TPO Uganda Project

Problem: The majority of the population of Kiryandongo District in Western Uganda is under age 18 (62%), and 99% of the refugee population have fled conflict in South Sudan, while the rest are from the Democratic Republic of Congo, Sudan, Kenya, Burundi, and Rwanda. Psychological distress is quite high among refugees in Uganda, affecting both caregivers and their children. However, there are limited health services and, less than 1% of the total population of people with mental health concerns in Kiryandongo are able to receive mental health and psychosocial support (MHPSS) services (Adaku et al., 2016).

Question: Journey of Life (JoL) addresses the ecologies of children and adolescents by working with caregivers, educators and community members to understand the importance of their support in the protection of children.
JoL has been implemented in various African settings; however, it had never been formally assessed in a humanitarian context. The aim of this work was to evaluate the implementation and effectiveness of the JoL intervention with a conflict-affected population living in Kiryandongo, Uganda.

Design & Methods: This JoL adaption focused on engaging caregivers in building awareness around child protection and fostering psychosocial support through reflection, dialogue, and action. The series of workshops were divided into 12 sessions that include psychoeducation, self-care, positive parenting, understanding children’s needs, identifying children who need help, and building on children’s strengths. The manualized protocol for 12 sessions was designed to be implemented by non-specialized humanitarian workers. There was an overall emphasis across the curriculum on creating nurturing and caring communities. The JoL study utilized a quasi-experimental design with a waitlist control group and an intervention group to examine the effectiveness of the JoL intervention among refugees displaced in Uganda. The hybrid effectiveness implementation study design utilized a quantitative approach to examine effectiveness and a qualitative approach to examine the implementation of the intervention.

Research Findings:

• JoL was successful in supporting caregiver well-being and encouraging positive parenting behavior.  
• Barriers to participation included individuals meeting basic needs, a lack of transportation, and language barriers. Men were less likely to participate in JoL than women. 
• Findings support an emerging evidence base of programs that improve psychosocial programming for refugees in humanitarian settings. Further work is needed to engage male caregivers and to explore the long-term effects of the program on caregivers and children

Policy & Practice Achievements:

• The Ministry of Gender, Labor and Social Development attended dissemination events and expressed interest in integrating study findings into expanding social protection programs, particularly for elderly caregivers of young children.  
• Within TPO, research findings have been presented at monthly management meetings. Key implementation findings and lessons learned have supported scale up interventions using JoL to support caregiver well-being and parenting practices.  
• Research findings were also presented to the Regional Psychosocial Support Initiatives and are currently in use for future program proposals.