Working from home and intimate partner violence among cis-women during the COVID-19 pandemic: evidence from a global, cross-sectional study.

BACKGROUND: Intimate partner violence (IPV) may have been exacerbated during the COVID-19 pandemic. This analysis aimed to determine how employment disruption during COVID-19, including working from home, was associated with IPV experience among cis-gendered women. METHODS: The International Sexual Health and Reproductive health (I-SHARE) study is a cross-sectional online survey implemented in 30 countries during the pandemic. Samples used convenience, online panel, and population-representative methods. IPV was a pre-specified primary outcome, measured using questions from a validated World Health Organisation instrument. Conditional logistic regression modelling was used to quantify the associations between IPV and changes to employment during COVID-19, adjusted for confounding. RESULTS: 13,416 cis-gender women, aged 18-97, were analysed. One third were from low and middle income countries, and two thirds from high income countries. The majority were heterosexual (82.7%), educated beyond secondary-level (72.4%) and childless (62.7%). During COVID-19 33.9% women worked from home, 14.6% lost employment, and 33.1% continued to work on-site. 15.5% experienced some form of IPV. Women working from home experienced greater odds of IPV than those working on-site (adjusted OR 1.40, 95% CI 1.12-1.74, p = 0.003). This finding was robust independent of sampling strategy and country income. The association was primarily driven by an increase in psychological violence, which was more prevalent than sexual or physical violence. The association was stronger in countries with high gender inequality. CONCLUSIONS: Working from home may increase IPV risk globally. Workplaces offering working from home should collaborate with support services and research interventions to strengthen resiliency against IPV.

Service use related to violence against women and children during COVID-19

BackgroundGlobally, concerns have been raised that the priority implementation of public health measures in response to COVID-19 may have unintended negative impacts on a variety of other health and wellbeing factors, including violence.AimThis study examined the impact of COVID-19 response measures on changes in violence against women and children (VAWC) service utilisation across European countries.MethodsA rapid assessment design was used to compile quantitative data related to changes in VAWC service utilisation during COVID-19. This included a survey distributed across WHO Europe Healthy Cities Networks and Violence Injury Prevention Focal Points, and a scoping review of media reports, journal articles, and reports.ResultsOverall, findings suggested that there was a median reported increase in VAWC service utilisation of approximately 20% during the COVID-19 pandemic. Crucially, however, change in service utilisation differed across sectors with the highest median increase in utilisation for NGOs (48%), a relatively small median increase for law enforcement services (6%), and a small decrease for health and social services (-8%).ConclusionsThe variation across sectors in changes in VAWC service utilisation has important implications for policymakers in the event of ongoing and future restrictions related to COVID-19 and more generally during other times of prolonged presence in the home. The increased global attention on VAWC during the pandemic should be used to drive forward the agenda on prevention, increase access to services, and implement better data collection mechanisms, to ensure the momentum and increased focus on VAWC during the pandemic is not wasted.

Global, regional, and national prevalence estimates of physical or sexual, or both, intimate partner violence against women in 2018.

BACKGROUND: Intimate partner violence against women is a global public health problem with many short-term and long-term effects on the physical and mental health of women and their children. The Sustainable Development Goals (SDGs) call for its elimination in target 5.2. To monitor governments' progress towards SDG target 5.2, this study aimed to provide global, regional, and country baseline estimates of physical or sexual, or both, violence against women by male intimate partners. METHODS: This study developed global, regional, and country estimates, based on data from the WHO Global Database on Prevalence of Violence Against Women. These data were identified through a systematic literature review searching MEDLINE, Global Health, Embase, Social Policy, and Web of Science, and comprehensive searches of national statistics and other websites. A country consultation process identified additional studies. Included studies were conducted between 2000 and 2018, representative at the national or sub-national level, included women aged 15 years or older, and used act-based measures of physical or sexual, or both, intimate partner violence. Non-population-based data, including administrative data, studies not generalisable to the whole population, studies with outcomes that only provided the combined prevalence of physical or sexual, or both, intimate partner violence with other forms of violence, and studies with insufficient data to allow extrapolation or imputation were excluded. We developed a Bayesian multilevel model to jointly estimate lifetime and past year intimate partner violence by age, year, and country. This framework adjusted for heterogeneous age groups and differences in outcome definition, and weighted surveys depending on whether they were nationally or sub-nationally representative. This study is registered with PROSPERO (number CRD42017054100). FINDINGS: The database comprises 366 eligible studies, capturing the responses of 2 million women. Data were obtained from 161 countries and areas, covering 90% of the global population of women and girls (15 years or older). Globally, 27% (uncertainty interval [UI] 23-31%) of ever-partnered women aged 15-49 years are estimated to have experienced physical or sexual, or both, intimate partner violence in their lifetime, with 13% (10-16%) experiencing it in the past year before they were surveyed. This violence starts early, affecting adolescent girls and young women, with 24% (UI 21-28%) of women aged 15-19 years and 26% (23-30%) of women aged 19-24 years having already experienced this violence at least once since the age of 15 years. Regional variations exist, with low-income countries reporting higher lifetime and, even more pronouncedly, higher past year prevalence compared with high-income countries. INTERPRETATION: These findings show that intimate partner violence against women was already highly prevalent across the globe before the COVID-19 pandemic. Governments are not on track to meet the SDG targets on the elimination of violence against women and girls, despite robust evidence that intimate partner violence can be prevented. There is an urgent need to invest in effective multisectoral interventions, strengthen the public health response to intimate partner violence, and ensure it is addressed in post-COVID-19 reconstruction efforts. FUNDING: UK Department for International Development through the UN Women-WHO Joint Programme on Strengthening Violence against Women Data, and UNDP-UN Population Fund-UNICEF-WHO-World Bank Special Programme of Research, Development, and Research Training in Human Reproduction, a cosponsored programme executed by WHO.

The impact of COVID-19 and associated measures on health, police, and non-government organisation service utilisation related to violence against women and children.

BACKGROUND: Globally, concerns have been raised that the priority implementation of public health measures in response to COVID-19 may have unintended negative impacts on a variety of other health and wellbeing factors, including violence. This study examined the impact of COVID-19 response measures on changes in violence against women and children (VAWC) service utilisation across European countries. METHODS: A rapid assessment design was used to compile data including a survey distributed across WHO Europe Healthy Cities Networks and Violence Injury Prevention Focal Points in WHO European Region member states, and a scoping review of media reports, journal articles, and reports. Searches were conducted in English and Russian and covered the period between 1 January 2020 and 17 September 2020. Data extracted included: country; violence type; service sector; and change in service utilisation during COVID-19. All data pertained to the period during which COVID-19 related public health measures were implemented compared to a period before restrictions were in place. RESULTS: Overall, findings suggested that there was a median reported increase in VAWC service utilisation of approximately 20% during the COVID-19 pandemic. Crucially, however, change in service utilisation differed across sectors. After categorising each estimate as reflecting an increase or decrease in VAWC service utilisation, there was a significant association between sector and change in service utilisation; the majority of NGO estimates (95.1%) showed an increase in utilisation, compared to 58.2% of law enforcement estimates and 42.9% of health and social care estimates. CONCLUSIONS: The variation across sectors in changes in VAWC service utilisation has important implications for policymakers in the event of ongoing and future restrictions related to COVID-19, and more generally during other times of prolonged presence in the home. The increased global attention on VAWC during the pandemic should be used to drive forward the agenda on prevention, increase access to services, and implement better data collection mechanisms to ensure the momentum and increased focus on VAWC during the pandemic is not wasted.

Women's Narratives about COVID-19, Preventive Practices and Sources of Information in Northwestern Tanzania.

COVID-19 has affected millions of people across the world. We conducted a phone based qualitative study to explore women's perceptions of COVID-19, knowledge of its symptoms, transmission, and prevention practices in Northwestern Tanzania. We also examined their sources of information about the disease. Findings show that much of women's framing of etiology, symptoms, and transmission routes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) greatly reflects the World Health Organization (WHO)/Centers for Diseases Control and Prevention (CDC) frame. Their preventive practices against COVID-19 included the biomedical, cultural, and religious frames, as participants engaged traditional practices and spiritual interventions alongside public health recommendations. Mass media was the main source of information about COVID-19, and one of the trusted sources, in addition to religious and local leaders. To be effective, health promotion programs on pandemics should make more use of the mass media, and communal networks to reach populations.

Contested or complementary healing paradigms? Women's narratives of COVID-19 remedies in Mwanza, Tanzania.

BACKGROUND: COVID-19 has caused worldwide fear and uncertainty. Historically, the biomedical disease paradigm established its dominance in tackling emerging infectious illnesses mainly due to innovation in medication and advances in technology. Traditional and religious remedies have emerged as plausible options for prevention and treatment of COVID-19, especially in Africa and Asia. The appeal of religious and traditional therapies against COVID-19 in the African setting must be understood within the historical, social, and political context. This study explored how women and community members dealt with suspected symptoms of COVID-19 in Mwanza, Tanzania. METHODS: This study was conducted in Nyamagana and Ilemela districts of Mwanza, Tanzania, between July and August 2020. We conducted 18 mobile phone in-depth interviews with a purposively selected sample of women aged 27-57 years participating in an existing longitudinal study. For safety reasons, smart mobile phones were used to collect the data. Each interview was audio recorded after obtaining verbal consent from the participants. The audio files were transferred to computers for analysis. Four researchers conducted a multistage, inductive analysis of the data. RESULTS: Participants reported wide use and perceived high efficacy of traditional remedies and prayer to prevent and treat suspected symptoms of COVID-19. Use was either alone or combined with public health recommendations such as hand washing and crowd avoidance. Despite acknowledging that a pathogen causes COVID-19, participants attested to the relevance and power of traditional herbal medication and prayer to curb COVID-19. Four main factors underline the symbolic efficacy of the traditional and religious treatment paradigms: personal, communal, and official reinforcement of their efficacy; connection to local knowledge and belief systems; the failure of biomedicine to offer a quick and effective solution; and availability. CONCLUSIONS: In the context of emerging contagious illnesses, communities turn to resilient and trusted treatment paradigms to quell fear and embrace hope. To tackle emerging infections effectively, it is essential to engage the broader sociopolitical landscape, including communal considerations of therapeutic efficacy.

Emerging responses implemented to prevent and respond to violence against women and children in WHO European member states during the COVID-19 pandemic: a scoping review of online media reports.

OBJECTIVES: This study aims to explore the strategies that governments and civil society organisations implemented to prevent and respond to the anticipated rise in violence against women and/or children (VAWC) during the 2019 novel coronavirus (COVID-19) pandemic. DESIGN: A scoping review and content analysis of online media reports. SETTING: WHO European region. METHODS: A scoping review of media reports and publications and a search of other grey literature (published from 1 January to 17 September 2020). Primary and secondary outcome measures included measures implemented by governments, public services and non-governmental and civil organisations to prevent or respond to VAWC during the early months of the COVID-19 pandemic. RESULTS: Our study found that in 52 of the 53 member states there was at least one measure undertaken to prevent or respond to VAWC during the pandemic. Government-led or government-sponsored measures were the most common, reported in 50 member states. Non-governmental and other civil society-led prevention and response measures were reported in 40 member states. The most common measure was the use of media and social media to raise awareness of VAWC and to provide VAWC services through online platforms, followed by measures taken to expand and/or maintain helpline services for those exposed to violence. CONCLUSION: The potential increase in VAWC during COVID-19-imposed restrictions and lockdowns resulted in adaptations and/or increases in prevention and response strategies in nearly all member states. The strength of existing public health systems influenced the requirement and choice of strategies and highlights the need for sustaining and improving violence prevention and response services. Innovative strategies employed in several member states may offer opportunities for countries to strengthen prevention and responses in the near future and during similar emergencies.