Jordan Surveillance Project Evaluation Final Report
20 May 2004 
By: Andrew L. Dannenberg, MD, MPH
National Center for Environmental Health
Centers for Disease Control and Prevention
4770 Buford Highway, Mailstop F-30, Atlanta GA 30341, USA
Email acd7@cdc.gov
Kathy A. Douglas, PhD (on assignment from CDC)
 Noncommunicable Diseases and Mental Health Cluster
World Health Organization
20, Avenue Appia, CH-1211 Geneva 27, Switzerland
Email douglask@who.int
Executive Summary
The Jordan Surveillance Project (JSP) is an integrated set of public health initiatives run 
by the Jordan Ministry of Health with technical assistance from the US Centers for 
Disease Control and Prevention (CDC) in collaboration with the US Agency for 
International Development (USAID). The project includes training in applied 
epidemiologic methods for Ministry of Health physicians, health directorate managers, 
health statisticians and others, enhancement of Jordan’s infectious and noncommunicable 
disease and mortality reporting surveillance systems, development of a hospital discharge 
data surveillance system, and development of a behavioral risk factor surveillance system 
to guide interventions to prevent noncommunicable disease. JSP began in 1997 and is 
currently completing Phase II of funding. In preparation for planning Phase III of 
funding for 2004-2009, USAID requested an independent evaluation of the 
accomplishments of JSP and recommendations for improvements for the next phase. 
The evaluation team consisted of two senior staff from CDC, with special expertise in 
public health training programs and in noncommunicable disease surveillance, who 
visited Jordan from May 9 to May 15, 2004. Their evaluation included interviews with 
approximate 40 persons including current and past participants and teachers of the Field 
Epidemiology Training Program and Data for Decision Making training program, 
national and local infectious disease and noncommunicable disease surveillance directors 
and their staff, and other senior staff within the Ministry of Health. Preliminary results 
were presented to the Minister of Health and to the Chief of the USAID Mission during 
the team visit.
Overall, the evaluation team found that the Jordan Surveillance Project has made 
excellent progress in achieving all of the stated objectives of the project, and strongly 
recommends that the next phase of the project be supported. Specific recommendations 
for improvements for the next phase of the project are presented in detail within this 
report and are summarized below.
2
1. For infectious disease surveillance:
· As planned, continue making improvements in the completeness, timeliness and 
accuracy of the data collected.
· Negotiate arrangements for MOH, universities, and other partners to analyze and 
publish collaboratively the surveillance data collected by MOH. Such 
cooperation would increase visibility of the surveillance systems as well as 
increase the actual use of the collected data.
2. For noncommunicable disease surveillance and interventions:
· Give more priority to this area to reflect the fact that most of the leading causes of 
morbidity and mortality in Jordan are noncommunicable diseases.
· Focus on systems development, and explore opportunities for harmonization/ 
synthesis to prevent vertical surveillance streams for each disease (note: one 
system to cover everything is not feasible). Focusing on systems development 
will help to integrate emerging and priority issues as they arise (e.g. HIV).
3. Increase JSP staff to adequately support the expanding project and enhance mentoring 
support for the participants—the heavy workload of existing staff could compromise 
JSP over the long-term.
4. Consider renaming JSP to reflect its diverse integrated components, including 
training, surveillance, and interventions, that are helping to strengthen the public 
health infrastructure in Jordan. Combinations of the words Jordan, Epidemiology, 
Training, Surveillance, Interventions, and Project could yield acronyms such as 
JSTEP, JESTIP, JESIT, JETSP, JETSIP, and others.
5. Provide more opportunities for FETP/DDM participant and partner networking and 
follow-up: 
· Hold a 2-day annual meeting of FETP/DDM graduates and current attendees to 
provide updates on new topic areas, deliver presentations on current projects, 
share experiences to help analyze problems, and network with each other. 
· Consider inviting partners (e.g. NGOs, universities) to the annual meeting to 
showcase accomplishments and facilitate potential collaboration.
· Provide periodic refresher training to improve skills in upgraded and new 
technology and in emerging topic areas, such as micronutrients, monitoring health 
impacts, advocating information to policy makers, developing sustainable
programs, etc., and specific skill-building topics. 
6. Identify staff to serve as managing editor for the proposed periodic (weekly, monthly, 
or quarterly) surveillance bulletin to help facilitate the sharing of experiences and 
dissemination of information on a regular basis.
7. Support 2-3 small grants for outstanding projects by FETP/DDM participants to 
facilitate turning good ideas into concrete action. 
8. Continue providing opportunities for participants to attend and present at regional and 
international conferences and meetings.
3
9. Consider holding governorate meetings in each region to showcase the work and 
increase the visibility of tools/research implemented through JSP with other 
physicians and hospital staff in the governorates. 
10. Explore links with JUST or Jordan University to enhance FETP so that participants 
may receive a masters degree and/or board level certification, as well as the applied 
epidemiology training.
11. Establish a unit within MOH focused on injury surveillance and prevention to reflect 
the importance of injury as one of the leading causes of morbidity and mortality in 
Jordan. 
12. Strengthen links to Egypt, Saudi Arabia and other countries in the region to provide 
regional support and leadership, and contribute to strengthening capacity overall in 
the region.
13. Consider developing a plan to upgrade computer hardware and software periodically 
for FETP and DDM participants and graduates and to provide increasing technical 
support to maintain the equipment. This will facilitate capacity to perform electronic 
transmission of reports and data across the governorates and to the MOH.
14. Develop a transition strategy for the MOH to assume increasing responsibility for the 
project over the long term. Develop memorandums of understanding to clarify roles 
and responsibilities across partner agencies, such as MOH, CDC, and others. 
I. Background
The goal of the Jordan Surveillance Project (JSP) is to provide the MOH with the 
capacity to produce sufficient health information to make policy determinations, resource 
allocation and programmatic improvements to increase the effectiveness and efficiency of 
public health practice. JSP is currently finishing phase II and preparing for phase III. As 
a first step in this process, an evaluation was requested by USAID in Jordan to examine 
how the JSP has been meeting its declared objectives and how JSP should be adapted to 
address emerging health issues and expanding needs. The Division of International 
Health of the Epidemiology Program Office at CDC selected Drs. Andrew Dannenberg 
and Kathy Douglas as the evaluation team.
Prior to the visit to Jordan, the evaluation team was provided with an organizational chart 
of the Ministry of Health, background information on the project, annual workplans, 
progress reports, training program curriculum, publications, and abstracts. The evaluation 
was conducted from 9-15 May 2004 in Amman and surrounding governorates. 
During the period of the evaluation, the team performed the following duties:
1. Reviewed the new and existing surveillance systems that JSP has supported and 
recommended strategies for JSP to continue to improve the systems including:
4
a. Mortality surveillance
b. Communicable disease surveillance
c. Noncommunicable disease surveillance
d. Behavioral risk factor surveillance
e. Hospital discharge information system
2. Assessed the Field Epidemiology Training Program’s (FETP) success in supporting 
the overall program’s objectives, focusing on:
a. Process of recruitment
b. Process and outcome of training
c. Career path of graduates
d. Relation of FETP to other governmental units 
e. Budget and staffing needs for sustainability
3. Assessed the Data for Decision Making (DDM) program success in supporting the 
overall program’s objectives, focusing on:
a. Process of recruitment
b. Process and outcome of training
c. Impact of the on-the-job training on participants’ day-to-day work activities
d. Usefulness of the training in improving current job performance and future job 
opportunities
e. Sustainability 
4. Reviewed the existing relationships between the two training programs, FETP and 
DDM, and recommended strategies to enable the programs to support each other 
without detracting from the different training objectives. 
5. Assessed opportunities to work with emerging topics, such as enhancing HIV/AIDS 
surveillance and prevention efforts, enhancing micronutrient deficiency surveillance 
and prevention, and initiating a Ministry unit focused on injury surveillance and 
prevention. 
The evaluation team interviewed approximately 40 individuals involved in the project in 
various capacities, including participants and instructors of the FETP and DDM 
programs, supervisors of staff who had participated in FETP or DDM, and individuals 
conducting any of the various surveillance activities (see the list of persons interviewed 
in Appendix A). The JSP team will use the results of the evaluation in planning for the 
next phase of the project, anticipated to begin in October 2004 and cover a five-year 
period. 
II. Overview 
JSP is considered to be an excellent, efficient, and beneficial strategy for the individuals 
and organizations involved in the project. Many participants consider JSP to be one of 
the greatest opportunities in their careers. Directors supervising graduates of the FETP 
and DDM training programs see major shifts in the scientific ability of their staff, which 
in many cases has resulted in promotions for the graduates of the programs. Having 
5
graduates of the FETP and DDM programs in each governorate also has resulted in a 
greater linkage across governorates toward supporting national health efforts.
Specifically, JSP has resulted in the following:
· Increased access to and quality of public health information
· Improved responses to outbreaks, both in terms of timeliness and systematic 
approaches 
· Established scientific procedures for collecting and analyzing epidemiological data
· Increased presentation skills and opportunities to share experiences at conferences 
and meetings for JSP participants
· Addressing work in a comprehensive manner
Commitment has been demonstrated by the MOH to strengthen JSP infrastructure. 
Actions already taken, or to be taken in the near future, by the MOH include:
· Making JSP an organizational unit, known as the Division of Applied Training in 
Epidemiology, within the MOH organigram (completed)
· Expanding space for the project team from five to eight offices (in progress)
· Providing additional staff (1 new full time staff person to begin in late May 2004; at 
least 2 additional staff are needed) 
Current weaknesses of JSP include not yet having a plan established to sustain and 
expand the project over the long-term, with the MOH assuming progressively more 
financial and technical support of the project. Further, some JSP activities, such as the 
periodic surveillance bulletin, have not been implemented due to understaffing. 
Additional staff specific to project areas, such as noncommunicable disease, mortality 
and hospital discharge data systems, and injury surveillance and prevention, would 
greatly enhance the project. 
III. Project Area Recommendations
The following JSP project areas were evaluated: 
1. Field Epidemiology Training Program (FETP)
2. Data for Decision Making Program (DDM)
3. Surveillance for infectious diseases
4. Surveillance for noncommunicable diseases
5. Behavioral risk factor surveillance
6. Mortality reporting
7. Hospital discharge data reporting
8. Opportunities for work with emerging topics
Preliminary results were delivered to His Excellency Said S. Darwazah, Minister of 
Health, on 12 May 2004 (see Appendix B for presentation summary). Results also were 
presented to the Chief of the Jordan USAID Mission on 13 May 2004 (see Appendix C 
for presentation summary). 
Strengths, weaknesses, and recommendations for each project area are described below.
6
1. Field Epidemiology Training Program (FETP) 
Strengths
1. FETP has trained or is training 30 physician participants who use their enhanced 
skills to benefit public health in Jordan.
2. Many participants reported that the training substantially improved their skills in 
epidemiology, computers, research, surveillance, presentations, report writing, and 
field investigations. Some also indicated their skills improved in speaking, reading 
and writing in English. 
3. Supervisors of FETP graduates consistently reported that these graduates do 
outstanding work in epidemiology, surveillance, and other aspects of public health.
4. FETP graduates are reported to conduct outbreak investigations quickly and 
systematically, and to help ensure that all suspected outbreaks are examined. Prior to 
the project, many actual or potential outbreaks were not investigated.
5. FETP provides more practical experience than existing public health degree 
programs; universities and other agencies approach MOH to ask about the practical 
epidemiology field experiences for their students.
6. Recruitment of appropriate and well qualified MOH physicians into FETP has been 
successful to date.
7. Having graduates of the FETP and DDM programs in each governorate has resulted 
in a greater linkage across governorates toward supporting national public health 
efforts.
Weaknesses
1. The FETP program is not linked to an academic degree or other credential that might 
increase the participant’s job potential (e.g. increased salary). This absence may be a 
deterrent for recruiting some highly capable physicians into the field of public health. 
2. The existing project staff work on numerous projects simultaneously, and at times 
these other commitments reduce their availability to facilitate/mentor program 
participants on the individual projects. 
Recommendations
1. Develop an annual two-day conference for FETP and DDM graduates and current 
participants to provide continuing education, showcase accomplishments, and 
enhance networking. Consider inviting university and other partner organization staff 
to attend at least part of the two-day conference to motivate partners to collaborate on 
specific activities. A planning meeting with these partners to determine collaborative 
roles and responsibilities could be held following the two-day conference. 
2. Explore associating the FETP with a higher level academic credential. Based on 
preliminary discussions with the Chairman of the Dept. of Public Health at JUST, it 
may be possible to offer a degree such as an MPH in conjunction with the FETP if the 
resident could fulfill some course requirements (estimated at 9-16 credits) and use an 
FETP project for thesis credit. The FETP should further explore this and other 
possibilities with the Dean at JUST and at other academic institutions. The potential 
for FETP experience to count toward board level certification deserves further 
consideration.
7
3. Identify resources to support additional FETP program staff to fulfill their expanding 
responsibilities, respond to new opportunities, and enhance mentoring of program 
participants. 
4. Support 2-3 small grants ($5000-$10000 range) for outstanding projects by 
FETP/DDM participants and graduates. To do this, establish a committee to review 
submitted proposals and select ones that make explicit contributions to improving 
public health practice. These projects could be showcased in various settings and 
serve as models for future projects by FETP/DDM participants. 
5. Develop a strategy for involving FETP/DDM graduates in new classes of training, or 
for sharing current work projects with each other to help maintain and enhance skills 
and increase networking.
6. Explore options to enroll participants into FETP from other countries in the Middle 
East to enhance international networking and improve public health across the region. 
7. Consider providing additional training on analysis of complex surveys as requested 
by some FETP graduates.
8. Consider providing an electronic reference library on CD-ROM to FETP and DDM 
participants and graduates to enhance their access to current information at a modest 
cost.
2. Data for Decision Making Program (DDM)
Strengths
1. DDM has trained or is training 52 senior and mid-level managerial and technical 
public health professionals in epidemiology, biostatistics, surveillance, management, 
communication, and economics to improve their use of data in making decisions to 
protect the public’s health. 
2. Persons trained include district public health officers, program managers, and deputy 
directors of health governorates.
3. Comments from current and past DDM participants indicate high satisfaction with 
quality and usefulness of training received.
4. Training two-person teams from each governorate is valuable for building public 
health capacity in those governorates.
5. By training high level public health professionals, DDM helps improve management 
skills and increase understanding of applied epidemiologic skills of the supervisors of 
FETP graduates.
 
Weaknesses
1. Some participants indicated they could have used more time for the DDM training, 
although increased time commitment would have competed with their regular job 
responsibilities.
2. The selection process has not been ideal; participants were nominated by their 
supervisors and some did not fit into program well. 7 of 15 program managers did 
not complete the 2002-03 class due to other commitments or insufficient interest.
8
Recommendations
1. Identify the next target groups for DDM. Hospital administrators may be appropriate 
in that such training would improve their links to public health and may facilitate 
improving hospital discharge data surveillance activities.
2. Develop a mechanism for ongoing continuing education of DDM graduates. This 
might include a periodic conference (at least annually; see recommendation #1 under 
FETP above) to review and update relevant information, a periodic written or 
electronic bulletin, and/or other methods.
3. Give further thought to identifying the optimal method for selecting DDM 
participants, to minimize the number of overcommitted or disinterested participants 
who join and then drop out of the training. 
4. Develop a strategy for involving FETP/DDM graduates in new classes of training, or 
for sharing current work projects with each other to help maintain and enhance skills 
and increase networking.
5. Review the program-related transportation needs of DDM participants, an issue that 
was raised as a concern by some participants.
3. Surveillance for infectious diseases
Strengths
1. Over the past several years, surveillance of infectious diseases in Jordan has greatly 
improved in completeness, timeliness, and accuracy, with weekly reporting of 42 
conditions now occurring regularly at the local and national level.
2. The FETP and DDM training programs have contributed substantially to these 
improvements by training local and national staff to conduct infectious disease 
surveillance and run the computer database systems. Local and national staff 
demonstrate substantial energy and enthusiasm for their work with these surveillance 
systems.
3. FETP trainees working with other MOH staff are now providing timely responses to 
investigate real and suspected increases in disease events identified in the surveillance 
system. 
Weaknesses
1. Several informants indicated that insufficient resources have been available at times 
to maintain and upgrade the surveillance system, such as updated computer hardware 
and software and transportation for investigations. 
2. A periodic bulletin to disseminate surveillance data has been planned but not 
published regularly due to insufficient staff resources. 
3. Several informants indicated that surveillance for sexually transmitted diseases has 
been limited due to the sensitive nature of the topic.
4. While cooperation on disease reporting has been excellent with public health clinics 
and hospitals, less cooperation has been obtained from physicians in the private 
sector.
9
Recommendations
1. Consider developing an MOH plan to insure periodic updating of computer hardware 
and software used for surveillance on the local and national levels.
2. Obtain necessary staff (perhaps ½ FTE) to edit and manage a periodic (weekly, 
monthly, or quarterly) surveillance bulletin that would have great value for 
disseminating information and as a teaching tool for FETP trainees who could write 
much of its content. 
3. Negotiate arrangements for MOH, universities, and other partners to analyze and 
publish collaboratively the surveillance data collected by MOH. Such cooperation 
would increase visibility of the surveillance systems as well as increase the actual use 
of the collected data.
4. Establish at MOH a regular review (perhaps every 1 – 2 years) of the list of reportable 
conditions to insure optimal use of surveillance resources.
5. Consider asking questions about risk factors for sexually transmitted diseases on one 
cycle of the BRFS survey to assess the magnitude of the problem of STDs in Jordan.
6. Offer encouragement such as training and feedback to private sector physicians to 
improve their cooperation in disease reporting.
7. Continue work with the MOH electronic reportable disease database, including 
electronic transmission of data from directorates to MOH, and periodic dissemination 
of surveillance reports.
4. Surveillance for noncommunicable diseases 
Strengths
1. Excellent cancer registry has been developed and is in place.
2. Various partner organizations and professionals in a range of functions all recognize 
that both noncommunicable disease data collection and program planning/ 
implementation are important and need strengthening.
Weakness
1. As is the case for many countries, this area needs to be given more priority and 
developed. 
Recommendations
1. Identify cardiovascular disease as a priority to match its status as the leading cause of 
death in Jordan (based on preliminary data) and develop a strategy and timeline to 
begin collecting and analyzing relevant data for action.
2. Implement screening at the primary health care center level to assess diabetes 
complications.
3. Consider recruiting non-physicians, especially behavioral scientists (e.g., sociologists, 
psychologists, and social workers), to enhance the noncommunicable disease area and 
adequately address the complexity of response needed.
4. Plan interventions based on improved noncommunicable disease surveillance so that 
data collection will result in public health action.
5. Explore linkages with other noncommunicable disease efforts, such as the 
WHO/CDC Evidence-Based Chronic Disease Prevention training program, to help 
strengthen noncommunicable disease capacity. 
10
5. Behavioral risk factor surveillance
Strengths
1. Successful implementation of BRFS in 2002 involving a nationally representative 
sample.
2. Current plans are underway to repeat implementation of BRFS in 2004.
3. Fewer resources are required to collect self-report behavioral and related risk factors, 
as compared to the collection of physical and biochemical measures.
Weaknesses
1. How to use BRFS data remains problematic because the field of noncommunicable 
diseases overall is not considered a priority by many health policy decision makers 
(problem throughout the world).
2. Concern about future BRFS implementation: the extra resources needed for the 
simultaneous collection of self-report data and of physical and biochemical measures 
may reduce the likelihood of having rapid and regular collection of self-report data 
(every 2-years) which is important to ensure effective linkage of data collection to 
data use for prevention purposes. 
Recommendation
1. Support current goal to conduct BRFS (self-report behavioral indicators) every 2 
years to provide timely trend data for program and policy planning, and for linking 
data collection to data use.
6. Mortality reporting
Strengths
1. The MOH Information Center has redesigned mortality reporting forms, which has 
resulted in improved mortality report quality. 
2. Hospitals have significantly increased their submission of mortality reports to the 
Information Center using the newly redesigned forms. 
3. Cancer mortality data have been standardized and therefore are more useful for 
assessing trends and for comparisons with other countries. 
Weakness
1. There are an insufficient number of professionals working as mortality coders.
Recommendations
1. Provide further training to physicians on accurate and complete submission of 
medical information for death certificates.
2. Increase the number of persons trained in ICD-10 coding to assist the current MOH 
staff with this responsibility. These individuals need to understand medical 
terminology, but do not need to be physicians. The coders should be supervised by a 
physician who can resolve difficult coding problems.
3. Increase dissemination of mortality data (“surveillance is data for action”) to health 
policy decision makers and academic researchers.
11
7. Hospital discharge data reporting 
Strength
1. Hospital discharge data coding has begun at Bashir Hospital and is being done by an 
energetic and enthusiastic, but overworked, physician.
Weaknesses
1. Hospital discharge data quality is currently poor and incomplete. 
2. Physicians are currently not motivated to provide complete and accurate diagnosis 
records.
3. There are an insufficient number of professionals working as coders. 
Recommendations
1. Increase number of persons trained to code hospital discharge data. These non￾physicians need to understand medical terminology and should be supervised by a 
physician who can resolve difficult coding problems.
2. Support the proposal for a hospital discharge information system submitted by the 
MOH and JSP on 29 January 2004 which has 4 objectives to: (1) create a coding unit 
within 25 MOH hospitals by 2008, (2) train personnel in ICD-10 coding, (3) furnish 
the 25 hospitals with the necessary equipment and supplies, and (4) support a 
centralized location within the MOH to serve as a central data warehouse. 
3. Consider implementing a hospital accreditation process that will require physicians to 
properly record discharge diagnoses. 
4. Consider implementing a requirement that physicians provide complete and accurate 
records to maintain hospital privileges. 
5. Increase dissemination of hospital discharge data to hospital administrators, health 
policy decision makers, and academic researchers.
8. Linkage with emerging priority topics (HIV, micronutrients, injuries)
Strength
1. The Ministry has identified and initiated work in a number of emerging priority topics 
by its process of periodic updates of the list of reportable diseases.
Weakness
1. Work on new priority topics is often guided by the availability of new resources for 
such projects. 
Recommendations
1. HIV/AIDS is a major cause of morbidity and mortality globally, although the 
incidence remains low in Jordan at present. Increased efforts in HIV surveillance and 
education, especially in high risk populations, would be valuable to reduce the 
likelihood of increased HIV incidence in Jordan.
2. Deficiencies of micronutrients, such iron, folic acid, vitamin A, and iodine, lead to 
highly preventable diseases and disabilities. Increased efforts for surveillance for 
these deficiencies and appropriate interventions would be highly cost-efficient.
12
3. Injuries, especially related to motor vehicles, are one of the leading causes (third 
based on preliminary data) of mortality and morbidity in Jordan as in much of the 
developed and developing world. The Ministry currently has no active programs 
focused on injury prevention; data on motor vehicle crashes are collected by the 
Department of Safety but not reviewed by MOH. Developing a small unit within the 
Ministry to improve injury surveillance and to identify and implement appropriate 
injury prevention strategies would yield substantial health benefits for Jordan. The 
National Center for Injury Prevention and Control at CDC could provide technical 
assistance to help develop such a unit. Based on limited information, the leading 
causes of injury in Jordan are expected to be motor vehicle crashes, falls, and burns; 
proven intervention strategies exist for these and other major causes of injury. 
IV. Recommendations covering multiple components of project 
1. Maintain separate, yet supporting functions of the two training programs, FETP and 
DDM, targeted to different participant audiences, providing differing depths of 
epidemiologic material coverage, offering differing course content (e.g. management 
and leadership content in the DDM training program), and providing training that 
requires different time commitments and covering different time periods. The FETP 
program is working well, targeting appropriate participants from entry and mid-level 
MOH staff, who can commit to the two-year intensive program, and who can return 
to their positions to strengthen epidemiologic technical work. DDM, on the other 
hand, targets middle- to senior-level staff who are in a position to strengthen not only 
technical functions of their work, but also administrative functions. Including some 
of the epidemiologic training from FETP into the DDM program generates "buy-in" 
and increases the understanding of these DDM individuals regarding the scientific 
basis of the technical work conducted by the FETP graduates. Providing management 
and leadership training in the DDM program also helps to enhance the skills required 
to improve health center operations.
2. Strengthen links of the project to Egypt, Saudi Arabia and other countries in the 
region to provide regional support and leadership, and contribute to strengthening 
capacity overall in the region. Because both infectious diseases and the risk factors 
for noncommunicable diseases transcend national boundaries and have major 
economic, socio-cultural, political, and environmental consequences on health, and 
because most countries do not have resources to address both infectious and 
noncommunicable diseases adequately, disease burden can no longer be effectively 
addressed by each country alone, but must be addressed across countries together to 
have maximum impact. Sharing project objectives and training programs with 
professionals from countries in the region to exchange information and best practices 
will not only help strengthen Jordan's health response, but will help to raise the 
standard overall for the region.
3. Develop a transition strategy for the MOH to assume increasing responsibility for the 
project over the long term. Develop a memorandum of understanding for each 
agreed-upon project activity to improve communication and clarify roles and 
responsibilities across partner agencies, such as MOH, CDC, and others. 
13
V. Summary
JSP is much more than a surveillance initiative. It is an integrated applied epidemiology 
program that has already begun to strengthen the health infrastructure in Jordan. 
Systematic infectious, noncommunicable disease, including behavioral risk factors, and 
mortality surveillance efforts have improved as a result of this project. Further, medical 
professionals who have participated in either the FETP or DDM consider JSP to be the 
best field application program offered in the country. This is supported by directors 
supervising these professionals, who have noticed significant changes in epidemiological 
skills among these professionals, as exercised routinely in day-to-day work. Because JSP 
is considered by all interviewed to be a tremendous success to date, the overall 
recommendation from this evaluation is to provide continued technical and financial 
support to strengthen and further expand this project, while considering the suggested 
changes described in this report.
14
Appendix A – Special presentations and persons interviewed
Special presentations
His Excellency Eng. Said S. Darwazah – Jordan Minister of Health
Ms. Anne Aarnes – Chief of USAID Mission, US Embassy, Amman
Persons interviewed, Jordan Surveillance Project Evaluation, May 9-15, 2004
Dr. Saed Kharabsheh – Secretary General, MOH
Dr. Ali Assad - Assistant Secretary General for Primary Health Care, MOH
Dr. Adel Belbeisi - Director for Disease Control, Ministry of Health (MOH)
Dr. Henry Walke – Jordan Surveillance Project Resident Advisor, CDC assignee 
Mr. David Piet - Team Leader, Population and Family Health Sector, USAID
Dr. Salwa Bitar Qtiet – Senior Project Management Specialist, USAID
Dr. Fawaz Shehab – MOH Counterpart for Jordan Surveillance Program
Dr. Meyasser Zinah - Non-Communicable Disease Program Manager, MOH
Dr. Sief Ed-Din Saleh - Director of Infectious Disease Surveillance, MOH
Dr. Faris Debabneh – Director of Information Center, MOH
Dr. Hydar Otoum - Director of School Health, MOH 
Dr. Moh'd Abu Sleih – Director, Community Medicine Program, Health Academy, MOH
Dr. Salah Mawajdeh – Director General, Jordan Food and Drug Administration 
Dr. Bassam Hijawi - Director of Health Safety, MOH 
Eng. Wisam Qarqash – Micronutrient Program Manager, MOH
Dr. Khaled Al-Hyari – Health Director, Salt
Dr. Zeyadd Abanda, Director, Director of Health Directorate, Ajloun 
Prof. Ahmed M.B. Alkafajei – Chairman, Dept of Public Health, Community and
 Family Medicine, Jordan University of Science and Technology, Irbid
Dr. Awai Hamid – Deputy Director, Bashir Hospital, Amman
Dr. Kamal Abu-Arqoup – Hospital discharge coder, Bashir Hospital, Amman
Data for Decision Making Program participants
Dr. Khaled Abbas Al-Kharabsheh, DDM 1999-2000, Deputy Director, Amman 
Health Directorate
Dr. Neyla Gargouri, DDM 2002-2003, Deputy Director, Laboratory Directorate
Ms. Wisam Qarqash, DDM 2002-2003, Head, Nutrition Department, MOH
Dr. Youssef Moh'd Abdellat, DDM 2004, Deputy Director, Amman Directorate
Ms. Nabila Jeedi, DDM 2004, Epidemiologist, Amman Directorate 
Dr. Ali Al-Dergham, DDM 2004, Deputy Director, Balqa Directorate, Salt
Mr. Abdullah Al-Jendi, DDM 2004, Epidemiologist, Balqa Directorate, Salt
Dr. Ziad Abandah, DDM 2004, Director of Health, Ajloun Directorate, Ajloun 
Mr. Ayman Smadi, DDM 2004, Epidemiologist, Ajloun Directorate, Ajloun 
Field Epidemiology Training Program participants 
Dr. Fawaz Shehab, FETP 1999-2001, JSP, Amman 
Dr. Samir Khalil, FETP 1999-2001, Director of Surveillance, Amman Directorate 
15
Dr. Assad Rahal, FETP 1999-2001, Primary Health Care, HIV, MOH 
Dr. Kariman Zein, FETP 2000-2002, Diarrhea surveillance, MOH 
Dr. Sami Sheikh Ali, FETP 2000-2002, Director of Surveillance, Salt 
Dr. Mohamad Syouf, FETP 2000-2002, Deputy EPI Manager, MOH 
Dr. Taiseer Ennab, FETP 2002-2003, Chief of Surveillance, Ajloon 
Dr. Majed Assad, FETP 2002-2003, Informatics Directorate, MOH
Dr. Neyla Gargouri, FETP 2003-2004, Leishmaniasis surveillance, MOH
Appendix B – presentation to Jordan Minister of Health
Appendix C – presentation to Chief of USAID Mission