Midwives reports of forms, causes, and responses to violence against women and girls in Yemen. A qualitative study with community midwives.

Violence against women and girls
(VAWG) is a serious human rights violation that has intensified in Yemen due to
war, displacement, and pandemics. The cultural stigma surrounding discussions
of VAWG, particularly sexual violence, compounded by a lack of resources for
affected individuals, poses significant challenges for research and program
implementation. This study involved qualitative interviews with 20 community
midwives from the National Yemeni Midwifery Association across four
governorates to explore the causes, forms, and consequences of VAWG and
identify potential resources for survivors. A Yemeni physician trained in
ethical VAWG research conducted the interviews, which were analysed
thematically by two researchers. The findings indicated that physical partner
violence was widely recognised as a crime; however, women and girls facing
sexual violence often faced severe social ramifications, including ostracism or
violence aimed at preserving family honour, leading to underreporting. Midwives
identified patriarchal culture and the ongoing economic crisis as key
contributors to VAWG. Health-related consequences for survivors included
physical injuries such as vaginal tears and obstetric fistula. Additionally,
midwives reported that survivors encountered humiliation within the healthcare
system. Most women and girls did not seek help; however, when they did, they
turned to their families or local leaders for support. To effectively
understand, prevent, and address VAWG in Yemen, strategies should prioritise
the safety and needs of women and align with cultural values. Insights from
community midwives can guide the development of VAWG-focused community-led
initiatives.<br><br>Ethical approval of the study protocol was obtained
from the Universitatsklinikum Heidelberg Research Ethics Committee (Approval
No. S-345/2021) and the Sana'a University of Medical Sciences (Approval No.
1548). Participants provided informed verbal consent because the COVID-19
pandemic was ongoing at the time of data collection and because the interview
did not ask for participants’ data or their experience of VAWG. While midwives
reported their experiences while working in SRH, we followed the best practice
for research with survivors of violence [19]. Interviewers were trained in conducting VAWG-related
research, and we ensured participants' privacy during the interview. Because of
the limited financial support for the project, we were not able to provide
psychological support to the respondents who shared their experiences of witnessing
or supporting survivors.