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

Presented by: Osama Abueita , B.SC, MPH NPO, Gaza Office Coordinator UNFPA, oPt 2 nd IAWG MENA meeting Cairo, March 19 th -21 st , 2012. Continuum of Care In The Gaza Strip in the context of emergency preparedness. Outline. General Overview Humanitarian Context

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

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  1. Presented by: Osama Abueita, B.SC, MPH NPO, Gaza Office Coordinator UNFPA, oPt 2nd IAWG MENA meeting Cairo, March 19th-21st, 2012 Continuum of Care In The Gaza Strip in the context of emergency preparedness

  2. Outline • General Overview • Humanitarian Context • Impact of crises on RH • Response (CoC model) • Way Forward

  3. General Overview OCHA, 2011

  4. 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

  5. Gaza Key HumanitarianIssues 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 2010

  6. 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

  7. 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 sealed OCHA2010

  8. 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 Chronic Crises on RH status

  9. 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)

  10. Response • Multiple health providers in Gaza • Strengthen coordination and complementarity • Strengthen emergency preparedness • Improve referral

  11. CoC Concept • Strengthen the link between different levels of care • Improve access to complementary and quality RH services

  12. COC Concept

  13. CoC Components • Rehabilitation/ renovation of facilities • Provision of equipment and supplies • Capacity building/development of Cadre • Community mobilization

  14. BAET AL MAQDES Baet Al Maqdes AL AWDA AL SHIFA AL HARAZEEN YAFA ALTAHREER TAL EL SULTAN

  15. CoC in Progress Rehabilitation/Renovation 7 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

  16. 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.

  17. CoC in Progress, continued • Equipment provided

  18. 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.

  19. Way forward; Challenges • Access & quality of RH services provision • Preparedness • Limited fund • Coordination COORDINATION coordination

  20. Thank you

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