The Palestinian Economy. Theoretical and Practical Challenges

Proceedings “The Palestinian Economy: Theoretical and Practical Challenges” 349
Palestinian Central Bureau of Statistics (PCBS), covered a national representative sample
of Palestinian households residing in the West Bank (WB) and Gaza Strip (GS), and
provide detailed information on households’ incomes and expenditures, individuals’
health care seeking behaviours and morbidity patterns, insurance coverage, and other
relevant socioeconomic characteristics. Consequently, the survey offers a unique
opportunity to assess, for the first time, inequity features of health care delivery system
proper to the OPT. Second, we present separately disaggregated results for three levels of
health care: primary, secondary and tertiary care. This allows us to examine whether
patterns of inequality differ across the levels of health care. Finally, we perform statistical
inference based on bootstrapping (BTS) methods. The latter provides the statistical basis
for testing for inequality dominance between concentration curves in order to reduce the
risk of biased interpretations due to sample structures.
The report is organised as follows: Section 2 reviews the main institutional and
contextual features of health care delivery in the OPT, which are of relevance to
understand the functioning and the characteristics of the specific health care system under
consideration. Section 3 sets out the methods used to measure and decompose inequality.
This is followed by describing the data requirements, the variables used, in addition to the
model choice and estimation procedures (Section 4). Section 5 presents the results of the
analysis. The penultimate section discusses the results and the value-added of
methodological developments, as well as study limitations (Section 6). We end with
conclusions and policy recommendations in the last section (Section 7).
2. The Palestinian health care system: geopolitical context and
organisation
2.1. Structure and Distribution
Four health care providers are currently responsible for the provision of health services
for the population residing in the OPT: the public sector (the Palestinian MoH), the
UNRWA, a group of Palestinian not-for-profit organisations (PNGOs), and a rapidly
developing private for-profit sector (PNA-MoH 2008). Despite the variable nature of the
four health care providers, a certain degree of “complementarity” has been identified
(Hamdan, Defever et al. 2003). For instance, following the political predicament and
economic hardships resulting from military closures, bantustanisation, and