Mechanisms underpinning interventions to reduce sexual violence in armed conflict: A realist-informed systematic review

Sexual violence is recognised as a widespread consequence of armed conflict and other humanitarian crises. The limited evidence in literature on interventions in this field suggests a need for alternatives to traditional review methods, particularly given the challenges of undertaking research in conflict and crisis settings. This study employed a realist review of the literature on interventions with the aim of identifying the mechanisms at work across the range of types of intervention. The realist approach is an exploratory and theory-driven review method. It is well suited to complex interventions as it takes into account contextual factors to identify mechanisms that contribute to outcomes. The limited data available indicate that there are few deterrents to sexual violence in crises. Four main mechanisms appear to contribute to effective interventions: increasing the risk to offenders of being detected; building community engagement; ensuring community members are aware of available help for and responses to sexual violence; and safe and anonymous systems for reporting and seeking help. These mechanisms appeared to contribute to outcomes in multiple-component interventions, as well as those relating to gathering firewood, codes of conduct for personnel and legal interventions. Drawing on pre-existing capacity or culture in communities is an additional mechanism which should be explored. Though increasing the risk to offenders of being detected was assumed to be a central mechanism in deterring sexual violence, the evidence suggests that this mechanism operated only in interventions focused on gathering firewood and providing alternative fuels. The other three mechanisms appeared important to the likelihood of an intervention being successful, particularly when operating simultaneously. In a field where robust outcome research remains likely to be limited, realist methods provide opportunities to understand existing evidence. Our analysis identifies the important potential of building in mechanisms involving community engagement, awareness of responses and safe reporting provisions into the range of types of intervention for sexual violence in crises

The evolution of strategic environmental assessment from the Law 20.417

La evaluación ambiental estratégica se incorporó el año 2010, como instrumento de gestión ambiental a través de la Ley N° 20.417, que creó el Ministerio del Medio Ambiente, el Servicio de Evaluación Ambiental y la Superintendencia del Medio Ambiente, la cual introdujo reformas importantes en la regulación del medio ambiente. Casi seis años más tarde, el reglamento para la Evaluación Ambiental Estratégica, fue aprobado mediante el Decreto 32/2015 del Ministerio del Medio Ambiente. Durante la ausencia de norma reglamentaria, Contraloría General de la República dio ciertas directrices a seguir por los Órganos Responsables al momento de evaluar ambientalmente los Instrumentos de Planificación Territorial, Planes y Políticas, estableciendo como ley supletoria para llevar a cabo el procedimiento administrativo a la Ley N° 19.880. Con ello se debió implementar abruptamente la EAE considerando ciertos vacíos legales que con la llegada del Reglamento se esperaban resolver.The strategic environmental assessment was incorporated in 2010 as an instrument of environmental management through the Law N° 20.417, that created the Ministry, the Environment Assessment Authority and the Superintendence, which made on the environment regulation, important reforms. Nearly six years later, the strategic environmental assessment regulation, was approved by Decree 32/2015 of the Environment Ministry. During the absence of regulatory standard, Contraloría General gave some guidelines to be followed by the responsible institutions that have to elaborate the strategic environmental assessment of the Territorial Planning Instruments, Plans and Public Policies, establishing as a suppletive law to this administrative procedure, the Law N° 19.880. This was an abrupt implementation, considering certain loopholes that are expected to be solved with the recently approved regulation

Gender-based violence and its association with mental health among Somali women in a Kenyan refugee camp: a latent class analysis

background In conflict-affected settings, women and girls are vulnerable to gender-based violence (GBV). GBV is associated with poor long-term mental health such as anxiety, depression and post-traumatic stress disorder (PTSD). Understanding the interaction between current violence and past conflict-related violence with ongoing mental health is essential for improving mental health service provision in refugee camps. Methods Using data collected from 209 women attending GBV case management centres in the Dadaab refugee camps, Kenya, we grouped women by recent experience of GBV using latent class analysis and modelled the relationship between the groups and symptomatic scores for anxiety, depression and PTSD using linear regression. Results Women with past-year experience of intimate partner violence alone may have a higher risk of depression than women with past-year experience of non-partner violence alone (Coef. 1.68, 95% CI 0.25 to 3.11). Conflict-related violence was an important risk factor for poor mental health among women who accessed GBV services, despite time since occurrence (average time in camp was 11.5 years) and even for those with a past-year experience of GBV (Anxiety: 3.48, 1.85–5.10; Depression: 2.26, 0.51–4.02; PTSD: 6.83, 4.21–9.44). Conclusion Refugee women who experienced past-year intimate partner violence or conflict-related violence may be at increased risk of depression, anxiety or PTSD. Service providers should be aware that compared to the general refugee population, women who have experienced violence may require additional psychological support and recognise the enduring impact of violence that occurred before, during and after periods of conflict and tailor outreach and treatment services accordingly

Research challenges in evaluating gender-based violence response services in a refugee camp

This article presents a case study of research in Dadaab, Kenya to highlight some of the relevant challenges encountered while conducting gender-based violence research in humanitarian settings. A longitudinal mixed-methods design was used to evaluate a comprehensive case-management intervention in the refugee complex near the border of Kenya and Somalia. We present an overview of both expected and unexpected challenges during preparation and implementation of the research, adaptations made to the research design, and lessons learned for future research in similar contexts. Some of the key challenges were attributed to the highly securitized and remote environment of Dadaab refugee camp, like many refugee camp settings, which created limitations for sampling designs, interview locations, and also created particular burdens for the research team members conducting interviews. In addition to the camp environment, the dynamic nature of events and trends in the camp setting created barriers to follow-up with longitudinal cohort participants as well as uncertainty on how to plan for future implementation of research design phases in response to camp changes. Conducting research in humanitarian settings requires a flexible approach to accommodate the challenges that can impact both service delivery and research activities. The discussion presented in this article contributes to the evolving practical guidance on conducting research in humanitarian settings

Disability, violence, and mental health among Somali refugee women in a humanitarian setting

Background There is limited evidence on the relationship between disability, experiences of gender-based violence (GBV), and mental health among refugee women in humanitarian contexts. Methods A cross-sectional analysis was conducted of baseline data (n = 209) collected from women enrolled in a cohort study of refugee women accessing GBV response services in the Dadaab refugee camps in Kenya. Women were surveyed about GBV experiences (past 12 months, before the last 12 months, before arriving in the refugee camps), functional disability status, and mental health (anxiety, depression, post-traumatic stress), and we explored the inter-relationship of these factors. Results Among women accessing GBV response services, 44% reported a disability. A higher proportion of women with a disability (69%) reported a past-year experience of physical intimate partner violence and/or physical or sexual non-partner violence, compared to women without a disability (54%). A higher proportion of women with a disability (32%) experienced non-partner physical or sexual violence before arriving in the camp compared to women without a disability (16%). Disability was associated with higher scores for depression (1.93, 95% confidence interval (CI) 0.54–3.33), PTSD (2.26, 95% CI 0.03–4.49), and anxiety (1.54, 95% CI 0.13–2.95) after adjusting for age, length of encampment, partner status, number of children, and GBV indicators. Conclusions A large proportion of refugee women seeking GBV response services have disabilities, and refugee women with a disability are at high risk of poor mental health. This research highlights the need for mental health and disability screening within GBV response programming

Intimate partner violence

Domestic or intimate partner violence is prevalent globally, occurring on a continuum from low-level coercion to lethal predatory behaviour, affecting 1 in 3 women (WHO et al. 2013). This chapter provides a broad outline of key research findings, particularly regarding prevalence, impacts and evidence for interventions. This is followed by a discussion of how intimate partner violence emerged as a body of practice and research, with an overview of the study of, and activism against, gendered violence. Key academic debates are reviewed, including those around gender symmetry, causal factors, meaningful outcome measures for interventions and engaging ethical research practice. The World Health Organization (WHO) provides a clear and succinct starting point, defining intimate partner violence as: \u27a pattern of behaviour by a current or former intimate partner causing physical, sexual or psychological harm which may include physical aggression, sexual coercion, psychological abuse and/or controlling behaviours\u27 (WHO 2013)

Relationship-Based Practice in Therapeutic Residential Care: A Double-Edged Sword

This article draws on the lived experiences and perspectives of young people and practitioners in therapeutic residential care to examine what constitutes relationship-based practice. Eight young people and twenty-six practitioners across three residential care services in Australia participated in this qualitative study. Framework analysis identifies that personalised engagement, a delicate balance between care and control, and perseverance through turbulent times are conducive to relationship-based practice in therapeutic residential care. Relationship-based practice is also found to be employed in a unique historical and relational context that demands mindful navigation through three specific professional boundary issues including self-disclosure, over-identification and physical contact. Against this context, relationship-based practice in therapeutic residential care is considered a \u27double-edged sword\u27, offering practitioners copious opportunities to build connections with young people in informal environments whilst needing to mitigate multiple ethical ambiguities. Implications for practice include the need to safeguard the \u27do no harm\u27 priority whilst resisting defensive or detached practice. Contextualising relationship-based practice within an ethical practice framework to embed ethics work in day-to-day practice becomes paramount