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Abstract
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Gender-based violence, as highlighted by Sophie Cousins in a World Report and by numerous other organisations (eg, UN and WHO), is a substantial public health issue leading to excess morbidity and mortality and is thought to be exacerbated during the COVID-19 pandemic.
Despite many months since the start of the pandemic and numerous calls expressing the urgent need for a public health approach to tackle gender-based violence, few countries have adopted sustainable or tangible policy measures to fulfil any such steps in this approach.
The first step relates to enhancement of surveillance measures, which provides epidemiological evidence to identify exceedances in gender-based violence and opportunities for targeted intervention dependent on identified risk factors. Initial concerns relating to the possibility of increased gender-based violence during the pandemic were reported by charitable helplines, which prompted some countries to increase policing activity. Solely relying on these measures as surveillance tools comes with limitations, including selection bias, confounding (such as the inability to adjust for seasonal variation), and limited information on survivors or perpetrators that could highlight targetable risk factors.
The most robust syndromic surveillance systems are derived from routinely collected public health data systems. Unfortunately, even in countries with high quality surveillance systems, such as the UK, routinely collected data (covering police, health care, social service, and education records) are inadequate as sources for gender-based violence surveillance when used in isolation because of substantial under-reporting and selection bias.5 Historic resistance to initiatives that could facilitate successful surveillance, such as routine enquiry of traumatic experiences, data linkage across public sectors, and the adoption of so-called safe technology (eg, hidden reporting apps) to detect gender-based violence, are slowly being overcome in the 21st century. The ethical risks of improved data collection and sharing, when carefully managed in addressing vulnerability, are far outweighed by the benefits to the survivor, both through more co-ordinated public sector involvement, and to wider society, and through more informed commissioning of population-based interventions to tackle gender-based violence...
Language: en |