Unveiling health disparities in Palestine: a qualitative study of stakeholders' perspectives

Healthcare services in Palestine are provided by the Ministry of Health, the United Nations Relief and Works Agency, Non-Governmental Organizations and private sector. These providers have played a complementary role in improving health services and the overall health situation in Palestine over the past two decades. However, health disparities in Palestine remain numerous; several health reports and surveys have indicated significant disparities in health outcomes within the Palestinian community. The Palestinian political, social, and economic contexts contribute to increased risk of health inequities in various aspects. This study explored these disparities in the healthcare from the perspectives of key sectoral stakeholders.

The study adopted a qualitative design to explore the perspectives of key stakeholders regarding health disparities within the Palestinian healthcare system. Sixteen in-depth interviews with purposefully selected key informants were carried out. We conducted content analysis to extract emerging themes and subthemes.

Three main themes and eleven subthemes were realized from participants' perceptions. The major three themes are: areas of health disparities, contributing factors to health disparities, and policy recommendations to enhance health equity. Three subthemes were recognized as main areas of health disparities: (1) healthcare services' provision, (2) health coverage and (3) health outcomes. Three subthemes were recognized as main contributing factors that are: (1) political factors, (2) socioeconomic and cultural factors, and (3) health system factors. Five main subthemes were recognized as major policy recommendations suggested by participants to enhance health equity: (1) Integrating health equity into policy frameworks, (2) Strengthening MoH leadership and fostering collaborative partnerships to advance health equity, (3) Enhancing healthcare infrastructure and delivery approach (4) Reforming the health insurance system for better equity and efficiency and universal coverage, and (5) Fostering community awareness and advocacy for advancing health equity and the right to health for all Palestinians.

This study identified significant policy debates about health disparities and its contributing factors in Palestine, arguing to drive evidence-based policy making and comprehensive reforms in the Palestinian health system to improve equity in healthcare access and coverage.