Background: Disasters have an unequal impact on the population because of differences in conditions of vulnerability, exposure, and capacity. Migrants and women are among the groups that are at greater risk for and disproportionately affected by disasters. However, despite the large body of evidence that analyzes their vulnerability separately, disaster research that targets migrant women is scant. The aim of this scoping review was to analyze the published scientific literature concerning the vulnerability of migrant women and the consequent negative impact they experience during disasters. Methods: A literature search was conducted on December 15th, 2021 on Pubmed, Scopus, and Web of Science databases. No time filter was applied to the search. Information regarding the article’s main characteristics and design, migrant women and their migration experience, as well as about the type of disaster was collected. The factors responsible for the vulnerability of migrant women and the negative outcomes experienced during a disaster were extracted and inductively clustered in main themes reflecting several vulnerability pathways. The review followed the Joanna Briggs Institute methodology for scoping reviews and relied on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Results: After full text review, 14 articles met the inclusion criteria. All of them adopted a qualitative methodology and focused on COVID-19. The pandemic negatively affected migrant women, by triggering numerous drivers that increased their level of exposure and vulnerability. Overall, six vulnerability factors have been identified: legal status, poverty conditions, pre-existing health conditions, limited agency, gender inequality and language and cultural barriers. These resulted in nine impacts: worsening of mental health status, poor access to care, worsening of physical health conditions, fraud, exacerbation of poverty, gender-based violence, jeopardization of educational path, and unfulfillment of their religious needs. Conclusions: This review provided an analysis of the vulnerability factors of migrant women and the pathways leading to negative outcomes during a disaster. Overall, the COVID-19 pandemic demonstrated that health equity is a goal that is still far to reach. The post-pandemic era should constitute the momentum for thoroughly addressing the social determinants of health that systematically marginalize the most vulnerable groups.

Background: Conflicts exacerbate dynamics of power and inequalities through violence normalization, which acts as a facilitator for conflict-related sexual violence. Literature addressing its negative outcomes on survivors is scant. The aim of this systematic review was to analyze the qualitative evidence reported in scientific literature and focusing on the negative consequences of conflict-related sexual violence on victims’ physical, psychological, and social dimensions of health in a gender-inclusive and disaggregated form. Methods: A literature search was conducted on January 13, 2023 on Pubmed, Scopus, and PsychArticles. The search strings combined two blocks of terms related to sexual violence and conflict. A time filter was applied, limiting the search to studies published in the last ten years. Information regarding the main characteristics and design of the study, survivors and their experience, and about conflict-related sexual violence was collected. The negative consequences of conflict-related sexual violence on the physical, psychological, and social dimension of victims were extracted according to the Biopsychosocial model of health. The review followed the Joanna Briggs Institute methodology for systematic reviews and relied on the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Results: After full text review, 23 articles met the inclusion criteria, with 18 of them reporting negative repercussions on physical health, all of them highlighting adverse psychological outcomes, and 21 disclosing unfavorable social consequences. The negative outcomes described in multiple studies were sexual and reproductive health issues, the most mentioned being pregnancy, manifestations of symptoms attributable to post-traumatic stress disorder, and stigma. A number of barriers to access to care were presented as emerging findings. Conclusions: This review provided an analysis of the negative consequences of conflict-related sexual violence on survivors, thus highlighting the importance of qualitative evidence in understanding these outcomes and addressing barriers to access to care. Conflict-related sexual violence is a sexual and reproductive health issue. Sexuality education is needed at individual, community, and provider level, challenging gender norms and roles and encompassing gender-based violence. Gender-inclusive protocols and services need to be implemented to address the specific needs of all victims. Governments should advocate for SRHRs and translate health policies into services targeting survivors of CRSV.

In 2008, the World Health Organization launched the Mental Health Gap Action Program (mhGAP) to scale up mental health care in non-specialized health care settings. Studies have demonstrated the benefits of mhGAP implementation while highlighting the need for better contextual adaptation and ongoing support. The challenge of integrating mental health into primary care is particularly noticeable in fragile and conflict-affected settings, where the need for such services is greater and health systems are often disrupted. A literature search was conducted on PubMed, PsycINFO, Scopus, and Web of Science to identify relevant peer-reviewed studies addressing the effectiveness of mhGAP in fragile and conflict-affected settings. Information was collected on study characteristics and design, impact of mhGAP, and main operational challenges. After full-text review, 10 articles met the inclusion criteria, reporting the impact of mhGAP on primary care personnel, on service user outcomes and in health systems. Studies reported post-training improvements in knowledge, mainly on epilepsy and psychosis. However, gaps remained in skills related to conducting mental state examinations, assessing suicide risk, and strengthening psychosocial support. The evidence was inconclusive regarding the impact of mhGAP on improving access to mental health care at the primary level. Several implementation challenges were identified, including an overemphasis on short-term knowledge transfer and the lack of structured supervision following mhGAP training.

Introduction: The Sexual Violence Relief center Soccorso Violenza Sessuale (SVS) is a specialist service, situated in Sant’Anna Hospital, an Obstetrics and Gynecology facility in Turin, North-West Italy. The study aimed to qualitatively analyze the transcripts of interviews routinely conducted by gynecologist and midwife in the first part of the medical examination of migrant patients accessing care at SVS after being subjected to conflict-related sexual violence (CRSV) in their home country or during migration and to explore the adverse outcomes of such violence on their health.Methods: Interview transcripts were purposely selected to include adult migrant patients (age > 18) subjected to CRSV in the different phases of migration and accessing SVS from January 1st, 2014, to September 4th, 2023. Data was extracted from the SVS archive, anonymized, and thematically analyzed.Results and discussion: In total, 43 interview transcripts were eligible for inclusion. All of them were related to cisgender women of Sub-Saharan origin describing different forms of violence as a driver for migration. CRSV was disclosed by 18 survivors as occurring in their home country and by 31 in transit (e.g., Libya), the most reported type being rape. 49% of the patients described adverse physical outcomes of CRSV, while 72% reported psychological sequelae. The findings confirm high levels and different modalities of violence throughout the migratory route. Qualitative analysis of interview transcripts served as a valuable source for understanding how survivors described the CRSV they endured, its consequences, as well as other violence encountered during migration.

Conflict-related sexual violence (CRSV) is a form of gender-based violence and a violation of human rights. Forensic medical examination of victims of CRSV can be performed for the clinical and forensic management of patients or as part of the medical affidavit in judicial protection procedures. The aim of this scoping review was to summarize the knowledge on the forensic medical examination of survivors of CRSV by analyzing what types of violence were described by survivors, as well as the outcome of medical examination and evaluation of the degree of consistency, and of protection procedures. After the screening process, 17 articles published between January 1st, 2013, and April 3rd, 2023, on PubMed, Scopus, and Web of Science were eligible for inclusion. The findings of our review confirm that literature addressing forensic medical examination of victims of CRSV is scarce, as well as studies describing physicians' opinion on the consistency of the findings and protection outcomes. Trained and experienced professionals are needed in order to document human rights violations, including CRSV-specific lesions.