Trauma Intervention in Sub-Saharan African Children: A Systematic Literature Review

Abstract

Sub-Saharan Africa is a part of the world that is highly affected by a large number of atrocities, causing a myriad of financial, physical health, and mental health consequences. Yet, unfortunately, according to the World Health Organization (WHO), this is also the part of the world that is least served by mental health services. In response, the WHO has created mandates to increase mental health resources and capacity in all countries. Researchers have taken on the work of introducing and adapting treatments in various sub-Saharan African countries with an aim to create sustainable, evidence-based treatment in a part of the world with high need. The current qualitative systematic review of the literature examines 20 articles that report on research conducted in sub-Saharan African countries with children who have suffered different types of traumas. This review answers questions concerning the types of treatments used, the people administering the treatments, the measures they take to adapt these treatments, and the types of outcomes that are seen. Overall, the majority of treatments being used are shown to be effective with the associated populations.

The impact of mental health and psychosocial support programmes on children and young people’s mental health in the context of humanitarian emergencies in low- and middle-income countries: A systematic review and meta-analysis

“…We identified several research gaps. In sub-Saharan Africa, although more than one-fifth of global refugees and internally displaced persons are hosted in countries such as the Central African Republic (CAR), the Democratic Republic of the Congo (DRC), Somalia and South Sudan (UNHCR, 2018 ), our systematic review identifies the paucity of rigorous evidence to inform the design and implementation of MHPSS programmes in this region, in line with the recent meta-review focusing on vulnerable African children (Katsonga-Phiri et al, 2019 ). Secondly, there is increasing recognition of the need to develop MHPSS programmes that are tailored to girls’ and boys’ needs, considering the social determinants of their individual psychological health and well-being (Purgato et al, 2018b ; Raslan et al, 2021 ; Lasater et al, 2022 ).…”

Comparing factor models of posttraumatic stress disorder (PTSD) with Somali refugee youth in Kenya: An item response theory analysis of the PTSD Checklist–Civilian Version.

“…Our study suggests that the PCL-17 offers a promising item set that can be utilized to assess PTSD in Somali youth, and that the EN model should be considered as a potential factor model in future research aimed at developing and/or modifying measures of posttraumatic stress among Somali youth. Consideration of the EN model is particularly important given that the majority (66%) of published articles on interventions with Sub-Saharan children document interventions that are rooted in cognitive–behavioral therapy (Katsonga-Phiri et al, 2017), and, as previously discussed, those with higher levels of numbing symptoms may be less likely to benefit from such interventions.…”

“…Despite the high rate of traumatic atrocities that occur in sub-Saharan Africa, this region is a part of the world that is underserved by mental health services (Katsonga-Phiri, Grant, & Brown, 2017). A recent systematic literature review of interventions with sub-Saharan African children and adolescents (birth to 19 years) noted that trauma symptoms are main outcomes assessed by mental health interventions with children in this region (Katsonga-Phiri et al, 2017). There is critical need to assess the effectiveness and longitudinal impact of these early interventions on PTSD symptomology throughout adolescence and young adulthood.…”

The mental health consequences on children of the war in Ukraine: A commentary

“…Indeed, many trauma counseling methods are culturally inappropriate in settings outside of where they are developed. This highlights how essential it is that all decisions and interventions be informed locally and nationally to ensure culturally appropriate and adapted therapeutic methods (for reviews see: Ehntholt and Yule, 2006;Gillies et al, 2016;Katsonga-Phiri et al, 2019;Sullivan and Simonson, 2016;Thomas et al, 2022). However, there is little guidance on how to deliver mental health interventions that are suitable for conflict settings specifically (Gaffey et al, 2021), and naturally delivery, coverage and effectiveness of interventions of mental health and psychosocial support will necessarily vary as a function of whether the conflicts are in low or middle-income countries (Kamali et al, 2020).…”