Silent survivors of sexual violence in conflict and the implications for HIV mitigation: experiences from Eritrea

Gruber, Janet

doi:10.2989/16085900509490344

Cited by 5 publications

(6 citation statements)

References 3 publications

(2 reference statements)

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“…Survivor care responses predominantly comprised either medical, advocacy and counselling assistance for survivors of rape, [42], [47], [49], [50], [51] which may include follow-up psychotherapy [52] or shelter [53]. A second prevailing model is provision of support groups [54], [55].…”

Section: Resultsmentioning

confidence: 99%

What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review

et al. 2013

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Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i) survivor care; ii) livelihood initiatives; iii) community mobilisation; iv) personnel initiatives; v) systems and security responses; vi) legal interventions and vii) multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms, settings, and interventions for conflict and crisis-related sexual violence. It points to the need for thorough implementation of initiatives that build on local capacity, while avoiding increased risk and re-traumatisation to survivors of sexual violence.

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Section: Resultsmentioning

confidence: 99%

What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review

et al. 2013

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“…Initially we found it challenging to establish separate evidence for this mechanism, as distinct from ‘There is help for this problem’. However, their distinct nature was illustrated by the outcome of an Eritrean survivor care intervention that attempted to provide care to women assaulted during the country’s occupation [ 54 ]. The intervention was instigated in response to a request by community elders, but ultimately husbands and fathers prevented women using the service, fearing stigma and loss of marriage-price.…”

Section: Resultsmentioning

confidence: 99%

Mechanisms underpinning interventions to reduce sexual violence in armed conflict: A realist-informed systematic review

et al. 2015

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Sexual violence is recognised as a widespread consequence of armed conflict and other humanitarian crises. The limited evidence in literature on interventions in this field suggests a need for alternatives to traditional review methods, particularly given the challenges of undertaking research in conflict and crisis settings. This study employed a realist review of the literature on interventions with the aim of identifying the mechanisms at work across the range of types of intervention. The realist approach is an exploratory and theory-driven review method. It is well suited to complex interventions as it takes into account contextual factors to identify mechanisms that contribute to outcomes. The limited data available indicate that there are few deterrents to sexual violence in crises. Four main mechanisms appear to contribute to effective interventions: increasing the risk to offenders of being detected; building community engagement; ensuring community members are aware of available help for and responses to sexual violence; and safe and anonymous systems for reporting and seeking help. These mechanisms appeared to contribute to outcomes in multiple-component interventions, as well as those relating to gathering firewood, codes of conduct for personnel and legal interventions. Drawing on pre-existing capacity or culture in communities is an additional mechanism which should be explored. Though increasing the risk to offenders of being detected was assumed to be a central mechanism in deterring sexual violence, the evidence suggests that this mechanism operated only in interventions focused on gathering firewood and providing alternative fuels. The other three mechanisms appeared important to the likelihood of an intervention being successful, particularly when operating simultaneously. In a field where robust outcome research remains likely to be limited, realist methods provide opportunities to understand existing evidence. Our analysis identifies the important potential of building in mechanisms involving community engagement, awareness of responses and safe reporting provisions into the range of types of intervention for sexual violence in crises.

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“…61 Only four articles evaluated healthcare services in regard to SV response. 48,49,63,64 One weak quality study, situated in Colombia, stressed the importance of a culturally sensitive integrated response to SV that allowed vulnerable women to access comprehensive sexual and reproductive health services. The project closely collaborated with different local governmental and civil society organisations, such as health councils, health committees, pastors, women's groups and youth networks, to create strong links with other relevant services such as legal aid, and to challenge local attitudes and social mechanisms that condone SV through awareness-raising campaigns.…”

Section: Treatment and Counsellingmentioning

confidence: 99%

“…Therefore, traditional or community support systems were not fully considered and might have affected the impact of the intervention. 63 Leskes et al 61 further evaluated two psychosocial programmes in Liberia, which were implemented for three months each by two different local NGOs. The evaluation compared their respective interventions, which included one intervention with individual counselling and another one with support group and skills training for income generation.…”

Section: Treatment and Counsellingmentioning

confidence: 99%

Programme potential for the prevention of and response to sexual violence among female refugees: a literature review

Robbers

Morgan

2017

Reproductive Health Matters

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Continuing international conflict has resulted in several million people seeking asylum in other countries each year, over half of whom are women. Their reception and security in overburdened camps, combined with limited information and protection, increases their risk and exposure to sexual violence (SV). This literature review explores the opportunities to address SV against female refugees, with a particular focus on low-resource settings. A systematic literature review of articles published between 2000 and 2016 was conducted following PRISMA guidelines. Databases including Medline (Ovid), PubMed, Scopus, PsychINFO, CINAHL and the Cochrane Library. Grey literature from key refugee websites were searched. Studies were reviewed for quality and analysed according to the framework outlined in the UNHCR Guidelines on Prevention and Response of Sexual Violence against Refugees. Twenty-nine studies met the inclusion criteria, of which 7 studies addressed prevention, 14 studies response and 8 addressed both. There are limited numbers of rigorously evaluated SV prevention and response interventions available, especially in the context of displacement. However, emerging evidence shows that placing a stronger emphasis on programmes in the category of engagement/participation and training/education has the potential to target underlying causes of SV. SV against female refugees is caused by factors including lack of information and gender inequality. This review suggests that SV interventions that engage community members in their design and delivery, address harmful gender norms through education and advocacy, and facilitate strong cooperation between stakeholders, could maximise the efficient use of limited resources.

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Silent survivors of sexual violence in conflict and the implications for HIV mitigation: experiences from Eritrea

Cited by 5 publications

References 3 publications

What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review

What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review

Mechanisms underpinning interventions to reduce sexual violence in armed conflict: A realist-informed systematic review

Programme potential for the prevention of and response to sexual violence among female refugees: a literature review

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