Mitigating gender-based violence risk in the context of COVID-19: lessons from humanitarian crises

Sharma, Vandana; Ausubel, Emily; Heckman, Christine; Patrick, Erin; Save, Dimple; Kelly, Jocelyn

doi:10.1136/bmjgh-2021-005448

Cited by 10 publications

(8 citation statements)

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“… 61 62 The COVID-19 pandemic has drawn attention to increased SGBV 63 and alcohol misuse, 64 65 resulting in calls for research in humanitarian contexts to address violence through improving services, tackling root causes and risk mitigation. 63 …”

Section: Discussionmentioning

confidence: 99%

“…60 There remain knowledge gaps regarding effective hazardous alcohol use prevention interventions among refugees, particularly regarding a comprehensive package of interventions that offer community engagement and awareness raising, focus on prevention as well as harm reduction, and include more intensive approaches for persons experiencing severe substance use concerns. 61 62 The COVID-19 pandemic has drawn attention to increased SGBV 63 and alcohol misuse, 64 65 resulting in calls for research in humanitarian contexts to address violence through improving services, tackling root causes and risk mitigation. 63 In sum, findings suggest that the SAVA syndemic is an urgent issue to address with urban refugee youth in Kampala.…”

Section: Discussionmentioning

confidence: 99%

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Examining the substance use, violence, and HIV and AIDS (SAVA) syndemic among urban refugee youth in Kampala, Uganda: cross-sectional survey findings

et al. 2022

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BackgroundInteractions between substance use, violence, HIV and AIDS, known as the ‘SAVA’ syndemic, are understudied among refugee youth. We assessed the synergistic effects of frequent alcohol use, depression and violence on HIV vulnerability among urban refugee youth aged 16–24 years in Kampala, Uganda.MethodsWe conducted a cross-sectional survey between January and April 2018 with a convenience sample of refugee youth aged 16–24 years living in informal settlements in Kampala (Kabalagala, Rubaga, Kansanga, Katwe, Nsambya). We assessed non-communicable health conditions (frequent [≥3 times per week] alcohol use [FAU]; depression); violence (young adulthood violence [YAV] at age ≥16 years, intimate partner violence [IPV]), and HIV vulnerability (past 12-month transactional sex; recent [past 3-month] multiple [≥2] sex partners). We calculated the prevalence and co-occurrence of non-communicable health conditions, violence and HIV vulnerability variables. We then conducted multivariable logistic regression analyses to first create unique profiles of FAU, depression, YAV and IPV exposures, and second to assess for interactions between exposures on HIV vulnerability outcomes.ResultsMost participants (n=445; mean age: 19.59, SD: 2.6; women: n=333, 74.8%, men: n=112, 25.2%) reported at least one non-communicable health condition or violence exposure (n=364, 81.8%), and over half (n=278, 62.4%) reported co-occurring exposures. One-fifth reported FAU (n=90; 20.2%) and one-tenth (n=49; 11%) major depression. In logistic regression models including all two-way product terms, adjusted for sociodemographics, we found (a) multiplicative interaction for joint effects of FAU and IPV (adjusted OR (aOR)=4.81, 95% CI: 1.32 to 17.52) on multiple sex partners, and (b) multiplicative interaction for joint effects of FAU and IPV (aOR=3.72, 95% CI: 1.42 to 9.74), and YAV and depression (aOR=7.13, 95% CI: 1.34 to 37.50), on transactional sex.ConclusionFindings signal the importance of addressing the SAVA syndemic among urban refugee youth in Uganda. Synergistic interactions indicate that addressing FAU, depression or violence may concomitantly reduce HIV vulnerability with urban refugee youth.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Examining the substance use, violence, and HIV and AIDS (SAVA) syndemic among urban refugee youth in Kampala, Uganda: cross-sectional survey findings

et al. 2022

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“…Many standard humanitarian interventions, norms, and so-called best practices have been redesigned and adapted to fit a new reality of limited in-person interaction and stay at home orders, including in displacement settlements and other humanitarian settings. With emerging evidence about how COVID-19 response measures have exacerbated GBV risk globally [ 39 – 41 ], GBV risk mitigation and the promising practices identified in this document are more relevant than ever and should be adopted and put into practice by all humanitarian practitioners. However, several aspects of the promising practices may need to be modified during the time of COVID-19 and potentially permanently moving forward as the humanitarian sector adopts precautions for any future outbreaks.…”

Section: Discussionmentioning

confidence: 99%

Promising practices for the monitoring and evaluation of gender-based violence risk mitigation interventions in humanitarian response: a multi-methods study

et al. 2022

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Background Risks of gender-based violence (GBV) are exacerbated in humanitarian crises. GBV risk mitigation interventions aim to reduce exposure to GBV and ensure that humanitarian response actions and services themselves do not cause harm or increase the risk of violence. The 2015 IASC Guidelines for Integrating Gender-Based Violence Interventions in Humanitarian Action (‘GBV Guidelines’) are a globally endorsed resource that provides comprehensive guidance for all humanitarian actors and sectors on GBV risk mitigation. While uptake of GBV risk mitigation approaches across multiple humanitarian sectors has occurred, there is limited understanding of how to monitor and evaluate GBV risk mitigation interventions. Methods A multi-methods study was conducted in 2019 to identify promising practices for the monitoring and evaluation (M&E) of GBV risk mitigation interventions in non-GBV sectors and to develop a set of illustrative case examples. The study included a comprehensive desk review of 145 articles, documents and resources from the published and grey literature, as well as 11 in-depth interviews and five focus group discussions with humanitarian practitioners. Using Dedoose software and a codebook developed a priori, qualitative data were transcribed and coded and a content analysis was conducted. Excerpts focusing on promising practices from the qualitative data and the desk review were analyzed together and grouped by thematic area. Similar promising practices were combined and consolidated to create a final list, and case examples were identified. Results Current promising practices for M&E of GBV risk mitigation activities in the following categories are described: (1) Coordination and collaboration, (2) Designing M&E approaches and tools for GBV risk mitigation activities, (3) Contextualization, (4) Developing and selecting indicators, (5) Data collection, (6) Data analysis and use of findings, (7) Potential safety concerns for affected populations and staff, and (8) Staff capacity and engagement. These are supplemented with seven diverse case examples to illustrate application of the promising practices using real-world examples. Conclusion This paper highlights current promising practices for M&E of GBV risk mitigation interventions in humanitarian response. Further application of these practices—alongside ongoing documentation of emerging approaches—will be critical to ensuring that GBV risk mitigation interventions are more rigorously tested with the aim of building the evidence base on the effectiveness of different GBV risk mitigation interventions within specific humanitarian sectors.

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“…Clinicians across all health care settings must be prepared to provide emotional and practical support, and to tailor personalized care to individual needs. Mental and physical health consequences related to interpersonal violence may persist long after the abusive situation has ended[ 34 - 36 ], and there is an urgent need to prevent long-term adverse effects and to extend periods of follow-up (Figure 1 ).…”

Section: A Need To Improve Treatment and Prevention Of Interpersonal Violence And Cardiovascular Outcomesmentioning

confidence: 99%

Interpersonal violence: Serious sequelae for heart disease in women

Mazza¹,

Marano²,

Castillo³

et al. 2021

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Experiencing various forms of violence in either childhood or adulthood has been associated with cardiovascular disease, both shortly after the event and during follow-up, particularly in women. The coronavirus disease 2019 pandemic has heightened the risk of domestic violence with serious sequelae for mental and cardiovascular health in women, possibly due to several contributing factors, ranging from lockdown, stay at home regulations, job losses, anxiety, and stress. Accordingly, it remains paramount to enforce proactive preventive strategies, at both the family and individual level, maintain a high level of attention to recognize all forms of violence or abuse, and guarantee a multidisciplinary team approach for victims of interpersonal or domestic violence in order to address physical, sexual, and emotional domains and offer a personalized care.

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Mitigating gender-based violence risk in the context of COVID-19: lessons from humanitarian crises

Cited by 10 publications

References 3 publications

Examining the substance use, violence, and HIV and AIDS (SAVA) syndemic among urban refugee youth in Kampala, Uganda: cross-sectional survey findings

Examining the substance use, violence, and HIV and AIDS (SAVA) syndemic among urban refugee youth in Kampala, Uganda: cross-sectional survey findings

Promising practices for the monitoring and evaluation of gender-based violence risk mitigation interventions in humanitarian response: a multi-methods study

Interpersonal violence: Serious sequelae for heart disease in women

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