Mother and Child Health Care (Al-Suhat Wal-Hayat Magazine)

Al-Suhat Wal'Hayat Interview, 1995.

Q1: What are the NHF projects in the realm of child health care, what is its philosophy on health issues and its future plans?

The NHF has three projects that are active in the field of child health care; the Institute for Child Health and Development, which is directly involved in child health care and two other projects that are indirectly involved: the Quality of Life Project and the Population Program for the Grassroots.

The Institute for Child Health and Development was founded in 1986 with the support of the Swedish "Save the Children" to raise child health care standards in Jordan by improving growth monitoring, diagnosis and treatment practices. It is the first and only facility to monitor and assess child growth and development. It conducts primary field research among children, and provides information to parents and teachers to increase awareness of early signs of childhood diseases and disabilities.

The Institute includes a model Mother and Child Health (MCH) Clinic and also has a Child Development Unit, which provides development assessment and supervision of minor and moderate disabilities through play therapy, and designs programs to improve the monitoring of physical health, psychological and social needs of children under the age of six. It has an aggressive outreach program that provides follow-up care and education for new mothers and the entire family on hygiene, nutrition, family planning and proper methods of breast feeding.

The Institute's main objectives are to introduce the concept of comprehensive child care to health professionals in the MCH services, to train child development specialists particularly in early detection and management of disabilities and to study and research the health issues of Jordanian mothers and children. Its emphasis on prevention and early detection differentiates the Institute from other MCH centers.

Harvard University's Institute for Social and Economics Policy in the Middle East cited the Institute as a model for its comprehensive approach and described its "psycho-social" services as the best of any country in the region.

The Quality of Life Project was initiated in cooperation with the World Health Organization and the Ministry of Health. Its holistic development approach caters to the economic, social and cultural needs by integrating income-generating schemes, health, education, national heritage, the environment and community participation in the program. The health component focuses on pre- and post-natal care, family planning and health education. The Noor Al Hussein Foundation has developed this project as a national model for socio-economic development in Jordan.

We are heartened that both the Institute and the Quality of Life Project have been recognized by international and United Nations organisation such as the World Health Organisation (WHO), the United Nations Population Fund (UNFPA) and the United Nations Development Fund for Women (UNIFEM) as model projects for the Middle East and the developing world. Furthermore, WHO is also planning to establish a regional center in Jordan based on the methodology of the Quality of Life Project.

The Population Program for the Grassroots is a three year program established in 1994 in cooperation with the government of Jordan and UNFPA. It aims at addressing Jordan's present rate of annual population growth by promoting awareness about population issues. The project aims at improving the well-being of the family by introducing mother and child health care clinics and birth-spacing in thirteen remote villages throughout Jordan, which are served by the Institute for Child Health and Development and the Quality of Life Project.

The NHF philosophy on health issues:

All our projects at NHF are based on a comprehensive approach that incorporates health education and medical services with integrated socio-economic development. We stress the importance of primary health care, empowering the communities to meet their own health needs and providing educational and training centers that support the national effort to raise the standard of health care in Jordan.

The NHF's future plans for child health care:

We at the NHF hope that the Institute for Child Health and Development will evolve into a regional training and consultative center and will be affiliated with the National Children's Hospital, which is a long cherished dreams for the people of Jordan. Upon construction, we hope that the hospital will be the first in the Kingdom to meet tertiary, secondary and some local primary health care needs of children in the 0-16 years age group; it will be accessible to all economic strata of Jordan's population. The hospital will not only be a center for pediatric medical services, but also a site for graduate medical education for pediatric, surgical, dental and allied scientific disciplines. It will also include a center for the assessment of child development, the treatment of cerebral palsy and will perform a comprehensive program of family guidance.

Q2: How does Your Majesty evaluate the standard of medical services offered by the public and private sector since Jordan has now become a regional medical center?

The standard of public and private health care services in Jordan is very high due to our many qualified specialists and diverse medical services. To maintain and raise this standard, Jordan must continue its measures to increase the number of public MCH centers and improve the performance and services of existing centers. Although the percentage of women who give birth under medical supervision is relatively high for the region and our child birth mortality rate is comparatively low, Jordan must strive to provide women with health services at all stages of their lives because women's health affects that of the family as a whole.

Another important health issue is breast cancer, which is the highest incidence of cancer among Jordanian women. I have routine mammograms and regular self-examinations and strongly urge all women to do the same. Jordanian doctors also advise that women undergo yearly Pap smear screening tests for the early detection of cervical cancer.

We also need to increase the availability of the essential services provided by public and private health centers to enable mothers to opt for spaced pregnancies. We should promote the formulation of multidisciplinary teams, which would include doctors, nurses, psychologists, social workers, physiotherapists and occupational therapists. As the Honorary President of the Jordan Physiotherapy Association, I am very concerned by the absence of physiotherapy training in Jordan and find it essential to establish rehabilitative departments in public and private universities, which would teach physiotherapy as well as occupational and speech therapy and would award the graduates university degrees rather than diplomas.

We also need to establish research and assessment centers for the early detection and treatment of childhood disabilities and to increase the rehabilitative centers for the disabled in Jordan, which currently only satisfy 2% of their needs. Due to our region's young population and high rates of fertility and population growth, it is likely that today's 13 to 15 million disabled Arab nationals may reach 20 million by the year 2000. I do not wish to pain a totally bleak picture of our region, which can boast several notable achievements such as steadily rising infant and child immunization rates, resulting in corresponding decline in infant-related disabilities, a sharp increase in social action by private and non-governmental groups, the impact of education on traditional attitudes to inter-marriage and dealing with disabled family members and finally greater sensitivity to the special needs of the disabled in day-to-day life. Full integration of the disabled should go beyond traditional efforts to help them adapt to their environment through training and rehabilitation. As a society, we must adapt the physical and social environment to the needs of the disabled, particularly in planing projects undertaken by the public sector. This would allow them to enjoy greater independence and self-reliance, which are an essential first step towards their full integration in society.

Q3: What are the most prominent issues related to science, health and child welfare that concern Your Majesty?

I encourage all mothers to breast feed their babies as I breastfed my children as long as possible; the World Health Organisation (WHO) now believes that over 1 million children could be saved if all babies were exclusively breastfed the first six months. I hope that all hospitals in our country will follow the lead of two of our major public hospitals in adopting UNICEF's "Baby Friendly Hospital Initiative" by rooming a mother with her newborn child, promoting breast feeding and discouraging breast milk substitutes. In addition to breast feeding my children, I also made sure that they regularly received their immunization shots and it is a source of pride for me and for the country that Jordan's child immunization rates against polio and measles are comparable to that of developed nations.

Physical affection during the early years for a child, which comprise one of the most critical stages in his / her development, is very important. I was struck by a study, which found that children who are constantly hugged by their parents grow taller than children whose parents did not demonstrate their affection physically.

In addition to child health, educating children and making them aware of and active in global issues is vital. I have encouraged our children to become involved in environmental programs from a very early age and am delighted that they accompany me on my tree planting campaigns and are becoming quite active in pollution and garbage control. School curricula should emphasize environmental issues and encourage their students to join community service programs. The Jubilee School, one of the Noor Al Hussein Foundation projects, emphasizes a diverse community service program and its students regularly take part in environmental clean up endeavors.

Another project affiliated with the Noor Al Hussein Foundation project is Jordan's first Children's Science Museum, which helps children understand the scientific and ecological cycles of life. The children can touch and manipulate the museum's exhibits to learn about the development of humankind through the ages, natural history, geography, science, the environment, outer space and the diverse cultures of the world. We also obtained a mobile science museum for children living in rural areas; housed in a large truck, the museum's exhibits focus on health and hygiene, the sciences, environmental protection and the history of Jordan.

Q4: How does Your Majesty evaluate the role of international organizations working in the field of mother and child welfare to combat the various disabilities and diseases afflicting children?

International organizations such as WHO and UNICEF have made great strides in mother and child health care by introducing various programs such as the baby-friendly hospitals, urging international vaccination programs, providing information on how to combat malnutrition and deficiency diseases and putting forth low-cost measures to combat childhood diseases such as breastfeeding, iodizing salt and ORT (oral rehydration therapy, which could prevent half the diarrheal death of children).

WHO and UNICEF in particular have supported our national efforts to combat the causes of childhood disabilities by focusing on disease prevention through immunization and early detection and treatment of disabilities. However, I must emphasize that international agencies function through our national programs -- the more we are active, the more benefit we will get from them.

Q5: How can we improve the role of national and international organizations working in the field of mother and child health care?

On the international level, countries should cooperate fully with international health organizations by assisting them in compiling accurate information, which would indicate the countries' strengths and weaknesses in mother and child health care (there are many areas such as the abuse of women and children which are not well-documented). This would enable international organizations to offer policies that suit the country's needs and are sensitive to the cultures and traditions of the country (especially in areas like birth-spacing). Countries should also ratify and implement the UN conventions on the rights of the child and the upcoming 4th World Conference for Women.

On the national level, we must enhance the role of women in the field of health and focus on women both as dispensers and beneficiaries of health services. This involves making academic and training positions available thus enabling women to occupy leading positions in the field of health. We should raise public awareness about the importance of primary health care especially of mother and child health care services by educating women on pertinent health issues, developing health education programs and encouraging the mass media to play an active part in the field of health education and awareness. It is imperative that we motivate, support and upgrade the level of professionals working a mother and child health care centers by promoting the practice of multidisciplinary teams and encouraging community involvement in the work of these centers.

Q6: Would Your Majesty say a few words to the readers of our magazine in Jordan and in neighboring Arab countries and especially to those working in the field of health?

Every member of society can and should contribute to the well-being of his / her community in a variety of ways that include volunteering at various health centers, which are usually understaffed and overwhelmed, becoming "health activists" by raising public awareness on pertinent health issues, adopting and promoting a healthy life-style.

I hope that, as a country, we will work hard to maintain and improve the standard of health care in Jordan by focusing on a comprehensive health approach through the promotion of multidisciplinary medical teams, becoming more active in the field of research and subsequently developing national programs that will tackle health issues of importance to our communities.