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Levey EJ, Rodriguez AEM, Chang AR, Rondon MB, Sanchez MLJ, Harrison AM, Gelaye B, Becker AE. A qualitative analysis of adolescent motherhood within the broader family context in Peru. FAMILY RELATIONS 2024; 73:1046-1066. [PMID: 38523658 PMCID: PMC10957107 DOI: 10.1111/fare.12904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 04/24/2023] [Indexed: 03/26/2024]
Abstract
Objective The purpose of this study was to characterize the impact of adolescent pregnancy on families and describe the needs of adolescent mothers and their infants in order to assess the need for intervention and identify potential intervention targets. Background Adolescent mothers and their offspring face an increased risk of mental health problems. Adolescent mothers and their families also face significant resource constraints; 95% live in low- and middle-income countries (LMICs). Cost-effective interventions are needed to improve outcomes for this vulnerable group. Method This qualitative study conducted in Lima, Peru, consisted of four clinician focus groups and 18 in-depth interviews with adolescent mothers and their family members. Data were coded thematically, and direct content analysis was employed. Results The study identified the following issues facing adolescent parents: the transition to parenthood, the need for family support, difficulty accessing support, the difficulty for family members of providing support, and ideas about responsibility and adolescent autonomy. Conclusion Overall, these findings demonstrate the need for interventions that engage families and address barriers to accessing support, including relationship conflict and differing beliefs about responsibility and autonomy. Implications Interventions are needed for adolescent mothers in LMICs that mobilize family support. Clinicians who care for these patients need to be aware of the family context and the resources available where they practice.
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Affiliation(s)
- Elizabeth J. Levey
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | | | - Andrew R. Chang
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | | | | | - Alexandra M. Harrison
- Department of Psychiatry, Harvard Medical School, Boston, MA
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA
| | - Bizu Gelaye
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Anne E. Becker
- Department of Psychiatry, Harvard Medical School, Boston, MA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
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2
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Abstract
The population of sub-Saharan children and adolescents is substantial and growing. Even though most of this population is vulnerable, there is no comprehensive understanding of the social-ecological factors that could be leveraged by mental health practitioners to support their resilience. The present study undertakes a narrative scoping review of empirical research (quantitative, qualitative, and mixed) on the resilience of children and adolescents living in sub-Saharan Africa to determine what enables their resilience and what may be distinctive about African pathways of child and adolescent resilience. Online databases were used to identify full-text, peer-reviewed papers published 2000-2018, from which we selected 59 publications detailing the resilience of children and/or adolescents living in 18 sub-Saharan countries. Studies show that the resilience of sub-Saharan children and adolescents is a complex, social-ecological process supported by relational, personal, structural, cultural, and/or spiritual resilience-enablers, as well as disregard for values or practices that could constrain resilience. The results support two insights that have implications for how mental health practitioners facilitate the resilience of sub-Saharan children and adolescents: (i) relational and personal supports matter more-or-less equally; and (ii) the capacity for positive adjustment is complexly interwoven with African ways-of-being and -doing.
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Affiliation(s)
- Linda Theron
- Department of Educational Psychology/Centre for the Study of Resilience, University of Pretoria, Pretoria, South Africa
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3
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Gómez-Restrepo C, Sarmiento-Suárez MJ, Alba-Saavedra M, Calvo-Valderrama MG, Rincón-Rodríguez CJ, González-Ballesteros LM, Bird V, Priebe S, van Loggerenberg F. Mental health problems and resilience in adolescents during the COVID-19 pandemic in a post-armed conflict area in Colombia. Sci Rep 2023; 13:9743. [PMID: 37328494 PMCID: PMC10276040 DOI: 10.1038/s41598-023-35789-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/24/2023] [Indexed: 06/18/2023] Open
Abstract
The impact of COVID-19 pandemic on mental health of adolescents are emerging and require particular attention in settings where challenges like armed conflict, poverty and internal displacement have previously affected their mental wellbeing. This study aimed to determine the prevalence of anxiety symptoms, depressive symptomatology, probable post-traumatic stress disorder and resilience in school-attending adolescents in a post-conflict area of Tolima, Colombia during the COVID-19. A cross-sectional study was carried out with 657 adolescents from 12 to 18 years old, recruited by convenience sampling in 8 public schools in the south of Tolima, Colombia, who completed a self-administered questionnaire. Mental health information was obtained through screening scales for anxiety symptoms (GAD-7), depressive symptomatology (PHQ-8), probable post-traumatic stress disorder (PCL-5) and resilience (CD-RISC-25). The prevalence observed for moderate to severe anxiety symptoms was 18.9% (95% CI 16.0-22.1) and for moderate to severe depressive symptomatology was 30.0% (95% CI 26.5-33.7). A prevalence of probable post-traumatic stress disorder (PTSD) of 22.3% (95% CI 18.1-27.2) was found. The CD-RISC-25 results for resilience had a median score of 54 [IQR 30]. These results suggest that approximately two-thirds of school-attending adolescents in this post-conflict area experienced at least one mental health problem such as anxiety symptoms, depressive symptomatology or probable PTSD during the COVID-19 pandemic. Future studies are of interest to establish the causal relationship between these findings and the impact of the pandemic. These findings highlight the challenge that schools have after pandemic to address the mental health of their students in order to promoting adequate coping strategies and implement prompt multidisciplinary interventions to reduce the burden of mental health problems in adolescents.
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Affiliation(s)
| | | | | | | | | | | | - Victoria Bird
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
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4
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Levey EJ, Harris BL, Laird LD, Kekulah I, Borba CPC, Henderson DC, Becker AE. Orphans in post-conflict Liberia: Seeking care in fractured communities. Transcult Psychiatry 2022; 59:235-248. [PMID: 35021921 PMCID: PMC9250424 DOI: 10.1177/13634615211066696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Orphans in post-conflict settings have unique needs that have not been well-characterized. In post-conflict Liberia, maternal orphans are more likely to be without care than paternal orphans. This study examined the experiences of maternal orphans in Liberia, as they attempted to care for themselves and seek care from others, and the barriers they faced. In-depth interviews were conducted with 75 post-conflict Liberian orphans. We performed a secondary narrative analysis of interview transcripts from all maternal or double orphans (n = 17). We identified similar elements across narratives: traumatic loss, disconnection from family and community, and the desire for a savior. Female high-risk orphans were more likely to have formal substitute caregiving arrangements in which they were living with someone who was a relative or had been selected by a relative. Male orphans more commonly lacked arranged substitute care, but this allowed them to form relationships with substitute caregivers of their choosing. Sex also played a role in the provision of caregiving; substitute care was provided by women. Findings highlighted the syndemic relationship between poverty, violence, transactional sex, trauma, and substance use that traps high-risk Liberian orphans. Interventions are needed to improve access to mental health care, sober communities, housing, and education support. The need to integrate these services into indigenous institutions and address barriers related to stigma is explored.
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Affiliation(s)
- Elizabeth J Levey
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital.,Department of Psychiatry, Harvard Medical School.,Department of Psychiatry, University of Illinois College of Medicine
| | | | - Lance D Laird
- Department of Family Medicine, 12259Boston University School of Medicine
| | - Isaac Kekulah
- Department of Psychiatry, University of Illinois College of Medicine
| | - Christina P C Borba
- Department of Psychiatry, 12259Boston University School of Medicine.,Department of Psychiatry, 1836Boston Medical Center
| | - David C Henderson
- Department of Psychiatry, 12259Boston University School of Medicine.,Department of Psychiatry, 1836Boston Medical Center
| | - Anne E Becker
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital.,Department of Psychiatry, Harvard Medical School.,Department of Global Health and Social Medicine, Harvard T.H. Chan School of Public Health
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5
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Cavazzoni F, Fiorini A, Veronese G. Alternative Ways of Capturing the Legacies of Traumatic Events: A Literature Review of Agency of Children Living in Countries Affected by Political Violence and Armed Conflicts. TRAUMA, VIOLENCE & ABUSE 2022; 23:555-566. [PMID: 33000687 DOI: 10.1177/1524838020961878] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND It has been revealed that the construct of agency plays a crucial role in contributing to children's positive functioning and well-being despite their traumatic contexts. Yet there is little agreement within the literature about the definition of agency, how agency is displayed by children, or how it should be investigated. AIMS This study provides a synthetic overview of studies that have analyzed the agency of children living in contexts affected by political violence and armed conflict. In the process, it highlights major theoretical breakthroughs and findings in this area of research. The aim was to review research investigating the different ways in which children's agency manifests itself within their everyday lives, as well as possible policy implications. METHOD We identified published peer-reviewed studies relating to children's agency in conflict-affected environments through a narrative literature review. An ecological framework was used to organize studies according to the different settings (personal, familial, cultural, or contextual) within which the children's agency was displayed. RESULTS Of 682 studies identified from online searches of the literature and the three additional sources gathered through bibliography mining, 63 qualified for full review, with 15 studies included in the final synthesis. Overall, the literature focused mostly on the ways in which children's ability to mobilize resources emerged in order to cope with their challenging contexts. CONCLUSION Scholars advocated for community-oriented and child-centered programs that are aimed not only at promoting recovery from symptoms but also at fostering advocacy and a sense of agency in children.
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Affiliation(s)
- Federica Cavazzoni
- Department of Human Sciences for Education "Riccardo Massa," 9305University of Milano-Bicocca, Italy
| | - Alec Fiorini
- Department of Human Sciences for Education "Riccardo Massa," 9305University of Milano-Bicocca, Italy
| | - Guido Veronese
- Department of Human Sciences for Education "Riccardo Massa," 9305University of Milano-Bicocca, Italy
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6
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Batubara IMS, Daulima NHC, Wardani IY, Kusumawati HN, Setiyawan S, Oktariani M, Rumiyati E. Resilience of Adolescents Survivors of Domestic Violence: A Qualitative Study. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The ability of adolescents to overcome the impact of domestic violence and reflect on the achievements is a form of resilience.
AIM: The study explored an in-depth description of the discovery process of the resilience ability in adolescent survivors of domestic violence.
METHODS: This qualitative research with a descriptive phenomenology approach interviewed seven adolescent survivors between the ages of 15 and 21. In-depth interviews were conducted, and demographic data were collected. Interviews were transcribed and coded thematically. Data was analyzed with the method of Colaizzi.
RESULTS: Four themes were derived from the interviews, including painful words from the close family member as a form of intimidation; the emotional response as imprinted feeling caused by the domestic violence; self-struggle starts from their own; and the happiness of the close family member as the purpose of life.
CONCLUSION: Adolescents responses to domestic violence cause mental health problems, however, they also manage to overcome problems, fulfill goals, and review their past and current life events to achieve life's purpose.
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Hook K, Ando K, Ghebrehiwet S, Harris B, Ojediran B, Syeda H, Henderson D, Borba C. Current state of the literature on mental health in Liberia: A systematic review. S Afr J Psychiatr 2020; 26:1502. [PMID: 33240551 PMCID: PMC7670006 DOI: 10.4102/sajpsychiatry.v26i0.1502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 08/05/2020] [Indexed: 12/04/2022] Open
Abstract
Background The Republic of Liberia recently experienced several events that resulted in wide-ranging societal impacts, including long-term civil war and an outbreak of Ebola. These types of events are linked to higher prevalence of mental disorders and psychosocial distress. As a result, it is likely that there is an increased prevalence of mental health disorders in the population. Aim To assess and review the recent mental health literature in order to provide insight into existing mental health needs and effective or recommended interventions in post-conflict Liberia. Setting Articles included in this study enrolled Liberians living in Liberia. Methods A search of four databases was conducted for studies of any type that assessed mental health in Liberia between 01 January 2003 and 27 March 2019. After reviewing 363 articles, 21 articles were included in the final analysis. Articles were coded to identify common themes and needs. Results The majority of studies used qualitative designs and were conducted in Monrovia, the capital city of Liberia. Common topics included adolescent mental health, intervention and assessment and post-conflict impacts. One article focused on mental health impacts after recovery from Ebola. Conclusion Overall, there is a dearth of mental health literature that focuses on Liberia. This suggests ample opportunity for researchers to investigate mental health needs amongst the Liberian population and effective psychiatric interventions. Existing recommendations often focus on addressing adolescent health needs, including substance use practices. Opportunities for future research particularly related to needs of adult populations and to mental health impacts of Ebola, abound.
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Affiliation(s)
- Kimberly Hook
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States of America.,Department of Psychiatry, Boston Medical Center, Boston, MA, United States of America.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA,United States of America
| | - Kanako Ando
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States of America
| | - Senait Ghebrehiwet
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States of America
| | - Benjamin Harris
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia
| | - Babawale Ojediran
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia
| | - Haniya Syeda
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States of America
| | - David Henderson
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States of America.,Department of Psychiatry, Boston Medical Center, Boston, MA, United States of America
| | - Christina Borba
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States of America.,Department of Psychiatry, Boston Medical Center, Boston, MA, United States of America
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8
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Parviniannasab AM, Rakhshan M, Momennasab M, Soltanian M, Rambod M, Akbarzadeh M. Haemophiliac adolescents' perspectives of resilience: A qualitative study based on the resilience in illness model. Clin Child Psychol Psychiatry 2020; 25:346-358. [PMID: 31814433 DOI: 10.1177/1359104519890905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A qualitative study was conducted to investigate the concept of resilience among Iranian haemophilic adolescents based on the Haase's Resilience in Illness Model (RIM). Purposive sampling was used to recruit 15 participants comprising haemophilic adolescents and their parents in the study. The data were collected through in-depth semi-structured interviews and analysed using direct content analysis. The themes and categories were defensive coping (emotive coping, evasive coping), courageous coping (optimism, constructive approach, seeking support), derived meaning (spiritual strategy, hope) and social support (support from family, friends and treatment teams). Social support, adopting a spiritual strategy and self-management behaviours played an important role among the adolescents in improving their level of resilience and skills to cope with haemophilia.
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Affiliation(s)
- Ali Mohammad Parviniannasab
- PhD candidate in Nursing, Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Community-based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Soltanian
- Community-based Psychiatric Care Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Rambod
- Community-based Psychiatric Care Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Akbarzadeh
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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9
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Abstract
Between 1989 and 2003, Liberia experienced a brutal civil war characterized by ethnic killings, sexual violence and the use of child soldiers. Five years after the war ended, half the population of Liberia was under 18 years old. Understanding the needs of these youth is thus essential to the recovery of the nation. This study focuses on the narratives of two female adolescents, selected from 75 in-depth individual interviews with post-conflict Liberian youth conducted in 2012. A narrative analysis approach was employed to examine each interview for multiple layers of meaning. The aim of the study was to elucidate factors that may enable post-conflict youth to reclaim a sense of agency and return to normal developmental tasks. The study explores the ways in which these youth navigate complicated power dynamics in the post-conflict setting and how gender impacts their experiences of their own agency and capability. The dynamics between the participants and the interviewer are explored to further illustrate how power dynamics manifest. These narratives support the involvement of youth in projects that help others as an avenue for promoting agency and resilience for themselves.
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10
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Rai S, Adhikari SB, Acharya NR, Kaiser BN, Kohrt BA. Elucidating adolescent aspirational models for the design of public mental health interventions: a mixed-method study in rural Nepal. Child Adolesc Psychiatry Ment Health 2017; 11:65. [PMID: 29299056 PMCID: PMC5740935 DOI: 10.1186/s13034-017-0198-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 12/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent aspirational models are sets of preferences for an idealized self. Aspirational models influence behavior and exposure to risk factors that shape adult mental and physical health. Cross-cultural understandings of adolescent aspirational models are crucial for successful global mental health programs. The study objective was elucidating adolescent aspirational models to inform interventions in Nepal. METHODS Twenty qualitative life trajectory interviews were conducted among adolescents, teachers, and parents. Card sorting (rating and ranking activities) were administered to 72 adolescents aged 15-19 years, stratified by caste/ethnicity: upper caste Brahman and Chhetri, occupational caste Dalit, and ethnic minority Janajati. RESULTS Themes included qualities of an ideal person; life goals, barriers, and resources; emotions and coping; and causes of interpersonal violence, harmful alcohol use, and suicide. Education was the highest valued attribute of ideal persons. Educational attainment received higher prioritization by marginalized social groups (Dalit and Janajati). Poverty was the greatest barrier to achieving life goals. The most common distressing emotion was 'tension', which girls endorsed more frequently than boys. Sharing emotions and self-consoling were common responses to distress. Tension was the most common reason for alcohol use, especially among girls. Domestic violence, romantic break-ups, and academic pressure were reasons for suicidality. CONCLUSION Inability to achieve aspirational models due to a range of barriers was associated with negative emotions-notably tension-and dysfunctional coping that exacerbates barriers, which ultimately results in the triad of interpersonal violence, substance abuse, and suicidality. Interventions should be framed as reducing the locally salient idiom of distress tension and target this triad of threats. Regarding intervention content, youth-endorsed coping mechanisms should be fortified to counter this distress pathway.
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Affiliation(s)
- Sauharda Rai
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Anek Marga, Baluwatar, Kathmandu, Nepal
| | - Safar Bikram Adhikari
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Anek Marga, Baluwatar, Kathmandu, Nepal
| | - Nanda Raj Acharya
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Anek Marga, Baluwatar, Kathmandu, Nepal
| | | | - Brandon A. Kohrt
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Anek Marga, Baluwatar, Kathmandu, Nepal
- Duke Global Health Institute, Duke University, Durham, NC USA
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC USA
- Department of Psychiatry, Duke University, Durham, NC USA
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11
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Rudzinski K, McDonough P, Gartner R, Strike C. Is there room for resilience? A scoping review and critique of substance use literature and its utilization of the concept of resilience. Subst Abuse Treat Prev Policy 2017; 12:41. [PMID: 28915841 PMCID: PMC5603070 DOI: 10.1186/s13011-017-0125-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/28/2017] [Indexed: 12/15/2022] Open
Abstract
Research in the area of illicit substance use remains preoccupied with describing and analyzing the risks of people who use drugs (PWUD), however more recently there has been a drive to use a strengths-based or resilience approach as an alternative to investigating drug use. This leads us to ask: what can be known about PWUD from the point of view of resilience? The objective of this scoping review is to analyze how the concept of resilience is defined, operationalized, and applied in substance use research. Popular health, social science, psychology, and inter-disciplinary databases namely: SCOPUS, PUBMED, PsycINFO, and Sociological Abstracts were searched. Studies were selected if they used the concept of resilience and if substance use was a key variable under investigation. A total of 77 studies were identified which provided a definition of resilience, or attempted to operationalize (e.g., via scales) the concept of resilience in some manner. Data were charted and sorted using key terms and fundamental aspects of resilience. The majority of studies focus on youth and their resistance to, or engagement in, substance use. There is also a small but growing area of research that examines recovery from substance addiction as a form of resilience. Very few studies were found that thoroughly investigated resilience among PWUD. Consistently throughout the literature drug use is presented as a 'risk factor' jeopardizing one's ability to be resilient, or drug use is seen as a 'maladaptive coping strategy', purporting one's lack of resilience. Currently, substance use research provides a substantial amount of information about the internal strengths that can assist in resisting future drug use; however there is less information about the external resources that play a role, especially for adults. Though popular, outcome-based conceptualizations of resilience are often static, concealing the potential for developing resilience over time or as conditions change. Studies of resilience among PWUD predominantly concentrate on health-related behaviours, recovery-related factors or predefined harm reduction strategies. Indeed, overall, current conceptualizations of resilience are too narrow to recognize all the potential manifestations of resilience practices in the daily lives of individuals who actively use drugs.
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Affiliation(s)
- Katherine Rudzinski
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7 Canada
| | - Peggy McDonough
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7 Canada
| | - Rosemary Gartner
- Centre for Criminology & Sociolegal Studies, University of Toronto, 14 Queen’s Park Crescent West, Toronto, ON M5S 3K9 Canada
| | - Carol Strike
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7 Canada
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12
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Tambo E, Chengho CF, Ugwu CE, Wurie I, Jonhson JK, Ngogang JY. Rebuilding transformation strategies in post-Ebola epidemics in Africa. Infect Dis Poverty 2017; 6:71. [PMID: 28486978 PMCID: PMC5424336 DOI: 10.1186/s40249-017-0278-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 03/06/2017] [Indexed: 11/10/2022] Open
Abstract
Rebuilding transformation strategies in post-Ebola epidemics in West Africa requires long-term surveillance and strengthening health system preparedness to disease outbreak. This paper assesses reconstruction efforts from socio-cultural, economic and ecological transformation response approaches and strategies in improving sustainable survivors and affected communities livelihood and wellbeing. A comprehensive approach is required in the recovery and rebuilding processes. Investing in rebuilding transformation requires fostering evidence-based and effective engaging new investors partnership strengthening, financing community-based programmes ownership, novel socio-economic innovations strategies and tools against the evolving and future Ebola epidemics. Thus, there should be improved community partnership, health and economic rebuilding programmes to address mistrust and care underutilization, poverty and care access inequity at all levels. Implementing effective post-Ebola national 'One Health' approach coupled with climate change mitigation and adaptations strategies is urgent public health needs aiming at improving the quality healthcare access, delivery trust and uptake in anticipation of EVD immunization program, productivity and emerging economy.
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Affiliation(s)
- Ernest Tambo
- Higher Institute of Health Sciences, Université des Montagnes, Bangangte, Cameroon
- Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Institute, Yaoundé, Cameroon
| | - Chryseis F. Chengho
- Department of Health and Life Sciences, University of Coventry, Coventry, Leicester, UK
| | - Chidiebere E. Ugwu
- Faculty of Basic Medical Sciences, Department of Human Biochemistry, NnamdiAzikiwe University Awka, Nnewi Campus, Awka, Nigeria
| | - Isatta Wurie
- Department of Chemical Pathology, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | | | - Jeanne Y. Ngogang
- Higher Institute of Health Sciences, Université des Montagnes, Bangangte, Cameroon
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13
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Levey EJ, Oppenheim CE, Lange BCL, Plasky NS, Harris BL, Lekpeh GG, Kekulah I, Henderson DC, Borba CPC. A qualitative analysis of parental loss and family separation among youth in post-conflict Liberia. VULNERABLE CHILDREN AND YOUTH STUDIES 2017; 12:1-16. [PMID: 28163770 PMCID: PMC5214285 DOI: 10.1080/17450128.2016.1262978] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/09/2016] [Indexed: 06/06/2023]
Abstract
Between 1989 and 2003, the Republic of Liberia experienced a brutal civil war. In 2008, the population was approximately 3.5 million people, and there were an estimated 340,000 orphans. Nearly 6000 more children were orphaned by the Ebola epidemic from 2014-2015. The goal of this research was to explore the impact of parental loss, identify moderating factors, and consider interventions that could help vulnerable youth in post-conflict societies following the loss of a parent. Seventy-five young people (age 13-18 years) in Monrovia, the capital city of Liberia, were recruited in 2012. Semi-structured interviews were conducted, and demographic data were collected. Interviews were then transcribed and coded thematically. The loss of a parent or other primary caregiver had a significant impact on psychosocial and emotional health. The timing of the loss, strength of connection with the deceased parent, and relationship with surviving parent or substitute caregiver were all relevant factors. Children separated from living parents were functioning better than those whose parents were deceased. The case of Liberian children underscores the importance of early caregiver relationships and the difficulties children face when such relationships are disrupted. Children who did not experience stable early relationships suffered disconnection from their families and communities.
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Affiliation(s)
- Elizabeth J. Levey
- Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | | | | | - Naomi S. Plasky
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Benjamin L. Harris
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia
| | - G. Gondah Lekpeh
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia
| | - Isaac Kekulah
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia
| | - David C. Henderson
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Christina P. C. Borba
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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