Proposal: Sexual Health Needs Assessment for a Jordanian Community

This report is a comprehensive health needs assessment proposal focused on sexual health within a Jordanian community. It begins with an introduction highlighting the importance of such assessments in healthcare initiatives, particularly in resource-constrained environments. The proposal then details the significance of sexual health, especially among youth, outlining the issue's causes, consequences, and the vulnerable population. It emphasizes the need for community-based interventions and the impact of social factors on sexual health. The report includes an overview of the healthcare landscape in Jordan, discussing the government's role, existing frameworks, and the need for continuous assessment. The assessment aims to evaluate the community's health issues to prioritize interventions effectively, considering the scarcity of resources. The methodology involves a mixed-method approach, incorporating surveys and focus groups to gather data from various stakeholders, including internal and external parties. The proposal is designed for hospital administration professionals, emphasizing the importance of evidence-based decision-making. The report also outlines the stakeholders involved and the data collection process, including pilot studies and consultation meetings.

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Health Needs Assessment 2
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Health Needs Assessment 2
Introduction
Before executing a healthcare initiative, it is important to consider its importance
to the community. A health needs assessment is a robust evidence-based evaluation
process that intends to prioritize the needs of a community through their involvement in
decision and resource allocation (Department of Health 2012). This paper outlines a
need assessment proposal for a community served by a local public hospital in
Hashemite Kingdom of Jordan regarding the sexual health among youths.
Overview of the Health Issue
Sexual health remains one of the most critical healthcare needs in a community.
Sexual health starts at childhood and remains progressive to maturity. At adulthood,
professional support through community-based mechanisms is needed as they proceed
into maturity and parenthood. Based on this scenario, sexual health cuts across the
entire community; however, the youth are vulnerable than any other group (Al-Shdayfat
and Green 2012). Poor sexual health emanates from lack of knowledge and awareness.
On the other hand, lack of a positive and respectful attitude and perception on the
sexual relationship is caused by social factors (WHO 2017).
As seen in Jordan, poor living conditions and lack of employment among youths
has contributed to unsafe sexual experience, violence, discrimination, and lack of the
desired free will when it comes to sexual relations among a significant percentage of
youths. There are several consequences of poor sexual health, which affect individual
and the community at large. Scholars have shown that there is relationship that exists
between poor sexual health and poverty, sexually transmitted infections, stigma, and

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social exclusion (Health Knowledge 2017). Cases of increased unintended pregnancies
are prevalent when there are no proper mechanisms to foster positive sexual health
(Health Knowledge 2017). Other challenges such as gender identities, infertility,
physical and mental instability, violence, and victimization have been reported as
consequences of poor sexual health.
It is considered that HIV and STI reported and registered cases only represent
20% of the actual occurrences. The WHO (2016) ascertained the lack of sexual health
data in Jordan as one of the impeding factors to successful health interventions.
However, about half of the youths in the country do not have access to professional-
based sexual health intervention. There is a need for its assessment and the
subsequent interventions for the community (Blum et al. 2012). Implementing such a
move implies that the hospital will be working towards preventing STI, unintended
pregnancies and abortions, mental and emotional well-being, social stigma, and
victimization and relationship violence in the community.
Population at Risk
Young people between the age of 15 and 35 constitute the largest percentage of
the population in Jordan. It is estimated that over 46% of the total population falls under
this category. Since the economy in this country is growing at a fast rate, youths play an
essential role in term of skills development and income generation. In fact, according to
USAID (2017), the government of Jordan could enhance its economic performance by
investing a greater part of their income in human capital development and job creation
based on the composition of their population. A failure to focus on this factor could lead
to significant social challenges in the country. Although the national and local

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government has strived to improve the social status of the Jordanian young generation,
there exists a notable level of disparity, which results in their exposure to health-related
risk factors. The same scenario is depicted in the local community served by this public
hospital, where youths struggle with unemployment, a higher cost of living, limited policy
frameworks that support young people, and lack of access to entrepreneurial resources.
Such a scenario contributes to the increasingly urban and rural poverty in the country
and the targeted region. About 50% of the youths are unemployed or living in poverty,
which makes them vulnerable to poor sexual health (USAID 2017).
It is paramount to recall that the process of supporting sexual health is
progressive since it starts at a childhood where social and emotional stability is natured.
At the youth level, factors such as self-esteem, skills, and education are foundational,
which advance to sexual maturity as the individuals enter into young adulthood and
beyond. Healthcare professionals play important roles by fostering positive behaviour
and awareness through collaboration with parties such as parents, school, media,
religious institutions, families, and other health partners (Rao et al. 2012).
Evidence-Based and Local and National Guidance
In Jordan, the current healthcare system is majorly relying on the public sector to
meet the set objectives in term of equality and access to services. The government
offers 67% of the total bed capacity in the country, which is estimated to be 12,000 it
totals shared between the 106 private and public facilities. The bed rate of 18 per
10,000 people in Jordan implies that it is among the highest rates in the entire Arab
region (Nazer and Tuffaha 2017). In this case, community-based healthcare issues
remain key concerns for the local and national government, which call for a proper

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mechanism for prioritization of needs while paying attention to the reduction of
inequality (Mansour 2012). Scholarly evidence points out how the country is highly
affected by different forms of inequality including access to healthcare, especially in
rural areas. Two factors have exacerbated healthcare inequality in Jordan: the influx in
the number of refugees and the increasing rate of population growth (Murshid et al.
2013). The government has therefore resorted to primary clinics to enhance access to
quick medical interventions.
The government of Jordan, through Sexual and Reproductive Health Rights
(SRHR) platform, has created a framework to ensure that evidence-based policies and
criteria on resource allocation are in place to achieve significant milestones in sexual
health. The government is committed to ensuring that relevant information is
disseminated to the targeted population and communities for them to have the desired
freedom and awareness regarding their sexuality (WHO 2015). Moreover, through the
SRHR platform, the state continues to improve access to reproductive health facilities
and resources to guarantee quality sexual healthcare. At the same time, the initiatives
also focus on groups who are denied the privileges and rights relating to sexual health.
Nevertheless, amid the existing frameworks and public-private sector partnership, there
is a significant sexual health disparity and challenges in the Hashemite Kingdom of
Jordan, which implies that continuous healthcare needs assessment in this area should
be carried out (Doocy et al. 2016; Gausman et al. 2019).
Aim
A health needs assessment is a multidimensional procedure involving systematic
methods of reviewing and evaluating health issues in a community (Becker 2015). The

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primary objective of this proposed health needs assessment will be to ensure that there
are a comprehensive evaluation and review of the issues facing a community to
determine a balanced way of prioritizing the interventions. The reason for such a
strategy is the inability of the available resources to meet all the needs at the same time
because of the scarcity factor. The public health department is facing a critical challenge
of allocating the limited resources while at the same time meeting the health needs of
the local community.
Moreover, through this health needs assessment will ensure that the decisions of
the department are founded on comprehensive data and evidence obtained from all
stakeholders. As mentioned before, it is apparent that the proposed assessment is
aimed at collecting and analysing community-based evidence to determine the
appropriate services that could be implemented. The interventions that will be enacted
after the assessment will be geared towards addressing the health inequality
characterizing this local community. Through the assessment, the hospital will seek to
engage with the identified group and collect their perspective and experience as a way
of contributing to the intended service planning as well as the allocation of resources.
Therefore, this proposed needs assessment will create a platform of engagement and
collaboration between the hospital and the targeted community or the population.
Additionally, this need assessment will determine the existing opportunities for cross-
sector collaboration with the purpose of enhancing the level of effectiveness and
creativity when implementing the interventions.

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Audience
This proposal is designed for hospital administration professionals. Healthcare
administrators are responsible for the business and planning roles of a healthcare
facility. The administrators rely on evidence-based assessment to make a decision
regarding the interventions to be supported by the hospital in line with the existing
limited resources. The proposal is specifically meant for the public health committee in
the hospital who will review and approve the proposal based on the existing evaluation
mechanisms in the department.
Stakeholders
The key stakeholders to be involved in the proposed need assessment are
divided into two major groups: internal and external. The internal stakeholders include
the director of public health, head of the communication department, board committee
members, head of finance and procurement, head of programs and services, and
director of nursing. The internal stakeholders are included because they directly
participate in the regular management and administrative activities of the hospital. For
example, the board is in charge of decision making while the head of programs and
services will provide the schedule, team members, and a monitoring and evaluation
framework. Moreover, the internal stakeholders mentioned above are directly involved
in the planning of external assessments. On the other hand, the external stakeholders
will include local authority, targeted community, special interest groups, funding
agencies, and quality assessors. The external stakeholders have a direct or indirect
interest in the assessment and the subsequent interventions that will be carried out. The
proposed assessment targets the youths, who reside within this community under the

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leadership of the local government. During the assessment, the hospital will require
financial resources and security for the staff members during fieldwork.
Methodology
The assessment process will involve multiple methods to collect the intended
data from the community and other stakeholders. The justification behind the use of
diverse methods is to ensure that a wide range of data is collected, which will enhance
the validity and reliability of the findings (Sarkies et al. 2015). The public health team will
adopt a mixed method approach, which involves the use of qualitative and quantitative
techniques to analyse the collected data. Qualitative approach will ensure that there is
the evaluation of experiences, attitudes, and perception of participants. On the other
hand, the quantitative part will concentrate on the numerical implication of the collected
data.
The need assessment team will employ the use of health surveys and focus
groups. The use of surveys in healthcare research and assessment is important
because they are easy to use and administer. Apart from physical administration of
surveys, they could also be disseminated online. Healthcare surveys are used when
collecting massive data regarding a phenomenon. However, they are also associated
with significant limitations such as possibility of respondents’ dishonesty, closed-end
questions are restrictive, and there is a high tendency to low validity of the findings. On
the other hand, the use of focus groups will be incorporated during data collection to
gather detailed information about the health issue. Survey is an appropriate tool for this
assessment because the public health department intends to gather multidimensional
aspects characterizing sexual health in this community.

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Focus groups are advantageous because they save time when compared to
interviews. Respondents are in a position to seek necessary clarifications. Extended
discussions build on emerging questions reveal additional information that could be
useful in the assessment. However, focus groups are complex to control whenever
there is a contention and it could discourage some respondents from participating
(Alexis 2019). The use of focus groups in this assessment is relevant because it will
ensure that the public health professional gather deep insight about the experiences of
the recruited participants. The tool will also reveal the degree of stigmatisation among
the youths in term of sexual health experiences.
The process of data collection will involve a consultation meeting with the internal
stakeholders, which will be followed by a pilot study. The preliminary study will be used
to test for the reliability and validity of the data collection instruments (Ferencz 2017).
Based on the results from the pilot assessment, improvement of the methods will be
carried out to enhance the meaningfulness and the presentation of the outcomes. Once
the tools have been modified, for example, the alignment of the survey and focus group
questions, the need assessment team will start the actual process of data collection
from the youths in the community. The respondents will strictly persons between 15 and
35 years of age.
Risks
The process of health needs assessment is usually associated with diverse risks
based on the scope and nature of the initiative being carried out. In this assessment, the
most common risk that could be encountered is the inability to achieve the desired team
impetus during the process. Teamwork and collaboration play an important role that

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enhances the effectiveness of the assessment in line with the set objectives. However,
it is not always straightforward and guaranteed that the stakeholders and the team
members will provide their support as expected. Therefore, it is important to plan on
how to handle such challenges by setting a corrective strategy. In this case, it is
important to allocate roles and responsibilities based on the groups within the team. At
the same time, another important approach that could be used to enhance participation
and teamwork is to divide the entire assessment into stages to allow a review and
diagnosis of any problems or risks before advancing to the next level. Moreover, based
on the setting and composition of the targeted community, it is possible to encounter
challenges while accessing and collecting data. Inadequate or inappropriate data could
lead to inappropriate and unreliable analysis and interpretation, which will impede the
attainment of the set objectives. However, this risk could be mitigated by conducting a
pilot study to determine the validity and reliability of the methodology.
Benefits
The proposed health needs assessment covers the entire targeted community as
the scope of the evaluation. In this case, the benefits extend beyond the targeted
population (Warren 2017). One of the primary benefits of this assessment is the need to
optimize the use of limited resources. As noted earlier, there are three critical concerns
to be addressed in this community; however, due to lack of enough resources, the
hospital is bound to focus on one issue. A comprehensive needs assessment ensures
that the hospital focuses on the most sensitive issue in the community. Nevertheless,
such a decision does not imply that the other problems in the community do not need
any significant attention. This assessment will benefit the community because their

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perspective and decisions will be integrated into the intervention framework. At the
same time, this needs assessment will enhance the hospital’s capacity to meet the
healthcare expectations of the community by bringing on board different partners and
teams to improve service quality. Moreover, the assessment will benefit targeted
patients who are affected by the condition. In this case, they will be able to access
prioritized healthcare services and sensitization meant to improve prevention measures.
Another group that will benefit from this assessment is the health professionals in this
public hospital. It is not easy to make a decision regarding the needs to prioritize in a
community with multiple health concerns (Ravishankar and Gausman 2016). However,
a comprehensive needs assessment makes the decision process apparent.
Conclusion
In conclusion, sexual health remains one of the crucial concerns in Jordan
because of the social factors and lack of access to professional help. Culture and
stigmatization of victims have prevented the implementation of effective intervention in
the community. However, the current data does not point to the exact scenario in the
country because only limited cases are reported.

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