Linkages between maternal experience of intimate partner violence and child nutrition outcomes: A rapid evidence assessment.

BACKGROUND: A strong evidence base indicates that maternal caregivers' experience of intimate partner violence [IPV] impacts children's health, cognitive development, and risk-taking behaviors. Our objective was to review peer-reviewed literature describing the associations between a child's indirect exposure to IPV and corresponding nutrition outcomes, with a particular focus on fragile settings in low and middle-income countries [LMICs]. METHODS: We conducted a rapid evidence assessment to synthesize quantitative associations between maternal caregivers' IPV experience and children's nutrition/growth outcomes (birthweight, feeding, and growth indicators). We included peer-reviewed research, published in English or Spanish after the year 2000, conducted in fragile settings in LMICs. RESULTS: We identified 86 publications that fit inclusion criteria. Amongst all associations assessed, a maternal caregiver's experience of combined forms of IPV (physical, sexual and emotional) or physical IPV only, were most consistently associated with lower birthweight, especially during pregnancy. Women of child-bearing age, including adolescents, exposed to at least one type of IPV showed a decreased likelihood of following recommended breastfeeding practices. Lifetime maternal experience of combined IPV was significantly associated with stunting among children under 5 years of age in the largest study included, though findings in smaller studies were inconsistent. Maternal experience of physical or combined IPV were inconsistently associated with underweight or wasting in the first five years. Maternal experience of sexual IPV during pregnancy appeared to predict worsened lipid profiles among children. CONCLUSION: Maternal caregivers' experience of IPV is significantly associated with low birthweight and suboptimal breastfeeding practices, whereas studies showed inconsistent associations with child growth indicators or blood nutrient levels. Future research should focus on outcomes in children aged 2 years and older, investigation of feeding practices beyond breastfeeding, and examination of risk during time periods physiologically relevant to the outcomes. Programmatic implications include incorporation of GBV considerations into nutrition policies and programming and integrating GBV prevention and response into mother and child health and nutrition interventions in LMIC contexts.

Promising practices for the monitoring and evaluation of gender-based violence risk mitigation interventions in humanitarian response: a multi-methods study.

BACKGROUND: Risks of gender-based violence (GBV) are exacerbated in humanitarian crises. GBV risk mitigation interventions aim to reduce exposure to GBV and ensure that humanitarian response actions and services themselves do not cause harm or increase the risk of violence. The 2015 IASC Guidelines for Integrating Gender-Based Violence Interventions in Humanitarian Action ('GBV Guidelines') are a globally endorsed resource that provides comprehensive guidance for all humanitarian actors and sectors on GBV risk mitigation. While uptake of GBV risk mitigation approaches across multiple humanitarian sectors has occurred, there is limited understanding of how to monitor and evaluate GBV risk mitigation interventions. METHODS: A multi-methods study was conducted in 2019 to identify promising practices for the monitoring and evaluation (M&E) of GBV risk mitigation interventions in non-GBV sectors and to develop a set of illustrative case examples. The study included a comprehensive desk review of 145 articles, documents and resources from the published and grey literature, as well as 11 in-depth interviews and five focus group discussions with humanitarian practitioners. Using Dedoose software and a codebook developed a priori, qualitative data were transcribed and coded and a content analysis was conducted. Excerpts focusing on promising practices from the qualitative data and the desk review were analyzed together and grouped by thematic area. Similar promising practices were combined and consolidated to create a final list, and case examples were identified. RESULTS: Current promising practices for M&E of GBV risk mitigation activities in the following categories are described: (1) Coordination and collaboration, (2) Designing M&E approaches and tools for GBV risk mitigation activities, (3) Contextualization, (4) Developing and selecting indicators, (5) Data collection, (6) Data analysis and use of findings, (7) Potential safety concerns for affected populations and staff, and (8) Staff capacity and engagement. These are supplemented with seven diverse case examples to illustrate application of the promising practices using real-world examples. CONCLUSION: This paper highlights current promising practices for M&E of GBV risk mitigation interventions in humanitarian response. Further application of these practices-alongside ongoing documentation of emerging approaches-will be critical to ensuring that GBV risk mitigation interventions are more rigorously tested with the aim of building the evidence base on the effectiveness of different GBV risk mitigation interventions within specific humanitarian sectors.

Gender-Based Violence Risk Mitigation by Non-GBV Specialists Prior to and during COVID-19: A Global Survey of Knowledge, Attitudes and Practices of Humanitarian Practitioners.

Available evidence indicates that the COVID-19 pandemic and response measures may lead to increased risk of gender-based violence (GBV), including in humanitarian contexts. This study examined the knowledge, attitudes, and practices of humanitarian practitioners related to GBV risk mitigation approaches during COVID-19 in order to refine current guidance and inform future materials. A global, online cross-sectional survey of humanitarian practitioners was conducted between November 2020 and April 2021. We calculated descriptive statistics and used Chi-square or Fisher's exact tests to compare knowledge, attitudes, and practices among GBV specialists and non-specialists. Of 170 respondents, 58% were female and 44% were GBV specialists. Almost all (95%) of the respondents agreed or strongly agreed that they have a role to play in GBV risk mitigation. Compared to GBV specialists, a higher proportion of non-specialists reported little to no knowledge on GBV risk mitigation global guidance (38% vs. 7%, p < 0.001) and on how to respond to a disclosure of GBV (18% vs. 3%, p < 0.001). Respondents reported several barriers to integrating GBV risk mitigation into their work during COVID-19, including insufficient funding, capacity, knowledge, and guidance. Efforts to mainstream GBV risk mitigation actions should continue and intensify, leveraging the lessons and experiences generated thus far.

Measuring gender-based violence risk mitigation in humanitarian settings: results from a comprehensive desk review and systematic mapping.

OBJECTIVES: To systematically document measurement approaches used in the monitoring and evaluation of gender-based violence (GBV) risk mitigation activities, categorise the types of available literature produced by sector, identify existing tools and measures and identify knowledge gaps within the humanitarian sector. DESIGN: Systematic mapping and in-depth review. DATA SOURCES: Pubmed, Global Health, PsychInfo, ReliefWeb, OpenGrey (grey literature), Google Scholar, Web of Science (Social Science Index)Eligibility criteria: a structured search strategy was systematically applied to 17 databases as well as registers, websites and other resources to identify materials published between 1 January 2005 and 15 May 2019. DATA EXTRACTION AND SYNTHESIS: Those resources that met the inclusion criteria underwent a comprehensive full-text review. A detailed matrix was developed and key data from each resource were extracted to allow for the assessment of patterns in thematic areas. RESULTS: A total of 2108 documents were screened. Overall, 145 documents and 112 tools were reviewed, representing 10 different humanitarian sectors. While numerous resources exist, many lack sufficient information on how to monitor outputs or outcomes of GBV risk mitigation activities. There is also limited guidance on how to integrate the measurement of GBV risk mitigation into existing monitoring and evaluation frameworks. Those reports that aimed to measure GBV risk mitigation activities mostly employed qualitative methods and few measured the impact of a GBV risk mitigation with robust research designs. CONCLUSIONS: Recent efforts to adapt humanitarian response to COVID-19 have highlighted new and existing challenges for GBV risk mitigation. There is a significant gap in the evidence base around the effectiveness of GBV risk mitigation across all sectors. Understanding and strengthening measurement approaches in GBV risk mitigation remains a critical task for humanitarian response.