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The Institute for Global Health and Development

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9

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Author: search.filters.author.Sempé, Lucas

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    Refugee integration in national health systems of low- and middle-income countries (LMICs): evidence synthesis and future research agenda
    (Elsevier, 2025-09-12) Olabi, Amina; Palmer, Natasha; Bertone, Maria Paola; Loffreda, Giulia; Bou-Orm, Ibrahim; Sempé, Lucas; Vera Espinoza, Marcia; Dakessian, Arek; Kadetz, Paul; Ager, Alastair; Witter, Sophie
    This paper reviews evidence on healthcare responses for refugees, documenting the different approaches and their effectiveness and impact in particular in relation to supporting integrating refugees into national health systems. The review adopted a purposeful, iterative approach, utilizing electronic databases, grey literature, and reference lists from relevant studies. A total of 167 studies, primarily from low- and middle-income countries (LMICs), focusing on refugees and forcibly displaced persons with empirical data, were included. The review highlights a substantial literature on refugee health and healthcare access, with well-covered areas including delivery models, access barriers, gaps in coverage, and specific health services such as psychosocial care, non-communicable diseases, mental health, and maternal and child health. However, less attention is given to integration models, health system responses, and their impact on system resilience and social cohesion. Few studies examine the costs, feasibility, or sustainability of integration models, and little research focuses on health system perspectives or comparative analyses. Moreover, the host health system's status, capacity, and needs are often underexplored. Some countries are particularly well-represented in studies, e.g. Turkey, Jordan, Lebanon, Bangladesh, Democratic Republic of Congo (DRC), and Uganda. There is however a paucity of data that would provide the basis for more quantitative or analytical evaluation from a systems perspective. This gap highlights the need for further research on effective integration models, their operational aspects, and their long-term impact on local health systems' resilience and sustainability. To support this research agenda, we propose a conceptual framework to provide analytic guidance for future research on healthcare responses for refugees and health system integration.
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    Peace of mind: A quasi-experimental, mixed-method evaluation of a community-based mental health intervention for persons affected by Neglected Tropical Diseases
    (Public Library of Science, 2025-09-04) Seekles, Maaike L.; Nganda, Motto; Kadima, Jacob; Sempé, Lucas; Kim, Joy; Omumbu, Pierre; Kukola, Junior; Ngenyibungi, Stephanie M.; Ngondu, Florent; Sabuni, Louis; Dean, Laura
    Evidence consistently shows high levels of mental distress amongst populations affected by skin NTDs. Self-help groups are thought to be a key intervention strategy to support affected persons. However, to date, self-help interventions have largely been concerned with physical improvements as opposed to psychological outcomes. This paper provides an evaluation of the impact of the ‘Peace of Mind’ intervention in Kasai Province, DRC. Peace of Mind was a community-based, peer-led mental health intervention, combining lay counselling, mutual support, self-care, and income generation activities within a self-help group model to address health, psychosocial and economic impacts of skin-NTDs. This mixed-methods study used a quasi-experimental difference-in-difference approach. A survey measured levels of depression, anxiety, and stigma before and after intervention. To facilitate data matching, machine learning was used to predict (based on age, sex, health zone and disability status) which participants in the baseline would have attended the self-help groups. In addition, qualitative and participatory methods including photovoice, in-depth interviews and key informant interviews were completed to elicit the experiences of group members and health staff. Our findings show that after 6 months of intervention this holistic approach was effective at reducing levels of depression (PHQ-9 score reduction ranging on average from -3.5 to -6.7 points, p < .05) and anxiety (GAD-7 score reduction from -2.0 to -3.3 points, p < .05) in persons affected by skin NTDs. However, the prevalence of depression (64%) and anxiety (52%) remained high with suicidal thoughts reported by 35% of respondents at endline. Whilst we found no impact on stigma scores, qualitative data indicated improvements to self-esteem and ability to take part in community life. To our knowledge, this is the first study in the DRC to evaluate the impact of a community-based, peer-led intervention on mental health outcomes of persons affected by skin-NTDs. Holistic self-help groups have the potential to serve as a key component of integrated NTD/mental health service provision at community-level. However, this should be accompanied by the integration of stigma-reduction strategies, the strengthening of primary health care capacities, and the establishment of mental health services at secondary and tertiary care levels.
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    ‘The Lost Peace’: Evidencing the Syndemic Relationship between Neglected Tropical Diseases and Mental Distress in Liberia
    (MDPI AG, 2024-08-17) McCollum, Rosalind; Barrett, Carrie; Zawolo, Georgina; Johnstone, Rachel; Godwin-Akpan, Tiawanlyn G.; Berrian, Hannah; Chowdhury, Shahreen; Kollie, Jerry; Kollie, Karsor; Rogers, Emerson; Parker, Colleen; Phillip, Maneesh; Sempé, Lucas; Seekles, Maaike; Smith, John Solunta; Seekey, Wede; Wickenden, Anna; Zaizay, Zeela; Theobald, Sally; Dean, Laura
    Neglected Tropical Diseases (NTDs) are a group of chronic infectious diseases of poverty affecting over one billion people globally. Intersections of NTDs, disability, and mental ill-health are increasingly evidenced but are rarely studied from a mixed-methods perspective. Here, we advance syndemic understandings by further assessing and contextualising the syndemic relationship between NTDs (particularly their associated disability) and mental distress in Liberia. Participatory qualitative methods, including body mapping (56 participants), social mapping (28 participants), and in-depth interviews (12) provided space for persons affected by NTDs to narrate their experiences. Simultaneously, 201 surveys explored experiences of common mental health conditions among persons affected by skin NTDs. An intersectionality approach was applied within the analysis for both qualitative and quantitative methods informed by Meyer’s minority stress model, adapted for NTDs. Qualitative data was analysed thematically and gender-disaggregated, univariable and multivariable analyses were applied to survey data for the outcome measures depression (PHQ-9) and anxiety (GAD-7). Disability was associated with higher levels of depression and anxiety (p < 0.001). An interaction between disability and being a women increased incidence risk ratio of depression (p < 0.001). In alignment with qualitative findings, persons affected experienced additional generalised (financial concerns), external (experience of stigma) and internal (experience of pain and physical symptoms) minority stressors, to varying degrees, which contributed towards their mental distress, and mental health conditions. These findings were used to co-develop a syndemic-informed person-centred health system response to address the suffering associated with NTDs and mental distress, including a focus on strengthening relationships between formal and informal community health actors and the broader health system.
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    Evaluación del protocolo de visitas domiciliarias de Pensión 65 durante COVID-19
    (Universidad Católica San Pablo, Arequipa, 2021) Sempé, Lucas; Lloyd-Sherlock, Peter
    El año 2020 ha estado marcado por la expansión del COVID-19 en el país, al igual que por los esfuerzos realizados por el Estado Peruano para hacer frente a las consecuencias de esta pandemia. Esto ha obligado a las distintas entidades y programas públicos -entre ellas, Pensión 65- a modificar, actualizar y adaptar sus procesos operacionales para atender las necesidades de sus usuarios de la forma más adecuada y eficaz posible dentro de un difícil contexto que afecta tanto a la salud, lazos sociales y economía de las familias, especialmente de aquellos más vulnerables. Considerando que la morbilidad a causa de la pandemia alcanza índices desproporcionados especialmente dentro de la población adulta mayor -hecho conocido con anterioridad en países como Italia y España-, donde a la fecha de la presente investigación (21 de diciembre de 2020), el 70% de los fallecidos oficialmente reconocidos en nuestro país corresponde justamente a los adultos mayores 1 ; por este motivo, resulta de mayor relevancia estudiar las acciones propuestas por el Programa Pensión 65 con la finalidad de enfrentar los efectos del COVID-19. Este estudio se desarrolló como resultado del XXI Concurso Anual de Investigación CIES 2019, con el auspicio del Ministerio de Economía y Finanzas. Esta investigación también se encuentra dentro del repositorio REPEC
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    An emergency strategy for managing COVID-19 in long-term care facilities in low and middle-income countries: the CIAT Framework (Version 3*)
    (2021-07-20) Lloyd-Sherlock, Peter; Bastos, João; Duarte, Meirelayne; Frank, Monica; Geffen, Leon; Giacomin, Karla; Kelly, Gabrielle; Montes de Oca, Veronica; Rojo, Almudena Ocejo; Redondo, Nelida; Saddi, Fabiana; Sasat, Siriphan; Sempé, Lucas; Vivaldo, Marissa
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    Balance de la Estrategia de Acompañamiento Pedagógico en Áreas Rurales de Perú en la Lógica del Presupuesto de Resultados
    (2015-12-17) Sempé, Lucas
    La presente investigación analiza la estrategia nacional llamada “Acompañamiento pedagógico” promovida por el Ministerio de Educación del Perú desde el año 2008, centrada en escuelas multi-grado rurales con lengua castellana y bilingues. La investigación se centra en los logros de aprendizaje de sus estudiantes así como evaluar y recomendar mejoras en su implementación. El primer objetivo fue determiner si existe diferencia significativa entre escuelas que han recibido acompañamiento pedagógico y aquellas que no han recibido en las pruebas nacionales tomadas a alumnus de segundo grado de primaria en comprensión lectora y matemáticas. Para ello se realizaron diversos tests de análisis de varianzas mixtas. Los hallazgos demuestran que han habido interacciones estadísticamente significativas entre recibir acompañamiento pedagógico por 3 años, lo cual indica que la estrategia es efectiva a fin de mejorar los aprendizajes de los estudiantes. La segunda meta de la investigación fue analizar la estrategia de acuerdo a la lógica subyacente en la política nacional de presupuesto por resultados en la que se enmarca la estrategia. Se realizó una revision y análisis documental, centrándose en el diseño lógico, focalización, organización y gasto público. Se encontraron inconsistencias en el diseño, problema de cobertura y la ausencia de estándares claros de organización.
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    Appraisal of a Learning Coaching Strategy in Rural Areas of Peru in a Results-based Budgeting Rationality
    (Sistema de Información Científica Redalyc, 2015) Sempé, Lucas
    This research analyzes a learning coaching strategy called Acompañamiento Pedagógico promoted by the ministry of Education of Peru since 2008 focusing in rural multi-grade (Spanish and bilingual) schools aiming to improve learning outcomes. It focuses on the learning achievements of its students and also seeks providing advice for improving functioning of the current strategy. The first goal was to determine if there is a significant difference in learning achievements in Spanish reading and comprehension and mathematics between coached and noncoached schools and were performed mixed-designed ANOVAs tests. The finding of statistically significant interactions between receiving coaching for 3-years disclosures an effective strategy in order to increase the goal of any educational system, the learning of students. The second goal of the research was analyzing if the present learning coaching strategy meets the standards set by the national results-based budgeting approach. For that purpose, a documentary review of policy design, focalization and expenditure were performed, finding a design inconsistency, some coverage problems and absence of clear standards and organization parameters.
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    Evaluación de uso de informes de la Evaluación Censal de Estudiantes en la escuela
    (FORGE, 2017-04) Sempé, Lucas; Andrade, Patricia
    Informe final del estudio cualitativo del uso de evaluaciones de aprendizajes, específicamente de la evaluación censal de estudiantes (ECE) en la escuela peruana.
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    Diseño de un sistema de seguimiento de egresados y una estrategia para la implementación de dicho sistema
    (Mejoramiento de la Calidad de la Educación Superior PROCALIDAD, 2018-01-02) Mori Valenzuela, Jorge; Sempé, Lucas; Colquehuanca Achulli, Raymundo; Guerrero Ortiz, Luis; Andrade Pacora, Patricia; Gargurevich Valdéz, José; Silva Martínez, José
    El documento caracteriza y describe el proceso del Seguimiento a Egresados en Instituciones de Educación Superior - IES, y sus vínculos con los mecanismos de toma de decisiones que favorezcan a los egresados en su inserción y trayectoria laboral, así como con los procesos institucionales de diseño curricular y de formación académica de la IES. La consultoría fue realizado por el consorcio conformado entre ENACCION y la Universidad Marcelino Champagnat.