Dr. Asad Ramlawi DG PHC & PH Current Health situation Challenges Future perspective

1. Dr. Asad Ramlawi DG PHC & PH • Current Health situation • Challenges • Future perspective

7. Apartheid wall

8. Qalqilia Ghetto Black fill More than 40,000 Palestinians are almost completely cut off from the world in open air prisons, with the wall completely surrounding Qalqilya, Ras Atiya and Arab Abu Farda, Health Inforum 2004

9. …Now looks like this.

10. The Jerusalem Envelope The Wall through Abu Dis…

11. 70km of wall will carve East Jerusalem in two and cut off an estimated 249,000 Palestinian residents from the rest of the West Bank

12. QUALITY OF CARE Accessibility restrictions Poverty Unemployment Poor nutritional status Low status of women Restrictions of movement Poor health indicators Poor quality of care

13. Population & demography/ 2012

15. Woman Health

16. Primary Health Care

17. Hospitals

18. MoH hospital indicators

19. Human Resources

20. Conti,,,

21. NCDs

24. Immunization schedule

25. Reported new cases of vaccine preventable diseases 2012

26. Reported new cases of active TB ( pulmonary & extra pulmonary , 2009-20012

27. Distribution of reported cases of active pul. TB by age group , 2012

28. The Palestinian PHC Statement • Political commitment to HFA through PHC • Institutional reforms ( departments of PHC) & decentralization ( district health systems) • Strengthening preventive & health promotion programs ( vertical programs) • Integration of preventive programs at various levels

29. The Palestinian PHC Statement • Promotion of community participation & inter sectoral collaboration (several modalities according to countries) • Development of community based initiatives ( promotion of social determinants of health, community empowerment, healthy settings) initiated with support from WHO since late 80s

30. The Palestinian PHC Statement • Promotion of PHC models for service delivery ( family health) • Reforms of health personnel education ( community oriented & problem based learning ) • Use of community health workers • Networkingamong countries & institutions (contribution of WHO)

31. Outcomes • Increased access to essential health care services ( preventive coverage) • Improvement of health status ( life expectancy) but inequalities persist between countries & within countries • Improvement of social determinants of health ( literacy, access to safe water & sanitation)

32. Challenges • Unfavorable socio-economic environment ( economic recession of 80s, structural adjustment programs, reduced public spending on health) • Moves towards market economy & privatization ( weakening social role of government) • Epidemiological & demographic transitions

33. Challenges • Political determinants ( wars, occupation, civil strife) • Globalization movement • Environmental & climate changes • Food crisis • Financial crisis

34. Objectives of PHC in Palestine Is to ensure that essential health care is available to everyone in the community with high quality standard. Plus Patient Safety

35. »The greatest challenge we face as a nation is to guarantee everyone access to health care and equity within the community. » FCM physicians must work to keep their professionalism and pride intact. »Family and Community Medicine is well-suited to lead health care reform in the 21 century.

36. VISION I wish every FCM physician becomes the master of community based services, primary care physician, central / focal referral point where he / she can acquire a niche in the society to help the patients and families and live up to the definition of “Friend, Philosopher , Guide and Leader".

37. Our Vision Our vision is that Primary Health Care Centers will be Palestinian first choice for health care. Lead the way to quality health care providing comprehensive, integrated, appropriate & wellness oriented services.

38. Our Mission Our mission is to promote, maintain and improve health & well-being of Palestinian and achieve better personal & population health outcomes by working proactively to provide integrated, efficient and effective health care services in a caring & professional manner, and by advancing the ability of individuals & communities to effectively respond to their health needs.

39. Northousedefined leadershipas : “ A process whereby an individual influences a group of individuals to achieve a common goal ” .

40. The future is now FCM Physicians... - FCM practice has long promoted outcomes, teams , accountability & LEADERSHIP in health care facility

41. Declare your values in what you do. • Demonstrate the value of what you do. • BE & FEEL YOU ARE A LEADE • Prepare the future for yourself ,for your patients and community …. بعون الله تعالى

42. Dr. Tawfik A. Khoja, Dr. Ali Al – shehri

43. Underlying determinants Health-care Right to Health Right to Health water, sanitation, food, nutrition, housing, healthy occupational and environmental conditions, education, information, etc. AAAQ Availability, Accessibility, Acceptability, Quality (General Comment No. 14 of the Committee on Economic, Social and Cultural Rights, explains CESCR Art 12. “The right of everyone to the highest attainable standard of physical and mental health”)

44. The Burden of Data Too much (mostly irrelevant) data is a common problem

45. When choosing indicators, remember:Information is like water…Too much and you drown in it; Too little and you die of thirst Theo Lippeveld, from Dr. Burghri, Pakistan MOH

46. Millennium development goals – related to reproductive and women's health • MDG 3 – achieve gender equality • MDG 4 – reduce child mortality • MDG 5 – improve maternal health • MDG 6 – to halt the spread of HIV and other diseases

47. Not everything that can be counted counts, and not everything that counts can be counted. Albert Einstein