"I have to listen to them or they might harm me" and other narratives of why women endure obstetric violence in Bihar, India.

BACKGROUND: Evidence suggests that obstetric violence has been prevalent globally and is finally getting some attention through research. This human rights violation takes several forms and is best understood through the narratives of embodied experiences of disrespect and abuse from women and other people who give birth, which is of utmost importance to make efforts in implementing respectful maternity care for a positive birthing experience. This study focused on the drivers of obstetric violence during labor and birth in Bihar, India. METHODS: Participatory qualitative visual arts-based method of data collection-body mapping-assisted interviews (adapted as birth mapping)-was conducted to understand women's perception of why they are denied respectful maternity care and what makes them vulnerable to obstetric violence during labor and childbirth. This study is embedded in feminist and critical theories that ensure women's narratives are at the center, which was further ensured by the feminist relational discourse analysis. Eight women participated from urban slums and rural villages in Bihar, for 2-4 interactions each, within a week. The data included transcripts, audio files, body maps, birthing stories, and body key, which were analyzed with the help of NVivo 12. FINDINGS: Women's narratives suggested drivers that determine how they will be treated during labor and birth, or any form of sexual, reproductive, and maternal healthcare seeking presented through the four themes: (1) "I am admitted under your care, so, I will have to do what you say"-Influence of power on care during childbirth; (2) "I was blindfolded … because there were men"-Influence of gender on care during childbirth; (3) "The more money we give the more convenience we get"-Influence of structure on care during childbirth; and (4) "How could I ask him, how it will come out?"-Influence of culture on care during childbirth. How women will be treated in the society and in the obstetric environment is determined by their identity at the intersections of age, class, caste, marital status, religion, education, and many other sociodemographic factors. The issues related to each of these are intertwined and cross-cutting, which made it difficult to draw clear categorizations because the four themes influenced and overlapped with each other. Son preference, for example, is a gender-based issue that is part of certain cultures in a patriarchal structure as a result of power-based imbalance, which makes the women vulnerable to disrespect and abuse when their baby is assigned female at birth. DISCUSSION: Sensitive unique feminist methods are important to explore and understand women's embodied experiences of trauma and are essential to understand their perspectives of what drives obstetric violence during childbirth. Sensitive methods of research are crucial for the health systems to learn from and embed women's wants, to address this structural challenge with urgency, and to ensure a positive experience of care.

Misperception of Norms About Intimate Partner Violence as a Driver of Personal IPV Attitudes and Perpetration: A Population-Based Study of Men in Rural Uganda.

Intimate partner violence (IPV) against women is a global public health problem. Conceptual frameworks suggest misperceived norms around IPV might drive perpetration of violence against women in southern and eastern Africa. We conducted a cross-sectional, population-based survey of all men residing in a rural parish in southwest Uganda, eliciting their endorsement of IPV in five hypothetical scenarios and their reported frequency of perpetration of violence against their wife/main partner. They also reported their perceptions about the extent to which most other men in their villages endorsed and/or perpetrated IPV, which we compared against the population data to measure the primary explanatory variable of interest: whether individuals misperceived norms around IPV. We fitted multivariable Poisson regression models specifying personal IPV endorsement and IPV perpetration as the outcomes. Overall, 765 men participated in the study (90% response rate): 182 (24%) personally endorsed IPV, and 78 of 456 partnered men (17%) reported perpetrating one or more acts of IPV at least once per month. Although most men neither endorsed nor reported perpetrating IPV, 342 (45%) men mistakenly thought that most other men in their villages endorsed IPV and 365 (48%) men mistakenly thought that most other men perpetrate IPV at least monthly. In multivariable regression models, men who misperceived most men to endorse IPV were more likely to endorse IPV themselves (adjusted relative risk [aRR] = 2.44; 95% CI [1.66, 3.59]; p < .001). Among partnered men, those who misperceived IPV perpetration to be normative were more likely to perpetrate IPV themselves (aRR = 4.38; [2.53, 7.59]; p < .001). Interventions to correct misperceived norms about IPV may be a promising method for reducing violence against women in rural Uganda.

Fear, "Discomfort," Anger, and Shame in the Night-Time Economy: Women's Responses to Unwanted Sexual Intrusions.

Despite a surge of attention to gender-based violence (GBV), research about the night-time economy (NTE) as a site of gendered violence is limited. Even less research examines women's emotional responses to "unwanted sexual intrusions" (USI) in the NTE. Analyzing women's emotional responses can generate deeper understanding of social phenomena, power and its operation, and is in keeping with feminist theorizing that uses a victim-survivor-centered approach. Analysis of qualitative data, from a survey we conducted in the United Kingdom, reveals women experience USI in the NTE as a frightening, shameful injustice. The article discusses these emotions in light of the changing "emotional climate" about GBV.

A positive yet complicated case of gender-based violence coordination: a qualitative study of Lebanon's protracted humanitarian emergency, 2012-22.

Gender-based violence (GBV), a global health and human rights concern, often intensifies during emergencies. This paper explores the evolution of GBV coordination in Lebanon's protracted Syrian refugee crisis from 2012-22. Utilising 38 in-depth interviews and a document review, the findings were analysed using the framework for effective GBV coordination. Lebanon provides a positive yet complicated example of GBV coordination. Initially established to address the refugee crisis, it matured into a collaborative national coordination mechanism, fostering trust and advancing localisation amidst sectarian complexities. However, the volatile, restrictive policy context hindered government co-leadership and engagement with refugee-led organisations. While essential GBV response services were expanded nationwide, lack of an interagency strategy on GBV risk mitigation and prevention compromised lasting change. The paper emphasises the importance of dedicated GBV coordinators, multi-year funding, and increased attention to GBV prevention. The findings underscore the transformative potential of humanitarian responses and advocate for enhanced engagement with national stakeholders to promote sustainability in protracted crises.

Canadian Gender-Based Violence Prevention Programs: Gaps and Opportunities.

Gender-based violence (GBV) prevention programs have long played an important part in both teaching the realities of GBV and training people in techniques to avert, mitigate, and respond to violence. This article examines the current state of GBV prevention training in Canada through an analysis of 81 GBV education programs provided by antiviolence organizations and universities. We identified notable gaps in topics relating to technology-facilitated violence and abuse in programs targeting men and in the provision of bystander intervention training. Each of these areas represents important, but as yet unrealized, opportunities in violence prevention.

Intimate Partner Violence, prevalence and its consequences: a community-based study in Gambella, Ethiopia.

Introduction: Intimate partner violence is defined as any behavior by a current or past male intimate partner during marriage, cohabitation, or any other formal or informal union that causes physical, sexual, or psychological harm. Men are the most common perpetrators of this against women. It affects almost one-third of all women worldwide. Objective: This study aimed to assess the prevalence, consequences, and factors associated with intimate partner violence among partnered women in Gambella town. Methods: A community-based, cross-sectional study design was employed. A systematic random sampling technique was used to select the study participants. Data was collected using a pretested, structured questionnaire. The data were entered and analyzed using SPSS software version 25. The bivariate and multivariate logistic regression method was used to identify factors associated with intimate partner violence. Variables with a p-value <0.05 were considered significantly associated with intimate partner violence. Results: The overall prevalence of intimate partner violence in the lifetime and the last 12 months was 58.8, 95% CI (54.0, 63.6), and 51.8, 95% CI (46.7, 56.8), respectively. More than half (53.3%) of the violence resulted in physical injury, while 32.9% were separated from their partners whereas, mother's history of exposure to IPV [AOR: 1.8, 95% CI (1.03-3.27), p < 0.05], respondent's age [AOR: 3.4, 95% CI (1.8, 6.5), p < 0.001], substance use [AOR:2.5, 95% CI (1.5-4.1), p < 0.001], disagreement on sexual intercourse [AOR:3.2, 95% CI (1.8-5.7), p < 0.01], monthly family income [AOR:0.32, 95% CI: (0.16-0.63), p < 0.01] and family size [AOR:2.8, 95% CI: (1.6-4.8), p < 0.01] were significantly associated with IPV. Conclusion: The study indicated that the prevalence of intimate partner violence was very high. Age of the woman, family size, substance use, economic status, were among factors significantly associated with intimate partner violence. Therefore, responsible stakeholders should respond to the deep-rooted and highly complicated gender inequality by implementing preventive measures.

[Impact of gender violence on girls and adolescents]. / Impacto de la violencia de género en las niñas y las adolescentes.

Gender is an important determinant of health. Its relationship with inequality and violence allows us to consider being a woman as a risk factor for health. Girls and teenager girls are not exempt from this circumstance, which conditions their lives from before birth and can determine their health status throughout life. It can vary according to social contexts, as various factors intersect with gender, adding risk and vulnerability to being a woman. Gender-based violence is often identified as a problem for adult women; however, the experience of discriminatory gender-based violence is constructed throughout women's lives, producing serious individual and social consequences from childhood. Accepting this violence as a «private or domestic matter¼ often prevents seeing the true dimension of the problem, its consequences, and the need to address it as a global issue.

Experiences of gender based violence and help seeking trends among women with disabilities: an analysis of the demographic and health surveys.

Women with disabilities are more likely to experience violence than women without disabilities and there is a critical gap in research regarding this topic. This study uses Demographic and Health Survey (DHS) data to analyse the association between disability and experiences of gender-based violence (GBV) and help-seeking behaviour among women in Haiti, Pakistan, Timor Leste, and Uganda. These countries were chosen because they are representative of the regions where the DHS is conducted and include questions about GBV and disability. The data was analysed based on recommendations from the Washington Group using a disability severity indicator. Logistic regression was the primary method of analysis. Generally, we found women with disabilities had the same or greater odds of experiencing GBV and had the same or lower odds of help-seeking. Given women with disabilities are at least at equal risk of experiencing GBV, it is imperative that programs be developed that are accessible to all women regardless of functional limitations. Also, additional research is needed to determine if there are differences by disability type, if intersectionality is relevant, and to include more unmarried women.

"Nenhuma Pessoa Idosa Merece Passar por Isso": Compreensão da Violência para Mulheres Gerontes / "Ninguna Persona Adulta Mayor Merece Pasar Por Esto": Comprensión de la Violencia para las Mujeres Adultas Mayores / "No Elderly Person Deserves to Go Through This": Understanding Violence Towards Elderly Women

Resumo Introdução: A violência contra idosos é um fenômeno crescente, ocasionando prejuízos à saúde, com diferentes desfechos e consequências às vítimas. A chance de idosas sofrerem-na no âmbito familiar supera a dos homens, sendo o gênero um fator de risco considerável. Objetivo: Analisar a compreensão da violência contra pessoas idosas segundo mulheres gerontes. Metodologia: Pesquisa descritiva com abordagem qualitativa desenvolvida com 22 idosas de uma comunidade no estado da Paraíba, Brasil, escolhidas por conveniência. Utilizou-se para coleta de dados entrevistas semiestruturadas, processadas pelo software Iramuteq, com posterior Análise de Conteúdo. Resultados: Foram evidenciadas cinco classes: ciclo de violência; rede de apoio ao idoso vítima de violência; Vivência de situações violentas; violência financeira; e simbologia da violência na sociedade, as quais denotam compreensão da violência envolvendo os diferentes tipos. Apoiam-se nos fatores da vivência familiar, cultura e outros, consubstanciando o profissional de saúde como fundamental para o desfecho. O gênero influenciou no que concerne ao olhar lançado sobre a violência física e psicológica, bem como na relevância dada às equipes de saúde para identificação de ocorrências e prevenção de possíveis danos. Conclusão: Os diversos tipos de violência contra a pessoa idosa foram reconhecidos, incluindo fatores individuais, comunitários e sociais no ciclo violento. Além disso, associaram o envelhecimento a maior suscetibilidade para sofrer violência, independente da tipologia. Destaca-se a potencialidade do serviço de saúde na assistência à pessoa idosa vítima de violência, elucidando casos e atuando precocemente para interrupção dos ciclos perpetrados, exigindo a necessidade constante de atualização profissional para lidar com situações detectadas.

Resumen Introducción: La violencia contra las personas adultas mayores es un fenómeno creciente, que causa daños a la salud, con diferentes desenlaces y consecuencias para las víctimas. La posibilidad de que las mujeres adultas mayores la sufran en el ámbito familiar supera la de los hombres, siendo el género un factor de riesgo considerable. Objetivo: Analizar la comprensión de la violencia contra las personas mayores según las mujeres adultas mayores. Metodología: Investigación descriptiva con enfoque cualitativo desarrollada con 22 mujeres adultas mayores de una comunidad en el estado de Paraíba, Brasil, elegidas por conveniencia. Para la recolección de datos, se utilizaron entrevistas semiestructuradas, procesadas por el software Iramuteq, con posterior análisis de contenido. Resultados: Se evidenciaron cinco tipos de violencia: ciclo de la violencia, red de apoyo población adulta mayor víctima de violencia, experimentar situaciones violentas, violencia financiera y simbología de la violencia en la sociedad, que denotan la comprensión de la violencia de diferentes tipos. Estas ideas están respaldadas en los factores de la experiencia familiar, la cultura y otros, donde la persona profesional de la salud se identifica como fundamental para el cuidado y apoyo. El género influyó en la mirada lanzada sobre la violencia física y psicológica, así como en la relevancia dada a los equipos de salud para la identificación de sucesos y la prevención de posibles daños. Conclusión: Se han reconocido los diversos tipos de violencia contra las personas mayores, incluidos los factores individuales, comunitarios y sociales en el ciclo de violencia. Además, asociaron el envejecimiento con una mayor susceptibilidad a sufrir violencia, independientemente de la tipología. Destaca la potencialidad del servicio de salud en la asistencia a la persona mayor víctima de violencia, mediante la identificación de casos y la actuación temprana para la interrupción de los ciclos perpetrados. De manera que, se evidencia la necesidad constante de actualización profesional para hacer frente a situaciones detectadas.

Abstract Introduction: Violence against the elderly is a growing phenomenon, causing damage to health, with different outcomes and consequences to the victims. The possibility of elderly women suffering it in the family context surpasses that of men, with gender being a considerable risk factor. Objective: To analyze the understanding of violence against the elderly according to elderly women. Method: Descriptive research with a qualitative approach developed with 22 elderly women from a community in the state of Paraíba, Brazil, chosen for convenience. The data collection was based on semi-structured interviews, processed by the Iramuteq software, with subsequent Content Analysis. Results: Five classes of violence against the elderly were evidenced: cycle of violence; support network for the elderly victims of violence; experience of violent situations; financial violence; and symbolism of violence in society, which denote an understanding of violence involving the different types. They are based on the factors of family experience, culture, and others, placing the health professional as a fundamental element for care and support. Gender influenced the perspective on physical and psychological violence, as well as the relevance given to health teams for the identification of occurrences and the prevention of possible damage. Conclusion: The various types of violence against the elderly have been recognized, including individual, community, and social factors in the violent cycle. In addition, they associated aging with greater susceptibility to suffering violence, regardless of the typology. It highlights the potential of the health service in assisting the elderly victim of violence, elucidating cases, and acting early to interrupt the cycles perpetrated, requiring the constant need for professional updating to deal with detected situations.

My Path to Recovery From Gender-Based Violence: Elusive, Victimized, or Agentive Position.

This article analyzes 10 autobiographical narratives of women who had experienced intimate relationship violence. In these narratives, we find several positions, that come from master narratives. These positions have some effects on the construction of subjectivities and on the process of recovery or redefinition of identity. The positions are (a) elusive, (b) victimized, and (c) agentive. The purpose of this article is to describe and analyze, from a feminist perspective, the position and subjectivity of women who suffer violence to address the prevention and treatment of this problem that affects individuals and society.

The magnitude of gender-based violence, health consequences, and associated factors among women living in post-war woredas of North Shewa zone, Amhara, Ethiopia, 2022.

Background: Gender-based violence (GBV) is a pervasive global public health concern and a violation of human rights, particularly pronounced in conflict settings where it is often used as a tool of warfare to instill fear and control populations. Objective: Assessment of Magnitude, Associated Factors, and Health Consequences of GBV among women living in war-affected woredas of North Shewa zone, Ethiopia, 2022. Methods: A community-based cross-sectional study was conducted, involving 845 randomly selected women living in conflict zones. Data on GBV experiences over the previous 3 months were collected through interviewer-administered questionnaires developed from literature review. The collected data underwent validation, entry into EPI data, and analysis using SPSS. Findings are summarized using descriptive statistics, AOR and 95% confidence interval. Result: The magnitude of GBV in this study was (490, 58.0%) where, (466, 55.0%) psychological violence, (254, 30.1%) physical violence, and (135, 16.0%) reported sexual violence. A majority of the physical violence, (161, 63.4%), occurred during conflict period, with (143, 56.3%) of these cases involving armed forces, and (161, 63.4%) women experiencing physical violence in their homes. Urban Residence AOR = 2.65, CI, (1.82-3.89), Educational status of Secondary education AOR = 0.33, CI, (0.19-0.57, and ≥College AOR = 0.17, CI, (0.09-0.35), Occupation of Housewife AOR = 1.88, CI, (1.20-2.94), Private employee AOR = 6.95, CI, (3.70-13.04), Gov't employee AOR = 5.80, CI, (2.92-11.50), and others (Students) AOR = 3.46, CI, (1.98-6.01), Ever had sexual intercourse AOR = 0.46, CI, (0.25-0.83), Have heard about SRH AOR = 0.59, CI, (0.40-0.89), Have had previous GBV exposure AOR = 0.24, CI, (0.15-0.38), having a previous history of sexual violence AOR = 0.30, CI, (0.16-0.57), and Number of sexual partner AOR = 1.84, CI, (1.13-2.99) were identified to be associated factors of GBV in our study area. The most commonly reported consequences of GBV were Anxiety, depression, physical injuries, self-blame, women had school dropout, and abortion. Conclusion: The study reveals a higher prevalence of GBV, resulting in profound physical, social, mental, and reproductive health challenges for survivors. To address this, multi-sectoral cooperation is advised to enhance women's empowerment, access to information, and psycho-social support in affected areas. Furthermore, national policymakers are urged to implement preventive measures during conflict and establish legal mechanisms to ensure accountability for perpetrators.

[Social media as platforms for the visibility of gender-based violence during the COVID-19 pandemic in Colombia]. / Redes sociales como escenarios para la visibilización de las violencias basadas en género durante la pandemia de covid-19 en Colombia.

The purpose of this research is to identify predominant problematizations in Colombian feminist Instagram accounts regarding gender-based violence during the first year of the COVID-19 pandemic. Employing a qualitative approach, a digital ethnography based on the principles of netnography was conducted as an alternative to detail the social worlds constructed from online groups. Fifty pieces of content from @lainsumisa and twenty pieces of content from @feministasenconstrucción, published between March 2020 and March 2021, were selected based on observations made within the online fieldwork framework. These were analyzed using discourse analysis techniques. The findings discuss the following emerging categories: unpaid household work, romanticized harassment, fatphobia, and the violation of Black and racialized women's rights. In this context, cyberactivism is presented as an opportunity for the emergence of collectives and support networks for women advocating for gender equality and their rights, towards questioning patriarchal ideas that jeopardize their well-being.

El propósito de esta investigación es identificar las problematizaciones predominantes en cuentas feministas colombianas de Instagram, sobre las violencias basadas en género durante el primer año de la pandemia de covid-19. Desde un enfoque cualitativo, se realizó una etnografía digital basada en los preceptos de la netnografía, como alternativa para detallar los mundos sociales construidos a partir de los grupos en línea. A partir de las observaciones realizadas en el marco del trabajo de campo en línea se seleccionaron 50 contenidos de @lainsumisa y 20 contenidos de @feministasenconstrucción, publicados entre marzo de 2020 y marzo de 2021, los cuales se analizaron mediante técnicas de análisis del discurso. Entre los hallazgos se discuten las siguientes categorías emergentes: el trabajo no remunerado en el hogar, el acoso romantizado, la gordofobia y la vulneración a las mujeres negras y racializadas. Al respecto, se plantea el ciberactivismo como una oportunidad para el surgimiento de colectivos y redes de apoyo para las mujeres que luchan por la equidad de género y por sus derechos, hacia el cuestionamiento de ideas patriarcales que atentan contra su bienestar.

Impacts of an abbreviated personal agency training with refugee women and their male partners on economic empowerment, gender-based violence, and mental health: a randomized controlled trial in Rwanda.

INTRODUCTION: We assessed the impact of a personal agency-based training for refugee women and their male partners on their economic and social empowerment, rates of intimate partner violence (IPV), and non-partner violence (NPV). METHODS: We conducted an individually randomized controlled trial with 1061 partnered women (aged 18-45) living in a refugee camp in Rwanda. Women received two days of training, and their partners received one day of training. The follow-up survey where all relevant outcomes were assessed was carried out at 6-9 months post-intervention. RESULTS: At follow up, women in the intervention arm were more likely to report partaking in income generating activities (aIRR 1.27 (1.04-1.54), p < 0.05) and skill learning (aIRR 1.59 (1.39-1.82), p < 0.001) and reported a reduction in experience of physical or sexual NPV in the past six months (aIRR 0.65 (0.39-1.07), p < 0.09). While improved, no statistically significant impacts were seen on physical or sexual IPV (aIRR 0.80 (0.58-1.09), p = 0.16), food insecurity (ß 0.98 (0.93 to 1.03), p = 0.396), or clean cookstove uptake (aIRR 0.95 (0.88 to 1.01), p = 0.113) in the past six months. We found statistically significant reduction in physical and sexual IPV amongst those experiencing IPV at baseline (aIRR 0.72 (0.50 to 1.02), p < 0.07). Small improvements in self-efficacy scores and our indicator of adapting to stress were seen in the intervention arm. Some challenges were also seen, such as higher prevalence of probable depression and/or anxiety (aIRR 1.79 (1.00-3.22), p = 0.05) and PTSD (aIRR 2.07 (1.10-3.91), p < 0.05) in the intervention arm compared to the control arm. CONCLUSION: Our findings echo previous research showing personal agency training can support economic well-being of women. We also find potentially promising impacts on gender-based violence. However, there is some evidence that integration of evidence-based mental health support is important when enhancing agency amongst conflict-affected populations. TRIAL REGISTRATION NUMBER: The trial was registered with ClinicalTrials.gov, Identifier: NCT04081441 on 09/09/2019.

Interpersonal violence against women and maternity care in Migori County, Kenya: evidence from a cross-sectional survey.

Background: Interpersonal violence (IPV) is an issue of major public health concern, with 24% of Kenyan women reporting physical violence perpetrated by a current husband or partner. IPV has profound impacts on physical and mental health outcomes, particularly for pregnant women; it has been found to increase the risk of perinatal mortality, low birth weight, and preterm birth. This study aims to identify variables associated with IPV and assess the effects of IPV experience on prenatal and peripartum maternal healthcare in Migori County, Kenya. Findings build on a previous study that investigated a smaller region of Migori County. Methods: Responses to cross-sectional household surveys conducted in six wards of Migori County, Kenya in 2021 from female respondents aged 18 and older were analyzed. The survey contained validated screening tools for interpersonal violence. Group-wise comparisons, and bivariate and multivariate logistic regression analyses were performed to describe community prevalence, factors associated with IPV against women, and the effect of IPV exposure on prenatal and peripartum health care. Results: This study finds that 2,306 (36.7%) of the 6,290 respondents had experienced lifetime IPV. IPV experience was associated with the age group 25-49 (adjusted odds ratio (aOR) 1.208; 95%CI: [1.045-1.397]; p = 0.011), monogamous marriage [aOR 2.152; 95%CI: (1.426-3.248); p < 0.001], polygamous marriage [aOR 2.924; 95%CI: (1.826-4.683); p < 0.001], being widowed/divorced/separated [aOR 1.745; 95%CI: (1.094-2.786); p < 0.001], feeling an attitude of "sometimes okay" toward wife beating [aOR 2.002 95%CI: (1.651, 2.428); p < 0.001], having been exposed to IPV in girlhood [aOR 2.525; 95%CI: (2.202-2.896); p < 0.001] and feeling safe in the current relationship [aOR 0.722; 95%CI: (0.609, 0.855); p < 0.001]. A depression score of mild [aOR 1.482; 95%CI: (1.269, 1.73); p < 0.001] and severe [aOR 2.403; 95%CI: (1.429, 4.039); p = 0.001] was also associated with IPV experience, and women who experienced emotional abuse were much more likely to have experienced IPV [aOR 10.462; 95% CI: (9.037, 12.112); p < 0.001]. Adjusted analyses showed that having experienced IPV was negatively associated with attending at least four antenatal care visits during the most recent pregnancy (OR 0.849, p = 0.044) and with having a skilled birth attendant (OR 0.638, p = 0.007). Conclusions: IPV is prevalent in Migori County, Kenya, with increased prevalence among women aged 25-49, those residing in West Kanyamkago, those in a monogamous or polygamous marriage, those who have been widowed/divorced/separated, and those with severe depressive symptoms. Further, IPV exposure is associated with lower use of maternal care services and may lead to worse maternal health outcomes. There is need for enhanced effort in addressing social and gender norms that perpetuate IPV, and this study can contribute to guiding policy interventions and community responses towards IPV.

Self-Defense Training to Reduce Violence Against Women and Girls: An Integrative Review.

BACKGROUND: Violence against women and girls (VAWG) is a serious threat to individual and public health with vast negative impacts, including numerous physical and mental health issues, as well as societal and economic consequences. Numerous women's self-defense interventions have been proposed to reduce the risk of victimization. AIMS: The current integrative review, based on Whittemore and Knafl's framework, was completed to synthesize current evidence on women's self-defense training, the impact of such training on outcomes related to VAWG, and evaluate the strength of evidence for women's self-defense training interventions. METHODS: A systematic literature search, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, was performed including a comprehensive computer-assisted database search, as well as citation searching and website searching for studies that included quantitative outcomes related to VAGW published between 2011 and 2023. Data were extracted and analyzed in accordance with Whittemore and Knafl's (2005) methodology, and the body of evidence was synthesized and best evidence recommendations developed based on the ©The Johns Hopkins Hospital/The Johns Hopkins University Evidence-Based Practice Model. RESULTS: Ultimately, 19 publications met inclusion criteria and were included in this review. Key findings included strong evidence for women's self-defense training to reduce attempted rape, completed rape, and nonconsensual sexual contact, as well as emerging evidence for reduction in posttraumatic stress disorder (PTSD) symptoms, among other positive outcomes. CONCLUSIONS: Further research is needed in more diverse populations at risk for violence and to identify key characteristics of effective interventions, including optimal content and dose.

Women's Use of Intimate Partner Aggression: Associations With Sexist Experiences.

Identity-based discrimination experiences have been associated with intimate partner aggression (IPA) use, yet very little research has examined sexist discrimination. This study explored whether women's experiences of sexist discrimination are associated with their IPA use. Participants were 626 predominantly white, cisgender, heterosexual women who completed self-report measures online. Women's sexist experiences were significantly and positively correlated with their IPA use, even after controlling for recent stressful experiences and gender-based violence exposures. Psychological distress symptoms significantly mediated the relation between sexist experiences and IPA use. The findings demonstrate the importance of considering the role of sexism in women's IPA.

Telemedicine and virtual healthcare for survivors of sexual assault and intimate partner violence: A qualitative study.

BACKGROUND: Survivors of sexual assault and intimate partner violence often face many challenges in seeking/receiving healthcare and are often lost to follow up. OBJECTIVES: Our study objectives are to evaluate the feasibility, acceptability, and satisfaction of using telemedicine technology among sexual assault and intimate partner violence patients who present to a Canadian Emergency Department. DESIGN: Qualitative research was conducted using a thematic approach. METHODS: Patients were identified from a case registry of all sexual assault and intimate partner violence cases seen between 1 April 2020 and 31 March 2022 from an emergency department of a large Canadian hospital. Qualitative trauma-informed interviews were conducted with consenting participants. Thematic qualitative analyses were performed to investigate barriers and drivers of telemedicine for follow-up care. RESULTS: Of the 1007 sexual assault and intimate partner violence patients seen during the study timeframe, 180 (8%) consented to be contacted for future research, and 10 completed an interview regarding telemedicine for follow-up care. All participants were cisgendered women, 5 (50%) experienced sexual assault, 6 (60%) physical assault, and 3 (30%) verbal assault. All knew their assailant, and 6 (60%) were assaulted by a current or former intimate partner. Three themes emerged as drivers of telemedicine use: increased comfort, increased convenience, and less time required for the appointment. Three thematic barriers to telemedicine use included lack of privacy from others, lack of safety from their assailant, and pressure to balance competing tasks during the appointment. CONCLUSION: This study illustrated that telemedicine for sexual assault and intimate partner violence follow-up care is feasible, acceptable, and can improve patient satisfaction with follow-up care. Ensuring safety and privacy are key considerations when offering telemedicine as an appropriate option for survivors.

A qualitative analysis of telemedicine and virtual healthcare for survivors of sexual assault and intimate partner violenceWhy was the study done? Sexual assault and intimate partner violence are prevalent issues in our society. More than 3/10 Canadian women have been sexually assaulted at least once since the age of 15 years and more than 4/10 Canadian women have experienced IPV in their lifetime. Survivors face many obstacles to receiving care after sexual assault and intimate partner violence and are often lost to follow up.What did the researchers do?The researchers studied the acceptability, feasibility, and satisfaction of using telemedicine technology among sexual assault and intimate partner violence survivors who presented to a Canadian Emergency Department. Sexual assault and intimate partner violence survivors were interviewed individually about their experience receiving follow-up care via telemedicine. The interviews were done using a trauma-informed approach, and data analyses were done to explore the barriers and drivers of telemedicine for follow-up care.What did the researchers find?The total number of interviews was 10, and all participants were cisgendered women. All knew their assailant and six were assaulted by a current or former intimate partner. Survivors found that telemedicine was an accessible way to have a follow-up appointment and were mostly satisfied with their experience. Three major drivers to using telemedicine included increased comfort being at home in their own space, increased convenience as they did not have to leave their house to have the appointment, and less time required for the appointment. Three major barriers to using telemedicine included lack of privacy from others during the appointment, pressure to balance competing tasks during the appointment, and lack of safety from their assailant.What do the findings mean?This study has shown that follow-up care for sexual assault and intimate partner violence survivors using telemedicine can be feasible, acceptable, and can improve patient satisfaction. However, it is important to consider factors such as safety and privacy on an individual basis when offering telemedicine as an option for follow-up care for survivors.

Injuries and /or trauma due to sexual gender-based violence among survivors in sub-Saharan Africa: a systematic scoping review of research evidence.

BACKGROUND: Sexual and gender-based violence (SGBV) is a prevalent issue in sub-Saharan Africa (SSA), causing injuries and trauma with severe consequences for survivors. This scoping review aimed to explore the range of research evidence on injuries and trauma resulting from SGBV among survivors in SSA and identify research gaps. METHODS: The review employed the Arksey and O'Malley methodological framework, conducting extensive literature searches across multiple electronic databases using keywords, Boolean operators, medical subject heading terms and manual searches of reference lists. It included studies focusing on injuries and trauma from SGBV, regardless of gender or age, published between 2012 and 2023, and involved an SSA countries. Two authors independently screened articles, performed data extraction and quality appraisal, with discrepancies resolved through discussions or a third author. Descriptive analysis and narrative synthesis were used to report the findings. RESULTS: After screening 569 potentially eligible articles, 20 studies were included for data extraction and analysis. Of the 20 included studies, most were cross-sectional studies (n = 15; 75%) from South Africa (n = 11; 55%), and involved women (n = 15; 75%). The included studies reported significant burden of injuries and trauma resulting from SGBV, affecting various populations, including sexually abused children, married women, visually impaired women, refugees, and female students. Factors associated with injuries and trauma included the duration of abuse, severity of injuries sustained, marital status, family dynamics, and timing of incidents. SGBV had a significant impact on mental health, leading to post-traumatic stress disorder, depression, anxiety, suicidal ideations, and psychological trauma. Survivors faced challenges in accessing healthcare and support services, particularly in rural areas, with traditional healers sometimes providing the only mental health care available. Disparities were observed between urban and rural areas in the prevalence and patterns of SGBV, with rural women experiencing more repeated sexual assaults and non-genital injuries. CONCLUSION: This scoping review highlights the need for targeted interventions to address SGBV and its consequences, improve access to healthcare and support services, and enhance mental health support for survivors. Further research is required to fill existing gaps and develop evidence-based strategies to mitigate the impact of SGBV on survivors in SSA.

"I Am Not Taking Sides as a Female At All": Co-Facilitation and Gendered Positioning in a Domestic Abuse Perpetrator Program.

The facilitation of domestic abuse perpetrator programs (DAPPs) by mixed gender co-facilitation pairs brings different facilitator perspectives and enables the modeling of egalitarian and respectful male-female relationships. This study analyzed 22 video and audio recordings of community-based DAPP groups featuring male participants, and male and female facilitators. Using thematic analysis, we aimed to understand how facilitators engaged participants and whether the facilitator's gender affected this. We found an asymmetry in the positioning of the facilitators. Group participants challenged both facilitators, but especially the female facilitators. Facilitator strategies toward behavior change included softening direct challenges (female facilitators) and mobilizing the shared category of men (male facilitators). Implications from this study are for reflective practice in facilitator management and supervision specifically focused on gendered power dynamics. Skilled facilitation is key to behavior change and the gendered interplay within groups may be a crucial element in the reduction of interpersonal violence and abuse.

Forensic medicine in (West-Bank) Palestine visions and obstacles.

Forensic medicine in Palestine is a new branch of medicine compared with other medical specialties and is still at a nascent stage. Only 6 medical doctors specializing in forensic medicine are currently practicing in Palestine, including only one female specialist (the author). Palestine has adopted a system that combines clinical forensic medicine and forensic pathology. Forensic doctors can deal with both the living and the dead and deal with cases of physical and sexual assault, gender-based violence, and domestic violence. In different courts, such as civil, military, and shariah, Palestinian judicial decisions depend primarily on forensic medical reports and the testimonies that forensic doctors provide for the court to explain their reports. Forensic medicine has a significant role and crucial impact on achieving justice for victims of all types of abuse, either dead or alive. However, the role of forensic medicine in achieving justice for victims, and hence fighting and eradicating violence, is underestimated and not fully understood by the general population. This paper introduces to the reader the status of forensic medicine in Palestine, focusing on the challenges and obstacles faced by both the victims and forensic doctors. Meeting these challenges and overcoming obstacles is essential for fighting all types of violence, including violence against women in Palestinian society. The current provision of forensic medical services in Palestine is less than satisfactory, being considerably hampered by the lack of legislation and regulations. Palestine is in great need of continued international support for forensic medicine and forensic services. Two projects supported by the United Nations put the country on the road, but there are still many miles to go toward the aim.