91. WHO/UNRWA Review Team. Review of Primary Health Care in Palestinian Refugee Camps Under UNRWA. The West Bank Field Report. Geneva: WHO, 1986: 50 pp.

An evaluation of UNRWA health services that was conducted in 1986 is described. Field work was conducted at the field office, three health centers and at the household level in five refugee camps. Based on the field work, and existing supporting data, a set of recommendations are made in the fields of planning, policy, resource development, information collection and the PHC program itself.
Concerning UNRWA general policy it is stressed that while PHC should rely on active community involvement, such initiatives from UNRWA have usually been perceived as implying recognition of a permanent refugee status and as being an attempt to disengage UNRWA from its commitments. As a result, UNRWA policy is presented as being limited to providing basic health services and the refugee community is being presented as the obstacle to community participation. The second limitation noted is financial in nature.
Within these two constraints, UNRWA services are generally presented in a positive light. The authors provide a detailed series of proposals for improvement including: managerial training at the health center level, utilization of existing health information in management, expansion of manpower, delegation of responsibility to nurses to lighten Medical Officers' workload, development of a community health team, renegotiating the referral systems to hospitals, "gradual but real" involvement of the population in PHC, in creasing budget, delegating more authority from Vienna to Field Health Officers, systematizing supervision procedures, decentralizing planning to the health center level, increasing the number of health centers, developing school health education, expanding referral of high risk pregnancies to hospitals, investigating demand for family planning services and delegating clinical ORS administration to nurses.