Abstract
BackgroundThere remains limited evidence on how armed conflict affects overall physical and mental well-being rather than specific physical or mental health conditions. The aim of this study was to investigate the influence of demographic characteristics, living conditions, and violent and traumatic events on general physical and mental health in Southern Sudan which is emerging from 20 years of armed conflict.MethodsA cross-sectional survey of 1228 adults was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Multivariate linear regression analysis was used to investigate the associations and relative influence of variables in three models of demographic characteristics, living conditions, and trauma exposure, on general physical and mental health status. These models were run separately and also as a combined model. Data quality and the internal consistency of the health status instrument (SF-8) were assessed.ResultsThe variables in the multivariate analysis (combined model) with negative coefficients of association with general physical health and mental health (i.e. worse health), respectively, were being female (coef. -2.47; -2.63), higher age (coef.-0.16; -0.17), absence of soap in the household (physical health coef. -2.24), and experiencing within the past 12 months a lack of food and/or water (coef. -1.46; -2.27) and lack of medical care (coef.-3.51; -3.17). A number of trauma variables and cumulative exposure to trauma showed an association with physical and mental health (see main text for data). There was limited variance in results when each of the three models were run separately and when they were combined, suggesting the pervasive influence of these variables. The SF-8 showed good data quality and internal consistency.ConclusionsThis study provides evidence on the pervasive influence of demographic characteristics, living conditions, and violent and traumatic events on the general physical and mental health of a conflict-affected population in Southern Sudan, and highlights the importance of addressing all these influences on overall health.
Highlights
There remains limited evidence on how armed conflict affects overall physical and mental well-being rather than specific physical or mental health conditions
A conservative population estimate of Juba at the time of this study was 150,000 people and this was rapidly increasing with people moving to Juba in the search for more economic opportunities, security and better access to education and health services. This includes many returning refugees, and there are a high number of internally displaced persons (IDPs) who fled to Juba during the war and those fleeing from the continuing insecurity elsewhere in Southern Sudan after the end of the war
As a result of this migration and limited resources and infrastructure, there are a number of unofficial makeshift settlements in Juba - for IDPs which are characterised by inadequate shelter, overcrowded conditions, and poor access to clean water and adequate sanitation
Summary
There remains limited evidence on how armed conflict affects overall physical and mental well-being rather than specific physical or mental health conditions. The aim of this study was to investigate the influence of demographic characteristics, living conditions, and violent and traumatic events on general physical and mental health in Southern Sudan which is emerging from 20 years of armed conflict. The influence of demographic factors, living conditions, and exposure to violent and traumatic events on specific physical health conditions and mental health conditions such as post-traumatic stress disorder, anxiety, and depression studies have explored factors associated with the overall health status of conflict-affected populations in lowincome countries [9,10,11], despite this being where the vast majority of conflict-affected persons live [12,13,14]. The aim of this study was to investigate the influence of demographic characteristics, living conditions, and violent and traumatic events on overall physical and mental health in Southern Sudan
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