Mental health needs and services in the West Bank, Palestine

Background Palestine is a low income country with scarce resources, which is seeking independence. This paper discusses the high levels of mental health need found amongst Palestinian people, and examines services, education and research in this area with particular attention paid to the West Bank. Methods CINAHL, PubMed, and Science Direct were used to search for materials. Results and conclusion Evidence from this review is that there is a necessity to increase the availability and quality of mental health care. Mental health policy and services in Palestine need development in order to better meet the needs of service users and professionals. It is essential to raise awareness of mental health and increase the integration of mental health services with other areas of health care. Civilians need their basic human needs met, including having freedom of movement and seeing an end to the occupation. There is a need to enhance the resilience and capacity of community mental health teams. There is a need to increase resources and offer more support, up-to-date training and supervision to mental health teams

Investigating the Willingness to Pay for a Contributory National Health Insurance Scheme in Saudi Arabia:A Cross-sectional Stated Preference Approach

Background: The Saudi Healthcare System is universal, financed entirely from government revenue principally derived from oil, and is ‘free at the point of delivery’ (non-contributory). However, this system is unlikely to be sustainable in the medium to long term. This study investigates the feasibility and acceptability of healthcare financing reform by examining households’ willingness to pay (WTP) for a contributory national health insurance scheme. Methods: Using the contingent valuation method, a pre-tested interviewer-administered questionnaire was used to collect data from 1187 heads of household in Jeddah province over a 5-month period. Multi-stage sampling was employed to select the study sample. Using a double-bounded dichotomous choice with the follow-up elicitation method, respondents were asked to state their WTP for a hypothetical contributory national health insurance scheme. Tobit regression analysis was used to examine the factors associated with WTP and assess the construct validity of elicited WTP. Results: Over two-thirds (69.6%) indicated that they were willing to participate in and pay for a contributory national health insurance scheme. The mean WTP was 50 Saudi Riyal (US$13.33) per household member per month. Tobit regression analysis showed that household size, satisfaction with the quality of public healthcare services, perceptions about financing healthcare, education and income were the main determinants of WTP. Conclusions: This study demonstrates a theoretically valid WTP for a contributory national health insurance scheme by Saudi people. The research shows that willingness to participate in and pay for a contributory national health insurance scheme depends on participant characteristics. Identifying and understanding the main influencing factors associated with WTP are important to help facilitate establishing and implementing the national health insurance scheme. The results could assist policy-makers to develop and set insurance premiums, thus providing an additional source of healthcare financing

Learning the hard way: the effect of violent conflict on student academic achievement

We study the effect of the Israeli–Palestinian conflict on various education outcomes for Palestinian high school students in the West Bank during the Second Intifada (2000–2006). Exploiting within-school variation in the number of conflict-related Palestinian fatalities during the academic year, we show that the conflict reduces the probability of passing the final exam, the total test score, and the probability of being admitted to university. The effect of conflict varies with the type and the timing of the violent events the student is exposed to and it is not significant for students in the upper tail of the test score distribution. We discuss various possible transmission mechanisms explaining our main result. Evidence suggests a role for both the conflict-induced deterioration of school infrastructures and the worsening in the student's psychological well-being due to direct exposure to violent events

Health-related quality of life of Gaza Palestinians in the aftermath of the winter 2008-09 Israeli attack on the Strip

<p><b>Background:</b> We document the health-related quality of life (HRQoL) of people living in the Gaza Strip 6 months after 27 December 2008 to 18 January 2009, Israeli attack.</p> <p><b>Methods:</b> Cross-sectional survey 6 months after the Israeli attack. Households were selected by cluster sampling in two stages: a random sample of enumeration areas (EAs) and a random sample of households within each chosen EA. One randomly chosen adult from each of 3017 households included in the survey completed the World Health Organization Quality of Life instrument, in addition to reported information on distress, insecurities and threats.</p> <p><b>Results:</b> Mean HRQoL score (range 0GÇô100) for the physical domain was 69.7, followed by the psychological (59.8) and the environmental domain score (48.4). Predictors of lower (worse) scores for all three domains were: lower educational levels, residence in rural areas, destruction to one's private property or high levels of distress and suffering. Worse physical and psychological domain scores were reported by people who were older and those living in North Gaza governorate. Worse physical and environmental domain scores were reported by people with no one working at home, and those with worse standard of living levels. Respondents who reported suffering stated that the main causes were the ongoing siege, the latest war on the Strip and internal Palestinian factional violence.</p> <p><b>Conclusion:</b> Results reveal poor HRQoL of adult Gazans compared with the results of WHO multi-country field trials and significant associations between low HRQoL and war-related factors, especially reports of distress, insecurity and suffering.</p&gt

Path loss model for outdoor environment at 17 GHz mm-wave band

This paper presents the path loss model for 17 GHz mm-Wave frequency spectrum. The millimeter-wave spectrum has been proposed for future high speed 5G cellular systems with large bandwidth requirement. Since this proposal, propagation studies characterizing and investigating the potential of mm-Wave spectrum have been aggressively performed. This work conducts measurement campaign to derive a path loss models for outdoor environment in line-of-sight (LOS) scenarios at 17 GHz mm-Wave frequency spectrum. The derived models are based on the log-normal shadowing model. The path loss exponent for the derived path loss models is 2.3, which indicates that the chosen outdoor environment is an open environment like free space. Comparison between the values of path loss provided by the measured data, the derived path loss model and the free space model is made. The differences between the path loss value from the measured data and the derived path loss model is 7dB, while 13 dB differences is found when comparing the measured data and the free space loss model

Non-communicable diseases in the Arab world

According to the results of the Global Burden of Disease Study 2010, the burden of non-communicable diseases (cardiovascular disease, cancer, chronic lung diseases, and diabetes) in the Arab world has increased, with variations between countries of different income levels. Behavioural risk factors, including tobacco use, unhealthy diets, and physical inactivity are prevalent, and obesity in adults and children has reached an alarming level. Despite epidemiological evidence, the policy response to non-communicable diseases has been weak. So far, Arab governments have not placed a sufficiently high priority on addressing the high prevalence of non-communicable diseases, with variations in policies between countries and overall weak implementation. Cost-effective and evidence-based prevention and treatment interventions have already been identified. The implementation of these interventions, beginning with immediate action on salt reduction and stricter implementation of tobacco control measures, will address the rise in major risk factors. Implementation of an effective response to the non-communicable-disease crisis will need political commitment, multisectoral action, strengthened health systems, and continuous monitoring and assessment of progress. Arab governments should be held accountable for their UN commitments to address the crisis. Engagement in the global monitoring framework for non-communicable diseases should promote accountability for effective action. The human and economic burden leaves no room for inaction.Scopu