42. Effects of conflict on women's reproductive health need to be recognised and managed

Clinicians need to be sensitive and aware of the unique challenges of women's reproductive health needs in times of conflict, suggests a review published in The Obstetrician & Gynaecologist (TOG).

Approximately 1.5 billion people are currently living in countries affected by conflict, fragility or large-scale violence. Women and children account for approximately 75% of those displaced by conflict and roughly 20% of those displaced are women of reproductive age and one in five will be pregnant.

This new review looks at how conflict can negatively impact all aspects of reproductive health, directly through damage to services, gender-based violence and forced displacement of populations and indirectly through reductions in the availability of basic healthcare.

The review states that gender-based violence, sexually transmitted infections (including HIV), and maternal and neonatal mortality and morbidity all flourish in times of conflict. Furthermore, the loss of access to adequate family planning and basic health services also increases reliance on traditional or harmful methods, including unsafe termination of pregnancy.

41. Giving Birth in Conflict Zones Like Congo - video

In conflict zones women in labor are unlikely to make it to a qualified doctor – much less a hospital. So they have to rely on a Clean Delivery Kit provided by the agencies, which consists of a sterile plastic sheet, soap, gloves, some tape and a razor.

View at: http://www.parentdish.com/videos-partner/giving-birth-in-conflict-zones-like-congo-460503321-210

40. Mental Health and Conflicts: Conceptual Framework and Approaches (pdf 2005)

By Florence Baingana, Ian Bannon and Rachel Thomas

Paper prepared for World Bank, Health, Nutrition and Population, Human Development Network, with the support of the National Institute of Mental Health of the US Government.

Abstract

The paper provides an overview of the Bank's role in conflict and development, and explores the links between poverty, social capital and mental and psychosocial disorders in conflict settings. The premise of the paper is that increased understanding and targeted interventions to deal with mental health can play an important role in effective post-conflict reconciliation and reconstruction.

It also argues that there are effective approaches that can be adapted to different conflict settings. The paper presents a conceptual framework based on experiences in and outside the Bank that can help guide interventions and approaches to address mental health and psychosocial disorders in conflict-affected countries.

The paper briefly examines mental health approaches adopted by the Bank in West Bank and Gaza, Bosnia-Herzegovina, Uganda, Burundi and Afghanistan. These brief country illustrations suggest there are a variety of approaches and a growing body of experience on which Bank country teams can draw.

The paper concludes by noting areas where additional research would seem appropriate and presenting suggestions for further Bank analytical and operational work.

Go to: http://hpod.pmhclients.com/pdf/baingana-mental-health.pdf

39. An intervention to improve mental health care for conflict-affected forced migrants in low-resource primary care settings: a WHO MhGAP-based pilot study in Sri Lanka (COM-GAP study) (2013)

By Chesmal Siriwardhana*, Anushka Adikari, Tine Van Bortel, Paul McCrone and Athula Sumathipala

* Corresponding author: Chesmal Siriwardhana - This email address is being protected from spambots. You need JavaScript enabled to view it.

Background

Inadequacy in mental health care in low and middle income countries has been an important contributor to the rising global burden of disease. The treatment gap is salient in resource-poor settings, especially when providing care for conflict-affected forced migrant populations. Primary care is often the only available service option for the majority of forced migrants, and integration of mental health into primary care is a difficult task.

The proposed pilot study aims to explore the feasibility of integrating mental health care into primary care by providing training to primary care practitioners serving displaced populations, in order to improve identification, treatment, and referral of patients with common mental disorders via the World Health Organization Mental Health Gap Action Programme (mhGAP).

The electronic version of this article is the complete one and can be found online at: http://www.trialsjournal.com/content/14/1/423