Health system in Palestine Rawan shaaban

Definition A health system is the combined entity of all resources, actors and institutions related to the financing, regulation and provision of all activities whose primary intent is to improve or maintain health (WHO, 2000).

Goals The goals for health systems according to the World Health Report 2000 - Health systems: improving performance (WHO, 2000) responsiveness to the expectations of the population and fair financial contribution

Health status and demographic % indicators 42.5 Population under 15 3.1 Population above 65 72.6 (M/F 70.2 / 72.9) Life expectancy 27.8 Infant mortality rate 7.1 Low birth weight 32.65 Crude birth rate/1000 4.48 Crude death rate/1000 25 Probability of dying before 1 year 10 Maternal mortality rate

Health status and demography Chronic disease in Palestine: diabetic, cardiovascular dse ,cancer .these diseases are major causes of death in palestine.1/10 of Palestinian population suffer from at least one of chronic disease. Communicable diseases:Palestine is well known country of high coverage of vaccination control of many diseases: poliomyelitis ,tuberculosis. Vaccination for measles increased from 92.5% in 2000 to 98.3 in 2008 AIDS :64 cases from 1988 to 2008.

Providers of health care in Palestine MOH (Main) : provides primary, secondary and tertiary health services and purchase the unavailable tertiary health services from domestic and abroad providers UNRWA : provides primary care services only for refugee and purchase secondary care services for the hardship cases Non governmental organizations (NGOs) provide primary, secondary and some tertiary services. Private Sector (for profit provider) : provides the three level of care through a variety of specialized hospitals and investigation centers

Primary health care There are general practitioners, clinics ,specialists, pediatric ,obstetric, internal medicine, health education activities and emergency services as well as the laboratory service, immunization of Palestinian is available. Primary health care providers are: MOH, NGOs, UNRWA and private provider. There are 2.41 general practitioners , .84 specialist , .77 dentist , .70 pharmacist , 4.42 nurses , .72 midwives, .72 health workers per 10,000 population in Palestine. There are 672 primary health centers for MOH, 425 primary health centers for UNRWA, and 178 centers for NGOs in Palestine

Public sector There are four types of public facilities providing primary health care services: Health post : provides preventive health services such as health education( hygiene ,sanitation ,safe water ).these services provided by visiting physician for once or twice a week .for example health promotion department In MOH Health clinics : is staffed by general practitioner, it provides curative and general services . Health center : provides a wider range of health services , which includes laboratory services, x ray services. Comprehensive health center: its provide full day preventive and curative services which include in addition to what offered in previous level ,physiotherapy, and consolations by a Varity of specialist, each comprehensive centers has 24 hours emergency services ,for example hospitals.

Secondary and tertiary care the secondary health care delivery is a mix of MOH, NGOs, UNRWA and private providers. Most of hospitals in Palestine are general hospital, there are some special hospitals for example pediatric and ophthalmic hospitals. MOH owned and operate 22 hospital with total capacity of 2735 beds There are 31 hospitals with capacity of 1565 beds owned and operate by NGOs. Private sector has 23 hospitals with total capacity 461 beds Cases that have no treatment in Palestine are refer to external hospital such as in Jordan , in 2008 there are 43,047 are refered to external hospitals

Ministry of health organization reference Ministry of health organization