Among all regions, women in Israeli settlements in the West Bank, recorded the highest total fertility rate in Israel, with **** live births per woman on average. Other regions with high fertility rates were the Jerusalem district and the Southern district. In contrast, the Haifa recorded the lowest fertility rate, at only **** births per woman.

Abstract

The 2000 Health Survey in the West Bank and Gaza Strip (MICS2) provides reliable estimates for several indicators, which were suggested to Palestinian Central Bureau of Statistics (PCBS) by decision makers, planners, and researchers in the field of health through a series of "User-Producer Dialogue"workshops. The survey includes also the indicators of the "End of Decade Goals Survey, MICS2" which were developed in cooperation with UNICEF, and the indicators of the "Baseline Health Survey" which were developed in cooperation with UNFPA.

The 2000 Health Survey in the West Bank and Gaza Strip was implemented on the eve of the INTIFADA in Palestine. The release of this report comes after less than three months since the beginning of the uprising. There is documented evidence that up to this time in the life of the INTIFADA, more than 100 Palestinian children have been killed and more than 3,500 are injured by the Israeli army and the Israeli settlers. International as well as local specialized agencies have indicated that hundreds of thousands of Palestinian children have been deeply affected psychologically by the events. The Israeli harsh measures and their continued aggression against the Palestinian population have left thousands of Palestinian households with no means of protection or support for their children. In view of these tragic developments, the results of this Survey could be used as a fairly good and reliable baseline to compare with when studying the impact of Israeli measures and actions against Palestinian children and households.

The Health Survey of 1996 and the Demographic Survey of 1995 were among the pioneering household surveys in the establishment phase of Palestinian Central Bureau of Statistics (PCBS). The two surveys where complementary to each other and were designed to provide detailed accounting and baseline data and statistics on the demographic and health status of Palestinian households and individuals. An update of the health survey was deemed necessary by PCBS and the Ministry of Health in order to update the baseline data on health situation in Palestine. The current survey (the 2000 health Survey in the West Bank and Gaza Strip) comes as a timely update ofthe various indicators, which were measured by the previous surveys, and as an answer to the statistical needs of the planners within government, NGO's, and specialized international agencies which are mandated to work in Palestine. This survey is in fact a realization of a partnership, which was formulated between PCBS, Ministry of Health, UNFPA and UNICEF in order to pool the demand side on data and produce a relevant data set for various stakeholders. The survey has tried to provide estimates for many indicators within the framework of UNICEF's efforts to support countries to come up with assessment of End Decade Goals as set out by UNICEF. It also tried to come up with the baseline data, which could be used in drafting a country strategy and a CPA exercise by UNFPA. The survey has also tried to provide enough details to allow the Ministry of Health finalize its strategic plan.

Geographic coverage

National

Analysis unit

• Individuals
• Households

Universe

The survey covered all de jure household members (usual residents), all women aged 15-54 years, all children aged 5-17 years and under 5 living in the household.

Kind of data

Sample survey data [ssd]

Sampling procedure

The sample design of the 2000 Health Survey in the West Bank and Gaza Strip (MICS) takes into account the main recommendations of UNICEF for this type of surveys.

The sample provides a subsample of household that receives health services from the Ministry of Health clinics.

The target population consists of all Palestin_ian households that usually reside in the Palestinian Territory. This type of survey concentrates on 2 subpopulations. the first one is ever-married women and aged (15-54) years. the second one is children less than 5 years.

The list of all Palestinian households has been constructed with some identification variables, after finishing the Population Census 1997 processes. The master sample was drowned to be used for different sample surveys. The master sample consists of 481-enumeration area (EA) (the average sizes about 120 households). The master sample is the sample frame of the 2000 Health Survey in the West Bank and Gaza Strip. The selected EAs were divided into small units called cells (with average size of 25 households). One cell per EA was selected.

Different criteria were taken into account when sample size was determined. The level of sampling error for the main indicators was considered, the result could be published at 3 subpopulations. and 10% incomplete questionnaire was assumed. The overall sample was 272 EAs, 178 in the West Bank and 94 in Gaza Strip. The Sample cells increased to 288 cells. 194 in West Bank and 94 in Gaza Strip. The number of households in the sample was 6,349 households, 4,295 in the West Bank and 2,054 in Gaza Strip.

The sample is a stratified multi-stage random sample.

Stratification: Four levels of stratification were made: 1. Stratification by governorates. 2. Stratification by place of residence which comprised: (a) Urban (b) Rural (c) Refugee Camps 3. Stratification by classifying localities, excluding governorate capitals, into three strata based on the ownership of households within these localities of durable goods. 4. Stratification by size locality (number of households).

A compact cluster design was adopted because the sample frame was old. As mentioned above, the first sampling units were divided into small units (cells). Then one cell from each EA was randomly selected.

For that part of Jerusalem, which was annexed after 1967 war, a list of households for the EAs in the frame was completed in 1999. Therefore a compact cluster design was not used in this part, and a random of households from the EAs was selected.

First stage sampling units are the area units (EAs) in the master sample. The second stage-sampling units are cells.

Mode of data collection

Face-to-face [f2f]

Research instrument

The questionnaire was developed by the Palestinian Central Bureau of Statistics after revision and adaptation of the following standard questionnaires: 1. The Health Survey questionnaire, which implemented by Palestinian Central Bureau of Statistics in 1996. 2. Demographic Survey questionnaire, which implemented by Palestinian Central Bureau of Statistics in 1995. 3. UNICEF questionnaire for Multiple Indicator Cluster Survey (MICS II). 4. Standard Demographic and Health survey questionnaire. 5. Other Demographic and Health Survey questionnaire (DHS).

The health survey - 2000 questionnaire consist of three main parts:

1. Household questionnaire which includes the following sections:
2. Control Sheet: which includes items related to quality control sample identification, interview schedule and interview results.
3. Household Roster: includes demographic variables such as age, sex, relation to head of household, date ofbirth and health variables such as health insurance and smoking.

4. Housing section: includes questions on housing conditions, such as water sanitation and iodized salt.

5. Women's Health questionnaire: this questionnaire was designed to collect data for all ever- married women aged less than 55 years, it consists of seven sections:

6. Reproduction.

7. Family planning.

8. Antenatal care and Breastfeeding.

9. Tetanus Toxoid Vaccination.

10. Desire of Reproduction.

11. Public Health and Health Awareness.

12. Knowledge of HIV.

13. Child Health Questionnaire: This module consists of six sections:

14. Birth Registration for children under five years.

15. Child Education for children aged 5-17 years .

16. Child Labor for children aged 5-17 years.

17. Child Health and Child Immunization for children under five years.

18. Child Ophthalmic Health for children under five years.

19. Anthropometry for children under five years.

Cleaning operations

IMPS was used in data entry. Data entry was organized in a number of files, corresponding to the main parts of the questionnaire.

A data entry template was designed to reflect an exact image of the questionnaire, and included various electronic checks: logical check, consisting checks and cross-validation. Continuously thorough checks on the overall consistency of the data files and sample allocation were sent back to the field for corrections.

Data entry started on may 18, 2000 and finished on June 8, 2000. Data cleaning and checking processes were initiated simultaneously with the data entry. Thorough data quality checks and consistency checks were carried out.

Final tabulation of results was performed using statistical package SPSS for Windows (version 8.0) and specialized health and demographic analysis programs.

Response rate

Overall 94.0% of the questionnaires were completed. 93.3% in the West Bank, and 95.5% in Gaza Strip. The response rate was about 97.7%, it was 96.9% in the West Bank and 99.3% in Gaza Strip.

Sampling error estimates

Since the data reported here are based on a sample survey and not on complete enumeration. They are subject to two main types of errors: sampling rrrors and non-sampling errors.

Sampling errors are random outcomes of the sample design, and are, therefore, easily measurable.

Non-sampling errors can occur at the various stages of the survey implementatipn in data collection and data processing, and are generally difficult to be evaluated statistically. They cover a wide range of errors, including errors resulting from non-response, sample frame