The Palestinian Economy. Theoretical and Practical Challenges

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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
354 Abu-Zaineh – Mataria substantial part of their working load being cases referred by the MoH (Mataria, Khatib et al. 2009). 2.1.4. The Private for-profit Sector A wide range of private practices including those of self-employed physicians and dentists, hospitals, diagnostic centers, and pharmacies represent the “for-profit private” health care sector. The private sector has expanded rapidly in the past few years, with phenomena such as group practices and private health insurance schemes beginning to develop. However, the extent to which its practices are monitored and regulated, as well as, the implications of its rapid growth for the public sector remain unclear (Giacaman, Abdul-Rahim et al. 2003). A comprehensive system of adequate and reliable data about the private for-profit health sector is lacking. Table 2.2 summarises some of the available figures on the different kinds of these practices. A prominent aspect of the private forprofit services is their concentration in the urban areas of the WB. Table 2.2: Private for-profit Health Practices by Type of Services and Region, 2005 Type of Services Region OPT WB (%) * GS (%) ** # % General Clinics 15.0 3.3 372 11.4% Specialist Clinic 33.2 53.3 1,273 39.3% Dentist Clinic 34.6 28.1 1,031 31.8% Medical Labs and Others ** 16.4 14.9 537 13.6% Specialist Hospital 0.8 0.4 25 0.8% Total 100 100 3,238 100 * Figures represent percentage distribution of sampled health institutions. ** Include radiology and imaging centers; physiotherapy centers; dental labs; optics centers and midwives. Source: PCBS. Health Care Providers and Beneficiaries Survey-2005, Main Findings, June 2006 2.2. Availability, Accessibility and Quality of Health Care Services: A Portrayal Availability of, and accessibility to, various types/levels of health care services are key elements in analysing equity in health care delivery in a given country (Mooney, Hall et
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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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