How do stakeholders assess Jordan's institutional readiness for universal health coverage? An exploratory qualitative interview study in Jordan.

چکیده اصلی

OBJECTIVES: To explore how senior stakeholders assess Jordan's institutional readiness for universal health coverage (UHC), identify institutional pathways connecting fragmentation, purchasing strategies, accountability and public trust, and develop a bounded, phased policy roadmap. DESIGN: Exploratory qualitative study using semi-structured key-informant interviews and reflexive thematic analysis. SETTING: Jordan's national health-policy, financing, insurance, regulatory, digital-health and service-delivery institutions. PARTICIPANTS: 18 purposively selected senior stakeholders, supplemented by selective snowball referrals, representing legislative, executive, public-finance, civil-insurance, digital-health, public and private provider and technical functions. RESULTS: Nine themes were organised into four higher-order groups: (1) institutional fragmentation, governance and equitable access; (2) financing, information and digital readiness; (3) strategic purchasing and coordinated service delivery; and (4) social legitimacy, resilience and adaptive implementation. Participants described political commitment and substantial provider capacity as important foundations, but identified fragmented authority and insurance arrangements, weak purchasing, limited actuarial and integrated claims data, inconsistent public-private regulation, geographic inequities and conditional public trust as major constraints. The analysis suggests an institutional translation gap through which existing assets are not consistently converted into equitable, financially sustainable coverage. CONCLUSIONS: Jordan's readiness is multidimensional and uneven rather than binary. A phased pathway should first establish governance, legal, actuarial, data and social-protection foundations; then pilot benefit, claims, purchasing and primary-care reforms; and subsequently scale coverage subject to predefined readiness criteria. Findings concerning social acceptability reflect elite stakeholder perceptions and require direct validation with uninsured people, refugees, rural communities and frontline providers.

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