Category Archives: Domestic violence

Making a case for the integration of mental health screening into HIV care

Source: Journal of Interpersonal Violence

Screening for Traumatic Experiences and Mental Health Distress Among Women in HIV Care in Cape Town, South Africa

“Traumatic events can negatively affect clinical outcomes among HIV positive women, particularly when those events result in ongoing psychological distress. Consequently, there have been calls to integrate screening and treatment of traumatic experiences and associated mental health disorders into HIV care. In South Africa, screening for traumatic experiences and mental health is not a routine part of HIV care. […]

Participants [of this study] almost unanimously agreed that it would be appropriate and acceptable to screen all women in the clinic setting for trauma and mental health symptoms. […]

The high prevalence of traumatic experiences and psychological distress in this study highlights an urgent need to integrate screening into routine HIV care. The study provides evidence of the acceptability of screening for trauma and mental health symptoms among HIV positive women, at the critical points of care engagement when they are initiating ART or have defaulted on ART. In addition, there is need to link women screened to interventions and services, as part of trauma informed HIV care.”

Full text available on Sage Journals

 

Violence against Women during and after pregnancy

Women are particularly vulnerable to domestic abuse during and after their pregnancy. 

Protect yourself and your baby – help is available!

It is important to know what kinds of behaviour is considered domestic abuse – it is not only physical or sexual harm. Did you know that domestic abuse can happen between any persons sharing a household – not only at the hands of your partner?

 

Do you have a safety plan in place for you and your baby should anything go wrong?

Find out more about all this important information in our Violence against Women leaflet

Looking for more information for new mothers? Check out our resource pages.

Breaking the link between gender-based and intimate partner violence and HIV

Intimate partner violence (IPV) during or before pregnancy is associated with many adverse health outcomes.

Pregnancy-related complications or poor infant health outcomes can arise from direct trauma as well as physiological effects of stress, both of which impact maternal health and fetal growth and development.

Antenatal care can be a key entry point within the health system for many women, particularly in low-resource settings. Interventions to identify violence during pregnancy and offer women support and counselling may reduce the occurrence of violence and mitigate its consequences.

This research will provide much-needed evidence on whether a short counselling intervention delivered by nurses is efficacious and feasible in low-resource settings that have a high prevalence of IPV and HIV.

Source: BMC Health Services ResearchBMC series

Follow the project: BioMed Central

Perinatal depression and anxiety: Let’s talk about moms and dads in Africa

In low- and middle-income countries (LMICs), competing health priorities, civil conflict, and a lack of political will mean that expenditure on mental health is a fraction of that needed to meet the mental health care needs of the population.

For mothers, this treatment gap is most notable in regions where health agendas focus on maternal mortality indicators.

Source: Essentials of Global Mental Health

Who is at risk of perinatal mental health disorder?

Common mental disorders during pregnancy and in the first year after birth are associated with certain risk factors. These include poverty, migration, extreme stress, exposure to violence (domestic, sexual and gender-based), previous history of mental disorders, alcohol and other drug use as well as low social support.

– Migration
– Violence and abuse
– Alcohol and drug use

In South Africa, there is a very high prevalence of adolescent pregnancies with 39% of 15- to 19-year old girls being pregnant at least once. When adolescent mothers suffer from depression, the likelihood of a subsequent teenage pregnancy nearly doubles.

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– Teenage pregnancy
– HIV/AIDS

How to address maternal mental illness among economically disadvantaged parents? 

Integration of services!

Mothers in many settings are using maternal and child health services as well as social services. Thus, detection and access will increase if maternal health screening and services are integrated into these public care platforms.

How to implement a maternal mental health intervention in low-resource settings?

We are sharing our lessons learned in this learning brief. 

We have also developed a Service Development Guidelines which demonstrates how to develop a mental health intervention at your facility, even with limited resources.

Find more free & open access resources for professionals on our website

And what about dads?

Postnatal depression can affect dads too. Find out about common concerns for new dads and discover helpful tips on how they can become more involved. We compiled a leaflet with information that could help you be better prepared for what is happening. The leaflets are available in

EnglishisiXhosa • Afrikaans • French

Domestic violence during pregnancy

Domestic violence is any physical, sexual, psychological or economic abuse that takes place between people who are sharing, or have recently shared a home.

In Africa, there is more violence against women than on any other continent. Three women are killed by their partners in South Africa every day, thats twice as many women than in the United States of America. Violence during pregnancy has negative effects for both the mother and the child. Abused women are more likely to delay getting pregnancy care and to attend fewer antenatal visits.

Our recent research study looked at pregnant women who experience domestic violence in Hanover Park, Cape Town. We looked at the profile of women who reported domestic violence and what factors in their lives were associated with this abuse.

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We found that women who were experiencing domestic violence were more likely than those without domestic violence to:

– have a current mental health problem like depression, anxiety, suicidal thoughts or behaviours, alcohol or drug abuse

– have had past mental health problems
– have experienced past abuse
– not feel supported by their partner
– not likely feel pleased about being pregnant
– more likely experience food insecurity and not have a job

Out of this study with developed a learning brief which targets any service providers who interact with vulnerable women and children, especially those service providers who work with pregnant women. Such services providers can arise from nongovernmental organisations (NGOs) or civil society organisations and may be healthcare providers or social service providers.
Find this and more on our resources for professionals pages.

Suicide risks among pregnant women and new mothers

To mark World Suicide Prevention Day we’d like to focus on suicidal thoughts during the perinatal period

Mothers’ emotional needs can go undetected during the perinatal period where there is much attention on the baby and women often face multiple difficulties. Studies have shown that women at risk for suicide may be easier identified, by increasing screening of expectant and new mothers for major depression and conflicts with intimate partners. Thus care providers and family may be able to detect symptoms and signs of suicidal thoughts and possibly prevent further distress or the development of suicidal behaviour.

Symptoms and warning signs include 

– Talk of suicide or dying “If I died, would you miss me?” or “It would be better if I were not here or dead.”
– Depressive symptoms, including feelings of guilt, hopelessness or no sense of the future.
– Feeling isolated or wanting to be alone “No one understands me”.
– Obsessive thinking – thinking ‘too much’, especially about harming oneself or dying
– Giving things away (clothes, expensive gifts), “When I am gone, I want you to have this.”

Our recently produced Issue Brief deals with some of the risk factors and unearths some of the myths surrounding suicide during and after pregnancy.

Suicide during pregnancy - myths

Read this and other Issue Briefs on our website

#WSPD16 will be commemorated on 10 September
Join the conversation on Twitter with the hashtag #WSPD16

Defeating the enemy within – intimate partner violence in South Africa

Abuse at the hands of one’s partner is rife across the world. And even though South Africa has the highest levels of this type of violence, healthcare providers are not trained to deal with it and it is still regarded as a taboo subject.

Domestic Violence in South Africa Image: Graeme Arendse

In South Africa, shocking statistics reveal that:

– half of all women killed are slain by their intimate partners
– this is the highest femicide rate in the world
– more than 50% of women report experiencing intimate partner violence, often during pregnancy
– 20% of women surveyed in antenatal clinics in Soweto reported sexual violence by an intimate partner
– 68% reported psychological abuse and
– more than a third of girls report having been sexually violated and
– 45% of children have witnessed their mothers being beaten

Now, the World Psychiatric Association has created the first comprehensive position paper and curriculum that can be used by institutes globally to try to combat intimate partner violence.

Simone Honikman, director of the Perinatal Mental Health Project (PMHP) in Cape Town, has hailed the new open-source curriculum, saying it will be very useful in South Africa. “I think this is an excellent resource for capacity building that may be easily adapted for our local setting. Over the years of working with health and social development workers of all types, we at the PMHP, have been struck by the need for improved access to accessible, competency-based training on addressing intimate partner violence and sexual violence.”

Read the full article by Tanya Farber in the Times Live here

 

IPV and HIV a vicious cycle

Gender Differences and Relationship Power Could be Key in Preventing HIV Among South African Adolescents

This study is the first known to examine gender differences in intimate partner violence and relationship power among adolescents in South Africa.

Millions of those infected with HIV worldwide are young women, ages 15-24, according to the World Health Organization. Because the HIV epidemic overlaps with an epidemic of intimate partner violence (IPV) against women and girls, researchers have suspected a correlation between inequities in relationship power and the risky sexual behavior that can lead to HIV transmission.

The research was conducted in South Africa, where the prevalence of both HIV and IPV is high and men often have more power in relationships than women. The team assessed data from more than 700 sexually experienced adolescents in Eastern Cape Province, South Africa who had been followed at regular intervals for 54 months as part of a separate NIH-funded trial.

Violence against women

Read more on this study on Gender Differences and Relationship Power Could be Key in Preventing HIV Among South African Adolescents | Annenberg School for Communication

Intimate Partner Violence (IPV) during pregnancy

Prevalence and Risk Factors in South Africa

Violence against women is a global problem which exacts a high burden of suffering on millions of women and families, including women who are pregnant and postpartum.

In South Africa, studies have shown that 36-40% of pregnant women experience physical IPV, while 15-19% experience sexual IPV.

In this vulnerable population, IPV is associated with a range of physical and mental health consequences for the mother including pregnancy loss, depression and post-traumatic stress disorder.

South African data have suggested a direct link between violence and HIV infection, where HIV-positive women are more likely than HIV-negative women to have experienced physical violence perpetrated by their partner. Alcohol and other drug use have been identified as another risk factor for IPV during pregnancy, as intoxication may lead to irresponsible behaviour such as violence

In South Africa, the mortality rate attributed to IPV is the highest globally and is double that of the United States. For the infant, there are increased risks associated with preterm delivery and low birth weight.

Read our policy brief on violence against women in South Africa and how to break the cycle on our website

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A women is killed every 8 hours in South Africa

 That is five times higher than the global average femicide rate!

It’s time for equal rights & lives free of Violence against Women!

#VAW #IWD2016 #Planet5050

Read our policy brief on violence against women in South Africa and how to break the cycle on our website

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Also recently published: the preliminary findings of the UN Special Rapporteur on the causes of violence against Women in South Africa, Ms. Dubravka Šimonović.

photo-women-daily-lives-mauritanua

The UN Women has released a photo essay ‘A day in the life of women’, to celebrate women all over the world on the occasion of International Women’s Day 2016

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