Background:
The
objective of this study was to project the likely Omanization levels by the end
of the 7th five-year plan (i.e. End-2010), if MoH educational institutions’
production levels continue at the current or anticipated levels and health
system infrastructure expansion takes place according to plan.
Methods:
Omanization
levels of health manpower by the end of the seventh plan period (2006-2010) is
assumed to depend on: (a) the current stock of manpower, (b) the attrition to
the stock due to resignation/retirement/termination, (c) additions to the stock
due to expansion / population growth / up-gradation of the infrastructure etc,
and other administrative decisions, and (d) production of Omani professionals by
national /overseas institutions. The likely future Omani stock of health
manpower by End-2010 is projected considering the Ministry’s current or
anticipated manpower production levels. Wherever, MoH is aware of the production
of any category outside MoH (viz. SQU, overseas institutions), it is considered
explicitly. Otherwise, such production is assumed to be zero. In this exercise,
the effect of attrition levels (which are usually low for the Omani personnel)
is marginally considered. Attrition rate in the Omani doctors category is under 0.3%
while that of the Omani nurse category is under 0.6%. The corresponding rates
for expatriates are higher: doctors: under 3% and nurses under 12%.
Results:
The
overall Omanization level of health manpower in the Ministry of Health is
expected to rise from 65.8% in End-2005 to 77-80% by end of the 7th plan
(End-2010).
43-45% of the physicians in MoH will be Omani in End-2010 (in comparison
to 27.3% in End-2005 and only 19% in End-2000), while 4 out of every 5 nurses
(or 79-83%) will be Omani in End-2010 (in comparison to 59.2 % in End-2005 and
only 36% in End-2000). Around 85% Omanization level will prevail by End-2010 in
the categories of assistant pharmacists, radiographers and sanitarians. Three
of the 10 health regions will be totally self-reliant in terms of number of
nurses (i.e. with 100% Omanis) before the end of the 7th plan viz. Dhahira (in
2007), Dakhliya (in 2009) and South Sharqiya (in 2010). MoH can potentially
achieve 100% Omanization of the nursing category in 2015, provided the graduates
can be freely placed in any region irrespective of the region where they have
graduated. If such a deployment policy cannot be enforced, then the regions
Muscat, Dhofar and Al Woustah (and MoH as a whole) cannot be expected to achieve
complete self-reliance by the end of the 8th Plan i.e. End-2015.
Recommendations:
The
findings suggest the need for initiating certain changes in the Ministry’s
production plan. MoH may increase or decrease intake in the courses and modify
the intake levels of regional nursing schools. Attempt should be made to deploy
nursing graduates to regions as required, irrespective of the regions where the
students graduate. It is apparent that in the consolidation phase of Oman’s
health care infrastructure development, the Ministry’s fresh requirements of
health manpower in certain categories are expected to fall, and so the Ministry
will find it unnecessary to continue production at the current levels. MoH may
reduce intake or close educational institutions or stop guaranteeing employment
to students in a particular region or in the Ministry’s institutions. Since,
in the larger national interest, MoH may continue to produce manpower without
giving any assurance that it will employ the graduates. In that case, MoH may
assist the Ministry of Manpower to develop a suitable policy for employment of
health manpower in the private sector. The Omanization of physicians, dentists,
nurses, pharmacists and other professionals in the private sector is a difficult
task before the Government. In the changing situation, the private sector should
be prepared to offer higher levels of remuneration and other service conditions
to the Omani staff, but the potential Omani employees should also be willing to
accept the best that the private sector can provide.
6.
Computer-Modelling Simplifies Physician Requirement Planning in Hospitals (June
2006).
Background:
Hospital
administrators find it difficult to respond objectively to demands for more
physicians by heads of departments, as they do not have a proper tool for
assessing physician requirement. It is necessary to evolve an objective approach
for decision-making on assessing requirement of physicians in hospitals.
Methods:
A
user-friendly physician requirement-planning model is developed, based on
workload-cum-allocation need, which can help hospital administrators respond
objectively to demands for more physicians. A Graphic User Interface (GUI) is
used in Java language. The user has to input information on work days / hours,
activity-wise standard times, annual workload information, bed capacity and
occupancy figures in a visual display screen and press a
“calculate button.”
This enables him to generate activity-wise and overall physician
requirements. If the user enters the figures on available number(s) of
positions, he is able to estimate the current physician productivity levels. If
the user wishes to generate an institutional summary covering all hospital
departments, he can do so by pressing another button “Ins Summary,” which
presents overall and specialty-wise current availability and requirement of
physicians.
Results:
The
new model has succeeded, through manpower assessment using computer modelling,
in empowering the hospital administrators and policy makers / planners to
respond promptly and objectively to requests by hospitals for more manpower.
Recommendations:
Health
administrators may use this model to visualize human resource implications of
changing utilization scenarios and variation in model parameters. Planners can
help Ministries of Health to streamline physician availability in hospitals and
prevent inequitable distribution.
7.
Nurse Requirement Planning: A Computer-based Model (June 2005).
Background:
This
paper touches on the debate on the issue of mandating a certain number of nurses
per patient in an inpatient unit, and then discusses a computer-assisted
approach for estimating nurse requirement, given prescribed patient-nurse
ratios. The paper claims that despite the validity of the logic of fixing
certain optimum nurse-to-patient ratios, it is often difficult to estimate nurse
requirement and allocate enough nurses to a public hospital.
It outlines a systematic approach for undertaking this otherwise tedious
and time-consuming job.
Methods:
The
paper dwells on the basic factors involved in estimating nurse requirement for
an inpatient ward, given stipulated patient-nurse ratios. It identifies the
information requirement for a comprehensive model for nurse requirement
planning. Once the required information becomes available, the next task is to
estimate unit-wise and overall nurse requirement. As the computational effort is
quite considerable, the paper develops and elucidates a computer-assisted nurse
requirement-planning model, which helps in systematizing and accelerating the
estimation process.
Results:
The
paper demonstrates the unique advantage of this computer-based approach for
objective decision-making for nurse staffing and for undertaking simulation
studies.
Recommendations:
The
authors advocate the widespread use of this model, as the new computer-based
nurse requirement planning model enables planners to respond objectively and
promptly to requests by nursing administrators for more nurses.
8.
HRH Job Classification Mapping and Database for the Sultanate of Oman-A document
prepared for WHO-EMORY, Ministry of Health, Sultanate of Oman (July 2005).
Background:
This
document, prepared at the instance of WHO-EMRO, was intended to serve as a
country database for the preparation of the World Health Report 2006. It has
also helped in HRH mapping for the Eastern Mediterranean Region.
Methods:
Information
has been compiled, analysed and presented using templates provided by WHO-EMRO,
so as to enable region-wide (and eventually world-wide) consolidation and
appropriate comparisons. The interpretations of the terminology and estimates
have been made in the national context, wherever necessary. The job categories
in Oman have been mapped to correspond to ISCO job categories to the extent
possible. National definitions have been provided.
Results:
MoH
HRH information covers MoH institutions, non-MoH government institutions as well
as the private sector. However, information reported, when aggregated to
category-level, may not enable one readily to find out the number of staff
having different job titles. MoH maintains also several computerized databases
for HRH as well as for financial management. This has enabled the study (a) to
disaggregate the category-based statistics down to individual job title level
whenever necessary, and (ii) to make category-wise estimates of urban-rural,
gender-wise and age-wise distribution.
Recommendations:
MoH
may periodically repeat this exercise in order to update this document as a tool
for HRH planning.
9.
Recruitment System in the Ministry of Health-A Study, Ministry of Health,
Sultanate of Oman (November 2004).
Background:
Many MoH officials share a common perception that the recruitment process in the
Ministry is slow. This study examined evidences supporting or negating this
perception and enquires into the reasons for the perceived delay.
Methods:
The study has been undertaken through the following steps: holding individual
unstructured interviews / discussions with the key actors, collecting and
analysing the relevant information from the Ministry’s databases, requesting
and receiving information from the interviewees, listing possible reasons for
the perceived recruitment delay, listing a few tentative suggestions for cutting
down the delays, holding focus group meetings and pre-testing tentative
recommendations.
Results:
The
two principal MoH agencies involved in recruitment perceive that the following
problems are a matter of concern:(a) too many resignations by technical staff,
(b) higher salaries offered in some other GCC countries, (c) short validity of
medical fitness certificates, (d) panels of selected candidates contain many
candidates for too long time, (e) reluctance of suitable candidates to apply for
jobs in Oman, (f) shrinkage in the number of applications due to unreasonable
qualification requirement, delay in resignation becoming effective due to
waiving notice period /substituting with leave, slow
processing time etc.
Recommendations:
MoH
should clarify the organization structure of DHA and achieve role clarity of the
main actors.
It
may re-design their functions so as to enable them to concentrate on technical
staff recruitment and other hospital affairs. A series of other steps for toning
up the recruitment system were indicated in the report.
10.
Human Resources Development for the Omani Physician
Category in the Ministry of Health: An Assessment of Fellowship Requirement for
the Sixth Five-Year Plan, Ministry of Health, Sultanate of Oman (July 2001).
Background:
MoH
had to recruit a large number of expatriate physicians to achieve accelerated
development of the health system infrastructure. MoH plans got a boost because of the commencement of
in-country production of Omani physicians and post-graduate medical education.
To support a smooth process of Omanization of physicians, MoH undertook a study
on the medical specialty category in 1994-95, which generated quick estimates of
the requirement of medical specialists in various fields. MoH had been
cooperating with the Sultan Qaboos University in running the medical
undergraduate and postgraduate programs. It had also been regularly deputing
Omani physicians for higher education abroad. All these activities contributed
to the Omanization of the physician category. This study was intended
to review the prevailing status of the Omani physicians category under MoH, and
to identify further actions needed to develop this category.
Methods: The steps in this exercise included (i) assessment
of overall stock of Omani physicians under MoH -- specialties; positions
occupied and spatial distribution, (b) study of educational profiles of
physicians under MOH-- completed educational attainment; stage of completion of
residency / international examination, (c) formulation of a fellowship scheme
and estimation of its resource implications. Stock
of Omani physicians and characteristics were assessed through a two-step
process: (i) preparation of region-wise lists using computerized HRMS database,
and (ii) cross-checking of lists with regional DGs.
A questionnaire was also circulated to all Omani physicians (below Senior
Specialist level) to collect additional information. Information on residency status of physicians and those on
higher education abroad etc. were collected from MoH-DGET. All these information were integrated into a unified database
and analysed in-depth.
Results:
This
study revealed that
MoH, at the time of the study, had a total stock of 391 Omani physicians
excluding 49 new interns. Among these, 300 were medical officers and 91 medical
specialists (including General Pediatrics: 14, Dermatology: 10, Internal
Medicine: 9 and General Surgery: 7). No. of Omani medical specialists was too
small in Obstetrics & Gynecology (only 3 Omani and 81 non-Omanis) and
Anesthesiology (only 1 Omani and 76 non-Omanis). Overall Omanization level among
medical specialists was found to be only 12%. Most of the Omani medical officers
had only the basic medical degree (93%). Of the 300 medical officers, 109
(i.e.36%) were pursuing residency programs, and of them only 19 (i.e.17%) had
cleared their OMSB Part 1. The highest number 37 (i.e. 34%) of MoH residents
chose FAMCO for their specialty education, 17 in Medicine (16%), 14 in Child
Health (13%), 13 in Surgery (12%), 11 in Laboratory Medicine (10%) and the
remaining 17 in the specialties of Obstetrics & Gynecology (6), A. & E.
(6) and Ophthalmology (5). None was found to be pursuing residency in the OMSB-approved
specialties of Anesthesiology, Radiology and Psychiatry. Few students seemed to
be opting for Obstetrics & Gynecology while many were going for Laboratory
Medicine (with a non-Omani stock of only 29 under MoH).
In addition, 28 other medical officers were on post-graduate education
abroad. Seven of them are specializing in Radiology, 4 in General Medicine and 3
in FAMCO/ Community Medicine. The study proposed a typology of fellowship viz.
Type-A (Junior Fellowship), Type-B (Senior Fellowship) and Type-C (Advanced
Fellowship) and proceeded to estimate the expected requirement of fellowships
under each type. In
the Optimistic Scenario, all eligible and deserving candidates should be given
the opportunity and full financial backing. However, if funds are limited, MoH
may adopt any of two other possible scenarios. In the Moderate Scenario, MoH
adopts a little stricter approach for selecting the deserving fellows. In the
Pessimistic Scenario, MoH adopts a very strict approach for identifying the
deserving fellows. The study estimated the requirement of fellowships during the
sixth five-year plan to be 258 under the Optimistic Scenario, 233 under Moderate
Scenario, and 130 under the Pessimistic Scenario. The
financial implication of the fellowships was estimated to vary from RO 7.8
million (Pessimistic
Scenario),
14.1 million (Moderate Scenario) to 16.8 million (Optimistic Scenario).
Recommendations:
The study urged MoH to
make every effort to achieve appreciable Omanization in the medical specialists
category.
To ensure an adequate supply of Omani physicians at least in the key
specialties, the study suggested that MoH should allocate the junior fellowships
under different specialties based on current
or projected availability of Omani
specialists vis-à-vis total specialty stock. It urged the
fellowship committee to disseminate widely the information on specialty-wise
fellowship availability. The committee should motivate the candidates to choose
the specialties of high priority to MoH so that MoH could build up a critical
mass of specialists in most specialties.
The study recommended that the senior and advanced fellowships might be
made available to candidates depending on the applications received and
fellowships available. It urged
MoH to make every effort to increase the scope of providing overseas experience
and on-the-job training to young Omani physicians. For this purpose, the
Government should allocate adequate financial resources to cover fellowships and
related expenses. The
study
recommended that the Government should attach the highest priority to medical
specialty education, and for this purpose, allocate a sum of around RO 10
Million for medical specialty fellowships in the 6th Five-Year Plan
11.
Feasibility Study on the Establishment of a National Physiotherapy Centre in
Muscat, Ministry of Health, Sultanate of Oman (April
2000).
Background:
Physiotherapy services were available, at the time of the study, in the Royal
Hospital and Khoula Hospital in Muscat, all regional hospitals and some wilayat
hospitals and extended health centres of the Ministry of Health, a few non-MoH
government institutions and a few clinics in the private sector. There was a
perception that some unmet needs existed in this component of the Ministry’s
health services, especially in the Muscat Capital Area. This study examined the
merits of a government proposal to set up a national physiotherapy centre in
Muscat. The objectives of this study were to assess the current situation of
physiotherapy services in Oman, highlight the unmet needs as perceived by
professionals, estimate the likely workload of a national physiotherapy centre
in Muscat and the cost of setting up and running such a centre.
Methods:
Physiotherapy
demand was estimated based on MoH service statistics (adjusted to remove
anomalies) and a specially prepared questionnaire for clinics. The research team
visited most private clinics for ascertaining the type of services and
facilities available. The utilization pattern of physiotherapy services in MoH
hospitals in Muscat was studied on a sample basis using a special recording form
encompassing aspects such as health condition treated, inpatient / outpatient
service, procedures undertaken, patient characteristics, referral particulars,
time taken for physiotherapy by patient / physiotherapist, and frequency of
treatment per week. In addition, a Delphi study was undertaken mainly to assess
the perceived gap in availability of physiotherapy services, and to solicit the
opinions of the physicians and concerned administrators.
Results:
The
service outlets of physiotherapy & rehabilitation services were estimated to
treat about 428 patients in the
Sultanate per working day excluding inpatients. The study found that the
physiotherapy caseload (outpatients only) was shared as follows: MoH units 49%,
non-MoH Government clinics 34% and private clinics 17%. The private sector saw
about 36.3 patients a day. Many of
these units found it difficult to survive due to low demand for their services.
80% of the patients were Omani. About half of the non-Omani patients were paying
patients sponsored by private employers. The study estimated that about 84% of
the capacity of OPD clinics was utilized; while in the private sector it was
about 53%. Low capacity utilization resulted mainly due to lack of demand for
paid services, patient inconvenience, improper planning / failure of appointment
system etc. The study estimated that about 25% of the inpatients required
physiotherapy, and implied shortage of 32 physiotherapists in MoH hospitals. The
study estimated that the development cost of a national physiotherapy and
rehabilitation centre would be to the tune of RO 1.3 Million and an annual
recurring cost of about RO 307,000. This implied 0.25% increase in the
Ministry’s annual recurring budget, if the unit was to be run by MoH. The
study argued that the private sector might not find an attractive market
segment, as existing private outlets were already serving the affluent segment
of the population.
Recommendations:
The study found that it
was worthwhile to augment physiotherapy and rehabilitation services in the
Sultanate to bridge the supply-demand gap. However, it indicated that a national
physiotherapy and rehabilitation centre should be established in Muscat provided
the estimated project cost was considered affordable. The study suggested that
satellite centres close to (or attached to) regional hospitals might be
preferable from the consideration of patient convenience.
12. Human
Resources Development Planning for the Nursing Category (Basic Nursing and
Post-basic Specialties), Ministry of Health, Sultanate of Oman
(January 2000).
Background:
From
just 450 nurses in 1975, the stock of nurses grew to 6,365 in MoH (and 7,728 in
the Sultanate) in 1998. This
resulted from the sustained MoH efforts to elevate health standards through
developing a modern health system infrastructure. Oman had to import nurses and
other health personnel in order to achieve accelerated health services
development. MoH recognized that health care provision depended largely on
adequacy of nurses and other human resources, and attached significant
importance to HRD (nursing education in particular) as a strategy for achieving
Omanization and health services development. MoH established regional nursing
institutes and achieved a deep penetration of this profession in Oman. It was
also expected to help ensure equitable spatial distribution of nurses. Effective
Omanization policy necessitated that Omani nurses should develop competence in
specialized nursing in a short time. Due to shortage of fellowship support, the
need for initiating a few one-year post-basic nursing courses increased further.
This study intended to take stock of the nursing manpower situation and identify
the need for mounting new educational initiatives. It also intended to generate
quick estimates of the requirement of nurses in general and specialist nurses in
selected fields.
Methods:
The steps in the approach for the nursing category were as follow: (i)
assess the overall stock of nurses in Oman and MoH share, (ii) study the
distribution of MoH Nurses across health regions / institutions, (iii) project
the future availability and requirement of nurses region-wise (and entire Oman)
under alternative scenarios and likely Omanization pattern over years, and (iv)
recommend future intake levels for regional nursing schools. A similar approach
was adopted for studying specialized nurses. The definition of a Specialist
Nurse adopted was: ‘A Specialist Nurse holds at least a post-basic nursing
certificate in a field of special nursing’. In the context of this study, a
nurse deployed in an area requiring use of specialized nursing procedures, was
termed as a ‘specialist nurse’ (whether qualified in the specialty or not).
It focused only on a few special nursing fields. Projections on the Nursing
Category were undertaken under a combination of 3 alternative infrastructure
scenarios and 2 alternative nurse production scenarios. Future stocks of nurses
(and Omanization levels) were projected for each year from 2000-2006 under the
alternative infrastructure / manpower production scenarios, using the author’s
manpower planning model for oil-rich developing nations. Projection of
specialist nurses in each specialty was undertaken using the same planning model
and certain assumptions. Projected future requirement of MoH nurses in a
specialty was estimated considering likely dates of completion of current /
anticipated projects and using applicable staffing norms. Projected availability
of Omani nurses in a specialty was estimated considering the recommended intake
into ongoing / proposed Post-basic specialist nurse programs. While projecting
Omanization level of specialist nurses in a group, it was assumed that the
prevailing Omanization level in the specialty was 0 % as all the Omani nurses,
engaged in special nursing procedures, would also have to be trained under the
post- basic course.
Results:
The Sultanate was found to have a reasonable nurse
population ratio (32.6 per 10,000 population in end-1998)) in comparison to
other countries at a similar income level, but only 24% were Omanis. Among MoH
nurses, 26.5% were Omanis. MoH employed over 82% of the nurses. Omani nurses in
MoH were found to be young with average age 27 years, and with average 4.2
years’ experience. Omanization level already reached reasonably high levels in
most regions except Al Wusta (0%), Musandam (13.2%) and Dhofar (13.2%). The
projection exercise on future stock of nurses and Omanization at national level
revealed that: (a) Omanization level in MoH only could be expected to increase
to 63-70% around 2006. With enhanced production of nurses in Muscat, 100%
Omanization might be achieved by 2010 / 2012. Even if overall intake could be
reduced from 550 to 535 with effect from 2001, and 35 nurses could be earmarked
for private sector, 100% Omanization would be attained in MoH by year 2011. (b)
Omanization level in Non-MOH Government Sector could be expected to increase to
35% around 2006. It was estimated
that 100% Omanization in this sector would be achieved by year 2026 / 2030. The
study found that if higher Omanization level was desired, it would be necessary
to release a higher % of MoH nurse outputs to Non-MoH Government sector.
(c) Omanization level in Private Sector could not be expected to rise
unless nursing school outputs joined it. However,
if 35 Omani nurses produced by MoH were to be made available to this sector from
2003 onwards, Omanization level might reach 19% by 2006, and 100% by 2020.
Omanization level of nurses in the entire Sultanate might be expected to
increase to 56-62% around 2006, and 100% by 2012 / 2014. The study estimated
that MoH had in May 1999 a total stock of 2,174 specialist nurses, nearly all
without specialized qualifications, (comprising 35% of total nurses). Of these,
429 (i.e. 19.7%) were Omanis. Specialist nurses were found to be distributed
widely across regions (40% in Muscat and 12% each in Dakhliya and North
Batinah). Omanization level among specialist nurses was found to be the highest
in South Sharqiya Region (around 57%) and fairly high in Dakhliya, Dhahira and
North Batinah regions (around 25%). In
terms of size, emergency nursing (405), surgical nursing (380) and
cardiac/critical care nursing (378) appeared to be the major specialties. These
three specialties together accounted for over 50% of specialist nurses.
Omanization of specialist nurses was found to be higher in emergency nursing
(31%) and nephrology nursing (26%), and lower in case of nursing midwifery (only
3%) and cardiac/critical care nursing (16%). For projection purposes only,
prevailing Omanization level was assumed to be zero for all specialties.
Omanization level of specialist nurses in MoH, as a whole, might increase from
0% in 1999 to 27-29% around 2006, and 100% by 2017 / 2018.
Recommendations:
The study suggested that overall intake level in
basic nursing may be fixed at 535, and in that case, Omanization level of nurses
in 2006 might be expected to reach about 67% in MoH, 37% in Non-MoH Government,
19% in the Private Sector and overall 56% in the Sultanate as a whole. Intake
levels in the nursing specialty programs should be fixed in the light of the
results of the projection exercise on specialist nurses. The study urged MoH to
consider setting up an Institute of Post-basic Nursing in Muscat to serve as the
focal centre for nursing specialty education, and target only moderate levels of
Omanization in the short run, on considerations of quality of care and need for
experience. It suggested that the curricula for each program should be designed
using task analysis and in consultation with relevant educators, administrators
and consultants. Close linkage between training institutes and service
institutions must be maintained. Courses should be carefully monitored.
Necessary actions should be taken to link the post-basic nursing programs with
higher education, career advancement and salary progression.
13.
The Health System Infrastructure and Human Resources Availability: An
Inter-Regional Comparison, Ministry of Health, Sultanate of Oman (March
1999).
Background:
The decade of the 90’s witnessed substantial planned development of the health
care infrastructure in Oman. In
this context, MoH desired a review of equity in the distribution of
infrastructure and human resources in the regions, where the health care system
development was believed to have been fairly adequate.
Such a review was expected to help in identifying potential actions for
further development of the health care system.
Methods:
This review, based entirely on the analysis of available statistical data, is
confined only to five of the ten health regions, viz. Dhofar, Dakhliya, North
Batinah, South Batinah and Dhahirah where the infrastructure was largely
complete. These 5 regions together constituted about 61% of the Sultanate’s
geographic area and about 57% of the population.
Results:
The study revealed that the health care infrastructure was not uniform across
the five regions. The variation could be explained partly by the heterogeneity
of the population size and its spatial distribution. The observed mix of health
care institutions in a region was largely due to three factors: (a) need to
respond to popular demand for a health institution in an interior area, and (b)
difficulty to respond objectively to such demands, (c) economic non-viability of
institutions in some wilayats / localities.
Overall bed availability was found to be comparable across regions,
except for the Batinah regions with lower bed-population ratios. But for these explainable disparities, spread of the health
care infrastructure appeared to be reasonably adequate and equitable. Overall
utilization of inpatient care facility in a region as a whole was found to be
small (50-60%) except in Dhofar (around 75%).
Although the delivery facilities in hospitals were seen to be well
utilized, health centres with maternity beds were found to be poorly utilized.
Extended health centres (without maternity beds) shared 18% of the deliveries
outside hospitals. The study noted that surgeries undertaken in the regions were
largely minor (up to 80-90% of the surgeries). Although the study noted
variations in manpower quantity and manpower population ratios across the
regions, it found no evidence of inequity in human resources availability. Crude
human resources productivity ratios revealed that human resources utilization
was uneven.
Recommendations:
The study recommended that further expansion of the health system infrastructure
in Oman should be strictly on workload considerations. It suggested that the
potential for further regulating patient visits should be explored inter alia
by strengthening the referral chain in certain regions and/or upgrading the
quality of services and improving the image of peripheral health centres and
local hospitals. The possibility of establishing some EHCs in regions such as
Dhofar and Dhahirah should be explored. The study suggested that MoH should
introduce and enforce strict attachment to selected primary health care
institutions and need-based referrals to higher institutions. Bed utilization
patterns in hospitals should be optimised through proper hospital admission and
discharge policy. The study concluded that the utilization of inpatient care
facilities should be closely monitored and bed capacities of some hospitals
should be reduced, while delivery suites (with 4 maternity beds) might be
provided in extended health centres if necessary. The number of maternity beds
in under-utilized health centres should be reduced to 2. Since 70% of the
surgeries in the Sultanate were found to be minor, the study opined against
increasing surgical facilities further. It urged MoH to develop a suitable
protocol for rational requisitioning of lab. Investigations. It recommended that
the staffing norms for wilayat hospitals should be reviewed.
Trend analysis of health care outputs and manpower productivity suggested
that the latter decreased as health care infrastructure expanded. The study
urged serious re-thinking on further expansion of the health care system.
14.
Review of Hospital Bed Capacity in Oman: An Exploratory Study (March
1999).
Background:
MOH needs to objectively examine all requests for setting up of new hospitals in
order to decide on establishing hospitals and health centres. This report
outlines an approach for decision-making on establishment of new hospitals,
closing poorly utilized hospitals, or reducing their bed capacity on realistic
assessment of the inpatient unit’s utilization potentials.
Methods:
The
study undertakes a situation analysis of the existing hospitals in different
regions in terms of their geographic location, catchment area and utilization.
It proposes a set of criteria for critical evaluation of the justifiability of
setting up a new hospital of a certain bed capacity and applies these to
recommend setting up/ closure or reduction of bed capacity.
Results:
The study revealed that the demand for establishment of one
new wilayat hospital and four new local Hospitals (in 4 different wilayats) was
justifiable. However, in other
wilayats certain adjustments (addition or reduction) of beds were in order. New
hospitals or addition of beds could be justified only for accessibility and
patient convenience.
Recommendations:
Altogether 180 new hospital beds were proposed (excluding 249 in the currently
approved plans), while an overall reduction of 208 hospital beds in the existing
hospitals was recommended. The study emphasized the need for improving the
quality of inpatient care services through upgrading manpower quality
(especially physicians). It highlighted the need for religiously adhering to the
referral policies adopted by MoH with a view to raising the utilization of
inpatient care services of primary care hospitals.
15.
Strengthening
Local Hospitals (With particular reference to Human Resources & Service
Areas). Consolidated Report, Ministry of
Health, Sultanate of Oman (March 1998).
[Condensed Version]
Background:
As
an integral part of its recent initiative to strengthen PHC infrastructure and
foster health development, MoH decided to focus on the local hospitals which
complemented the health centres’ PHC activities. The study made an on-the-spot
assessment of the situation in local hospitals in conjunction with other
available information. The objectives of the study were to ascertain the
manpower situation and the adequacy of the local hospital premises, to identify
the constraints hindering optimum utilization of human resources, to develop
manpower norms for local hospitals, and to generate policy leads for further
development of PHC in Oman. This study covered all local hospitals (23 out of
28) in the country except those in Dhofar and Al Wusta.
Methods:
The
study involved the following steps: consolidation and analysis of available
statistical information, preparation of brief questionnaires for discussion and
collection of supplementary information, visits to hospitals, discussions with
MOs in-charge and observation of work areas of the hospital building, analysis
of data and preparation of certain documents (viz. guidelines for decisions on
the physical infrastructure and the staffing of local hospitals, manpower norms
for every local hospital based on work load and/or allocation considerations,
preparation of a consolidated study report incorporating the salient information
relating to it and an overall assessment of the situation and recommendations
for action). The level of utilization of local hospitals was reviewed using four
key indicators viz. OPD attendance, Bed Occupancy Rate (and Average No. of
Inpatients Per Day), Number of Deliveries conducted and Number of (Minor)
Surgeries undertaken. Manpower situation in every local hospital was reviewed
against norms proposed for it, and the need for adjusting manpower availability
was determined. The financial implication of additional manpower was also
estimated.
Results:
The
local hospitals in the Sultanate were found to be a heterogeneous set of
outlets, with a wide variation in the catchment area population, from a mere
1,078 to 24,500. The buildings (service areas) of the 23 local hospitals were
rated as follows: Satisfactory: 10, Moderately Satisfactory: 9 and
Unsatisfactory: 4. Many of the 9
hospitals, with ‘moderately satisfactory’ status were found to require some
additions, alterations and repairs. OPD attendance in local hospitals was
observed to vary widely: over 50% with daily average attendance below 200 and
nearly 90% with average below 300. Three hospitals had attendance in range
325-350. The inpatient care facilities were found to be generally poorly
utilized. Bed Occupancy Rate was
found to be below 30% in over one-third of the 23 local hospitals, including
some only with 6%. Only 3 hospitals were found to have bed occupancy of at least
60%. Average no. of inpatients was found to be 4 or below in one-third of the 23
local hospitals. Only 17% of the hospitals had 20 or more inpatients per day.
The utilization of delivery suites in local hospitals was found to be generally
low. Over 80% local hospitals were observed to undertake 1 delivery per day on
an average, with only 2 hospitals having daily 2 deliveries
on an average. As many as 60% of the 23 local hospitals were found to undertake
utmost 1 minor Surgery per day on an average, only 3 hospitals undertaking 2 or
more minor surgeries per day on an average. Availability of human resources in
local hospitals widely varied; total number of staff ranged 18-98, with 5 of the
hospitals having only one physician.
Recommendations:
The study recommended that modern hospital buildings should be constructed for
the 4 local hospitals in unsatisfactory condition.
MoH should not make ad-hoc decisions on any local hospital building,
because such decisions might imply that the needs of a more deserving local
hospital would be compromised due to resource constraints. A team from MoH D.G.
Engineering should make an on-the-spot assessment of these structures and provide cost estimates for
decision-making. As capacity utilization was found to be low, the study opined
against expansion of bed capacity in any wilayats. It recommended certain
principles or guidelines for staffing local hospitals. Considering workload and
allocation needs, and following these guidelines, certain staffing patterns
(norms) were proposed for the local hospitals. Based on these norms, the study
recommended fresh recruitment in the key professional categories for 93
personnel (viz. 21 physicians, 2 dentists, 31 nurses, 8 assistant pharmacists,
12 lab. technicians, 5 AMROs and 14 medical record clerks) and 51 others in the
remaining categories. This implied a total estimated annual cost of about R.O.
713,567. The policy leads on related aspects emanating from the study included:
possible enhancement of registration charges, review of the role of a Wilayat
Superintendent and the justification for hiring a catering contractor in
under-utilized hospitals.
16.
Strengthening Health Centres (With particular reference to Human Resources &
Service Areas). Consolidated Summary of Seven Regional Reports,
Ministry of Health, Sultanate of Oman (December
1997).
Background:
Oman
has been engaged in developing its health care infrastructure through planned
development since the 70’s. MoH recognized the need to take stock of the
situation in existing health centres with a view to strengthening its PHC
delivery system. This exploratory study undertook a quick on-the-spot assessment
of the situation, in conjunction with the available service statistics. The
objectives of the study were: to ascertain the manpower situation and the
adequacy of the health centre premises, to identify the constraints hindering
optimum utilization of human resources in PHC delivery; to develop manpower
norms for PHC centres and to generate policy leads for further development of
PHC in the Sultanate. This study covered all the regions of Oman except Dhofar,
Musandam and Al Wusta. The extended health centres (polyclinics), local/wilayat
hospitals and the public health/malaria units (not integrated with health
centres) were excluded from this study.
Methods:
The
study involved the following steps: (a) preparation of brief questionnaires for
discussion and collection of supplementary information, (b) pre-testing the
questionnaires, (c) consolidation of available statistical information, (d)
visiting health centres, discussions with those in-charge, (e) tour of health
centre buildings and work areas, (f) analysis of the data and preparation of the
following documents: guidelines (or a policy framework) on decisions relating to
the physical infrastructure and the staffing of health centres, a summary report
for every region and all health centres in that region, incorporating the
salient information relating to it, an overall assessment of the situation and
recommendations for action, manpower
norms for every PHC centre based on work load and/or allocation considerations,
a consolidated study report summarizing the findings of the study and outlining
its recommendations. A pilot study was undertaken in the South Batinah region,
and a framework for documentation was developed. After further discussion, this
prototype was finalized and adopted for reporting on all the regions. Manpower
situation in every health centre was reviewed against manpower norms proposed
for it, and the need for adjusting manpower availability was determined. The
financial implication of additional manpower was also estimated.
Results:
Health
centre catchment area populations were found to vary widely, from mere 62 to
over 80,000. The visits revealed a wide variation in the physical structures
ranging from excellent situation in the newly constructed structures to highly
inadequate rented buildings or antiquated MoH structures. As many as 16% of the
70 health centres were seen to be functioning in rented buildings. The service
areas could be rated as satisfactory in 47% of the health centres, moderately
satisfactory in 36% and unsatisfactory in 17%. The study found the health
centres in Oman to be a heterogeneous set of outlets, with wide variation in OPD
attendance. Over 50% health centres were found to have daily average attendance
below 50 while about 75% below 100. Three health centres were found to have
daily attendance in the range 300-400 and another 2 health centres in the range
600-750. Number of staff in a health centre was seen to vary from just 1
employee to over 100. Most health centres were found to have 1 or 2 physicians,
a few health centres without a single physician. Number of physicians in a
health centre varied from 0 to 10, while the number of nurses varied from 1 to
28. Total number of personnel in a health centre ranged from 1 to 109.
Newly constructed health centres were generally seen to be better
staffed, while some over-burdened existing health centres continued to suffer
from staff shortages.
Recommendations:
The study recommended that MoH should meticulously decide on renovation /
replacement of a health centre building. It should not make any ad-hoc building
decisions for a health centre, since such decisions could imply that the needs
of a more deserving health centre would be compromised due to resource
constraints. It was suggested that
in case of a recommendation other than the continuance of status quo, a
team from MoH D.G. Engineering should make an on-the-spot assessment of the
structure and provide a cost estimate. Based on this information, the cost
implications of the proposals should be estimated and furnished to policy-makers
for decision-making. It recommended that MoH should cautiously exercise the
option of renting a building for use as a health centre so as to avoid inflating
MoH recurring budget. New health centre buildings should be constructed,
resources permitting, for the centres in ‘unsatisfactory’ status. Many
health centres rated as ‘moderately satisfactory’ deserved some additions,
alterations or repairs. Other health centres required no special action except
some minor repairs /routine maintenance or
rectification of local inconveniences. The study recommended specific staffing
norms for every healthy centre and urged that staffing decisions should be based
on these norms. In this context, it urged MoH to adopt the proposed guidelines
for staffing health centres, instead of responding to demands voiced by the
regional Directorate Generals in an ad-hoc fashion. It recommended fresh
recruitment in key professional and other categories of about 300 personnel (41
physicians, 49 nurses, 44 assistant pharmacists, 43 lab. technicians, 25 health
educators, 13 sanitary inspectors, 7 radiographers, 39 medical record clerks, 20
drivers and 19 watchmen) for the health centres studied, implying a total
estimated annual cost of about R.O. 1.7 million. The policy leads on related
aspects emanating from the study included: developing a system of registering
every family resident in the catchment area of a health centre / local hospital
and fixing eligibility for care, fixing criteria for opening health centres and
upgrading a health centre to an EHC/ local or wilayat hospital.
17.
Human Resources Planning for Medical Specialties: A Futures Study, Ministry of
Health, Sultanate of Oman (July,
1995).
Background:
Oman reached distinct landmarks in the field of
education when it graduated the first batch of physicians and initiated
post-graduate medical education in the country. MoH health sector plans got boosted by these developments.
MoH perceived that its medical specialty manpower planning could help shape the
future of medical education in Oman. The objective of this study was to generate
quick estimates of the requirement of medical specialists /GPs in various
fields, so as to enable health policy-makers, planners and medical educators to
get a glimpse of the future scenarios in the development of medical specialties
in Oman, and base their immediate decisions on these projections.
Methods:
The steps in this exercise were: (a) assessing overall stock of medical
specialists in Oman, employed by MoH and other agencies,
(b) assessing, in greater detail, the stock position of medical
specialists in Oman and MoH in particular (in various specialties and
positions), (c) studying demographic & educational profiles of medical
specialists under MoH, (d) estimating shortages / net additional requirements of
medical specialists in MoH under various specialties, (e) projecting future
population in Oman considering annual growth rate as per census, (f)
computing bed-population ratio and physician-bed ratio for Oman, and
comparing these with other GCC
& developed countries, (g) setting up alternative scenarios
for future health infrastructure development in Oman in terms of
bed-population ratio and physician-bed ratio, and
project future requirement of beds
and physicians (specialists and GPs ) in Oman, under
several alternative scenarios, (h) estimating
the numbers of medical specialists
required under each specialty (junior specialist to senior consultant)
under each scenario, assuming
that current % share of each
specialty in the overall stock of medical specialists
will continue
in the future, and (i) studying the implications of future requirements
of specialists for medical education.
Results:
At the time of the study Oman had a stock of
2,424 physicians (excluding 82 GPs under MOH reserve budget) of which 789 were
medical specialists. MoH shared 63% of total physicians and 66% of medical
specialists. There were 55 Omani medical specialists (7% of total). Leading
specialties were: Pediatrics, Gen. Medicine, Obs. & Gynecology,
Anesthesiology and Gen. Surgery (combined 43 % of medical specialists stock).
Attrition rate for non-Omani medical specialists was 13.1 % in 1994 (20.3
% in Senior Consultants cadre). 85
medical specialists were due to retire (attain age 60+) during 1995-2005.
Highest replacement demands were found to be in the Obs.& Gynecology, Gen.
Surgery, Gen. Medicine, Ophthalmology, Pediatrics, and Anesthesiology. The study
observed that Omanization of medical specialists would be a big challenge,
necessitating considerable investment in HRD. At the time of the study, all but
1 MoH Omani physician were working in Muscat, suggesting that in future, Omani
medical specialists/GPs would have to be increasingly assigned outside Muscat
for achieving smooth Omanization. The study detected an overall shortage of 128
medical specialists in MoH institutions, and additional 158 medical specialists
for manning plan projects, implying a total need of 286 medical specialists up
to 1997 to clear shortages or man plan projects. Omani bed population ratio was
expected to grow in the future. The
study estimated that the stock of physicians might rise from 2,498 (end-1994) to
3,054 in 2001 and 4,476 in 2005. Omanization level of physicians could reach 24
% in 2001 and 28 % in 2005, unless intake of Omani medical students in the
graduate program of SQU / overseas institutions was raised substantially. Stock
of medical specialists could be expected most likely to rise from 744 in end
1994 to 992 in 2001 and 1,452 in 2005. Omanization level of medical specialists
in 2001 and 2005 could, according to the study, reach 20 % in 2001 and 33 % in
2005. Of the total likely stock of 1,452 medical specialists in Oman in year
2005, there might be 188 Pediatricians, 162 Specialists in General Medicine, 160
Obstetricians & Gynecologists, 133 Anesthesiologists, 144 Specialists in
General Surgery, 99 Ophthalmologists etc. This futures study clearly revealed
that the Omanization potential of the medical profession in the foreseeable
future would be limited, unless intake in the medical degree program could be
raised adequately or sufficient financial allocation was made for Omani students
to pursue medical education abroad.
Recommendations:
The study recommended that
Oman might produce a total of 464 medical specialists during 2000-2005. The
suggested class size for a specialty in 1995 was 6 each for General Medicine,
Pediatrics and Obstetrics and Gynecology, 5 for Anesthesiology, 2-3 in the
specialties FAMCO, Orthopedics, ENT, Ophthalmology, Laboratory Medicine group,
and Radiology and 1-2 in most other specialties. It urged immediate steps to
mount a P.G. residency program in Anesthesiology, ENT and Orthopedics at the SQU
College of Medicine. According to the study, the intakes could be doubled for
each specialty during 1998-2000. The study urged serious debate on the role of
FAMCO (or General Practice) in Oman. It pointed out that if FAMCO specialists
were to replace the MOs, working as General Practitioners in MoH, it would be
necessary to step up more substantially the production of such specialists,
implying that fewer medical graduates would be available to pursue post graduate
programs in the key specialties of Gen. Medicine, Pediatrics, Obs. &
Gynecology, Gen. Surgery and Anesthesiology (in which there was a large
expatriate presence). The study
indicated that there was no need for Oman to start local residency training
programs in Psychiatry, Dermatology, TB & Chest Diseases and several other
specialties, for each of which only 1-2 students might be sent abroad for
acquiring PG qualifications. It
opined that education in medical /surgical super specialties might not be
effective or economic to mount locally, and some of those with PG qualification
in General Medicine/Surgery might be deputed abroad for pursuing education in
medical / surgical super-specialties. The study recommended further toning up of
medical education in Oman by steps such as increasing intake for the
undergraduate degree program (local/overseas), introduction of training grades,
increased financial allocation for overseas fellowships, augmentation of faculty
resources, continued modernization of MoH hospitals, standardization of teaching
requirements for clinical practice, continued efforts for accreditation of
residency training programs and coordinated academic and health services
planning.
18. Towards Developing
a Management Information & Evaluation System for Human Resources Management,
Ministry of Health, Sultanate of Oman (December
1994).
Background:
MoH
believed that, in order to facilitate improvements in all HRD components, a
sound MIS was a necessary condition. Such an MIS should ideally meet all
information needs for management. The objective of this study was to assess the
available databases of the Ministry and examine how far these needs were being
met, and to identify the changes necessary to evolve an integrated on-line MIS.
Methods:
The
study attempted to review the prevailing situation in terms of duplication of data, gaps in information needs, and the
felt needs for a more interactive information system. The manner of collecting,
documenting and processing information in each section was ascertained through
detailed discussions with those handling the information. The mode and frequency
of processing (manual or computer- was also noted. For this purpose the HRM
process was studied minutely and depicted graphically. Data flows in various
sections were analysed taking into consideration the information content, method
of processing, purpose, frequency of generation and distribution. Sample formats
of records; registers and computer outputs were collected. On the basis of a
comprehensive review of the information needs of the users and the strengths and
weaknesses of existing data systems, this report espoused a design of a MIS for
Human Resources Management from the users’ perspectives, and delineated the
steps for its implementation, with a view to developing a good background document
for systems professionals to complete the task of creating and operating a sound
MIS.
Results:
The study detected several merits and demerits of
the available system. It found that the maintenance of many registers/records in
the budget section of administration and manual processing of the information
could be avoided through computerization and linkage with the personnel
department’s information system. The study found that the use of different
languages (English / Arabic) created an unnecessary constraint in data
processing. Computer processing of information was seen to hold potential for
quicker data processing and response. The information system in leave section
was found to function well. The study noted the possibility of avoiding the need
to keep parallel information in DGHA’s computerized system by linking it with
the Employee Information System, provided additional fields were added in latter
to include qualifications, date of birth, date of acceptance of resignation,
likely date of exit, etc. in order to satisfy their specific information needs.
Prompt information on intra-regional transfers could enable DGHA to take swift
actions for temporary replacements. Similarly, most of the data maintained by
DGHA-Directorate of Nursing Affairs were found to be similar to those in the
Employee Information System. To avoid this duplication, data on date of birth,
training, performance grade, leave record, qualifications /experience should be
added in the Employee Information System. DGs of regions were found to maintain
the same information, and such duplication could be avoided. Sharing of data in
a common database would also help avoid data duplication on nursing by MoH-HQ
and Regional HQ nursing departments. The study found that all data at the
education and training directorate general were maintained manually in routine
correspondence files making information retrieval very difficult. Data fields
provided in the Employee Information System (designed and operated by the
computer directorate) were insufficient to cater to senior management’s
information needs. Using a specially prepared data matrix, the study showed that
the type of data handled by different sections contained over 75% common data
fields.
Recommendations:
The study recommended a framework for a MIS for Human Resource Management taking
into consideration the information needs at all levels of MoH-HQ, Regions and
Institutions. It recommended that the following items should constitute the
basic employee data: Staff No, Name, Nationality, Sex, Date of birth,
Educational qualification, Specialty, Category, Job Title, Budget, Date of
appointment, Class / Grade, Date of entry into present grade and Present
location. In addition to this,
other data such as Place of temporary posting with Period of posting, Date on
which proceeding on leave and the likely date of arrival etc. should be
incorporated as these would be required to generate certain reports. To meet
DGET ‘s requirement the training details such as Starting date of program,
Topic, Duration of training in weeks, Location (Local / Abroad), Cumulative
training (in weeks) should be included. The study recommended provision to
permit the Passport section, Leave section and other sections to have their own
data fields as additional inputs. It was suggested that the information system
should provide for the common database in a core module and build different user
modules around the core. In order to preserve the reliability and accuracy of
the proposed interactive on-line information system, the study urged system
designers to fix clearly the responsibility for the upkeep of the core data and
the responsibility for the functioning of the specialized modules. It suggested
setting up of a central HRMS Cell at MOH-HQ and making the Directorate of
Personnel responsible for maintaining it and generating routine periodic
reports. The user departments should be made responsible for feeding, updating,
maintaining their specialized modules and generating needed routine /ad-hoc
reports. Two scenarios for installing the MIS-HRM were proposed for
consideration: (a) The system would be networked and available to users
country-wide, and (b) The system would be available on local area network within
MoH-HQ, and information would be transferred in diskettes periodically to the
regions.
19. Human Resources
Development Planning for Selected Categories: A Long Range Perspective, Ministry
of Health, Sultanate of Oman (October 1993).
Background:
This study was undertaken in the context of the on-going Fourth Five-year
Health Development Plan 1991-1995. This plan and the broad program document on
HRD clearly envisaged the health infrastructure development and the required HRD
over 1991-1995. New educational programs were initiated in this and the previous
health development plans. Subsequent detailed programming of HRD in the newly
established modern regional hospitals came up with improved staffing standards
for hospitals. In this context MoH felt the need also for detailed programming
of manpower production in the Fourth Five-year plan in order to achieve the dual
goals of health status improvement and achieving self-sufficiency (or
Omanization) in health care human resources. The objectives of this exercise
were: to review the HR situation in regard to the selected categories in terms
of the stock, profile, distribution etc.; to review manpower production and
further potentials; to project future requirement, availability, Omanization
levels under alternative scenarios and recommend appropriate intake levels; and
to recommend a systematic program of Omanization through assessing the
Omanization potentials of every non-Omani employees in the selected categories.
The study covered the five categories laboratory technicians, radiographers,
assistant pharmacists, sanitarians, physiotherapists (produced by MoH) and the
category of Pharmacists for which no local educational facility was available.
Methods:
The
study was essentially a quantitative exercise for which the following steps were
followed. Several forms were designed for data collection. These forms covered
list of staff and their characteristics, profile of students abroad, data on
applicants to MoH courses and the academic performance of those who joined the
courses, data on stock / resignations / terminations and appointments etc. The
required data were collected from multiple sources: records of Directorate
Generals of Health Services of various regions, records and personnel files
maintained by the Directorate of Personnel (Directorate General of
Administration - HQ), records of the Directorate General of Education &
Training, etc. Data were collected through personal visits, surface mail /
diskettes/ telephone calls or faxes etc. Analysis of data was undertaken using
standard statistical packages. For projecting future availability, requirement
and Omanization level, the study utilized its own manpower planning model. For
assessing manpower requirement the researchers developed tentative staffing
norms for various types of health institutions (in the light of systematic
institution-wise studies conducted earlier and discussions with policy-makers),
current manpower availability and requirement during the plan period. The study
projected the manpower situation and Omanization level under alternative supply
/demand scenarios (manpower production/ health system infrastructure scenarios),
and recommended desirable intake levels for manpower production in each of the
selected categories. For arriving at the intake decisions, the study considered
the likely supply of secondary graduates and the ‘potential intake’ assuming
an upper bound to admission/applicants ratio. The study also developed and used
a confidential scoring system for estimating an ‘Omanization Potential
Score’ for all non-Omani staff and generated a graded list of staff as an
input to decision-making for systematic replacement of expatriate staff in the
selected categories.
Results:
The
study came up with a detailed set of tables, conclusions and recommendations on
each of the selected categories, too detailed to be summarized here. To
exemplify the nature of outputs of the study, the results could be summed up for
just one category viz. laboratory technicians. The total stock of laboratory
technicians was found to be 456 of which 25% were Omani. Of the total stock,
over 50% were found to be located in the Muscat capital area. Almost 100% of the
Omani staff were seen to be only in the capital area. Most of the Omani staff
were found to be in the age group 20-30 years and possessing a maximum of 5
years’ work experience. Most expatriate staff were in 30-45 age group and with
at least 10 years’ experience. Most expatriate staff held higher educational
degrees, while the Omani staff were mostly MoH diploma holders, suggesting the
need for overseas education of Omani staff to prepare them for senior
appointments in the future. The study noted an increasing trend in the number of
staff lost annually due to various reasons especially resignations / Omanization.
Production of laboratory technicians was seen to have been uneven over the
years. The study noted significant growth in the number of applications to the
Ministry’s laboratory technician’s post-secondary diploma course, but number
of admissions increased only marginally. Most applications were mainly from
nearby Muscat, Dakhliya and North Sharqiya regions, suggesting limited
penetration of the profession in the more distant regions. Potential intake to
the course was estimated to be 60 per year considering increase in applications
and success rate. The study projected the likely Omanization level under various
scenarios. For instance, it showed that if all the projects of the five-year
plan were implemented, the total stock of laboratory technicians would rise to
around 930 and the maximum Omanization level would be 36% by end-2000 provided
that
intake level was increased by 25% during 1994-1997 and by 50% during 1998-2001
over the 1993 level.
Recommendations:
The study recommended increases in intake levels of all courses and provision of
fellowships to Omani staff for higher education (as indicated in the relevant
segments of the report). It proposed certain reforms in admission policy to
ensure regional penetration of various professions covered by the study. It
suggested a deployment strategy for defusing concentration of Omanis in the
capital. The study also recommended supervisory training for senior staff and
independent curriculum reviews. It proposed a more humane approach to
Omanization of staff using data on staff profiles and a formula, which
incorporates concerns of both staff and MoH.
20. Human Resources
Potentials of Diwan Aam (HQ)
Employees: Report on a Study of the Directorate General of Pharmaceutical
Affairs and Drug Control. (Vol. 1 & 2) Ministry of Health, Sultanate of Oman
(September 1992).
Background:
This study was undertaken as a part of a series of studies on MoH-HQ directorate
generals focused on qualitative aspects of human resources management. Its main
objectives were: to assess the human resources situation in terms of potentials
of individual employees for further growth within MoH, to examine employee
morale, and to assess the need for individual-level actions. The study was
expected also to yield policy leads for strengthening human resources
management.
Methods:
The
following steps were followed for undertaking the study: two forms (a Personnel
File Summary Form PFSF and a semi-structured Personal Interview Questionnaire
PIQ) were designed and pre-tested, all employees in the directorate general were
listed, relevant information were extracted from their personal files maintained
by the Directorate of Personnel and summarized using PFSF, individual interviews
were held using PIQ and relevant interview data were incorporated in PFSF
analysed and interpreted. PFSF provided for summarizing identification
particulars, demographic characteristics, employment/experience record, training
record, performance appraisal summary and general observations. PIQ contained
items on description of duties, self-assessment of workload, level of
satisfaction with working conditions, self-assessment of competence and
suggestions for raising it, employee preference for alternative jobs,
supervisor’s assessment, goal orientation and Omani / non-Omani interaction. The interviewers assessed the growth
potential of every employee using a number of characteristics such as overall
impression, age, educational level, job satisfaction level and supervisor’s
rating. Omanization potential of every expatriate employee was also assessed
using an innovative scoring device and reported it in a confidential report
(Volume 2 of this study). 77 (or 90%) of the 86 employees were interviewed.
Results:
At
the time of the study only 21% of the staff were Omani. Of the Omani staff over
50% were found to be aged 35 and below. They were found to be about 6 years
younger on an average than their non-Omani colleagues. They were seen to have
about 3 years of professional education less than their expatriate colleagues on
an average. It was also found that the non-Omani staff were more experienced
than their national colleagues (average 9.2 years compared to 2.6 years).
However, the national staff were seen to earn on average about RO 200 more than
their expatriate colleagues, suggesting that with increased Omanization the
budget of the directorate general would have to be raised substantially in the
future. Job promotions were found to be more rare for non-Omani staff than the
national staff. Training opportunities were found to be rare for the staff of
this directorate general since 67% of Omanis and 94% of expatriate staff had
never attended any organized training course. Need for computer training and /or
subject matter training was perceived by most employees. Interestingly 40% of the Omani staff and 47% of the
expatriate staff considered their own workload as ‘average’ suggesting that
many might have been having low workload. Most staff, Omanis and expatriates
alike, did not desire any change in their job functions although their duties
were often not in the mainstream of their professions. The level of staff
dissatisfaction with their working conditions were seen to be high in respect of
training, promotional opportunities, incentives/rewards/prizes and
salary/allowances among both Omani and expatriate staff. Many non-Omani staff
members were also bothered about job insecurity while many Omani staff members
were concerned about lack of recognition of their work. An overall job
satisfaction index computed for both groups showed no significant differential
among them in their job satisfaction levels. While both groups were found to
consider responsibility, nature of work and recognition as important working
conditions, the Omani staff viewed training and authority as also important, and
the expatriates considered guidance/supervision and salary/allowances also
important. The study found that only 27% of Omani staff and 21% of expatriate
staff could be considered to have high growth potentials, while one-third of the
staff in each group were assessed to have low potential. The staff’s goal
perception was found to be limited. The study found many cases of improper
utilization of professional staff engaged in work unrelated to their
professional education. (Volume 2 results are withheld from this abstract).
Recommendations:
The study urged MoH to develop a careful strategy for Omanizing the jobs
in the Directorate General of Pharmaceutical Affairs & Drug Control (DGPA
& DC). It was suggested that, for this purpose, the following points should
be considered: review of the curriculum of the pharmacy assistants program and
its relevance to DGPA & DC functions, need for greater involvement of this
department’s staff in the running of this program, sponsoring more staff of
DGPA & DC for overseas education and training of young secondary graduates
for short training to work as administrative assistants in this department. The
study urged DGPA & DC to develop procedural manuals covering various work
units in order to tap the experience of senior (especially expatriate) staff. It
also suggested that process studies should be undertaken to improve work
procedures. Several measures were recommended for streamlining the manpower
utilization patterns in DGPA & DC. The study strongly urged this department
to mount specially designed in-service training programs. It recommended that
MoH should try to increase the promotional avenues for its staff.
It was suggested that the synergy of this department’s various units
should be enhanced through regular well-organized monthly meetings of its
directors.
