Health differentials among women aged 15–54 years in the occupied Palestinian territories: a cross-sectional study of data from the Palestinian Family Health Survey 2010. (August 2017)

• Record Type: Journal Article
• Authors: Bates, Katie; Ghandour, Rula; Imseeh, Sawsan; Mitwalli, Suzan; Nasr, Shiraz; Hammoudeh, Doaa; Coast, Ernestina; Leone, Tiziana; Giacaman, Rita
• Is Part Of: Lancet. Volume 390(2017)Supplement 2
• Page Start: S28
• Publication Date: 2017-08
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(17)32079-2
• Languages: English
• ISSNs: 0140-6736

Abstract

Abstract: Background: Available evidence suggests that women in the occupied Palestinian territory are served by an overburdened health system that prioritises family planning and reproductive services above provision for other health care that women may need. To address this gap, we investigated ill-health and disparities in the health of all women across the life course, not just those who are married with children, in the occupied Palestinian territories. Methods: Cross-sectional data for women aged 15–54 years from the Palestinian Family Health Survey 2010 were used (n=15 734). Determinants of binary health outcomes were analysed (self-reported chronic illness, self-reported acute illness, self-rated health) using separate weighted logistic regression models with region, locality, sociodemographic, and socioeconomic explanatory variables (n=14 819). Findings: 11% of women reported a chronic illness (n=2176), 22% reported an acute illness (n=3811) and 21% rated their health as poor (n=3708). Parity did not increase the odds of reporting a chronic or acute illness. Highly parous women (4–7 and ≥8 children) rated their health as poorer compared with nulliparous women (odds ratio 1·65, 95% CI 1·01–2·69 and 1·73, 1·06–2·81, respectively). Pregnant women rate their health as poorer (1·29, 1·10–1·52), but are no more likely to report an acute illness and less likely to report chronic illness than non-pregnant women (0·706, 0·51–0·98). Compared with being married, being divorced was associated with poorer self-rated health (3·97, 1·53–10·30), whereas being single was associated with less acute illness (0·59, 0·39–0·88). Women from Gaza reported lower levels of illness and better self-rated health than women in the West Bank, despite poorer health infrastructure and similar burdens of illness. Interpretation: Despite the focus of the health system on family planning and reproductive services, we found little evidence that married women with children have increased ill-health in the occupied Palestinian territory. A broader range of health services for women is needed. Funding: Emirates Foundation, LSE Middle East Centre.