Progress of The Lancet Palestinian Health Alliance

Abstract

The Lancet Palestinian Health Alliance (LPHA) is a loose network of Palestinian, regional, and international researchers who are committed to the highest scientific standards in describing, analysing, and evaluating the health and health care of Palestinians, to contributing to the international scientific literature, and to developing local evidence-based policy and practice. The LPHA has five stated activities: to present and publish research findings; advocacy, based on science; developing scientific methods that are culture-specific; building capacity for research; and increasing academic collaboration within the occupied Palestinian territory, Lebanon, and across the region. The LPHA has always been a network of individuals, not institutions. These individuals are not bound by the LPHA and the LPHA is not bound by anything said by individuals. The LPHA “speaks” only through its scientific outputs, as presented at annual conferences and published in scientific abstracts and papers. For the first five LPHA conferences, in Ramallah (West Bank, Palestine) twice, Beirut (Lebanon), Cairo (Egypt), and Amman (Jordan), 434 abstracts were submitted, and 258 (59%) accepted for presentation, 118 as oral presentations, and 140 as posters. 138 abstracts have been published in The Lancet, including 40 in this issue from the 2014 conference in Amman. 15 presentations have been published as full scientific articles. 60% of the presented studies were quantitative, 14% qualitative, and 14% mixed. There were smaller numbers of audits, commentaries, and reviews. 60% of studies collected primary data, 34% secondary data, and 6% both primary and secondary data. 41% of studies were based in the West Bank, 18% in Gaza, 20% in both, 4% in East Jerusalem, 7% in Lebanon, and 4% in Jordan. 54% of presenters were women. 13% were younger than 30 years of age, 29% aged 30–39 years, and 52% aged 40 years or older. A third of presenters were health professionals, 31% academics, 13% PhD students, 6% other students, 6% managers and 7% researchers, with the rest noted as advisors, consultants or occupation unknown. A quarter of presentations have involved various types of health needs assessment, such as child health, adolescent health and health of the elderly; 19% were on aspects of political violence; 13% on specific diseases; 12% on environmental, occupational, nutritional or mental health; 11% on refugee status; 6% on health care research; 4% on evaluations of interventions, 4% on fertility; 2% on evidence-based medicine and the rest on other topics such as inequality and methodological and information system related issues. A key function of the LPHA has been to use structured enquiry to describe the health and health care of ordinary Palestinians living in extraordinary circumstances. Rudolf Virchow, the founder of social medicine, said many years ago, “Medicine is a social science and politics nothing but medicine on a large scale”.1Taylor R Rieger A Medicine as a social science: Rudolf Virchow on the typhus epidemic in Upper Silesia.Int J Health Serv. 1985; 15: 547-559Crossref PubMed Scopus (71) Google Scholar WHO's report on the Social Determinants of Health confirmed this association.2WHOCommission on social determinants of health. Closing the gap in a generation. World Health Organization, Geneva2008www.who.int/social_determinants/thecommission/finalreport/en/index.htmlGoogle Scholar It is inevitable—given the circumstances of most Palestinians living under Israeli military occupation in the West Bank, during economic and nutritional siege and military bombardment in Gaza, or as refugees in Lebanon or from Syria—that many research studies include the effect of the political context on health. Research can be scientific without being political, and political without being scientific. Science is discredited as science if shown to be influenced by political views and ideology, beyond what scientific results indicate. Policies are not always based on research evidence, but can be improved when they are. The key test for researchers is “what do our data allow us to say?” The LPHA has never been larger, more productive, more broadly-based and more vibrant. Having completed a successful first 5 years, the challenge is to continue building capacity and improving quality. GW is a Trustee of the UK charity Medical Aid for Palestinians. We declare no competing interests. We thank Lee Moya Bradley and Shiraz Nasr at the Institute of Community and Public Health at Birzeit University, who helped categorise the data, and Rima Mourtada and Chantal Sarkis at the Faculty of Health Sciences, American University of Beirut, who did the analyses.