Sudanese Refugees Research Articles

Implementation of Healthy Men Healthy Communities: A Health Promotion and Gender-Based Violence Prevention Program for Male South Sudanese Refugees in Uganda.

Men living in refugee settings are often exposed to violence, poverty, and social instability, which impacts physical and mental health and increases the risk of perpetrating sexual and gender-based violence. Healthy Men Healthy Communities was developed as a male-led health promotion program to address men's physical and mental health and their role in creating healthy relationships and families. Three community leaders from the settlements were trained to facilitate the program, which was implemented among six groups consisting of twelve men in each group. Pre/post surveys and feedback were collected among the facilitators and participants. Facilitators suggested culturally appropriate ways to present physical activities as a stress reduction technique and the importance of spacing out births. The small group setting facilitated open conversations on topics such as birth spacing and healthy partner communication. Participants experienced an increase in knowledge and confidence in practicing the program content, such as stress-reduction techniques and healthy communication strategies. Participants recommended additional topics such as fertility and sexually transmitted infections. The Healthy Men Healthy Communities program has the potential for wider implementation among male South Sudanese refugees to promote their health as well as the health of their families.

Interests of IGAD Member States in the South Sudan Peace Process, 2013- 2023

Three civil wars have been witnessed in South Sudan. The first Sudanese Civil war began in 1955 pitting troops from the Central government of Sudan and the Southern Sudan Liberation Movement (SSLM) rebels. This war ended after the Addis Ababa Agreement of 1972. The second war began in 1983 and ended in 2005 with the signing of the Comprehensive Peace Agreement between. A referendum in 2011 overwhelmingly voted for the independent state of South Sudan. Two years (2013) after the birth of the South Sudan nation a third civil war erupted. The civil war pitted former Vice-President Dr Riek Machar against the government of President Salva Kirr of South Sudan. The humanitarian crisis and abuse of human rights associated with the civil conflict prompted the international community through regional powers to intervene and restore stability in South Sudan. The war in South Sudan has persisted despite the efforts by IGAD and other players in the peace process. This study this study examines the interests of IGAD member states in the South Sudan peace process between 2013 and 2023. Anchored on the realism theory of international relations this study argued that interests of IGAD member states has tended to slow down the peace process in South Sudan between 2013 and 2023. This study 1takes the form of an explanatory research1design. Purposive and snow balling sampling techniques were used to identify 410 respondents for field interviews. The study purposively identified 385 South Sudanese refugees in Nairobi. A total of 25 other respondents who included; representatives of the warring factions in South Sudan residing in Kenya, IGAD officials, EAC officials and Diplomats from IGAD member states were also interviewed. This study noted that in as much as different players have significantly contributed to the peace process; interveners’ interests have tended to slow down the peace process in South Sudan.

Cash transfers amid shocks: A large, one-time, unconditional cash transfer to refugees in Uganda has multidimensional benefits after 19 months

Refugees in protracted displacement are often limited in their opportunities for income-generating activities and investments, making them dependent on aid for meeting basic needs. In the context of stretched humanitarian aid budgets, it is a necessary policy question to determine ways to increase refugees’ self-reliance. In this study, we combine a randomized controlled trial with extensive longitudinal qualitative data to explore the multidimensional impacts of a large, one-time, unconditional transfer of 1,000 USD to households of predominantly South Sudanese refugees living in protracted displacement in Uganda. Estimated after 19 months, we find that the transfer significantly increased households’ consumption, asset values, business ownership, business revenue, psychological well-being, and self-reliance. We find positive but insignificant effects on food security, migration, employment, or female empowerment. Overall, a large one-time cash transfer given in the context of shocks has multidimensional improvements in refugees’ lives, providing meaningful movement towards self-reliance.

Sexual and reproductive healthcare utilisation and affordability for South Sudanese refugees and host populations in Northern Uganda: A mixed methods study.

Given Uganda's increasing refugee population, the health financing burden on refugee and host populations is likely to increase because Uganda's integrated health system caters to both populations. We used sexual, reproductive, and maternal health (SRMH) as a lens to assess the utilisation and user cost of health services in Northern Uganda to identify potential gaps in SRMH services and their financing. We conducted a cross-sectional survey among 2,533 refugee and host women and girls in Arua and Kiryandongo districts. We conducted 35 focus group discussions and 131 in-depth interviews with host and South Sudanese refugees, community members, health workers, NGO and governmental actors. Qualitative data were analysed thematically using a framework approach. Quantitative data were analysed using t-test, chi-square tests, multivariate logistical regression, and a two-part model. We found high levels of access to maternal care services among refugee and host communities in Northern Uganda, but lower levels of met need for family planning (FP). Refugees had higher uptake of delivery care than host communities due to better-resourced refugee facilities, but incurred higher costs for delivery kits and food and less for transport due to facilities being closer. FP uptake was low for both groups due to perceived risks, cultural and religious beliefs, and lack of agency for most women. Host communities lack access to essential maternal healthcare services relative to refugees, especially for delivery care. Greater investment is needed to increase the number of host facilities, improve the quality of SRMH services provided, and further enhance delivery care access among host communities. Ongoing funding of delivery kits across all communities is needed and new financing mechanisms should be developed to support non-medical costs for deliveries, which our study found to be substantial in our study. All populations must be engaged in co-designing improved strategies to meet their FP needs.

Prevention and promotion effects of Self Help Plus: secondary analysis of cluster randomised controlled trial data among South Sudanese refugee women in Uganda

IntroductionEvidence-based and scalable prevention and promotion focused mental health and psychosocial support interventions are needed for conflict-affected populations in humanitarian settings. This study retrospectively assessed whether participation in Self Help...

Factors contributing to the high prevalence of intimate partner violence among south Sudanese refugee women in Ethiopia

BackgroundIntimate partner violence is a universally occurring form of violence against women which is perpetrated by a husband or other intimate partner. It is a common public health problem during humanitarian crisis. Despite this, little is known about the problem among South Sudanese refugee women in Ethiopia.ObjectiveThis study aimed to determine the prevalence of intimate partner violence and identify its contributing factors among married refugee women in Pinyudo refugee camp, Gambella, Ethiopia in 2021.MethodsA community-based cross-sectional study was conducted from March to June 2021. A random sample of 406 refugee women was included in the study. A structured, pretested, and interviewer-administered questionnaire was used to collect the data. Data were entered into epi-data version 3.1 and exported to SPSS version 22 for analysis. Multivariable logistic regression was run to identify factors associated with intimate partner violence. Statistical significance was affirmed using Adjusted Odds Ratio with its 95% Confidence Interval at a p-value ≤ 0.05.ResultsA total of 406 married refugee women participated in the study making a response rate of 96.2%. The overall prevalence of intimate partner violence in the past 12 months was 48.3% 95% CI= (43.6–53.2). Low-income contribution [AOR = 2.4, 95% CI: 1.2–5.5], and attitudinal acceptance [AOR = 2.1, 95%CI: 1.2–3.8] were significantly associated with the problem.ConclusionThe prevalence of intimate partner violence is alarmingly high as half of participating women reported facing the problem in the year preceding the study. Low-income contribution and attitudinal acceptance were associated with a higher probability of experiencing violence. The government, humanitarian organizations, and other stakeholders should enable refugee women to generate income. There should be continuous women empowerment and behavioral interventions to improve refugee women’s attitudes towards intimate partner violence.

P17-036-23 Perceived Facilitators and Barriers to Complementary Feeding of Children Among South Sudanese Refugees in Post-Emergency Settlements in the West-Nile Region, Uganda

P17-036-23 Perceived Facilitators and Barriers to Complementary Feeding of Children Among South Sudanese Refugees in Post-Emergency Settlements in the West-Nile Region, Uganda

“Think Positive, Save a life”? Resilience and Mental Health Interventions as Political Abandonment in a Refugee Settlement in Northern Uganda

ABSTRACT This article investigates the entanglements of resilience-based refugee policies and mental health interventions in the refugee settlement of Palabek, northern Uganda. I argue that both resilience refugee policies and mental health humanitarian interventions stem from a neoliberal logic which shifts responsibility onto individuals for their psychological and economic wellbeing. I show that there are direct links between chronic food insecurity and rates of mental illness among South Sudanese refugees in Palabek settlement. By individualising social suffering, mental health discourses and interventions mask the failures of humanitarian assistance in Uganda. As such, they justify and enable the political abandonment of refugees.

Unknown risk: assessing refugee camp flood risk in Ethiopia

The number of global refugees has been rising annually for the last decade. Many of these refugees are housed within camps, in temporary structures, vulnerable to the impacts of flooding. The flood risk of refugees is not well understood. Flood risk guidance available for camp planners and managers is vague, and existing flood risk data is often lacking in the remote areas where camps are typically located. We show how global data should, and should not, be used to assess refugee flood risk in Ethiopia; a country hosting 725 000 refugees, primarily from four neighboring countries, in 24 camps. We find that global population (GP) datasets, typically used in national flood risk assessments, do not accurately capture camp populations (CPs). Even the most accurate GP datasets are missing three fifths of camp flood exposure. We propose, and test, alternative approaches for representing exposure that combine reported estimates of CP with data on camp area, building footprints, and population density. Applying these approaches in our national flood risk assessment, we find that 95.8% of camps in Ethiopia are exposed to flooding of some degree and between 143 208 (19.8%) and 182 125 refugees (25.2%) are exposed to a 1% annual exceedance probability flood (100 year return period). South Sudanese refugees are the nationality most exposed to flooding, but Eritrean refugees are the nationality most exposed to flooding with a high risk to life. Promisingly, we find that many camps may be set up in such a way that reduces the exposure of refugees to flooding. Our study demonstrates that global data, augmented with local data, can be useful for understanding the flood risk of refugee camps. The consistent scalable approach can be used as a first-order analysis of risk, identifying risk hotspots, and help to prioritize further detailed analyses to inform within-camp adaptation.

Attitudes of Refugees Towards Integration: The Experience of South Sudanese Refugees in Adjumani District in Uganda.

The question of how socioeconomic situations in and around refugees' settlement in Uganda affect their motivation and attitudes towards integration has not been clearly addressed in the literature. To address this gap, this study explores the integration framework, and uses thematic and content analysis to analyse data collected via in-depth interviews and focus group discussions. The study finds that access to socioeconomic factors such as livelihood opportunities and social services, especially education and health, can either motivate and positively affect refugees' attitudes, or demotivate and negatively affect refugees' attitudes towards integration in the host community. Other motivating factors were family history and success stories of refugees who were successfully integrated in the host community. Suggestions for improving refugee integration included empowerment in vocational skills, access to grants and loans, access to land for agriculture, and access to labour market. These require greater cooperation among different stakeholders, including policy makers, nongovernmental organisations, international organisations, and governments, to coalesce resources and buttress integration of refugees in the host society.

Durable Resolutions

Abstract Studies that examine the administration of justice in refugee camps highlight the legal plurality that commonly characterizes such sites, and the normative friction it creates between government and humanitarian institutions and community structures. Drawing upon research among South Sudanese refugees in Uganda and Ethiopia, this article foregrounds the place of transnational networks and temporal experiences in shaping processes of dispute resolution among refugees. South Sudanese refugees regularly turn to community structures to arbitrate disputes, even when these disputes relate to crimes that, under the laws of host states, must be reported to the authorities. As opposed to the individualized formal justice systems of host states, which are limited by borders, community justice links refugees across countries, draws on understandings of past communal events and relationships, prioritizes communal harmony and order, and thus produces a sense of continuity under conditions of dispersal and extreme precarity.

On the Fringes of Aid: Humanitarian Organisations and Sudanese Refugees in the Democratic Republic of Congo, 1966–1972

Abstract Thousands of Southern Sudanese refugees fled southward into the Orientale province of the Democratic Republic of Congo in the late 1960s. This article examines the challenges posed by fragmentary archival sources from humanitarian organisations, and a small number of interviews, for understanding the actions of Sudanese refugees as they entered a province already battered by civil war. Expatriate staff struggled to negotiate with the Congolese and Sudanese governments, who both wanted to limit the threat of rebels. Furthermore, the particular goals and recordkeeping methods of humanitarian organisations post major challenges for interpreting the sources. However, oral testimonies of former aid workers and refugees demonstrate that Sudanese refugees did clearly shape their journeys and how they negotiated with refugee assistance programmes. This article thus offers new perspectives for researchers on the value and pitfalls of various individual humanitarian agency records.

Breastfeeding among South Sudanese refugees in protracted settlements in Adjumani district, Uganda: facilitators and barriers

BackgroundEvidence suggests that forced migration and refugee status may adversely impact mothers’ breastfeeding choices. Furthermore, suboptimal breastfeeding practices have been reported among vulnerable populations including those living in refugee settlements. Therefore, this study investigated the barriers and facilitators of breastfeeding in protracted settlements in Adjumani district, in the West Nile region in Uganda.MethodsThis study was conducted among refugees living in protracted settlements located in Uganda in July 2019. Participants, originally from South Sudan, included mothers (n = 63) and fathers (n = 32) of children less than 24 months of age. Agojo, Ayilo-I, and Nyumanzi were randomly selected among the 17 refugee settlements in Adjumani. Participants formed a total of six focus group discussions (FGDs); four FGDs for mothers and two FGDs for fathers. Each FGD consisted of 15–16 participants. Data were transcribed verbatim and back-translated into English. Thematic analysis was used and data were analyzed using NVivo, v. 12.ResultsFacilitators of breastfeeding included knowledge of breastfeeding benefits, support from husband/father, support from the community, and support from non-governmental organizations. Mothers and fathers noted that breastfeeding protected children from diseases and breastfed children grew well. Fathers, the community, and organizations provided material support for breastfeeding mothers. Four themes were identified as barriers to breastfeeding: physical, socioeconomic, knowledge, and psychosocial. Mothers and fathers described physical barriers such as mothers stop breastfeeding when they are sick or they feel they are not producing enough breastmilk. Mothers reported that working or educated mothers may use other milk to feed their infant. Some mothers and fathers believed infants under six months needed more than breastmilk. Fathers described psychosocial barriers such as mothers’ fear of pain during breastfeeding and maternal mental health issues.ConclusionInterventions and policies that aim to improve breastfeeding in protracted settlements should consider addressing the barriers to breastfeeding at each level: physical, socioeconomic, knowledge, and psychosocial. Involving and encouraging support from husbands/fathers, relatives, and the community may increase adherence to breastfeeding recommendations.

Psychological Capital and Quality of life of Refugees in Uganda During COVID-19 Pandemic: A Serial Mediation Model.

Background: The COVID-19 pandemic has in the past two years caused and continues to cause enormous effects on lifestyle, mental health, and quality of life. With no known treatment and vaccination, behavioral control measures became central in controlling the pandemic. However, the intensity of the pandemic and the stringent control measures were immensely stressful. The control measures became an added psychological burden to people living in precarious situations such as refugees in low-income countries. Purpose: Given the benefits of psychological capital, the present study aimed at investigating the role of psychological capital in enhancing the quality of life among refugees in Uganda during the COVID-19 pandemic. It was hypothesized that the effects of psychological capital on quality of life are serially mediated through coping strategies, adherence to COVID-19 control measures, and mental health. Methods: Data was collected using a self-administered questionnaire in July and August 2020 after the first lockdown. Participants were 353 South Sudanese and Somali refugees living in Kampala city suburbs and Bidibidi refugee settlement. Findings: Psychological capital was positively associated with approach coping, mental health, and quality of life. However, psychological capital was negatively associated with adherence to COVID-19 control measures. Significant indirect effects of psychological capital on quality of life through approach coping, mental health, and adherence were found. However, serial mediation effects were only substantial via approach coping and mental health. Conclusion: Psychological capital is an important resource in coping with the challenges posed by COVID-19 and maintaining a good level of psychological functioning and quality of life. Preserving and boosting psychological capital is essential in responding to COVID-19 and other related disasters and crises, which are common in vulnerable populations such as refugee communities in low-income countries.

Durable Displacement and the Protracted Search for Solutions: Promising Programs and Strategies

In March 2022, the Center for Migration Studies of New York (CMS) released a request for papers (RFP) for a special issue of its Journal on Migration and Human Security (JMHS), devoted to identifying solutions to situations of protracted displacement. The co-editors selected 10 papers for this special issue by authors from a dozen countries, including two refugees. The papers cover several large populations in protracted displacement, as well as other less-publicized groups. The former include: Rohingya refugees in Cox’s Bazar, Bangladesh; Internally displaced persons (IDPs) living on the outskirts of Baku, Azerbaijan; Afghans in Pakistan since the 1970s; Syrians in Turkey since 2011; Syrian, Iraqi, Yemeni, Sudanese, Somali, and Iranian refugees in Turkey, Jordan, and Lebanon; IDPs and Venezuelan migrants in Colombia; Somali refugees in Ethiopia and Kenya; Central Americans seeking protection in Mexico and the United States; and IDPs in Northern Mexico who have been displaced and stranded due to violence, deportation, and US and Mexican asylum policies. This paper introduces and integrates the themes and recommendations from this special issue. Section 1 provides a short overview of the scope, growth, and consequences of protracted displacement. Section 2 situates this phenomenon in a legal context and examines traditional and complementary solutions to displacement. Section 3 outlines topline findings, recommendations, and cross-cutting themes from the special issue. Section 4 offers conclusions and final reflections.

Immigration: An American History by Carl J. Bon Tempo and Hasia R. Diner

In this book, Bon Tempo and Diner provide a readable and expansive survey of U.S. immigration history. Moving briskly from the seventeenth century to the present day, they chart the twists and turns in U.S. immigration patterns, policies, and bureaucracies, as well as in the lives of U.S. immigrants. Along the way, they incorporate many recent, important trends in immigration historiography—including an emphasis on race and racism, on immigrants from all over the world (both women and men), and on its transnational dimensions (notwithstanding the subtitle “American History”). They also dot their narrative with compelling personal stories of varied, lesser-known immigrants—Irish union leader Leonora Barry; Sudanese refugee Achut Deng; Louise Norton, Malcolm X’s mother, who migrated to the United States from the West Indies by way of Canada; and struggling Chinese artist Qiming Lui.In a book of such breadth, central arguments can be difficult to decipher, but Bon Tempo and Diner stress two of them. The first is the “primary significance [of] … economic matters”—especially “work and the nation’s labor needs”—“in explaining the United States’ immigration history” (4). The second is the centrality of the state in determining which immigrants could come to the United States, which of them could stay, which of them could become full-fledged members of the nation, and which of them could access a full range of rights, protections, and resources in their new home. In concluding, the authors highlight three surprisingly straightforward historical themes that “best arm our readers as the story of immigration and the United States continues to unfold” (362). In addition to the argument above about the state’s importance, they insist that “immigrants came to North America in search of a better life” and that they “are like us” (362, 363).In making these and other claims, Bon Tempo and Diner draw from a mix of sources, including government and think-tank reports, newspaper and magazine articles, memoirs, oral histories, and even an occasional YouTube video, campaign advertisement, or protest poster. But their main source is the scholarship of historians and, to a lesser extent, political scientists, sociologists, economists, legal scholars, anthropologists, and others. Hence, the book has a faint interdisciplinary flavor. Its main audience, however, appears to be non-specialists in immigration history, as fine an audience as any but one that brings some disadvantages, especially for readers of this journal. In their understandable effort to keep the story moving, Bon Tempo and Diner tend to shy away from any deep engagement with the big theoretical debates that roil much of the immigration scholarship. For example, they avoid any analysis of the extent to which political institutions, political traditions, social forces, economic interests, cultural dynamics, or some combination thereof is responsible for the many shifts in U.S. immigration policy over time. Nor do they interrogate the role that capitalism, in its various configurations, played. Is it true, as one scholar recently suggested, that the “interests and strategies of capital” have largely determined U.S. immigration policy over the years?1 For a book that places “economic matters” at the center of the story, it is surprising that the authors seldom address these issues systematically.Immigration is nonetheless a valuable, far-reaching history. Those wishing for more interdisciplinarity and theory, however, might consult older overviews by Ngai, Tichenor, and Zolberg.2

Inclusive refugee-hosting can improve local development and prevent public backlash

Large arrivals of refugees raise concerns about potential tensions with host communities, particularly if refugees are viewed as an out-group competing for limited material resources and crowding out public services. To address these concerns, calls have increased to allocate humanitarian aid in ways that also benefit host communities. This study tests whether the increased presence of refugees, when coupled with humanitarian aid, improves public service delivery for host communities and dampens potential social conflict. We study this question in Uganda, one of the largest and most inclusive refugee-hosting countries. The data combines geospatial information on refugee settlements with original longitudinal data on primary and secondary schools, road density, health clinics, and health utilization. We report two key findings. First, even after the 2014 arrival of over 1 million South Sudanese refugees, host communities with greater refugee presence experienced substantial improvements in local development. Second, using public opinion data, we find no evidence that refugee presence has been associated with more negative (or positive) attitudes towards migrants or migration policy.

A Peer-Led Integrated Nutrition Education Intervention through Care Groups Improved Complementary Feeding of Infants in Postemergency Settlements in the West-Nile Region in Uganda: A Cluster Randomized Trial

BackgroundComplementary feeding of infants in refugee settlements remains inadequate. Furthermore, there has been limited evaluation of interventions addressing these nutrition challenges. ObjectiveThis study examined the effects of a peer-led integrated nutrition education intervention on infant complementary feeding by South Sudanese refugee mothers in the West-Nile region in Uganda. MethodsA community-based randomized trial enrolled 390 pregnant women (during third trimester) as the baseline. Two arms [mothers-only and parents-combined (both mothers and fathers)] comprised treatments with a control. Infant feeding was assessed using WHO and UNICEF guidelines. Data were collected at Midline-II and Endline. The medical outcomes study (MOS) social support index was used to measure social support. An overall mean score of >4 was considered optimal social support, a score of ≤2 was none or little support. Adjusted multivariable logistic regression models determined the effects of the intervention on infant complementary feeding. ResultsAt the end of the study, infant complementary feeding improved significantly in both mothers-only and parents-combined arms. There was a positive effect on the introduction of solid, semisolid, and soft foods (ISSSF) in the mothers-only arm at both Midline-II {adjusted odds ratio (AOR) = 4.0]} and Endline (AOR = 3.8). Likewise, ISSSF was better for the parents-combined arm at both Midline-II (AOR = 4.5) and Endline (AOR = 3.4). Minimum dietary diversity (MDD) was significantly better at the Endline for the parents-combined arm (AOR = 3.0). Minimum acceptable diet (MAD) was significantly better at Endline for both mothers-only (AOR = 2.3) and parents-combined arms (AOR = 2.7). Infant consumption of eggs and flesh foods (EFF) was improved only in the parents-combined arm at both Midline-II (AOR = 3.3) and Endline (AOR = 2.4). Higher maternal social support was associated with better infant MDD (AOR = 3.3), MAD (AOR = 3.6), and EFF (AOR = 4.7). ConclusionEngaging both fathers and mothers in care groups benefited complementary feeding of infants. Overall, this peer-led integrated nutrition education intervention through care groups improved infant complementary feeding in the West-Nile postemergency settlements in Uganda.This trial was registered at clinicaltrials.gov as NCT05584969.

Did the Arab Spring generate affective polarization? Experimental evidence from five Arab countries

ABSTRACT We examine whether disagreements about the Arab Spring uprisings, in five countries that experienced protests, have transitioned into the non-political sphere. To test this spillover effect, we ask two questions: (a) does interacting with fellow nationals who have opposing attitudes towards the Arab Spring generate less pro-social behaviour compared to situations where such disagreements are absent, and (b) whether the degree of affective polarization – if it exists – depends on the severity of the uprising’s outcome. We explore these questions by running two lab-in-the-field experiments – measuring fairness and interpersonal trust – with 1274 subjects from five Arab countries: Syrian refugees, Sudanese refugees, Jordanians, Tunisians and Egyptians. We find significant results on both fairness and trust among the Syrian sample – who experienced the most violent version of the events – and partly among Sudanese refugees. Our findings indicate that the intensity of political polarization (particularly turning it into a violent conflict and generating refugees) is critical in producing the hypothesized spillover effect of affective polarization.

Critical Roles of Refugee Leaders and Service Providers in the Gender-based Violence (GBV) Help-Seeking of Refugee Survivors

Gender-based violence (GBV) is a complicated challenge embedded in displaced people’s lived experiences throughout the conflict displacement cycle. Despite the awareness of existing institutionalised help-seeking referral pathways, these do not necessarily translate to the full utilisation of such services. This paper examines the critical role of refugee leaders and service providers in potentially enabling and realising a GBV survivor’s help-seeking. By adapting a meso-level analysis, it attempts to explain how social networks built within conflict and displacement contribute to responding to GBV. Based on the review of collected interviews in 2019 from refugee leaders and service providers working with South Sudanese refugees in selected settlements in Uganda, the paper reflects on the importance of network, norms and trust in effectively responding to GBV in conditions of conflict-affected displacement.