Improving Healthcare at the Intersection of Gender and Protracted Displacement amongst Somali and Congolese Refugees and Internally Displaced People, 2020-2024

Jeffery, Laura and Lowe, Lucy and Falisse, Jean-Benoit and Mahmud, Amina Jama and Furaha Mirindi, Germaine and Mutombo, Paulin Beya Wa Bitadi and Vearey, Joanna and Osur, Joachim and Dakessian, Arick (2025). Improving Healthcare at the Intersection of Gender and Protracted Displacement amongst Somali and Congolese Refugees and Internally Displaced People, 2020-2024. [Data Collection]. Colchester, Essex: UK Data Service. 10.5255/UKDA-SN-856947

This project aimed to help displaced people to access appropriate healthcare for long-term physical and mental health conditions associated with protracted displacement, conflict, and gendered violence. The category of Sexual and Gender-Based Violence (SGBV) receives a great deal of attention. However, there is limited research on how gendered violence, including violence relating to sexuality, is experienced in displacement contexts. There is also limited understanding of how gender, sexuality, and related violence affect access to healthcare, and how that can result in neglected chronic health conditions, particularly mental ill-health. Similarly, much attention is devoted to immediate healthcare needs following SGBV, but longer-term physical and mental health conditions are not adequately addressed. Displaced people face multiple barriers when seeking healthcare in protracted displacement settings, with the result that long-term health conditions are often misdiagnosed and mistreated or undiagnosed and untreated.

This project examined access to care and the responsiveness of healthcare providers for displaced Congolese and Somalis in Eastern Democratic Republic of Congo (DRC), Somali, Kenya, and South Africa. Eastern DRC and Somalia have both experienced long-term conflict and displacement since the early 1990s, leading to large populations of Internally Displaced People (IDPs) within these countries and large refugee populations across the region. Conflict and displacement in Eastern DRC and Somalia are characterised by high rates of sexual and gender-based violence, and victims are stigmatised through prevailing gender and sexual norms. Existing health research tends to focus on the immediate aftermath of violence rather than on long-term mental and physical health conditions. The project had eight field sites in four countries. The four IDP field sites were one formal camp and one informal settlement each in Eastern DRC and Somalia, both of which have weak health systems. The four refugee field sites were Congolese and Somali settlements in Kenya and South Africa, which have different health systems and different refugee laws and policies.

The project brought together researchers and practitioners from international development, migration studies, gender studies, medical anthropology, public health and health policy, and medical sciences to undertake interdisciplinary empirical research in these protracted displacement contexts. Panzi Foundation (DRC) and ARQ International (Netherlands) guided teams of researchers based at the University of Edinburgh (UK), the University of Kinshasa (DRC), the Somali Institute for Development and Research (Somalia), Amref International University (Kenya), and the University of Witwatersrand (South Africa). Project activities were designed to: 1) enhance the capacity of partner organisations; 2) support the inclusion of displaced people in healthcare systems; 3) foster international networks.

Data description (abstract)

The study aimed to acquire the following aims:
1) To support the right to healthcare and Universal Health Coverage (UHC) in contexts of protracted displacement and vulnerability (SDG3).
2) To improve gender equality in the context of gendered access to healthcare services (SDG5).

The main objectives were:
1) To identify and analyse current policy processes that respond to the health needs of forcibly displaced people and
thereby identify existing models for integrating those populations into health systems that could be made applicable to our
various protracted displacement contexts.
2) To identify key neglected chronic mental health conditions (and comorbid chronic physical health conditions) associated
with protracted displacement, conflict, and gendered violence.
3) To map the types and locations of healthcare providers that displaced people turn to for treatment for chronic mental
health conditions (and comorbid physical health conditions).
4) To document how gender and other factors influence health seeking by displaced people for physical and mental health
conditions associated with displacement, conflict and violence.

The research questions were:
1) What existing models for integrating displaced people into national healthcare systems could be applied in our protracted displacement contexts?
2) What mental health chronic conditions (and comorbid physical conditions) associated with displacement, violence, and gendered conflict are currently neglected in our field sites?
3) What types of healthcare providers do displaced people turn to for treatment for mental (and physical) ill-health conditions associated with displacement, conflict and violence?
4) How do gender and other factors influence whether and when displaced people seek treatment for mental and physical health conditions associated with conflict and violence?

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