Continuum of Care In The Gaza Strip in the context of emergency

preparedness

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Presented by: Osama Abueita, B.SC, MPH NPO, Gaza Office Coordinator

UNFPA, oPt

2nd IAWG MENA meetingCairo, March 19th-21st, 2012

OutlineGeneral Overview

Humanitarian Context

Impact of crises on RH

Response (CoC model)

Way Forward

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General Overview

3OCHA, 2011

West Bank Key Humanitarian Issues

Shrinking Space for Palestinians • Fragmentation of the West Bank

(Separation Barrier)

• Access and Movement Restrictions

(Area C and East Jerusalem)

• House Demolition, Settler Violence

OCHA 2011

Israeli Blockade on Gaza since June 2007• Air/sea movement banned• All exports banned• All Import banned except (restricted to food

and hygiene; limited cash/fuel )• Medical referrals restricted• Buffer zones (ARA, agricultural areas)

OCHA 20105

Gaza Key Humanitarian Issues

The Impact of the Blockade 95% of private business closed More than 120,000 jobs lost Hospital functioning impeded Electricity reduced and

intermittent Increased health risks due to

polluted sea water Deterioration of water supply &

sanitation services

Sewage infiltrates into the aquifer: only 5-10% of the extracted water is safe

OCHA 2010

The Gaza War: 2008-2009

1.4 million civilians unprotected:• Massive military aerial and

ground bombardment • Densely populated – small

area• No safe space – no bomb

shelters• No alarm/warning system• No place to flee – all borders

sealedOCHA2010

Impact of Chronic Crises on RH status

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National level: • Limited access to RH services

• Low quality of health care provision

• Weak referral system (fragmented health care system)

• Increase home delivers (birth at checkpoints)

• Increase pregnant women morbidity

Impact of Crises on RH status

In Gaza;• Restricted access to health facilities: - Isolated areas - Shifting health care priority toward war victims - Reduced capacity of health system due to direct hit

• Quality of care- 31% increase in miscarriage cases.

- 14% increase in CS rates in the first month (Jan 09)- 50% increase in neonatal death- Early discharge after delivery (within 30 minutes)

• Psycho-social consequences experienced by caregivers especially mothers (i.e. IDPs)

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Response• Multiple health providers in Gaza

• Strengthen coordination and complementarity

• Strengthen emergency preparedness

• Improve referral

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CoC Concept

Strengthen the link between different levels of care

Improve access to complementary and quality RH services

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COC Concept

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CoC Components

Rehabilitation/ renovation of facilities

Provision of equipment and supplies

Capacity building/development of Cadre

Community mobilization

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BAET AL MAQDES

AL AWDA

AL SHIFA

AL HARAZEEN

YAFA

ALTAHREER

TAL EL SULTAN

Baet Al Maqdes

CoC in ProgressRehabilitation/Renovation7 hospitals maternities(2 NGOs, 4 MOH) 2 PHCs(1NGO,1MOH) 3 phases process, phase one in 90%completed,phase 2 just started, phase 3 not started yet.

Training Emergency obstetrics protocols 170 health staff are scheduled to be trained, 80% completed. Safe delivery:

58 health staff from 13 hubs were trained ALSO

48 health staff were trained

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Community mobilization:

MOH-HEPD:- Training of 42 PHC staff

- Production of brochures, flip charts and documentary film regarding safety information of mother-child care.

MAP UK:-Community awareness in Rafah and Khanyounis areas.-Information booklet on danger signs and hubs locations

PFPPA:

80 awareness sessions in Gaza communities regarding RH issues.16

CoC in Progress, continued

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• Equipment provided

Medical Furniture Medical Equipment$0

$50,000

$100,000

$150,000

$200,000

$250,000

$300,000

$350,000

$400,000

$450,000

UNRWANGO'sMoH

Way forward MISP echo training in Gaza

Enhance coordination with UNRWA on HKs

Update HNC and OCHA CP plans

Advocacy with MOH for EmOC in crises, GBV at maternity wards etc.

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Way forward; Challenges Access & quality of RH services provision

Preparedness

Limited fund

Coordination COORDINATION coordination

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Thank you

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