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Decades of 'feminist' sexual- and gender-based violence (SGBV) policies have produced limited change in southern African SGBV rates. Recent critiques highlight ongoing colonial legacies in such policymaking, arguing that these legacies limit the potential for liberatory change. Further, reflecting on such discourses can highlight reasons behind global public health intervention failure. To promote reflexivity among public health actors who create, reproduce, and implement SGBV policies, this paper presents a critical discourse analysis of how women's empowerment is constructed in foundational global and national health and development policies bearing on SGBV in Zambia. The analysis identifies neoliberal feminist discourses of empowerment: (i) the protection of women, which perpetuates a saviour complex; (ii) the promotion of equality to men, which excludes those deemed unworthy; (iii) the eradication of harmful cultural norms, which challenge the preservation of African values; and (iv) (neoliberal) empowerment through women's attained employment and capital, which empowers women within unequal economic relations rather than liberating women from those relations. The author critiques such neoliberal empowerment discourses for failing to structurally transform the conditions for women's liberation. This paper offers a first step to the dismantling of colonial structures in SGBV policies by unpacking and promoting reflexivity about such discourses. [ABSTRACT FROM AUTHOR]

There has been a push for understanding gendered violence in WASH in recent times. Attention is therefore shifting to how these issues are conceptualised, considering their embeddedness in context. One step primarily is to understand how existing policies in WASH acknowledge the needs of women and girls in WASH. In doing this, we conducted a summative content analysis of selected policy documents on WASH: five at the international level and five each from Ghana, Uganda and Kenya. Findings suggest that existing policies inadequately acknowledge WASH related gender-based violence and pay little attention to the complex ways gender and WASH relations are intimately connected. Generally, a holistic policy approach for addressing gender-based violence in WASH is needed. The paper recommends a system policy approach to address the unique needs of women and girls in WASH in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

This paper aims to provide an analytical insight on the current state of knowledge on gender-based violence among people with disabilities, a topic where the level of data is relatively low. We briefly discuss the current research on: (a) the prevalence, risk factors and the theoretical approaches for gender-based violence among people with disabilities. (b) Service provision among people with disabilities who experience gender-based violence. (c) We also highlight areas where further research is required, the applicable theoretical approaches and provide an example on how Sweden is attempting to bridge this knowledge gap through implementing the Disability and Intimate-partner violence project (DIS-IPV) project. [ABSTRACT FROM AUTHOR]

This paper presents the results of formative research conducted from January to June 2020 in the Department of Atlántico, Caribbean region of Colombia, whose findings were used as inputs to design the national strategy for comprehensive sexuality education (CSE) outside school – Tírala Plena – including its curriculum. This is within the framework of the multi-country project coordinated by UNFPA and WHO aimed at generating evidence on the role of facilitators in the delivery of CSE in non-school contexts. The research was carried out in four municipalities in northern Colombia, in rural and marginal urban contexts with conditions of vulnerability for the adolescent population, including a strong presence of migrant populations from Venezuela. A total of 150 male and female adolescents ages 10–17 participated in the formative research. Workshops such as patchwork quilt, body mapping and talking maps were used as methods to gather information. The groups were divided by sex and age (10–13 years old and 14–17 years old). Knowledge, attitudes and social norms regarding adolescent pregnancy, sexually transmitted infections, including human immunodeficiency virus, and gender-based violence, were identified in adolescents (schooled and not schooled, but with minimal or no access to CSE). All of the above enabled us to establish a set of recommendations for the strengthening of the CSE strategy Tírala plena. [ABSTRACT FROM AUTHOR]

We report on a comparative situational analysis of comprehensive abortion care (CAC) in Botswana, Eswatini, Lesotho and Namibia. We conducted systematic literature searches and country consultations and used a reparative health justice approach (with four dimensions) for the analysis. The following findings pertain to all four countries, except where indicated. Individual material dimension: pervasive gender-based violence (GBV); unmet need for contraception (15−17%); high HIV prevalence; poor abortion access for rape survivors; fees for sexual and reproductive health (SRH) services (Eswatini). Collective material dimension: no clear national budgeting for SRH; over-reliance on donor funding (Eswatini; Lesotho); no national CAC guidelines or guidance on legal abortion access; poor data collection and management systems; shortage and inequitable distribution of staff; few facilities providing abortion care. Individual symbolic dimension: gender norms justify GBV; stigma attached to both abortion and unwed or early pregnancies. Collective symbolic dimension: policy commitments to reducing unsafe abortion and to post-abortion care, but not to increasing access to legal abortion; inadequate research; contradictions in abortion legislation (Botswana); inadequate staff training in CAC. Political will to ensure CAC within the country's legislation is required. Reparative health justice comparisons provide a powerful tool for foregrounding necessary policy and practice change. [ABSTRACT FROM AUTHOR]

Background: The Syrian conflict has resulted in major humanitarian crises. The risk is particularly high amongst female children who face additional gendered risks, such as harassment and sexual violence, including a rise in prevalence of child marriage. Despite the importance of this topic, current literature remains relatively scarce. Objectives: This study aims to explore the social and healthcare repercussions of Syrian refugee child marriages in Jordan and Lebanon. Methods: A systematic review of the literature was carried out to gather evidence, from a total of eight articles. Data analysis was conducted using the Critical Appraisal Skills Programme check tool to systematically assess the trustworthiness, relevance and results of the included papers. Results: The findings of this research identify tradition, honour, economics, fear, and protection-related factors as drivers of child marriage of refugees in Jordan and Lebanon. These motives overlap with findings regarding access to reproductive health and reproductive rights. The lack of autonomy of the child to give informed consent is augmented in the context of protracted violence and displacement. Conclusion: There is a need for a holistic approach to provide safe spaces, education, and protection to young girls and their families to reduce their acceptance of child marriage. [ABSTRACT FROM AUTHOR]

While there are a growing number of interventions and evaluations of programmes aimed at changing gender norms and violence against women and girls, there remains a dearth of documentation outlining the challenges faced in conducting these interventions and evaluations, particularly in traditional and low literacy settings. The Do Kadam Barabari Ki Ore (Two Steps Towards Equality) programme sought to understand what works to prevent violence against women and girls in Bihar, India. This paper draws insights from process evaluation data. It describes promising features and challenges of implementation, and characteristics which weaken the potential effects of complex, community based, social sector programmes that aim to change deeply entrenched gender power hierarchies. We drew on the Medical Research Council framework for process evaluation in analysing our process evaluation data, and focus on mechanisms of impact, and factors inhibiting programme success, including contextual and implementation challenges. The paper also outlines measures that may help overcome observed challenges and areas that require modifications and/or further investigation. The programme experienced several challenges. These included contextual issues, such as the lack of leadership skills of those delivering the intervention and the gap between expected responsibilities and activities of government platforms and reality. Implementation challenges were encountered in reaching men and boys, younger women and the community at large and ensuring their regular attendance; and in maintaining the fidelity of the intervention activities. Our insights call for an evidence-supported dialogue on these challenges and how best to anticipate and address them. [ABSTRACT FROM AUTHOR]

There is growing interest in engaging men and boys in health and development programmes targeting the intersection of HIV risk, substance abuse, and violence. Understanding the conceptualisations of masculinities or masculine identities that shape both behaviours and opportunities for intervention is central to advancing the global agenda to engage men in health and development interventions. This paper examines an intervention using soccer and job training to engage and deliver activities for HIV prevention, substance abuse, and gender-based violence in a South African township. A literature review provides theoretical, historical and social context for the intersection of gender, masculinity, soccer, violence, and sexual relationships. Qualitative data from in-depth interviews and focus groups is analysed using theoretical and contextual frames to elucidate the negotiation of shifting, contradictory, and conflicting masculine roles. Results highlight how changing risky, normative behaviours among young men is a negotiated process entailing men's relationships with women and with other men. [ABSTRACT FROM AUTHOR]

Brazil is a middle-income country with universal maternity care, mostly by doctors. The experience of normal birth often includes rigid routines, aggressive interventions, and abusive, disrespectful treatment. In Brazil, this has been referred to as dehumanised care and, more recently, as obstetric violence. Since the early 1990s, social movements (SM) have struggled to change practices, public policies and provider training. The aim of this paper is to describe and analyse the role of SM in promoting change in maternity care, and in provider training. In this integrative review using a gender-oriented approach, we searched the Scielo database and the Ministry of Health’s (MofH) publications and edicts for institutional and research papers on SM initiatives addressing disrespect and abuse in the last 25 years (1993-2018) in Brazil, and their impact on public policies and training programmes. We analyse these groups of interrelated initiatives: (1) political actions of SM resulting in changes in public policies and legislation; (2) events organised by SM for diffusion of information to the public; (3) MofH policies to humanise childbirth with participation of SM; and (4) initiatives to change providers’ training, including legal actions based on obstetric violence reports. To promote real change in maternity care, the progression of policies and enabling environment of laws, regulations, and broad dissemination of information, need to go hand in hand with changes in all health providers’ training - including a solid base in ethics, gender and human rights. [ABSTRACT FROM AUTHOR]

Background: Urban informal settlements remain sites of high HIV incidence and prevalence, as well as violence. Increasing attention is paid on how configurations of young men's masculinities shape these practices through exploring how men build respect and identity. In this paper, we explore how young Black South Africans in two urban informal settlements construct respect and a masculine identity. Methods: Data are drawn from three focus groups and 19 in-depth interviews. Results: We suggest that while young men aspire to a 'traditional' masculinity, prioritising economic power and control over the household, we suggest that a youth masculinity emerges which, in lieu of alternative ways to display power, prioritises violence and control over men's sexual partners, men seeking multiple sexual partners and men's violence to other men. This functions as a way of demonstrating masculinity and their position within a public gender order. Discussion: We suggest there are three implications of the findings for working with men on violence and HIV-risk reduction. First, there exist a number of contradictions in men's discourses about masculinity that may provide spaces and opportunities for change. Second, it is important to work on multiple issues at once given the way violence, alcohol use, and sexual risk are interlinked in youth masculinity. Finally, engaging with men's exclusion from the capitalist system may provide an important way to reduce violence. [ABSTRACT FROM AUTHOR]

Brazil has a historical gap regarding information on violence against women. Herein we aimed to evaluate the association of socioeconomic and demographic characteristics with physical violence against women in Brazil, as well as the possible escalation of violence to severe patterns of violence. We analysed data from the 3rd Brazilian Household Survey on Substance Use, in 2015. The main outcomes were reporting any physical violence and being stabbed/shot in the last 12-months. Logistic regressions were fitted to assess the association between socioeconomic and demographic variables with the outcomes. We estimated 3.8 million women reported any physical violence (5.52%): 3.79% reported threats to beat/ push/kick, 1.87% threats with knife/gun, 2.49% were beaten/pushed/kicked, 0.63% were spanked/ choked, and 0.21% were stabbed/shot. The higher the severity of violence, the higher the number of types of violence experienced. The likelihood of reporting any violence was higher among women 18–24 years, without a stable partner, who were at an informal job or unemployed, and who live in urban areas. The sociodemographic characteristics associated with reporting any violence reinforce the importance of addressing gender inequalities. Evidence of escalation violence reinforces the need to protect and care for women who report any type of violence. [ABSTRACT FROM AUTHOR]

Lethal violence requires a gender-based analysis which recognises that femicide is different from homicide in many ways. Structural factors such as national income and wealth equality together with government policies may influence the scale of the problem globally. This study is an original attempt to examine associations between femicide rates, these structural factors and national action plans using a longitudinal design. Data from two international surveys were combined to examine anti-femicide actions (n = 133 countries) and temporal femicide prevalence trends (n = 66 countries) in the context of national income and wealth inequality factors. The United Nations Survey of Crime Trends and Operations of Criminal Justice Systems was used to estimate femicide rates per country 2003–2014 and the World Health Organisation Global Status Report on Violence Prevention provided data on policy initiatives in place by 2014. Results indicate that femicide rates decreased by 32% worldwide but increased by 26% in low- and medium-income countries. The structural factors of low income and high inequality were significantly negatively associated with the 2014 femicide rate. Structural factors must be addressed alongside policy and legal initiatives if significant gains are to be made toward eradicating violence against women and girls. [ABSTRACT FROM AUTHOR]

South Africa has a significant violence problem. The exposure of girls and women to interpersonal violence is widespread, and the victimization of men, especially to severe and homicidal forms of aggression, is of considerable concern, with male homicide eight times the global rate. In the last two decades, there have been a plethora of South African policies to promote safety. However, indications suggest that the policy response to violence is not coherently formulated, comprehensive, or evenly implemented. This study examines selected South African national legislative instruments in terms of their framing and definition of violence and its typology, vulnerable populations, and prevention. This study comprises a directed content analysis of selected legislative documents from South African ministries mandated to prevent violence and its consequences or tasked with the prevention of key contributors to violence. Documents were selected using an electronic keyword search method and analyzed independently by two researchers. The legislative documents recognized the high levels of violence, confirmed the prioritization of selected vulnerable groups, especially women, children, disabled persons, and rural populations, and above all drew on criminological perspectives to emphasize tertiary prevention interventions. There is a policy focus on the protection and support of victims and the prosecution of perpetrators, but near absent recognition of men as victims. There is a need to broaden the policy framework from primarily criminological and prosecutorial perspectives to include public health contributions. It is likewise important to enlarge the conceptions of vulnerability to include men alongside other vulnerable groups. These measures are important for shaping and resourcing prevention decisions and strengthening primary prevention approaches to violence. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to examine the association between perpetrator gender and victim gender and the use of sexually aggressive tactics (e.g., persistent enticement, verbal pressure, taking advantage of the inability to consent, and ignoring explicit non-consent). Methods: Participants were recruited from research panels to complete an online survey. They were asked to indicate which, if any, of 39 sexually aggressive tactics—representing four categories and nine subcategories—they had used to obtain sex, answering based on the gender with whom they most often have sex. Participants included 132 men who answered based on experiences with men (MSM), 131 men who answered based on experiences with women (MSW), 232 women who answered based on experiences with men (WSM), and 56 women who answered based on experiences with women (WSW). Results: MSM were more likely than all other groups to use enticement and more likely than WSM to engage in explicitly nonconsensual sex. WSM were more likely than MSW and WSW to take advantage of their partner's impaired ability to consent. There was no difference among groups in use of verbal pressure. Conclusions: Gendered sexual stereotypes may contribute to the types of tactics used by men and women against men and women. [ABSTRACT FROM AUTHOR]

Women are exposed to a variety of life stressors, particularly violence, during their lifetime which increases the risk of developing various psychiatric and somatic diseases, with the dysregulated secretion of cortisol as one potential biological mechanism. We examined the association between violence and other life stressors and hair cortisol concentration (HCC) in a population of urban women. We included 470 adult women (age = 21-86 years) attending the Cancer Detection Clinic in Iceland. The Life Stressor Checklist-Revised (LSC-R; 30-items) was used to assess exposure. HCC was measured with liquid chromatography coupled with tandem mass spectrometry. We used linear regression models to assess the association between life stressors and log-transformed HCC. The median HCC (pg/mg) in the study population was 4.9 (range 0.6-616.6). HCC was not associated with background covariates, including age (p=0.868), education level (p=0.824), marital status (p=0.545), income (p=0.363), occupation (p=0.192), but associated with current smoking (p=0.013). We noted a 3.3% (95% CI: 0.17-6.6%) associated increase in HCC per endorsed life stressor after adjusting for age and smoking, while non-violent life stressors were not associated with HCC. Per endorsed violence item, we observed a 10.2% (95% CI: 1.4-19.7%) associated increase in HCC after age and smoking adjustment. Women with lifetime exposure to both physical and sexual violence presented with higher HCC than unexposed women (p=0.010), after age and smoking adjustment. Lifetime exposure to violence was associated with higher levels of HCC in a community sample of women. These findings need confirmation with prospective studies. [ABSTRACT FROM AUTHOR]

Immigrant populations experience diverse barriers to access healthcare services in the host countries. Among them, undocumented immigrants have more restricted legal access conditions and higher risk of having poorer health. Likewise, women are more likely to seek healthcare and face gender-based factors that hinder their access. This thesis analysed the access of undocumented immigrants and immigrant women to public healthcare services in the Basque Country (Spain). The thesis contained three sub-studies, carried out with qualitative and quantitative methods. For the quantitative approach, the trend in the number of consultations in a free clinic for undocumented immigrants was analysed before and after the launch of a new law, using a negative binomial regression analysis (n = 9,272). For the qualitative approach, qualitative content analysis was applied to 25 in-depth interviews with 14 immigrant women and 11 free clinic healthcare professionals. No clear relationship was found between the application of more restrictive legal conditions for immigrants to access public healthcare services and the trend of attendance of undocumented immigrants to a free clinic. Access of undocumented immigrants and immigrant women to healthcare services was subject to barriers dependent on their characteristics, health system functioning, legal requirements and a stereotyped and poor social consideration of immigrants, shared by professionals at the health centres. Meanwhile, provision of legal information and support by individual professionals, social organizations and personal networks represented main facilitators for accessing. For the access of undocumented immigrants and immigrant women, structural and individual barriers based on their social vulnerability were found. Among others, gender-based violence reduced women's possibility to access healthcare services and being undocumented led to restricted access entitlement and to fear rejection at health centres. Therefore, besides ensuring immigrants' legal entitlement, there is need of promoting rights-based attention to get more inclusive health systems. [ABSTRACT FROM AUTHOR]

Girls face gendered violence on an everyday basis, and this may have severe health consequences. Purpose: The aim of this study was to learn about gendered violence facing girls in rural Sweden in their everyday life, as it is experienced by the girls themselves. Method: Using the photovoice method, we worked with 35 girls in an upper secondary school, aged between 16 and 20, to explore how they navigated social spaces and developed strategies for increased safety. Results: Thematic analysis revealed two main themes (constant fear and strategies) and four sub themes (fear of being raped, fear of being labelled and excluded, being "appropriately" sexually active, and appearance and performance for increased feelings of safety). Conclusion: We considered how gendered violence facing girls led to fear and marginalization in a range of situations and interactions. Consequently, girls occupied significantly smaller social spaces compared to boys, and we argue that this was reproduced and upheld through everyday practices informed by hegemonic masculinity and performativity. [ABSTRACT FROM AUTHOR]

Violence against women and girls (VAWG) is a public health problem and one of the most prevalent human rights violations in the world. Recently practitioners and researchers have taken an interest in community participation as a strategy for preventing VAWG. Despite the recent enthusiasm however, there has been little articulation of how participation in VAWG prevention programmes mobilises communities to challenge social norms and prevent VAWG. In an attempt to help address this gap, this article seeks to answer two research questions: (1) How does participation theoretically mobilise communities to prevent VAWG, and (2) how do nominally participatory programmes make use of these theoretical concepts in their (explicit or implicit) theories of change? To answer the first question, we draw on two well-recognised theories of participation and community mobilisation – Rifkin and Pridmore’s continuum of participation and Freire’s steps towards achieving critical consciousness – to clarify theoretical assumptions about how participation can mobilise community to reduce VAWG. To answer our second research question, we present the results from a review of primary prevention programmes that seek to reduce VAWG through community participation. Our analysis examines the explicit and implicit theories of change for these prevention programmes against the assumptions outlined from the theoretical literature. Our results help to better articulate realistic goals for community mobilisation and outline a theoretical basis for how participation as part of programming can effectively mobilise communities to reduce violence. We argue that, in order to be both effective and sustainable, the role of external agents in introducing programmes needs to be secondary to the ownership and empowerment of communities in designing and delivering their own strategies for VAWG prevention. [ABSTRACT FROM AUTHOR]

This article presents a case study of research in Dadaab, Kenya to highlight some of the relevant challenges encountered while conducting gender-based violence research in humanitarian settings. A longitudinal mixed-methods design was used to evaluate a comprehensive case-management intervention in the refugee complex near the border of Kenya and Somalia. We present an overview of both expected and unexpected challenges during preparation and implementation of the research, adaptations made to the research design, and lessons learned for future research in similar contexts. Some of the key challenges were attributed to the highly securitized and remote environment of Dadaab refugee camp, like many refugee camp settings, which created limitations for sampling designs, interview locations, and also created particular burdens for the research team members conducting interviews. In addition to the camp environment, the dynamic nature of events and trends in the camp setting created barriers to follow-up with longitudinal cohort participants as well as uncertainty on how to plan for future implementation of research design phases in response to camp changes. Conducting research in humanitarian settings requires a flexible approach to accommodate the challenges that can impact both service delivery and research activities. The discussion presented in this article contributes to the evolving practical guidance on conducting research in humanitarian settings. [ABSTRACT FROM AUTHOR]

There is significant evidence of the prevalence and factors associated with domestic violence in high and low-income country settings. However, men's views on domestic violence are still understudied and have never been reported in Nepali society. The aim of the study was to explore Nepali men's perceptions regarding domestic violence in their communities. The authors undertook a qualitative study using focus group discussions. Sixty-six married men, considered they were responsible for upholding family discipline and physically demonstrating their masculinity, and they suggested that violence was a mean for achieving this. Men's frustration when unable to fulfil their family's expectations or material needs, and cultural attitudes that precluded interference in other families' lives, were perceived as factors contributing to domestic violence. The men held the opinion that women also perpetrated domestic violence. Some men were reluctant to accept domestic violence as a norm in Nepali families and were aware of recent changes in societal expectations regarding gender roles. Overall, the Nepali men who participated in the study held different and sometimes opposing views on domestic violence, ranging from violence justified as a necessity for family discipline, uneasy acceptance that violence was commonplace in families, to definite opposition to the use of domestic violence. The study's findings provide information for identifying points of intervention for violence-prevention efforts and strategies to alter the social and cultural norms that lead to acceptance of domestic violence. [ABSTRACT FROM AUTHOR]

Background: Stability of measures in quantitative social science research is crucial to understand. There is very little evidence on the stability of violence against women and girls measures in the global South. Objective: To assess the test-retest stability of violence against women and girls measures, amongst young (18–30) people in South Africa. Methods: Data were collected from 124 women and 112 men at zero weeks (time 1) and two weeks (time 2), who resided in urban informal settlements in South Africa. Prevalence of each construct was assessed using chi-square contingency tables. Stability of self-report over time was assessed using Cohen's Kappa. Bivariate logistic regression assessed factors associated with changing responses between time 1 and time 2. Results: At group level prevalence of all measures showed no significant differences. Stability of self-report: kappas for past year physical IPV were both k0.20, for ever physical IPV (women k0.58; men k0.50). Sexual IPV in past 12m (women k0.44; men k0.18), and for ever sexual IPV (women k0.56; men k0.46). Kappas for men's perpetration of non-partner sexual violence was k0.29 for past 12m and k0.38 ever. In bivariate regression, completion of secondary education was associated with a reduced odds of changing responses over the time-period for sexual IPV ever women (OR0.16, 0.02–1.04), sexual IPV past 12 months men (OR 0.09, 0.01–0.56), past 12 month non-partner sexual violence men (OR0.19, 0.02–1.41) and lifetime non-partner sexual violence (OR0.23, 0.04–1.19). Being male, compared to being female, was associated with an increased likelihood of changing responses for past 12 month sexual IPV (OR2.10, 1.08–4.09). Conclusions: Prevalence estimates of violence against women measures are stable at group level, but stability of self-reported measures remains a concern. Individual statistical analyses must be treated with caution. Future studies are required to develop further understandings of stability of measures over time. [ABSTRACT FROM AUTHOR]

Background: Intersectionality has received increased interest within population health research in recent years, as a concept and framework to understand entangled dimensions of health inequalities, such as gender and socioeconomic inequalities in health. However, little attention has been paid to the intersectional middle groups, referring to those occupying positions of mixed advantage and disadvantage. Objective: This article aimed to 1) examine mental health inequalities between intersectional groups reflecting structural positions of gender and economic affluence and 2) decompose any observed health inequalities, among middle groups, into contributions from experiences and conditions representing processes of privilege and oppression. Design: Participants (N = 25,585) came from the cross-sectional 'Health on Equal Terms' survey covering 16- to 84-year-olds in the four northernmost counties of Sweden. Six intersectional positions were constructed from gender (woman vs. men) and tertiles (low vs. medium vs. high) of disposable income. Mental health was measured through the General Health Questionnaire-12. Explanatory variables covered areas of material conditions, job relations, violence, domestic burden, and healthcare contacts. Analysis of variance (Aim 1) and Blinder-Oaxaca decomposition analysis (Aim 2) were used. Results: Significant mental health inequalities were found between dominant (high-income women and middle-income men) and subordinate (middle-income women and low-income men) middle groups. The health inequalities between adjacent middle groups were mostly explained by violence (mid-income women vs. men comparison); material conditions (mid- vs. low-income men comparison); and material needs, job relations, and unmet medical needs (high- vs. mid-income women comparison). Conclusions: The study suggests complex processes whereby dominant middle groups in the intersectional space of economic affluence and gender can leverage strategic resources to gain mental health advantage relative to subordinate middle groups. [ABSTRACT FROM AUTHOR]

Background: High rates of violence and HIV have been documented within the South African context. Constructions of masculinity and femininity that position men as dominant and highly sexually active and women as subordinate and acquiescent have been found to contribute towards gender inequality. This inequality is in turn related to negative health consequences, specifically violence against women, children, and other men, as well as sexual risk. Within this context it becomes important to explore how problematic constructions of gender are being (re)produced and how these constructions are being challenged. Families have been identified as key sites in which gender is both constructed and enacted on a daily basis and it is within this space that children are first exposed to notions of gender. Objective: This article draws from a study that was intended to expand on the limited understandings of the ways in which gender (in)equality is constructed and conveyed within the context of South African families on an everyday basis. Design: Children and parents in 18 families from a range of different material and cultural backgrounds were interviewed about the meanings and practices of gender within their homes. Data were analysed using a Foucauldian discourse analysis. Results: The data reveal how problematic constructions of masculinity and femininity are (re)produced but also challenged within a range of different families. Gender and gender (in)equality are therefore routinely accomplished in complex ways. Conclusions: These findings have important implications for promoting gender equality and therefore for disrupting violence and sexual risk as gendered health issues. [ABSTRACT FROM AUTHOR]