Academic journal article Bulletin of the World Health Organization

Low Infant Mortality among Palestine Refugees despite the odds/Contre Toute Attente, Une Faible Mortalite Infantile Chez Les Refugies palestiniens/Baja Mortalidad Infantil Entre Los Refugiados Palestinos Contra Pronostico

Academic journal article Bulletin of the World Health Organization

Low Infant Mortality among Palestine Refugees despite the odds/Contre Toute Attente, Une Faible Mortalite Infantile Chez Les Refugies palestiniens/Baja Mortalidad Infantil Entre Los Refugiados Palestinos Contra Pronostico

Article excerpt

Introduction

Sixty years have passed since about 900 000 Palestinians fled their land. This event affected all countries near Palestine and generated the oldest and largest protracted refugee population in the world. (1)

Throughout the decades that have transpired since that event, Palestine refugees have enjoyed different levels of access to health-care services in their host countries. However, in many places they face discrimination and are a socially and economically vulnerable population (2,3) whose main primary health-care provider continues to be the United Nations Relief and Works Agency (UNRWA) for Palestine Refugees in the Near East. Today this agency serves almost 5 million beneficiaries in Jordan, Lebanon, the Syrian Arab Republic, the Gaza Strip and the West Bank, territories whose young populations have high fertility rates. UNRWA delivers comprehensive primary health care, among other services, and it focuses particularly on maternal and child health, with targeted activities from preconception (4) throughout gestation and the post-delivery period.

Mortality among children within the first year of life (i.e. infant mortality) is an important indicator of the health status of a population and correlates strongly with more comprehensive measures of health, such as disability-adjusted life expectancy.S Although infant mortality surveys are carried out periodically within countries hosting Palestine refugees, distinguishing between refugee and non-refugee populations is difficult2 and the use of different survey methods by the countries makes it hard to perform comparisons and to assess trends across countries over time.

This paper presents the results of an infant mortality survey conducted by UNRWA in 2008 in Jordan, Lebanon, the Syrian Arab Republic, the Gaza Strip and the West Bank and compares them with the results of two earlier UNRWA studies performed with identical methods. (6) The trends presented in this paper in infant and early child mortality among Palestine refugees in the Near East for the 10-year period from 1995 to 2005 have never been published before.

Methods

In 2008, we conducted a cross-sectional survey to estimate infant mortality among Palestine refugees served by UNRWA. The preceding birth technique (7) was adopted so that the results could be compared with those of two identical surveys conducted by UNRWA in 1997 and 2003. (6) Using the infant mortality rates reported in the previous UNRWA surveys, (6) we calculated the minimum sample size needed in each UNRWA field of operation to estimate infant mortality to the nearest 5 deaths per 1000 live births with a confidence level of 95%. Beginning on 15 February 2008, we interviewed women who were registering the birth of a neonate (index birth) at UNRWA primary-health-care facilities and who had given birth to at least one other child, until the required sample size was attained. The data collection period varied between countries, however, since the number of newly registered infants in a given period was different in each. Data collection lasted approximately 4.5 months in Jordan, 9 months in the Syrian Arab Republic and the West Bank and 12.5 months in Lebanon. Because data in the Gaza Strip were collected twice to validate the preliminary results, data collection there took 15 months. The compiled survey forms were transferred to the UNRWA Health Department in Amman, Jordan, where the data were entered, cleaned and analysed using EpiInfo 2000 (Centers for Disease Control and Prevention, Atlanta, United States of America).

Following the preceding birth technique, which is used to indirectly estimate infant and early child mortality (defined here as death within the first three years of life), we asked women whether the preceding child (i.e. the last one born before the index birth) was still alive or not. If they reported that the preceding child was dead, we asked them the age of the child at death and the main cause of death. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.