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 Palestine refugee population.
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 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 or the family history of an individual. Now care is delivered by multidisciplinary medical teams, who provide comprehensive, continuous to care to the patients and families registered with them.
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 equalized the workload among staff.
As part of the Family Health Team approach, UNRWA has introduced operational changes to improve efficiency in the clinics. These include the reorganization 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.
From maternal and child health to family planning, preventive 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 Palestine refugee women receive regular check-ups, screenings, supplements to prevent congenital malformation, and protection against micronutrient deficiencies. High-risk hospital deliveries are subsidized by the Agency.
The family health team provides mothers with health education and counselling on child care. Infants and children from birth to 5 years old receive a thorough medical examination in the clinics and when first enrolling in UNRWA schools. Services also include growth monitoring, immunization, and screening for disabilities, child abuse and neglect. Oral health, vitamin supplementation and health education are also priorities.
Through their family health team, adolescent and Palestine 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 psychosocial 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.
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 screening 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 Palestine refugee population.
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 preventive 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 health history of the individual and his or her family.
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, the ongoing armed conflict in Syria has halted expansion in that field.