Capacity-building in the Palestinian Authority Ministry of Health: Creating ownership to ensure success

Since its formation in 1995, the Palestinian Authority (PA) has progressed significantly in ensuring the health of its population. However, an eight-year intifada and continuous changes among Ministry of Health (MoH) staff have slowed reform in the PA. Furthermore, the Gaza/West Bank separation resulted in a fragmented MoH, making communication and coordination a major challenge. Considerable improvements have been made in primary health care, but issues such as treatment of chronic disease, costly referrals abroad, a weak health insurance system, and high dependence on donor funding remain.

USAID responded to these challenges by awarding a large health project in 2008—the Palestinian Health Sector Reform and Development Project. As a first step, the project supported the MoH in conducting a structured self-assessment to formally identify and prioritize gaps in governance, health finance, health information systems, health service delivery, pharmaceutical management, and human resources, and to create ownership of assessment findings and solutions. The assessment process and resulting report were built around the concepts of equity, quality, transparency and openness, and served as the basis for the development of an Institutional Development Plan that identified specific interventions to be undertaken over the next five years. Interventions were organized under the Ministry's regulatory, service provision, and donor coordination mandates and were linked to the MoH three-year National Strategic Health Plan. The self assessment and Institutional Development Plan processes resulted in a sense of ownership, optimism and enthusiasm for carrying the plan forward by the Ministry, while remaining flexible to address emerging needs as they arise.