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

Trafficking in women. The health of women in post-trafficking services in Europe who were trafficked into prostitution or sexually abused as domestic labourers

Background. The trafficking of women and adolescents into exploitative and forced labour is a growing crime and a severe form of violence against women. Little theory or research-based evidence currently exists on the health risks and consequences associated with trafficking. Objectives. This thesis presents conceptual models and describes systematically collected data on the health risks and consequences of trafficked women and adolescents, and considers methodological implications of research with this vulnerable group. Methods. Two studies, one qualitative and one quantitative, were conducted with women trafficked predominantly for sexual exploitation. The formative research exploring trafficking-related health risks was carried out in five European states with a total of 28 women. The quantitative survey was conducted with a cohort of 207 attending post-trafficking services in seven European States. Semi-structured interviews were carried out over three time periods (0-14 days, 28-56 days and 90+ days) to document reported pre-trafficking and trafficking-related risk exposures and post-trafficking physical, sexual, reproductive and mental health symptoms. Results. Risk exposures included high levels of pre-departure and in-trafficking violence (physical and/or sexual). Perceived physical health symptoms were prevalent, especially at the first interview, with neurological symptoms (e.g., headaches) being the most prevalent and persistent. Most physical symptoms reduced between the first and second interviews. Symptoms suggestive of post-traumatic stress disorder were reported over the three interviews by 56%,12% and 7% of women, respectively. Depression levels remained extremely high throughout the study. Anxiety and hostility levels were also high, but decreased more than depression. Conclusions. These descriptive analyses offer theoretical models and new evidence on risk and health symptom patterns. Findings suggest the need for urgent and longterm comprehensive health care services, an adequate legal period of recovery and reflection, and research methods sensitive to the risks associated with studying this vulnerable population

Learning from returnee Ethiopian migrant domestic workers: a qualitative assessment to reduce the risk of human trafficking.

BACKGROUND: International migration has become a global political priority, with growing concern about the scale of human trafficking, hazardous work conditions, and resulting psychological and physical morbidity among migrants. Ethiopia remains a significant "source" country for female domestic workers to the Middle East and Gulf States, despite widespread reports of exploitation and abuse. Prior to introduction of a "safe migration" intervention, we conducted formative research to elicit lessons learned by women who had worked as domestic workers abroad. The aim of the study was to identify realistic measures future migrants could take to protect themselves, based on the collective insights and experience of returnees. METHODS: We conducted a qualitative assessment among returnee domestic labour migrants in Amhara Region, Ethiopia, an area considered a "hotspot" for outmigration. We conducted in-depth interviews and focus group discussions with a total of 35 female returnees, exploring risk and protective factors experienced by Ethiopian women during domestic work abroad. We used thematic content analysis to identify practical messages that could improve prospective migrants' preparedness. RESULTS: Returnees described the knowledge and skills they acquired prior to departure and during migration, and shared advice they would give to prospective migrants in their community. Facilitators of positive migration included conforming to cultural and behavioural expectations, learning basic Arabic, using household appliances, and ensuring safety in employers' homes. Respondents also associated confidence and assertiveness with better treatment and respect, and emphasized the importance of access to external communication (e.g. a mobile phone, local sim card, and contact details) for help in an emergency. Following their own challenging or even traumatic experiences, returnees were keen to support resilience among the next wave of migrants. CONCLUSIONS: There is little evidence on practices that foster safer migration, yet attention to human trafficking has led to an increase in pre-migration interventions. These require robust evidence about local risk and protective factors. Our findings identify knowledge, skills, attributes and resources found useful by returnee domestic workers in Amhara region, and have been used to inform a community-based programme aiming to foster better decision-making and preparation, with potential to offer insights for safer migration elsewhere

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

Men's and women's experiences of violence and traumatic events in rural Cote d'Ivoire before, during and after a period of armed conflict.

OBJECTIVE: We assessed men's and women's experiences of gender based violence and other traumatic events in Côte d'Ivoire, a West African conflict-affected setting, before, during and after a period of active armed conflict (2000-2007). DESIGN: Cross-sectional, household survey. SETTING: 12 rural communities directly impacted by the Crisis in Côte d'Ivoire, spanning regions controlled by government forces, rebels and UN peacekeepers in 2008. PARTICIPANTS: 2678 men and women aged 15-49 years. PRIMARY OUTCOME MEASURES: Violence exposures measured since age 15. Questions included intimate partner physical and sexual violence; physical and sexual violence by others (including combatants) and exposure to traumatic events before, during and after the Crisis period (2000-2007). RESULTS: Physical and/or sexual violence since age 15 was reported by 57.1% women and 40.2% men (p=0.01); 29.9% women and 12.3% men reported exposure to any violence in the past year. Nearly 1 in 10 women (9.9%) and 5.9% men (p=0.03) were forced to have sex by a non-partner since age 15, and 14.8% women and 3.3% men (p=0.00) reported their first sexual experience was forced. Combatants were rarely reported as sexual violence perpetrators (0.3% women). After the Crisis, intimate partner physical violence was the most frequently reported form of violence and highest among women (20.9% women, 9.9% men, p=0.00). Fearing for their life was reported by men and women before, during and after the Crisis. CONCLUSIONS: Sexual violence in conflict remains a critical international policy concern. However, men and women experience different types of violence before, during and after conflict. In many conflict settings, other forms of violence, including intimate partner violence, may be more widespread than conflict-related sexual violence. Alongside service provision for rape survivors, our findings underscore the need for postconflict reconstruction efforts to invest in programmes to prevent and respond to intimate partner violence and trauma

Human trafficking and labor exploitation: Toward identifying, implementing, and evaluating effective responses.

In an Editorial, Ligia Kiss and Cathy Zimmerman discuss the need for research on the prevention of human trafficking and mitigation of its effects

What is the prevalence of and associations with forced labour experiences among male migrants from Dolakha, Nepal? Findings from a cross-sectional study of returnee migrants.

OBJECTIVES: Growing numbers of people are migrating outside their country for work, and many experience precarious conditions, which have been linked to poor physical and mental health. While international dialogue on human trafficking, forced labour and slavery increases, prevalence data of such experiences remain limited. METHODS: Men from Dolakha, Nepal, who had ever migrated outside of Nepal for work were interviewed on their experiences, from predeparture to return (n=194). Forced labour was assessed among those who returned within the past 10 years (n=140) using the International Labour Organization's forced labour dimensions: (1) unfree recruitment; (2) work and life under duress; and (3) impossibility to leave employer. Forced labour is positive if any one of the dimensions is positive. RESULTS: Participants had worked in India (34%), Malaysia (34%) and the Gulf Cooperation Council countries (29%), working in factories (29%), as labourers/porters (15%) or in skilled employment (12%). Among more recent returnees (n=140), 44% experienced unfree recruitment, 71% work and life under duress and 14% impossibility to leave employer. Overall, 73% experienced forced labour during their most recent labour migration.Forced labour was more prevalent among those who had taken loans for their migration (PR 1.23) and slightly less prevalent among those who had migrated more than once (PR 0.87); however the proportion of those who experienced forced labour was still high (67%). Age, destination and duration of stay were associated with only certain dimensions of forced labour. CONCLUSION: Forced labour experiences were common during recruitment and at destination. Migrant workers need better advice on assessing agencies and brokers, and on accessing services at destinations. As labour migration from Nepal is not likely to reduce in the near future, interventions and policies at both source and destinations need to better address the challenges migrants face so they can achieve safer outcomes

Migration Planning Among Female Prospective Labour Migrants from Nepal: A Comparison of First-Time and Repeat-Migrants

As international female labour migration has increased, so too have efforts to prevent the exploitation of labour migrants. However, evidence to underpin prevention efforts remains limited, with little known about labour migrants’ migration planning processes. Using data from a survey of female prospective labour migrants from Nepal, this article compares socio-demographics and migration-planning processes between first-time and repeat-migrants. We identified several factors which might increase repeat-migrants’ vulnerability to exploitation during the migration process, or obstruct their engagement in pre-migration interventions: more rapid migration planning than first-time migrants; lower involvement in community groups; and a perception that they already have the knowledge they need. Only one-third of repeat-migrants planned to go to the same destination and 42 per cent to work in the same sector as previously. With repeat-migration a common livelihoods strategy, it is crucial that interventions are guided by evidence on the needs of both first-time- and repeat-migrants