Palestinian health-related publications in international medical journals: an analysis of the trend

BACKGROUND: The health system in the occupied Palestinian territory (oPt) was established as a result of the Oslo Accords in 1993. Since then it has been supported by many donor countries, UN agencies, and international non-governmental organisations. Higher education for Palestinian students in the health specialty has been supported, especially by Oslo University, and health research, including research to assess the health system, has been encouraged. References cited in reviews indicate an increase in the reports in international medical journals about issues that affect the health of the Palestinian people since the signing of the accord. However, the trend in this increase has not been studied. The aim of this study was to review trends in the reports published about health-related issues in Palestinian people between 1940 and 2011. METHODS: We defined a Palestinian health-related report as one that includes “Palestinian” as a keyword in medical journals. We identified such articles using the Medline database, accessed through PubMed. We gathered the yearly numbers of the publications and then calculated the mean and SD of reports for 1940–66; 1967–86 (third Arab-Israeli war in 1967); 1987–92 (first Palestinian intifada [uprising] in 1987); 1993–99 (Oslo Accords in 1993); 2000–08 (second intifada in 2000); and 2009–11 (The Lancet Series about health in the oPt in 2009). We also recorded the number of reports about Palestinian health-related issues from 1993 to 2011, and did a linear regression analysis to identify the time trend during this period. 95% CIs were used to indicate significance. FINDINGS: The mean number of Palestinian health-related reports per year was 0·3 (SD 0·6, range 0–2) during 1940–66, 0·9 (1·0, 0–3) in 1967–86, and 5·3 (3·9, 1–13) in 1987–92. After the signing of the Oslo Accords in 1993, the mean increased to 15·9 (9·3, 2–30) in 1993–99, and was 50·7 (15·0, 33–72) in 2000–08. When The Lancet published the series about health in the oPt (11 reports), the number of reports rose to 92 in 2009 and then fell to 79 in 2010 and 75 in 2011. The trend in the yearly numbers of reports about Palestinian health-related issues between 1993 and 2011 was significantly increased (slope of the time trend curve 4·6, 95% CI 3·8–5·3). INTERPRETATION: The number of reports about Palestinian health-related issues increased rapidly after the signing of the Oslo Accords. The highest number of reports was published in 2009, and The Lancet Series was a substantial component. Repeats of the opportunity provided by The Lancet seem likely to encourage research and publication by individuals who have not traditionally had many chances to compete internationally. In this study, we have focused only on the crude numbers of reports. Additional research will help to provide details about the overall publication trend and to assess the focus of the study (health-related issues and target areas and populations) and research institutions involved. FUNDING: None.