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      Health professionals’ perspectives on the impact of COVID-19 on sexual and gender-based violence (SGBV) and SGBV services in Rohingya refugee communities in Bangladesh

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          Abstract

          Background

          The COVID-19 pandemic has acutely affected Rohingya refugees living in camps in Cox’s Bazar, Bangladesh. Reported increases in sexual and gender-based violence (SGBV) were attributed in part to pandemic-related public health measures. In addition, the Government of Bangladesh’s restrictions to prevent the spread of COVID-19 have impacted the provision of comprehensive care for survivors of sexual violence. This study sought to understand how the COVID-19 pandemic affected SGBV and the provision of services for Rohingya survivors in Bangladesh.

          Methods

          Interviews were conducted with 13 professionals who provided or managed health care or related services for Rohingya refugees after the onset of the COVID-19 pandemic in March 2020.

          Results

          At the outset of the COVID-19 pandemic, organizations observed an increase in the incidences of SGBV. However, health care workers noted that the overall number of survivors formally reporting or accessing services decreased. The pandemic produced multiple challenges that affected health workers’ ability to provide essential care and services to Rohingya survivors, including access to the camps, initial designation of SGBV-related services as non-essential, communications and telehealth, difficulty maintaining confidentiality, and donor pressure. Some emerging best practices were also reported, including engaging Rohingya volunteers to continue services and adapting programming modalities and content to the COVID-19 context.

          Conclusions

          Comprehensive SGBV services being deemed non-essential by the Government of Bangladesh was a key barrier to providing services to Rohingya survivors. Government restrictions adversely affected the ability of service providers to ensure that comprehensive SGBV care and services were available and accessible. The Government of Bangladesh has not been alone in struggling to balance the needs of displaced populations with the necessary precautions to prevent the spread of COVID-19 and its response can provide lessons to others overseeing the provision of services during epidemics and pandemics in other humanitarian settings. The designation of comprehensive services for survivors of SGBV as essential is vital and should be done early in establishing disease prevention and mitigation strategies.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12913-022-08122-y.

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          Most cited references15

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          Violence against women during covid-19 pandemic restrictions

          Protections for women and girls must be built into response plans
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            Gender-Based Violence During COVID-19 Pandemic: A Mini-Review

            Purpose: Quarantine is necessary to reduce the community spread of the Coronavirus disease, but it also has serious psychological and socially disruptive consequences. This is known as the quarantine paradox that also includes a surge in the cases of gender-based violence. However, there exists a clear gap of rigorous literature exploring the issue. Hence, the current paper attempts to understand gender-based violence as an aspect of the COVID-19 lockdown. It reviews the pattern of rise in gender violence cases and the resultant psychological and social issues and attempts to create awareness by initiating a discourse urging for change in the response towards the victims of gender-based violence. The paper further attempts to suggest measures to mitigate the issues arising out of gender violence during quarantine. Method: The current paper reviews the literature on the rise of gender-based violence in the times of current and past pandemics. The paper also reviews the published reports in scientific as well as mass media literatures focusing on the rise of gender-based violence during the imposed lockdown, its consequences, and the measures taken by the governments to tackle the issue. Results: The present review reveals that similar to the previous pandemics and epidemics, there has been an alarming rise in the incidents of gender-based violence during the COVID-19 pandemic. The present review further reveals various other risk factors that have been found attributive to the surge of gender-based violence such as economic insecurity and alcohol consumption. The results of the review indicate that despite its global prevalence, gender-based violence has been one of the most neglected outcomes of pandemics. Moreover, the legislatures and services available for such victims are often inadequate and, thus, worsening their situation. Conclusion: Pandemic situations have been found to be associated with advancements in the medical field. However, a part and parcel of this situation is the age-old practice of quarantine that has several negative outcomes. This also includes a surge in gender-based violence that raises serious concerns about the safety of women. As the legislatures provided and measures taken by the governments are falling short in dealing with the issue, a number of non-government organizations are stepping up to provide necessary services to these victims.
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              How the coronavirus disease 2019 pandemic is impacting sexual and reproductive health and rights and response: Results from a global survey of providers, researchers, and policy‐makers

              Introduction We aimed to give a global overview of trends in access to sexual and reproductive health and rights (SRHR) during the coronavirus disease 2019 (COVID‐19) pandemic and what is being done to mitigate its impact. Material and methods We performed a descriptive analysis and content analysis based on an online survey among clinicians, researchers, and organizations. Our data were extracted from multiple‐choice questions on access to SRHR services and risk of SRHR violations, and written responses to open‐ended questions on threats to access and required response. Results The survey was answered by 51 people representing 29 countries. Eighty‐six percent reported that access to contraceptive services was less or much less because of COVID‐19, corresponding figures for surgical and medical abortion were 62% and 46%. The increased risk of gender‐based and sexual violence was assessed as moderate or severe by 79%. Among countries with mildly restrictive abortion policies, 69% had implemented changes to facilitate access to abortion during the pandemic, compared with none among countries with severe restrictions ( P  < .001), 87.5% compared with 46% had implemented changes to facilitate access to contraception ( P  = .023). The content analysis showed that (a) prioritizations in health service delivery at the expense of SRHR, (b) lack of political will, (c) the detrimental effect of lockdown, and (d) the suspension of sexual education, were threats to SRHR access (theme 1). Requirements to mitigate these threats (theme 2) were (a) political will and support of universal access to SRH services, (b) the sensitization of providers, (c) free public transport, and (d) physical protective equipment. A contrasting third theme was the state of exception of the COVID‐19 pandemic as a window of opportunity to push forward women's health and rights. Conclusions Many countries have seen decreased access to and increased violations of SRHR during the COVID‐19 pandemic. Countries with severe restrictions on abortion seem less likely to have implemented changes to SRHR delivery to mitigate this impact. Political will to support the advancement of SRHR is often lacking, which is fundamental to ensuring both continued access and, in a minority of cases, the solidification of gains made to SRHR during the pandemic.
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                Author and article information

                Contributors
                Lgreen@phr.org
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                4 June 2022
                4 June 2022
                2022
                : 22
                : 743
                Affiliations
                [1 ]Physicians for Human Rights, PC Culture Housing Society, House #44, Road #11, Block-Kha, Adabor, Mohammadpur, 1207 Dhaka, Bangladesh
                [2 ]GRID grid.475613.2, ISNI 0000 0001 2110 1589, Physicians for Human Rights, ; 434 Massachusetts Ave. Suite 503, Boston, MB 02118 USA
                [3 ]GRID grid.213910.8, ISNI 0000 0001 1955 1644, Physicians for Human Rights, Georgetown University School of Medicine, ; 3900 Reservoir Road, NW, DC 20007 Washington, USA
                Article
                8122
                10.1186/s12913-022-08122-y
                9166216
                34974828
                ddbe533f-c832-4cdf-97e1-0d4a6b775a71
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 29 November 2021
                : 24 May 2022
                Funding
                Funded by: Anonymous Donor
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2022

                Health & Social care
                covid-19,sexual and gender-based violence,health systems,sexual violence services,refugee health,humanitarian settings,conflict-affected populations

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