Drawing on revenues from oil exports which had started in 1967, far-reaching plans for socio-economic development were implemented, and delicate balances were pursued between the various components of the Sultanate and the powerful tribes of the interior. Continuity and innovation apparently merged, affecting the welfare and health sectors as well. The latter, financed through the burgeoning oil and gas revenues, was developed in a rapid and impressive way.

In July 1970, when life expectancy was 49 years, there were only two hospitals, run by an American Mission, and ten clinics and dispensaries in the whole country. Three years later there were already nine fully operative hospitals at Ruwi, Salalah, Tan‘am, Matrah, Muscat, Nizwa, Rostaq, Sohar and Sumail, and rising numbers of health centres and dispensaries in each region.

The Ministry of Health developed the system in three main stages. Between 1976 and 1990 the focus was mainly on health infrastructure building, then between 1991 and 2005 new strategies were adopted to establish a system of decentralised health centres, widely spread in eleven health administrative divisions throughout a country divided in seven administrative regions. In such a way, the right to free primary health services could rapidly be guaranteed to Omani citizens almost everywhere, from urban areas to the most isolated rural and Bedouin’s areas, from the mountains to the desert and the coasts.

Between 2006 and 2010 more comprehensive plans were conceived to involve both central health institutions and local structures in the various divisions, in order to better address the new challenges. Health initiatives based on prevention became a top priority: while malaria and other infectious diseases had been eradicated in a few years, non-communicable diseases had started increasing with modernisation.

The relevance of a community-based approach comes to the fore: in 2000 Oman reached the World Health Organisation’s top ranking for the ability to invest efficiently in health improvements, apparently without disparities. Such an approach seems to be quite consistent with the Ibadi ethos, which contributed throughout the centuries to “weld together Omani society into a unity that was relatively little divided by social barriers”.

The social principles of “justice, equality, and equal opportunities between Omanis” are also clearly expressed in article 12 of the Basic Statute of the State, declaring the state’s responsibility “for public health and the means of prevention and treatment of diseases and epidemics”, and adding that “the State endeavours to provide healthcare for every citizen and encourages the establishment of private hospitals, polyclinics and medical institutions.” The latest available data, related to the quality of health developed during Sultan Qaboos’ reign, place Oman in line with the other GCC member States and in the group of countries with the highest human development (see figure 1).