Engaging refugee women and girls as experts: co-creating evidence on sexual exploitation and abuse in humanitarian crises using creative, participatory methods

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  • 1 George Washington University, , USA
  • | 2 Independent Consultant, , Lebanon
  • | 3 Independent Consultant, , Uganda
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Background:

Humanitarian evidence is produced in settings of heightened power imbalances between research stakeholders. Yet evidence production processes often lack explicit reflection of who is shaping the questions asked and making meaning of the answers.

Aims and objectives:

Empowered Aid is participatory action research that seeks to mitigate sexual exploitation and abuse (SEA) perpetrated by aid actors. Refugee women and girls in Uganda and Lebanon, as experts on SEA risk, are engaged co-researchers in generating evidence on how to make aid distributions safer.

Methods:

Diverse creative processes are utilised to co-produce knowledge about SEA risks and strategies to reduce them. These same processes are used to reflect on power dynamics within the research process itself, local gender power dynamics, and structural power dynamics between aid actors and those receiving aid.

Findings:

Fifty-five Syrian and South Sudanese refugee women and girl co-researchers used ethnographic methods to document their and their peers’ lived experiences of SEA risks while accessing humanitarian aid. Creative methods including drawing, drama, storytelling, community mapping, and body mapping were applied during data collection and qualitative analysis, as well as in reflection and action analysis workshops. SEA was reported across all the types of aid studied, and these findings are being used to adapt aid distribution processes.

Discussion and conclusions:

Creative and participatory practices can address the barriers, such as illiteracy (including computer illiteracy) and lack of training, often cited as limiting researchers’ ability to share power with affected communities, and allow for greater co-production of knowledge and evidence.

Abstract

Background:

Humanitarian evidence is produced in settings of heightened power imbalances between research stakeholders. Yet evidence production processes often lack explicit reflection of who is shaping the questions asked and making meaning of the answers.

Aims and objectives:

Empowered Aid is participatory action research that seeks to mitigate sexual exploitation and abuse (SEA) perpetrated by aid actors. Refugee women and girls in Uganda and Lebanon, as experts on SEA risk, are engaged co-researchers in generating evidence on how to make aid distributions safer.

Methods:

Diverse creative processes are utilised to co-produce knowledge about SEA risks and strategies to reduce them. These same processes are used to reflect on power dynamics within the research process itself, local gender power dynamics, and structural power dynamics between aid actors and those receiving aid.

Findings:

Fifty-five Syrian and South Sudanese refugee women and girl co-researchers used ethnographic methods to document their and their peers’ lived experiences of SEA risks while accessing humanitarian aid. Creative methods including drawing, drama, storytelling, community mapping, and body mapping were applied during data collection and qualitative analysis, as well as in reflection and action analysis workshops. SEA was reported across all the types of aid studied, and these findings are being used to adapt aid distribution processes.

Discussion and conclusions:

Creative and participatory practices can address the barriers, such as illiteracy (including computer illiteracy) and lack of training, often cited as limiting researchers’ ability to share power with affected communities, and allow for greater co-production of knowledge and evidence.

Key messages

  • Evidence production processes require reflection on who shapes the questions and participates in answering them.

  • Creative, participatory practices support co-production of knowledge and evidence with marginalised groups.

  • Co-producing knowledge about violence with those most affected by it creates actionable evidence to reduce risks.

  • Refugee women and girls are experts in contextual safeguarding.

Background

Efforts to build evidence on how best to deliver humanitarian assistance have grown over the past decade, and increasingly inform the decision making of governments and other aid actors. Much of this knowledge is produced in settings where power imbalances between research participants, users, and producers are heightened, and where the stakes for impacting lives and livelihoods are high. Yet evidence production processes often lack explicit reflection of who is shaping the questions asked, participating in making meaning of the answers, and exercising power to put them into action. Just as calls for ‘localising’ humanitarian aid focus on shifting power by allocating a greater share of resources to local humanitarian actors for programming; so is a similar approach needed in relation to how the knowledge that informs humanitarian response is generated (Robillard et al, 2020).

Creativity and co-production are valuable tools for moving from evidence into practice, in ways that allow both for innovation and utility (Metz et al, 2019). The literature on co-production includes a diversity of terms to describe such processes, with co-production and participatory action research (PAR) sometimes considered synonymous (Ottman et al, 2011). Both describe ways of moving beyond strict categories of ‘researcher’ and ‘subject’ to make scientific inquiry more inclusive, particularly of those whose lives are being studied. Such methods directly raise questions around ‘What counts as participation?’ and whose voices matter; they also demand careful, ongoing and proactive consideration of ethics, safety and transformative social change. As Baum et al (2006) note, there are three important ways in which PAR stands out as compared to conventional research: it is action-oriented and based on iterative reflection processes in which: ‘Action is achieved through a reflective cycle, whereby participants collect and analyze data, then determine what action should follow. The resultant action is then further researched and an iterative, reflective cycle perpetuates data collection, reflection, and action as in a corkscrew action’ (Baum et al, 2006). It places a primary focus on sharing power within the research process. Finally, PAR maintains a sense of place, with data and information remaining in the context from which it was produced and the very people being researched actively engaged, rather than merely being passive ‘respondents’ or ‘subjects’ (Baum et al, 2006). Creative, arts-based processes and methods are often used within PAR, with some considering ‘creative action research’ as a variant of PAR in which these processes are foregrounded (Cox et al, 2021). PAR has its roots in marginalised populations and the social justice work of Paulo Freire (Baum et al, 2006), and continues to be used with those facing intersecting oppressions, including poor women in Colombia during a pandemic (Marzi, 2021); refugee and asylum-seeking women in London (Greenfields, 2017); and arts-based PAR with refugee women in Burma (Rubesin, 2018).

This article examines the mechanisms through which creative, participatory processes contributed to co-producing evidence within a participatory action research study called Empowered Aid. We first describe how these processes enabled co-production of evidence in research with displaced populations; second, how they enabled co-produced evidence to be actioned in practice and policy; and third, how the bureaucratic and organisational (aid) ecosystems that define humanitarian settings can limit the effectiveness of co-production.

The Empowered Aid study aims to better prevent sexual exploitation and abuse (SEA) perpetrated by humanitarian aid actors. Such abuses first came to light in 2001, with a United Nations report that detailed pervasive sexual exploitation of female refugees in Guinea, Liberia and Sierra Leone by international and national aid workers and UN Peacekeepers (UNGA, 2002). In the intervening two decades, donors and agencies working in humanitarian response have put in place institutional responses to SEA, such as reporting and complaint mechanisms (IASC Secretariat, 2006). However, the coverage and effectiveness of many of these mechanisms have been limited, with minimal uptake in reporting abuses due to a lack of access, information, and trust in the process or the organisations leading it (Lattu, 2007). Accountability mechanisms have also focused on responding to abuses already perpetrated, rather than working to prevent them. Empowered Aid engages refugee women and girls as experts in what is needed to address these risks and make aid distributions safer. Further information about the methods and findings will be published elsewhere, and those wishing to read more in the interim may access the results reports and briefs developed for humanitarian actors to immediately put this learning to use at globalwomensinstitute.gwu.edu/empowered-aid-resources.

Methods

Empowered Aid is a multi-year, multi-country participatory action research study with women and girls living in Uganda and Lebanon, which host some of the largest refugee populations in the world. In Uganda, the study takes place in Bidi Bidi and Imvepi settlements, among South Sudanese refugee communities who fled civil conflict, and the Ugandan ‘host’ communities they live among. In Lebanon, it takes place in the urban and peri-urban areas of Tripoli, the country’s second-largest city, among refugees from Syria; as well as in Akkar, a rural area in northern Lebanon. Refugee populations in each country are largely prohibited from meaningful employment and citizenship status, and dependent on government and non-governmental aid structures to access food, shelter, fuel, water, and other necessities.

Empowered Aid’s first phase aims to understand how aid distributions may create or reinforce opportunities for sexual exploitation and abuse. Ethnographic fieldwork and qualitative methods, conducted by and with refugee women and girls, gather their lived experiences and observations of SEA risks they and their peers face when accessing each type of aid, as well as their recommendations for addressing these risks. The second phase applies these findings, using implementation science to support aid agencies in both identifying and addressing SEA risks within their distribution programming. Implementation science can be defined as ‘the scientific study of methods to promote the systematic uptake of research findings and other EBPs [evidence-based practices] into routine practice, and, hence, to improve the quality and effectiveness of health services’ (Bauer et al, 2015). The study is based at the Global Women’s Institute (GWI) at the George Washington University and carried out in partnership with local and international humanitarian actors active in each setting: CARE International in Lebanon and the International Rescue Committee (IRC) in Uganda. Within each country, research managers were recruited from the countries under study and with an emphasis on experience working with affected communities, and training on research provided, so that access to higher education was less of a barrier to serving in a research leadership role. Local technical advisory groups (TAGs) were established, consisting of representatives from national research or academic institutions, local and international aid groups, relevant government ministries, and women’s rights organisations. Local partners facilitated discussions with refugee women and girls who had expressed concern about SEA, to share the potential for undertaking participatory research and understand who wanted to take part.

The study engaged a core group of 29 South Sudanese women and girls (15–17 years) in northern Uganda, and 26 Syrian women and girls (15–17 years) in northern Lebanon. They selected the areas of focus: food, water, sanitation, and hygiene (WASH), and shelter were selected in both countries, as well as fuel and firewood in Uganda, and cash and voucher assistance in Lebanon. Within each country, the core group of researchers were part of the research process, from planning data collection activities and designing tools, to data collection, analysis and meaning making. In the design stage, the research team, including refugee researchers as well as staff of the partner agencies (many of whom come from the host communities among which refugees live), undertook training in participatory action research and ethnographic methods, namely how to use participant observation to systematically observe and document their and their peers’ lived experiences accessing life-saving humanitarian aid, and the SEA risks they face while doing so (GWI, 2020c). Their observations were shared back through semi-structured, participatory focus group discussions and in-depth interviews aligned to the different forms of aid observed. Non-governmental organisation (NGO) staff facilitating these sessions also recorded field notes and were trained on trauma-informed data collection techniques. Qualitative interviews and participatory group discussions were facilitated among refugee researchers, and also conducted with other groups including refugee men and boys; host community women, girls, men, and boys; and those living with disabilities. Key informant interviews were conducted with key stakeholders from community leadership structures and humanitarian actors. In total, 127 people were engaged in Uganda and 70 in Lebanon.

The methods described above utilised diverse creative processes to co-produce knowledge about SEA risks and strategies to reduce them. Guided visualisation, drawing, storytelling, drama, body mapping and community mapping were used within research design workshops, as well as within the data collection and analysis tools and processes, which were adapted or developed collaboratively by the research team (GWl, 2020a; 2020b). Due to limited literacy among many of the researchers, participant observations were shared back verbally rather than in writing. This also was a safety consideration, given that someone seen to be observing and taking notes in these settings can lead to suspicion – particularly when that person is of a lesser status within the patriarchal power structure. Instead, researchers collected their data as observations or ‘word pictures’: descriptions and stories which they communicated back to the rest of the research team within the semi-structured interviews and participant group discussions or ‘PGDs’. PGDs were held at the beginning and end of the data collection period, and included listing and ranking exercises, as well as open-ended stories or vignettes. Later PGDs employed community mapping, to capture points of safety and points of risk within the geographies in which refugee communities live, work and play. Body mapping was used to reflect on the experience of being part of the research team, and its impacts on the researcher as well as her social networks.

Importantly, these same processes were used to reflect on power dynamics within the research process itself, as well as local gender power dynamics and structural power dynamics between aid actors and those receiving aid. Reflection and feedback sessions were held halfway through the data collection period, in which intentional space was provided for international, national and refugee research team members to reflect on their experience of partaking in the research process thus far. These sessions included time for self-reflection on one’s own power within the research process, and actions that can enhance or reduce power imbalances. Examples of prompts used are detailed below, and facilitation guides co-produced by the study team are available so that others may replicate and adapt these processes (GWl, 2020d). Throughout the study and particularly during data analysis, aspects of grounded theory were applied (Strauss and Corbin, 1998; Birks and Mills, 2015). The analytical process of constant comparative analysis was modified to undertake coding and category development in an iterative, participatory way that allowed for non-literate members of the research team to contribute to making meaning out of the qualitative data gathered from their observations and experiences. GWI and NGO (non-governmental organisation) partner research team members read all transcripts and field notes to develop an initial set of themes, using qualitative software (Dedoose). These were then shared with the refugee research team members visually in ‘action analysis’ workshops (GWl, 2020a).1 Refugee team members provided further verbal feedback, which was captured in memos and used to revise and refine the categories; and engaged in participatory ranking exercises to prioritise the main recommendations for action arising from the findings. Thus literacy, including computer literacy, were not required to be active agents in deriving theory, from data that has been systematically gathered and analysed (co-producing knowledge), and marrying theory to practice through translating findings into actionable recommendations for humanitarian stakeholders.

Ethical and safety considerations included participatory risk-benefit analysis among stakeholders; specialised training for research team members; ensuring clear referral pathways for cases of abuse or other issues identified; staff care and supportive supervision; and ongoing reflection processes and feedback processes. Information cards detailing relevant services were provided to all participants. Training included trauma-informed interviewing techniques; recognising and responding to signs of distress such as being triggered or dissociating; staff care processes; and safety planning. Inclusion in the study did not require disclosing whether one had experienced abuse, however, due to widespread prevalence globally it can be assumed that some participants are survivors. To minimise discomfort or harm, none of the research tools asked about personal experiences of violence or abuse, and body mapping focused only on participants’ experience of being part of the research. All activities were conducted with trained social workers as part of the research team or on call. The George Washington University Institutional Review Board (IRB) reviewed and approved the research protocol, in addition to input, review and feedback from the local TAGs. Consent was considered both as an ethical imperative and a form of empowering research participants to direct the degree of their participation. For those age 15–17, separate consent forms were developed, with social workers from the NGO partners first obtaining written consent from a parent or legal guardian before seeking assent from girls directly. All participants were asked for additional consent to record interviews and focus groups; focus groups were not recorded if at least one person did not consent. Separate written consent was also obtained before taking photos at workshops or other project activities. During all individual and group activities, participants were reminded of their power to choose not to answer or to end their participation at any time. Compensation was provided in line with NGO partners’ policies for similar engagement of community members’ time, specifically in the form of a small token of appreciation (that is, cloth for tailoring) given to all participants, regardless of whether they completed or dropped out of the study. Participants needing to take public transportation were reimbursed for this cost or provided with in-kind transport.

Findings

How creative, participatory practices enabled co-production of evidence in research with displaced populations

The first phase of Empowered Aid took place in 2019–2020 and began with participatory action research design workshops, followed by three months of data collection, a ‘pause’ for reflection workshops halfway through, and then ‘action analysis’ workshops to synthesise and analyse findings. As described above, the study’s design, analysis and synthesis processes were conducted jointly, with an emphasis on visual and low-literacy tools to break down barriers for participation among the refugee researchers involved. This began in the design workshops, with guided visualisations that asked each member of the research team to first consider their vision for the impact that Empowered Aid can have, alongside other actions to address abuse in their communities. After closing their eyes and contemplating this, they were invited to use paper, markers and paint to capture their visualisation with a drawing and/or words. They were then asked to pause and reflect on the question: ‘How do I see my role in this impact?’, before being invited to add to their existing drawing, or make a new one. Figure 1 shows several of the drawings resulting from the guided visualisations conducted at the outset of the work in Lebanon. This process helped to engage each member of the team, regardless of literacy, English language ability, or previous experience as a researcher, in collaboratively envisioning what the project could achieve and how their participation was central to that. Employing this at the outset of the design stage was seen as supportive to co-production processes, especially as the drawings were prominently displayed on the walls throughout the multi-day workshop, as a visual reference point (for those who wished to display theirs). It is likely that there is some version of response bias present, in that responses were overwhelmingly positive about the type of change the project would be able to achieve. The reflection workshop, discussed further below, offered more directed opportunities at soliciting critique, whereas visioning exercises are often focused on the positive.

Brightly colored pieces of paper with drawings by participants capture, in images and words, what arose for them during the guided visualization exercise. These include a flower, a tree, a person on a swingset, a heart in the middle of a globe with people holding hands around its perimeter, a roadway with two girls that says “Guiding a safer environment”, and a dove with arrows that says, “Dove of peace! Problem solver, Passionate changemaker, Power to change, Power to support.”
Figure 1:

Guided visualisation and drawing exercise undertaken at the outset of research design workshops, to collectively vision the impact of the research and each person’s role in achieving it

Citation: Evidence & Policy 18, 2; 10.1332/174426421X16420949265777

Storytelling and drama also played a large role in design and data collection processes. The phenomena under study, sexual exploitation and abuse, can take many different forms, and universal definitions of violence may or may not capture the ways in which it is understood, observed, and talked about within a specific population. Open-ended stories, or vignettes, were developed by NGO team members who were also caseworkers; these stories were anonymised accounts of actual events that occur within the refugee communities. These scenarios then provide an open-ended prompt for storytelling, in which a victim or survivor (used synonymously in this article) faces an abusive or exploitative situation, and women and girl researchers fill in the ways in which the survivor may respond, where she would go to for help and why – or why not, and how other family or community members would react. Once built collectively, these stories were then acted out in small group role plays, in which the survivor took on different characteristics: an adolescent, a person living with disabilities, a widow. Each group was asked to reflect upon the role plays of the others using a set of prompts, including whether they would further change anything to suit their context. Once fully developed, these vignettes were used within the data collection tools, specifically the participatory group discussions, to undertake similar exercises with both refugee and host community members.

A photo of the flipchart used in one of the participatory group discussions shows a stick figure labeled “Sara” in the middle, surrounded by different colored post-its showing responses to having experienced violence (in yellow), potential actions to reduce future violence (in green), and her feelings as a survivor (in pink).
A photo of the flipchart used in one of the participatory group discussions shows a stick figure labeled “Sara” in the middle, surrounded by different colored post-its showing responses to having experienced violence (in yellow), potential actions to reduce future violence (in green), and her feelings as a survivor (in pink).
Figure 2:

Open-ended stories, or vignettes, were used to produce knowledge on how SEA happens and how survivors, their families and communities respond. These were drawn using flipchart paper and art supplies (this page), and later diagrammed during the qualitative thematic analysis (next page). These examples are drawn from a group exercise among girl researchers in northern Uganda

Citation: Evidence & Policy 18, 2; 10.1332/174426421X16420949265777

Photo credit: Harriet Kolli

Mapping was used to reflect both outward and inward spaces. Community mapping was used to identify risks and unsafe places, as well as locations that women and girls considered safe and/or helpful in the face of abuse. Using flipchart paper, colored post-its, stickers, and coloured markers, researchers mapped the communities in which they live – or for the NGO caseworkers involved, the communities in which they worked. This was done at the outset of the research, during the design phase to inform research locations and questions, as well as in the final participatory group discussion at the end of the data-collection process, to reflect the additional observations gathered over three months of data collection back into the mapping exercise. Figure 3 shows the depth and breadth of knowledge co-produced through these community maps. In addition to being included within the qualitative thematic analysis (discussed further below), the maps themselves were shared back with NGO staff to provide visual, spatially-relevant data to inform their programming.

The hands of several girls, who are living as refugees from Syria in Lebanon, are shown as they hold markers and point to create a community map of safe and dangerous places in their neighborhood.
The hands of several girls, who are living as refugees from Syria in Lebanon, are shown as they hold markers and point to create a community map of safe and dangerous places in their neighborhood.
Figure 3:

Community mapping exercises with women and girls served to identify SEA risks and safe or unsafe places in their communities

Citation: Evidence & Policy 18, 2; 10.1332/174426421X16420949265777

Body mapping was also used at the outset of the research design process, and again as the data collection phase closed. Researchers were invited to have a partner help them draw an outline of their body; as pictured in Figure 4 below, a few chose to represent their bodies in other ways, such as through stylised drawings. After a period of quiet reflection, a series of prompts were used to reflect on the intellectual, emotional, social and physical experience of participating in this research: asking how it affected their thoughts, and inviting use of the art supplies provided to represent this through drawings, words, or symbols, focusing on the head area of the outline; how it affected emotions, focusing on the heart or chest area; how it affected social connections, focusing on the hands; and how it affected them physically, focusing on the legs. By ‘bookending’ the mapping exercises, participants could express their experience of the research at the outset and again at the end of data collection, and reflect upon how this had evolved or changed. While this exercise did not directly explore sexual violence, the facilitation process included reminders that participants could choose to refrain from all or part of the activity, and trained social workers were available to speak with at any time. While none of those participating sought such support, these measures were in place to support refugee women and girls to feel safe and in control of their involvement. Figure 4 shares several of the body maps drawn by women and girls in Lebanon and Uganda.

Refugee girl members of the Empowered Aid team in Uganda use markers to draw symbols and colors onto silhouettes of their body, as captured in flipchart paper spread on the floor, in the body mapping exercise.
Refugee girl members of the Empowered Aid team in Uganda use markers to draw symbols and colors onto silhouettes of their body, as captured in flipchart paper spread on the floor, in the body mapping exercise.
Figure 4:

This page: South Sudanese adolescent girls living as refugees in Uganda take part in a body mapping activity during the research design workshops in Uganda. Next page: example of body mapping exercise with adolescent girls, to identify SEA risks and safe or unsafe places in their communities. Here a more stylised representation was chosen by the participant.

Citation: Evidence & Policy 18, 2; 10.1332/174426421X16420949265777

Halfway through the three months of data collection, ‘reflection’ workshops were held, as an intentional space within which to pause and reflect on power dynamics, both within the communities under study as well as within the multi-national research team. Such reflection practices are critical to qualitative, ethnographic, and feminist research methods, and to participatory action research. The workshop curriculum focused on three main components: 1) a reflection on the research process so far; 2) what has been enjoyable and what has been challenging within the process; and 3) a reflection on power and power dynamics both within the study and in relation to aid distribution (the subject of study). Visual and movement-based activities similar to those described above – guided visualisation, storytelling, and drama exercises – allowed for full participation regardless of literacy level. In addition, among the NGO and research institute team members, a component of at-home journaling was added to allow for additional reflection of their own power. Prompts used for the journaling exercise include:

Even when trying our best to listen actively and openly, we may also judge women and girls when they share experiences of disempowerment and abuse with us. Reflect on times when you may have felt judgment about something shared in the research process. Be honest with yourself (no one else will read these notes). Journal on the following prompts:

How can you hold space to listen with less judgment in future?

What kinds of support would help you? (GWI, 2020d)

A diagram has 3 lines showing different continuums or axes: the first is between “women” (written on the left) and “men” (written on the right), the second between “participant-researcher” and “staff-researcher”, and the third between “aid recipient” and “aid worker”. Post-its are placed at different points on the axes with notes about how power is held—or not—by each group.
A diagram has 3 lines showing different continuums or axes: the first is between “women” (written on the left) and “men” (written on the right), the second between “participant-researcher” and “staff-researcher”, and the third between “aid recipient” and “aid worker”. Post-its are placed at different points on the axes with notes about how power is held—or not—by each group.
Figure 5:

This page: power continuum exercise undertaken by the research team in Lebanon. Next page: adolescent girl team members in Uganda reflect on times when they feel they have power, and times when they feel they lack power, both in their communities and within the research process.

Citation: Evidence & Policy 18, 2; 10.1332/174426421X16420949265777

Photo credit: Alina Potts

Given the sensitivity of the topic under study, social and emotional support for all research team member-participants was incorporated throughout all stages. Refugee women and girls were provided with up-to-date information about accessing services (psychosocial, health, counselling, and so on) before and after each activity, as well as how to contact trained social workers should a need arise anytime during or after the study. At the end of the study, women and girls came together in age-disaggregated groups to reflect on the experiences they had and – importantly – celebrate their participation and achievements through a ‘graduation’ ceremony, with certificates recognising their role as participatory action researchers.

How creative, participatory practices enabled co-produced evidence to be actioned in humanitarian practice and policy

As described above, aspects of grounded theory were applied to the participatory analysis process, building on integration of these approaches in research on sexual abuse (Teram et al, 2005). Within this study, an initial set of categories were presented visually (Figure 6) in ‘action analysis’ workshops with the refugee research team, thus literacy (including computer literacy) was not required to be active agents in co-producing knowledge. Importantly for the action component of the research, a participatory prioritisation exercise was used, in which women and girls (in separate, age-specific workshops) voted for their top three recommendations by placing three stickers on their first priority recommendation, two stickers on their second, and one sticker on their third. These were tallied and the overall rank is shown in Figure 7.

A watercolor painting and drawing shows several trees on the left and right, dark areas signifying the bush (forests) and a road, and a man with a knife threatening a woman in the midst of the trees. The houses are far away so she is isolated.
Figure 6:

A visual representation of findings used in the Action Analysis workshops with women and girls to facilitate sharing and participatory analysis. This drawing from Uganda shows risks of SEA identified when women and girls go to collect wood and grasses for fuel.

Citation: Evidence & Policy 18, 2; 10.1332/174426421X16420949265777

A woman in a brightly patterned skirt, striped shirt and sandals is shown from the shoulder down, leaning over a table and placing sticky-paper shaped like flowers onto a picture with several women drawn on it.
Figure 7:

Refugee women researchers in Uganda vote to prioritise a set of action-oriented recommendations for practitioners and policymakers, to better mitigate SEA risk and make aid distributions safer

Citation: Evidence & Policy 18, 2; 10.1332/174426421X16420949265777

The study’s first phase of qualitative research found sexual exploitation and abuse by aid and non-aid actors to be pervasive in all of the types of aid explored, and across all points of the distribution process. Across both countries, sexual exploitation and abuse were most frequently mentioned in relation to accessing food, shelter and cash assistance; during interactions at distribution points, when registering for aid, or when going to and from distribution locations. However, SEA also occurs in relation to trying to find out about or receiving information on collecting aid, and when storing aid. Perpetrators were identified as aid or distribution actors as well as taxi drivers (including ‘boda boda’ or motorcycle taxi drivers in Uganda), NGO-contracted truck drivers or construction workers, host community members, and other refugees; as well as, in Lebanon specifically, landlords, religious leaders or staff at places of worship, and foreign men seeking brides. Little clarity of or faith in reporting mechanisms, lack of support from families or communities, loss of aid, the normalisation of SEA, and confusion around the identity of the perpetrator, all serve as powerful deterrents to reporting SEA. Other forms of gender-based violence were also mentioned in relation to accessing aid during data collection. In each country, the researchers identified ten or eleven priority recommendations for making aid safer, including more female aid workers, and support for safe transportation (Potts et al, 2020a; 2020b).

Their observations and recommendations were applied, in the second or ‘implementation science’ phase of the research (defined above), to actual aid distribution processes among an expanded group of NGO partners. The knowledge co-produced through participatory and creative processes was used to show as well as tell, demonstrating how contextual safeguarding approaches can be applied to aid distribution systems: in other words, making sure the context is safe rather than responding only after an incident of harm has occurred. The Empowered Aid team worked with partners to ‘pilot’ the application of recommendations from Phase I, while simultaneously applying the findings around SEA risk to adapt programme monitoring tools, in order to better capture aid recipients’ perceptions of risk and safety throughout the distribution process. Outcomes of the work include adapted programme design, implementation, and monitoring and evaluation (M&E) materials and tools. Creative, participatory processes supported uptake in a number of ways, both within each country, as key aid stakeholders, who were part of the TAG or otherwise consulted in the research, shared and applied the findings within their own organisations and sectors of operation. The ability to translate evidence generated by this research is perhaps best attested to by those who did so, in each country. The first example is notable as it shows how a United Nations agency applied findings when responding to the large explosion in the port of Beirut (the ‘Beirut Blast’) on 4 August 2020; the second is an example of uptake within social sciences teaching and learning – with potential for the way future practitioners and policymakers understand and apply knowledge:

… after the Beirut blast, UNICEF did a large-scale cash assistance program for families affected by the blast. Again here, we used a lot of Empowered Aid’s findings and tools to make this program much safer. It was quite interesting to see that the Empowered Aid action research shed light on the importance of information sharing with women and girls themselves because we all know that information is power and with whatever we do we want to give back the power to women and girls. That is why we made sure when presenting the cash program, we reached out to women-led organizations, domestic workers organizations, organizations for persons with disabilities, and all these marginalized overlooked groups were part of this information sharing about the cash assistance program. (UNICEF member of Lebanon TAG)

… I have used these tools as practical examples while teaching how research is qualitative and quantitative and how it should be contextualized and what is the method for using mixed approach between desk research, focus groups, surveys, as we usually do as sociologists. (National academic and civil society member of Lebanon TAG)

And a reflection by one of the NGO research partners in the study’s second phase, on what mechanisms were most useful for research uptake:

Precisely speaking, we had joint dissemination workshops but we focused disseminating to the stakeholders, like coordinating partners both [government and United Nations agencies] and then other partners that were involved in distributions. This was done together with IRC and then also we had the community distributions whereby we invited community members and community leaders to disseminate the findings.… And from that actually new recommendations were coming up, which we are adding to the reports based on what works and what may not work well. (Monitoring and evaluation staff, World Vision Uganda)

The adapted tools and outcomes of the pilots form an evidence-based ‘toolkit’ that can be further adapted by other humanitarian actors to support contextualised identification and prioritisation of ways to improve aid distributions (GWI, 2021). Importantly, putting the findings into action is not only meaningful for humanitarian aid policymakers, practitioners, and the communities they serve; refugee researchers, who elected to form an advisory group for the implementation science phase to review and input into programmatic tools and findings, expressed the ways in which their experience of evidence-to-policy-and-practice affected them on a deeply personal level. Many who reported that involvement in the study’s implementation, and empowering them to understand and use the results to change their own lives in relation to receiving aid, specifically mentioned the value of creative, participatory methods in doing so: as ‘Leila’ (her chosen pseudonym), a refugee woman researcher in Lebanon, shared: “The drawings were very good, they reflected everything we discussed to help us understand the risks around the distribution we face on the way to the distribution or at the distribution site. They also reflected our experience with aid distributers”. Another member of the team, ‘Mona’, said: “Yes, I agree with the findings because they came from our experiences and they allowed us to have more confidence in ourselves”.

How the bureaucratic and organisational (aid) ecosystems that define humanitarian settings can limit the effectiveness of co-production

To the extent that aid delivery systems address sexual exploitation and abuse, it is often as a reaction to reported cases, with clearly defined perpetrators and victims/survivors willing to come forward and report their stories to the same type of actors that were implicated in their abuse. Even within these bounds, accountability for perpetrators is relatively rare and often short-lived: as a participatory group discussion with adolescent girls in Uganda shared: “To me, concerning the issue of food, like these men or these humanitarian workers convincing women [to have sexual relationships in exchange for food aid]. I think security people should be deployed but again you find that at times these security people also turn themselves to do the same things. Now, how are you going to support us in this field?” Thus, the invitation to co-produce may be met with a healthy degree of mistrust and suspicion.

Allowing space for this and, perhaps most importantly, time, was found to be a very valuable part of supporting co-production processes within these settings, where power imbalances are so pronounced. While aid programmes often incorporate participatory methods in their assessments, these are often not designed for longer-term engagement, as aid, by its nature, is meant to be short-lived. Despite global averages of 20 years in displacement (European Commission, 2021), funding cycles still often fall on one-year (or shorter) increments. One-off focus group discussions or other community engagements, carried out year after year around the same topics with little visible sign of improvement or direct dissemination of findings to displaced communities, can leave them to view data collection and research as both extractive and divorced from their realities. The multi-year funding obtained by the project was important in being able to build trust within these structural constraints. Not only because it allowed time for co-production at all stages of the research process; but also because it allowed for time to apply the findings in real-life situations and share those outcomes back with researchers and affected communities. Even without such funding, trust can be built by increasing transparency at all stages of research, through including those most affected in decisions about design, implementation, analysis and dissemination. Creating space for feedback – whether positive or negative – and showing that the feedback was listened to by responding to it within the course of the study, is also important for building trust.

Within the growing body of evidence for effective and safe humanitarian programming, there is also a bias toward quantitative data and, within the violence prevention field, to studies that can produce generalisable statistics around prevalence. Sharing findings with stakeholders is key to turning evidence into practice, and policy often required providing information around the differences between quantitative and qualitative data, and the uses of the latter; for example, conversations on how the strong deterrents to reporting SEA and other forms of gender-based violence often lead to underestimates of prevalence (Palermo et al, 2014). Qualitative data can also help to answer questions about how violence manifests, and what can be done to address it, in the words of those most affected.

One way of addressing this was working with research managers, who themselves were trained as practitioners and advocates, and thus oriented to how the qualitative data would be received by other actors. The Empowered Aid research manager in Uganda described her own learning journey with qualitative research:

Qualitative data is really valuable and with my experience from Empowered Aid, I learned that qualitative data is so engaging for readers. You read from the place of the respondent or from the participant. Qualitative data helps you to feel, to listen, to hear, the respondents. It helps you to connect and imagine their scenarios and situations. And I think it provides the readers with a lot more content in terms of the field, of the issues that the women are talking about.

In a field in which ‘expertise’ is often seen as being either international and/or requiring degrees in higher education, this participatory action research demonstrates how NGO aid workers, and most importantly, refugee women and girls are experts in contextual safeguarding.

Limitations

Limitations of the study included access issues that often affect humanitarian settings, including curfews that sometimes necessitated activities ending earlier than otherwise would have occurred, and extended time for staff travelling to meeting points in the refugee settlements on days when it rained and roads were compromised. The study worked with NGO partners including trained social workers, who had other roles within their organisations that sometimes competed for their time and caused changes to interview schedules, which some refugee women and girls noted in the reflection sessions as posing difficulties for them; thus this issue was attended to in the second part of data collection through negotiation with NGO managers. Both of these factors may have limited the quality and quantity of data shared during interviews and participatory group discussions. In seeking to engage adolescent girls, it was found that young women aged 18–19 years felt more comfortable joining group activities with the adolescent girls (ages 15–17 years) than being grouped with older women. This is not uncommon, given that in many cultures ‘adolescence’ can extend beyond 17 years of age. After discussing with younger participants to gauge their consent, the groupings were adjusted. While this means that the findings from adolescent girls do not strictly fit the international age guidance, they are grounded within and relevant to each context. While not a methodological limitation, it is also important to note that several of the adolescent girls and women involved in the research in Uganda had children of their own; culturally, it can be common for children to be engaged as caregivers when mothers are unavailable. Social workers from the NGO research team spoke with these women and girls in advance and described the childcare that would be available, so as to prevent young girls being pulled out of school or away from their homes in order to take care of children while their mothers attended workshops or other project activities.

Discussion and conclusion

In defining co-productive research practices, we may look to how they define themselves. In a previous issue of this journal, Graeme et al (2019) put forward a set of questions that explore motivations, power, knowledge, and legitimacy, with prompts such as: ‘Who and what should benefit?’, ‘What should be the purposes?’, and ‘What should be the measures of success?’ (Graeme et al, 2019). Within Empowered Aid, we held similar discussions among research partner institutions, as well as with the refugee researchers during design workshops. In seeking to describe here some of the mechanisms we used in those conversations, we seek to show how participatory, creative practices can serve to ‘demystify’ research praxis and lower the barriers to engagement, particularly for those whose citizenship status, literacy level, or dependency on aid, mean that they are often asked questions without being asked what the questions should be. In this case, the researchers from refugee communities have access to particular knowledge and expertise that goes untapped, to the detriment of those working to improve the effectiveness of humanitarian aid. Should it not be accessed in ways that meet the needs of the knowers (affected women and girls), rather than those who seek to know (aid actors)? Furthermore, they are fully capable of not only sharing, but making meaning out of their experiences, when participatory, creative co-production approaches are also applied to data synthesis and analysis processes.

Resourcing co-production processes – starting with who is involved in answering the types of questions listed above, and sharing capacity to support their engagement – also contributes to equity within research co-production processes: ‘Rather than expecting one project to fit the bill of a “perfect” co-production project, resources should be put into fostering a series of meaningful interactions with key partners from high income countries as well as LMICs, within and beyond academia. This would nurture co-production efforts in the spirit of equitable partnerships’ (Beran et al, 2021). Creative and arts-based methods are well-suited to ‘decolonising’ research processes – even those which are otherwise ‘participatory’ – by supporting more transparent and horizontal processes that allow for a multitude of voices and dynamic forms of place- and people-based expression (Mitchell and Sommer, 2016; Seppälä et al, 2021). By exploring how creative methods are applied within participatory research on complex social issues, Empowered Aid provides a case study from which to bring into focus the mechanisms through which creative, participatory methods enable people with less access to resources to engage in research processes as co-producers of knowledge; as well as potential challenges to the veracity of the evidence they generate. Refugee women and girls engaged in the research spoke of their experiences of feeling empowered by the research skills they gained, the decisions they were part of informing, and the ways in which they were consulted:

I learnt how to be strong and self-sufficient. I felt like I became a new person after I took part in this project. Most importantly, I developed strength for my kids and a sense of self-efficacy. (Syrian refugee woman researcher in Lebanon)

From this training, we raised our communities, we were able to change behaviours of other people because they copy from us we do and what we learnt from here, we don’t leave them behind and we also tell them. (South Sudanese refugee adolescent girl researcher in Uganda)

My experience was very good; it allowed me to speak and express my opinions freely. All we wanted was for someone to give us the space to express our thoughts. My personality grew stronger through this experience. (Syrian refugee woman researcher in Lebanon)

I feel empowered from that training of Empowered Aid. Now I have the experience of being a woman standing in front of people, talking to people, even helping those ones with problems. (South Sudanese refugee woman researcher in Uganda)

Finally, to connect co-produced knowledge to changing practice or policy requires deliberate stakeholder engagement from the outset, using a framework such as that described in the previous special issue by Bammer (2019). The national and global Technical Advisory Groups are one example of how, within Empowered Aid, multiple stakeholders of varying levels of power were engaged in asking and answering these questions around motivation, legitimacy, and so on. This is perhaps even more important when the research problems being addressed are complex, and mapping out power and hierarchy within stakeholder engagement processes is also particularly relevant to the ‘localisation’ agenda within humanitarian aid. Thus researchers, practitioners, and policymakers who seek to engage in co-production processes are more likely to move beyond merely ‘informing’, ‘consulting’, and ‘involving’ those living out the research problems in their daily lives, to ‘collaborating’ with them, and potentially even allowing for an ‘empowering’ engagement with them.

In conclusion, while barriers to participation, such as lack of literacy and training, are often cited as limiting researchers’ ability to share power, creative and participatory practices can open space for greater co-production of knowledge and evidence.

Note

1

There is a dearth of documented participation practices specifically for the analysis phase of research, thus ‘action analysis’ is a term created within the study to reflect the participatory analysis processes developed and employed. These are described further within the study materials cited above.

Funding

This work was supported by the United States Department of State, Bureau of Population, Refugees, and Migration under Grant number SPRMCO18CA0094.

Research ethics statement

The George Washington University Institutional Review Board (IRB) reviewed and approved the research protocol, with approval provided on 3 April 2019 for phase 1 and 26 March 2020 for phase 2. A local Technical Advisory Group (TAG) was set up to review all tools and advise the research team. Ethical and safety considerations included participatory risk-benefit analysis among stakeholders; specialised training for research team members, based on leading guidance from the World Health Organization; involvement of NGO partner focal points and a clear referral pathway for any cases of SEA or other needs identified; and ongoing reflection processes with participants to allow them to raise concerns in a variety of ways.

Contributor statement

AP and LF wrote the first draft of the manuscript, AP wrote subsequent drafts, and HK provided inputs throughout. AP conceptualised the study and LF, HK and AP co-led design processes in each country. AP, LF and HK conducted data analysis and interpretation utilising participatory processes with other study team members.

Acknowledgements

This study represents the collective expertise of 55 South Sudanese and Syrian women and girls living in Uganda and Lebanon as refugees, who engaged in this participatory action research as refugee researchers. The following represents those who chose to be named, and the name (or pseudonym, denoted by quotation marks) they prefer: Harriet Opani, Mary Kiden, Sitima, Karaba Peter, Julia, Hellen Manano, Harriet Tabu, Dauphine, Mary C, Janet, Laura Cinthy, Mirabel, Emmy Baraza, Lady Aminah, Rose Monday, Grace Kiden, Esther Namadi, Grace Awate, Margret Kiden, Angaika Poni, ‘Malak’, Suzan Taktak, ‘Zeina’, Amal Koussa, ‘Leila’, Imane Ibrahim, ‘Jawaher’, ‘Mona’, ‘Nawal’, and Lama Sibaii. The authors also wish to acknowledge and thank the wider Empowered Aid research team who participated in Phase 1 study co-design processes, data collection, analysis, and write-up: globally, Elizabeth Hedge, Amelia Reese, Chelsea Ullman, Aminat Balogun, Amal Hassan, and Zoe Garbis; in Uganda, Esther Apolot, Monica Ayikow, Nancy Awio, Annet Fura, Aminah Likicho, Fatuma Nafish, Chandiru Zamuradi, Lealya Sebbi, Zuleika Munduru, Zahara Beria, Harriet Kezaabu, Anne Grace Aleso, Doreen Abalo, Consolate Apio, and Aishah Namugenyi, with special thanks for translation support to Monica Ayite; in Lebanon: Farah Hallak, Georgette Alkarnawayta, Wafaa Obeid, Reem Boukhary, Farah Baltagi, Angeliki Panagoulia, and Marwa Rahhal. In addition, the authors wish to thank all the individuals from the Global Women’s Institute (GWI), International Rescue Committee in Uganda, and CARE International in Lebanon, who provided support to the implementation of the study; and to the members of Empowered Aid’s global and national Technical Advisory Groups, who provided important contributions to the research design, analysis, and uptake. Our deepest gratitude to all refugee and host community members and humanitarian stakeholders who generously shared their time and stories with us; and appreciation to the helpful comments of two anonymous reviewers and the special editors.

Conflict of interest

The authors declare that there is no conflict of interest.

References

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  • View in gallery

    Guided visualisation and drawing exercise undertaken at the outset of research design workshops, to collectively vision the impact of the research and each person’s role in achieving it

  • View in gallery View in gallery

    Open-ended stories, or vignettes, were used to produce knowledge on how SEA happens and how survivors, their families and communities respond. These were drawn using flipchart paper and art supplies (this page), and later diagrammed during the qualitative thematic analysis (next page). These examples are drawn from a group exercise among girl researchers in northern Uganda

  • View in gallery View in gallery

    Community mapping exercises with women and girls served to identify SEA risks and safe or unsafe places in their communities

  • View in gallery View in gallery

    This page: South Sudanese adolescent girls living as refugees in Uganda take part in a body mapping activity during the research design workshops in Uganda. Next page: example of body mapping exercise with adolescent girls, to identify SEA risks and safe or unsafe places in their communities. Here a more stylised representation was chosen by the participant.

  • View in gallery View in gallery

    This page: power continuum exercise undertaken by the research team in Lebanon. Next page: adolescent girl team members in Uganda reflect on times when they feel they have power, and times when they feel they lack power, both in their communities and within the research process.

  • View in gallery

    A visual representation of findings used in the Action Analysis workshops with women and girls to facilitate sharing and participatory analysis. This drawing from Uganda shows risks of SEA identified when women and girls go to collect wood and grasses for fuel.

  • View in gallery

    Refugee women researchers in Uganda vote to prioritise a set of action-oriented recommendations for practitioners and policymakers, to better mitigate SEA risk and make aid distributions safer

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    • Export Citation
  • Beran, D., Pesantes M.A., Berghusen M.C., Hennig B.J., Jacobi J., Lazo-Porras M., Llanque, A., Placella, E., Robledo-Abad, C., Bayona, M.T. and Miranda, J.J. (2021) Rethinking research processes to strengthen Co-production in low and middle income countries, BMJ (Clinical research ed.), 372. https://www.bmj.com/content/bmj/372/bmj.m4785.full.pdf

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    • Search Google Scholar
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  • Lattu, K. (2007) To complain or not to complain: still the question: consultations with humanitarian aid beneficiaries on their perceptions of efforts to prevent and respond to sexual exploitation and abuse, Humanitarian Accountability Partnership (HAP), https://reliefweb.int/report/world/complain-or-not-complain-still-question-consultations-humanitarian-aid-beneficiaries.

    • Search Google Scholar
    • Export Citation
  • Marzi, S. (2021) Participatory video from a distance: co-producing knowledge during the COVID-19 pandemic using smartphones, Qualitative Research, 117. doi: 10.1177/14687941211038171

    • Search Google Scholar
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  • 1 George Washington University, , USA
  • | 2 Independent Consultant, , Lebanon
  • | 3 Independent Consultant, , Uganda

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