Jordanian Social Norms and the Risk of Intimate Partner Violence and Limited Reproductive Agency

Intimate partner violence (IPV) is a pervasive global problem that violates the rights of millions of women each year and has been linked with a multitude of adverse physical, mental, and reproductive health outcomes. In Jordan, socio-cultural constructs of masculinity and female sexuality legitimize control exerted on and violence perpetrated against women. These include the gendered social norms that keep women in disempowered positions and limit their ability make fundamental reproductive decisions such as whether and when to become pregnant. This paper explores some of the mechanisms by which low levels of gender equity increase Jordanian women’s risk of violence and affect their exercise of reproductive agency. Grounded in an empowerment framework and informed by a social ecological model, this research tested the hypothesis that experiencing IPV increases women’s risk of compromised reproductive agency, as evidenced by: increased odds of unintended pregnancy and unmet need for family planning (FP). These analyses revealed important social influences at the individual, interpersonal, and community levels that place women at increased risk for experiencing IPV. They also revealed that exposure to IPV is an independent risk factor for limited reproductive agency, with women who had experienced violence having a 39% increased risk of unintended pregnancy and 43% increased risk of unmet need for FP. The magnitude of these associations was even greater when community norms regarding IPV and women’s autonomy were considered in the model, showing increased risk of 46% and 69%, respectively. These analyses reveal that IPV is significant barrier to the achievement of gender equity in Jordan, as it perpetuates gendered imbalances in power and also imposes great social and health costs on women. This paper discusses the implications of these analyses for designing research and programming initiatives to promote lasting change in support of gender equity and empowerment for Jordanian women

Risk Factors for Men’s Lifetime Perpetration of Physical Violence against Intimate Partners: Results from the International Men and Gender Equality Survey (IMAGES) in Eight Countries

This paper examines men’s lifetime physical intimate partner violence (IPV) perpetration across eight low- and middle-income countries to better understand key risk factors that interventions can target in order to promote gender equality and reduce IPV. We use data from men (n = 7806) that were collected as part of the International Men and Gender Equality Survey (IMAGES) in Bosnia and Herzegovina, Brazil, Chile, Croatia, Democratic Republic of Congo (DRC), India, Mexico, and Rwanda. Results show that there is wide variation across countries for lifetime self-reported physical violence perpetration (range: 17% in Mexico to 45% in DRC), men’s support for equal roles for men and women, and acceptability of violence against women. Across the sample, 31% of men report having perpetrated physical violence against a partner in their lifetime. In multivariate analyses examining risk factors for men ever perpetrating physical violence against a partner, witnessing parental violence was the strongest risk factor, reinforcing previous research suggesting the inter-generational transmission of violence. Additionally, having been involved in fights not specifically with an intimate partner, permissive attitudes towards violence against women, having inequitable gender attitudes, and older age were associated with a higher likelihood of ever perpetrating physical IPV. In separate analyses for each country, we found different patterns of risk factors in countries with high perpetration compared to countries with low perpetration. Findings are interpreted to identify key knowledge gaps and directions for future research, public policies, evaluation, and programming

Healthcare workers' perspectives and practices regarding the disclosure of HIV status to children in Malawi: A cross-sectional study

Background: In 2011 the World Health Organisation recommended that children with a diagnosis of HIV be gradually informed about their HIV status between the ages of 6 and 12 years. However, to date, literature has focused mainly on primary caregiver and child experiences with HIV disclosure, little is known about healthcare workers' perspectives and practices of HIV status disclosure to children. The aim of this study was to assess healthcare workers' perspectives and practices regarding the disclosure of HIV status to children aged between 6 and 12 years in Malawi. Methods: A cross-sectional survey was used to collect data from 168 healthcare providers working in antiretroviral clinics in all government District and Tertiary Hospitals in Malawi. Participants were asked questions regarding their knowledge, practice, and barriers to HIV disclosure. Data were analysed using binary logistic regression. Results: Almost all healthcare workers (98%) reported that it was important to disclose HIV status to children. A significant proportion (37%) reported that they had never disclosed HIV status to a child and about half estimated that the rate of HIV disclosure at their facility was 25% or less. The main barriers to disclosure were lack of training on disclosure (85%) and lack of a standard tool for disclosure (84%). Female healthcare workers (aOR) 2.4; 95% CI: 1.1-5.5) and lack of training on disclosure (aOR 7.7; 95% CI: 3.4-10.7) were independently associated with never having disclosed HIV status to a child. Conclusions: This study highlights the need for providing appropriate training in HIV disclosure for healthcare workers and the provision of standardised disclosure materials

Primary caregivers, healthcare workers, teachers and community leaders' perceptions and experiences of their involvement, practice and challenges of disclosure of HIV status to children living with HIV in Malawi: A qualitative study

Background: The World Health Organisation has recommended that healthcare workers, teachers and community leaders work with parents to support children living with HIV. The aim of this study was to assess the perceptions and experiences of primary caregivers and other care providers such as healthcare workers, teachers, and community leaders regarding their involvement, practice and challenges of HIV disclosure to children aged between 6 and 12 years living with HIV in Malawi. Methods: Twelve focus group discussions and 19 one-on-one interviews involving a total of 106 participants were conducted in all three administrative regions of Malawi. The interviews and focus group discussions explored perceptions and experiences regarding involvement, practice and challenges of disclosure of HIV status to children. Data were analysed using thematic analysis. Results: Primary caregivers, healthcare workers, teachers, and community leaders all reported that the disclosure of HIV status to children was not well coordinated because each of the groups of participants was working in isolation instead of working as a team. A "working together" model emerged from the data analysis where participants expressed the need for them to work as a team in order to promote safe and effective HIV status disclosure through talking about HIV, sharing responsibility and open communication. Participants reported that by working together, the team members would ensure that the prevalence of HIV disclosure to young children increases and that there would be a reduction in any negative impact of disclosure. Conclusion: Global resources are required to better support children living with HIV and their families. Healthcare workers and teachers would benefit greatly from training in working together with families living with HIV and, specifically, training in the disclosure process. Resources, in the form of books and other educational materials, would help them explain HIV and its effective management to children and families

Details on data collection in each country (adapted from Barker et al. [32] and Levtov [33]).

<p>Details on data collection in each country (adapted from Barker et al. [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0118639#pone.0118639.ref032" target="_blank">32</a>] and Levtov [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0118639#pone.0118639.ref033" target="_blank">33</a>]).</p

What’s Gendered about Gender-Based Violence? An Empirically Grounded Theoretical Exploration from Tanzania

Violence is often considered gendered on the basis that it is violence against women. This assumption is evident both in “gender-based violence” interventions in Africa and in the argument that gender is irrelevant if violence is also perpetrated against men. This article examines the relation of partner violence not to biological sex, but to gender as conceptualized in feminist theory. It theorizes the role of gender as an analytical category in dominant social meanings of “wifebeating” in Tanzania by analyzing arguments for and against wife-beating expressed in 27 focus group discussions in the Arumeru and Kigoma-Vijijini districts. The normative ideal of a “good beating” emerges from these data as one that is supported by dominant social norms and cyclically intertwined with “doing gender.” The author shows how the good beating supports, and is in turn supported by, norms that hold people accountable to their sex category. These hegemonic gender norms prescribe the performance of masculinity and femininity, power relations of inequality, and concrete material exploitation of women’s agricultural and domestic labor. The study has implications for policy and practice in interventions against violence, and suggests untapped potential in theoretically informed feminist research for understanding local power relations in the Global South

Brief report: Parent–adolescent child concordance in social norms related to gender equity in marriage – findings from rural India

The purpose of this exploratory study was to assess parent-adolescent child concordance on social norms related to gender equity in marriage in rural Maharashtra, India. Survey data on marital norms related to girl’s marital age and choice, contraception, and marital violence (MV) were collected from unmarried adolescents (n=113 girls, 116 boys) and their parents (n=227 mothers, 203 fathers). Concordance was assessed using a Cohen’s unweighted Kappa statistic, with analyses stratified by sex of parent and child. Analyses revealed fair (K=.25-.27) mother-daughter concordance on girls’ right to choose when to marry, contraception use, and acceptability of MV. Father-son concordance was seen on girls’ right to choose when (K=.22, slight) and who (K=.20, fair) to marry and MV acceptability (K=.53, moderate). No opposite sex parent-child concordance was revealed. Results indicate same but not opposite sex parent-child concordance on gender equity social norms related to marriage, suggesting same sex transfer of these norms