The Eastern Mediterranean is the second most inactive region globally and has the highest levels of inactivity among women.1 In addition, few countries in the region have national policies on noncommunicable diseases (NCDs) and/or physical activity. In Oman, a country in the Arabian Gulf, the prevalence of insufficient physical activity is particularly high, especially in women and girls (men = 29.6%, women = 48.5%, adolescent boys = 84.6%, girls = 91.7%).2,3 Demographic and epidemiological changes brought on by modernization, economic development, and shifts in traditional lifestyles and occupational patterns have contributed to the low prevalence of physical activity.4,5 The rising prevalence of obesity and diabetes, and increased susceptibility of the population to these conditions, demands accelerated multisectoral action to promote physical activity.4–7
In 2014, officials in Oman embarked on positive action to address high levels of inactivity in the country. The process of developing a national policy framework for physical activity began in December 2014 with the appointment of a national focal point for physical activity in the Ministry of Health (MOH). This appointment provided a dedicated resource and a leader to drive the physical activity agenda. Policymakers in Oman followed seven key strategic steps in the development of a national physical activity plan. These actions took place over a 3-year period, from January 2015 to February 2018; each step is explained below.
Step 1: Mapping Existing Actions on Physical Activity Promotion
In January 2015, the MOH began mapping existing actions on physical activity promotion from the education, health, municipalities, sports, and planning sectors. This mapping exercise facilitated the policy development process by providing a shared understanding of the actions already underway in each sector.
Step 2: Holding Meetings With Stakeholders From Each Ministry
Throughout February and March 2015, meetings were held with key ministries including the education, municipalities, sports, and planning sectors. Discussions focused on the increasing prevalence of NCDs resulting from insufficient physical activity. The need for multisectoral collaboration was emphasized, alongside discussions on potential areas of shared action. During these meetings, each sector was requested to nominate a focal point to join a multisectoral executive team to support the MOH in developing a plan of action that was aligned to the needs of each sector and existing strategies and resources.
Step 3: Drafting a Multisectoral Action Plan
Based on the information obtained throughout the multisector meetings, the MOH drafted a physical activity action plan for Oman. Following the guidance of the “seven best investments” for national action to promote physical activity,8 the draft plan included actions across seven key areas: public education, schools, communities, health services, sports, urban design, and transport policies.
Step 4: Meeting With a WHO Expert and Hosting Two 1-Day Workshops
The draft action plan was reviewed by a WHO expert in March 2015. During the visit, meetings with decision makers from key sectors were conducted. Two 1-day workshops with technical officers from the education, health, municipality, and sports sectors were also held. These interactions raised awareness about physical activity and health and provided an opportunity to share experiences on promoting physical activity in the country. Further examinations of the challenges and opportunities in Oman allowed refinement of the draft plan of action.
Step 5: Integrating Physical Activity Into the Broader NCD Policy Agenda
In February 2016, the MOH committed to the development of a National Policy for the Prevention and Controls of NCDs.9 Eight multisectoral task forces were formally established in August 2016, one of which was responsible for physical activity. The physical activity task force included members from four sectors (education, health, municipalities, and sports) and was chaired by the Ministry of Sports Affairs. Each task force was responsible for developing a 5-year plan of action following the structure outlined in the national policy. The draft physical activity plan prepared the preceding year was translated into Arabic and reviewed and finalized by the task force.
Step 6: Adoption of the Plan
Once the physical activity plan of action was finalized, it was presented to the National NCD Committee. This committee compiled the plans from each task force to create the National NCD Plan of Action 2017–2025, and the plan was circulated to all relevant sectors for endorsement. In February 2018, the plan was launched during a large multisectoral event under the patronage of His Highness Sayyid Shihab bin Tariq Al Said, Advisor to His Majesty Sultan Qaboos Al Said, and in the presence of high-level decision makers.
Step 7: Leading the Implementation of the New National Plan
The National Policy Framework for Physical Activity, which forms part of the wider National NCD Plan of Action, comprises a range of actions across multiple sectors and settings. Each action is assigned to a ministry that is primarily responsible for its implementation. Targets have been set for many of the actions, as well as timelines over which the actions will be completed.
Since the launch, a range of initiatives have been implemented, including the delivery of capacity-building courses to train midlevel managers from various sectors about physical activity and health; the development of a national protocol for counseling on physical activity in the health care setting; the implementation of initiatives to promote physical activity in schools including playground markings, active classrooms, and guidelines on adopting a whole-of-school approach to physical activity promotion; and initiatives to improve the environment for physical activity including marking footpaths to indicate distance walked in the capital area and the production of guidelines on public open spaces for physical activity.
Over the past few years, support for physical activity promotion has been substantially strengthened in Oman and a national action plan now exists to address high levels of inactivity in the country. This builds on previous successes in NCD policy and intersectoral partnerships in Oman, including the school health, community-based initiatives, and tobacco control programs.7,10 Support for the physical activity agenda was strengthened by political commitment to the NCD agenda more broadly. Embedding the physical activity plan within the broader NCD policy was important for getting the policy both approved and funded.
Acknowledgments
The authors acknowledge the support of numerous technical officers from different sectors in Oman for their active contribution in developing the National Physical Activity Plan of Action. The views expressed in this paper are those of the authors and do not necessarily reflect those of the WHO. No funds were required to support this work.
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