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All Journal Jurnal Riset Ilmu Kesehatan Umum dan Farmasi Antigen: Jurnal Kesehatan Masyarakat dan Ilmu Gizi International Journal of Health Science
Helsa Nasution
Universitas Al Washliyah (UNIVA) Medan
Health Professions Public Health Social Sciences

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Administrative Resilience in Middle Eastern Healthcare within Conflict Zones Agustina Bangun; M. Agung Rahmadi; Luthfiah Mawar; Suranta Ginting; Hariana Erdewi Sinaga; Helsa Nasution; Nurzahara Sihombing
International Journal Of Health Science Vol. 5 No. 3 (2025): November : International Journal of Health
Publisher : Lembaga Pengembangan Kinerja Dosen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/ijhs.v5i3.6206

Abstract

This study examines the construct of administrative resilience within mental and physical health service systems in Middle East conflict zones using Confirmatory Factor Analysis (CFA) within Structural Equation Modeling (SEM). Data were derived from 847 policy documents and operational reports from twelve countries (2018–2024), accessed through official online sources. The measurement model showed good fit indices (χ²/df = 2.134, CFI = 0.962, TLI = 0.955, RMSEA = 0.047, SRMR = 0.038), indicating structural stability and validity of the theoretical model. CFA confirmed four dimensions of administrative resilience with significant loadings: Adaptive Policy (λ = 0.871, CR = 12.453, p < 0.001), Cross-Sector Coordination (λ = 0.834, CR = 11.287, p < 0.001), Professional Competence (λ = 0.792, CR = 10.564, p < 0.001), and Operational Stability (λ = 0.815, CR = 11.098, p < 0.001). Reliability results were strong (Cronbach's α = 0.863–0.921; Composite Reliability = 0.879–0.934; AVE = 0.647–0.782). Findings reinforce Boin and Lodge’s (2016) concept of organizational resilience and extend Comfort et al. (2010) by integrating operational stability as a relevant dimension in conflict settings. Unlike Kruk et al. (2015), which focused on general health systems, this study identifies unique adaptive mechanisms within dual mental–physical services while addressing the fragmentation gap noted by Jawad et al. (2019) through empirical formulation of interdependent administrative dimensions.
Development of a Culturally Grounded Trauma Assessment Protocol in the Middle Eastern Context Luthfiah Mawar; M. Agung Rahmadi; Luthfiyah Aqilah Siagian; Sasa Maghfirah Siregar; Andieni Pratiwi; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF) Vol. 3 No. 4 (2025): Oktober : Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF)
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/jrikuf.v3i4.885

Abstract

This study systematically evaluates and develops a trauma assessment protocol based on local cultural contexts through a review and meta-analysis of 87 studies published between 2000 and 2023. Using JASP 0.16.1 and Comprehensive Meta-Analysis V3, results revealed a significant effect size (d = 0.78, 95% CI [0.65, 0.91], p < 0.001), indicating that culturally grounded protocols are more valid than conventional ones. Meta-regression analysis showed that cultural sensitivity accounted for 42.3% of improvements in diagnostic accuracy (β = 0.423, SE = 0.089, p < 0.001), highlighting the importance of cross-cultural understanding in assessment design. Moderator analysis identified three key factors influencing protocol effectiveness: knowledge of local cultural contexts (Q = 24.31, df = 3, p < 0.001), use of culturally appropriate language (Q = 18.76, df = 2, p < 0.001), and involvement of community leaders (Q = 15.92, df = 2, p < 0.001). The study’s heterogeneity was moderate (I² = 68.5%, τ² = 0.142), reflecting variations in implementation. These findings build on prior work by Alarcón et al. (2009) and Jackson et al. (2017), reinforcing the importance of integrating cultural values into trauma assessments. The results demonstrate a more adaptive, systematic framework with significant improvements in predictive validity (AUC = 0.89 compared to 0.76 in non-cultural protocols). This meta-analysis contributes significantly to developing trauma assessment protocols that are more culturally responsive, offering strong empirical evidence for integrating cultural elements into clinical practice.
An Early Warning Framework for Mental Health Crises in Conflict-Affected Areas of the Middle East Luthfiah Mawar; M. Agung Rahmadi; Sri Rahayu Sukirman; Nur Suci Ramadhani; Putri Widia Ramadhani Rambe; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi Vol. 3 No. 4 (2025): November: Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/antigen.v3i4.886

Abstract

This study examines the effectiveness of the Early Warning System (EWS) in anticipating and responding to mental health crises in conflict-affected regions of the Middle East through a systematic review of 47 scholarly articles published between 2014 and 2024. The meta-regression findings indicate a significant contribution of EWS implementation to the reduction of post-traumatic stress disorder (PTSD) symptoms with a coefficient of β = -0.67 (p < .001), as well as depressive symptoms with a coefficient of β = -0.59 (p < .001) among populations directly affected by armed conflict. Among 12,456 respondents analysed, 73.8% reported a reduction in anxiety symptoms following the implementation of EWS, with an effect size of d = 0.82 (95% CI [0.76, 0.88]). Digitally based early warning systems demonstrated a significantly higher level of effectiveness (OR = 2.34, 95% CI [1.98, 2.70]) than conventional systems, which are more manual and reactive. Moderator analysis indicated that age (β = -0.31, p < .01) and the duration of exposure to conflict (β = 0.44, p < .001) play important roles in moderating the relationship between EWS interventions and various mental health indicators. These findings expand upon the conclusions of Fu et al. (2020) and Salesi (2023), which previously explored psychosocial interventions in conflict zones, by adding a new dimension—examining digital technology and predictive algorithms within EWS frameworks. The study explicitly demonstrates that integrating machine learning models into EWS can enhance the predictive accuracy of potential mental health crises to 84.6%, representing a novel contribution that has not been comprehensively documented in prior academic literature
Community Based Prevention Strategies for Collective Trauma in Conflict Zones of the Middle East M. Agung Rahmadi; Luthfiah Mawar; Liza Adilia Pury; Naura Aqilah Rizal; Wilda Simangunsong; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi Vol. 3 No. 4 (2025): November: Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/antigen.v3i4.926

Abstract

This meta-analysis provides an in-depth examination of the effectiveness of community-based interventions in alleviating collective trauma experienced by populations in conflict zones of the Middle East, compiling 47 empirical studies (N = 12,483) published between 2000 and 2023. The synthesis indicates a significant impact of community-based interventions on reducing PTSD symptoms, with a substantial effect size (d = 0.82, 95% CI [0.76, 0.88], p < .001) and moderate heterogeneity (I² = 68%), reflecting inter-study variation yet remaining within interpretable bounds. Among the strategies analysed, community psychosocial support programs demonstrated the most pronounced effectiveness (β = 0.74, p < .001), followed by collective narrative therapy (β = 0.68, p < .001) and family-based rehabilitation interventions (β = 0.59, p < .001), all underscoring the relevance of approaches rooted in social networks and interpersonal relations. Moderator analyses revealed that longer program duration, particularly interventions spanning at least 6 months (β = 0.71, p < .001), and active engagement of local leaders (β = 0.65, p < .001) were critical determinants of intervention success. Furthermore, meta-regression findings indicated a strong and consistent correlation between the intensity of community involvement and reductions in collective trauma symptoms (R² = 0.73, p < .001), highlighting that social participation is not merely complementary but constitutes the foundation of program efficacy. In the researchers' view, these findings extend the contributions of prior studies by Hassan et al. (2016) and Morrison & Marrison (2024) by affirming the central role of local wisdom in trauma recovery processes, while offering a conceptual contribution in the form of an integrative framework that merges psychosocial interventions with community cultural values. Consequently, these results provide not only an empirical basis for developing more effective trauma-healing programs in Middle Eastern conflict zones but also underscore the urgency of contextual adaptation to ensure that interventions meet the most essential needs of affected populations.
Co-Authors Agustina Bangun Andieni Pratiwi Annisa Ardianti Br Tarigan Hariana Erdewi Sinaga Liza Adilia Pury Luthfiah Mawar Luthfiah Mawar Luthfiyah Aqilah Siagian M. Agung Rahmadi M. Agung Rahmadi Naura Aqilah Rizal Nur Suci Ramadhani Nurzahara Sihombing Putri Widia Ramadhani Rambe Sasa Maghfirah Siregar Sri Rahayu Sukirman Suranta Ginting Wilda Simangunsong