title: After abduction: exploring access to reintegration programs and mental health status among young female abductees in Northern Uganda.
abstract: BACKGROUND
  Reintegration programs are commonly offered to former combatants and abductees to acquire civilian status and support services to reintegrate into post-conflict society. Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status among young women who had accessed reintegration programming compared to those who self-reintegrated.
  
  
  METHODS
  This cross-sectional study analysed interviews from 129 young women who had previously been abducted by the Lords Resistance Army (LRA). Data was collected between June 2011-January 2012. Interviews collected information on abduction-related experiences including age and year of abduction, manner of departure, and reintegration status. Participants were coded as 'reintegrated' if they reported ≥1 of the following reintegration programs: traditional cleansing ceremony, received an amnesty certificate, reinsertion package, or had gone to a reception centre. A t-test was used to measure mean differences in depression and anxiety measured by the Acholi Psychosocial Assessment Instrument (APAI) to determine if abductees who participated in a reintegration program had different mental status from those who self-reintegrated.
  
  
  RESULTS
  From 129 young abductees, 56 (43.4%) had participated in a reintegration program. Participants had been abducted between 1988-2010 for an average length of one year, the median age of abduction was 13 years (IQR:11-14) with escaping (76.6%), being released (15.6%), and rescued (7.0%) being the most common manner of departure from the LRA. Traditional cleansing ceremonies (67.8%) were the most commonly accessed support followed by receiving amnesty (37.5%), going to a reception centre (28.6%) or receiving a reinsertion package (12.5%). Between group comparisons indicated that the mental health status of abductees who accessed ≥1 reintegration program were not significantly different from those who self-reintegrated (p > 0.05).
  
  
  CONCLUSIONS
  Over 40% of female abductees in this sample had accessed a reintegration program, however significant differences in mental health were not observed between those who accessed a reintegration program and those who self-reintegrated. The successful reintegration of combatants and abductees into their recipient community is a complex process and these results support the need for gender-specific services and ongoing evaluation of reintegration programming.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada ; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada ; Liu Institute for Global Issues, University of British Columbia, 6576 NW Marine Dr, Vancouver, Canada.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Muldoon
authors.affiliation: The AIDS Support Organization, Gulu, Uganda Mulago Hospital Complex, PO Box 10443, Kampala, Uganda.
authors.forename: Godfrey
authors.initials: G
authors.lastname: Muzaaya
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, 677 Huntington, Ave, Boston, MA 02115, USA.
authors.forename: Theresa S
authors.initials: TS
authors.lastname: Betancourt
authors.affiliation: The AIDS Support Organization, Gulu, Uganda Mulago Hospital Complex, PO Box 10443, Kampala, Uganda.
authors.forename: Mirriam
authors.initials: M
authors.lastname: Ajok
authors.affiliation: The AIDS Support Organization, Gulu, Uganda Mulago Hospital Complex, PO Box 10443, Kampala, Uganda.
authors.forename: Monica
authors.initials: M
authors.lastname: Akello
authors.affiliation: Simon Fraser University, Burnaby, British Columbia, 8888 University Drive, Burnaby, BC V5A 1S6, Canada.
authors.forename: Zaira
authors.initials: Z
authors.lastname: Petruf
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Nguyen
authors.affiliation: Liu Institute for Global Issues, University of British Columbia, 6576 NW Marine Dr, Vancouver, Canada.
authors.forename: Erin K
authors.initials: EK
authors.lastname: Baines
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada ; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada ; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Kate
authors.initials: K
authors.lastname: Shannon
keywords: Abduction; Mental health; Northern Uganda; Reintegration; Women