Dataset Information

Socio-economic, trafficking exposures and mental health symptoms of human trafficking returnees in Ethiopia: using a generalized structural equation modelling.

ABSTRACT:

Background

Mental health problems among trafficked persons could be the result of concomitantly interwoven effects of various factors. Analyzing the networked relationships concurrently could be a more substantive approach to better understand the role of risk factors in this population. This study aimed to assess the magnitude of mental health symptoms as well as the association among socio-demographic, trafficking related exposure variables, and mental health problems of Ethiopian returnees from trafficking.

Methods

A sample of 1387 returnees who were trafficked via three major human trafficking corridors of Ethiopia were selected consecutively. Data related to socio-economic, trafficking exposure variables, and symptoms of mental illness were collected in personal interviews. Anxiety was measured with a brief measure for generalized anxiety disorder (GAD-7), depression with a patient health questionnaire (PHQ-9), and PTSD with post-traumatic checklist (PCL-C). Generalized structural equation modeling was employed to estimate the relationships among exogenous, mediating, and endogenous variables simultaneously.

Results

The prevalence of symptoms of anxiety was estimated at 51.9% (95% CI 49.3-54.6%); PTSD was estimated at 34.5% (95% CI 32.1-37.1%) and depression at 58.3% (95% CI 55.6-60.9%). Restricted freedom of movement had a direct positive effect on anxiety (??=?1.24, 95% CI 0.97-1.51), depression (??=?0.94, 95% CI 0.71-1.17) and PTSD (13.00, 95% CI 11.23-14.77). Violence experienced during the trafficking period was a mediator variable and significantly associated with anxiety (??=?0.46; 95% CI 0.26-0.66) and PTSD (??=?4.00; 95% CI 2.06-5.94). History of detention had a positive total effect on GAD (total ??=?1.380, 95% CI 1.074-1.687) and PTSD (total ??=?15.63, 95% CI 13.708-17.545), and direct positive effect on depression (??=?0.89, 95% CI 0.65-1.13).

Conclusion

Ethiopian trafficked persons were highly likely to return with increased levels of mental health symptoms, namely anxiety, depression, and PTSD. Socio-economic and trafficking related exposures mediated by violence were factors affecting mental health symptoms. Thus, in addition to economic re-integrations of victims, strategies should be designed and implemented to address the prevalent mental health problems.

SUBMITTER: Gezie LD

PROVIDER: S-EPMC6199759 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Socio-economic, trafficking exposures and mental health symptoms of human trafficking returnees in Ethiopia: using a generalized structural equation modelling.

Gezie Lemma Derseh LD Yalew Alemayehu Worku AW Gete Yigzaw Kebede YK Azale Telake T Brand Tilman T Zeeb Hajo H

International journal of mental health systems 20181024

<h4>Background</h4>Mental health problems among trafficked persons could be the result of concomitantly interwoven effects of various factors. Analyzing the networked relationships concurrently could be a more substantive approach to better understand the role of risk factors in this population. This study aimed to assess the magnitude of mental health symptoms as well as the association among socio-demographic, trafficking related exposure variables, and mental health problems of Ethiopian retu ...[more]

PMID: 30386421

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Project description:BackgroundHuman trafficking was affecting a number of individuals in Ethiopia that resulted in various health problems and human right violations. Though the pushing and pulling factors of human trafficking were identified qualitatively, their effect on trafficking status were not measured quantitatively; the magnitude of human trafficking among returnees was not also quantified.MethodsPrimary data were collected from 1342 Ethiopian returning migrants from abroad via Metemma-Yohannes, Moyale, and Galafi border towns from May to October 2016 consecutively. The status of each returnee as trafficked or non-trafficked was determined based on the UN 2000 definition of human trafficking. Factor analyses were conducted on the push and pull factors of migration to identify the underlying constructs. Considering the common underlying concept of items that load on the push and pull factors, the newly emerged construct variables were named in consultation with sociologists before used as independent variables. Finally, the effect of these and other variables on trafficking status were measured using generalized estimation equation.ResultThe magnitude of human trafficking among returning migrants was estimated at 50.89% (95%CI: 0.4822-0.5357). The odds of being trafficked was positively associated with female sex (AOR = 1.55, 95%CI: 1.10-2.17), low household wealth quintile (AOR = 2.55, 95%CI: 1.46-4.44), being smuggled at departure (AOR = 4.48, 95%CI: 3.19-6.29), strong desire for successful oversea life (AOR = 3.98, 95%CI: 2.63-6.02), high level of risk-opportunity imbalance before departure (AOR = 6.10, 95%CI: 4.01-9.30), and strong feeling of hopelessness at success in home-country (AOR = 8.64, 95%CI: 5.62-13.30).ConclusionHalf of the returned Ethiopian migrants were trafficked. Sex, household wealth quintile, smuggling status, exposure to seductive information about oversea life, risk-opportunity imbalance before departure, and feeling hopelessness for success at home were among the factors associated with human trafficking.

Project description:IntroductionEthiopia has achieved the fourth Millennium Development Goal by reducing under 5 mortality. Nevertheless, there are challenges in reducing maternal and neonatal mortality. The aim of this study was to estimate maternal and neonatal mortality and the socio-economic inequalities of these mortalities in rural south-west Ethiopia.MethodsWe visited and enumerated all households but collected data from those that reported pregnancy and birth outcomes in the last five years in 15 of the 30 rural kebeles in Bonke woreda, Gamo Gofa, south-west Ethiopia. The primary outcomes were maternal and neonatal mortality and a secondary outcome was the rate of institutional delivery.ResultsWe found 11,762 births in 6572 households; 11,536 live and 226 stillbirths. There were 49 maternal deaths; yielding a maternal mortality ratio of 425 per 100,000 live births (95% CI:318-556). The poorest households had greater MMR compared to richest (550 vs 239 per 100,000 live births). However, the socio-economic factors examined did not have statistically significant association with maternal mortality. There were 308 neonatal deaths; resulting in a neonatal mortality ratio of 27 per 1000 live births (95% CI: 24-30). Neonatal mortality was greater in households in the poorest quartile compared to the richest; adjusted OR (AOR): 2.62 (95% CI: 1.65-4.15), headed by illiterates compared to better educated; AOR: 3.54 (95% CI: 1.11-11.30), far from road (?6 km) compared to within 5 km; AOR: 2.40 (95% CI: 1.56-3.69), that had three or more births in five years compared to two or less; AOR: 3.22 (95% CI: 2.45-4.22). Households with maternal mortality had an increased risk of stillbirths; OR: 11.6 (95% CI: 6.00-22.7), and neonatal deaths; OR: 7.2 (95% CI: 3.6-14.3). Institutional delivery was only 3.7%.ConclusionHigh mortality with socio-economic inequality and low institutional delivery highlight the importance of strengthening obstetric interventions in rural south-west Ethiopia.

Project description:There is a growing body of literature suggesting that the arts can support mental health. However, both arts participation and cultural engagement are unevenly patterned across the population, with a strong social gradient. This social gradient is also evident in mental health. So it remains unclear whether the relationship between arts engagement and mental health can in fact be explained by socio-economic status (SES). This study explores this question specifically in relation to cultural engagement (e.g. visiting museums/galleries/cinema/theatre/concerts) using data from 8780 adults aged 50 + from the English Longitudinal Study of Ageing. We used a statistical triangulation approach, running three separate sets of analyses that each have different strengths and address different statistical limitations or biases. Using logistic regression, the relationship between cultural engagement and mental health was still present when including covariates relating to SES, and there was no evidence of moderation by SES either through the inclusion of interaction terms or stratification. Using propensity score matching, matching participants based on their SES, we also consistently found evidence of the relationship. Finally, using fixed-effects regression which takes account of all time-invariant factors (which include multiple aspects of SES) even if unobserved, we also found no attenuation of the relationship. Overall, this confirms previous reports that cultural engagement is linked with a lower odds of depression amongst adults aged 50 + by demonstrating a robust association in a nationally-representative sample of older adults. While SES does explain around half of the association between cultural engagement and depression, we found no evidence that it either acts as a moderator or the main explanatory factor, with independent associations maintained across all three approaches. However, the fact that higher SES is associated with more frequent engagement indicates that, in population terms, SES is still an important determinant of the salutogenic impact of culture.

Dataset Information

Socio-economic, trafficking exposures and mental health symptoms of human trafficking returnees in Ethiopia: using a generalized structural equation modelling.

Background

Methods

Results

Conclusion

Publications

Socio-economic, trafficking exposures and mental health symptoms of human trafficking returnees in Ethiopia: using a generalized structural equation modelling.

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