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Fisseha SE, López ML, Brummelaar MT, Hibiso HW. Sources of resilience for refugee youth in Ethiopia: Exploring the role of education, work, community, religion, and family. CHILD ABUSE & NEGLECT 2024:106978. [PMID: 39153937 DOI: 10.1016/j.chiabu.2024.106978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 06/14/2024] [Accepted: 07/31/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Young refugees' resilience is linked to involvement in socio-ecological systems that contribute to their well-being. OBJECTIVE This study aimed to understand the experiences and factors contributing to resilience among young Sudanese and South Sudanese refugees (aged 16, M = 16 years; N = 40; 21 males, 19 females) residing at the Sherkole refugee camp in Ethiopia's Benishangul-Gumuz region. METHOD Six focus groups (N = 40) and four key informant interviews with government officials, caregivers, and school teachers explored themes related to resilience using thematic analysis. Member checking ensured findings aligned with participants' perspectives. A socio-ecological framework guided the exploration of multidimensional factors. RESULTS Five themes emerged: (1) support systems, (2) work engagement, (3) access to education, (4) role of religion, and (5) community engagement. Work opportunities helped young refugees cope with challenges, but key informants raised concerns about potential risks to education. Social connection and community engagement fostered a harmonious relationship with the host community. Religion and education alleviated stress and worries. The themes interrelated - community engagement improved host community relationships, increasing job opportunities and income (leading to better support systems). Religious activities and education also benefited relationships and provided relaxation. CONCLUSION This study supports the dynamic and multi-systemic nature of resilience within a socio-ecological framework. Findings can inform future resilience-promoting interventions and policies for young refugees.
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Affiliation(s)
- Senper Elias Fisseha
- College of Education and Behavioural Science, School of Psychology, Addis Ababa University, Ethiopia; Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands.
| | - Mónica López López
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands.
| | - Mijntje Ten Brummelaar
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Habtamu Wondimu Hibiso
- College of Education and Behavioural Science, School of Psychology, Addis Ababa University, Ethiopia
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Ager A, Metzler J. The Accumulating Evidence-Base Regarding Child Friendly Spaces: Policy and Practice Implications. INTERVENTION 2022. [DOI: 10.4103/intv.intv_12_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Wood B, Kallestrup P. Benefits and Challenges of Using a Participatory Approach with Community-based Mental Health and Psychosocial Support Interventions in Displaced Populations. Transcult Psychiatry 2021; 58:283-292. [PMID: 33509062 DOI: 10.1177/1363461520983626] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The mental health burden of displaced communities is enormous and ever-increasing. Community-based Mental Health and Psychosocial Support (CB-MHPSS) interventions are seen as vital in addressing this challenge, and they have been lauded as being integral in the overall multi-level Mental Health and Psychosocial Support Intervention approach in humanitarian settings. This article assumes that CB-MHPSS innately require a participatory approach to truly benefit the targeted population. It explores important benefits and challenges of using a participatory approach with CB-MHPSS interventions, as well as identifying key considerations in their design and implementation. A literature review of the PubMed database, Web of Science, The Cochrane Library of Systematic Reviews, and defined 'grey literature' identified 42 relevant articles. Thematic analysis identified dilemmas raised by many of the authors, including: the disconnect between using a participatory community-based approach and evidence-based medicine; using locally derived versus standardised measures; incorporating local mental health expressions and idioms into the intervention versus using standardised diagnostic classifications; empowering communities versus falling into the hands of local power dynamics and agendas; and trying to allow for sufficient time to develop relationships and build trust with the targeted community. The findings can serve to encourage reflexivity and critical thinking in the design and implementation of future CB-MHPSS interventions, which will be required to develop robust evidence that supports CB-MHPSS interventions in displaced communities.
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Metzler J, Jonfa M, Savage K, Ager A. Educational, psychosocial, and protection outcomes of child- and youth-focused programming with Somali refugees in Dollo Ado, Ethiopia. DISASTERS 2021; 45:67-85. [PMID: 31322750 DOI: 10.1111/disa.12392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Child- and youth-friendly spaces have become a common feature of emergency humanitarian provision. This study reports on the outcomes of child and youth learning centres (CYLCs) in Ethiopia's Buramino Camp established for those fleeing conflict in Somalia. Eighty-five youths completed baseline assessments shortly after arrival and follow-up assessments three to six months later. Caregivers of 106 younger children completed similar appraisals. 693 children attending the CYLCs completed pre- and post-educational assessments, which indicated major gains-significant at p<0.0001-in both literacy (younger children, t=9.06; youth, t=13.87) and numeracy (younger children, t=13.94; youths, t=17.10). Children's CYLC attendance increased reports of met needs among caregivers (t=2.53, p<0.05) and youths (t=2.57, p<0.05), and, among caregivers but not youths, significantly moderated protection concerns (t=2.39, p<0.05, and t=-1.90, p=0.06, respectively). There was general improvement in psychosocial well-being over time for all children; CYLC attendance predicted greater reductions in reported difficulties only among younger children (t=2.51, p<0.05).
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Affiliation(s)
- Janna Metzler
- Senior Research Officer, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, United States
| | - Mesfin Jonfa
- Education in Emergency Specialist, World Vision Ethiopia, Ethiopia
| | - Kevin Savage
- Humanitarian Research Director, World Vision International, Geneva, Switzerland
| | - Alastair Ager
- Professor of Population and Family Health, Columbia University, United States
- Now Director of the Institute for Global Health and Development, Queen Margaret University, United Kingdom
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Metzler J, Diaconu K, Hermosilla S, Kaijuka R, Ebulu G, Savage K, Ager A. Short- and longer-term impacts of Child Friendly Space Interventions in Rwamwanja Refugee Settlement, Uganda. J Child Psychol Psychiatry 2019; 60:1152-1163. [PMID: 31106415 PMCID: PMC6852245 DOI: 10.1111/jcpp.13069] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The establishment of Child Friendly Spaces (CFSs) has become a widespread intervention targeting protection and support for displaced children in humanitarian contexts. There is a lack of evidence of impact of these interventions with respect to both short-term outcomes and longer-term developmental trajectories. METHODS We collected data from caregivers of Congolese refugee children residing in Rwamwanja Refugee Settlement at three timepoints. To assess short-term impact of CFSs, we compared indicators assessed shortly after refugees' arrival (baseline, T1) and endline (T2, three to six months after CFS implementation) amongst 430 CFS attenders and 161 nonattenders. Follow-up assessments after the end of CFS programming were conducted 18 months post-baseline (T3) with caregivers of 249 previous CFS attenders and 77 CFS nonattenders. RESULTS In the short-term, attendance at CFSs was associated with better maintenance of psychosocial well-being (PSWB; β = 2.093, p < .001, Cohen's d = .347) and greater increases in developmental assets (β = 2.517, p < .001, Cohen's d = .231), with significantly stronger impacts for girls. CFS interventions meeting higher programing quality criteria were associated with greater impact on both PSWB and development assets (β = 2.603 vs. β = 1.793 and β = 2.942 vs. β = 2.337 for attenders at higher and lower-quality CFSs c.f. nonattenders, respectively). Amongst boys, benefits of program attendance were only indicated for those attending higher-quality CFS (β = 2.084, p = .006 for PSWB). At follow-up, however, there were no discernable impacts of prior CFS attendance on any measures. Age and school attendance were the only characteristics that predicted an outcome - developmental assets - at follow-up. CONCLUSIONS Attendance at CFSs - particularly involving higher-quality programming - supported children's well-being and development. However, sustained impact beyond active CFS programming was not demonstrated. Intervention goals and strategies in humanitarian contexts need to address the challenge of connecting children to other resources to facilitate developmental progress in conditions of protracted displacement.
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Affiliation(s)
- Janna Metzler
- Department of Population and Family HealthMailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Karin Diaconu
- Institute for Global Health and DevelopmentQueen Margaret UniversityEdinburghScotlandUK
| | | | | | | | - Kevin Savage
- Humanitarian and Emergency AffairsWorld Vision InternationalGenevaSwitzerland
| | - Alastair Ager
- Department of Population and Family HealthMailman School of Public HealthColumbia UniversityNew YorkNYUSA,Institute for Global Health and DevelopmentQueen Margaret UniversityEdinburghScotlandUK
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Wessells MG. Supporting resilience in war-affected children: How differential impact theory is useful in humanitarian practice. CHILD ABUSE & NEGLECT 2018; 78:13-18. [PMID: 29254697 DOI: 10.1016/j.chiabu.2017.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/09/2017] [Indexed: 06/07/2023]
Abstract
This paper examines the utility of the Differential Impact Theory for child protection practitioners who work in humanitarian settings, with a focus on war-affected children. A primary advantage of DIT is that it focuses efforts to strengthen children's resilience on improving children's social ecologies at different levels. This ecological focus is more likely to address the sources of children's suffering and resilience and also helps to avoid the problems associated with an individualized focus. It also shows how DIT provides a differentiated view of war-affected children and stimulates multiple interventions at different ecological levels, avoiding the common error of taking a one size fits all approach to intervention. In keeping with DIT, it suggests that child protection practice would benefit from addressing macro-level risks such as poverty and discrimination that are drivers of various harms to children and from more systematic linkages between macro- and micro-levels. It concludes that DIT serves as a critical lens for viewing current work on child protection in humanitarian settings and also for illuminating ways to develop more comprehensive supports for children's resilience.
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DeJong J, Sbeity F, Schlecht J, Harfouche M, Yamout R, Fouad FM, Manohar S, Robinson C. Young lives disrupted: gender and well-being among adolescent Syrian refugees in Lebanon. Confl Health 2017; 11:23. [PMID: 29167697 PMCID: PMC5688457 DOI: 10.1186/s13031-017-0128-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The conflict in Syria that began in 2011 has resulted in the exodus of over 5 million Syrian refugees to neighbouring countries, with more than one million refugees currently registered by UNHCR in Lebanon. While some are living in tented settlements, the majority are living in strained conditions in rented accommodation or collective shelters in the Bekaa Valley next to Syria. Adolescents are particularly vulnerable in any crisis. In 2013–4, the American University in Beirut in collaboration with the Women’s Refugee Commission, Johns Hopkins and Save the Children, sought to understand the specific experiences of very young adolescents, those 10–14 years of age, in this protracted crisis context. Methods The study was conducted in 2014 in Barelias and Qabelias – two urban areas located close to each other in the Beka’a valley that has a large concentration of Syrian refugees. Focus group discussions (FGDs), including community mapping and photo elicitation, were conducted with 10–12 and 13–14 year old Syrian refugee adolescents, in order to obtain information about their experiences and perspectives. FGDs were also implemented with 15–16 year old Syrian refugees and separately also with adult refugees, to consider their perspectives on the needs and risks of these adolescents. Results A total of 16 FGD (8 for each sex, with 6–9 participants in each) were conducted in Arabic across the two sites, with 59 female participants and 59 male participants. The experiences and risks faced by these adolescents were significantly impacted by economic strain and loss of educational opportunities during displacement, and only a minority of adolescents in the study reported attending school. Additionally, on-going protection risks for girls were felt to be higher due to the crisis and displacement. In Lebanon this has resulted in increased risks of child marriage and limitations in mobility for adolescent girls. Adolescents, themselves expressed tensions with their Lebanese counterparts and feared verbal attacks and beatings from school-aged Lebanese male youth. Conclusions Families and adolescents have been dramatically affected by the conflict in Syria, and the resulting forced displacement. The loss of educational opportunities is perhaps the most significant effect, with long-term devastating outcomes. Additionally, the futures of Syrian girls are deeply affected by new protection concerns, particularly as they are exposed to an unfamiliar and more liberal society in Lebanon. Child marriage and limitations in their mobility – particularly for girls - are presented by families as coping strategies to these risks. Programming is needed to ensure sustained education access for all adolescents, and to educate very young adolescents and their parents on managing their own health and well-being, given the multiple strains. More effort is needed to encourage positive interaction between adolescent Lebanese and adolescent Syrian refugees.
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Affiliation(s)
- Jocelyn DeJong
- Faculty of Health Sciences, American University in Beirut, Beirut, Lebanon
| | - Farah Sbeity
- Faculty of Health Sciences, American University in Beirut, Beirut, Lebanon
| | | | - Manale Harfouche
- Faculty of Health Sciences, American University in Beirut, Beirut, Lebanon
| | - Rouham Yamout
- Faculty of Health Sciences, American University in Beirut, Beirut, Lebanon
| | - Fouad M Fouad
- Faculty of Health Sciences, American University in Beirut, Beirut, Lebanon
| | | | - Courtland Robinson
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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McLeigh JD, Katz C, Davidson-Arad B, Ben-Arieh A. The Cultural Adaptation of a Community-Based Child Maltreatment Prevention Initiative. FAMILY PROCESS 2017; 56:393-407. [PMID: 26568326 DOI: 10.1111/famp.12193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A unique primary prevention effort, Strong Communities for Children (Strong Communities), focuses on changing attitudes and expectations regarding communities' collective responsibilities for the safety of children. Findings from a 6-year pilot of the initiative in South Carolina have shown promise in reducing child maltreatment, but efforts to adapt the initiative to different cultural contexts have been lacking. No models exist for adapting an initiative that takes a community-level approach to ensuring children's safety. Thus, this article addresses the gap by providing an overview of the original initiative, how the initiative was adapted to the Israeli context, and lessons learned from the experience. Building on conceptualizations of cultural adaptation by Castro et al. (Prevention Science, 5, 2004, 41) and Resnicow et al. (Ethnicity and Disease, 9, 1999, 11), sources of nonfit (i.e., sociodemographic traits, political conflict, government services, and the presence and role of community organizations) were identified and deep and surface structure modifications were made to the content and delivery. Ultimately, this article describes the adaption and dissemination of a community-based child maltreatment prevention initiative in Tel Aviv, Israel, and addresses researchers' calls for more publications describing the adaptation of interventions and the procedures that need to be implemented to achieve cultural relevance.
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Affiliation(s)
- Jill D McLeigh
- Kempe Center for Prevention and Treatment of Child Abuse and Neglect, University of Colorado School of Medicine, Aurora, CO
| | - Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | | | - Asher Ben-Arieh
- Paul Baerwald School of Social Work, Hebrew University, Jerusalem, Israel
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McDonell JR, Ben-Arieh A, Melton GB. Strong Communities for Children: Results of a multi-year community-based initiative to protect children from harm. CHILD ABUSE & NEGLECT 2015; 41:79-96. [PMID: 25747873 DOI: 10.1016/j.chiabu.2014.11.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 11/24/2014] [Accepted: 11/24/2014] [Indexed: 06/04/2023]
Abstract
This article reports the evaluation results from Strong Communities for Children, a multi-year comprehensive community-based initiative to prevent child maltreatment and improve children's safety. The outcome study consisted of a survey of a random sample of caregivers of children under age 10 in the Strong Communities service area and a set of comparison communities matched at the block group level on demography. Survey data were collected in two waves 4 years apart. Data were collected on (a) perceptions of the neighborhood and neighbors (e.g., neighboring, collective efficacy), (b) perceptions of neighbors' parenting practices, (c) parental attitudes and beliefs (e.g., parental stress; parental efficacy), and (d) self-reported parenting practices. The survey data were supplemented by data on substantiated reported rates of child abuse and neglect per 1,000 children and ICD-9 coded child injuries suggesting child abuse and neglect per 1,000 children. Compared to the non-intervention sample across time, the Strong Communities samples showed significant changes in the expected direction for social support, collective efficacy, child safety in the home, observed parenting practices, parental stress, parental efficacy, self-reported parenting practices, rates of officially substantiated child maltreatment, and rates of ICD-9 coded child injuries suggesting child maltreatment. These promising results, obtained through multiple methods of evaluation, confirm that a community mobilization strategy can shift norms of parents' care for their children and neighbors' support for one another, so that young children are safer at home and in the community. Replications should be undertaken and evaluated in other communities under diverse auspices.
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Affiliation(s)
- James R McDonell
- Institute on Family & Neighborhood Life, Clemson University, 2073 Barre Hall, Clemson, SC 29634, USA
| | - Asher Ben-Arieh
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Israel
| | - Gary B Melton
- Kempe Center for Prevention and Treatment of Child Abuse and Neglect, University of Colorado School of Medicine and Colorado School of Public Health, USA
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Hemmati MA, Shokoohi H, Masoumi M, Khateri S, Soroush M, Modirian E, Poor Zamany Nejat Kermany M, Hosseini M, Mousavi B. Mental health disorders in child and adolescent survivors of post-war landmine explosions. Mil Med Res 2015; 2:30. [PMID: 26568841 PMCID: PMC4644284 DOI: 10.1186/s40779-015-0052-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To describe the mental health status of 78 child and adolescent survivors of post-war landmine explosions. METHODS Child and adolescent survivors of landmine explosions who were younger than 18 years old at the time of the study were identified and enrolled in this study. The mental health status of the participants was assessed by general health assessment and psychiatric examinations. Psychiatric assessment and diagnosis were undertaken using the Diagnostic and Statistical Manual for mental disorders (DSM-IV) criteria. A psychiatrist visited and interviewed each survivor and identified psychiatric disorders. RESULTS Seventy-eight child and adolescent survivors with a mean age of 16.11 ± 2 years old were identified and agreed to participate in the study. The mean age of the victims at the time of injury was 8.2 ± 3.12 years old (range 2-15). Thirty-seven (47.4 %) of the adolescent survivors suffered from at least one psychiatric disorder. Twenty-nine survivors (37.1 %) were newly diagnosed and needed to start medication and psychiatric treatment. The most common findings were anxiety disorders (34.6 %), including posttraumatic stress disorder (PTSD) in 20 (25.6 %), and generalized anxiety disorder (GAD) in 7 (9 %) subjects. Mild-Moderate depression was found in 5 (6.4 %) subjects. No personality disorders were observed, and two patients suffered from mental retardation. The study results revealed a significant association between age of casualty, duration of injury and limb amputation, and types of psychological disorders. CONCLUSION Child and adolescent survivors of landmine explosions had a high prevalence of psychiatric disorders.
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Affiliation(s)
| | - Hamid Shokoohi
- Department of Emergency Medicine, George Washington University, Washington, DC USA
| | - Mehdi Masoumi
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
| | - Shahriar Khateri
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
| | - Mohammadreza Soroush
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran ; NO.25, Farrokh St., Moghaddas Ardebily Ave., Chamran Highway, Tehran, Iran
| | - Ehsan Modirian
- Emergency Department, Medical Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Maryam Hosseini
- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
| | - Batool Mousavi
- Community and Preventive Medicine, Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
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