Examining implementation of an intervention to reduce psychological distress and intimate partner violence in a refugee camp setting

摘要

An integrated approach to reduce intimate partner violence and improvemental health in humanitarian settings requires coordination acrosshealth and protection services. We developed and tested the Nguvuintervention, which combined evidence-based interventions forpsychological distress and intimate partner violence among Congoleserefugee women in Nyarugusu refugee camp (Tanzania). We conducted29 semi-structured interviews with Nguvu participants and stakeholdersto explore the relevance, acceptability, feasibility, and impact of thisintervention. Participants reported that the intervention aligned withneeds and filled a gap in programming, yet further adaptations mayimprove the fit of the intervention. The Nguvu intervention wasacceptable to participants, including group discussion of sensitivetopics. Confidentiality was highly regarded among staff andparticipants, which improved safety and acceptability. It was feasible totrain non-specialist refugee workers to deliver the intervention withadequate supervision. Facilitators noted contextual challenges thatmade it difficult to implement the intervention: limited infrastructure,competing priorities, and population mobility. The intervention wasperceived to improve awareness of the association between violenceand mental health, reduce self-blame, and build skills to improvewellbeing. Recommended adaptations reveal promising, yet challengingfuture directions for addressing social determinants of mental healthand implementing multi-sectoral programmes in complex humanitariansettings.