Pathways to improved adolescent mental health via an economic and gender equality intervention with conflict affected families

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Project Summary/Abstract In the Democratic Republic of Congo, families have experienced more than two decades of violence, displacement and political instability resulting in extreme poverty with limited educational and economic opportunities. Child poverty and exposure to trauma is widespread and particularly concentrated in conflict- affected and rural areas. Childhood exposure to multiple adversities can lead to a lifetime of poor mental health. In rural DRC, we found parent’s self-report of poor mental health and victimization or perpetration of intimate partner violence (IPV) had a significant negative impact on their young adolescents’ mental health, with different impacts for boys and girls. The underlying ideologies of male authority and women’s place being in the home has led to gender norms that restrict opportunities with limited attention to effects on mental health. The study provides a unique opportunity with a proven Congolese partner to examine the combined and synergistic effects of two proven structural interventions; 1) Rabbits for Resilience (RFR), youth-led economic empowerment program; and 2) Indashyikirwa (IK), a couples/parents-based gender equality program on adolescent mental health. Using a clustered randomized controlled trial with three groups (RFR only, IK only, RFR + IK), we examine the combined and synergistic effects of the interventions and the pathways through which RFR and IK improves adolescent mental health. We will test two hypotheses: 1) Adolescents in the RFR + IK and RFR only households will report greater improvement in mental health via pathway of improved self-efficacy, school attendance, food security and peer relationships compared to adolescents in IK only households; and 2) Adolescents in RFR + IK and IK only households will report greater improvement in mental health via the pathway of improved parent relationship quality and power sharing, reduced exposure to IPV, improved parental mental health and support of gender equitable norms compared to adolescents in RFR only households. Differences in pathways of the intervention effect will be examine by sex of adolescent. The significance cannot be underestimated given nearly 1 in 5 children live in conflict- affected areas, worldwide - and are facing a lifetime of poor mental health with inequitable access to education and economic opportunities.