Multilevel Determinants of Integrated Service Delivery for Intimate Partner Violence and Mental Health in Humanitarian Settings.

Journal: International journal of environmental research and public health

Volume: 18

Issue: 23

Year of Publication: 2021

Affiliated Institutions:  Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY , USA. School of Psychiatry, University of New South Wales, Sydney, NSW , Australia. Public Health Section, United Nations High Commissioner for Refugees (UNHCR), Rue de Montbrillant , Geneva, Switzerland. Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam P.O. Box , Tanzania. The MHPSS Collaborative, Rosenørns Allé , Copenhagen, Denmark. HIAS, Silver Spring, MD , USA. Department of Public Health, Global Health Section, University of Copenhagen, Nørregade , Copenhagen, Denmark.

Abstract summary 

Inter-agency guidelines recommend that survivors of intimate partner violence in humanitarian settings receive multisectoral services consistent with a survivor-centered approach. Providing integrated services across sectors is challenging, and aspirations often fall short in practice. In this study, we explore factors that influence the implementation of a multisectoral, integrated intervention intended to reduce psychological distress and intimate partner violence in Nyarugusu Refugee Camp, Tanzania. We analyzed data from a desk review of donor, legal, and policy documents; a gender-based violence services mapping conducted through 15 interviews and 6 focus group discussions; and a qualitative process evaluation with 29 stakeholders involved in the implementation of the integrated psychosocial program. We identified the challenges of implementing a multisectoral, integrated intervention for refugee survivors of intimate partner violence at the structural, inter-institutional, intra-institutional, and in social and interpersonal levels. Key determinants of successful implementation included the legal context, financing, inter-agency coordination, engagement and ownership, and the ability to manage competing priorities. Implementing a multisectoral, integrated response for survivors of intimate partner violence is complex and influenced by interrelated factors from policy and financing to institutional and stakeholder engagement. Further investment in identifying strategies to overcome the existing challenges of implementing multisectoral approaches that align with global guidelines is needed to effectively address the burden of intimate partner violence in humanitarian settings.

Authors & Co-authors:  Greene M Claire MC Bencomo Clarisa C Rees Susan S Ventevogel Peter P Likindikoki Samuel S Nemiro Ashley A Bonz Annie A Mbwambo Jessie K K JKK Tol Wietse A WA McGovern Terry M TM

Study Outcome 

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Statistics
Citations :  Garcia-Moreno C., Pallitto C., Devries K., Stockl H., Watts C., Abrahams N. Global and Regional Estimates of Violence against Women: Prevalence and Health Effects of Intimate Partner Violence and Non-Partner Sexual Violence. World Health Organization (WHO); Geneva, Switzerland: 2013.
Authors :  10
Identifiers
Doi : 12484
SSN : 1660-4601
Study Population
Male,Female
Mesh Terms
Gender-Based Violence
Other Terms
gender-based violence;humanitarian;integrated care;intimate partner violence;mental health;multisectoral
Study Design
Study Approach
,Qualitative
Country of Study
Tanzania
Publication Country
Switzerland