- Edinburgh, Scotland, UK
Alastair Ager
Columbia University, Population and Family Health, Faculty Member
- Humanitarianism, Monitoring And Evaluation, Impact Evaluation, Refugee Studies, Refugees and Forced Migration Studies, Psychosocial Research, and 10 moreChild protection, Disaster mental health, social work intervention, psychosocial support, Public Health Systems & Services Research, Health Care Systems, Health Systems, Health Seeking Behaviour, Sexual and Gender-Based Violence, Complex Adaptive Systems, Development and Religion(s), and Religions and Humanitarismedit
- Alastair Ager is Director of the Institute for Global Health and Development, Queen Margaret University, Edinburgh, P... moreAlastair Ager is Director of the Institute for Global Health and Development, Queen Margaret University, Edinburgh, Professor of Population and Family Health at the Mailman School of Public Health, Columbia University, and Deputy Chief Scientific Adviser to the UK Department for International Development. He has worked in the field of health and development for over 30 years, after training in psychology at the universities of Keele, Wales and Birmingham. He has worked as Head of the Department of Psychology at the University of Malawiedit
Background. Over recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced... more
Background. Over recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced needs of the population and utilising relevant community-based resources to address them. This study took a grounded approach to identify the ways in which adults in Sierra Leone express psychological distress. Methods. Rapid ethnographic methods deployed included 75 case study interviews with community members, 12 key informant (KI) pile sorts and 55 KI interviews. Thematic analysis of data was supported by frequency analysis and multi-dimensional scaling. Results. Thirty signs of distress were identified. The only consistent 'syndrome' identified with respect to these was a general concept of crase, which referred to psychosis-related presentation but also a wide range of other signs of distress. We did not find consensus on locally defined concepts for mild-moderate forms of mental disorder: people use multiple overlapping signs and terms indicating psychological distress. Conclusions. Analysis supports calls to view mental health problems as a 'continuum of distress' rather than as discrete categories. This framing is coherent with opportunities for prevention and response in Sierra Leone which do not focus primarily on formal healthcare service providers but rather involve a range of community-based actors. It also enables attention to be paid to the identification of milder signs of distress with a view to early response and prevention of more severe mental health problems.
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Background: There has been an 8-fold increase in use of the term resilience within scientific and scholar literature over the last twenty years. The arena of public policy has also seen increasing use made of the concept, both with... more
Background: There has been an 8-fold increase in use of the term resilience within scientific and scholar literature over the last twenty years. The arena of public policy has also seen increasing use made of the concept, both with respect to child well-being and development and wider issues. Method: A focal sample of literature comprising 108 papers addressing public policy implications of work on child resilience was identified by a structured bibliographic search. Results: This literature suggests that current work: is characterized by a breadth of sectoral engagement across the fields of education, social work, and health; demonstrates diversity with regard to the systemic levels – individual (biological and psychological), communal (including systems of faith and cultural identity), institutional and societal – with which it engages; but is based more upon conceptual rather than empirical analysis. Major themes of policy recommendation target strengthened family dynamics, increased capacity for counseling and mental health services, supportive school environments, development of community programs, promotion of socioeconomic improvement and adoption of a more comprehensive conception of resilience. Evaluations of resiliency-informed policy initiatives are limited in number, with greatest rigor in design associated with more discrete programmatic interventions. Conclusion: A number of strategies to strengthen research-policy linkages are identified. These include greater commitment to operationalize indicators of resilience at all levels of analysis; more coherent engagement with the policy making process through explicit knowledge translation initiatives; and developing complex adaptive systems models amenable to exploring policy scenarios .
Background: This paper reports on the use of a " neighborhood method " to measure the nature and incidence of violence against women and girls in post-conflict Liberia. Methods: The study population comprised females in Montserrado and... more
Background: This paper reports on the use of a " neighborhood method " to measure the nature and incidence of violence against women and girls in post-conflict Liberia. Methods: The study population comprised females in Montserrado and Nimba counties. Study participants were randomly selected for interviews using multi-stage cluster sampling. 30 clusters of households were sampled in each county. Information on incidents of domestic violence and rape within the preceding 18 months was collected with regard to females of all ages in the respondent's household, and those of her four closest neighbors to make up the full sample.
Research Interests:
Recent years have seen significant growth in both the size and profile of the humanitarian sector. However, little research has focused upon the constructions of humanitarian practice negotiated by agencies and their workers that serve to... more
Recent years have seen significant growth in both the size and profile of the humanitarian sector. However, little research has focused upon the constructions of humanitarian practice negotiated by agencies and their workers that serve to sustain engagement in the face personal challenges and critique of the humanitarian enterprise. This study used the public narrative of 129 website postings by humanitarian workers deployed with the health-focused international humanitarian organization M edecins Sans Fronti eres (MSF) to identify recurrent themes in personal, organizationally-condoned, public discourse regarding humanitarian practice. Data represented all eligible postings from a feature on the agency's UK website from May 2002 to April 2012. The text of postings was analysed with respect to emergent themes on an iterative basis. Comprehensive coding of material was achieved through a thematic structure that reflected the core domains of project details, the working environment, characteristics of beneficiaries and recurrent motivational sub-texts. Features of the co-construction of narratives include language serving to neutralize complex political contexts; the specification of barriers as substantive but surmountable; the dominance of the construct of national-international in understanding the operation of teams; intense personal identification with organization values; and the use of resilience as a framing of beneficiary adaptation and perseverance in conditions that e from an external perspective e warrant despair and withdrawal. Recurrent motivational sub-texts include 'making a difference' and contrasts with 'past professional constraints' and 'ordinary life back home.' The prominence of these sub-texts not only highlights key personal agendas but also suggests e notwithstanding policy initiatives regarding stronger contextual rooting and professionalism e continuing organizational emphasis on externality and volunteerism. Overall, postings illustrate a complex co-construction of medical humanitarianism that reflects a negotiated script of personal and organizational understandings adapted to evolving demands of humanitarian engagement.
Deployment of resident female Community Health Extension Workers (CHEWs) to a remote rural community led to major and sustained increases in service utilization, including antenatal care and facility-based deliveries. Key components to... more
Deployment of resident female Community Health Extension Workers (CHEWs) to a remote rural community led to major and sustained increases in service utilization, including antenatal care and facility-based deliveries. Key components to success: (1) providing an additional rural residence allowance to help recruit and retain CHEWs; (2) posting the female CHEWs in pairs to avoid isolation and provide mutual support; (3) ensuring supplies and transportation means for home visits; and (4) allowing CHEWs to perform deliveries. ABSTRACT Introduction: Nigeria has one of the highest maternal mortality ratios in the world. Poor health outcomes are linked to weak health infrastructure, barriers to service access, and consequent low rates of service utilization. In the northern state of Jigawa, a pilot study was conducted to explore the feasibility of deploying resident female Community Health Extension Workers (CHEWs) to rural areas to provide essential maternal, newborn, and child health services.
Background: Strengthening health research capacity in low-and middle-income countries remains a major policy goal. The Health Research Capacity Strengthening (HRCS) Global Learning (HGL) program of work documented experiences of HRCS... more
Background: Strengthening health research capacity in low-and middle-income countries remains a major policy goal. The Health Research Capacity Strengthening (HRCS) Global Learning (HGL) program of work documented experiences of HRCS across sub-Saharan Africa. Methods: We reviewed findings from HGL case studies and reflective papers regarding the dynamics of HRCS. Analysis was structured with respect to common challenges in such work, identified through a multi-dimensional scaling analysis of responses from 37 participants at the concluding symposium of the program of work. Results: Symposium participants identified 10 distinct clusters of challenges: engaging researchers, policymakers, and donors; securing trust and cooperation; finding common interest; securing long-term funding; establishing sustainable models of capacity strengthening; ensuring Southern ownership; accommodating local health system priorities and constraints; addressing disincentives for academic engagement; establishing and retaining research teams; and sustaining mentorship and institutional support. Analysis links these challenges to three key and potentially competing drivers of the political economy of health research: an enduring model of independent researchers and research leaders, the globalization of knowledge and the linked mobility of (elite) individuals, and institutionalization of research within universities and research centres and, increasingly, national research and development agendas. Conclusions: We identify tensions between efforts to embrace the global 'Community of Science' and the promotion and protection of national and institutional agendas in an unequal global health research environment. A nuanced understanding of the dynamics and implications of the uneven global health research landscape is required, along with a willingness to explore pragmatic models that seek to balance these competing drivers.
The availability of simple, specific, and inexpensive on-site detection methods is of key importance for deployment of pathogen surveillance networks. We developed a nontechnical and highly specific colorimetric assay for detection of... more
The availability of simple, specific, and inexpensive on-site detection methods is of key importance for deployment of pathogen surveillance networks. We developed a nontechnical and highly specific colorimetric assay for detection of pathogen-derived peptides based on Saccharomyces cerevisiae—a genetically tractable model organism and household product. Integrating G protein–coupled receptors with a visible, reagent-free lycopene readout, we demonstrate differential detection of major human, plant, and food fungal pathogens with nano-molar sensitivity. We further optimized a one-step rapid dipstick prototype that can be used in complex samples, including blood, urine, and soil. This modular biosensor can be economically produced at large scale, is not reliant on cold-chain storage, can be detected without additional equipment, and is thus a compelling platform scalable to global surveillance of pathogens.
Background: Gender-based violence (GBV) is a significant problem in conflict-affected settings. Understanding local constructions of such violence is crucial to developing preventive and responsive interventions to address this issue.
The NIHR Research Unit on Health in Situations of Fragility at Queen Margaret University, Edinburgh is focused on addressing the delivery of vital health services in places where displacement, conflict, pandemic disease or weak capacity... more
The NIHR Research Unit on Health in Situations of Fragility at Queen Margaret University, Edinburgh is focused on addressing the delivery of vital health services in places where displacement, conflict, pandemic disease or weak capacity makes this especially challenging. Find out more at: https://www.qmu.ac.uk/ruhf
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Background: This paper revisits the themes of an influential 1993 review regarding the factors shaping the mental health and psychosocial well-being of refugees to take stock of developments in the evidence base and conceptualisation of... more
Background: This paper revisits the themes of an influential 1993 review regarding the factors shaping the mental health and psychosocial well-being of refugees to take stock of developments in the evidence base and conceptualisation of issues for refugee children over the last 25 years. Methods: The study deployed a systematic search strategy. This initially identified 784 papers, which was reduced to 65 studies following application of inclusion and exclusion criteria. We used a later iteration of Bronfenbrenner's bioecological model of human development-the PPCT model-to consolidate evidence. Results: We identify a range of risk and protective factors operating at individual, familial, community and institutional and policy levels that influence outcomes for refugee children. The dynamics shaping the interaction of these influences are linked to the life course principles of socio-historical time and developmental age, proximal processes and child agency. Conclusions: Actions at individual, familial, community, school, institutional and policy levels all have potential traction on mental health and psychosocial well-being of refugee children. However, evidence suggests that greatest impact will be secured by multilevel interventions addressing synergies between ecological systems, approaches engaging proximal processes (including parenting programmes) and interventions facilitating the agency of the developing refugee child.
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In light of the recent Ebola epidemic, Francesco Checchi and colleagues argue that the World Health Organization’s response to health emergencies is not fit for purpose and put forward six proposals to reform WHO’s crisis response.
Research Interests:
Background: Yobe State has faced severe disruption of its health service as a result of the Boko Haram insurgency. A systems dynamics analysis was conducted to identify key pathways of threat to provision and emerging pathways of response... more
Background: Yobe State has faced severe disruption of its health service as a result of the Boko Haram insurgency. A systems dynamics analysis was conducted to identify key pathways of threat to provision and emerging pathways of response and adaptation.
Research Interests:
Abstract BACKGROUND: Strengthening health research capacity in low- and middle-income countries remains a major policy goal. The Health Research Capacity Strengthening (HRCS) Global Learning (HGL) program of work documented experiences... more
Abstract
BACKGROUND:
Strengthening health research capacity in low- and middle-income countries remains a major policy goal. The Health Research Capacity Strengthening (HRCS) Global Learning (HGL) program of work documented experiences of HRCS across sub-Saharan Africa.
METHODS:
We reviewed findings from HGL case studies and reflective papers regarding the dynamics of HRCS. Analysis was structured with respect to common challenges in such work, identified through a multi-dimensional scaling analysis of responses from 37 participants at the concluding symposium of the program of work.
RESULTS:
Symposium participants identified 10 distinct clusters of challenges: engaging researchers, policymakers, and donors; securing trust and cooperation; finding common interest; securing long-term funding; establishing sustainable models of capacity strengthening; ensuring Southern ownership; accommodating local health system priorities and constraints; addressing disincentives for academic engagement; establishing and retaining research teams; and sustaining mentorship and institutional support. Analysis links these challenges to three key and potentially competing drivers of the political economy of health research: an enduring model of independent researchers and research leaders, the globalization of knowledge and the linked mobility of (elite) individuals, and institutionalization of research within universities and research centres and, increasingly, national research and development agendas.
CONCLUSIONS:
We identify tensions between efforts to embrace the global 'Community of Science' and the promotion and protection of national and institutional agendas in an unequal global health research environment. A nuanced understanding of the dynamics and implications of the uneven global health research landscape is required, along with a willingness to explore pragmatic models that seek to balance these competing drivers
BACKGROUND:
Strengthening health research capacity in low- and middle-income countries remains a major policy goal. The Health Research Capacity Strengthening (HRCS) Global Learning (HGL) program of work documented experiences of HRCS across sub-Saharan Africa.
METHODS:
We reviewed findings from HGL case studies and reflective papers regarding the dynamics of HRCS. Analysis was structured with respect to common challenges in such work, identified through a multi-dimensional scaling analysis of responses from 37 participants at the concluding symposium of the program of work.
RESULTS:
Symposium participants identified 10 distinct clusters of challenges: engaging researchers, policymakers, and donors; securing trust and cooperation; finding common interest; securing long-term funding; establishing sustainable models of capacity strengthening; ensuring Southern ownership; accommodating local health system priorities and constraints; addressing disincentives for academic engagement; establishing and retaining research teams; and sustaining mentorship and institutional support. Analysis links these challenges to three key and potentially competing drivers of the political economy of health research: an enduring model of independent researchers and research leaders, the globalization of knowledge and the linked mobility of (elite) individuals, and institutionalization of research within universities and research centres and, increasingly, national research and development agendas.
CONCLUSIONS:
We identify tensions between efforts to embrace the global 'Community of Science' and the promotion and protection of national and institutional agendas in an unequal global health research environment. A nuanced understanding of the dynamics and implications of the uneven global health research landscape is required, along with a willingness to explore pragmatic models that seek to balance these competing drivers
Research Interests:
Introduction: Nigeria has one of the highest maternal mortality ratios in the world. Poor health outcomes are linked to weak health infrastructure, barriers to service access, and consequent low rates of service utilization. In the... more
Introduction: Nigeria has one of the highest maternal mortality ratios in the world. Poor health outcomes are linked to
weak health infrastructure, barriers to service access, and consequent low rates of service utilization. In the northern state
of Jigawa, a pilot study was conducted to explore the feasibility of deploying resident female Community Health
Extension Workers (CHEWs) to rural areas to provide essential maternal, newborn, and child health services.
Methods: Between February and August 2011, a quasi-experimental design compared service utilization in the pilot
community of Kadawawa, which deployed female resident CHEWs to provide health post services, 24/7 emergency
access, and home visits, with the control community of Kafin Baka. In addition, we analyzed data from the preceding
year in Kadawawa, and also compared service utilization data in Kadawawa from 2008–2010 (before introduction of
the pilot) with data from 2011–2013 (during and after the pilot) to gauge sustainability of the model.
Results: Following deployment of female CHEWs to Kadawawa in 2011, there was more than a 500% increase in rates
of health post visits compared with 2010, from about 1.5 monthly visits per 100 population to about 8 monthly visits per
100. Health post visit rates were between 1.4 and 5.5 times higher in the intervention community than in the control
community. Monthly antenatal care coverage in Kadawawa during the pilot period ranged from 11.9% to 21.3%, up
from 0.9% to 5.8% in the preceding year. Coverage in Kafin Baka ranged from 0% to 3%. Facility-based deliveries by a
skilled birth attendant more than doubled in Kadawawa compared with the preceding year (105 vs. 43 deliveries total,
respectively). There was evidence of sustainability of these changes over the 2 subsequent years.
Conclusion: Community-based service delivery through a resident female community health worker can increase
health service utilization in rural, hard-to-reach areas.
weak health infrastructure, barriers to service access, and consequent low rates of service utilization. In the northern state
of Jigawa, a pilot study was conducted to explore the feasibility of deploying resident female Community Health
Extension Workers (CHEWs) to rural areas to provide essential maternal, newborn, and child health services.
Methods: Between February and August 2011, a quasi-experimental design compared service utilization in the pilot
community of Kadawawa, which deployed female resident CHEWs to provide health post services, 24/7 emergency
access, and home visits, with the control community of Kafin Baka. In addition, we analyzed data from the preceding
year in Kadawawa, and also compared service utilization data in Kadawawa from 2008–2010 (before introduction of
the pilot) with data from 2011–2013 (during and after the pilot) to gauge sustainability of the model.
Results: Following deployment of female CHEWs to Kadawawa in 2011, there was more than a 500% increase in rates
of health post visits compared with 2010, from about 1.5 monthly visits per 100 population to about 8 monthly visits per
100. Health post visit rates were between 1.4 and 5.5 times higher in the intervention community than in the control
community. Monthly antenatal care coverage in Kadawawa during the pilot period ranged from 11.9% to 21.3%, up
from 0.9% to 5.8% in the preceding year. Coverage in Kafin Baka ranged from 0% to 3%. Facility-based deliveries by a
skilled birth attendant more than doubled in Kadawawa compared with the preceding year (105 vs. 43 deliveries total,
respectively). There was evidence of sustainability of these changes over the 2 subsequent years.
Conclusion: Community-based service delivery through a resident female community health worker can increase
health service utilization in rural, hard-to-reach areas.
Research Interests:
Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and... more
Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial.
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The field of mental health and psychosocial support (MHPSS) in humanitarian emergencies has shown remarkable development over the last two decades.1 Mental health was once a notable omission from the health priorities to be addressed in... more
The field of mental health and psychosocial support (MHPSS) in humanitarian emergencies has shown remarkable development over the last two decades.1 Mental health was once a notable omission from the health priorities to be addressed in the context of humanitarian response (Ager 1999 ; PWG 2002 ). Humanitarian work was focused principally on addressing material needs, implicitly judging non-material needs as of lower priority in acute emergencies and more challenging to address, being subject to local cultural variation (Harrell-Bond 1986 ). Now, however, MHPSS has been firmly established— viewed within a broader framing of the psychosocial well-being of communities impacted by crisis— as a key sector of humanitarian response (Mollica et al. 2004 ).
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Expatriate humanitarian aid workers are often exposed to traumatic events and human suffering in the context of their deployments. Internal resources, such as having recourse to a transcendent spiritual framework, may play an important... more
Expatriate humanitarian aid workers are often exposed to traumatic events and human suffering in the context of their deployments. Internal resources, such as having recourse to a transcendent spiritual framework, may play an important part in creating a meaningful perspective on the work and developing coping strategies to overcome challenging experiences. Aid workers from agencies based in North America and Europe participated in a longitudinal study of stress and mental health between 2005 and 2009 (Lopes Cardozo et al., 2012). Participants completed assessments of spiritual transcendence, trauma exposure, psychiatric distress, and posttraumatic life changes at predeployment (n = 212), postdeployment (n = 170), and a 3- to 6-month follow-up assessment (n = 154). Latent class growth analysis indicated 3 distinct trajectories of spiritual changes across the sample: (1) a group with high spiritual transcendence at predeployment with small, but significant, decreases over time; (2) a group with moderate and stable spiritual transcendence scores; and (3) a group with low and slightly decreasing spiritual transcendence scores over the study period. Participants who reported a religious affiliation were more likely to be in the high spiritual transcendence group, and different trajectories were not associated with likelihood of psychiatric distress at postdeployment or follow-up. However, those reporting higher spiritual transcendence were more likely to report positive life changes following their deployments. Findings suggest that spiritual transcendence was relatively stable in this sample, and that aid workers with greater spiritual transcendence may be more oriented toward personal growth after trauma exposure in their work. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
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Resilience research with war-affected populations has long conceptualized resilience as the absence of psychopathology and operationalized it by use of standardized measures. However, literature on resilience increasingly highlights the... more
Resilience research with war-affected populations has long conceptualized resilience as the absence of psychopathology and operationalized it by use of standardized measures. However, literature on resilience increasingly highlights the importance of also including indicators of positively valued functioning as well as contextually sensitive indicators of resilience. This study used a participatory approach to examine the contextual conceptualization of youth resilience in the aftermath of war in northern Uganda, as defined by groups of stakeholders (youths, parents, elders, leaders, teachers) in four communities. The results identify 40 indicators covering a multiplicity of domains of functioning. The rationales behind these indicators were clustered into the broad themes: progress, self-reliance, social connectedness, morality, health, and comfort. The findings suggest that positively and negatively valued aspects of functioning are both key to conceptualizing resilience, and indicate the importance of including contextually distinguished indicators. The findings further point to the role of individual and collective processes in the construction of resilience, and to the need to take into account the contexts wherein resilience is conceptualized and observed. This study generated contextually sensitive indicators of young people's resilience, which can be used, complementary to existing measures of functioning, to provide a more comprehensive and culturally sensitive view of youths' resilience in the wake of war adversity.
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© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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The Partnership for Reviving Routine Immunization in Northern Nigeria - Maternal, Newborn and Child Health initiative supports efforts by the government of Nigeria to bridge primary health care (PHC) policies and services at three levels... more
The Partnership for Reviving Routine Immunization in Northern Nigeria - Maternal, Newborn and Child Health initiative supports efforts by the government of Nigeria to bridge primary health care (PHC) policies and services at three levels of government: federal, state and local. The paper suggests that understandings informed by complexity theory and complex adaptive systems have been helpful in shaping policy and programme design across these levels. To illustrate this, three initiatives are explored: Bringing PHC under one roof, enhancing access to funding provided by the Global Alliance for Vaccines and Immunization, and strengthening the midwives service scheme. These initiatives have demonstrated how concepts and experience developed at subnational level can influence national policy and practice, and how work at subnational levels can add value to nationally conceived and nationally driven plans for PHC.
Research Interests:
Recent years have seen significant growth in both the size and profile of the humanitarian sector. However, little research has focused upon the constructions of humanitarian practice negotiated by agencies and their workers that serve to... more
Recent years have seen significant growth in both the size and profile of the humanitarian sector. However, little research has focused upon the constructions of humanitarian practice negotiated by agencies and their workers that serve to sustain engagement in the face personal challenges and critique of the humanitarian enterprise. This study used the public narrative of 129 website postings by humanitarian workers deployed with the health-focused international humanitarian organization Médecins Sans Frontières (MSF) to identify recurrent themes in personal, organizationally-condoned, public discourse regarding humanitarian practice. Data represented all eligible postings from a feature on the agency's UK website from May 2002 to April 2012. The text of postings was analysed with respect to emergent themes on an iterative basis. Comprehensive coding of material was achieved through a thematic structure that reflected the core domains of project details, the working environment, characteristics of beneficiaries and recurrent motivational sub-texts. Features of the co-construction of narratives include language serving to neutralize complex political contexts; the specification of barriers as substantive but surmountable; the dominance of the construct of national-international in understanding the operation of teams; intense personal identification with organization values; and the use of resilience as a framing of beneficiary adaptation and perseverance in conditions that--from an external perspective--warrant despair and withdrawal. Recurrent motivational sub-texts include 'making a difference' and contrasts with 'past professional constraints' and 'ordinary life back home.' The prominence of these sub-texts not only highlights key personal agendas but also suggests--notwithstanding policy initiatives regarding stronger contextual rooting and professionalism--continuing organizational emphasis on externality and volunteerism. Overall, postings illustrate a complex co-construction of medical humanitarianism that reflects a negotiated script of personal and organizational understandings adapted to evolving demands of humanitarian engagement.
Research Interests:
Background This paper reports on the use of a “neighborhood method” to measure the nature and incidence of violence against women and girls in post-conflict Liberia. Methods The study population comprised females in Montserrado and Nimba... more
Background
This paper reports on the use of a “neighborhood method” to measure the nature and incidence of violence against women and girls in post-conflict Liberia.
Methods
The study population comprised females in Montserrado and Nimba counties. Study participants were randomly selected for interviews using multi-stage cluster sampling. 30 clusters of households were sampled in each county. Information on incidents of domestic violence and rape within the preceding 18 months was collected with regard to females of all ages in the respondent’s household, and those of her four closest neighbors to make up the full sample.
Findings
Households in the sample contained 7015 females (1687 girls, 4586 women, 742 age missing) in Montserrado and 6632 (2070 girls, 4167 women, 95 age missing) in Nimba. In the previous 18 months 54.1% (CI 53.1-55.1) and 55.8% (CI 54.8-56.8) of females in Montserrado and Nimba respectively were indicated to have experienced non-sexual domestic abuse; 19.4% (CI 18.6-20.2) and 26.0% (CI 25.1-26.9) of females in Montserrado and Nimba respectively to have been raped outside of marriage; and 72.3% (CI 70.7-73.9) and 73.8% (CI 72.0-75.7) of married or separated women in Montserrado and Nimba respectively to have experienced marital rape. Husbands and boyfriends were reported as the perpetrators of the vast majority of reported violence. Strangers were reported to account for less than 2% of the perpetrators of rape in either county. Incidents were most commonly disclosed to other family members or to friends and neighbors, and less often to formal authorities such as the police, court or community leaders. Incidents were approaching fifty times more likely to be reported to police if perpetrated by strangers rather than intimate partners.
Conclusions
Violence against women and girls is widespread in the areas studied. Programming needs to address the fact that this violence is primarily occurring in the household, where most incidents go unreported outside the immediate family or social circle. Police and hospital reports severely under-represent these known perpetrators. Inter-interviewer variance and differences in reports for self and neighbors for some outcomes caution the precision and validity of some estimates. However, the potential utility of the neighborhood method for estimating prevalence rates with an accuracy suitable for programmatic purposes in conflict-affected and post-conflict settings is noted.
This paper reports on the use of a “neighborhood method” to measure the nature and incidence of violence against women and girls in post-conflict Liberia.
Methods
The study population comprised females in Montserrado and Nimba counties. Study participants were randomly selected for interviews using multi-stage cluster sampling. 30 clusters of households were sampled in each county. Information on incidents of domestic violence and rape within the preceding 18 months was collected with regard to females of all ages in the respondent’s household, and those of her four closest neighbors to make up the full sample.
Findings
Households in the sample contained 7015 females (1687 girls, 4586 women, 742 age missing) in Montserrado and 6632 (2070 girls, 4167 women, 95 age missing) in Nimba. In the previous 18 months 54.1% (CI 53.1-55.1) and 55.8% (CI 54.8-56.8) of females in Montserrado and Nimba respectively were indicated to have experienced non-sexual domestic abuse; 19.4% (CI 18.6-20.2) and 26.0% (CI 25.1-26.9) of females in Montserrado and Nimba respectively to have been raped outside of marriage; and 72.3% (CI 70.7-73.9) and 73.8% (CI 72.0-75.7) of married or separated women in Montserrado and Nimba respectively to have experienced marital rape. Husbands and boyfriends were reported as the perpetrators of the vast majority of reported violence. Strangers were reported to account for less than 2% of the perpetrators of rape in either county. Incidents were most commonly disclosed to other family members or to friends and neighbors, and less often to formal authorities such as the police, court or community leaders. Incidents were approaching fifty times more likely to be reported to police if perpetrated by strangers rather than intimate partners.
Conclusions
Violence against women and girls is widespread in the areas studied. Programming needs to address the fact that this violence is primarily occurring in the household, where most incidents go unreported outside the immediate family or social circle. Police and hospital reports severely under-represent these known perpetrators. Inter-interviewer variance and differences in reports for self and neighbors for some outcomes caution the precision and validity of some estimates. However, the potential utility of the neighborhood method for estimating prevalence rates with an accuracy suitable for programmatic purposes in conflict-affected and post-conflict settings is noted.
Research Interests:
Research Interests:
Expatriate aid workers (n = 214) representing 19 nongovernmental organizations (NGOs) completed a redeployment survey, including measures of mental health (depression, anxiety, and posttraumatic stress disorder [PTSD]); risk factors... more
Expatriate aid workers (n = 214) representing 19 nongovernmental organizations (NGOs) completed a redeployment survey, including measures of mental health (depression, anxiety, and posttraumatic stress disorder [PTSD]); risk factors
(childhood trauma, family risk, and adult trauma exposure); and resilience factors (coping, social support, and healthy lifestyle) to assess their baseline mental health during preparation for deployment. Multiple regression analysis indicated that childhood trauma/family risk was not significantly related to depression, anxiety, or PTSD symptoms when controlling for report of prior mental illness; yet, adult trauma exposure was significantly related to all three. Social support contributed significant variance to depression and PTSD. NGOs can help applicants recognize the effects of recent trauma and the resilience provided by a healthy social network.
(childhood trauma, family risk, and adult trauma exposure); and resilience factors (coping, social support, and healthy lifestyle) to assess their baseline mental health during preparation for deployment. Multiple regression analysis indicated that childhood trauma/family risk was not significantly related to depression, anxiety, or PTSD symptoms when controlling for report of prior mental illness; yet, adult trauma exposure was significantly related to all three. Social support contributed significant variance to depression and PTSD. NGOs can help applicants recognize the effects of recent trauma and the resilience provided by a healthy social network.
In the aftermath of the civil war that extended from 1983–2009, humanitarian organizations provided aid to the conflict-affected population of the Vanni region in northern Sri Lanka. In August, 2010, a needs assessment was conducted to... more
In the aftermath of the civil war that extended from 1983–2009, humanitarian organizations provided aid to the conflict-affected population of the Vanni region in northern Sri Lanka. In August, 2010, a needs assessment was conducted to determine the mental-health status of Sri Lankan national humanitarian aid staff working in conditions of stress and hardship, and consider contextual and organizational characteristics influencing such status. A total of 398 staff members from nine organizations working in the Vanni area participated in the survey, which assessed stress, work characteristics, social support, coping styles, and symptoms of psychological distress. Exposure to traumatic, chronic, and secondary stressors was common. Nineteen percent of the population met criteria for posttraumatic stress disorder (PTSD), 53% of participants reported elevated anxiety symptoms, and 58% reported elevated depression symptoms. Those reporting high levels of support from their organizations were less likely to suffer depression and PTSD symptoms than those reporting lower levels of staff support (OR = 0.23, p < .001) and (OR = 0.26, p < .001), respectively. Participants who were age 55 or older were significantly less likely to suffer anxiety symptoms than those who were between 15 and 34 years of age (OR = 0.13, p = .011). Having experienced travel difficulties was significantly associated with more anxiety symptoms (OR = 3.35, p < .001). It was recommended that organizations provide stress-management training and increase support to their staff. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Research Interests:
Background: There has been an 8-fold increase in use of the term resilience within scientific and scholar literature over the last twenty years. The arena of public policy has also seen increasing use made of the concept, both with... more
Background: There has been an 8-fold increase in use of the term resilience within scientific and scholar literature over the last twenty years. The arena of public policy has also seen increasing use made of the concept, both with respect to child well-being and development and wider issues.
Method: A focal sample of literature comprising 108 papers addressing public policy implications of work on child resilience was identified by a structured bibliographic search. Results: This literature suggests that current work: is characterized by a breadth of sectoral engagement across the fields of education, social work, and health; demonstrates diversity with regard to the systemic levels – individual (biological and psychological), communal (including systems of faith and cultural identity),
institutional and societal – with which it engages; but is based more upon conceptual rather than empirical analysis. Major themes of policy recommendation target strengthened family dynamics, increased capacity for counseling and mental health services, supportive school environments, development of community programs, promotion of socioeconomic improvement and adoption of a more comprehensive conception of resilience. Evaluations of resiliency-informed policy initiatives are limited
in number, with greatest rigor in design associated with more discrete programmatic interventions. Conclusion: A number of strategies to strengthen research-policy linkages are identified. These include greater commitment to operationalize indicators of resilience at all levels of analysis; more coherent engagement with the policy making process through explicit knowledge translation initiatives;
and developing complex adaptive systems models amenable to exploring policy scenarios. Keywords: Resilience, recommendations, policy, (complex adaptive) systems, knowledge transfer.
Method: A focal sample of literature comprising 108 papers addressing public policy implications of work on child resilience was identified by a structured bibliographic search. Results: This literature suggests that current work: is characterized by a breadth of sectoral engagement across the fields of education, social work, and health; demonstrates diversity with regard to the systemic levels – individual (biological and psychological), communal (including systems of faith and cultural identity),
institutional and societal – with which it engages; but is based more upon conceptual rather than empirical analysis. Major themes of policy recommendation target strengthened family dynamics, increased capacity for counseling and mental health services, supportive school environments, development of community programs, promotion of socioeconomic improvement and adoption of a more comprehensive conception of resilience. Evaluations of resiliency-informed policy initiatives are limited
in number, with greatest rigor in design associated with more discrete programmatic interventions. Conclusion: A number of strategies to strengthen research-policy linkages are identified. These include greater commitment to operationalize indicators of resilience at all levels of analysis; more coherent engagement with the policy making process through explicit knowledge translation initiatives;
and developing complex adaptive systems models amenable to exploring policy scenarios. Keywords: Resilience, recommendations, policy, (complex adaptive) systems, knowledge transfer.
Research Interests:
This study examined the mental health of national humanitarian aid workers in northern Uganda and contextual and organizational factors predicting well-being. A cross-sectional survey was conducted among 376 national staff working for 21... more
This study examined the mental health of national humanitarian aid workers in northern Uganda and contextual and organizational factors predicting well-being. A cross-sectional survey was conducted among 376 national staff working for 21 humanitarian aid agencies. Over 50% of workers experienced 5 or more categories of traumatic events. Although, in the absence of clinical interviews, no clinical diagnoses were able to be confirmed, 68%, 53%, and 26% of respondents reported symptom levels associated with high risk for depression, anxiety disorders, and posttraumatic stress disorder (PTSD), respectively. Between one quarter and one half of respondents reported symptom levels associated with high risk regarding measured dimensions of burnout. Female workers reported significantly more symptoms of anxiety, depression, PTSD, and emotional exhaustion than males. Workers with the United Nations and related agencies reported fewest symptoms. Higher levels of social support, stronger team cohesion, and reduced exposure to chronic stressors were associated with improved mental health. National humanitarian staff members in Gulu have high exposure to chronic and traumatic stress and high risk of a range of poor mental health outcomes. Given that work-related factors appear to influence the relationship between the two strategies are suggested to support the well-being of national staff working in such contexts.
Copyright © 2012 International Society for Traumatic Stress Studies.
Copyright © 2012 International Society for Traumatic Stress Studies.
Research Interests:
Abstract OBJECTIVES: To strengthen the evidence-base for policy and practice for support of children outside of family care requires effective, efficient and sustainable mechanisms for monitoring and evaluation. Toward that end, two core... more
Abstract
OBJECTIVES:
To strengthen the evidence-base for policy and practice for support of children outside of family care requires effective, efficient and sustainable mechanisms for monitoring and evaluation. Toward that end, two core questions guided a systematic review of evidence: What strategies are appropriate for monitoring the needs and circumstances of children outside of family care? What strategies are suitable for evaluating the impact of the programs intended to serve such children?
METHODS:
A structured document search and review process was implemented within the context of the U.S. Government Evidence Summit on Protecting Children Outside of Family Care of December 2011. Through successive review phases, initially using structured screening criteria, followed by thematic review by an expert panel, 73 documents were identified for analysis.
RESULTS:
Analysis of models and strategies indicates that: (1) tools are available for assessment of children's needs, but require refining to accommodate contextual demands; (2) well-designed evaluations are able to identify the influence of assistance; (3) long-term follow-up is crucial to developing a strong evidence-base on effective strategies; and (4) insights into systems-wide monitoring mechanisms are emerging. In addition to describing key components of monitoring and evaluation strategies, findings draw attention to the evaluation of children's resiliency and protective factors, community based monitoring and the role of caregivers, as well as concerns over the stigmatization of children (through data collection methodologies encouraging the 'labeling' of children) and the importance of children's participation.
CONCLUSIONS:
Fostering a stronger evidence-base to improve protection for vulnerable children requires evaluations that are integrated into program development, use context-appropriate methodologies able to assess intervention scalability and employ more longitudinal designs to explore children's trajectories. Further, future programming will benefit from systems-wide data coordination and international comparisons, research that emphasizes coping and resilience mechanisms, and children's participation in monitoring and evaluation.
Copyright © 2012 Elsevier Ltd. All rights reserved.
OBJECTIVES:
To strengthen the evidence-base for policy and practice for support of children outside of family care requires effective, efficient and sustainable mechanisms for monitoring and evaluation. Toward that end, two core questions guided a systematic review of evidence: What strategies are appropriate for monitoring the needs and circumstances of children outside of family care? What strategies are suitable for evaluating the impact of the programs intended to serve such children?
METHODS:
A structured document search and review process was implemented within the context of the U.S. Government Evidence Summit on Protecting Children Outside of Family Care of December 2011. Through successive review phases, initially using structured screening criteria, followed by thematic review by an expert panel, 73 documents were identified for analysis.
RESULTS:
Analysis of models and strategies indicates that: (1) tools are available for assessment of children's needs, but require refining to accommodate contextual demands; (2) well-designed evaluations are able to identify the influence of assistance; (3) long-term follow-up is crucial to developing a strong evidence-base on effective strategies; and (4) insights into systems-wide monitoring mechanisms are emerging. In addition to describing key components of monitoring and evaluation strategies, findings draw attention to the evaluation of children's resiliency and protective factors, community based monitoring and the role of caregivers, as well as concerns over the stigmatization of children (through data collection methodologies encouraging the 'labeling' of children) and the importance of children's participation.
CONCLUSIONS:
Fostering a stronger evidence-base to improve protection for vulnerable children requires evaluations that are integrated into program development, use context-appropriate methodologies able to assess intervention scalability and employ more longitudinal designs to explore children's trajectories. Further, future programming will benefit from systems-wide data coordination and international comparisons, research that emphasizes coping and resilience mechanisms, and children's participation in monitoring and evaluation.
Copyright © 2012 Elsevier Ltd. All rights reserved.
Research Interests:
Research Interests:
The purpose of this research as a mid-term review to determine the strengths, weaknesses, opportunities and threats for the Indigo programme from the perspectives of the partners, students, supervisors and the project management team.... more
The purpose of this research as a mid-term review to determine the strengths, weaknesses, opportunities and threats for the Indigo programme from the perspectives of the partners, students, supervisors and the project management team. This article draws upon the research findings and suggests that the reflections and experiences of a broad range of stakeholders will not only facilitate direct programmatic learning, but also inform models of partnership in health research capacity building more generally. -
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
Research Interests:
A survey of global health experts attending an invited meeting provided a means to map key issues perceived to be shaping emerging global public health agendas. Eighty-five participants proposed three major issues likely to have the most... more
A survey of global health experts attending an invited meeting provided a means to map key issues perceived to be shaping emerging global public health agendas. Eighty-five participants proposed three major issues likely to have the most significant impact on the field of global health in the coming years. Six raters grouped the resultant items, with multi-dimensional scaling (MDS) analysis producing a composite two-dimensional map depicting the overall patterning of items. Thematic clusters were incorporated within four major domains: changing health and prevention needs (15% of items), globalisation and global health governance (33% of items), transforming health systems (30% of items) and innovations in science and technology (7% of items). The remaining 15% of items addressed forms of environmental change. The distribution of items across domains was not significantly influenced by the current professional role of participants, their current location in the 'global north' or 'global south' or their region of focus (although the latter approached threshold significance). The constraints on interpretation imposed by the biases influencing participation in the survey are noted. However, the exercise suggests the potential for coherently defining shared agendas for diverse stakeholders to address emerging priorities. The closer integration of environmental concerns with other global public issues is clearly warranted.
Research Interests:
Maternal mortality ratios in northern Nigeria are among the worst in the world, over 1,000 per 100,000 live births in 2008, with a very low level and quality of maternity services. In 2009, we carried out a study of the reasons for low... more
Maternal mortality ratios in northern Nigeria are among the worst in the world, over 1,000 per 100,000 live births in 2008, with a very low level and quality of maternity services. In 2009, we carried out a study of the reasons for low utilisation of antenatal and delivery care among women with recent pregnancies, and the socio-cultural beliefs and practices that influenced them. The study included a quantitative survey of 6,882 married women, 119 interviews and 95 focus group discussions with community and local government leaders, traditional birth attendants, women who had attended maternity services and health care providers. Only 26% of the women surveyed had received any antenatal care and only 13% delivered in a facility with a skilled birth attendant for their most recent pregnancy. However, those who had had at least one antenatal consultation were 7.6 times more likely to deliver with a skilled birth attendant. Most pregnant women had little or no contact with the health care system for reasons of custom, lack of perceived need, distance, lack of transport, lack of permission, cost and/or unwillingness to see a male doctor. Based on these findings, we designed and implemented an integrated package of interventions that included upgrading antenatal, delivery and emergency obstetric care; providing training, supervision and support for new midwives in primary health centres and hospitals; and providing information to the community about safe pregnancy and delivery and the use of these services.
Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Research Interests:
Abstract BACKGROUND: Children in northern Uganda have undergone significant psychosocial stress during the region's lengthy conflict. A Psychosocial Structured Activities (PSSA) program was implemented in 21 schools identified as... more
Abstract
BACKGROUND:
Children in northern Uganda have undergone significant psychosocial stress during the region's lengthy conflict. A Psychosocial Structured Activities (PSSA) program was implemented in 21 schools identified as amongst those most severely affected by conflict-induced displacement across Gulu and Amuru Districts. The PSSA intervention comprised a series of 15 class sessions designed to progressively increase children's resilience through structured activities involving drama, movement, music and art (with additional components addressing parental support and community involvement).
METHOD:
Eight schools were selected by random quota sampling from those schools receiving the PSSA intervention. Two hundred and three children were identified in these schools as being scheduled to receive intervention, and were followed up 12 months later following engagement with PSSA activities. A comparison group comprised 200 children selected from schools that had met inclusion criteria for receipt of intervention, but were not scheduled for intervention coverage until later. Preliminary research used participatory focus group methodology to determine local indicators of child well-being as viewed by parents, teachers, and children respectively. Pre- and post- assessments focused on ratings for each child - by parents, teachers and children - with respect to these indicators.
RESULTS:
Significant increases in ratings of child well-being were observed in both intervention and comparison groups over a 12-month period. However, the well-being of children who had received the PSSA intervention increased significantly more than for children in the comparison group, as judged by child and parent (but not teacher) report. This effect was evident despite considerable loss-to-follow-up at post-testing as a result of return of many households to communities of origin.
CONCLUSION:
General improvement in child well-being over a 12-month period suggests that recovery and reconstruction efforts in Northern Uganda following the onset of peace had a substantive impact on the lives of children. However, exposure to the PSSA program had an additional positive impact on child well-being, suggesting its value in post-conflict recovery contexts.
© 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.
BACKGROUND:
Children in northern Uganda have undergone significant psychosocial stress during the region's lengthy conflict. A Psychosocial Structured Activities (PSSA) program was implemented in 21 schools identified as amongst those most severely affected by conflict-induced displacement across Gulu and Amuru Districts. The PSSA intervention comprised a series of 15 class sessions designed to progressively increase children's resilience through structured activities involving drama, movement, music and art (with additional components addressing parental support and community involvement).
METHOD:
Eight schools were selected by random quota sampling from those schools receiving the PSSA intervention. Two hundred and three children were identified in these schools as being scheduled to receive intervention, and were followed up 12 months later following engagement with PSSA activities. A comparison group comprised 200 children selected from schools that had met inclusion criteria for receipt of intervention, but were not scheduled for intervention coverage until later. Preliminary research used participatory focus group methodology to determine local indicators of child well-being as viewed by parents, teachers, and children respectively. Pre- and post- assessments focused on ratings for each child - by parents, teachers and children - with respect to these indicators.
RESULTS:
Significant increases in ratings of child well-being were observed in both intervention and comparison groups over a 12-month period. However, the well-being of children who had received the PSSA intervention increased significantly more than for children in the comparison group, as judged by child and parent (but not teacher) report. This effect was evident despite considerable loss-to-follow-up at post-testing as a result of return of many households to communities of origin.
CONCLUSION:
General improvement in child well-being over a 12-month period suggests that recovery and reconstruction efforts in Northern Uganda following the onset of peace had a substantive impact on the lives of children. However, exposure to the PSSA program had an additional positive impact on child well-being, suggesting its value in post-conflict recovery contexts.
© 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.
Research Interests:
Abstract OBJECTIVES: The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to... more
Abstract
OBJECTIVES:
The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of assessments that effectively identify, and suggest means of response to, threats to children's rights and well-being in emergency settings.
METHODS:
In the context of a field evaluation of an inter-agency resource kit, crisis settings where an inter-agency assessment of child protection had been considered in the period August 2008 to July 2010 were identified. Email correspondence, telephone-based structured interviews and documentary review collated information from child protection coordinating agencies from a total of twenty sites, the minority of which had proceeded to complete an assessment. This paper presents case studies of the experience in Georgia (following the conflict between Russian and Georgian forces in August 2008), Gaza (following the Israeli military incursion beginning in December 2008), Haiti (following the earthquake of January 2010), and Yemen (following the ceasefire agreement between the government and rebel forces in early 2010). CASE STUDY FINDINGS: In each setting the context of the humanitarian emergency is outlined. The processes of the planning (and, where appropriate, implementation) of the child protection assessment is described. Where available, the findings of the child protection assessment and their use in shaping interventions are summarized.
PRACTICE IMPLICATIONS:
Case studies document experience across humanitarian settings widely divergent in terms of the nature of the emergency, social-political context, and institutional capacity. Despite such differences, analysis suggests securing inter-agency coordination, preparation and capacity building, and means of ensuring timeliness of findings to be recurrent themes in the effective mobilization of an effective assessment able to inform programming.
Copyright © 2011 Elsevier Ltd. All rights reserved.
OBJECTIVES:
The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of assessments that effectively identify, and suggest means of response to, threats to children's rights and well-being in emergency settings.
METHODS:
In the context of a field evaluation of an inter-agency resource kit, crisis settings where an inter-agency assessment of child protection had been considered in the period August 2008 to July 2010 were identified. Email correspondence, telephone-based structured interviews and documentary review collated information from child protection coordinating agencies from a total of twenty sites, the minority of which had proceeded to complete an assessment. This paper presents case studies of the experience in Georgia (following the conflict between Russian and Georgian forces in August 2008), Gaza (following the Israeli military incursion beginning in December 2008), Haiti (following the earthquake of January 2010), and Yemen (following the ceasefire agreement between the government and rebel forces in early 2010). CASE STUDY FINDINGS: In each setting the context of the humanitarian emergency is outlined. The processes of the planning (and, where appropriate, implementation) of the child protection assessment is described. Where available, the findings of the child protection assessment and their use in shaping interventions are summarized.
PRACTICE IMPLICATIONS:
Case studies document experience across humanitarian settings widely divergent in terms of the nature of the emergency, social-political context, and institutional capacity. Despite such differences, analysis suggests securing inter-agency coordination, preparation and capacity building, and means of ensuring timeliness of findings to be recurrent themes in the effective mobilization of an effective assessment able to inform programming.
Copyright © 2011 Elsevier Ltd. All rights reserved.
Research Interests:
Abstract OBJECTIVES: What impact does the strengthening of child rights have on the experience and circumstances of children? CRC General Comment 13 emphasizes that defining measurable targets for improvements in child protection is a... more
Abstract
OBJECTIVES:
What impact does the strengthening of child rights have on the experience and circumstances of children? CRC General Comment 13 emphasizes that defining measurable targets for improvements in child protection is a key element of efforts to strengthen child rights and well-being across the world. This paper describes an attempt to identify key domains relevant to such mapping of child protection indicators, and the feasibility of collecting data-from existing data sources or otherwise-to complete a "National Child Protection Index Report" summarizing achievements and concerns at a national level.
METHODS:
A process of inter-agency consultation was facilitated by the CPC Learning Network to establish a template for the Index Report. The template was modeled on that used for the "Countdown to 2015" maternal, neonatal and child health initiative, aiming to capture indices not only of key protection risks but also implementation and coverage of key protection measures. The work drew on indicator development and policy initiatives by a number of international child protection agencies. The template developed was used as a basis to pilot national data collection in Indonesia and, at a sub-national level, in northern Uganda.
FINDINGS:
The template provides a concise summary of protection issues of relevance to a broad range of constituencies, global and national. However, in the pilot settings, existing routine data collection was inadequate to effectively populate a large proportion of indicators. Mechanisms of collating findings from discrete assessments-another potential source of data for completion of the index report-were also generally underdeveloped.
PRACTICE IMPLICATIONS:
In settings where state infrastructure allows the collection and analysis of routine data in such domains as health and economic activity, such efforts should be extended to the child protection sector. Discrete assessments by governmental or non-governmental agencies also provide significant potential for more effective sharing and collation of information. National Child Protection sub-clusters or equivalent structures can play an important role in facilitating both of these processes.
Copyright © 2011 Elsevier Ltd. All rights reserved.
OBJECTIVES:
What impact does the strengthening of child rights have on the experience and circumstances of children? CRC General Comment 13 emphasizes that defining measurable targets for improvements in child protection is a key element of efforts to strengthen child rights and well-being across the world. This paper describes an attempt to identify key domains relevant to such mapping of child protection indicators, and the feasibility of collecting data-from existing data sources or otherwise-to complete a "National Child Protection Index Report" summarizing achievements and concerns at a national level.
METHODS:
A process of inter-agency consultation was facilitated by the CPC Learning Network to establish a template for the Index Report. The template was modeled on that used for the "Countdown to 2015" maternal, neonatal and child health initiative, aiming to capture indices not only of key protection risks but also implementation and coverage of key protection measures. The work drew on indicator development and policy initiatives by a number of international child protection agencies. The template developed was used as a basis to pilot national data collection in Indonesia and, at a sub-national level, in northern Uganda.
FINDINGS:
The template provides a concise summary of protection issues of relevance to a broad range of constituencies, global and national. However, in the pilot settings, existing routine data collection was inadequate to effectively populate a large proportion of indicators. Mechanisms of collating findings from discrete assessments-another potential source of data for completion of the index report-were also generally underdeveloped.
PRACTICE IMPLICATIONS:
In settings where state infrastructure allows the collection and analysis of routine data in such domains as health and economic activity, such efforts should be extended to the child protection sector. Discrete assessments by governmental or non-governmental agencies also provide significant potential for more effective sharing and collation of information. National Child Protection sub-clusters or equivalent structures can play an important role in facilitating both of these processes.
Copyright © 2011 Elsevier Ltd. All rights reserved.
Research Interests:
This article argues that functional secularism frames the discourse of contemporary humanitarianism. While in principal ‘neutral' to religion, in practice this framing serves to marginalize religious language, practice and experience in... more
This article argues that functional secularism frames the discourse of contemporary humanitarianism. While in principal ‘neutral' to religion, in practice this framing serves to marginalize religious language, practice and experience in both the global and local conceptualization of humanitarian action. Illustrated with examples from a range of humanitarian contexts, it is argued that the resulting discourse fosters a humanitarian response that is ill-equipped to engage with dynamics of faith within displaced populations. Humanitarianism needs to acknowledge the advent of post-secularism signalled by many social theorists, and engage with greater awareness of the role of faith—both liberal materialist and religious—in addressing a range of issues of core relevance to the field: the clarification of core humanitarian values, the retention of a human rights framework able to define and protect human dignity, and appropriate means of addressing religious experience and well-being in the course of humanitarian programming.
Research Interests:
Current methods to estimate the incidence of gender-based violence in complex emergencies tend to rely on nonprobability samples. Population-based monitoring is undertaken relatively infrequently. This article provides a systematic review... more
Current methods to estimate the incidence of gender-based violence in complex emergencies tend to rely on nonprobability samples. Population-based monitoring is undertaken relatively infrequently. This article provides a systematic review of published literature that represents attempts to quantify the magnitude of gender-based violence in emergency settings. Searches adopted a Boolean procedure, which led to initial selection of material that was then reviewed against set criteria. Only 10 studies met the final criteria for inclusion. Intimate partner violence, physical violence, and rape were the three categories of violence most frequently measured. Rates of intimate partner violence tended to be quite high across all of the studies-much higher than most of the rates of wartime rape and sexual violence perpetrated by individuals outside of the home. Direct comparisons of rates of violence were hindered by different case definitions, recall periods, and other methodological features. Recommendations for future studies are offered based on lessons learned from the studies reviewed.
Research Interests:
Abstract BACKGROUND: Gender-based violence is viewed as a significant problem in conflict-affected regions throughout the world. However, humanitarian organizations typically have been unable to reliably estimate the incidence of rape,... more
Abstract
BACKGROUND:
Gender-based violence is viewed as a significant problem in conflict-affected regions throughout the world. However, humanitarian organizations typically have been unable to reliably estimate the incidence of rape, intimate partner violence and other forms of sexual abuse in such settings. Such estimates are required to inform programming in contexts such as northern Uganda.
METHODS:
We sought to establish incidence rates for gender-based violence in internally-displaced-persons camps in northern Uganda. The assessments involved a "neighbourhood methodology," in which adult female heads of household reported about their own, their sisters' and their neighbours' experiences. 299 households were selected for interview across four camps by using systematic random sampling.
FINDINGS:
Interviews were completed by 204 respondents (5 women having declined interview and 90 not having been successfully contacted). These respondents reported on themselves, a total of 268 sisters and 1206 neighbours. Reports with respect to these alternative populations produced estimates of overall incidence of intimate partner violence in the past year of 51.7% (95% CI 44.8 to 58.7; respondents), 44.0% (95% CI 41.2 to 46.9; respondents' sisters) and 36.5% (95% CI 30.7 to 42.3; respondents' neighbours). In the same period, estimates of incidence of forced sex by husbands were 41.0% (95% CI 34.2% to 47.8%), 22.1% (95% CI 17.0 to 27.2) and 25.1% (95% CI 22.5 to 27.6), respectively, with incidence of rape by a perpetrator other than an intimate partner estimated at 5.0% (95% CI 2.0% to 8.0%), 4.2% (95% CI 1.8 to 6.6) and 4.3% (95% CI 3.1 to 5.5), respectively.
INTERPRETATION:
Gender-based violence-particularly intimate partner violence-is commonplace in postconflict Uganda. The neighbourhood method provides a promising approach to estimating human right violations in humanitarian settings.
BACKGROUND:
Gender-based violence is viewed as a significant problem in conflict-affected regions throughout the world. However, humanitarian organizations typically have been unable to reliably estimate the incidence of rape, intimate partner violence and other forms of sexual abuse in such settings. Such estimates are required to inform programming in contexts such as northern Uganda.
METHODS:
We sought to establish incidence rates for gender-based violence in internally-displaced-persons camps in northern Uganda. The assessments involved a "neighbourhood methodology," in which adult female heads of household reported about their own, their sisters' and their neighbours' experiences. 299 households were selected for interview across four camps by using systematic random sampling.
FINDINGS:
Interviews were completed by 204 respondents (5 women having declined interview and 90 not having been successfully contacted). These respondents reported on themselves, a total of 268 sisters and 1206 neighbours. Reports with respect to these alternative populations produced estimates of overall incidence of intimate partner violence in the past year of 51.7% (95% CI 44.8 to 58.7; respondents), 44.0% (95% CI 41.2 to 46.9; respondents' sisters) and 36.5% (95% CI 30.7 to 42.3; respondents' neighbours). In the same period, estimates of incidence of forced sex by husbands were 41.0% (95% CI 34.2% to 47.8%), 22.1% (95% CI 17.0 to 27.2) and 25.1% (95% CI 22.5 to 27.6), respectively, with incidence of rape by a perpetrator other than an intimate partner estimated at 5.0% (95% CI 2.0% to 8.0%), 4.2% (95% CI 1.8 to 6.6) and 4.3% (95% CI 3.1 to 5.5), respectively.
INTERPRETATION:
Gender-based violence-particularly intimate partner violence-is commonplace in postconflict Uganda. The neighbourhood method provides a promising approach to estimating human right violations in humanitarian settings.
Research Interests:
This paper uses the foundation of the conceptual framework proposed by Ager and Strang (2004a, 2008) to reflect on the focus and findings of papers in this special issue on refugee integration and other recent work. Arguing that... more
This paper uses the foundation of the conceptual framework proposed by Ager and Strang (2004a, 2008) to reflect on the focus and findings of papers in this special issue on refugee integration and other recent work. Arguing that ‘mid-level theory’ of the sort presented in the framework provides a strong basis for structuring academic debate and dialogue with practitioners and policymakers, we identify four key issues that although of some current interest warrant further attention. First, we consider recent evidence from Europe and elsewhere on how prevailing notions of nationhood and citizenship determine understandings of integration, and argue that this powerfully shapes the social space available to refugees with regard to ‘belonging’. Second, we note the wide adoption of concepts of social capital in framing components of social connection in the context of integration, but suggest greater attention is paid to the manner in which bonds, bridges and links establish forms of reciprocity and trust in social relations. Third, we examine the notion that integration is a ‘two way’ process, and suggest how this might be expanded to embrace the multiplicity and fluidity of social meaning and identity. Fourth, we reflect on Hobfoll’s (1998) work on ‘resource acquisition spirals’ as a basis for effectively conceptualizing the dynamic interplay between factors mapped by the framework in shaping trajectories of integration.
Research Interests:
ABSTRACT This paper reports on an evaluation of a program in Sierra Leone that sought to support the community reintegration of young women and girls formerly associated with armed groups and forces. In the absence of baseline data, we... more
ABSTRACT This paper reports on an evaluation of a program in Sierra Leone that sought to support the community reintegration of young women and girls formerly associated with armed groups and forces. In the absence of baseline data, we used locally-derived indicators of reintegration and village timelines to conduct a retrospective cohort study of the progress of 142 girls and young women towards achievement of community reintegration following their experience of abduction. Although girls and young women in both intervention and comparison communities had made progress towards integration, the intervention was associated with improved mental health outcomes and higher ratings on some aspects of marriage quality. For those who had found the greatest challenges in reintegrating, the intervention additionally appeared to support community acceptance and inclusion in women's bondo activities.
Research Interests:
Thirty specialists in humanitarian work supporting the care and protection of children in crisis settings completed a 3-phase Delphi consultation. Proposals of best practice were elicited, reviewed, and rated by participants. A high level... more
Thirty specialists in humanitarian work supporting the care and protection of children in crisis settings completed a 3-phase Delphi consultation. Proposals of best practice were elicited, reviewed, and rated by participants. A high level of consensus support was reached for 55 statements. These statements emphasized utilization of existing resources, participation, and inclusivity. The influences of resilience theory, social ecology, and cultural sensitivity were clearly evident. The utilization of developmental theory could be strengthened in relation to more differentiated understanding of the operation of protective influences and conceptualization of such influences in terms of "adaptive systems." Wider research engagement by development scientists in diverse cultural settings and clear formulation of findings for practitioners and policy makers would further support evidence-based humanitarian practice.
Research Interests:
This article describes a participative ranking methodology for identifying local understanding of reintegration and adjustment of potential value in programme planning and evaluation. It was applied in the specific context of girls... more
This article describes a participative ranking methodology for identifying local understanding of reintegration and adjustment of potential value in programme planning and evaluation. It was applied in the specific context of girls formerly associated with fighting forces in Sierra Leone. Fourteen discussion groups, utilizing spontaneous listing and participative ranking activities, within a focus group framework, were conducted in 10 communities. Discussions served to identify family support, marriage, involvement in communal activities and income generating activities as locally seen as significant indicators of a girl's successful reintegration after the war. This method offers a flexible approach to identifying culturally relevant indictors of reintegration that have the potential for wide use in programme planning and evaluation.
Research Interests:
A major humanitarian concern during the continuing crisis in Darfur, Sudan, has been the protection of children, although there has been little in the way of comprehensive analysis to guide intervention. Founded on a situational analysis... more
A major humanitarian concern during the continuing crisis in Darfur, Sudan, has been the protection of children, although there has been little in the way of comprehensive analysis to guide intervention. Founded on a situational analysis conducted between October 2005 and March 2006, this paper documents the significant threats to children's well-being directly linked to the political conflict. It demonstrates the role of non-conflict factors in exacerbating these dangers and in promoting additional protection violations, and it uses the 'protective environment' framework (UNICEF Sudan, 2006a) to identify systematic features of the current environment that put children at risk. This framework is shown to provide a coherent basis for assessment and planning, prompting broad, multidisciplinary analysis, concentrating on preventive and protective action, and fostering a systemic approach (rather than placing an undue focus on the discrete needs of 'vulnerable groups'). Constraints on its present utility in emergency settings are also noted.
Research Interests:
It is 10 years since the adoption of the Cape Town Principles and Best Practices on the Prevention of Recruitment of Children into the Armed Forces and on Demobilization and Social Reintegration of Child Soldiers in Africa. The field of... more
It is 10 years since the adoption of the Cape Town Principles and Best Practices on the Prevention of Recruitment of Children into the Armed Forces and on Demobilization and Social Reintegration of Child Soldiers in Africa. The field of programming for the reintegration of children associated with armed forces and armed groups has made significant strides in this period. However, important gaps in the knowledge base remain. This paper examines empirical evidence that supports lessons learned from work with children formerly connected with fighting forces. It evaluates what is known, where promising practice exists, and lacunae in five programming areas: psychosocial support and care; community acceptance; education, training and livelihoods; inclusive programming for all war-affected children; and follow-up and monitoring. While the 2007 Paris Commitments to Protect Children from Unlawful Recruitment or Use by Armed Forces or Groups mark an emerging consensus on many issues, there is still a critical need for more systematic studies to develop the evidence base supporting intervention in this area.
Research Interests:
Integration has become both a key policy objective related to the resettlement of refugees and other migrants, and a matter of significant public discussion. Coherent policy development and productive public debate are, however, both... more
Integration has become both a key policy objective related to the resettlement of refugees and other migrants, and a matter of significant public discussion. Coherent policy development and productive public debate are, however, both threatened by the fact that the concept of integration is used with widely differing meanings. Based on review of attempted definitions of the term, related literature and primary fieldwork in settings of refugee settlement in the UK, the paper identifies elements central to perceptions of what constitutes ‘successful’ integration. Key domains of integration are proposed related to four overall themes: achievement and access across the sectors of employment, housing, education and health; assumptions and practice regarding citizenship and rights; processes of social connection within and between groups within the community; and structural barriers to such connection related to language, culture and the local environment. A framework linking these domains is presented as a tool to foster debate and definition regarding normative conceptions of integration in resettlement settings.
Research Interests:
The author reflects on the implications of guidelines that are a reflection of professional consensus. In the case of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings, the author suggests that consensus... more
The author reflects on the implications of guidelines that are a reflection of professional consensus. In the case of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings, the author suggests that consensus represents (1) a political achievement promising improved interagency coordination; (2) a core knowledge base defining key principles and practices; and (3) a useful basis to structure further enquiry to gather a stronger evidence base for programming
Research Interests:
Research Interests:
INTRODUCTION: Afghanistan has high levels of disability due to prolonged conflict. An important part of the reconstruction process in Afghanistan is strengthening health service capacity and, within this, rehabilitation services. AIMS:... more
INTRODUCTION:
Afghanistan has high levels of disability due to prolonged conflict. An important part of the reconstruction process in Afghanistan is strengthening health service capacity and, within this, rehabilitation services.
AIMS:
To identify training needs of, and key issues affecting, Afghan physiotherapists.
METHODS:
20 interviews and clinical accompaniment of 15 physiotherapists/physiotherapy assistants (APA) carried out in the second quarter of 2003. Analysis was using a grounded theory approach.
RESULTS:
Five themes emerged: (1) Low professional profile of physiotherapy; (2) Difficult working conditions; (3) Difficulty identifying personal training needs; (4) Difficulty with clinical reasoning at undergraduate level; (5) Variable levels of clinical competence.
DISCUSSION:
Many of the challenges facing Afghan physiotherapists are not unique to Afghanistan but are exacerbated by a lack of government recognition of the profession. War has isolated Afghan physiotherapists from completed professional links and consequently the undergraduate curriculum had not matched developments in other comparable countries. This has contributed to the difficulties therapists' experience with current clinical reasoning and accessing new practice developments. Culture also influences attitudes towards training and has restricted female travel and access to education.
CONCLUSIONS:
Core training needs include disability sensitization, reflective practice and clinical reasoning. The physiotherapy curriculum needs updating and links with ongoing research need to be established to keep abreast of new developments.
Afghanistan has high levels of disability due to prolonged conflict. An important part of the reconstruction process in Afghanistan is strengthening health service capacity and, within this, rehabilitation services.
AIMS:
To identify training needs of, and key issues affecting, Afghan physiotherapists.
METHODS:
20 interviews and clinical accompaniment of 15 physiotherapists/physiotherapy assistants (APA) carried out in the second quarter of 2003. Analysis was using a grounded theory approach.
RESULTS:
Five themes emerged: (1) Low professional profile of physiotherapy; (2) Difficult working conditions; (3) Difficulty identifying personal training needs; (4) Difficulty with clinical reasoning at undergraduate level; (5) Variable levels of clinical competence.
DISCUSSION:
Many of the challenges facing Afghan physiotherapists are not unique to Afghanistan but are exacerbated by a lack of government recognition of the profession. War has isolated Afghan physiotherapists from completed professional links and consequently the undergraduate curriculum had not matched developments in other comparable countries. This has contributed to the difficulties therapists' experience with current clinical reasoning and accessing new practice developments. Culture also influences attitudes towards training and has restricted female travel and access to education.
CONCLUSIONS:
Core training needs include disability sensitization, reflective practice and clinical reasoning. The physiotherapy curriculum needs updating and links with ongoing research need to be established to keep abreast of new developments.
Research Interests:
Letter to the Editors: Integrating psychosocial issues in humanitarian and development assistance: a response to Williamson and Robinson (A reaction to their article in Intervention Volume 4, Number 1, March 2006)
Research Interests:
The Tibet-TPO project in Dharamsala, North India aims to provide culturally sensitive psychosocial support to Tibetan refugees. In this study we have examined the cultural and spiritual constructions of mental distress of Tibetan exiles... more
The Tibet-TPO project in Dharamsala, North India aims to provide culturally sensitive psychosocial support to Tibetan refugees. In this study we have examined the cultural and spiritual constructions of mental distress of Tibetan exiles from a secondary analysis of previously published data. Tibetans refugees' constructions of mental distress were intimately linked to cultural, religious and political factors. Family and religious support were regarded as key coping strategies, yet many new refugees lacked both family support and detailed knowledge and understanding of Tibetan Buddhism. Not all of those interviewed were positive about ‘western approaches’ to dealing with mental distress, but those using the service seemed to do so in a pragmatic and integrative way. We conclude that culturally sensitive psychosocial support can usefully ‘fill a gap’, especially for new refugees who lack both family support and access to, or understanding of, traditional religious coping mechanisms.
Research Interests:
BACKGROUND: There is growing evidence of the impact on children's well-being of exposure to political conflict in such settings as the Palestinian territories. This study examined the impact of child-focused interventions involving... more
BACKGROUND:
There is growing evidence of the impact on children's well-being of exposure to political conflict in such settings as the Palestinian territories. This study examined the impact of child-focused interventions involving structured activities, supported by provision of equipment and training of facilitators. The focus of interventions was participation in recreational, cultural and other non-formal activities supporting the development of resilience. Impacts were hypothesised on children's social and emotional well-being, relationships with parents and degree of future orientation.
METHODS:
Two hundred and fifty children from the West Bank and 150 children from Gaza took part in the study. Of these 400 children, 300 comprised the intervention group. Fifty children from Gaza and 50 children from the West Bank comprised the comparison group. There were equal numbers of girls and boys in all groups, with similar proportions of children aged between 6 and 11 years, and between 12 and 17 years. Measures used were the Child Behavior Checklist (CBCL), the Parental Support Scale and the Hopefulness Scale: Youth Version. Assessment was made as children enrolled on the structured activity programmes (T1) and again twelve months later (T2).
RESULTS:
There was no difference in the CBCL Total, Internalising or Externalising problem scores at baseline (Time 1) between the children who subsequently took the intervention and those who did not. Compared to children in the comparison group, children in the intervention group had lower CBCL total problem scores, externalising problem scores, and internalising problem scores at Time 2 compared to Time 1. Exposure to the intervention was not associated with changes in children's hopefulness, but those receiving the intervention in the West Bank did report improved parental support at Time 2.
CONCLUSIONS:
The intervention appeared successful in improving children's emotional and behavioural well-being but not hopefulness. It was also linked with increased parental support in some areas (those located in the West Bank).
There is growing evidence of the impact on children's well-being of exposure to political conflict in such settings as the Palestinian territories. This study examined the impact of child-focused interventions involving structured activities, supported by provision of equipment and training of facilitators. The focus of interventions was participation in recreational, cultural and other non-formal activities supporting the development of resilience. Impacts were hypothesised on children's social and emotional well-being, relationships with parents and degree of future orientation.
METHODS:
Two hundred and fifty children from the West Bank and 150 children from Gaza took part in the study. Of these 400 children, 300 comprised the intervention group. Fifty children from Gaza and 50 children from the West Bank comprised the comparison group. There were equal numbers of girls and boys in all groups, with similar proportions of children aged between 6 and 11 years, and between 12 and 17 years. Measures used were the Child Behavior Checklist (CBCL), the Parental Support Scale and the Hopefulness Scale: Youth Version. Assessment was made as children enrolled on the structured activity programmes (T1) and again twelve months later (T2).
RESULTS:
There was no difference in the CBCL Total, Internalising or Externalising problem scores at baseline (Time 1) between the children who subsequently took the intervention and those who did not. Compared to children in the comparison group, children in the intervention group had lower CBCL total problem scores, externalising problem scores, and internalising problem scores at Time 2 compared to Time 1. Exposure to the intervention was not associated with changes in children's hopefulness, but those receiving the intervention in the West Bank did report improved parental support at Time 2.
CONCLUSIONS:
The intervention appeared successful in improving children's emotional and behavioural well-being but not hopefulness. It was also linked with increased parental support in some areas (those located in the West Bank).
Research Interests:
BACKGROUND: Over the last 15 years, rehabilitation of offenders has been rigorously researched, resulting in new knowledge and understanding about factors decreasing recidivism amongst them. Typically, such interventions have been based... more
BACKGROUND:
Over the last 15 years, rehabilitation of offenders has been rigorously researched, resulting in new knowledge and understanding about factors decreasing recidivism amongst them. Typically, such interventions have been based on cognitive behavioural therapy. However, until recently, little research had been carried out on the rehabilitation of offenders with mental disorder. The authors present the first systematic review of the efficacy of structured group interventions with mentally disordered offenders.
AIM:
To evaluate structured group interventions with mentally disordered offenders through systematic review of the evidence for their efficacy and effectiveness.
METHODS:
A standardized search strategy, with complementary methods of data retrieval to ensure a high degree of recall, was employed. Meta-analysis was not undertaken due to sample heterogeneity and lack of comparable data. Instead, effect sizes were calculated on all papers with sufficient data. Pooled effect sizes were calculated for groups of interventions with a similar focus.
RESULTS:
Twenty studies were retrieved that fitted the inclusion criteria. It was possible to categorize these, predominantly British, studies into four main themes: problem-solving; anger/aggression management; self-harm; and other. The mean pooled effect sizes for the first two groups were suggestive of a moderate to high effect, but methodological variation means that these findings should still be treated as preliminary.
DISCUSSION AND CONCLUSIONS:
Calculated effect sizes give optimism for the efficacy of structured group interventions with mentally disordered offenders. It is important now that more rigorous and consistent research methods be applied, even in secure hospital environments. Some suggestions towards achieving this are offered, drawing from the work to date, inclusive of the need for agreement on common outcome measures and development of networks to improve sample sizes.
Copyright (c) 2006 John Wiley & Sons, Ltd
Over the last 15 years, rehabilitation of offenders has been rigorously researched, resulting in new knowledge and understanding about factors decreasing recidivism amongst them. Typically, such interventions have been based on cognitive behavioural therapy. However, until recently, little research had been carried out on the rehabilitation of offenders with mental disorder. The authors present the first systematic review of the efficacy of structured group interventions with mentally disordered offenders.
AIM:
To evaluate structured group interventions with mentally disordered offenders through systematic review of the evidence for their efficacy and effectiveness.
METHODS:
A standardized search strategy, with complementary methods of data retrieval to ensure a high degree of recall, was employed. Meta-analysis was not undertaken due to sample heterogeneity and lack of comparable data. Instead, effect sizes were calculated on all papers with sufficient data. Pooled effect sizes were calculated for groups of interventions with a similar focus.
RESULTS:
Twenty studies were retrieved that fitted the inclusion criteria. It was possible to categorize these, predominantly British, studies into four main themes: problem-solving; anger/aggression management; self-harm; and other. The mean pooled effect sizes for the first two groups were suggestive of a moderate to high effect, but methodological variation means that these findings should still be treated as preliminary.
DISCUSSION AND CONCLUSIONS:
Calculated effect sizes give optimism for the efficacy of structured group interventions with mentally disordered offenders. It is important now that more rigorous and consistent research methods be applied, even in secure hospital environments. Some suggestions towards achieving this are offered, drawing from the work to date, inclusive of the need for agreement on common outcome measures and development of networks to improve sample sizes.
Copyright (c) 2006 John Wiley & Sons, Ltd
Research Interests:
The focus of humanitarian and development assistance to post-conflict societies has in recent years typically broadened from narrow socioeconomic concerns to address broader mechanisms of social and psychological recovery within... more
The focus of humanitarian and development assistance to post-conflict societies has in recent years typically broadened from narrow socioeconomic concerns to address broader mechanisms of social and psychological recovery within war-affected populations. Interventions seeking to assist in such recovery are, however, frequently contested in terms of aims and approach. Competing discourses regarding such support for communities are identified, and their ideological roots considered. A conceptual framework for psychosocial intervention in complex emergencies is presented, which seeks to relate together diverse approaches to community support within a single schema. The framework identifies three core domains with respect to which the resources of communities, the impact of conflict and means of intervention can be conceptualized. These three domains of human capacity, social ecology, and culture and values are illustrated with respect to the post-conflict setting of communities on the Tigray-Eritrea border. The framework suggests a number of concepts of relevance for structuring community development interventions in such settings. Two specific areas are examined in detail. First, the social capital concepts of bonds, bridges and links are elaborated, and the respective role of each in post-conflict recovery considered. Second, three key processes in conceptualizing the process of community development are identified as engagement, negotiation and transformation.
Research Interests:
Despite emphasis on strengthening local health care provision, concern remains regarding the rates of utilization of state-provided services within Orissa. The reported study examined patterns of service utilization across the rural... more
Despite emphasis on strengthening local health care provision, concern remains regarding the rates of
utilization of state-provided services within Orissa. The reported study examined patterns of service
utilization across the rural population of four districts of Orissa, with special reference to perceptions of
the availability and quality of state services at the primary care level. Within the selected districts, 219
interviews were conducted across 66 villages. Households reported utilizing a wide range of health care
providers, although hospitals constituted the most frequently–and primary health care centres (PHCs)
the least frequently–accessed services. Private practitioners (qualified and unqualified) represented a
major sector of provision. This included high rates of access by scheduled tribes and castes (running at
approximately twice the rate of access to both local and PHC provision). Key factors guiding patterns of
utilization were reputation of the provider, cost and physical accessibility. Local health provision
through assistant nurse midwives and male health workers was generally perceived of poor quality,
with the lowest rates of resolution of health problems of all service providers. The location of a subcentre
base for assistant nurse midwives within a village had no demonstrable impact on access to
services. Acknowledging constraints on broader generalization, the implications of the findings for
informing health policy and programming within Orissa are noted. This includes support for current
efforts to strengthen the capacity of PHC and sub-centre level provision within the state, and
acknowledgement of the potentially growing role of effectively regulated private provision in meeting
the needs of the rural poor.
utilization of state-provided services within Orissa. The reported study examined patterns of service
utilization across the rural population of four districts of Orissa, with special reference to perceptions of
the availability and quality of state services at the primary care level. Within the selected districts, 219
interviews were conducted across 66 villages. Households reported utilizing a wide range of health care
providers, although hospitals constituted the most frequently–and primary health care centres (PHCs)
the least frequently–accessed services. Private practitioners (qualified and unqualified) represented a
major sector of provision. This included high rates of access by scheduled tribes and castes (running at
approximately twice the rate of access to both local and PHC provision). Key factors guiding patterns of
utilization were reputation of the provider, cost and physical accessibility. Local health provision
through assistant nurse midwives and male health workers was generally perceived of poor quality,
with the lowest rates of resolution of health problems of all service providers. The location of a subcentre
base for assistant nurse midwives within a village had no demonstrable impact on access to
services. Acknowledging constraints on broader generalization, the implications of the findings for
informing health policy and programming within Orissa are noted. This includes support for current
efforts to strengthen the capacity of PHC and sub-centre level provision within the state, and
acknowledgement of the potentially growing role of effectively regulated private provision in meeting
the needs of the rural poor.
Research Interests:
Twenty years of conflict has severely disrupted the infrastructure and economy of Afghanistan. Disability levels are high and much of the population has little access to health facilities. Re-establishing and strengthening rehabilitation... more
Twenty years of conflict has severely disrupted the infrastructure and economy of Afghanistan. Disability levels are high and much of the population has little access to health facilities. Re-establishing and strengthening rehabilitation services is therefore an important country priority. The aims of this study were to explore perceptions of the nature of disability in Afghanistan and to identify implications for the development of rehabilitation services. Over a 4-week period, interviews and focus groups, supplemented by field observations, were held with a range of service users and other stakeholders (including physiotherapist service providers and representatives of the Afghan Disability Committee) in the districts of Kabul and Herat. Data analysis identified three core themes in discussions with respondents: the nature of disability, causes of disability and rehabilitation priorities for people with disability (PWD). Afghan society distinguishes between traumatic and congenital disability, but disability awareness is much greater for persons with traumatic disability. This group enjoys much greater representation in disabled people's organizations. There is a strong cultural responsibility to care and provide for PWD rather than to encourage independence. Healthcare professionals reflect a medical model in their attitudes towards PWD. A key priority of PWD is economic. There is a low understanding of rehabilitation practice by PWD and medical staff. Training for rehabilitation workers and wider health professionals needs to reflect greater emphasis on a social model of disability. Public awareness and enablement of people with congenital disability needs to be raised.
Research Interests:
A psychosocial care project for Tibetan torture survivor's and other Tibetan refugees suffering from psychological distress was opened in Dharamsala, North India in 1995 by a western non-government organisation (NGO) in collaboration with... more
A psychosocial care project for Tibetan torture survivor's and other Tibetan refugees suffering from psychological distress was opened in Dharamsala, North India in 1995 by a western non-government organisation (NGO) in collaboration with the Tibetan government-in-exile. The clinic explicitly sought to integrate western and local traditional approaches to healing. The aim of the present study was to examine the views of key stakeholders of the project in the context of broader cultural and social issues faced by exiled Tibetans. Twenty individual interviews were conducted with 'officials' (members of the Tibetan government-in-exile, religious leaders, other community leaders, and senior medical staff), the staff of the project (Tibetan and western) and the clients themselves. The interviews were taped, transcribed, and analysed using a grounded theory approach. All interviewees considered that mental health was an important issue and that awareness of psychological health in the community had improved since the initiation of the project. Clients and staff of the project, and some of the 'officials', believed that it provided a much-needed service and that it effectively and sensitively combined western psychological approaches with local cultural and religious beliefs and practices. However, a majority of the 'officials' felt that mental health issues were not a top priority in the competing health needs of the community, and that other ways of dealing with such problems (using traditional approaches or local health services) were adequate. Given these and other factors, the longer-term sustainability of the project appears to be a major challenge. According to the users and providers interviewed, the current project has developed an important and beneficial psychosocial support service. However, the continuing debate amongst community leaders regarding the place and future of the project suggests the importance of accommodating the views and priorities of all local stakeholders--and focusing on sustainability and capacity building of relevant community members--from the outset of such projects. This includes acknowledging the perceived threat to traditional beliefs and coping strategies--particularly in the context of wider socio-cultural disruption--posed by initiatives seeking to integrate western intervention approaches with local healing resources
Research Interests:
ABSTRACT To position refugee mental health more effectively on the developing global health and humanitarian agendas requires effective communication in policy-making processes. The capacity to answer three simple but demanding questions... more
ABSTRACT To position refugee mental health more effectively on the developing global health and humanitarian agendas requires effective communication in policy-making processes. The capacity to answer three simple but demanding questions arguably determines the readiness of those working in this field to seek such influence. Reviewing current knowledge on the global context of refugee mental health with respect to the questions ‘What is the need?’, ‘What can we do about it?’ and ‘Will it work?’ suggests significant conceptual advance in this area over the last decade, and increasing consensus on broad intervention strategy. It remains important to document impact more effectively, however, if policy-makers are to be persuaded to invest more resources in promoting mental health interventions with displaced and war-affected populations.
Research Interests:
Cognitive behavioural treatment manuals have increased in frequency, purpose and impact over the last 40 years. Despite numerous papers on the topic, few empirical studies regarding the constitution of treatment manuals have been... more
Cognitive behavioural treatment manuals have increased in frequency, purpose and impact over the last 40 years. Despite numerous papers on the topic, few empirical studies regarding the constitution of treatment manuals have been conducted. A Delphi study examining the factors that constitute a good cognitive behavioural treatment manual is presented. This study generated a consensus of opinion of factors that therapists and researchers should consider when developing and appraising treatment manuals for cognitive behavioural interventions. Limitations of the study and the potential relevance of the research are discussed.
Research Interests:
Mental health is becoming a central issue for public health complex emergencies. In this review we present a culturally valid mental health action plan based on scienti.c evidence that is capable of addressing the mental health effects of... more
Mental health is becoming a central issue for public health complex emergencies. In this review we present a culturally valid mental health action plan based on scienti.c evidence that is capable of addressing the mental health effects of complex emergencies. A mental health system of primary care providers, traditional healers, and relief workers, if properly trained and supported, can provide cost-effective, good mental health care. This plan emphasises the need for standardised approaches to the assessment, monitoring, and outcome of all related activities. Crucial to the improvement of outcomes during crises and the availability to future emergencies of lessons learned from earlier crises is the regular dissemination of the results achieved with the action plan. A research agenda is included that should, in time, fill knowledge gaps and reduce the negative mental health effects of complex emergencies.
Research Interests:
The ever-growing range of approaches to psychosocial intervention in areas of armed conflict reflects a wide diversity in underlying perspective. Practitioners are faced with questions of effectiveness and appropriateness of... more
The ever-growing range of approaches to psychosocial
intervention in areas of armed conflict reflects a
wide diversity in underlying perspective.
Practitioners are faced with questions of effectiveness
and appropriateness of interventions. The author
presents a conceptual framework formulated by the
Psychosocial Working Group that offers a way of
understanding psychosocial well being that embraces
the breadth of the field. This framework is used to
explore the assessment of the impact of events, by
directing attention towards both the depletion and
accretion of human, social and cultural resources as
a result of armed conflict. Issues of effective, appropriate
and ethical interventions are discussed in
relation to the fundamental importance of facilitation
of community engagement.
intervention in areas of armed conflict reflects a
wide diversity in underlying perspective.
Practitioners are faced with questions of effectiveness
and appropriateness of interventions. The author
presents a conceptual framework formulated by the
Psychosocial Working Group that offers a way of
understanding psychosocial well being that embraces
the breadth of the field. This framework is used to
explore the assessment of the impact of events, by
directing attention towards both the depletion and
accretion of human, social and cultural resources as
a result of armed conflict. Issues of effective, appropriate
and ethical interventions are discussed in
relation to the fundamental importance of facilitation
of community engagement.
Research Interests:
Validated measures are needed for assessing resilience in conflict settings. An Arabic version of the Child and Youth Resilience Measure (CYRM) was developed and tested in Jordan. Following qualitative work, surveys were implemented with... more
Validated measures are needed for assessing resilience in conflict settings. An Arabic version of the Child and Youth Resilience Measure (CYRM) was developed and tested in Jordan. Following qualitative work, surveys were implemented with male/female, refugee/nonrefugee samples (N = 603, 11–18 years). Confirmatory factor analyses tested three-factor structures for 28-and 12-item CYRMs and measurement equivalence across groups. CYRM-12 showed measurement reliability and face, content, construct (comparative fit index = .92–.98), and convergent validity. Gender-differentiated item loadings reflected resource access and social responsibilities. Resilience scores were inversely associated with mental health symptoms, and for Syr-ian refugees were unrelated to lifetime trauma exposure. In assessing individual, family, and community-level dimensions of resilience, the CYRM is a useful measure for research and practice with refugee and host-community youth.
Research Interests:
There are major challenges of conducting evaluations in humanitarian crises such as natural disasters and armed con icts. However evaluation is a vital tool for improving current psychosocial programs as well as future planning,... more
There are major challenges of conducting evaluations in humanitarian crises such as natural disasters and armed con icts. However evaluation is a vital tool for improving current psychosocial programs as well as future planning, programming and decision-making. Evaluation provides the means to improve program performance, identify potential unintended negative consequences and build inter-agency consensus on good and promising practices. Essentially, the wider impact of well-documented, reliable evaluations will be the building of a stronger knowledge base for e ective psycho- social practice.
Research Interests:
Reflecting on research from a wide range of perspectives and contexts, a number of elements of an approach founded upon principles of resilience can be identified. In particular, work informed by the perspective of resilience may be... more
Reflecting on research from a wide range of perspectives and contexts, a number of elements of an approach founded upon principles of resilience can be identified. In particular, work informed by the perspective of resilience may be characterized by: PRO-CAPACITIES EMPHASIS: An emphasis on strengths, resources, and capacities rather than deficits; PREVENTIVE FOCUS: Anticipation of actions that reduce the impact of adversity; MULTI-LEVEL ANALYSIS: Attention to multiple levels of influence ranging from the structural and cultural through to the community and the individual; and SYSTEMS ORIENTATION: Mapping influences within ecologically-nested systems.
Research Interests:
Briefing paper for meeting on lessons for DFID's health response in Syria, 25 February 2016. The brief highlights - on the basis of a series of case studies and ongoing work - three observations. (1) participatory Group Model Building... more
Briefing paper for meeting on lessons for DFID's health response in Syria, 25 February 2016. The brief highlights - on the basis of a series of case studies and ongoing work - three observations. (1) participatory Group Model Building (GMB) provides a promising mechanism for local consideration of systems resilience; (2) adversity prompts diverse, contextually-related adaptation strategies in health systems; (3) recurrent systems-level characteristics are best basis for generalization and facilitating local problem-solving regarding resilience.
Research Interests:
The case study was conducted principally from the perspective of the International Center for AIDS Care and Treatment Programs (ICAP) at Columbia University, an implementing partner funded by Centers for Disease Control and Prevention... more
The case study was conducted principally from the perspective of the International Center for AIDS Care and Treatment Programs (ICAP) at Columbia University, an implementing partner funded by Centers for Disease Control and Prevention (CDC) under the U.S. President’s Emergency Plan for Aids Relief (PEPFAR). ICAP provided technical assistance for HIV- related programming to the Ministry of Health during this period. ICAP supported family- focused and multidisciplinary HIV services in health facilities across the country, working to build district capacity for provision of comprehensive HIV services1. These services included: pediatric and adult HIV care and treatment (including provision of ART); integrated tuberculosis/HIV care and treatment; rapid HIV testing for adults and children; diagnostic testing/analysis (including Dried Blood Spot DNA PCR testing for infants); community outreach; HIV support groups; and peer education programs. While the Ministry of Health (MOH) provided salaries to the majority of health facility staff and was also responsible for the procurement of drugs, ICAP provided salary support to some staff at health facility level such as data clerks.
Research Interests:
Our research points to numerous examples of contributions best made by local faith communities in the context of humanitarian response. However, challenges to effective engagement of local capacity and barriers in connecting local faith... more
Our research points to numerous examples of contributions
best made by local faith communities in the context
of humanitarian response. However, challenges to effective
engagement of local capacity and barriers in connecting
local faith community resources to wider humanitarian response
persist in the current response to the Syrian crisis.
We draw from challenges and opportunities identified to
suggest some practical actions for humanitarian agencies
to more effectively partner with religious groups.
best made by local faith communities in the context
of humanitarian response. However, challenges to effective
engagement of local capacity and barriers in connecting
local faith community resources to wider humanitarian response
persist in the current response to the Syrian crisis.
We draw from challenges and opportunities identified to
suggest some practical actions for humanitarian agencies
to more effectively partner with religious groups.
Research Interests:
The potential role of local faith communities (LFCs) in promoting resilience in contexts of humanitarian crisis has, despite recent policy interest, been a neglected area of study. This article reports on a structured review of evidence... more
The potential role of local faith communities (LFCs) in promoting resilience in contexts of humanitarian crisis has, despite recent policy interest, been a neglected area of study. This article reports on a structured review of evidence regarding such contributions based on an analysis of 302 publications and reports, supplemented by 11 written submissions from humanitarian non- governmental organizations (NGOs) and 10 stakeholder interviews. Analysis is structured with respect to three major humanitarian processes—disaster risk reduction; emergency response; and facilitating transitional and durable solutions—relevant to the promotion of resilience in populations that are displaced, at risk of displacement or refugee-impacted. Major themes emerging from the analysis concern: the diversity of stakeholder perspectives on the presence and influence of LFCs on local humanitarian response; the resources—material and non-material—potentially made available through LFCs to crisis-affected communities; and the opportunities—and substantive challenges—for greater LFC partnership with humanitarian organizations.
Research Interests: Refugee Studies, Faith Based Organizations, Faith-Based Development Organisations, Refugees and Forced Migration Studies, Asylum and refugees studies, migration and integration, and 5 moreRefugees, migration and immigration, Asylum Seekers and Refugees, Faith-based humanitarian organisations, Faith Based Response to Conflicts, and Islamic Faith-based Organizations
Evidence Brief created for the World Humanitarian Summit on religious engagement in humanitarian action in relation to the fifth core responsibility of the UNSG's report "One Humanity, Shared Responsibility."
Research Interests:
Evidence Brief created for the World Humanitarian Summit on the religious engagement in humanitarian action in relation to the fourth core responsibility of the UNSG's report "One Humanity, Shared Responsibility."
Research Interests:
Exposure to conflict and natural disasters poses significant risks to the mental health and psychosocial wellbeing of affected populations. Children and adolescents are particularly vulnerable given that humanitarian emergencies often... more
Exposure to conflict and natural disasters poses significant risks to the mental health and psychosocial wellbeing of affected populations. Children and adolescents are particularly vulnerable given that humanitarian emergencies often disrupt the very social institutions, community resources, economic livelihoods, and infrastructural supports that children depend on for normal growth and development. Although children can be remarkably resilient and adaptive to change in their environments, such disruption of the social fabric commonly warrants the mobilization of interventions addressing mental health and psychosocial support to further facilitate recovery and growth (Loughrey & Eyber, 2003; Boothby, Wessells & Strang, 2006; Hunter, 2012).
Research Interests:
Research Interests:
This paper reports findings from a cross-sectional analysis measuring the relationship between household livelihoods and children's well-being and protection in two districts of western Uganda. 246 households completed a household... more
This paper reports findings from a cross-sectional analysis measuring the relationship between household livelihoods and children's well-being and protection in two districts of western Uganda. 246 households completed a household questionnaire measuring income, assets, livelihood activities, and various child outcomes. Multivariate analysis indicated that household asset level and livelihood activity were both positively associated with improved child physical well-being. Households with greater assets reported fewer child protection risks. Findings suggest that although economic strengthening activities may improve the physical well-being of children, there remains a need to integrate psychosocial support to households to complement such provisions in securing child protection and well-being.
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In war a¡ected populations there is often severe disruption of societal cohesion. Additionally, grief and traumatisation, along with insu⁄cient health services and a lack of security, give rise to an increase of mental health problems.... more
In war a¡ected populations there is often severe disruption of societal cohesion. Additionally, grief and traumatisation, along with insu⁄cient health services and a lack of security, give rise to an increase of mental health problems. Social capital is potentially a key resource to support post con£ict recovery, and is increasingly considered not merely as a resource supporting economic and social development, but also an important in£uence on population health. However, linkages between social capital and mental health are complex. Therefore, this article begins with an introduction to the construct of social capital, then provides an overview of the main ¢ndings on its relation to health and wellbeing, as well to mental health in general and in post emergency situations. Finally, it explores if social capital may be promoted intentionally, as pursued through a community based sociotherapy programme in Rwanda.While there appears to be a rationale for promoting social capitalwithin...
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Civil conflict, natural disasters, pandemic disease and famine continue to place the work of humanitarian assistance high in public consciousness. The last twenty years have seen a concerted attempt by humanitarian agencies – both... more
Civil conflict, natural disasters, pandemic disease and famine continue to place the work of humanitarian assistance high in public consciousness. The last twenty years have seen a concerted attempt by humanitarian agencies – both non-governmental and inter-governmental – to develop best professional practice in their fields of operation. The current work of such agencies bears the clear mark of contribution from many disciplines, ranging from agricultural to management sciences, from macroeconomics to social anthropology, from engineering to medicine. However, the contribution from psychology has, to date, been modest.
There are, however, signs of this circumstance changing, with psychologists beginning to make contributions in a number of areas of activity. The purpose of this paper is to (1) identify the constraints that have limited the previous contribution of psychology in the arena of humanitarian assistance and (2) map areas where contributions have begun to be made, or offer particular potential for future contribution. The broad assertion of the paper is that the obstacles to appropriate application of psychological knowledge in the furtherance of the work of humanitarian assistance agencies are very real but, with due sensitivity, flexibility and breadth of vision, there are many areas of the discipline of psychology – both pure and applied – that can make a meaningful contribution to the conceptualization and implementation of humanitarian assistance.
There are, however, signs of this circumstance changing, with psychologists beginning to make contributions in a number of areas of activity. The purpose of this paper is to (1) identify the constraints that have limited the previous contribution of psychology in the arena of humanitarian assistance and (2) map areas where contributions have begun to be made, or offer particular potential for future contribution. The broad assertion of the paper is that the obstacles to appropriate application of psychological knowledge in the furtherance of the work of humanitarian assistance agencies are very real but, with due sensitivity, flexibility and breadth of vision, there are many areas of the discipline of psychology – both pure and applied – that can make a meaningful contribution to the conceptualization and implementation of humanitarian assistance.
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One of the earliest accounts of the psychological and social issues faced by refugees is Kraus’s pre-war study of forced new settlers fleeing to the USA from Nazi Germany The analysis is interesting from a number of standpoints, but none... more
One of the earliest accounts of the psychological and social issues faced by refugees is Kraus’s pre-war study of forced new settlers fleeing to the USA from Nazi Germany The analysis is interesting from a number of standpoints, but none more so than its title, ‘Starting life anew in a strange country’. For many this phrase will capture something of
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... as untrue; the poor work constantly to survive but receive little to show for it in return. ... over issues such as firewood collection and the distribution of food rations escalated into violent attacks ... is evident in the way in... more
... as untrue; the poor work constantly to survive but receive little to show for it in return. ... over issues such as firewood collection and the distribution of food rations escalated into violent attacks ... is evident in the way in which they are relocated to other areas by state ministries without ...
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The government’s strategy for integration sets out how the government can collaborate with other stakeholders to encourage local communities to support refugees, provide access to suitable English language tuition and promote employment... more
The government’s strategy for integration sets out how the government can collaborate with other stakeholders
to encourage local communities to support refugees, provide access to suitable English language tuition and
promote employment of refugees. The main aims of the strategy are to include refugees as equal members of
society, help refugees develop their potential and facilitate access to the support necessary for integration.
In support of the new strategy, the government has provided three additional funding streams: funding to
refugee organisations, funding to community organisations and funding through the Refugee Integration
Challenge Fund. In addition to these funds, the European Refugee Fund provided funds to be administered by
the UK. The Challenge Fund and the European Refugee Fund provide funding to facilitate integration in areas
such as access to employment, health care and education.
To facilitate the implementation of the refugee integration strategy and to ensure that new policies to promote
integration are based on evidence, the Home Office established a research team to conduct research on
immigration and integration. Whilst a lot is known about how to integrate refugees and other migrants,
further research is required to identify interventions that are effective in the UK context. Additionally, the cost
of different strategies to enhance integration, appropriate measures of outputs and outcomes and the social
and economic impact of integrating refugees and migrants on host communities and services will also need to
be examined. The IRSS/ERA team has therefore planned a research programme to increase our knowledge
about integration, identify and evaluate strategies that are effective and appropriate for use in the UK and to
disseminate that knowledge to policy makers and service providers.
These developments have clear implications for the settlement and integration of refugees. The mechanisms for
social integration are many, ranging from national governments to local governments, to organisations such
as churches, sports clubs, schools, non-governmental organisations (NGO’s) and finally, immigrants, members
of ethnic minority groups and members of host communities. To what extent should these players adapt
themselves to embrace diversity? How should members of the receiving society adapt to such changes? How
do we develop evidence-based policies in integration? What does integration mean for diverse groups?
By bringing together policy makers, academics, NGOs, and refugees at the national integration conference
in Manchester, we aim to address these questions and generate a common understanding of the current
challenges and the policy mechanisms in existence to meet them. The conference will focus principally on the
situation in the UK. This will be supplemented with an overview of the policy and research being conducted in
Canada and Europe.
to encourage local communities to support refugees, provide access to suitable English language tuition and
promote employment of refugees. The main aims of the strategy are to include refugees as equal members of
society, help refugees develop their potential and facilitate access to the support necessary for integration.
In support of the new strategy, the government has provided three additional funding streams: funding to
refugee organisations, funding to community organisations and funding through the Refugee Integration
Challenge Fund. In addition to these funds, the European Refugee Fund provided funds to be administered by
the UK. The Challenge Fund and the European Refugee Fund provide funding to facilitate integration in areas
such as access to employment, health care and education.
To facilitate the implementation of the refugee integration strategy and to ensure that new policies to promote
integration are based on evidence, the Home Office established a research team to conduct research on
immigration and integration. Whilst a lot is known about how to integrate refugees and other migrants,
further research is required to identify interventions that are effective in the UK context. Additionally, the cost
of different strategies to enhance integration, appropriate measures of outputs and outcomes and the social
and economic impact of integrating refugees and migrants on host communities and services will also need to
be examined. The IRSS/ERA team has therefore planned a research programme to increase our knowledge
about integration, identify and evaluate strategies that are effective and appropriate for use in the UK and to
disseminate that knowledge to policy makers and service providers.
These developments have clear implications for the settlement and integration of refugees. The mechanisms for
social integration are many, ranging from national governments to local governments, to organisations such
as churches, sports clubs, schools, non-governmental organisations (NGO’s) and finally, immigrants, members
of ethnic minority groups and members of host communities. To what extent should these players adapt
themselves to embrace diversity? How should members of the receiving society adapt to such changes? How
do we develop evidence-based policies in integration? What does integration mean for diverse groups?
By bringing together policy makers, academics, NGOs, and refugees at the national integration conference
in Manchester, we aim to address these questions and generate a common understanding of the current
challenges and the policy mechanisms in existence to meet them. The conference will focus principally on the
situation in the UK. This will be supplemented with an overview of the policy and research being conducted in
Canada and Europe.
Final Report on the Advanced Research Training Seminar (ARTS) on Qualitative Research Methods: Applications Across Cultures and Ethnic Groups at the University of Ottawa, Canada, 22–25 August 1996 This meeting - which followed on from... more
Final Report on the Advanced Research Training Seminar (ARTS) on Qualitative Research Methods: Applications Across Cultures and Ethnic Groups at the University of Ottawa, Canada, 22–25 August 1996
This meeting - which followed on from the 26th International Congress of Psychology in Montreal of 16-21 August 1996- was attended by 19 participants drawn across the globe (including China, India, Bangladesh, Mexico, Brazil, Russia, Belarus, Ukraine, Poland and Croatia.)
This meeting - which followed on from the 26th International Congress of Psychology in Montreal of 16-21 August 1996- was attended by 19 participants drawn across the globe (including China, India, Bangladesh, Mexico, Brazil, Russia, Belarus, Ukraine, Poland and Croatia.)
Faith, Secularism, and Humanitarian Engagement: Finding the Place of Religion in the Support of Displaced Communities Ager, A and Ager, J. (2015) Strengthening local humanitarian engagement demands not only rethinking dominant... more
Faith, Secularism, and Humanitarian Engagement: Finding the Place of Religion in the Support of Displaced Communities
Ager, A and Ager, J. (2015)
Strengthening local humanitarian engagement demands not only rethinking dominant understandings of religion, but also revisiting the principles and practices of humanitarianism. …
Available Formats: HardcovereBook
from £14.99 £24.99
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Ager, A and Ager, J. (2015)
Strengthening local humanitarian engagement demands not only rethinking dominant understandings of religion, but also revisiting the principles and practices of humanitarianism. …
Available Formats: HardcovereBook
from £14.99 £24.99
Valentine's Special: Shop like an employee and enjoy a 40% discount on books and eBooks! Use coupon code EMPLOYEE40 through February 15, 2021.*
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The growth of the world's refugee population has been a major phenomenon of the late-20th century. This volume brings together senior authors from a range of disciplinary backgrounds to analyze key forces shaping the contemporary... more
The growth of the world's refugee population has been a major phenomenon of the late-20th century. This volume brings together senior authors from a range of disciplinary backgrounds to analyze key forces shaping the contemporary experience of forced migration. It considers global, social and personal dimensions of displacement, demonstrating their close interrelationship in forging the experience of refuge. Recurrent themes include the importance of valuing the resources, capacities and meanings indigenous to refugee communities, and the intimate linkage of the personal and political in the lives of refugees. In addition to providing deeper insight into the challenges and tensions of the refugee experience, the text seeks to provide a foundation for more informed debate on refugee assistance and asylum policies and practice.
The application of microcomputers to clinical psychology has existed from the beginning of its introduction in the early 1980's. Examines the field today as well as its future directions. Topics include: selection and support of... more
The application of microcomputers to clinical psychology has existed from the beginning of its introduction in the early 1980's. Examines the field today as well as its future directions. Topics include: selection and support of microcomputer systems, computer-assisted psychometric, neuropsychological and psychological problem assessment, computer-based psychological treatment and cognitive rehabilitation, applications with children and people with learning difficulties, monitoring and evaluating clinical service delivery, expert systems, and psychological aspects of the new technological age.
... 048 India Printed m the United States of America Library of Congress Cataloging-in-Publication Data Aboud, Frances E. Health psychology in ... 97 Measuring the Magnitude of AIDS and HIV 99 International Prevalence Rates and Patterns... more
... 048 India Printed m the United States of America Library of Congress Cataloging-in-Publication Data Aboud, Frances E. Health psychology in ... 97 Measuring the Magnitude of AIDS and HIV 99 International Prevalence Rates and Patterns 101 Prevention Strategies: Whom and ...
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Armed conflict and the mass displacement it can produce brings with it specific dynamics that impact on the experiences of poverty, on issues of psychosocial well-being, and on ways in which forced migrants confront the difficulties they... more
Armed conflict and the mass displacement it can produce brings with it specific dynamics that impact on the experiences of poverty, on issues of psychosocial well-being, and on ways in which forced migrants confront the difficulties they face. This chapter focuses on the interrelationship between displacement, poverty and psychological factors in order to gain insight into the daily challenges in the lives of refugees and the internally displaced.
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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... more
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. Discussion We identified challenges with respect to study design, methods, and dissemination: these included the logistics and acceptability of implementing a randomized controlled trial in a humanitarian context, the selection and refinement of culturally-relevant research tools and community-based practices, and the dissemination of ...
Research Interests: Psychology, Cognitive Psychology, Mental Health, Resilience, Conflict, and 15 moreCognition, Impact Evaluation, Stress, Health, Public Health, Adolescent, Medicine, War, Cortisol, Partnership, Refugee, Psychological Intervention, Longitudinal, Psychosocial, and Practice-led research in creative arts
Research Interests: Psychology, Clinical Psychology, Psychological Assessment, Psychiatry, Sexual Abuse, and 13 morePsychometrics, Adolescent, Medicine, Humans, Business and Management, Child Sexual Abuse, Female, Clinical Sciences, Convergent Validity, Reproducibility of Results, Severity of Illness Index, Psychiatric Status Rating Scales, and Paediatrics and reproductive medicine
Evidence for a single underlying factor structure of posttraumatic stress disorder (PTSD) in children remains elusive. We assessed the underlying factor structure of the Child PTSD Symptom Scale through exploratory (EFA) and confirmatory... more
Evidence for a single underlying factor structure of posttraumatic stress disorder (PTSD) in children remains elusive. We assessed the underlying factor structure of the Child PTSD Symptom Scale through exploratory (EFA) and confirmatory factor analyses (CFA) in 570 survivors of the 2015 Gorkha earthquake in Nepal. The EFA suggests that the three-factor DSM-IV model fit these data best. The CFA suggests that while the DSM-IV model adequately fit these data, the four-factor King model fit them better. There was no evidence of differential item functioning by age or gender, and internal consistency of the scale was high. PTSD (overall or by factor) was not correlated with functional impairment. Inconsistent psychometric results across contexts and methodologies suggest that our current theoretical conceptualizations and empirical models of posttraumatic stress are lacking. Future studies must both document the instrument properties to assure internal validity and cross-study comparisons and, bolstered by increased psychometric data and analyses, rework theoretical models of PTSD with improved cross-cultural validity.
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BackgroundStudies of psychological distress in Sierra Leone have typically used measures which were developed for use in other contexts, and which often have not been adapted or validated for use in Sierra Leone. This has resulted in a... more
BackgroundStudies of psychological distress in Sierra Leone have typically used measures which were developed for use in other contexts, and which often have not been adapted or validated for use in Sierra Leone. This has resulted in a lack of reliable information about the patterns of psychological distress within the population, which is a barrier to the development of effective and appropriate mental health services. The aim of the study was to develop a locally-appropriate measure of psychological distress for Sierra Leone.MethodsThe new measure consists of two instruments: the Sierra Leone Psychological Distress Scale (SLPDS) and a gendered measure of ability to carry out daily tasks—a Function scale—as an indication of the severity of distress. A three-phase mixed methods exploratory sequential study was conducted. Phase 1 was item generation and testing, leading to the development of a set of potential items for both instruments. Phase 2 was a small pilot study (N = 202) lead...
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Qualitative comparative analysis (QCA) is a relatively new method that examines causal complexity. Its use in mental health research is nascent. In low-income and fragile settings, with weak mental health service provision, identifying... more
Qualitative comparative analysis (QCA) is a relatively new method that examines causal complexity. Its use in mental health research is nascent. In low-income and fragile settings, with weak mental health service provision, identifying pathways of recovery from psychological distress can inform the appropriate deployment of scarce community and public resources. This paper examines the use of QCA to identify predictors of recovery in Sierra Leone. Our study explored lay perceptions of the signs of recovery from psychological distress caused by such events as the loss of a family member, severe sickness, and loss of a relationship. The data drew upon 75 interviews with women and men, across four districts of Sierra Leone, who described the signs of recovery from psychological distress they have observed in one person known to them. The truth table generated through QCA software indicated two signs of recovery— work/study and healthy relations—to be the most prevalent across different...
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Research Interests: Political Science and L
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Health Systems Resilience: A Systems Analysis is a ReBUILD affiliate research project applying a systems dynamics approach to understand, predict and identify mechanisms that influence the resilience of health systems in contexts of... more
Health Systems Resilience: A Systems Analysis is a ReBUILD affiliate research project applying a systems dynamics approach to understand, predict and identify mechanisms that influence the resilience of health systems in contexts of adversity. The project is implemented by the Mailman School of Public Health, Columbia University, in collaboration with the School of Public Health, University of Western Cape. Resilience is now a dominant concept underpinning development and humanitarian support in contexts vulnerable to crisis, including conflict. This paper is an analysis of the circumstances in the health sector in Yobe state in northern Nigeria, related, and in response to the Boko Haram insurgency beginning around 2011 and continuing to the present. The paper makes a number of Key Points: Yobe State has faced severe disruption of its health service as a result of the Boko Haram insurgency. •Population migration and transport restrictions have severely impacted access to health pro...
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Background Noncommunicable diseases (NCDs), including mental health, have become a major concern in low- and middle-income countries. Despite increased attention to them over the past decade, progress toward addressing NCDs has been slow.... more
Background Noncommunicable diseases (NCDs), including mental health, have become a major concern in low- and middle-income countries. Despite increased attention to them over the past decade, progress toward addressing NCDs has been slow. A lack of bold policy commitments has been suggested as one of the contributors to limited progress in NCD prevention and management. However, the policies of key global actors (bilateral, multilateral, and not-for-profit organisations) have been understudied. Methods This study aimed to map the key global actors investing in action regarding NCDs and review their policies to examine the articulation of priorities regarding NCDs. Narrative synthesis of 70 documents and 31 policy papers was completed, and related to data collated from the Global Health Data Visualisation Tool. Results In 2019 41% of development assistance for health committed to NCDs came from private philanthropies, while that for other global health priorities from this source was...
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Background Over recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced... more
Background Over recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced needs of the population and utilising relevant community-based resources to address them. This study took a grounded approach to identify the ways in which adults in Sierra Leone express psychological distress. Methods Rapid ethnographic methods deployed included 75 case study interviews with community members, 12 key informant (KI) pile sorts and 55 KI interviews. Thematic analysis of data was supported by frequency analysis and multi-dimensional scaling. Results Thirty signs of distress were identified. The only consistent ‘syndrome’ identified with respect to these was a general concept of crase, which referred to psychosis-related presentation but also a wide range of other signs of distress. We did not find consensus on locally defined concepts for...
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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... more
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 ...
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Background.In emergencies and resource-poor settings, non-specialists are increasingly being trained to provide psychosocial support to people in distress, with Psychological First Aid (PFA) one of the most widely-used approaches. This... more
Background.In emergencies and resource-poor settings, non-specialists are increasingly being trained to provide psychosocial support to people in distress, with Psychological First Aid (PFA) one of the most widely-used approaches. This paper considers the effectiveness of short training programmes to equip volunteers to provide psychosocial support in emergencies, focusing particularly on whether the PFA training provided during the Ebola outbreak enabled non-specialists to incorporate the key principles into their practice.Methods.Semi-structured interviews were conducted in Sierra Leone and Liberia with 24 PFA trainers; 36 individuals who participated in PFA training; and 12 key informants involved in planning and implementing the PFA roll-out.Results.Findings indicate that many PFA training-of-trainers were short and rarely included content designed to develop training skills. As a result, the PFA training delivered was of variable quality. PFA providers had a good understanding ...
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More than one in every hundred of the world’s population has experienced being forcibly displaced. Religion constitutes a key dimension of the experience of the vast majority of forced migrants, but humanitarian response—on the basis of... more
More than one in every hundred of the world’s population has experienced being forcibly displaced. Religion constitutes a key dimension of the experience of the vast majority of forced migrants, but humanitarian response—on the basis of its concern for neutrality and impartiality—has an uneasy relation with it. The secular framing of humanitarianism has come under sustained critique, encouraging a deeper understanding of the dynamics of local faith communities. Theological reflection within faith traditions speaks to both notions of hospitality among hosts and of life in exile among migrants. Dialogue with such reflection offers insight not only into the role of religion in the support of displaced communities but also in the reimagining of global polity in a complex, plural, post-secular age.
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The secular framing of humanitarianism privatizes, marginalizes and instrumentalizes religion. Mental health and psychosocial support is a key programming area with displaced communities. Faith-based organizations have been active in... more
The secular framing of humanitarianism privatizes, marginalizes and instrumentalizes religion. Mental health and psychosocial support is a key programming area with displaced communities. Faith-based organizations have been active in supporting such interventions, but there is little evidence of religious perspectives being meaningfully incorporated in programming. This is despite mounting acceptance of the relevance of religious resources, beliefs and practices for community recovery. Analysis of the work of local faith groups working with Syrian refugees in Jordan similarly indicates how a secular script obscures and constrains the contribution from religious sources. The language used in documents exploring key areas of humanitarian strategy—humanitarian reform and disaster risk reduction—also demonstrates the uncritical presumption of a secular perspective which obstructs engagement with faith.
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Violence, abuse and neglect constitute major threats to children’s health and wellbeing globally. However, until recently, relatively little systematic attention has been paid to the role of faith communities in shaping the protective... more
Violence, abuse and neglect constitute major threats to children’s health and wellbeing globally. However, until recently, relatively little systematic attention has been paid to the role of faith communities in shaping the protective environment for children. This paper describes the development of a measure to capture child-protective disposition amongst faith communities through field studies with faith leaders and their spouses in Senegal, Uganda and Guatemala. Identifying common factors related to child care and protection practices, orientation to child rights and approaches to discipline, the measure potentially serves to both inform and evaluate interventions seeking to engage with the beliefs and behaviours of faith communities to support children’s health and wellbeing.
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Exposure to conflict and natural disasters poses significant risks to the mental health and psychosocial wellbeing of affected populations. Children and adolescents are particularly vulnerable given that humanitarian emergencies often... more
Exposure to conflict and natural disasters poses significant risks to the mental health and psychosocial wellbeing of affected populations. Children and adolescents are particularly vulnerable given that humanitarian emergencies often disrupt the very social institutions, community resources, economic livelihoods, and infrastructural supports that children depend on for normal growth and development. Although children can be remarkably resilient and adaptive to change in their environments, such disruption of the social fabric commonly warrants the mobilization of interventions addressing mental health and psychosocial support to further facilitate recovery and growth (Loughrey &amp; Eyber, 2003; Boothby, Wessells &amp; Strang, 2006; Hunter, 2012).
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Briefing paper for meeting on lessons for DFID&#39;s health response in Syria, 25 February 2016. The brief highlights - on the basis of a series of case studies and ongoing work - three observations. (1) participatory Group Model... more
Briefing paper for meeting on lessons for DFID&#39;s health response in Syria, 25 February 2016. The brief highlights - on the basis of a series of case studies and ongoing work - three observations. (1) participatory Group Model Building (GMB) provides a promising mechanism for local consideration of systems resilience; (2) adversity prompts diverse, contextually-related adaptation strategies in health systems; (3) recurrent systems-level characteristics are best basis for generalization and facilitating local problem-solving regarding resilience.
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The purpose of this research as a mid-term review to determine the strengths, weaknesses, opportunities and threats for the Indigo programme from the perspectives of the partners, students, supervisors and the project management team.... more
The purpose of this research as a mid-term review to determine the strengths, weaknesses, opportunities and threats for the Indigo programme from the perspectives of the partners, students, supervisors and the project management team. This article draws upon the research findings and suggests that the reflections and experiences of a broad range of stakeholders will not only facilitate direct programmatic learning, but also inform models of partnership in health research capacity building more generally. - If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
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Research Interests: Psychology, Cognitive Science, Developmental Psychology, Philosophy of Agency, Child and adolescent mental health, and 15 moreMental Health, Refugee Studies, Migration Studies, Psychosocial stressors, Medicine, Children, Refugee, Psychological Intervention, Psychosocial, Clinical Sciences, Protective factors, Psychosocial factors, Child and Adolescent Mental Health, Stressors, and Psychosocial support
Major knowledge gaps remain concerning the most effective ways to address mental health and psychosocial needs of populations affected by humanitarian crises. The Research for Health in Humanitarian Crisis (R2HC) program aims to... more
Major knowledge gaps remain concerning the most effective ways to address mental health and psychosocial needs of populations affected by humanitarian crises. The Research for Health in Humanitarian Crisis (R2HC) program aims to strengthen humanitarian health practice and policy through research. As a significant portion of R2HC’s research has focused on mental health and psychosocial support interventions, the program has been interested in strengthening a community of practice in this field. Following a meeting between grantees, we set out to provide an overview of the R2HC portfolio, and draw lessons learned. In this paper, we discuss the mental health and psychosocial support-focused research projects funded by R2HC; review the implications of initial findings from this research portfolio; and highlight four remaining knowledge gaps in this field. Between 2014 and 2019, R2HC funded 18 academic-practitioner partnerships focused on mental health and psychosocial support, comprisin...
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The availability of simple, specific, and inexpensive on-site detection methods is of key importance for deployment of pathogen surveillance networks. We developed a nontechnical and highly specific colorimetric assay for detection of... more
The availability of simple, specific, and inexpensive on-site detection methods is of key importance for deployment of pathogen surveillance networks. We developed a nontechnical and highly specific colorimetric assay for detection of pathogen-derived peptides based on Saccharomyces cerevisiae-a genetically tractable model organism and household product. Integrating G protein-coupled receptors with a visible, reagent-free lycopene readout, we demonstrate differential detection of major human, plant, and food fungal pathogens with nanomolar sensitivity. We further optimized a one-step rapid dipstick prototype that can be used in complex samples, including blood, urine, and soil. This modular biosensor can be economically produced at large scale, is not reliant on cold-chain storage, can be detected without additional equipment, and is thus a compelling platform scalable to global surveillance of pathogens.
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Validated measures are needed for assessing resilience in conflict settings. An Arabic version of the Child and Youth Resilience Measure (CYRM) was developed and tested in Jordan. Following qualitative work, surveys were implemented with... more
Validated measures are needed for assessing resilience in conflict settings. An Arabic version of the Child and Youth Resilience Measure (CYRM) was developed and tested in Jordan. Following qualitative work, surveys were implemented with male/female, refugee/nonrefugee samples (N = 603, 11-18 years). Confirmatory factor analyses tested three-factor structures for 28- and 12-item CYRMs and measurement equivalence across groups. CYRM-12 showed measurement reliability and face, content, construct (comparative fit index = .92-.98), and convergent validity. Gender-differentiated item loadings reflected resource access and social responsibilities. Resilience scores were inversely associated with mental health symptoms, and for Syrian refugees were unrelated to lifetime trauma exposure. In assessing individual, family, and community-level dimensions of resilience, the CYRM is a useful measure for research and practice with refugee and host-community youth.
Research Interests: Psychology, Cognitive Science, Education, Peace and Conflict Studies, Child and adolescent mental health, and 15 moreCommunity Resilience, Conflict, Child Development, Humanitarian Intervention, Forced Migration, Positive Youth Development, Global Mental Health, Family Resilience, Medicine, Middle East, Refugee, Confirmatory factor analysis, Convergent Validity, Child and Adolescent Mental Health, and Developmental and Educational Psychology
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Research Interests: Sociology, Refugee Studies, Political Science, Faith Based Organizations, Faith, and 8 moreFaith-Based Development Organisations, Refugees and Forced Migration Studies, Asylum Seekers and Refugees, Faith and Development in Sub-Saharan Africa, Faith Based Response to Conflicts, Islamic Faith-based Organizations, Religions and Humanitarism, and Humanitarian Crisis
Although epilepsy may be successfully managed with appropriate medication, in Africa epileptics are often vilified, sometimes because of traditional beliefs about the illness. We investigated the strength of beliefs which 112 rural... more
Although epilepsy may be successfully managed with appropriate medication, in Africa epileptics are often vilified, sometimes because of traditional beliefs about the illness. We investigated the strength of beliefs which 112 rural Malawians held regarding traditional and medical explanations for the cause, treatment and cure of epilepsy. Those who believed in traditional causes of epilepsy also endorsed traditional treatment for it, though they did not see such treatment as curative. Those who believed in a medical treatment, did however see such treatment as curative. Knowledge of a local medical facility for the treatment of epilepsy was also positively related to the belief that epilepsy is curable. The ability of people to simultaneously hold medical and traditional beliefs about epilepsy was noted.
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This report summarises the rich conversations which were had over the course of a two-day workshop on Local Faith Community Responses to Displacement, which was held in Beirut on the 17th and 18th July 2017. As well as drawing on research... more
This report summarises the rich conversations which were
had over the course of a two-day workshop on Local Faith Community
Responses to Displacement, which was held in Beirut on the 17th and 18th July 2017. As well as drawing on research from the Refugee Hosts project, this report points to key issues and themes relating to faith and local communities which require further consideration both within the context of the Middle East and further afield. The report and workshop was made possible by the AHRC, ESRC and the generous support of the UCL Knowledge Exchange Fund.
had over the course of a two-day workshop on Local Faith Community
Responses to Displacement, which was held in Beirut on the 17th and 18th July 2017. As well as drawing on research from the Refugee Hosts project, this report points to key issues and themes relating to faith and local communities which require further consideration both within the context of the Middle East and further afield. The report and workshop was made possible by the AHRC, ESRC and the generous support of the UCL Knowledge Exchange Fund.