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Rajaratnam S, Azman A. Violence and trauma encountered by Rohingya women fleeing to Malaysia: a qualitative study. Arch Womens Ment Health 2024; 27:233-240. [PMID: 38006427 DOI: 10.1007/s00737-023-01402-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/15/2023] [Indexed: 11/27/2023]
Abstract
Rohingya women are doubly marginalized owing to their ethnicity and gender. Therefore, this study aims to describe the unique experiences of violence faced by Rohingya women who fled Myanmar and Bangladesh to seek asylum in Malaysia before, during, and after their transit. Primary data were collected from 33 participants comprising Rohingya women refugees and asylum seekers, medical social workers, medical officials, volunteer workers/activists, refugee organization officers, and a mental health care provider. Thematic analysis was used to identify the patterns in and relationships between the concepts in the collected data. Rohingya women were exposed to various forms of violence and trauma by various groups of men, including those from their own community, throughout their journey to and in Malaysia. The lack of recognition of refugees and asylum seekers in Malaysia prevents them from having mainstream or legal access to jobs, education, and healthcare, and this predicament compounds their suffering from violence, especially for women and girls. Rohingya women and girls in Malaysia need better access to healthcare, resources, and support to identify and address violence, which has a significant impact on their health.
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Affiliation(s)
- Surendran Rajaratnam
- Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia.
| | - Azlinda Azman
- School of Social Sciences, Universiti Sains Malaysia, USM, 11800, Georgetown, Penang, Malaysia
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Hinson L, Pliakas T, Schaub E, Nourou AM, Angelone C, Brooks MI, Abga AA, Congo Z, Ki B, Trasi R. Does a school-based intervention increase girls' sexual and reproductive health attitudes and intentions? Results from a mixed-methods cluster-randomized trial in Burkina Faso. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000910. [PMID: 38079379 PMCID: PMC10712850 DOI: 10.1371/journal.pgph.0000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 11/06/2023] [Indexed: 02/12/2024]
Abstract
Adolescent girls in Burkina Faso face unintended pregnancy risk due to a lack of contraceptive use. The (re)solve project was designed to address contraceptive misperceptions and increase girls' perceptions of their pregnancy risk, primarily through a participatory game and a health passport aimed at easing health facility access. The intervention components were implemented for girls in private and public school in grades 4ème and 3ème (grades 9 and 10) in Ouagadougou and Bobo Dioulasso, Burkina Faso. We conducted an impact evaluation using a mixed-methods cluster randomized control trial design to evaluate (re)solve's impact on girls' intentions to use contraception, among other outcomes. Thirty-two schools were randomly allocated intervention or control. The evaluation included quantitative longitudinal surveys at baseline (N = 2,372) and endline (N = 2,072), qualitative in-depth interviews with girls in the intervention group at baseline (N = 41) and endline (N = 48) and with implementation staff (N = 35) and experts (N = 14) at endline. We used generalized estimating equations (GEE) analysis for the main analysis. Girls receiving the intervention had more positive attitudes related to contraception at endline compared to girls at control schools. (re)solve had a positive effect on girls' intention to use contraception (aOR = 1.59, 95% CI 0.97-2.61), though this did not reach statistical significance. The impact was particularly large among girls who had never had sex, girls who attended public schools, and girls in 3ème. Qualitative findings suggest the intervention was well received and positively shifted attitudes and facility-seeking behaviors for many girls, but that myths and misconceptions related to contraceptive use persist in this mostly young, sexually naïve population. That the (re)solve intervention appears to have shifted adolescent girls' attitudes toward using contraception, coupled with positive trends in intention to use contraception, indicates that interventions like (re)solve may 'prime the pump' for behavior change and increasing girls' use of contraception. Trial registration number and date: https://www.isrctn.com/ISRCTN15387847 Registered on June 15th 2021.
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Affiliation(s)
- Laura Hinson
- International Center for Research on Women, Washington, DC, United States of America
| | - Triantafyllos Pliakas
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Londom, United Kingdom
- GSK Vaccines, Wavre, Belgium and Impact Epilysis, Thessaloniki, Greece
| | - Emily Schaub
- International Center for Research on Women, Washington, DC, United States of America
| | | | - Cecelia Angelone
- Pathfinder International, Washington, DC, United States of America
| | | | | | - Zakari Congo
- Pathfinder International, Ouagadougou, Burkina Faso
| | - Bruno Ki
- Pathfinder International, Ouagadougou, Burkina Faso
| | - Reshma Trasi
- Trasi Duarte Consulting, Santa Clara, CA, United States of America
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Fielding-Miller R, Shabalala F, Masuku S, Raj A. Epidemiology of Campus Sexual Assault Among University Women in Eswatini. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP11238-NP11263. [PMID: 31738110 PMCID: PMC7231640 DOI: 10.1177/0886260519888208] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sexual assault on university campuses has attracted growing attention, but there is little data available on the scope of the problem in Southern Africa. We sought to measure the prevalence of campus sexual assault among female university students at the University of Eswatini and describe the experience of survivors using a mixed-methods study design. Women were randomly sampled from a list of all full-time female university students provided by the office of the registrar, and participants completed a brief behavioral survey in a private study office using a tablet with computer-assisted self-interview software. Women who indicated experiences of sexual violence during the survey were invited to self-identify themselves to study staff to participate in a follow-up qualitative interview. We measured sexual assault using the Sexual Experiences Survey-Short Form Version (SES-SFV). We found that women in University were over 6 times more likely to report forced or coerced sex in the previous 12 months than has been previously reported in the general population. Sixty percent of participants reported experiencing an attempted or completed sexual assault in their lifetime, and a total of 38% reported an assault in the past 12 months. The vast majority (93%) of assailants were known to their victim, and the majority (56%) of perpetrators were romantic partners. The majority of participants had never disclosed their assault, and victim blaming and stigma emerged as highly salient themes during in-depth qualitative interviews. Food insecurity, losing a parent before age 21, and hazardous drinking were all significantly associated with experiencing sexual assault in the previous 12 months, as was experiencing a previous assault before the age of 18. To our knowledge, this is the first generalizable study of campus sexual assault prevalence conducted in the Southern African region.
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Affiliation(s)
| | | | - Sakhile Masuku
- Faculty of Health Sciences, University of Eswatini, Mbabane, Eswatini
| | - Anita Raj
- University of California, San Diego School of Medicine, USA
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Salazar-Vizcaya L, Kusejko K, Schmidt AJ, Carrillo-Montoya G, Nicca D, Wandeler G, Braun DL, Fehr J, Darling KEA, Bernasconi E, Schmid P, Günthard HF, Kouyos RD, Rauch A. Clusters of Sexual Behavior in Human Immunodeficiency Virus-positive Men Who Have Sex With Men Reveal Highly Dissimilar Time Trends. Clin Infect Dis 2021; 70:416-424. [PMID: 30874293 DOI: 10.1093/cid/ciz208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/08/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Separately addressing specific groups of people who share patterns of behavioral change might increase the impact of behavioral interventions to prevent transmission of sexually transmitted infections. We propose a method based on machine learning to assist the identification of such groups among men who have sex with men (MSM). METHODS By means of unsupervised learning, we inferred "behavioral clusters" based on the recognition of similarities and differences in longitudinal patterns of condomless anal intercourse with nonsteady partners (nsCAI) in the HIV Cohort Study over the last 18 years. We then used supervised learning to investigate whether sociodemographic variables could predict cluster membership. RESULTS We identified 4 behavioral clusters. The largest behavioral cluster (cluster 1) contained 53% of the study population and displayed the most stable behavior. Cluster 3 (17% of the study population) displayed consistently increasing nsCAI. Sociodemographic variables were predictive for both of these clusters. The other 2 clusters displayed more drastic changes: nsCAI frequency in cluster 2 (20% of the study population) was initially similar to that in cluster 3 but accelerated in 2010. Cluster 4 (10% of the study population) had significantly lower estimates of nsCAI than all other clusters until 2017, when it increased drastically, reaching 85% by the end of the study period. CONCLUSIONS We identified highly dissimilar behavioral patterns across behavioral clusters, including drastic, atypical changes. The patterns suggest that the overall increase in the frequency of nsCAI is largely attributable to 2 clusters, accounting for a third of the population.
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Affiliation(s)
- Luisa Salazar-Vizcaya
- Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, Switzerland
| | - Katharina Kusejko
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Axel J Schmidt
- Division of Infectious Diseases and Infection Control, Cantonal Hospital St. Gallen, Switzerland.,Sigma Research, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | - Dunja Nicca
- Institute of Nursing Science, University of Basel, Switzerland
| | - Gilles Wandeler
- Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, Switzerland
| | - Dominique L Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Jan Fehr
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland
| | - Katharine E A Darling
- Infectious Diseases Service, Department of Medicine, University Hospital of Lausanne (CHUV), Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Lugano Regional Hospital, Switzerland
| | - Patrick Schmid
- Division of Infectious Diseases and Infection Control, Cantonal Hospital St. Gallen, Switzerland
| | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Andri Rauch
- Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, Switzerland
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Kajubi P, Ruark A, Hearst N, Ruteikara S, Green EC. Assessment of an HIV-prevention intervention for couples in peri-urban Uganda: pervasive challenges to relationship quality also challenge intervention effectiveness. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2020; 19:249-262. [PMID: 33119459 DOI: 10.2989/16085906.2020.1811357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Reducing multiple and concurrent partnerships has been identified as a priority in generalised HIV epidemics, yet developing successful interventions to bring about such behaviour change has proven challenging. We offered a three-session intervention aimed to improve couple relationship quality and address HIV risk factors, particularly concurrent sexual partnerships (CSP), in a peri-urban community of Kampala, Uganda. Before launching the intervention, a different group of community members participated in eight single-gender focus group discussions (FGDs) which explored issues of couple relationship quality and satisfaction. Findings from the FGDs guided the intervention. All 162 couples invited to the intervention completed a survey pre- and post-intervention. In FGDs, women and men discussed challenges faced in their relationships, including pervasive dissatisfaction, financial constraints, deception and lack of trust, poor communication, lack of sexual satisfaction, and concurrent sexual partnerships. A difference-in-difference analysis showed no measurable impact of the intervention on relationship quality or sexual risk behaviours over a six-month follow-up among 183 individuals who participated in the intervention, although many stated in response to open-ended questions that they had experienced positive relationship changes. Qualitative findings suggest high demand for couple-focused interventions but also reveal many individual-, couple-, community- and structural-level factors which contribute to women and men seeking concurrent sexual partnerships. More intensive interventions may be needed to overcome these barriers to behaviour change and reduce HIV risk. These findings also raise questions about how to interpret divergent qualitative and quantitative data, a topic which has received little attention in the literature.
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Affiliation(s)
- Phoebe Kajubi
- The Uganda Academy for Health Innovation & Impact, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Currently at Child Health and Development Centre, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Allison Ruark
- Department of Medicine, Brown University, Providence, USA; currently Department of Applied Health Sciences, Wheaton College, Wheaton, IL, USA.,Ukwanda Centre for Rural Health, Stellenbosch University, South Africa
| | - Norman Hearst
- Department of Family and Community Medicine, School of Medicine, University of California, San Francisco, USA
| | | | - Edward C Green
- Department of Anthropology, The George Washington University, Washington, DC, USA
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Psychometric validation of a growth Mindset and Team Communication Tool to measure self-views of growth mindset and team communication skills. J Am Pharm Assoc (2003) 2020; 60:818-826. [PMID: 32446650 DOI: 10.1016/j.japh.2020.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/25/2020] [Accepted: 04/10/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to develop and conduct psychometric validation of a tool to assess self-views of a growth mindset and team communication skills among pharmacists. DESIGN The Mindset and Team Communication Tool was developed to assess self-views of growth mindset and team communication. The survey consisted of 2 parts: (1) 14 items on growth mindset and (2) 13 items on team communication; a 4-point Likert scale of agreement was used as an option to answer all items. SETTING AND PARTICIPANTS The survey was administered to first-year student pharmacists from 2017 to 2019. The participants completed a presurvey at the beginning of the semester and a postsurvey at the end of the semester (3-month follow-up period). OUTCOME MEASURES Psychometric validation was performed by assessing the following properties: face and content validity, internal consistency reliability, construct validity, test-retest reliability, responsiveness validity, and convergent validity. RESULTS A total of 174 participants completed both the pre- and postsurvey (response rate = 92.7%). Internal consistency reliability demonstrated a Cronbach alpha coefficient of 0.827. Construct validity showed that all measures, except for 6 items, loaded highly onto 2 components. Test-retest reliability revealed a statistically significantly positive relationship between the pre- and postsurvey scores. Responsiveness validity demonstrated a statistically significant improvement in the score when an intervention was provided. Convergent validity showed no correlation between the tool score and course grades. CONCLUSION The Mindset and Team Communication Tool demonstrated validity and reliability across a robust set of psychometric values and provides a foundation to describe pharmacists' self-views and explore associations of these views with behavior in teamwork-based environments.
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Kidman R, Kohler HP. Emerging partner violence among young adolescents in a low-income country: Perpetration, victimization and adversity. PLoS One 2020; 15:e0230085. [PMID: 32142550 PMCID: PMC7059948 DOI: 10.1371/journal.pone.0230085] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/20/2020] [Indexed: 11/22/2022] Open
Abstract
Background Intimate partner violence (IPV) is prevalent in high- as well as low-income contexts. It results in a substantial public health burden and significant negative socioeconomic and health outcomes throughout the life-course. However, limited knowledge exists about IPV during early adolescence. This period is critical during the transition to adulthood for at least two reasons: it is when the majority of adolescents in low-income countries first encounter dating, sexuality and partnerships, often with older adolescents or adults, and it is also the period when lifelong patterns of violence and norms about acceptable IPV are formed. The current study is one of the first to measure IPV prevalence among young adolescents in a low-income setting, examine the potential etiology, and investigate relationships with gender ideology, poverty, mental health and childhood adversity. Methods We surveyed 2,089 adolescents aged 10–16 in Malawi using standardized instruments. We estimated the prevalence of IPV, and use multivariate logistic regression to test potential correlates. Results More than a quarter (27%) of ever-partnered adolescents in Malawi report being victimized. A substantial proportion of both male and female adolescents (15%) report committing violence against their partner. Girls were more likely than boys to report being a victim of sexual IPV (24% versus 8%), and boys more likely to perpetrate such (9% versus 1%). Almost 10% of the sample had both committed and been a victim of IPV. Cumulative childhood adversity (e.g., physical abuse, witnessing domestic violence) was a consistent and strong correlate of IPV victimization (adjusted odds ratio (aOR) 1.30) and of perpetration (aOR 1.35). Depression and PTSD were likewise associated with IPV victimization in the overall sample. Notably, gender ideology was not predictive of either victimization or perpetration, even among boys. Conclusions IPV is common for both male and female young Malawian adolescents, and includes both victimization and perpetration. IPV compounds other adversities experienced by adolescents in this low-income setting, and it is rarely alleviated through help from the health system or other formal support. These findings underscore the need to intervene early when interventions can still break destructive pathways and help foster healthier relationships. This focus on early adolescence is particularly critical in low-income countries given the early onset and rapid pace of the transition to adulthood, with sexual activity, dating and partnership thus being common already in young adolescence. Promising interventions would be those that reduce violence against or around children, as well as those that reduce the impacts of such trauma on mental health during adolescence.
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Affiliation(s)
- Rachel Kidman
- Department of Family, Population and Preventive Medicine, Core Faculty, Program in Public Health, Stony Brook University (State University of New York), Stony Brook, NY, United States of America
- * E-mail:
| | - Hans-Peter Kohler
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, United States of America
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Colbert CY, French JC, Arroliga AC, Bierer SB. Best practice versus actual practice: an audit of survey pretesting practices reported in a sample of medical education journals. MEDICAL EDUCATION ONLINE 2019; 24:1673596. [PMID: 31671286 PMCID: PMC6830238 DOI: 10.1080/10872981.2019.1673596] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/29/2019] [Accepted: 09/19/2019] [Indexed: 06/10/2023]
Abstract
Background: Despite recommendations from survey scientists, surveys appear to be utilized in medical education without the critical step of pretesting prior to survey launch. Pretesting helps ensure respondents understand questions as survey developers intended and that items and response options are relevant to respondents and adequately address constructs, topics, issues or problems. While psychometric testing is important in assessing aspects of question quality and item performance, it cannot discern how respondents, based upon their lived experiences, interpret the questions we pose.Aim: This audit study explored whether authors of medical education journal articles within audited journals reported pretesting survey instruments during survey development, as recommended by survey scientists and established guidelines/standards for survey instrument development.Methods: Five national and international medical education journals publishing survey articles from Jan. 2014 - Dec. 2015 were audited to determine whether authors reported pretesting during survey development. All abstracts within all issues of these journals were initially reviewed. Two hundred fifty-one articles met inclusion criteria using a protocol piloted and revised prior to use.Results: The number of survey articles published per journal ranged from 11 to 106. Of 251 audited articles, 181 (72.11%) described using a new instrument without pretesting, while 17 (6.77%) described using a new instrument where items were pretested. Fifty-three (21.12%) articles described using pre-existing instruments; of these, no articles (0%) reported pretesting existing survey instruments prior to use.Conclusions: Findings from this audit study indicate that reported survey pretesting appears to be lower than that reported in healthcare journals. This is concerning, as results of survey studies and evaluation projects are used to inform educational practices, guide future research, and influence policy and program development. Findings apply to both survey developers and faculty across a range of fields, including evaluation and medical education research.
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Affiliation(s)
- Colleen Y. Colbert
- Education Institute, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Judith C. French
- General Surgery Residency Program, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, Ohio
| | - Alejandro C. Arroliga
- Department of Medicine, Baylor Scott & White Health/Texas A&M HSC College of Medicine, Temple, Texas
| | - S. Beth Bierer
- Education Institute, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
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Dimitropoulos G, Landers A, Freeman V, Novick J, Schmidt U, Olmsted M. A feasibility study comparing a web‐based intervention to a workshop intervention for caregivers of adults with eating disorders. EUROPEAN EATING DISORDERS REVIEW 2019; 27:641-654. [DOI: 10.1002/erv.2678] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 03/11/2019] [Accepted: 03/15/2019] [Indexed: 12/14/2022]
Affiliation(s)
| | - Ashley Landers
- Human Development and Family ScienceVirginia Polytechnic Institute and State University Falls Church Virginia
| | - Victoria Freeman
- University Health NetworkToronto General Hospital Toronto Ontario Canada
| | - Jason Novick
- Department of SociologyMount Royal University Calgary Alberta Canada
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and NeuroscienceKing's College London London UK
| | - Marion Olmsted
- University Health NetworkToronto General Hospital Toronto Ontario Canada
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Sigalla GN, Mushi D, Gammeltoft T. "Staying for the children": The role of natal relatives in supporting women experiencing intimate partner violence during pregnancy in northern Tanzania - A qualitative study. PLoS One 2018; 13:e0198098. [PMID: 29856784 PMCID: PMC5983414 DOI: 10.1371/journal.pone.0198098] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 05/14/2018] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Intimate partner violence (IPV) is a global health and human rights problem. In Tanzania, national studies have shown that half of all women experience partner violence in their lifetime, 38% reported being abused during a period of 12 months and 30% during pregnancy. Despite the benefits of social support to women victims of violence during pregnancy, a majority of women hesitate to seek help and, if they do, they mainly turn to their natal relatives for support. However, this process of help-seeking and the type of support received is not well documented and needs to be explored with a view to future interventions. This article investigates women's own perspectives on the support they receive from natal relatives when experiencing IPV during pregnancy. MATERIALS AND METHODS Eighteen participants who experienced physical IPV during pregnancy were purposively selected from a cohort of 1,116 pregnant women enrolled in a project that aimed at assessing the impact of intimate partner violence on reproductive health. In-depth interviews were used to explore the social support received from the natal family among women who experienced partner violence during pregnancy. All interviews were audio recorded, transcribed, coded and analyzed. RESULTS Women who experienced severe IPV during pregnancy were more likely to seek help from natal relatives. Severe violence was defined by the women as acts that occurred frequently and/or resulted in injury. The women's natal relatives were willing to provide the support; however, they strongly encouraged women to maintain their marriage so that they could continue caring for their children jointly with their partners. Emotional support was the commonest form of support and included showing love and empathy and praying. Information provided to victims aimed mainly at advising them to maintain their marriage. Practical support included direct financial support and building their economic base to reduce dependency on their partners. When the couple was on the verge of separation, mediation was provided to save the marriage. CONCLUSION Women who experienced partner violence preferred to seek help from their natal relatives. The support provided by natal relatives was beneficial; however, maintaining the marriage for the care of children and family was given the highest priority, over separation. As a consequence, many women continued to live with violence. Stakeholders supporting victims of violence need to understand the priorities of victims of violence and structure intervention to address their needs.
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Affiliation(s)
- Geofrey Nimrod Sigalla
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Health, Evangelical Lutheran Church in Tanzania, Arusha, Tanzania
| | - Declare Mushi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Tine Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
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Fielding-Miller R, Dunkle K. Constrained relationship agency as the risk factor for intimate partner violence in different models of transactional sex. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2018; 16:283-293. [PMID: 29132281 PMCID: PMC5878059 DOI: 10.2989/16085906.2017.1345768] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Women who engage in transactional sex are more likely to experience intimate partner violence (IPV) and are at higher risk of HIV. However, women engage in transactional sex for a variety of reasons and the precise mechanism linking transactional sex and IPV is not fully understood. We conducted a behavioural survey with a cross-sectional sample of 401 women attending 1 rural and 1 urban public antenatal clinic in Swaziland between February and June 2014. We used structural equation modelling to identify and measure constrained relationship agency (CRA) as a latent variable, and then tested the hypothesis that CRA plays a significant role in the pathway between IPV and transactional sex. After controlling for CRA, receiving more material goods from a sexual partner was not associated with higher levels of physical or sexual IPV and was protective against emotional IPV. CRA was the single largest predictor of IPV, and more education was associated with decreased levels of constrained relationship agency. Policies and interventions that target transactional sex as a driver of IPV and HIV may be more successful if they instead target the broader social landscape that constrains women’s agency and drives the harmful aspects of transactional sex.
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Affiliation(s)
- Rebecca Fielding-Miller
- a Department of Medicine , University of California , San Diego , California , USA.,b Center on Gender Equity and Health , University of California , San Diego , California , USA
| | - Kristin Dunkle
- c South African Medical Research Council , Pretoria , South Africa
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