Perceptions of Non-Communicable Disease and War Injury Management in the Palestinian Health System: A Qualitative Study of Healthcare Providers Perspectives

Marwan Mosleh, 1, 2 Yousef Aljeesh, 3 Koustuv Dalal, 1, 4 Charli Eriksson, 5 Heidi Carlerby, 1 Eija Viitasara 1 1Department of Health Sciences (HLV), Public Health Science, Mid Sweden University, Sundsvall, Sweden; 2Ministry of Health, Gaza, Palestine; 3International Public Health Medicine, Islamic University, Gaza, Palestine; 4Department of Epidemiology, Biostatistics, and EBM; Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan; 5Department of Public Health, Stockholm University, Stockholm, SwedenCorrespondence: Marwan Mosleh Tel +970599859122Email Marwan.mosleh@miun.seBackground: Palestine, like other low-income countries, is confronting an increasing epidemic of non-communicable disease (NCD) and trend of war injury. The management of health problems often presents a critical challenge to the Palestinian health system (PHS). Understanding the perceptions of healthcare providers is essential in exploring the gaps in the health system to develop an effective healthcare intervention. Unfortunately, health research on management of NCD and war injury has largely been neglected and received little attention. Therefore, the study aimed to explore the perspectives of healthcare providers regarding NCD and war injury management in the PHS in the Gaza Strip.Methods: A qualitative study approach was used, based on four focus group discussions (FGDs) involving a purposive sampling strategy of 30 healthcare providers from three main public hospitals in Gaza Strip. A semi-structured topic guide was used, and the focus group interviews data were analyzed using manifest content analysis. The study was approved by the Palestinian Health Research Council (PHRC) for ethics approval.Results: From the healthcare providers perspective, four main themes and several sub-themes have emerged from the descriptive manifest content analysis: functioning of healthcare system; system-related challenges; patients-related challenges; strategies and act