Livestock/animal assets buffer the impact of conflict-related traumatic events on mental health symptoms for rural women

Nancy Glass, Nancy A Perrin, Anjalee Kohli, Mitima Mpanano Remy, Nancy Glass, Nancy A Perrin, Anjalee Kohli, Mitima Mpanano Remy

Abstract

Background: In the context of multiple adversities, women are demonstrating resilience in rebuilding their futures, through participation in microfinance programs. In addition to the economic benefits of microfinance, there is evidence to suggest that it is an effective vehicle for improving health.

Methods: The parent study is a community-based trial to evaluate the effectiveness of a livestock microfinance intervention, Pigs for Peace (PFP), on health and economic outcomes with households in 10 villages in eastern Democratic Republic of Congo. The analysis for this manuscript includes only baseline data from female participants enrolled in the ongoing parent study. Multiple regression analysis was used to examine if livestock/animal asset value moderates the relationship between conflict-related traumatic events and current mental health symptoms.

Findings: The majority of women are 25 years or older, married, have on average 4 children in the home and have never attended school. Nearly 50% of women report having at least one livestock/animal asset at baseline. Over the past 10 years, women report on average more than 4 (M = 4.31, SD 3·64) traumatic events (range 0-18). Women reported symptoms consistent with PTSD with a mean score of ·2.30 (SD = 0·66 range 0-4) and depression with a mean score of 1.86 (SD = 0·49, range 0-3.47). The livestock/animal asset value by conflict-related traumatic events interaction was significant for both the PTSD (p = 0·021) and depression (p = 0·002) symptom models.

Interpretation: The study provides evidence of the moderating affect of livestock/animal assets on mental health symptoms for women who have experienced conflict. The findings supports evidence about the importance of livestock/animal assets to economics in rural households but expands on previous research by demonstrating the psychosocial effects of these assets on women's health.

Trial registration: clinicaltrials.gov NCT02008708.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Participant Flowchart.
Figure 1. Participant Flowchart.
Participant flowchart at baseline data collection.

References

    1. Wakabi W (2008) The Democratic Republic of the Congo in crisis. Lancet 372:2011–2012.
    1. Coghlan B, Brennan RJ, Ngoy P, Dofara D, Otto B, et al. (2006) Mortality in the Democratic Republic of Congo: a nationwide survey. Lancet 367:44–51.
    1. Johnson K, Scott J, Rughita B, Kisielewski M, Asher J, et al. (2010) Association of sexual violence and human rights violations with physical and mental health in territories of the Eastern Democratic Republic of the Congo. JAMA 304:553–562.
    1. Omba Kalonda JC (2008) Sexual violence in the Democratic Republic of Congo: impact on public health? Les violences sexuelles en République Démocratique du Congo: Quelles conséquences sur le plan de santé publique? Med Trop 68:576–578.
    1. Peterman A, Palermo T, Bredenkamp C (2011) Estimates and determinants of sexual violence against women in the Democratic Republic of Congo. Am J Public Health 101:1060–1067.
    1. Neuner F, Schauer M, Karunakara U, Klaschik C, Robert C, et al. (2004) Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees. BMC Psychiatry 4:34.
    1. Kohrt BA, Hruschka DJ, Worthman CM, Kunz RD, Baldwin JL, et al. (2012) Political violence and mental health in Nepal: prospective study. Br J Psychiatry 201:268–275.
    1. Roberts B, Damundu EY, Lomoro O, Sondorp E (2009) Post-conflict mental health needs: a cross-sectional survey of trauma, depression and associated factors in Juba, Southern Sudan. BMC Psychiatry 9:7.
    1. Cyrulnik B (2008) Children in war and their resiliences. In: Parens H, Blum HP, Akhtar S, editors. The unbroken soul: tragedy, trauma and human resilience. Lanham, MD: Jason Aronson, Inc. pp.22–36.
    1. Betancourt TS, Khan KT (2008) The mental health of children affected by armed conflict: protective processes and pathways to resilience. Int Rev Psychiatry 20:317–328.
    1. Verhoef HS (2002) Seeing beyond the crisis: what international relief organizations are learning from community-based child bearing practices. In: Lerner RM, Jacobs F, Wertlieb D, editors. Handbook of applied developmental science: promoting positive child, adolescent, and family development through research, policies and programs (The SAGE program on applied developmental science). Thousand Oaks, CA: Sage Publications, Inc.
    1. Cox TP (2012) Farming the battlefield: the meanings of war, cattle and soil in South Kivu, Democratic Republic of the Congo. Disasters 36:233–248.
    1. Glass N, Ramazani P, Tosha M, Mpanano M, Cinyabuguma M (2012) A Congolese-US participatory action research partnership to rebuild the lives of rape survivors and their families in eastern Democratic Republic of Congo. Glob Public Health 7:184–195.
    1. Maass BL, Musale DK, Chiuri WL, Gassner A, Peters M (2012) Challenges and opportunities for smallholder livestock production in post-conflict South Kivu, eastern DR Congo. Trop Anim Health Prod 44:1221–1232.
    1. Kandala NB, Madungu TP, Emina JBO, Nzita KPD, Cappuccio FP (2011) Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter? BMC Public Health 11.
    1. Rossi L, Hoerz T, Thouvenat V, Pastore G, Michael M (2005) Evaluation of health, nutrition and food security programmes in a complex emergency: the case of Congo as an example of a chronic post-conflict situation. Public Health Nutrition 9:551–556.
    1. Consortium for Improved Agriculture-based Livelihoods in Central Africa (2008) Final Report Phase I - CIALCA January 2006-December 2008. Belgium: CIALCA, Directorate General for Development Cooperation (DGDC).
    1. Maass BL, Katunga Musale D, Chiuri WL, Peters M (2010) Diagnostic survey of livestock production in South Kivu/DRCongo. Nairobi, Kenya: Centro Internacional de Agricultura Tropical (CIAT). 36 p.
    1. Zozo R, Chiuri WL, Katunga Musale D, Maass BL (2010) Report of a participatory rural appraisal (PRA) in the groupements of Miti-Mulungu and Tubimbi, South Kivu/DR Congo. Nairobi, Kenya: Centro Internacional de Agricultura Tropical (CIAT). 32 p.
    1. Leatherman S, Metcalfe M, Geissler K, Dunford C (2011) Integrating microfinance and health strategies: examining the evidence to inform policy and practice. Health Policy and Planning 1–17.
    1. Gertler P, Levine DI, Moretti E (2009) Do microfinance programs help families insure consumption against illenss? Health Economics 18:257–273.
    1. Kim J, Ferrari G, Abramsky T, Watts C, Hargreaves J, et al. (2009) Assessing the incremental effects of combining economic and health interventions: the IMAGE in South Africa. Bull World Health Organ 87:824–832.
    1. Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, et al. (2006) Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. Lancet 368:1973–1983.
    1. Kohli A, Tosha M, Ramazani P, Safari O, Bachunguye R, et al.. (2012) Family and Community Rejection and a Congolese Led Mediation Intervention to Reintegrate Rejected Survivors of Sexual Violence in Eastern Democratic Republic of Congo. Health Care Women Int.
    1. Greeson JKP, Briggs EC, Layne CM, Belcher HME, Ostrowski SA, et al.. (2013) Traumatic childhood experiences in the 21st century: broadening and building on the ACE studies with data from the National Child Traumatic Stress Network. Journal of Interpersonal Violence.
    1. Garcia-Moreno C, Jansen HAFM, Ellsberg M, Heise L, Watts C (2005) WHO Multi-country study on women's heath and domestic violence against women: initial results on prevalence, health outcomes and women's responses. Geneva: World Health Organization.
    1. Mollica RF, McDonald LS, Massagli MP, Silove DM (2004) Measuring trauma, measuring torture: instructions and guidance on the utilization of teh Harvard Program in Refugee Trauma's Versions of The Hopkins Symptom Checklist-25 (HSCL-25) and The Harvard Trauma Questionnaire.
    1. Mollica RF, Donelan K, Tor S, Lavelle J, Elias C, et al. (1993) The effect of trauma and confinement on functional health and mental health status of Cambodians living in Thailand-Cambodia border camps. JAMA 270:581–586.
    1. Onyut LP, Neuner F, Ertl V, Schauer E, Odenwald M, et al. (2009) Trauma, poverty and mental health among Somali and Rwandese refugees living in an African refugee settlement - an epidemiological study. Confl Health 3:6.
    1. Sabin M, Lopes Cardozo B, Nackerud L, Kaiser R, Varese L (2003) Factors associated with poor mental health among Guatemalan refugees living in Mexico 20 years after civil conflict. JAMA 290:635–642.
    1. Nanama S, Frongillo EA (2012) Altered social cohesion and adverse psychological experiences with chronic food insecurity in the non-market economy and complex households in Burkina Faso. Social Science & Medicine 74:441–451.
    1. Cox TP (2008) The land as casualty: Soil, cattle and the future in South Kivu, DRC: University College London. 55 p.
    1. Mupawaenda AC, Chawatama S, Muvavirirwa P (2009) Gender issues in livestock production: a case study of Zimbabwe. Trop Anim Health Prod 41.
    1. Bass JK, Annan J, McIvor Murray S, Kaysen D, Griffiths S, et al. (2013) Controlled trial of psychotherapy for Congolese survivors of sexual violence. N Engl J Med 368:2182–2191.
    1. World Health Organization (2011) Mental Health Atlas 2011 - Democratic Republic of the Congo. World Health Organization.

Source: PubMed

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