Sexual and Reproductive Health and Rights in Palestine (SRHR) 2021-2024

n 2021/2022, PMRS was able to care for a total of 109 146 beneficiaries for its SRHR health program running across the West Bank and Gaza Strip. PMRS's work continues to encompass a comprehensive primary healthcare offering, safe spaces and gender-based violence initiatives, in addition to youth health, and sexual & reproductive health and rights initiatives. In 2021/2022 the SRHR program consisted of clinical services, policy and advocacy reform, health awareness campaigns, training sessions for health professionals and capacity building within community and organizational structures. All with a focus on empowering women who are one of the most marginalized demographics within Palestine and to breaking down the deeply entrenched socio-cultural norms that present as barriers for access to SRH and SRHR. Achievements : a) A key objective is "Palestinians in the West Bank and Gaza have access to quality preventive and curative primary health care services in PMRS' medical centers specifically with a focus to increase accessibility of MHPSS and SRHR services". PMRS expanded its SRH services that were offered as part of its comprehensive PHC model in 2021. Overall, PMRS's Women's and SRH clinics tended to a total of 28 030 female beneficiaries with a 13% increase from the year 2020. b) as part of PMRS's efforts to build the capacities of its staff in 2021, PMRS trained staff on GBV and MISP (Minimal Implemented Service Package for SRH) and MHPSS including referral pathways and mechanisms. A total of 91 health workers were trained over a period of 6 days with 6 hours of training per day (a total of 36 hours) on SRHR topics. c) as part of PMRS's comprehensive PHC model, it endeavored to reach more women and men including Persons with Disability (PwD) and especially Women's with Disability (WWD) to have access to SRHR and MHPPS services via comprehensive PHC model. Overall, PMRS reached 644 women and 174 WWD for SRH services, 1 679 males and 115 males with disabilities for SRH services. For MHPSS, 185 people in total (106 women and 79 men) and 59 PwD benefited from staff receiving psychosocial support training and mainstreaming MHPSS services into core PHC. A total of 3 424 women benefited from the psychosocial support and counselling services via safe spaces and remote service offering for women, GBV and vulnerable demographics e.g. rural/remote, access restricted areas (ARA). d) Overall, during the 2021/2022 seven PHC centers have been supported with the needed SRH equipment and materials to increase access to SRHR services among vulnerable women. The centers were supported with IUD insertion kits, additionally one of these centers was supported by autoclave to sterilize the equipment used. e) Total beneficiaries who have been registered for the mammogram mobile clinic services was 7 399 women, 5 487 of them were referred from the awareness sessions conducted by the health workers for further follow up and investigation. Between July to December 2021, 1 551 women received clinical examination services from the clinic team and 1 236 received mammogram screening. Generally speaking, when women and girls access center-based health services, they only receive medical services, while the counselling continues to be neglected. When women seek health services, they do not need only medical examination, but also, they need to talk, express, and share their experiences during their life cycle. As a response, PMRS has established a midwifery led team to provide health based counselling and psychosocial support to women and girls on SRH. The team was able to: • Create mutual dialogue and to build also the trustful relationship with the beneficiaries. • Responds to the beneficiaries' social, emotional, cultural, and physical needs. • Respect the beneficiary's diversity and backgrounds, and respond equally to their needs. • Provide health promotion and psychosocial support. • Identify SRH problems and provide counseling accordingly. In 2021, PMRS's MISP was updated to include all of PMRS's SRHR specific indicators across all of the programs and not only for the SRHR specific programs. This is a big step towards mainstreaming SRHR as part of its comprehensive health care model. PMRS's 11 mobile clinics continued to deliver PHC and SRH care to 580 Palestinian communities. As part of its move to apply a comprehensive approach, PMRS has ensured that each mobile outreach service has at least one female health specialist. Additionally, PMRS has commenced the scaling of its midwifery program ensuring 4 new midwives have been included in the mobile PHC teams. With a particular focus on pre, peri, and post-natal care, in addition, to support for breastfeeding and screening for PND (postnatal depression) and GBV vulnerabilities. They have been utilizing the national referral pathways for both PND/MHPSS and GBV. Currently, PMRS has 4 midwives focused on SRH care and SRHR education and awareness and will continue to scale this model until all mobile clinics have a trained midwife.

The proposed program will be implemented by PMRS and will have the following goals: 1- Palestinians, women & men, girls and boys, without discrimination, have access to quality primary comprehensive health care focusing on SRHR and Mental Health and Psychosocial services (MHPSS) service and support delivery. 2- Mobilized and empowered local communities advocating for their SRHR rights with emphasis on youth, women and marginalized groups. 3- A resilient Palestinian civil society has been strengthened.