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人道主义和公共卫生紧急情况中的性别暴力协调:一项范围综述

Gender-based violence (GBV) coordination in humanitarian and public health emergencies: a scoping review.

作者信息

Raftery Philomena, Howard Natasha, Palmer Jennifer, Hossain Mazeda

机构信息

Department of Global Health and Development and Health in Humanitarian Crises Centre, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.

Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore, 117549, Singapore.

出版信息

Confl Health. 2022 Jun 28;16(1):37. doi: 10.1186/s13031-022-00471-z.

Abstract

BACKGROUND

Gender-based violence (GBV) is a global health, human rights, and protection issue, which can increase during emergencies. GBV coordination is an essential component of every humanitarian response, ensuring that, from the earliest phases of a crisis, accessible and safe services are available and prevention and mitigation mechanisms are implemented to reduce GBV. We sought to address the limited evidence on GBV coordination, by reviewing literature on GBV coordination in emergencies, identifying facilitators and barriers influencing effectiveness.

METHODS

We conducted a scoping review on GBV coordination in emergencies from 1990 to 2020. Studies explicitly discussing GBV coordination in humanitarian, natural disaster and public health emergencies, in low or middle-income countries, were included. Using thematic analysis, we developed a six-topic framework to synthesise evidence on effective GBV coordination and present recommendations for strengthening GBV coordination in emergencies.

FINDINGS

We included 28 of 964 sources identified, covering 30 different emergency settings across 22 countries. Sources spanned emergency settings, with minimal evidence in public health emergencies and none focussed solely on GBV coordination. Several sources suggested that timely establishment of GBV coordination mechanisms, led by dedicated, experienced coordinators, increased funding and strengthened service provision. GBV risk mitigation was compromised by weak commitment across sectors, poor accountability systems, and limited engagement of affected women. Inclusive GBV coordination, involving national and local actors is vital but engagement efforts have been inadequate and localisation funding targets not yet achieved. Implementation of the GBV Information Management System has reinforced coordination, funding allocation and service provision. While specialist GBV services remain insufficient, emergencies can present opportunities for expansion. Sustainability and long-term impact are compromised by over-reliance on international leadership and funding, weak commitment by governments, and limited attention to GBV prevention.

CONCLUSION

Despite enhanced global commitments to addressing GBV in recent years, it remains consistently under-prioritised and under-resourced. Recommendations to strengthen GBV coordination in emergencies include: funding dedicated GBV coordination positions across all types of emergencies, building the global GBV coordination workforce, expanding inclusion of national actors and investing in GBV risk mitigation and prevention through multiyear funding. The evidence-based framework for effective GBV coordination presented here, can guide further research in diverse emergencies.

摘要

背景

基于性别的暴力(GBV)是一个全球性的健康、人权和保护问题,在紧急情况下可能会增加。GBV协调是每个人道主义应对行动的重要组成部分,确保从危机的最初阶段起,就能提供可获得且安全的服务,并实施预防和缓解机制以减少GBV。我们试图通过回顾关于紧急情况下GBV协调的文献,找出影响有效性的促进因素和障碍,来解决GBV协调方面证据有限的问题。

方法

我们对1990年至2020年期间紧急情况下的GBV协调进行了范围界定审查。纳入了在低收入或中等收入国家明确讨论人道主义、自然灾害和公共卫生紧急情况下GBV协调的研究。通过主题分析,我们制定了一个包含六个主题的框架,以综合关于有效GBV协调的证据,并提出加强紧急情况下GBV协调的建议。

结果

我们从964个来源中纳入了28个,涵盖22个国家的30种不同紧急情况。来源涵盖各种紧急情况,在公共卫生紧急情况下的证据极少,且没有一个仅专注于GBV协调。一些来源表明,由敬业、经验丰富的协调员牵头及时建立GBV协调机制,可增加资金并加强服务提供。跨部门承诺不力、问责制度不完善以及受影响妇女参与有限,削弱了GBV风险缓解工作。包容性的GBV协调,包括国家和地方行为体,至关重要,但参与努力不足,地方化资金目标尚未实现。GBV信息管理系统的实施加强了协调、资金分配和服务提供。虽然专门的GBV服务仍然不足,但紧急情况可为扩展提供机会。过度依赖国际领导和资金、政府承诺不力以及对GBV预防关注有限,损害了可持续性和长期影响。

结论

尽管近年来全球在应对GBV方面的承诺有所增加,但GBV一直未得到足够重视,资源也不足。加强紧急情况下GBV协调的建议包括:为各类紧急情况设立专门的GBV协调职位提供资金,建设全球GBV协调工作队伍,扩大国家行为体的参与,并通过多年期资金投资于GBV风险缓解和预防。此处提出的有效GBV协调的循证框架,可指导在各种紧急情况下的进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3700/9238064/ee0f7d5dccf9/13031_2022_471_Fig1_HTML.jpg

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