Issued on 9^th December 2001 by HE the Minister.

The Ministry of Health (MoH) 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 in keeping with the directives of His Majesty Sultan Qaboos, MoH hereby issues the following guidelines to govern human resources development.

I PLANNING
The Ministry acknowledges, based on its experience with it over the decade of the 90’s, that human resources planning is vital to the development of the Omani health care system. 

The planning approach will continue to be based on the following principles: (a) the need to develop a critical mass of Omani personnel in all key professional categories, (b) the need to ensure adequate and appropriate manpower availability in various categories and in different health institutions / regions, and (c) the need to achieve high manpower productivity through optimum utilization of human resources.

MoH will appoint necessary task forces comprising planners, educators and professional leaders in order to ensure sound human resources planning. The task forces will be entrusted inter alia to undertake needed human resources planning in order to (i) recommend appropriate numbers /levels of production of different categories of health manpower, and (ii) establish norms and standards for staffing.

II MANPOWER PRODUCTION
The Ministry of Health attaches significant importance to human resources development as a strategy for achieving effective health services development in the Sultanate. In view of this, MoH will continue to advocate the need to increase the budgetary allocation for human resources development. The regional directorate generals of health services may play an effective role in mobilizing funds for training regional staff. They may explore the potentials for collaboration with the private sector for mobilizing local resources.

The Ministry considers education & training as the key strategy for achieving self-sufficiency in health care human resources.  As a part of this strategy, the Ministry will continue to develop its chain of health professional educational institutes all over the Sultanate according to needs.

In order to ensure quality education and training, MoH will see to it that the recruitment of qualified staff meets the increased demands of the teaching institutions.

Apart from enriching the faculty resources of the institutes through new recruitment and faculty development, MoH will continuously assess and upgrade the infrastructure of the institutes in terms of physical structure, learning resources and the use of information technology. MoH believes that improved co-ordination between the in-service training co-ordinators and the training institutes helps in reducing the theory-practice gap, and urges all concerned to do their best to achieve it.

It will continuously assess the need for production of professional categories in the Sultanate and establish local facility for it. Once the desired level of Omanization has been achieved in a professional category, MoH may convert the educational programme for that category according to the needs of the services. The institutions no longer required for producing basic graduates may, if necessary, be upgraded to produce specialized professionals in the related category.

MoH will review the need for re-commencing the discontinued programmes for categories such as basic physiotherapists, sanitary inspectors and health educators, in order to meet the demands of the services.

The educational curricula will be reviewed and reformed with WHO or other international technical assistance, with a view to making these locally relevant. The periodical reviews of the curricula will consider the need to meet the changing needs of the services (e.g. midwifery services at primary health care level, geriatric care and psychiatric care).

MoH will continue to solicit and achieve regional and international accreditation to its educational programmes. 

MoH will consider the need to expand / modify the post-basic programmes and decentralize production to regional level if necessary, in order to speed up Omanization of nurses working in specialized areas (e.g. Midwifery for Secondary /Tertiary Care).

MoH will consider introducing new programmes according to the service needs and based on human resources planning. Specific needs for initiating new educational programmes will also be reviewed.

As at present, MoH will continue to assist in the running of medical undergraduate and speciality educational programmes (in the priority fields).

MoH will similarly identify important fields in which local production facility is not available or economically non-viable, and mobilize adequate fellowship resources to support candidates for overseas education.

MoH expects the Training and Scholarship Committee to determine the needs for professional development in tune with the demands of the services.

III LICENSING
MoH recognizes the need for developing a uniform licensing policy applicable to all employers of health manpower so that any individual practicing or desiring to practice a health care profession in Oman is appropriately qualified and licensed to practice according to agreed criteria / process.

MoH will appoint a broad-based national committee on licensing in order to come up with a proposal for forming a single apex body (National Licensing Authority for Health Professionals) consisting of qualified health care professionals, administrators, legal experts and government representatives. This body will be duly constituted and authorized to grant license to practice health care professions. MoH will move the concerned authorities to enact necessary legislation for this purpose.

The proposed National Licensing Authority will define specific criteria required for each professional category of health professionals.

The license granted will be limited to the practice of the specific profession and valid for a pre-determined period, but renewable for similar periods by the competent authority on verification of satisfactory professional performance.

The Licensing authority will have the power to periodically monitor the performance, investigate any instance of malpractice and take necessary action including suspension or even cancellation of such a license.

Click here to download the Guidelines on Registration of Physicians issued by DGHA

[Note: The Ministry of Health has established in 2001 the Oman Nursing & Midwifery Council (ONMC) by a Ministerial Decree (67/2001). This Ministerial Decree has granted ONMC the authority to license nursing and midwifery practitioners.]

(Click here to access ONMC)

IV RECRUITMENT
MoH will try to streamline the administrative processes so as to ensure timely recruitment of staff whether for filling an existing vacancy or for a new project.  It will review the recruitment system and reduce /eliminate the bureaucratic delays and administrative obstacles in its own department of personnel or other government departments/ministries such as MoCS and immigration authorities. 

MoH recognizes the need for formulating clear job descriptions and position requirements for all disciplines, and disseminating these to all concerned. Available job descriptions will be given to staff when a job is offered. Selection criteria will be fixed on the basis of position requirements.

V DEPLOYMENT AND TRANSFER OF STAFF
Detailed guidelines for staff deployment will be developed by the Ministry of Health for its institutions at primary / secondary / tertiary level. Deployment of manpower in various regions / institutions will be in conformity with the established norms and standards.  

Allocation of personnel to the health care institutions in the various health regions will largely be according to the workload indicators of staffing needs embodied in the human resources planning exercises undertaken by the national head quarters from time to time. This will reflect the changing utilization scene in the institutions, consequent to the development of the national health care infrastructure.

MoH desires that the deployment and transfer of staff correspond with the needs of the services according to established criteria for the deployment of all categories of personnel taking into consideration (a) region / remoteness of the place of posting, (b) catchment area and population, (c) services, (d) workload / manpower productivity, (e) existing and approved manpower based on the planning calculations, and  (f) social circumstances.

MoH will review periodically, on a scientific basis, the current staffing and deployment patterns in all health facilities (hospitals and health centers). Necessary re-adjustment will be made in manpower deployment in order to have a proper balance. MoH desires a thorough review of manpower situation every 3 years, with a view to taking corrective actions for increased or decreased workloads from the time the originally sanctioned manpower was allocated to these institutions. A monitoring system will be developed and implemented in order to ensure that appropriate deployment of staff is maintained.

A uniform policy of rotation should be formulated in all regions, to the extent possible, in order to decide on transfers of staff from one location to another. Concerned technical units such as the office of the superintendent of hospital affairs (DGHA) and the directorate of nursing services (DGHA) will develop and implement protocols for managing the rotation of junior personnel in order to expand their experience.

MoH desires that the staff working in remote areas be rotated every 2 years. MoH will explore the possibility of providing “hardship allowance” to the staff working in remote areas, in accordance with the rules and regulations in force.

Re-deployment will be largely on productivity considerations, or under certain contingent circumstances. The Ministry will try to minimize such transfers out of institutions with high manpower productivity.

Although the health regions will continue to enjoy certain degree of autonomy in regard to re-deployment  (or intra-regional transfer) of staff members within the region (but according to the approved staffing patterns), the national head quarters will retain and exert the authority of inter-regional transfers.

Standardized policy guidelines governing inter-regional transfers will be developed by MoH-HQ. The criteria will include (a) letter of recommendation from regions (indicating inter alia the duration of service in a remote/ difficult region), (b) the candidates’ background, (c) review of his/ her staff appraisal record, and (d) the needs of the services.

The concerned technical unit of MoH-HQ will ensure that the transferred candidate’s experience and qualification match the qualifications and experience of the replaced candidate to the extent possible.

VI DECENTRALIZATION IN HUMAN RESOURCES MANAGEMENT
In order to ensure successful decentralization, MoH will seek regional participation in HRM whenever possible. MoH recognizes the roles of each level of decentralization. Clear-cut lines of responsibility will be established and concomitant authority will be given.

MoH will ensure that while undertaking human resources planning and / or deciding on the type and number of medical, nursing, paramedical and administrative staff, consultation is sought whenever possible with the respective heads of departments, heads of facility and DG’s office. However, scientific criteria will be given preference over aspects such as individual opinion or social/local constraints.

MoH does not favour regional participation in the recruitment process pertaining to professional staff, as this is difficult in terms of feasibility, logistics, etc. The national head quarters of the Ministry of Health will continue to enjoy and exert the full authority and responsibility in respect of recruitment of such personnel. The concerned technical /administrative unit of MoH-HQ will, however, be answerable for recruitment delay and the quality of new recruits.

MoH will empower the Heads of Departments to execute their responsibilities towards managing the department, maintaining discipline, recommending rewards for good performance, cost control, utilization of resources, etc.

Click here to download the Guidelines to Autonomous Hospitals on HRM issued by DGHA

VII UTILIZATION, RETENTION, APPRAISAL, DEVELOPMENT AND PROMOTION
The Ministry is committed to the optimal utilization of health care personnel. In order to achieve this desired goal, the Ministry will take all necessary measures to increase the potentials for effective and efficient utilization of the personnel. These measures will include: (i) achieving role clarity through preparation and dissemination of job descriptions for every category, (ii) ensuring effective supervision of personnel through training of first-line managerial personnel, (iii) job enrichment and job enlargement through rotation and role re-definition wherever necessary, (iv) introduction of objective performance appraisal systems and performance-linked incentives, (v) need-based continuing educational programmes and (vi) various other approaches for raising job satisfaction  and performance motivation.

MoH will try, as far as possible, that its employees earn time-bound promotions to higher grades in conformity with the civil service rules, subject to satisfactory performance and service records.

MoH believes that besides time-bound promotions, all other types of promotions should be based strictly on individual merit and the requirement of the post. In-service promotion will normally be given preference over fresh recruitment even for junior posts.

MoH urges that the concerned technical / administrative units, while contemplating to grant an employee a promotion to a higher post, should give due considerations to the individual’s ability to shoulder the responsibilities expected of the higher post, instead of using the attainment of qualifications as the sole / main criterion. 

MoH will try to observe that while considering an expatriate employee for promotion, his /her experience in Oman is also given due weightage.

MoH will normally process promotion application of an individual only if the concerned technical unit’s head of the department recommends it.

MoH wishes to emphasize to its staff that the civil service rules, Omanization strategy, and the retirement scheme in force govern their continuation in service.

MoH expects the performance appraisal system not only to meet the Civil Service requirements, but also the need for performance improvement in order to achieve improvements in the quality of health care. The concerned technical units should come up with proposals for modifying the existing Civil Service appraisal format in order to make these more specific to the MoH and respective job specifications and actual performance. The special grade staff may be required by their Heads of Departments to submit a self-appraisal report for review.

MoH desires that all human resources managers should appreciate that overtime rules should be applied only when there is genuine staff shortage, and when the work situation necessitates it.

MoH will consider the possibility of granting official leave to staff (for professional development), to enable them to present scientific papers at international conferences. The Omani and expatriate staff may be granted a maximum of 7 days’ study leave per annum to attend such conferences.

Click here to download the recent guidelines on staff attendance and scheduling, disciplinary case management and in-service promotion issued by DGHA

VIII OMANIZATION
In pursuance of the proclamation of Omanization as a national strategy by His Majesty Sultan Qaboos, the Ministry of Health has recognized its significance in the health sector and adopted it as a national goal for the Ministry. MoH perceives Omanization as a socio-economic need so that eventually the nation can become self-reliant (in terms of human resources) for meeting its health care needs.

MoH intends to achieve eventual Omanization of all important health professions. However, the Ministry recognizes the risks associated with indiscriminate / hasty replacement of expatriates by Omani personnel, without serious considerations of the implications in terms of quality of patient care. In view of this, the Ministry will continue to pursue a careful Omanization process while upholding the interest of both the potential Omani staff and the clientele of the health care institutions. To maintain the standard of the MoH service and quality, Omanization will be implemented in a phased manner.

MoH expects the expatriate employees to make special efforts to impart relevant knowledge, skills and attitudes to their Omani colleagues. Similarly, the young Omani staff are also encouraged to make special efforts to acquire appropriate knowledge and skills from other more competent expatriate or Omani colleagues. The employees are also expected to develop proper work ethics and work culture, and cooperate in the Ministry’s organizational development efforts. 

IX CONTINUING EDUCATION / TRAINING
The Ministry recognizes the increasing importance of continuing education / training in the context of a growing stock of Omani manpower. All categories of staff will be given opportunities for training.

Keeping this in mind the training infrastructure will be strengthened and a continuing education system will be set up in order to try to observe that all professionals working for the MoH remain updated with the latest developments in their field, so that they can deliver high quality care.

MoH will establish a National Standing Committee on Continuing Education (NSC on CE) chaired by HE the Undersecretary for Planning Affairs and consisting of educators and service providers, with representation from the regions. Other health care providers will also be invited to join this national body.

MoH expects that training activities will be better planned on the basis of systematic training needs assessment, better coordinated through the National Standing Committee on CE, and better utilized through judicious selection of trainers and trainees and regularly evaluated through a system of pre-and post evaluation.  MoH will favour inclusion of CE as a programme in the national health plan / regional health plan.  MoH will appoint a CE Expert at the national level to co-ordinate the CE activities.

The proposed NSC on CE will be expected to establish a CE system, which will conduct training needs analysis, review proposals for activities against needs/ standards (including practical skills based training), allocate CE credit for all categories of health care personnel including private health care providers and establish a mechanism for follow-up and evaluation of the CE activities. MoH will consider inviting local private educational institutes to provide courses/ workshops required on a regular basis.

MoH will allocate a separate budget and support staff for maintaining the CE System. Further, physical infrastructure and other resources for CE will be augmented in every region. MoH will allow regions to raise funds or utilize private sector sponsorship for organizing CE activities. MoH will continue to make efforts to try to observe support for regional participation in national activities held in Muscat, in the form of accommodation, transportation and allowances.

When such a continuing education system is in place, career advancement of personnel will be linked to their attendance and effective participation in relevant training programmes. CE credit will become mandatory and linked to annual appraisal reports, incentives and promotions.

In order to facilitate CE, MoH will make concerted effort to upgrade existing libraries in MoH-HQ and Regions through employment of competent librarians, local procurement of books / journals, subscription to international journals and provision of audio-visual aids. It will support increased access to the Internet as a tool for distance learning and wider dissemination of training / learning material and adopt evidence- based medicine concept.

Click here to download the Continuing Professional Education Policy Statement

Click here to download the Ministry of Health Accreditation Guidelines

MoH believes that the intrinsic quality of human resources (and the quality of its actual performance), besides its quantity, significantly determines the quality of health care. Hence, HRD is vitally important for achieving TQI.

MoH will take the necessary steps to enhance individual performance motivation and team work through reinforcing positive appraisal and personnel development and conducting relevant training, research and development program.

MoH urges all health services leaders / managers to manage the personnel effectively in order to achieve high quality and cost efficiency. For this purpose, they must try to raise staff awareness of costs and quality and to motivate the concerned staff to reduce the costs and improve quality of care.

MoH desires that the quality of performance of medical, nursing, paramedical and support services personnel be monitored through the proposed quality improvement system. A similar system may be developed to monitor the quality of performance of the health care personnel engaged in the private sector.