1
|
Andersson Nystedt T, Herder T, Agardh A, Asamoah BO. No evidence, no problem? A critical interpretive synthesis of the vulnerabilities to and experiences of sexual violence among young migrants in Europe. Glob Health Action 2024; 17:2340114. [PMID: 38651216 PMCID: PMC11041515 DOI: 10.1080/16549716.2024.2340114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Growing evidence indicates that young migrants are particularly vulnerable to sexual violence, however most research has focused on instances of sexual violence occurring in conflict zones and during transit. Much less attention has been given to the vulnerabilities to and experiences of sexual violence among young migrants in Europe. OBJECTIVES To understand the scientific evidence regarding the experiences of and vulnerabilities to sexual violence among young migrants (aged 11-30 years) in Europe. METHODS A search of three databases resulted in 1279 peer reviewed articles published between 2002 and 2022. Of these, 11 were included in this review. A critical interpretive synthesis methodology was applied. RESULTS Few studies investigate sexual violence among young migrants in Europe. The existing studies focus on very specific sub-groups of migrants, and as such, experiences of persons outside these groups are largely absent from the academic discourse. How sexual violence is understood varies across studies, often conflated with other forms of violence, hampering comparisons. However, the results of this review indicate that young migrants in Europe, both male and female, experience sexual violence and there are multiple sources of vulnerabilities at all levels of the socioecological model. CONCLUSION The scarcity of research regarding sexual violence among young migrants in Europe could give rise to the perception that no evidence means no problem, resulting in a continued lack of attention to this issue. There is a critical need to address this gap to inform prevention interventions, to identify victims, and to facilitate access to care.
Collapse
Affiliation(s)
- Tanya Andersson Nystedt
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Tobias Herder
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Anette Agardh
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Benedict Oppong Asamoah
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| |
Collapse
|
2
|
Pérez‐Aronsson A, Inge E, Alanbari H, Alsalamah I, Ghannoum M, Mohammad ZA, Metso FJ, Holmqvist F, Belachew J, Filén T, Hennoks FP, Sarkadi A, Warner G. Co-Design Workshops to Develop a Psychosocial Support Service Model for Refugees in Sweden Affected by Gender-Based Violence. Health Expect 2024; 27:e14177. [PMID: 39129706 PMCID: PMC11317807 DOI: 10.1111/hex.14177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Experiencing gender-based violence (GBV) is common among refugees. Intersecting systems of oppression can increase the risk of GBV and of suffering detrimental consequences, while concurrently creating barriers to meaningful support. Despite this, refugees with lived experience of GBV are rarely involved in the development, planning and adaptation of services and policies. METHODS This article reports on a formative research process that aimed to involve public contributors (refugee victim-survivors of GBV) and relevant stakeholders in co-designing a service model aimed at improving psychosocial support in Sweden. Led by a partnership of public contributors and academic researchers, the research process consisted of iterative cycles of co-design workshops, complemented by scoping of existing literature. RESULTS The co-design process resulted in a characterisation of the psychosocial service system needs, as perceived by the survivor co-researchers and stakeholders, and a two-level empowerment and support service model. The model included (i) a community-based intervention to promote help-seeking and (ii) psychosocial group support delivered in specialist clinics. Outcomes of the project included perceived benefits for those involved, service-led direct changes and acquisition of funding for continued research on the co-designed model. CONCLUSION Improving psychosocial support for refugees in Sweden affected by GBV requires safe spaces to connect with peers and familiarise with available services, laws and rights in the society. Further, strengthened collaborations across sectors are necessary to meet the variety of needs. Co-design workshops were an effective way to initiate changes in the service delivery model for psychosocial support for refugees in Sweden affected by GBV. PATIENT OR PUBLIC CONTRIBUTIONS This is a participatory reflection on a participatory process. The survivor co-researchers contributed to designing and carrying out the PPI process and have co-authored this manuscript.
Collapse
Affiliation(s)
- Anna Pérez‐Aronsson
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
- Centre for Women's Mental Health During the Reproductive Lifespan—WOMHERUppsala UniversityUppsalaSweden
| | - Elin Inge
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Heba Alanbari
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Iman Alsalamah
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Miras Ghannoum
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Zozan Abu Mohammad
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Frida Johansson Metso
- Swedish Red Cross Competence Centre for Rehabilitation of Torture and War TraumaStockholmSweden
| | - Frida Holmqvist
- Information SwedenCounty Administrative Boards of Västra GötalandGothenburgSweden
| | - Johanna Belachew
- Kvinnofridsmottagningen (Outpatient Clinic for Women Subjected to Violence), Uppsala University Hospital, Region Uppsala, and National Centre for Knowledge on Men's Violence Against Women (NCK)Uppsala UniversityUppsalaSweden
| | - Tove Filén
- Kvinnofridsmottagningen (Outpatient Clinic for Women Subjected to Violence), Uppsala University Hospital, Region Uppsala, and National Centre for Knowledge on Men's Violence Against Women (NCK)Uppsala UniversityUppsalaSweden
| | - Frida Pålsson Hennoks
- Kvinnofridsmottagningen (Outpatient Clinic for Women Subjected to Violence), Uppsala University Hospital, Region Uppsala, and National Centre for Knowledge on Men's Violence Against Women (NCK)Uppsala UniversityUppsalaSweden
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| |
Collapse
|
3
|
Antolínez Domínguez I, Jorge Barbuzano E. The Continuum of Violence and Interstices in the Journeys and Bodies of Women on the Move From West Africa. Violence Against Women 2024:10778012241263107. [PMID: 39043124 DOI: 10.1177/10778012241263107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
On the migration route from Western and Central Africa to Europe, aggression toward women's bodies has played a prominent role. In this study, we analyze this route as a continuum of violence and also study the interstices to confront it. Using a biographical narrative methodology, we analyze the narratives of 52 migrant women, through life stories or creative narrative workshops carried out in Mali, Morocco, and Spain. The results allow us to systematize the continuum of violence that the women report, understood as a pedagogy of cruelty but also the possible spaces to build a safe landscape.
Collapse
|
4
|
Nobels A, De Schrijver L, Van Landuyt M, Vandeviver C, Lemmens GMD, Beaulieu M, Keygnaert I. "In the End You Keep Silent": Help-Seeking Behavior Upon Sexual Victimization in Older Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2318-2343. [PMID: 38149594 DOI: 10.1177/08862605231220017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Sexual violence is considered a prominent mental health problem. Exposure to sexual victimization during lifetime has been linked to mental health problems in old age. Research in adult victims has shown that they experience many barriers for disclosure and seeking professional help upon sexual victimization. However, information on help-seeking behavior in older victims of sexual violence is non-existent. With this study we aim for a better understanding of help-seeking behavior upon sexual violence in older adults. We used a mixed methods approach with an explanatory sequential design. Data were collected through structured face-to-face interviews with a random sample of 227 sexual violence victims of 70 years and older living in Belgium. Quantitative data were triangulated with qualitative data from 15 in-depth interviews with older victims. We found that up to 60% of older sexual violence victims never disclosed their experiences and 94% never sought professional help. Help-seeking is a complex process comprising several phases, which are affected by strong feelings of shame and self-blame, ageist premises and taboos about sexuality. In the end, most victims choose to cope on their own. Occasional disclosure only happens decades after the sexual violence took place. Older victims do not spontaneously disclose to healthcare workers but expect professionals to initiate the conversation. In conclusion, few older victims disclose or seek professional help upon sexual victimization. Healthcare professionals working with older adults need capacity building through training, screening tools, and care procedures to initiate conversation on sexual violence, and to detect signs, prevent, mitigate and respond to sexual victimization in older adults.
Collapse
Affiliation(s)
- Anne Nobels
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Lotte De Schrijver
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Vlaamse Vereniging van Klinisch Psychologen, Brussels, Belgium
| | - Mira Van Landuyt
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law, and Social Law, Ghent University, Ghent, Belgium
| | - Gilbert M D Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin-Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Marie Beaulieu
- School of Social Work, Research Chair on Mistreatment of Older Adults and Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Ines Keygnaert
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Women's Clinic, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
5
|
Andersson Nystedt T, Svensson P, Herder T, Asamoah BO, Ouis P, Agardh A. Coming across a hidden problem in an excluded population in Sweden: professionals' experiences of young migrants' disclosures of sexual violence. CULTURE, HEALTH & SEXUALITY 2024; 26:621-637. [PMID: 37489949 DOI: 10.1080/13691058.2023.2234431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/05/2023] [Indexed: 07/26/2023]
Abstract
Growing evidence suggests that young migrants are particularly vulnerable to sexual violence. As young migrants often lack family and social networks, professionals are often the recipients of disclosures of sexual violence. This study aimed to explore how professionals experience young migrants' disclosures of sexual violence. A qualitative design was used, based on 14 semi-structured interviews with a range of professionals from the public sector and civil society in southern Sweden. The data were analysed using qualitative content analysis. The overarching theme developed was 'coming across the hidden problem of sexual violence in an excluded population' supported by three sub-themes: 'linking structural marginalisation and vulnerability to sexual violence'; 'realising that sexual violence is one among many other concerns'; and 'taking pride in backing up young people betrayed by society'. Professionals expressed a strong sense of responsibility due to the complex vulnerabilities of young migrants and their lack of access to services. This, coupled with the lack of clarity about how to respond to disclosures of sexual violence, can lead to moral distress. There is a need to strengthen support for professionals, including recognition of ethical dilemmas and the establishment of formal connections between organisations making access more straightforward and predictable.
Collapse
Affiliation(s)
- Tanya Andersson Nystedt
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Pia Svensson
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Tobias Herder
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Benedict Oppong Asamoah
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Pernilla Ouis
- Department of Social Work, Faculty of Health and Society, Malmö University, Malmö, Sweden
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Anette Agardh
- Social Medicine and Global Health, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
| |
Collapse
|
6
|
Tsegay SM, Tecleberhan S. Violence Against Women: Experiences of Eritrean Refugee Women in Britain. Violence Against Women 2023:10778012231220372. [PMID: 38099701 DOI: 10.1177/10778012231220372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
There is a dearth of research on violence against women and girls among refugees, particularly in their host countries. Therefore, informed by a feminist theoretical framework and semistructured interviews, this study explores violence against women focusing on Eritrean refugee women's experiences in Britain. The findings suggest that Eritrean refugee women experience various types of violence, which have short- and long-term effects on their lives. Moreover, the data indicate that host and origin countries' socioeconomic and cultural situations shape the experiences of refugee women. The research aims to better understand violence against women among refugees and thus improve refugee women's experiences.
Collapse
|
7
|
Lokot M, Hartman E, Hashmi I. Participatory approaches and methods in gender equality and gender-based violence research with refugees and internally displaced populations: a scoping review. Confl Health 2023; 17:58. [PMID: 38066619 PMCID: PMC10704759 DOI: 10.1186/s13031-023-00554-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
Using participatory approaches or methods are often positioned as a strategy to tackle power hierarchies in research. Despite momentum on decolonising aid, humanitarian actors have struggled to describe what 'participation' of refugees and internally displaced persons (IDPs) means in practice. Efforts to promote refugee and IDP participation can be tokenistic. However, it is not clear if and how these critiques apply to gender-based violence (GBV) and gender equality-topics that often innately include power analysis and seek to tackle inequalities. This scoping review sought to explore how refugee and IDP participation is conceptualised within research on GBV and gender equality. We found that participatory methods and approaches are not always clearly described. We suggest that future research should articulate more clearly what constitutes participation, consider incorporating feminist research methods which have been used outside humanitarian settings, take more intentional steps to engage refugees and IDPs, ensure compensation for their participation, and include more explicit reflection and strategies to address power imbalances.
Collapse
Affiliation(s)
- Michelle Lokot
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Erin Hartman
- London School of Hygiene and Tropical Medicine, London, UK
| | - Iram Hashmi
- London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
8
|
Nobels A, Meersman C, Lemmens G, Keygnaert I. "Just something that happened?": Mental health impact of disclosure and framing of sexual violence in older victims. Int J Geriatr Psychiatry 2023; 38:e6036. [PMID: 38088814 DOI: 10.1002/gps.6036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Despite the important impact of sexual violence (SV) on mental health, few victims disclose their experiences. Although research in adult victims suggests that SV disclosure could protect against long-term mental health problems, studies in older adults are lacking. OBJECTIVES To establish the prevalence of depression, anxiety, posttraumatic stress disorder (PTSD), suicide attempts, and self-harm, their association with SV disclosure, and the moderating effect of sociodemographic characteristics and SV framing in the relation between SV disclosure and the different mental health outcomes in older SV victims. METHODS Data on sexual victimisation, mental health, SV framing, and disclosure were collected through structured face-to-face interviews with 171 randomly selected sexually victimised adults of 70 years and older living in Belgium. SV was measured using behaviourally specific questions based on a broad definition. Mental health outcomes were measured using validated scales. RESULTS Depression, anxiety and PTSD were reported by 34%, 33% and 9% of participants respectively, 5% had attempted suicide and 1% reported self-harm during lifetime. SV framing was associated with the kind of help victims consulted. SV disclosure was not linked with depression and anxiety, but was associated with an increase of PTSD symptoms in older victims with care dependency (p = 0.004) or a chronic illness and/or disability (p = 0.025). CONCLUSIONS SV disclosure in itself does not protect against adverse mental health outcomes in old age. Capacity building of professionals trough training and development of clinical guidelines and care procedures may increase appropriate response to SV disclosure by older victims.
Collapse
Affiliation(s)
- Anne Nobels
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Women's Clinic, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|
9
|
Khouani J, Landrin M, Boulakia RC, Tahtah S, Gentile G, Desrues A, Vengeon M, Loundou A, Barbaroux A, Auquier P, Jego M. Incidence of sexual violence among recently arrived asylum-seeking women in France: a retrospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 34:100731. [PMID: 37927433 PMCID: PMC10624985 DOI: 10.1016/j.lanepe.2023.100731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 11/07/2023]
Abstract
Background The prevention of sexual violence (SV) occurring shortly after arrival in host countries towards female asylum seekers requires knowledge about its incidence. We aimed to determine the incidence of SV and its associated factors during the past year of living in France among asylum-seeking females who had arrived more than one year earlier but less than two years. Methods We conducted a retrospective cohort study using a life-event survey of asylum-seeking females who had been registered in southern France by the Office for Immigration for more than one year but less than two. The primary outcome was the occurrence of SV during the past year, weighted by the deviation in age and geographical origin of our sample from all females registered. The nature of SV was noted, and associated factors were explored by a logistic regression model. Findings Between October 1, 2021, and March 31, 2022, 273 females were included. Eighty-four females experienced SV during the past year of living in France (26.3% weighted [95% CI, 24-28.8]), 17 of whom were raped (4.8% weighted [95% CI, 3.7-6.1]). Being a victim of SV prior to arrival in France (202, 75.7%) was associated with the occurrence of SV after arrival (OR = 4.6 [95% CI, 1.8-11.3]). Lack of support for accommodation was associated with se.xual assault (OR = 2.6 [95% CI, 1.3-5.1]). Interpretation The months following arrival in a European host country among asylum-seeking females appear to be a period of high incidence of SV; even higher for those who previously experienced SV prior to arrival. Reception conditions without support for accommodation seem to increase exposure to sexual assault. Funding DGOS-GIRCI.
Collapse
Affiliation(s)
- Jérémy Khouani
- Aix Marseille University, CEReSS, UR3279, Marseille, France
- Department of General Practice, Aix Marseille University, Marseille, France
| | - Marion Landrin
- Department of General Practice, Aix Marseille University, Marseille, France
| | | | - Sarah Tahtah
- Université Cote d’Azur, Département d’Enseignement et de Recherche en Médecine Générale, RETINES, LAPCOS, HEALTHY, Nice, France
| | - Gaëtan Gentile
- Department of General Practice, Aix Marseille University, Marseille, France
- Aix Marseille University, Institut des Neurosciences des Systèmes, INS UMR1106, France
| | - Anne Desrues
- Aix Marseille University, CEReSS, UR3279, Marseille, France
| | - Marine Vengeon
- Université Cote d’Azur, Département d’Enseignement et de Recherche en Médecine Générale, RETINES, LAPCOS, HEALTHY, Nice, France
| | - Anderson Loundou
- Aix Marseille University, CEReSS, UR3279, Marseille, France
- Department of Public Health, APHM, Marseille, France
| | - Adriaan Barbaroux
- Université Cote d’Azur, Département d’Enseignement et de Recherche en Médecine Générale, RETINES, LAPCOS, HEALTHY, Nice, France
| | - Pascal Auquier
- Aix Marseille University, CEReSS, UR3279, Marseille, France
- Department of Public Health, APHM, Marseille, France
| | - Maeva Jego
- Aix Marseille University, CEReSS, UR3279, Marseille, France
- Department of General Practice, Aix Marseille University, Marseille, France
| |
Collapse
|
10
|
Nesterko Y, Schönenberg KH, Glaesmer H. Mental health of recently arrived male refugees in Germany reporting sexual violence. Med Confl Surviv 2023; 39:4-27. [PMID: 36475329 DOI: 10.1080/13623699.2022.2151742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Conflict-related sexual violence (CRSV) is one of the most severe and stigmatizing human rights violations. The recognition of men and boys as targets of sexual violence is a rather recent development. In the present study data on experiences of sexual violence as well as mental health outcomes were analysed in recently arrived male refugees (N = 392) in Germany. More than one third of the men interviewed (n = 128; 36.6%) reported having experienced sexual violence. Compared to male refugees without experiences of sexual violence, male refugee survivors showed higher prevalence rates of PTSD. Moreover, some differences were found between the subgroups on the single symptoms level, indicating higher severity in those affected by sexual violence, including negative alterations in cognition/mood, suicidal ideation, and nervousness or shakiness inside. The findings provide initial data on prevalence of sexual violence and related mental health outcomes in male refugees newly arrived in Germany and emphasize the significance of sexual violence as a risk factor for different mental health outcomes. This provides clear implications for health care professionals that could aid them in better identifying those affected. Finally, further research is urgently needed that takes a closer, more differentiated look at sexual violence in male refugee populations.
Collapse
Affiliation(s)
- Yuriy Nesterko
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Kim Hella Schönenberg
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| |
Collapse
|
11
|
Fomenko E, Keygnaert I, Van Poel E, Collins C, Gómez Bravo R, Korhonen P, Laine MK, Murauskiene L, Tatsioni A, Willems S. Screening for and Disclosure of Domestic Violence during the COVID-19 Pandemic: Results of the PRICOV-19 Cross-Sectional Study in 33 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3519. [PMID: 36834213 PMCID: PMC9964689 DOI: 10.3390/ijerph20043519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic left no one untouched, and reports of domestic violence (DV) increased during the crisis. DV victims rarely seek professional help, yet when they do so, they often disclose it to their general practitioner (GP), with whom they have a trusting relationship. GPs rarely screen and hence rarely take the initiative to discuss DV with patients, although victims indicate that offering this opportunity would facilitate their disclosure. This paper aims to describe the frequency of screening for DV by GPs and disclosure of DV by patients to the GP during the COVID-19 pandemic, and to identify key elements that could potentially explain differences in screening for and disclosure of DV. The PRICOV-19 data of 4295 GP practices from 33 countries were included in the analyses, with practices nested in countries. Two stepwise forward clustered ordinal logistic regressions were performed. Only 11% of the GPs reported (much) more disclosure of DV by patients during COVID-19, and 12% reported having screened for DV (much). Most significant associations with screening for and disclosure of DV concerned general (pro)active communication. However, (pro)active communication was performed less frequently for DV than for health conditions, which might indicate that GPs are insufficiently aware of the general magnitude of DV and its impact on patients and society, and its approach/management. Thus, professional education and training for GPs about DV seems highly and urgently needed.
Collapse
Affiliation(s)
- Elizaveta Fomenko
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Ines Keygnaert
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Esther Van Poel
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Claire Collins
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
- Research Centre, Irish College of General Practitioners, D02 XR68 Dublin, Ireland
| | - Raquel Gómez Bravo
- Centre Hospitalier Neuropsychiatrique, Rehaklinik, L-9002 Ettelbruck, Luxembourg
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, L-4366 Esch-sur-Alzette, Luxembourg
| | - Päivi Korhonen
- Department of General Practice, University of Turku and Turku University Hospital, 20521 Turku, Finland
| | - Merja K. Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
- Folkhälsan Research Center, 00280 Helsinki, Finland
| | - Liubove Murauskiene
- Public Health Department, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania
| | - Athina Tatsioni
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Sara Willems
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| |
Collapse
|
12
|
De Schrijver L, Nobels A, Harb J, Nisen L, Roelens K, Vander Beken T, Vandeviver C, Keygnaert I. Victimization of Applicants for International Protection Residing in Belgium: Sexual Violence and Help-Seeking Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12889. [PMID: 36232187 PMCID: PMC9566446 DOI: 10.3390/ijerph191912889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sexual violence (SV) literature on applicants for international protection (AIPs) shows that they are at high risk of victimization. The study objectives are to provide an exploratory overview of the occurrence of SV in AIPs in Belgium and their help-seeking behavior (HSB). This overview is crucial to develop prevention strategies and care paths focusing on providing adequate care to AIP SV victims in Belgium. METHODS Quantitative data from structured interviews with AIPs (n = 62) triangulated with qualitative data from in-depth interviews with AIP SV victims (n = 11) served to explore the nature and impact of SV in AIPs in Belgium and their HSB. RESULTS A total of 83.9% of respondents have experienced SV. A total of 61.3% were victimized within the past year. Victimization seems more gender-balanced than in the general population. AIPs link SV to their legal status and their associated vulnerable situation. HSB upon SV was very limited in this sample. Help-seeking barriers interfering with the decision-making process to consult (in)formal resources were identified. CONCLUSIONS AIPs in Belgium are at high risk of SV. Despite the impact of SV on AIPs' lives, HSB upon SV is rare. The provision of age-appropriate sexual education and development of policies that will reduce help-seeking barriers is needed.
Collapse
Affiliation(s)
- Lotte De Schrijver
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Anne Nobels
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
- Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jonathan Harb
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Laurent Nisen
- CARE-ESPRIst, Études et Évaluations, University of Liège, 4000 Liège, Belgium
| | - Kristien Roelens
- Department of Obstetrics and Gynecology, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium
| | - Tom Vander Beken
- Department of Criminology, Criminal Law and Social Law, Institute for International Research on Criminal Policy, Ghent University, 9000 Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Institute for International Research on Criminal Policy, Ghent University, 9000 Ghent, Belgium
- Research Foundation—Flanders (FWO), 1000 Brussels, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| |
Collapse
|
13
|
Fomenko E, De Schrijver L, Vandeviver C, Keygnaert I. Locked up at home: a cross-sectional study into the effects of COVID-19 lockdowns on domestic violence in households with children in Belgium. BMC Public Health 2022; 22:1719. [PMID: 36088357 PMCID: PMC9463669 DOI: 10.1186/s12889-022-14135-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Policymakers worldwide took measures to limit the spread of the COVID-19-virus. While these sanitary measures were necessary to fight the spread of the virus, several experts warned for a significant impact on mental health and a potential increase in domestic violence. To study the impact of the COVID-19 measures in Belgium, and the factors influencing the occurrence of domestic violence, we set up the study on relationships, stress, and aggression. In this study, we evaluate the prevalence of domestic violence victimization during the COVID-19 lockdown in Belgian children aged zero to seventeen years and the associations of the parents' financial status, relationships, mental health, and previous victimization to the child's victimization. METHODS A stepwise forward binary logistic regression was used to analyse the association between multiple risk factors of domestic violence and victimization of the respondent's child. The respondent being an assailant, the respondent's age, and the age of the children in the household were added as moderators. RESULTS In this model an association with domestic child abuse was found for the age of the respondent, the household's size, the presence of children between zero and five years in the household, the perceived stress level of the respondent, and victimization of the respondent during the first wave of the sanitary measures, as well as victimization before the COVID-19 pandemic. None of the interacting effects were found to be significant. CONCLUSION It is advisable to make extra efforts to improve well-being when maintaining sanitary measures by providing appropriate assistance and helping households struggling with increased or acute stress to install positive coping strategies - especially in larger households with children between six and 17 years. Besides, our findings draw attention to the clustering of risk of child and adult violence exposure in lockdown situations as well as to the potential cumulative impact of exposure to violence across the lifespan and across generations. It is key to invest in training healthcare workers and staff at schools to screen for and assess risks of domestic violence development and ongoing or past occurrence in order to detect, refer and follow-up on families at risk.
Collapse
Affiliation(s)
- Elizaveta Fomenko
- ICRH - Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Lotte De Schrijver
- ICRH - Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | | | - Ines Keygnaert
- ICRH - Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium.
| |
Collapse
|
14
|
De Schrijver L, Cismaru Inescu A, Hahaut B, Vandeviver C, Nisen L, Keygnaert I. Research in Hard-to-Reach Populations: Challenges and Strategies for Conducting Sexual Violence Studies in Applicants for International Protection Beyond the European General Data Protection Regulation. Int J Health Policy Manag 2022; 11:1934-1941. [PMID: 34664494 PMCID: PMC9808247 DOI: 10.34172/ijhpm.2021.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/30/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Conducting research in hard-to-reach populations such as applicants for international protection (AIPs) brings along a number of research challenges. This is especially true for sexual violence (SV) research. METHODS We developed a study design with the intent to reach AIPs in a randomized and anonymous manner including potential illiterate respondents as well, while avoiding as much bias as possible. However, this method was developed just before the entry into force of the new European General Data Protection Regulation (GDPR), upon which important new research challenges emerged. RESULTS This paper describes the original study design developed to estimate SV prevalence in AIPs in Belgium. We discuss the impact of the GDPR on the recruitment strategy applied to conduct a survey on SV in a randomly selected sample of AIPs, the adapted approach to conduct the study beyond GDPR and lessons learned for future research on sensitive topics in hard-to-reach populations such as AIPs. CONCLUSION To achieve reliable prevalence numbers and provide high-quality data on SV in AIPs while respecting the GDPR regulations, studies will require an approach that has become significantly more time consuming and resource-intensive to implement.
Collapse
Affiliation(s)
- Lotte De Schrijver
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Bastien Hahaut
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium
| | - Christophe Vandeviver
- Institute for International Research on Criminal Policy, Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium
- Research Foundation—Flanders (FWO), Brussels, Belgium
| | - Laurent Nisen
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| |
Collapse
|
15
|
Nobels A, Cismaru-Inescu A, Nisen L, Hahaut B, Lemmens GMD, Vandeviver C, Keygnaert I. Challenges in Conducting Sexual Health and Violence Research in Older Adults Beyond the General Data Protection Regulation: A Belgian Case Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP14695-NP14715. [PMID: 33966514 DOI: 10.1177/08862605211015256] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Because of a growing older population, the sexual health (SH) of older adults, including sexual violence (SV), is becoming an increasingly important public health concern. Yet, reliable SV prevalence rates and risk factors are lacking, due to methodological shortcomings in current studies. SV research involves challenges regarding safety and disclosure, especially in older adults. In this paper, we reflect on the methods used in a sexual health and violence (SH&V) study in older adults balancing between privacy rules imposed by the General Data Protection Regulation (GDPR) and ethical and safety guidelines.To ensure the acceptability of the questionnaire, it was tested in a two-phase pilot study. To maximize SV disclosure, the questionnaire built up gradually towards the more sensitive SV modules. Interviewers were trained to approach participants in a non-judgmental manner. Due to GDPR, our data collection method was changed from a random sampling via the National Register to a cluster random probability sampling with a random walk finding approach.Older adults were willing to discuss SH&V during a structured face-to-face interview with trained interviewers. Following strict safety guidelines, no major incidents were reported. The cluster random probability sampling with random walk finding approach provided an adequate sampling frame, but was inefficient and time-consuming.Doing research on SH&V in older adults is feasible but requires a substantial investment of time and the challenges involved may incur greater costs. In order to guarantee further research on sensitive topics in older adults, we recommend that an interdisciplinary expert group consisting of researchers, donors, and policymakers investigates how GDPR and public health research in hard-to-reach populations can be better matched.
Collapse
Affiliation(s)
- Anne Nobels
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Adina Cismaru-Inescu
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - Laurent Nisen
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium
| | - Bastien Hahaut
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium
| | - Gilbert M D Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
- Christophe Vandeviver and Ines Keygnaert are joint last authors
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Christophe Vandeviver and Ines Keygnaert are joint last authors
| |
Collapse
|
16
|
El-Moslemany R, Mellon L, Tully L, McConkey SJ. Factors Associated With Intimate Partner Violence Perpetration and Victimization in Asylum Seeking and Refugee Populations: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:827-839. [PMID: 33302818 DOI: 10.1177/1524838020977147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Intimate partner violence (IPV) is a common and serious health and justice problem. Asylum seekers and refugees are generally vulnerable to violence and may be particularly vulnerable to IPV. The aim of this study is to identify factors associated with IPV perpetration and victimization in asylum seeking and refugee populations through a systematic review of the literature. PubMed, Web of Science, Scopus, Embase, Global Health, PsycINFO, Westlaw, and Social Science Research Network databases were searched. Quantitative studies were included according to a population, exposure, outcome framework. Studies were critically appraised with the Joanna Briggs Institute's System for the Unified Management, Assessment and Review of Information tool and quality assessed according to the Grading of Recommendations, Assessment, Development, and Evaluations approach. Meta-analysis was not possible due to heterogeneity. A complex multitude of factors associated with IPV perpetration and victimization in asylum seeking and refugee populations was found. Narrative synthesis of 23 studies showed an inverse association between both perpetrator and victim education level and IPV. Relationship factors, legal status, and age were also important factors associated with IPV. The majority of studies had a cross-sectional design. Heterogeneity in definitions of IPV, sample, methods, statistical procedures, and outcomes was reported. Low education level is a consistent modifiable factor associated with IPV in asylum seeking and refugee populations. This work points to a testable intervention that stakeholders could trial to address the unjust and unhealthy problem of IPV. More and better quality research using standardized definitions, longitudinal design, and sensitive tools is needed in this area.
Collapse
Affiliation(s)
| | - Lisa Mellon
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Louise Tully
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | |
Collapse
|
17
|
Tan SE, Kuschminder K. Migrant experiences of sexual and gender based violence: a critical interpretative synthesis. Global Health 2022; 18:68. [PMID: 35765002 PMCID: PMC9241205 DOI: 10.1186/s12992-022-00860-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gender based violence (GBV) is a critical issue and migrants are at higher risk of experiencing and being victimized by GBV. This critical interpretative synthesis (CIS) examines migrants experiences of GBV with a focus on different migrant groups and experiences at different stages of the migrant journey. METHOD The guiding question of this review is: "how do migrants experience gender-based violence?" A total of 84 studies were included in the CIS, of which 67 peer-reviewed academic articles were selected from 2356 studies found on WebofScience, MedLINE, and ProQuest, and 17 relevant studies from the grey literature were selected from the time period 2011 to 2020. All final studies were reviewed and synthesized using a critical inductive approach to formulate the key results. RESULTS The results demonstrate a high prevalence of GBV amongst migrants, and in particular among vulnerable migrant groups such as forced migrants and irregular migrants, with an emerging focus on male victims. Findings of the CIS revealed three key themes: 1) Most GBV occurrences are rooted in unequal power dynamics; 2) Victims often live with long-lasting consequences that are worsened by their fear of disclosure and stigmatization; 3) There are differential understandings of victimhood across organizations, communities, and victims themselves. In order to support access, sampling, and methodological challenges in this field of research, this article also reports its findings on common risk-factors identified, consequences and coping mechanisms reported, protection policies targeting GBV, and finally, available databases and data collection methods. CONCLUSION Further directions for research should be encouraged to move beyond prevalence reporting into identifying risk-factors and possible prevention in both sexes. In addition, more research on GBV experiences throughout migrants' journeys, and coping mechanisms should be encouraged.
Collapse
Affiliation(s)
- Sze Eng Tan
- UNU-MERIT / Maastricht University, Boschstraat 24, 6211, AX, Maastricht, The Netherlands
| | - Katie Kuschminder
- Department of Political Science, University of Amsterdam, Nieuwe Achtergracht 166, 1018, Amsterdam, WV, Netherlands.
| |
Collapse
|
18
|
Phillimore J, Block K, Bradby H, Ozcurumez S, Papoutsi A. Forced Migration, Sexual and Gender-based Violence and Integration: Effects, Risks and Protective Factors. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2022. [DOI: 10.1007/s12134-022-00970-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractThis paper is the first to use empirical evidence to directly examine the relationship between sexual and gender-based violence (SGBV) and multi-dimensional processes of integration of forced migrant SGBV survivors. While it is acknowledged that forced migrants are subjected to a continuum of violence, including SGBV, during the refugee journey, little is known about the long-term impact of SGBV and how it might be mitigated. Our paper, drawing on empirical evidence from 255 interviews with migrants and stakeholders in Australia, the UK, Sweden and Turkey, documented in detail the complex interactions between SGBV and integration using the Indicators of Integration framework. By bringing together the literature on the continuum of violence, SGBV and the Indicators of Integration framework, we identify, on the one hand, the impact of SGBV on integration, and, on the other, how the indicators framework can be used to identify protective and risk factors for forced migrant survivors.
Collapse
|
19
|
van Daalen KR, Kallesøe SS, Davey F, Dada S, Jung L, Singh L, Issa R, Emilian CA, Kuhn I, Keygnaert I, Nilsson M. Extreme events and gender-based violence: a mixed-methods systematic review. Lancet Planet Health 2022; 6:e504-e523. [PMID: 35709808 PMCID: PMC10073035 DOI: 10.1016/s2542-5196(22)00088-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 05/03/2023]
Abstract
The intensity and frequency of extreme weather and climate events are expected to increase due to anthropogenic climate change. This systematic review explores extreme events and their effect on gender-based violence (GBV) experienced by women, girls, and sexual and gender minorities. We searched ten databases until February, 2022. Grey literature was searched using the websites of key organisations working on GBV and Google. Quantitative studies were described narratively, whereas qualitative studies underwent thematic analysis. We identified 26 381 manuscripts. 41 studies were included exploring several types of extreme events (ie, storms, floods, droughts, heatwaves, and wildfires) and GBV (eg, sexual violence and harassment, physical violence, witch killing, early or forced marriage, and emotional violence). Studies were predominantly cross-sectional. Although most qualitative studies were of reasonable quality, most quantitative studies were of poor quality. Only one study included sexual and gender minorities. Most studies showed an increase in one or several GBV forms during or after extreme events, often related to economic instability, food insecurity, mental stress, disrupted infrastructure, increased exposure to men, tradition, and exacerbated gender inequality. These findings could have important implications for sexual-transformative and gender-transformative interventions, policies, and implementation. High-quality evidence from large, ethnographically diverse cohorts is essential to explore the effects and driving factors of GBV during and after extreme events.
Collapse
Affiliation(s)
| | - Sarah Savić Kallesøe
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK; Centre for Infectious Disease Genomics and One Health, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Fiona Davey
- Health Equity Network, University of Cambridge, Cambridge, UK
| | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education, and Innovation in Health Systems, School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland
| | - Laura Jung
- Medical Faculty, Leipzig University, Leipzig, Germany
| | - Lucy Singh
- London School of Hygiene & Tropical Medicine, London, UK
| | - Rita Issa
- Institute for Global Health, University College London, London, UK
| | - Christina Alma Emilian
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Isla Kuhn
- Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| |
Collapse
|
20
|
Quintas J, Guerreiro A, de Carvalho MJL, Duarte V, Pedro AR, Gama AF, Keygnaert I, Dias S. The Implication of the First Wave of COVID-19 on Mental Health: Results from a Portuguese Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6489. [PMID: 35682079 PMCID: PMC9180313 DOI: 10.3390/ijerph19116489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/14/2022] [Accepted: 05/23/2022] [Indexed: 12/04/2022]
Abstract
The social conditions created by the COVID-19 pandemic had a great potential to affect the mental health of individuals. Meta-analyses indicate a rise in these problems in these periods among general populations, patients and health professionals, even with substantial heterogeneous results. This paper examines mental health impacts specifically during the first wave of COVID-19. An online survey was conducted with a Portuguese convenience sample (N = 1.062) comprising questions about substance use, perceived stress, post-traumatic stress disorder and self-damage behaviors. The results concerning substance use show an extensive use of medication to sleep or calm down, especially among women and older respondents, a small percentage of alcohol consumers with a high pattern of use and less frequent cannabis consumption, even with a quarter of users who began only in the COVID-19 period. The rates of perceived stress and PTSD were higher compared with international prevalence estimations during the pandemic conditions. Both correlated measures were worse for women and young people. Another problematic issue was the rate of suicidal ideation, with a relevant proportion of starters during this period. These data reinforce the need to promote access to mental health services.
Collapse
Affiliation(s)
- Jorge Quintas
- CJS—Interdisciplinary Research Centre on Crime, Justice and Security, School of Criminology, Faculty of Law, University of Porto, 4050-123 Porto, Portugal;
| | - Ana Guerreiro
- CJS—Interdisciplinary Research Centre on Crime, Justice and Security, School of Criminology, Faculty of Law, University of Porto, 4050-123 Porto, Portugal;
- Department of Social and Behavioral Sciences, University of Maia (UMAIA), 4475-690 Maia, Portugal;
| | - Maria João Leote de Carvalho
- NOVA School of Social Sciences and Humanities (NOVA FCSH), 1069-061 Lisbon, Portugal;
- CICS.NOVA—Interdisciplinary Centre of Social Sciences, 1099-085 Lisbon, Portugal
| | - Vera Duarte
- Department of Social and Behavioral Sciences, University of Maia (UMAIA), 4475-690 Maia, Portugal;
- CICS.NOVA—Interdisciplinary Centre of Social Sciences, 1099-085 Lisbon, Portugal
| | - Ana Rita Pedro
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (A.R.P.); (A.F.G.); (S.D.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal
| | - Ana Filipa Gama
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (A.R.P.); (A.F.G.); (S.D.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal
| | - Inês Keygnaert
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
- WHO Collaborating Centre: International Centre for Reproductive Health (ICRH), Centre for Social Studies on Migration and Refugees (CESSMIR), 9000 Ghent, Belgium
| | - Sónia Dias
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (A.R.P.); (A.F.G.); (S.D.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal
| |
Collapse
|
21
|
Duea SR, Zimmerman EB, Vaughn LM, Dias S, Harris J. A Guide to Selecting Participatory Research Methods Based on Project and Partnership Goals. JOURNAL OF PARTICIPATORY RESEARCH METHODS 2022; 3:10.35844/001c.32605. [PMID: 35799626 PMCID: PMC9258244 DOI: 10.35844/001c.32605] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Participatory research engages community stakeholders in the research process, from problem identification and developing the research question, to dissemination of results. There is increasing recognition in the field of health research that community-engaged methods can be used throughout the research process. The volume of guidance for engaging communities and conducting participatory research has grown steadily in the past 40+ years, in many countries and contexts. Further, some institutions now require stakeholder engagement in research as a condition of funding. Interest in collaborating in the research process is also growing among patients and the public. This article provides an overview for selecting participatory research methods based on project and partnerships goals.
Collapse
Affiliation(s)
| | - Emily B. Zimmerman
- Department of Family Medicine and Population Health, Division of Epidemiology, VCU Center on Society and Health, Virginia Commonwealth University
| | - Lisa M. Vaughn
- College of Medicine, Cincinnati Children’s Hospital Medical Center/University of Cincinnati
| | - Sónia Dias
- Public Health Research Center, NOVA National School of Public Health
| | - Janet Harris
- School of Health & Related Research, University of Sheffield
| |
Collapse
|
22
|
Pérez YM, Gama A, Pedro AR, de Carvalho MJL, Guerreiro AE, Duarte V, Quintas J, Aguiar P, Keygnaert I, Dias S. The links of stress, substance use and socio-demographic factors with domestic violence during the Covid-19 pandemic in Portugal. J Public Health (Oxf) 2022:6551086. [PMID: 35312006 DOI: 10.1093/pubmed/fdac024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Lockdown, as a measure implemented to combat the coronavirus disease 2019 (COVID-19) pandemic, left many domestic violence (DV) victims trapped with their abusers. This study intends to explore the links between perceived stress, substance use and socio-demographic factors with DV experiences during COVID-19 pandemic in Portugal. METHODS A cross-sectional study was carried out on a sample of 1062 participants over 16 years old, residing in Portugal. Data were collected through an online survey conducted between April and October 2020. The associations between potential factors and DV were investigated using bivariable analysis and multivariable logistic regression. RESULTS The prevalence of DV reported was 13.75% (n = 146), disaggregated into psychological violence (13%, n = 138), sexual violence (1.0%, n = 11) and physical violence (0.9%, n = 10). Multivariable analyses confirmed that perceived financial difficulties (OR = 1.608; P = 0.019), use of medications to sleep or calm down (OR = 1.851; P = 0.002) and perceived stress (OR = 2.443; P = 0.003) were responsible for DV exposure during COVID-19 pandemic. Younger age (<25 years old) and consumption of alcohol were associated with a higher risk of DV victimization. CONCLUSIONS Interventions aimed at preventing and confronting DV are necessary within the strategies to combat COVID-19 in Portugal, especially aimed at groups in vulnerable situations, during and after the pandemic.
Collapse
Affiliation(s)
- Yilian M Pérez
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal
| | - Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), 1169-056 Lisbon, Portugal
| | - Ana R Pedro
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), 1169-056 Lisbon, Portugal
| | - Maria J L de Carvalho
- CICS.NOVA - Interdisciplinary Centre of Social Sciences, 1070-312 Lisbon, Portugal.,NOVA School of Social Sciences and Humanities (NOVA FCSH), 1069-061 Lisbon, Portugal
| | - Ana E Guerreiro
- University Institute of Maia (ISMAI), 4475-690 Maia, Portugal.,School of Criminology, Faculty of Law, University of Porto, 4050-123 Porto, Portugal
| | - Vera Duarte
- CICS.NOVA - Interdisciplinary Centre of Social Sciences, 1070-312 Lisbon, Portugal.,University Institute of Maia (ISMAI), 4475-690 Maia, Portugal
| | - Jorge Quintas
- School of Criminology, Faculty of Law, University of Porto, 4050-123 Porto, Portugal.,CJS, Interdisciplinary Research Center on Crime, Justice and Security, 4050-123 Porto, Portugal
| | - Pedro Aguiar
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), 1169-056 Lisbon, Portugal
| | - Ines Keygnaert
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.,WHO Collaborating Centre: International Centre for Reproductive Health (ICRH), Centre for Social Studies on Migration and Refugees (CESSMIR), 9000 Ghent, Belgium
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), 1169-056 Lisbon, Portugal
| |
Collapse
|
23
|
Semple S, Dobson R, O'Donnell R, Zainal Abidin E, Tigova O, Okello G, Fernández E. Smoke-free spaces: a decade of progress, a need for more? Tob Control 2022; 31:250-256. [PMID: 35241597 DOI: 10.1136/tobaccocontrol-2021-056556] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/03/2021] [Indexed: 12/28/2022]
Abstract
Adoption of smoke-free measures has been one of the central elements of tobacco control activity over the past 30 years. The past decade has seen an increasing number of countries and proportion of the global population covered by smoke-free policies to some extent. Despite reductions in global smoking prevalence, population growth means that the number of non-smokers exposed to the harms caused by secondhand smoke remains high. Smoke-free policy measures have been shown to be useful in protecting non-smokers from secondhand smoke, and can additionally increase cessation and reduce smoking initiation. Policies tend to be aimed primarily at enclosed public or workplace settings with very few countries attempting to control exposure in private or semiprivate spaces such as homes and cars, and, as a result, children may be benefiting less from smoke-free measures than adults. Compliance with legislation also varies by country and there is a need for education and empowerment together with guidance and changing social norms to help deliver the full benefits that smoke-free spaces can bring. Restrictions and policies on use of electronic cigarettes (e-cigarettes) in smoke-free settings require more research to determine the benefits and implications of bystanders' exposure to secondhand e-cigarette aerosol, dual use and smoking cessation.
Collapse
Affiliation(s)
- Sean Semple
- Institute of Social Marketing and Health, University of Stirling, Stirling, UK
| | - Ruaraidh Dobson
- Institute of Social Marketing and Health, University of Stirling, Stirling, UK
| | - Rachel O'Donnell
- Institute of Social Marketing and Health, University of Stirling, Stirling, UK
| | - Emilia Zainal Abidin
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Olena Tigova
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Gabriel Okello
- African Centre for Clean Air, Kampala, Uganda.,Cambridge Institute for Sustainability Leadership, University of Cambridge, Cambridge, UK.,AirQo, College of Computing and Information Sciences, Makerere University, Kampala, Uganda
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| |
Collapse
|
24
|
Nobels A, Lemmens G, Thibau L, Beaulieu M, Vandeviver C, Keygnaert I. "Time Does Not Heal All Wounds": Sexual Victimisation Is Associated with Depression, Anxiety, and PTSD in Old Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2803. [PMID: 35270496 PMCID: PMC8910002 DOI: 10.3390/ijerph19052803] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 11/21/2022]
Abstract
Sexual violence (SV) has an important impact on mental health. Childhood sexual abuse is linked to internalising disorders in later life. In older adults, SV occurs more often than previously believed. Moreover, health care workers lack the skills to address SV in later life. Studies researching the mental health impact of lifetime SV, i.e., SV during childhood, adulthood, and old age, are lacking. Between July 2019 and March 2020, 513 older adults living in Belgium participated in structured face-to-face-interviews. Selection occurred via a cluster random probability sampling with a random walk finding approach. Depression, anxiety, and posttraumatic stress syndrome (PTSD) were measured using validated scales. Participants were asked about suicide attempts and self-harm during their lifetime and in the past 12 months. SV was measured using behaviourally specific questions based on a broad SV definition. We found rates for depression, anxiety, and PTSD of 27%, 26%, and 6% respectively, while 2% had attempted suicide, and 1% reported self-harm in the past 12 months. Over 44% experienced lifetime SV and 8% in the past 12 months. Lifetime SV was linked to depression (p = 0.001), anxiety (p = 0.001), and PTSD in participants with a chronic illness/disability (p = 0.002) or no/lower education (p < 0.001). We found no link between lifetime SV and suicide attempts or self-harm in the past 12 months. In conclusion, lifetime SV is linked to mental health problems in late life. Tailored mental health care for older SV victims is necessary. Therefore, capacity building of professionals and development of clinical guidelines and care procedures are important.
Collapse
Affiliation(s)
- Anne Nobels
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
- Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, 9000 Ghent, Belgium;
- Department of Head and Skin–Psychiatry and Medical Psychology, Ghent University, 9000 Ghent, Belgium
| | - Lisa Thibau
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
| | - Marie Beaulieu
- School of Social Work, Research Chair on Mistreatment of Older Adults and Research Centre on Aging, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, 9000 Ghent, Belgium;
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium;
| |
Collapse
|
25
|
Nobels A, Cismaru-Inescu A, Nisen L, Hahaut B, Beaulieu M, Lemmens G, Adam S, Schapansky E, Vandeviver C, Keygnaert I. Sexual violence in older adults: a Belgian prevalence study. BMC Geriatr 2021; 21:601. [PMID: 34702179 PMCID: PMC8546387 DOI: 10.1186/s12877-021-02485-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Sexual violence (SV) is an important public health problem which may cause long-lasting health problems. SV in older adults remains neglected in research, policies and practices. Valid SV prevalence estimates and associated risk factors in older adults are currently unavailable. In this study we measured lifetime and past 12-months sexual victimisation in older adults living in Belgium, its correlates, assailant characteristics and the way that victims framed their SV experiences. Methods SV was measured using behaviourally specific questions based on a broad definition of SV. Participants were selected via a cluster random probability sampling with a random route finding approach. Information on sexual victimisation, correlates, assailant characteristics and framing was collected via structured face-to-face interviews with adults aged 70 years and older living in Belgium (community-dwelling, assisted living and nursing homes). Results Among the 513 participants, the lifetime SV prevalence was 44% (55% F, 29% M). Past 12-months prevalence was 8% (9% F, 8% M). Female sex and a higher number of sexual partners were associated with lifetime SV (p < .05), non-heterosexual sexual orientation with past 12-months SV (p < .05). Correlates identified to be linked to elder abuse and neglect in previous studies were not linked with SV in our sample. ‘Someone unknown’ was identified as most common assailant. Conclusions Sexual victimisation appears to be common in older adults in Belgium. Both correlates and assailant characteristics seem to differ from previous studies on elder abuse and neglect. Recognizing older adults as a risk group for sexual victimisation in research, policies and practices is of the utmost importance. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02485-3.
Collapse
Affiliation(s)
- Anne Nobels
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. .,Department of Psychiatry, Ghent University Hospital, Ghent, Belgium.
| | - Adina Cismaru-Inescu
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium.,Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - Laurent Nisen
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium
| | - Bastien Hahaut
- CARE-ESPRIst, Études et évaluations, University of Liège, Liège, Belgium
| | - Marie Beaulieu
- School of Social Work and Research Centre on Aging, University of Sherbrooke, Quebec, Canada
| | - Gilbert Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium.,Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Stéphane Adam
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | - Evelyn Schapansky
- Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium.,Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| |
Collapse
|
26
|
Nobels A, Keygnaert I, Robert E, Vandeviver C, Haekens A, Lemey L, Strobbe M, Van Den Noortgate N, Lemmens GMD. 'Breaking the silence': Sexual victimisation in an old age psychiatry patient population in Flanders. Int J Geriatr Psychiatry 2021; 36:1550-1558. [PMID: 33969546 DOI: 10.1002/gps.5565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/06/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Sexual violence (SV) is linked to mental health problems in adulthood and old age. However, the extent of sexual victimisation in old age psychiatry patients is unknown. Due to insufficient communication skills in both patients and healthcare workers, assessing SV in old age psychiatry patients is challenging. AIMS To assess lifetime and sexual victimisation in the past 12-months, correlates and SV disclosure in an old age psychiatry population. METHODS Between July 2019 and March 2020, 100 patients at three old age psychiatry wards across Flanders participated in a face-to-face structured interview receiving inpatient treatment. The participation rate was 58%. We applied the WHO definition of SV, encompassing sexual harassment, sexual abuse with physical contact without penetration, and (attempted) rape. RESULTS In 57% of patients (65% F, 42% M) SV occurred during their lifetime and 7% (6% F, 9% M) experienced SV in the past 12-months. Half of the victims disclosed their SV experience for the first time during the interview. Only two victims had disclosed SV to a mental health care professional before. CONCLUSIONS Sexual victimisation appears to be common in old age psychiatry patients, yet it remains largely undetected. Although victims did reveal SV during a face-to-face interview to a trained interviewer, they do not seem to spontaneously disclose their experiences to mental health care professionals. In order to provide tailored care for older SV victims, professionals urgently need capacity building through training, screening tools and care procedures.
Collapse
Affiliation(s)
- Anne Nobels
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Ines Keygnaert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Egon Robert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium.,Research Foundation-Flanders (FWO), Brussels, Belgium
| | - An Haekens
- Psychiatric Hospital Alexianen Zorggroep Tienen, Tienen, Belgium
| | - Lieve Lemey
- Department of Psychiatry and Psychosomatic Medicine, AZ Sint-Jan Bruges-Ostend AV, Bruges, Belgium
| | | | | | - Gilbert M D Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium.,Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| |
Collapse
|
27
|
Phillimore J, Pertek S, Akyuz S, Darkal H, Hourani J, McKnight P, Ozcurumez S, Taal S. "We are Forgotten": Forced Migration, Sexual and Gender-Based Violence, and Coronavirus Disease-2019. Violence Against Women 2021; 28:2204-2230. [PMID: 34533382 PMCID: PMC9118490 DOI: 10.1177/10778012211030943] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Adopting a structural violence approach, this article explores, with survivors and practitioners, how early coronavirus disease-2019 pandemic conditions affected forced migrant sexual and gender-based violence survivors’ lives. Introducing a new analytical framework combining violent abandonment, slow violence, and violent uncertainty, we show how interacting forms of structural violence exacerbated by pandemic conditions intensified existing inequalities. Abandonment of survivors by the state increased precarity, making everyday survival more difficult, and intensified prepandemic slow violence, while increased uncertainty heightened survivors’ psychological distress. Structural violence experienced during the pandemic can be conceptualized as part of the continuum of violence against forced migrants, which generates gendered harm.
Collapse
Affiliation(s)
- Jenny Phillimore
- Social Policy, 1724University of Birmingham Edgbaston Campus, Edgbaston, Birmingham, UK
| | - Sandra Pertek
- Social Policy, 1724University of Birmingham Edgbaston Campus, Edgbaston, Birmingham, UK
| | - Selin Akyuz
- 52948Department of Political Science and International Relations, TED University, Turkey
| | - Hoayda Darkal
- Social Policy, 1724University of Birmingham Edgbaston Campus, Edgbaston, Birmingham, UK
| | - Jeanine Hourani
- Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Saime Ozcurumez
- 52948Department of Political Science and International Relations, TED University, Turkey
| | | |
Collapse
|
28
|
Van Hout MC. Human rights violations, detention conditions and the invisible nature of women in European immigration detention: a legal realist account. Int J Prison Health 2021; 18:1-14. [PMID: 34227377 DOI: 10.1108/ijph-03-2021-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper was to conduct a legal realist assessment of women's situation in European immigration detention which focuses on relevant international and European human rights instruments applicable to conditions and health rights in detention settings, academic literature and relevant European Court of Human Rights (ECtHR) jurisprudence since 2010. DESIGN/METHODOLOGY/APPROACH In spite of the United Nations human rights frameworks and European Union (EU) standards, conditions in European immigration detention settings continue to pose a health risk to those detained. Migrant health rights when detained are intertwined with the right not to be subjected to arbitrary detention, detention in conditions compatible for respect for human dignity and right to medical assistance. Migrant women are particularly vulnerable requiring special consideration (pregnant and lactating women; single women travelling alone or with children; adolescent girls; early-married children, including with newborn infants) in immigration detention settings. FINDINGS The situation of women in immigration detention is patchy in EU policy, academic literature and ECtHR jurisprudence. Where referred to, they are at best confined to their positionality as pregnant women or as mothers, with their unique gendered health needs ill-resourced. ECtHR jurisprudence is largely from male applicants. Where women are applicants, cases centre on dire conditions of detention, extreme vulnerability of children accompanying their mother and arbitrary or unlawful detention of these women (with child). ORIGINALITY/VALUE Concerns have been raised by the European Parliament around immigration detention of women including those travelling with their children. There is a continued failure to maintain minimum and equivalent standards of care for women in European immigration detention settings.
Collapse
Affiliation(s)
- Marie Claire Van Hout
- Public Health Institute, Faculty of Health of Liverpool John Moores University, Liverpool, UK
| |
Collapse
|
29
|
Roura M, Dias S, LeMaster JW, MacFarlane A. Participatory health research with migrants: Opportunities, challenges, and way forwards. Health Expect 2021; 24:188-197. [PMID: 33528082 PMCID: PMC8077110 DOI: 10.1111/hex.13201] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/21/2020] [Accepted: 12/31/2020] [Indexed: 12/15/2022] Open
Abstract
CONTEXT Migration is one of the most politically pressing issues of the 21st century but migrant health remains an under-researched area. The International Collaboration for Participatory Health Research (ICPHR) working group on migration developed this position statement to address opportunities and challenges in relation to migrant health. It aims to contribute to a shift from a deficit model that sees migrants as passively affected by policies to their reconceptualization as citizens who are engaged in the co-creation of solutions. METHODS This paper examines the opportunities and challenges posed by the use of PHR with migrants. It draws on a broad literature to provide examples of successful PHR with migrants and highlights critical issues for consideration. FINDINGS Successful initiatives illustrate the value of engaging migrants in the definition of the research agenda, the design and implementation of health interventions, the identification of health-protective factors and the operationalization and validation of indicators to monitor progress. Within increasingly super diverse contexts, fragmented community landscapes that are not necessarily constructed along ethnicity traits, inadequate structures of representation, local tensions and operational barriers can hamper meaningful PHR with migrants. CONCLUSION For each research context, it is essential to gauge the 'optimal' level and type of participation that is more likely to leverage migrants' empowerment. The development of Monitoring and Evaluation tools and methodological strategies to manage inter-stakeholder discrepancies and knowledge translation gaps are steps in this direction. PATIENT OR PUBLIC CONTRIBUTION This paper draws from contributions of migrant populations and other stakeholders to policymaking.
Collapse
Affiliation(s)
- Maria Roura
- School of Public HealthUniversity College CorkCorkIreland
| | - Sonia Dias
- NOVA National School of Public Health, Public Health Research CenterUniversidade NOVA de Lisboa & Comprehensive Health Research Center (CHRC)LisboaPortugal
| | | | - Anne MacFarlane
- School of Medicine LimerickLimerickIreland
- Health Research InstituteUniversity of LimerickLimerickIreland
| |
Collapse
|
30
|
Gama A, Pedro A, de Carvalho M, Guerreiro A, Duarte V, Quintas J, Matias A, Keygnaert I, Dias S. Domestic Violence during the COVID-19 Pandemic in Portugal. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2021. [DOI: 10.1159/000514341] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The measures implemented to combat the COVID-19 pandemic led populations to confinement at home, with increased risk of domestic violence due to extended shared time between victims and offenders. Evidence on domestic violence in times of pandemic is lacking. This study examines the occurrence of domestic violence, associated factors and help seeking during the COVID-19 pandemic. An online survey was conducted in Portugal between April and October 2020 by NOVA National School of Public Health. The survey was disseminated through partner networks, media, and institutions working within the scope of violence. Data were collected on the experience of domestic violence, and help seeking during the pandemic. In a total of 1,062 respondents, 146 (13.7%) reported having suffered domestic violence during the pandemic, including psychological (13.0%, <i>n</i> = 138), sexual (1.0%, <i>n</i> = 11), and physical (0.9%, <i>n</i> = 10) abuse. Overall, the lower the age, the more the reported domestic violence. Also, a higher proportion of participants who perceived difficulties to make ends meet during the pandemic reported domestic violence. Differences between women and men and across educational levels on reported domestic violence were not statistically significant. Bivariate logistic analyses showed that, among women, reported domestic violence was more likely among those with up to secondary education compared to higher education. Most of the victims did not seek help (62.3%), the main reasons being considering it unnecessary, that help would not change anything, and feeling embarrassed about what had happened. Only 4.3% of the victims sought police help. The most common reasons for not coming forward to form a complaint were considering the abuse was not severe and believing the police would not do anything. Our findings indicate that domestic violence during the COVID-19 pandemic was experienced by both sexes and across different age groups. There is a need for investing in specific support systems for victims of domestic violence to be applied to pandemic contexts, especially targeting those in more vulnerable situations and potentially underserved.
Collapse
|
31
|
Lugova H, Samad N, Haque M. Sexual and Gender-Based Violence Among Refugees and Internally Displaced Persons in the Democratic Republic of the Congo: Post-Conflict Scenario. Risk Manag Healthc Policy 2020; 13:2937-2948. [PMID: 33328772 PMCID: PMC7734039 DOI: 10.2147/rmhp.s283698] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/23/2020] [Indexed: 12/26/2022] Open
Abstract
The ongoing humanitarian crisis in the Democratic Republic of the Congo has triggered sexual and gender-based violence, including rape, sexual slavery, trafficking, intimate partner violence, and sexual exploitation. Gender inequalities and abuse of power experienced by women and young girls at refugee settings further exacerbate their vulnerability to different forms of violence. This study aimed to offer an evidence-based approach to developing strategies in tackling the complex problem of sexual and gender-based violence among refugees and internally displaced persons in the Congo. We conducted a narrative review of all the relevant papers known to the authors to explore the origins of the problem, its implications on public health, and its impact on equity. The study revealed that sexual assault survivors face physical and psychological sufferings, excruciating emotions, and profound disruption of their social well-being since they are often stigmatized and ostracized by society. The analysis of current government policies revealed a lack of programs to address survivors' specific concerns and policy enforcement problems. This study suggested strategic objectives and policy implementation steps. The proposed strategies address women empowerment and gender stigma, provision of effective health services, and adequate response action.
Collapse
Affiliation(s)
- Halyna Lugova
- Unit of Community Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Nandeeta Samad
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
32
|
Rodella Sapia MD, Wangmo T, Dagron S, Elger BS. Understanding access to professional healthcare among asylum seekers facing gender-based violence: a qualitative study from a stakeholder perspective. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:25. [PMID: 32957996 PMCID: PMC7507652 DOI: 10.1186/s12914-020-00244-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 09/06/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND When it comes to gender-based violence (GBV), migrant women and girls represent the most vulnerable group. GBV can happen at any stage of migrants' flight and/or during the asylum process. It has severe consequences on their life and health. Victims therefore need timely access to healthcare. This study explores the context GBV victims face when they seek refuge in Switzerland. METHODS Qualitative methodology was used where we conducted five semi-structured focus groups and three interviews. A total of sixteen stakeholders participated in the study. They were either involved in the asylum process or provided healthcare to asylum seekers. We analyzed the data using framework analysis. RESULTS Study participants noted lack of confidence of the GBV victims in the legal and in the healthcare systems as major barriers to disclosure of GBV. Since only GBV exerted before fleeing the home country gives the right to asylum, they pointed out that victims do not disclose GBV that took place after they left their home country. Language was identified as a barrier to disclosure of GBV as well as to healthcare access. Continuity of care at the moment of transfer from federal to cantonal (i.e. state) accommodations is another issue that was deemed critical. Study participants felt that health professionals must be trained to identify GBV victims. The first-contact caregiver available to these victims was deemed as the most competent professional that could act as a "GBV coordinator". CONCLUSION In Switzerland, access to healthcare is guaranteed to all asylum seekers on a legal and structural level. Yet, health seeking by GBV survivors is hindered by factors such as lack of confidence in the legal system, trust in health providers, and continuity of care during the asylum process. Building trust in legal institutions, health structures, and professionals should be enhanced to facilitate disclosure and to strengthen resilience. This includes a healthcare system with competent professionals, support with language and cultural needs, as well as seamless continuity of care beyond cantonal borders.
Collapse
Affiliation(s)
- Mirjam D Rodella Sapia
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland. .,University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Stéphanie Dagron
- Global Studies Institute / Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Center of Legal Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
33
|
Oliveira C, Oliveira Martins MDR, Dias S, Keygnaert I. Conceptualizing sexual and gender-based violence in European asylum reception centers. ACTA ACUST UNITED AC 2019; 77:27. [PMID: 31164983 PMCID: PMC6545000 DOI: 10.1186/s13690-019-0351-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 05/07/2019] [Indexed: 11/26/2022]
Abstract
Background Sexual and gender based violence (SGBV) is a major public health problem and a violation of human rights. Refugees, asylum seekers and migrants are exposed to a constant risk for both victimization and perpetration. Yet, in the context of European asylum reception centers (EARF) professionals are also considered to be at risk. Our study explores the conceptualization of SGBV that residents and professionals have in this specific context. Further, we intent to identify key socio-demographic characteristics that are associated with SGBV conceptualization for both groups. Methods We developed a cross-sectional study using the Senperforto project database. Semi-structured interviews were conducted with residents (n = 398) and professionals (n = 202) at EARF. A principal component analysis (PCA) was conducted to variables related with knowledge on SGBV. Chi-square test and Fisher’s exact test were applied to understand if significant statistical association exists with socio-demographic characteristics (significant level 0.5%). Results The majority of residents were male (64.6%), aged from 19 to 29 years (41.4%) and single (66.8%); for professionals the majority were women (56.2%), aged from 30 to 39 years (42.3%) and married (56.8%). PCA for residents resulted in 14 dimensions of SGBV representing 83.56% of the total variance of the data, while for professionals it resulted in 17 dimensions that represent 86.92% of the total variance of the data. For both groups differences in SGBV conceptualization were found according to host country, sex, age and marital status. Specific for residents we found differences according to the time of arrival to Europe/host country and type of accommodation, while for professionals differences were found according to legal status and education skills. Conclusion Residents and professionals described different conceptualization of SGBV, with specific types of SGBV not being recognized as a violent act. Primary preventive strategies in EARF should focus on reducing SGBV conceptualization discrepancies, taking into account socio-demographic characteristics.
Collapse
Affiliation(s)
- Charlotte Oliveira
- 1Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Maria do Rosário Oliveira Martins
- 1Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Sónia Dias
- 1Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, Rua da Junqueira 100, 1349-008 Lisbon, Portugal.,2Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ines Keygnaert
- 3International Centre for Reproductive Health, Department of Public Health and Primary Care, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
34
|
Violence Experience among Immigrants and Refugees: A Cross-Sectional Study in Italy. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7949483. [PMID: 30345306 PMCID: PMC6174783 DOI: 10.1155/2018/7949483] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/13/2018] [Indexed: 12/29/2022]
Abstract
The objectives of this cross-sectional investigation among a random sample of immigrants and refugees in Italy were to gain an insight into the extent and type of the episodes of violence and to assess their association with different characteristics. Data was collected from September 2016 to July 2017 using a face-to-face structured interview. A total of 503 subjects participated. Overall, 46.5% and 40% of the sample reported having experienced some form of violence in Italy at least once since they arrived and during the last 12 months. Psychological violence was the most common form experienced by 53.2% of the participants, 40.3% experiencing physical violence, 18.9% economic violence, and only 6.5% intimate partner violence. The risk of experiencing at least one form of violence in the last 12 months in Italy was more likely to occur among immigrants who have been in Italy much longer and less likely in those who lived in a camp. The number of episodes of violence experienced since they arrived in Italy was significantly higher in female, in those who have been in Italy much longer and in those who had experienced at least one racially discriminatory episode of violence, whereas those with middle and high school or above educational level and those who did not experience psychological consequences of the violence had experienced a lower number of episodes. These results must be used to strengthen interventions and policies aimed at preventing violence among this population.
Collapse
|
35
|
De Schrijver L, Vander Beken T, Krahé B, Keygnaert I. Prevalence of Sexual Violence in Migrants, Applicants for International Protection, and Refugees in Europe: A Critical Interpretive Synthesis of the Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1979. [PMID: 30208610 PMCID: PMC6165364 DOI: 10.3390/ijerph15091979] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 09/07/2018] [Indexed: 11/21/2022]
Abstract
(1) Background: Sexual violence (SV) is a major public health problem, with negative socio-economic, physical, mental, sexual, and reproductive health consequences. Migrants, applicants for international protection, and refugees (MARs) are vulnerable to SV. Since many European countries are seeing high migratory pressure, the development of prevention strategies and care paths focusing on victimised MARs is highly needed. To this end, this study reviews evidence on the prevalence of SV among MAR groups in Europe and the challenges encountered in research on this topic. (2) Methods: A critical interpretive synthesis of 25 peer-reviewed academic studies and 22 relevant grey literature documents was conducted based on a socio-ecological model. (3) Results: Evidence shows that SV is highly frequent in MARs in Europe, yet comparison with other groups is still difficult. Methodologically and ethically sound representative studies comparing between populations are still lacking. Challenges in researching SV in MARs are located at the intrapersonal, interpersonal, community, societal, and policy levels. (4) Conclusions: Future research should start with a clear definition of the concerned population and acts of SV to generate comparable data. Participatory qualitative research approaches could be applied to better grasp the complexity of interplaying determinants of SV in MARs.
Collapse
Affiliation(s)
- Lotte De Schrijver
- UGent-International Centre for Reproductive Health, 9000 Ghent, Belgium.
| | - Tom Vander Beken
- UGent-Institute for International Research on Criminal Policy, 9000 Ghent, Belgium.
| | - Barbara Krahé
- Department of Psychology, University of Potsdam, 14476 Potsdam, Germany.
| | - Ines Keygnaert
- UGent-International Centre for Reproductive Health, 9000 Ghent, Belgium.
| |
Collapse
|
36
|
Assessing reported cases of sexual and gender-based violence, causes and preventive strategies, in European asylum reception facilities. Global Health 2018; 14:48. [PMID: 29743084 PMCID: PMC5944050 DOI: 10.1186/s12992-018-0365-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 05/01/2018] [Indexed: 12/02/2022] Open
Abstract
Background Sexual and gender-based violence (SGBV) is a widespread public health problem and a violation of human rights rooted in gender and power inequities. Refugees, asylum-seekers and migrants living in European asylum reception facilities (EARF) are especially vulnerable to SGBV. To contribute to closing the gap on systematic and accurate evidence on SGBV, we aim to explore reported cases of SGBV, causes and preventable measures described by residents and professionals from EARF. Methods We developed a cross-sectional study using the Senperforto project database. Semi-structured interviews were conducted with residents (refugees, asylum-seekers and unaccompanied minors) and professionals (service and health care providers) at EARF, in 7 European countries. We used IBM® SPSS software to analyze our data. Further, statistical tests – Chi-square Test and Fisher’s exact test (5% significance level) were conducted. Results In total 562 respondents: 375 residents (R) and 187 professionals (P) participated in the study. The majority of respondents were male (56.9%), aged 19 to 39 years (67.3%). Respondents described 698 cases of SGBV (R 328, P 370), comprising 1110 acts of multi-types of violence. Respondents from Malta (160) and Belgium (143) reported the highest number of SGBV cases. The main reported causes were frustration and stress (R 23.6%, P 37.6%, p 0.008) and differences related with cultural background (R 19.3%, P 20.3%, p 0.884). Respondents assumed that these acts of violence could be prevented by SGBV prevention interventions (R 31.5%, P 24.7%, p 0.293); improving living conditions (R 21.7%, P 15.3%, p 0.232); and promoting communication (R 16.1%, P 28.2%, p 0.042). The majority of R were not aware of existing preventable measures in the asylum facility or host country. While the majority of P were aware of existing preventable measures in the asylum facility or country. Proposed SGBV prevention strategies in EARF included SGBV sensitization and awareness, improving living conditions and improving communication between R and P. Conclusion In the EARF context, SGBV is characterized by multi-types of violence acts, yet R and P believe that prevention is possible. Our results call for urgent integrative prevention strategies that are in line with country-level and international regulations.
Collapse
|
37
|
Structural violence and marginalisation. The sexual and reproductive health experiences of separated young people on the move. A rapid review with relevance to the European humanitarian crisis. Public Health 2018; 158:156-162. [DOI: 10.1016/j.puhe.2018.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 03/05/2018] [Accepted: 03/07/2018] [Indexed: 01/13/2023]
|
38
|
Robbers GML, Morgan A. Programme potential for the prevention of and response to sexual violence among female refugees: a literature review. REPRODUCTIVE HEALTH MATTERS 2017; 25:69-89. [PMID: 29214917 DOI: 10.1080/09688080.2017.1401893] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Continuing international conflict has resulted in several million people seeking asylum in other countries each year, over half of whom are women. Their reception and security in overburdened camps, combined with limited information and protection, increases their risk and exposure to sexual violence (SV). This literature review explores the opportunities to address SV against female refugees, with a particular focus on low-resource settings. A systematic literature review of articles published between 2000 and 2016 was conducted following PRISMA guidelines. Databases including Medline (Ovid), PubMed, Scopus, PsychINFO, CINAHL and the Cochrane Library. Grey literature from key refugee websites were searched. Studies were reviewed for quality and analysed according to the framework outlined in the UNHCR Guidelines on Prevention and Response of Sexual Violence against Refugees. Twenty-nine studies met the inclusion criteria, of which 7 studies addressed prevention, 14 studies response and 8 addressed both. There are limited numbers of rigorously evaluated SV prevention and response interventions available, especially in the context of displacement. However, emerging evidence shows that placing a stronger emphasis on programmes in the category of engagement/participation and training/education has the potential to target underlying causes of SV. SV against female refugees is caused by factors including lack of information and gender inequality. This review suggests that SV interventions that engage community members in their design and delivery, address harmful gender norms through education and advocacy, and facilitate strong cooperation between stakeholders, could maximise the efficient use of limited resources.
Collapse
Affiliation(s)
- Gianna Maxi Leila Robbers
- a MPH Graduate of the University of Melbourne, Nossal Institute for Global Health, University of Melbourne , Melbourne , VIC , Australia
| | - Alison Morgan
- b Senior Technical Advisor, Maternal Health, Nossal Institute for Global Health, University of Melbourne , Melbourne , VIC , Australia
| |
Collapse
|
39
|
Pannetier J, Ravalihasy A, Lydié N, Lert F, Desgrées du Loû A. Prevalence and circumstances of forced sex and post-migration HIV acquisition in sub-Saharan African migrant women in France: an analysis of the ANRS-PARCOURS retrospective population-based study. LANCET PUBLIC HEALTH 2017; 3:e16-e23. [PMID: 29307383 DOI: 10.1016/s2468-2667(17)30211-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/25/2017] [Accepted: 10/19/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sub-Saharan African migrant women are a key population at risk of HIV infection in Europe. Using data from the ANRS-PARCOURS study, we aimed to assess the prevalence of forced sex after migration and its association with post-migration acquisition of HIV as well as the circumstances of forced sex after migration, including housing and administrative insecurity, among sub-Saharan African migrant women living in the Paris Region, France. METHODS The ANRS-PARCOURS study was a retrospective life-event survey done between February, 2012, and May, 2013, in health-care facilities in the Paris region of France. Women were eligible if they were born in sub-Saharan Africa, aged between 18 and 59 years, and had been diagnosed with HIV infection at least 3 months earlier for women receiving HIV care or not diagnosed with HIV. In this analysis, we used ANRS-PARCOURS study data to compare the incidence of forced sex after migration in three groups of sub-Saharan African migrant women: those who acquired HIV after migrating, those who acquired HIV before migrating, and those without HIV. We assessed the associations between forced sex, sexual partnerships, and living conditions after migration with mixed-effects logistic regression and generalised structural equation models. The study is registered with ClinicalTrials.gov, number NCT02566148. FINDINGS We obtained data from 980 eligible individuals who participated in the ANRS-PARCOURS study (407 without HIV and 573 HIV-positive) from 54 randomly selected health-care facilities. We excluded 20 women whose HIV infection could not be dated and eight women with missing data from the analyses, for a total of 405 women in the reference group (without HIV) and 547 women in the HIV group (156 with post-migration HIV acquisition, 391 with pre-migration HIV). Women who acquired HIV after migration experienced forced sex after migration more frequently than women without HIV (24 [15%] vs 18 [4%]; p=0·001). Forced sex after migration was associated with being hosted by family or friends (β=0·95, 95% CI 0·19-1·72) and lack of stable housing (β=1·10, 0·17-2·03). Lack of a residence permit was also associated with forced sex after migration. INTERPRETATION The social hardships faced by sub-Saharan African migrant women after migration, especially a lack of housing or lack of a residence permit, increases their exposure to sexual violence and to HIV infection. FUNDING The French National Agency for Research on AIDS and Viral Hepatitis, Santé publique France, the national public health agency.
Collapse
Affiliation(s)
- Julie Pannetier
- CEPED, IRD, Université Paris Descartes, Inserm, équipe SAGESUD, Paris, France.
| | | | | | - France Lert
- CEPED, IRD, Université Paris Descartes, Inserm, équipe SAGESUD, Paris, France
| | | | | |
Collapse
|
40
|
Larsson M. Migration - A global challenge with implications for sexual and reproductive health and care. SEXUAL & REPRODUCTIVE HEALTHCARE 2016; 9:A1. [PMID: 27634666 DOI: 10.1016/j.srhc.2016.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Margareta Larsson
- Chief editor, Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden.
| |
Collapse
|
41
|
Cuthill F. Political representation for social justice in nursing: lessons learned from participant research with destitute asylum seekers in the UK. Nurs Inq 2016; 23:211-22. [PMID: 27562573 DOI: 10.1111/nin.12132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/28/2022]
Abstract
The concept of social justice is making a revival in nursing scholarship, in part in response to widening health inequalities and inequities in high-income countries. In particular, critical nurse scholars have sought to develop participatory research methods using peer researchers to represent the 'voice' of people who are living in marginalized spaces in society. The aim of this paper is to report on the experiences of nurse and peer researchers as part of a project to explore the experiences of people who find themselves destitute following the asylum process in the UK. In seeking to explore social injustice, three challenges are identified: lack of a robust political theory, institutional/professional constraints and an absence of skills to engage with the politics of social (in)justice. Each challenge is presented, opposing voices outlined and some possible solutions are suggested. The work of political theorist Nancy Fraser is used as a conceptual framework, in particular her focus on mis/framing and political representation for social justice. In addition, it is suggested that social justice needs to be further embedded in nursing policy and curriculum. Finally, nurses are encouraged to develop practical political skills to engage with both politics and the media in a neoliberal globalizing world.
Collapse
Affiliation(s)
- Fiona Cuthill
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
42
|
Keygnaert I. In Search of the Third Eye, When the Two Others Are Shamefacedly Shut? Comment on "Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development". Int J Health Policy Manag 2016; 5:325-7. [PMID: 27239882 DOI: 10.15171/ijhpm.2016.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/08/2016] [Indexed: 11/09/2022] Open
Abstract
Ivanova et al explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies in 4 countries. They adapted the EquiFrame of Amin and colleagues of 2011, to SRH vulnerable groups which we believe could now be used for analysis of national SRH polices beyond those 4 countries. Although we fully agree with the authors' two main findings that vulnerable groups and human rights' principles are not sufficiently integrated in SRH policies nor granted the possibility to participate in the process of development in those four countries, we do believe that these shortcomings are not limited to those countries only nor to the identified vulnerable groups either. We are convinced that the issue of SRH as such is still framed within a very limited logic for all with vulnerable groups being perceived as an extra threat or an extra burden.
Collapse
Affiliation(s)
- Ines Keygnaert
- ICRH, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
43
|
What the eye does not see: a critical interpretive synthesis of European Union policies addressing sexual violence in vulnerable migrants. REPRODUCTIVE HEALTH MATTERS 2015; 23:45-55. [PMID: 26718996 DOI: 10.1016/j.rhm.2015.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 11/08/2015] [Accepted: 11/11/2015] [Indexed: 11/24/2022] Open
Abstract
In Europe, refugees, asylum seekers and undocumented migrants are more vulnerable to sexual victimisation than European citizens. They face more challenges when seeking care. This literature review examines how legal and policy frameworks at national, European and international levels condition the prevention of and response to sexual violence affecting these vulnerable migrant communities living in the European Union (EU). Applying the Critical Interpretive Synthesis method, we reviewed 187 legal and policy documents and 80 peer-reviewed articles on migrant sexual health for elements on sexual violence and further analysed the 37 legal and 12 peer-reviewed articles among them that specifically focused on sexual violence in vulnerable migrants in the EU-27 States. Legal and policy documents dealing with sexual violence, particularly but not exclusively in vulnerable migrants, apply 'tunnel vision'. They ignore: a) frequently occurring types of sexual violence, b) victimisation rates across genders and c) specific risk factors within the EU such as migrants' legal status, gender orientation and living conditions. The current EU policy-making paradigm relegates sexual violence in vulnerable migrants as an 'outsider' and 'female only' issue while EU migration and asylum policies reinforce its invisibility. Effective response must be guided by participatory rights- and evidence-based policies and a public health approach, acknowledging the occurrence and multiplicity of sexual victimisation of vulnerable migrants of all genders within EU borders.
Collapse
|