Table 5 Findings from the qualitative studies (n = 15)
Author (Year) | Country | Setting | Study population | Type of sexual exploitation or trafficking | Thematic findings on risk factors | Thematic findings on abduction | Thematic findings on perpetrators | Thematic findings on adverse consequences/outcomes | Quality score |
|---|---|---|---|---|---|---|---|---|---|
Bartels [26] | Lebanon | Refugee camps | Syrian refugees, Ages 18+ years | Early or forced marriage | informal tents, economic insecurity, need for employment | Families need to be made more aware of the risk of abduction. | Perpetrators were host country men, employers, aid workers, and family members. | increased social/physical abuse, maternal mortality, human trafficking, commercial sexual exploitation, sexually transmitted diseases (STDs), HIV | 70% |
Betancourt [37] | Sierra Leone | Conflict affected regions | Former child soldiers Age 10–17 caregivers, Former child soldiers’ relatives, key informants | Sexual exploitation of combatants | - | A high majority of the sample youth reported joining the Revolutionary united Front (RUF) by force/abduction. | stigma, decline in adaptive and pro-social behaviours, internalizing problems | 70% | |
Brosnan [27] | Jordan, Turkey, Lebanon, Iraq | Refugee camps and urban displacement | Refugees, Government officials, IGO representatives, Non-governmental organization (NGO) staff | Early or forced marriage | displacement, economic insecurity, walking to school, rape | Families used early marriage as a way to safeguard their daughters honour. | Perpetrators were family members, host country citizens and armed forces personnel. | shame, stigma, anxiety, trauma, interrupted education, repeated rape | 45% |
Carlson [28] | Uganda | Internally displaced persons camps | Formerly abducted women/girls Additional use of key informants to target group | Early or forced marriage, Sexual exploitation of combatants | customary practices, economic hardship, puberty, living in an internally displaced persons camp, youth | Abduction was carried out by the Lord’s Resistance Army personnel and the field commanders had priority to forced marriages. | Often field commanders were the greatest culprits with multiple wives. | pregnancy, physical harm, mental harm, separation from family, death | 70% |
CSUCS [53] | DRC | Conflict affected regions, North and South Kivu | Military officials, government officials, NGO workers, child protection workers, community members, relatives | Sexual exploitation of combatants | war, absence of parents vulnerable children, armed groups, displacement, legal protection | - | The perpetrators were members of the Forces Armées de la République Démocratique du Congo (FARDC). | injury, death | 50% |
Denov [42] | Sierra Leone | Conflict affected regions | RUF former child soldiers Age 14–21 (all were 18 or under at time of exposure) | Sexual exploitation of combatants | war, widespread impoverishment, the breakdown of human security, and the gradual atomization of families and communities | Abductions often lasted between 2–18 months. | Victims were abducted by RUF soldiers. | physical, psychological, and social effects, community rejection, education dropout, | 60% |
Denov [43] | Sierra Leone | All regions | Former child soldiers | Sexual exploitation of combatants | war, unprotected children, fragmented political economy, disempowered women | All the participants had been abducted by the RUF under circumstances of extreme coercion, violence, and fear. | The RUF were most often responsible for abductions. | depression, violent injuries, pregnancy, stabbing, vomiting | 60% |
Gottschalk [29] | Uganda | Refugee camps | Refugees | Early or forced marriage | financial constraints, displacement, absence of parents, reduced livelihood options, war, untrained police, limited protective services, extramarital sexual relationships, physical insecurity | - | Often it is parents or guardians arranging the early marriages. | physical injury, social stigmas, rejection from family, school drop out | 65% |
Higonnet [30] | Cote d’Ivoire | Conflict affected regions | Survivors and witnesses of sexual violence | Early or forced marriage, Sexual exploitation of combatants, Sex slavery | low status of women and girls, conflict, low social status, economic disadvantage, traveling employment, political leaders wives and family members, displacement | - | Often girls were abducted by combatants and when they resisted abduction they were physically punished. | death, unwanted pregnancy, STIs, anxiety, shame, anger, depression, and fear | 65% |
Kaya [47] | Afghanistan | All regions | victims of trafficking or kidnapping, smuggled migrants, key informants | Sex slavery | protracted conflict, insecurity, limited access, instability, poverty, lack of trafficking awareness, loss of livelihood, high proportion of widows/orphans/people with disabilities, criminal networks, multiple neighbouring countries | A majority of trafficking victims are abducted under the lure of a better life or positive outcome and the remaining are kidnapped by force. | Many traffickers are involved in complex criminal networks. Often an individual's own family will sell them. | stigmatization, psychological harm, physical distress, pregnancy, loss of education | 80% |
Kippenberg [31] | DRC | Conflict affected regions | victims of rape, relatives, witnesses, community members, military combatants | Early or forced marriage, Sex slavery | conflict insecurities, insufficient pay for soldiers | - | The sample reported that the sexual exploitation was predominantly committed by the 14th brigade of the FARDC. | injury, death | 70% |
Save the Children [32] | Jordan | Refugee camps | refugees | Early or forced marriage | poverty, insecurity, fear of violence, conflict, youth | Many Syrian refugee families arranged the daughters’ weddings to Jordanian men. | - | poverty, loss of education, separation from family and friends, limited access to reproductive health, physical harm, mental and emotional strain, domestic violence, premature pregnancy | 35% |
Schlecht [33] | Uganda | Refugee camps | Ugandan and Congolese refugees | Early or forced marriage, Sexual exploitation of combatants | conflict, poverty, divided family, school dropout, early relationships, loss of livelihood | Families often planned early marriages and bride prices. During conflict there is militia-perpetrated abduction, forced marriage, and sex slavery. | - | poor health outcomes, poor social outcomes, early sexual debut, high risk pregnancy, limitations in negotiating condom use, STDs, school dropout, limited economic opportunity | 70% |
Stavrou [34] | Angola | Conflict affected regions | Formerly abducted girl soldiers Avg. 21 years | Early or forced marriage | combat zones, presence of soldiers, youth, displacement | - | The perpetrators were most often military personnel. | STDs, pregnancy, exhaustion, malnutrition, TB, abuse, death | 60% |
Weber [35] | Uganda | Conflict affected regions | victims of military violence, relatives of victims, and former LRA abductees | Early or forced marriage, Sexual exploitation of combatants | conflict, youth, displacement, travel | - | The perpetrators were most often military personnel. | unwanted pregnancy, STDs, injury, death | 50% |