Our work is structured over an initial four-year period in three phases of development:

  • Phase 1
  • Phase 2
  • Phase 3

In Phase 1 (2017-2018) Scoping, Assessment and Design, researchers will appraise key challenges in delivery of the NCD and mental health interventions in the contexts of Lebanon and Sierra Leone. Research will focus on identifying health systems and community factors contributing to fragility of the integrated ‘system for health’ relevant to delivery and uptake of these interventions. This phase will feature structured reviews of relevant published and grey literatures; preliminary field research mapping challenges related to fragility utilizing a range of cutting-edge quantitative and qualitative methodologies; synthesis of findings; and consultation with policymakers, providers and service users.




Research Briefs on NCDs and MHPSS in Lebanon and Sierra Leone. The RUHF research teams at QMU, COMAHS and AUB are working together on a range of research studies to prevent and manage NCDs, and improve access to quality mental health care in fragile settings. These briefs offer a summary of key findings and recommendations for policy makers, health practitioners, NGOs and academics.


          You can download the Research Briefs here:


"Non-Communicable Diseases in Fragile Settings: The Case of Syrian Refugees in Lebanon"


"Mental Health and Psychosocial Support in Fragile Settings: The Case of Syrian Refugees in Lebanon"


"Addressing the silent epidemic in Sierra Leone: preventing and managing non-communicable diseases"


"Improving understanding of and access to quality mental health care in Sierra Leone"


Scoping Studies on MHPSS and NCDs in Sierra Leone. After a rigorous review of the literature on mental health and psychosocial support (MHPSS) and non-communicable diseases (NCDs) in Sierra Leone, QMU and COMAHS research teams completed these open access Scoping Studies which provide insights into barriers and opportunities to improve health service provision in this fragile setting.


          You can view and download the Scoping Studies here:


       "A Scoping Study on Mental Health and Psychosocial Support (MHPSS) in Sierra Leone"


       "A Scoping Study on Non-Communicable Diseases (NCDs) in Sierra Leone"


Presentation  Analysing NCDs care in public health services in El Salvador. Is stronger community engagement part of the solution?’. Researchers from RUHF, Marta Jimenez and Montse Leon, conducted research fieldwork in El Salvador between March and June 2018, in collaboration with QMU researcher, Nicole Vidal. The preliminary findings were presented at QMU, Edinburgh in May and El Salvador and Madrid (Spain) in June.


               You can view and download the slides used in the presentations here

               Find out how patients with chronic diseases live in El Salvador. Watch the video here


Webinar 'Health Systems in Situations of Fragility'. This presentation was given by Professor Sophie Witter on 17th May 2018 for the American University of Beirut - Global Health Institute's Webinar series: "Global Health and Conflict".


You can view and download the slides used in the webinar here

In Phase 2 (2019-2020) Strategic Intervention and Evaluation, we will use our analyses of institutional and community factors facilitating and constraining interventions to identify strategic actions to increase service accessibility, accountability and quality. Again deploying innovative methodologies, we will evaluate the impact of these strategic actions, focusing on care delivery and uptake at the interface of health systems and communities.

In Phase 3 (2020-2021) Generalisation and Dissemination, we will build on evidence from our work in Lebanon and Sierra Leone in the earlier phases to formulate a health in fragility assessment framework to inform intervention planning and health system appraisal and strengthening in LMICs globally. We will test, refine and validate this health in fragility analytic framework through intervention research both in different contexts.

NIHR Research Unit on Health in Fragility (RUHF)

Please contact us to find out more about our work.

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NIHR Research Unit on Health in Fragility (RUHF)

NIHR Research Unit on Health in Fragility (RUHF)
0131 474 0000
  • RUHF News

Researchers from UK, Sierra Leone and Australia discuss health provision in fragile settings

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19 November 2018

QMU at the World’s First Global Ministerial Summit on Mental Health

Queen Margaret University’s Professor Alastair Ager is speaking at the world’s first global minister read more

05 October 2018

QMU and COMAHS conduct research activities in collaboration with the Ministry of Health in Sierra Leone

Researchers from QMU and COMAHS engaged the Ministry of Health (MoHS) in Sierra Leone and other key read more

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