Experiences of gender-based violence and its reproductive health impacts among adolescent girls and women residing in informal settlements in Kampala, Uganda during the COVID-19 pandemic

Background: Gender-based violence (GBV) adversely affects the physical, sexual, and emotional health of women and girls, potentially directly influencing reproductive health. Systemic inequities, such as gender inequality and poverty that predispose women to GBV are often exacerbated in low- and middle-income countries (LMICs) where resources are limited, especially in informal settlements. Women residing within informal settlements face barriers to resources and must navigate power dynamics that put them in truly vulnerable positions. The COVID-19 pandemic exacerbated many inequities worldwide, including GBV. In this study, we explored the impact of GBV on reproductive health among adolescent girls and women (AGW) residing in informal settlements in Kampala, Uganda during the COVID-19 pandemic. Methods: This study utilized data from focus groups among 64 AGW living in informal settlements in Kampala, Uganda to explore experiences of GBV. Thematic analysis of focus group transcripts was conducted via deductive and inductive coding in Dedoose. Results: Themes identified were increased participating in sex work due to financial instability, leading to increased risk for sexually transmitted infections, unwanted pregnancy, young pregnancy, unsafe abortion leading to infertility or death, decreased educational attainment, and being pressured into undesired relationships. Discussion: With women disproportionately experiencing GBV, it is essential to investigate its effects on women’s health. Longterm disparities in women’s health research alongside recent discourse over reproductive health and rights indicates further investigation into contributing factors, especially among those who are disproportionately at risk for facing negative social determinants of health.