Promoting resilience among displaced adolescent girls in northern Pakistan may buffer against developmental risks such as violence exposure and associated longer-term consequences for physical and mental well-being. However, girls' access... more
Promoting resilience among displaced adolescent girls in northern Pakistan may buffer against developmental risks such as violence exposure and associated longer-term consequences for physical and mental well-being. However, girls' access to such programming may be limited by social norms restricting movement. A mixed-method evaluation examined change over time, feasibility, and acceptability of the COMPASS program in three districts of Khyber-Pakhtunkhwa province through a single-group within-participant pretest-posttest of adolescent girls aged 12–19 enrolled in the intervention (n = 78), and qualitative in-depth interviews with girls following posttest completion (n = 15). Primary outcomes included improvements in movement, safety, and comfort discussing life skills topics with caregivers, operationalized quantitatively as number of places visited in the previous month, number of spaces that girls felt safe visiting, and comfort discussing puberty, education, working outside the home, and marriage, respectively. Secondary outcomes included psychosocial well-being, gendered rites of passage, social support networks, perceptions of support for survivors of violence, and knowledge of services. Quantitative pretest-posttest findings included significant improvements in movement, psychosocial well-being, and some improvements in social support, knowledge of services, and gendered rites of passage; findings on safety and comfort discussing life skills topics were not significant. Qualitative findings illuminated themes related to definitions of safety and freedom of movement, perceptions and acceptability of program content, perceptions of social support, and perceptions of blame and support and knowledge of services in response to violence. Taken together, findings illustrate positive impacts of life skills programming, and the need for societal changes on gender norms to improve girls' safety in public spaces and access to resources.
Research Interests:
Refugee adolescents face increased vulnerability to child protection risks including abuse, neglect, violence, and exploitation. The aim of this qualitative study was to examine the nature of violence against adolescents in Kiziba Camp,... more
Refugee adolescents face increased vulnerability to child protection risks including abuse, neglect, violence, and exploitation. The aim of this qualitative study was to examine the nature of violence against adolescents in Kiziba Camp, Rwanda, using an ecological framework to analyze the factors that influence protection risks and abuse disclosure across multiple system levels. In order to understand these issues more comprehensively, a transgenerational inquiry sought perceptions from both adolescents and their caregivers. In April 2016, as part of a larger, comprehensive study on adolescent protection, 19 focus group discussions were conducted with a total of 70 adolescents and 68 caregivers from the Democratic Republic of Congo. A qualitative content analysis identified three salient themes. First, structural protection risks exist for adolescents in Kiziba Camp, with economic insecurity and resource constraints resulting in specific risks such as overcrowded housing and adolescents traveling for firewood collection. Second, intergenerational conflict between caregivers and adolescents was perceived to negatively influence abuse disclosure. Lastly, protection mechanisms and reporting pathways were underutilized as caregivers and adolescents expressed concern over the shame, embarrassment, and social rejection that characterized formal disclosure in Kiziba, often rooted in restrictive and inequitable gender norms. These findings suggest that efforts at child protection should be multi-faceted and address structural aspects of risk; household levels of communication and trust; and societal norms that deter abuse reporting. The study also underscores the need for further research on risk and protective factors in camp settings to better tailor interventions aiming to reduce violence against children.
Research Interests:
Little is known about the differential experiences with violence among girls in conflict-affected societies based on their involvement in formal education. A quantitative survey was conducted with girls between the ages of 10–14 across 14... more
Little is known about the differential experiences with violence
among girls in conflict-affected societies based on their involvement
in formal education. A quantitative survey was conducted with girls
between the ages of 10–14 across 14 sites in South Kivu, Democratic
Republic of the Congo. The prevalence of three forms of violence
was estimated across four levels of participation in formal education,
and multivariable mixed effects logistic regression models were
used to compare girls’ increasing levels of education to those who
reported never attending school. Trend tests across the four levels of
education were conducted for violence outcomes. Girls’ higher levels
of participation in formal education were significantly associated
with lower reported rates of physical and sexual violence. Findings
suggest a significant protective effect of formal education on girls
from physical and sexual violence. Findings also suggest a significant
relationship between girls’ age and risk of experiencing physical and
sexual violence.
among girls in conflict-affected societies based on their involvement
in formal education. A quantitative survey was conducted with girls
between the ages of 10–14 across 14 sites in South Kivu, Democratic
Republic of the Congo. The prevalence of three forms of violence
was estimated across four levels of participation in formal education,
and multivariable mixed effects logistic regression models were
used to compare girls’ increasing levels of education to those who
reported never attending school. Trend tests across the four levels of
education were conducted for violence outcomes. Girls’ higher levels
of participation in formal education were significantly associated
with lower reported rates of physical and sexual violence. Findings
suggest a significant protective effect of formal education on girls
from physical and sexual violence. Findings also suggest a significant
relationship between girls’ age and risk of experiencing physical and
sexual violence.
Research Interests:
Violence against women and girls is a global concern, and particularly salient in humanitarian settings. Successful efforts to prevent gender-based violence in humanitarian settings must address a wide range of issues, from discriminatory... more
Violence against women and girls is a global concern, and particularly salient in humanitarian settings. Successful efforts to prevent gender-based violence in humanitarian settings must address a wide range of issues, from discriminatory laws to explicit community support for violence, and yet, at the core of these efforts is reducing oppressive gender and social norms. This study examined local attitudes towards and social norms around responding to physical and sexual abuse of girls through interviews conducted with adolescent girls (n = 66) and with caregivers (n = 58) among two conflict-affected populations: villages in South Kivu in the Democratic Republic of the Congo and Sudanese and South Sudanese refugees in Ethiopian camps. The findings suggest how communities use violence as a tool to enforce the importance of girls practicing community-defined " good " adolescent girl behavior, and have implications for gender-based violence programming among other conflict-affected populations.
Research Interests:
Purpose: This article examines the effects of a girls' social empowerment program, Creating Opportunities through Mentoring, Parental Involvement and Safe Spaces, on economic vulnerability of participating adolescent refugee girls in... more
Purpose: This article examines the effects of a girls' social empowerment program, Creating Opportunities through Mentoring, Parental Involvement and Safe Spaces, on economic vulnerability of participating adolescent refugee girls in Ethiopia. Methods: Adolescents aged 13-19 years from three refugee camps were randomly assigned to either a treatment (n ¼ 457) or control (n ¼ 462) condition. Participants in the treatment condition received 40 fixed-curriculum, mentor-facilitated sessions once a week over a period of 10 months, whereas those in the control condition were not exposed to the curriculum. Caregivers of girls in the treatment arm also participated in 10 discussion sessions held once a month over the same period, where they learned about issues relevant to adolescent girls' well-being and safety. Data were collected from adolescent girls at baseline and approximately 10 months following intervention initiation. Results: Using logistic regression modeling, we found that, following the intervention, girls in the treatment arm were no more or less likely than those in the control arm to attend school, work for pay, work for pay while not being enrolled in school, or engage in transactional sexual exploitation. Conclusions: Findings suggest that stand-alone social empowerment programs may not reduce economic vulnerability for adolescent girls without simultaneously implementing economic empowerment programs or taking additional measures to address broader structural barriers.
Research Interests:
Despite government interest in promoting birth registration, more than a third of Indonesian children do not have a birth certificate, affecting the realisation of both their human and citizen rights. While barriers to registering... more
Despite government interest in promoting birth registration, more than a third of Indonesian children do not have a birth certificate, affecting the realisation of both their human and citizen rights. While barriers to registering children's births in Indonesia have been assessed, there is limited research on how communities perceive the importance of having a birth certificate. This study used focus group discussions to explore parental motivations around birth registration. The results of a thematic analysis found that perceived use of birth certificates, perceived control over the application process and social norms related to certificate ownership affect the intention to apply.
Research Interests:
Background Little is known about violence against children in refugee camps and settlements, and the evidence-base concerning mental health outcomes of youth in refugee settings in low and middle-income countries is similarly small.... more
Background Little is known about violence against children in refugee camps and settlements, and the evidence-base concerning mental health outcomes of youth in refugee settings in low and middle-income countries is similarly small. Evidence is needed to understand patterns of violence against children in refugee camps, and associations with adverse mental health outcomes. Methods Surveys were conducted with adolescent refugees (aged 13–17) in two refugee contexts – Kiziba Camp, Rwanda (n = 129) (refugees from Democratic Republic of Congo) and Adjumani and Kiryandongo refugee settlements, Uganda (n = 471) (refugees from South Sudan). Latent Class Analysis was utilized to identify classes of violence exposure (including exposure to witnessing household violence, verbal abuse, physical violence and sexual violence). Logistic regressions explored the association between latent class of violence exposure and symptoms of depression and anxiety. Results In Rwanda, a two-class solution was identified, with Class 1 (n = 33) representing high levels of exposure to violence and Class 2 (n = 96) representing low levels of exposure. In Uganda, a three-class solution was identified: Class 1 (high violence; n = 53), Class 2 (low violence, n = 100) and Class 3 (no violence, n = 317). Logistic regression analyses indicated that latent violence class was associated with increased odds of high anxiety symptoms in Rwanda (AOR 3.56, 95% CI 1.16–0.95), and high v. no violence class was associated with depression (AOR 3.97, 95% CI 1.07–7.61) and anxiety symptoms (AOR 2.04, 95% CI 1.05–3.96) in Uganda. Conclusions The present results support the existing evidence-base concerning the association between violence and adverse mental health outcomes, while identifying differences in patterns and associations between refugee youth in two different contexts.
Research Interests:
Background: Family-level predictors, including caregiver depression, are considered important influences on adolescent mental health. Adolescent depression and anxiety in refugee settings is known to be a significant public health... more
Background: Family-level predictors, including caregiver depression, are considered important influences on adolescent mental health. Adolescent depression and anxiety in refugee settings is known to be a significant public health concern, yet there is very limited literature from humanitarian settings focusing on the relationship between caregiver mental health and adolescent mental health. In the context of a larger study on child protection outcomes in refugee settings, researchers explored the relationship between caregiver depression and adolescent mental health in two refugee settlements, Kiryandongo and Adjumani, in Uganda.
Research Interests:
Interpersonal violence against women and children has increasingly been recognized as a public health priority in humanitarian emergencies. However, because the household is generally considered a private sphere, violence between family... more
Interpersonal violence against women and children has increasingly been recognized as a public health priority in humanitarian emergencies. However, because the household is generally considered a private sphere, violence between family members remains neglected. A systematic literature review was conducted to identify predictors of household violence in humanitarian emergencies. PubMed, Web of Science, and Scopus were searched from January 1, 1998, to February 16, 2016. A predictor was defined as any individual, household, or community-level exposure that increases or decreases the risk associated with physical, sexual, or emotional interpersonal violence between two or more people living together. All studies reporting on quantitative research were eligible for inclusion. Results were analyzed using qualitative synthesis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed as applicable. The search strategy resulted in 2,587 original records, of which 33 studies met inclusion criteria. Thirty-two of the 33 studies used a cross-sectional design. This was the first known systematic review of predictors of household violence in humanitarian settings. The household framework drew attention to several factors that are associated with violence against both women and children, including conflict exposure, alcohol and drug use, income/economic status, mental health/coping strategies, and limited social support. There is a need for longitudinal research and experimental designs that can better establish temporality between exposures and household violence outcomes, control for confounding, and inform practice. In the interim, programmers and policy makers should try to leverage the predictors identified by this review for integrated violence prevention and response strategies, with the important caveat that ongoing evaluation of such strategies is needed.
Research Interests:
Background. Evidence suggests adolescent self-esteem is influenced by beliefs of how individuals in their reference group perceive them. However, few studies examine how gender-and violence-related social norms affect self-esteem among... more
Background. Evidence suggests adolescent self-esteem is influenced by beliefs of how individuals in their reference group perceive them. However, few studies examine how gender-and violence-related social norms affect self-esteem among refugee populations. This paper explores relationships between gender inequitable and victim-blaming social norms, personal attitudes, and self-esteem among adolescent girls participating in a life skills program in three Ethiopian refugee camps. Methods. Ordinary least squares multivariable regression analysis was used to assess the associations between attitudes and social norms, and self-esteem. Key independent variables of interest included a scale measuring personal attitudes toward gender inequitable norms, a measure of perceived injunctive norms capturing how a girl believed her family and community would react if she was raped, and a peer-group measure of collective descriptive norms surrounding gender inequity. The key outcome variable, self-esteem, was measured using the Rosenberg self-esteem scale. Results. Girl's personal attitudes toward gender inequitable norms were not significantly predictive of self-esteem at endline, when adjusting for other covariates. Collective peer norms surrounding the same gender inequitable statements were significantly predictive of self-esteem at endline (ß = −0.130; p = 0.024). Additionally, perceived injunctive norms surrounding family and community-based sanctions for victims of forced sex were associated with a decline in self-esteem at endline (ß = −0.103; p = 0.014). Significant findings for collective descriptive norms and injunctive norms remained when controlling for all three constructs simultaneously. Conclusions. Findings suggest shifting collective norms around gender inequity, particularly at the community and peer levels, may sustainably support the safety and well-being of adolescent girls in refugee settings.
BACKGROUND: Gender-based violence (GBV) is a significant problem in conflict-affected settings. Understanding local constructions of such violence is crucial to developing preventive and responsive interventions to address this issue.... more
BACKGROUND:
Gender-based violence (GBV) is a significant problem in conflict-affected settings. Understanding local constructions of such violence is crucial to developing preventive and responsive interventions to address this issue.
METHODS:
This study reports on a secondary analysis of archived data collected as part of formative qualitative work - using a group participatory ranking methodology (PRM) - informing research on the prevalence of GBV amongst IDPs in northern Uganda in 2006. Sixty-four PRM group discussions were held with women, with men, with girls (aged 14 to 18 years), and with boys (aged 14 to 18 years) selected on a randomized basis across four internally displaced persons (IDP) camps in Lira District. Discussions elicited problems facing women in the camps, and - through structured participatory methods - consensus ranking of their importance and narrative accounts explaining these judgments.
RESULTS:
Amongst forms of GBV faced by women, rape was ranked as the greatest concern amongst participants (with a mean problem rank of 3.4), followed by marital rape (mean problem rank of 4.5) and intimate partner violence (mean problem rank of 4.9). Girls ranked all forms of GBV as higher priority concerns than other participants. Discussions indicated that these forms of GBV were generally considered normalized within the camp. Gender roles and power, economic deprivation, and physical and social characteristics of the camp setting emerged as key explanatory factors in accounts of GBV prevalence, although these played out in different ways with respect to differing forms of violence.
CONCLUSIONS:
All groups acknowledged GBV to represent a significant threat - among other major concerns such as transportation, water, shelter, food and security - for women residing in the camps. Given evidence of the significantly higher risk in the camp of intimate partner violence and marital rape, the relative prominence of the issue of rape in all rankings suggests normalization of violence within the home. Programs targeting reduction in GBV need to address community-identified root causes such as economic deprivation and social norms related to gender roles. More generally, PRM appears to offer an efficient means of identifying local constructions of prevailing challenges in a manner that can inform programming.
Gender-based violence (GBV) is a significant problem in conflict-affected settings. Understanding local constructions of such violence is crucial to developing preventive and responsive interventions to address this issue.
METHODS:
This study reports on a secondary analysis of archived data collected as part of formative qualitative work - using a group participatory ranking methodology (PRM) - informing research on the prevalence of GBV amongst IDPs in northern Uganda in 2006. Sixty-four PRM group discussions were held with women, with men, with girls (aged 14 to 18 years), and with boys (aged 14 to 18 years) selected on a randomized basis across four internally displaced persons (IDP) camps in Lira District. Discussions elicited problems facing women in the camps, and - through structured participatory methods - consensus ranking of their importance and narrative accounts explaining these judgments.
RESULTS:
Amongst forms of GBV faced by women, rape was ranked as the greatest concern amongst participants (with a mean problem rank of 3.4), followed by marital rape (mean problem rank of 4.5) and intimate partner violence (mean problem rank of 4.9). Girls ranked all forms of GBV as higher priority concerns than other participants. Discussions indicated that these forms of GBV were generally considered normalized within the camp. Gender roles and power, economic deprivation, and physical and social characteristics of the camp setting emerged as key explanatory factors in accounts of GBV prevalence, although these played out in different ways with respect to differing forms of violence.
CONCLUSIONS:
All groups acknowledged GBV to represent a significant threat - among other major concerns such as transportation, water, shelter, food and security - for women residing in the camps. Given evidence of the significantly higher risk in the camp of intimate partner violence and marital rape, the relative prominence of the issue of rape in all rankings suggests normalization of violence within the home. Programs targeting reduction in GBV need to address community-identified root causes such as economic deprivation and social norms related to gender roles. More generally, PRM appears to offer an efficient means of identifying local constructions of prevailing challenges in a manner that can inform programming.
Research Interests:
Background Governments have an ethical imperative to safeguard children in residential care institutions at all times, including in the aftermath of an emergency. Yet, a lack of accurate data about how the magnitude and characteristics of... more
Background
Governments have an ethical imperative to safeguard children in residential care institutions at all times, including in the aftermath of an emergency. Yet, a lack of accurate data about how the magnitude and characteristics of this population may change due to an emergency impedes leaders’ ability to formulate responsive policies and services, mobilize resources and foster accountability. The purpose of this study was therefore to determine the feasibility of evaluating movement of children into residential care following an emergency.
Methods
The pilot study took place in Les Cayes commune in the Sud Department of Haiti in April 2017. Six months prior to the pilot, the area was severely affected by Hurricane Matthew, with widespread devastation to property, livestock and livelihoods. Using a two-stage process, the team created a comprehensive list of residential care institutions in Les Cayes. At each facility, the data collectors attempted to administer four separate tools: a group count tool, a record review tool, interviews with staff, and interviews with children 10 years of age and older.
Results
Out of 27 known institutions in Les Cayes, 22 institutions consented to participate in the research. Within these 22 institutions, the prevalence of new arrivals to residential care since Hurricane Matthew varied significantly across the four tools, ranging from 0.69% according to the aggregated child interviews to 20.96% according to the aggregated staff interviews. Record availability and quality was very poor and child participation was difficult to arrange due to travel and scheduling constraints.
Interpretation
Robust measurement of new arrivals to residential care institutions was not feasible in Haiti following Hurricane Matthew. Moreover, many of the challenges encountered are likely to be encountered in humanitarian emergencies in other settings. Therefore, the research team does not recommend scale-up of these methods in most humanitarian settings. Alternative approaches that incorporate household survey methods to ascertain movement into residential care based on reports from caregivers may be more realistic in places with poor pre-existing governance systems and weak registries and records for residential care institutions.
Governments have an ethical imperative to safeguard children in residential care institutions at all times, including in the aftermath of an emergency. Yet, a lack of accurate data about how the magnitude and characteristics of this population may change due to an emergency impedes leaders’ ability to formulate responsive policies and services, mobilize resources and foster accountability. The purpose of this study was therefore to determine the feasibility of evaluating movement of children into residential care following an emergency.
Methods
The pilot study took place in Les Cayes commune in the Sud Department of Haiti in April 2017. Six months prior to the pilot, the area was severely affected by Hurricane Matthew, with widespread devastation to property, livestock and livelihoods. Using a two-stage process, the team created a comprehensive list of residential care institutions in Les Cayes. At each facility, the data collectors attempted to administer four separate tools: a group count tool, a record review tool, interviews with staff, and interviews with children 10 years of age and older.
Results
Out of 27 known institutions in Les Cayes, 22 institutions consented to participate in the research. Within these 22 institutions, the prevalence of new arrivals to residential care since Hurricane Matthew varied significantly across the four tools, ranging from 0.69% according to the aggregated child interviews to 20.96% according to the aggregated staff interviews. Record availability and quality was very poor and child participation was difficult to arrange due to travel and scheduling constraints.
Interpretation
Robust measurement of new arrivals to residential care institutions was not feasible in Haiti following Hurricane Matthew. Moreover, many of the challenges encountered are likely to be encountered in humanitarian emergencies in other settings. Therefore, the research team does not recommend scale-up of these methods in most humanitarian settings. Alternative approaches that incorporate household survey methods to ascertain movement into residential care based on reports from caregivers may be more realistic in places with poor pre-existing governance systems and weak registries and records for residential care institutions.
Research Interests:
Adolescent girls in sub-Saharan Africa have been deemed one of the most critical populations to address in the campaign for an HIV-free generation. Experiences of intimate partner violence (IPV), harmful gender norms, diminished personal... more
Adolescent girls in sub-Saharan Africa have been deemed one of the most critical populations to address in the campaign for an HIV-free generation. Experiences of intimate partner violence (IPV), harmful gender norms, diminished personal agency, and age-disparate sex have been identified as factors in the increasing rate of new infections among this population. Using baseline data from a cluster-randomized controlled trial in three refugee camps in Benishangul-Gumuz Regional State in Ethiopia, our study quantitatively examined the associations between HIV risk factors, attitudes on gender inequality, IPV acceptability, and self-esteem for female adolescent refugees primarily from Sudan and South Sudan (n = 919). In multivariate models, adjusting for age and education, results showed girls who were more accepting of gender inequitable norms and IPV had greater odds of ever experiencing forced (OR 1.40, CI 1.15–1.70; OR 1.66, CI 1.42–1.94) or transactional sex (OR 1.28, CI 1.05–1.55; OR 1.59, CI 1.37–1.85) compared to girls who demonstrated less approval. Higher self-esteem was associated with increased odds of condom use (OR 1.13, CI 1.02–1.24) as well as decreased odds of adolescent marriage (OR 0.93, CI 0.90–0.95), age-disparate sex (OR 0.90, CI 0.86–0.94), and transactional sex (OR 0.96, CI 0.93–0.99). The findings suggest acceptance of inequitable gender norms (including those that perpetuate violence against women) and low self-esteem to be associated with common HIV risk factors among refugee adolescents living in Ethiopia. Greater attention towards the intersections of gender equality and self-valuation is needed when seeking to understand HIV risk among refugee adolescent girls in sub-Saharan Africa.
Introduction This study explores findings of a population-based approach to measure the prevalence of unaccompanied and separated children (UASC) during the Hurricane Matthew aftermath in Haiti. Methods We conducted a cross-sectional... more
Introduction This study explores findings of a population-based approach to measure the prevalence of unaccompanied and separated children (UASC) during the Hurricane Matthew aftermath in Haiti. Methods We conducted a cross-sectional survey using two-stage cluster sampling. Participants were asked to provide information on their own household composition, as well as the household composition of their closest neighbour (the Neighborhood Method). The study took place between February and March 2017 in Haiti's Sud Department, a region severely affected by Hurricane Matthew in October 2016. 1044 primary respondents provided information about their own household, and 4165 people in the household of their closet neighbour. The primary outcome measured was the prevalence of UASC in the Sud Department following Hurricane Matthew. Secondary outcomes of interest included the characteristics of these children, including age, sex, reason for separation and current caregiver. results Of the 2046 children currently living in the surveyed households, 3.03% (95% CI 2.29% to 3.77%) were reported to have been separated from their normal caregiver during Hurricane Matthew. Among these 62 children, 9 were unaccompanied, and there were slightly more boys than girls (56% vs 44%, p=0.37). Of the 2060 children who lived in surveyed households when the hurricane hit, 1.12% (95% CI 0.67% to 1.57%) had since departed without their caregiver. The prevalence of separation reported for neighbours' households was not significantly different from that in respondents' households (p values between 0.08 and 0.29). Conclusions This study is the first known attempt to measure the prevalence of child separation following a natural disaster. Overall, the rates of separation were relatively low. Similarities between primary and secondary reports of child separation via the Neighborhood Method indicate that this may be a viable approach to measuring UASC in certain contexts.
The study described in this article explores the functioning of existing community-based child protection mechanisms in two districts in Aceh, Indonesia and identifies issues that need to be addressed for improved prevention and response... more
The study described in this article explores the functioning of existing community-based child protection mechanisms in two districts in Aceh, Indonesia and identifies issues that need to be addressed for improved prevention and response programming for children experiencing violence, abuse and exploitation. Ninety-six in-depth interviews and 23 focus group discussions were used to document child protection threats and local means of support. The research identified domestic violence, early marriage, school dropout, child labor and violent teachers as key communal concerns. In exploring referral pathways, it was learned that protection concerns are primarily kept secret, addressed within the family, or shared with friends, and that national and regional child protection legislation is viewed as in tension with local values. The study identifies a number of challenges that must be addressed if better linkages between local and national child welfare policies are to be established.
Research Interests:
Numerous social factors shape girls' lives in conflict-affected settings, affecting their vulnerability to gender-based violence (GBV). Qualitative research methods were used to examine spaces of perceived safety and risk for girls living... more
Numerous social factors shape girls' lives in conflict-affected settings, affecting their vulnerability to gender-based violence (GBV). Qualitative research methods were used to examine spaces of perceived safety and risk for girls living in two conflict-affected populations: camps in Ethiopia hosting primarily South Sudanese and Sudanese refugees and communities in eastern Democratic Republic of Congo. Three major themes emerged: (a) challenges around caregiver–child communication regarding development, sex, and sexual violence; (b) a typology of safe/risky spaces; and (c) the influence of male-dominated spaces on experiences and fear of GBV. The findings have implications for programs focused on reducing adolescent girls' vulnerability to violence within conflict-affected contexts.
Research Interests:
Participative Ranking Methodology is a ‘mixed methods’ approach to data collection, in which a group of knowledgeable participants are guided in generating responses to a specific question or set of questions. It is a ‘mixed methods’... more
Participative Ranking Methodology is a ‘mixed methods’ approach to data collection, in which a group of knowledgeable participants are guided in generating responses to a specific question or set of questions. It is a ‘mixed methods’ approach in that it draws on both quantitative and qualitative methodologies to generate rich, contextualized data that can nonetheless be counted, ranked, and
compared across or within groups. This methodology promotes an engaged and participatory process, which rapidly highlights key findings while providing the opportunity for deeper analysis as resources permit. Collected in a structured manner, results can be swiftly consolidated and used to develop action plans addressing
identified priorities.
compared across or within groups. This methodology promotes an engaged and participatory process, which rapidly highlights key findings while providing the opportunity for deeper analysis as resources permit. Collected in a structured manner, results can be swiftly consolidated and used to develop action plans addressing
identified priorities.
Research Interests:
Despite considerable research on barriers to girls' participation in education, little is understood about the experiences of female survivors of sexual violence as they interact with the school system. Using data from a 2007-08... more
Despite considerable research on barriers to girls' participation in education, little is understood about the experiences of female survivors of sexual violence as they interact with the school system. Using data from a 2007-08 longitudinal qualitative data set, the barriers to school enrolment were explored for survivors of sexual violence as well as other conflict-affected girls-in Lira District, Northern Uganda. The results of the analysis suggest that all girls, regardless of their status as sexual violence survivors, face similar barriers to accessing education that need to be addressed in a holistic and comprehensive manner. Financial constraints, the quality of schools, and cultural barriers that do not prioritize girls' education, as well as the prevalence of early marriage and pregnancy, were common experiences for all girls enrolled in the study. Additionally, girls faced self-doubt and a lack of self-efficacy about their ability to achieve in school, which was compounded by bullying from peers and stigma from the community. For survivors of sexual violence these barriers were strengthened by virtue of their 'doubly disadvantaged' status. Additional support and targeted interventions are needed to empower this particularly vulnerable group to overcome the barriers impeding school enrolment.
Research Interests:
Orphanhood is common in sub-Saharan Africa, and is a critical issue shaping global assistance for children. Care arrangements for children are often fluid, and many 'orphaned' children have a surviving biological parent. This study... more
Orphanhood is common in sub-Saharan Africa, and is a critical issue shaping global assistance for children. Care arrangements for children are often fluid, and many 'orphaned' children have a surviving biological parent. This study examines the protective effects of family-level factors on early sex and pregnancy in rural Sierra Leone. A survey of 530 adolescents in 2 districts in Sierra Leone was analysed to evaluate associations between living arrangement and orphanhood on recent sexual activity and pregnancies out of wedlock. After controlling for confounders, living with one's mother (AOR = 0.46, 95% CI: 0.22-1.00) and living with both parents (AOR = 0.36, 95% CI: 0.17-0.73) were protective against recent sexual activity. Orphan status was not significantly associated with recent sexual activity. Among 164 sexually active adolescents, neither living arrangement nor orphanhood was associated with pregnancy. This study demonstrates the protective effect of living with a surviving biological parent to delay early sexual debut. Once an adolescent becomes sexually active; however, living arrangement is not associated with the risk of pregnancy out of wedlock. The findings suggest that supporting family connectedness and preventing unnecessary family separation may benefit at least some aspects of adolescent sexual and reproductive health in Sierra Leone.
Research Interests:
Children who are separated from their families and usual caregivers in emergencies face a multitude of risks to their health and wellbeing. This study presents findings from the first known population-based estimation of separation in an... more
Children who are separated from their families and usual caregivers in emergencies face a multitude of risks to their health and wellbeing. This study presents findings from the first known population-based estimation of separation in an emergency setting. Point prevalence and basic characteristics were measured to inform programming, policies and funding for affected populations. A household survey was carried out in the Democratic Republic of the Congo to estimate separation subsequent to an attack by the M23 militia group. Separation was tracked in terms of children arriving into the household after the M23 attacks and children who had departed from the household after the recall event without their parent or usual caregiver. Five hundred and twenty-two households were surveyed. In the sample of 2,197 children living in the respondents' homes at the time of data collection, 8.47% (n = 186) were separated children who had newly arrived in the household since the M23 attack. In the sample of 2,034 children living in the respondents' homes prior to the M23 attack, 5.31% (n = 108) children had since departed from the household, resulting in separation from their parents or usual caregivers. Characteristics of children who arrived and children who departed diverged in terms of age, reasons for separation and frequency of unaccompaniment. The findings indicate the potential for population-based estimation of separation to be replicated in emergency settings to inform funding appeals and programmatic response.
Research Interests:
Two national household surveys, the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys, drive assessment of the Millennium Development Goals, Poverty Reduction Strategies, and other major international platforms in... more
Two national household surveys, the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys, drive assessment of the Millennium Development Goals, Poverty Reduction Strategies, and other major international platforms in most low-and middle-income countries. However, little attention has been given to the fact that household surveys are limited to people living in households, therefore excluding some of the world's most vulnerable populations and including the homeless, people living in institutions, and migrant laborers. The situation of children living outside of households is particularly precarious because many of these children are also outside of families or in families that cannot adequately care for them. Deprivation and stress related to these early life experiences can negatively affect health and productivity across the life course. This manuscript reviews the issues facing children outside of households and argues for the importance of gathering robust data about this population to formulate responsive policies and services, mobilize resources , and foster accountability. Cambodia is highlighted to illustrate the recent work that the government has undertak-en to quantify two key subgroups of children outside of households: children living in residential care institutions and homeless children living on the street or in other public places. The methods, ethical considerations, and implications of Cambodia's enumeration are discussed.
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Sexual violence is an issue of significant concern in conflict-affected societies, with girls often among those most affected. While formal support services such as medical care, psychosocial support, and legal assistance for survivors... more
Sexual violence is an issue of significant concern in conflict-affected societies, with girls often among those most affected. While formal support services such as medical care, psychosocial support, and legal assistance for survivors are undeniably important, informal actors also play a key but poorly understood role in assisting survivors. This study examines the experiences of young female survivors of sexual violence in northern Uganda in order to explore the variety of roles (both positive and negative) that informal support networks played in contributing to survivors’ healing and recovery. In-depth interviews were conducted with 12 female survivors of sexual violence between the ages of 13–17 who were living in camps for internally displaced persons (IDPs) in Lira, northern Uganda. Each girl participated in a series of 4 interviews over a 1-year period. Girls participating in this study identified social stigma to be the primary source of psychosocial distress following an incident of sexual violence, as well as the most significant barrier to their recovery and reintegration. Findings also suggest that the relationship between a girl and her perpetrator had a significant impact on the type of follow-up support she received— particularly with regard to her ability to access justice. Survivor accounts also indicate that family members played a complex role in girls’ lives following an incident of abuse—in some cases providing significant support, while in others exposing girls to additional stigma or marginalization. Findings offer important insights to inform the development of response initiatives that build upon community-based networks, while also strengthening linkages between formal and informal forms of support in the lives of survivors.
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Background: International child protection work has undergone a paradigm shift, moving from addressing issues such as trafficked children, street children, and child labour separately to a more integrated systems approach. As a young... more
Background: International child protection work has undergone a paradigm shift, moving from addressing issues such as trafficked children, street children, and child labour separately to a more integrated systems approach. As a young nation still marked by conflict, South Sudan offers insight into how the interplay between a fragile national child protection system in a conflict-affected country and the efforts of international humanitarian actors can promote or undermine systems strengthening.
Methods: From June to August 2012, 52 semi-structured key informant interviews with international-, national-, and community-level actors were completed. Eight community-level focus group discussions (FGDs) were also conducted separately with men, women, boys, and girls. Interview guides were designed to explore participant perceptions of child protection system functioning. Data were analysed using a grounded theory approach.
Results: Four dimensions emerged as crucial pillars for child protection systems strengthening: coordination, capacity, funding, and community inclusion. These factors were found to have taken root in unequal measure. Respondents at all systemic levels indicated that child protection systems strengthening efforts operated largely in isolation from the quotidian realities of children, families, and communities.
Conclusions: The humanitarian apparatus—marked by short-term funding and accountability to the international community—will require significant reform to situate humanitarian efforts in a systems strengthening framework. If the objective is to strengthen national child protection systems, emergency response activities must better align with household- and community-level efforts to protect children.
Methods: From June to August 2012, 52 semi-structured key informant interviews with international-, national-, and community-level actors were completed. Eight community-level focus group discussions (FGDs) were also conducted separately with men, women, boys, and girls. Interview guides were designed to explore participant perceptions of child protection system functioning. Data were analysed using a grounded theory approach.
Results: Four dimensions emerged as crucial pillars for child protection systems strengthening: coordination, capacity, funding, and community inclusion. These factors were found to have taken root in unequal measure. Respondents at all systemic levels indicated that child protection systems strengthening efforts operated largely in isolation from the quotidian realities of children, families, and communities.
Conclusions: The humanitarian apparatus—marked by short-term funding and accountability to the international community—will require significant reform to situate humanitarian efforts in a systems strengthening framework. If the objective is to strengthen national child protection systems, emergency response activities must better align with household- and community-level efforts to protect children.
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Violence against adolescent girls occurs at alarmingly high rates in conflict-affected settings, in part due to their increased vulnerability from their age and gender. However, humanitarian programming efforts have historically focused... more
Violence against adolescent girls occurs at alarmingly high rates in conflict-affected settings, in part due to their increased vulnerability from their age and gender. However, humanitarian programming efforts have historically focused either on child abuse prevention or intimate partner violence prevention and have not fully addressed the specific needs of adolescent girls, including engagement of caregivers to reduce risk of violence against adolescent girls. Thus, the objectives of this analysis are to examine the whether gendered and parental attitudes of caregivers in South Kivu, Democratic Republic of Congo (DRC) were associated with their adolescent girls' experiences of violence and girls' attitudes towards IPV. Cross-sectional data from 869 girls (10–14 years) and their caregivers (n = 764) were drawn from a baseline assessment of a violence prevention evaluation conducted in 2015. Findings suggest that female caregiver's gender equitable attitudes for adults may be associated with reduced odds of sexual abuse and less acceptance of IPV for adolescent girl children. Parenting attitudes and beliefs and gender equity for girl children were not associated with violence risk for girls, while increased accepting attitudes of negative discipline were only associated with lowered odds of sexual abuse. Understanding of caregivers' attitudes may provide potential insight into how to more effectively engage and develop programming for caregivers to promote the safety and well-being of adolescent girls.
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Methodologies to measure gender-based violence (GBV) have received inadequate attention , especially in humanitarian contexts where vulnerabilities to violence are exacerbated. This paper compares the results from individual audio... more
Methodologies to measure gender-based violence (GBV) have received inadequate attention , especially in humanitarian contexts where vulnerabilities to violence are exacerbated. This paper compares the results from individual audio computer-assisted self-administered (ACASI) survey interviews with results from participatory social mapping activities, employed with the same sample in two different post-conflict contexts. Eighty-seven internally displaced adolescent girls from the Democratic Republic of the Congo and 78 Suda-nese girls living in Ethiopian refugee camps were interviewed using the two methodologies. Results revealed that the group-based qualitative method elicited narratives of violence focusing on events perpetrated by strangers or members of the community more distantly connected to girls. In contrast, ACASI interviews revealed violence predominantly perpetrated by family members and intimate partners. These findings suggest that group-based methods of information gathering frequently used in the field may be more susceptible to socially accepted narratives. Specifically, our findings suggest group-based methods may produce results showing that sexual violence perpetrated by strangers (e.g., from armed groups in the conflict) is more prevalent than violence perpetrated by family and intimate partners. To the extent this finding is true, it may lead to a skewed perception that adolescent GBV involving strangers is a more pressing issue than intimate partner and family-based sexual violence, when in fact, both are of great concern.
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Children in humanitarian settings are thought to experience increased exposure to violence, which can impair their physical, emotional, and social development. Violence against children has important economic and social consequences for... more
Children in humanitarian settings are thought to experience increased exposure to violence, which can impair their physical, emotional, and social development. Violence against children has important economic and social consequences for nations as a whole. The purpose of this review is to examine population-based approaches measuring violence against children in humanitarian settings. The authors reviewed prevalence studies of violence against children in humanitarian contexts appearing in peer-reviewed journals within the past twenty years. A Boolean search procedure was conducted in October 2014 of the electronic databases PubMed/Medline and PsychInfo. If abstracts contained evidence of the study's four primary themes e violence, children, humanitarian contexts and population-based measurement e a full document review was undertaken to confirm relevance. Out of 2634 identified articles, 22 met the final inclusion criteria. Across studies, there was varying quality and no standardization in measurement approach. Nine out of 22 studies demonstrated a relationship between conflict exposure and adverse health or mental health outcomes. Among studies that compared rates of violence between boys and girls, boys reported higher rates of physical violence, while girls reported higher rates of sexual violence. Children in infancy and early childhood were found to be among the most under-researched. Ultimately, the body of evidence in this review offers an incomplete picture regarding the prevalence, nature and impact of violence against children in emergencies, demonstrating a weak evidence base for some of the basic assumptions underpinning humanitarian practice. The development of standardized approaches to more rigorously measure violence against children is urgently needed in order to understand trends of violence against children in humanitarian contexts, and to promote children's healthy development and well-being.
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Background: Violence against adolescent girls in humanitarian settings is of urgent concern given their additional vulnerabilities to violence and unique health and well-being needs that have largely been overlooked by the humanitarian... more
Background: Violence against adolescent girls in humanitarian settings is of urgent concern given their additional vulnerabilities to violence and unique health and well-being needs that have largely been overlooked by the humanitarian community. In order to understand what works to prevent violence against adolescent girls, a multi-component curriculum-based safe spaces program (Creating Opportunities through Mentorship, Parental involvement and Safe Spaces – COMPASS) will be implemented and evaluated. The objectives of this multi-country study are to understand the feasibility, acceptability and effectiveness of COMPASS programming to prevent violence against adolescent girls in diverse humanitarian settings.
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Background: This article reports on the use of the 'neighborhood method' to measure the prevalence and basic characteristics of children who became separated from their parents or usual caregivers subsequent to an attack by the M23... more
Background: This article reports on the use of the 'neighborhood method' to measure the prevalence and basic characteristics of children who became separated from their parents or usual caregivers subsequent to an attack by the M23 militia group in North Kivu, Democratic Republic of the Congo. Methods: A two-stage household cluster survey was conducted in 522 households in North Kivu in August 2014. Heads of households were asked about separated children in their household, as well as the households of their two closest neighbors. Separation was tracked in terms of children who arrived into the households after the M23 attacks and children who departed from the households after the recall event without their parent(s) or usual caregiver. For a subset of 44 neighbor pairs, respondents were asked to report on the same household to assess inter-rater reliability. Data about primary respondents and their neighbors were assessed to determine whether the neighborhood method was a comparable, reliable and efficient alternative to a traditional household survey about separated children.
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The Three Delays Model has proven a useful framework for examining barriers to seeking obstetric care and preventing maternal and child mortality. This article demonstrates the applicability of the Three Delays Model to the case of civil... more
The Three Delays Model has proven a useful framework for examining barriers to seeking obstetric care and preventing maternal and child mortality. This article demonstrates the applicability of the Three Delays Model to the case of civil registration in rural Indonesia and examines ways that efforts to strengthen civil registration services can draw on lessons from maternal and child health programming. Twenty focus group discussions were conducted using a participatory ranking exercise in four Indonesian districts. Focus groups were stratified into four groups: (1) government officials involved in civil registration, (2) civil society organization members that assist communities in civil registration, and (3) female and (4) male community members. Transcripts were analyzed using constant comparative method and thematic analysis, revealing barriers that communities commonly faced in accessing civil registration services. In examining the categories and themes related to these barriers, the research team found a significant overlap with the factors and phases of the Three Delays Model. Participants were delayed from seeking registration services by a range of sociocultural factors and by the perceived inaccessibility and poor quality of services. Once they decided to seek care, long distances to services and poor transportation options delayed their access to registration offices. Finally, a series of bottlenecks in service provision created extended delays once applicants reached registration offices. Ownership of civil registration documents in Indonesia remains exceptionally low, with just over half of children and youth possessing a birth certificate. To strengthen civil registration and health systems more generally, it is important to understand the factors that enable and constrain civil registration, how these factors relate to one another, and how they change over a child's life.
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Background: Audio-Computer Assisted Self-Interview (ACASI) is a method of data collection in which participants listen to pre-recorded questions through headphones and respond to questions by selecting their answers on a touch screen or... more
Background: Audio-Computer Assisted Self-Interview (ACASI) is a method of data collection in which participants listen to pre-recorded questions through headphones and respond to questions by selecting their answers on a touch screen or keypad, and is seen as advantageous for gathering data on sensitive topics such as experiences of violence. This paper seeks to explore the feasibility and acceptability of using ACASI with adolescent girls and to document the implementation of such an approach in two humanitarian settings: conflict-affected communities in eastern Democratic Republic of Congo (DRC) and refugee camps along the Sudan-Ethiopia border. Methods: This paper evaluates the feasibility and acceptability of implementing ACASI, based on the experiences of using this tool in baseline data collections for COMPASS (Creating Opportunities through Mentorship, Parental involvement, and Safe Spaces) impact evaluations in DRC (N = 868) and Ethiopia (N = 919) among adolescent girls. Descriptive statistics and logistic regression models were generated to examine associations between understanding of the survey and selected demographics in both countries.
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Little is known about the patterns and mechanisms by which humanitarian emergencies may exacerbate violence against children. In this article, we propose using the ecological framework to examine the impact of humanitarian emergencies on... more
Little is known about the patterns and mechanisms by which humanitarian emergencies may exacerbate violence against children. In this article, we propose using the ecological framework to examine the impact of humanitarian emergencies on interpersonal violence against children. We consider the literature that supports this framework and suggest future directions for research to fill identified gaps in the framework. The relationship between humanitarian emergencies and violence against children depends on risk factors at multiple levels, including a breakdown of child protection systems, displacement, threats to livelihoods, changing gender roles, changing household composition, overcrowded living conditions, early marriage, exposure to conflict or other emergency events, and alcohol abuse. The empirical evidence supporting the proposed emergency/violence framework is limited by cross-sectional study designs and a propensity to predominantly examine individual-level determinants of violence, especially exposure to conflict or emergency events. Thus, there is a pressing need to contextualize the relationship between conflict or emergency events and violence against children within the wider ecological and household dynamics that occur during humanitarian emergencies. Ultimately, this will require longitudinal observations of children, families and communities from before the emergency through recovery and improvements to ongoing global surveillance systems. More complete data will enable the humanitarian community to design effective, appropriate and well-targeted interventions
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Background. Girls at early stages of adolescence are vulnerable to violence victimization in humanitarian contexts, but few studies examine factors that affect girls' hope in these settings. We assessed attitudes toward traditional gender... more
Background. Girls at early stages of adolescence are vulnerable to violence victimization in humanitarian contexts, but few studies examine factors that affect girls' hope in these settings. We assessed attitudes toward traditional gender norms as an effect modifier of the relationship between violence exposure and future orientation in displaced girls. Methods. Secondary analysis, using multivariable regression of cross-sectional data from girls ages 10–14 in South Kivu, Democratic Republic of the Congo. Key variables of interest were attitudes toward intimate partner violence (IPV), Children's Hope Scale (CHS) score, and exposure to physical, emotional, and sexual violence within the last 12 months. Additional covariates included age, educational status, and territory. Results. The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for physical violence (β = −0.09, p = 0.040) and unwanted sexual touching (β = −0.20, p = 0.003) among girls age 10–14, when adjusting for other covariates. The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for forced sex (β = −0.22, p = 0.016) among girls age 13–14, when adjusting for covariates. Findings for emotional violence, any form of sexual violence , and coerced sex trended toward lower CHS scores for girls who reported higher acceptance of IPV, but did not reach significance. Conclusions. Findings support the utility of gender norms-transformative programming in increasing resilience of girls who have experienced sexual violence in humanitarian contexts.
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Objectives: The primary objective of this study was to collect baseline data on the number of children living in residential care institutions in Cambodia. The secondary objective was to describe the characteristics of the children (eg,... more
Objectives: The primary objective of this study was to collect baseline data on the number of children living in residential care institutions in Cambodia. The secondary objective was to describe the characteristics of the children (eg, age, sex, duration of stay, education and health). The data were intended to guide recent efforts by the Government of Cambodia to reduce the number of children living in residential care institutions and increase the number of children growing up in supportive family environments.
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Background: The Government of Cambodia has committed to supporting family care for vulnerable children, including homeless populations. Collecting baseline data on the numbers and characteristics of homeless adolescents was prioritized to... more
Background: The Government of Cambodia has committed to supporting family care for vulnerable children, including homeless populations. Collecting baseline data on the numbers and characteristics of homeless adolescents was prioritized to illuminate the scope of the issue, mobilize resources and direct the response. Methods: Administrative zones across seven cities were purposively selected to cover the main urban areas known to have homeless populations in Cambodia. A complete enumeration of homeless individuals between the ages of 13 and 17 was attempted in the selected areas. In addition, a second independent count was conducted to enable a statistical estimation of completeness based on overlap across counts. This technique is known as capture-recapture. Adolescents were also interviewed about their schooling, health and other circumstances. Results: After adjustment by the capture-recapture corrective multipliers (range: 3.53-27.08), the study yielded an estimate of 2,697 13–17 year old homeless adolescents across all seven cities. The total number of homeless boys counted was significantly greater than homeless girls, especially in older ages. Conclusions: To the authors' knowledge, this is the first time capture-recapture methods have been applied to a homeless estimation of this scale in a resource-limited setting. Findings suggest the number of homeless adolescents in Cambodia is much greater than one would expect if relying on single count data alone and that this population faces many hardships.
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Background: Children's right to participate in data collection during emergencies has been widely recognized by humanitarian actors. However, participation in such activities can expose children to risk. Tensions have been noted between... more
Background: Children's right to participate in data collection during emergencies has been widely recognized by humanitarian actors. However, participation in such activities can expose children to risk. Tensions have been noted between the right to participate and other principles, such as the imperative to 'do no harm.' With little evidence to inform guidance on addressing this tension, our study sought to identify expert consensus on whether and how children participate in emergency-related data collection activities. Methods: We employed a three-round Delphi technique with a purposive sample of 52 child protection specialists. Respondents answered two open-ended questions in round one. A thematic analysis of responses generated a set of unique statements addressing the study questions. In the second round, respondents rated each statement on a five-point scale. In the final round, respondents reviewed the group's average ratings for each statement with the option to revise their own ratings. A statement was said to have reached clear consensus when at least 90% of respondents agreed or strongly agreed with the statement.
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Background: Over half of displaced civilians in humanitarian emergencies are children, and these settings pose unique threats to children’s safety with long–lasting consequences. Our study broadens the limited evidence on violence against... more
Background: Over half of displaced civilians in humanitarian emergencies are children, and these settings pose unique threats to children’s safety with long–lasting consequences. Our study broadens the limited evidence on violence against adolescent girls in emergencies by estimating prevalence and predictors of violence among adolescent girls age 13–14 in South Kivu, Democratic Republic of the Congo (DRC), and age 13–19 in refugee camps in the Benishangul–Gumuz region of Ethiopia.
Methods: Survey data were collected from a sample of 1296 adolescent girls using Computer–Assisted Personal Interview and Audio Computer–Assisted Self–Interview programming. Predictors of violence were modeled using multivariable logistic regression.
Findings: The majority of adolescent girls (51.62%) reported experiencing at least one form of violence victimization in the previous 12 months: 31.78% reported being hit or beaten, 36.79% reported being screamed at loudly or aggressively, and 26.67% experienced unwanted sexual touching, forced sex, and/or sexual coercion. Across both countries, ever having a boyfriend and living with an intimate partner were strong predictors of violence. Fewer years of education completed in DRC, and young age in Ethiopia, were also associated with reported victimization.
Conclusions: Prevalence of violence against adolescent girls is high in these two conflict–affected contexts. Findings indicate a need for programs targeting younger populations, broader efforts to address different forms of victimization, and increased recognition of intimate partners and caregivers as perpetrators of violence in conflict–affected settings.
Methods: Survey data were collected from a sample of 1296 adolescent girls using Computer–Assisted Personal Interview and Audio Computer–Assisted Self–Interview programming. Predictors of violence were modeled using multivariable logistic regression.
Findings: The majority of adolescent girls (51.62%) reported experiencing at least one form of violence victimization in the previous 12 months: 31.78% reported being hit or beaten, 36.79% reported being screamed at loudly or aggressively, and 26.67% experienced unwanted sexual touching, forced sex, and/or sexual coercion. Across both countries, ever having a boyfriend and living with an intimate partner were strong predictors of violence. Fewer years of education completed in DRC, and young age in Ethiopia, were also associated with reported victimization.
Conclusions: Prevalence of violence against adolescent girls is high in these two conflict–affected contexts. Findings indicate a need for programs targeting younger populations, broader efforts to address different forms of victimization, and increased recognition of intimate partners and caregivers as perpetrators of violence in conflict–affected settings.
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A key diversity issue in many societies is how to support vulnerable children in an equitable manner. This article examines the effort in Sierra Leone to achieve child rights and child protection through an impositional approach of law,... more
A key diversity issue in many societies is how to support vulnerable children in an equitable manner. This article examines the effort in Sierra Leone to achieve child rights and child protection through an impositional approach of law, child rights education, and requirements to use formal response channels. Rapid ethnography in 2 districts indicated that local people viewed child rights as a harm to children because it compromised parents' ability to discipline their children. Overwhelmingly, people used traditional family and community mechanisms in responding to these harms and even in regard to criminal offenses. The causes of the disconnect between the nonfor-mal and formal systems are analyzed using cultural rights theory and conflict theories, and implications for practice are discussed.
This study was conducted to estimate prevalence of gender-based violence (GBV) among female Somalis in Ethiopian refugee camps and host communities, compare prevalence in camps and communities, and compare prevalence in flight and in... more
This study was conducted to estimate prevalence of gender-based violence (GBV) among female Somalis in Ethiopian refugee camps and host communities, compare prevalence in camps and communities, and compare prevalence in flight and in camp. Systematic random sampling was used to select households in Awbare camp (n = 85), Awbare town (n = 76), and Kebribeyah camp (n = 83). GBV was common and overwhelmingly domestic. Prevalence was higher in Awbare town than Kebribeyah camp. Women were at increased risk of GBV in camp compared with in flight. The domestic nature of GBV in humanitarian settings requires attention. Assumptions about violence in humanitarian settings should be further tested.
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Children who are separated from their families and usual caregivers in emergencies face a multitude of risks. The humanitarian community lacks methods to systematically capture changes in the frequency and nature of such separations over... more
Children who are separated from their families and usual caregivers in emergencies face a multitude of risks. The humanitarian community lacks methods to systematically capture changes in the frequency and nature of such separations over time. A mobile phone-based community surveillance system was piloted in the Democratic Republic of the Congo. The goal was to identify new cases of unaccompanied and separated children on a weekly basis. Over an 11-week period, community focal points reported 62 cases of separation across 10 communities. The majority of children had been under the care of their parents prior to separation. More than half of the children were unaccompanied, meaning that they were living without an adult relative or customary caregiver. The pilot results suggest that implementing a mobile phone-based surveillance system in a humanitarian setting may be feasible and cost-effective and fills a critical gap in the measurement of separated and unaccompanied children in emergencies. A longer pilot to better understand how the system performs over time is recommended.
The purpose of this research was twofold: to understand community-identified threats to child well being in Aceh province, Indonesia, and to map communal mechanisms in place to respond to these threats. The research was undertaken in two... more
The purpose of this research was twofold: to understand community-identified threats to child well being in Aceh province, Indonesia, and to map communal mechanisms in place to respond to these threats. The research was undertaken in two districts (one severely affected by the 2004 tsunami, the other less so). The team employed a variety of qualitative methodologies including focus group discussions, a participatory ranking methodology, key informant interviews, community timelines and functional network analyses.The study found that school-drop out, early marriage and domestic violence were understood as key concerns in communities. Sexual harassment, drug abuse (use ofgele/marijuana), bullying and the fear of kidnapping were also identified as problems. The findings indicate that children rely most heavily on informal networks (family members, teachers, the imam and other local ²leaders²) to mediate or respond to such threats to their well being.This was the case in both districts...
Background: Gender-based violence (GBV) is a major cause of injury and death. Data on the magnitude of GBV in conflict remain limited, particularly at a population-level. This study was conducted to 1) estimate the prevalence of GBV among... more
Background: Gender-based violence (GBV) is a major cause of injury and death. Data on the magnitude of GBV in conflict remain limited, particularly at a population-level. This study was conducted to 1) estimate the prevalence of GBV among female Somalis in two Ethiopian refugee camps and females in the neighboring host communities, 2) compare the prevalence of GBV among females in the refugee camps with prevalence among females in the host communities and 3) compare the prevalence of GBV among refugees in flight from Ethiopia to Somalia with prevalence in camps. Methods: Systematic random sampling was used to select households in AwBarre Camp (n=85), AwBarre Town (n=76) and Kebribeya Camp (n=83). The Neighborhood Method was used in which interviewers asked respondents about their experiences with physical violence and rape in the past 12 months as well as the experiences of females in their household and the households of their four closest neighbors. Results: GBV was common in all ...
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Continuing dependence on aid that waxes and wanes with time and that comes largely from external sources can lead to feelings of powerlessness. It can furthermore undermine family- and community-based initiatives to protect children.