Oral health and workforce issues –

reflections from Oman

Dr. Salahudeen Al Bulushi

Director of Dental & Oral Health
Ministry of Health
Content
 Introduction
 Demography
 Oral health status of Omani population
 Workforce in Oman
 Challenges and need for improvements
 Public health measures implemented
 Future prospective
 Key factors in workforce planning
 Introduction
 Human resources are critical in to the sustainability of any healthcare system.

 Achieving self reliance was developed by the strategic direction of various

healthcare governing bodies, so has the work done to develop national
programs, utilize scholarship opportunities, and conduct appropriate
continuing professional development activities to ensure a strategic approach
to addressing the needs of the expanding Omani population.

 Healthcare leaders from the civil, armed forces, educational, and private
institutions have created a harmonious collaborative effort to develop,
strengthen, and sustain an internationally reputed healthcare system and
subsequent workforce.
Omani population distribution according to age

Cumulative
Age group percentage of
population %
0-4 13.2
5-9 23.4
10-14 34
15-19 46.1
20-24 59
25-29 70.5
30-34 79.5
35-39 85.4
40-44 89.3
45-49 92.3
50-54 94.5
55-59 96.2
60-64 97.5
65-69 98.7
70-74 99.3
75-79 99.7
80+ 100
ORAL HEALTH STATUS OF OMANI
POPULATION
 Percentage of Caries free Children aged (2-5)1
70

60

50

40

30

20

10

0
Age (Yrs)
2 3 4 5
1. Alazri. K, Alnabhani, Y. Prevalence & risk factors for Early childhood caries: Armed forces Hospital experience in the
sultanate of Oman – poster presentation at Oman International dental conference 2013
 Mean dmft/deft of Children aged (2-5 Years) in Oman1
Mean dmft

0
1 2 3 4 Age (Yrs)

1. Alazri. K, Alnabhani, Y. Prevalence & risk factors for Early childhood caries: Armed forces Hospital experience in the
sultanate of Oman – poster presentation at Oman International dental conference 2013
Mean deft of 6 year old Children in Oman2

year deft

2007 4.25

2008 4.4

2009 4.9

2010 5.3

2011 5.1

2. Ministry of Health Annual Health reports

 Dental caries trend (DMFT) in 12-years-old children in
Oman

2.5

2
DMFT

1.5

0.5

0
1979 1991 1993 2001 2006
Year
mean DMFT of 12 years in each governorates
2.5

1.5

2001
2006
1

0.5

0
Al Dhakhilya North south Sharqiya Al Dhahira Dhofar North Batinah south Batinah Musandam Muscat Al wusta
Sharqiya
 Dental caries trend (DMFT) in 15-years-old children in
Oman
3.5

2.5
DMFT

1.5

0.5

0
1996 2006
Year
 Mean DMFT of adults in Oman3
 Cross sectional study of 319 teachers who are randomly
selected from Muscat Governorate public schools in Oman
 Age of participants ranged from 23 to 50 (mean 30.9 SD
5.3)
 Findings:
 Caries free 7%
 Mean DMFT 6.3 (SD 4.2)

3 Al Harthi L., Cullinan M., Leichter J., Thomson M. Oral health of an adult group in Oman –
poster presentation at Oman International dental conference 2013
Workforce in Oman
 Number of Dentist and Dental Auxiliaries in Oman
Dental
Oral Dental Dental Dental
Ortho Endo Prostho Paedo Perio. Lab
Sector GP Surgery Public Therapi Hygiens DSA Total
Spl Spl Spl Spl Spl Technici
Spl Health st ts
an

214 7 10 2 3 2 1 4 1 3 27 177 451

MOH

37 2 2 1 3 1 0 0 3 18 35 55 157
MOD

4 0 3 1 0 1 0 0 1 0 1 4 15
SQUH

3 0 0 0 1 0 0 0 1 3 0 7 15
Diwan

1 1 1 0 1 0 0 0 0 2 4 1 11
ROP

424 30 1 1 3 3 1 0 2 59 1 1 526
Private

Total 683 40 17 5 11 7 2 4 8 85 68 245 1175

 Percentage of Change in the number of dentists (1995
To 2010)
700

600

500

400

300

200

100

0
End-1995 End-2000 End-2005 End-2010
 Dentists per 10,000 population
2.5

1.5

0.5

0
End-1995 End-2000 End-2005 End-2010
Dental Workforce Distribution by Health Sub-Sector
(2010)

40%
Ministry of Health
Other Govt.
57%
Private Sector

3%
Omanization of Dental Workforce by Health Sub-
Sectors (2010)
2%

53%
Ministry of Health
Other Govt.
Private Sector
75%
 Dental Workforce Densities in Selected Countries
(2010)
18
16
14
12
10
8
6
4
2
0

Number per 10,000 population

Source: the WHO statistics 2010
Healthcare Workforce Densities in Selected Countries (2010)
compared to reported DMFT in 12 years old children

18
16.3
16

14

12 Dentistry
Population Ratio
10 8.9
7.8 DMFT 12 YRS
8 7.3 7.4
6.8 OLD
5.8
6 5.2
4.2 4.3
4 3.5 3.6
2 2.3
2

0
 Public Health measures implemented

 Topping up fluorides in the public water

 Topical Fluoride applications and fissure sealant in Oman

Future prospective
 Pre-school children fluoride applications
 School-based dental preventive programmes
 Increase number of pediatric, orthodontists specialist
services
 Expanding the primary health care services
 Public education campaign focused on oral health
prevention and education.
 The establishment of the National Dental Workforce
Planning Group
Challenges and need for improvements
 Private dental college to train undergraduate dental
students

 Rapid expansion (or planned expansion) of dental

facilities by most service providers

 Un organized private dental sector

 Risk factors
 Key factors in workforce planning
 WHO (2001) and the Canadian Health services Research Foundation
(2007) a comprehensive study of the workforce planning may take into
consideration:
 Changing health needs in the population;
 Productivity, practice patterns or variances in specialty mix
 Increased investment in health promotion and chronic disease
management and the resulting need for different skills and
deployment;
 Advances in treatment and technology that may change the type and
amount of treatment patients need;
 New service delivery models
 Expanded scopes of practice and new deployment models/roles;
and The distribution of the workforce.
Key factors in workforce planning
 Key implications for healthcare decision-makers must
involve a need-based and outcome-directed outcome,
the needs do not remain constant, and changes are multi-
faceted requiring multi-disciplinary intervention that is
clearly measured and documented
 Towards better
Oral health for our
children