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

美国在全球卫生领域发挥着重要作用。它既是全球最大的创新资助者， 卫生和最大的捐助者，以照顾和支持计划在撒哈拉以南非洲地区。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认识不足的限制， 贫困、社会孤立、长期压力和创伤，以及获得医疗服务的机会有限， 健康方面的差距。本研究的总体目标是为大规模实施 经济方案，以改善性暴力和基于性别的暴力的女性幸存者的健康。 在过去的十年里，在刚果民主共和国，强奸被用作战争武器， 在那里，叛乱分子和士兵对妇女和女孩进行残酷的攻击、强奸、酷刑和残害。 强奸幸存者往往因感染、疾病、贫穷、耻辱和社会孤立而受到进一步的创伤。的 研究的目的是测试一个创新的、由村庄领导的小额信贷项目对性暴力和性别暴力的有效性 幸存者健康、家庭经济稳定以及重返家庭和村庄。我们的初步 有证据表明，由村庄主导的小额信贷项目改善了刚果妇女的健康状况， 家庭经济稳定，通过增加资金来购买食品、住房和药品并支付 儿童的学费。幸存者还报告说，慢性压力对健康的负面影响有所减少， 由于这些家庭和村庄再次成为生产性家庭和村庄， 成员作为我们初步工作的结果，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）进行的五年实验性试验。在这场审判中，10 刚果民主共和国南基伍瓦伦古地区Ngweshe酋长领地的村庄将被随机分配到 小额信贷干预组（n=5）和延迟控制组（n=5）。结果将根据个人来衡量 在干预村和对照村的家庭水平。我们估计， 干预和控制村将有500户参与。成果的衡量 将在基线和基线后3、6、12和18个月评估时收集每个村庄的数据。 该研究涉及国家少数民族健康和健康差异中心（NCMHD）的优先事项， 制定和测试结构性干预措施，以减少健康差距。研究结果将为科学提供信息， 大规模实施结构性干预的基础，目的是建立因果关系 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的关系， 性暴力和基于性别的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.