Health study in northern Uganda calls for improved services for internally displaced persons

There are over 1 million internally displaced persons (IDPs) in Uganda due to the 20-year conflict waged between a rebel group, the Lord's Resistance Army, and the central government.

Previous research on the health of IDPs has focused on specific physical and mental health conditions, but a study just published in the 'online first' section of the Journal of Epidemiology and Community Health (http://jech.bmj.com/onlinefirst.dtl) and led by Bayard Roberts of the London School of Hygiene & Tropical Medicine (LSHTM)'s Conflict and Health Programme, and Dr. Felix Ocaka of the Faculty of Medicine at Gulu University, Uganda, has for the first time sought to examine the determinants of general health among IDPs, including the physical, mental, emotional and social characteristics of health.

The authors carried out a cross-sectional survey in November 2006 with 1206 IDPs in 28 IDP camps in Gulu and Amuru districts of northern Uganda. Interviewees were asked questions from the SF-8 instrument to measure how they rated their general health. Interviewees were also asked questions on factors affecting health status, such as gender, age, educational level, number of people in the household, access to latrines, water and hygiene, health services, food security, alcohol intake, history of displacement, exposure to violent and traumatic events and sense of safety in the camps.

Variables which had a significant negative effect on physical or mental health included gender, age, marital status, income, distance of camp from home areas, food security, use of soap, and sense of safety in the camp. A number of individual trauma variables and the frequency of trauma exposure also had negative associations with both physical and mental health. The use of family for emotional support showed a positive association with better mental health.

Bayard Roberts, Research Fellow in Conflict & Health at LSHTM, comments: 'This is one of the first studies to quantify the factors that affect the overall physical and mental health of internally displaced persons. It provides data on the impact of deprivation of basic goods and services on both physical and mental health. We also found a strong association between the frequency and type of exposure to traumatic events on both poor physical and mental health. Many of the trauma variables reported took place in the camps, and the variable on perceived lack of safety in the camps had a strong negative association with mental health. The study provides evidence of the importance of ensuring adequate assistance and protection in camp situations to reduce exposure to traumatic events and poor health outcomes.'

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