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

Spangaro J, Adogu C, Zwi AB, Ranmuthugala G, Davies GP - Confl Health (2015)

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: School of Social Sciences, University of New South Wales, Ground Floor Morven Brown Building, Sydney, 2052 NSW Australia.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus

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Mentions: Results of the search strategy are reported in Fig. 1. Twenty studies were included: 11 identified from websites, one from a key informant and the remaining 8 through bibliographic databases. The studies were conducted in 17 countries predominantly in Africa with Rwanda being the country in which most studies were conducted (4). Nine studies addressed sexual violence which occurs in conflict settings, with 11 addressing post-conflict settings. No outcome studies addressed the disaster setting. 20 additional studies which reported on interventions, but which did not include outcomes informed the analysis. One of these was disaster focused [37]. Table 2 describes the included studies differentiated by intervention type. For the most part the studies reported on separate programs, although two included data on the Médecins Sans Frontières program in Congo [38, 39], and two others reported on the International Criminal Tribunal for Rwanda [40, 41].Fig. 1


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

Spangaro J, Adogu C, Zwi AB, Ranmuthugala G, Davies GP - Confl Health (2015)

Filtering of search results
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4499895&req=5

Fig1: Filtering of search results
Mentions: Results of the search strategy are reported in Fig. 1. Twenty studies were included: 11 identified from websites, one from a key informant and the remaining 8 through bibliographic databases. The studies were conducted in 17 countries predominantly in Africa with Rwanda being the country in which most studies were conducted (4). Nine studies addressed sexual violence which occurs in conflict settings, with 11 addressing post-conflict settings. No outcome studies addressed the disaster setting. 20 additional studies which reported on interventions, but which did not include outcomes informed the analysis. One of these was disaster focused [37]. Table 2 describes the included studies differentiated by intervention type. For the most part the studies reported on separate programs, although two included data on the Médecins Sans Frontières program in Congo [38, 39], and two others reported on the International Criminal Tribunal for Rwanda [40, 41].Fig. 1

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: School of Social Sciences, University of New South Wales, Ground Floor Morven Brown Building, Sydney, 2052 NSW Australia.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus