Infectious diseases remain a global threat, with low- and middle-income countries disproportionately affected due to socio-economic and demographic vulnerabilities. Robust laboratory systems are critical for early detection, outbreak containment, and guiding effective interventions. This study aimed to map and evaluate Jordan’s laboratory diagnostic network for communicable diseases, identify gaps, and recommend strategies to strengthen capacity, harmonization, and alignment with international standards. A multi-method approach was employed in 2023 through collaboration between the Jordan Center for Disease Control and the Health Care Accreditation Council. Data were collected via (i) a desktop review of 226 national and international documents; (ii) 20 key informant interviews with stakeholders from the public, private, military, veterinary, and academic sectors; and (iii) 23 field visits across 27 laboratories in four Jordanian governorates. Data were analyzed thematically and synthesized using the LABNET framework, which outlined ten core laboratory capacities. Findings were validated through a multi-sectoral national workshop with 90 participants. The mapping revealed the absence of a unified national laboratory strategic plan, with governance dispersed across multiple authorities and limited inter-sectoral coordination. Standard operating protocols (SOPs) existed for high-priority diseases such as T.B, HIV, influenza, and COVID-19 but were lacking or outdated for other notifiable diseases, particularly zoonoses. Quality management was inconsistent, with limited participation in external quality assurance programs and minimal accreditation uptake. Biosafety and biosecurity frameworks were fragmented and insufficiently enforced, while workforce shortages, high turnover, and limited specialized training constrained laboratory performance. Despite these challenges, Jordan demonstrated strengths including skilled laboratory staff, established reference centers, and international collaborations, which provide a platform for improvement. Jordan’s laboratory network has foundational strengths but faces systemic challenges in policy coherence, standardization, quality assurance, and workforce capacity. Addressing these gaps requires the development of a national laboratory strategic plan, strengthened legal and regulatory frameworks, enhanced quality management and accreditation, and integrated One Health coordination across human, animal, and environmental health sectors. These measures will improve diagnostic reliability, preparedness, and alignment with the global health security agenda.

During the global COVID-19 pandemic, hospitals faced tremendous pressure to cope with the emergency preparedness situations needed to cater for the influx of patients while maintaining their essential services. This study aimed to assess the level of readiness of hospitals in Jordan to respond to the COVID-19 pandemic using the WHO hospital readiness checklist. A cross-sectional survey using the modified and validated checklist was conducted in Jordan between 15 May and 15 June 2021. The checklist entailed ten key response functions with a total of 60 activities. Data from 22 hospitals were collected through a structured survey process by two surveyors for each hospital. The overall readiness score of hospitals was 1.77 ± 0.20, with a lower overall score in the northern region (1.65 ± 0.24) than the middle (1.86 ± 0.07) or southern (1.84 ± 0.14) regions. The diagnosis response function scored highest (1.95); but despite efforts, contingency plan development was not met by most hospitals, with a total score ≤ 1.45. Provision of psychological support and occupational health support to ensure the wellbeing of staff scored below average. Outcomes from this survey exposed gaps while offering a framework for upcoming endeavors to improve hospital readiness for any potential pandemic.

Salma Jaouni, Peter Lachman, Samar Hassan; When Donor Funding Ends: Reflections from Jordan’s HCAC on Sustainable Health System Strengthening, Internationa

Background: The advent of the COVID-19 pandemic caused a rapid increase in demand for healthcare services over a prolonged period, and the hospital emergency preparedness system has been essential. Therefore, this study aimed to explore Jordanian hospitals’ response to emergency situations and examine the underlying role and effect of accreditation programs as a “Quality and Patient Safety” tool to deal with emergency situations during the pandemic. Methods: An online survey for a cross-sectional study was conducted in Jordan between 1 March and 30 May 2022, to examine the opinions of hospitals’ top, senior, and middle managers using a validated questionnaire. Results: A total of 200 healthcare providers from 30 hospitals participated in the study. From the areas within accreditation standards that were investigated, capacity building on emergency preparedness and communication abilities received the least scores (2.46 and 2.48, respectively). Additionally, hospitals with mature quality and patient safety culture (>3 accreditation cycles) demonstrated a statistically significant difference in score in two domains–emergency preparedness (p = 0.027) and infection prevention and control (p = 0.024). Conclusions: During outbreaks, hospitals that are required to comply with accreditation standards that address all emergency preparedness aspects will fare better in quality performance.

Salma Jaouni Araj, Samar Hassan; State of Quality in the COVID-19 Era “Initiatives and Priorities for Improving Quality in the Future” Reflections from the EMR

Background: Donor-funded health programmes strengthen national quality systems in low-income and middle-income countries, but abrupt withdrawal of external support can create institutional gaps and threaten service sustainability. Aim: To analyse the impact of sudden donor funding cessation, using the experience of the Health Care Accreditation Council (HCAC) as an illustrative case, and to explore implications for quality infrastructure and health system resilience. Methods: This structured case-based policy analysis draws on institutional documentation, administrative records and publicly available reports to examine the effects of funding withdrawal on quality programmes and organisational capacity. Results: Funding cessation led to contraction of technical workforce capacity, scaling back of quality improvement and professional development activities, and disruption of accreditation-related support. The case exposed vulnerabilities associated with donor dependency and insufficient transition planning. Conclusion: Abrupt donor withdrawal can weaken quality systems and patient safety gains. Strengthening resilience requires diversified financing, structured transition frameworks and institutional strategies that embed quality governance within nationally owned systems.