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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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    Rethinking pathways to well-being: the function of faith practice in distress alleviation among displaced Muslim women affected by war
    (Frontiers Media, 2025-07-21) Rutledge, Kathleen K.
    Background: For many populations globally, coping approaches employed during times of extreme adversity are rooted in religious convictions. Positive religious coping following potentially traumatic events and in times of crisis is widely evidenced as resilience promoting. Despite international mandates for aid and mental health responses to enable such coping, there is limited guidance for work with distinct faith groups and limited quantitative evidence overall. This mixed methods study examined the role of faith in mental health among displaced Muslim women affected by conflict, highlighting implications for responders. Methods: A total of 160 questionnaires, 50 interviews, and four focus groups were conducted among 160 Sunni Muslim women in an Iraqi internally displaced persons (IDP) camp with subjects who had been affected by the Islamic State of Iraq and Syria (ISIS) conflict. A total of 19 faith leaders, MHPSS providers, and humanitarian workers were interviewed as key informants. Qualitative responses were analyzed using inductive thematic analysis, while statistical tests examined variable correlations between the mean scores of response groups. Results: Religious meanings were attributed to every aspect of daily life, in addition to shaping fundamental understandings of wellbeing, the ultimate goals of life, and the coping strategies employed. Religiosity was high. Prayer, reciting, or reading the Qur’an, and fasting were widely reported as a means of comfort, stress relief, divine protection, and daily provision. The function of faith practices in distress alleviation was mediated by the individual’s beliefs regarding the afterlife and by their perception of God’s “care” for their life and situation. Self-appraised “inadequate” faith practice—seen as incompatible with the fundamental goal of life for many in the study, entering Paradise after death—and feeling that God does not “care”, were variables associated with higher distress and poor mental health. Gender-blind approaches in the camp and exclusion of faith needs from assessments and response actions compounded distress by creating access barriers. Ensuring access to gender- and faith-sensitive coping resources (when requested by the affected individuals) is likely to boost mental health outcomes, particularly when such supports align with recovery and/or strengthening of the individual’s sense of connectedness to a benevolent, responsive God.
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    Understanding the health needs of internally displaced persons: A scoping review
    (Elsevier, 2021-10-29) Cantor, David James; Swartz, Jina; Bayard, Roberts; Abbara, Aula; Ager, Alastair; Bhutta, Zulfiqar A.; Blanchet, Karl; Bunte, Derebe Madoro; Chukwuorji, JohnBosco Chika; Daoud, Nihaya; Ekezie, Winifred; Jimenez-Damary, Cecilia; Jobanputra, Kiran; Makhashvili, Nino; Rayes, Diana; Restrepo-Espinosa, Maria Helena; Rodriguez-Morales, Alfonso J.; Bukola, Salami; Smith, James
    We seek to strengthen understanding of the health needs of internally displaced persons (IDPs) in contexts of conflict or violence. Based upon a scoping review, our paper identified limited evidence on IDPs health, but nevertheless indicates that IDPs tend to experience worse health outcomes than other conflict-affected populations across a range of health issues; and this is due to the particularly vulnerable situation of IDPs relative to these other populations, including reduced access to health services. Further research is required to better understand these needs and the interventions that can most effectively address these needs.
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    Help seeking, trust and intimate partner violence: Social connections amongst displaced and non-displaced Yezidi women and men in the Kurdistan region of northern Iraq
    (BMC, 2020-08-28) Strang, Alison; O'Brien, Oonagh; Sandilands, Maggie; Horn, Rebecca; Funding for the study was provided by Tearfund UK
    Background: Conflict and displacement impact the social fabric of communities through the disruption of social connections and the erosion of trust. Effective humanitarian assistance requires understanding the social capital that shapes patterns of help seeking in these circumstances - especially with stigmatised issues such as violence against women (VAW) and intimate partner violence (IPV).
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    Evaluating the reliability and validity of secondary reporting to measure gender-based violence in conflict and disaster
    (BMC, 2020-08-06) Stark, Lindsay; Roberts, Les; Yu, Gary; Tan, Timothy M.; Nagar, Aishwarya; Ager, Alastair
    Background Accurately identifying the magnitude of gender-based violence (GBV) in humanitarian settings is hindered by logistical and methodological complexities. The ‘Neighborhood Method’, an adapted household survey that uses primary and secondary reporting to assess the prevalence of GBV in humanitarian settings, reduces the length of time and cost associated with traditional surveys. Primary female adult respondents disclose incidents of physical violence, intimate and non-intimate partner rape for themselves, other females in their homes (standard reporting) and other women and children in their social networks (secondary reporting). This study examines the reliability and validity of this inclusion of secondary reporting to determine the comparability of the Neighborhood Method to a traditional survey approach.
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    Measuring the psychosocial, biological, and cognitive signatures of profound stress in humanitarian settings: Impacts, challenges, and strategies in the field
    (BioMed Central, 2020-06-23) Panter-Brick, Catherine; Eggerman, Mark; Ager, Alastair; Hadfield, Kristin; Dajani, Rana; This research was funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme (https://www.elrha.org/project/yale-psychosocial-call2/) for a total GPB 295,131 in 2015–17 (grant #14045). Elrha aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises (elrha.org/r2hc). The R2HC programme is funded equally by the Wellcome Trust and the UK Government.
    Background: Evidence of ‘what works’ in humanitarian programming is important for addressing the disruptive consequences of conflict and forced displacement. However, collecting robust scientific evidence, and ensuring contextual relevance, is challenging. We measured the biological, psychosocial, and cognitive impacts of a structured psychosocial intervention, implemented by Mercy Corps with Syrian refugees and Jordanian host-community youth. In this paper, we present a case analysis of this evaluation study and reflect on the scientific contributions of the work, the challenges experienced in its delivery, and the strategies deployed to address them.
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    Health system resilience in the face of crisis: Analysing the challenges, strategies and capacities for UNRWA in Syria
    (Oxford University Press, 2019-10-18) Jamal, Zeina; Alameddine, Mohamad; Diaconu, Karin; Lough, Graham; Witter, Sophie; Ager, Alastair; Fouad, Fouad M.
    Health system resilience reflects the ability to continue service delivery in the face of extraordinary shocks. We examined the case of the United Nations Relief and Works Agency (UNRWA) and its delivery of services to Palestine refugees in Syria during the ongoing crisis to identify factors enabling system resilience. The study is a retrospective qualitative case study utilizing diverse methods. We conducted 35 semi-structured interviews with UNRWA clinical and administrative professionals engaged in health service delivery over the period of the Syria conflict. Through a group model building session with a sub-group of eight of these participants, we then elicited a causal loop diagram of health system functioning over the course of the war, identifying pathways of threat and mitigating resilience strategies. We triangulated analysis with data from UNRWA annual reports and routine health management information. The UNRWA health system generally sustained service provision despite individual, community and system challenges that arose during the conflict. We distinguish absorptive, adaptive and transformative capacities of the system facilitating this resilience. Absorptive capacities enabled immediate crisis response, drawing on available human and organizational resources. Adaptive capacities sustained service delivery through revised logistical arrangements, enhanced collaborative mechanisms and organizational flexibility. Transformative capacity was evidenced by the creation of new services in response to changing community needs. Analysis suggests factors such as staff commitment, organizational flexibility and availability of collaboration mechanisms were important assets in maintaining service continuity and quality. This evidence regarding alternative strategies adopted to sustain service delivery in Syria is of clear relevance to other actors seeking organizational resilience in crisis contexts.
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    Resilience capacities of health systems: Accommodating the needs of Palestinian refugees from Syria
    (Elsevier, 2018-10-21) Alameddine, Mohamad; Fouad, Fouad M.; Diaconu, Karin; Jamal, Zeina; Lough, Graham; Witter, Sophie; Ager, Alastair
    Resilience is increasingly recognised as a key process mitigating the impact of shocks and stressors on functioning. The literature on individual and community resilience is being extended to address characteristics of resilient service delivery systems in contexts of adversity. The validity and utility of a capacity-oriented resilience framework (including absorption, adaptation and transformation) is examined with respect to the functioning of United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) health systems in Lebanon and Jordan in the context of the Syrian crisis. We completed 62 semi-structured interviews (30 in Lebanon in November - December, 2016, and 32 in Jordan in January 2017) with professionals at primary care, area, and country management levels. Participants reflected on changes in population health status and health service delivery during the Syrian crisis, notably with respect to the influx of refugees from Syria. Interviews were analysed through inductive thematic analysis and used to critically interrogate health systems resilience against a pro-capacities framework. We find that UNRWA systems in Lebanon and Jordan were broadly resilient, deploying diverse strategies to address health challenges and friction between host and refugee populations. Absorptive capacity was evidenced by successful accommodation of increased patient numbers across most service areas. Adaptive capacities were reflected in broadening of collaboration and reconfiguration of staff roles to enhance service delivery. Transformative capacities were demonstrated in the revision of the service packages provided. While manifest as technical capacities, these clearly drew upon solidarity and commitment linked to the political context of the Palestinian experience. The study adds to the limited literature on health system and organizational resilience and indicates that capacity-oriented framings of resilience are valuable in extracting generalizable lessons for health systems facing adversity. The proposed resilience framework promises to guide strategies for sustained care delivery in these contexts.