Development of a screening tool to identify female survivors of gender-based violence in a humanitarian setting: qualitative evidence from research among refugees in Ethiopia

Conflict and Health

Alexander Vu⁵  Sonal Singh³  Leonard S Rubenstein¹  Amsale Aberra²  Kiemanh Pham⁴  Nancy Glass⁵  Andrea L Wirtz⁴ 

[1] Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA;University of Washington School of Law, Seattle, USA;Department of General Internal Medicine, Johns Hopkins Medical Institutes, Baltimore, USA;Department of Emergency Medicine, Johns Hopkins Medical Institutes, Baltimore, USA;Department of International Health, Johns Hopkins School of Public Health, Baltimore, USA

关键词: Ethiopia;    Reproductive health;    Sexual violence;    Gender-based violence;    Conflict;    Displacement;    Refugee;   

Others  :  804583
DOI  :  10.1186/1752-1505-7-13

 received in 2013-02-04, accepted in 2013-06-03,  发布年份 2013

【 摘 要 】

Background

High levels of gender-based violence (GBV) persist among conflict-affected populations and within humanitarian settings and are paralleled by under-reporting and low service utilization. Novel and evidence-based approaches are necessary to change the current state of GBV amongst these populations. We present the findings of qualitative research, which were used to inform the development of a screening tool as one potential strategy to identify and respond to GBV for females in humanitarian settings.

Methods

Qualitative research methods were conducted from January-February 2011 to explore the range of experiences of GBV and barriers to reporting GBV among female refugees. Individual interview participants (n=37) included female refugees (≥15 years), who were survivors of GBV, living in urban or one of three camps settings in Ethiopia, and originating from six conflict countries. Focus group discussion participants (11 groups; 77 participants) included health, protection and community service staff working in the urban or camp settings. Interviews and discussions were conducted in the language of preference, with assistance by interpreters when needed, and transcribed for analysis by grounded-theory technique.

Results

Single and multiple counts of GBV were reported and ranged from psychological and social violence; rape, gang rape, sexual coercion, and other sexual violence; abduction; and physical violence. Domestic violence was predominantly reported to occur when participants were living in the host country. Opportunistic violence, often manifested by rape, occurred during transit when women depended on others to reach their destination. Abduction within the host country, and often across borders, highlighted the constant state of vulnerability of refugees. Barriers to reporting included perceived and experienced stigma in health settings and in the wider community, lack of awareness of services, and inability to protect children while mothers sought services.

Conclusions

Findings demonstrate that GBV persists across the span of the refugee experience, though there is a transition in the range of perpetrators and types of GBV that are experienced. Further, survivors experience significant individual and system barriers to disclosure and service utilization. The findings suggest that routine GBV screening by skilled service providers offers a strategy to confidentially identify and refer survivors to needed services within refugee settings, potentially enabling survivors to overcome existing barriers.

【 授权许可】

   
2013 Wirtz et al.; licensee BioMed Central Ltd.

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