Women's Shelter, a prison in reverse: when the protection of victims imprisons them. / Casa-abrigo, uma prisão às avessas: quando a proteção às vítimas as aprisiona.

This article aimed to know a Shelter for women in situations of intimate partner violence at imminent risk of death located in the state of Rio de Janeiro from the perception of its professionals. To this end, this qualitative research adopted semi-structured interviews with seven professionals directly involved with the care and assistance to the Shelter's user population. The findings were interpreted through Bardin's thematic content analysis. Moreover, the profile of the women and children sheltered in 2021 was drawn based on the data provided by the institution. In conceptual terms, this work focused on intersectional feminist theoretical references. Among the results, we argue that the shelter is permeated by contradictions, from its normative idealizations to institutional practices: on the one hand, the shelter represents the possibility of salvation, that is, of interrupting the escalation of violence and, therefore, preventing femicide. However, on the other hand, it appears as an upside-down prison, which "incarcerates" the victims. We highlight the importance of thinking about new ways to ensure protection for women who need this shelter.

O artigo teve como objetivo conhecer uma casa-abrigo para mulheres em situação de violência por parceiros íntimos (VPI) em risco iminente de morte localizada no estado do Rio de Janeiro a partir da percepção de seus profissionais. Para tanto, a pesquisa teve abordagem qualitativa e foram realizadas entrevistas semiestruturadas com sete profissionais envolvidos/as diretamente no atendimento e na assistência às mulheres atendidas pela casa-abrigo. A interpretação dos achados se deu por meio da técnica de análise de conteúdo temática preconizada por Bardin. Além disso, foi traçado o perfil das mulheres e crianças abrigadas no ano de 2021, com base nos dados disponibilizados pela instituição. Em termos conceituais, este trabalho debruçou-se sobre referenciais teóricos feministas interseccionais. Entre os resultados, argumenta-se que a casa-abrigo está permeada por contradições, desde suas normativas às práticas institucionais: por um lado, representa uma possibilidade de "salvação", isto é, de interrupção da escalada da violência e, portanto, de impedimento do feminicídio, mas, por outro, aparece como uma prisão "às avessas", que "prende" as vítimas. Aponta-se a importância e a urgência de pensar novas formas de garantir proteção às mulheres que necessitam desse tipo de abrigamento.

Intimate partner violence during pregnancy and quality of life in Southern Brazil: a cross-sectional study, 2022.

OBJECTIVE: To analyze the association between intimate partner violence during pregnancy (IPVP) and quality of life (QOL). METHODS: A cross-sectional study was conducted with pregnant women receiving care in Primary Health Care in the municipality of Criciúma, Santa Catarina state, Brazil, in 2022; QOL was assessed in the physical, psychological, social relationship and environmental domains using WHOQOL-Bref instrument; IPVP was evaluated by means of the World Health Organization Violence Against Women; Crude and adjusted linear regression analyses were performed. RESULTS: A total of 389 pregnant women were evaluated; IPVP was observed in 13.6% of cases; in the adjusted analysis, IPVP remained associated with physical, psychological and social relationship domains; pregnant women who experienced IPVP had a reduction in their QOL score by 9.77, 11.07 and 8.95 points, respectively, when compared to those who did not experience IPVP. CONCLUSION: IPVP was associated with poorer QOL in the physical, psychological and social relationships domains. Health services equipped to address and prevent violence against pregnant women are essential. MAIN RESULTS: Intimate partner violence (IPV) was observed in 13.6% of pregnant women and was associated with poorer quality of life in the physical, psychological and social relationship domains. IMPLICATIONS FOR SERVICES: The results emphasize the need for an intersectoral approach in addressing the issue, with specialized healthcare centers for situations of violence integrated with social assistance and public security. PERSPECTIVES: Development of intersectoral policies and actions that strengthen existing ones and ensure social and healthcare assistance to pregnant women victims of violence and their children, given the negative impact of IPVP on quality of life.

Gender policy and intimate partner violence in Colombia.

In 1995, Colombia signed the first legally binding international treaty that criminalizes all forms of violence against women. Subsequently, the government took several steps to improve laws and policies, but the progress was slow. This study uses a differences-in-differences approach and Demographic and Health Survey data to estimate the impact of a renewed effort to reduce intimate partner violence (IPV), based on recommendations by the UN. To identify the effect of the national policies, it uses the fact that while the central government passes laws and formulates policies, it partly relies on departments (provinces) to implement them. Of Colombia's 32 departments and Bogota D.C., approximately a quarter had some type of gender policy in place by 2011. The main finding is that self-reported intimate partner violence decreased from 20% to 16% between 2010 and 2015 in departments that had implemented IPV policies, while it remained at 19% in the others.

Development of an HIV/STI and partner violence health promotion intervention for abused US Virgin Islands women.

Women in the US Virgin Islands (USVI) experience intimate partner violence (IPV) and human immunodeficiency virus (HIV) at disproportionate rates compared to women on the US mainland. Women in violent relationships report experiencing controlling behaviours that decrease their ability to negotiate for sex using condoms or to prevent unwanted pregnancies. Though several evidence-based interventions exist to prevent either IPV or HIV, few address them through an integrated health promotion approach or attend to particular USVI cultural mores. This article describes the systematic development of a theory based, culturally tailored, integrated health promotion intervention that addresses IPV and HIV among USVI women experiencing abuse. The process included: (i) identifying and integrating evidence-based health promotion interventions, (ii) conducting formative research using focus groups, (iii) synthesizing focus group data to inform intervention development and (iv) developing a culturally and linguistically appropriate intervention specific to the needs and concerns of USVI women. The Empowered Sisters Project: Making Choices Reducing Risks (ESP) was developed through this research. ESP is a three-session health promotion curriculum focussed on enhancing sexual health and safety among women experiencing abuse. The ESP intervention components included promoting condom use, increasing IPV and HIV knowledge and developing a personalized safety plan. Health professionals facilitated individual intervention sessions using culturally tailored visual media and scripts. This program focussed on experiences of women living in the USVI and has implications for utility across the Caribbean diaspora.

Marriage as a Protective Factor Against Intimate Partner Violence Suffered by Women. Exploring Mechanisms.

Research has consistently found that married women experienced less intimate partner violence (IPV) than cohabiting ones. However, most existing studies focus on the incidence of IPV as a binary indicator, while the severity of that exposure or the different types of violence has been largely ignored. This article begins to address these issues with a multivariate approach, for some Latin American countries. The study reports that married women suffered less violence than cohabiting women for each singular type of violence, even after controlling by education, age, locality, wealth, and personal violence history. This article proposes a novel mechanism that helps to explain these findings: marriage would provide a framework that fosters investment in the quality of the couple's relationship, thus preventing IPV. The estimates on the couple's investments support these predictions.

Pathways to change: Three decades of feminist research and activism to end violence against women in Nicaragua.

This paper presents the results of nearly three decades of partnership between feminist researchers and activists to prevent violence against women and girls (VAWG) in Nicaragua. A household survey conducted in 1995 in León, the country's second-largest city, revealed that 55 per cent of women had experienced lifetime physical intimate partner violence (IPV), and 27 per cent had experienced IPV in the last 12 months. The study results were instrumental in changing domestic violence laws in Nicaragua. A follow-up study in 2016 found a decrease of 63 per cent in lifetime physical IPV and 70 per cent in 12-month physical IPV. This paper examines possible explanations for the reduction, including the policy reforms resulting from feminist advocacy. We compare risk and protective factors for physical IPV, such as changes in women's attitudes towards violence, their use of services, and knowledge of laws, using data from both the 1995 and 2016 surveys, as well as three waves of Demographic and Health Surveys. We conclude that the decline in IPV can be partially attributed to the efforts of the Nicaraguan women's movements to reform laws, provide services for survivors, transform gender norms, and increase women's knowledge of their human rights.

A case study comparison of engaging community activists to prevent gender-based violence in Peru and Rwanda.

Community mobilisation is recognised as an important strategy to shift inequitable gender norms and ensure an enabling environment to prevent gender-based violence (GBV). Yet there is a need to better understand the factors that facilitate effective community activism in particular contexts. Although fundamental to the success of mobilisation programmes, there is also limited appreciation of the experiences and agency of engaged community activists. This paper draws on qualitative evaluations from two community mobilisation GBV prevention programmes: the Gender Violence in the Amazon of Peru (GAP) Project and the Indashyikirwa programme in Rwanda. In Peru, participatory data was collected, in addition to baseline and endline interviews with 8 activists. In Rwanda, baseline and endline interviews and observations were conducted with 12 activists, and interviews were conducted with 8 staff members. The data was thematically analysed, and a comparative case study approach was applied to both data sets. The comparative study identified similar programmatic aspects that could hinder or enable activist's engagement and development, and how these are embedded within contextual social and structural factors. We discuss these insights in reference to the current emphasis in public health on individualistic programming, with insufficient attention to how wider environments influence violence prevention programming.

Combating IPV With Community Leaders in Honduras: An Evaluation of an IPV Training Program Among Teachers and Health Professionals.

Intimate partner violence (IPV) among women in Latin America, including Honduras, is serious. To help IPV victims, a community-based educational program has been implemented. This study aims to examine the impact of IPV training among teachers and health care professionals (n = 160) on increases in IPV knowledge, attitudes, and self-efficacy when dealing with IPV victims using a pretest and posttest design. We found that the treatment group who received IPV training showed significantly lower justification for IPV, higher gender equality attitudes, and higher IPV knowledge as well as higher confidence levels in identifying IPV victims and safety planning for victims. We concluded that the IPV training program using the community-based approaches has the potential to help IPV victims in Honduras. More efforts should be made to increase the educational opportunities the community members can receive.

"At Least I Didn't Get Raped": A Qualitative Exploration of IPV and Reproductive Coercion among Adolescent Girls Seeking Family Planning in Mexico.

Adolescent girls who report intimate partner violence (IPV) are at an increased risk of experiencing reproductive coercion (RC); both these forms of gender-based violence (GBV) are associated with unintended pregnancy. Yet little is known about these experiences among adolescent girls in Mexico. Qualitative data were collected as part of formative research for the adaptation of an evidence-based intervention to address RC and IPV in community health centers in Tijuana, Mexico. From September, 2017 to January, 2018, adolescent girls aged 16 to 20 years old (n = 20) seeking voluntary family planning (FP) services were identified and recruited from two publicly funded community health centers. We conducted semi-structured, in-depth interviews and analyzed the transcripts using inductive and deductive techniques. Participants in this sample commonly described experiencing IPV and RC (including pregnancy coercion and contraceptive sabotage), which many girls reported resulted in unintended pregnancy. Further, participants' narratives and general lack of knowledge on how to cope with IPV or RC illuminated the acceptability of offering GBV prevention intervention within FP clinics serving this population. Findings highlight an urgent need to prevent IPV and RC, and reduce risk for unintended pregnancy among adolescent girls in this region and the potential of FP clinics to serve as a safe space for intervention delivery. Findings contribute to the limited qualitative evidence from Mexico, describing adolescent girl's experiences of IPV and RC, strategies for preventing pregnancy in the context of RC, and opportunities for support from FP providers.

Midwives' experiences with screening for intimate partner violence in Santiago, Chile.

Although intimate partner violence (IPV) is well-established as a highly prevalent global issue, research examining the experience of health providers who screen women at risk for IPV is scarce. We aimed to explore the experience of midwives in primary health care centers in Santiago, Chile, regarding identification of at-risk women and barriers to screening. We highlight the intersection of complex issues of global relevance, such as culture, language, provider-patient relationships, and allocation of time and resources. In our results, we illustrate the importance of providing midwives extended time, interpreter services, and cross-cultural education to address IPV in their transcultural context.

Violência nas relações de intimidade entre adolescentes: revisão sistemática de intervenções realizadas na escola / Intimate partner violence among adolescents: a systematic review of school based interventions / Violencia en las relaciones íntimas entre los adolescentes: una revisión sistemática de las intervenciones realizadas en la escuela

O objetivo deste estudo foi analisar os resultados de intervenções realizadas em escolas visando prevenção ou redução da ocorrência de violência nas relações de intimidade. Foi realizada uma revisão sistemática da literatura, mediante consulta em bases de dados nacionais e internacionais. Para a revisão bibliográfica, a pergunta norteadora foi: "Quais os resultados de intervenções realizadas em escolas visando prevenção ou redução da ocorrência de violência nas relações de intimidade dos estudantes?", elaborada utilizando-se a estratégia PICO (Paciente/Problema, Intervenção, Controle/Comparação e Resultados). Nas sete bases de dados, foi realizado o cruzamento de palavras-chave: "Intimate partner violence" ou "Dating violence", "Randomized Controlled Trial" e "School". Dentre os 82 artigos identificados, oito atenderam aos critérios de inclusão e foram analisados, sendo a maioria dos Estados Unidos. A maioria das intervenções foram bem-sucedidas na prevenção ou redução da violência por parceiro íntimo, mediante a redução tanto da vitimização quanto da perpetração da violência. As testemunhas dessa violência passaram a se posicionar ativamente contra os agressores. Portanto, a violência nas relações de intimidade pode ser prevenida ou reduzida com intervenções realizadas em escolas.

The objective of this study was to analyze the results of interventions carried out in schools aimed at preventing or reducing the occurrence of violence in intimate relationships. A systematic literature review was performed by consulting national and international databases. For the literature review, the guiding question was: "What are the results for interventions carried out in schools aimed at preventing or reducing the occurrence of violence in students' intimate relationships?", elaborated using the PICO strategy (Patient/Problem, Intervention, Control/Comparison and Results). In the seven databases, keywords were crossed: "Intimate partner violence" or "Dating violence", "Randomized Controlled Trial" and "School." Among the 82 articles identified, eight met the inclusion criteria and were analyzed, the majority being from the USA. Most interventions were successful in preventing or reducing intimate partner violence by reducing both victimization and perpetration of violence. Witnesses of this violence started to take an active stand against the aggressors. Therefore, violence in intimate relationships can be prevented or reduced with interventions carried out in schools.

El objetivo de este estudio fue analizar los resultados de las intervenciones realizadas en las escuelas para prevenir o reducir la ocurrencia de violencia en las relaciones íntimas. Se realizó una revisión sistemática de la literatura consultando bases de datos nacionales e internacionales. Para la búsqueda bibliográfica, la pregunta orientadora fue: "¿Cuáles son los resultados de las intervenciones realizadas en las escuelas dirigidas a prevenir o reducir la ocurrencia de violencia en las relaciones íntimas de los estudiantes?", se elaboró ​​utilizando la estrategia PICO (Paciente/Problema, Intervención, Control/Comparación y Resultados. En las siete bases de datos se cruzaron las palabras clave: "Violencia de pareja" o "Violencia en el noviazgo", "Ensayo controlado aleatorio" y "Escuela".De los 82 artículos identificados, ocho cumplieron los criterios de inclusión y fueron analizados, siendo la mayoría de los EE. UU. La mayoría de las intervenciones tuvieron éxito en prevenir o reducir la violencia de pareja al reducir tanto la victimización como la perpetración de la violencia Los testigos de esta violencia comenzaron a tomar una posición activa contra los agresores Por lo tanto, la violencia en las relaciones íntimas se puede prevenir o reducir con las intervenciones realizadas s en las escuelas.

Caracterización de la violencia en el noviazgo en estudiantes de Medicina de la provincia de Cienfuegos / Characterization of dating violence in Medicine students from the province of Cienfuegos

RESUMEN Introducción: la violencia en el noviazgo es reconocida como una de las principales manifestaciones de violencia en estudiantes universitarios; requiere estudio e intervención. Objetivo: caracterizar la violencia en el noviazgo de estudiantes de Medicina de la Universidad de Ciencias Médicas de Cienfuegos. Materiales y métodos: se realizó un estudio descriptivo en 240 estudiantes de segundo año de Medicina. Se utilizó un cuestionario autoadministrado. Las variables fueron: sexo, edad, años de estudio, tipos de violencia más frecuentes en el noviazgo, manifestaciones de tipos de violencia, direccionalidad, conocimiento de las consecuencias negativas, y tipos de consecuencias. Se empleó la estadística descriptiva. Resultados: un 62,5 % percibió la violencia psicológica como la más frecuente. El 85,8 % describió diversas manifestaciones y el 14,2 % no pudo hacerlo. Se reconoció entre las manifestaciones o expresiones conductuales psicológicas la cosificación, degradación y las amenazas. En la violencia física, los golpes, y en la sexual, mirar a las mujeres como objetos sexuales e infidelidad. Imperó bidireccionalidad en las agresiones (63 %). Se demostró con un 87,5 % que la violencia tiene consecuencias negativas en la esfera cognitivo-afectivo-conductual. Conclusiones: los estudiantes percibieron que la violencia en el noviazgo es bidireccional, con predominio de la violencia psicológica, que genera daños a la salud. La convergencia entre la percepción del evento y los escasos conocimientos que poseen acerca de la violencia en el noviazgo, entorpece develar la magnitud de este problema de salud. Aquí radica la necesidad de realizar un conjunto de actuaciones dirigidas a su reducción (AU).

ABSTRACT Introduction: dating violence is recognized as one of the main manifestations of violence in university students; it requires study and prevention. Objective: to characterize dating violence of medical students of the University of Medical Sciences of Cienfuegos. Materials and methods: a descriptive study was carried out in 240 second-year medical students. A self-administered questionnaire was used. The variables were: sex, age; years of study, most frequent types of dating violence, manifestations of violence types, directionality, knowledge of the negative consequences and types of consequences. Descriptive statistics was used. Results: 62.5 % of students perceived psychological violence as the most frequent. 85.8 % described several manifestations and 14.2 % were unable to do so. Among psychological behavioral manifestations or expressions, they recognize reification, degradation and threats; blows are integrated into the physical violence, and looking at women as sexual objects and infidelity into the sexual violence. Bi-directionality prevailed in aggressions (63 %). It was shown in 87.5 % that violence has negative consequences in the cognitive-affective-behavioral sphere. Conclusions: the students perceived that dating violence is bidirectional with a predominance of psychological violence generating health damages. The combination between their perception of the event and the little knowledge they have about dating violence hinders disclosing the magnitude of this health problem. Herein lays the need of carrying out a group of actions aimed at reducing it (AU).

Actions to prevent sexual violence against adolescents: an integrative literature review.

OBJECTIVE: to identify actions to prevent adolescent sexual violence. METHOD: an integrative literature review of five databases, Medline/Pubmed, Scopus, Lilacs, Bdenf, Cinahl using the following descriptors "adolescent" "adolescence" "youth" "primary prevention" "prevention" "primary" "sexual violence", plus the Boolean operators AND and OR, with a final sample of 24 articles; the evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation. RESULTS: the review identifies different structures of the study object, classified in the categories "Interventions with programs created by authors" and "Interventions with standard programs". CONCLUSION: there are actions to prevent sexual violence against adolescents; the participants' knowledge was assessed immediately after the intervention, but the assessment of the participants' acquisition of habits and behavioral changes was to a lesser extent; health prevention is crucial for society's healthy development, which demonstrates that its applicability in the environment directly favors human health.

Evaluation of Parenting Interventions to Prevent Violence Against Children in Colombia: A Randomized Controlled Trial.

The effects of the International Child Development Programme (ICDP) and the specific addition of a violence prevention module were observed in a preidentified population in Colombia where children are experiencing high levels of violence. Participants were 176 parents of 3- to 4-year-olds attending child centers who were randomly allocated to one of three conditions: organized Community Activities at child centers and ICDP (CA + ICDP), CA, ICDP, and a preventive Violence Curriculum (CA + ICDP + VC), or a comparison group with only CA. The parents completed questionnaires about corporal punishment, intimate partner violence, community violence, and mental health at baseline and at 6 months follow-up. Univariate logistic regressions were used to examine uses of child violence, predictors of intimate partner violence, and prevalence of mental health problems. McNemar tests were used to assess differences between intervention groups and comparison group at two different time points. Participants were mostly female (78.5%) and had an average age of 32 years. Among these, 58.5% had been exposed to community violence and 98.3% reported using physical assault to discipline their children. Reported prevalence of child violence decreased in all groups whereas the reduction of severe forms of violence was larger for the intervention groups, and especially for the CA + ICDP + VC group. There was a significant reduction of victimization of intimate partner violence in both intervention groups as well as a decrease in mental health problems, especially for the CA + ICDP group (from 22.4% to 5.1%). The general ICDP seems effective in reducing violence. The addition of a specific violence intervention component seemed to reduce intimate partner violence, but not violence related to children. The comparison group attending the child center and other social activities also reported reduced violence but to a lesser extent than the groups who attended specific interventions.

Intimate Partner Violence: Barriers to Action and Opportunities for Intervention Among Health Care Providers in São Paulo, Brazil.

Health care providers (HCPs) who directly interact with women play a critical role in intimate partner violence (IPV) prevention and response. The aim of this study was to identify the structural and interpersonal barriers to IPV response among HCPs working in public health clinics in Santo André, Brazil. Eligible participants included all HCPs providing direct care to individuals at three public health clinics. Participants self-administered an adapted Knowledge, Attitudes, and Practices survey on IPV. Data were analyzed using Epi Info 7 and SAS 9.4. 114 HCPs completed surveys. Less than half of HCPs (41%, n = 34) reported ever having asked a woman about abuse in the past year. HCPs who perceived fewer barriers were more likely to report asking about IPV. The top three reported barriers to asking women about IPV included the following: few opportunities for one-on-one interaction (77%, n = 65), a lack of privacy (71%, n = 60), and fear of offending women (71%, n = 60). Fewer providers who perceived the barriers of lack of privacy asked about IPV (50.8%, n = 33 compared with 84.2%, n = 16; p < .05); less providers who perceived few opportunities for private patient interactions asked about IPV (48.3%, n = 29 compared with 75.0%, n = 18; p < .05). Our results support the need for a systems approach of institution-wide reforms altering the health care environment and avoiding missed opportunities in IPV screening and referring women to appropriate resources or care. Two of the most frequently reported barriers to asking IPV were structural in nature, pointing to the need for policies that protect privacy and confidentiality. Within the Brazilian context, our research highlights the role of HCPs in the design and implementation of IPV interventions that both strengthen health systems and enable providers to address IPV.

Structural violence: Its many faces and challenges in research, policies, prevention, and intervention.

In this themed issue of the Journal of Prevention & Intervention in the Community, each contribution deals with a different face or aspect of violence. A first block, comprising three articles, deals with Gender-Based Violence (GBV): The first article draws a picture of the general situation of Gender-Based Violence (GBV), its numbers, causes, intersectionalities, and consequences, and reflects upon implications for action. The second article focuses on a particular face of GBV: Intimate partner violence IPV, and determines, based on the analysis of DHS data from Peru, the persistence and perpetuating effects of personal history of violence on the likelihood of IPV. The third article on GBV addresses a different aspect: distorted thoughts about women in a sample of men imprisoned for violence against women in Spain, including thoughts on the culture of honor, gender stereotypes, and jealousy and infidelity as justifiers of gender violence. A second block of articles deal with other forms of social violence: The fourth article reviews literature on the variables associated with adolescent antisocial behavior, such as: family and peers with antisocial backgrounds, antisocial peer attitudes, alcohol consumption, offensive behavior, education level, perception of safety in the community, and attention deficit hyperactive disorder, to find support for a bioecological model as a plausible framework for understanding antisocial behavior in juvenile offenders. The fifth article analyzes two experiences in educational settings, with children, young university students, and graduates, aimed at reconstructing and re-processing collective memories with regard to violence during the two decades of armed conflict in Peru. A sixth article experimentally proves the effects of a pedagogic module on political violence in Peru on knowledge, attitudes, and perceptions with regard to violence as a means to exert social control or social domination.

School Nurses on the Front Lines of Healthcare: A Guide in the Recognition of and Response to Teen Dating Violence in Your Schools.

Teen dating violence (TDV) has become more prevalent in our schools, exacerbated by the omnipotent presence of social media and portals of what dating and gender roles "should be" in Hollywood films and television shows. It is important to recognize that TDV is a threat to mental health, and potentially physical health, and school nurses should develop a framework for recognizing problematic social, physical, and emotional interactions between students. This article describes typical presentations of TDV through a case, providing a mnemonic for recognition and resources for prevention.

Violence against women during the COVID-19 pandemic: An integrative review.

BACKGROUND: During the COVID-19 pandemic, incipient data have revealed an increase in violence against women (VAW). OBJECTIVE: To analyze the existing scientific literature on strategies and recommendations to respond to VAW during the implementation of social distancing measures in response to the COVID-19 pandemic. SEARCH STRATEGY: An integrative review was conducted based on articles published between December 2019 and June 2020. Suitable articles were identified from the PubMed, SciELO, and LILACS databases, using relevant terms. SELECTION CRITERIA: Eligible studies included opinion and primary research articles describing the dynamics of VAW during quarantine and in the context of the restrictive measures taken during the COVID-19 pandemic and proposing recommendations to respond to this issue. DATA COLLECTION AND ANALYSIS: Data were extracted from eligible publications and qualitative synthesis was used. MAIN RESULTS: The 38 articles included in the study showed that some factors increasing women's vulnerabilities to violence were exacerbated during the social distancing and lockdown period. Health professionals are essential for screening and responding to VAW during the pandemic. CONCLUSIONS: Strategies must include integrated actions aiming to prevent and respond to violence during and after the COVID-19 pandemic. These must be designed based on lessons learned from previous public health emergencies.

Applying a complex adaptive systems approach to the evaluation of a school-based intervention for intimate partner violence prevention in Mexico.

Despite calls for evaluation practice to take a complex systems approach, there are few examples of how to incorporate complexity into real-life evaluations. This article presents the case for using a complex systems approach to evaluate a school-based intimate partner violence-prevention intervention. We conducted a post hoc analysis of qualitative evaluation data to examine the intervention as a potential system disruptor. We analysed data in relation to complexity concepts particularly relevant to schools: 'diverse and dynamic agents', 'interaction', 'unpredictability', 'emergence' and 'context dependency'. The data-two focus groups with facilitators and 33 repeat interviews with 14-17-year-old students-came from an evaluation of a comprehensive sexuality education intervention in Mexico City, which serves as a case study for this analysis. The findings demonstrate an application of complex adaptive systems concepts to qualitative evaluation data. We provide examples of how this approach can shed light on the ways in which interpersonal interactions, group dynamics, the core messages of the course and context influenced the implementation and outcomes of this intervention. This gender-transformative intervention appeared to disrupt pervasive gender norms and reshape beliefs about how to engage in relationships. An intervention comprises multiple dynamic and interacting elements, all of which are unlikely to be consistent across implementation settings. Applying complexity concepts to our analysis added value by helping reframe implementation-related data to focus on how the 'social' aspects of complexity influenced the intervention. Without examining both individual and group processes, evaluations may miss key insights about how the intervention generates change, for whom, and how it interacts with its context. A social complex adaptive systems approach is well-suited to the evaluation of gender-transformative interventions and can help identify how such interventions disrupt the complex social systems in which they are implemented to address intractable societal problems.