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1.
BMJ Glob Health ; 8(5)2023 05.
Article in English | MEDLINE | ID: covidwho-20241254

ABSTRACT

Changes in research practice during the COVID-19 pandemic necessitates renewed attention to ethical protocols and reporting for data collection on sensitive topics. This review summarises the state of ethical reporting among studies collecting violence data during early stages of the pandemic. We systematically searched for journal publications from the start of the pandemic to November 2021, identifying 75 studies that collected primary data on violence against women and/or violence against children. We developed and applied a 14-item checklist of best practices to assess the transparency of ethics reporting and adherence to relevant global guidelines on violence research. Studies reported adhering to best practices on 31% of scored items. Reporting was highest for ethical clearance (87%) and informed consent/assent (84/83%) and lowest for whether measures to promote interviewer safety and support (3%), for facilitating referrals for minors and soliciting participant feedback were in place (both 0%). Violence studies employing primary data collection during COVID-19 reported on few ethical standards, obscuring stakeholder ability to enforce a 'do no harm' approach and to assess the reliability of findings. We offer recommendations and guidelines to improve future reporting and implementation of ethics within violence studies.


Subject(s)
COVID-19 , Pandemics , Child , Female , Humans , Checklist , Reproducibility of Results , Violence/prevention & control
2.
Reprod Health ; 20(1): 41, 2023 Mar 09.
Article in English | MEDLINE | ID: covidwho-2289125

ABSTRACT

BACKGROUND: Contraceptive use among young women in Nairobi remains low despite high general knowledge of family planning (FP) methods. This paper draws on social norms theory to explore the role of key influencers (partners, parents and friends) in women's FP use and how women anticipate normative reactions or sanctions. METHODS: A qualitative study with 16 women, 10 men and 14 key influencers across 7 peri-urban wards in Nairobi, Kenya. Interviews were conducted during the COVID-19 pandemic in 2020 by phone. A thematic analysis was conducted. RESULTS: Women identified parents, specifically mothers, aunts, partners, friends and healthcare workers as key influencers on FP. Their interactions with these key influencers varied based on trust, the information they needed about FP, and whether they perceived a key influencer to perpetuate or challenge existing social norms on FP. Mothers were perceived to understand the social risks of using FP and thus could advise on discreet FP use, and aunts were trusted and approachable sources to impartially describe the benefits and drawbacks of FP. Although women identified partners as key FP decision makers, they were cognisant of possible power imbalances affecting a final FP choice. CONCLUSIONS: FP interventions should consider the normative influence key actors have on women's FP choices. Opportunities to design and deliver network-level interventions which seek to engage with social norms surrounding FP in order to challenge misconceptions and misinformation among key influencers should be explored. Intervention design should consider dynamics of secrecy, trust and emotional closeness that mediate discussions of FP to address changing norms. Further training to change norms held by healthcare providers about why women, in particular unmarried young women, access FP should be provided to reduce barriers for FP access.


Women's decisions to use family planning (FP) are influenced by social norms, the unwritten rules of appropriate actions within social networks, and are shaped by advice and information received from key influencers­important individuals who shape what is acceptable within social networks. The aim of this study was to understand how key influencers uphold and transmit information and norms about FP, and explore who women consult as they make FP decisions and why they consult these key influencers.We interviewed 16 women, 10 partners and 14 key influencers in peri-urban Nairobi, Kenya.We found that key influencers for decisions about FP included mothers, aunts, partners, friends and healthcare providers. In making a decision about FP use, women consulted key influencers based on who they deemed trustworthy to keep their FP use secret and described less trust to speak with men about FP in their social networks. Mothers understood the social risks of using FP and so could advise on its discreet use, and aunts were approachable sources of impartial information about FP. Although women identified partners as key decision makers, they were aware that power imbalances might affect final FP choices.Our findings underscore the importance of FP interventions working with women's social networks and to address social norms influencing women's decisions in using FP. Interventions to change FP norms should consider dynamics of secrecy, trust and emotional closeness that affect FP discussions among women's networks.


Subject(s)
COVID-19 , Friends , Male , Humans , Female , Pandemics , Kenya , Family Planning Services , Parents
3.
Child Soc ; 2022 Sep 05.
Article in English | MEDLINE | ID: covidwho-2240098

ABSTRACT

Uganda had the longest period of school closures worldwide as a response measure during the Covid-19 pandemic. Drawing on longitudinal qualitative data from the Contexts of Violence in Adolescence Cohort Study (CoVAC) (2018-2023), we examine how this has affected the lives of adolescents in Uganda. Our analysis showcases how intersecting inequities based on socioeconomic circumstances, gender and location have intensified, with detrimental effects on young people's educational paths and life circumstances. Strategies that take the intersections of these inequities into account are urgently needed to help the most disadvantaged and marginalized young people return to school.

4.
BMJ Glob Health ; 7(11)2022 11.
Article in English | MEDLINE | ID: covidwho-2119186

ABSTRACT

Collecting data to understand violence against women and children during and after the COVID-19 pandemic is essential to inform violence prevention and response efforts. Although researchers across fields have pivoted to remote rather than in-person data collection, remote research on violence against women, children and young people poses particular challenges. As a group of violence researchers, we reflect on our experiences across eight studies in six countries that we redesigned to include remote data collection methods. We found the following areas were crucial in fulfilling our commitments to participants, researchers, violence prevention and research ethics: (1) designing remote data collection in the context of strong research partnerships; (2) adapting data collection approaches; (3) developing additional safeguarding processes in the context of remote data collection during the pandemic; and (4) providing remote support for researchers. We discuss lessons learnt in each of these areas and across the research design and implementation process, and summarise key considerations for other researchers considering remote data collection on violence.


Subject(s)
COVID-19 , Child , Humans , Female , Adolescent , Pandemics , Violence/prevention & control
5.
SSM Qual Res Health ; 2: 100031, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1991275

ABSTRACT

The COVID-19 response has profoundly affected women's access to family planning services in Kenya. While prior studies have shown how the COVID-19 response created barriers to accessing family planning (FP) services, less is known about how the pandemic affected the normative influence that partners, peers, and health providers exert on women's FP choices. In this qualitative study, we interviewed 16 women (aged 18-25 years), 10 men in partnerships with women, and 14 people in women's social networks across 7 low-income wards in Nairobi, Kenya. Our findings suggest that COVID-19 response measures changed the contexts of normative influence on FP: financial insecurity, increased time at home with husbands or parents, and limited access to seek the support of health workers, friends, and other people in their social network affected how women negotiated FP access and use within their homes. Our study underscores the importance of ensuring FP is an essential service in a pandemic, and of developing health programs that change norms about FP to address the gendered burden of negotiating FP during COVID-19 and beyond.

6.
Bull World Health Organ ; 99(10): 730-738, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1463418

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has affected children's risk of violence in their homes, communities and online, and has compromised the ability of child protection systems to promptly detect and respond to cases of violence. However, the need to strengthen violence prevention and response services has received insufficient attention in national and global pandemic response and mitigation strategies. In this paper, we summarize the growing body of evidence on the links between the pandemic and violence against children. Drawing on the World Health Organization's INSPIRE framework to end violence against children, we illustrate how the pandemic is affecting prevention and response efforts. For each of the seven INSPIRE strategies we identify how responses to the pandemic have changed children's risk of violence. We offer ideas for how governments, policy-makers, and international and civil society organizations can address violence in the context of a protracted COVID-19 crisis. We conclude by highlighting how the current pandemic offers opportunities to improve existing child protection systems to address violence against children. We suggest enhanced multisectoral coordination across the health, education, law enforcement, housing, child and social protection sectors. Actions need to prioritize the primary prevention of violence and promote the central role of children and adolescents in decision-making and programme design processes. Finally, we stress the continued need for better data and evidence to inform violence prevention and response strategies that can be effective during and beyond the COVID-19 pandemic.


La pandémie de maladie à coronavirus 2019 (COVID-19) a eu un impact sur le risque de violence à l'égard des enfants à domicile, au sein de leur communauté et en ligne. Elle a également empêché les systèmes de protection de l'enfance d'identifier rapidement les situations de ce type et d'y réagir dès que possible. Pourtant, la nécessité de renforcer les services de prévention et d'action en la matière n'a pas été suffisamment prise en compte dans les stratégies nationales et internationales d'intervention et d'atténuation des effets de la pandémie. Le présent document reprend l'accumulation de preuves confirmant les liens entre pandémie et violence à l'égard des enfants. En nous inspirant du cadre INSPIRE de l'Organisation mondiale de la Santé visant à mettre fin à la violence à l'encontre des enfants, nous illustrons la façon dont la pandémie affecte les efforts de prévention et d'action. Pour chacune des sept stratégies INSPIRE, nous déterminons comment les mesures de lutte contre la pandémie ont influencé le risque de violence envers les enfants. Nous formulons des pistes pour que les gouvernements, les législateurs, les institutions internationales et les organisations de la société civile puissent remédier à cette violence dans un contexte de crise prolongée due à la COVID-19. En guise de conclusion, nous mettons en lumière les opportunités qu'offre la pandémie actuelle d'améliorer les systèmes existants de protection de l'enfance pour mieux combattre la violence envers les enfants. Nous suggérons d'accroître la collaboration entre les secteurs de la santé, de l'éducation, du maintien de l'ordre, du logement, des droits de l'enfant et de la protection sociale. Les actions entreprises doivent se focaliser sur la prévention primaire de la violence et promouvoir le rôle central des enfants et adolescents dans les processus de conception de programmes et de prise de décisions. Enfin, nous soulignons le besoin permanent de données et de preuves fiables pour orienter les stratégies de prévention et d'intervention face à la violence, afin de garantir leur efficacité pendant et après la pandémie de COVID-19.


La pandemia de la enfermedad por coronavirus (COVID-19) ha afectado al riesgo de violencia infantil que sufren los niños en sus hogares, comunidades y en línea, y ha puesto en peligro la capacidad de los sistemas de protección infantil para detectar y responder rápidamente a los casos de violencia. Sin embargo, la necesidad de reforzar los servicios de prevención y respuesta a la violencia no ha recibido suficiente atención en las estrategias nacionales y mundiales de respuesta y mitigación de la pandemia. En este documento, resumimos el creciente conjunto de pruebas sobre los vínculos entre la pandemia y la violencia infantil. Basándonos en el marco INSPIRE de la Organización Mundial de la Salud para poner fin a la violencia infantil, ilustramos cómo la pandemia está afectando a los esfuerzos de prevención y respuesta. Para cada una de las siete estrategias de INSPIRE, identificamos cómo las respuestas a la pandemia han cambiado el riesgo de violencia infantil. Ofrecemos ideas sobre cómo los gobiernos, los responsables políticos y las organizaciones internacionales y de la sociedad civil pueden abordar la violencia en el contexto de una crisis prolongada de COVID-19. Concluimos destacando cómo la pandemia actual ofrece oportunidades para mejorar los sistemas de protección infantil existentes para abordar este tipo de violencia. Sugerimos una mayor coordinación multisectorial en los sectores de la salud, la educación, la aplicación de la ley, la vivienda y la protección social infantil. Las acciones deben priorizar la prevención primaria de la violencia y promover el papel central de los niños y adolescentes en los procesos de toma de decisiones y en el diseño de programas. Por último, subrayamos la necesidad permanente de contar con mejores datos y pruebas para fundamentar las estrategias de prevención y respuesta a la violencia que puedan ser eficaces durante la pandemia de COVID-19 y seguir vigentes cuando ésta pase.


Subject(s)
COVID-19 , Pandemics , Adolescent , Child , Global Health , Humans , Pandemics/prevention & control , SARS-CoV-2 , Violence/prevention & control
7.
BMJ Glob Health ; 6(5)2021 05.
Article in English | MEDLINE | ID: covidwho-1216802

ABSTRACT

Since early 2020, global stakeholders have highlighted the significant gendered consequences of the COVID-19 pandemic, including increases in the risk of gender-based violence (GBV). Researchers have sought to inform the pandemic response through a diverse set of methodologies, including early efforts modelling anticipated increases in GBV. For example, in April 2020, a highly cited modelling effort by the United Nations Population Fund (UNFPA) and partners projected headline global figures of 31 million additional cases of intimate partner violence due to 6 months of lockdown, and an additional 13 million child marriages by 2030. In this paper, we discuss the rationale for using modelling to make projections about GBV, and use the projections released by UNFPA to draw attention to the assumptions and biases underlying model-based projections. We raise five key critiques: (1) reducing complex issues to simplified, linear cause-effect relationships, (2) reliance on a small number of studies to generate global estimates, (3) assuming that the pandemic results in the complete service disruption for existing interventions, (4) lack of clarity in indicators used and sources of estimates, and (5) failure to account for margins of uncertainty. We argue that there is a need to consider the motivations and consequences of using modelling data as a planning tool for complex issues like GBV, and conclude by suggesting key considerations for policymakers and practitioners in using and commissioning such projections.


Subject(s)
COVID-19 , Gender-Based Violence , Models, Theoretical , Female , Gender-Based Violence/statistics & numerical data , Humans
8.
Child Abuse Negl ; 116(Pt 2): 104897, 2021 06.
Article in English | MEDLINE | ID: covidwho-987266

ABSTRACT

BACKGROUND: The COVID-19 pandemic could increase violence against children at home. However, collecting empirical data on violence is challenging due to ethical, safety, and data quality concerns. OBJECTIVE: This study estimated the anticipated effect of COVID-19 on violent discipline at home using multivariable predictive regression models. PARTICIPANTS: Children aged 1-14 years and household members from the Multiple Indicator Cluster Surveys (MICS) conducted in Nigeria, Mongolia, and Suriname before the COVID-19 pandemic were included. METHODS: A conceptual model of how the COVID-19 pandemic could affect risk factors for violent discipline was developed. Country specific multivariable linear models were used to estimate the association between selected variables from MICS and a violent discipline score which captured the average combination of violent disciplinary methods used in the home. A review of the literature informed the development of quantitative assumptions about how COVID-19 would impact the selected variables under a "high restrictions" pandemic scenario, approximating conditions expected during a period of intense response measures, and a "lower restrictions" scenario with easing of COVID-19 restrictions but with sustained economic impacts. These assumptions were used to estimate changes in violent discipline scores. RESULTS: Under a "high restrictions" scenario there would be a 35%-46% increase in violent discipline scores in Nigeria, Mongolia and Suriname, and under a "lower restrictions" scenario there would be between a 4%-6% increase in violent discipline scores in these countries. CONCLUSION: Policy makers need to plan for increases in violent discipline during successive waves of lockdowns.


Subject(s)
COVID-19 , Child Abuse , Adolescent , Adult , Aggression , Child , Child Abuse/statistics & numerical data , Child, Preschool , Female , Humans , Infant , Male , Nigeria/epidemiology , Pandemics , Prevalence , Punishment , Risk Factors , SARS-CoV-2 , Suriname/epidemiology , Surveys and Questionnaires
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