title: The health-care system: an assessment and reform agenda.
abstract: Attempts to establish a health plan for the occupied Palestinian territory were made before the 1993 Oslo Accords. However, the first official national health plan was published in 1994 and aimed to regulate the health sector and integrate the activities of the four main health-care providers: the Palestinian Ministry of Health, Palestinian non-governmental organisations, the UN Relief and Works Agency, and a cautiously developing private sector. However, a decade and a half later, attempts to create an effective, efficient, and equitable system remain unsuccessful. This failure results from arrangements for health care established by the Israeli military government between 1967 and 1994, the nature of the Palestinian National Authority, which has little authority in practice and has been burdened by inefficiency, cronyism, corruption, and the inappropriate priorities repeatedly set to satisfy the preferences of foreign aid donors. Although similar problems exist elsewhere, in the occupied Palestinian territory they are exacerbated and perpetuated under conditions of military occupation. Developmental approaches integrated with responses to emergencies should be advanced to create a more effective, efficient, and equitable health system, but this process would be difficult under military occupation.
authors.affiliation: Institute of Community and Public Health, Birzeit University, Birzeit, occupied Palestinian territory.
authors.forename: Awad
authors.initials: A
authors.lastname: Mataria
authors.forename: Rana
authors.initials: R
authors.lastname: Khatib
authors.forename: Cam
authors.initials: C
authors.lastname: Donaldson
authors.forename: Thomas
authors.initials: T
authors.lastname: Bossert
authors.forename: David J
authors.initials: DJ
authors.lastname: Hunter
authors.forename: Fahed
authors.initials: F
authors.lastname: Alsayed
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Moatti
mesh_terms: D003906:Developing Countries; D017598:Efficiency, Organizational; D005544:Forecasting; D018166:Health Care Reform / Q000458:organization & administration*; D006287:Health Planning Guidelines; D006290:Health Planning Technical Assistance; D006297:Health Services Accessibility / Q000458:organization & administration; D006305:Health Status Indicators; D019456:Health Transition; D006801:Humans; D007373:Interinstitutional Relations; D008877:Middle East; D009313:National Health Programs / Q000458:organization & administration*; D020380:Needs Assessment / Q000458:organization & administration*; D009937:Organizational Objectives; D009938:Organizations / Q000458:organization & administration; D011057:Politics; D012066:Relief Work / Q000458:organization & administration; D014480:United Nations / Q000458:organization & administration; D014857:Warfare