While inclusive, this broad definition can be unwieldy and difficult to operationalize [ 3 , 4 ]. However, as pointed out by Paris in , narrower definitions risk excluding important threats to personal security that do not relate to these five indicators [ 3 ]. Multiple authors have explored the role of inequality and oppression in inter- and intrastate violence.
In general, studies have found that greater social disparities between segments of society are associated with greater levels of conflict [ 8 , 10 , 11 ].
Risking Human Security
The role of gender inequity in conflict has also been previously explored. Melander found that states with higher rates of gender inequity, as measured by female participation in parliament and female to male higher education attainment ratio, have higher rates of intrastate conflict [ 12 ]. Similarly, Caprioli found that states with higher levels of gender inequity had higher rates in intrastate violence between and [ 8 ]. Assessing levels of human security remains challenging. Given the links described between human security indicators and a greater propensity to intra- and interstate conflict, measurement of human security could be used both to herald potential deterioration within a conflict and to monitor progress of post-conflict state conditions.
Leaning and Arie in [ 10 ] developed a model designed for this purpose. The main strength of this model is its ability to detect threats to human security at a more granular level that may be used to predict community level violence—a key difference from other approaches that focus on aggregate national indicators. This model, however, does not explicitly incorporate gender sensitive measures. The following study explores human security and gender using quantitative measures in Djohong District, Cameroon, a rural region to where members of the Mbororo tribe from the Central African Republic CAR have fled in response to a decade of targeted killings, kidnappings, forced taxation and extortion, beatings, and the burning and looting of their homes and villages [ 13 , 14 ].
These human rights violations have occurred at the hands of government troops, anti-government rebel groups, and opportunistic gangs of bandits known locally as coupeurs de route [ 15 ]. During their flight, the coupeurs de route targeted the Mbororo, locally perceived as wealthy pastoralists, stealing their livestock or kidnapping their family members and forcing them to pay large ransoms.
Arriving in Djohong with little or no assets, the Mbororo refugees had become considerably dependent on the international aid community and Cameroonian host population. In early , the United Nations Office for the Coordination of Humanitarian Affairs UNOCHA cited a high burden of sexual violence in the internally displaced and refugee population, but detailed statistics were lacking [ 16 ].
We examined human security indicators based on the Leaning-Arie model and performed a population-based study for measures of sexual and gender based violence. From this, we used the model to determine whether a human security framework that does not specifically incorporate measures related to gender would capture insecurity faced by women affected by displacement and recent conflict, and to assess whether or not gender-specific measures are needed when measuring human security.
Embedded within the survey instrument were indicators of human security derived from the Leaning-Arie model, assessing three domains of psychosocial stability that suggest individuals and communities are most stable when their core attachments to home, community and the future are intact. The text below outlines these three domains and provides examples of how each was specifically studied.
Female refugee and host population participants were selected using a two-stage household cluster design. The first stage included a random selection of 40 clusters villages weighted by refugee and host population estimates from the UN High Commissioner for Refugees UNHCR registration lists of January and from Djohong District government officials, respectively.
The latter figures were estimates of the Cameroonian population using census figures adjusted for annual population growth. Since the human security dataset came from a study designed to also characterize gender-based violence GBV in the region, the estimated prevalence of GBV was used to determine sample size.
Since observations within a cluster may be more alike than observations across clusters, particularly with shared perceptions of human security, we took this intra-cluster correlation into account in the sample size calculation. This design effect, defined as the ratio of the variance taking into account the cluster sample design and variance of a simple random sample design with the same number of observations, was conservatively estimated at 2.
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To minimize the possibility of increased intra-cluster correlation and homogeneity on the outcome of sexual violence prevalence and to limit design effect, we sampled more clusters in the first stage and fewer households in the second stage [ 21 ]; the second stage included 15 randomly selected women per cluster for a final sample size of respondents. In stage one, clusters were defined as villages.
To account for the modest variation in village populations across the district, probability proportional to size PPS sampling was used to randomly select clusters. As the refugee population does not live in segregated areas but is interspersed among the host Cameroonian villages [ 13 ], we reasoned that random sampling in each village would result in a sample demographic similar to the population demographic.
All villages in Djohong District were considered for possible selection. A household was defined as a group of individuals living under the same roof and eating meals from the same pot.
Village chiefs assisted the research team to identify the geographic center of each village selected. From that point, the team randomly selected a direction by spinning a pen on a flat surface and then randomly selected a number of houses to pass to reach the first sampled household. Each subsequent household whose door was nearest to the door of the previous household was surveyed until all 15 surveys within the cluster were completed. To minimize non-response, a pre-visit announcement was sent to each village cluster to request the presence of all adult women in the village for the day of sampling.
Three attempts were made to contact selected households where respondents were initially unavailable. When, as a result of PPS sampling, larger villages contained more than one cluster, clusters were geographically distributed according to the location of population centers. In polygamous households, the senior wife was interviewed, a decision based on cultural custom. For the purposes of this study, sexual violence was defined as any physically or verbally forced sexual act, including molestation, forced undressing, forced or unwelcome touching of a sexual nature, forced intercourse, forced insertion of an object into any body cavity or any other non-consensual sexual act, whether completed or not.
Perpetrators were defined as the person or persons responsible for the forced act.
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Given considerations of confidentiality, no identification or proof was used to verify refugee status. The survey instrument, much of which had been field tested the previous year for a baseline prevalence study on sexual violence, was translated and back-translated by bilingual French-English speakers in Cameroon, then tested and colloquially adjusted by data collectors who were local health professionals with the Cameroonian Ministry of Health at Djohong Hospital as well as local community health workers on staff with an international health non-governmental organization NGO. Training included detailed explorations of each question with fine-tuning of terms and translation in French and in the local language, Fulfulde.
Data collectors were then trained on the sampling methodology, including the EPI method, using simulated models of villages with varying configurations. Following training on the survey instrument, interviews were conducted in Fulfulde in a setting that ensured privacy and confidentiality. This study was conducted in accordance with the WHO ethical and safety recommendations for researching, documenting and monitoring sexual violence in emergencies [ 24 ].
Prior to survey questions on sexual violence, a second verbal consent was obtained to allow the participant an opportunity to refuse to answer questions in this section.
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Respondents were assured that their names would not be recorded, that there would be no penalties or benefits for refusing or agreeing to participate, and were offered access to counseling and medical services through the international NGO and local providers as needed. All male data collectors were required to have previous experience in the care of female survivors of sexual violence, either as clinicians or as sexual violence counselors.
While WHO guidelines recommend female surveyors and translators whenever possible, the lack of female staff and the availability of experienced sexual violence male counselors in the region necessitated their inclusion as surveyors. The survey instrument did not identify respondents. The lead field investigators checked the data for errors, then coded and entered it daily into a password protected Excel spreadsheet.
Non-identifiable hard copies were stored in a locked facility on the NGO compound in Djohong District. At the end of the survey, the lead investigators securely transported hard copies to a locked storage facility at the Harvard Humanitarian Initiative where they remained accessible only to the lead investigators. Cluster sampling design was accounted for in the analysis; a generalized Hansen-Hurwitz estimator for a two-stage cluster design was used to estimate the means and percentages and confidence intervals were constructed by calculating the standard error of the generalized Hansen-Hurwitz estimator.
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Receiver operating curve ROC analysis was used to evaluate the predictive value of human security indicators for both lifetime and six-month sexual violence. Three predictive models were analyzed for their ability to predict sexual violence within the refugee and host populations: 1 age and ethnicity; 2 age, ethnicity, time in village, and all human security indicators; and 3 age, ethnicity, time in village and community human security indicators only.
Of the randomly selected households, three declined to participate, for an overall response rate of Due to prior notification in each village of the upcoming survey, all female heads of household were present on the days of data collection; all targeted respondents were reached within three visits. The final sample resulted in The mean size of refugee households was 6. As expected, refugee respondents had spent significantly less time in their current village than host population respondents: for refugees, a mean of 3.
Similarly, a slightly larger proportion of Cameroonian women had extended family in the current village Cameroonians However, of the refugee respondents, A high proportion of both refugees and host population lived in more permanent mud brick structures refugees Cameroonian A relatively large proportion of refugees in eastern Cameroon reported land ownership. Though confidence intervals overlap, Cameroonian households had a higher average daily income refugee Refugees had access to protected wells in greater proportions While When asked if they could rely on someone in the village for help if they were alone, When asked specifically if a non-family villager would take them to the hospital if they became sick, a lower proportion of refugees believed they would Human security outcomes: sense of attachment to the community, perceptions in the affirmative.
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Though measures of attachment to community differed between refugees and Cameroonians, both had similarly high measures with respect to a positive sense of future. These data suggest that the majority of refugees in Eastern Cameroon were not planning to return to CAR at the time of this study. Female heads of household were asked whether or not they had experienced sexual violence during their lifetimes or during the past six months. A complete report on the prevalence of sexual violence in this population has been previously published [ 17 ]; a selection of these data are presented here to highlight the context of human security measures.
Lifetime prevalence of sexual violence among all Djohong district female heads of household was Among the female refugee population, The prevalence of sexual violence over the last six months of those women who reported a sexually violent event was nearly identical: Thus, further analyses are on respondents. For refugee female heads of households, Of the respondents who reported at least one incident of sexual violence during their lifetimes, Furthermore, this perpetrator was more commonly reported by refugee women, Of the female heads of household who reported sexual violence, 41 Refugee survivors of sexual violence described the perpetrator as a friend or member of their community Among refugees who reported sexual violence, A majority of both refugee and host population sexual violence survivors had not reported these events to the authorities.
Only The ability of human security indicators to predict the presence or absence of lifetime and six-month sexual violence was determined using receiver operating characteristic ROC analysis. These results provide evidence for the need to collect data that directly quantifies the level of sexual violence in a community. Refugees and host population report similar levels of human security in terms of attachment to home, community, and a positive grasp of the future. Though some human security indicators differ between these populations, overall they reflect a relatively stable population at the time of this study, where refugees not only feel safe but also have access to land, livelihoods, clean water, shelter, and wish to remain in their newly adopted villages for many years to come.
Refugees appeared to be able to attain stability and security in Eastern Cameroon—in fact, though the proportion of refugees that owned land was lower than the proportion of host population that owned land, refugees and Cameroonians who owned land owned in similar amounts, suggesting equal opportunity to grow livelihoods between the two groups.
Similarly, refugees had equal levels of assets as many host population households. Refugees and Cameroonians were both similarly attached to their villages, desiring to stay in the same village well into the future. However, despite the unusual and encouraging stability and egalitarian quality of these human security findings, these human security indicators missed an epidemic of sexual violence that endangered the lives and health of refugee and host population women.
ROC analysis shows that human security indicators measured in this study did not uncover either lifetime or six-month sexual violence. These data suggest that current, gender-blind means of describing human security are missing serious threats to the safety of one half of the population. Why is it crucial that measures of human security be sensitive to gender?