ONA History

Nursing in Oman – A Brief History

Nursing in the Arab Gulf Countries is embedded in early Islamic history. During the Islamic period (570 – 632 AD), the time of Prophet Muhammed (PBUH), a woman named Rufaida Al-Asalmiya, whose father was a doctor, provided care to injured and dying soldiers during the holy wars (jihad). She spent the rest of her life developing and improving nursing and was allegedly the founder of a school of nursing (Hussain, 1981). While the claim cannot be verified Kasule (2003) believes that Rufaida did train women as nurses and with permission of the Prophet Muhammed (PBUH) she set up a clinic within a mosque to promote and teach health related living (Al Osimy, 2004).
As the West celebrates Florence Nightingale, an English nurse, widely considered the founder of modern nursing, we celebrate Rufaida Al-Aslamia, who went with the Prophet on many holy wars to treat the sick soldiers (Zakai, 2011).

Until the last century Arabian historical literature about nurses and nursing was insignificant. American mission nurses cared for King Saud and his family in the 1890s which marked the start of a growing ex-patriate nursing workforce (Amerding, 2003. Similarly in Oman nursing takes root from the early 1900s when the American Missionary Association nurses provided health care services through a medical clinic set up in Muttrah, Muscat. In 1913 a women’s hospital, As Saadah Hospital was established in Muscat and in 1917 an Indian nurse-midwife joined the team and cared for women during childbirth. During the 1930’s and 40’s, Al Rahma Hospital and two other hospitals were established; one of which was for infectious diseases such as tuberculosis and leprosy. In the early 1950’s, a 35-bedded women’s hospital was founded in order to provide antenatal and intra-natal care. In 1959, 10 health centers and 12 dispensaries were inaugurated in Sohar, Ibra, Nizwa, Seeb and Rustaq. A number of young Omanis were employed and trained to carry out simple nursing procedures in these facilities.

By 1970 various health care facilities around the country were providing preventive and curative services. During the same period the American Missionary Association started a formal two year nursing program for 5 male medical orderlies within the Muttrah Hospital (named as Al Rahma School of Nursing) on request of the government of the Sultanate of Oman, in anticipation of the quick development of the healthcare system and requirement for locally trained nurses. The Ministry of Health (MOH) took over the management of the hospital and commenced formal nursing education in 1973. The number of recruited students grew and the length of the nursing program was increased to three and a half years matching international nursing programs. Graduating nurses received a Certificate in Nursing. In the year 1979, a Directorate of Nursing was established at the Ministry of Health and Ms. Sally Sedwick, a British nurse, became the first Director of Nursing.

As with most other Arab Gulf countries foreign trained nurses established the nursing profession. However a vigorous effort was launched to encourage Omanis who could work within the framework of the prevailing traditional culture and religious values of Islam to join the profession. In 1982, Ms. Asiya bint Ali Al Kharusi became the first Omani to be appointed as the Director of Nursing. During the same period many Omani nurses were awarded scholarships to travel overseas to specialize in different fields of nursing. A major milestone in nursing education was achieved in 1982 when the Institute of Health sciences was inaugurated at Al Wattayah, Muscat. Along with nursing, the multi-disciplinary institution, catering exclusively to young Omani, also provided training in disciplines such as laboratory science, radiography and physiotherapy. To meet the demand of nursing which was growing at a brisk pace, the Ministry of Health introduced an Assistant Nursing Program during 1982-1988. A total of 156 students (102 females and 54 males) completed this program with the last batch graduating in 1990.

Since the early nineties, nursing has undergone a series of far-reaching improvements that has helped underpin the creation of a professional, competent and forward looking cadre of nursing staff. The Directorate of Nursing was restructured to include heads of nursing in the various regions of the Sultanate. Five nursing education institutes were established in Salalah, Nizwa, Ibri, Sohar and Sur in 1991 and new institutes were progressively opened in Rustaq, Ibra, North Batinah, Dhahira and Dhakliya regions. In addition, some young Omanis travelled overseas for nurse training gaining a bachelor’s degree in nursing. Today more than 1500 nurses are undergoing training in the MoH nursing institutes.

In 1994, a section for registration and licensing was added to the Directorate of Nursing and Oman was co-opted as a member of the Arab Gulf Cooperation Countries Nursing and Midwifery Technical Committee. A national Professional Code of Conduct was introduced in 2000 (ONMC, 2005, 2008). Nurses are also required to attend continuing education to maintain competency in practice (DNMA, 2007).

In 2001, the Oman Nursing Council (ONC) was established by Ministerial Decree (67/2001). Its main aim is to promote professionalism in the service by enforcing the Professional Code of Conduct as well as develop high standards in education and nursing and midwifery practice. It plays a key role in promoting competency among Omani nurses through its requirements for license renewal. Until 2008 the functions of the Oman Nursing Council were merged with those of the Directorate of Nursing with the intention of advancing the legal and administrative requirements of a professional nursing workforce until such times the different functions became clearly differentiated.

While midwifery had been considered a specialist nursing role there was a growing demand to support the domain of midwives in a different way to that of nurses. Midwifery practice concerns working with well women who are pregnant, through childbirth and caring for their newborn. In Oman the specialty midwifery education program is longer than the other nursing specialty programs (OSNI, not dated). On the international front the International Confederation of Midwives promotes “autonomous midwives as the most appropriate caregivers for childbearing women and in keeping birth normal, in order to enhance the reproductive health of women, and the health of their newborn and their families” (www.internationalmidwives.org). In their wisdom and in order to promote and acknowledge that midwifery has its own philosophy and scope of practice the ONC and DNA added midwifery to their nomenclature and became the ONMC and the DNMA.

A study of the Maternity Services in Oman was commissioned by the Ministry in 2006. The results in the report “Midwifery services and education in the Sultanate of Oman: The way forward” identified three major themes:

1. Maternity service provision;

2. Midwifery; and

3. Primary health care.

Many recommendations were made under these themes and a number of sub-themes related to system issues, facilities and resources, staffing, employment conditions, public perception, Omanization, the midwifery profession, midwives’ role and functions, licensure, education, community midwives, health education, maternal and child health clinics, and postnatal and neonatal follow up (White, 2006).

In 2008 a pilot study was undertaken to assess the feasibility of running midwifery-led community based midwifery, in the wilyat of Quriyat. The findings were very positive from the perspective of the women in the community but not feasible at the time from the service provider perspective due to shortage of staff and resources (White, 2008). However the pilot program promoted a later initiative in North Batinah. This program aims to expand the role of midwives and will be evaluated in 2013.

The Oman Special Nursing Institute was opened in 2001 initially providing post basic training in Neonatal and Pediatric intensive care, Adult Critical Care, Nephrology, Nursing Administration, Mental Health, and Midwifery. Today there are seven specialty programs as Infection Prevention and Control Nursing was added in 2010 and a further specialty program in Community Health Nursing is commencing. The present intake capacity is over 130 candidates. Graduates are awarded a post basic diploma in a respective specialty. Villanova University, University of Central Lancashire, Cardiff University and Glasgow Caledonia University have all contributed to the development of specialty programs and building the capacity and capabilities of the teachers. A one year BSc (Hons) in Nursing Studies for nurses already holding basic and post basic specialty diplomas began in 2009 under the regulations of Cardiff University and the graduates are awarded a Cardiff University degree.

Sultan Qaboos University (SQU) joined the nursing education effort in 2002 by offering a Baccalaureate program in nursing. Masters and PhD programs in nursing are envisaged at SQU for the future. Also in 2002 the University of Nizwa was established by the Decree of His Majesty Sultan Qaboos bin Said (41/99) as a non-profit university that included a nursing school, the only institution of its kind in the Sultanate. Its broad purpose is to educate students, equip them with the values, knowledge and life skills needed to enrich their lives, and to empower them to contribute meaningfully to the progress of society. A number of Omani nurses have been awarded master degrees in Nursing or allied disciplines from international universities and today there are 4 senior Omani nurses holding PhDs and 15 currently in PhD programs. Complementing nursing services and effectively collaborating with the MOH in the delivery of high standards of nursing care in the country, nurses in the Sultanate of Oman Armed Forces, Royal Oman Police, Royal Diwan, and the private sector, contribute significantly to the overall development and shaping of nursing practice and the nursing profession in Oman. ​

Nursing world-wide and, at times, throughout history, has been recognized as a noble profession that combines expertise with compassion in service to patients. Its rapid growth in recent years, from a fledgling group in the early years of Oman’s blessed renaissance, to a roughly 12,000 strong nursing community today is a testament to the enthusiasm and personal commitment of His Majesty Sultan Qaboos bin Said, and Omani nurses to their profession plus the dedication of expatriate nurses that have shared their knowledge and experience along the way.