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BMJ. 2007 August 11; 335(7614): 277.
PMCID: PMC1941864

Infant mortality rises in Palestinian territories—but other health indicators show improvement

A new report calls for urgent international help in tackling health problems in the Palestinian territories. It shows an increase in infant mortality and a doubling of the number of cases of mental illness.

The authors also report increases in the numbers of cases of food poisoning, sexually transmitted diseases, and contaminated drinking water; a deterioration in nutrition; failure to achieve targets on mortality from heart disease and strokes; and poor provision of services for elderly and disabled people (Public Health doi: 10.1016/j.puhe.2007.04.017).

The report, which looks at the state of Palestinian primary health care and the achievements of the Palestine national strategic health plan 1999-2003, says, however, that a number of significant improvements have occurred, including a leap in the number of people being vaccinated, a drop in the incidence of HIV infection, and lower rates of smoking.

The authors, from the University of Crete School of Medicine, Al-Quds University in Jerusalem, and the Palestinian Ministry of Health, write, “Although there has been progress and promising changes in vital health, especially crude death rate and life expectancy, there are also alarming indicators that should attract the attention of Palestinian leaders.”

They add, “Certain health promotion and environmental health actions should be undertaken urgently by the Palestinian health care services to cope with environmental and sanitary conditions, and to further improve health status regarding communicable and non-communicable diseases in Palestinians. The main barrier to the success of the [plan] was the lack of follow-up due to political and socio-economic instability. There is an urgent need for international intervention and support.”

Their results show that from 1999 to 2003 the crude birth rate had fallen by 17.1%, the crude death rate by 0.6%, and the total fertility rate by 11.8%. Life expectancy had gone up by 0.8%.

The report lists a number of achievements over this period, including falls in mortality from breast cancer and lung cancer and in maternal mortality, a reduction of 64.3% in the incidence of HIV and AIDS, and a drop of 19% in the number of smokers aged over 10. There was also, it says, a “remarkable” improvement in immunisation coverage.

But infant mortality grew by 8.6%, and targets on heart disease had not been achieved. By 2003 heart disease mortality had fallen by 13.2%, against a target of 40%. Mortality from stroke fell by 6.5%, against a target of 40%.

Targets on sexually transmitted diseases had also not been achieved; the incidence of these diseases grew by 66%. Numbers of cases of food poisoning rose by 22.4%, and the percentage of water samples contaminated with coliform rose from 15.5% to 20.4%.

On disability, the report says, “Despite the fact that the plan focused on expanding rehabilitation and disability services to cover up to 80% of the population by 2003, little has been done.”

It says that Palestinians' nutrition status has worsened since 2000 and points out that real per capita income fell by half during the study period, resulting in six in 10 people falling below the poverty line.


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