The Association between Internal Displacement Status and Violent Injuries in Jaffna District, Sri Lanka: A Retrospective Population-based Survey Open Access

Abstract

The Association between Internal Displacement Status and Violent Injuries in Jaffna
District, Sri Lanka: A Retrospective Population-based Survey

by Lana Meiqari

Introduction Injuries account for 12% of the global burden of disease. Forced displacement is
one of the effects of complex humanitarian emergencies, and little is known about the burden of
injuries among vulnerable populations such as internally displaced persons (IDPs).

Objectives To describe the burden of violent injury during the complex humanitarian emergency
in Sri Lanka by estimating the annual incidence of violent injury; and to examine the association
between internal displacement and violent injuries during the conflict in Jaffna District, Sri
Lanka.

Methods Between July and September 2009, a multistage cluster sample survey was conducted
among 1494 households (HHs) in Jaffna District including 2 IDP camps. The study participants
included 8,096 people; 30% of them were displaced since April 2000. The head of the household
was asked to report if any HH members had a violence-related injury since April 2000. Bivariate
analysis and multivariable logistic regression methods were used to determine the association
between displacement status and reporting a violent injury.

Results The overall incidence of violence-related injuries among Jaffna residents is 130 cases per
100,000 persons per year. IDPs were more likely to report a violent injury than non-IDPs
(OR=3.1; 95% CI, 2.0-4.7). After adjusting for age, current status, religion and access to health
care facility, the odds of reporting a violent injury is still significantly higher among IDPs
compared to non-IDPs (OR=2.9; 95% CI, 1.9-4.5).

Conclusion Among residents of Jaffna District in Sri Lanka, the odds of reporting a violence-
related injury is significantly associated with displacement status.

Key Words Complex humanitarian emergency, internal displacement, forced displacement,
population displacement, refugee, epidemiology of injury, violence-related injury.

Table of Contents

List of Abbreviations

List of Tables

List of Figures

Chapter I: Introduction

Background

Study Objective(s)

Armed Conflict in Sri Lanka

Study Setting: Jaffna District

Chapter II: Literature Review

Definition of Terms

Global Burden of Injury

Epidemiologic Basis of Injury

Injury Prevention

Injury during Complex Humanitarian Emergencies (CHEs)

Injury among Refugees and IDPs

Injury in Sri Lanka

Summary

Chapter III: Methods

Research Question

Data Source

Study Population

Survey Design

Data Collection

Sample Size

Measures

Statistical Analysis

Ethical Approval

Chapter IV: Results
Chapter V: Discussion
Chapter VI: References
Appendix A: Tables

Appendix B: Figures

Appendix C: Supplementary Tables

About this Master's Thesis

Rights statement

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MSPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	refugee population displacement violence-related injury forced displacement epidemiology of injury internal displacement Complex humanitarian emergency
Committee Chair / Thesis Advisor	Carter, John T, Emory University
Committee Members	Anderson, Mark, US Centers of Disease Control and Prevention
Partnering Agencies	CDC

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