The future of a country is in the hands of its people. Jordan has the opportunity to access a demographic dividend that could double its economic growth over the next 25 years, but this requires policy-makers to understand the demographic trends and create a policy environment that takes maximal advantage of demographic potential. Over the next 50 years, Jordan’s demographics will change dramatically – a change that has the potential to translate into dividend or great difficulty for the country. The country’s population is growing rapidly, doubling over the last 20 years and likely to double again by 2029. More important, however, is the demographic transition the country is undergoing, as it moves from high fertility and mortality, to low fertility and mortality (David Bloom, “Demographic Transition and Economic Opportunity: The Case of Jordan,” April 2001).

Challenges

Jordan has one of the fastest growing populations in the world. Between the two censuses in 1979 and 1994, the population grew from 2.1 to 5.1 million people, an average increase of 2.7 percent annually. At this rate, the population of Jordan will double in 25 years. The Government of Jordan (GOJ) has recognized that this will place tremendous strain on Jordan's natural resource base.

Jordan's focus has been on developing its human potential, essentially by advancing the well-being of its citizens. While overall health conditions in Jordan - low infant mortality rates and high life expectancy - are among the best in the region, the population growth rate continues to be a major development constraint - especially when analyzed in light of the quantity and quality of services to be provided to accommodate this rapid increase in population. The landmark passage of the National Population Strategy (NPS) in March 1996 and the passage of the Reproductive Health Action Plan, a sub-strategy of the NPS, in April 2004 make it clear that Jordan is serious about family planning. One of the principal elements of the Strategy is the reinforcement of the "right of families to produce an appropriate number of children and to have access to information and family planning methods in order to make their decisions freely, albeit in line with religious and cultural values."

Jordan faces several other key issues including less than fully functional public health systems, a significant unmet demand for high quality maternal - child health care services and information, and a significant increase in the prevalence of chronic diseases. Fortunately, due to the GOJ’s existing policy on HIV/AIDS prevention coupled with conservative social norms, the AIDS epidemic is not expected to pose a significant threat to Jordanians during the next five years.

Response

Given the situation above, USAID/Jordan, in partnership with the Ministry of Health (MOH), will continue to support programs that expand and institutionalize high quality health care services and information at national and sub-national levels in Jordan. This partnership strongly emphasizes family planning, reproductive health and maternal and child health services. In tandem with activities that strengthen the delivery of maternal and child health services, USAID is working to improve important health indicators such as life expectancy, infant mortality, and morbidity. These efforts occur at all levels of the health system, but especially at the local level where health care workers interact the most with citizens. To improve important health management systems, USAID is assisting the MOH to adopt a more competitive legal and regulatory framework for the health sector. This includes heath insurance reforms, decentralization of hospitals, development of systems for continuous medical education, and adoption of relevant health provider incentives. USAID will also begin to work closely with the GOJ to better integrate on-going primary health services strategies and programs that prevent and treat chronic diseases. Finally, USAID will assist in the development and implementation of a national health communication strategy encouraging Jordanians to practice healthy lifestyles.

A focus on expanding and strengthening the public-private-NGO sector partnership will help ensure that the poor, the disadvantaged and the hard to reach populations will be the primary beneficiaries of USAID’s health programs.

Highlights

USAID has been a leading donor in the health sector for many years, working closely with the GOJ and other donors to improve the delivery of health care services in the Kingdom. Cooperation efforts between the MOH, the National Population Council and USAID have led to improving the policy and regulatory environment for the health sector. These include the development and adoption of Jordan’s first National Population Strategy, improving data collection systems to help decision-makers in policy reform efforts aimed at improving the long-term sustainability of Jordan’s health care system, and strengthening Jordan’s epidemiological surveillance system for chronic and acute diseases.

At the clinical level, the quality of services at each of Jordan’s 380 primary health care clinics has been improved through renovation and provision of furniture and specialized medical equipment, clinical training of service providers, establishment of performance improvement review systems, and improvement of the management information system under the USAID-funded Primary Health Care Initiatives project.

[Note: All statistical data are from the Demographic Health Surveys and the Department of Statistics]