Medium term strategy 2016-2021 - UNRWA
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medium term strategy
2016-2021
ii medium term strategy 2016-2021 © 2016 UNRWA About UNRWA UNRWA is a United Nations agency established by the General Assembly in 1949 and mandated to provide assistance and protection to some 5 million registered Palestine refugees. Its mission is to help Palestine refugees in Jordan, Lebanon, Syria, West Bank and the Gaza Strip achieve their full human development potential, pending a just and lasting solution to their plight. UNRWA services encompass education, health care, relief and social services, camp infrastructure and improvement, and microfinance. Cover photo: A schoolgirl in Am’ari Elementary Girls’ School in the West Bank. © 2013 UNRWA Photo by Alaa Ghosheh She is one of 580,000 Palestine refugee children who will become an adult during the period 2016-2021. Unless action is taken to improve their chances in life: • Over 90 per cent will complete basic education, but many will not find gainful employment; • Around 60 per cent will have lived through at least one conflict; • Over one third will be a member of a family living in poverty; and • A small number of girls, around 7,000, will have had their first child before turning 18. For this schoolgirl and many like her, UNRWA will: • Protect her rights under international law; • Ensure she completes a quality basic education; • Ensure she receives quality primary health care; • Ensure she is given the opportunity to build their capabilities; and • Ensure she is not deprived of their basic needs of food, shelter and environmental health… … so that she can pursue the future she wants for herself.
united nations relief and works agency iii
acronyms and abbreviations
AUB American University of Beirut NGO Non-governmental organization
CBO Community-based organization NRC Norwegian Refugee Council
CERI Consolidated Eligibility and Registration Instructions OHCHR Office of the High Commissioner for Human Rights
CEDAW Convention on the Elimination of All Forms of oPt occupied Palestinian territory
Discrimination against Women
PCBS Palestinian Central Bureau of Statistics
CIP Camp Improvement Plan
RBM Results-based management
CPIS Camp Profile Information System
RSSP Relief and social services programme
CRC Convention on the Rights of the Child
SDGs Sustainable Development Goals
CRPD Convention on the Rights of Persons with Disabilities
SLA Sustainable Livelihoods Approach
e-Health Electronic medical information system
SSNP Social Safety Net Programme
EMIS Educational Management Information System
TVET Technical and Vocational Education and Training
EPI Expanded Programme on Immunization
UNCT UN Country Team
ERP Enterprise Resource Planning
UNDG United Nations Development Group
ESF Education Science Faculties
UNDP United Nations Development Programme
FESA Faculty of Educational Sciences and Arts
UNESCO United Nations Educational, Scientific and Cultural
FHT Family Health Team Organization
GBV Gender-based violence UNFPA United Nations Population Fund
HRCRT Human Rights, Conflict Resolution and Tolerance UNGA United Nations General Assembly
ICESCR International Covenant on Economic, Social and UNHCR United Nations High Commissioner for Refugees
Cultural Rights
UNICEF United Nations Children’s Fund
IDP Internally displaced person
UNRWA United Nations Relief and Works Agency for Palestine
MCSP Microcredit Community Support Programme Refugees in the Near East
MLA Monitoring Learning Achievement UN WOMEN United Nations Entity on Gender Equality and the
Empowerment of Women
MTS Medium Term Strategy
WFP World Food Programme
MPI Multidimensional Poverty Index
WHO World Health Organization
NCD Non-communicable disease
iv medium term strategy 2016-2021 table of contents commissioner-general’s foreword 1 executive summary 3 chapter 1: context analysis and assumptions 10 chapter 2: palestine refugee needs 12 human development indicators 13 protection threats 20 chapter 3: an international response 24 chapter 4: unrwa’s operational response and objectives 27 strategic outcome 1: refugees’ rights under international law are protected and promoted 30 strategic outcome 2: refugees’ health is protected and the disease burden is reduced 34 strategic outcome 3: school-aged children complete quality, equitable and inclusive basic education 39 strategic outcome 4: refugee capabilities strengthened for increased livelihood opportunities 44 strategic outcome 5: refugees are able to meet their basic human needs of food, shelter and environmental health 49 chapter 5: management and operational effectiveness 54 chapter 6: financial requirements 62 annex 1: common monitoring matrix 2016-2021 64 annex 2: enterprise risks by strategic outcome 78 annex 3: evaluation plan 79 annex 4: operationalizing the strategy 80 strategic planning 80 operational planning 81 emergency response 81 endnotes 82
united nations relief and works agency 1
commissioner-general’s foreword
In many ways, the current organizations (NGOs) and the broader international
collective predicament of community.
Palestine refugees is so
The Agency’s response during the strategic period will
dire as to be existential
focus on its clear mandate from the General Assembly
in nature. The situation
and comparative advantages, which include the scale and
is incredibly bleak in the
geographic coverage of its operations, its coordinated and
region, the pressures are
diversified programming and, above all, its workforce – the
immense on Palestinians
majority of whom are Palestine refugees themselves and
and on Palestine
members of the communities they serve. In drawing on
refugees, and the threats
its operational strength, the Agency’s strategic priorities
to their future and the
will be to continue to provide protection to all refugees
unsustainability of their
including the most vulnerable; improve access to and the
situation have become increasingly visible. This is therefore
quality of primary health care in responding to the changing
the very time when hope is needed more strongly than
health needs of refugees; provide quality, inclusive and
ever and when political action is required to change the
equitable basic education; build the capacities of refugees
circumstances to bring about a fundamental change of
so they are better prepared to take advantage of livelihood
paradigm.
opportunities; and assist refugees to meet their basic
Halfway into the seventh decade of its existence, UNRWA is human needs, especially in times of conflict.
both an illustration of what has been achieved for Palestine
We are conscious that a number of challenges lie ahead,
refugees over this period and a living reminder of what
including those arising from the increasingly unstable
happens when no political solutions are found to address
context in which UNRWA operates. The previous MTS
the underlying causes of a situation of historic injustice.
period saw the start of the conflict in Syria. It also saw a
While the Agency is steadfast in its commitment to provide
major conflict in Gaza during the summer of 2014. The
for the human development and protection needs of some
unacceptable loss of life, predominantly civilians including
5 million Palestine refugees in Gaza, Jordan, Lebanon, Syria
hundreds of children; mass displacement; and extensive
and the West Bank including East Jerusalem, it is clearly
destruction in the Gaza conflict in 2014 have appalled
convinced that there is nothing more important for the
and shamed the world. The tragic conflict in Syria, one of
refugees themselves than a just and lasting solution to
the most catastrophic of recent times, has resulted in the
their situation.
displacement of more than half of the 560,000 registered
This Medium Term Strategy (MTS) presents the Agency’s Palestine refugees and has seen many of the Palestine
statement of intent for UNRWA operations for the period refugee camps embroiled in the conflict. The siege of
2016-2021. It reflects the growing and evolving needs Yarmouk camp, which has trapped thousands of civilians
of the Palestine refugee populations and outlines the without proper access to humanitarian assistance, has
Agency’s response to meeting these needs and providing come to symbolize the intense human suffering and depth
access to vital services for all refugees who may need them, of the crisis. We must not forget that behind these statistics
focusing particularly on the vulnerable who need these are the lives of men, women and children, individual
services the most. The strategy is designed to be applicable destinies, with hopes and aspirations for a better future.
in any security context, capturing the unique character of
Even outside of these devastating events, the situation
UNRWA which has the ability to operate in diverse contexts,
remains challenging for Palestine refugees. The occupation
including in the most intense and violent conflicts.
of the Gaza Strip and the West Bank, including East
The MTS lays out a set of Strategic Outcomes designed to Jerusalem, continues to constrain life for refugees in
address the needs of Palestine refugees, and UNRWA will extreme ways. In Gaza, the illegal blockade has had a
implement a very active and committed effort to mobilize ruinous effect on the economy and the Strip is faced with
support and resources to achieve those Outcomes. When the prospect of becoming unliveable within the MTS period
considering the Agency’s primary achievements over unless urgent remedial action is taken by the international
past decades, and its responsibilities moving forward, it is community. The situation for Palestine refugees in Lebanon
important to acknowledge the remarkable contribution of is exacerbated by a lack of rights and socioeconomic
the host and donor governments in accommodating and exclusion. In Jordan, Palestine refugees also face hardships,
supporting Palestine refugees. At the same time, meeting including thousands living in substandard shelters in need
the needs of all Palestine refugees requires the collective of rehabilitation and increasing numbers living in abject
effort of many actors, including other members of the poverty, with those living in camps particularly affected.
United Nations family in the region, non-governmental
2 medium term strategy 2016-2021
These factors together point to the unsustainability of the international community can ensure that the vulnerability
Palestine refugee situation. The ongoing denial of rights, of the Palestine refugee community is addressed and that
constrained socioeconomic conditions and exposure refugees’ rights are protected.
to multiple crises – often spilling across borders – have
It can also ensure that the formidable human capital
severely impacted upon the ability of many refugees to
development – one that many countries in the world would
attain basic standards of human development. These
envy Palestinians for – is not lost to the corrosive effects
factors, combined with the enduring refugee condition
of occupation, conflict and neglect. UNRWA for its part is
of Palestine refugees, have posed continuous obstacles
committed to ensuring that the means made available to it
to the development of what has traditionally been a well-
are used in the most effective and efficient way possible. The
educated, highly skilled and self-sufficient population
present MTS contains specific management commitments
in the Middle East. The humanitarian cost of the present
to that effect.
situation is untenable and calls for the achievement of
a just and comprehensive solution to the situation of I am confident that, with your help, we can deepen the
Palestine refugees. It, however, also further underlines the needed solidarity and that my colleagues and I will ensure
critical importance of the role of UNRWA for the refugees the Agency continues fulfilling its role to carry out its
in terms of protection and assistance. We will continue to essential work in support of Palestine refugees, while the
honour our obligations to Palestine refugees until there is international community more actively contributes to a
a solution to their plight. final – and very long overdue – settlement to the Palestinian
issue. The time for an end to the injustice suffered by
In this context, international solidarity in support of our
Palestine refugees has come.
Agency is essential. By supporting and sustaining UNRWA
in its mission to provide health, education, social services,
protection and emergency assistance to refugees, and by Pierre Krähenbühl
providing the diplomatic and financial support necessary
for UNRWA to discharge its tasks in a landscape which is Commissioner-General
complex, challenging and, in places, highly dangerous, the
united nations relief and works agency 3
© 2013 UNRWA Photo by Alaa Ghosheh
executive summary
1. Following the 1948 Arab-Israeli War, the United Nations access to primary health-care services to families
Relief and Works Agency for Palestine Refugees in the comprising 3.68 million individuals, which translates
Near East (UNRWA) was established under General into almost 9.5 million consultations annually, and
Assembly resolution 302 (IV) of 8 December 1949 contributes towards Palestine refugees experiencing
to provide assistance to Palestine refugees in five health outcomes in line with host countries in areas
fields of operations – Jordan, Lebanon, the Syrian such as infant and maternal mortality. In 2014, the
Arab Republic, the West Bank, and the Gaza Strip. Agency provided social safety net assistance to
The mission of UNRWA is to help Palestine refugees 294,000 persons and made a positive impact on
achieve their full potential in human development the lives of 730,000 people through inclusive and
under the difficult circumstances in which they participatory infrastructure and camp improvement
live.1 As the General Assembly has expressed, in the interventions. The UNRWA microfinance programme
absence of an international political solution to the has developed into one of the stronger institutions
situation of Palestine refugees after over six decades, of its type in the region, delivering over 225,000
the Agency’s provision of services will remain loans from 1991 to 2010 valued at almost US$ 257
essential for the well-being, human development and million, and was internationally recognized in 2011
protection of the refugees.2 for excellence in social performance reporting.
Furthermore, UNRWA has a well-established record
2. UNRWA is well regarded as a pioneer in public service
of responding rapidly and effectively to emergencies,
delivery in both stable and fragile contexts. In 2014, the
including in promoting protection, for example in
Agency succeeded in educating more than 490,000
the ongoing Syrian conflict, the two intifadas in the
children and over the course the period 2016 – 2021,
occupied Palestinian territory (oPt), and the Lebanese
over 250,000 children will have completed the basic
civil war, to name just a few.
education cycle in UNRWA schools. UNRWA provides
© 2014 UNRWA Photo by Shareef Sarhan 4 medium term strategy 2016-2021
united nations relief and works agency 5
3. In 2015, UNRWA provided direct services through a including those required to develop coping strategies
workforce of over 30,000 persons, primarily Palestine and build resilience. Poverty rates and unemployment
refugees themselves. This workforce includes 22,000 are particularly acute in a number of Palestine refugee
education staff, 3,300 health staff, 1,100 sanitation camps and gatherings.
labourers, and over 370 social workers working in
7. Refugees are facing an increasing number of
over 900 facilities (including schools, health centres,
protection threats from armed conflicts in Syria,
and technical and vocational training centres) across
the West Bank and the Gaza Strip. The number of
its five fields of operations.
refugees who are excluded from key aspects of social,
4. The Medium Term Strategy (MTS) presents the political and economic life by virtue of their legal
Agency’s strategic vision and objectives for its status and the fact that they do not enjoy the same
programmes and operations for the period 2016-2021, basic human rights as other citizens is growing. The
with the aim of maximizing its use of resources and vulnerability of different groups, including women,
the impact of UNRWA operations in serving refugees. children and persons with disabilities, to violence and
It reaffirms the Agency’s commitment to advocating abuse is also increasing. Prolonged political, social
and providing for the human development and and economic instability combined with repeated
protection needs of Palestine refugees. and widespread violations of human rights will have
significant adverse effects upon the mental health
5. There is good reason to believe that the period
and psychosocial well-being of Palestine refugees.
2016-2021 will be one of growing complexity in the
environment in which UNRWA operates and among 8. Against this backdrop of growing vulnerability,
the most difficult periods in Palestine refugee history. UNRWA, lacking the national policy tools through
While negotiations aiming to achieve a durable which states address a multiplicity of social and
solution to the Israeli-Palestinian conflict that economic challenges, must sustain its investment
includes a final resolution to the plight of Palestine in the human capital of the refugees through
refugees are expected to continue during the continued delivery of core services. As we transition
strategic period, it is assumed that the West Bank and between strategic periods, this nexus of conflict, the
the Gaza Strip will remain under Israeli occupation. absence of a solution to the refugee question, and
The first year of the strategic period could potentially the profound challenges of economic development
be the ninth year that 1.28 million refugees in the and poverty that face the region will continue to
Gaza Strip experience an illegal blockade leading to increase the demand for core UNRWA services and,
electricity, fuel and food crises and restrictions on in crises, emergency assistance. In responding to
Gaza’s capacity to create jobs, pushing the population these challenges, the Agency will consider ways to
further into poverty. The occupation in the West strengthen its responses to poverty through more
Bank, the barrier and its associated regime will give effective synergies between its existing programmes.
rise to increased protection issues for approximately
9. The factors behind the human development and
775,000 refugees. A protracted crisis, with cyclical
protection crisis faced by refugees are beyond the
degrees of intensity and widespread insecurity,
control of UNRWA. It is vital that the underlying
is expected to characterize much of the strategic
causes are addressed by the United Nations Member
period in Syria, affecting 450,000 Palestine refugees
States, including the parties to the different conflicts.
still living in the country. In Jordan, hosting some 2.1
The consequences of inaction are unacceptable.
million Palestine refugees along with other refugees
Unemployment will grow, and there will be higher
from Iraq and Syria will continue to place a huge
health and social welfare costs, higher insecurity and
burden on the already strained economy and natural
lower economic growth. An impoverished, embittered
resources, as well as the stability of the country. At the
and isolated population will turn increasingly to risky
start of the MTS period, more than 450,000 Palestine
and dangerous behaviours, with implications for host
refugees registered in Lebanon will continue to face
communities and countries in the region.
exclusion, discrimination and the ongoing denial of
their rights. 10. In the strategic period, UNRWA will remain the lead
international actor in reducing the impact of the
6. Palestine refugees are facing a human development
above threats and will remain committed to providing
and protection crisis. Levels of food insecurity and
support to all Palestine refugees who register for its
poverty are high and increasing. Rates of youth
services. UNRWA will focus on building the capacity
unemployment, especially affecting female youth, are
of Palestine refugees and doing everything possible
alarming.3 Despite Palestine refugees having strong
to create an enabling environment for them to
human capital as a result of the education and health
exercise those capacities. Doing so will create greater
structures provided by UNRWA and host authorities,
resilience and help mitigate against the local and
the majority of refugees do not have access to the full
regional impact of the challenges facing refugees.
range of assets required for sustainable livelihoods,
6 medium term strategy 2016-2021
11. UNRWA has identified five strategic outcomes that it of the Agency’s successful Family Health Team (FHT)
will work to accomplish over the strategic period with reforms. Through a range of initiatives, including
the assistance of regional, national and local partners. capacity-building of paramedical and medical staff,
The outcomes have been identified based on an establishment of specialized referral mechanisms,
understanding of the Agency’s accomplishments over and wide-reaching health promotion and protection
the course of the previous Medium Term Strategy for services, it will curb the increasing prevalence of non-
the period 2010-2015 and an appreciation of where communicable diseases (NCDs), mental illness and
the Agency’s operations were less successful. psychosocial problems. UNRWA will ensure improved
access for Palestine refugees to health services
12. First, UNRWA will ensure that its own operations
where such access is restricted by a lack of rights
meet minimum protection standards. UNRWA will
or restrictions on movement. In its hospitalization
further protect and promote the rights of Palestine
subprogramme, UNRWA will direct focus and accord
refugees under international law. It will do so for
highest priority to those refugees with life-threatening
Palestine refugees whose rights under international
illnesses requiring life-saving/life-supporting medical
humanitarian and human rights law are being
care, but who lack the necessary financial assets or
violated as a consequence of armed conflict. It will
insurance coverage to attain such treatment. UNRWA
do so for refugees who are excluded from key aspects
will work with partners to ensure refugees benefit
of social, political and economic life by virtue of their
from specialist care that UNRWA is unable to provide
legal status and the fact that they do not enjoy the
and to maximize opportunities to increase resource
same human rights as other citizens. It will work
mobilization through partnerships.
through its programmes to provide support and
assistance to groups who are vulnerable to violence, 14. Third, UNRWA will ensure school-aged children
abuse, neglect and exploitation. complete quality, equitable and inclusive basic
education to enable students, over time, to develop
13. Second, UNRWA will protect refugees’ health and
the cognitive, social, cultural and personal capabilities
reduce the burden of disease. It will do so through
to best equip them to realize their potential as an
the continued provision of universally accessible
individual and as a member of their society. Beyond
quality primary health care and the implementation
the basic education provided by UNRWA, this potential
© 2014 UNRWA Photo by Alaa Ghoshehunited nations relief and works agency 7
is leveraged through Palestine refugee children’s
access to education at secondary and tertiary levels
in host authority institutions. Among other things,
UNRWA will increase its focus on students who
require targeted interventions, including children
with disabilities; children from poor backgrounds;
children with additional psychosocial needs; children
who are underperforming in standardized tests;
children who have experienced abuse, physical
violence and exploitation; and children with severe
diseases. UNRWA will ensure its school facilities are
accessible and provide a conducive and safe learning
environment. Through best practice emergency
© 2014 UNRWA Photo by Shareef Sarhan
programming, UNRWA will ensure Palestine refugee
children who are affected by conflict are not deprived
of the right to education. UNRWA will work with
partners to both improve the quality of its education addressing water resource, supply and networks,
programme and ensure increased access of refugees sewerage networks, and water drainage in camps
to education providers. that suffer from severe deteriorated environmental
infrastructure conditions. UNRWA will further ensure
15. Fourth, UNRWA will increase the capabilities of Palestine refugees are benefiting from the services
refugees – particularly youth, women, the poor provided by others in ensuring their basic needs
and other vulnerable groups – to take advantage are met. Where UNRWA is required, by necessity, to
of livelihood opportunities. Despite the challenges provide services itself, it will do so in the most efficient
associated with doing so, UNRWA will work and effective manner possible.
towards improving refugees’ access to livelihood
opportunities through innovative projects, advocacy 17. In order to achieve the above outcomes, UNRWA
and support programmes tailored to address local will establish a stronger foundation of efficient and
threats and vulnerabilities. UNRWA will enhance effective management through three commitments.
its work with global, regional and local partners First, UNRWA commits to build an ambitious
to improve refugees’ access to the human, social, relationship and fundraising approach with the
natural, physical and financial capital required to express aims of maximizing resources and finding
enhance livelihood opportunities and to ensure the new solutions to bridge a looming financial gap
investments made by UNRWA are not wasted through and of transforming several existing collaborative
inactivity and dangerous behaviour. In addition, arrangements with partner organizations into long-
UNRWA will identify a number of priority Palestine term strategic engagements that enhance the
refugee communities in which socioeconomic opportunities available to refugees. Second, UNRWA
conditions are particularly dire and in which commits to further strengthen its management
improvement projects have the potential to increase systems to maximize impact and effective response,
livelihood opportunities and reduce the incidence of as well as to address some key sustainability
poverty. UNRWA will continue to ensure that its own challenges facing the Agency. Third, UNRWA commits
human resources and procurement requirements to fostering and instituting a culture of partnership
benefit Palestine refugees and local suppliers to the with refugees and staff, including staff unions.
maximum extent possible. 18. This strategy responds to calls from the Agency’s
16. And fifth, UNRWA will ensure refugees are able donors to deliver the most cost-effective and
to meet their basic human needs of food, shelter impactful services possible. It responds to host
and environmental health to ensure that its efforts governments’ insistence that they not be required to
to build the human capability of refugees are not bear a greater burden – a burden they cannot meet
undermined. Refugees’ ability to meet their basic financially – of supporting refugees. It responds
needs has seldom been at greater threat than to the legitimate demands of refugees to provide
today. UNRWA will target, first, the abject poor4 them with protection and support at this time of
through direct cash and food assistance and through great need. Most importantly, the MTS reiterates
preferential treatment in other services. It will make the unsustainability of the refugee condition and
every effort to ensure Palestine refugees live in impresses upon the international community the
conditions that meet minimum acceptable standards urgency of resolving the plight of Palestine refugees.
of safety and health. UNRWA will prioritize projectsWEST BANK SYRIA LEBANON HQ
8
JORDAN GAZA
2.11 M 1.28 M 774k 529k 453 k
$143 M $493 M $153 M $200 M $201 M $50 M
IN ANNUAL IN ANNUAL IN ANNUAL IN ANNUAL IN ANNUAL IN ANNUAL
EXPENDITURE EXPENDITURE EXPENDITURE EXPENDITURE EXPENDITURE EXPENDITURE
medium term strategy 2016-2021
UNRWA services
739 Health staff 1,016 Health staff 789 Health staff 437 Health staff 357 Health staff
23 Health care facilities 22 Health care facilities 42 Health care facilities 23 Health care facilities 27 Health care facilities
1.2 M served persons 1.2M served person 476 K served persons 423k served persons 331k served persons
5,301 9,422 2,783 2,503 1,915
education staff education staff education staff education staff education staff
119K 174 240K 252 51K 97 46K 94 38K 68
pupils schools pupils schools pupils schools pupils schools pupils schools
123 Relief and social 346 Relief and social 188 Relief and social 113 Relief and social 146 Relief and social
services staff services staff services staff services staff services staff
267 Sanitation labourers 269 Sanitation labourers 186 Sanitation labourers 96 Sanitation labourers 183 Sanitation labourers
6,890 staff 12,518 staff 4,844 staff 3,322 staff 2,897 staff 533
47% 53% 50% 53% 46% staff
Figure 1: UNRWA operations, 2014© 2014 UNRWA Photo by Shareef Sarhan united nations relief and works agency 9
10 medium term strategy 2016-2021
chapter 1: context analysis and
assumptions
19. The Middle East is experiencing significant political, pose an increasing existential threat to Gaza as a
social and economic changes. Instability and, in some liveable place.
cases, active conflict are expected to characterize
23. In the West Bank, protection challenges as a result
the macro-environment for most, if not all, of the
of the occupation, including conflict-related
strategic period. Recent events in all fields of UNRWA
violence; detentions, including those of children;
operations indicate that the coming strategic period
military incursions into refugee camps; restrictions
could herald even more complexity and uncertainty.
on movements and access to productive resources;
20. While a peaceful, comprehensive and durable forced displacement; demolitions of Palestinian-
solution to the Israeli-Palestinian conflict that includes owned structures; and settler violence are expected
a final resolution to the plight of Palestine refugees to continue to affect the daily life of all Palestinians,
is unlikely during the strategic period, the United including refugees. At the same time, the economy
Nations will remain actively engaged with all relevant is expected to remain stagnant, contributing to high
actors in an effort to sustain the peace process. rates of unemployment, poverty and food insecurity.
Taken collectively, these challenges will not only
21. The West Bank5 and the Gaza Strip are expected to
undermine the ability of Palestinians, including
remain under Israeli occupation. It is expected that
refugees, to live in dignity, leaving them vulnerable
the State of Palestine will continue efforts to establish
to a loss of assets and livelihoods, but also represent
itself as a fully functioning and self-reliant State;
significant constraints to the Palestinian Authority
however, it is likely that many Palestine refugees will
in providing a full scope of services to citizens and
remain reliant on UNRWA services.
exercising the right to self-determination on behalf of
22. The first year of the strategic period could potentially the population.
be the ninth year that the Gaza Strip experiences
24. The conflict in Syria continues to worsen, with
an illegal blockade leading to electricity, fuel, food
devastating consequences for all civilians. All twelve
and health crises. Unless a political solution to the
Palestine refugee camps have been directly affected,
conflict is found in the near future, the prospect
including by looting, indirect fire and shelling. Tens of
remains that this blockade will continue in some form
thousands of Palestinian homes have been destroyed.
into the strategic period. Due to the many years of
Damage to the economic environment and essential
blockade, isolation and repeated intense conflicts,
infrastructure has increased dependence on UNRWA
the Gaza Strip will likely continue to be one of the
and threatens to further reverse human development.
weakest economies in the world. Barring significant
Violence and widespread insecurity are expected
changes in the blockade (lifting in full or a major
to continue in Syria in the strategic period. Conflict
easing), it is likely that the access regime will remain
lines have shown to be dynamic, and it is expected
challenging, with restrictions on the movement of
that some areas in which Palestine refugees reside
people and goods. Access to land and fishing areas
will remain insecure or unstable and that access will
is also likely to remain severely limited, in addition
be restricted or interrupted at different times and at
to renewed restrictions on imports. As the blockade
different places. Palestinians from Syria have voiced
continues to restrict Gaza’s capacity to create jobs,
a deep sense of insecurity about their future in Syria
the majority of the population will be pushed further
and the wider region. Even in the unlikely event of a
into poverty. The relatively short yet intense conflicts
halt to all violence, the widespread damage to homes,
and incursions that have characterized recent years
as well as health and education infrastructure, will
may continue with cross-border violence resulting
require a considerable reconstruction effort and the
in death and injury. The greater intensity, protraction
challenges of economic recovery will be immense.
and severity of the 2014 conflict in the Gaza Strip,
which outstripped the Agency’s worst-case scenarios 25. Lebanon’s stability, including its security and
many times over, underlines the continued volatility economy, are likely to continue to be negatively
and unpredictability of the Gaza Strip and the gulf affected by the ongoing conflict in Syria and the
that remains before any political solution can be 1.2 million Syrian refugees it is hosting. Despite
found. The longer-term consequences of these some significant challenges, it is not expected that
events are still unfolding at the time of publication of there will be internal strife, although the security
this strategy. In addition, environmental and resource situation will remain tense. It is assumed that stresses
concerns, including the acute water shortage, will generated by a large refugee population, coupledunited nations relief and works agency 11
© 2013 UNRWA Photo by Carole Alfarah
with limited national resources and a challenged strong and stable levels of peace and security above
economy, will further negatively affect Lebanon’s all other UNRWA fields of operations.
border policy towards Palestinian refugees from Syria
27. In addition to the crises and emergencies already
(PRS), preventing them from entering and increasing
being experienced by Palestine refugees, instability
the risk that they will be returned by force.
may lead to further volatility across some areas of
26. Jordan will continue to host millions of refugees, UNRWA operations during the strategic period. In
whether they are Palestine refugees or from Syria and this regard, it is assumed that the macro-environment
Iraq. This trend generates growing challenges for the will be characterized by a continuation of the current
stability of the country, in particular on its economy cycle of complex emergencies. With a growth in the
and limited natural resources, most notably water. number of refugees living in poverty and the absence
Heightened external security threats are expected of a solution to the refugee question, demand for
to continue to pose a risk of internal conflict. UNRWA emergency assistance will persist, combined
Notwithstanding the aforementioned, over the with a rising demand for core services.
period of the 2010-2015 MTS, Jordan has experienced12 medium term strategy 2016-2021
© 2014 UNRWA Photo by Shareef Sarhan
chapter 2: palestine refugee needs
28. In 2014, 5.15 million Palestine refugees and 439,746 representing increases of 2.9 per cent and 15.6 per
other eligible persons were registered with UNRWA, cent, respectively, on the 2014 population.6 Growth
totalling 5.59 million registered persons. Projections rates vary between fields, with the fastest growth
suggest that, from this baseline, the total registered expected in the Gaza Strip and more moderate
population is expected to increase to 5.75 million growth projected in Lebanon.
across UNRWA fields in 2016 and 6.46 million in 2021,
Figure 2: Actual and projected registered UNRWA population, 2010-20217united nations relief and works agency 13
Human Development Indicators concentrated in refugee camps and among refugees,
as well as middle and southern governorates in both
29. The concept of human development is one of the areas. Unchanged from the previous year, ongoing
two foundation principles of the Agency’s vision high food insecurity levels represent a reversal of
and mandate. Human development is the process improvements in the West Bank and the Gaza Strip
of increasing the ability of people to make decisions between 2009 and 2011 when overall food insecurity
affecting their own lives. The three essential in Palestine fell to around 27 per cent. In Jordan, 13.5
dimensions of human development are a long and per cent of refugees residing outside of camps live
healthy life, acquired knowledge, and access to below the national poverty line (JOD 814 a year, per
resources for a decent standard of living. Human person), with the poverty rate for refugees living inside
development is nevertheless a broad and evolving of camps significantly higher at 30.7 per cent.10 The
concept. Additional choices valued by people include conflict in Syria, meanwhile, has resulted in extensive
dignity, empowerment, and respect for human and ongoing damage to homes and installations, and
rights and political freedoms. Human development around 5 per cent of the housing stock in Gaza was
requires building capacities, but also requires an rendered uninhabitable by the conflict in 2014.11 At
enabling environment in which refugees have access its height, the conflict displaced over 475,000 people
to opportunities to exercise their capacities safely in Gaza; nearly 300,000 took shelter in 90 UNRWA
and freely. Palestine refugees must be able to do so schools operating as designated emergency shelters.
with confidence that the efforts they make today to An estimated 100,000 homes were damaged or
develop themselves and their communities will not destroyed, affecting more than 600,000 people.
be lost tomorrow.
32. Disaggregation of key indicators by gender, residence
30. Many health- and education-related indicators for and socioeconomic status across all three essential
Palestine refugees reflect significant achievements dimensions of human development, moreover, reveals
in human development over time. Life expectancy a more complex picture of overlapping achievements
at birth, for example, an indication of the overall and deprivations. Gender equality is at the core of
mortality level of a population, is similar to host human development. Literacy rates among female
populations and higher than average expectancies refugees, despite significant achievements over
among both men and women in the Arab world. time, for example, continue to lag behind those of
Overall achievements in literacy are also high and male refugees across all fields of UNRWA operations.
generally exceed levels of high- and medium-ranked Refugee women also experience lower levels of
countries on the human development index. These employment and higher levels of unemployment in
achievements among others can be attributed in most fields of UNRWA operations.12
large part to the strength of UNRWA programmes.
A significant number of Palestine refugees also have 33. Refugees living in camps are generally more
access to other education and health services in their vulnerable than those living outside of camps, with
respective host countries. substantial variations in health, education, livelihood
opportunities, poverty rates and living conditions
31. Indicators in other areas are far less positive and reflect across camps in each field.13 Furthermore, multiple
ongoing and in some cases increasing deprivation. In indicator cluster surveys in Syria, Lebanon, the
Lebanon, for example, a 2010 survey revealed two West Bank and the Gaza Strip highlight significant
thirds of the Palestine refugee population as living variations in human development achievements
in poverty.8 Noting the correlation between money- and deprivations for refugee women and children in
metric and multidimensional measures of poverty, camps, gatherings, and urban and rural areas.
the study highlights the importance of securing good
health, food security, adequate education, access to 34. Prolonged political, social and economic instability
stable employment, decent housing and possession combined with repeated and widespread violations
of essential household assets as integral to long- of human rights further impair capacities and
term poverty reduction. A recent study (2014) in the opportunities for human development. Research
occupied Palestinian territory found food insecurity indicates, for example, that rates of behavioural and
levels of 57 per cent in Gaza and 19 per cent in the West emotional and post-traumatic stress are as high as 35
Bank due primarily to the effects of the blockade and to 40 per cent among Palestine refugees.14
occupation.9 Food insecurity rates were particularly14
UNRWA CAMP PROFILE 2021
Estimated camp population Registered camp population Estimated camp population Registered camp population
Nahr el-Bared Jenin
of registered of registered Far'a
Wavel living in camps living in camps Nur Shams
Tulkarm
Beddawi
Aqbat Jabr
Burj Shemali Ein el-Sultan
Askar
Rashidieh
Balata
Camp No. 1
El Buss
46% 24% Deir 'Ammar
Mieh Mieh Jalazone
Am'ari
Ein El Hilweh
Kalandia
Shatila Shu'fat
medium term strategy 2016-2021
Deheishe
Dbayeh
Beit Jibrin
Burj Barajneh Aida
Arroub
Mar Elias Fawwar
0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 0 5,000 10,000 15,000 20,000 25,000 30,000 35,000
LEBANON WEST BANK
GAZA JORDAN
Jabalia Souf
Jerash
Khan Younis
Irbid
Rafah
Husn
Maghazi Zarqa
Deir El-Balah Marka
Talbieh
Bureij
of registered of registered Amman New Camp
Nuseirat living in camps living in camps Jabal el-Hussein
Beach Baqa'a
0 20,000 40,000 60,000 80,000 100,000 120,000 140,000 160,000 0 50,000 100,000 150,000 200,000 250,000
Estimated camp population Registered camp population 43% 18% Estimated camp population Registered camp population
Camp profile data is not included for Syria due to uncertainty in population projections as a result of the ongoing conflict
Figure 3: Projected UNRWA Camp Profiles for 2021united nations relief and works agency 15
35. The demographic projections above, moreover, paint The number of poor is expected to increase from 1.63
a worrying picture about the sustainability of human million (2012) to 2.17 million (2021), of whom 566,000
development, with potential for further erosion of will be abject poor. Excluding refugees ordinarily
refugee capacities and denial of opportunities for resident in Syria, the population of refugee camps
their exercise not just today but for future generations is expected to be approximately 916,000 in 2021, of
of Palestine refugees. In 2021, an estimated 1.1 million whom approximately 145,000 are expected to be
Palestine refugees will be of school age – half of living in 33,800 substandard shelters.
whom are expected to be attending UNRWA schools.
In 2021...
470,000 will
be between 0-
3 years of age
20 per cent will be
between 40 - 59
1.1 million Palestine refugees
will be children of school age,
6.45 million
of whom, approximately
570,000 are expected to be
attending UNRWA schools
people will be
registered with
40 - 59
3.9 million will be of UNRWA
working age (15 - 64)
2.9 million will be
children or youth
(44.5 per cent of
the population)
1.6 million will be women of
reproductive age (15 - 49 years)
Figure 4: Demographic profile of registered persons in 2021
36. UNRWA has adopted a holistic approach to addressing 37. The life-cycle approach to human development
Palestine refugee needs and works to enhance their is preventative and global. It includes work to
overall well-being. For this reason, needs are assessed ensure health, psychosocial well-being, education
per life-cycle stage. Early and ongoing investments and employment opportunities, and an enhanced
throughout the life cycle strengthen refugee capacities protection of a person’s rights. UNRWA takes advantage
over the course of their lives. When combined with of the potential it has to impact the full life of a refugee
efforts to protect opportunities for the exercise of these in all these interlinked areas insofar as available
capacities, such investments enhance individual and resources allow.15
community resilience to various shocks, from illness to
job loss and armed conflict.
Figure 5: Stages in the life cycle16 medium term strategy 2016-2021
for served refugees, with somewhat lower rates for
© 2013 UNRWA Photo by Alaa Ghosheh
the Palestine refugee population as a whole.20 Infant
mortality among served refugees has fallen from 160
per 1,000 live births during the 1950s to less than 25
some six decades later.21 The maternal mortality ratio
among Palestine refugees who utilize UNRWA health
services is well below the target set by the post-2015
sustainable development agenda.22
40. Although pregnant women, nursing mothers
and infants are well served by UNRWA and other
health services, including those provided by host
authorities, these groups are particularly vulnerable
in the instance of an emergency or protracted crisis.23
Without an adequate response, there will be serious
long-term consequences for these populations in
the future. In addition to deaths caused by armed
conflict, ongoing instability and insecurity can also
contribute to shifts in mortality.24
41. Continuing stress and hardship caused by the
conditions of poverty and conflict seriously endanger
Pregnancy, Birth and Infancy (-9 Months to 1 Year) capacities of mothers to adequately protect
38. In 2021 there will also be an estimated 1.66 million and enhance the development of their infants.25
women of reproductive age (15-49) of whom around Prolonged situations of fear, stress and insecurity
334,000 will utilize UNRWA services. Meeting the directly contravene essential psychosocial well-being
health needs of Palestine refugee women in the pre- needs of infants and their mothers and might have
and post-natal periods of the life cycle is essential. negative consequences on healthy psychosocial
Intervention at this stage will contribute to better development.26 The Agency’s capacity to pick up such
human development indicators for maternal mortality issues at present are limited, but they are particularly
and morbidity, infant and child mortality rates, and attended to by midwives.
immunization rates. However, needs at this life stage
go further, and it is essential to track children beyond Early Childhood and Pre-School Years (1 to 5 Years)
the initial round of immunizations and through the 42. Focusing on the early childhood years is crucial to
crucial first 1,000 days. Investing in the health and ensure that children are socially and cognitively well
nutrition of mothers and children during pregnancy prepared for subsequent years. It is essential that
and early childhood reduces the risk of suffering children at risk of chronic malnutrition and exposed
from disabilities and impairments later in life and to situations of prolonged stress, fear, insecurity and
dramatically increases cognitive and social abilities trauma, as noted above, are identified and supported;
and, therefore, performance in schooling.16 This is a that health screenings are institutionalized; and
key enabler to achieving access to higher education, that psychosocial support needs are addressed
being more productive and earning higher wages as and resilience strengthened before the first grade.
adults.17 Targeted ‘best practice’ programmes have Failure to intervene during these years could have
achieved a combined societal and individual benefit lifelong consequences. Poor health outcomes and
eight times greater than the cost per participant a lack of preschool affects school attendance and
over a 25-year period,18 with a 40-year follow-up performance. Poverty and under-nutrition during
highlighting even greater positive impact.19 preschool account for a loss of more than two
39. Palestine refugee women and infants are broadly able school grades.27 Early childhood education has
to access pre- and post-natal health care. Proximity been increasingly recognized over recent decades
of health centres and clinics to refugees living as helping “to improve children’s cognitive abilities
inside camps has contributed to easy access to the and socioemotional development, help create a
Agency’s medical services and high utilization rates foundation for lifelong learning, make children’s
by refugees. Infectious and communicable diseases learning outcomes more equitable, reduce poverty
are under control owing to high immunization rates, and improve social mobility from generation to
and there has been significant progress in reducing generation.”28 Governments are increasingly investing
infant, child and maternal mortality over time. in early childhood education and care as a dimension
Immunization for diphtheria, tetanus and pertussis of anti-poverty and educational equity measures.29
(DTP) and measles (1-year-olds) is nearly universal 43. Children from disadvantaged families and householdsunited nations relief and works agency 17
are especially at risk with regard to health and social and emotional skills and attitudes and values of
the opportunity to participate in early childhood responsible citizenship, innovation and leadership.
education. This may lead to them not achieving their
46. Primary education, at the very minimum, is key for
potential in school and subsequently having fewer
individuals and societies to extricate themselves
employment opportunities, resulting in low incomes,
from poverty. For lower-middle-income regions (like
high fertility rates, and an inability to properly provide
pre-conflict Syria and the West Bank), the average
an appropriate level of care for their children, thus
personal income returns to primary, secondary and
contributing to the intergenerational transmission of
tertiary education over a ten-year period have been
poverty. This is exacerbated by poor environmental
measured at 10 per cent, 7 per cent and 15 per cent,
infrastructure and health and a lack of outdoor safe
respectively, and in upper-middle-income countries
spaces for children.
(like Jordan and Lebanon), the returns were 10 per
44. In the Palestine refugee context, health screening is cent, 7 per cent, and 17 per cent, respectively.31
relatively well achieved through the UNRWA health However, it is not only attendance levels or completed
programme and levels of literacy among mothers are years of schooling that matters. Ensuring school
relatively high. Despite these programme successes, children are healthy and well nourished and that
many refugees have conveyed the lack of quality the education provided is of high quality, relevant,
preschooling as a concern with regard to the early equitable and accessible is also essential. It is also
development of their children.30 key that specific and differentiated psychosocial well-
being of children is promoted and that any needs
Children of Basic School Age (6 to 15 Years) are assessed and addressed, fostering their overall
45. Ensuring Palestine refugee children of school age state of well-being and protecting them specifically
have access to basic education is fundamental to in situations of extreme stress, chronic fear, loss and
helping them gain the knowledge and skills they trauma. It is of critical importance that children who
need to achieve their human development potential. come from disadvantaged families have full access
Education is the development of individual and to quality education. It is, furthermore, vital that the
societal capacities towards the realization of his/her school environment is conducive to learning and
full potential. This encapsulates developing cognitive, provides comfort, safety and a healthy environment.
© 2014 UNRWA Photo by Alaa Ghosheh18 medium term strategy 2016-2021
© 2014 UNRWA Photo by Alaa Ghoshehunited nations relief and works agency 19
47. Palestine refugees are relatively well served at this 51. Despite positive achievements in primary enrolment,
stage in life, primarily but not exclusively by the school attendance declines significantly at the
UNRWA education programme. Palestine refugees secondary level. Multiple indicator cluster surveys in
have high rates of male and female adult literacy pre-conflict Syria, Palestine and Lebanon reveal that as
across all UNRWA fields of operations.32 As noted few as two thirds of children and youth of secondary
earlier, male literacy is consistently higher than female school age are attending school.38
literacy rates across all fields, by 5 percentage points
52. Gender parity in school enrolment and women’s
or less. Enrolment levels at the primary level are also
education levels in school, moreover, do not translate
high, with net attendance in the mid- to high nineties
into gains in female employment.39 In addition, female
across all fields of UNRWA operations. Disaggregation
labour force participation rates for all women of
of attendance data, however, reveals significant
working age in all UNRWA fields, as noted earlier, is
variations by residence and socioeconomic status.33
lower than the regional average for Arab states, which
48. Education indicators for Palestine refugees also point in itself is the lowest in the world.40 Early marriage is
to gender parity in school enrolment levels and very of great concern and is another barrier to the effective
low school dropout rates.34 Refugee dropout rates at participation of women in the workforce.41
the elementary school level are particularly low and
53. Certain subgroups of youth are especially vulnerable
compare favourably with national rates and regional
due to limited opportunities resulting from exclusion,
averages.35
discrimination and the ongoing denial of their
Late Adolescence and Early Adulthood (15 to 24 rights. In Jordan, ex-Gazan youth are vulnerable to
impoverishment.42 In Lebanon, non-ID Palestinian
Years) youth, who are not registered with UNRWA or the
49. Between 2012 and 2021, the number of Palestine Lebanese authorities, are particularly vulnerable to
refugee youth is estimated to increase from 1.04 deprivation and social exclusion. In the West Bank,
million to 1.08 million. Youth is an important transition young men are especially vulnerable to violence, and
period as adolescents and young adults engage with Bedouin youth are another marginalized subgroup
society and the world of work. The youth age group that experiences high levels of discrimination. Given
has specific needs for quality education, training, the ongoing conflict in Syria, a vast proportion of youth
sexual and reproductive health, and rights awareness, remain socially and economically excluded and face
in addition to livelihood/employment opportunities. a range of protection issues.43 Youth with disabilities
They are more likely than adults, for example, to be lack access to education and employment, resulting in
unemployed or underemployed due to lack of work greater social exclusion.
experience, social networks, job search skills, financial
resources and productive employment opportunities.36 Adulthood and Middle Age (25 to 59 Years)
Failure to effectively respond to these needs will 54. The number of Palestine refugees aged 25-59 is
condemn a significant proportion of Palestine estimated to increase from 2.12 million in 2012 to 2.78
refugees to being under-skilled and unemployed, with million in 2021, of whom 1.29 million will have reached
poor family planning limiting capacities and reducing middle age (40-59). Adults are expected to provide
opportunities for human development. This in turn for themselves and for their families. Employment
will perpetuate cycles of deprivation and poverty is not only central to the development of capacities
and could have destabilizing social effects, as well as and opportunities for human development, but it is
negatively impact on economic growth and security. also associated with dignity and stable and cohesive
50. The situation of ongoing conflict in the Gaza Strip and societies. Loss of jobs and unemployment impacts
Syria; the prolonged situation of poverty in Lebanon other dimensions of human development, from
and Jordan; and the ongoing and fluctuating conflict a reduction in life expectancy as a result of health
in the West Bank imply multiple challenges for the problems to high rates of depression and loss of
whole population, but specifically have an adverse educational opportunities. Children may leave school
impact on the lives of young adults caught in between to work, further eroding their chances of escaping
a lack of opportunity and existence in a continuous poverty in the future.44 Those that are in middle age are
cycle of violence. Psychosocial well-being is often not especially at risk of poor health outcomes and limited
achieved, and specific psychosocial support activities livelihood opportunities. If livelihood opportunities
are necessary to strengthen resilience and avoid loss are lost in the latter years of this life period because of,
of life perspectives. The opportunity for Palestine for example, war, it is often more difficult for a person
refugee youth to engage in meaningful employment to recover and rebuild their lives than for those who
is limited. Unemployment and joblessness is high and are younger. In most UNRWA fields, psychosocial well-
increasing.37 being is seriously endangered and life is characterizedYou can also read
