TY - JOUR

T1 - Multilevel determinants of integrated service delivery for intimate partner violence and mental health in humanitarian settings

AU - Claire Greene, M.

AU - Bencomo, Clarisa

AU - Rees, Susan

AU - Ventevogel, Peter

AU - Likindikoki, Samuel

AU - Nemiro, Ashley

AU - Bonz, Annie

AU - Mbwambo, Jessie K.K.

AU - Tol, Wietse A.

AU - McGovern, Terry M.

N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021

Y1 - 2021

N2 - Inter-agency guidelines recommend that survivors of intimate partner violence in humanitarian settings receive multisectoral services consistent with a survivor-centered approach. Providing integrated services across sectors is challenging, and aspirations often fall short in practice. In this study, we explore factors that influence the implementation of a multisectoral, integrated intervention intended to reduce psychological distress and intimate partner violence in Nyarugusu Refugee Camp, Tanzania. We analyzed data from a desk review of donor, legal, and policy documents; a gender-based violence services mapping conducted through 15 interviews and 6 focus group dis-cussions; and a qualitative process evaluation with 29 stakeholders involved in the implementation of the integrated psychosocial program. We identified the challenges of implementing a multisec-toral, integrated intervention for refugee survivors of intimate partner violence at the structural, inter-institutional, intra-institutional, and in social and interpersonal levels. Key determinants of successful implementation included the legal context, financing, inter-agency coordination, engagement and ownership, and the ability to manage competing priorities. Implementing a multisectoral, integrated response for survivors of intimate partner violence is complex and influenced by inter-related factors from policy and financing to institutional and stakeholder engagement. Further in-vestment in identifying strategies to overcome the existing challenges of implementing multisec-toral approaches that align with global guidelines is needed to effectively address the burden of intimate partner violence in humanitarian settings.

AB - Inter-agency guidelines recommend that survivors of intimate partner violence in humanitarian settings receive multisectoral services consistent with a survivor-centered approach. Providing integrated services across sectors is challenging, and aspirations often fall short in practice. In this study, we explore factors that influence the implementation of a multisectoral, integrated intervention intended to reduce psychological distress and intimate partner violence in Nyarugusu Refugee Camp, Tanzania. We analyzed data from a desk review of donor, legal, and policy documents; a gender-based violence services mapping conducted through 15 interviews and 6 focus group dis-cussions; and a qualitative process evaluation with 29 stakeholders involved in the implementation of the integrated psychosocial program. We identified the challenges of implementing a multisec-toral, integrated intervention for refugee survivors of intimate partner violence at the structural, inter-institutional, intra-institutional, and in social and interpersonal levels. Key determinants of successful implementation included the legal context, financing, inter-agency coordination, engagement and ownership, and the ability to manage competing priorities. Implementing a multisectoral, integrated response for survivors of intimate partner violence is complex and influenced by inter-related factors from policy and financing to institutional and stakeholder engagement. Further in-vestment in identifying strategies to overcome the existing challenges of implementing multisec-toral approaches that align with global guidelines is needed to effectively address the burden of intimate partner violence in humanitarian settings.

KW - Gender-based violence

KW - Humanitarian

KW - Integrated care

KW - Intimate partner violence

KW - Mental health

KW - Multisectoral

U2 - 10.3390/ijerph182312484

DO - 10.3390/ijerph182312484

M3 - Journal article

C2 - 34886211

AN - SCOPUS:85119918068

VL - 18

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

SN - 1661-7827

IS - 23

M1 - 12484

ER -