ArticleBMJ global health2026
Factors influencing access to primary healthcare services for refugee children under five in the Palestinian West Bank: a qualitative study with female caregivers.
Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPalestinian refugee children under five face social, economic and political challenges that may affect their access to primary healthcare (PHC) services. This study aimed to explore barriers to and facilitators of access to PHC services for refugee children under five in the north of the West Bank.
methodsThis qualitative study was conducted from May to September 2025. Semistructured interviews were conducted to explore the views of caregivers of children under the age of five in three refugee camps in the north of the Palestinian West Bank: Askar, Balata and Camp No. 1. The interview guide was formulated and the results were synthesised on the basis of the adapted Availability, Accessibility, Acceptability and Quality framework with incorporated elements from Levesque's framework. The methods, procedures and field work were pretested before data collection. Data were collected through in-person interviews at social community centres within the refugee camps and analysed via deductive thematic analysis.
resultsAll of the 20 participants interviewed were female caregivers. Thematic analysis revealed 22 barriers and 13 facilitators across eight themes. The main barriers were service and medication shortages, safety concerns from military incursions and inadequate communication of information. The main facilitators were short distance to health clinics, autonomous decision-making and trust in provider competence and service quality. Other, less frequently mentioned barriers were crowdedness, long waiting times and preferential treatment favouring staff's personal acquaintances. Additionally, participants suggested a stronger social media presence to disseminate information about health and healthcare services. CONCLUSIONS AND RECOMMENDATIONS: Access to PHC services for children under five is limited by interruptions of services and medications, lack of safety and inadequate information. Humanitarian response strategies should maintain stable supply chains for paediatric services. Digitalisation of communication should rely on a participatory, user-centred design involving caregivers and be supplemented by official social media presence.
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