Health Centers in Zarqa
Failing to meet the needs of residents

"It is too crowded at the registrar desk, the crowd at the laboratory is abnormal... The place does not accommodate so many people, but we are forced to go there," said Maher Ismail, 42. He was describing a recurrent scene every time he visits his local healthcare center in Zarqa Governorate where patients swarm the place and its different departments.

Maher and family were using Al-Ameriya Comprehensive Healthcare Center near his residence in Al-Russeifa District, Zarqa Governorate. Now he frequents Al-Mshairfeh Comprehensive Health Center, about four kilometers away from his home, after Al-Ameriya Center was shut down last year.

Maher is also compelled to go to Amman for specialist referral in a government hospital there, to get medical follow-up because of fractures he suffers from in the back and foot.

This data-driven story reveals that a citizen's share of medical care at public health centers in Zarqa Governorate has declined since 2014. The analysis also shows significant variations in the number of specialists doctors in these centers year on year.

Difficult Access

Maher is not alone to suffer from the health center closure in his area. Fatima Ibrahim, 75, lives in Al-Russeifa District also and faces difficulties in seeing a doctor because the healthcare center is too far from her neighborhood.

Fatima used to seek medical attention monthly at Al-Ameriya Comprehensive Health Center close to her residence, due to her chronic diseases that require continuous medical follow-up . Recently, she has not been able to see a doctor in Al-Mshairfeh Comprehensive Center, where she was transferred as it is too far and she cannot afford the cost of transport.

Fatima says, “Until now I could not go. I had hurt my leg, and the distance is too far for me.” She said the cost of reaching Al-Mshairfeh Health Center is JOD 5, as the trip requires taking a private taxi.

Al-Ameriya Comprehensive Health Center was closed in October 2021 for the second time after cracks appeared in the ceiling and walls. The nearest health center is more than 4 kilometers away from Al-Ameriya.

The center was closed for the first time in 2013 for maintenance after cracks appeared inside and outside the building.

Sami Ziade, 60, seems more fortunate than others, as he usually visits a health clinic in his area where monthly treatments for his chronic illness are being dispensed. He visits the doctor almost every four months.

Sami, who lives in Jana'a neighborhood, Zarqa Qasabah District, confirms that there are specialized clinics in Wadi Al-Hijr Comprehensive Health Center where he checks in. The center has a number of specialized clinics, including family medicine, internal medicine and dentistry, as well as a general medicine clinic, he said.

A dermatologist is available at the center once a week, while there is no longer a weekly orthopedic clinic as before, Sami said.

Jad Youssef, 45, also uses Wadi Al-Hijr Comprehensive Health Center because of his high blood pressure.

Jad confirms that there is no orthopedic clinic or orthopedic specialist at the center, he said.

Jad says the center is usually busy on monthly treatment dispensing days.

Saed Mustafa, 44, who lives in Al-Russeifa District is forced to check in at private clinics or buy medicines from a private pharmacy because the health center is too far from his home.

Saed and his family of 12, checked in at Al-Ameriya Comprehensive Health Center near his home, but now they find it difficult to go to other health centers because they are too far from their neighborhood. He says, "Now we are having a hard time. The trip takes us more than two to three hours. I have to take the day off because the health center is far from me... the road trip alone takes an hour."

Saed pays about JOD 4 for his private transportation as public transport take more time to reach the center and cost him JOD 1.5.

Zarqa Governorate is located to the north east of Amman. It is the third largest governorate in terms of population in Jordan, where about 1.58 million people live.

The governorate has three districts, Zarqa Qasabah, Al-Russeifa and Al-Hashimiyah. It also has three subdistricts: Birin, Al-Dhalil and Al-Azraq. The governorate has 43 public health centers, of which only 10 offer comprehensive healthcare services. The region also has 32 maternity and children health centers.

The governorate also hosts some UNRWA health centers in Al-Zarqa area and Hattin refugees camp, which provide health services to the residents there. In addition some charitable organizations provide for few healthcare centers in the area.

The data analysis shows that a citizen's share in Zarqa Qasabah and Al-Russeifa districts of medical visits to government health centers has decreased compared to other areas in the governorate, namely Al-Hashimiyah District and the three subdistricts of Birin, Al-Dhalil and Al-Azraq. The same data also shows a decline in the proportion of centers available to the population in the governorate compared with other governorates.

New Health Care Center, More Difficulties

In 2021, a comprehensive healthcare center was established in Zarqa Governorate as part of a consolidation plan of four primary health care centers.

The New Zarqa Comprehensive Health care Center includes clinics specialized in family medicine, pediatrics and dentistry. There are also two clinics for orthopedic and dermatological diseases available for one day a week, according to the center's director Mohammed Al-Hayek.

However, the center, located in the Zarqa Qasabah District, lacks specialized doctors in several fields, including gynecology and otolaryngology, according to Al-Hayek.

Al-Hayek explains that the capacity of the medical facility is between 10,500 and 11,000 patients visit per month. Generalist clinics receive 350-400 patients daily with only three resident doctors.

The center is located in an area that is not served with adequate lines of transportation, and suffers from a big medical staff shortage due to the increasingly large number of patients, according to the center’s manager.

Basman Al-Bashir, a doctor at the family medicine clinic there confirms that the number of those who attend the clinic is increasing and reaches no less than 100 patients daily.

The center has three family medicine clinics that operate four days a week, each receiving 40-50 patients a day, most of them chronically ill.

The medical staff at these clinics are limited to one specialist and a qualified doctor, in addition to three doctors in the residence program, according to Al-Bashir.

Poor Distribution

Director of the Health Affairs Department in Zarqa, Khaled Abdel-Fattah, says that all the comprehensive health care centers have doctors specialized in family medicine, gynecology, dermatology and internal medicine. The sub-clinics are managed by available doctors in the neighboring centers.

Abdel-Fattah said specialized doctors may cover more than one health center during their work week depending on the center and are not usually available daily in the same center. He also noted that health centers are only overcrowded at peak hours between 8:00am and 11:00am.

However, the data analysis shows a marked contrast in the number of specialty clinics in Zarqa Governorate year on year, and indicates a decrease in their numbers during the last two years.

Former Minister of Health Saad Al-Kharabsheh points out that the establishment of health centers depends on demographic considerations the size of the local population, the level of poverty, and the access of the area to other health sectors, including the private and military sectors, in addition to other factors.

Al-Kharabsheh says he believes that there is a poor distribution in health care centers and sometimes an abundance of doctors in some other areas, especially with regard to specialists in comprehensive healthcare centers.

The shortage of specialists doctors in the public Health sector is not confined to healthcare centers, he said: Hospitals are also suffering from a big shortage in some medical specialties, and that is why the ministry of health pays to use the services of private sector doctors for two or three days a week where those are needed to meet the demand.

Al-Kharabsheh pointed out that investment in primary healthcare in Jordan is still modest, as the percentage of spending on this sector does not exceed 25 percent of the total expenditure on healthcare in the country. He emphasized the importance of making this sector available to those who need it due to the crucial role it plays in preventing many diseases and reducing the high cost of treatment in hospitals.