{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T14:42:03Z","timestamp":1784990523954,"version":"3.55.0"},"reference-count":44,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009660","name":"London School of Hygiene and Tropical Medicine","doi-asserted-by":"publisher","award":["LSHTM Covid-19 Response Fund grant"],"award-info":[{"award-number":["LSHTM Covid-19 Response Fund grant"]}],"id":[{"id":"10.13039\/100009660","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,2,13]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the impact of South Africa\u2019s COVID-19 hard lockdown on the provision of services to survivors of violence against women (VAW).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a qualitative study using semistructured interviews. Data was analysed thematically. We conducted 18 semistructured interviews (10 face-to-face and 8 online or by phone) with service providers and key informants (KIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted across healthcare facilities, social services, national helplines and shelters in Gauteng province, South Africa. Data was collected between September 2022 and October 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The sample included 18 participants, purposively selected, comprising 13 frontline service providers (nurses, social workers and managers) and 5 KIs. Participants shared their experiences of delivering VAW services during the lockdown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The findings highlight five key themes affecting VAW service provision during COVID-19. (1) Confusion and uncertainty: initial uncertainty about whether VAW services were essential led to temporary closures and reduced availability. (2) Decreased demand for services: fear of mobility restrictions and reporting barriers reduced access, particularly in the first lockdown month. (3) Adaptations by providers: services shifted to remote counselling, while shelters paused new intakes. (4) Challenges in service provision: staff shortages, resource constraints (eg, personal protective equipment shortages) and disrupted referral systems hindered service delivery. (5) Emotional impact on frontline workers: health and helpline workers faced stress, fear of infection, social stigma and burnout, affecting their well-being and capacity to respond effectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study highlights how South Africa\u2019s COVID-19 hard lockdown disrupted essential VAW services, emphasising the need for resilient service delivery models during crises. Strengthening staffing, resources and improving referral pathways are critical for mitigating the emotional and operational challenges faced by service providers and for ensuring sustained support for survivors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-095058","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T23:21:22Z","timestamp":1740698482000},"page":"e095058","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Exploring the impact of COVID-19 hard lockdown on service provision for survivors of violence against women in South Africa: a qualitative study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7487-9634","authenticated-orcid":false,"given":"Manuela","family":"Colombini","sequence":"first","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4171-9129","authenticated-orcid":false,"given":"Nwabisa Jama","family":"Shai","sequence":"additional","affiliation":[{"name":"Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinky","family":"Mahlangu","sequence":"additional","affiliation":[{"name":"Gender and Health Research Unit, South African Institute for Medical Research, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"2025121508052266000_15.2.e095058.1","unstructured":"World Health Organization . Violence against women prevalence estimates, 2018. Geneva World Health Organization; 2021."},{"key":"2025121508052266000_15.2.e095058.2","unstructured":"World Health Organization, London School of Hygiene and Tropical Medicine, and South African Medical Research Council . Global and regional estimates of violence against women: prevalence and health impacts of intimate partner violence and non-partner sexual violence. World Health Organization Geneva; 2013."},{"key":"2025121508052266000_15.2.e095058.3","unstructured":"Peterman A , Potts A , O\u2019Donnell M , et al . Pandemics and violence against women and children. CGD working paper 528. 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