Quality and timely antenatal care is a vital component of pregnancy care for the well-being of mothers and babies. The aim of this study of to assess self-reported obstetricians' adherence to national and international antenatal care guidelines in Lebanon. This cross-sectional study approached all obstetricians registered with the Lebanese Society of Obstetrics and Gynecology and the Lebanese Order of Physicians to participate in an online and telephone-based survey.
View Article and Find Full Text PDFIn line with the peer reviewers comments, the authors have added highlights in stead of an abstract. It was felt that it was better able to capture the findings and is more in line with the paper's target audience.
View Article and Find Full Text PDFObjective: Food environments are a major determinant of children's nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food environments around schools in Greater Tunis, Tunisia - an LMIC of the Middle East and North Africa region with an ongoing nutrition transition and increasing rates of childhood obesity.
View Article and Find Full Text PDFHumanitarian health care models increasingly incorporate care for non-communicable diseases (NCDs). Current research evidence focuses on burden of disease, service provision and access to care, and less is known about patient's experience of the continuum of care in humanitarian settings. To address this gap, this study explored experiences of displaced Syrian and vulnerable Lebanese patients receiving care for hypertension and/or diabetes at four health facilities supported by humanitarian organisations in Lebanon.
View Article and Find Full Text PDFIntroduction: Since the start of the Syrian conflict in 2011, Jordan and Lebanon have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs). We aimed to explore NCD service provision to Syrian refugees in these two host countries and to identify lessons learned that may inform the global response to the changing health needs of refugees.
Methods: Between January 2017 and June 2018, we conducted 36 in-depth interviews with stakeholders from Jordan and Lebanon, as well as global stakeholders, to understand the context, the achievements, gaps and priorities in the provision and uptake of NCD prevention, testing and treatment services to Syrian refugees.
Background: Female genital mutilation/cutting (FGM/C) is a nonmedical procedure entailing the modification of the external female genitalia. A description of the prevalence and distribution of FGM/C allows the tracking of progress toward ending FGM/C by 2030 (Sustainable Development Goal (SDG): target 5.3).
View Article and Find Full Text PDFBackground: Almost half of the under-5 deaths occur in the neonatal period and most can be prevented with quality newborn care. The already vulnerable state of newborns is exacerbated in humanitarian settings. This review aims to assess the current evidence of the interventions being provided in these contexts, identify strategies that increase their utilisation and their effects on health outcomes in order to inform involved actors in the field and to guide future research.
View Article and Find Full Text PDFBackground: This systematic review aimed to identify and describe the factors that influence female genital mutilation/cutting (FGM/C).
Methods: Searches were conducted in Medline, PsycInfo, Web of Science, Embase and the grey literature from 2009 to March 2020 with no language restrictions, using related MESH terms and keywords. Studies were included if they were quantitative and examined factors associated with FGM/C.
Interactive community-based theatre is used to engage with audience members and allow for free exchange of ideas relevant to context. It aims to bring about a new understanding of an issue while challenging people's attitudes and perceptions. Its application within the field of sexual and reproductive health has been limited, particularly in low and middle-income contexts.
View Article and Find Full Text PDFObjective: To investigate the effects of providing a daily healthy school snack on children's nutritional, social and educational outcomes and explore stakeholders' perceptions of an emergency school feeding programme (SFP).
Design: Convergence triangulation mixed-methods study design. Associations were examined between receiving the school feeding intervention and children's outcomes using multivariable regression models.
Background: The WHO Region for the Eastern Mediterranean has had a history of complex migration patterns, with high levels of migration to, from and within the Region, overlaid by massive recent forced displacement. Relatively little is known about the health system response to this large-scale mobility.
Aims: To review the literature on the Region critically, identify gaps and suggest areas needing research and policy attention.
Lancet Child Adolesc Health
July 2021
Ensuring diets of children aged 6-23 months meet recommended guidance is crucial for growth and development and for the prevention of malnutrition including stunting, wasting and micronutrient deficiencies. Despite some improvement, indicators related to undernutrition and overnutrition fall short of global targets in the Middle East and North Africa (MENA) region that consist of low- and middle-income countries witnessing political and social changes and a nutrition transition. This research aims at reviewing the situation related to the diets of children aged 6-23 months in five selected countries in the MENA region, examining factors affecting complementary feeding and providing recommendations for guiding effective strategies to improve it.
View Article and Find Full Text PDFArmed conflict disproportionately affects the morbidity, mortality, and wellbeing of women, newborns, children, and adolescents. Our study presents insights from a collection of ten country case studies aiming to assess the provision of sexual, reproductive, maternal, newborn, child, and adolescent health and nutrition interventions in ten conflict-affected settings in Afghanistan, Colombia, Democratic Republic of the Congo, Mali, Nigeria, Pakistan, Somalia, South Sudan, Syria, and Yemen. We found that despite large variations in contexts and decision making processes, antenatal care, basic emergency obstetric and newborn care, comprehensive emergency obstetric and newborn care, immunisation, treatment of common childhood illnesses, infant and young child feeding, and malnutrition treatment and screening were prioritised in these ten conflict settings.
View Article and Find Full Text PDFBackground: Lebanon currently hosts around one million Syrian refugees. There has been an increasing interest in integrating eHealth and mHealth technologies into the provision of primary health care to refugees and Lebanese citizens.
Objective: We aimed to gain a deeper understanding of the potential for technology integration in primary health care provision in the context of the protracted Syrian refugee crisis in Lebanon.
Background: Women and children suffer disproportionately in armed-conflicts. Since 2011, the protracted Syrian crisis has fragmented the pre-existing healthcare system. Despite the massive health needs of women and children, the delivery of key reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) interventions, and its underlying factors are not well-understood in Syria.
View Article and Find Full Text PDFBackground: Hypertension is a leading risk factor for mortality and morbidity globally and in the Arab world. We summarize the evidence on awareness, treatment, and control of hypertension, to assess the extent of gaps in the hypertension continuum of care. We also assess the influence of gender and other social determinants at each level of the cascade of care.
View Article and Find Full Text PDFBMC Int Health Hum Rights
October 2019
Background: Violence against women has particular importance for women's health and wellbeing in the Arab world, where women face persistent barriers to social, political and economic equality. This review aims to summarize what is known about the prevalence of physical, sexual and emotional/psychological intimate partner violence (IPV) against women in the 22 countries of the Arab League, including geographic coverage, quality and comparability of the evidence.
Methods: A systematic review of IPV prevalence in Arab countries was carried out among peer-reviewed journal articles and national, population-based survey reports published by international research programmes and/or governments.
Background: Since the beginning of the Syrian conflict in 2011, Jordan, Lebanon and Turkey have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs).
Objectives: We aimed to describe the ways in which these three host country health systems have provided NCD services to Syrian refugees over time, and to highlight the successes and challenges they encountered.
Methods: We conducted a descriptive review of the academic and grey literature, published between March 2011 and March 2017, using PubMed and Google searches complemented with documents provided by relevant stakeholders.
Purpose: This article presents a systematic review of the prevalence of violence against adolescents in the 22 countries of the Arab League.
Methods: Data on physical and emotional child maltreatment, sexual abuse, bullying and fighting, violence in schools, and intimate partner violence against adolescent girls were retrieved using: (1) a systematic search for peer-reviewed journal articles using Medline and the Social Sciences Citation Index; and (2) a search for nationally-representative, population-based surveys.
Results: Published evidence suggests that physical, sexual, and emotional violence against adolescents is widespread in the Arab region.
Background: Physical inactivity is associated with excess weight and adverse health outcomes. We synthesize the evidence on physical inactivity and its social determinants in Arab countries, with special attention to gender and cultural context.
Methods: We searched MEDLINE, Popline, and SSCI for articles published between 2000 and 2016, assessing the prevalence of physical inactivity and its social determinants.
Introduction: Women and children account for a disproportionate morbidity burden among conflict-affected populations, and yet they are not included in global accountability frameworks for women's and children's health. We use Countdown to 2015 (Millennium Development Goals) health indicators to provide an up-to-date review and analysis of the best available data on Syrian refugees in Jordan, Lebanon and Turkey and internally displaced within Syria and explore data challenges in this conflict setting.
Methods: We searched Medline, PubMed, Scopus, Popline and Index Medicus for WHO Eastern Mediterranean Region Office and relevant development/humanitarian databases in all languages from January 2011 until December 2015.
Although the issue of breastfeeding in Lebanon has risen on the political agenda, the country does not meet international recommendations for early breastfeeding practices. This study analysed barriers to dissemination, implementation, and enforcement of key policies to improve early breastfeeding practices. We conducted interviews with stakeholders in breastfeeding policy in Lebanon and used a framework approach for analysing data.
View Article and Find Full Text PDFObjective: While gender differences in hypertension and increased prevalence rates among women at midlife have been documented in multiple settings, the evidence on the Arab world has not been systematically examined. This review summarizes the evidence related to gender disparities in midlife hypertension in this region.
Methods: We searched MEDLINE and Social Sciences Citation Index (SSCI) databases for studies, published between January 2000 and August 2015, on hypertension in the 22 countries of the Arab region.
Digital technology is increasingly used in humanitarian action and promises to improve the health and social well-being of populations affected by both acute and protracted crises. We set out to (1) review the current landscape of digital technologies used by humanitarian actors and affected populations, (2) examine their impact on health and well-being of affected populations, and (3) consider the opportunities for and challenges faced by users of these technologies. Through a systematic search of academic databases and reports, we identified 50 digital technologies used by humanitarian actors, and/or populations affected by crises.
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