Hospital functionality in the Gaza Strip: analysis of the World Health Organization health resources and services availability monitoring system database, 7 Oct 2023 to 31 Oct 2024

BACKGROUND: Since October 2023, the destruction of Gaza's health care system and the barriers to providing critical hospital-based health care services to the Palestinian population have been extensively documented. AIMS: The objective of this study was to provide an aggregate and by-governornate descriptive analysis of individual hospital functionality and hospital system capacity over the first 13 months of conflict. METHODS: Thirty-five public, private, and non-governmental hospitals were analyzed from 7 October 2023 to 31 October 2024. Data sources included WHO 'rapid response' database and the WHO Health Resources and Services Availability Monitoring System. Data were combined to create a longitudinal and spatial representation of individual hospital capacity status (fully, partially, minimally, and nonfunctional). Hospital functionality status was weighted and aggregated to provide a proxy estimate of total hospital system capacity. RESULTS: By 28 October 2023, 71.4% (n = 25) of hospitals were in the partially functional status, and 28.6% (n = 10) hospitals were rendered nonfunctional. Hospital system functionality hit its lowest point (13.9%) on 5 April 2024 and did not exceed 33% after December 2023. The largest number of hospitals in nonfunctional status was twenty-five, which occurred twice during the study period, once in November 2023 and again in April 2024, resulting in 71.4% nonfunctional status among all hospitals. CONCLUSION: This study provides additional evidence that the Gaza Strip's hospital system was directly affected by the first year of the conflict, greatly impacting the ability to provide critical health services.