School health service in the Southern District of Israel - between privatization and nationalization

School health service in the Southern District of Israel - between privatization and nationalization | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article School health service in the Southern District of Israel - between privatization and nationalization Tzion Dadon, Ya'akov M Bayer, Anat Rosenthal, Michael Gdalevich This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3655916/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 07 Oct, 2024 Read the published version in Israel Journal of Health Policy Research → Version 1 posted 4 You are reading this latest preprint version Abstract Background For over three decades, Israel’s economic policy has favored privatization of public services, including healthcare, generating an ongoing and prolonged debate. In 1997 school health services (SHS) for elementary and middle school pupils had undergone privatization that led to reduced budgets, as well as standards, for nurses and physicians. Following these changes, the service has dwindled and is now focused primarily on vaccinations. Between 2007 and 2012, under private management, in the Southern District, service quality diminished substantially, leading to a significant decline in vaccination coverage. Consequently, in 2012, a decision was made to revert the SHS back to state control. Methods This study analyzes the differences in the operation of SHS between the period the service was operated by a private contractor (2011-2/2012) and the period operated by the Ministry of Health (3/2012–2013). We examined the vaccination coverage rates, screening tests and health education provided in schools. Results We found a statistically significant increase in health services per pupil in the Southern District of the Ministry of Health following the nationalization of the service. There was a significant increase both in routine vaccinations’ coverage and screening tests, but a slight reduction in health education activities. Conclusions These findings indicate the benefits associated with the management of health services by the state and its institutions, in conjunction with other services at both national and district levels. The case study of SHS in the Southern District of Israel can serve as an important example highlighting the impacts of privatization vs nationalization of health services, with potential implications in other fields. These insights should be integral to future discussions of healthcare service privatization Public health Pupil health Vaccination coverage Screening tests Health education Full Text Cite Share Download PDF Status: Published Journal Publication published 07 Oct, 2024 Read the published version in Israel Journal of Health Policy Research → Version 1 posted Editorial decision: Major revision 27 Feb, 2024 Reviewers invited by journal 20 Jan, 2024 Reviewers agreed at journal 19 Jan, 2024 First submitted to journal 29 Nov, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3655916","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":268235924,"identity":"ade658b2-83f6-49dc-8ff9-23acb3a05dc9","order_by":0,"name":"Tzion Dadon","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2klEQVRIiWNgGAWjYFACxgYGBjYQyXwAyJOQIaiBB6GFLQGkhYcILSAA1sJjgBDAB+z5Dzc+Liizk+2X7vn86kaNBQ8D++GjG/DbcrDZeMa5ZOOZc85us845BnQYT1raDbxaGBvbpHnbmBM33MjdZpzDBtQiwWOGXwszI0hLPVBLzjPjnH/EaGEDazkM0sL8OLeNGC1nGJuNec4dN545I82MObdPgoeNkF/Y+48/fMxTVi3bL5H8+HPOtzo5fvbDx/BqQQZsEmCSWOUgwPyBFNWjYBSMglEwcgAARVBDi34ttHcAAAAASUVORK5CYII=","orcid":"https://orcid.org/0009-0001-9852-4245","institution":"Ben-Gurion University of the Negev","correspondingAuthor":true,"prefix":"","firstName":"Tzion","middleName":"","lastName":"Dadon","suffix":""},{"id":268235925,"identity":"a5350c38-3071-40c3-83d3-9489a6f27b0a","order_by":1,"name":"Ya'akov M Bayer","email":"","orcid":"","institution":"Ben-Gurion University of the Negev","correspondingAuthor":false,"prefix":"","firstName":"Ya'akov","middleName":"M","lastName":"Bayer","suffix":""},{"id":268235926,"identity":"05af71c8-8ff1-47b6-8646-e32bf90a3afe","order_by":2,"name":"Anat Rosenthal","email":"","orcid":"","institution":"Ben-Gurion University of the Negev","correspondingAuthor":false,"prefix":"","firstName":"Anat","middleName":"","lastName":"Rosenthal","suffix":""},{"id":268235927,"identity":"235786a1-6ceb-4c97-b025-98bff4278eea","order_by":3,"name":"Michael Gdalevich","email":"","orcid":"","institution":"Ben-Gurion University of the Negev","correspondingAuthor":false,"prefix":"","firstName":"Michael","middleName":"","lastName":"Gdalevich","suffix":""}],"badges":[],"createdAt":"2023-11-23 20:05:56","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3655916/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3655916/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13584-024-00647-3","type":"published","date":"2024-10-07T15:57:55+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":66597227,"identity":"af8c227c-2466-4bb2-bd47-7e8759a4c25f","added_by":"auto","created_at":"2024-10-14 16:08:40","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":296933,"visible":true,"origin":"","legend":"","description":"","filename":"articlenoname2.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3655916/v1_covered_8426732e-9464-46ac-bca7-83b772ab7944.pdf"}],"financialInterests":"","formattedTitle":"School health service in the Southern District of Israel - between privatization and nationalization","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"israel-journal-of-health-policy-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jhpr","sideBox":"Learn more about [Israel Journal of Health Policy Research](http://ijhpr.biomedcentral.com/)","snPcode":"13584","submissionUrl":"https://www.editorialmanager.com/jhpr/default2.aspx","title":"Israel Journal of Health Policy Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Public health, Pupil health, Vaccination coverage, Screening tests, Health education","lastPublishedDoi":"10.21203/rs.3.rs-3655916/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3655916/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eFor over three decades, Israel\u0026rsquo;s economic policy has favored privatization of public services, including healthcare, generating an ongoing and prolonged debate. In 1997 school health services (SHS) for elementary and middle school pupils had undergone privatization that led to reduced budgets, as well as standards, for nurses and physicians. Following these changes, the service has dwindled and is now focused primarily on vaccinations. Between 2007 and 2012, under private management, in the Southern District, service quality diminished substantially, leading to a significant decline in vaccination coverage. Consequently, in 2012, a decision was made to revert the SHS back to state control.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study analyzes the differences in the operation of SHS between the period the service was operated by a private contractor (2011-2/2012) and the period operated by the Ministry of Health (3/2012\u0026ndash;2013). 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