In 1994, the newly-established Palestinian Authority or PA inherited a neglected healthcare system from Israeli authorities, who occupied the West Bank and Gaza Strip in 1967.

The Palestinian ministry of health, the United Nations Relief and Works Agency or UNRWA, non-governmental organizations and the private sector are the primary health care providers in the occupied Palestinian territories. The ministry offers primary, secondary and specialized care. Its other main role is to regulate and legislate the sector.

Before the outbreak of the second intifada in September 2000, health indicators in the occupied Palestinian territories showed improvement. However, the pace of improvement is much slower compared to progress in Israel health indicators.

BRITISH MANDATE TO OCCUPATION

British authorities controlled Palestine between 1920 and 1948. Authorities only provided basic public health services. After the 1948 war, separate health systems emerged. Israel controlled central Palestine, Jordan administered the West Bank and Egypt administered the Gaza Strip.

UNRWA provided health services for the hundreds of thousands of Palestinian refugees, and the private sector and charities administered hospitals and clinics. After Israel occupied the West Bank and Gaza Strip, its military took control of the public healthcare system.

Israeli authorities restricted budgets, referred patients to Israeli hospitals and limited licenses for new healthcare projects in the occupied West Bank and Gaza. The healthcare system stagnated as hospitals and health facilities were shut down or undeveloped. Palestinian medical professionals were blocked from participating in decision making and management.

During the late 1970s and early 1980s, infant mortality was high, estimated at 50-100 deaths per 1000 live births. Morbidity levels were also high, and the rate of malnutrition was 50 percent among children in some communities.

PALESTINIAN INITIATIVES

Popular health committees, many affiliated with Palestinian political movements, emerged in the late 1970s alongside civil society groups. They aimed to build independent health institutions and infrastructure. Volunteer workers reached out to the underprivileged. These initiatives mainly concentrated on a preventative and educational approach to health. They also emphasized popular participation. As a result, new concepts and methods in healthcare provision were introduced, mainly focusing on primary healthcare.

GENERAL HEALTH CONCERNS

In 2009, the occupied Palestinian territories continue to cope with illnesses characteristic of  developing countries (infectious diseases, malnutrition and so forth). Additionally, increasing rates of so-called modern diseases (cardiovascular diseases, diabetes, hypertension, cancer, etc.) add to overall health concerns.

Non-communicable diseases pose a serious public health problem as they are the leading causes of death (heart diseases: 25 percent, malignant neoplasm: 19 percent, accidents: 15 percent and cerebrovascular conditions: 8 percent).

Anemia is a major consequence of nutritional inadequacies. Over a quarter of children under five and a third of women of child-bearing age are anemic. Other deficiencies include lack of vitamin A and iodine. The level of chronic malnutrition among under-fives appears to be increasing, along with obesity and dietary-related chronic diseases, particularly in older age groups.

CHILDREN & WOMENzzz*zS HEALTH

The maternal mortality ratio is estimated at 7.7 per 100,000 live births among women aged between 15 and 49. Although this ratio has been decreasing progressively over the past few years, the figure does not reflect the real situation on the ground. Diagnosis and reporting is often erroneous as increasing Israeli security measures have severely restricted women’s access to healthcare services.

According to Palestinian Central Bureau of Statistic data, the infant mortality rate has slightly increased from 24 per 1000 live births in 2004, to 25 per 1000 in 2006. The under-fives mortality rate remained the same between 2004 and 2006 at 28 per 1000 live births. In terms of causes of death, prematurity and low birth weight alone constituted 27 percent of all reported deaths among 0–19 year olds.