Psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda: burden and associations

Recent research shows that psychological distress is on the rise globally as a result of the COVID-19 pandemic and restrictions imposed on populations to manage it. We studied the association between psychological distress and social support among conflict refugees in urban, semi-rural and rural set...

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Published in:	Conflict and health Vol. 16; no. 1; pp. 25 - 12
Main Authors:	Seruwagi, Gloria, Nakidde, Catherine, Lugada, Eric, Ssematiko, Maria, Ddamulira, Dunstan P, Masaba, Andrew, Luswata, Brian, Ochen, Eric A, Okot, Betty, Muhangi, Denis, Lawoko, Stephen
Format:	Journal Article
Language:	English
Published:	England BioMed Central 12-05-2022 BMC
Subjects:	Adequacy Anxiety Attachment Availability Conflict Coronaviruses COVID-19 Data collection Demographic variables Demographics Disease transmission Domestic violence Emotional abuse Households Human settlements Inequality Medical research Mental health Mental health services MHPSS Pandemics Peers Population Post traumatic stress disorder Psychological distress Psychological research Psychological stress Refugee camps Refugees Rural areas Social factors Social interaction Social interactions Social networks Social organization Social support Statistical significance Support services Urban / rural Urban refugees Variation Uganda Burundi Rwanda COVID-19 Urban refugees Conflict refugees Psychological distress Uganda MHPSS Urban / rural Social support
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Summary:	Recent research shows that psychological distress is on the rise globally as a result of the COVID-19 pandemic and restrictions imposed on populations to manage it. We studied the association between psychological distress and social support among conflict refugees in urban, semi-rural and rural settlements in Uganda during the COVID-19 pandemic. Cross-sectional survey data on psychological distress, social support, demographics, socio-economic and behavioral variables was gathered from 1014 adult refugees randomly sampled from urban, semi-rural and rural refugee settlements in Uganda, using two-staged cluster sampling. Data was analyzed in SPSS-version 22, and statistical significance was assumed at p < 0.05. Refugees resident in rural/semi-rural settlements exhibited higher levels of psychological distress [F(2, 1011) = 47.91; p < 0.001], higher availability of social interaction [F(2, 1011) = 82.24; p < 0.001], lower adequacy of social interaction [F(2, 1011) = 54.11; p < 0.001], higher availability of social attachment [F(2, 1011) = 47.95; p < 0.001], and lower adequacy of social attachment [F(2, 1011) = 50.54; p < 0.001] than peers in urban settlements. Adequacy of social interaction significantly explained variations in psychological distress levels overall and consistently across settlements, after controlling for plausible confounders. Additionally, adequacy of social attachment significantly explained variations in psychological distress levels among refugees in rural settlements, after controlling for plausible confounders. There is a settlement-inequality (i.e. rural vs. urban) in psychological distress and social support among conflict refugees in Uganda. To address psychological distress, Mental Health and Psychosocial Support Services (MHPSS) should focus on strategies which strengthen the existing social networks among refugees. Variations in social support are a key predictor of distress which should guide tailored need-adapted interventions instead of duplicating similar and generic interventions across diverse refugee settlements.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1752-1505 1752-1505
DOI:	10.1186/s13031-022-00451-3