A Home Healthcare Services Company - Zarqa

Pre-Feasibility Study
Establishing A Home Healthcare Services Company

Zarqa
April, 2017
Establishing A Home Healthcare Services Company- Zarqa
Table of contents
1. EXECUTIVE SUMMARY ............................................................................................ 4

2. THE MACROECONOMIC ENVIRONMENT .................................................................. 7
2.1 AN OVERVIEW OF THE HASHEMITE KINGDOM OF JORDAN.........................................................7
2.2 POPULATION .....................................................................................................................8
3.2 ECONOMIC INDICATORS IN THE KINGDOM .......................................................................... 10
2.4 THE JORDANIAN INVESTMENT ENVIRONMENT ...................................................................... 14
2.5 THE ECONOMIC ENVIRONMENT IN THE SHORT AND MEDIUM TERM ......................................... 17
3. MARKET STUDY .................................................................................................... 18
3.1 PROJECT DESCRIPTION ..................................................................................................... 18
3.2 EXPECTED SERVICES DESCRIPTION ...................................................................................... 18
3.3 THE CURRENT STATUS OF HEALTH SECTOR .......................................................................... 19
3.4 MARKET ANALYSIS .......................................................................................................... 21
3.5 MARKETING STRATEGY ..................................................................................................... 39
3.6 DEMAND ANALYSIS ......................................................................................................... 44
4. TECHNICAL STUDY ................................................................................................ 46
4.1 THE DESIGNED PROJECT CAPACITY ..................................................................................... 46
4.2 THE REQUIRED FIXED ASSETS ............................................................................................ 47
4.3 THE REQUIRED HUMAN RESOURCES ................................................................................... 50
4.4 SPECIAL REQUIREMENTS ................................................................................................... 54
4.5 THE REQUIRED LICENSES .................................................................................................. 56
4.6 PROJECT TIMETABLE ........................................................................................................ 57
5. FINANCIAL STUDY ................................................................................................. 58
5.1 FINANCIAL ASSUMPTIONS ................................................................................................. 58
5.2 INVESTMENT COST .......................................................................................................... 59
5.3 FINANCING ..................................................................................................................... 59
5.4 REVENUES...................................................................................................................... 59
5.5 THE PROJECTED COSTS..................................................................................................... 63
5.6 PROJECTED FINANCIAL STATEMENTS .................................................................................. 65
5.7 FINANCIAL, ECONOMIC AND SOCIAL ANALYSIS ..................................................................... 68
6. RISK AND SENSITIVITY ANALYSIS ........................................................................... 71
6.1 RISK ANALYSIS ................................................................................................................ 71
6.2 SENSITIVITY ANALYSIS ...................................................................................................... 75
2
A Home Healthcare Services

Company
3
1. Executive Summary
This study aims at identifying the pre-feasibility of a project for establishing a home
healthcare services company in Zarqa Governorate, which can provide home nursing
services to the residents of the governorate and neighboring governorates who wish or their
medical or personal conditions require access to necessary nursing services at their homes,
and also those who suffer chronic medical conditions, the elderly, people with special needs
and others whose conditions require special care and follow-up until their treatment is
completed.
Table 1: Initial indicators of the project

Establishing A Home Healthcare Services Company (At-Home Nursing
Projects Name
And Therapeutic Treatment Inside And Outside The Center)
Sector Health Sector
Governorate Zarqa
Region Zarqa
 Providing nursing services for the patient at home around the
clock for chronic and incurable medical conditions such as
cerebral/deep coma and elderly conditions. The patient is
provided with accompanying male / female nurse on two shifts
(night / day) to perform the following tasks and services for the
patient:
- Providing medical equipment for incurable cases such as medical
bed, respirator, suction apparatus, sphygmomanometer, glucose
meter, special towels, urine bags, intravenous solutions,
cannula, medical supplies such as cotton, syringes, etc…
- Observing the patients at home, measuring blood pressure and
sugar levels, inserting cannulas to take the blood samples,
taking the urine samples to be tested from time to time ... etc.
Products/Services - Cleaning the patient and helping him with washing.
- Providing comfort to the patient at home and monitoring his /
her health conditions.
- Giving the patient his medication regularly and according to the
instructions of the supervising physician.
 Post-surgery rehabilitation, wound care, providing care after
urinary catheter and for bedsores.
 Dealing with the stool holes outside the abdominal wall.
 Treatment with intravenous injection at home.
 Diabetes care
 Coordinating with ambulance services.

 Non-medical care services provided by a range of nursing
assistances and service providers to help the elderly, the disabled
4
and patients to recover and recuperate in their own homes,

including help with bathing and dressing, diet control and eating
habits, and help with meals, walking and mobility, in addition to
reminding the patients of medication timings and helping them
work out to improve joint movement, accompanying the patients
to visit doctors, and sharing conversation with them.
 Therapeutic treatment (functional and physical therapy), which
includes:
- Rehabilitation of spinal cord diseases and injuries.
- Rehabilitation of diseases of the musculoskeletal system.
- Rehabilitation of rheumatism and osteoporosis.
- Rehabilitation of sports injuries and muscle spasm.
The project aims to attract at-home qualified nurses and
physiotherapists. The project works to develop these services and
make them safe and accessible for those who wish to benefit from
Project Description
them without problems through regular employment, As the
company employs, trains, and secures means of transport and
communication for them.
Investment Cost The project investment cost is about JD 321,000.

The Average Return
The average return on investment over ten years is about 10.8%
On Investment
Internal Rate Of
The internal rate of return for the project is about 19.7%
Return
Average Added Value The average added value of the project over ten years is about JD
Of The Project 319,000.
The Sensitivity Analysis indicates a low risk in case of 10% increase in

Risk Assessment investment cost, or 10% increase in operating costs, whereas a high
risk in case of 10% decrease in revenues.
 Providing home nursing service and physiotherapy in an organized
manner.
 Creating a safe environment for work and contracting with
households.
 Creating new jobs opportunities and reviving the economy.
 Employing more unemployed and / or retired nurses and
The Project
physiotherapists.
Justifications
 Lack of similar rehabilitation centers in the governorate, however
there are some people who perform this service at home after
they finish their work in hospitals.
 The Increasing demand for similar service centers in other
Governorates.
 The higher increase in private health insurance.
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 There are no integrated services for treating chronic medical

conditions which combine at-home nursing and physiotherapy
(physical and functional therapy).
 These services are currently provided within the governorate
individually and unorganized or through some institutions in
Amman.
 There are only centers for physiotherapy and there is still an
urgent need for other centers
 The Ministry of Health
Partners/Stakeholders
 Relevant municipality
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2. The Macroeconomic Environment
2.1 An Overview of the Hashemite Kingdom of Jordan
The Hashemite Kingdom of Jordan is a landlocked country surrounded by land except at its
southern extremity at the port of Aqaba, where that area is the only sea exit area in Jordan.
The Kingdom is bordered at its west side by Palestine and the Mediterranean Sea, at its
south and east by the Kingdom of Saudi Arabia, at north east by Iraq and at north by Syria.
Figure 1: Map of the Hashemite Kingdom of Jordan
Jordan is marked by three climatic zones from west to east including the Jordan Valley, most
of which lies below sea level and is considered subtropical, and upland areas to the east of
the Jordan Valley, ranging in height from 100 to 1500 meters above sea level and this is one
of the areas dominated by Mediterranean climate, and the desert areas stretching to the
east of the highlands.
The total area of the Kingdom is approximately 89.3 thousand square kilometers, and the
semi-desert conditions prevail in over 80% of this area where there are some wet lands
settings like Azraq Basin.
The kingdom is divided administratively into twelve governorates distributed into three
regions: the Northern Region (includes the governorates of Irbid, Mafraq, Jerash and Ajloun)
while the Central Region (includes the governorates of the capital, Zarqa, Balqa, Madaba)
and the Southern Region (includes the governorates of Karak, Tafila, Ma'an, Aqaba), and the
major cities are Amman (the capital), Zarqa and Irbid.
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2.2 Population
Based on the General Census of Population and Housing in 2015, the population in the
kingdom amounted to about 9.5 million people with a population density of 107.3
inhabitants per km2, where the Capital City knocked off other governorates by population
amounting to about 4 million people and a population density of 538.8 inhabitants per km2,
mainly because Amman is the most attractive governorate for Jordanians and for those
coming to Jordan from other countries, followed by Irbid Governorate with a population of
1.8 million people, and then Zarqa Governorate with a population of 1.4 million. Tafila
Governorate which is considered to be the least populous governorate whose population is
about 96 thousand people.
Table 2: Number of population and population density in the Kingdom for 2015
Population density
Governorate Population (people) Area (Km2)
(people/ km2)
Central Region
Capital 4007526 ,,5,7 528.8
Zarqa 1364878 4761 286.7
Balqa 491709 1120 439.0
Madaba 189192 749 201.3
North Region
Irbid 1770158 1572 1126.1
Mafraq 549948 26551 20.7
Jerash 237059 410 578.2
Ajloun 176080 420 419.2
Southern Region
Karak 316629 3495 90.6
Tafeileh 96291 2209 43.6
Maan 144082 32832 4.4
Aqaba 188160 6905 27.2
Total of Kingdom 9531712 88793.5 107.3
Source: Department of Statistics, Jordan General Population and Housing Census, 2015
On the other hand, the population growth rate has reached about 3% in 2010 and increased
to 9% during the years 2013 and 2014 and then dropped a little during 2015 to reach about
8%, according to demographic surveys for the Department of Statistics. The reason for the
high growth rates is attributed to the influx of large numbers of refugees from Syria to the
Kingdom which resulted in a marked decline in per capita real GDP index by 5.4% to JD
1,197.4, based on the Statements of the Central Bank of Jordan.
The unemployment rate among Jordanians also witnessed a rise by 1.1 percentage to reach
to 13%, due to the structural imbalances that the labor market is suffering from and the
acquisition of the low-paid foreign workers on a large number of new jobs in the economy,
according to the Central Bank of Jordan.
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Table 3: Number of population and population growth in the Kingdom, thousand

2010 2011 2012 2013 2014 2015
population 6698.0 6993.0 7427.0 8114.0 8804.0 9531.7
growth rate %2 %4 %6 %7 %7 %8
Source: Department of Statistics
Figure 2: population growth rate in the Kingdom

10%
9%
8%
7%
6%
5%
4%
3%
2%
1%
0%
2010 2011 2012 2013 2014 2015
growth rate
9
2.3 Economic Indicators in the Kingdom 1
Countries across the Middle East are still suffering from instability and closure or partial
closure of borders; including the borders of important markets for the Kingdom’s products.
These factors led to a decline in the performance of many of the economic sectors, including
the external sector, national exports, touristic income, and Foreign Direct Investment (FDI),
and they contributed to a slowdown in the economic growth to about 2.4% in 2015,
compared to 3.1% in 2014. The growth achieved in 2015 came from growth across several
economic sectors, especially in the finance, insurance, and real estate services; the
transport, storage, and communications services; the mining industry; the manufacturing
industry; and the agriculture sector. These sectors contributed a combined 1.8 percentage
points (or 75%) of the growth rate achieved during 2015, reflecting the diversity of the
economic growth sources in the Kingdom.
Additionally, the general price level registered a decline in the prices of oil, commodities,
and other related services in the global markets. Therefore, the general price level,
measured by the relative change in the average consumer price index deflated by 0.9% in
2015, compared to the inflation of 2.9% in 2014.
The budget deficit, after aid, increased by 1.2% to a record 3.5% of GDP, compared with
3.2% in the previous year. In addition, the Balance of Payments’ Current Account recorded a
deficit of 8.9% of GDP, compared with 7.3% in 2014. At the end of 2015, the net public debt
amounted to 22,847.5 million Jordanian Dinars (85.8% of the GDP), with an increase of 5.0%
of the GDP. However, the total public debt reached 24,876.5 million Jordanian Dinars (93.4%
of GDP). This increase resulted from financing both the general budget deficit and the
guarantees for loans for the National Electricity Company and the Water Authority, as well
as the slowdown of economic growth during 2015. The indebtedness of the National
Electricity Company and the Water Authority recorded 6.7 billion Jordanian Dinars at the
end of 2015.
On the monetary and banking front, most monetary indicators experienced positive
development in performance in 3915, primarily in the Central Bank’s foreign reserves, which
maintained comfortable levels that amounted to about $14.2 billion. The dollarisation rate
decreased, which reflected positive demand for Jordanian Dinars in comparison to other
major foreign currencies. With regards to the activities of licensed banks, the outstanding
balance of credit increased by 9.5%, to reach 21,103.5 million Jordanian Dinars at the end of
2015. The total deposits registered with licensed banks increased by 7.7%, to reach 32,598.5
million Jordanian Dinars at the end of 2015. The increase in deposits came as a result of the
high dinar deposits, which increased by 2,001.4 million Jordanian Dinars (8.3%), and higher
foreign currency deposits, which increased by 336.1 million Jordanian Dinars (5.4%).
Furthermore, many of the external sector indicators registered a drop in performance in

2015 due to the deepening instability in the region and almost full closure of the borders
1
The Central Bank of Jordan
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with Iraq and Syria. However, the drop in oil prices in the global markets contributed to the
decline in the Kingdom’s imports bill for energy, as it dropped by 49.6%, which in turn
contributed to a decline in total imports and the trade deficit by 11.4% and 14.0%,
respectively. Thus, the Current Account, excluding aid, declined to 11.9% of GDP, compared
to 12.4% in 2014.
The Current Account deficit increased after aid, to reach 2,365.6 million Jordanian Dinars
(8.9% of GDP) in 2015, compared with a deficit of 1,851.7 million Jordanian Dinars (7.3% of
GDP) in 2014. This decline is due mainly to the decline in total exports by 6.6% and the
decline in surplus in the services account by 27.7%, as touristic income decreased by 7.1%,
and the decline in the surplus in the current transfers account decreased as a result of
reduced foreign aid.
Capital and financial accounts resulted in a net inflow of 1,593.7 million Jordanian Dinars in
2015, compared to 909.0 million Jordanian Dinars in 2014; this was due to the Kingdom’s
higher net obligations towards the outside world. Foreign Direct Investment registered a net
inflow of 909.4 million Jordanian Dinars, and the reserved investment registered an inflow of
918.4 million Jordanian Dinars due to the Kingdom issuing Eurobonds that are worth $2.0
billion in the global markets. The withdrawal of bank loans on behalf of the Central Bank
increased the use of funds from the International and Arab Monetary Funds by 543.3 million
Jordanian Dinars. This led to the registration of a surplus in the overall Balance of Payments
of 328.7 million Jordanian Dinars during 2015, compared to a surplus of 1,550.7 million
Jordanian Dinars during 2014.
According to the Central Bank of Jordan, the increased international investment at the end
of 2015 showed an increase in the external net liabilities of the Kingdom, which reached
24,357.5 million Jordanian Dinars, compared with 22,578.8 million Jordanian Dinars at the
end of 2014. This was due to an increase in the external balance of assets and financial
liabilities for all of the economic sectors in the Kingdom, which reached to 18,657.9 million
Jordanian Dinars and 43,015.5 million Jordanian Dinars, respectively, during 2015.
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Table 4: main economic indicators 2011 to 2015 in millions of dinars

2111 2112 2113 2114 2112
Population (millions) 6.993 7.427 8.114 8.804 9.532
Unemployment rate 12.9 12.2 12.6 11.9 13.0
Production and Prices
GNP at current market prices 20,288.8 21,690.0 23,611.2 25,141.2 26,289.6
GDP at current market prices 20,476.6 21,965.5 23,851.6 25,437.1 26,637.4
The rate of growth in GDP at constant
2.6 2.7 2.8 3.1 2.4
market prices (%)
The total national disposable income
23,743.5 24,774.9 28,424.5 30,302.1 30,234.7
at current prices
The rate of growth in gross national
disposable income at current prices 4.7 –0.2 8.6 3.1 –2.4
(%)
Change in the index of consumer
4.2 4.5 4.8 2.9 –0.9
prices (%)
The change in the GDP deflator (%) 6.4 4.5 5.6 3.4 2.3
Money and Banking
Exchange rate of the Jordanian dinar
1.410 1.410 1.410 1.410 1.410
to the US dollar
Money supply (P2) 24,118.9 24,945.2 27,363.4 29,240.4 31,605.5
Net foreign assets of the banking
9,370.1 6,665.5 6,923.4 7,932.3 8,137.3
system
Net domestic assets of the banking
14,748.8 18,279.7 20,440.0 21,308.1 23,468.2
system
Net debt of the government 6,701.4 9,461.3 10,494.8 10,473.9 11,386.4
Private sector debts (Residents) 14,925.0 15,953.6 17,222.5 17,852.8 18,704.5
(1)
Other factors –6,877.6 –7,135.2 –7,277.3 –7,018.5 –6,622.7
Deposits in dinars at licensed banks 19,119.1 17,711.1 21,003.0 24,013.1 26,014.5
Foreign currency deposits at licensed
5,258.8 7,258.6 6,590.2 6,247.9 6,584.0
banks
Rediscount rate (%) 4.50 5.00 4.50 4.25 3.75
Treasury bills interest rate for 6
3.232 3.788 - - -
months (%)
Public Finance
Total revenue and foreign aid 5,413.9 5,054.2 5,758.9 7,267.6 6,796.4
Ratio to GDP (%) 26.4 23.0 24.1 28.6 25.5
Total spending 6,796 6,878.2 7,077.1 7,851.1 7,722.9
Ratio to GDP (%) 33.2 31.3 29.7 30.9 29.0
Overall deficit/savings (on an accrual
–1,382.7 –1,824.0 –1,318.2 –583.5 –926.5
basis)
Ratio to GDP (%) –6.8 –8.3 –5.5 –2.3 –3.5
Net outstanding balance of the
8,915.0 11,648.0 11,863.0 12,525.0 13,457.0
domestic public debt
Ratio to GDP (%) 43.5 53.0 49.7 49.2 50.5
(2)
Outstanding external public debt 4,486.8 4,932.4 7,234.5 8,030.1 9,390.5
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2111 2112 2113 2114 2112

Ratio to GDP (%) 21.9 22.5 30.3 31.6 35.3
Foreign Trade and Balance of Payments
Current account –2,098.8 -3,344.9 -2,487.7 -1,851.7 -2,365.6
Ratio to GDP (%) –10.2 –15.2 –10.4 –7.3 –8.9
Trade balance (Deficit) –6,261.7 –7,486.6 –8,270.1 –8,495.6 –7,249.3
Ratio to GDP (%) –30.6 –34.1 –34.7 –33.4 –27.2
Commodity exports 5,684.5 5,599.5 5,617.9 5,953.6 5,558.3
(3)
Imports of goods (FOB) 11,946.2 13,086.1 13,888.0 14,449.2 12,807.6
Balance of services (net) 896.0 1,332.3 1,209.5 1,778.9 1,286.4
Income account (net) –187.8 –275.5 –240.4 –295.9 –347.8
Current transfers (net) 3,454.7 3,084.9 4,813.3 5,160.9 3,945.1
Capital and financial account (net) 2,298.9 3,808.9 1,811.1 908.9 1,593.7
Direct foreign investment in Jordan
1,055.0 1,074.3 1,281.2 1,426.7 905.1
(net)
Source: Monthly Statistical Bulletin, Central Bank of Jordan
3. Includes the debts of public and financial institutions and other factors, as shown in the Monetary Survey
Agenda.
4. This represents the total balance of drawn loans, minus total repayments.
5. Does not include imports of non-resident entities.
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2.4 The Jordanian Investment Environment
Investment Law No. 30 for 2014
Investment Law no. 30 for 2014 is considered an appropriate legislative framework to attract
foreign investments and stimulate local investments. It is considered a competitor to other
investment laws in the region because it contains many advantages, incentives, and
guarantees, and it offers a range of incentives and benefits in and outside the Development
and Free Zones. The law includes a series of public provisions, such as foreign investment
guarantees (depositing and withdrawal of capital, investment management, and transfers)
and the inadmissibility of the disbarment of investment property. The law offers provisions
to settle investment disputes, protection, and encouragement of mutual investment
agreements between the Kingdom and other countries.
The following shows the major incentives granted by the law:
 Incentives and Benefits outside the Development and Free Zones
 The production inputs for the industrial and crafts sectors are exempted from customs
duties.
 The return of the general sales tax on the production inputs for the industrial and crafts
sectors within 30 days.
 Production inputs and fixed assets of the industrial and crafts sectors are exempted
from customs duties and are granted a reduction in general sales tax to 0%.
 Returning to the sales tax on the services needed to practice economic activity within
30 days.
 The goods that are necessary for the economic activities of the following sectors are
exempted from customs duties and are subject to 0% general sales tax:
- Agriculture and livestock, hospitals and specialised medical centres, hotels and
touristic facilities, touristic entertainment and recreation centres, call centres,
scientific research centres and laboratories, art and media production, convention
centres and exhibitions, transfers and/or distributions and/or extraction of water,
gas and oil derivatives, air transport, maritime transport, and railways.
 Incentives and Benefits inside the Development and Free Zones
 5% income tax on the income generated from economic activity within the
Development Zone.
 5% income tax on income generated from economic activity in the industrial sector.
 Tax exemptions that are granted in the Kingdom on goods and services exports.
 Reduction of sales tax to 0% on goods and services that are used by the establishment
in order to exercise its activity inside the Development Zone.
 7% sales tax on specific services provided by a registered company in the zone when
these services are consumed in the zone.
 Exemptions from customs duties except for a specified number of goods.
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 The Reduction of Income Tax in the Least Developed Areas for Regulation No. 44 for
2016
 The reduction of income tax in the least developed areas for Regulation No. 44 for 2016
was approved. It aims to create an attractive environment for investments that
promote economic development through the reduction of income tax outside the
Development Zones and in the least developed areas in the Kingdom. The regulation
specified the areas that are considered least developed and identified the activities that
are excluded from this reduction.
 Under the provisions of Articles 4 and 5 of this regulation, the areas that were
categorised as least developed and enjoy the reduction in income tax are divided into
four categories; each category enjoys a reduction in income tax on their activities for a
period of 20 years.
 Category A includes the Northern Valley District, Deir Alla District, Shouneh Al-
Janoubieh District, the Southern Valley District, Rweished District, the Northern Desert
District, the North Western Desert District, Al-Azraq Province, Al-Jiza District except for
the borders of the new Al-Jiza municipality, Al-Moakar District except for the borders of
Al-Moakar municipality, and the Governorate of Aqaba except for the Aqaba Special
Economic Zone. The reduction rate for this category is 100%.
 Category B includes the Governorates of Maan, Tafileh, Karak, and Ajloun. The
reduction rate for this category is 80%.
 Category C includes the Governorates of Jarash, Mafraq, and Irbid except the borders of
the Greater Irbid Municipality. The reduction rate for this category is 60%.
 Category D includes the Governorates of Madaba, Balqa, Amman except for the Greater
Amman Municipality, and Zarqa except for the borders of Zarqa Municipality and
Russaifeh Municipality. The reduction rate for this category is 40%.
 Trade and Free Trade Agreements
The most important agreements are:

 Jordan joining the World Trade Organisation in 2000, which led to the opening of the
markets of 150 countries for Jordanian exports in goods and services, and provided new
opportunities of access to other countries within a clear and transparent environment
of laws, regulations, and procedures.
 A series of regional trade agreements, such as the Jordan Partnership Agreement with
the European Union, Agadir Agreement, Free Trade Arab Agreement, the free trade
agreement between Jordan and the European Free Trade Association, and the adoption
of the Euro-Mediterranean simplification of the rules of the Origin System, which
includes the decision to simplify the rules of the origins of Jordanian products between
Jordan and the European Union came into effect on July 19, 2016, and will remain in
effect until December 31, 2026.
 A series of bilateral trade agreements with many countries, such as the free trade
agreement between Jordan and the United States of America, the Qualified Industrial
Zones Agreement, the free trade agreement between Jordan and Singapore, the free
15
trade agreement with Turkey, the free trade agreement with Canada, and many other
agreements.
 Jordan has signed more than 35 agreements with Arab and foreign countries in order to
prevent double taxation between Jordan and these countries, thus protecting investors’
rights.
 The Agreement of Promotion and Protection of Investments and the Movement of
Capital between the Arab Countries was signed in 2000 with 11 Arab countries who are
members of the Arab Economic Unity Council, in order to establish an appropriate
environment for investments and economic cooperation between investors in the Arab
countries, thus pushing and stimulating investment activities by providing
encouragement and mutual protection for Arab investments.
Human Development Report for 2015
The Human Development Report that was issued by the United Nations Development
Program in 3915 showed that Jordan fell 2 points to number 89. Please note that Jordan’s
place on the Human Development Report index value has improved slightly.
Global Competitiveness Report
The Kingdom’s rank has improved by one point in the Global Competitiveness Report for the
year 2016/2017, at 63 out of 138 countries compared to 64 out of 140 countries in the
2015/2016 report. It is considered an insignificant improvement, especially because of the
reduction in the number of countries participating in this year’s report. Amongst the Arab
countries, Jordan was ranked after the United Arab Emirates, Qatar, the Kingdom of Saudi
Arabia, Kuwait, and Bahrain, who were ranked 16, 18, 29, 34, and 39, respectively.
Doing Business Report
In the Doing Business Report that was issued by the World Bank Group, Jordan is still ranked
118, up one rank from the 2016 report, because of the variation in the performance of the
different sub-indicators. Jordan ranked ninth among the Arab countries; the United Arab
Emirates was ranked first among the Arab countries at 26, followed by Bahrain at 63 and
Oman at 66.
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2.5 The Economic Environment in the short and medium term
Risks analysis implemented by BMI indicates that the Jordan's political and economic risks in
the short and medium term are less than the overall average of the world and the Middle
East. The state's risks and the operational risk are estimated to be within the acceptable
levels. The international institutions' forecasts point out that the economic and foreign trade
indicators are expected to achieve acceptable rates of growth with the exception of the
continued increase in internal and external indebtedness.
Table 2: Assessment of short and long-term risks

Long term Short term Operational State
political Economic political economic risks risks
Jordan 63.1 39.2 66.6 46.2 58.7 55.4
Turkey 60.2 49.4 58.4 56.9 55.9 56.1
Egypt 53.3 45 52.4 48.7 42.9 47.5
Lebanon 45.8 54 55.4 53.5 44.2 49.5
West Bank and
33.1 38.1 32.2 36.5 32.5 34.3
Gaza
Syria 22.9 24.4 22.4 23.6 29.3 26.1
Regional average 49.4 46.9 51.2 48.7 46.6 48.3
global average 64.1 50.7 61.3 51.9 49.8 54.6
Source: the economy and state risks, IHS, 15/09/2016
Table 6: The most important key economic indicators 2016-2020

Indicator 2016 2017 2018 2019 2020
The growth rate of GDP 2.6 2.7 2.8 3.2 3.1
GDP (in USD billions) 39.6 42.1 44.8 47.8 50.9
Population (In millions) 9.8 10.1 10.4 10.7 11.0
Consumer Price Index (% change) -0.7 1.8 3.3 4 3.2
Exports (in USD billions) 7.3 7.6 8.2 8.8 9.6
Imports (in USD billions) 18.3 19.2 20.1 21.3 22.8
Foreign direct investment, the net value (in USD
1.5 1.5 1.6 1.6 1.7
billions)
Foreign direct investment, the net value (% of
3.7 3.7 3.6 3.4 3.3
GDP)
Foreign exchange reserves (in USD billions) 13.9 14.9 15.7 16.8 17.7
Total external debt (in USD billions) 24.4 27.8 30.7 33.7 36
Total external debt (% of GDP) 61.6 66 68.6 70.4 70.6
Total external debt (% of foreign currency
127.3 138.3 143.6 147.5 147.8
earnings)
Source: the economy and state risks, IHS, 15/09/2016
17
3. Market Study
3.1 Project Description
The project aims to attract at-home qualified nurses and physiotherapists. The project seeks
to develop these services and make them safe and accessible for those who wish to benefit
from them without problems through regular employment. As the company employs, trains,
and secures means of transport and communication for them. The importance of the project
is that it shortens the length of stay of patients in the hospital and reduces the expenses,
whether incurred by patients or insurance companies and ensure the continuity of care and
treatment in the patient's home and the continuity of educating the patient in consistence
with his need. The project includes:
 Post-surgical rehabilitation, wound care, provision of care for skin ulcers and diabetes
care and maternity care
 Non-medical care services provided by nursing staff and service providers to assist the
elderly, the disabled and the patients to recover and recuperate in their own homes.
 Nursing observation including follow-up on the condition which requires long-term
follow-up for chronic diseases.
 Monitoring the condition in general after leaving hospital.
 physiotherapy (physical and functional therapy)
3.2 Expected Services Description
Services of the Project include:
 Providing nursing services for the patient at home around the clock for chronic and
incurable medical conditions such as cerebral coma and elderly conditions. The
patient is provided with accompanying male / female nurse on two shifts (night / day)
to perform the following tasks and services for the patient:
 Providing medical equipment for incurable cases such as medical bed, respirator,
suction apparatus, sphygmomanometer, glucose meter, special towels, urine bags,
intravenous solutions, cannula, medical supplies such as cotton, syringes, etc…
 Observing the patients at home, measuring blood pressure and sugar, inserting
cannulas to take the blood samples, taking the urine samples to be tested from
time to time ... etc.
 Cleaning the patient and helping him with washing.
 Providing comfort to the patient at home and monitoring his / her health
condition.
 Giving the patient his medication regularly and according to the instructions of the
supervising physician.
 Postoperative rehabilitation, wound care, providing care after urinary catheter and for
skin ulcers.
 Dealing with the stool holes outside the abdominal wall.
18
 Treatment with intravenous injection at home.

 Diabetes care
 Psychotherapy, respiratory therapy, and referring to hospitals when necessary
 Coordinating with ambulance services.
 Non-medical care services provided by a range of nursing assistance and service
providers to help the elderly, the disabled and patients to recover and recuperate in
their own homes, including help with bathing and dressing, diet control and eating
habits, and help with meals, walking and mobility, in addition to reminding the
patients of medication timings and helping them work out to improve joint
movement, accompanying the patients to visit doctors, and sharing conversation with
them.
 Therapeutic treatment (functional and physiotherapy) which includes:
 Rehabilitation of spinal cord diseases and injuries.
 Rehabilitation of diseases of the musculoskeletal system.
 Rehabilitation of rheumatism and osteoporosis.
 Rehabilitation of sport injuries and muscle strain.
3.3 The Current Status of Health Sector
The total number of hospitals in the Kingdom in 2015 was 102 hospitals according to the
annual report of Ministry of Health, including 31 hospitals of Ministry of Health and 12
hospitals for Royal Medical Services in addition to 59 hospitals of the private sector, while
the number of beds per 10,000 populations amounted to 13 beds. The number of
admissions in Ministry of Health hospitals in the Kingdom increased during the years from
2011 to 2015.
Figure 3: The Number of Admissions in Ministry of Health Hospitals during the years from 2011 to
2015
380000
370000 369538
360000
354699
350000
347929
340000 339628
332607
330000
320000
310000
2011 2012 2013 2014 2015
Source: Ministry of Health, 2015 Annual Statistical Report
19
With regard to health centers, the numbers of health centers in the Kingdom reached 675
health centers in 2015, 99 of which are comprehensive centers, 378 are primary centers and
198 are secondary centers.
At the level of Zarqa Governorate, the health sector is one of the sectors whose indicators
are still low compared with their percentage at the Kingdom`s level. The number of primary
healthcare centers in Zarqa reached 109 centers accounting for 7% of the kingdom's total
primary health centers. The average population per health center is 12522 individuals, which
is much higher than average of the Kingdom which is 6202 individuals.
As for the indicators of the primary health services sector, the hospital sector undergoes
similar problems related to pressure placed on services and lack of cadres. In Zarqa
Governorate, there are 8 hospitals containing 1315 beds, including 5 private hospitals
containing 315 beds and 3 hospitals for the public sector containing 1000 beds.
The number of beds per 10,000 people in Zarqa Governorate is 10 beds, which is lower than
the average of the Kingdom, which are 13 beds. Moreover, this average decreases
significantly, particularly in the private sector hospital beds which reach about half of the
average of the Kingdom. This is may be attributed either to the low purchasing power of the
population or to the poor quality of health services and their non-inclusiveness of required
specializations in private hospitals, it also may be because the governorate is near Amman,
where the populations can obtain special medical services from the service providers in the
capital.
It is also noted that the average number of the employees per bed in Zarqa Governmental
Hospitals is the lowest in the Kingdom as it amounts to 0.5, while the average of the
Kingdom is 3.1 employees per bed.
Employment in the Sector
The number of employees in the health sector in Zarqa Governorate is 5,872 employees,
accounting for 3.2% of the total workforce in Zarqa Governorate and 8.4% at the level of the
Kingdom. The number of workers in the health sector in Zarqa Governorate is less than the
employment rate in the health sector of the Kingdom, the matter which reflects the need to
pay attention to the sector and provide it with sufficient health personnel.
Table 7: Number of employees in health sector:

Zarqa % of Governorate to
Sector Kingdom
governorate Kingdom
Number of employees in
5,872 69,902 8.4%
health sector
Total number of employees 183,507 1,398,029 13.13%
Ratio of employees in health
3.2% 5%
sector
Source: Department of Statistics, Employment & Unemployment survey 2015, study team Calculation
20
3.4 Market Analysis
Zarqa Governorate is lacking the integrated home healthcare companies providing all the
services needed by patients with chronic diseases and cases requiring follow-up and special
care after accidents, fractures, burns, surgeries, care for the elderly, children or women after
deliveries and other home healthcare services. The services provided in the governorate are
limited to the physiotherapy services in specialized centers which is required by certain
medical conditions resulting from accidents or fractures injuries, while the other conditions
seek home healthcare services from the neighboring governorates, particularly the capital.
As the number of home nursing centers in the Kingdom has reached 65 centers, including 53
in Amman, according to the statistics of Ministry of Health. The number of physiotherapy
and rehabilitation centers in the Kingdom has reached 75 independent centers outside
hospitals, 51 of which are located in Amman.
The Market analysis of healthcare services depends on several factors, including the number
of hospital admissions and the number of surgeries, particularly those in need for care and
follow-up after surgeries, in addition to the prevalence of chronic diseases and burns cases
at the level of Zarqa or the Kingdom as a whole. The following table shows the number of
admissions in Ministry of Health sector and the private sector in Zarqa Governorate.
Admissions
Table 8: Hospital admissions in 2015

No. of
Hospitals Sector No. of Beds No. of Sick Days
Admissions
Ministry of Health Hospitals 674 44,960 151,146
Private Hospitals 283 28,104 48,939
Total of Zarqa Governorate 957 73,064 200,085
Kingdom's Total of Both Sectors 8,308 641,971 1,692,657
Ratio of Kingdom 12% 11% 12%

Source: Ministry of Health, 2015 Annual Statistical Report, a study team Calculation
The following table also shows the special admissions of Ministry of Health hospitals in Zarqa
Governorate, foremost of which are the surgeries, orthopedic, obstetrics, Gynecology,
urology, and intensive care, which are the most important admissions which may require
home healthcare services.
21
Table 9: The Admissions of MINISTRY OF HEALTH hospitals in Zarqa and the kingdom for 2015
Ratio of Admissions to
No. of No. of Sick
Item the Sector's Total
Admissions Days
Admissions
General Surgery 8,239 27,797 18%
Orthopedics 2,273 8,407 5%
Obstetrics & Gynecology 14,600 29,262 32%
Urology 314 729 1%
ICU 1,764 7,285 4%
CCU 515 2,123 1%
others 17,255 75,543 38%
total 44,960 151,146 100%
Total of Kingdom 369,538 1,154,942
Ratio of Governorate to Kingdom 12% 13%

Source: Ministry of Health, 2015 Annual Statistical Report, study team Calculation
The following table shows the ambulance and emergency service recipients at Ministry of
Health hospitals in Zarqa Governorate for 2015.
Table 11: Ambulance and emergency service recipients at Ministry of Health hospitals for 2015
Non-
Item Emergency Total
emergency
Ministry of Health Hospitals in Zarqa
65,369 159,994 225,363
Governorate
Total of Kingdom 1,244,605 1,732,910 2,977,515
Ratio of Zarqa Governorate to Kingdom 5% 9% 8%

Surgeries
With regard to the surgeries; the orthopedic, plastic and burn surgeries are the most
surgeries which need special postoperative care and follow-up. Medical conditions of this
type of operations require follow-up and additional treatments after surgery to fully recover.
The following table shows the number of surgeries in Ministry of Health hospitals and
private hospitals in Zarqa Governorate. It is noted that the orthopedic surgeries accounted
for about 10% of the total surgeries performed in the governorate, while the ratio of plastic
22
and burns surgeries were the lowest ratios and accounted for only about 1% of the total
surgeries.
Table 11: Surgeries of 2015
Ratio of
Ministry Ratio of
Surgeries
Ministry Zarqa's of Private Kingdom's Zarqa
Performed
of Private Hospitals Health Hospitals Total of Governorate
Type of Surgery to the
Health Hospitals of Both Hospitals in the Both to the
Total
Hospitals Sectors in the Kingdom Sectors Kingdom's
Surgeries
Kingdom Total
in Zarqa
General Surgery 2,940 5,131 8,071 17,785 38,743 56,528 34% %14.28
Chest Surgery &

0 9 9 829 3,005 3,834 0% %0.23
Blood Vessels
Neurosurgery 0 145 145 954 4,340 5,294 1% %2.74
Orthopedic Surgery 1,750 740 2,490 10,263 13,246 23,509 10% %10.59
Plastic & Burns 79 140 219 1,073 5,439 6,512 1% %3.36
Urology Surgery 458 1,169 1,627 3,624 8,671 12,295 7% %13.23
Pediatric Surgery 0 428 428 2,855 3,965 6,820 2% %6.28
Otorhinolaryngology 847 1,471 2,318 5,986 12,990 18,976 10% %12.22
Ocular Surgery 1,100 48 1,148 8,397 14,104 22,501 5% %5.10
Gynecological
3,661 3,526 7,187 33,502 28,027 61,529 30% %11.68
Surgery
Oral & Maxillofacial
39 58 97 3,666 1,266 4,932 0% %1.97
Surgery
Others 0 0 0 56 4 60 0% %0.00
Total 10,874 12,865 23,739 89,047 133,800 222,847 100% 10.65%
The surgeries are classified into three sections: minor, medium and major surgeries. The
ratio of major surgeries in the Kingdom is 43.84%, the medium surgeries account for 25.7% ,
while the minor surgeries account for a ratio of 30.45%. It is noted that the ratio of major
surgeries which need special postoperative follow-up and care account for the largest
proportion of surgeries in Ministry of Health hospitals in Zarqa Governorate, the matter
which requires specialized services to take care of this type of surgeries.
23
Table 12: Surgeries classified by its degree in Ministry of Health hospitals for 2015
Degree Ratio of Ratio of

Zarqa Prince Faisal Total of Ratio of
of Surgeries Zarqa to
Hospital Hospital Kingdom (kingdom)
Surgery (Zarqa) kingdom
Minor 2,515 763 27,118 30.45 %30.15 %12.09
Medium 1,826 1,065 22,888 25.7 %26.59 %12.63
Major 3,229 1,576 39,041 43.84 %43.27 %12.05
Total 7,570 3,304 89,047 100 100% 12.21%

Burn Cases
The admissions of burn cases at Ministry of Health hospitals in Zarqa Governorate account
for about 22% of the total burn cases, while 11% of the cases are referred, and the other
67% are treated. At the level of the Kingdom, the ratio of burn cases in Ministry of Health
hospitals in Zarqa was only 2% of the total cases in the Kingdom. The following table shows
the number of burn cases in Ministry of Health hospitals in Zarqa for 2015.
Table 13: Number of burn cases in Ministry of Health hospitals for 2015
Referred to
Name of
Admissions Treated Another Total
Hospital
Hospital
Zarqa
60 180 30 270
Governorate
Total of kingdom 1,467 16,380 137 17,984
Ratio of Kingdom 22% 67% 11% 100%

% of governorate
4% 1% 22% 2%
to kingdom
The Elderly
With regard to the services which can be provided to the elderly, it was found that the ratio
of elderly persons over the age of 65 years in Zarqa Governorate to the Kingdom was 13%,
while the ratio of those over the age of 80 was about 11%.
The following table shows the distribution of age groups of older persons in Zarqa
Governorate and the Kingdom in 2015.
24
Table 14: Distribution of age groups of older persons in Zarqa and the Kingdom in 2015
Age group
Total population Zarqa ratio of
Age group Zarqa percentage in
of the kingdom the kingdom
Zarqa
65 years and above 45,117 351,679 3.3% 13%
80 years and above 5,962 52,047 0.4% 11%
Total population 1,364,878 9,531,712 100.0% 14%
Source: Department of Statistics, General Population and Housing Census 2015, study team Calculation
Chronic Diseases
The Department of Statistics carried out a survey of chronic diseases during the fourth
quarter of 2010 to a representative sample from all over the Kingdom. The survey covered
about 13 thousand families and its results are summarized as follows:
 About 34% of households in Jordan have at least one person with a chronic disease
 About 13% of the population in Jordan suffer from chronic diseases and it is higher
among females than males
 High blood pressure is the most prevalent disease among chronic diseases by 39%
 About 5% of people have high blood pressure and about 4% have diabetes
 About 11% of the population of Jordan aged 25 years and over have high blood
pressure
 The elderly are the most vulnerable to chronic diseases by about 6% of Jordan's
population
 95.5% of people with chronic diseases use medicines and treatments prescribed to
them
In addition, the national study on the prevalence of diabetes and other chronic diseases,
published by the National Center for Diabetes, Endocrinology and Genetics, indicated an
increase in the chronic diseases in Jordan. The following table shows the prevalence of
chronic diseases including diabetes, Arterial tension (blood pressure), Obesity and
Cholesterol in Jordan, in 2016.
25
Table 12: Prevalence of chronic diseases among the age group of 25 years and over, in Jordan during
2016.
The number of
The Level of disease The ratio of infected people to
infected people aged
Chronic Disease according to the approved the population of the kingdom
25 and older in the
measurement of the age group 25 and older*
Kingdom
Level of diabetes less than
2,403,534 54.9%
100
Diabetes Level of diabetes (100 - 125) 1,112,018 25.4%
The Level of diabetes is more
862,470 19.7%
than or equal to 126
High arterial Arterial tension 95/160 1,221,468 27.9%
tension Arterial tension 90/140 1,514,796 34.6%
Arterial tension 85/135 1,851,903 42.3%
BMI is less than 25 766,154 17.5%
Obesity
BMI (25 - 29) 1,462,259 33.4%
BMI is greater than or equal
2,149,609 49.1%
to 30
Total cholesterol
2,110,207 48.2%
Cholesterol
High - density cholesterol 1,611,112 36.8%
LDL cholesterol 2,092,695 47.8%
Triglycerides 2,022,646 46.2%
Source: National study on the prevalence of diabetes and other chronic diseases, National Center for Diabetes,
Endocrinology and Genetics.
* The percentages were calculated based on the total population of the Kingdom aged 25 and older. They are
4,378,022 persons.
In a report by World Health Organization (WHO) entitled "Chronic non-communicable

diseases, summary of countries 2014", Jordan reported that the mortality of the following
non-communicable diseases is as follows:
Table 16: Mortality of chronic diseases in Jordan during 2014

Disease Percentage
Cardiovascular diseases 35%
Cancer 15%
Respiratory diseases (asthma and crisis) 3%
Diabetes 7%
Source: World Health Organization, 2014
26
The risk factors among adults, which increase the effect of these chronic diseases, were as
illustrated in the following table.
Table 17: Risk Factors that increase the negative effects of chronic diseases
Ratio among males Ratio among
Risk Factors Ratio of total (%)
(%) females (%)
Smoking 47 6 26
Alcohol consumption rate 1.2 0.2 0.7
per capita (liter)
High blood pressure 21.1 16.5 18.9
(2008)
Obesity (2008) 24 36.4 30
Source: World Health Organization, Country Summary 2014 (Jordan, p. 100).
According to World Health Organization, the number of diabetics in the world increased
from 108 million in 1980 to 422 million in 2014, and the rate of diabetes among adults over
the age of 18 increased from 4.7% to 8.5% during the same period. Diabetes spreads faster
in low and middle income countries such as Jordan. It is a major cause of blindness (2.6%),
kidney failure, heart attacks, strokes and loss of lower limbs due to gangrene. Diabetes is
expected to be the seventh leading cause of death in the world by 2030. People with
diabetes are more likely to have heart attacks and strokes two to three times. The lack of
ischemia is responsible for the amputation and eradication of the lower limbs. Patients who
do not take diabetes or stress medications make up 50% of strokes.
Cancer
According to the National Cancer Registry in 2013, the rate of cancer in general for all ages
was 82.9 per 100,000 persons (76.1 for males and 90.1 for females), while crude infection
rate was 103.4 per million children (107.1 for males and 99.5 for females).
Table 18: The number of cancer cases classified by the nationality and the gender of the case in
Jordan during 2013.
Nationality -Gender Males Females Total
Jordanians 2,564 2,852 5,416
Non- 1,718 1,610 3,328
Jordanians
Total 4,282 4,462 8,744
Source: Ministry of Health, Report of National Cancer Registry, 2013
27
The following diagram shows the number of cancer cases in Jordan between 2000 and 2013.
Table 19: Number of cancer cases in Jordan since 2000 until 2013.
6000
5000
4000
3000
2000
1000
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
The following table shows the number of cancer cases in Jordan classified by the age group
and the gender of the case.
Table 21: Number of cancer cases classified by age group and gender in Jordan for 2013
Age Group Males Females Total
0-14 years old 134 118 252
15-24 years old 92 112 204
25 - 39 years old 248 440 688
40-59 years old 819 1,168 1,987
60 - 79 years old 1,128 897 2,025
80 years old or more 140 111 251
unknown 3 6 9
Total 2564 2852 5416
It is noteworthy that the five most common cancers among males are colorectal cancer,
which represent 12% among males, lung cancer (11%), bladder cancer (8.3%), prostate
cancer (7.7%), and leukemia (6.6%).
As for the most common cancers among females, breast cancer ranked first with 36.5%,
colorectal cancer by 9.4%, thyroid cancer by 6.1%, uterine cancer by 5.3%, and finally
leukemia by 4.7% of the total cancers. The following table shows the ten most common
types of cancer for Jordanian cases in 2013.
28
Table 21: The 10 most common types of cancer among Jordanians for both genders for 2013
Ratio of Total Jordanian
Type of Cancer Number
Cases
Breast 1,067 19.7%
Colon and rectum 593 10.9%
Lymph nodes 401 7.4%
lungs 346 6.4%
Leukemia 303 5.6%
Thyroid 233 4.3%
Bladder 231 4.3%
prostate 197 3.6%
Stomach 175 3.2%
brain 153 2.8%
It is noteworthy to the importance of the proposed project in Zarqa Governorate for

providing home nursing services for cancer cases in the governorate and neighboring
governorates, in which cancer cases are very high than the Kingdom's other governorates.
Table 22: The number of cancer cases in Jordan by governorate and gender in 2013.
Males Females Total

Governorate/gender
Amman 1,587 1,766 3,353
Zarqa 227 249 476
Balqa 123 133 256
Madaba 45 45 90
Total number in
1,982 2,193 4,175
Central Governorates
Irbid 303 342 645
Jerash 36 45 81
Ajloun 30 29 59
Al-Mafraq 45 43 88
Total number in
414 459 873
Northern Governorates
Karak 68 70 138
Aqaba 36 40 76
Ma`an 23 30 53
Tafileh 16 24 40
Total number of
143 164 307
Southern Governorates
Others 25 36 61
Total 2,564 2,852 5,416
29
Regarding the number of deaths from cancers of different types, the following table shows
these numbers classified by the age group of cases and gender in 2013.
Table 23: the number of deaths from cancer by gender and age group for 2013
Age group/gender Males Females Total
0-14 years old 24 18 42
15-24 years old 13 16 29
25 - 39 years old 63 71 134
40-59 years old 290 226 516
60 - 79 years old 483 275 758
80 years old or more 67 53 120
Total 940 659 1599
Demand Analysis
It is worth mentioning that it is difficult to determine the volume of demand for home
healthcare services due to many reasons. The most important reason is the increase in
chronic diseases that require home care in Jordan and worldwide; and it is difficult to expect
the pace of this increase, in addition to increasing awareness of these diseases and how to
prevent them or mitigate their effects. Most of these services offered to patients are not
covered in private insurance in Jordan, except physiotherapy. Accordingly, a field survey was
conducted on a sample of 95 people in Zarqa Governorate. The survey measured their
satisfaction about the healthcare services that can be provided by the company and how
they are receiving them, as well as their opinions about establishing an integrated company
to provide comprehensive home healthcare services in one specialized place in Zarqa
Governorate. The results of the survey concluded that 60% of the recipients had previously
received healthcare services.
Regarding how they received healthcare services, the survey concluded that 28.6% of the
recipients received these services by a nurse, 21.4% received them at a public or private
hospital, 20% by a doctor, 8.6% received them at a24-hour emergency center and another
8.6% in outpatient clinics. The results also illustrated that about 12.9% received healthcare
services by a physiotherapist. None of the recipients received these services through a home
healthcare company. The following table shows healthcare services received by the
recipients.
30
Table 24: Healthcare services received by the recipients.
Ratio of total Ratio of total

Service Number
services recipients
Giving injections 29 19% 31%

Measuring pressure/diabetes 42 28% 44%
Blood sampling 30 20% 32%
Natural therapy 7 5% 7%
Provision of medical equipment for 0%
0 0%
medical cases
Installing a urine bag 3 2% 3%
Cleaning and changing wounds 6 4% 6%
Cleaning and changing burns 0 0% 0%
Taking care of and helping fractures 1%
1 1%
cases
Accompanying an elderly patient and 3%
3 2%
taking care of him / her at night / day
Taking care of a helpless patient part 2%
2 1%
time/full time
Taking care of a coma patient 24 0%
0 0%
hours a day
Installing cannula for giving 27%
intravenous solutions, intravenous 26 17%
injections and taking blood sampling
An accompanying nurse after birth or 0%
0 0%
surgery (Filipino or local)
Other (general review) 1 1% 1%
Total *150 100%
Source: The Field Survey of the Study team
* Recipients can choose more than one service (total number of recipients: 95).
In addition, respondents were asked about their views on establishing a specialized company
to provide home healthcare services. 11% of them expressed their agreement and support
for establishing such a company in Zarqa Governorate. The following table shows the
services that the recipients want the company to provide.
31
Table 22: Healthcare services that recipients want to be provided in the home healthcare Company.
Ratio of Total Ratio of Total
Answer Number
Services Recipients
Rehabilitation and physiotherapy 25 17% 27.4%
Providing supervision and services
14 9% 14.7%
for total disability cases
Providing supervision and
11 7% 12.6
accompaniment for Aging cases
Taking care of and serving Coma
5 3% 5.3%
patients
Monitoring and measuring blood
20 13% 22.1%
pressure
Monitoring and taking care of burns 9 6% 9.5%
Taking care of and serving partial
11 7% 11.6%
disability cases
Taking care of fractures and
4 3% 5.3%
accidents cases
Taking care of diabetic cases
(measurements, giving medicines,
10 7% 11.6%
treating and changing the dressing
of limbs infections)
Providing medical devices and
11 7% 11.6%
supplies for the medical case
Providing the accompanying nurse
14 9% 15.8%
service (at day/ night)
Providing a 24-hour accompanying
7 5% 7.4%
nurse service
Providing an accompanying nurse
service for a short time after birth or 8 5% 9.5%
surgery
Total 149 100% 70
Source: The Field Survey of the Study team
*Recipients can choose more than one service.
Concerning the criteria for choosing a home healthcare center, the recommendation of the
doctor monitoring the case of the patient came in the first place as shown in the following
table.
32
Table 26: The criteria for choosing a home healthcare company.

Criterion Likely Weight
The recommendation of the doctor who
25.14
monitors the case of the patient
The recommendation of the hospital that
23.76
received and treated the case
Providing payment facilities 20.62
The fame and reputation of the company 19.90
The reputation of the staff in the company 18.67
The recommendation of a relative or friend 15.43
The results of the field survey of the healthcare recipients in terms of their satisfaction with
the services they received concluded that there is high satisfaction with these services. 77%
of all respondents indicated that they are satisfied with the quality of the services provided,
while 69%expressed their satisfaction with the manner of the supervising doctor, and about
63% were satisfied with hygiene and sterilization.
Overview of the Main Competitors
This part of the study shows the main competitors from home healthcare centers and
physiotherapy centers in Zarqa Governorate, and similar centers in Amman. It is worth
mentioning that Zarqa lacks specialized home nursing companies. Currently there is a
company operating partially in Zarqa city through its main branch in Shmeisani (Amman),
and an institution for selling medical equipment and supplies in Zarqa and meeting the
needs of clients on demand. There are also a number of physiotherapy centers whose
objectives are divided into educational, profit and civil society institutions. The following is
the most important information available about these centers.
Title of the Center Nour Al Ain for Home Nursing

Jordan, Amman - Shmeisani / Zarqa (through selling medical
Location
equipment and supplies)
Noor Al Ain provides home nursing services through its main branch in
General Amman. It provides services for day-to-day cases and intensive care
Description cases, in addition to accommodation services at the homes of chronic
cases and also for normal cases that require intensive care.
The center provides home nursing services for two types of cases:
normal cases require basic nursing services at the home of the case
Services provided
and cases requiring intensive care, as well as overnight stays at their
homes for normal or intensive care.
Prices of normal cases at the patient's home:
 8 hours a day: JD12
 12 hours a day: JD 35
Prices  24 hours a day: JD 50
Prices of intensive care at the patient's home:
33
The Name of the
Al Baidar Physiotherapy Center
Center
Location Jordan, Zarqa - Near Jabal Al-Zaytoon Hospital
General The center consists of two treatment rooms, a reception room and a
Description management room with an area of approximately 170 square meters.
The center provides physiotherapy services for each of the following:
 Muscle
Services provided  Bone injuries
 Nerves and spinal cord
 Sports injuries
Price per session JD 10-15 depending on the case
The Name of the

Al Ebdaa Physiotherapy Center
Center
Location Jordan, New Zarqa – St. 36
General The Center consists of four therapists who provide physiotherapy
Description services. The Center receives 250-300 cases per month.
 Muscle
Services provided  Bone injuries
 Nerves and spinal cord
 Child therapy
Price per session 10-15 dinars
The Name of the

Basmet Amal Physiotherapy Center
Center
Location Jordan, Zarqa - Rusayfah - Al-Rashid neighborhood
General The Center consists of two therapists who own the center and provide
Description physiotherapy services. It receives about 150 cases per month.
 Muscle
 Bone injuries
Services provided
 Sports injuries
 Child therapy
 Nerves and spinal cord therapy
Price per session JD 15
34
The Name of the

Al Batrawy Modern Center for Physiotherapy
Center
Location Jordan, Zarqa - Al Karama - Al Falah Roundabout
The area of the center is about 170 square meters and consists of a
General
reception room, a physiotherapy room for children and two treatment
Description
rooms in addition to a hydrotherapy room.
 Child therapy
Services provided  Physical therapy of all kinds
 Treatment of spinal cord injuries
 Treatment of bone and muscle injuries
Price per session JD 10 - 15
The Name of the

Yajouz Specialized Center for Physiotherapy
Center
Location Jordan, Yajouz - Northern Mountain
General
The center consists of two physiotherapy rooms and a reception room
Description
 Bone and muscle injuries
 Neurosurgery
Services provided
 Sports injuries
 Spinal cord injuries
Price per session JD 10
35
Name of the
Alsakinah for home nursing care
Center
Location Jordan, Amman
Alsakinah company provides home nursing services by the adoption
and a license from the Jordanian Ministry of Health and offers a group
of nursing care services, and private care services in the home
environment. The services include rehabilitation after surgery, wounds
care, then the care after the urinary catheter, Care of stool openings
outside the abdominal wall, injecting intravenous therapy at home,
care of dermal ulcerations, diabetes patients' care, maternity and
newborn. It also includes psychotherapy services, respiratory therapy,
General conversion to hospitals when it is necessary, and coordination with
Description ambulance services, for home care services are care services non
medical that is provided by a group of nursing assistances and service
providers to help the elderly people, the disabled, patients on
hospitalization and convalescence in their own homes, including to
help in bathing and dressing, control of diet and eating habits, help in
healthy foods, walking, movement, and to remind them of the dates of
medication and exercise to improve the movement of articulations,
accompany patients to visit doctors, the accompanying and the
conversation.
 Nursing Home
 Private care
Provided Services  Physical Therapy
 Accommodation on the system of morning and afternoon shifts
 Providing the medical supplies
 the morning shift (8:00 am - 6 pm) with a nurse: JD 30
 the morning shift (8:00 am - 6 pm) with accompaniment: JD 25
Price per session
 24-hour shift with a nurse: JD 50
 24-hour shift with escort: JD 40
36
Name of the
Rainsy for medical services
Center
Location Jordan, Amman - Shmeisani
Company specializing in patient healthcare and answering all their
needs in their homes under the standards of Jordanian Ministry of
health through providing more than 20 medical services by more than
100 medical staff, as the company provides more than 5000 medical
device for patients.
In addition to therapeutic services provided by the company, it

provides patient transfer service from hospitals to homes and across
all provinces of the Kingdom, in addition to transfer of patients from
General
the Jordan bridge and by transferring of patients to Gulf Cooperation
Description
Council and North Africa.
The company has also allocated a special section to provide superior

care to patients from all over the world under the concept of medical
tourism, as the assistance of all administrative and logistical measures
such arranging appointments, consultancy and accommodation to
persons accompanying patients in addition to the assistance in any
financial procedures and providing interpretation services if it is
necessary.
 Home nursing
 Physical therapy
 Patients transfer
 Children accompanying
 Providing medical devices
 Radiography
Provided Services  Bio-Analyses
 Wounds and ulcers care
 Diabetic foot care
 Giving intravenous injections and muscular
 food regulation
 Personal care
 Medical tourism
37
Name of the
Almajd to the nursing services
Center
Location Jordan, Amman - Sports city
The Company provides home nursing services in patients ' homes
either by providing specific services through independent visits or
General
through overnight at patients' homes and caring for them and watch
Description
them for a certain time of the day or throughout the entire day, in
addition to providing necessary medical devices for patients.
 Nursing home
Provided Services
 Providing medical devices
 Matinee system / the evening 12-hour: JD 35
 24-hour system to become a full or two shifts: 60 JD
 Nursing Accompanying around the clock: JD 1,300 monthly
Price per session
 Visiting a patient to give needles, or installing feeders or Urine bags
and other: JD 25
 Patient bed rent: JD 100 per month
It is worth-noting that King Hussein Cancer Center consists of the Department of cancer
patient's care in their homes and it is the Department of palliative care, which emphasizes
the importance of a service to take care of cancer patients outside of the hospitals,
especially in advanced stages of the disease. The following provides some information about
the department.
Name of the
King Hussein Cancer Center – Palliative care
Center
Location Jordan, Amman - King Hussein Cancer Center
Nursing staff in the Department of palliative care at King Hussein
Cancer Center are divided into two types, namely internal nursing and
external nursing. Internal staff cares to give a treatment for cancer
patients at the Centre, and consists of a head of Department, five
supervisors, five male nurses and six female nurses in addition to three
participated nurses, While external staff of the section consists of four
General
teams and each group includes 2-3 nurses of both genders. The Center
Description
offers treatment for cancer patients in their homes in condition that
the patient has previously received treatment in the center i.e. he is
one of his patients, and the patient state should be transferred from
the section Advisers of the palliative care, as well as the patient is in
the fourth stage of his disease (the stage which the disease spreads in
the body).
Palliative care services received by the patient at home include
medication to huge pain, giving antibiotics in case of infections in the
Provided Services
patient and giving the antipyretic drugs in addition to giving RPM
treatment to them and the other services.
Price per session Paid JD20 at the patient's first visit and JD12 for subsequent visits
38
(reviews), in addition to pay the insurance value which amounts JD 50.

2.5 Analysis of Prices
The results of field survey conducted in Zarqa governorate on a sample of respondents

showed average prices of healthcare that they received, the following table shows the
analysis of home healthcare services prices in Zarqa governorate.
Table 27: Prices analysis of home healthcare

Average Price per Average monthly
Service
session (JD) payment (JD)
Rehabilitation and physical therapy
17.19 100
within the company's center
Rehabilitation center inside the House 17.71 175
Following and accompanying the old
17.8 521
age
Following and servicing the coma
16 425
cases
Following up and care for Burns 13.47 220
Following and total disability services 15.2 540
Following and partial disability service 17.4 325
Following up and care for fractures
14.38 325
and accidents cases
Following the cases of diabetes
(measurements, giving the
10.44 130
medications, the limbs and infections
treatment)
Providing Nurse service accompanying
21.5 427.78
day/night
3.5 Marketing strategy
Targeted market
The Project targets the following clients:

 Jordanians Patients especially from Zarqa governorate, the governorates of the
Kingdom and who have cases that require home healthcare services such as following
the pressure and diabetes, their implications and patient care after surgery, fractures,
Burns and accidents
 old people and Injured with partial or total disability of Zarqa governorate, the
governorates of the Kingdom
 chronic disease cases in Kingdom in Zarqa governorate, the governorates of the
Kingdom
39
 Injured cases which require phonation (physiotherapy or functional), such as disk,

cramping and who are conducting operations of changing an articulation.
Expected Services and Products
Expected project services include:

 Providing the nursing services accompanying to the patient at home around the clock
for hardship and chronic cases, such as cases of cerebral trance and old people, as the
patient is secured by nurse male/female accompanying on a double shift (night/day)
to perform the following functions and services for the patient:
- Providing of medical equipment for intractable cases such as medical bed,
breathing apparatus, a suction of phlegm, a pressure gauge, Measuring apparatus
of sugar, private sheets, urine bags, intravenous solutions, the cannula, medical
supplies such as cotton, syringes and others.
- Following up the patients at home and measuring pressure, sugar and installation
of the cannula for blood sampling, and took urine samples to be tested from time
to time ... etc.
- Cleaning the patient and the assistance to wash him
- Working on the patient's comfort at home and monitoring his health
- Giving the patient his medication regularly according to the supervisor doctor's
instructions of the case
 Rehabilitation after surgery, wounds care, care after a urinary catheter and skin care
of dermal ulcerations.
 Care of stool openings outside the abdominal wall
 injecting intravenous therapy at home
 Diabetes patients Care
 Psychological therapy, respiratory therapy, conversion to hospitals when it is
necessary
 Coordination with ambulance services
 Non-medical care services provided by a group of nursing assistances and service
providers to help the old people, the disabled, and patients on hospitalization and
convalescence in their own homes, including assistance in bathing, dressing, and
monitoring the diet and eating habits. As well as helping them in diets, walking,
movement, and to remind them the dates of medication and exercise to improve the
movement of articulations, accompanying patients to visit doctors, and the
accompanying conversation.
 Physiotherapy (physical and occupational therapy) and includes:
- Rehabilitation of diseases and spinal cord injuries and spine
- Rehabilitation of the musculature diseases - Circulatory
- Rehabilitation of Rheumatism and osteoporosis.
- Rehabilitation of sports injuries and muscular tension.
The Expected Prices
40
The below table shows the proposed prices for the home healthcare services, based on the
results of the market survey and analysis of competitors, with taking into consideration that
the recipients of field survey are often demanding lower prices by about 20 - 30% of what
they are willing to pay for the services that they have received.
Table 28: The expected price for home nursing services:
Statement Prices (JD)

Follow simple home cases a monthly, such as
diabetes, pressure, wounds and burns ... etc. / visit JD 450 annually
for an hour and an average of 60 visits per year.
Follow-up daily cases that need constant care, such
as the old people, orthopedic, fractures and partial
25 JD/visit
disability, but for a limited period (a visit for at least
8 hours mostly).
Monthly follow-up cases that need constant care
but partially (a visit duration at least from 8-12 JD 650 a monthly
hours mostly).
Follow-up cases that need constant attention to the
clock, such as coma and total disability (two shifts JD 1,200 a monthly
and duration of each shift 12 hours).
The following table shows the proposed prices for physiotherapy services (natural and
functional).
Table 29: Prices expected for physiotherapy services.

Cost of the
Ratio of cases Cost of the session
Statement session at home
(%) in the center (JD)
(JD)
Rehabilitation of diseases and
20 15 20
spinal cord injuries and spine
Rehabilitation of the
musculature diseases - 40 10 15
Circulatory
Rehabilitation of Rheumatism
20 10 15
and osteoporosis.
The rehabilitation of sports
20 10 15
injuries and muscular tension.
Average cost of the session 100 11 16
Promotion
Promotional strategy for the project requires the following:

 Have a good experienced technical director and have the ability to manage technical
staff of nurses, which includes male/female nurses, and their assistants.
41
 The presence of a manager who specializes in physiotherapy and has good experience
in the field and the ability to management therapists who are working at the center
 Focus on doctor's specialization in cases that require services healthcare (such as
orthopedic physicians, internists, heart and nerves) in Zarqa governorate and its
surroundings to convert their patients to the company.
 Focus on insurance companies and give advantages as reduction of prices and
payment facilities. Put advertisements in brochures of insurance companies and
highlighting the advantages of the company as it is the first of its type in the
governorate, which specializes in all healthcare services in one place.
 Put advertisements in hospitals and specialized clinics.
 Designing a website and using of social media
 Brochures of the company and the services provided by the company.
 Put advertisements in local newspapers and other media at the beginning of the
project.
 Put advertisements billboards on the main streets and roads leading to the company
Selling
The project's sale strategy requires as follows:

 Receive patients directly
 Perform frequent visits to cases in their homes or stay in the patient's home
 Conclude contracts with insurance companies
 Work to conclude contract with hospitals and clinics specialized in cases which require
healthcare services
 Work to conclude contracts with local and international civil society organizations
such as charities associations, put their own packages with preferential prices to serve
their beneficiaries of daily, monthly and chronic cases whether ordinary or partial
disability, or total cases.
Services
Strategy of providing services for the project requires as follows:

 The presence of doctors and nurses with extensive experience and good reputation in
the company
 High professional and emphasis on the quality of services and used materials
 Credibility in dealing and the presence when requested (quick response)
 The presence of sufficient number of staff and service providers to take care of
patients and their families/accompaniers
 Effective and cooperation with doctors, hospitals and other medical organizations.
 Conclude a partnership and cooperation agreements with local and international civil
society organizations (charities association)
 Get all the quality and accreditation certificates (locally and internationally)
 Participate in business associations concerned to benefit from the development
programs offered for members
 Intensive care to the patient and permanent and continuous cleanliness
 Respect the rules of Hygiene, cleanliness and public safety
42
 Maintenance of equipment continuously

 Interest in the proper appearance of employees and service providers
 Attention of good and decent treatment with clients and their families or their
companions, whether at home or in the physiotherapy center
 Attention of providing service quickly to patients
43
3.6 Demand Analysis
The Department of statistics data and field surveys carried out by the National Centre for
diabetes, endocrinology and genetics has been used, to get indicators on the volume of the
market for some home healthcare services. The following table shows the volume of the
expected demand for the most important healthcare services (follow up high blood pressure
patientient, diabetes patients and their care, in addition to the partial disability and the
coma resulting from these cases) .
Table 31: Preliminary indicators to quantify the demand for home healthcare for the first year of
the project
Number of
potential Number of
2018 injured with Total of
potential
(Expected pressure those who
injured with
Statement 2015 2016 2017 date for disease (5% will need a
diabetes (4%
starting a of the private
of the
company) population) care
population)*
*
Number of population
1,368,800 1,407,400 1,447,089 1,487,897 74,395 59,516 -
of Zarqa governorate
Number of population
5,531,712 5,687,706 5,848,100 6,013,016 300,651 240,521 -
of the Kingdom
Number of injured people with pressure/diabetes from who Zarqa 20,756 11,725 32,481
have a critical reading, according to a study made by the
National Center for diabetes, endocrinology and Genetics
(27.9% and 19.7% respectively). This figure represents all Kingdom 83,882 47,383 131,264
patients may use home healthcare services to follow up from
time to time.
A number of injured people who don't use medications and Zarqa 934 528 1,462
treatments prescribed for them (4.5%) according to the
Kingdom 3,775 2,132 5,907
studying statistics
The number of exposed people to injury of stroke (50%) Those Zarqa 467 264 731
who do not take their medications so they need careful
Kingdom 1,887 1,066 2,953
consideration either partial or total.
Source: field surveys of the Department of statistics and study team ' adding to national study to find out the
prevalence of diabetes and other chronic diseases, National Center for diabetes, endocrinology and genetics.
* Chronic diseases Survey, Department of statistics 2011
As we have previously mentioned, it is difficult to determine the volume of the demand on

the proposed project services that reached some expectations for the first year. It is difficult
to predict the growth rates on the demand for these services due to the increasing number
of chronic diseases all over the world and especially in Jordan. Since there are no companies
that offer integrated services in Zarqa governorate therefore its market share will be
measured with its design capacity or his ability to absorb the potential beneficiaries of the
company's services.
44
And the following table clarifies the amount of expected demand at the first year.
Table 31: the expected demand for the first year

Case number (expected
Statement Number of Visits
demand size)
Following simple home cases monthly
such as diabetes, blood pressure, cuts
255 60
and burns…etc/ visit for an hour at an
average 60 visits annually
Following cases needed to continuous
care such as the elderly, bones,
fractures, total weakness cases, but for 6 104
limited time (visit time minimum often is
8 hours)
3 months
care, but partially( visit time is often (8- 6
per year
12) hour
care hourly such as trance and total 4 yearly
weakness ( two shifts both has 12 hours)
In the matter of gnomic treatment centre (functional and physical therapy), has been
designed to contain 75% of cases inside the centre and 25% of cases at homes.
45
4. Technical Study
4.1 The Designed Project Capacity
The following table clarifies the Designed capacity of the project
Table 32: Design capability of project

Item No. of Cases a year
Following simple home cases monthly such as diabetes,
310 case at an average 60 visits
blood pressure, cuts and burns…etc/ visit for an hour as
annually for every case
an average 60 visits yearly
Following cases needed to continuous care such as the
12 cases annually at an average
elders, bones, fractures, total weakness cases, but for
104 visits for every case
limited time (visit time minimum often is 8 hours)
Following cases needed to continuous care, but partly( 13 cases annually at as an
visit time is often (8-12) hour average 6 months per year for
every case
Following cases needed to continuous care hourly such as
4 cases annually at a year
trance and total weakness ( two shifts both has 12 hours
Functional and physical therapy inside centre 4500 cases/sessions
Functional and physical therapy inside home 100 cases/sessions
And for reaching the designed capacity, it is necessary to rent separated buildings (according
to ministry of health instructions), the area of the first is 80 m2 and to be specialized for
home nursing services, the other is 170 m2 and to be specialized for gnomic treatment
Centre. Functional and physical therapy centre should have 4 rooms for treatment, out of
which one could be for children and another for women. In addition to hydrous treatment
room and sport exercises and devices hall, also waiting hall and rooms for management,
physicians and specialists.
46
4.2 The Required Fixed Assets
The following table shows the total fixed assets cost which reach JD177.5 thousand.
Table 33: Total fixed assets cost of centre

Item Unit Price (JD) Amount
Modifications to building and decoration 250 50 12,500
Devices and equipment for physiotherapy
- - 60,000
centre
Devices and equipment for house nursing - - 10,000
Furniture - - 30,000
Information technology - - 25,000
Transport vehicles 4 - 40,000
Total 177,500
* calculated based on market study findings
** Cost includes the necessaries of infrastructure and electromechanical work
And the following table shows the most important equipment for physiotherapy and
functional treatment center.
47
Table 34: the most important equipment for physiotherapy and functional treatment center
and their expected cost
Total cost
Statement Number Price (JD)
(JD)
Ankle exercise device 1 2,000 2,000
Weight for ankle Whole group 100 100
Cervical tightness group 1 1,500 1,500
Compress warming device 1 200 200
Warming device by atoms 1 1,000 1,000
Manual fixed bicycle device 1 500 500
Automatic fixed bicycle device 1 5,000 5,000
Wet dock for extremities superior 1 2,500 2,500
Wet dock for extremities inferior 1 2,500 2,500
Ice making machine including
1 200 200
accessories or cold compress device
Infrared treatment device (large) 1 600 600
Interferer current treatment device 1 700 700
Mirror 1 100 100
Electric warning device )low and
1 700 700
medium)
Treatment device by wax 1 100 100
Parallel walking device 1 300 300
Ultrasonic treatment (inside and
2 1,000 2,000
outside the centre)
Mural staircase 1 200 200
Wheelchair (2 ordinary + 1
3 700 2,100
locomotive)
Ordinary bed for physiotherapy 4 100 400
Backbone traction machine 1 4,000 4,000
Hot sand sack 2 50 100
Modern running device 1 4,000 4,000
Weights set ( from 0.5 – 15 kg ) 2 1,000 2,000
Movable Infra red treatment device
4 15 60
(small)
Interferer current treatment device
2 100 200
(small/movable)
Towels Various set 200 200
Others various devices and
- 1,940 1,940
equipment
Total 60,000
48
As the following table shows the most important devices and necessary equipment
for the home care company.
Table 32: the most important devices and necessary equipment for the home care company
and their expected cost.
Statement Number Price (JD) Total cost (JD)
Medical bed 1 1,000 1,000
Respirator device 1 500 500
Vaporization device 4 50 200
Phlegm pull device 4 100 400
Oxygen cylinder 1 150 150
Full nursing bag for every nurse
(manometer device, sugar
measuring device, stethoscope,
hammer, lamp, medical scissors, 18 300 7,200
medical accessories, such as
injections, medical gloves and
medical alcohol..etc
Hunger for nutritious solution. IV
1 50 50
solution
Others accessories for nurses - 500
Total 10,000
49
4.3 The Required Human Resources
The following table shows the required human resources for project. The number of the
required staff is about 33 employees with a total salary JD187,440 annually.
Table 36: The required human resources for the project

Total
No. of Salary Operational Administrative
Item Salary(JD/
Personnel (JD/monthly) (JD/annually) (JD/annually)
annually)
General manager 1 1,200 14,400 14,400 -
Secretary 1 300 3,600 3,600 -
Head of healthcare
department (technical
1 800 9,600 - 9,600
manager/resident doctor/
legal nurse
Head of physiotherapy
treatment department
(Physiotherapists, 1 800 9,600 - 9.66
functional treatment
specialist
Male / female
4 450 21,600 - 21,600
Physiotherapists
nurse 22 450 118,500 - 118,800
Accountant 1 300 3,600 - 3,600
administrator/
1 300 3,600 - 3,600
writer/medical registries
Courier 1 220 2,640 - 2,640
Total 33 187,440 21,600 165,840
50
The following table shows the general job description of required job in the project.
Table 37: the general job description of required jobs in the project.
Task Task Description
Planning, organizing, cooperating, and control for what is relating to the
firm internal management, cooperating in determining of firm policy, and
managing what is relating to work. And reviewing reports which are sent
General manager
back to management department, supervising its analysis operation,
studying occurred problems, putting solutions, technical and administrative
supervising of personnel and increasing their aptitude, observing of the
career authenticity instructions abidance.
 Undertaking of the managing and following tasks related to the
department including the technical part and distributing tasks using
scientific method, creating clear policy for tasks, preparing and
equipping the firm with equipment, tools, medical, non-medical
accessories, developing work styles and presented services, further
more following, supervising on firm training programs, and making sure
from applied systems and regulations for all these. And technical
general manager have to do the following tasks :
 Supervising on work, monitoring labors, and making sure of
commitment of service providers using the functional description
besides their task according to accredited professional criteria for each
other.
 Providing necessary medical devices expenditures for offering the
service
 Planning for home health care or accrediting therapeutic plan
prepared of attending physician or health care organization in case of
Head of beneficiary from both besides its including to diagnostic and medical
nursing/technical procedures which have prepared further more medicine, drugs,
manager multipliers during residence and health case of benefiter when being
transferred
 Organizing of files and archives.
 Observing general safety conditions.
 Adhering to prevent infection, its conditions, and requirements besides
offered service availability concluding health and medical reports.
 Furnishing technical procedures reference continuously for specializations
in the organization.
 Reporting on vestigial violence the benefiter gets in according to vestigial
violence protecting law.
 Providing minimum opportunities of the accredited continuous education
according to directors for this purpose.
 Getting previous agreement of the ministry before issuing any
announcement about the organization or its services.
 Obligating to salaries list of service providers and personnel according to
51
applied legislations.
 Declaring healthcare procedures list being accredited and legalized from
specified area in a prominent place in the organization.
 Declaring list of service provider's rights and benefiter rights in a prominent
place in the organization.
 He shall manage and follow up on the works pertaining to the department
technically, distribute works in a scientific manner, develop a clear policy for
work, prepare and equip the Center in terms of medical and non-medical
tools, devices and supplies, develop work methods and the provided
services, follow up and supervise the training programs implemented in the
Center, and ensure the applicable controls and regulations. The Department
Head shall perform the following functions:
 Supervise work, oversee the employees and ensure that the service
providers comply with their respective job description and duties in
accordance with the occupational standards applicable to them respectively.
 Provide the medical devices and consumables required to provide the
service
 Follow the correct scientific methods and treatment procedures in the
Head of Physiotherapy evaluation and rehabilitation of patients
Department/  Organize records and files and open a therapeutic record for each patient
Physiotherapy specialist  Comply with public safety requirements
 Provide a manual of technical procedures for the specialties in the Agency
on a continuous basis
 Report any domestic violence against the beneficiary in accordance with the
Family Violence Protection Act
 Provide the minimum continuing educational opportunities approved in
accordance with the instructions issued for this purpose
 Obtain the prior approval of the Ministry before issuing any announcement
about the center or its services
 Comply with the Regulations on the wages of the service providers and
employees according to the applicable legislation
 Announce a duly approved and certified wages regulation.
 Announce a list including the rights of the service providers and beneficiaries
in prominent position in the center.
 The Nurse shall do the following:
 Perform daily nursing tasks for patients in their homes and according to the
directions of the doctor and treatment plan set by the doctor supervising
the case under direct follow up of the technical director.
Male nurse / female  Prepare the patient for the prescribed procedures and help in assessing the
nurse patient's condition.
 Assist the doctor in conducting tests and any procedures related to direct
patient care.
 Provide nursing care for the patient in terms of maintaining his health and
help him to perform the simplest daily tasks.
52
 Note the patient's health status and report any changes to the technical
manager and the doctor supervising the case.
 Take all necessary measures to prevent the spread of infection and help the
patient eat, bathe, perform personal care measures and take medication
regularly.
 Assist and prepare the patient for systematic sampling and assist him in
taking intravenous solutions.
 Provide psychological support to the patient and show interest in the
patient's comfort and maintain privacy during all stages.
 The accountant shall do the following:
 Participate in the preparation of the estimated budget of the Department in
coordination with the concerned employees in the company.
 Follow up, prepare, review, amend and adopt the administrative regulation
pertaining to the administrative unit, which includes procedures, rules,
instructions, functional organizational structure, functions, competencies,
job description cards and powers regulations.
 Establish the financial plans of the Center, monitor the policies and
procedures related to the financial plans and ensure that they comply with
the laws and regulations.
 Participate in the preparation of the estimated budget including salaries,
allowances, operational expenses, maintenance and operation programs
and expenses of current and new medical and treatment cases.
 Follow up the comparison between accounts in coordination with the
Accountant/
operations department.
administrative / records
 Provide all human resources services such as recruitment, evaluation,
clerk
preparation of performance plans, promotions, etc., and prepare human
resources policies, rules, procedures and programs.
 Perform the procedures and policies required to ensure the attendance and
departure of employees and the payment of their financial dues in
accordance therewith and record their leaves.
 Prepare the payroll of the Center's staff and reports pertaining to discipline.
 Supervise the database preparation and updating regarding all the vacant
jobs at the Center to attract the job applicants with the specifications
required for the vacant jobs.
 Follow up the incoming job application and archive, sort and select
applications that meet the company requirements
 Maintain and update patients and beneficiaries' records through the
Physiotherapy Center in coordination with the competent director, nurse
and physiotherapist
53
4.4 Special Requirements
The following table shows the general and special requirements for the home health care
services which have to be observed for developing and implementing the project:
Table 38: The general and special requirements for a home healthcare company:
Statement Conditions
The healthcare services shall include any of the following services:
 Medical treatment
 Nursing care
 Physiotherapy
 Occupational treatment
Healthcare
 Nutrition
services
 Clinical psychology, psychological health and psychological guidance
 Speech and hearing therapy
The services are provided to the beneficiary at his home upon his request or the
request of his parent, guardian, or custodian or upon reference from the treating
physician or health agency.
Both the Technical Director and the Head of the Center shall:
 Hold a Jordanian nationality
 Not have been convicted in a felony or misdemeanor that violates honor and
public morals
 Not be committed to service to any other party
 Abide by the ethics of the profession and the laws, regulations and instructions
regulating same.
 Have experience of not less than five years
 Have a permit to practice any of the health or medical professions from Ministry
of Health.
 Work full-time in the management of the company
 Have obtained the bachelor Degree at least in the physiotherapy.
Employees
The technical manager of the Physiotherapy Center shall:
 Comply with the public safety requirements.
 Be aware of the principles of infection prevention and the requirements of same
and provide a high quality service provided that the same shall be established in
the medical and healthcare reports.
 Provide a manual of technical procedures for the specialties in the Agency on a
continuous basis.
 Report any domestic violence against the beneficiary in accordance with the
Family Violence Protection Act
 Provide the minimum continuing educational opportunities approved in
accordance with the instructions issued for this purpose
 Obtain the prior approval of the Ministry before issuing any announcement about
the center or its services
54
Statement Conditions
 Comply with the Regulations on the wages of the service providers and
employees according to the applicable legislation
 Announce a duly approved and certified wages regulation.
 Announce a list including the rights of the service providers and beneficiaries in
prominent position in the center.
Both the Technical manager and the Physiotherapy Center manager shall:
 Supervise work and control the employees and ensure that the service providers
comply with their respective job description and duties in accordance with the
occupational standards applicable to them respectively.
 Provide the medical‫ ص‬devices and consumables required to provide the service.
 Develop the home healthcare plan or approve the treatment plan developed by
the therapist or the health Agency in case the beneficiary is transferred from
either of them provided that this treatment plan includes the medical and
diagnostic procedures which have already been completed, the given
medications and treatment, the complications occurring during the stay at
hospital and the beneficiary's state when referred.
 Arrange the records and files
The Company's owner shall inform the Ministry of any change occurring to the
information, data and documents submitted thereby when applying for licensing the
Company.
 The area allocated for the home healthcare department shall not be less than 80
m2
 The area of the building dedicated to the Department of physiotherapy shall not
be less than 100 m2
 The following should be available within the center:
- Waiting lounge
- Rooms for treatment
- Sanitary facilities, with one dedicated to the use of persons with disabilities
The Building - Equipment for evaluation and treatment
- A suitable elevator shall available if the center is not located on the ground
floor
 If the company wishes to provide home healthcare services in addition to the
physiotherapy within a specialized center, the entrance of each department shall
be detached from the other
 Healthcare shall not be provided within the company / department headquarters
 Medical devices and supplies may not be sold, however, they shall be available.
55
4.5 The Required Licenses
The following table shows the necessary licenses required to be issued from the different
entities for implementing the project
Table 39: The licenses required for the project

Statement The Entity
The Company's Registration
 Ministry of Industry Trade and supply, Ministry of Health
and licensing
 Ministry of Health
Operation  Social security corporation
 Income and sales tax Department Municipality of Zarqa
Conditions of Company License2
The Company's license requires the following:
 General safety conditions and sanitary conditions such as lighting and ventilation
 Technical Director / Center Manager
 The necessary communication means
 A number of service providers and administrative staff appointed in accordance with
the instructions issued for this purpose
The Company shall have the following records and files:
 Records of service providers

 Staff records
 Medical files for beneficiaries
Minister shall form a committee called the Licensing Committee of Home Healthcare
Services Agencies, headed by the Director of the concerned Directorate in the Ministry. The
Committee shall have the following functions and powers:
 Consider the application for the agency license

 Appoint two members of the committee to inspect the agency to be licensed
 Study complaints related to the service provided by the agency and follow up the
renewal of its license
 Form one or more sub-committees in the governorates and identify their functions
and powers
 Prepare the necessary instructions to implement the provisions of this Law
 Perform any other tasks assigned thereto by Minister
2
By Law No. (84) of 2016 on Home Health Care Agencies Licensing
56
4.6 Project Timetable
The following figure shows the project implementation period which is 6 months, as follows:
Months
Phase
1 2 3 4 5 6
Studies
Approvals, Licensing and
registration of the
company
furnishing
Employment, Operation
and Inauguration
Total Duration 6 Months
57
5. Financial Study
5.1 Financial Assumptions
The following table illustrates the financial assumptions of the project.
Table 41: the financial assumptions of the project

Item Assumption
Inflation Rate 3%
Financing Structure Equity constitutes 199% of the investment
Working Capital 6 months of annual cost
Pre-Operating Expenses 3% of total investment
Tax Rate 20%
The costs of contracting with orthopedic
doctors and physiotherapy to supervise 20% of total revenues
cases within the center
The Cost Of Medical Supplies 30% of total revenues
Cost of water, diesel, and electricity 3% of total revenues
Annual Depreciation JD 27 thousand annually
Maintenance JD 2 thousand
Other Operational Costs 2% of total revenues
Staff benefits 25% of salaries
Annual Salaries Increase 3%
Staff Incentives 1% of total revenues
Assets Depreciation Rate 10%-20% of the asset value
Accounts Receivable 1 month of annual cost
Inventory 3% of total revenues
58
5.2 Investment Cost
The project's Investment cost is estimated at JD 321 thousand distributed among fixed
assets of JD 178 thousand, working capital and pre-operating expenses totaled of about JD
143 thousand. The following table shows the project's Investment cost.
Table 41: the project's investment cost

Item Value (in thousand JD)
Fixed assets 178
Pre-operating expenses 9
Working capital 134
Total 321
5.3 Financing
The project will be financed with the shareholders by 100% which is estimated at about JD
321 thousand, while there is no need to any loans. The following table shows the financing
schedule for to the implementation of the project.
Table 42: Project financing structure

Item Value (in thousand JD) %
Equity 321 100%
Loan 0 0%
Total 321 100%
5.4 Revenues
The following table shows the total revenues of the project, where it is noted that the
revenues in the first year amounts to about JD 252.3 thousand, and increased to reach up to
JD 518.7 thousand in the tenth year.
59
Table 43: project revenue

Item Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10
revenues - Home Nursing
Number of working days
annually 265 265 265 265 265 265 265 265 265 265
Follow-up simple monthly cases such as diabetes, pressure, wounds, burns, etc. (through local charities and international organizations) / visit for one hour with an average
of 60 visits per year
Number of annual cases 355 219 219 219 219 219 219 219 219 219
Average annual fees 459 464 4,, 473 596 533 52, 552 5,9 58,
Total revenue from
114,,59 142,685 14,,776 153,425 15,,998 161,,17 166,5,9 1,1,56, 1,6,,14 183,916
simple cases
Follow-up of cases requiring continuous care such as seniors, bones, fractures and partial disability but for a limited period (visit duration not less than 8 hours mostly)
Average number of visits
194 194 194 194 156 156 156 156 156 156
per year
Average fees per visit 35 36 3, 3, 38 37 29 21 23 22
Total revenue from cases
requiring ongoing
attention but with a 15,699 34,193 22,199 24,972 53,6,4 54,354 55,883 5,,558 57,385 61,962
specified number of
weekly visits
Follow-up of cases requiring continuous care but with partial time (duration of visit is usually 8-12 hours)
Average monthly fees 659 6,9 679 ,19 ,23 ,54 ,,6 ,77 832 848
Time period (month) 2 2 2 4 4 5 5 6 6 6
total revenue from
follow-up cases that
1,,559 33,974 36,874 26,724 28,943 48,7,7 59,447 63,255 64,335 66,153
require continuous care
but with partial time
60
Follow-up cases that need constant care around the clock such as coma and total disability (two shifts, each shift 12 hours)
Average monthly fees 1,399 1,326 1,3,2 1,211 1,251 1,271 1,422 1,4,6 1,539 1,566
Time period (month) 13 13 13 13 13 13 13 13 13 13
Revenues from Follow-up
cases that need constant
care around the clock
5,,699 57,238 61,198 63,741 64,837 66,,,4 68,,,, ,9,841 ,3,766 ,5,155
such as coma and total
disability (two shifts, each
shift 12 hours)
Total income from home
205,500 249,209 269,097 286,404 312,554 331,726 341,678 362,321 373,190 384,386
nursing
Revenue - physical and Functional Therapy
Number of working days
299 299 299 299 299 299 299 299 299 299
annually
Number of annual cases /
sessions within the
1,899 3,999 3,499 2,299 4,399 4,599 4,599 4,599 4,599 4,599
center
Average session fee/ case 11 11 13 13 13 12 12 14 14 14

Revenue from treatment
17,899 33,669 38,998 27,666 51,777 5,,284 57,196 69,8,7 63,,95 64,586
within the center
Number of cases / annual
sessions outside the 499 699 899 1,199 1,499 1,599 1,599 1,599 1,599 1,599
center
Average session fee/
16 16 1, 1, 18 17 17 39 39 31
outside the centre
Revenue from outside 6,499 7,888 12,589 17,323 35,311 3,,832 38,65, 37,51, 29,493 21,215
61
the center
total revenue from
36,399 23,548 41,58, 58,878 ,,,319 85,39, 8,,,62 79,276 72,198 75,791
physiotherapy
Revenue
Total revenues from
205,500 249,209 269,097 286,404 312,554 331,726 341,678 362,321 373,190 384,386
home nursing
Total revenue from
36,399 23,548 41,58, 58,878 ,,,319 85,39, 8,,,62 79,276 72,198 75,791
physiotherapy
Other income (from
medical supplies for 39,559 34,731 36,719 38,649 21,355 22,1,2 24,168 26,323 2,,217 28,427
home nursing)
Total Revenues -
252.25 306.68 337.59 373.94 421.02 450.11 463.61 488.95 503.62 518.73
thousand JD
62
5.5 The Projected Costs
Operating Costs
The following table shows the project's operating costs according to the previous
assumption over ten years. The medical supplies costs in Year 1 amounted to JD 6.2
thousand which increase to reach JD 11.5 thousand in Year 10. Moreover, the salaries' cost
amount to JD 133 thousand in Year 1 which increases to JD 216 thousand in year 10.
Table 44: Operating Costs of the Project

Operating Costs (in thousand JD)
Salaries 132.7 170.8 175.9 181.2 186.7 192.3 198.0 204.0 210.1 216.4
Staff Benefits 33 43 44 45 47 48 50 51 53 54
Cost of
5 7 8 12 15 17 18 18 19 19
outsourcing
The Cost Of
Medical 6.2 7.5 8.1 8.6 9.4 10.0 10.3 10.9 11.2 11.5
Supplies
Electricity
Water, and 7.6 7.8 8.0 8.3 8.5 8.8 9.0 9.3 9.6 9.9
diesel
Depreciation 27 27 27 27 27 27 27 27 27 27
Maintenance 2 2 2 2 2 2 2 2 2 2
Others 5.0 6.1 6.8 7.5 8.4 9.0 9.3 9.8 10.1 10.4
Rents 8 8 8 8 8 9 9 9 10 10
Total 226 278 288 300 312 323 332 341 351 360
Figure 4: Projected Operating Costs of the Project

300
250
200
150
100
50
0
Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10
Salaries Cost of outsourcing The Cost Of Medical Supplies
63
Administrative Expenses
The following table shows the projected administrative expenses of the project. Employees'
salaries reach JD 15 thousand in the first year and increase to JD 20 thousand in the tenth
year. The marketing expenses are about JD 5 thousand in the first year and increase to
reach JD 6.6 thousand in the tenth year.
Table 42: General and Administrative Expenses

General and Administrative Expenses (in thousand JD)
Salaries 15.1 15.6 16.9 16.5 1,.9 1,.5 18.1 18.6 17.3 17.,
Staff Benefits 2.8 2.7 4.9 4.1 4.2 4.4 4.5 4.6 4.8 4.7
Staff
3.5 2.1 2.4 2., 4.3 4.5 4.6 4.7 5.9 5.3
Incentives
Stationery 2.5 2.6 2.7 2.8 2.8 2.9 3.0 3.1 3.2 3.3
Professional
2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.8 2.9 3.0
Fees
Marketing
5.0 5.2 5.4 5.5 5.7 5.8 6.0 6.2 6.4 6.6
Expenses
Other
2.0 2.1 2.2 2.3 2.4 2.6 2.7 2.8 3.0 3.1
Expenses
Amortization 9.4 - - - - - - - - -
Total 42.3 34.5 35.8 37.2 38.8 40.2 41.5 43.0 44.4 45.9
64
5.6 Projected Financial Statements
Income Statement
The following table shows the projected income statement of the project. It indicates that
gross profit will increase from JD 26 thousand in the first year to JD 158 thousand in the
tenth year. The net profit before tax will also increase from JD 14 thousand in the third year
to JD 112 thousand in the tenth year, and the net profit after tax will increase from JD 11
thousand in the third year to JD 90 thousand in the tenth year.
Table 46: The Projected Income Statement

Income Statement(in thousand JD)
Year
Item Year 1 Year 2 Year 3 Year4 Year 5 Year 6 Year 7 Year 8 Year 9
10
Revenues 252.3 306.7 337.6 373.9 421.0 450.1 463.6 488.9 503.6 518.7
Operating
costs (cost of 226.1 278.0 287.9 299.7 312.5 322.8 331.6 341.3 350.7 360.4
sales)
Gross profit 26.1 28.7 49.7 74.2 108.6 127.3 132.0 147.6 152.9 158.3
Administrative
42.3 34.5 35.8 37.2 38.8 40.2 41.5 43.0 44.4 45.9
expenses
Net profit (16.2) (5.8) 13.9 37.0 69.7 87.1 90.4 104.6 108.5 112.4
financial
- - - - - - - - - -
expenses
Net profit
(16.2) (5.8) 13.9 37.0 69.7 87.1 90.4 104.6 108.5 112.4
before tax
Tax - - 2.8 7.4 13.9 17.4 18.1 20.9 21.7 22.5
Net profit
(16.2) (5.8) 11.1 29.6 55.8 69.7 72.3 83.7 86.8 89.9
after tax
Figure 5: Projected Income Statement

400
350
300
250
200
150
100
50
0
Year 1 Year 2 Year 3 Year4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10
-50
Gross profit Net profit before tax Net profit after tax
65
Projected Balance Sheet
The following table shows the projected balance sheet of the project during the first ten
years. It indicates that total assets will increase from JD 321 thousand in the year of
incorporation to about JD 509 thousand in the tenth year.
Table 47: Projected financial position statement

Projected Balance Sheet (In thousand JD)
incorporation
Statement
Year 10
Year of
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Assets
Cash 134 162 185 213 247 192 239 287 338 391 445
Receivables - 21 26 28 31 35 38 39 41 42 43
Inventory - 8 9 10 11 13 14 14 15 15 16
Other assets - 3 3 3 4 4 5 5 5 5 5
Total current assets 134 193 223 255 293 244 294 345 399 453 509
Fixed assets 187 187 187 187 187 282 282 282 282 282 282
Cumulative
- 37 64 91 118 146 173 200 227 255 282
Depreciation
Pre-operating
- - - - - - - - - - -
expenses
Net assets 187 150 123 96 69 136 109 82 55 27 -
Total assets 321 343 346 351 362 381 403 426 453 481 509
Shareholders Equity And Liabilities
Accrued Expenses
- 38 47 48 50 52 54 56 57 59 61
And Payables
Long Term Loans - - - - - - - - - - -
Total Liabilities 38 47 48 50 52 54 56 57 59 61
Shareholders
321 321 321 321 321 321 321 321 321 321 321
Contributions
Retained Earnings - (16) (22) (19) (10) 7 28 50 75 101 128
Shareholders' Equity 321 305 299 302 311 328 349 371 396 422 449
Shareholder Equity
321 343 346 351 362 381 403 426 453 481 509
And Liabilities
66
Cash Flow Statement
The following table shows the projected cash flow statement of the project during the first
ten years. It indicates that the cash flow from operation activities will increase from JD 27
thousand in the first year to JD 117 thousand in the tenth year; while the Cash at the ending
period will increase from JD 134 thousand in the year of incorporation to JD 445 thousand in
the tenth year.
Table 48: The expected cash flows statement

Cash Flow Statement (in thousand JD)
incorporat
Statement
Year 10
Year of
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
ion
Operation Activities
Net profit - (16) (6) 11 30 56 70 72 84 87 90
Depreciation - 37 27 27 27 27 27 27 27 27 27
Change in
- 7 2 (2) (2) (4) (2) (0) (2) (0) (0)
working capital
Cash flow from
- 27 23 36 54 79 95 99 109 114 117
operation
Investing Activities
Fixed assets (187) - - - - (95) - - - - -
Cash flow from
(187) - - - - (95) - - - - -
investment
Financing Activities
Capital (Equity) 321 - - - - - - - - - -
Loan - - - - - - - - - - -
dividends - - - (8) (21) (39) (49) (51) (59) (61) (63)
Cash flow from
financing 321 - - (8) (21) (39) (49) (51) (59) (61) (63)
activities
Net cash flow 134 27 23 28 34 (55) 46 49 51 53 54
Cash at the
beginning 0 134 162 185 213 247 192 239 287 338 391
period
Cash at the
134 162 185 213 247 192 239 287 338 391 445
ending period
67
5.7 Financial, Economic and Social Analysis
Financial Analysis
The following table shows the financial analysis of the project. It indicates that the net profit
ratio will increase from 3.3% in the third year to 17.3% in the tenth year, and the return on
investment will increase from 3.2% in the third year to 17.7% in the tenth year.
Table 49: Financial Analysis

Financial Analysis (In Thousand JD)
Year Year Year Year Year Year Year Year Year Year
Item
1 2 3 4 5 6 7 8 9 10
Assets 343 346 351 362 381 403 426 453 481 509
Revenues 252 307 338 374 421 450 464 489 504 519
Profits (16) (6) 11 30 56 70 72 84 87 90
Capital
321 321 321 321 321 321 321 321 321 321
(Equity)
Net Profit % -6.4% -1.9% 3.3% 7.9% 13.3% 15.5% 15.6% 17.1% 17.2% 17.3%
Return On
Investment -4.7% -1.7% 3.2% 8.2% 14.7% 17.3% 17.0% 18.5% 18.1% 17.7%
(ROI)
Return On
-5.0% -1.8% 3.5% 9.2% 17.4% 21.7% 22.5% 26.1% 27.0% 28.0%
Capital (ROC)
Net Profit On
-6.4% -1.9% 3.3% 7.9% 13.3% 15.5% 15.6% 17.1% 17.2% 17.3%
Revenues
Assets
Turnover 0.74 0.89 0.96 1.03 1.11 1.12 1.09 1.08 1.05 1.02
(Time)
Figure 6: The Financial Analysis

40.00%
30.00%
20.00%
10.00%
0.00%
Year 1 Year 2 Year 3 Year Year Year Year Year Year Year
-10.00%
-20.00%
Net Profit % Return On Investment (ROI)
68
Economic Analysis
The following table shows the economic analysis of the project during the first ten years, we
conclude that:
 Internal rate of return was 19.7%. It exceeded four times the rate of return on
assets, which means the economic feasibility of the project
 The present value of the project reached about JD 478 thousand. It exceeds the
investment with JD 157 thousand, which means the economic feasibility of the
project.
 The profitability index of the project reached 1.49 times, which means that the
expected value of the project will increase by one time and half of the investment
value, which indicates that the project is feasible.
 The project payback period is 6 years.
Table 21: The Economic Analysis

Economic Analysis (thousand JD)
Year of Year Year Year Year Year Year Year Year Year
Year
Statement incorpo
1 2 3 4 5 6 7 8 9 10
ration
Net cash flow

from operations (321) 27 23 36 54 79 95 99 109 114 117
and investment
Terminal Value - - - - - - - - - - 449
Net Cash flow (321) 27 23 36 54 79 95 99 109 114 566

Internal Rate of 19.7%
Return (IRR)
Present Value 478
Net present 157
value
Profitability 1.49
Index (Time)
Payback period 6.00
(Year)
69
Social Analysis
The following table shows the social analysis of the project. It is noticed that the number of
staff required for the project will increase from 33 employees in the first year to 51
employees in the tenth year. All these employment opportunities will be for Jordanians.
The added value of the project will also increase from JD 171 thousand in the first year to JD
413 thousand in the tenth year. The income tax will also increase from JD 3 thousand to
reach JD 22 thousand in the tenth year.
Table 21: the Social Analysis

Social Analysis
Year Year Year Year Year Year Year Year Year Year
Statement
1 2 3 4 5 6 7 8 9 10
Number of 33 35 36 38 40 42 44 46 49 51
Employees
Jordanian 33 35 36 38 40 42 44 46 49 51
employees
The added value
- thousand 171 230 257 288 329 354 365 388 400 413
dinars
Income tax - - 3 7 14 17 18 21 22 22
(thousand JD)
sales tax value – - - - - - - - - - -
thousand JD
Exports value /
imports - - - - - - - - - -
substitution
Figure 7: the social analysis

500
450
400
350
300
250
200
150
100
50
0
Year 3 Year Year 5 Year 6 Year 7 Year 8 Year 9 Year 10
The added value - thousand JD 171 230 Income tax (thousand JD) - -
70
6. Risk and Sensitivity Analysis
6.1 Risk Analysis
The following table shows the risk matrix analysis that may face the project.
Table 22: Project risk matrix

Risks Type of Risks Risk Assessment
 Credit Risk  The financial risks that
Credit risk represents the risk may face the company are
of the company's financial loss low, because the
as a result of the customer's company payment
method is cash
defualt of the contractual
 There is no risk of
obligation or that of the party currency exchange,
dealing with the company because the company
through a financial sales and purchases by
instrument. These risks are local currency
mainly caused by trade  There is no risk of
receivables and others. inflation because the
company's pricing is
based on a periodic basis
 Liquidity Risk
Liquidity risk is the risk
resulting from the company's
inability to meet its financial
obligations at time. The
company's liquidity
Financial Risks management is to ensure as
much as possible that the
company always maintain
enough liquidity to meet its
obligations as they become
due and payable in normal
and emeregency conditions
without incurring
unacceptable losses or risks
that affect the company's
reputation.
 Risk Of Currency
Fluctuation
Currency risk is the risk of the
fluctuation of the value of
financial instrument, due to
fluctuations in foreign
currency exchange rates.
71
 inflation risk
It is the risk associated with
the possibility that the
inflation or the rise in the cost
of living might lead to the
decrease the real value of the
investment.
 Strategic Risk  The risks are considered
It is the risk resulting from low before the company’s
taking bad decisions by the establishment, because of
company's management, or getting the approval of
the official authorities
implementing the decisions in
 Reputational risk is very
a wrong way, or not taking the high, as the company
decisions at the right time; deals with very sensitive
which leads to losses or issues such as treatment
causes loss of alternative  Market risk in the short
opportunities. term will be low because
of the low competition
from the private sector
 Legal and Regulatory Risks
These risks are reflected as a
result of non-compliance with
laws, guidelines and
instructions governing the
work. Legal risks are caused by
the company's break of the
Business risk (sector risk)
laws governing the work in
the state in which the
company operates. While
regulatory risks arise from the
company's violation of laws
and standards issued by the
regulatory authorities.
 Reputation Risk
Reputation risk arises from
influential negative public
views which result in great
losses of customers or money.
It includes the actions of the
company's management or its
employees which project a
negative image of the
company, its performance and
72

its relationships with
customers and other
stakeholders. Reputation risk
also results from circulating
rumors about the company
and its activities.
 Competition Risk
Competition risk results from
domestic and external
competitors and reduces sales
and profits.
Operational risk involves  Operational risks are very
losses resulting from the low, for the company will
failure of internal operations, contract with specialized
technical bodies to
human resources and
develop the required
systems. It includes: information systems, in
order to manage
 IT Risks operations
They are losses arising from  Competitive salaries will
downtime or systems failure be paid
due to the infrastructure,  Information security plan
information technology, or will be put in place to
safely keep the company
the lack of systems, and any
information
failure or malfunction in the
systems. They include: the
crash of computer systems,
breakdowns in
Operational Risk
communication systems,
programming errors,
computer viruses and
opportunities losses due to
breakdown.
 Human Resources Risk

Losses caused by employees
or related to them
(intentionally or
unintentionally). It also
includes acts that are
intended as methods of
cheating, abusing property or
circumvent the law,
regulations or company policy
73

by officials or employees, as
well as losses arising from the
relationship with the
customer, shareholders,
regulators and any third party.
State Risk includes politicians'  State Risk is considered to
interference, civil unrest, be low, due to security
wars, financial and monetary and political stability;
State Risk international reports
policies and high level of
indicate that State Risk is
debts. low both in medium and
long terms
74
6.2 Sensitivity Analysis
First: Increase of Investment cost by 10%
The following table shows the results of the sensitivity analysis when investment cost
increases by 10%.
Table 23: Investment Increase by 10%

Index Base Impact Change
Internal Rate of Return (IRR) 19.7% 18.3% 1.4%
The Present Value at a discount rate of 13% (in
477.7 487.1 -9.5
Thousand JD)
Net Present Value at a discount rate of 13% (in
156.6 133.9 22.6
Thousand JD)
Profitability Index (Time) 1.5 1.4 0.1
Payback period (Year) 6.0 6.4 -0.4
The Net Profit Ratio – an average of 10 years 9.9% 9.9% 0.0%
Return on Investment - an average of 10 years 10.8% 10.1% 0.7%
Return on Capital – an average of 10 years 14.9% 13.5% 1.4%
Net profit on Revenue - an average of 10 years 9.9% 9.9% 0.0%
Return Assets%– an average of 10 years 1.0 0.9 0.1
The added value - an average of 10 years (in
319.5 319.5 0.0
thousand JD)
income tax - an average of 10 years (in
12.5 12.5 0.0
thousand JD)
sales tax - an average of 10 years (in thousand
0.0 0.0 0.0
JD)
The above analysis refers to the feasibility of investment in the project, in light of the high
cost of the total investment of the project, which increased by 10%. It is noted that:
 the internal rate of return reaches 18.3%, which is considered high for investment
purposes
 the new payback period is 6.4 years, and it is reasonable for recovery purposes
 the return on capital is 13.5%, which is suitable for investment purposes
75
Second: Reducing Revenues by 10%
The following table shows the results of the sensitivity analysis when reducing revenues by
10%.
Table 24: reducing revenues 10%

477.7 264.4 213.2
Thousand JD)
156.6 -56.6 213.2
Thousand JD)
Return Assets%– an average of 10 years 1.0 1.2 -0.2
319.5 278.3 41.2
thousand JD)
12.5 5.4 7.1
thousand JD)
0.0 0.0 0.0
JD)
The above analysis shows the low sensitivity of the project in the case of reducing the
revenues or demand by 10%. It indicates that:
 the internal rate of return is 10.3%, which is considered high for investment
purposes
 the new payback period is 8.7 years and it is reasonable for recovery purposes
 the return on capital reaches 4.2%, which is suitable for investment purposes
76
Third: Increasing the Operating Costs by 10%
The following table shows the results of the sensitivity analysis when increasing the
operating costs by 10%.
Table 22: Increasing the Operating Costs by 10%

477.7 306.6 171.1
Thousand JD)
156.6 -14.5 171.1
Thousand JD)
Return Assets%– an average of 10 years 1.0 1.2 -0.2
319.5 288.3 31.1
thousand JD)
12.5 7.3 5.2
thousand JD)
0.0 0.0 0.0
JD)
The above analysis shows the feasibility of the project in light of increasing the operating
costs of the project by 10%. It indicates that:
 the internal rate of return is 12.3%, which is considered high for investment
purposes
 the new payback period is 8 years and it is reasonable for recovery purposes
 the return on capital is 6.8%, which is suitable for investment purposes
77

A Home Healthcare Services Company - Zarqa

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A Home Healthcare Services Company - Zarqa

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Pre-Feasibility Study

Establishing A Home Healthcare Services Company

1. EXECUTIVE SUMMARY ............................................................................................ 4

A Home Healthcare Services

Table 1: Initial indicators of the project

 Coordinating with ambulance services.

and patients to recover and recuperate in their own homes,

Investment Cost The project investment cost is about JD 321,000.

The Sensitivity Analysis indicates a low risk in case of 10% increase in

 There are no integrated services for treating chronic medical

2. The Macroeconomic Environment

2.1 An Overview of the Hashemite Kingdom of Jordan

Figure 1: Map of the Hashemite Kingdom of Jordan

Table 3: Number of population and population growth in the Kingdom, thousand

Figure 2: population growth rate in the Kingdom

2.3 Economic Indicators in the Kingdom 1

Furthermore, many of the external sector indicators registered a drop in performance in

Table 4: main economic indicators 2011 to 2015 in millions of dinars

2111 2112 2113 2114 2112

2.4 The Jordanian Investment Environment

Investment Law No. 30 for 2014

The following shows the major incentives granted by the law:

 Incentives and Benefits outside the Development and Free Zones

 Incentives and Benefits inside the Development and Free Zones

 Trade and Free Trade Agreements

The most important agreements are:

Human Development Report for 2015

2.5 The Economic Environment in the short and medium term

Table 2: Assessment of short and long-term risks

Table 6: The most important key economic indicators 2016-2020

3.1 Project Description

3.2 Expected Services Description

Services of the Project include:

 Treatment with intravenous injection at home.

3.3 The Current Status of Health Sector

Source: Ministry of Health, 2015 Annual Statistical Report

Employment in the Sector

Table 7: Number of employees in health sector:

3.4 Market Analysis

Table 8: Hospital admissions in 2015

Private Hospitals 283 28,104 48,939

Total of Zarqa Governorate 957 73,064 200,085

Kingdom's Total of Both Sectors 8,308 641,971 1,692,657

Ratio of Kingdom 12% 11% 12%

Orthopedics 2,273 8,407 5%

Obstetrics & Gynecology 14,600 29,262 32%

Urology 314 729 1%

ICU 1,764 7,285 4%

CCU 515 2,123 1%

others 17,255 75,543 38%

total 44,960 151,146 100%

Total of Kingdom 369,538 1,154,942

Ratio of Governorate to Kingdom 12% 13%

Ratio of Zarqa Governorate to Kingdom 5% 9% 8%

Chest Surgery &

Neurosurgery 0 145 145 954 4,340 5,294 1% %2.74

Plastic & Burns 79 140 219 1,073 5,439 6,512 1% %3.36

Urology Surgery 458 1,169 1,627 3,624 8,671 12,295 7% %13.23

Pediatric Surgery 0 428 428 2,855 3,965 6,820 2% %6.28

Otorhinolaryngology 847 1,471 2,318 5,986 12,990 18,976 10% %12.22

Ocular Surgery 1,100 48 1,148 8,397 14,104 22,501 5% %5.10

Total 10,874 12,865 23,739 89,047 133,800 222,847 100% 10.65%