Suchergebnisse

Abstract
Background
The impacts of infectious disease outbreaks, epidemics, and pandemics are not gender neutral. Instead, infectious diseases and gender-based violence (GBV) mutually reinforce each other. Women and girls in humanitarian settings are disproportionately impacted as crises exacerbate gender inequality, violence, and community transmission. A syndemic model of infectious disease and GBV draws attention to their critical linkage, enabling more effective approaches to address both infectious disease transmission and GBV prevalence.

Main body
Implementation of infectious disease control measures have been consistently absent of critical gender considerations in humanitarian settings. We drew learnings from Ebola, Zika, and COVID-19 to highlight how women and girls living in humanitarian settings have faced bi-directional syndemic vulnerabilities between GBV and infectious disease. Our findings indicate that Ebola, Zika, and COVID-19 exacerbated GBV risk and experience of GBV increased community transmission of these infectious diseases. Moreover, we identified a failure of existing policies to address this mutually deleterious linkage. Thus, we advocate for policymakers to ask three foundational questions: (i) What are the gendered bi-directional risk pathways between infectious disease and GBV?; (ii) How can we act on the gendered risk pathways?; and, (iii) Who should be involved in designing, implementing, and evaluating gender-sensitive policies?

Conclusion
Our syndemic policy framework challenges existing thinking on a neglected issue that disproportionally impacts women and girls. By offering foundational guidance to address and thwart the syndemic of infectious disease and GBV in humanitarian settings, we endeavor to proactively and holistically address the reinforcing linkage between GBV and current or emergent infectious diseases.

BackgroundDuring humanitarian crises, women face both heightened vulnerabilities and a disruption to their social networks. Previous research points to the positive impact of women's collectives in low-income settings, but less is known about the distinct forms, mechanisms, and consequences of the social support that emerges from these collectives, particularly for women affected by conflict. Recognizing the importance of social support in such contexts, this study utilizes the photovoice methodology to examine the dynamics of social support across women's collectives in three distinct settings.MethodsThis study recruited forcibly displaced women participating in women's collectives in Indonesia (n = 5), Jordan (n = 12), and Uganda (n = 11). Photovoice, a participatory research method that centers the voices of study participants, was implemented across 7–8 sessions in each setting. Participants took photographs in response to four prompts and then discussed their pictures and lived experiences related to social support in facilitated discussion groups. Transcripts were analyzed using thematic analysis and a mixed inductive and deductive approach.ResultsAcross all study sites, participants highlighted the importance of five types of informal social support: emotional, instrumental, informational, companionship, and esteem support. Emotional support, one of the most prominently mentioned forms, served to buffer against stressors and enhance mental well-being. Instrumental and informational support facilitated meeting basic needs, accessing resources, and, in Uganda, improving members' physical safety. Companionship support fostered a sense of belonging and shared identity, while esteem support validated members' perspectives and aspirations and bolstered self-worth. In the Jordan collective, esteem support proved especially beneficial in countering the marginalization members experienced in their community.DiscussionFindings underscore the critical role of women's collectives in providing diverse forms of social support to foster empowerment, agency, and resilience among forcibly displaced women. By centering the voices of participants and employing survivor-centered approaches like photovoice, this study amplifies the perspectives of women within these collectives, contributing to more inclusive and responsive humanitarian interventions. Future research should continue prioritizing women's experiences and research questions, ensuring that interventions address their needs effectively.

Violence against women is increasingly being recognized as an urgent public health priority and a significant human rights concern, as well as a major threat to social and economic development. Globally, an estimated 20 percent of all women will face some form of violence during their lifetime, including emotional coercion, physical violence, and sexual violence. The overall objective of the impact evaluation is to identify low-cost and scalable interventions, which demonstrate improvements in social, psychological, and economic functioning of sexual violence survivors in eastern Democratic Republic of Congo (DRC). To this end, the authors conducted an impact evaluation of a village savings and loans association (VSLA) program to understand its impact on economic, social, and psychological outcomes for a sample of female sexual violence survivors. The impact evaluation had four components: (1) a qualitative needs assessment; (2) a quantitative baseline assessment; (3) a qualitative post-program assessment; and (4) a quantitative post-program assessment. This report presents a brief description of components 1 and 2 and then a full description of the method and results of the impact evaluation focusing on components 3 and 4. In terms of improving the psychological, social, and economic well-being of survivors of sexual violence, this study shows important results in some of the social and economic outcomes, but fewer results than expected for psychological outcomes. One recommendation from these results will be to explore the idea of pairing VSLA with other interventions to work more specifically on the certain outcomes that VSLA may not change on its own.

Background Violence against adolescent girls in humanitarian settings is of urgent concern given their additional vulnerabilities to violence and unique health and well-being needs that have largely been overlooked by the humanitarian community. In order to understand what works to prevent violence against adolescent girls, a multi-component curriculum-based safe spaces program (Creating Opportunities through Mentorship, Parental involvement and Safe Spaces – COMPASS) will be implemented and evaluated. The objectives of this multi-country study are to understand the feasibility, acceptability and effectiveness of COMPASS programming to prevent violence against adolescent girls in diverse humanitarian settings. Methods/design Two wait-listed cluster-randomized controlled trials are being implemented in conflict-affected communities in eastern Democratic Republic of Congo (N = 886 girls aged 10–14 years) and in refugee camps in western Ethiopia (N = 919 girls aged 13–19 years). The intervention consists of structured facilitated sessions delivered in safe spaces by young female mentors, caregiver discussion groups, capacity-building activities with service providers, and community engagement. In Ethiopia, the research centers on the overall impact of COMPASS compared to a wait-list group. In DRC, the research objective is to understand the incremental effectiveness of the caregiver component in addition to the other COMPASS activities as compared to a wait-list group. The primary outcome is change in sexual violence. Secondary outcomes include decreased physical and emotional abuse, reduced early marriage, improved gender norms, and positive interpersonal relationships, among others. Qualitative methodologies seek to understand girls' perceptions of safety within their communities, key challenges they face, and to identify potential pathways of change. Discussion These trials will add much needed evidence for the humanitarian community to meet the unique needs of adolescent girls and to promote their safety and well-being, as well as contributing to how multi-component empowerment programming for adolescent girls could be adapted across humanitarian settings. Trial registration Clinical Trials NCT02384642 (Registered: 2/24/15) and NCT02506543 (Registered: 7/19/15).