To Live in Peace: A Participatory Study to Develop Indicators of Psychosocial Wellbeing in Community Context

Background and Purpose: Psychosocial programmes to support community wellbeing during and after armed conflict form an essential component of social work practice in humanitarian emergencies. However, there is limited research exploring the meaning of this concept with local people, leaving evidence for program effectiveness extremely thin. Social work science provides a way forward by offering examples of participatory methods that can be used to engage diverse populations to examine these phenomena together in community contexts, co-creating processes of healing and transformation.

Methods: This study was completed in 2018 at a Protection of Civilians (POC) site in Wau, South Sudan, which sheltered 32,676 persons (52% female, 48% male) fleeing conflict-related violence. Its immediate objectives were to understand the operational meaning of “psychosocial well-being” for women and men respectively in cultural context such that programs could be developed on community, family and individual levels and then measured for effectiveness.

744 participants, (387 female, 357 male) aged 18 through 65 were engaged in 21 focus groups for men and 25 for women. Participants were selected among volunteers who recruited from each of the 21 ethnolinguistic groups to be sure that all of the groups were included. The study was conducted in two rounds. The first elicited free listing of ideas, words, phrases, and examples that defined emic conceptions of psychosocial wellbeing. These were transcribed verbatim and then coded thematically in an iterative process, with like operational definitions forming domains. The results were then presented to a second round of focus groups in which participants were shown the domains and their operational definitions in graphic form and asked to validate the findings by participatory ranking, then eliminate irrelevant ones and alter any that were incorrectly captured.

Findings: The study yielded 7 interrelated domains of wellbeing for women and 9 for men, that were agreed and operationalized across the different ethnolinguistic groups. The domains for the women were in ranked order, peace; children well-cared for; connection to traditions, culture and spirituality; access to information, resources and basic needs; togetherness with family; advocacy and justice; togetherness with the community. For men the domains, in ranked order, were peace; access to formal education; togetherness with the community; practicing traditions, culture and spirituality; recreation; ability to provide for the family; togetherness with family; advocacy and justice; access to information, resources and basic needs.

Conclusion and Implications: The domains were used to design, monitor, and evaluate programs to support the affected adult population. A framework for evaluation was created in which program participants could measure the effectiveness of the programs in improving their experience of psychosocial wellbeing by tracing progress toward domain goals.

This study illustrates how asking people in crisis about their aspirations for wellbeing and ways in which they might return to that state can be an effective approach to engage them in collaborative healing processes. By engaging community members in the process of measuring progress toward healing, social work science can also fill a gap in the literature on the effectiveness of programs for psychosocial well-being.