{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:33:20Z","timestamp":1787924000320,"version":"build-2784847793"},"reference-count":43,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"unspecified","delay-in-days":150,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"European Union\u2019s Directorate General for International Partnerships","award":["HUM\/2017\/393-881"],"award-info":[{"award-number":["HUM\/2017\/393-881"]}]},{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","award":["ES\/S009965\/1"],"award-info":[{"award-number":["ES\/S009965\/1"]}],"id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,11,11]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Educators\u2019 mental health is crucial for educational outcomes and student well-being, yet limited attention has been given to the psychological effects of violence on teachers, particularly in conflict-affected regions. We explore the relationship between exposure to violence and teachers\u2019 mental health in Eastern Democratic Republic of the Congo (DRC) and Southern Niger, two regions experiencing prolonged and ongoing conflict.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected unique survey data from 990 teachers working in zones of active conflict over three periods from 2019 to 2021. Measures of violence exposure were obtained through self-reports and geo-localised incident data. Mental health outcomes were assessed using a Post-Traumatic Stress Disorder (PTSD) checklist (PCL-C) alongside supplementary metrics, including a burnout inventory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study identifies significant correlations between exposure to violence and adverse mental health outcomes among teachers. In the final survey round, the mean PCL-C score was 27.07 (95% CI 26.02 to 28.13), with potential PTSD symptoms prevalent among 36.14% (95% CI 31.52% to 40.76%) of the research participants (using a 28 cut-off score). These findings are strongly correlated with related metrics such as self-reported trauma and burnout indicators. Variations were observed across gender and regional lines, with female educators showing higher susceptibility to PTSD symptoms. The experience of past and new violence, as reported using different metrics, was correlated with higher PTSD scores. PTSD scores were negatively correlated with teacher professional well-being and teaching practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings underscore the urgent necessity to address the psychosocial impact of conflict-related violence on educators in the DRC and Niger. Implementing and enhancing mental health support frameworks may lessen long-term repercussions on teacher well-being and educational quality. This study offers critical insights into the underexplored domain of teachers\u2019 mental health in conflict settings, signalling an urgent call for policy action to support these educators.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003535","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T06:15:25Z","timestamp":1764569725000},"page":"e003535","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["The mental health toll of conflict-induced violence on teachers: evidence from a longitudinal survey in DRC and Niger"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2404-4983","authenticated-orcid":false,"given":"Diego","family":"De La Fuente Stevens","sequence":"first","affiliation":[{"name":"Department of Economics, University of Sussex, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0291-731X","authenticated-orcid":false,"given":"Jean-Benoit","family":"Falisse","sequence":"additional","affiliation":[{"name":"Centre of African Studies, The University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Polepole","family":"Bazuzi","sequence":"additional","affiliation":[{"name":"Marakuja Kivu Research, Goma, Congo (the Democratic Republic of the)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Matabishi","sequence":"additional","affiliation":[{"name":"Institut Sup\u00e9rieur P\u00e9dagogique de Bukavu, Bukavu, Congo (the Democratic Republic of the)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4351-3941","authenticated-orcid":false,"given":"Gauthier","family":"Marchais","sequence":"additional","affiliation":[{"name":"Institute of Development Studies, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,30]]},"reference":[{"key":"2026010703075665000_3.2.e003535.1","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1080\/14767724.2023.2233481","article-title":"Dissatisfied but nowhere to go: teacher attrition in the context of mass unemployment in Sub-Saharan Africa","volume":"23","author":"Bennell","year":"2025","journal-title":"Globalisation, Societies and Education"},{"key":"2026010703075665000_3.2.e003535.2","unstructured":"UNESCO . Transforming education from within: current trends in the status and development of teachers. World Teachers; 2022. Available: https:\/\/unesdoc.unesco.org\/ark:\/48223\/pf0000383002 [Accessed 21 Mar 2025]."},{"key":"2026010703075665000_3.2.e003535.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijedudev.2025.103228","article-title":"The teachers who leave: Teacher attrition in Burkina Faso","volume":"113","author":"Bedasso","year":"2025","journal-title":"Int J Educ Dev"},{"key":"2026010703075665000_3.2.e003535.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdeveco.2019.102387"},{"key":"2026010703075665000_3.2.e003535.5","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1093\/qje\/qjaa027","article-title":"The Effects of Police Violence on Inner-City Students*","volume":"136","author":"Ang","year":"2020","journal-title":"Q J Econ"},{"key":"2026010703075665000_3.2.e003535.6","doi-asserted-by":"publisher","DOI":"10.1162\/REST_a_00628"},{"key":"2026010703075665000_3.2.e003535.7","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1080\/15388220.2022.2105857","article-title":"Teachers\u2019 Safety and Workplace Victimization: A Socioecological Analysis of Teachers\u2019 Perspective","volume":"21","author":"Berkowitz","year":"2022","journal-title":"J Sch Violence"},{"key":"2026010703075665000_3.2.e003535.8","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1038\/s44220-025-00413-7","article-title":"Mental health consequences of exposure to mass and non-mass shootings in a national sample of US adults","volume":"3","author":"Peterson","year":"2025","journal-title":"Nat Mental Health"},{"key":"2026010703075665000_3.2.e003535.9","doi-asserted-by":"crossref","first-page":"e469","DOI":"10.1016\/S2468-2667(22)00061-5","article-title":"Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis","volume":"7","author":"Mesa-Vieira","year":"2022","journal-title":"Lancet Public Health"},{"key":"2026010703075665000_3.2.e003535.10","doi-asserted-by":"crossref","DOI":"10.1136\/bmjment-2023-300773","article-title":"Depression, violence and socioeconomic outcomes among refugees in East Africa: evidence from a multicountry representative survey","volume":"26","author":"Pozuelo","year":"2023","journal-title":"BMJ Ment Health"},{"key":"2026010703075665000_3.2.e003535.11","doi-asserted-by":"crossref","unstructured":"Mendenhall M , Marchais G , Boothby N , et al . Education and resilience in crisis: challenges and opportunities in sub-saharan Africa. Bristol University Press; 2024. Available: https:\/\/bristoluniversitypress.co.uk\/education-crisis-and-resilience [Accessed 21 Mar 2025].","DOI":"10.56687\/9781529234718"},{"key":"2026010703075665000_3.2.e003535.12","unstructured":"Falk D , Frisoli P , Varni E . The importance of teacher well-being for student mental health and resilient education systems. Forced Migr Rev 2021. Available: https:\/\/ora.ox.ac.uk\/objects\/uuid:4cf91bee-3f5b-43e6-b1de-3e7bf4bbc52a"},{"key":"2026010703075665000_3.2.e003535.13","unstructured":"World Health Organization . World mental health report: transforming mental health for all. 2022."},{"key":"2026010703075665000_3.2.e003535.14","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v6.28541"},{"key":"2026010703075665000_3.2.e003535.15","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1086\/734798","article-title":"Violence Against Teachers and the Entanglement of Schools in Violent Conflict in Eastern Democratic Republic of the Congo","volume":"69","author":"Marchais","year":"2025","journal-title":"Comp Educ Rev"},{"key":"2026010703075665000_3.2.e003535.16","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/afraf\/adaa022","article-title":"The Sahel crisis since 2012","volume":"120","author":"Raleigh","year":"2021","journal-title":"Afr Aff (Lond)"},{"key":"2026010703075665000_3.2.e003535.17","unstructured":"GCPEA . Education under attack. Global Coalition to Protect Education from Attack; 2024. Available: https:\/\/eua2024.protectingeducation.org\/"},{"key":"2026010703075665000_3.2.e003535.18","doi-asserted-by":"crossref","DOI":"10.1038\/s44184-023-00051-w","article-title":"Mental health outcomes, literacy and service provision in low- and middle-income settings: a systematic review of the Democratic Republic of the Congo","volume":"3","author":"Ngamaba","year":"2024","journal-title":"Npj Ment Health Res"},{"key":"2026010703075665000_3.2.e003535.19","unstructured":"Abdourahamane MM . Gouvernance de l\u2019\u00e9ducation au Niger: les acteurs et leurs pratiques. 2022. Available: https:\/\/www.torrossa.com\/gs\/resourceProxy?an=5501573&publisher=FZ2990 [Accessed 03 Feb 2025]."},{"key":"2026010703075665000_3.2.e003535.20","doi-asserted-by":"crossref","first-page":"53","DOI":"10.33682\/h6vr-fsnx","article-title":"Implementing Free Primary Education in a Crisis Context: COVID-19 and Education Reform in South Kivu, Democratic Republic of the Congo","volume":"8","author":"Falisse","year":"2022","journal-title":"Journal on Education in Emergencies"},{"key":"2026010703075665000_3.2.e003535.21","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-021-03343-7","article-title":"PTSD, depression and anxiety in Ebola virus disease survivors in Beni town, Democratic Republic of the Congo","volume":"21","author":"Kaputu-Kalala-Malu","year":"2021","journal-title":"BMC Psychiatry"},{"key":"2026010703075665000_3.2.e003535.22","unstructured":"Spoont M . Screening for post-traumatic stress disorder (PTSD) in primary care: a systematic review. 2013."},{"key":"2026010703075665000_3.2.e003535.23","doi-asserted-by":"publisher","DOI":"10.1002\/da.20226"},{"key":"2026010703075665000_3.2.e003535.24","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1348\/096317900166877","article-title":"The factorial validity of the Maslach Burnout Inventory\u2010General Survey (MBI\u2010GS) across occupational groups and nations","volume":"73","author":"Schutte","year":"2000","journal-title":"J Occupat & Organ Psyc"},{"key":"2026010703075665000_3.2.e003535.25","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.childyouth.2018.09.041","article-title":"Teacher burnout in pre-schools: A cross-cultural factorial validity, measurement invariance and latent mean comparison of the Maslach Burnout Inventory, Educators Survey (MBI-ES)","volume":"94","author":"Aboagye","year":"2018","journal-title":"Child Youth Serv Rev"},{"key":"2026010703075665000_3.2.e003535.26","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.psychres.2017.09.022","article-title":"PTSD, burnout and well-being among rescue workers: Seeking to understand the impact of the European refugee crisis on rescuers","volume":"262","author":"Chatzea","year":"2018","journal-title":"Psychiatry Res"},{"key":"2026010703075665000_3.2.e003535.27","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1111\/disa.12245","article-title":"Monitoring and reporting attacks on education in the Democratic Republic of the Congo and Somalia","volume":"42","author":"Bennouna","year":"2018","journal-title":"Disasters"},{"key":"2026010703075665000_3.2.e003535.28","unstructured":"Falk D , Varni E , Johna JF , et al . Landscape review: teacher well-being in low resource, crisis, and conflict-affected settings. Washington, DC: Education Equity Research Initiative, 2019."},{"key":"2026010703075665000_3.2.e003535.29","doi-asserted-by":"publisher","DOI":"10.1111\/cdev.12184"},{"key":"2026010703075665000_3.2.e003535.30","doi-asserted-by":"publisher","DOI":"10.2307\/2095465"},{"key":"2026010703075665000_3.2.e003535.31","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31612-X"},{"key":"2026010703075665000_3.2.e003535.32","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003090","article-title":"National and regional prevalence of posttraumatic stress disorder in sub-Saharan Africa: A systematic review and meta-analysis","volume":"17","author":"Ng","year":"2020","journal-title":"PLoS Med"},{"key":"2026010703075665000_3.2.e003535.33","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20031802","article-title":"PTSD (Posttraumatic Stress Disorder) in Teachers: A Mini Meta-Analysis during COVID-19","volume":"20","author":"Idoiaga Mondragon","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2026010703075665000_3.2.e003535.34","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.133.2.183"},{"key":"2026010703075665000_3.2.e003535.35","doi-asserted-by":"crossref","unstructured":"Park CL , Currier JM , Harris JI , et al . Trauma, meaning, and spirituality: translating research into clinical practice. American Psychological Association; 2017. Available: https:\/\/psycnet.apa.org\/record\/2016-20922-000 [Accessed 05 Jun 2025].","DOI":"10.1037\/15961-000"},{"key":"2026010703075665000_3.2.e003535.36","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s12310-022-09507-4","article-title":"An Examination of the Associations Among Teacher Secondary Traumatic Stress, Teacher\u2013Student Relationship Quality, and Student Socio-Emotional Functioning","volume":"14","author":"Simon","year":"2022","journal-title":"School Ment Health"},{"key":"2026010703075665000_3.2.e003535.37","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-017-1304-4","article-title":"Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women","volume":"17","author":"Gelaye","year":"2017","journal-title":"BMC Psychiatry"},{"key":"2026010703075665000_3.2.e003535.38","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30060-9"},{"key":"2026010703075665000_3.2.e003535.39","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/S2215-0366(14)70312-8","article-title":"Mental health interventions in schools in high-income countries","volume":"1","author":"Fazel","year":"2014","journal-title":"Lancet Psychiatry"},{"key":"2026010703075665000_3.2.e003535.40","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-054856","article-title":"School-based MHPSS interventions in humanitarian contexts: a realist review","volume":"12","author":"Lasater","year":"2022","journal-title":"BMJ Open"},{"key":"2026010703075665000_3.2.e003535.41","doi-asserted-by":"crossref","DOI":"10.1016\/j.jmh.2022.100129","article-title":"Pathways to care: IDPs seeking health support and justice for sexual and gender-based violence through social connections in Garowe and Kismayo, Somalia and South Kivu, DRC","volume":"6","author":"Boeyink","year":"2022","journal-title":"J Migr Health"},{"key":"2026010703075665000_3.2.e003535.42","doi-asserted-by":"crossref","DOI":"10.1017\/S2045796020001018","article-title":"Scaling up mental health care and psychosocial support in low-resource settings: a roadmap to impact","volume":"29","author":"Jordans","year":"2020","journal-title":"Epidemiol Psychiatr Sci"},{"key":"2026010703075665000_3.2.e003535.43","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1086\/682902","article-title":"Cumulative Risk and Teacher Well-Being in the Democratic Republic of the Congo","volume":"59","author":"Wolf","year":"2015","journal-title":"Comp Educ Rev"}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2025-003535","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T11:11:01Z","timestamp":1767784261000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2025-003535"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":43,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,11,30]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/bmjph-2025-003535"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2025-003535","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}