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Does poverty alleviation decrease depression symptoms in post-conflict settings? A cluster-randomized trial of microenterprise assistance in Northern Uganda

  • E. P. Green (a1), C. Blattman (a2), J. Jamison (a3) and J. Annan (a4)
Abstract
Background.

By 2009, two decades of war and widespread displacement left the majority of the population of Northern Uganda impoverished.

Methods.

This study used a cluster-randomized design to test the hypothesis that a poverty alleviation program would improve economic security and reduce symptoms of depression in a sample of mostly young women. Roughly 120 villages in Northern Uganda were invited to participate. Community committees were asked to identify the most vulnerable women (and some men) to participate. The implementing agency screened all proposed participants, and a total of 1800 were enrolled. Following a baseline survey, villages were randomized to a treatment or wait-list control group. Participants in treatment villages received training, start-up capital, and follow-up support. Participants, implementers, and data collectors were not blinded to treatment status.

Results.

Villages were randomized to the treatment group (60 villages with 896 participants) or the wait-list control group (60 villages with 904 participants) with an allocation ration of 1:1. All clusters participated in the intervention and were included in the analysis. The intent-to-treat analysis included 860 treatment participants and 866 control participants (4.1% attrition). Sixteen months after the program, monthly cash earnings doubled from UGX 22 523 to 51 124, non-household and non-farm businesses doubled, and cash savings roughly quadrupled. There was no measurable effect on a locally derived measure of symptoms of depression.

Conclusions.

Despite finding large increases in business, income, and savings among the treatment group, we do not find support for an indirect effect of poverty alleviation on symptoms of depression.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
*Address for correspondence: E. P. Green, Duke Global Health Institute, Box 90519, Durham, North Carolina 27708, USA. (Email: eric.green@duke.edu)
References
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Annan, J, Blattman, C, Mazurana, D, Carlson, K (2011). Civil war, reintegration, and gender in Northern Uganda. Journal of Conflict Resolution 55, 877908.
Blattman, C, Green, E, Jamison, J, Lehmann, C, Annan, J (forthcoming). The returns to microenterprise support among the ultra-poor: a field experiment in post-war Uganda. American Economic Journal: Applied Economics.
Bolton, P, Bass, J, Betancourt, T, Speelman, L, Onyango, G, Clougherty, KF, Neugebauer, R, Murray, L, Verdeli, H (2007). Interventions for depression symptoms among adolescent survivors of war and displacement in Northern Uganda. JAMA: The Journal of the American Medical Association 298, 519527. doi: 10.1001/jama.298.5.519
Burns, JK (2015). Poverty, inequality and a political economy of mental health. Epidemiology and Psychiatric Sciences 24, 107113. doi: 10.1017/S2045796015000086
Das, J, Do, Q-T, Friedman, J, McKenzie, D, Scott, K (2007). Mental health and poverty in developing countries: Revisiting the relationship. Social Science and Medicine 65, 467480.
Fernald, LC, Hamad, R, Karlan, D, Ozer, EJ, Zinman, J (2008). Small individual loans and mental health: a randomized controlled trial among South African adults. BMC Public Health 8, 409.
GBD (2010, 2012). Global Burden of Disease Study 2010 (GBD 2010) Results by Cause 1990–2010. Institute for Health Metrics and Evaluation (IHME): Seattle, WA.
Haushofer, J, Fehr, E (2014). On the psychology of poverty. Science 344, 862867. doi: 10.1126/science.1232491
Haushofer, J, Shapiro, J (2013). Household response to income changes: evidence from an unconditional cash transfer program in Kenya. Unpublished manuscript (http://ipc.umich.edu/pdf/haushofer-shapiro-2014-03-27.pdf)
IDMC (2012). Need to Focus on Returnees and Remaining IDPs in Transition to Development. IDMC: Geneva, Switzerland (http://www.internal-displacement.org/assets/library/Africa/Uganda/pdf/Uganda-May-2012.pdf)
Lund, C, Breen, A, Flisher, AJ, Kakuma, R, Corrigall, J, Joska, JA, Swartz, L, Patel, V (2010). Poverty and common mental disorders in low and middle income countries: a systematic review. Social Science and Medicine 71, 517528.
Lund, C, De Silva, M, Plagerson, S, Cooper, S, Chisholm, D, Das, J, Knapp, M, Patel, V (2011). Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet 378, 15021514. doi: 10.1016/S0140-6736(11)60754-X
Miranda, JJ, Patel, V (2005). Achieving the millennium development goals: does mental health play a role? PLoS Medicine 2, e291.
Ozer, EJ, Fernald, LC, Weber, A, Flynn, EP, VanderWeele, TJ (2011). Does alleviating poverty affect mothers’ depressive symptoms? A quasi-experimental investigation of Mexico's Oportunidades programme. International Journal of Epidemiology 40, 15651576.
Patel, V, Kleinman, A (2003). Poverty and common mental disorders in developing countries. Bulletin of the World Health Organization 81, 609615.
Prince, M, Patel, V, Saxena, S, Maj, M, Maselko, J, Phillips, MR, Rahman, A (2007). No health without mental health. Lancet 370, 859877.
Thornicroft, G, Patel, V (2014). Including mental health among the new sustainable development goals. BMJ 349, g5189g5189. doi: 10.1136/bmj.g5189
Tol, WA, Barbui, C, Galappatti, A, Silove, D, Betancourt, TS, Souza, R, Golaz, A, van Ommeren, M (2011). Mental health and psychosocial support in humanitarian settings: linking practice and research. Lancet 378, 15811591. doi: 10.1016/S0140-6736(11)61094-5
UN (2014). Millennium Development Goals Report 2014. United Nations, New York.
Vinck, P, Pham, PN, Stover, E, Weinstein, HM (2007). Exposure to war crimes and implications for peace building in northern Uganda. JAMA: The Journal of the American Medical Association 298, 543554. doi: 10.1001/jama.298.5.543
WHO (2011). Mental Health Atlas 2011. World Health Organization: Geneva.
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