Zoonosis is a contagious illness that has spread from an animal species to people. Zoonotic infections can infect humans through direct contact, as well as through food, water, or the environment. They can also be bacterial, viral, parasitic, or involve unconventional agents. Each year, zoonotic infections kill millions of people around the world. While some zoonotic diseases have been recorded or studied, others remain unidentified. A surveillance-response system that integrates human and animal health, the environment, and food production components (iSRS), known as a One Health approach, is becoming more and more in demand on a worldwide level to investigate and detect zoonotic infections that are frequently transmitted from animals, food, and the environment to humans. One Health is a collaborative, multisectoral, and transdisciplinary approach to obtaining optimal health outcomes that acknowledge the connectivity between humans, animals, and their shared environment. The inter-sectoral collaboration of numerous stakeholders in a complex health system, along with the flexibility to adapt to local demands and the current health system constraints, is a vital part of enabling the success of the One Health approach. Thus, Mapping across relevant sectors builds an understanding of a successful multi-sectoral One Health approach.

This project intends to examine and map the current zoonotic disease reporting and control, as well as cross-sectoral collaboration and structures of the ministries of health and agriculture in Palestine. Zoonotic illnesses are widespread and have a significant impact on public health. Brucellosis, salmonellosis, rabies, West Nile virus, tuberculosis, avian influenza (H5N1), and leishmaniosis were all reported and examined in Palestine, along with other illnesses. This requires reviewing and understanding the infrastructures, protocols, laws, responsibilities, activities, strategies, and initiatives of the Palestinian ministerial departments involved in zoonotic disease detection and reporting. Additionally, publicly accessible data from national government agencies will be examined, including program guidelines, yearly reports, official websites, interministerial communications, and minutes of meetings. To collect, clarify, and verify data, in-person interviews with officials, subject matter experts, and technical representatives of the ministries of health and agriculture will also be held.

PI: Niveen Abu-Rmeileh 

Research team: Said Abukhattab (Chief Researcher), Maysaa Nimer, Hanin Basha, Fa’ida Awashreh, Ali Baradiea, Walaa Saleh, Eias Salhab, Mohammad Salaymeh

Antimicrobial resistance (AMR) poses a significant threat to public health globally, exacerbated by zoonotic epidemic risk, climate change, and the release of antibiotic-resistant bacteria and genes into the environment. This project aims to address the growing concern of AMR in Palestine through a comprehensive One Health approach. The study focuses on assessing the frequency, distribution, and hotspots of AMR, investigating the impact of urbanization and food production on AMR, identifying pathways of AMR transmission, and developing interventions to disrupt its spread.To achieve these objectives, the project adopts a multifaceted methodology, employing innovative techniques such as wastewater-based surveillance, shotgun metagenomics analysis, and culture-based screening. Surveys directed at laboratories will play a crucial role in assessing the prevalence of resistant pathogens, offering a comprehensive view of the current state of AMR.

The utilization of MinION sequencing technology stands out as a cutting-edge approach, providing real-time insights into the complex dynamics of antimicrobial resistance. This forward-thinking strategy aligns with the project's overarching goal of establishing a robust AMR surveillance system, while concurrently implementing water and sanitation interventions. The collaboration with local partners adds a layer of depth to the initiative, ensuring that the interventions are contextually relevant and effective. The incorporation of advanced technology not only enhances the project's scientific rigor but also positions it as a catalyst for evidence-based interventions and policy recommendations. In essence, this comprehensive approach, combining scientific innovation with collaborative partnerships, aspires to contribute significantly to the amelioration of AMR-related challenges in Palestine. The outcomes are anticipated to not only inform effective public health interventions but also foster a broader understanding of AMR dynamics in the local context.

PI: Niveen Abu-Rmeileh

Research team: Said Abukhattab (Chief Researcher), Leen Humos, Shadi Hasan, Monawwar Abdulrahman.

“United against Tobacco and COVID” is an anti-smoking media campaign that is currently being implemented in Palestine. This campaign is in partnership with the Global Health Development |EMPHNET and under the auspices of the Palestinian Ministry of Health. It is part of a regional campaign that includes several Arab countries, namely Jordan, Iraq and Egypt along with Palestine.

It aims at raising awareness, creating social mobilization and advocacy using radio spots that will be broadcasted in one national radio station and two sub-national radio stations covering the West Bank, Jerusalem and Gaza. In addition to designing electronic posters that will be published on a digital screen at the main entrance of Birzeit University and on its social media platforms, and stickers that will be attached to public transportation buses. The campaign will also include students' activities where the “Campaign Challenge” will be launched. The challenge is a competition between three groups of students from three different universities to produce the best content about the topic of the campaign to be posted on the social media platforms.

PI: Niveen Abu-Rmeileh

Research team: Arein Awad
 

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The Long-Term Institutional (LID) Grant is a 5-year grant from the World Health Organization intended to strengthen capacity in sexual and reproductive health research. The aim of this project is to build a qualified Palestinian team in sexual and reproductive health. The team will include public health researchers and clinicians. The research team is part of the UNDP/UNFPA/Unicef/ WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) Alliance for Research Capacity Strengthening (RCS) which is an initiative that brings together institutions conducting research in sexual and reproductive health and rights (SRHR) in collaboration with WHO regional and country offices.

PI: Niveen Abu-Rmeileh

Research team: Aisha Shalash, Yasmeen Wahdan, Hassan Alsalman, Ala Shihab, Alaa Hamed.

The project informs current and future Health Information System (HIS) planning and implementation for adolescent reproductive health in the West Bank and Gaza Strip by generating evidence about its technical, social, and operational drivers, and recommendations to address gaps in data, indicators, and analysis. It explores the factors that influence the design and operation of a health information system for adolescent health in contexts of acute and protracted conflict, and the resulting conditions of fragility. Government entities and communities are engaged in a co-design and co-implementation approach to ensure future integration of the recommendations in the health information system. A cross-cutting focus on sound gender analysis and research ethics is integrated across the project, including how the questions and activities are framed and carried out, and how data is analyzed and used. Gender issues are studied at the systems level, examining gender dimensions such as who decides on the indicators, who collects, analyzes, and uses the data, the level of women’s involvement in decision-making and planning adolescent services, as well as the gender differences in workload and unpaid work related to a health information system for adolescent health. A strong capacity-strengthening strategy includes the training of graduate students, most of whom are women.

PI: Niveen Abu Rmeileh

Research team: Maysaa Nemer (Co-PI), Aysha Shalash, Tamara Mari, Yasmeen Wahdan

The study aims to explore individual, provider, institutional and health systems factors that either promote or prevent respectful or disrespectful practices during childbirth in health facilities. The team aims to validate the WHO’s community survey tool and estimate the prevalence of mistreatment during childbirth in the occupied Palestinian territory.

PI: Niveen Abu Rmeileh

Research team: Yasmeen Wahdan

This project aims to generate knowledge on adolescents’ perceptions of and requirements for sexual and reproductive health (SRH) services among Palestinian refugee camp dwellers in the West Bank and Jordan. SRH services are currently offered only to married girls and women by the United Nations Relief and Works Agency (UNRWA)’s health department. The project addresses this critical gap by designing an intervention to expand SRH services to unmarried young and adolescent girls using a rights-based perspective. The study uses mixed methods to design, implement, and evaluate the intervention and it will also train the research team at UNRWA. This will expand the scope of SRH services within existing UNRWA service structures and enhance the capacity of UNRWA staff to conduct research. The expected knowledge products include reports and publications in peer-reviewed scientific journals, as well as relevant policy briefs.

PIs: Weeam Hammoudeh and Rita Giacaman

Research team: Abdullatif Husseini, Rula Ghandour, Dima Masoud, Reem Ladadweh

This project is part of ICPH’s work on the mental health workstream through the ESRC funded project-Research for Health in Conflict (R4HC-MENA). The aim of this project is to strengthen capacities for research in mental health in conflict among academics, researchers and practitioners. As part of this project, we conducted a needs assessment among organizations working in mental health in Palestine. We then developed an intensive course along with Hanna Kienzler and Nancy Tamimi from King’s College London entitled ‘Research Methods for Mental Health in Conflict’, which was taught at Birzeit University  during the summer of 2018. We subsequently developed an online course which was implemented in the Gaza Strip Feb 2020, and have expanded the course to the MENA region with a new cycle running Novemeber 2020.

Research team: Weeam Hammoudeh, Rita Giacaman, Abdullatif Husseini, Hala Khalawi KCL team: Hanna Kienzler, Nancy Tamimi, and Mathias Regent

In this proposed mixed-methods project, we aim to understand how people give meaning to, make sense of, and cope with various forms of deprivation and the traumas and impacts of conflict and military occupation.  We will develop new metrics to assess deprivation and its links to health outcomes. By linking local understandings of deprivation and health we re-examine and re-evaluate dominant theoretical paradigms in the social and health sciences. We examine multiple dimensions of deprivation under conditions of prolonged conflict in Palestine. We identify the presence of multiple dimensions of deprivation (economic, material, nutritional, and political) and its determinants, paying particular attention to geographic variation within Palestine. We examine the links between different forms of deprivation and health and wellbeing, focusing on less tangible and under-researched impacts of conflict, including the links between subjective and objective measures of health, and the roles of political and social determinants.

Co-PI’s: Weeam Hammoudeh and Rita Giacaman

Research team: Suzan Mitwalli, Rawan Kafri, and Shiraz Nasr

This project aims to understand the health and data governance systems in the West Bank and Gaza Strip and Jordan. The research explores how governments are approaching new national digital health strategies and how these systems interact with human rights concerns. The aim is to understand operational-level practices of data governance, with a particular focus on fragile settings, how these intersect with human rights and gender equality, and what changes are necessary to ensure that vulnerable populations receive trusted and quality care.

PI: Niveen Abu Rmeileh

Research team: Maysaa Nemer (Co-PI), Tamara Mari

This course examines the intersection of health and human rights in theory and in practice. Promotion and protection of human rights and promotion and protection of health are fundamentally linked to health policies and programs and can promote respect, protection and promotion of human rights and human rights principles through their design and implementation. Conversely, systemic or structural deficits can negatively impact human rightsprotections. Meanwhile, documentation of human rights violations and promoting accountability for effective protection and prevention of violations can be central to improving health outcomes, particularly where mortality and morbidity are closely linked to such violations.

PI: Rita Giacaman

Team members: Reem Ladadwa, Shiraz Nasr

This project is part of an initiative that will provide evidence and strengthen capacity for bridging the knowledge gap in responding to the growing COVID-19 health crisis both in the short-term and longer-term. The initiative will support research on resilience building and preparedness to serve the needs of refugees and other populations on the move by promoting inter-sectoral approaches, including building bridges between humanitarian and development responses to reduce and control health risks for displaced populations, and leverage local opportunities. This project will generate evidence to understand the effects of the COVID-19 pandemic on refugees and internally-displaced people in the West Bank and the health system’s ability to meet their needs. It will also strengthen the health system through incorporating research and health information system strengthening. The methodology for this study will comprise three phases. There will be an initial rapid situation assessment and community engagement to analyze the pandemic response and engage with institutional and policy stakeholders. Next phase is larger scale quantitative and qualitative research activities followed by the translation of research for policy and practice to inform longer term preparedness and resilience of the health system. Throughout these stages, building capacities for research will be carried out, particularly in health system preparedness with regards to health human resources, health information system and community engagement. This project will lead to enhanced knowledge production both for short-term rapid response to COVID-19 as well as a longer-term participatory approach to pandemic preparedness and resilience from a gender and equity perspective for refugee and internally displaced populations.

PI: Weeam Hammoudeh

Research team: Rita Giacaman (Co-PI), Lama Shakhshir

This project will address the knowledge gap in the economics of waterpipe tobacco smoking in the eastern Mediterranean region. This multi-country project involves four-institution collaboration across Lebanon, the West Bank, Egypt, and Jordan to generate critically needed information on the increasing popularity and rate of waterpipe smoking, and model the economic impact of fiscal policies on tobacco control. The project team will present this economic evidence in a format that can be used by policymakers to strengthen the coherence and coverage of tobacco control policies in the region to improve population health and contribute to public revenues.

PI: Niveen Abu-Rmeileh

Research team: Sameera Awawdeh

Short project title: Fruits, vegetables, and NCDs in the Ramallah and al-Bireh governorate This project aims to understand the food system and the potential factors associated with fruit and vegetable consumption among Palestinians living in the Ramallah and al-Bireh governorate, West Bank. The study explores the role of availability, affordability, quality, awareness, and current policies to recommend the most efficient interventions to increase fruit and vegetable consumption at the national level. The methodology involves a document review of all available laws, regulations, and policies related to fruits and vegetables in Palestine, in-depth interviews with policymakers and key stakeholders, a household survey, a vendors’ survey, an online survey among Birzeit University students, focus group discussions, and a quality assessment of fresh fruits and vegetables. The project anticipates implementable evidence-based policy recommendations based on a clear assessment of policies, quality, affordability, availability, and awareness regarding fruits and vegetables in Ramallah and al-Bireh governorate on the West Bank. Expected outcomes include 1) Sustainable policies promoting fruits and vegetable consumption. 2) Effective interventions to increase awareness of the health benefits of fruits and vegetables. 3) Specific guidelines to improve the quality of fruits and vegetables produced in the West Bank.

PI: Abdullatif Husseini

Research team: Jamil Harb (Co-PI), Rita Giacaman (Co-PI), Widad Zeidan, Haneen Taweel, Reem Abbasi, Dalia Abu Thaher, Bayan Shamasneh, Dalia Ghosheh and Manal Shuaib. 

This is a project involving partners from Jordan, Lebanon, Palestine (the Gaza Strip and the West Bank) and Birmingham University in the UK, as well as other UK universities. It focuses on supporting and contributing to interdisciplinary work to identify and critically evaluate dominant public and institutional discourses, and individual and community attitudes on disability in contexts of conflict. It supports the development of theoretical and empirical research to inform and co-produce new interdisciplinary knowledge on disability in conflict, and its practical application in education, through dialogue between the arts and humanities with the domains of medical sciences, law and education. It builds upon the educative process of co-producing new interdisciplinary knowledge, in order to address challenges in education delivery, access and quality in formal and informal settings, and across the life-course to address the needs of this most marginalized group in conflict settings.

PI: Rita Giacaman

Team members: Reem Ladadwa and Lina Abdulsamad

This study is part of a four-year ESRC funded project - Research for Health in Conflict (R4HC-MENA): embedding multi-sectoral research capability and partnerships across Middle and Near East (MENA) (2017-2021). This study aims to describe the multidimensional palliative care needs of Palestinians in the West Bank with advanced cancer. The study objectives are: To identify the palliative care needs and experiences of people living with advanced cancer in the West Bank, Palestine, focusing on the three most prevalent cancers– i.e. breast, colon, and lung; to describe the mental health challenges related to living with poor prognosis in the context of ongoing structural and political violence; and to determine the political economy of cancer screening, treatment, and palliative care for people living in the West Bank.

PI: Weeam Hammoudeh

Research team: Abdullatif Husseini (Co-I), Rita Giacaman (Co-I), and Suzan Mitwalli

This research project explores the transformations that took place in the Jordan Valley following the Oslo Accords of 1993, and the populations’ views about the effects of these transformations on their life, work, and health. Given our broad definition of environment, we highlight and identify the environmental, political and socio-economic factors and the interactions among these factors which could have led to changes in the living and working conditions of agricultural working women in the Jordan Valley and their health. The study utilizes a mixed methods approach, starting with a qualitative study among working women and their families, then a quantitative study among a representative sample of agricultural working women from the Jordan Valley, to assess the living and working conditions, in addition to the related health effects and the occupational health and safety of these women. The project also includes awareness raising activities for women using discussion groups, workshops and the production of educational materials for improving safety and health in low-resources settings.

PI: Maysaa Nemer

Research team: Ahmed Heneiti, Suzan Mitwalli, Dina Zidan

This research project is an amendment to an ongoing research among female farmers in the Jordan Valley, West Bank. The original research project aimed to investigate the working conditions, living conditions and occupational exposures among these workers, and possible health outcomes that are related to occupational exposure. The study specifically examines respiratory health and musculoskeletal problems. In this new addition to the original study, we will assess heat exposure and related health outcomes among the same group of workers. The study is the first of its kind in Palestine, and the Jordan Valley is one of the warmest areas of the West Bank, where the effects of heat stress combined with workload on agricultural workers’ health will be investigated. The project will contribute to understanding the effect of heat stress on health, and may be used to plan for intervention programs that can reduce heat stress among agricultural workers in the Jordan Valley.

PI: Maysaa Nemer

Research team: Suzan Mitwalli, Dina Zidan