J.25 GBV West Honduras Mescla 2019.pdf

MONITORING AND EVALUATION SUPPORT

FOR COLLABORATIVE LEARNING AND

ADAPTING (MESCLA) ACTIVITY

GENDER-BASED VIOLENCE STUDY IN WESTERN HONDURAS

SUBMISSION DATE: February 5, 2019 Contract Number: AID-OAA-I-15-00019 – Task Order Number: AID-522-TO-16-00002

This publication was produced for review by the United States Agency for International Development. It was prepared by Dexis Consulting Group.

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 2

MONITORING AND EVALUATION

SUPPORT FOR COLLABORATIVE LEARNING

AND ADAPTING (MESCLA) ACTIVITY

GENDER-BASED VIOLENCE STUDY IN WESTERN HONDURAS

SUBMITTED TO:

USAID/Honduras

PREPARED BY:

The Global Women’s Institute at the George Washington University and Estudios e Investigaciones de Centroamérica for Dexis Consulting Group

DISCLAIMER:

The authors’ views expressed in this document do not necessarily reflect the views of the United States Agency for International Development or the United States Government.

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 3

TABLE OF CONTENTS

Figures and Tables 4 ………………………………………………………………………………….…….…

Authors and Acknowledgments 5 …………………………………………………………………….…… Acronym List………………………………………………………………………………………....……...6 Executive Summary 7 …………………………………………………………………………………………

Background and Methods 7 ………………………………………………………………………………..

Results 7 ……………………………………………………………………………………………………

Implications for Action 8 …………………………………………………………………………………...

Recommendations 8 …………………………………………………………………………………….

Specific Recommendations for USAID DO2 Programming 9 …………………………………………..

Recommendations for Future Research 9 ……………………………………………………………

1. Background 10 …………………………………………………………………………………………..

1.1 Introduction 10 ………………………………………………………………………………………...

1.2 Context of the Study 11 ……………………………………………………………………………….

2. Study design and methods 13 …………………………………………………………………………...

2.1 Study Aims 13 ………………………………………………………………………………………….

2.2 Conceptual Framework 13 …………………………………………………………………………….

2.3 Study Area 15 …………………………………………………………………………………………..

2.4 Methodology…… 15 …………………………………………………………………………………..

2.5 Ethical Considerations 19 ……………………………………………………………………………...

3. Findings 20 ………………………………………………………………………………………………

3.1 Characteristics of Women and Girls in Western Honduras 20 ………………………………………

3.2 Gender Norms: Patriarchal Structure 20 ……………………………………………………………...

3.3 Gender-Based Violence in the Home 23 ………………………………………………………………

3.4 Gender-Based Violence in the Community 42 ………………………………………………………...

3.5 Other Types of Violence Based on Gender 47 ………………………………………………………..

4. Conclusions and Recommendations 53 ………………………………………………………………

4.1 Conclusions and General Recommendations 53 ……………………………………………………...

4.2 Specific Recommendations for USAID DO2 Programming 56 ………………………………………..

4.3 Recommendations for Future Research 57 ……………………………………………………………

5. References 59 …………………………………………………………………………………………...

6. Annexes 61……………………………………………………………………………………………...

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 4

FIGURES AND TABLES

Figure 1. Ecological Model on Violence against Women 14 Figure 2. Map of the Six Departments of Western Honduras 15

Figure 3. Proportion of women who agree with gender unequal statements 23 Figure 4. Proportion of women who justify violence 24 Figure 5. Prevalence of lifetime and past 12 months intimate partner violence reported by women and girls (ages 15-64) in Western Honduras 25 Figure 6. Prevalence of all types of violence by Department 26 Figure 7. Association between prevalence of different types of VAWG and women’s assessment of their health condition 27 Figure 8. Proportion of women who experience any type of IPV in their lifetime by age at first marriage/union and age at first pregnancy 29 Figure 9. Proportion of women who experience any type of IPV in their lifetime by her and her male partner’s education level 29 Figure 10. Proportion of women who have experienced different forms of IPV by controlling behaviors 32 Figure 11. Proportion of women survivors of IPV who sought help in an institution 35 Figure 12. Proportion of women survivors of IPV who did not seek help according to the reasons for not seeking help 36 Figure 13. Prevalence of different types of non-partner sexual abuse 44 Figure 14. Percentage of women survivors of non-partner sexual abuse who sought help at a formal institution 45

Table 1. Household survey response rates 16 Table 2. Focus groups and in-depth interviews 18 Table 3. Proportion of boys and girls according to activities they carryout when not in school 21 Table 4. Proportion of boys and girls who agree with gender unequal statements 22 Table 5. Proportion of girls and boys who said that they have suffered some type of abuse in school 47 Table 6. Proportion of children according to reaction of teachers when boys and girls misbehave 49

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 5

AUTHORS

Manuel Contreras-Urbina Margarita Quintanilla Víctor Manuel Morales Jessica Sánchez Angela Bourassa Junior Ovince Elizabeth Rojas

ACKNOWLEDGMENTS

USAID: Roger Sánchez, Michelle Wittenberger, Ritza Avilez, Samantha Croasdaile.

Fieldworker Coordinator: Kerin Yoseline Aceituno.

Fieldworkers: Household Survey: Lilian Vásquez Hernández, Elsa Marina Chavarría, María Mártires Vásquez, Alicia Gissela Nicolás, Glenda Lisbeth Carrillo, Dania Patricia Domínguez, Fani Yadira Hernández, Tesla Elisep García (Supervisora), Gloria Sarahí Ochoa, Johana Vanessa Erazo, Maritza Mansilla, Mirian Itzamary Orellana, Tania Yamileth Andrade, Ligia Villanueva (Supervisora), Estrella Milla Murillo, Isis Xaviera Caballero, Ashley Flores Celix, Digna Alicia Mateo, Lilian Sarahí Orellana, Elida Omery López, María Celedonia Martínez, Kresly Yadira Perdomo, Carlos Alfredo Caballero (Supervisor), Elva Jissel Majano, Yoselin Kibeth Trochez, Evelin Yosiris Sabillon, Karla Yosselin Ferrera, Elisenda Ríos, Hilda Lorena Ruiz, Alejandra Sarahí Guzmán, Luis Felipe Ruiz (Supervisor).

Focus Groups: Jennifer Zelaya, Karen Yaneth Medina, Carmen Martínez, Mirna Estefany Aguilar, Mildred Larissa Mejía.

ANED Consultants: Siomara Bertrand, Diana Ortez, John Sebastián Hulse, Marlon Colindres.

EICA Team: Kerin Yoseline Aceituno, Karina Maribel Carcamo, Karen Yaneth Medina, Josué Jonathan Alvarado, Eda Alicia Meza.

Fieldwork Consultant: Laura Navarro Mantas.

Technical Advisory Group: Nancy Waleska Zúniga, Sally O’Neill, Amparo Canales, Carolina Padilla, Margarita Bueso, Liliam Castañeda, Maycol Lenin Guerrero, Gustavo Bardales, Karina Maradiaga.

MESCLA: Patricia McLaughlin, Rosibel Gómez Zúñiga, Chloé Revuz, Roger Pipe, Miguel Cabal, Claire Mai, Steven Armendariz.

Editor: María Alexandra Arriaga

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 6

Acronym List

CDCS Country Development Cooperation Strategy DO Development Objective DHS Demographic Health Survey IPV Intimate Partner Violence GBV Gender-Based Violence LAC Latin America and the Caribbean LGTBI Lesbian, Gay, Transexual/Gender, Bisexual and

Intersex MESCLA Monitoring and Evaluation Support for

Collaborative Learning and Adapting UN United Nations VAWG Violence Against Women and Girls WHO World Health Organization

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 7

EXECUTIVE SUMMARY

BACKGROUND AND METHODS

Addressing gender-based violence (GBV) is a priority issue for the United States Agency for International Development’s Mission in Honduras (USAID/Honduras). As part of the USAID/Honduras’ Country Development Cooperation Strategy’s (CDCS) Development Objectives (DOs), the Global Women’s Institute (GWI) at the George Washington University (GWU) and Estudios e Investigaciones de Centroamérica (EICA), undertook an in-depth analysis of different types of GBV in Western Honduras. Studies on GBV in Western Honduras have been scarce and limited and the only source for assessing rates of different types of GBV has been the Demographic Health Survey (DHS). This study combines quantitative (household and school-based surveys) and participatory qualitative methods to explore the situation of GBV in both urban and rural areas of six Departments in Western Honduras.

This study, the most comprehensive diagnosis conducted in this region, supports the objectives of USAID’s Development Objective Two (DO2) in Western Honduras and contributes to the evidence base for USAID’s current and future programs and policies globally.

RESULTS

In Western Honduras, violence against women occurs most frequently within heterosexual partners and is perpetrated mainly by men towards women. Gender patriarchal norms are learned at early ages by males and females and contribute to high levels of GBV. Although there generally is social acceptance for women to acquire an education or job, there also is a prevailing expectation for women to fulfill more traditional roles.

Among the women surveyed, half reported to have suffered some form of violence by their male partners and 35 percent reported such violence within the previous 12 months. One out of 4 women reported physical and/or sexual violence by their male partners, and all forms of intimate partner violence (IPV) were slightly higher in rural areas compared to urban areas.

The survey revealed that almost 55 percent of women justified the violence against them. Women at higher risk of any form of violence include those who became pregnant at an early age, are from a low economic background, have a controlling partner, lack social support, suffered violence during childhood, and those who have become economically empowered but lack gender sensitization in the household.

Most of women who suffer physical and/or sexual IPV remain silent and do not report the violence to official institutions. The most commonly identified obstacles to reporting violence are lack of knowledge, absence of reliable services, and social stigma. Limitations in the health and other support systems’ capacity to provide services for violence survivors also contribute to low reporting.

Among men and women, the perceptions of insecurity are strikingly different. While male students mention fear of guns, alcohol and drug use, and robbers, female students fear harassment and sexual abuse. In the household survey, 11 percent of women said they had experienced rape or attempted rape by a non-partner in their lives, and just over 3 percent said they had experienced rape or attempted rape by a non-partner in the previous 12 months. The prevalence of sexual abuse by a non-partner

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 8 reached 24 percent of women when accounting not only for rape and attempted rape, but also for sexual harassment and other forms of abuse.

Sexual abuse begins at an early age. Sixty-five percent of women who have suffered non-partner sexual violence had this experience before the age of 18. In addition, of the total women surveyed who have had sexual relations, 18 percent said that their first sexual relationship had been forced or non-consensual. This percentage was higher among women in rural than urban areas.

Although most children consider the school environment as a safe space, the survey revealed that almost half of all children have suffered some type of abuse in school. The variety of abuses included insults, humiliation, beatings, and being touched in their intimate parts. Respondents shared that it is common in school for children to touch the private parts of girls, with 1 in 5 children confirming this.

The study examined issues affecting the Lesbian, Gay, Transexual/gender, Bisexual and Intersex (LGTBI) population and noted the absence of organized groups for this group. Conservatism, including strong religious beliefs, directly affects the LGTBI population and is an obstacle to free sexuality. Participants (mainly women) recognize the discrimination against the LGTBI population but ultimately believe that the LGTBI populations should not have the same rights as the rest of the population. The study also included issues affecting persons with disabilities. Interviewed officials acknowledge that few women with disabilities report abuses but that these cases exist and that structural and social obstacles prevent women with disabilities from filing complaints.

IMPLICATIONS FOR ACTION

RECOMMENDATIONS

The study results demonstrate a need for programs that focus on transforming cultural norms and gender attitudes to eliminate discriminate against women, and for implementation plans to apply a multicultural and ethnic approach. Recommendations include: a) adapt initiatives that have been successful in other contexts; b) include in all social policies at the local level an obligatory mandate for the inclusion of a gender perspective and prevention of GBV; c) strengthen—including financially and technically—local women organizations that work on the topic of gender equality; d) support academic programs that have an objective to transform the norms around gender discrimination; e) work at the institutional level with different types of organizations, including in the private sector, to change their regulations and policies for the prevention of different types of GBV.

Child maltreatment has a gender component. Recommendations to prevent child maltreatment from a gender perspective include: a) establish “zero tolerance” for all types of child abuse in any environment or space; b) promote workshops within schools for mothers / fathers to teach appropriate ways to discipline children and avert physical or psychological violence; c) promote actions for the total eradication of physical aggression by teachers against children as a form of punishment.

Shortcomings in services effect reporting and support. Recommendations include: a) improve attention towards survivors of violence from the health sector, which has had significant setbacks in victim support; b) prioritize rural areas that lack services, in both health and protection, and include legal support for survivors.

Among the populations most at risk of abuse and least likely to report are LGTBI individuals and persons with disabilities. Recommendations to prevent and address discrimination and violence include:

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 9

a) strengthen organizations that work with the LGTBI population and with people with disabilities; b) prioritize work with adolescents and young people who are more open to transformations, using an intersectionality approach that takes into account other forms of discrimination experienced by this population; c) promote awareness campaigns for officials and the population in general.

SPECIFIC RECOMMENDATIONS FOR USAID DO2 PROGRAMMING

Some USAID DO2 programmatic activities have specific strategies on gender equality or approaches for gender mainstreaming that provide a framework and enhance the visibility of this important work. These strategies and approaches have three main limitations: a) deficient implementation of systematic and long-term actions that give concrete results in the transformation of gender norms; b) lack of monitoring of the implementation of these plans in relation to their gender actions; c) absence of specific work on GBV.

Recommendations to address these three limitations include: a) refocus the work of schools towards a more integral and holistic approach, incorporating actions regarding bullying but with a gender perspective; b) carry out systematic and long-term training on gender equality and prevention of GBV for the staff responsible for implementation of USAID projects; c) incorporate a gender component in all entrepreneurship and economic empowerment activities for women, including work with men; d) adapt programs on the transformation of gender norms by applying a multicultural vision, given the ethnic diversity in Western Honduras.

RECOMMENDATIONS FOR FUTURE RESEARCH

Research and programming activities can enable greater impact throughout a broader region.

Recommendations include: a) conduct a more specific study that takes into account the entire life cycle of women who suffer violence, from childhood to adulthood, inquiring about central moments in their lives; b) analyze in greater depth the situation of women in La Paz from a multicultural perspective; c) analyze in-depth the barriers to accessing services, both at a personal, family, and institutional level, including psycho-social, medical, and legal support services; d) conduct more research with men exploring how different types of masculinities are linked to perpetration of violence against women and girls, as well as victimization including sexual abuse against boys and other forms of violence among men;

e) conduct a more in-depth analysis on GBV by examining the impact, both positive and negative, of community economic development interventions, including actions that focus on women’s economic empowerment; f) carry out similar studies in other areas of Honduras and in the surrounding region where USAID implements programs; and compare results and provide feedback to strengthen the development and implementation of USAID programs in Central America.

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 10

1. BACKGROUND

1.1 INTRODUCTION

Over 20 years ago, the international community convened in Beijing for the Fourth World Conference on Women to highlight pressing global issues facing women and girls. As a result of this conference, a total of 189 United Nations (UN) member states adopted the Beijing Platform for Action, which galvanized key stakeholders to work towards ending deeply entrenched gender inequalities and related manifestations, such as gender-based violence (GBV).1 Prior to Beijing, numerous governments within the Latin America and Caribbean region (LAC) came together in 1994 to sign and ratify the Inter- American Convention on the Prevention, Punishment and Eradication of Violence Against Women (also known as the Convention of Belém do Pará). These international agreements are mostly a result of the unprecedented work of many women’s rights movements at local and regional levels, and have created a global momentum to respond to and prevent GBV.

Despite progress, GBV remains a pandemic issue. In 2013, the World Health Organization (WHO) estimated that 35 percent of women globally experience sexual and/or physical intimate partner violence (IPV) or sexual assault at some point in their lives. In Latin America and the Caribbean, over one third of women (36 percent) have reported experiencing either IPV or non-partner sexual violence (NPSV) (World Health Organization, 2013). The LAC region has the second highest prevalence of NPSV globally. While many different interventions have been implemented to reduce GBV, the evidence base remains limited, particularly for large-scale interventions. The most effective community-based interventions often include several different components, address GBV risk factors, and engage community members in a sustained and sensitive manner (Ellsberg, et al., 2015). There is an urgent need for robust evidence in order to determine how structural interventions can contribute to primary prevention of gender-based violence.

Addressing GBV is a priority for the United States Agency for International Development’s Mission in Honduras (USAID/Honduras). In partnership with Dexis Consulting Group (Dexis), USAID/Honduras is implementing the Monitoring and Evaluation Support for Collaborative Learning and Adapting (MESCLA) Activity. The MESCLA Activity seeks to support achievement of USAID/Honduras’ CDCS Development Objectives (DOs). The goal of CDCS is “a more prosperous and safer Honduras that advances inclusive social and economic development among vulnerable populations.” To achieve this goal, USAID/Honduras has defined three overarching Development Objectives:

• DO1: Citizen security increased for vulnerable populations in urban, high-crime areas.

• DO2: Extreme poverty sustainably reduced for vulnerable populations in Western Honduras.

• DO3: Public administration at the national level is more transparent and responsible.

For USAID, the focus on gender is a key piece of its CDCs to ensure the respect of human rights and effective sustainable development. As such, USAID/Honduras has envisioned a series of tasks to ensure proper inclusion of gender issues, including an in-depth analysis of different types of GBV and the

1 This study refers to gender-based violence (GBV) as defined in the United Nations Declaration on the Elimination of Violence Against Women, adopted by the UN General Assembly in 1993: “any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.” It is not a form of individual violence based on physical superiority, but of discriminatory relations emerging from the patriarchal social structure that influence gender relations.

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 11 connection with program areas, activities, and goals under DO2 in Western Honduras. In order to accomplish this task, the Global Women’s Institute (GWI) at the George Washington University (GWU), along with Estudios e Investigaciones de Centroamérica (EICA), was selected to carry out research and analysis. This report presents the main findings of this study.

1.2 CONTEXT OF THE STUDY

Honduras, like other LAC countries, has a patriarchal society. This social structure places women in subordinate roles and perpetuates gender inequalities (INE, 2016), and creates cultural norms, rules, and practices that reinforce a superior status for men. Through gender norms, a man's violence against women is legitimized as part of the privilege of male domination. The position of men in society is further influenced through the culture of machismo, in which men are expected to be strong and aggressive, especially in relation to women. Gender inequality impacts various sectors of society.

Although women currently have greater access to education than in past decades, even more than men do (INE, 2016), this does not translate into better economic opportunities or status for women: for every woman integrated into the labor force, there are two men, but for domestic jobs that have lower remuneration the proportion is 1 man for every 20 women (INE, 2016). Wages also reveal inequality:

for every Lempira (Honduras currency) that a man receives, a woman receives 86 cents. Another economic indicator where gender inequality persists is property ownership: only 8 percent of women have individual possession of land, in contrast to 30 percent of men. Leadership and decision-making positions also expose gender inequality; for example, men make up over three-fourths of elected officials nationally (USAID, 2015).

Gender inequality translates to high levels of GBV.2 Honduras continues to have high rates of different types of violence against women and girls. An urgent issue is that of femicide which has increased exponentially in recent years. Between 2005 and 2015, the number of registered femicide cases increased by 390 percent (Sánchez & Sánchez, 2015). Gang violence poses a significant threat to women, with 15 percent of femicides committed by a gang member (IUDPAS, 2015). Gang members threaten, abduct, rape, and assault Honduran women in retaliation for grievances against family and friends.

According to a 2015 UN special rapporteur report from Honduras, “Violence against women is widespread and systematic and affects women and girls in numerous ways. A climate of fear, in both the public and private spheres, and a lack of accountability for violations of human rights of women are the norm, despite legislative and institutional developments” (Manjoo, 2015). The last decade has seen an increase in violence against activists who defend human rights and denounce femicide linked to organized crime.

The Government of Honduras (GOH) recognizes GBV as a priority issue and has established laws and policies to protect women who experience violence. The Law Against Domestic Violence, enacted in 1997, criminalizes domestic violence and seeks to protect the physical, psychological and sexual integrity of women. The Criminal Code also addresses GBV, focusing on all inter-family violence. Federal criminal codes do not, however, delineate the different types of GBV that women experience, such as sexual violence within marriage, marriage to underage girls, sexual abuse, and sexual harassment (Center for Women's Rights, 2014).

Laws and legal policies in Honduras have focused primarily on responding to GBV situations rather than implementing primary prevention strategies. The Integral Policy of Coexistence and Citizen Security

2 For definitions of different types of violence mentioned in this study, please see Annex 1.

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 12

(PICSC) 2011-2022 attempted to focus on a more holistic approach by convening the GOH officials with the public and private sector leaders and with citizenry as a whole to address GBV at all levels.

Despite attention to the issue and recent legal progress, implementation is dismal. At the local level, the challenges are even greater due to lack of support for GBV prevention and response to survivors of violence.

Weak public institutional structures contribute to the inadequate operationalization of laws and policies in Honduras. Institutions such as the Judiciary, Public Ministry, National Police, and Ministry of Health have attempted to enhance their response to GBV but impediments to implementation include insufficient political will, inadequate budgets, centralized service locations in cities making access difficult from rural areas, absence of or inadequate training and awareness of GBV within police and other Departments, and a pattern of sexist culture and norms. Additionally, the National Institute for Women (INAM) lost authority and power when it was folded into the Sectorial Cabinet of Inclusion and Social Development. Non-governmental organizations (NGOs), human rights organizations, and universities offer alternative legal services, care and support, however they are limited by budget and size (USAID, 2015).

Similar to legal policy, interventions are mostly reactive and take place in the densely populated cities of Tegucigalpa and San Pedro Sula. Recently, community-based participatory research is emerging as a tool to understand the roots of violence and prevention (USAID, 2015). The literature review found limited studies on GBV in Western Honduras and that the only source for accessing rates of different types of GBV is the DHS.3 According to 2011-12 DHS, about 20 percent of women in Western Honduras have experienced physical, sexual or emotional violence committed by their husband or partner in the 12 months of 2012.4

Overall reports of GBV and IPV in Western Honduras are slightly lower than the national average but remain high. The Departments of Lempira and Copán have lower lifetime and one-year prevalence of GBV against women aged 15-49. In Santa Bárbara there are higher levels of sexual violence (both by a non-partner and partner), exceeding those of the national average. The highest levels of physical or sexual violence by a partner are in La Paz but may not be statistically significant compared to the other Departments (for DHS tables of GBV in Western Honduras, see Annex 2).

In general, IPV is common and normalized in Western Honduras, with both perpetrators and victims expressing acceptance of IPV as a normal experience. A study conducted to understand community perceptions of IPV found a strong disparity between the views of female healthcare volunteers (FCV) who saw cultural norms as having the strongest influence on behavior, and male community leaders (MCL) who saw jealousy and gossip as the causes of violence (Sukhera, Cerulli, Gawinski, & Morse, 2012). In addition, the study found that MCLs denied the existence of partner violence and minimized its impact on women.

Acceptance of IPV is largely influenced by the views of social contacts. Women’s perceptions of IPV acceptability are most influenced by the views of others within their household, while men’s perceptions of violence are strongly affected by those within their household as well as the perceptions of neighbors and peers (Shakya, et al., 2016).

Some evidence shows the migration of men in Western Honduras as an additional risk factor for GBV (Sukhera, Cerulli, Gawinski, & Morse, 2012). While men are away working as migrant farmers, many

3 The Demographic Health Survey in Honduras is referred to as the Encuesta Demografica y de Salud (ENDESA).

4 The prevalence mentioned in the paragraph was calculated using the DHS Program StatCompiler https://www.statcompiler.com/en/

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 13 women run their households independently, become accustomed to autonomy, and experience greater safety within the home. When the men return with money and alcohol, violence follows. The results of this study indicate that interventions targeting the household, specifically on the periphery of the community, are the most effective to enact change.

This current study provides in-depth analysis of the different types of GBV in Western Honduras. The research team utilized different types of methodologies to prepare the most comprehensive diagnosis to date. The information will not only improve USAID programs that are currently in place, but will also contribute to the evidence base for future programs and policies around GBV.

2. STUDY DESIGN AND METHODS

2.1 STUDY AIMS

The primary goal of the study is to develop an in-depth analysis of GBV issues and related program areas, activities, and goals under DO2 in Western Honduras, resulting in recommendations and concrete actions to contribute to the reduction in GBV.

Specific Objectives:

a. Calculate lifetime prevalence of different forms of (physical, sexual, economic, and emotional) partner violence against women and girls and in the last 12 months.

b. Calculate the lifetime prevalence of non-partner sexual violence against women and girls and in the last 12 months.

c. Identify and analyze the factors associated with different types of GBV.

d. Identify and analyze the circumstances in which different types of GBV occur and the characteristics of the perpetrators.

e. Identify and analyze some of the consequences of violence suffered by women and their children.

f. Identify and analyze how families and communities respond to different cases of GBV.

g. Identify the types of services that exist for women, LGTBI individuals, and people living with disabilities who suffer violence.

h. Identify and analyze the diverse existing programs in the communities that could have potentially contributed to the response and prevention of GBV.

i. Identify what other types of gender-based violence are predominant in the community.

j. Analyze the situation and perception of safety of children – both boys and girls - in the school environment.

k. Understand the gender norms and attitudes of both adults and children in the community and their relationship with different types of GBV.

l. Make recommendations for additional strategic interventions by USAID/Honduras DO2 activities that would decrease levels of GBV in Western Honduras.

2.2 CONCEPTUAL FRAMEWORK

Analysis of GBV, particularly when directed towards women and girls, relies on various theoretical models that have been developed to help understand the nature of the problem. The most common approach among scholars is a multidimensional perspective that gathers comprehensive information and

Societal

• Gender, social and economic inequalities

• Discriminatory legal frameworks

• Cultural norms that support violence

Community

• Poverty

• High crime levels

• Acceptance of gender norms and

VAWG

• Stigma for divorce

• Community violence

• Lack of sanctions for violence

Relationship

• Marital discord

• Poor parenting

• Violent parental conflict

• Low socio-economic household status

• Inequitable decision making

Individual

• Childhood violence

• Acceptance of VAWG

• Age

• Education

• Employment or livelihoods opportunities

• Asset ownership

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 14 incorporates a variety of different levels of analysis. Among the different models that use a multidimensional approach, the ecological model has the most widespread dissemination.5

Using an adaptation of the ecological model to understand men's violence against their partners, Heise (1998) found this phenomenon to be the product of a system of interacting factors that are associated with violence and are conceptualized at four different levels of the social environment (Heise, 1998).

The four levels of the social environment that influence conceptualization are: the macrosystem (structural or societal level), the mesosystem (community level), the microsystem (level of relationship of the couple), and the individual (level of personal history of the individual). This study takes from the ecological model the notion of conceptualizing the problem considering these four levels of social reality.

Figure 1. Ecological Model on Violence Against Women

GBV by men against their female partners is legitimized through society’s use of social norms. These norms are reproduced and socialized within communities and through individuals, beyond the legal statutes in which violence is framed within the Honduran legal system. In this work, social legitimacy is understood as the quality of a social power that produces and maintains the dominant beliefs of society.

In addition to the multidimensional approach, there are various theoretical approaches that focus specifically on certain issues related to gender-based violence. Some of these theories reference, directly

5 The ecological model originates from the General Theory of Systems, developed by the Austrian biologist Ludwig Von Bertalanffy (Von Bertalanffy, 1968). The model for the study of violence was presented for the first time by Belskey (1980), who used it to organize a variety of causes associated with the abuse of infants (Belskey, 1980). Later it was applied to interpersonal violence by different authors (Carlson, 1984), (Dutton, 1988) and (Edelson & Tolman, 1992). In 1998 Heise presented a specific model to understand violence between couples by the male (Heise, 1998) and it is this model that, in recent years, has been widely cited by a large number of researchers dedicated to the subject.

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 15 or indirectly, the legitimization of violence. This study takes into account two of the theories that approach the problem of violence from a social macro perspective: the patriarchal / feminist theory and the theory of the culture of violence. These theories are explained in Annex 3.

2.3 STUDY AREA

This study includes research conducted in both urban and rural areas of six Departments in Western Honduras: Copán, Intibucá, La Paz, Lempira, Ocotepeque and Santa Bárbara. These six Departments represent an ethnically diverse population with two large indigenous populations: Lenca and Maya. The DO2 USAID intervention 2014-2019 involves the 143 municipalities of these Departments.

Figure 2. Map of the Six Departments of Western Honduras

2.4 METHODOLOGY

Research for this study incorporated a literature review, a cross-sectional household survey, a quantitative school survey, complementary interviews with key informants, and participatory discussions with focus groups. The scope and approach are described below.

Literature Review

A brief literature review provided background on the research and informed the design of the methodological tools. The literature included published and unpublished research articles, and Honduras GBV programmatic reports, particularly from the Western region. In addition, the authors of the study

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 16 developed a mapping of existing interventions for gender equality and GBV in order to obtain information on current prevention activities and services for survivors in the region.

Cross-Sectional and Representative Household Survey

A cross-sectional and representative survey was carried out in households among women aged 15 to 64 years in the DO2 implementation areas in Western Honduras. The survey is based on the WHO multi-country study on women’s health and domestic violence model, which was translated and adapted by GWI for use in Central America. The survey engaged 1,006 women in the region, which jointly represented the six Departments of Western Honduras: Copán, Intibucá, La Paz, Lempira, Ocotepeque, and Santa Bárbara. For programmatic and cost considerations, the donors and partners involved agreed that the sample would not represent each Department, but instead would represent the geographic area of the 6 Departments as a whole. For the first sampling stage, the random selection of 4 Departments involved Copán, La Paz, Lempira, and Santa Bárbara. For more information of the sample frame, please see Annex 4.

For the household-based survey, the team used a sampling frame methodology to randomly select the individual households for their participation. For the selected households, the team used the following criteria to determine the participating women:

• Female between 15 and 64 years of age;

• Residence at the study site;

• Lives primarily in the selected home, or visits the home for at least 4 weeks, or works as a domestic worker in the home and usually sleeps there at least 5 nights a week.

Only 1 woman per household was selected, and their selection was made randomly. From a sample of 1,257 households visited, 1,135 were reached (90 percent). Out of 1,135 households, 1,050 of them had an eligible woman. Of those with an eligible woman, the team interviewed 1,006 individuals (96 percent) (see Table 1).

Table 1. Household survey response rates

Household response rate

Number of HH visited 1257

Number of HH empty 77

Number of HH with no member at time of visit 29

Number of dwelling not found, not accessible 16

Number of HH interviewed 1135

HH response rate 90.3

Number of HH with eligible women 1050

Number of HH without eligible women 85

Individual response rate

Number of HH Interviewed (with eligible women) 1050

Number of women not at home / not available 20

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 17

Individual response rate

Number of selected women who has a disability to answer the questionnaire or to understand the consent form 5

Number of selected women who postponed the interview 19

Number of women interviewed 1006

Individual response rate 95.8

Survey in Schools

The research team carried-out a self-administered survey in schools in order to measure knowledge, attitudes and behaviors of this subgroup. The main focus of this survey was on children’s attitudes and knowledge around gender equality, situations of violence in the school and home, and their sense of safety. This survey was based on a questionnaire that GWI developed and piloted previously in the Caribbean. The schools and classrooms were randomly selected, and the students of the selected classrooms were invited to participate in the study. The sample frame was a sub-sample of the household sample frame (see Annex 5). Overall, the survey included 237 enrolled girls and boys, from 10-14 years of age.

Qualitative Component

Focus Group Discussions – Free Listing To obtain information on the types of violence that are more common in the home, communities and schools, researchers utilized free listing in focus groups with community members and other key stakeholders (representatives of international, national and local organizations, service providers, school children and school staff). Trained facilitators asked participants to mention forms of violence they knew and then wrote the responses on adhesive paper and pasted them on a blackboard. The papers were color code to denote the gender of the victim. The facilitator then polled the participants to better understand the context (where, when, by whom, how often) of the different types of violence.

Focus Group Discussions – Open Stories and Venn Diagrams To gather detailed information about access to services and supports, the team designed a participatory method that used open (or incomplete) GBV-related stories and involved community members, interested representatives of international, national and local organizations, service providers, school children and school staff. The beginning of two independent stories was presented to participants, but they intentionally left out the detailed development and outcome. This approach allowed the researcher to map what kind of services are available to survivors of GBV and detail any barriers to accessing such services. It was also used to better visualize the accessibility and usefulness of the different possible sources of support (both formal and informal). The team also used Venn diagrams.

Semi-Structured Interviews – Interviews with Key Informants and Stakeholders When there was an absence of formative information in the previous phases of the investigation, the team conducted semi-structured interviews in a one-on-one environment to obtain more in-depth information. Key informants at different times included community leaders, health service providers, legal authorities, local government representatives and school staff, and other stakeholders. The semi-structured interview process provided a general frame of reference, included questions to guide the conversation to address the specific research questions, and allowed flexibility in the conversation.

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 18

Participatory Safety Mapping During the work with school children, the research team facilitated the development of physical maps of the school areas and their surroundings. Through this process, the school children identified the areas that are considered "safe" or "unsafe" and why.

The team used intentional sampling to ensure the breadth of knowledge and experience. If necessary, additional participants were found by snowball sampling. Focus groups included specific groups of women, men, boys and girls.

Table 2. Focus groups and in-Depth interviews

Departments Focus groups Participation

Copán, Intibucá, La Paz, Lempira, Ocotepeque and Santa Bárbara

6 focus groups per Department

● Boys 10-14 years of age

● Girls 10-14 years of age

● Male youths 15-19 years of age

● Female youths 15-19 years of age

● Female adults

● Male adults

Copán and Francisco Morazán

2 focus groups per Department

Lesbian, Gay, Transsexual/gender, Bisexual and Intersex (LGTBI) individuals

Intibucá and Santa Bárbara

2 focus groups per Department

Advocates and people with disabilities.

Departments In-depth interviews Participation

Copán, La Paz, Lempira, and Santa Bárbara

5 individual interviews per Department

● Local authority

● NGO

● School representatives

● Police

● Health service providers

Process and Data Analysis

Quantitative Data The research team used descriptive statistics to assess the prevalence and characteristics of GBV of the target population and their responses to violence and social norms. Using SPSS, GWI conducted bivariate (t-test, Chi-square) and multivariate regressions to identify the individual risk level and protection factors for different types of violence.

Qualitative Data The team gathered qualitative date to increase understanding about the key characteristics of the different forms of violence present in the study population. Notetakers captured the information from interviews and focus groups for the qualitative study. GWI and EICA staff analyzed the notes according to topics that corresponded to the research questions and relevance to the investigation. Using the Open Code 4.03, the team first used a combination of Priori Theory and Grounded Theory to develop and assign codes for the notes and to mark the relevant text segments from each interview and focus group discussion with the appropriate code. By using codes, the research team was able to link data segments and develop analytical categories. The team then examined the most important categories and established connections between the categories.

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2.5 ETHICAL CONSIDERATIONS

The team paid particular attention to ethical considerations, guided by the WHO eight recommendations for conducting safe and ethical research on violence against women and girls (VAWG). Seven of the WHO recommendations related directly to this investigation and were incorporated:

• The safety of the respondents and the research team is fundamental and should guide all decisions about the project.

• Prevalence studies should be methodologically sound and should be based on current research experience on how to minimize underreporting of violence.

• The protection of confidentiality is essential to ensure the safety of women and girls, as well as the quality of the data.

• All members of the research team should be carefully selected and receive specialized training and ongoing support.

• The study design should include actions that seek to reduce any possible anguish caused by the study among its participants.

• Field workers should be trained to refer to local services and sources of support that are available to women and girls who request assistance. If there are few resources, it may be necessary for the study to create short-term support mechanisms.

• Researchers and donors have an ethical obligation to ensure that their findings are interpreted appropriately and used to promote regulations and development of interventions.

The research protocol of this study was approved in full by the Institutional Review Board (IRB) of the School of Medical Science of the National Autonomous University of Honduras (UNAH) and by the Technical Advisory Group (TAG) in Honduras, which is an independent body of experts on VAWG research and programming made up of local, national, and international practitioners representing both NGO and government structures. In addition, the team secured permission from appropriate authorities at national and local levels to conduct the research.6

6 For more information on the ethical considerations, contact the research team for the research protocol.

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3. FINDINGS

3.1 CHARACTERISTICS OF WOMEN AND GIRLS IN WESTERN HONDURAS

The majority of participants in the household surveys were young (median age, 33 years); did not identify with a particular ethnic group, (62 percent stated ‘none’ while 31 percent identified as Lenca)7;

were from rural areas (70 percent, as opposed to 30 percent coming from an urban area); and, independently from their place of living, described themselves as Christian (51 percent self-identified as Catholic and 40 percent as Evangelical).

The majority of women married young and were economically dependent on their partners. Eighty-eight percent of study participants were in a union, and within this group seven percent of unions occurred before the age of 15, and 40 percent before the age of 18. Only 24 percent of women worked outside of the home, while 53 percent depended on their partner’s income. Many of the participants also had low levels of education, 72 percent of women had a primary education, and 11 percent had no education level. Furthermore, most participants – 97 percent had never lived outside of the region.

These characteristics indicated that most women in Western Honduras have a low-socioeconomic background.8

3.2 GENDER NORMS: PATRIARCHAL STRUCTURE

Honduras has a patriarchal society structure that perpetuates gender inequalities, giving more value to the lives of men and boys than those of women and girls. This patriarchal structure regulates the gender

7 To obtain information about ethnicity, researchers asked participants which ethic group they belong to, having different options to respond: mixed, Lenca, Maya, Garifuna, etc. The fact that more than 60 percent of women did not identify themselves with any group might be a reflection of the discrimination against indigenous groups in the country in which people do not want to identify themselves as part of any of these ethnic groups. In future surveys, it is recommended to use other type of techniques to capture this information, for example asking questions around the knowledge of ethnic languages in surveys or conducting some type of ethnographic analysis.

8 See Annex 6 for additional data on the characteristics of women and girls in Western Honduras.

Monitoring & Evaluation Support for Collaborative Learning and Adapting (MESCLA) 21 norms that are spread through the actions of people and institutions. The survey captured how these gender dynamics develop at an early age for both males and females.

Patriarchal gender roles are well-defined and reinforced from a young age in the home. The school-based survey revealed that around 4 out of 10 children, who were 10 to 14 years of age, had worked for money.9 Among the children who had worked for money, 70 percent were boys. Girls, on the other hand, were more active helping at home. In the same survey, when we asked, “What do you do when you are not in school?” 87 percent of girls said they helped with household chores whereas 58 percent of boys said they were involved in the household tasks (see Table 3).

Table 3. Proportion of Boys and Girls According to Activities They Carry Out When Not in School

Activities

* p < .05

Responses from girls n= 125

Respo…