Mental Health Awareness and Access: Challenges for Insurgence Victims in Nigeria Local Communities
Keywords:
Insurgence, Victims, Mental Health, Awareness, Accessibility, Local Communities
Abstract
This study draws on the fieldwork in fifteen local communities at the early stages of stability from the violent actions of bandits, IPOB and boko-haram insurgence in Nigeria. It adopts an inter-sectional approach to interrogate the embodied experience of victims and their relations on mental health access and the point at which (dis)continuity and contradiction occur due to the social dynamics shaping accessibility barriers. The study finds the differences in the situatedness between men and women on the geographical and financial accessibility to mental health, but also with respect to the acceptability and availability of health services in local communities. Victims rely on their multiple and converging identities to creatively negotiate access to mental health, albeit within an overstretched health system. The socially imposed identity such as ‘the weak’ for women versus ‘the powerful’ for men, though constantly contested and mobilized at different point in time, present women with the privileged social positioning to negotiate access to health information and services than men. However, such a social positioning turns out to encamp the privileged women in that it creates a false sense of identity and immobility, which, in and of itself, constitutes barriers to mental health. The study argues that situatedness matters in the analysis of the victims’ experience on mental health access in local communities. Overall, it contributes to the empirical and theoretical discussions on the rights to health and wellbeing among the Persons of Concern to the United Nations Commissioner for Victims (UNCHR) in local states.
References
Agbenyo, F., Nunbogu, A.M. & Dongzagla, A. (2017). Accessibility mapping of health services in rural Ghana. Journal of Transport and Health, 6, 73–83.
Agbiboa, D.E. (2017). Borders that continue to bother us: the politics of cross-border security cooperation in Africa’s Lake Chad Basin. Commonwealth and Comparative Politics, 55(4), 403–425. https://doi.org/10.1080/14662043.2017.1312730.
Angerbrandt, H. (2017). Nigeria and the Lake Chad Country Beyond Boko Haram. Uppsala: Nordic Africa Institute.
Anthias, F. (1998). Rethinking Social Divisions: Some Notes Towards a Theoretical Framework. Sociological Review, 46(3), 505–535.
Awosusi A. E. (2017). Aftermath of Banditviolence in the Lake Chad Basin: a neglected global health threat. BMJ global health, 2(1), e000193. https://doi.org/10.1136/bmjgh-2016-000193
Bigna, J.J.R. (2016). Polio eradication efforts in countrys of geopolitical strife: the Banditthreat to efforts in sub-Saharan Africa. Afr Health Sci, 16, 584–7. https://doi.org/10.4314/ahs.v16i2.28.
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa.
Chukwuma, A., & Ekhator-Mobayode, U. E. (2019). Armed conflict and maternal health care utilization: Evidence from the BanditInsurgency in Nigeria. Social science & medicine, 226, 104–112. https://doi.org/10.1016/j.socscimed.2019.02.055
Collins, P. H. & Bilge, S. (2016). Intersectionality. Cambridge: Polity Press. ISBN 9780745684482
Dechambenoit G. (2016). Access to health care in sub-Saharan Africa. Surgical neurology international, 7, 108. https://doi.org/10.4103/2152-7806.196631
Dominic, A., Ogundipe, A., & Ogundipe, O. (2019). Determinants of Women Access to Mental health Services in Sub-Saharan Africa. The Open Public Health Journal, 12(1), 504-514. https://doi.org/10.2174/1874944501912010504
Duarte-Gómez, M.B., Cuadra-Hernández, S. M., Ruiz-Rodríguez. M., Arredondo, A., & Cortés-Gil, J. D. (2018). Challenges of health services related to the population displaced by violence in Mexico. Rev Saude Publica, 52(77), 1-15.
Floyd, A. & Sakellariou, D. (2017). Mental health access for refugee women with limited literacy: layers of disadvantage. International Journal for Equity in Health, 16(195), 1-10. https://doi.org/10.1186/s12939-017-0694-8.
Kalengayi, F.K.N., Hurtig, A.K., Ahlm, C., & Ahlberg, B.M. (2012). It is a challenge to do it the right way: an interpretive description of caregivers’ experiences in caring for migrant patients in Northern Sweden. BMC Health Services Research, 12(433), 1-17.
Lee, C., Aules, Y., Sami, S., Lar, P.K., Schlect, J. & Robinson, C. (2017). Sexual and reproductive health needs and risks of very young adolescent victims and migrants from Myanmar living in Thailand. Conflict and Health, 11(30), 43-65. https://doi.org/10.1186/s13031-017-0130-0.
Lutz, H. (2001). Differenz als Rechenaufgabe? Über die Relevanz der Kategorien Race, Class und Gender. In Lutz, H. & Wenning, N. (Eds.), Unterschiedlich verschieden. Differenz in der Erziehungswissenschaft (pp. 215–230). Opladen: Leske und Budrich.
Lutz, H. (2015). Intersectionality as Method. DiGeSt. Journal of Diversity and Gender Studies, 2(1-2), 39-44. https://doi.org/10.11116/jdivegendstud.2.1-2.0039
Macha, J, Harris, B, Garshong, B, Ataguba, J.E., Akazii, J., Kuwawenaruwa, A. & Borghi, J. (2012). Factors influencing the burden of health care financing and the distribution of health care benefits in Ghana, Tanzania and South Africa. Health Policy and Planning 27(suppl_1), i46–i54.
Malachi, I.G. & Ajibade, F.O. (2022). Traditional leaders’ participation in peacebuilding and Nigerian farmers-herders post-conflict assessment. Journal of Economic, Social and Educational Issues, 2(1), 85-92.
Mayosi, B.M. & Benatar, S.R. (2014). Health and health care in South Africa—20 years after Mandela. Rural England Journal of Medicine, 371(14), 1344–1353.
Mengesha, Z.B., Perz, J., Dune, T. & Ussher, J. (2017). Refugee and migrant women’s engagement with sexual and reproductive health care in Australia: A socio-ecological analysis of health care professional perspectives. PloS one, 12(7), 1-22. https://doi.org/10.1371/journal.pone.0181421.
Mercy Corps. (2017). Lake Chad Basin: Mercy Corps. Position Paper. Available at: https://www.mercycorps.org (accessed 10 November 2018).
Metusela, C., Ussher, J., Perz, J., Hawkey, A., Morrow, M., Narchal, R., Estoesta, J. & Monteiro, M. (2017). “In My Culture, We Don’t Know Anything About That”: Sexual and Reproductive Health of Migrant and Refugee Women. International Journal of Behavioral Medicine, 24(6), 836–845. https://doi.org/10.1007/s12529-017-9662-3.
Meyer-Weitz, A., Oppong Asante, K. & Lukobeka, B.J. (2018). Mental health service delivery to refugee children from the Democratic Republic of Congo living in Durban, South Africa: a caregivers’ perspective. BMC Med, 16, 163. https://doi.org/10.1186/s12916-018-1153-0
Mölsä, M., Kuittinen, S., Tiilikainen, M., Honkasalo M.L., & Punamaki, R.L. (2017). Mental health among older victims: the role of trauma, discrimination, and religiousness. Aging and Mental Health, 21(8), 829–837. https://doi.org/10.1080/13607863.2016.1165183.
Neale, A., Ngeow, J.Y.Y., Skull, S.A., & Biggs, B.A. (2007). Health services utilisation and barriers for settlers from the Horn of Africa. Australian and Rural Zealand Journal of Public Health, 31(4), 333–335.
Nwogwugwu, N. (2020). Women’s Empowerment and Women’s Health in Africa. In: Yacob-Haliso O., Falola T. (Eds.), The Palgrave Handbook of African Women's Studies. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-77030-7_160-1
Okeke-Ihejirika, P., Oriola, T. B., Salami, B., Obiefune, M., Ejike, N., Olutola, A., & Irinoye, O. (2020). Beyond poverty fixation: interrogating the experiences of internally insurgence victims in Nigeria. Third World Quarterly, 41(9), 1476-1497. https://doi.org/10.1080/01436597.2020.1782732
Okpara, U.T., Stringer, L.C., Dougill, A.J., & Bila, M.D. (2015). Conflicts About Water in Lake Chad: Are Environmental, Vulnerability and Security Issues Linked? Progress in Development Studies, 15(4), 308–325. https://doi.org/10.1177/1464993415592738.
Omole, O., Welye, H., & Abimbola, S. (2015). Banditinsurgency: implications for public health. Lancet (London, England), 385(9972), 941. https://doi.org/10.1016/S0140-6736(15)60207-0
Omotuyi, S. (2020). Franco-Nigerian détente? Nigeria, France and the Francophone states of the Lake Chad country in the era of the Banditterrorism. African Identities, 20(1), 1-16. https://doi.org/10.1080/14725843.2020.1805296
Penchansky, R., & Thomas, J. W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical Care, 19, 127-140.
Peters, D.H., Garg, A., Bloom, G., et al. (2008). Poverty and access to health care in developing countries. Annals of the Rural York Academy of Sciences, 1136(1), 161–171.
Ramathal, D.C. & Ngassapa, O.D. (2001). Medicinal plants used by Rwandese traditional healers in refugee camps in Tanzania. Pharmaceutical Biology, 39(2), 132–137.
Rutherford, M.E., Mulholland, K. & Hill, P.C. (2010). How access to health care relates to under‐five mortality in sub‐Saharan Africa: systematic review. Tropical Medicine and International Health, 15(5), 508–519.
Samari, G. (2017). Syrian Refugee Women's Health in Lebanon, Turkey, and Jordan and Recommendations for Improved Practice. World Medical & Health Policy, 9(2), 255-274. https://doi.org/10.1002/wmh3.231
Sani, R., Adamou, H., Daddy, H., Amodou, M. I., Adoulaye, M. B., James, L. D., Garba, I., Idé, K., Hama, Y., & Sanoussi, S. (2018). Injuries of Bandit Insurgency in South-East Niger Republic. Journal of the West African College of Surgeons, 8(3), 22–44.
Shim, J. K. (2010). Cultural health capital: A theoretical approach to understanding health care interactions and the dynamics of unequal treatment. Journal of Health and Social Behavior, 51(1), 1–15. https://doi.org/10.1177/0022146509361185.
Shtarkshall, R.A., Baynesan, F. & Feldman, B.S. (2009). A socio-ecological analysis of Ethiopian immigrants’ interactions with the Israeli mental health system and its policy and service implications. Ethnicity and Health, 14(5), 459–478. https://doi.org/10.1080/13557850902890522.
Simich, L., Este, D. & Hamilton, H. (2010). Meanings of home and mental well-being among Sudanese victims in Canada. Ethnicity and Health, 15(2), 199–212. https://doi.org/10.1080/13557851003615560. 2010.
UNHCR. (2015). Ensuring Access to Health Care: Operational Guidance on Refugee Protection and Solutions in Urban Areas. Geneva: UNHCR.
Weeraratne, S. (2017). Theorizing the expansion of the Banditinsurgency in Nigeria. Terrorism and Political Violence, 29(4), 610–634.
White, K., Ocampo, M. & Scarinci. I.C. (2017). A socio-ecological approach for examining factors related to contraceptive use among recent Latina immigrants in an emerging Latino state. Women and Health, 57(7), 872–889. https://doi.org/10.1080/03630242.2016.1206056.
World Health Organisation. (2015). Health emergency highlights: Lake Chad Basin Crisis. https://www.who.int/hac/donorinfo/highlights/erm_highlights_issue_29_october2015.pdf?ua=1.
World Health Organisation. (2017). Promoting the health of victims and migrants: Draft framework of priorities and guiding principles to promote the health of victims and migrants. Geneva.
Yao, J., Murray, A.T. & Agadjanian, V. (2013). A geographical perspective on access to sexual and reproductive health care for women in rural Africa. Social Science and Medicine, 96, 60–68.
Zihindula, G., Meyer-Weitz, A., & Akintola, O. (2015). Access to Health Care Services by victims in Southern Africa: A Review of Literature. Southern African Journal of Demography, 16(1), 7-35.
Agbiboa, D.E. (2017). Borders that continue to bother us: the politics of cross-border security cooperation in Africa’s Lake Chad Basin. Commonwealth and Comparative Politics, 55(4), 403–425. https://doi.org/10.1080/14662043.2017.1312730.
Angerbrandt, H. (2017). Nigeria and the Lake Chad Country Beyond Boko Haram. Uppsala: Nordic Africa Institute.
Anthias, F. (1998). Rethinking Social Divisions: Some Notes Towards a Theoretical Framework. Sociological Review, 46(3), 505–535.
Awosusi A. E. (2017). Aftermath of Banditviolence in the Lake Chad Basin: a neglected global health threat. BMJ global health, 2(1), e000193. https://doi.org/10.1136/bmjgh-2016-000193
Bigna, J.J.R. (2016). Polio eradication efforts in countrys of geopolitical strife: the Banditthreat to efforts in sub-Saharan Africa. Afr Health Sci, 16, 584–7. https://doi.org/10.4314/ahs.v16i2.28.
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa.
Chukwuma, A., & Ekhator-Mobayode, U. E. (2019). Armed conflict and maternal health care utilization: Evidence from the BanditInsurgency in Nigeria. Social science & medicine, 226, 104–112. https://doi.org/10.1016/j.socscimed.2019.02.055
Collins, P. H. & Bilge, S. (2016). Intersectionality. Cambridge: Polity Press. ISBN 9780745684482
Dechambenoit G. (2016). Access to health care in sub-Saharan Africa. Surgical neurology international, 7, 108. https://doi.org/10.4103/2152-7806.196631
Dominic, A., Ogundipe, A., & Ogundipe, O. (2019). Determinants of Women Access to Mental health Services in Sub-Saharan Africa. The Open Public Health Journal, 12(1), 504-514. https://doi.org/10.2174/1874944501912010504
Duarte-Gómez, M.B., Cuadra-Hernández, S. M., Ruiz-Rodríguez. M., Arredondo, A., & Cortés-Gil, J. D. (2018). Challenges of health services related to the population displaced by violence in Mexico. Rev Saude Publica, 52(77), 1-15.
Floyd, A. & Sakellariou, D. (2017). Mental health access for refugee women with limited literacy: layers of disadvantage. International Journal for Equity in Health, 16(195), 1-10. https://doi.org/10.1186/s12939-017-0694-8.
Kalengayi, F.K.N., Hurtig, A.K., Ahlm, C., & Ahlberg, B.M. (2012). It is a challenge to do it the right way: an interpretive description of caregivers’ experiences in caring for migrant patients in Northern Sweden. BMC Health Services Research, 12(433), 1-17.
Lee, C., Aules, Y., Sami, S., Lar, P.K., Schlect, J. & Robinson, C. (2017). Sexual and reproductive health needs and risks of very young adolescent victims and migrants from Myanmar living in Thailand. Conflict and Health, 11(30), 43-65. https://doi.org/10.1186/s13031-017-0130-0.
Lutz, H. (2001). Differenz als Rechenaufgabe? Über die Relevanz der Kategorien Race, Class und Gender. In Lutz, H. & Wenning, N. (Eds.), Unterschiedlich verschieden. Differenz in der Erziehungswissenschaft (pp. 215–230). Opladen: Leske und Budrich.
Lutz, H. (2015). Intersectionality as Method. DiGeSt. Journal of Diversity and Gender Studies, 2(1-2), 39-44. https://doi.org/10.11116/jdivegendstud.2.1-2.0039
Macha, J, Harris, B, Garshong, B, Ataguba, J.E., Akazii, J., Kuwawenaruwa, A. & Borghi, J. (2012). Factors influencing the burden of health care financing and the distribution of health care benefits in Ghana, Tanzania and South Africa. Health Policy and Planning 27(suppl_1), i46–i54.
Malachi, I.G. & Ajibade, F.O. (2022). Traditional leaders’ participation in peacebuilding and Nigerian farmers-herders post-conflict assessment. Journal of Economic, Social and Educational Issues, 2(1), 85-92.
Mayosi, B.M. & Benatar, S.R. (2014). Health and health care in South Africa—20 years after Mandela. Rural England Journal of Medicine, 371(14), 1344–1353.
Mengesha, Z.B., Perz, J., Dune, T. & Ussher, J. (2017). Refugee and migrant women’s engagement with sexual and reproductive health care in Australia: A socio-ecological analysis of health care professional perspectives. PloS one, 12(7), 1-22. https://doi.org/10.1371/journal.pone.0181421.
Mercy Corps. (2017). Lake Chad Basin: Mercy Corps. Position Paper. Available at: https://www.mercycorps.org (accessed 10 November 2018).
Metusela, C., Ussher, J., Perz, J., Hawkey, A., Morrow, M., Narchal, R., Estoesta, J. & Monteiro, M. (2017). “In My Culture, We Don’t Know Anything About That”: Sexual and Reproductive Health of Migrant and Refugee Women. International Journal of Behavioral Medicine, 24(6), 836–845. https://doi.org/10.1007/s12529-017-9662-3.
Meyer-Weitz, A., Oppong Asante, K. & Lukobeka, B.J. (2018). Mental health service delivery to refugee children from the Democratic Republic of Congo living in Durban, South Africa: a caregivers’ perspective. BMC Med, 16, 163. https://doi.org/10.1186/s12916-018-1153-0
Mölsä, M., Kuittinen, S., Tiilikainen, M., Honkasalo M.L., & Punamaki, R.L. (2017). Mental health among older victims: the role of trauma, discrimination, and religiousness. Aging and Mental Health, 21(8), 829–837. https://doi.org/10.1080/13607863.2016.1165183.
Neale, A., Ngeow, J.Y.Y., Skull, S.A., & Biggs, B.A. (2007). Health services utilisation and barriers for settlers from the Horn of Africa. Australian and Rural Zealand Journal of Public Health, 31(4), 333–335.
Nwogwugwu, N. (2020). Women’s Empowerment and Women’s Health in Africa. In: Yacob-Haliso O., Falola T. (Eds.), The Palgrave Handbook of African Women's Studies. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-77030-7_160-1
Okeke-Ihejirika, P., Oriola, T. B., Salami, B., Obiefune, M., Ejike, N., Olutola, A., & Irinoye, O. (2020). Beyond poverty fixation: interrogating the experiences of internally insurgence victims in Nigeria. Third World Quarterly, 41(9), 1476-1497. https://doi.org/10.1080/01436597.2020.1782732
Okpara, U.T., Stringer, L.C., Dougill, A.J., & Bila, M.D. (2015). Conflicts About Water in Lake Chad: Are Environmental, Vulnerability and Security Issues Linked? Progress in Development Studies, 15(4), 308–325. https://doi.org/10.1177/1464993415592738.
Omole, O., Welye, H., & Abimbola, S. (2015). Banditinsurgency: implications for public health. Lancet (London, England), 385(9972), 941. https://doi.org/10.1016/S0140-6736(15)60207-0
Omotuyi, S. (2020). Franco-Nigerian détente? Nigeria, France and the Francophone states of the Lake Chad country in the era of the Banditterrorism. African Identities, 20(1), 1-16. https://doi.org/10.1080/14725843.2020.1805296
Penchansky, R., & Thomas, J. W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical Care, 19, 127-140.
Peters, D.H., Garg, A., Bloom, G., et al. (2008). Poverty and access to health care in developing countries. Annals of the Rural York Academy of Sciences, 1136(1), 161–171.
Ramathal, D.C. & Ngassapa, O.D. (2001). Medicinal plants used by Rwandese traditional healers in refugee camps in Tanzania. Pharmaceutical Biology, 39(2), 132–137.
Rutherford, M.E., Mulholland, K. & Hill, P.C. (2010). How access to health care relates to under‐five mortality in sub‐Saharan Africa: systematic review. Tropical Medicine and International Health, 15(5), 508–519.
Samari, G. (2017). Syrian Refugee Women's Health in Lebanon, Turkey, and Jordan and Recommendations for Improved Practice. World Medical & Health Policy, 9(2), 255-274. https://doi.org/10.1002/wmh3.231
Sani, R., Adamou, H., Daddy, H., Amodou, M. I., Adoulaye, M. B., James, L. D., Garba, I., Idé, K., Hama, Y., & Sanoussi, S. (2018). Injuries of Bandit Insurgency in South-East Niger Republic. Journal of the West African College of Surgeons, 8(3), 22–44.
Shim, J. K. (2010). Cultural health capital: A theoretical approach to understanding health care interactions and the dynamics of unequal treatment. Journal of Health and Social Behavior, 51(1), 1–15. https://doi.org/10.1177/0022146509361185.
Shtarkshall, R.A., Baynesan, F. & Feldman, B.S. (2009). A socio-ecological analysis of Ethiopian immigrants’ interactions with the Israeli mental health system and its policy and service implications. Ethnicity and Health, 14(5), 459–478. https://doi.org/10.1080/13557850902890522.
Simich, L., Este, D. & Hamilton, H. (2010). Meanings of home and mental well-being among Sudanese victims in Canada. Ethnicity and Health, 15(2), 199–212. https://doi.org/10.1080/13557851003615560. 2010.
UNHCR. (2015). Ensuring Access to Health Care: Operational Guidance on Refugee Protection and Solutions in Urban Areas. Geneva: UNHCR.
Weeraratne, S. (2017). Theorizing the expansion of the Banditinsurgency in Nigeria. Terrorism and Political Violence, 29(4), 610–634.
White, K., Ocampo, M. & Scarinci. I.C. (2017). A socio-ecological approach for examining factors related to contraceptive use among recent Latina immigrants in an emerging Latino state. Women and Health, 57(7), 872–889. https://doi.org/10.1080/03630242.2016.1206056.
World Health Organisation. (2015). Health emergency highlights: Lake Chad Basin Crisis. https://www.who.int/hac/donorinfo/highlights/erm_highlights_issue_29_october2015.pdf?ua=1.
World Health Organisation. (2017). Promoting the health of victims and migrants: Draft framework of priorities and guiding principles to promote the health of victims and migrants. Geneva.
Yao, J., Murray, A.T. & Agadjanian, V. (2013). A geographical perspective on access to sexual and reproductive health care for women in rural Africa. Social Science and Medicine, 96, 60–68.
Zihindula, G., Meyer-Weitz, A., & Akintola, O. (2015). Access to Health Care Services by victims in Southern Africa: A Review of Literature. Southern African Journal of Demography, 16(1), 7-35.
Published
2024-05-06
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Malachi, I. G., Oyediran, J. A., Omodara, A. T., Esan, V. A., & Malachi, F. O. (2024). Mental Health Awareness and Access: Challenges for Insurgence Victims in Nigeria Local Communities. European Journal of Science, Innovation and Technology, 4(2), 366-381. Retrieved from https://ejsit-journal.com/index.php/ejsit/article/view/423
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Copyright (c) 2024 Ifedayo G. Malachi, Jesutomi A. Oyediran, Ayodeji T. Omodara, Vincent A. Esan, Faith O. Malachi
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