The Palestinian Economy. Theoretical and Practical Challenges

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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