Health Economics In Palestine Within A Global Context: A Review Study Till 2006 (original) (raw)
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Catastrophic Healthcare Payments and Impoverishment in the Occupied Palestinian Territory
Applied Health Economics and Health Policy, 2010
Background: Financial protection from the risks of ill health has globally recognized importance as a principal performance goal of any health system. This type of financial protection involves minimizing catastrophic payments for healthcare and their associated impoverishing effects. Realization of this performance goal is heavily influenced by factors related to the overall policy environment and sociopolitical context in each country. Objectives: To examine the incidence and intensity of catastrophic and impoverishing healthcare payments borne by Palestinian households between 1998 and 2007. The incidence and intensity of these effects are examined within the historically unique policy and socioeconomic context of the occupied Palestinian territory. Methods: A healthcare payment was considered catastrophic if it exceeded 10% of household resources, or 40% of resources net of food expenditures. The impoverishing effect of healthcare was examined by comparing poverty incidence and intensity before and after healthcare payments. The data source was a series of annual expenditure and consumption surveys covering 1998 and 2004-7, and including representative samples of Palestinian households (n = 1231-3098, per year). Total household expenditure was used as a proxy for household level of resources; and the sum of household expenses on a comprehensive list of medical goods and services was used to estimate healthcare payments. Results: While only around 1% of the surveyed households spent ‡40% of their total household expenditures (net of food expenses) on healthcare in 1998, the percentage was almost doubled in 2007. In terms of impoverishing effect, while 11.8% of surveyed households fell into deep poverty in 1998 due to healthcare payments, 12.5% of households entered deep poverty for the
The political economy of health system reform in Israel
Health Economics, 1995
On June 15, 1994, the Israeli Parliament voted to enact the National Health Insurance bill (NHI). The bill marks the end of a process that lasted for virtually as long as Israel's almost 50 year history. Israel's attempts at health reform began long before the current spate of reforms in many Western countries.' Faced with many of the same problems of access, equity and cost control common to many of its counterparts, Israel initiated a reform process based on the recommendations of a prominent State Commission of Inquiry into the Israeli Health System (the Netanyahu Commission) which reported to the Government in 1990.2 The Commission's proposals were based on a diagnosis indicating that the major problems of the system stem from the lack of clarity regarding the rights of citizens to health care, the lack of a clear allocation of responsibility and accountability among government, insurance or sick funds, and providers in the system, and undue centralization of system operations. T h i s diagnosis led to three major planks for reform: (1) enactment of national health insurance legislation granting a basic package of care to each citizen and hence bringing most of the system's finance under public auspices; (2) divesting the Government from the organization, management and provision of care; hence integrating the management of preventive and psychiatric services provided by the government with the primary and other services provided by sick funds, and granting financial and operational independence to at least government hospitals; and (3) restructuring the Ministry of Health.
Health and health care in Israel: an introduction
Lancet (London, England), 2017
Starting well before Independence in 1948, and over the ensuing six decades, Israel has built a robust, relatively efficient public system of health care, resulting in good health statistics throughout the life course. Because of the initiative of people living under the British Mandate for Palestine (1922-48), the development of many of today's health services predated the state's establishment by several decades. An extensive array of high-quality services and technologies is available to all residents, largely free at point of service, via the promulgation of the 1994 National Health Insurance Law. In addition to a strong medical academic culture, well equipped (albeit crowded) hospitals, and a robust primary-care infrastructure, the country has also developed some model national projects such as a programme for community quality indicators, an annual update of the national basket of services, and a strong system of research and education. Challenges include increasing pr...
2009
We describe the demographic characteristics, health status, and health services of the Palestinian population living in Israeli-occupied Palestinian territory, and the way they have been modifi ed by 60 years of continuing war conditions and 40 years of Israeli military occupation. Although health, literacy, and education currently have a higher standard in the Israeli-occupied Palestinian territory than they have in several Arab countries, 52% of families (40% in the West Bank and 74% in the Gaza Strip) were living below the poverty line of US$3·15 per person per day in 2007. To describe health status, we use not only conventional indicators, such as infant mortality and stunting in children, but also subjective measures, which are based on people’s experiences and perceptions of their health status and life quality. We review the disjointed and inadequate public-health and health-service response to health problems. Finally, we consider the implications of our fi ndings for the pr...
Health status and health services in the occupied Palestinian territory
The Lancet, 2009
We describe the demographic characteristics, health status, and health services of the Palestinian population living in Israeli-occupied Palestinian territory, and the way they have been modifi ed by 60 years of continuing war conditions and 40 years of Israeli military occupation. Although health, literacy, and education currently have a higher standard in the Israeli-occupied Palestinian territory than they have in several Arab countries, 52% of families (40% in the West Bank and 74% in the Gaza Strip) were living below the poverty line of US$3·15 per person per day in 2007. To describe health status, we use not only conventional indicators, such as infant mortality and stunting in children, but also subjective measures, which are based on people's experiences and perceptions of their health status and life quality. We review the disjointed and inadequate public-health and health-service response to health problems. Finally, we consider the implications of our fi ndings for the protection and promotion of health of the Palestinian population, and the relevance of our indicators and analytical framework for the assessment of health in other populations living in continuous war conditions.
Strengthening the Palestinian Health System
2005
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A ‘transitional’ context for health policy development: the Palestinian case
Health Policy, 2002
The objective of this article is to focus on the challenges and opportunities the Palestinian health care system is currently facing in a 'transitional period', which started subsequent to the Oslo Agreement in 1993. The characteristics of 'transition' have to be highlighted in order to understand the context and peculiarities in which the Palestinian health care system is operating. A descriptive analysis is provided of the historical, political, economic and socio-demographic elements to gain an insight into the complex context of the Occupied Palestinian Territories, a country in 'transition'.
Palestinian primary health care in light of the National Strategic Health Plan 1999–2003
Public Health, 2008
Methods: This descriptive study used content analysis with a retrospective review of data gathered from the PNSHP and other related reports and publications. Results: The crude death rate and total fertility rate had improved, but the infant mortality rate had increased by the end of the study period. Heart diseases were the primary cause of death in Palestine. Acceptable vaccination coverage had mainly been achieved, particularly for tetanus, diphtheria, measles and polio. There were still concerns regarding water supply and other sanitary conditions, a notable increase in the incidence of vector-borne diseases, especially cutaneous Leishmaniasis in West Bank, and mental health had worsened by the end of the study period. Conclusions: Certain health promotion and environmental health actions should be undertaken urgently by the Palestinian health care services to cope with environmental and sanitary conditions, and to further improve health status regarding communicable and non-communicable diseases in Palestinians. Health research and surveys are insufficient and should be undertaken regularly. The main barrier to the success of the PNSHP was the lack of follow-up due to political and socioeconomic instability. There is an urgent need for international intervention and support.