TY - JOUR
T1 - Comprehensive development and testing of the ASIST-GBV, a screening tool for responding to gender-based violence among women in humanitarian settings
AU - Wirtz, A. L.
AU - Glass, N.
AU - Pham, K.
AU - Perrin, N.
AU - Rubenstein, L. S.
AU - Singh, S.
AU - Vu, A.
N1 - Funding Information:
Our thanks are due to the displaced women and survivors in Ethiopia and Colombia who provided their experiences and input to contribute to the development and testing of the GBV screening tool. Additional gratitude is due to Decssy Cuspoca, Amsale Aberra, and Gabriel Jacquet, who supported field research. Thanks are due members of UNHCR Geneva, Margriet Veenma; UNHCR Ethiopia: Catherine Evans, Dr. Dejene; and UNHCR Colombia: Terry Morel, Saskia Loochkartt, and Teemar Kidane who supported this project from conceptualization through implementation. We thank the Ministry of Health and Social Protection in Colombia, particularly Susanna Helfer-Vogel and Rocío Gutiérrez, as well as Dr. Tesafaye and colleagues in ARRA in Ethiopia for their review and support of this project. We thank Pastoral San José de Guaviare, Hospital José María Hernández, and UNHCR suboffices for their efforts and use of their facility for research in Colombia. We thank the International Rescue Committee, PAPDA, ARRA, and UNHCR suboffices for their efforts and use of facilities for research in Ethiopia. This project was funded as a gift of the U.S. Government (U.S. Department of State, Bureau of Population, Refugees, and Migration). Opinions expressed in the article do not necessarily reflect UNHCR’s position or opinions.
Publisher Copyright:
© 2016 Wirtz et al.
PY - 2016/4/20
Y1 - 2016/4/20
N2 - Background: Conflict affected refugees and internally displaced persons (IDPs) are at increased vulnerability to gender-based violence (GBV). Health, psychosocial, and protection services have been implemented in humanitarian settings, but GBV remains under-reported and available services under-utilized. To improve access to existing GBV services and facilitate reporting, the ASIST-GBV screening tool was developed and tested for use in humanitarian settings. This process was completed in four phases: 1) systematic literature review, 2) qualitative research that included individual interviews and focus groups with GBV survivors and service providers, respectively, 3) pilot testing of the developed screening tool, and 4) 3-month implementation testing of the screening tool. Research was conducted among female refugees, aged ≥15 years in Ethiopia, and female IDPs, aged ≥18 years in Colombia. Results: The systematic review and meta-analysis identified a range of GBV experiences and estimated a 21.4 % prevalence of sexual violence (95 % CI:14.9-28.7) among conflict-affected populations. No existing screening tools for GBV in humanitarian settings were identified. Qualitative research with GBV survivors in Ethiopia and Colombia found multiple forms of GBV experienced by refugees and IDPs that occurred during conflict, in transit, and in displaced settings. Identified forms of violence were combined into seven key items on the screening tool: threats of violence, physical violence, forced sex, sexual exploitation, forced pregnancy, forced abortion, and early or forced marriage. Cognitive testing further refined the tool. Pilot testing in both sites demonstrated preliminary feasibility where 64.8 % of participants in Ethiopia and 44.9 % of participants in Colombia were identified with recent (last 12 months) cases of GBV. Implementation testing of the screening tool, conducted as a routine service in camp/district hospitals, allowed for identification of GBV cases and referrals to services. In this phase, 50.6 % of participants in Ethiopia and 63.4 % in Colombia screened positive for recent experiences of GBV. Psychometric testing demonstrated appropriate internal consistency of the tool (Cronbach's α = 0.77) and item response theory demonstrated appropriate discrimination and difficulty of the tool. Conclusion: The ASIST-GBV screening tool has demonstrated utility and validity for use in confidential identification and referral of refugees and IDPs who experience GBV.
AB - Background: Conflict affected refugees and internally displaced persons (IDPs) are at increased vulnerability to gender-based violence (GBV). Health, psychosocial, and protection services have been implemented in humanitarian settings, but GBV remains under-reported and available services under-utilized. To improve access to existing GBV services and facilitate reporting, the ASIST-GBV screening tool was developed and tested for use in humanitarian settings. This process was completed in four phases: 1) systematic literature review, 2) qualitative research that included individual interviews and focus groups with GBV survivors and service providers, respectively, 3) pilot testing of the developed screening tool, and 4) 3-month implementation testing of the screening tool. Research was conducted among female refugees, aged ≥15 years in Ethiopia, and female IDPs, aged ≥18 years in Colombia. Results: The systematic review and meta-analysis identified a range of GBV experiences and estimated a 21.4 % prevalence of sexual violence (95 % CI:14.9-28.7) among conflict-affected populations. No existing screening tools for GBV in humanitarian settings were identified. Qualitative research with GBV survivors in Ethiopia and Colombia found multiple forms of GBV experienced by refugees and IDPs that occurred during conflict, in transit, and in displaced settings. Identified forms of violence were combined into seven key items on the screening tool: threats of violence, physical violence, forced sex, sexual exploitation, forced pregnancy, forced abortion, and early or forced marriage. Cognitive testing further refined the tool. Pilot testing in both sites demonstrated preliminary feasibility where 64.8 % of participants in Ethiopia and 44.9 % of participants in Colombia were identified with recent (last 12 months) cases of GBV. Implementation testing of the screening tool, conducted as a routine service in camp/district hospitals, allowed for identification of GBV cases and referrals to services. In this phase, 50.6 % of participants in Ethiopia and 63.4 % in Colombia screened positive for recent experiences of GBV. Psychometric testing demonstrated appropriate internal consistency of the tool (Cronbach's α = 0.77) and item response theory demonstrated appropriate discrimination and difficulty of the tool. Conclusion: The ASIST-GBV screening tool has demonstrated utility and validity for use in confidential identification and referral of refugees and IDPs who experience GBV.
KW - Colombia
KW - Conflict
KW - Ethiopia
KW - Gender-based violence
KW - Humanitarian setting
KW - Internally-displaced person
KW - Refugees
KW - Screening
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U2 - 10.1186/s13031-016-0071-z
DO - 10.1186/s13031-016-0071-z
M3 - Article
C2 - 27099617
AN - SCOPUS:84966335538
SN - 1752-1505
VL - 10
JO - Conflict and Health
JF - Conflict and Health
IS - 1
M1 - 71
ER -