School health services in Israel - back from outsourcing to state

School health services(SHS) in Israel were established before the state itself. SHS cover all 1st to 9th graders (ages 6-14) in the country. Over the years, SHS, including three main directions of school vaccinations, screening programs and health promotion, were highly successfull. However, due to governmental preference of outsourcing of public services, in 2005, SHS were transferred by tender to contractor. During the following 7 years the service did not thrive. Albeit still high vaccination rates, screening coverage decreased and health promotion was reduced to minimum. In the Southern District the situation was worse than elsewhere: reduced vaccination coverage, especially in the nomadic Bedouin population, low screening and health promotion non-existant. These factors led in 2011 to a partial policy revision. Starting March 2012 the SHS in the South returned to the Health Ministry, including the proportional part of the overall SHS budget. A prompt improvement in outcomes followed this decision. While the SHS, provided by private contractors in the rest of the country continued as before, the Southern District enjoyed a steep increase in coverage rates within the same school-year, both for sreening programs and vaccination rates. At the end of the year, in July 2012, the vaccination rates were 20% higher than those achieved by the contractor. The coverage rates in Bedouin population were identical to other subgroups. Currently, the process continues, and the full evaluation due by July 2013. Already, despite financial difficulties and nurses shortage, primary results show substantial improvement for SHS in the South!