Economics of primary healthcare: cost estimation of clinical services at primary care facilities in the six countries of the Gulf Cooperation Council.

OBJECTIVE: While the Gulf Cooperation Council (GCC) countries have demonstrated a strong commitment to strengthening primary healthcare (PHC), the costs of delivering these services in this region remain relatively unexplored. Understanding the costs of PHC delivery is essential for effective resource allocation and health system efficiency. DESIGN: We used an ingredient-based method to estimate the cost of delivering a selection of services at PHC facilities in the six GCC countries in 2019. Services were categorised into eight programmes: immunisation; non-communicable diseases (NCDs); oral and dental care; child health; nutrition; mental health; reproductive, maternal, neonatal and child health and general practice. The cost estimation focused on two key ingredients: the costs of drugs and supplies and the healthcare workforce cost. The coverage rates of specific types of health services, including screening and mental health services, were also estimated. Data for the analysis were obtained from ministries of health, health statistics reports, online databases, national surveys and scientific literature. RESULTS: The estimated costs of delivering the selected services at public PHC facilities in the six GCC countries totalled US$5.7 billion in 2019, representing 0.34% of the combined 2019 GDP. The per capita costs varied from US$69 to US$272. General practice and NCD programmes constituted 79% of the total costs modelled while mental health ranged between 0.0% and 0.3%. Over 8 million individuals did not receive NCD screening services, and over 30 million did not receive needed mental health services in public PHC facilities across the region. CONCLUSIONS: To our knowledge, this is the first study to estimate the costs of services delivered at PHC facilities in the GCC countries. Identifying the main cost drivers and the services which individuals did not receive can be used to help strengthen PHC to improve efficiency and scale up needed services for better health outcomes.

Risk Factors Associated with COVID-19 Infected Healthcare Workers in Muscat Governorate, Oman.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide, causing a global public health crisis. Healthcare workers (HCWs) are vulnerable due to their role in the management of COVID-19 infected patients. As of June 2020, a total of 847 HCWs in Oman had reportedly contracted COVID-19, with an incidence rate of 1.47%. This study therefore aimed to identify factors associated with COVID-19 infection among HCWs in Muscat Governorate, Oman, as well as to evaluate adherence to infection prevention and control (IPC) measures. METHODS: This cross-sectional study involved cases of laboratory-confirmed COVID-19 infection among HCWs working under the Directorate General of Health Services of Muscat Governorate, Ministry of Health, between February and June 2020. Data regarding the participants' sociodemographic characteristics, risk factors, pre-existing medical conditions, and adherence to IPC measures were collected using a self-administered questionnaire distributed via a web-based mobile application. RESULTS: A total of 126 HCWs with confirmed COVID-19 infection participated in the study. Of these, 72.2% were female, 53.2% worked in primary care facilities, and 61.1% were medical doctors or nurses. Only 18.1% were over 45 years of age and 30.2% had pre-existing medical conditions. While 29.4% had never received IPC training, the majority followed recommended hand hygiene practice (96.8%) and social distancing protocols (93.7%) and wore protective facemasks for routine patient care (96.9%). CONCLUSION: While the majority of HCWs followed crucial IPC measures, one-third had never received specific IPC training or faced restrictions on PPE use. HCWs, including those in housekeeping and administrative functions are recommended to undergo rigorous IPC training. In addition, high-risk HCWs could be assigned duties away from active COVID 19 cases. It is recommended to restructure health facilities for better adherence to IPC standards.

Attitudes and impact among people with abnormal premarital screening test results in Muscat governorate's primary healthcare centers in 2018.

Hereditary hemoglobin disorders are among the most common inherited diseases globally. In Oman, the burden of hereditary hemoglobin disorders has long been recognized as a major public health problem. In Oman, the prevalence of SCD ranges between 0.2 and 0.3% and of homozygous B-thalassemia was 0.07-0.08% while the prevalence of sickle cell trait and B-thalassemia trait reached up to 4.8-6% and 2-2.6% respectively. Glucose-6-phosphate dehydrogenase (G6PD) had a high prevalence in Oman, being 25% in males and 10% in females. The premarital screening and counseling (PMSC) program is an important preventative service for the most common hereditary hemoglobin disorders in Oman. The aim of this research is to study the attitude of those with abnormal premarital screening results and the impact of these results. This cross-sectional study was carried out in all primary healthcare centers in the Muscat governorate in 2018 to analyze abnormal premarital screening (PMS) tests results which mainly include sickle cell disease, thalassemia, and G6PD deficiency. Data were collected through telephone questionnaires with those with abnormal PMS test results. The questionnaire consisted of 3 parts investigating sociodemographic characteristics, attitudes toward PMS, and impact of the screening on participants. Of the 159 participants, 72.3% were between 20 and 29 years of age. Over two-thirds (71.5%) took PMS test while engaged. Consanguineous marriage was reported in 38.4% of married participants. The majority (94.3%) of participants believed PMSC to be important and (90%) agreed PMS should be obligatory before marriage. Half took the test as a personal decision while 17% complied with their spouse. Healthcare worker advice accounted for 21.4% of participants' decisions. Participant response to positive PMS results showed that 23% canceled their engagement, while 13.8% continued with marriage. Overall, 57.9% believed that PMS affected their lives positively. There is a relatively high favorable attitude toward PMSC. More effort is needed to raise public awareness regarding early PMS. Additionally, further genetic counseling before and after PMS testing is essential for the program's success.