Advancing Equitable Health Policy

17 February 2022

With the new government in place and the national budget finalized, Shatil organizers have successfully advanced a number of public health measures to reduce health inequalities in Israel’s periphery. This series of successes speaks to Shatil’s prominence as a leader in the field, and the strength of the relationships Shatil organizers have built with decision-makers at all levels of government.

Health outcomes are dramatically unequal across Israel. Compared to Israel’s center, the rest of the country has fewer hospital beds per capita, and roughly half as many doctors. In the Negev, the average life expectancy is a full seven years less than in central Israel. Infant mortality rates in the north of Israel, home to some 1.43 million residents, are twice those in the center. These statistics are even more dire for Israel’s Palestinian citizens, whose life expectancy is three years less and infant mortality over double that of Jewish society. The number of those who suffer from at least one chronic disease has doubled in the past decade.

Shatil-led health forums are dedicated to working with grassroots activists, local authorities, and national leaders to close these gaps. In the North, the Citizens’ Forum for the Promotion of Health in the Galilee (Northern Health Forum) has successfully built relationships with decision-makers, and is increasingly a trusted source of health policy recommendations. This month, a bill based on a Northern Health Forum position paper outlining essential changes to ambulance provision was presented to the Knesset. The bill would require the national ambulance hotline run by Magen David Adom (MADA) to dispatch the closest ambulance of any provider, rather than only the closest MADA ambulance. 60% of the population in the north of the country is served primarily by local Palestinian and ultra-Orthodox ambulance provider services, rather than MADA. The bill’s passage would make emergency services more accessible and should lead to an improvement in health outcomes around the country. This bill is a direct outcome of Shatil and the Forum’s work with a coalition of northern ambulance providers formed in 2020, and represents a major step in the democratization of emergency service provision in Israel.

Shatil’s leadership in the fight for health equality in the periphery is being recognized elsewhere as well. When NIF grantee Tag Meir and the Masorti Movement held a conference to commemorate Hadassah founder Henrietta Szold, they called on Shatil forum members – Professor Nadav Davidovich, dean of the School of Public Health at Ben Gurion University of the Negev, and Dr. Reem Younis of Carmiel Hospital — to take part in a panel on equality in the public health system and to provide insights about and inspiration for Jewish-Palestinian partnership in advancing shared health goals. In addition, Lev Aran, Shatil coordinator of the Northern Health Forum, and Galit Yahya Tzfadia, Shatil coordinator of the Southern Health Coalition, are to be part of a committee formed by the Ministry of Health to examine health outcomes in Israel’s’ peripheral regions over the past 10 years. The committee’s work is part of a larger study commissioned by the Ministry of Health to examine health outcomes in the entire country over the last decade.

In another instance, Shatil and members of the Northern Health Forum took part in a conference attended by Health Minister Nitzan Horowitz (Meretz) and Education Minister Yifat Shasha-Biton (New Hope) to launch the Health’s Ministry’s Ilanot initiative, which aims to encourage medical students from the north to study and then practice in the region. The program, which requires medical schools in the north to fill a quota of local students, was established following research by the Forum showing that medical students studying in the north were far more likely to remain there to practice if they were from the region.

As Shatil organizer Lev Aran reflects on these achievements, he remembers the darkness of the last two years, when, without a national budget or a functioning Knesset, meaningful change felt like a distant goal. Yet even in those conditions, Shatil and hundreds of Forum members “refused to be discouraged,” Lev said. “We spent that time laying the groundwork and building relationships across the country. And now, years later, we’re finally seeing the fruit of that work.”

Photo Credit: Mohamed Alinbari