The Hashemite Kingdom of Jordan

National Report On Follow Up to the World Summit for Children (Jordan’s End-of-Decade Report)

December 2000 (edited translation from Arabic)

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Contents

I.

INTRODUCTION AND BACKGROUND ..........................................................................................................3

II.

PREPARING PROCES S - END-OF-DECADE REPORT (EDR) ....................................................................4

III.

FOLLOW-UP ACTIONS AND MONITORING...........................................................................................5

IV.

SPECIFIC ACTIONS FOR CHILD SURVIVAL, PROTECTION AND DEVELOPMENT ...................6

V. LESSONS LEARNT (CONDUCIVE BASIC FACTORS, PROGRESS IMPEDING FACTORS, CHALLENGES, AND OUTSTANDING ISSUES)....................................................................................................28

VI. FUTURE ACTIONS (RECOMMENDED PROCEDURES AT NATIONAL AND INTERNATIONAL LEVELS)..........................................................................................................................................................................31

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I.

Introduction and Background

On 29-30 September 1990, the largest gathering of world leaders assembled at the United Nations Headquarters in New York to discuss a one-item agenda: “ Children”. Led by 71 heads of state and governments, in addition to 88 other senior officials, mostly at the ministerial level, the unprecedented World Summit adopted, during its concluding session, a Declaration on the Survival, Protection and Development of Children as well as a Plan of Action for implementing the Declaration during the nineties. Her Majesty Queen Noor Al-Hussein headed Jordan’s delegation to this meeting. The World Summit for Children (WSC), which endorsed the Convention on the Rights of the Child (CRC), was the first global action taken for its implementation. In expressing their commitment to the Summit, the world leaders agreed to be guided by the principle “First Call for Children.” This principle mandates that the essential needs of children should be given high priority in the allocation of resources, in bad times as well as good, at national and international levels as well as stressing the role of the family. Jordan asserts its faith in basic human rights and the dignity of the individual by endorsing and ratifying international covenants, conventions, and plans including the Universal Declaration of Human Rights, the six major conventions including the CRC, and the Convention on Elimination of all Forms of Discrimination Against Women (CEDAW). Prompted by its clear political commitment, represented by His Majesty the late King Hussein, and Her Majesty Queen Noor Al-Hussein, and fostered and by His Majesty King Abdullah II and Her Majesty Queen Rania Al-Abdullah, Jordan has striven to translate its commitment to human rights through the establishment of appropriate mechanisms. In 1992 The Jordanian National Committee for Women (JNCW), chaired by Her Royal Highness Princess Basma Bint Talal, was established. That was followed by the National Task Force for Children (NTFC) which was formed pursuant to a royal decree issued by His Majesty the late King Hussein in 1995. In 1999 both the Human Rights Department at the Prime Ministry and the National Team for Early Childhood Development, chaired by Her Majesty Queen Rania Al- Abdullah, were formed. Also chaired by Her Majesty Queen Rania is the Royal Commission for Human Rights, which was established in the year 2000 along with the National Team for Family Safety (NTFS) As an immediate reaction to the WSC, Jordan ratified the CRC in 1991 and in May 1992, under the auspices of His Majesty the late King Hussein and Her Majesty Queen Noor AlHussein, the National Conference on Children was held in Jordan. The conference aimed at outlining a general framework for a national strategy for childhood in collaboration with all parties involved in childcare in the country. The strategy covered the areas of health, education, environment, information, culture, and children with special needs. As an outcome of the conference, the National Plan of Action for Children (NPA) for the period 1993-2000 was drawn up, using the World Summit Declaration on the Survival, Protection, and Development of Children as a springboard.

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The objectives and policies of the NPA were streamlined in the various sectors of the socioeconomic development plan for the years 1993 – 1997. A section on the issues of children and youth in the Jordanian society has, for the first time ever, been included under the Chapter “Human Development” of the present socio-economic development plan 1999-2003. In collaboration with government and non-governmental organisations (NGOs) and with the support of the United Nations Children’s Fund (UNICEF), Jordan submitted its 1993 initial national report and the 1998 subsequent periodic national report to the UN Child Rights Committee in Geneva. The Committee’s comments were reviewed and answered during a meeting with the Committee’s members in Geneva. Furthermore, Jordan has submitted its initial and subsequent periodic reports on the CEDAW to the United Nations CEDAW Committee. Policies and programmes ensuring the rights of Jordanian women have been integrated in the various sectors of the present socio-economic development plan. The plan uses social equity as a basis for addressing women’s issues. II.

Preparing Process - End-of-Decade Report (EDR)

Government organisations and NGOs involved in childhood development participated in the preparation of the EDR together with other parties and committees especially formed for this purpose. A task force made up of the Ministry of Planning (MOP) as a reference authority, the Ministry of Social Development (MOSD), the NTFC and the UNICEF-Jordan Country Office was formed. This task force held several meetings during which an agreement was reached on the following: a) A National Committee of government organisations and NGOs involved in childhood development and childcare issues in Jordan will be formed to participate in preparing the EDR. b) The MOP will prepare the National Report based on the comments from the National Committee and other relevant resources. The MOP invited the members of this National Committee to take part in the preparation of the preliminary reports and the mechanism for preparing the National Report was agreed upon. The participants were regularly asked to provide the MOP with required feedback and report baseline data within specific deadlines. Jordan’s national reports, including those on the rights of women and children, were utilised. The Department of Statistics’ (DOS) surveys on family health, the annual publications and statistical reports, as well as the reports made on the followup to the NPA were also used as references. A special UNICEF-supported study on iodine deficiency among children in Jordan was also carried out to provide needed data for the report.

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III.

Follow-up Actions and Monitoring

A

At the National Level

The undertaking made by Jordan during the World Summit for Children and its commitment to the World Summit Declaration and Plan of Action have been translated into action through the following steps: 1. A National Conference on Childhood was held in 1992 outlining the framework of a national strategy for children, which was eventually developed into the NPA for 1993 – 2000. 2. The objectives of the NPA were mainstreamed in the country’s plan for the years 19931997. A section on women, youth, and children is included in the present plan for the years 1999-2003. 3. Timely preparation and submission of the National Report to the Committee of the Rights of the Child. 4. Special regard was given in the national budget and the development aid budget at the time of allocation of resources to programmes that help achieve child survival, protection and development. Expenditures on social aspects have amounted to more than 20% of the total public expenditure. 5. Civil society institutions including women’s organisations, societies, NGOs and the official mass media have been involved in meeting the objectives of the NPA, which were based on the World Declaration and Plan of Action of the World Summit for Children. These parties have also collaborated in providing parents with the knowledge and skills necessary for the nurture and development of their children. 6. The DOS has undertaken the task of gathering and disseminating the data required for monitoring child-specific social indicators, and has started separating all data collected according to gender. The DOS is setting up a section for women’s and children’s statistics under the Demographic and Social Statistics Directorate, with the aim of following up on the status of women and children and covering new areas in this field. 7. A research and data base unit has been established at the NTFC for monitoring and followup purposes. 8. A plan has been developed and a national committee for emergencies formed to respond to natural and man-made disasters to protect women and children afflicted the hardest. 9. The academia and centres for studies have undertaken basic and applied research aimed at accelerating the accomplishment of the goals endorsed under the Declaration of the World Summit for Children. B

At the International Level

1. International development agencies participated in the 1992 National Conference on Childhood, and provided the support required from them for the NPA. 2. United Nations agencies including the United Nations Children’s Fund (UNICEF), the

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United Nations Development Fund for Women (UNIFEM), the United Nations Development Programme (UNDP) and others have extended technical support in the process of preparing Jordan’s periodic reports on the rights of women and children. 3. In line with the achievements Jordan has made in childhood-related areas, certain international organisations have, in recent years, supported Jordan in programmes dedicated to monitoring and sustaining these accomplishments. 4. International agencies have participated in the mid-decade review of the progress made in the implementation of the commitments undertaken in the World Summit and its Plan of Action. 5. In 1997, Jordan signed a co-operation agreement with the United Nations High Commission for Refugees (UNHCR) to empower it to assume its international tasks of providing protection to all refugees, especially children, during their stay in Jordan whereby they were given assistance and tax exemptions in accordance with the 1951 treaty and the 1967 protocol for refugees. This is in addition to the signing of other treaties. IV.

Specific Actions for Child Survival, Protection and Development

Jordan has striven to meet the needs of its people as a whole, and children in particular. Government organisations and NGOs have co-operated to achieve the goals for the survival, protection and development of the country’s children. This has been achieved despite Jordan’s limited resources. Following is a summary of the most important accomplishments Jordan has achieved within the framework of the provisions stipulated in the CRC: 1. The Convention on the Rights of the Child (CRC) The earliest possible ratification of the CRC shall be promoted, where it has not already been ratified. Every possible effort should be made in all countries to disseminate the CRC and, wherever it has already been ratified, to promote its implementation and monitoring. Jordan has joined the list of signatory countries to the CRC in 1990, and ratified it on 9 April, 1991. In spite of Jordan’s reservations to Articles 14, 20, and 21 of the CRC, such reservations are not directed to any of the CRC’s basic principles such as those relating to the definition of the child, equality, and non-discrimination. In fact, Jordanian lawmakers have, by virtue of the provisions of the country’s constitution, abided by most of the provisions stipulated in the CRC. As a result of the efforts made by parties concerned with childhood issues, the NTFC, in cooperation with the MOSD, drafted a law for the Draft Childhood Act in 1996 in harmony with the provisions of the CRC. The Draft Childhood Act is awaiting deliberation in preparation for its ratification according to the country’s constitutional process. Although a few legal provisions

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for childhood exist, they are distributed among a number of Jordanian laws. Despite the fact that they conform to some provisions of the CRC, many of these provisions still need to be updated and developed. The Jordanian Government has worked on ensuring child rights and raising awareness of children’s rights. The MOSD set up a team supporting the rights of the child in 1998. As part of its achievements in this field, the team prepared a training kit on the rights of the child, and, in co-operation with certain NGOs, held training and awareness courses for social workers involved with children. Government organisations, in co-operation with numerous NGOs, have raised awareness about the CRC. Various workshops were held to increase understanding of the articles of this convention. This effort was aimed at making children, their parents, and the community at large aware of all articles of the CRC through workshops held for the supervisors of childhood programmes, kindergarten teachers, and the children themselves. Programmes for the training of personnel at institutions on issues related to the CRC have been developed and implemented. The trainees, in turn, have trained their colleagues and subordinates through a programme covering all regions countrywide. A field survey “Awareness of Jordan’s Society of the Rights of the Child” was conducted in 1998 along with an awareness campaign on the rights of the child. An evaluation survey was conducted thereafter to assess the impact of the campaign. A regional conference on the rights of the child was held in 1999, followed by a workshop in the year 2000 to incorporate the CRC and the CEDAW concepts in the curricula of the faculties of law at Jordanian universities. Efforts have been made to teach the CRC and the CEDAW courses at respective schools of law. Work has been completed on creating a database of research conducted on childhood and another database for Jordan’s legislation as part of efforts undertaken by the NTFC to provide a comprehensive information system on children throughout the kingdom. The NTFC has also developed and launched a web-site encompassing the aforementioned databases, researches and legislation, as well as a summary of certain conferences on childhood. Action has been taken to update and safeguard specific mechanisms concerned with the rights of women and children. An appeal is underway to develop and update several national laws and legislation such as the Penal Law, Juvenile Law, Personal Status Law and Nationality Law. A new draft of the Penal Law has been formulated to address abuse and violence against children. 2. Child Health Effective action must be taken to combat childhood diseases by strengthening primary health care and basic health services. Programmes for the prevention and treatment of AIDS shall receive high priority. Universal access to safe and clean drinking water and sanitation shall be provided, and water-borne diseases shall be controlled. Over the past ten years, the health sector has witnessed progress in the health status of the

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Jordanian public in general, and that of its children in particular. During 1990 – 1999, the infant mortality rate was reduced from 34 to 28 per 1000 live births, and the under-5 mortality rate (U5MR) from 39 to 31 per 1000 live births. Maternal mortality rate was reduced from 60 to 41 per 100,000 births according to the maternal mortality survey conducted in 1996. Governmental and non-governmental bodies, and the United Nations for Relief and Works Agency (UNRWA) provide health services and basic treatment for children. They provide health care services through primary health centres and maternity and childhood centres. In addition, there are several programmes such as the national immunisation programme and perinatal care programmes. Other programmes deal with family planning, the control of communicable diseases, nutrition and malnutrition, conservation of the environment and protection from pollution, as well as the enhancement of services through continued training of personnel. Numerous fundamental actions have been taken to control childhood diseases. Preventable diseases, like measles and polio, have been eradicated. Primary and basic health care services have been expanded, raising the total of primary health care centres in Jordan from 292 in 1990 to 383 in 1999, and maternity and childhood centres from 161 in 1990 to 337 in 1999. The total number of comprehensive, primary and secondary health centres is now 1,191. Polio has been eradicated in Jordan. As no polio cases have been reported since 1995, Jordan is in the process of being declared a polio-free country. Neonatal tetanus was eliminated in 1995 although three cases were reported during 1999. Both cases of measles and related deaths have been reduced and efforts are underway to eliminate measles cases by 2005.A hundred and fifteen non-fatal incidences have been recorded. A high level of immunisation coverage, exceeding 90%, has been maintained. Immunisation against Hepatitis B, mumps, measles, and rubella, as well as meningitis has been added to the national immunisation programme. The percentage of women immunised with one or more tetanus doses has reached 40%. To combat diarrhoea, 17 oral hydration centres have been created in the country’s hospitals and training has been conducted on proper measures for treating diarrhoea and the use of hydration solutions. No linked deaths have been reported over the past few years, and the diarrhoeal incidence rate has been reduced to less than 20 per 1000. In terms of acute respiratory infections in children, five national training centres have been established in five cities and since the beginning of 1995, these centres have enforced a programme for combating respiratory diseases according to the World Health Organisation’s (WHO) protocol. The mortality rate of these diseases has been reduced. Numerous health education activities on the prevention of contagious diseases such as diarrhoea and respiratory tract infections, and the introduction of correct treatment are continuously carried out through the mass media. The quality of service at the country’s basic health centres has been enhanced through a comprehensive project launched a few years ago. Various actions have been taken to enhance the level of the ongoing health care services through the improvement of administrative and procedural approaches, the upgrading of health facilities (hospitals and health centres), better qualified health care workers including maternity and childhood personnel. All nation-wide

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health centres will be supplied with major medical specialists (internists, gynaecologists, paediatricians, and surgeons) and more powers will be delegated to health directorates in the governorates throughout the country. Jordan’s population growth rate has declined over the last decade due to the policies the country has set and duly observed. Family planning policies have been expanded, and the fertility rate has declined from 5.6 children in 1990 to 3.8 in 1999. The age of first marriages has meanwhile risen to 24 and 27 years for females and males respectively. Birth spacing services have been increased and breast-feeding encouraged, and three hospitals have been declared Baby-Friendly Hospitals. A nutrition monitoring system has been established at maternity and childhood centres to monitor and follow up the health and nutritional needs of pregnant woman. The Parental Care Project focusing on women’s and children’s perinatal health is under development. In the field of the early detection of children’s disabilities, an auditory centre has been assigned the task of detecting hearing disabilities. A clinic for the treatment of inherited phenylketoneurea and a genetic counselling clinic have also been created. A pre-marital blood test is offered free of charge to the public. Furthermore, health awareness activities to prevent disabilities have also been implemented through audio-visual media and field visits. To foster the integrated monitoring role of the Ministry of Health (MOH), numerous policies and programmes to increase the general quality of health care have been carried out. Specialised committees have been formed with respect to the health sector-related legislation. The committees are assigned the task of developing the regulations and instructions needed for implementing the provisions of the Code of the High Health Council. Priority was given to issuing various legislation concerning health organisations, professional malpractice, and work hazards at health institutions. One million of the nation’s poor have been incorporated in the comprehensive medical insurance scheme. A hospital specialised in contagious paediatric diseases has also been established. As for the provision and quality control of safe drinking water, co-ordination is underway among several government authorities, to ensure clean drinking water to 96.6% of the total population. Quality of various types of water outputs (drinking, sewage, industrial) is monitored. A plan of action has been devised to test samples and take necessary measures in close cooperation with all bodies concerned. 59.2% of the population had access to the services of the sewage network in 1997 and 99.3% of the population had safe access to sanitary means of excreta disposal. NGOs play a crucial role in raising public awareness about the importance of the prevention of diseases such as diarrhoeal diseases and respiratory tract infections, and about their treatment through preventive and curative approaches. The awareness-raising efforts assumed by NGOs is also meant to encourage breast-feeding, prevent diseases, promote immunisation and pre-marital medical examination, as well as to illustrate the importance of treatment, disease prevention, reproductive health, AIDS, and adequate child nutrition. A national plan has been developed to treat and combat AIDS. Another plan has been drawn up to combat narcotic drugs and psychotropic substances. Numerous anti-tobacco programmes

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have been implemented to fight the smoking habits of youth and children. These plans have been mainstreamed in the school curricula. A law has been enacted prohibiting the sale of alcohol to those less than 18 years. Insulin is distributed to children free of charge, and customs duties on blood glucose meters have been lifted. The country’s record in cancer shows great improvement. Cancer monitoring is administered through 83 hospitals and 13 laboratories, where cases are detected, followed up and recorded. There have been 15,000 cases in Jordan. The Healthy Villages Project has been implemented in 16 villages to enhance the role of the local society in solving its problems. Clinics have been set up at government schools to provide medical services to large government schools or smaller school complexes within the various regions. It is worth mentioning that the Draft Childhood Act allocates a complete section to children’s health care covering the antenatal rights of the child, preventive measures to protect child health and school health care. 3. Food and Nutrition To overcome malnutrition through the provision of adequate household food security. To develop strategies ensuring creation of job opportunities, increased income and knowledge dissemination, and to support the services necessary for enhancing food production and distribution. Several actions have been taken to control malnutrition and improve the nutritional status of under-5- year- old children. A national team has been formed to start the activities of a project for a nutritional monitoring system at maternity and childhood centres due to the vital role they play in providing care to the most vulnerable groups in society, particularly children. A national plan has been devised in order to ensure nutritional meals in school cafeterias. Training courses are held for personnel involved in children’s issues, and educational publications are prepared for and distributed to mothers and families. With adequate support from UNICEF, many surveys on anaemia, iodine deficiency, vitamin A deficiency, and others have been implemented. A health survey on iodine deficiency among school children aged 8-10 years was conducted in 1993 and showed that the iodine deficiency rate in children of that age group reached 38%. Based on this result, Jordan’s salt manufacturing specification was amended in 1995 to include iodine in table salt. A national committee was formed to take action and supervise the process of salt iodization. A monitoring system was set to ensure that salt was supplemented with iodine and maintained follow-up and surveillance of salt factories to identify the problems facing them in the process of salt iodization and help them find relevant solutions. According to a survey conducted by the MOH in close co-operation with UNICEF, vitamin A

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deficiency is not a public health problem in Jordan. However, another survey conducted in underprivileged areas showed that 21% of children are suffering from low serum retinol. Based on this result, vitamin A capsules were distributed to the first, second and third school graders in the surveyed areas. Breast-feeding has been encouraged and the initiative for Baby-Friendly Hospitals signed and applied to three hospitals. A national code for breast-milk substitutes has been formulated, and the international code applied. Government and non-governmental awareness campaigns about the importance of breast-feeding and sound nutrition for the mother and child were launched. The campaigns included information programmes on the radio, in newspapers, television spots, books and publications, and the implementation of orientation programmes including lectures, seminars, and workshops on parental care and the reproductive health of the young also formed part of these campaigns. In contributing to food security, the voluntary sector gives support to families and helps them through income-generating programmes. The Development and Employment Fund offers loans to male and female applicants to establish small businesses. Moreover, NGOs and international organisations such as UNRWA, and the Social Security Programmes encourage such businesses. A strategy to overcome unemployment was devised in 1998. The discussion and updating of the national strategy for agriculture up till 2010 to gain food security, and preserve, develop and sustain natural resources is underway. Governmental and non-governmental bodies serve meals and milk in some schools in impoverished areas. Packaged rations are offered to poor families. It is worth mentioning that the Draft Childhood Act allocates a complete section to children’s food and nutrition. (Provision of adequate food to children, overcoming health problems, and the compliance of nutritional supplements to the standards and specifications established according to regulations.) 4. Role of Women, Maternal Health and Family Planning: To enhance the status of women and girls and their equal access to health, nutrition, education, training, and credit services, guidance services, family planning services, perinatal (prenatal, natal, and postnatal) care-giving services, access to referral facilities in complicated cases, and other fundamental services. Within the framework of the policies and general trends towards achieving gender equality and advancement of women, there has been an evident recognition by the Government of the importance and enhancement of the role of women in all areas. The Jordanian National Commission for Women (JNCW), chaired by Her Royal Highness Princess Basma Bint Talal, was established in 1992 by virtue of a Council of Ministers’ resolution. Concerned official sectors and major private sub-sectors are represented in the JNCW, which is intended for the promotion of the status women and integrating them in developmental issues. The JNCW has

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become an accredited mechanism for submitting proposals on policies dealing with social services, health and medical care, education, employment, and property acquisition. In 1993, the JNCW devised the first national strategy for women in collaboration with all public and private sectors involved in women’s issues. The strategy covers six major areas: Legislative, economic, social, political, educational and health. The JNCW has contributed to the amendment of a number of laws such as The Labour Law and The Civil Service Law. It has also proposed changes to many others such as Social Security, Health Insurance, Nationality and Civil Status with a view to bringing down the pensionable age for women to enable them to provide due care for their children. Meanwhile, a gender perspective has been incorporated in the Government’s 1999-2003 socio-economic development plan. Governmental and non-governmental bodies, together with UNRWA provide services to women, and implement awareness programmes in a number of areas. A nutritional monitoring system has been set up to collect information on the status of pregnant women and personnel have been trained on nutritional care and other aspects relevant to such women. Awareness and educational courses were held on food and nutrition for the groups with special needs such as children, and pregnant and lactating women. Educational pamphlets have been distributed to these groups and an initiative for safe motherhood launched. According to the Demographic and Housing Survey (DHS) 1997, the proportion of women who received antenatal medical care by skilled health personnel rose from 80% in 1990 to 95.7% in 1997. The average antenatal care visits was eight and the percentage of women with four visits was 86%. The proportion of deliveries at hospitals increased from 78% in 1990 to 93% in 1997 (DHS 1997). Deliveries attended by trained medical personnel rose from 87% in 1990 to 97% in 1997. Licensing or the renewal of the licenses of traditional midwives is only granted in remote areas and after proper training. The proportion of women using any method of family planning increased from 40% in 1990 to 56.7% in 1999. A survey on women aged 15-49 years showed that 28% of women of childbearing age suffered from anaemia, and that pregnant women suffering from it were given iron supplements in clinics. Antenatal and postnatal care services are offered free of charge at all of the 23 maternity and childhood centres that have been established at major hospitals in the kingdom. The centres provide counselling and training on postnatal care, family planning, and childcare services. Couples in Jordan have universal access to services and information on birth spacing methods through the implementation of several projects such as birth spacing, lactation, maternal and child care, and the enhancement of reproductive health services. These efforts are further implemented through the printing and distribution of educational materials, training manuals, and the production of television spots. In co-operation with the Jordanian Family Planning Association and other societies in the field, government authorities prepare and conduct training courses for both sexes aged 12-18 years to provide them with information on all stages of pregnancy. The National Population Strategy includes a section on birth spacing. NGOs have undertaken numerous health education activities regarding maternal health,

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illustrating the risks to adolescent married women, and calling for the raising of marital age to 18 years for girls and to 21 years for boys, in line with the CRC and the Draft Childhood Act. It is believed that at these ages, couples will have a level of awareness that empowers them to provide care for their children and to better shoulder their responsibilities. The Draft Childhood Act includes certain rules for family planning and maternal health under the clause “Antenatal child rights.” It points out that care should be provided to pregnant women from the date of conception. Pre-marital medical tests should be taken, and couples should be made aware of the risks of untimely pregnancies. Mothers should also be made aware of the importance of breast-feeding. 5. Role of the Family To support the efforts of parents and other caregivers to nurture and care for children, and to prevent the separation of children from their families. Whenever children are separated from their families, arrangements should be made for appropriate alternative family care or institutional placement. A Family Protection Department has been set up by the Directorate of Public Security to care for abused children. The Department aims at ensuring the safety of families and combating abuse affecting women and children. The department investigates cases of abuse both inside and outside the family. Specific government authorities support family efforts in child care, make alternative arrangements for children of unknown parentage, sponsor and educate orphaned children, and rehabilitate them through various projects and vocational courses. A directorate, devoted to women’s and children’s affairs, has been created at the Ministry of Awqaf and Islamic Affairs. The directorate calls for the rearing of children in a way that enhances gender equality. Alternative family protection for children from separated families and children of unknown parentage is provided through the four family and childhood institutions of the MOSD. These institutions care for some 306 children. The issues and concerns of children, who are separated from their own families, are well monitored. There are 19 institutions hosting, on average, 1000 male and female children annually. Children with unknown parentage are able to live in alternative family care. The Foster Placement Programme, undertaken by the MOSD, has provided placement for more than 500 children. The Nationality Law states that Jordanian nationality status is granted to those children until the nationality of either parent is identified. A Family Protection Project has also been launched in Jordan. Assuming a pioneering role, the project tackles social problems in collaboration with government and non-governmental institutions. It also protects and supports victims of abuse and violence, especially women and children. Furthermore, the project aims at developing an integrated national strategy to reduce domestic violence, child abuse, and sexual abuse in co-operation with government and nongovernmental institutions operating in the field. Task forces to support the project’s management team have been formed. The project has direct links to the NTFS, chaired by Her Majesty Queen Rania Al-Abdullah.

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Numerous NGOs have undertaken several activities such as the setting up of The Children’s Hostel for children whose parents are divorced, enabling them to meet their parents in a familylike atmosphere supported by a family-counselling programme. Inside the camps, UNRWA social workers pay regular visits to families with problems and give educational lectures to eligible ones. Programmes have been introduced to develop basic knowledge and skills in parents to enable them to nurture their children. These programmes include the Better Parenting Project, which is supported by UNICEF, and implemented by a number of government organisations and NGOs. Many regular training sessions have been held at kindergartens to support the role of the family in insuring the proper rearing of children. There are socio-legal counselling centres to help solve family problems. Doctors are called upon to volunteer to work for these community centres. The Draft Childhood Act contains certain clauses on family care including parental responsibility and prevention of abuse. 6. Basic Education and Literacy To give priority to early childhood development and basic education for all, reduce adult illiteracy (15+), provide vocational training and preparation for employment, and to increase acquisition of knowledge, skills, and values through all available educational channels. In confirmation of its commitment to providing education for all, Jordan issued a new law for education (Law No. 3 of 199.) According to this law, the free compulsory primary education stage is increased to ten years instead of nine. Secondary education now includes: 1. The comprehensive stream: a) academic (scientific, literary, Islamic religion), b) vocational (industrial, agricultural, etc.). 2. The vocational stream: enables students to acquire the basic skills of crafts. Common cultural subjects are offered as basic requirements for the various branches of higher education. Jordan has accomplished educational advancement over the last ten years. The education sector has witnessed tangible progress through upgrading the educational process, the enhancement of educational facilities, increasing educational opportunity and making education compulsory. The education sector has continued upgrading and enhancing the efficiency of the general and higher education systems and vocational training through the preparation of the preliminary draft for amendment of the Education Law. Focus has been centred on developing examinations and curricula, and implementing policies targeted towards enhancing scientific research. This has been done through the upgrading of the infrastructure of the educational and training institutions such as the establishment and maintenance of schools and educational centres.

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In the field of early childhood, several nursery schools and kindergartens have been opened. Their total number now stands at 713, most of which are in the central region of the country. They are sponsored by public and private institutions where the working mother is employed. They serve some 1.57% of the total number of children aged 0-4 years accounting for 25.64% of the total number of children, and 13.99% of the total population. It is worth mentioning that the National Team for Early Childhood Development, headed by Her Majesty Queen Rania, has formulated a draft strategy for early childhood. The strategy was discussed at a national conference held in November 2000, and amendments thereto are underway. The Education Law No. 3 of 1994 classifies the kindergarten stage as one of the educational stages in Jordan’s educational hierarchy. The Law defines this stage, limits it to two pre-school years, sets its general and specific objectives, and specifies its age group at 4-5 years. In line with the instructions of the National Team for Early Childhood Development as well as with the Government’s efforts and the recommendations of the Educational Development Conference, the Ministry of Education is considering the enrolment of five-year old children in public schools for one year preceding the first grade. The number of kindergartens reached 1098 in the school year 99/2000; most of them belong to the private and voluntary sectors. Enrolment rate for children aged 4-5 years rose to 26% in 1997 compared to 18% in 1990. Fifteen public kindergartens accommodating 375 children were established in rural areas. In the MOE’s annual expansion plan for the following school year 2000/2001, 58 kindergartens were established in rural areas with 1300 enrolments. The MOE encouraged the private and voluntary sectors to set up kindergartens, which totalled 1138 in 2000/2001. NGOs have undertaken several activities in this field, like preparing the teacher’s manual for the kindergarten stage, and conducting training courses for teachers on using these manuals. Story and song- writing for pre-school children are encouraged. By the year 2003 teacher training programmes will have been introduced in all governorates. Educational courses for kindergarten teachers are underway to develop the language skills of kindergarten children. As the majority of children in this age group receive care from their parents only, emphasis has been placed on the implementation of programmes targeting parents such as the Better Parenting Project. This project aims at raising the awareness of parents on the proper nurture of children and their needs at different ages. Many activities have been created for special education including students’ acceleration programmes, pioneer centres programmes, and the activation of the programmes and services offered to talented and gifted students through opening five pioneer centres in five governorates. The centres have trained personnel to cater for talented and gifted students. Moreover, activities include the implementation of acceleration programmes for 180 academically gifted students. Schools such as Al-Hussein School and The Jubilee School have been built to cater for innovative students.

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Students with special needs have also been given due attention. Action has been taken to develop comprehensive diagnostic examinations throughout the governorates, and to expand the educational services offered to them. This is in addition to the various programmes aimed at assisting students with special needs. Action has also been taken to integrate students with minor audio-visual disabilities into public schools. Certain private schools are also working on introducing this service. Three hundred educational resource rooms had been established by 2000/2001 serving more than 6000 primary school students. Teachers and other personnel attending to these students have been efficiently trained. Special equipment such as audiometers has been provided where needed. Regarding literacy, the Government, in co-operation with NGOs and international organisations such as UNRWA, has worked to set up literacy centres. It has adopted several programmes including literacy programmes. In the school year 2000/2001, the illiteracy rate for the population aged 15+ has declined from 19.5% in 1990 to 11.2% (6% males and 16.6% females.) Both the number of adult literacy centres and the number of females enrolling in these centres have increased, bringing the total to 425 centres in 1999/2000 (36 for males and 389 for females), with 6853 enrolments, 708 males and 6145 females. Teachers involved in literacy activities have received due training. NGOs encourage illiterate women to enrol in literacy classes by preparing suitable locations for these classes, and linking literacy programmes to a number of development projects implemented at the centres. They also provide educational and recreational activities for children aged 7-14 years in a number of centres and summer camps. Many educational awareness activities targeting adults on the importance of the education of their children have also been held. Work is underway to minimise failure and dropout rates. Dropout rates at the primary school stage reached 1.20% in 1997/1998. Educational curricula have been developed, new subjects and modern educational techniques introduced. In addition, appropriate buildings and facilities have been provided, teachers and administrators trained, and the private sector encouraged to invest in schooling. It is worth noting that the enrolment rate reached 100% for children in the first grade. The Government exempts school uniforms from sales tax to relieve the financial burden on parents. Computer skills have been introduced in the first four primary grades. At Palestinian refugee camps, literacy rates for males and females are equal, and all children of school age have enrolled. The MOE will provide computers for schools within a three-year project (2000-2003) starting from the school year 2000/2001.By the year 2000/2001, the MOE will have started to teach the English language to all primary school children. The teaching of French has, since 1993, been introduced to grades eight and nine and will be taught to all secondary students in the future. In 1998/1999, three governerates established six academic/sports schools with the aim of supporting national sports teams. Population, health and environmental education, as well as child rights and the theatre programme for “education through drama” have been integrated in the MOE’s programmes.

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Manuals for health education for grades 1-6 have been prepared, and several workshops have been held. Television programmes have been produced on issues relating to health and environmental education. A course in geology and ecology has been introduced at the secondary education level. Counselling and guidance services regarding child development are provided. Child abuse, violence, exploitation and vulnerability to accidents are also covered. The number of educational counselling personnel at public and private schools rose to 977 in 1999/2000, and they have been prepared to pursue higher diplomas and master degrees, and trained in social skills, decision-making skills and problem-solving skills. Other training programmes included critical, innovative, and rational thinking, peace promotion, family counselling, child rights, and students’ problem-solving programmes. The counselling and guidance staff has received training at universities on conducting personal tests, vocational tendency tests, and differential potential tests. They also received training on service provision to students with special needs, be they talented and gifted, or those with learning difficulties. The National Commission for Human Rights Education has been formed to promote the teaching of human rights concepts, including women’s and children’s rights at school. This will be accomplished by reviewing the school curricula, identifying deficiencies in this respect, and making recommendations to ensure human rights concepts are taught to primary school children. Seminars on this topic have been held in co-operation with universities and other concerned organisations. The agenda included issues related to violence against women and children in the Jordanian society, prevention of child labour, educational programmes for the young, family protection, the girl child and her freedom of choice, protection of children against narcotics, and time management. A public awareness campaign on the dangers of terrorism has been prepared, and so has the MOE’s plan to protect students and the school environment from the dangers of school violence. A third plan has been developed to protect children from child labour. The fourth, prepared by the counselling and guidance staff at schools, addresses the following issues: Development of a spirit of co-operation and teamwork among students, student counselling and the promotion of responsibility. A programme on students’ mediation in problem solving and conflict resolution has also been implemented. Under-15 year old children have been exempted from entry fees to touristic and archaeological sites. Sports complexes and youth camps have been expanded. In co-ordination with the artistic and cultural commissions, organisations and other parties, measures have been taken to disseminate Arabic and Islamic culture. Jordan’s contribution has been through the introduction of publications, translations, conferences, festivals, and exhibitions. Transmission time allocated for children’s programmes on television and radio has been increased, and children’s participation allowed in programme management. The number of involved personnel has been increased, a training service-based course on the production of children’s programmes was held to expand the scope of services to children. Bookstores, specifically set up for children, have been opened and a national information system established.

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Organisations play a significant role in this field. They have created the Children’s Museum for Heritage and Science, Mobile Life and Science Museum, and the National Centre for Music. They also held creativity competitions for children. The Jordanian Children’s Parliament has been established to ensure freedom of opinion for the child. Conferences on the Jordanian child were held in 1994 and 1996. The annual Arab Children Congress has been convened in Jordan since 1980, and so do the yearly festivals for the “Child’s Song Festival,” the Children’s Theatre, in addition to the annual celebrations of the Arab Child Day and the World Day for Children. Several national organisations deal with vocational education in Jordan such as the Vocational Training Corporation of the Ministry of Labour (MOL), the consultative centres at Jordan’s universities, the private sector’s organisations, the MOE and others. Vocational training forms part of the secondary stage education, and students enrol in it according to their capabilities and tendencies. The MOE offers scientific and educational services to the various branches of vocational training, like curricula and school textbooks, along with its continued efforts to upgrade and update curricular books as it did over the period 1995 – 1999. These efforts included the expansion of vocational education curricula such as industrial education for girls and home economics for boys. A programme has been implemented to enhance the employment opportunities of secondary school students by introducing the General Secondary Certificate – Vocational Branch. Vocational schools are linked to the labour market. In addition, committees have been formed at schools to promote vocational schools. The number of vocational schools throughout the country is being increased. Thirty-one new schools have been built and the 23 existing ones expanded. Vocational facilities and workshops are being upgraded. The efficiency of vocational training teachers is being enhanced through various behavioural and technical training courses. Self-employment concepts are incorporated in vocational education curricula and textbooks to raise the students’ awareness of the labour market and its requirements. The subject “vocational education” has been incorporated in all primary schools, vocational trends developed, students’ tendencies detected early, and various programmes for vocational orientation through the mass media and awareness channels implemented. The Draft Childhood Act allocates one separate section to children’s culture and education. 7. Children in Especially Difficult Circumstances Provide for special care to children living in especially difficult circumstances including elimination of economic exploitation, and combating youth addiction to narcotic drugs, tobacco and alcohol. Certain measures have been taken to provide services to this category of children. A programme for the protection of children and juveniles has been initiated at the MOSD, targeting those living in especially difficult circumstances; e.g. street children and displaced children. Four Family and childhood institutions provide protection to children less than 12 years. The Handicapped Care Law of 1993 spells out the rights of people with special needs to social integration, education, and rehabilitation. The 1994 Census included data on the disabled

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(1% of the population) and their disabilities. Registration of the disabled and the setting up of a network of rehabilitation programmes have been initiated with a view to reducing the cost of institutional service, early detection of disabilities, and activation of the role of the society. The National Centre for Community-Based Rehabilitation has been established as the first centre of its kind within the region to provide regular training in the areas of community- based rehabilitation. Expansion activities have been undertaken to construct schools and centres for the disabled, and develop programmes to support their families. Sports activities for the disabled in Jordan are available. Educational videotapes have been produced to assist the disabled in practising sports activities. The Handicapped Children’s Rehabilitation and Care Centre provides integrated social care to disabled children. Children suffering from mild mental retardation, hearing, and vision problems receive special education services from more than 35 centres for the handicapped. NGOs have opened a number of special education centres for the rehabilitation of motor, hearing, and mental disabilities. Every year since 1995, a special rally has been held to continue to raise public awareness about disabilities and people with special needs. A fund for medical instruments and rehabilitation services was created in 1994 to provide care for at least 120 cases per annum. Treatment units for poliomyelitis have been founded where necessary. Training programmes for mothers of the disabled have been implemented and resource rooms have been made available at government schools. Other activities include raising public awareness, the provision of information on the disabled and their disabilities and the implementation of preliminary and specialised training courses in special education. To reduce disabilities, free pre-marital blood tests for couples have been started. The law has been changed to curb road accidents, to reduce pollution and promote road safety. The traffic institute was also established, and several traffic awareness parks were created for children. A national plan to combat the use of narcotic drugs and psychotropic substances has been devised for the period 1999-2001. Other organisations are undertaking activities to combat smoking among children and child labour. The Family Protection Project has been launched in Jordan. Assuming a pioneering role, the project tackles social problems in collaboration with government and non-governmental institutions. It adopts human rights as a comprehensive approach to handle abuse of and violence against vulnerable groups as a whole, and women and children in particular in full conformity with religious norms and provisions. Furthermore, the project aims at reducing domestic violence, child abuse, and sexual abuse through various institutions operating in this field. Task forces to support the project’s management team have been created. This project has direct links to the NTFS. Many of the MOSD’s personnel have attended training courses to acquire the knowledge and skills needed to raise the standard of living of children suffering in difficult circumstances. Police officers, recruits and social workers are trained in the best techniques for dealing with children who are victims of domestic, sexual and physical abuse. Investigations are conducted in a psychologically comfortable atmosphere and special rooms appropriately conforming to child rights.

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Both Jordan’s Ministry of Foreign Affairs (MOFA) and the NTFC support and reinforce the articles of the Optional Protocol annexed to the CRC, which Jordan ratified in the year 2000. To protect children from economic exploitation, the Child Labour Division has been created at the MOL. This division will be the accredited national centre for the numerous bodies concerned with child labour in Jordan. A national database for child labour was created in 1999 to measure its economic and social dimensions. In co-operation with the International Labour Organisation, the MOL is preparing a national strategy for implementing the convention of the project for “Combating Child Labour in Jordan.” The project is aimed at supporting and developing the MOL’s capabilities to set up national strategies that gradually combat child labour. This will be accomplished through programmes aimed at reintegrating children into the society, as well as rehabilitating and protecting them, especially those working in hazardous conditions. Work will also be taken to enforce Conventions 138 and 182. Jordan’s Government has, for many years, been providing services for refugees. UNRWA supports Palestinian families at camps, and conducts surveys and research to identify the demographic and socio-economic circumstances of these families. Due to UNRWA’s reduced services, the Government of Jordan contributes to the provision of medical services to these refugees, and legalises their travel documents and civil status registries. In 1999, a team for family protection was formed at the MOSD with the aim of protecting children and women from neglect and all types of abuse, be it physical, sexual or emotional. Training and awareness courses have been held to combat abuse and specify abuse-related legislation to ensure applicability of its legal role. Several centres have been established to monitor the abuse of children and to receive related complaints. It is further noted that the NTFS and The Family Protection Project in Jordan aim, among other things, at upgrading the capacities of the personnel specialised in domestic violence issues. The Child Protection Programme undertaken by a NGO in co-operation with the Government provides protection for children against vulnerability to abuse and all types of exploitation, besides their efforts to develop training programmes for the staff handling children’s issues. Funded by UNICEF, a training manual is being prepared to train and qualify social and psychological counselling staff on scientific principles and approaches to tackle child abuse. Moreover, awareness programmes are provided to prevent such abuse. A centre has been founded at Prince Al-Hasan Camp/ Al-Nassr area. This centre undertakes several activities and programmes including surveys and research. It works at raising public awareness and provides training through regular workshops for parents and children, and offers weekly child-oriented programmes to counsel children and develop their capabilities. The centre

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holds summer festivals, child-to-child sessions, and conducts a free medical day. It also provides opportunity for library membership, and records 120-140 child visits weekly. A NGO, in co-operation with government authorities, has set up “Dar Al-Aman” (A centre for child rehabilitation and protection). This centre has been set up to implement the CPP. It also aims at providing services to families and children, and to conduct surveys and research on issues relating to child abuse, awareness, training, counselling and guidance, as well as to followup abuse cases. Being the first of its kind in the region, the centre offers rehabilitation and psychiatric treatment to abuse victims, and pursues cases reported by official and non-official sources. It is worth mentioning that the Draft Childhood Act allocates a separate section for “Penal Responsibility and Violence against Children,” and identifies the types of violence children may be vulnerable to. It also imposes severe penalties on parties committing any type of violence against children. Another section is designated for “Penal Responsibility and the Juvenile.” For disabled children, the Draft Childhood Act enlists a clause under “Social Care” on the care for disabled children and assurance of their rights in terms of care and education, training, rehabilitation, establishment of vocational and dedicated institutes and corporations, in addition to providing the necessary facilities for the disabled. 8. Protection of Children during Armed Conflict To provide special protection for children in situations of armed conflicts, and to build the foundation of a peaceful world by disseminating the values of peace, tolerance, understanding and dialogue. Conscription into the Jordanian Armed Forces is now confined to specific cases of a professional nature. Jordan’s Military observes the age prescribed by the United Nations for participation in International Peacekeeping Forces, preferably and normally set at no less than 21 years. Jordan has ratified the four Geneva Conventions, and currently works towards enforcing them, especially through participation in the International Peacekeeping Forces. Jordan also contributes to the enforcement of the fourth Geneva Convention in the Occupied Palestinian Territories. Amman, the capital city of Jordan, accommodates the Consulting Services Office through which the International Commission of the Red Cross (ICRC) and Red Crescent Movement work hard to offer their consultative services within the scope of the International Human Law in the Arab Region. A seminar on the implementation of this law was held in 1997, when important recommendations were made including the call to form national committees to attend to all issues relating to this law. A regional meeting was held to follow up these recommendations, and affirm the dissemination and updating of Jordan’s legislation to abide by the law’s provisions. This will ensure the protection of civilians, especially women and children who may be affected by armed conflicts. The Regional Centre for Human Security has, at its

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head office in Amman, held several awareness meetings on the issues that may threaten security. A Royal Commission for the Enforcement of International Human Law has been formed with the membership of several official and non-official organisations. A manual on International Human Law is being prepared to familiarise the military with the clauses of the Law. Extra-curricular activities of schools are intended to spread the values of peace, tolerance, understanding and dialogue. NGOs undertake many activities to disseminate values of tolerance and understanding such as the annual Arab Children’s Congress and the programmes of the Society for Children’s International Summer Villages. The society receives children from different parts of the world to spread and encourage peace, understanding, tolerance, and dialogue. In co-operation with Jordan’s Ministry of Justice and MOFA, the NTFC has made specific remarks on the Optional Protocol “Armed Conflicts and Raising the Conscription Age” annexed to the CRC. The remarks are not only in line with the Protocol, but also emphasise its clauses. Attempts are ongoing to introduce programmes for the protection and care of children in situations of armed conflicts. The Draft Childhood Act includes a clause on the protection of children in situations of war, disasters, and emergencies. 9. Children and the Environment To prevent environmental degradation by observing the goals of world summits, inculcating respect for the natural environment, and changing wasteful consumption patterns. The General Corporation of Environment Protection (GCEP) has implemented several policies and procedures. It completed the study on the waste dump area at Madhouna/Al-Ghbari, and the dangerous waste dump area at Swaqa. As a result, a project is now underway in cooperation with the French authorities to reduce its adverse effects on the local society. Work is ongoing on another project to produce Methane from organic household waste. Application of clean technology has been introduced to preserve water, as well as to control and prevent pollution. On means of transportation, noise levels have been controlled, and the replacement of old vehicles encouraged. Environment management practices have been observed to evaluate the environmental impact of various projects including ISO 14001. An agreement to control air pollutants such as dust and gases in certain regions has been made, and prominent natural reserves in Jordan such as Dana in southern Jordan, have been expanded. To introduce the public to issues related to the environment and its importance at all levels, a number of non-governmental societies have been created, and are learning from the experiences and contributions of other regional and international organisations. Environmental issues have been incorporated into the curricula of schools and universities. To encourage tourism, various natural reserves, public parks, forests and protection programmes have been set up.

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With regards to the ozone layer, a number of programmes have been implemented enhancing environmental performance including replacement of ozone-depleting substances with ozonefriendly ones. In a bid to increase the Jordanian producer’s competitive capabilities, the environmental programme for fostering local industries has been enforced, and the private sector and banks are now involved in environmental investment. Regarding environmental protection and pollution reduction, certain environmental legislation and laws have been completed, while others are still underway. Efforts are ongoing to enforce the Environment Law through GCEP (A study is being conducted to transform it into a ministry for the environment). Regulations for environmental control and inspection have been prepared, and so has the legislation required for their implementation. An emergency plan to overcome oil pollution in the Gulf of Aqaba has been designed, the waste dump area at Russeifa east of Amman reclaimed, and the specifications for lessening gas emissions from vehicles approved. Phase I of the comprehensive plan for land use in Jordan’s northern and southern regions has been preliminarily completed; however, the one for the central region has not. Debts have been exchanged for the implementation of environmental programmes. Information on changes in environmental laws and legislation world-wide and on specifications, standards, and modern applied technology and its impact on trade have always been made available to interested parties. Indicators linking pollutants to health and environmental emergency plans have been produced. Registration and use of chlorinated hydro-carbonates and pesticides containing heavy metals and mercury have been banned. Posters and stickers in Arabic showing features of all pesticides have been approved. Lectures, and Muslims’ Friday sermons have been dedicated to topics like cleanliness, preservation of the environment, tree planting, the kind treatment of birds and animals, preservation of water and other resources. In addition, there are public and official campaigns for the protection of the environment. Units on the environment have been included in the science curricula of all school children. A manual for comprehensive education including environmental activities has been prepared, and some 861 schools have participated in the Nature Protection Club. The teacher’s manual has been prepared to encourage the use of environmentally friendly materials during lessons. Jordan has been represented in the South Eastern Mediterranean Project for Environment Protection. Environmental concepts have been included as separate units and lessons in the Social Education textbooks of grades 6-10. NGOs assume the role of spreading environmental awareness, holding workshops, and involving children in forestation and environmental protection programmes such as the Children’s Parliament Programme. Through a network of community development centres, several NGOs direct local societies towards identifying available resources and how to better utilise them. This can be accomplished through the adequate and relevant training of the local community, and conducting various studies using the Participatory Rural Approach (PRA). A number of environment-related educational activities are implemented, including water rationing and preservation, water cleanliness and maintenance of water reservoirs, creation of a number of water harvesting projects, the recycling of household waste, and raising family awareness

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concerning the need for a safe household environment. Such awareness includes the correct use of pesticides, food safety, ventilation, personal cleanliness, and childcare. Through children’s clubs, efforts are made to teach children about the importance of the preservation and protection of the environment. This is also achieved through specialised training workshops on the environment and numerous relevant field visits. Instilling this concept is also carried out through cleanliness campaigns and introducing children to agriculture through their participation in several agricultural activities within their areas, and supporting the annual campaign carried out in Jordan under the slogan “Everything is of Value”. The Draft Childhood Act allocates a section to environmental protection. 10. Alleviation of Poverty and Revitalisation of Economic Growth To confront poverty and external debts problem, mobilise resources to meet the needs of development, cease net transfer of resources from developing to developed countries, create an equitable trading system, and to give children the foremost priority in socioeconomic development. During the past ten years, the national economy has gradually shifted from protected market practices to open market practices. The shift has entailed the adoption of an economic reform programme covering several major areas, the most important of which is the reform and restructure of customs duties and other taxes. This reform process has consequently reflected on the structure and revenues of the state budget. The reformed areas also include the financial and banking systems, which has resulted in enhancing the balance of payments. A set of economic legislation to support the market and activate the economic movement has also been adopted. Jordan’s commitment to the Euro-Jordanian Association and the country’s accession to the World Trade Organisation have resulted in new challenges for national industries. Changes such as gradual changes in management and production practices, the introduction of new industries, and the closure of old ones have contributed to the slowing down of the national economic growth during the transitional period. On the other hand, the country’s economy has started to improve but this has not yet become apparent. Examples of this include the entry of new industries within the framework of the Qualified Industrial Zones Agreement, the expansion of the Food-for-Oil Agreement with Iraq, and the state of political and economic co-operation Jordan has, especially with Arab countries. The latter may positively influence production, exports, and labour markets. Due to economic factors, and the population growth at rates outpacing the economic growth rate, the per capita share of the Gross Domestic Product (GDP) has declined to JD 1045 with an estimated increase in the actual GDP growth to some 2.5% this year.

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Over the past year, Jordan has made extensive efforts to repay creditor countries and institutions and reduce external debts. Great strides have been made in terms of reducing the country’s debts, obtaining grants and loans, debt rescheduling, and partially transforming debts into investments. Foreign debts to GDP ratio reached 98% in 1999, a percentage that calls for further efforts to cancel these debts. Jordan’s authorities have taken several measures to attract and encourage foreign investment. Perhaps the main achievement in this respect is the “one-shop stop” service initiated in 1999 by the Investment Promotion Corporation (IPC), recently changed to the Jordan Investment Board. IPC’s “Committee of Facilitating the Investment Projects’ Procedures” has since then, started following up and co-ordinating the issuing of licenses and preliminary approvals for investment projects. Accordingly, licensing procedures have been undertaken by various parties for some 120 investment projects. Jordan has also introduced a privatisation programme that mandates the withdrawal of the Government from various productive sectors. The programme has been adopted as a component of a comprehensive strategy to encourage entrepreneurs and promote the private sector’s role, through the creation of an appropriate legal, organisational, and economic environment. Jordan has always given due attention to the status of the poorer segment of its population through access to free primary education, health services, medical insurance for civil servants, creation of specific funds to support income-generating projects, and the diversification of income resources. Accordingly, several societies have been established and many surveys have been conducted for this purpose. In 1989, the first study on poverty was conducted. It was updated in 1993, and followed by a third study in 1997. A strategy to curb poverty and support the efforts of large families through productive family programmes was set up. The Development and Employment Fund financed 8,000 projects during the last nine years, generating about 16,670 job opportunities. Financing of cottage industries and individual projects have been initiated, with women accounting for 27% of the total borrowers. The government offers incentives to the private sector to make housing units affordable to low-income groups, and allocates land lots for this purpose. According to studies conducted in 1996, the proportion of people living in abject poverty in Jordan reached 15%. To confront poverty, the Government adopted a national strategy for poverty alleviation and unemployment. he strategy aims at increasing opportunities for people, making use of their capabilities and improving their standards of living in a manner that supports their effective participation in all occupations. During 1997, the Government, through the ministries and institutions concerned, designed an integrated strategy for poverty alleviation and unemployment, and for advancing the socioeconomic level of the most disadvantaged segments of the society. The strategy has, among other things, resulted in the creation of the Social Productivity Programme (SPP) to increase the overall level of productivity of Jordanians as a whole, and the underprivileged segments in particular.

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To accomplish the overall objective of the strategy, which is planned to be implemented in two phases (Phase I for three years and Phase II for seven). The SPP aims at achieving several objectives. Among these are to increase the income levels of the poor and the improvement of economic and investment opportunities for the underprivileged segments through developing the micro-enterprises sector, and increasing their job opportunities through re-qualification, training, and integration into the labour market. The objectives also include the improvement of the livelihoods of the poor and underprivileged segments through the development of the surrounding financial and social infrastructure. Furthermore, the objectives are set to create an effective pattern of comprehensive development in poor localities through the application of all the SPP components to selected pilot areas. The ultimate purpose of such a pattern is to develop the economic and social potentials of these localities in a way that makes them more capable of fulfilling their developmental requirements. Phase I of SPP aims at confronting and remedying the instant impact of poverty and unemployment through five integrated, practical and overlapping programmes. These programmes, implemented by a number of ministries, government organisations and NGOs are: The Restructuring of the National Aid Fund (RENAF), development and funding of small enterprises, training and employment support, infra-structure development in poor areas, and comprehensive development pioneer projects. The SPP has made several achievements targeting the reduction of poverty and unemployment in the country. Through the restructuring and expansion of the RENAF programme, beneficiary families have increased from 32,000 to 47,000. Computerisation and restructuring of the RENAF’s activities are underway, and the programme for supplementing family income has been prepared and will soon be in operation. The training and support programme has provided training for about 3,000 unemployed trainees, of whom 2,900 have found jobs in various regions in the country. As for the development and funding of small enterprises, the RENAF offers administrative and technical support for the sustainable micro-finance sector in the country. The programme offers training and counselling services for entrepreneurs. It has granted 12,000 loans to the value of JD3 million provided through four intermediary financing institutions offering services to all governorates all over the Kingdom. Under the infrastructure development in poor areas programme, projects have been implemented for 14 local councils. Lists of local councils requiring physical and social infrastructure development during phase 1 of the SPP (covering 154 councils) have been approved. Work has already started to develop the infrastructure in 13 camps and 14 unplanned housing areas in both Amman and Zarqa. Regarding the Pioneer Projects for Comprehensive Development, three projects have been launched in the Northern Desert (Badia), the Lib area in Madaba, and in the city of Ma’an, in co-operation with several institutions and non-governmental parties. Moreover, a number of

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direct intervention projects for the amount of JD 2.3 million have been financed and implemented in various areas in the country. These projects fulfil the developmental needs of those areas. To increase opportunities of public participation, special strategies are underway to extend investment opportunities and create a suitable economic environment through programmes and activities targeted towards increased competitiveness and economic growth. As a long-term objective, these strategies are designed to achieve more equitable allocation of resources, revenues and benefits of development to all segments of the society. For purposes of accomplishing socio-economic development, as a right for all citizens, social and economic plans are produced, and implementation of development programmes followed up. External financing resources are explored and development-targeted financial and technical grants and assistance to Jordan co-ordinated. Jordan gives special priority to children in the socio-economic development process. The 1999-2003 economic and social plan was designed last year within the framework of a long-term development strategy. The plan includes a section on children’s and youth’s issues and the health, education, and culture sectors include childrelated policies and procedures. Through the Zakat Fund, the Ministry of Awqaf and Islamic Affairs supports 50,000 families each month. The Ministry provides emergency assistance to eligible groups, and supports, rehabilitates, and trains poor families and students. It also creates income-generating projects, offers food parcels to needy families, especially during Ramadan. It also supports several projects such as the Poor Student Fund, the Poor Patient Fund, and the Orphan Sponsorship. Plans for reducing unemployment have been made, and a committee to conduct a study on planning the labour market formed. Special workshops on economic opportunities have been organised by several institutions. These workshops are intended to train the young on how to find job opportunities and achieve self-reliance. The Government enables some disabled children to benefit from the productive rehabilitation programmes provided by the MOSD’s Productive Vocational Rehabilitation Centres. Cash assistance is also provided to certain poor families with disabled children through the Disabled Assistance Programme operated by the NAF. The Government further enables children in need of alternative family protection while receiving institutional placement to obtain on average a monthly grant of JD 6. It also offers productive rehabilitation loans to juveniles and children discharged from social care through the Vocational Rehabilitation Programme and others. In order to alleviate poverty, NGOs, concerned ministries and government institutions, national development commissions, and some international institutions co-operate in the implementation of productive programmes to help underprivileged families. These programmes help families affected by the reform programme to increase their income either through small productive projects or creating new job opportunities for them. Women’s organisations have empowered some women in order to involve them in the comprehensive development process.

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Rehabilitation is intended to help women to assist their children in all occupations and fulfil their minimal needs to overcome the increasing poverty problem. Through several income-generating projects, and in addition to the work of the government, NGOs and UNRWA create job opportunities for the unemployed to increase their incomes. This effort will enhance the health, educational and nutritional care for the children of needy families. In co-operation with government authorities, some NGOs conduct studies on poor families. Fact sheets are prepared about poor children in Jordan. Certain studies and activities have been conducted on child labour in order to better deal with this problem and protect children from economic exploitation. V.

Lessons Learnt (Conducive basic factors, progress impeding factors, challenges, and outstanding issues)

Jordan benefits from several factors that have helped the country accomplish the majority of the end-of-decade goals. Jordan’s commitment to the rights of the child has been translated into numerous practical steps over the past few years. It has resulted in substantial groundbreaking progress apparent in several areas. Jordan feels proud of the efforts of various organisations that have led to the accelerated accomplishment of many goals. In addition, several other internal and external factors have had an impact on the achievement of some accomplishments, and have created difficulties on the road to achieving others. These include: 1-Economic factors: The Second Gulf War and its consequences have overburdened the national economy due to numerous factors. Most important of these is the increased pressure it placed on the infrastructure and services provided. This pressure came as a result of the unexpected influx of thousands of Jordanians from the Gulf countries. It was also caused by the closure of traditional markets to Jordanian products, all resulting in limited enhancement of the services targeting children in Jordan. Certain economic factors have limited the expansion of child-based projects and programmes. These factors include increased poverty and unemployment rates, limited resources, the enforcement of economic reform programmes, privatisation and market liberalisation. Added to that are limited job opportunities, lack of optimal exploitation of available resources and potentials, lower rural work productivity, random deployment of urban areas at the expense of arable lands. Also, there is the Municipal Council’s limited budgets that hinder implementation of set plans, the reduction of food production due to the high cost of agricultural materials and products, water scarcity, the high cost of living, large families and higher dependency rates within families. 2-Legislative/Legal factors: The backlog of pending laws and codes at the Lower House of Parliament impedes their updating to keep abreast of the times, especially the outdated ones which were endorsed years ago. These laws and codes include the Juvenile Law and the Penal Code. Committees have been formed to study these laws and introduce the necessary amendments to them.

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3-Technical Factors: 1. Lack of full-time specialised, technical personnel working for children’s rights. 2. Lack of information and regular statistics needed for child protection in cases such as child labour. 3. The need for sophisticated medical technology in the public health sector and the need for greater co-ordination between the public and private health sectors. 4. The insufficient number of necessary medical laboratories. 5. Scarcity of available training and rehabilitation opportunities. 6. The low number of centres offering legal and social counselling. 7. The lack of a modern curricula to keep pace with modern developments.

4-Demographic Factors: 1. High population growth and fertility rates. 2. High proportion of children and their dependency in the Jordanian society. 3. Migration from rural to urban areas. 4. Crowded cities that cause the spread of social problems. 5. Waves of forced involuntary migration from neighbouring countries including workers returning from the Gulf States. 5-External Factors: There are several external factors that have obstructed the childhood development process in Jordan. These include: 1. 2. 3. 4.

The stumbling peace process leading to political and economic instability in the area. Contemporary international economic challenges, especially globalisation. Jordan’s compliance with economic pressures and international developments. The financial requirements of international bodies and donor countries and lack of concessions regarding Jordan’s debts. These factors have consequently led to reduced Government spending on main services including health, education, and other social services. Moreover, UNRWA’s budget and responsibilities have been reduced leading to further burdens on the state budget to provide health, educational and other services to Palestinian refugees in Jordan. This budget amounts to US$ 350 million per annum. The amount exceeds UNRWA’s budget for its five operations areas: the West Bank and Gaza Strip, Syria, Jordan and Lebanon.

6-Social Factors: These factors include: 1. False conceptions. 2. Lack of awareness and illiteracy especially among females. 3. Lack of general awareness programmes broadcast by the media. 4. The insufficient number of female communicators in local communities. 5. Inadequate educational and informational programmes concentrating on child welfare. 7-The Health Sector: The most important problems still facing this sector include:

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1. Limited facilities. 2. The absence of clear and specific directions to help overcome high-risk pregnancies. 3. The absence of a co-ordinated referral system between hospitals and other centres providing antenatal and postnatal care. 4. The neglect of postnatal care when studies and surveys are conducted. 5. The lack of female physicians and inadequate counselling services at some health centres. 6. The lack of laboratories at some maternity and childhood centres. 7. The lack of co-ordination between parties producing related educational material. These factors all affect the extent of benefits received from health services and health development in Jordan. Challenges: Numerous challenges, whether economic, demographic or cultural, are a source of worry to the parties responsible for childhood development in Jordan. The challenges include: 1- Health: 1. Jordan has succeeded in greatly reducing the under-5 infant mortality rate; However, the country faces the challenge of focusing efforts on reducing the neonatal mortality rate by providing more training facilities to provide further perinatal care to the mother and child. 2. Causes of infant mortality should be identified, and the effect of acute respiratory system diseases on the infant mortality rate established. 3. Immunisation coverage stands at more than 90% of children. Further awareness about the importance of enforcing the immunisation programmes approved by the MOH should be continued. Special focus should be placed on continuous monitoring of the immunisation levels in Jordan to sustain the achievements made in this field. 4. Co-ordination among the parties concerned with monitoring table salt iodization and supplementation with other nutritives should be enhanced. 5. Efforts should be made to prevent certain diseases resulting from deficiency of basic nutritive elements such as iron and vitamin A, by continued distribution of relevant supplements at the MOH’s centres, especially in the areas where people are suffering from anaemia and vitamin A deficiencies. Health personnel should be trained to handle such diseases, and a manual on these deficiencies should be available for health workers. 6. Mechanisms should be created to investigate maternal mortality and improve the procedures for referral of high-risk pregnancies. 7. The role of health centres in encouraging Baby-Friendly Hospitals should be enhanced, and the private sector should be involved in supporting and implementing this initiative. 8. There should be co-ordination among all the parties concerned to produce a comprehensive national plan with focus on female adolescents and youths and providing for their health as well as their psychological, social and economic needs. 9. Family planning programmes should be intensified to fulfil the unmet needs of family planning services. To overcome the above challenges, Jordan should have access to direct and indirect international support especially in terms of the exchange of technology and training of the

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technical cadre. 2- Environment: Due to the negative impact of pollution on the health of the Jordanian public especially children, relevant mechanisms and legislation should be created to control air, soil and water pollution. The impact of water shortages on the number of diarrhoeal incidences should be monitored, especially in underprivileged areas. 3- Education and Culture: Adjustments should be made to rectify the failure of programmes for both gifted and dyslexic children, and to bolster limited cultural, entertainment and sports activities for the young in all governorates. Other issues to be considered include dropouts from the primary education stage, school violence, and a reduction of illiteracy rates especially among females in the rural areas. Revenue from the Vocational Training Centers should be increased and free access to international expertise in vocational and technical education and training should be provided. Vocational training for the disabled should be expanded, general vocational training centres, programmes, curricula and facilities developed and upgraded to cope with changes in the labour market. 4- Children in Especially Difficult Circumstances: Awareness of sound and safe child rearing methods should be enhanced and incidences of abuse should be prevented by increasing the number of qualified centres to care for and rehabilitate abused children. Procedures permitting the conscription of children less than 18 years of age should be studied. The increase in child labour should be controlled and children should be included in the social security system. Services targeting the disabled should be expanded. VI.

Future Actions (Recommended Procedures at National and International Levels)

Government parties and NGOs have worked for years to fulfil the needs of children in Jordan. Voluntary work plays an important role in terms of childhood care especially concerning their protection and participation. Despite the progress Jordan has made on the road to childhood development, future action is still needed. National support of child rights, as well as international support are needed if progress is to be maintained. Legislation: Amending and elaborating certain national laws and legislation to cope with emerging developments while highly prioritising the interests of the child and family. Health: 1. Creating systems to monitor high-risk pregnancies through antenatal care programmes. Referral procedures between centres and hospitals should be developed. All deliveries

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2.

3.

4.

5.

6. 7.

should take place at health centres or hospitals. Special attention should be given to children’s departments, especially the Premature Baby Special Care Units (BSCU). Creating systems to identify maternal mortality rate and activating the National Safe Motherhood Committee. The quality of antenatal, natal and postnatal services, as well as family planning services should be enhanced. Training, education, awareness, and coordination with the private sector regarding tetanus vaccinations should continue. Special attention should be rendered to women’s and female adolescents’ health. Expanding the umbrella of health insurance and social security. Comprehensive medical insurance should be provided for children, and free pre-marital medical examinations offered, while enforcing related legislation. Increasing the number of health projects and programmes targeting children in especially difficult circumstances, concentrating on underprivileged areas in order to increase the level of health care in these areas in line with the achievements made at the national level. Establishing a health screening system that requires the examination of every new-born child to prevent congenital disabilities such as congenital phenylketoneurea, galactosemia and hypothyroidism. The technical infrastructure for the enforcement of this system should be provided. Providing the required technical and financial support to premature BSCUs in all hospitals and to improve their services and efforts to reduce the number of perinatal deaths. Training the health cadre working for children, maternity, and reproductive health fields.

To overcome the above challenges, Jordan should have access to direct and indirect international support for all health sectors. Nutrition and Food Safety: 1. Monitoring the producers’ commitment to standards of table salt iodization and supplementation with other nutritives such as iron. 2. Manufacturing children’s foodstuff supplemented with iron and vitamins. 3. Enforcing laws and legislation stipulating the right of working women to breast-feed their infants. 4. Regional planning to maintain arable areas and natural resources. 5. Amending current legislation regarding construction on agricultural land beyond certain areas. The law should introduce deterrent penalties to curb construction on arable lands. It should also include incentives to encourage owners of agricultural land to invest in and maintain their property. Construction Regulation No. 19 for 1985 should be amended. 6. Consolidating joint regional efforts to solve the water problem in the area. To overcome the above challenges, Jordan should have access to direct international food aid and the technology to make optimal use of agricultural land, water resources, and food preservation. Culture: 1. Increasing the number of children’s cultural centres especially for girls, and establishing

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clubs, libraries, recreational facilities, and playgrounds especially in heavily populated areas and camps. Girls should be given increased opportunities through appropriate programmes. A greater number of awareness and training programmes should be designed for parents and extended families on issues related to children’s and adolescents’ rights. 2. Encouraging authors to produce meaningful material for children, and reducing the prices of children’s books and magazines. The number of children’s educational television and radio programmes should be increased. This calls for greater international technical support through art programmes, and national cultural bodies should be supported, especially in the activation of programmes targeting children’s education. Environment: 1. Obtaining financial support for the GCEP, and recruiting specialised technical cadre. 2. Establishing environment labs. 3. Developing public awareness by incorporating environmental concepts in the school curricula. Relevant sermons in places of worship should be encouraged. 4. Disseminating knowledge and awareness through the mass media. Children and other community members should be involved in issues relating to the protection of the environment by means of awareness programmes and training workshops and other similar means. 5. Involving local communities in the country’s strategies to ensure people’s monitoring of water resources. 6. Observing and combating lead pollution. 7. Consolidating joint regional efforts to solve the water problem in the region. International support must be provided to preserve the environment through providing advanced environment-friendly technology as well as providing assistance to remedy existing environmental problems.

Alleviation of Poverty: 1. Attracting investment through the creation of a business environment attractive to Jordanian, Arab and foreign investors. 2. Increasing the budgets allocated to social, health and education services. Further job opportunities should be created by promoting productive projects and small incomegenerating projects. New vocational schools should be established and developed to cope with market demand, and educational and awareness pamphlets should be produced. 3. Working towards the alleviation of poverty and the reduction of unemployment. Large families should be supported through establishing and funding group projects. 4. Enforcing the national policy on population to control the growth rate, and controlling uneven population distribution. 5. Encouraging reverse migration from urban to rural areas.

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6. International support to Jordan should be offered especially in areas targeting better living standards and lower unemployment rates through direct investment in various economic sectors. 7. International parties should be called upon to cancel Jordan’s debts to assist the country to overcome obstacles hampering the progress of the development process and to maintain its sustainability. 8. Efforts of the world community should be consolidated to achieve a just and permanent settlement in the Middle East. 9. The right of return and indemnity for Palestinian refugees should be secured. Education: 1. Increasing the number of public kindergartens and providing them with facilities and educational materials. Kindergarten staff should be adequately trained. 2. Establishing more primary schools and literacy centres as well as providing further training for their employees. 3. Encouraging computer literacy and the teaching of information technology subjects at private and public schools. 4. Developing and improving the curriculum at literacy centres as well as providing financial and moral incentives for the students who use them. 5. Customs duties on educational books, aids, and games should be exempted. 6. Developing textbooks by enriching them with verses from the Holy Quran and the Prophet’s Hadith (sayings) as well as Islamic proverbs and tales related to child rearing and children’s rights. International support should be provided to enhance the quality of education and provide the technology needed by students and teachers alike. Child Protection: 1. Drawing a national plan of action for the National Strategy for Early Childhood Development for the forthcoming decade. 2. Conducting a comprehensive national survey to identify the economic, social and psychological attributes of working children and their working conditions, and providing the necessary finances. Seminars and workshops on child labour should be held to raise awareness of the parties concerned, and to co-ordinate their efforts towards creating the best alternatives for the psychological and physical health of children. Qualified personnel working with children should be made available and rehabilitation programmes should be set up for children. 3. Expanding the scope of training and increasing awareness of all aspects of child abuse through workshops and other activities for teachers, parents, children and all child caregivers. Specialised people should be involved in developing awareness and training programmes for children’s protection and rehabilitation. 4. Developing a national strategy for family security and family affairs in general while setting adequate plans for its implementation.

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5. Incorporating children’s rights in all the educational levels wherever necessary as well as defining these rights from religious and legal perspectives. Raising Awareness: 1. Drawing an integrated information strategy to advance the status of the child in all domains as well as raising awareness of children’s rights. 2. Raising awareness about reproductive health. 3. Using the mass media, especially television programmes as a tool of change. Emphasis should be placed on religious education for the moral values it imparts to the young. 4. Raising awareness of the public role in assuming social responsibility towards children. 5. Enhancing the spirit of voluntary work targeting children. Information Development: 1. Developing the means to gather statistics to monitor children’s status in Jordan, with special emphasis on gathering indicators according to gender and geographic areas to identify areas and groups in need of specialised programmes. 2. Setting up and adopting systems to collect indicators relating to child protection such as indicators for child labour, children with special needs, and children placed in institutions. International support should therefore be provided to Jordan in the field of information development, and the provision of the necessary technology and programmes to achieve it.

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Statistical Appendix

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Introduction: This report summarizes the statistical developments related to Jordan’s achievements related to the World Summit for Children. The aim of the report is to provide the most reliable data available in Jordan from which progress during the 1990s can be assessed and trends, where possible, highlighted. This statistical report is an annex to the main report on Jordan’s national achievements on the follow up to the World Summit for Children. It should be read in conjunction with the main report. The report reviews the indicators used to assess Jordan’s achievement of the 27 Goals for children. For each indicator, the report identifies the baseline and latest values and, where possible, describes the trends and how realistic they are, and discusses the quality of the indicators used. Additional narrative discussions of some indicators are found in the main body of the report. Accordingly, in the interest of clarity and conciseness, the report is structured as follows: A table is prepared for every indicator used to assess how far Jordan has reached in achieving the 27 goals of the world summit for children. The table includes: 123456-

Definition of the indicator. Baseline values of the indicator. Most recent values of the indicator. Sources of data. Data quality discussion. Comments on trends and progress .

The following abbreviations are used for the most referred to sources of data: DHS 1990: DHS 1997: JAFS 1999:

Demographic and Health Survey 1990, Jordanian Department of Statistics, Macro International Inc. Demographic and Health Survey 1997, Jordanian Department of Statistics, Macro International Inc. Jordan Annual fertility Survey 1999, Department of Statistics, International Programmes Centre, US Census Bureau.

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The World Summit Goals and Related Indicators Goal 1: Between 1990 and the year 2000, reduction of infant and under-five mortality rate by one third or to 50 and 70 per 1,000 live births respectively whichever is less. Indicators: 1.1 1.2

Under-five mortality rate: Probability of dying between birth and exactly five years of age, per 1,000 live births. Infant mortality rate: Probability of dying between birth and exactly one year of age, per 1,000 live births.

6.1 Under-five mortality rate: Probability of dying between birth and exactly five years of age, per 1,000 live births. Baseline data Most Recent data Value Male Female Total Value Male Female Total 39 33 30 31 Year 1990 Year 1999 Source DHS 1990 Sources DHS 1997, JAFS 1999 Data The DHS survey report Data The DHS 97 uses direct quality considers the quality of the data quality estimates and suggests that on children’s age at death to be U5MR is 34 per 1,000, the good. Except for some increase annual fertility survey uses at 12 months and to a lesser indirect estimates which have degree at 3 months, the been adjusted and gives the distribution of children’s age at latest estimates shown above. death show a smooth curve Comments: The survival rate data from DHS 90, DHS97, and the annual fertility surveys of 1998, 1999 show that under-five mortality rates are declining at a slow pace. There have been six national surveys between 1990 and 1999 that have measured child mortality. The latest, the annual fertility survey for 1999, examines the six surveys and suggests that “Jordan’s infant mortality rate is probably in the 25 to 30 per 1,000 range in 1999.” So while the trend in infant mortality rates is on the decline, and as mentioned in the annual fertility survey for 1999: “Because infant and child mortality are rare events in Jordan, survey-based measurement systems are not well-suited to provide timely estimates of infant and child mortality for health and population programme monitoring and management." Survey results show that while there are no gender disparities in mortality rates, they exist between regions where they are higher in the south and in rural areas.

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6.2 Infant mortality rate: Probability of dying between birth and exactly one year of age, per 1,000 live births. Baseline data Most Recent data Value Male Female Total Value Male Female Total 34 26.8 25 26 Year 1990 Year 1999 Source DHS 1990 Source DHS 1997, JAFS 1999 Data The DHS survey report Data The DHS 97 uses direct quality considers the quality of the data quality estimates and suggests that on children’s age at death to be IMR is 29 per 1,000, the good. Except for some increase annual fertility survey uses at 12 months and to a lesser indirect estimates which have degree at 3 months, the been adjusted and gives the distribution of children’s age at latest estimates shown above. death show a smooth curve. Comments: The survival rate data from DHS 90, DHS97, and the annual fertility surveys of 1998, 1999 show that infant rates are declining at a slow pace. There have been six national surveys between 1990 and 1999 that have measured child mortality. The latest, the annual fertility survey for 1999, examines the six surveys and suggests that “Jordan’s infant mortality rate is probably in the 25 to 30 per 1,000 range in 1999.” So while the trend in infant mortality rates is on the decline, and as mentioned in the annual fertility survey for 1999: “Because infant and child mortality rates are rare events in Jordan, survey-based measurement systems are not well suited to provide timely estimates of infant and child mortality for health and population programme monitoring and management." Survey results show that while there are no gender disparities in mortality rates, they exist between regions where they are higher in the south and in rural areas. Goal 2: Between 1990 and the year 2000, reduction of maternal mortality rate by half . Indicators: 2.1

Maternal mortality ratio: Annual number of deaths of women from pregnancy related causes, when pregnant or within 42 days of termination of pregnancy, per 100,000 live births.

2.1 Maternal mortality ratio: Annual number of deaths of women from pregnancy-related causes during pregnancy or within 42 days of the termination of pregnancy, per 100,000 live births. Baseline data Most Recent data Value 48-60 Value 41

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Year Source

1990 Based on review of hospital records, some studies cite a figure of 60 per 100,000 based on DOS No reliable data is available, estimates vary from 48 to 60 per 100,000.

Year Source

1996 National Maternal Mortality Study (1995-1996), Ministry of Health, Johns Hopkins University. Data Data The National Survey used the quality quality Reproductive Age Mortality Survey Method (RAMOS). Another source of data for maternal mortality ratio is from the DHS 1997 that states maternal mortality ratio as 79 per 100,000. Both figures reflect low rates of maternal mortality ratio using the Indirect Sisterhood Method applicable to the period around 1985, however, the maternal mortality study is a more reliable method for calculating maternal mortality. Comments. Meaningful assessment of trends is not possible. However, it is safe to assume that the maternal mortality ratio has decreased between 1990 and 2000, given that the percentage of births attended by a trained birth attendant is estimated to have increased from 87.2% to 99%. Maternal mortality ratio in Jordan is among the lowest in the Middle East and the North Africa region. Goal 3: Between 1990 and the year 2000, the reduction of severe and moderate malnutrition among under-five children by half. Indicators 3.1

3.2

3.3

Underweight prevalence: Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations from median weight for age of NCHS/WHO reference population. Stunting prevalence: Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations from median height for age of NCHS/WHO reference population. Wasting prevalence: Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations from median weight for height of NCHS/WHO reference population.

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3.1 Underweight prevalence: Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations from median weight for age of NCHS/WHO reference population. Baseline data Most Recent data Value % Male Female Total Value Male Female Total 6.7, 1.0 6.2, 0.7 6.4, 0.9 4.6, (0.5) 5.5, (0.5) 5.1, (0.5) Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data Data are evaluated using the Data Data are evaluated using the quality NCHS/CDC international quality NCHS/CDC international reference population as per reference population as per WHO recommendation, 82% of WHO recommendation , 91% of the sampled children were eligible children were weighed. A successfully measured. small percentage of collected data was considered not usable, the reporting is based on data gathered on 89% of eligible children. Comments: There was a 1.3% point decrease in the underweight prevalence between the years 1990 and 1997. Between 1990 and 2000, the reduction in underweight prevalence is projected to be a decrease from 6.4 to 4.5, a 30% reduction. This is not a reduction by half as per the goal, however, given the low value for underweight children to start with, it is more difficult to reach the target of 3.2. There are no significant disparities between the nutritional status of boys and girls 3.2 Stunting prevalence: Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations from median height for age of NCHS/WHO reference population Baseline data Most Recent data Value Male Female Total Value Male Female Total 19.6, 5.7 18.9, 4.8 19.3, 5.3 8.1, 1.8 7.4,1.3 7.8, 1.6 Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data Data are evaluated using the Data Data are evaluated using the quality NCHS/CDC international quality NCHS/CDC international reference population as per reference population as per WHO recommendation, 82% of WHO recommendation , 91% the sampled children were of eligible children were successfully measured. weighed. A small percentage of collected data was considered not usable, the reporting is based on data

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gathered on 89% of eligible children. Comments: Between the years 1990 and 1997, there was a reduction of 11.5% points in stunting prevalence. Between 1990 and 2000 the reduction in stunting prevalence is projected to be a decrease from 19.3 to 2.8; an 85% reduction. This exceeds the goal of 50% reduction. However, this is not seen as very realistic. There are no significant disparities between the nutritional status of boys and girls. 3.3 Wasting prevalence: Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations from median weight for height of NCHS/WHO reference population. Baseline data Most Recent data Value Male Female Total Value Male Female Total 3.5, 0.7 2.2, 0.3 2.8, 0.5 1.7, 0.1 2.0, 0.3 1.9, 0.2 Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data Data are evaluated using the Data Data are evaluated using the quality NCHS/CDC international quality NCHS/CDC international reference population as per reference population as per WHO recommendation , 82% WHO recommendation, 91% of the sampled children were of eligible children were successfully measured. weighed. A small percentage of collected data was considered not usable, the reporting is based on data gathered on 89% of eligible children. Comments: Between the years 1990 and 1997, there was a reduction of 0.9% points in wasting prevalence. Between 1990 and 2000, the reduction in wasting prevalence is projected to be a decrease from 2.8% to 1.6%; a 43% decrease between 1990 and 2000. Goal 4: Universal access to safe drinking water Indicators 4.1

Use of safe drinking water: Proportion of population who use any of the following types of water supply for drinking: (1) piped water; (2) public tap; (3) borehole/pump; (4) well (protected/covered); (5) protected spring.

4.1

Use of safe drinking water: Proportion of population who use any of the following types of water supply for drinking: (1) piped water; (2) public tap; (3) borehole/pump; (4) well (protected/covered); (5) protected spring

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Baseline data Value Urban Rural Total 97.4 91.2 96.6 Year 1990 Source DHS 1990 Data Types of water supply included quality in the indicator are: piped water into residence and yard, public tap only. River, spring, dam, well, tanker truck are excluded.

Most Recent data Value Urban Rural Total 98.2 85.4 96.1 Year 1997 Source DHS 1997 Data Types of water supply included quality in the indicator are: piped water into residence and yard, public tap and well in residence only. River, spring, dam, public well, tanker truck are excluded. Comments: At the national level, the use of safe drinking water between 1990 and 2000 is estimated to have remained constant at 96%. Over the same period, the use of safe drinking water in rural areas is estimated to have decreased to 83%. This is an indication of the need to continue vigilant monitoring of the use of safe drinking water. Recent draught seasons and water shortages can seriously endanger the quantity and quality of safe water available to the Jordanian public. It is worth mentioning that the percentage of rural households using water tankers, which is excluded from the indicator, has increased between 1990 and 1997 from 2.9% to 10.6%. Goal 5: Universal access to sanitary means of excreta disposal Indicators 5.1

Use of sanitary means of excreta disposal: Proportion of population who have, within their dwelling or compound: (1) toilet connected to sewage system; (2) any other flush toilet (private or public); (3) improved pit latrine; (4) traditional pit latrine

5.1

Use of sanitary means of excreta disposal: Proportion of population who have, within their dwelling or compound: (1) toilet connected to sewage system; (2) any other flush toilet (private or public); (3) improved pit latrine; (4) traditional pit latrine. Baseline data Most Recent data Value Urban Rural Total Value Urban Rural Total 86 99.8 96.8 99.3 Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data Data Indicator is calculated for quality quality households connected to public sewage networks and

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holes. Comments: The percentage of households that use sanitary means of excreta disposal has risen significantly by 13.3% points between 1990 and 2000. Goal 6: Universal access to basic education, and achievement of primary education by at least 80 per cent of primary school children through formal schooling or non-formal education of comparable learning standard, with emphasis on reducing the current disparities between boys and girls Indicators 6.1 6.2 6.3

Children reaching grade five: Proportion of children entering first grade of primary school who eventually reach grade 5. Net primary school enrollment ratio: Proportion of children of primary school age enrolled in primary school. Net primary school attendance rate: Proportion of children of primary school age attending primary school.

6.1

Children reaching grade five: Proportion of children entering first grade of primary school who eventually reach grade 5 Baseline data Most Recent data Value Male Female Total Value Male Female Total 109.2 108.3 108.7 97.5 97.7 97.6 Year 1990 Year 1998 Source Jordan EFA report Source Jordan’s EFA report Data Data quality quality Comments 6.2

Net primary school enrollment ratio: Proportion of children of primary school age enrolled in primary school. Baseline data Most Recent data Value Male Female Total Value Male Female Total 87.9 85.8 86.87 95.1 94.2 94.7 Year 1990 Year 97/98 Source Jordan’s EFA report Source Jordan’s EFA report Data quality Comments 6.3

Net primary school attendance rate: Proportion of children of primary school age attending primary school 44

Baseline data Value Male Female Total 93.50 93.21 93.46 Year 1990 Source Jordan’s EFA report Data quality Comments

Most Recent data Value Male Female Total 97.25 96.99 97.12 Year 97/98 Source Jordan’s EFA report

Goal 7: Reduction of the adult illiteracy rate (the appropriate age group to be determined in each country) to at least half its 1990 levels, with emphasis on female literacy Indicators 7.1

Adult literacy rate: Proportion of population aged 15 years and older who are able, with understanding, to both read and write a short simple statement on their everyday life.

7.1

Adult literacy rate: Proportion of population aged 15 years and older who are able, with understanding, to both read and write a short simple statement on their everyday life. Baseline data Most Recent data Value Male Female Total Value Male Female Total 88.7 71.2 80.2 92.7 81.3 87.3 Year 1990 Year 1998 Source Jordan’s EFA report Source Jordan’s EFA report Data quality Comments: Adult literacy rates continue to increase with the rising levels of school enrollment. Figures are very comparable with those of the DHS 97 data which show that adult literacy rate has increased from 82% to 88.9% between 1990 and 1997 Goal 8: Provide improved protection of children in especially difficult circumstances and tackle the root causes leading to such situations Indicators 8.1

Total child disability rate: Proportion of children aged less than 15 years with some reported physical or mental disability.

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8.1

Proportion of children aged less than 15 years with some reported physical or mental disability. Baseline data Most Recent data Value Male Female Total Value Male Female Total Year Source

1990

Year Source

1997

Data quality Comments: Reliable data on the total child disability rate is lacking, a survey of 10% of Jordanian households which accompanied the 1994 census quotes the proportion of the population with disabilities to be 1.3%. Goal 9: Special attention to the health and nutrition of the female child and to pregnant and lactating women Indicators 9.1 9.2

9.3 9.4 9.5

Under-five mortality rate male/female: Probability of dying between birth and exactly five years of age, per 1000 live births - disaggregated by gender. Underweight prevalence male/female: Proportion of under-fives who fall below minus 2 standard deviations from median weight for age of NCHS/WHO reference population - disaggregated by gender. Antenatal care: Proportion of women aged 15-49 attended at least once during pregnancy by skilled health personnel. HIV prevalence: Proportion of population aged 15 - 49 who are HIV positive disaggregated by gender and age. Anemia: Proportion of women aged 15 - 49 years with hemoglobin levels below 12 grams/100ml blood for non-pregnant women, and below 11 grams/100ml blood for pregnant women.

9.1 Under-five mortality rate: Probability of dying between birth and exactly five years of age, per 1,000 live births Baseline data Most Recent data Value Male Female Total Value Male Female Total 39 33 30 31 Year 1990 Year 1999 Source DHS 1990 Sources DHS 1997, JAFS 1999 Data The DHS survey report Data The DHS 97 uses direct quality considers the quality of the data quality estimates and suggests that on children’s age at death to be U5MR is 34 per 1,000, the

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good. Except for some increase annual fertility survey use at 12 months and to a lesser indirect estimates which have degree at 3 months, the been adjusted and gives the distribution of children’s age at latest estimates shown above. death shows a smooth curve. Comments: The survival rate data from DHS 90, DHS97, and the annual fertility surveys of 1998, 1999 show that under-five mortality rates are declining at a slow pace. There have been six national surveys between 1990 and 1999 that have measured child mortality. The latest, the annual fertility survey for 1999, examines the six surveys and suggests that “Jordan’s infant mortality rate is probably in the 25 to 30 per 1,000 range in 1999.” So while the trend in infant mortality rates is on the decline, and as mentioned in the annual fertility survey for 1999: “Because infant and child mortalities are rare in Jordan, surveybased measurement systems are not well-suited to provide timely estimates of infant and child mortality for health and population programme monitoring and management." Survey results show that while there are no gender disparities in mortality rates, they exist between regions where they are higher in the south and in rural areas. 9.2

Underweight prevalence: Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations from median weight for age of NCHS/WHO reference population. Baseline data Most Recent data Value % Male Female Total Value Male Female Total 6.7, 1.0 6.2, 0.7 6.4, 0.9 4.6, (0.5) 5.5, (0.5) 5.1, (0.5) Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data Data are evaluated using the Data Data are evaluated using the quality NCHS/CDC international quality NCHS/CDC international reference population as per reference population as per WHO recommendation, 82% of WHO recommendation, 91% of the children sampled were eligible children was weighed. A successfully measured. small percentage of collected data was considered not usable; the reporting is based on data gathered on 89% of eligible children. Comments: There was a 1.3% point decrease in the underweight prevalence between the years 1990 and 1997. Between 1990 and 2000, the reduction in underweight prevalence is projected to be a decrease from 6.4 to 4.5, a 30% reduction. This is not a reduction by half as per the goal, however, given the low value for underweight children to start with, it is more difficult to reach the target of 3.2. There are no significant disparities between the nutritional status of boys and girls.

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9.3

Antenatal care: Proportion of women aged 15-49 attended at least once during pregnancy by skilled health personnel Baseline data Most Recent data Value 80 Value 95.7 Year Source Data quality

1990 DHS 1990 Antenatal care includes care provided by a doctor, trained nurse, or midwife. Traditional birth attendants are not included.

Year Source Data quality

1997 DHS 1997 Antenatal care includes care provided by a doctor, trained nurse, or midwife. Traditional birth attendants are not included. Comments: The percentage of women with at least one ante-natal care visit increased from 80 to 95.7% over the period 1990-1997. A 15.7% point increase. The percentage of women with at least one antenatal care visit is realistically estimated to be 96-97% based on the past projections. The percentage of women with at least four antenatal care visits has increased from 67% to 86% between 1990 and 1997. 9.4

HIV prevalence: Proportion of population aged 15 – 49 who are HIV positive - desegregated by gender and age. Baseline data Most Recent data Value Male Female Total Value Male Female Total 0.02 per 0.05 per 1,000 1,000 Year 1990 Year 2000 Source Reports of the national AIDS Source Reports of the national AIDS committee/Ministry of Health committee/ Ministry of Health Data Based on the estimate that 49% Data Based on the estimate that quality of the population is in the age quality 49% of the population is in the group 15-49. The number of age group 15-49. The number cumulative cases of HIV in of cumulative cases of HIV in 1990 was 36. 2000 was 118. Comments: Ministry of Health officials consider the reported HIV positive cases to be under- reported. The Ministry estimates the number of HIV positive cases in 2000 to be 600. Based on this estimate, HIV prevalence is estimated to be 0.25 per 1,000. 9.5

Anemia: Proportion of women aged 15 - 49 years with hemoglobin levels below 12 grams/100ml blood for non-pregnant women, and below 11 grams/100ml blood for pregnant women. Baseline data Most Recent data Value No data Value 28.6

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Year Source

1990

Year Source

1996 Prevalence and determinants of anemia and iron deficiency among Jordanian women 1549 years of age: A national study. Ministry of Health, UNICEF, May 1996. Data N/A Data National sample of 1540 quality quality women surveyed. Questionnaires were doublechecked in the field. Comments: Estimates of progress are not possible given that only one value or anemia is known. Goal 10: Access by all couples to information and services to prevent pregnancies that are too early, too closely spaced, too late or too many Indicators 10.1

10.2

Contraceptive prevalence: Proportion of women aged 15 - 49 who are using (or whose partner is using) a contraceptive method (either modern or traditional). Total fertility rate: Average number of live births per woman who has reached the end of her child-bearing years.

10.1

Contraceptive prevalence: Proportion of women aged 15 - 49 who are using (or whose partner is using) a contraceptive method (either modern or traditional). Baseline data Most Recent data Value Urban Rural Total Value Urban Rural Total 40 57 53 56.7 Year 1990 Year 1999 Source DHS 1990 Source JAFS 1999. Data Data is for currently married Data Data is for currently married quality women. Traditional methods quality women. Traditional methods include prolonged breastinclude prolonged breastfeeding. feeding. Comments: There was a 16.7% point increase in the proportion of women who are using a contraceptive method. 10.2

Total fertility rate: Average number of live births per woman who has reached the end of her child-bearing years

49

Baseline data Value 5.6

Most Recent data Value 3.8

Year 1990 Year 1999 Source DHS 1990 Source JAFS 1999. Data Data quality quality Comments: There is clear evidence that the total fertility rate has continued a steady accelerated decline from 1990 to 2000. As seen from the DHS90, and DHS97, and annual fertility surveys of 1998 and 1999, the TFR has declined from 5.6, 4.3, 3.9 to 3.8 respectively. Goal 11: Access by all pregnant women to pre-natal care, trained attendants during childbirth and referral facilities for high-risk pregnancies and obstetric emergencies Indicators 11.1

Antenatal care: Proportion of women aged 15-49 attended at least once during pregnancy by skilled health personnel. Child birth care: Proportion of births attended by skilled health personnel. Obstetric care: Number of facilities providing comprehensive essential obstetric care per 500,000 population. Obstetric care: Number of facilities providing basic essential obstetric care per 500,000 population.

11.2 11.3 11.4

11.1

Antenatal care: Proportion of women aged 15-49 attended at least once during pregnancy by skilled health personnel.

Baseline data Value Urban Year Source Data quality

Rural

Total 80

1990 DHS 1990 Antenatal care includes care provided by a doctor, trained nurse, or midwife. Traditional birth attendants are not included.

Most Recent data Value Urban Year Source Data quality

Rural

Total 95.7

1997 DHS 1997 Antenatal care includes care provided by a doctor, trained nurse, or midwife. Traditional birth attendants are not included. Comments: The percentage of women with at least one antenatal care visit increased from 80 to 95.7% over the period 1990-1997. A 15.7% point increase. The percentage of women with at least one antenatal care visit is realistically estimated to be 96-97% based on the past projections.

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11.2 Child birth care: Proportion of births attended by skilled health personnel. Baseline data Value 87.2

Most Recent data Value 96.7

Year Source Data quality

1990 Year 1997 DHS 1990 Source DHS 1997 Calculated as deliveries Data Calculated as deliveries attended by a doctor, trained quality attended by a doctor, trained nurse or midwife. Traditional nurse or midwife. Traditional birth attendants (attending 8.6% birth attendants are excluded. of deliveries)are excluded. Comments: Between 1990 and 1997, the percentage of deliveries attended by a skilled birth attendant increased by 9.5% points. An 11% increase over the two reference periods. Between 1990 and 2000, the percentage of births attended by a skilled birth attendant is estimated to increase from 87.2 to 99%. 11.3

Obstetric care: Number of facilities providing comprehensive essential obstetric care per 500,000 population. Baseline data Most Recent data Value 7.5 Value 8.5 Year Source Data quality

1990 Ministry of Health official records Based on the estimate that the population in 1990 was 3.6 million, served by 54 comprehensive obstetric care facilities.

Year Source Data quality

2000 Ministry of Health official records Based on the estimate that the population in 2000 is 4.9 million, served by 84 comprehensive obstetric care facilities.

Comments 11.4

Obstetric care: Number of facilities providing basic essential obstetric care per 500,000 population. Baseline data Most Recent data Value Value Year 1990 Year Source Source Data quality Comments: Almost all deliveries in Jordan are in hospitals, basic obstetric care is not provided in health facilities.

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Goal 12: Reduction of low birth weight (less than 2.5 kg) rate to less than 10 per cent Indicators 12.1

Birth weight below 2.5 Kg: Proportion of live births that weigh below 2500 grams

12.1Birth weight below 2.5 Kg: Proportion of live births that weigh below 2500 grams Baseline data Most Recent data Value Male Female Total Value Male Female Total 8.8 9.4 Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data Birth weight was successfully Data Birth weight was successfully quality obtained for more that 85% of quality obtained for 95% of the eligible babies. In order to babies. check for consistency, mothers were also asked about the size of their babies. According to the mothers 17% of the babies were smaller than the average size, this shows some degree of consistency. Comments: According to the 1996 Jordan living conditions survey, the percentage of low birth weight children was 11%, however the DHS survey data is considered more accurate. Goal 13: Reduction of iron deficiency anemia in women by one third of the 1990 levels Indicators 13.1

Anemia: Proportion of women aged 15 – 49 with hemoglobin levels below 12 grams/100ml blood for non-pregnant women, and below 11 grams/100ml blood for pregnant women.

13.1

Anemia: Proportion of women aged 15 - 49 years with hemoglobin levels below 12 grams/100ml blood for non-pregnant women, and below 11 grams/100ml blood for pregnant women Baseline data Most Recent data Value No data Value 28.6 Year Source

1990

Year Source

52

1996 Prevalence and determinants of

anemia and iron deficiency among Jordanian women 1549 years of age: A national study. Ministry of Health, UNICEF, May 1996. Data N/A Data National sample of 1540 quality quality women surveyed. Questionnaires were doublechecked in the field. Comments: Estimates of progress are not possible given that only one value or anemia is known.

Goal 14: Virtual elimination of iodine deficiency disorders Indicators 14.1 14.2 14.3

Iodized salt consumption: Proportion of households consuming adequately iodized salt. Low urinary iodine: Proportion of population (school age children or general population) with urinary iodine levels below 10 micrograms/100ml urine. Goiter in school children: Proportion of children aged 6 – 11 years with any size of goiter (palpable and visible combined).

14.1

Iodized salt consumption: Proportion of households consuming adequately iodized salt Baseline data Most Recent data Value Urban Rural Total Value Urban Rural Total 3 86% Year 1990 Year 2000 Source Estimate based on percentage of Source Prevalence of iodine deficiency households consuming imported among children aged 8-11, salt that was the only iodized salt Ministry of Health, UNICEF, available illegally on the market. 2000. Unpublished report. Data Very rough estimate. Not as a Data quality result of household or other quality surveys. Comments: The percentage has dramatically increased following the changes in the specification for salt iodization. In the DHS 1997, the percentage of households consuming iodized salt was found to be 95%, but this is based on investigating the container for the salt and checking to see if it is stated as containing iodized salt. It is not based on using the test kits. The figure 86% is considered more realistic.

53

14.2

Low urinary iodine: Proportion of population (school age children or general population) with urinary iodine levels below 10 micrograms/100ml urine. Baseline data Most Recent data Value Male Female Total Value Male Female Total No data 24.5% Year Year 2000 Source Source Prevalence of iodine deficiency among children aged 8-11, Ministry of Health, UNICEF, 2000. Data Data quality quality Comments: The national study on the prevalence of iodine deficiency among children aged 8-11 does not specify the proportion of population (school age children) with urinary iodine levels below 10 micrograms/100ml urine, hence a trend analysis is not possible. 14.3

Goiter in school children: Proportion of children aged 6 – 11 years with any size of goiter (palpable and visible combined). Baseline data Most Recent data Value Male Female Total Value Male Female Total 38 33.5 Year 1993 Year 2000 Source Prevalence of iodine deficiency Source Prevalence of iodine deficiency among children aged 8-11, among children aged 8-11, Ministry of Health, UNICEF, Ministry of Health, UNICEF, 1994. 2000. Unpublished report. Data The national study was Data quality conducted in 1993, sample size quality was 2,700 students aged 8-11 with a response rate of 91%. Comments: Since the introduction of mandatory salt iodization in 1995, there is evidence that the prevalence of goiter in the country is decreasing. Goiter has decreased from 38% to 33% between 1993 and 2000. This trend should be assessed with care given the expected variations in the determination of goiter size at the individual level. However given that the percentage of iodized salt has increased considerably, it is safe to assume that the prevalence of goiter is on the decrease. Goal 15: Virtual elimination of vitamin A deficiency and its consequences, including blindness

54

Indicators 15.1

Children receiving vitamin A supplements: Proportion of children 6 - 59 months of age who have received high doses of vitamin A supplements in the last 6 months.

15.2

Mothers receiving vitamin A supplements: Proportion of mothers who received a high dose of vitamin A supplements before their infants were 8 weeks old.

15.3

Low vitamin A: Proportion of children 6 - 59 months of age with serum retinol below 20 micrograms/100ml.

15.1

Children receiving vitamin A supplements: Proportion of children 6 – 59 months of age who have received high doses of vitamin A supplements in the last 6 months.

Baseline data Value Male Year Source Data quality

15.2

Female

Total

1990 No data N/A

Most Recent data Value Male Year Source Data quality

Female

Total

No data N/A

Mothers receiving vitamin A supplement: Proportion of mothers who received a high dose vitamin A supplement before infant was 8 weeks old

Baseline data Value Male

Female

Total N/A

Most Recent data Value Male

Female

Total N/A

Year Year Source Source Data quality Comments: There is no routine programme for mass supplementation of vitamin A to children, however, a study conducted in 1999 on school children aged 6-9 years in certain high risk areas showed significant vitamin A deficiency among those children. Accordingly a supplementation programme was implemented during the year 2000 which targeted around 10,000 students with 2 doses of vitamin A. The Jordanian Ministry of Health in cooperation with the Ministry of Education and other concerned parties will continue to monitor vitamin A deficiency status in the future. Please see 15.3 below

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15.3

Low vitamin A: Proportion of children 6 – 59 months of age with serum retinol below 20 micrograms/100ml

Baseline data Value Male Year Source

No Data

Female

Total

Most Recent data Value Male

Female

Total 4%

Year Source

1997 Assessment of vitamin A status among Jordanian children, Ministry of Health, UNICEF & WHO, 1997. Data Data Based on a sample of 400 quality quality children aged 6 to 71 months in three under-privileged areas. Two types of data were used; data on serum retinol values as a direct indicator and indirect indicators pertaining to nutrition, anthropometry, socio-economic data, vaccination, and illness-related indicators. Comments: Progress and trend analysis is not possible given the absence of baseline data. There is no routine programme for mass supplementation of vitamin A to children, however, a study conducted in 1999 on school children aged 6-9 years in certain high-risk areas showed significant vitamin A deficiency among those children. Accordingly a supplementation programme was implemented during the year 2000 which targeted around 10,000 students with 2 doses of vitamin A. The Jordanian Ministry of Health in cooperation with the Ministry of Education and other concerned parties will continue to monitor vitamin A deficiency status in the future. Goal 16: Empowerment of all women to breast-feed their children exclusively for four to six months and to continue breast-feeding, with complementary food, well into the second year Indicators 16.1 16.2 16.3

Exclusive breast-feeding rate: Proportion of infants less than 4 months (120 days) of age who are exclusively breast-fed. Timely complementary feeding rate: Proportion of infants 6 - 9 months (180 to 299 days) of age who are receiving breast milk and complementary food. Continued breast-feeding rate: Proportion of children 12 - 15 months of age who are breast-feeding.

56

16.4 16.5

Continued breast-feeding rate: Proportion of children 20 - 23 months of age who are breast-feeding. Number of baby-friendly facilities: Number of hospitals and maternity facilities which are designed as baby-friendly according to global BFHI criteria.

16.1

Exclusive breast-feeding rate: Proportion of infants less than 4 months (120 days) of age who are exclusively breast-fed Baseline data Most Recent data Value Male Female Total Value Male Female Total 24.8%* 15%* Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data The figure above is for children Data The figure above is for children quality aged 2-3 months. The quality aged –3 months. The percentage of children 0-1 percentage of exclusively exclusively breast-fed is 38.9%. breast-fed children < 2 months is 20% and the percentage of exclusively breast-fed children 2-3 months is 10.9%. Comments: Care should be made in comparing the above figures since they refer to different age groups, although breast-feeding has remained over 90% between 1990 and 1997, exclusive breast-feeding is not very common and has not been very successfully promoted in Jordan. 16.2

Timely complementary feeding rate: Proportion of infants 6 – 9 months (180 to 299 days) of age who are receiving breast milk and complementary food. Baseline data Most Recent data Value Male Female Total Value Male Female Total 59.4* 64.3* Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data The figure above is for children Data The figure above is for children quality aged 8-9 months. The quality aged 8-9 months. The percentage of children 6-7 percentage of children 6-7 months with timely months with timely complementary feeding is complementary feeding is 59.6%. 72%. Comments: Care should be made in comparing the above figures since they refer to different age group than those identified in the indicator 16.3

Continued breast-feeding rate: Proportion of children 12 - 15 months of age who are breast-feeding

57

Baseline data Value Male

Female

Total 30*

Most Recent data Value Male

Female

Total 34*

Year Source Data quality

1990 Year 1997 DHS 1990 Source DHS 1997 The figure above is for children The figure above is for children aged 14-15 months. The aged 14-15 months. The percentage of children 12-13 percentage of children 12-13 with continued breast-feeding with continued breast-feeding rate is 47.6%. rate is 48.8%. Comments: Care should be made in comparing the above figures since they refer to different age groups than those identified in the indicator 16.4

Continued breast-feeding rate: Proportion of children 20 - 23 months of age who are breast-feeding. Baseline data Most Recent data Value Male Female Total Value Male Female Total 8.9* 11.3* Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data The figure above is for children The figure above is for children quality aged 22-23 months. The aged 22-23 months. The percentage of children 20-21 percentage of children 20-21 with continued breast-feeding with continued breast-feeding rate is 14.6%. rate is 13.2%. Comments: Care should be made in comparing the above figures since they refer to different age groups than those identified in the indicator. 16.5

Number of baby friendly facilities: Number of hospitals and maternity facilities which are designed as baby-friendly according to global BFHI criteria. Baseline data Most Recent data Value 0 Value 3 Year Source

1990 Official Ministry records

of

Year Health Source

2000 Official Ministry of Health records

Data Data quality quality Comments: Progress in the implementation of this goal has been slow. Only 3 of the 17 government hospitals have been certified as baby-friendly and none of the private, teaching, or military hospitals have been certified as baby-friendly.

58

Goal 17: Growth promotion and its regular monitoring to be institutionalized in all countries by the end of the 1990s Indicators No indicators Goal 18: Dissemination of knowledge and supporting services to increase food production to ensure household food security Indicators No indicators Goal 19: Global eradication of poliomyelitis by the year 2000 Indicators 19.1

Polio cases: Annual number of cases of polio.

19.1 Polio cases: Annual number of cases of polio. Baseline data Most Recent data Value 0 Value 0 Year Source

1990 Ministry of Health routine reports and official records The quality of the Ministry of Health reporting system in 1990 was weak; hence it cannot be certain that this is a reflection of the true situation.

Year Source

2000 Ministry of Health routine reports and official records Data Data Since 1995, The Ministry of quality quality Health’s surveillance system has been considered to be mature and sensitive enough to reflect the actual situation. The Ministry of Health keeps vigilant surveillance of communicable diseases. The quality of the surveillance system is guaranteed by the adequate number of acute flacid paralysis cases reported. Comments: There was an outbreak of polio cases in 1992, which was controlled. The last confirmed wild polio case in the country was reported in 1993. Diligent monitoring systems are in place to ensure sustainability of progress and surveillance.

59

Goal 20: Elimination of neonatal tetanus by 1995 Indicators 20.1

Neonatal tetanus cases: Annual number of cases of neonatal tetanus – For reporting at the regional and global levels.

20.1 Neonatal tetanus cases: Annual number of cases of neonatal tetanus Baseline data Most Recent data Value Male Female Total Value Male Female Total 9 3 Year 1990 Year 1999 Source Ministry of Health routine Source Ministry of Health routine reports and official records reports and official records Data Data quality quality Comments: The incidence of neonatal tetanus is less than 1 per 1,000 live births in all the districts in the country. The goal is considered accomplished. Also over 97% of births are attended by a skilled birth attendant under clean conditions. Goal 21: A reduction of 95 per cent in measles deaths and reduction of 90 per cent of measles cases compared to pre-immunization levels by 1995, as a major step to the global eradication of measles in the long run Indicators 21.1 21.2

Under-five deaths from measles: Annual number of under-five deaths due to measles Measles cases: Annual number of cases of measles in children under five years of age

21.1

Under-five deaths from measles: Annual number of under-five deaths due to measles Baseline data Most Recent data Value Male Female Total Value Male Female Total 0 0 Year 1990 Year 2000 Source Ministry of Health records Source Ministry of Health records Data Data quality quality Comments: Reported mortalities related to measles are negligible.

60

21.2

Measles cases: Annual number of cases of measles in children under five years of age. Baseline data Most Recent data Value Male Female Total Value Male Female Total 56 48 104 19 18 37 Year 1990 Year 2000 Source Ministry of Health routine Source Ministry of Health routine reports and official records. reports and official records. Data Data quality quality Comments: Measles-related deaths are decreasing with the increase in immunization coverage. An increase in certain years is reported due to the nature of the disease. Goal 22: Maintenance of a high level of immunization coverage (at least 90 per cent of children under one year of age by the year 2000) against diphtheria, pertussis, tetanus, measles, poliomyelitis, tuberculosis and against tetanus for women of child-bearing age Indicators 22.1 22.2 22.3 22.4 22.5

DPT immunization coverage: Proportion of one-year-old children immunized against diphtheria, pertussis, and tetanus (DPT). Measles immunization coverage: Proportion of one-year-old children immunized against measles. Polio immunization coverage: Proportion of one-year-old children immunized against poliomyelitis. Tuberculosis immunization coverage: Proportion of one-year-old children immunized against tuberculosis. Children protected against neonatal tetanus: Proportion of one-year-old children protected against neonatal tetanus through immunization of their mother.

22.1

DPT immunization coverage: Proportion of one year old children immunized against diphtheria, pertussis and tetanus (DPT) Baseline data Most Recent data Value Male Female Total Value Male Female Total 92 96 Year 1990 Year 1999 Source Ministry of Health routine Source Ministry of Health routine reports and official records. reports and official records. Data Percentage of children aged 12- Data Percentage of children aged Quality 23 months who have received 3 Quality 12-23 months who have doses of DPT by 12 months of received 3 doses of DPT by

61

age. 12 months of age. Comments: Immunization coverage remains high for all diseases. Data is comparable with the DHS 1990 and 1997 which state the immunization figures as 92% and 93.5% respectively. 22.2

Measles immunization coverage: Proportion of one-year-old children immunized against measles. Baseline data Most Recent data Value Male Female Total Value Male Female Total 87 94 Year 1990 Year 1999 Source Ministry of Health routine Source Ministry of Health routine reports and official records reports and official records Data Percentage of children aged 12- Data Percentage of children aged quality 23 months who have measles quality 12-23 months who have vaccination by 12 months of received measles vaccination age. by 12 months of age. Comments: Immunization coverage remains high for all diseases. Data from the DHS 1990 and 1997 state the immunization figures as 74.7% and 82.9% respectively. 22.3

Polio immunization coverage: Proportion of one-year-old children immunized against poliomyelitis. Baseline data Most Recent data Value Male Female Total Value Male Female Total 92 97 Year 1990 Year 1999 Source Ministry of Health routine Source Ministry of Health routine reports and official records. reports and official records. Data Percentage of children aged 12- Data Percentage of children aged quality 23 months who have received 3 quality 12-23 months who have doses of polio by 12 months of received 3 doses of polio by age. 12 months of age. Comments: Immunization coverage remains high for all diseases. Data from the DHS 1990 and 1997 state the immunization figures to be 92.6% and 93% respectively. 22.4

Tuberculosis immunization coverage: Proportion of one-year-old children immunized against tuberculosis. Baseline data Most Recent data Value Male Female Total Value Male Female Total 15.8 23.3 Year 1990 Year 1997

62

Source Data quality

DHS 90 Source DHS 97 Percentage of children aged 12- Data Percentage of children aged 23 months who have received quality 12-23 months who have BCG vaccination by 12 months received BCG vaccination by of age either from the 12 months of age either from vaccination card or the mother’s the vaccination card or the report if there was no written mother’s report if there was no report. written report. Comments: BCG vaccination was administered upon school entry (6 years), hence the low vaccination rates, starting 2000, the national immunization programme schedule was changed and BCG is now administered at birth in line with WHO recommendations. This figure is expected to increase dramatically in the next few years. 22.5

Children protected against neonatal tetanus: Proportion of one-year-old children protected against neonatal tetanus through immunization of their mother. Baseline data Most Recent data Value Male Female Total Value Male Female Total 20 40 Year 1990 Year 1999 Source Ministry of Health routine Source Ministry of Health routine reports. reports. Data Data quality quality Comments: the incidence of neo natal tetanus is less than 1 per 1000 in all districts. The low immunization coverage is due to problems in the definition of the denominator. Ministry of Health officials consider the above figures as an underestimate since many women who completed their vaccination doses are not registered or reported since they are not eligible for further vaccination. The Ministry of Health estimates real coverage to be 80%. Goal 23: Reduction by 50 per cent in the deaths due to diarrhoea in children under the age of five years and 25 per cent reduction in the diarrhoea incidence rate Indicators 23.1 23.2 23.3

Under-five deaths from diarrhoea: Annual number of under-five deaths due to diarrhoea Diarrhoea cases: Average annual number of episodes of diarrhoea per child under five years of age. ORT use: Proportion of children 0 - 59 months of age who had diarrhoea in the last two weeks who were treated with oral hydration salts or an appropriate household solution (ORT).

63

23.4

Home management of diarrhoea: The proportion of children 0 - 59 months of age who had diarrhoea in the last two weeks and received increased fluids and continued feeding during the episode.

23.1

Under five deaths from diarrhoea: Annual number of under- five deaths due to diarrhoea. Baseline data Most Recent data Value Male Female Total Value Male Female Total 7 0 Year 1990 Year 2000 Source Ministry of Health routine Source Ministry of Health routine reports and official records reports and official records Data Data quality quality Comments: The Jordan EPI/CDD & child mortality survey states that diarrhoea-related mortality in 1990 was less that 1 per 1,000 (0.5). 23.2

Diarrhoea cases: Average annual number of episodes of diarrhoea per child under five years of age. Baseline data Most Recent data Value Male Female Total Value Male Female Total 1.2 Year 1990 Year Source Jordan EPI/CDD & child Source mortality survey Data Data quality quality Comments: No recent data is available hence a trend analysis is not possible. 23.3

ORT use: Proportion of children 0 - 59 months of age who had diarrhoea in the last two weeks who were treated with oral hydration salts or an appropriate household solution (ORT). Baseline data Most Recent data Value Male Female Total Value Male Female Total 77.6 deleted deleted 78 Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data ORT includes solutions Data The indicator is calculated as quality prepared from ORS packets quality the percentage of children aged and homemade solutions such as 0-59 who had diarrhoea in the sugar water, tea, and rice-water. 2 week period preceding the

64

DHS 90 shows that 64.4% had home solutions, 41.7% had ORS packet, the percentage who had neither was 22.4%, and the percentage receiving antibiotics was 30.2%.

survey who were treated with ORT.

Comments: 23.4

Home management of diarrhoea: The proportion of children 0 - 59 months of age who had diarrhoea in the last two weeks and received increased fluids and continued feeding during the episode. Baseline data Most Recent data Value Male Female Total Value Male Female Total 72 Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data The DHS 90 assessed the Data The indicator is calculated as quality feeding habits of children 0 –59 quality the percentage of children aged who are still breast-feeding and 0-59 months who had who had diarrhoea in the last diarrhoea in the last two weeks two weeks. Of these children and received increased fluids. only 4% had increased breastIt does not mention continued feeding, the survey did not cover feeding during the episode. other children who are not breast-feeding to assess if they had increased their fluid intake. Comments: Virtually all mothers know about oral hydration packets for the treatment of diarrhoea, 98% in 1990 and 1997. Trend analysis based on the above figures is not possible. Goal 24: Reduction by one third in the deaths due to acute respiratory infections in children under five years Indicators 24.1 24.2

Under-five deaths from acute respiratory infections: Annual number of underfive deaths due to acute respiratory infections. Care-seeking for acute respiratory infections: Proportion of children 0 - 59 months of age who had ARI in the last two weeks and were taken to an appropriate health provider.

65

24.1 Under-five deaths from acute respiratory infections: Annual number of underfive deaths due to acute respiratory infections. Baseline data Most Recent data Value Male Female Total Value Male Female Total No data No data Year 1990 Year Source Source Data quality Comments 24.2

Care-seeking for acute respiratory infections: Proportion of children 0 - 59 months of age who had ARI in the last two weeks and were taken to an appropriate health provider. Baseline data Most Recent data Value Male Female Total Value Male Female Total No data 77.9 74 76.3 Year 1990 Year 1997 Source Source DHS, Macro, published in 1999. Data Data The DHS 97 data state that quality quality 76.3% of children under five who had a cough accompanied by short rapid breathing during the last two weeks preceding the survey were taken to a health facility or provider. Comments: No baseline data, and no trend analysis possible Goal 25: Elimination of guinea-worm disease (dracunculiasis) by the year 2000 Indicators Non applicable in Jordan Goal 26: Expansion of early childhood development activities, including appropriate low-cost family and community-based interventions Indicators

66

26.1 26.2

Pre-school development: Proportion of children aged 36 - 59 months who are attending some form of organized early childhood education programme. Underweight prevalence: Proportion of under-fives who fall below minus 2 standard deviations from median weight for age of NCHS/WHO reference population.

26.1Preschool development: Proportion of children aged 36 – 59 months who are attending some form of organized early childhood education programme Baseline data Most Recent data Value Male Female Total Value Male Female Total 25.1 21.5 23.3 29.7 27.3 28.5 Year 1990 Year 1998 Source Jordan’s EFA report Source Jordan’s EFA report Data Defined in the EFA report as Defined in the EFA report as quality gross enrollment in early gross enrollment in early childhood development childhood development programmes. programmes. Comments 26.2Underweight prevalence: Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations from median weight for age of NCHS/WHO reference population. Baseline data Most Recent data Value % Male Female Total Value Male Female Total 6.7, 1.0 6.2, 0.7 6.4, 0.9 4.6, (0.5) 5.5, (0.5) 5.1, (0.5) Year 1990 Year 1997 Source DHS 1990 Source DHS 1997 Data Data are evaluated using the Data Data are evaluated using the quality NCHS/CDC international quality NCHS/CDC international reference population as per reference population as per WHO recommendation, 82% of WHO recommendation, 91% of the children sampled were eligible children were weighed. A successfully measured small percentage of collected data was considered not usable; the reporting is based on data gathered on 89% of eligible children.

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Comments: There was a 1.3% point decrease in the underweight prevalence between the years 1990 and 1997. Between 1990 and 2000, the reduction in underweight prevalence is projected to be a decrease from 6.4 to 4.5, a 30% reduction. This is not a reduction by half as per the goal, however, given the low value for underweight children to start with, it is more difficult to reach the target of 3.2. There are no significant disparities between the nutritional status of boys and girls.

Goal 27: Increased acquisition by individuals and families of the knowledge, skills and values required for better living, made available through all educational channels, including the mass media, other forms of modern and traditional communication and social action, with effectiveness measured in terms of behavioural change Indicators No indicators

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