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Lo A, Griffin G, Byambadash H, Mitchell E, Dantas JAR. "Stuck Due to COVID": Applying the Power and Control Model to Migrant and Refugee Women's Experiences of Family Domestic Violence in the Context of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:627. [PMID: 40283850 PMCID: PMC12027428 DOI: 10.3390/ijerph22040627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2025] [Revised: 03/28/2025] [Accepted: 04/02/2025] [Indexed: 04/29/2025]
Abstract
The COVID-19 pandemic had acute and lasting gendered impacts around the world, with UN Women declaring a shadow pandemic of violence against women. This study aimed to explore the impact of the COVID-19 pandemic on migrant and refugee women's experiences of family domestic violence (FDV) in Western Australia (WA) using a community-based participatory research approach. Thirty-eight interviews and two qualitative surveys conducted with 27 women were included in the analysis. Interview and survey data underwent reflexive thematic analysis informed by the Power and Control Wheel, generating three themes and ten subthemes: (1) the facets of violence women experienced (isolation; economic violence; emotional violence; visa vulnerabilities; fear and uncertainty), (2) the systemic enablers of FDV and barriers to seeking help (FDV service provision; the immigration system), and (3) the impact of the COVID-19 pandemic and government measures on women and family (enabling FDV; reducing the impact of FDV; COVID-19 paled into insignificance). While for some migrant and refugee women, government measures facilitated access to support for FDV, our findings show that for others, the COVID-19 pandemic exacerbated and became part of the violence they had already experienced. Recommendations for tailored FDV and other support during the COVID-19 pandemic are discussed, including the expansion of family violence provisions for all visa types.
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Affiliation(s)
| | | | | | | | - Jaya A. R. Dantas
- Curtin School of Population Health, Curtin University, Bentley 6102, Australia; (A.L.); (G.G.); (H.B.); (E.M.)
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Shanthosh J, Lynch E, Cullen P, Henry A, Korczak V. 'It's a challenging environment' health worker perspectives on domestic violence presentations to emergency departments in New South Wales hospitals in the context of the COVID-19 pandemic. BMC Health Serv Res 2025; 25:467. [PMID: 40158075 PMCID: PMC11954287 DOI: 10.1186/s12913-025-12597-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 03/17/2025] [Indexed: 04/01/2025] Open
Abstract
BACKGROUND Domestic and family violence (DFV) is a significant issue in Australia, with one in four women experiencing DFV in their lifetime. Emergency departments (EDs) within public hospitals are a priority setting for identifying, treating, and referring those at risk through sensitive clinical inquiry. However, there remains a dearth of evidence regarding health staff's knowledge, skills, and confidence in addressing the burden of DFV from their perspective. This research aims to address the evidence gap from the perspectives of health workers working within a diverse range of public hospital EDs in New South Wales (NSW), Australia, at the time of the COVID-19 pandemic. METHODS Semi-structured interviews were conducted online, adhering with COVID-19 restrictions at the time, and thematic analysis performed. RESULTS While EDs within NSW hospitals are often a first port of call for those experiencing DFV, clinician health staff perceive overwhelmingly, that they lack the capacity individually and institutionally to appropriately address presentations and had little knowledge of existing policies and procedures. CONCLUSIONS Policy and programmatic solutions to the capacity gap need to be current, highly feasible for an ED environment and ongoing to account for rotating staff and the evolving nature of DFV presentations. The preparedness of EDs within public hospitals in NSW will be crucial to the success of strategic initiatives and recent historic law reforms in supporting victim-survivors and preventing DFV.
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Affiliation(s)
- Janani Shanthosh
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Elena Lynch
- School of Engineering UNSW, Sydney, Australia
| | - Patricia Cullen
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- School of Population Health UNSW, Sydney, Australia
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, Australia
| | - Amanda Henry
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, Sydney, Australia
| | - Viola Korczak
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Royal Prince Alfred Hospital, Sydney, Australia
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Haen LS, McGown M, Taylor S, Conroy L, Velonis A. Systemic Occupational Health Needs of Gender-Based Violence Advocates: Findings From the Early Months of the Pandemic. J Occup Environ Med 2024; 66:e145-e152. [PMID: 38349323 DOI: 10.1097/jom.0000000000003065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
OBJECTIVE This study explores occupational health burdens faced by domestic and sexual violence advocates, many of which intensified during the COVID-19 pandemic. It identifies key stressors and offers advocate-driven recommendations to improve their wellbeing, addressing the lack of system-level interventions in the occupational health literature. METHODS Semistructured interviews were conducted with 22 advocacy professionals. Thematic content analysis guided transcript coding, and researchers shared initial results with participants in two member checking sessions to validate the preliminary findings. RESULTS Advocates experienced logistical, emotional, and systemic stressors, including loss of peer support and unempathetic workplace cultures. Recommendations prioritize advocate wellbeing and call for systemic changes. CONCLUSIONS Advocates' occupational stressors highlight the need for system-level solutions to enhance their occupational wellbeing, particularly during large-scale emergencies. Collaborative efforts among employers, funders, and staff are essential to address system deficiencies.
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Affiliation(s)
- Lisa Sophia Haen
- From the Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois (L.S.H., M.M.G., S.T., A.V.); and Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois (L.C.)
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Kunasagran PD, Mokti K, Ibrahim MY, Rahim SSSA, Robinson F, Muyou AJ, Mujin SM, Ali N, Chao GGC, Nasib R, Loong ACE, Rahim NBA, Ahmad MH, Dhanaraj PS, Arumugam P, Yusoff J. The Global Landscape of Domestic Violence against Women during the COVID-19 Pandemic: A Narrative Review. Korean J Fam Med 2024; 45:3-11. [PMID: 37848369 PMCID: PMC10822725 DOI: 10.4082/kjfm.23.0084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/03/2023] [Accepted: 07/31/2023] [Indexed: 10/19/2023] Open
Abstract
The coronavirus disease (COVID-19) pandemic has led to an alarming increase in domestic violence against women owing to lockdown measures and limited access to support services. This article provides insights into the global prevalence of domestic violence, barriers to seeking help, its impact on women and children, and the best practices implemented worldwide. Domestic violence encompasses various forms of abuse; many young women experience partner violence. Barriers to seeking help include fear, financial constraints, lack of awareness of available services, and distrust among stakeholders. The consequences of domestic violence affect the mental health of both mothers and children. Countries have increased shelter funding and developed innovative protocols to reach survivors and address this issue. However, the healthcare sector's involvement in addressing domestic violence has been limited. This review advocates collaboration among healthcare institutions and government bodies. Key recommendations include utilizing telehealth services, implementing comprehensive training programs, establishing effective referral systems, enhancing health education, developing a domestic violence registry, improving the responses of law enforcement and justice systems through healthcare integration, promoting data sharing, and conducting further research. Healthcare systems should recognize domestic violence as a public health concern and detect, prevent, and intervene in cases to support survivors.
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Affiliation(s)
- Priya Dharishini Kunasagran
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Khalid Mokti
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Mohd Yusof Ibrahim
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Syed Sharizman Syed Abdul Rahim
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Freddie Robinson
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Adora J Muyou
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Sheila Miriam Mujin
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Nabihah Ali
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Gary Goh Chun Chao
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Rudi Nasib
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Abraham Chiu En Loong
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Nachia Banu Abdul Rahim
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Mohd Hafizuddin Ahmad
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | | | - Pathman Arumugam
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Jamilah Yusoff
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
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Henry A, Yang J, Grattan S, Roberts L, Lainchbury A, Shanthosh J, Cullen P, Everitt L. Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study. Front Glob Womens Health 2022; 3:819953. [PMID: 35814835 PMCID: PMC9257034 DOI: 10.3389/fgwh.2022.819953] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Australian antenatal care includes specific screening and service provision for domestic and family violence (DFV) and mental health. However, the COVID-19 pandemic resulted in major care changes, including greatly expanded telehealth. Given difficulties in a safe assessment and management of disclosures via telehealth, DFV and mental health service provision might be substantially impacted. This study therefore aimed to assess COVID-19 effects on DFV and mental health screening, as well as broader service provision from the perspective of local maternity service providers. Methods Mixed-methods study of staff surveys and interviews of staff directly involved in pregnancy care (doctors, midwives, and allied health) in three Sydney (Australia) maternity units, from October 2020 to March 2021. Surveys and interviews interrogated perceived effects of the COVID-19 pandemic on delivery (ensuring required services occurred), timeliness, and quality of (a) overall maternity care and (b) DFV and mental health screening and care; and also advantages and disadvantages of telehealth. Surveys were descriptively analyzed. Interviews were conducted online, recorded, and transcribed verbatim prior to thematic analysis. Results In total, 17 interviews were conducted and 109 survey responses were received. Breakdown of survey respondents was 67% of midwives, 21% of doctors, and 10% of allied health. Over half of survey respondents felt the pandemic had a negative effect on delivery, timeliness, and quality of overall pregnancy care, and DFV and mental health screening and management. Perceived telehealth positives included convenience for women (73%) and reducing women's travel times (69%). Negative features included no physical examination (90%), difficulty regarding non-verbal cues (84%), difficulty if interpreter required (71%), and unsure if safe to ask some questions (62%). About 50% felt telehealth should continue post-pandemic, but for <25% of visits. Those perceived suitable for telehealth were low-risk and multiparous women, whereas those unsuited were high-risk pregnancy, non-English speaking, and/or mental health/psychosocial/DFV concerns. “Change to delivery of care” was the central interview theme, with subthemes of impact on mental health/DFV screening, telehealth (both positive and negative), staff impact (e.g., continuity of care disruption), and perceived impact on women and partners. Discussion While telehealth may have an ongoing, post-pandemic role in Australian maternity care, staff believe that this should be limited in scope, mostly for low-risk pregnancies. Women with high risk due to physical health or mental health, DFV, and/or other social concerns were considered unsuited to telehealth.
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Affiliation(s)
- Amanda Henry
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales (NSW), Sydney, NSW, Australia
- Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
- The George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, Australia
- *Correspondence: Amanda Henry
| | - Jennifer Yang
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales (NSW), Sydney, NSW, Australia
| | - Sarah Grattan
- The George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Lynne Roberts
- Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
- St George and Sutherland Clinical School, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | | | - Janani Shanthosh
- The George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, Australia
- Australian Human Rights Institute, UNSW Sydney, Kensington, NSW, Australia
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Kensington, NSW, Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Louise Everitt
- Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
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Leroux J, Johnston N, Brown AA, Mihic A, DuBois D, Trudell A. Delivery of Distance Counselling to Survivors of Sexual Violence: A Scoping Review of Promising and Best Practices. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221097427. [PMID: 35514077 PMCID: PMC9082742 DOI: 10.1177/00469580221097427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Distance counselling holds immense potential for improving access to trauma supports for survivors of sexual violence (SV), and particularly for under-served groups who disproportionately experience violence and myriad barriers to accessing in-person supports. And yet, the evidence-base for the practice and delivery of distance counselling remains under-developed. In the context of COVID-19, where telehealth applications have undergone a rapid uptake, we undertook a scoping review of existing evidence of therapeutic and organizational practices related to the real-time (synchronous) delivery of distance counselling to survivors of SV. We based our scoping review methods on Arksey and O'Malley framework and in accordance with the guidance on scoping reviews from the Joanna Briggs Institute (JBI) and PRISMA reporting guidelines for scoping reviews. A comprehensive search of MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Sociological Abstracts was undertaken in October 2020, and again in March 2022. Searching, reviewing, appraisal, and data extraction was undertaken by two reviewers. In total, 1094 records were identified that resulted in 20 studies included. Descriptions, findings, and recommendations were gleaned and synthesized into potential practices using inductive thematic analysis. While many studies have an appreciative orientation to distance counselling, these benefits tend to be framed as non-universal, and conditional on survivor safety, flexibility, anonymity, survivor choice, strong and inclusive technology, and a supported workforce.Despite the limited evidence-base, we present several clusters of findings that, taken together, can be used to support current COVID-19 distance counselling initiatives with survivors, as well as guide the future development of best practices.
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Affiliation(s)
- Janette Leroux
- Sexual Assault Centre Kingston, Kingston, Ontario, Canada
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Natalie Johnston
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | | | - Alanna Mihic
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Denise DuBois
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - AnnaLise Trudell
- Anova, Gender-Based Violence Shelter and Sexual Assault Centre London, Ontario, Canada
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