Assessment of Healthcare Delivery for Hemophilia Patients in Palestine: Challenges, Gaps, and Opportunities for Improvement
Date
2025-12-22
Authors
Nadi Hassan Abed Eid Zawahra
نادي حسن عبد عيد زواهرة
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Abstract
Bleeding disorders like hemophilia are rare inherited conditions. However, it still requires around-the-clock specialized multidisciplinary healthcare to prevent severe complications and maintain an acceptable quality of life. In resource-limited and politically constrained settings like Palestine, providing comprehensive hemophilia care continues to be extremely difficult. Therefore, this study sought to assess healthcare provision for West Bank/Palestine hemophilia patients, identify primary issues, and pinpoint gaps in care, in addition to addressing the potential to improve the accessibility and the tier of care provided, as well as equity for under-resourced patients.
A cross-sectional, mixed-methods study was carried out from March 2024 to August 2025. Quantitative data was collected via a structured survey from 99 patients diagnosed with hemophilia A or B, equating to around 28% of the registered hemophilia population in the West Bank/Palestine. Patients were purposefully sampled from multiple governorates. Most respondents were male (93.9%), under the age of 35 (84.8%), and lived in rural areas (63.6%) and low-income households (59.6%) with income levels under USD 500 monthly. SPSS was utilized for descriptive and inferential statistical analyses (t-tests, one way ANOVA, correlation, multiple linear regression). Of the qualitative data collected through open-ended questions, thematic analyses were done to augment the quantitative data.
The findings disclosed serious shortcomings in hemophilia health care. 79.8% of patients reported occasional shortages of clotting factor concentrates. Financial barriers were reported by 53.5% of patients, while 77.8% of patients experienced issues related to transportation. 57.6% of the participants received prophylaptic Repl in 94.9% of the patients that were sufficiently prepared to control the bleeding. 78.8% of the patients did not have regular orthopedic consultations, and 70.7% did not have psychological debriefing. More than 80% of patients felt that there were too few hemophilia treatment centers, diagnostic centers, and specialized healthcare workers. There was a mixed patient satisfaction with healthcare services, with only 35.3% of patients indicating satisfaction with the services they received. Results of the multiple regression analysis showed that the frequency of bleeding episodes, perceived healthcare service accessibility, and health education of the patient were significant predictors of satisfaction with the care quality (p<0.05). There was low awareness (18.2%) of national policies pertaining to the treatment of patients with hemophilia, and this awareness was related to lower household incomes.
In summary, the obstacles to hemophilia care in the West Bank/Palestine include a lack of medications, a lack of specialized services, a lack of adequate services, a lack of patient education, a lack of policy dissemination, and a lack of policy dissemination. The maintenance of supply chain processes, the establishment of specialized treatment centers, the improvement of provider education, the enhancement of patient education, the enhancement of psychosocial support, and the adoption of national hemophilia guidelines of defined focus are needed to improve the inequities in health outcomes of hemophilia patients in Palestine.