TY - JOUR
T1 - Development of a screening tool to identify female survivors of gender-based violence in a humanitarian setting
T2 - Qualitative evidence from research among refugees in Ethiopia
AU - Wirtz, Andrea L.
AU - Glass, Nancy
AU - Pham, Kiemanh
AU - Aberra, Amsale
AU - Rubenstein, Leonard S.
AU - Singh, Sonal
AU - Vu, Alexander
N1 - Funding Information:
Our thanks are due to the refugee women in Ethiopia who provided their experiences and input to contribute to the development of the GBV screening tool. Additional gratitude is due to Rehana Gubin and Lopa Basu who supported the qualitative coding. The authors appreciate the support provided by the Center for Public Health and Human Rights for the development of the GBV screening tool. Thanks are due Menbere Dawit, Matilda Svensonn, Margriet Veenma, Catherine Evans, Dr. Dejene, and others in UNHCR as well as Dr. Tesafaye and colleagues in ARRA who supported this project from conceptualization through implementation. This project was funded as a gift of the U.S. Government (U.S. Department of State, Bureau of Population, Refugees, and Migration). Publication of this article was funded in part by the Open Access Promotion Fund of the Johns Hopkins University Libraries.
PY - 2013
Y1 - 2013
N2 - Background: High levels of gender-based violence (GBV) persist among conflict-affected populations and within humanitarian settings and are paralleled by under-reporting and low service utilization. Novel and evidence-based approaches are necessary to change the current state of GBV amongst these populations. We present the findings of qualitative research, which were used to inform the development of a screening tool as one potential strategy to identify and respond to GBV for females in humanitarian settings. Methods. Qualitative research methods were conducted from January-February 2011 to explore the range of experiences of GBV and barriers to reporting GBV among female refugees. Individual interview participants (n=37) included female refugees (≥15 years), who were survivors of GBV, living in urban or one of three camps settings in Ethiopia, and originating from six conflict countries. Focus group discussion participants (11 groups; 77 participants) included health, protection and community service staff working in the urban or camp settings. Interviews and discussions were conducted in the language of preference, with assistance by interpreters when needed, and transcribed for analysis by grounded-theory technique. Results: Single and multiple counts of GBV were reported and ranged from psychological and social violence; rape, gang rape, sexual coercion, and other sexual violence; abduction; and physical violence. Domestic violence was predominantly reported to occur when participants were living in the host country. Opportunistic violence, often manifested by rape, occurred during transit when women depended on others to reach their destination. Abduction within the host country, and often across borders, highlighted the constant state of vulnerability of refugees. Barriers to reporting included perceived and experienced stigma in health settings and in the wider community, lack of awareness of services, and inability to protect children while mothers sought services. Conclusions: Findings demonstrate that GBV persists across the span of the refugee experience, though there is a transition in the range of perpetrators and types of GBV that are experienced. Further, survivors experience significant individual and system barriers to disclosure and service utilization. The findings suggest that routine GBV screening by skilled service providers offers a strategy to confidentially identify and refer survivors to needed services within refugee settings, potentially enabling survivors to overcome existing barriers.
AB - Background: High levels of gender-based violence (GBV) persist among conflict-affected populations and within humanitarian settings and are paralleled by under-reporting and low service utilization. Novel and evidence-based approaches are necessary to change the current state of GBV amongst these populations. We present the findings of qualitative research, which were used to inform the development of a screening tool as one potential strategy to identify and respond to GBV for females in humanitarian settings. Methods. Qualitative research methods were conducted from January-February 2011 to explore the range of experiences of GBV and barriers to reporting GBV among female refugees. Individual interview participants (n=37) included female refugees (≥15 years), who were survivors of GBV, living in urban or one of three camps settings in Ethiopia, and originating from six conflict countries. Focus group discussion participants (11 groups; 77 participants) included health, protection and community service staff working in the urban or camp settings. Interviews and discussions were conducted in the language of preference, with assistance by interpreters when needed, and transcribed for analysis by grounded-theory technique. Results: Single and multiple counts of GBV were reported and ranged from psychological and social violence; rape, gang rape, sexual coercion, and other sexual violence; abduction; and physical violence. Domestic violence was predominantly reported to occur when participants were living in the host country. Opportunistic violence, often manifested by rape, occurred during transit when women depended on others to reach their destination. Abduction within the host country, and often across borders, highlighted the constant state of vulnerability of refugees. Barriers to reporting included perceived and experienced stigma in health settings and in the wider community, lack of awareness of services, and inability to protect children while mothers sought services. Conclusions: Findings demonstrate that GBV persists across the span of the refugee experience, though there is a transition in the range of perpetrators and types of GBV that are experienced. Further, survivors experience significant individual and system barriers to disclosure and service utilization. The findings suggest that routine GBV screening by skilled service providers offers a strategy to confidentially identify and refer survivors to needed services within refugee settings, potentially enabling survivors to overcome existing barriers.
KW - Conflict
KW - Displacement
KW - Ethiopia
KW - Gender-based violence
KW - Refugee
KW - Reproductive health
KW - Sexual violence
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U2 - 10.1186/1752-1505-7-13
DO - 10.1186/1752-1505-7-13
M3 - Article
C2 - 23758886
AN - SCOPUS:84878814182
SN - 1752-1505
VL - 7
JO - Conflict and Health
JF - Conflict and Health
IS - 1
M1 - 13
ER -