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Article History

Received: 11 September 2017

Accepted: 28 September 2018

First Online: 11 October 2018

Ethics approval and consent to participate

: No Institutional Review Board (IRB) exists at the Palestinian Ministry of Health (MoH) in the Gaza-Strip, which retains jurisdiction over providing approvals for access to medical records and medical databases owned by each individual hospital. The authorized body to provide approvals for studies that involve secondary health data as well as collection and analysis of primary data from both healthcare providers and patients is provided by the Human Resources Department at the MoH in the Gaza-Strip. Therefore, ethical approval for this study was obtained from the Human Resources Department at the MoH in the Gaza-Strip, which issues ethical and administrative approvals for studies involving patients and their families. The approvals were then presented to the administrative bodies of the local hospitals in the Gaza-Strip, which in turn gave their approval and provided the research team with access to medical records housed by the individual hospitals and the available contact information for the families of deceased women who were identified to be part of the potential sample for this study. The procedure, followed in Gaza at the time of this study, did not require approval by relatives to view the medical documentation of the deceased women. The hospitals included in this study were Al-Shifa Hospital in Gaza-City, Shuhada Al-Aqsa Hospital in Deir Al-Balah, Nasser Hopsital in Khan Younis, Al-Helal Al-Emirati Hospital in Rafah and Al-Awda Hospital in Jabalia Refugee Camp, which was the only private hospital. All approvals for this study had been obtained prior to data collection.In addition, and before conducting the interviews with family members or healthcare providers, written consent was obtained from those who were interviewed in person, whereas verbal consent was obtained from participants who were interviewed over the phone due to family preference. This had been agreed to by the Human Resources Department of the MoH. Prior to obtaining consent, the aims of the study were explained to the participants, and they were informed that they had the right to refuse participation in the study, or to withdraw at any time without being penalized. The collected data were kept under high confidentiality and anonymity as each case was assigned a code number. The women’s confidentiality was preserved throughout the study. It was explained to participants that the data collected might be published after having been analysed at the aggregate level.

: All patients’ data were kept strictly confidential and anonymity was preserved throughout the research process. Consent for publication was obtained from the interviewees and the Human Resources Department at the Ministry of Health.

: The authors declare that they have no competing interests.

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