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

Author

Listed:
  • M. Claire Greene

    (Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA)

  • Clarisa Bencomo

    (Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA)

  • Susan Rees

    (School of Psychiatry, University of New South Wales, Sydney, NSW 2033, Australia)

  • Peter Ventevogel

    (Public Health Section, United Nations High Commissioner for Refugees (UNHCR), Rue de Montbrillant 94, 1201 Geneva, Switzerland)

  • Samuel Likindikoki

    (Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam P.O. Box 65001, Tanzania)

  • Ashley Nemiro

    (The MHPSS Collaborative, Rosenørns Allé 12, 1634 Copenhagen, Denmark)

  • Annie Bonz

    (HIAS, Silver Spring, MD 20910, USA)

  • Jessie K. K. Mbwambo

    (Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam P.O. Box 65001, Tanzania)

  • Wietse A. Tol

    (Department of Public Health, Global Health Section, University of Copenhagen, Nørregade 10, 1165 Copenhagen, Denmark)

  • Terry M. McGovern

    (Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA)

Abstract

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.

Suggested Citation

  • M. Claire Greene & Clarisa Bencomo & Susan Rees & Peter Ventevogel & Samuel Likindikoki & Ashley Nemiro & Annie Bonz & Jessie K. K. Mbwambo & Wietse A. Tol & Terry M. McGovern, 2021. "Multilevel Determinants of Integrated Service Delivery for Intimate Partner Violence and Mental Health in Humanitarian Settings," IJERPH, MDPI, vol. 18(23), pages 1-17, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12484-:d:689199
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    References listed on IDEAS

    as
    1. Melissa Meinhart & Ilana Seff & Katrina Troy & Samantha McNelly & Luissa Vahedi & Catherine Poulton & Lindsay Stark, 2021. "Identifying the Impact of Intimate Partner Violence in Humanitarian Settings: Using an Ecological Framework to Review 15 Years of Evidence," IJERPH, MDPI, vol. 18(13), pages 1-19, June.
    2. Struckmann, Verena & Leijten, Fenna R.M. & van Ginneken, Ewout & Kraus, Markus & Reiss, Miriam & Spranger, Anne & Boland, Melinde R.S. & Czypionka, Thomas & Busse, Reinhard & Rutten-van Mölken, Mauree, 2018. "Relevant models and elements of integrated care for multi-morbidity: Results of a scoping review," Health Policy, Elsevier, vol. 122(1), pages 23-35.
    3. Karen M Devries & Joelle Y Mak & Loraine J Bacchus & Jennifer C Child & Gail Falder & Max Petzold & Jill Astbury & Charlotte H Watts, 2013. "Intimate Partner Violence and Incident Depressive Symptoms and Suicide Attempts: A Systematic Review of Longitudinal Studies," PLOS Medicine, Public Library of Science, vol. 10(5), pages 1-11, May.
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