Gender-Based Violence and Mental Health in Urban Refugees and Asylum Seekers in Kampala, Uganda

Background: The relationship between gender-based violence (GBV) and mental health outcomes among conflict-affected populations has been documented. However data on urban refugees, a population representing nearly half of the world's 10.5 million refugees, is limited. We assessed the relationship between GBV and mental health outcomes among a population of female urban refugees. Methods: Using a computerized database, we selected a stratified simple random sample of Congolese and Somali refugees/asylum seekers aged 15–59 living in Kampala during September 2010. Trained interviewers assessed history of violence, depressive symptoms (using the Hopkins Symptom Checklist-25) and posttraumatic stress disorder (PTSD) (using the Harvard Trauma Questionnaire). To measure the association between violence and PTSD, we used logistic regression, adjusting for age and relationship status. Results: Of the 500 women selected, 117 participated (23.4% response rate, 1.2% refusal rate). Women lived in Kampala an average of 3 years. The lifetime prevalence of experiencing any violence (physical and/or sexual violence), physical violence and sexual violence were 77.5%, 76.2% and 63.3%, respectively. Almost all women (92%) had depression symptoms and 71.1% had PTSD symptoms. Women with a history of physical violence were more likely to report symptoms of PTSD (adjusted odds ratio [AOR]=8.4, 95% Confidence Interval [CI]=2.3–30.5), as were women with a history of sexual violence (AOR=4.2, 95% CI=1.5–11.7). Conclusions: Despite a low response rate, a history of violence was strongly associated with PTSD among the majority of women surveyed. Survey findings expanded access to psychosocial programs for refugees however additional GBV and mental health services are needed.