Chua Calida S, Ansah John P, Tep Sovanvorleak, Oy Sreymom, Ung Mengieng, Yi Siyan
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Center for Community Health Integration, Case Western Reserve University, Cleveland, OH, United States.
Front Public Health. 2024 Nov 21;12:1336785. doi: 10.3389/fpubh.2024.1336785. eCollection 2024.
The COVID-19 pandemic has intensified global mental health challenges, particularly for vulnerable groups like female entertainment workers (FEWs), a critical HIV-affected population in Cambodia. Already facing pre-existing inequalities, FEWs encountered heightened difficulties due to the pandemic's disruption of their livelihoods. Their susceptibility to mental health problems is exacerbated by poverty and the occupational stressors they regularly endure. This study aims to identify COVID-19-related factors adversely impacting the mental well-being of FEWs in Cambodia and explore potential interventions to mitigate these effects.
In December 2021, we conducted a two-day workshop in Phnom Penh using a group model-building approach with stakeholders from diverse backgrounds to gather collective insights. We employed the qualitative system dynamics method of causal loop diagram mapping to visualize the factors affecting FEWs' mental health. Based on participants' perceptions and experiences, we constructed a causal loop diagram to develop a comprehensive systems perspective.
The workshop involved 27 stakeholders, including representatives from national institutions ( = 3), local NGOs ( = 17), an international NGO ( = 1), and the FEW community ( = 6). Our analysis identified 13 feedback loops highlighting key factors influencing the mental well-being of FEWs during the pandemic. These factors included the loss of family members, financial instability, fear of COVID-19 infection, the pressure of children's homeschooling due to school closures, and food insecurity. In response, stakeholders proposed a range of interventions, including alternative vocational training, increased awareness of mental health issues, access to mental health services, and programs targeting gender-based violence within FEW communities.
A collaborative, multi-sectoral approach is crucial to addressing the mental health challenges of FEWs in Cambodia. Prioritizing the establishment of accessible, affordable, and high-quality mental health services, alongside the implementation of targeted interventions, is essential to mitigate the negative mental health impacts of the pandemic and enhance the overall well-being of FEWs.
新冠疫情加剧了全球心理健康挑战，对于柬埔寨受艾滋病影响严重的女性娱乐工作者这一弱势群体而言尤为如此。女性娱乐工作者此前就面临着各种不平等问题，疫情对她们生计的破坏使她们遇到了更多困难。贫困以及她们经常承受的职业压力源加剧了她们患心理健康问题的易感性。本研究旨在确定对柬埔寨女性娱乐工作者心理健康产生不利影响的与新冠疫情相关的因素，并探索减轻这些影响的潜在干预措施。
2021年12月，我们在金边举办了为期两天的研讨会，采用群体模型构建方法，与来自不同背景的利益相关者共同收集集体见解。我们运用因果循环图绘制的定性系统动力学方法来直观呈现影响女性娱乐工作者心理健康的因素。基于参与者的认知和经验，我们构建了一个因果循环图，以形成全面的系统视角。
该研讨会有27名利益相关者参与，包括国家机构代表（3名）、当地非政府组织代表（17名）、一个国际非政府组织代表（1名）以及女性娱乐工作者群体代表（6名）。我们的分析确定了13个反馈回路，突出了疫情期间影响女性娱乐工作者心理健康的关键因素。这些因素包括家庭成员离世、经济不稳定、对感染新冠病毒的恐惧、学校关闭导致的子女在家上学压力以及粮食不安全。作为应对措施，利益相关者提出了一系列干预措施，包括替代性职业培训、提高对心理健康问题的认识、提供心理健康服务以及针对女性娱乐工作者群体中基于性别的暴力行为的项目。
采取协作性的多部门方法对于应对柬埔寨女性娱乐工作者的心理健康挑战至关重要。优先建立可及、可负担且高质量的心理健康服务，并实施针对性的干预措施，对于减轻疫情对心理健康的负面影响以及提升女性娱乐工作者的整体福祉至关重要。
