Children are entitled to the highest attainable standard of health. PMRS believes that in order to reach this standard, health must be viewed in a holistic, comprehensive manner, which includes all facets of child well-being. Child development is multidimensional including physical, cognitive, emotional and social dimensions and child well being exists when a child is able to realize his or her potential and vise versa. Child health reflects more than physical well being, it also necessarily includes mental and social health.
Biddo Clinic (Child Friendly Space)
Palestinian child health context:
During Al Aqsa Intifada, about 689 Palestinian students aged less than 18 years were killed. That number is equivalent to about 25 education classes and this almost like killing students of a whole school.
Data indicate that 37.9% of Palestinian children under five suffer from iron deficiency anemia, and congenital abnormalities continue to be number one cause of death among infants.
Much can be done to protect the life and well being of children, families and communities in terms of prevention, early detection, management and health education. Improvements have been achieved in some health indicators, while other indicators either worsened or failed to show any progress.
The three major indicators that reflect the health situation of children in Palestine are: vaccination, nutrition, and congenital anomalies:
Maythaloun Clinic (Well baby Examiniation)
About 133000 children will not have the chance to get their basic vaccines because of the Wall and the closures. At the same time, the closure made it difficult for the medical staff to conduct primary health care programs, including vaccinations, which called for carrying out national immunization campaigns during the last year such as the national campaign for MMR vaccine.
Nutrition is very crucial for health and especially for child health. The separation of families from their lands and water recourses as a result of the construction of the Wall, loss of jobs and increased level of unemployment have lead to increased rates of both poverty and malnutrition.
According to UNICEF, 37.9% of Palestinian children under five suffered from iron deficiency anemia, about 3.5% children were underweight, about 2.5% children suffered from wasting and about 9% suffered from stunting.
Number one cause of death among infants is congenital abnormalities. One can predict that these cases will increase in result of the increase in the number of isolated areas, thus increasing consanguineous marriage. Therefore, screening and prevention activities will become more crucial.
Palestine is in the stage of epidemiological transition, where a disease profile of children characteristic to underdevelopment (diarrhea, respiratory diseases and malnutrition) is combined with concerns more typical for developed countries, such as accidents, psychological problems, abuse and neglect. For instance, diarrhea and intestinal parasites are highly prevalent in refugee camps in particular, due to poor environmental conditions.
The Israeli army and settlers continue to directly and indirectly affect the health and well being of Palestinians, often threatening their lives. What is unique in the Palestinian case is the continuity of trauma, which is not due to a natural disaster but a manmade one.
A major dimension of the situation in previous years is the continuation of the constructions of the Wall on the Palestinian land, separating people from their lands and children from their schools. To date, about 16 villages are totally isolated and other 50 villages will be separated from their lands.
The overall goal:
Improve child health in Palestine, through improving the health care and prevention mechanisms in order to detect any developmental abnormalities and other diseases in early stages.
PMRS seeks to create a child friendly environment that will allow for an early childhood development intervention initiative. The program will help to address the problem that there is no systematic, regular health and growth monitoring for children till the age of 5 years.
Promoting better child health care.
Creating child- friendly environments.
Improving community awareness.
Ensuring holistic approach to child care.
Kufur Raye Clinic (Data Entry)
The Target Group:
The target group is children from ages 0-18 (with a special emphasis on children under five) with specific services for each age group.
Health workers: the program is targeting doctors, community health workers and counselors to improve their capacity and skills in child health care.
Parents and families in the target communities.
Education staff, including kindergarten and school teachers.
Community members, other organizations and leaderships in the community.
Promoting better child health care
In this program, PMRS has built up a model for quality child health care in Palestine. This is of special importance because of the bad socio-economic situation and because of the weakening of the Palestinian Authority.
Within the scope of working in the healthy child clinics a special file Well baby file was developed for children aged between 1 day- 5 years to be used in clinics as a tool for early detection of disability among children, this file was developed through constructive discussions which took place between clinic officials and program coordinators and a comprehensive revise for community health. One of the important issues, which were taken into consideration, was to make sure that this file would be complementary to the national file used in the Palestinian ministry of health clinics.
The file is filled out by health workers and doctors previously trained on filling out such files which will help in child development monitoring and early disability detection.
These files contain general information and data on the child such as family information, the family medical history, the mother’s pregnancy date, and other information related to child growth and mental and physical development, nutrition, regular medical checks, vaccines, medical transfers, and blood tests.
Moreover the program established a computerized data base information system for the well baby file, and the health workers in the PMRS were trained to insert the medical information from the Well baby file into the computer.
The Well baby file was developed an idea to design a Palestine information system through which it will be possible to obtain different medical indicators for children since birth up to 5 years of old.
PMRS is providing psychosocial health services in five areas (Ramallah, Jerusalem, Jenin, Qalqilya and Tulkarem, and Gaza). Main activities include individual counseling (for mothers, children and adolescents), group counseling, debriefing and support to the staff, and health education sessions.
Creating a child friendly environment
Child friendly spaces was created within PMRS clinics and centers. These clinics maintaned a special room and special equipment for children. In these rooms, children can interact, play and express themselves with the presence of their parents and the staff. It also provides a good opportunity for both parents and health staff to discuss issues related to child health and development and sometimes to raise general issues and concerns.
Improving community awareness
One of the major objectives of the child health program is to promote child health in the Palestinian society, and encourage people and parents to adopt healthy lifestyles to improve their health and the health of their children.
This has been implemented through:
Discussions with the women’s groups in the communities.
Health sessions in the clinics, schools, kindergartens.
The distribution of printed health education materials.
The distribution of health massages through the TV spots.
Health campaigns: breastfeeding and child nutrition.
The international day activities
Gaza, Um Nasser clinic, drawing contest
Ensure holistic approach to child health care
Within a view towards the provision of comprehensive health care to children and achieving an integrated approach toward services, the child health program has maintained close cooperation with the different programs and structures within PMRS. The following is a brief account of the scope of cooperation with the various programs at PMRS.
School Health Program
The school health program is now an integrated part of the program. The reason to this is that the child health program according to the plan involves children up to the age of 18. The older children get their health checked at school and therefore it is natural that the school health is an integrated part of the child health program.
• Cooperation covered the following aspects:
o The health service component in the school health.
o Rehabilitation of the schools and kindergartens.
o Training and capacity building.
• Health education program:
o Revision of health education materials (internal and external materials)
o Organization of health education sessions
o Active learning training.
• Woman’s health program:
o Postnatal home visits to examine postpartum mothers and newborns
• Community Based Rehabilitation program:
o Referral of children needing rehabilitation services to the CBR and receiving referrals of children in need for medical services.
o Joint activities: summer camps, home visits.
• Psychosocial program:
o Referral of children suffering from psychosocial problems
o Trainings in the fields of psychosocial health
• School of community health:
o Planning for the child health related training.
o Improving the capacity of the health professionals working in the child health
o Improvement of the resource center.