Randomised Controlled Trial of a Trauma-Informed Health Education Intervention for Conflict-Displaced Women in North East Nigeria

Women displaced by conflict in North East Nigeria experience compounded health vulnerabilities arising from trauma exposure, disrupted health services, and gender-based violence, necessitating trauma-informed approaches to health education. This study conducted a randomised controlled trial to evaluate the effectiveness of a trauma-informed health education intervention for conflict-displaced women in North East Nigeria, with sites in Borno and Adamawa states. A total of 340 adult displaced women were randomised to a 12-week trauma-informed health education programme or to a standard health information comparison condition. The programme integrated trauma-sensitive facilitation, psychological first aid principles, and evidence-based health education content on reproductive health, nutrition, and disease prevention. Primary outcomes included health knowledge, self-efficacy, and psychological wellbeing measured at baseline, post-intervention, and six-month follow-up. Intention-to-treat analysis using generalised linear mixed models was applied. Results showed significantly greater improvements in health knowledge (adjusted mean difference 14.2 points, p less than 0.001), self-efficacy (11.3 points, p less than 0.001), and psychological wellbeing (10.8 points, p less than 0.01) in the intervention arm, sustained at six-month follow-up. The study provides the first experimental evidence for trauma-informed health education effectiveness among conflict-displaced Nigerian women. Keywords: trauma-informed health education, conflict-displaced women, North East Nigeria, randomised controlled trial, psychological wellbeing