克服全民健康覆盖道路上的障碍：巴勒斯坦卫生系统分析（英）2025

An Analysis of thePalestinian Health Overcoming the Obstacles on thePath to Universal Health Coverage: An Analysis of the PalestinianHealth System December 2025 © 2025 International Bank for Reconstruction and Development / The World Bank1818 H Street NW, Washington, DC 20433Telephone: 202-473-1000; Internet: www.worldbank.orgSome rights reserved 1 2 3 428 27 26 25 This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusionsexpressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governmentsthey represent. The World Bank does not guarantee the accuracy, completeness, or currency of the data included in this work anddoes not assume responsibility for any errors, omissions, or discrepancies in the information, or liability with respect to the use of orfailure to use the information, methods, processes, or conclusions set forth. The boundaries, colors, denominations, links/footnotes Nothing herein shall constitute or be construed or considered to be a limitation upon or waiver of the privileges and immunities ofThe World Bank, all of which are specifically reserved. Rights and Permissions This work is available under the Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO) http://creativecommons.org/licenses/by/3.0/igo. Under the Creative Commons Attribution license, you are free to copy, distribute, transmit, and adapt this work, including Attribution—Please cite the work as follows: Duran, Denizhan; Haemmerli, Manon Yvonne; Elshawarby, Amr; Elnahass, Nevine.2025.Overcoming the Obstacles on the Path to Universal Health Coverage: An Analysis of the Palestinian Health System. Washington, Translations—If you create a translation of this work, please add the following disclaimer along with the attribution:This translationwas not created by The World Bank and should not be considered an official World Bank translation. The World Bank shall not be Adaptations—If you create an adaptation of this work, please add the following disclaimer along with the attribution:This is anadaptation of an original work by The World Bank. Views and opinions expressed in the adaptation are the sole responsibility of the Third-party content—The World Bank does not necessarily own each component of the content contained within the work. TheWorld Bank therefore does not warrant that the use of any third-party-owned individual component or part contained in the workwill not infringe on the rights of those third parties. The risk of claims resulting from such infringement rests solely with you. If youwish to re-use a component of the work, it is your responsibility to determine whether permission is needed for that re-use and to All queries on rights and licenses should be addressed to World Bank Publications, The World Bank, 1818 H Street NW, Washington,DC 20433, USA; e-mail: pubrights@worldbank.org. ISBN (electronic): 978-1-4648-2292-6DOI: 10.1596/978-1-4648-2292-6 Cover background image: Designed by Freepik. CONTENTS Acknowledgments vi 1Health outcomes5 2Physical and human resources, health system capacity and quality 3OverviewofhealthfinancingflowsinthePalestinianhealthsystem 4Revenue raising and health expendituresComposition of health expenditures by revenue sourceGeneral government spending on healthOut-of-pocket spending 22 6Purchasing arrangements 7Policy recommendations 8Annex 1: Enrollment conditions in health insurance 36 9Annex 2: Analysis on outside medical referralsAnalysis of OMR conditionsAnalysis of OMR destination hospitalsCancer deep dive 43 Figure 1.1Population pyramid in West Bank and Gaza, 2022Figure 1.2Changes in the distribution of the burden of disease in West Bank and Gaza (2009) and risk factors(2019)Figure 1.3Distribution of hypertension prevalence by age, 2022 (left), and blood pressure control amongadults 18–69, by sex, 2022 (right)Figure 1.4Distribution of diabetes prevalence by age, 2022 (left), and blood sugar control among adults40–69, by sex, 2022 (right)Figure 2.1Evolution of health workers per 1,000 population in West Bank and Gaza (left), comparison ofphysicians per 1,000 in West Bank and Gaza and comparator countries (right)Figure 3.1Financing flows for the Palestinian health financing system, with the overall system (top), and Gazaflows (bottom)Figure 4.1Current health expenditures as a share of GDP in West Bank and Gaza and peer averages, 2000–2022Figure 4.2Evolution and decomposition of per capita (left) and current (right) health spending in West Bankand Gaza across financing agents, 2000–2023Figure 4.3Government spending on health as a share of general government expenditure, 2013–2024Figure 4.4General government spending on health per capita versus GDP per capita in West Bank and Gazaand comparator countries, 2023 Figure 9.4Share of OMR destinations by volume 2023–2024Figure 9.5Share of OMR destinations by expenditures 2023–