Conclusion
The important findings from this study indicates the need for birth defect policy to establish a national surveillance system for birth defects. This measure will help in recording of the epidemiology of congenital anomalies, measuring the burden on public health and anticipate the health care needs with the implementation of preconception preventative measures. Currently we have only a notification system at ministry of health and compliance to fill the form is not 100 percent in all the regions and health care centers. Preconception genetic counselling, folic acid fortification and supplement, healthy lifestyle promotion and sufficient nourishment advice can contribute effectively in birth defect prevention programs. Therefore, major efforts are needed to increase awareness of the occurrence and risk factors of congenital anomalies through public health education and advocacy.
Funding statement: there was no funding available for the study.
Disclosure of interests: “The authors declare no conflicts of interest” including relevant financial, personal, political, intellectual or religious interests.
Contribution to authorship: SAU, BAF, SH, IAS, and MAS:  Conceptualization, Methodology, Software: Data curation, Writing- Original draft preparation. IAS, BAF, MAS and SAU : Visualization, Investigation. BAF, MAS, IAS and SH :  Supervision.: IAS and SH : Software, Validation.: IAS, BAF, MAS, SAU and SH:  Writing- Reviewing and Editing.
Details of ethics approval: The Scientific Research Committee, at the Royal Hospital, Muscat, has approved the study on 23rd January 2018 with a reference number SRC#5/2018.