Towards an integrated theoretical framework for understanding water insecurity and gender-based violence in Low-and middle-income countries (LMICs)

The impacts of COVID-19 on older adults in Uganda and Ethiopia: Perspectives from non-governmental organization staff and volunteers

The COVID-19 pandemic had a substantial impact on older adults, especially in Sub-Saharan Africa (SSA). To support older adults during this time, non-governmental organizations (NGOs) coordinated programs to help provide for basic needs related to food and water security and healthcare. This research explores the attitudes, perceptions and experiences of NGO staff and volunteers who provided support to older adults in SSA in rural East Africa during the COVID-19 pandemic. In-depth interviews (n = 28) were conducted with NGO staff and volunteers in Uganda and Ethiopia between September and December of 2022. Overall, NGO staff and volunteers reported high levels of knowledge surrounding the COVID-19 pandemic and stated that one positive of the COVID-19 pandemic was the improved hygiene practices. However, the NGO staff and volunteers also reported that the pandemic and the associated public health measures exacerbated pre-existing social inequalities, such as increasing pre-existing levels of food insecurity. The exacerbation of pre-existing social inequalities may be one reason for the increased reliance on NGO services. The learnings from the COVID-19 pandemic and associated public health measures can be utilized to create targeted strategies to mitigate the negative impacts of future public health crises on vulnerable populations.

Water insecurity is associated with gender-based violence: A mixed-methods study in Indonesia

Gender Based Violence (GBV) is a global pandemic and water insecurity is increasing in intensity and extent. This study explores the association between these two global health threats. Cross-sectional, quantitative data were collected via surveys (n = 365 adult women) to measure household water insecurity (HWI) and women's experiences of GBV in the last year. Qualitative data were collected from semi-structured interviews (n = 24 men and women), two focus group discussions (n = 25 men and women) and a multi-stakeholder meeting (n = 35 men and women) to explore experiences, attitudes and risk factors associated with HWI and GBV. Multivariate logistic regression analysis showed that women in water insecure households were more than twice as likely to report experiencing GBV in the last year (OR = 2.2, CI: 1.0-4.9, p = 0.051). Examining household water insecurity scores as a continuous variable revealed an increased odds of reporting GBV with each increase in the HWISE score (OR = 1.1, CI: 1.0; 1.1, p < 0.001). Qualitative data indicates that the intersection between HWI, a patriarchal social organization and a caste system produced water-related conflicts between intimate partners, between daughters-in-law and their in-laws, and between masters and enslaved women. These results are presented using an integrated theoretical framework - a Feminist Political Ecology of Health (FPEH) - to illustrate the many ways women encounter and experience multi-dimensional forms of violence across scales in connection to water insecurity. The combination of robust qualitative and quantitative data presented in this study suggests that HWI may be causally related to GBV in this context.

"Gender-Based Water Violence": Cross-Cultural Evidence for Severe Harm Associated With Water Insecurity for Women and Girls

We examined how study participants in Indonesia and Peru viewed the relationship between water insecurity and women's health via thematic analysis of interviews and focus groups. Participants reported that water insecurity led to vaginal infections, miscarriage, premature births, uterine prolapse, poor nutrition, restricted economic opportunities, and intergenerational cycles of poverty. Participants in both countries stated that extreme burdens associated with water insecurity should be categorized as violence. Based on these findings, we developed the concept of "gender-based water violence," defined as the spectrum of stressors associated with water insecurity that are so severe as to threaten human health and well-being, particularly that of women and girls.

'We are all women here in Canada': Intimate bargains in WASH spaces

In many parts of the world access to adequate water, sanitation and hygiene (WASH) is entwined with gender relations. While there is emerging research on how gender relations intersect with socio-cultural practices and norms to produce gender-based violence in WASH, little is known about how these gender relations are intimately produced, reproduced and embodied in place. Drawing insights from feminist political ecology and gendered geographies of power, this paper uses retrospective narratives of Ghanaian migrants in Canada to advance this scholarship in three significant ways. First, the findings demonstrate how gender relations in WASH produce everyday vulnerabilities differently among women and men. Second, they highlight the complex ways women bargain with patriarchal structures to ensure their safety in WASH spaces. Finally, the findings show how gender relations and roles in WASH transform in transnational spaces in which gendered WASH roles and responsibilities are blurred. The findings draw policy attention to the interconnectedness of WASH and gender equality and the need for policy and practice change to advance gender equity in WASH.

COVID-19 brought the water struggles in Ghana into our homes in Canada: Collective emotions and WASH struggles in distant locations during health emergencies

The COVID-19 pandemic has heightened and made visible the embodied consequences of water, sanitation and hygiene (WASH) inequalities and the relationalities of health in place. This paper combines insights from relational geographies and embodied epidemiology to explore psychosocial concerns among Ghanaian migrants in Canada due to their multiple and simultaneous roles in the WASH space in Ghana, particularly during the COVID-19 pandemic. We explored this using narratives from in-depth interviews with 27 participants (16 women and 11 men) residing in Ontario, Canada. The case of Ghana offers insight into how social ties with home communities could provide a safety net during emergencies but could also affect the psychosocial wellbeing of migrants. Results revealed four interrelated psychosocial stressors, including social stressors, financial stressors, stressors related to perceived inequality and stressors related to the fear of infection during WASH access. The paper underscores the urgent need for research to move beyond local health implications of WASH inequalities and begin to prioritize how these social inequalities are embodied at distant locations.

Gender-Based Violence - Magnitude and Types in Northwest Ethiopia

Background

Violence Against Women (VAW) becomes a serious public health issue as unnecessary morbidity and mortalities affect women and girls. Women who experience violence had the possibility of another of violence. Although gender-based violence (GBV) is a common problem in Ethiopia, the burden is not well studied.

Objective

This study determines the magnitude of Gender-Based Violence among women receiving Sexual and Reproductive Health Services in a Specialized Hospital.

Methods

Institution-based retrospective follow-up study was conducted at the University of Gondar Comprehensive Specialized Hospital among gender-based violence (GBV) service users from January 2017 to January 2022. Data were collected from register logbooks and also medical records for some variables, using a tool prepared by refereeing literature and adapting locally available resources and researchers experiences. Epi-info 7 was used to enter the data and exported it to SPSS V-23 for analysis. Descriptive statistics like frequencies, percentages, means and standard deviations are computed for all variables.

Results

The lifetime proportion of sexual and physical violence was found to be 81% and 5%, respectively, while 3% of women experienced both sexual and physical violence. One hundred seventy (29.4%) of the incidents were done by an intimate-partners (boyfriend/husband). The majority (86%) had extra genital injuries. After genital examination, about one-fourth (25%) of survivors had fresh hymenal tears. About three-fourths (75.1%) of the survivors visit the health facility within threes day after the incident.

Conclusion

The study found that GBV is common in Northwest Ethiopia. Future research should involve sensitive methods and grounded approaches to explore survivors' experiences and views on local gender cultures and other contextual factors. Establishing One-stop-center could improve the quality of the services provided to the women.

Attention to the needs of women and girls in WASH: An analysis of WASH policies in selected sub-Saharan African countries

There has been a push for understanding gendered violence in WASH in recent times. Attention is therefore shifting to how these issues are conceptualised, considering their embeddedness in context. One step primarily is to understand how existing policies in WASH acknowledge the needs of women and girls in WASH. In doing this, we conducted a summative content analysis of selected policy documents on WASH: five at the international level and five each from Ghana, Uganda and Kenya. Findings suggest that existing policies inadequately acknowledge WASH related gender-based violence and pay little attention to the complex ways gender and WASH relations are intimately connected. Generally, a holistic policy approach for addressing gender-based violence in WASH is needed. The paper recommends a system policy approach to address the unique needs of women and girls in WASH in sub-Saharan Africa.

I feel the pains of our past water struggles anytime I turn on the tap: Diaspora perceptions and experiences of water, sanitation, and hygiene (WaSH) gendered violence in Ghana

Gender-based violence resulting from water, sanitation and hygiene (WASH) insecurity is a major public health problem. WaSH gender-based (WaSH-GBV) is a spatio-temporal experience and has disproportionate health and wellbeing impacts on women and girls. However, the global community of WaSH practitioners and policymakers is yet to adequately address women's vulnerability to violence in relation to WaSH access. Informed by the feminist political ecology of health framework, we conducted in-depth interviews (n = 27, 16 women and 11 men) with Ghanaian immigrants to Canada to explore perceptions of WaSH experiences over lifecourse. Results revealed that participants' perceptions and experiences of GBV are both socially and context dependent, organized around four dimensions: structural, physical, psychological, and sexual. These muti-scalar dimensions of diasporans' WaSH experiences and perceptions in Ghana are discussed along with their implications for policy and practice, specifically in enhancing health equity and water security.