UNRWA Health Department Annual Report 2012

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) serves over five million registered Palestine refugees across its five fields of operation: Jordan, Lebanon, Syria, the West Bank, and Gaza. The Health Department is one of UNRWA's major programs, providing primary health care services to the refugee population. This report summarizes the key achievements, challenges, and developments in the UNRWA Health Program during 2012.

Overview of Health Services

In 2012, the UNRWA Health Program continued to provide comprehensive primary health care services to Palestine refugees through a network of 137 health centers across its five fields of operation. These services included medical care, maternal and child health, family planning, communicable disease control, and non-communicable disease management. The total number of patient visits exceeded 10.7 million, representing an average of 2.1 visits per beneficiary.

Primary Health Care Services

Medical Care

The medical care program remained the backbone of UNRWA's health services, accounting for 62% of all patient visits in 2012. Medical staff provided curative care for acute and chronic conditions, with standardized treatment protocols ensuring quality across all health centers. The program continued to emphasize preventive care through health education and screening for early detection of diseases.

Maternal and Child Health (MCH)

The MCH program provided essential services to pregnant women, new mothers, and children under five. In 2012, 93% of pregnant women received at least four antenatal care visits, and 99% of deliveries occurred in health facilities, demonstrating high coverage of maternal health services. The infant mortality rate remained low at 23 per 1,000 live births, while under-five mortality was 26 per 1,000 live births.

The immunization coverage continued to be high, with 97% of infants receiving all recommended vaccinations by their first birthday. The expanded program on immunization included vaccines against tuberculosis, polio, diphtheria, pertussis, tetanus, hepatitis B, measles, mumps, and rubella.

Family Planning

The family planning program provided counseling and contraceptive methods to refugee couples. In 2012, the program reached approximately 28% of eligible women of reproductive age, contributing to improved maternal and child health outcomes through appropriate birth spacing.

Non-Communicable Diseases

In 2012, UNRWA continued to expand its non-communicable disease (NCD) program, focusing on diabetes mellitus, hypertension, and other chronic conditions. The number of registered NCD patients increased to 89,400, representing a 12% increase from the previous year. This growth reflected both improved case detection and the rising prevalence of NCDs in the refugee population.

Disease Type	Number of Registered Patients (2012)
Diabetes	49,700
Hypertension	35,200
Other NCDs	4,500

The NCD program implemented a patient-centered approach with regular follow-up, medication provision, and health education to promote self-management and prevent complications.

Disease Surveillance and Control

The surveillance system for communicable diseases, including tuberculosis and leishmaniasis, continued to function effectively in 2012. The tuberculosis program detected and treated 1,060 cases, maintaining a treatment success rate of 91%. The program also implemented directly observed treatment, short-course (DOTS) strategy to ensure treatment adherence.

In Gaza and parts of the West Bank, the leishmaniasis control program focused on case detection, treatment, and vector control. A total of 1,150 cases were reported and treated in 2012, a 15% reduction compared to the previous year, reflecting the effectiveness of control measures.

Mental Health and Psychosocial Support

In 2012, UNRWA recognized mental health as an essential component of primary health care. The Agency initiated the integration of basic mental health services into its primary health care program, training staff in detection and management of common mental disorders. This initiative was particularly important in fields affected by conflict and displacement, where psychological distress was widespread.

Environmental Health and Sanitation

The environmental health program focused on water quality monitoring, food safety, solid waste management, and vector control in refugee camps. In 2012, despite resource constraints, the program maintained essential services, ensuring that 96% of refugee camps had regular waste collection and that water sources met safety standards.

Emergency Response

In 2012, the health program responded to several emergencies, including the escalation of conflict in Gaza, the ongoing crisis in Syria, and its impact on refugees in Lebanon and Jordan. In Gaza, the Agency pre-positioned essential medical supplies and implemented contingency plans to maintain health services during periods of heightened violence.

In response to the Syria crisis, UNRWA provided health services to Palestine refugees displaced within Syria as well as those who fled to neighboring countries. Mobile health units and additional staff were deployed to serve displaced populations, ensuring continuity of care despite challenging circumstances.

Staff Development and Quality Assurance

In 2012, UNRWA continued its efforts to strengthen health workforce capacity through training and professional development. A total of 5,200 training sessions were conducted for health staff, covering clinical skills, management, and quality improvement. The Agency also implemented the Family Health Team approach, which reorganized service delivery into interdisciplinary teams to provide more comprehensive and patient-centered care.

Partnerships and Collaboration

UNRWA's health program benefited from partnerships with WHO, other UN agencies, NGOs, and government health authorities. These partnerships supported capacity building, service provision, and funding. In 2012, collaborations with the Global Fund to Fight AIDS, Tuberculosis and Malaria, the European Union, and various donor governments enabled the Agency to maintain and expand essential health services.

Challenges and Constraints

Despite these achievements, the health program faced significant challenges in 2012:

• Financial constraints limited the Agency's ability to fully address the growing needs, particularly in areas with high population growth and increasing refugee influxes.
• The political and security context in several fields, particularly Syria and Gaza, hampered service delivery and strained available resources.
• The growing burden of non-communicable diseases required expanded resources, including medications, diagnostic capabilities, and specialized human resources.
• Infrastructure limitations in some health centers affected the quality and range of services that could be provided.

Looking Ahead

As UNRWA moves beyond 2012, the Health Department remains committed to providing quality primary health care to Palestine refugees. Future priorities include expanding the NCD program, strengthening mental health services, improving infrastructure, and enhancing health information systems. The Agency will continue to advocate for predictable funding to support these essential services, which are a lifeline for millions of Palestine refugees.

UNRWA's health program represents not only a humanitarian response to immediate needs but also an investment in the long-term health and well-being of Palestine refugees. Through sustained commitment and support, the Agency aims to maintain the high standards of health care that have characterized its services for over six decades.

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