Healthcare system challenges in the Gaza Strip during armed conflict: findings from a cross-sectional survey of medical professionals

Introduction. Armed conflicts place considerable strain on healthcare systems by damaging infrastructure, limiting access to essential medical resources and increasing demand for emergency care. This study assessed the functioning of the healthcare system in the Gaza Strip during the ongoing conflict from the perspective of healthcare professionals working in the region. Material and methods. A cross-sectional survey was conducted between December 2023 and May 2024 among 57 health-care professionals working in six major hospitals in the Gaza Strip. The questionnaire assessed healthcare system performance, availability of personnel and medical resources and the types of injuries encountered in daily practice. Descriptive statistics, the chi-square test and the Wilcoxon signed-rank test were used for data analysis. Results: The most commonly reported shortages involved dressing materials (26.0%), water (20.1%), medications (16.0%), and specialized medical equipment (12.4%). More than half of respondents reported that at least half of injured patients required immediate medical attention. The distribution of reported injuries associated with mortality differed significantly from the expected distribution (χ²(15) = 51.87; p < 0.001), with burns reported more frequently than expected. Respondents also reported a marked decline in the healthcare system performance after the onset of the conflict (mean score 2.82 vs. 1.49; Z=−5.55; p<0.001). Conclusions: The findings show that the deterioration of healthcare delivery in the Gaza Strip is driven not only by damage to medical infrastructure but also by shortages of essential supplies and the increasing burden placed on healthcare workers. Overall, these challenges may limit the capacity to provide timely and effective care, particularly for patients with severe trauma. The strengthening of healthcare systems in conflict settings requires protecting healthcare personnel, maintaining reliable supply chains and ensuring uninterrupted access to essential medical resources.