- Report -

Ukraine

Making every school a health-promoting school: global standards and indicators

Credits

author

Outcome

Supportive and empowering societies through addressing health risk factors

[COUNTRY STORY]

Multistakeholder action to improve health and wellness and reduce health inequity through the first Healthy Island initiative in the East Mediterranean Region

Oman

Photo: WHO Oman Fitness equipment has been installed in public spaces on Masirah Island to encourage physical activity

Healthy Island initiative to improve health and wellness

In Oman, Non-communicable diseases (NCDs) are responsible for 72% of all deaths with nearly one in five adults dying from NCDs before the age of 70. To combat risk factors for NCDs including tobacco use, physical inactivity, and unhealthy diets, the government of Oman launched the Healthy Island initiative on Masirah Island in 2022 in collaboration with the World Health Organization (WHO). This initiative is the first of its kind in the WHO Eastern Mediterranean Region and aims to address social determinants of health by empowering communities to adopt healthier lifestyles. Despite challenges posed by the COVID-19 pandemic, the Healthy Island Initiative has had a positive impact through activities such as co-funding and constructing a harbour for local fishermen, developing a small market area for economically disadvantaged women, and constructing playgrounds to promote physical activity in children. It is anticipated that the comprehensive systems approach adopted will lead to a decrease in NCDs across the island, particularly in underserved and disadvantaged populations.

Key WHO Contributions

Deployment of Healthy Island initiative from another WHO Region
Conduct of capacity building of political and administrative leaders
Use of WHO tools for monitoring and evaluation
Conceptualization of initatives to address social determinanats of health.

How did Oman, with the support of the WHO Secretariat, achieve this?

The Ministry of Health (MoH) in Oman has taken a proactive stance to address the social determinants of health with its policy statement that paves the way for health and non-health measures, and through the MoH’s Community Based Initiative (CBI) department which was established with WHO’s financial and technical support in the early 1980’s. Over the past two decades, the CBI has endeavoured to equitably improve health and socio-economic development through Healthy Lifestyles, Healthy City, and Healthy Village projects across Oman.

WHO’s Healthy Island initiative seeks to create healthier environments for people to live, work, and play through evidence-based advocacy, policy development, leadership, multisectoral planning, partnerships, and community participation. While the vision has served as a unifying theme for health protection and health promotion in the Pacific, it had not previously been implemented in the East Mediterranean Region. In 2022, WHO Oman collaborated with Oman’s MoH to launch the Healthy Island initiative on the largest and most populous island in the Gulf Cooperation Council (GCC) states, Masirah Island. Early in 2022, WHO Oman catalyzed the approach through advocacy at the subnational level. WHO organized meetings with Masirah Island’s local governor and health committee and, in September 2022, held a national workshop. More than 40 local governors attended the workshop to learn the principles of the healthy cities approach and share knowledge from their practical experience.

^{A healthy walkway for women is currently under construction on Masirah Island.}Photo credit: WHO Oman.

To build the governance and leadership capacity to deploy a comprehensive and integrated approach at the subnational level, WHO Oman and the WHO Regional Office for the Eastern Mediterranean provided financial, logistical, and technical support to design and deliver trainings. Delivered to health committees, the MoH, and local community leaders, the trainings focused on problem identification, solution development, fundraising, implementation, and the evaluation of health outcomes. To further support the evaluation of health outcomes, WHO Oman provided technical expertise to the MoH's CBI to use a WHO pre-set 80-indicator checklist for monitoring and evaluation. WHO Oman also provided practical recommendations to improve documentation of achievements and ensure inclusion of key success factors for implementation. To further promote data-driven decision-making, WHO support included developing an electronic survey platform to improve baseline assessment of villages, cities, and islands, and enhance analysis and interpretation of results. This platform will ensure long-term accountability through monitoring and evaluation and enable data dissemination through a centralized database and a dashboard for data visualization.

Partnerships between community organizations and the government enable the continuous identification and resolution of priority issues. By providing technical advice to the MoH, WHO Oman facilitates the selection, development and implementation of initiatives that address social determinants of health. WHO Oman also provides ongoing technical expertise and guidance to steer projects at the subnational level through an executive board and health committee. This enables an evidence-informed approach that is guided by global guidelines and standards, such as the Eastern Mediterranean Region's guide to implementing healthy cities. For example, WHO Oman advocated for the inclusion of community emergency preparedness activities in Healthy Island activities, given Oman's vulnerability to cyclones.

“Health interventions are most effective when they are tailored to meet local needs. In Oman, the World Health Organization has been working alongside local communities so that, together, we can ensure that all people have the opportunity to lead healthier lives”

- Dr Jean Jabbour, WHO Representative to Oman

Communities then participate in the planning, financing, and implementation of activities, with community leaders playing a key role in communication as was demonstrated in 2021 when local communities collaborated with the local government and Civil Society Organizations to successfully generate demand for COVID-19 vaccination.

The involvement of multiple stakeholders has made the Healthy Island Initiative a powerful tool for tackling the issue of NCDs in Oman. This is of utmost importance given the country's large area and dispersed population, which has posed a challenge to effective coordination in the past.