A. Introduction

Primary health care shifts the emphasis of health care to the people themselves and their needs, reinforcing and strengthening their own capacity to maintain health. The growth of these services has been driven by community members’ desire to receive a service that is accessible, at an appropriate cost, with a focus on health promotion and disease prevention and health education. Accordingly, primary health care needs to be delivered close to the people using health technologies that are accessible, acceptable, affordable and appropriate.^[1] Primary health care centers serve the health care needs of their community, and thus, are integral to the well-being of these communities.

B. Aim

The standards identify those aspects of program structure and operation that the HCAC regards as essential to program quality and achievement of primary health care goals. They specify the optimal requirements for programs to ensure quality services related to health promotion and disease prevention, family planning and reproductive health, client care and outcomes of care, client satisfaction, and client safety. It also serves as an education guide for facilities that wish to establish new programs or improve existing programs.

C. Framework and guiding principles of HCAC Hospital Standards

One of the goals of primary health care is the enhancement of reproductive health services. Based on the philosophy of the World Health Organization (WHO), reproductive health implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this philosophy is the right of men and women to be informed of and to have access to safe, effective, affordable and acceptable methods of fertility regulation of their choice. While overall health conditions in Jordan - low infant mortality rates and high life expectancy - are among the best in the region, the population growth rate continues to be a major development constraint - especially when analyzed in light of the quantity and quality of services to be provided to accommodate this rapid increase in population. In light of the importance of this issue, HCAC has group of standards related to family planning (FP) and reproductive health (RH) services as part of the care offered in the primary health care facilities.

The standards are written with a focus on the clients - not on a unit or the professional who provides health care services.

Client-centered care is based on several key principles:

Dignity and respect:
Incorporating the values, beliefs and cultural backgrounds of clients into the planning and delivery of care; resolving complaints and conflicts as soon as possible.

Information sharing:
Encouraging clients to share their perspectives & questions and healthcare professionals providing information regarding illness & treatment options in terms that the client can understand.

Participation:
Preparing and supporting clients and families to participate in care at the level they choose.

Continuity:
Providing care across the continuum; designing systems that promote seamless transitions between home, hospital, primary health care, and the community.

D. Eligible Institutions

All centers that offer primary health care services are eligible to apply for accreditation.

E. Organization of the standards Manual

The standards will provide facilities with a framework for addressing service delivery and coordination, planning, policy, management and the relationship with other service providers and the wider community. The standards introduce the most important elements of client safety to a facility and create the capacity for the primary care center to continually improve its quality of services to benefit clients.

This manual follows the structure of the primary care standards. They are divided into 12 clusters as follows:

Cluster 1: Governance and Leadership

Cluster 2: Clients’ rights

Cluster 3: Access and Continuity of Care

Cluster 4: Client Care

• Client Assessment
• General Care
• Local Anesthesia Care
• Dental and oral health care
• Non-communicable diseases
• Communicable diseases
• Emergency Care
• Reproductive Health
• Child Health
• Medication Management
• Laboratory services
• Radiology

Cluster 5: Medical Records

• Electronic Medical Records

Cluster 6: Human Resource Management

Cluster 7: Facility and Environment

Cluster 8: Infection Prevention and Control

Cluster 9: Quality Improvement and Client Safety

Cluster 10: Information Management

Cluster 11: Health Education

Cluster 12: Community Engagement

For each cluster, there is an intent statement that assists the staff to understand the standards and a list of the key documents that are required for review by the surveyors. In each cluster, every standard is listed followed by the measurable elements, and survey process. The survey process is identical to what the surveyors will look for to determine how to score the standard.

F. Classification of standards

Standards are classified as critical, core, and stretch. The guiding definitions are as follows:

Critical (34 Standards)
Critical standards are those standards that address laws and regulations or, if not met, may cause death or serious harm to clients, visitors, or staff.

Core (100 Standards)
Core standards are the standards addressing systems, processes, policies and procedures that are important for client care. However, partially met compliance with these standards must not pose a threat of harm or death for clients, visitors or staff.

Stretch (20Standards)
Stretch standards are standards that are important, but not easy to implement due to time or resource constraints, or a need for culture change.