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Comprehensive development and testing of the ASIST-GBV, a screening tool for responding to gender-based violence among women in humanitarian settings.

Wirtz AL, Glass N, Pham K, Perrin N, Rubenstein LS, Singh S, Vu A - Confl Health (2016)

Bottom Line: Qualitative research with GBV survivors in Ethiopia and Colombia found multiple forms of GBV experienced by refugees and IDPs that occurred during conflict, in transit, and in displaced settings.Psychometric testing demonstrated appropriate internal consistency of the tool (Cronbach's α = 0.77) and item response theory demonstrated appropriate discrimination and difficulty of the tool.The ASIST-GBV screening tool has demonstrated utility and validity for use in confidential identification and referral of refugees and IDPs who experience GBV.

View Article: PubMed Central - PubMed

Affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, USA.

ABSTRACT

Background: Conflict affected refugees and internally displaced persons (IDPs) are at increased vulnerability to gender-based violence (GBV). Health, psychosocial, and protection services have been implemented in humanitarian settings, but GBV remains under-reported and available services under-utilized. To improve access to existing GBV services and facilitate reporting, the ASIST-GBV screening tool was developed and tested for use in humanitarian settings. This process was completed in four phases: 1) systematic literature review, 2) qualitative research that included individual interviews and focus groups with GBV survivors and service providers, respectively, 3) pilot testing of the developed screening tool, and 4) 3-month implementation testing of the screening tool. Research was conducted among female refugees, aged ≥15 years in Ethiopia, and female IDPs, aged ≥18 years in Colombia.

Results: The systematic review and meta-analysis identified a range of GBV experiences and estimated a 21.4 % prevalence of sexual violence (95 % CI:14.9-28.7) among conflict-affected populations. No existing screening tools for GBV in humanitarian settings were identified. Qualitative research with GBV survivors in Ethiopia and Colombia found multiple forms of GBV experienced by refugees and IDPs that occurred during conflict, in transit, and in displaced settings. Identified forms of violence were combined into seven key items on the screening tool: threats of violence, physical violence, forced sex, sexual exploitation, forced pregnancy, forced abortion, and early or forced marriage. Cognitive testing further refined the tool. Pilot testing in both sites demonstrated preliminary feasibility where 64.8 % of participants in Ethiopia and 44.9 % of participants in Colombia were identified with recent (last 12 months) cases of GBV. Implementation testing of the screening tool, conducted as a routine service in camp/district hospitals, allowed for identification of GBV cases and referrals to services. In this phase, 50.6 % of participants in Ethiopia and 63.4 % in Colombia screened positive for recent experiences of GBV. Psychometric testing demonstrated appropriate internal consistency of the tool (Cronbach's α = 0.77) and item response theory demonstrated appropriate discrimination and difficulty of the tool.

Conclusion: The ASIST-GBV screening tool has demonstrated utility and validity for use in confidential identification and referral of refugees and IDPs who experience GBV.

No MeSH data available.


Related in: MedlinePlus

a. Study sites in Ethiopia. b. Study sites in Colombia. Image provided by U.S. Dept. of State Geographer and Landsat
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Fig1: a. Study sites in Ethiopia. b. Study sites in Colombia. Image provided by U.S. Dept. of State Geographer and Landsat

Mentions: Research activities were conducted among refugees living in urban and camp settings of Ethiopia and IDPs living in Colombia. Ethiopia is home to almost 730,000 refugees, as of January 2015, and predominant refugee populations originate from Somalia, Eritrea, and South Sudan [20]. Refugees from several other countries, such as the Democratic Republic of Congo, Burundi and Rwanda in the Great Lakes region of Africa also reside in Ethiopia. Colombia has one of the highest numbers of IDPs in the world and, as of December 2014, an estimated 5.8 million people were displaced within the country [21]. Most IDPs have been displaced from rural to urban areas; yet, violence in larger urban centers has led to substantial intra-urban displacement, signifying a shift in displacement modalities. Both countries were selected based on discussions with officers from UNHCR and U.S. Department of State, diversity of contexts and refugee/IDP populations, and availability of local collaborative organizations. Individual sites for all phases were based on site visits to determine appropriateness for screening (quality, availability, and confidentiality of GBV-related services) and discussions with local UNHCR and implementing partner office staff. Figure 1 displays mapped locations of where each data collection and testing phase took place in Ethiopia and Colombia.Fig. 1


Comprehensive development and testing of the ASIST-GBV, a screening tool for responding to gender-based violence among women in humanitarian settings.

Wirtz AL, Glass N, Pham K, Perrin N, Rubenstein LS, Singh S, Vu A - Confl Health (2016)

a. Study sites in Ethiopia. b. Study sites in Colombia. Image provided by U.S. Dept. of State Geographer and Landsat
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837612&req=5

Fig1: a. Study sites in Ethiopia. b. Study sites in Colombia. Image provided by U.S. Dept. of State Geographer and Landsat
Mentions: Research activities were conducted among refugees living in urban and camp settings of Ethiopia and IDPs living in Colombia. Ethiopia is home to almost 730,000 refugees, as of January 2015, and predominant refugee populations originate from Somalia, Eritrea, and South Sudan [20]. Refugees from several other countries, such as the Democratic Republic of Congo, Burundi and Rwanda in the Great Lakes region of Africa also reside in Ethiopia. Colombia has one of the highest numbers of IDPs in the world and, as of December 2014, an estimated 5.8 million people were displaced within the country [21]. Most IDPs have been displaced from rural to urban areas; yet, violence in larger urban centers has led to substantial intra-urban displacement, signifying a shift in displacement modalities. Both countries were selected based on discussions with officers from UNHCR and U.S. Department of State, diversity of contexts and refugee/IDP populations, and availability of local collaborative organizations. Individual sites for all phases were based on site visits to determine appropriateness for screening (quality, availability, and confidentiality of GBV-related services) and discussions with local UNHCR and implementing partner office staff. Figure 1 displays mapped locations of where each data collection and testing phase took place in Ethiopia and Colombia.Fig. 1

Bottom Line: Qualitative research with GBV survivors in Ethiopia and Colombia found multiple forms of GBV experienced by refugees and IDPs that occurred during conflict, in transit, and in displaced settings.Psychometric testing demonstrated appropriate internal consistency of the tool (Cronbach's α = 0.77) and item response theory demonstrated appropriate discrimination and difficulty of the tool.The ASIST-GBV screening tool has demonstrated utility and validity for use in confidential identification and referral of refugees and IDPs who experience GBV.

View Article: PubMed Central - PubMed

Affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, USA.

ABSTRACT

Background: Conflict affected refugees and internally displaced persons (IDPs) are at increased vulnerability to gender-based violence (GBV). Health, psychosocial, and protection services have been implemented in humanitarian settings, but GBV remains under-reported and available services under-utilized. To improve access to existing GBV services and facilitate reporting, the ASIST-GBV screening tool was developed and tested for use in humanitarian settings. This process was completed in four phases: 1) systematic literature review, 2) qualitative research that included individual interviews and focus groups with GBV survivors and service providers, respectively, 3) pilot testing of the developed screening tool, and 4) 3-month implementation testing of the screening tool. Research was conducted among female refugees, aged ≥15 years in Ethiopia, and female IDPs, aged ≥18 years in Colombia.

Results: The systematic review and meta-analysis identified a range of GBV experiences and estimated a 21.4 % prevalence of sexual violence (95 % CI:14.9-28.7) among conflict-affected populations. No existing screening tools for GBV in humanitarian settings were identified. Qualitative research with GBV survivors in Ethiopia and Colombia found multiple forms of GBV experienced by refugees and IDPs that occurred during conflict, in transit, and in displaced settings. Identified forms of violence were combined into seven key items on the screening tool: threats of violence, physical violence, forced sex, sexual exploitation, forced pregnancy, forced abortion, and early or forced marriage. Cognitive testing further refined the tool. Pilot testing in both sites demonstrated preliminary feasibility where 64.8 % of participants in Ethiopia and 44.9 % of participants in Colombia were identified with recent (last 12 months) cases of GBV. Implementation testing of the screening tool, conducted as a routine service in camp/district hospitals, allowed for identification of GBV cases and referrals to services. In this phase, 50.6 % of participants in Ethiopia and 63.4 % in Colombia screened positive for recent experiences of GBV. Psychometric testing demonstrated appropriate internal consistency of the tool (Cronbach's α = 0.77) and item response theory demonstrated appropriate discrimination and difficulty of the tool.

Conclusion: The ASIST-GBV screening tool has demonstrated utility and validity for use in confidential identification and referral of refugees and IDPs who experience GBV.

No MeSH data available.


Related in: MedlinePlus