Burns Rachel, Wickramage Kolitha, Musah Anwar, Siriwardhana Chesmal, Checchi Francesco
1Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
International Organisation for Migration (UN Migration Agency), Sri Lanka Country Mission, 62 Ananda Coomaraswamy Mawatha, Colombo, 00300 Sri Lanka.
Confl Health. 2018 Oct 1;12:41. doi: 10.1186/s13031-018-0176-7. eCollection 2018.
Although the adverse impacts of conflict-driven displacement on health are well-documented, less is known about how health status and associated risk factors differ according to displacement experience. This study quantifies health status and quality of life among returning refugees, internally displaced persons, and the host community in a post-conflict district in Northern Sri Lanka, and explores associated risk factors.
We analysed data collected through a household survey ( = 570) in Vavuniya district, Sri Lanka. The effect of displacement status and other risk factors on perceived quality of life as estimated from the 36-item Short Form Questionnaire, mental health status from 9-item Patient Health Questionnaire, and self-reported chronic disease status were examined using univariable analyses and multivariable regressions.
We found strong evidence that perceived quality of life was significantly lower for internally displaced persons than for the host community and returning refugees, after adjusting for covariates. Both mental health status and chronic disease status did not vary remarkably among the groups, suggesting that other risk factors might be more important determinants of these outcomes.
Our study provides important insights into the overall health and well-being of the different displaced sub-populations in a post-conflict setting. Findings reinforce existing evidence on the relationship between displacement and health but also highlight gaps in research on the long-term health effects of prolonged displacement. Understanding the heterogeneity of conflict-affected populations has important implications for effective and equitable humanitarian service delivery in a post-conflict setting.
尽管冲突导致的流离失所对健康的不利影响已有充分记录，但对于健康状况及相关风险因素如何因流离失所经历而异，人们了解得较少。本研究对斯里兰卡北部一个冲突后地区的返乡难民、境内流离失所者和收容社区的健康状况及生活质量进行了量化，并探讨了相关风险因素。
我们分析了通过在斯里兰卡瓦武尼亚区进行的一项家庭调查（n = 570）收集的数据。使用单变量分析和多变量回归，研究了流离失所状况和其他风险因素对从36项简短问卷估计的感知生活质量、9项患者健康问卷评估的心理健康状况以及自我报告的慢性病状况的影响。
我们发现有力证据表明，在调整协变量后，境内流离失所者的感知生活质量显著低于收容社区和返乡难民。心理健康状况和慢性病状况在各组之间没有显著差异，这表明其他风险因素可能是这些结果更重要的决定因素。
我们的研究为冲突后环境中不同流离失所亚群体的整体健康和福祉提供了重要见解。研究结果强化了关于流离失所与健康之间关系的现有证据，但也凸显了关于长期流离失所对健康的长期影响研究中的差距。了解受冲突影响人群的异质性对于冲突后环境中有效和公平的人道主义服务提供具有重要意义。
