A Theoretical Framework for Analysing Mental Distress and Food Insecurity Among South Sudanese Refugees in Bidibidi Settlement, Uganda: An African Perspective

The protracted displacement of South Sudanese refugees in Uganda presents complex public health challenges. In the Bidibidi settlement, mental distress and food insecurity are significant, yet their interrelationship is not well theorised from an African, context-specific perspective. Existing frameworks often neglect the unique socio-cultural and displacement-related factors of this setting. This article aims to develop a theoretical framework for analysing the association between mental distress and food insecurity among South Sudanese refugees in Bidibidi. Its objectives are to synthesise relevant concepts from African psychosocial models and public health literature, and to propose a contextually grounded model elucidating the bidirectional pathways between these conditions. The framework was constructed through a critical synthesis and integrative review of existing literature. This involved analysing concepts from African ethnopsychology, refugee mental health models, and food security frameworks, which were synthesised to propose a coherent theoretical model specific to Bidibidi. Key insights: The framework posits a cyclical, reinforcing relationship where food insecurity acts as both a profound stressor and a consequence of impaired functioning due to mental distress. A key insight is the central mediating role of perceived loss of social role and community cohesion, which is exacerbated by food scarcity. The framework provides a context-sensitive tool for understanding the complex nexus of mental distress and food insecurity in Bidibidi. It moves beyond Western-centric models by centring African psychosocial concepts and the realities of protracted refugee settlements. Future empirical research should utilise this framework to guide mixed-methods studies. Programme planners should design integrated interventions that address food security and mental health simultaneously, focusing on restoring social capital and culturally meaningful coping mechanisms. theoretical framework, mental distress, food insecurity, refugees, South Sudan, Uganda, Bidibidi settlement, African perspective This article contributes a novel theoretical framework grounded in African psychosocial concepts to analyse the bidirectional relationship between mental distress and food insecurity in a protracted refugee settlement, offering a tool for context-specific research and intervention design.