"Gender-Based Water Violence": Cross-Cultural Evidence for Severe Harm Associated With Water Insecurity for Women and Girls.

We examined how study participants in Indonesia and Peru viewed the relationship between water insecurity and women's health via thematic analysis of interviews and focus groups. Participants reported that water insecurity led to vaginal infections, miscarriage, premature births, uterine prolapse, poor nutrition, restricted economic opportunities, and intergenerational cycles of poverty. Participants in both countries stated that extreme burdens associated with water insecurity should be categorized as violence. Based on these findings, we developed the concept of "gender-based water violence," defined as the spectrum of stressors associated with water insecurity that are so severe as to threaten human health and well-being, particularly that of women and girls.

Teenage pregnancy in Tambogrande, Peru: causes, consequences and cycles of violence and disadvantage.

Teenage pregnancy carries adverse consequences for health and well-being. In this article, we investigate the perceived causes, consequences and cycles of violence and disadvantage associated with teenage pregnancy in Tambogrande, Peru using an applied anthropological approach. Data were drawn from a larger project investigating the relationship between water insecurity and gender-based violence in Indonesia and Peru. The analysis presented here is derived from 49 semi-structured interviews and 5 focus groups with local community members and stakeholders in Peru. Study participants highlighted two main factors contributing to teenage pregnancy in Tambogrande: machismo and religious deterrents to contraceptive use. Participants described how these factors overlapped, resulting in gendered power imbalances that increased the risk of violence, decreased educational opportunities, and reduced the economic independence of women. However, study participants stated that educational interventions targeting machismo could reduce teenage pregnancy and break the associated cycle of disadvantage. Future research will further investigate local social and gender norms to inform the design of a rights-based educational intervention, targeting upstream factors associated with teenage pregnancy in this area.

Strategies for COVID-19 transmission control and mitigation in a psychiatric hospital in Mexico.

In the context of the emerging COVID-19 pandemic, one of the great challenges is to generate effective strategies for the control of nosocomial infections, specifically in psychiatric hospitals with populations considered at risk (older adults or individuals with comorbidities). This article describes the strategies for prevention, containment and treatment of infection transmission implemented during a COVID-19 outbreak that occurred in July 2020 in a psychiatric hospital of the State of Mexico. The population was comprised by women with prolonged hospital stay (mean = 24 years), mostly geriatric (mean = 64 years), with various psychiatric disorders and comorbidities. In total, 19 COVID-19-positive cases were diagnosed, out of which thirteen had mild symptoms and six were asymptomatic. There were no alterations in mental state, psychiatric symptoms or underlying diseases. Algorithms were developed for the management and treatment of suspected/confirmed COVID-19 cases. Finally, the generation of comprehensive strategies, quick and timely actions, as well as adequate management of human resources favoring interdisciplinary work, were deemed to have contributed to contain and mitigate the COVID-19 outbreak, which constitutes a precedent in the psychiatric field with institutionalized patients.

En el contexto de la emergente pandemia de COVID-19, uno de los grandes desafíos es generar estrategias eficaces de control de infecciones nosocomiales, específicamente en hospitales psiquiátricos con población considerada de riesgo (adultos mayores o con comorbilidades). En el presente artículo se describen las estrategias de prevención, contención y tratamiento de contagio, a partir de un brote de COVID-19 ocurrido en julio de 2020 en un hospital psiquiátrico del Estado de México. La población estuvo constituida por mujeres con estancia hospitalaria prolongada (media = 24 años), en su mayoría geriátricas (media = 64 años), con trastornos psiquiátricos diversos y comorbilidades. En total se diagnosticaron 19 casos positivos de COVID-19, de los cuales 13 cursaron con sintomatología leve y seis resultaron asintomáticos. No se presentaron alteraciones en el estado mental, en la sintomatología psiquiátrica ni en las enfermedades de base. Se realizaron algoritmos para el manejo y tratamiento de los casos sospechosos o confirmados de COVID-19. Finalmente, se consideró que la generación de estrategias integrales, acciones rápidas y oportunas, así como una adecuada gestión de recursos humanos favorecedora del trabajo interdisciplinario contribuyeron a contener y mitigar el brote de COVID-19, constituyéndose en un precedente en el ámbito psiquiátrico con pacientes institucionalizadas.