Using reproductive health services to address sexual and gender-based violence in post-conflict northern Uganda.

2019 ◽  
Author(s):  
Keneth Opiro ◽  
Francis Pebolo Pebalo ◽  
Neil Scolding ◽  
Charlotte Hardy
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Health Workers ◽  
Northern Uganda ◽  
Gender Based Violence ◽  
Reproductive Health Services ◽  
Service Workers ◽  
Post Conflict ◽  
Gender Based ◽  
And Gender

Abstract Abstract Background Sexual and gender-based violence (SGBV), including rape and child sexual abuse, remains a significant challenge in post-conflict northern Uganda, including within refugee settlements. Many victims have never sought help from health-related services. Consequently, the scale of the problem is unknown, and SGBV victims’ injuries, both psychological and physical, remain undetected and unaddressed. We hypothesized that health workers in rural Reproductive Health Services could provide a valuable resource for SGBV screening and subsequent referral for support. Methods Our project had three elements. First, Reproductive Health Service workers were trained in the knowledge and skills needed to screen for and identify women who had experienced SGBV, using a questionnaire-based approach. Second, the screening questionnaire was used by reproductive health workers over a 3-month period, and the data analysed to explore the scale and nature of the problem. Third, victims detected were offered referral as appropriate to hospital services and/or the ActionAid SURGE (Strengthening Uganda’s Response to Gender Equality) shelter in Gulu. Results 1656 women were screened. 778 (47%) had a history of SGBV, including 123 victims of rape and 505 victims of non-sexual violence. 1,254 (76%) had been directly or indirectly affected by conflict experiences; 1066 had lived in IDP camps. 145 (9%) were referred at their request to Gulu SGBV Shelter under SURGE. Of these, 25 attended the shelter and received assistance, and a further 20 received telephone counselling. Conclusion Undetected SGBV remains a problem in post-conflict northern Uganda. Reproductive Health Service workers, following specific training, can effectively screen for and identify otherwise unreported and unassisted cases of SGBV. Future work will explore scaling up to include screening in hospital A&E departments, incorporate approaches to screening for male victims, and the impact of taking both screening and support services to rural communities through local clinics with mobile teams.

Sexual and reproductive health survey in the time of COVID-19 – Latvia, 2020

2021 ◽  
Author(s):  
Gunta Lazdane ◽  
◽  
Dace Rezeberga ◽  
Ieva Briedite ◽  
Inara Kantane ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Family Relationships ◽  
Online Survey ◽  
Gender Based Violence ◽  
Reproductive Health Services ◽  
Health And Nutrition ◽  
Validated Questionnaire ◽  
Variables Selection ◽  
Gender Based ◽  
And Gender

The results of the anonymous online survey of people living in Latvia age 18 and over, using internationally (I-SHARE) and nationally validated questionnaire. Data include following variables: Selection, socio-demographics, social distancing measures, couple and family relationships, sexual behavior, access to condoms and contraceptives, access to reproductive health services, antenatal care, pregnancy and maternal and child health, abortion, sexual and gender-based violence, HIV/STI, mental health, and nutrition. (2021-02-08)

scholarly journals Perceptions of the Drivers of Sexual and Gender Based Violence in Post Conflict Northern Uganda

2013 ◽  
Vol 10 ◽  
pp. 84-102 ◽  
Author(s):  
Paul Bukuluki ◽  
John David Kisuule ◽  
Alex Bagabo Makerere ◽  
Berit Schei ◽  
Johanne Sundby
Keyword(s):  
Northern Uganda ◽  
Gender Based Violence ◽  
Group Discussions ◽  
Female Partners ◽  
Post Conflict ◽  
Qualitative Approaches ◽  
Related Stigma ◽  
Gender Based ◽  
And Gender ◽  
And Control

This paper explores the perceived forms and drivers of sexual and gender based violence in post conflict settings with focus on Northern Uganda. It applied qualitative approaches primarily using in-depth interviews, focus group discussions and key informant interviews. Study findings revealed that although all forms of violence are perceived to be prevalent, physical and emotional violence were perceived to be the most occurring. Men were perceived to be the main perpetrators of violence. However, there were cases of men who reported to experience violence from women. Few men reported violence to authorities because it was perceived to be stigmatizing; such men would be perceived as weak in a patriarchal society that perceives ideal men to be strong and less susceptible to physical, emotional and sexual abuse. Early marriages are a major form of gender based violence which was perceived as normal in a number of communities despite the evidence that it contributes to negative social and reproductive health outcomes . Sexual violence cases in form of rape, defilement as well as incest were perceived to be on the rise in the sub-region. The study identified several drivers of SGBV including poverty, power imbalances in access to and control over resources, insecurity, blaming HIV infection on female partners, HIV related stigma and discrimination, alcohol and substance abuse

scholarly journals Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review

2021 ◽  
pp. sextrans-2020-054896
Author(s):  
Navin Kumar ◽  
Kamila Janmohamed ◽  
Kate Nyhan ◽  
Laura Forastiere ◽  
Wei-Hong Zhang ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Health Disparities ◽  
Reproductive Health ◽  
Sexual Health ◽  
Scoping Review ◽  
Partner Violence ◽  
Intimate Partner ◽  
Gender Based Violence ◽  
Gender Based ◽  
And Gender

ObjectivesThe COVID-19 pandemic has exposed and exacerbated existing socioeconomic and health disparities, including disparities in sexual health and well-being. While there have been several reviews published on COVID-19 and population health disparities generally—including some with attention to HIV—none has focused on sexual health (ie, STI care, female sexual health, sexual behaviour). We have conducted a scoping review focused on sexual health (excluding reproductive health (RH), intimate partner violence (IPV) and gender-based violence (GBV)) in the COVID-19 era, examining sexual behaviours and sexual health outcomes.MethodsA scoping review, compiling both peer-reviewed and grey literature, focused on sexual health (excluding RH, IPV and GBV) and COVID-19 was conducted on 15 September 2020. Multiple bibliographical databases were searched. Study selection conformed to Joanna Briggs Institute (JBI) Reviewers’ Manual 2015 Methodology for JBI Scoping Reviews. We only included English-language original studies.ResultsWe found that men who have sex with men may be moving back toward pre-pandemic levels of sexual activity, and that STI and HIV testing rates seem to have decreased. There was minimal focus on outcomes such as the economic impact on sexual health (excluding RH, IPV and GBV) and STI care, especially STI care of marginalised populations. In terms of population groups, there was limited focus on sex workers or on women, especially women’s sexual behaviour and mental health. We noticed limited use of qualitative techniques. Very few studies were in low/middle-income countries (LMICs).ConclusionsSexual health research is critical during a global infectious disease pandemic and our review of studies suggested notable research gaps. Researchers can focus efforts on LMICs and under-researched topics within sexual health and explore the use of qualitative techniques and interventions where appropriate.

Sexual and gender-based violence and torture experiences of Sudanese refugees in Northern Uganda: health and justice responses

2020 ◽  
Vol 16 (4) ◽  
pp. 389-414
Author(s):  
Helen Jane Liebling ◽  
Hazel Rose Barrett ◽  
Lillian Artz
Keyword(s):  
Human Rights ◽  
Service Provision ◽  
South Sudan ◽  
Northern Uganda ◽  
Gender Based Violence ◽  
Content Type ◽  
Human Rights Abuses ◽  
Gender Based ◽  
And Gender ◽  
Sudanese Refugees

Purpose This British Academy/Leverhulme-funded research (Grant number: SG170394) investigated the experiences and impact of sexual and gender-based violence (SGBV) and torture on South Sudanese refugees’ health and rights and the responses of health and justice services in Northern Uganda. Design/methodology/approach It involved thematic analysis of the narratives of 20 men and 41 women refugees’ survivors of SGBV and torture; this included their experiences in South Sudan, their journeys to Uganda and experiences in refugee settlements. In total, 37 key stakeholders including health and justice providers, police, non-government and government organisations were also interviewed regarding their experiences of providing services to refugees. Findings All refugees had survived human rights abuses carried out in South Sudan, on route to Uganda and within Uganda. Incidents of violence, SGBV, torture and other human rights abuses declined significantly for men in Uganda, but women reported SGBV incidents. The research demonstrates linkages between the physical, psychological, social/cultural and justice/human rights impact on women and men refugees, which amplified the impact of their experiences. There was limited screening, physical and psychological health and support services; including livelihoods and education. Refugees remained concerned about violence and SGBV in the refugee settlements. While they all knew of the reporting system for such incidents, they questioned the effectiveness of the process. For this reason, women opted for family reconciliation rather than reporting domestic violence or SGBV to the authorities. Men found it hard to report incidences due to high levels of stigma and shame. Research limitations/implications Refugees largely fled South Sudan to escape human rights abuses including, persecution, SGBV and torture. Their experiences resulted in physical, psychological, social-cultural and justice effects that received limited responses by health and justice services. An integrated approach to meeting refugees’ needs is required. Practical implications The authors make recommendations for integrated gender sensitive service provision for refugees including more systematic screening, assessment and treatment of SGBV and torture physical and emotional injuries combined with implementation of livelihoods and social enterprises. Social implications The research demonstrates that stigma and shame, particularly for male refugee survivors of SGBV and torture, impacts on ability to report these incidents and seek treatment. Increasing gender sensitivity of services to these issues, alongside provision of medical treatment for injuries, alongside improved informal justice processes, may assist to counteract shame and increase disclosure. Originality/value There is currently a lack of empirical investigation of this subject area, therefore this research makes a contribution to the subject of understanding refugees’ experiences of SGBV and torture, as well as their perceptions of service provision and response. This subject is strategically important due to the pressing need to develop integrated, gendered and culturally sensitive services that listen to the voices and draw on the expertise of refugees themselves while using their skills to inform improvements in service responses and policy.

scholarly journals Policy Implementation Challenges and Barriers to Access Sexual and Reproductive Health Services Faced By People With Disabilities: An Intersectional Analysis of Policy Actors’ Perspectives in Post-Conflict Northern Uganda

2021 ◽  
Author(s):  
Muriel Mac-Seing ◽  
Emmanuel Ochola ◽  
Martin Ogwang ◽  
Kate Zinszer ◽  
Christina Zarowsky
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Policy Implementation ◽  
Sexual And Reproductive Health ◽  
People With Disabilities ◽  
Northern Uganda ◽  
Health Service Provision ◽  
Policy Actors ◽  
Post Conflict ◽  
Barriers To Access

Background: Emerging from a 20-year armed conflict, Uganda adopted several laws and policies to protect the rights of people with disabilities, including their sexual and reproductive health (SRH) rights. However, the SRH rights of people with disabilities continue to be infringed in Uganda. We explored policy actors’ perceptions of existing pro-disability legislation and policy implementation, their perceptions of potential barriers experienced by people with disabilities in accessing and using SRH services in post-conflict Northern Uganda, and their recommendations on how to redress these inequities. Methods: Through an intersectionality-informed approach, we conducted and thematically analysed 13 in-depth semi-structured interviews with macro level policy actors (national policy-makers and international and national organisations); seven focus groups (FGs) at meso level with 68 health service providers and representatives of disabled people’s organisations (DPOs); and a two-day participatory workshop on disability-sensitive health service provision for 34 healthcare providers. Results: We identified four main themes: (1) legislation and policy implementation was fraught with numerous technical and financial challenges, coupled with lack of prioritisation of disability issues; (2) people with disabilities experienced multiple physical, attitudinal, communication, and structural barriers to access and use SRH services; (3) the conflict was perceived to have persisting impacts on the access to services; and (4) policy actors recommended concrete solutions to reduce health inequities faced by people with disabilities. Conclusion: This study provides substantial evidence of the multilayered disadvantages people with disabilities face when using SRH services and the difficulty of implementing disability-focused policy in Uganda. Informed by an intersectionality approach, policy actors were able to identify concrete solutions and recommendations beyond the identification of problems. These recommendations can be acted upon in a practical road map to remove different types of barriers in the access to SRH services by people with disabilities, irrespective of their geographic location in Uganda.

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