The WHO
collaborative programme
HIV/AIDS AND SEXUALLY TRANSMITTED DISEASES
Situation analysis
The Jordanian National AIDS Program was established in January 1986, shortly after the first AIDS case was diagnosed. The National AIDS Programme is the responsibility of the General Directorate of Primary Health Care in Ministry of Health. At the higher level of the programmatic structure there is National AIDS Committee headed by the secretary general of the Ministry of health, and includes in its membership experts in different branches of health from all health sectors.. There is awareness among higher authorities in the country about the extent of the problem and NAP is recognized as an active department in the Ministry. Mobilization of local resources is still in the beginning, there is need for further work in this regard
Main activities of NAP such as surveillance, education and training are conducted through directorates and with involvement of other involved departments. The Manager heads the programme with physician as assistant who is responsible also for counseling centre and hotline. Two health workers are working in the programme.. National AIDS Committee guides the work of NAP. There is good collaboration with NGOs and private sector, mainly in field of training, education and policy making.
HIV/AIDS cases should be notified according to public health low. In addition to that, there are attempts to strengthen voluntary counseling and testing. Total number of All notified HIV/AIDS cases until the end of 2000 were 258 cases among which are 118 Jordanians. As of end of June 2001, the cumulative total number of all HIV /AIDS cases detected in Jordan is 268. Modes of transmission of reported cases show that 28.5% of all reported cases were due to blood and blood products and sexual contacts played a role in occurrence of more than 50% of all HIV/AIDS cases. Vertical transmission was a mode of transmission for 3 detected cases, which makes 1,4% of all HIV/AIDS cases. Total number of HIV/AIDS among foreigners in Jordan is 150 which makes nearly 56% of all detected HIV/AIDS cases.
Ministry of Health offers laboratory testing, kits for blood screening ( All donated blood units are screened for HIV in Jordan) and triple treatment for AIDS patients. This responsibility is adopted and financial allocations are renewed annually within the budget of the ministry. Screening is conducted in selected population groups such as foreigners who intend to stay in Jordan for more than one month, prisoners. Infection control procedures are followed in health settings. There is infection control national committee who issued infection control guidelines for health workers.
STD control is one of week points in programme activities. Although several activities have been conducted in this regard, such as training of health workers on syndromic approach and adoption of reporting of syndromic cases, we still need the collaboration of private sector to fully implement control strategies.
Main constraints
Major gaps in the programme include unknown extent of STD problem, no guidelines for the prevention and treatment of STDs, the absence of SCM, problems in STD treatment seeking behavior of patients, no home care and lack of psychological support for PLWA, no proper treatment of opportunistic infections, infection control procedures are not fully adhered to, hospital waste is not properly disposed of and difficulties in reaching high risk groups.
Objectives
- Revise the structure of NAC to include all sectors
- Assess STD burden in Jordan
- Establish national guidelines for the prevention and treatment of STDs; introduce SCM of STD in medical education curriculum
- Increase community awareness of the STD problem
- Introduce home based care for PLWA, including VCT and psychological support
- Insure the proper diagnoses and treatment of opportunistic infections
- Ensure diagnoses and management of pregnant women with HIV/AIDS to prevent MTCT
- Improve infection control procedures
- Strengthen regulations for hospital waste disposal
Priorities
- Assessing the STD problem;
- Developing guidelines for the prevention and management of STDs and improving treatment.
Performance indicators
- NAC is reconstructed
- Prevalence and incidence of STD are known
- Guidelines for the prevention and treatment of STD in place
- ARV drugs are available for all AIDS patients
- % Of PLWA are followed up and supported
- Number of physicians trained in the care for HIV/AIDS patients
- % Of pregnant women with HIV/AIDS are properly treated and managed
