1. Health,Gender and Human Rights in the OPT Juzoor for Health and Social Development December 2011 Salwa Najjab MD

2. OCCUPATION 60 years of continuous war 40 years of Israeli military occupation

3. West Bank, Gaza have been under Israeli occupation since 1967. Territorial fragmentation of the West Bank and complete isolation of the Gaza Strip and Jerusalem-since 2000 Occupied Palestinian Territory (oPt)

5. Gates to villages

6. Juzoor For Health & Social Development جذور للإنماء الصحي والاجتماعي

7. Checkpoint to Jerusalem

8. Since 2001, UNFPA recorded more than 70 cases of women in labor who were delayed at checkpoints which resulted in unattended births, causing maternal and newborn deaths Birth and Death at Checkpoints

9. Land Confiscation

10. Over 100 Settlements-500,500 Settlers Violation of international law

11. Daily violation of Human Rights and Dignity

12. Challenges in Palestine Low status of women Poverty Poor quality of care Accessibility restrictions Deteriorating nutritional status Unemployment Funding restrictions Apartheid Wall

13. Gender inequality Poverty Political conflict Limited decision making power Factors impacting women's health

14. Selected Health Indicators in Palestine Indicators (PCBS)West BankGazaPalestine Population (2011) 2,580,1671,588,7914,168,858 Poverty 21 %45.7%65.8% Total Fertility Rate 4.15.24.6 Life expectancy --M 70.5-F 73 Maternal Mortality rate per 100,000 --60 - 70 Proportion of children below the age of 15 41%48% Refugee 28%68%

15. Early Marriage 1 Improving Maternal Health to Achieve the Millennium Development Goals in the Eastern Mediterranean Region : A Youth Lens. One third of girls marry before age 18 6% become mothers TWICE as likely to die while giving birth Under 15 FIVE more times likely to die in childbirth 1

16. Infant Mortality Rate Infant mortality is 27.6/1000; 67% occur within the early neonatal period. (Palestinian Health Survey 2006).

17. UNFPA assessment after the war 40% increase in miscarriage cases 50% increase in neonatal deaths Home births increased from 5% to 35% Increase in c/s from 15% to 32% Increase in premature delivery Shifa hospital

18. Rapid Epidemiological Transition Burden of NCDs greater on women Early Pregnancy, Short Birth Intervals; unmet needs for FP; Epidemic of Psychosocial Disorders; Gender Based Violence

19. Morbidity among men and women in their 50s

20. Women are particularly vulnerable to the improper functioning of the following public services Education Justice Health

21. Challenges of the Health System Fragmented and inconsistent MoH, UNRWA, NGOs and Private Sector High migration of skilled professionals Biomedical approach to health

22. Women's Health services in Palestine Limited training opportunities Poor Skills of health providers Lack of evidence based protocols Continuous lowering of quality of care Affects Womens Health status No systematic inquiry process Lack of supervision Inadequate Health System

23. Health Care Providers

24. Health Policy Environment Weak role of professional bodies and regulatory frameworks. Incomplete and inadequate licensing and accreditation systems. Weak policy making and implementation.

25. Health Financing Dependency on donor aid Weak budget planning and fiscal management systems Lack of a Monitoring and Evaluation (M&E) Framework Low percentage of PNA budget spent on health

26. It is time to ask ourselves What can we do to change? -not- What happened?

27. Juzoor for Health and Social Development Palestinian NGO established in 1996 working at the national level towards A Healthier Palestine, where all Palestinians achieve the highest standard of well-being

28. Juzoors Approach Views Health from a rights perspective. Adheres to principles of Equity. Answers the Continuous Health Education needs Looks at the emergency needs with a developmental perspective Addresses social determinants of health

29. Juzoor Strategic Areas: Empowering CommunitiesContinuous Professional DevelopmentImpacting Health and Social Policies

30. Empowering Communities… Empowering Marginalized Groups Enhancing Women & Youths health economic security through social protection.

31. Continuous Professional Development Facilitate dialogue among different health care levels Standardize the skills of health care providers Enhance the interactions between health service provides Improve access to High Quality Care

32. Mental Health in PHC

33. OB Cases Workstations West Bank Gaza ALSO cont.

34. Short Courses ALSO NRP PALS BLS ACLS Infection Prevention and Control Normal Childbirth

35. Impacting Health and Social Policy Contribute to the national level policy dialogue Palestinian Health Policy Forum Building alliances with policy making organizations Middle East Health Policy Forum

36. Safety in women's health care SAFETY POLICIES AND MEASURES WOMENS HEALTH RIGHTS HEALTH ETHICS

37. Thank You