The impact of COVID-19 on women and children in the UK who were victims of domestic abuse: a practitioner perspective

PurposeThis study aims to explore the impact of COVID-19 on women and children in the UK who were victims of domestic abuse.Design/methodology/approachThe authors draw from their experiences of working in the domestic abuse sector to reflect on the impact of lockdown restrictions on women and children, focussing on the impact of government restrictions that created an environment in which abusers could control the movement of victims.FindingsThe impact of the pandemic was significant as victims were locked into the abuse, unable to escape for fear of breaching lockdown rules. The lockdown affected victims of different forms of violence against women and girls in the UK including forced marriage and female genital mutilation, which highlighted the ramifications of intersectional inequalities for abuse victims.Originality/valueThis paper articulates the devastating impact of the pandemic on vulnerable women, and their fair and just access to the family courts. This paper concludes that women were failed by the government and that there was not nearly enough support from support agencies, which has left many at risk and suffering significant harm.

Gender-based violence in a rural Nigerian community during the COVID-19 era: a call for policy action

Introduction: gender-based violence (GBV) is a global pandemic which is deeply rooted in culture, hence the need to contextually understand its occurrence and patterns in rural settings. The objective of this study assessed respondents´ attitude, prevalence, the perceived risk factors, patterns and predictors of GBV in Ife-Odan, Osun State, Nigeria. Methods: cross-sectional study design was used and multi-stage sampling method employed to recruit 450 consenting adults. A pretested interviewer-administered, semi-structured questionnaire was used for data collection. Both descriptive and inferential statistics were carried out. Results: mean age (±SD) of the respondents was 30.73±7.0, 58.7% of them were females and 88.0% had negative attitude to GBV. Prevalence of any form of GBV was 16.2%. Predominant GBV types included intimate partner violence (IPV) (58.3%), female genital mutilation (FGM) (31.1%), Sexual violence (6.9%) and incest (3.4%). Perceived risk factors of GBV included cultural acceptance, substance abuse, lack of punishments for GBV offenders, indecent female dressing styles, social media influences, effects of COVID-19 lockdown and male dominance. However, gender (AOR=7.82;95%CI=2.35-8.17), marital status (AOR=3.23;95%CI=1.82-3.78), religion (AOR=5.02;95%CI=1.78-9.63) and attitude (AOR=4.23;95%CI=2.267-5.82) were the significant predictors of past GBV experiences in the study setting. Conclusion: gender-based violence (GBV) is prevalent in the study setting, with IPV being the most common. There is need for policymakers to focus on cultural transformation by designing a robust awareness campaign against GBV in rural Nigerian communities. Traditional and religious leaders should be sensitized and involved in the campaign programs using all available channels of communication. Laws prohibiting perpetration of GBV need to be fully implemented. © 2023, Pan African Medical Journal. All rights reserved.

A Rare and Complex Case of Non-suicidal Self-Mutilation in a Patient With Schizophrenia.

The literature describing acts of non-suicidal self-mutilation (NSSM) in the adult population is limited. Of the cases that document NSSM, a disproportionate number of these individuals have a history of psychiatric illnesses. Although the motivation to perform NSSM varies across patients, the literature suggests that past self-injurious behaviors, extreme religious delusions, and command hallucinations are the most significant risk factors. The primary forms of NSSM include ocular, genital, and limb mutilation. Limb mutilation is the least common of the three and typically occurs proximal to the wrist or hand. Here, we present a rare case involving a 42-year-old man with schizophrenia who was hospitalized due to osteomyelitis of his autoamputated digits. This case is unique in involving multiple digits of the hand and using a rare amputation method. We aim to compare this case with the existing body of work on NSSM and identify factors that may predispose patients to act on these extreme impulses. We also highlight a novel interventional program that reduces psychiatric and medical comorbidities.

Caesarean childbirth and associated factors during Covid-19 pandemic at public hospitals in the Sidama region, Southern Ethiopia.

Background: The increasing number of caesarean births worldwide concerns pregnant women, obstetric service providers, and the country's economy. Unnecessary caesarean childbirth increases childbirth complications and the cost of health care in low-income countries, including Ethiopia. Objective: This study aims to assess caesarean birth and associated factors at the Sidama region public hospitals, Southern Ethiopia, 2020. Methods: An institution-based cross-sectional study was conducted among 484 women who gave birth at public hospitals in the Sidama region. A multi-stage sampling technique was employed. The data were collected from 1st to 30th of July 2020 by face-to-face interviews using a semi-structured questionnaire (see Table S1: see supplementary materials associated with this article on line), and the wealth index was analysed by principal component analysis. Backward logistic regression used an adjusted odds ratio and a 95% confidence interval to assess the strength and association between the caesarean section and its associated factors. A P-value of < 0.05 was used to declare statistical significance. Result: Caesarean childbirth in this study was 34.3%. In this study, partograph monitoring (AOR = 2.23, CI = 1.13, 4.38), previous caesarean birth (AOR = 3.21, CI = 1.28,8.17), having genital cutting/mutilation (AOR = 2.51, CI = 1.14,5.53), intermittent cardiotocography monitoring during childbirth (AOR = 2.3, CI = 1.14, 4.49), absence of companionship during delivery (AOR = 4.97, CI = 2.37, 10.43) and is not remembering the last normal menstrual period (AOR = 3.12, CI = 1.40,6.94) had increased the odds of caesarean birth. Conclusion: Studies show that the prevalence of caesarean has alarmingly increased in both developed and developing countries. However, the magnitude of caesarean section differs from country to country and in rural and urban areas; the magnitude of caesarean section in this study is much higher than the WHO recommends threshold. The local health bureau and obstetric care providers should pay attention to the caesarean section and need intervention in partograph plotting, companionship, cardiotocography, and female genital mutilation.

A Review of Sexual and Reproductive Health Outcomes of Female Genital Mutilation and with the Context of Covid-19 Pandemic

Female Genital Mutilation (FGM) is commonly known as female genital cutting or female circumcision. This traditional practice is harmful and practiced in many countries without any fear of worse health outcomes. FGM is linked with worse sexual and reproductive health outcomes and complications through which young girls and women have to go through earlier in the incidence and later in life. These complications include sexual dysfunction, menstrual issues, difficulties with labor and delivery, infections, and infertility. The role of healthcare providers, community stakeholders, and young people is very significant in fighting FGM.

Impact of COVID-19 on increasing female genital mutilation (FGM) in Africa: A study of Tanzania and Nigeria

Women's sexual and reproductive health and rights (SRHR) have been undermined from time to time due to female genital mutilation (FGM). Women and girls experiencing FGM in many developing countries, including Tanzania and Nigeria. The aim of this study is to investigate the problems that occurred during the COVID-19 pandemic, which contributed to the high rates of FGM in Tanzania and Nigeria. This study uses a qualitative method to see the prevalence of FGM in both countries which has increased since the COVID-19 pandemic. This study is supported by the Patriarchal theory of Sylvia Walby, which explains why men try to oppress and control women as figures who dominate society. The study results show that both Nigeria and Tanzania have seen an increase in FGM amid COVID-19, with school closures placing teenage girls at the highest risk of FGM. The study concludes that the government, private institutions, and other development stakeholders should work together to find solutions to assist communities and families in ending FGM. If these efforts arc implemented, then the 2030 sustainable development agenda can become a reality in ending FGM in Nigeria and Tanzania.

The perceived effects of COVID-19 pandemic on female genital mutilation/cutting and child or forced marriages in Kenya, Uganda, Ethiopia and Senegal.

BACKGROUND: The effects of COVID-19 on harmful traditional practices such Female Genital Mutilation/Cutting (FGM/C) and Child or Forced Marriages (CFM) have not been well documented. We examined respondents' perceptions on how the COVID-19 pandemic has affected FGM/C and CFM in Kenya, Uganda, Senegal, and Ethiopia. METHODS: A cross-sectional study design with a mixed methods approach was used. Data collection on participants' perceptions on the effects of COVID-19 on FGM/C and CFM took place between October-December 2020. Household surveys targeting women and men aged 15-49 years in Kenya (n = 312), Uganda (n = 278), Ethiopia (n = 251), and Senegal (n = 208) were conducted. Thirty-eight key informant interviews with programme implementers and policymakers were carried out in Kenya (n = 17), Uganda (n = 9), Ethiopia (n = 8), and Senegal (n = 4). RESULTS: In Kenya, the COVID-19 pandemic has contributed to the increase in both FGM/C and CFM cases. Minimal increase of FGM/C cases was reported in Uganda and a significant increase in CFM cases. In Ethiopia, the COVID-19 pandemic had a limited perceived effect on changes in FGM/C and CFM. In Senegal, there were minimal perceived effects of COVID-19 on the number of FGM/C and CFM cases. The pandemic negatively affected implementation of interventions by the justice and legal system, the health system, and civil societies. CONCLUSIONS: The pandemic has had varied perceived effects on FGM/C and CFM across the four countries. Generally, the pandemic has negatively affected implementation of interventions by the various sectors that are responsible for preventing and responding to FGM/C and CFM. This calls for innovative approaches in intervening in the various communities to ensure that women and girls at risk of FGM/C and CFM or in need of services are reached during the pandemic. Evidence on how effective alternative approaches such as the use of call centres, radio talk shows and the use of local champions as part of risk communication in preventing and responding to FGM/C and CFM amid COVID-19 is urgently required.

Impact of COVID-19 on Gender Equality, Sexual and Reproductive Health Rights of Adolescent Girls and Young Women: A Narrative Review

Adolescent girls and young women constitute a vulnerable population worldwide and an easy target to secondary impacts of a pandemic due to societal norms, existing age, and gender-based inequalities, leading to a condition known as "second pandemic". Due to local and national lockdowns to prevent coronavirus spread, educational institutions, workplaces, health services have been shut down making adolescent girls and women prone to sexual, physical exploitation, gender-based violence, educational, financial loss, lack of sexual and reproductive health services. The present review briefs some of these secondary impacts of the COVID-19 pandemic on adolescent girls and women, which if taken care of can prevent many long-term consequences. Methodology: The literature was searched from governmental, non-governmental sites and agencies, like WHO, UN, UNICEF, Guttmacher Institute, International Labor Organization, and English peer -reviewed journals, using the USA National Library of Medicine (Pubmed) database, the regional portal of Virtual Health Library, and Scientific Electronic Library Online. The data from the onset of the COVID-19 pandemic till March 2021 on the impact of COVID-19 on women and children was searched and studied. The descriptors used were school drop-out children, adolescent girls, women suffering at home/work, unmet need for contraception, unwanted pregnancies, unsafe abortion, child marriages, and female genital mutilation. Results and Conclusion: COVID-19 pandemic has resulted in a "hidden pandemic" against women and children. There is a skyrocketing rise in violence against women/girls, teenage pregnancies, school drop-outs, child marriages, abuse, female genital mutilation. Hence, women and adolescent girls should be protected from the shadowing effects of the pandemic.

Adolescent girls, a forgotten population in resource-limited settings in the COVID-19 pandemic: implications for sexual and reproductive health outcomes.

Adolescent sexual and reproductive health is an essential aspect that may be forgotten in the COVID-19 pandemic. Valuable insights gained from previous humanitarian crises indicate undesirable short and long-term adolescent maternal consequences in low resource settings. Young girls are at a higher risk of dropping out of school and being forced into early child marriages and high-risk jobs that predispose them to sexual exploitation and sexual and gender-based violence. Economic recessions, supply chain disruptions and reallocation of resources may limit access and utilisation of services and commodities. The COVID-19 pandemic thus indirectly exposes adolescent girls to multiplied risks of unintended pregnancies, sexually transmitted infections including HIV and Human Papilloma Virus. Sexual and gender-based violence, including female genital mutilation cases may increase as intervention programmes to avert these are disrupted, and the resultant psychosocial and socioeconomic consequences may be devastating. Thus, a pro-active approach is required to come up with frameworks to ensure the minimum initial service package for reproductive health. A multi-sectoral collaborative intersection of relevant stakeholders in adolescent sexual and reproductive health is therefore urgently desired.