Providing international support for the development and implementation of family medicine in Palestine

Improving the morale and self esteem of Palestinian family medicine health care professionals through provision of solidarity, relief of isolation and involvement in the wider international family medicine community.

What We Do

  • Support and deliver education and training in family medicine
  • Help strengthen the quality of the health system across the West Bank, through the development of quality curricula, standards, assessments and examinations
  • Help foster a community of family medicine healthcare practitioners in Palestine and involve them in the wider international community of family medicine

We do this through:

  • Online and face to face training programmes
  • Development of quality curricula, standards, assessments and examinations
  • And helping to foster a community of family medicine healthcare practitioners in Palestine and involve them in the wider international community of family medicine.

1: Family medicine specialist training:

Family Medicine residency programme

We support the An Najah National University (ANNU) Residency programme in Family Medicine through curriculum development, and support to faculty and residents.

Training centres

We are providing support for the development of the three FM training centres designated to provide family practice experience and training for the doctors in the FM residency programme. These are situated in the northern, central and southern areas of the West Bank.  Residents will work under the supervision Palestinian FM specialist doctors who in turn will be supported by visiting FM specialists working under the auspices of FIDFMP

Training Trainers

We hold courses for doctors to help them develop skills for training future FM specialists.

Online tutorials for FM residents
In collaboration with the ANNU faculty, we are providing the FM residents with a programme of case based tutorials, delivered by FM specialists in the UK and Palestine via Medicine Africa, an online platform. It is intended that the tutorials will become an integral part of the ANNU residency programme.

2: Family Practice Orientation and transition

We support the process of helping primary care workers shift their thinking towards a model of primary care based on family practice. In order to facilitate this, we are creating a distance learning transitional training programme for nurses, doctors, pharmacists.  This is designed to enhance the effectiveness of primary care and enable teams to practice according to accepted principles of FM.

Context

Palestine comprises two distinct entities: Gaza and the West Bank. The population of Gaza is 1.8m, and the West Bank 4m.  It is ranked as a middle income country, however it has not yet been accorded full nationhood status by the UN and is heavily dependent on donor money.In health terms the standard indices are comparable to those of neighbouring Arab countries, but not as good as Israel.  A major effort has been put into programmes of child immunization and maternity & child health, with considerable success.  The birth rate has fallen and there is a population ‘bulge’ around the age of 18-45.Overall this has implications for the future, and there is concern about making effective provision for care of an ageing population and the probable increased prevalence of non-communicable chronic disease.  In order to deal with the latter, a WHO programme has recently been introduced across the West Bank to manage chronic disease, specifically cardiovascular disease and diabetes.

Current provision in the West Bank

There are at least four different sectors providing primary care facilities: the Ministry of Health (MoH); The United Nations Relief and Welfare Agency (UNRWA) which provides health care, education and services for Palestinian refugees; NGOs; and private sector.UNWRA clinics are only available to refugees, but refugees are also free to go to MoH clinics.  Primary care is provided by GPs and nurses, almost none of whom have had any formal training in family medicine.In order to staff existing facilities with a limited numbers of doctors, the Ministry of Health moves doctors around on a daily basis, to clinics in different geographic areas. Nurses and other staff are fixed to clinics, many of which have pharmacies and small laboratories attached. There is as yet no system of electronic records or unique registration.

History of FIDFMP involvement

Until recently all doctors working in primary care were similar to UK GPs prior to the advent of vocational training in the 1960s. This changed when Dr Samar Musmar came back to Palestine after training and working as a FM doctor in Florida.  She wanted to introduce formal FM training into Palestine, and set up a training scheme based at An Najah University in Nablus.The scheme comprises 2 years in hospital posts and 2 years in primary care.  At the time of writing around 12 doctors have completed the training and passed the Palestinian Board of Family Practice exam, and 8 are completing the course and 15 have joined as 1st Year Residents in 2016.Founding members of IDFMP met with Dr Musmar and worked with her and the MoH, to lend international support.In 2014, IDFMP partnered with Medical Aid for Palestinians (MAP) to jointly expand support. The Ministry of Health (MoH) of the Palestinian Authority announced plans to re-orientate existing primary healthcare services toward the FP approach with support from WHO. UNRWA has similarly been rolling out this approach in its 128 primary care clinics over the past three years.

In October 2014, representatives of IDFMP and MAP visited the West Bank for meetings with the MoH, WHO and ANNU to agree in principle the roles that each organisation might play. This was followed in March 2015 by a
high level delegation from the MoH, ANNU and WHO Palestine for meetings in London. The delegation visited clinics and training facilities and worked together on a Strategy and Action Plan.

One of the main areas of FIDFMP activity in 2015 was the development and delivery of a series of online seminars and case presentations for faculty members, and residents and graduates of the ANNU FM residency programme, using the Medicine Africa online platform.