During 2009 and 2010 comprehensive reviews conducted in all five Fields revealed a number of challenges and opportunities for strengthening UNRWA health services:
- Non-communicable disease care and preventive services are limited. UNRWA should increase its focus on these areas while still maintaining its successful core health services.
- Health centers are over-crowded. There is an urgent need to address over-use of health facilities in order to ensure quality of care.
- The closed organizational culture within UNRWA limits exposure to new opportunities. UNRWA should actively engage in fora where host country health policy is discussed and continually seek creative ways to improve access to quality health care for its beneficiaries through negotiating with the MOH and other service providers.
- Future changes in host country polices could result in greater reliance on UNRWA to fund or subsidize hospital care. There is a lack of detailed information available on the types of hospital cases referred and the services received. The establishment of a data base to manage hospital related information was recommended, to better enable UNRWA to negotiate the services costs, and to monitor the quality of services received.
- While UNRWA health programs collect a wealth of data, information is fragmented along vertical lines. Revisions are needed to rationalize the current health information system and to facilitate comprehensive analysis of health information at facility level, including financial and human resources data. Knowledge of refugees‟ living conditions, including health seeking behavior and expenditures, is also limited.
- Current reporting lines within UNRWA’s health departments are vertical, confined to technical divisions and with little responsibility at facility level. Changes in the health department structure at field office level are recommended, to better reflect the support needs of an evolving primary health care system.
The Family Health Team approach aims to address all these issues.