Sex trafficking and sexual exploitation in settings affected by armed conflicts in Africa, Asia and the Middle East: systematic review

Background Sex trafficking and sexual exploitation has been widely reported, especially in conflict-affected settings, which appear to increase women’s and children’s vulnerabilities to these extreme abuses. Methods We conducted a systematic search of ten databases and extensive grey literature to gather evidence of sex trafficking and sexual exploitation in conflict-affected settings. International definitions of “sexual exploitation” and “sex trafficking” set the indicator parameters. We focused on sexual exploitation in forms of early or forced marriage, forced combatant sexual exploitation and sexual slavery. We extracted prevalence measures, health outcomes and sexual exploitation terminology definitions. The review adhered to PRISMA guidelines and includes quality appraisal. Results The search identified 29 eligible papers with evidence of sex trafficking and sexual exploitation in armed conflict settings in twelve countries in Africa, Asia, and the Middle East. The evidence was limited and not generalizable, due to few prevalence estimates and inconsistent definitions of “sexual exploitation”. The prevalence estimates available indicate that females were more likely than males to be victims of sexual exploitation in conflict settings. In some settings, as many as one in four forced marriages took place before the girls reached 18 years old. Findings suggest that the vast majority of former female combatants were sexually exploited during the conflict. These studies provided various indicators of sexual exploitation compatible to the United Nation’s definition of sex trafficking, but only 2 studies identified the exploitation as trafficking. None of the studies solely aimed to measure the prevalence of sex trafficking or sexual exploitation. Similar descriptions of types of sexual exploitation and trafficking were found, but the inconsistent terminology or measurements inhibited a meta-analysis. Conclusions Findings indicate there are various forms of human trafficking and sexual exploitation in conflict-affected settings, primarily occurring as early or forced marriage, forced combatant sexual exploitation, and sexual slavery. The studies highlight the extraordinary vulnerability of women and girls to these extreme abuses. Simultaneously, this review suggests the need to clarify terminology around sex trafficking in conflict to foster a more cohesive future evidence-base, and in particular, robust prevalence figures from conflict-affected and displaced populations

Agent-based modeling for migration and modern slavery research: a systematic review

AbstractThis systematic review aims to synthesize how agent-based modeling (ABM) has been used in migration and modern slavery research and provide the basis to model development for social science researchers exploring the use of ABM. We searched five bibliographic databases using two terminology categories: (1) migration or modern slavery terminology; (2) complex system methods terminology. Two reviewers conducted independent article screening. Peer-reviewed articles presenting original migration or modern slavery ABMs were included. Data extraction included model development steps and model characteristics. The dataset was synthesized and compared across studies. We identified 28 articles for inclusion. Many of the ABMs tested theories and about half were based on empirical data. Model development varied considerably and reported methods were extremely opaque. Only five studies used a structured development framework. The most common model involved agents deciding whether and where to migrate and attempting migration. Climate change was a common exogenous scenario modeled. Most of the ABMs did not undergo any sensitivity analysis or validation.ABM has a greater capacity to account for heterogeneous and dynamic decision-making than more frequently applied methods in research on migration and modern slavery. However, there is still a paucity of studies adopting ABM methods. These reviewed ABMs highlight gaps in the reporting and implementing of model development. ABM is a promising technique to address many urgent and complex questions in research on migration and modern slavery to better support decision-makers, but addressing current methodological gaps is a critical first step.</jats:p

The use of Bayesian networks for realist evaluation of complex interventions: evidence for prevention of human trafficking

Complex systems and realist evaluation offer promising approaches for evaluat-ing social interventions. These approaches take into account the complex interplay among factors to produce outcomes, instead of attempting to isolate single causes of observed effects. This paper explores the use of Bayesian networks (BNs) in real-ist evaluation of interventions to prevent complex social problems. It draws on the example of the theory-based evaluation of the Work in Freedom Programme (WIF), a large UK-funded anti-trafficking intervention by the International Labour Organi-sation in South Asia. We used BN to explore causal pathways to human traffick-ing using data from 519 Nepalese returnee migrants. The findings suggest that risks of trafficking are mostly determined by migrants’ destination country, how they are recruited and in which sector they work. These findings challenge widely held assumptions about individual-level vulnerability and emphasize that future invest-ments will benefit from approaches that recognise the complexity of an interven-tion’s causal mechanisms in social contexts. BNs are a useful approach for the con-ceptualisation, design and evaluation of complex social intervention

Systematic review of social norms, attitudes, and factual beliefs linked to the sexual exploitation of children and adolescents.

BACKGROUND: Despite growing interest in the role of social norms in perpetuating the harmful practice of sexual exploitation of children and adolescents (SECA), little is known about the state of the literature on this issue. OBJECTIVE: This systematic review aims to summarize what associated norms, attitudes and factual beliefs have been identified by the SECA literature worldwide. METHODS: Multiple database searches were conducted using controlled vocabulary and keywords referring to SECA. RESULTS: Our searches identified 3690 unique references. After applying our exclusion criteria, 49 studies, including over 14,000 participants from 37 countries and most world regions, were included. Across studies we identified six injunctive norms perpetuating SECA: owning goods as a social status marker ; being sexually active; exchanging sex for favors; contributing financially to the household; stigma and discrimination against young people who experienced SECA; and lack of social sanctions for SECA perpetrators. These norms were supported by enhanced tolerance of SECA when it involved older or more physically developed adolescents and when it occurred in poverty-affected contexts. Beliefs around markers that denote adolescents' readiness for sex; men's entitlement to sex; and the perceived benefits of intergenerational relationships, also contributed to the maintenance and reproduction of SECA. Findings from all regions suggested that marginalized young people are particularly vulnerable to SECA. CONCLUSIONS: Interventions to reduce SECA must consider individual, social, and structural factors and how they interrelate. Context-specific social norms interventions are needed to address harmful norms, promote protective norms, and improve services for those who have experienced SECA

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

‘They Say Our Work Is Not Halal’: Experiences and challenges of refugee community workers involved in gender-based violence prevention and care in Dadaab, Kenya

Notwithstanding the growing centrality of refugee community workers (RCWs) in the current response to gender-based violence (GBV) in the Dadaab refugee camps, they remain poorly studied. Using interview data, we explored the work-related experiences and challenges as well as GBV-related beliefs of RCWs. Whilst they demonstrated elevated knowledge of the forms and drivers of GBV in their community, some of the RCWs did not deem early marriage, female genital mutilation and wife-beating to be GBV acts. In their work, RCWs were motivated by compassion for survivors as well as a sense of community service, but they faced challenges such as insecurity; poor pay; opposition and violence by community members; tense relationships with and suspicion by professional providers; and limited skills and preparation in GBV management. RCWs’ GBV-related beliefs and work experiences underscore the challenges of programming in a complex humanitarian space and offer insights for strengthening their contribution in GBV care and service delivery

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

Gender based violence research methodologies in humanitarian settings: an evidence review and recommendations

This is a guidance document offering recommendations in the areas of research methodology and research ethics to support researchers in developing humanitarian GBV-themed research proposals