Posted: March 14, 2009

Hanan F Abdul Rahim, Laura Wick, Samia Halileh, Sahar Hassan-Bitar, Hafedh Chekir, Graham Watt, Marwan Khawaja

The Countdown to 2015 intervention coverage indicators in the occupied Palestinian territory are similar to those of other Arab countries, although there are gaps in continuity and quality of services across the continuum of the perinatal period. Since the mid-1990s, however, access to maternity facilities has become increasingly unpredictable. 

Mortality rates for infants (age ≤1 year) and children younger than 5 years have changed little, and the prevalence of stunting in children has increased. Living conditions have worsened since 2006, when the elected Palestinian administration became politically and economically boycotted, resulting in unprecedented levels of Palestinian unemployment, poverty, and internal conflict, and increased restrictions to health-care access. Although a political solution is imperative for poverty alleviation, sustainable development, and the universal right to health care,

women and children should not have to wait. Urgent action from international and local decision makers is needed for sustainable access to high-quality care and basic health entitlements. 

Introduction

Maternal and child health are important components of present and future population health in the occupied Palestinian territory, where roughly 40% of the

population are women of reproductive age and children younger than 5 years.¹ Although the economic situation had been on a downward trend since the second intifada (popular uprising against occupation) in 2000,² living conditions worsened after the elections in January, 2006, which gave the political party Hamas control of the Palestinian Legislative Council and brought about a political and economic boycott by several countries in the international community.³Poverty in the occupied Palestinian territory has risen sharply, and more than a third of the population is classified as food insecure.⁴

The Israeli-imposed system of several hundred checkpoints and barriers to movement has severely restricted access to services,⁵ and these restrictions can be especially crucial in perinatal and child-health emergencies.⁶

In this report, we discuss the situation in the occupied Palestinian territory with respect to the fourth and fifth Millennium Development Goals (MDGs) for reduction of child mortality and improvement of maternal health, respectively, and we use the Countdown to 2015⁷ indicators to assess coverage of priority interventions.

However, because coverage indicators alone do not indicate the complexity of maternal and child health-care provision in a specific context, ⁸ we describe the broad context of service provision, which is characterized by challenges common to many low-income and middle-income countries, such as poverty, poor nutrition, and an overburdened public-health system, but which is also unique in terms of the presence of a military occupation and a state of protracted conflict.⁹

Within the constraints of the present economic and political conditions, we propose changes for improvement of the services provided to women and children in the short term, and we make long-term recommendations that presuppose a conducive political situation.

Read the report

References

1 Palestinian Central Bureau of Statistics. Palestinian family health survey, 2006: preliminary report. Ramallah: Palestinian Central Bureau of Statistics, 2007.

2 World Bank. West Bank and Gaza economic developments and prospects —March, 2008. West Bank and Gaza: World Bank, 2008.

http://go.worldbank.org/A6Y2KDMCJ0 (accessed Dec 1, 2008).

3 Stanforth R. Poverty in Palestine: the human cost of the financial boycott. April 2007. Oxfam briefing note. Oxford, UK: Oxfam International Secretariat, 2007. http://www.oxfam.de/download/Palestinian_Aid_Crisis.pdf (accessed March 31, 2008).

4 Food and Agriculture Organisation of the United Nations and United Nations World Food Program. Comprehensive food security and vulnerability analysis. Jerusalem: Food and Agriculture Organisation of the United Nations and United Nations World Food Program, 2007.

5 UN Relief and Works Agency. United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), November 2007. UNRWA emergency appeal 2008. Gaza Strip: United Nations Relief and Works Agency, 2008. http://www.un.org/unrwa/emergency/appeals/2008-appeal.pdf (accessed Feb 11, 2008).

6 Murray S, Pearson S. Maternity referral systems in developing countries: current knowledge and future research needs. Soc Sci Med 2006; 62: 2205–15.

7 Countdown Coverage Writing Group and on behalf of the Countdown to 2015 Core Group. Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking coverage of interventions. Lancet 2008; 371: 1247–58.

8 Countdown Working Group on Health Policy and Health Systems. Assessment of the health system and policy environment as a critical complement to tracking intervention coverage for maternal, newborn, and child health. Lancet 2008; 371: 1284–93.

Report´s name: Maternal and hild health in the Occupied territory.

By: Hanan F Abdul Rahim, Laura Wick, Samia Halileh, Sahar Hassan-Bitar, Hafedh Chekir, Graham Watt, Marwan Khawaja

Year: 2009

Source:

http://www.thelancet.com