Browsing by Author "Costa, Diogo"
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- Impact of non-pharmaceutical interventions on COVID-19 incidence and deaths: cross-national natural experiment in 32 European countriesPublication . Costa, Diogo; Rohleder, Sven; Bozorgmehr, KayvanPurpose Non-pharmaceutical interventions (NPIs) have been the cornerstone of COVID-19 pandemic control, but evidence on their effectiveness varies according to the methods and approaches taken to empirical analysis. We analysed the impact of NPIs on incident SARS-CoV-2 across 32 European countries (March-December 2020) using two NPI trackers: the Corona Virus Pandemic Policy Monitor – COV-PPM, and the Oxford Covid-19 Government Response Tracker – OxCGRT. Methods NPIs were summarized through principal component analysis into three sets, stratified by two waves (C1-C3, weeks 5–25, and C4-C6, weeks 35–52). Longitudinal, multi-level mixed-effects negative binomial regression models were fitted to estimate incidence rate ratios for cases and deaths considering different time-lags and reverse causation (i.e. changing incidence causing NPIs), stratified by waves and geographical regions (Western, Eastern, Northern, Southern, Others). Results During the first wave, restrictions on movement/mobility, public transport, public events, and public spaces (C1) and healthcare system improvements, border closures and restrictions to public institutions (C2) were associated with a reduction in SARS-CoV-2 incidence after 28 and 35-days. Mask policies (C3) were associated with a reduction in SARS-CoV-2 incidence (except after 35-days). During wave 1, C1 and C2 were associated with a decrease in deaths after 49-days and C3 after 21, 28 and 35-days. During wave 2, restrictions on movement/mobility, public transport and healthcare system improvements (C5) were also associated with a decrease in SARS-CoV-2 cases and deaths across all countries. Conclusion In the absence of pre-existing immunity, vaccines or treatment options, our results suggest that the observed implementation of different categories of NPIs, showed varied associations with SARS-CoV-2 incidence and deaths across regions, and varied associations across waves. These relationships were consistent across components of NPIs derived from two policy trackers (CoV-PPM and OxCGRT).
- Intimate partner violence during COVID-19: systematic review and meta-analysis according to methodological choicesPublication . Costa, Diogo; Scharpf, Florian; Weiss, Alexa; Ayanian, Arin H.; Bozorgmehr, KayvanBackground: Intimate Partner Violence (IPV) is the most common form of interpersonal violence and a major public health problem. The COVID-19 pandemic might have contributed to an increase in IPV experiences. To evaluate changes in IPV prevalence during the pandemic, it is important to consider studies’ methodological characteristics such as the assessment tools used, samples addressed, or administration modes (e.g., face-to-face, telephone or online interviews), since they may influence disclosure and were likely affected by pandemic-imposed mobility restrictions. Methods: Systematic review and meta-analysis of empirical studies addressing IPV against women, men, or both, during the COVID-19 period. We searched six electronic databases until December 2021, including articles in English, German, Spanish, French or Portuguese languages. We extracted and synthesised characteristics of studies related to sampling (clinical, community, convenience), type assessment tool (standardised questionnaire, specifically created questions), method of administration (online, telephone, face-to-face), and estimates of different forms of IPV (physical, sexual, psychological). IPV estimates were pooled stratified by study characteristics using random-effects models. Results: Of 3581 publications, we included 103 studies. Fifty-five studies used a standardized instrument (or some adaptations) to assess IPV, with the World Health Organisation Questionnaire and the Revised Conflicts Tactics Scales being the most frequent. For 34 studies, the authors created specific questions to assess IPV. Sixty-one studies were conducted online, 16 contacted participants face-to-face and 11 by telephone. The pooled prevalence estimate for any type of violence against women (VAW) was 21% (95% Confidence Interval, 95%CI = 18%-23%). The pooled estimate observed for studies assessing VAW using the telephone was 19% (95%CI = 10%-28%). For online studies it was 16% (95%CI = 13%-19%), and for face-to-face studies, it was 38% (95%CI = 28%-49%). According to the type of sample, a pooled estimate of 17% (95%CI = 9%-25%) was observed for studies on VAW using a clinical sample. This value was 21% (95%CI = 18%-24%) and 22% (95%CI = 16%-28%) for studies assessing VAW using a convenience sample and a general population or community sample, respectively. According to the type of instrument, studies on VAW using a standardized tool revealed a pooled estimate of 21% (95%CI = 18%-25%), and an estimate of 17% (95%CI = 13%-21%) was found for studies using specifically created questions. Conclusions: During the pandemic, IPV prevalence studies showed great methodological variation. Most studies were conducted online, reflecting adaptation to pandemic measures implemented worldwide. Prevalence estimates were higher in face-to-face studies and in studies using a standardized tool. However, estimates of the different forms of IPV during the pandemic do not suggest a marked change in prevalence compared to pre-pandemic global prevalence estimates, suggesting that one in five women experienced IPV during this period.
- Sexual and reproductive health outcomes of women who experienced violence in Germany: analysis of the German health interview and examination survey for adults (DEGS1)Publication . Wellmann, Antonia Marie; Costa, DiogoObjectives: Violence against women is a widespread public health concern with severe effects to women’s sexual and reproductive health, including higher risks for miscarriage or stillbirth, unintended pregnancy and induced abortion. This study examined the association between women exposure to physical violence, psychological violence and sexual and reproductive health outcomes (contraceptive use, miscarriage or stillbirth and abortion) in Germany. Methods: This study used a cross-sectional research design to analyze data on violence against women and sexual and reproductive health (SRH) outcomes collected through the German Health Interview and Examination Survey for Adults, Wave 1, between 2008 and 2011 (n = 3149 women, aged 18–64 years). Multivariable logistic regression models were used to assess the association between experiences of violence among women and the presence of sexual and reproductive health outcomes, considering the influence of socio-demographic and health-related factors (age, marital status, socioeconomic status, social support, number of children, alcohol consumption, health status, chronic conditions). Results: Three associations remained significant (p<0.05) in fully-adjusted models: (i) exposure to physical violence by a parent or caregiver and birth control pill utilization (aOR, adjusted Odds Ratio, 95% CI: 1.36, 1.02–1.81) (ii) exposure to physical violence since the age of 16 and miscarriage or stillbirth (aOR, 95%CI: 1.89, 1.17–3.04); and (iii) exposure to psychological violence by a parent or caregiver and abortion (aOR, 95%CI: 1.87, 1.30–2.70). Conclusions: The results suggest that adult German women who experienced physical or psychological violence since the age of 16, including violence perpetrated by a parent or caregiver, were more likely to report miscarriage or stillbirth and abortion. Direct assessment of violence experiences against women should be conducted by healthcare professionals in clinical encounters, particularly by obstetrics and gynaecological specialists, for the prevention of women´s adverse sexual and reproductive health outcomes. Furthermore, violence should be treated as a major public health concern and addressed through a multisectoral approach, involving the healthcare and educational sectors, researchers and relevant policymakers.
- Strengthening data systems on violence against women in the Western Balkans and TürkiyePublication . European Institute for Gender Equality; Costa, DiogoViolence against women and girls and gender-based violence is a cause and effect of gender inequality and the power imbalance between women and men, and one of the most widespread violations of human rights. This deeply entrenched phenomenon requires a coordinated and targeted prevention and policy response based on reliable and comparable data and evidence. Over the past years, EU candidate countries and potential candidates from the Western Balkans (Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia, Serbia) and Türkiye have strengthened their data collection on violence against women (VAW), contributing to a better understanding of patterns and trends and providing much-needed data for evidence-based policymaking. However, gaps in comprehensive, disaggregated data on various forms of VAW still pose a barrier to fully understanding the scope and scale of VAW in each country or region.
- Understanding economic violence against women: the need for harmonized definitions and data in the EUPublication . European Institute for Gender Equality; Costa, Diogo
- Understanding intimate partner femicide in the European Union: the essential need for administrative data collectionPublication . European Institute for Gender Equality; Costa, Diogo
- Understanding psychological violence against women: the need for harmonized definitions and data in the EUPublication . European Institute for Gender Equality; Costa, Diogo
- Understanding rape in the European Union: the essential need for administrative data collectionPublication . European Institute for Gender Equality; Costa, Diogo
- Understanding the impact of context on migrant health: what we know from natural experiments. (Policy Brief)Publication . Biddle, Louise; Hintermeier, Maren; Costa, Diogo; Wasko, Zahia; Bozorgmehr, Kayvan
- Women fleeing the war: access to sexual and reproductive healthcare in the EU under the temporary protection directivePublication . European Institute for Gender Equality; Costa, DiogoThis report presents the findings of a study launched following Russia’s war of aggression against Ukraine on 24 February 2022, which led to a displacement of an unprecedented scale and forced over 8 million people – mostly women and children – to flee Ukraine and seek refuge and protection across Europe (United Nations High Commissioner for Refugees (UNHCR) data, as of 9 May 2023). The overarching objective of this report is to assess the availability of specialised services available in the European Union for victims of conflict-related sexual violence (CRSV). More specifically, the report aims to identify gaps in the provision of sexual and reproductive health (SRH) services and offers recommendations to ensure that victims of CRSV enjoy immediate access to them. This three-phase study comprised desk research, an EU-wide questionnaire completed by 26 experts representing EU Member States and 12 follow-up interviews with representatives of relevant NGOs and public bodies conducted in four of the Member States: Czechia, Germany, Poland and Slovakia.