms of stroke.
Expected results:
 Achieve wider coverage of the target groups.
 Increase in the number of chronic diseases detected.
 Providing early appropriate treatment.
2.2 Start to include the age group of 30 to 40 years with high-risk factor for chronic diseases
(obesity, family history) within the national non-communicable disease screening program.
Expected results:
 Increase the number of cases of chronic disease detected.
 Providing early appropriate treatment.
 Reducing the complications of these diseases.
Strategies to Achieve 3rd Objective: Good control of non –communicable disease and reduce
complications
3.1 Training and strengthening the manpower in the field of non-communicable diseases and
develop new jobs as medical assistance such as (Heamodialysis Technician ,Grader and
Retinal Photographer, Respiratory Therapist, Diabetes Nurse Specialist, Echocardiographic
Technician, Physiotherapist ,Speech Therapist.
Expected results:


Availability of qualified medical professionals for proper diagnosis and treatment in both
primary and secondary.
Availability of medical staff, to provide the best care for patients with non-communicable
diseases.
3.2 Expansion in specialty clinics by introducing new clinics in polyclinics and hospitals to
support the existing ones such as (Cardiology clinics – Transient Ischemic attack clinics –
asthma clinics – nephrology clinics – retinal clinics) conducted by specialists in the field.
Expected results:




Availability of better services at both primary and secondary levels.
Reduction in the number of cases transferred to hospitals.
Reduce the burden on the tertiary level.
Availability of clinics to follow up cases of Transient Ischemic Attack in the referral
hospitals
3.3 Consolidate health services for non-communicable diseases in polyclinics by providing
echocardiography machines, spriometry, digital camera for retina, and diagnostic
equipment to measure venous blood sugar, glycated hemoglobin and microalbuminuria.
Expected results:

Availability of better services at both primary and secondary levels.


Reduction in the number of cases transferred to hospitals.
Reduce the burden on the tertiary level.
134
3.4 Consolidate and expand the combined clinics that provide comprehensive medical
service to the patient, such as combined clinics for diabetes and pregnancy, diabetes,
nephrology clinics, hypertension and nephrology clinics.
Expected results:
3.5
 Better care for high-risk patients.
 Reducing the rate of complication among patients.
 Providing optimal treatment for hypertensive patients, diabetes and chronic renal failure.
3.5Establish a medical team for diabetic foot surgery in Khoula Hospital and regional
hospitals.
Expected results:

Existence of an integrated medical team specialized in foot surgery.
3.6 Expansion in diabetic foot clinics to cover all health centers per 10000 populations.
Expected results:



Reduce the burden on referral hospitals
Reduction in the rate of foot amputation
Reduce the complications rate among patients
3.7Improve diabetic foot clinics so that to be able to perform the biomechanical of the foot and
nail surgery and establish four laboratories for diabetic foot in Sohar - Sur - Salalah – Nizwa.
Expected results:
* Reduction in the rate of foot amputation.
* Improve the quality of life for patients with diabetes
* Reduce the complications rate among patients
1.8 Prepare a national proposal for peritoneal dialysis services and assess the experience of
Sohar, Nizwa Hospital in this regard as a prelude to the adoption of the service at the
national level.
Expected results:
 Adoption of peritoneal dialysis service at the national level.
 Increase in cases of peritoneal dialysis for end stage renal disease.
3.9 Update the current practical manual and create new manual for the diagnosis and
treatment of non-communicable diseases.
Expected results:

Provide guidelines for medical professional for the diagnosis and treatment of noncommunicable diseases at the national level.
Strategies to Achieve 4th Objective: To promote researches and studies in the field of noncommunicable disease
4.1 Converting current paper records for non-communicable diseases to electronic records.
Expected results:


Provide detailed information about non-communicable diseases.
Provide optimum care based on the available data.
135
4.2 Create indicators to measure the quality of health services in non-communicable disease
such as quality indicators for dialysis - health education – nutrition - therapeutic
interventions for diabetic foot - curative and palliative services for cancer - emergency
services for myocardial infarction – Stroke.
Expected results:

Improve the quality of health services provided to patients.
4.3 Conduct researches to support medical practice in non- communicable disease with
evidence –based methodology.
Expected results:


Improvement of services in the area of non-communicable diseases.
Provide a database for decision-makers and planners.
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Number of regions implemented the national
strategy for diet, physical activity and health.
Annually
0
1.1b
Presence of a dietitian to follow the national
strategy for diet, physical activity and health.
Annually
NA
1.1c
Existence of legislation prohibiting the use
of trans fats in the Sultanate.
Annually
NA
Available
1.1d
Existence of legislation determining the
amount of absolute salt and the daily
requirement per person in processed foods.
Annually
NA
Available
1.2a
Presence of a national law for the regulation of
tobacco use.
Annually
NA
Available
1.2b
1-2- b - Number of “quit smoking” clinics
Annually
1
5
Annually
33% of box
value
75% of box
value
tax
All regions
Available
1
1.2c
percentage
of
the
rate on tobacco from retail sale price.
1.3a
Percentage of annual coverage of the target
group in the national screening program.
Annually
37%
70%
1.4a
Number of Trained nutrition technicians on
the therapeutic feeding for chronic diseases.
Annually
40
70
136
Indicators
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
50
1.5a
Number of well beings clinics in regions.
Annually
15
1.6a
Number of Healthy Cities projects.
Annually
4
8
Indicators of Strategies of 2nd Objective
2.1a
Percentage of annual coverage of the target
group in the national screening program in
group age of 40 years and above.
Annually
2.1b
Number of campaigns and activities that have
been implemented to raise awareness for
early symptoms
of strokes
and patterns
of healthy life.
Annually
2.2a
Number of new diabetic cases detected in the
age group 30-40.
Annually
37%
70%
NA
50
1093
1300
NA
Available
- Heamodialysis Technician
0
150
- Grader and Retinal Photographer
0
30
0
22
- Diabetes Nurse Specialist
0
120
- Echocardiographic Technician
0
35
-Physiotherapist
0
11
- Speech Therapist
0
11
Indicators of Strategies of 3rd Objective
3.1a
Availability of a uniform method for the
training of primary care and emergency
physicians to detect and diagnose patients with
stroke and early referral.
Annually
Number of manpower:
- Respiratory Therapist
Annually
3.1b
3.2a
Number of polyclinics that have cardiology
clinics.
Annually
0
8
3.2b
Number of polyclinics that have asthma
clinics.
Annually
9
16
137
Indicators
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
3.2c
Number of polyclinics that have nephrology
clinics.
Annually
6
12
3.2d
Number of polyclinics that have hypertension
clinics.
Annually
13
20
3.2e
Number of regional hospital that have
transient ischemic attach (TIA) clinics.
Annually
0
All regional
hospitals
3.2f
Number of regional hospital that have stroke
treatment units.
Annually
1
All regional
hospitals
3.2g
Number of polyclinics that have retinal clinics
and using digital camera for retina.
Annually
0
8
0
25
0
25
2
25
0
25
Equipment numbers:
- Echocardiography machines
- Spriometry
3.3a
Annually
- Digital camera for retina
- Diagnostic equipment to measure venous
blood sugar, glycated hemoglobin and
microalbuminuria
3.4a
Number of combined clinics for diabetes and
nephrology.
Annually
2
10
3.5a
Number of hospitals that have medical team
for diabetic foot surgery.
Annually
0
4
3.6a
Number of diabetic foot mini clinics in health
centers.
Annually
0
50
3.7a
Number of advance diabetic foot clinics.
Annually
0
4
3.8a
Number of patients treated with peritoneal
dialysis.
Annually
25
100
3.9a
Number of practical manual of noncommunicable disease for primary health care.
Annually
6
10
138
Current
situation
Targeted
situation
2010
2015
0
1
0
1
0
1
Annually
2
7
Annually
1
3
Follow
up
timing
Indicators
Indicators of Strategies of 4th Objective
Number of electronic
communicable disease
4.1a
register for non-
- Diabetes
Annually
- Chronic renal disease
- Stroke
4.2a
4.2b
Number of non-communicable
programs that have quality indicators.
disease
Number of researches based on evidence –
based
methodology.
139
Domain Fourteen
Eye Health
140
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Eye Health
INTRODUCTION:
The bilateral blindness declined from 8.2% reported in 2005 to 5.6% in 2009 among 40
years and older Omani population. Elimination of blinding Trachoma is the reflection of
decline in the infectious eye diseases. Oman has applied in 2009 to World Health
Organization for certification that blinding trachoma is no more a public health problem. On
other hand low vision disabilities are rising in different age groups. This is due to changing
demography, epidemic of life style related health issues and high rate of birth defects.
The policy of the Ministry of Health for eye care is inspired by philosophy of VISION 2020
- The Right to the Sight. The health plans therefore aim to reduce the diseases leading to
blindness through early detection and appropriate interventions to reduce blinding
complications. It also favors improving preventive and curative services that are provided to
citizens at all health institutions. For this, developing human resources and modernizing
ophthalmic technologies for the diagnosis and treatment requires a reorganization of services
mainly at secondary and tertiary level of eye care centers.
OBJECTIVES:
1. To control factors leading to blindness in all age groups.
2. To Maintain Trachoma prevalence below WHO recommended standards for elimination of
blinding trachoma.
3. Reorganization of eye care services at all eye care levels specially the secondary and tertiary
levels to improve preventive, curative and rehabilitative eye health services.
OBJECTIVE’S INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To control factors leading to blindness in all age groups
1.
2.
Percentage of bilateral blindness
(<3/60) in 40 years and older citizen.
8.2%
5.6%
4%
Coverage rate of Refractive services for
school children (grade 1, 4, 7 & 10).
90%
95%
100%
141
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
Percentage of eye screening of patient
with diabetes.
80%
NA
100%
Percentage of glaucoma in the
population aged 40 years and above.
4.7%
NA
5%
Indicators
3.
4.
Second Objective’s Indicators: Maintain active Trachoma prevalence below WHO recommended
level
1.
2.
Percentage of active Trachoma among
1st grade school children.
0.4%.
0.4%
Less then
0.4%
Prevalence of Trachoma complications
among Omani population aged 15 years
and above.
4.1%
0.1%
0.1%
Third Objective’s Indicators: Reorganization of eye care services in all eye care levels specially
secondary and tertiary to improve preventive; curative and rehabilitative eye health services to
be compatible with VISION- 2020 THE RIGHT TO THE SIGHT.
1.
2.
3.
Ratio of Ophthalmic Unit / 100,000
population.
1.6
2.0
2.0
Ratio of Ophthalmologists / 100,000
population.
4.8
5.0
5.0
Ratio of Refractionists and ophthalmic
nurses per 100,000 population.
2.7
3.0
3.8
2,210
1,400
3,000
90%
95%
98%
NA
50%
100%
NA
NA
100% of
cases
4.
Cataract Surgery
population/ year.)
Rate
(/million
5.
Percentage of IOL implantation to total
cataract surgeries.
6
Percentage of Diabetic patients with
STDR who underwent laser treatment.
7.
Percentage of children with low vision
who were provided low vision aid at
secondary/ tertiary care hospital.
142
STRATEGIES:
Strategies to Achieve 1st Objective: To control factors leading to blindness in all age groups
1.1 To continue proactive eye examination of patients with chronic eye diseases and
diseases with priority in primary health care and to provide cadres (optometrist) capable
of early diagnosis to assess the vision and eye problems.
Expected results:
 Early detection of the serious and blinding eye cases.
 Reduction in incidence of diseases causing blindness.
 Reduction in incidence of cases referred to central hospitals.
 Reduction in rate of visual disability among children.
1.2 To co-operate with other ministries and private sector in order to reduce the incidence
of occupational and non occupational eye injuries.
Expected results:

Availability of data on rate of occupational & non occupational eye injuries in registration
under care of occupation health care directorate.
 Improved awareness and preventive measures at work places with particular hazard to eye
among workers.
 Existence of an international standard model for dealing with eye injuries and its reporting.
1.3 Introduce amblyopia (lazy eye) screening at age of 3-4 years of age.
Expected results:
 Availability of complete data for the cases of lazy eye and poor vision.
 Early intervention for the treatment of lazy eye if treatable.
 Low percentage of children with congenital preventable blindness.
1.4 Comprehensive eye assessment of population aged 40 and above at eye units of
extended health centers for detection of glaucoma, entropion, dry eye, age related macular
degeneration, and cataracts.
Expected results:
 Early detection of eye cases.
 Early therapeutic and surgical intervention.
 Reduction in rate of blinding complications associated with the disease detected.
1.5 To encourage community participating through different health committees and
supportive groups for eye health promotion and adoption of healthy lifestyle so as to
prevent eye diseases.
Expected results:


High sense of belonging and positive interaction of community with health service providers.
High level of community awareness and advocacy for adopting healthy lifestyles to prevent
eye diseases.
1.6 Annual eye examination for diabetic patients in all governorates, enhance documenting
diabetic retinopathy in all governorates and start the accountability system for retrieval of
DR cases causing blindness.
143
Expected results:
 High proportion of DR cases detected.
 Low proportion of cases of blindness due diabetes and retinal disorders.
 Decline in cases of defaulters to follow-up for annual examination of the eye.
 Decline in cases of defaulters to laser treatment of STDR and follow up.
1.7 To establish a system for co-operation between local and international health associations
and private sector.
Expected results:

Presence of a joint committee responsible for implementing a system for co-operation
between concerned authorities.
 Joint efforts in the field of preventive ophthalmic care.
 Increased participation of stakeholders to develop the eye health services.
1.8 To encourage private sector to provide eye health services by strengthening eye care
facilities.
Expected results:
 Availability of efficient private sector with standard eye care services.
 Reduction of workload on government health institutions for eye care.
 Presence of collaboration between the two sectors for better delivery of eye care.
Strategies to Achieve 2nd Objective: Maintain active Trachoma prevalence below standard
level recognized by WHO
2.1 Continuation of early detection of cases of active trachoma among 1st grade students.
Expected results:
 Maintain low levels of active trachoma transmission potential.
2.2 Continuation of addressing blinding trachoma through health services.
Expected results:
 Maintain low levels of visual disabilities due to Trachomatous Trichiasis (TT).
Strategies to Achieve 3rd Objective: Reorganization of eye care services in all eye care levels
especially secondary and tertiary levels to improve the preventive, curative and rehabilitative
eye health services to be compatible with VISION- 2020 THE RIGHT TO THE SIGHT.
3.1 To provide latest diagnostic equipments, care facilities and surgical instruments to
governorate hospitals with special emphasis on sterilization system for micro surgical
instruments.
Expected results:




Improved resources for quality eye care in all governorates.
Rise in level of eye care and surgical techniques and modern methods of management and
quality of instruments.
Reduced cases transferred from other governorates to the tertiary eye care units at Muscat.
Increased life of instrument and equipment without damage due to faulty sterilization.
144
3.2 Strengthening and supporting eye health care services at the tertiary level by establishing
an eye bank for Corneal transplantation and a center for low vision.
Expected results:
 Presence of a specialized and advanced eye care system in Oman.
 Improved eye services at tertiary level.
 Improved visual function and quality of life of low vision disabled.
3.3 Upgrading human resources at eye health care by continuous training and sending eye
doctors abroad for higher qualification/skills and active participation in international
conferences.
Expected results:


Improved services in all ophthalmic subspecialties in secondary/ tertiary eye centers.
Improved performance and access to the latest developments in the field of eye care.
3.4
Training
and
building
capacity
of
eye
health
care
staff:
(Optometrists, refractionists, ophthalmic nurses, ophthalmic assistants, eye surgery nurses,
specialist in low vision care, orthopticians, fundus photographers and graders, etc).
Expected results:
 Availability of qualified Omani refractionists.
 Highly efficient nursing staff at operation theaters, in-patient facilities and outpatient clinics.
 Increase efficiency and productivity of eye specialists.
 Early detection and intervention of refractive errors.
3.5 Expansion of ophthalmic services in institutions of secondary and tertiary care to increase
the surgical outcomes (quantitative and qualitative).
Expected results:
 Comprehensive eye health care to citizens in different governorates.
 Availability of high quality and skilled surgeries.
3.6 Provide technology needed for the comprehensive eye health care in the governorates by:

Provide a digital fundus camera in all eye units of the governorates and (OCT) to
one per governorate with the necessary facilities of electronic linkage to ‘centre for
diabetic retinopathy’ for review and evaluation.

Telemedicine and other facilities for evaluating eye diseases, especially diabetes,
glaucoma and other retinal disorders by providing labor force in all major areas
and link them with health care centers (the highest in the Muscat area).

Supply of consumables and IOLs of required types and adequate quantities to
governorates.

Establishment of laser unit for management of diabetic retinopathy in all
governorates.
Expected results:



Keeping pace with advances in eye health care.
Availability of state of art eye health services in all governorates.
Decreased work load on the tertiary eye care units.
145
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Rate of newly detected glaucoma cases.
Annually
3.7%
1.1b
Number of newly detected Cataract cases.
Annually
4,940
5%
30,000
(6,000/year)
1.1c
Prevalence of communicable eye diseases in
school children.
Annually
0.1%
>0.1%
1.2a
Presence of a plan and mechanism for
cooperation between the MOH and other
related sectors.
By end of
the current
plan
NA
Available
1.2b
Number of audio and visual messages about the
health of the eye.
Annually
5/year
30
1.3a
Number of cases of refractive defects of vision
and visual impairment among school students
Annually
12,484
5,000/year
1.4a
Number of newly detected glaucoma cases.
Annually
2,790
4,000/year
1.4b
Number of newly detected cataract cases.
Annually
4,940
30,000
(6,000/year)
1.5a
Availability of a joint committee for eye health.
By the end
of current
plan
1.5b
Number of wilayat with plans to raise
awareness about eye health.
Annually
10
All wilayat
1.6a
Number of newly detected cases of Diabetic
Retinopathy.
Annually
2243
9000
1.7a
Availability of a joint committee for eye health.
By the end
of current
plan
NA
Available
1.7b
Number of annual meetings between program
in-charge & private sector DG.
Annually
0
5
1.8a
Number of private eye clinics.
Annually
25
35
146
Available
Available
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 2nd Objective
2.1a
Existence of a committee to follow and report
cases of trachoma.
Annually
Available but
need to be
activated
Available and
active
2.2a
Percentage of schools with active trachoma
cases in first grade.
Annually
64%
100%
2.3b
Percentage of health institutions to report cases
of active trachoma.
Annually
90%
100%
Indicators of Strategies of the 3rd Objective
3.1a
Percentage of governorates having a well
equipped Ophthalmic Unit.
3.2a
Availability of Eye Bank.
3.2b
Availability of Low vision care unit.
3.3a
Number of Omani trained in sub-specialties.
3.3b
3.3c
Number
of
Omani
Ophthalmologists
participated with researches in International
Conferences.
Number
of
Omani
Ophthalmologists
participated in International Conferences.
Annually
70%
100%
NA
Eye bank
present &
functioning
NA
1
3
10
Annually
3
15
Annually
10
50
by end of
the current
plan
by end of
the current
plan
Annually
3.3d
Number of Omani doctors in Ophthalmology
residency program under OMSB.
Annually
7
20
3.3e
Number of Courses conducted in the field of
eye health
Annually
7
20
3.4a
Number of Omani trained as Optometrist or
refractionist.
Annually
21
70
3.4b
Number of Omani trained as mid level care in
eye services.
by end of
the current
plan
NA.
120
N.A
All the
governorate
hospitals
3.5a
Number of governorate hospital with eye units.
147
Annually
Indicators
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
3.6a
Number of Wilayat hospitals with eye units &
surgical facilities.
Annually
0
2
3.7a
Number of extended health centers
polyclinics with digital fundus camera.
Annually
2
All the
centers
3.7b
Number of governorates with laser facilities.
Annually
8
All the
governorates
148
or
Domain Fifteen
Ear Health
149
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Ear Health
INTRODUCTION:
The 8th- 5 year Health plan‟ aimed at preventing hearing loss (HL) and addressing
causes of hearing impairment. Hence MOH focused on strengthening health services so as
to provide health services of high standards to citizen of all ages. Hearing screening of
newborn had started in all governorates
MoH saved no effort in applying measures for prevention of ear diseases leading to
hearing loss by early detection and management of ear diseases to prevent complications.
This was achieved through improving preventive and therapeutic services in all MoH
institutes by keeping ENT medical specialties up to date and using the highest technology
medical equipments for diagnosis and treatment, and as a result, the surgical intervention
for middle ear diseases increased progressively.
It is also worth mentioning achievement, the start of cochlear implant surgeries for the
first time in sultanate by Omani surgeons with highest international surgical faculties and
re-habilitation of such cases after surgery by specialized Omani audiologists and speech
and language pathology.
OBJECTIVES:
1. Prevention of Hearing loss among all Omani population.
2. Treatment and rehabilitation of patients with hearing loss.
150
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: Prevention of Hearing loss among all Omani population
1.
Prevalence survey for hearing loss in
the community.
5.5%
NA
4.5%
(1996 survey)
2.
Percentage of hearing loss cases
registered
at
ENT
out-patient
departments in MOH institutes.
27%
24
20%
3.
Percentage of newly born screened
babies for hearing loss to the total
newly born.
24.3
98.7%
100%
4.
Percentage of hearing loss cases among
newly born screened babies
0.5%
0.4%
0.3%
5.
Percentage of hearing loss cases among
screened school children.
0.2%
0.2%
< 0.1%
6.
Rate of cases of OME per 1000
population.
8
NA
3
7.
Rate of cases of CSOM per 1000
population.
3
NA
<1
Second Objective’s Indicators: Treatment and rehabilitation of patients with hearing loss
1.
Percentage of Middle ear surgeries for
restoration of hearing out of all ear
diseases.
13.2%
NA
50%
2.
Percentage of cases with improved
hearing after surgery.
70%
83%
>90%
3.
Percentage of cases successfully
rehabilitated out of all cases with HL.
25%
30%
50%
151
STRATEGIES:
Strategies to Achieve 1st Objective: Prevention of Hearing loss among all Omani population
1.1Newborn Screen for Hearing in all MoH hospitals and health institutions with
maternity beds.
Expected results:

Early detection of cases with Hearing loss.
1.2 Hearing assessment for all pre-school age children at primary health care centers.
Expected results:
 Establishing Data base for hearing problems in this age group.

Early detection, treatment and rehabilitation of cases.
1.3 Ear care programme for Training of all Doctors working in primary health care
centers.
Expected results:
 Early detection of ear diseases leading to hearing loss.
1.4 Health promotion about prevention and care of ear diseases through mass media.
Expected results:
 Increased awareness among community regarding ear diseases and their prevention.
1.5 Issuing health education booklets and leaflets for ear diseases and prevention methods.
Expected results:
 Improved health education material and increased awareness about ear diseases.
Strategies to Achieve 2nd Objective: Treatment and rehabilitation of patients with hearing loss
2.1 Sending Omani Doctors for studying and training abroad in ENT specialty.
Expected results:
 Availability of Omani ENT specialists.
 Providing highly specialized medical services.
2.2 Training medical personnel from regional areas in audiology and speech disorders (8 in
Muscat, 4 from each category and 2 in every ENT set up, 1 from each category).
Expected results:

Providing services of audiology and speech and language disorders in all regions.
152
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Percentage of newly born babies screened for
HL in all hospitals and maternity centers.
Annually
88%
>95%
1.2a
Percentage of school age children screened for Annually
HL in all primary health centers every year.
98%
100%
1.3a
Number of Workshops in ear care held for Annually
doctors working in primary health centers.
2
10
1.4a
Number of session on ear care in mass media.
Annually
2
5
1.5a
Number of distributed booklets copies of ear
diseases.
Annually
3
3
Indicators of Strategies of the 2nd Objective
2.1a
Number of Omani doctors trained in ENT
specialty.
Annually
3
15
2.2a
Number of trained personnel from regions in
audiology and speech and language disorders.
Annually
6
25
153
Domain Sixteen
Oral and Dental Health
154
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Oral and Dental Health
INTRODUCTION:
Oral health is a state of well-being of the oral cavity. This means improving good
teeth and supportive tissues is integral to general health and essential for better health. It
implies being free of chronic oro-facial pain, oral and pharyngeal (throat) cancer, oral
tissue lesions, birth defects and other diseases and disorders that affect the oral, dental and
craniofacial tissues. It is a direct reflection of the health of the entire body and the
interrelationship between oral and general health is proven by evidence.
Dental caries is the most common disease in the world and this is due to the rapidly
changing socioeconomic and political conditions, shifting in nutrition behavior from
traditional towards more westernized diet high in sugars, coupled with ubiquity of
tobacco, inadequate application of preventive measures and an inappropriate establishment
of oral health care delivery systems.
Oral Health surveys have showed that 1 out of every 4 children in the age 5 – 6 years
had dental caries. This percentage rises to 90% in low socioeconomic countries. Dental
caries has a great impact on the child nutrition and performance in school. Children who
suffer from dental pain are 12 times more likely to be late or absent from school than
healthier children. Dental diseases reflect the nutritional and behavioral state of the
community.
In 1975 they were only 6 dentists providing oral health care in Oman. Now days there
have been a significant increase in the dentists in Oman. The 2010 reports showed the
number of dentists rise up to 654. In the past, the Oral health services were providing
curative treatments only and rarely directed towards the causes of the disease. This was
mainly due to the lack of oral health care workers. In the recent years, Ministry of Health
adopted a proper planning and strategies to fight the causes of oral and dental diseases and
preventing the diseases at an early age to avoid the high cost of treatments. These
strategies have developed to be provided within the primary oral health care.
The surveys conducted by Ministry of Health in 2009 have showed the percentage of
oral diseases were reached 88% for 6 years old children, with caries index average 4.4 in
primary dentition. Also the caries index average has shown huge decrease in oral diseases
around 51% in permanent teeth for 12 years old children and the mean of caries index
(DMFT) was 1.3 in 2006 comparing to 2001 in which the percent of oral diseases were
over 70% and the mean of caries index was 1.65.
155
This improvement in oral health indicators is another evident of good planning to
prevent the oral diseases at an early age, in order to reduce the high cost of advanced
treatments. This plan will move forward to reduce the percentage of dental caries to reach
world class standards. Therefore, this plan will give us great opportunity to ensure
providing the best dental care based on the latest scientific methods applied by Ministry of
health.
OBJECTIVES:
1. Improving Oral and Dental Health services provided to priority groups in the community.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: Improving Oral and Dental Health services provided to priority
groups in the community.
1.
Ratio of Dental Surgeons per 10,000 of
Omani population.
0.97
0.76
1
2.
Caries Index – deft [decayed, extracted,
filled Primary teeth] for 6 years old
children.
5
4.4
4
1.5
1.1
1
2.8
1.7
1.5
0.1
0.1
0.1
0.33
0.2
0.2
0.1
0.1
0.2
0.11
0.1
0.2
Average carious teeth among:
3.


12 years old children.
15 years old children.
Average missing teeth among:
4.


12 years old children.
15 years old children.
Average filled teeth among:
5.


12 years old children.
15 years old children.
156
Indicators
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
93.8%
91.7%
87%
6%
7.7%
9%
Percentage of treatment needed for 12
years old children.
6.
[Unmet Restorative Index = 100 -F/
(D+F) x 100].
Percentage of care provided.
7.
[Care Index = F/DMF x 100].
Percentage of the children affected by dental caries at age of:
 6 years
84.5%
88%
85%
 12 years
70%
51%
45%
 15 years
73.2%
60.5%
55%
9.
Percentage of children (6-7 years) at
High Risk of developing dental caries
[deft > 5].
45%
33%
30%
10.
Percentage of children (6-7 years)
receiving preventive oral health
treatment.
33%
94%
100%
8.
STRATEGIES:
Strategies to Achieve 1st Objective: Improving Oral and Dental Health services provided to
priority groups in the community
1.1Provision of comprehensive primary health care to Omani population across the Sultanate
including (preventive & restorative treatments, extractions, periodontal therapy, oral
prophylaxis and single rooted canal treatments).
Expected results:





Improvements in the oral health status in the community.
Dental caries reduction.
Increase the restored tooth.
Decrease in the percentage of extracted teeth.
Improvements in the Oral cavity cleanliness.
1.2 Training of staff in extended programme of quality assurance and epidemiology in
directory of Dental and Oral Health Department-Ministry of Health.
Expected results:

Increase the quality of the provided services.
157
1.3 Training of dentists specialized in oral and dental health in primary health care centers.
Expected results:
 Increase dentists‟ skills and ensure providing advanced dental services.
1.4 Provide secondary services for OMFS and Orthodontics in referral hospitals.
Expected results:
 Increase the level of provided dental care across the Sultanate.
1.5 Training of the Extended Programme for Immunization (EPI) nurses & Health educators
in primary health care centres to provide oral health promotion to mothers regarding child
dental health for 6 months-5 years of age.
Expected results:
 Reduction of dental caries in primary teeth.
1.6 Regular inspection & monitoring of the fluoride level to ensure 0.5-0.8 p.p.m. of Fluoride
level in drinking water.
Expected results:
 50% Reduction in the prevalence of dental caries in the fluoridated communities.
1.7 Provision of oral health care to special need groups.
Expected results:
 Improvements in the oral health status of this group.
1.8 To continue the preventive school oral health programme directed to the grade one & Two
school children (Topical fluoride application twice a year for the medium & high risk children
and fissure sealant to the high risk children).
Expected results:
 Protecting the permanent teeth from early carious lesions.
 Oral health education to grade one & two schoolchildren.
1.9 Strengthening the tooth brushing drills for grade one schoolchildren.
Expected results:
 Increased awareness of schoolchildren towards oral diseases.
1.10 Conducting annual Oral Health Promotion campaigns for schoolchildren and the
community.
Expected results:

Increasing health awareness, community involvement and the private sector to improve the oral
health.
158
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Ratio of Dental Units per 10,000 of the Omani
Population.
Annually
0.67
0.8
1.2a
Number of Trained Dentists/Staff in Quality
assurance and Epidemiology in Directory of
Dental and Oral Health Department.
End of the
current
plan
0
1 Quality
Assurance and
1
Epidemiology
1.3a
Percentage of specialized dentist in primary
health care.
Annually
0
5%
1.4a
Percentage of regions that have Orthodontic
and OMFS units.
Annually
0
20%
Annually
13
136
Annually
24%
50%
1.5a
1.6a
Number of training courses for the EPI nurses
and health educators in primary health care
centres.
Percentage of population receiving fluoridated
water.
1.7a
Percentage of Special Care Needs Groups
receiving regular Dental Care.
Annually
58%
70%
1.8a
Percentage of schools receiving the preventive
school oral health programme.
Annually
88%
100%
1.8b
1-8-b- Percentage of screened children in the
preventive school oral health programme.
Annually
88%
100%
1.8c
Percentage of sealant retention after one year
of placement.
Every two
years
38%
75%
1.8d
Percentage of grade one & two schoolchildren
received fissure sealant.
Annually
65%
80%
1.8e
Percentage of grade one & two schoolchildren
received biannual topical fluoride application.
Annually
94%
100%
1.9a
Percentage of grade one & two schoolchildren
received toothbrushes and toothbrushes drills.
Annually
100%
100%
1.10a Number of Oral Health Promotion Campaigns.
Annually
30
170
159
Domain Seventeen
Mental Health
160
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Mental Health
INTRODUCTION:
Mental health services in Oman are provided through the three levels of health care:
Primary, Secondary and Tertiary Care. This ensures the provision of adequate, effective and
good level mental health care for all citizens.
Primary psychiatric care is provided through all the primary health centers. Secondary
psychiatric care is provided through outpatient psychiatric clinics in all the regional hospitals
and Extended Health Centers. Ibn Sina hospital provides tertiary psychiatric care to all
referred cases from all parts of the Sultanate. It also provides secondary psychiatric care to the
population of the Governorate of Muscat. In addition, the Psychiatric Emergency Section of
Ibn -Sina hospital provides round the clock emergency psychiatric care.
The focus of the eighth Five-Year Plan for Health Development (2011-2015) is to
further improve the standard of care by providing more specialized care for the patients and to
address a number of common psychiatric problems that have been identified through analysis
of statistics and morbidity trends in the Arabian Gulf States and other neighboring Middle
Eastern countries.
An improved standard of care is ensured by the process of continued service upgrades
and continued technical training that is being done for all levels of health providers.
Implementation of the policy of decentralization and autonomy for all hospitals under the
Ministry of Health has led to the provision of health services at regional hospitals under local
regional control so there is a need to create a system for evaluating the quality of psychiatric
services provided in the autonomous regional hospitals. This would ensure the provision of an
equally high standard of care from every hospital. It would also be possible to then apply the
same indicators in the different regions in order to assess and compare the quality of
performance among them.
Ibn Sina Hospital is the only tertiary care psychiatric hospital that provides inpatient
care to the population of Oman. It has only 89 beds, and this is grossly inadequate for the
needs of the country. Establishing a new 245 beds psychiatric hospital is included as a priority
of this plan. With an adequate number of beds, specialized services, emphasis on
rehabilitation and staff training this hospital will provide the highest international standards of
psychiatric care to the patients in Oman.
161
OBJECTIVES:
1. To improve the quality of mental health services provided to adults for some of the prevailing
psychiatric disorders (schizophrenia, anxiety, and depression).
2. To improve the quality of mental health services for psychological, behavioral, and learning
disorders of children and adolescents.
3. To reduce the incidence of substance dependence and its harmful consequences.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To improve the quality of mental health services provided to adults
for some of the prevailing psychiatric disorders (schizophrenia, anxiety, and depression).
1.
Percentage of new patients with anxiety
disorders to the total number of new
patients attending the primary health
care centers.
Not applicable
Not applicable
5%
2.
Percentage of new patients with
depressive disorders to the total number
of new patients attending the primary
health care centers.
Not applicable
Not applicable
5%
3.
Percentage of new patients with anxiety
disorders to the total number of new
patients attending the psychiatric
clinics.
36%
23%
20%
4.
Percentage of new patients with
depressive disorders to the total number
of new patients attending the psychiatric
clinics.
30%
20%
20%
5.
Percentage of new patients with
schizophrenia to the total number of
new patients attending the psychiatric
clinics.
22%
11.8%
20%
6.
Percentage of patients with depressive
disorders admitted to central hospital to
the total number of patients admitted.
12%
26%
20%
162
Indicators
7.
Percentage
of
patients
with
schizophrenia admitted to central
hospital to the total number of patients
admitted.
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
40%
28%
30%
Second Objective’s Indicators: To improve the quality of mental health services for
psychological, behavioral, and learning disorders of children and adolescents.
1.
Percentage of children new patients with
behavioral, mental, and learning
disorders to the total number of patients
attending Psychiatric Clinics.
3%
8.6%
10%
2.
Percentage of adolescent new patients
with behavioral and mental disorders to
the total number of patients attending
Psychiatric Clinics.
1%
10.7%
12%
Third Objective’s Indicators: To Reduce the incidence of substance dependence and its
harmful consequences
1.
Percentage of new patients with alcohol
dependence to the total number of new
patients attending the central hospital.
2%
1.17%
6%
2.
Percentage of new patients with
dependence on substances other than
alcohol, to the total number of patients
attending the central hospital.
0.3%
3.2%
10 %
3.
Number of addictive patients that
treated in rehabilitation departments of
the central hospital.
Not applicable
Not applicable
100
4.
Number of Opioid dependent patients
on replacement therapy.
Not applicable
Not applicable
100
5.
Percentage of patients who drop out
from replacement therapy.
Not applicable
Not applicable
20%
163
STRATEGIES:
Strategies to Achieve 1st Objective: To improve the quality of mental health services
provided to adults for some of the prevailing psychiatric disorders (schizophrenia,
anxiety, and depression).
1.1Mental Health Act legislation and put it under implementation.
Expected results:

The existence of clear definitions to the legal rights of patients, including the right of
authorizing the consent with respect to mental health and means of treatment.
 A precise legal definition of the duties and rights of workers in the field of mental health.
 A precise legal criterion for the treatment of patients and cases requiring compulsory
treatment.
1.2 Implementation of the program of integrating mental health in primary health care.
Expected results:

Accessibility to mental health services for the majority of patients in all parts of the
Sultanate.
 Reducing the work load on health complexes and reference hospitals in the regions.
 Reduction of the work load on the central psychiatric hospital.
 Improve the communication between medical staff and patient's families to maintain
remission.
 Reduce the impact of stigma on patients.
 Decrease the frequency of exacerbations of mental illness.
1.3 Establish mental health departments in reference hospitals in some regions (North
Batna, Al-Dakhilya).
Expected results:

Accessibility to diagnostic and therapeutic services provided by specialist psychiatrists and
social workers and maintenance of adequate follow up of patients.
 Ensure patient follow-up by the same medical staff after discharge from the hospital and this
has a great effect on the continuation of patient treatment and enhance patient's adherence to
treatment.
 . Improve communication with families of patients to follow up the patient within his family
and social surroundings.
 Decrease the burden of the patient's transfer to the central hospital and residence in.
 Reduce the large number of patients and the length of waiting lists in the central hospital.
1.4 Open mental health clinics in all health complexes in the Willayets.
Expected results


Improve the quality of mental health services at secondary health care level.
Improve communication with patients and their families, and lessening the impact of social
stigma on patients.
164
1.5 Establishment of a new Psychiatric Hospital providing tertiary care services and highly
specialized mental health care services.
Expected results:



The provision of mental health service capable of accommodating patients from all over the
Sultanate.
Provision of psychiatric sub specialized services (forensic psychiatry, childhood and
adolescence psychiatry, old age psychiatry).
Improve rehabilitation services for the patients with mental illness.
Strategies to Achieve 2nd Objective: To improve the quality of mental health services
for psychological, behavioral, and learning disorders of children and adolescents.
2.1 Training of primary health care physicians to diagnose and treat mental illnesses of
children and adolescents.
Expected results:

Early diagnosis and management of mental and behavioral disorders in children and
adolescents.
 Reduction of the impact of mental and behavioral disorders in children and adolescents on
their social, educational functioning.
2.2 Training of primary health care nurses to care for children and adolescents with
mental and/or behavioral disorders.
Expected results:

Early and adequate management of mental and behavioral disorders in children and
adolescents.

Reduction of the impact of mental and behavioral disorders in children and adolescents on
their social, educational functioning.
2.3 Opening of Psychiatric and behavioral Clinics for children and adolescents in the
health complexes and reference hospitals.
Expected results:

Early diagnosis and management of mental and behavioral disorders in children and
adolescents.
 Reduction of the impact of mental and behavioral disorders in children and adolescents on
their social, educational functioning.
2.4 Opening of a center for psychological counseling for children and adolescents in AlDakhilya region.
Expected results:
 Prevention of psychological, educational, social and behavioral problems among students.
 Provision of support and counseling services to children, adolescents and their families.
2.5 Training of social workers in schools on how to identify mental and behavioral
disorders in students and how to manage them.
Expected results:


Increase the capacity and efficiency of social workers to deal with students who suffer from
mental disorders.
Expansion and development of mental health services for school students.
165
2.6 Training of school health physicians on diagnosis and management of mental,
behavioral and learning disorders among students.
Expected results:

Improve the ability of school health physicians to diagnose and manage mental, behavioral
and learning disorders among students.
2.7 Training of psychiatrists in secondary and tertiary care on child & adolescent
psychiatry.
Expected results:

Improvement of the scientific level and professionalism of psychiatrists in the field of
psychiatry and behavioral sciences related to children and adolescents.
Strategies to Achieve 3rd Objective: To Reduce the incidence of substance dependence
and its harmful consequence
3.1 Implementation of the Program (prevention and treatment of drug dependence) in
some of the regions/governorates.
Expected results:


Reduction of the problem of addiction in society.
Reducing the rate of relapse cases & reduction of the rate of infectious diseases resulting
from the use of injectable drugs.
3.2 Initiating replacement therapy for patients dependent on opium or its derivatives
(central hospital).
Expected results:

Reduction of infectious diseases resulting from the use of contaminated heroin injections
(viral hepatitis. AIDS).
 Reduction of mortalities resulting for heroin overdose.
3.3 Open sections for vocational rehabilitation, social and life skills training for alcohol and
drug dependents.
Expected results:

Rehabilitation of the addict and training on social, vocational and family activities for the
purpose of providing the social environment, which assists in the abandonment of addiction.
166
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a Presence of Mental Health act.
Annually
NA
Available and
active
Percentage of primary health care physicians
1.2a trained on diagnosis and management of
mental disorders.
Annually
4%
100%
Percentage of primary health care nurses
1.2b trained on diagnosis and care provision for
patients with mental disorders.
Annually
1%
50%
Percentage of cases with mental disorders
1.2c diagnosed and treated in primary health care
centres to the total number of cases.
Annually
Not
applicable
10%
Number of reference hospitals at regions
1.3a /governorates with established mental health
sections.
Annually
1
3
1.4a
Number of polyclinics that have mental health
clinics.
Annually
19
21
1.4b
Number of psychiatrists
regions/governorates.
Annually
28
50
1.4c
Number of psychiatric nurses in central
psychiatric hospital.
Annually
157
300
1.4d
Number of psychiatric nurses in regions/
governorates.
Annually
29
50
1.4e
Number of social workers in psychiatric
clinics of regions/ governorates.
Annually
Nil
10
1.5a
Establishment of new central psychiatric
hospital.
Annually
NA
Available
working
in
Indicators of Strategies of the 2nd Objective
Percentage of primary health care physicians
trained on children and adolescents mental
2.1a
health to the total number of primary health
care physicians.
167
Annually
4%
100%
Follow
up
timing
Indicators
Percentage of primary health care nurses
trained on children and adolescents mental
2.2a
health to the total number of primary health
care nurses.
2.3a
Number of children
psychiatric clinics.
2.4a
and
adolescents
Annually
Current
situation
Targeted
situation
2010
2015
1%
50%
Annually
2
10
Number of psychological counseling centers
for children and adolescents.
Annually
0
1
2.5a
Percentage of school social workers trained
on children and adolescents mental health.
Annually
5%
2.6a
Percentage of school health physicians trained
on children and adolescents mental health.
Annually
Percentage of general psychiatrists trained on
children and adolescents mental health.
Annually
2.7a
50%
100%
4%
100%
10%
Indicators of Strategies of the 3rd Objective
Number
of
regions/governorates
that
3.1a implement the program for the prevention and
treatment of addiction.
Annually
2
3
3.2a
Total number of addictive patients treated by
drug replacement therapy.
Annually
Not
applicable
100
3.2b
Percentage of patients who drop out from
drug replacement therapy.
Annually
Not
applicable
20%
Number of addictive patients that had been
3.3a rehabilitated in rehabilitation centers (central
hospital).
Annually
Not
applicable
100
168
Domain Eighteen
Genetic Diseases
169
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Genetic Diseases
INTRODUCTION:
As the knowledge of genetics expands with an increasing pace, the advances in Human
Genetics are translated into Disease Prevention and Health Promotion worldwide.
Genetic services are recognized as being important in maintaining high quality medical
service for the population and are an efficient tool to prevent genetic disease, reducing
mortality and handicap and saving national health and social resources.
Availability of the Genetic Service and Genomic Technologies increase chances of every
Omani family to have healthy children and ensure early and proper care for those affected by
adult onset disorders. Also each individual genetic disease is rare event, but overall
prevalence of inherited diseases is high due to extremely large variety. High prevalence of
genetic disease in Omani community makes it impossible to be managed by research
institutions and becomes an important service obligation.
The preventive measures that can reduce the risk of genetic diseases among high risk
people are available now, which can lead to a progress in the field of individual preventive
medicine. Laboratory tests and genetic examination are now used to anticipate individual‟s
predisposition to adult onset disorders and patient‟s response to medicines. As a result of all
these new developments, “Genetics” will occupy a central position in the practice of clinical
medicine and public health in the near future. Genetic conditions are found worldwide and a
common knowledge is that every human on Earth has few genetic imperfections.
Community based survey performed in 2010-2011 as needs assessment procedure for
congenital and multifactorial disorders in Omani community. The figures of morbidity and
mortality in newborns, infants and children reflect the situation in traditional Omani
community where communicable diseases were successfully controlled and prevention
measures for genetic disorders is in a preparation phase. Current study confirmed genetic and
congenital disorders being major contributors to morbidity, mortality in handicap (Figure 1).
Isolated physical
disability; 44%
Learning
difficulties; 8%
Other; 7%
Congenital
deafness and
blindness; 10.30%
Congenital
anomalies; 13.30%
Inborn errors of
metabolism and
rare disorders; 6%
Intellectual
disability; 37%
Genetic Blood
disorders; 15%
170
The prevalence of handicapped children in Oman increases progressively due to presence of
comprehensive health care system and improvement in quality of life. The number of
surviving affected children increases alongside the annual birth cohort, causing a
considerable burden on the healthcare services.
PRIORITIES
1. Intellectual and physical disabilities due to various groups of disorders:
chromosomal rearrangements, congenital malformation syndromes, inborn errors of
metabolism, neurodegenerative diseases, congenital myopathies, skeletal
dysplasia‟s, dermatological conditions, congenital blindness and deafness. These
diseases have long-term impact on public health and community. Consequently,
necessary actions should be taken by public health to prevent these diseases as the
number of disabled people may increase 5 – 10 times in the next 50 years.
2. Genetic blood disorders: Around 10% of Omani people are carriers of gene of
sickle cell anemia and 3% are carriers of gene of Beta-thalassaemia. Approximately
120 children are born yearly with sickle cell anemia and 20 with Beta-Thalassaemia.
It is expected that through the next 10 years the number of the cases will increase
to be 1200 cases of sickle cell anemia and 200 cases of thalassaemia if the
preventive measures are not provided. The curative management of all these new
cases could cost about $17 million yearly while provision of preventive methods
cost about 10% of this sum. One case of Beta-Thalassaemia or two of sickle cell
anemia may save $ 500.000.
3. Care for affected by malignancies.
a. Familiar cancers: From 10 to 20% of cancer cases are familiar so more studies
and specific preventive approaches are needed. Breast Cancers and Colon Cancers
are common.
b. Hematological Cancers care
4. Adult onset disorders
Diabetes mellitus: About 20% of Omani population is suffering from diabetes
mellitus which means more studies are needed to identify the specific genetic
predisposing factors.
OBJECTIVES:
1. Provision of effective preventive measures and developing Molecular Genetic
technology expertise capable of supporting local effective prevention programs.
2. Improving the quality of the services provided in the field of genetic health.
3. Provision & expanding of premarital examination to reduce the prevalence of genetic
diseases and congenital malformation.
4. To raise the public awareness of genomic technology and its benefits. To continue
genomics education, capacity building and training in new technologies;
171
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: Provision of effective preventive measures and developing Molecular
Genetic technology expertise capable of supporting local effective prevention programs
Percentage of newborns with genetic
10%
10%
5%
diseases or congenital malformation.
Rate of cases of Sickle Cell Anemia /
2.
2.4
2
1
1000 population.
Rate of Thalassaemia cases /1000
3.
0.4
0.3
0.1
population.
Rate of Down syndrome / 1000
4.
2
2.3
1
population.
Percentage of moderate to severe
5.
mental retardation cases among children
5%
5%
2%
below 15 years.
Second Objective’s Indicators Improving the quality of the services provided in the field of genetic
health.
1.
1.
Number of Scientists sent abroad for
studying genetic sciences.
NA
2
5
2.
Availability of Quality assurance
program in the field of genetic health.
NA
NA
Available
&applied
3.
Availability of Tandem mass test.
NA
NA
Available
&applied
Third Objective Indicators: Provision of premarital examination to reduce the prevalence of
genetic diseases and congenital malformation
Percentage of primary health institutions
1.
providing
premarital
examination
10%
20%
50%
services.
Fourth Objective Indicators: To raise the public awareness of genomic technology and its benefits.
To continue genomics education, capacity building and training in new technologies
Percentage of Secondary schools where
1.
20%
40%
100%
genetic education was introduced.
Percentage of couples had been
2.
1%
5%
50%
counseled premarital.
172
STRATEGIES:
Strategies to Achieve 1st Objective: Provision of effective preventive measures and developing
Molecular Genetic technology expertise capable of supporting local effective prevention
programs.
1.1 Establishing facilities in a National Genetic Center to provide Clinical and Laboratory
diagnostic services carry on Prevention Programs besides conducting training activities and
researches in the field of genetic health.
Expected results:
 Availability of local diagnostic services and prevention programs of high quality.
 Clinical Genetic Consultation provision in Regions.
1.2 Presenting base line data about genetic diseases and congenital malformations.
Expected results:
 Hospital-based data is available. Population-based data is required.
 Central notification of congenital and genetic disorders.
 DNA storage facility.
1.3 Records of community prevalence of genetic diseases, congenital malformations and
handicap.
Expected results:

Monitoring birth prevalence of genetic diseases and cong anomalies in order to assess
efficiency of the prevention programmes.
1.4 Training Omani nationals in Clinical Genetics and Laboratory Genetic Technology.
Expected results:

Acquiring national expertise in Molecular Genetics and Health Biotechnology for disease
prevention and provision of high standard of Medical Care in Oman.
1.5 Draw National Policy regarding Genetic and Congenital Disorders in the Sultanate.
Expected results
 Availability of National Policy regarding Genetic and Congenital Disorders
1.6 Coordination with other Health programms within Ministry of Health, other Ministries
and the Omani community in prevention of handicapping genetic disorders.
Expected results
 Comprehensive national effort to prevent handicapping genetic disorders.
Strategies to Achieve 2nd Objective: Improving the quality of the services provided in the field of
genetic health.
2.1 Development of external quality assessment scheme and accreditation scheme for genetic
laboratories.
Expected results:



Reach international standard capacity for diagnosis and carrier testing in families affected by
genetic disorders.
Reach the international quality standard of genetic tests.
Establishing quality control scheme in National Genetic Center.
173
2.2 Establish genetic laboratories and technologies of international quality in National
Genetic Center.
Expected results:

Availability of modern gene testing technology Satisfy requirements of Health Care in genetic
testing in: ( Haemoglobin disorders ,Tumor markers for Hematological Cancer patients, Mental
retardation, Breast Cancer, Colon Cance, Cardiogenetics, Neurogenetics, Immunogenetics,
Others).
2.3Continue education& professional training for Omani Nationals in Clinical and Laboratory
Genetics.
Expected results:

Availability on national manpower in Laboratory Genetics, Bioinformatics, Clinicalgenetics,
and Councelling to satisfy requirements of Oman Healthcare and maintain high standars of
Medical care in the Sultanate.
2.4 Conduct Research in genetics and epidemiology of handicapping genetic disorders, and adult
onset disorders of high impact.
Expected results:

Effective planning of genetic services and effective prevention strategies to improve health of
Omani population.
Strategies to Achieve 3rd Objective: Provision & expanding of premarital examination to reduce
the prevalence of genetic diseases and congenital malformation
3.1 Training of the primary health care staff on premarital examination and counseling for
hemoglobin disorders and intellectual disability.
Expected results:
 Presence of trained health staff in premarital counseling and Health Education in genetic health.
3.2 Establishment of special clinic in each region (in addition to 6 wilayat of Muscat) to provide
premarital examination services in order to prevent congenital and genetic disorders among
those planning for marriage.
Expected results:
 The premarital examination services are available for all couples throughout the Sultanate.
3.3 Increase capacity (manpower, equipment and consumables) of laboratories at secondary
Care (Regional Hospitals) in premarital testing for Haemoglobin Disorders (HPLC for Sickle
Cell, Beta-Thalassaemia diagnostics) and G6PD deficiency.
Expected results:

Available manpower and equipment (HPLC equipment, lab technicians, councellors and
statistical registration), and consumables for Premarital testing for Sickle Cell and Beta
Thalassaemia.
3.4 Introduce Basic Genetics and Counseling skills in Institute of Health Science.
Expected results:

Graduates are familiar with basic genetics, health education and genetic counseling.
174
Strategies to Achieve 4th Objective: To raise the public and medical staff awareness of genomic
technology and its benefits. To continue genomics education, capacity building and training in
new technologies;
4.1 Study most efficient Methods of Health Education in Genetic Health.
Expected results:
 Cost-effective and efficient health education in Genetic Health matters.
4.2 Developing specific educational package about genetic health matters taking in consideration
local traditions.
Expected results:
 Increased community knowledge about Genetic Health.
4.3 Educate Omani population about the impact of Genetic diseases and the ways it can be
prevented.
Expected results:

Decrease in the rate of consanguineous marriage among families with past history of genetic
diseases.
4.4 Genetic Center provide update to medical professional about modern genetics, genetic
technologies available to their utilization:

To improve health.

Genetic disease management.

Prevention of genetic and adult onset disorders.
Expected results:

Health Care professionals of Ministry of Health are familiar with availability of new
technologies, advances of genetic testing and modern management of genetic and multifactorial
disorders with genetic component.
175
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
1.1b
1.1c
1.1d
1.1e
1.1f
1.1g
1.1h
Functions in National Genetic Center.
Number of laboratories with advanced
technology machines and equipment in
Genetic Center Laboratories.
Annually
Not present
Expanding to
satisfy the
needs of Oman
health Care
Annually
One
laboratory
for
Karyotyping
and FISH
5 laboratories
Number of man power working in the
national genetic center:
▪ Doctors
▪ Nurses (Counselors)
Annually
▪ Laboratory technicians
▪ Health educators
Presence of national register/database for
genetic
diseases
and
congenital Annually
malformation.
Number of research studies conducted in the
Annually
field of genetic diseases.
Number of Omani staff trained on clinical
Annually
genetics and laboratory genetic technology.
Existance of national Policy regards genetic Annually
and congenital disorders.
Number of meetings annually with related Annually
governmental sectors.
2
1
10
0.0
There is
incomplete
registry
4
6
40
6
The registry is
present
2
5 research
studies
4
24
NA
available
0
4
Indicators of Strategies of the 2nd Objective
2.1a
2.1b
Presence of external quality assessment
scheme for genetic laboratories and
International Accreditation.
Number of doctors trained in Clinical
genetics.
Annually
Not present
Present
Annually
2
4
2.1c
Number of Laboratory Geneticist.
Annually
20
100
2.1d
Number of genetic Nurses.
Annually
0
20
Health Educators updated in genetic
Councelling.
Number of sessions for Community Support
Groups updated in Genetic Councelling
&Genetic Ethics.
Annually
10%
50%
Annually
1
50
2.1e
2.1f
176
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
Number of workshops in Laboratory and
Clinical genetics.
Number of laboratory geneticists with MD
and PhD.
Annually
0
10
Annually
10
30
Number of research studies in genetic health.
Annually
1
5
Indicators
2.1g
2.1h
2.1i
Indicators of Strategies of the 3rd Objective
3.1a
3.2a
3.2b
3.3a
3.3b
3.4a
Number of trained primary health care health
staff (doctors and nurses) about premarital
examination and counseling in the health
institutions / year.
Number of clinics providing premarital
examination services in PHC.
Percentage of attendance who are going to
marriage and received counseling and
premarital examination per year.
Mean number of health education seminars
about importance of premarital examination
in secondary school.
Mean number of educational courses for
community support group members on
importance of premarital examination.
Basic genetic and counseling skills
introduced in curriculum of institute of health
science.
Annually
Not present
20 (2 from
each region)
Annually
1
10
Annually
5% of the
targets
50% of the
targets
Annually
One seminar
/school/year
Annually
The courses
are not
regular
Annually
--
Two seminars
/school / year
and 2 national
seminars/ year
One training
course for each
group / year
The curriculum
changed
Indicators of Strategies of the 4th Objective
4.1a
Presence of study on the most efficient
methods of health education in genetic
health.
4.2a
Presence of specific educational package
about genetic health matters taking in
consideration local traditions.
Annually
4.2b
Number of health education seminars in
omani community about impact of genetic
diseases and ways of prevention.
Annually
177
Annually
Not present
The study is
present
The
educational
Not present
package is
present
2 seminars /
2national
region/year and
seminars/year
2 national
seminars /year
Domain Nineteen
Environmental and Occupational Health
178
Vision: Alleviation of Risks Threatening The Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Environmental and Occupational Health
INTRODUCTION:
With the fast industrial and economical growth in Oman and the increase in the
number of national workforce, without doubt there will be environmental and occupational
exposures that will be reflect in the health safety of the surrounding environment and the
workers in different sectors. The recent published data indicates that the workers constitute 32
% of the general Omani population. The workers in different governmental and private
sectors, including the health care workers, are exposed to serious dangerous hazards in their
work environment, which can result in serious health effects such as injuries, diseases and
death. All these effects will dramatically affect the productivity and so affecting the national
economy and the sustainable development.
Nowadays, the air pollution problems and its related-health effect on the other hand
are one of the community concerning issues especially in the areas near the industrial
development. The issues of food safety, medical waste, environmental health impacts of the
developmental projects are all issues of focus that need attention and allocation of resources
to allow the health sector to perform its related responsibility and functions in these aspects.
As a result of all these developments, there is a need to develop a national
occupational disease surveillance system, new injuries-related disability assessment system,
national occupational health and safety program for health care workers especially the
radiation safety, exposure to chemicals and hazardous drugs. Capacity building in term of
human resources, infrastructure, analytical services and research is needed to allow the health
sector to monitor and evaluate the related health effects.
The research study indicates that the morbidity of respiratory disease and water borne
diseases are high in the waste dumping area. The methods for solid medical waste
management need further development. As a result the environmental health issues need to be
highlighted and promoted in this 5 year plan.
The following table indicates the national environmental standard maximum pollution
concentrations for the common air contaminants.
179
Table: National environmental standard maximum pollution concentrations 2011.
Threshold
Concentration
Contaminant
Carbon
(CO)
Nitrogen
(NO2)
Sulphur
(SO2)
Permissible excess
8 hour running mean
One 8 hour period in
any 12 month period
9 hours in any 12
month period
monoxide
10 mg/m3
dioxide
200 μg/m3
1 hour mean
150 μg/m3
1 hour mean
Ozone (O3)
Particulate
(PM10)
Averaging
period
Matter
dioxide
Not to be exceeded
50 μg/m3
24 hour mean
One 24 hour period in
any 12 month
350 μg/m3
1 hour mean
9 hours in any 12
month period
Not to be exceeded
570 μg/m3
1 hour mean
OBJECTIVE:
1. To reduce the environmental and occupational health morbidity and mortality.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To reduce the environmental and occupational health morbidity and
mortality.
National environmental standard maximum
pollution concentrations:
1.
2.
Carbon monoxide (CO)
Nitrogen dioxide (NO2)
Ozone (O3)
Particulate Matter (PM10)
Sulphur dioxide (SO2)
NA
Number of hospital admission due to
respiratory disease in main industrial cities.
180
NA
NA
32820
See the above
table for the
Permissible
excess of
each
contaminants
(number) 10
% reduction
from the
current
situation
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
3.
Number of hospital admission due to asthma
in main industrial cities in Oman.
NA
3555
4.
Number of hospital admission due to
circulatory diseases in main industrial cities
in Oman.
NA
14832
5.
Incidence of ARI in main industrial cities in
Oman.
NA
5.3
6.
Incidence of occupational injuries per 1000
workers.
NA
2
0.89
3.14
(number) 10
% reduction
from the
current
situation
(number) 10
% reduction
from the
current
situation
(rate) 10 %
reduction
from the
current
situation
(rate) 10 %
reduction
from the
current
2
49.04
28
20
29.6%
17%
10%
NA
NA
0
NA
2
0
7.
8.
9.
10.
11.
Incidence of poisoning per 1000 population.
Incidence of water-borne disease per 1000
population (admitted/confirmed).
Percentage of biological contamination in
tested water sample.
Number of health care workers with a
radiation dose > 20 m/sv/year.
Number of outbreak from water-borne
disease.
13.
Incidence of occupational injuries and
diseases in health care per 1000 health care
workers.
NA
NA
(rate) 10 %
reduction
from the
current
14.
Number of mortality due to environmental
and occupational exposure.
NA
20
10
*main industrial cities in Oman: Cites with industrial state or heavy industrial establishment such as Muscat,
Sohar, Sur, Nizwa, Salalah and Al dqum
STRATEGIES:
Strategies to Achieve 1st Objective: Reduce the environmental and occupational health morbidity
and mortality.
1.1 Strengthening the infrastructure for environmental and occupational health by:

Increase the number of beneficiaries from environmental and occupational health
services -especially poisoning-related-by upgrading the analytical laboratory services for
environmental and occupational health centrally and in North Al-Batinah Region.
181

Implementation of the National Strategy for Occupational Safety and Health
(establishment of national OHS for health care workers, risk assessment, establishment
of medical surveillance and medical fitness program, establishment of disability
assessment System, provision of occupational medical service, reporting of occupational
injuries and diseases, healthy workplace).

Development of national guidelines for primary health care doctors and health
inspectors( national guidelines for occupational health in primary health care, OHS
guidelines for health inspectors, risk assessment guideline, updating the national
guideline for HIA).

Initiating the 2nd phase of GIS (Geographical Information System).

Integration of health impacts assessment in the national policy by inter-sectoral
cooperation (representation of MOH in the Higher Committee for Town Planning,
national guidelines for HIA, health licensing for developmental projects).

Implementation of risk assessment and water safety plan with cooperation with
Authority for Electricity and Water.

Expanding the National Injuries Surveillance Program.

Implementation of chemical safety in laboratory and handling of hazardous drugs
programs.

Initiating/Implementation of the national plan for preventing occupational noise induced
hearing loss (ONIHL).

Establishment of the national program for medical waste management.

Conducting researches in environmental and occupational health with cooperation of
other sectors.
Expected results:
 Provision of service related to prevention environmental and occupational hazards.
 Improvement of environmental and occupational health services.
 Protection of health care workers from occupational exposure.
 Tracking/notification of occupational noise induced hearing loss (ONIHL).
 Health licensing for developmental projects.
1.2 Development of human resources in environmental and occupational health by:

Increase the number of doctors specialized in occupational medicine and health.

Training of primary health care doctors through EOH Medicine Course in collaboration
with OMSB.

Introducing OH in medical school curriculum ( SQU and Oman Medical College).

Introducing the EOH subject in nursing curriculum and sending for post-graduate
study in occupational nursing.
182

Training of health inspectors in occupational hygiene (2 per region).

Training of doctors in disability assessment committee in national guidelines for
disability assessment.
Expected results:
 Availability of trained national personnel in environmental and occupational medicine/health.
1.3 Increase awareness about environmental and occupational medicine/ health by:

Continue celebrating the World Day for Health and Safety at Work.

Increase the number of health education materials.

Increase awareness of school students about environmental and occupational health.

Further Improvement of DEOH website.

Conducting health education campaign regarding heat exposure, noise exposure and
chemical exposure.
Expected results:

Increase awareness among community and health care workers about environmental and
occupational health issues.
STRATEGIE’S INDICATORS:
Follow
up
timing
Indicators
Current
situation
2010
Indicators of Strategies of the 1 Objective
Targeted
situation
2015
st
1.1a
1.1b
1.1c
1.1d
1.1e
Number of beneficiaries from Poison
Control Center.
Number of actions, programs implemented
from National Strategy for OHS.
Number of national guidelines in EOH.
Percentage of health programs which
implement GIS.
Number of developmental projects which
their health impacts have been assessed.
1.1f
Number of cases which is assessed using
national guidelines for disability assessment.
1.1g
Number of workers exposed to noise
>=85db for 8hrs/day in industrial state.
183
Annually
200
1000
Annually
0
5
Annually
1
6
Annually
0
100%
Annually
0
100%
Annually
0
100%
NA
(number) 20%
reduction from
the current
situation
Annually
Indicators
1.1h
1.1i
1.2j
1.2a
1.2b
1.2c
1.2d
1.3a
1.2b
1.2c
Current
situation
Targeted
situation
2010
2015
Annually
NA
(rate) 20%
reduction from
the current
situation
Annually
0
100%
Annually
3
5
Annually
6
20
Annually
30
135
Every two
years
0
6
Annually
0
All members in
disability
assessment
committee
Annually
10
20
Annually
Annually
1
4
3
15
Follow
up
timing
Incidence of occupational noise induced
hearing loss in industrial state.
Percentage of health institutions which
implement national program for medical
waste management.
Number of researches and studies in EOH.
Number of national qualified personnel in
EOH.
Number of trainee in EOM course from
OMSB and primary health care workers.
Number of health inspectors trained in
Industrial hygienist program.
Number of doctors trained by national
guideline for disability assessment.
Number of health education materials in
EOH.
Number of topics in curriculum.
Number of awareness campaigns.
184
Domain Twenty
Accidents and Injuries
185
Vision: Alleviation of Risks Threatening the Public Health
Goal: Reduction of Mortality and Morbidity Rates of Diseases and
Accidents to the Lowest International Levels
Domain: Accidents and Injuries
INTRODUCTION:
The intentional and environment-based injuries can either be prevented or mitigated
in terms of magnitude. This can be made possible if the underpinning causes delineated so
that the proper preventive measures to reduce public exposure. The surrounding environment
should be the first target to address these causes. The accident bear adverse economic, social
and health burden on the Sultanate since the latest statistics show that injuries are the leading
cause of morbidity among men and rank the sixth leading cause of morbidity among women.
The injuries account for 8 % of total mortality of hospitalized patients (Situational Analysis
of injuries in Oman 2008). The Ministry of Health plays a central role in prevention of
injuries and safety promotion in collaboration with other governmental sectors. The data had
been provided by the Ministry of Health were used in the national strategic planning aimed at
accidents prevention and safety promotion. The Ministry has been a faithful promoter of
accidents prevention and safety enhancement in order to priories these themes within the
government planning. The financial and human resources need to be identified in order to
prevent injuries and promote safety in the different levels of health care system.
After the misfortunate environmental calamities that took place in 2007 and 2010 and
the H1N1 swine flu epidemic the disaster preparedness and emergency response became a
focus of national interest. In response, the Ministry of Health paid a great attention to this
national issue in the eighth 5-year plan in order to meet the national, regional and
international requirements. The initial survey conducted by the Department of Environmental
and Occupational Health in collaboration with the World Health Organization and European
Union showed the real need for clear preparedness and response plan to medical and public
health emergencies and the definite shortage in the specialized personnel in disaster
management.
This plan will define the vision and the strategic goals for Ministry of Health in the
injuries prevention and safety promotion and the emergency preparedness and response for
medical and public health emergencies. It will also provide a guideline approach for creation
of safety culture and the priorities in medical and public health emergencies.
OBJECTIVES:
1. To decrease morbidity and mortality and disability resulting from the accidents and medical
and public health emergencies.
186
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To decrease morbidity , mortality & disability resulting from the
accidents and medical and public health emergencies
(rate)
Reduction by
1.
Incidence of Injuries per 10000 population.
NA
86
10% from the
current
situation
(rate)Reduction
Deaths Rate of Injuries per 10000
by 5% from the
2.
NA
0.399
population.
current
situation
(rate)
Reduction by
3. Deaths rate of RTA per 10000 population.
NA
0.316
5% from the
current
situation
(number)
Reduction by
4. Number of Non-fatal injuries from RTA.
NA
9709
5% from the
current
situation
(rate)
Reduction by
Deaths rate from other non-RTA injuries per
5.
NA
0.183
5% from
10000 population.
current
situation
(percentage)
Reduction by
6. Percentage of Disability due to injuries.
NA
8%
5% from the
current
situation
(number)
Reduction by
Number of injuries and deaths related
7.
Nil
24x
5% from the
disaster.
current
situation
x Deaths from 2010 environmental calamities
187
STRATEGIES:
Strategies to Achieve 1st Objective: To decrease morbidity , mortality & disability resulting from
the injuries and medical and public health emergencies.
1.1 Development of human resources and the basic infrastructure through:

Qualifying Omani-nationals to specialize in injuries prevention and safety promotion and
emergency preparedness and response.

Conduct specialized training courses in injuries prevention and safety promotion for the
medical personnel.

Incorporation of injuries prevention and safety promotion into the health curriculum of
medical schools, nursing schools and health inspection.

Conduct a simulation exercise to practice medical and public health emergencies.

Providing the basic infrastructure needed for the emergency preparedness and response
in the health care system.
Expected results:

Existence of qualified and specialized nationals in injuries prevention and safety promotion and
medical and public health emergencies.
 Improvement in the quality of the services provided to prevent injuries and enhance safety.
1.2 Strengthening of injuries surveillance system and emergency data collection through:

Approval of injuries electronic surveillance system in all health institutions.

Training of health personnel in injuries electronic surveillance system.

Continuous update of medical and public health emergencies data.

Distribution of the collected data regarding the emergencies and injuries prevention
using the GIS.
Expected results:
 Establishment of effective e-surveillance system.
 Improvement in the quality of the data regarding injuries notification.
 Deriving accurate data regarding injuries to support prevention program.
 Provision of the necessary data to plan for public health and medical emergencies.
 Pinpointing of hazards, risks and weakness in the health system.
1.3 Establishment of the national policies regarding injuries prevention and the preparedness
and response to the medical and public health emergencies through:

Formulate a national framework relaying on injuries prevention and safety promotion.

Establishment of a national committee to run the injuries prevention and safety
promotion program.

Involvement of the concerned parties of the government in the program of injuries
prevention and safety enhancement.
 Formulation of national safety standards.
Expected results:

Formulation of national prevention plan for injuries prevention and safety promotion in
collaboration with other governmental sectors.
188
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
1.1a
Number of A/E staff trained to deal with
injuries.
Annually
200
50% of A/E
Staff
50% of A/E
Staff
1.1b
Number of A/E staff trained in BLS &
ACLS.
Annually
Total number of
trained staff in
all departments:
ACLS=900
BLS=1400
1.1c
Number of A/E Staff trained on ATLS.
Annually
NA
Number of A/E Staff trained on different
emergencies and crises.
Number of A/E departments with
infrastructure to respond to emergency for
all hazards:
 PPE for All hazards
 Negative pressure isolation room
 Decontamination room
 back up communication system
Number of simulation drills in different
emergency themes.
Number of health institutions implementing
the injury e-surveillance.
Number of trained staff in injury
surveillance.
Number of injury prevention awareness
campaign.
Number of topics regarding accidents
prevention and safety promotion adopted by
the willayate health committees.
Number of community-based injuries
prevention and safety enhancement projects
done by Wilayat health committees.
Annually
143
1.1d
1.1e
1.1f
1.2a
1.2b
1.3a
1.3b
1.3c
50% of A/E
Staff
50% of A/E
Staff
Every two
years
Zero (not
complete)
All A/E
departments in
Referral
hospitals
Biannual
13
20
Annually
Zero
All referral
hospitals
Annually
15
100
Annually
Zero
20
Annually
Zero
20
Annually
Zero
10
All referral and
regional
hospitals
All referral and
regional
hospitals
1.3d
Number of hospitals with emergency plan
for all hazards.
Annually
Zero
1.3e
Number of hospitals with hospital safety
index worked out (HSI).
Annually
Zero
1.3f
Number of A/E departments with chemical
information resources (MSDS/Chemical
Safety Database).
Annually
Zero
All A/E
departments
1.3g
Number of researches in the field.
Annually
3
6
189
Vision Four
Promoting Woman and Child health and
maintaining the health of elderlies
190
Domain Twenty One
Woman Health
191
Vision: Promoting Woman and Child Health and Maintaining
The Health of Elderlies
Goal: Improving Health Care Provided to
Women and Children and Elderlies
Domain: Woman Health
INTRODUCTION:
Since the Renaissance, Ministry of Health has committed to promote the health and
development of the Omani citizens. Under this objective MoH has put the basis for basic and
specialized heath components in its place. Health services in Oman have developed
dramatically in quantity and as well as quality. Now, 98% of population has accessibility to
universal health care at primary health care level and specialized care at secondary and
advanced care at tertiary level. This is as a result of well-organized and integrated health care
system and further to decentralization of primary health care services and establishment of
autonomous hospitals.
Women represent half the community and are important human resource. God has
blessed women with special gift of giving birth to babies and ability to breast-feeding. In
addition, they are the institution of care and builder of the new generation who subsequently
will take the responsibility of building healthy and productive community.
As high as 28.83% of the total Omani population is females in the reproductive age
(15-49), Women being an important section of the population, Ministry of Health (MoH) pay
special attention to women‟s health. MoH has adopted a lot of polices and strategies to
promote women‟s health.
During the seventeenths and the eighteenths of last century the focus was to provide a
comprehensive health service for children and mothers during reproductive age, which
include providing antenatal, childbirth and postnatal cares. In the nineteen's two components
of reproductive health were introduced; birth spacing program and infertility program. After
ensuring stability and quality of these programs, the focus shifted at the beginning of the third
century to adolescent health and menopausal health.
Review of health indicators for the year 2009, pertaining to women‟s health have
shown a great improvement in the health services provided to mothers, like Ante-natal
coverage reaching to 99.4 % and birth attended by supervised medical attendants to 98 %. In
addition, the Maternal Mortality Ratio has dropped to 13.4 per 100,000 live births, which is
lower than many of the international and surrounding countries. This ratio reflects the
progress, development and improved quality of maternal health services. The health statistics
also show an increase in maternal outpatient Morbidity from 0.2% in 1996 to 0.7% in 2009.
At the same time the inpatient morbidity due to maternal causes increase from 9.4% in 1996
to 11.9% in 2009.
192
The Population Pyramid in 2009 shows that about 7 % of population is of females
beyond reproductive age. This percentage will increase, taking in account the current life
expectancy, which is around 75.7 years for females. This age group usually faces a lot of
medical problems most of which start by the end of the reproductive age. Post reproductive
problems in women affect the quality of life and necessitate providing special services for
them like, regular medical checkup for prevention and early detection of diseases such as
osteoporosis, breast and cervical cancer etc, that warrant conducting studies and providing
data on the causes and morbidity amongst this age group
For all above challenges and taking into the account the recommendation of international
conferences on reproductive health and Oman‟s obligation to international convention and its
principles to improve the woman health in all stages of her life, the objectives, goals and
strategies of the 8th five-year plan (2011-2015) have been put in place.
OBJECTIVES:
1. Expansion in the provision of Reproductive Health services package in the Ministry of Health'
Facilities.
2. Improving Reproductive practices in the community.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
argeted
situation
2015
First Objective’s Indicators: Reduction of morbidity and mortality rates among women in the
reproductive age
Maternal Mortality Rate (Per 100,000 live
1.
15.4
13.4 (2009)
10
births).
2.
Still birth Rate (Per 1000 births).
9.2
8.8 (2009)
8
Number of regions that provide service of
3.
0
2
11
screening for breast cancer.
Number of regions that provide health
4.
1
2
11
service for menopausal women.
Percentage of children born for HIV mothers
5.
NA
NA
100%
with negative HIV result at age ≥18 months.
Second Objective’s Indicators: Improving the healthy reproductive practice in the community
Percentage of women who have birth at
1.
39.1%
37.7%
40%
interval more than 3 years.
Percentage of births to mother less than 20
2.
4.14%
3.8%
3%
years old.
Percentage of births to mother more than 35
3.
14.14%
12.7%
11%
years old.
Prevalence of B.S method use (modern and
4.
traditional) between women in reproductive
NA
28.2%*
30%
age.
* world health survey 2008
193
STRATEGIES:
Strategies to Achieve 1st Objective: Expansion in the provision of Reproductive Health services
package in the Ministry of Health' Facilities
1.1 Adding service of screening for breast cancer to the package of woman health services at
primary health care level and training health care providers on clinical breast examination and
breast self examination.
Expected results:
 Increase in the number of breast cancer cases detected at early stage.
1.2 Training of health care providers on counseling on screening for breast cancer.
Expected results:
 Increase in the number of breast cancer cases detected at early stage.
1.3 Putting an annual advocacy plan for governorates to expand breast cancer screening
services.
Expected results:


Increase number of breast cancer cases detected at early stage.
Increase in the percentage of women who aware of the methods of screening and early detection
of breast cancer.
1.4 Training health care providers on pregnancy and childbirth management guidelines in
collaboration with other concerned sections, departments, primary health care facilities and
hospitals.
Expected results:
 Improvement in the quality of health services provided to pregnant women.
 Increase in the percentage of clients satisfied with the services.
1.5 Training health care providers on counseling in antenatal, delivery and postpartum issues.
Expected results:

Presence of high percentage of health care providers with counseling skills in Mother‟s Health
issues.
 Reduction in maternal morbidity and mortality.
1.6 Strengthening health care providers' skills on dealing with obstetric emergencies through
introducing ALSO program.
Expected results:
 Improvement in health care providers' skills on dealing with obstetric emergency.
1.7 Provision of counseling, testing and treatment services to reduce sexually transmitted
disease especially HIV in mothers.
Expected results:


Early detection of HIV in pregnant women.
Reduction in the number of children with HIV due to mother to child transmission.
194
1.8 Training health care providers on the guidelines on management of menopause with
collaboration with other concerned sections, departments, and primary health care centers and
hospitals.
Expected results:
 Improvement in the quality of health services provided for menopausal woman.
 Increase in the percentage of clients satisfied with the services.
1.9 Training health care providers on counseling in medical problems related to menopause.
Expected results:

Presence of high percentage of health providers with counseling skills on menopausal health
issues.
Strategies to Achieve 2nd objective: Improving community reproductive practice
2.1 Expanding birth spacing services through adding new contraceptive method to the
currently provided birth spacing methods and encouraging women to use long acting methods.
Expected results:
 Increase in the number of clients benefited from the birth spacing services.
2.2 Continue training of health care providers on birth spacing services to strengthen their
skills.
Expected results:
 Increase in the number of clients benefited from the birth spacing services.
 Reduction in maternal morbidity.
 Improvement in the services provided.
2.3 Continue training health care providers on counseling in birth spacing.
Expected results:
 Reduction in maternal morbidity
 Increase in the number of clients benefited from the birth spacing services.
2.4 Strengthen health education and media activities through conducting awareness campaigns
to reduce early, late and frequent pregnancies.
Expected results:




Increase in the number of clients benefited from the birth spacing services.
Reduction in percentage pregnancies in young age (less than 20 years).
Reduction in percentage pregnancies in old age ( more than 35 years)
Reduction in percentage frequent pregnancies (birth at interval less than 3 years).
195
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
1.1a
1.1b
1.2a
1.2b
1.3a
1.4a
1.4b
1.4c
1.4d
1.5a
1.6a
1.6b
1.7a
Number of regions that provide service of
screening for breast cancer.
Percentage of primary health care institutions
that provide service of screening for breast
cancer.
Percentage of trained doctors and nurses at
primary health care institutions on clinical
breast
examination
and
breast
self
examination.
Percentage of trained Arabic speakers doctors
and nurses on providing counseling on
screening for breast cancer issues.
Number of health education/ awareness
activities on importance of early detection of
breast cancer.
Percentage of trained doctors at primary health
care institutions on pregnancy and childbirth
management guidelines (level I).
Percentage of trained nurses and midwives at
primary health care institutions on pregnancy
and childbirth management guidelines (level
I).
Percentage of trained doctors at secondary
health care institutions on pregnancy and
childbirth management guidelines (level II).
Percentage of trained nurses and midwives at
secondary health care institutions on
pregnancy and childbirth management
guidelines (level II).
Percentage of trained Arabic speakers doctors
and nurses at primary and secondary health
care institutions on providing counseling
pregnancy and childbirth issues.
Percentage of trained doctors and midwives in
maternity wards on ALSO program.
Percentage of deliveries occurring under
medical supervision.
Percentage of trained Arabic speakers doctors
and nurses at primary and secondary health
care institutions on providing counseling on
HIV in pregnancy.
196
Annually
2
All
governorate
Annually
15.27%
80%
Annually
13.9%
70%
Annually
8.8%
70%
Annually
703
5000
Annually
8.6%
80%
Annually
9.5%
80%
Annually
32%
80%
Annually
11.2%
80%
Annually
Annually
Training
curricula
will be
produce in
2012
Not in place
yet
60%
50%
Annually
98.6%
99%
Annually
14.5%
50%
Follow
up
timing
Current
situation
2010
Targeted
situation
2015
Percentage of registered pregnant women who
are screened for HIV.
Percentage of eligible HIV mothers who are
receiving treatment.
Annually
97.4%
100%
Annually
77%
100%
Percentage of children born for HIV mothers
with negative HIV result at age ≥18 months.
Percentage of HIV mothers who are using
birth spacing at 18 months after delivery.
Percentage of trained doctors and nurses at
primary and secondary (gynecology clinic)
health institutions on management of
menopause guidelines.
Percentage of trained Arabic speakers doctors
and nurses
at primary health care and
secondary health care institutions on providing
counseling on menopausal health issues.
Annually
NA
96%
Annually
NA
100%
Annually
7%
80%
Annually
9.6%
60%
Indicators
1.7b
1.7c
1.7d
1.7e
1.8a
1.9a
Indicators of Strategies of 2nd Objective
2.1a
Number of contraceptive methods that are
provided by Ministry of Health.
Percentage of primary health care Institutions,
which provide the service of IUCD insertion.
Percentage of PHC Institutions with a trained
male staff on BS counseling.
Percentage of Primary Health Care institutions
with room specified for counseling.
Annually
5
6
Annually
42.21%
60%
Annually
41.89%
80%
Annually
11%
20%
2.4a
Number of health projects on Birth Spacing
Programme that are adopted by health
committees.
By the end
of current
plan
3
50
2.4b
Percentage of users of contraceptive methods
of during first year delivery.
Every two
years
NA
80%
2.4c
Percentage of users of modern contraceptive
methods during first year after delivery.
Every two
years
24.2%
35%
Annually
37.7%
40%
Annually
3.8%
3%
Annually
12.7%
11%
2.2a
2.3a
2.3b
2.4d
2.4c
2.4e
Percentage of women who have birth at
interval more than 3 years.
Percentage of births to mother less than 20
years old.
Percentage of births to mother more than 35
years old.
197
Domain Twenty Two
Child Health
198
Vision: Promoting Woman and Child Health and Maintaining
The Health of Elderlies
Goal: Improving Health Care Provided to
Women and Children and Elderlies
Domain: Child Health
INTRODUCTION:
For over three decades, child health has been recognized as a priority in Oman. Investing
in children is investing in our future, healthy children have a greater chance of growing up
into strong, healthy, productive adults that can carry the society forwards. This commitment
was further strengthened in 1996 by the signatory on the Convention of the Rights of the
Child and joining the international arena in achieving the Millennium Developmental Goals;
Children under 18 makeup over one third of the population in Oman.
The ministry of Health has developed diverse strategies to improve health of children, to
cover a range of aspects, be it; infectious diseases, care of the newborn baby, promotion of
breast feeding, care of the sick child, safety and accident prevention, etc…
This commitment resulted in the remarkable advances in reducing child mortalities. As the
rate for under 5 year of age has reached 12/1000 live birth and the infant mortality was
9.6/1000 live birth in the year 2009.
However to further reduce child mortality, there is a need now to strengthen and integrate
existing programmes, upscale healthy services provided to children, raise levels of
competencies of health care providers, increases level of awareness among community and
families and introduce new strategies to cover emerging issues.
This cycle of planning aims to further reduce mortality of children and improve quality of
health care provided to them. Introduce health services to children with chronic illnesses, and
children victim of maltreatment. Strengthen health services at a community level. Coordinate
efforts of different stake holders involved in child health strategies.
OBJECTIVES:
1. To reduce childhood mortality and morbidity rates with focus on neonates, infants and
children less than 5 years of age.
2. To improve quality of health services provided to children with a focus on:
 Children with special needs.
 Children with chronic illnesses.
 Children victims of maltreatment.
3. To enhance coordination between different domains related to child health at a central
level.
199
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To reduce childhood mortality and morbidity rates with focus on
neonates, infants and children less than 5 years of age.
1.
Infant mortality rate/1000 LB.
10.3 (2004)
9.6
8.5
2.
Perinatal mortality rate/1000 LB.
14.46
13.9 (2008)
12
3.
Under 5years mortality rate/1000 LB.
11.05
12
10
4.
Rate of children under 5 affected with
diarrhea /1000 child.
263
240
150
5.
Percentage of severe diarrhea cases admitted
to the total number of cases.
0.2%
0.2%
0.1%
6.
Number of deaths due to diarrhea.
None
None
None
7.
Rate of acute respiratory tract infections
/1000 children less than 5 years.
1500
Percentage of severe infections cases
admitted to total number of acute respiratory
infections cases.
0.3%
8.
1123
1000
(2009)
0.2%
0.2%
Second Objective’s Indicators: To improve quality of health services provided to children with a
focus on:



Children with special needs.
Children with chronic illnesses.
Children victims of maltreatment.
1.
Number of health centers with defined
service package for children with chronic
illnesses.
0
0
At least one
health facility
for every
region
2.
Number of chronic illnesses included in the
package (Down Syndrome & Asthma).
0
0
2
Third Objective’s Indicators: To enhance coordination between different domain related to child
health at a central level.
1.
Availability of Child Health Committee at a
central level.
200
NA
NA
Available at
central level
STRATIGIES:
Strategies to Achieve 1st Objective: To reduce childhood mortality and morbidity rates with focus
on neonates, infants and children less than 5 years of age
1.1 Train doctors & midwives working at delivery facilities on Neonatal Resuscitation.
Expected results:
 Increase percentage of certified doctors and nurses on Neonatal Resuscitation Programme.
 Improve skills of providers on dealing with critical care of newborns.
 Reduce complications associated with deliveries and critically ill newborns.
1.2 Train doctor working at Pediatrics and Accident & Emergency departments on Pediatrics
Advanced Life Support.
Expected results:
 Increase percentage of certified doctors on PALS.
 Improve skills of doctors of dealing with emergency pediatrics.
 Reduce child mortality.
1.3 Increase number of certified cites of training on NRP & PALS.
Expected results:
 Optimize training requirements of regions.
1.4 Establish a trained transport team (pediatricians & nurses) for the transport of critical
cases to the referral hospitals and provision of the necessary equipment.
Expected results:
 Decreased complications associated with transportation of ill children.
1.5 Complete equipments lists for neonatal care at all health facilities where deliveries are
being conducted.
Expected results:
 Improved care for newborns.
 Reduction of Perinatal mortality rates.
1.6 Complete equipment list needed for caring of children at pediatrics wards and emergency
departments.
Expected results:
 Better care for children at emergency situations.
 Reduce child mortality rates.
1.7 Analyze causes of perinatal and infant mortality in Oman.
Expected results:


Have a clear understanding of leading causes of perinatal and infant mortalities in Oman, as per
the regions.
Improve health services provided to newborns and infants.
201
1.8 Train doctors on care of the newborn guidelines level 1 and level 2.
Expected results:
 Trained doctors on standardized care for newborns.
1.9 Expand coverage of Integrated Management of Childhood Illnesses strategy.
Expected results:
 All Primary Health Care Facilities implementing the IMCI strategy.
1.10 Strengthen the community component of IMCI.
Expected results:
 Increasing awareness level of the community in managing childhood illnesses.
1.11 Train medical and Nursing students on the IMCI strategy.
Expected results:
 Implementing the pre service component of the IMCI Strategy.
Strategies to achieve 2nd objective: To improve quality of health services provided to children
with a focus on:
 Children with special needs.
 Children with chronic illnesses.
 Children victims of maltreatment.
2.1 Conduct a study to determine the prevalence of inherited disorders in Oman.
Expected results:
 Identify the most common inherited congenital disorders that can be screened for at birth.
2.2 Expanding neonatal screening tests performed to include hereditary blood disorders
(Sickle Cell Disease & Thalassemia) and some metabolic disorders in collaboration with the
Genetic Center.
Expected results:
 Increasing number of disorders screened for.
 Improving health status of children through early detection of inherited diseases.
2.3 Set up a follow up system for children with chronic illnesses at health facility level.
Expected results:
 Up scaled health services provided to children with chronic illness.
2.4 Integrate home services to children through community nursing program.
Expected results:


Increase accessibility of health services to certain groups of children.
A data base for children requiring community nursing services.
202
2.5 Set up a follow up system for children victims of maltreatment.
Expected results:
 Strengthen reporting system of child maltreatment.
 Improved health service and psychological support to abused children.
2.6 Carry out a qualitative research on child maltreatment.
Expected results:
 Have a better understanding of factors contributing to child maltreatment.
Strategies to achieve 3rd Objective: To enhance coordination between different domains related to
child health at a central level.
3.1 Establish a central committee for child health.
Expected results:

A better collaboration among child health programmes and strategies.
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
Annually
1.1a
Percentage of doctors & midwives working at
health establishments with delivery facilities
and are trained on Neonatal Resuscitation.
Annually
1.2a
Percentage of doctors working at pediatrics
wards and A&E departments who are trained on
Pediatric Advanced Life Support (PALS).
1.3a
1.3b
1.4a
64%
95%
30%
95%
Number of training sites on NRP.
By the
end of the
current
plan
1 (Royal
Hospital)
5
Number of training sites for PALS
By the
end of the
current
plan
2 (Royal
Hospital&
Sohar
Hospital)
5
Availability of an online system
Intensive Care Units
By the
end of the
current
plan
NA
Available
that links
203
Indicators
Follow
up
timing
Current
situation
2010
Targeted
situation
2015
By the
end of the
current
plan
Zero
(as per new
guidelines)
At least one
team in each
Secondary
Hospital
Annually
1 (Royal
Hospital)
All secondary
hospitals
1.4b
Number of specialized safe transport teams.
1.5a
Number of secondary hospitals that have
fulfilled the central list for safe transport
equipments.
1.5b
Percentage of health facilities with delivery
services that have completed the central list of
equipments.
Annually
58%
100%
1.6a
Percentage of pediatrics wards and A&E
departments with a complete list of pediatrics
equipments.
Annually
1 (Royal
Hospital)
100%
1.7a
A national study to analyze causes of perinatal
and infant mortalities.
By the
end of the
current
plan
NA
Study
conducted
1.8a
Availability of training guidelines on Hospital
based child care.
By the
end of
2013
NA
available
1.8b
Percentage of doctors working in pediatrics
wards that are trained on hospital based child
care.
Annually
zero
30%
1.9a
Percentage of primary health care facilities
implementing the IMCI strategy.
Annually
80%
100%
1.9b
Percentage of Primary Health Care (PHC)
doctors trained on the IMCI strategy.
Annually
61%
90%
1.9c
Percentage of nurses working at PHC that are
trained on the IMCI strategy.
Annually
70%
90%
1.10a
Percentage of health educators trained on the
IMCI strategy.
Annually
70%
90%
1.10b
Percentage of PHC implementing
community component of IMCI strategy.
Annually
10%
50%
1.10c
Number of regions supporting the community
component of the IMCI.
Annually
1
All regions
204
the
Indicators
Follow
up
timing
Current
situation
2010
Targeted
situation
2015
1.11a
Percentage of health care providers trained on
the IMCI.
Annually
60%
80%
1.11b
Percentage of trained academics on IMCI.
Annually
20%
70%
1.11c
Percentage of Medical students at SQU &
Oman medical College trained on IMCI.
Annually
10%
60%
1.11d
Percentage of medical students who received
clinical training on the IMCI.
Annually
5%
60%
1.11e
Percentage of institutes and colleges that are
teaching the IMCI.
Annually
zero
50%
Indicators of Strategies of the 2nd Objective
A national study to determine the 5 most
common hereditary disorders at birth.
By the
end of the
current
plan
NA
available
2.2a
Number of diseases screened for at birth.
By the
end of the
current
plan
2
5
2.2a
Number of health education activities in
relation to child safety inside and outside the
house.
Annually
NA
At least one per
month.
2.2b
Percentage of screened newborns on the
congenital hypothyroidism.
Annually
99.8 %
99%
2.2c
Percentage of secondary hospitals with delivery
facilities and are provided with an echo hearing
test.
Annually
70%
95 %
2.2d
Percentage of screened newborns on the
hearing screening program.
Annually
81.6%
>95%
2.3a
Availability of guidelines on follow up for
children
with
chronic
illnesses
and
implementing it at hospital levels. (Down
Syndrome & Asthma).
By the
end of
2012
NA
available
2.1a
205
Follow
up
timing
Current
situation
2010
Targeted
situation
2015
2.3b
Percentage of doctors trained on chronic
illnesses guidelines.
By the
end of
2013
NA
30%
2.3c
Percentage of health facilities implementing the
chronic illnesses guidelines.
By the
end of
2013
NA
30%
2.4a
Categories of children included
community nursing program.
in
the
By the
end of
2013
NA
5
2.4b
Percentage of children included
community nursing program.
in
the
Annually
NA
At least 30% of
children
2.5a
Available guidelines for management and
follow up of maltreated children.
By the
end of
2013
NA
available
Qualitative research on child maltreatment in
Oman.
By the
end of the
current
plan
NA
available
Indicators
2.6a
Indicators of Strategies of the 3rd Objective
3.1a
Availability of a central committee for child
health
206
By the
end of the
current
plan
NA
available
Domain: Twenty Three
Elderlies Care
207
Vision: Promoting Woman and Child Health and Maintaining
The Health of Elderlies
Goal: Improving Health Care Provided to
Women and Children and Elderlies
Domain: Elderlies Care
INTRODUCTION:
Elderlies age group (60 years and above) is a growing group in Omani population, it
represents about 3.76% from the total population (according to 2009 med-year estimate), and
with the expectation of further growing in coming decades. This increase is attributed to the
impressive improvement in living status and the services provided for the individual and
community including health care, which as a result leads to remarkable decrease in mortality
rates and increase in expected age at birth.
Elderlies population divided to tow main groups: the first group including elderlies that are
functionally able. They can manage about the care of themselves without a support or
caregiver. The second group are totally or partially dependant or retarded. The latter group
needs most of the support and their dependency either due to senility process or neglect from
there caregiver, this lead to accumulation of senility effects and may lead to total dependency
and as a result very high cost of care.
Senility is continuous biological process all the biological system undergoing though it.
The effect of senility varies from individual to another and from community to another, but
with proper care can delay or minimize its effect or even prevent it. Many morbidities are in
relation with senility (osteoporosis, osteoarthritis, dementia, HTN, DM,…ect).
Morbidity as consequences of senility can create a very huge burden on the health care in all
levels and the community evenly. Elderlies care either institutional or community care (home
care) is very important, since it can relieve the burden on the health system, community and
the elderlies also. Therefore, Ministry of health and through the comprehensiveness of its
services to cover all groups of the population elderlies care programme is founded to shape
the care provided for this very important group of people.
OBJECTIVES:
1. To promote elderlies care service for elderlies population who can reach to PHC institutions
and those who cannot reach to improve their quality of life.
2. To empower PHC institutions to provide elderlies care services.
3. To raise the awareness of the community about the importance of elderlies care service to
encourage their contribution in this service.
208
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To promote elderlies care service for elderlies population either who
can reach or cann’t to PHC institutions to improve their quality of life.
1.
Percentage of PHC institutions that provide
elderlies care service.
zero
6.6%
80%
2.
Percentage of elderlies who use elderlies
care service.
zero
3.4%
80%
3.
Percentage of elderlies who can‟t reach
PHC institutions and involved in home care
service.
NA
3.2%
70%
4.
Average number of visits for home care
group in all regions.
NA
< visit / month
A visit / month
Second Objective’s Indicators: To empower PHC institutions to provide elderlies care services.
1.
Number of regional coordinator for the
programme of elderlies care.
zero
zero
11
2.
Average number of nurses working as
institutional coordinator for the programme.
zero
zero
One nurse /
institution
3.
Average number of physiotherapist for each
sector*.
zero
zero
Physiotherapies
/sector
4.
Average number of physiotherapy units for
each sector*.
zero
Zero
Unit / sector
5.
Average number vehicles for each sector*.
zero
zero
Vehicle/ sector
6.
Availability of elderlies care guideline in all
PHC institutions.
NA
NA
available
7.
Number of nurses trained to provide
elderlies care service.
zero
zero
A nurse/
institute (at
least)
8.
Number of master trainer doctors.
zero
zero
A doctor/
region
*(total number of sectors is 78 sector in all regions)
209
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Third Objective’s Indicators: To raise the awareness of the community about the importance of
elderlies care service to encourage their contribution in this service.
1.
Number of community activities to raise
awareness about elderlies care.
zero
2 / institution at
least*
2 / institution at
least
2.
Percentage of people in community who
know about the importance of elderlies
care.
NA
NA
60%

This data was available from Al Dakhliya region for 2010.
STRATEGIES:
Strategies to Achieve 1st Objective: To promote elderlies care service for elderlies population either
who can reach or cann’t to PHC institutions to improve their quality of life.
1.1 Nominate a regional focal point and programme coordinator.
Expected results:
 Better follow up and monitoring of the programme in the regions.
1.2 Implement proper elderlies care service mechanisms in PHC institutions.
Expected results:
 Provide standard elderlies care services.
1.3 Determine a service pathway in PHC institution.
Expected results:
 Easy flow of the elderlies in all stations of the service.
1.4 Create elderlies care service guideline for PHC institutions.
Expected results:
 Availability of reference for provision of elderlies care service.
1.5 Implement home care service mechanism.
Expected results:
 Provide standard home care service easily.
1.6 Determine home care service pathway and checklists.
Expected results:

Provide easy and standard home care service for elderlies.
210
Strategies to Achieve 2nd objective: To empower PHC institutions to provide elderlies care services.
2.1 Support PHC institutions with necessary number of nurses.
Expected results:

Ensure continuity of elderlies care service.
2.2 Support PHC institutions with physiotherapists.
Expected results:

Provide physiotherapy service for elderlies in PHC setting.
2.3 Support PHC institutions with mobile physiotherapy units.
Expected results:

Provide physiotherapy service for elderlies in PHC setting.
2.4 Provide transportation for elderlies care team in PHC setting.
Expected results:

Ensure easy follow of service providing team in inter-institution and in the community.
2.5 Provide enough printed material for provision of service.
Expected results:
 Easy provision of service.
2.6 Provide enough educational materials.
Expected results:
 Raise the awareness and knowledge of the targeted group.
2.7 Train elderlies care service providers.
Expected results:

Provide a proper service with trained staff.
2.8 Train trainers in elderlies care.
Expected results:

Continuity of training of staff in all regions.
2.9 Coordinate with Ministry of social development about elderlies care.
Expected results:

Participation of social workers in the service and provision of comprehensive social service.
Strategies to Achieve 3rd Objective: To raise the awareness of the community about the importance
of elderlies care service to encourage their contribution in this service.
3.1 Prepare community awareness package.
Expected results:

Easy community education process.
211
3.2 Training of health educators and community support groups about elderlies care education
package.
Expected results:
 Availability of trained staff for the process of community awareness.
3.3 Conduct a community based study to measure community awareness.
Expected results:

Measuring community awareness about elderlies care service.
STRATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
1.1a
Percentage of regions with elderlies care
programme focal point.
Annually
100%
100%
1.1b
Percentage of regions with elderlies care
programme coordinator.
Annually
100%
100%
1.2a
Percentage of Health
elderlies care guidelines.
Annually
zero
100%
1.3a
Percentage of Health institutions with clear
elderlies service pathway.
Annually
zero
100%
1.4a
Percentage of Health institutions
elderlies care service manual.
Annually
zero
100 %
1.5a
Percentage of PHC institutions with home
care package.
Annually
zero
100 %
1.6a
Percentage of PHC institutions with home
care package checklists.
Annually
zero
100%
institutions
with
with
Indicators of Strategies of the 2nd Objective
2.1a
Percentage of PHC institutions with trained
nurses in elderlies care.
Annually
zero
80 %
2.2a
Percentage of sectors with physiotherapist.
Annually
zero
60%
2.3a
Percentage of sectors with physiotherapy
units
Annually
zero
60%
212
Indicators
Follow
up
timing
Current
situation
2010
Targeted
situation
2015
2.4a
Percentage of sectors with vehicle.
Annually
zero
75%
2.5a
Percentage of institutions with elderlies care
printed list.
Annually
zero
90%
2.6a
Percentage of institutions with elderlies care
educational materials.
Annually
zero
90%
2.7a
Percentage of regions with trained doctor.
Annually
zero
90%
2.8a
Availability of training of trainers workshops.
Annually
zero
Available
2.9a
Percentage of sectors with social workers.
Annually
zero
60%
Indicators of Strategies of the 3rd Objective
3.1a
Percentage of PHC institutions
community awareness package.
with
Annually
zero
100%
3.2a
Percentage of PHC institutions with (two)
staff trained on proper community education
about elderlies care.
Annually
zero
75 %
3.3a
Number of field studies on community
awareness about the importance of elderlies
care.
Annually
N.A
2
213
Vision Five
Dissemination of Healthy lifestyles in the
Community
214
Domain: Twenty Four
Health Education and Communication
215
Vision: Dissemination of Healthy Lifestyles in the Community
Goal: Increasing Health Awareness, Correcting Attitudes and Establishing
Healthy Behaviors and Practices in the Community
Domain: Health Education and Communication
INTRODUCTION:
Health education plays a prominent role not only at dissemination of health
information to the community but also in informing the citizens about the programs and
services offered by the Ministry in order for them to take advantage of these services. Health
Education is a joint responsibility of all health workers in different health institution and not
exclusively on health educators.
Health education is an important and integral part of all health services and programs
of the Ministry of Health and its various institutions that spread throughout community. The
Ministry of health therefore making considerable efforts in supporting health education
programmes towards the achievement of established goals and targets intended to sensitize.
In the past few decades, Oman has gone through unprecedented socioeconomic
development. Life expectancy has increased dramatically, major infectious diseases have
been controlled or eradicated and infant mortality rates have been reduced. The rapid
development of the country‟s physical infrastructure has facilitated easy access to and
availability of health and non-health facilities for all citizens. Economic growth has played an
important role in these achievements. Simultaneously, the country has begun to experience
the emergence of an increased rate in non communicable diseases such as diabetes, heart
disease, hypertension and cancer and behaviors related to unhealthy lifestyles.
The emergence and persistence of such practices and unhealthy behaviors, and the
consequent significant increase in morbidity indicators and other health problems, represents
a major challenge to the efforts of awareness-raising and education. It also form a heavy
burden on health care and treatment therefore there is an urgent need to introduce modern and
attractive strategies in health education. As well as building capacities of health care workers
in the field of health education and related subjects.
health education is a continuous process, it is necessary to develop a database on
different risky behaviors and practices in the community as well as conducting different
studies which assist in determining the priority issues in the community and therefore
planning different awareness raising programs.
Health education works with different community organizations and government
agencies. Aiming to help the community to identify its needs, draw upon its problem-solving
abilities, and mobilize its resources to develop, promote, implement and evaluate strategies to
improve its own health status.
OBJECTIVES:
1. Developing and improving the health education services.
2. Developing the skills and building the capacity of MOH staff working in the field of health
education.
3. Increasing health awareness, targeted at changing unhealthy attitudes and practices and
promoting healthy lifestyles and behaviors in the community.
216
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: Developing and improving the health education services
Rate of health educators per 10,000
population.
NA
One health
educator for
20,000 of the
population
2.
Presence of a health education strategy.
NA
Not completed
3.
Percentage of health institutions that meet
the standard prerequisites of health
education as per the quality auditing
form.
0%
NA
80%
4.
Percentage of the Willayat that have well
equipped health education rooms.
0%
5%
50%
1.
One health
educator for
10,000 of the
population
A strategy
present
Number of educational packages produced in the following subjects:
5.

Adolescents health

Healthy lifestyles

Elderlies care
NA
In preparation
NA
NA
NA
NA
One Package
for each subject
Second Objective’s Indicators: Developing the skills and building the capacity of MOH staff working
in the field of health education
Presence of continuing education
Existence of a
NA
NA
1.
program for health educators.
program
3 centrally
3 centrally
Number of training activities conducted
2.
5
56 at regional
44 at regional
in the field of health education.
level
level
Percentage of primary health care workers who have been trained in health education:
3.

Health educators
NA
50%
100%

Doctors
5%
27%
45%

Nurses
16%
28%
50%

Pharmacists
Pharmacists
0%
27%
57%

medical orderlies
25%
51%
65%
&
Assistant
217
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Third Objective’s Indicators: Increasing health awareness, targeted at changing unhealthy attitudes
and practices and promoting healthy lifestyles and behaviors in the community
The proportion of citizens who have knowledge about :
1.
2.
3.


Risks of Tobacco.
Importance of moderate physical
activities.
 Healthy nutritional habits.
The proportion of citizens who:
 Practicing moderate physical
activity

Smoking

Obese
Availability of baseline data regarding
knowledge, attitudes and practices of the
community of towards important health
issues.
52%*
84.3%**
95%
NA
70.2%
90%
66%
89%
90%
NA
33.4%***
50%
NA
6.9%****
3%
NA
24.8%****
10%
NA
NA
available
Percentage of the beneficiaries from health education activities in the :
4.
5.

Health institutions
10%
14%
50%

Community
15%
42%
50%
The number of health educational activities and events that have been implemented to raise health
awareness in the community through:
5 at central
 Health campaigns
3central level
level
NA
55 at regional
77 at regional
level annually
level
7 central level
3central level
 Health exhibitions
8
202 at regional
100 at regional
level annually
level annually
 IEC materials produced
45
95
500
218
STRATIGIES:
Strategies to Achieve 1st objective: Developing and improving the health education services
1.1 Adopting new methodologies and approaches in the field of health education.
Expected results:
 Improve the quality of health education activities.
1.2 Expansion in the number of health educators.
Expected results:
 Increase the number of health educators and improve services
1.3 Coordination with different five-year plan health programs to develop a joint communication
plans.
Expected results:
 Improve the effectiveness of health education activities.
 Coordinated efforts in directing health messages to the targeted groups.
1.4 Establishing a national call center for the various health topics.
Expected results:
 Increase awareness of various health problems.
 Monitor the important health problems and issues of concern to the community.
1.5 Review and update the curriculum for health educators.
Expected results:
 Updated curriculum for health educators.
Strategies to achieve 2nd Objective: Developing the skills and building the capacity of MOH staff
working in the field of health education
2.1 Developing a of continuing education program for health educators in education and health
communication.
Expected results:
 Increase the efficiency and effectiveness of health educators.
2.2 Providing abroad qualification for the staff in the field of health education and communication,
media and social marketing.
Expected results:
 Qualified expertise staff to improve services.
2.3 Training health care workers on health education and communication, media, social marketing
and methodology of IEC materials production.
Expected results:
 A well trained team.
219
Strategies to Achieve 3rd Objective: Increasing health awareness, targeted at changing unhealthy
attitudes and practices and promoting healthy lifestyles and behaviors in the community
3.1 Establish a database on the knowledge, attitudes and practices of community towards different
health issues.
Expected results:
 Identifying the knowledge, attitudes and practices prevailing in the society and its impact on health
to find appropriate interventions.
3.2
Production
of
attractive
and
advanced
high
quality
IEC
materials.
Expected results:
 Provision of a variety of attractive IEC materials support healthy behviours.
3.3 Adapting new approaches to market and promote health in the media.
Expected results:

Efficient healthy messages in the media.
3.4
Unify
health
messages
with
Expected results:
the
concerned
programs
and
sectors.
 Increase the effectiveness of health messages.
3.5 Conduct a study to evaluate the impact of health education activities in the community.
Expected results:

Improve health education activities according to the results of the evaluation of interventions
implemented.
STARATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
Situation
2010
Targeted
Situation
2015
Indicators of Strategies of the 1st Objective
1.1a
Presence of an integrated health education
strategy.
1.1b
The presence of an electronic record to
document the health education activities.
By the
end of
2012
NA
Strategy present
By the
end of
2012
NA
Electronic record
present
By the
end of
2012
NA
Manual present
Annually
NA
Manual present
The presence of manual for health educators.
1.1c
1.1d
The presence of manual on methodology of
IEC materials production.
220
Indicators
1.1e
The presence of manuals on communication
skills with the media.
Follow
up
timing
Current
Situation
2010
Targeted
Situation
2015
By the
end of
2012
NA
Manual present
1.2a
Number of health educators enrolled in the
Annually
ministry annually.
2
30 yearly
1.3a
Number of communication plans for
Annually
programs that have implemented strategies.
NA
Communication Plan/
strategy implemented
1.4a
The establishment of a health national call By
the
center.
end of the
NA
current
plan
1.5a
The existence of an updated curriculum for
health education.
By the
end of the
current
plan
Call center established
NA
updated curriculum
Indicators of Strategies of the 2nd Objective
2.1a
The Existence of continuing
program for health educators.
education
End of the
current
NA
plan
program present
Number of training programs implemented in the area:
2.2
2.3a
a. Health education and communication
Annually
NA
11
b. Media
Annually
NA
11
c. Social Marketing
Annually
NA
11
d. Production of IEC materials
Annually
1
11
The number of qualified personnel in the
field of health communication, media and
social marketing.
Annually
NA
3
Percentage of primary health care workers who have been trained in the field of:
2.4
a. Health education and communication
Annually
NA
30%
b. Health media
Annually
NA
20%
c. Social marketing
Annually
NA
20%
Annually
NA
30%
d. IEC materials production
221
Follow
up
timing
Indicators
Current
Situation
2010
Targeted
Situation
2015
Indicators of Strategies of the 3rd Objective
3.1a
The availability of a database on knowledge,
By the
attitudes and practices in the community
end of
NA
Baseline Date available
towards health issues.
2013
Number of educational materials have been produced according to the steps of scientific-based
educational material for the production of:
3.2
3.3a
3.3b
3.3c
3.4a
3.4b
3.4c
3.5a
a. Printed:
Annually
b. Audio:
Annually
c. Audiovisual:
Annually
The number of health messages broadcasted in the media:
27
0
0
350(70 yearly)
25(5 yearly)
25(5 yearly)
a. Television
Annually
b. Radio
Annually
c. Press
Annually
The number of health programs implemented in the media :
a. Television
Annually
b. Radio
Annually
The number of Media professionals who have
Annually
been trained on the health topics.
The number of activities which was
Annually
characterized by a unified health messages.
The number of health messages that have
been developed in collaboration with Annually
different programs and other sectors.
Number of IEC materials produced in
cooperation with the different programs and
Annually
other sectors.
60
NA
4
100
100
150
51
99
100
150
170
50
10
25
27
50
55
70
NA
Study present
The presence of a study evaluating the impact
of health education activities in the
community.
222
By the
end of the
current
plan
Domain Twenty Five
Adolescent and Youth Health
223
Vision: Dissemination of Healthy Lifestyles in the Community
Goal: Increasing Health Awareness, Correcting Attitudes and Establishing
Healthy Behaviors and Practices in the Community
Domain: Adolescent and Youth Health
INTRODUCTION:
Adolescents and youth in the age group 10 to 24 years constitute a significant sector of Omani
society. They represent approximately 34% of the population as per the census 2003. They are
also considered the main investment in the future national development.
Adolescence is considered a transition stage in human being lives, as he/she gets physical,
biological, psychological and social changes which substantially shape his/her personality and
attitudes. However during this delicate phase of a lifetime, many sources can influence the
attitudes and behaviors of adolescent and youth such as peer pressure, media and
communication technology…etc. Adolescents and youth may be exposed to risky behaviors
such as sexual behaviors, tobacco and drugs addiction, exposure to psychological diseases
which may negatively affect their attitudes and practices.
Many studies conducted by Ministry of Health had shown that adolescents and youth are
vulnerable to many risk behaviors such as smoking and unsafe driving. Not only that, these
studies also revealed that adolescents have misconceptions about a lot of issues related to
reproductive and sexual health.
According to that , Ministry Of Health with other concerned ministries have implemented the
Information, Education and Communication strategy(IEC) for adolescents and youth health
emphasizing the main role of the health services provided for adolescents and youth . In
order to continue the hard work and to improve the health services provided for youth, a study
was conducted in 2006 to evaluate the health services provided for this group through the
schools and primary health care, and to know their opinions and attitudes towards their
reproductive and sexual health needs.
The study revealed many gaps associated with the health services provided for adolescents
and youth, of these:





Primary health care provides certain reproductive and sexual health services for
adolescents and youth through maternal and child clinics which provide only
antenatal care and health education on birth spacing for adults .
There is no health services specific for adolescents and youth such as counseling
The most important recommendations from this study are:
The importance of establishing adolescents and youth clinics in order to focus and
improve the quality of reproductive and sexual health services provided for this age
group which is suitable for the different developmental stages.
The importance of improving the health education programs to be more suitable and
appropriate with the information needs of adolescents and youth
224

The importance of provision of appropriate health educational materials for
adolescents and youth.
According to these recommendations, the objectives of this domain will focus on promotion
of adolescents and youth health.
OBJECTIVES:
1. To promote the role of primary health care in providing services appropriate for adolescents
and youth in all regions of the Sultanate.
2. To increase awareness about adolescents and youth issues in order to promote healthy lifestyles
in all regions of the Sultanate.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To promote the role of primary health care in providing services
appropriate for adolescents and youth in all regions of the Sultanate
61
1.
The number of adolescents‟ clinics in the
primary health care.
0
11
2.
Number of added services provided for
adolescents and youth in the primary health
care institutes (counseling, investigations,
health education …).
Not applicable
1
3.
Number of studies conducted to evaluate to
what extent the health services provided at
PHC institutes is adolescents and youth
friendly.
NA
(evaluation of
services in
2006)
2
4.
4-percentage of health educators who are
trained on advocacy for youth health
services.
NA
Not applicable
80%
(One clinic per
Wilayet)
At least 3
services
1
Second Objective’s Indicators: To increase awareness about adolescents and youth issues in order to
promote healthy lifestyles in all regions.
1.
Percentage of adolescents (15-19years)
who have good knowledge about
reproductive health.
225
50%
NA
(2001)
90%
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
2.
Percentage of youth (19 - 24years old) who
know the symptoms of sexually transmitted
infections (STI).
NA
23.3%
70%
3.
Percentage of youth (19-24 years old) who
know that physical activity and dieting are
optimum measures to control overweight.
NA
70.2%
90%
4.
Number of studies conducted to know the
level of awareness among adolescents,
youth and their families about the
adolescents and youth health issues.
Adolescent‟s
survey 2001
University &
college survey
2010
2
Indicators
STRATIGIES:
Strategies to Achieve 1st Objective: To promote the role of primary health care in providing services
appropriate for adolescents and youth.
1.1 Development of training manuals and clinical guidelines dealing with adolescents and youth
health issues.
Expected results:

Increase knowledge and skills of health workers in the primary health care institutions.

Improve the health services provided for adolescents and youth.
1.2 Training of health workers in primary health care institutions on dealing with adolescents and
youth health issues.
Expected results:

Improve the quality of health services provided for adolescents and youth.

Increase knowledge and skills of health workers in primary health care institutes on health issues of
adolescents and youth.
1.3 Provision of counseling service for adolescents and youth in the primary health care
institutions appropriate for their needs.
Expected results:

Solving adolescents and youth health problems especially related to reproductive health issues.
226
1.4 liaison /coordinate with IT and PHC Department to improve the computer/information system
to register and document the clients visiting the adolescents’ clinics.
Expected results:
 Retrieve the data and indicators of adolescents and youth.
Strategies to Achieve 2nd Objective: To increase awareness about adolescents and youth issues in
order to promote healthy lifestyles in all regions of the Sultanate
2.1 Development of educational package targeting adolescents, youth and their families in order to
change their knowledge, attitudes and behaviors in relation to issues like adolescence, tobacco,
sexually transmitted diseases, physical activity, reproductive health, mental health and nutrition
related problems…etc.
Expected results:
 Increase the percentage of adolescents and youth who are aware about their health issues.
 Reduce the percentage of adolescents and youth who exercise risky behaviors.
2.2 Increase the educational and media activities to advocate for the adolescents and youth health
services provided in the primary health care institutes in collaboration with Health Education
Directorate.
Expected results:

Increase awareness among adolescents, youth and their community about the health services
available for them.
 Availability of the media support for proper utilization of adolescent‟s and youth‟s health services.
2.3 Collaboration and coordination between different sectors involved in the National Strategy of
Information, Education and Communication on adolescents’ and youth’s health.
Expected results:
 Increase knowledge among adolescents and youth about their health related issues.
2.4 Strengthening the participation of health committees and community based initiatives to
support the educational activities targeting the adolescents and youth.
Expected results:


Increase the care of adolescents and youth health issues.
Adoption of the health committees and community based initiatives (at the Wilayats level) for the
educational activities about adolescents and youth health issues.
227
STARATEGIES’ INDICATORS:
Follow up
timing
Indicators
Current
situation
2010
Targeted situation
2015
Indicators of Strategies of the 1st Objective
Availability
of
clinical
By the end of the
1.1a guidelines on adolescents and
current plan
youth health.
NA
Available & Applied
Availability of
Training
By the end of the
1.1b manual on adolescents and
current plan
youth counseling.
NA
Available
Number of health workers
(doctors &nurses) who are
1.2a
trained on the clinical and
training guidelines.
Annually
Not applicable
50-100 health workers
/region
Number
of
training
workshops for health workers
1.2b
on how to use the clinical and
training guidelines.
Annually
Not applicable
1-2 workshops per region
annually
Percentage
of
health
educators who are trained on
1.2c health
education
of
adolescents and youth health
issues.
Annually
8.9%
80%
Percentage
of
health
institutions which provide
1.3a
counseling for adolescents
and youth.
Annually
6.3%
80%
NA
available
Availability of improved data
By the end of the
1.4a system for adolescents and
current plan
youth health.
Indicators of Strategies of the 2nd Objective
Number
of
educational
materials published by MOH By the end of the
2.1a
at the central level on
current plan
adolescents and youth health.
228
4
5-7 through the plan
Indicators
Follow up
timing
Current
situation
2010
Number
of
educational
materials
published
by By the end of the
2.1b
regions on adolescents and
current plan
youth health.
Targeted situation
2015
0
1-2 per region through
the plan
Annually
1-2 activity
/institution/annually
5-7 per
institution/annually
Annually
NA
2-5 /region/annually
Percentage of sectors that
have
implemented
the
National
Strategy
of
2.3a
Information, Education and
Communication
in
adolescent‟s health.
Annually
70% without
Muscat & Dhofar
100%
Number of Wilayats that
incorporate the adolescents
2.4a
and youth health in their
health activities.
Annually
50
All wilayats
Number
of
educational
2.2a activities conducted at the
PHC on adolescent‟s health.
Number of activities in the
community that advocate for
adolescents and youth health
2.2b services provided at PHC
institutes annually.
229
Domain Twenty Six
School and college health
230
Vision: Dissemination of Healthy Lifestyles in the Community
Goal: Increasing Health Awareness, Correcting Attitudes and Establishing
Healthy Behaviors and Practices in the Community
Domain: School and College Health
INTRODUCTION:
Education has witnessed a tremendous development in the Sultanate and has reached the
number of students based on estimates for 2008/2009 about 584401 students, out of them
43396 (7.4%) students in private schools.
The educational indicators point to high rates of gross enrollment and net per year as they
reach the total enrollment for the academic year 2008 / 2009 to 99.2% for grades 1-6, 101.7%
for grades 7-9, 91.3% for grades 10-12, while Net enrollment rates are of the same year,
91.4% for grades 1-6, 83.6% for grades 7-9, 71.6% for grades 10-12
The number of schools in the Sultanate is 1250, including a school in 1047 government
schools, 3 schools for Special Education and 200 private schools. The number of schools staff
is about 53487 people (46533 teachers and 6954 administrative)
Many studies conducted in the Ministry of Health had shown that the students are prone to
exercise a lot of negative behaviors. The MOH annual report showed that there is an increase
in the prevalence of overweight and obesity among school students, where in 2009 amounting
to about 2% for grade one, 9% for grade seven and 9.3% for grade ten.
In order to care for this category, school health services are currently available through the
Ministry of Health. It aim to provide comprehensive school health services for all students in
government schools and some services to private schools and care centers for people with
disabilities. The school community includes students as well as school staff and parents, who
are in need to enable them to improve their health and practice healthy behaviors that may
reflect on the behavior of students.
A comprehensive school health program includes eight core components which are
health education, school health services, a healthy safe and supportive environment, nutrition
promotion, encourage physical activity, mental health promotion as well as promotion of
school staff health and community participation. In 2008 the National School Health Strategy
was launched .It was developed by school health department in coordination with the sectors
concerned the health of school students and with technical support of WHO-EMRO.
In order to promote the health of students in universities, colleges and higher
educational institutions, the Ministry of Health in collaboration with the World Health
Organization in 2008 conducted a survey to measure their knowledge, attitudes and practices.
The results showed poor knowledge and practices, especially in the field of nutrition, physical
activity, tobacco use, alcohol, substances abuse, road safety, STI and HIV/AIDS. A multisectoral action plan was developed in collaboration with universities and institutions of higher
231
education and other related government and non-governmental sectors concerned with health
of this category.
OBJECTIVES:
1. To promote healthy lifestyles among all categories of the school community in all regions of
the Sultanate.
2. Development and expansion of efficient, high quality, and comprehensive health services to all
school community in all regions of the Sultanate.
3. To promote the health of students in higher educational institutions in all regions of the
Sultanate.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective's Indicators: To promote healthy lifestyles among all categories of school community
in all regions of the Sultanate
1.
Percentage of students in grade one who
suffer from underweight.
14.2%
12.7%*
8%
2.
Percentage of students in grade one who
suffer from overweight and obesity.
1.1%
2.17%*
1%
3.
Percentage of students in grade seven who
suffer from overweight and obesity.
3.9%
9.48%*
5%
4.
Percentage of students in grade ten who
suffer from overweight and obesity.
4.1%
9.59%*
5%
5.
Percentage of students in grade seven who
are current smokers.
3.1%
NA
2%
(2007)
8.7%
Percentage of students in grade seven who
currently use smokeless tobacco.
NA
Percentage of students in grade seven who
currently use shisha.
NA
8.
Percentage of students in grade ten who are
current smokers.
NA
5.9%
3%
9.
Percentage of students in grade ten who
currently use smokeless tobacco.
NA
6.1%
3%
6.
7.
232
5%
(2007)
5.4%
3%
(2007)
Indicators
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
NA
3.9%
1.5%
10.
Percentage of students in grade ten who
currently use shisha.
11.
Percentage of students in grade seven who
eat vegetables and fruits at least five times
per day.
10.8%
NA**
100% increase
from current
situation
12.
Percentage of students in grade ten who eat
vegetables and fruits at least five times per
day.
8%
12.5%
60%
13.
Percentage of students in grade seven who
walk for at least half an hour daily 5-7 days
per week.
18.2%
NA**
100% increase
from current
situation
14.
Percentage of students in grade ten who
walk for at least half an hour daily 5-7 days
per week.
25.1%
21.3%
60%
15.
Percentage of students in grade seven who
spend three hours or more in watching TV
or using computers and video games.
33.1%
NA**
30% reduction
from the current
situation
16.
Percentage of students in grade ten who
spend three hours or more in watching TV
or using computers and video games.
34.3%
33%
25%
17.
Percentage of students in grade seven who
always have breakfast in the past 30 days.
49.2%
NA**
100% increase
from current
situation
18.
Percentage of students in grade ten who
always have breakfast in the past 30 days.
32%
30.5%
60%
19.
Percentage of students in grade seven who
eat fast foods 3 or more days per week.
11.8%
NA**
30% reduction
from the current
situation
20.
Percentage of students in grade ten who eat
fast foods 3 or more days per week.
8.2%
24.6%
15%
21.
Percentage of students in grade seven who
use seat belt in a car driven by another.
NA**
75% increase
from current
situation
22.
Percentage of students in grade ten who use
seat belt in a car driven by another.
NA**
75% increase
from current
situation
233
31.1%
33.7%
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
23.
Percentage of students in grade seven who
have been in a physical attack in last 12
months.
46.9%
NA**
30% reduction
from the current
situation
24.
Percentage of students in grade seven who
have been in a physical fight in last 12
months.
47.6%
NA**
30% reduction
from the current
situation
25.
Percentage of students in grade seven who
have been bullied in last 12 months.
33.2%
NA**
30% reduction
from the current
situation
26.
Percentage of students in grade ten who
have been in a physical attack in last 12
months.
29.4%
29.4%
20%
27.
Percentage of students in grade ten who
have been in a physical fight in last 12
months.
34.5%
37.3%
25%
28.
Percentage of students in grade ten who
have been bullied in last 12 months.
39.2%
41.8%
30%
29.
Percentage of school staff who use any
kind of tobacco.
NA
14.1%
8%
30.
Percentage of school staff who eat
vegetables and fruits at least five times per
day.
NA***
50% increase
from current
situation
31.
Percentage of school staff who walk for at
least half an hour daily 5-7 days per week.
NA***
50% increase
from current
situation
NA
NA
*WHO-BMI for age curve was used in 2008/2009
** Data of physical screening of students in grades seven and ten for year 2011/2012 will be considered as
baseline of the current plan
*** A KAPB on lifestyles will be conducted in 2011 /2012 and could be considered the baseline of the
current plan
234
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Second Objective's Indicators: To expand the efficient, high quality, and comprehensive health
services to all school community in all regions of the Sultanate
1.
Percentage of public schools with
comprehensive school health services to
students.
100%
100%
100%
2.
Percentage of public schools where quality
assurance program for school health is
implemented.
NA
1%
50%
3.
Percentage of public schools with
comprehensive school health services to
school staff.
NA
20.3%
100%
4.
Percentage of private schools with
comprehensive school health services.
30%
60%
100%
5.
Percentage of centers of disabilities which
have comprehensive school health services.
50%
60%
100%
Third Objective's Indicators: To promote health of students in high educational institutions in all
regions of the Sultanate
1.
Percentage of students in high educational
institutions who smoke cigarettes.
NA
9.9%
5%
2.
Percentage of students in high educational
institutions who smoke shisha.
NA
7.7%
5%
3.
Percentage of students in high educational
institutions who use chewable tobacco.
NA
3.9%
2%
4.
Percentage of students in high educational
institutions who eat at least 5 servings from
vegetables and fruits.
NA
12.4%
60%
5.
Percentage of students in high educational
institutions who walk at least half an hour
daily for 5-7 days per week.
NA
50.1%
75%
6.
Percentage of students in high educational
institutions who spend three hours or more
in watching TV or using computers.
NA
28.7%
15%
235
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
7.
Percentage of students in high educational
institutions who have breakfast daily in the
past 30 days.
NA
23.9%
60%
8.
Percentage of students in high educational
institutions who eat fast foods 3 times or
more in the past 7 days.
NA
46%
25%
9.
Percentage of students in high educational
institutions who use seat belt while driving.
NA
71.4%
90%
10.
Percentage of high education institutions
which have health education programs.
1%
80%
100%
Indicators
STRATEGIES:
Strategies to Achieve 1st Objective : To promote healthy lifestyles among all categories of school
community in all regions of the Sultanate
1.1 Expansion of the national health promoting schools network.
Expected results:

Raise awareness of school community towards healthy lifestyles.
1.2 Implementation of peer education strategy in all health issues among school community.
Expected results:

Raise awareness of school community.
1.3 Monitoring of high risk behaviors among school community.
Expected results:

Availability of indicators related to health behaviors of school community.
1.4 Provision of training and health education programs to school staff.
Expected results:

Increase health awareness of school staff.
1.5 Provision of health education programs to parents.
Expected results:

Increase health awareness of the parents.
1.6 Expand the benefits from Facts for Life book and the school health websites.
Expected results:

Increase health awareness of school community.
236
1.7 Ensure healthy safe school environment which support to learning and work.
Expected results:
 Presence of healthy, safe and supportive school environment.
Strategies to Achieve 2nd Objective : To develop and expand the efficient, high quality, and
comprehensive health services to all school community in all regions of the Sultanate
2.1 Continuous provision of efficient, high quality school health services to students and school
staff in public schools.
Expected results:
 Increase the beneficiaries of school health services.
2.2 Encourage and support the provision of school health services in private schools and centers
for special needs.
Expected results:
 Complete coverage of health services to students in educational institutions.
2.3 Strengthen the cadre of school health especially school health nurses as per one nurse for
each school.
Expected results:
 Availability of adequate trained nurses to provide comprehensive effective school health services.
2.4 Strengthen the cadre of school health department and school health sections with nurses for
planning, supervision, training and monitoring the school health nurses in schools.
Expected results:
 Availability of supervision, training and monitoring of school health nurses from central level.
2.5 Continuous implementation of the national school health strategy with other related sectors.
Expected results:
 Coordination between different sectors concerned with students' health.
2.6 Strengthen the well equipped school health clinics in all schools.
Expected results:
 Improve quality of services provided.
2.7 Availability of electronic database on students' health through e-portal of Ministry of
Education.
Expected results:
 Availability of indicators to be used for improvement of the services.
2.8 Evaluation of the beneficiary satisfaction.
Expected results:

Availability of data on the beneficiary satisfaction.
237
Strategies to Achieve 3rd Objective : To promote health of students in high educational institutions
in all regions of the Sultanate
3.1 Strengthen the organizational structure of school health department and sections in the
regions to include a section in the department / unit in the sections for planning, supervising and
monitoring the health programs in the high education institutions.
Expected results:
 Facilitation of monitoring and evaluation of school and collage health programs.
3.2 Advocacy and implementation of health promotion in the high educational institutions.
Expected results:
 Raising students' awareness on health promotion.
3.3 Implementation of peer education approach in all issues related to healthy lifestyle in the
high educational institutions.
Expected results:
 Raising high educational students' awareness towards healthy lifestyles.
3.4 Supervise the implementation of multisectoral plan of action on health promotion of high
educational students.
Expected results:
 Coordination between all related sectors.
3.5 Monitoring of high risk behaviors among high education students.
Expected results:

Availability of indicators related to health behaviors of students in high institutions.
STARATEGIES’ INDICATORS:
Follow
up
timing
Indicators
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
Percentage of schools joined the National
Health promoting Schools Network.
Annually
20.3%
60%
1.2a
Percentage of school health nurses trained
on peer education approach from total
number of school health nurses.
Annually
13.5%
80%
238
Indicators
on
peer
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
Annually
46
165
1.2b
Number of training courses
education in all regions.
1.2c
Number of peer educators from schools
students trained in issues related to lifestyles.
Annually
3036
5-10 students in
each school
1.2d
Number of peer educators from school staff
trained in issues related to lifestyles.
Annually
Not
applicable
2-5 staff in each
school
1.3a
By the end
Number of studies conducted to monitor the
of the
health behaviors among school staff.
current
plan
1
2
1.3b
By the end
Presence of periodic monitoring system for
of the
risk factors among students.
current
plan
Present but
incomplete
Present and
complete
1.4a
Number of health education sessions
conducted for school staff in different health
issues.
Annually
3 sessions in
20.3% of
schools
At least 3- 5
sessions in each
school annually
1.5a
Number of health education sessions
conducted for parents in different health
issues.
Annually
2 sessions in
20.3% of
schools
At least 2-4
sessions in each
school annually
1.6a
Number of users of Facts For Life and
school health websites.
Annually
Not
applicable
4000 annually
1.7a
Percentage of schools with healthy, safe and
supportive environment.
Annually
20.3%
60%
Indicators of Strategies of the 2nd Objective
2.1a
Percentage of schools provides school
health services with quality assurance
program.
Annually
1%
50%
2.2a
Percentage of private schools which have a
comprehensive school health services.
Annually
60%
100%
239
Follow
up
timing
Current
situation
Targeted
situation
2010
2015
2.2b
Percentage of centers of disabilities which
have a comprehensive school health
services.
Annually
60%
100%
2.3a
Percentage of schools with full time school
health nurse.
Annually
0
100%
2.3b
Number of training courses/ workshops for
school health nurses.
Annually
1 workshop
per region
annually
3-5 Courses/
workshops per
region annually
2.3c
Percentage of school health nurses trained in
mental health promotion.
Annually
1%
80%
Annually
1doctor /7
schools
1doctor/4 schools
Indicators
2.3d
Doctors (part time)/schools ratio.
(Estimated)
2.3e
Number of central courses for school health
nurses' trainers.
Annually
0
5
2.4a
Number of nurses working in school health
department.
End of the
current
plan
0
2
2.4b
2-4-B Number of nurses working in school
health section in the regions.
End of the
current
plan
3
11 ( 1 in each
region)
2.5a
Percentage
of
concerned
sectors
implementing the national school health
strategy.
Annually
60%
100%
2.6a
Percentage of schools which have equipped
school health clinic.
Annually
80%
100%
2.7a
2-7-A Percentage of schools which have
electronic data base for students‟ health.
Annually
10%
100%
240
Follow
up
timing
Indicators
2.8a
Number of studies conducted to evaluate the
beneficiaries‟ satisfaction.
End of the
current
plan
Current
situation
Targeted
situation
2010
2015
0
1
Indicators of Strategies of the 3rd Objective
3.1a
Percentage of regions where school health
section has a unit for higher education
institutions.
Annually
0
100%
3.2a
Percentage of higher education institutions
that declared health promoting institution.
Annually
0
25%
3.3a
Number of peer educators from students in
higher education institutions trained in issues
related to healthy lifestyles.
Annually
5-10 students
in some
institutions
5-10 students in
each institution
3.4a
Presence of coordination between the
concerned sectors in implementing the
multi-sectoral plan on health promotion.
End of the
current
plan
Not
Applicable
Present
3.5a
Number of studies conducted to monitor
health behaviors among students of higher
education institutions.
End of the
current
plan
241
1
1
by the end of the
plan
Vision Six
Better Nutrition for All
242
Domain Twenty Seven
Nutrition
243
Vision: Better Nutrition for All
Goal: Improvement of the Nutritional Status of Omani Society
Domain: Nutrition
INTRODUCTION:
Studies and researches have indicated a prevalence of nutritional issues among different
groups of the society in the Sultanate of Oman, which rise concerns among health authorities
since malnutrition of different types affects negatively on immunity, and increase the chances
and durations of morbidity among children and childbearing and pregnant women.
Furthermore, it affects the capacity of individual productivity.
Since 8.6% of children under the age of five suffer from low weight, 44% of children
suffer from mild to moderate anemia at the age of 9 months and 45.5% at the age of 18
months in 2009. For school children, the percentage of anemia reached to around 48.9%
among boys and 52.7% among girls in 2004. The percentage of anemia among childbearing
women reached to 39.6% and 12% among males in 2004, and, the percentage of anemia
reached to 27.5% among pregnant women in 2009.
About iodine deficiency and vitamin A deficiency, it have been found in 2004 that about
34% of the Omani society do not use iodized table salt, which shows that the goal of full
coverage of the iodized table salt have not achieved, and this indicator raises concerns about
the probability of diseases associated with iodine deficiency. Also, there is a need to fortify
some of the food products with vitamin A and vitamin D, such as vegetable oils beside the
continuation to provide Vitamin A doses along with vaccines, which led to decrease in the
rate of retinol deficiency from 20.8% in 1994 to 5.2% in 1999.
It should be noted that there are no clear indicators about the nutritional status of school
children. However, studies showed that the rate of fat and meat consumption exceeded the
recommended amount by 25%, while the rate of consumption of carbohydrates, fruits and
vegetables, and dairy products decreased by 50%. The rate of obesity has been around 24.8%
in 2008 (Global Health Survey, WHO). And when comparing this percentage with
neighboring countries, it was found that the Sultanate of Oman is the only country where the
rate of obesity among males and females is equal. Moreover, this rate is double the rate of
obesity among males in the Kingdom of Bahrain and the United Arab Emirates, and more
than five times in Iran. As well as, there are no clear indicators to know the prevalence of
diseases associated with food contamination, but the food borne disease surveillance program
cleared that there was 255 observed cases of food poisoning for every 10000 of the population
during 2009, and this percentage compose about 1.4% of the total patients attending the OPD
in health institutions.
OBJECTIVES:
1.
2.
3.
4.
5.
Promotion of food and nutrition policies and strategies.
Promotion and management of infant and young child nutrition.
Control of micronutrients deficiency among the whole population.
Improve nutrition and dietetics services in all health institutes.
Support of food safety systems in coordination with other sectors.
244
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective's Indicators: Promotion of food and nutrition policies and strategies.
1.
Availability of updated National Food &
Nutrition Policy.
NA
NA
Available & updated
2.
Availability of a protocol determines the
nutrition components which exist in the
Diet, Physical activity, and Health Strategy
(DPAHS).
NA
NA
Available
3.
Availability of a protocol determines the
nutrition programs in the Healthy lifestyle
programs.
NA
NA
Available
4.
Availability of a protocol based on scientific
evidence to control overweight and obesity
among community.
NA
NA
Available
Second Objective’s Indicators: Promotion and Management of infant and young child nutrition.
1.
Prevalence rate of underweight (weight-forage) in children less than 5 years of age.
17.9%
8.6 %
< 5%
2.
Prevalence rate of wasting (weight-forheight) in children less than 5 years of age.
7%
7%
< 5%
3.
Prevalence rate of overweight in children
less than 5 years of age.
NA
2.3 %
2.3 %
4.
Prevalence rate of obesity in children less
than 5 years of age.
NA
0.5 %
0.5 %
Third Objective's Indicators: Control of micronutrients deficiency among the whole population.
1.
Prevalence of anemia in children at 9
months of age.
NA
29%
18%
2.
Prevalence of anemia in children at 18
months of age.
NA
39.8%
18%
3.
Prevalence of anemia in adolescent girls
(10th grade).
NA
NA
38%
245
Past
situation
2005
Indicators
4.
Prevalence of anemia in pregnant women.
5.
Percentage of household salt iodization
coverage.
Current
situation
2010
Targeted
situation
2015
42%
29.2%
<25%
68.5%
68.5%
>90%
Fourth Objective’s Indicators: Improve nutrition and dietetics services in all health institutes.
1.
Availability of approved standard guidelines
for the organization of dietetics practice.
NA
NA
available
2.
Percentage of primary health institutions
with qualified dietitians according to the
standards.
0%
0%
20%
3.
Percentage of secondary health institutions
with qualified dietitians.
0%
0%
10%
4.
Percentage of tertiary health institutions
with qualified dietitians.
0%
0%
50%
5.
Percentage of primary health institutions
which are evaluated annually for nutrition
and dietetic services.
NA
50%
100%
6.
Percentage of primary health institutions
which provide the targeted quality of
nutrition and dietetic services.
0%
0%
10%
7.
Percentage of institutions with nutrition
clinics equipped as per MOH standards.
0%
20%
50%
Fifth Objective’s Indicators: Support of food safety systems in coordination with other sectors
1.
Incidence of food borne disease (Salmonella
cases) infections.
NA
28 .0
Reduction by 10%
2.
Number of food poisoning outbreak.
NA
2
Reduction by 10%
3.
Number of MoH
HACCP system.
NA
0%
20%
hospitals
applying
STRATIGIES:
246
Strategies to Achieve 1st Objective: Promotion food and nutrition policies and strategies.
1.1 Establishment of a taskforce from different involved sectors.
Expected results:
 Availability of approved national food & Nutrition Policy.
1.2 Implementation of nutrition components of DHPAS.
Expected results:
 Availability of DHPAS applied nutrition components.
 Implementation of 20% of nutrition activities outlined in DHPAS.
1.3 Incorporation of nutrition objectives in cooperation with healthy lifestyle projects.
Expected results:
 Availability of document specifies nutrition-related projects to healthy lifestyles.
 Availability of guidelines for the nutrition-related projects to healthy lifestyles.
1.4 Enact community measures for obesity prevention into national policies and procedures.
Expected results:
 Reduction in overweight and obesity rate in the community.
1.5 Implementation of the communication strategy of the Omani Food-based Dietary
Guideline.
Expected results:
 Increased awareness of school students regarding overweight and obesity.
 Reduction in overweight and obesity rate among school students population.
Strategies to Achieve 2nd Objective: Promotion and management of infant and young child
nutrition.
2.1 Implementation of national IYCF policy according to WHO guidelines.
Expected Results:
 Availability of a protocol to monitor and evaluate the national IYCF policy.
 All health staff are trained on the IYCF policy.
 All health institutions implement the national IYCF policy.
2.2 Development and implementation of Child Nutrition Manual.
Expected Results:
 Availability of the manual.
 Achievement of Optimal child nutrition guidelines.
2.3 Revitalize BFHI.
Expected Results:

Availability of BFHI manual.
247
 Improvement of child health services in the hospitals.
 100% of targeted health institutions are accredited as BFHI institution.
Strategies to Achieve 3rd Objective: Control of micronutrients deficiency among the whole
population.
3.1 Development and implementation of National strategy for IDA control and management.
Expected results:
 Availability of national policy on control and management of IDA.
 Availability of a protocol to evaluate the national strategy of IDA among children and women.
3.2 Implementation of International Guideline for Certification to achieve status of elimination
of IDD.
Expected results:
 Certificate that Oman is free of IDD.
Strategies to Achieve 4th Objective: Improve nutrition and dietetics services in all health institutes.
4.1 Develop and implement Standard Guideline for Dietetics in Oman.
Expected results:
 Availability of standard guidelines for dietetics practice to improve service.
4.2 Establishment of Registration Process in MOH for nutritionist and dietitians and diet
technicians.
Expected results:
 Availability and implementation of accreditation system.
4.3 Collaborate with academic institution to accredit Dietetic program.
Expected results:

Availability of accreditation system of MoH institutions for dietetic training & its implementation
to improve service quality.
Strategies to Achieve 5th Objective: Support of food safety systems in coordination with other
sectors.
5.1 Conduct the Total Diet Study.
Expected results:

Availability of study to determine the levels of bacteriological and chemical contamination of
foods as well as pesticide residues in agricultural products.
5.2 Strengthen Surveillance of Communicable Food-Borne Diseases.
Expected results:

Availability of enhanced food-borne disease surveillance for planning and decision making.
248
5.3 Implementation of HACCP in all MOH institutions.
Expected results:

To determine the hazard analysis and critical points for food-borne disease.
STARATEGIES’ INDICATORS:
Indicators
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
Availability of approved national
food & Nutrition Policy.
By the end of
the current plan
NA
Available
1.2a
Availability of DHPAS applied
nutrition components.
By the end of
the current plan
NA
Available
1.2b
Percentage of implemented DHPAS
applied nutrition components.
Annually
Inapplicable
20%
1.3a
Availability of document
specifies
nutrition-related
projects to healthy lifestyles.
Annually
NA
Available
1.3b
Availability of guidelines for
nutrition -related projects to healthy
lifestyles.
By the end of
the current plan
NA
Available
1.4a
Availability of protocol for evidencebased community measures to
prevent obesity.
Annually
NA
Available
1.5a
Percentage
of
governorate
implementing communication plan
for Omani food dietary guideline.
Annually
NA
100%
1.1a
Indicators of Strategies of the 2nd Objective
2.1a
2.1b
Availability of a protocol to monitor
and evaluate the national IYCF
policy.
Annually
NA
Available
Percentage of health staff who are
trained on the IYCF policy.
Annually
NA
100%
249
Follow up
timing
Current
situation
2010
Targeted
situation
2015
2.1c
Percentage of health institutions
implements the national IYCF
policy.
Annually
NA
100%
2.2a
Availability of the child nutrition
manual.
By the end of
the current plan
NA
Available
2.2b
Percentage of health staff who are
trained on the manual.
Annually
Inapplicable
50%
2.2c
Percentage of health
which have the manual.
Annually
NA
100%
2.3a
Availability of BFHI manual.
By the end of
the current plan
NA
Available
2.3b
Availability of training tools for the
manual.
Annually
NA
Available
&implemented
2.3c
Percentage of hospital certified as
BFHI.
Annually
Inapplicable
100%
2.3d
Percentage of primary health centers
certified as BFI.
Annually
Inapplicable
100%
Indicators
institutions
Indicators of Strategies of the 3rd Objective
3.1a
Availability of a protocol to monitor
the National strategy for iron
By the end of
deficiency anemia in women and the current plan
children.
NA
Available
3.1b
Availability of an updated policy to
By the end of
control and monitor IDA program.
the current plan
NA
Available
3.1c
Percentage of the policy activities
which are implemented.
NA
20%
3.2a
Percentage of implementation of the
By the end of
Universal Sustained Iodization (USI)
the current plan
protocol.
Inapplicable
80%
Annually
250
Follow up
timing
Indicators
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 4th Objective
4.1a
Availability of a standard guideline
By the end of
for dietetics practice.
the current plan
4.1b
Number of clinical Dietetics as
trainers.
4.2a
4.3a
NA
Available
Annually
0
2
Availability of accreditation system
to register dietitians and Diet Tech.
Annually
NA
Available &
implemented
Availability of accreditation system
in health institutions to train
dietitians.
Annually
NA
Available &
implemented
Indicators of Strategies of the 5th Objective
5.1a
Availability of implemented Total
By the end of
Diet Study.
the current plan
NA
Available
5.2a
Availability of a protocol for the food
By the end of
borne disease surveillance.
the current plan
NA
Available
5.2b
Percentage of health institutions
which implement the protocol.
Annually
Unimplemente
d
20%
5.3a
Number of auditing staff for HACCP.
Annually
NA
1
5.3b
Availability of a training and
By the end of
evaluation guideline for HACCP.
the current plan
NA
Available
5-3-c percentage of hospital dietetics
staff who trained on HACCP
Annually
0
20%
5-3-d
percentage
implement HACCP
Annually
0
100%
of
hospitals
251
Vision Seven
Joint Action for Better Community Health
252
Domain Twenty Eight
Community Participation
253
Vision: Joint Action for Better Community Health
Goal: Mobilization of the Community and Health Related Sectors for
Health Promotion
Domain: Community Participation
INTRODUCTION:
Community participation is known in health sector as the process in which the
individuals are responsible for their own health, and wellbeing of their society.
Community participation can be achieved through participating actively in planning,
implementation and evaluation of community developmental initiatives.
Since, the participation of the Community -in various forms- is considered one of the
main pillars of the health care system, the Ministry of Health strives to achieve this by
connecting health institutions with local community to help diagnose health problems and
assimilate them, and also to improve the capacity of individuals in identifying their needs.
Therefore, service delivery, quality and outcome can be enhanced, and utilization of the
resources can be improved so these services can remain continuous and citizens can create
sense of ownership of the service provided by primary health care.
The formation of willayat health committees (WHCs) under the Ministerial Order
No.(33/1999 m) was developed to add a new feature in the health system in Oman which
is to engage the community and the government sectors -related to health- as a sponsor of
health projects and activities. These health committees have already contributed
effectively in the planning, implementing and tracking health issues in order to find best
solutions. This led the health committees to adapt community based-initiatives ( CBIs)
and healthy project in different states in Oman.
Community support groups (CSGs) were established in 1992 as one of mechanisms in
the community health development and showed a great example of community
participation in the progress of their own health. Since their establishment, these groups
work as a link between the health system and the community, and their presence created
an essential shift in concepts and perceptions among the public in promoting their health
Therefore, the Ministry of Health showed special attention and interest in these
volunteering groups, whose numbers reached (3076) volunteer by the end of 2009. The
ministry provided various mechanisms and methods to provide appropriate methods to
build their capacity. Thus, the ministry developed a accredited training curriculum that
contains six health topics related to healthy lifestyles, namely: (reproductive health,
nutrition, communication skills, tobacco, physical activity, accidents and first aid).
CBI approach includes community participation and building connections and
cooperation between different sectors to improve health, economic and environmental
assets of communities. Such intervention is created to strengthen the capacity of people to
interact with the health developmental process, and to strengthen the coordination between
sectors to support their own self-management to improve the health of their community.
Public‟s health is everyone's responsibility from government sectors, non-governmental
organizations, civil society to the media. . A good example of these achievements can be
seen in Nizwa healthy lifestyles project in 1999, Sur Healthy City 2002, Qalhat Healthy
Village in 2002, healthy villages and neighborhoods in Muscat 2004, Sohar Healthy City
in 2006, Salalah Healthy City in 2006.
254
In order to enjoy life and good health, individuals must have proper personal
resources and physical capacity to boost their health, therefore, health promotion is not
just about following healthy life style patterns, but many other factors overlap in order to
reach healthy life style. Hence, health is not the responsibility of the Ministry of Health
only, but the responsibility of many other ministries and bodies and organizations as well
as the public, all join their efforts to promote health.
Our goal is to promote community participation to access health through monitoring
and meeting the Eighth Five Year Plan activity and indicators. We hope that all efforts and
cooperation between various sectors to achieve the development of community
participation in health expansion and the application of health promotion strategy in the
Sultanate.
OBJECTIVES:
1. Implementation of health promotion strategy.
2. Improve the mechanisms of community participation.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective's Indicators: The implementation of health promotion strategy
Existence of a
The existence of a multisectoral plan of
1.
NA
NA
plan of action
action related to health promotion strategy.
The proportion of sectors implementing the
2.
NA
NA
45%
action Plan.
Second Objective's Indicators: To Improve the mechanisms of community participation in the health
The number of community-based initiatives
1.
9
13
25
that have been implemented.
The proportion of CBI sites that are
NA
2.
implementing components of CBI approved
5%
80%
by WHO.
The proportion of CBIs that have completed
NA
3.
5
100%
all the stages of implementation.
The number of community support group
4.
4291
3075
5000
(CSG‟s).
The proportion of (CSG‟s) trained in the
NA
NA
5.
30%
training curriculum.
Participation rate of non-health sectors in
NA
NA
6.
80%
the meetings of WHCs.
The proportion of the implementing
NA
NA
7.
recommendations of the WHCs of the total
80%
recommendations.
Number of community based projects
8.
NA
35
60
project carried out by the WHCs.
255
STRATIGIES:
Strategies to Achieve 1st Objective: The implementation of health promotion strategy.
1.1 Approval of the organizational structure for health promotion (National Committee for Health
Promotion).
Expected results:
 Facilitate following -up of health promotion activities.
 Organized work with relevant sectors in the field of health promotion.
1.2 Formation of a team from various sectors to implement the strategic action plan of health
promotion.
Expected results:
 Facilitate following-up of health promotion activities.
 Organized work with relevant sectors in the field of health promotion.
1.3 Include health promotion short course in the curriculum of health educational institutions
(institutes of health, medical colleges, Oman Medical Specialty Board).
Expected results:
 The presence of human resources in health promotion.
1.4 Capacity building of health workers in the field of health promotion.
Expected results:
 The presence of trained health staff in the field of health promotion
Develop assessment and evaluation to assess the activities of the health promotion strategy.
Expected results:
 Enhanced Performance.
Strategies to Achieve 2nd Objective: Improve the mechanisms of community participation in health.
2.1 Capacity Building of health workers in CBI Management.
Expected results:
 The presences of a trained staff manage CBI.
2.2 Application of self-monitoring tools for community-based initiatives.
Expected results:
 Ease follow-up of sites in CBI.
2.3 Following up implementation of action plans in all initiatives.
Expected results:

Ease of monitoring and evaluation of CBI sites.
2.4 Establishment of community information centers in all healthy villages.
Expected results:
 Existence of indicators at the village level.
2.5 Conducting of training workshops for CSGS on the training curriculum for CSGS.
Expected results:
 Improve the knowledge and skills of community support groups on the training curriculum
topics of healthy lifestyle (Tobacco, nutrition, physical activity, accidents, first aid, and
reproductive health).
 The existence of volunteers trained to deliver health messages to the community in core
subjects.
2.6 Training members of WHCs to CBI Management.
Expected results:
 The presence of trained WHCs members on management of Community based projects.
 Improve the level of community based health projects implemented.
256
2.7 Advocate for the role of community participation in health promotion.
Expected results:
 Increasing awareness of the concept of community participation in health.
2.8 Adopting ways and means to motivate CSGs and members of WHCs.
Expected results:
 To maintain a base of CSGs and ensure their continuity and to improve their performance.
 More efficient members of the WHCs.
STARATEGIES’ INDICATORS:
Follow up
timing
Indicators
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
By the end of
2012
NA
Existence of
structure
1.2a
The number of sectors related to
health
participating
in
the
implementation of health promotion
strategy.
Annually
0
6
1.3a
The proportion of educational
institutions that have included the
health promotion short course in
their curriculum.
Annually
0
20%
1.4a
Number of training activities that
have been implemented in the field
of health promotion.
Annually
NA
5 (Rate of 1 /
Region) annually
1.4b
The number of trained people on the
training curriculum for health
promotion.
Annually
NA
12
Annually
0
3
Annually
NA
60%
1.1a
1.4c
1.5a
The existence of an
organizational structure.
approved
The number of qualified personnel in
the field of health promotion.
Percentage of activities carried out
from the health promotion strategy
action plan.
Indicators of Strategies of the 2nd Objective
2.1a
2.1b
2.1c
The number of trainings targeted to
build capacities of CBI focal points.
The number of trained people on
management of community-based
initiatives.
The percentage of participants
(members of the community ) in
training activities,
Annually
3
5 (Rate of 1 /
Region) annually
Annually
20
50
Annually
NA
20%
257
Indicators
Follow up
timing
Current
situation
2010
Targeted
situation
2015
2.2a
The proportion of CBI sites that are
applying the self Monitoring tools.
Annually
NA
100%
2.3a
The proportion of healthy villages
that are applying the cluster
representative‟s approach.
Annually
6%
All healthy villages
2.4a
The number of villages that have By the end of
Community Information Centre.
the current Plan
4
25 (Rate of 1 /
Region) annually
2.5a
Number of workshops conducted for
CSGs, in the training curriculum.
Annually
NA
22
2.5b
The proportion of CSGs members
who are trained on the training
curriculum.
Annually
0
25%
2.6a
Number of training activities
conducted in the management of
Community based projects
for
members of WHCs.
Annually
3
65
2.6b
Proportion of members of WHC‟s
who have been trained on the
management of community-based
projects.
Annually
11%
60%
2.7a
Participation rate of other relevant
sectors in the meetings of WHCs.
Annually
NA
80%
2.7b
The number of private sectors that
By the end of
contribute in financing of community
the current Plan
activities.
25
170
2.7c
Number
projects.
By the end of
the current
Plan
35
60
2.8a
The proportion of the members of
the CSG‟s who have received any
kind of incentives (honor, training,
overseas visits ... etc) at the central
level.
By the end of
the current
Plan
30%
50%
2.8b
The proportion of members of WHC
who received the reward of any kind
(incentives, training, overseas visits
... etc) at the central level.
By the end of
the current
Plan
11%
60%
of
Community
Based
258
Vision Eight
Reaching to Distinction in Administrative Practices
259
Domain Twenty Nine
Health Management
260
Vision: Reaching to Distinction in Administrative Practices
Goal: Development of Health Administration upon all levels
Domain: Health Management
INTRODUCTION:
The development of health services in Sultanate of Oman is considered one of the
distinctive markers which demonstrate the Economical and Social Development. That under
the wise leadership of His Majesty Sultan Qaboos bin Said .has been achieved these
fundamental and measurable changes in the quality and size of health service delivery. Has
raised its stature in developing countries
The Health care system in the Sultanate of Oman is based on sound fundamental
principles, one of which is the development of Health Administration. Each level of health
care services has an Administration or Department to ensure the efficiency of Human and
other resource. The five fundamental Administrative functions are „Planning, Organization,
Recruitment, Supervision, & Follow-up.
However, one of the main strategic directions in the8th Five year health plan is the
enhancement of the communications, techniques and strengthening of decentralization
through the application of a suitable model at different levels of the health care system
Attaining distinction in administrative practices will be achieved through training and
equal distribution of human resources, increase of technical expertise and proper resource
management.
OBJECTIVES:
1. Improvement & activation of performance practices within the health care system.
2. Activation of decentralization.
3. Equal/Balanced distribution of Human and material resources.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective's Indicators: Improvement & activation of performance practices within the health
care system.
Availability of manual \ policy of
1.
NA
NA
Available
documentation sections.
Percentage of health institutions that apply
2.
57.7%
57%
100%
computer system.
Percentage of health administrative
NA
3.
departments connected to the integrated
75%
100%
communications network (MPLS).
Percentage of health institutions connected
NA
4.
to integrated communications network
22%
100%
(MPLS).
261
Past
situation
2005
Indicators
Current
situation
2010
Presentage of occupations that have job
NA
60%
descriptions.
The
existence
of
comprehensive
Available but
NA
6.
administrative manuals.
not complete
Second Objective's Indicators: Activation of decentralization system
Number of Wilayats that has a
1.
9
55
decentralized health administration section.
Existence of study proposal for extent of
NA
NA
2.
availability & given authorization for all
leadership (First lines).
The existence of a legal affair in the
NA
NA
3.
governorates.
Third Objective's Indicators: Equal/Balanced distribution of different resources.
5.
1.
2.
3.
Percentage of the health institutions that are
covered with human resources according
to the measurable criteria.
Percentage of management that are covered
with human resources according to the
measurable criteria.
Percentage of health institutions that are
covered with
equipments and tools
according to the measurable criteria.
Targeted
situation
2015
100%
Available and
complete
61
Available
Available
33%
44%
100%
40%
50%
100%
46%
66%
100%
STRATIGIES:
Strategies to Achieve 1st Objective: Improvement & activation of performance practices within the
health care system.
1.1 Support communication between the health systems at all levels.
Expected results :


Easiness of procedures.
Saving time and effort in different treatments.
1.2 Activation of documentation in the Directorate.
Expected results :

Easiness of follow up of procedures.
1.3 Introduction of information technology system in human resources.
Expected results :

Completion of transactions on time and with accuracy.
262
Strategies to Achieve 2nd Objective: Activation of decentralization system.
2.1 Specification of budget for the activities of Directorate of Health Services.
Expected results :
 Activated and reinforced activities in the Directorate of Health Services.
2.2 Prepare a proposal for administrative leaderships (First lines).
Expected results :
 Easiness of procedures.
 Saving time.
2.3 Formulate a guideline for activation mechanism between Directorates & Autonomous
hospitals.
Expected results :


Complete health services delivery.
Distribution of representing health services in a systematic manner.
Strategies to Achieve 3rd Objective: Equal/Balanced distribution of different resources
3.1 To develop mechanisms to reward the administrative staff.
Expected results :
 Raise staff satisfaction.
3.2 Efficient use of human resources.
Expected results :
 Enhancement of service levels of delivery & performance quality.
 Increase and speed of productivity.
STARATEGIES’ INDICATORS:
Indicators
Follow up
timing
Current
situation
Targeted
situation
2010
2015
Indicators of Strategies of the 1st Objective
1.1a
1.1b
1.2a
1.3a
Availability
of
standardized
Annually
administrative work manual.
Percentage
of
electronic
correspondence to all correspondence
Annually
(on the institutions and all regional
level).
Number of Directorates that has By the end of
documentation sections.
the current plan
Percentage of trained electronic
Annually
system to all workers.
263
Available and
not authorized
Available and
authorized
NA
50%
NA
All directorate
NA
80%
Indicators
1.4a
Follow up
timing
Number of Directorates that has legal By the end of
affairs sections.
the current plan
Current
situation
Targeted
situation
2010
2015
NA
All directorate
Indicators of Strategies of the 2nd Objective
2.1a
2.2a
2.3a
Percentage of Directorate of health
Annually
service that has specified budget for
its activities.
Existence of proposal for the
Annually
availability and authorizations for
st
administrative leaderships (1 line).
Percentage
of
administrative
By the end of
authorities at Directorate General
the current plan
levels.
0%
100%
NA
Available and
activated
NA
100%
Indicators of Strategies of the 3rd Objective
Percentage of staff rewarded.
Annually
NA
5%
Percentage of staff satisfaction
among the administrative.
Existence of National criteria
for
distribution of resources between
health institutions.
Annually
53%
70%
Annually
NA
Available
3.2b
By the end of
Presence of work guide for human
the current plan
resources.
NA
Available
3.2c
Existence of employment guide.
By the end of
the current plan
NA
Available
3.1a
3.1b
3.2a
264
Vision Nine
An Efficient Health Information and Research
System to Meet the Needs of Health System
265
Domain Thirty
Health Information and Statistic
266
Vision: An Efficient Health Information and Research System to
Meet the Needs of Health System
Goal: Strengthening the System of Statistics,
Health Information and Research
Domain: Health Information and Statistic
INTRODUCTION:
Health information is a major pillar of the health system. It is an essential tool and an
important reference for decision makers and development planners to set the health plans in a
scientific manner, and contribute to the development of the health services that will reflect in
the improvement of the health of individuals and population.
The main objective of health information is to provide data and information that are valid,
comprehensive, recent and updated and affordable at the appropriate time and place. Health
information should be useful for planning, follow-up and evaluation of the various activities
and programs of health. It should also, contribute to the process of decision making at
administrative and technical levels.
In spite of developments in the health information system at the Ministry of Health, there is
still scope for further development by addressing some of the problems that have been
identified during assessment of the health information system which can be summarized as
follows:


Information technology systems don‟t cover all health institutions, may not satisfy all
needs of health information system as regards the raw data.
Shortage of some data, such as the health economics, data on environmental health,
occupational health and elderlies health.
These problems led to the emergence of some shortcomings in terms of providing the
necessary information, such as:



Absence of some important data necessary for planning and follow-up.
Weak coordination between the Information technology and the health information
system.
There is a need to develop the abilities and skills of users of health information
(administrators, professionals and design makers).
OBJECTIVES:
1. Provide comprehensive data and information to meet the needs of the health system.
2. Improve the quality of the health information system outputs.
3. Ensure optimal use of the health information by health workers.
267
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective's Indicators: Providing comprehensive data and information to meet the needs of the
health system
1.
Data that was made available on a
regular basis (qualitative indicator).
-
Private Inst.
Statistics
Health
Economic Data
Births &
Deaths Data
Environmental
and
occupational
health Data
Mental Health
Data
Health
prescriptions
Data
Second Objective’s Indicators: Improve the quality of the health information system outputs.
The application of criteria for evaluating information system and health indicators
1.

Data collection
methods

Timeliness of data

Periodicity of data


Consistency and
completeness of data
Representatives of
data

Data desegregation
-
%76
%04
-
%60
%00
-
%67
%00
-
%76
%60
Third Objective's Indicators: Ensure the optimal use of health information by health workers.
1.
The Percentage of health institutions
covered by the electronic information
system of total health institutions.
268
-
%77
%85
STRATIGIES:
Strategies to Achieve 1st Objective: Provide comprehensive data and information to cover the needs
of the health system
1.1 Increase Coordination among data and information producers within the Ministry of Health.
Expected results:

Make available data produced outside HIS.
1.2 Increase coordination among data and information producers outside the Ministry of Health.
Expected results:

Make available data produced outside Ministry Of Health.
1.3 Support infrastructure for information and statistics system.
Expected results:

Enough number of statisticians to deal with data made availability.

Provide computer and databases to deal with data made availability.
Strategies to Achieve 2nd Objective: Developing the outcome quality of Health Information Officer
2.1 Training statisticians on data analysis and interpretation of results.
Expected results:

More efficient statisticians.

Statisticians trained in analyzing data.
2.2 Provide manuals to unify definitions in the health information system.
Expected results:

Manuals of definitions made available.
2.3 Develop tools to measure the quality of statistics and health information.
Expected results:

Tools to measure health information made available.

Assurance of decision makers about quality of the data and health indicators.
2.4 Modify data collection tools.
Expected results:

Valid data made available.

Save time spent in data collection.
Strategies to Achieve 3rd Objective: Ensure the optimal use of the health information by health
workers
3.1 Training health workers in understanding and optimally use health indicators.
Expected results:

Evidence based decisions.
3.2 Diversity in the methods of presentation and dissemination the information and health data.
Expected results:

Data and health indicators available at appropriate time to decision makers.
269
STARATEGIES’ INDICATORS:
Follow up
timing
Indicators
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
Departments within the Ministry of Health, that provide data periodically (qualitative indicator).

1.1a



Communicable disease
department
Non- communicable
disease department
Environmental and
Occupational Health
Financial planning
Annually
NA
Available
Annually
NA
Available
Annually
NA
Available
Annually
NA
Available
Agencies outside the Ministry of Health, that provides data periodically.

Medical Services in
Armed forces
Annually
Annual data not
details
Monthly details
data

Medical Services in
R.O.P.
Annually
Annual data not
details
Monthly details
data

Medical services at the
Diwan of Royal Court
Annually
Annual data not
details
Monthly details
data
1.2b
The percentage of the private health
sector which are sending monthly
statistics.
Annually
59%
80%
1.3a
Number of Statisticians.
Annually
83
101
1.3b
Omanization among statisticians
Annually
67%
90%
1.2a
Indicators of Strategies of the 2nd Objective
2.1a
Statisticians with master degree in health
statistics (cumulative).
Annually
2
10
2.1b
Workshops in health statistics and
applied epidemiology.
Annually
1
10 ( 2 in a year)
270
Follow up
timing
Current
situation
2010
Targeted
situation
2015
2.1c
Number of statisticians attending health
statistics and applied epidemiology
workshops.
Annually
25
25 per workshop
2.2a
Manuals of definitions and terms.
Annually
Available
Available &
updates
2.3a
Use HMN tool to evaluate health
system.
Every two
years
1
2
Indicators
Age
Sex
Address
2.4a
Levels
of
(descriptive)
data
desegregation
Age
Annually
Sex
Distribute
inpatient
statistics as
week days
… etc
Indicators of Strategies of the 3rd Objective
3.1a
Number of workshops in optimal use of
information for health workers.
Annually
0
5
3.1b
Number of health workers attending
workshops in optimal use of information.
Annually
0
200
The availability of a variety of methods to disseminate health information.

Books and health facts.

Electronic CD.

Publishing in website.

Publishing
in
advertisements boards.
Publishing in newspaper
& magazines to raise
health awareness.
3.2a

271
Annually
Done
Continue
Annually
Done
Continue
Annually
Done
Continue
Annually
Done
Continue
Annually
Done
Continue
Domain Thirty One
Health Research and Studies
272
Vision: An Efficient Health Information and Research System to
Meet the Needs of Health System
Goal: Strengthening the System of Statistics,
Health Information and Research
Domain: Health Research and Studies
INTRODUCTION:
Health research is an investment for development and health improvement. It is an
essential source of evidence- based information that cannot be provided through routine
sources that are required for the process of planning; implementation; monitoring and
evaluation. Research is an essential tool for formulation of solid information system and
database.
Therefore, the Ministry of Health (MoH) had established the Department of Research and
Studies under the Directorate General of Planning since 1991 which draws the research
policy and sets the research priorities from the "fifth 5-Year Plan for Health Development,
1996-2000” and onward. The research policy aims at spreading of research culture;
promotion of the scientific approach; development of research skills & infrastructures at
different levels of health sectors and utilization of research findings in planning and
improving the effectiveness and efficiency of health system and decision making.
In this respect, the Research and Studies department, during this eight 5 year plan,
focuses on the availability of well-trained and competent researchers at the central and
regional levels who are capable to conduct researches and training.
To have accurate and reliable data, there should be a commitment to the standard
regulations of scientific methods & ethical considerations of researches. Hence, ethical
approval should be obtained from the Ethical and Review Committee as to yield good quality
of research and good output.
In addition to have high quality of researches, it is also important to get use of the
available data and information from the previous researches and surveys as these researches
provide evidence base for the health policy and decisions makers in their implementation
plans. Furthermore, It is also important to narrow the gap between the “knowledge and
action” through appropriate communication and interactions between the decision makers
and the researchers as this will lead to appropriate use of evidences from the researches for
policies formulation.
However, the success of any research should not only be measured by the number of
researchers or number of published papers, but also by implementation and appropriate
utilization of research findings.
Conducting researches require collaboration between different sectors and
institutions, as this Multidisciplinary approach will lead to study the problem from different
aspects; mobilization of resources and solutions, which are beyond the single sector.
Furthermore, links are important between researchers (supply side), research users (demand
side) and funding agencies in addition to partnerships with the community, NGOs and the
private sector.
Worldwide, less than 10% of health research budget each year is devoted to the health
problems of 90% of the world population. The so called “10/90 gap” leads to many
international conferences which recommended helping correct or narrowing the gap and
273
focusing research effort on the research priorities, improving the allocation of the research
funds and by facilitating collaboration between partners.
The general aim of the Eight "5- year Plan for Health Development" is to achieve
more development & progression in researches & studies by managing the problems &
obstacles that identified through analyzing the health situation. These obstacles are:







The available qualified manpower and financial resources cannot meet the demands
of the researches.
There are no enough trained persons to train others for research methods and ethics
and for statistical analysis, especially in the regions.
Poor verification of researches and studies priorities at regional levels.
Poor obligation and commitment to the planned priority proposals/researches and
this causes deficiency in the needed data and information for planning and
monitoring processes at the levels of both the centre and the regions
Poor documentation and follow up to the steps of some researches that affects the
utilization of research findings for planning, policy formulation and decision
making..
Lack of obligation of some researchers with regard to submission of their proposals
to the Research and Ethical Review Committee at the central or regional levels. This
led to execution of research by unqualified researchers and to duplication of
researches in many times.
Lack of longitudinal; projection; interventional and evaluative studies and
inadequate secondary/advanced analysis of available data.
OBJECTIVES:
1. Provision of data and information that are required by health system through
conducting researches and studies by the domains.
2. To develop technical capabilities and skills of Health Research Teams on research
design, methodology and other skills.
3. To develop and improve the capacity of research users at different levels to utilize
information as a tool for evidence-based planning and management.
4. To develop and strengthen the infrastructure of Health Research System (HRS) and
ensure its high quality.
274
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: Provision of data and information that are required by health system
through conducting researches and studies.
1.
Percentage of health and health related
domains in the eight 5 - Year Plan for
Health Development which conducted
research to provide required information for
the process of monitoring and evaluation.
50%
70%
85%
2.
Percentage of conducted researches to the
total number of the targeted researches.
50%
65%
75%
Second Objective’s Indicators: To develop technical capabilities and skills of Health Research
Teams on research design, methodology and other skills.
1.
Percentage of researches that been approved
by MoH Research & Ethics committee, to
the total number of the conducted
researches.
NA
65%
80%
2.
Percentage of trainees who conducted
researches to the total trainees on research
design and methodology.
NA
NA
50%
Third Objective’s Indicators: To develop and improve the capacity of research users at different
levels to utilize information as a tool for evidence-based planning and management.
1.
Percentage of researches utilized for
planning and improving health services to
the total researches.
NA
60%
80%
Fourth Objective’s Indicators: To develop and strengthen the infrastructure of Health Research
System (HRS) and ensure its high quality
1.
Availability of updated and well established
research data base.
NA
NA
Available
2.
Percentage and number of published
researches to the conducted researches
(Scientific conferences & workshops –
Local, regional or international Journal).
NA
NA
60%
275
STRATIGIES:
Strategies to Achieve 1st Objective: Provision of data and information that are required by
health system through conducting researches and studies by the domains
1.1 Identification of the research priorities and direct the researches towards the priority
health problems, towards vulnerable groups and health system problems.
Expected results:


Provision of enough data on priority health problems aiming at decreasing of morbidity and
mortality; improving the quality of life; better utilization of resources, assuring health care
equality; understanding reasons of diseases spreading and performing appropriate
intervention.
Provision of detailed information to meet the needs of health planning and policy making.
2.1 Introducing "Package of Periodic Training" on research that supporting the domains
and the different health programmes.
Expected results:

Improvement of quality of writing research proposal as this will facilitate the approval of
Research and Ethics committee.
 Availability of appropriately conducted researches according to the plan, which are adherent
to the scientific standards of the research.
1.3 Involvement of private sector, NGOs and community in different stages of research.
Expected results:
 Availability of researches that are directed to accommodate the community needs.
 Ensure different resources of finance.
1.4 Coordination among research stakeholders inside and outside the Ministry of Health
and international organizations.
Expected results:

Availability of "memorandum of understanding" between the concerned research
authorities agreed and signed by all of them , such as ( academics; scientific research council
of Oman; other ministries and international organizations ) and the Ministry of Health in
order to be adherent to research priorities which should be an area for collaboration and
support to each others.
 Availability of high quality joint researches from the domains to be used for planning.
Strategies to Achieve 2nd Objective: To develop technical capabilities and skills of Health
Research Teams on research design, methodology and other research skills
2.1 Training for developing the skills in research methods, research ethics, in addition to
the other skills of research.
Expected results:

Empowerment of the researchers' capabilities as to conduct high standard researches. This
276
includes research ethics; follow up of research conduction; statistical analysis; appropriate
research writing for publication in scientific journals, and utilization of results for evidencebased policies and decisions making.
 Promotion of research culture and increase trust on quality research results as this will
encourage the users to utilize the findings.
 Developing and improving the capacity of Research and Ethics Review Committees.
 Avoid wastage of resources allocated for studies conducted on unscientific basis.
 Encouragement of the researchers to cooperate together and to be adherent to the research
ethics, publications and authorship credits.
2.2 Availability of trained & qualified research staff who are capable to train others on
research methods and ethics.
Expected results:


Availability of trained researchers at the central and regional levels who capable to conduct
researches and studies in accordance with the research standards.
Improvement of quality and efficiency of the Research and Ethics committees in the regions.
Strategies to Achieve 3rd Objective: To develop and improve the capacity of research users at
different levels to utilize information as a tool for evidence-based planning and management.
3.1 Training of the health planners and decision makers on how to use the research results.
Expected results:

Capacity development of the directors, policy makers and health care providers on use of
research findings for planning and improvement of health services.
 Implementation of the research findings and formulation of polices.
 Enhancement of the process of planning and decisions making based on knowledge and
evidence.
 Encouragement of the second line leaders to use the evidence-based knowledge on their
practices.
3.2 Promotion of evidence- based medicine for clinical research and health management.
Expected results:
 Clinical practices of health care providers, managers and researchers based on evidence.
 Improvement of the health care services.
Strategies to Achieve 4th Objective: To develop and strengthen the infrastructure of Health
Research System (HRS) and ensure its high quality
4.1 Formulation of plans for recruiting of adequate number of qualified staff for the
Department of Research and Studies through coordination with Human Resources
Department.
Expected results:


Provision of adequate number of research specialists, statisticians and information
technology specialists and coordinator to carry out the health research plan activities in order
to achieve the objectives of the plan.
To send a number of research specialists abroad to have higher studies in research methods
and ethics as to be able train the others.
277
4.2 Establishing Data Base for research activities, results and research necessary for
planning and decision making.
Expected results:
 Avoidance of double and repetitive researches.
 Dependence on evidence based knowledge when making decisions.
4.3 Facilitation for the MoH researchers to have access to scientific references through
subscriptions to medical periodicals.
Expected results:
 Available information from different sources.
 Availability of full text published papers of other countries and in Oman.
 Easy and in depth analysis of data and its interpretation.
 Facilitate decisions making based on evidence from the research.
4.4 Revision and expansion of the functions of the "Research & Ethical Review
Committee" centrally and activating the committees in the health regions.
Expected results:

To have an upgraded rules for reviewing and approval of research proposals and revision of
the final reports.
 Coordination with other sectors, ministries, research and academic institutes, and
international organizations.
 High quality researches that following the scientific research guidelines; avoiding repetition
or duplication and with highly reliable findings that can be used for planning, decisions
making and polices formulation.
4.5 Encouragement of publications of the researches results through:

Creating electronic websites.

Training in how to formulate polices that based on evidences, and training in
scientific writing of articles and publication.
Expected results:

Increase of interactions between decision makers and managers from one side and the
researches from the other side for the purpose of decision and policies formulation based on
knowledge and evidences that obtained through the research.
278
STRATEGIES’ INDICATORS:
Indicators
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
1.1a
Availability of priority list of
research (central and in every
region).
Annually
Central &
Regional
priority list
Updated Central
& regional
priority lists
1.1b
Percentage of research &
studies conducted to total
targeted research in the 5 y.
plan.
Annually
65%
75%
1.2a
Number of trainings including
the periodic training package
(after meeting with the focal
pionts of the different domains
at central and regional levels.)
Annually
Not applied
4 trainings
1.2b
Number of trained persons in
the training package of the
research.
Annually
Not applied
25 trainees /
workshop ( 100 in
the plan)
1.2c
Number of protocols that been
applied to and approved by the
Research
&
Ethics
Committee.
Annually
NA
15 protocol per
year
1.3a
Percentage of researches that
conducted by MoH in
collaboration
with
and
participation
of
private
sectors, NGOs or community.
Annually
10%
30%
1.4a
Number of meetings between
the concerned people of the
research after signing the
memorandum
of
understanding.
Annually
Not applied
4 meetings ( once
per year)
Indicators of Strategies of the 2nd Objective
2.1a
Number of training workshops
held for developing research
capabilities and skills.
Two workshops
Annually
annually
279
One workshop
annually ( in total
5 in the 8th plan)
Follow up
timing
Current
situation
2010
Targeted
situation
2015
2.1b
Number of trainees for
developing
research
capabilities and skills.
Annually
60 trainees
annually
30 trainees
annually
2.1c
Number of trainees sent
abroad to study research
methodology and ethics.
Annually
Not applied
5
2.2a
Number of training workshops
held to qualify researchers in
order to be capable to train
others (TOT) (2-3 months).
Annually
Not applied
(new indicator)
Two trainings
workshops per the
8th plan
Indicators
2.2b
Number of trainees who are
capable to train others (2-3
months).
NA
Annually
(new indicator)
25 trainees per
workshop
( 50 persons
during the whole
8th plan)
Indicators of Strategies of the 3rd Objective
3.1a
Number of workshops held to
train in how to implement the
researches findings and use
them for policies formulation
and decision making.
3.1b
Number of trainees on the
above mentioned workshops.
Annually
Annually
One workshop
40 trainees
Two workshops/
the 8th plan
30
trainees/workshop
( 60 in total/plan)
3.2a
Number of workshops held in
favor
of
Evidence-based
Medicine.
Annually
1
Once per year
3.2b
Number of trainees in
Evidence-based Medicine- in
the fields of clinical practice
and health management and
administration.
Annually
30 trainees
annually
30 trainees
annually
280
Indicators
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 4th Objective
Presence of
4.1a
Presence of central plan for
sanctioning
the
required
manpower/human resources.
Annually
Presence of
central plan
4.1b
Number
of
research
specialists/experts
in the
Department of Research and
Studies.
Annually
3
5
4.1c
Number of statisticians in the
Department of Research and
Studies.
Annually
3
5
4.1d
Presence
of
supporting
manpower
(information
technology
persons,
coordinators etc-.)
Annually
NA
2
4.2a
Presence of well established &
updated database for different
research activities.
Annually
NA
Available
4.2b
Number of subscriptions in
websites and/or electronic
journals.
Annually
NA
2 websites
4.3a
Numbers of regions that have
active research committees
(conduct
at
least
3
meetings/year.)
Annually
4
All regions
4.3b
Presence of annual timed
work plan for research
activities at the beginning of
each year in each region.
Annual
Presence of
annual work
plan for every
region
Presence of
annual work plan
for every region
4.3c
Presence of periodic reports
from Research Committee
/Research Coordinator in each
region about their annual
achievements.
Annually
Presence of
annual report
for every region
Presence of
annual report for
every region
281
updated central
plan
Follow up
timing
Current
situation
2010
Targeted
situation
2015
4.3d
Percentage
of
reviewed
studies by Research & Ethics
Review Committee to the total
number of conducted studies.
Annually
60%
90%
4.4a
Percentage
of
published
studies to the total number of
the conducted studies.
Annually
NA
60%
4.4b
Conduct a study to assess the
performance of the Health
Research System in Oman.
By the end
of the
current plan
NA
Presence of the
study
Indicators
282
Vision Ten
Achieving Integrated Digital Environment
283
Domain: Thirty Two
Information Technology
284
Vision: Achieving Integrated Digital Environment
Goal: Facilitate and speed the access to electronic system data
Domain: Information Technology
INTRODUCTION:
Information Technology (IT) is one of the most important pillars that underpin the
development plans of the Ministry of Health. The importance of IT is in linking all the health
and administrative institutions to various computer systems to achieve integrated digital
environment. Because of this importance it has been included within the Eighth Five Years
Plan of the Ministry of Health (2011-2015) to meet the Ministry's policy aimed to develop all
disciplines.
The Ministry of Health has introduced technology which includes various systems and
programs into most of its institutions. An integral example is the implementation of health
information system (ALSHIFA) which is implemented in 248 health institutes in various
provinces of the Sultanate. This program won two awards in 2010; The Sultan Qaboos Award
for Excellence in eGovernment in eProject category and United Nations Public Service
Award (UNPSA) in Advancing Knowledge Management in Government category. In order to
facilitate the extraction and the accuracy of health data, the directorate of IT implemented
Nabd ALSHIFA (HIMS Pulse), a program that collects and analyzes data on the national
level. Given the importance of electronic connectivity, the ministry sought to link various
health institutions to the ministry headquarters, where it linked about 75% of health
institutions and 22% of its administrative institutions via MPLS. It also implemented
electronic referral to all patients from different provinces of the Sultanate. To better control
and track infectious cases, IT applied an electronic notification system among many health
institutions linking them to the ministry main campus for updated decision-making and
follow up.
Despite these achievements, there are numerous difficulties and challenges that the ministry
is facing on implementing its objectives and vision, the most prominent of these challenges
and difficulties are the following:

The availability of adequate infrastructure to link the various health institutions in the
Sultanate.

Attain unified national electronic health record for the patient, where this step it
requires availability and speedy telecommunication, standardize coding for
investigations and procedures and other administrative issues.
Lack of specialized human resources staff turnover for workers in the field of
information technology because of the great competition by many of the private
sectors.
Ensure the security and confidentiality of information.


OBJECTIVES:
1. To expand the digital infrastructure in various administrative and health institutes and
consolidate ALSHIFA system among various health institutions.
2. To support IT staff.
3. To activate the electronic communication within the health system.
4. To provide e-services through the website of the Ministry.
5. Access to unified national electronic health records for the patient.
285
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To expand the digital infrastructure in various administrative and
health institutes and consolidate ALSHIFA system among various health institutions.
1.
Percentage of health institutions that
applies information technology systems.
60%
75%
100%
2.
Percentage of administrative institutions
connected
to
the
integrated
communication network (MPLS).
0%
75%
100%
3.
Percentage
of
health
institutions
connected
to
the
integrated
communication network (MPLS).
0%
22%
100%
4.
Percentage of education institutions
connected
to
the
integrated
communication network (MPLS).
0%
0%
100%
5.
The percentage of Health institutions
using the latest version of ALSHIFA
system.
0%
Less than 1%
75%
6.
Percentage
satisfaction.
NA
NA
90%
7.
Availability of Data protection policy.
NA
NA
Available
8.
The percentage of uptime during the year.
100%
100%
100%
9.
The percentage of health institutes that
experience suspension of work due to
electronic health system.
2%
2%
0
10.
The percentage of Government health
institutions not under Ministry of Health
linked to the Ministry of Health.
0%
20%
100%
11.
The percentage of private institutions
linked to the Ministry.
0%
0%
50%
1.
Number of IT technicians for each Health
Center.
1 for 10 Health
Centers
1 for 8 Health
Centers
1 for 3
Health
Centers
2.
Number of IT technicians for each poly
clinic.
0
0
1 for each
Poly Clinic
of
ALSHIFA
Users
Second Objective’s Indicators: To Support IT Staff
286
Indicators
Past
situation
2005
Current
situation
2010
Targeted
situation
2015
3.
Number of IT technicians for each
province hospital or local hospital.
0
1 for two
hospitals
1 for each
hospital
4.
Number of IT technicians for each
secondary care institute.
2
2
3 for each
institute
5.
Number of IT technicians for each tertiary
care institute.
3
4
5 for each
institute
Third Objective’s Indicators: To activate the electronic communication within the health system
1.
The percentage of feedback to the number
for referral.
0%
28.8%
100%
2.
The percentage of electronic notification
to the requests.
0%
27%
100%
3.
The percentage of health institutes own
email facility.
0%
30%
100%
4.
The percentage of Administration
institutes own email facility.
0%
100%
100%
5.
The
percentage
of
electronic
communication
to
the
entire
communication.
0%
22.1%
50%
6.
The percentage of electronic archive
communication.
0%
0%
50%
7.
The percentage of staffs having the
International Computer Driving License
(Information Technology Authority staff
training project).
NA
NA
100%
8.
The
percentage
satisfaction
from
communications.
NA
NA
90%
of
beneficiaries‟
active
methods
Fourth Objective’s Indicators: To provide e-services through the website of the Ministry
1.
The number of e-services provided in the
ministry website for the staff and the
citizens.
0
5
10
2.
The number of e-services provided in
eoman portal.
0
NA
10
3.
The existence of
protection policy.
NA
NA
Available
4.
The number of network hacks.
NA
2
0
digital
network
287
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Fifth Objective’s Indicators: Access to unified national electronic health records for the patient
1.
The existence of a policy for unified
national electronic health record.
NA
2.
The existence of a system to standardize
the data according to the international
standards.
N.A
NA
Available
Available and
not active
Available
and active
NA
NA
13%
NA
NA
10%
NA
NA
8%
The percentage of ID used in the health
electronic:
3.
Health Centers
Poly clinics
Hospitals
4.
The presence of Central Database.
NA
NA
Available
5.
The percentage of health institutes linked
to the central database.
0%
0%
50%
6.
The percentage of health institutes not
under Ministry of Health umbrella linked
to the central database.
0%
0%
50%
288
STRATEGIES:
Strategies to Achieve 1st Objective: To expand the digital infrastructure in various
administrative and health institutes and consolidate ALSHIFA system among various health
institutions.
1.1 Completing the introduction of information technology in the health institutes and
connecting them to an integrated network between regions and central level.
Expected results:
 Improve the healthcare and administration transaction.
 Time availability on transferring data and correspondence response.
1.2 Preamble the computer rooms at Health institutes to meet Information Technology
Authority standards.
Expected results:
 Availability of suitable environment for the staff.
1.3 Upgrade internal hardware and software in the administrative and health institutes.
Expected results:
 Obtain faster time to complete tasks.
 Reduce work downtime because of hardware or software failure.
1.4 Conducting analytical study on the real problems of Health Information Management
System (ALSHIFA).
Expected results:
 Knowing the percentage of ALSHIFA users‟ satisfaction.
 Rise to the best level in the ALSHIFA system efficiency.
1.5 Seeking to gain an international classification in the field of information security such
as ISO (17 799) and ISO (27 033) or (HIPPA).
Expected results:
 Secure network and free of problems.
 Runs longer period.
 Gain the users confidence and services beneficiaries.
1.6 Raise digital awareness for the electronic health system users.
Expected results:
 Reduce data manipulation and systems misuse.
1.7 Develop data protection policy.
Expected results:
 Secure network and free of problems.
 Reduce systems misuse.
1.8 Regular development to protect data via upgrading programs and its security devices.
Expected results:

Secured data
289
Strategies to Achieve 2nd Objective: To support IT staff
2.1 Train the trainee in the regions and governance on ALSHIFA system.
Expected results:
 Increase the number of the trainee on ALSHIFA system.
 Easy to deal with ALSHIFA system and enhance the service.
2.2 Train and qualify IT staff.
Expected results:
 Pursue the development.
 More efficient on solving problems.
 Upgrade IT staff level to work more effectively.
2.3 Develop a physical and moral stimulation mechanism for the IT staff.
Expected results:
 Increase the staff performance.
 Increase staff retention rate.
Strategies to Achieve 3rd Objective: To activate the electronic communication within the health
system.
3.1 Cover the electronic communication between the health systems at all levels.
Expected results:

Experience and exchange administrative, health and medical information to provide better
services in the regions.
 Activate referrals, feedback and electronic notification.
3.2 Develop a supportive policy for electronic correspondence.
Expected results:
 Better use of electronic correspondence system.
 Easy to follow-up electronic correspondence.
3.3 Activate electronic Archive.
Expected results:
 Reduce the traditional storage spaces.
 Easy search for documents.
 Possibility to save for long period.
3.4 Find mechanisms to raise the level of knowledge in information technology between the
staff in the ministry.
Expected results:


Increase the staff awareness on electronic culture.
Easy for the staff to deal with new systems.
290
Strategies to Achieve 4th Objective: To provide e-services through the website of the Ministry.
4.1 Insert important enhancements into the ministry website to provide electronic services.
Expected results:
 Save time of beneficiaries.
 Publishing the information in a good manner.
 Pursue Oman Digital Society initiative.
4.2 Appointing specialized team to manage the website and its database.
Expected results:
 High efficiency e-services.
 Secured environment for the electronic transaction on the Intranet.
4.3 Develop a policy to protect the digital network.
Expected results:
 Secure network and free of problems.
4.4 Regular development to protect data via upgrading programs and its security devices.
Expected results:
 Secured data.
Strategies to Achieve 5th Objective: Access to unified national electronic health records for the
patient.
5.1 Coordinate with other actors (Government and Private) who provide health services
for unifying data exchange.
Expected results:
 Ease of data collection.
 Connect other actors with central database.
 Quick and effective transactions and data exchange between stakeholders.
5.2 Establishing a national technical committee for unifying the medical file.
Expected results:
 Having decisions that serve the connection with other actors.
 Availability of criteria to standardize the database within the electronic health system.
5.3 Adopt and apply the international criteria to unify the database and patient file.
Expected results:
 Easy to manage the health database.
 Easy to communicate electronically.
5.4 Create a central database.
Expected results:


Available central database contains all patients‟ information.
Easy access to integrate data about the patient from any location in the Sultanate.
291
STRATEGIES’ INDICATORS:
Follow up
timing
Indicators
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
1.1a
Percentage of institutes having
electronic connection.
Annually
57%
100%
1.2a
Percentage of computer rooms in
the health and administrative
institutes
meeting
the
Information
Technology
Authority requirements.
Annually
60%
100%
1.3a
Percentage of stopped work due
to
hardware
or
systems
malfunction.
Biannual
2%
0%
1.4a
Availability of analytical study By the end
on real problems relates to
of the
ALSHIFA system.
current plan
NA
Available
1.4b
Rate of ALSHIFA
satisfaction.
By the end
of the
current plan
NA
90%
1.5a
Availability of application for
international classification in
information security.
Every two
years
NA
Available
1.6a
Percentage of digital awareness
for the health electronic system
users.
Annually
NA
90%
1.7a
Availability of data protection
policy.
Every two
years
NA
Available
1.8a
Percentage of upgrade programs
and devices of information
security.
Every two
years
10%
80%
users‟
Indicators of Strategies of the 2nd Objective
2.1a
Percentage of ALSHIFA system
trainee.
Annually
292
40%
100%
Follow up
timing
Current
situation
2010
Targeted
situation
2015
2.2a
Number of Internal IT training
provided by Directorate General
of IT.
Annually
12
60
2.3a
Percentage of IT staff retention.
Annually
70%
90%
Indicators
Indicators of Strategies of the 3rd Objective
3.1a
Percentage
of
electronic
communication
coverage
between the health systems.
Annually
27%
80%
3.2a
Availability of active policy
about electronic correspondence
use.
Annually
NA
Available and
Active
3.2b
Percentage
of
electronic
correspondence activation.
Annually
10%
70%
3.3a
Percentage of electronic archive
activation.
Annually
0%
50%
3.4a
Presence of knowledge level in
information technology between
the staff in the ministry.
Annually
40%
100%
Indicators of Strategies of the 4th Objective
4.1a
Percentage of the ministry
website enhancements.
Annually
30%
80%
4.2a
Number of specialized team in
managing the website.
Annually
2
6
4.3a
Availability of active policy to
protect the digital network.
Annually
NA
Available and
Active
4.4a
Percentage of upgrade software
and devices of information
security.
Annually
10%
60%
Indicators of Strategies of the 5th Objective
5.1a
Percentage of ministry of health
hospitals connected to the central
database.
Annually
293
0%
50%
Follow up
timing
Current
situation
2010
Targeted
situation
2015
5.1b
Percentage
of
government
hospitals not under ministry of
health connected to the central
database.
Annually
0%
30%
5.2a
Availability of national technical
committee for notifying the
medical file.
By the end
of the
current plan
NA
Available
5.3a
Availability of criteria to
standardize the database within
the national electronic health
records.
Annually
NA
Available
By the end
of the
current plan
NA
Available
Indicators
5.4a
Availability of central database.
294
Vision Eleven
Availability of Qualified Human Resources to
Work in Health Institutions
295
Domain: Thirty Three
Human Resources Development and
Omanization in the Health
296
Vision: Availability of Qualified Human Resources in Suitable
Numbers to Work in Health Institutions
Goal: Ensuring the Availability of Adequate Numbers of Suitably
Qualified, Trained and Efficient Workforce
Domain: Human Resources Development and
Omanization in the Health Field
INTRODUCTION:
Human resources development is considered one of the main pillars for health care systems
planning. Hence, MOH Inaugurates its 8th five year plan with evaluating the Human
Resources Development and Omanization as one of its main priorities.
The Ministry of Health attaches significant importance to human resources development as a
strategy for achieving effective health services development in the Sultanate of Oman. Not
only, MoH spends about two third of its recurrent budget on human resources, but also MOH
ensures that most ,if not all, high skilled specialties are available with modern and advanced
medical equipments, beside providing controlled and guaranteed qualitative health services.
The Ministry of Health has developed a plan for Education & Training in the basic
educational programmes for health professions by establishing a chain of educational
institutes in most of the governorates in the Sultanate. The number of graduates from these
institutions from 2006 to 2010 reached 3,299 graduates of whom 2,479 graduates were in the
General Nursing area.
MoH also focused on post-basic specialized programmes, by allowing number of the MOH
Omani staff to join the needed specialized nursing programmes such as: Renal Dialysis
nursing, SCABU, Midwifery, Nursing Management, adult ICU nursing, psychiatry health
nursing, Physiotherapy and health education, also in the field of health administration. The
number of post-basic specialized programmes graduates from 2006 to 2009 reached 750
graduates. The field of medical continuing education was also facilitated by number of
programs and activities implemented on both central and regional level and accredited from
Omani Medical Specialty Board.
Every year number of medical doctors are being sent to developed countries for specializing
in medical and allied health fields. Also, the Omani Medical Specialty Board (OMSB) plays
an active role in training and qualifying Omani doctors by introducing a group of
programmes that enables the omani doctors to pass regional and international exams and gain
certificates that are identified internationally, also, the OMSB helps the omani doctors to
continue their learning in more specialized fields in various worldwide countries that are
connected professionally and scientifically with the sultanate. In 2010, OMSB enrolled 341
doctors in different specialties. The Omanization level in physician category has increased.
The Omani physician percentage has increased from 27% in the year 2005 to 32 % in the
year 2010. Also the Specialist/ Consultant percentage has increased from 23% to 27% in the
same period. This increase in the doctors omanization ratio in spite the fact that there were a
big expansions during that period in health services which required more Non-Omani doctors
to cover these expansions.
297
OBJECTIVES:
1. To provide adequate and equitable numbers of trained manpower to all MoH
institutions.
2. Accelerate the process of manpower appointing and recruitment.
3. Reduce the number of resignations in all job categories especially in medical and Paramedical job categories.
4. To train Omani health cadres in various health fields.
5. To Develop Continuing Education further in MoH.
6. Development of the learning resources infrastructure.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective’s Indicators: To provide adequate and equitable numbers of trained manpower to all
MoH institutions
Total
%
Total
% Total
%
No. Omani No. Omani No. Omani
Category
1.
Health Administrators
129
95%
139
98%
153
100%
2.
Physicians
2981
27%
4123
32%
5185
38%
2.1
Med. Specialists
1094
23%
1678
27%
1996
32%
2.2
Medical Administrators
47
57%
61
72%
83
93%
2.3
Medical Officers
1840
29%
2384
35%
3106
40%
3
Dentists
168
41%
259
53%
372
55%
4.
Pharmacists
154
49%
279
66%
323
78%
5.
Nurses
7909
59%
10059
6.
Physiotherapists
123
64%
7.
Sanitarians
168
8.
8- Radiographers
9.
Lab. Technicians
298
67% 11802
74%
174
64%
375
64%
86%
211
81%
289
84%
401
60%
579
63%
669
66%
873
52%
1259
60%
1467
65%
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
10.
Asst. Pharmacists
690
69%
1049
63%
1272
65%
11.
Medical Orderlies
2184
100%
2781
100% 3326
100%
12.
Other Paramedical Staff
831
86%
1093
88%
1335
92%
12.1 Dental Technicians
137
99%
219
100%
276
99%
12.2 Dieticians
98
97%
139
99%
175
100%
12.3 Health Educators
124
100%
128
100%
183
100%
12.4 Misc. Paramedic Staff
472
76%
607
79%
701
81%
13.
Other Technical Staff
179
56%
247
65%
266
64%
13.1 Scientists / Engineers
102
43%
109
48%
98
35%
13.2 Technicians
77
73%
138
79%
168
73%
3374
96%
4039
98%
4898
98%
14.1 White Collars
2285
94%
2927
97%
3586
98%
14.2 Skilled Labours
676
99%
855
100% 1001
100%
14.3 Unskilled Labours
413
100%
257
100%
311
100%
15.
268
26%
299
47%
214
74%
20432
66%
26592
14.
Other Support Staff
Teachers/ Tutors
Grand Total
299
70% 31946
72%
Past
Indicators
situation
2005
Current
situation
2010
Targeted
situation
2015
Second Objective’s Indicators: Accelerate the process of manpower appointing and recruitment
1.
Existence of internal procedures in both
MOH and other related ministries to
accelerate omanization and appointing
process for all jobs.
NA
NA
Available and
active
Third Objective’s Indicators: Reduce the number of resignations in all job categories specially in
medical and Para-medical categories
1.
Percentage (No.) of Resigned doctors in
different speciality.
NA
Past
Indicators
situation
2005
7.3% (285)
Year: 2009
5%
Current
situation
2010
Targeted
situation
2015
Fourth Objective’s Indicators: To train Omani health cadres in various health fields
Category
Inside Outside Inside Outside Inside Outside
Number of Employees trained and qualified in different specialties:
1.
-
Post Graduate
NA
NA
6
266
22*
329*
-
University degree
NA
NA
40
245
29*
270*
-
No. of different training courses
NA
NA
NA
NA
600
90
-
No. of trainees
NA
235
4285
171
5999** 239**
296
404
370
Finding a technique to connect training with
NA
employment.
Assumption: To Increase Training Activities: * 10%
** 40%
NA
Available
2.
No of doctors enrolled at OMSB.
3.
300
Past
Indicators
situation
2005
Current
situation
2010
Targeted
situation
2015
Fifth Objective’s Indicators: To Develop Continuing Education further in MoH
Continuing education programmes:
14
-
1.
2.
3.
No. of continuing education programmes
performed on central level for different
categories.
-
No. of continuing education programmes
performed on regional level for different
categories
- No. of participants in continuing education
activities on central level
- No. of participants in continuing education
activities on regional level
- Percentage
of
continuing
education
programmes accredited by OMSB
No. of scientific studies conducted to study the
effect of continuing education programmes.
Existence of job careers for staff development
coordinators and medical librarians.

NA
51
(Programmes
and
Workshops)
(Programmes
and
Workshops)
NA
6144
8050
NA
1805
726
NA
106463
120950
NA
50%
80%
NA
1
2
NA
NA
Available
No. of continuing education programmes on central level during the 8th five year plan (20112015) are expected to be less than before to concentrate more on increasing the No. of
continuing education programmes conducted on regional level
** Percentage of continuing education programmes conducted on regional level is expected to be
less than before to concentrate more on the “How will the quality of the programmes?” not
“How many programmes conducted?” . The training and professional development units will
facilitate the quality studies to include any programme with the continuing education
programmes plan
301
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Sixth Objective’s Indicators: Development of learning resources infrastructure
Existence of a study to establish learning
resources center.
Existence of an organizational structure for
2.
learning resources center.
No. of central scientific databases
3.
(membership in publications and e-books).
1.
NA
NA
Available
NA
NA
Available
0
0
5
STRATEGIES:
Strategies to Achieve 1st Objective: To provide adequate and equitable numbers of trained
manpower to all MoH institutions
1.1 The human resources distribution’s standards on all levels of health institution sorted
according to priorities.
Expected results:
 Availability of manpower distributed on health institutions according to standards.
1.2 Stability of professional staff in their technical specialty with clear job description and
limitation of transfer to other job categories.
Expected results:
 Immovability of professional staff and performing their job according to job description.
 Elimination of human resources shortage.
1.3 Conducting a study to identify specialties with omanization ratios to be increased.
Expected results:
 Availability of solid plans of manpower production in different categories.
Strategies to Achieve 2nd Objective: Accelerate the process of manpower appointing and
recruitment.
2.1 Shorten the MOH internal appointment process by setting a time frame and a responsible
person for each process.
Expected results:
 Satisfaction among appointed staff.
 Faster recruitment process for needed staff.
2.2 Coordination with other involved organizations to accelerate their related process of
recruitment.
Expected results:


Abridge the related process of recruitment from the involved organizations side.
Faster enrollment of new staff.
302
2.3 Using modern communications techniques in communication with nominees (ECommunication).
Expected results:
 Saving time in transfer of nominees‟ information.
2.4 Searching for additional sources to attract medical cadres from different countries.
Expected results:
 More job applicants.
Strategies to Achieve 3rd Objective: Reduce the number of resignations in all job categories
specially in medical and Para-medical job categories.
3.1 Payment of motivating Special allowances for rare specialties.
Expected results:
 Lower number of resignations among rare special cadres.
 Improved Quality of services provided.
3.2 Activate the bonus and special allowances mechanism to encourage energetic staff, with the
assignment of an annual financial item for that purpose.
Expected results:
 High performance among staff.
3.3 Annual rewarding system for staff with high performance whom contributed in rising the
work performance rates.
Expected results:
 High satisfaction and performance among staff.
3.4 Introducing opportunities for active administrative staff to continue their education in
different fields needed by the MOH.
Expected results:

Availability of adequate number of trained and qualified administrative staff that can cover
different fields required by MOH.
Strategies to Achieve 4th Objective: To train Omani health cadres in various health fields
4.1 Training and qualifying Omani staff in different specialties (inside and outside the
Sultanate).
Expected results:
 Increase in the efficiency of Omani employees in various specialties.
4.2 Continuing performing training courses inside the Sultanate for various categories in the
MOH health institutions and match the training and development with the actual needs.
Expected results:



Benefit of large number of employees in various fields.
Improvement in the quality of performance in the training courses.
Improvement in the quality of performance of staff as a result of training.
303
Strategies to Achieve 5th Objective: To Develop Continuing Education further in MoH
5.1 Develop health cadres capabilities by:

Activate Continuing Education Programmes for different health specialties at central
level.

Activate Continuing Education Programmes for different health specialties at regional
level.

Strengthen and encouraging planning for professional development programmes
accredited by OMSB.

Strengthen the evidence-based practices and conducting scientific studies to measure the
effect of implementing the continuing education programmes.

Setting job careers for staff development coordinators and medical librarians.
Expected results:

Increase in the efficiency of professional health employees and quality improvement of health
services.
Strategies to Achieve 6th Objective: Development of the learning resources infrastructure
6.1 Strengthen the infrastructure of learning resources by:

Preparing a study to identify the need to develop the learning resources infrastructure.

Introducing an evaluation study about the effect of developing the learning resources
infrastructure on upgrading the capabilities of health workers through central activities
and programmes.

Activate the membership of central scientific databases (publications and e-books).

Establish a time frame plan for the development of learning resources infrastructure.
Expected results:


Development of health categories in line with the MOH needs.
Availability of modern learning resources with most recent technology to serve all health regions.
304
STRATEGIES’ INDICATORS:
Indicators
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
1.1a
Availability of updated list of
Manpower in health institutes.
No. of Students expected to join in
Basic Diploma.*
1.2a
Annually
Available but not
updated
Updated List
Available
2011
2012
2013
2014
2015
Total
 sOuOela dneG
434
469
469
469
469
2310
 cONeMla blL lOMiueMn
50
50
50
50
50
250
 slNepaeloiOeG
30
30
30
30
30
150
 Physiotherapists
20
20
20
20
20
100
 tOuDla sneaOeg uGGeGDluD
16
16
16
16
16
80
 cONeMla sOMpeN lOMiueMelu
15
15
15
15
15
75
 Assistant Pharmacist
latoT
50
50
50
50
50
250
615
650
650
650
650
3215
*Expected Number enrolled from 2011 to 2015 based on the assumption of unchanged intake during
the year 2010.
1.2b
No. of Students Enrolled and
Expected to graduate with PostBasic Specialized Diploma*,**.
 Renal Dialysis
 Midwifery
 SCBU/Nursery
 Nursing Administration
 Intensive Care (Adult) Nursing
 Psychiatric Nursing
 Infection Control
 Nursing Bsc
latoT
2011
2012
2013
2014
2015
Total
23
63
21
27
27
18
24
27
23
63
21
27
27
18
24
27
23
63
21
27
27
18
24
27
23
63
21
27
27
18
24
27
23
63
21
27
27
18
24
27
115
315
105
135
135
90
120
135
230
230
230
230
230
1150
Remarkes:
* Assumption is that the number of Graduates is equal to the number enrolled because the period of
study of specialized diploma is one year.
** Estimation of graduates for the years 2011 –2015 is based on the assumption that the same intake
level as of 2010 will be maintained till 2015.
$ Distribution of students of Midwifery: 26 in Institute of Specialized Nursing, 14 in North Al Batinah
Institute, 15 in Ad Dakhliyah Institute and 8 at Adh Dhahirah Institute.
305
Indicators
1.3a
Availability of a study to identify
specialties with omanization ratios
to be increased.
Follow up
timing
Current
situation
2010
Targeted
situation
2015
By the end
of the
current plan
NA
Available
Indicators of Strategies of the 2nd Objective
2.1a
2.2a
2.3a
Presence of faster process of
appointment and recruitment.
Presence of coordination with other
related organization to accelerate
appointing process.
Presence of modern communication
techniques with nominees.
Annually
Available but not
Active
Available and
Active
Annually
Available
Available and
more Active
Annually
NA
Available
Indicators of Strategies of the 3rd Objective
3.1a
3.1b
3.2a
3.3a
Presence of special allowances to
motivate rare specialties.
Percentage of Medical and paramedical cadres resignations.
Presence of active mechanism for
granting bonus and allowances for
active employees.
Presence Annual rewarding system.
Annually
NA
Available
Annually
7.3%
(Year: 2009)
5%
By the end
of the
current plan
NA
Available
NA
Available
Annually
th
Indicators of Strategies of the 4
4.1a
4.2a
4.2b
4.2c
4.2d
Presence of Training and qualifying
plan for Omani staff in different
specialties.
Existence of a mechanism to
identify actual needs of training in
different specialties.
Reviewing of annually trained
numbers.
Identifying job description for each
job category to connect the training
course with the job career.
Presence of Scientific Technique to
measure the outcome of training.
Objective
Annually
Available
Available and
Continued
Annually
Available but not
accurate
Available and
accurate
Annually
NA
Available
Annually
NA
Available
Annually
Available but not
Active
Available and
Active
Indicators of Strategies of the 5th Objective
5.1a
5.1b
Presence of a plan for continuing
education
programmes
development on central level.
Number of continuing education
programmes
for
different
specialties on central level.
Annually
Available
Available with
service results
focused
Annually
51
14
306
Indicators
5.1c
5.1d
5.1e
Number of continuing education
programmes
for
different
specialties on regional level.
Percentage of accredited continuing
education programmes.
Presence of job career for staff
development coordinators and
medical librarians.
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Annually
6144
8050
Annually
30%
80%
Every 4
months
NA
Available
Indicators of Strategies of the 6th Objective
6.1a
6.1b
6.1c
6.1d
Presence of a study to identify the
need for a developed center for
education and learning resources.
Number of central scientific
databases (publications and ebooks).
Presence of a time frame for
establishing a developed center for
education and learning resources.
Presence of a developed center for
education and learning resources
for MOH health institutions in
Wattaya.
Annually
Available
Available and
active
Annually
0
5
Annually
NA
Available
Annually
NA
Available
307
Domain: Thirty Four
Health Educational Institutions in Ministry
of Health
308
Vision: Availability of Qualified Human Resources in Suitable Numbers to
Work in Health Institutions
Goal: Ensuring the Availability of Adequate Numbers of Suitably
Qualified, Trained and Efficient Workforce
Domain: Health Educational Institutions in Ministry of Health
INTRODUCTION:
The Ministry of Health has established Health Educational Institutions aiming at the
preparation of suitably qualified nurses and allied medical workforce, who can work
efficiently according to the standards of practice, based on proof and evidence, and who are
able to positively interact with the other members of the health team.
The great accomplishments that the ministry has achieved correspond to the country's
general vision of the development of manpower in the last four decades. Hence the MoH has
spread out the health education umbrella over the regions since 1991. As a result, the number
of educational institutions reached up to 16 institutions which hold 17 programs; 7 basic
programs, 8 specialized programs and 2 BSN programs.
The Ministry efforts during earlier plans concentrated on extending educational
opportunities in health professions, through basic and specialized programs. That was to meet
the increasing needs of the health care services with more staff of these professions due to the
expansion in the health sector. However, the MoH decided to shift the focus to the expansion
of constituting specialized programs, such as Infection Control Program. Furthermore,
undergraduate programs, BSN and physiotherapy have been started in collaboration with
international universities.
The ministry also recognizes the importance of educational curriculum review and
development for all its programs, so that these reach international standards in the field. This
was to make sure that the programs meet the new developments in education so that the
students have the chance to enroll in advanced studies in the future.
The ministry believes that the quality of performance and outcome of the educational
institutions is far-fetched without periodical review of the basic components of the of these
institutions, the operations and procedures they implement, improving and updating them so
that they meet the changes in higher education, in general, and health education in particular.
Therefore, core domains, relating to improving the basic structure of the Health Educational
Institutions and improving their curricula, abilities and capabilities have been introduced in
this plan. Consequently, this will contribute to the preparation of these institutions for quality
audit by the Oman Academic Accreditation Authority, which will take place in 2013, as a
first phase for Academic Accreditation. This phase is just to ascertain the effectiveness of the
operations and procedures of these institutions in accomplishing their goals and objectives, in
preparation for the institutional accreditation process and the accreditation of the educational
programs, as a second phase.
OBJECTIVES:
1. To improve and implement the Quality Assurance schemes in the Health Educational
Institutions.
2. To improve the academic programs to conform with the national frames, standards and
trends of higher education and professional practice.
309
3. To improve the infrastructure of the Health Educational Institutions, so that it meets the
demands of higher education.
4. To continue developing the capabilities and skills of the teaching staff and the
administrative staff and retain qualified staff.
5. To enhance the capabilities and skills of the teaching staff and students on approach
and methodology of scientific research.
6. To promote the academic and the student relationships with other universities and
colleges, nationally and internationally.
OBJECTIVES’ INDICATORS:
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
First Objective's Indicators: To improve and implement the Quality Assurance schemes in the
Health Educational Institutions.
1.
Percentage of Health Educational Institutions
which implement the Total Quality Systems.
NA
NA
100%
2.
Number of qualified auditors to implement
audit and review activities according to the
educational institutions' quality systems.
0
8
15
Second Objective's Indicators: To improve the academic programs to conform with the national
frames, standards and trends of higher education and professional practice.
1.
Percentage of curricula complying with the
national standards of higher education to the
total curriculum revised.
NA
30%
70%
2.
Number
of
multi-phase
transitional,
educational programs – Diploma and then
Bachelor's Degree.
0
1(Physiothera
py)
4 (General
Nursing P,
Physiotherapy
P, medical
imaging P,
Medical
Laboratory P)
3.
Percentage of the enhanced Programs Oman
Nursing Institute complying with the
national standards of higher education and
future vision of health development.
0
NA
100%
310
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Third Objective's Indicators: To improve the infrastructure of the Health Educational Institutions,
so that it meets the demands of teaching and training.
1.
2.
3.
Presence of organizational structures of the
proposed academic institutions (College of
Nursing & Health Sciences and its regional
branches, and Higher Institute for Health
Specialties).
Presence of an integrated information
system and website for the proposed
academic institutions.
Availability of an electronic scientific library
that includes the latest journals/periodicals.
NA
NA
Presence of
approved
organizational
structures
Different and
non-integrated
systems are
available
Different and
nonintegrated
systems are
available
Presence of an
integrated and
a unified
information
and knowledge
system
NA
Availability of
an electronic
scientific
library
NA
4.
Percentage of subscribed electronic
journals/periodicals.
NA
12.2%
30% of
periodicals to
subscribe to
(Total
subscribed
journals are 82
periodical)
which cover all
the educational
programs
5.
Percentage of educational programs
connected to the electronic library.
0
0
50%
6.
Number of digital simulators.
NA
3
20
311
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Fourth Objective's Indicators: To continue developing the capabilities and skills of the teaching staff
and the administrative staff and retain qualified staff.
1.
Percentage of staff trained in the field of
active teaching.
18%
43.8%
85%
2.
Percentage of staff trained in the field of
clinical assessment methodologies.
25%
55.6%
85%
3.
Percentage
of
administrative
and
professional leadership in the field of
administration to the total number.
10%
26%
50%
4.
Number of Omani staff sponsored to obtain
PhD degree.
0
12
20
Fifth Objective's Indicators: To enhance the capabilities and skills of the teaching staff and students
on approach and methodology of scientific research.
1.
Percentage of trainees who conducted
research to the total trainees on research
design and methodology.
1%
2%
10%
2.
Percentage of research utilized for planning
and improving teaching and the related
activities.
NA
NA
50%
3.
3. Number of published research in scientific
conference / scientific journals.
NA
NA
4
4.
Availability of data-base for research.
NA
NA
Availability of
this data base
312
Past
situation
2005
Indicators
Current
situation
2010
Targeted
situation
2015
Sixth Objective's Indicators: To promote the academic and the student relationships with other
universities and colleges, nationally and internationally
1.
Number of ratified agreements with national
and international universities and colleges
that includes academic & student
relationship, curriculum development, and
using electronic teaching learning resources.
3
3
6
STRATEGIES:
Strategies to Achieve 1st Objective: To improve and implement the Quality Assurance schemes in
the Health Educational Institutions.
1.1 Establishing a Quality Assurance Section in the proposed academic institutions (College of
Nursing and Health Sciences, and Higher Institute for Health Specialties.).
Expected Results:


Availability of a Quality Assurance Unit in the Directorate General of Education and Training.
Availability of effective collecting data mechanisms to review the followed plans and mechanisms
and to put and implement plans for improvement.
 Availability of work operational guides for quality.
 Facilitating the implementation of the Quality Assurance activities in the Health Educational
Institutions.
1.2 Continuing to enhance the skills of both the teaching staff and the administrative staff in
terms of assuring and improving the quality of performance in the educational institutions
through:

Implementing training programs for the staff of the Health Educational institutions on
the concepts of quality in higher education institutions.

Exchanging experience, nationally and internationally.
Expected Results:





Raising the teaching staff's potentiality in the field of the higher educational institutions quality.
Raising the confidence among the teaching staff to implement ADRI model to analyse the scopes
of the activities and the teaching and training processes which are included in the Quality Audit
Manual, released by the Omani for Academic Accreditation Authority (OAAA) to determine the
accomplishments, the weakness and improvement mechanisms.
Enhancing quality of education and training in the Health Educational Institutions.
Availability of selected teaching staff capable of training in the field of quality.
Availability of personnel capable of running the Quality Assurance and enhancement programs in
the Health Educational Institutions.
313
1.3 Developing Quality Assurance guides in the Health Educational Institutions.
Expected Results:

Availability of effective mechanisms to collect data about the activities of the Health Educational
Institutions and related indicators.
 Facilitating the implementation of the Quality Assurance activities and plans for improvement in
the health educational institutions.
 Enhancing quality of education and training in the Health Educational Institutions.
1.4 Implementing the Quality Assurance schemes and enhancement plans in the Health
Educational Institutions.
Expected Results:
 Quality of the administrative and professional processes in the Health Educational Institutions.
1.5 Preparing the Health Educational Institutions for the external audit by Oman Academic
Accreditation Authority (OAAA).
Expected Results:


Being aware of the strengths and weakness and the interventions needed.
Teaching and administrative staff and students acquisition of the self-assessment related
information and the skills required for improvement.
 Raising other stakeholders' awareness of the self-assessment portfolio content.
Strategies to Achieve 2nd Objective: To improve the academic programs to conform with the
national frames and standards, the higher education modern trends and professional practice
2.1 To prepare guidelines for the curriculum reviewing committees to prepare, follow up
implementation, evaluates and improve curriculum.
Expected Results:

Availability of effective mechanisms to implement, follow up, evaluation of curriculum at all
levels.
 Experience exchange in the field of reviewing, implementation, follow up, and improving
curriculum.
2.2 To review curriculum and implement related plans for improvement.
Expected Results:




A unified foundation period for the students of the Basic Diploma Programs.
Availability of common, unified core courses for the Basic Diploma Program.
Facilitating a student's transfer from one program into another.
Facilitating a student's transfer from one phase (educational level) into another within the program
he/she is enrolled in.
 Curriculum which meets the national framework of higher education.
 New curricula that meet the health system needs for health Professionals.
Strategies to Achieve 3rd Objective: : To improve the infrastructure of the Health Educational
Institutions so that it meets the demands of teaching and training
3.1 To prepare a study on the actual situation of the educational institutions and to provide a
comprehensive suggestion for the need of merging them into one college.
314
Expected Results:
 Getting the utmost benefit of resources, lessening expenditure and shared utilization.
 Facilitating a student's transfer from one program into another.
 Facilitating the implementation of various programs of academic plans.
 Availability of opportunities for students to improve their academic performance.
3.2 To establish a unified database for the student information.
Expected Results:

Availability of information, relating to the Health Education Institutions, for staff, students,
parents and others.
3.3 Renovating the buildings of the Educational Institutions to fit the requirements of the
variant educational programs.
Expected Results:
 Sufficient areas for teaching and training activities.
 Active learning which is applicable through team work and small group discussions.
 Granted teaching of certain courses to a large number of students.
3.4 Modernizing teaching and learning resources.
Expected Results:




Plentifulness of scientific references and electronic periodicals/journals.
Subscription of the Health Educational Institutes in the websites of the periodicals that are
related to the various educational programs.
Simplicity of obtaining latest information from periodicals/journals and international scientific
resources.
Consolidating process of active learning and training, using virtual tools/simulators, training
manikins/models and electronic panels/boards.
Strategies to Achieve 4th Objective: To continue to developing the capabilities and skills of the
teaching staff and the administrative staff and reserve qualified staff
4.1 Updating the knowledge and the skills of the teaching staff in the field of the teaching
strategies to continuously reinforce active learning and the assessment approach.
Expected Results:

Enhancing the performance of the teaching staff in using teaching tools and strategies to reinforce
active learning.
 Enhancing the performance of the teaching staff in using various methodologies to assess student
learning in the theoretical and practical aspects.
 Enhancing the students‟ ability of reflective thinking of their educational experiences and to utilize
these experiences to improve the learning standards.
 Enhancing the students‟ ability to interact during the educational activities.
4.2 Activating incentive’s mechanism for the employees to reinforce job stability.
Expected Results:


Granting job stability for the employees.
Enhancing work incentives output rates.
315
4.3 To continue to enhance the capabilities of the administrative staff.
Expected Results:
 Enhancing the performance of the administrative staff in all administrative fields.
 Providing Omani administrative staff capable of running the Health Education Institutions.
 Availability of a plan for administrative succession.
 Availability of administrative processes and procedures.
4.4 Qualifying Omani staff at the Ph.D. level in the specializations required.
Expected Results:



Availability of a plan to qualify Omani staff at the Ph.D. level in the specializations required.
Qualified Omani staff at the Ph.D. level for the various educational programs.
Increased number of staff who holds the Ph.D. Degree.
Strategies to Achieve 5th Objective: To enhance the capabilities and skills of the teaching staff and
students on approach and methodology of scientific research
5.1 Training to enhance the skills in the field of the research and studies approach.
Expected Results:

Enhancing the performance of the teaching staff in the field of conducting studies and research to
conduct research scientifically.
 The quality of research complies with the scientific methodology which makes research results
trustworthy hence, encouraging the use of these results in planning and executing these plans.
 Students‟ gain the basic research skills to conduct primary research scientifically.
 Availability of selected teaching staff capable of training in the field of conducting studies and
research.
5.2 Continue to train in the field of evidence-based practice in teaching and other professional
practices.
Expected Results:

Enhancing the performance of the teaching staff in the field of teaching and evidence-based
practice.
 Evidence-based education and practice is carried out by the teaching staff.
 Students acquire the basic concepts of the evidence based practice.
5.3 Procuring scientific references for the teaching staff researchers.
Expected Results:
 Teaching staff researchers access scientific references easily.
 Plenty of information from various resources.
 Availability of full research studies conducted in the Sultanate and in the other countries.
5.4 Cooperation with other sectors affiliated with the stages of conducting research.
Expected Results:



Directed research for the related professional and social needs.
Community projects to health based on actual needs.
Availability of channels for communication and cooperation with professional organizations and
community based institutions.
316
Strategies to Achieve 6th Objective: To promote the academic and the student relationships with
other universities and colleges, nationally and internationally.
6.1 Arranging student visits to national and international universities and colleges of mutual
academic and professional relationships.
Expected Results:

Opportunities provided for students to gain learning and training experiences which are NA in the
Health Education Institutions run by the MoH.
6.2 Doing mutual teaching staff visits with universities and colleges.
Expected Results:

Opportunities provided for a bigger number of the teaching staff to learn about educational and
training systems, programs and experiences which are not granted by the Health Education
Institutions run by the MoH.
6.3 Obtaining a license which grants access to the learning and teaching electronic sites of
universities and colleges.
Expected Results:
 Making use of the teaching and learning resources of universities and colleges.
6.4 Reviewing curriculum by specialists from universities and colleges.
Expected Results:

Curriculum conforms to modern trends in health and education.
STRATEGIES’ INDICATORS:
Indicators
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
1.1a
1.2a
1.2b
1.2c
Availability of a Quality Assurance
Section in the proposed academic
By the end of
institutions (College of Nursing and
2012
Health Sciences, and Higher Institute
for Health Specialties.).
The number of workshops to train
employees on the concepts Quality
Annually
Assurance.
Percentage of staff participated in
national and regional conferences
Annually
and workshops in the field of higher
education institutions.
Number of quality auditors in the
Annually
educational institutions who were
trained by OAAC.
317
Availability of
unapproved
organizational
structure
Availability of
approved
organizational
structures
32
4 at the central
level and 64 at the
Institutional level
40%
85%
8
15
Indicators
1.2d
1.3a
1.4a
1.4b
Number of staff capable of leading
Quality Assurance programs in the
Health Educational Institutions.
Availability of guidelines for total
quality of the mechanisms in the
Health Educational Institutions.
Number of Health Educational
Institutions which implemented the
quality enhancement projects.
Number of annual meetings held to
follow up and review the quality
systems in the Health Educational
Institutions, at the central level.
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Annually
9
20
Every two
years
Guidelines under
development
Comprehensive
guide available
Annually
2
14
Annually
Periodic but not
annual meetings
5
1.5a
Availability of an approved portfolio
for self-evaluation.
Mid of the
year 2012
NA
Approved
portfolio for selfevaluation
1.5b
Number of scopes where quality is
implemented, according to the
quality moderation guidelines issued
by the OAAC.
End of the
year 2012
NA
All scopes (9)
Indicators of Strategies of the 2nd Objective
2.1a
2.2a
2.2b
2.2c
Availability of guidelines
reviewing curriculum.
for
Availability of a unified foundation
program for the basic programs
students which compiles to the
Omani higher education standards.
Number of core courses and the
shared ones among the educational
programs.
Number of implemented programs
after being improved.
Disintegrated
guidelines
available
Unified guidelines
for reviewing
curriculum
available
Un unified
foundation
program is
available
Available unified
foundation
programs (English
Language, Maths,
Learning Skills,
IT)
By the end of
2013
NA for basic
programs (1),
specialised
programs (applied
research)
4 (Anatomy and
Physiology,
Introduction to
Research,
Introduction to
Health,
Biochemistry)
By the end of
2012
7 (Nursing,
Physiotherapy, Xray, Labs, Mouth
& Dental Health,
Adult and
Paediatric ICU
14
By the of
2012
Mid of the
year 2011
318
Indicators
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 3rd Objective
3.1a
A proposal for merging the
By the end of
educational institutions into one
2011
college is on the table.
First draft of a
plan is available
A proposal for
merging the
educational
institutions into
one college is on
the table along
with other
recommendations
3.1b
Availability
of
approved
organizational structures of the
proposed
academic
institutions By the end of
(College of Nursing and Health
2012
Sciences, and Higher Institute for
Health Specialties.).
A proposed
organisational
structure is
available
Approved
organisational
structures are
available
3.2a
Availability of a unified database of
By the end of
students
informationStudent
2014
Management System (SMS).
3.3a
Number of halls that can hold at
least 100 students.
3.4a
Disjointed various A unified student
systems are
management
available
system is available
By the end of
2013
3
11
Number of digital simulators.
Annually
3
20
3.4b
Number of institutes which possess
electronic panels/boards for active
learning and through electronic sites.
Annually
1
14
3.4c
Availability of an educational portal
for
the
Health
Educational
Institutions.
Annually
NA
Availability of an
educational portal
* One computer
per 5 students
* One computer
per 3 students
* One computer
per each teacher
* One computer
per each teacher
Number of computers to:
3.4d
-
Students
-
Teachers
Annually
Indicators of Strategies of the 4th Objective
4.1a
4.1b
4.2a
Percentage of teaching staff trained
in the field of teaching strategies to
reinforce active learning (Student
Centered Learning).
Percentage of teaching staff trained
in assessment techniques.
Percentage of employees granted
incentives.
Annually
43.8%
85%
Annually
43.8%
85%
Annually
0
50% in every year
319
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Availability of a study to assess the
current situation of the teaching staff
and job satisfaction.
Number of Omani staff trained in the
field of administration.
By the end
of the current
plan
NA
Job satisfaction
study available
Annually
29
50
4.3b
Availability of work guide for
administrative procedures.
By the end of
2012
Comprehensive
guide unavailable
Administrative
work guide
available
4.4a
Number of Omani staff sponsored to
be PhD qualified.
Annually
12
20
Indicators
4.2b
4.3a
Indicators of Strategies of the 5th Objective
5.1a
Availability of a study to evaluate
the current situation of the research
system.
Primary study
conducted
A study of the
current situation
available
5.1b
Availability of database of research
activities and researchers.
Annually
NA
Database of
research activities
and researchers
available
5.1c
Number of researcher capable of
conducting research training.
Annually
5
10
5.1d
Number of workshops conducted
centrally in the field of improving
research skills and capabilities.
Annually
0
4
5.1e
Percentage of employees trained in
scientific research methodologies.
Annually
15%
45%
5.1f
Number of trainees who conducted
research and studies.
Annually
11
22
5.1g
Number of educational programs
which trained students to conduct
primary research systematically.
By the end of
2011
12
14
5.2a
Number of workshops in the field of
evidence-based practice.
Annually
12
64 workshops at
the institutional
level
5.2b
Percentage of trainees in the field of
evidence-based practice compared to
staff total number.
Annually
34%
85%
5.3a
Number of subscribed electronic
sites and periodicals.
Annually
10
36
5.4a
Number
projects.
Annually
6
14 projects at the
institutional level
of
health
community
By the end of
2011
320
Indicators
Follow up
timing
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 6th Objective
6.1a
6.1b
6.2a
6.3a
6.4a
Percentage of ratified agreements
that includes mutual students visits.
Number of students who visited
national
and
international
universities and colleges of ratified
agreements.
Number of teaching staff who visited
national
and
international
universities and colleges of ratified
agreements.
Number of users of the electronic
teaching and learning resources
available in the universities and
colleges of ratified agreements.
Number of curriculum developed in
cooperation with universities and
colleges of ratified agreements.
Annually
0
100%
Annually
0
15 per program
encompassed in
the agreement
Annually
7
Annually
40 (OSNI) 27
(IHS)
Annually
3
321
10 per each
program
encompassed in
the agreement
All students of the
programs
encompassed in
the agreement
All programs
encompassed in
the agreement
Vision Twelve
Improving the health services provided by the
private health sector according to a health
system that is based on excellence, quality and
the scientific and practical efficiency; and to
ensure the rights of patients and their safety.
322
Domain: Thirty Five
Health services for the Private Health
Sector
323
Vision: Improving the Health Services Provided by the Private Health
Sector According to a Health System that is Based on Excellence,
Quality and the Scientific and Practical Efficiency;
and to Ensure the Rights of Patients and their Safety.
Goal: To Support the Private Health Sector in Order to Provide
Preventive, Curative and Promotive Health Services to All Members of
Community According to International Quality Standards and Licensing.
And to Supervise the Private Health Establishments as per the National
Legislation and Regulations in Order to Ensure the Efficiency of Health
Services Provided and their Consistency with Government Health Services
to Fulfill the Needs of Community Members.
Domain: Health Services for the Private Health Sector
INTRODUCTION:
The health services provided by the private health sector are considered to be one of
the reliable sectors worldwide because of its importance in achieving a solidarity health
community. Private health establishments are the main supporter of the government health
services. In the Sultanate, the private health establishments have a wide range of diversity in
terms of type and complexity of health service as well as their distribution over the country in
order to meet the urgent need to support the government health sector and to enrich the health
services provided to the community in many specialized services. Furthermore, the private
health sector would help in raising the quality, efficiency and effectiveness of these services
and to reduce the shortage of medical staff in our health institutions.
During the past ten years the growth of private health sector has gone up throughout
the Sultanate; and the governorate of Muscat had the lion's share because of the density of
population and increasing demand for various specialties. There are more than thousand
health institutions are now registered with the Department of private health establishments,
which vary between hospital, specialist and general clinic. These institutions cover all kind of
major and minor specialties as well as diagnostic laboratory and radiology services.
With this diversity in private sector, it is mandatory to get solid legislations and laws
to control the work of those institutions that have become one of the main stakeholders of
health system in the country. Thus, strengthening of legislation for those institutions and their
development have become the main concern of health authority in order to govern their
works, protect patient and his family's safety and to raise the efficiency of professional staff
to deliver good quality of health services. Therefore, this would not possible to take place
unless there are modern standards and legislation in place that are able to accommodate the
accredited patient safety and health quality protocols.
One of the strategic objectives for the private health sector is to incorporate its
services with the government health sector to form an integrated health system in order to
meet the growing needs for health services and to achieve this strategy, the private health
sector needs to get solid infrastructure of accurate data and statistics upon which to build
strategic plans with the existence channels of communication between private and
government health institutions. Also referral system protocol that govern referral of patients
to and from various institutions needs further development to ensure receiving high quality
health services which have become the ABCs of any health system.
324
Among the most prominent challenges facing the private health sector in the Sultanate
is the lack of adequate legislation and laws to legalize and organize the work of those
institutions in order to ensure the provision of health service quality and safety of patients.
The second challenge that to be focused on is the inadequacy of trained inspector among the
technical and administrative personals who are holding the legitimate authority.
Therefore, the rationale behind inclusion of private health services among other healthcare
domains is mainly to improve their strategic planning in order to achieving the future vision
and goals of private health sector in the country.
OBJECTIVES:
1. Strengthen and enforcing the legislation and laws governing the work of the private
health sector.
2. Developing the inspection and monitoring system of private health establishments.
OBJECTIVES’ INDICATORS:
PAST
SITUATION
2005
INDICATORS
CURRENT
SITUATION
2010
TARGETED
SITUATION
2015
First Objective’s Indicators: Strengthen and enforcing the legislation and laws governing the work
of the private health sector
1.
Existence of updated and enabled human
medical& dental practicing regulation for
private health sector.
Available
Available
Not-Updated
Updated and
Enabled
Regulation
2.
Existence of Updated requirements guideline
for licensing of private health establishments.
Available –
not-updated
Available –
not-updated
Updated
Guideline
3.
Existence of updated requirement guideline
for licensing health professionals.
Available –
not-updated
Available –
not-updated
Updated
Guideline
4.
Percentage of private health establishments
that apply human medical & dental practicing
regulation.
60%
70%
100%
5.
Percentage of private health establishments
that apply the requirements guideline for
licensing of private health establishments.
60%
70%
100%
6.
Existence of Complementary and Alternative
Medicine Law.
NA
NA
Available
7.
Existence of patients‟ referral protocol to and
from private health establishments.
NA
NA
Available
325
INDICATORS
PAST
SITUATION
2005
CURRENT
SITUATION
2010
TARGETED
SITUATION
2015
8.
Existence of dress code policy for health
professional personals.
NA
NA
Available
9.
Existence of list of legal penalties for private
health establishments.
NA
NA
Available
10
Existence of issuing sick leave policy.
NA
NA
Available
11
Existence of drugs prescription policy.
NA
NA
Available
12
Existence of clinical privilege for all medical
and surgical specialities.
NA
NA
Available
13
Existence of IVF (in vitro fertilization) Law.
NA
NA
Available
Second Objective’s Indicators: Developing the inspection and monitoring system of private health
establishments
1.
Rate of technical and administrator personals
who got legitimate authority.
NA
Available for
few personals
but not
enabled
2.
Existence of unified and approved mechanism
for inspection for all over Sultanate's regions
and governorates.
Un-unified
mechanisms
Un-unified
mechanisms
Unified
mechanism
3.
Rate of technical and administrator personals
who are trained on inspection and monitoring.
Zero
Zero
100%
326
One per 10
health
establishments
STRATIGIES:
Strategies to Achieve 1st objective: Strengthen and enforcing the legislation and laws governing the
work of the private health sector
1.1 Provide and enable the human medical & dental practicing regulations and policies that govern
the work of private health establishments and supervise their implementation of these legislation by:

Make sure that all private health establishments have got these regulations and policies.

Conduct workshops and seminars to all private health establishments to explain and clarify
these regulations and policies.

Train the technical and administrators (the In-charge of private sector) Staff on how to
monitor the abidance of private health establishments of these regulations during inspection
visits.
Expected results:

All private health establishments are well informed and be aware of all regulations that
oversee the work and practice of private health sector.
 Decrease the number of the administrative and technical breaches committed by private
health establishments.
Strategies to Achieve 2nd Objective: Developing the inspection and monitoring system of private
health establishments
2.1 Make sure that all private health institutions are inspected and monitored according to well
established inspection system through which:

Standardize the mechanism of inspection and monitoring.

Training of inspection teams.

Well documentation of field visits (central and regional) by proper written reports.

Auditing the quality of inspection reports that are submitted by the inspection teams.
Expected results:



There is a uniform mechanism of inspection and monitoring for all regions.
The members of inspection team are well trained on how to inspect the private health
establishments.
Increase the number of field visits to these establishments by the inspection team.
327
STRATEGIES’ INDICATORS:
Follow up
timing
Indicators
Current
situation
2010
Targeted
situation
2015
Indicators of Strategies of the 1st Objective
1.1a
Number of workshops that are carried out
to demonstrate the current regulations for
private health establishments.
Annually
1
5
1.1b
The percentage of inspection teams'
members who are trained on how to
perform inspection's procedures.
Annually
Zero
50%
1.1c
Number of private health establishments
that are provided with copy of regulations.
Annually
NA
All private
health
establishments
1.1d
Number of private health establishments
that had been withdrawn their licenses due
to breach of regulations.
Annually
Zero
Zero
1.1e
Number of private health establishments
that had been stopped temporarily from
work due to breach of regulations.
Annually
5
Zero
1.1f
Number of workshops and meetings that
were held to demonstrate the regulations
to private health establishments.
Annually
Once a year at
central level
At least once a
year in each
region
Indicators of Strategies of the 2nd Objective
2.1a
Availability of a standardized form of
inspection and monitoring of private
health establishments.
Annually
Available but
not standardized
Standardized
form is available
2.1b
Percentage
of
private
health
establishments that had been inspected by
the regional inspection teams on average
of three times more per year.
Annually
60%
100%
2.1c
Percentage
of
private
health
establishments that had been inspected by
the central inspection team on average of
once or more per year.
Annually
10%
100%
2.1d
Percentage of inspection reports that were
submitted by the inspection teams are
upon the best required quality of
documentation.
Annually
40%
≥ 90%
328