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AbstractThe psychological burden of conflict-induced displacement is severe. Currently, there are 80 million displaced persons around the world, and their number is expected to increase in upcoming decades. Yet, few studies have systematically assessed the effectiveness of programs that assist displaced persons, especially in settings of extreme vulnerability. We focus on eastern Democratic Republic of Congo, where myriad local armed conflicts have driven cycles of displacement for over 20 years. We conducted a within-village randomized field experiment with 976 households, across 25 villages, as part of the United Nations' Rapid Response to Population Movements program. The program provided humanitarian relief to over a million people each year, including vouchers for essential nonfood items, such as pots, pans, cloth, and mattresses. The vouchers led to large improvements in psychological well-being: a 0.32 standard deviation unit (SDU) improvement at 6 weeks, and a 0.18 SDU improvement at 1 year. There is no evidence that the program undermined social cohesion within the village, which alleviates worries related to programs that target some community members but not others. Finally, there was no improvement in child health.

Background: Women's empowerment may require women to change their beliefs and views about their rights and capabilities. Empowerment programs often target women who have survived sexual and gender-based violence (SGBV), with the justification that these women may develop disempowered beliefs as a coping mechanism, or face greater barriers to, or derive greater benefits from, the adoption of empowered beliefs and preferences. We investigated an intensive, six-month residential empowerment program ("City of Joy") for SGBV survivors in eastern Democratic Republic of the Congo (DRC), where more than one in five women have experienced SGBV. Methods: We asked 175 participants about their beliefs and preferences pertaining to political, financial, and domestic empowerment. Interviews took place immediately before and after participation in the program, and we tested for differences in views of empowerment between entry and exit using paired t-tests and McNemar's test. We also conducted 50 semi-structured interviews about empowerment with an additional 30 women who had completed the program up to 5 years earlier and then returned to their home community. Results: Prior to enrolling in the program, participants had fairly empowered views regarding politics, less empowered views regarding finances, and still less empowered views regarding the domestic sphere. After completing the program, participants had significantly more empowered views in all three domains, particularly regarding domestic violence, how families should treat men and women, and women's economic rights. Participants in their home communities reported taking a more active role in community affairs and speaking out against the mistreatment of women. Conclusion: This study adds to the evidence that women's empowerment programs can change participants' beliefs and thus increase the confidence with which they participate in their communities and support one another.

City of Joy Brief Points is an intensive six-month support program for survivors of sexual violence in eastern Democratic Republic of the Congo (DRC) that aims to transform vulnerable women into community leaders. What transformations do we see in participants from the time of starting the program to the end of the program? Systematic survey results indicate that the women display significant changes in their attitudes and knowledge about women's empowerment and leadership, indicating that the program has a strong immediate effect on changing the participants' views on female leadership. However, further research is needed on the degree to which – and for whom – these positive changes endure after the women re-enter their home communities.

INTRODUCTION: Inadequate water and sanitation is a central challenge in global health. Since 2008, the Democratic Republic of Congo government has implemented a national programme, Healthy Villages and Schools (Villages et Ecoles Assainis (VEA), with support from UNICEF, financed by UK's Foreign, Commonwealth and Development Office. METHODS: A cluster-level randomised controlled trial of VEA was implemented throughout 2019 across 332 rural villages, grouped into 50 treatment and 71 control clusters. Primary outcomes included time spent collecting water; quantity of water collected; prevalence of improved primary source of drinking water; and prevalence of improved primary defecation site. Secondary outcomes included child health, water governance, water satisfaction, handwashing practices, sanitation practices, financial cost of water, school attendance and water storage practices. All outcomes were self-reported. The primary analysis was on an intention-to-treat basis, using linear models. Outcomes were measured October–December 2019, median 5 months post-intervention. RESULTS: The programme increased access to improved water sources by 33 percentage points (pp) (95% CI 22 to 45), to improved sanitation facilities by 26 pp (95% CI 14 to 37), and improved water governance by 1.3 SDs (95% CI 1.1 to 1.5), water satisfaction by 0.6 SD (95% CI 0.4 to 0.9), handwashing practices by 0.5 SD (95% CI 0.3 to 0.7) and sanitation practices by 0.3 SD (95% CI 0.1 to 0.4). There was no significant difference in financial cost of water, school attendance, child health or water storage practices. CONCLUSION: VEA produced large increases in access to and satisfaction with water and sanitation services, in self-reported hygiene and sanitation behaviour, and in measures of water governance. TRIAL REGISTRATION NUMBER: AEARCTR-0004648; American Economic Association RCT registry.