Etudes par pays volume 2, PDF, 346 p., 1,4 Mo - Femise
Etudes par pays volume 2, PDF, 346 p., 1,4 Mo - Femise Etudes par pays volume 2, PDF, 346 p., 1,4 Mo - Femise
11873_2002 Study D2: Poverty, Informal Sector, Health and Labour 2.4. Phenomenology Jordan is in the midst of an epidemiological transition with acute respiratory infections and prenatal diseases still causing a large loss of productive life while non-communicable diseases and illnesses are becoming increasingly prevalent. Infant and child mortality indicators are favorable compared with other countries in the region and with other countries at similar levels of income, although they are still high by OECD standards. Despite significant declines in fertility in recent years (from 5.6 children per woman in 1990), Jordan’s total fertility rate (TFR) of 4.6 children per woman is still quite high. Population growth is high largely as a result of high fertility, low mortality, and migration. - The Health Sector Study highlighted that while the health system performs relatively well in terms of overall access and outcomes, it is expensive and inefficient, and there are geographic maldistributions of resources. Jordan spends about 8 percent of its GDP on health care, well in excess of most middle income and even some western industrialized countries. While Jordan provides coverage for its poor and disabled, an estimated 20 percent of the population lacks formal coverage, and Government financing for health care could be better structured to reflect ability to pay. Lack of a coordinated policy apparatus and relevant data for decision-making preclude effective policy-making across Jordan’s multiple public and private financing arrangements and delivery systems. - There are significant inefficiencies in the service delivery system. There is excess overall capacity as evidenced by a hospital occupancy rate of 63 percent (69 percent in the public sector and 49 percent in the private sector; 80 percent is the generally accepted benchmark). Inappropriate hospital use results from lack of an effective referral system and a hospital-based orientation for treatment. Inefficient case management leads to costly inpatient treatment of conditions that could be treated on an outpatient basis and excessive use of expensive drugs. The centralized allocation process for supplying and equipping facilities and paying personnel in the public sector provides few incentives for the efficient delivery of services at the individual institution level. Finally, there are inefficiencies in terms of overall management, procurement, storage, distribution, pricing policies, and the rational use of pharmaceuticals, FONDAZIONE CENSIS 85
11873_2002 Study D2: Poverty, Informal Sector, Health and Labour which account for over one-fourth of health spending and two percent of GDP. - There is limited data to evaluate the quality of care and consumer satisfaction. The rapid growth in the private sector suggests dissatisfaction with the services provided through the public sector and is leading towards a two-tiered system of care (those who can afford to pay go to the private sector while those who cannot are relegated to the public health facilities). The lack of management systems (e.g., for patient records, inventory) in the public sector do not foster good case management and follow-up. Indeed, there are few incentives in the public sector for providers to be concerned about the quality of services provided. Quality could also be jeopardized by the lack of standards and norms for infrastructure. FONDAZIONE CENSIS 86
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- Page 59 and 60: APPENDIX
- Page 61 and 62: Table 2 - Population Distribution b
- Page 63 and 64: Table 7 Gross Domestic Product at F
- Page 65 and 66: Table 9 Investment and Saving durin
- Page 67 and 68: Table 12: Income, Distribution and
- Page 69 and 70: Table 15-c: Poverty measures by edu
- Page 71 and 72: Table 20 : Housing conditions by po
- Page 73 and 74: Table 24 The Number of Crimes Repor
- Page 75 and 76: Rank Country CPI 2002 score Surveys
- Page 77 and 78: Table 26 Maternal Health Indicators
- Page 79 and 80: JORDAN Royal Scientific Society
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- Page 109 and 110: Population Projection 2000 - 2005 Y
- Page 111 and 112: Distribution of Population Living i
- Page 113 and 114: Total Jordanians Non jordanians Tot
- Page 115 and 116: Table 3 - Growth Rates of Economic
- Page 117 and 118: Contribution of Economic Sectors to
- Page 119 and 120: Table 1 Main Economic Indicators (C
- Page 121 and 122: Table 2 Expenditure on Gross Domest
- Page 123 and 124: Table 30 Components of Public Expen
- Page 125 and 126: Table 32 Outstanding External Publi
- Page 127 and 128: Table 34 Distribution of External L
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- Page 133 and 134: Table 2 - The Composition of Greek
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11873_2002 Study D2: Poverty, Informal Sector, Health and Labour<br />
which account for over one-fourth of health spending and two percent of<br />
GDP.<br />
- There is limited data to evaluate the quality of care and consumer<br />
satisfaction. The rapid growth in the private sector suggests<br />
dissatisfaction with the services provided through the public sector and is<br />
leading towards a two-tiered system of care (those who can afford to pay<br />
go to the private sector while those who cannot are relegated to the public<br />
health facilities). The lack of management systems (e.g., for patient<br />
records, inventory) in the public sector do not foster good case<br />
management and follow-up. Indeed, there are few incentives in the public<br />
sector for providers to be concerned about the quality of services<br />
provided. Quality could also be jeo<strong>par</strong>dized by the lack of standards and<br />
norms for infrastructure.<br />
FONDAZIONE CENSIS<br />
86
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