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刚果民主共和国东部针对女性性暴力幸存者的一项经济干预措施所产生的经济、社会及心理健康影响。

Economic, social and mental health impacts of an economic intervention for female sexual violence survivors in Eastern Democratic Republic of Congo.

作者信息

Bass J, Murray S, Cole G, Bolton P, Poulton C, Robinette K, Seban J, Falb K, Annan J

机构信息

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Ministry of Human Services, Government of Alberta, Edmonton, Alberta, Canada.

出版信息

Glob Ment Health (Camb). 2016 Jun 6;3:e19. doi: 10.1017/gmh.2016.13. eCollection 2016.

Abstract

BACKGROUND

Conflict-affected communities face poverty and mental health problems, with sexual violence survivors at high risk for both given their trauma history and potential for exclusion from economic opportunity. To address these problems, we conducted a randomized controlled trial of a group-based economic intervention, Village Savings and Loans Associations (VSLA), for female sexual violence survivors in the Democratic Republic of Congo.

METHODS

In March 2011, 66 VSLA groups, with 301 study participants, were randomized to the VSLA program or a wait-control condition. Data were collected prior to randomization, at 2-months post-program in June 2012, and 8-months later for VSLA participants only. Outcome data included measures of economic and social functioning and mental health severity. VSLA program effect was derived by comparing intervention and control participants' mean changes from baseline to 2-month follow-up.

RESULTS

At follow-up, VSLA study women reported significantly greater food consumption and significantly greater reductions in stigma experiences compared with controls. No other study outcomes were statistically different. At 8-month follow-up, VSLA participants reported a continued increase in food consumption, an increase in economic hours worked in the prior 7 days, and an increase in access to social resources.

CONCLUSIONS

While female sexual violence survivors with elevated mental symptoms were successfully integrated into a community-based economic program, the immediate program impact was only seen for food consumption and experience of stigma. Impacts on mental health severity were not realized, suggesting that targeted mental health interventions may be needed to improve psychological well-being.

摘要

背景

受冲突影响的社区面临贫困和心理健康问题,鉴于其创伤经历以及被排除在经济机会之外的可能性,性暴力幸存者面临这两种问题的风险很高。为了解决这些问题,我们针对刚果民主共和国的女性性暴力幸存者开展了一项基于群体的经济干预措施——乡村储蓄与贷款协会(VSLA)的随机对照试验。

方法

2011年3月,66个VSLA小组(共301名研究参与者)被随机分配到VSLA项目组或等待控制组。在随机分组前、2012年6月项目结束后2个月以及8个月后(仅针对VSLA参与者)收集数据。结果数据包括经济和社会功能以及心理健康严重程度的测量指标。VSLA项目的效果通过比较干预组和对照组参与者从基线到2个月随访的平均变化得出。

结果

在随访时,与对照组相比,参与VSLA研究的女性报告食物消费量显著增加,耻辱经历显著减少。其他研究结果在统计学上没有差异。在8个月的随访中,VSLA参与者报告食物消费量持续增加,过去7天的经济工作时长增加,获得社会资源的机会增加。

结论

虽然有较高精神症状的女性性暴力幸存者成功融入了一个基于社区的经济项目,但该项目的直接影响仅体现在食物消费和耻辱经历方面。对心理健康严重程度的影响并未实现,这表明可能需要有针对性的心理健康干预措施来改善心理健康状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7181/5314746/cb9add9766be/S2054425116000133_fig1.jpg

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