Figures
Abstract
Background
Healthcare access disparities are a significant public health concern, particularly in low- and middle-income countries like Jordan. Despite advancements in healthcare infrastructure, barriers such as financial constraints, cultural norms, and logistical challenges persist, exacerbated by the influx of refugees. This study evaluates the influence of demographic, socioeconomic, and health-related factors on healthcare access and utilization in Jordan, aiming to identify specific barriers and disparities.
Methods
A nationwide survey was conducted in April 2024 using Facebook for recruitment, with 908 eligible participants aged 18–65 completing the survey. Data on healthcare access, barriers, and demographic variables were collected using a validated questionnaire. Statistical analyses included chi-squared tests and Kruskal-Wallis tests to assess differences in healthcare access across subgroups.
Results
Marital status significantly influenced healthcare access, with never-married individuals reporting better access to immediate and specialist care compared to married participants. Employment status revealed disparities, as students had better access to immediate and specialist care, while retired individuals had better access to routine check-ups. Self-reported health status was strongly associated with healthcare access, as individuals reporting excellent health experienced fewer delays and demonstrated higher trust in providers. Barriers to healthcare access included financial constraints, time limitations, and fear of diagnosis, while surgical access challenges centered on cost and waiting times.
Citation: Al-Ajlouni YA, Ayyad M, Tanashat M, Al Ta’ani O, AlMomani H, Nusier J, et al. (2026) Healthcare access and barriers in Jordan: Insights from a Nationwide Survey. PLoS One 21(3): e0345456. https://doi.org/10.1371/journal.pone.0345456
Editor: Ahmad H. Al-Nawafleh, Mutah University, JORDAN
Received: December 22, 2025; Accepted: March 5, 2026; Published: March 24, 2026
Copyright: © 2026 Al-Ajlouni et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The data underlying the results presented in this study are not publicly available due to ethical and confidentiality restrictions imposed by the University of Jordan Ethical Committee and the terms of participant consent. De-identified data may be made available to qualified researchers upon reasonable request to: University of Jordan Ethical Committee The University of Jordan Amman 11942 Jordan Telephone: +962 6 5355000 Website: https://ju.edu.jo This study was approved by the University of Jordan Ethical Committee (Decision No. 181/2024; March 18, 2024).
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
1. Introduction
Access to healthcare is a fundamental determinant of population health outcomes. Globally, significant disparities persist, with approximately half of the world’s population lacking access to essential health services [1]. This gap is particularly pronounced in low- and middle-income countries, where financial constraints, inadequate infrastructure, and workforce shortages impede healthcare delivery. In 2017, the World Health Organization (WHO) and the World Bank reported that about 100 million people are pushed into extreme poverty annually due to out-of-pocket health expenses [1].
In the Middle East and North Africa (MENA) region, barriers to healthcare access include economic, political, and social dimensions [2]. Political instability and conflict have disrupted healthcare systems, leading to shortages of medical supplies and personnel [3,4]. While contexts vary across the region, several settings illustrate how conflict and displacement have strained both refugee and host populations’ access to care. For instance, in the occupied Palestinian territories, restrictions on movement and systemic discrimination have significantly hindered access to healthcare services. A report by Médecins Sans Frontières highlighted that approximately 300,000 Palestinians in the West Bank face barriers to accessing healthcare, with more than half of the communities lacking adequate services [5]. Similarly, in Lebanon, the Syrian refugee crisis has placed enormous strain on an already fragile healthcare system, resulting in growing unmet health needs among both refugees and host communities [Makhoul et al., 2021; Ammar et al., 2016; Doocy et al., 2016]. These regional parallels highlight how large-scale displacement and limited resources compound access challenges in host countries, including Jordan. Further, economic challenges, such as high unemployment rates and poverty, further exacerbate these barriers, limiting individuals’ ability to afford care [6,7].
The Jordanian healthcare system comprises of public, private and donor-funded sectors which include Ministry of Health (MoH), Royal Medical Services (RMS), university hospitals and United Nations agencies [8]. Despite 70% of the population in Jordan being covered by some form of health insurance disparities in healthcare access remain [9]. Uninsured citizens, low-income workers, and refugees are particularly susceptible to this limited healthcare access. Cultural factors, such as gender norms and societal roles, also influence healthcare-seeking behaviors, potentially delaying timely access to care. Around 28% of total health spending was reported to be out-of-pocket expense which poses a significant financial burden on the population [9].
Furthermore, and as of 2024, approximately 650,000 Syrian refugees have sheltered in Jordan in addition to Palestinian, Iraqi, and other displaced groups [10]. This has substantially affected the healthcare system, increasing public service demand and straining limited resources in underserved areas [11]. This burden has led to overcrowding of healthcare facilities, longer waiting times, and unbalanced distribution of care.
This study aims to examine how demographic factors—including marital status, employment, and self-reported health status—are associated with perceived healthcare access and perceived barriers to medical care among adults in Jordan. By focusing on participants recruited through social media platforms, the study captures perspectives from a broad cross-section of Jordanian society. Understanding these perceptions is essential for developing targeted public health interventions that improve healthcare accessibility and equity. Identifying specific barriers reported by different demographic groups can help policymakers and healthcare providers implement culturally and contextually appropriate strategies to address these challenges and reduce health disparities.
2. Methodology
2.1. Data and study sample
Participants for this study were recruited using a nationwide survey targeting adults aged 18–65 residing in Jordan at the time of survey administration in April 2024. Facebook was selected as the recruitment platform because of its widespread use in Jordan, with approximately 65.94% of the population actively using the platform during March and April 2024. An advertisement targeting eligible adults aged 18–65 years residing in Jordan was disseminated during this period and managed by an independent researcher. To broaden reach and enhance participant recruitment, snowball sampling was employed by allowing respondents to share the survey link within their social networks. The survey was administered through Qualtrics, a platform for online survey administration previously utilized in health research [12], and was available in both Arabic and English to accommodate the linguistic diversity of participants. The questionnaire was originally developed in English using previously validated survey items. For this study, the survey was translated into Arabic using a forward–backward translation process. Initial translation from English to Arabic was conducted by bilingual members of the study team, followed by back-translation into English by an independent bilingual reviewer. The final Arabic version was reviewed by the study authors to ensure conceptual equivalence, clarity, and cultural appropriateness for the Jordanian context. No substantive modifications were made to the original survey items. Furthermore, and to prevent duplicate responses, IP address restrictions were implemented using the survey platform’s “prevent ballot box stuffing” feature. Additionally, all internal protocol addresses associated with responses were manually reviewed to identify and exclude potential duplicates.
2.2. Sample size and completion
A total of 4257 participants accessed the survey link, of which 2434 (57.2%) met eligibility criteria. Reasons for exclusion included being under 18 years of age or residing outside Jordan at the time of the survey. Of the eligible participants, 908 provided complete responses, corresponding to a completion rate of 37.3% among eligible participants and 21.3% of those who initially accessed the survey link.
No a priori formal sample size calculation was performed. Instead, the sample size was determined pragmatically, based on the predefined data collection period in April 2024 and the available resources for Facebook recruitment. All eligible respondents who completed the questionnaire within this period were included, resulting in a final analytic sample of 908 participants.
Although no a priori formal sample size calculation was performed, the achieved sample of 908 participants substantially exceeds the minimum sample sizes typically recommended for detecting small-to-medium effects in cross-sectional analyses, and is comparable to or larger than those used in similar nationwide or online surveys on healthcare access and health-related outcomes in Jordan [13–15].
2.3. Measures
2.3.1. Primary measures.
- Perceived Healthcare Access: Multiple items were used to evaluate urgent care, primary care, specialty care, and surgical services. Participants were asked to report appointment waiting times, ability to communicate with providers, and relational continuity of care. Example items include: “In the last 12 months, how often did you get an appointment for a check-up or routine care at a doctor’s office or clinic as soon as you needed. Responses were recorded using categorical scales, ranging from “Never” to “Always.”
- Perceived Barriers to Medical Care: Barriers were assessed using multiple-choice questions adapted from previously validated instruments (e.g., BRFSS and CAHPS item sets). Participants were asked to select reasons that prevented or delayed medical care from a predefined list (e.g., ‘Too busy to make time,’ ‘Worried about the cost,’ ‘Fear of diagnosis,’ etc.). These responses were used to assess self-reported barriers to accessing care. Perceived barriers to surgical care were similarly assessed through multiple-choice questions, where participants selected from reasons such as financial cost, prolonged waiting times, or lack of service availability
- Overall Views of the Healthcare System: Three items were used to evaluate participants’ confidence in the healthcare system’s quality, safety, and affordability. Example: “How confident are you that if you become seriously ill, you will be able to afford the care you need?” Responses ranged from “Very confident” to “Not at all confident.”
2.3.2. Additional measures.
- Sociodemographic: Participants provided information on age, gender (male or female), marital status, employment status (employed, self- employed, unemployed, student or retired), and region of residence within Jordan.
All survey items utilized in this research were adopted from previously validated items [16,17]. While these survey questions were originally developed for use in American populations, they were reviewed by thestudy authors to ensure clarity and contextual appropriateness for the Jordanian population.. No modifications were made to the original survey items. Full survey items relevant to the aims of this study are demonstrated in Appendix A.
2.4. Statistical analysis
Statistical analyses were conducted using PQStat Software v.1.8.2.238. The Shapiro-Wilk test was applied to evaluate the normality of the data. Normally distributed variables were summarized as mean ± standard deviation (SD), while non-normally distributed data were described using median and interquartile range (IQR). The Mann-Whitney U test and chi-squared (χ2) test were used to compare differences in healthcare access outcomes between male and female participants. To examine differences across employment statuses, the Kruskal-Wallis one-way analysis of variance was employed, followed by post-hoc analysis using Dunn’s Bonferroni correction. A p-value of <0.05 was considered statistically significant for all analyses.
2.5. Ethical approval
This study was approved by the University of Jordan Ethical Committee on March 18th, 2024 (Decision No. 181/2024). Participation was voluntary, and all responses were anonymized to ensure confidentiality. Electronic informed consent was obtained from all participants prior to participation. The first page of the Qualtrics survey presented an information sheet detailing the study purpose, procedures, risks, benefits, and confidentiality data. Participants were required to actively indicate their consent by selecting “I agree to participate” before accessing any survey questions; respondents who did not provide consent were automatically exited from the survey. Only adults aged 18–65 years were eligible to participate; no minors were included in this study.
3. Results
3.1. Demographic characteristics
We included 908 participants with an average age of 31.4 ± 13.79. The sex distribution shows that 55.6% of the participants are female and 44.4% are male. In terms of employment, most of the participants are students (49.8%), followed by employed individuals (31.6%), unemployed individuals (11.2%), and retired individuals (7.4%). As for marital status, most of the participants have never been married (62%), while 32.6% are married, and the rest are either separated (1.4%), widowed (2.3%), or divorced (1.7%). Approximately 50% of participants had very good health status as perceptually reported. The participants are from various cities, with the majority residing in Irbid (45.4%) and Balqa (38%). Table 1 summarizes the distribution of participants across cities in Jordan.
3.2. Sex
No significant differences were observed between males and females regarding any of health access dimensions (immediate care, routine check-ups, specialist appointments, communication with doctors and trust in healthcare providers) (Table 2).
3.3. Marital status
The results from Table 3 indicate significant differences in healthcare access based on marital status. For immediate care, there was a significant difference (χ² = 38.4, df = 20, p = 0.008), with never married individuals generally reporting higher access and less need for medical appointments compared to married individuals, as highlighted by the post-hoc analysis (p = 0.015). Moreover, significant differences were observed for specialist appointments (χ² = 41.1, df = 16, p = 0.001), with never married individuals again reporting higher access and less need for specialist appointments, supported by the post-hoc analysis (p = 0.0001). Communication with regular doctors differed across marital status groups (χ² = 15.0, df = 8, p = 0.059), with married individuals more likely to communicate effectively with their doctors (p = 0.028). No significant differences were found for routine check-ups, and trust in healthcare providers did not show significant differences.
3.4. Employment
Overall, students generally had higher access to immediate care and specialist appointments, while retired individuals had higher access to routine check-ups, and employed individuals reported better communication with their regular doctors (Table 4). For immediate care, there was a significant difference (χ² = 27.9, df = 15, p = 0.022), with students reporting higher access and not needing an appointment compared to retired individuals, as highlighted by the post-hoc analysis (p = 0.03). Significant differences were also observed for routine check-ups (χ² = 26.6, df = 12, p = 0.009), with retired individuals reporting higher access compared to students, as they reported higher number of appointments compared to students (p = 0.007). For specialist appointments there was a significant difference (χ² = 24.7, df = 12, p = 0.017). A higher proportion of students (22.8%) reported not needing an appointment compared to employed individuals (16.7%). However, when appointments were needed, students reported higher access compared to employed individuals (p = 0.035). Communication with regular doctors showed a significant difference (χ² = 16.9, df = 6, p = 0.010), with employed individuals having a higher proportion reporting being able to communicate effectively with their doctors compared to students (p = 0.006). No significant differences were found in trust in healthcare providers (χ² = 2.4, df = 6, p = 0.878).
3.5. Health status
Overall, individuals in better health statuses generally had higher access to immediate care, routine check-ups, specialist appointments, and a higher proportion reported effective communication and trust with their healthcare providers as compared to other groups. (Table 5). For immediate care, there was a significant difference (χ² = 82.8, df = 25, p < 0.0001), with individuals reporting “Excellent” health having the highest percentage of not needing an appointment (42.1%) and those in “Poor” health having the highest percentage of waiting more than 7 days (33.3%). Significant differences were also observed for routine check-ups (χ² = 62.6, df = 20, p < 0.0001), with individuals in “Excellent” health reporting the highest proportion of not needing an appointment (23.7%) and those in “Poor” health reporting not getting an appointment as soon as needed (33.3%). For specialist appointments, there was a significant difference (χ² = 52.8, df = 20, p < 0.0001), with 24.7% of individuals with “Excellent” health reported not requiring an appointment and 44.4% of individuals with “Poor” health reported to wait more than 7 days. Communication with regular doctors showed a significant difference (χ² = 27.7, df = 10, p = 0.002), with individuals in “Very Good” health had the highest proportion reporting effective communication with their doctors (57.2%) compared to those in “Fair” health (41.4%). Trust in healthcare providers also showed a significant difference (χ² = 19.6, df = 10, p = 0.003), with individuals in “Excellent” health having the highest proportion reporting trust in their health providers (66.3%) compared to those in “Fair” health (51.7%).
3.6. Barries to healthcare access and surgery
Regarding access to surgery, the most commonly reported response (48%) was that participants reported no reason for being unable to access surgical care. Other notable reasons include waiting too long for surgery (7%), being unable to leave the house due to health issues (6%), and the unavailability of services (5%). Personal or family responsibilities also impact 5% of the individuals. Concerning the barriers to healthcare access, the most common reason, affecting 25% of respondents, is being too busy to make time for a visit. Following this, 14% of individuals do not put off going to the doctor. Other notable reasons include having too many other things to worry about (10%), difficulty making an appointment (9%), and fear of what the doctor might find (8%). Financial constraints and embarrassment each affect 6% of respondents. Descriptive data for perceived barriers to healthcare access and surgical care were summarized using frequencies and percentages and presented graphically (Fig 1).
Bar charts display the frequency (n) and percentage (%) of participants reporting barriers to accessing surgery (top panel) and general healthcare services (bottom panel), including financial, logistical, and communication-related challenges.
4. Discussion
This study sought to investigate the association between demographic, socioeconomic, and health-related factors on healthcare access and utilization among Jordanian adults, aiming to identify specific barriers and disparities. Our study highlights significant disparities in healthcare access in Jordan, driven by demographic and socioeconomic factors. Notably, marital status influenced access, with never-married individuals reporting better access to immediate care and specialist appointments than married participants. Employment status also played a critical role, as students exhibited superior access to immediate and specialist care, while retired individuals had better access to routine check-ups. Self-reported health status emerged as a strong determinant, with individuals in better health experiencing fewer delays and reporting higher trust in healthcare providers compared to those in poor health. Additionally, barriers to surgery were primarily related to cost, waiting times, and health-related immobility, while general barriers to healthcare access included being too busy and fear of diagnosis.
Marital status significantly influenced access, with never-married individuals reporting better access to immediate and specialist care compared to their married counterparts. For instance, only 16.9% of married participants accessed immediate care when needed, compared to 29.8% of never-married individuals. This trend mirrors findings in the MENA region and developed countries, where social roles and family responsibilities often hinder healthcare-seeking behaviors among married individuals [18,19]. Additionally, a higher proportion of married participants reported being able to communicate with their primary physician compared to never-married participants. Interestingly, gender did not emerge as a significant determinant of healthcare access in our study. This contrasts with two review articles assessing gender variation in health utilization, which showed findings on gender disparities in both the Arab world and globally, where women often face barriers due to cultural preferences for same-gender providers and logistical challenges [19,20]. Conversely, our findings revealed equal proportions of men (25.3%) and women (28.1%) reporting same-day access to immediate care. This may reflect improvements in gender equity within Jordan’s healthcare system. For example, Jordan’s National Strategy for Women (2020–2025) focuses on health equity emphasizing women’s access to quality healthcare and gender-responsive planning [21]. These initiatives with increased healthcare literacy can contribute to better equitable healthcare across genders.
Employment status emerged as a significant factor influencing healthcare access. Students reported superior access to immediate and specialist care, with 33% not requiring an appointment for immediate care and 22.8% bypassing the need for specialist visits. In contrast, retired individuals had the highest access to routine check-ups, with 22.4% reporting timely appointments compared to 10.8% of employed individuals. These findings align with studies in the MENA region on barriers to early presentation to colorectal cancer for instance, where a cross-sectional study in Palestine showed that although employment could provide a financial buffer, it limits the time available for healthcare utilization which might affect the perception of individuals about access to healthcare for their medical concerns [22]. Moreover, the observed patterns suggest that younger populations are less reliant on structured healthcare services due to employment related factors including time restrictions and limited availability, while retired individuals prioritize routine and preventive care measures possibly due to more time availability. Policymakers should consider these trends to design flexible healthcare systems accommodating diverse employment statuses.
Moreover, participants’ self-reported health status significantly influenced healthcare access, mirroring global trends linking better overall health with improved utilization of healthcare services. Individuals in excellent health were significantly less likely to require immediate care, with 42.1% not needing appointments compared to only 22.2% in poor health. Similarly, 44.4% of participants reporting poor health waited more than seven days for a specialist appointment, showing the complexity and urgency of needs of the patient simultaneously highlighting the limited availability of services for specialized care in public healthcare. Similar findings have been reported in studies on publicly insured populations like those under Medicaid in the U.S., where structural inefficiencies lead to delay in access to care. While this study did not collect data on income, the comparison is made to represent the similarity in system-level limitations rather than income-related differences [23]. The significant association between health status and trust in providers, with 66.3% of individuals in excellent health trusting their providers compared to 51.7% in fair health, further indicates the reciprocal relationship between healthcare experiences and perceptions of quality [24,25].
Importantly, surgical access in Jordan presents a microcosm of broader healthcare challenges. While nearly half of respondents reported no barriers to surgery, financial constraints affected 10%, and 7% faced excessive waiting times. Health-related immobility and unavailable services were additional barriers. Compared to broader regional findings, these rates are relatively moderate, potentially reflecting Jordan’s public health investments [26]. However, the persistence of logistical and systemic issues highlights the need for capacity-building and infrastructure enhancements. General barriers to healthcare access included being too busy to make an appointment and fear of diagnosis, echoing cultural and psychological hurdles documented in the Arab Barometer survey [26,27]. These barriers were more pronounced among younger populations. Furthermore, Jordan’s healthcare access challenges mirror those documented in neighboring MENA countries, with urban-rural disparities, logistical barriers, and cultural influences playing central roles. For instance, several studies highlight the role of transportation costs and urban concentration of healthcare providers in limiting access [28,29]. Moreover, the persistent role of financial barriers in surgical access aligns with findings from Tunisia and Morocco, where out-of-pocket costs remain a major deterrent to healthcare utilization [19]. System-level barriers, such as waiting times and appointment availability, also parallel global trends in barriers to healthcare access [23,30,31]. For instance, Medicaid populations in the US face similar delays in accessing preventive care despite insurance coverage [23]. This indicates that financial interventions alone are insufficient and must be complemented by systemic reforms, including expanded provider capacity, reduced waiting times, and improved care coordination, which remain persistent barriers to healthcare access across both high- and middle-income countries. [32–34]. Thus, addressing these challenges in Jordan require a multifaceted approach combining financial support with systemic reforms to improve availability of serviced, responsiveness, and continuity of care.
4.1. Strengths and limitations
This study provides a comprehensive and localized exploration of healthcare access disparities in Jordan, highlighting how demographic and socioeconomic factors influence healthcare utilization. One of the strengths of this research is its ability to combine multiple determinants—such as marital status, employment, and self-reported health status—into a single analysis. This approach offers a holistic understanding of how various factors intersect to shape individuals’ experiences with healthcare services. Moreover, the comparative analysis with findings from other MENA countries and the U.S. helps contextualize the results within global healthcare access trends, further emphasizing the relevance of these issues in Jordan and the broader region. Another key strength is the policy relevance of the findings. By identifying specific barriers (e.g., cost, waiting times, and fear of diagnosis), the study provides actionable recommendations that align with current healthcare challenges in Jordan. The potential for future interventions, such as the integration of telemedicine and expansion of public-private partnerships, can guide policymakers in addressing gaps in healthcare access and improving service delivery for diverse populations.
Despite its strengths, this study has several limitations that should be considered when interpreting the findings. First, the cross-sectional design limits the ability to draw causal inferences, and the observed associations between demographic characteristics, self-reported health status, and healthcare access should be interpreted descriptively rather than causally. In addition, the analyses were primarily bivariate and did not account for potential confounding or interrelationships between factors such as age, marital status, employment status, and health status. Future studies incorporating multivariable models would help clarify the independent contribution of these factors.
Second, the study relied on self-reported data, which may be subject to recall bias and social desirability bias. Moreover, several key constructs, including trust in healthcare providers, fear of diagnosis, and perceived barriers to care, are inherently subjective and may not fully align with objectively measured system-level barriers. Although survey items were adapted from widely used and previously validated U.S.-based instruments and underwent forward–backward translation and expert review, no formal cultural or psychometric validation was conducted for the Jordanian context. This may affect the interpretation and cross-cultural comparability of subjective measures.
Third, the representativeness of the sample may be limited. Recruitment via social media, particularly Facebook, facilitated broad and rapid distribution but may have excluded individuals with limited internet access, lower digital literacy, or older age, introducing potential selection bias. Additionally, the sample was weighted toward women, students, and never-married individuals, potentially underrepresenting older adults, individuals from lower socioeconomic backgrounds, refugees, and those with chronic health conditions.
Finally, the questionnaire was not formally piloted prior to full deployment. Although all items were derived from previously validated instruments and reviewed for clarity and contextual relevance, the absence of pilot testing may have limited the identification of minor issues related to question interpretation or response burden.
Future research should aim for a larger, more diverse sample to better capture the full spectrum of healthcare access issues across Jordan. Finally, while the study explores several key factors influencing healthcare access, it does not fully delve into the cultural and psychological barriers that may affect healthcare-seeking behavior. Certain structural barriers like disability status, caregiving burden etc. have also not been accounted for which are highlighted in regional studies. Qualitative research focusing on individuals’ attitudes, beliefs, and experiences with the healthcare system could provide a deeper understanding of these barriers and further inform targeted interventions.
4.2. Future directions and policy implications
Addressing the barriers to healthcare access in Jordan requires a multifaceted approach that combines policy reform, community engagement, and technological utilization. Future efforts should prioritize the integration of digital health solutions such as telemedicine and mobile health platforms to improve accessibility and reduce logistical barriers, particularly for individuals in remote or underserved areas. Use of telemedicine and mobile health services showed promising improvement in healthcare accessibility in the MENA region especially during and after the COVID-19 pandemic providing substantial evidence for importance of integration of digital health tools [35,36].
Additionally, fostering public-private partnerships (PPPs) can help expand healthcare infrastructure and increase the availability of specialist services and reasonable appointment times, reducing the strain on public healthcare systems. Jordan has previously benefited from PPPs in health, profoundly in tertiary care expansion [37]. To better understand and address cultural and psychological barriers, qualitative research exploring patient attitudes and beliefs about healthcare, especially among underserved groups, is essential.
Policymakers should also consider implementing health equity monitoring frameworks to track progress and identify gaps in service delivery. Finally, education and training programs for healthcare providers should emphasize cultural competency and patient-centered care to build trust and improve communication, ultimately enhancing patient experiences and outcomes in Jordan [38].
5. Conclusion(s)
This study exemplifies the significant disparities in healthcare access in Jordan, highlighting the influence of demographic, socioeconomic, and health-related factors on individuals’ ability to access care. Key determinants, such as marital status, employment, and self-reported health status, reveal distinct patterns that suggest targeted interventions are needed to address these disparities. While barriers like cost, waiting times, and fear of diagnosis remain persistent challenges, the findings emphasize the potential for policy reform, the integration of digital health solutions, and enhanced public-private partnerships to improve access, especially for underserved populations. Ultimately, addressing these barriers will require a multifaceted approach that combines systemic improvements with cultural sensitivity and community engagement to ensure equitable healthcare access for all Jordanians.
Supporting information
S1 File. Survey questionnaire used in the study.
The questionnaire included items assessing self-reported health status, healthcare access (urgent care, primary care, specialty care, communication access, and relational continuity), barriers to medical care, perceptions and access to surgical care, and demographic characteristics of participants.
https://doi.org/10.1371/journal.pone.0345456.s001
(DOCX)
References
- 1.
WHO WB. Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses. 2017.
- 2. Katoue MG, Cerda AA, García LY, Jakovljevic M. Healthcare system development in the Middle East and North Africa region: Challenges, endeavors and prospective opportunities. Front Public Health. 2022;10:1045739. pmid:36620278
- 3. Badri R, Dawood I. The implications of the Sudan war on healthcare workers and facilities: a health system tragedy. Confl Health. 2024;18(1):22. pmid:38494471
- 4. Ahmed SK. Addressing the effects of war on Gaza’s healthcare system. Cureus. 2023;15(12):e50036.
- 5.
Frontieres MS. West Bank Palestine communities face healthcare access challenges. 2024.
- 6. Frazier TL, et al. Addressing financial barriers to health care among people who are low-income and insured in New York City, 2014-2017. J Community Health. 2023;48(2):353–66.
- 7. McMaughan DJ, Oloruntoba O, Smith ML. Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging. Front Public Health. 2020;8:231.
- 8. Tamimi A, Al-Abbadi M, Tamimi I, Juweid M, Ahmad M, Tamimi F. The transformation of Jordan’s healthcare system in an area of conflict. BMC Health Serv Res. 2024;24(1):1033. pmid:39243074
- 9.
Global Obesity Observatory. Jordan: Health systems summary. Global Obesity Observatory. 2023. https://data.worldobesity.org/country/jordan-109/health-systems.pdf
- 10.
Relief International. Overview: Jordan. https://www.ri.org/countries/jordan/
- 11. Fernandes P, Odusina EK, Ahinkorah BO, Kota K, Yaya S. Health insurance coverage and maternal healthcare services utilization in Jordan: evidence from the 2017-18 Jordan demographic and health survey. Arch Public Health. 2021;79(1):81. pmid:34011379
- 12.
Qualtrics L. Qualtrics. Utah, USA: Qualtrics. 2014.
- 13.
Cohen J. Statistical power analysis for the behavioral sciences. Routledge. 2013.
- 14. Alzougool B. Using social media applications for accessing health-related information: evidence from Jordan. Interdisciplinary Journal of Information, Knowledge & Management. 2024;19.
- 15. Abuhammad S, Alzoubi K, Khabour O, Mukattash T. Jordanian National Study of Nurses’ Barriers and Predictors for Research Utilization in Clinical Settings. Risk Manag Healthc Policy. 2020;13:2563–9. pmid:33209066
- 16. Weech-Maldonado R, Carle A, Weidmer B, Hurtado M, Ngo-Metzger Q, Hays RD. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) cultural competence (CC) item set. Med Care. 2012;50(9 Suppl 2):S22–31. pmid:22895226
- 17.
Health UD, Services H, Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta: Centers for Disease Control and Prevention (CDC). 2005.
- 18.
Eley NT, E N, McKenna K, Carrington Johnson A, Guest G. Beyond the individual: Social and cultural influences on the health-seeking behaviors of African American men. 2019.
- 19.
NM K. Access and barriers to health care delivery in Arab countries: a review. 2012.
- 20. Vlassoff C. Gender differences in determinants and consequences of health and illness. J Health Popul Nutr. 2007;25(1):47–61. pmid:17615903
- 21.
United Nations. General framework for gender equality in Jordan.
- 22. Elshami M, Ayyad M, Hamdan FK, Alser M, Al-Slaibi I, Naji SA, et al. Perceived barriers to early presentation and symptom-specific time to seek medical advice for possible colorectal cancer symptoms among Palestinians. Sci Rep. 2023;13(1):6871. pmid:37105988
- 23. Allen EM, Call KT, Beebe TJ, McAlpine DD, Johnson PJ. Barriers to Care and Health Care Utilization Among the Publicly Insured. Med Care. 2017;55(3):207–14. pmid:27579910
- 24. Birkhäuer J, Gaab J, Kossowsky J, Hasler S, Krummenacher P, Werner C, et al. Trust in the health care professional and health outcome: A meta-analysis. PLoS One. 2017;12(2):e0170988. pmid:28170443
- 25. Armstrong K, Rose A, Peters N, Long JA, McMurphy S, Shea JA. Distrust of the health care system and self-reported health in the United States. J Gen Intern Med. 2006;21(4):292–7. pmid:16686803
- 26.
Thomas K. Challenges of health care in the Middle East and North Africa. 2019.
- 27. Al-Jumaili AA, Ahmed KK, Koch D. Barriers to healthcare access for Arabic-speaking population in an English-speaking country. Pharm Pract (Granada). 2020;18(2):1809. pmid:32477432
- 28. Goddard M, Smith P. Equity of access to health care services: theory and evidence from the UK. Soc Sci Med. 2001;53(9):1149–62. pmid:11556606
- 29. Foster J, Dale J, Jessopp L. A qualitative study of older people’s views of out-of-hours services. Br J Gen Pract. 2001;51(470):719–23. pmid:11593832
- 30. El Bcheraoui C, Tuffaha M, Daoud F, Kravitz H, AlMazroa MA, Al Saeedi M, et al. Access and barriers to healthcare in the Kingdom of Saudi Arabia, 2013: findings from a national multistage survey. BMJ Open. 2015;5(6):e007801. pmid:26070798
- 31. Elreichouni A, Aly S, Maciejewski K, Salem I, Ghossein N, Mankash MS, et al. Health services access, utilization, and barriers for Arabic-speaking refugees resettled in Connecticut, USA. BMC Health Serv Res. 2022;22(1):1337. pmid:36369007
- 32.
World Health Organization. Tracking universal health coverage: 2021 global monitoring report. 2020. https://www.who.int/publications/i/item/9789240040618
- 33. Wu Y, Bardey D, Chen Y, Li S. Health care insurance policies When the provider and patient may collude. Health Econ. 2021;30(3):525–43. pmid:33332654
- 34. Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 2018;6(11):e1196–252. pmid:30196093
- 35.
World Health Organization. Global strategy on digital health 2020–5.
- 36. Obeidat AZ, El-Salem K. A national telemedicine program in the Kingdom of Jordan - Editorial. Ann Med Surg (Lond). 2021;62:145–9. pmid:33520212
- 37.
Hilber A, Baker HF, Srouji Y, Nolan C, Fouad FM. Midterm Performance Evaluation of the USAID/Jordan Health Service Delivery Activity. United States Agency for International Development (USAID).
- 38.
Betancourt R, Carrillo JE, A R G. Cultural competence in health care: Emerging frameworks and practical approaches. 2002.