A community-based intervention to improve mental health in female survivors of sexual and gender-based violence (SGBV) in a peri-urban community of Misisi in Lusaka, Zambia

Chiwele, Kayumba (2025) A community-based intervention to improve mental health in female survivors of sexual and gender-based violence (SGBV) in a peri-urban community of Misisi in Lusaka, Zambia. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Despite the high prevalence of domestic violence cases in Zambia’s poor communities and the trauma associated with the survivors, most initiatives that seek to prevent sexual and gender-based violence (SGBV) remain small-scale and short-term. Using a longitudinal mixed-method design, this doctoral study sought to assess the extent and main forms of SGBV that women and girls are exposed to in Misisi compound, a peri-urban community in Zambia and then went on to evaluate the feasibility and preliminary effectiveness of a novel trauma-focused community-based intervention (CBI) supporting survivors. Paper 1 reviews and evaluates existing literature on the effectiveness of interventions designed to enhance mental health in female SGBV survivors from LMICs. The review finds that whilst CBIs are increasingly becoming popular in addressing SGBV, more research is needed to explore psychological interventions delivered by lay counsellors in LMICs, as there remains a significant gap in this research area. Paper 2 presents Stage 1 of the research, comprising the delivery of a co-developed TF-CBT training to a group of six wives of religious leaders (Amai Busas) with no mental health background and demonstrates its effectiveness in enhancing their confidence, knowledge, and skills in delivering TF-CBT to survivors. Paper 3 presents Stage 2 of the study, which demonstrates the feasibility, acceptability and effectiveness of a six-week TF-CBT intervention delivered by the trained Amai Busas in significantly improving mental health among female SGBV survivors and positively impacting the community. My key finding and contribution to knowledge is that a co-developed, culturally adapted CBI delivered by trained and supervised members of a low-resource community was successful in enhancing the mental health of women affected by SGBV in a LMIC country with a shortage of mental health specialists. Additionally, a training co-developed in collaboration with lay community members had a positive outcome and impact on participants’ knowledge, skills and perception of their ability to support female survivors of SGBV.