647 - Pediatric Healthcare Challenges in the West Bank before and during the Gaza War: A Qualitative Study

Publication Number: 3627.647

Ru'a Rimawi, Dana-Farber Cancer Institute, Brookline, MA, United States; Hala Abdo, AlQuds University, Ramallah, N/A, Palestinian Territories; Nadine K. Jawad, Weill Cornell Medicine, New York, NY, United States; Navid Madani, Dana-Farber Cancer Institute, Boston, MA, United States; C. Nicholas Cuneo, Johns Hopkins University, Baltimore, MD, United States; Fatima Karaki, Refugee Research Equity and Collaboration in Health, Los Angeles, CA, United States; Gary Darmstadt, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, United States

Background: The West Bank in the occupied Palestinian territories has endured decades of conflict. The Ministry of Health (MoH) serves as the primary healthcare provider in the West Bank, alongside the private sector and the United Nations Relief and Works Agency (UNRWA). Since the onset of the Gaza war in October 2023, violence in the West Bank has intensified, accompanied by severe movement restrictions and economic collapse that have disrupted daily life. This volatile context poses major challenges to healthcare access and delivery.

Objective: While the war’s impact on healthcare in Gaza has been well documented, its consequences in the West Bank remain underexplored. Given children’s particular vulnerability in conflict settings, this study examines barriers to pediatric healthcare access and delivery in the West Bank before and during the war

Design/Methods: This qualitative descriptive study, approved by the IRBs of Al-Quds University, Stanford University, Johns Hopkins University, and Dana-Farber Cancer Institute, involved semi-structured interviews with 21 pediatricians across the West Bank. Participants were recruited through purposive sampling, with regional and sectoral (MoH, UNRWA, private) representation

Results: Participants reported that even before the war, pediatric healthcare in the West Bank was constrained by a shortage of subspecialists, inefficient referral pathways, and strain on the MoH. During the war, these challenges were exacerbated by direct attacks on healthcare facilities, movement restrictions, and growing security concerns. These factors decreased healthcare accessibility for both patients and physicians. Economic collapse and rising poverty further reduced families’ ability to afford care. Shortages of essential medical supplies, including medications, nutritional supplements, and vaccines, were widely reported due to shipment and funding constraints. Attacks on UNRWA facilities and decreased ability to pay for private services redirected more patients to MoH hospitals and clinics, placing additional pressure on an already overstretched system.

Conclusion(s): Prolonged conflict has left the West Bank’s healthcare system deeply fragile, with children at particular risk. Movement restrictions, funding constraints, and strain on the MoH have disrupted continuity of care. During periods of escalating violence, the healthcare system is further weakened by restricted access, supply shortages, and growing dependence on the MoH, threatening its capacity to sustain healthcare delivery. Strengthening healthcare resilience is essential to protect pediatric access to care amid ongoing instability.