The role of non-governmental organizations in the health sector in the occupied Palestinian territory: a cross-sectional qualitative study. (August 2017) - Tucktuck, Marina
Abstract: Background: Non-governmental organizations (NGOs) have had an important role in the Palestinian health sector before and after the creation of the Palestinian Ministry of Health (PMoH) in 1994. Few studies have addressed the role of NGOs in the Palestinian health sector. The aim of this study was to investigate the current role of local and international NGOs (INGOs) in the development of the Palestinian health system's policies and programmes. Methods: A qualitative study of nine semi-structured interviews was conducted with key representatives from the main actors in the Palestinian health sector: the PMoH, five local NGOs and three INGOs. After obtaining verbal consent, interviews were conducted from October to December 2014, and focused on the NGO's scope of work, priority setting, regulation, coordination and influence on national health policies. Findings: The majority of the local NGOs focused on primary healthcare and rehabilitation, while most of the INGOs worked on health development and emergency response. Local NGOs and INGOs complemented the work of the PMoH in health-service provision. Both were constrained by the predetermined national health strategy set by the PMoH without the active involvement of other actors. INGOs' activities were constrained by pre-determined international health agendas, available funding and restrictions related to the military occupation. The coordination mechanism between the PMoH, local NGOs, and INGOs is limited to a health and nutrition cluster, a partnership of organisations that is committed to providing needs and evidence-based responses, with little effect on policies and plans. Despite available methods to avoid duplication and fragmentation of work and to fill service provision gaps, some NGOs agreed that the limited coordination and discontinuity of certain projects restrict their ability to fully meet the health needs of the Palestinian population. Interpretation: Local and international NGOs have a crucial role in providing essential services for Palestinians, with the PMoH as the main actor. Although there is some coordination between the PMoH, local NGOs and INGOs on meeting community needs, this remains limited by funding constraints. The contribution of NGOs to policy formulation is small. Stakeholders' active involvement in national health policy development, with a focus on local needs, should be encouraged. Funding: None.