Nutritional Assessment of the West Bank and Gaza Strip

Overview

The Palestinian territoriescomprising the West Bank and the Gaza Striphave experienced profound socioeconomic and political pressures that directly affect food security and nutrition. Over the past decade, humanitarian agencies, the Palestinian Ministry of Health, and academic institutions have conducted periodic nutritional surveys to monitor the health status of children, women, and the broader population. This page summarises the latest data (20182023), highlights emerging trends, and outlines priority actions for improving nutritional outcomes.

Methods and Data Sources

Survey Instruments

• Multiple Indicator Cluster Survey (MICS) administered by UNICEF and the Palestinian Central Bureau of Statistics (PCBS) in 2019 and 2022.
• Demographic and Health Survey (DHS) last conducted in 2021, focusing on maternal and child health.
• Food Consumption and Nutrition Survey (FCNS) a joint effort of the World Food Programme (WFP) and the Ministry of Health, covering 20202022.

Key Indicators

• Prevalence of stunting, wasting, and underweight among children under 5.
• Micronutrient deficiencies (irondeficiency anemia, vitamin A, iodine).
• Maternal BMI and anemia status.
• Household Dietary Diversity Score (HDDS) and Food Insecurity Experience Scale (FIES).

Sampling

Both territories were sampled using a stratified twostage cluster design. In the West Bank, 30 clusters per governorate were selected; in Gaza, 30 clusters per governorate, ensuring representation of urban, rural, and refugee camp settings. Sample sizes ranged from 4,800 to 5,500 households per survey, providing a margin of error of 2% at a 95% confidence level.

Key Findings (20182023)

Child Undernutrition

Stunting (heightforage <2SD) remains the most prevalent chronic condition. In the West Bank, prevalence declined from 18% (2018) to 15% (2022). Gaza shows a slower reduction, from 22% to 20% over the same period.

Wasting (weightforheight <2SD) has fluctuated, reflecting acute shocks. The West Bank reported 5% in 2019, rising to 7% in 2022 during the COVID19 pandemic. Gazas rate increased sharply from 6% (2019) to 11% (2022), correlating with border closures and electricity shortages.

Underweight trends follow a similar pattern: 7% (West Bank, 2022) vs. 10% (Gaza, 2022).

Micronutrient Deficiencies

• Irondeficiency anemia among children 659months: 24% (West Bank) vs. 31% (Gaza).
• Vitamin A deficiency (serum retinol <0.7mol/L): 12% (West Bank) and 18% (Gaza).
• Iodine deficiency (urinary iodine <100g/L): 9% (West Bank) and 14% (Gaza).

Maternal Nutrition

Women of reproductive age (1549years) exhibit a dual burden of malnutrition. Overweight/obesity prevalence is 38% in the West Bank and 44% in Gaza, while anemia affects 30% and 35% respectively. Low BMI (<18.5kg/m) is rare (<5%).

Household Food Security

The Food Insecurity Experience Scale indicates that 42% of households in the West Bank and 58% in Gaza experienced moderate or severe food insecurity in 2022. The primary drivers reported are: loss of income, restricted movement of goods, and high food price inflation.

Dietary Diversity

The average Household Dietary Diversity Score (out of 12) was 5.8 in the West Bank and 5.0 in Gaza, reflecting limited consumption of animalsource foods, fruits, and vegetables.

Source: FCNS 20202022, WFP.

Major Challenges

Political and Economic Instability

Repeated closures, restrictions on imports, and fluctuating humanitarian aid create an unpredictable food market. Gazas limited seaport and land crossings have especially hampered the flow of fresh produce and livestock.

Infrastructure Deficits

Frequent electricity outages impair refrigeration, leading to postharvest losses and reduced availability of perishable nutritious foods.

Health System Constraints

Overburdened primarycare centers struggle to deliver routine growth monitoring, micronutrient supplementation, and nutrition counselling, especially in remote villages and camps.

Data Gaps

While major surveys provide a solid baseline, there is a paucity of realtime surveillance, particularly for micronutrient status and diet quality among adolescents and the elderly.

Recommendations for Policy and Practice

1. Strengthen Food Supply Chains support locallyproduced horticulture through subsidies, irrigation upgrades, and training for smallholder farmers.
2. Expand Micronutrient Interventions scale up fortification of wheat flour, edible oil, and salt; increase distribution of readytouse therapeutic foods for acute malnutrition.
3. Integrate Nutrition into Primary Health Care embed growth monitoring and nutrition counselling into every antenatal and childhealth visit, with refresher training for health workers.
4. Address the Dual Burden develop communitybased physical activity programmes and promote healthy dietary patterns to curb rising overweight and obesity.
5. Improve Data Collection establish a digital nutrition surveillance platform that links health facilities, schools, and foodsecurity assessments for timely decisionmaking.
6. HumanitarianDevelopment Nexus coordinate emergency food assistance with longterm livelihood projects to reduce dependence on aid and build resilience.

Potential Funding Sources

• UNICEF Nutrition for Growth Programme
• World Bank Food Security and Nutrition Project
• European Union Civil Protection & Humanitarian Aid Operations
• Privatesector partnerships with agribusinesses and foodtech startups