预防低收入国家少女遭受基于性别的暴力侵害:系统综述。
Preventing gender-based violence victimization in adolescent girls in lower-income countries: Systematic review of reviews.
机构信息
Hubert Department of Global Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA 30322, USA; Department of Sociology, Emory University, 1555 Dickey Dr., Atlanta, GA 30322, USA.
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA 30322, USA.
出版信息
Soc Sci Med. 2017 Nov;192:1-13. doi: 10.1016/j.socscimed.2017.08.038. Epub 2017 Sep 11.
This systematic review of reviews synthesizes evidence on the impact of interventions to prevent violence against adolescent girls and young women 10-24 years (VAWG) in low- and middle-income countries (LMICs). Theories of women's empowerment and the social ecology of multifaceted violence frame the review. Child abuse, female genital mutilation/cutting (FGMC), child marriage, intimate partner violence (IPV), and sexual violence were focal outcomes. Our review followed the Assessment of Multiple Systematic Reviews (AMSTAR) for the systematic review of reviews, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for a systematic review of recent intervention studies. Of 35 reviews identified between June 7 and July 20, 2016, 18 were non-duplicate systematic reviews of medium-to-high quality. Half of these 18 reviews focused on interventions to prevent IPV. Only four focused on adolescents, of which three focused on child marriage and one compared findings across early and late adolescence. None focused on interventions to prevent child abuse or sexual violence in adolescent/young women. From these 18 reviews and the supplemental systematic review of intervention studies, data were extracted on 34 experimental or quasi-experimental intervention studies describing 28 interventions. Almost all intervention studies measured impacts on one form of VAWG. Most studies assessed impacts on child marriage (n = 13), then IPV (n = 8), sexual violence (n = 4), child abuse (n = 3), and FGMC (n = 3). Interventions included 1-6 components, involving skills to enhance voice/agency (n = 17), social networks (n = 14), human resources like schooling (n = 10), economic incentives (n = 9), community engagement (n = 11) and community infrastructure development (n = 6). Bundled individual-level interventions and multilevel interventions had more favorable impacts on VAWG. Interventions involving community engagement, skill-building to enhance voice/agency, and social-network expansion show promise to reduce VAWG. Future interventions should target poly-victimization, compare impacts across adolescence, and include urban, out-of-school, married, and displaced/conflict-affected populations in LMICs, where VAWG may be heightened.
本系统综述综合了干预措施预防中低收入国家(LMICs)10-24 岁少女和年轻女性遭受暴力(VAWG)的影响的证据。妇女赋权理论和多方面暴力的社会生态学框架构成了本次综述。儿童虐待、女性生殖器切割/切割(FGMC)、童婚、亲密伴侣暴力(IPV)和性暴力是重点结果。我们的综述遵循系统综述的评估多重系统综述(AMSTAR),以及最近干预研究的系统综述的首选报告项目(PRISMA)。在 2016 年 6 月 7 日至 7 月 20 日之间确定的 35 项综述中,有 18 项是具有中等到高质量的非重复系统综述。其中一半的综述重点关注预防 IPV 的干预措施。只有四项重点关注青少年,其中三项重点关注童婚,一项比较了青少年和青少年后期的发现。没有一项关注预防少女/年轻女性遭受虐待或性暴力的干预措施。从这 18 项综述和干预研究的补充系统综述中,提取了 34 项描述 28 项干预措施的实验或准实验干预研究的数据。几乎所有的干预研究都测量了一种形式的 VAWG 的影响。大多数研究评估了童婚的影响(n=13),其次是 IPV(n=8)、性暴力(n=4)、儿童虐待(n=3)和 FGMC(n=3)。干预措施包括 1-6 个组成部分,涉及增强声音/机构的技能(n=17)、社交网络(n=14)、人力资源(如学校教育)(n=10)、经济激励(n=9)、社区参与(n=11)和社区基础设施发展(n=6)。捆绑的个人层面的干预措施和多层次的干预措施对 VAWG 有更有利的影响。涉及社区参与、增强声音/机构的技能建设和社交网络扩展的干预措施显示出减少 VAWG 的潜力。未来的干预措施应该针对多方面的受害情况,比较青春期的影响,并包括中低收入国家的城市、失学、已婚和流离失所/受冲突影响的人群,在这些国家,VAWG 可能更为严重。