Palestinian primary health care in light of the National Strategic Health Plan 1999--2003.

BACKGROUND In 1994, the Palestinian Health Authority took over responsibility for primary health care (PHC) in Gaza Strip and West Bank. OBJECTIVES This paper reports on the Palestinian National Strategic Health Plan (PNSHP 1999--2003). The extent to which the PHC objectives were achieved is discussed, together with areas that still require improvement. METHODS This descriptive study used content analysis with a retrospective review of data gathered from the PNSHP and other related reports and publications. RESULTS The crude death rate and total fertility rate had improved, but the infant mortality rate had increased by the end of the study period. Heart diseases were the primary cause of death in Palestine. Acceptable vaccination coverage had mainly been achieved, particularly for tetanus, diphtheria, measles and polio. There were still concerns regarding water supply and other sanitary conditions, a notable increase in the incidence of vector-borne diseases, especially cutaneous Leishmaniasis in West Bank, and mental health had worsened by the end of the study period. CONCLUSIONS Certain health promotion and environmental health actions should be undertaken urgently by the Palestinian health care services to cope with environmental and sanitary conditions, and to further improve health status regarding communicable and non-communicable diseases in Palestinians. Health research and surveys are insufficient and should be undertaken regularly. The main barrier to the success of the PNSHP was the lack of follow-up due to political and socio-economic instability. There is an urgent need for international intervention and support.