Graduation Date

Fall 12-17-2021

Document Type


Degree Name

Doctor of Philosophy (PhD)


Medical Sciences Interdepartmental Area

First Advisor

Danstan Bagenda

Second Advisor

Sharon Medcalf

Third Advisor

Leeza Struwe

Fourth Advisor

Bree Akesson

MeSH Headings

Psychiatry and Psychology, mental health, maternal and child health, global health, international health, preparedness


Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In addition, we assess the reliability and validity of a mental distress screening tool (the Refugee Health Screener-13) among 103 Syrian mothers who gave birth during the pandemic in Lebanon. This screening tool was developed for refugees resettled in the United States and was never used previously on Arabic refugees in low resource settings. We used an innovative approach that combines the two approaches as a mixed-methods study to bridge the gap between western practice and the Syrian cultural understanding of mental health. This research is significant for public health because it provides a necessary part of the knowledge base needed by the aiding agencies to detect mental health conditions among refugees. It is also significant for science because it addresses crucial concepts related to the relationship between social supports, cultural practices, early marriage, and mental health, which can be transferred into other similar settings.

Available for download on Monday, November 27, 2023