Assessing violence in healthcare in the occupied Palestinian territories

Violence in healthcare is a major challenge in fragile and conflict-affected countries such as the occupied Palestinian territories.

To analyse and compare violence in healthcare in the occupied Palestinian territories with other conflict-affected settings.

From the Safeguarding Health in Conflict Coalition database, we collected data for 2017 to 2021 on health workers killed, injured, kidnapped, assaulted, sexually abused, threatened, and arrested, and on the destruction and damage to health care facilities for 15 conflict-affected countries and the occupied Palestinian territories. We collected similar monthly data for September 2022 to July 2024 for the occupied Palestinian territories. Using mixed-effects negative binomial regression we compared data from the occupied Palestinian territories with the 15 countries. Using negative binomial models, we conducted a pre-post analysis of the data from the occupied Palestinian territories, using October 2023 as the reference point.

Between 2017 and 2021, there were significantly higher rates of attacks on health workers [IRR = 20.75 (95% CI: 2.66, 161.60)] and of the total number of violence incidents (22.26 [2.17, 228.64]) in the occupied Palestinian territories than in the 15 countries, but no significant difference in the attacks on health facilities. Attacks on health workers [IRR = 110 (30, 413)] and health facilities [IRR = 150 (31, 751)], and total violence incidents [IRR = 73 (24, 220)], increased significantly after October 2023 in the occupied Palestinian territories.

There is a need for multinational, multisectoral support systems to enhance safety and security for health workers and health facilities and to enhance the resilience of health systems against current and future conflicts in the occupied Palestinian territories.