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  • 1
    In: Journal of Water, Sanitation and Hygiene for Development, IWA Publishing, Vol. 12, No. 12 ( 2022-12-01), p. 883-893
    Kurzfassung: Refugee youth disproportionately experience sexual and gender-based violence (SGBV) and water insecurity, yet their SGBV experiences in the context of water insecurity are understudied. In this qualitative study, we conducted six focus groups (n = 48) and in-depth individual interviews (IDI) (n = 12) with refugee youth aged 16–24, and IDI with refugee elders (n = 8) in Bidi Bidi Refugee Settlement, Uganda. We applied thematic analysis informed by a social contextual framework and found that (1) SGBV is gendered, whereby adolescent girls and young women (AGYW) were targets for violence (symbolic context), and is intertwined with gender norms linked to AGYW's water collection roles (relational context); (2) water scarcity and off-site access to water infrastructure, combined with limited lighting, provide insecure environments that exacerbate AGYW's SGBV risks (material context); (3) participant generated solutions to water insecurity-related SGBV included engaging men and communities in dialogue and water collection (relational context), technology (e.g., solar lighting), improved security, and additional water points (material context). Findings signal the need to integrate water and sanitation hygiene development with SGBV prevention and sexual health (e.g., post-rape care) interventions. Refugee youth and communities should be meaningfully engaged in developing contextually relevant, gender transformative services to mitigate SGBV risks and advance health and rights.
    Materialart: Online-Ressource
    ISSN: 2043-9083 , 2408-9362
    Sprache: Englisch
    Verlag: IWA Publishing
    Publikationsdatum: 2022
    ZDB Id: 2642398-4
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    In: International Journal of Qualitative Methods, SAGE Publications, Vol. 22 ( 2023-01)
    Kurzfassung: Sexual and gender-based violence (SGBV) is a persistent concern in humanitarian contexts, yet there is a dearth of SGBV prevention and post-rape clinical care interventions tailored for refugee youth. Graphic medicine, the use of images and text such as in comic books, has been employed to depict lived experiences to promote health, wellbeing, and education. Comic books provide a low-cost, youth-friendly approach to health promotion that is accessible to varying literacy levels. Limited research, however, has described the process of developing graphic medicine approaches for SGBV prevention and sexual violence stigma reduction with and for refugee youth in humanitarian settings. To address this knowledge gap, this paper shares a Qualitative Comic Book Mapping approach, whereby qualitative data alongside theoretical and empirical SGBV literature informed the development of comic book scenarios with refugee youth aged 16-24 in Bidi Bidi refugee settlement, Uganda. Steps included conducting focus groups and in-depth individual interviews with 78 community members (youth, elders, service providers) in Bidi Bidi to explore SGBV lived experiences among refugee youth in Bidi Bidi and ideas for solutions to reduce SGBV and related stigma, in addition to improving post-rape care experiences and engagement. The Qualitative Comic Book Mapping approach involved: a) thematic analysis of qualitative data and identification of overarching themes; b) aligning qualitative themes with theories of change for SGBV prevention and stigma reduction; and c) co-developing comic book scenarios with refugee youth peer navigators and community experts to integrate SGBV prevention and stigma reduction theory with refugee youth lived experiences. The final comic book involved five youth-focused scenarios and was integrated in an intervention with refugee youth, including providing youth with a blank version of the comic book to complete themselves. We share how theoretically-informed comic books can be developed from qualitative data with refugee youth in a humanitarian setting.
    Materialart: Online-Ressource
    ISSN: 1609-4069 , 1609-4069
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2023
    ZDB Id: 2135788-2
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    In: Conflict and Health, Springer Science and Business Media LLC, Vol. 15, No. 1 ( 2021-01-07)
    Kurzfassung: Contextual factors including poverty and inequitable gender norms harm refugee adolescent and youths’ wellbeing. Our study focused on Bidi Bidi refugee settlement that hosts more than 230,000 of Uganda’s 1.4 million refugees. We explored contextual factors associated with wellbeing among refugee adolescents and youth aged 16–24 in Bidi Bidi refugee settlement. Methods We conducted 6 focus groups ( n  = 3: women, n  = 3: men) and 10 individual interviews with young refugees aged 16–24 living in Bidi Bidi. We used physical distancing practices in a private outdoor space. Focus groups and individual interviews explored socio-environmental factors associated with refugee youth wellbeing. Focus groups were digitally recorded, transcribed verbatim, and coded by two investigators using thematic analysis. Analysis was informed by a social contextual theoretical approach that considers the interplay between material (resource access), symbolic (cultural norms and values), and relational (social relationships) contextual factors that can enable or constrain health promotion. Results Participants included 58 youth (29 men; 29 women), mean age was 20.9 (range 16–24). Most participants (82.8%, n  = 48) were from South Sudan and the remaining from the Democratic Republic of Congo (17.2% [ n  = 10]). Participant narratives revealed the complex interrelationships between material, symbolic and relational contexts that shaped wellbeing. Resource constraints of poverty, food insecurity, and unemployment (material contexts) produced stress and increased sexual and gender-based violence (SGBV) targeting adolescent girls and women. These economic insecurities exacerbated inequitable gender norms (symbolic contexts) to increase early marriage and transactional sex (relational context) among adolescent girls and young women. Gendered tasks such as collecting water and firewood also increased SGBV exposure among girls and young women, and this was exacerbated by deforestation. Participants reported negative community impacts (relational context) of COVID-19 that were associated with fear and panic, alongside increased social isolation due to business, school and church closures. Conclusions Resource scarcity produced pervasive stressors among refugee adolescents and youth. Findings signal the importance of gender transformative approaches to SGBV prevention that integrate attention to resource scarcity. These may be particularly relevant in the COVID-19 pandemic. Findings signal the importance of developing health enabling social contexts with and for refugee adolescents and youth.
    Materialart: Online-Ressource
    ISSN: 1752-1505
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2021
    ZDB Id: 2273783-2
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    In: Conflict and Health, Springer Science and Business Media LLC, Vol. 14, No. 1 ( 2020-12)
    Kurzfassung: Advancing mental health among refugee and displaced adolescents and youth is critically important, as chronic psychological stress can have lifelong harmful impacts. These groups experience socio-environmental stressors that can harm mental health. Informed by a social contextual framework, this study explored the prevalence of depression among urban refugee and displaced youth in Kampala, Uganda and associations with symbolic (violence), relational (social support), and material (food and community insecurity) contexts. Methods We implemented a cross-sectional survey with refugee and displaced adolescent girls and young women and adolescent boys and young men aged 16–24 living in Kampala’s informal settlements. We conducted peer-driven recruitment, whereby peer navigators shared study information with their networks and in turn participants were invited to recruit their peers. We conducted gender disaggregated analyses, including stepwise multiple regression to examine factors associated with depression. We then conducted structural equation modeling (SEM) using weighted least squares estimation to examine direct paths from violence, food insecurity, and community insecurity to depression, and indirect effects through social support. Results Among participants ( n  = 445), young women ( n  = 333) reported significantly higher depression symptoms than young men ( n  = 112), including any symptoms (73.9% vs. 49.1%, p   〈  0.0001), mild to moderate symptoms (60.4% vs. 45.5%, p  = 0.008), and severe symptoms (13.5% vs 3.6%, p  = 0.002). SEM results among young women indicate that the latent violence factor (lifetime sexual and physical violence) had direct effects on depression and social support, but social support did not mediate the path from violence to depression. The model fit the data well: χ2(3) = 9.82, p  = 0.020; RMSEA = 0.08, 90% CI [0.03, 0.14], CFI = 0.96). Among young men, SEM findings indicate that food insecurity had direct effects on social support, and an indirect effect on depression through the mediating role of social support. Fit indices suggest good model fit: χ2(3) = 2.09, p  = 0.352; RMSEA = 0.02, 90% CI [0.000, 0.19], CFI = 0.99. Conclusions Findings reveal widespread depression among urban refugee and displaced youth in Kampala, disproportionately impacting young women. Contextual factors, including food insecurity and violence, increase depression risks. Strategies that reduce gender-based violence and food insecurity, and increase social support networks, have the potential to promote mental health among urban refugee and displaced youth.
    Materialart: Online-Ressource
    ISSN: 1752-1505
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2020
    ZDB Id: 2273783-2
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 5
    In: Journal of the International AIDS Society, Wiley, Vol. 24, No. 3 ( 2021-03)
    Kurzfassung: HIV‐related risks may be exacerbated in humanitarian contexts. Uganda hosts 1.3 million refugees, of which 60% are aged under 18. There are knowledge gaps regarding HIV testing facilitators and barriers, including HIV and intersecting stigmas, among urban refugee youth. In response, we explored experiences and perspectives towards HIV testing strategies, including HIV self‐testing, with urban refugee youth in Kampala, Uganda. Methods We implemented a qualitative study with refugee cisgender youth aged 16 to 24 living in Kampala's informal settlements from February‐April 2019. We conducted five focus groups with refugee youth, including two with adolescent boys and young men, two with adolescent girls and young women and one with female sex workers. We also conducted five key informant (KI) interviews with government, non‐government and community refugee agencies and HIV service providers. We conducted thematic analyses to understand HIV testing experiences, perspectives and recommendations. Results Participants (n = 49) included young men (n = 17) and young women (n = 27) originally from the Democratic Republic of Congo [DRC] (n = 29), Rwanda (n = 11), Burundi (n = 3) and Sudan (n = 1), in addition to five KI (gender: n = 3 women, n = 2 men; country of origin: n = 2 Rwanda, n = 2 Uganda, n = 1 DRC). Participant narratives revealed stigma drivers included fear of HIV infection; misinformation that HIV is a “Ugandan disease”; and blame and shame for sexual activity. Stigma facilitators included legal precarity regarding sex work, same‐sex practices and immigration status, alongside healthcare mistreatment and confidentiality concerns. Stigma experiences were attributed to the social devaluation of intersecting identities (sex work, youth, refugees, sexual minorities, people living with HIV, women). Participants expressed high interest in HIV self‐testing. They recommended HIV self‐testing implementation strategies to be peer supported and expressed concerns regarding sexual‐ and gender‐based violence with partner testing. Conclusions Intersecting stigma rooted in fear, misinformation, blame and shame, legal precarity and healthcare mistreatment constrain current HIV testing strategies with urban refugee youth. Findings align with the Health Stigma and Discrimination Framework that conceptualizes stigma drivers and facilitators that devalue intersecting health conditions and social identities. Findings can inform multi‐level strategies to foster enabling HIV testing environments with urban refugee youth, including tackling intersecting stigma and leveraging refugee youth peer support.
    Materialart: Online-Ressource
    ISSN: 1758-2652 , 1758-2652
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2467110-1
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 6
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 33, No. 4 ( 2022-03), p. 374-384
    Kurzfassung: Urban refugee youth may live in social contexts characterized by structural drivers of HIV such as poverty and violence. Knowledge gaps remain regarding HIV testing practices among urban refugee youth, despite the increasing trend toward refugee settlement in urban contexts. This study examined social contextual factors associated with lifetime HIV testing among urban refugee youth in Kampala, Uganda. Methods We conducted a community-based study with a peer-recruited cohort of urban refugee youth aged 16–24 years living in Kampala’s informal settlements, and present baseline cross-sectional findings. We conducted descriptive statistics and logistic regression to examine socio-demographic (e.g., gender and age), material (e.g., income insecurity and education), relational (e.g., social support), and symbolic contexts (e.g., HIV-related stigma and intimate partner violence (IPV]) associated with lifetime HIV testing. Results Participants ( n = 450) had a mean age of 20.4 years (standard deviation: 2.4 years), most lived in Uganda for 1–5 years (53.2%), and less than half reported lifetime HIV testing (43.4%). In multivariable analyses, odds of lifetime HIV testing were higher among youth with secondary school education or higher (adjusted odds ratio (aOR] : 2.30, 95% confidence interval (CI]: 1.27–4.17), currently employed (aOR: 1.79, 95% CI: 1.03–3.10), and reporting IPV (aOR: 3.61, 95% CI: 1.43–9.10). Having children was marginally associated with HIV testing (aOR: 2.17, 95% CI: 0.98–4.81, p = 0.052). Conclusions Findings demonstrate suboptimal HIV testing and the importance of tailored strategies to reach urban refugee youth who are unemployed and have limited formal education. There is a need to meaningfully engage urban refugee youth to create enabling environments for sexual health.
    Materialart: Online-Ressource
    ISSN: 0956-4624 , 1758-1052
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2022
    ZDB Id: 2009782-7
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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