Influence of international stakeholder and health-care agendas in the Palestinian Family Survey, 2010: a qualitative assessment of a national health survey

Abstract

Background Population health surveys play a vital part in enabling the planning, implementation, and monitoring of national health programmes and policies. However, the construction of these surveys is often determined by international stakeholders' agendas and implementation is restricted by availability of local resources. We used the Palestinian Family Survey (PFS) 2010 as a case study to inform the discussion on health surveys in the Arab region. MethodsWe used qualitative research methods involving a detailed document review of all PFS materials (eg, questionnaires, interviewer instructions and training manuals, reports) to assess the construction and implementation of the PFS in the occupied Palestinian territories. We compared the of the PFS 2010 survey instruments with contemporary health policies and practices.Findings We found a mismatch between the PFS content and data requirements at the national level. Some PFS content appeared to reflect international agendas rather than local health needs-for example, detailed questions about HIV/AIDS in a context with fewer than 100 reported cases since 1988. By contrast, health issues that were important in the context, such as mental health or exposure to violence, were not included in the PFS. There were inconsistencies in data collection by age and sex. For example, women aged 54-59 years were excluded from all survey modules except for the household roster, and there were few questions on the health of women who had never married.Interpretation Although population surveys are an important source of evidence in resource-poor settings, these findings suggests a need to re-evaluate health surveys, taking into account the necessity of addressing health concerns within their specific national context, while retaining the ability to monitor international health targets. Funding Emirates Foundation, London School of Economics Middle East Centre.

A vision to strengthen resources and capacity of the Palestinian health research system: a qualitative assessment

“…In contrast, another study revealed that public investment is the main source in the region's countries and HR funding is among the lowest globally and WHO Regional Office for the eastern Mediterranean is a key body offering HRF (4). There are other funding gaps concerning the donors' conditions, influence and procedural difficulty (39,41) and the scarcity of national resources due to the political conditions. For sustainable HRF, HR should receive the commitment of a fixed budget, at least 1% of the national health expenditure (2), along with a national integrated and pooled fund under government stewardship financed by Palestinian and non-Palestinian entities' contributions (4,18).…”