Introduction:

Medical waste, or clinical waste, is generated in hospitals, clinics, and

pharmaceutical manufacturing as a result of the treatment and medicine that is being
generated from the healthcare sectors. This waste can have a severe effect on both the
environment and population health. It is therefore mandatory for healthcare sectors to
have an effective medical waste management plan to eliminate real health and
environmental hazards.

The health care system in Jordan consists of 3 main sectors: the governmental
Hospitals sector, Military Hospitals sector (Royal Medical services) and the private
sector. Both sectors include hospitals, primary care clinics, pharmacies, and other
ancillary services. There are a total of 116 private and public hospitals in Jordan,
providing 14,741 beds. The public sector accounts for the majority of these hospital beds
(66%), with the remainder being provided by private hospitals.

In addition, the population estimated of 10,309,000 inhabitants, however all of the public
and private hospitals in Jordan offering services to Jordanian and non-Jordanian patients.

Table (): Number of Population, Hospitals and beds in all over Jordan*

Item/Year 2018 2017 2016 2015 2014

Population 10,309,000.0 10,053,000.0 9,798,000.0 9,531,712.0 6,675,000.0
(Million) 0 0 0 0 0
Hospitals 116 116 110 104 104
Beds in all
hospitals 14,741.00 14,779.00 13,731.00 13,115.00 12,407.00
*Ministry of Health, 2018
 Beds in all hospitals
15,000.00

14,500.00

14,000.00

13,500.00

13,000.00
Beds in all
12,500.00 hospitals

12,000.00

11,500.00

11,000.00
2018 2017 2016 2015 2014

Number of total hospitals

118
116
114
112
110 Number of total
hospitals
108
106
104
102
100
98
2018 2017 2016 2015 2014

Fig. (): Number of total hospitals Fig. (): Total beds in all hospitals

Recently, the healthcare sector in Jordan has grown and evolved rapidly, as new public
and private hospitals have been built and established.
 2018
Health Sector Hospital Beds Health Sector Beds 2018 (%)
(no) (no) % Beds
Ministry of Ministry of Health
Health 32 5208 35.3
Royal Medical 34.4 Royal Medical
35.3
Services
Services 16 3316 22.5
Hospital of Hospital of
University of
University of Jordan
Jordan 1 599 4.1
Hospital of King Hospital of King
Abdullah
Abdullah 1 541 3.7 3.7
22.5
Private Sector 66 5077 34.4 4.1 Private Sector

Total 116 14741 100

Table (): The percentage distribution of beds in

Fig():The percentage distribution of beds in
different hospitals
different hospitals

As appeared above, the number of private hospitals is 66, while the government has 32
hospitals, 16 hospitals for the royal medical services and 2 university hospitals. These
hospitals offer various medical specialties to patients such as Cardiovascular related
diseases, Neurosurgery, Orthopedics, Pediatrics, Cancer Treatment, Infertility,
Ophthalmology, Beauty, Psychiatry, Addiction and other medical specialties.

Table (): The distribution of the Hospitals beds in different hospitals*

Items 2018 2017 2016 2015 2014

Hospitals in Kingdom(No.) 14,740.00 14,779.00 13,731.00 13,115.00 12,497.00
Beds in government
hospitals (No.) 5,208.00 5,170.00 5,177.00 5,077.00 4,783.00
Beds in Royal Medical
services (No) 3,316.00 3,476.00 2,917.00 2,551.00 2,269.00
Beds in University of Jordan
Hospital (No.) 599.00 599.00 599.00 599.00 577.00
Beds in King Abdullah
Hospitals (No.) 541.00 542.00 542.00 538.00 523.00

Beds in Private sectors (No.) 5,077.00 4,992.00 4,496.00 4,350.00 4,345.00

  Ministry of Health, 2018

Hospital beds include inpatient beds available in public, private, general, and specialized
hospitals and rehabilitation centers. In most cases beds for both acute and chronic care
are included. There is increase over the last five years in beds in different hospitals in
Jordan. In Jordan, the hospital bed rate of about 14 beds per 10000 people, Ministry of
Health 2018.

The most beds valid at the hospitals affiliated to the Ministry of Health, then the private
sector, followed by the Royal Medical Services, Hospital of the University of Jordan, and
finally Hospital of king Abdullah.

Primary health care clinics in Jordan provide quick access to medical care and offer
vaccination, maternity and child care, and chronic disease management services. They
operate in urban as well as rural areas and range in size from small individual clinics to
comprehensive multiline centers, depending on the area and population served.

Table (): Medical Health Centers for five years *

Items (No)/
Year 2018 2017 2016 2015 2014

Comprehensive
health centers 111 110 102 99 98

Primary health
centers 367 376 380 378 377

Sub-health
centers 181 187 194 198 202
Maternity and
childhood
centers 506 504 464 460 452
Chest Diseases
Center 12 12 12 12 12
 Dental clinics 420 419 405 402 397 Medical Health Centers, 2018

Comprehensive
111 health centers
Primary health
420 centers
Sub-health centers
367
Maternity and
childhood centers
Chest Diseases
12 Center
Dental clinics
181
506

Fig (): The distribution of Medical Health

Centers, 2018.

The health workforce in Jordan consists mainly of Doctors, pharmacists, dentists, and
nurses. Other health care providers include laboratory scientists, physiotherapists,
nutritionists, midwives, and medical radiation technicians. Nurses represent the majority
of health workers in Jordan (39%), followed by Doctors (30%), pharmacists (17 %), and
dentists (10%).

Table () : The distribution of the health workforce in Jordan

Ministry Hospital of
of Medical Hospital of University of Private Percentage
Sectors Health services King Abdullah Jordan UNRWA Sector Total (%)
Doctors 5838 2190 595 722 89 14322 23756 30
Dentist 743 411 0 111 29 6161 7456 10
Pharmacist 805 482 46 27 2 12192 13554 17
Nurse 10309 7591 887 772 220 10364 30093 39
Legal
midwifes 1612 410 23 18 34 1222 3319 4

Health workforce by sectors in Jordan, 2018

16000
14000
12000
10000
8000 Doctors
6000 Dentist
4000 Pharmacist
Nurse
2000
Legal midwifes
0
h s h n A r
ealt v ice u lla r da RW ecto
fH er d Jo UN
S
yo
ls Ab of te
r ica
ng is ty ir va
ist ed Ki r P
in M f
ive
M lo n
ita fU
sp la o
Ho it
osp
H

Fig () : The distribution of the health workforce in Jordan

The private sector is the main employer of health workers in Jordan. Public sector
pharmacists work in the Ministry of Health, university hospitals, Royal Medical Services.

Jordan can be divided into three main parts, the northern, middle (that includes Amman city)
and the southern part. These parts include 30 public hospitals and 1427 public medical centers
directed by MOH.
Table ():Geographical distribution for hospitals
Geographical distribution for hospitals
Items North Middle South Total (no)
Hospital
27.00 77.00 12.00 109.00 12.00
s (no)
Beds 2,500.0 10,773.0 1,506.0 14,779.0 27.00 North
(no) 0 0 0 0 Middle
South

77.00

Fig ():Geographical distribution for

hospitals

Jordan has a well-established local pharmaceutical manufacturing sector, which covers up to

25% of the country’s needs. The rest of the medications are imported through drug wholesalers
and importers.14 All medicines in the Jordanian market must be registered with the Jordan Food
and Drug Administration (JFDA). As an independent institution, the JFDA regulates drugs and
ensures their safety, quality, and affordability. All registered medications have a fixed national
retail price that is determined by the JFDA

According to 2013 figures, for every 10 000 Jordanians, there are 44.8 nurses and midwives,
28.6 physicians, 17.8 pharmacists, and 10.4 dentists.5,27 These per-population rates are
considered among the highest in the Middle East. However, there are major geographic
disparities in the distribution of health workers among the major cities and the rural
governorates in the Kingdom.5,27 In addition, the country recently received about 1.4 million
Syrian refugees, which has caused an unplanned increase in the population and is putting
pressure on the health sector and the number of health care providers available per 10 000
inhabitants.

Pharmaceutical Industry
The Jordanian pharmaceutical industry has grown remarkably over the past 4 decades.
Currently, there are 16 drug manufacturing companies in the Kingdom, after accounting
for mergers and restructuring during the past 2 years.14 Jordan joined the World Trade
Organization in 2000, which reduced export barriers and lowered industry tariffs.
About 80% of pharmaceutical production is exported to over 60 global markets, making
the pharmaceutical sector a key contributor to Jordan’s economy.14 Pharmacists in local
pharmaceutical companies work in research and development, quality control, regulatory
affairs, or sales and marketing. In addition, there are several offices for multinational
companies in Jordan, where pharmacists work in sales and marketing or medical
departments. Notably, sales and marketing jobs attract a high percentage of Jordan’s
pharmacy graduates because of the relatively high salaries and other benefits (e.g., car
allowance), which contrast with the limited opportunities and compensation available in
hospital and community pharmacies.