Minimum initial service package (MISP) for sexual and reproductive health for women in a displacement setting: a narrative review on the Syrian refugee crisis in Lebanon

Background Women and girls are disproportionately affected in times of conflict and forced displacement, with disturbance in access to healthcare services leading to poor sexual and reproductive health outcomes. The minimal initial service package (MISP) was created to mitigate the consequences of conflict and prevent poor sexual and reproductive health (SRH) outcomes, especially among women and girls. The aim of this narrative review was to explore the SRH response for Syrian refugee women and girls in Lebanon, with a focus on MISP implementation. Methodology A comprehensive literature search was conducted for peer-reviewed articles in 8 electronic databases and multiple grey literature sites for articles published from March 2011 to May 2019. The target population was Syrian refugee women in Lebanon displaced from Syria as a result of the conflict that erupted in March 2011. The selected articles addressed MISP, SRH needs and services, and barriers to service access. A narrative synthesis was conducted, guided by the six main objectives of the MISP. Results A total of 254 documents were retrieved, from which 12 peer-reviewed articles and 12 reports were included in the review. All identified articles were descriptive in nature and no studies evaluating MISP or other interventions or programs were found. The articles described the wide range of SRH services delivered in Lebanon to Syrian refugee women. However, access to and quality of these services remain a challenge. Multiple sources reported a lack of coordination, leading to fragmented service provision and duplication of effort. Studies reported a high level of sexual and gender-based violence, pregnancy complications and poor antenatal care compliance, and limited use of contraceptive methods. Very few studies reported on the prevalence of HIV and other STIs, reporting low levels of infection. Multiple barriers to healthcare access were identified, which included system-level, financial, informational and cultural factors, healthcare workers. Conclusion This study highlights the main SRH services provided, their use and access by Syrian refugee women in Lebanon. Despite the multitude of services provided, the humanitarian response remains decentralized with limited coordination and multiple barriers that limit the utilization of these services. A clear gap remains, with limited evaluation of SRH services that are pertinent to achieve the MISP objectives and the ability to transition into comprehensive services. Improving the coordination of services through a lead agency can address many of the identified barriers and allow the transition into comprehensive services.

«… det vanskeligste er jo å finne noe fornuftig å gjøre»: Om betydningen av arbeid og aktivitet for mennesker med ROP-utfordringer

This chapter explores ways in which work and other activities contribute meaning in the everyday lives of people with co-occurring challenges. There is still insufficient knowledge about the importance of work and activity among people with co-occurring challenges. This is evident in the Norwegian context, where people with co-occurring challenges are marginally represented in the workforce and other realms of activity. The conceptual framework in this chapter is based on symbolic interactionism, which implies meaning as a formative process. The methodological design is a bottom-up perspective, and the empirical sample consists of qualitative interviews with 13 women and men with challenges and/or co-occurring challenges. The findings indicate that work and activity have a significant impact, providing structure in their everyday lives and benefiting others. Work and activity contribute to affiliation in society and the local community. The conclusion indicates that emphasis and attention on work and activity as basic needs for people with co-occurring challenges is required: work and activity must become a central part of comprehensive services aimed at people with co-occurring challenges.

BASIC PRINCIPLES OF FORMING A REGIONAL TRANSPORTATION AND LOGISTICS SYSTEM

One of the areas of comprehensive services to the population of our republic is the transport and logistics system. Today, the logistics industry is rapidly penetrating all areas of our society.Among them is the formation of a transport and logistics system in the region for the organization of high-quality services for the population. This thesis presents the basic principles of the formation of the transport and logistics system and the problems that it solves

Analisis Hukum Perpajakan terhadap Investasi Properti Terkait dengan Penerimaan Pajak di Kota Medan

The method used in this research is normative juridical approach is prescriptive to examine the sources of literature relevant to the theme of research, including research on the general principles of law, legislation, as well as provisions on the cash receipts from the tax sector property. Implementation of the UN tax collection and BPHTB include data collection, assessment, determination, administration and comprehensive services, of course this is not easy and has many obstacles. The obstacles encountered in the area of property tax collection comes from internal and external side. In terms of internal investment required a high cost in the provision of facilities, shortage of human resources in collecting taxes, updating the data base, while in terms of the external is the awareness of the community in paying taxes, their mode of misappropriation of law and the administration of the taxpayer, as well as the role of notary still less than the maximum help in the collection of property taxes.

Reframing Healthcare

Healthcare systems are faced with increasingly complex demands: ageing populations, chronic diseases, growing drug ineffectiveness, and access to comprehensive services are just a few of the challenges we face. Design offers methods, practices and processes to help address these rising complications. While design and health have a long history of working together, much of this work has been limited. In this paper, we make the case for further opportunities for design and health to work together in deep, innovative and human ways. We begin by discussing the transformative space of design, then we articulate the similarities between design and healthcare. We then present two health design research projects that employ design methods and processes within healthcare settings, exploring new opportunities for design and health to collaborate. We conclude by summarizing the benefits and challenges of these projects, articulating future possibilities for design and healthcare to collaborate.

Capitalizing on the Health Impacts of Improving Housing Conditions

Chapter 5 looks at the impact of the Green & Healthy Homes Initiative (GHHI) and its various partners in government, the private sector, and philanthropy in work it carried out which was intended to revolutionize health and housing. The aim has been to break the current link between unhealthy housing and unhealthy families. As GHHI has expanded its work some common themes have emerged, which the chapter outlines. When measuring the impact of comprehensive services, access to data is critical, the chapter argues. Armed with the information from robust analysis, providers such as GHHI and its partners are able to maximize program design and referral sources.