scholarly journals ­­­Opportunities for gender transformative approaches in a community-based drowning reduction program in Bangladesh

2020 ◽  
Author(s):  
Medhavi Gupta ◽  
Aminur Rahman ◽  
NC Dutta ◽  
Devaki Nambiar ◽  
Rebecca Ivers ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Gender Equity ◽  
Gender Norms ◽  
Community Context ◽  
Program Sustainability ◽  
Community Based ◽  
Double Burden ◽  
Program Delivery ◽  
Gender Based ◽  
The Impact

Abstract Background: Community-based programs in rural low-and middle-income country settings are well-placed to conduct gender transformative activities that aid program sustainability and catalyse wider social change, such as reducing gender inequities that in turn improve health outcomes. The Anchal program is a drowning prevention intervention for children aged 1-5 years old in rural Bangladesh. It provides community crèche-based supervision delivered by local trained paid-female volunteers. We aimed to identify the impact of the Anchal program on gender norms and behaviours in the community context, and the effects these had on program delivery and men and women’s outcomes. Methods: Qualitative in-depth interviews, focus group discussions and observations were conducted with program beneficiaries and providers. Gender impacts and outcomes were analysed using FHI 360’s Gender Integration Framework. Results: The Anchal program was found to be a gender accommodating program as it catered for communities’ gender-based roles and constraints but did not actively seek to change underlying beliefs, perceptions and norms that led to these. The program in some cases enhanced the independence and status of female community staff. This changed perceptions of communities towards acceptable levels of physical mobility and community involvement for women. Conversely, gender impacted program delivery by reducing the ability of female supervisory staff to engage with male community leaders. The double burden of wage and household labour carried by local female staff also limited performance and progression. Gender-based constraints on staff performance, attrition and community engagement affected efficiency of program delivery and sustainability. Conclusions: The Anchal program both adapted to and shaped community gender norms and roles. The program has well-established relationships in the community and can be leveraged to implement gender transformative activities to improve gender-based equity. Health programs can broaden their impacts and target social determinants of health like gender equity to increase program sustainability and promote equitable health outcomes.

scholarly journals Community-Based Participatory Intervention Research with American Indian Communities: What is the State of the Science?

2019 ◽  
Vol 3 (Supplement_2) ◽  
pp. 39-52 ◽  
Author(s):  
Jordan B Hearod ◽  
Marianna S Wetherill ◽  
Alicia L Salvatore ◽  
Valarie Blue Bird Jernigan
Keyword(s):  
Health Outcomes ◽  
Community Participation ◽  
Participatory Research ◽  
Community Based Participatory Research ◽  
Community Based ◽  
Observational Study Design ◽  
Study Characteristics ◽  
Community Outcomes ◽  
State Of The Science ◽  
The Impact

ABSTRACT We conducted a 2-phase systematic review of the literature to examine the nature and outcomes of health research using a community-based participatory research (CBPR) approach with AI communities to assess both the value and the impact of CBPR, identify gaps in knowledge, and guide recommendations for AI research agendas. Using PRISMA guidelines, we searched the peer-reviewed literature published from 1995 to 2016 and identified and reviewed 42 unique intervention studies. We identified and catalogued key study characteristics, and using the Reliability-Tested Guidelines for Assessing Participatory Research Projects, we quantified adherence to participatory research principles across its four domains. Finally, we examined any association between community participation score and health outcomes. The majority of studies (76.7%) used an observational study design with diabetes, cancer, substance abuse, and tobacco being the most common topics. Half of the articles reported an increase in knowledge as the primary outcome. Our findings suggest that a CBPR orientation yields improved community outcomes. However, we could not conclude that community participation was directly associated with an improvement in health outcomes.

scholarly journals Study protocol for a longitudinal study evaluating the impact of rape on women’s health and their use of health services in South Africa

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017296 ◽  
Author(s):  
Naeemah Abrahams ◽  
Soraya Seedat ◽  
Carl Lombard ◽  
Andre P Kengne ◽  
Bronwyn Myers ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Longitudinal Study ◽  
Health Services ◽  
Health Outcomes ◽  
Service Providers ◽  
Adult Women ◽  
Gender Based Violence ◽  
Gender Based ◽  
The Impact

IntroductionSouth Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care.Methods and analysisThis longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied.Ethics and disseminationThe South African Medical Research Council’s Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published.

scholarly journals Gender Equity and Norms in Health Programs: Learnings from a Drowning Reduction Program in Bangladesh

2020 ◽  
Author(s):  
Medhavi Gupta ◽  
Aminur Rahman ◽  
Notan Chandra Dutta ◽  
Md. Shafkat Hossain ◽  
Devaki Nambiar ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Outcomes ◽  
Gender Norms ◽  
Health Programs ◽  
Leadership Roles ◽  
Gender Analysis ◽  
Community Based ◽  
Mixed Methods Approach ◽  
Reduction Program ◽  
Part Time

Abstract Background: Community-based health programs implemented in low-and middle-income countries have additional health impacts beyond their targeted outcomes, such as on gender norms, roles and relationships. Programs should measure their effects on gender to respond to any unexpected consequences. Hence, we conducted a gender analysis on a drowning reduction program in rural Bangladesh providing survival swimming classes to children.Methods: A mixed-methods approach was used. Quantitative program monitoring data was analysed to assess gender differences in program participation and engagement. A qualitative approach using interviews, focus group discussions and observations aimed to find explanations for quantitative findings and additional experiences of the program. The analysis was conducted using Family Health International 360’s Gender Integration Framework.Results: Fewer girls participated in the swimming classes than boys due to cultural perceptions on appropriate activities for girls and their greater involvement in domestic work. Women were not hired in leadership roles in the implementing organisation due to constraints on transport access and perceptions on women’s ability to conduct labour-intensive activities. However, the program influenced communities to become more accepting of local women’s mobility and involvement in employed work due to their engagement in the program as swim instructors. Women swim instructors were also more satisfied with the pay and part-time nature of the work as men were able to earn more elsewhere, and so women were recruited in higher numbers by the implementing organisation.Conclusions: Systematised strategies are required to ensure equal participation of girls and boys in swim classes and enable equitable drowning outcomes. Within the implementing organisation, changes to attitudes and the formulation of gender-specific strategies will support women in leadership roles, ensuring that women-specific issues are considered in program delivery. The implementing organisation may also consider strategies to combat perceptions that lower-paying part time work is more suitable for women than men. Addressing these issues would have positive implications for the health and equity of both men and women in these rural communities.Contributions to literature· Community-based health programs have impacts on gender norms, roles and relationships within their context of implementation, which in turn affect individuals’ health outcomes unexpectedly. These effects are rarely analysed.· This study describes a novel application of a gender analysis to a drowning reduction program in Bangladesh, using a mixed-methods approach.· We show that the program had positive impacts on women’s mobility and access to employment, but also identify opportunities for this program to actively transform harmful gender norms for equitable health outcomes.· Implementers of health programs may follow a similar methodology and framework to identify how they are affecting health outcomes through impacts on gendered constraints, norms and relationships.

scholarly journals The Impact of Community Size, Community Climate, and Victimization on the Physical and Mental Health of SGM Youth

2019 ◽  
Vol 52 (3) ◽  
pp. 427-448
Author(s):  
Megan S. Paceley ◽  
Jessica N. Fish ◽  
Margaret M. C. Thomas ◽  
Jacob Goffnett
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Physical Health ◽  
Online Survey ◽  
Community Context ◽  
Physical And Mental Health ◽  
Community Size ◽  
Health Community ◽  
The Impact ◽  
Community Climate

Sexual and gender minority (SGM) youth experience high rates of victimization leading to health disparities. Community size and community climate are associated with health outcomes among SGM youth; however, we lack studies that include them as covariates alongside victimization to understand their collective impact on health. This study utilized minority stress theory to understand how community context shapes experiences of victimization and health among SGM youth. SGM youth in one Midwestern U.S. state completed an online survey ( n = 201) with measures of physical health, mental health, community context, and victimization. Data were analyzed via multiple regression using a path analysis framework. Results indicate that perceived climate was associated with mental, but not physical, health; Community size was unrelated to health outcomes. Victimization mediated the association between community climate and mental health. Findings are discussed in light of current literature and implications for research and practice are shared.

Community Supports and COVID-19: Self-Determination in a Pandemic

2020 ◽  
Vol 58 (6) ◽  
pp. 453-457
Author(s):  
David A. Ervin ◽  
Donyale Hobson-Garcia
Keyword(s):  
Developmental Disabilities ◽  
General Population ◽  
Health Outcomes ◽  
Health Risks ◽  
Health And Safety ◽  
Self Determination ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
The Impact ◽  
Community Supports

Abstract The coronavirus disease 2019 (COVID-19) is impacting people with intellectual and developmental disabilities (IDD) significantly. Early data on the impact of COVID-19 suggests that people with IDD are experiencing more severe health outcomes compared to the general population. In addition to their elevated health risks, people with IDD, like the rest of the population, are struggling with boredom, isolation, and loneliness as they shelter in place. As people with IDD seek a return to their jobs, friends and families, and the activities of their community, community-based provider organizations must strike a difficult balance between actions that are intended to protect the health and safety of people they support and actions that honor people's choices and encourage self-determination. Practical issues that community-based provider organizations must consider when striking the correct balance are discussed, and recommendations on ways to support people with IDD to make informed, self-determined choices during the pandemic are offered.

scholarly journals COVID-19 Pandemic and Its Gendered Impact on Indian Physicians

2021 ◽  
pp. 1093-1100
Author(s):  
Sabita Jiwnani ◽  
Priya Ranganathan ◽  
Virendra Tiwari ◽  
Apurva Ashok ◽  
Devayani Niyogi ◽  
...  
Keyword(s):  
Gender Equity ◽  
Text Messaging ◽  
Domestic Work ◽  
Women Physicians ◽  
Full Time ◽  
Pay Gap ◽  
Personal Lives ◽  
Gender Based ◽  
The Impact ◽  
E Mail

PURPOSE The 2018 WHO health workforce report analyzing gender equity in 104 countries reported that although women constituted 70% of the workers, they were less likely to be employed full-time and faced a 28% gender pay gap. The ongoing COVID-19 pandemic has affected professional as well as personal lives of physicians. We conducted a survey among Indian physicians to understand this impact. METHODS A 31-point anonymized survey to evaluate the impact of the COVID-19 pandemic and resultant lockdown on physicians' domestic responsibilities was disseminated via e-mail and text messaging applications. Our aim was to evaluate whether the impact was gender-based and to look for differences in aspects of domestic work, childcare, and professional commitments. RESULTS We obtained 1,041 responses, of which 643 identified themselves as men and 393 as women. An increase in the domestic responsibilities during the lockdown was confirmed by 90% of the women compared with 82% men. More women than men were solely responsible for domestic chores (38.7% v 23.7%), managed their children's education (74% v 31%), and felt an adverse impact of the pandemic on their professional work (60.8% v 42.6%). Fewer women's spouses (57/359) than men's (174/594, P = .00001) were forced to take leave or work reduced hours, and double the proportion of women (3.5% v 1.5%) had to quit their jobs to manage responsibilities at home. CONCLUSION As the COVID-19 pandemic and the lockdown measures threw newer challenges, more women physicians than men (81% v 63%) shouldered the burden of increased domestic work and childcare. This survey highlights the need to re-examine the specific challenges faced by women physicians and identify means to support and empower them.

scholarly journals Gender Transformative Approaches to Engaging Men in Gender-Based Violence Prevention: A Review and Conceptual Model

2016 ◽  
Vol 19 (2) ◽  
pp. 231-246 ◽  
Author(s):  
Erin Casey ◽  
Juliana Carlson ◽  
Sierra Two Bulls ◽  
Aurora Yager
Keyword(s):  
Conceptual Model ◽  
Gender Equity ◽  
Social Action ◽  
Social Activism ◽  
Empirical Literature ◽  
Gender Based Violence ◽  
Engaging Men ◽  
Gender Based ◽  
And Behavior ◽  
The Impact

Engaging men and boys as participants and stakeholders in gender-based violence (GBV) prevention initiatives is an increasingly institutionalized component of global efforts to end GBV. Accordingly, evidence of the impact of men’s engagement endeavors is beginning to emerge, particularly regarding interventions aimed at fostering gender equitable and nonviolent attitudes and behaviors among men. This developing evidence base suggests that prevention programs with a “gender transformative” approach, or an explicit focus on questioning gender norms and expectations, show particular promise in achieving GBV prevention outcomes. Interventions targeting attitude and behavior change, however, represent just one kind of approach within a heterogeneous collection of prevention efforts around the globe, which can also include community mobilization, policy change, and social activism. The degree to which gender transformative principles inform this broader spectrum of men’s engagement work is unclear. The goals of this article are twofold. First, we offer a conceptual model that captures and organizes a broader array of men’s antiviolence activities in three distinct but interrelated domains: (1) initial outreach and recruitment of previously unengaged males, (2) interventions intended to promote gender-equitable attitudes and behavior among men, and (3) gender equity-related social action aimed at eradicating GBV, inclusive of all genders’ contributions. Second, we review empirical literature in each of these domains. Across these two goals, we critically assess the degree to which gender transformative principles inform efforts within each domain, and we offer implications for the continuing conceptualization and assessment of efforts to increase men’s participation in ending GBV.

scholarly journals The impact of gender equity in agriculture on nutritional status, diets, and household food security: a mixed-methods systematic review

2020 ◽  
Vol 5 (3) ◽  
pp. e002173
Author(s):  
Helen Harris-Fry ◽  
Hayaan Nur ◽  
Bhavani Shankar ◽  
Giacomo Zanello ◽  
Chittur Srinivasan ◽  
...  
Keyword(s):  
Food Security ◽  
Gender Equity ◽  
Low Income ◽  
Household Food Security ◽  
Middle Income ◽  
Middle Income Countries ◽  
Household Food ◽  
Gender Based ◽  
Meta Analyses ◽  
The Impact

IntroductionUndernutrition rates remain high in rural, low-income settings, where large, gender-based inequities persist. We hypothesised that increasing gender equity in agriculture could improve nutrition.MethodsWe conducted a systematic review to assess the associations between gender-based inequities (in income, land, livestock, and workloads) and nutrition, diets and food security outcomes in agricultural contexts of low-income and middle-income countries. Between 9 March and 7 August 2018, we searched 18 databases and 14 journals, and contacted 27 experts. We included quantitative and qualitative literature from agricultural contexts in low-income and middle-income countries, with no date restriction. Outcomes were women’s and children’s anthropometric status, dietary quality and household food security. We conducted meta-analyses using random-effects models.ResultsWe identified 19 820 records, of which 34 studies (42 809 households) met the inclusion criteria. Most (22/25) quantitative studies had a high risk of bias, and qualitative evidence was of mixed quality. Income, land and livestock equity had heterogeneous associations with household food security and child anthropometric outcomes. Meta-analyses showed women’s share of household income earned (0.32, 95% CI −4.22 to 4.86; six results) and women’s share of land owned (2.72, 95% CI -0.52 to 5.96; three results) did not increase the percentage of household budget spent on food. Higher-quality studies showed more consistently positive associations between income equity and food security. Evidence is limited on other exposure–outcome pairings.ConclusionsWe find heterogeneous associations between gender equity and household-level food security. High-quality research is needed to establish the impact of gender equity on nutrition outcomes across contexts.PROSPERO registration numberCRD42018093987.

Male and Female Perceptions and Experiences of Sexual and Gender-based Violence in South Kivu, Eastern DRC

2020 ◽  
pp. 088626052098330
Author(s):  
Elyse J. Thulin ◽  
Andrew Lustig ◽  
Violette Perrotte ◽  
Marx Lwabanya ◽  
Tyler Evans
Keyword(s):  
Sexual Violence ◽  
Partner Violence ◽  
Democratic Republic Of Congo ◽  
Physical Violence ◽  
Gender Based Violence ◽  
Community Based ◽  
South Kivu ◽  
Gender Based ◽  
And Gender ◽  
The Impact

Conflict settings are often the context of some of the highest rates of sexual and gender-based violence (SGBV). Although women are disproportionately the victims of SGBV, they are not the only victims. Indirect impacts of SGBV also impact men, families, and communities. Examining SGBV as only a woman’s concern reinforces the hegemonic gender-binary view that SGBV somehow does not include men, who can be direct victims of SGBV, family members of female victims of SGBV, and/or perpetrators of SGBV. This qualitative study seeks to fill a gap by exploring the impact of SGBV on individuals, families, and communities, and potential options to ameliorate those issues. Data were collected in 2019 from community-based discussions in South Kivu, Democratic Republic of Congo. Women described being direct victims of SGBV, as well as the burden of being at constant alert to the possible threat of violence. Men talked more about SGBV being perpetrated against women, and the indirect effect on men’s perception of their social husband and/or father role to protect and provide for their family. Taken together, women and men describe three types of violence: sexual violence by an unknown assailant who is often associated the rebel groups or the military; sexual violence from a known assailant within one’s community; and sexual or physical violence within intimate partnerships (i.e., intimate partner violence). Women focused more on community-based solutions to reduce their exposure to violence, while men discussed the government’s responsibility to end the long-standing conflict that has severely disrupted lives. Practically, these findings support the need to specify different types of SGBV, and the opportunity to tailor interventions by type.

scholarly journals The Impact of COVID-19 on Mental Health outcomes among hospital fever clinic attendants across Nepal: A community-based cross-sectional study

2020 ◽  
Author(s):  
Hridaya Raj Devkota ◽  
Tula Ram Sijali ◽  
Ramji Bogati ◽  
Meraj Ahmad ◽  
Karuna Laxmi Shakya ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Health Status ◽  
Health Outcomes ◽  
Psychological Impact ◽  
Mental Health Outcomes ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
The Impact

Background: The COVID 19 pandemic has been creating a panic and distressing situations among the entire population globally including Nepal. No study has been conducted assessing the psychological impact of this pandemic on the general public in Nepal. The objective of this study is to assess the mental health status during COVID 19 outbreak and explore the potential influencing factors among the population attending the hospital fever clinics with COVID 19 symptoms. Methods: A cross sectional survey was conducted between May to June, 2020 with a sample of 645 participants aged 18 and above in 26 hospitals across Nepal. Telephone interviews were conducted using a semi-structured questionnaire along with a validated psychometric tool, the Depression, Anxiety and Stress (DASS21) scale. The metrics and scores of symptoms and their severity were created and analyzed. Multivariate logistic regression was used to determine the association of potential covariates with outcome variables. Results: The prevalence of anxiety, depression and stress were 14%, 7% and 5% respectively. Participants from Bagmati province reported higher level of anxiety (OR 3.87, 95% CI 1.42 10.59), while stress (OR 4.78, 95% CI 1.09 21.29) and depressive symptoms (OR 3.37, 95% CI 1.10 10.35) observed higher among the participants in Province 1. Women were more at risk of anxiety (OR 4.26, 95% CI 2.21 8.20) and depression (2.75, 95% CI 1.16 6.51) than men. Similarly, people with primary level education found more prone to all factors, stress (OR 20.35, 95% CI 2.06 201.19), anxiety (OR 3.10, 95% CI 1.24 7.91), and depression (OR 4.41, 95% CI 1.29 15.07). More farmers than labors showed higher odds (OR 2.25, 95% CI 1.01 5.01) for anxiety, while individuals surveyed who reported their health status as poor-had higher odds (OR 5.95, 95% CI 1.08 32.68) for depression. Also, people currently living in rented houses reported more stress (OR 3.11, 95% CI 1.07 9.05) and those living far from family reported higher rates of depressive symptoms (OR 3.57, 95% CI 1.01 12.58). Conclusion: The study identified increased prevalence of stress, anxiety and depressive symptoms during the initial stage of COVID 19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate community-based mental health programs targeting individuals who have had COVID 19 symptoms and who are prone to develop adverse mental health outcomes. Key words: COVID 19, Depression, Anxiety, Stress, Pandemic, Public Health, Nepal

Sign in / Sign up

Export Citation Format

Share Document