Accessibility and availability of health care services to internally displaced persons, in Kitgum and Pader districts, northern Uganda

Introduction: During 1986-2009, an estimated 1.6 million persons were internally displaced from northern and eastern regions of Uganda due to civil war. We investigated accessibility to and availability of health care services for the internally displaced persons in Kitgum and Pader districts, northern Uganda. Methods: This was a cross-sectional study conducted in Kitgum and Pader districts, northern Uganda. We interviewed a total of 1383 respondents comprising 968 (70%) adults and 415 (30%) adolescents;60% were females and 40% males, randomly selected from 35 of 67 (52.2%) internally displaced persons (IDP) camps. We held 27 key informant interviews and 52 focus group discussions. Data were entered in EPI data version 3.02 and analysed using SPSS version 12.00 statistical packages. Findings: Two thirds of the respondents 67.5% lived within 5 km distance of a health facility. The majority 62.9% of respondents mentioned that health related information was readily provided. 43.5% of health providers were always available in a health facility. A quarter 25.1% of health facilities always had drugs available, while 56.9% of the drugs prescribed were always available. Two thirds of the respondents 65.9% were satisfied with the health care services provided. The main reasons for the choice of a health facility were proximity 29.6%, provision of free treatment 24.7% and availability of drugs 17.2%. Main barriers to health care access were due to the lack of financial resources, trained personnel, and inadequate drugs and supplies in the health facilities. Conclusions and Recommendations: The majority of IDPs lived in close proximity to health facilities and obtained health care services from public health facilities. Access to health care was determined mainly by proximity and availability of free services and drugs. Although geographic accessibility to health services was high, lack of finances, information and decision power hindered access to health care services.

Prevalence of <i>Helicobacter pylori</i>Infection among Internally Displaced Persons from Bakassi Peninsular and Etim Ekpo in South Southern, Nigeria

Helicobacter pylori (H. pylori), is an important global infection with a worldwide prevalence of about 40 percent. This infection is contagious and mostly acquired during childhood through the fecal-oral and oral-oral route. A total of 1560 blood specimens were aseptically collected from Internally Displaced Persons comprising female and male from the warring communities of Bakassi Peninsular and Etim Ekpo Local Government Area in South Southern, Nigeria. The specimens were screened for H. pylori using Elisa kits following standard serological techniques. The overall prevalence rate was 464 (29.7%). There was significant difference (p H. pylori infection;its distribution varied between age group, educational status, habits or behaviors of the subjects with children within 5 to 14 years having the highest rate of 274 (17.6%), followed by 78 (4.99%) from adults (51 years and above) and 17 (1.08%) from active age range of 36 - 45 years old. Subjects with primary and quranic level of education showed a total of 274 (17.56%) positive cases to H. pylori. Analysis of sex-specific distribution revealed that females had the highest prevalence of 312 (20%). The helicobacter infection shows a significant difference at (p H. pylori infection. Crowding in camps and increasing household contact have been considered as risk factors of H. pylori infection. Adequate infrastructural provision and availability of portable water with good hygienic environment will drastically reduce the high rate spread of H. pylori bacterium in the IDPs communities in Nigeria.

Gut Bacteria and Nutritional Status of Nigerian Children at an Internally Displaced Persons’ Camp in Benue State, Nigeria: A Pilot Study

This study was conducted to determine the gut bacteria and nutritional status of children (n = 30) aged 2 - 11 in Benue’s largest internally displaced persons (IDP) camp since information on this is lacking. Gut bacteria were identified using culture techniques, while Body Mass Index (Kg/m2), Weight-for-Height (WHZ), and Weight-for-Age (WAZ) z scores were computed from anthropometric measurements. Socio-demographic and economic variables were collected via structured questionnaires. IBM SPSS v25 was used to analyze the data, with p Salmonella spp., Shigella spp., and Escherichia coli compared to children from a nearby private school (n = 10), except for E. coli, where the prevalence was equal. The results for BMI revealed that 23 (57.5%) of the children had a healthy weight while 17 (42.5%) were underweight.WAZ z-scores were between (-0.02 - 2.51) with evidence of mildly underweight (20%) and mildly overweight (5%) children. WHZ z-scores were between -0.03 - 2.37, with moderately wasted (30%) and severely wasted (5%) found. To ensure better health outcomes for residents, conditions in the camp must be improved.

Into the Fold Refugees, internally displaced persons, returnees and the challenge of integration in Africa

Refugees,internally displaced persons,returnees and the challenge,of integration in Africa.

Reciprocal Association between Psychological Distress and PTSD and Their Relationship with Pre-Displacement Stressors among Displaced Women

It is established in the psychological literature that pre-displacement stressors,PTSD symptoms,and psycholo-gical distress are associated among internally displaced persons.However,existing studies have not demonstrated the mechanism underlying these associations.This study compared two explanatory models;one with PTSD symptoms severity explaining the indirect association between pre-displacement stressors and psychological dis-tress,and the other with psychological distress explaining the indirect relationship between pre-displacement stressors and PTSD symptoms severity.In a cross-sectional design,631 women(Mean age=31.18±8.59)were conveniently and purposely selected from the displaced women harboured in two camps in Borno State,Nigeria,due to the Boko-Haram insurgency.Data were collected utilizing structured questionnaires and subjected to path analyses.Results demonstrated that PTSD symptoms severity and psychological distress indirectly explained their respective and independent association with pre-displacement stressors.However,PTSD symptoms had a statis-tically larger standardized indirect effect size,greater indirect effect percentage,and bigger kappa-squared(k2)effect size than psychological distress.PTSD symptoms and psychological distress may have a reciprocal influence on each other from pre-displacement stressors.However,PTSD symptoms can better explain the association between pre-displacement stressors and psychological distress than the other way around.These outcomes have important implications for the psychological treatment of displaced persons.

国际救灾法:一个正在形成的国际法律部门

国际灾害援助规范虽然不是新近才有的事物,但近些年来重大灾害频发,国际援助规模的扩大和媒体对灾害反应的关注使国际救灾中的协作、灾民的生存状态问题凸显出来。国际社会开始为解决这些问题建立法律机制作出努力,并取得了诸多成果,昭示着一个国际救灾法部门的产生。关于该部门的调整对象,国际法文件对"灾害"往往采用广义定义的方法以便利国际援助的扩大;救灾规范也涵盖到灾前准备和灾后恢复重建阶段。国际救灾法已经形成了一个包括诸多公约、决议和声明、谅解备忘录、行动守则、指南和标准等在内的法律框架,虽然这些规范还缺乏综合性、融贯性。国际救灾法的发展也促进了对这一法律部门研究的兴起。

跨国工程移民权益与环境资源的保护——以哈萨克斯坦“CAREC”运输走廊工程案为例

在跨国工程建设中必须对移民权益与环境资源予以妥善保护,否则容易引发纠纷,哈萨克斯坦"CAREC"走廊工程案就是一个典型例子。在哈萨克斯坦政府和法院解决未果的情况下,该案最终交由工程融资机构世界银行的问责机构进行处理,至今仍未彻底终结。对世界银行监察组在本案中的运作及哈萨克斯坦政府的缺失进行探究有着重要意义。

国内流离失所者及其保护及相关国际法问题

国内流离失所者与难民不同的是其没有跨越国境到他国而是在其本国境内流离失所,造成国内流离失所的原因也与造成难民的原因不同,武装冲突、普遍的暴力、侵犯人权、自然灾害等是造成国内流离失所的主要原因。随着国内流离失所者数量的大规模增加,其已成为国际社会面临的重要人道挑战。近年来,联合国发布了《流离失所者指导规则》,非盟制定了《关于保护和救助非洲流离失所者的非洲公约》,表明了国际社会将流离失所者作为单独的受保护的群体进行帮助和保护的趋势。此外,国际人道法中关于禁止在武装冲突中移送或迁移平民的规定,有助于防止流离失所,国际刑法则规定驱逐和移送平民人口构成危害人类罪、战争罪和灭种族罪等国际罪行,国际社会也有这方面的审判实践。联合国难民署、红十字国际委员会等机构将保护国内流离失所者作为其工作内容,并且在保护国内流离失所者中发挥了重要作用。

浅谈避灾安置场所的标准化设置和管理

浙江省作为沿海省份,台风、洪涝、干旱、地震、滑坡、泥石流、雪灾、低温冷冻等灾害均有发生,近年来灾害发生的频率、程度都有所提高。浙江省在避灾科学的实践基础上,在避灾安置场所的制度安排、建设质量、建设数量等各方面都居于我国领先地位。本文通过比较国内外的避灾安置场所的软硬体设施,分析国内避灾安置场所在应对灾情的反应能力、保障能力以及对灾后重建的支援能力,规范、统一避灾安置场所的各项制度,旨在为浙江省避灾安置场所的未来发展和建设提供指引,从而提升全方位、多层次综合防灾减灾救灾能力,保障人民生命安全、生活安定、人性尊严。