Suchergebnisse

This article uses a case study design to explore attempted intimate femicide in metropolitan São Paulo, Brazil. We conducted 30 in-depth interviews with adult women on community and personal relationship experiences, health-care services, and national legislation about violence against women. Through a thorough transcript review, we identified two participants, Maria* and Raquel*, whose intimate partners attempted to kill them. We used a modified grounded theory approach to code the entire sample, and further analysed these transcripts to identify missed opportunities for intervention in both the prevention of- and responses to intimate partner violence (IPV), and the antecedents of attempted intimate femicide.
Both women had normalized experiences of violence, and experienced psychological abuse prior to the attempted intimate femicide. Social and familial networks were sources of shame for Raquel and support for Maria. Neither woman expressed confidence in law enforcement's ability to protect women and girls from IPV.
These cases illustrate the need for multi-tiered interventions to prevent femicide in Brazil, which boasts one of the highest global female homicide rates. Although anti-femicide laws exist, better mechanisms are needed to integrate health, legal and social services for IPV and femicide prevention. In addition, community- and interpersonal- level interventions that counteract the Brazilian 'culture of violence' and machismo may provide support for at-risk women and girls.
*pseudonyms have been used to protect the identity of the participants

PURPOSE AND OBJECTIVES: Low- and middle-income countries (LMICs) have a large burden of noncommunicable diseases and confront leadership capacity challenges and gaps in implementation of proven interventions. To address these issues, we designed the Public Health Leadership and Implementation Academy (PH-LEADER) for noncommunicable diseases. The objective of this program evaluation was to assess the quality and effectiveness of PH-LEADER. INTERVENTION APPROACH: PH-LEADER was directed at midcareer public health professionals, researchers, and government public health workers from LMICs who were involved in prevention and control of noncommunicable diseases. The 1-year program focused on building implementation research and leadership capacity to address noncommunicable diseases and included 3 complementary components: a 2-month online preparation period, a 2-week summer course in the United States, and a 9-month, in-country, mentored project. EVALUATION METHODS: Four trainee groups participated from 2013 through 2016. We collected demographic information on all trainees and monitored project and program outputs. Among the 2015 and 2016 trainees, we assessed program satisfaction and pre-post program changes in leadership practices and the perceived competence of trainees for performing implementation research. RESULTS: Ninety professionals (mean age 38.8 years; 57% male) from 12 countries were trained over 4 years. Of these trainees, 50% were from India and 29% from Mexico. Trainees developed 53 projects and 9 publications. Among 2015 and 2016 trainees who completed evaluation surveys (n = 46 of 55), we saw pre-post training improvements in the frequency with which they acted as role models (Cohen's d = 0.62, P <.001), inspired a shared vision (d = 0.43, P =.005), challenged current processes (d = 0.60, P <.001), enabled others to act (d = 0.51, P =.001), and encouraged others by recognizing or celebrating their contributions and accomplishments (d = 0.49, P =.002). Through short on-site evaluation forms (scale of 1-10), trainees rated summer course sessions as useful (mean, 7.5; SD = 0.2), with very good content (mean, 8.5; SD = 0.6) and delivered by very good professors (mean, 8.6; SD = 0.6), though they highlighted areas for improvement. IMPLICATIONS FOR PUBLIC HEALTH: The PH-LEADER program is a promising strategy to build implementation research and leadership capacity to address noncommunicable diseases in LMICs.