This study examined different barriers to the access and utilization of primary health care services by the elderly in the occupied Palestinians territories. We collected quantitative data from a larger convenience sample of a national survey of 1299 persons in the occupied Palestinian territories (oPt) that examined the effects of Israel's colonization and its effects on health care delivery between October 2021 and February 2022. The research tool was based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questionnaire. The data was obtained from 76 elderly participants with a mean age of 68.33 years standard deviation (SD = 7.09 years). The majority (75%) reported having at least one chronic health issue and having limited access to health care. They had all finished at least six years of education. The participants claimed having health insurance, while 47.4 percent reported paying for out-of-pocket expenses and medical care was a burden. Access and affordability of health care was a problem for 70 percent of participants. Older persons and their families face access to care issues created by political, geographic, and economic barriers. Poor incomes, war-like conditions, a weak health care system, and a lack of comprehensive care delivery all impact their health.

Background: Cancer is a leading cause of mortality in Palestine. The number of cancer cases is increasing, whereas the late stage of diagnosis is common for the majority of cases. Modern diagnostics and medicine are contributing to more positive outcomes for patients when diagnosed early; however, the holistic approach to patient care, patient satisfaction, quality of life (QOL), and survivorship are often overlooked. Patients with cancer are usually treated by physicians and other health professionals employing the “medical model” without considering other factors that might positively affect their treatment. For this pioneering survey, the Functional Assessment of Chronic Illness Therapy-General (FACT-G) tool was used. This study aimed to measure the satisfaction of patients with cancer undergoing outpatient treatments and assess their QOL. Materials and Methods: The FACT-G scale in Arabic has four sections, measuring physical, emotional, social, and functional well-being, was used in a survey of 203 patients with cancer currently undergoing chemotherapy, radiotherapy, and hormonal therapies. Patients were surveyed in the summer of 2019, within 1 year of diagnosis when they were outpatients, all of whom were attending a major cancer center in a Palestinian hospital. Results: Emotional well-being scored the lowest (from a total of 24; mean 11.31 (standard deviation (SD) 5.45)) whereas social/family well-being scored the highest (from a total of 28), mean 22, (SD ± 5.78). The overall mean for the four sections was 63.57 (SD 12.44). Conclusion: To ensure better management of symptoms and treatments, important indicators are now available for health professionals and researchers to learn more about the QOL of patients. Evaluating the physical, social, emotional, and functional states of patients with cancer undergoing outpatient treatments enabled us to learn more about the struggles they face while understanding how they were coping during their cancer journey.

Bayesian estimation of the linear regression parameter system is considered by deploying Median Rank Set Sampling (MRSS). The full conditional distributions and the associated posterior distribution are obtained. Therefore, based on Markov Chain Monte Carlo simulation, the Bayesian point estimates and credible intervals for the regression parameters are determined. To measure the efficiency of the obtained Bayesian estimates concerning the frequentist estimates we compute the asymptotic relative efficiency of the obtained Bayesian estimates using Markov Chain Monte Carlo simulation.

Background Antibiotic resistance is a global problem, and the World Health Organization has made this problem one of its priorities for solving. Therefore, a survey was carried out to investigate the knowledge, attitude, awareness, and perceptions of antibiotic resistance among physicians and to assess the correlation between the knowledge of antibiotic resistance and their years of experience in some Palestinian hospitals. Methods This was a cross-sectional study that targeted physicians who are working in different healthcare facilities in Hebron and Bethlehem governorates. We used a questionnaire for data collection. The questionnaire consists of 42 questions to measure the knowledge, attitudes, awareness, and perceptions of antibiotic use and resistance. Results The response rate was 91.33% (137 of 150 physicians completed the questionnaire). The participants' ages ranged from 25 to 56 years, and the majority were males (n = 116, 84.7%) working in governmental hospitals (n = 83, 60.6%). Of physicians, 69.3% (n = 95) perceived antibiotic resistance as a very important worldwide problem, while 54.7% (n = 75) perceived a very important problem in the country, 54.0% (n = 74) a very important problem in their hospital, and 59.1% (n = 81) a very important problem in their departments. Methicillin-resistant Staphylococcus aureus was the most known antibiotic-resistant bacteria followed by extended-spectrum beta-lactamases. Only 47 physicians (34.3%) think that antibiotics are not used appropriately in their department. Respondents' physicians showed that the development of antibiotic resistance was due to various factors that include self-medication n= (92, 67.2%), overuse of antibiotics (n = 83, 60.6%), and uncompleted treatment (n= 87, 63.5). Senior specialists/consultants were found to be more knowledgeable about antibiotic resistance. Conclusion In our survey, physicians showed variable knowledge and perceptions of antibiotic resistance. Introducing educational programs is necessary to improve their understanding and perceptions of antibiotic resistance, as well as their attitude toward antibiotic use.

Background: Since October 2023, the humanitarian crisis in Gaza has dramatically escalated and food insecurity (FI) has rapidly deteriorated. In the face of such situation, it has been recommended that accurate information on FI should be integrated in emergency reporting systems in order to better target and assess the impact of humanitarian aid. To achieve this, field practitioners, researchers and decision-makers should be equipped with user-friendly and psychometrically sound measures tailored to real-life war situations and the Palestinian context. Therefore, the present study aimed to test the psychometric properties of the Food Insecurity Experiences Scale (FIES) in a sample of Arabic-speaking community adults currently living in the Gaza Strip during the war. Methods: This study used a cross-sectional design, snowball sampling as a recruiting strategy, and a self-administered online questionnaire to collect data from participants. It was performed during the period from September 1st to 30th, 2024. A total of 534 valid responses were received and were included in the final analysis. Results: Approximately one out of two people in Gaza were experiencing any FI. Fit indices in confirmatory factor analysis indicated that a one-factor solution fit the data with acceptable factor loadings. Furthermore, our findings indicated that the Arabic version of the FIES presented an excellent level of reliability, with both Cronbach's alpha and McDonald omega coefficients of .94. Cross-sex measurement invariance in the FIES was established at scalar and metric levels. Finaly, concurrent validity was evidenced by FIES's positive correlations with water insecurity experiences, post-traumatic stress, depression and anxiety symptoms. Conclusion: Altogether, our findings showed that the FIES fulfils requirements of validity and reliability, and may thus be considered as appropriate tool for assessing FI in war-affected populations currently suffering from hunger. The FIES is simple, short, economic and time-effective. It could therefore be easily implemented in war settings to measure and monitor FI for clinical, research and policy-making purposes.

Background: Equity in access to quality healthcare is a fundamental human right. Yet studies demonstrate that some people receive preferential treatment while others are discriminated against. Wasta is a prevalent strategy whereby personal connections are used for influence and may result in gaining unfair advantages over others. This study aims to investigate wasta use in healthcare, the factors associated with its use, and the impact of wasta use on the equity and quality of healthcare services. Methods: A mixed-methods study utilizing a quantitative survey and qualitative interviews was conducted in Palestine (West Bank and Gaza) between October 2021 and February 2022. Quantitative analysis was performed using Stata version 14. Bivariate and multivariate logistic regressions assessed the relationship between wasta use and individual-level variables such as gender, residence, age, employment status, and financial situation. Content analyses of qualitative transcripts were performed using Dedoose version 9. Textual quotes were grouped into major and minor themes. Results: Multivariate regressions revealed that wasta use is more prevalent among refugee camp dwellers and more frequent in Gaza compared to the West Bank. Wasta was also employed to a greater degree among government employees. Qualitative interviews complemented the quantitative results and added further insights into the consequences of Wasta use in healthcare settings such as negatively impacting quality and equity in healthcare services. Conclusion: Wasta use in healthcare can have an adverse effect on equity and quality. Ensuring efficient processes, reduced financial burdens, stringent accountability measures, transparency, and training programs can contribute to diminishing the need for using wasta in healthcare. By addressing both systemic and cultural factors that perpetuate wasta, societies can move closer to healthcare systems characterized by fairness, accessibility, and ethical integrity.