Barriers and facilitators to physical and mental health help-seeking among Congolese male refugee survivors of conflict-related sexual violence living in Kampala

Abstract

In Uganda, over 1.3 million refugees have fled armed conflicts from neighbouring countries, with about 251 730 refugees from the Democratic Republic of Congo (DRC) alone. In this article we report on a qualitative research study on the help-seeking behaviour of Congolese male refugee survivors of conflict-related sexual violence (CRSV) living in Kampala, Uganda. We recruited 10 Congolese male survivors of war-related rape and 6 Ugandan service providers (psychologists, social workers and physicians) who participated in individual interviews focused on barriers and facilitators to care seeking in Kampala, Uganda. We found that the major barriers to help-seeking were socio-cultural and political factors, health system and infrastructural barriers, poverty and livelihood barriers, physical effects of CRSV, fear of marital disharmony and breakup, and self-sufficiency The major facilitators were social support, symptom severity, professionalism among service providers, availability of free tailored services and information, education and communication. On the basis of our findings, we recommend that a multidisciplinary and multisectoral approach is important to address these barriers. In addition, we suggest that the Ugandan government should develop legislation and health policies to create protection for men who have experienced sexual violence.Keywords: armed conflict; conflict-related sexual violence; male refugee survivors; help-seeking; physical and mental health; barriers; and facilitators