Massad Salwa, Tucktuck Marina, Dar Khawaja Ranin, Dalloul Hadil, Saman Khalid Abu, Salman Rand, Kafri Rawan, Khammash Hatem
World Health Organization-Palestinian National Institute of Public Health, Research Unit - Ramallah, Palestine.
St. George's University, School of Medicine - Grenada, West Indies.
J Multidiscip Healthc. 2020;13:1551-1562. doi: 10.2147/JMDH.S270484. Epub 2020 Nov 13.
Geopolitical segregation of Palestine has left a fragile healthcare system with an unequal distribution of services. Data from the Gaza Strip reflect an increase in infant mortality that coincided with a significant increase in neonatal mortality (12.0 to 20.3 per 1,000 live births).
A baseline study was carried out to evaluate available resources in neonatal units throughout Palestine.
A cross-sectional, hospital-based study was conducted in 2017 using the World Health Organization's "Hospital care for mothers and newborn babies: quality assessment and improvement tool." Data on the main indicators were updated in 2018.
There were 38 neonatal units in Palestine: 27 in the West Bank, 3 in East Jerusalem, and 8 in the Gaza Strip. There was an uneven geographic distribution of incubators in relation to population and births that was more marked in the Gaza Strip; 79% of neonatal units and 75% of incubators were in the West Bank. While almost all hospitals with neonatal units accepted very and extremely low birth weight and admitted out-born neonatal cases, there was a shortage in the availability of incubators with humidifiers, high-frequency oscillatory ventilation, mechanical ventilators with humidifiers and isolation wards. There was also a considerable shortage in neonatologists, neonatal nurses, and pediatric subspecialties.
Almost all the neonatal units accepted extremely low birth weight neonatal cases despite not being ready to receive these newborns due to considerable shortages in human resources, equipment, drugs, and essential blood tests, as well as frequent disruptions in the availability of based amenities. Together, these factors contribute to the burden of providing quality care to newborns, which is further exacerbated by the lack of referral guidelines and challenges to timely referrals resulting from Israeli measures. Ultimately, this contributes to suboptimal care for neonates and negatively impacts future health outcomes.
巴勒斯坦的地缘政治隔离使得其医疗体系脆弱，服务分配不均。加沙地带的数据显示婴儿死亡率上升，同时新生儿死亡率显著增加（从每1000例活产中的12.0例增至20.3例）。
开展一项基线研究，以评估巴勒斯坦各地新生儿病房的可用资源。
2017年采用世界卫生组织的“孕产妇和新生儿医院护理：质量评估与改进工具”进行了一项基于医院的横断面研究。主要指标的数据于2018年更新。
巴勒斯坦有38个新生儿病房：约旦河西岸27个，东耶路撒冷3个，加沙地带8个。孵化器在地理上与人口和出生情况的分布不均衡，在加沙地带更为明显；79%的新生儿病房和75%的孵化器位于约旦河西岸。虽然几乎所有设有新生儿病房的医院都接收极低体重和超低体重新生儿并收治外出生的新生儿病例，但配备加湿器的孵化器、高频振荡通气设备、带加湿器的机械通气设备和隔离病房短缺。新生儿科医生、新生儿护士和儿科亚专业人员也严重短缺。
尽管由于人力资源、设备、药品和基本血液检测严重短缺，以及基本设施供应经常中断，几乎所有新生儿病房都未做好接收这些新生儿的准备，但几乎所有新生儿病房仍接收超低体重新生儿病例。这些因素共同构成了为新生儿提供优质护理的负担，而以色列的措施导致缺乏转诊指南以及及时转诊面临挑战，这进一步加剧了这种负担。最终，这导致对新生儿的护理欠佳，并对未来的健康结果产生负面影响。
