Project Title: Shaping Research for Health in the Arab World: A Systems and Network Approach to Advance Knowledge, Inform Policy, and Promote Public Health. IDRC Project Number-Component Number: 106981-001 By: 1. Abdulrahim, Sawsan 2. Afifi, Rima 3. Alameddine, Mohamad 4. DeJong, Jocelyn 5. Dewachi, Omar 6. El Jardali, Fadi 7. Germani, Aline 8. Ghattas, Hala 9. Habib, Rima 10. Jabbour, Samer 11. Nakkash, Rima 12. Nuwayhid, Iman 13. Sibai, Abla Report Type: Final Technical report Period covered by the report: June 2012 – January 2019 Date: May 10, 2019 Countries where project was carried out: - Lebanon (All components) - Oman, Egypt, Jordan, Tunisia, Bahrain (K2P) - Syria, Occupied Palestinian territories (RHWG) - Egypt, Bahrain, Jordan, USA, Palestine, United Arab Emirates (TCRG) - Yemen, Jordan, Palestine and Egypt (AEHN) - Syria, Lebanon, Turkey, Germany (LCS) Countries on which research was carried: - Arab region (CRPH) - Arab countries and Turkey (RHWG) - Iraq, Syria (WGHWG) - Morocco, Kuwait, Iraq, Bahrain, Sudan and Palestine (NCD) - Syria (LCS) - USA, Denmark, Oman and Kuwait, Canada, Germany, Turkey (Health inequities) - Syria (AEHN) - Arab countries and Turkey (M&E) Full Name of Research Institution: American University of Beirut (Faculty of Health Sciences - FHS) Address of Research Institution: American University of Beirut P.O. Box 11-0236 Riad El-Solh, Beirut 1107 2020 Lebanon Names and Contact Information of Primary Researcher from FHS: Aline Germani Center for Public Health Practice (CPHP) [email protected] Center for Research on Population and Health Hala Ghattas (CRPH) [email protected] Fadi El-Jardali Knowledge to Policy (K2P) Center [email protected] Agriculture, Environment, and Health Research Rima Habib Project (AEH) [email protected] Jocelyn DeJong Reproductive Health Working Group (RHWG) [email protected] Rima Nakkash Tobacco Control Research Group (TCRG) [email protected] Warfare, Public Health, and the Crisis of the State Omar Dewachi (War and Global Health Working Group [email protected] (WGHWG)) Mohamad Alameddine Occupational violence [email protected] 20 /9 Non-Communicable Diseases Research Working Abla Sibai Group (NCD) [email protected] The Lancet-American University of Beirut Samer Jabbour Commission on Syria: Health in Conflict (LCS) [email protected] Sawsan Abdulrahim Health Inequities [email protected] Sawsan Abdulrahim Disability and public health [email protected] Samer Jabbour Social Science and Public Health [email protected] Rima Afifi Monitoring and Evaluation (M&E) [email protected] 30 /9 Table of contents page number SYNTHESIS ........................................................................................................................ 5 PROGRESS REPORT - OBJECTIVE 1: “To build research capacity and enhance knowledge production in the region” I. Center for Research on Population and Health (CRPH) .......................................... 12 II. Research Networks 1. Reproductive Health Working Group (RHWG) ............................................ 25 2. Tobacco Control Research Group (TCRG) ................................................... 31 3. Agriculture, Environment, and Health Network (AEHN) ............................. 36 4. Social Science and Public Health ................................................................ 40 III. Research ideas that FHS and CRPH are nurturing 1. Warfare, Public Health, and the Crisis of the State: (War and Global Health Working Group) .................... .................................................................... 41 2. Occupational Violence…………. .................................................................... 47 3. Non-Communicable Diseases Research Working Group (NCD) ................... 50 4. Monitoring health inequities through enhancing the quality of existing data: a demonstration project in Lebanon ................................................. 56 5. Disability and Public Health ... .................................................................... 60 IV. The Lancet-American University of Beirut Commission on Syria: Health in Conflict ............................................. .................................................................... 62 PROGRESS REPORT - OBJECTIVE 2: “To strengthen and influence policy and promote evidence-informed decision making in the region” I. Knowledge to Policy (K2P) Center ..... .................................................................... 65 PROGRESS REPORT - OBJECTIVE 3: “To strengthen public health professional practice in the region” I. Center for Public Health Practice (CPHP) ............................................................... 77 PROGRESS REPORT - OBJECTIVE 4 “Advance an institutional model for academic public health based on a systems approach that integrates and enhances synergy between research, knowledge translation and policy impact, and outreach and practice, and uses networks to impact public health in the region” I. Monitoring and Evaluation ............... .................................................................... 87 40 /9 SYNTHESIS Shaping public health education, research and policy in the Arab World This initiative at the Faculty of Health Sciences (FHS) aimed to strengthen systems and institutions for research and education in public health and facilitate opportunities for inter- disciplinary collaboration on critical health issues across institutional and geographical boundaries in the MENA region. To this end, FHS developed and promoted a model for public health schools based on three collaborating academic Centers to enhance synergies between research, capacity development of junior researchers, knowledge translation and professional practice. The Faculty was guided by a vision that calls for transformational education producing agents of change, relevant research informed by concerned partners and stakeholders and translated into impactful public health practice and policy, and a public health movement that strengthens institutional and individual collaborations across the region and expresses the voices, needs, and aspirations of its peoples within the region and in global policy circles. To achieve this ambitious vision, FHS adopted its innovative, homegrown 360° systems-network model to public health which is illustrated below. Research CRPH Networks Teaching/ Learning Departments GPHP Practice CPHP K2P Policy Basically, FHS realized that if we want to shape public health in the region, there is a need to facilitate synergy between research, practice, and policy and approach any public health issue using these three lenses concurrently as early as possible in the process. The Centers for Research on Population and Health (CRPH), Public Health Practice (CPHP), and Knowledge to Policy (K2P) institutionalize these three functions and serve as the engines for each of these three domains as well as the facilitators for interaction and synergy between research, practice, and policy. The Graduate Public Health Program (GPHP) and other academic programs at FHS are situated in the middle of this model providing an innovative learning medium for FHS students as they become immersed during their formative years to view public health holistically in all of its dimensions (research, policy, and practice from a multidisciplinary and collaborative perspective). We also recognized that FHS cannot do it alone acknowledging the fragile and uncertain context of public health in the region. As a result, our model accommodated and supported the creation and continuity of regional 50 /9 research networks of like-minded individuals and institutions as a prerequisite for any change. However, early on we realized that taking this model to scale within the region is a long and probably a multi-decade endeavor. We also understood that although our model may not fit the needs of sister academic institutions in the region its spirit and commitment to reach beyond disciplinary and geographic boundaries will. The IDRC’s grant, awarded in 2012, helped FHS set the foundations for the realization of this vision. Furthermore, the flexibility provided to FHS within this grant proved to be most useful and allowed FHS to be relevant and responsive to changes in Lebanon and the region. After all, the proposal was written as the Arab uprisings were unfolding. In it, we described the diversity in the Arab world, a region with some of the richest and poorest countries of the world with striking inequities in health indicators between and within countries. We highlighted the lack of public health infrastructure in the region and of human and financial resources to carry out the mission of public health, and the deep isolation of public health academics, and practitioners as a result of despotic regimes, lack of freedom, protracted war, occupation, and conflict. With the uprisings and the multiyear wars in several countries, the situation has exacerbated with more than half of the Arab countries engaged in active wars or heavily affected by them. Many of the health and social gains accumulated over decades have been lost, totally or partially, in some of these countries such as Iraq, Yemen, Libya, and Syria. The burden of these wars and conflicts spread out beyond the political borders of these countries. The situation in Syria, which has been described as the largest humanitarian crisis in modern day history, had a major impact on its neighboring countries. Lebanon, a country of 4.5 million residents, hosts more than one million Syrian refugees presenting