230 research outputs found

    Stressors, Supports, and the Social Ecology of Displacement: Psychosocial Dimensions of an Emergency Education Program for Chechen Adolescents Displaced in Ingushetia, Russia

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    This study explores the psychosocial benefits of an emergency education intervention serving adolescents displaced by the war in Chechnya. Interviews with 55 Chechen adolescents living in spontaneous settlements in Ingushetia, Russia were collected in the fall of 2000. The study set out to describe key stressors and sources of social support available to youth being served by the International Rescue Committee’s (IRC) emergency education program. Of particular interest was the degree to which the education program addressed psychosocial goals such as increasing social support and alleviating strains including idleness, the lack of safe and structured places for youth to spend time, and concerns about lost years of schooling expressed by children and families. Findings indicated that young people and their families were facing a number of physical and emotional stressors. Regarding physical stressors, adolescents described the “living conditions” in the spontaneous settlements as the most difficult thing they faced. The physical and material deprivations experienced in the settlements were described in terms of living in an “abnormal” or “inhuman” way, including poor or crowded living conditions; infrequent supplies of food, medicines and educational materials; and concerns about parents and older adolescents being able to find work. Regarding emotional stressors, participants identified a variety of sources including loss of home, loss of time/idleness, separation from loved ones, tensions with the Ingush host community, and concerns about their ability to be productive in the future. Furthermore, a sense of humiliation linked to deprivation pervaded the experience of Chechen youth in these IDP settlements. The data indicated a number of ways in which the emergency education program provided benefits by enriching sources of support, providing meaningful activity and opportunities to learn, and a place and space for young people to spend time and connect to others. In particular, youth leaders described how the program had improved their confidence in working with others and had influenced their career goals. However, the contrast between the desire of adolescents “to live like other kids” and the options available to them presented a dilemma for the emergency education program: adolescents were craving normality, but for any intervention to be delivered, it had first to begin with creative and adaptive strategies that were by no means a complete replacement for formal, mainstream education. The programmatic and policy implications of these findings are presented in the discussion

    Connectedness, Social Support and Mental Health in Adolescents Displaced by the War in Chechnya

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    This study presents an exploratory, cross-sectional investigation of factors associated with internalizing emotional and behavioral problems (anxiety/depression, emotional withdrawal, and somatic complaints) in a sample of adolescents displaced by the war in Chechnya and interviewed in the fall of 2000. Social support and connectedness with family, peers, and the larger community were given particular attention as potential protective processes explaining variation in internalizing mental health problems as measured by the Achenbach Youth Self Report (YSR) scale (1991). It was hypothesized that family, peer and community connectedness, and global ratings of social support would be associated with lower levels of internalizing mental health problems in this population. Findings indicated that, consistent with other studies of war-affected children, internalizing behaviors in this sample of displaced adolescents were higher compared to rates in samples published on non-war-affected Russian adolescents. Expected gender differences were observed, with girls reporting higher internalizing problems than boys. No differences by gender on social support or family connectedness were observed; however, males reported higher peer connectedness and community connectedness than did females. In multivariate analyses, family connectedness was indicated as an enduring and significant predictor of lower internalizing mental health problem scores upon adjusting for covariates and all other forms of support investigated

    Long term mental health outcomes of Finnish children evacuated to Swedish families during the second world war and their non-evacuated siblings: cohort study

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    Objectives To compare the risks of admission to hospital for any type of psychiatric disorder and for four specific psychiatric disorders among adults who as children were evacuated to Swedish foster families during the second world war and their non-evacuated siblings, and to evaluate whether these risks differ between the sexes. Design Cohort study. Setting National child evacuation scheme in Finland during the second world war. Participants Children born in Finland between 1933 and 1944 who were later included in a 10% sample of the 1950 Finnish census ascertained in 1997 (n=45 463; women: n=22 021; men: n=23 442). Evacuees in the sample were identified from war time government records. Main outcome measure Adults admitted to hospital for psychiatric disorders recorded between 1971 and 2011 in the Finnish hospital discharge register. Methods We used Cox proportional hazards models to estimate the association between evacuation to temporary foster care in Sweden during the second world war and admission to hospital for a psychiatric disorder between ages 38 and 78 years. Fixed effects methods were employed to control for all unobserved social and genetic characteristics shared among siblings. Results Among men and women combined, the risk of admission to hospital for a psychiatric disorder did not differ between Finnish adults evacuated to Swedish foster families and their non-evacuated siblings (hazard ratio 0.89, 95% confidence interval 0.64 to 1.26). Evidence suggested a lower risk of admission for any mental disorder (0.67, 0.44 to 1.03) among evacuated men, whereas for women there was no association between evacuation and the overall risk of admission for a psychiatric disorder (1.21, 0.80 to 1.83). When admissions for individual psychiatric disorders were analyzed, evacuated girls were significantly more likely than their non-evacuated sisters to be admitted to hospital for a mood disorder as an adult (2.19, 1.10 to 4.33). Conclusions The Finnish evacuation policy was not associated with an increased overall risk of admission to hospital for a psychiatric disorder in adulthood among former evacuees. In fact, evacuation was associated with a marginally reduced risk of admission for any psychiatric disorder among men. Among women who had been evacuated, however, the risk of being admitted to hospital for a mood disorder was increased.Peer reviewe

    Safeguarding the Lives of Children Affected by Boko Haram: Application of the SAFE Model of Child Protection to a Rights-Based Situation Analysis

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    The Boko Haram insurgency in northeast Nigeria is responsible for the highest number of lives lost in Africa in the past decade. The country has witnessed significant violations of the United Nations Convention on the Rights of the Child, which Nigeria has signed and ratified. For instance, Nigeria had the second-highest number of children recruited to armed groups and the third-highest number of abductions in 2018. Current humanitarian efforts primarily target camps for internally displaced persons, while state strategies focus mainly on addressing security through combatant-targeted interventions. However, there is a need for more rights-based, integrated, and multifaceted approaches to tackle the interrelated threats to the security of children and their families affected by the conflict. This paper uses the SAFE model of child protection—which examines the interrelatedness of safety, access, family, and education and economic security—to analyze the challenges of children and youth affected by the conflict. We highlight the need for a gendered approach; strategies that address poverty and cultural and governance barriers; and interdisciplinary, context-specific, and autonomous child protection systems. The paper calls for urgent and increased attention to the core rights and human security needs of these children to avoid a replay of negative outcomes of conflict, where the costs and consequences propagate a cycle of violence and disadvantage

    Developing and Validating the Youth Conduct Problems Scale-Rwanda: A Mixed Methods Approach

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    This study developed and validated the Youth Conduct Problems Scale-Rwanda (YCPS-R). Qualitative free listing (n = 74) and key informant interviews (n = 47) identified local conduct problems, which were compared to existing standardized conduct problem scales and used to develop the YCPS-R. The YCPS-R was cognitive tested by 12 youth and caregiver participants, and assessed for test-retest and inter-rater reliability in a sample of 64 youth. Finally, a purposive sample of 389 youth and their caregivers were enrolled in a validity study. Validity was assessed by comparing YCPS-R scores to conduct disorder, which was diagnosed with the Mini International Neuropsychiatric Interview for Children, and functional impairment scores on the World Health Organization Disability Assessment Schedule Child Version. ROC analyses assessed the YCPS-R’s ability to discriminate between youth with and without conduct disorder. Qualitative data identified a local presentation of youth conduct problems that did not match previously standardized measures. Therefore, the YCPS-R was developed solely from local conduct problems. Cognitive testing indicated that the YCPS-R was understandable and required little modification. The YCPS-R demonstrated good reliability, construct, criterion, and discriminant validity, and fair classification accuracy. The YCPS-R is a locally-derived measure of Rwandan youth conduct problems that demonstrated good psychometric properties and could be used for further research

    Family-centred approaches to the prevention of mother to child transmission of HIV

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    Background: Prevention of mother to child transmission (PMTCT) programmes have traditionally been narrow in scope, targeting biomedical interventions during the perinatal period, rather than considering HIV as a family disease. This limited focus restricts programmes' effectiveness, and the opportunity to broaden prevention measures has largely been overlooked. Although prevention of vertical transmission is crucial, consideration of the family environment can enhance PMTCT. Family-centred approaches to HIV prevention and care present an important direction for preventing paediatric infections while improving overall family health. This paper reviews available literature on PMTCT programmatic models that have taken a broader or family-centred approach. We describe findings and barriers to the delivery of family-centred PMTCT and identify a number of promising new directions that may achieve more holistic services for children and families. Methods: Literature on the effectiveness of family-centred PMTCT interventions available via PubMed, EMBASE and PsycINFO were searched from 1990 to the present. Four hundred and three abstracts were generated. These were narrowed to those describing or evaluating PMTCT models that target broader aspects of the family system before, during and/or after delivery of an infant at risk of acquiring HIV infection (N = 14). Results: The most common aspects of family-centred care incorporated by PMTCT studies and programme models included counselling, testing, and provision of antiretroviral treatment for infected pregnant women and their partners. Antiretroviral therapy was also commonly extended to other infected family members. Efforts to involve fathers in family-based PMTCT counselling, infant feeding counselling, and general decision making were less common, though promising. Also promising, but rare, were PMTCT programmes that use interventions to enrich family capacity and functioning; these include risk assessments for intimate partner violence, attention to mental health issues, and the integration of early childhood development services. Conclusions: Despite barriers, numerous opportunities exist to expand PMTCT services to address the health needs of the entire family. Our review of models utilizing these approaches indicates that family-centred prevention measures can be effectively integrated within programmes. However, additional research is needed in order to more thoroughly evaluate their impact on PMTCT, as well as on broader family health outcomes

    A qualitative case study of child protection issues in the Indian construction industry: investigating the security, health, and interrelated rights of migrant families

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    Background: Many of India’s estimated 40 million migrant workers in the construction industry migrate with their children. Though India is undergoing rapid economic growth, numerous child protection issues remain. Migrant workers and their children face serious threats to their health, safety, and well-being. We examined risk and protective factors influencing the basic rights and protections of children and families living and working at a construction site outside Delhi. Methods: Using case study methods and a rights-based model of child protection, the SAFE model, we triangulated data from in-depth interviews with stakeholders on and near the site (including employees, middlemen, and managers); 14 participants, interviews with child protection and corporate policy experts in greater Delhi (8 participants), and focus group discussions (FGD) with workers (4 FGDs, 25 members) and their children (2 FGDs, 9 members). Results: Analyses illuminated complex and interrelated stressors characterizing the health and well-being of migrant workers and their children in urban settings. These included limited access to healthcare, few educational opportunities, piecemeal wages, and unsafe or unsanitary living and working conditions. Analyses also identified both protective and potentially dangerous survival strategies, such as child labor, undertaken by migrant families in the face of these challenges. Conclusions: By exploring the risks faced by migrant workers and their children in the urban construction industry in India, we illustrate the alarming implications for their health, safety, livelihoods, and development. Our findings, illuminated through the SAFE model, call attention to the need for enhanced systems of corporate and government accountability as well as the implementation of holistic child-focused and child-friendly policies and programs in order to ensure the rights and protection of this hyper-mobile, and often invisible, population
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