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

1Indicator200220001997

2Population Growth Rate3.7%3%3.1%

3Crude Birth Rate27.2/100033.2/100034.5/1000

4Crude Death Rate3.1/1000 birth3.2 / 1000 birth3.5

5Life Expectancy Rate71.971.871.5

6Infant Mortality Rate23.322.7 /1000 birth24

7Maternal Mortality Rate (per 100,000)

13.8 (reported)37.3 ( reported)77( Estimated)

8Total Fertility Rate4.314.315.58

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

GovernmentUNRWANGOs&

Private

TOTAL

PHC35951185595

Hospitals2114769

H. Beds23035818954256

Impact on HealthImpact on Healthsince September 2000since September 2000

• 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

• 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 wallImpact 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.

Complete enclosure

9 pockets of isolated communities.

These communities are served by a total of 36 clinics.

Ramallah enclaves mostly affected.

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