Faculty of Health Sciences
American University of Beirut “May 2006 Issue No. 3”
In This Issue
Welcome to the third issue of CRPH News. This newsletter mental health among different subpopulations. The
of the Center for Research on Population and Health (CRPH) studies are planned for three communities on the outskirts
disseminates information about CRPH and its ongoing of Beirut.
activities to researchers and policy makers in Lebanon, the
Our two collaborative research programs, the Urban Health
region, and internationally. In this issue, we report on the
Study (UHS) and Choices and Challenges in Changing
many collaborations, research outputs, and activities that
Childbirth (CCCC), have continued to progress. The UHS is
have been the result of ongoing research initiatives from
working towards improving the health of poor communities
the CRPH and its affiliates over the past year.
in Beirut. A UHS Dissemination Team was formed to
We received a substantial grant from the Wellcome Trust to share findings of the UHS study with each participating
support our research program Health Status, Wellbeing and community. CRPH also initiated a series of research briefs
Population Change in the Middle East: A Research Network concerning the findings of the UHS for dissemination to
Approach. This funding will contribute to new research policy makers and community members.
studies, strengthen the CRPH infrastructure, and increase
CCCC regional research group has taken on studies focusing
capacity for population and public health research in the
on childbirth policies, the use and availability of maternity
Arab Middle East.
services, and delivery and postpartum practices. The group
CRPH research affiliates presented an informational has been seeing the evidence generated from previous
session, Population Health: From Research to Practice, observational research feed into intervention projects in
highlighting the main findings of two research projects. four countries in the region: Lebanon, Palestine, Syria and
The presentation was given at AUB’s Faculty of Health Egypt.
Sciences international scientific conference Public Health:
Finally, we highlight contributions from our monthly
Reaching Beyond Boundaries held in honor of the FHS
research seminar series, news from our affiliates, and
50th anniversary. CRPH affiliates also organized poster
profiles of our visiting research fellows.
presentation sessions summarizing the methodology and
selected findings from one research study. We invite you to learn more about CRPH and
its research activities by visiting our website at:
CRPH’s Urban Health Research Group (UHRG) focuses on http://staff.aub.edu.lb/~webcrph.
four themes: youth, women’s health, women and work, Marwan Khawaja, PhD
and older persons. The group is planning randomized Director
controlled studies to evaluate interventions to improve Center for Research on Population and Health
1. In This Issue 6. Publications from Sponsored Research
2. FHS Receives a Major Research Grant from the Wellcome 7. CRPH Research Seminars
8. CRPH Affiliates News
3. CRPH Participates in the 50th Anniversary of FHS
9. Visiting Fellows Program at the CRPH
4. Urban Health Research Group
5. Choices and Challenges in Changing Childbirth
AUB-CRPH News May 2006 1
FHS Receives a Major Research CRPH Participates in the 50th 3. Dissemination of Findings – Nida’ el-Helou, CRPH,
Woman and Work
Grant from the Wellcome Trust Anniversary of FHS 4. A Community Perspective – Ahmad Kheil, Islamic
• Gendered Division of Household Responsibilities in the
Urban Outskirts of Beirut
Health Association, Beirut, Lebanon.
The Wellcome Trust, UK, awarded the Faculty of Health The year 2004 marked the 50th anniversary (1954-2004) 5. Planning Intervention Studies – Rima Afifi, HBED, FHS, Elderly Health
Sciences (FHS) a second major grant of $3.1 million for of FHS, the first independent school of public health AUB.
five years starting January 1, 2005, to support the research in the Arab region. Celebrating the occasion, activities • The Urban Health Study (UHS) – The Elderly Component:
6. The Future of Urban Health Research – David Vlahov,
program Health Status, Wellbeing and Population Change in were held throughout the year and culminated in an Socio-demographic and health profile of the elderly
Center for Urban Epidemiologic Studies at The New
the Middle East: A Research Network Approach. international scientific conference entitled Public Health: population
York Academy of Medicine and Columbia University,
Reaching Beyond Boundaries held December 10-11, 2004. USA. • Religiosity and Depression among Elderly in Three
Propelled by the research interests of the CRPH, directed by
The conference addressed current challenges to public Suburban Underprivileged Communities in Beirut
Dr. Marwan Khawaja, the grant provides support for three CRPH also organized poster presentation sessions at the
health education, research, and practice in the Arab
main areas: new research studies, increased research conference, summarizing the methodology and selected • Risk of Mortality among the Elderly: Application of the
infrastructure and building a research network. findings from the different themes of the Urban Health indirect technique using the orphanhood method
As part of the conference, the CRPH organized a session Study, namely:
Through the Wellcome Trust grant, two studies will be
entitled Population Health: From Research to Practice. Two
launched. The first will focus on the health and wellbeing
of women of childbearing age, older people (60+ years
research projects, carried out by the center and funded by
the Wellcome Trust, were presented during the session: Methods Urban Health Research Group
old) and adolescents (9-11 years old) living in impoverished
“Choices and Challenges in Changing Childbirth” and • Communities in the Study (Community-based
communities on the outskirts of Beirut. The second is
the “Urban Health Study.” The session disseminated the participatory research) The Urban Health Research Group (UHRG) at CRPH
a series of regional studies on the medical practices,
main findings of these research projects, highlighting the was formed with FHS-wide participation to promote a
policies and determinants of changing childbirth and • Urban Health Study: Design and methodology
benefits and challenges of regional and multidisciplinary multidisciplinary approach to the conception, planning
post-partum care. These studies relate to choices and
collaboration and drawing on the experiences of and analysis of research at AUB. Working groups emerged
challenges in changing childbirth research and aim to: 1)
test ways to change poor obstetric practices and improve
disseminating research findings to the communities under Poverty and Urban Environment around four research themes: youth, women’s health,
study. The discussion explored options for further policy- women and work, and older persons. Currently, the UHRG
health in childbirth and newborn care; 2) contribute • Household Structure and the Production of Urban
oriented research. is in the process of planning randomized controlled studies
to the international debate on best practices; 3) collect Poverty: Findings from outer Beirut, Lebanon
and analyze baseline information on use, availability Choices and Challenges in Changing Childbirth is a regional in three urban neighborhoods – Bourj Barajneh, Hay el
and perception of maternity services; and 4) consolidate program hosted at the Faculty of Health Sciences with • Environmental Housing Quality in Three Underserved Sellom and Nabaa – relying on findings from the Urban
the CRPH network and build capacity among network partners in Egypt, Palestine and Syria. The program maps Urban Communities in the Outskirts of Beirut, Health Study and the support of organizations from the
partners. childbirth practices in the region, the use and availability Lebanon neighborhoods. The studies aim to evaluate interventions
of childbirth services, as well as delivery and postpartum to improve mental health among different subpopulations
Additionally, CRPH’s research infrastructure will be of the three neighborhoods.
strengthened enabling it to provide management, field
practices. Four presentations discussed the findings of Adolescent Health
the research projects and emphasized the benefits and
work, logistical and computing support for these research
challenges of having a regional network. Presentations • Distrust, Social Fragmentation and Adolescents’ Health
projects. The funds will build research capacity in the
included: in the Outer City: Beirut and beyond
region by facilitating the consolidation and expansion
of the CRPH’s training and statistical support services 1. Choices and Challenges in Changing Childbirth • The Environment of Youth Related to Tobacco in
to other population and health researchers. Funds will Research Network – Tamar Kabakian, Department of Lebanon: Analysis by gender and tobacco type
also be used to develop a summer training program Health Behavior and Education (HBED), FHS, AUB. • Youth Caught Between Community and Country: The
where researchers can enhance their skills by working case of Beirut suburbs
with CRPH’s data sets or those from their own country. 2. Models of Transition from Research into Action –
The Regional Visiting Fellows Program--whereby regional Hyam Bashour, Department of Community Medicine, • Urban Health Study – Adolescent Health Component:
scholars visit the CRPH for one to three months and University of Damascus, Syria. Socio-demographics, health, and social profile of the
contribute to its research activities--will also be supported 3. Childbirth in Egypt: Actual Practices vs. Evidence-based adolescent population
by the funding. Care – Karima Khalil, Population Council, Egypt.
Finally, the Wellcome Trust funds support a research 4. Perspectives on Childbirth: A Regional Overview –
network dedicated to building capacity for population Faysal El-Kak, HBED, FHS, AUB. • Women’s Health
and public health research in the Middle East. It provides
scholarships for Master of Public Heath and Master of 5. Perspectives on Childbirth: The Case of Palestine – • Beyond Reproductive Health: Listening to women about
Science training, for hosting regional and visiting fellows, Laura Wick, Institute of Community and Public Health, their health in disadvantaged Beirut neighborhoods
and organizing regional workshops and meetings. Birzeit University, Palestine.
• Women Self-Reporting Health and Reproductive Health
Scholarship funds are dedicated for ten regional students 6. Reflections on Changing Childbirth Practices and Problems: Patterns and choice of care
enrolling in the Master of Public Health program, and for Policies – Oona Campbell, London School of Hygiene
two local MDs and five regional students enrolling in the and Tropical Medicine, UK. • Psychological Distress among Women in the Outskirts
Master of Science (Epidemiology or Population Health) of Beirut: Are somatic symptoms in underprivileged
The Urban Health Study is a community-based participatory
programs. communities an expression of women’s distress?
research project working to improve the health of poor
urban communities in Beirut by addressing the social • Symptomatology of Menopause among Middle-Aged
determinants of health. Presentations included: Women in Pre and Early Post Menopause Phase
Residing in Low Income Communities
1. Overview of the Urban Health Study – Marwan Khawaja,
Director of CRPH, FHS, AUB. Bourj Barajneh
2 AUB-CRPH News May 2006 2. Engaging the Communities – Jihad Makhoul, HBED, AUB-CRPH News May 2006 3
In 2005, members of the four working groups spent communities have the right to discuss the findings, and Conferences and Meetings Oral presentations:
considerable time in the three communities identifying perhaps contribute to the analysis of the data collected.
Members of the UHRG participated in the following • Afifi-Soweid, R. Planning for intervention research
community-based organizations and other stakeholders to The group recognizes that the communities’ numerous
conferences in 2005 (two local, one regional and seven in the Urban Health Study.
be involved in the research. The groups employed varying resources, strengths and skills should be invested in when
approaches to community participation, but in each case, addressing health problems and promoting wellbeing. international) where they presented 13 oral presentations • Afifi-Soweid, R. Peering through the looking glass:
the partnerships strengthened the research design. The and eight poster sessions: The concept of positive youth development.
The first phase of the dissemination activities targeted
youth group, for instance, helped create the Community 1. Population Association of America (PAA) Annual • Kaddour, A. Process of community involvement in
community gatekeepers and fieldworkers who were
Youth Committee, composed of NGOs working with youth Meeting. March-April 2005. USA. intervention research.
recruited from the communities. In this phase, the
in the Bourj Barajneh camp, funders of projects and young
investigators explained the UHS’s preliminary findings, • Khawaja, M., Twetel-Salem, M., and Mowafi, • Khawaja, M., et al. Women/reproductive health
people themselves. This committee has emerged as the
including socio-economic conditions; health and education; M. Household structure and the production of intervention in the outskirts of Beirut: A research
key partner in a broadly participatory process to plan,
environmental and housing conditions; and adolescent, urban poverty: Findings from outer Beirut. Oral proposal.
conduct and eventually evaluate the intervention.
elderly and reproductive health. Seventeen dissemination presentation. 4. XXV International Union for the Scientific Study of
To map community-based resources, the women’s sessions were held in the three communities, attended by Population (IUSSP) International Population Conference.
health group extended their consultations to directors members of 40 different NGOs working in the communities 2. Improving Services for the Elderly Palestinian Refugees
July 2005. France
of neighborhood associations, NGOs, health center staff, as well as by fieldworkers and interested members of the in Lebanon. June 2005. Lebanon.
employees of local government offices, schools, health communities. Oral presentations:
• Chaaya, M. The status of elderly population in Burj
clubs and midwives and gynecologists in local private Barajneh Palestinian camp: Results from the Urban • Jarallah, Y. (2005). Adolescents’ health and
The sessions solicited useful and critical comments about
practice. The sustained contact with the communities Health Study. Oral presentation. wellbeing: The role of ethnicity, built environment
the study. Overall, the responses showed that the study’s
has given the CRPH a more nuanced understanding of and social support. MSc. Population Health, FHS/
findings reinforced the community members’ pre-existing 3. Reproductive Health Working Group. July 2005.
the issues and community concerns, supplementing and AUB.
knowledge about certain socioeconomic and health Lebanon.
sometimes challenging the survey data.
conditions in their communities. In addition, the study • Khawaja, M., and Mowafi, M. Cultural capital and
findings highlighted new issues of concern which may self-assessed health in low income women: A case
UHS Dissemination help guide future activities of community organizations. study from Greater Beirut, Lebanon.
The Urban Health Study (UHS) Dissemination Team was The UHS Dissemination Team aimed at presenting the Poster presentation:
formed in October 2003 to share findings of the study research material in a less academic format – although they
have yet to reach out directly to the community members • Ibrahim, G. (2004). Women’s autonomy and
with community leaders, grass-root activists, policy
themselves. Engaging the right people in communities, utilization of reproductive health services in three
makers and people from the community. With the next
balancing the conflicting priorities of community groups impoverished areas in Lebanon. MSc. Population
phase of the project focusing on intervention studies,
(and their need for interventions) with the resource Health, FHS/AUB.
engagement of the community stakeholders in the study
was seen as vital. Members of the UHRG believe that constraints of FHS, and making the data user-friendly – 5. Seminar for faculty and graduate students of the St.
participating communities should be informed about the while preserving its accuracy and addressing the concerns Louis University School of Public Health. August 2005.
findings which may be used to improve their community’s of the researchers – are all of vital importance to the UHS USA.
health conditions. Moreover, the group insists that the Dissemination Team.
• Afifi-Soweid, R. Social determinants of health in
Lebanon: The Urban Health Research Project. Oral
6. XVIII International Symposium on Epidemiology in
Occupational Health. September 2005. Norway.
• Habib, R. R., Hamdan, M., Nuwayhid, I., and Odaymat,
F. A healthy houseworker effect: On women’s
involvement in domestic labor. Published on-line in:
Occupational and Environmental Medicine, 62(10).
7. Environmental Health Risk. September 2005. Italy.
• Habib, R., Basma, S., Yeretzian, J.S., and Aybout, D.
The built environment in poor urban communities
in the outskirts of Beirut, Lebanon. Published in the
conference proceedings. Oral presentation.
8. Fourth International Conference on Urban Health.
October 2005. Canada.
• Chaaya, M. Religiosity and elderly mental
health: Evidence from refugee and non-refugee
underprivileged urban communities.
• Chaaya, M. Working conditions and mental health
among elderly from three underprivileged urban
communities in Beirut.
Rural houses in Urban Slums-Bourj Barajneh A bridge crossing Nabaa and Bourj Hammoud
4 AUB-CRPH News May 2006 AUB-CRPH News May 2006 5
Choices and Challenges in mother and her baby, while other beneficial practices
were not adopted. Moreover, many hospitals in our region
5. National Workshop on Maternal Mortality in
Lebanon: A Call to Action. March 2004. Lebanon.
Changing Childbirth did not routinely evaluate their normal labor practices;
instead, practices were tailored to benefit providers rather
The aim of the workshop was to raise awareness on
maternal mortality in Lebanon and work towards
than women or their babies. launching a National Committee on Maternal Mortality
(NCMM). The NCMM was formed in May 2004.
CCCC research network carries out a coordinated research We also made a narrower exploration of antenatal and
program of regional studies involving: AUB, Lebanon; postpartum care. In-depth studies in Syria and Lebanon 6. Evidence-Based Practices in Normal Birth. February
Damascus University, Syria; Birzeit University, Palestine; confirmed that there was no clear package of antenatal 2004. Palestine.
and Egypt team in the Reproductive Health Working Group, care in use, and that many antenatal practices deviated
at the Population Council. The CRPH hosts the project and from the best evidence. The aim of the workshop was to improve care during
provides technical assistance in research design, sampling, normal birth in the Maqassed teaching hospital in
In-depth interviews with women found that they are not Jerusalem by comparing the usual care to evidence-
data collection and analysis.
involved in the decision-making process for normal care based practices.
Researchers in the CCCC research network undertook studies or c-section. In Syria, there was a lack of trust, reports of
focusing on childbirth policies, the use and availability of bad treatment and fear of being left alone. In Lebanon, 7. Research Methods and the Implementation of
maternity services, delivery and postpartum practices. women were discontent, yet trusted the physician’s choices Intervention Studies. February 2004. Palestine.
of procedures. Based on the Egyptian study, providers This aim of this workshop was to help participants prepare
Policy studies looking at general policy in Palestine,
perceive normal labor as unworthy of much attention; for the intervention study on routine vs. selective amniotomy
caesarian-sections in Lebanon, and general hygiene in
they want to study ‘difficult’ or complicated cases. They
Egypt identified areas where maternity care could be
also had difficulty communicating with women and would
improved, and clarified the immediate and policy factors
value receiving training on communication skills.
necessary to bring about change. This research suggested
that changing childbirth policies and practices at the The findings of theses studies have fed into intervention
national level will not be easy. Difficulties stem from a projects currently on-going in the four countries.
variety of causes, including unstable political context, lack Further large scale interventions are being designed for
of political commitment to evidence-based policymaking, implementation in the next five years of the program.
weak government oversight and regulations, lack of
national guidelines, lack of provider accountability, profit
Hay el Sellom motives, fragmented health infrastructures and the low Conferences, Workshops and Meetings
priority given to women’s health. CCCC research network organized seven local and regional
• El Shareef, M., & Afifi Soweid, R. How do youth in workshops during 2004 and 2005:
Our analyses of existing data sets in the four countries,
urban communities self identify. such as the Demographic and Health Surveys and the
• El Shareef, M., Afifi-Soweid, R., Nehlawi, M., & Pan Arab Project for Child Health, indicated the presence 1. Designing and Conducting Randomized Controlled
Rouhana, A. The environment of youth related of fairly good antenatal coverage, a considerable and Trials. May 2005. Lebanon. CCCC Designing and Conducting Randomized Controlled Trials
to tobacco in Lebanon: Analysis by gender and growing use of skilled attendants at delivery, and low use This RCT short course provided participants with insight
of postpartum care relative to other services. They also at Maqassed Hospital, Jerusalem, with obstetricians,
tobacco type. on designing and conducting randomized controlled trials.
showed that care is largely private, and that the c-section The course was led by Professors Diana Elbourne (from physicians and midwives at that hospital.
• Kaddour, A., and Nakkash, R. Realities and rate is increasing rapidly. Home births are decreasing, the London School of Hygiene and Tropical Medicine, Members of the research network attended one regional
complexities of community involvement: Experiences except in Palestine, where the proportion of home births UK) and Rona McCandlish (from the National Perinatal
from impoverished urban neighborhoods in meeting and two international conferences where they
attended by skilled attendants has been rising. Epidemiology Unit, UK). made six oral presentations about their research work:
Studies describing the immediate environment of 2. Care during Normal Birth in Maternity Facilities.
9. Fourth International Congress on Women Work & 1. Reproductive Health Working Group. July 2005.
childbirth focusing on the routines and practices November 2004. Palestine.
Health. November 2005. India. Lebanon.
of health care facilities, were pioneered in Lebanon,
adapted and operationalized in Syria and subsequently in This workshop disseminated the results of the study on • Abdulsalam, A. Effect of a community-based
Oral presentation: maternity policies and practices in the West Bank and held
Palestine. Collaborators in Egypt conducted an innovative intervention on postnatal outcomes: A study in
• Habib, R.R., Nuwayhid, I., Merhi, M., & Myntti, C. observational study documenting, for the first time, how interactive discussions with midwives on how to improve Damascus, Syria
Gendered division of household responsibilities doctors and nurses actually manage normal labor in a practices in their facilities in the West Bank.
in the urban outskirts of Beirut. Published in the typical facility, as compared to standardized guidelines. The • Wick, L., and el Hassan, S. The weight of RCT’s in
conference proceedings. 3. Writing a Group Paper on Birthing Practices in the changing medical practices: The example of breech
Palestine study investigated the care provided for normal
Arab Region. July 2004. Lebanon. presentation at Maqassed Hospital, Jerusalem
Poster Presentations: childbirth in West Bank maternity hospitals. Overall, the
studies reveal that few obstetric practices were evidence- This workshop resulted in the writing of a group paper on • The Egyptian Childbirth Team. Preliminary findings
• Habib, R.R., Hamdan, M., Nuwayhid, I., based: some were even potentially dangerous for the birthing practices in the Arab region authored by the four- from the Galaa Intervention to improve selected
Odaymat, F., & Campbell, O.M.R. Homemakers country regional CCCC team. The paper was published as: provider practices for delivering women.
and musculoskeletal disorders. Published in the Choices and Challenges in Changing Childbirth Research
conference proceedings. Network. (2005). Routines in facility-based maternity care: • Osman, H. Maternal mortality study, Lebanon.
Evidence from the Arab World. BJOG: an International 2. XXV IUSSP International Population Conference. July
• Habib, R.R., Nuwayhid, I., and Yeretzian, J.S. Paid Journal of Obstetrics and Gynecology, 112, 1270–1276.
work and domestic labor in urban communities 2005. France
in Lebanon. Published in the conference 4. “Changing Childbirth: Experiences from the Arab • Kabakian, T. Routines in facility-based maternity
proceedings. region,” Middle East Medical Assembly (MEMA). May care: Evidence from the Arab region. Oral
10. Lebanese Society of Family Medicine Fourth Annual 2004. Lebanon presentation.
Conference. November 2005. Lebanon. This session disseminated the findings of the regional 3. XXVII Annual ASPHER Conference, College of Health
team’s work. It was done in collaboration with the Sciences, American University of Armenia. September
• Chaaya, M. Determinants of depression among
Lebanese Society of Obstetrics and Gynecology. 2005. Armenia
poor elderly women: Findings from refugee and
non-refugee communities in the outskirts of Beirut, • Kabakian, T. Birthing in the Arab Region: How to
Lebanon. Oral presentation. translate research into policy. Oral presentation.
Choices and Challenges in Changing Childbirth Team
6 AUB-CRPH News May 2006 AUB-CRPH News May 2006 7
Publications from 5. Kabakian-Khasholian, T., and Campbell, O.M.R. (2005).
A simple way to increase services use: Triggers of
2. Chmeitally, H. (2005). Self-rated health and wellbeing
among the elderly: Evidence from three under-
CRPH Research Seminars
Sponsored Research women’s uptake of postpartum services. BJOG: an
International Journal of Obstetrics and Gynaecology, 112,
privileged communities in southern Beirut. MSc.
1315-1321. The CRPH hosted several scholars to give talks during its
3. Choueiry, N. (2005). Displacement and health status in monthly research seminars in 2004:
6. Khalil, K., Elnoury, A., Cherine, M., Sholkamy, H., low income women: Findings from a population based
Publications in scholarly journals Hassanien, N., Mohsen, L., Breebaart, M., and survey in greater Beirut. MSc. Population Health, FHS/
January, 2004 - The Forgotten Palestinian Refugees
of Egypt by Oroub El Abed, Researcher on Palestinian
Affiliates of the CRPH published six articles in scholarly Shoubary, A. (2005). Hospital practices vs. evidence- AUB. Refugees, AUC, Cairo
journals using the data of the Urban Health Study and seven based medicine: Categorization of normal labor
practices observed in an Egyptian teaching hospital. 4. Jarallah, Y. (2005). Adolescents’ health and wellbeing: There are an estimated 50,000 Palestinians in Egypt
articles using data produced by the Choices and Challenges
Birth, 32(4), 283-290. The role of ethnicity, built environment and social at present. Only a small number receives assistance
in Changing Childbirth research network during 2005.
support. MSc. Population Health, FHS/AUB. from UNHCR, the majority live without international or
Abstracts of these articles are available on the website of 7. Wick, L., Mikki, N, Giacaman, R., and Halabi, H.
CRPH (http://wwwlb.aub.edu.lb/~webcrph/). 5. Jawad, M. (2005). Normative stressors and psychological governmental assistance. This research project looked at
(2005). Childbirth in Palestine: Reported practices and how Palestinian refugees in Egypt earn their incomes; the
evidence-based guidelines. International Journal of wellbeing in the context of post-war environment. PhD.
Urban Health Study Gerontology Program, University of Massachusetts various sectors of the economy in which they are employed
Gynecology and Obstetrics, 89, 174-178. and the positions held; the standard of living they achieve,
1. Kaddour, A., Hafez, R., and Zurayk, H. (2005). Women’s Boston.
including their health and educational level; and the
perception of reproductive health in three communities Research Briefs 6. Ibrahim, G. (2004). Women’s autonomy and utilization survival strategies and coping mechanisms that Palestinians
around Beirut, Lebanon. Reproductive Health Matters, of reproductive health services in three impoverished have adopted while residing in their host country. The
CRPH initiated a series of research briefs summarizing
13(25), 34-42. areas in Lebanon. MSc. Population Health, FHS/AUB. research also examined changing governmental policies
selected findings from the Urban Health Study with the
2. Khawaja, M. (2005) Impoverishment and urban health aim of disseminating this data to a wider audience of often influenced by political events, toward Palestinians in
7. Saliba, M. (2004). Age and symptomology of menopause
in outer Beirut: Findings from the Urban Health Study. policy makers and community members. The first research Egypt and how these policies have impacted their living
in three urban Lebanese communities. MSc. Population
Journal of Urban Health, 82(Supplement 2), ii100 brief is entitled “A Profile of the Labor Force in Two Urban conditions over the past 50 years.
(Abstract). Lebanese Communities” and describes gender and age February, 2004 - An Approach to Managing Poverty in
distributions of the labor force, as well as their educational Other Materials Lebanon by Adib Nehmeh, Project Manager - Capacity
3. Khawaja, M., and Mowafi, M. (2005). Cultural capital and occupational characteristics, in the neighborhoods Building for Poverty Reduction UNDP / Ministry of Social
and morbidity in low income women: A case study from of Nabaa and Hay el Sellom. The brief concluded that 1. Wick, L., and Mikki, N. (2004). Reported Practices Affairs, Lebanon
outer Beirut. Journal of Urban Health, 82(Supplement people in these neighborhoods are generally low-skilled and Evidence-Based Guidelines: Implications for Safe
2), ii123 (Abstract). with an early entry into the labor force, which continues Childbirth in Palestine. Study Report. Palestine: Institute “Capacity Building for Poverty Reduction” is a joint project
to be male-dominated. However, working women tend to of Community and Public Health, Birzeit University. between the United Nations Development Programme
4. Mowafi, M., and Khawaja, M. (2005). Poverty: A occupy higher status jobs than men. (UNDP) and the Ministry of Social Affairs (MoSA) in Lebanon.
glossary. Journal of Epidemiology and Community Health, 2. Institute of Community and Public Health. (2003). This seminar provided information about the project’s
59(4), 260-264. The second research brief, entitled “Patterns of Household “Childbirth under Siege” [Booklet in Arabic] (illustrated main components and explained that this project is based
Income and Personal Wages in Two Urban Lebanese booklet for women on home birth distributed in the on a preparatory assistance study which identified national
5. Saab, B.R., Salem, M.T., Chaaya, M., and Campbell, Communities”, highlights the significant features of income West Bank and Gaza). Palestine: Institute of Community statistical survey needs, and institutional capacity building
O.M. (2005). Psychological distress among marginalized patterns in Nabaa and Hay el Sellom. It also includes the and Public Health, Birzeit University. needs in MoSA, including its social development services
women in the outskirts of Beirut: Determinants and residents’ own assessments of their economic situation. centers (SDSCs). The project includes the implementation
association with health perception. Journal of Urban Residents in these neighborhoods regard themselves as 3. Institute of Community and Public Health. (2003). of a national multi-purpose household survey. It also
Health, 82(4), 653-665. poor, and most households depend on more than one “Mabruk Maa Ajakum – Building Skills for Midwifery comprises a reform plan for the Ministry to promote the
source of income to make ends meet. The briefs are Care during the Period of Childbirth and The administration of social services at the central level, and
6. Saab, B.R., el Roueiheb, Z., Chaaya, M., and Sibai, published in English and Arabic and are available on the Postpartum” [Booklet in Arabic] (guide for midwives
A. (2005). Determinants of depression among poor a strategy of a program-based decentralization of services
CRPH website. distributed in the West Bank and Gaza). Palestine: through its SDSCs and its partnership with NGOs.
elderly women: Findings from refugee and non-refugee Institute of Community and Public Health, Birzeit
communities in the outskirts of Beirut, Lebanon. 1. Center for Research on Population and Health. (2005). University. March 2004 - Why Do Neighbors Have Different
Europe’s Journal of Psychology, 1 (3). (Online Journal). A Profile of the Labor Force in Two Urban Lebanese Environmental Priorities? A Contextual Interpretation of
Communities. Research Brief 001. Beirut: Center 4. Sholkamy, H., Khalil, K., Cherine, M., Elnoury, A., Environmental Risk Perception in Beirut by Abbas El-Zein,
Choices and Challenges Breebaart, M., and Hassanein, N. (2003). An
for Research on Population and Health, American Associate Professor, Environmental Health Department, FHS
in Changing Childbirth Observation Checklist for Facility-Based Normal Labor
University of Beirut.
and Delivery Practices: The Galaa Study. Monographs in Differences in environmental risk perception have
1. Bashour, H., and Abdulsalam, A. (2005). Syrian been explained using cultural theory, attitude theory,
2. Center for Research on Population and Health. (2005). Reproductive Health No.5. Cairo: Population Council.
women’s preferences for birth attendant and birth socioeconomic indicators or the characteristics of the risk
Patterns of Household Income and Personal Wages
place. Birth, 32(1), 20-26. 5. Arasoughly, A. (2002). Birth at the Checkpoint [video]. itself. The complex dynamics of access to environmental
in Two Urban Lebanese Communities. Research Brief
2. Bashour, H., Hafez, R., and Abdulasalam, A. (2005). Syrian 002. Beirut: Center for Research on Population and Ramallah: Ministry of Health and UNFPA. resources in cities add new dimensions to the perception
women’s perceptions and experiences of ultrasound Health, American University of Beirut. 6. Kabakian-Khasholian, T., and Najem, M. (2001). “Alf of urban environmental risk. A quantitative interpretation
screening in pregnancy: Implications for antenatal policy. Mabrouk” (illustrated booklet for women on postpartum of environmental risk perception in a Beirut neighborhood
Reproductive Health Matters, 13(25), 147-154. PhD and MSc Thesis health in Arabic). was presented using five sets of explanatory variables:
socioeconomic status, behavior, health, locality and
3. Choices and Challenges in Changing Childbirth One PhD thesis in Gerontology and six MSc theses (four 7. Wick, L. (1999). Traditional Birth Attendants in the West environmental perception.
Research Network. (2005). Routines in facility-based in Population Health, one in Epidemiology, one in Bank: An Assessment of System Building and Training
maternity care: Evidence from the Arab World. BJOG: Environmental Sciences) were also produced using data April, 2004 - Faith and Social Insurance: The Role of
Needs. Report. Palestine: Institute of Community and
an International Journal of Obstetrics and Gynecology, from the Urban Health Study. Religion in Social Welfare in Lebanon by Rana Jawad, PhD
Public Health and Women’s Health and Development
112, 1270-1276. Candidate, University of Nottingham, UK
1. Bayrakdar, S. (2005). Women and paid labor in Directorate.
4. Giacaman, R., Wick, L., Abdul-Rahim, H., and Wick, three poor urban areas in outskirts Beirut. MSc. The role of religion in the conceptualization and practice
L. (2005). The politics of childbirth in the context of Environmental Sciences, FHS/AUB. of social welfare in Lebanon was investigated. A profile of
conflict: Policies or de facto practices? Health Policy, 72, the Ministry of Social Affairs and five religious NGOs from
129-139. different sects was assessed on issues relating to their
philosophy of welfare and their policies and programs.
8 AUB-CRPH News May 2006 AUB-CRPH News May 2006 9
The following conclusions were offered: (1) welfare has
an instrumental role in Lebanon (2) the family remains
CRPH Affiliates News design of a randomized controlled trial funded by the
Wellcome Trust examining the effect of mobilizing pregnant
Hala Tamim (Assistant Professor, Dept. of Epidemiology
and Population Health, email@example.com) is a new CRPH
the key locus of welfare (3) religious welfare highlights women to demand better services during their delivery, in affiliate. She recently received two grants: one from the
the importance of Takaaful (4) religious faith is a key selected Lebanese hospitals. Wellcome Trust in September 2004 for her research
factor for both service-providers and service-users, which Rima Afifi-Soweid (Associate Professor, Chair
of the Dept. of Health Behavior and Education, project: “Implementation of an intervention to reduce
challenges the conventional need for social insurance Karima Khalil (Program Coordinator, Population Council,
firstname.lastname@example.org) received a grant for $10,000 Canadian the caesarean-section rate: A collaborative multi-center
(5) political interference affects the social welfare sector email@example.com) is working on evaluating providers’
from IDRC/RITC for her research project “Public position study in Beirut,” and another from the University Research
and (6) it is questionable to what extent the policies and training approaches to decrease the practice of harmful
programs of welfare actors in Lebanon are treating the toward tobacco control policy.” She published papers Board, in October 2004, for her research project: “Asthma,
delivery and postpartum practices in a teaching hospital
causes of poverty. on smoking behavior and tobacco control, and on body Hay Fever and Eczema among 6-7 year olds and 13-14 year
in Cairo, a study funded by the Wellcome Trust, Choices
weight amongst adolescents. She presented posters in the old school students in Lebanon.” In 2004, Dr. Tamim also
October, 2004 - The Social and Economic Situation in and Challenges in Changing Childbirth, and the Ford
Middle East Medical Assembly meeting held in Beirut, May participated in the Lebanese Epidemiological Association
Lebanon: Prospects and Reality by Adib Nehme, Policy Foundation Cairo Office. She has published articles on safe
2004; a report to the Welfare Association regarding the 10th Annual Conference in November, the First Regional
Advisor for Poverty Reduction, SURF-AS (Sub-regional motherhood and childbirth. She also held presentations
situation of Palestinian refugees in Lebanon; and a process Conference on Tobacco Control in May in Cairo, and
Resource Facility for Arab States) at the Social Research Center at the American University
evaluation of the Dbayeh health center. In addition, she Children and the Mediterranean Conference, in February.
in Cairo, January 2004, and in the Middle East Medical
The report, “The Socio-economic Condition in Lebanon: presented an inventory of KAP studies related to sexual in Genoa, Italy.
Association MEMA meeting held in Beirut, May 2004
Reality and Prospects,” was launched on 11 August, 2004. and reproductive health of young persons in the Arab as well as for the American Public Health Association
It is the output of an extended and coordinated effort
between the Ministry of Social Affairs and United Nations
states. She also conducted a needs assessment related
to research and intervention for sexual and reproductive
meeting in Washington, DC, November 2004. Visiting Fellows Program at
Development Programme (UNDP) through the project
“Capacity Building for Poverty Reduction.” This report
health of young persons in the Arab states to the UNFPA. Marwan Khawaja (Associate Professor, Dept. of
Epidemiology and Population Health, and CRPH Director,
attempts to compile the major existing data, covering Hyam Bashour (Professor, Damascus University, firstname.lastname@example.org) attended the annual
email@example.com) is currently working on a study meeting of the Panel for Social Science and Operations The Center for Research on Population and Health has
in particular the period between 1996 and 2002, with
entitled: “Effects of a community-based intervention on Research on Reproductive Health, organized by the WHO sponsored Visiting Fellows since January 2003. Selected
emphasis on the status of the social sectors in the country
postnatal outcomes.” Dr. Bashour, as a coordinator of the Department of Reproductive Health and Research, in Fellows from the Arab region visit CRPH from one to three
regarding education, health, employment, housing, labor,
Syrian team, has participated in all of the Choices and Geneva, September 2004. He also participated in the months to collaborate with faculty affiliates of the Faculty
social protection and others. It deals with these issues
Challenges in Changing Childbirth project workshops and Global Commission on International Migration’s regional of Health Sciences on ongoing research projects or to
and indicators from a developmental perspective and in
participated in the Choices and Challenges in Changing hearing for the Mediterranean and the Middle East held undertake their own research utilizing CRPH facilities and
an analytical manner, providing suggestions for policy
Childbirth session in the Middle East Medical Assembly, in Cairo, in September 2004. Dr. Khawaja presented two data resources. During the summer of 2004, CRPH hosted
May 2004, discussing women’s experiences with maternity papers at the Third International Urban Health Conference the following research fellows:
November, 2004 - Care-Seeking Behavior of Women Living care. Dr. Bashour recently had a paper accepted in Birth in Boston, in October 2004, as well as two posters in the
in Underprivileged Urban Communities in Outer Beirut by Sawsan Abdulrahim (June 8-August 7, 2004): Doctoral
analyzing Syrian women’s preferences for birth attendant Population Association of America Annual Meeting in candidate and graduate student instructor at the University
Faysal el-Kak, Lecturer, Health Behavior and Education and birth place.
Department, FHS Boston, in April 2004. In 2005, he organized two sessions of Michigan, Abdulrahim is expected to obtain her PhD in
Rima Habib (Assistant Professor, Dept. of Environmental for the Population Association of America Annual Meetings Health Behavior and Education in 2005. She analyzed data
This study looked at patterns of care-seeking behavior on the demography of the Middle East and North Africa,
Health, firstname.lastname@example.org) received grants from the from the Adolescent Health Survey at CRPH to prepare a
and provider choice in women’s self-reporting health and and the International Union for the Scientific Study of
reproductive health conditions in three urban communities University Research Board at the American University of manuscript for publication.
Beirut and from the Safadi Foundation to conduct research Population (IUSSP) meetings on Forced Migration.
around Beirut. The study examined contextual parameters Rita Giacaman (July 1-30, 2004): Dr. Giacaman has a PhD in
of each community, and the symptomatology of health on environmental radon levels in Lebanon (2004-current). Judy Makhoul (Assistant Professor, Dept. of Health Clinical Pharmacy and an M.Phil. in Sociology and Social
and reproductive health problems. A cross-sectional Dr. Habib also received a grant from the University Research Behavior and Education, email@example.com) participated Policy. She is the Research and Program Coordinator as
survey of a sub-population sample distributed in the three Board for her research on women’s exposure to detergents in the Third International Conference on Urban Health, in well as Associate Professor at the Institute of Community
communities was interviewed face-to-face. Women in in domestic work. She is currently involved in a research October 2004. She also participated in the Ministry of Social and Public Health at Birzeit University in Palestine. Dr.
the refugee camp community had the highest utilization project on women’s work and health funded by a grant Affairs (MoSA) conference on “How Universities View the
of services – mostly subsidized services. In the other Giacaman worked toward consolidating exchange relations
from the Wellcome Trust. In the course of her involvement ‘Family’,” held at St Joseph University, in November 2004, and cooperation between ICPH and FHS, focusing on joint
two communities, more women utilized private services. in the Ecohealth project in Bebnine, “Understanding
Female providers were preferred for reproductive health where she presented a paper in Arabic: “The influence training schemes and research. She also completed various
Water, Understanding Health” funded by the IDRC (Jan of families on their youth,” based on research findings components of research and initiated discussions with FHS
problems. Women with low incomes are significantly
more likely to use subsidized health services for their 2005-current), Dr Habib conducted fieldwork training for from two projects. Dr. Makhoul also published a paper faculty members on possible areas of research cooperation.
general health problems, while women with zero parity 24 interviewers and supervisors in the town of Bebnine in analyzing violence as the silent determinant of child labor. She participated in the joint retreat between FHS and ICPH.
and covered by health insurance are significantly more July 2005. She has published papers on cancer incidence She traveled to Cairo, in May 2004, as a member of the Dr. Giacaman also presented a seminar on “Palestinian
likely to use private services for their reproductive health and mortality among nuclear industry workers, and on Arab Families Working Group and as a member of the youth in crisis” to FHS faculty members and visitors.
problems. community participation and water quality in a coastal Border Crossings, War and Displacement team to meet
area in Lebanon. During 2004, Dr. Habib participated in with the group to discuss the disbursement of funds for Hania Sholkamy (July 1-30, 2004): An Assistant Professor
the following conferences: the 38th Middle East Medical research projects. at the Social Research Center of the American University in
Assembly in May, in Beirut; the Coastal Zone Asia Pacific Cairo (AUC), she received her PhD in Social Anthropology
Conference in September, in Brisbane; the 17th International Iman Nuwayhid (Professor, Dept. of Environmental Health, in 1997. Her fellowship focused on working with Dr.
Symposium on Epidemiology in Occupational Health in firstname.lastname@example.org) was a visiting professor in the Judy Makhoul of the FHS to develop further ideas for a
October, in Melbourne; and the 7th World Congress of Department of Community Medicine in the Faculty of publication on qualitative research methods in the Arab
Bioethics in November, in Sydney. Medicine at the UAE University from mid-August to mid- World. The product will be a joint publication from FHS at
September in 2004. Dr. Nuwayhid submitted three articles AUB and AUC.
Tamar Kabakian (Assistant Professor, Dept. of Health for publication in the past year relating to the occupational
Behavior and Education, email@example.com) is a co- health of children working in industrial shops, occupational
coordinator of the regional project Choices and Challenges health research in developing countries, and an
in Changing Childbirth. She is currently involved in the interdisciplinary approach to environmental education.
10 AUB-CRPH News May 2006 AUB-CRPH News May 2006 11
Ahmad Mandil (July 16- August 16, 2004): A Professor at the Abdel-Ilah Yaakoubd (August 2-September 2, 2004): A
Epidemiology Department of the High Institute of Public research professor at the National Institute of Statistics
Health at Alexandria University, Egypt, Dr. Mandil received and Applied Economics (INSEA) in Rabat, Morocco, Dr.
his DrPH in Epidemiology in 1991. He is currently working in Yaakoubd received his PhD in Demography in 1989. During
collaboration with Dr. Hala Tamim (CRPH affiliate) on “Pre- his fellowship, he collaborated with FHS faculty members
conceptional care and folic acid research,” in coordination concerning his research project which evaluates the
with the UCLA-School of Public Health. This research was evolution of the state of women’s health, particularly their
funded by UCLA and extended until May 2005. During reproductive health, in relation to their gender.
the fellowship, he worked closely with Dr. Hala Tamim
analyzing results as well as drafting research papers.
Join Us as a Visiting Fellow
The CRPH initiated the Visiting Fellows Program in January 2003. Selected fellows from the Arab region may visit CRPH
for a period of one to three months to collaborate with FHS faculty affiliates on ongoing research projects, or to undertake
their own research, utilizing the facilities of the Center and its data resources. Candidates must have an affiliation with an
academic (university) or research institution, must hold a postgraduate degree and must have a good working knowledge
of English. A fellowship application and list of required documents may be requested from Ms. Ruba Ismail, Program
Administrator, via email at firstname.lastname@example.org. The fellowship application should be submitted at least three months prior to
the proposed starting date of the fellowship.
The Master of Science in Population Health at FHS
The graduate program is designed to provide training in Population Sciences, focusing on the impact of population change
on health. The program offers basic training in population theory and analysis as well as in quantitative research methods.
Students enrolled in the Master of Science in Population Health program will participate in collaborative research activities
with FHS through the Center to gain practical hands-on experience. Students will also have access to the Center’s data
generated by the Urban Health Study and other studies for their thesis research.
The university catalogue and graduate admission application form can be requested from the AUB admissions office via e-
mail at email@example.com or downloaded from the AUB main web page http://www.aub.edu.lb.
Opportunities for qualified students to receive financial aid are available in the form of Graduate Assistantships, Graduate
Scholarships, and other sources of funding, such as research grants (when available), which are administered through FHS.
Information regarding financial assistance for FHS graduate programs can be obtained via e-mail from Arabia Mohammad
Ali Osseiran at firstname.lastname@example.org.
How to Contact Us
To learn more about CRPH research activities, subscribe to the newsletter, or to request an application for the Visiting Fellows
Program, contact us at:
Tel: + 961 1 347 444, ext. 4616 or 4666
Fax: + 961 1 744 470
12 AUB-CRPH News May 2006