Omani health care groups tackle lifestyle-related disease

Oman’s health authorities are devoting substantial resources to solve what is perhaps their steepest immediate challenge: curbing the spread of unhealthy habits that have led to a rise in lifestyle diseases like cancer and diabetes among a relatively sedentary populace.

ASSESSMENT: Such ailments, formally known as noncommunicable diseases (NCDs), now account for 70% of deaths in Oman, according to the World Health Organisation (WHO) – and their prevalence is rising. In the 20 years to 2016, the share of NCD-related morbidity cases at state-run facilities increased from 42.5% to 44% among outpatients, and from 36.1% to 40.3% for inpatients, according to the Ministry of Health (MoH). A child born in Oman today has an 18% chance of dying prematurely from one of them.

ACTION ITEMS: One prominent organisation in turnaround efforts is the Nizwa Healthy Lifestyle Project (NHLP), which coordinates preventive activity across public and private institutions. In early 2017 it launched a programme to ensure smoke-free zones in outdoor venues like the historical souq (market) in Muscat, following its nationwide indoor smoking ban passed in 2010. The public response was positive: a 2016 survey showed near-unanimous support among both locals and foreigners for enacting the ban.

A second NHLP effort is the Healthy Restaurants initiative, whereby a handful of dining outfits have volunteered to develop a healthier section on their menu with items that are low in sugar, salt and fat. The pilot programme clears a path for voluntary cooperation on a larger scale, part of a broader low-salt MoH programme that has seen the country’s top bakeries cut sodium content in bread by 10% since 2015. The target was raised to 20% in 2016 and expanded to cheeses.

AWARENESS: As part of its ongoing work in public education, in early 2017 the MoH launched a one-year social marketing and mass media campaign aimed at encouraging Omanis to exercise. The programme is utilising multiple channels to send messages about the benefits of physical activity under the slogan “Health begins with one step”, accompanied by public events hosted at schools, malls, hospitals and parks. With help from the WHO, an MoH taskforce also drew up a national strategy for promoting physical activity, with a goal to reduce the share of the under-exercised population by 10%. To improve monitoring, in March 2017 the ministry launched a National Nutritional Survey to gauge diets, completing fieldwork by November, as well as a National Health Survey on NCDs in February, with fieldwork finished in May 2017. Conclusions from both will inform the MoH’s next moves in 2018 and beyond.

DIRECTIVES: Other approaches involve more direct intervention. The MoH is currently conducting studies to gauge the likely effects of a junk food tax that would drive up prices of unhealthy foods by 125-500%, according to Dr Amira Al Raidan, the ministry’s director of health education and awareness. Her division is also stepping up the monitoring of nutrition levels in school meals, and producing short video clips distributed via social media to educate the public on obesity, fitness, diabetes and children’s health.

As next steps in this vein, a joint mission run by the WHO in 2016 recommended Oman convert import taxes on tobacco to excise taxes, then raise them significantly; shift food subsidies from unhealthy products to healthy ones; and enforce proper product labelling to indicate a food’s level of sodium, sugar and fat.

SCORECARD: Of 10 key prevention measures tracked in the WHO’s annual “NCD Progress Monitor” report – which gauges progress on countries’ time-bound commitments to the UN’s Sustainable Development Goals – Oman had already accomplished five by 2017: providing drug therapy and counselling to prevent heart attacks and strokes; forming guidelines on the management of cancer, diabetes and other diseases; conducting awareness campaigns on the importance of diet and exercise; taking steps to reduce over-consumption of alcohol; and setting national NCD targets.