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1.
Am J Epidemiol ; 193(4): 636-645, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-37968380

RESUMO

Extreme climate events are related to women's exposure to different forms of violence. We examined the relationship between droughts and physical, sexual, and emotional intimate partner violence (IPV) in India by using 2 different definitions of drought: precipitation-based drought and socioeconomic drought. We analyzed data from 2 rounds of a nationally representative survey, the National Family Health Survey, where married women were asked about their experiences of IPV in the previous year (2015-2016 and 2019-2021; n = 122,696). Precipitation-based drought was estimated using remote sensing data and geographic information system (GIS) mapping, while socioeconomic drought status was collected from government records. Logistic regression models showed precipitation-based drought to increase the risk of experiencing physical IPV and emotional IPV. Similar findings were observed for socioeconomic drought; women residing in areas classified as drought-impacted by the government were more likely to report physical IPV, sexual IPV, and emotional IPV. These findings support the growing body of evidence regarding the relationship between climate change and women's vulnerability, and highlight the need for gender responsive strategies for disaster management and preparedness.


Assuntos
Secas , Violência por Parceiro Íntimo , Humanos , Feminino , Fatores de Risco , Violência , Índia/epidemiologia , Parceiros Sexuais/psicologia , Prevalência
2.
Annu Rev Public Health ; 45(1): 277-294, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38842174

RESUMO

Violence against women, especially intimate partner violence, is recognized as a global public health issue due to its prevalence and global reach. This article outlines the scope of the issue, with respect to its prevalence, health outcomes, and risk factors, and identifies key milestones that led to its global recognition: methodological and data advances, acknowledgment as a criminal justice and health issue, support by the global women's movement, and the robust evidence demonstrating that intimate partner violence is preventable. Key issues for the future include recognition and consideration of intersectionality in research, improvements in the measurement of other forms of violence against women, and the need to scale up prevention efforts that have documented success. Violence against women is an urgent priority as it affects individuals, their families and surroundings, and the entire global health community.


Assuntos
Saúde Global , Violência por Parceiro Íntimo , Saúde Pública , Saúde da Mulher , Humanos , Feminino , Violência por Parceiro Íntimo/estatística & dados numéricos , Violência por Parceiro Íntimo/prevenção & controle , Fatores de Risco , Prevalência
3.
BMC Pregnancy Childbirth ; 24(1): 353, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741050

RESUMO

INTRODUCTION: Non-consented care, a form of obstetric violence involving the lack of informed consent for procedures, is a common but little-understood phenomenon in the global public health arena. The aim of this secondary analysis was to measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as to examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence. METHODS: We measured the prevalence of non-consented care and three of its variations, forced sterilization or contraception, forced cesarean section, and forced consent on paperwork, during childbirth in Mexico for 2016 (N = 24,036) and 2021 (N = 19,322) using data from Mexico's cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH). Weighted data were stratified by geographical regions. We performed adjusted logistic regression analyses to explore associations. RESULTS: The national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021. A decrease in the prevalence was observed for forced contraception or sterilization without knowledge, forcing women to sign paperwork, and non-consented cesarean sections nationally and in most regions. Women between the ages of 26 and 35 years, married, cohabiting with partner, living in urban settings, who do not identify as Indigenous, and who received prenatal services or gave birth at the Mexican Institute of Social Security (IMSS) facilities experienced a higher prevalence of non-consented care. Being 26 years of age and older, living in a rural setting, experiencing stillbirths in the last five years, having a vaginal delivery, receiving prenatal services at IMSS, or delivering at a private facility were significantly associated with higher odds of reporting non-consented care. CONCLUSION: While a decrease in most of the variations of non-consented care was found, the overall prevalence of non-consented care and, in one of its variations, pressure to get contraceptives, increased at a national and regional level. Our findings suggest the need to enforce current laws and strengthen health systems, paying special attention to the geographical regions and populations that have experienced higher reported cases of this structural problem.


Assuntos
Cesárea , Humanos , Feminino , México/epidemiologia , Gravidez , Adulto , Estudos Transversais , Prevalência , Cesárea/estatística & dados numéricos , Adulto Jovem , Parto , Adolescente , Consentimento Livre e Esclarecido/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Inquéritos e Questionários , Esterilização Reprodutiva/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos
4.
BMC Womens Health ; 24(1): 321, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834977

RESUMO

Violence against women is a phenomenon that involves at least 35% of women worldwide. Violence can be sexual, physical, and/or psychological, perpetrated by the partner, another family member, or a stranger. Violence is a public health problem because its consequences include higher morbidity, higher mortality, and short and long-term physical and psychological health diseases. Most studies prove an association between any type of violence and some chronic pain diagnoses but no one has done a complete collection of this evidence. This systematic review and meta-analysis aimed to evaluate whether this association is statistically significant, including the largest number of studies. Through the inclusion of 37 articles, the association has been demonstrated. Compared with no history of violence, women who did experience violence showed 2 times greater odds of developing chronic pain. The impact of violence was significant also on fibromyalgia separately, but not on pelvic pain.PROSPERO registrationPROSPERO CRD42023425477.


Assuntos
Dor Crônica , Humanos , Dor Crônica/psicologia , Dor Crônica/epidemiologia , Feminino , Dor Pélvica/psicologia , Dor Pélvica/epidemiologia , Dor Pélvica/etiologia , Fibromialgia/psicologia , Fibromialgia/epidemiologia , Fibromialgia/complicações
5.
BMC Womens Health ; 24(1): 258, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38658963

RESUMO

BACKGROUND: Violence against women (VAW) is a significant public health problem. With the emergence of the COVID-19 pandemic, the frequency and severity of VAW has escalated globally. Approximately one in four women in Nepal have been exposed to either physical, psychological, and/or sexual violence in their lifetime, with husbands or male partners being the perpetrators in most cases. VAW prevention has been under-researched in low- and middle-income countries, including Nepal. This study aims to explore the perspectives of local stakeholders, including healthcare providers and survivors of violence in Madhesh Province. The overarching goal is to provide insights for designing prevention and support programs that are acceptable to communities and cater to the needs of survivors. METHODS: An explorative qualitative study was conducted in Madhesh Province, southern Nepal. A total of 21 interviews, including 15 in-depth interviews (IDIs) with health care providers, three IDIs with women seeking general or maternal and child health services at health care centres, three key informant interviews with the local stakeholders working in the field of VAW, and one focus group discussion with violence survivors, were conducted in Nepali by trained field interviewers. Interviews were recorded, transcribed, translated into English, and analysed using content analysis. RESULTS: VAW, particularly physical violence, was a common experience in the study area. Sociocultural traditions such as dowry, child marriages and son preference were identifiable triggers for VAW, causing significant physical injuries and mental health problems, including suicide. Health care providers reported that violence survivors often hide their experiences of violence and do not seek any kind of help. Women feared that violence would increase in frequency and intensity if their perpetrators found out that they had disclosed their experiences of violence to health care providers. Local stakeholders emphasized the importance of engaging community leaders and garnering support from both women and men in interventions designed to reduce VAW and its impacts on mental health. CONCLUSIONS: Participants reported that verbal and physical violence is often perceived as a normal part of women's lives. Women should be made aware of available support services and empowered and supported to increase access and uptake of these services. Additionally, more individual-based counselling sessions that encourage women to escape violence and its mental health consequences while maintaining privacy and confidentiality are recommended.


Assuntos
Pesquisa Qualitativa , Humanos , Nepal , Feminino , Adulto , Saúde Mental , Masculino , Sobreviventes/psicologia , Pessoal de Saúde/psicologia , Pessoa de Meia-Idade , COVID-19/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Adulto Jovem , Grupos Focais
6.
Arch Womens Ment Health ; 27(2): 233-240, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38006427

RESUMO

Rohingya women are doubly marginalized owing to their ethnicity and gender. Therefore, this study aims to describe the unique experiences of violence faced by Rohingya women who fled Myanmar and Bangladesh to seek asylum in Malaysia before, during, and after their transit. Primary data were collected from 33 participants comprising Rohingya women refugees and asylum seekers, medical social workers, medical officials, volunteer workers/activists, refugee organization officers, and a mental health care provider. Thematic analysis was used to identify the patterns in and relationships between the concepts in the collected data. Rohingya women were exposed to various forms of violence and trauma by various groups of men, including those from their own community, throughout their journey to and in Malaysia. The lack of recognition of refugees and asylum seekers in Malaysia prevents them from having mainstream or legal access to jobs, education, and healthcare, and this predicament compounds their suffering from violence, especially for women and girls. Rohingya women and girls in Malaysia need better access to healthcare, resources, and support to identify and address violence, which has a significant impact on their health.


Assuntos
Refugiados , Violência , Masculino , Humanos , Feminino , Malásia/epidemiologia , Pesquisa Qualitativa , Refugiados/psicologia , Pessoal de Saúde
7.
BMC Public Health ; 24(1): 1022, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38609932

RESUMO

BACKGROUND: Violence against women (VAW) severely impacts their physical and mental health. In some cultures, women can normalize certain types of violence if they were linked to home models in childhood and, eventually, do not seek for help in adulthood. We aimed to determine, in Peruvian women, (1) the association between witnessing violence in their family of origin and VAW experienced in adulthood, (2) the extent to which women who have experienced VAW seek some help, and (3) identify VAW prevalence by Peruvian region. METHODS: Cross-sectional study of secondary data obtained from the 2019 National Demographic and Family Health Survey (ENDES). The outcome was VAW (psychological, physical and sexual violence), whereas the exposure was witnessing violence in the home of origin. Help-seeking behavior was a secondary outcome, for which VAW was the exposure. Prevalence ratios (PR) were estimated to assess both associations, unadjusted and adjusted for covariates (aPR). RESULTS: Data from 14,256 women aged 15 to 49 years were analysed. 51.5% reported having experienced VAW and 43.8% witnessed violence in the home of origin during childhood. Witnessing inter-parental violence in childhood was associated with psychological violence aPR = 1.25 (95% CI: 1.17-1.33), physical aPR = 1.52 (95% CI: 1.38-1.67), and sexual aPR = 1.99 (95% CI: 1.57-2.52). Women who have experienced both types of violence (physical and sexual) were more likely to help-seeking (aPR = 1.30, 95% CI: 1.14-1.50) than women suffering only one type of violence. CONCLUSION: Women who reported having witnessed home violence in their childhood are more likely to experience Violence Against Women (VAW) by their current partner. Physical and sexual violence with a current partner was more associated with witnessing inter-parental violence in childhood, and when physical and sexual violence jointly occurred women were more help-seeking. The southern region of Peru is identified as an area of high vulnerability for women. It is crucial to promote educative and community-based programs aimed at the prevention and early recognition of VAW.


Assuntos
Comportamento de Busca de Ajuda , Humanos , Feminino , Peru/epidemiologia , Estudos Transversais , Pais , Violência
8.
BMC Public Health ; 24(1): 1391, 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38783247

RESUMO

BACKGROUND: Intimate partner violence (IPV) is recognized as a main public health challenge, with serious consequences for women's physical, mental, sexual, and reproductive health. Despite its public health importance, most studies of IPV in Ethiopia mainly focused on individual characteristics and didn't identify how factors operating at different levels affect IPV. Thus, there is limited evidence regarding the hierarchical-level factors of IPV and the effect of individual and community-level determinants of IPV. The aim of this study is to assess the individual and community-level factors associated with violence against women among ever-married reproductive-age women in Ethiopia. METHODS: A retrospective analysis of secondary data retrieved from the Ethiopia Demographic and Health Survey was conducted among reproductive age group women (15-49 years of age) who reported ever being married within the available data set for the domestic violence module. STATA 14 was used to conduct the analysis. A two-level mixed-effects logistic regression analysis was used to determine associations between IPV and individual- and community-level factors. IPV variability across the community was assessed using ICC and PCV. The model's fitness was assessed using the Akaike information criterion (AIC), the Bayesian information criterion (BIC), and the likelihood ratio test. RESULT: The life time prevalence of IPV in this study was 33% [95% CI: 30.74, 34.25]. Women's age 20-24 (AOR = 5.85, 95% CI: 201 3.10, 11.04), 25-29 age group (AOR = 6.41, 95% CI; 3.34, 12.32), 30-34 age group (AOR = 9.48, 95% CI: 4.71, 19.06), 35-39 age group (AOR = 9.88, 95% CI: 4.79, 20.39), 40-44 age group (AOR = 11.10, 95% CI: 5.16, 23.89), and 45-49, (AOR = 14.15, 95% CI: 6.01, 32.80), early marriage (AOR = 1.21, 95% CI: 1.08, 1.47), witnessing inter-parental violence during childhood (AOR = 2.80, 95% CI: 2.16, 3.96), having a lot of living children (AOR = 0.45, 95% CI: 0.26, 0.74), having a partner who drank alcohol (AOR = 3.00, 95% CI: 2.42-3.67), decision-making autonomy of the women (AOR = 0.77, 95% CI: 0.62, 0.97), Poor wealth index (AOR = 1.64, 95% CI: 1.23, 2.18), middle wealth index (AOR = 1.86, 95% CI: 1.36, 2.54) and exposure to media (AOR = 1.47, 95% CI: 1.06, 2.00) were all significantly associated with IPV. CONCLUSION AND RECOMMENDATION: This study showed that one-third of the women experienced IPV in their lifetime. The finding suggested that community based interventions and multi-sectorial collaborations are needed to reduce the IPV and its adverse consequences.


Assuntos
Inquéritos Epidemiológicos , Violência por Parceiro Íntimo , Humanos , Feminino , Etiópia/epidemiologia , Adulto , Adolescente , Violência por Parceiro Íntimo/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto Jovem , Estudos Retrospectivos , Prevalência , Fatores de Risco , Análise Multinível , Fatores Socioeconômicos
9.
BMC Public Health ; 24(1): 1944, 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39030550

RESUMO

BACKGROUND: Myths of sexual aggression have a negative influence in aggressive behavior against women, in the institutional approaches to sexual violence and in how women cope with it. The objective of this study is to describe acceptance of myths of sexual aggression in young women and men residing in Spain. METHOD: Cross-sectional study carried out online with 2,515 women (50.2%) and men (49.8%) ages 18-35 in Spain in 2020. Information on myths was collected using the Acceptance of Modern Myths About Sexual Aggression Scale (AMMSA). We described the myths most prevalent among women and men. The variables associated with myths were identified using multiple regression. The regression models were adjusted by sociodemographic and sexual orientation variables. RESULTS: The average AMMSA values were higher among men [mean: 3.11; standard deviation (sd):1.23] than among women (mean 2.49 sd:1.11). In both sexes, the myths with greater acceptance showed the presence of patriarchal gender roles in sexual contacts. Men were more likely than women to accept myths that question allegations and severity of violence. Having a higher level of educational studies (ß -0.350 sd: 0.046) was associated with lower average AMMSA values. Being born in Latin America (ß 0.047 sd: 0.063) was associated with higher average AMMSA values. Among heterosexual men, AMMSA values were greater than among gay and bisexual men. Among women, there was no difference in average AMMSA values based on sexual orientation. CONCLUSIONS: Myths persist during youth that question and trivialize sexual violence against women. It is necessary to implement strategies that reduce these myths, particularly in heterosexual men, in those of foreign-born origin and among those with low levels of education.


Assuntos
Agressão , Delitos Sexuais , Humanos , Espanha , Masculino , Estudos Transversais , Feminino , Adulto , Adulto Jovem , Adolescente , Agressão/psicologia , Delitos Sexuais/estatística & dados numéricos , Delitos Sexuais/psicologia , Inquéritos e Questionários , Comportamento Sexual/estatística & dados numéricos , Comportamento Sexual/psicologia
10.
BMC Public Health ; 24(1): 397, 2024 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-38326852

RESUMO

BACKGROUND: Intimate Partner Violence (IPV) exposes women and children to a wide range of challenges across housing, employment, social connections, and child well-being and is a public health issue. IPV survivors are at heightened risk of housing insecurity and homelessness. Emergency shelters have historically offered respite and support, but the emergence of second-stage shelters provides longer-term solutions. Despite their significance, there has been a lack of comprehensive research on second-stage shelters. This study focuses on understanding the needs of IPV survivors accessing second-stage shelters, aiming to illuminate unexplored aspects of support. To examine the current published peer-reviewed literature and gray literature on second-stage shelters, a scoping review was conducted. METHODS: This scoping review used the method suggested by Arksey & O'Malley (2005) and considered all studies that focused on women who had experienced IPV and were accessing transitional housing/second-stage shelters. RESULTS: Sixteen articles, mainly from the USA and published between 1985 and 2022, were included in the analysis. The findings highlighted themes of (1) a safe(r) place, with the subtheme of 'gated' communities, and (2) programming and services, with the subtheme of does one size fit all? and (3) insider support, with subthemes of paid insider support and peer insider support. CONCLUSIONS: Housing instability was evident, and the need for multiple and individualized tailored options of programming and support along with housing security was identified. Second-stage housing policy and practice implications are addressed which illuminate unexplored aspects of support.


Assuntos
Habitação , Violência por Parceiro Íntimo , Criança , Humanos , Feminino , Instabilidade Habitacional , Aconselhamento , Sobreviventes
11.
BMC Public Health ; 24(1): 1463, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822292

RESUMO

BACKGROUND: spousal violence against women (SVAW) is a common form of violence that occurs within the family context, with spouses being the main perpetrators. Afghanistan has one of the highest rates of SVAW in the world, and its impact on reproductive health and fertility is not well understood. This study aims to investigate the extent to which SVAW influences the total fertility rate (TFR) of Afghan women. METHODS: In this study, a regression model of discrete-time survival models was used to calculate the total fertility rate (TFR), parity progression ratio (PPRs), and average closed birth intervals (CBI) between two children. The method used in this study has its roots in the works of Griffin Finney (1983) and was further developed by Redford et al. (2010). The study population utilized the 2015 Afghanistan Demographic and Health Survey, and sample weights were used to ensure accurate estimates for the population of Afghanistan as a whole. RESULTS: The study found that women in Afghanistan who have experienced SV are more likely to progress to the next parity, start childbearing faster, and continue to do so. Women who have not experienced SV tend to progress to higher parities at a slower pace during their initial reproductive years. The study also suggests that women with spousal violence (SV) experience may have slightly higher fertility rates and shorter birth intervals for certain birth orders, although the differences between the two groups are generally small. Specifically, the total fertility rate (TFR) for women who experienced SV was 6.9, while the TFR for women who did not experience SV was 6.2. CONCLUSIONS: These results provide valuable information for policymakers and public health professionals in developing effective policies and programs to address SVAW and improve maternal and child health outcomes in Afghanistan.


Assuntos
Coeficiente de Natalidade , Humanos , Afeganistão , Feminino , Adulto , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto Jovem , Adolescente , Pessoa de Meia-Idade , Inquéritos Epidemiológicos , Gravidez
12.
BMC Public Health ; 24(1): 51, 2024 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-38166754

RESUMO

BACKGROUND: The necessary execution of non-pharmaceutical risk-mitigation (NPRM) strategies to reduce the transmission of COVID-19 has created an unprecedented natural experiment to ascertain whether pandemic-induced social-policy interventions may elevate collateral health risks. Here, we assess the effects on violence against women (VAW) of the duration of NPRM measures that were executed through jurisdictional-level orders in the United States. We expect that stay-at-home orders, by reducing mobility and disrupting non-coresident social ties, are associated with higher incident reporting of VAW. METHODS: We used aggregate data from the Murder Accountability Project from January 2019 through December 2020, to estimate count models examining the effects of the duration of jurisdictional-level (N = 51) stay-at-home orders on femicide. Additionally, we used data from the National Incident-Based Reporting System to estimate a series of count models that examined the effects of the duration of jurisdictional-level (N = 26) stay-at-home orders on non-lethal violence against women, including five separate measures of intimate partner violence (IPV) and a measure of non-partner sexual violence. RESULTS: Results from the count models indicated that femicide was not associated with COVID-19 mitigation strategies when adjusted for seasonal effects. However, we found certain measures of non-lethal VAW to be significantly associated in adjusted models. Specifically, reported physical and economic IPV were positively associated with stay-at-home orders while psychological IPV and non-partner sexual violence were negatively associated with stay-at-home orders. The combination measure of all forms of IPV was positively associated with the duration of stay-at-home orders, indicating a net increase in risk of IPV during lockdowns. CONCLUSIONS: The benefits of risk-mitigation strategies to reduce the health impacts directly associated with a pandemic should be weighed against their costs with respect to women's heightened exposure to certain forms of violence and the potentially cascading impacts of such exposure on health. The effects of COVID-19 NPRM strategies on IPV risk nationally and its immediate and long-term health sequelae should be studied, with stressors like ongoing pandemic-related economic hardship and substance misuse still unfolding. Findings should inform the development of social policies to mitigate the collateral impacts of crisis-response efforts on the risk of VAW and its cascading sequelae.


Assuntos
COVID-19 , Violência por Parceiro Íntimo , Humanos , Feminino , Estados Unidos/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Fatores de Risco , Prevalência , Controle de Doenças Transmissíveis , Violência , Violência por Parceiro Íntimo/prevenção & controle
13.
BMC Public Health ; 24(1): 33, 2024 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-38166875

RESUMO

BACKGROUND: Violence against women (VAW) research is a sensitive topic, which has been conducted mainly using face-to-face methods. The COVID-19 pandemic lockdown and restrictions on movement presented an opportunity to conduct VAW research using remote methods. We discuss how we adapted methods, reflect on lessons learned, and make recommendations highlighting key considerations when conducting remote research on a sensitive topic of VAW. METHODS: We designed and conducted an exploratory qualitative study using remote methods with 18 men and 19 women, aged 18 years and older, who lived with their partner or spouse during lockdown in South Africa. The aim of the study was to explore experiences of COVID-19 lockdown, and its link to women and children's experiences of violence in the homes. Data presented in this paper draws from researchers' reflections drawn from debriefing sessions during the research process, and from participants' interview transcripts. FINDINGS: Remote recruitment of participants took longer than anticipated, and we had to re-advertise the study. We could not ensure safety and privacy during interviews. Regardless of all the safety and privacy measures we put in place during the research process, some participants had an adult person present in the room during interviews, and the researchers had no control over interruptions. Rapport was difficult to establish without an in-person connection, which limited disclosure about violence experience (amongst women) and perpetration (amongst men). CONCLUSIONS: Given the methodological and ethical challenges which limited disclosure of VAW remotely, we conclude that telephone interviews used in our study impacted on the quality of study data. Therefore, we do not recommend VAW research to be conducted remotely, unless it is essential and participants are already known to the interviewer and trust has been established.


Assuntos
COVID-19 , Violência por Parceiro Íntimo , Adulto , Masculino , Criança , Humanos , Feminino , África do Sul/epidemiologia , Pandemias , Controle de Doenças Transmissíveis , Violência , Pesquisa Qualitativa
14.
BMC Med Ethics ; 25(1): 32, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38504254

RESUMO

BACKGROUND: Studying global health problems requires international multidisciplinary teams. Such multidisciplinarity and multiculturalism create challenges in adhering to a set of ethical principles across different country contexts. Our group on health system responses to violence against women (VAW) included two universities in a European high-income country (HIC) and four universities in low-and middle-income countries (LMICs). This study aimed to investigate professional and policy perspectives on the types, causes of, and solutions to ethical challenges specific to the ethics approval stage of the global research projects on health system responses to VAW. METHODS: We used the Network of Ethical Relationships model, framework method, and READ approach to analyse qualitative semi-structured interviews (n = 18) and policy documents (n = 27). In March-July 2021, we recruited a purposive sample of researchers and members of Research Ethics Committees (RECs) from the five partner countries. Interviewees signposted policies and guidelines on research ethics, including VAW. RESULTS: We developed three themes with eight subthemes summarising ethical challenges across three contextual factors. The global nature of the group contributed towards power and resource imbalance between HIC and LMICs and differing RECs' rules. Location of the primary studies within health services highlighted differing rules between university RECs and health authorities. There were diverse conceptualisations of VAW and vulnerability of research participants between countries and limited methodological and topic expertise in some LMIC RECs. These factors threatened the timely delivery of studies and had a negative impact on researchers and their relationships with RECs and HIC funders. Most researchers felt frustrated and demotivated by the bureaucratised, uncoordinated, and lengthy approval process. Participants suggested redistributing power and resources between HICs and LMICs, involving LMIC representatives in developing funding agendas, better coordination between RECs and health authorities and capacity strengthening on ethics in VAW research. CONCLUSIONS: The process of ethics approval for global research on health system responses to VAW should be more coordinated across partners, with equal power distribution between HICs and LMICs, researchers and RECs. While some of these objectives can be achieved through education for RECs and researchers, the power imbalance and differing rules should be addressed at the institutional, national, and international levels. Three of the authors were also research participants, which had potential to introduce bias into the findings. However, rigorous reflexivity practices mitigated against this. This insider perspective was also a strength, as it allowed us to access and contribute to more nuanced understandings to enhance the credibility of the findings. It also helped to mitigate against unequal power dynamics.


Assuntos
Comitês de Ética em Pesquisa , Violência , Humanos , Feminino , Pesquisa Qualitativa , Renda , Projetos de Pesquisa
15.
Health Res Policy Syst ; 22(1): 71, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38914999

RESUMO

BACKGROUND: Despite a large growth in evidence on violence against women (VAW) over the last 25 years, VAW persists, as do gaps in the field's knowledge of how to prevent and respond to it. To ensure that research on VAW in low- and middle-income countries (LIMCs) is addressing the most significant gaps in knowledge, and to prioritise evidence needs to reduce VAW and better support victims/survivors, the Sexual Violence Research Initiative (SVRI) and Equality Institute (EQI) led a process of developing a global shared research agenda (GSRA) on VAW in LMICs. METHODS: The GSRA was developed through a six-stage adaptation of the Child Health and Nutrition Research Initiative (CHNRI) method, which draws on the principle of the 'wisdom of the crowd'. These steps included: a review of the literature on VAW in LMICs and development of domains; the generation of research questions within four domains by an Advisory Group; the consolidation of research questions; scoring of research questions by a Global Expert Group and the Advisory Group according to three criteria (applicability, effectiveness and equity); consultation and validation of the findings with the Advisory Group; and wide dissemination of the findings. RESULTS: The highest ranked research questions in the GSRA pertain to the domain of Intervention research, with some highly ranked questions also pertaining to the domain of Understanding VAW in its multiple forms. Questions under the other two domains, Improving existing interventions, and Methodological and measurement gaps, were not prioritised as highly by experts. There was strong consistency in top ranked research questions according to experts' characteristics, albeit with some important differences according to experts' gender, occupation and geographical location. CONCLUSIONS: The GSRA findings suggest that currently the VAW field is shifting towards intervention research after several decades of building evidence on understanding VAW, including prevalence, drivers and impacts of violence. The findings also suggest a strong emphasis on under-served populations, and under-researched forms of VAW. Future priority setting exercises in LMICs that seek to decolonise knowledge should ensure that methodologies, and modalities of engagement, put diverse voices at the centre of engagement. Trial registration Not applicable.


Assuntos
Países em Desenvolvimento , Humanos , Feminino , Pesquisa , Violência de Gênero/prevenção & controle , Delitos Sexuais/prevenção & controle , Saúde Global , Violência/prevenção & controle
16.
Violence Vict ; 39(1): 21-37, 2024 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-38453372

RESUMO

This study examined 1,134 cases of violence against women in intimate partner relationships with violations of protective orders in a monitoring period of up to 15 months. The dynamics of time and violence were analyzed in the cases of multiple violation versus one-time violation, with the objective of identifying and thus neutralizing the risk factors for this type of recidivism. The results showed that early violation, serious physical violence, death threats, as well as jealousy, harassment, and control are related to multiple violation. This article discusses the results in comparison with other research and proposes measures to avoid revictimizations.


Assuntos
Violência por Parceiro Íntimo , Maus-Tratos Conjugais , Humanos , Feminino , Maus-Tratos Conjugais/prevenção & controle , Comportamento Sexual , Parceiros Sexuais , Fatores de Risco , Violência , Violência por Parceiro Íntimo/prevenção & controle
17.
Afr J Reprod Health ; 28(2): 116-124, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38425273

RESUMO

The study was cross-sectional research that surveyed 410 nurses and midwives from March 2020 to March 2021 in Turkey. The aim of this study was to evaluate the knowledge and attitudes of nurses and midwives towards recognizing violence against women. The "Scale for Nurses' and Midwives' Recognition of the Symptoms of Violence against Women" were used. The average total scale score was 20.3 ± 3.2. The score of participants who are receiving postgraduate education, working in the field of gynaecology and obstetrics, and considering intervention as a professional responsibility when encountering a woman who has experienced violence was found to be significantly higher than the other groups (p<.05). It is important for midwives and nurses to be aware of signs of violence to identify violence against women. Providing education to midwives and nurses regarding signs of violence against women will contribute to the recognition, prevention, and awareness of violence.


L'étude était une recherche transversale qui a enquêté sur 410 infirmières et sages-femmes de mars 2020 à mars 2021 en Turquie. L'objectif de cette étude est d'évaluer les connaissances et les attitudes des infirmières et des sages-femmes envers la reconnaissance de la violence contre les femmes. L'échelle de reconnaissance des symptômes de la violence contre les femmes des infirmières et des sages-femmes a été utilisée. Le score moyen total de l'échelle était de 20,3 ± 3,2. Le score des participants qui suivent une formation de troisième cycle, travaillant dans le domaine de la gynécologie et de l'obstétrique, et considérant l'intervention comme une responsabilité professionnelle lorsqu'ils rencontrent une femme victime de violence s'est avéré significativement plus élevé que les autres groupes (p<.001). Il est important que les sages-femmes et les infirmières soient conscientes des signes de violence pour identifier la violence contre les femmes. Fournir une éducation aux sages-femmes et aux infirmières concernant les signes de violence contre les femmes contribuera à la reconnaissance, à la prévention et à la sensibilisation à la violence.


Assuntos
Tocologia , Enfermeiras e Enfermeiros , Gravidez , Feminino , Humanos , Tocologia/educação , Atitude do Pessoal de Saúde , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Violência , Inquéritos e Questionários
18.
Aten Primaria ; 2024 Mar 26.
Artigo em Espanhol | MEDLINE | ID: mdl-38538482

RESUMO

Intimate partner violence against women (IPV) has devastating effects on the healthcare and well-being of women and their children. Physical, psychological, and social consequences, a worse perception of their own health, and loss of quality of life are well-documented, while aftereffects persist in time even after the end of abuse. Psychological consequences of abuse last longer and are more serious. IPV also affects sons and daughters, disabled people, family, and the attacker himself. Many health problems, both physical and mental, that lead women to go to healthcare services in search of help have an origin in the violence they experience. Treatment of the symptoms without awareness of its relation to such violence favours medicalization, iatrogenesis, and chronification. Psychological violence poses a threat that is invisible, subtle, cumulative, and difficult to detect; it is, however, the most destructive.

19.
Prev Med ; 166: 107379, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36495926

RESUMO

Violence against women is rampant in China. Even though meaningful strides have been made in the country, it remains disturbingly common for men to assault women-verbally or physically, who may or may not be their partners-in broad daylight in China. To make the situation worse, COVID-19, along with its restrictions, has both undermined women's ability to escape from abuse or violence and society's ability to provide timely help to victims. In light of the rising violence against women post-COVID, in this paper, we discuss the policy imperatives for countries like China to establish effective guardrails and support systems to protect women from the dehumanizing and destabilizing crime that is violence against women-a social malaise that not only harms and undermines the safety of society's daughters, mothers, and grandmothers, but also the integrity of local communities and social contract, let along shared humanity and global solidarity at large.


Assuntos
COVID-19 , Violência Doméstica , Feminino , Humanos , Pandemias/prevenção & controle , COVID-19/prevenção & controle , Violência , Crime , Políticas , Violência Doméstica/prevenção & controle
20.
Int J Equity Health ; 22(1): 204, 2023 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-37789397

RESUMO

BACKGROUND: Women living in indigenous communities in Peru currently experience extremely high rates of intimate partner violence (IPV). Over the past 10 years, there has been a large multi-sectoral initiative to establish a national network of Centros de Emergencia de la Mujer (Women's Emergency Centres) that integrate health and police services, and substantial increase in efforts from non-governmental organisations in supporting survivors of violence. However, there is currently little evidence on how existing services meet the needs of indigenous women experiencing violence in Peru. METHODS: As part of a broader mixed-methods participatory VAWG prevention study, we assessed existing service provision for women experiencing violence in an indigenous Quechua community from Amantaní, Peru. This involved 17 key informant interviews with legal, government, police, and civil society representatives. We used the UN Women Essential Services Package for Women and Girls Subject to Violence framework to guide our analysis. RESULTS: Participants identified major gaps in existing services for indigenous women survivors of violence in Peru. They discussed survivors and perpetrators not being identified by the health system, a lack of IPV response training for health professionals, IPV not being prioritised as a health concern, and a lack of health services that are culturally appropriate for indigenous populations. Survivors who report to police are often treated poorly and discriminated against. Legal systems were perceived as insufficient and ineffective, with inadequate legal measures for perpetrators. While legal and policy frameworks exist, they are often not applied in practice. Service provision in this region needs to adopt an intercultural, rights based, gendered approach to IPV response and prevention, considering cultural and linguistic relevance for indigenous populations. CONCLUSION: The role of structural violence in perpetuating indigenous women's experiences of violence and undermining their access to services must be central to designing and implementing appropriate policies and services if they are to meet the needs of indigenous women in Peru.


Assuntos
Violência por Parceiro Íntimo , Violência , Feminino , Humanos , Peru , Violência/prevenção & controle , Grupos Populacionais , Sobreviventes
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