Context
The Arab minority in Israel have faced significant health disparities compared with Jews, including lower life expectancy, higher chronic illness rates, and elevated infant mortality. Also, Arabs reside primarily in geographically peripheral and socioeconomically disadvantaged areas, where access to health workforce and infrastructure is more limited.
Recognizing these disparities, the Ministry of Health identified the need to strengthen the health system’s response to the needs of the Arab population. To this end, it conducted research to assess community needs and define appropriate intervention programs. As a result, priority was given to the most prevalent health issues in Arab communities, which include diabetes, obesity, genetic diseases, early childhood development, and mental health, with the goal of preventing disease and improving the quality of care.
Impetus for the reform
Israel’s healthcare system has long faced Arab-Jewish health disparities. The COVID-19 pandemic, followed by the war initiated in October 2023, highlighted the urgent need for a more resilient and equitable health system. In response and based on Government Resolution No. 550 “The Economic Program to Reduce Gaps in Arab Society by 2026”, the Ministry of Health launched a targeted initiative to improve health access and outcomes of the Arab population (see https://www.gov.il/he/pages/dec550_2021 for the text of the resolution).
Main purpose of the reform
The reform seeks to build sustainable, community-rooted health ecosystems that are responsive to local Arab needs.
Content and characteristics
The reform builds on local health governance units (health units) that have been established in several local authorities prior to the reform, operating at varying levels of capacity and scope. These units enable local authorities to take a proactive role in promoting health, preventing disease, and addressing social determinants of health. The health units operate as part of the local authority and focus on identified priority areas to promote the health of residents.
In the Arab population, where local authorities often enjoy high levels of trust, these units are seen as key agents of change. As part of the reform new health units have been established in 18 Arab local authorities and three additional units are currently being developed. The reform also supports existing health units in local authorities whose intervention programs meet the required criteria, enabling them to expand their activities.
The local health units promote disease prevention and bring health to the forefront of the local agenda. They work to encourage healthy lifestyles in the community through awareness days (for example, nutrition workshop for diabetes prevention), improving accessibility to health services (for example, child development services), and create infrastructure to support physical activity (for example, walking paths and exercise spaces were developed in 10 Arab towns).
Implementation steps taken
Health units are performing the following activities:
- Employing staff to promote residents’ health, often local residents familiar with the community’s needs;
- Training staff for strategic planning and community engagement;
- Creating operational work plans for 2025;
- Health campaigns, workshops, and organized community health days were held to promote healthy lifestyles and encourage behaviour changes. For example, obesity prevention programs were implemented, including among children.
Outcomes to date and evaluation
- A measurement and evaluation program was developed to assess progress in reducing disparities.
- A national dashboard of health indicators is under development to support long-term monitoring and transparency.