The Palestinian Economy. Theoretical and Practical Challenges

Proceedings “The Palestinian Economy: Theoretical and Practical Challenges” 353
facilities, while the rest seek health care elsewhere (Hamdan, Defever et al. 2003).
UNRWA primarily focuses on basic health services, such as disease prevention and control,
primary care, family health, health education, physiotherapy and psychological support and
environmental health (Schoenbaum, Afifi et al. 2005). UNRWA’s health services are
provided through a network of PHC centers throughout the WB and GS; 35 centers in the
WB and 18 in GS, representing about 8.1% of all PHC centers in the OPT (Table 2.1). In
addition, UNRWA provides some secondary care services – for which patients must pay
10-25% of the cost – through a limited number of contractual agreements for hospital care
with NGOs providers, besides its hospital in the WB (63 beds).
2.1.3. The Private not-for-profit Sector (NGOs)
The private not-for-profit sector is represented by a network of Palestinian Non-
Governmental and private voluntary organisations (PNGOs). PNGOs had a central role in
providing health care before the creation of the Palestinian MoH in 1994. Currently, there
are about 49 non-governmental not-for-profit health societies providing health services
for the Palestinian population (Hamdan, Defever et al. 2003). PNGOs contribute to the
provision of all levels of health care, and have a tendency to provide PHC services to
communities under-served by the other agencies, especially in rural areas of the WB. The
number of PHC centers run by PNGOs fell from 242 in 1992 to 177 in 1994 (Barghouthi
and Lennock 1997), and from 214 in 2004 to 185 in 2005, which represent about 28.3%
of the total PHC centers in the OPT (Table 2.1). While the decline in recent years was
attributed to a new classification system (MoH-PHIC 2006), the early decline following
Oslo accords was mainly due to abrupt changes in donors’ aid policies and the PNA
budget allocation strategy (Barghouthi and Lennock 1997). It is important to note that this
decline was more than made up for by the increase in the number of the MoH’s PHC
centres, where about 170 new PHC facilities were opened (mostly in the WB) in under 13
years (HPU 2008a). The average population per facility has, however, grown from 5,294
persons per facility in 2000 up to 5,752 persons per facility in 2006 (HPU 2008a). It is
noteworthy that some facilities’ services have been integrated and coordinated between
the MoH and some non-governmental organisations, where joint clinics are now available
(HPU 2008a). In addition to PHC centers, the non-governmental sector operates some
1,681 beds in 30 hospitals (representing 33.5% of the total beds). Compared with those
run by the MoH, the non-governmental hospitals are found under-utilised, with