The Palestinian Economy. Theoretical and Practical Challenges

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Proceedings “The Palestinian Economy: Theoretical and Practical Challenges” 351 across the WB and GS. The role played by each of the four health care providers is summarised below. Table 2.1: Distribution of Health Care Services by Regions and Providers, 2005 Primary Care Centers* Secondary and Tertiary Hospitals** Hospital beds per provider** Market share based on number of visits*** Rate of utilisation as percentage of total patients **** MoH UNRWA NGOs Private WB GS WB GS WB GS WB GS Total 360 56 35 18 130 55 -- -- 654 12 10 1 0 20 10 21 2 76 1,316 1,499 63 0 1,196 485 432 34 5,025 46.1% 19.7% 12.8% 21.4% 100% 47.0% 24.6% 11.7% 16.7% 100% *Ministry of Health. Health Status in Palestine, 2005 Annual report, Palestine, October 2006 (p.14) ** Ministry of Health. Health Status in Palestine, 2005 Annual report, Palestine, October 2006 (p.34, 38) *** PCBS. Health Care Providers and Beneficiaries Survey-2005, Main Findings, June 2006 (p.57) **** World Bank, BCRD. The Role and Performance of Palestinian NGOs in Health, Education & Agriculture, December 2006 (p.46) -- Reliable data about the private for-profit sector is lacking, however, it is estimated that there are about 370 self-employed GP clinics in the WB, and about 80 in the GS (MOH 1999) 2.1.1. The Public Sector The public sector comprises the MoH and the Military Medical Services (a network of basic health services reserved for employees of the Palestinian security services) (Hamdan, Defever et al. 2003). Currently, the MoH is the main provider of health care for the Palestinian population in the WB and GS (MOH-MHIS 2002). It owns and manages the majority of PHC centers, with a total of 416 centers, representing about 63.6% of all PHC centers scattered all over the WB and GS (Tables 2.1). In 2004, about 46.1% of total health care visits took place at Ministry of Health facilities, 21.4% in the private for-profit
352 Abu-Zaineh – Mataria sector, with the remaining 32.5% shared between UNRWA and non-governmental organisations (PNGOs) in a ratio of 60:40, respectively (PCBS 2006). Lately, the share of the MoH in overall service delivery has risen significantly, mainly due to the extension of GHI coverage after the outbreak of the second Intifada (end 2000), and the accompanying massive impoverishment of the population (HPU 2008a). Of the 76 hospitals in the OPT (1.3 beds per 1000 capita: 1.2 in the WB and 1.4 in GS), the MoH operates 22 hospitals with a total of 2,815 beds, representing 56.03% of total hospital beds. Most of MoH hospitals are over-utilised, with average occupancy rate of 80%. Consequently, the MoH hospitals frequently have to reject cases due to the “full occupancy” (Mataria, Khatib et al. 2009). The average number of patients admitted to hospitals per year is estimated by 11% of the total population and this is a high percentage for a young population of which the percentage of the population over 65 years old is around 3% (PCBS 2006). The high rate of admissions to hospitals and short length of stay may indicate either unnecessary admissions or early discharge (Mataria, Khatib et al. 2009). It is important to indicate that the MoH does not operate any health services in the Palestinian East Jerusalem, contrary to other health care providers, since Israel considers it as part of its State, taking control of health care in that area. On the other hand, the MoH is outsourcing specific tertiary health care and advanced diagnostic services with local and overseas providers. The total number of referred cases for hospitalisation (57.5% of the cases) and consultation (42.5% of the cases) amounted up to 10,764 cases in 2001 (MOH-MHIS 2002). Patients are mainly referred to other local providers, including PNGOs and the private sector (61.6% of the cases), and to Egypt, Jordan and Israel with 17.6%, 12.3% and 8.5% of the cases, respectively (MOH-MHIS 2002). 2.1.2. The United Nations Relief and Works Agency (UNRWA) UNRWA provides a variety of social services of education, health care, and social relief and support to registered Palestinian refugees in the WB and GS (including East Jerusalem), as well as, in the neighbouring Arab countries (UNRWA 1995). The existence of the organisation depends on reaching a solution to the Palestinian refugees’ problem. Today, UNRWA counts 4.1 million of registered Palestinian refugees of which 1.6 million living in the WB and GS (about 45% of the OPT population). Consequently, almost half the OPT population should be, in principle, entitled to UNRWA services. However, only a segment of the registered refugees receives health services at UNRWA
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The Palestinian Economy Theoretical
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© Gianni Vaggi - Marco Missaglia -
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VOLUME II
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246 Zagha 1. Introduction The local
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248 Zagha and groups in political d
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250 Zagha drawbacks in the politica
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252 Zagha it is not surprising that
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254 Zagha economy (including expend
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256 Zagha social norms sharply dist
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258 Zagha Bird (1995) puts it, info
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260 Zagha intergovernmental fiscal
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262 Zagha low rate flat tax levied
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264 Zagha need to be given access t
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266 Zagha Such failures are found i
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268 Zagha 4.1.3. The Relationship b
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270 Zagha a final account report of
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272 Zagha 4.1.6. Functions of LGUs
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274 Zagha • Management of LGU ass
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276 Zagha Figure 2: Local Governmen
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278 Zagha In summary, what the data
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280 Zagha on the cash basis. Almost
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282 Zagha Figure 7: Business Opinio
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284 Zagha within the Palestinian na
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286 Zagha Table 5: Number of NGOs i
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288 Zagha Fiscal decentralisation i
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290 Zagha Burki, J., Perry, G., Dil
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292 Zagha Palestinian Legislative C
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Issues, Performance and Trajectorie
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Proceedings “The Palestinian Econ
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424 Olivera provisions - in particu
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426 Olivera Figure 1: Economic Grow
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428 Olivera 3. Traditional economic
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430 Olivera costs and lower market
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The Palestinian Economy. Theoretical and Practical Challenges

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