Prepared by: Dr. Musa Ajlouni January, 2010 - World Health ...

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avoid poverty; (ii) improving the quality and efficiency of public services; and (iii)addressing severe resource constraints, beginning with water.Jordan achieved universal child immunization and has made considerable progress inreducing the major health risks to infants and children. The Country has been polio freesince 1995. Major progress was achieved in lowering the infant and child mortality rates,as well as the maternal morality rates. Presently, Jordan is one of the countries with thelowest infant and maternal morality rates in the region.Jordan, like other middle income countries, is witnessing an epidemiological transition,which is characterized by an increase of non-communicable diseases, particularlycardiovascular diseases, cancer, diabetes and chronic respiratory conditions.2. Country Health SystemJordan has one of the most modern health care infrastructures in the Middle East.Jordan’s health system is a complex amalgam of three major sectors: Public, private,and donors.The general Health Policy is set by the High Health Council that represents all health careproviders. The national health strategy is aimed at creating a comprehensive health caresystem, utilizing both public and private service providers covering all levels of care andimproving the quality of health services by implementing a national health servicesaccreditation program.In 2007, total health expenditures –both public and private was estimated at 1016 millionJD, This is equivalent to 9.05% of GDP. About 79% of the population in Jordan iscovered by formal health insurance.Problems related to accessibility, equity, duplication of services, poor coordinationamong major providers, unregulated private sector, low utilization rates in the privatesector, limited quality improvement programs, inefficient use of available resources ,poormanagement and inappropriate health information system are the main challengesfacing all providers of health care in Jordan.3. Health Workers Situation3.1 Health workers stock and trendsThe total number of health workers was 91756 (12% of the total employees in the publicand private sectors). The country has 2.5 physicians (generalists and specialists), 3.8nurses (all categories), 0.9 dentists, and 1.3 pharmacists per thousand population.During the last four years the number of most health professions and their percentagesto population has been increasing; registered and associate nurses have the highestincrease rate per thousand population. The nurse to doctor ratio in the health sector as awhole (1.2 nurses to 1.0 doctor) remains very low and is among the lowest group ofcountries in the world.3.2 Gender distribution by health occupation/cadreFemales comprise about 44% of the total health workers in Jordan. Women are highrepresented (more than 50%) in nursing cadres, dental technicians, pharmacists, labscientists, and most paramedics. Men are very high represented in some cadres (moreJordan HRH Profile,Musa Ajlouni (Jan 2010) 6
than 70%) as physicians, dentists, pharmacy assistants and environment health workers.The percentage of male RNs is expected to increase during the next four years as malegraduates from nursing faculties comprise about 60% of the total graduating nurses.Most of the unemployed nurses are male nurses.3.3 Age distribution by health occupation/cadreMost of the health cadres in Jordan (85%) are below 50 years of age. Young healthworkers(less or equal 30 years of age) constitute about 40% of the total health workforce in Jordan.3.4 Region and geographical distribution by health occupation/cadreThe distribution of health workforce for all categories goes in favor of the Middle Region.There are geographical disparities in the distribution of health workers mainly physiciansamong urban and rural areas.3.5 Sector distribution by health occupation/cadreThe non state sector (private sector and faith based organizations) is the main employerof HRH in Jordan (51.2%). The private health sector attracts experienced healthprofessionals from the public sector. Government employed physicians and other healthcadres are not allowed to practice in the private sector. The MOH has recentlycontracted with physicians from the private sector to meet the shortage in some medicalspecialties.3.6 Distribution of health occupation/cadre according to work placeThere are imbalances in the distribution of health cadres between hospitals and primaryhealthcare facilities. About 50% of total MOH staff works in hospitals, while thispercentage is 80% and 23% for RMS and the private sector respectively. 90% of theMOH registered nurses work in hospitals, while only 6% work at PHC.4. HRH Production4.1 Pre-service education of health workforceJordan has a strong high education system for physicians, dentists, pharmacists, nursesand allied health sciences. Jordan has three main levels of health workforce formaleducation: community college/associate degree programs (2 years after secondaryschool), university/undergraduate (4-6 years after secondary school) and post-graduate(1-4 years after university degree).There are 38 associate degree programs: 27 programs for nursing and midwifery and 11programs for allied health professions.Public and private universities conduct programs of 4-6 academic years leading to aBachelor’s degrees for physicians, dentists, pharmacists, nurses,midewifery,physiotherapy, occupational therapy,nutrition,laboratory sciences, optometry,radiology sciences, otology, speech pathology, health services administration, applieddental sciences and biomedical engineering. Physicians and dentists are educated inpublic universities only.Universities, MOH, and RMS have been involved in partnership arrangements fortraining of health sciences students in local community hospitals.Few public universities conduct post graduate programs leading to high degrees such asJordan HRH Profile,Musa Ajlouni (Jan 2010) 7
Page 1 and 2: PpppPrepared by:Dr. Musa AjlouniJan
Page 3 and 4: CONTENTACKNOWLEDGEMENT.............
Page 5 and 6: FIGURESFIGURE 1.1:TRENDS OF POPULAT
Page 7: EXECUTIVE SUMMARYIntroductionJordan
Page 11 and 12: pharmacists and nurses respectively
Page 13 and 14: INTRODUCTIONBackgroundJordan is a l
Page 15 and 16: 1. COUNTRY OVERVIEW1.1 Geography an
Page 17 and 18: Inflationary pressures on the back
Page 19 and 20: generation, along with emphasis on
Page 21 and 22: 2. COUNTRY HEALTH SYSTEM2.1 Governa
Page 23 and 24: The United Nations Relief and Work
Page 25 and 26: 2.3 Health care financingIn 2007, t
Page 27 and 28: HRH Observatory (HRHO) was establis
Page 29 and 30: Table 3.2: Health worker Population
Page 31 and 32: 20000180001600014000120001000080006
Page 33 and 34: Table 3.4: Gender distribution by h
Page 35 and 36: Table 3.6: Percentage Distribution
Page 37 and 38: 3.2.4 Geographical distribution by
Page 39 and 40: Table 3.8: Urban/Rural distribution
Page 41 and 42: The health sector in Jordan, public
Page 43 and 44: ALI YAVAR JUNG NATIONAL INSTITUTE F
Page 45 and 46: 4.1.6 Student Entry Requirements fo
Page 47 and 48: PostGraduateUniversity/Undergraduat
Page 49 and 50: 4.1.9 Governance of High Education
Page 51 and 52: Box 4.1: Functions of High Educatio
Page 53 and 54: Table 4.6: Students Admitted to Hea
Page 55 and 56: Table 4.8: Training outputs in the
Page 57 and 58: Figure 4.4:Annual Output of Univers
Page 59 and 60:
4- Supervising the internship train
Page 61 and 62:
4.3 Health workforce requirementsNo
Page 63 and 64:
5.HRH UTILIZATION: PRIORITY AND PRA
Page 65 and 66:
There are two types of staff turnov
Page 67 and 68:
Although there are formal procedure
Page 69 and 70:
There is no long-range plan for hum
Page 71 and 72:
not have specific legislation for m
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- Link financial incentives to actu
Page 75 and 76:
) Regulating and monitoring health
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6.7 The National Observatory for HR
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7. CONCLUSION AND RECOMMENDATIONSTh
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· A national program for capacity
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18) DOS.Jordan Department of Statis
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ANNEXE 1 : DEFINITIONS OF HEALTH WO
Page 87 and 88:
ANNEXE 2: HEALTH WORKFORCE CLASSIFI
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Enrolled NursesAlso called nurse te
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Dentists (specialist)At least 5 yea
Page 93 and 94:
Note: This program was stopped in19
Page 95 and 96:
11. Environmental and PublicHealth
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OpticianAt least 4 years of univers
Page 99 and 100:
Anesthesia Technician2 years in ane
Page 101 and 102:
Annex 3: HRH STRATEGIC DIRECTION AN
Page 103 and 104:
Questions Findings Remarks (if any)
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Public sectorQuestions Findings Rem
Page 111 and 112:
Page 113 and 114:
Page 115:
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