Karlee Silver

Karlee Silver is VP Programs for Grand Challenges Canada. Dr. Silver is responsible for the strategy of the Stars in Global Health, Saving Lives at Birth, Saving Brains and Global Mental Health programs. She is a thought leader for the Every Woman Every Child Innovation Marketplace and helps manage the Fellows who contribute to the Innovation Marketplace activities.

Peter A. Singer

Peter Singer has dedicated the last decade to bringing innovation to tackling the health challenges of the world’s poorest people. He is well known around the world for his creative solutions to some of the most pressing global health challenges. Dr. Singer is Chief Executive Officer of Grand Challenges Canada. He is also Director at the Sandra Rotman Centre at University Health Network and Professor of Medicine at University of Toronto.

Violence against women is unfortunately a universal phenomenon, taking many forms and affecting every society. Regardless of the form of violence – rape used as a tool of war, sexual slavery, psychological abuse or domestic violence – violence against women disrupts women’s human rights and its impact resonates throughout families and society.

Recent global prevalence figures indicate that 35% of women worldwide have experienced either intimate partner violence or non-partner sexual violence in their lifetime. The real scope of violence against woman is most likely unknown because fear, embarrassment, intimidation, or sense that it will simply not help limits reporting. In many areas, victims of family violence suffer in silence, due to the limited availability of healthcare, the lack of social support services or stigma.

These issues are central to Canada’s foreign and domestic policies and our nation is committed to the view that gender equality is not only a human rights issue, but is also an essential component of sustainable development, social justice, peace, and security.

That’s why Grand Challenges Canada, funded by the Government of Canada, supports these 12 innovative projects that address this global issue. This represents an investment of $3.3 million.

Rape is an intolerable form of violence and a major risk factor for HIV. Stigma and taboo are some unique barriers that prevent victims reporting rape to authorities. Researchers lack alternative tools to identify the extent of the problem in communities as many rape cases go unreported and perpetrators go unpunished. One of our projects in South Africa has developed an inexpensive, user-friendly, self-interviewing smart phone application to help researchers identify the extent of rape in communities as it overcomes barriers to reporting rape, ultimately ending the impunity that protects rapists and sustains HIV. Results confirmed that the app is an efficient and affordable solution with the potential to revolutionize the way research about sexual violence is conducted. because it reduces the amount of time and skilled professionals normally required to conduct research. The greatest asset of the app proved to be a voice application that could capture respondents’ views and feelings, offering a variety and range of responses that extend far beyond the list of multiple choice answers usually collected in traditional research.

A soon to be announced new project in the Democratic Republic of Congo is testing whether a mental health intervention on mothers who are victims of sexual violence has a significant and positive effect on brain development of their infants. The intervention will be delivered as part of a post-natal health program, using a delivery system that can be duplicated in similar low-resource environments. This project is the first intervention study designed specifically to improve on cognitive, emotional, motor and linguistic development of infants by providing mental health services to mothers experiencing major depression and traumatic stress who are victims of sexual violence and rape. To test its effect, 10 community health workers will be trained to deliver the post-natal health and nutrition program with a treatment intervention for depression to 200 women and their infants.

0287Reducing the number of HIV infections is also the focus of a project in Kenya, called “No sugar for me: an interactive multifaceted approach to fight against sugar-daddies and reduce HIV among adolescents.” A game-based phone application teaches adolescent girls in Western Kenya about the risks of transactional sex and thus HIV infection. The results showed that training girls on negotiation skills was an effective way of reducing the risk of girls having sex with sugar daddies. In six months’ time, the knowledge of safe sex increased over 50%. The project collaborated with schools, the local county education officials and the Kenya Scouts Association. It influenced the local county officials to introduce a policy document to include the training of better negotiating skills to schoolgirls to be taught alongside the school curriculum.

0422Bold Ideas for Girls (BIG) is the title of another project in Kenya. Our innovators there are providing an integrated program with gender and life-skills, vocational and entrepreneurial skills, and HIV evidence-informed behavioral interventions (EBIs), to girls aged 15-24 years in Mukuru Slums. Improving negotiation and life skills is a good prevention tactic to reduce violence against women, because it empowers them with knowledge and the right attitude to prevent those situations. The project can increase knowledge and practice of HIV/STI prevention and raise their social- economic status.  On average, knowledge and skill levels increased from 49% to 88% or more. A total of 5,000 has been reached through the BIG project.

Adolescent girls in Zambia face social constraints that make them vulnerable to early pregnancy, HIV and school dropout. The innovation that we are supporting will guard them against violence or intimidation. The project will teach and evaluate an innovative Negotiation Skills Curriculum that will equip girls with the ability to build healthier futures for themselves. 3146 girls were enrolled in the study and results showed that the training helped girls acquire and retain knowledge on negotiation skills and when to apply it. Moreover, the team demonstrated that the training resulted in a statistically significant improvement in the girls’ outcomes in a game designed to simulate real world behavior. This project received follow-on funding for scale up through USAID Development Innovations Venture program (DIV).

0089 - BiaberProject2In Ethiopia, the Biaber Project developed and delivered a training system to teach health care providers to screen for domestic partner violence and common mental disorders and provide treatments that are brief, safe, and effective. A total of 240 health care workers trained in provision of mental health care, including how to address stigma, domestic partner violence, treatment options/medications and undertake interpersonal therapy adapted for Ethiopia for the first time. As a result, 4,800 people with common mental disorders are now accessing care from a trained provider, including 480 people engaged in Interpersonal Psychotherapy adapted for the Ethiopian context. The Project will  introduce this community adapted package of mental health training into the curriculums of psychiatry residents, the new family doctor residency and undergraduate nursing programs to ensure sustained care.

In Kenya, violence against women is a potent risk factor for depression, anxiety, post-traumatic stress and other common mental disorders, for which no or minimal mental health support is provided.  This project will test the effectiveness of Cognitive Behavioral Therapy (CBT) as a way for para-professionals in low-income settings to help such women, creating a much-needed template for interventions that could be contextualized and rolled out for different violence-affected populations globally, engaging government structures to ensure sustainability. Fifty women are currently participating in this intervention, and early results show a significant reduction in Post-traumatic stress disorder (PTSD)  symptoms as compared to those in the control group.

0331 Domestic violence is a reality for many Haitian children, leading to developmental, behavioral and emotional problems. Unfortunately, Haiti lacks the infrastructure to manage the mental health needs of its people, so Haitians must draw on their traditional healing networks to address their mental health issues. Grand Challenges Canada is supporting a project that will create a network of Haitian community services and caregivers to promote mental health, to offer psychosocial services and, specifically, to oppose family violence, abuse and the potential mental health problems caused. This is complemented by a school based intervention aimed at addressing child mental health challenges.

 

0334Dealing with youth and urban violence is the main focus of a project in Jamaica. The country has the world’s third highest homicide rate (53 per 100,000). We are funding the development of a Community Engagement Cultural Therapy program that will stimulate group discussion of painful issues using drama, song and dance to translate and help express concerns. The community will be guided through the creation of goals for social and financial development.  Objectives include reducing child conduct disorders, as well as reducing domestic and interpersonal violence among youths and adults, stimulating youth employment and reducing poverty.

 

 

Colombia copes with 5.4 million internally displaced persons due to armed conflict.  In the capital of Bogota, 70% of these displaced persons are women and children, including many indigenous peoples and Afro-Colombians, living marginally and at high risk of anxiety, depression and post-traumatic stress disorder.  A novel project led by Universidad de los Andes is testing what is called OSITA (Outreach, Screening, and Intervention for TraumA for Internally Displaced Women). Supported by a mobile phone app, OSITA has trained community health workers to screen for and refer severe cases of mental disorders. 64 women are already receiving treatment through this project, of whom 17 have been referred to specialist care.

0333In Guatemala, an estimated 28% of the population can anticipate a mental disorder in their lifetime, with women of childbearing age showing the highest rates of depression and anxiety, especially those living in indigenous areas and prone to economic hardship and family troubles. 16 women leaders have been trained to identify troubled women (including after being violated) and to create support groups to help women build skills and address self-defined  needs including food and shelter, and gender issues. The project aims to reach over 300 women and their infants  integrating mental health into existing, though limited, health programs in marginalized communities.

Exposure to family violence and maternal mental health problems are two risks to optimal early childhood development. Our project in Vietnam links communities in rural Vietnam with a multidisciplinary and international team to develop and test a universal low-cost, non-stigmatizing psycho-educational program to address the risks faced by children throughout pregnancy and infancy. Since last year, Learning Clubs have started to offer sessions to 334 pregnant women and parents of children younger than 24 months.


As Melinda Gates explained in her piece in Science last year, advances in gender equality, women’s empowerment and women’s rights are needed if we are to make progress against remaining health and development goals. Ending violence against women and girls is a sine qua non  to realizing empowerment and equality for women and girls everywhere. Grand Challenges Canada will continue to work closely with all our partners to apply innovation to  to accelerate progress for women and girls.

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