Self-Esteem, Socioeconomic Status and Social Participation of Persons with Disabilities Living in Areas Affected by Armed Conflict in Colombia.
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ABSTRACT:
SUBMITTER: Yamada T
PROVIDER: S-EPMC8073117 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The peace agreement with the Colombian guerrilla group Fuerzas Armadas Revolucionarias de Colombia-Ejército del Pueblo represented an opportunity for peacebuilding and victims' reparation, rather than the end of the internal armed conflict. In this context, this study aimed to uncover the consequences of conflict on victims' health and on health service provision, and their perceived health status during the post-accord stage in the Meta region, located in the country's eastern plains. Historically, this region has been one of the territories most affected by the presence of conflict-related groups and armed confrontations. Through focus groups, this research explored the health perceptions and experiences of victims of armed conflict. Ten focus groups were conducted with men and women, victims of the armed-conflict, in four municipalities with different degrees of armed conflict intensity. The focus group transcripts were coded using NVivo. The results show that the way women have experienced conflict and the effects of conflict on mental health in general for men, women, and children were recurrent themes in the dialogue of victims. Likewise, it highlights the need to understand the barriers that the current health model imposes on the right to health itself. From the victim's perspective, they experience stigmatization, discrimination, and revictimization when accessing health services. These barriers co-occur along with structural limitations of the health system that affect the general population.
| S-EPMC8890648 | biostudies-literature
Project description:Anthropogenic change has been associated with population growth, land use change, and changing economies. However, internal migration patterns and armed conflicts are also key drivers of anthropogenic and demographic processes. To better understand the processes associated with this change, we explore the spatial relationship between forced migration due to armed conflict and changing socioeconomic factors in Colombia, a country which has a recent history of 7 million internal migrants. In addition, we use remote sensing, Google Earth Engine, as well as spatial statistical analyses of demographic data in order to measure anthropogenic change between 1984 and 2013-a socio-politically important period in Colombia's armed conflict. We also analyze spatiotemporal relationships between socioeconomic and anthropogenic changes, which are caused by forced migration. We found that forced migration is significantly and positively related to an increasing rural-urban type of migration which results from armed conflict. Results also show that it is negatively related to interregional displacement. Indeed, anthropogenic change pertaining to different regions have had different correlations with forced migration, and across different time periods. Findings are used to discuss how socioeconomic and political phenomena such as armed conflict can have complex effects on the dynamics of anthropogenic and ecological change as well as movement of humans in countries like Colombia.
| S-EPMC7685458 | biostudies-literature
Project description:BackgroundThe effect of the Colombian armed conflict on the mental health of adolescents is still poorly understood.AimsGiven social interventions are most likely to inform policy, we tested whether two potential intervention targets, family functioning and social capital, were associated with mental health in Colombian adolescents, and whether this was moderated by experience of violence and displacement.MethodsWe examined the cross-sectional association between family functioning, cognitive social capital, structural social capital and 12-month prevalence of Composite International Diagnostic Interview (CIDI) diagnosed psychiatric disorder, using data on 12 to 17-year-old adolescents (N = 1,754) from the 2015 National Mental Health Survey of Colombia, a nationally representative epidemiological study. We tested whether associations survived cumulative adjustment for demographic confounders, experience of non-specific violence and harm and displacement by armed conflict.ResultsNeither structural nor cognitive social capital were associated with better mental health. Better family functioning was associated with reduced risk of poor mental health in an unadjusted analysis (OR 0.90 [0.85-0.96]), and after cumulative adjustments for demographic confounders (OR 0.91 [0.86-0.97]), non-specific violence and harm (OR 0.91 [0.86-0.97]) and social capital variables (OR 0.91 [0.85-0.97]). In the final model, each additional point on the family APGAR scale was associated with a 9% reduced odds of any CIDI diagnosed disorder in the last 12 months.ConclusionsBetter family functioning was associated with better mental health outcomes for all adolescents. This effect remained present in those affected by the armed conflict even after accounting for potential confounders.
| S-EPMC9597145 | biostudies-literature
Project description:The high incidence of armed conflicts in biodiverse regions poses significant challenges in achieving international conservation targets. Because attitudes towards risk vary, we assessed different strategies for protected area planning that reflected alternative attitudes towards the risk of armed conflicts. We find that ignoring conflict risk will deliver the lowest return on investment. Opting to completely avoid conflict-prone areas offers limited improvements and could lead to species receiving no protection. Accounting for conflict by protecting additional areas to offset the impacts of armed conflicts would not only increase the return on investment (an effect that is enhanced when high-risk areas are excluded) but also increase upfront conservation costs. Our results also demonstrate that fine-scale estimations of conflict risk could enhance the cost-effectiveness of investments. We conclude that achieving biodiversity targets in volatile regions will require greater initial investment and benefit from fine-resolution estimates of conflict risk.
| S-EPMC4820849 | biostudies-other
Project description:PurposeWe assessed the validity of the EQ-5D instrument; explored correlations between area of residence's conflict intensity and individual health-related quality of life (HRQoL); and identified factors associated with HRQoL in a conflict-affected population in Colombia.MethodsWe conducted a household survey among residents of the Meta province, collecting longitudinal information about HRQoL (EQ-5D-3L instrument), health, demographic and socio-economic indicators, for years 2014 (pre-2016 peace accord), 2018 (post-peace accord) and 2019 (follow-up). After examining EQ-5D's validity, we analysed panel data using multivariate random effects models to explore associations between area conflict levels (and other factors) and HRQoL. We scrutinised these results further through multivariate linear regressions using cross-sectional data, and provided preliminary estimates of quality-adjusted life years (QALYs) gained since the Colombian peace accord.ResultsIn total, 1309 individuals provided information for years 2014 and 2018; 1106 individuals were followed-up in 2019. Mean EQ-5D scores in 2014, 2018 and 2019 were 0.898, 0.846 and 0.902, respectively. The tests confirmed the validity of EQ-5D. Our estimations indicated a dose-response relationship between conflict levels and HRQoL: people in lightly and heavily affected areas had 0.019 and 0.037 lower EQ-5D scores (respectively) than people in non-affected areas. Other relevant factors included age, marital status, education, assets and health status. We estimated QALY gain of 0.0343 per individual and 20,752 for all Meta adults since the peace accord.ConclusionWe found EQ-5D to be a valid instrument for HRQoL measurement in a conflict-affected population. Area conflict intensity was negatively associated with individual HRQoL.
| S-EPMC8602178 | biostudies-literature
Project description:BackgroundThe consequences of armed conflicts impose considerable burdens on the economy and health care services, particularly in countries that are not equipped to deal with them, such as in the Middle-East, and North African countries. Little is known about the burden of mortality and injury resulting from the Libyan armed conflict. This study aimed to determine the trends and patterns of mortality, injury and disabilities directly associated with the Libyan armed conflict and analyze the geographic variation within the country during 2012-2107.MethodsData on conflict-related deaths, injuries, and disabilities were obtained from the national registry offices. The information included date, place, and demographic information. A questionnaire was also used to obtain information from the affected individuals and their families. National and regional trends of mortality, injury and disabilities were calculated. Spatial analysis was performed using geographic data available on all documented cases to analyze clustering of mortality and injury.ResultsA total of 16,126 deaths and 42,633 injuries were recorded with complete information during the Libyan conflict from 2012 till 2017. The overall mortality rate was 2.7/1000 population and injury rate was 7.1/1000. The overall male-to-female ratio of mortality and injury was 4.4:1; 42.3% were single and aged 20-30 years old, and 26.4% were aged 31-40 years. Moreover, injuries resulted in death in 20.1% of cases and disability in 33.5% of the cases. Most of the disabilities were caused by blasts, while gun shots resulted in more deaths. The overall mortality and injury rates were highest during 2015-2017. These rates were highest in the eastern region. Injuries were most concentrated in Benghazi and Derna in the east, followed by Sert and Musrata in the central region.ConclusionsConflict-related mortality, injury and disability has inflicted a heavy burden on the Libyan society that may persist for a long time. The rates of these casualties varied in time and place. National, well-planned efforts are needed to address this serious situation and its consequences.
| S-EPMC6510427 | biostudies-literature
Project description:Nature-based tourism has the potential to enhance global biodiversity conservation by providing alternative livelihood strategies for local people, which may alleviate poverty in and around protected areas. Despite the popularity of the concept of nature-based tourism as an integrated conservation and development tool, empirical research on its actual socioeconomic benefits, on the distributional pattern of these benefits, and on its direct driving factors is lacking, because relevant long-term data are rarely available. In a multi-year study in Wolong Nature Reserve, China, we followed a representative sample of 220 local households from 1999 to 2007 to investigate the diverse benefits that these households received from recent development of nature-based tourism in the area. Within eight years, the number of households directly participating in tourism activities increased from nine to sixty. In addition, about two-thirds of the other households received indirect financial benefits from tourism. We constructed an empirical household economic model to identify the factors that led to household-level participation in tourism. The results reveal the effects of local households' livelihood assets (i.e., financial, human, natural, physical, and social capitals) on the likelihood to participate directly in tourism. In general, households with greater financial (e.g., income), physical (e.g., access to key tourism sites), human (e.g., education), and social (e.g., kinship with local government officials) capitals and less natural capital (e.g., cropland) were more likely to participate in tourism activities. We found that residents in households participating in tourism tended to perceive more non-financial benefits in addition to more negative environmental impacts of tourism compared with households not participating in tourism. These findings suggest that socioeconomic impact analysis and change monitoring should be included in nature-based tourism management systems for long-term sustainability of protected areas.
| S-EPMC3338832 | biostudies-literature
Project description:The psychological burden of conflict-induced displacement is severe. Currently, there are 80 million displaced persons around the world, and their number is expected to increase in upcoming decades. Yet, few studies have systematically assessed the effectiveness of programs that assist displaced persons, especially in settings of extreme vulnerability. We focus on eastern Democratic Republic of Congo, where myriad local armed conflicts have driven cycles of displacement for over 20 years. We conducted a within-village randomized field experiment with 976 households, across 25 villages, as part of the United Nations' Rapid Response to Population Movements program. The program provided humanitarian relief to over a million people each year, including vouchers for essential nonfood items, such as pots, pans, cloth, and mattresses. The vouchers led to large improvements in psychological well-being: a 0.32 standard deviation unit (SDU) improvement at 6 weeks, and a 0.18 SDU improvement at 1 year. There is no evidence that the program undermined social cohesion within the village, which alleviates worries related to programs that target some community members but not others. Finally, there was no improvement in child health.
| S-EPMC9896939 | biostudies-literature
Project description:BACKGROUND: Armed conflict and war are among the leading causes of disability and premature death, and there is a growing share of civilians killed or injured during armed conflicts. A major part of the civilian suffering stems from indirect effects or collateral impact such as changing risk profiles for infectious diseases. We focused on rural communities in the western part of Côte d'Ivoire, where fighting took place during the Ivorian civil war in 2002/2003, and assessed the dynamics of socioeconomic risk factors for neglected tropical diseases (NTDs) and malaria. METHODOLOGY: The same standardized and pre-tested questionnaires were administered to the heads of 182 randomly selected households in 25 villages in the region of Man, western Côte d'Ivoire, shortly before and after the 2002/2003 armed conflict. PRINCIPAL FINDINGS: There was no difference in crowding as measured by the number of individuals per sleeping room, but the inadequate sanitation infrastructure prior to the conflict further worsened, and the availability and use of protective measures against mosquito bites and accessibility to health care infrastructure deteriorated. Although the direct causal chain between these findings and the conflict are incomplete, partially explained by the very nature of working in conflict areas, the timing and procedures of the survey, other sources and anecdotal evidence point toward a relationship between an increased risk of suffering from NTDs and malaria and armed conflict. CONCLUSION: New research is needed to deepen our understanding of the often diffuse and neglected indirect effects of armed conflict and war, which may be worse than the more obvious, direct effects.
| S-EPMC2731884 | biostudies-literature
Project description:BackgroundOlder persons are often unable to leave conflict areas; however, little is known about the mental and physical health among this population. Our objective was to determine the prevalence of and whether there was an association between psychological distress and disability among older persons affected by conflict in eastern Ukraine.MethodsWe conducted a cluster-randomized cross-sectional household survey of persons aged ≥60 years in government and non-government controlled areas (GCA and NGCA) of Donetsk and Luhansk regions in January-March 2016. Psychological distress and dependency (degree of disability) were measured using the Kessler K6 Psychological Distress Scale and Katz Index of Independence in Activities of Daily Living, respectively. Association between psychological distress and dependency was assessed using logistic regression adjusting for demographic and socioeconomic characteristics.ResultsFinal sample included 758 and 418 persons in GCA and NGCA, respectively. Prevalence of serious psychological distress was 33.6% (95% Confidence Interval (CI), 28.0-39.7%) in GCA and 42.5% (95%CI, 36.1-49.2%) in NGCA. Overall, 32.2% (95%CI, 27.9-36.7%) of independent persons and 74.0% (95%CI, 65.2-81.2%) of moderately/severely dependent persons reported serious psychological distress (P < .0001). Being dependent, a woman, and having a chronic disease were all significantly associated with psychological distress in a logistic regression model.ConclusionsPrevalence of serious psychological distress was very high compared with rates reported from developed countries and was highly associated with disability. Health services for the disabled, including psychological as well as physical support, could help in reducing the proportion of people needing mental health services not normally identified.
| S-EPMC6503356 | biostudies-literature