Abstract
Somalia remains one of the world’s most fragile states, where protracted conflict, recurrent climate shocks, and large-scale displacement have eroded social cohesion and weakened public services. Internally displaced persons (IDPs), particularly women, face multiple overlapping vulnerabilities including the loss of livelihoods, disrupted social networks, economic insecurity, and heightened exposure to gender-based violence (GBV). Traditional protection mechanisms often collapse in displacement settings, while access to formal mental health and psychosocial support (MHPSS) services remains extremely limited due to workforce shortages and resource constraints. These conditions contribute to significant health and wellbeing challenges among Somali women. Evidence indicates high levels of psychosocial distress and violence exposure: approximately one-third of Somali women report lifetime intimate partner violence, and nearly one in five report experiences of non-partner violence.
To address these intersecting risks, the International Organization for Migration in Somalia piloted an integrated program known as Horseed with female self-help groups (SHGs) in IDP settlements. The pilot combined livelihoods support with a psychosocial curriculum adapted from the World Health Organization Self-Help Plus (SH+) stress management program. Participants engaged in structured group sessions focused on emotional regulation, coping strategies, and peer support, alongside livelihoods training and start-up inputs. Early findings indicated improvements in coping capacity, perceived social support, and confidence in managing stress. Women also reported increased motivation and ability to re-engage in income-generating activities, suggesting that lay-facilitated, group-based MHPSS programming is feasible and acceptable in this context.
Building on these promising results, this study proposes a randomized controlled trial (RCT) to rigorously evaluate the Horseed model. The trial will enroll approximately 1,295 recently displaced women across 65 SHGs, randomly assigned to one of three arms: (1) control, (2) livelihoods support only, or (3) livelihoods support combined with an 8–12 week MHPSS curriculum. Outcomes will be assessed at baseline, 6 months, and 12 months using validated measures of psychosocial wellbeing, resilience, GBV exposure, and economic stability to determine whether integrated livelihoods and MHPSS programming can strengthen resilience and reduce GBV risk among conflict-affected women.