Adolescent Girls Need Tailored Aid for Gender-Based Violence in Humanitarian Settings

By Carolyn Crist

December 28, 2020

NEW YORK (Reuters Health) - Adolescent girls often fall through the cracks of humanitarian programming due to an intersection of age and gender, according to a group of social workers and public-health specialists.

Traditional gender-based violence programs tend to focus on adult women, and child protective services tend to focus on younger ages, leaving out those between ages 10-19, Dr. Lindsay Stark of Washington University in St. Louis, Missouri, and colleagues note in The Lancet Child and Adolescent Health.

"Adolescent girls can also be more hidden from the public sphere due to early marriage, child rearing or other domestic responsibilities and restrictive gender norms, making them more difficult to access," she told Reuters Health by email.

With a global pandemic, natural disasters and long-term political conflicts in many countries, nearly 168 million people worldwide need humanitarian aid, and that number is expected to grow, Dr. Stark said.

Adolescent girls experience high levels of rape, physical abuse and emotional abuse, she added, which affects the girls, their families and the surrounding community. The humanitarian sector is developing new strategies to help adolescent girls, which researchers are testing now to seek funding and support from policymakers.

"These girls have a unique set of needs, which often requires tailored or targeted programming," she told.

Few peer-reviewed studies have focused on the prevalence of gender-based violence in humanitarian settings, the authors write, especially among girls. A handful of studies in sub-Saharan Africa suggest that about 40% of female adolescents experience some form of intimate-partner violence, and more than a quarter experience non-partner sexual violence. Adolescent girls have reported that they were raped, kidnapped, and forced into sexual slavery, child marriage and female genital mutilation.

Dr. Stark and colleagues propose an adapted framework to understand gender-based violence among adolescent girls and identified several barriers that may prevent humanitarian programs from providing aid.

The framework includes factors at the individual, relational, community and societal levels, including submissive femininity and dominant masculinity, stigma and silence in the family, religious and cultural justification of abuse, and discriminatory laws and practices.

Overall, one of the best interventions seems to be access to healthcare focused on the survivor's needs, the authors write, especially sexual and reproductive healthcare. Mobile clinics, free transportation and atypical office hours can help adolescent girls access services. As part of this, humanitarian programs can also offer mental-health services, psychosocial support and safe spaces for women and girls.

Economic-empowerment programs have also helped women to earn their own income and receive food assistance, the authors write, which should be targeted toward adolescent girls as well.

In some cases, however, these programs perpetuate violence in cultures where men are expected to be the financial breadwinners. Programs that combine financial empowerment with social-norms programming have been the most effective, according to Dr. Stark and her colleagues. These programs promote gender equity and call on male leaders to publicly denounce gender-based violence.

Importantly, the authors write, targeted programs need to consider the cultural context and include women and girls in the community to determine what may work best.

"We need to hear from girls about the work they want and build job training and access - likely focused on self-employment - using mentors in the community who have designed their own businesses," said Dr. Nancy Glass of the Johns Hopkins Center for Global Health in Baltimore, Maryland. Dr. Glass, who wasn't involved with this paper, has researched gender-based violence in Africa and South America.

"We should prioritize the voice of adolescent girls and advocates," she told Reuters Health by email. "Parents, teachers, business and community leaders, and governmental leaders need to be engaged as part of the solution."

The upheaval that accompanies a humanitarian crisis creates an opening for structural and social change, the authors write.

"Addressing violence can't wait," said Maureen Murphy of The Global Women's Institute at George Washington University in Washington, D.C. Murphy, who also wasn't involved with the new paper, has researched gender-based violence in Africa and Asia.

"We need to think about how to prevent violence against adolescent girls and better support girls who are survivors of violence, even in the midst of wider displacement and conflict," she told Reuters Health by email.

SOURCE: The Lancet Child and Adolescent Health, online November 19, 2020.