Towards Ethical International Research Partnerships in Gender-Based Violence Research: Insights From Research Partners in Kenya

Research with survivors of gender-based violence in low- and middle-income countries is important to improve understanding of experiences of violence and the policies that can help combat it. But this research also implies risks for survivors, such as re-traumatization, safety concerns, and feelings of exploitation. These risks are magnified if research is undertaken by researchers from high-income countries, whose positionality produces power inequalities affecting both participants and research partners. This article describes the ethical challenges of international gender-based violence research from the perspective of Kenyan researchers and organizations and identifies recommendations about how to prevent them.

Download Full-text

Gender-Based Violence Against Adolescent and Young Adult Women in Low- and Middle-Income Countries

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2014.09.003 ◽

2015 ◽

Vol 56 (2) ◽

pp. 188-196 ◽

Cited By ~ 44

Author(s):

Michele R. Decker ◽

Amanda D. Latimore ◽

Suzumi Yasutake ◽

Miriam Haviland ◽

Saifuddin Ahmed ◽

...

Keyword(s):

Young Adult ◽

Adolescent And Young Adult ◽

Adult Women ◽

Gender Based Violence ◽

Young Adult Women ◽

Middle Income ◽

Middle Income Countries ◽

Gender Based ◽

Low And Middle Income

Download Full-text

The Latest Treatment Interventions Improving Mental Health Outcomes for Women, Following Gender-Based Violence in Low-and-Middle-Income Countries: A Mini Review

Frontiers in Global Women's Health ◽

10.3389/fgwh.2021.792399 ◽

2021 ◽

Vol 2 ◽

Author(s):

Lily St. John ◽

Rebecca Walmsley

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Healthcare Systems ◽

Mental Health Outcomes ◽

Gender Based Violence ◽

Middle Income ◽

Middle Income Countries ◽

Humanitarian Crises ◽

Gender Based ◽

Low And Middle Income

Gender-based violence (GBV), specifically violence against women, is a worldwide pandemic. Prevalence is further escalated in low-and-middle-income countries and in humanitarian crises. Survivors are left with a combination of post-traumatic stress disorder, depression and anxiety. These mental health disorders lead to further morbidity and mortality. Despite its high prevalence and co-morbidities, gender disparities and mental health stigma globally lead to few interventions developed for this population. The aim of this review is to highlight the mental health interventions developed in the past 5 years, for women following GBV in low-and-middle-income countries. It aims to discuss their efficacy and controversies when implemented into healthcare systems, understand the gaps that remain in the field and suggest future research developments. A thorough literature search revealed 16 new interventions available for improving mental health outcomes for women following GBV in low-and-middle-income countries. Following an in-depth evaluation of the papers, one intervention was successful in effectively implementing treatment into healthcare systems—“PM+.” However, it proved only to be effective in the short term. Further research must be done for improving long-term mental health outcomes. Results demonstrated poor follow-up for women engaging in group therapy. The review also highlights community workers were used in service delivery to reduce barriers accessing care. No interventions proved effective in humanitarian crises, despite GBV escalated in these settings. There are very few interventions available in comparison to the prevalence of this global health issue. Therefore, this review encourages further research and improvements in mental healthcare interventions following GBV.

Download Full-text

Global Justice and Health Systems Research in Low- and Middle-Income Countries

The Journal of Law Medicine & Ethics ◽

10.1111/jlme.12202 ◽

2015 ◽

Vol 43 (1) ◽

pp. 143-161 ◽

Cited By ~ 20

Author(s):

Bridget Pratt ◽

Adnan A. Hyder

Keyword(s):

Global Health ◽

International Research ◽

Global Justice ◽

High Income ◽

Ethical Framework ◽

Middle Income ◽

Middle Income Countries ◽

Systems Research ◽

Health Justice ◽

Low And Middle Income

More than a decade ago, Solomon Benatar and Peter Singer argued that “a new, proactive research ethics…must ultimately be concerned with reducing inequities in global health and achieving justice in health research and health care.” Towards this objective, a limited amount of recent scholarship has started to consider whether a theoretical basis exists for the position that international research should help promote global health equity and, if so, what the implications are for its conduct. Theories of justice from political philosophy establish obligations for parties in high-income countries to improve the health of parties in low- and middle-income countries (LMICs). These theories have been shown to provide grounds for the claim that international research should be conducted to advance justice in global health. What this means for research actors from high-income countries is the focus of a recently proposed ethical framework: “research for health justice.”

Download Full-text

Rights based approaches to sexual and reproductive health in low and middle-income countries: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0250976 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250976

Author(s):

Majel McGranahan ◽

Joselyn Nakyeyune ◽

Christopher Baguma ◽

Nakibuuka Noor Musisi ◽

Derrick Nsibirwa ◽

...

Keyword(s):

Systematic Review ◽

Reproductive Health ◽

Sexual And Reproductive Health ◽

Risk Of Bias ◽

Gender Based Violence ◽

Middle Income ◽

Sexually Transmitted ◽

Middle Income Countries ◽

Gender Based ◽

Low And Middle Income

Introduction The Sustainable Development Goals, which are grounded in human rights, involve empowering women and girls and ensuring that everyone can access sexual and reproductive health and rights (Goal 5). This is the first systematic review reporting interventions involving rights-based approaches for sexual and reproductive health issues including gender-based violence, maternity, HIV and sexually transmitted infections in low and middle-income countries. Aims To describe the evidence on rights-based approaches to sexual and reproductive health in low and middle-income countries. Methods EMBASE, MEDLINE and Web of Science were searched until 9/1/2020. Inclusion criteria were: Study design: any interventional study. Population: females aged over 15 living in low and middle-income countries. Intervention: a “rights-based approach” (defined by the author) and/or interventions that the author explicitly stated related to "rights". Comparator: clusters in which no intervention or fewer components of an intervention were in place, or individuals not exposed to interventions, or exposed to fewer intervention components. Outcome: Sexual and reproductive health related outcomes. A narrative synthesis of included studies was undertaken, and outcomes mapped to identify evidence gaps. The systematic review protocol was registered on PROSPERO (CRD42019158950). Results Database searching identified 17,212 records, and 13,404 studies remained after de-duplication. Twenty-four studies were included after title and abstract, full-text and reference-list screening by two authors independently. Rights-based interventions were effective for some included outcomes, but evidence was of poor quality. Testing uptake for HIV and/or other sexually transmitted infections, condom use, and awareness of rights improved with intervention, but all relevant studies were at high, critical or serious risk of bias. No study included gender-based violence outcomes. Conclusion Considerable risk of bias in all studies means results must be interpreted with caution. High-quality controlled studies are needed urgently in this area.

Download Full-text

Towards an integrated theoretical framework for understanding water insecurity and gender-based violence in Low-and middle-income countries (LMICs)

Health & Place ◽

10.1016/j.healthplace.2021.102651 ◽

2021 ◽

Vol 71 ◽

pp. 102651

Author(s):

Abraham Marshall Nunbogu ◽

Susan J. Elliott

Keyword(s):

Theoretical Framework ◽

Gender Based Violence ◽

Water Insecurity ◽

Middle Income ◽

Middle Income Countries ◽

Gender Based ◽

And Gender ◽

Low And Middle Income

Download Full-text

Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Nutrients ◽

10.3390/nu13031038 ◽

2021 ◽

Vol 13 (3) ◽

pp. 1038

Author(s):

Ana Carolina B. Leme ◽

Sophia Hou ◽

Regina Mara Fisberg ◽

Mauro Fisberg ◽

Jess Haines

Keyword(s):

English Language ◽

Economic Status ◽

High Income ◽

Dietary Guidelines ◽

Systemic Review ◽

Healthy Children ◽

Future Health ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

Download Full-text

Social Epidemiology and Global Mental Health: Expanding the Evidence from High-Income to Low- and Middle-Income Countries

Current Epidemiology Reports ◽

10.1007/s40471-017-0107-y ◽

2017 ◽

Vol 4 (2) ◽

pp. 166-173 ◽

Cited By ~ 15

Author(s):

Joanna Maselko

Keyword(s):

Mental Health ◽

Social Epidemiology ◽

Global Mental Health ◽

High Income ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Download Full-text

Abstract WP418: A Systematic Comparison of Key Features of Ischaemic Stroke Prevention Guidelines in Low- and Middle-income vs High-income Countries

Stroke ◽

10.1161/str.48.suppl_1.wp418 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Hernan O Bayona ◽

Mayowa Owolabi ◽

Wayne Feng ◽

James R Sawers ◽

Paul Olowoyo ◽

...

Keyword(s):

Stroke Prevention ◽

High Income ◽

Evidence Based ◽

Vascular Risk ◽

Eligibility Criteria ◽

Middle Income ◽

Middle Income Countries ◽

Prevention Guideline ◽

Prevention Guidelines ◽

Low And Middle Income

Introduction: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low- and Middle-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. Focus therefore, should be on approaches enabling healthcare systems to improve control of vascular risk factors. Objective: We aimed to compare important features of stroke prevention guidelines between LMICs and High Income Countries (HICs). Methods: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: “Stroke” and “Guidelines”. We critically appraised the articles for evidence level, issuance frequency and implementation aspects to clinical practice. Results: Among 45 stroke prevention guidelines published, 28 (62%) met eligibility criteria: 7 from LMICs (25%) and 21 from HICs (75%). LMIC-issued guidelines were less likely to have conflict of interest declarations (57% vs. 100%, p=0.01), involve high quality systematic reviews (57% vs. 95%, p= 0.03), had good dissemination channels (14% vs 71%, p=0.02). The patient views and preferences were the most significant stakeholder considerations in HICs (43%, p=0.04) compared with LMICs. Conclusion: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.

Download Full-text

Effective Strategies for Global Health Training Programs A Systematic Review of Training Outcomes in Low and Middle Income Countries

Global Journal of Health Science ◽

10.5539/gjhs.v8n11p278 ◽

2016 ◽

Vol 8 (11) ◽

pp. 278 ◽

Cited By ~ 2

Author(s):

Aprill Z. Dawson ◽

Rebekah J. Walker ◽

Jennifer A. Campbell ◽

Leonard E. Egede

Keyword(s):

Medical Training ◽

Skills Training ◽

High Income ◽

Training Methods ◽

Middle Income ◽

Training Outcomes ◽

Effective Strategies ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Low And Middle Income

INTRODUCTION: Low and middle-income countries face a continued burden of chronic illness and non-communicable diseases while continuing to show very low health worker utilization. With limited numbers of medical schools and a workforce shortage the poor health outcomes seen in many low and middle income countries are compounded by a lack of within country medical training.METHODS: Using a systematic approach, this paper reviews the existing literature on training outcomes in low and middle-income countries in order to identify effective strategies for implementation in the developing world. This review examined training provided by high-income countries to low- and middle-income countries.RESULTS: Based on article eligibility, 24 articles were found to meet criteria. Training methods found include workshops, e-learning modules, hands-on skills training, group discussion, video sessions, and role-plays. Of the studies with statistically significant results training times varied from one day to three years. Studies using both face-to-face and video found statistically significant results.DISCUSSION: Based on the results of this review, health professionals from high-income countries should be encouraged to travel to low- middle-income countries to assist with providing training to health providers in those countries.

Download Full-text