Purpose Coronavirus disease 2019 (COVID-19) is an infectious disease that has rapidly spread to most cities in the world since December 2019 causing a rise in global mortality and adverse effects on mental health. This paper aims to examine the potential implications of the pandemic for mental health in societies with economic and political instability, focusing on Lebanon. Design/methodology/approach Previous empirical research into mental health and COVID-19 was examined in relation to the Lebanese context. Findings There is a risk of poor mental health in Lebanon owing to the deleterious effects of military conflict and political instability over several decades. More recently, the country is also experiencing the worst economic crisis in its history with unprecedented rates of unemployment, inflation, poverty, and devaluation of the national currency. It is suggested that the lockdown measures may be depriving the Lebanese people of effective coping strategies, such as group memberships (e.g., religion), social support and community involvement, during the COVID-19 outbreak. This in turn may lead to the deployment of maladaptive coping strategies in the population. Practical implications Mental health services are still in their formative phases in Lebanon and mostly run by civil society organizations. There is an urgent need for a national action plan to respond to the potential mental health burden and use of maladaptive coping strategies which may arise in the aftermath of COVID-19. Originality/value This paper provides a novel analysis of mental health in Lebanese society through the lens of social, political, economic and psychological factors.

Although the prevalence of obesity has rapidly increased in the low‐ and middle‐income countries of the Middle East and North Africa (MENA) and Latin America and the Caribbean (LAC) regions, child undernutrition remains a public‐health challenge. We examined region‐specific sociodemographic determinants of this double burden of malnutrition, specifically, the co‐occurrence of child stunting and overweight, using Demographic and Health Survey and Multiple Indicator Cluster Survey data (2003–2016) from 11 countries in the MENA (n = 118,585) and 13 countries in the LAC (n = 77,824) regions. We used multiple logistic regressions to model region‐specific associations of maternal education and household wealth with child nutritional outcomes (6–59 months). The prevalence of stunting, overweight, and their co‐occurrence was 24%, 10%, and 4.3% in children in the MENA region, respectively, and 19%, 5%, and 0.5% in children in the LAC region, respectively. In both regions, higher maternal education and household wealth were significantly associated with lower odds of stunting and higher odds of overweight. As compared with the poorest wealth quintiles, decreased odds of co‐occurring stunting and overweight were observed among children from the second, third, and fourth wealth quintiles in the LAC region. In the MENA region, this association was only statistically significant for the second wealth quintile. In both regions, double burden was not statistically significantly associated with maternal education. The social patterning of co‐occurring stunting and overweight in children varied across the two regions, indicating potential differences in the underlying aetiology of the double burden across regions and stages of the nutrition transition.

Drawing on identity process theory from social psychology, this study explores the protective and risk factors of psychological distress and self-harm in a religiously diverse sample of heterosexual and non-heterosexual students at an English-speaking university in Lebanon. A convenience sample of 209 undergraduate students participated in a cross-sectional survey and completed measures of religiosity, identity threat, psychological distress and self-harm. Results indicated that non-heterosexual participants exhibited higher levels of psychological distress, were more likely to report self-harm, and reported lower levels of religiosity than their heterosexual counterparts. The multiple regression analyses showed that religiosity is protective against psychological distress, and that sexual orientation distress predicts selfharm. In order to reduce the risk of psychological distress and self-harm, it will be necessary to challenge stigma towards sexual minorities, to promote engagement with a broader range of social identity categories (other than just religion), and to ensure that individuals of all faiths and sexualities in Lebanon are able to access counselling support if they require it.

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Background In Lebanon, HIV is concentrated in both native and refugee communities of men who have sex with men (MSM). For over 10 years, the National AIDS Program (NAP) has offered HIV voluntary counselling and testing through a partnership with nongovernmental organizations (NGOs). In 2018, implementation of HIV self-tests (HIVST) was introduced, and this self-care intervention has been further scaled up during the coronavirus disease 2019 (COVID-19) pandemic. This paper (1) describes the effectiveness of implementing HIVST in Lebanon, and (2) discusses how the success of HIVST implementation has been reflected during the COVID-19 pandemic. Methods The NAP conducted a series of workshops (July–November 2018) to introduce HIVST services for healthcare workers working at different NGOs. The workshops highlighted that HIVST would be distributed for free, that it would be confidential and voluntary, and that participants were encouraged to notify the NGOs of their results, which would be kept strictly confidential. NGOs collected data anonymously and confidentially from beneficiaries (age, consistency of condom use and HIV testing history), who were asked to call back with the results of their HIVST. At the NAP, data were combined, aggregated and analysed. Results In 2019, the NGOs distributed 1103/1380 (79.9%) HIVST kits to their beneficiaries. The NGOs collected feedback on 111 kit results, of which two were HIV-positive. Feedback about HIVST results from beneficiaries was low (111/1103) due to noncompliance of beneficiaries and the lack of human and financial resources in the NGOs. From January through May 2020, a total of 625/780 HIVST kits (80.1%) were distributed. This period was divided into pre-COVID-19 and during COVID-19. The follow-up with the beneficiaries during COVID-19 was much improved because of the absence of on-site activities, shifting more efforts towards HIVST (449/625). There have been no reports of social harm related to HIVST. Conclusion HIVST implementation in Lebanon serves as an example of introducing a self-care intervention as part of a community-led effort. In order to maintain HIVST services at the same improved level, reorganization of care is needed within each NGO following the adaptation process due to COVID-19, along with continuous monitoring and evaluation of HIVST reported data.