The COVID-19 pandemic produced alarming rates of disease and mortality globally, yet few nations were as severely impacted as Brazil. The pandemic also exposed and exacerbated persistent forms of structural violence across Brazil, which complicated gender-based violence (GBV) prevention and response efforts. While structural violence is not new, the systemic pressure and uncertainty introduced by COVID-19 intensified the detrimental impact of structural violence on the lives of Brazilians impacted by GBV. This work qualitatively investigated how the COVID-19 pandemic amplified structural violence and GBV in Brazil.We analyzed key informant interviews (KII) conducted with 12 service providers working in sectors related GBV prevention and response in Roraima, Boa Vista, and Rio de Janeiro. Interviews were audio-recorded, transcribed, and translated from Portuguese or Spanish into English, before applying deductive and inductive coding approaches through a collaborative data reduction process. The theoretical lens of structural violence outlined by Farmer and Rylko-Bauer guided the thematic development.Analyses identified three themes. First, structural violence manifests as policies of inaction and erasure, which reduce the opportunity for upward social mobility among GBV survivors including Black women, trans persons, and people who live in the favelas. Policies of inaction and erasure fail to acknowledge/adequately respond to the significant health and safety needs of these communities. Second, structural violence is a fundamental cause of violence against women and children. Finally, service providers described community driven responses that address the dire survival needs (i.e., food insecurity) imposed by COVID-19, within a context of structural violence. These community driven responses were innovative, agile, and based on dire needs expressed to, and observed by, the service providers interviewed.This analysis highlights how the COVID-19 pandemic exacerbated existing forms of structural violence prevalent throughout Brazil. Findings stress the urgency with which the Brazilian government and international organization must act to support community driven programs that strive to address the most basic human needs.
Background A strong evidence base indicates that maternal caregivers’ experience of intimate partner violence [IPV] impacts children’s health, cognitive development, and risk-taking behaviors. Our objective was to review peer-reviewed literature describing the associations between a child’s indirect exposure to IPV and corresponding nutrition outcomes, with a particular focus on fragile settings in low and middle-income countries [LMICs]. Methods We conducted a rapid evidence assessment to synthesize quantitative associations between maternal caregivers’ IPV experience and children’s nutrition/growth outcomes (birthweight, feeding, and growth indicators). We included peer-reviewed research, published in English or Spanish after the year 2000, conducted in fragile settings in LMICs. Results We identified 86 publications that fit inclusion criteria. Amongst all associations assessed, a maternal caregiver’s experience of combined forms of IPV (physical, sexual and emotional) or physical IPV only, were most consistently associated with lower birthweight, especially during pregnancy. Women of child-bearing age, including adolescents, exposed to at least one type of IPV showed a decreased likelihood of following recommended breastfeeding practices. Lifetime maternal experience of combined IPV was significantly associated with stunting among children under 5 years of age in the largest study included, though findings in smaller studies were inconsistent. Maternal experience of physical or combined IPV were inconsistently associated with underweight or wasting in the first five years. Maternal experience of sexual IPV during pregnancy appeared to predict worsened lipid profiles among children. Conclusion Maternal caregivers’ experience of IPV is significantly associated with low birthweight and suboptimal breastfeeding practices, whereas studies showed inconsistent associations with child growth indicators or blood nutrient levels. Future research should focus on outcomes in children aged 2 years and older, investigation of feeding practices beyond breastfeeding, and examination of risk during time periods physiologically relevant to the outcomes. Programmatic implications include incorporation of GBV considerations into nutrition policies and programming and integrating GBV prevention and response into mother and child health and nutrition interventions in LMIC contexts.
In the last two decades, academic research has made significant progress exploring the life courses of so-called “children born of war” (CBOW). Similarly, the unintended consequences of peacekeeping operations, including the experiences of victims of sexual exploitation and abuse, and children born of these interactions, have received preliminary academic attention. This paper compares peacekeeper-fathered children (PKFC) to other CBOW to determine how these two groups relate to one another. We draw on research conducted in two peacekeeping contexts where personnel have been accused of fathering and abandoning children (Haiti and the Democratic Republic of Congo) to empirically situate PKFC within the category of CBOW. We introduce 5,388 micro-narratives from Haitian and Congolese community members (Haiti n = 2,541, DRC = 2,858) and 113 qualitative interviews with mothers/grandmothers of PKFC (Haiti n = 18, DRC n = 60) and PKFC (DRC n = 35) to investigate how PKFC fit in the CBOW paradigm. Our findings demonstrate that many of the multi-level adversities faced by PKFC resemble those of the broader reference group. Given their shared developmental needs and experiences of exclusion, we conclude that PKFC constitute CBOW and ought to be included in conceptualisations pertaining to them. Acknowledging PKFC as CBOW offers new opportunities for policy development to (a) enhance protection and support of all CBOW and (b) remind states of their commitments to uphold the rights of all children.
Abstract During the United Nations Stabilization Mission in Haiti (MINUSTAH), reports of sexual abuse and exploitation and children fathered by peacekeepers were brought forward to the UN. In 2017, a cross-sectional mixed-methods survey was administered by Haitian research assistants using SenseMaker ® , a rapid data collection tool that allows participants to share a narrative on a topic of interest. In total, 2541 self-interpreted narratives in relation to the experiences of Haitian women and girls vis-à-vis peacekeepers were collected from a convenience sample of Haitian males and females across Haiti. This exploratory secondary data analysis analyzes whether narratives about sexual misconduct perpetrated by MINUSTAH peacekeepers were associated with rural, semi-urban, or urban locations and investigates the relationship between sharing narratives about sexual misconduct and the desire to engage with the UN/MINUSTAH. After adjustment, narratives addressing sexual misconduct were more likely to be shared in rural locations, compared to urban locations (RR rural : 1.19; 95% CI: 1.03, 1.38). Personal experiences of sexual misconduct were more likely (RR sex : 4.52; 95% CI: 3.34, 6.12) to be associated with rejection of the UN/MINUSTAH, compared to personal narratives of positive/neutral experiences. This research is an empirical steppingstone to understanding the distribution and consequences of peacekeeper-perpetrated sexual abuse and exploitation in Haiti.
An emerging evidence base has explored the nutritional consequences of gender-based violence (GBV) perpetrated against girls during childhood/adolescence. We conducted a rapid evidence assessment of quantitative studies describing associations between GBV and girls' nutrition.We adapted systematic review methods and included empirical, peer-reviewed studies, published after 2000 (until November, 2022), that were written in Spanish or English and reported quantitative associations between girls' exposure to GBV and nutrition outcomes. A variety of GBV forms were considered: childhood sexual abuse (CSA), child marriage, preferential feeding of boys, sexual IPV and dating violence. Nutrition outcomes included anemia, underweight, overweight, stunting, micronutrient deficiencies, meal frequency, and dietary diversity.In total, 18 studies were included, 13 of which were conducted in high-income countries. Most sources utilized longitudinal or cross-sectional data to quantify associations between CSA, sexual assault, and intimate partner/dating violence and elevated BMI/overweight/obesity/adiposity. Findings suggest that CSA perpetrated by parents/caregivers is associated with elevated BMI/overweight/obesity/adiposity via cortisol reactivity and depression; this relationship may be compounded by additional intimate partner/dating violence in adolescence. The effects of sexual violence on BMI are likely to emerge during a sensitive period of development between late adolescence and young adulthood. Emerging evidence was found regarding the relationship between child marriage (and the related exposure: age at first pregnancy) and undernutrition. The association between sexual abuse and reduced height and leg length was inconclusive.Given that only 18 studies were included, the relationship between girls' direct exposure to GBV and malnutrition has received little empirical attention, especially with respect to studies conducted in LMIC and fragile settings. Most studies focused on CSA and overweight/obesity, where significant associations were found. Future research should test the moderation and mediation effects of intermediary variables (depression, PTSD, cortisol reactivity, impulsivity, emotional eating) and consider sensitive periods of development. Research should also explore the nutritional consequences of child marriage.
Gender-based violence (GBV) is disproportionately perpetrated against women and girls, due to harmful gender and social norms, structural gender-based power inequalities and pervasive discrimination against women and girls globally. In settings of fragility (eg, weak governance and humanitarian emergencies), risk factors for GBV are exacerbated while protective factors are eroded. Adequate nutrition is critical for mental and physical health and ensuring adequate nutrition for children in fragile settings is particularly critical. Fragile settings include heightened risk for GBV and malnutrition, but the combined impact of these two health contributors has rarely been examined together. Based on a rapid evidence assessment, we present evidence for associations between GBV against women and girls and child nutrition outcomes, identifying gaps in the evidence base and discussing key conceptual and methodological issues concerning research on this intersection. Improved understanding of the intersections between GBV and nutrition outcomes can help further highlight the linkages between these two public health issues and help inform programming and policy in both sectors.
The COVID-19 pandemic has necessitated rapid development of preparedness and response plans to quell transmission and prevent illness across the world. Increasingly, there is an appreciation of the need to consider equity issues in the development and implementation of these plans, not least with respect to gender, given the demonstrated differences in the impacts both of the disease and of control measures on men, women, and non-binary individuals. Humanitarian crises, and particularly those resulting from conflict or violence, exacerbate pre-existing gender inequality and discrimination. To this end, there is a particularly urgent need to assess the extent to which COVID-19 response plans, as developed for conflict-affected states and forcibly displaced populations, are gender responsive.Using a multi-step selection process, we identified and analyzed 30 plans from states affected by conflict and those hosting forcibly displaced refugees and utilized an adapted version of the World Health Organization's Gender Responsive Assessment Scale (WHO-GRAS) to determine whether existing COVID-19 response plans were gender-negative, gender-blind, gender-sensitive, or gender-transformative.We find that although few plans were gender-blind and none were gender-negative, no plans were gender-transformative. Most gender-sensitive plans only discuss issues specifically related to women (such as gender-based violence and reproductive health) rather than mainstream gender considerations throughout all sectors of policy planning.Despite overwhelming evidence about the importance of intentionally embedding gender considerations into the COVID-19 planning and response, none of the plans reviewed in this study were classified as 'gender transformative.' We use these results to make specific recommendations for how infectious disease control efforts, for COVID-19 and beyond, can better integrate gender considerations in humanitarian settings, and particularly those affected by violence or conflict.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
