Exploring resource scarcity and contextual influences on wellbeing among young refugees in Bidi Bidi refugee settlement, Uganda: findings from a qualitative study

Abstract

Background Contextual factors including poverty and inequitable gender norms harm refugee adolescent and youths’ wellbeing. Our study focused on Bidi Bidi refugee settlement that hosts more than 230,000 of Uganda’s 1.4 million refugees. We explored contextual factors associated with wellbeing among refugee adolescents and youth aged 16–24 in Bidi Bidi refugee settlement. Methods We conducted 6 focus groups (n = 3: women, n = 3: men) and 10 individual interviews with young refugees aged 16–24 living in Bidi Bidi. We used physical distancing practices in a private outdoor space. Focus groups and individual interviews explored socio-environmental factors associated with refugee youth wellbeing. Focus groups were digitally recorded, transcribed verbatim, and coded by two investigators using thematic analysis. Analysis was informed by a social contextual theoretical approach that considers the interplay between material (resource access), symbolic (cultural norms and values), and relational (social relationships) contextual factors that can enable or constrain health promotion. Results Participants included 58 youth (29 men; 29 women), mean age was 20.9 (range 16–24). Most participants (82.8%, n = 48) were from South Sudan and the remaining from the Democratic Republic of Congo (17.2% [n = 10]). Participant narratives revealed the complex interrelationships between material, symbolic and relational contexts that shaped wellbeing. Resource constraints of poverty, food insecurity, and unemployment (material contexts) produced stress and increased sexual and gender-based violence (SGBV) targeting adolescent girls and women. These economic insecurities exacerbated inequitable gender norms (symbolic contexts) to increase early marriage and transactional sex (relational context) among adolescent girls and young women. Gendered tasks such as collecting water and firewood also increased SGBV exposure among girls and young women, and this was exacerbated by deforestation. Participants reported negative community impacts (relational context) of COVID-19 that were associated with fear and panic, alongside increased social isolation due to business, school and church closures. Conclusions Resource scarcity produced pervasive stressors among refugee adolescents and youth. Findings signal the importance of gender transformative approaches to SGBV prevention that integrate attention to resource scarcity. These may be particularly relevant in the COVID-19 pandemic. Findings signal the importance of developing health enabling social contexts with and for refugee adolescents and youth.

Gender Dimensions of Climate Insecurity

“…138 Within the camp, women and girls have been primarily responsible for gathering water and firewood. 139 This corresponds with broader trends, with cultural norms in many localities placing this responsibility on women and girls. 140 One study shows that ecological deterioration including deforest ation has led to increased resource scarcity.…”

Using Land to Promote Refugee Self-Reliance in Uganda

“…While there is literature on Uganda's refugee policy and self-reliance [6,[9][10][11][12][13][14][15][16], it focuses on the policy and not the planning process of establishing the physical settlement and the resulting outcomes. Additionally, while there have been some UN evaluations of Bidi Bidi, few academic investigations have been published despite its position as the largest refugee settlement in Uganda (see [56]).…”

Ngutulu Kagwero (agents of change): study design of a participatory comic pilot study on sexual violence prevention and post-rape clinical care with refugee youth in a humanitarian setting in Uganda

“…Qualitative research was conducted with refugee youth sexual violence survivors, elders, healthcare providers, and police officers to understand sexual violence drivers and facilitators (focus groups) and post-rape clinical care experiences and recommendations (in-depth interviews). The research team analyzed these qualitative data and worked together to develop scenarios for the comics [57].…”

“…Thematic analysis is a theoretically flexible analytic approach that involves six phases: 1) translating and transcribing the data, reading, and becoming familiar with the data; 2) developing codes across the entire data set with preliminary ideas; 3) exploring the ways that codes may reflect larger themes; 4) mapping the relationships between themes; 5) refining the themes and the overall story being generated by the data, including defining the themes; and 6) producing a report of the data by extracting selected data to reflect the themes, and tying the themes back to the existing literature [59]. We created eight scenarios for the comic book based on the emerging themes and findings from the analysis of qualitative data [57] that explored sexual violence experiences among youth and post-rape care preferences (Table 1). Each scenario is 1-2 pages in length in the comic book.…”