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World Health
Organization Gender, Women and He=
alth
"Putting Women First"
Ethical and Safety recommendations for R= esearch on Violence against Women
Ethical and Safety recommendations for R= esearch on Violence against Women
Henrica A.F.=
M.
Jansen
=
;
Training in
Research in
Reproductive
Health/Sexual Health
14 March 2006
World Health
Organization Gender, Women and He=
alth
Objective of this session<=
span
style=3D'font-family:Arial;mso-ascii-font-family:"Times New Roman";mso-bid=
i-font-family:
Arial;mso-special-format:lastCR;display:none'>
•Research on sensitive topics r=
aise
specific ethical and
safety issues, that may go beyond those
covered by CIOMS Guidelines:
the example of Violence aga= inst Women
the example of Violence aga= inst Women
=
<=
span
class=3DBB style=3D'position:absolute;left:-3.59%'>•To
give you access to the guidelines developed for
this type of research
World Health
Organization Gender, Women and He=
alth
To whom do woman talk about physical partner violence?
![](3D"slide0715_image004.png")
![](3D"slide0715_image005.png")
<=
span
style=3D'font-size:133%;color:#003399;mso-color-index:0'>1.Many women never talked about it bef=
ore
– implicat=
ions
for the interviewers
2.Very few women have talked with
"formal services" – implications for value of these services as source of data
World Health
Organization Gender, Women and He=
alth
Putting women’s saf=
ety
first in violence research
=
<=
span
style=3D'mso-special-format:bullet;position:absolute;left:-3.85%'>•=
2.
Studies need to be methodologically sound
=
• =
3.
Confidentiality for safety and data quality
•4. Selection and training of team
members
•5. Actions to reducing distress to
respondents
•6. Possibilities of referral, sup=
port
mechanisms
•7. Proper interpretation and use =
of
study results
•8. Violence questions in other
surveys
![](3D"slide0569_image006.jpg")
World Health
Organization Gender, Women and He=
alth
1. Safety of respondents and research <=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman";
font-size:91%'>team
<=
span
style=3D'mso-special-format:bullet;position:absolute;left:-3.88%'>•=
Frame
the study not in terms of violence (but further
information should be give as part of consent
procedure)
•Only one woman per household
=
•Train interviewers about
interruptions
•Logistics and budget planning sho=
uld
consider respondent and interviewer
safety
=
=
=
World Health
Organization Gender, Women and He=
alth
2. Studies need to be methodologically <=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman";
font-size:91%'>sound
•Avoid loaded terms as abuse, rape, violence
•Give attention to wording, length of interview, multiple opportunities for disclosure, etc.
•Sex, skill, attitude and training of interviewer
•When results unexpected, discuss findings with key <=
/span>informants, community groups before dissemination
World Health
Organization Gender, Women and He=
alth
3. Confidentiality for safety and data <=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman";
font-size:91%'>quality
•Address this in training of
interviewers; no interviewers
working in their own community
•Confidentiality procedures, consent process
•Handling
of tapes, names
•Presentation
of findings: no one community or individual
can be identified
•Handling
of photographs
<=
span
style=3D'visibility:hidden'>•
World Health
Organization Gender, Women and He=
alth
<=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman"'>Fieldwork
<= i>Brazil
<= i>Brazil
World Health
Organization Gender, Women and He=
alth
4. Selection and training of team <=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman";
font-size:91%'>members
•Training should include introduct=
ion
on gender and violence
<=
/div>
•Training
as opportunity for research staff to come
to terms with own experiences
•Addressing
emotional needs of team members
•Role
of interviewers: Not counselling, not trying
to "save" respondents
<=
span
style=3D'visibility:hidden'>•
World Health
Organization Gender, Women and He=
alth
Support
for interviewers
<= i>Peru
<= i>Peru
World Health
Organization Gender, Women and He=
alth
5. Actions to reducing distress to <=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman";
font-size:91%'>respondents
•Ask all questions in supportive and non-judgemental manner (language of questions)
•Train interviewers to deal with distress
•Train when and how to terminate interview
•All interviews should end in a positive manner
<=
span
style=3D'font-size:113%;visibility:hidden'>•
World Health
Organization Gender, Women and He=
alth
•"Somehow it made me feel
good, because it was something that I had never
told anyone before. Now I’ve told someone"=
.
<=
span
class=3DBB style=3D'position:absolute;left:-4.43%'>•--Respondent,
Brazil
World Health
Organization Gender, Women and He=
alth
6. Possibilities of referral, support <=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman";
font-size:91%'>mechanisms
•If possible meet prior to field w=
ork
with potential providers of support=
3;
•Develop
list of resources and offer to all respondents
– either small enough to be hidden or
include a range of other services
•Where
few resources exist, consider having a trained
counsellor or women's advocate accompany
the teams
World Health
Organization Gender, Women and He=
alth
7. Proper interpretation and use of =
study results
<=
span
style=3D'font-size:88%'>•R=
esearch
findings should be fed into ongoing advocacy,
policy-making and intervention activities
<=
span
style=3D'mso-special-format:bullet;position:absolute;left:-3.8%'>•<=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman"'>Involve
advocacy and service groups etc from the
beginning as part of research team or advisory
committee. Also in use and advocacy
•Researchers need to be proactive =
in
ensuring that research findings are
interpreted appropriately by
public and media-
=
=
World Health
Organization Gender, Women and He=
alth
8. Violence questions in other surveys
•Be aware of the challenges of
ensuring data quality and
ensuring respondent safety
•It
makes sense only of research team is willing and
able to address basic ethical and methodological
guidelines.
World Health
Organization Gender, Women and He=
alth
• …”We were so naïve. When we first added questions =
on violence into our survey on contraceptive use we =
=
did nothing special…it never occurred to us that we =
=
would have problems.
Later we found out that three women had been severely beaten for participating in =
=
our survey. We =
felt
awful and realized then that we were in over our
heads..
(Researcher from Mexico)
World Health
Organization Gender, Women and He=
alth
Interviewer
Training
World Health
Organization Gender, Women and He=
alth
Goals of interviewer training
•=
To increase sensitivity of participants to gender issues at a personal as well as a community level;
•=
To develop a basic understanding of gender-based violence, its characteristics, causes and impact on =
<=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman";
font-size:88%'>the health of women and children;
•=
To understand the goals of the Multi-Country Study <=
/span>on Women’s Health and Domestic Violence;
=
•<=
/span>To learn skills for interviewing, taking into account safety and ethical guidelines;
•<=
/span>To become familiar with the questionnaire and protocol of the WHO Multi-Country Study.
World Health
Organization Gender, Women and He=
alth
Example of training schedule
•Week 1
•Presentations
from advocacy groups/NGOs
•Sensitization
to concepts of gender and violence
•Anonymous
disclosure about personal and others’ experiences
of partner violence
•Exposure
to support options for women living with
violence (including field visit)
•Aim
and overview of the WHO Study and questionnaire
•Interviewing
techniques and safety measures
World Health
Organization Gender, Women and He=
alth
•Week 2
•=
Detailed question by question
explanation of questionnaire
explanation of questionnaire
•=
Role-plays and field practice of approaching the household and using the complete questionnaire – <=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman";
font-size:88%'>including interviewing survivors of intimate partner =
violence, practice at how to respond if interview =
interrupted or if respondent becomes distressed
=
•=
Separate sessions for supervisors on supervisory =
procedures
World Health
Organization Gender, Women and He=
alth
•Week 3
•=
Sampling procedures, including
repeated visits and re-sampling
repeated visits and re-sampling
•=
Pilot testing of questionnaire and all field procedures, =
including logistics, safety measures, supervisory procedures in at least two different locations, alternated by debriefing and feedback sessions
<=
/span>
•=
Final adjustments to questionnaire and field =
procedures
•=
Training of data entry staff on all aspects of data =
=
management using questionnaires from pilot study
World Health
Organization Gender, Women and He=
alth
Evidence of the value of training=
Serbia and
Montenegro 2003
selected interviewers, trained
during 3 weeks
<=
span
style=3D'visibility:hidden'>•
•<=
span
style=3D'visibility:hidden'>•
World Health
Organization Gender, Women and He=
alth
Special training vs professional <=
span
lang=3DEN-GB style=3D'font-family:"Times New Roman";mso-ascii-font-family:=
"Times New Roman";
font-size:91%'>interviewers
38%
46%
Respondent
satisfaction – without
violence
29%
46%
Respondent
satisfaction – with
violence
21%
26%
Disclosure rate
86%
93%
Response rate
Professional,&#=
13;
1 day training<=
/span>
Inexperienced,&=
#13;
3 week training=
World Health
Organization Gender, Women and He=
alth
“I learned a lot from the beginning of the training, till the <=
span
style=3D'position:absolute;top:18.25%;left:27.34%;width:70.22%;height:7.5%=
'>end of the survey. The survey opened wounds, but I had to learn to face it and cope with it. The respondents really needed and enjoyed this experience… My career path changed, … because I could do something which can make a difference…” Interviewer from Namibia
<=
/span>
World Health
Organization Gender, Women and He=
alth
Points to take home<=
/b>
<=
/div>
•=
A
population based survey on violence against women should be and can b=
e done
ethically and safely
=
•Women are willing to share experiences
with trained and empathetic interviewers
World Health
Organization Gender, Women and He=
alth
Group work
INDIVIDUAL CONSE= NT FORM
INDIVIDUAL CONSE= NT FORM
World Health
Organization Gender, Women and He=
alth
W= HO VAW Study
Objectives
<=
span
style=3D'font-size:88%'>•Estimates of preval=
ence
of violence against women
•Associations between partner violence and health variables
•Risk and protective factors for domestic violence against women
•Strategies used by women who experience domestic violence
World Health
Organization Gender, Women and He=
alth
•&=
#13;
•Hello, my name is
*. I work for *. We are conducting a survey in STUDY LOCATION to learn about women’s health and =
life experiences. =
You
have been chosen by chance (as in a lottery / raffle) =
to
participate in the study.
•I want to assure you
that all of your answers will be kept strictly secret. I will not keep a record of your name or address. Y=
ou have the right to stop the interview at any time, or to skip
any questions that you
don’t want to answer. There are no
right or wrong answers. Some of the topics may be difficult to=
discuss, but many women have found it useful to have the opportunity to talk.
•Your participation =
is
completely voluntary but your experiences could be very helpful to other women in COUNTRY.
•Do you have any
questions?
•The interview takes
approximately * minutes to
complete.
•Do you agree to be
interviewed?
![](3D"slide0718_image018.png")
![](3D"slide0718_image019.png")
![](3D"slide0718_image020.png")
![](3D"slide0718_image021.png")
![](3D"slide0718_image022.png")
![](3D"slide0718_image023.png")
![](3D"slide0718_image024.png")
![](3D"slide0718_image025.png")
![](3D"slide0718_image026.png")
![](3D"slide0718_image027.png")
World Health
Organization Gender, Women and He=
alth
•NOTE WHETHER RESPON=
DENT
AGREES TO INTERVIEW OR NOT
•[ ]
DOES NOT AGREE TO BE INTERVIEWED THANK PARTICIPANT FOR HER TIME AND END
•&=
#13;
•[ ]
AGREES TO BE INTERVIEWED
•
Is now a good time = to talk?
Is now a good time = to talk?
•It’s very important
that we talk in private. Is this =
a good
place to hold t=
he
interview, or is there somewhere else that you would like to go?
=
•________________=
____________________________________
•TO BE COMPLETED =
BY
INTERVIEWER
•I CERTIFY THAT I HA=
VE
READ THE ABOVE CONSENT PROCEDURE TO THE PARTICIPANT.
•SIGNED:
•
![](3D"slide0719_image028.png")
World Health
Organization Gender, Women and He=
alth
Introduct=
ion
of Section 7 to ask about violence experience
• “ When two people marry or live together, they =
=
usually share both good and bad moments. I would now like to ask you some questions about your current and past relationships and how your husband / partner treats (treated) you.
If anyone interrupts us I will change the topic of conversation. I would again like to assure you that your answers will be kept secret, and that you do not have to answer any questions that you do not want to. May I
continue?”
<=
span
style=3D'visibility:hidden'>•
World Health
Organization Gender, Women and He=
alth
<=
span
style=3D'visibility:hidden'>•
jansenh@who.int
=
http://www.who.int/gender/
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