Transition to Lower Fertility and Childhood Mortality in the Occupied Palestinian Territory

This presentation describes recent fertility and childhood mortality trends in the occupied Palestinian territory (oPt), using data from four national-level household surveys conducted between 1995 and 2006.

Historically among the highest in the world, Palestinian fertility rates in the oPt, began to slow, especially in the West Bank, but also stalled in Gaza since 2000, when the second Palestinian Uprising (Intifada) erupted. Despite the recent decline, such levels of fertility are still among the highest in the world. The transition to lower fertility was mainly due to changes in nuptiality. Although age at marriage decreased slightly, many more women remained single. Demand for children, however, remains high, especially in the resource-poor and unstable context of Gaza. In unstable political contexts such as Palestine, children, and sons in particular, can serve as political resources for families and clans.

Although levels of infant and childhood mortality are low in Palestine in comparison to regional standards, they have not fallen since 1990. The stalling of declines in mortality can be attributed to several factors, including economic hardship, changes in the causes of death, Israeli army checkpoints preventing access to health care, and deterioration in health conditions of women, especially during pregnancy. There is also evidence of increased disparity in infant mortality between the West Bank and Gaza especially during the recent past.

In conclusion, the continuing conflict and worsening economic situation provide clues to address the stalled mortality decline and the persistence of high fertility among Palestinian women.