Collaborating with Community-Based Organizations to Understand Barriers and Facilitators of Mental Health for Adolescent Girls and Young Women in Burundi

Background and Purpose

Adolescent girls and young women in Burundi face significant mental health challenges due to exposure to traumatic situations experienced during the recent conflict in the country. According to a report by the World Health Organization, mental health disorders are a leading cause of disability among young people in Burundi. Additionally, stigma and lack of access to mental health services further exacerbate the problem. This study aimed to collaborate with community-based organizations to understand the barriers and facilitators of mental health and well-being strategies for adolescent girls and young women in Burundi.

Methods

We used purposive sampling to recruit participants for the Key Informant Interviews (KIIs) and Focused Group Discussions (FDGs). Purposive sampling ensured the inclusion of diverse and representative participants with specific characteristics relevant to the study's objectives, such as community-based organizations (CBOs) that serve girls with different socio-economic backgrounds and marginalization statuses. The sample included CBOs, adolescent girls, young women, and their parents/caregivers. The sample consists of 40 KIIs and four FGDs with the girls (10 participants per FDG). Working through community-based organizations provided access to the girls in the CBO programs and gave voice to the lived experiences of the girls and young women. In addition, using a qualitative approach allowed us to gain a deeper understanding of the challenges faced by girls.

Results

CBOs and the participants identified several barriers to girls' access to mental health services, including the lack of availability of mental health services, the stigma attached to seeking mental health services, and the lack of confidentiality when seeking mental health services. The results of this study revealed four themes: 1) a significant lack of access to essential services for girls in Burundi, but more pronounced for those in remote and conflict-affected areas and the stigma attached to mental health. 2) School-based mental health interventions provide the safest and most stable spaces for girls and provide the most effective strategy to mitigate trauma 3) Responsiveness to the cultural context in providing mental health services is critical, such as embedding interventions and services in gender and social norms, incorporating traditional healing mechanisms and healers, and understanding and using local language and words for mental health and 4) collaborating with community-based organizations to plan, design and implement mental health interventions and services

Conclusion and Implications

Overall, this study highlighted the importance of involving key CBOs in addressing the needs of girls. Through CBOs, both in school and out of school, girls' mental health can be addressed. For in-school girls, CBOs can be leveraged to train teachers to provide social-emotional support to the girls because schools offer a safe, supportive, inclusive, and positive environment. Parents could also receive the same training to support their girls at home. For out-of-school girls, partnering with community groups, religious institutions, and youth organizations to provide opportunities for social and emotional skill development through extra-curricular activities, peer groups, and community service initiatives is a viable strategy.