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Barrier Analysis and In-depth Qualitative Interviews Report - West Bank and Gaza Strip

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Executive Summary

INTRODUCTION:

Palestinians are facing a double burden of malnutrition; high levels of micronutrient deficiencies alongside increasing obesity rates and undernourishment.1 Children under the age of five in the West Bank and Gaza Strip are particularly vulnerable as a result of micronutrient deficiencies, as well as pregnant and lactating women (PLW). In the Access-Restricted Areas (ARA) in the Gaza Strip, 18% of pregnant women and 14% of lactating mothers who live in ARA are undernourished. 86% of children under five living in ARA did not have a minimal accepted diet.

A number of factors contribute to the malnutrition rates. Inhabitants in these areas are exposed to chronic and acute political violence, including settler violence and forced evacuation. They are isolated and marginalised and face persistent restrictions on their movement and access to resources and services.

The population has difficulties in accessing healthcare facilities due to cost of transportation; cost of health services; and difficulties crossing checkpoints.

To address these and other key maternal, infant and young child health and nutrition (MIYCHN) practices and the high rates of anaemia, there is a need to understand the facilitating factors as well as the barriers to practicing these behaviours that exist in these complicated environments. Therefore, WFP and UNICEF, in consultation with their Regional Nutrition and Health Advisors, jointly identified six behaviours to focus on for this study. The six behaviours were selected because they are promoted through the Ministry of Health (MoH), UNICEF, and WFP programmes among Palestinian women. However, there has been little improvement to date. The behaviours explored were: 1) Exclusive Breastfeeding, 2) Continued Breastfeeding, 3) Minimum Dietary Diversity, 4) Feeding Frequency, and 5) & 6) Consumption of high-iron5 foods for pregnant and lactating women, and children 2-5 years old. Behaviours 1-4 were selected by UNICEF and behaviours 5-6 by WFP.

To gain an in-depth understanding of these behaviours, a mixed-methods research approach was taken, including Barrier Analysis (BA) questionnaires and in-depth qualitative interviews in both the West Bank and Gaza Strip.