Towards Effective Chronic Case Management : Improving the Efficiency of Outside Medical Referrals in West Bank and Gaza

The Palestinian health system suffers from chronic challenges related to protracted conflict and limited health system inputs, coupled with a high burden of non-communicable diseases (NCD). Over 75 percent of the disease burden is attributable to NCD, particularly cancers, diabetes, cardiovascular, and cerebrovascular diseases. While this burden is not particularly different from comparable middle-income settings, the Palestinian health system is not able to effectively control this burden due to its unique political and economic context. Over the past two decades, the health system has evolved to have more of a focus on curative interventions at the hospital level, with less of a priority accorded to preventive interventions at the population level. At the same time, due to financial and governance constraints, the government has not been able to effectively respond to this burden, which necessitates moving towards a patient-centered, integrated model