Background: Women across the world are mistreated during childbirth. We aimed to develop and implement evidence-informed, validated tools to measure mistreatment during childbirth, and report results from a cross-sectional study in four low-income and middle-income countries. Methods: We prospectively recruited women aged at least 15 years in twelve health facilities (three per country) in Ghana, Guinea, Myanmar, and Nigeria between Sept 19, 2016, and Jan 18, 2018. Continuous observations of labour and childbirth were done from admission up to 2 h post partum.
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Elsevier, EClinicalMedicine, Volume 23, June 2020
Background: There is a growing body of research exploring how intimate partner violence affects contraceptive decision-making, recognizing that these decisions are reflective not only of access and acceptability, but also spousal power imbalances. Unfortunately, there is a dearth of knowledge regarding contraceptive choices following gender-based violence during pregnancy. There are an estimated 7·8 million in India affected by violence during pregnancy, and an ongoing, heavy reliance on female sterilization as the dominant form of contraception.
Elsevier, EClinicalMedicine, Volume 20, March 2020
Background: Sexual harassment of women in academic medicine may impede advancement and productivity. This study analyzes the longitudinal effects of sexual harassment on academic advancement and productivity among women. Methods: We undertook a longitudinal analysis to predict effects of sexual harassment reported in 1995 on career outcomes measured in 2012–13, among a sample of women in academic medicine (N = 1273) recruited from 24 U.S. medical schools.
Elsevier, EClinicalMedicine, Volume 22, May 2020
Background: In Niger the prevalence of girl child marriage and low female control over family planning (FP) has resulted in the world's highest adolescent fertility. Male control of FP is associated with intimate partner violence (IPV) and reproductive coercion (RC). We assessed associations of IPV and RC with FP use among married adolescent girls (ages 13–19 years) in Dosso, Niger (N = 1072).
Elsevier, The Lancet Global Health, Volume 8, November 2020
Background: Stay-at-home orders (lockdowns) have been deployed globally to control COVID-19 transmission, and might impair economic conditions and mental health, and exacerbate risk of food insecurity and intimate partner violence. The effect of lockdowns in low-income and middle-income countries must be understood to ensure safe deployment of these interventions in less affluent settings. We aimed to determine the immediate impact of COVID-19 lockdown orders on women and their families in rural Bangladesh.
Elsevier, The Lancet Global Health, Volume 8, November 2020
Background: Stay-at-home orders (lockdowns) have been deployed globally to control COVID-19 transmission, and might impair economic conditions and mental health, and exacerbate risk of food insecurity and intimate partner violence. The effect of lockdowns in low-income and middle-income countries must be understood to ensure safe deployment of these interventions in less affluent settings. We aimed to determine the immediate impact of COVID-19 lockdown orders on women and their families in rural Bangladesh.
Elsevier, The Lancet Global Health, Volume 8, February 2020
Background: Innovative solutions are required to provide mental health support at scale in low-resource humanitarian contexts. We aimed to assess the effectiveness of a facilitator-guided, group-based, self-help intervention (Self-Help Plus) to reduce psychological distress in female refugees. Methods: We did a cluster randomised trial in rural refugee settlements in northern Uganda. Participants were female South Sudanese refugees with at least moderate levels of psychological distress (cutoff ≥5 on the Kessler 6).
Elsevier, Forensic Science International: Synergy, Volume 1, 2019
Sexual and gender based violence (SGBV) is notoriously difficult to investigate and prosecute. SGBV occurs in varied contexts and requires flexibility in the investigative approach in order to develop a strong evidence base to enable successful prosecutions. In this paper we focus on the need for innovation and development of training protocols for gathering testimonial and forensic evidence in SGBV cases, particularly in low resource environments, such as developing countries, displaced communities, and conflict and post-conflict societies.
Elsevier, Forensic Science International: Synergy, Volume 1, 2019
Sexual and Gender Based Violence (SGBV) in Kenya is highly complex requiring a multi-sectoral approach for comprehensive management. This complexity is worsened by the acceptance of Sexual Violence within a patriarchal society, harmful traditional and cultural practices, breakdown of law and order especially during electoral periods, all heightened by abject poverty. There are numerous programs on interventions costing millions in local and foreign currency, however grave gaps still exist at key levels across all sectors even after years of continued intervention.
Elsevier, Forensic Science International: Reports, Volume 2, December 2020, 100053
In this brief perspective piece, a rural sexual assault nurse examiner (SANE) program is described in the hopes that dissemination will lead to increased numbers of rural SANEs, increased reporting of sexual assaults in rural and underserved communities, increased prosecution rates of sexual assault perpetrators, and program sustainability through the provision of a nurse-centered approach to training and support. This article contributes SDGs 3, 5, 9, and 16.