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The Institute for Global Health and Development

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    The myth of the 1-day training: The effectiveness of psychosocial support capacity-building during the Ebola outbreak in West Africa
    (Cambridge University Press, 2019-05-07) Horn, Rebecca; O'May, Fiona; Esliker, Rebecca; Gwaikolo, Wilfred; Woensdregt, Lise; Ruttenberg, Leontien; Ager, Alastair
    Background - In emergencies and resource-poor settings, non-specialists are increasingly being trained to provide psychosocial support to people in distress, with Psychological First Aid (PFA) one of the most widely-used approaches. This paper considers the effectiveness of short training programmes to equip volunteers to provide psychosocial support in emergencies, focusing particularly on whether the PFA training provided during the Ebola outbreak enabled non-specialists to incorporate the key principles into their practice. Methods - Semi-structured interviews were conducted in Sierra Leone and Liberia with 24 PFA trainers; 36 individuals who participated in PFA training; and 12 key informants involved in planning and implementing the PFA roll-out. Results - Findings indicate that many PFA ToTs were short and rarely included content designed to develop training skills. As a result, the PFA training delivered was of variable quality. PFA providers had a good understanding of active listening, but responses to a person in distress were less consistent with the guidance in the PFA training or with the principles of effective interventions outlined by Hobfoll et al. Conclusions - There are advantages to training non-specialists to provide psychosocial support during emergencies, and PFA has all the elements of an effective approach. However, the very short training programmes which have been used to train non-specialists in PFA might be appropriate for participants who already bring a set of relevant skills to the training, but for others it is insufficient. Government/NGO standardisation of PFA training and integration in national emergency response structures and systems could strengthen in-country capacity.
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    'I don't need an eye for an eye': Women's responses to intimate partner violence in Sierra Leone and Liberia
    (Taylor & Francis, 2016-02) Horn, Rebecca; Puffer, Eve S.; Roesch, Elisabeth; Lehmann, Heidi
    This paper explores the possibilities for agency in intimate partner violence (IPV) situations from the perspective of women in Sierra Leone and Liberia using focus group discussions (N groups = 14, N participants = 110) and individual interviews (N = 20). Findings identify multiple interrelated factors influencing the decisionmaking of women experiencing IPV. At the individual level, emotional factors and women's knowledge of their rights and options influence their decision-making. At the relational level, the role of neighbours, family and friends is crucial, both for emotional support and practical assistance. At the community level, more formal structures play a role, such as chiefs and women's groups, though their effectiveness varies. At the structural level are barriers to effective responses, including a poorly functioning criminal justice system and a social system in which children often stay with fathers following separation or divorce. Strong cultural beliefs operate to keep women in abusive relationships. We identify implications for prevention and response services and make practice recommendations. Since the desire of most women experiencing IPV was to live in peace with their husbands, interventions should respect women's priorities by focusing more on prevention and interventions to end the violence, rather than solely assisting women to leave violent relationships.