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Cataract Surgical Services in Palestine.

Ranad Maswadi^1,2, Covadonga Bascaran¹, Gerry Clare³

¹London School of Hygiene and tropical medicine, London, UK.

Ophthalmic Epidemiology

|June 14, 2021

Summary

The cataract surgical rate in Palestine was 2,117 operations per million population in 2015, below the WHO target. Most surgeries were funded by insurance, with varied techniques and payment systems across regions.

Keywords:

Cataract cataract payment methods cataract surgical output cataract surgical rate

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Area of Science:

Ophthalmology
Public Health
Health Services Research

Background:

Cataract surgery is a key indicator of ophthalmic care quality and accessibility.
Comprehensive assessments of cataract surgical services in Palestine (West Bank, Gaza Strip, East Jerusalem) were previously lacking.

Purpose of the Study:

To estimate the cataract surgical rate (CSR) in Palestine for the year 2015.
To investigate the prevalent modes of payment and referral systems for cataract surgery in the region.

Main Methods:

A cross-sectional study was conducted in 2016, interviewing Medical Directors of 22 Palestinian cataract surgical centers.
Data on cataract output, surgical techniques, and payment methods for 2015 were collected using structured questionnaires.
The cataract surgical rate was calculated by dividing the total 2015 cataract surgeries by the estimated population of Palestine.

Main Results:

A total of 9,908 cataract surgeries were performed in 2015, yielding a CSR of 2,117 operations per million population.
Phacoemulsification was the predominant technique (73.4%), though extracapsular cataract extraction was common in government centers (67%).
Significant regional disparities were observed: Gaza Strip saw more surgeries in government/NGO centers, while West Bank referred many government-diagnosed cases to private/NGOs. Seventy-eight percent of surgeries were insurance-funded.

Conclusions:

The estimated cataract surgical rate in Palestine falls below the World Health Organization's recommended target.
Insurance is the primary funding source for the majority of cataract surgeries in Palestine.
Understanding payment and referral systems is crucial for improving ophthalmic care access and efficiency.