Health and Nutrition Cluster performance – first half of 2015

Access to basic healthcare out of reach for many Palestinians in vulnerable communities

Most interventions included in the 2015 Strategic Response Plan (SRP) by members of the Health and Nutrition Cluster aim at achieving strategic objective 4 (one of the Plan’s six objectives): to ensure that 1.6 million people (men, women, boys, girls, refugees, no-refugees) across the oPt have access to essential services in areas where access is restricted.

UNRWA in Gaza provided psychosocial support to more than 400,000 students and patients. Mobile health services in the West Bank were not operational in the reporting period but were resumed in August 2015 after receiving funding from the Humanitarian Pooled Fund (HPF). The cluster also collected information on restricted access of vulnerable populations to primary health care and diffused this through the appropriate publications and channels. Health partners also responded to health needs following home demolitions in Area C in cases where a health need was identified through assessments.

Shortages of drugs and disposables in Gaza (average of 30 per cent over the past five years, and up to 50 per cent in medical disposables) negatively impacts the delivery of health services, contribute to the deterioration of patients suffering from diseases such as cancer and heart conditions, and increases the need for more costly referrals outside Gaza.

Nevertheless, there were major gaps in service provision, with only 30 per cent of the targeted beneficiaries reached. Cluster objective one (see table below) was achieved partially due to limited funding. Progress against cluster objective two was better; there were however, major gaps in training of staff with only 43 per cent of the targeted beneficiaries reached. Carrying out health awareness (mostly activities in Gaza) on nutrition, reproductive health and emergency at the community exceeds the targeted group estimated number.

Gaza: infant health jeopardized by shortages in laboratory testing materials

For months, healthcare providers in the Gaza Strip have had insufficient laboratory material for testing two important congenital diseases that could lead to serious development problems—phenylketonuria (PKU) and neonatal hypothyroidism. The tests should be performed within two weeks after birth for immediate interventions. Roughly 5,000 tests are needed every month. However, because of the lack of new supplies of lab materials, the Ministry of Health (MoH) in Gaza has been forced to store screening samples due to months-long shortages of the necessary lab reagents. There is currently a backlog of 30,000 blood samples taken from Gaza newborns.

With a few exceptions, when emergency testing material supplies were used, pediatricians are receiving test results four to five months after birth, which delays the start of treatment when needed. According to Dr. Iman, a pediatrician in Al Rimal Clinic in Gaza city, which tests all samples in the Gaza Strip, two-thirds of which are from UNRWA clinics, priority for testing is being given for “infants from families who are known carriers for either condition, rather than putting them on the waiting list.” However, not even priority cases are currently being tested. PKU screenings in the West Bank have been stopped since August due to laboratory shortages of reagents.

The Ministry of Health appeals frequently to UN agencies and donors for emergency supplies but such procurements cannot be either timely or sustainable. In May 2015 the MoH in Gaza appealed to UNICEF for an emergency shipment of the testing kits, which are not expected to arrive before November.

This situation takes place in the context of continuous shortages in medicines and medical supplies at public health facilities, more pronounced in Gaza, but also significant in the West Bank, as a result of funding gaps in the Ministry of Health in Ramallah. In August, 28 per cent of essential drugs (and 36 per cent of medical disposables) were at zero stock level in Gaza; shortages were particularly high for laboratory reagents (40 per cent). The MoH in Ramallah reported that 19% of essential and complementary drugs (102 of 547 items) were at zero stock in the West Bank, which supplies Gaza facilities as well. The average drug zero stock for 2015 in the West Bank was 23%.