The health situation in the WB and GS is affected by social, economic and environmental variables such as income, social status, and availability of appropriate water resources, sewage and waste disposal facilities and habitation. The Palestinian society, as other third world countries, is characterised by a high fertility level and the widespread prevalence of several common diseases.
Data indicate a recent notable improvement in some health aspects such as a decrease in infant mortality, and an increase in overall life expectancy. Vaccination rates are also improving. The health infrastructure, however, seem to be deteriorating.
1. Infant mortality
Statistics indicate that infant mortality at 28/1000 live births in 1980. This ratio increased to 41 cases in 1992, then dropped again to 28 in 1996.
2. Life expectancy.
Life expectancy is estimated at 66-71.7 years. In 1992, life expectancy was estimated at 66 years according to data prepared by UNICEF. In 1996, the PCBS estimated female life expectancy at 71.7 - 73.5 and male life expectancy at 70 years.
3. Fertility
Birth rates in Palestine are considered one of the highest in the world, with 6.24 child per woman (7.44 in the GS and 5.61 in the WB). Estimated total births are 50 in 1000 in the GS, and 40 in 1000 in the WB.
4. Common diseases
In recent years it has been possible – because of vaccination - to almost eliminate several previously common diseases such as diphtheria, whooping cough, tetanus, and polio. Some of the remaining widespread diseases are hepatitis, smallpox, measles, brucellosis and mumps. The most widespread disease especially among children is diarrhea.
Management
The Palestinian Ministry of Health manages 178 primary health clinics in the WB and 29 clinics in GS. 210 clinics were managed by non-government organisations (NGOs) in 1992, which dropped to 128 clinics at present. NGOs, however, still manage a third of the total number of 1959 hospital beds. UNRWA also contributes to health services through its 22 medical clinics in the WB and 11 in the GS.
Employment in the Health Sector
There are 12 doctors per 10,000 inhabitants in the WB/GS, in comparison to 24/10,000 in Jordan and 28/10,000 in Israel. The ratio of nurses per inhabitants is 1/1400. 63.6% of those employed in the health sector work at non-governmental establishments. 30.7% of doctors, 40% of nurses and 56% of managers work in the government health sector.
Health care clinics employ 2265 employees (1316 in the WB and 949 in the GS), 16% of whom are doctors (in general and specialised practices) while 30% occupy administrative positions. The remaining are nurses, midwives and other employees.
Hospital bed availability
Statistics show a ratio of 1.1 hospital bed/1000 distributed over government and non-government sectors in addition to UNRWA. Government hospitals contain 61% of total hospital beds, while 37% of hospital beds are in private/non governmental hospitals and 2% in UNRWA hospitals.
Although the ratio of hospital beds per capita seems adequate, there are discrepancies in the geographic distribution of these beds. There are, for example, 2.5 hospital beds/1000 in the central area of the WB, in comparison to 0.4 hospital bed/1000 in the Hebron District.
Geographic distribution of medical services
Medical facilities are unevenly distributed amongst the different geographic areas. Almost 65% of houses in the Hebron District are located far from the nearest health centre versus 22% in other areas of the WB. Rural areas also suffer from a lack of health clinics; there are 277 villages inhabited by 14% of the population which do not have any medical clinics and 196 other communities inhabited by 9% the rural population lack even primary health services.