The document summarizes CEPAM's work responding to gender-based violence (GBV) in Ecuador through service provision, advocacy, and awareness campaigns. It describes CEPAM's history of establishing health centers and legal services for GBV survivors. It also discusses Ecuador's National Plan for eradicating GBV, implemented through partnerships between government agencies and civil society organizations like CEPAM. While progress has been made in laws, justice access, and awareness campaigns, more work is still needed to improve health and social services, increase funding, and change underlying social norms accepting GBV.
AIDSTAR-One Case Study: Jane Goodall Institute in TanzaniaAIDSTAROne
1) The Jane Goodall Institute (JGI) in Tanzania works to mainstream HIV programming into its natural resource management and economic growth activities.
2) JGI home-based care provider Jumanne helps an HIV-positive family in Kasuku village, including transporting the sick daughter to the hospital and supporting their adherence to antiretroviral treatment.
3) By addressing local health, education, and economic priorities, JGI's community-centered conservation model fosters synergies between natural resource protection and socioeconomic development in communities surrounding Gombe National Park.
Earning Their Way to Healthier Lives: Women First in MozambiqueAIDSTAROne
A complex matrix of factors, such as low literacy, early sexual initiation, and limited economic opportunities, increases the vulnerability of women to HIV infection in Mozambique. The Women First program addresses the role that poverty and lack of access to health information play in the spread of HIV through legal rights and income-generating activities.
This case study covers one of the 31 programs from the Africa Gender Compendium, an AIDSTAR-One gender and HIV integration resource. A series of five Africa Gender Compendium case studies is accompanied by a findings report, which describes lessons learned, gaps, and common experiences across the programs.
Download this and other gender & HIV resources: http://j.mp/zyjmG7
This document discusses reinvigorating condoms as an HIV prevention tool. It summarizes that condoms are effective at preventing HIV transmission but there are still barriers to their use. Condoms play a key role in HIV prevention strategies alongside other interventions. However, risk compensation behaviors, structural barriers like criminalization of homosexuality, and lack of messaging around dual protection can reduce condom uptake and consistent use. The document calls for addressing these challenges and rigorously evaluating condom programming elements to improve access and effectiveness in different epidemic settings.
AIDSTAR-One Findings Report: Analysis of Services to Address Gender-based Vio...AIDSTAROne
Because gender-based violence (GBV) is widely recognized as both a cause and a consequence of HIV infection, the President's Emergency Plan for AIDS Relief (PEPFAR) has identified reducing GBV as one of its five high-priority gender strategies. As part of this effort, AIDSTAR-One conducted case studies in three countries where GBV services were available: Swaziland, Vietnam, and Ecuador. The case studies and this accompanying findings report aim to identify and share promising programmatic approaches and disseminate key elements of success for replication and scale-up.
www.aidstar-one.com/focus_areas/gender/resources/reports/gbv_series_findings_report
AIDSTAR-One Issue Paper: The Debilitating Cycle of HIV, Food Insecurity, and ...AIDSTAROne
This document aims to facilitate an understanding of the bi-directional relationship between HIV and food and nutrition security. It illuminates the causes of HIV-related food and nutrition insecurity, and points to a list of programmatic interventions and resources to consider for addressing each cause in detail. http://j.mp/U1L0iV
The document discusses several initiatives that have been taken in Asia to promote gender equality in humanitarian response efforts. It provides examples of:
1) A "DRR Gender Checklist" used in the Philippines to ensure gender inclusion in disaster risk reduction programming.
2) "Women Friendly Spaces" set up in Pakistan after floods to provide psychosocial support and empowerment opportunities for women.
3) A "Gender Emergency Checklist" developed for Pakistan and Afghanistan to remind aid groups of key gender issues to consider in emergency response.
4) Efforts in Nepal after the 2015 earthquake to establish a gender working group, develop gender indicators, and advocate for women's participation in recovery planning.
“Women are not only victims, they have driving power of changes, exclusive knowledge and skills that have crucial importance for providing solutions and managing risks”.
During the last 10 years 3 400 natural disasters took place in the world – hurricanes, floods earthquakes and other natural calamities. More than 700000 people died, more than 1,4 mln were injured and 23mln lost shelter. In general disaster affected 1,5 bln people and women, children and vulnerable people were most affected.
Thematic Assessment on Physical Assault - YemenMuhammad Idrees
The document summarizes the findings of a GBV assessment conducted in 8 governorates in Yemen in December 2015. It finds that reports of physical assault against women have increased significantly since the start of the conflict in March 2015, with 66% of respondents indicating a rise. Key reported causes for the increase include displacement, lack of economic opportunities, breakdown of rule of law, and psychological impacts of the conflict. The frequency and severity of physical violence was found to vary between governorates. Recommendations are made for improved GBV prevention and response programming combining efforts of communities, humanitarian organizations, and local associations.
AIDSTAR-One Case Study: Jane Goodall Institute in TanzaniaAIDSTAROne
1) The Jane Goodall Institute (JGI) in Tanzania works to mainstream HIV programming into its natural resource management and economic growth activities.
2) JGI home-based care provider Jumanne helps an HIV-positive family in Kasuku village, including transporting the sick daughter to the hospital and supporting their adherence to antiretroviral treatment.
3) By addressing local health, education, and economic priorities, JGI's community-centered conservation model fosters synergies between natural resource protection and socioeconomic development in communities surrounding Gombe National Park.
Earning Their Way to Healthier Lives: Women First in MozambiqueAIDSTAROne
A complex matrix of factors, such as low literacy, early sexual initiation, and limited economic opportunities, increases the vulnerability of women to HIV infection in Mozambique. The Women First program addresses the role that poverty and lack of access to health information play in the spread of HIV through legal rights and income-generating activities.
This case study covers one of the 31 programs from the Africa Gender Compendium, an AIDSTAR-One gender and HIV integration resource. A series of five Africa Gender Compendium case studies is accompanied by a findings report, which describes lessons learned, gaps, and common experiences across the programs.
Download this and other gender & HIV resources: http://j.mp/zyjmG7
This document discusses reinvigorating condoms as an HIV prevention tool. It summarizes that condoms are effective at preventing HIV transmission but there are still barriers to their use. Condoms play a key role in HIV prevention strategies alongside other interventions. However, risk compensation behaviors, structural barriers like criminalization of homosexuality, and lack of messaging around dual protection can reduce condom uptake and consistent use. The document calls for addressing these challenges and rigorously evaluating condom programming elements to improve access and effectiveness in different epidemic settings.
AIDSTAR-One Findings Report: Analysis of Services to Address Gender-based Vio...AIDSTAROne
Because gender-based violence (GBV) is widely recognized as both a cause and a consequence of HIV infection, the President's Emergency Plan for AIDS Relief (PEPFAR) has identified reducing GBV as one of its five high-priority gender strategies. As part of this effort, AIDSTAR-One conducted case studies in three countries where GBV services were available: Swaziland, Vietnam, and Ecuador. The case studies and this accompanying findings report aim to identify and share promising programmatic approaches and disseminate key elements of success for replication and scale-up.
www.aidstar-one.com/focus_areas/gender/resources/reports/gbv_series_findings_report
AIDSTAR-One Issue Paper: The Debilitating Cycle of HIV, Food Insecurity, and ...AIDSTAROne
This document aims to facilitate an understanding of the bi-directional relationship between HIV and food and nutrition security. It illuminates the causes of HIV-related food and nutrition insecurity, and points to a list of programmatic interventions and resources to consider for addressing each cause in detail. http://j.mp/U1L0iV
The document discusses several initiatives that have been taken in Asia to promote gender equality in humanitarian response efforts. It provides examples of:
1) A "DRR Gender Checklist" used in the Philippines to ensure gender inclusion in disaster risk reduction programming.
2) "Women Friendly Spaces" set up in Pakistan after floods to provide psychosocial support and empowerment opportunities for women.
3) A "Gender Emergency Checklist" developed for Pakistan and Afghanistan to remind aid groups of key gender issues to consider in emergency response.
4) Efforts in Nepal after the 2015 earthquake to establish a gender working group, develop gender indicators, and advocate for women's participation in recovery planning.
“Women are not only victims, they have driving power of changes, exclusive knowledge and skills that have crucial importance for providing solutions and managing risks”.
During the last 10 years 3 400 natural disasters took place in the world – hurricanes, floods earthquakes and other natural calamities. More than 700000 people died, more than 1,4 mln were injured and 23mln lost shelter. In general disaster affected 1,5 bln people and women, children and vulnerable people were most affected.
Thematic Assessment on Physical Assault - YemenMuhammad Idrees
The document summarizes the findings of a GBV assessment conducted in 8 governorates in Yemen in December 2015. It finds that reports of physical assault against women have increased significantly since the start of the conflict in March 2015, with 66% of respondents indicating a rise. Key reported causes for the increase include displacement, lack of economic opportunities, breakdown of rule of law, and psychological impacts of the conflict. The frequency and severity of physical violence was found to vary between governorates. Recommendations are made for improved GBV prevention and response programming combining efforts of communities, humanitarian organizations, and local associations.
The document discusses how climate change disproportionately impacts women. It notes that women are more dependent on natural resources for tasks like collecting water and food. Climate disasters exacerbate gender inequalities by increasing women's workloads and restricting their access to education and resources. The impacts of climate change on women are often overlooked in international agreements. Studies show women face higher risks during natural disasters and their agricultural livelihoods are threatened by climate impacts like changing rainfall patterns and food price increases.
The document discusses children's vulnerability during disasters in the Philippines and the importance of child participation. It summarizes the programs of Share An Opportunity Philippines Inc., which works to support children affected by poverty and disasters. Focus group discussions with children in disaster-impacted areas explored their views on how communities and parents can better ensure children's survival, protection, participation, and development during and after disasters. The children provided input on safe evacuation locations and engaging youth in disaster risk reduction committees. The report recommends empowering children and including them in community disaster planning.
1) Nigeria saw a over 50% reduction in polio cases in 2009 compared to 2008, with Rotary playing a key role through advocacy and immunization efforts.
2) Rotary advocates to government, religious, and traditional leaders and conducts workshops to train local Rotary leaders in polio eradication.
3) The decline is attributed to increased support from federal, state and local governments as well as allies like journalists and women's groups working with communities.
The document summarizes KANCO activities in November 2013, including participating in a Run for Child Health event and naming an employee of the month. It provides information on monitoring activities and contacting KANCO on social media or via email. The editorial discusses KANCO's role in supporting HIV/AIDS, TB and other health organizations in Kenya by strengthening communities and policies. It notes KANCO's membership of over 1200 organizations and accreditation by the International HIV and AIDS Alliance to support joint HIV/AIDS and TB actions at the community level in Kenya.
AIDSTAR-One Faith-Based Organizations and HIV Prevention with MARPs in MexicoAIDSTAROne
La Iglesia de la Reconciliación, VIHas de Vida, and El Mesón de la Misericordia are three faith-based organizations in Mexico that implement innovative HIV prevention activities with most-at-risk populations, including men who have sex with men and sex workers. They integrate messages on HIV prevention within a holistic approach that addresses spirituality, sexuality, and health. Through diverse activities like educational talks and workshops, as well as referrals to testing and care, these organizations help fill gaps and reduce stigma for at-risk groups.
This document discusses Phillip Blond's perspective on using civil society and association to address health inequalities in the UK. It notes decreases in civic engagement, volunteering, and social cohesion. Strengthening social capital by supporting community groups and encouraging participation in health programs could help reduce inequalities. Peer-to-peer communication and promoting personal responsibility are highlighted as strategies.
Thank client for sharing
Remind of test results timeline
Provide contact information
Offer additional support
Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
Celebrating 10 Years of Great Journalism Fostered by the Dennis A. Hunt Fund ...reportingonhealth
This document provides information about the Dennis A. Hunt Fund for Health Journalism, which has supported over 60 journalists over the past 10 years in producing impactful investigative journalism projects related to community health issues. Some of the projects have led to policy changes and community improvements, such as increased access to healthcare and reductions in environmental toxins. The fund continues to support new classes of journalists each year in addressing important health topics.
This document summarizes research on child soldiers in Uganda. It discusses facts about abduction rates over time, reasons for torture and killing by the Lord's Resistance Army, and the experiences of former child soldiers. It also analyzes policies around amnesty for former soldiers and challenges with reintegration support, finding that education and livelihood assistance has been inadequate compared to health and psychosocial needs.
Women are the backbone: health promotion, gender equity and post disaster rec...Taller Salud
In 2017, two devastating hurricanes impacted Puerto Rico in a three week period. As women and community members became the first responders to the emergency, Taller Salud, a women’s health organization in Puerto Rico, leverage response and recovery relief efforts with a gender analysis approach, health promotion strategies and pursuit of accountable governance in response and resource allocation.
This document discusses sexually transmitted infections (STIs) among adolescents in Snowflake, Arizona. It notes that STI rates have been rising nationwide and in Navajo County specifically. Snowflake has a small, conservative, and religious population that provides little sexual education. The author conducted a clinical project to provide STI education and resources to patients at a clinic in Snowflake. The project aimed to raise awareness of the rising local STI rates and provide prevention information to address the lack of existing education. Barriers to the project included personal and religious discomfort discussing sexuality, but the author implemented the project by offering handouts and discussing local STI data and prevention strategies depending on patient receptiveness.
This document summarizes a research study that examined how social support structures impact the successful resettlement of Burmese and Burundian refugees in a Midwestern city in the United States. The study utilized qualitative interviews with 13 Burmese and 23 Burundian refugees to understand how support from resettlement agencies and social networks affected refugees' well-being and ability to access resources. Key findings included that gaps in employment and housing services from resettlement agencies negatively impacted refugees, while strong social support networks provided emotional, informational and instrumental support that helped refugees cope with challenges. The results contribute to understanding how to best assist refugee families through strengthening support structures.
Importance of information system in raising public awareness about domestic v...Masum Hussain
Across the globe, information system tools have helped fuel social movements. Information system has been shown to strengthen social actors’ ability to challenge and change power relations in society, providing platforms for debate, reflection, influencing and mobilizing people. To better understand the potential of information system to engage especially young people in efforts to prevent domestic violence the Partners for Prevention regional project, Engaging Young Men Through Information system for the Prevention of Domestic violence’ which supported information system awareness campaigns designed to raise awareness and motivate young people to take action to prevent domestic violence has revealed practical lessons from three awareness campaigns on the effective use of information system tools for violence protection.
The Experimental Child - Child and Family Impacts of the Coronavirus SyndemicUniversité de Montréal
The Experimental Child - Child and Family Impacts of the Coronavirus Syndemic
Abstract
Not only is the coronavirus crisis a natural laboratory of stress offering health and social care services a unique historical opportunity to observe its impact on entire populations around the world, but the responses to the crisis by international health authorities, such as the WHO, along with national and local educational institutions and health care and social services, are creating an unprecedented and unpredictable environment for children and youth. This hostile new environment for growth and development is marked by the sudden and unpredictable imposition of confinement and social isolation, cutting off or limiting opportunities for the development of cognitive abilities, peer relationships, and social skills, while exposing vulnerable children and youth to depriving, negligent, or even abusive home environments.
For this reason, this crisis has been renamed a syndemic, encompassing two different categories of disease—an infectious disease (SARS-CoV-2) and an array of non-communicable diseases (NCDs). Together, these conditions cluster within specific populations following deeply-embedded patterns of inequality and vulnerability (Horton, 2020). These pre-existing fault lines of inequity, poverty, mental illness, racism, ableism, ageism create stigma and discrimination and amplify the impacts of this syndemic. And children are the most vulnerable population around the world. The impact on children is part of a cascade of consequences affecting societies at large, smaller communities, and the multigenerational family, all of which impinge on children and youth as the lowest common denominator (Di Nicola & Daly, 2020).
This exceptional set of circumstances—in response not only to the biomedical and populational health aspects but also in constructing policies for entire societies—is creating an “experimental childhood” for billions of children and youth around the world. With its commitment to the social determinants of health and mental health, notably in light of the monumental Adverse Childhood Events (ACE) studies (Felitti & Anda, 2010), social psychiatry and global mental health in partner with child and family psychiatry and allied professions must now consider their roles for the future of these “experimental children” around the world. The parameters for observing the conditions of this coronavirus-induced syndemic in the family and in society, along with recommendations for social psychiatric interventions, and prospective paediatric, psychological, and social studies will be outlined.
Keywords: Children & families, COVID-19, syndemic, ACE Study, confinement, social isolation
You have been tasked with orienting new registered nurses in the emergency department in your hospital about how to manage child abuse and neglect cases. The orientation should cover child abuse and neglect definitions, prevention, detection, intervention and treatment, reporting, and interdisciplinary resources.
Child and Family Impacts of the Coronavirus Syndemic: Developmental, Family, ...Université de Montréal
My presentation is part of the WASP-WPA Interorganizational Symposium for the WPA 21st Virtual World Congress of Psychiatry, Catragena, Colombia, October 16-21, 2021
Session Description
At this time, the death toll from COVID-19 is approaching 3 million people worldwide. The full toll of COVID-19 far exceeds
even this sobering number. Beyond the direct biological impacts of an infectious disease, the global impact of COVID-19 is
revealing and magnifying pre-existing fractures in our social structures. COVID-19 has led to significant differential impacts
among groups across age, health and socio-cultural variables, whether through increased direct illness morbidity and
mortality in the elderly or those with mental illness, or through indirect impacts associated with widespread societal and
health system changes, including youth impacted by confinement and social isolation impinging on development of prosocial
skills, increased caregiver and family stresses ranging from financial distress to violence, and further disenfranchisement of
already marginalized and vulnerable groups. At the same time, heightened public awareness and outcry about such
disparities has the potential to fuel new alliances, challenging and perhaps dismantling some historical stereotypes of race,
ethnicity, gender, sexual orientation, age, disability and illness. Rather than a pandemic, the global impacts reveal a
syndemic – multiple pandemics along different lines, both the viral/biological pandemic, plus a social pandemic superimposed
on pre-existing fault lines of inequity, poverty, mental illness, racism, sexism, ableism, ageism and other forms of stigma and
discrimination. This session will include discussion of the varied impacts of COVID-19 and exploration of their root causes
from a social psychiatry perspective.
The document discusses major health care policies and events that occurred in the United States between the 1960s and 1970s. Some key developments included the passage of Medicare and Medicaid in 1965 which provided health insurance to the elderly and poor. The Surgeon General's report on smoking was released in 1964, leading to increased regulation of tobacco. The Supreme Court legalized abortion in 1973 with the Roe v. Wade decision. Other policies focused on expanding access to family planning and reproductive health services. However, comprehensive national health insurance reform remained elusive despite numerous proposals throughout this period.
The document provides guidelines for preventing and responding to gender-based violence (GBV), particularly sexual violence, in humanitarian emergencies. It emphasizes the importance of establishing a minimum set of multisectoral interventions from the earliest stages of an emergency to prevent GBV and provide assistance to survivors. The guidelines are intended to help humanitarian organizations coordinate their prevention and response efforts and establish comprehensive programming as the emergency situation stabilizes.
Allowing Men to Care: Fatherhood Project in South AfricaAIDSTAROne
In South Africa, men are increasingly rejecting wide-spread stereotypes of manhood by stepping forward to challenge gender roles that compromise their well-being and the health of their partners and their families. This case study documents the Sonke Gender Justice Network’s Fatherhood project, which was designed to reduce HIV transmission and address related problems, such as gender-based violence, women’s overwhelming burden of care, and the preponderance of children in need of care and support.
Download this and other gender & HIV resources: http://j.mp/wnq6nT
AIDSTAR-One Case Study: Addressing HIV and Gender from the Ground Up in KenyaAIDSTAROne
In Kenya, the government's work against HIV is supplemented frequently by civil society organizations. These organizations, however, are often faced with a lack of available funding and knowledge. The Maanisha Community Focused Initiative, a program that works in many of Kenya's provinces, works to provide CSOs with both grants and capacity building in all HIV program areas while simultaneously addressing multiple gender-related issues.
This case study covers one of the 31 programs from the Africa Gender Compendium, an AIDSTAR-One gender and HIV integration resource. A series of five Africa Gender Compendium case studies is accompanied by a findings report, which describes lessons learned, gaps, and common experiences across the programs.
Download this or other HIV & gender resources: http://j.mp/wFzKZ0
The document discusses how climate change disproportionately impacts women. It notes that women are more dependent on natural resources for tasks like collecting water and food. Climate disasters exacerbate gender inequalities by increasing women's workloads and restricting their access to education and resources. The impacts of climate change on women are often overlooked in international agreements. Studies show women face higher risks during natural disasters and their agricultural livelihoods are threatened by climate impacts like changing rainfall patterns and food price increases.
The document discusses children's vulnerability during disasters in the Philippines and the importance of child participation. It summarizes the programs of Share An Opportunity Philippines Inc., which works to support children affected by poverty and disasters. Focus group discussions with children in disaster-impacted areas explored their views on how communities and parents can better ensure children's survival, protection, participation, and development during and after disasters. The children provided input on safe evacuation locations and engaging youth in disaster risk reduction committees. The report recommends empowering children and including them in community disaster planning.
1) Nigeria saw a over 50% reduction in polio cases in 2009 compared to 2008, with Rotary playing a key role through advocacy and immunization efforts.
2) Rotary advocates to government, religious, and traditional leaders and conducts workshops to train local Rotary leaders in polio eradication.
3) The decline is attributed to increased support from federal, state and local governments as well as allies like journalists and women's groups working with communities.
The document summarizes KANCO activities in November 2013, including participating in a Run for Child Health event and naming an employee of the month. It provides information on monitoring activities and contacting KANCO on social media or via email. The editorial discusses KANCO's role in supporting HIV/AIDS, TB and other health organizations in Kenya by strengthening communities and policies. It notes KANCO's membership of over 1200 organizations and accreditation by the International HIV and AIDS Alliance to support joint HIV/AIDS and TB actions at the community level in Kenya.
AIDSTAR-One Faith-Based Organizations and HIV Prevention with MARPs in MexicoAIDSTAROne
La Iglesia de la Reconciliación, VIHas de Vida, and El Mesón de la Misericordia are three faith-based organizations in Mexico that implement innovative HIV prevention activities with most-at-risk populations, including men who have sex with men and sex workers. They integrate messages on HIV prevention within a holistic approach that addresses spirituality, sexuality, and health. Through diverse activities like educational talks and workshops, as well as referrals to testing and care, these organizations help fill gaps and reduce stigma for at-risk groups.
This document discusses Phillip Blond's perspective on using civil society and association to address health inequalities in the UK. It notes decreases in civic engagement, volunteering, and social cohesion. Strengthening social capital by supporting community groups and encouraging participation in health programs could help reduce inequalities. Peer-to-peer communication and promoting personal responsibility are highlighted as strategies.
Thank client for sharing
Remind of test results timeline
Provide contact information
Offer additional support
Providing HIV related services to our community through compassionate direct care, prevention and outreach activities.
Celebrating 10 Years of Great Journalism Fostered by the Dennis A. Hunt Fund ...reportingonhealth
This document provides information about the Dennis A. Hunt Fund for Health Journalism, which has supported over 60 journalists over the past 10 years in producing impactful investigative journalism projects related to community health issues. Some of the projects have led to policy changes and community improvements, such as increased access to healthcare and reductions in environmental toxins. The fund continues to support new classes of journalists each year in addressing important health topics.
This document summarizes research on child soldiers in Uganda. It discusses facts about abduction rates over time, reasons for torture and killing by the Lord's Resistance Army, and the experiences of former child soldiers. It also analyzes policies around amnesty for former soldiers and challenges with reintegration support, finding that education and livelihood assistance has been inadequate compared to health and psychosocial needs.
Women are the backbone: health promotion, gender equity and post disaster rec...Taller Salud
In 2017, two devastating hurricanes impacted Puerto Rico in a three week period. As women and community members became the first responders to the emergency, Taller Salud, a women’s health organization in Puerto Rico, leverage response and recovery relief efforts with a gender analysis approach, health promotion strategies and pursuit of accountable governance in response and resource allocation.
This document discusses sexually transmitted infections (STIs) among adolescents in Snowflake, Arizona. It notes that STI rates have been rising nationwide and in Navajo County specifically. Snowflake has a small, conservative, and religious population that provides little sexual education. The author conducted a clinical project to provide STI education and resources to patients at a clinic in Snowflake. The project aimed to raise awareness of the rising local STI rates and provide prevention information to address the lack of existing education. Barriers to the project included personal and religious discomfort discussing sexuality, but the author implemented the project by offering handouts and discussing local STI data and prevention strategies depending on patient receptiveness.
This document summarizes a research study that examined how social support structures impact the successful resettlement of Burmese and Burundian refugees in a Midwestern city in the United States. The study utilized qualitative interviews with 13 Burmese and 23 Burundian refugees to understand how support from resettlement agencies and social networks affected refugees' well-being and ability to access resources. Key findings included that gaps in employment and housing services from resettlement agencies negatively impacted refugees, while strong social support networks provided emotional, informational and instrumental support that helped refugees cope with challenges. The results contribute to understanding how to best assist refugee families through strengthening support structures.
Importance of information system in raising public awareness about domestic v...Masum Hussain
Across the globe, information system tools have helped fuel social movements. Information system has been shown to strengthen social actors’ ability to challenge and change power relations in society, providing platforms for debate, reflection, influencing and mobilizing people. To better understand the potential of information system to engage especially young people in efforts to prevent domestic violence the Partners for Prevention regional project, Engaging Young Men Through Information system for the Prevention of Domestic violence’ which supported information system awareness campaigns designed to raise awareness and motivate young people to take action to prevent domestic violence has revealed practical lessons from three awareness campaigns on the effective use of information system tools for violence protection.
The Experimental Child - Child and Family Impacts of the Coronavirus SyndemicUniversité de Montréal
The Experimental Child - Child and Family Impacts of the Coronavirus Syndemic
Abstract
Not only is the coronavirus crisis a natural laboratory of stress offering health and social care services a unique historical opportunity to observe its impact on entire populations around the world, but the responses to the crisis by international health authorities, such as the WHO, along with national and local educational institutions and health care and social services, are creating an unprecedented and unpredictable environment for children and youth. This hostile new environment for growth and development is marked by the sudden and unpredictable imposition of confinement and social isolation, cutting off or limiting opportunities for the development of cognitive abilities, peer relationships, and social skills, while exposing vulnerable children and youth to depriving, negligent, or even abusive home environments.
For this reason, this crisis has been renamed a syndemic, encompassing two different categories of disease—an infectious disease (SARS-CoV-2) and an array of non-communicable diseases (NCDs). Together, these conditions cluster within specific populations following deeply-embedded patterns of inequality and vulnerability (Horton, 2020). These pre-existing fault lines of inequity, poverty, mental illness, racism, ableism, ageism create stigma and discrimination and amplify the impacts of this syndemic. And children are the most vulnerable population around the world. The impact on children is part of a cascade of consequences affecting societies at large, smaller communities, and the multigenerational family, all of which impinge on children and youth as the lowest common denominator (Di Nicola & Daly, 2020).
This exceptional set of circumstances—in response not only to the biomedical and populational health aspects but also in constructing policies for entire societies—is creating an “experimental childhood” for billions of children and youth around the world. With its commitment to the social determinants of health and mental health, notably in light of the monumental Adverse Childhood Events (ACE) studies (Felitti & Anda, 2010), social psychiatry and global mental health in partner with child and family psychiatry and allied professions must now consider their roles for the future of these “experimental children” around the world. The parameters for observing the conditions of this coronavirus-induced syndemic in the family and in society, along with recommendations for social psychiatric interventions, and prospective paediatric, psychological, and social studies will be outlined.
Keywords: Children & families, COVID-19, syndemic, ACE Study, confinement, social isolation
You have been tasked with orienting new registered nurses in the emergency department in your hospital about how to manage child abuse and neglect cases. The orientation should cover child abuse and neglect definitions, prevention, detection, intervention and treatment, reporting, and interdisciplinary resources.
Child and Family Impacts of the Coronavirus Syndemic: Developmental, Family, ...Université de Montréal
My presentation is part of the WASP-WPA Interorganizational Symposium for the WPA 21st Virtual World Congress of Psychiatry, Catragena, Colombia, October 16-21, 2021
Session Description
At this time, the death toll from COVID-19 is approaching 3 million people worldwide. The full toll of COVID-19 far exceeds
even this sobering number. Beyond the direct biological impacts of an infectious disease, the global impact of COVID-19 is
revealing and magnifying pre-existing fractures in our social structures. COVID-19 has led to significant differential impacts
among groups across age, health and socio-cultural variables, whether through increased direct illness morbidity and
mortality in the elderly or those with mental illness, or through indirect impacts associated with widespread societal and
health system changes, including youth impacted by confinement and social isolation impinging on development of prosocial
skills, increased caregiver and family stresses ranging from financial distress to violence, and further disenfranchisement of
already marginalized and vulnerable groups. At the same time, heightened public awareness and outcry about such
disparities has the potential to fuel new alliances, challenging and perhaps dismantling some historical stereotypes of race,
ethnicity, gender, sexual orientation, age, disability and illness. Rather than a pandemic, the global impacts reveal a
syndemic – multiple pandemics along different lines, both the viral/biological pandemic, plus a social pandemic superimposed
on pre-existing fault lines of inequity, poverty, mental illness, racism, sexism, ableism, ageism and other forms of stigma and
discrimination. This session will include discussion of the varied impacts of COVID-19 and exploration of their root causes
from a social psychiatry perspective.
The document discusses major health care policies and events that occurred in the United States between the 1960s and 1970s. Some key developments included the passage of Medicare and Medicaid in 1965 which provided health insurance to the elderly and poor. The Surgeon General's report on smoking was released in 1964, leading to increased regulation of tobacco. The Supreme Court legalized abortion in 1973 with the Roe v. Wade decision. Other policies focused on expanding access to family planning and reproductive health services. However, comprehensive national health insurance reform remained elusive despite numerous proposals throughout this period.
The document provides guidelines for preventing and responding to gender-based violence (GBV), particularly sexual violence, in humanitarian emergencies. It emphasizes the importance of establishing a minimum set of multisectoral interventions from the earliest stages of an emergency to prevent GBV and provide assistance to survivors. The guidelines are intended to help humanitarian organizations coordinate their prevention and response efforts and establish comprehensive programming as the emergency situation stabilizes.
Allowing Men to Care: Fatherhood Project in South AfricaAIDSTAROne
In South Africa, men are increasingly rejecting wide-spread stereotypes of manhood by stepping forward to challenge gender roles that compromise their well-being and the health of their partners and their families. This case study documents the Sonke Gender Justice Network’s Fatherhood project, which was designed to reduce HIV transmission and address related problems, such as gender-based violence, women’s overwhelming burden of care, and the preponderance of children in need of care and support.
Download this and other gender & HIV resources: http://j.mp/wnq6nT
AIDSTAR-One Case Study: Addressing HIV and Gender from the Ground Up in KenyaAIDSTAROne
In Kenya, the government's work against HIV is supplemented frequently by civil society organizations. These organizations, however, are often faced with a lack of available funding and knowledge. The Maanisha Community Focused Initiative, a program that works in many of Kenya's provinces, works to provide CSOs with both grants and capacity building in all HIV program areas while simultaneously addressing multiple gender-related issues.
This case study covers one of the 31 programs from the Africa Gender Compendium, an AIDSTAR-One gender and HIV integration resource. A series of five Africa Gender Compendium case studies is accompanied by a findings report, which describes lessons learned, gaps, and common experiences across the programs.
Download this or other HIV & gender resources: http://j.mp/wFzKZ0
This document discusses domestic violence against women and girls. It provides an overview of the scope and magnitude of the problem globally. Some key points include:
- Domestic violence is perpetrated by intimate partners and family members and includes physical, sexual, and psychological abuse.
- Estimates suggest 20-50% of women worldwide experience physical violence from intimate partners.
- Violence against women occurs throughout their lives, from sex-selective abortions and infanticide of baby girls to abuse as children and adults within their homes and families.
- In addition to the physical and mental health consequences for women and children, domestic violence has significant social and economic costs.
- A coordinated, multi-sectoral approach is needed
The document discusses how HIV/AIDS disproportionately affects women and girls globally. It outlines that nearly half of all HIV cases worldwide are among women, and young women ages 15-24 are most at risk. Factors like gender inequality, lack of education, poverty, and violence against women increase women's vulnerability to infection. Effective prevention requires empowering women through education, access to healthcare and protection methods, and eliminating discrimination.
This document analyzes the history and effectiveness of the Violence Against Women Act (VAWA) in support of its 2013 reauthorization. It describes how VAWA was originally passed in 1994 to address the widespread problems of domestic violence and sexual assault. VAWA created a coordinated community response and provided funding for victim services. Reauthorizations in 2000, 2005, and 2013 expanded protections. VAWA has significantly reduced domestic violence and intimate partner violence rates and saved billions of dollars. The document recommends further improving responses in rural areas by training churches and schools to address needs.
The National Women and AIDS Collective (NWAC) is advocating for policy changes to better support HIV-positive women. It represents 25 organizations across the US that provide services to HIV+ women. NWAC aims to improve HIV surveillance data to better reflect women's realities and needs. It has achieved several policy successes and positions itself to influence national strategies. Sustaining NWAC is important to advance women's leadership and acknowledge socioeconomic factors driving HIV risks for women.
An overview and summary on the research done for the Break the Silence: End Child Abuse Campaign. by Rhoda Reddock, The University of the West Indies, St Augustine Campus, Trinidad and Tobago.
Prevention and Response To Gender-Based Violence in Lagos State [Standard Ope...OluwatobiOpadokun
SOPs describe the clear procedures and standards for all actors, outlining roles, responsibilities and present a working manual for those who agree to work together in pursuit of a common interest. SGBV SOPs are developed to assist in creating a coordinated multi-sectoral response, referral and prevention structure for persons at risk.
This SOP is as a one-stop document to provide the response guidelines and pathways for intervenors and other actors (individuals and organisations) respond-ing to GBV and who are known as service providers. It provides information about the proper channels for reporting cases, referrals and facilitating access to justice for survivors/victims of VAWG/SGBV/SRHR/HP in Lagos State. It delineates the roles, responsibilities and procedures for all actors for the best interest of victims/survivors
This article discusses how extreme poverty increases women's vulnerability to HIV transmission in Malawi, violating their right to life. It summarizes the findings of a study by Women and Law in Southern Africa that examined women's experiences with HIV/AIDS. The study found that poverty drives high-risk behaviors and gender inequality perpetuates women's vulnerability. Since there is no HIV cure, persistent poverty and powerlessness infringes on women's right to life. A rights-based approach is needed to address development and poverty reduction in the context of the HIV pandemic.
The document summarizes the key findings of a consultation on the issues and barriers facing transgender people in accessing HIV and other services in Yangon, Myanmar. The consultation identified low levels of condom use and HIV awareness within the transgender community. It also found that transgender people face discrimination in healthcare settings, preventing access to prevention, treatment, and support services. Common issues included stigma, unfriendly services, and a lack of tailored HIV prevention interventions. The document recommends improving health services, reducing risk behaviors, and addressing discrimination in order to improve transgender health outcomes in Yangon.
Fourteen years ago I was asked to prepare the following document. After it was completed, the contractor asked me to re-do it because they had made a mistake in the age they wanted covered. [They seemed to believe the information was too sensitive politically] and buried the report. I'm submitting it here now to learn what the LinkedIn audience thinks. Is it time to update it?
APCRSHR10 Virtual plenary presentation by Sivananthi Thanenthiran of ARROWCNS www.citizen-news.org
This is the plenary presentation by Sivananthi Thanenthiran, Executive Director of ARROW, which took place as part of 8th session of 10th Asia Pacific Conference on Reproductive and Sexual Health and Rights (APCRSHR10) Virtual, on 28th September 2020, on the theme of "Safe abortion and sexual and reproductive health and rights (SRHR) in Asia and the Pacific". 28 September is also observed as International Safe Abortion Day.
C H A I R
Amy Williamson, Country Director, Marie Stopes International, Cambodia
P L E N A R Y S P E A K E R S
* Dr Suchitra Dalvie, coordinator, Asia Safe Abortion Partnership (ASAP) | "Abortion and Reproductive Justice: The Unfinished Revolution"
* Sivananthi Thanenthiran, Executive Director, ARROW | "Right to Safe Abortion: putting women at the centre of the discourse and practice"
A B S T R A C T P R E S E N T E R S
* Katherine Gambir | Is Self-Administered Medical Abortion as Effective as Provider-Administered Medical Abortion? A Systematic Review and Meta-Analysis
* Aryanty Riznawaty Imma | Challenges in Recording Abortion Related Complications at Health Facilities in Setting Where Abortion is Highly Restricted
* Dr Yaghoob Foroutan | Abortion’s Patterns and Determinants in Iran: Attitudinal Dynamics
* Maria Persson | A Qualitative Study on Healthcare Providers’ Experiences of Providing Comprehensive Abortion Care in the Humanitarian Setting in Cox’s Bazar, Bangladesh
For more information on this session go to www.bit.ly/apcrshr10virtual8
#SRHR #sexualhealth #reproductiverights #familyplanning #womenshealth #genderequality #SDGs #abortion #MyAbortionMyHealth #28Sept #InternationalSafeAbortionDay #SafeAbortion #BodilyAutonomy
The document discusses several issues related to HIV/AIDS and domestic violence in India. It notes that around 2.3 million people in India are currently living with HIV, with infection rates increasing throughout the 1990s. Stopping the spread of HIV/AIDS is necessary for sustainable development in India given its large population. The document also discusses that an estimated 4 million women in India experience domestic violence each year, which is the leading cause of injury for women aged 15-44. Non-governmental organizations play an important role in educating people about HIV/AIDS prevention and supporting domestic violence survivors.
Ending violence against girls and women cristinagss
Domestic violence, sexual violence against women and human trafficking are the three most pervasive problems women rights activists from the Good Shepherd Sisters Congregation encounter in the 72 nations in which they operate. To better understand how women fall prey to this cycle of violence and abuse the New York-based NGO, Good Shepherd International Justice Peace Office (GSIJP) undertook a globe-spanning survey to determine who’s most at risk and how this pattern can be broken. Here are the results.
Gender-based violence, especially against women, is a significant problem in Kenya. Over 40% of married women report experiencing domestic or sexual violence. Factors like education levels, religion, and socioeconomic status influence the high rates of violence. Domestic violence is underreported, but surveys found 39% of women experienced physical violence and 14% sexual violence. Rape, female genital mutilation, and human trafficking also harm women in Kenya. Addressing violence requires legal reforms, awareness campaigns, support services, and challenging social norms.
The Madison County AIDS Program (MadCAP) is seeking funding to implement an HIV/AIDS risk reduction program for adolescents in Madison County high schools. The program will use the evidence-based BART (Becoming a Responsible Teen) curriculum over the 2016-2017 school year. The goal is to reduce HIV rates among teens and young adults by increasing HIV knowledge, perceived risk of infection, and safe sex practices. Freshmen students will participate in sessions on causes, transmission, testing and prevention. The program aims to have 75% of participants increase essential HIV knowledge and perceive themselves at higher risk of infection after. It will also teach proper condom use through demonstrations to further prevent spread of HIV. Evaluation will compare pre-
Restrictions-on-a-Woman-s-Reproductive-ChoiceLucinda Lee
Restricting access to reproductive healthcare and factual information leads to negative outcomes. It increases rates of preventable sexually transmitted diseases like HIV and HPV by limiting condom access and sex education. It also increases unintended pregnancy by promoting ineffective abstinence-only programs instead of contraception education and access. This damages individuals' health and economic opportunities, as well as increasing healthcare and social costs to society. Evidence shows that providing open access to factual information and medical services through education and contraception improves public health outcomes.
PCI-Media Impact made important
strides in 2012 working with communities around
the globe to address some of our world’s most entrenched problems. Over the course of its 27 years,
Media Impact has developed a sophisticated understanding of population-related issues and the
inter-connectivity of population with poverty, health and the environment.
AIDSTAR-One Breaking New Ground in VietnamAIDSTAROne
1) The STEP program in Vietnam aims to integrate gender considerations into CARE's work by providing support services to male and female drug users and sex workers both before and after their release from detention centers.
2) The program recognizes that gender inequality increases vulnerability and provides gender-sensitive counseling, health services, job training, and social support to help prevent violence and relapse.
3) Services include pre-release counseling at detention centers and post-release drop-in centers that provide counseling, referrals, home visits, and community education with the goal of smooth reintegration.
Similar to AIDSTAR-One Civil Society and Government Unite to Respond to Gender-based Violence in Ecuador (20)
AIDSTAR-One Report: Rapid Assessment of Pediatric HIV Treatment in NigeriaAIDSTAROne
This document summarizes a rapid assessment of pediatric HIV treatment in Nigeria conducted by AIDSTAR-One in 2011.
Part I identified several barriers to providing quality pediatric HIV care: human resource constraints, lack of caregiver involvement, limited disclosure to children and adolescents, adherence challenges, and inadequate resources at sites. It provides recommendations to address these barriers, such as limiting staff transfers, improving caregiver support, using age-appropriate adherence tools, and expanding electronic medical records.
Part II reviewed outcomes of 1,516 pediatric patients and found 4.2% mortality and 19.1% loss to follow up. Few health systems challenges significantly impacted treatment outcomes. Earlier treatment initiation and reduced loss to follow up are needed.
AIDSTAR-One Case Study: Targeted Outreach Program BurmaAIDSTAROne
The document summarizes the Targeted Outreach Project (TOP) in Burma, which works to scale up HIV programming among sex workers. TOP was launched in 2004 by Population Services International to provide health services and empowerment opportunities to female sex workers and men who have sex with men. It has expanded to 18 cities across Burma, reaching over 70% of estimated sex workers and 25% of estimated men who have sex with men. TOP operates drop-in centers that provide a range of free health services including STI testing/treatment, family planning, and HIV counseling/testing. It also offers social/economic support through small loans, education, and advocacy to improve participants' well-being and reduce risky behaviors. Evaluation data
AIDSTAR-One Co-trimoxazole Pilot Assessment ReportAIDSTAROne
AIDSTAR-One developed and piloted provider and patient educational tools to increase appropriate prescription and use of co-trimoxazole for eligible people living with HIV. Before and after the pilot, AIDSTAR-One conducted a mixed-methods assessment to analyze the effectiveness and acceptability of the co-trimoxazole tools. This report recommends adoption and scale-up of the tools in Uganda and other countries.
AIDSTAR-One conducted a 3-year demonstration project in Namibia to reduce heavy drinking and risky sexual behavior among bar patrons in a low-income neighborhood on the outskirts of Namibia's capital, Windhoek. This report describes how the intervention was implemented, monitored, and evaluated, and reports the final assessment results. It also offers key recommendations for future research and programming. http://aidstarone.com/focus_areas/prevention/resources/reports/alcohol_namibia_intervention_report
AIDSTAR-One HIV Treatment Guidelines in Guyana - The Fast Track to Diagnosis ...AIDSTAROne
This case study details Guyana's process for revision of their national HIV treatment guidelines, based on WHO's 2010 revised recommendations . While many countries are still working to revise their national guidelines in response to WHO's latest guidance, the National AIDS Programme in Guyana has been implementing elements of WHO's 2010 recommendations since 2006.
www.aidstar-one.com/focus_areas/treatment/resources/case_study/guyana_treatment_guidelines
AIDSTAR-One Implementation of WHO's 2008 Pediatric HIV Treatment GuidelinesAIDSTAROne
In April 2008, the WHO Technical Reference Group for Pediatric HIV/ART and Care released a series of nine updated recommendations for diagnostic testing, initiation of treatment, and appropriate treatment regimens for HIV-exposed and infected infants. This technical brief outlines practical implementation considerations for program planners and policymakers working to incorporate these recommendations into their local efforts.
http://www.aidstar-one.com/implementation_whos_2008_pediatric_hiv_treatment_guidelines
AIDSTAR-One Protecting Children Affected by HIV Against Abuse, Exploitation, ...AIDSTAROne
This document is intended to explore strategies to protect children orphaned or made vulnerable by HIV (OVC) from abuse, exploitation, violence, and neglect. The report draws from lessons learned by OVC program managers, designers, and policy developers—particularly those associated with the President’s Emergency Plan for AIDS Relief (PEPFAR).
http://www.aidstar-one.com/focus_areas/OVC/reports/protecting_children_affected_by_HIV
AIDSTAR-One Increasing Access to Prevention of Mother-to-Child Transmission S...AIDSTAROne
This technical report discusses the many services needed throughout the prevention of mother-to-child transmission (PMTCT) and infant care services continuum and identifies potential barriers to service coverage, access, and utilization. AIDSTAR-One provides examples of evidence-based and emerging practices to mitigate these barriers.
www.aidstar-one.com/focus_areas/pmtct/resources/report/increasing_access_to_pmtct_services
AIDSTAR-One Prevention of Alcohol-Related HIV Risk BehaviorsAIDSTAROne
A growing body of research suggests that alcohol consumption is associated with the sexual behaviors that put people at risk for HIV. In developing countries battling severe HIV epidemics, addressing harmful drinking in conjunction with interventions to reduce sexual risk behavior may reduce HIV transmission more quickly than conventional HIV prevention interventions alone. Developed for program planners and implementers, this technical brief reviews the evidence on new and innovative programs in this emerging area. The brief catalogs what is known about the relationship between harmful alcohol use and HIV sexual risk behavior and offers a critical analysis of interventions to address the issue.
www.aidstar-one.com/focus_areas/prevention/resources/technical_briefs/prevention_alcohol_related_risk_behavior
AIDSTAR-One Meeting the Psychosocial Needs of Children Living with HIV in AfricaAIDSTAROne
An abbreviated version of the Equipping Parents and Health Providers to Address the Psychological and Social Challenges of Caring for Children Living with HIV in Africa report, this technical brief documents promising practices in critical services related to the psychological and social wellbeing of perinatally-infected children in Africa. These promising practices include the identification, testing, and counseling of children so that they are linked to appropriate care as early as possible, as well as on-going support to help children and their families manage disclosure, stigma, grief and bereavement processes.
www.aidstar-one.com/focus_areas/care_and_support/resources/technical_briefs/foundation_future
AIDSTAR-One NuLife—Food and Nutrition Interventions for UgandaAIDSTAROne
This technical report examines a nutritional assessment, counseling, and support (NACS) program in Uganda that uses a quality improvement approach to services.
www.aidstar-one.com/focus_areas/care_and_support/resources/report/nulife_food_and_nutrition_interventions_uganda
AIDSTAR-One PRASIT: Using Strategic Behavioral Communication to Change Gender...AIDSTAROne
1) The PRASIT program in Cambodia uses strategic behavioral communication to promote positive gender norms and reduce HIV risk among at-risk populations.
2) It comprises three initiatives - SMARTgirl focuses on entertainment workers, MStyle targets men who have sex with men, and You're the Man addresses gender norms among male clients of entertainment workers.
3) The initiatives use branding, peer outreach, and educational sessions to promote safer sexual practices and empower at-risk groups. The goal is to challenge norms that increase HIV vulnerability and portray at-risk populations as intelligent and able to protect their health.
AIDSTAR-One Outreach to Most-at-Risk Populations through SIDC in LebanonAIDSTAROne
Successful outreach to most-at-risk populations (MARPs) recognizes the sociocultural context and particularly the gendered norms in which MARPs live. This case study (one of nine in a series) documents how outreach workers in Lebanon raise awareness about how gender norms can increase HIV risk; deliver basic information on HIV, hepatitis, and other STIs; offer counseling to support positive behavior change, and distribute free condoms, syringes, and lubricants.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/sidc_lebanon
AIDSTAR-One STIGMA Foundation in IndonesiaAIDSTAROne
Integrating strategies to address gender inequity and change harmful gender norms is an increasingly important component of HIV programs. However, gender integration among programs targeting most-at-risk populations (MARPs) is much less prevalent. In Indonesia, the STIGMA Foundation uses a peer outreach model to help men and women who inject drugs live safer, healthier, more productive lives through community organizing, advocacy, and networking.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/STIGMA_foundation
Prompted by a growing knowledge of the complexity of HIV transmission, many countries are reassessing the nature of their HIV epidemics. "Mixed" epidemics, or concurrent epidemics experienced by both the general population and members of most-at-risk populations (MARPs), are of growing importance in HIV programming. Nigeria, a country with a range of regional and local epidemics, is now attempting to incorporate programming for MARPs into the national HIV response. This case study documents the country's analysis of its epidemics and the efforts of the Nigerian government to adjust their national strategic plan according to the results of the analysis.
www.aidstar-one.com/focus_areas/prevention/resources/case_study_series/nigeria_mixed_epidemics
AIDSTAR-One Caring for Children Living with HIV in AfricaAIDSTAROne
This report, Equipping Parents and Health Providers to Address the Psychological and Social Challenges of Caring for Children Living with HIV in Africa, provides information to better understand the psychological and social challenges faced in Africa by perinatally-infected children (aged 0-12 years), their parents/caregivers, and their health providers. It explores factors that contribute to the ability of children living with HIV to cope and thrive, and identifies the tools and approaches being used to help parents/caregivers and health providers provide psychosocial support (PSS) to these children. The report elaborates on the themes discussed in the Meeting the Psychosocial Needs of Children Living with HIV in Africa technical brief.
www.aidstar-one.com/focus_areas/care_and_support/resources/report/clhiv_pss_needs_africa
AIDSTAR-One Sex Work and Life with Dignity: Sex Work, HIV, and Human Rights P...AIDSTAROne
In Peru, where cultural norms emphasize women's subordination and the importance of masculinity, programs with a focus on gender—particularly those involving sex workers—are often underfunded and underrepresented. This case study (one of nine in a series) describes how three organizations focused on sex workers and transgendered and transsexual people have joined together to advance the rights of sex workers. The Sex Work, HIV, and Human Rights Program uses a democratic and participatory approach in order to raise awareness of human rights and advocate for sex workers' rights on both national and local levels.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/life_with_dignity_peru
AIDSTAR-One Different Needs But Equal Rights: Giving Voice to Transgender Com...AIDSTAROne
Although transgender individuals are a highly vulnerable segment of El Salvador's population, the national political climate has only recently begun to support HIV programming that is tailored to their needs. Additionally, limited access to medical services and legal protection and considerable societal stigma and discrimination means that organizations working with transgender individuals must meet a variety of complex and varied needs. This case study, one of 9 in a series, describes the challenges and successes of the Solidarity Association to Promote Human Development (ASPIDH), an NGO that promotes transgender rights via sensitization, education, and advocacy activities.
www.aidstar-one.com/focus_areas/gender/resources/case_study_series/aspidh_salvador
AIDSTAR-One Emergency Planning for ART During Post-Election Violence in KenyaAIDSTAROne
In 2007, Kenya experienced a wave of violence following its presidential elections. This case study documents the emergency plans that had been in place to ensure continuity of HIV treatment programs prior to the outbreak of violence, and the events that occurred during the period of violence. It also highlights the changes to contingency planning for HIV that have taken place since the violence ended.
www.aidstar-one.com/focus_areas/treatment/resources/case_study_series/emergency_planning_for_art_kenya
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Hiranandani Hospital in Powai, Mumbai, is a premier healthcare institution that has been serving the community with exceptional medical care since its establishment. As a part of the renowned Hiranandani Group, the hospital is committed to delivering world-class healthcare services across a wide range of specialties, including kidney transplantation. With its state-of-the-art facilities, advanced medical technology, and a team of highly skilled healthcare professionals, Hiranandani Hospital has earned a reputation as a trusted name in the healthcare industry. The hospital's patient-centric approach, coupled with its focus on innovation and excellence, ensures that patients receive the highest standard of care in a compassionate and supportive environment.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
AIDSTAR-One Civil Society and Government Unite to Respond to Gender-based Violence in Ecuador
1. AIDSTAR-One | CASE STUDY SERIES March 2012
Civil Society and Government
Unite to Respond to Gender-
Based Violence in Ecuador
I
n a small makeshift building outside a southern Quito hospital,
10 women sit together to share their stories as survivors of
violence at the hands of their husbands or intimate partners.
One woman tearfully asks the group whether it is true that she
will be liable for her boyfriend’s debts if she leaves him, as her
boyfriend has threatened her. Other women share their own
similar stories of abuse and threats used against them by their
partners. A social worker facilitates the discussion among the
Myra Betron
women, all grateful for a confidential space where they can talk
about their struggles and seek answers to their questions about
Women participating in a violence a possible life beyond their violent relationships.
support group in a Quito hospital
where the Ministry of Public Health
is piloting specialized GBV services. The building, which houses not only the counseling room but also a
space for medical examination and collection of forensic evidence,
is part of an pilot initiative by Ecuador’s Ministry of Public Health
(MSP) to institute comprehensive services for gender-based violence
(GBV) in the health system. The initiative reflects lessons learned
over more than a decade of collaboration between the government
and the nongovernmental organization (NGO) Centro Ecuatoriano
para la Promoción y Acción de las Mujeres (the Ecuadorian Center for
Women’s Advocacy and Action, or CEPAM), a largely privately funded
organization that is a leading proponent of the grassroots movement
to eliminate GBV. In 2007, the government identified the eradication
of GBV as a national priority and developed the National Plan for the
By Myra Betron Eradication of Gender Violence against Children, Adolescents and
Women. In 2009, the government eliminated the ministry responsible
for gender equality and promotion, the National Women’s Council, so
the plan is now being implemented through government-civil society
AIDSTAR-One
John Snow, Inc.
1616 North Ft. Myer Drive, 11th Floor This publication was produced by the AIDS Support and Technical Assistance Resources
Arlington, VA 22209 USA (AIDSTAR-One) Project, Sector 1, Task Order 1.
Tel.: +1 703-528-7474 USAID Contract # GHH-I-00-07-00059-00, funded January 31, 2008.
Fax: +1 703-528-7480 Disclaimer: The author’s views expressed in this publication do not necessarily reflect the views of the United States
www.aidstar-one.com Agency for International Development or the United States Government.
2. AIDSTAR-One | CASE STUDY SERIES
partnerships between various ministries and a among adults 15 to 49 years of age. An estimated
number of local NGOs who provide technical 36,000 adults aged 15 and older are living with HIV,
assistance and expertise in GBV, led by CEPAM. of which approximately 11,000 are female (Joint
United Nations Programme on HIV/AIDS 2011). Men
CEPAM has been a major force in providing care who have sex with men, transgender people, and
and support to GBV survivors as well as raising sex workers are the populations most at risk for HIV.
awareness about the issue both in Guayaquil in Prevalence of HIV is estimated to be 19.3 percent
Guayas Province, where it is located in Ecuador, among men who have sex with men in the capital,
and nationally. This case study documents both Quito, with higher prevalence in Guayaquil and
CEPAM’s comprehensive response to GBV, along the coast (International HIV/AIDS Alliance
which has been honed over many years, and the 2010). Despite some advances in recent years,
organization’s partnership with the Government access to high-quality health care, such as HIV
of Ecuador to address GBV holistically through testing and counseling, remains inadequate, and
both provision of services and prevention there are gaps in services for the most vulnerable
interventions. Methods used to develop this case populations. Stigma and discrimination, resulting
study include a review of program reports and from a culture of machismo and misinformation
evaluations; interviews with CEPAM’s management, about HIV, contribute to HIV transmission and
representatives of government agencies, and hinder progress toward achieving universal access
selected donor organizations; and focus group to prevention services. HIV prevention efforts
discussions with CEPAM staff, community with women have focused largely on prevention
volunteers, and users of GBV services and youth of mother-to-child transmission. Gender-based
programs. violence has not been viewed as a driver of HIV,
and therefore the national HIV response has not
Gender-based Violence and included official significant strategies to address
GBV. One exception is an incipient effort in the
HIV in Ecuador MSP to include the link between GBV and HIV in
guidelines and protocols as well as training modules
Gender-based violence: As in many to improve the health sector response to violence.
countries worldwide, GBV in Ecuador is a common
occurrence that is widely accepted by society.
According to the 2004 Demographic and Maternal-
Infant Health Survey, approximately one in three (31
Policy Environment
percent) ever-married or -partnered women aged
15 to 49 years had experienced physical intimate Currently, Ecuador has strong political will and
partner violence in their lifetime (Centro de Estudios comprehensive laws and policies regarding GBV.
de Población y Desarrollo Social 2004). Over 40 The Law against Violence toward Women and the
percent had experienced verbal or psychological Family (Law 103) was enacted in 1995, but few
violence, and 11.5 percent had experienced rape. women who experience GBV actually report this
The survey also found that about seven percent of to the authorities or seek judicial redress due to
all females aged 15 to 49 had been forced to have multiple reasons that include lack of knowledge
sex. about their rights; stigma, shame, or fear of
discrimination; fear of reprisal from the perpetrator;
HIV: Ecuador has a concentrated HIV epidemic and the complexity of the legal system, among
with a national average prevalence of 0.4 percent others. Ecuador does have a system of Comisarías
2 AIDSTAR-One | March 2012
3. AIDSTAR-One | CASE STUDY SERIES
para la Mujer y las Familias (Police for Women and Families), which
is a special justice system meant to deal with domestic violence BOX 1. POLICE FOR
in a specialized and efficient manner (see Box 1). However, there WOMEN AND FAMILIES
are only 33 units of the Police for Women and Families set up
In 1994, Ecuador established
throughout the entire country, 7 of which are in the two largest
its first Police for Women
cities—Guayaquil and Quito—while the remaining 26 are spread
and Families in Guayaquil
among 215 districts. Thus, according to one expert interviewed,
as a way to guarantee that
many women still have to pass through the formal justice system,
domestic violence does not go
where women face further discrimination and abuse. For example,
unpunished. Staff can only attend
CEPAM legal staff noted that many public servants in the justice
to cases that involve what are
system believe that a woman can provoke sexual violence due to
considered minor infractions;
her actions or the manner in which she dresses.
anything more—that is, any
Law 103 also requires the police, personnel of the Ministry of offense or injury that causes
Government, and health professionals to report any cases of GBV a three-day absence from
of which they are aware to the authorities. In 2008, Ecuador passed work—is considered a crime
a revised constitution that also recognizes the rights of vulnerable and is referred to the police.
groups, including women, children, and adolescents, to be free Punishment imposed by the
from violence, mistreatment, and sexual exploitation. There are still Police for Women and Families
several barriers that prevent due justice for perpetrators of GBV. can include prison time for up
For example, police often take bribes from perpetrators to refrain to seven days, reparation for
from processing cases, and health providers fear involvement in injuries or goods destroyed, or
lengthy court deliberations, threats from perpetrators, and slander community service. Protection
by lawyers. These concerns among health care providers are orders are also issued on request
more acute in some rural and small communities where providers of the plaintiff.
are well known. Despite supportive laws and policies, much work
Source: Camacho and Jácome
still needs to be done to change the underlying social norms that
2008.
accept GBV.
The government has also recognized GBV as an issue affecting
human rights, public health, development, and citizen safety
(Republic of Ecuador 2007) through specific policies and programs.
Most notably, President Correa passed Presidential Decree No.
620 in 2007, which identifies the eradication of GBV as a state
policy. Based on this decree, a team of experts developed the
National Plan, which was to be implemented by multiple agencies
that span a broad range of sectors, including governance, public
health, education, justice, women, children, and families. The
National Plan is coordinated by a technical secretariat made up of
representatives from the Ministry of Justice, Ministry of Education,
MSP, Ministry of Government, the Ministry of Economic and
Social Investment (MIES), the National Council of Children and
Adolescence, and the National Institute of Children and Families.
The formation of this multi-sectoral coordinating body was done
Civil Society and Government Unite to Respond to Gender-Based Violence in Ecuador 3
4. AIDSTAR-One | CASE STUDY SERIES
by design in order to avoid any one agency, likely CEPAM was formed in 1983, originally with the
an underfunded one, to be unduly burdened with vision of promoting and defending women’s rights
leading the implementation of the plan. and improving the disadvantaged status of women
in Latin American society. At that time, the focus
Over the past three years, since the launch of the of CEPAM’s work was to support the development
National Plan, the government and its partners of women’s community-based organizations and
have made considerable progress in establishing groups to increase the visibility of women’s issues,
the infrastructure and human resources needed including the undervaluation of domestic work
to begin ensuring access to justice and scale-up and women’s limited participation as leaders in
of comprehensive services for GBV survivors, the community. CEPAM also attended to women’s
including health services and psychological, social, reproductive health needs, which were often
and economic support. The National Plan is still neglected by Ecuadorian society at large.
in its early stages of implementation in part due to
limited technical capacity and insufficient funding. This led the organization to identify violence
On one hand, government is reliant on civil society against women as a key determinant of women’s
programs that have many more years of experience health. In 1990, CEPAM opened a health center
addressing GBV but are limited in size and scope; in Guasmo, one of the poorest neighborhoods
on the other, the government has not assigned a of Guayaquil. This center, run largely by local
budget for the National Plan in its entirety. Instead, women working for a minimal stipend, gave the
each government agency named in the National women of Guasmo access to a broad range of
Plan is responsible for designating funds to achieve health services, including management of the
its objectives. As a result, the greatest progress has consequences of domestic and sexual violence—
been made in improving laws and access to justice the most common reason for women’s return
and implementation of a national campaign to visits. The Guasmo center was also CEPAM’s first
change social norms that perpetuate GBV (see Box experience in collaborating with the government in
2). The improvement of health and social services service provision. Over 12 years of collaboration,
is still limited to small-scale, formative efforts that CEPAM, the community, and the provincial
are being supported by organizations like CEPAM. government developed a model of care with special
emphasis on sexual and reproductive health and
GBV, which is now financed and successfully run
by the provincial government. Key to the success
CEPAM Program Objectives is the fact that the primary physician had been an
employee of CEPAM for 15 years; currently, her
CEPAM’s mission is to develop new attitudes, employment contract is both with CEPAM and with
practices, and public policies that improve people’s the MSP.
lives by promoting gender equality between men
and women. The organization’s specific objectives Shortly after the establishment of the Guasmo
are preventing and mitigating the effects of Health Center, CEPAM also began offering advisory
violence against women, and promoting sexual legal services for women dealing with such issues
and reproductive health and rights through service as divorce, property rights, government registration
provision, advocacy, awareness-raising, and for legal identity cards, and GBV. Based on high
behavior change and community mobilization community demand, this program moved from
campaigns. informing women of their basic rights to offering
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BOX 2. GOALS AND STRATEGIES OF THE 2007 NATIONAL PLAN FOR THE
ERADICATION OF GENDER VIOLENCE AGAINST CHILDREN, ADOLESCENTS AND
WOMEN1
1. Transforming sociocultural patterns that dictate that gender violence is natural: A major component of the National
Plan is the countrywide mass media communication campaign, “Reacciona, Ecuador: El Machismo es Violencia”
(React, Ecuador: Machismo Is Violence), which includes television spots, posters, and other social media. The
budget for the National Plan currently allocates most of its resources to this component of the plan.
2. Strengthening a comprehensive system to protect and restore the rights of GBV survivors: This component entails
strengthening existing GBV services so that they provide a multi-sectoral response. As an initial step, the MIES
is supporting five civil society organizations throughout the country that are already providing these multi-sectoral
services, including CEPAM in Guayaquil. The MIES is also slated to provide financial support to five shelters for
women and children who are experiencing violence. The Ministry of Government is piloting the integration of multi-
sectoral services (psychological and socioeconomic support, legal advice, and referrals to health services) into two
public justice centers in Chone and Durán. These centers bring together various actors in the justice sector, including
the police, prosecutors, and the Police for Women and Families, to provide relevant services to those in need. Finally,
in 2009, the MSP developed and released new guidance on integrated care for survivors of violence, which updated
previous protocols released in 1995. The MSP is training health care providers on these norms and is pilot testing
the integration of specialized rooms and services for GBV survivors—including medical, psychological, and social
services—in six hospitals throughout the country.
3. Developing a registry to document cases of GBV in Ecuador: The goal of this component is to have one national
registry that will receive information from various institutions in the health, justice, and education sectors. However,
interviewees for this case study said that this component of the plan has made little progress.
4. Increasing access to justice: This component is designed to reduce impunity for perpetrators of GBV; provide free,
efficient, and immediate access to justice for victims; and ensure that the investigative process does not revictimize
survivors. Case study interviewees reported that progress on this component has mainly consisted of integrating
multi-sectoral services into the Police for Women and Families and prosecutors’ offices, where women report cases
of violence. However, in 2004 and 2009, laws were revised to detail responsibilities for providers (collecting forensic
evidence and providing expert opinions) and judicial entities (procedures for processing or prosecuting cases). The
MSP has also made efforts to increase the number of forensic doctors in the country—currently there are just 53—
through training and accreditation. Finally, interventions under this component include workshops to transform sexist
and misogynistic attitudes among police and judges who are easily bribed by perpetrators and thus prevent due
justice.
5. Institutionalizing the response to GBV outlined in the National Plan: This component, designed to ensure a
sustainable response to GBV, includes assigning budgets; coordinating activities across sectors and at national,
provincial, and municipal levels; decentralizing services and activities; and monitoring and evaluation. The objective
of this component is to ensure that strategies to respond to GBV are an obligatory fixture in each ministry. To date,
very little has advanced under this objective. Challenges identified include limited budgets, which have not been
optimized and channeled to high-priority interventions agreed upon by all sectors; the government’s inexperience in
coordinating with civil society; and lack of technical capacity and political will at lower levels of government.
1
The advances highlighted in Box 2 are for the timeframe of 2007 to 2009, prior to data collection for this case study, which was done mid-2010.
Civil Society and Government Unite to Respond to Gender-Based Violence in Ecuador 5
6. AIDSTAR-One | CASE STUDY SERIES
health and counseling services. Additionally, in can provide economic support, such as the National
1998 CEPAM established a center for adolescents, Institute of Family and Children.
where peer educators provide information on sexual
and reproductive health and life skills, including Guasmo Health Center: The Guasmo Health
ways to address violence. Peer educators are Center now provides a full range of health services.
taught to recognize and refer to CEPAM cases of Providers within general medicine, obstetrics, and
violence that they identify in schools or among their family planning services conduct GBV screening
peers. when they suspect violence and provide follow-up
care when violence is identified. Important features
Today, CEPAM’s work on GBV, which includes of GBV services include regular training on GBV
family violence (against children and adolescents), for clients and staff, psychological services for
violence against women, and sexual violence, survivors, and referral to specialized GBV services
focuses on service provision with complementary such as CEPAM for continuous counseling and to
activities for prevention and advocacy. In addition to the Police for Women and Families for legal follow-
collaboration at the Guasmo Health Center, CEPAM up.
operates a center that offers comprehensive
GBV services, including health, psychosocial Community-based rights counselors:
support, and legal services, and is the site for peer Donor funding allowed CEPAM Guayaquil to train
education, prevention activities, and CEPAM’s several “rights counselors.” These counselors
administrative and research-related work. CEPAM serve as advocates for GBV survivors by orienting
also has legal staff on-site at the Police for Women survivors to their rights, referring them to GBV
and Families and prosecutor’s office of Guayas services, and when necessary, accompanying
Province as part of a pilot program supported by the them to services. Each counselor, a GBV survivor,
national government, as described subsequently. underwent an intensive process of psychological
CEPAM’s major GBV programs can be described support and training to become a community
as follows. educator and advocate for women’s rights,
particularly related to GBV. The rights counselors
refer GBV survivors to a network of services that
Comprehensive GBV services: CEPAM
in Guayaquil is one of the few organizations in
Ecuador that provides comprehensive services for
GBV survivors, including legal aid, psychological
counseling services, access to medical attention,
and social support. A multi-sectoral team
provides these services, now at no cost thanks
to government funding through the MIES. When
a survivor arrives at CEPAM for services, she
is first interviewed by an intake counselor who
identifies her specific needs and assesses her risk.
She is then referred to a service provider, such
as a psychologist, legal counselor, social worker,
Myra Betron
or doctor, depending on her immediate need. If
necessary, the survivor may also be referred to a
shelter, specialized health service, or agency that Obstetrician and patients at the Guasmo Health Center.
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7. AIDSTAR-One | CASE STUDY SERIES
were established with support from the Inter- and protocols and accompanying operational
American Development Bank. Ten years after guidelines for integrated GBV services. Likewise,
their training, these counselors are still known and the National Institute of Family and Children (part of
consulted by community members. the MIES) has sought CEPAM Guayaquil’s technical
assistance to develop a service model for GBV. In
Prevention activities: CEPAM Guayaquil addition, the MIES is supporting a pilot project to
conducts prevention activities to complement its develop integrated services in the Police for Women
service provision. These activities focus on three and Families of Guayas Province and in the Guayas
main areas: Province prosecutor’s office.
1. Raising awareness of the right to live free of CEPAM Guayaquil has also been tasked with a
violence through workshops, discussions, and series of activities to support the MIES and MSP in
films in the general community and in schools the implementation of activities under the National
Plan. These include:
2. Discussing masculinity, including nonviolence,
• Training health providers working in hospital
in youth sexual and reproductive health peer
emergency rooms on how to identify and
educator groups
register cases of GBV, and how to provide
comprehensive management in those cases,
3. Conducting home visits to provide counseling
including addressing concerns about HIV, other
and education to improve parent-child
sexually transmitted infections, and reproductive
communication.
health
Advocacy and technical assistance to • Training a team of MSP trainers in six provinces
the government: CEPAM, as an organization on the updated MSP guidance on providing
and part of the women’s movement made up of integrated care to survivors of GBV
several organizations in Ecuador, conducts ongoing
advocacy with the government at municipal, district, • Establishing and piloting a center that specializes
and national levels. Advocacy takes the shape in services for sexual violence for the MIES
not just of raising awareness and demanding
• Developing a model for a legal response to GBV
change, but also working closely with government
within the justice system, particularly on the part
to design GBV response strategies and programs.
of prosecutors, commissioners, and the police,
For example, CEPAM participates significantly
for the Ministry of Government
in civil society roundtables held by the municipal
government of Guayaquil in order to encourage • Integrating a gender perspective, including
the establishment of community-based structures GBV, within the National Institute of Family
to respond to GBV, which is now a process in and Children, which currently specializes in
development. addressing violence and abuse against children
and adolescents.
At the national level, CEPAM is currently providing
technical assistance to help the MIES integrate
its comprehensive model of services into public What Worked Well
institutions throughout Ecuador. The MIES has
contracted CEPAM in Guayaquil to provide Multi-sectoral approach: A defining feature
technical assistance in the development of norms of CEPAM’s programs is that they provide multiple
Civil Society and Government Unite to Respond to Gender-Based Violence in Ecuador 7
8. AIDSTAR-One | CASE STUDY SERIES
services. This approach allows users of CEPAM’s staff and counselors reported major life changes
services to receive psychological, health, legal, resulting from this process, including divorce from
and social work services all in one location—an an abusive partner, employment with CEPAM, and
important factor for women who have limited resumption of formal studies. The organization has
economic resources or time. An evaluation of empowered many participants to educate others
CEPAM’s services identified a key feature of their around sexual and reproductive health and rights.
multi-sectoral work as the horizontal structure of Several community-based counselors and youth
how each team relates to each other, allowing educators interviewed reported that they continue
service providers to build close relationships with to provide information about GBV in the community
clients (Quevedo Terán and Condo 2010). Where and at CEPAM’s center.
CEPAM cannot provide the specialized care
needed, a functional referral system is in place. “CEPAM has shown us that we
This system is not formalized through directories or
standardized referral procedures, but CEPAM staff
as women are worthy, and we are
said that they refer clients to organizations where important because we are pivotal
they know high-quality attention is provided. to our children…we can be good
Extensive follow-up and guidance for GBV
examples for our children.”
survivors: CEPAM staff follows women closely –Female GBV survivor and client of
through the long legal and counseling processes as
an important strategy to help women out of violent CEPAM services
situations. Because women perceive violence as a
natural part of their intimate partner relationships, High credibility combined with advocacy
they often resign themselves to staying with at multiple levels: Its many years of advocacy
their violent partners. CEPAM staff has found it and community mobilization have garnered strong
effective to motivate clients to continue with legal political support for CEPAM, improving the NGO’s
or separation processes and self-transformation opportunities to seek sustainability. Because of its
through continual therapy, talks, or films about other national-level advocacy and its many years of work
women who have survived violence. Recognizing in GBV, including collaboration with the government,
that many women would prefer not to leave their CEPAM has been able to position itself as a leading
families, CEPAM also coaches families on conflict expert on GBV in Ecuador. As such, CEPAM and its
mediation and communication skills in order to former and present staff have been involved in the
encourage each member of the family to avoid the design of government structures and programs to
use of violence in times of conflict. address GBV, namely the National Plan. This has
helped the NGO secure government funding—for
Increasing individual awareness of GBV example, to support implementation of the National
and reproductive health rights: CEPAM Plan.
Guayaquil has been able to raise awareness among
community-based counselors about their rights with Government-civil society partnership:
respect to GBV. Based on interviews conducted CEPAM’s collaboration with government has
during the field work, community-based counselors resulted in improved quality of GBV services.
said that CEPAM workshops have changed their Collaboration with the Police for Women and
lives by allowing them to examine their experiences Families and the prosecutor’s office has improved
and get support from other participants. CEPAM understanding within the justice system of the
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9. AIDSTAR-One | CASE STUDY SERIES
multifaceted needs of women experiencing overextending itself by trying to support the
violence. Likewise, the presence of CEPAM staff government’s efforts to scale up GBV services. This
at the Guasmo Health Center raises the visibility can be particularly problematic if the government
of these issues and sensitizes government staff. takes advantage of CEPAM’s good work without
CEPAM, in turn, provides expertise and follow-up providing adequate funding and political support.
care, such as in social support, the government Moreover, government overdependence on CEPAM
entities cannot. could very likely result in stymied government-
run services and cause a vicious cycle of
overdependence on CEPAM.
Challenges
Continuing culture of violence: Interview
Need for coordination: CEPAM staff noted respondents said that the perception of violence
that collaboration with a multi-sectoral team as a “natural” part of life is a major barrier to their
requires ongoing meetings and communication. work on GBV. CEPAM staff said, for example, that
With the elimination of the National Women’s despite their significant impact within institutions for
Council, the government has recognized the need public justice, many people in the justice sector still
for a dedicated coordinating body to manage and know little about the rights of women, children, and
prioritize the missions of each of the institutions youth with respect to violence. The justice sector
involved in implementing the National Plan. requires continuous, broad-based sensitization and
behavior change campaigns to transform gender-
Sustainability: CEPAM receives piecemeal
inequitable norms and attitudes.
funding from various international donors, which
results in start-and-stop activities. In the case of the
community-based rights counselors, for example,
when the donor-funded project that built their
Recommendations
capacity and initiated activities came to an end,
Take an integrated approach: An effective
the counselors stopped meeting with multi-sectoral
response to GBV requires an integrated approach—
GBV networks to coordinate their detection and
including health, legal, and social services, as
referral efforts. Similarly, several staff members
well as economic support where possible—so
noted that they work on short-term contracts that
that women can overcome their violent situations.
in some cases were terminated because of lack of
CEPAM has integrated into its activities reflections
funding.
on gender norms and rights with the intent of
Scale-up: In this early stage of implementing addressing myths about men’s and women’s
the National Plan in Ecuador’s major cities, there roles in relationships and promote gender equity.
are many challenges to effectively reaching GBV Although it is not always possible to offer each of
survivors. In more remote areas of the country, these services in one location, organizations should
where even fewer or no NGOs are present to build alliances with and refer to other organizations
provide support, there are vast gaps in GBV that offer services they cannot offer. This approach
services. Ecuador is making a respectable effort facilitated CEPAM’s comprehensive response. For
to start but will face an even larger challenge in example, at the CEPAM Guayaquil Health Center,
scaling up GBV services to the rest of the country. the obstetrician identified the need for on-site legal
services, and at the Police for Women and Families,
Overdependence on CEPAM by users mentioned that they would like to see medical
government: CEPAM may run the risk of services.
Civil Society and Government Unite to Respond to Gender-Based Violence in Ecuador 9
10. AIDSTAR-One | CASE STUDY SERIES
Do not forget men: The lack of activities that on a large scale, CEPAM is also strengthening
work with men to change norms and attitudes that and fostering community advocacy and citizen
perpetuate violence is a significant gap in CEPAM’s participation in policy development to ensure
programming. Some focus group participants said that the government fulfills its commitments to
that their male partners did not support the way addressing GBV.
their attitudes had changed as a result of CEPAM’s
services, and several wished CEPAM would work Provide long-term technical assistance
with men as well. CEPAM’s Integrated Center for to governments to ensure sustainability:
Adolescents and Youth does work with male youth, CEPAM’s experiences at the Guasmo Health
and the center is currently training three male Center, the Police for Women and Families of
youth as facilitators on the topic of masculinity. Guayas, and the Guayas Province prosecutor’s
Focus group discussions with youth indicated some office show that it is possible for government and
positive impact from these efforts, such as changes civil society to partner in the implementation of
in violent attitudes and behavior, particularly gang services. However, this is hardly an overnight
violence. As the organization grows, expanding process. It took 12 years for CEPAM’s model
this work to adult men may be another important of care to be successfully transferred to the
strategy. At the very least, collaboration with other government, and the center’s coordinator remains
programs that do work with men, or advocating for employed by CEPAM.
such programs with the government, would be a Clearly establish roles and
logical next step. responsibilities within the partnership:
The balance between civil society participation
Frame GBV as a broader health and
and government leadership is a fine one.
development issue: CEPAM sees GBV as
Interviewees cautioned that too much participation
not simply an issue for individual men and women
and leadership by civil society can lead to
in violent relationships, but as a social problem
government over-reliance on civil society to assume
requiring action and mitigation from institutions
responsibility in the response to GBV—resulting,
and community members alike. GBV is a health
for example, in a failure to fund activities planned
problem that affects sexual, reproductive, maternal,
under the leadership of civil society organizations.
and mental health, as well as HIV, but it is also a
One strategy to ensure that the government fulfills
social problem with profound effects on community
its role is to limit civil society participation, in initial
and national development. Linking GBV to these
phases of implementation, to representatives and
wider development concerns can place the issue
organizations that compete for technical assistance
at a higher priority level and increase support for
roles. There should be a mechanism for input from
its eradication. In Ecuador, where citizen safety is a
all parties involved in the partnership. In addition,
priority, framing GBV as a problem of security was
the government should ensure appropriate funding
strategic to CEPAM’s efforts to advance the GBV
levels for all aspects of the National Plan, which
agenda in higher reaches of government.
includes prevention and resources as well as
awareness raising.
Mobilize and engage others: To improve
its long-term political and financial sustainability,
CEPAM Guayaquil found it necessary to increase
advocacy to persuade the government to assume
Future Programming
greater responsibility in providing GBV services. CEPAM staff currently counsel survivors about
Realizing that true change requires advocacy the potential health consequences of violence,
10 AIDSTAR-One | March 2012
11. AIDSTAR-One | CASE STUDY SERIES
particularly sexual violence, and refer the survivor Progress and Challenges under IMPACT 2010. Available
or her family to facilities where sexually transmitted at www.aidsalliance.org/linkingorganisationdetails.
infection services and HIV testing and post- aspx?id=28 (accessed March 2011)
exposure prophylaxis are available. CEPAM would
Joint United Nations Programme on HIV/AIDS. 2011.
like to provide these services but does not have Country Profile: Ecuador. Available at www.unaids.org/
the resources or the proper facilities (such as a en/regionscountries/countries/ecuador (accessed March
laboratory), and current law allows the provision of 2011)
post-exposure prophylaxis only at hospitals. Yet in
hospitals, the availability and accessibility of these Quevedo Terán, A., and T. Condo. 2010. Evaluación de
services are limited because providers still have la Calidad de los Servicios de Atención a la Violencia
limited knowledge about survivors’ needs and rights de Género, Intrafamiliar y Sexual 2009-2010, CEPAM.
to these services. CEPAM will continue to advocate Guayaquil, Ecuador: CEPAM Guayaquil.
to persuade the government to decentralize Republic of Ecuador. 2007. Plan Nacional para la
provision of post-exposure prophylaxis, emergency Erradicación de la Violencia de Género hacia la Niñez,
contraception, and HIV testing for GBV survivors, to Adolescencia y Mujeres. Quito, Ecuador: Gobierno
increase access to these critical services. g Nacional de la República del Ecuador.
RESOURCES ACKNOWLEDGMENTS
Centro Ecuatoriano para la Promoción y Acción de The author would like to thank CEPAM staff in Guayaquil
las Mujeres Guayaquil. 2007. Conociendo…Exigimos who took the time to organize interviews with key
Nuestros Derechos: Guías de Capacitación Sobre informants and program participants and accompany
Violencia Intrafamiliar y Derechos de Familia. Guayaquil, her during the process. These include Patricia Reyes,
Ecuador: CEPAM Guayaquil. Tatiana Ortiz, Marjorie Lopez, Laura Sanchez, Annabelle
Arevalo, and Sara Martillo. Likewise, the author
Ministerio de Salud Pública del Ecuador. 2009. Normas appreciates the time of all key informants among CEPAM
y Protocolos de Atención Integral de la Violencia de staff as well as the provincial and national government.
Género, Intrafamiliar Y Sexual por Ciclos de Vida. In particular, information and leadership provided by
Primera edición. Quito, Ecuador: Ministerio de Salud Miricam Alciver and Mercy Lopez at the government
Pública del Ecuador. level were invaluable. The author acknowledges
Rosa Salazar for her documentation of focus group
discussions with CEPAM’s Guayaquil staff and
REFERENCES participants. Thanks to the U.S. President’s Emergency
Plan for AIDS Relief Gender Technical Working Group
Camacho, G., and N. Jácome. 2008. Mapeo de las for their support and careful review of this case study.
Comisarías de la Mujer y la Familia en el Ecuador 2008. Finally, heartfelt thanks go to the survivors of violence
Quito, Ecuador: Centro de Planificación y Estudios who shared their stories.
Sociales.
Centro de Estudios de Población y Desarrollo Social. RECOMMENDED CITATION
2004. Encuesta Demográfica y de Salud Materna e
Infantil. Available at www.cepar.org.ec/endemain_04/ Betron, Myra. 2012. Civil Society and Government Unite
nuevo05/indice.htm (accessed March 2011) to Respond to Gender-Based Violence in Ecuador. Case
Study Series. Arlington, VA: USAID’s AIDS Support and
International HIV/AIDS Alliance. 2010. Ecuador. Alliance Technical Assistance Resources, AIDSTAR-One, Task
Country Studies: A Global Summary of Achievements, Order 1.
Civil Society and Government Unite to Respond to Gender-Based Violence in Ecuador 11
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