\n\t\t\t\t8. The Palestinian population in the occupied Palestinian territory is undergoing a demographic transition as the result of relatively low infant mortality and under 5-year-old-mortality rates (28.3\/1000 live births), a high fertility rate and an increase in life expectancy (see paragraph 2 in main document).\n\t\t\t\t<\/div>\n
\n\t\t\t\t9. Although according to the indicators, the overall health status of Palestinians in the occupied Palestinian territory has not changed significantly, the current situation gives reason to predict a deterioration in health standards of the Palestinians. Poverty and food insecurity in particular have increased among vulnerable groups, including communities living near the separation barrier where residents are prevented from reaching jobs and markets. Among those affected by the wall, 50.3% were reported to have reduced food supplies, 51.5% were living below the poverty line and 47.7% were reported not to be connected to a sewage disposal system, compared to 40.1%, 40.9% and 37.8%, respectively, of those not affected by the wall.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t10. The coverage of prenatal services remains at a high level (96.5% in 2004). Postpartum care coverage, however, is still low but appears to have increased over time in the occupied Palestinian territory from 19.7% in 1996 to 26.3% in 2000 and 33.3% in 2004; still about two-thirds of women in the occupied Palestinian territory are not receiving any postpartum care. The fertility rate has declined from around 6 in 2000 to an estimated 4.5 in 2005. The use of family planning methods increased from 45.2% in 1996 to 51.4% in 2000 but dropped to 49% in 2004.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t11. The infant and under-5 mortality rates are lower than the average values in countries in the Middle-East and North Africa (infant mortality rate 53\/1000 live births) and comparable with those in neighbouring Arab countries, but considerably higher than in Israel (infant mortality rate 5\/1000; under-5 mortality rate 6\/1000).\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t12. Acute malnutrition affected 2.8%, 1.4% and 1.9% of young children in the occupied Palestinian territory in 1996, 2000 and 2004, respectively. Stunting, on the other hand, continuously increased from 7.2% of children under five in 1996 to 9.4% in 2004, thus representing a mild public health problem. However, in the event of a further deterioration in the economic situation, stunting levels are likely to increase.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t13. Over one quarter of children under the age of five and 31.1% of women of child-bearing age have Iron-deficiency anaemia. Other micronutrient deficiencies concern vitamin A, vitamin D and iodine. Some 22% of children under five are vitamin A deficient and 53.9% are at the threshold of deficiency. The figures for vitamin A deficiency are significantly higher in the Gaza Strip (26.5%) than in the West Bank (18.9%). Rickets is widely reported throughout the Gaza Strip but rarely occurs in the West Bank; in 2003 and 2004, respectively 444 and 325 cases were reported in the occupied territories. Studies conducted in 2004 indicated a prevalence of iodine deficiency of 15%. However,more than two thirds of households report the consumption of iodized salt, the figures being significantly higher in the Gaza Strip (82.7%) than in the West Bank (56.5%).\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t14. The prevalence of common mental disorders (post-traumatic stress, anxiety, mood and somatoform disorders in 2003 was reported to be 40.3% among the 59% of the population that had been directly exposed to violence, compared to 12.6% among the 31% of the population that had not had such exposure. Research carried out by the Palestinian Counseling Center in the Qalqiliya area showed that a substantial proportion of those surveyed had thoughts of ending their life; the majority felt no hope for the future and expressed feelings of constant anger because of circumstances beyond their control; all reported feeling stressed. Feelings of insecurity also increased in areas directly affected by the separation wall (90% compared to 75% in other areas of the West Bank).\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t15. Over the past few years, the Palestinian Authority has succeeded in preventing and controlling most infectious diseases through public health programmes of immunization, health education and strengthened epidemiological surveillances. In 2004, communicable diseases accounted for only 10.1% of the total mortality. Hepatitis A, B and C are endemic in the occupied Palestinian territory and the surrounding region generally. The immunization schedule for children includes hepatitis B vaccine with a coverage rate of more than 95%. The rate of tuberculosis in the occupied Palestinian territory has dropped to 0.85 per 100 000 in 2004. The incidence rates for both AIDS and HIV infection are reported as 0.03 per 100 000.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t16. Cardiovascular diseases (39.6%), cancer (9.9%), diabetes mellitus (3.6%) and renal failure (3.4%) and perinatal conditions (9.7%) are currently the main causes of death among the general population.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t17. There has been a sharp increase in the number of fatal accidents, with a specific death rate of 9.1\/100 000 in 1995 and 36.0\/100 000 in 2002. In 2003, this rate decreased to 24\/100 000 but increased further in 2004 to reach 32.4\/100 000. The main cause of accidental injuries remains road-traffic crashes.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t
HEALTH SYSTEM<\/strong>\n\t\t\t\t<\/div>\n<\/p>\n
\n\t\t\t\t18. The Ministry of Health and UNRWA are the main providers of health services in the occupied Palestinian territory. UNRWA covers the 1 635 000 refugees and the Ministry has regulatory responsibility for the health system. Local nongovernmental organizations and private professionals also provide some health services. The multiplicity of health providers operating without a unified policy causes some fragmentation of health service delivery.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t19. The health facility network in the occupied Palestinian territory is well developed, in quantitative terms. At the end of 2004, the number of comprehensive primary health-care clinics totalled 731 (606 in the West Bank and 125 in the Gaza Strip); of these, 413 (56.5%) are run by the Ministry of Health, 53 (7.3%) by UNRWA and 265 (36.3%) by nongovernmental organizations. In addition, there are 230 maternal and child health clinics (202 in the West Bank and 28 in the Gaza Strip), 153 specialized clinics (64 in the West Bank; 89 in the Gaza Strip), 197 clinics for family planning (153 in the West Bank; 44 in the Gaza Strip) and 58 dental clinics (27 in the West Bank; 31\n\t\t\t\t<\/div>\n
\n\t\t\t\tin the Gaza Strip).\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t20. Of the 19 544 employees in the Palestinian health system in 2004, more than half (56.9%) worked in the public sector (Ministry of Health). Human resources in the health sector of the occupied Palestinian territory are unevenly distributed between regions and types of professionals. The ratio of nurses to doctors is low (1.5 nurse per doctor), compared to recommended standards.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t21. It has been estimated that, until 2002, Palestinian doctors graduated from 450 different universities in 120 countries. There is no recognized medical specialist training in the occupied Palestinian territory, although in some hospitals it is possible to undertake internships and residencies in some specializations recognized by Jordanian and Palestinian boards.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t22. The per capita health expenditure in the occupied Palestinian territory is higher than the regional average. According to the latest estimation from an ad hoc survey, per capita total health expenditure was US$ 138.4 in 2003. The public health system relies heavily on international assistance and its sustainability is a matter of great concern. A breakdown of total health expenditure in 2002 by source of funding showed that the Ministry of Finance accounted for 15%, the general population for 38% (including health insurance premiums, co-payments and fees in public and private facilities) and donors for 48%. Salaries represent nearly half health Ministry’s budget, and referral abroad is the third highest expense item. Every year thousands of patients seek care abroad, mainly in Egypt, Israel and Jordan. In 2004 the total number of patients referred for admission to hospital and consultation abroad was 31 744, an increase of 57.9% compared with 2003.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t23. About one quarter of the population is not covered by health insurance. In 2004, 76.1% of households in the occupied Palestinian territory were reported to be covered by health insurance. Of these, more than half had government coverage, and about one third were covered by UNRWA. The remaining population was covered by social security, military health-insurance schemes, or Israeli insurances.\n\t\t\t\t<\/div>\n
<\/p>\n
\n\t\t\t\t24. Access to health care is generally fair. However, there are strong grounds for assuming that Palestinians’ access to services has been adversely affected by the restrictions of movement, the separation barrier and the deterioration in the economic situation. Furthermore, the recent political developments and the reduction of funding to the Ministry of Health are likely to have a negative impact on the health sector. A decline in public health programmes and possible disruption of health services are expected if this funding crisis continues.\n\t\t\t\t<\/div>\n
\n\t\t\t\t= = =\n\t\t\t\t<\/div>\n
\n\t\t\t\t_____________\n\t\t\t\t<\/div>\n
\n\t\t\t\t
1 <\/span>Defined as per capita consumption of US$ 2.3 per day for a benchmark household of two adults and four children.<\/span>\n\t\t\t\t<\/div>\n<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan: progress report 1. The Arab population in the occupied Palestinian territory continues to be subject to high levels of poverty and unemployment (43% and 22.5%, respectively, in 2005). Structural constraints such as the permit and closure system regulating the […]<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"template":"","meta":{"footnotes":""},"country":[897],"document-category":[1323],"document-source":[2529],"committee-meeting":[],"document-subject":[1945,1937,2533,2097],"entity":[1985,1729],"document-language":[6542],"class_list":["post-204916","document","type-document","status-publish","hentry","country-israel","document-category-report","document-source-world-health-organization-who","document-subject-assistance","document-subject-economic-issues","document-subject-health","document-subject-social-issues","entity-state","entity-united-nations-system","document-language-english"],"_links":{"self":[{"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document\/204916","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document"}],"about":[{"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/types\/document"}],"author":[{"embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/users\/1"}],"version-history":[{"count":0,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document\/204916\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/media?parent=204916"}],"wp:term":[{"taxonomy":"country","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/country?post=204916"},{"taxonomy":"document-category","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document-category?post=204916"},{"taxonomy":"document-source","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document-source?post=204916"},{"taxonomy":"committee-meeting","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/committee-meeting?post=204916"},{"taxonomy":"document-subject","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document-subject?post=204916"},{"taxonomy":"entity","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/entity?post=204916"},{"taxonomy":"document-language","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document-language?post=204916"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}