Humanitarian and government support and mental health among refugees in Ugandan settlements, 2021

Limited research exists on mental health among displaced populations in sub-Saharan Africa. As one of the largest hosts of refugees worldwide, Uganda provides an opportunity to conduct research and examine health outcomes in this context. This study aimed to understand which factors were associated with probable depression and anxiety among refugees in Uganda and which forms of support correlate with better mental health in this population. The 2021 Uganda Refugee Population-based HIV Impact Assessment was a cross-sectional survey of households in refugee settlements in Uganda. Heads of households were asked whether they had received government or humanitarian support in the past 12 months. Patient Health Questionnaire-4 screenings were used to assess probable depression and anxiety. Descriptive statistics were used to evaluate sociodemographic differences in mental health and in whether respondents received support. A survey-weighted logistic regression model was used to assess the relationship between receipt of support and depression or anxiety. Of 2,555 participants with complete data, 54.6% were female, and the median (interquartile range: 20–39) age was 28 years old. Food was the most common type of support with 76.0% of individuals living in households that received this support, with significant differences by age group, country of origin, time in Uganda, settlement region, and wealth index. Approximately 13.3% ( n = 409) of refugees had probable depression and 14.0% ( n = 421) had probable anxiety. Those who received food support had 57% (Adjusted Odds Ratio (aOR) 0.43, 95% CI 0.29–0.65) lower odds of probable depression and 52% (aOR 0.48, 95% CI 0.32–0.71) lower odds of probable anxiety. Those who received water and sanitation support had 40% (aOR 0.60, 95% CI 0.37–0.99) lower odds of probable depression and 45% (aOR 0.55, 95% CI 0.35–0.88) lower odds of probable anxiety. Other forms of support were not significantly associated with a benefit to mental health. Food and water support are associated with better mental health among refugees in Ugandan settlements. These findings suggest that assistance addressing basic needs may play an important role in promoting well-being among refugees, though the direction of these associations cannot be established from cross-sectional data.