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GOAL

Supporting government and partners in health system strengthening for better mental health of Syrian refugees and host communities in Lebanon.

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About

GOAL is a three-year research project which began in February 2020 with funding from the United Kingdom’s Global Challenges Research Fund (GCRF). GOAL seeks to support health system responsiveness to the mental health needs of people affected by protracted displacement in Lebanon.

The GOAL Partnership

GOAL is a partnership between the National Mental Health Program of Lebanon (Ministry of Public Health), the London School of Hygiene and Tropical Medicine, ABAAD, St Joseph’s University of Beirut, War Child Holland (Research and Development Department and War Child Lebanon), and Positive Negatives. GOAL applies a co-production approach, with key stakeholders centrally involved in the project design and implementation.

Research

The aim of GOAL is to support government and partners in strengthening the ability of health systems to meet the mental health needs of refugee and host communities affected by protracted displacement, focusing on Lebanon. GOAL consists of five Work Packages focusing on governance (transparency, accountability, and integrity), governance (participation), financing, and capacity strengthening.

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Syrian Refugees in Lebanon

There are over one million Syrian refugees living in Lebanon, with the majority living there for over five years. There are high levels of mental health needs among Syrian refugees in Lebanon because of the day-to-day challenges they face in Lebanon and also the effects of the war in Syria and forced displacement to Lebanon. There are also high unmet mental health needs among vulnerable host populations in Lebanon. While effective mental health interventions do exist, there are major gaps in treating mental health needs among both Syrian refugees and Lebanese. The challenge is how to best deliver such services, including designing health systems to support effective delivery. This requires the close involvement of Syrian refugees and Lebanese living with mental disorders in designing relevant and impactful services and systems. 

About
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There are over one million Syrian refugees living in Lebanon, with the majority living in Lebanon for over five years. Lebanon is experiencing many of the health challenges found in other protracted displacement settings, such as high unmet mental health needs among refugee and host populations and fragmented health policy responses. While effective mental health services exist, there are major gaps in access to them. The challenge is how to best deliver such services, including designing health systems to support effective delivery. This requires the close involvement of Syrian refugees and Lebanese living with mental disorders in designing relevant and impactful services and systems. 

GOAL is a three-year research project which began in February 2020 with funding from the United Kingdom’s Global Challenges Research Fund (GCRF).  It is a collaboration between the London School of Hygiene and Tropical Medicine, the National Mental Health Program of Lebanon, St. Joseph’s University of Beirut, Abaad, War Child Holland (Lebanon office), and Positive Negatives.

The overall aim of GOAL is to support government and partners in strengthening the ability of health systems to meet the mental health needs of refugee and host communities affected by protracted displacement, focusing on Lebanon.

The specific objectives of GOAL are to:

  1. Explore barriers and facilitators to strengthening health system governance for supporting access to culturally appropriate mental health care for Syrian refugees and host populations in Lebanon
  2. Strengthen mental health service user participation in health system governance in Lebanon
  3. Identify sustainable financing mechanisms that can strengthen health system responses for mental health services for Syrian refugees and host communities in Lebanon
  4. Strengthen capacity on governance and health financing to support a resilient and sustainable health system addressing the mental health needs of Syrian refugees and host populations in Lebanon
  5. Maximise the value of the project findings and methods for other protracted displacement settings in ODA countries

GOAL applies a co-production approach, with key stakeholders (particularly mental health service users) centrally involved in the project design, implementation and research. Gender informs all aspects of GOAL’s research and capacity strengthening activities. 

The GOAL Partnership
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GOAL is a partnership between the National Mental Health Program of Lebanon, the London School of Hygiene and Tropical Medicine, ABAAD, St Joseph’s University of Beirut, War Child Holland (Research and Development Department and War Child Holland), and Positive Negatives. GOAL applies a co-production approach, with key stakeholders centrally involved in the project design and implementation.

GOAL Partners

Abaad logo

 

Positive Negatives logo

 

Ministry of Public Health logo

 

USJ ISSP logo

 

War Child logo

 

 

 

The GOAL Team
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London School of Hygiene and Tropical Medicine, Principal Investigator
Rabih El Chammay

Rabih El Chammay

National Mental Health Program of Lebanon / Abaad, Co-Investigator / Lebanon lead
Michèle Kosremelli Asmar

Michèle Kosremelli Asmar

Professor, Institute of Public Health, St Joseph’s University, Co-investigator
Ghida Anani

Ghida Anani

Director, ABAAD
Felicity Brown

Felicity Brown

War Child Holland / Lebanon, Co-Investigator
Emily Oliver

Emily Oliver

Managing Director, Positive Negatives

Daniela
Fuhr

Assistant Professor
London School of Hygiene and Tropical Medicine, Co-investigator

Josephine
Borghi

Associate Professor
London School of Hygiene and Tropical Medicine, Co-investigator

Martin
McKee

Professor
London School of Hygiene and Tropical Medicine, Co-investigator
Noor Kik

Noor Kik

National Mental Health Program of Lebanon / Abaad, researcher
Thurayya Zreik

Thurayya Zreik

Abaad, Researcher

Nadim Abu Alwan

Abaad, Researcher

Neha
Singh

Assistant Professor
London School of Hygiene and Tropical Medicine, Researcher

Adrianna
Murphy

Assistant Professor
London School of Hygiene and Tropical Medicine, Researcher
Research
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GOAL consists of five research and capacity strengthening Work Packages (described below). 

Gender is a cross-cutting issue informing all aspects of GOAL. The work on gender will examine how structures, practice, and culture influence gendered expectations, roles, and power imbalances; and this in turn influences governance, policy making and the different lived experiences of using mental health services.

Co-production is also central to the GOAL approach, particularly involving the National Mental Health Program of Lebanon and mental health service users in the co-design and co-implementation of the project activities and outputs. We will also examine the benefits and challenges of co-production for the research in GOAL.

Work Package One: Governance (transparency, accountability, and integrity)

The objective of Work Package One is to explore barriers and facilitators to strengthening health system governance for supporting access to culturally appropriate mental health care for Syrian refugees and host populations in Lebanon. We use the TAPIC framework on health system governance, based upon governance attributes of transparency, accountability, participation, integrity and capacity. The research methods include literature reviews, qualitative interviews, and quantitative surveys with service providers.

Work Package Two: Governance (participation)

The objective of Work Package Two is to strengthen mental health service user participation in health system governance in Lebanon. This will seek to support mental health service users (refugee and Lebanese host population) as agents and advocates for change in the policy-process as their role is recognised as central to supporting more responsive health systems. The research methods will include qualitative interviews and focus groups with mental health service users, and semi-structured interviews with other key stakeholders from the government, UN, NGOs and universities.

Work Package Two also includes the development of communications formats to help inform policy and public attitudes towards mental health. The materials may include short animations, augmented reality digital images, and an interactive story platform. The GOAL partner Positive Negatives will co-create these communication formats with mental health service users and project partners.

Work Package Three: Financing

The objective of Work Package Three is to identify sustainable financing mechanisms that can strengthen health system responses for mental health services for refugees and host communities in Lebanon. The research methods will include systematic reviews, secondary data and document review, a quantitative survey with mental health service users, and qualitative research with Syrian refugees and Lebanese host populations, local and national stakeholders from government, NGOs, UN agencies and refugee representatives working on MHPSS programming and policies.

Work Package Four: Capacity Strengthening

The objective of Work Package Four is to strengthen capacity on governance and health financing to build a resilient and sustainable health system addressing the mental health needs of refugees and host populations in Lebanon. It will include technical training related to governance and financing, intuitional support for conducting research, and support to individual researchers through professional mentoring and development programmes.

Work Package Five: Global Resonance

The objective of Work Package Five is to maximise the value of the project findings and methods for other protracted displacement settings in other countries. Activities will include: the development of analytical frameworks on mental health governance and financing in protracted displacement settings to support the project’s work in other protracted displacement contexts; and three workshops in Beirut, London, and Nairobi. The communications formats led by Positive Negatives will also be used to provide examples of innovative materials demonstrating the participation of mental health service users in research, policy-making processes, advocacy and public engagement.

 

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GOAL Kick-Off Meeting

On 24 and 25 February 2020 members from all the collaborating organisations came together to officially launch the GOAL project at a meeting hosted by St Joseph's University in Beirut. As well as being a chance for the team to get to know each other better,

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Bayard Roberts (GOAL PI) welcomes everyone to GOAL project kick-off meeting

this two day meeting provided an opportunity to further develop research plans and define outputs for this exciting three year project.

GOAL project awarded funding by the United Kingdom Research Initiative

We are delighted to announce that the GOAL project has been awarded funding by the United Kingdom Research Initiative through the Global Challenges Research Fund / Economic and Social Research Council.