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While there is increased attention to child marriage, defined as marriage before 18 years of age, in countries where the practice is especially prevalent, less attention has been directed at understanding the factors affecting relationships, marriage and cohabitation among adolescents affected by conflict and displacement. This article presents factors which contribute to early relationships and informal marriages in conflict and post-conflict settings, based on qualitative research undertaken among two distinct populations in Uganda: internally displaced persons in Mucwini transit camp in northern Uganda and Congolese refugees in the Nakivale refugee settlement in southwestern Uganda. Themes were examined through a social–ecological framework. Findings indicate that fundamental shifts in economies, family relationships, and communication combined with structural changes encountered in settlements resulted in changed relationships and marriage patterns. Participants reported that poverty, splintering of family, and lack of education – which they believed to be exacerbated by conflict in both settings – had profoundly affected the views, perceptions and behaviours of youth around relationships and marriage. We identify interventions applicable to humanitarian settings that would offer refugee and internally displaced adolescents greater and more meaningful opportunities for development. Si le mariage d'enfants, défini comme le mariage avant l'âge de 18 ans, bénéficie d'une attention accrue dans les pays où la pratique est particulièrement fréquente, on s'est moins attaché à comprendre les facteurs influençant les relations amoureuses, le mariage et la cohabitation entre adolescents touchés par le conflit et le déplacement. Cet article présente les facteurs qui contribuent à des relations précoces et des mariages informels dans les contextes de conflit et post-conflit, sur la base d'une recherche qualitative entreprise parmi deux populations distinctes en Ouganda : des déplacés internes dans le camp de transit de Mucwini en Ouganda septentrional et des réfugiés congolais dans le camp de réfugiés de Nakivale, dans le sud-ouest de l'Ouganda. Les thèmes ont été examinés au moyen d'un cadre socio-écologique. Les conclusions indiquent que des réorientations fondamentales dans les économies, les relations familiales et les communications, jointes à des changements structurels rencontrés dans les environnements, ont abouti à des modifications des relations amoureuses et des modes de mariage. Les participants ont indiqué que la pauvreté, l'éclatement de la famille et le manque d'instruction – des facteurs qui avaient été à leur avis exacerbés par le conflit dans les deux environnements – avaient profondément influencé les idées, les perceptions et les comportements des jeunes autour des relations amoureuses et du mariage. Nous identifions les interventions applicables aux contextes humanitaires qui pourraient offrir aux adolescents réfugiés et déplacés internes des possibilités accrues et plus constructives de développement. Pese a la creciente atención al matrimonio infantil, definido como matrimonio antes de los 18 años de edad, en países donde la práctica está muy extendida, se ha prestado menos atención a entender los factores que afectan las relaciones, el matrimonio y la cohabitación entre adolescentes afectados por conflicto y desplazamiento. En este artículo se exponen los factores que contribuyen a relaciones tempranas y matrimonios informales en ámbitos de conflicto y postconflicto, a raíz de investigaciones cualitativas realizadas en dos poblaciones diferentes: personas desplazadas internamente en el campamento temporal de Mucwini, en Uganda septentrional y refugiados congoleses en el asentamiento de refugiados de Nakivale, en Uganda meridional-occidental. Se examinaron las temáticas mediante un marco socioecológico. Los hallazgos indican que los cambios fundamentales en economías, relaciones familiares y comunicación, combinados con cambios estructurales encontrados en los asentamientos, produjeron cambios en las relaciones y en los patrones matrimoniales. Los participantes relataron que la pobreza, división de la familia y falta de educación –que creen eran exacerbadas por conflicto en ambos ámbitos– habían afectado profundamente los puntos de vista, percepciones y comportamientos de la juventud en torno a las relaciones y el matrimonio. Identificamos las intervenciones aplicables a ámbitos humanitarios que ofrecerían a refugiados y adolescentes desplazados internamente mayores y más significativas oportunidades de desarrollo. [ABSTRACT FROM AUTHOR]

The international community typically responds to refugee situations by establishing ‘care and maintenance’ programmes specifically for refugees. Limited resources may also be directed to hosting communities, but donors often channel the bulk of funding through UNHCR and its implementing partner NGOs, who in turn create service delivery structures that are operated in parallel to local structures. Although there may be cause for this approach in a short-term emergency phase, particularly if the host country systems are very weak, this eventually becomes financially problematic if refugees continue to live in exile for years at a time. In the short term, it can also engender an inequitable and inefficient use of scarce resources. This paper traces the evolution and impact of implementing refugee health services in parallel to local systems using observations from Uganda, and offers Quality Design as a model for planning the local integration of services. [ABSTRACT FROM AUTHOR]

In an emergency, the international community responds to the immediate health needs of refugees through the establishment of action-oriented, life-saving services. Healthcare delivery is often managed with limited, if any, coordination with local health management structures. In situations where refugees remain in the host country for many years, sustainability issues inevitably arise. Refugee-hosting governments may ultimately be called upon to assume the management and funding of refugee services. Planning for service integration, while protecting against declines in service quality, is a challenge in the typically resource-poor host environments. This paper discusses these issues by presenting the experience of the West Nile districts in northern Uganda, and describes quality design as a relevant planning methodology. Quality design is a systematic planning approach that documents and directly incorporates the service users' self-defined expectations and needs.