BACKGROUND

Inequalities in the provision, distribution and utilization of healthcare services are the most commonly used variables to measure health system equity. Health inequalities in the Palestinian health system are evidenced due to geopolitical and socioeconomic challenges. This study evaluates the equity of healthcare resource distribution and utilization in the West Bank, focusing on primary healthcare centers and hospital services managed by the Palestinian Ministry of Health over a six-year period (2017-2022).

METHODS

The data was extracted from the Annual Health Reports for the investigated six years, covering the eleven governorates of the West Bank. The distribution of primary healthcare centers, hospital beds, and health workforce was assessed using standardized measures per population and geographic area, service utilization trends were analyzed across governorates. The Gini coefficient was calculated to evaluate equity in resource allocation.

RESULTS

Disparities in resources allocation and services expansion and utilization are noticed among the different governorates. Hospital services expanded at a higher rate (18.5% increase in beds, and 5.8% increase in standardized beds ratio to population) compared to PHC centers (6.8% increase in centers, and - 4.63% for the standardized ratio of PHC centers to population). The rates varied widely among different governorates in both areas. Human resources growth rates lagged behind infrastructure expansion. Despite these inequities, the Gini coefficient values suggested relatively balanced resource allocation at the population level ranging between 0.078 and 0.164, though higher values for Gini coefficients and inequalities are found for resources distribution by geographic area.

CONCLUSION

The findings emphasize the urgent need for a strategic equity-oriented approach that integrates community needs, geographic accessibility and workforce development. Comprehensive plans for strengthening healthcare services at different levels; focusing on PHC services and aligning workforce growth with infrastructure expansion are essential for achieving universal health coverage in Palestine.