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This paper describes how socio-ecological theory and a syndemic health systems and public health approach may help address the plight of youth in situations of political violence and humanitarian emergencies. We describe the treatment gap caused by discrepancies in epidemiological prevalence rates, individual and family needs, and available human and material resources. We propose four strategies to develop a participatory public health approach for these youth, based on principles of equity, feasibility, and a balance between prevention and treatment. The first strategy uses ecological and transgenerational resilience as a theoretical framework to facilitate a systems approach to the plight of youth and families. This theoretical base helps to engage health care professionals in a multisectoral analysis and a collaborative public health strategy. The second strategy is to translate pre-program assessment into mental health and psychosocial support (MHPSS) priorities. Defining priorities helps to develop programs and policies that align with preventive and curative interventions in multiple tiers of the public health system. The third is a realistic budgetary framework as a condition for the development of sustainable institutional capacity including a monitoring system. The fourth strategy is to direct research to address the knowledge gap about effective practices for youth mental health in humanitarian settings.

BackgroundResearch suggests that in environments where community conflict and violence are chronic or cyclical, caregiving can impact how children may begin to reproduce violence throughout the various stages of their lives. The aim of this study is to understand how caregiving affects processes of reproducing violence and resilience among children in conflict-affected Burundi.MethodsWe combined a socio-ecological model of child development with a child-actor perspective. We operationalized the core concepts ‘vulnerable household’, ‘resilience’, and ‘caregiving’ iteratively in culturally relevant ways, and put children's experiences at the center of the inquiry. We carried out a comparative case study among 74 purposively sampled vulnerable households in six collines in three communes in three provinces in the interior of Burundi. Burundian field researchers conducted three consecutive interviews; with the head of the household, the main caregiver, and a child.ResultsOur findings reveal a strong congruence between positive caregiving and resilience among children. Negative caregiving was related to negative social behavior among children. Other resources for resilience appeared to be limited. The overall level of household conditions and embedment in communities attested to a generalized fragile ecological environment.ConclusionsIn conflict-affected socio-ecological environments, caregiving can impact children's functioning and their role in reproducing violence. Interventions that support caregivers in positive caregiving are promising for breaking cyclical violence.

The present study aimed to examine the factor structure of the Childhood Trauma Questionnaire (CTQ; Bernstein & Fink, 1998), highlight rates of abuse and neglect among Burundian adolescents, compare these rates with those found in high-income nations, and examine the cumulative effect of multiple types of abuse and neglect on depression and PTSD symptoms. Participants were 231 adolescents and youth (M=14.9, SD=1.99, 58.4% female) from five provinces of Burundi, a country in Central Africa affected by war and political violence. Translation and back-translation of the CTQ was carried out to obtain an adaptation of CTQ in Kirundi, the native language of Burundi. With the exception of one item on 'molestation' in the factor of sexual abuse, the five-factor structure of CTQ was obtained comprising latent factors, namely emotional, physical, and sexual abuse, and emotional and physical neglect. The rate of abuse and neglect ranged from 14.7-93.5% with more than 37% reporting 4 or more types of abuse and neglect experiences. Emotional abuse and neglect, and physical neglect were 2-3 times higher among Burundian adolescents when compared with studies from high-income countries using the CTQ. A cumulative effect of multiple types of abuse and neglect was found, such that, those with 4 or more types of maltreatment were higher on symptoms of depression and posttraumatic stress. Findings highlight the need for culturally sensitive, standardized, and validated measures and norms for gauging childhood maltreatment in Burundi and related need for preventative interventions on childhood maltreatment.

Abstract:The 1994 genocide against the Tutsi in Rwanda and its aftermath led to large-scale individual traumatization, disruption of family structures, shifts in gender roles, and tensions in communities, which are all ongoing. Previous research around the world has demonstrated the transgenerational effects of mass violence on individuals, families and communities. In Rwanda, in light of recurrent episodes of violence in the past, attention to the potential 'cycle of violence' is warranted. The assumption that violence is passed from generation to generation was first formulated in research on domestic violence and child abuse, but is receiving increasing attention in conflict-affected societies. However, the mechanisms behind intergenerational transmission are still poorly understood. Based on qualitative research with 41 mothers and their adolescent children, we investigated how legacies of the 1994 genocide and its aftermath are transmitted to the next generation through processes in the family environment in Rwanda. Our findings reveal direct and indirect pathways of transmission. We also argue that intergenerational effects might best be described as heterotypic: genocide and its aftermath lead to multiple challenges in the children's lives, but do not necessarily translate into new physical violence. Further research is needed on how children actively engage with conflict legacies of the past.

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In this article, we explore the precarity of rural youth livelihoods in the aftermath of war in eastern Burundi. Combining ideas from agrarian studies and youth studies, we argue that a generational approach helps to expose structural problems of reproduction in rural communities. In the aftermath of civil war, young men and women experience their livelihoods and preparations for independent householding as 'lacking'. They are aware of the unsustainability of current practices of land inheritance and farming, and their concerns orient them to other livelihood possibilities. Their responses to difficulties in social reproduction vary. Formal (secondary) education and gender in particular affect strategies of circular migration and marriage, and expose young people to hardship and violence in different ways. However, in contrast to what is often assumed in studies of rural African youth, most young people do aspire to a farming future, at some time and under better conditions. Nous explorons les ressources des jeunes ruraux dans l'est du Burundi après la guerre. En combinant des idées à partir des études agraires et des études sur la jeunesse nous défendons qu'une approche générationnelle assiste à exposer les problèmes structurels de la reproduction sociale des communes rurales. Les jeunes hommes et femmes éprouvent leurs moyens de subsistance et les préparations pour vivre en ménage indépendant comme 'insuffisant'. Ils sont conscients que leur mode d'héritage des terres et la façon de les cultiver ne sont plus durables, cela les orientent vers des alternatives pour « trouver la vie ». Notamment, l'éducation formelle et du genre influencent les stratégies de la migration circulaire et du mariage, et expose les jeunes aux épreuves et aux violences en différentes manières. Contrairement aux suppositions souvent exprimées concernant les jeunes ruraux africains, la majorité des jeunes aspire à un avenir dans l'agriculture, dans des conditions meilleures.

Literature on political vigilante groups has centred on the violence and conflict that emanate from their activities. This article approaches political vigilante groups as political actors who engage in political mobilisation and participation and therewith also contribute to nation state building. It explores how such groups participate in Ghana’s democratic governance and asks whether violence is an inevitable characteristic. The article builds on individual in-depth interviews and focus group discussions with political vigilante group members in Kumasi and Tamale in 2019. Findings show that political vigilante “youth” appeared to refer primarily to the social position attributed to non-elite groups in the political field. Political vigilante groups are multi-faceted in their organisational structures, membership, and activities both during electoral campaigns and during governing periods. While some groups revert to violence occasionally, the study concludes that political vigilante groups, in enabling different voices to be heard, are also contributing to democratic governance.