Understanding medical neglect: Perspectives of Palestinian youth from East Jerusalem

Background

Child medical neglect is defined as the failure to provide timely healthcare to the child, placing them at risk of harm. Despite Israel's universal health coverage, East Jerusalem (EJ) Palestinian youth and their families face unique socioeconomic realities and inequitable healthcare access that are shaped by the broader socio-political climate and policies that further challenge healthcare provision. Engaging EJ youth in research, as potentially vulnerable to medical neglect and as experts in their lives, fills a current gap in understanding their specific experiences and healthcare needs.

Objective

This qualitative inquiry explored EJ Palestinian youths' perceptions of medical neglect via review and discussion of medical neglect case vignettes.

Participants and setting

Arab-speaking Palestinian youth aged 12 to 14 were recruited from two EJ schools to participate in data collection activities. Data collection was facilitated by the research team in a confidential space within local EJ school libraries.

Methods

We addressed our qualitative research aims via semi-structured focus groups, one each for boys and girls who participated in the study. Both parental consent and youth assent were obtained before youth participation. Open-ended questions for each focus group featured questions about healthcare and medical neglect, youth reflections on three medical neglect vignettes, and healthcare advocacy questions. Discussions were transcribed, translated into English, and subjected to inductive thematic analysis.

Results

A total of 14 youth participated in the study's focus groups, one each for boys and girls (57 %). The youth demonstrated an awareness of their lived environments, socio-political contexts, cultural influences, and rights-based expectations regarding caregiving. The five main themes included perceived severity and chronicity of medical neglect, emotional impact, systemic factors, shared responsibility, and valuing the child's perspective.

Conclusion

EJ youth understand the complex challenges and competing needs within their community. Findings point to the potential role of youth engagement in research related to healthcare systems, particularly in violence-risk living environments. This study encourages further research to amplify youth voices within complex sociopolitical contexts.