PERFECTING THE PANACEA

Oman 2015 | HEALTH & EDUCATION | REVIEW: HEALTH

Oman has a healthcare system it can be rightly proud of. The next step for the government is to hone in on particular weaknesses and gaps in the system.

Oman's healthcare system has undoubtedly come on in leaps and bounds since its modern beginning in the 1970s when the Sultanate had two hospitals with only 12 beds. The system is considered world-class today, with a total of 66 public and private hospitals, and a ratio of one bed for every 624 people; a 3.1% increase in 2013 over the 2012 figure. Out of the total number of hospitals, 12 are run by the private sector. In addition, there are 245 public healthcare clinics and a further 1,026 run by the private sector, serving a total population of 3.9 million. The level of access to treatment is also extremely high in Oman, at 98.4% according to the Oman World Health Survey 2008. And when the public comes into contact with the health system, their satisfaction with the overall experience is 76%-77% according to the same survey.

Oman stands out as a model example when it comes to truly universal public healthcare provision. All citizens, and any foreign worker employed in the public sector, has full, free access to public medical and dental care, as well as prescriptions. When appropriate treatment is not available in the Sultanate, the Ministry of Health will fund treatment abroad for its citizens.

NEW DEVELOPMENTS IN 2014

Despite the good performance to date, the government is not resting on its laurels when it comes to the health of the nation. The government's healthcare budget for 2014 was $3 billion, up from $1.3 billion in 2013 signaling that public spending on health is still accelerating. Initiatives announced in 2014 include the signing in June of agreements for the design of five new public hospitals which will create a further 900 beds and 193 outpatient clinic facilities in total. These are for Al-Suwaiq in Al Batinah governorate, Khasab in Musandam, Najat in North Al Batinah, Samail in Al Dakhilyah, and Al Falah in South Al Sharqia. On top of this, a further three hospitals and 17 health centers are in the final construction tender phase according to the Ministry of Health.

The Ministry of Health's current National Health Policy spanning 2011 to 2015 sets out the government's objectives for the healthcare system in general. In October, the Ministry launched its new Contact Center as part of its policy goals to improve community health education and awareness. The call center is only running in the Muscat governorate at this stage, and will be rolled out to other regions over time. Community feedback and data about frequently occurring health complaints will be used by the Ministry to target solutions in conjunction with the Sultanate's health entities that are electronically linked into the Contact Center system.

EDUCATION & OMANIZATION

Wider reaching and better community education about health issues and lifestyle choices is just one side of the government's knowledge drive in the health sector. Increasing the levels of Omanization and the domestic education of healthcare professionals remained firmly on the government's radar in 2014. As of 2013 Oman had 1.99 doctors per 1,000 people, an increase of 2.1% over 2012. There are 4.40 nurses for every 1,000 people, again an increase of 2.1% over 2012 figures. However, the numbers of healthcare professionals required to run both the public and private segments of the market cannot be met currently from within Oman's human resource and education pool. K. Jayan, Vice-President of Starcare UK, a private health provider in Oman told TBY that this is “...a critical issue facing the country. The local production of experts in the healthcare sector is not sufficient to meet its demand in the market." Starcare has no less than 22 nationalities working in its hospital, while in the public sector at the Royal Hospital, 85% of the specialists and medical officer posts are still staffed by expatriates.

Oman currently has three medical education facilities, at the Sultan Qaboos University, the private University of Nizwa, and the Oman Medical College. Oman has graduated 1,940 physicians since 1986 when medical education first started in the Sultanate. As well as expanding its medical training resources, the reality is that Oman needs to find ways to attract its youth into the medical profession, and then get them to stay in-country once qualified, if the government's Omanization goals are to be achieved over the coming years.

TREATMENT TARGETING

In 1970 when His Majesty Sultan Qaboos bin Said took the throne, life expectancy in the state was as low as 40 years, but that figure is up to a respectable 76.6 as of 2013. By way of comparison, life expectancy in the US is not that much higher at 78.74, below for example the UK and Germany, where the average is over 80. Unsurprisingly, the biggest health threats to longevity in Oman now are those commonly associated with a high income economy and society. Specifically, coronary heart disease and hypertension are the top two causes of death at 28.49% and 14.25% respectively, followed by diabetes, which accounts for 14.25% of total deaths in the Sultanate. Indeed, Shyam Sailesh, Director for the private Apollo Sugar Clinic brand in Oman, told TBY that nearly 13% of the population has been diagnosed with diabetes, while undiagnosed sufferers could amount to another 13%. According to the International Diabetes Federation Europe, the global average for adults suffering from diabetes is 8.3%, and in the European region (including Russia and Turkey) the rate is 8.4%. Oman is clearly well above the average in this regard and some private health providers are seeing this as an area for growth in the provision of services. For example, in 2013 Apollo opened a new specialist Sugar Clinic for Diabetics in Ruwi, Muscat.

A related health issue that Oman has been actively working on at the international and regional level this year is smoking, given that tobacco is a major contributor to diabetes and cardiovascular diseases, amongst other complaints. According to World Health Organization (WHO) data, in 2008 14.7% of Omani males aged 18 years and over smoked, although the figure for women was much lower at 0.2%. In 2010, the percentage for men had risen to 24.7% and for women to 1.3%. While these figures are quite low by world standards, they are creeping up. In March 2014, Muscat played host to the GCC's 15th Symposium on Tobacco and Trade where one of the topics under discussion was the use of regulation, taxation, and trade controls to prevent increases in smoking related diseases in the GCC region. Oman is already party to the WHO's Framework Convention on Tobacco Control (FCTC), which it signed in 2005, the same year that the Convention came into force. At a subsequent FCTC Conference of Parties meeting in Moscow in October, Oman's representative from the Ministry of Health, Dr. Jawad Ahmed Al Lawati, reiterated Oman's commitment to tobacco taxation measures to curb consumption, as reported by The Times of Oman. At present, taxation as a percentage of the retail price of the most widely sold brand of cigarettes in Oman stands at 22%. This is still relatively low when you compare that the tax on cigarettes in Egypt, for example, is 73%.

In June 2014, Oman's National Committee for Drugs and Psychotropic Substances marked the International Day Against Drug Abuse and Illicit Trafficking at a gathering in Muscat. According to Ministry of Health information, the Sultanate is experiencing a rise in the number of registered drug addicts. As of the end of 2013 the number was 4,150 compared to 3,935 in 2012. This YoY increase of 215 is significant, given that this is only the figure for registered addicts, overall numbers of addicts are likely to be higher.