As part of its ongoing efforts to improve the quality and accessibility of the primary health care services it delivers to Palestine refugees, UNRWA has introduced the Family Health Team approach.
In a changing environment of increasing health care needs - particularly with the increase of chronic non-communicable diseases, rising health care costs and limited financial resources - it has become imperative to find and adopt new strategies to respond effectively to the emergent needs of the population.
UNRWA’s health mission
To provide quality health care for Palestine refugees that enables them to live long and healthy lives by ensuring universal access to quality comprehensive services, preventing and controlling diseases, and protecting and promoting family health.
The Family Health Team Approach
A person-centred health care system
The Family Health Team is a new, person-centred approach, devoted to improving the quality and delivery of public primary health care for Palestine refugees.
The reform has introduced a shift in focus. Previously, care was provided to treat specific ailments without taking into consideration the comprehensive health status neither of an individual nor of his or her family history. Now care is delivered by multi-disciplinary medical teams who are delivering comprehensive and continuous care to their patients and families registered with them.
One family, one family health team
Each Family Health Team is made up of at least one doctor, a nurse and a clerk. Each team manages approximately the same number of family files which has improved patient flow in the clinic and equalised the workload among staff.
Series of improvements
As part of the Family Health Team approach, UNRWA has introduced operational changes to improve efficiency in the clinics. These include the reorganisation of the staff to work in teams, the use of appointment systems, the introduction of e-health -an electronic management system for patient files, and physical modifications in the clinics to facilitate patients’ access.
Primary health services provided by the Family Health Team
From maternal and child health to family planning, preventative and curative care, outpatient and diagnostic services, oral care, specialists, pharmacies, and referrals, Palestine refugees have access to comprehensive health care provided by their family health teams.
Registered women receive regular check-ups, screenings, supplements to prevent congenital malformation, and protection against micro-nutrient deficiencies. High-risk hospital deliveries are subsidised by the Agency.
Infant and child care
The family health team provides mothers with health education and counselling on child care. Infants and children from birth to five years old receive a thorough medical examination in the clinics and when first enrolling in UNRWA schools. Services also include growth monitoring, immunisation, and screening for disabilities, child abuse, and neglect. Oral health, vitamin supplementation, and health education are also priorities.
Adolescent and adult care
Through their family health team, adolescent and adult refugees can access the preventive and curative services available in UNRWA clinics. Overall, these include screening for breast cancer, family planning, community mental health and psycho-social support (in the occupied Palestinian territory), gender-based violence screening and counselling, outpatient services, health education and nutrition awareness, oral-health services, diagnostic services, physical rehabilitation, and dispensaries.
Active ageing and the burden of chronic disease
The reduction in the incidence of communicable diseases combined with modifications in lifestyle and ageing have led to a change in Palestine refugees’ morbidity profile; with a rise in cases of cardiovascular disease, diabetes, and cancer. The Agency is intensifying its creening programme to detect disease and begin management as early as possible. The focus of UNRWA care is on diabetes and hypertension as both conditions are common among the refugee population.
E-health and pioneering cohort monitoring analysis
Introduced with the family health team approach is an electronic patient record system referred to as “e-health”. The current patient record system is based on hard-copy folders. As a complement to the family health team approach, e-health ensures that family health teams can readily follow up and/or offer curative or preventative services as result of having consolidated information about the patient’s health.
Streamlining service delivery into an electronic platform improves data management within the health care centres; informs on patterns in diseases and treatment through cohort monitoring; simplifies the reporting and referral processes, and allows for a holistic view of the individual and family health history.
Ongoing expansion in 2013
UNRWA is progressively rolling out the Family Health Team approach throughout all of the 139 clinics in its five fields. By the end of 2012, FHT had expanded to 36 clinics, mostly in Gaza, the West Bank, Jordan and Lebanon. Unfortunately, ongoing hostilities in Syria have halted expansion.