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1.
BMC Public Health ; 24(1): 1944, 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39030550

RESUMO

BACKGROUND: Myths of sexual aggression have a negative influence in aggressive behavior against women, in the institutional approaches to sexual violence and in how women cope with it. The objective of this study is to describe acceptance of myths of sexual aggression in young women and men residing in Spain. METHOD: Cross-sectional study carried out online with 2,515 women (50.2%) and men (49.8%) ages 18-35 in Spain in 2020. Information on myths was collected using the Acceptance of Modern Myths About Sexual Aggression Scale (AMMSA). We described the myths most prevalent among women and men. The variables associated with myths were identified using multiple regression. The regression models were adjusted by sociodemographic and sexual orientation variables. RESULTS: The average AMMSA values were higher among men [mean: 3.11; standard deviation (sd):1.23] than among women (mean 2.49 sd:1.11). In both sexes, the myths with greater acceptance showed the presence of patriarchal gender roles in sexual contacts. Men were more likely than women to accept myths that question allegations and severity of violence. Having a higher level of educational studies (ß -0.350 sd: 0.046) was associated with lower average AMMSA values. Being born in Latin America (ß 0.047 sd: 0.063) was associated with higher average AMMSA values. Among heterosexual men, AMMSA values were greater than among gay and bisexual men. Among women, there was no difference in average AMMSA values based on sexual orientation. CONCLUSIONS: Myths persist during youth that question and trivialize sexual violence against women. It is necessary to implement strategies that reduce these myths, particularly in heterosexual men, in those of foreign-born origin and among those with low levels of education.


Assuntos
Agressão , Delitos Sexuais , Humanos , Espanha , Masculino , Estudos Transversais , Feminino , Adulto , Adulto Jovem , Adolescente , Agressão/psicologia , Delitos Sexuais/estatística & dados numéricos , Delitos Sexuais/psicologia , Inquéritos e Questionários , Comportamento Sexual/estatística & dados numéricos , Comportamento Sexual/psicologia
2.
Health Sociol Rev ; : 1-13, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38946047

RESUMO

Like other parts of the world, women and girls in the Commonwealth Caribbean (CC) experience high and escalating rates of physical and sexual violence. The interview presented outlines some factors that underscore the gendered disparities of violence against women in the Caribbean as well as how healthcare responses are not developed for marginalised women and girls. The interview explores the invisibility of women and girls within healthcare and broader national healthcare structures responses through case details analysis of a Barbadian strategic litigation case. The interview calls for transdisciplinary approaches to analysing the effectiveness of the global health system that make space for not just traditional research approaches but also lived experiences 'from below' and input of advocates and activists. Despite Barbados being a signatory to a range of global health initiatives to improve healthcare responses to gender-based violence, the country does not have a formalised, comprehensive national plan to inform prevention and intervention measures. The interview shows the connections between plantocratic patriarchal culture (PPC) and the existing gaps that cause harm to women and girls who experience various types of gendered violence.

3.
Int J Nurs Knowl ; 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-39031844

RESUMO

PURPOSE: To verify clinical validity evidence for the ineffective social support network nursing diagnosis. METHOD: A quantitative, descriptive, cross-sectional study was performed with 98 violence-victimized women treated in two reference centers for violence in the city of Recife, Pernambuco, Brazil. The women were interviewed from August 2021 to June 2022. FINDINGS: The clinical indicators that best predicted the nursing diagnosis were as follows: Frustration with unmet support expectations, negative social interaction, perceived neglect of support demands, feeling of abandonment, low reciprocity, and encouragement of negative behaviors. Etiological factors that showed greater association were excessive demand for support, limited social network, social isolation, the fragility of institutional service networked organizations, and inadequate appreciation of available social support. CONCLUSIONS: The clinical validity evidence for the ineffective social support network nursing diagnosis has been verified. Thus, the validated clinical indicators and etiological factors can accurately diagnose and predict the emergence of this phenomenon in violence-victimized women. IMPLICATIONS FOR NURSING PRACTICE: The results contribute to advancing scientific knowledge in nursing teaching, research, and practice and support the nursing process in violence-victimized women.


OBJETIVO: Verificar evidências de validade clínica para o diagnóstico de enfermagem Rede de Apoio Social Ineficaz. MÉTODO: Estudo quantitativo, descritivo e transversal realizado com 98 mulheres vítimas de violência atendidas em dois centros de referência em violência na cidade do Recife, Pernambuco, Brasil. As mulheres foram entrevistadas no período de agosto de 2021 a junho de 2022. RESULTADOS: Os indicadores clínicos que melhor predisseram o diagnóstico de enfermagem foram: Frustração com Expectativas de Apoio Não Atendidas, Interação Social Negativa, Negligência Percebida nas Demandas de Apoio, Sentimento de Abandono, Baixa Reciprocidade e Incentivo a Comportamentos Negativos. Os fatores etiológicos que apresentaram maior associação foram Demanda Excessiva de Apoio, Rede Social Limitada, Isolamento Social, Fragilidade das Organizações em Rede de Serviços Institucionais e Valorização Inadequada do Apoio Social Disponível. CONCLUSÕES: Foram verificadas evidências de validade clínica para o diagnóstico de enfermagem Rede de Apoio Social Ineficaz. Assim, os indicadores clínicos e fatores etiológicos validados têm a capacidade de diagnosticar e prever com precisão o surgimento deste fenômeno em mulheres vítimas de violência. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: A validação clínica do diagnóstico fundamenta as intervenções de enfermagem direcionadas às mulheres vítimas de violência e à sua rede de apoio social. PALAVRAS­CHAVE: Apoio social; Educação saudável; diagnóstico de enfermagem; rede social; violência contra as mulheres.

4.
Soc Sci Med ; 356: 117144, 2024 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-39032196

RESUMO

Alcohol is recognized as a driver of intimate partner violence (IPV) perpetration and experience, but relatively little research has focused on the role of couples' drinking patterns, nor pathways between alcohol and violence. We draw on data collected among young (18-30 year old) people living in informal settlements who self-selected to enroll in an intervention trial to reduce IPV in Durban, South Africa to understand these dynamics. Between September 2015 and September 2016 quantitative data were collected from women, who reported on their own experiences of IPV and alcohol use, as well as their partner's own alcohol use. To contextualise and interpret the quantitative results, we use qualitative data from women and men (who were not in relationships with one another) to understand potential pathways through which alcohol use may shape conflict in relationships. All forms of IPV (physical and/or sexual, emotional and economic) were more common among women where either, they alone had problematic drinking levels, their partner was frequently drunk but they did not have problematic alcohol use, or they had problematic alcohol use and their partner was drunk frequently. Qualitative data suggested women and men in relationships rarely drank together. Three potential ways in which alcohol use increased conflict and IPV: disinhibition, with women and men more likely to get into arguments and speak 'badly' to one another; the impact of men's drinking on relationships, including economic provision and providing emotional support; and, the close association between alcohol consumption and infidelity, with women's public drinking being particularly stigmatized and male partner's seeing this as a challenge to their authority and control. Interventions addressing the alcohol-IPV nexus need to also address male patriarchal control and alcohol's close association with infidelity and the impact on finances, as well as reducing alcohol use.

5.
BMC Prim Care ; 25(1): 258, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014330

RESUMO

BACKGROUND: Men's violence against women is a global health problem causing physical, mental, sexual and reproductive ill-health. The World Health Organisation has estimated that every third woman in the world has been exposed to physical and/or sexual violence. Swedish primary care is central for victims of violence, as it is normally the first port of call for seeking healthcare. This requires professional competence on violence, and its causes. It also requires resources for working with violence prevention, disclosure and supportive actions. The aim of this study is to deepen the understanding of how primary care professionals in Sweden deal with violence against women. We analyse their viewpoints, experiences and practices of working with violence as a health problem, and especially if, and if so how, they ask patients about violence. METHODS: A qualitative, explorative research design was adopted. Research interviews were conducted with 18 health professionals at eight primary care clinics. These clinics were located in four different regions, from the south to the north, in large urban areas, middle-size cities and rural areas. The interviews were voice recorded and transcribed verbatim. Thematic analysis was used to analyse the interviews. RESULTS: Three themes, with a total of ten related sub-themes, were developed. These themes are: (a) Varying understandings and explanations of violence against women; (b) The tricky question of asking about violence; and (c) Multiple suggestions for improving primary care's work with violence against women. The awareness of violence varied considerably, with some practitioners being highly knowledgeable and having integrated violence into their everyday practice, whereas others were less knowledgeable and had not paid much attention to violence. The very naming of violence seemed to be problematic. Several suggestions for improvements at professional, managerial and organisational levels were articulated. CONCLUSIONS: The results shed important light on the professionals' problems and struggles when dealing with violence against women in primary care. Better support and resources from the healthcare organisation, clearer leadership and more detailed policy would improve and facilitate everyday practice. All of these factors are indispensable for primary care's work with victims of men's violence against women.


Assuntos
Atitude do Pessoal de Saúde , Atenção Primária à Saúde , Pesquisa Qualitativa , Humanos , Suécia , Feminino , Masculino , Adulto , Pessoal de Saúde/psicologia , Entrevistas como Assunto , Pessoa de Meia-Idade , Violência de Gênero/prevenção & controle , Violência de Gênero/psicologia
6.
Trials ; 25(1): 486, 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39020408

RESUMO

BACKGROUND: In 2021, more than two-thirds of the world's children lived in a conflict-affected country. In 2022, 13 million Ukrainians were forced to flee their homes after Russia's full-scale invasion. Hope Groups are a 12-session psychosocial, mental health, and parenting support intervention designed to strengthen parents, caregivers, and children affected by war and crisis. The primary objective of this study is to evaluate the effectiveness of Hope Groups among Ukrainians affected by war, compared to a wait-list control group. This protocol describes a promising decentralized intervention delivery model and an innovative research design, which estimates the causal effect of Hope Groups while prioritizing prompt delivery of beneficial services to war-affected participants. METHODS: This protocol describes a pragmatic cluster randomized controlled trial (RCT) among Ukrainians externally displaced, internally displaced within Ukraine, and living at home in war-affected areas. This study consists of 90 clusters with 4-7 participants per cluster, totaling approximately n = 450 participants. Intervention clusters will receive 12-session Hope Groups led by peer facilitators, and control clusters will be wait-listed to receive the intervention after the RCT concludes. Clusters will be matched on the facilitator performing recruitment and intervention delivery. Primary outcomes are caregiver mental health, violence against children, and positive parenting practices. Secondary outcomes include prevention of violence against women and caregiver and child well-being. Outcomes will be based on caregiver report and collected at baseline and endline (1-week post-intervention). Follow-up data will be collected among the intervention group at 6-8 weeks post-intervention, with aims for quasi-experimental follow-ups after 6 and 12 months, pending war circumstances and funding. Analyses will utilize matching techniques, Bayesian interim analyses, and multi-level modeling to estimate the causal effect of Hope Groups in comparison to wait-list controls. DISCUSSION: This study is the first known randomized trial of a psychosocial, mental health, and parenting intervention among Ukrainians affected by war. If results demonstrate effectiveness, Hope Groups hold the potential to be adapted and scaled to other populations affected by war and crisis worldwide. Additionally, methodologies described in this protocol could be utilized in crisis-setting research to simultaneously prioritize the estimation of causal effects and prompt delivery of beneficial interventions to crisis-affected populations. TRIAL REGISTRATION: This trial was registered on Open Science Framework on November 9, 2023. REGISTRATION: OSF.IO/UVJ67 .


Assuntos
Cuidadores , Saúde Mental , Poder Familiar , Humanos , Cuidadores/psicologia , Ucrânia , Poder Familiar/psicologia , Criança , Ensaios Clínicos Pragmáticos como Assunto , Conflitos Armados/psicologia , Feminino , Guerra , Masculino
7.
J Interpers Violence ; : 8862605241254143, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38842209

RESUMO

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.

8.
Health Res Policy Syst ; 22(1): 71, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38914999

RESUMO

BACKGROUND: Despite a large growth in evidence on violence against women (VAW) over the last 25 years, VAW persists, as do gaps in the field's knowledge of how to prevent and respond to it. To ensure that research on VAW in low- and middle-income countries (LIMCs) is addressing the most significant gaps in knowledge, and to prioritise evidence needs to reduce VAW and better support victims/survivors, the Sexual Violence Research Initiative (SVRI) and Equality Institute (EQI) led a process of developing a global shared research agenda (GSRA) on VAW in LMICs. METHODS: The GSRA was developed through a six-stage adaptation of the Child Health and Nutrition Research Initiative (CHNRI) method, which draws on the principle of the 'wisdom of the crowd'. These steps included: a review of the literature on VAW in LMICs and development of domains; the generation of research questions within four domains by an Advisory Group; the consolidation of research questions; scoring of research questions by a Global Expert Group and the Advisory Group according to three criteria (applicability, effectiveness and equity); consultation and validation of the findings with the Advisory Group; and wide dissemination of the findings. RESULTS: The highest ranked research questions in the GSRA pertain to the domain of Intervention research, with some highly ranked questions also pertaining to the domain of Understanding VAW in its multiple forms. Questions under the other two domains, Improving existing interventions, and Methodological and measurement gaps, were not prioritised as highly by experts. There was strong consistency in top ranked research questions according to experts' characteristics, albeit with some important differences according to experts' gender, occupation and geographical location. CONCLUSIONS: The GSRA findings suggest that currently the VAW field is shifting towards intervention research after several decades of building evidence on understanding VAW, including prevalence, drivers and impacts of violence. The findings also suggest a strong emphasis on under-served populations, and under-researched forms of VAW. Future priority setting exercises in LMICs that seek to decolonise knowledge should ensure that methodologies, and modalities of engagement, put diverse voices at the centre of engagement. Trial registration Not applicable.


Assuntos
Países em Desenvolvimento , Humanos , Feminino , Pesquisa , Violência de Gênero/prevenção & controle , Delitos Sexuais/prevenção & controle , Saúde Global , Violência/prevenção & controle
9.
Front Psychol ; 15: 1360192, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38939216

RESUMO

Purpose: The purpose of this study is to bring a multilevel perspective to the discussion of the antecedents of violence against women in higher education settings. Originality/value: This paper was guided by the need indicated in the literature for research on the multiple levels that constitute the context of violence against women, as this is a public health problem, a designation that indicates the urgency with which this pervasive phenomenon should be addressed. The university context is conducive to this type of research, as it includes situations that favor instances of violence. Additionally, it aligns with the United Nations Sustainable Development Goals (SDGs) of Gender Equality and Quality Educations. Design/methodology/approach: This paper follows a qualitative and interpretative approach. This choice was due to the need to know the "how" and "why" elements that are part of violence against women in the university context. As the main source of evidence for the study, we conducted 20 in-depth interviews with women (victims) and men (aggressors), all university students involved in situations of violence. The transcription of the interviews generated 346 quotations, including 41 analysis codes. Findings: After conducting the data coding, we identified that (i) the actions and omissions of the educational institution, (ii) the taste for violence, the perception of self-efficacy and the influence of the aggressors' group of friends, and (iii) the apparent dichotomy between women's vulnerability and women's strength are among the main antecedents of violence against women. The article concludes with possible research questions to combat violence. Among the contribution of the discussions presented in our article, we highlight the importance of adopting a multilevel view so that we can better understand and fight against this violence, the existence of which is not restricted to the university context.

10.
Violence Against Women ; : 10778012241259712, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38870450

RESUMO

Groups are a common clinical intervention for women survivors of intimate partner violence (IPV). This secondary mixed-methods analysis from a study of 567 Canadian women from the prairie provinces compared the mental health and well-being of 131 women who had attended a IPV group to 436 women who had not attended any group. Qualitatively, perspectives from 131 women (113 comments; 18 interviews) who attended some form of group treatment were analyzed. Of the 199 coded comments about the IPV groups, most were positive (157 or 78.9%), while the remaining 21.1% (42) reflected concerns or suggested changes. Clinical implications are provided.

11.
Forensic Sci Int ; 361: 112084, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38879897

RESUMO

Violence against women is a significant public health concern, with femicide as its most extreme manifestation. This crime is often perpetrated by current or former intimate partners, thus taking the name of intimate partner femicide (IPF). Although international comparisons are essential for prevention policies, cross-country comparative studies are scarce in this context. The aim of this study was to evaluate and compare clinical, epidemiological and medico-legal characteristics of IPF autopsy cases investigated at the Institutes of Legal Medicine of two Western European cities, in order to identify a potential medico-legal pattern of IPF. Autopsy and police reports of IPF cases occurred in the judicial district of Freiburg (Germany) and Padova (Italy) from 2000 to 2022 were analyzed. Data relating to victims, perpetrators, relationship context, and circumstantial and pathological-forensic characteristics of the homicide were collected. Statistical analyses were performed to explore potential relationships between the data collected. Additionally, a review of the literature dealing with autopsy-based studies on IPF was performed. Overall, 82 cases of IPF were analyzed, 39 from Freiburg and 43 from Padova. A total of 6 papers fulfilled the review inclusion criteria. Our study identified a medico-legal pattern of IPF and demonstrated that it did not vary substantially between the two European Countries considered, suggesting that certain IPF characteristics are shared at the European level. However, a significant finding emerged regarding the higher prevalence of firearm-related IPFs in Italy compared to Germany. Forensic pathology research might contribute to developing targeted prevention policies to protect women from this lethal form of violence.

12.
Cureus ; 16(5): e59825, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38846205

RESUMO

Background Intimate partner violence is one of the major problems experienced by women all over the world. Almost one in three women have experienced one or more forms of violence at least once in their lifetime. These estimates confirm that physical and sexual intimate partner violence remains pervasive in the lives of women across the globe. Intimate partner violence has been found to have a severe impact on mental health such as depression symptoms. This study aimed to assess the prevalence of intimate partner violence in terms of controlling behavior, sexual, and physical violence, and its association with depression in women of Chengalpattu district, India. Methods It is a community-based cross-sectional study conducted in 12 villages under the field practicing area of the rural health training center of Chettinad Health and Research Institute in Kelambakkam, India, by simple random sampling among 190 women participants ever married or partnered of age ≥18 years. A pre-tested, semi-structured questionnaire was used which included the WHO Violence Against Women Instrument (VAWI) in the English language and Patient Health Questionnaire 9 (PHQ 9). The collected data was entered in Microsoft Office Excel (Microsoft Corporation, Redmond, United States) and analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). A probability value (p-value) of less than 0.05 was considered statistically significant. Results The mean (SD) age of the study participants was 34 (±8) years. Among the 190 participants, 57.4% reported controlling behavior, 31.1% reported physical violence and 7.4% reported sexual violence by the intimate partner at least once in the past 12 months. About 34.7% were found to have mild depression and 21.6% with moderate depression. There was a significant association between intimate partner violence and depression in women (p < 0.001) Conclusion The present study found that there is a huge impact of intimate partner violence on the mental health of women whether it is psychological, physical, or sexual. There is a need for awareness and effective management of violence against women, especially in rural areas. Strategies focusing on women's education, leadership, empowerment, decision-making, and financial independence are very much needed.

13.
BMC Womens Health ; 24(1): 321, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834977

RESUMO

Violence against women is a phenomenon that involves at least 35% of women worldwide. Violence can be sexual, physical, and/or psychological, perpetrated by the partner, another family member, or a stranger. Violence is a public health problem because its consequences include higher morbidity, higher mortality, and short and long-term physical and psychological health diseases. Most studies prove an association between any type of violence and some chronic pain diagnoses but no one has done a complete collection of this evidence. This systematic review and meta-analysis aimed to evaluate whether this association is statistically significant, including the largest number of studies. Through the inclusion of 37 articles, the association has been demonstrated. Compared with no history of violence, women who did experience violence showed 2 times greater odds of developing chronic pain. The impact of violence was significant also on fibromyalgia separately, but not on pelvic pain.PROSPERO registrationPROSPERO CRD42023425477.


Assuntos
Dor Crônica , Humanos , Dor Crônica/psicologia , Dor Crônica/epidemiologia , Feminino , Dor Pélvica/psicologia , Dor Pélvica/epidemiologia , Dor Pélvica/etiologia , Fibromialgia/psicologia , Fibromialgia/epidemiologia , Fibromialgia/complicações
14.
Annu Rev Public Health ; 45(1): 277-294, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38842174

RESUMO

Violence against women, especially intimate partner violence, is recognized as a global public health issue due to its prevalence and global reach. This article outlines the scope of the issue, with respect to its prevalence, health outcomes, and risk factors, and identifies key milestones that led to its global recognition: methodological and data advances, acknowledgment as a criminal justice and health issue, support by the global women's movement, and the robust evidence demonstrating that intimate partner violence is preventable. Key issues for the future include recognition and consideration of intersectionality in research, improvements in the measurement of other forms of violence against women, and the need to scale up prevention efforts that have documented success. Violence against women is an urgent priority as it affects individuals, their families and surroundings, and the entire global health community.


Assuntos
Saúde Global , Violência por Parceiro Íntimo , Saúde Pública , Saúde da Mulher , Humanos , Feminino , Violência por Parceiro Íntimo/estatística & dados numéricos , Violência por Parceiro Íntimo/prevenção & controle , Fatores de Risco , Prevalência
15.
Violence Against Women ; : 10778012241257244, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38803299

RESUMO

This mixed-methods secondary analysis examined VAW shelter use by 662 Canadian women abused by partners (50.5% Indigenous, 43.4% White, and 6.1% visible minority). Women who had never resided in shelters (n = 242) had less Severe Combined and Total IPV on the Composite Abuse Scale and fewer PTSD symptoms. More nonresidents worked full time and had higher incomes and no children. The 420 women residents mentioned strengths (70.4%) such as supportive staff and safety, and concerns (29.6%) about unsupportive staff and the shelter rules or facility. Some Indigenous women reported racist attitudes by shelter staff and child apprehensions. Practice implications are presented.

16.
Health Policy Plan ; 39(6): 552-563, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38758072

RESUMO

Domestic violence (DV) is a global prevalent health problem leading to adverse health consequences, yet health systems are often unprepared to address it. This article presents a comparative synthesis of the health system's pre-conditions necessary to enable integration of DV in health services in Brazil, Nepal, Sri Lanka and occupied Palestinian Territories (oPT). A cross-country, comparative analysis was conducted using a health systems readiness framework. Data collection involved multiple data sources, including qualitative interviews with various stakeholders; focus-group discussions with women; structured facility observations; and a survey with providers. Our findings highlight deficiencies in policy and practice that need to be addressed for an effective DV response. Common readiness gaps include unclear and limited guidance on DV, unsupportive leadership coupled with limited training and resources. Most providers felt unprepared, lacked guidance and felt unsupported and unprotected by managers and their health system. While in Brazil most providers felt they should respond to DV cases, many in Sri Lanka preferred not to. Such organizational and service delivery challenges, in turn, also affected how health providers responded to DV cases leaving them not confident, uncertain about their knowledge and unsure about their role. Furthermore, providers' personal beliefs and values on DV and gender norms also impacted their motivation and ability to respond, prompting some to become 'activists' while others were reluctant to intervene and prone to blame women. Our synthesis also pointed to a gap in women's use of health services for DV as they had low trust in providers. Our conceptual framework demonstrates the importance of having clear policies and highlights the need to engage leadership across every level of the system to reframe challenges and strengthen routine practices. Future research should also determine the ways in which women's understanding and needs related to DV help-seeking are addressed.


Assuntos
Violência Doméstica , Grupos Focais , Humanos , Feminino , Nepal , Violência Doméstica/prevenção & controle , Sri Lanka , Brasil , Pessoal de Saúde/psicologia , Atenção à Saúde/organização & administração , Pesquisa Qualitativa , Masculino , Entrevistas como Assunto , Adulto , Liderança
17.
Violence Against Women ; : 10778012241252013, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38710508

RESUMO

Child abuse and masculinity have been linked to intimate partner violence (IPV) perpetration. However, there is a lack of work examining multiple aspects of masculinity as links between early abuse experiences and men's IPV perpetration. Grounded in notions of gendered power and patriarchy, this study aimed to examine hostile masculinity, male peer support for violence against women, and problematic anger as aspects of masculinity connecting childhood victimization and men's violence against women. Structural equation modeling results demonstrated that childhood adversity was indirectly related to IPV perpetration via the proposed factors. However, various patterns emerged based on the type of childhood abuse experienced. Practice-based implications are offered.

18.
BMC Pregnancy Childbirth ; 24(1): 353, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741050

RESUMO

INTRODUCTION: Non-consented care, a form of obstetric violence involving the lack of informed consent for procedures, is a common but little-understood phenomenon in the global public health arena. The aim of this secondary analysis was to measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as to examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence. METHODS: We measured the prevalence of non-consented care and three of its variations, forced sterilization or contraception, forced cesarean section, and forced consent on paperwork, during childbirth in Mexico for 2016 (N = 24,036) and 2021 (N = 19,322) using data from Mexico's cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH). Weighted data were stratified by geographical regions. We performed adjusted logistic regression analyses to explore associations. RESULTS: The national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021. A decrease in the prevalence was observed for forced contraception or sterilization without knowledge, forcing women to sign paperwork, and non-consented cesarean sections nationally and in most regions. Women between the ages of 26 and 35 years, married, cohabiting with partner, living in urban settings, who do not identify as Indigenous, and who received prenatal services or gave birth at the Mexican Institute of Social Security (IMSS) facilities experienced a higher prevalence of non-consented care. Being 26 years of age and older, living in a rural setting, experiencing stillbirths in the last five years, having a vaginal delivery, receiving prenatal services at IMSS, or delivering at a private facility were significantly associated with higher odds of reporting non-consented care. CONCLUSION: While a decrease in most of the variations of non-consented care was found, the overall prevalence of non-consented care and, in one of its variations, pressure to get contraceptives, increased at a national and regional level. Our findings suggest the need to enforce current laws and strengthen health systems, paying special attention to the geographical regions and populations that have experienced higher reported cases of this structural problem.


Assuntos
Cesárea , Humanos , Feminino , México/epidemiologia , Gravidez , Adulto , Estudos Transversais , Prevalência , Cesárea/estatística & dados numéricos , Adulto Jovem , Parto , Adolescente , Consentimento Livre e Esclarecido/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Inquéritos e Questionários , Esterilização Reprodutiva/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos
19.
Span J Psychol ; 27: e13, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38757250

RESUMO

The apparently contradictory co-existence of high levels of gender equality and intimate partner violence against women (IPVAW) found in Nordic countries has been termed the Nordic Paradox. The aim of this study was to examine how the Nordic Paradox is discussed and explained by Spanish professionals working in the IPVAW field. Five focus groups (n = 19) and interviews with key informants (n = 10) were conducted. Four main categories of possible explanations for the Nordic Paradox were identified: Macro-micro disconnect (i.e., discordance between individual beliefs and behaviors and macro-social norms of gender equality), IPVAW as multicausal (i.e., IPVAW defined as a multicausal phenomenon that does not necessarily have to be associated with gender equality), cultural patterns of social relationships (i.e., the role of social relationships and the way people relate to each other in the Nordic countries), and backlash effect (i.e., men's reaction to greater equality for women). Although this study does not provide a final explanation for the Nordic paradox, its results provide us with a better understanding of the phenomenon and can help to advance research in this field.


Assuntos
Violência por Parceiro Íntimo , Humanos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/etnologia , Masculino , Adulto , Espanha/etnologia , Feminino , Equidade de Gênero , Países Escandinavos e Nórdicos , Normas Sociais , Pessoa de Meia-Idade , Prevalência , Grupos Focais , Relações Interpessoais
20.
BMC Public Health ; 24(1): 1391, 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38783247

RESUMO

BACKGROUND: Intimate partner violence (IPV) is recognized as a main public health challenge, with serious consequences for women's physical, mental, sexual, and reproductive health. Despite its public health importance, most studies of IPV in Ethiopia mainly focused on individual characteristics and didn't identify how factors operating at different levels affect IPV. Thus, there is limited evidence regarding the hierarchical-level factors of IPV and the effect of individual and community-level determinants of IPV. The aim of this study is to assess the individual and community-level factors associated with violence against women among ever-married reproductive-age women in Ethiopia. METHODS: A retrospective analysis of secondary data retrieved from the Ethiopia Demographic and Health Survey was conducted among reproductive age group women (15-49 years of age) who reported ever being married within the available data set for the domestic violence module. STATA 14 was used to conduct the analysis. A two-level mixed-effects logistic regression analysis was used to determine associations between IPV and individual- and community-level factors. IPV variability across the community was assessed using ICC and PCV. The model's fitness was assessed using the Akaike information criterion (AIC), the Bayesian information criterion (BIC), and the likelihood ratio test. RESULT: The life time prevalence of IPV in this study was 33% [95% CI: 30.74, 34.25]. Women's age 20-24 (AOR = 5.85, 95% CI: 201 3.10, 11.04), 25-29 age group (AOR = 6.41, 95% CI; 3.34, 12.32), 30-34 age group (AOR = 9.48, 95% CI: 4.71, 19.06), 35-39 age group (AOR = 9.88, 95% CI: 4.79, 20.39), 40-44 age group (AOR = 11.10, 95% CI: 5.16, 23.89), and 45-49, (AOR = 14.15, 95% CI: 6.01, 32.80), early marriage (AOR = 1.21, 95% CI: 1.08, 1.47), witnessing inter-parental violence during childhood (AOR = 2.80, 95% CI: 2.16, 3.96), having a lot of living children (AOR = 0.45, 95% CI: 0.26, 0.74), having a partner who drank alcohol (AOR = 3.00, 95% CI: 2.42-3.67), decision-making autonomy of the women (AOR = 0.77, 95% CI: 0.62, 0.97), Poor wealth index (AOR = 1.64, 95% CI: 1.23, 2.18), middle wealth index (AOR = 1.86, 95% CI: 1.36, 2.54) and exposure to media (AOR = 1.47, 95% CI: 1.06, 2.00) were all significantly associated with IPV. CONCLUSION AND RECOMMENDATION: This study showed that one-third of the women experienced IPV in their lifetime. The finding suggested that community based interventions and multi-sectorial collaborations are needed to reduce the IPV and its adverse consequences.


Assuntos
Inquéritos Epidemiológicos , Violência por Parceiro Íntimo , Humanos , Feminino , Etiópia/epidemiologia , Adulto , Adolescente , Violência por Parceiro Íntimo/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto Jovem , Estudos Retrospectivos , Prevalência , Fatores de Risco , Análise Multinível , Fatores Socioeconômicos
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