Psychosocial support for adolescent girls in post-conflict settings: beyond a health systems approach
Date
2017-12-09
Authors
Samuels, Fiona
Jones, Nicola
Abu Hamad, Bassam
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press
Abstract
Adaptive and adequately resourced health systems are necessary to achieve good health outcomes
in post-conflict settings, however domains beyond the health system are also critical to ensure
broader wellbeing. This paper focuses on the importance of psychosocial support services for adolescent
girls in fragile contexts. Its starting point is that adolescence is a pivotal time in the life course
but given the physical, cognitive and emotional changes triggered by the onset of puberty, it can
also be a period of heightened sensitivity and vulnerability to trauma, social isolation, bullying by
peers, a lack of supportive adults and gender-based and sexual violence. Our findings highlight why
humanitarian and biomedical approaches in their current form are inadequate to address these complexities.
Drawing on qualitative fieldwork (consisting of in-depth and key informant interviews as
well as group discussions in Gaza, Liberia and Sri Lanka involving a total of 386 respondents across
the three countries), we argue that going beyond biomedical approaches and considering the social
determinants of health, including approaches to tackle discriminatory gendered norms and barriers
to service access, are critical for achieving broader health and wellbeing. While all three case study
countries are classified as post-conflict, the political economy dynamics vary with associated implications
for experiences of psychosocial vulnerabilities and the service environment. The study concludes
by reflecting on actions to address psychosocial vulnerabilities facing adolescent girls. These
include: tailoring services to ensure gender and age-sensitivity; investing in capacity building of service
providers to promote service uptake; and enhancing strategies to regulate and coordinate actors
providing mental health and psychosocial support services.
Description
Keywords
Psychosocial , adolescence , girls , post-conflict , social determinants of health , wellbeing , health , Gaza , Liberia , Sri Lanka