Health Status in Palestine
Palestine - Demographic
• From a health perspective OPt consists of two
geographical areas- the West Bank (including
East Jerusalem) and the Gaza strip .
• The West Bank is an area of about 5,800 Km2
with a population of just over 2 million.
• The Gaza is a densely populated area of
360Km2 with a population of a little over 1
million
Palestine – Demographic, Cont..
• 26% of the population of the West Bank are refugees.
• 65% of Gaza population are refugees.
• The Palestinian population are young with nearly 20%
being under 5 years old, 47% under 15, and only 5%
being over 60 years old.
• Average household size is just over 6 .
• Population growth 3%.
• 85% of Palestinians have access to water networks.
• 34% of Palestinians in the West Bank and 54% in Gaza
are connected to sewage networks
• Per capita spend on health ( year 2000) US$ 100 ( 6.5%
of per capita GDP).
Selected Health Indicators
1
Indicator
2002
2000
1997
2
Population Growth Rate
3.7%
3%
3.1%
3
Crude Birth Rate
27.2/1000
33.2/1000
34.5/1000
4
Crude Death Rate
3.1/1000 birth
3.2 / 1000 birth
3.5
5
Life Expectancy Rate
71.9
71.8
71.5
6
Infant Mortality Rate
23.3
22.7 /1000 birth
24
7
Maternal Mortality Rate (per
100,000)
13.8 (reported)
37.3 ( reported)
77( Estimated)
8
Total Fertility Rate
4.31
4.31
5.58
Health Care Services
There are four major health care providers
operating in Palestine
• Ministry of Health
• UNRWA
• NGOs
• Private sector
Health Care Services
Distribution of Health Care Facilities by Provider
Government UNRWA
51
NGOs TOTAL
&
Private
185
595
Hospitals 21
1
47
69
H. Beds 2303
58
1895
4256
PHC
359
Impact on Health
since September 2000
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High number of victims
High number of injured
High number of expected disabilities
Lack of access to health services duo to
checkpoints and closures.
• performance of health providers and quality of
services (next slide)
• Budget constrains
• Implementation of development of health care
system affected badly
Cont..
• Health insurance revenues decreased by 60%
• Number of food samples and bacteriological water
samples for laboratory tests decreased by 33%
• Accumulation of garbage in cites and villages causing
severe in both health and environment
• The immune response of children for measles vaccine
was affected duo to disturbance of cold chain.
• Discontinuation of vaccination campaigns duo to
prevention of medical teams from reaching villages and
remote areas
• Decrease vaccination of anti-rabies vaccine for animal
bites cases by 17%, hepatitis A cases by 16% , hepatitis
B for adults by 23% and anti tetanus vaccination by 35%
Cont..
• Surveillance of inf. Diseases decreased
• Shigelloses outbreak ( 556) was reported in
Hebron
• 50 cases of infectious diseases were unable to
visit the central labs. For diagnosis and follow
up, 200 patients of hepatitis B &C could not
continue follow up
• 1500 contacts to hepatitis B delayed from
receiving immunization on time
• Patients with chronic diseases could not receive
proper follow up and medication
Segregation wall
General Effect of the wall
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Economic effect- poverty- malnutrition
Stress
Destruction of the health and referral systems
Increased costs
Prevention of patients movement
Prevention of health workers movement
Cutting off communities
Blocking ambulances
Blocking vaccines & medical, supplies
Blocking preventive care
Decline in care for chronic patients
Serious effect on Cancer patients
Impact of separation wall
• The wall will affect 161,700 dunams which is
2.9% of West Bank land area.
• It was estimated that the wall will cause direct
harm to at least 210,000 Palestinians residing in
67 villages, towns and cities.
• The wall will affect all the life aspects of the
Palestinians including Health, Education,
Employment, farming and social life.
• 145 out of 190 Km (stage 1) start operating
since July 2003.
Implications on the health care system
1. Creation of 22 vulnerable enclaves (71 clinics)
separated from the West Bank.
2. A change in the geographical distribution of
health care facilities.
3. Isolation of rural communities from urban
centers.
4. Lower quality of health care services.
5. Reliance on Humanitarian Aid.
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Complete enclosure
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 9 pockets of isolated
communities.
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 These communities are
served by a total of 36
clinics.
 Ramallah enclaves
mostly affected.
Time of openings