URC Collaborated on Developing Criteria for Centers of Excellence in Family Planning and Reproductive Health in Jordan

Women in Jordan report need to delay births

The recently published Jordan Population and Family Health Survey found that three-fourths (76%) of married women in Jordan reported a potential need for family planning services to either limit or space births (53 percent did not want to have any more children, and 23 percent wanted to delay having another child for at least two years).

In Jordan, the average woman bears more than three children during her lifetime (the total fertility rate is 3.5), and many women who want to limit or space their births already have many children. 

Use of family planning and reproductive health services found to be low in Jordan

Despite the high demand for family planning, the survey showed that the use of family planning and reproductive health services at public sector facilities was lower than at private clinics. (About 44% of women sought contraceptives from the public sector, while over 55% sought them through the private sector.)  Less than 23% sought family planning methods at government health care clinics. 

A study funded by the US Agency for International Development (USAID) examined why. It found that many clients at public health care clinics reported feeling the quality of care at public health clinics for family planning and reproductive health was low. It also identified several barriers to receiving family planning at public clinics, including long wait times and overcrowding, weak postnatal services, and a lack of information on permanent family planning methods.

Identifying barriers to unmet need for family planning

URC’s Jordan Health Care Accreditation Project (JHAP) worked with key stakeholders to develop criteria for health care clinics specializing in reproductive health and family planning. 

JHAP’s purpose was to establish a strong system of quality assurance and accreditation to address changing health needs and to sustain health care improvements. From 2007 to 2013, JHAP worked to build the capacity of Jordan’s Health Care Accreditation Council (HCAC), a civil society organization the project helped to establish and build.  HCAC, the only accreditation body in the Middle East represented on the Accreditation Council of the International Society for Quality in Health Care, aimed to develop health care standards, certify health care professionals, monitor compliance with standards, and award accreditation.

With family planning and reproductive health high on the Jordan Ministry of Health policy agenda, HCAC convened a task force of key stakeholders to identify issues underlying unmet family planning needs. The task force developed a “cause and effect” diagram that included factors like the effect of receiving counseling, the influence of client-provider relationships, distance from clinics, shortages of key supplies, and lack of female health care providers.

HCAC then used this information to develop criteria to address the barriers to providing high-quality family planning and reproductive health services.  The task force developed these criteria as statements of the outcomes necessary for the provision of excellent services.

Health Care Accreditations Council develops the Family Planning and Reproductive Health Center of Excellence Model

HCAC developed the Family Planning and Reproductive Health Center of Excellence Model to reflect the criteria described above. As the figure shows, the guiding principle in the center of the model is the client and family. The star symbolizes excellence; additional guiding principles for a center of excellence are depicted within the star. The domains of the center of excellence, which encircle the principles, include the criteria required to achieve certification.

Each domain has about five criteria for excellence. For example, for the domain “service providers,” the criteria included:

  1. Staffing plans support the organization mission and strategies.
  2. Organization management organizes the service providers to efficiently and effectively accomplish the work of the organization.
  3. Delivery of services is provided by qualified service providers in a manner that is client- and family-centered, culturally competent, and consistent with best practices.
  4. All providers are respectful of client beliefs and values; providers do not impose their personal values upon clients.
  5. Health care providers apply client-provider interaction principles and have effective communication skills.

The guiding principle of continuous quality improvement surrounds the entire model, demonstrating the overarching influence that quality improvement has in implementing a center of excellence. The model was designed in a circular shape to demonstrate that the quest for improving quality is an on-going, dynamic process.

The center of excellence framework was derived from elements of both the Baldrige Criteria for Performance Excellence and the King Abdullah II Award for Excellence. Both of these frameworks address measuring the performance of an organization and focus on common dimensions of quality.

JHAP collaborated with Jordan’s Ministry of Health to incorporate family planning and reproductive health standards into the HCAC Primary Health Care Accreditation Standards

Through the USAID-funded Jordan HealthCare Accreditation project (JHAP), URC first worked with the Jordan Higher Council to incorporate family planning and reproductive health standards into the HCAC Primary Health Care Accreditation Standards.  These standards are used to accredit hospitals across the country.

Infographic about continuous quality improvement
The Health Care Accreditation Council's Family Planning and Reproductive Health Center of Excellence Model
August 21, 2013
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