USAID Health Finance and Governance Activity: Public Health Insurance and PHC: Community Awareness and Perceptions

The main purpose of this study was to support the development of communication messages that would enhance the services of primary healthcare centers and increase community awareness regarding public providers of health insurance. Fifty Jordanian individuals participated in the focus group discussions, which explored six overarching areas of interest, including the importance of health insurance subscriptions, coverage, and services, satisfaction, information resources about public health insurance, perception of royal court exemptions, and primary healthcare. The results showed a substantial knowledge gap around the different types of civil health insurance, enrollment, insurance coverage, benefits, and administrative procedures. Participants also lacked awareness about their insurance rights and packages. The focus group discussions revealed several key findings. Participants perceived primary healthcare services as being linked to non-emergency cases and complained about the manners and communication skills of primary healthcare providers and hospital staff. Nepotism and favoritism at primary healthcare centers were also major concerns. Young men perceived that they were disadvantaged when it came to insurance, as they were often thrown out of their parents' insurance at 18 or 25 if they were university students. Women in general confused maternal child health free services with pregnancy insurance. Participants emphasized the need for community participation in the process of amending health insurance regulations, which should be participatory and transparent. They suggested using websites and social media for feedback and ensuring that primary healthcare centers provide transparent information and standardize services to eliminate negative perceptions of nepotism and corruption. Participants also recommended that primary healthcare staff be trained on customer service and a helping attitude. The focus group discussions highlighted several contentious issues that require immediate attention, including cancer treatment, insurance for those over 60, insurance for children under 6, voluntary insurance, and pregnancy insurance. Almost all participants were aware of the details for accessing royal court exemptions but perceived it as being "for granted" or "given," where wasta could only speed up the process. The USAID Health Finance and Governance Activity will collaborate with the Ministry of Health to use these findings to improve primary healthcare services and awareness on civil insurance entitlements through social media platforms and the development of information, education, and communication materials. The Activity aims to support Jordan's commitment to universal health coverage and improve health sector sustainability and resilience in the country.