During 2007 the Health Systems Strengthening (HSS) Project in Jordan designed a survey to measure client satisfaction with facilities, services and providers at health centers. The survey focused on key aspects of the major interventions being carried out by HSS, specifically looking at satisfaction with family planning, antenatal care and child care services. It collected information from clients at health centers regarding their perception of access and the quality of care, adequacy and appropriateness of referrals, satisfaction with privacy of care, time spent by providers with patients, and communications between providers and patients. The facility based survey collected exit interviews from 992 users of general practice (GP) and maternal and child health (MCH) services of MoH health centers during the months of January and February 2007. In total, approximately 24 individuals were selected for interviews in each of the 39 health centers that were identified through the sampling methodology1. The survey conducted interviews with 504 clients of GP and 488 clients of MCH services. The interviews included: - Personal information such as, age, sex, education, employment status, income, reasons for choosing the health center, main health provider, type of care sought, and specific contents of the antenatal, family planning and child health care services. In addition, the age of the child receiving CHC services was recorded; however, this was not recorded for GP. - Facility information, for instance, region, directorate, type of health center and service used. - Access to care, how convenient the hours of operation are, ease of reach, waiting times and the availability of drugs. - Attendance at health promotion sessions, and referrals to hospital. - Satisfaction with specific aspects of their visit to the provider and the care received, namely: technical competence of staff (the client€™s perception), interpersonal communication issues, including how well the provider welcomes clients and how well they ask questions and communicate key information regarding treatment, amenities, including the physical space of the facility and the adequacy of waiting areas. - Composite measures of quality of care including privacy, communication and provider interaction and overall satisfaction. - Recognition of quality improvement initiatives at the facilities, and association of improvements to an initiative or program. Although the clients of the MoH health centers are, according to the survey, relatively satisfied with the care received, there are many opportunities to improve the content and quality of care in Jordan. Overall, the users of the public health system give passing scores for satisfaction of care - on average 8 out of 10 for all of the issues explored, with the exception of questions on cleanliness and accessibility (the time and distance) of the health center. Very few users (only 8.6 %) reported attending health promotion sessions, a missed opportunity to engage the population in contributing to During 2007 the Health Systems Strengthening (HSS) Project in Jordan designed a survey to measure client satisfaction with facilities, services and providers at health centers. The survey focused on key aspects of the major interventions being carried out by HSS, specifically looking at satisfaction with family planning, antenatal care and child care services. It collected information from clients at health centers regarding their perception of access and the quality of care, adequacy and appropriateness of referrals, satisfaction with privacy of care, time spent by providers with patients, and communications between providers and patients. The facility based survey collected exit interviews from 992 users of general practice (GP) and maternal and child health (MCH) services of MoH health centers during the months of January and February 2007. In total, approximately 24 individuals were selected for interviews in each of the 39 health centers that were identified through the sampling methodology1. The survey conducted interviews with 504 clients of GP and 488 clients of MCH services. The interviews included: - Personal information such as, age, sex, education, employment status, income, reasons for choosing the health center, main health provider, type of care sought, and specific contents of the antenatal, family planning and child health care services. In addition, the age of the child receiving CHC services was recorded; however, this was not recorded for GP. - Facility information, for instance, region, directorate, type of health center and service used. - Access to care, how convenient the hours of operation are, ease of reach, waiting times and the availability of drugs. - Attendance at health promotion sessions, and referrals to hospital. - Satisfaction with specific aspects of their visit to the provider and the care received, namely: technical competence of staff (the client€™s perception), interpersonal communication issues, including how well the provider welcomes clients and how well they ask questions and communicate key information regarding treatment, amenities, including the physical space of the facility and the adequacy of waiting areas. - Composite measures of quality of care including privacy, communication and provider interaction and overall satisfaction. - Recognition of quality improvement initiatives at the facilities, and association of improvements to an initiative or program.   Although the clients of the MoH health centers are, according to the survey, relatively satisfied with the care received, there are many opportunities to improve the content and quality of care in Jordan. Overall, the users of the public health system give passing scores for satisfaction of care - on average 8 out of 10 for all of the issues explored, with the exception of questions on cleanliness and accessibility (the time and distance) of the health center. Very few users (only 8.6 %) reported attending health promotion sessions, a missed opportunity to engage the population in contributing to improving their health status. The increased coverage of health promotion sessions among the users of health care centers could be an opportunity to reduce risks for diseases, to make better use of the FP, ANC and CHS, and to promote early detection and control of chronic diseases. The survey identified two key areas where there are opportunities to improve the quality of care: privacy of care; and communication with providers, including the pharmacist; the average score was less that 6 out of 10. Many clients reported that they were not examined, and when they were examined the curtains were not closed and/or other people were present. Most clients did not receive explanations on how to manage their health, including diet and the use of medication. The results of the survey show other gaps in performance that could be overcome through training and supervision of staff, also contributing to better quality of care. Specifically for Family Planning, midwives could provide more follow-up appointments and make sure women are better informed about the family planning method they are using, the advantages and disadvantages of other methods, making sure their clients concerns about getting pregnant are addressed. In addition, there could be an effort to promote the use of antenatal care in the first trimester of pregnancy. Likewise, content of the antenatal care visits could be improved, making sure that the women receive enough counseling and information about special cases and postnatal care. The referral process seems cumbersome, and some clients may be lost along the way, although most do report receiving care from a specialist. There are additional missed opportunities to improve the continuity of care since very few clients reported that their specialist sent feedback to the health center. Half of the patients did not return to the health centers, thus putting pressure on hospital services and limiting the potential of primary care in health centers.