突发公共卫生事件与性健康和生殖健康、基于性别的暴力以及少女早婚之间的关联

——原载《BMC公共卫生》2023年第23卷，论文编号：117——

<BMC Public Health> 2023, volume 23, Article No: 117

【摘要】背景：随着 COVID-19 继续影响世界各地的生活和生计，妇女和女童受到的影响尤为严重。危机局势和相关的应对措施，例如封锁、学校关闭和旅行限制，往往会加剧少女面临的逆境和侵犯人权行为。我们进行了一项快速审查，以综合证据证明与青春期女孩中基于性别的不平等相关的突发公共卫生事件 (PHE) 的影响。方法: 我们系统地搜索了五个主要数据库。记录被导入在线筛选工具 Rayyan，10% 的记录经过三重筛选以符合资格。我们纳入了定性、混合方法和定量研究，以评估PHE与以下任何结果之间的关系：(1) 基于性别的暴力，(2) 早婚/强迫婚姻，以及 (3) 性健康和生殖健康。 由于纳入研究设计的异质性，未进行荟萃分析，并以叙述方式总结研究。发现: 在最初的 6004 篇文章中，有11项研究符合我们的资格标准。其中五项评估了自然灾害的影响，六项侧重于COVID-19大流行的后果。七项研究关注PHE对基于性别的暴力的影响，三项研究关注性健康和生殖健康，只有一项研究关注早婚。研究强调的主要影响包括 (1) 身体、心理和性虐待的增加，(2) 少女怀孕的发生率增加，(3) 月经卫生管理不善，以及 (4) 早婚的发生率。这些影响对于青春期的女孩来说，背后的机制是PHE特定的应对策略，如家庭限制、学校关闭、家庭经济状况恶化（如无力支付学费或日常生活费用）以及工作量减少和增加。结论：尽管关于COVID-19对基于性别的暴力、性健康和生殖健康，尤其是少女的强迫婚姻或早婚的影响的证据有限，但对其他PHE的研究结果表明，在危机期间，这些有害后果会加剧。我们的审查结果对为青春期女孩提供生活技能培训、金融知识培训、信贷支持和安全空间的政策和计划具有重要意义。

【关键词】性别不平等，突发公共卫生事件，青春期少女，性与生殖健康，童婚，暴力侵害妇女，COVID-19

[Abstract] Background: As COVID-19 continues to impact lives and livelihoods around the world, women and girls are disproportionately affected. Crisis situations and related response measures, such as lockdowns, school closures, and travel restrictions, often exacerbate the adversities and human rights violations faced by adolescent girls. We conducted a rapid review to synthesise evidence on the impact of public health emergencies (PHEs) related to gender-based inequalities among adolescent girls. Methods：We systematically searched five major databases. Records were imported into the online screening tool Rayyan, and 10% of the records were triple screened for eligibility. We included qualitative, mixed-methods, and quantitative studies that assessed the relationship between PHEs and any of the following outcomes: (1) gender-based violence, (2) early/forced marriage, and (3) sexual and reproductive health. Due to the heterogeneity of included study designs, no meta-analysis was performed, and studies were summarised narratively. Findings:  Out the initial 6004 articles, 11 studies met our eligibility criteria. Five of these assessed the impact of natural disasters and six were focused on consequences of the COVID-19 pandemic. Seven studies focused on the impact of PHEs on gender-based violence, three focused on sexual and reproductive health, and only one study looked at early marriage. The main impacts highlighted by the studies included (1) increases in physical, psychological, and sexual abuse, (2) increase in the occurrence of teenage pregnancy, (3) poor menstruation hygiene management, and (4) occurrence of early marriages. Mechanisms underlying these impacts were PHE-specific response strategies like home confinement, closure of schools, the worsening of families’ financial situation such as the inability to pay for school fees or day-to-day living costs, and the disempowerment of and increased workloads for adolescent girls. Conclusion:  Although evidence on the impact of COVID-19 on gender-based violence, sexual and reproductive health, and especially forced or early marriage of adolescent girls is limited, results from studies on other PHEs indicate that during crises, these detrimental outcomes are exacerbated. Findings from our review have important implications for policies and programs providing life skills training, financial literacy training, credit support, and safe spaces for adolescent girls.

[Key words] Gender inequality, Public health emergencies, Adolescent girls, Sexual and reproductive health, Child marriage, Violence against women, COVID-19

论文原文：Shruti Shukla, Jessy Amarachi Ezebuihe & Janina Isabel Steinert (2003). Association between public health emergencies and sexual and reproductive health, gender-based violence, and early marriage among adolescent girls: a rapid review. BMC Public Health, volume 23, Article number: 117.

https://doi.org/10.1186/s12889-023-15054-7

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