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Brown DS, McNelly S, Meinhart M, Sesay I, Poulton C, Stark L. Associations between intimate partner violence and women's labor market outcomes in Nigeria. Glob Health Res Policy 2024; 9:21. [PMID: 38898516 PMCID: PMC11188153 DOI: 10.1186/s41256-024-00362-1] [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: 05/25/2023] [Accepted: 06/07/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Little is known regarding economic impacts of intimate partner violence (IPV) in humanitarian settings, especially the labor market burden. Examining costs of IPV beyond the health burden may provide new information to help with resource allocation for addressing IPV, including within conflict zones. This paper measures the incidence and prevalence of different types of IPV, the potential relationship between IPV and labor market activity, and estimating the cost of these IPV-associated labor market differentials. METHODS The association between labor market outcomes, IPV experience, and conflict exposure among women ages 15-49 in Nigeria were studied using the 2018 Nigeria Demographic and Health Survey and 2013-17 Uppsala Conflict Data Program data. Descriptive analysis was used to identify patterns of IPV and labor outcomes by region. Based on this, multivariable logistic regression models were used to estimate the association between labor market participation and lifetime IPV exposure. These models were combined with earnings data from the United Nations Human Development Report 2021/2022 and a top-down costing approach to quantify the impacts in terms of lost productivity to the Nigerian economy. RESULTS Substantial differences in IPV exposure and labor market outcomes were found between conflict and non-conflict-affected areas. Women with past year or lifetime exposure to physical, emotional, or "any" IPV were more likely to withdraw from the labor market in the past year, although no differences were found for sexual IPV or conflict-affected regions. We estimate an average reduction of 4.14% in the likelihood of working, resulting in nearly $3.0 billion USD of lost productivity, about 1% of Nigeria's total economic output. CONCLUSIONS Increased odds of labor market withdraw were associated with several measures of IPV. Withdrawal from the formal labor market sector has a substantial associated economic cost for all of Nigerian society. If stronger prevention measures reduce the incidence of IPV against women in Nigeria, a substantial portion of lost economic costs likely could be reclaimed. These costs underscore the economic case, alongside the moral imperative, for stronger protections against IPV for girls and women in Nigeria.
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Affiliation(s)
- Derek S Brown
- George Warren Brown School, Washington University in St. Louis, Goldfarb Hall, Room 241, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Samantha McNelly
- George Warren Brown School, Washington University in St. Louis, Goldfarb Hall, Room 241, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Melissa Meinhart
- George Warren Brown School, Washington University in St. Louis, Goldfarb Hall, Room 241, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | | | | | - Lindsay Stark
- George Warren Brown School, Washington University in St. Louis, Goldfarb Hall, Room 241, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
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Kaul A, Saboor L, Ahmad A, Mannell J, Paphitis SA, Devakumar D. What are the experiences and psychosocial needs of female survivors of domestic violence in Afghanistan? A qualitative interview study in three Afghan provinces. BMJ Open 2024; 14:e079615. [PMID: 38839389 PMCID: PMC11163623 DOI: 10.1136/bmjopen-2023-079615] [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: 09/06/2023] [Accepted: 05/20/2024] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVES This study aimed to qualitatively explore (1) the experiences of female survivors of domestic abuse and mental health problems in Afghanistan; (2) how female survivors of violence and abuse, male members of the community and service providers perceive and respond to mental health and domestic violence in Afghanistan and (3) the provision of mental health services for female survivors of violence and abuse in Afghanistan, including the barriers and challenges faced around accessing mental health services. DESIGN Qualitative interviews and framework thematic analysis. SETTING Kabul, Bamyan and Nangarhar in Afghanistan. PARTICIPANTS 60 female survivors of domestic abuse, 60 male community members and 30 service providers who work with female survivors of domestic abuse. RESULTS Experiences of multiple and compounding traumatic experiences of violence, armed conflict, and complex and competing psychosocial concerns were common among the female survivor participants. All female survivor participants reported experiencing negative mental health outcomes in relation to their experiences of violence and abuse, which were further precipitated by widespread social stigma and gender norms. Support and service provision for female survivors was deemed by participants to be insufficient in comparison to the amount of people who need to access them. CONCLUSIONS There are many risks and barriers women face to disclosing their experiences of violence and mental health problems which restrict women's access to psychological support. Culturally relevant services and trauma-informed interventions are necessary to respond to these issues. Service providers should be trained to effectively recognise and respond to survivors' mental health needs.
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Affiliation(s)
- Anjuli Kaul
- Section of Women's Mental Health, King's College London, London, UK
| | - Lamba Saboor
- Institute for Global Health, University College London, London, UK
| | | | | | | | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
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Namer E, Shimbre MS, Alagaw A, Guyo TG. Intimate partner violence and associated factors among married adolescent girls and young women in the pastoralist community of South Ethiopia: is intimate partner violence associated with cultural phenomena? Front Public Health 2024; 12:1329699. [PMID: 38584912 PMCID: PMC10995306 DOI: 10.3389/fpubh.2024.1329699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 02/21/2024] [Indexed: 04/09/2024] Open
Abstract
Background Violence against women is a major public health problem that affects the physical, sexual, mental, and social wellbeing of more than one-third of all women worldwide. Hence the purpose of this study was to determine the prevalence of physical and sexual intimate partner violence (IPV) and associated factors among married adolescent girls and young women (AGYW) belonging to the pastoralist community of Dassenech district, South Omo Zone, South Ethiopia. Methods A community-based cross-sectional survey was conducted among married AGYW in the Dassenech district from March 1, 2022, to April 1, 2022. A multi-stage sampling technique was adopted to select 545 participants. The data were collected using pre-tested and standardized WHO multi-country study tools. A binary logistic regression model was fitted to identify the independent predictors of physical and sexual intimate partner violence. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to measure the effect size, and finally, a p-value<0.05 was considered statistically significant. Results The prevalence of physical IPV among AGYW belonging to the pastoralist community of Dassenech district was 44.1% (95% confidence interval (CI): 40%, 48%) and that of sexual IPV was 39.3% (95% CI: 35%, 43%). The husband only deciding for the household (AOR = 11.36; 95% CI: 6.97, 18.53), the father performing the Dimi cultural ceremony (AOR = 3.70; 95% CI: 2.22, 6.14), and frequent quarrels (AOR = 2.06; 95% CI: 1.07, 3.99) are significantly associated with physical IPV. Both partners drinking alcohol (AOR = 3.47; 95% CI: 1.94, 6.20), the husband only deciding for the household (AOR = 11.23; 95% CI: 6.91, 18.27), and frequent quarrels (AOR = 2.29; 95% CI: 1.15, 4.56) were factors significantly associated with sexual IPV. Conclusion Physical and sexual intimate partner violence is a significant public health problem in the study area. Therefore, interventional measures to change the attitude of cultural leaders, providing education to married men and women on risky sexual behavior, and empowering women need to be prioritized to prevent the occurrence of this problem.
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Affiliation(s)
- Ergudo Namer
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mulugeta Shegaze Shimbre
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Amsalu Alagaw
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tamirat Gezahegn Guyo
- Department of Public Health, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
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Bapolisi WA, Makelele J, Ferrari G, Kono-Tange L, Bisimwa G, Schindler C, Merten S. Engaging men in women's empowerment: impact of a complex gender transformative intervention on household socio-economic and health outcomes in the eastern democratic republic of the Congo using a longitudinal survey. BMC Public Health 2024; 24:443. [PMID: 38347559 PMCID: PMC10863082 DOI: 10.1186/s12889-024-17717-5] [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: 03/22/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND In the Democratic Republic of the Congo, women in (peri-)urban areas are commonly engaged in small trade, which allows them to meet the basic needs of their families. Microsaving approaches are a low-risk option to obtain financing for economic activities. A project combining men's sensitization on gender equity and women's empowerment through village savings and loan associations were implemented in North and South Kivu to raise the household economic level. OBJECTIVE This study assessed how involving men in gender equity affects women's health and socio-economic outcomes, including food security. METHODS A cohort study was conducted with 1812 women at the baseline; out of them 1055 were retrieved at the follow-up. Baseline data collection took place from May to December 2017 and the follow-up from July 2018 to January 2019. To identify socio-economic changes and changes of gender relations, linear and logistic regressions were run. RESULTS Results showed that the household income improved with intervention (coefficient = 0.327; p = 0.002), while the capacity to pay high bills without contracting debts decreased (coefficient = 0.927; p = 0.001). We did not find enough statistically significant evidence of the influence of the intervention on skilled birth attendance (coefficient = 0.943; p = 0.135), or family planning use (coefficient = 0.216; p = 0.435) nor women's participation in the decision-making (coefficient = 0.033; p = 0.227) nor on couple's cohesion (coefficient = 0.024; p = 0.431). Food insecurity levels decreased over time regardless of being in the intervention or control area. CONCLUSION Empowering women while sensitizing men on gender aspects improves financial well-being (income). Time, security, and strong politics of government recognizing and framing the approach are still needed to maximize the benefit of such projects on social factors such as women's participation in decision-making and social cohesion.
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Affiliation(s)
- Wyvine Ansima Bapolisi
- Université Catholique de Bukavu, Democratic Republic of the Congo, Bukavu, Sud-Kivu, Democratic Republic of the Congo.
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Jean Makelele
- CARE International, Goma, Democratic Republic of the Congo
| | - Giovanfrancesco Ferrari
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Ghislain Bisimwa
- Université Catholique de Bukavu, Democratic Republic of the Congo, Bukavu, Sud-Kivu, Democratic Republic of the Congo
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Amin SN, Al-Jussani GN, S Hassan S, Sharif AF, Ismail AA, Badie Taher D, Aolymat I, El-Akabawy G, Zayed AA. Evaluating cognitive and affective abilities among medical students: behavioural and medicolegal perspectives. PeerJ 2024; 12:e16864. [PMID: 38317841 PMCID: PMC10840496 DOI: 10.7717/peerj.16864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
Medical students attending university for the first time experience a new environment, full of significant social, cultural, and intellectual challenges. Moreover, drug abuse and bullying among university students are major global concerns. The aim of the current study was to assess the impact of medicolegal issues on undergraduate and postgraduate students. It is a cross-sectional survey-based study, with each set of questions investigating cognitive functions, aggression, personality, and exposure to medicolegal issues. Males and those with a chronic disease have been significantly exposed to medicolegal issues; exposed students were significantly older than nonexposed ones. The scores of aggression were significantly higher among exposed and male students. The cognitive scores were higher for the students from rural areas than in urban areas, and females were more neurotic than males. The current study recommends conducting campaigns to educate university students on the importance of formally disclosing unethical behaviors and listening to the victims to facilitate overcoming their negative feelings. As many victims feel comfortable disclosing victimization to their friends, we recommend conducting peer educational programs to help friends support their colleagues regarding unethical misconduct.
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Affiliation(s)
- Shaimaa Nasr Amin
- Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
- Physiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ghada Nazar Al-Jussani
- Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Sherif S Hassan
- Department of Internal Medicine, University of California, Riverside, California, United States
| | - Asmaa F. Sharif
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed A. Ismail
- Community Medicine and Public Health Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
- Kansas Department of Health and Environment, Topeka, Kansas, USA
| | - Dina Badie Taher
- Department of Psychiatry, Kasr al Ainy, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Iman Aolymat
- Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Gehan El-Akabawy
- Department of Basic Medical Sciences, College of Medicine, Ajman University, Ajman, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Anatomy and Embryology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Abeer Ahmed Zayed
- Department of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Clark CJ, Bergenfeld I, Cheong YF, Najera H, Sardinha L, García-Moreno C, Heise L. Patterns of Women's exposure to psychological violence: A global examination of low- and middle-income countries. SSM Popul Health 2023; 24:101500. [PMID: 37727254 PMCID: PMC10506161 DOI: 10.1016/j.ssmph.2023.101500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/15/2023] [Accepted: 08/25/2023] [Indexed: 09/21/2023] Open
Abstract
Introduction Under Sustainable Development Goal 5, prevalence of intimate partner violence (IPV) is a globally reportable indicator. There is a lack of consensus on how to measure and report psychological IPV, affecting prevalence estimates and cross-country comparability. We examine similarities and differences in the patterning of women's experiences of psychological abuse in low- and middle-income countries (LMICs) to inform common cut points. Methods Data include 13,452 ever-partnered women from six LMICs participating in the WHO multi-country study on women's health and domestic violence against women and 306,101 from 47 LMICs participating in the Demographic and Health Surveys. A confirmatory latent class analysis (LCA) approach was applied to identify the optimal class structure using the 3 DHS and 4 WHO psychological IPV items, assessed the impact of physical and sexual IPV on class structure, and tested class generalizability across countries. We validated the three-class solution by regressing the classes on physical IPV, sexual IPV, controlling behaviors, and injury due to domestic violence. We used item response theory (IRT) methods to assess item-level characteristics of the items. Results Analysis confirmed the three-class structure in most countries. Addition of physical and sexual IPV did not change overall class structure or improve discrimination or homogeneity of the items. The three-class structure was invariant within most WHO-classified regions. Operationalized classes informed by the LCA resulted in prevalences of roughly 90% low-to-no class, 7% moderate-intensity class, and 3% high-intensity class. Classes showed convergent validity with all outcomes tested. IRT analysis revealed good discriminations but substantial information overlaps over a narrow range of the latent psychological violence construct. Conclusions This study confirms the three-class pattern but suggests some differences across countries. and regions. We suggest cut points distinguishing violent from non-violent acts and demarcating levels of severity for future study. Findings offer evidence-based guidance to rectify challenges.
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Affiliation(s)
- Cari Jo Clark
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Irina Bergenfeld
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yuk Fai Cheong
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Hector Najera
- Programme for Development Studies. National Autonomous University of Mexico PUED-UNAM, Mexico
| | - LynnMarie Sardinha
- The UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Claudia García-Moreno
- The UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Lori Heise
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Prevention Collaborative1, USA
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Kurt G, Akın A. Gender and exposure to childhood violence are important determinants of domestic violence among academics. Heliyon 2023; 9:e22078. [PMID: 38034745 PMCID: PMC10682135 DOI: 10.1016/j.heliyon.2023.e22078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023] Open
Abstract
Domestic violence is a common and significant social problem that threatens public health, violates human rights, and poses significant obstacles to national development. This study aimed to evaluate both male and female academics' knowledge and views on domestic violence, and determine its incidence and risk factors among academics. Participants comprised 304 academics working at universities, who were selected by cluster sampling from seven regions of Turkey. Data were analyzed using thematic coding, descriptive statistics, and multivariate logistic regression. Of the 304 participants, 56.9 % were female academics. The incidence of domestic violence among the academics was 21.4 %, with 25.4 % of female and 16.0 % of male academics reporting having experienced it. Academics who were victims of domestic violence were mostly exposed to it from their spouses. Academics also reported experiencing emotional violence. Female academics were 2.3 times more likely to experience domestic violence than men. Academics who were exposed to violence in childhood experienced 14.1 times more domestic violence than those who were not. Although it seems that a high status in society as an academic reduces the rates of exposure to domestic violence, gender, and witnessing or experiencing violence in early childhood are the most important risk factors for this population. The lack of a solution for domestic violence can be attributed to non-deterrent punishments.
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Affiliation(s)
- Gonca Kurt
- Department of Health Care Services, Pazar Vocational School of Higher Education, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Ayşe Akın
- Department of Public Health, School of Medicine Department of Internal Medicine, Başkent University, Ankara, Turkey
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Gopalakrishnan L, Bertozzi S, Bradshaw P, Deardorff J, Shakya Baker H, Rabe-Hesketh S. The Role of Gender Norms on Intimate Partner Violence Among Newly Married Adolescent Girls and Young Women in India: A Longitudinal Multilevel Analysis. Violence Against Women 2023:10778012231208999. [PMID: 37885422 DOI: 10.1177/10778012231208999] [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: 10/28/2023]
Abstract
Gender norms have been posited to impact intimate partner violence (IPV), but there is scant evidence of the longitudinal association between community-level gender norms and IPV. Using longitudinal data on 3,965 married girls surveyed in India, we fitted mixed-effects ordinal and binary logistic regression models for physical IPV intensity and occurrence of sexual IPV. We found a 26% increase in the odds that women experience frequent physical IPV per one unit increase in greater community-level equitable gender norms. We did not find an association between community-level equitable gender norms and sexual IPV. Findings suggest that the relationship between gender norms and physical and sexual IPV differs, indicating the need for tailored interventions for different types of IPV.
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Affiliation(s)
- Lakshmi Gopalakrishnan
- Department of Health Policy and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Stefano Bertozzi
- Department of Health Policy and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Patrick Bradshaw
- Department of Epidemiology, University of California, Berkeley, Berkeley, CA, USA
| | - Julianna Deardorff
- Department of Community Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - Holly Shakya Baker
- Infectious Diseases & Global Public Health, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Sophia Rabe-Hesketh
- School of Education, School of Education, University of California, Berkeley, Berkeley, CA, USA
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Christia F, Larreguy H, Parker-Magyar E, Quintero M. Empowering women facing gender-based violence amid COVID-19 through media campaigns. Nat Hum Behav 2023; 7:1740-1752. [PMID: 37550411 DOI: 10.1038/s41562-023-01665-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/23/2023] [Indexed: 08/09/2023]
Abstract
COVID-19 heightened women's exposure to gender-based and intimate partner violence, especially in low-income and middle-income countries. We tested whether edutainment interventions shown to successfully combat gender-based and intimate partner violence when delivered in person can be effectively delivered using social (WhatsApp and Facebook) and traditional (TV) media. To do so, we randomized the mode of implementation of an intervention conducted by an Egyptian women's rights organization seeking to support women amid COVID-19 social distancing. We found WhatsApp to be more effective in delivering the intervention than Facebook but no credible evidence of differences across outcomes between social media and TV dissemination. Our findings show little credible evidence that these campaigns affected women's attitudes towards gender or marital equality or on the justifiability of violence. However, the campaign did increase women's knowledge, hypothetical use and reported use of available resources.
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Affiliation(s)
- Fotini Christia
- SSRC, IDSS and Department of Political Science, MIT, Cambridge, MA, USA
| | - Horacio Larreguy
- Departments of Economics and Political Science, Instituto Tecnológico Autónomo de México, Mexico City, Mexico.
| | | | - Manuel Quintero
- Department of Pure Mathematics and Mathematical Statistics, University of Cambridge, Cambridge, UK
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Schmidt M, Kedia SK, Dillon PJ, Howell KH. Challenges to Help-Seeking Among Women of Color Exposed to Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8088-8113. [PMID: 36799512 DOI: 10.1177/08862605231153880] [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: 06/03/2023]
Abstract
Women exposed to intimate partner violence (IPV) often rely on support from their informal support networks to obtain resources that may mitigate IPV. This study explored the challenges women of color encounter in seeking advice and information from their informal support networks (i.e., family, friends, neighbors, community members) regarding IPV support services. In-depth interviews were conducted with 29 IPV survivors who self-identified as Black or Hispanic. Data were analyzed using grounded theory methodology. Results showed that participants lacked informational support, both in their communities and in their interpersonal relationships with family and friends. Communities treated IPV as normal and propagated the belief that women's responsibilities were to men and family. Family and friends discouraged IPV information seeking and advised that IPV should be kept private to avoid community shaming. The community environments also lacked information about resources for women experiencing IPV. The lack of information from their informal support networks appeared to delay participants' help-seeking. As the frequency and severity of violence escalated, some participants engaged in independent information searching, using social media and online information sources as well as conventional media like radio and newspapers. Others received information from first responders in the wake of a violent emergency. Participants described the information they received online or from first responders as empowering, encouraging them to engage in support services. Similarly, they felt empowered by the information they received from social workers, counselors, and victims' advocates, and they wished to use what they learned to help other women in similar circumstances. Women experiencing IPV and their communities need more information regarding IPV support services. Successful interventions for IPV survivors and their support networks may necessitate community-level education and altering biased perceptions of gender-appropriate behaviors.
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Okedare OO. Intimate partner violence among unmarried young women (18-24 years) in urban communities, Ibadan, Nigeria. Int J Adolesc Med Health 2023; 0:ijamh-2023-0035. [PMID: 37347722 DOI: 10.1515/ijamh-2023-0035] [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: 03/25/2023] [Accepted: 06/01/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVES Intimate partner violence (IPV) is a global health problem that affects more than one-third of women globally. Young women who experience IPV face the same consequences as older women. Previous studies on IPV have not studies young women exclusively, thus, we aimed to report the prevalence of IPV and predictors among young women in Ibadan, Nigeria. METHODS A community-based cross-sectional survey, using multistage cluster technique was conducted to determine the past-year prevalence of IPV among unmarried young women (n=736) from 20 communities in five Local Government Areas in Ibadan, Nigeria. The independent variables were respondents and their partners' background information. Dependent variables were experience of physical, sexual, psychological and any IPV. Data were analysed using descriptive statistics and binary logistic regression (α0.05). RESULTS Psychological IPV was the most prevalent form of IPV (50.1 %). Prevalence of any IPV was 56.3 %. At the bivariate level, having children, acceptance of IPV, ever had sex, age at first sex, experience at sexual debut, partners being with other women while being with the respondents, partners alcohol use, and partners witness of abuse as a child were significantly associated with IPV. However, only acceptance of IPV, experience at sexual debut, and partners being with other women while being with the respondents remained significant at the multivariate level. CONCLUSIONS IPV is a common occurrence among young women. Both individual and partners characteristics, especially acceptance of IPV contribute significantly to experience of IPV among young women. Hence, interventions targeted at reduction of IPV acceptance will greatly reduce the prevalence of IPV.
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Affiliation(s)
- Omowumi O Okedare
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
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Hartmann M, Appaiah P, Datta S, Browne EN, Banay RF, Caetano V, Spring H, Sreevasthsa A, Thomas S, Srinivasan K. "My Family Was Also Happy": Couples' Qualitative Reports of a Combined Behavioral Economics and Cognitive Behavioral Therapy Intervention to Reduce Alcohol Use and Intimate Partner Violence. Violence Against Women 2023:10778012231170866. [PMID: 37122246 DOI: 10.1177/10778012231170866] [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: 05/02/2023]
Abstract
Improving intimate partner violence interventions requires understanding pathways to change among couples participating in these interventions. This article presents qualitative data from 18 males and 16 females who participated in a combined behavioral economics (contingency management) and cognitive behavioral therapy alcohol and violence reduction intervention trial in Bengaluru, India. Results confirmed several theorized pathways of change, as well as identified further mechanisms through which the intervention supported the change. These included the emotional impacts of incentives, perceived and actual accountability via breathalyzers and family involvement, and enhanced support gained through counseling skills. Findings reveal critical insights into intervention design for future implementation.
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Affiliation(s)
- Miriam Hartmann
- Women's Global Health Imperative, RTI International, Berkeley, CA, USA
- Karolinska Institutet, Stockholm, Sweden
| | | | | | - Erica N Browne
- Women's Global Health Imperative, RTI International, Berkeley, CA, USA
| | | | | | | | | | - Susan Thomas
- St. John's Research Institute, Bengaluru, Karnataka, India
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Gracia-Leiva M, Ubillos-Landa S, Puente-Martínez A, Arias-Rodríguez G, Nieto-Betancour L, Tobar-Lasso MJ, Páez-Rovira D. A Cross-Cultural Sequential Model of the Association Between Young Spanish and Colombian Women Victims of Power Imbalance and Suicide Risk: The Mediating Role of Dating Violence and Rumination. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:6195-6229. [PMID: 36342222 PMCID: PMC9969490 DOI: 10.1177/08862605221132780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
For young women, the power imbalance in favor of males in dating relationships has been related to dating violence (DV) victimization. In addition, the use of rumination to cope with DV may increase their psychological distress. The purpose of the current study was to examine whether experiences of DV and rumination mediate the association between power imbalance and suicide risk (SR). The sample comprised 1,216 young women aged between 18 and 28 years from Colombia (n = 461) and Spain (n = 755), in a heterosexual dating relationship, not married or cohabiting with a partner and without children. The following scales were applied: The Sexual Relationship Power Scale-Modified, The Dating Violence Questionnaire--R (DVQ-R); Cyberdating Abuse Questionnaire, Measure of Affect Regulation Scale (MARS), and The Spanish Suicide Risk Scale. A sequential mediation paths model was tested. Results indicated that power imbalance was associated with DV victimization. Furthermore, DV was associated with more rumination, which was also linked to a greater SR in both countries. Rumination may be a mechanism through which experiences of DV victimization negatively influence mental health in young women and is an important variable related cross-culturally to SR. The findings suggest an equality approach, addressing the power imbalance in dating relationships, empowering girls to prevent DV, and teaching coping strategies for dealing with victimization and its consequences.
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Affiliation(s)
| | | | - Alicia Puente-Martínez
- University of the Basque Country,
Donostia, Spain
- University of Burgos, Spain
- University of Salamanca, Spain
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Pérez-Martínez V, Marcos-Marcos J, Cerdán-Torregrosa A, Briones-Vozmediano E, Sanz-Barbero B, Davó-Blanes MC, Daoud N, Edwards C, Salazar M, La Parra-Casado D, Vives-Cases C. Positive Masculinities and Gender-Based Violence Educational Interventions Among Young People: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:468-486. [PMID: 34282677 DOI: 10.1177/15248380211030242] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Hegemonic masculinity has been recognized as contributing to the perpetration of different forms of gender-based violence (GBV). Abandoning hegemonic masculinities and promoting positive masculinities are both strategies used by interventions that foreground a "gender-transformative approach." Preventing GBV among young people could be strengthened by engaging young men. In this article, we aim to systematically review the primary characteristics, methodological quality, and results of published evaluation studies of educational interventions that aim to prevent different forms of GBV through addressing hegemonic masculinities among young people. MAIN BODY We conducted a systematic review of available literature (2008-2019) using Medline (PubMed), Scopus, Web of Science, PsycInfo, the CINAHL Complete Database, and ERIC as well as Google scholar. The Template for Intervention Description and Replication was used for data extraction, and the quality of the selected studies was analyzed using the Mixed Method Appraisal Tool. More than half of the studies were conducted in Africa (n = 10/15) and many were randomized controlled trials (n = 8/15). Most of the studies with quantitative and qualitative methodologies (n = 12/15) reported a decrease in physical GBV and/or sexual violence perpetration/victimization (n = 6/15). Longitudinal studies reported consistent results over time. CONCLUSIONS Our results highlight the importance of using a gender-transformative approach in educational interventions to engage young people in critical thinking about hegemonic masculinity and to prevent GBV.
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Affiliation(s)
- Vanesa Pérez-Martínez
- Community Nursing, Preventive Medicine and Public Health and History of Science Department, 16718University of Alicante, Spain
| | - Jorge Marcos-Marcos
- Community Nursing, Preventive Medicine and Public Health and History of Science Department, 16718University of Alicante, Spain
| | - Ariadna Cerdán-Torregrosa
- Community Nursing, Preventive Medicine and Public Health and History of Science Department, 16718University of Alicante, Spain
| | | | - Belen Sanz-Barbero
- Epidemiology and Statistics Department, National School of Health Carlos III, Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - MCarmen Davó-Blanes
- Community Nursing, Preventive Medicine and Public Health and History of Science Department, 16718University of Alicante, Spain
| | - Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, 26732Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Clarie Edwards
- School of Applied Social Studies, 8795University College Cork, Ireland
| | - Mariano Salazar
- Department of Global Public Health, GloSH research group, Karolinska Institutet, Stockholm, Sweden
| | | | - Carmen Vives-Cases
- Community Nursing, Preventive Medicine and Public Health and History of Science Department, 16718University of Alicante, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
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15
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Mehra D, Srivastava S, Chandra M, Srivastava N, Laaksonen M, Saarinen HE, Mehra S. Effect of physical mobility, decision making and economic empowerment on gender-based violence among married youth in India-SAWERA project. BMC Public Health 2023; 23:548. [PMID: 36959579 PMCID: PMC10034242 DOI: 10.1186/s12889-023-15421-4] [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: 09/15/2022] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
Background Preventing and responding to gender-based violence (GBV) is both a human rights imperative and a multifaceted economic issue. GBV can also act as a barrier to economic empowerment. The aim of the study was to examine the association between women’s empowerment (physical mobility, decision making and economic resources) and GBV among married youth in India. Methods Community based cross-sectional study was conducted among married youth in the age group of 15–24 years, in two selected districts of Uttar Pradesh and Rajasthan, India. The data was collected from 578 youth. Pre-validated scales were used to assess women’s empowerment indicators (physical mobility, decision making and economic resources). The outcomes assessed were scales on physical and sexual violence. Multivariate regression models examined associations between women’s empowerment, spousal characteristics, socio-economic status and demographics. Results The overall results of the study found that restricted physical mobility had a negative association with sexual violence [AOR: 0.49; CI 0.26–0.92]. Women with no decision-making power had higher odds of physical violence [AOR: 2.12; CI 0.01–4.43] and sexual violence [AOR: 1.96; CI 1.02–3.77]. Having no economic resources had a negative association with sexual violence [AOR: 0.19; CI 0.09–0.39]. Women going through spousal controlling behavior had a higher likelihood of physical [AOR: 3.79; CI 1.75–8.19] and sexual violence [AOR: 4.03; CI 2.09–7.79]. It was also found that married women from rural areas and other ethnic backgrounds had higher odds of physical violence. Conclusion There is a crucial need to work towards women’s empowerment, with progressive gender roles such as greater decision-making, physical mobility and economic resources to reduce GBV. An established method that has worked in various contexts is adopting gender transformative approaches that involve men. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-023-15421-4.
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Affiliation(s)
- Devika Mehra
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
- grid.4514.40000 0001 0930 2361Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Shobhit Srivastava
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
| | - Murari Chandra
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
| | - Namita Srivastava
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
| | | | | | - Sunil Mehra
- grid.503716.60000 0004 1766 9202MAMTA Health Institute for Mother and Child, New Delhi, India
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16
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Underwood CR, Casella A, Hendrickson ZM. Gender norms, contraceptive use, and intimate partner violence: A six-country analysis. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 35:100815. [PMID: 36738730 DOI: 10.1016/j.srhc.2023.100815] [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: 08/24/2022] [Revised: 01/11/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND While considerable research has explored associations between gender norms and various sexual and reproductive health behaviors (SRH) with the aim of informing programs, no studies have examined whether couple concordance on specific gender norms is associated with both contraceptive use and reduced intimate partner violence (IPV) experience. METHODS This study relies on analysis of Demographic and Health Survey (DHS) couples' datasets from Mali, Nigeria, Nepal, Pakistan, Tanzania, and Zambia that were collected in/after 2015 and include the DHS Domestic Violence Module for female respondents. To examine the associations between couple concordance regarding household decision-making or justification of violence (wife beating) and women's use of modern contraceptives or experience of violence, bivariate and multivariate logistic regression models were fit using Stata15. RESULTS Joint decision-making about large household purchases was significantly positively associated with modern contraceptive use in all study countries as well as with reduced odds of IPV experience in adjusted models in Tanzania and Zambia. In Nigeria, women's justification for violence was negatively associated with contraceptive use. Across settings, women in couples where both justified violence had significantly increased odds of reporting IPV experience. CONCLUSIONS The evidence suggests that family planning programs should support joint decision-making as it was positively associated with contraceptive use across the six countries and is a proxy for shared economic power within the household. IPV reduction and prevention programs should also consider encouraging joint decision-making given the correlations found in two settings. Programs should enable participants to interrogate attitudes regarding justifying violence against female partners and propose approaches to avoid IPV. Finally, husbands' alcohol consumption, a strong predictor of IPV experience, has too long been overlooked.
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Affiliation(s)
- Carol R Underwood
- Johns Hopkins University, Bloomberg School of Public Health, Department of Health, Behavior & Society, USA; Johns Hopkins Center for Communication Programs, USA.
| | | | - Zoé Mistrale Hendrickson
- Johns Hopkins University, Bloomberg School of Public Health, Department of Health, Behavior & Society, USA; Johns Hopkins Center for Communication Programs, USA
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Bo L, Yating P. Long-Term Impact of Domestic Violence on Individuals-An Empirical Study Based on Education, Health and Life Satisfaction. Behav Sci (Basel) 2023; 13:bs13020137. [PMID: 36829366 PMCID: PMC9951938 DOI: 10.3390/bs13020137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/26/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
This paper takes the China Health and Retirement Longitudinal Survey (CHARLS) as a sample to assess the long-term impacts of domestic violence experienced in childhood on individuals. First, from the four dimensions of injury from violence, negligent care, emotional abuse and witness to domestic violence, an indicator system for quantifying domestic violence is constructed. Second, the simultaneous equation of self-evaluation health and life satisfaction is estimated by the seemingly unrelated regression model. Starting with education, health and life satisfaction, the long-term impact of domestic violence experiences on individuals is quantitatively assessed, providing empirical evidence for preventing and curing domestic violence and healing trauma. The empirical research shows the following: (1) An experience of domestic violence significantly reduces educational achievements. Compared with the three dimensions of injury from violence, negligent care and witnessing domestic violence, emotional abuse has the greatest negative impact on educational achievements. (2) Domestic violence significantly reduces the self-assessed health level and life satisfaction and increases the subjective mental health risk. Based on the complexity and concealment of domestic violence, combined with empirical research conclusions, this paper proposes countermeasures to prevent and control domestic violence.
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Affiliation(s)
- Liu Bo
- School of Economics, Hunan Agricultural University, Changsha 410128, China
| | - Peng Yating
- School of Pharmacy, Changsha Health Vocational College, Changsha 410600, China
- Correspondence: ; Tel.: +86-152-0086-6387
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Sood S, Kostizak K, Mertz N, Stevens S, Rodrigues F, Hauer M. What Works to Address Violence Against Children (VAC) in and Around Schools. TRAUMA, VIOLENCE & ABUSE 2022; 23:1317-1329. [PMID: 33655786 DOI: 10.1177/1524838021998309] [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: 06/12/2023]
Abstract
Violence against children (VAC) is a pervasive, global issue with both short- and long-term health, social, and economic consequences. This systematic review sought to identify best practices for designing and implementing social and behavior change communication (SBCC) programs targeting VAC in and around schools. Combinations of key search terms within five domains were entered into four databases: PubMed Central, Google Scholar, Sociological Abstracts, and EBSCOhost. Results were screened according to the inclusion and exclusion criteria. Namely, articles had to be published in English, be published after March 2014, focus on VAC in and around schools, focus on children, and use SBCC approaches. The searches produced 892,271 results. Of these, 63,183 were screened and 54 articles were selected. These articles were combined with 16 articles, gathered from a previous systematic review using the same databases and search domains conducted by the same research team, for a total of 70 articles. Articles were quantitatively analyzed using a coding guide in STATA and qualitatively analyzed using Nvivo. Results showed that most programs addressed bullying, were implemented in high-income countries, and included children aged 10 and older. Best practices in program design were using theory, conducting formative research, and involving program beneficiaries. Best practices in implementation were combining whole-school and targeted approaches, including special and hidden populations, involving secondary and tertiary audiences, using nonclassroom settings, using peer leader/mentor and cascade training models, and conducting process monitoring. Implications and avenues for future planning and implementation of SBCC interventions to address VAC in and around schools are discussed.
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Affiliation(s)
- Suruchi Sood
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Kelli Kostizak
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Nicole Mertz
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Sarah Stevens
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Farren Rodrigues
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Michael Hauer
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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19
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Beltrán LF, Davis DA, Barrington C, Castro M, Pérez D. 'I did not get this disease on the street; it was brought home as a gift': Gender, violence and HIV vulnerability among Cuban women. CULTURE, HEALTH & SEXUALITY 2022; 24:1107-1121. [PMID: 34254895 DOI: 10.1080/13691058.2021.1925744] [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: 10/14/2020] [Accepted: 04/30/2021] [Indexed: 06/13/2023]
Abstract
While gay, bisexual and other men who have sex with men are most affected by HIV in Cuba, infections among women have increased over time, but there has been little research to contextualise their vulnerability to HIV. The purpose of this study was to explore the role of gender and violence in shaping vulnerability to HIV among Cuban women. Qualitative in-depth interviews were conducted with women living with HIV at an outpatient HIV clinic in Havana. Narrative and thematic technique were used to systematically analyse the data. Participants described negotiating sexual relationships in a context where traditional gender norms merge with the paradox of increasing professional opportunities for women alongside growing economic precarity. Interconnected economic and emotional dependence along with violence influenced the acceptance of certain behaviours that heightened vulnerability to HIV, including inconsistent condom use and infidelity. Gender transformative approaches that recognise the complex interplay between gender norms, economic precarity and violence are needed to address women's vulnerability to HIV in the Cuban context. Such efforts can reinforce existing strategies to promote behaviourally focused prevention while creating an enabling environment for the integration and expansion of biomedical innovation in HIV prevention.
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Affiliation(s)
- Lisandra Fuentes Beltrán
- Department of Epidemiology, Centre of Research, Diagnosis and Reference, Pedro Kourí Tropical Medicine Institute, Havana, Cuba
| | - Dirk A Davis
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marta Castro
- Teaching Department, Pedro Kourí Tropical Medicine Institute, Havana, Cuba
| | - Dennis Pérez
- Department of Epidemiology, Centre of Research, Diagnosis and Reference, Pedro Kourí Tropical Medicine Institute, Havana, Cuba
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20
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Paphitis SA, Bentley A, Asher L, Osrin D, Oram S. Improving the mental health of women intimate partner violence survivors: Findings from a realist review of psychosocial interventions. PLoS One 2022; 17:e0264845. [PMID: 35299229 PMCID: PMC8929660 DOI: 10.1371/journal.pone.0264845] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is highly prevalent and is associated with a range of mental health problems. A broad range of psychosocial interventions have been developed to support the recovery of women survivors of IPV, but their mechanisms of action remain unclear. METHODS Realist review following a prospectively published protocol in PROSPERO (CRD42018114207) and reported using the Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMSES) guidelines. RESULTS Evidence was extracted from 60 reviews and triangulated in expert consultations. Mechanisms of action were categorised as either associated with intervention design and delivery or with specific intervention components (access to resources and services; safety, control and support; increased knowledge; alterations to affective states and cognitions; improved self-management; improved family and social relations). CONCLUSIONS Findings suggest that psychosocial interventions to improve the mental health of women survivors of IPV have the greatest impact when they take a holistic view of the problem and provide individualised and trauma-informed support.
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Affiliation(s)
- Sharli Anne Paphitis
- Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
- * E-mail:
| | - Abigail Bentley
- Gender Violence and Health Centre, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Laura Asher
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - David Osrin
- Institute for Global Health, University College London, London, United Kingdom
| | - Sian Oram
- Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
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21
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Schaaf M, Boydell V, Topp SM, Iyer A, Sen G, Askew I. A summative content analysis of how programmes to improve the right to sexual and reproductive health address power. BMJ Glob Health 2022; 7:bmjgh-2022-008438. [PMID: 35443940 PMCID: PMC9021801 DOI: 10.1136/bmjgh-2022-008438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/27/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Power shapes all aspects of global health. The concept of power is not only useful in understanding the current situation, but it is also regularly mobilised in programmatic efforts that seek to change power relations. This paper uses summative content analysis to describe how sexual and reproductive health (SRH) programmes in low-income and middle-income countries explicitly and implicitly aim to alter relations of power. METHODS Content analysis is a qualitative approach to analysing textual data; in our analysis, peer-reviewed articles that describe programmes aiming to alter power relations to improve SRH constituted the data. We searched three databases, ultimately including 108 articles. We extracted the articles into a spreadsheet that included basic details about the paper and the programme, including what level of the social ecological model programme activities addressed. RESULTS The programmes reviewed reflect a diversity of priorities and approaches to addressing power, though most papers were largely based in a biomedical framework. Most programmes intervened at multiple levels simultaneously; some of these were 'structural' programmes that explicitly aimed to shift power relations, others addressed multiple levels using a more typical programme theory that sought to change individual behaviours and proximate drivers. This prevailing focus on proximate behaviours is somewhat mismatched with the broader literature on the power-related drivers of SRH health inequities, which explores the role of embedded norms and structures. CONCLUSION This paper adds value by summarising what the academic public health community has chosen to test and research in terms of power relations and SRH, and by raising questions about how this corresponds to the significant task of effecting change in power relations to improve the right to SRH.
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Affiliation(s)
- Marta Schaaf
- Independent Consultant, Brooklyn, New York, USA
- Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland
| | - Victoria Boydell
- School of Health and Social Care, University of Essex Faculty of Science and Health, Colchester, UK
| | - Stephanie M Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Aditi Iyer
- Ramalingaswami Centre on Equity and Social Determinants of Health, Public Health Foundation of India, Bangalore, India
| | - Gita Sen
- Ramalingaswami Centre on Equity and Social Determinants of Health, Public Health Foundation of India, Bangalore, India
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22
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Getinet W, Azale T, Getie E, Salelaw E, Amare T, Demilew D, Lemma A, Kibret D, Aklilu A, Tensae T, Srahbzu M, Shumet S. Intimate partner violence among reproductive-age women in central Gondar zone, Northwest, Ethiopia: a population-based study. BMC Womens Health 2022; 22:109. [PMID: 35397559 PMCID: PMC8994176 DOI: 10.1186/s12905-022-01685-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/29/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Violence against women is the most widespread kind of human rights violation, and it has been linked to a wide range of consequences. The most prominent psychosocial and mental health concern that has serious effects for women's physical and mental well-being. This study assessed the prevalence and associated factors of women's violence by intimate partner among women in the reproductive age group (15-49). METHODS Multistage community-based cross-sectional study was conducted among reproductive age group women in the central Gondar zone. We recruited 845 participants and interviewed by health extension workers using face-to-face interviews. We used a Women's Abuse Screening test to outcome variable; it has a total score ranges 0-16, a score > 1 indicates positive for the presence of intimate partner violence within a year. Variables were coded and entered to Epi data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics and multivariate logistic regression analysis was run for data analysis. Adjusted odds ratios (AOR) with a 95% confidence level (CI) were declared significant. RESULT Among a total of 845 participants 804 responded to the interviews with a response rate of 95%. The prevalence rate of intimate partner violence is 391(48.6%). From multivariate logistic regression analysis women being married [AOR:3.85; 95% CI (2.38, 6.22)], high school and above educational status [(AOR: 0.43; 95% CI (0.30, 0.61), women's having > 3children [(AOR: 1.82, 95% CI (1.0, 3.1)], having a household food insecurity[(AOR: 2.09, 95% CI (1.51, 2.91)], having life threatening events [(AOR: 2.09; 95% CI (1.51, 2.91)], moderate social support [(AOR: 0.60; 95% CI (0.41, 0.83)], depression [(AOR: 3.12; 95% CI (1.60, 6.07) were significantly associated with violence by intimate partner at 95% CI . CONCLUSION Intimate partner violence is common among reproductive-age women. Married, women with several children, food insecurity, life-threatening events, and depression were all found to be significant predictors of violence. Measures should be taken to raise community awareness, particularly among intimate partners, their families, and government officials.
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Affiliation(s)
- Wondale Getinet
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Telake Azale
- Institute of Public Health College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Eskedar Getie
- Institute of Public Health College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Endalamaw Salelaw
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadele Amare
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Demeke Demilew
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Alemu Lemma
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Destaw Kibret
- Central Gondar Zonal Health Office, Gondar, Ethiopia
| | - Abayneh Aklilu
- School of Midwifery College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techalo Tensae
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mengesha Srahbzu
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Shegaye Shumet
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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23
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Gibson MA, Gurmu E, Cobo B, Rueda MM, Scott IM. Measuring Hidden Support for Physical Intimate Partner Violence: A List Randomization Experiment in South-Central Ethiopia. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP4238-NP4257. [PMID: 32370582 PMCID: PMC8980453 DOI: 10.1177/0886260520914546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Understanding how and why physical intimate partner violence (IPV) persists in high-risk communities has proven difficult. As IPV is both sensitive and illegal, people may be inclined to misreport their views and experiences. By embedding a list randomization experiment (LRE), which increases respondent privacy, in a survey of 809 adult Arsi Oromo men and women in rural south-central Ethiopia, we test the reliability of direct questioning survey methods (e.g., used in the Demographic and Health Surveys) for measuring attitudes that underpin the acceptability of IPV. Participants were randomly assigned versions of the survey in which they were asked either directly or indirectly about the acceptability of wife-beating. By comparing responses across these surveys, we identify the extent to which views are being misreported using direct questioning methods, as well as identifying the "true" predictors of continued support for wife-beating. Indirect questioning reveals that almost one third of the sample believe that wife-beating is acceptable. Adults (particularly men) who are less educated (<3 years schooling) or living in households where women do not participate in economic decision making are among those most likely to identify wife-beating as justifiable (>50% endorsement). These individuals, however, are also more inclined to hide their approval when asked directly by an interviewer. That we find high but underreported support for wife-beating among some members of the community demonstrates a clear need to encourage a more open dialogue, to prevent violence toward women remaining undetected and thus unchanged. This finding also raises questions about the accuracy of traditional direct questioning for capturing information on IPV attitudes and norms. Of relevance to policy, we find that wife-beating is entirely absent only among adults with higher levels of education, living in households where decision making is shared between couples.
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Su Z, McDonnell D, Cheshmehzangi A, Ahmad J, Chen H, Šegalo S, Cai Y. What "Family Affair?" Domestic Violence Awareness in China. Front Public Health 2022; 10:795841. [PMID: 35309197 PMCID: PMC8930911 DOI: 10.3389/fpubh.2022.795841] [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: 11/08/2021] [Accepted: 01/17/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Domestic violence is toxic to society. With approximately one in three women on average falling victim to domestic violence, systematic solutions are needed. To further complicate the issue, mounting research shows that COVID-19 has further exacerbated domestic violence across the world. Situations could be even more pronounced in countries like China, where though domestic violence is prevalent, there is a dearth of research, such as intervention studies, to address the issue. This study investigates key barriers to domestic violence research development in China, with a close focus on salient cultural influences. Methods A review of the literature on domestic violence in China in PubMed, PsycINFO, and Scopus was conducted to answer the research question. The search was focused on three themes, domestic violence, China, research, and cultural influences. Results The study findings show that categorizing domestic violence as a "family affair" is a key barrier to domestic violence research development in China-an incremental hindrance that prevents the public and policymakers from understanding the full scale and scope of domestic violence in China. In addition to abusers, witnesses, and victims, even law enforcement in China often dismisses domestic violence crimes as "family affairs" that resides outside the reach and realm of the law. The results indicated that mistreating domestic violence crimes as "family affairs" is a vital manifestation of the deep-rooted cultural influences in China, ranging from traditional Confucian beliefs in social harmony to the assumed social norms of not interfering with other people's businesses. Conclusion Domestic violence corrupts public health and social stability. Our study found that dismissing domestic violence cases as "family affairs" is an incremental reason why China's domestic violence research is scarce and awareness is low. In light of the government's voiced support for women's rights, we call for the Chinese government to develop effective interventions to timely and effectively address the domestic violence epidemic in China.
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Affiliation(s)
- Zhaohui Su
- School of Public Health, Institute for Human Rights, Southeast University, Nanjing, China,*Correspondence: Zhaohui Su
| | - Dean McDonnell
- Department of Humanities, South East Technological University, Carlow, Ireland
| | - Ali Cheshmehzangi
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China,Network for Education and Research on Peace and Sustainability (NERPS), Hiroshima University, Hiroshima, Japan
| | - Junaid Ahmad
- Prime Institute of Public Health, Peshawar Medical College, Peshawar, Pakistan
| | - Hengcai Chen
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China
| | - Sabina Šegalo
- Department of Microbiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China,Yuyang Cai
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Bhuwania P, Heymann J. Tuition-free secondary education and women's attitudes toward intimate partner violence: Evidence from Sub-Saharan Africa. SSM Popul Health 2022; 17:101046. [PMID: 35242994 PMCID: PMC8866889 DOI: 10.1016/j.ssmph.2022.101046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/23/2022] Open
Abstract
Intimate partner violence against women (IPVAW) is devastatingly common around the world. It rose further during the pandemic, increasing the urgency of finding interventions to prevent IPVAW and supporting women's ability to exit violent situations. Interventions that prevent violence and eliminate views among perpetrators that violence is acceptable should be top priority. It is also critical to study women's attitudes toward IPVAW as these shape women's responses to the abuse and their exit options. Moreover, research shows that these attitudes have a direct impact on women's health outcomes. We examine the effect of tuition-free secondary education on women's attitudes toward IPVAW across 29 Sub-Saharan African countries using data from the Demographic and Health Surveys conducted between 2000 and 2019. Using the difference-in-difference-in-differences strategy, we estimate the change in women's attitudes toward IPVAW in countries that implement tuition-free secondary policy compared with countries with tuition-free primary alone and those without any tuition-free policy during the study period. We find that while tuition-free primary education policy alone did not reduce the probability of IPVAW being perceived as justified, tuition-free secondary reduced it significantly. The probability that IPVAW was perceived as justified under at least one circumstance declined by 5.3 percentage points more on average in countries that adopted tuition-free policy up to the secondary level relative to those that adopted only up to the primary level. Tuition-free secondary affects four of the five circumstances under which IPVAW was perceived as justified — if she goes out without telling the husband, argues with him, neglects children or refuses sex. We observed no declines for when she burns food, suggesting different factors affecting this outcome. Our findings underscore the importance of making a stronger commitment toward policies that make secondary education more accessible to not only benefit education outcomes but also advance population health. Intimate Partner Violence against women (IPVAW) is on the rise globally. We examine tuition-free education policy's effect on women's attitudes toward IPVAW. Our study exploits variation in the timing of policy rollout in Sub-Saharan Africa. Tuition-free primary policy alone did not affect women's attitudes toward IPVAW. Tuition-free secondary reduced the probability of IPVAW being perceived as justified.
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Abujilban S, Mrayan L, Hamaideh S, Obeisat S, Damra J. Intimate Partner Violence Against Pregnant Jordanian Women at the Time of COVID-19 Pandemic's Quarantine. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP2442-NP2464. [PMID: 33403908 DOI: 10.1177/0886260520984259] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In Jordan, women experience considerable levels of different types of violence. The emerging data from different countries indicate that intimate partner violence (IPV) has intensified since the COVID-19 outbreak. The main purpose of the current study is to find out whether there is any difference in the incidence of IPV during and before the COVID-19 pandemic quarantine and whether any sociodemographical factors are related to the incidence of IPV against pregnant women during quarantine. A cross-sectional, correlational design was in this study. The snowball sampling technique was adopted to select the participants, which produced a nonrepresentative sample of 215 pregnant women. The participants completed the Arabic version of the World Health Organization's Domestic Violence Questionnaire Screening Tool (DVQST). We found that women were exposed to different types of IPV before and during the quarantine. The most prevalent form of IPV was control and humiliation (n 172, 80%) and the least prevalent was sexual violence ((n 33, 15.3%), (n 24, 11.2%), respectively). However, there were statistically significant lower DVQST scores during the COVID-19 quarantine than before the quarantine. All types of IPV are significantly correlated with each other and with relationship problems (marital conflict, verbal fighting, understanding each other). While the findings are not generalizable to the general population of pregnant women in Jordan because the sample consisted only of women of high socioeconomic status due to the use of a nonprobability sampling technique, national campaigns should be developed and implemented in order to reduce IPV and change community behaviors and attitudes toward violence against women. It is also recommended that policymakers develop plans to help pregnant women during quarantine by, for example, training care providers on how to access vulnerable women.
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John NA, Adebayo A, Boychuk NA, OlaOlorun F. Intimate partner violence (IPV) prevention using a cross-sectoral couple-based intervention: results from a cluster randomised control trial in Ibadan, Nigeria. BMJ Glob Health 2022; 7:bmjgh-2021-007192. [PMID: 35140139 PMCID: PMC8830218 DOI: 10.1136/bmjgh-2021-007192] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/20/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Intimate partner violence (IPV) is the most common form of violence women experience globally. Economic empowerment interventions have been implemented across countries to prevent and address IPV, with mixed results. A sociological 'male-backlash' model suggests that addressing unequal gender norms is crucial to reduce IPV. This study evaluates the impact of a multipronged intervention among heterosexual couples in urban and periurban Ibadan that aimed at reducing IPV by increasing financial and reproductive literacy, fostering gender equality and improving relationship quality. METHODS A four-arm mixed-methods cluster randomised control trial was employed. Baseline data and end line data six months postintervention were collected to estimate changes in key outcomes. In-depth interviews were conducted with 15 couples 2 years postintervention to explore the drivers of changes in outcomes. Difference-in-differences regression models were estimated to compare changes in IPV levels across the three intervention arms and control arm, and thematic analysis was conducted to understand drivers of change in IPV outcomes. RESULTS Physical IPV decreased significantly in the gender socialisation (GS) (β: -4.63 (SE: 2.12)) and GS and financial literacy (β: -4.61 (SE: 2.02)) groups as compared with the control group. Changes in emotional and sexual IPV were marginally significant or insignificant, respectively, suggesting that the intervention did not have an impact on non-physical forms of IPV. In the in-depth interviews, couples reported improved communication and trust, enhanced conflict management skills, and increased mutual respect as a result of participation across intervention arms, which may have facilitated the reduction of violence in their relationships. CONCLUSION This study highlights the potential utility of gender transformative interventions for improving physical IPV outcomes. Future research should seek to understand the mechanisms that influence sexual and emotional IPV as their aetiology may be different from physical violence. TRAIL REGISTRATION NUMBER The study protocol was registered at ClinicalTrials.gov (ID: NCT03888495).
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Affiliation(s)
- Neetu A John
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Ayodeji Adebayo
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Natalie A Boychuk
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Funmilola OlaOlorun
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
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Lennon SE, Aramburo AMR, Garzón EMM, Arboleda MA, Fandiño-Losada A, Pacichana-Quinayaz SG, Muñoz GIR, Gutiérrez-Martínez MI. A qualitative study on factors associated with intimate partner violence in Colombia. CIENCIA & SAUDE COLETIVA 2021; 26:4205-4216. [PMID: 34586272 DOI: 10.1590/1413-81232021269.21092020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 07/08/2020] [Indexed: 11/22/2022] Open
Abstract
Intimate partner violence (IPV) is a human rights violation and a serious global public health problem. This study investigated factors associated with IPV in female survivors in Colombia. Four focus group discussions with female survivors of IPV and 15 key informant interviews with professionals from psychological, social and legal services and community leaders were conducted in Cali and Tuluá. Participant recruitment was via purposive sampling. Transcripts were analysed manually taking a social constructivist standpoint and a content analysis approach. Factors associated with IPV were divided into four themes: cultural beliefs, jealousy, alcohol abuse, and personal history of IPV. The first theme was divided into: patriarchy, gender roles, normalisation of violence, and unawareness of rights, economic dependence, and 'men own women'. The sub-themes were all inter-related and underpinned by patriarchal values. IPV was described as a sociocultural construction formed by patriarchal values ingrained in community and societal norms and individual processes. Therefore, academia, governmental and non-governmental bodies and society are urged to together, create preventative, context specific strategies for individuals, communities and societies.
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Affiliation(s)
- Shirley Evelyn Lennon
- Cisalva Institute, Universidad del Valle. Calle 4B No. 36-00 Edificio 135, Barrio San Fernando Viejo. Cali. 760043 Cali Colombia.
| | | | | | - María Adelaida Arboleda
- Cisalva Institute, Universidad del Valle. Calle 4B No. 36-00 Edificio 135, Barrio San Fernando Viejo. Cali. 760043 Cali Colombia. .,Red de Salud de Ladera ESE. Cali Colombia
| | - Andrés Fandiño-Losada
- Cisalva Institute, Universidad del Valle. Calle 4B No. 36-00 Edificio 135, Barrio San Fernando Viejo. Cali. 760043 Cali Colombia.
| | - Sara Gabriela Pacichana-Quinayaz
- Cisalva Institute, Universidad del Valle. Calle 4B No. 36-00 Edificio 135, Barrio San Fernando Viejo. Cali. 760043 Cali Colombia.
| | | | - María Isabel Gutiérrez-Martínez
- Cisalva Institute, Universidad del Valle. Calle 4B No. 36-00 Edificio 135, Barrio San Fernando Viejo. Cali. 760043 Cali Colombia.
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Fornari LF, da Fonseca RMGS. Board Game Violetas: the perspective of professionals addressing violence against women. Rev Esc Enferm USP 2021; 55:e20200238. [PMID: 34435608 DOI: 10.1590/1980-220x-reeusp-2020-0238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/24/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the potentialities and limits of the board game Violetas to address violence against women, from the perspective of the professionals who work in assisting the victims. METHOD This is an interventional study with a qualitative approach. Thirty professionals from the Casas da Mulher Brasileira (Brazilian Women's Houses) in Brasília, Campo Grande and Curitiba participated. Data collection was carried out during Critical-Emancipatory Workshops. Data were subjected to thematic content analysis with the support of the software webQDA. RESULTS As potentialities, the professionals mentioned the game design, the collaborative participation, and the ludicity as learning facilitators, stimulating reflections on the visibility of violence, assistance to victimized women, and the articulation of the supportive network services. As limitations of the study, the lack of familiarity with games, the understanding of the rules, and some issues contained in the game were mentioned. CONCLUSION The game proved to be a powerful educational strategy for the training and qualification of the professionals involved in the supportive network.
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Affiliation(s)
- Lucimara Fabiana Fornari
- Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem, São Paulo, SP, Brazil
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Mazza M, Marano G, del Castillo AG, Chieffo D, Monti L, Janiri D, Moccia L, Sani G. Intimate partner violence: A loop of abuse, depression and victimization. World J Psychiatry 2021; 11:215-221. [PMID: 34168968 PMCID: PMC8209536 DOI: 10.5498/wjp.v11.i6.215] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/25/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Intimate partner violence has been recognized as a serious public health issue. Exposure to violence contributes to the genesis of, and exacerbates, mental health conditions, and existing mental health problems increase vulnerability to partner violence, a loop that imprisons victims and perpetuates the abuse. A recently described phenomenon is when male violence against females occurs within intimate relationships during youth, and it is termed adolescent or teen dating violence. In this narrative review, factors associated with intimate partner violence and consequences of exposure of children to parental domestic violence are discussed, along with possible intensification of violence against women with the spread of coronavirus disease 2019 pandemic and subsequent lockdown. Intervention programs with a multicomponent approach involving many health care settings and research have a pivotal role in developing additional strategies for addressing violence and to provide tailored interventions to victims. Prevention policy with a particular attention on healthy child and adolescent development is mandatory in the struggle against all forms of violence.
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Affiliation(s)
- Marianna Mazza
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giuseppe Marano
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Angela Gonsalez del Castillo
- Service of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Daniela Chieffo
- Service of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Laura Monti
- Service of Clinical Psychology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Delfina Janiri
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Lorenzo Moccia
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- Department of Neurosciences, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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Intimate partner violence against adolescents and young women in sub-Saharan Africa: who is most vulnerable? Reprod Health 2021; 18:119. [PMID: 34134704 PMCID: PMC8210343 DOI: 10.1186/s12978-021-01077-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Intimate partner violence (IPV) is a global public health and human rights issue that affects millions of women and girls. While disaggregated national statistics are crucial to assess inequalities, little evidence exists on inequalities in exposure to violence against adolescents and young women (AYW). The aim of this study was to determine inequalities in physical or sexual IPV against AYW and beliefs about gender based violence (GBV) in sub-Saharan Africa (SSA). Methods We used data from the most recent Demographic and Health Surveys (DHS) conducted in 27 countries in SSA. Only data from surveys conducted after 2010 were included. Our analysis focused on married or cohabiting AYW aged 15–24 years and compared inequalities in physical or sexual IPV by place of residence, education and wealth. We also examined IPV variations by AYW’s beliefs about GBV and the association of country characteristics such as gender inequality with IPV prevalence. Results The proportion of AYW reporting IPV in the year before the survey ranged from 6.5% in Comoros to 43.3% in Gabon, with a median of 25.2%. Overall, reported IPV levels were higher in countries in the Central Africa region than other sub-regions. Although the prevalence of IPV varied by place of residence, education and wealth, there was no clear pattern of inequalities. In many countries with high prevalence of IPV, a higher proportion of AYW from rural areas, with lower education and from the poorest wealth quintile reported IPV. In almost all countries, a greater proportion of AYW who approved wife beating for any reason reported IPV compared to their counterparts who disapproved wife beating. Reporting of IPV was weakly correlated with the Gender Inequality Index and other societal level variables but was moderately positively correlated with adult alcohol consumption (r = 0.48) and negative attitudes towards GBV (r = 0.38). Conclusion IPV is pervasive among AYW, with substantial variation across and within countries reflecting the role of contextual and structural factors in shaping the vulnerability to IPV. The lack of consistent patterns of inequalities by the stratifiers within countries shows that IPV against women and girls cuts across socio-economic boundaries suggesting the need for comprehensive and multi-sectoral approaches to preventing and responding to IPV.
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Jethá E, Keygnaert I, Martins E, Sidat M, Roelens K. Domestic violence in Mozambique: from policy to practice. BMC Public Health 2021; 21:772. [PMID: 33888119 PMCID: PMC8061038 DOI: 10.1186/s12889-021-10820-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/30/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND To reduce the impact of domestic violence (DV), Mozambican governmental and non-governmental entities are making efforts to strengthen the legislative framework and to improve the accessibility of care services for survivors of violence. Despite this remarkable commitment, the translation of policies and legislation into actions remains a considerable challenge. Therefore, this paper aims to identify gaps in the implementation of existing national policies and laws for DV in the services providing care for survivors of DV. METHODS This qualitative study comprised of two approaches. The first consisted of content analysis of guidelines and protocols for DV care provision. The second consisted of in-depth interviews with institutional gender focal points (Professionals with experience in dealing with aspects related to DV). The analysis of the document content was based on a framework developed according to key elements recommended by international agencies (PAHO and UN) for design of DV policies and strategies. Data from the in-depth interviews, where analysed in accordance with the study objectives. RESULTS Eleven (11) guidelines/protocols of care provision and innumerable brochures and pamphlets were identified and analysed. There is a standardised form which contains fields for police and the health sector staff to complete, but not for Civil Society Organisations. However, there is no specific national DV database. Although the seventeen (17) focal points interviewed recognised the relevance of the reviewed documents, many identified gaps in their implementation. This was related to the weaknesses of the offender's penalisation and to the scarcity of care providers who often lack appropriate training. The focal points also recognised their performance is negatively influenced by socio-cultural factors. CONCLUSION Within services providing care to survivors of DV, a scarcity of guidelines and protocols exist, compromising the quality and standardisation of care. The existence of guidelines and protocols was regarded as a strength, however its implementation is still problematic. There was also recognition for the need to strengthening by governmental and non-governmental entities the defined policies and strategies for DV prevention and control into practice.
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Affiliation(s)
- Eunice Jethá
- Community Health Department Eduardo Mondlane University, Faculty of Medicine, Salvador Allende Avenue, 702 Maputo, Mozambique
- International Centre for Reproductive Health, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Ines Keygnaert
- International Centre for Reproductive Health, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Emilia Martins
- MIHER Mozambican Institute for Health and Research, Maputo, Mozambique
| | - Mohsin Sidat
- Community Health Department Eduardo Mondlane University, Faculty of Medicine, Salvador Allende Avenue, 702 Maputo, Mozambique
| | - Kristien Roelens
- Department of Obstetrics & Gynaecology, Faculty of Medicine & Health Sciences, Ghent University, Ghent University Hospital, Ghent, Belgium
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Laird JJ, Klettke B, Hall K, Clancy E, Hallford D. Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2017682. [PMID: 32960280 PMCID: PMC7509625 DOI: 10.1001/jamanetworkopen.2020.17682] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention. OBJECTIVE To provide a meta-analytic synthesis of studies examining factors associated with CSE and to quantify their relative importance. DATA SOURCES Electronic databases searched to June 2019 included Medline, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Informit, yielding 396 nonduplicative records. Literature search was performed in July 2019. STUDY SELECTION Inclusion criteria were quantitative investigations of sexual exploitation and mean sample age of 18 years or younger. DATA EXTRACTION AND SYNTHESIS Literature review and data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Thirty-seven studies met final inclusion criteria. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive odds ratios (ORs) for each factor. Data were analyzed from September 1 to October 28, 2019, and prediction intervals calculated in June 2020. MAIN OUTCOMES AND MEASURES Child sexual exploitation, defined as coerced sexual acts between a child or a young person (aged ≤18 years) and an individual or a group in exchange for money, gifts, substances, or other commodities and associated factors. RESULTS Thirty-seven unique studies were included with a total of 67 453 unique participants (mean [SD] age of 16.2 [2.5] years; 49.9% female). Fifty-two factors associated with CSE were included in the meta-analysis. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviors (OR, 6.31 [95% CI, 3.12-12.76]; P < .001), having more than 5 sexual partners (OR, 5.96 [95% CI, 1.63-21.87]; P = .007), a diagnosis of posttraumatic stress disorder (OR, 5.29 [95% CI, 3.40-8.22]; P < .001), historical exposure to child pornography (OR, 5.50 [95% CI, 0.99-30.53]; P = .049), and a history of childhood sexual abuse (OR, 3.80 [95% CI, 3.19-4.52]; P < .001). A number of other potentially modifiable factors had moderate to strong associations. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, children and adolescents affected by sexual exploitation showed high levels of sexual risk taking, multiple sexual partners, posttraumatic stress disorder, exposure to child pornography, and childhood trauma. Accurate detection of CSE may prevent this type of sexual violence occurring to adolescents and/or provide opportunities for intervention and recovery. Therefore, prevention and intervention efforts will likely benefit from integrating these factors into screening, assessment, and treatment.
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Affiliation(s)
- Jessica J. Laird
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
| | - Bianca Klettke
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - Kate Hall
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
- Addictive and Anti-Social Behaviour Research, Deakin University Centre for Drug Use, Geelong, Australia
| | - Elizabeth Clancy
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - David Hallford
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
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Gashaw BT, Schei B, Solbraekke KN, Magnus JH. Ethiopian Health Care Workers' Insights into and Responses to Intimate Partner Violence in Pregnancy-A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103745. [PMID: 32466276 PMCID: PMC7277814 DOI: 10.3390/ijerph17103745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 12/24/2022]
Abstract
Violence against women is a global pandemic, with the potential to spread through generations. Intimate partner violence has impacts on women’s sexual, reproductive, and psycho-social health. It can occur during pregnancy and adversely affect the health of both mother and child. Health care workers involved in antenatal care can have a unique role in identifying intimate partner violence and in intervening, preventing, and mitigating its consequences. In this study, the objective was to explore Ethiopian health care workers’ insights of and responses to intimate partner violence in pregnancy. Using an exploratory design, this qualitative study includes ten semi-structured interviews of health care workers representing different antenatal care centers in Jimma, Ethiopia. The content analyses of translated interview notes were conducted with Atlas.ti7 software, (Atlas.ti Scientific Software Development Gmbh, Berlin). The health care workers shared their insights of the consequences of intimate partner violence during pregnancy in addition to their experience with and responses to the victims. There was a limited understanding of the extent of the adverse impacts of intimate partner violence on pregnancy outcomes, as well as the potential long-term health implications. The informants described how they only gave medical treatment for obstetric complications or visible trauma during pregnancy. There was no formal referral to or linkages with other resources. Women’s empowerment and systemic changes in the health care, including training and capacity building, clear guidelines addressing management of intimate partner violence in pregnancy, and inclusion of intimate partner violence screening tools in the Ethiopian antenatal care chart/card, were recommended by the informants. The adverse impacts of intimate partner violence on pregnancy outcomes were poorly understood by the Ethiopian health care workers in this study. They offered limited assistance to the victims and recommended changes in the routine antenatal care (ANC) and health care systems. They identified various policy initiatives focusing on women’s empowerment to reduce intimate partner violence and its complications especially during pregnancy.
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Affiliation(s)
- Bosena Tebeje Gashaw
- College of Health Sciences, Jimma University, 1355 Jimma, Ethiopia
- Faculty of Medicine, University of Oslo, 0316 Oslo, Norway;
- Correspondence:
| | - Berit Schei
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, University of Science and Technology, N-7489 Trondheim, Norway;
- Department of Obstetrics and Gynaecology, St. Olav’s Hospital, 7030 Trondheim University Hospital, N-7489 Trondheim, Norway
| | | | - Jeanette H. Magnus
- Faculty of Medicine, University of Oslo, 0316 Oslo, Norway;
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
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