Dataset Information

Men's and women's experiences of violence and traumatic events in rural Cote d'Ivoire before, during and after a period of armed conflict.

ABSTRACT:

Objective

We assessed men's and women's experiences of gender based violence and other traumatic events in Côte d'Ivoire, a West African conflict-affected setting, before, during and after a period of active armed conflict (2000-2007).

Design

Cross-sectional, household survey.

Setting

12 rural communities directly impacted by the Crisis in Côte d'Ivoire, spanning regions controlled by government forces, rebels and UN peacekeepers in 2008.

Participants

2678 men and women aged 15-49 years.

Primary outcome measures

Violence exposures measured since age 15. Questions included intimate partner physical and sexual violence; physical and sexual violence by others (including combatants) and exposure to traumatic events before, during and after the Crisis period (2000-2007).

Results

Physical and/or sexual violence since age 15 was reported by 57.1% women and 40.2% men (p=0.01); 29.9% women and 12.3% men reported exposure to any violence in the past year. Nearly 1 in 10 women (9.9%) and 5.9% men (p=0.03) were forced to have sex by a non-partner since age 15, and 14.8% women and 3.3% men (p=0.00) reported their first sexual experience was forced. Combatants were rarely reported as sexual violence perpetrators (0.3% women). After the Crisis, intimate partner physical violence was the most frequently reported form of violence and highest among women (20.9% women, 9.9% men, p=0.00). Fearing for their life was reported by men and women before, during and after the Crisis.

Conclusions

Sexual violence in conflict remains a critical international policy concern. However, men and women experience different types of violence before, during and after conflict. In many conflict settings, other forms of violence, including intimate partner violence, may be more widespread than conflict-related sexual violence. Alongside service provision for rape survivors, our findings underscore the need for postconflict reconstruction efforts to invest in programmes to prevent and respond to intimate partner violence and trauma.

SUBMITTER: Hossain M

PROVIDER: S-EPMC3939650 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Men's and women's experiences of violence and traumatic events in rural Cote d'Ivoire before, during and after a period of armed conflict.

Hossain Mazeda M Zimmerman Cathy C Kiss Ligia L Kone Drissa D Bakayoko-Topolska Monika M Manan David K A DK Lehmann Heidi H Watts Charlotte C

BMJ open 20140225 2

<h4>Objective</h4>We assessed men's and women's experiences of gender based violence and other traumatic events in Côte d'Ivoire, a West African conflict-affected setting, before, during and after a period of active armed conflict (2000-2007).<h4>Design</h4>Cross-sectional, household survey.<h4>Setting</h4>12 rural communities directly impacted by the Crisis in Côte d'Ivoire, spanning regions controlled by government forces, rebels and UN peacekeepers in 2008.<h4>Participants</h4>2678 men and wo ...[more]

PMID: 24568959

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Project description:BACKGROUND:Men and women's perceptions of intimate partner violence (IPV) within crisis-affected populations are not well understood. This mixed-methods study examined the frequency of IPV against women in urban Cote d'Ivoire, and qualitatively explored how men and women perceive the impact of various forms of IPV on health, everyday activities, and feelings of shame. METHODS:A survey was administered to Ivorian women (N = 80) to measure the frequency of IPV, and ten focus group discussions were conducted with women (n = 46) and men (n = 45) to explore perceptions of different forms of IPV, including its impacts on disruptions to health, everyday activities, and experiences of shame. RESULTS:Half of all surveyed women (53.6%) reported past year exposure to physical, sexual, or emotional IPV. Of the multiple types of violence, emotional IPV was most common (46.4%), followed by sexual IPV (21.7%) and physical IPV (17.4%). Focus group participants identified additional forms of violence including economic IPV and community discrimination. Lack of financial resources and unemployment were common problems among crisis-affected women and were described as an underlying source of IPV. Both women and men reported that shame and stigma play a large role in how women experience the repercussions of IPV, regardless of the form of violence, with public episodes of IPV almost always seen as more detrimental than private episodes of IPV. CONCLUSIONS:These results underscore the need for increased social support mechanisms for women to reduce the shame, stigma, and isolation associated with their experiences. The creation of safe and supportive spaces for women to talk about and challenge social norms may be an important first step in reducing community shaming and the secrecy that often surrounds IPV. Safe spaces along with broader societal outreach, including challenging men's social positions and creating opportunities for increasing economic resources can, in turn potentially decrease the frequency of IPV and its deleterious impacts on a woman's well-being.

Project description:ObjectivesAmong nationally representative cross-sections of women in need of contraception from Burkina Faso, Côte d'Ivoire and Kenya, we aimed to: (1) examine the intersection of past-year physical/sexual intimate partner violence (IPV), emotional IPV and reproductive coercion (RC) and (2) assess the impact of physical/sexual IPV, emotional IPV and RC on women's contraceptive use outcomes, including current contraceptive use, method type and covert use.DesignThe present analysis uses cross-sectional female data collected in Burkina Faso (December 2020-March 2021), Côte d'Ivoire (October-November 2021) and Kenya (November-December 2020).SettingsBurkina Faso, Côte d'Ivoire and Kenya PARTICIPANTS: Analytical samples were restricted to partnered women with contraceptive need who completed a violence module (Burkina Faso n=1863; Côte d'Ivoire n=1105; Kenya n=3390).Primary and secondary outcome measuresThe exposures of interest-past-year emotional IPV, physical/sexual IPV and RC-were assessed using abridged versions of the Revised Conflict and Tactics Scale-2 and Reproductive Coercion Scale, respectively. Outcomes of interest included current contraceptive use, contraceptive method type (female controlled vs male compliant), and covert contraceptive use, and used standard assessments.ResultsAcross sites, 6.4% (Côte d'Ivoire) to 7.8% (Kenya) of women in need of contraception experienced RC; approximately one-third to one-half of women experiencing RC reported no other violence forms (31.7% in Burkina Faso to 45.8% in Côte d'Ivoire), whereas physical/sexual IPV largely occurred with emotional IPV. In multivariable models, RC was consistently associated with covert use (Burkina Faso: aOR 2.84 (95% CI 1.21 to 6.64); Côte d'Ivoire: aOR 4.45 (95% CI 1.76 to 11.25); Kenya: aOR 5.77 (95% CI 3.51 to 9.46)). Some IPV in some settings was also associated with covert use (emotional IPV, Burkina Faso: aOR 2.99 (95% CI 1.56 to 5.74); physical/sexual, Kenya: aOR 2.35 (95% CI 1.33 to 4.17)).ConclusionsAcross settings, covert use is a critical strategy for women experiencing RC. Country policies must recognise RC as a unique form of violence with profound implications for women's reproductive health.

Project description:BackgroundEvidence from armed conflict settings points to high levels of intimate partner violence (IPV) against women. Current knowledge on how to prevent IPV is limited-especially within war-affected settings. To inform prevention programming on gender-based violence in settings affected by conflict, we evaluated the impact of adding a targeted men's intervention to a community-based prevention programme in Côte d'Ivoire.MethodsWe conducted a two-armed, non-blinded cluster randomized trial in Côte d'Ivoire among 12 pair-matched communities spanning government-controlled, UN buffer, and rebel-controlled zones. The intervention communities received a 16-week IPV prevention intervention using a men's discussion group format. All communities received community-based prevention programmes. Baseline data were collected from couples in September 2010 (pre-intervention) and follow-up in March 2012 (one year post-intervention). The primary trial outcome was women's reported experiences of physical and/or sexual IPV in the last 12 months. We also assessed men's reported intention to use physical IPV, attitudes towards sexual IPV, use of hostility and conflict management skills, and participation in gendered household tasks. An adjusted cluster-level intention to treat analysis was used to compare outcomes between intervention and control communities at follow-up.ResultsAt follow-up, reported levels of physical and/or sexual IPV in the intervention arm had decreased compared to the control arm (ARR 0.52, 95% CI 0.18-1.51, not significant). Men participating in the intervention reported decreased intentions to use physical IPV (ARR 0.83, 95% CI 0.66-1.06) and improved attitudes toward sexual IPV (ARR 1.21, 95% CI 0.77-1.91). Significant differences were found between men in the intervention and control arms' reported ability to control their hostility and manage conflict (ARR 1.3, 95% CI 1.06-1.58), and participation in gendered household tasks (ARR 2.47, 95% CI 1.24-4.90).ConclusionsThis trial points to the value of adding interventions working with men alongside community activities to reduce levels of IPV in conflict-affected settings. The intervention significantly influenced men's reported behaviours related to hostility and conflict management and gender equitable behaviours. The decreased mean level of IPV and the differences between intervention and control arms, while not statistically significant, suggest that IPV in conflict-affected areas can be reduced through concerted efforts to include men directly in violence prevention programming. A larger-scale trial is needed to replicate these findings and further understand the mechanisms of change.Trial registrationclinicaltrials.gov NCT01803932.

Project description:Background:South Sudan has endured decades of armed conflict, with the most recent in 2016. This has left the health system and infrastructure overstretched by a myriad of infectious diseases like tuberculosis. Our study aimed at quantitatively and qualitatively documenting TB dynamics and challenges with access to health care during a period of civil unrest in Wau. Materials & Methods:A cross sectional study was carried out between January and February 2016 at Wau Teaching Hospital (WTH). Sputum was randomly collected from 207 of the 1035?TB suspects and analyzed using Ziehl-Neelsen (ZN) and Fluorescent Microscopy (FM), Culture, Capilia MTBC Neo, and DST. The laboratory results and questionnaire metadata were used for descriptive statistics, logistic regression in R version 3.4.2. These results were presented along with results from a qualitative assessment of the situation at WTH. Results:Of 207?TB suspects, 39 (18.8%) were positive on FM with bacilli growth on culture, later confirmed as Mycobacterium tuberculosis complex. Only 5.4% of the cases were resistant to Isoniazid. Age; 20-45 OR?=?13 (95%CI?=?2.4-25.6, p?=?0.011),?>?46 OR?=?3 (95%CI?=?0.5-58, p?=?0.005) and raw milk consumption OR?=?2.2 (95%CI?=?0.37-42.48, p?=?0.005) were associated with being TB positive. The qualitative evaluation reveals that gunfights in the surroundings of Wau influenced the number of patients attending WTH, with some travelling up to 545?km to seek medical attention. Conclusion:We report a high prevalence of tuberculosis among patients who presented at WTH, with approximately 1 out of 5 individuals testing positive for tuberculosis. This is likely an underestimation given the challenges patients had to endure as they sought medical attention. Tuberculosis epidemiology is likely to be driven by individual and household factors, but further investigations are needed to fully understand the risk profile. The tools in use were adequate for TB diagnostics and we observed a remarkably low prevalence of drug resistance, a statistic that is worth preserving. We therefore call for action from all stakeholders.

Dataset Information

Men's and women's experiences of violence and traumatic events in rural Cote d'Ivoire before, during and after a period of armed conflict.

Objective

Design

Setting

Participants

Primary outcome measures

Results

Conclusions

Publications

Men's and women's experiences of violence and traumatic events in rural Cote d'Ivoire before, during and after a period of armed conflict.

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