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Developing and validating trauma-informed, community-embedded mental health and psychosocial support models for sexual and gender-based violence survivors in resource-constrained settings - NU/LSHTM project

Supervisory team

Nagasaki University 

LSHTM  

The project

Sexual and gender-based violence (SGBV) is a devastating public health and human rights crisis, with severe consequences in Low- and Middle-Income Countries (LMICs), where poverty, weak health systems, and ongoing or recent conflict intersect (Stark & Ager, 2011). In conflict-affected regions, SGBV is weaponised through systematic acts of brutality, used to dismantle community structures, and instil fear (Johnson et al., 2008).  The psychological impacts are profound; a controlled trial in the DRC found nearly 74% of women survivors experienced severe distress, including depression, anxiety, and PTSD (Bass et al., 2013). Despite this, up to 85% of survivors in LMIC settings receive no Mental Health and Psychosocial Support (MHPSS) (Tol et al., 2011). 

While MHPSS interventions are increasingly expected to be trauma-informed and community-embedded, this model requires critical adaptation. This project directly addresses the caution that community-based responses can inadvertently reinforce existing power hierarchies (Abramowitz & Kleinman, 2008).  

Project Aim: This project aims to develop and preliminarily validate a contextually adapted, trauma-informed, and community-embedded MHPSS model for SGBV survivors in a selected resource-constrained, conflict-affected setting.

The research will employ a multi-phase, mixed-methods design: 

  1. Situational Analysis & Scoping: A comprehensive scoping review and stakeholder mapping will critically assess the MHPSS landscape and explicitly examine the capacity, inclusivity, and potential fragmentation of local community structures, directly engaging with Abramowitz & Kleinman's (2008) critique.
  2. Formative Qualitative Research: In-depth interviews and focus group discussions with SGBV survivors, community health workers, and key informants will explore local conceptualizations of trauma, healing, barriers to care, and sources of resilience.
  3. Co-Design of the MHPSS Model: Participatory workshops with survivors and local stakeholders will co-design a draft MHPSS model, outlining key components and delivery mechanisms (e.g., via trained community health workers).
  4. Preliminary Validation and Feasibility Testing: The co-designed model will be piloted with a small cohort to assess its acceptability, feasibility, and safety, using qualitative feedback and preliminary outcome measures for refinement. 

References 

  • Abramowitz, S. & Kleinman, A. (2008). Humanitarian intervention and cultural translation: a review of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. Intervention, 6(3), pp.219–227.
  • Bass, J.K. et al. (2013). Controlled trial of psychotherapy for Congolese survivors of sexual violence. New England Journal of Medicine, 368(23), pp.2182–2191.
  • Johnson, K. et al. (2008). Association of combatant status and sexual violence with health outcomes in postconflict Liberia. JAMA, 300(6), pp.676–690.
  • Stark, L. & Ager, A. (2011). A systematic review of prevalence studies of gender-based violence in complex emergencies. Trauma, Violence & Abuse, 12(3), pp.127–134.
  • Tol, W.A. et al. (2011). Mental health and psychosocial support in humanitarian settings: linking practice and research. The Lancet, 378(9802), pp.1581–1591. 

The role of LSHTM and NU in this collaborative project

This joint PhD project will be co-led by the London School of Hygiene & Tropical Medicine (LSHTM) and Nagasaki University (NU), with both institutions offering complementary expertise to support the candidate in developing a robust, interdisciplinary, and contextually grounded research project. 

LSHTM will guide the candidate in gender and mental health research, drawing on its long-standing work addressing the structural drivers of health inequities globally. With a strong foundation in feminist, intersectional, and decolonial approaches, LSHTM will support candidates in critically analysing how power, gender, and institutional hierarchies shape both experiences of violence and access to care. The institution will also mentor candidates in developing ethical and reflexive research practices, ensuring that studies uphold principles of equity, co-production, and survivor-centred engagement. LSHTM will provide expertise in mixed methods, combining advanced quantitative techniques with qualitative approaches to examine patterns, determinants, and lived experiences of mental health outcomes. 

Nagasaki University will guide the candidate in implementation science and health systems adaptation, contributing deep expertise in designing and scaling public health interventions in fragile and resource-constrained contexts. NU will support the operational dimensions of the mixed-methods research, including the feasibility, sustainability, and integration of community-embedded MHPSS models into existing health systems. It will also play a key role in mentoring candidates on policy translation and strategic engagement with governmental and non-governmental stakeholders. Nagasaki will provide expertise in qualitative methods, employing in-depth interviews, participatory approaches, and thematic analysis to capture the lived experiences and contextual factors that influence the uptake of interventions. 

Together, LSHTM and NU will provide integrated supervision and mentorship that bridges conceptual development, mixed-methods approaches, critical analysis, and real-world application. The candidate will benefit from joint academic guidance, shared networks, and cross-institutional learning opportunities, ensuring that their research is both theoretically rigorous and practically transformative for survivors of SGBV and the systems intended to support them. 

Particular prior educational requirements for a student undertaking this project

In addition to the standard entry requirements, applicants should demonstrate: 

  • Minimum 2 years’ field experience in humanitarian/crisis settings, working with trauma or SGBV survivors.
  • High proficiency in the local language of the proposed research setting.
  • Demonstrated understanding of the unique patterns of violence in LMICs, such as the weaponization of sexual violence or deliberate disease transmission during conflict.
  • Demonstrated interest or experience in qualitative and participatory research methods. 
     

Skills we expect a student to develop/acquire whilst pursuing this project

The student will develop an interdisciplinary skillset to support feminist, justice-oriented mixed-methods research and implementation in complex global health settings, including: 

  • Mixed-Methods Research Design: Proficiency in designing and implementing a phased study, combining qualitative and quantitative methods for intervention development.
  • Community-Based Participatory Research (CBPR): Advanced skills in facilitating co-design workshops and ensuring the research process is led by community priorities and knowledge.
  • Ethical and Reflexive Research Practice: Training in conducting ethically sound, survivor-informed research in high-stakes environments, with emphasis on safeguarding, relational ethics, and community accountability.
  • Gender and Intersectionality Analysis: Critical tools for analysing how power, gender, and other axes of identity shape experiences of trauma, access to care, and the design of interventions.
  • Implementation Science Fundamentals: Capacity to assess feasibility, acceptability, and sustainability, preparing the MHPSS model for potential future scale-up within complex health systems.