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Overview of Public Health in Palestine

 

According to the Palestinian Central Bureau of Statistics (2017), the estimated population of Palestine is 4,780,978, with around 2,881,687 people living in the West Bank (5,655 sq. km) and 1,899,291 in the Gaza Strip (365 sq. km). The largest percentage of the population is under the age of 17 (43.9%). Males make up 51% of the population and females 49%.

 

The average family size is 5.1 people per household (4.8 in the West Bank and 5.6 in Gaza). Around 78.3% of the population (excluding residents of East Jerusalem) has health insurance, 98.1% is educated, 27.2% is unemployed, and 5.8% is disabled.

 

For further information and statistics on the population of Palestine, please refer to the Palestinian Central Bureau of Statistics (PCBS) report published in February 2018: http://www.pcbs.gov.ps/Downloads/book2364-1.pdf

 

A World Bank report (2018) shows that around 29% of Palestinians live in poverty, while 2.5 million are in need of humanitarian assistance. According to the World Food Programme (2018), 22.5 million are food insecure.

 

Access to health services in the West Bank is restricted by the Israeli separation wall and checkpoints. Palestinian patients, health workforce, and ambulances are refrained from accessing referral hospitals in East Jerusalem, as entrance to the city is only possible for holders of Israeli-issued permits. The process of obtaining a permit is complicated, and can result in delays or denial of care. Gaza patients in need of specialized health care may also be denied care due to the closure of the Rafah border crossing with Egypt or the complicated process of passing through the border.

 

For further information on the geopolitical situation in Palestine, please refer to the OCHA website via the link below:

 

 

According to the Palestinian Central Bureau of Statistics (2016), total current expenditure on health reached 1.419 million USD (10.7% of GDP). Expenditure is covered by the government (around 37%), private insurance companies (around 3%), households/out-of-pocket (around 41%), non-profit organizations (around 18%), and others (around 1%).

 

The Palestinian Ministry of Health (MoH), UNRWA, Military Health Services, NGOs, and the private sector cover primary, secondary, and tertiary health care services. According to the MoH (2017), there are 743 primary health care centers in Palestine (583 in the West Bank and 160 in Gaza), and 81 hospitals (51 in the West Bank, including East Jerusalem, and 30 in Gaza).

 

According to the Palestinian Ministry of Health (2017), the burden of non-communicable diseases in Palestine is high. The leading causes of death are cardiovascular diseases, cancer, cerebrovascular diseases, conditions in perinatal period, and diabetes. Related risk-factors such as smoking, unhealthy diet, and sedentary lifestyle are widespread.

 

Life expectancy in Palestine has increased to 73.8; 74.1 in the West Bank and 73.3 in Gaza; 75.4 for females and 72.3 for males. Disability rates are 2.7% in the West Bank and 2.4% in Gaza (MoH, 2017).

 

Due to political instability and worsening living conditions in Gaza, disabilities, traumatic injuries, and amputations are increasing. The burden of mental and psychological disorders is prevalent due to the occupation’s continuous use of violence, lack of personal security, human rights violations, and restrictions on movement.

 

Water scarcity in Palestine seriously impacts public health in Palestine. According to the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation, the percentage of the population served by piped water services dropped from 88% in 1995 to 56% in 2015. In Gaza, high proportions of fecal indicator bacteria have been detected in drinking-water supplies. Furthermore, the coastal aquifer is low, contaminated, and overused. Wastewater treatment is inadequate, resulting in untreated sewage, causing further contamination of coastal seawater in Gaza.

 

PCBS states that infant mortality in 2017 reached 10.7 deaths per 1000 live births, and the under-five mortality rate reached 12.1 deaths per 1,000 live births. This reflects a significant improvement when compared to death rates in previous years. The MoH (2017) estimated the maternal mortality rate in Palestine to be 5.9 per 100,000 live births.

 

The WHO continues to support the MoH in sustaining high vaccination coverage for communicable diseases and effective monitoring of health indicators. According to the MoH (2017), incidence rates of reported communicable diseases are: 3.71 H1N1, 6.5 other bacterial meningitis, 3.0 food poisoning, 9.4 hepatitis A, and 2.4 acute flaccid paralysis (AFP) per a population of 100,000. Reported sexually-transmitted infections in 2017 were over 50,000. In addition to communicable diseases, the incidence rate of mental disorders per 100,000 population was 117.2.

 

Based on PNIPH's 2017 research on the extent of illicit drug use in Palestine, only 1.8% of the male population above 15 (26,500 individuals) were identified as high-risk drug users.