A Network Analysis of Resource Utilization in a Refugee Camp

Background: Since 1964, protracted conflict in Sri Lanka has caused an influx of 250,000 refugees to Indian refugee camps. During this transmigration period, refugee families experience a greater risk for daily stressors, family conflict, and mental health needs. Social work research can play a crucial role in guiding the development and implementation of evidence-based policies targeting the effects of transmigration stress. Additionally, social work research may enhance the resource infrastructure available to camp refugees, which has previously been shown to be effective in mitigating the mental health effects of migration stressors. This study examined camp refugees' resource needs and utilization over time and investigated the relationships between such uses, transmigration stressors, and mental well-being. The research questions guiding this study are: 1) Do formal sources of assistance, based on network values, affect the measures of well-being of the refugees?; and 2) Do informal sources of assistance, based on network values, affect the measures of well-being of the refugees?

Methods: Using a community-based participatory (CBPR) design, the principal investigator and twelve camp health workers conducted interviews with 120 Sri Lankan Tamil refugee families living in the Trichy refugee camp.. Data was collected in two waves. Interviews were constructed based on the consultation and feedback gained through discussions with the community board, which included the Organization for Eelam Refugee Rehabilitation (OfERR), and under the guidance of Tamil Community Collaborative Board (TCCB). Standardized measurements were used to assess transmigration stressors and mental well-being. Resource utilization was assessed through structured interviews on the use of formal and informal family support. Participants were asked to identify key support figures, their location, relationships, institution affiliation, type of support provided, accessibility, and utilization frequency. We created support graphs based on the resource utilization and then used network analysis to calculate the impact on mental, physical, and social well-being according to the type and frequency of the support. This analysis was done using both linear statistical models and nonlinear decision tree models.

Results: 97% of the total sample access formal resources from non-governmental and governmental support. 76.7% of the total sample use informal family support, and 33.6% use informal friend support. The total transmigration stressor score was significantly associated with various health outcomes. Refugees who accessed support from family reported higher levels of family functioning than refugees who did not use these resources. Network results will also be discussed in detail.

Conclusion and implications: Differences emerged between the need for and actual use of resources by camp refugees. This study also highlights that in the absence of formal resources to help address stressors, refugees are turning to informal support systems, when available. Refugee-serving programs should consider the complex relationships between resource needs, utilization, and migration stressors during the transmigration period. Government and non-government agencies should focus on increasing access to appropriate resources to help attenuate the relationship between transmigration stress and adverse health effects. Findings also underscore the need for implementing creative policy solutions for building and sustaining more effective interventions for camp refugees.