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Jordan
>> Regional Overview >>Jordan Overview Program Data Sheet
278-003
USAID MISSION: Jordan
PROGRAM TITLE: Reproductive and Primary Health Care (Pillar: Global Health)
STRATEGIC OBJECTIVE AND NUMBER: Improved Access to and Quality of Reproductive and Primary Health Care, 278-003
STATUS: Continuing
PLANNED FY 2002 OBLIGATION AND FUNDING SOURCE: $18,000,000 ESF
PROPOSED FY 2003 OBLIGATION AND FUNDING SOURCE: $41,500,000 ESF
INITIAL OBLIGATION: FY 1995 ESTIMATED COMPLETION DATE: FY 2004Summary: USAID’s program of reproductive and primary health care includes:
- Improved knowledge of contraceptives;
- Increase availability of reproductive and primary health care services in the public sector;
- The private sector family planning initiative;
- Increased rationalization of the health financing system.
Jordanian families throughout the kingdom, mothers and children under five in particular, and users of primary healthcare clinics are the beneficiaries of the programs.
Inputs, Outputs, and Activities: FY 2002 Program: In FY 2002, USAID’s program with the Primary Health Care Initiatives (PHCI) will focus on training, service provision, logistics and management systems for primary and reproductive health. The PHCI activity aims to improve quality, management and efficiency of reproductive and PHC services at all 380 Ministry of Health (MOH) PHC centers. It includes extensive training programs and technical assistance to upgrade 200 primary health centers selected to serve as models for high quality primary, reproductive, and basic health services, while the remaining centers will benefit from a basic support package. The 200 focal centers will receive intensive improvements, including clinical training, quality assurance systems, upgrades in health management information systems, management improvements, renovations and equipment. USAID will provide technical assistance and training to the major Jordanian institution involved in reproductive health, the Jordanian Association for Family Planning (JAFPP). JAFPP, which focuses on service delivery, embarked on an institutional plan aimed at achieving sustainability. The program will increase efficiency in health financing and management and provide specialized technical support. Specific activities envisaged include a program on HIV/AIDS management and impact; support for demographic and health surveys; infectious disease surveillance; efforts to introduce new family planning methods and improve the quality of services offered by public and private providers; and support for the National Population Council and other organizations on communication strategies, policy development and other issues.
Planned FY 2003 Program: USAID plans to use FY 2003 resources to continue providing technical assistance and training to PHCI, JAFPP, health financing and management programs, and programs through USAID’s pillar bureaus. In addition, USAID anticipates the possible design and launch of a national-level poverty alleviation program that will focus on low-income communities, including support for community-based activities focusing on quality of life issues, a "Girls and Young Women’s Education Project" ($7 million), and a follow-on for PHCI.
All contracts and grants funded with resources from the Jordan Program will incorporate clauses that implement the President's directive reinstating the Mexico City Policy.
SUBMISSION OF THIS PROGRAM DATA SHEET CONSTITUTES FORMAL RENOTIFICATION OF USAID’S INTENT TO OBLIGATE FY 2002 RESOURCES FOR THE ACTIVITIES DESCRIBED ABOVE. Performance and Results: USAID continues to be the major donor of family planning services, supplies, information and training for physicians, nurses, midwives and pharmacists. USAID-funded programs have contributed to a continuing decline in the total fertility rate from 5.6 children in 1990 to 3.5 in 2001. Seventy percent of the decline in fertility resulted from changes in marital fertility, while 30% resulted from a delayed age of marriage. The rate of increase in the modern Couple Protection Rate (CPR), while meeting the 2001 target, seems to be slowing down in the last five years. However, the continuing decline in fertility rates in the rate of natural increase is encouraging. The seeming contradiction between the slowing down of CPR annual increases and the continuing decline in the total fertility rate is likely the result of further counseling and expanded availability, resulting in more effective use of contraceptives. The later age of marriage is also a factor.
Progress in reducing infant deaths has been significant. The Infant Mortality Rate (IMR) has been reduced from 70 deaths per 1,000 live births in 1972 to 29 in the last survey. These reductions are due mainly to child survival programs and family planning. While infant and child mortality rates continue their downward trend, there are differentials among subgroups. IMR is a good indicator of overall socioeconomic status of a population or community. In Jordan there is considerable variation among regions—the south has an IMR 41% higher than the north. This underscores the validity of the strategy to focus more resources on the south and rural areas.
PHCI activities during 2001 included extensive training programs for health provider teams throughout the kingdom, and quality improvement systems functioning in 34 focal centers. Capacity of managers at the governorate level has been strengthened to ensure sustainability of primary health improvements.
With USAID assistance, the Ministry of Health completed the second annual compilation of national health accounts, a national health expenditures and facility utilization survey. The findings from these surveys are being used to plan and monitor the Government of Jordan’s new health policy reforms to address such issues as cost recovery, health insurance schemes, financing options, performance-based incentives for primary health care staff, and decentralization. Through the Centers for Disease Control, the U.S. Government has provided support for strengthening the national epidemiological surveillance system.
USAID successfully launched a new five-year cost recovery and sustainability activity to support the JAFPP, a successful NGO that provides 25% of family planning services in Jordan but still relies on donor assistance. The goal of this activity is to assist JAFPP to increase its recovery of overall costs from the current 44% to at least 75%, while maintaining its 25% share of family planning services in a highly competitive market. Finally, a small new HIV/AIDS program was launched aimed at high-risk groups as a means of addressing a problem that so far has had only a modest impact in the kingdom. An HIV/AIDS hotline and voluntary testing and counseling center have been established for the first time in Jordan.
Principal Contractors, Grantees, or Agencies: Abt Associates; Tulane University; Futures Group; Deloitte Touche Tohmatsu; John Snow International; Johns Hopkins University; U.S. Bureau of Census; Academy for Educational Development; Centers for Disease Control and Prevention; Engender Health; and Family Health International; University of Colorado; Initiatives, Inc; and TransCentury Associates. Major host country partners include the Ministry of Health; Jordan University Hospital; Royal Medical Services; Department of Statistics; and Jordanian non-governmental organizations.
US Financing in Thousands of Dollars
278-003 Improved Access to and Quality of Reproductive and Primary Health Care DA ESF Through September 30, 2000 Obligations 10,718 50,882 Expenditures 9,154 31,226 Unliquidated 1,564 19,656 Fiscal Year 2001 Obligations 0 17,938 Expenditures 1,292 17,012 Through September 30, 2001 Obligations 10,718 68,820 Expenditures 10,446 48,238 Unliquidated 272 20,582 Prior Year Unobligated Funds Obligations 0 0 Planned Fiscal Year 2002 NOA Obligations 0 18,000 Total Planned Fiscal Year 2002 Obligations 0 18,000 Proposed Fiscal Year 2003 NOA Obligations 0 41,500 Future Obligations 0 71,680 Est. Total Cost 10,718 200,000
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Last Updated on: May 29, 2002 |
