A microfinance intervention to improve health of rape survivors in the DRC

美国在全球卫生方面发挥着重要作用。它既是全球最大的创新资助者 世界卫生组织是撒哈拉以南非洲关怀和支持项目的最大捐赠者。它的有效性和 这些努力的可持续性受到对社会决定因素作用的认识差距的限制，例如 贫穷、社会孤立、长期压力和创伤以及获得保健服务的机会有限 健康方面的差距。这项研究的总体目标是为大规模实施 改善性暴力和基于性别的暴力的女性幸存者健康的经济方案。 在刚果民主共和国的过去十年里，强奸被用作一种战争武器， 在那里，叛军和士兵使妇女和女孩遭受残酷的攻击、强奸、酷刑和肢解。 强奸幸存者往往因感染、疾病、贫困、耻辱和社会孤立而进一步遭受创伤。这个 研究目标是测试一个创新的、由村庄领导的针对SGBV的小额信贷计划的有效性 幸存者的健康、家庭经济稳定以及重新融入家庭和村庄。我们的预赛 有证据表明，一个由村庄领导的小额信贷方案改善了刚果妇女的健康和 家庭经济稳定，通过增加购买食品、住房和药品的资金并支付 孩子们的学费。幸存者还报告说，慢性压力对健康的负面影响有所减少， 与SGBV相关的耻辱和创伤，因为他们再次成为富有成效的家庭和村庄 会员。作为我们前期工作的结果，我们的小额信贷-学术研究合作提出了一个 使用混合方法(定量和定性技术)进行为期五年的试验性试验。在这场试验中，10人 刚果民主共和国南部瓦伦古地区Ngweshe酋长领地的村庄将被随机分配到 小额信贷干预组(n=5)或延迟对照组(n=5)。结果将在个人身上进行衡量 干预村和对照村的家庭水平。我们估计这两个地区各有50户家庭 干预控制村共500户参加。对以下方面的结果进行衡量 将在基线和基线评估后3、6、12和18个月收集每个村庄的数据。 这项研究涉及国家少数民族健康和健康差距中心(NCMHD)的优先事项 制定和测试结构性干预措施，以缩小健康差距。研究结果将为科学提供信息 大规模实施结构性干预措施的基础，目的是建立因果关系 在微型金融干预与改善健康、家庭经济安全和重新融入社会之间 性暴力和性别暴力的幸存者及其家人。

The United States plays a significant role in global health. It is both the largest funder of innovation in global health and the largest donor to care and support programs in sub-Saharan Africa. The effectiveness and sustainability of these efforts are limited by gaps in knowledge of the role of social determinants, such as poverty, social isolation, chronic stress and trauma, and limited access to health care services has on disparities in health. The overall goal of the study is to build the science base for large-scale implementation of economic programs to improve the health of women survivors of sexual and gender based violence (SGBV). The last decade in the Democratic Republic of Congo (DRC) has seen the use of rape as a weapon of war, where rebels and soldiers subject women and girls to brutalizing attacks, rape, torture, and mutilation. Survivors of rape are often further traumatized by infections, disease, poverty, stigma and social isolation. The study objective is to test the effectiveness of an innovative, village-led microfinance program on SGBV survivor's health, household economic stability, and reintegration to family and village. Our preliminary evidence indicates that a village-led microfinance program improves Congolese women's health and household economic stability, through increased funds to purchase food, housing and medication and to pay school fees for children. Survivors also report a reduction in the negative health impacts of chronic stress, stigma and trauma associated with SGBV because they are once again productive family and village members. As a result of our preliminary work, our microfinance-academic research collaboration proposes a five-year experimental trial using mixed-methods (quantitative and qualitative techniques). In this trial, 10 villages in the Ngweshe Chiefdom in the Walungu Territory in South Kivu DRC will be randomized to either the microfinance intervention (n=5) or delayed control (n=5) group. Outcomes will be measured at the individual and household levels in both intervention and control villages. We estimate 50 household in each of the intervention and control villages will participate for a total of 500 households. Measurement of outcomes in each village will be collected at baseline and 3, 6, 12 and 18-months post-baseline assessment. The study addresses the National Center for Minority Health and Health Disparities (NCMHD) priorities to develop and test structural interventions to reduce health disparities. Research findings will inform the science base for large-scale implementation of structural interventions, with the aim to establish a causal relationship between a mcirofinance intervention and improved health, household economic security, and reintegration for survivors of sexual and gender-based violence and their families.