Evaluating Oman's Health Financing System: Challenges and Pathways to Universal Health Coverage

Background: This study assesses Oman's current healthcare financing scheme and explores future directions for sustainable and equitable financing. Method: A mixed method approach was utilized, comprising semi-structured interviews with 25 key stakeholders. Descriptive statistics, compound annual growth rate (CAGR), correlation, and regression modelling were used for quantitative analysis, and thematic analysis was conducted on the qualitative data. Result: The primary source of financing is government revenue, which accounts for 84% of current health expenditure (CHE). There was zero real growth of per capita CHE (CAGR = -0.35%) relative to gross domestic product. Regression analyses found that a decline in out-of-pocket payments (-0.42, p < 0.01) and an increase in voluntary health insurance and enterprise financing (0.38, p < 0.01) had statistically significant effects on financing transition. Stakeholder interviews revealed that affordability is a major issue, particularly for small- and medium-sized enterprises (78% uninsured). Besides that, informal employees and low-income expatriates, combined with regulatory weaknesses, are the major challenge to health financing. Conclusion: Although the system in Oman provides financial protection, it is undermined by fiscal unsustainability. The main recommendations, including compulsory private insurance, subsidies to vulnerable groups, and strengthening regulation, are necessary to achieve Vision 2040.