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Archives for Women

Masculinity and Violence in Conflict

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

Why does masculinity devolve into madness in the face of violence? Why is it that we time and time again see a marked increase in the horrific misdeeds committed by men toward women when conflict arises? Throughout history, including up to this very day, a consequence of large-scale violence and war is a significant increase in the rate of gender-based violence that women experience in the form of rape and specific targeting by combatants. During widespread conflict, the breakdown of society and normalization of violence that extends from war into broader society is a commonly used explanation for rampant gender-based violence. Hypermasculinity, a term used to describe an increase in aggressive and misogynistic masculine traits, is also used in explaining why gender-based violence is practically treated as a given component of war. Even after a conflict has been politically resolved, the impact that widespread violence and societal conflict has on the people that experience it and live through it is profound, traumatizing, and proves difficult to overcome.

Historically, women have been treated as spoils of war and routinely victimized when communities were razed. This still happens in contemporary conflicts where we see rape used as a weapon to further traumatize and dehumanize specific communities and as a means to project power. Today in Syria, in addition to the higher incidences of direct gender-based violence, we see a different kind of indirect violence perpetrated against young women and girls in the form of child marriage practices, where families use their children as what is in essence a bartering good out of a pure need to survive. Even after a conflict has politically met its end, the violence experienced in conflict cuts deeply into the communities that are attempting to recover from its lasting impacts. In Liberia, high incidences of intimate partner violence are still reported a decade removed from the end of the civil war that tore through the country.

We need to help, but how? How do we recover from war and the cycle of violence that it fuels? How do we help women who experience violence during war, for that matter? Trauma from violence exposes everybody to the after-effects of war, but providing support through empowering and providing social services to both men and women can help with moving away from a violent society and contribute toward peacebuilding and maintaining stability. Politically empowering women and other marginalized populations, spreading awareness of the specific kinds of violence women experience while holding those responsible accountable for their crimes, and bringing women to the negotiation table needs to happen if we hope to distance ourselves from the ugliness of history. We also need to focus on a positive form of masculinity to contribute toward a peaceful and prosperous society, and move away from the hypermasculinity that pushes men and boys towards violence during times of conflict and disaster. While we have a long way to go, these steps will help us move towards gender equality and a more prosperous society.

Political Transition Assistance and Prevention of Gender Based Violence

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

She was abandoned as a baby at a rural hospital in Bihar, India. The hospital, at a loss for what to do with an infant girl, gave her away – to a brothel. Through concerted efforts of an anti-human trafficking organization in India, Apne Aap Women Worldwide, she was adopted and housed at the nonprofit’s shelter for girls. Thanks to Apne Aap, she escaped the brothel at an early age, rescued from a life of forced prostitution that awaited her. This year she graduated from secondary school. She wants to be a doctor.

In a nearby village named Khawaspur, I met a girl about the same age who was living a very different life. Despite significant efforts to remove her from the red light area of the village, she was forced into prostitution at the age of 12. For the past 5 years she has been living with daily exposure to sexual violence. Forced to lie about her age to authorities, she lives in hollow silence.

Younger students have participated in a USAID program, based on an understanding that young people are still developing ideas about gender and relationships. Photo Credit: J. Harris, International Medical Corps

Younger students have participated in a USAID program, based on an understanding that young people are still developing ideas about gender and relationships. Photo Credit: J. Harris, International Medical Corps

I saw these two stories with my own eyes, and learned of the cruel cycle that we at USAID try to break:  poverty, women’s systematic exclusion, and a lack of education, among other factors, all contribute to endemic gender-based violence (GBV) and the disproportionate maltreatment of women.   Endemic GBV and women’s inequality on the other hand threaten the stability and development of any given country or region.  In addition, we know that in conflicts and crises, GBV is more prevalent and these issues are magnified.  This is why USAID continues to be focused on ending GBV.

GBV is the violation of human rights on the basis of gender, and encompasses a wide-range of issues including bride kidnapping, sexual violence, and human trafficking. Given the breadth and complexity of the issue, USAID’s Office of Transition Initiatives (OTI) helps increase community education, support for prevention and response, and women’s inclusion in political processes – all critical issues that threaten both the stability and rights of citizens, such as GBV.

For example, in Kyrgyzstan, where bride kidnappings are a serious issue, OTI partnered with a local NGO to engage students from three universities in the southern city of Osh in discussions on bride kidnapping and recent changes to laws that increase jail time for perpetrators. Young women – and men – are uninformed about bride kidnapping laws and the legal process, and women often face stigma from communities and families when attempting to resist captivity.  With OTI’s support, the local organization activity utilized street theater performances, t-shirts, brochures, and public service announcements to empower students to take a stand against bride kidnapping and serve as an example for others.  In addition to confronting bridal kidnapping, the program functioned as part of a larger effort to address sources of instability and support the democratic transition,

In Burma, OTI supports a local organization to conduct a qualitative study on violence against women.  Women’s rights organizations plan to utilize the findings to enhance service and response mechanisms and support prevention and response programs around the country.

To address sexual violence in Sri Lanka, OTI-supported youth led more than 1,000 individuals in protests against sexual violence, with representation from diverse ethnic and religious groups from six districts across Sri Lanka.  Support for these youth groups was delivered through OTI’s Sexual Assault Forensic Evaluation (SAFE) program.

In addition to these activities directly addressing gender-based violence, the Office of Transition Initiatives supports a number of other initiatives as components of transition programming in countries including Syria, Tunisia, Afghanistan, and Burma. These initiatives promote women’s participation in the political process, build the role of women in government and civil society, and raise awareness on critical issues impacting women and girls. Inclusion of women in transition processes will promote their positions as equal stakeholders in democracy, and encourage prevention of gender-based violence. In conflict and crisis environments, providing an inclusive platform for those impacted by sexual violence to become agents of change in their own communities is critical for protecting the rights and security of individuals, and for the development of legitimate political processes.

With writing support from Lisa Bower, Program Manager and Gender Point of Contact at the Office of Transition Assistance, and  Melissa Hough, Special Assistant to the Assistant Administrator, Bureau for Democracy, Human Rights, and Governance.

Transforming Gender Norms and Ending Child Marriage: The Role of Boys

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

Child marriage has recently gained heightened attention by donors, researchers, activists, program implementers, and policymakers. The international community has increasingly recognized child marriage as a violation of girls’ rights, health, and well-being, and efforts to prevent and respond to child marriage have prioritized critical “hot spots” where the practice is particularly grave and widespread. Yet, it is also crucial to shed light on a current “blind spot” in these efforts: the role of boys in ending child marriage.

When males are included in strategies and interventions to address child marriage, the focus is mostly on the key role that men play as powerful gatekeepers: fathers and religious and community leaders, whose support must be galvanized to intervene on behalf of girls. The forward-looking USAID Vision for Action on Child Marriage, for example, includes engaging men as an important part of mobilizing communities to shift norms that perpetuate child marriage. But the Vision does not stop there; it further states that, “equally important is reaching out to boys at a young age to encourage equitable gender attitudes and norms so that they can be allies in preventing child marriage and change agents within their communities.” This aspect of male engagement is usually not highlighted in child marriage discussions, yet raises a vital question: What needs to happen to create a generation of boys that resists and rejects child marriage for themselves in the future?

A young girl.  Photo Credit: Kendra Helmer/USAID

The international community has increasingly recognized child marriage as a violation of girls’ rights, health, and well-being, and efforts to prevent and respond to child marriage have prioritized critical “hot spots” where the practice is particularly grave and widespread. Yet, it is also crucial to shed light on a current “blind spot” in these efforts: the role of boys in ending child marriage. Photo Credit: Kendra Helmer/USAID

This “demand-side” orientation requires long-term investments aimed at changing the social and behavioral gender norms that drive child marriage. What if all future men refused to marry a child bride? Though directly addressing this side of the equation is seldom mentioned, there are promising interventions with young girls and boys that seek to transform gender attitudes and behaviors with the goal of promoting gender equality more broadly. One example is the USAID-funded Gender Roles, Equality, and Transformation (GREAT) project.

Although GREAT does not directly address child marriage, it works with adolescents (ages 10-19) and their communities to reduce gender-based violence and improve reproductive health in Uganda. Building on the CHOICES project in Nepal, GREAT recognizes early adolescence as a window of opportunity—a time when the formation of gender norms and identities is taking place. The project utilizes participatory activities to engage young girls and boys in gender equality discussions. For example, project staff ask young girls and boys to pile-sort cards representing various household and community tasks, to show who is responsible for them. Girls and boys (including sisters and brothers) see the pile of tasks assigned to girls steadily grow larger than the boys’ pile. The activity prompts conversations about fairness, as boys remark on the larger burden carried by their sisters.

These types of “a-ha” moments are crucial entryways to deeper critical reflections that can begin a journey towards gender equality. By tapping into young boys’ sense of justice at a very young age, interventions such as these, which seek to transform gender norms early in the process of childhood development, hold the promise of shaping a future generation of men as allies in wiping out child marriage globally.

Farmer Field Schools: A Safe Place to Discuss Gender-Based Violence

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

Gender-based violence affects people everywhere, including the predominantly agrarian rural communities where USAID and its partners work to improve agricultural production.

Farmer Field Schools, where men and women smallholder farmers teach each other about appropriate farming techniques, are a common and long-standing approach to improving their production.

Tanzanian Greenhouse

Through the introduction of low-cost greenhouses and high-quality seeds, tomato farmers receiving support from USAID’s Tanzania Agriculture Productivity Program are seeing significant increases in yields. Pictured here, a man and woman work together outside one of these greenhouses. Photo Credit: Fintrac Inc.

In Bunda District in Western Tanzania, a USAID partner, Canadian Physicians for Aid and Relief (CPAR), is finding that Farmer Field Schools can be a forum for men and women to discuss sensitive issues such as gender-based violence.

One group relayed the following story:

Kizom Farm Field School (FFS) group member Saada cultivated cotton this year with her children. She sold the cotton for Tsh 400,000 (about $266) and planned to use the money to start a ‘mgahawa’ (tea shop) in the centre of the village as an additional source of income.

Before she could proceed with her plans, her husband Amos seized the money. Having discussed human rights in her FFS group and being fully aware of her basic human rights, Saada stood up to her husband and demanded that he return the money. He then beat her. She reported the incident to her FFS group. As a result, a delegation of the FFS group leadership visited the husband.

Amos claimed that women in this society have no right to own money so the delegation, including his wife, spoke to him at length about equal rights for all of society and the fact that Saada has every right to hold and control cash, and most certainly the cash she earned from the cotton. Furthermore they told him that Saada has the right at all times to be treated with respect and live free from violence.

Amos apologized to the FFS delegation and to Saada, and said that he would not beat or take money from her again. The money was already gone – spent on other women, Saada figures — but their relationship is now on a new footing. Saada has further stressed to her husband that she has the right to equal ownership of everything in the household. Amos will now be held to greater accountability for his actions. Not only is Saada fully aware of her rights, she has her whole FFS group of women and men ready to back her up – and has served as an inspiration to members of her community.

CPAR’s experience with Farmer Field Schools demonstrates the importance of providing an opportunity to discuss topics such as gender-based violence, even when it is not directly related to the group’s original purpose.  Having a place for women and men to talk and learn together, in this experience, created an environment of support for human rights and freedom from violence.

A Thing of the Past

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

Shahida Begum is a young Bangladeshi mom who hails from the northern district of Bogra, where her parents arranged her marriage at the age of sixteen. At the ceremony, her mother and father agreed to pay the groom’s family a dowry in exchange for taking Shahida’s hand in marriage. Though illegal, the traditional practice of paying a dowry—usually a lump sum of cash or valuable property transferred from the bride’s family to the family of the groom—still occurs in Bangladesh, particularly in rural areas.

In the beginning of their married life, things were going well for Shahida and her husband. However, after a few months, Shahida’s in-laws began to demand more dowry money. After several refusals, the requests transformed into heated verbal pressure from her husband’s family, yet Shahida and her family continued to resist. The situation continued to escalate to the point where physical violence was exerted against Shahida by her husband. The violence grew worse with the birth of an unexpected baby girl. Finally, the abuse became so intense that she had no choice but to flee to her parents’ home. Even though her husband knew that she was breastfeeding their daughter, he did not allow Shahida to take their child when she walked out the door.

Like Shahida, this woman signed an official agreement following an alternative dispute resolution meeting, which upheld charges of abuse she filed against her husband and assures additional legal action under the Domestic Abuse Act if she suffers violence in the future. Photo by Md. Arif Hossain/USAID Protecting Human Rights Project

Like Shahida, this woman signed an official agreement following an alternative dispute resolution meeting, which upheld charges of abuse she filed against her husband and assures additional legal action under the Domestic Abuse Act if she suffers violence in the future. Photo by Md. Arif Hossain/USAID Protecting Human Rights Project

Bangladesh is considered a rising performer in achieving development milestones. Not only does it boast a growing economy, it is also on track to meet most of the Millennium Development Goals, including MDG3 to “Promote Gender Equality and Empower Women.” Today, there is equal enrollment of boys and girls in primary and lower secondary schools, and the number of seats in parliament was raised in 2004 from 300 to 345—the additional 45 seats reserved for women lawmakers.

Despite this progress, violence continues to destroy the lives of many Bangladeshi women and girls. The Daily Star—a popular national newspaper—reported that 822 women were victimized for dowry in 2012; of them, nearly 300 were killed. These numbers only reflect official reports and don’t tell the full story. Privately, domestic violence is widespread in Bangladesh. A baseline survey conducted by the U.S. Agency for International Development (USAID) in 2011 found that 75 percent of women surveyed believed that domestic violence is justified if a wife disobeys her husband.

USAID is working with the Government of Bangladesh to implement and enforce the Domestic Violence Prevention and Protection Act of 2010 to make tragedies like Shahida’s a thing of the past. Public awareness campaigns educate citizens about the law and the consequences of domestic violence. In addition, USAID has trained nearly 300 human rights defenders—half of them women—to enforce existing human rights laws, including the Domestic Violence Act. Grassroots social protection groups made up of social workers, doctors, religious leaders, teachers, and students monitor domestic violence in their communities and help victims access legal channels and alternative dispute forums to settle incidents of abuse.

After leaving her child behind, Shahida lived at her father’s home where she felt safe. During this time, she experienced a wave of emotion and confusion. She had heard about domestic violence happening in her community but never thought she would be a victim. Most of all, her soul longed to return to her baby daughter.

Shahida began to seek help and found a social protection group in her community. This group was part of USAID’s Protecting Human Rights program in which a legal counselor, police and social protection group members promised Shahida to help resolve the dispute. The group also provided psychosocial counseling.

The social protection group organized two alternative dispute resolution sessions in which Shahida, her husband and their respective family members convened to present their stories. Forum members listened to the testimonies and discussed the accounts amongst themselves. After coming to a ruling, members of the group brokered an agreement among the parties in which Shahida would be allowed to return to her in-laws’ house and be reunited with her daughter. To ensure she would not face future violent acts, the Protecting Human Rights program issued a clause in which they would file a court case against Shahida’s husband or his family under the Domestic Violence Prevention and Protection Act if she is abused in any way.

In August 2013, Shahida returned to her husband’s home.  She says she feels safer with her daughter in her arms and also takes comfort in regular monitoring by USAID’s Protecting Human Rights program to ensure a violence free life for Shahida and her child.

As part of the 16 Days of Activism against Gender-Based Violence, we renew our commitment to end the abuse that traps so many women and girls in Bangladesh and around the world. Let us work together, in partnership, to make all forms of violence a thing of the past.

USAID Activities Respond to Gender-Based Violence

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

In Rwanda, in 2012 alone, 3,472 women and girls were raped, defiled, beaten or killed, according to a statement by the Commissioner of Police John Bosco Kabera to The New Times, July 9, 2012.  More than half of newly married women reported suffering physical or sexual violence by an intimate partner. Nearly 80 percent of those women claim the violence occurred during the last 12 months (Rwanda Demographic and Health Survey, 2010).

Before the establishment of One Stop Centers, victims had to first go to the police station to give testimonies of their ordeal, and then travel back to the hospital to receive treatment, and only then received the official report to take back to the police station. No legal counsel was available onsite. The process could take days to complete, with victims shuffled from one service to another, re-living their traumatic experience and sharing the same details with different groups. Many would give up and go home. With the new One Stop Centers, all services are located on the same site. The whole process takes approximately four hours, during which time the victim remains at the Center while a dedicated staff of doctors, nurses, police officers, and social workers handle her case.

A group of community health workers being trained to identify and help respond to GBV cases in their community surrounding the Nyamata Health Center; discussion around the importance of gender equality and establishment of one stop centres in Nyamata/Bugesera district. Photo credit: USAID/Rwanda

A group of community health workers being trained to identify and help respond to GBV cases in their community surrounding the Nyamata Health Center; discussion around the importance of gender equality and establishment of one stop centres in Nyamata/Bugesera district. Photo credit: USAID/Rwanda

USAID’s Rwanda Family Health Project is supporting the Ministry of Health in fighting gender-based violence through the establishment of two One Stop Centers in Nyamata and Nemba Hospitals. One Stop Centers offer critical integrated services to victims, including immediate counseling, treatment, lab tests for HIV and other sexually transmitted diseases, and a physical examination by a doctor. Once exams are completed and evidence recorded, an onsite police officer submits the medical report to the court for legal proceedings.

Olive Mukase, a psychiatric nurse that is trained in dealing with victims of gender-based violence reflects, “It is a cultural and economic matter. In Rwanda, women believe that they need to remain silent so as not to bring attention or trouble to the household. The husband is the chief and a woman must respect what he says and does. Sometimes, she is scared that if she reports him to the police he could be sent to prison and she will not be able to provide for her family.” Ms. Mukase counsels victims and encourages them to help other women in their community find the courage to speak up and get help. Unfortunately, few women that are victims of gender-based violence will seek help, believing that the perpetrator will eventually stop. Only when the violence becomes unbearable do some women seek help.

Marthe Nyirarutimana, a Community Health Worker in a rural village outside of Nyamata, has recently been trained by the Program to raise awareness of gender-based violence in her community and how to refer victims to support services.  She shared that before receiving training, she did not think about how, as a community health worker, she would be involved in this issue. She now plays an active role in identifying cases, referring, and accompanying victims to health centers for care and treatment.

Marthe continues to work closely with local authorities to raise awareness of gender-based violence in her community. She describes how at first the community was resistant.  After her outreach, members began to discuss gender-based violence-what it is, why it occurs and how it should be handled. Most importantly, the community now knows that the victims should and can be taken to the One Stop Center for help.

One message that was echoed by these brave front-line workers is the need to break the silence around gender-based violence. Olive and Marthe are just two of the people committed to changing gender perceptions and providing services to the victims of gender-based violence in Rwanda. During these 16 Days of Activism Against Gender-Based Violence, support Olive and Marthe and others by becoming a part of the movement that gives voice to victims around the world.

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A Courageous Journey

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

I am always impressed by the spirit and courage of acid survivors. One of the women I recently met during a public event is 32-year-old  Nadia Bano from the suburbs of Punjab in Pakistan.

Nadia had been a happily married woman with three children, two sons and a daughter. Her brother had refused an attempted forced marriage to Nadia’s sister-in-law which provoked the deplorable attack that became the turning point in Nadia’s life. Furious at the rejection, and seeking revenge, her in-laws threw acid on her face one night while she was asleep. Her face was severely burnt, and she lost one of her ears.

"Like Nadia, women at a USAID-supported vocational center in Punjab, Pakistan are trained in different skills so they can earn a living for themselves and their families." Photo credit: Raja Zulfiqar

“Women at a USAID-supported vocational center in Punjab, Pakistan are trained in different skills so they can earn a living for themselves and their families.” Photo credit: Raja Zulfiqar

In Pakistan, acid attacks are predominantly against women, although there are a few attacks on men. The motivation behind such brutal acts is usually hate, revenge, jealousy, or disputes about money or land. Survivors of domestic violence are often left with long-term psychological and physical trauma; after 4 years and 17 surgeries, Nadia recovered physically, but not psychologically. It is a fundamental human right that women must be free to live without fear of domestic violence, and that’s what Nadia was  looking for.

“I didn’t want people to pity me, all I desired was for someone to help me find a job so I could actually be able to feed my children,” said Nadia. During one of her treatment sessions in Islamabad, a doctor told her about USAID’s Gender Equity Program. The program provides small grants to Pakistani organizations to fund projects that expand access to justice for women, increase knowledge of women’s rights and combat gender-based violence.

Under the USAID project, Nadia took part in a “Visual Arts Expression” workshop and learned the art of taking photographs. As a part of the training, she also was given a camera. She had always wanted to capture and praise the beauty of others through her camera, and she is now using her new skills to do so, and earn an income.

“I was keen to use my skill to spread smiles across my community which I am able to do now,” Nadia said. She is hopeful that in the near future she will be able to start her own professional photography and events management business, so she can continue to capture happy moments for her family and friends. Female photographers are in demand in communities like Nadia’s, where many people are not comfortable hiring a male photographer to take photos of women.

Today, in the wake of the Oscar-winning film, “Saving Face,” the issue of gender-based violence, specifically acid attacks in Pakistan, has received global attention. But much more work is still needed to be done to eradicate this brutal act from society. Talking about the 16 Days of Activism Against Gender-Based Violence to me means that we should support courageous women like Nadia in reviving their hopes and let them realize that their existence for this world is even more important than any other person as they are the genuine  symbols of courage and bravery.

Combating gender-based violence is a long-standing goal of the United States Government. The equal participation of women in the political, economic and social spheres is a key ingredient for democratic development. As in other countries, USAID provides critical support to Pakistani institutions and communities working on gender-based violence issues. Central to this effort is USAID’s Gender Equity Program, implemented by the Aurat Foundation, which seeks to build the capacity of governmental and non-governmental organizations throughout Pakistan so that women like Nadia can live a better life.

Using Photography to Evaluate Project Impact

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

As researchers, it is sometimes easy to become engrossed in the mechanics of the research process – fretting over sample size, quality control, response bias and other technicalities. Admittedly, there are moments when we fail to really “see” the actual people our research strives to help.

My colleague Jeffrey Edmeades and I were reminded of this while in Ethiopia’s Amhara region for a project working to improve the lives and future opportunities for child brides in the region. Called TESFA, which means “hope” in Amharic, the project was implemented by CARE Ethiopia, evaluated by the International Center for Research on Women (ICRW) and funded by the Nike Foundation. TESFA gave young, married, extremely marginalized girls unprecedented opportunities to learn about their health, to interact with their peers, and to participate in the social, economic and political life of their families and communities.

A young married girl is learning how to use a camera during the first day of a week long Participatory Research Activity using the  Photovoice method. She, along with nine other program participants were asked to use photography to document their lives and the impact the TESFA program had on them. Photo credit: Robin Hayes

A young married girl is learning how to use a camera during the first day of a week long Participatory Research Activity using the Photovoice method. She, along with nine other program participants were asked to use photography to document their lives and the impact the TESFA program had on them. Photo credit: Robin Hayes

Most of the more than 5,000 girls we worked with over the three-year project had similar stories: Married off by their parents at nine, 14, 16, to much older men – strangers, really. Forced to drop out of school. Frightening, unwanted first sexual encounters.

Because of the remarkable similarity in their experiences, it was at times easy to fall into viewing these girls – our “research subjects”– as a large, homogenous group. Our experience in Ethiopia reminded us how critical it is not to have such a lens, but rather, to see participants as the individuals they are. We found that giving greater prominence to the individual experiences of program beneficiaries – in their own voices – illuminated our research and evaluation processes.

Specifically, during the final year of TESFA, we implemented the Photovoice strategy, which gives marginalized communities an opportunity to represent themselves through photography, as an element of program evaluation. It can also serve as a tool for advocacy and policy change. If adapted into a program, it can also become part of the intervention itself, where participants can gain confidence and communication skills to speak up about their lives.

We trained ten girls in the mechanics and ethics of photography, and for five days in April 2013, they used donated digital cameras to document their days and the impact the program had on their lives. Their images are beautiful and revealing. Accompanied by the girls’ descriptions, the photos helped us see the aspects of the program that they most valued.

Our research findings support much of what Photovoice revealed. Among them: Young wives reported much more communication with their husbands. Girls’ management of household finances improved and couples experienced greater financial security. Girls’ knowledge about their sexual and reproductive health increased significantly. And they were using contraceptives at a higher rate than before they became involved in TESFA.

Using participatory research methods like Photovoice to complement traditional approaches can lead to a richer understanding of programs’ outcomes. For beneficiaries like the child brides we worked with in Ethiopia – and other often overlooked groups – it can provide an unprecedented opportunity to build confidence and skills. And, to really be seen.

Robin Hayes is an Independent research consultant and Social Justice photographer who was part of the TESFA research team at ICRW. Jeffrey Edmeades also contributed to this blog. Edmeades is a senior social demographer who directed ICRW’s evaluation of the TESFA project.

Next 16 Days Blog Post: A Courageous Journey
Previous 16 Days Blog Post: New Evidence on Child Marriage Prevention in Ethiopia

New Evidence on Child Marriage Prevention in Ethiopia

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

Defined as a formal marriage or informal union before the age of 18 years, child marriage is a practice that increases a girl’s risk of school dropout, maternal mortality, short birth intervals, vulnerability to gender-based violence, and poor mental health, among other adverse outcomes. Estimates suggest that 1 in 3 girls in the developing world are married before the age of 18. In areas such as the Amhara Region of Ethiopia, the prevalence of child marriage (CM) is among the highest in the world, with 2009 estimates showing that 50% of girls were married before the age of 18.

To help address the needs of 50 million adolescents who are already married, USAID invested in programs through PEPFAR to reach more than 220,000 married adolescent girls in Amhara, Ethiopia with access to family planning, STI services, HIV services, financial literacy, and menstruation management.

To help combat child marriage before it happens, USAID invests in research to prevent CM in “hot spot” areas with high CM prevalence. In Amhara, Ethiopia, as well as hot spot regions of Tanzania and Burkina Faso, USAID is supporting an innovative five-arm study on the effectiveness and cost of community education, economic incentives, and educational support on delaying marriage among adolescent girls, compared to control communities not receiving interventions.

Join the conversation with @USAID on Twitter using #16days.

Join the conversation with @USAID on Twitter using #16days.

USAID promotes dissemination and use of new evidence on effective strategies for child marriage prevention. A 2013 study (PDF) published by Anastasia Gage, supported under the USAID-funded MEASURE Evaluation project, sheds new light on how exposure to behavior change communication (BCC) affects knowledge and attitudes on CM among parents and guardians in Amhara Region. Although parents and guardians often decide when and who a girl marries, little data exists on effective strategies to change CM attitudes and knowledge among these gatekeepers.

Results from Gage’s study show that almost all parents were exposed to CM prevention messages from 1-2 communication channels.  Social influence was important to parents. Parents who believed their communities disapproved of CM were more likely to believe that marriage before age 18 was too early and that their daughters had the right to choose their own partner. By addressing parental attitudes and perceptions, programs can change social norms around child marriage. Future BCC campaigns on CM prevention should address the role of social influence on parental behaviors and attitudes and reinforce the health, economic, and educational benefits of delayed marriage. Evaluations of BCC programs should include a comparison group, monitor interventions for coverage, and measure changes in behaviors and practices.

USAID continues to support data collection on CM. Since 1984, the Agency has funded more than 260 Demographic and Health (DHS) surveys, which allow for identification of areas with the highest prevalence of CM. USAID supports rigorous evaluations of conditional cash transfer programs to delay CM among girls in India and Bangladesh, countries that account for the largest number of child brides in the world.

Learn more about USAID’s policies to address CM in Ending Child Marriage and Meeting the Needs of Married Children: The USAID Vision for Action. This vision is part of a suite of interlinked gender policies including the U.S. Strategy to Prevent and Respond to GBV Globally, the Gender Equality and Female Empowerment Policy, National Action Plan on Children in Adversity, Youth in Development Policy and National Action Plan on Women, Peace & Security.

R.E.S.P.E.C.T Find Out What It Means To Us

From November 25th (International End Violence Against Women Day) throughDecember 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

It is no accident that Aretha Franklin’s rendering of “Respect” rapidly became an anthem for marginalized and disenfranchised individuals and groups. The denial of human rights, particularly the most basic rights, such as respect, touches on a universal chord.

In recent years, global attention has been growing surrounding the horrifying issue of disrespect and abuse of women during childbirth.

Indonesia Maternal Health

USAID’s presence in Indonesia has been vital to the success of various health initiatives. The Blue Circle campaign of the 1980s and the Bidan Delima program in 2005 are just two examples of these initiatives that made it possible for women, like those pictured waiting in line, to receive maternal and child health and family planning services at community health centers. Photo credit: USAID/Indonesia

Think about the treatment you, or your wife, sister or daughter, expect from your maternity care provider. He or she is responsible for helping you (or your partner) give birth safely. Can you imagine a doctor scolding you for not using family planning to control your fertility? Or being separated from your newborn because you don’t have enough money to pay the discharge bill? Or giving birth unclothed while visitors walk by?

In both developing and developed countries around the world, pregnant women experience disrespect that ranges from subtle denial of their autonomy to blatant abuse. Numerous studies (PDF) document physical abuse in childbirth, including slapping, restraining, suturing without pain medication, or forcibly pushing on a woman’s abdomen. For women carrying or at high risk for HIV, the fear of stigma and discrimination from providers is often compounded by stigma from partners and families, especially regarding HIV testing or positive status disclosure.

This lack of respectful care also deters many women from seeking hospital care; instead they choose to give birth at home without the care of a skilled health attendant. This increases the change of complications from childbirth, possibly causing death.

While some may blame healthcare providers, many of these providers are working under suboptimal conditions, with many being overworked, underpaid, and burdened with unmanageable caseloads. The lack of empowerment, dignity, and security for midwives and nurses is driven by deep-rooted attitudes derived from gender, class, caste, race and cultural norms towards women. These problems undermine the resilience of midwives and nurses and negatively impact their capacity to provide quality care.

What does respect for women giving birth mean? The Universal Rights of Childbearing Women Charter (PDF) clearly outlines what respect means; certainly it includes the physical safety of pregnant women, but it also includes the respect for women’s basic human rights, including respect for women’s choices, preferences, feelings, and autonomy. It also means addressing the conditions of healthcare providers.

To eliminate the humiliation and abuse of women in childbirth, USAID supports the White Ribbon Alliance to lead global and country level advocacy and the University Research Corporation TRAction Project (PDF) to carry out implementation research to assess the prevalence of disrespect and abuse and test approaches to decrease these behaviors. With USAID funding, the Jhpiego/MCHIP Project has developed a comprehensive Respectful Maternity Toolkit available throughout the world. Furthermore, USAID is partnering with the World Health Organization to review the evidence on the status and working conditions of midwives and address the disrespect and abuse of women in childbirth.

We see the need for increased awareness and support for civil society engagement and advocacy, and the need to work with all involved in the direction, management and provision of care to women giving birth. Global initiatives, such as the Third Global Forum on Human Resources for Health, are key opportunities to realize these basic human rights.

Until recently, this was a problem hidden behind a veil of silence. Now we hear the silence being broken across the globe, but it is just a start.  Women’s voices need to be heard. And all of us need to respond to promote social justice and improve quality of care. Women’s lives depend on it.

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