Active Public Health & Healthcare Pregnancy, Children & Inherited Conditions

NIHR Global Health Research Group on Violence Against Women and Violence Against Children: University of Birmingham/University of Cape Town in partnership with the Lancet Commission

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One in three women and over one billion children worldwide experience violence, yet most research on the issue comes from wealthy countries. This project works with survivors in South Africa, Mexico, Peru, Brazil and Sri Lanka to co-produce evidence on preventing violence against women and children in low-resource settings. The problem is stark: data, survivor engagement insights, and effective prevention strategies are abundant in high-income nations but scarce in the global south. The team will build survivor panels, map healthcare burdens using country-specific datasets, calculate the economic cost of inaction through macroeconomic modelling, and identify what actually works to prevent violence. They will also train early-career researchers and share findings with the World Health Organization, United Nations, and UNICEF. If successful, this research could shift how governments and international bodies design violence prevention policies in low- and middle-income countries. It could give survivors a direct voice in shaping health systems and legal frameworks, and provide concrete cost estimates that make the case for investment. The work is applied and policy-focused, with no fundamental science component—its value lies in generating actionable, context-specific recommendations for the five anchor countries and beyond.

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Question: How can we develop and adopt best practice in preventing violence against women (VAW)/violence against children (VAC) in diverse low resource settings? Background: VAW, (estimated to affect one in three women), and VAC (affecting over one billion children), are global public health issues associated with a substantial burden of morbidity and mortality. The Lancet Commission on VAW/C (an unfunded organisation of which the applicants are members) was established to identify best practice in adopting a public health approach to VAW/C globally. We identified that data/insights/survivor engagement on VAW/C are abundant in high-income countries but scarce in LMICs. We have identified five anchor countries who are engaged to address these concerns and provide recommendations to support other Southern Hemisphere nations. Aim: Our aim is to work across South Africa, Mexico, Peru, Brazil and Sri Lanka to co-produce (with survivors of VAW/C) research using a trauma informed framework which will help us understand the effects of violence across different contexts, provide recommendations to prevent violence and build local research capacity. Developing diverse, representative and inclusive survivor panels 1) Focus groups to explore setting specific barriers to survivor engagement in research/optimal methods for recruitment and sustainability, 2) Creation of a best practice framework for survivor panel development, 3) Development of sustainable survivor panels which are linked in with health decision makers & 4) Evaluation of survivor panel success and impact. Understanding the healthcare burden 1) Mapping exercise identifying country-specific datasets which could inform research into harms associated with VAW/C, 2) Undertaking a series of epidemiological studies describing which sub-groups of the population experience the greatest burden of harms & 3) Supplement gaps in the current data through a national survey over-sampling under-served communities. Describing the economic cost of inaction 1) Updating systematic reviews describing the breadth of harms associated with VAW/C, 2) Focus groups with key stakeholders capturing additional harms & 3) Social accounting matrix generated macroeconomic estimates of the cost of inaction. Finding out what works to prevent violence 1) Updating reviews and mapping exercises identifying what works to prevent VAW/C, 2) Creating culturally specific evaluation frameworks for complex evaluation, 3) Assessing policy efforts in relation to best practices & 4) Consensus exercise to identify where policy gaps exist & develop novel solutions. Knowledge exchange and training 1) Multi-disciplinary knowledge exchange programme (including short courses, workshops, videos and interactive lectures) relating to: engaging survivors in research/dissemination, health data science, health economics, complex evaluation and policy evaluation, 2) training programme for early career, doctoral and postgraduate researchers & 3) mentoring scheme for early career researchers. Timeline: 48 months Impact and dissemination: These objectives have been developed with survivors and the project is ultimately designed to give a voice to survivors in these 5 countries and beyond. The Commission will support the research team to share findings through co-produced; academic publications, workshops, videos, conference events, and through directly influencing policy in the World Health Organization, United Nations and UNICEF Innocenti.

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