Table 3 Illustrative quotes for different subthemes

Theme 1: Areas of health disparities

1.1 Healthcare service provision

“Based on the data we have; I think health disparities are most evident in the area of healthcare provision. The difference is striking when visiting communities in Area C, you can see the difference in access to primary healthcare compared to those living in urban areas”. (Participant 13, male)

1.2. Health coverage

“UNRWA insurance doesn’t cover everything, it has wide and free coverage for primary health care, but the coverage for hospitals includes large copayments compared to MOH insurance” (Participant 2, Male)

1.3. Health outcomes

“The MICS results certainly indicate differences in health indicators or healthcare outcomes, both between the West Bank and Gaza, also among the different governorates. Another example is the maternal mortality ratio in Gaza Strip reached more than 60, while at the national level it is less than that and was 47” (Participant 13, Male)

Theme 2: Contributing factors to health disparities

2.1. Political factors

“The major structural determinant for health disparities in Palestine is Israeli occupation; settlers and occupation causing systematic inequalities that mean that Palestinians have major barriers to those conditions or healthcare services that would grant them good health and wellbeing” (Participant 3, Male)

2.2. Socioeconomic and cultural factors

“Health disparities are affected by health access behavior which differs between city and village. In rural areas, woman can’t go alone to the clinic, husband or mother-in-law should accompany the wife. Health access behavior is determined by cultural and social aspects, personal attitude, knowledge and practices, and attitudes of healthcare workers.” (Participant 7, Female)

2.3. Health system factors

“lack of adequate governmental budget negatively affects the availability of adequate staffing, medications, lab materials and equipments, and thus affects the ability to provide services equally”. (Participant 5, Male)

Theme 3: Policy recommendations to enhance health equity

3.1. Integrating health equity into different policy frameworks

“We need real actionable direct policies targeting the roots causes of inequity. We need a clear policy with specific goals and specific interventions, in order to achieve the goal of improving quality of health services and equity for all Palestinians (participant 1, Male)

3.2. Enhancing healthcare infrastructure and delivery approach

Family health approach will contribute to improve access to primary health care services and ensure its provision for all equally and efficiently (Participant 5, Male)

3.3. Strengthening MoH leadership and collaborative partnerships to advance health equity

MOH is the most capable for leading the health sector for better equity, MOH is the main responsible actor for the health situation in the country, so it is responsible for process of health development, through establishing plans and strategies to promote equity in cooperation with partners that are UNRWA, private and NGOs sectors (Participant 11, Male)

3.4. Reforming the health insurance system for better equity and efficiency and universal coverage

The issue of health insurance needs to be reviewed and evaluated by specialists. We need health insurance to be fairer in several aspects, in terms of coverage and payment of premiums and copayments. We need comprehensive health insurance system that considers transparency and oversight. (Participant 16, Male)

3.5. Fostering community awareness and advocacy for the right to health for all Palestinian

We should promote advocacy for health equity in cooperation with the international community, focusing on vulnerable groups and the right to health for all people. (Participant 10, Female)