1
|
Salihu D, Chutiyami M, Bello UM, Wong EML, Pich J, Alsharari AF, Ali MU, Sulaiman SK, Kwan RYC. Coping strategies of internally displaced persons and the host community in a region of armed conflict: A cross-sectional study. Psychiatry Res 2024; 339:116035. [PMID: 38885568 DOI: 10.1016/j.psychres.2024.116035] [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] [Received: 02/13/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Conflict leads to the displacement of people, making it more difficult for them to cope with increasing stress. In war-affected regions, people use different strategies to cope with their stress. This study examines the coping strategies of internally displaced persons (IDPs) and those in host communities in war zones. METHODS People living in the IDP camp and host communities in Maiduguri, Nigeria were recruited using a convenient sampling strategy. A 28-item Hausa version of the Brief COPE Scale wasused for data collection. Data were analyzed using linear regression and presented as unstandardized beta (B) and standard error (SE). RESULTS A total of 562 participants were recruited (IDPs, n = 281; and the host communities, n = 281). Problem- and emotion-focused coping strategies were identified as the most common approaches used in host communities; however, dysfunctional strategies were morecommon among the IDPs. Age (younger or older adulthood) was identified as a predictor forthe use of emotion-, problem-, and dysfunctional-focused coping strategies. CONCLUSION Host communities were more likely to use a problem-and emotion-focused approach to coping, while IDPs were more likely to use dysfunctional strategies. Location and demographic factors (being single, aged 18-29years, >50 years and older) also influenced coping.
Collapse
Affiliation(s)
- Dauda Salihu
- Jouf University, College of Nursing, Sakaka, Saudi Arabia.
| | - Muhammad Chutiyami
- University of Technology Sydney, Faculty of Health, School of Nursing and Midwifery, Sydney, Australia
| | - Umar Muhammad Bello
- Glasgow Caledonian University, School of Health and Life Sciences, Department of Physiotherapy and Paramedicine, Glasgow, United Kingdom
| | | | - Jacqueline Pich
- University of Technology Sydney, Faculty of Health, School of Nursing and Midwifery, Sydney, Australia
| | | | - Mohammed Usman Ali
- The Hong Kong Polytechnic University, Department of Rehabilitation Sciences, Kowloon City, Hong Kong SAR, China
| | | | - Rick Yiu Cho Kwan
- Tung Wah College, School of Nursing, Kowloon City, Hong Kong SAR, China
| |
Collapse
|
2
|
Jolof L, Rocca P, Carlsson T. Support interventions to promote health and wellbeing among women with health-related consequences following traumatic experiences linked to armed conflicts and forced migration: a scoping review. Arch Public Health 2024; 82:8. [PMID: 38225672 PMCID: PMC10790529 DOI: 10.1186/s13690-023-01235-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 12/28/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Women exposed to armed conflicts and forced migration face significant health-related risks and consequences. Consequently, there is a need to identify and develop effective interventions that provide tailored support for them. The aim of this scoping review was to examine research evaluating support interventions promoting the health and well-being among women with traumatic experiences linked to armed conflict and/or forced migration. METHODS A scoping review of empirical studies evaluating non-pharmacologic/non-surgical interventions promoting health and well-being among adult women with traumatic experiences linked to armed, torture, and/or forced migration, identified through systematic searches in February 2022 within five databases (AMED, CINAHL, Cochrane Library, PsycINFO, and PubMed). Methodological characteristics and results were extracted and analyzed with narrative analysis using tabulations, descriptive statistics, text-based summaries, and thematization. RESULTS Assessment of 16 748 records resulted in 13 included reports. The methodological approaches were quantitative (n = 9), qualitative (n = 2), and mixed methods (n = 2), with most reports being feasibility/pilot studies (n = 5) and/or randomized controlled trials (n = 4). The most common recruitment strategy was non-probability sampling (n = 8). Most interventions were conducted in North America (n = 4), Asia (n = 3) or Middle East (n = 3). Thirteen intra-intervention techniques and five categories of components utilized within the interventions were identified, the most common being skill building (n = 12). Ten developed the interventions through theoretical frameworks or manuals/therapy, while five developed interventions through public or stakeholder involvement. Eleven studies evaluated outcomes related to psychological health, disorders, or distress. A large proportion of the investigated outcomes showed post-exposure improvements and improvements when compared with controls. Qualitative findings highlighted improved mental and physical health, empowerment and stigma reduction, and enhanced knowledge. CONCLUSION Few studies have developed and evaluated tailored support interventions for this population, containing a range of components and intra-intervention techniques. No clear focus was identified regarding outcome measures, and most studies used non-probability sampling. Few developed interventions through public contribution in collaboration with women. While limited studies show promising effects on women's mental health, more empirical intervention research that closely corresponds to women's needs are needed.
Collapse
Affiliation(s)
- Linda Jolof
- The Red Cross Treatment Center for Persons Affected by War and Torture, Malmö, Sweden
| | - Patricia Rocca
- The Red Cross Treatment Center for Persons Affected by War and Torture, Malmö, Sweden
| | - Tommy Carlsson
- The Department of Health Sciences, The Swedish Red Cross University, Huddinge, Sweden.
- The Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| |
Collapse
|
3
|
Tewabe DS, Azage M, Wubetu GY, Fenta SA, Worke MD, Asres AM, Getnet WA, Kassie GG, Menber Y, Munea AM, Zeru T, Bekele SA, Abdulahi SO, Adamne TB, Belete HD, Beyene BB, Abte M, Mersha TB, Dadi AF, Enquobahrie DA, Frissa SM, Geda YE. Gender-based violence in the context of armed conflict in Northern Ethiopia. Confl Health 2024; 18:1. [PMID: 38172905 PMCID: PMC10763028 DOI: 10.1186/s13031-023-00563-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Gender-based violence (GBV) particularly against women is unfortunately common during armed conflicts. No rigorous and comprehensive empirical work has documented the extent of GBV and its consequences that took place during the two years of devastating armed conflict in Northern Ethiopia. This study aims to assess GBV and its consequences in war-torn areas of northern Ethiopia. METHODS We used a qualitative method augmented by quantitative method to enroll research participants. We conducted in-depth interviews to characterize the lived experiences of GBV survivors. All interviews were conducted confidentially. The data were collected to the point of data saturation. All interviews were transcribed verbatim into local language, translated into English, and analyzed using a thematic analysis approach. We also used reports from healthcare facilities and conducted a descriptive analysis of the demographic characteristics of study participants. RESULTS One thousand one hundred seventy-seven persons reported GBV to healthcare providers. The qualitative study identified several forms of violence (sexual, physical, and psychological). Gang rape against women including minors as young as 14 years old girls was reported. Additionally, the perpetrators sexually violated women who were pregnant, and elderly women as old as 65 years, who took refuge in religious institutions. The perpetrators committed direct assaults on the body with items (e.g., burning the body with cigarette fire) or weapons, holding women and girls as captives, and deprivation of sleep and food. GBV survivors reported stigma, prejudice, suicide attempts, nightmares, and hopelessness. GBV survivors dealt with the traumatic stress by outmigration (leaving their residences), seeking care at healthcare facilities, self-isolation, being silent, dropping out of school, and seeking counseling. CONCLUSION GBV survivors were subjected to multiple and compounding types of violence, with a wide range of adverse health consequences for survivors and their families. GBV survivors require multifaceted interventions including psychological, health, and economic support to rehabilitate them to lead a productive life.
Collapse
Affiliation(s)
| | - Muluken Azage
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.o.Box: 79, Bahir Dar, Ethiopia.
| | | | - Sisay Awoke Fenta
- Emergency Response and Recovery Officer, Amhara Region, Bahir Dar, Ethiopia
| | - Mulugeta Dile Worke
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Wallelign Alemnew Getnet
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Genet Gedamu Kassie
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.o.Box: 79, Bahir Dar, Ethiopia
| | - Yonatan Menber
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.o.Box: 79, Bahir Dar, Ethiopia
| | - Alemtsehay Mekonnen Munea
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.o.Box: 79, Bahir Dar, Ethiopia
| | - Taye Zeru
- Amhara Public Health Institute, Amhara Region, Bahir Dar, Ethiopia
| | | | | | | | | | | | - Melkamu Abte
- Amhara Regional Health Bureau, Amhara Region, Bahir Dar, Ethiopia
| | - Tesfaye B Mersha
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Abel Fekadu Dadi
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Daniel A Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Souci M Frissa
- Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, King's College London, London, UK
| | - Yonas E Geda
- Department of Neurology and the Franke Barrow Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix, AZ, USA
| |
Collapse
|
4
|
Piñeros-Ortíz SE, Urrego-Mendoza ZC, Garzón-Orjuela N, Eslava-Schmalbach J. Social determinants, symptoms and mental problems in adults internally displaced by armed conflict. Soacha, Colombia, 2019. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2024; 53:8-16. [PMID: 38677942 DOI: 10.1016/j.rcpeng.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/08/2022] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To characterise social determinants of health, mental health problems and potentially problematic symptoms in the adult population displaced by internal armed conflict in Colombia. METHODS Cross-sectional descriptive study with a random sample of 98 adults forcefully displaced to Soacha, Colombia, due to internal armed conflict. The Self Report Questionnaire to detect potentially problematic mental health problems and symptoms, and a structured questionnaire on social determinants of health were applied. RESULTS The median age was 38 [interquartile range, 28-46] years, and women predominated (69.39%). The median time since displacement was 36 [16-48] months, and time since settlement in Soacha, 48 [5-48] months. 86.32% survived on less than the minimum wage per month and 93.87% did not have an employment contract. 42.86% and 7.14% reported being owners of their homes before and after displacement, respectively. Upon arriving in Soacha, 79.60% went to primary support networks and 3% to institutions. Before displacement, 16.33% lacked health insurance and 27.55% afterwards. Regarding mental health problems; there were possible depressive or anxious disorders in 57.29%; possible psychosis in 36.73%; and potentially problematic symptoms in 91.66%, being more prevalent and serious in women (p = 0.0025). CONCLUSIONS A deterioration in living conditions and a higher prevalence of potentially problematic mental health problems and symptoms was reported in displaced adult populations settled in Soacha compared to other regions of the country. Analyses with complementary perspectives are required to evaluate these differences.
Collapse
|
5
|
Lamontagne E, Nyako HY, Enemo A, Sunday A, Muhammad A, Abdullah RM, Okiwu H, Undelikwo V, Ogbozor P, Amusan O, Alaba O, Undelikwo G, Takpa K, Ashefor G, Kavanagh M, Foláyan MNO. The health inequity and socioeconomic inequality faced by adolescent girls and women on the move living with or at high risk of HIV infection, during the COVID-19 pandemic in Nigeria. BMJ Glob Health 2023; 8:e012116. [PMID: 38135297 DOI: 10.1136/bmjgh-2023-012116] [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: 03/07/2023] [Accepted: 09/09/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND We assessed if women and girls on the move living with or at high risk of HIV faced increased health inequity and socioeconomic inequalities during the COVID-19 pandemic compared with other vulnerable women and girls. METHODS We used data collected through a survey conducted in Nigeria between June and October 2021. Women and girls living with or at risk of HIV were recruited voluntarily, using a combination of venue-based and snowball sampling. We performed multivariable logistic regression models per mobility and HIV status to determine associations between health inequity, socioeconomic inequalities and macrosocial characteristics. FINDINGS There were 3442 participants, of which 700 were on the move. We found no statistical difference between HIV-negative women and girls on the move and those not on the move. On the opposite, we found substantial differences in health inequity and socioeconomic inequalities between women and girls on the move living with HIV and those not on the move living with HIV. There are very strong associations between being a woman or girl on the move living with HIV and facing economic precarity (aOR 6.08, 95% CI 1.94 to 19.03), food insecurity (aOR 5.96, 95% CI 2.16 to 16.50) and experiencing more gender-based violence since COVID-19 started (aOR 5.61, 95% CI 3.01 to 10.47). INTERPRETATION Being a woman or girl on the move and living with HIV compound increased health and socioeconomic vulnerabilities. The COVID-19 crisis seems to have exacerbated inequalities and gender-based violence. These findings call for more feminist interventions to protect women on the move living with HIV during health crises.
Collapse
Affiliation(s)
- Erik Lamontagne
- Joint United Nations Programme on HIV/AIDS, Johannesburg, South Africa
- Aix-Marseille Université, Marseille, France
| | | | - Amaka Enemo
- Nigeria Sex Workers Association, Kubwa, Nigeria
| | - Aaron Sunday
- African Network of Adolescent and Young Persons Development, Barnawa, Nigeria
| | - Amira Muhammad
- Northern Nigerian Transgender Initiative, Abuja, Nigeria
| | | | | | | | - Pamela Ogbozor
- Department of Psychology, Enugu State University of Science and Technology, Enugu, Nigeria
| | | | | | | | | | - Greg Ashefor
- National Agency for the Control of AIDS, Abuja, Nigeria
| | - Matthew Kavanagh
- Joint United Nations Programme on HIV/AIDS, Geneve, Switzerland
- Georgetown University, Washington, Washington DC, USA
| | | |
Collapse
|
6
|
Tassang AE, Guoqing S, Akintunde TY, Sayibu M, Isangha SO, Adedeji A, Musa TH. Social integration, solidarity, and psychological health of internally displaced persons in Cameroon: Exploring the role of community satisfaction. Heliyon 2023; 9:e20361. [PMID: 37800072 PMCID: PMC10550570 DOI: 10.1016/j.heliyon.2023.e20361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 09/05/2023] [Accepted: 09/20/2023] [Indexed: 10/07/2023] Open
Abstract
Background/Introduction Conflict-induced displacement continue to be a pressing public policy concern due to the adverse effects on the well-being of internally displaced persons (IDPs). Understanding the integration process of these individuals, particularly the role of solidarity and social integration in fostering a sense of belonging and improving their community experiences and psychological well-being, remains unclear. This study investigates the role of community satisfaction in the relationship among social integration, solidarity, and psychological health of IDPs in Cameroon. Methods Cross-sectional data from 428 displaced individuals in the Ntui subdivision, Cameroon, were analyzed using structural equation modeling (SEM). This technique tested four latent variables: social integration, solidarity, community satisfaction, and psychological health. Results The results show a direct association between solidarity and both community satisfaction (β = 0.282; p < 0.001) and psychological health (β = 0.137; p < 0.01). Community satisfaction also has a direct relationship with the psychological health of the IDPs (β = 0.292; p < 0.001). An indirect effect of solidarity on psychological health through community satisfaction was observed (β = 0.084 (SE = 0.025, CI = [0.047, 0.129], p < 0.001)). However, no mediational effect of community satisfaction was found on the association between social integration and psychological health. The model accounted for 7% of the variance in community satisfaction (R2 = 0.07) and 20% of the variance in psychological health (R2 = 0.20). Conclusion: The findings indicate a strong sense of solidarity among the displaced persons in the studied communities in Cameroon, which promotes their psychological health via community satisfaction. As such, interventions should aim to foster solidarity among displaced persons to enhance their community experiences and psychological health.
Collapse
Affiliation(s)
- Angwi Enow Tassang
- Department of Sociology, School of Public Administration, Hohai University, Nanjing, 211100, China
- National Research Center for Resettlement, Hohai University, Nanjing, China
- Asian Research Center, Hohai University, Nanjing, China
| | - Shi Guoqing
- Department of Sociology, School of Public Administration, Hohai University, Nanjing, 211100, China
- National Research Center for Resettlement, Hohai University, Nanjing, China
- Asian Research Center, Hohai University, Nanjing, China
| | - Tosin Yinka Akintunde
- Department of Sociology, School of Public Administration, Hohai University, Nanjing, 211100, China
- Department of Social Work, Chinese University of Hong Kong, Sha tin, Hong Kong
| | - Muhideen Sayibu
- Department of Science and Technology Communication Policy, University of Science and Technology of China, China
| | - Stanley Oloji Isangha
- Department of Social and Behavioral Sciences, College of Liberal Art and Social Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Adekunle Adedeji
- Northwest University, Faculty of Humanities, Mafikeng, South Africa
| | | |
Collapse
|
7
|
Workie K, Tinsae T, Salelew E, Asrat B. Gender-based violence and its associated factors among internally displaced women in Northwest Ethiopia: a cross-sectional study. BMC Womens Health 2023; 23:166. [PMID: 37024889 PMCID: PMC10080783 DOI: 10.1186/s12905-023-02306-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Gender-based violence (GBV) is a common human right violence in conflict-affected communities. Women with GBV are prone to experience mental health problems such as post-traumatic stress disorder, depression, and anxiety. However, there is a paucity of evidence as to what extent the problem is affecting internally displaced women (IDW) in Ethiopia. This study aimed to assess the prevalence of GBV and its associated factors among IDW in Northwest Ethiopia. METHODS A cross-sectional study was conducted among IDW residing at three humanitarian sites from May to June 2022 in Northwest Ethiopia. Study participants were selected using a stratified simple random sampling technique from the three sites. GBV was assessed using a 6-item Assessment Screen to Identify Survivors Toolkit questionnaire for Gender-based violence (ASIST-GBV). Data were analyzed using binary logistic regression. All variables with a p-value of ≤ 0.05 in the multivariable analysis were defined to have a statistically significant association with GBV at a 95% confidence interval (CI). RESULTS Of 424 approached candidates, 412 (97.2%) of them participated in the study. A one-year prevalence of GBV was 37.9% (95%CI = 33.2-42.6) among IDW in Northwest Ethiopia. The mean age of the participants was 31.3 (± 7.6) years. Young women, 18-24 years old (AOR = 3.52, 95%CI = 2.15-5.34, p ≤ 0.001) and 25-29 years old (AOR = 2.41, 95%CI = 1.57-3.24, p ≤ 0.001) had a statistically significant association with GBV. Moreover, having no social protection (AOR = 3.18, 95%CI = 2.65-6.22, p ≤ 0.001), being current alcohol user (AOR = 2.54, 95%CI = 1.22-4.78, p ≤ 0.001) and being single in marital status (AOR = 1.69, 95%CI = 1.18-2.87, p < 0.01) showed a statistical association with GBV. CONCLUSION We found a high prevalence of GBV among IDW in Northwest Ethiopia which indicates that IDW are prone to GBV. We call for immediate action and special attention to young women in conflict-affected parts of Ethiopia. It is crucial to establish a system that ensures the safety, security, and well-being of women in humanitarian settings.
Collapse
Affiliation(s)
- Keralem Workie
- Department of Psychiatry, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, P.o.Box: 196, Gondar, Ethiopia
| | - Endalamaw Salelew
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, P.o.Box: 196, Gondar, Ethiopia
| | - Biksegn Asrat
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, P.o.Box: 196, Gondar, Ethiopia.
| |
Collapse
|
8
|
Rasheed OS, López-Rodríguez L, Navas M. Withstanding psychological distress among internally displaced Yazidis in Iraq: 6 years after attack by the Islamic State of Iraq and the Levant. BMC Psychol 2022; 10:262. [DOI: 10.1186/s40359-022-00973-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/31/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Insurgents of the Islamic State of Iraq and the Levant created a crisis that has had immediate and long-term consequences for the population in Iraq. Yazidis are among the most affected ethnos religious groups in the region. The current study focuses on investigating the level of psychological distress and its association with subjective resilience among the Yazidi minority 6 years after the attack by the Islamic State of Iraq and the Levant.
Methods
The present study recruited four hundred and twenty-two Yazidi individuals (50.8% female) residing in two camps in the Iraqi Kurdistan region. In face-to-face interviews, each participant replied to different scales to measure psychological distress (i.e., depression, anxiety, and stress), perceived stress, and subjective resilience. In addition, they were asked questions about mental health and psychosocial service acquisition.
Results
The results indicate that levels of psychological distress were high among the target population; around 65% of respondents reported having some level of psychological distress. Moreover, women showed not only higher level of psychological distress but also revealed slightly lower subjective resilience as compared to male participants. Hierarchical regressions showed that subjective resilience significantly contributed to the predictive model of distress beyond demographics and having received or not mental health and psychosocial support. Subjective resilience was significantly associated to less anxiety (R2adj = .157, ΔR2 = .022, p = .010) and stress (R2adj = .083, ΔR2 = .026, p = .008) in Mam-Rashan camp; and to less depression (R2adj = .184, ΔR2 = .095, p < .001), anxiety (R2adj = .140, ΔR2 = .024, p = .034), stress (R2adj = .046, ΔR2 = .047, p = .005), and perceived stress (R2adj = .024, ΔR2 = .032, p = .022) in Shekhan camp.
Conclusions
Conflict and displacement contribute to high level of psychological distress. Resilience, however, seem to have a negative association with psychological distress. Additionally, living conditions and sex also played an important role in both psychological distress and resilience. Consequently, Yazidi community residing in camps are in need of further support to alleviate the consequences of displacement. We critically discuss the differences in the results among participants per camp and by sex, and its implications.
Collapse
|
9
|
O'Connell KA, Hailegebriel TS, Garfinkel D, Durham J, Yakob B, Kassaw J, Kebede AT. Meeting the Sexual and Reproductive Health Needs of Internally Displaced Persons in Ethiopia's Somali Region: A Qualitative Process Evaluation. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00818. [PMID: 36316134 PMCID: PMC9622291 DOI: 10.9745/ghsp-d-21-00818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 09/26/2022] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Meeting the sexual and reproductive health and rights (SRHR) needs of internally displaced persons (IDPs) is critical. Despite increased prioritization and coverage of sexual and reproductive health (SRH) services in humanitarian settings in recent decades, significant unmet needs remain. In Ethiopia, there are more than 2 million IDPs, an estimated 40% of whom have unmet need for modern contraceptives. To address this, EngenderHealth implemented a model of SRHR programming in Ethiopia's Somali region. We share the lessons learned from this project to improve access to SRH services among IDPs. METHODS In 2021, an independent research team implemented a qualitative process evaluation among 13 key informant interviews (KIIs) with health system actors, local government partners, and organizations, and 4 focus group discussions (FGDs) with community members and community health volunteers. The team selected participants purposively following the maximum variation sampling technique and analyzed the data in NVivo 12. The team used KII and FGD guides to explore and understand what was implemented, which stakeholders were engaged in the processes and how, what was achieved, and the barriers and facilitators in implementation. RESULTS Contributions to project achievements included strong partnerships and stakeholder engagement, an enabling environment for SRHR, improving health worker capacity, and flexibility and adaptability. Challenges included a fragile security situation, retention of providers, and difficulty in accessing gender-based violence services, exacerbated by the coronavirus disease (COVID-19) pandemic. CONCLUSION Our article offers guidance for organizations and government entities seeking to design and implement SRHR programs in humanitarian settings. Findings highlight the importance of prioritizing SRHR programming in IDP settings and illustrate adaptable activities to assist with project implementation and minimize operational challenges.
Collapse
Affiliation(s)
| | | | | | | | - Bereket Yakob
- College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | | | | |
Collapse
|
10
|
Olufadewa II, Adesina MA, Oladele RI, Ayorinde TA. “Watching my family being killed by terrorists made me really depressed”: Mental health experiences, challenges and needed support of young internally displaced persons in northern Nigeria. J Migr Health 2022; 6:100121. [PMID: 35694419 PMCID: PMC9178342 DOI: 10.1016/j.jmh.2022.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 05/06/2022] [Accepted: 05/28/2022] [Indexed: 11/28/2022] Open
Abstract
Background Over 3.9 million people have been displaced in Nigeria as a result of the over one-decade-long Boko Haram insurgency and about 2.1 million of this population are internally displaced within the country. Young internally displaced persons (IDPs) are at higher risk of mental illness such as depression, anxiety, post-traumatic stress disorder (PTSD) among others, however, there are sparse studies on this population. Therefore, this study explored the mental health experiences, challenges, and needed support for young internally displaced persons in Durumi and New Kuchingoro Internally Displaced Persons Camps in Nigeria. Methods This qualitative study was conducted among young IDPs in Durumi and New Kuchingoro IDP camps in Northern Nigeria. Fourteen (14) focus group discussions comprising 89 participants and 30 in-depth interviews with 30 participants were conducted with young IDPs. The interviews were in Hausa and Pidgin English, audio-recorded, transcribed, translated into English, and applied thematic analysis was done using MAXQDA Analytics Pro 2020 Results A total of 89 participants consisting of 47 males and 42 females participated in the FGDs and IDIs. Five key themes emerged from the FGDs and IDI: (1) knowledge about mental health, (2) mental Health Experiences, (3) coping strategies, (4) availability of mental health and other health Support, and (5) needed support. Young IDPs had fair knowledge about mental healthcare. Participants reported their experience before displacement as being peaceful with members of the family together in a good environment while they experienced stress, trauma, shock, sadness, and symptoms of anxiety, depression, and PTSD during and post displacement. Personal coping strategies such as listening to music, engaging in sports, reading books, farming, and other economic activities were reported by participants. Participants reported the absence of structured and specialized mental health support in the IDP camps and solicited mental health, physical health, economic and educational support. Conclusion Young IDPs had negative experiences that led to symptoms of mental health disorders such as depression, anxiety disorders, PTSD among others with little or no access to quality mental healthcare. Hence, they require specialized and structured mental health support to lead healthy and productive lives. Policy and programs aimed at increasing access to mental health information and services for forced migrants are recommended.
Collapse
|
11
|
Peralta-Jiménez JA, Urrego-Mendoza ZC. Salud sexual y reproductiva de mujeres afrocolombianas víctimas del conflicto armado en Bojayá, Chocó, Colombia. Estudio de métodos mixtos, 2019. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGÍA 2022; 73:11-27. [PMID: 35503300 PMCID: PMC9084901 DOI: 10.18597/rcog.3763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/22/2022] [Indexed: 11/04/2022]
Abstract
Objetivos: explorar la salud sexual y reproductiva, en interfaz con la salud mental, en las mujeres supervivientes de la masacre de Bojayá, considerando los aspectos físicos y psicológicos involucrados en el pleno ejercicio de la sexualidad y en la reproducción a partir del análisis de registros de valoraciones clínicas recolectados en 2018.Materiales y métodos: estudio descriptivo mixto, cuantitativo tipo serie de casos y cualitativo tipo narrativo de tópicos. En el componente cuantitativo participaron 44 mujeres supervivientes directas de un artefacto explosivo; en el componente cualitativo participaron 10 de ellas, que presentaban disfunción sexual. El muestreo fue por conveniencia. Las fuentes de información fueron los registros de atención. Se midieron variables sociodemográficas, antecedentes, ginecobstétricos, síntomas, signos y diagnósticos de disfunción sexual y de salud mental a partir del CIE X. Análisis epidemiológico descriptivo y análisis narrativo cualitativo, en los que se identificaron temáticas emergentes sobre problemáticas vivenciadas y priorizadas, así como eventos significativos relacionados.Resultados: la edad promedio fue 45 años; 54% presentaba sintomatología ginecológica; 32 %dificultades para acceder a planificación familiar; 23 % disfunciones sexuales; 13,63 % antecedente de violencia sexual; y 34 % violencia intrafamiliar; 61,36 % con trastorno de estrés postraumático; el componente cualitativo evidenció frecuentes vivencias de violencia de pareja, problemas familiares, y sufrimiento por sintomatología no tratada.Conclusiones: en mujeres supervivientes del conflicto armado, deben evaluarse rutinariamente posibles disfunciones sexuales, trastornos postraumáticos, y antecedentes de poli victimización. Son necesarios nuevos estudios descriptivos y analíticos, explorando estos aspectos y sus relaciones.
Collapse
|
12
|
Moreno-Chaparro J, Piñeros-Ortiz S, Rodríguez-Ramírez L, Urrego-Mendoza Z, Samacá-Samacá D, Garzón-Orjuela N, Eslava-Schmalbach J. Mental health consequences of armed conflicts in adults: an overview. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:68-91. [PMID: 35312994 PMCID: PMC10803861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
Armed conflicts (AC) in the world are still active and lead to the growth of violence, with a possible impact on mental health (MH).
Collapse
Affiliation(s)
- Jaime Moreno-Chaparro
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- School of Medicine, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Sandra Piñeros-Ortiz
- Violence and Health Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- Department of Psychiatry, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Laura Rodríguez-Ramírez
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Zulma Urrego-Mendoza
- Violence and Health Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- Department of Public Health, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Daniel Samacá-Samacá
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Nathaly Garzón-Orjuela
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Javier Eslava-Schmalbach
- Health Equity Research Group, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
- Hospital Universitario Nacional de Colombia, Bogotá, Colombia
| |
Collapse
|
13
|
Boeyink C, Ali-Salad MA, Baruti EW, Bile AS, Falisse JB, Kazamwali LM, Mohamoud SA, Muganza HN, Mukwege DM, Mahmud AJ. Pathways to care: IDPs seeking health support and justice for sexual and gender-based violence through social connections in Garowe and Kismayo, Somalia and South Kivu, DRC. J Migr Health 2022; 6:100129. [PMID: 36110499 PMCID: PMC9467885 DOI: 10.1016/j.jmh.2022.100129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/22/2022] [Accepted: 09/02/2022] [Indexed: 11/07/2022] Open
Abstract
A growing literature documents the significant barriers to accessing care that Internally Displaced Persons (IDPs) face. This study focuses on gender-based violence (SGBV), an issue often exacerbated in times of forced displacement, and adds to extant debates by considering the wide range of social connections (pathways and actors) involved in providing care beyond the formal biomedical (and justice) system. This research asks, who do IDPs turn to following SGBV and why? How effective do IDPs perceive these social connections to be? To answer these research questions, the study used ‘participatory social mapping’ methodology for 31 workshops held with over 200 participants in Somalia and the Democratic Republic of the Congo in 2021/2022. Pathways to SGBV-related care for IDPs appear eclectic and contingent upon not only the availability and accessibility of support resources but also social, cultural and gendered beliefs and practices. ‘Physical’, mental health, and justice needs are intertwined. They are hard to decouple as many actors cut across need categories, including family, faith and aid organisations, and customary institutions. Comparing Congolese and Somali sites of displaced communities, we see significant similarities and overlaps in pathways to care. While both countries have experienced severe erosions of state capacity, NGOs and parallel faith-based and customary legal, psychological, and health systems have filled the state's weakness to varying degrees of acceptance by IDP participants. A comprehensive understanding of the local milieu, which requires illuminating the logics behind where people actually turn to for care, is crucial for interventions supporting SGBV victims/survivors; indeed, they risk being inefficient if they only address barriers to formal systems.
Collapse
|
14
|
Acuti Martellucci C, Qaderi S, Tanimoto T, Ozaki A. Afghan women and children's health: Three main challenges under Taliban and COVID-19. J Glob Health 2021; 11:03126. [PMID: 34956634 PMCID: PMC8684792 DOI: 10.7189/jogh.11.03126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Shohra Qaderi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Akihiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan.,Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| |
Collapse
|
15
|
Impact of Family Separation on Subjective Time Pressure and Mental Health in Refugees from the Middle East and Africa Resettled in North Rhine-Westphalia, Germany: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111722. [PMID: 34770236 PMCID: PMC8582773 DOI: 10.3390/ijerph182111722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/22/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022]
Abstract
Little is known about social determinants among refugees resettled in Germany. This study aims to examine the impact of family separation on refugees' subjective time pressure and mental health. Data come from the FlueGe Health Study (n = 208), a cross-sectional study administered by Bielefeld University. We used logistic regression analysis to investigate the effect of family separation on (i) being time-stressed and (ii) having a high risk for adverse mental health, considering sociodemographic and postmigration factors. As a result, more than 30% of participants with a spouse or partner and about 18% with a child or children reported separation. Multiple logistic regression showed that family separation was not associated with being time-stressed, but separation from at least one child was associated with adverse mental health (OR = 3.53, 95% CI = [1.23, 10.11]). In conclusion, family separation primarily contributes to adverse mental health among refugees from the Middle East and Africa resettled in North Rhine-Westphalia, Germany. Therefore, policies and practices that facilitate family reunification can contribute significantly to the promotion of refugees' mental health and well-being.
Collapse
|
16
|
Cantor D, Swartz J, Roberts B, Abbara A, Ager A, Bhutta ZA, Blanchet K, Madoro Bunte D, Chukwuorji JC, Daoud N, Ekezie W, Jimenez-Damary C, Jobanputra K, Makhashvili N, Rayes D, Restrepo-Espinosa MH, Rodriguez-Morales AJ, Salami B, Smith J. Understanding the health needs of internally displaced persons: A scoping review. J Migr Health 2021; 4:100071. [PMID: 34820657 PMCID: PMC8600058 DOI: 10.1016/j.jmh.2021.100071] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/01/2022] Open
Abstract
We seek to strengthen understanding of the health needs of internally displaced persons (IDPs) in contexts of conflict or violence. Based upon a scoping review, our paper identified limited evidence on IDP health, but nevertheless indicates that IDPs tend to experience worse health outcomes than other conflict-affected populations across a range of health issues; and this is due to the particularly vulnerable situation of IDPs relative to these other populations, including reduced access to health services. Further research is required to better understand these needs and the interventions that can most effectively address these needs.
Collapse
Affiliation(s)
- David Cantor
- Internal Displacement Research Programme, School of Advanced Study, University of London, UK
| | | | - Bayard Roberts
- Health Services Research and Policy Department, London School of Hygiene and Tropical Medicine, UK
| | - Aula Abbara
- Department of Infectious Disease, Imperial College London, London, UK; Syria Public Health Network
| | - Alastair Ager
- Institute for Global Health & Development, Queen Margaret University, Edinburgh, UK
- Mailman School of Public Health, Columbia University, USA
| | | | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, University of Geneva, Switzerland
| | | | | | - Nihaya Daoud
- Department of Public Health, Ben-Gurion University of the Negev, Israel
| | | | | | | | | | - Diana Rayes
- Johns Hopkins Bloomberg School of Public Health, USA
| | | | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Fundacion Universitaria Autónoma de las Americas, Colombia
- Universidad Cientifica del Sur, Peru
| | | | - James Smith
- Elrha; Health in Humanitarian Crises Centre, London School of Hygiene and Tropical Medicine, UK
| |
Collapse
|
17
|
Fagbamigbe AF, Olaseinde O, Fagbamigbe OS. Timing of first antenatal care contact, its associated factors and state-level analysis in Nigeria: a cross-sectional assessment of compliance with the WHO guidelines. BMJ Open 2021; 11:e047835. [PMID: 34588242 PMCID: PMC8479944 DOI: 10.1136/bmjopen-2020-047835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To assess the compliance of WHO guidelines on the timeliness of antenatal care (ANC) initiation in Nigeria and its associated factors and to provide subcountry analysis of disparities in the timing of the first ANC in Nigeria. DESIGN Cross-sectional. SETTING Nationally representative data of most recent pregnancies between 2013 and 2018 in Nigeria. PARTICIPANTS Women with pregnancies within 5 years before the study. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome variable was the trimesters of the first ANC contact. Data were analysed using descriptive statistics, bivariable and multivariable multinomial logistic regression at 5% significance level. RESULTS Of all the 21 785 respondents, 75% had at least one ANC contact during their most recent pregnancies within the five years preceding the data collection. Among which 24% and 63% started in the first and second trimester, respectively. The proportion who started ANC in the first trimester was highest in Benue (44.5%), Lagos (41.4%) and Nasarawa (39.3%) and lowest in Zamfara (7.6%), Kano (7.4%) and Sokoto (4.8%). Respondents aged 40-49 years were 65% (adjusted relative risk ratio (aRRR: 1.65, 95 % CI: 1.10 to 2.45) more likely to initiate ANC during the first trimester of pregnancy relative to those aged 15-19 years. Although insignificant, women who participate in their healthcare utilisation were 4% (aRRR: 1.04, 95 % CI: 0.90 to 1.20) times more likely to have early initiation of ANC. Other significant factors were respondents' and spousal educational attainment, household wealth quintiles, region of residence, ethnicity, religion and birth order. CONCLUSIONS Only a quarter of pregnant women, initiated ANC contact during the first trimester with wider disparities across the states in Nigeria and across the background characteristics of the pregnant women. There are needs to enhance women's autonomy in healthcare utilisation. Concerted efforts on awareness creation and empowerment for women by all stakeholders in maternal and child healthcare are antidotes for early ANC contact initiation.
Collapse
Affiliation(s)
- Adeniyi Francis Fagbamigbe
- Epidemiology and Medical Statistics, University of Ibadan College of Medicine, Ibadan, Oyo, Nigeria
- Division of Population and Behavioral Sciences, School of Medicine, University of St. Andrews, St. Andrews, UK
| | | | | |
Collapse
|
18
|
Malik MA, Akhtar SN, Albsoul RA, Alshyyab MA. Conflict driven displacement and child health: Evidence based on mother's nationality from Jordan Population and Family Health Survey. PLoS One 2021; 16:e0257080. [PMID: 34492080 PMCID: PMC8423276 DOI: 10.1371/journal.pone.0257080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 08/23/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction Armed conflicts result in greater vulnerability and socioeconomic inequality of populations besides risking their health and well-being. Conflict intensifies the health needs and risks the life and well-being of individuals at large through displacement. Therefore, our study aims to apprise the interventions to which children under-five living in Jordan are especially at risk for acute respiratory infections, diarrhea, and fever in the conflict circumstances. Materials and methods Secondary data analysis is used in the present study. We used a weighted sample of around 9650 children from Jordan Population and Family Health Survey (JPFHS), 2017–18. Bivariate analysis including prevalence rates were used to examine the distribution of socio-demographic characteristics of children. The study has also used multinomial logistic regression model, in order to evaluate the variations in the probability of nationality of under-five children living in Jordan. Results “Syrian nationalist” children have a higher relative risk of ARI (RRR = 1.19, [1.08, 1.32]), and “Other-nationalist” children have two times greater risk of ARI compared to “Jordanian children.” The relative risk of diarrhea is lower among “Syrian nationalist” and “Other-nationalist” children compared to “Jordanian children.” Children belong “Other-nationalist” are found to be less relative risk of fever (RRR = 0.9, [0.80, 1.01]) than “Jordanian children.” Conclusions Our study concludes that conflict-driven displacement has an immediate effect on child health through access, availability, and affordability of health care services, resulting in more significant health care risks. However, sufficient investment is required to address such adversities that affect the health care system due to uneven demand as experienced by the Jordanian health care system. Thus, collaborative efforts through global partners can play a significant role in the countries facing the challenges of managing these health care emergencies.
Collapse
Affiliation(s)
- Manzoor Ahmad Malik
- Department of Humanities and Social Sciences, Indian Institute of Technology (IIT), Roorkee, India
| | - Saddaf Naaz Akhtar
- Centre for the Study of Regional Development, School of Social Sciences-III, Jawaharlal Nehru University, New Delhi, India
- * E-mail:
| | - Rania Ali Albsoul
- Department of Family and Community Medicine, The University of Jordan, Amman, Jordan
| | - Muhammad Ahmed Alshyyab
- Faculty of Medicine, Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
19
|
Meagher K, Attal B, Patel P. Exploring the role of gender and women in the political economy of health in armed conflict: a narrative review. Global Health 2021; 17:88. [PMID: 34348740 PMCID: PMC8334332 DOI: 10.1186/s12992-021-00738-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background The ripple effects of protracted armed conflicts include: significant gender-specific barriers to accessing essential services such as health, education, water and sanitation and broader macroeconomic challenges such as increased poverty rates, higher debt burdens, and deteriorating employment prospects. These factors influence the wider social and political determinants of health for women and a gendered analysis of the political economy of health in conflict may support strengthening health systems during conflict. This will in turn lead to equality and equity across not only health, but broader sectors and systems, that contribute to sustainable peace building. Methods The methodology employed is a multidisciplinary narrative review of the published and grey literature on women and gender in the political economy of health in conflict. Results The existing literature that contributes to the emerging area on the political economy of health in conflict has overlooked gender and specifically the role of women as a critical component. Gender analysis is incorporated into existing post-conflict health systems research, but this does not extend to countries actively affected by armed conflict and humanitarian crises. The analysis also tends to ignore the socially constructed patriarchal systems, power relations and gender norms that often lead to vastly different health system needs, experiences and health outcomes. Conclusions Detailed case studies on the gendered political economy of health in countries impacted by complex protracted conflict will support efforts to improve health equity and understanding of gender relations that support health systems strengthening.
Collapse
Affiliation(s)
- Kristen Meagher
- Research for Health Systems Strengthening in northern Syria, Conflict and Health Research Group (CHRG), Department of War Studies, King's College London, London, UK.
| | - Bothaina Attal
- Faculty of Medicine and Health Sciences, Sana'a University, Yemen and Centre for Business Research, University of Cambridge, Cambridge, UK
| | - Preeti Patel
- Research for Health Systems Strengthening in northern Syria, Conflict and Health Research Group (CHRG), Department of War Studies, King's College London, London, UK
| |
Collapse
|
20
|
Amodu OC, Salami BO, Richter S, Okeke-Ihejirika P. Reproductive healthcare for women in IDP camps in Nigeria: An analysis of structural gaps. Glob Public Health 2021; 16:563-577. [PMID: 32960742 DOI: 10.1080/17441692.2020.1810296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Health and health service access for women displaced by terrorism from Northeast Nigeria is a serious problem. Existing government and humanitarian initiatives in Northeast Nigeria focus on food, security, housing, water and sanitation to the neglect of health access needs, especially access to reproductive health. With no policy in place and very little existing research, the systemic influences surrounding IDP women's health in Nigeria are not well understood. This study aimed to identify structural gaps influencing access to reproductive health care for women displaced by terrorism in Nigeria. The findings highlight important factors that undermine reproductive health access for internally displaced women: poor governance of the primary health care sector in Nigeria and insufficient co-ordination between the federal government and implementing agencies. Results have implications for policy and administrative restructuring in the primary health sector, as well as for improved funding allocation for the provision of reproductive health services. The Federal Government and all institutions managing healthcare funds should implement strategies to ensure strong leadership and accountability in health development assistance and practices. Specifically, a special taskforce should be established to co-ordinate and harmonise the development activities targeting improvements in the health and wellbeing of IDPs.
Collapse
Affiliation(s)
| | | | - Solina Richter
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | | |
Collapse
|
21
|
Madoro D. A Cross-Sectional Analysis of the Prevalence and Determinants of Mental Distress Among Ethiopian Returnees. Neuropsychiatr Dis Treat 2021; 17:2849-2857. [PMID: 34511916 PMCID: PMC8415761 DOI: 10.2147/ndt.s317803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/21/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Returning internally displaced persons (IDPs) to their homes can be a difficult and traumatic experience, particularly after a long period of displacement. Furthermore, traumatic experiences encountered during displacement during the flight process may be replayed in the minds of IDP returnees when they return to their original locations, raising the risk of re-traumatization. This could have a detrimental impact on the mental health of returning IDPs. Despite this, the mental health of returnee IDPs in Ethiopia has received less consideration. As a result, the aim of this study was to determine the prevalence and determinants of mental distress among Ethiopian returnees. METHOD AND PARTICIPANTS A community-based cross-sectional study with 623 participants was conducted from January 1 to 30, 2021, using a systematic sampling technique. The Kessler psychological distress scale was used to assess mental distress (K-10). Bivariable and multivariable binary logistic regression is used to investigate the relationship between variables. Statistical significance was described as a P-value of less than 0.05 with a 95% confidence interval. RESULTS The total number of people interviewed was 623, with a 100% response rate. With a 95% confidence interval of 47 to 51.9, the prevalence of psychological distress was 49.4%. Unemployment (AOR=2.1, 95% CI 1.38 to 3.40), inadequate social support (AOR=1.92, 95% CI 1.53 to 2.56), having little knowledge of post-returnee life (AOR=2.17, 95% CI 1.23 to 3.37), and the number of traumatic events (AOR=1.92, 95% CI 1.53 to 2.56) were all found to be significant in the multivariate logistic regression. CONCLUSION Returnee IDPs have a high prevalence of psychological distress, according to this report. It is suggested that knowledge of how to adapt to a new life after returning to the original land be given, as well as consistent psychosocial help.
Collapse
Affiliation(s)
- Derebe Madoro
- Department of Psychiatry, Dilla University's College of Medicine and Health Sciences, Dilla, Ethiopia
| |
Collapse
|
22
|
Okagbue HI, Oguntunde PE, Obasi ECM, Adamu PI, Opanuga AA. Diagnosing malaria from some symptoms: a machine learning approach and public health implications. HEALTH AND TECHNOLOGY 2021. [DOI: 10.1007/s12553-020-00488-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
23
|
Fatemi F, Moslehi S. Challenges of Reproductive Health Management in the Camps of Internally Displaced Persons: A Systematic Review. Ethiop J Health Sci 2021; 31:179-188. [PMID: 34158765 PMCID: PMC8188104 DOI: 10.4314/ejhs.v31i1.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Internally Displaced Persons (IDPs) in the camps face many reproductive health challenges. They should meet their needs timely to save their lives. This paper outlines a systematic review to discuss the challenges of reproductive health management in the camps of internally displaced persons. METHODS For this research, electronic databases including PubMed, Science Direct, Scopus, Pro Quest, Google Scholar and Cochrane Library till January 1, 2020 were searched. A threestage screening process was used for the selection of literature due to PRISMA checklist. Finally, a thematic synthesis approach was applied to analyze the data. RESULTS In total, 133 articles were identified; 11 articles met the inclusion criteria for entering the process of final analysis. The findings were demonstrated in six main categories of availability and accessibility of reproductive health services, sexual and gender-based issues, human rights, social and cultural issues, coordination and collaboration, and mental health issues. The remarkable result of this study highlighted that the main challenges are lack of access to health services, violence against women and lack of household education. CONCLUSION Results of this systematic review present valuable advice for policy makers and managers to prepare and respond effectively and timely to reproductive health challenges of internally displaces persons. Disaster preparedness plans and contingency plans for maintaining and developing reproductive health in IDPs camps are recommended.
Collapse
Affiliation(s)
- Farin Fatemi
- PhD, Research center for health sciences and technologies, Semnan University of Medical Sciences, Semnan, Iran
| | - Shandiz Moslehi
- PhD, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
24
|
Rajbangshi PR, Nambiars D, Srivastava A. "We wish to have good medical care": findings from a qualitative study on reproductive and maternal health of internally displaced women in India. Sex Reprod Health Matters 2021; 29:2059324. [PMID: 35486074 PMCID: PMC9067944 DOI: 10.1080/26410397.2022.2059324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Internally displaced women are underserved by health schemes and policies, even as they may face greater risk of violence and unplanned pregnancies, among other burdens. There are an estimated 450,000 internally displaced persons in India, but they are not formally recognised as a group. Displacement has been a common feature in India's northeast region. This paper examines reproductive and maternal health (RMH) care-seeking among Bru displaced women in India. The study employed qualitative methodology: four focus group discussions (FGDs) were held with 49 displaced Bru women aged 18-45 between June and July 2018; three follow-up interviews with FGD participants and five in-depth interviews with community health workers (Accredited Social Health Activists - ASHAs) in camps for Bru displaced people in the Indian state of Tripura. All interviewees gave written or verbal informed consent; discussions were conducted in the local dialect, recorded, and transcribed. Data were indexed deductively from a dataset coded using grounded approaches. Most women were unaware of many of the RMH services provided by health facilities; very few accessed such care. ASHAs had helped increase institutional deliveries over the years. Women were aware of temporary contraceptive methods as well as medical abortion, but lacked awareness of the full range of contraceptive options. Challenges in accessing RMH services included distance of facilities from camps, and multiple costs (for transport, medicines, and informal payments to facility staff). The study highlighted a need for comprehensive intervention to improve RMH knowledge, attitudes, and practices among displaced women and to reduce access barriers.
Collapse
Affiliation(s)
- Preety R Rajbangshi
- Senior Research Fellow, Public Health Foundation of India, New Delhi, India. Correspondence:
| | - Devaki Nambiars
- Senior Research Scientist, Public Health Foundation of India, New Delhi, India
| | - Aradhana Srivastava
- Senior Research Scientist, Public Health Foundation of India, New Delhi, India
| |
Collapse
|
25
|
Lugova H, Samad N, Haque M. Sexual and Gender-Based Violence Among Refugees and Internally Displaced Persons in the Democratic Republic of the Congo: Post-Conflict Scenario. Risk Manag Healthc Policy 2020; 13:2937-2948. [PMID: 33328772 PMCID: PMC7734039 DOI: 10.2147/rmhp.s283698] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/23/2020] [Indexed: 12/26/2022] Open
Abstract
The ongoing humanitarian crisis in the Democratic Republic of the Congo has triggered sexual and gender-based violence, including rape, sexual slavery, trafficking, intimate partner violence, and sexual exploitation. Gender inequalities and abuse of power experienced by women and young girls at refugee settings further exacerbate their vulnerability to different forms of violence. This study aimed to offer an evidence-based approach to developing strategies in tackling the complex problem of sexual and gender-based violence among refugees and internally displaced persons in the Congo. We conducted a narrative review of all the relevant papers known to the authors to explore the origins of the problem, its implications on public health, and its impact on equity. The study revealed that sexual assault survivors face physical and psychological sufferings, excruciating emotions, and profound disruption of their social well-being since they are often stigmatized and ostracized by society. The analysis of current government policies revealed a lack of programs to address survivors' specific concerns and policy enforcement problems. This study suggested strategic objectives and policy implementation steps. The proposed strategies address women empowerment and gender stigma, provision of effective health services, and adequate response action.
Collapse
Affiliation(s)
- Halyna Lugova
- Unit of Community Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Nandeeta Samad
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|