Introduction to Oman Health Care System 2018-2019 PDF

Sultanate of Oman Ministry of Health Bachelor of Science in Nursing Program Introduction to Oman Health Care System Course code NUR 101 Course Outline Academic Year 2018/2019 Year I Semester I Page 1 of 79 Sultanate of Oman Ministry of Health Bachelor of Science in Nursing Program Course Outline 1. Course information Course Title Introduction to Oman Health Care System Course Code: NUR101 Credit Hours Allocated: 2 Actual Hours allocated: 30 Placement of the course : First Year - Semester One Pre-requisite courses: Completion of Foundation Program Co – requisite courses: --- Course category Discipline Institutional compulsory Elective Course owner Oman Collage of Health Science Language of instruction English Arabic 2. Course Description: This course introduces the student to the Ministry of Health (MOH) health care system; and provides a brief discussion regarding the development of the health care delivery system in Oman. The course provides explanation of basic concepts of health, determinates of health, wellness illness continuum primary health care and levels of prevention. The course provides a brief description to the functions of World Health Organization and International health organizations that are active internationally and in Oman. The course also introduces educational programs run by the Ministry of Health that undergo the common Foundation program. These programs are: Basic Nursing Diploma run by Nursing Institutes; Medical Laboratory Sciences, Diagnostic Radiography Physiotherapy, Dental surgery Assistant, and Baccalaureate degrees run by the Institute of Health Sciences (IHS); Health Information Management run by Oman Health Information Management Institutes (OHIMI); and Assistant Pharmacy Technician run by Oman Institute of Assistant Pharmacy (OIAPH). 3. Course Learning Outcomes (CLOs). 1. CLO1: Demonstrate ability to comprehend some of the concepts related to health and illness and factors affecting health. 2. CLO2: Describe nursing profession and recognize the various nursing specialty programs offered at OSNI. 3. CLO3: Recognize the health care system in Oman 4. CLO4: Determine the different roles and responsibilities of nurses and other health care professionals 5. CLO5. Identify and share information related to the structure and functions of various departments in the primary health care institution Page 2 of 79 4. CLOs PLOs/SLOs, Generic Graduate Attributes Mapping Matrix * PLO/SLO - Program learning outcome/Student learning outcomes **CLO - Course Learning Outcomes Generic Graduate Attributes 1. Knowledgeable and skillful 2 Critical Thinker 3 Collaborator and team player 4 Effective communicator 5 Lifelong learner 6 Ethical, legal, and professional awareness 7 Good and engaged citizen 8 Culturally sensitive CLO** PLO/SLO Relevant to this Course Applicable Generic Number Graduate Attribute 1 , 3, & 4 Integrates knowledge from nursing, health and other 1&2 disciplines to explain nursing decision and interventions 2&4 Understands and values the roles, knowledge and skills of 1&3 the health team in relation to own responsibilities 5 Communicates and shares relevant information including 2, 3 & 4 views of clients, family and / or care givers with other health team members involved in providing services 3&4 Contributes to team leadership by reinforcing goals so as to 3&6 promote respect and confidence amongst team. 3&4 Takes opportunities to learn with/from other members of 1&3 health care team. 1 Demonstrates ability to interpret risks and know the 1,2 determinants of disease Participate effectively in daily life, and in social service to 5 ,7, 8 promote the population health CLOs, Assessment, and Teaching learning strategies mapping matrix CLO** Method of assessment When to be assessed Teaching and learning Number Strategies 1, 2 & 3 Written test 1 Summative assessment lecture discussion, role playing, test 1 ( week 7) ,concept mapping, group learning 4&5 Written test 2 Summative assessment lecture discussion, role playing, test 2 (week 13) ,concept mapping, group learning 1, 2, 3, 4 &5 Final Assessment final (week 16-17) lecture discussion, role playing, ,concept mapping, group learning Page 3 of 79 5. Assessment Plan: Assessment Percentage In-course assessment Test one 25% Test Two 25% Final Examination 50% Total 100% Note: A rubrics to evaluate students work such as assignment, project, portfolio, case study, reflection essay etc. is to be developed by course teacher as applicable. 6. Grading System: The course grade is calculated on percentage basis and each grade has a numerical value in accordance with the following table: Grade Grade Point % Grade Grade Point % A 4.00 100-90 C 2.00 68 - less than 71 A- 3.75 85 - less than 90 C- 1.75 65 - less than 68 B+ 3.25 81 - less than 85 D+ 1.50 60 - less than 65 B 3.00 78 - less than 81- D 1.00 50- less than 60 B- 2.75 75 - less than 78 F ‫( صفر‬0) Less than 50 C+ 2.25 71 - less than 75 7. Course Contents: Introduction: Terminologies, Definitions and Concepts The Health Care System in Oman The Health Care Delivery System in Oman International Health Organizations Introduction to Professionalism and Programs Provided by Ministry of Health Introduction to Nursing Profession Post Basic Nursing Specialties Introduction to Health Information Management Introduction to Physiotherapy Introduction to Medical Laboratory Introduction to Radiography/ Medical Imaging Introduction to Oral Health Introduction to Pharmacy Field visits to primary health care settings and hospital departments 8. Student Learning Activities Field Visit 1: Primary Health Care Settings Field Visit 2: Hospital Departments Page 4 of 79 9. Submission date of assignment/ case study/ project/…..: (to be filled out by the course teacher/coordinator at the collage branch level) 10. Late submission: (e.g. Assignments are to be completed and handed in on time either electronically or hard copy. In order to be fair to students who complete their assignment on time, work that is not submitted on the specified date will be considered as late and will be panelized 10% off of the assigned grade par day late. If a student is absent on the day of submission, the work assigned is still due via email during the working hours of the specified submission date.). Note: consistency of implementation across all courses and by various teachers should be maintained 11. Extension: (Extension is rarely granted and are only allowed in unforeseen circumstances (student’s sever sickness, death of a family member, events that beyond student’s control e.g. natural events) 12. Academic integrity: (it is the student responsibility to be aware and informed about academic integrity and unfair practices policy, it is available in the student handbook. Breaching the policy will subject the student to penalties. Examples of unacceptable behaviors include cheating, plagiarism, academic fraud) 13. Continuous Quality Improvement (CQI) Plan: This course will be reexamined in light of the feedback that will be obtained from teachers and students at the end of semester one of the academic year 2018/2019. A standardized course evaluation form will be used. it is recommended that teachers, students, and planners review the course every two years 14. Required Resources Text book: (this may include, required textbooks, references, online resources, journals, etc.) Required Textbook: Curriculum Task force (2015) – Introduction to Oman Health Care System: DGHRD, MOH Muscat, Oman. Other Reference: Material from this session is adopted from Introduction to Health Concepts of Health & Nursing Profession (2010) DGET, MOH Definition of health (1948) WHO. Retrieved from on 16th August, 2011 Carol Taylor, Carol Lillis & Priscilla LeMone (2001) Fundamentals of Nursing, (6th Ed.) Philadelphia:Lippincott Williams & Wilkins: 3-21 Ruth F.Craven& Constance J.Hirnle (2008) Fundamentals of Nursing, (6th Ed), Philadelphia: Lippincott Williams & Wilkins: 32-42 Selanders LC.(2010 ) The power of environmental adaptation: Florence Nightingale's original theory for nursing practice. Journal of Holistic Nursing.28(1). Page 5 of 79 Omar HasanKasule, Sr., “RufaidahbintSa’ad - Historical Roots of the Nursing Profession in Islam,” Islamic Medicine Forum, retrieved from: http://www.islamicmedicines.com/forum/muslims-medical-history/350-historical-roots-nursing- profession-islam.html. Ibrahim B. Syed, "Efficient Hospitals: Islamic Medicine's Contribution to Modern Medicine," Imam Reza (A.S.) Network, Retrieved from: http://www.imamreza.net/eng/imamreza.php?id=5135. Salah Zaimeche, “Al-Qayrawan (Tunisia),” Foundation for Science Technology and Civilization, Retrieved from:http://www.muslimheritage.com/uploads/Qayrawan.pdf. 1. Oman Specialized Nursing Institute 2013 brochure. 2. Students ‘handbook of Midwifery program 3. Students ‘handbook of Nephrology Nursing program 4. Students ‘handbook of Critical Care Nursing in Pediatrics & Neonatology program 5. Students ‘handbook of Adult Critical Care Nursing program 6. Students ‘handbook of Nursing Administration program 7. Students ‘handbook of Mental Health Nursing program program 8. Students ‘handbook of Infection Prevention & Control Nursing program Abdelhak M., Grostick, S., Hanken, M. A., Jacobs, E. (2001), Health Information: Management of A Strategic Resource (2ndEd.), W.B. Saunders Company, Philadelphia, USA. Green M. A., Bowe M. J. (2005), Essentials of Health Information Management: Principles and Practices, Delmar, USA. Johns, M. L. (Ed), (2011), Health Information Management Technology: An Applied Approach (3rded), AHIMA press, USA. Quoted from the course overview of the subject “Introduction to health professions” which is taught in Institute of Health Sciences for the previous groups DoniL.Bird& Debbie S.Robinson.(2005). Modern dental Assisting. St. Louis. Elsevier Saunders. Kate Kelly (2009).The History of Medicine, Early Civilization: Prehistoric Times to 500 C.E. Kate Kelly (2009).The History of Medicine, The Middle Age: 500-1450 C.E. Ministry of health educational programs available at: http://www.moh.gov.om/nv_menu.php?fNm=education/moheduprog.htm&SP=1 Pharmacy Program, the Higher College of Technology available at: http://www.hct.edu.om/college_history.asp Pharmacy Program, Oman Medical College. Available at: http://www.omc.edu.om/pharmacyprogram.htm. Page 6 of 79 Pharmacy Program, College of Nursing and Pharmacy, University of Nizwa. Available at: http://www.unizwa.edu.om/index.php?contentid=54 E- Resources 1. http://www.moh.gov.om - http://www.unicef.org/infobycountry/oman.html 2. http://www.who.int/countries/omn/en/ - http://www.icn.ch. 3. http://www.who.int/ 4. http://medical-dictionary.thefreedictionary.com 5. http://www.omancensus.net/new 6. http://www.moh.gov.om/nv_menu.php?fNm=reports/devofhelt.htm 7. http://en.wikipedia.org 8. http://www.unicef.org/infobycountry/oman.html 9. http://en.wikipedia.org/wiki/Professional 10. http://www.islamicmedicines.com/forum/muslims-medical-history/350-historical-roots- nursing-profession-islam.html 11. http://www.imamreza.net/eng/imamreza.php?id=5135 12. http://www.muslimheritage.com/uploads/Qayrawan.pdf. Ministry of health educational 13. http://www.moh.gov.om/nv_menu.php?fNm=education/moheduprog.htm&SP=1 14. http://www.hct.edu.om/college_history.asp 15. http://www.omc.edu.om/pharmacyprogram.htm. 16. http://www.unizwa.edu.om/index.php?contentid=54 Course Taskforce members (2011): Dr. Salem Al-Touby (Chairperson) (Dean, ONI) Ms. Saada Al-Barwani (ONI) Mr. Saed Al-Bimani (IHS) Dr. Mohammed Elsawi (HIS) Edited By: Amina H. Al Maskari, (INI) Prepared and Reviewed (2014): Mr. Ahmed Faraj, (Dean, SNI & NBNI) Mr. Redha Al Qubtan (Head, Foundation Program) Reviewed & Edited (2014): Ms. Amina Al Maskari Ibra NI Dr. Visitacion O. Bumalay Al Dakhiliya NI Dr. Abdullah Al Batasshi Al Dhahira NI Reviewed (July 2018) Ms. Amina Al Maskari Chairperson, Ibra NI Dr. Jeanette Ranao Perez, Member, Ibra NI Ms. Bincy M Philip, Member, Ibra NI Page 7 of 79 (Field Visit) Shared Learning Experiences I. Objectives 1. Identify the different units/departments in the Primary Health Care Settings. 2. Identify the different units/departments in the Hospital settings. 2. Discuss, understand and share learning about the structure and various functions of each department. II. Guidelines for the Field Visit Learning Experience The two field visits aims to complement students’ learning about and understanding of various health care settings. 1. Students are divided into groups of 3-6 2. Each group will visit all the departments in rotations and discuss its structure and functions. Each visit to be planned and completed within one day (3 hours of clinical visit followed by 3 hours discussion and sharing of learning) 3. Each group will have to write one ungraded report of 1-2 selected unit or department after each visit. The report can be handwritten as it is not for submission nor grading. 4. Each group will share & present the selected unit/department report after completion of both the field visits. 5. Finally and immediately following the visit (preferably on the same day), students can also compare and discuss the various units in primary health care and hospital settings through presentation and sharing of learning experience. III. The various units / departments to be visited are: a. Primary Health care setting 1. Nursing department 2. Radiology 3. Pharmacy 4. Medical laboratory 5. Dental services 6. Health information management 7. School health 8. Community outreach services Page 8 of 79 b. Hospital Health care services 1. Nursing department 2. Health information management 3. Physiotherapy 4. Medical laboratory 5. Radiography 6. Dental services 7. Pharmacy IV. The topics of discussion under each Unit / Department are: 1. Location and placement of the units/ departments under it if any 2. Staff responsibilities/scope of practice 3. Objectives 4. Services offered 5. Records and reporting system. 6. Collaboration of this unit with nursing unit Page 9 of 79 Course Calendar This calendar is to be filled by course teachers to indicate significant activities of the course e.g. in course assessment, submission of assignment, field visit, any other significant activity This table is to filled out by the concerned course teacher/coordinator at the institute level Course Title Course Code.: Section: Place and time of classes Time and venue of conducting classes Course Teacher(s) If the course is taught by more than one teacher, the name of /Coordinator: course coordinator to be added also here Office Hours: There should be specific office hour designated for each course where students can have access to course teacher(s) Office Location Specify the office number and the floor if applicable Office Phone: Specify office phone Email : Email for official use, it is advisable to have a designated email for a given course. Weekly Schedule: this includes weekly sessions, content to be covered, dates of course work (online/ offline examination and all forms of assignment (written paper, project, case study, portfolio etc.), and final examination Week # Session & number Contents to be covered Date of in-course work and of hours final exam 1 2. 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 2018 Introduction to Oman HCS AY 2018-2019.doc Page 10 of 79 TABLE OF CONTENTS Class Session I (1 Hour).............................................................................................................................................. 12 Course Overview..................................................................................................... Error! Bookmark not defined. Class Session II ( I Hour)............................................................................................................................................ 12 Introduction: Terminologies, Definitions and Concepts........................................................................................ 123 Class Session III (1 Hour)........................................................................................................................................... 17 The Health Care System in Oman......................................................................................................................... 178 Class Session IV (2hours)............................................................................................................................................ 23 The Health Care Delivery System in Oman.......................................................................................................... 234 Class session V (1 Hour)............................................................................................................................................ 35 International Health Organizations........................................................................................................................ 356 Class Session VI (1 Hour)........................................................................................................................................... 39 Introduction to professionalism and Programs Provided by Ministry of H............................................................. 40 Field Visit I ( 6 Hours)............................................................................................................................................... 43 Primary Health Care settings................................................................................................................................... 43 Clinical visit (3 Hours)................................................................................................................................................ 43 Class Session VII (1 Hour)......................................................................................................................................... 44 Introduction to Nursing Profession........................................................................................................................ 445 Class Session VIII (1 Hour)......................................................................................................................................... 49 Evolution of Post Graduate Specialty Programs ---------------------------------------------------------------------------------------------50 Class Session IX (1Hour)............................................................................................................................................ 56 Introduction to Health Information Management.................................................................................................. 567 Class Session X (1 Hour)............................................................................................................................................ 59 Introduction to physiotherapy.................................................................................................................................. 60 Class Session XI (1 Hour).......................................................................................................................................... 62 Introduction to Medical Laboratory Science......................................................................................................... 623 Class Session XII (1 Hour)......................................................................................................................................... 67 Introduction to Radiography /Medical Imaging.................................................................................................... 678 Class Session XIII (1 Hour)........................................................................................................................................ 71 Introduction to Oral Health.................................................................................................................................... 712 Class Session XIV (1 Hour)........................................................................................................................................ 74 Introduction to Pharmacy...................................................................................................................................... 745 Field Visit II (6 Hours).............................................................................................................................................. 79 Hospital Departments.............................................................................................................................................. 79 Clinical visit (3 Hours)................................................................................................................................................ 79 Report Presentations (3 Hours).................................................................................................................................... 79 2018 Introduction to Oman HCS AY 2018-2019.doc Page 11 of 79 Class Session I ( I Hour) Course Overview Class Session II ( I Hour) Introduction: Terminologies, Definitions and Concepts OBJECTIVES 1. Discuss ethos of healthcare in Islam 2. Discuss definition and concepts of related terminologies. a. Definition of health. b. Concepts of health. c. Degrees of wellness & illness 3. Discuss the following terms related to health:  Wellness Illness continuum  Concept of wellness wellbeing  Dimensions of wellness 4. Identify determinants of Health 2018 Introduction to Oman HCS AY 2018-2019.doc Page 12 of 79 Introduction: Terminologies, Definitions and Concepts Ethos of Healthcare in Islam In Islamic traditions caring is the manifestation of love for Allah and the Prophet Muhammad. Caring in Islam, however, is more than the act of empathy; instead, it consists of being responsible for, sensitive to, and concerned with that in need, namely the weak, the suffering and the outcasts of society. In short, health care is deemed as service to the patients and to Allah, as opposed to other professions that are commercial based. This ethos was the fundamental motivating factor for the majority of health services in the history of Islam. Definition of Health The World Health Organization defined health as a “state of complete physical mental and social wellbeing and not merely absence of disease or infirmity”. (WHO, 1948) "Actualization of inherent and acquired human potential through goal-directed behavior, competent self-care, and satisfying relationships with others" (Pender, 1996). From the previous definition we recognize that health is not just the absence of illness but the presence of a positive capacity to lead an energetic, satisfying and productive life. (Smith, 1983) Health, therefore, should be viewed as a state of equilibrium between human physical, biological and social environmental factors requiring constant adjustment and adaptation. (Last, 1987) ONCEPTS OF HEALTH Health is a relative not an absolute concept. Most people contrast health with illness or disease that is, a person can move from one category to the other from sick-well again in an absolute sense. So both health and illness are relative and exist in varying degrees, it is helpful to consider both in terms of a scale or continuum. Degrees of wellness and illness Wellness and illness always involve many levels (degrees). Figure 1 Figure 1: Spectrum of Health and Illness POSITIVE HEALTH BETTER HEALTH WELLNES FREEDOM FROM S SICKNESS UNRECOGNISED SICKNESS ILLNESS MILD SICKNESS SEVERE SICKNESS DEATH 2018 Introduction to Oman HCS AY 2018-2019.doc Page 13 of 79 1. Degrees of illness: A person with terminal cancer or end stage renal disease is classified as “very ill” while one recovering from a surgery (appendectomy) is “less ill “and another with infections like mononucleosis as “mildly” ill. These are examples of the degrees or levels of illness. 2. Degrees of wellness: A person with chronic arthritis may be classified as “ mildly well “ if functions minimally with his disease while an old person who is functioning at an optimal level of wellness is classified as “Well”. WELLNESS - ILLNESS CONTINUUM: The wellness illness continuum ranges from optimal health at one end of the continuum to death or total disability at the other end of the continuum The health of the individual, family, group or community moves back and forth along this continuum through the life span (Figure3). (Green and Anderson, 1986). Increasing level of Increasing level of Illness Wellness Figure 2: Wellness –Illness Continuum The above Figure shows the wellness illness continuum. The level (degree) of illness increases as one move towards total disability or death; the level of wellness increases as one moves toward optimal health. This continuum shows the relative nature of health and illness. At any given time a person can be placed at some point along the continuum. Traditionally, the majority of health care was focused on treating of acute and chronic conditions at the illness end of the continuum. Gradually the emphasis shifted to include attention to the wellness end of the continuum. Community health practice range over the entire continuum it always work to improve the degree of health in individuals, families, groups and communities in particular, community health practice emphasize the promotion and preservation of positive health and prevention of illness and disability. (Green and Anderson 1986) 2018 Introduction to Oman HCS AY 2018-2019.doc Page 14 of 79 Concept of wellness wellbeing Wellness is a state of wellbeing. It is a choice, a way of life, a process, efficient handling of energy, and integration of body, mind, and spirit, and loving acceptance of self. To realize optimal health and wellness, people must deal with the factors within each dimension. Dimensions of Wellness (Figure 3): 1. Physical - The ability to carry out daily tasks to achieve fitness by maintaining adequate nutrition, avoid using drugs and alcohol or using tobacco. 2. Emotional - The ability to manage stress and to express feelings or emotions appropriately. It is the ability to recognize, accept, and express feelings and to accept one’s limitation. 3. Social - The ability to interact successfully with people as a whole and within the environment of each person as part. 4. Intellectual - The ability to learn and use information effectively for personal, family, and career development. 5. Spiritual - Person’s own morals, values and ethics or the religious beliefs of an individual. Figure 3: Dimensions of Wellness 2018 Introduction to Oman HCS AY 2018-2019.doc Page 15 of 79 DETERMINANTS OF HEALTH Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact. The determinants of health include: The contexts of people’s lives determine their health, and so blaming individuals for having poor health or crediting them for good health is inappropriate. Individuals are unlikely to be able to directly control many of the determinants of health. These determinants—or things that make people healthy or not—include the following factors, and many others: a. the social and economic environment, b. the physical environment, and c. the person’s individual characteristics and behaviors References Material from this session is adopted from INTRODUCTION TO HEALTH Concepts of Health & Nursing Profession (2010) DGET, MOH Definition of health (1948) WHO. Retrieved from, http://www.who.int/ on 16th August, 2011 2018 Introduction to Oman HCS AY 2018-2019.doc Page 16 of 79 Class Session III (1 Hour) The Health Care System in Oman OBJECTIVES 1. Define health care system 2. Discuss the health care system in Oman 3. Identify the structure of the Ministry of Health 4. Identify categories of Health Care Providers in the Ministry of Health 2018 Introduction to Oman HCS AY 2018-2019.doc Page 17 of 79 The Health Care System in Oman Definition of health care system “Health care system is a term usually used to refer to the system or program by which health care is made available to the population and financed by government, private enterprise, or both. In a larger sense, the elements of a health care system embrace the following: 1. Personal health care services for individuals and families, available at hospitals, clinics, neighborhood centers, and similar agencies, in physicians' offices, and in the clients' own homes; 2. The public health services needed to maintain a healthy environment, such as control of water and food supplies, regulation of drugs, and safety regulations intended to protect a given population; 3. Teaching and research activities related to the prevention, detection, and treatment of disease; and 4. Third party (health insurance) coverage of system services.” (Saunders, 2007) Health Care system in Oman Since 1970 and after the Omani Renaissance, His Majesty Sultan Qaboos Bin Said has always emphasized the importance of health in social and economic development. This has stimulated the Government to realize the potential returns from investments in health. Improved health would contribute to economic growth by reducing production losses because of workers' illness, increasing enrollment and achievements of school children who form the basis for the developing population, and freeing, for alternative uses, resources that would otherwise have to be spent on treating patients. Therefore, the Government made a commitment to develop a modern welfare state, including promotion of health of the Omani people. A Royal Decree was issued to establish the Ministry of Health (MOH) in August 1970. Since then, the MOH was able to build from scratch a modern national system that offers all Omani citizens universally accessible health services free of charge. Such developments were only possible through proper health planning and therefore the MOH developed Five-Year plans, the first of which started in 1976. The Ministry of Health (MOH) is responsible for ensuring the availability of health care to the people of Oman. In course of implementing its health development plans, the Ministry’s organization had to be adapted in tune with the strategies and objectives that were crystallized during 1990. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 18 of 79 Strategies and Objectives of Health Care System in Oman 1. Regionalization of health services and decentralization of decision making in specified technical, administrative and financial affairs. 2. Emphasizing the role and importance of planning. 3. Development of Education and Training in health. 4. Emphasizing the importance of health systems research. 5. Emphasizing the importance of regional and international relation The Structure of the Ministry of Health His Excellency the Minister of Health is assisted by three Undersecretaries respectively for Planning Affairs, Health Affairs, and Administrative & Financial Affairs. A number of Directorates-General and Directorates come under each of the Offices of the Undersecretaries. The Minister is also assisted by a number of advisors and consultants, in addition to Directorate General of Internal Audit, the Directorates General of Legal Affairs, the Directorate General of Royal Hospital, the Directorate General of Quality Assurance Center and a number of Directorates that are linked directly with the office of HE, the Minister such as Directorate of Public Relations, International Relations etc. Royal Decree # 36/2014- Official Gazette 1064)) 2018 Introduction to Oman HCS AY 2018-2019.doc Page 19 of 79 2018 Introduction to Oman HCS AY 2018-2019.doc Page 20 of 79 2018 Introduction to Oman HCS AY 2018-2019.doc Page 21 of 79 HEALTH CARE PROVIDERS Health care services is provided by different health care providers who work together as a team. Each member in the health care team has specific roles and responsibilities.. 1. Physicians have various specialties for examples , surgeon, anesthesiologist ,gynecologist and urologist 2. Nurses and Midwives 3. Radiographers 4. Physiotherapists 5. Laboratory Technicians 6. Dental Surgeon Assistance 7. Pharmacists 8. Dietitians 9. Occupational therapists 10. Medical Record Technicians 11. Prosthetists Reference Material from this session is adopted from INTRODUCTION TO HEALTH Concepts of Health & Nursing Profession (2010) DGET, MOH MOH organizational structure (2011) retrieved from http://www.moh.gov.om/ on 16th August 2011 Saunders Comprehensive Veterinary Dictionary (2007) 3rd Ed: Elsevier retrieved from http://medical-dictionary.thefreedictionary.com/ on 17th August 2011 2018 Introduction to Oman HCS AY 2018-2019.doc Page 22 of 79 Class Session IV (2hours) The Health Care Delivery System in Oman OBJECTIVES 1. Discuss the geographical features of Oman 2. List the categories of the health care delivery system in Oman. a. Identify the Policy of the MOH b. State the functions of the MOH 3. Discuss the levels of care provided by Oman health care institutions 4. Identify the health care delivery facilities in Oman. a. Differentiate between Regional Referral Hospital, Health Center and Extended Health Center. b. Names of and services provided by various hospitals. 1) National Referral Hospital 2) Regional Referral Hospital c. Names and the functions of Extended Health Centers. d. Names and functions of other government sectors' hospitals. e. Private sectors hospitals 2018 Introduction to Oman HCS AY 2018-2019.doc Page 23 of 79 The Health Care Delivery System in Oman GEOGRAPHICAL FEATURES Regions and Governorates of Sultanate of Oman The Sultanate of Oman lies on the south east corner of the Arabian Peninsula between latitudes 16˚40' and 26˚-20' north and longitudes 51˚50', and 59˚40' east. Its coast runs to a distance of 3,165 km from the Strait of Hormuz in the north to the borders of the Republic of Yemen, thus overlooking three seas, the Arabian Gulf, the Gulf of Oman and the Arabian Sea.http://www.omanet.om/english/geo/map.asp It is bordered to the west by United Arab Emirates and the Kingdom of Saudi Arabia, to South by the Republic of Yemen, the Strait of Hormuz to the North and the Arabian Sea to the East. The Sultanate occupies a total area of about (309,500) square kms and includes different terrains that vary front plain, to highlands and mountains. The coastal plain overlooking the Gulf of Oman and the Arabian Sea forms the most important plain of Oman, the area of which amounts to 3% of the total landmass. The coastline of Oman starts from the north to the south stretching to an average of about 1700 kilometers while the mountain make up 15% or the total area, paramount among which are two ranges: Al Hajr mountains which stretches in the form of an area from Ras Musandam in the north to Ras Al Had. The second is Al Qara mountain range situated in the far side of south west of Oman. Sand and desert cover the greatest area as they represent approximately 82% of the total area: most of it is the Empty Quarter. The Sultanate's climate varies from one area to another. In the coastal areas we find a hot and humid weather in summer while it is hot and dry in the interior, except for some high areas as the weather is moderate over the whole year. In the southern area the weather is more moderate. Rain in Oman is scarce and irregular. However, sometimes heavy rainfall is also reported. Governorate of Dhofar is an exception, where heavy and regular rain is registered from June to October due to monsoon. Government Administratively, Oman is divided into eleven governorates with 61 wilayates (administrative districts) (), presided over by appointed executives (Walis) responsible for settling local disputes, collecting taxes, and maintaining peace. Most wilayates are small in area, but can vary considerably in population. —The 11 governorates are (Muscat Governorate, Dhofar Governorate, Musandam Governorate, Al-Buraimi Governorate, Al Dakhliya Governorate, North Al Batinah Goveronorate, South Al Batinah Governorate, South Al Shariqiya Governorate, North Al Shariqiya Governorate and Al Wusta Governorate and Al Dhahirah Governorate) The governors of those governorates are appointed directly by the Sultan and hold a Minister of State or Under Secretary rank. Moreover, Walis are appointed by the Minister of Interior. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 24 of 79 CENSUS OF SULTANATE OF OMAN The Ministry of National Economy estimated the population according to the National Census as follows: Year Total population Omani Expatriate 2016 4,414,000 2,428,000 1,986,000 2015 4,159,000 2,345,000 1,814,000 2014 3,992,893 2,260,705 1,732,188 2012 3,623,001 2,092,560 1,530,441 Life expectancy at birth Year Total population Male Female 2016 76.9 74.7 79.3 2015 76.4 74.2 78.8 2014 76.6 74.8 78.5 2012 76.2 years 74.5 years 74.3 years Source: Annual Health Report (2016): Directorate General of Health Planning, MOH THE HEALTH CARE DELIVERY SYSTEM The Health Care Delivery System is divided into three categories. These are: 1. Health institutions run by the Ministry of Health. 2. Health institutions run by other government sectors. 3. Health institutions run by private sectors. NATIONAL HEALTH POLICY OF THE MINISTRY OF HEALTH National Health Policy of MOH In the light of the health situation analysis in the Sultanate, the achievements of the previous health plans and the existing problems and difficulties, the national health policy for the years 2011-2015 was formulated as under: A. The work and activities of Ministry of Health and other health-related agencies are directed for achieving the following goals: 2018 Introduction to Oman HCS AY 2018-2019.doc Page 25 of 79 1. Make available primary and specialized health care to all people Reduce of mortality and morbidity rates of different diseases with to attain health indicators similar to that of the developed countries 2. Taking preventive measures infectious and parasitic diseases aiming at eradication especially among children and school pupils 3. Applying the latest methods for the prevention, early case finding and prompt treatment of chronic diseases to control complication. 4. Provide health care for the elderly and handicapped 5. Provide preventive measures and treatment to all types of injury 6. Develop and train Omani workforce in all health professional categories to improve Omanization levels 7. Develop information technology and facilitate access to information B. Pursuing the following directives: 1. Primary care is the first and basic entry for all levels of health care 2. Ensure quality of health services 3. Equity in distribution, accessibility and acceptability of all services 4. Gradually promote community involvement in all health activities 5. Ensure good and complete coordination among all health care providers 6. Reduce wastage in material and human resources for health 7. Gradual delegation of authority and responsibility to the Wilayat level 8. Promote effective participation of private sector in health C. Attention, formulation and implementing plan for the following priorities 1. Promotion of primary health care services and ensuring its quality 2. Prevention and control of non-communicable diseases, accidents and causes of morbidities, mortalities, and disabilities 3. Development maternal health and reduce childhood morbidity and mortality 4. Promote the decentralization policy and hospital autonomy 5. Promote the health awareness of the community and establish a culture of healthy lifestyle Reference: https://www.moh.gov.om/en_US/national-health-policy 2018 Introduction to Oman HCS AY 2018-2019.doc Page 26 of 79 ‫‪FUNCTIONS OF THE MINISTRY OF HEALTH‬‬ ‫‪The functions of the Ministry are summarized as follows:‬‬ ‫اختصاصات وزارة الصحة‬ ‫‪ )1‬إعداد السياسات الصحية في إطار السياسة العامة للدولة‪ ،‬ومتابعة تنفيذها بعد إقرارها‬ ‫من مجلس الوزراء‪.‬‬ ‫‪ )2‬التخطيط اإلستراتيجي إلدارة وتوجيه تقديم الخدمات الصحية في إطار الخطط الوطنية‬ ‫للتنمية‪ ،‬بما فيها المشروعات اإلنمائية والبرامج الصحية وغيرها ومتابعة تنفيذها‬ ‫وتقييمها‪.‬‬ ‫‪ )3‬تقديم الخدمات الصحية بجميع أوجهها الوقائية والعالجية لكافة المواطنين وأسرهم‪،‬‬ ‫والمقيمين على أرض السلطنة وذلك وفقا للقوانين واللوائح والقرارات المنظمة لذلك‪.‬‬ ‫‪ )4‬اتخاذ ما يلزم بالوسائل العلمية الحديثة للوقاية من األمراض سواء أكانت األمراض‬ ‫المعدية أو غير المعدية‪.‬‬ ‫‪ )5‬منح تراخيص مزاولة المهن الطبية والطبية المساعدة والصيدلة‪ ،‬وتنظيم ومراقبة‬ ‫أدائها‪ ،‬وذلك وفقا ألحكام القوانين واللوائح والقرارات المتعلقة بذلك‪.‬‬ ‫‪ )6‬التخطيط لتنمية الموارد البشرية في المجال الصحي في إطار سياسة التنمية البشرية في‬ ‫الدولة‪ ،‬بما في ذلك وضح استراتيجية وطنية للتعليم الصحي بهدف تحقيق االكتفاء‬ ‫الذاتي من الفئات الطبية المساعدة العامة والتخصصية في مختلف المجاالت الصحية‪.‬‬ ‫‪ )7‬توفير المعلومات واإلحصاءات الصحية‪ ،‬والقيام بالدراسات والبحوث في المجاالت‬ ‫الصحية المختلفة بما يخدم عمليات اتخاذ القرارات والتخطيط والمتابعة والتقييم‪.‬‬ ‫‪ )8‬إعداد برامج التدريب والتأهيل للفئات الطبية والطبية المساعدة وسائر الموظفين‬ ‫العمانيين العاملين في الوزارة للنهوض بمستواهم علميا ومهنيا‪.‬‬ ‫‪ )9‬التعاون مع المؤسسات التعليمية الصحية بالسلطنة في تدريب خريجيها بالمستشفيات‬ ‫التابعة لوزارة الصحة‪.‬‬ ‫العمل على توفير األدوية واتخاذ اإلجراءات الالزمة لضمان جودتها‪.‬‬ ‫‪)10‬‬ ‫مراقبة تصنيع واستيراد وتداول األدوية وإصدار التراخيص‪ ،‬وذلك وفقا ألحكام‬ ‫‪)11‬‬ ‫القوانين واللوائح والقرارات المنظمة لذلك‪.‬‬ ‫‪2018 Introduction to Oman HCS AY 2018-2019.doc‬‬ ‫‪Page 27 of 79‬‬ ‫تشجيع القطاع الخاص على المساهمة في دعم الخدمات الصحية‪ ،‬وإصدار‬ ‫‪)12‬‬ ‫التراخيص إلنشاء المؤسسات الصحية الخاصة‪ ،‬وذلك وفقا ألحكام القوانين واللوائح‬ ‫والقرارات المنظمة لذلك‪.‬‬ ‫نشر الوعي الصحي في المجتمع‪ ،‬وتشجيع أفراده على المشاركة في تعزيز‬ ‫‪)13‬‬ ‫وصون صحتهم‪.‬‬ ‫التعاون مع الوزارات والجهات المعنية في األمور ذات العالقة بالصحة ‪،‬‬ ‫‪)14‬‬ ‫وخاصة المتعلقة بالبيئة والمواصفات الغذائية وسالمتها وغيرها‪.‬‬ ‫العمل على تنمية العالقات مع الدول األخرى الخليجية والعربية واألجنبية ‪،‬‬ ‫‪)15‬‬ ‫وكذلك المنظمات الدولية في المجاالت الصحية المختلفة‪ ،‬والتعاون معها بالتنسيق مع‬ ‫وزارة الخارجية لتحسين الحالة الصحية محليا وإقليميا وعالميا‪.‬‬ ‫تنظيم عق د المؤتمرات الصحية داخل السلطنة‪ ،‬وتمثيل السلطنة في المؤتمرات‬ ‫‪)16‬‬ ‫والمناسبات المتعلقة بالصحة‪ ،‬وحضور اجتماعات المنظمات الصحية في الخارج‪.‬‬ ‫تنظيم فعاليات التعليم والتطوير المهني المستمر من خالل الندوات وحلقات‬ ‫‪)17‬‬ ‫العمل واللقاءات العلمية واأليام الصحية وغيرها من الفعاليات ذات الطابع التطويري ‪،‬‬ ‫وتعزيز قدرات الكوادر العاملة في الوزارة‪.‬‬ ‫متابعة التطورات واإلنجازات الصحية‪ ،‬وما يستجد من وقائع في البيئة الصحية‬ ‫‪)18‬‬ ‫الدولية‪ ،‬واتخاذ التدابير المناسبة لمواكبة التطور أو مواجهة االحتماالت‪.‬‬ ‫تعزيز االلتزام بأخالقيات المهنة ‪ ،‬وذلك طبقا للقوانين المنظمة للعمل الصحي‪.‬‬ ‫‪)19‬‬ ‫إعداد مشروعات القوانين واللوائح الالزمة لتنفيذ هذه االختصاصات‬ ‫‪)20‬‬ ‫المرجع‪ :‬الجريدة الرسمية العدد (‪ – )1064‬مرسوم سلطاني رقم ‪2014/36‬م‪.‬‬ ‫‪2018 Introduction to Oman HCS AY 2018-2019.doc‬‬ ‫‪Page 28 of 79‬‬ Duties/Responsibilities of the Ministry of Health/ Functions of the Ministry of Health 1) Prepare health policies within the framework of the general policy of the country and follow up their implementation, after the approval of the Cabinet/Council of Ministers. 2) Set a strategic plan for the management and guidance of the provision of health services within the framework of the national development plans, including developmental projects, health programs, and others and follow-up implementation and evaluation. 3) Provide health services in all its forms, preventive and curative, to all citizens and their families and expatriates, in accordance with the laws, regulations and decisions governing them. 4) Take the latest necessary scientific measures to prevent diseases, whether infectious or non- communicable diseases. (5) Grant licenses for practicing medical professions, assistant medical professions, and pharmacy and regulate and monitor their performance in accordance with the laws, regulations and decisions relating to them. 6) Plan for the development of human resources in the medical field within the framework of the human development policy in the country, including setting a national strategy for health education in order to achieve self-sufficiency of the assistant medical professionals, general and specialized, in various medical areas. 7) Provide medical information and medical statistics, and carry out studies and research in the various medical fields to serve decision-making, planning, monitoring and evaluation. 8) Prepare training and rehabilitation programs for medical professionals, assistant medical professionals, and all other Omani employees working in the Ministry to enhance their performance at the scientific and professional levels. 9) Cooperate with the health education institutions in the Sultanate in training its graduates in hospitals run by the Ministry of Health. 10) Provide medicines and take the necessary measures to ensure their quality. 11) Monitor and control the manufacturing, importing, and circulation of medicines and the issuance of licenses, in accordance with the laws, regulations and decisions governing them. 12) Encourage the private sector to contribute to the support of health services and issue licenses for the establishment of private health institutions, in accordance with the laws, regulations and decisions governing them. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 29 of 79 13) Spread health awareness in the community and encourage its members to participate foster and maintain their well-being. 14) Cooperate with ministries and other authorities concerned in matters related to health, especially those related to the environment, diet specifications and safety …etc. 15) Develop relations with other Gulf, Arab and foreign countries, as well as international organizations in various health fields, and cooperate with them in coordination with the Ministry of Foreign Affairs to improve the health status locally, regionally and globally. 16) Organize health conferences in the Sultanate, represent the Sultanate in conferences and events related to health, and attend meetings of health organizations abroad. 17) Organize activities of lifelong education and professional development through seminars, workshops, scientific meetings, health days and other events of a developmental nature, and strengthening the capabilities of the working staff in the ministry. 18) Follow up health developments and achievements, and the latest developments in the international health environment, and take appropriate measures to cope with development or face all possibilities. 19) Reinforce the commitment to the ethics of the profession, in accordance with the laws governing health work. 20) Prepare draft laws and regulations which are necessary to implement these terms of reference. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 30 of 79 Types of Ministry of Health Institutions The Ministry of Health Institutions has increased from 2 hospitals and 9 clinics in 1970 to 49 hospitals and 167 health centers in the year of 2008. These health institutions are distributed throughout the country so that health care facilities are within the reach of every one. These health institutions provide three levels of health care: 1. Primary health care. This is a basic level of health care that includes programs directed at the promotion of health, early diagnosis of disease or disability, and prevention of diseases. 2. Secondary health care. This refers to an intermediate level of health care where specialist facilities are available to deal with complex health problems referred from primary level. This care comprises of essential curative services. 3. Tertiary health care. This refers to super specialist care which is provided by the regional or central level institute and supports and compliments the action carried out at the primary and secondary levels. The types of Health services run by the MOH may be broadly described as under the Hospitals: Regional Referral Hospital: A Hospital that provides secondary and tertiary cares to inhabitants of the health region in which it is located. It is usually built in the center of a health region and is considered as a referral hospital for critical cases from other hospitals and health centers of the health region. These hospitals are Sultan Qaboos Hospital in Dhofar, Ibra, Al-Dhakhliya, Rustaq, Sohar and Ibri. National Referral Hospital: Regional hospitals of the Muscat Governorate act as national referral hospitals for critical cases from other regional hospitals. These are the Royal Hospital (Internal medicine, surgical, cancer and cardiology), Al Nahdha Hospital (Ophthalmology, Ear, Nose, and Throat & dermatology), Khoula Hospital (mainly orthopedic cases and reconstructive surgeries) and Ibn- Sina Hospital (Psychiatry specialty). 2018 Introduction to Oman HCS AY 2018-2019.doc Page 31 of 79 FUNCTIONS OF REFERRAL HOSPITALS Most regional referral hospitals provide secondary and some degree of tertiary health care services and are supported by highly specialized tertiary hospitals situated in Muscat Governorate. These are Royal Hospital, Khoula Hospital and Al- Nahdha Hospital. The following are specialties provided in referral hospitals: 1. Internal Medicine, inclusive of Nephrology and cardiology. 2. Dermatology. 3. Psychiatry. 4. Child health/Pediatrics. 5. Obstetrics and Gynecology. 6. General Surgery and Urology. 7. Ophthalmology. 8. Ear, Nose, and Throat. 9. Orthopedics. 10. Accidents and Emergency. 11. Oral Health including Dentistry. 12. Physiotherapy & Rehabilitation. National Referral Hospitals (Muscat Region) Name of Hospital Specialty 1 Royal Hospital Highly specialized and largest hospital in Oman. It provides secondary and tertiary health care for internal medicine, pediatrics, obstetrics and gynecology, and general surgery. 2 Khoula Hospital Highly specialized hospital in Trauma, orthopedics, neurosurgery and, Burns and plastic surgery. 3 Al Nahdha Hospital Specialized in Dermatology, Ophthalmology, Ear, Nose, and Throat, Oral Health including Dentistry. It also provides Primary Health Care. 4 Al Massrah Hospital Provides mental health services. (Psychiatry) Wilayat Hospital: A hospital the provides both primary and secondary health care to inhabitants of the wilayat in which it is located and those of nearby wilayates like Sumail and Saham Hospitals Local Hospital: A small hospital that provides primary health care services to inhabitants in nearby villages. In addition, it provides inpatient services to those patients who are in need for continuous medical care and/ or observation. Such as WadiHeebi and WadiBani Omar 2018 Introduction to Oman HCS AY 2018-2019.doc Page 32 of 79 Regional Referral Hospitals Governorate Name of the Hospital Dhofar Sultan Qaboos Hospital Ad Dakhiliyah Nizwa Hospital North Ash Sharqiyah Ibra Hospital South Ash Sharqiyah Sur Hospital North Al Batinah Sohar Hospital South Al-Batinah Al Rustaq Hospital AdhDhahirah Ibri Hospital Al Buraimi Al Buraimi Hospital Musandam Khasab Hospital Al Wusta Haima Hospital Health Centers: 1. Health Center: A health center provides primary health care to the people in the surrounding catchment area or community. 2. Health Center with beds: A health center provides primary health care services and is equipped with a number of beds. These beds are used as maternity beds (and/ or observation beds). These health centers are also equipped with a delivery suite and a delivery table. Such health centers serve people in the catchment area. 3. Extended Health Center: A health center provides primary health care services and in addition there are some specialized outpatient clinics in different specialties. They serve the people in the catchment area. They do not have inpatient services. FUNCTIONS OF EXTENDED HEALTH CENTERS Generally the function of Extended Health Centers is to provide Primary Health Care on the following specialties. 1. General Practitioner Clinics (Medical/surgical). 2. Dermatology. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 33 of 79 OTHER GOVERNMENT (NON- MINISTRY OF HEALTH) HEALTH CARE INSTITUTIONS According to MOH 2008 Annual Report there are other organizations that provide health care beside Ministry of Health institutions. The Sultan Qaboos University Hospital is a highly specialized referral and teaching hospital which provides secondary and tertiary health care. The Diwan Medical Services and the Ministry of Defense (MOD) runs Armed Forces Medical Services for its employees and dependents. There are three (3) hospitals run by MOD providing primary and secondary health care. The Royal Oman Police Hospital and Petroleum Development Oman (PDO) provide healthcare serves to employees and their dependents. The services provided by this hospital are mainly primary and secondary health care. PRIVATE HEALTH CARE INSTITUTIONS According to MOH 2014 Annual Health Report there are 13 private hospitals, 334 general clinics, 224 specialized clinics and polyclinics, 225 dental clinics and 64 Chinese and Indian clinics. The number of private pharmacies is 550 in 2014.(Oman Census, 2014). References Material from this session is adopted from INTRODUCTION TO HEALTH Concepts of Health & Nursing Profession (2010) DGET, MOH Annual Health Report (2014) Department of Information & Statistics, Directorate General Of Planning, Ministry of Health, Oman. Retrieved from http://www.moh.gov.om/, on 14th July, 2016 Oman Census (2010) retrieved from http://www.omancensus.net/new/ on 15 August, 2011 Mortality Indicator, Oman Retrieved from: http://www.moh.gov.om/nv_menu.php?fNm=reports/devofhelt.htm, on17th August 2011 2018 Introduction to Oman HCS AY 2018-2019.doc Page 34 of 79 Class session V (1 Hour) International Health Organizations OBJECTIVES 1. Describe the Function of WHO 2. Describe the following International health organizations responsibilities/activities both internationally and in Oman a. World Health Organization (WHO) and The Eastern Mediterranean Regional Office (EMRO) of WHO b. UNICEF 2018 Introduction to Oman HCS AY 2018-2019.doc Page 35 of 79 INTERNATIONAL HEALTH ORGANIZATIONS WORLD HEALTH ORGANIZATION (WHO) The World Health Organization (WHO) is a specialized agency of the United Nation (UN) that acts as a coordinating authority on international public health. WHO was founded in 1948. It is a specialized agency of the United Nations with 191 member states, and de-centralized into six regions namely, African region, region of the Americas, South East Asian region, European region, Western Pacific region and Eastern Mediterranean region. Oman comes under Eastern Mediterranean Region (EMR). The WHO headquarters is in Geneva, and the regional headquarters is in Cairo (Egypt). Functions of WHO The WHO's constitution states that its objective "is the attainment by all people of the highest possible level of health. WHO promotes technical cooperation for health among nations, carries out programs to control and eradicate diseases and strives to improve the quality of human life. WHO has four main leadership functions:  To give worldwide guidance in the field of health  To set global standards for health  To cooperate with governments in strengthening national health policies and programs  To develop and promote the rational use of appropriate health technology, information and standards Activities of WHO “The WHO is involved in various activities for members worldwide. Examples of these activities include:  Control outbreaks of infectious disease, such as SARS, malaria, tuberculosis, influenza, and HIV/AIDS,  Support and sponsors programs to prevent and treat such diseases.  Supports the development and distribution of safe and effective vaccines, pharmaceutical diagnostics, and drugs, such as through the Expanded Program on Immunization.  Develops and promotes the use of evidence-based tools, norms and standards to support Member States to inform health policy options. It oversees the implementation of the International Health Regulations, and publishes a series of medical classifications such as the International Statistical Classification of Diseases (ICD).  Publish a World Health Report including an expert assessment of a specific global health topic. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 36 of 79  Carry out health-related campaigns – for example, to boost the consumption of fruits and vegetables worldwide and to discourage tobacco use. Each year, the organization marks World Health Day focusing on a specific health promotion topic.  Conductor support health research in many areas such as: communicable diseases, reproductive health, non-communicable conditions injuries and health policy”. (Wikipedia, 2011) UNICEF (United Nations Children's Fund or originally the United Nations International Children's Emergency Fund) is an agency devoted to the welfare of children and cooperates with the World Health Organization in immunization programs. UNICEF was established in 1946 and currently has over 200 offices in 115 developing countries. The current focus is on establishing long-term human development and on providing emergency relief and rehabilitation assistance when needed UNICEF Oman has the following main responsibilities:  contributes to building the capacity of health professionals  Supports the training of youth leaders and counselors on HIV/AIDS and sexually transmitted infections.  UNICEF has played a very effective role in finalizing the review and enhancement of the draft Juvenile Law.  Vitamin A supplementation continues to be an integral part of the regular Expanded Program on Immunization and UNICEF continues to facilitate the provision of free Vitamin A capsules for Oman as part of the Global Alliance on Vaccines and Immunization.  UNICEF also contributes to national capacity building in the area of educational planning.  UNICEF is advocating for the adoption of minimum standards for pre-schools with a clear quality assurance and control role for the government. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 37 of 79 WORLD HEALTH ORGANIZATION (WHO) ANNUAL EVENTS The World Health Organization (WHO) celebrates annually different occasions that deem important to promote awareness among people of the world. In addition to that each year WHO makes a theme raising awareness and emphasizing on a particular disease or practice. Some these even include:  World Health Day: 7 April  World Diabetes Day: 14 November  World AIDS Day: 1 December References Material from this session is adopted from INTRODUCTION TO HEALTH Concepts of Health & Nursing Profession (2010) DGET, MOH Wikipedia: World Health Organization retrieved from: http://en.wikipedia.org/wiki/World_Health_Organization. On 22 August, 2011 UNICEF, Oman: retrieved fromhttp://www.unicef.org/infobycountry/oman.html On 22 August, 2011 2018 Introduction to Oman HCS AY 2018-2019.doc Page 38 of 79 Class Session VI (1 Hour) Introduction to professionalism and Programs Provided by Ministry of Health OBJECTIVES: 1. Define the term profession and professional 2. Describe criteria for professionals 3. Discuss the role of DGHR ( Director General of Human Resources), MOH in promoting professionalism 2018 Introduction to Oman HCS AY 2018-2019.doc Page 39 of 79 Introduction to professionalism and Programs Provided by Ministry of Health Definition of Profession and Professional A profession is a vocation founded upon specialized educational training. It is a specialized body of knowledge gained through education & training and provide a unique service to others. A professional the word professional traditionally means a person who has obtained a degree in a professional field. Examples of professions include: medicine, law and engineering. Health care providers working in close contact with clients have in general common professional roles which include: caregiver, communicator, teacher and counselor. (Wikipedia, 2011) Main criteria of professionals include the following:  Possesses a well-defined and well organized body of knowledge.  Expert and specialized knowledge in field which one is practicing.  Enlarges the body of knowledge and improves its techniques by use of scientific method  Functions autonomously in the formulation of professional policy and standards in control of professional activity  Members are committed toward work as a life-time pursuit  Has developed within the group a code of ethics  Practitioners must be motivated by altruism (a desire to help others) The role of DGHR, MOH in promoting professionalism The ministry of health recognizes manpower as a key resource in the health care system and emphasizes the need to optimize its planning, production and management. In order to ensure that human resources development helps in achieving and sustaining the highest possible level of health for its people. The Ministry of Health attaches significant importance to human resource development and promotion professionalism. The ministry considers education and training as the key strategy for achieving self-sufficiency in health care human resources. The Directorate General of Human Resources (DGHR) is responsible to educate and train qualified health professionals and to strengthen the ministry employees' performances to deliver a high quality care. This is achieved by identifying the ministry needs of qualified workforce, and set plans, strategies and polices in the field of education, training, scholarships, continuing 2018 Introduction to Oman HCS AY 2018-2019.doc Page 40 of 79 education and library and learning resources. DGHR provides high standard education and training to meet the health needs and expectations of the society by offering innovative educational programs, continuing professional education, scholarship and research that promote lifelong learning. Below is a table showing the name of the different health institutes currently run by the Ministry of Health and the types of programs/ professions each of them runs. MINISTRY OF HEALTH TRAINING INSTITUTIONS Sr. # Name of Institute Programs Offered 1 Institute of Health Sciences (IHS) Medical Laboratory Sciences Diagnostic Radiography Medical imaging (BSc) Physiotherapy Dental surgery Assistant Oral Health (BSc) Baccalaureate degrees 2 Oman Assistant Pharmacy Institute (OAPI) Assistant Pharmacy Technician Pharmacy (BSc) 3 Oman Health Information Management Health Information Institute (OHIMI) Management 4 *Nursing Institutes around the Country Basic Nursing Diploma BS in Nursing 5 Oman Specialized Nursing Institute (OSNI) – Nephrology Nursing Post Graduate Specialty programs Pediatric Critical Care Midwifery Nursing Administration Mental Health Nursing Critical Care Nursing (Adult) Infection Prevention & Control Community Health Baccalaureate program in Nursing 2018 Introduction to Oman HCS AY 2018-2019.doc Page 41 of 79 The advancement in health care systems involves upgrading of the basic diploma programs to under graduate programs that award Bachelor Degrees in respective specialties. The next four sessions discuss the basic programs run by the the MoH Educational Institutes and go through the common Foundation program: these programs are as follow:  Nursing Program run by Nursing Institutes  Medical Laboratory Sciences, Diagnostic Radiography/Medical Imaging. Physiotherapy. Dental surgery Assistant/Oral Health, run by IHS  Health Information Management run by OHIMI  Pharmacy Program run by OAPI References Material from this session is adopted from INTRODUCTION TO HEALTH Concepts of Health & Nursing Profession (2010) DGET, MOH MOH organizational structure (2014) retrieved from: https://www.moh.gov.om/en/-3on 14th July 2016 Wikipedia (2011). Professionalism, Retrieved from: http://en.wikipedia.org/wiki/Professional, on 22 August, 2011 2018 Introduction to Oman HCS AY 2018-2019.doc Page 42 of 79 Field Visit I ( 6 Hours) Primary Health Care settings Objectives 1. Identify the different units/departments in the Primary Health Care settings. 2. Discuss and understand the structure and various functions of each department. Clinical visit (3 Hours) Report Presentation (3 Hours) 2018 Introduction to Oman HCS AY 2018-2019.doc Page 43 of 79 Class Session VII (1 Hour) Introduction to Nursing Profession Malathi Natarajan. MSN, RN, RM Nurse Trainer, ONI, MOH OBJECTIVES 1. Define the term Nursing. 2. Discuss the aims of a Nursing profession. 3. Describe the Roles and responsibilities of Nurses. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 44 of 79 Introduction to Nursing Profession Introduction Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death. Nursing is both art and science. The science of nursing is the knowledge base for the care that is given, and the art of nursing is the skilled application of that knowledge to help others reach maximum health and quality of life. Definitions of Nursing The word Nurse originated from the Latin word nutrix, meaning nourish. Most definitions of nurse and nursing describe the nurse as a person who nourishes, fosters, and protects; a person prepared to take care of sick, injured, and aged people (Basavanthappa, 2003). Nursing is a multifaceted profession evidenced by the following is different definitions for the profession of Nursing:  International Council of Nurses The following definition was written by Virginia Henderson and adopted by the International Council of Nurses (ICN) in 1973: The unique function of nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery that he would perform unaided if he had necessary strength, will or knowledge and to do this in such a way as to help him gain independence as rapidly as possible.  Florence Nightingale “The act of utilizing the environment of the client to assist him in his recovery” (Nightingale, 1859/1992)  The American Nurses Association (ANA) “Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human responses; and advocacy in health care for individuals, families, communities, and populations” (ANA, 2004) 2018 Introduction to Oman HCS AY 2018-2019.doc Page 45 of 79 Nursing as a profession Nursing is gaining recognition as a profession (i.e., more than a job or occupation) based on the criteria shared by all professions:  A well-defined body or knowledge  A strong service oriented  Recognized authority by a professional group  A code of ethics  A professional organization that sets standards  Ongoing research  Autonomy Aims of Nursing Profession Four broad aims of nursing practice can be identified in the definitions of nursing:  To promote health  To prevent illness  To restore health  To facilitate coping To meet these aims, the nurse uses knowledge, skills, and critical thinking to give care in a Variety of traditional and expanding nursing roles. To provide knowledgeable care, the nurse uses cognitive, technical, interpersonal, and ethical /legal competencies essential to nursing practice. Nursing Roles and Responsibilities. Caregiver The provision of care to patients that combines both the art and the science of nursing in meeting physical, emotional, intellectual social cultural, and spiritual needs. Communicator The use of effective interpersonal and therapeutic communication skills to establish and maintain helping relationships with patients of all ages in a wide variety of health care settings. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 46 of 79 Teacher The use of communication skills to assess, implement, and evaluate individualized teaching plans to meet learning needs of patients and their families. Counselor The use of therapeutic interpersonal communication skills to provide information, make appropriate referrals, and facilitate patients problem solving and decision making skills. Leader The assertive, self-confident practice of nursing when proving care, efficient change, and functioning with groups. Researcher The participation in or conduct of research to increase knowledge in nursing and improve patient acre. Advocate The protection of human or legal rights and securing of care for all patients based on the belief that patients have the right to make informed decision about their own health and lives. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 47 of 79 References Material from this session is adopted from INTRODUCTION TO HEALTH Concepts of Health & Nursing Profession (2010) DGET, MOH Carol Taylor, Carol Lillis & Priscilla LeMone (2001) Fundamentals of Nursing, (6th Ed.) Philadelphia:Lippincott Williams & Wilkins: 3-21 Ruth F.Craven& Constance J.Hirnle (2008) Fundamentals of Nursing, (6th Ed), Philadelphia: Lippincott Williams & Wilkins: 32-42 Selanders LC.(2010 ) The power of environmental adaptation: Florence Nightingale's original theory for nursing practice. Journal of Holistic Nursing.28(1). Omar HasanKasule, Sr., “RufaidahbintSa’ad - Historical Roots of the Nursing Profession in Islam,” Islamic Medicine Forum, retrieved from: http://www.islamicmedicines.com/forum/muslims-medical-history/350-historical-roots-nursing- profession-islam.html. Ibrahim B. Syed, "Efficient Hospitals: Islamic Medicine's Contribution to Modern Medicine," Imam Reza (A.S.) Network, Retrieved from: http://www.imamreza.net/eng/imamreza.php?id=5135. Salah Zaimeche, “Al-Qayrawan (Tunisia),” Foundation for Science Technology and Civilization, Retrieved from:http://www.muslimheritage.com/uploads/Qayrawan.pdf. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 48 of 79 Class Session VIII (1 Hour) Post Graduate Specialty Programs Materials of this session is offered by Oman Specialized Nursing Institute Learning objectives: 1. Discuss the evolution of post basic nursing specialties. a. Review the development of post basic nursing specialties b. List the various post basic programs offered at Oman Specialized Nursing Institute (OSNI) 2. Discuss the process of change from post basic to post graduate education. 3. Discuss the aims of various programs offered at OSNI. 1. Midwifery (MWP) 2. Nephrology Nursing (NNP) 3. Critical Care Nursing in Pediatrics & Neonatology (CCNPNP) 4. Adult Critical Care Nursing (ACCNP) 5. Health Services Management (HSMP) 6. Mental Health Nursing (MHNP) 7. Infection Prevention & Control Nursing (IPCNP) 8. BSc in Nursing Studies (BSc NS) 9. BSc (Hons) in Community Health Nursing Practice (BSc CHNP) 10. Emergency Nursing (ENP) 2018 Introduction to Oman HCS AY 2018-2019.doc Page 49 of 79 Evolution of Post Graduate Specialty Programs History In the past, prior to opening of Oman Specialized Nursing Institute, there were post-basic specialty programs conducted at Muscat (MNI) and Oman Nursing Institutes (ONI). The first specialty offered was Midwifery program in 1995 but then it was temporarily stopped and it was reinstituted in 1999. Then the program of Nephrology nursing was started in 1997 and Critical Care Nursing in Pediatrics and Neonatology Program was instituted in 1999. Later on, in November 2001, Oman Specialized Institute was formally opened with its own building to increase the supply of nurses with specialized skills. After its opening, a fourth course Nursing Administration was offered in 2003 in collaboration with Villanova University, USA. Later the institute extended its Midwifery Program to North Batinah in 2002, Al Dhahira Nursing Institute in 2003 and Al Dhakhiliya Nursing Institute in 2004 and also has initiated the succeeding programs; Infection Prevention and Control Nursing 2009 BSc Nursing Studies Program 2009 BSc (Hons) in Community Health Nursing Practice 2012 Emergency Nursing 2015 In 2015 the institute under the auspices of Ministry of Health was accredited to upgrade its educational system to post graduate at level 5. Hence, each program has reviewed and modified their curriculum to be aligned with the educational system of a post graduate education. Nursing Administration Program (NAP) for instance has undergone a major change and the program was changed to Health Services Management to meet the demands of developing future health care leaders not only from the field of nursing but also from other health care providers. Another milestone OSNI has done is the initiation of the Emergency Nursing Program (ENP) which has commenced in year 2015 with 19 students as possible pioneer graduates. OSNI provides various programs of post graduate specialty courses for nurses and other related health care providers across the country and awards certificates for post graduate education. It is a mandate that Specialty nursing and Midwifery education will be offered for candidates who hold Bachelor’s degree only. Specialty Programs Offered at OSNI Currently, there are 10 programs running at OSNI. One of these programs award Bachelor’s in general nursing studies and another one a Bachelor’s of Honors in Community Health Nursing Practice. The remaining 7 programs provide mainly specialty nursing. In addition, one of the programs provides a course based on Interprofessional Education Model (IPE). 2018 Introduction to Oman HCS AY 2018-2019.doc Page 50 of 79 The following are the different specialties offered at OSNI; 1. Nephrology Nursing Program (1997) 2. Critical Care Nursing in Pediatrics & Neonatology Program (1999) 3. Midwifery Program (started in 1995 then stopped and resumed in (1999) The MOH has also expanded the Midwifery Program, adding three additional programs to train nurse-midwives in other parts of the country. i.North Batinah Nursing Institute (2002) ii. Al-Dhahira Nursing Institute (2003) iii.Al-Dhakhiliya Nursing Institute (2004) 4. Health Services Management (2003) former Nursing Administration Program 5. Adult Critical Care Nursing (2004) 6. Mental Health Nursing (2004) 7. Infection Prevention & Control Nursing (2009) 8. BSc in Nursing Studies (2009) former BSc Top Up Degree 9. BSc (Hons) in Community Health Nursing (2012) 10.Emergency Nursing (2015) Synopsis and Aims of Various Programs Midwifery Program (MWP) The program was established to prepare qualified nurses to become Midwives. The aim is to provide independent midwifery practitioners, capable of providing effective care for women and their families. They are able to make informed decisions and collaborate with other health care professionals in promoting health. Midwifery education and training is a priority to develop human resources to fulfill the country’s need to improve the quality of care for women during the childbearing years and beyond. The program was re-launched in 1999 in Muscat with 18 students. Over the following three years the program was inaugurated in Regional Institutes with a total of 65 candidates per year. Nephrology Nursing Program (NNP) The aim of Nephrology Nursing Program is to prepare specialist nurse practitioner to be equipped with the knowledge, skills and professional values for advocating the prevention of renal disease and promoting renal health. It will also promote interdisciplinary communication and cooperation, encourages efficient use of resources, and address ongoing issues related to professional nephrology nursing practice. Furthermore, will promote professional growth and reward and recognize achievement in clinical practice in the Sultanate of Oman. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 51 of 79 Health Services Management Program (HSMP) The aim of this program is grounded on the preparation of future health services managers who are able to lead and manage various healthcare organizations with accountability, integrity and effectiveness. The program integrates the substantial pillar of inter-professional education and embeds it into the practice to provide an in-depth understanding of collaboration, collegiality and teamwork within a multidisciplinary perspective. This 30-credit program equips the students with the multifaceted knowledge, skills, and attitudes on organizational strategic management, human resource management, ethics, leadership, epidemiology, biostatistics, healthcare finance and economics, health research and project management. To strengthen those knowledge areas vis-à-vis problem solving skills, decision making, and critical thinking, the students are immersed to various clinical settings. As a result, students as future managers and leaders are expected to heighten their level of competence with dexterity towards the development of health strategies, initiatives, and sustainable plan of action, among others. Critical Care Nursing in Pediatrics & Neonatology Program (CCNPNP) The aim of Critical Care Nursing in Pediatrics and Neonatology Program is to prepare a nurse- specialist at post graduate level (level 5) for an active, expanded role in the deliverance of critical care nursing to neonates, children and families through the application of advance evidence/evidence based practice within religious, ethical, legal and trans-cultural contexts in collaboration with related stakeholders. The program is consistent with the aims of the Ministry of Health, Directorate of Nursing and Midwifery Affairs, Directorate General of Human Resources Development and Oman Quality Framework. The main objectives of the program are to:  Prepare qualified pediatric and neonatal critical care nurses to work independently and efficiently and to effectively deliver safe and quality care to neonates and children and their families.  Prepare specialist pediatric / neonatal nurses with advanced skills and knowledge through analytical, critical and reflective strategies to meet the needs of health care services.  Promote innovative and research-based teaching and learning approaches to enable students to develop skills at higher levels of competence consistent with the national and international standards and practice 2018 Introduction to Oman HCS AY 2018-2019.doc Page 52 of 79 Adult Critical Care Nursing Program (ACCNP) The aim of this program is to prepare competent and qualified Critical Care Nurses who can function independently and efficiently in the critical care units based on updated research evidence. As one of the priorities of Human Resource Development is to meet the increasing demand of specialized nurses in Oman as revealed by the increasing number of admissions in critical care areas, this program is committed to produce post graduate critical care nurses to provide holistic care to complex and critically ill adult patients in the Sultanate of Oman. Mental Health Nursing Program (MHNP) The aim of the Mental Health Nursing Program is to facilitate the growth and development of nurses who have undertaken to study this specialty at a postgraduate diploma level to be intellectually active practitioners and promote evidence led practice for the benefit of individuals with a mental health problem. The students are prepared to assist individuals with a mental health problem to cope with life and regain their individuality, independence and self-esteem. Students are introduced to the fundamentals of a safe practice on mental health nursing through a shortened fast-track study methodology to produce a reflective and informed mental health nurse practitioner who will utilize research findings and evidence to enhance quality care of individuals in hospital and community settings. In addition to developing skills for a higher level of practice, MHN provides leadership and directions required in this emerging branch of study in the Sultanate. Infection Prevention and Control Nursing Program (IPCNP) The aim of the post graduate diploma in Infection Prevention and Control Nursing Program is to prepare students who can play an active role in identifying and reducing the risk of acquiring and transmitting healthcare – associated infections by providing a safe working environment within health care settings and the community among patients, healthcare workers and visitors through the application of scientific evidence. BSC in Nursing Studies (former Top-Up Bachelor’s Degree) BSc (Hons) Nursing Studies started in the year 2009 affiliated with Cardiff University, UK. This Program is assigned as four modules with 120 UK credits. The learning and teaching of modules within the program will focus on the creation of critical thinkers, developing the reflexive practitioner who is able to analyze, synthesize and apply new learning to practice. The purpose of this program is to explore the roles of the nurse as a change agent/leader and evaluate the 2018 Introduction to Oman HCS AY 2018-2019.doc Page 53 of 79 opportunities and barriers to implementing these roles in future professional practice. Leadership is a key theme throughout the program and students will be expected to develop the skills and knowledge to become effective leaders of nursing. The graduates of this program are awarded with certificate of Bachelors of Science (Hons) in nursing. Successful completion of this program will qualify the graduates to apply for the post graduate diploma specialty in nursing offered at OSNI. Specific Aims of the BSc program  To enable the qualified nurse to develop a deeper understanding of the discipline of nursing and to apply this knowledge to professional practice.  To enable the qualified nurse to enhance her / his understanding of the research process and the application of evidence to enhance the profession of nursing. BSc (Hons) in Community Health Nursing Practice (BSc CHNP) BSc (Hons) in Community Health Nursing Practice started in the year 2012 and was jointly implemented with Cardiff University, UK. Prior to the Program, a pre-academic course is prepared to orient Community Health Nursing student to understand the role of Community Health Nurse as a caregiver, an educator, a researcher and a manager in different community settings. It emphasizes on the study and application of nursing roles and functions in health promotion and disease prevention based on concepts of primary health care. The students are exposed to the theoretical concepts of community health nursing, maternal and child health, school health, working population health and elderly care. After the pre-academic program, the students start the BSc which is taught for 12 months. The program consists of four main modules including Fundamentals of Community Practice, Diabetes Care and Management, Health Promotion and Managing Chronic Diseases and Advancing Community Health Nursing Practice. The program is usually followed by an 8-week internship that aims at the students consolidating and utilizing the knowledge gained throughout the program in Omani community. The Memorandum of Agreement with Cardiff University for the BSc (Hons) in Community Health Nursing Practice program will end in year 2016 i.e. the last cohort will graduate from this program in the last quarter of year 2016. By then, the total number of graduates of the program will be 92 community health nurses. The program is planned to be promoted to the Postgraduate Diploma level which is going to commence in the Academic Year 2017/ 2018. 2018 Introduction to Oman HCS AY 2018-2019.doc Page 54 of 79 Emergency Nursing Program (ENP) Emergency Nursing Program (ENP) was designed to improve the knowledge, skill and attitude of nurses working in the emergency rooms and extended health centers in Oman and thereby to add to quality care. ENP was introduced as sub-specialty within the ACCNP in the academic year 2005-2006 in partnership with faculty from University of Central Lancashire in UK for three years and since then it is being run fully by ACCNP faculty in Oman Speciali

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