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Evaluation report

2000 Oman: The Mortality and Health Transition in Oman: Patterns and Processes



Author: Hill, A. G.; Muyeed, A. Z.; al-Lawati, J. A.

Executive summary

Background

Health indicators such as infant, under five and maternal mortality rates continued to show progressive and consistent reduction in the Sultanate over the past three decades. Several diseases have been eliminated and life expectancy at birth has reached levels comparable to those in developed countries. An extensive network of modern health facilities providing full range services is made available and easily accessible to the entire Omani population. Although various sources have previously documented different aspects of the Omani experience in health development, however, this Report is the first comprehensive documentation of the entire experience. It is also unique in the wealth of data and information, which was complied in it from various sources and also by the depth of its analysis.

Purpose / Objective

This report is an attempt to analyze and document Oman's achievements in health development. It describes the health status of the Oman people in the pre-Renaissance era (before 1970) and the subsequent changes in different health parameters. It also attempts to establish attribution and furnish understanding for the roles of direct health interventions and indirect social and economic factors on the advent of the observed health transition.

Methodology

Desk review and critical analysis of existing UNICEF and government surveys and studies.

Key Findings and Conclusions

Childhood mortality data describe one of the fastest drops in infant and under-5 mortality on record. A particular characteristic of the mortality transition in Oman was the way in which differentials between rural and urban, educated and less educated sections of the population have been kept to a minimum.

The coverage of the immunization program rose rapidly in the 1980s and reached 94% in 1992 for all of the vaccine-preventable diseases. In the 1995 Oman Family Health Survey, all children aged 12-23 months at interview had received BCG immunization and 98% had received measles vaccination.

Although the nutritional status of infants and children has improved from a decade ago, malnutrition and obesity persist. The 1992 hospital deliveries show that 91% of new-borns weighed at least 2500 grams. The proportion of children entering primary school with weight-for-age corresponding to the minimum median reference values fell to 64%. The results of a 1992 nutritional survey found that 17% of infants were underweight, and among children between 3 and 10 the figure varied from 25% to 35%.

In the 1990s, major progress in water and sanitation were achieved. In 1990, the Environmental Health Section was developed into a full department. The preliminary results are promising with the enteritis and other diarrhoeal disease reduced from 273,920 cases in 1990 to 193,709 cases in 1992; a reduction of 29.3% from 1990 and 41% from 1984. Bacillary dysentery and amoebiasis reduced from 8,445 cases in 1989 to 4,446 cases in 1992; a reduction of 47.4% from 1990 and 74% from 1986.

The provision of good quality, widely dispersed and free health services has transformed the health of the Omani population. Barriers to the use of public health services have broken down. Interest in surveillance and in special studies has provided a strong numerical basis for planning and assessment. Oman has also kept up-to-date with new technical developments and different approaches to health care provision. Services have been greatly decentralized with an increasing reliance on well-trained nurses.

Recommendations

There is a lingering problem of malnutrition among children and the 'shift' of the burden of disease from communicable to chronic non-communicable diseases and injuries associated with road traffic accidents.

With such a rapid fall in mortality and an imminent decline in fertility, the age distribution of the Oman population will alter dramatically. Care of the elderly and disabled will become a new problem in the very near future.

In the health sector, more stress will need to be laid on the effectiveness, efficiency and sustainability of Oman's national health system. Very few serious evaluations of the effectiveness of past interventions have been conducted. This makes decisions on which services to develop very difficult. The role of the private sector will be of increasing importance in the future. Additional information and analysis can contribute to a well-planned transition of services from the public to private sector.



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Report information

Date:
2000

Region:
MENA

Country:
Oman

Type:
Survey

Theme:
Health - Other

Partners:
Government of Oman, WHO Regional Office for the Eastern Mediterranean

PIDB:

Follow Up:

Language:
English

Sequence Number:
1998/045

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