scholarly journals Understanding access to professional healthcare among asylum seekers facing gender-based violence: a qualitative study from a stakeholder perspective

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mirjam D. Rodella Sapia ◽  
Tenzin Wangmo ◽  
Stéphanie Dagron ◽  
Bernice S. Elger
Keyword(s):  
Continuity Of Care ◽  
Asylum Seekers ◽  
Home Country ◽  
Access To Healthcare ◽  
Critical Study ◽  
Structural Level ◽  
Gender Based Violence ◽  
Framework Analysis ◽  
Gender Based ◽  
Study Participants

Abstract Background When it comes to gender-based violence (GBV), migrant women and girls represent the most vulnerable group. GBV can happen at any stage of migrants’ flight and/or during the asylum process. It has severe consequences on their life and health. Victims therefore need timely access to healthcare. This study explores the context GBV victims face when they seek refuge in Switzerland. Methods Qualitative methodology was used where we conducted five semi-structured focus groups and three interviews. A total of sixteen stakeholders participated in the study. They were either involved in the asylum process or provided healthcare to asylum seekers. We analyzed the data using framework analysis. Results Study participants noted lack of confidence of the GBV victims in the legal and in the healthcare systems as major barriers to disclosure of GBV. Since only GBV exerted before fleeing the home country gives the right to asylum, they pointed out that victims do not disclose GBV that took place after they left their home country. Language was identified as a barrier to disclosure of GBV as well as to healthcare access. Continuity of care at the moment of transfer from federal to cantonal (i.e. state) accommodations is another issue that was deemed critical. Study participants felt that health professionals must be trained to identify GBV victims. The first-contact caregiver available to these victims was deemed as the most competent professional that could act as a “GBV coordinator”. Conclusion In Switzerland, access to healthcare is guaranteed to all asylum seekers on a legal and structural level. Yet, health seeking by GBV survivors is hindered by factors such as lack of confidence in the legal system, trust in health providers, and continuity of care during the asylum process. Building trust in legal institutions, health structures, and professionals should be enhanced to facilitate disclosure and to strengthen resilience. This includes a healthcare system with competent professionals, support with language and cultural needs, as well as seamless continuity of care beyond cantonal borders.

scholarly journals Understanding access to professional healthcare among asylum seekers facing gender-based violence: a qualitative study from a stakeholder perspective

2020 ◽  
Author(s):  
Mirjam Rodella Sapia ◽  
Tenzin Wangmo ◽  
Stéphanie Dagron ◽  
Bernice S. Elger
Keyword(s):  
Continuity Of Care ◽  
Asylum Seekers ◽  
Home Country ◽  
Access To Healthcare ◽  
Critical Study ◽  
Structural Level ◽  
Gender Based Violence ◽  
Framework Analysis ◽  
Gender Based ◽  
Study Participants

Abstract Background: When it comes to gender-based violence (GBV), migrant women and girls represent the most vulnerable group. GBV can happen at any stage of migrants’ flight and/or during the asylum process. It has severe consequences on their life and health. Victims therefore need timely access to healthcare. This study explores the context GBV victims face when they seek refuge in Switzerland. Methods: Qualitative methodology was used where we conducted five semi-structured focus groups and three interviews. A total of sixteen stakeholders participated in the study. They were either involved in the asylum process or provided healthcare to asylum seekers. We analyzed the data using framework analysis.Results: Study participants noted lack of confidence of the GBV victims in the legal and in the healthcare systems as major barriers to disclosure of GBV. Since only GBV exerted before fleeing the home country gives the right to asylum, they pointed out that victims do not disclose GBV that took place after they left their home country. Language was identified as a barrier to disclosure of GBV as well as to healthcare access. Continuity of care at the moment of transfer from federal to cantonal (i.e. state) accommodations is another issue that was deemed critical. Study participants felt that health professionals must be trained to identify GBV victims. The first-contact caregiver available to these victims was deemed as the most competent professional that could act as a “GBV coordinator”.Conclusion: In Switzerland, access to healthcare is guaranteed to all asylum seekers on a legal and structural level. Yet, health seeking by GBV survivors is hindered by factors such as lack of confidence in the legal system, trust in health providers, and continuity of care during the asylum process. Building trust in legal institutions, health structures, and professionals should be enhanced to facilitate disclosure and to strengthen resilience. This includes a healthcare system with competent professionals, support with language and cultural needs, as well as seamless continuity of care beyond cantonal borders.

scholarly journals Understanding access to professional healthcare among asylum seekers facing gender-based violence: a qualitative study from a stakeholder perspective

2020 ◽  
Author(s):  
Mirjam Rodella Sapia ◽  
Tenzin Wangmo ◽  
Stéphanie Dagron ◽  
Bernice S. Elger
Keyword(s):  
Continuity Of Care ◽  
Asylum Seekers ◽  
Home Country ◽  
Access To Healthcare ◽  
Critical Study ◽  
Structural Level ◽  
Gender Based Violence ◽  
Framework Analysis ◽  
Gender Based ◽  
Study Participants

Abstract Background: When it comes to gender-based violence (GBV), migrant women and girls represent the most vulnerable group. GBV can happen at any stage of migrants’ flight and/or during the asylum process. It has severe consequences on their life and health. Victims therefore need timely access to healthcare. This study explores the context GBV victims face when they seek refuge in Switzerland. Methods: Qualitative methodology was used where we conducted five semi-structured focus groups and three interviews. A total of sixteen stakeholders participated in the study. They were either involved in the asylum process or provided healthcare to asylum seekers. We analyzed the data using framework analysis.Results: Study participants noted lack of confidence of the GBV victims in the legal and in the healthcare systems as major barriers to disclosure of GBV. Since only GBV exerted before fleeing the home country gives the right to asylum, they pointed out that victims do not disclose GBV that took place after they left their home country. Language was identified as a barrier to disclosure of GBV as well as to healthcare access. Continuity of care at the moment of transfer from federal to cantonal (i.e. state) accommodations is another issue that was deemed critical. Study participants felt that health professionals must be trained to identify GBV victims. The first-contact caregiver available to these victims was deemed as the most competent professional that could act as a “GBV coordinator”.Conclusion: In Switzerland, access to healthcare is guaranteed to all asylum seekers on a legal and structural level. Yet, health seeking by GBV survivors is hindered by factors such as lack of confidence in the legal system, trust in health providers, and continuity of care during the asylum process. Building trust in legal institutions, health structures, and professionals should be enhanced to facilitate disclosure and to strengthen resilience. This includes a healthcare system with competent professionals, support with language and cultural needs, as well as seamless continuity of care beyond cantonal borders.

scholarly journals Understanding access to professional healthcare among asylum seekers facing gender-based violence: a qualitative study from a stakeholder perspective

2020 ◽  
Author(s):  
Mirjam Rodella Sapia ◽  
Tenzin Wangmo ◽  
Stéphanie Dagron ◽  
Bernice S. Elger
Keyword(s):  
Healthcare System ◽  
Continuity Of Care ◽  
Asylum Seekers ◽  
Home Country ◽  
Access To Healthcare ◽  
Trust Building ◽  
Structural Level ◽  
Gender Based Violence ◽  
Gender Based ◽  
Study Participants

Abstract Background: When it comes to gender-based violence (GBV), migrant women and girls represent the most vulnerable group. GBV can happen at any stage of migrants’ flight and/or during asylum process. It has severe consequences on their life and health. Victims therefore need timely access to healthcare. This study explores the context GBV victims are faced with when they seek refuge in Switzerland. The study focuses on the organizational framework and the current strategies handling medical and psychological support. It identifies access barriers and maps needed support within the health system. Methods : Qualitative methodology was used where we conducted five semi-structured focus groups and three interviews with sixteen stakeholders involved in the asylum process and health care professionals. We analysed the data using framework analysis. Results : Study participants noted lack of confidence from the GBV victims in the legal and in the healthcare system as major barriers to disclosure of GBV. Since only GBV exerted before fleeing the home country gives the right to asylum, they also pointed out that victims do not disclose GBV that took place after they left their home country. Language was identified as a barrier to disclosure as well as healthcare access. Continuity of care at the moment of transfer from federal to cantonal accommodations is another issue that was deemed critical. Study participants felt that health professionals must be trained to identify GBV victims. First-contact caregivers available to these victims were deemed as the most competent professionals that could act as a “GBV coordinator”. Conclusion : In Switzerland, access to healthcare is guaranteed to all asylum seekers on a legal and structural level. Yet, health seeking by GBV survivors is hindered by major factors such as (lack of) confidence in the legal system, trust building in health providers and a breach in continuity of care during the asylum process. Trust building in legal institutions, health structures and professionals should be enhanced to facilitate disclosure and strengthen resilience. This includes a healthcare system with competent professional, support with language, cultural needs and seamless continuity of care beyond cantonal borders.

scholarly journals Exploring the feasibility and acceptability of integrating screening for gender-based violence into HIV counselling and testing for adolescent girls and young women in Tanzania and South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manuela Colombini ◽  
◽  
Fiona Scorgie ◽  
Anne Stangl ◽  
Sheila Harvey ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Young Women ◽  
Hiv Risk ◽  
Clinical Staff ◽  
Gender Based Violence ◽  
Process Data ◽  
Hiv Counselling And Testing ◽  
Gender Based ◽  
Study Participants

Abstract Background Gender-based violence (GBV) undermines HIV prevention and treatment cascades, particularly among women who report partner violence. Screening for violence during HIV testing, and prior to offering pre-exposure prophylaxis (PrEP) to HIV uninfected women, provides an opportunity to identify those at heightened HIV risk and greater potential for non-adherence or early discontinuation of PrEP. The paper describes our experience with offering integrated GBV screening and referral as part of HIV counselling and testing. This component was implemented within EMPOWER, a demonstration project offering combination HIV prevention, including daily oral PrEP, to young women in South Africa and Tanzania. Methods Between February 2017 and March 2018, a process evaluation was conducted to explore views, experiences and practices of stakeholders (study participants and study clinical staff) during implementation of the GBV screening component. This article assesses the feasibility and acceptability of the approach from multiple stakeholder perspectives, drawing on counselling session observations (n = 10), in-depth interviews with participants aged 16–24 (n = 39) and clinical staff (n = 13), and notes from debriefings with counsellors. Study process data were also collected (e.g. number of women screened and referred). Following a thematic inductive approach, qualitative data were analysed using qualitative software (NVivo 11). Results Findings show that 31% of young women screened positive for GBV and only 10% requested referrals. Overall, study participants accessing PrEP were amenable to being asked about violence during HIV risk assessment, as this offered the opportunity to find emotional relief and seek help, although a few found this traumatic. In both sites, the sensitive and empathetic approach of the staff helped mitigate distress of GBV disclosure. In general, the delivery of GBV screening in HCT proved to be feasible, provided that the basic principles of confidentiality, staff empathy, and absence of judgment were observed. However, uptake of linkage to further care remained low in both sites. Conclusion Most stakeholders found GBV screening acceptable and feasible. Key principles that should be in place for young women to be asked safely about GBV during HIV counselling and testing included respect for confidentiality, a youth-friendly and non-judgmental environment, and a functioning referral network.

scholarly journals PERCEPTION OF WOMEN ON SEXUAL AND GENDER BASED VIOLENCE IN NSUKKA, ENUGU STATE

2020 ◽  
Vol 7 (1) ◽  
pp. 257-270
Author(s):  
Oliver Eya ◽  
◽  
Adaoga Obuna ◽  
Grace Odinye ◽  
Christy Obi-Keguna ◽  
...  
Keyword(s):  
Physical Violence ◽  
Traditional Values ◽  
Gender Based Violence ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Enugu State ◽  
Gender Based ◽  
And Gender ◽  
Study Participants

Sexual and gender issues have been a problem in Africa and in Nigeria in particular where females were considered less important than their male counterparts in their families, cooperatives, businesses, academic matters among others. Gender-Based Violence (GBV) is deeply rooted in many cultural and traditional values. It is regarded as a normal attitude, remains hidden and tacitly condoned. It has devastating health impacts on the women, as women are mostly controlled and dominated by their partners in a relationship and must never complain of sexual harassment and in the case of childlessness; the woman must accept it as her fault. This study was located in Nsukka Local Government area of Enugu State. A cross sectional survey of 200 study participants was conducted. The instruments used for data collection were structured 194 questionnaire and6 in-depth interview guide. The data was analyzed using Statistical Package for Social Sciences (SPSS), frequency distribution tables and chi-square (χ²) for hypotheses. The findings from the study stated that sexual/psychological, physical violence and preference of male child are the major forms of GBV in Nsukka, Enugu State. Majority of the respondents (55.7%) indicated that Spiritual manipulation and illiteracy/ignorance are the major causes of GBV. The study also concluded and recommended that mass sensitization/awareness, empowerment, advocacy by social workers, through domestication of the Convention to Eliminate All Forms of Discrimination against Women (CEDAW), will help curb GBV as indicated by 42.7% of the respondents.

scholarly journals Experiences of gender-based violence in women asylum seekers from Honduras, El Salvador and Guatemala

2020 ◽  
Vol 29 (3) ◽  
pp. 46-58 ◽  
Author(s):  
Kim A. Baranowski ◽  
Eileen Wang ◽  
Megan R. D'Andrea ◽  
Elizabeth K. Singer
Keyword(s):  
United States ◽  
Human Rights ◽  
El Salvador ◽  
Partner Violence ◽  
Asylum Seekers ◽  
Psychological Evaluation ◽  
The United States ◽  
Human Rights Violations ◽  
Gender Based Violence ◽  
Gender Based

Introduction: Every year, thousands of women flee gender-based violence in Honduras, El Salvador, and Guatemala (sometimes collectively referred to as the Northern Triangle) in an attempt to seek asylum in the United States. Once in the United States, their legal teams may refer them for a psychological evaluation as part of their application for asylum. Licensed clinicians conduct in-depth interviews in order to document the psychological impact of the reported human rights violations. Method: Using archival de-identified data from a human rights program, this study gathered the experiences of gender-based violence reported by 70 asylum-seeking women from Honduras, El Salvador, and Guatemala who participated in pro bono psychological evaluation. Descriptive data were analyzed using a modified consensual qualitative research (CQR-M) method.Results: These asylum seekers reported exposure to systemic violence, including severe intimate partner violence, as well as physical and sexual assaults, and threats of death by organized criminal groups in their communities. Additionally, over a third of women reported experiences of violence during their migration. The majority of asylum seekers endorsed symptoms associated with anxiety (80%) and depression (91%), as well as trauma-and stressor-related symptoms (80%). Discussion: The results of this study elucidate the manyforms of gender-based violence experienced by women in this region, the physical and psychological sequelae of this persecution, and the systemic forces that prevent them from remaining in their countries of origin. The research results also highlight the potential impact of trauma on the women’s ability to testify effectively during asylum legal hearings, elucidate factors that may contribute to their resilience in light of the human rights violations they survived, and suggest implications for clinical practice.

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