Impact case study database

Prof Ghebremeskel and Dr Min’s rigorously conducted study for the first time demonstrated a high prevalence of vitamin D and omega-3 fatty acid deficiency and physical inactivity in Omani school children aged 9 and 10 years, Their findings led directly to

(1) improvements in school nutrition information and advice for parents, school principals and administrators and health professionals;

(2) changed nutrition and physical activity practices of schools;

(3) the implementation of the Oman national nutrition survey; and

(4) informed the recommendations of the fortification consultant commissioned by UNICEF Oman to assess food enrichment programme, [S3].

School nutrition information and advice – As a result of the research conducted by Ghebremeskel et al, Dr Samia Al Ghannami, Director of Nutrition in the Ministry of Health of Oman, and her team introduced and are continuing to deliver nutrition education and advice to schools, parents and school food suppliers through multiple platforms - face-to-face meetings, newspapers and radio, [S2]. The purpose of the nutrition education programme is to:

(1) Provide comprehensive information on the prevalence of vitamin D, omega 3 fatty acids, iron and other micro-nutrient deficiency in Omani school children and its adverse health consequences,

(2) Educate parents and other stakeholders about the dietary sources of the aforementioned nutrients,

(3) Influence positively parental attitude on nutritional and food selection behaviour of their children.

The newspaper and radio nutrition programmes introduced in 2018 have nationwide (Oman-wide) reach and impact. Since 2018, Dr Al Ghannami and her colleagues have delivered monthly face-to-face nutrition and health education sessions. Each session is aimed at children and parents of a class with an average size of 30 children. Over the three years to June 2020, 1440 children and their parents have been educated on a healthy and balanced diet and the adverse effects of nutrient deficiency on growth and development, and behaviour and cognitive ability. [S3]

Nutrition and physical activity practices of schools – In 2018, the three schools which participated in the study, after receiving feedback, advice and guidance based on the research findings from Dr Al Ghannami and her team, started to provide a fresh, healthy and nutrient-rich meals, which include fish, vegetables and fruits, during the mid-morning break five days a week for children aged 6 to 10 years (n=950). They have also instituted a regular supervised physical activity programme during school days for children aged 9 and 10 (n=400). [S2]

Oman national nutrition survey (2017) – Ghebremeskel and Min’s research findings revealing vitamin D, omega-3 fatty acid and iron deficiency in school children in Muscat informed the Ministry of Health of Oman’s decision to conduct further studies and evaluations of nutritional deficiencies amongst its population. Their findings, as Dr Salima Al Mamary, Director of Nutrition Department, noted, specifically provided a piece of strong evidence for the Ministry to conduct a national survey on the micronutrient status of children and women of childbearing age to find out if the deficiency is apparent in different age population groups. Subsequently, the Nutrition Department, Ministry of Health Sultanate of Oman, surveyed 1677 babies and infants 6 to 59 months of age and 1749 women of childbearing age. The sample sizes constitute about 15% of their respective population groups. The findings of the Ministry’s survey, which was led by Dr Samia Al Ghannami and her team in collaboration with Professor K Ghebremeskel were “consistent with the findings of the study by Ghebremeskel and Min, revealing” a vitamin D deficiency in 10% of the children and insufficiency in 54%, [S3]. As a result of the survey and Ghebremeskel and Min’s findings, the Ministry of Health in conjunction with UNICEF Oman “commissioned the fortification Consultant to evaluate [both] the findings of [Ghebremeskel and Min’s research] and the Omani Nutrition Survey and to provide recommendations on the feasibility of [a] fortification programme” [S3].

Recommendations of the UNICEF commissioned fortification consultant (2018): After evaluating the findings of Ghebremeskel and Min’s research, which identified deficiencies in vitamin D omega 3 fatty acids in school children, and the subsequent Oman National Nutrition Survey, the UNICEF consultant concurred with Ghebremeskel and Min’s recommendations [S1] that vitamin D should be included in the fortification programme for staple foods including milk and cooking oils consumed by adults and children in the country to help alleviate the deficiency of the nutrient. In 2019, the World Bank estimated Oman’s population to be 4.9 million people. Dr Mamary of the Ministry of Health’s Nutrition Department confirmed that in 2020 Ghebremeskel and Min’s recommendation is being implemented across Oman [S3].

Oman's economic development and self-sufficiency were explicitly linked to the health of its population at The International Conference on Seafood Safety, Quality and Traceability Systems in Muscat in March 2014. At the conference, co-sponsored by the regional office of the UN’s Food and Agriculture Organization (FAO), the government’s investment in the fishing sector and the importance of safe and healthy products for domestic markets were highlighted by Dr Hamed bin Said al Oufi, Under-Secretary, Ministry of Agriculture and Fisheries.[S4] He pledged to increase the number of fishing ports in the country by 10 by 2020 and “ensure the provision of safe and healthy products for human consumption in domestic markets”. The need for accessible supply of fish to support the health of the population was affirmed by the inclusion at the conference of Prof Ghebremeskel’s keynote presentation of the research findings.[S5]