The Violence Against Children Surveys (VACS): Using VACS data to drive programmes and policies.

The Violence Against Children Surveys (VACS) are nationally representative surveys of males and females aged 13-24 years, designed to measure the burden of sexual, physical, and emotional violence experienced in childhood, adolescence and early adulthood. As of 2020, 22 countries implemented or are implementing a VACS. Since the first article using VACS data was published in 2009, several peer-reviewed articles have been published on the VACS. However, no publications have analysed the breadth of the work and how the data are represented in the literature. We conducted a review of the peer-reviewed research which used VACS data or mentioned the VACS. Between 2009 and July 2020, 50 peer-reviewed articles with data from 11 countries were published. Two studies (2/50; 4.0%) focused on boys, while 14 studies (14/50; 28.0%) focused on violence against girls. Fourteen articles focused on sexual violence (14/50; 28.0%), compared to three on emotional violence (3/50; 6.0%), and two on physical violence (2/50; 4.0%). Lastly, 52% of the articles (26 of the 50) were first authored by someone at the U.S. Centers for Disease Control and Prevention. We identified the need to support local authors, and additional research on violence against boys, and physical and emotional violence.

The global politics of the age-gender divide in violence against women and children.

Decades of collective and cumulative work by practitioners, activists and researchers have made violence prevention an important part of international development agendas. However, violence prevention and response work addressing women and children has historically been siloed. Those working at the intersection of violence against women (VaW) and violence against children (VaC) have wrestled with the age-gender divide. Addressing the historical and political influences that underpin this divide will likely enhance progress towards more integrated strategies. This paper examines the origins and development of this polarisation and potential strategies for a more coordinated and collaborative agenda. This paper draws on the insights gained from eleven (11) semi-structured interviews conducted with key violence prevention actors in VaW and VaC from across the globe, alongside relevant published literature. Informants were purposively sampled on the basis of their expertise in the field. Findings reveal key differences and tensions between the two fields, including in collection and use of research and evidence, core conceptual frameworks, and the development, funding and implementation of policy and practice. Potential opportunities for future synergies between the two fields are highlighted, particularly through a focus on the adolescent girl.

Gender, culture and reproductive decision-making among recent Mexican migrants in California.

This study of the experiences of recent Mexican immigrants living in California explores the changing perceptions of sexual and societal norms, including gender roles and resulting reproductive decision-making, that appear to accompany the migration process. These norms are compared to those held by migrants' families of origin in Mexico. We analysed 44 semi-structured interviews conducted with a client-based population in order to identify reproductive perceptions and practices that appear to be influenced by recent migration. Using a grounded theory approach, 26 women and 18 men's narratives were analysed to understand the complexity of changing expectations and resulting reproductive health practises. The social marginalisation and isolation of immigrants' experiences, the challenges of new socio-economic factors and access to health services appear to reshape views on reproductive decisions. While traditional gender roles and large families remain a spoken ideal, in practice these reproductive patterns are changing. Our analysis suggests that the migration process does alter relationships, reproductive decisions and contraceptive use among recent Mexican immigrants. The public health goal should be to provide an array of accessible and affordable services, tailored to the needs of this increasingly larger population of recent Mexican migrants in California and throughout the USA.

Author Correction: Addressing violence against children online and offline.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

[Use of family planning services and its relationship with women's decision-making and support from their partner]. / Uso de servicios de planificación familiar de la Secretaría de Salud, poder de decisión de la mujer y apoyo de la pareja.

OBJECTIVE: To identify the influence of reproductive characteristics and women empowerment with the use of family planning services. MATERIAL AND METHODS: Cases and non-cases design with neighborhood controls (147 users and 146 non-users of family planning services during 2003), in Guanajuato State, Mexico. Various indexes were constructed to evaluate women's empowerment and its relationship with family planning use. RESULTS: The use of family planning services was positively and significantly associated with the woman's power to make decisions (High: OR 3.2, CI95% 1.4-7.4), a high level of communication with her partner on contraceptive use (OR 3.5, CI95% 1.4-9.3); and a greater number of pregnancies (> 6 children: OR 4.4, CI95% 1.4-13.8). CONCLUSION: Factors such as a high level of female decision-making and more partner support for contraceptive use are related to the use of family planning services. Therefore, developing strategies that involve men and support female empowerment could contribute to increasing the use of family planning services.

Meeting the reproductive health care needs of adolescents: California's Family Planning Access, Care, and Treatment Program.

PURPOSE: To examine the effect of the California Office of Family Planning's Family Access, Care, and Treatment Program (Family PACT), which was established in 1997 to provide comprehensive, reproductive health services for low-income adolescents and adults. Program evaluation was used to measure access to services, develop a profile of users, identify service utilization patterns, and assess the sensitivity of the health care system to the needs of adolescents. METHODS: Data sources include baseline data on California's previously established family planning services, enrollment, and claims data for the first 4 years of Family PACT, client exit interviews, and on-site observations. RESULTS: Adolescents represented 21% of all clients served by Family PACT in fiscal year 2000-2001 (FY 2000-2001). Adolescent clients served increased from 100,000 in FY 1995-1996 to more than 260,000 in FY 2000-2001(161% increase). The proportion of males has increased from 1% to 11%. In FY 2000-2001, Hispanics comprised 50% of adolescent clients, followed by 32% white, 9% African-American, and 6% Asian, Filipino, or Pacific Islander. Over one-half were aged 18 or 19 years, 42% were aged 15 to 17 years, and 5% were aged younger than 15 years. Contraceptive methods most often dispensed were barrier methods (55% for females, 72% for males), oral contraceptives (44%), contraceptive injections (16%), and emergency contraceptives (7%); 57% received sexually transmitted infection screening. CONCLUSIONS: By linking eligibility determination to the delivery of services, removing cost barriers, increasing the numbers and types of providers offering publicly funded services, and ensuring confidentiality, greater numbers of adolescents obtained needed reproductive health care, thus ensuring an opportunity to reduce unintended pregnancies and sexually transmitted infections.

Barriers and promoters of home-based pasteurization of breastmilk among HIV-infected mothers in greater Dar es Salaam, Tanzania.

BACKGROUND: For the past decade, heat-treating breastmilk has been an infant feeding option recommended by the World Health Organization as a strategy to reduce vertical transmission. However, little is known about field experiences with it. Our primary objective was to explore the barriers and promoters of the implementation of breastmilk pasteurization, "flash-heating" (FH), in the real-world setting of Dar es Salaam, Tanzania. SUBJECTS AND METHODS: Nineteen in-depth interviews were conducted with participants in a home-based infant feeding counseling intervention in which FH was promoted after 6 months of exclusive breastfeeding. Additionally, three focus group discussions were conducted with peer counselors. Interviews were transcribed, translated, and coded independently using NVivo 8 software (QSR International). Data were analyzed using the socioecological framework. RESULTS: Information and support provided by peer counselors were the most important promoters of initiation and continuation of FH; this impacted individual-, interpersonal-, and institutional-level promoters of success. Other promoters included perceived successful breastmilk expression, infant health after initiation of FH, and the inability to pay for replacement milks. Stigma was the most important barrier and cut across all levels of the framework. Other barriers included doubt about the safety or importance of pasteurized breastmilk, difficulties with expressing milk (often attributed to poor diet), and competing responsibilities. The most common suggestion for improving the uptake and duration of FH was community education. CONCLUSIONS: Given the acknowledged role of breastmilk pasteurization in the prevention of vertical transmission, further implementation research is needed. A multilevel intervention addressing barriers to FH would likely improve uptake.

Uso de servicios de planificación familiar de la Secretaría de Salud, poder de decisión de la mujer y apoyo de la pareja / Use of family planning services and its relationship with women's decision-makingand support from their partner

OBJETIVO: Identificar la influencia de las características reproductivas y el empoderamiento femenino en el uso de servicios de planificación familiar (PF). MATERIAL Y MÉTODOS: Diseño de casos y no casos pareado por controles vecindarios (147 usuarias y 146 no usuarias de servicios de PF de la Secretaría de Salud durante 2003), en dos municipios del estado de Guanajuato, México. Análisis logístico multivariado para identificar diferencias entre usuarias y no usuarias. RESULTADOS: El uso de servicios de PF se asoció positiva y significativamente con poder de decisión de la mujer (alto: RM=3.2; IC95 por ciento 1.4-7.4); comunicación con la pareja para el uso de métodos de PF (RM =3.5; IC95 por ciento 1.4-9.3), y número de embarazos en su vida (> 6 hijos: RM =4.4; IC95 por ciento 1.4-13.8). CONCLUSIONES: El desarrollo de estrategias que involucren a los hombres y que, por otra parte, fomenten y fortalezcan el empoderamiento femenino, puede contribuir a una mayor utilización de servicios de PF.

OBJECTIVE: To identify the influence of reproductive characteristics and women empowerment with the use of family planning services. MATERIAL AND METHODS: Cases and non-cases design with neighborhood controls (147 users and 146 non-users of family planning services during 2003), in Guanajuato State, Mexico. Various indexes were constructed to evaluate women's empowerment and its relationship with family planning use. RESULTS: The use of family planning services was positively and significantly associated with the woman's power to make decisions (High: OR 3.2, CI95 percent 1.4-7.4), a high level of communication with her partner on contraceptive use (OR 3.5, CI95 percent 1.4-9.3); and a greater number of pregnancies (> 6 children: OR 4.4, CI95 percent 1.4-13.8). CONCLUSION: Factors such as a high level of female decision-making and more partner support for contraceptive use are related to the use of family planning services. Therefore, developing strategies that involve men and support female empowerment could contribute to increasing the use of family planning services.