Premarital check surges amid RO55 million burden

STAFF REPORTER
MUSCAT, NOV 14
Oman’s healthcare sector is undergoing a major preventive transformation following the enforcement of mandatory premarital medical screening, a policy aimed at curbing hereditary blood disorders that currently drain RO 55 million from the national health budget each year.
Since January 1, 2026, completing a premarital medical exam has been a legal prerequisite for finalising any marriage contract involving an Omani citizen, under Royal Decree No 111/2025.
According to Dr Raya bint Said al Kamyani, Public Health Specialist and Head of the Preconception Care Section at the Ministry of Health, public compliance has surged across all governorates since the law took effect. Even before the mandate, voluntary participation climbed sharply — rising from 39 per cent of registered marriages in 2024 to 64 per cent in 2025, driven by a nationwide awareness campaign.
Today, the ministry’s digital screening platform, Tawafuq, is fully integrated with the Notary Public’s electronic contracting system, Tawtheeq, automatically blocking the registration of any marriage lacking a verified medical certificate.
The economic and human stakes behind the policy are substantial. Treating sickle cell anaemia costs Oman’s health system roughly RO 40 million annually, while thalassemia care adds another RO 15 million. National survey data shows that 5.3 per cent of Omani children under five carry the sickle cell trait and 4.2 per cent carry the thalassemia trait — rates expected to mirror those of young adults entering marriage.
Despite these carrier rates, Dr Al Kamyani noted that roughly 99 per cent of screened couples are medically compatible. Only 1 per cent of screenings reveal 'genetic incompatibility,' where both partners carry a recessive trait. However, each incompatible pairing carries a 25 per cent chance per pregnancy of passing on a severe hereditary disorder. While consanguineous or kin marriages—which account for approximately 58 per cent of unions in Oman—elevate genetic risks, Dr Al Kamyani emphasised that non-related couples face the exact same 25 per cent risk if both happen to be carriers.

Crucially, the law mandates testing, not marital outcomes. 'The physician's role is limited to explaining the results, clarifying safe versus high-risk options, and outlining preventive choices,' Dr Al Kamyani explained. 'The final decision remains entirely with the couple.' Early indicators suggest strong public responsiveness to medical advice, though officials urge couples to get tested well before formal engagements — ideally as the very first step — to avoid social pressure while awaiting confirmatory lab results.
To ensure privacy, positive results are disclosed individually in confidential counselling sessions before couples meet together, and specific medical findings are omitted from the final marriage certificate. Unauthorised disclosure carries strict legal penalties.
Currently, the screening covers sickle cell anaemia, beta-thalassemia, Hepatitis B and C, HIV, and syphilis. Supported by over 135 specially trained physicians across public and private clinics, the Ministry of Health has also expanded newborn screening to 26 genetic and metabolic conditions and is now studying early genetic screening for school students to build a healthier future generation.