Disability, childhood experiences of violence and associated health outcomes in refugee settlements in Uganda

Background: There is limited evidence regarding the associations between disability, childhood experiences of violence, and associated health outcomes in humanitarian settings. Objective: We examined the prevalence of childhood sexual, physical, and emotional violence by disability status, explored associations between childhood violence and type of disability (limitation), perpetrator types, and the negative health outcomes associated with experiencing childhood violence by disability status. Participant and Setting: Participants included 1338 females and 927 males aged 13–24 years living in refugee settings in Uganda. Methods: Data were from a cross-sectional Humanitarian Violence against Children and Youth Survey (HVACS) conducted between March and April 2022 in Uganda. Analysis entailed cross-tabulation with a chi-square test and estimation of bivariate and multivariate logistic regression models. Results: For both females and males, the prevalence of sexual violence in childhood was higher among those with disabilities compared to those without disabilities (23.2% vs. 11.5% for females; and 15.7% vs. 7.6% for males). The odds of experiencing sexual violence were higher among females with physical limitations (self-care [AOR:2.1; 95%CI-1.0-4.3] and task performance [AOR:2.5; 95%CI = 1.3–5.2]) and males with both physical [AOR:4.4; 95%CI = 1.4–13.7] and communication [AOR:4.1; 95%CI = 1.3–12.9] limitations compared to those without such limitations. Experiencing violence and having disabilities increased the odds of reporting negative health outcomes including severe mental distress and symptoms or being diagnosed with STI among females by three times. Conclusion: In Uganda's refugee settings, the prevalence of childhood violence is higher among children and youth with disabilities compared to those without disabilities. Females with disabilities and who had experienced childhood violence were considerably more susceptible to negative health outcomes. These findings underscore the need for targeted child protection and response interventions to address the vulnerabilities of children and youth, and particularly for those with disabilities and female children.