دور المنظمات الاهلية الفلسطينية في قطاع غزة في تعزيز النظام الصحي الفلسطيني
عائد محمود مصطفى ياغي
The aim of this study is to assess the role of the Palestinian health Non-Governmental Organizations (NGOs) in promoting the health system in the Gaza Strip through investigating their profiles, identifying the services they provide and exploring the status of coordination among them and with other health providers particularly the Palestinian Ministry of Health (MOH). The design of this study is quantitative, qualitative, cross sectional descriptive one. The quantitative component included all the health NGOs operating in the Gaza Strip and were implemented using a structured interviewed questionnaire distributed to 43 health NGOs among them 42 positively responded (96%). The qualitative component implemented through conducting in-depth interviews with purposively selected eight related experts who all positively responded. The results of the study services through 49 health centers and 16.7% of them provide secondary health care services through 7 hospitals which operate 287 beds. Considerable number of NGOs was found to be not licensed by the MOH (30%) which is regarded as a manifestation of chaos and partially attributed to the inability of the MOH to perform its regulatory role effectively. Additionally, the study shows that the total number of human resources working in the health NGOs is 2171 persons; 26.5% of them were working on parttime basis and many were working in other health organizations. The study shows that the spirit of voluntarism is declining within these organizations. Furthermore, the study shows that 9.5% of health NGOs have had cooperation agreements with the MOH and there was a consensus among experts on the importance of having written contractual agreements between the MOH and these organizations. Also, there was a consensus that health NGOs should be systematically involved in the national health planning processes. The study shows that 73.8% of organizations surveyed have a memb rship in the NGOs coordinating bodies and 93% of the interviewed NGOs stressed on the importance of coordination between them. Broadly, there was a consensus that the coordination level is regarded as poor between health NGOs and other health providers particularly the MOH which is by the Palestinian law; the responsible coordinating body. The study recommends that health NGOs need to strengthen the coordination among themselves and between themselves and the other health providers. Additionally, health NGOs need to design and provide their services in a complementary rather than duplicative way. Supporting financial and management systems within NGOs is a priority area. It is also recommended that the MOH should reinforce its regulatory roles through appropriate licensing and follow-up.