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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
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OutlineGeneral Overview
Humanitarian Context
Impact of crises on RH
Response (CoC model)
Way Forward
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General Overview
3OCHA, 2011
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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
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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
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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
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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
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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
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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
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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
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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
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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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