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

旨在改善刚果民主共和国强奸幸存者健康的小额信贷干预措施

• 批准号: 8074269
• 负责人: NANCY E GLASS
• 金额: $ 38.43万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-12-24 至 2015-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8074269
• 关键词: 15 year old; Address; Africa South of the Sahara; Animal Husbandry; Area; Caring; Cattle; Cessation of life; Child; Chronic stress; Collaborations; Communities; Conflict (Psychology); Coupled; Democratic Republic of the Congo; Disease; Economics; Effectiveness; Family; Fees; Food; Forcible intercourse; Fright; Funding; Gender; Goals; Goat; Government; Health; Health Services; Health Services Accessibility; Health Status; Household; Housing; Human Rights; Individual; Infection; Injury; Intervention; Interview; Kidnappings; Knowledge; Life; Measurement; Measures; Methods; Natural Disasters; Outcome; Patient Self-Report; Persons; Pharmaceutical Preparations; Play; Population; Poverty; Randomized; Reporting; Research; Resources; Role; Rwanda; Schools; Science; Security; Social isolation; Soldier; Source; Stigmata; Survivors; Techniques; Testing; Theft; Torture; Trauma; USAID; United States; Violence; War; Woman; Women' s Health; Work; assault; base; economic impact; girls; global health; health disparity; health economics; improved; innovation; killings; man; member; minority health; programs; response; social stigma; weapons

DESCRIPTION (provided by applicant): 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 microfinance intervention and improved health, household economic security, and reintegration for survivors of sexual and gender-based violence and their families. PUBLIC HEALTH RELEVANCE: 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 microfinance intervention and improved health, household economic security, and reintegration for survivors of sexual and gender-based violence and their families.

描述（由申请人提供）：美国在全球健康中起着重要作用。它既是全球卫生中最大的创新资助者，也是撒哈拉以南非洲护理和支持计划的最大捐助者。这些努力的有效性和可持续性受到对社会决定因素作用的知识的差距，例如贫困，社会隔离，慢性压力和创伤以及有限的医疗服务对健康差异的机会。该研究的总体目的是建立科学基础，以大规模实施经济计划，以改善基于性别和性别的暴力（SGBV）的女性幸存者的健康。刚果民主共和国（DRC）的最后十年将强奸用作战争武器，叛乱分子和士兵在那里妇女和女孩遭到野蛮袭击，强奸，酷刑和肢解。强奸的幸存者通常会因感染，疾病，贫困，污名和社会隔离而进一步创伤。该研究的目的是测试一项创新的，乡村主导的小额信贷计划对SGBV幸存者的健康，家庭经济稳定以及与家庭和村庄的重新融合的有效性。我们的初步证据表明，一个由乡村主导的小额信贷计划通过增加资金购买食物，住房和药物并为儿童支付学费，从而改善了刚果妇女的健康和家庭经济稳定。幸存者还报告说，与SGBV相关的慢性压力，污名和创伤对健康的负面影响有所减少，因为它们再次是生产性的家庭和乡村成员。由于我们的初步工作，我们的小额信贷 - 学术研究合作提出了一项使用混合方法（定量和定性技术）的五年实验试验。在这项试验中，在南基库drc的Walungu地区NGWeshe酋长国的10个村庄将被随机分为小额信贷干预（n = 5）或延迟对照组（n = 5）组。在干预和控制村庄的个人和家庭层面上，结果将衡量。我们估计每个干预措施中的50个家庭将参加总共500个家庭。每个村庄的结局的测量将在基线和基线后的3、6、12和18个月收集。该研究针对国家少数族裔健康与健康差异（NCMHD）的优先事项，以制定和测试结构性干预措施，以减少健康差异。研究发现将为科学基础提供大规模实施结构干预措施，旨在建立小额信贷干预与改善健康，家庭经济安全以及为基于性别和性别的暴力及其家人的幸存者重新融合的因果关系。 公共卫生相关性：该研究涉及国家少数民族健康与健康差异（NCMHD）的优先事项，以制定和测试结构性干预措施，以减少健康差异。研究发现将为科学基础提供大规模实施结构干预措施，旨在建立小额信贷干预与改善健康，家庭经济安全以及为基于性别和性别的暴力及其家人的幸存者重新融合的因果关系。