Health
One of the priorities to extend the coverage of social protection in the country is the need for efficient and universal health care. The National Agenda 2006-2015 proposes universal health insurance as a priority goal within the Social Welfare Theme to be reached by 2012 (Government of Jordan, 2005).
The system consists of highly fragmented mix of private and public programmes. The major public programmes which deliver and finance health care are the Ministry of Health and the Royal Medical Services complemented by smaller university-based public providers. United Nations Relief and Works Agency (UNRWA) provides care to the Palestinian refugees living in Jordan.
Social security does not include a health insurance scheme. Including such a scheme is one of the priorities of the Social Security Corporation and the new Draft Social Security Law. However, some experts express concerns over sustainability of the proposed new scheme.
Expenditure and financing
Expenditure on health in Jordan is among the highest in the region with 8% in 2010 (5.4% if considering only public health expenditure) (WHO, 2012).
According to the World Health Organization, in 2008 approximately 37.5% of the health care spending originated from private sources, 57% from the public budget, and around 5.5% came from donors and other sources.
Considering that Jordan is a relatively small economy with limited resources, the level of health care expenditures relative to GDP is high and comparable to many developed OECD countries. In the long term, especially taking into account the demographic characteristics of the country, aging and steady growth rates, continued expenditures will become problematic given demographic change towards a young and aged population profile.
Coverage
The data availability with reference to utilization rates, coverage, and expenditures on health services is limited. Fragmentation of the system, limited monitoring and record-keeping result in multiple coverage. Despite the fact that estimated 75% of theJordanians have some form of health insurance, the concern remains that the quality of care afforded to the poor is insufficient.
Medical care is provided free for the beneficiaries of National Aid Fund. As described above, the NAF recommends to the Ministry of Health people in need who are eligible to receive free medical care. The National Zakat Fund (NZF) provides additional medical care for the neglected poor with no or little access to health care.
The National Zakat Fund provided additional medical care to approximately 12,000 individuals spending about JD 1.4 million in the past five years. However, considering the nature of the Zakat Fund’s operations, the budget of the institution is dependent on the discretion of the donors, therefore, it is not a sustainable source of social assistance funding. Moreover, donations made to the local Voluntary Zakat Committees must be used locally which creates inequality between the poorer and richer regions. This refers not only to the medical services provision of NZF but to all the programmes administered by the Fund.
Despite the effort and high priority which the extension of coverage and increasing the health services’ quality has taken in the National Agenda, the goal of reaching full coverage seems still unlikely by the year 2012. The system requires a holistic reform in order to increase efficiency and avoid duplication. According to the High Health Council in 2008, it is estimated that due to the rapid population growth in Jordan, sustaining the level of health care expenditures will present with significant challenges.