The assessment’s other findings provide important data regarding household-level access to food, the ability of the market to provide various products and the ability of clinics to respond to the rising levels of malnutrition and anemia. These findings reveal that the current nutritional crisis is exacerbated by market disruptions from curfews, closures, military incursions, border closures and checkpoints; decreased caloric and micronutrient intake by preschool-aged children; and the fact that healthcare providers may not be adequately identifying and diagnosing malnutrition in their communities.

Unlike the levels of malnutrition, the prevalence for anemia among children 6-59 months of age varies little between the West Bank (20.9 percent) and the Gaza Strip (18.8 percent). Four of five children in both areas have inadequate iron and zinc intake, deficiencies which cause anemia and immune deficiencies, respectively. Over half the children in both areas have inadequate caloric and vitamin A intake, while half the children in both areas have inadequate folate intake. Non-urban areas of the Gaza Strip fared worse in all categories of intake. A large percentage of reproductive-aged non-pregnant women have deficiencies in energy, iron, folate and zinc consumption, critical for healthy fetal development. Reproductive-aged women also show a 15-20 percent decrease in per diem calorie and protein intake compared to 2000.

In assessing clinics, the survey found that attention to growth and monitoring of children declines as the age of the child increases, so that only 18 percent of children 25-36 months had had their weight recorded in the previous six months prior to the interview. Despite the objective prevalence of malnutrition from the clinics’ own records, clinic managers subjectively estimated only 1 percent of preschool-aged children were malnourished. The clinic survey covered a sample of 68 clinics, half of which did not have protocols or guidelines within the clinic setting to standardize the diagnosis and treatment of malnutrition and anemia, or the guidelines for counseling or follow-up for such cases. As much as 27.9 percent of all 68 clinics (19) and 40.7 percent of the 27 rural clinics (11) lack supplemental iron for children.

Finally, the assessment found that infant formula and other high-protein foods critical for growth sustained major market disruption. West Bank retailers cited incursions/curfews as the major reason for disruption (53 percent) followed by road closures/checkpoints (38 percent). West Bank wholesalers cited road closures/checkpoints as the major reason for disruption (52 percent) followed by incursions/curfews (34 percent). For both Gaza Strip retailers and wholesalers, border closures were cited as the major reason for disruption (60 percent and 63 percent respectively) followed by road closures/checkpoints (20 percent and 15 percent respectively). The market survey was a representative sample of 660 retailers and 140 wholesalers stratified by urban wholesale, urban retail, large village and refugee camp, and small village.

The assessment was funded and supported by CARE International with a grant from the U.S. Agency for International Development (USAID). The assessment was implemented by the Palestinian Al Quds University and the Global Management Consulting Group with technical assistance from Johns Hopkins University.

To read the executive summary of the assessment, click here.

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