Education, health and other social services are central to Oman Vision 2040, the country’s long-term development framework that aims to create a knowledge-driven, diversified and competitive economy. Indeed, the authorities are working to shift a portion of the local workforce to the private sector, as well as enhance the role of private entities in the provision of both heath care and insurance – factors that will be key in transferring some of the government’s current cost burdens to the private sector.
In terms of education, the government has prioritised equipping Omani nationals with the skills and knowledge to compete in a changing employment market, whether that means adopting technology in the classroom or expanding the reach of technical and vocational education and training (TVET) programmes and institutions.
In the health care sector, the government is focused not only on encouraging private participation – including by mandating health insurance for those employed in the private sector, as well as tourists and other foreign visitors – but also on strengthening the local pharmaceutical value chain with an eye to ensuring a secure supply of medical goods. At the same time, the authorities are working to reduce the incidence of non-communicable disease (NCD), which is linked to a growing burden of care in an increasing sedentary society, mirroring a pattern being seen in many developed economies.
Education Structure & Oversight
Education in Oman spans four levels: pre-primary for students between the age of four and five; primary, for those six to 11 years of age; secondary, for 12- to 17-yearolds; and tertiary, for those 18 and older.
The Ministry of Education (MoE) is charged with supervising and regulating the K-12 segment, and is working to optimise educational and learning processes through digitalisation, among other measures. Moreover, each of the 11 governorates has a Directorate General of Education responsible for implementing the federal ministry’s policies.
The MoE is one of two education ministries: the Ministry of Higher Education, Research and Innovation (MHERI) is tasked with providing oversight and regulating both public and private universities. Its objectives include building a higher education segment that facilitates creativity, scientific research and innovation; diversifying sources of funding for the segment; boosting national competencies to help the workforce be more competitive on a local and global level; and creating curricula that is in line with local values. MHERI is also responsible for all TVET programmes in the country through its Undersecretary for Vocational Training.
Assessment & Accreditation
Another important player in the higher education space is the Oman Authority for Academic Accreditation and Quality Assurance of Education (OAAAQA), an independent body responsible for maintaining the quality of higher education institutions and programmes, as well as adhering to international quality benchmarks. Every institution of higher learning must be assessed by the OAAAQA in line with countrywide standards that are both aligned with international best practices and adapted to the domestic context. It was established by royal decree in January 2021 and reports to the Council of Ministers.
Previously known as the Oman Academic Accreditation Authority, the entity’s remit was expanded in 2021 to include accreditation as well as quality control through the formulation of a quality-assurance system; the creation of assessment and auditing tools; personnel training; and the proposal of draft laws related to its authority.
In August 2022 the organisation published the Oman Qualifications Framework, a comprehensive, integrated, mandatory blueprint for those in both public and private institutions. The document establishes a basis for recognition of learning to ensure students receive a certain level of education.
Key Policies
The sector is guided by the National Education Strategy 2040 (NES 2040), launched in 2018 to modernise and improve the sector. It aims to equip Omanis with the knowledge and skills needed to compete in an evolving workforce, with five substrategies: educational management; student enrolment and progress across levels and sectors; quality assurance; research and development; and funding.
“Oman has made education one of its top priorities, and the government has recognised its importance in developing the economy and readying the workforce for future opportunities,” Sheikh Salim bin Hamood Al Hashmi, chairman of Global Education Services, a local private school operator, told OBG. “In this context, NES 2040 aims to prepare young Omanis with the knowledge and skills necessary to become more productive and competitive, while maintaining their national identity and values.”
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Sector Breakdown
The government has prioritised the development of the education sector, identifying it as key to reaching wider economic goals. The sector has grown significantly over the previous five decades. In 1970 there were three schools with 900 students in the country, but by the 2020/21 academic year there were 1182 public schools, 590 of which were co-ed, 369 for males and 223 for females. That year there were 678,359 students enrolled in government schools, 334,707 of which were female and 343,652 of which were male. The majority of students enrolled in public schools – some 652,606 – were nationals.
In line with these efforts, civil ministries for education, health and housing have typically received a substantial share of the annual budget. The 2023 iteration of the spending bill prioritised social objectives such as job creation, the development of income-generating jobs across the country, digital transformation and spending on basic services. To that end, that year the government allocated the largest proportion of funding for social services – which itself accounted for nearly 40% of the total budget – to education. In 2023 education received OR1.9bn ($4.9bn), with funding earmarked for a range of projects, including a public-private partnership to construct 42 new schools.
In the 2021/22 academic year 78,529 pupils were attending private K-12 institutions, 43,633 of which were male and 34,896 of which were female. Broken down by the level of education, there were 27,963 kindergarteners, 26,185 students in grades one through four, 18,617 students in grades five through 10, and 5764 students in grades 11 and 12.
Teaching Staff
In 2020/21 public schools employed 56,827 teachers – 68% of which were women and 84% of which were Omani nationals. The governorate with the largest number of teachers was Al Batinah North, with 10,574 teachers; this was followed by Muscat (9260), Al Dakhiliyah (7972) and Al Batinah South (6924). That academic year there were 10,746 administrators and technicians employed in government schools. On the private side, meanwhile, 8340 teachers were employed in 2020/21. In addition, 2141 individuals were employed as administrators and technicians.
Tertiary Education
Sultan Qaboos University is the sole public university in Oman, and is home to nine colleges: arts and social sciences; economics and political science; science; education; agriculture and marine sciences; engineering; medicine and health sciences; nursing; and law. In 2020 the university employed 2998 staff and had 18,366 students enrolled: 16,353 undergraduates and 2013 postgraduates. That year the university issued 200 grants, with humanities and social sciences receiving the greatest proportion, at OR524,422 ($1.4m). This was followed by environmental and biological research, and life and health sciences.
As of 2020/21 there were 28 private universities across the country – up from one in 1995 – with some 35,000 students, including Dhofar University, the German University of Technology in Oman, the University of Nizwa and the Arab Open University. MHERI is working to expand this and offers private entities a number of incentives to enter the market, such as certain Customs exemptions and land grants.
Vocational Training
Central to both Vision 2040 and NES 2040 aims to equip the workforce with the skills and knowledge needed in a rapidly changing workforce in order to bolster competitiveness. Specifically, NES 2040 aims to introduce technical and vocational pathways in post-basic education that will facilitate continued learning, and develop a qualifications framework for technical and vocational pathways, in addition to academic ones, in a manner that allows students to transfer between pathways.
A national technical and vocational education framework would then be developed in line with the newly implemented qualifications. This is especially important as firms have reported challenges recruiting Omani nationals. A survey of 106 firms conducted between May and June 2022 by the Oman Chamber of Commerce and Industry, published by the International Labour Organisation (ILO), found that during the Covid-19 pandemic companies had difficulty hiring Omanis due to, among other reasons, a lack of skills – especially technical skills – and work experience. The study also found that the proportion of nationals in the private sector workforce increased from 15% to 24% in 2021, which the ILO noted could suggest that the health crisis resulted in Omanis replacing foreigners in the workforce.
To that end, in March 2022 MHERI announced that it – in partnership with the ministries of labour, finance and economy – would form a team tasked with creating a clear framework for developing vocational colleges. The following month MHERI signed an agreement with Sohar Aluminium to develop a series of vocational colleges across the country, part of the government’s efforts to expand the role of the private sector in bridging the skills gap.
Efforts to increase the number of students in vocational programmes have already paid off: in 2021 there were 6217 students studying in vocational programmes, up from 5782 in 2020 and 5394 in 2019, according to data from the National Centre for Statistics and Information. The number of TVET institutions also increased, from four in 2002 to six in 2016 and eight in 2023. “The development of training centres is a key area of focus for the government, with the goal of thoroughly reviewing national training capabilities, quality, capacity and financial performance,” Ibrahim Al Harthi, managing director of local consulting firm Takatuf, told OBG. “Partnering with local and international entities is crucial to raising quality standards and increasing value.”
Technology
Among NES 2040’s key priorities is the development and adoption of education technology (edtech). While uptake was relatively slow prior to the pandemic, the health crisis proved to be a catalyst for digitalisation. In mid-March 2020 the authorities closed all schools and universities, later ending the school year early in May of that year. To ease students back to the so-called new normal, in September 2020 the sultan issued a directive to make 2020/21 the Year of Blended Learning to help facilitate the use of electronic platforms and online classrooms, alongside traditional methods of teaching. The following month the government announced the launch of the MoE’s Google Classroom portal, and in March 2022 the government renewed its agreement with the tech giant. More than 40,000 teachers and 600,000 students had utilised the platform between its launch and March 2022.
Oman’s recent efforts go beyond the use of tech tools in the classroom to include training young students in ICT and emerging technologies, the importance of which was underscored by the shift to digitalisation during the pandemic (see ICT chapter). In June 2022 the MoE, in partnership with UNESCO and the Regional Centre for Educational Planning, announced that they were working together to adopt artificial intelligence (AI) curricula in K-12 schools.
Health Oversight
The government provides universal health care to Omanis free of charge at the point of delivery, and to expatriates at discounted rates. If care is not available in the country, the ministry provides sponsorship for patients seeking care abroad. The Ministry of Health (MoH) oversees the provision of services in Oman with an aim to ensure the availability of comprehensive health care.
The MoH also has oversight over the Health Council, which is responsible for providing policy direction for the sector. It runs hospitals at the national and local level, which are supported by other public clinics run by entities such as Sultan Qaboos University, the Ministry of Defence and the Royal Oman Police, as well as private hospitals and clinics.
In addition to bolstering the provision of publicly provided health care services, the MoH has sought to develop private institutions’ contribution to and investment in the health sector by providing technical expertise and advisory services to private sector entities, as well as monitoring during their planning, construction and operational phases.
Several directorates fall under the MoH’s purview, including those offering guidance for family and community health, environmental health, health education, nursing affairs, community participation, education and training, and NCD surveillance and control. The Directorate of General Planning is tasked with executing sector-specific plans, while the Directorate General of Pharmaceutical Affairs and Drug Control develops and implements pharmaceutical policy, and assures the availability of medicines.
Health Expenditure
Oman committed the equivalent of 4.1% of GDP to health-related expenditure in 2019, up from 2.1% in 2008 but down from 4.4% in 2016, according to the most recent World Bank figures. That period has also seen a similar trend in health expenditure per capita, rising from $445.50 in 2008 to $636.89 in 2016 before moderating to $624.74 in 2019. The government has traditionally accounted for the vast majority of total health care expenditure, contributing between 78.8% and 89.8% of the sector’s total funding between 2000 and 2019, underscoring the importance of efforts to increase the capacity of private providers to provide care as the population grows and associated costs rise. The proportion of out-of-pocket spending nearly halved in the 2008-19 period, from 12.5% to 6.6%.
Highlighting the ongoing prioritisation of the health care sector and other social services, nearly 40% of the national budget – or some OR4.3bn ($11.2bn) – was allocated to social services in 2023. Of that figure, 44% of the total, or approximately OR1.9bn ($4.9bn), was earmarked for education; 22% (OR946m, $2.5bn) for social welfare and health, respectively; and 12% (OR516m, $1.3bn) for housing. The health care sector’s allocation included financing for public-private partnerships, including the development of renal dialysis centres and the Al Taafi Suhar Centre. The MoH’s total expenditure was OR882.8m ($2.3bn) in 2021, down from OR994.1m ($2.6bn) in 2020 – an increase reflective of pandemic-response spending – but up from OR699.5m ($1.8bn) in 2018 and OR814.9m ($2.1bn) in 2019.
General Indicators
Oman had a population of around 4.5m as of 2021, according to the MoH’s annual health report, the majority – or 2.8m – of which were Omani nationals, with the remaining 1.7m made up of foreigners. The population is concentrated around the capital Muscat, where 29% reside, though the governorates of Al Batinah North (18%), Al Dakhiliyah (11%) and Al Sharqiyah South (11%) were also significant population centres.
While life expectancy has more than doubled in recent years – increasing from 35 years in 1960 to 73 years in 2000 – between 2019 and 2021 life expectancy at birth declined from 78 years to 74.1 years. This trend was seen among both males and females over the same period, in a decline attributed by the MoH to the repercussions of the Covid-19 pandemic. Similar life expectancy declines have been observed in other markets, including the US.
Although infant mortality rates have fallen, dropping from 14 deaths per 1000 live births to 10 between 2000 and 2020, the maternal mortality ratio fluctuated from 12 per 100,000 live births in 2014 to 21 in 2015, 20 in 2016, 14 in 2017 and 23 in 2018. However, this marks an improvement from 48 per 100,000 live births in 1990.
Disease Burden
Rising health care costs are attributable, in part, to the rising incidence of NCDs such as diabetes and hypertension, a trend being seen across the GCC. An MoH study released in February 2022 showed that NCDs cost the economy an estimated OR1.1bn ($2.9bn) a year – OR486m ($1.3bn) in lost productivity and OR609m ($1.6bn) in health spending – with 72% of deaths attributed to NCDs. In 2021 the incidence of NCDs, at 229 per 10,000 population, was triple that of communicable diseases, at 74 per 10,000 population.
Those associated with the digestive system such as GERD and Crohn’s accounted for the greatest proportion of NCDs, at 43 per 10,000 population, followed by circulatory system diseases such as hypertension, heart attack and stroke (36 per 10,000 population); and blood diseases such as anaemia, clotting disorders and cancer (34 per 10,000 population). The morbidity rate for anaemia was 33 per 10,000 people, followed by heart disease (12), diabetes (7) and hypertension (2).
In May 2022 the MoH announced that one-third of the population over the age of 18 had hypertension. To help address this, in December 2022 the government launched a countrywide campaign for the early detection of NCDs through a new Check and Assured programme, which includes screening or tests for high blood pressure, diabetes, chronic kidney failure, high cholesterol and obesity.
Infrastructure & Services
The number of doctors and hospital beds per 10,000 residents has stayed relatively stable in recent years: during the 2017-21 period the former ranged from 19.7 doctors per 10,000 people to 20 doctors, and the latter from 14.7 nurses per 10,000 to 15.6 nurses. As of 2021 there were 88 hospitals with 7096 beds, up from 83 hospitals and 6894 beds in 2019.
In 2021 there were 12.5m outpatient visits to MoH facilities, the bulk of which were to general practices (59%), followed by medical clinics (6.5%), accidents and emergency (6.2%), gynaecology (5.2%), and child health and immunisation (4.7%). That same year there were a total of 325,696 inpatient visits, with a bed occupancy rate of 55%, up from 47.8% in 2020 – an increase due in large part to the strain of the pandemic on the health care sector.
Medical Staff
There were 56,119 individuals employed in the health sector at the end of 2021, two-thirds of whom were employed by the MoH, according to the ministry’s annual report. That year the sector had an Omanisation rate of 57%, reflective of the government’s efforts to bolster the national workforce. While that figure was high for positions in administration (91%), sanitation (82%) and technical and support staff (80-90%), it remained relatively low for doctors (29%), emphasising the importance of the MoH’s efforts to expand training.
As of the end of 2021, 9026 doctors were employed in Oman, 64% of whom were employed by the MoH, 29% by the private sector and the remaining 7% by other government entities. Over half were general practitioners – at 4568 – followed by specialists (3540) and consultants (918). At the same time, there were 19,892 nurses – 72% of whom were employed by the ministry, 20% by the private sector and 8% by other public offices. The sector also employed 2792 pharmacists, 1623 dentists, and a combined 254 medical and health assistants.
The government’s efforts to expand the availability of care have paid off. Between 2000 and 2021 the number of doctors per 10,000 people rose from 13.6 to 19.9, the number of nurses increased from 32.6 to 43.9, the number of pharmacists was up from 2.1 to 6.2, and the number of dentists grew from 1.1 to 3.6. The number of specialists, which rose from 4.5 to 9.8, saw a larger increase compared to general practitioners, at 9 to 9.8, reflecting the government’s efforts to provide more specialised care.
Public Facilities
The government has focused on developing public health care facilities in recent years. As of 2021 the MoH was responsible for 191 health centres, 51 hospitals and 21 extended health centres. That year there were 5166 hospital beds under MoH supervision – up from 5039 in 2017 – with the largest share in internal medicine (35.6%), followed by surgery (23.7%), paediatrics (19.5%), gynaecology and obstetrics (16.6%), and general care (4.6%). In addition to MoH facilities, there were six hospitals with a total of 813 beds run by other government entities in 2021, as well as 76 dispensaries and primary health care centres.
Private Care
The private sector has traditionally played a smaller role in the provision of health care. However, the government is working to expand its contribution to help meet broader health goals.
Similar to the public sector, there has been an expansion in private capacity in recent years. Of the 88 hospitals in operation in 2021, 31 were private facilities, with 1117 beds – or 15.7% of the total –up from 27 hospital and 985 beds in 2019. The number of private clinics, meanwhile, rose from 1254 to 1503 over the same period, and the network of private pharmacies expanded from 788 to 883.
Insurance
While the government provides health care free of charge to nationals, in recent years the authorities have sought to disperse the burden of spending, protect policyholders and increase the number of individuals covered by health insurance. Indeed, between 2017 and 2021 the number of individuals with health insurance expanded from fewer than 400,000 to 610,000 – an increase of 52.5%.
In January 2023 the Capital Market Authority (CMA) announced it had issued an order for compulsory health insurance for the private sector, and finalised regulations and legislative support related to the country’s new mandatory health insurance programme. Under the new programme, and according to a royal decree, insurance entities are now classified into three groups: general, life, and health and family insurance. Previously, the sector was limited to general and life (see Insurance chapter).
The launch of the programme had been in development for a number of years, with the CMA announcing in July 2018 that it was working with government entities such as the MoH and the Ministry of Manpower to mandate the provision of health care insurance for those employed in the private sector.
The scheme is set to include private sector employees – both Omani and expatriates – and their dependents, as well as tourists and other visitors. In late July 2021 the CMA began to roll out the Dhamani Health Insurance Exchange Platform, which, once fully operational, will connect regulators such as the MoH and the Royal Oman Police with insurers and health care providers. As of April 2022 the platform had on-boarded more than 100 entities.
Pharmaceuticals
Imported medicines and other products made up the majority of the $500m spent on pharmaceuticals on an annual basis as of 2021, and the government has worked in recent years to bolster local production to help meet growing demand – estimated at 10% a year – as well as to ensure a steady supply of medicines and equipment.
As of 2021 there were five domestic pharmaceutical firms, three of which produced finished products. Underscoring the urgency of developing the local industry, Oman imports nearly all its biosimilar injectables, insulin, oncology products, vaccines, and products such as masks and gloves.
To help bolster local production, in March 2021 the government announced plans to establish five new pharmaceutical facilities to help domestically produced medicines and products gain a larger market share. The government aims to increase this from 8% in 2021 to 20% by 2025 and ultimately 50% by the end of 2050 (see analysis).
Pharma companies have traditionally faced several challenges, including a lack of an integrated multi-institutional system, and relatively few local research and development (R&D) programmes in the field. However, the authorities hope efforts to expand domestic production will not only result in more secure supply chains, but also bolster the economy through R&D investment and value added.
Outlook
The government’s emphasis on strengthening education at all levels – pre-primary, primary, secondary and tertiary – as well as its prioritisation of health care service delivery has helped the country improve its social service provision in recent years. These trends are set to continue, with an expanding role for private actors in both the education and health sectors, as well as a renewed emphasis on standards and accreditation. These will both be crucial to Oman’s efforts to position itself as a destination for investment from home and abroad.
Underscoring the opportunities for growth are efforts to lessen the burden on public facilities in both sectors, bolster the local pharmaceuticals and medical supplies value chain to ease reliance on imports, mandate private health insurance, bridge the skills gap through an emphasis on TVET, and adopt the use of edtech in the classroom and beyond. Meeting related targets will help the country realise the broader objectives of the Vision 2040 economic development framework. The continued emphasis on social services will not only help Oman meet its wider development goals, but also ensure that the resulting benefits are widespread and sustainable.
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