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BackgroundThe Portable Eye Examination Kit (Peek) is a mobile phone–based ophthalmic testing system that has been developed to perform comprehensive eye examinations. Shortages in ophthalmic personnel, the high cost, and the difficulty in transporting equipment have made it challenging to offer services, particularly in rural areas. Peek offers a solution for overcoming barriers of limited access to traditional ophthalmic testing methods and has been pilot tested on adults in Nakuru, Kenya, and compared with traditional eye examination tools. ObjectiveThis qualitative study evaluated the acceptability and usability of Peek in addition to perceptions regarding its adoption and nationwide deployment. MethodsSemistructured interviews were conducted with patients and analyzed using a framework approach. This included analysis of interviews from 20 patients, 8 health care providers (HCPs), and 4 key decision makers in ophthalmic health care provision in Kenya. The participants were purposefully sampled. The coding structure involved predefined themes for assessing the following: (1) the context, that is, environment, user, task, and technology; (2) patient acceptability, that is, patients' perceived benefits, patient preference, and patient satisfaction; (3) usability, that is, efficiency, effectiveness, learnability, and flexibility and operability of Peek; and (4) the benefits of Peek in strengthening eye care provision, that is, capabilities enhancer, opportunity creator, social enabler, and knowledge generator. Emerging themes relating to the objectives were explored from the data using thematic analysis. ResultsPatients found Peek to be acceptable because of its benefits in overcoming the barriers to accessing ophthalmic services. Most thought it to be fast, convenient, and able to reach a large population. All patients expressed being satisfied with Peek. The HCPs perceived it to satisfy the criteria for usability and found Peek to be acceptable based on the technology acceptance model. Peek was also found to have features required for strengthening ophthalmic delivery by aiding detection and diagnosis, provision of decision support, improving communication between provider and patient and among providers, linking patients to services, monitoring, and assisting in education and training. Some of the deployment-related issues included the need for government and community involvement, communication and awareness creation, data protection, infrastructure development including capacity creation, and training and maintenance support. ConclusionsAccording to all parties interviewed, Peek is an acceptable solution, as it provides a beneficial service, supports patients' needs, and fulfills HCPs' roles, overall contributing to strengthening eye health.

Background: Half of the world's children experience violence every year, but the meaning of violence is not universally agreed. We may therefore risk failing to measure, and address, the acts that matter most to children and adolescents. In this paper, we describe and synthesise evidence on how children and adolescents in sub-Saharan Africa conceptualise different behavioural acts which are deemed violence in childhood under WHO and UN CRC definitions. Methods and findings: We conducted a systematic review of qualitative studies. We searched PsychINFO, CINAHL, Embase, Global Health, Medline and ERIC for all publications released prior to March 2023. 30 papers met inclusion criteria. We synthesised primary data from children and adolescents and drew upon theoretical and contextual interpretations of authors of included studies. Only 12 of more than 45 sub-Saharan African countries were represented with relevant research. Of the 30 included papers, 25 came from three countries: South Africa, Uganda and Ghana. Only 10 of 30 papers reported data from young children (pre-adolescence), and 18 of 30 papers primarily focused on sexual violence. 14 studies used child friendly and/or participatory methods. From this limited evidence, we identified six overarching themes in how children and adolescents conceptualised their experiences of acts internationally recognised as violence: 1) adults abusing or neglecting responsibility; 2) sexual violence from peers, family and community members; 3) violence in established intimate relationships; 4) emotional violence surrounding sex from peers and community members; 5) fighting and beating between peers; 6) street and community dangers. No studies meeting our inclusion criteria specifically examined children or adolescents' conceptualisations of homophobic or transphobic violence; violence against children with disabilities; boys' experiences of sexual violence from male perpetrators; trafficking, modern slavery or conflict; child labour; or female genital mutilation. We found that three dimensions were important in how children and adolescents constructed conceptualisations of violence: their age, relationship to the perpetrator, and the physical location of acts they had experienced. These dimensions were interrelated and gendered. Conclusion: The current limited evidence base suggests children and adolescents' conceptualisations of violence overlapped with, but were also distinct from, the WHO and UNCRC definitions of violence. Currently international survey tools focus on measuring types and frequencies of particular acts and neglect to focus on children's understandings of those acts. Relationship to perpetrator, age of child, physical location are all important in how children conceptualise their experiences of acts internationally recognised as violence, and therefore might be important for their health and social outcomes. Those developing measures should account for these dimensions when developing items for testing. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic has affected children's risk of violence in their homes, communities and online, and has compromised the ability of child protection systems to promptly detect and respond to cases of violence. However, the need to strengthen violence prevention and response services has received insufficient attention in national and global pandemic response and mitigation strategies. In this paper, we summarize the growing body of evidence on the links between the pandemic and violence against children. Drawing on the World Health Organization's INSPIRE framework to end violence against children, we illustrate how the pandemic is affecting prevention and response efforts. For each of the seven INSPIRE strategies we identify how responses to the pandemic have changed children's risk of violence. We offer ideas for how governments, policy-makers, and international and civil society organizations can address violence in the context of a protracted COVID-19 crisis. We conclude by highlighting how the current pandemic offers opportunities to improve existing child protection systems to address violence against children. We suggest enhanced multisectoral coordination across the health, education, law enforcement, housing, child and social protection sectors. Actions need to prioritize the primary prevention of violence and promote the central role of children and adolescents in decision-making and programme design processes. Finally, we stress the continued need for better data and evidence to inform violence prevention and response strategies that can be effective during and beyond the COVID-19 pandemic. La pandemie de maladie a coronavirus 2019 (COVID-19) a eu un impact sur le risque de violence a l'egard des enfants a domicile, au sein de leur communaute et en ligne. Elle a egalement empeche les systemes de protection de l'enfance d'identifier rapidement les situations de ce typeetd'y reagirdesque possible. Pourtant, la necessitede renforcer les services de prevention et d'action en la matiere n'a pas ete suffisamment prise en compte dans les strategies nationales et internationales d'intervention et d'attenuation des effets de la pandemie. Le present document reprend l'accumulation de preuves confirmant les liens entre pandemie et violence a l'egard des enfants. En nous inspirant du cadre INSPIRE de l'Organisation mondiale de la Sante visant a mettre fin a la violence a l'encontre des enfants, nous illustrons la facon dont la pandemie affecte les efforts de prevention et d'action. Pour chacune des sept strategies INSPIRE, nous determinons comment les mesures de lutte contre la pandemie ont influence le risque de violence envers les enfants. Nous formulons des pistes pour que les gouvernements, les legislateurs, les institutions Internationales et les organisations de la societe civile puissent remedier a cette violence dans un contexte de crise prolongee due a la COVID-19. En guise de conclusion, nous mettons en lumiere les opportunites qu'offre la pandemie actuelle d'ameliorer les systemes existants de protection de l'enfance pour mieux combattre la violence envers les enfants. Nous suggerons d'accroitre la collaboration entre les secteurs de la sante, de l'education, du maintien de l'ordre, du logement, des droits de l'enfant et de la protection sociale. Les actions entreprises doivent sefocaliser sur la prevention primaire de la violence et promouvoir le role central des enfants et adolescents dans les processus de conception de programmes et de prise de decisions. Enfin, nous soulignons le besoin permanent de donnees et de preuves fiables pour orienter les strategies de prevention et d'intervention face a la violence, afin degarantir leur efficacite pendantetapres la pandemie de COVID-19. La pandemia de la enfermedad porcoronavirus (COVID-19) ha afectado al riesgo de violencia infantil que sufren los ninos en sus hogares, comunidades y en linea, y ha puesto en peligro la capacidad de los sistemas de proteccion infantil para detectar y responder rapidamente a los casos de violencia. Sin embargo, la necesidad de reforzar los servicios de prevencion y respuesta a la violencia no ha recibido suficiente atencion en las estrategias nacionales y mundiales de respuesta y mitigacion de la pandemia. En este documento, resumimos el creciente conjunto de pruebas sobre los vinculos entre la pandemia y la violencia infantil. Basandonos en el marco INSPIRE de la Organizacion Mundial de la Salud para poner fin a la violencia Infantil, ilustramos como la pandemia esta afectando a los esfuerzos de prevencion y respuesta. Para cada una de las siete estrategias de INSPIRE, identificamos como las respuestas a la pandemia han cambiado el riesgo de violencia infantil. Ofrecemos ideas sobre como los gobiernos, los responsables politicos y las organizaciones internacionales y de la sociedad civil pueden abordar la violencia en el contexto de una crisis prolongada de COVID-19. Concluimos destacando como la pandemia actual ofrece oportunidades para mejorar los sistemas de proteccion infantil existentes para abordar este tipo de violencia. Sugerimos una mayor coordinacion multisectorial en los sectores de la salud, la educacion, la aplicacion de la ley, la vivienda y la proteccion social infantil. Las acciones deben priorizar la prevencion primaria de la violencia y promover el papel central de los ninos y adolescentes en los procesos de toma de decisiones y en el diseno de programas. Por ultimo, subrayamos la necesidad permanente de contar con mejores datos y pruebas para fundamentar las estrategias de prevencion y respuesta a la violencia que puedan ser eficaces durante la pandemia de COVID-19 y seguir vigentes cuando esta pase. [phrase omitted], Introduction Throughout the coronavirus disease 2019 (COVID-19) pandemic, children have often been referred to as silent spreaders, low-risk or invisible carriers of the disease. These descriptions negate the well-documented adverse [...]

In this qualitative study of women participating in an intimate partner violence (IPV) prevention trial, experiences of IPV and the context that shapes support-seeking were explored through in-depth interviews and focus groups discussions. Decisions to seek support were influenced by a range of factors including fear of further abuse, shame, acceptance of IPV as normal, belief that IPV is a private matter between the couple, economic dependence on male partners, and a poorly responsive legal and justice system. Gender empowerment programs need to intervene at the social, cultural, political, and economic levels that shape justification and meanings attached to IPV and women's decisions in seeking support. [ABSTRACT FROM AUTHOR]

Scientists and global commentators watched African countries closely in the early months of the COVID‐19 pandemic, predicting an impending disaster: the virus was projected to overwhelm already weak health systems. These expectations were informed by imaginaries of Africa as an inevitable site of epidemic disaster. This paper draws on accounts from Sierra Leone, Tanzania, and Democratic Republic of the Congo to contrast global catastrophe framings with everyday imaginations and experiences of crisis and crisis management. Utilising ethnographic research, the paper initially explores how COVID‐19 was understood in relation to previous epidemics, from HIV (human immunodeficiency virus) to Ebola, as well as political conflict. It then considers how global crisis narratives both inform and are in tension with everyday collective and personal experiences. The paper brings these empirical reflections into a conversation with theoretical debates on the discursive construction of crisis and its effects, and argues that these tensions matter because crisis framings have consequences. [ABSTRACT FROM AUTHOR]