Conflict and Health最新文献

{"title":"Defending the right to health in Gaza: a call to action by health workers.","authors":"Fatima Mohammed, Umniha Siddig Ahmed Elgailani, Sondos Yassir Ibrahim Ali, Razan Faisal Abdullah Mohamed, Elaine Tan Su Yin, Martha L Bravo-Vasquez","doi":"10.1186/s13031-024-00613-5","DOIUrl":"https://doi.org/10.1186/s13031-024-00613-5","url":null,"abstract":"<p><p>The ongoing conflict in Gaza has led to severe destruction of the health system and eventually its collapse. Moreover, multiple attacks on health workers were reported which led to obstacles in service delivery. The conflict has led to further humanitarian crises including shortage of food, water sanitation, and hygiene, and outbreaks of infectious diseases. About 2 million of Gaza's population are internally displaced with the majority in Rafah. Rafah's population has increased by 500% in less than four months. This has led to acute food severity in Gaza for the whole of the population. Moreover, the cut of UNRWA aid is expected to further expand the humanitarian crisis as over 2 million of the population depends on the aid.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 1","pages":"57"},"PeriodicalIF":3.1,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A psychosocial bouldering intervention improves the well-being of young refugees and adolescents from the host community in Lebanon: results from a pragmatic controlled trial","authors":"Katharina Luttenberger, Beat Baggenstos, Charbel Najem, Charles Sifri, Piotr Lewczuk, Anne Radegast, Simon Rosenbaum","doi":"10.1186/s13031-024-00615-3","DOIUrl":"https://doi.org/10.1186/s13031-024-00615-3","url":null,"abstract":"Mental health and psychosocial support (MHPSS) is increasingly considered vital for addressing the needs of displaced communities. The mental health of young people in Lebanon, including members of the host community and refugees, has been severely affected by multiple crises. Physical activity (PA) is an effective means for enhancing mental health, but evidence of PA’s impact on mental health among forcibly displaced populations is still emerging and often varies widely across studies. In this waitlist-controlled study, we examined the effectiveness of an 8-week psychosocial bouldering group intervention offered by the nonprofit organization ClimbAID on psychological well-being, distress, self-efficacy, and social cohesion in a group of mostly Syrian refugee adolescents residing in the Bekaa Valley, Lebanon. The intervention consisted of 8 sessions and took place once a week for 2 h in a group of up to 12 adolescents with 2 trained facilitators and up to 2 volunteers, supervised by a climbing instructor and a social worker. Multilevel analyses were performed for all outcomes. 233 people were included in the study. The dropout rate was approximately 33%. The IG improved significantly more than the waitlist group in terms of overall mental well-being and psychological distress. Group allocation was a significant predictor of improvements in mental well-being and psychological distress and showed a trend toward predicting self-efficacy. There was no positive impact of the intervention on social cohesion. Even in complex humanitarian settings of forced displacement, a psychosocial bouldering intervention reduces psychological distress and increases well-being in a mixed group of host and refugee youth in Bekaa, Lebanon. Prospectively registered with ISRCTN 13005983, registered April 1st, 2022.","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"7 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Under-five mortality during the war in Tigray: A community-based study.","authors":"Bereket Berhe Abreha, Girmatsion Fisseha, Mache Tsadik, Awol Yemane Legesse, Hale Teka, Hiluf Ebuy Abraha, Martha Yemane Hadush, Gebrehaweria Gebrekurstos, Brhane Ayele, Abraha Gebreegziabher Hailu, Haile Tsegay, Mohamedawel Mohamedniguss Ebrahim, Hagos Godefay, Tsega Gebremariam, Tigist Hagos, Kibrom Muoze, Afewerk Mulugeta, Tesfit Gebremeskel","doi":"10.1186/s13031-024-00614-4","DOIUrl":"10.1186/s13031-024-00614-4","url":null,"abstract":"<p><strong>Background: </strong>Child mortality is one of the key indicators of the Sustainable development goals. The Ethiopian healthcare system in general and Tigray's healthcare system in particular has shown a remarkable progress in terms of reducing maternal, neonatal, and under-five mortality in the last couple of decades. However, the war erupted in November 2020 caused the healthcare system to collapse and little is known about the status of child mortality in Tigray. Thus, this study aimed to examine the magnitude and causes of under-five child mortality in the embattled Tigray region was conducted from October 2020 - May 2022.</p><p><strong>Methods: </strong>A cross-sectional community-based survey was employed. The study included all zones except the western zone and some areas of eastern and north western Tigray bordering Eritrea. These areas were skipped for security reasons. Based on multistage cluster sampling, 121 tabiyas in districts were selected. Census was conducted to survey 189,087 households in the 121 Tabiyas. A locally developed household screening tool and the latest world health organization verbal autopsy instrument were used. The Verbal Autopsy data was processed using the Inter-VA-5.1 (probabilistic modeling) to assign the cause of death. Under-five mortality rate (U5MR) was calculated per 1000 live births with a 95% confidence interval (CI).</p><p><strong>Results: </strong>In the present study, out of 29,761 live births, 1761 under-five children died giving an under-five mortality rate of 59(95% CI, 57-62) per 1000 live births. Deaths in the neonatal period and post-neonatal period accounted for 60% and 19.9% of the deaths respectively. Overall, the top 3 causes of under-five child mortality in the present study were: Perinatal asphyxia (n = 277,18%,) prematurity (n = 235,16%) and diarrheal diseases (n = 162, 12.5%). In those who died after first month of life, diarrheal diseases, lower respiratory tract infection, sever acute malnutrition and HIV were the main causes of death. Concerning the place of death, 61.6% of the children died at home.</p><p><strong>Conclusion: </strong>The present study revealed the doubling of under-five mortality in Tigray from where the figure stood in the pre-war period. The leading causes of death in under-five mortality are potentially preventable in situation where the healthcare system is functioning. Restoring the healthcare system and its apparatus, improving access to skilled institutional delivery, smooth perinatal transition, improving nutrition status of children, access to full course of vaccines could ameliorate the staggering under-five mortality rate in the war in Tigray.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 1","pages":"55"},"PeriodicalIF":3.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It's normal to be afraid\": attacks on healthcare in Ouaka, Haute-Kotto, and Vakaga prefectures of the Central African Republic, 2016-2020.","authors":"Natalya Kostandova, Jennifer OKeeffe, Blaise Bienvenu Ali, Pierre Somsé, Audrey Mahieu, Odilon Guesset Bingou, Sebastien Dackpa, Gerard Mbonimpa, Leonard Rubenstein","doi":"10.1186/s13031-024-00610-8","DOIUrl":"10.1186/s13031-024-00610-8","url":null,"abstract":"<p><strong>Introduction: </strong>Attacks on healthcare have further weakened the already fragile health system in the Central African Republic. We investigated attacks on healthcare in three conflict-affected prefectures-Ouaka, Haute-Kotto, and Vakaga-from 2016 to 2020. The study aim was to gain an in-depth understanding of the immediate and long-term effects of attacks on healthcare workers, facilities, supply chain, quality of care, and other components of the health system. We provide a qualitative description of the incidents, assess their impacts, identify mitigation efforts, and discuss challenges to recovery.</p><p><strong>Methods: </strong>We used purposive and snowball sampling to identify participants in the study. Semi-structured key informant interviews were conducted with administrative and health authorities, front-line personnel, and staff of non-governmental organizations. Interviews were done in Sango, French, or English. Recorded interviews were transcribed and notes taken for non-recorded interviews. Transcripts and notes were analyzed using inductive coding, allowing participant responses to guide findings.</p><p><strong>Results: </strong>Of 126 attacks identified over the study period, 36 key informants discussed 39 attacks. Attacks included killings, physical and sexual assault, abductions, arson, shelling with grenades, pillage, occupations, and verbal threats. The violence led to extended closures and debilitating shortages in healthcare services, disproportionately affecting vulnerable populations, such as children under five, or people who are elderly, chronically ill, or displaced. Healthcare workers faced psychological trauma and moral injury from repeated attacks and the inability to provide adequate care. Personnel and communities made enormous efforts to mitigate impacts, and advocate for assistance. They were limited by failed reporting mechanisms, ongoing insecurity, persistent lack of resources and external support.</p><p><strong>Conclusion: </strong>Effective strategies to safeguard healthcare from violence exist but better support for communities and health workers is essential, including measures to assess needs, enhance security, and facilitate recovery by quickly rebuilding, resupplying, and re-staffing facilities. CAR's government, international organizations, and donors should make concerted efforts to improve reporting mechanisms and end impunity for perpetrators. Their investment in community organizations and long-term health system support, especially for health worker training, salaries, and psychosocial care, are vital steps towards building resilience against and mitigating the impacts of attacks on healthcare.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 1","pages":"54"},"PeriodicalIF":3.1,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11351750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing healthcare under the threat of gang-violence: a survey of Haitian healthcare providers.","authors":"Rachel Victoria Belt, Nadege Jacques, Larry Pierre, Elizabeth Greig, Kazem Rahimi","doi":"10.1186/s13031-024-00612-6","DOIUrl":"10.1186/s13031-024-00612-6","url":null,"abstract":"<p><p>In addition to having some of the worst health outcomes in the region, Haiti faces a political and economic crisis. The most recent humanitarian crisis includes an increase in homicides and kidnappings in the capital Port-au-Prince. This study is a cross-sectional, mixed methods online survey of health workers and medical students in Port-au-Prince from May 20 - September 15, 2023. It provides evidence of the kidnapping risk healthcare workers face and shares the perspective of a medical community operating in a challenging context to provide a continuity of care under the threat of violence. The survey of Haitian health workers and students show a significant risk of kidnapping with 44% of respondents reporting that they had a colleague kidnapped in the previous 2 years. 5 of the 249 respondents had been kidnapped and all were young, female health workers. 74% of health workers and students surveyed reported they plan to continue their profession abroad. Although teletraining was viewed as a positive opportunity to continue training cadres of medical professionals, health workers shared numerous limitations present for the expansion of telemedicine in the Haitian context. In addition to describing the experience of the Haitian healthcare professional during this crisis and documenting barriers to teletraining and telemedicine, this survey documents design considerations for mobile phone surveys with healthcare providers working in areas affected by conflict.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 1","pages":"53"},"PeriodicalIF":3.1,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I will take part in the revolution with our people\": a qualitative study of healthcare workers' experiences of violence and resistance after the 2021 Myanmar coup d'etat.","authors":"Rohini J Haar, Katerina Crawford, Larissa Fast, Than Htut Win, Leonard Rubenstein, Karl Blanchet, Louis Lillywhite, Nicholus Tint-Zaw, Myo-Myo Mon","doi":"10.1186/s13031-024-00611-7","DOIUrl":"10.1186/s13031-024-00611-7","url":null,"abstract":"<p><strong>Background: </strong>In Myanmar, ongoing conflict since the 2021 military coup d'etat has been characterized by targeted violence against health workers (HWs), particularly those participating in the pro-democracy movement. Existing knowledge about the challenges faced by health workers in Myanmar is scant, including their perspectives on mitigating their suffering and the broader impact on community health. This knowledge gap prompted our study to assess the extent of the violence, its impact on the workers and the community, and identify resource priorities.</p><p><strong>Methods: </strong>This qualitative study employed purposive and snowball sampling to recruit health workers affiliated with the Civil Disobedience Movement (CDM). We interviewed 24 HWs in Myanmar between July and December 2022, predominantly physicians and nurses. We used a semi-structured interview guide and conducted interviews remotely due to the security situation. We adopted content analysis to understand participation in the CDM movement, experiences of violence, personal and professional impacts, the sequelae to community health, how HWs responded as well as their ongoing needs.</p><p><strong>Results: </strong>Thematic content analysis revealed that violence was both individually targeted and widespread. Health workers faced professional, financial, and personal impacts as a result. The health system as a whole has been severely diminished. Health workers have had to adapt to continue to provide care, for example some fled to rural areas and worked clandestinely, exchanging their services for food and shelter. In those settings, they continued to face insecurity from airstrikes and arrests. Health workers have also experienced moral distress and burden due to their resistance and protest against the regime.</p><p><strong>Conclusion: </strong>The coup and ensuing violence severely disrupted the healthcare system, resulting in shortages of supplies, reduced quality of care, and exacerbated challenges during the COVID-19 pandemic. Despite facing significant hardships, HWs remained resilient, engaging in resistance efforts within the CDM and seeking support from local communities and international organizations. They expressed a need for increased awareness, financial assistance, and concrete support for the health system to address the crisis.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 1","pages":"52"},"PeriodicalIF":3.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Global health diplomacy in humanitarian action.","authors":"Luca Falqui, Fangfang Li, Yufeng Xue","doi":"10.1186/s13031-024-00609-1","DOIUrl":"10.1186/s13031-024-00609-1","url":null,"abstract":"","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 1","pages":"51"},"PeriodicalIF":3.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hunger in the shadow of conflict: analyzing malnutrition and humanitarian challenges in Sudan.","authors":"Amira Mohamed, Anmar Homeida","doi":"10.1186/s13031-024-00604-6","DOIUrl":"10.1186/s13031-024-00604-6","url":null,"abstract":"<p><strong>Background: </strong>Conflict has become a global reality, particularly impacting millions of children, with the majority of conflicts occurring in developing nations, where 90% of the world's children reside. The Horn of Africa, especially Sudan, has faced severe conflicts, with the year 2023 witnessing one of the toughest conflicts in the region, resulting in a high number of internally displaced persons and refugees. Children, especially in areas like Darfur, Khartoum, Gezira, and Kordofan, bear the brunt of ongoing large-scale conflicts, facing widespread human rights violations and resource damage. Before the conflict that began in April 2023, Khartoum was home to numerous children's hospitals, but now only Elbuluk Hospital remains operational, facing a surge in admissions due to displacement and subsequent returns of civilians seeking medical care. Although malnutrition cases have increased, the case fatality rate associated with severe acute malnutrition has doubled from approximately 6% to 12% by March 2024, possibly due to uneven food distribution amid sporadic peace efforts.</p><p><strong>Recommendations: </strong>Investing in grassroots organizations is crucial for facilitating effective humanitarian aid delivery, as they are uniquely positioned to identify and address local needs promptly and efficiently. Strengthening these organizations enhances their capacity to coordinate aid distribution and provide essential services tailored to regional conditions. Persistent violations of International Humanitarian Law (IHL) in conflict zones impede humanitarian efforts. Robust collaboration between international and local stakeholders is necessary to uphold and enforce IHL, with a focus on protecting civilian lives and ensuring safe, unhindered access for humanitarian aid while respecting the dignity of all affected individuals.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 1","pages":"50"},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the integration of refugee health data into national health information systems in Jordan, Lebanon, and Uganda.","authors":"Lama Bou-Karroum, Najla Daher, Mathilda Jabbour, Laila Akhu-Zaheya, Wejdan Khater, Aladeen Alloubani, Christopher Garimoi Orach, Henry Komakech, Sara Bennett, Fadi El-Jardali","doi":"10.1186/s13031-024-00608-2","DOIUrl":"10.1186/s13031-024-00608-2","url":null,"abstract":"<p><strong>Background: </strong>With the increasing number of protracted refugee crises globally, it is essential to ensure strong national health information systems (HIS) in displacement settings that include refugee-sensitive data and disaggregation by refugee status. This multi-country study aims to assess the degree of integration of refugee health data into national HIS in Jordan, Lebanon, and Uganda and identify the strengths and weaknesses of their national HIS in terms of collecting and reporting on refugee-related health indicators.</p><p><strong>Methods: </strong>The study employs a comparative country analysis approach using a three-phase framework. The first phase involved reviewing 4120 indicators compiled from global health organizations, followed by a multi-stage refinement process, resulting in 45 indicators distributed across five themes. The second phase consisted of selecting relevant criteria from the literature, including data sources, annual reporting, disaggregation by refugee status, refugee population adjustments, accuracy, and consistency. The third phase involved assessing data availability and quality of the selected indicators against these criteria.</p><p><strong>Results: </strong>Our analysis uncovered significant challenges in assessing the health status of refugees in Jordan, Lebanon, and Uganda, primarily stemming from limitations in the available health data and indicators. Specifically, we identified significant issues including incomplete local data collection with reliance on international data sources, fragmented data collection from various entities leading to discrepancies, and a lack of distinction between refugees and host populations in most indicators. These limitations hinder accurate comparisons and analyses. In light of these findings, a set of actionable recommendations was proposed to guide policymakers in the three countries to improve the integration of refugee health data into their national HIS ultimately enhancing refugees' well-being and access to healthcare services.</p><p><strong>Conclusion: </strong>The current status of refugee-related health data in Jordan, Lebanon, and Uganda indicates the need for improved data collection and reporting practices, disaggregation by refugee status and better integration of refugee health data into national HIS to capture the health status and needs of refugees in host countries. Key improvement strategies include establishing a centralized authority for consistent and efficient data management, fostering transparent and inclusive data governance, and strengthening workforce capacity to manage refugee health data effectively.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 Suppl 1","pages":"49"},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study of cultural concepts of distress among Rohingya refugees in Cox's Bazar, Bangladesh.","authors":"Kathy Trang, Caroline Hiott, A K Rahim, Shafiqur Rahman, Alice J Wuermli","doi":"10.1186/s13031-024-00606-4","DOIUrl":"10.1186/s13031-024-00606-4","url":null,"abstract":"<p><strong>Background: </strong>Rohingya refugees residing in Bangladesh have been exposed to profound trauma in addition to ongoing daily stressors of living in the refugee camps. Accurate assessments of mental health burden and their impact among this population require culturally sensitive tools that remain lacking in this context. The purpose of this study was to characterize salient cultural concepts of distress (CCDs), their causes, consequences, and approaches to treatment, among Rohingya refugees living in Cox's Bazar, Bangladesh, to help inform future measurement and intervention design.</p><p><strong>Methods: </strong>Between December 2020 and March 2022, 106 free-listing interviews and 10 key informant interviews were conducted with community members to identify and better understand common CCDs. Rohingya research staff analyzed the interview transcripts by tabulating the frequency of unique CCDs in the free-listing interviews and the unique attributed causes, signs, consequences, and treatment strategies for each CCD in the key informant interviews.</p><p><strong>Results: </strong>In total, five CCDs were identified: tenshon (tension), bishi sinta (excessive thinking), feshar (pressure), gum zai nofara (unable to sleep), and shoit-shoit lagon (feeling restless and/or trapped). Although the five CCDs had overlapping symptoms, they also had unique presentation, consequences, and preferred strategies for treatment that may impact service-seeking behavior. Three out of the five CCDs were considered life-threatening, if severe and left untreated.</p><p><strong>Conclusion: </strong>The five CCDs identified are culturally salient ways of experiencing and communicating distress within this community but are not adequately captured in existing mental health assessments for this population. This may negatively impact programmatic efforts among the group.</p>","PeriodicalId":54287,"journal":{"name":"Conflict and Health","volume":"18 1","pages":"48"},"PeriodicalIF":3.1,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}