The Jordan Healthcare Accreditation Council (HCAC) was established in 2007 to elevate the level of quality and patient safety in Jordan. It achieves this broad aim through the provision of accreditation awards and supporting packages of consultation, training, standards development and advocacy. Since 2020, the HCAC team has dedicated a great deal of its efforts towards addressing the ongoing COVID-19 pandemic.

The ever-changing nature of the virus, and the stringent measures taken by the Jordanian Government to prevent the spread of COVID-19 has affected the nature and continuity of health care services in Jordan. As a result, HCAC has made interventions and launched initiatives to promote quality, safety, and continuity of care during the COVID-19 health crisis.

Since the emergence of COVID-19 in December 2019, the Government of Jordan implemented various preventive and control measures to mitigate the spread of the disease. However, despite early stringent measures, Jordan has experienced multiple waves of significant transmission over the last two years.

During case surges, understaffed hospitals have been overwhelmed, primary care services disrupted, and home care provision fragmented.

In 2020, 35% of countries, including Jordan, reported interruptions in essential health services such as reproductive, maternal, newborn, child and adolescent health services, along with nutrition services, as well as one or more disruptions to essential NCD services. Examples include:

Lockdown measures resulted in the closure of clinics and ultimately meant that many individuals were no longer able to receive their regular healthcare and medication. A survey of vulnerable populations by UNICEF, UNHCR and the WFP showed that 24% of patients faced challenges accessing essential medicines, and 19% faced challenges accessing health services. Furthermore, a survey of persons with disabilities showed that 88% could not go to hospitals or clinics for their regular check-ups or additional needs.

• Sexual and reproductive health

Research on pandemics shows that when health systems are stressed, sexual and reproductive health services are given less priority. While fertility rates increase during pandemics, women are less likely to seek maternal and postnatal services. Further research suggests that the COVID-19 pandemic will cause a 10% decline in service coverage of essential pregnancy-related and newborn care. Survey data on women in Jordan shows similar results, where more than 50% of them reported not being able to access safe maternity services during the lockdown. Nevertheless, it is important to acknowledge that the Government’s measures ensured the continued provision of crucial maternal services such as antenatal, post-pregnancy, delivery and post-birth services.

Since the start of the COVID-19 pandemic, the HCAC has pledged to be a beacon for patients, health care providers and their institutions.

As major supporters of the health care sectors, and in line with the Council’s message to drive continuous improvement in quality and health care safety, HCAC launched a Quality competition with the theme “Maintaining health care quality and patient safety in light of the COVID-19 pandemic.”

Health care institutions were asked to submit projects showcasing creative ideas with a wide impact that were seeking to adapt to the permanent change caused by the COVID-19 crisis.

Accredited institutions were given technical support, guidance and direction to ensure their services continued without disruption, while maintaining quality and safety.

In response to the HCAC quality competition, many institutions implemented innovative ideas that enabled them to win the competition, including:

• One of the winning hospitals established eClinic, eConsult and eReferral services, which have resulted in 4 million visits to the electronic platform, 7400 requests to activate monthly drugs, 2800 patients being seen remotely, and 19 600 appointments being renewed electronically via the platform.

• A winning laboratory established home-based care services to enable COVID and non-COVID related laboratory testing, facilitated by a user-friendly, 24/7 mobile application and WhatsApp service. The service included an automated customer satisfaction platform which allowed customers to provide feedback through their mobile phone, easily and quickly.

• Establishing remote counselling services is what one winning primary health care centre did, to provide support and counselling to customers. The counselling related to postpartum care, postnatal care, breastfeeding, complementary feeding, and family planning services.

In summary, the quality competition supported and highlighted successful interventions that were helping to maintain the continuity of essential services.

• Telemedicine has been playing a crucial role in mitigating the impact of the COVID-19 pandemic and maintaining essential health services in Jordan. Additionally, remote counselling was instrumental in the continuation of postnatal service during the first COVID-19 lockdown. This formed part of a broader effort to ensure the maintenance of MNCH services.

• Outreach and home-based diagnostic services have also played a key role in ensuring timely services and were fundamental to combating the pandemic spread.

There were difficulties in attracting institutions to participate and implement improvement projects. This was tackled by:

• a nationwide social media campaign to raise awareness;

• hosting an awareness session;

• active follow-up with all accredited institutions to encourage their participation.

To be able to showcase achievements and success stories at the international level and fund winners to sustain their achievements.