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Situation Analysis
Priority Health Issues

Jordan enjoys many health indicators close to those of developed countries. Although family planning (FP) and reproductive health (RH) are still cornerstones of the country’s health priorities, greater attention is now being paid to family and preventive health behaviors that are related to lifestyle. Quality of health services has long been a priority of the King, and July 2004 marked his first pronouncement to his Cabinet regarding the importance of family planning campaigns.  Incorporating both FP/RH and preventive health priorities, the CPFH emphasizes three areas of focus for the coming five years of health communication programming:  (1) Reproductive health / family planning; (2) Maternal and child health; and (3) Healthy lifestyles / chronic non-communicable diseases.   These three areas are used in this strategy and in other strategy documents for the purposes of planning and for monitoring and evaluation.  However, the BCC initiatives may not breakdown their activities in this way but rather in a manner that best appeals to the target audiences.

1.1  Healthy lifestyles / chronic and non-communicable diseases

Chronic or “lifestyle” diseases such as diabetes, obesity and cardiovascular diseases have begun to replace infectious diseases as the leading causes of morbidity and mortality, especially among older Jordanians. One quarter (25%) of boys and 15% of girls between the ages of 13 and 15 smoke, with 12% initiating smoking by age 9 and 48% between ages 10 and 13 (Global Youth Survey, 2000). According to self-report data, thirty percent (30%) of Jordanians are current smokers, with a much higher percentage of men smoking than women (Behavior Risk Factor Surveillance, 2002). The same survey reports that 6% of the population ages 18 to 65+ has diabetes, 22% has high blood pressure, and 21% has hypercholesterolemia (Behavioral Risk Factor Surveillance, 2002). Two thirds of those 18 to 65+ report that they do no practice weekly vigorous physical activity, 33% report that they have never had their blood pressure checked, and 82% report that they have never had their cholesterol checked (Behavior Risk Factor Surveillance, 2002). More than half of ever married women (54%) are overweight or obese, as measured by a body mass index (BMI) over 25 (DHS, 2002). Only 17% of ever married women have had a screening examination for breast cancer, the most prevalent cancer among Jordanian women (DHS, 2002; Jordanian National Cancer Registry, 2001). The increase in prevalence of chronic conditions and their associated risk factors creates an imperative to promote healthy lifestyles, including less use of tobacco, better nutrition, more exercise and greater attendance at screening to detect chronic diseases. Most of the chronic or "life style” diseases are related to certain health behaviors to which the communication can play a crucial role.


1.2 Healthy lifestyles / chronic and non-communicable diseases

Chronic or “lifestyle” diseases such as diabetes, obesity and cardiovascular diseases have begun to replace infectious diseases as the leading causes of morbidity and mortality, especially among older Jordanians. One quarter (25%) of boys and 15% of girls between the ages of 13 and 15 smoke, with 12% initiating smoking by age 9 and 48% between ages 10 and 13 (Global Youth Survey, 2000). According to self-report data, thirty percent (30%) of Jordanians are current smokers, with a much higher percentage of men smoking than women (Behavior Risk Factor Surveillance, 2002). The same survey reports that 6% of the population ages 18 to 65+ has diabetes, 22% has high blood pressure, and 21% has hypercholesterolemia (Behavioral Risk Factor Surveillance, 2002). Two thirds of those 18 to 65+ report that they do no practice weekly vigorous physical activity, 33% report that they have never had their blood pressure checked, and 82% report that they have never had their cholesterol checked (Behavior Risk Factor Surveillance, 2002). More than half of ever married women (54%) are overweight or obese, as measured by a body mass index (BMI) over 25 (DHS, 2002). Only 17% of ever married women have had a screening examination for breast cancer, the most prevalent cancer among Jordanian women (DHS, 2002; Jordanian National Cancer Registry, 2001). The increase in prevalence of chronic conditions and their associated risk factors creates an imperative to promote healthy lifestyles, including less use of tobacco, better nutrition, more exercise and greater attendance at screening to detect chronic diseases. Most of the chronic or "life style” diseases are related to certain health behaviors to which the communication can play a crucial role. 

1.3 Maternal and Child Health

The maternal mortality ratio in Jordan is 41 per 100,000 live births (UNICEF, 2002). Twenty six percent (26%) of women of childbearing age have anemia (DHS, 2002). Although 97% of pregnant women utilize antenatal care services at least once during their pregnancy and 91% attend at least four times, only 43% of women who attend are informed about complications of pregnancy. National Standard Operating Procedures (SOP) indicate that women attend a postnatal checkup within one week of delivery, and a second postnatal visit within 42 days of delivery. However, only 1% of women attend postnatal care within two days of delivery, 25% attend between 3 and 39 days, and 65% do not attend postnatal checkups at all. Of those women who do not receive postnatal care, 88% explain that they did not need postnatal care as they were not feeling sick; 6% report that they were not aware of the availability of the service (DHS, 2002).

Although overall infant mortality has dropped significantly in Jordan in the past 15 years, neonatal and child mortality have remained relatively constant during that time, underlining the need for early childhood programming. Mortality is higher in rural areas, in the Northern and Southern regions and among children born to mothers with lower levels of education. The major causes of infant and child death are due to acute respiratory infections and diarrhea, often in combination with one another. Forty percent (40%) of newborn infants are breastfed within one hour of birth, and 79% begin breastfeeding within one day of birth (DHS, 2002). Although the World Health Organization (WHO) advises six months of exclusive breastfeeding, the median duration of exclusive breastfeeding in Jordan is less than one month, and the average age of weaning time is 4 to 5 months (DHS, 2002). Micronutrient deficiency is of concern, as 34% of children under age 5, and 9% of school age children have anemia (DHS, 2002); 15% of those under age 5 and 47% of school age children are deficient in Vitamin A (Micronutrients National Health Survey, 2002). According to 1995 data from the WHO, 78% of children have dental caries by age 6, and 92% have them by age 15 (Mouth and Dental Diseases Survey MOH & WHO, 1995).  
  
2.Audiences     
 
Intended Audiences

Sixty one percent (61%) of Jordan's population is under the age of 25, and 89% is younger than age 50. As the vast majority of the population is of viable reproductive age, family planning and reproductive health messages are particularly relevant. In addition, promotion and adoption of healthy lifestyles among youth will contribute to a reduction in non-communicable chronic diseases as the population ages.

Mass media penetration in Jordan is high. Across all age groups and regions of the country, more than 99% of the population has at least one television in the home. On any given day, 81% of the population listens to the radio. Sixty one (61%) read a daily newspaper at least one day per week, and 51% read a weekly magazine or newspaper at least once a month. (PARC Jordan National Multimedia Index, 2003).

 

   
 
 
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Self eLearning