Comparative analysis of the health status of the population in six health zones in South Kivu: a cross-sectional population study using the WHODAS

Conflict and Health

Ghislain Bisimwa Balaluka¹  Christian Molima Eboma¹  Espoir Bwenge Malembaka¹  Hermès Bimana Karemere¹  Samuel Lwamushi Makali²  Phillippe Donnen³  Albert Tambwe Mwembo⁴  Anne-Sophie Lambert⁵  Jean Macq⁵  Steven Barnes Ssali⁶ 

[1] Ecole Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo;Ecole Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo;Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of Congo;Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium;Ecole de Santé Publique, Université de Lubumbashi, Lubumbashi, Democratic Republic of Congo;Institut de Recherche Santé et Société, Université Catholique de Louvain, Brussels, Belgium;Makerere University, Kampala, Uganda;

关键词: Health status;    Population;    WHODAS;    Conflict;    South Kivu;    DRC;   

DOI  :  10.1186/s13031-021-00387-0

来源: Springer

【 摘 要 】

BackgroundThe eastern Democratic Republic of Congo (DRC) has experienced decades-long armed conflicts which have had a negative impact on population’s health. Most research in public health explores measures that focus on a specific health problem rather than overall population health status. The aim of this study was to assess the health status of the population and its predictors in conflict settings of South Kivu province, using the World Health Organization Disability Assessment Schedule (WHODAS).MethodsBetween May and June 2019, we conducted a community-based cross-sectional survey among 1440 adults in six health zones (HZ), classified according to their level of armed conflict intensity and chronicity in four types (accessible and stable, remote and stable, intermediate and unstable). The data were collected by a questionnaire including socio-demographic data and the WHODAS 2.0 tool with 12 items. The main variable of the study was the WHODAS summary score measuring individual’s health status and synthesize in six domains of disability (household, cognitive, mobility, self-care, social and society). Univariate analysis, correlation and comparison tests as well as hierarchical multiple linear regression were performed.ResultsThe median WHODAS score in the accessible and stable (AS), remote and stable (RS), intermediate (I) and unstable (U) HZ was 6.3 (0–28.6); 25 (6.3–41.7); 22.9 (12.5–33.3) and 39.6 (22.9–54.2), respectively. Four of the six WHODAS domain scores (household, cognitive, mobility and society) were the most altered in the UHZs. The RSHZ and IHZ had statistically comparable global WHODAS scores. The stable HZs (accessible and remote) had statistically lower scores than the UHZ on all items. In regression analysis, the factors significantly associated with an overall poor health status (or higher WHODAS score) were advanced age, being woman, being membership of an association; being divorced, separated or widower and living in an unstable HZ.ConclusionsArmed conflicts have a significantly negative impact on people’s perceived health, particularly in crisis health zones. In this area, we must accentuate actions aiming to strengthen people’s psychosocial well-being.

【 授权许可】

CC BY