Health Sovereignty Under Occupation: A Comparative Analysis of Health System Constraints and Their Implications for Nursing Practice in Conflict Settings

ObjectivesTo examine documented occupation-related constraints in relation to health-system functioning through comparative document analysis and to explore potential implications for nursing practice in conflict-affected settings.MethodsA comparative qualitative case study of Gaza and the West Bank examined documentary accounts of health-system constraints during 2015-2023. An earlier manuscript version reported an analytical corpus of 347 documents; the original source inventory and records needed to verify that count are no longer available. Documents were interpreted through a hybrid deductive-inductive thematic approach and mechanism-oriented comparison. The analysis did not use formal causal process tracing or directly measure nursing practice or patient outcomes.ResultsThe cited documentary accounts describe healthcare-access barriers, resource limitations, reported service interruptions, and constraints affecting health personnel across the two settings. These observations inform hypothesized pathways relevant to nursing practice and patient care, neither of which was directly measured.ConclusionThe documentary analysis identifies recurring patterns of health-system constraints that appear to be associated with disruptions in health-system functioning in the two examined settings. Health sovereignty and the proposed dual-model framework are conceptual interpretations requiring further empirical examination. The implications proposed for nursing practice and patient outcomes were not directly tested.