Social perceptions of gender-based violence among displaced communities in Burkina Faso and their interactions with protection systems

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In Burkina Faso, the security crisis and the scale of internal displacement have profoundly transformed community norms, lived experiences of violence, and institutional responses. Aim This study aimed to analyze social perceptions and lived experiences of GBV among internally displaced populations, while examining organizational responses through the perspectives of service providers operating in forced displacement contexts. Methods Guided by Yuval-Davis’ intersectional framework, this exploratory qualitative study was conducted in Kaya, in the Centre-Nord region. Data were collected through 58 focus group discussions involving 352 internally displaced persons, including women, men, adolescent girls and boys, and community leaders. Additionally, 28 service providers involved in GBV care across medical, psychosocial, social, and judicial sectors were interviewed. A comprehensive mapping of GBV-related services was conducted. Data were analyzed using thematic analysis supported by NVivo software. Results Findings indicate that although community-based protection mechanisms exist, their availability and effectiveness remain uneven. Legal and institutional responses are often perceived as misaligned with deeply rooted social, cultural, and religious norms. Forced displacement contributes to the reconfiguration of social relations and the normalization of intimate partner violence. Women and girls adopt harmful survival strategies, including transactional sex, in response to severe economic precarity. Psychological impacts fear, shame, stigma, and emotional distress were widely reported. Access to psychosocial support was associated with emotional relief and pathways toward recovery. Conclusion These findings highlight the need for integrated approaches that link community perceptions, lived experiences, and institutional responses to strengthen GBV prevention and psychosocial care in humanitarian settings. Gender-based violence Forced displacement Social perceptions Lived experiences Service providers Psychosocial well-being Public health response Burkina Faso. Introduction Gender-based violence (GBV) constitutes a major global public health and human rights challenge, affecting individuals across all social, cultural, and economic contexts [ 1 ]. It encompasses a wide range of harmful acts, including physical, sexual, psychological, and economic violence perpetrated based on gender and sustained by unequal power relations [ 2 ]. Beyond its immediate physical consequences, GBV has profound and enduring effects on mental health, psychosocial well-being, and social functioning, contributing to depression, anxiety, post-traumatic stress, social isolation, and diminished agency [ 3 ]. As such, GBV is increasingly recognized not only as a violation of human rights but also as a critical determinant of population health requiring coordinated, multisectoral responses [ 4 ] . Humanitarian crises, particularly those involving armed conflict, insecurity, and forced displacement, substantially intensify the risk and severity of GBV [ 5 ]. In these contexts, the disruption of social structures, erosion of community protection mechanisms, and breakdown of institutional services heighten vulnerability among affected populations [ 6 ]. Internally displaced persons (IDPs), especially women, girls, and other socially marginalized groups, are disproportionately exposed to violence both within and beyond the household [ 7 ]. Forced displacement reshapes gender relations, alters social norms, and introduces new forms of economic precarity, all of which may normalize or exacerbate violent practices [ 8 ]. At the same time, fear, stigma, and mistrust of formal institutions often deter survivors from seeking care, resulting in significant underreporting and unmet psychosocial needs [ 7 ]. In Burkina Faso, the protracted security crisis has led to large-scale internal displacement and a marked increase in reported cases of GBV over recent years [ 8 ]. Data from the GBV Sub-Cluster indicate a steady rise in incidents, including sexual violence, intimate partner violence, forced marriage, denial of access to resources, and psychological abuse. These trends reflect not only the deterioration of security and social cohesion but also the growing strain placed on health, social, and judicial systems tasked with responding to GBV. Importantly, reported figures likely underestimate the true burden of violence, as social norms, fear of retaliation, and limited access to services continue to silence many survivors [ 7 ]. While a substantial body of literature documents the prevalence and typology of GBV in humanitarian and displacement settings, less attention has been paid to how GBV is perceived, interpreted, and negotiated within displaced communities themselves [ 7 ]. Social perceptions shaped by cultural beliefs, religious norms, and gendered expectations play a decisive role in defining what constitutes violence, what is tolerated or normalized, and which forms of abuse remain invisible. These perceptions directly influence survivors’ coping strategies, help-seeking behaviors, and psychosocial trajectories [ 8 ]. Understanding GBV through the lens of social perceptions is therefore essential for designing interventions that are both culturally sensitive and effective in promoting mental well-being [ 9 ]. At the organizational level, GBV prevention and response rely on a complex network of actors, including health professionals, psychologists, social workers, case managers, and judicial personnel[ 10 ]. These service providers operate at the interface between institutional mandates and community realities, often navigating significant constraints related to resources, security, training, and social resistance. Their perspectives offer critical insight into how protection systems function in practice, how policies are translated into everyday care, and where gaps persist between formal frameworks and lived experiences. Yet, service providers’ voices remain underrepresented in qualitative research on GBV in displacement contexts, despite their central role in shaping access to care and psychosocial support [ 11 ]. To address these gaps, this study adopts an intersectional qualitative approach grounded in Yuval-Davis’ framework, which emphasizes the constitutive interplay between social locations, power relations, and institutional structures [ 12 ]. By combining the perspectives of internally displaced populations with those of service providers involved in GBV care, this research examines GBV as both a lived social experience and an organizational process [ 13 ]. Specifically, the study explores social perceptions and lived experiences of GBV among internally displaced populations in Burkina Faso, while also analyzing organizational responses through the perspectives of service providers. By bridging community experiences with institutional practices, this study aims to contribute to a more nuanced understanding of GBV and to inform integrated, psychosocially informed public health responses in forced displacement settings. Methods Study design and reporting We conducted an exploratory qualitative study to examine gender-based violence (GBV) in a forced displacement setting through two complementary lenses: (i) social perceptions and lived experiences among internally displaced persons (IDPs), and (ii) organizational responses as described by GBV service providers. The study combined focus group discussions (FGDs) with IDPs and individual interviews with service providers. Reporting was guided by the Consolidated criteria for reporting qualitative research (COREQ) [ 14 ], and the methods were designed to maximize transparency, credibility, and analytic rigor. Conceptual framework The study was informed by Yuval-Davis’ intersectional framework, which conceptualizes power relations as operating across interrelated levels (structural and institutional; organizational; interpersonal and experiential) [ 15 ]. This framework supported an analysis of how GBV is perceived and negotiated in everyday life within displaced communities (experiential dimension) and how protection and care systems operate and are interpreted in practice (organizational dimension). Study setting The study was conducted in Kaya, the Centre-Nord region of Burkina Faso, a major area hosting internally displaced populations due to the national security crisis. Data collection took place between 4 February and 8 March 2022across selected displacement/host sites in Kaya. Participants and sampling Internally displaced participants (FGDs) IDP participants were recruited to ensure diversity by gender and age group and to capture community-level perceptions and experiences of GBV. Five participant categories were targeted: women, men, adolescent girls, adolescent boys, and community leaders. A total of 58 FGDs were conducted with 352 participants. Sampling followed a stratified approach to ensure representation across these participant categories. Where site-level lists or community structures allowed, selection was conducted using simple random procedures within strata (e.g., drawing from available lists or rosters). When random selection was not feasible due to field constraints, a systematic selection based on order of availability was applied to minimize selection bias while maintaining diversity targets. Eligibility criteria included: (i) being an IDP residing in Kaya during the study period (or a community leader within the sites), and (ii) providing informed consent to participate. Service providers (individual interviews) To document organizational responses and professional perspectives, we interviewed 28 service providers involved in GBV survivor care, covering medical, psychosocial, social, and judicial support. Care structures were identified through an exhaustive mapping (census) of institutions actively providing GBV-related services in Kaya at the time of the study, including health centers, police/judicial services, social services, and psychosocial support organizations. Within identified structures, providers were selected using a purposive strategy based on two inclusion criteria: (i) being present in Kaya during data collection, and (ii) having received prior training in GBV care. Among eligible providers in each structure, one or more individuals were selected depending on availability and willingness to participate. When possible, investigators performed simple random selection using nominative lists provided by institutions; in facilities with few eligible staff, a systematic selection based on availability order was applied. The interviewed providers included health workers (n = 16), case managers (n = 5), psychologists (n = 5), and judicial police officers (n = 2). The predominance of health workers reflects the larger number of operational health facilities in the study area. Data collection procedures Field team and training Data collection was conducted by six trained data collectors organized into three pairs. All data collectors had prior experience in research on GBV and sexual and reproductive health. Training covered the study objectives, qualitative facilitation techniques, trauma-informed and survivor-centred approaches, confidentiality, referral pathways, and the use of mobile data collection tools. Instruments and language Semi-structured guides were developed for FGDs and service provider interviews. Guides were drafted in French and translated into Mooré to support participant comprehension. Data collection was conducted in the language preferred by participants. FGDs lasted approximately one hour on average. Data capture and management Data were collected using KoboCollect on smartphones to support secure capture of metadata and structured field notes. With participants’ consent, sessions were audio-recorded. Field notes were taken systematically to document contextual factors (e.g., group dynamics, non-verbal cues, interruptions) and to support interpretation. Data processing and analysis Audio recordings were transcribed verbatim. When interviews were conducted in Mooré, content was translated into French during transcription, with attention to preserving meaning and culturally specific expressions. Data were managed and analyzed using NVivo (version 12). Analysis followed reflexive thematic analysis as described by Braun and Clarke [ 16 ]. The analytic process included: (1) familiarization with the data; (2) initial coding across the full dataset; (3) development of candidate themes; (4) review and refinement of themes; and (5) theme definition and reporting. Coding was conducted by multiple team members to strengthen analytic breadth. Regular analytic meetings were held to compare interpretations, refine the codebook, and resolve discrepancies through discussion. Themes were organized to reflect the study’s dual focus: (i) organizational dimensions (protection mechanisms, service availability, institutional/legal norms, perceived gaps), and (ii) experiential dimensions (intimate partner violence, stigma and shame, psychosocial distress and recovery, survival strategies such as transactional sex). To enhance the robustness of “bridging evidence,” we explicitly compared patterns emerging from IDP FGDs with service provider interviews, identifying convergences (shared perceptions) and divergences (mismatched understandings) relevant to GBV prevention and care. Trustworthiness and rigor [ 17 ] Multiple strategies were used to strengthen trustworthiness: Credibility: triangulation of perspectives (IDPs and service providers), systematic documentation through field notes, and iterative team discussions to refine interpretations. Dependability: standardized procedures for training, data collection, transcription, and coding; maintenance of an analytic log describing key decisions. Confirmability: use of verbatim excerpts to support themes and a transparent audit trail of coding and theme development. Transferability: thick description of setting, participant groups, and service structures to support assessment of relevance to similar humanitarian contexts. Ethical considerations and participant safety The study protocol received approval from the National Ethics Committee for Health Research (CERS), Burkina Faso (No. 2022-01-012; 17 January 2022). All participants provided free and informed consent before participation. The purpose of the study, the voluntary nature of participation, confidentiality measures, and audio-recording procedures were explained in the participant’s preferred language. Given the sensitivity of GBV, facilitators used trauma-informed practices, avoided pressure to disclose personal experiences, and ensured privacy during discussions. Where relevant, participants were informed about available GBV support services and referral options in the study area. Results Participant characteristics Internally displaced participants A total of 352 internally displaced persons (IDPs) participated in the study through 58 focus group discussions. Participants were distributed across five categories: women, men, adolescent girls, adolescent boys, and community leaders. This diversity allowed for an in-depth exploration of gender- and age-specific perceptions and experiences of gender-based violence (GBV) in forced displacement settings. The gender-disaggregated distribution is presented in Table 1 below. Table 1 Distribution of focus group discussions by target group Target groups Number of focus groups Number of participants Adolescent girls 13 81 Adolescent boys 13 78 Women 13 89 Men 13 61 Community leaders 6 43 Total 58 352 The study recorded a high participation rate of 98.3%. Of the seven focus group discussions planned with community leaders, six were conducted. The seventh focus group could not be held due to the absence of the designated community leader at the concerned site. Below is the distribution by Internally Displaced Persons (IDP) Hosting Sites, presented in Table 2 . Table 2 Distribution of focus group discussions by IDP hosting site IDP hosting site Number of IDPs Women Men Girls Boys Leaders Total Tiwèga site 4,994 4 4 4 4 1 17 Koum-Kuili 3,661 3 3 3 3 0 12 Watinoma 2,985 2 2 2 2 1 9 Zargongo 1,659 1 1 1 1 1 5 38 Villas 1,650 1 1 1 1 1 5 Boulgou-Yarga 1,589 1 1 1 1 1 5 Bisnogho 946 1 1 1 1 1 5 Total 17,484 13 13 13 13 6 58 Service providers In addition, 28 service providers involved in GBV prevention and response were interviewed. Among them, 17 were women, and 11 were men. Health workers constituted the largest subgroup (n = 16), followed by psychologists/social workers (n = 5) and case managers (n = 5). Judicial police officers represented the smallest subgroup (n = 2). Most service providers (n = 19) reported more than five years of professional experience, while nine had between one and five years of experience. Regarding seniority in their current position, the majority (n = 14) had served for more than three years, with others reporting a tenure of one to three years (n = 11) or less than one year (n = 3). This profile reflects a workforce with substantial professional exposure to GBV-related cases in the study setting. Below is the distribution of participants presented in Table 3 . Table 3 Distribution of participants by profile and sex Participants M F Total Health workers 6 10 16 Psychologists / Social workers 2 3 5 Judicial police officers 1 1 2 Case managers 2 3 5 Total respondents 11 17 28 Organizational dimensions of GBV Community-based protection mechanisms Across displacement sites, participants described the presence of community-based protection mechanisms, often organized through local committees. These structures were perceived as playing a preventive role by identifying vulnerable individuals, mediating conflicts, and facilitating referrals to formal services. However, their availability and effectiveness varied considerably across sites, with some communities reporting strong coordination and others describing limited or symbolic functionality. “ We have a community-based mechanism that reports cases of violence and identifies vulnerable individuals, such as persons with disabilities or those who are ill and in need of assistance.” (Community leader). “When someone faces a problem, they approach the committee, which then informs the relevant actors to find a solution.” (Interview with women). Service providers emphasized that community mechanisms often constitute the first point of contact for survivors, but their capacity is constrained by limited resources, insecurity, and sociocultural resistance. “Committees are often the first point of contact for survivors. We work with them to ensure that reported cases are promptly referred for appropriate care.” (Service provider). Availability and accessibility of GBV services IDPs generally expressed appreciation for existing GBV services, particularly medical and psychosocial support, noting improvements in awareness and immediate assistance. Nevertheless, access to services remained uneven, with geographic, security-related, and informational barriers limiting utilization in certain sites. Service providers corroborated these observations, highlighting challenges related to workload, insufficient staffing, and interruptions in service delivery due to insecurity. “Many people are not aware that services are available, because there is not enough information and awareness campaigns on the issue. In addition, some IDPs live far from the service centers.” (Service provider). Legal and institutional frameworks Perceptions of legal and institutional responses to GBV were highly ambivalent. While some participants viewed existing laws and policies as protective of women’s rights, others perceived them as conflicting with cultural, religious, or moral norms. This tension was particularly salient regarding legislation related to sexual and reproductive health. Service providers reported navigating these tensions in their daily practice, balancing legal obligations with community resistance and survivors’ fears of social repercussions. “The law on gender-based violence is not well known among the population. Some people believe that legal access to safe abortion contradicts cultural and religious norms. Even local actors sometimes share these beliefs, which complicates implementation.” (Service provider) Inclusion, social cohesion, and institutional trust Participants frequently described coexistence and cooperation among displaced populations and host communities, emphasizing ethnic and social inclusion within protection structures. However, trust in institutions varied, with some IDPs expressing skepticism toward formal actors due to unmet expectations or perceived discrimination. Service providers acknowledged that trust-building is a gradual process, often hindered by previous negative experiences and misinformation. “Service providers must adhere to ethics and professional standards. We must treat every survivor with dignity and avoid any form of judgment. Otherwise, the service will be perceived as unsafe, and trust in providers will be undermined.” (Service provider). Experiential dimensions of GBV Intimate partner violence and social normalization Intimate partner violence emerged as one of the most frequently discussed forms of GBV. While many participants recognized forced sexual relations and physical abuse as violations of individual rights, others described these practices as normalized within marital or religious frameworks. This ambivalence reflects deeply rooted gender norms that shape perceptions of consent, authority, and obligation within intimate relationships. “If it’s not the case with you intellectuals, in our context, being a Muslim woman, the day the husband wants to have sex, even if the woman has just given birth, she is obliged to accept. Otherwise, she will cause problems for her husband, and he will go look for other women.” (interview with a woman). Service providers confirmed that normalization of intimate partner violence remains a major barrier to reporting and care. “I know that forcing a woman to have sexual intercourse is unacceptable violence. But in our society, such acts are often considered normal. Women who dare to speak out are often reprimanded. That is why many refuse to report these incidents.” (Service provider). Psychosocial consequences and mental well-being Survivors described a wide range of psychological and emotional consequences associated with GBV, including fear, shame, persistent distress, and social withdrawal. For many, stigma and fear of judgment constituted significant barriers to disclosure. Conversely, access to psychosocial support was associated with emotional relief, restored self-worth, and improved coping capacities. “Before, I lived in constant fear, but thanks to the advice and support I received, this fear gradually disappeared.” (Interview with a survivor). The psychological trajectories of survivors remain heterogeneous and are strongly shaped by internal and contextual barriers. Shame and fear of judgment hinder the expression of traumatic experiences. "They often feel deep shame after experiencing violence. Many are afraid to speak out and fear not being understood by those they might turn to to share their experiences.” (Service provider). Stigmatization and community attitudes Although expressions of empathy toward survivors were common, stigmatizing attitudes persisted. Survivors were sometimes blamed, socially isolated, or subjected to gossip, exacerbating psychological suffering and discouraging help-seeking. Service providers identified stigma as a critical obstacle to sustained engagement with care services. “Some survivors are often singled out and criticized by others. They become the subject of gossip and judgment. This stigmatization isolates them and makes their recovery process even more difficult.” (Service provider). Survival strategies under economic precarity Severe economic hardship emerged as a central driver of harmful survival strategies, particularly among women and adolescent girls. Transactional sex was frequently cited as a means of securing food or necessities in the absence of stable livelihoods or social support. Service providers confirmed encountering such situations regularly and emphasized the ethical and psychosocial dilemmas they pose. “Hunger pushes us to accept indecent proposals, sometimes from people who are actually unable to truly help us.” (Interview with women). "Some women find themselves without any support. Their husbands have been killed by terrorists. With no resources or family support, they are sometimes forced into sex work to provide for their children. This situation frequently exposes them to sexually transmitted infections and unwanted pregnancies. Managing these consequences often remains complex.” (Service provider). Convergence and divergence between community and service provider perspectives Comparative analysis revealed both convergence and divergence between IDP and service provider perspectives. While both groups acknowledged the prevalence of GBV and the importance of psychosocial support, discrepancies emerged regarding perceptions of institutional effectiveness, survivor agency, and the feasibility of legal recourse. These divergences highlight gaps between lived experiences and organizational responses, underscoring the need for integrated, context-sensitive GBV interventions. “ Support services exist and are accessible, but on the ground, displaced people do not perceive them the same way. Many hesitate to file complaints or go to the facilities out of fear or because they doubt the outcome of the process .” (Service provider). Discussion This study examined gender-based violence (GBV) in a forced displacement context in Burkina Faso by bridging social perceptions and lived experiences among internally displaced populations with organizational responses as articulated by service providers. By integrating these complementary perspectives, the findings highlight GBV as both a socially embedded phenomenon and a systemic public health challenge, deeply shaped by gender norms, power relations, and institutional constraints [ 18 ]. GBV, social norms, and the normalization of violence in displacement settings The findings reveal that GBV, particularly intimate partner violence, is simultaneously recognized as a violation of rights and normalized through entrenched social, cultural, and religious norms. This ambivalence has been widely documented in humanitarian contexts, where displacement disrupts social regulation while reinforcing patriarchal structures that legitimize male authority and female subordination [ 19 ]. In this study, forced displacement appears to intensify these dynamics by weakening traditional accountability mechanisms and increasing economic dependency, thereby normalizing practices that would otherwise be contested [ 20 ]. The normalization of violence reported by participants reflects what intersectional scholars describe as the interaction between structural vulnerability and everyday power relations [ 21 ]. Displacement reshapes gender roles and expectations, but often in ways that reproduce inequality rather than challenge it [ 22 ]. This normalization has direct implications for mental well-being, as survivors may internalize violence as inevitable, limit disclosure, and delay or avoid seeking support [ 23 ]. Psychosocial consequences and pathways to recovery Consistent with prior research, survivors described profound psychological and emotional distress, including fear, shame, anxiety, and social withdrawal [ 24 ]. These experiences underscore GBV as a major determinant of mental health in humanitarian settings [ 25 ]. Importantly, the study highlights the dual role of stigma: it not only exacerbates psychological suffering but also constitutes a structural barrier to care by discouraging disclosure and reinforcing silence [ 26 ]. At the same time, both survivors and service providers emphasized the positive impact of psychosocial support on emotional relief and recovery. Access to listening spaces, respectful care, and sustained follow-up enabled some survivors to regain a sense of safety, agency, and future orientation [ 27 ]. These findings reinforce the importance of trauma-informed and survivor-centred approaches in GBV programming and align with evidence demonstrating that psychosocial interventions can mitigate the mental health consequences of violence even in highly constrained settings [ 28 ]. Organizational responses and the limits of protection systems From an organizational perspective, the study reveals a fragmented landscape of GBV prevention and response. While community-based protection mechanisms and formal services exist, their effectiveness is uneven and often constrained by insecurity, limited resources, and sociocultural resistance [ 29 ]. Service providers described operating at the intersection of institutional mandates and community realities, frequently negotiating tensions between legal frameworks and local norms. Legal and policy instruments addressing GBV were perceived ambivalently, particularly when they conflicted with prevailing moral or religious values. This gap between normative frameworks and social acceptance complicates implementation and may undermine trust in institutions [ 30 ]. Service providers’ accounts illustrate how frontline actors absorb these tensions, often assuming roles that extend beyond their formal responsibilities to mediate, reassure, and adapt interventions to local contexts [ 31 ]. Survival strategies, economic precarity, and ethical dilemmas The emergence of harmful survival strategies such as transactional sex highlights the central role of economic precarity in shaping GBV risks and responses [ 32 ]. For many women and girls, displacement-induced poverty constrains choice and agency, rendering survival strategies both rational and deeply stigmatized [ 33 ]. These practices further expose individuals to violence, exploitation, and psychological harm, creating cycles of vulnerability that extend beyond immediate incidents of GBV [ 34 ]. Service providers reported encountering significant ethical and professional dilemmas when supporting survivors engaged in such strategies, particularly in the absence of viable livelihood alternatives [ 35 ]. These findings underscore the need to situate GBV interventions within broader social protection and economic support frameworks, rather than addressing violence in isolation [ 36 ]. Bridging lived experiences and public health responses A key contribution of this study lies in its explicit comparison of community and service provider perspectives, revealing areas of convergence and divergence. While both groups acknowledge the prevalence of GBV and the importance of psychosocial support, differences emerge regarding perceptions of institutional effectiveness, survivor agency, and the feasibility of legal recourse [ 35 ]. These gaps illustrate the limits of top-down interventions that fail to account for lived realities and social meanings attached to violence [ 37 ]. Bridging these perspectives is essential for designing public health responses that are both effective and socially legitimate. Integrated approaches that combine community engagement, culturally sensitive psychosocial care, legal protection, and economic support are more likely to address the complex determinants of GBV and promote sustainable improvements in mental well-being [ 38 ]. Implications for policy and practice The findings have several implications for GBV prevention and response in humanitarian settings. First, interventions must explicitly address social norms and power relations that normalize violence, rather than focusing solely on individual behavior change [ 39 ]. Second, strengthening psychosocial services and ensuring continuity of care are critical for mitigating the mental health impacts of GBV [ 40 ]. Third, service providers require sustained training, institutional support, and security to navigate ethical dilemmas and community resistance effectively [ 41 ]. Finally, GBV programming should be embedded within broader public health and social protection strategies that address economic precarity and structural vulnerability [ 42 ]. Strengths and limitations This study benefits from the triangulation of perspectives across diverse participant groups, including internally displaced populations and service providers, which enhances analytic depth and credibility. However, the sensitivity of GBV may have led to underreporting or socially desirable responses. Additionally, the findings are context-specific and may not be directly generalizable to all displacement settings, although they offer transferable insights for similar humanitarian contexts. Conclusion This study shows that gender-based violence (GBV) in forced displacement settings in Burkina Faso is deeply embedded in social norms and structural inequalities, with significant consequences for psychosocial well-being. By combining the perspectives of internally displaced populations and service providers, the findings highlight how lived experiences of violence intersect with uneven and constrained organizational responses. GBV is frequently normalized in contexts of insecurity and economic precarity, shaping survivors’ coping strategies, help-seeking behaviors, and mental health trajectories. While access to psychosocial support contributes to emotional relief and recovery, service providers face persistent challenges related to limited resources, sociocultural resistance, and institutional constraints. Bridging community perceptions with organizational practices is essential to strengthening GBV prevention and response. Integrated, survivor-centred, and psychosocially informed public health approaches that address social norms, economic vulnerability, and service capacity are critical to mitigating the mental health burden of GBV in humanitarian contexts. Declarations Ethics approval and consent to participate This study was conducted in accordance with all relevant institutional guidelines and regulations, as well as the ethical principles outlined in the Declaration of Helsinki. The study was reviewed and approved by the Health Research Ethics Committee (Protocol No. 2022-01-012, dated January 17, 2022). Before participation, the study objectives were explained to all participants, and informed consent was obtained, including consent to audio recordings. The consent process was conducted in Moré to ensure the participants' complete understanding. Confidentiality and voluntary participation were emphasized throughout the study. Consent for publication Not applicable Competing interests The authors declare that they have no competing interests. Authors' information The authors come from Burkina Faso, and Cameroon. Funding This research did not receive any funding from external sources. Author Contribution BS developed the research strategy and was responsible for data extraction. PN provided expertise in qualitative methodology. All authors contributed to drafting the manuscript, critically revised it for important intellectual content, and approved the final version of the manuscript. Acknowledgements We would like to acknowledge the study participants and the individuals who assisted with data collection for their invaluable contributions to this research. Data Availability The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request. References Zinyemba KG, Hlongwana K. Men’s conceptualization of gender-based violence directed to women in Alexandra Township, Johannesburg, South Africa. BMC Public Health. 2022;22:2235. https://doi.org/10.1186/s12889-022-14616-5 . Woldearegay HG, Gebretnsae H, Mackey A, Bigalky J, Petrucka P. Understanding nature, barriers, and facilitators in addressing sexual and gender-based violence (SGBV) in conflict zones of Africa: A scoping review. 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Glob Health Action. 2017;10:1270816. https://doi.org/10.1080/16549716.2017.1270816 . Pfefferbaum B, North CS. Child disaster mental health services: a review of the system of care, assessment approaches, and evidence base for intervention. Curr Psychiatry Rep. 2016;18:5. Wessells MG, Kostelny K. The Psychosocial Impacts of Intimate Partner Violence against Women in LMIC Contexts: Toward a Holistic Approach. Int J Environ Res Public Health. 2022;19:14488. https://doi.org/10.3390/ijerph192114488 . Hossain M, Pearson RJ, McAlpine A, Bacchus LJ, Spangaro J, Muthuri S, et al. Gender-based violence and its association with mental health among Somali women in a Kenyan refugee camp: a latent class analysis. J Epidemiol Community Health. 2021;75:327–34. https://doi.org/10.1136/jech-2020-214086 . Overstreet NM, Quinn DM. The Intimate Partner Violence Stigmatization Model and Barriers to Help Seeking. Basic Appl Soc Psychol. 2013;35:109–22. https://doi.org/10.1080/01973533.2012.746599 . Tarabih S, Arnault DS. Enabling factors that facilitate recovery among survivors of gender-based violence. J Psychiatr Ment Health Nurs. 2024;31:836–44. https://doi.org/10.1111/jpm.13037 . Ganson B, Wennmann A. Business and conflict in fragile states: The case for pragmatic solutions. Routledge; 2018. Sahraoui N, Freedman J. Gender-Based Violence as a Continuum in the Lives of Women Seeking Asylum: From Resistance to Patriarchy to Patterns of Institutional Violence in France. In: Freedman J, Sahraoui N, Tastsoglou E, editors. Gend.-Based Violence Migr. Cham: Springer International Publishing; 2022. pp. 211–34. https://doi.org/10.1007/978-3-031-07929-0_9 . Perrin N, Marsh M, Clough A, Desgroppes A, Yope Phanuel C, Abdi A, et al. Social norms and beliefs about gender based violence scale: a measure for use with gender based violence prevention programs in low-resource and humanitarian settings. Confl Health. 2019;13:6. https://doi.org/10.1186/s13031-019-0189-x . Ikuteyijo OO, Martin Hilber A, Fatusi AO, Akinyemi AI, Merten S. Stakeholders’ engagement with law to address gender-based violence in Southwest Nigeria: a qualitative study using normalisation process theory to explore implementation challenges. BMJ Public Health. 2024;2:e001326. https://doi.org/10.1136/bmjph-2024-001326 . Rudzinski K, Hudspith LF, Guta A, Comber S, Dewar L, Leiper W, et al. Navigating fragmented services: a gender-based violence (GBV) critical feminist analysis of women’s experiences engaging with health and social supports in three Canadian cities. BMC Public Health. 2025;25:1213. https://doi.org/10.1186/s12889-025-21919-w . Lwamba E, Shisler S, Ridlehoover W, Kupfer M, Tshabalala N, Nduku P, et al. Strengthening women’s empowerment and gender equality in fragile contexts towards peaceful and inclusive societies: A systematic review and meta-analysis. Campbell Syst Rev. 2022;18:e1214. https://doi.org/10.1002/cl2.1214 . Abu-Lughod L. Do Muslim Women Really Need Saving? Anthropological Reflections on Cultural Relativism and Its Others. Am Anthropol. 2002;104:783–90. https://doi.org/10.1525/aa.2002.104.3.783 . Voth Schrag RJ, Fantus S, Leat S, Childress S, Wood L. Experiencing Moral Distress Within the Intimate Partner Violence & Sexual Assault Workforce. J Fam Violence. 2024;39:899–911. https://doi.org/10.1007/s10896-023-00567-x . Lyles E, Glass N, Sidabutar E, Roa EG, Hoyos C, Pacheco A, et al. Expanding the evidence on integration of cash assistance in gender-based violence case management in humanitarian settings: lessons learned from multi-country evaluations. Confl Health. 2025;19:55. https://doi.org/10.1186/s13031-025-00691-z . Agu IC, Das M, King R, Agwu P, Mbachu CO. A scoping review of interventions addressing gender-based violence in West Africa: examining typologies, delivery mechanisms, outcomes, and stakeholder involvement. Confl Health. 2025;19:70. https://doi.org/10.1186/s13031-025-00712-x . Sabri B, Gielen A. Integrated multicomponent interventions for safety and health risks among black female survivors of violence: a systematic review. Trauma Violence Abuse. 2019;20:720–31. Agu IC, Das M, King R, Agwu P, Mbachu CO. A scoping review of interventions addressing gender-based violence in West Africa: examining typologies, delivery mechanisms, outcomes, and stakeholder involvement. Confl Health. 2025;19:70. https://doi.org/10.1186/s13031-025-00712-x . Gevers A, Dartnall E. The role of mental health in primary prevention of sexual and gender-based violence. Glob Health Action. 2014;7:24741. https://doi.org/10.3402/gha.v7.24741 . Rudzinski K, Hudspith LF, Guta A, Comber S, Dewar L, Leiper W, et al. Navigating fragmented services: a gender-based violence (GBV) critical feminist analysis of women’s experiences engaging with health and social supports in three Canadian cities. BMC Public Health. 2025;25:1213. https://doi.org/10.1186/s12889-025-21919-w . Chadambuka C, Namyalo PK, Raghunauth R, Arora N, Kouyoumdjian F, Essue BM. Precarious employment and gender-based violence against migrant women: A scoping review mapping the intersections. PLoS ONE. 2025;20:e0337690. https://doi.org/10.1371/journal.pone.0337690 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 27 Feb, 2026 Editor assigned by journal 19 Feb, 2026 Submission checks completed at journal 18 Feb, 2026 First submitted to journal 18 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8823508","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":598289835,"identity":"702508fc-e7e4-49ea-a974-ac0683ca456a","order_by":0,"name":"Souleymane BAYOULOU","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYBACAzBZACYZDzBUAClm5gYitEBIhgMMZ0BaGEnRwtgGtg2/FnP2M4aPeQxsEhv4Dx848HFebTR/O1DLj4ptOLVY9uQYG/MYpCU2SKQlHJy57XjujMOMDYw9Z27jdtiBHDNpHoPDQC1AknfbsdwGoBZmxjY8Ws6/gWrhPwPUMudY7nyCWm7AbGHIAWppqMndQEiL5YxnxYZzDNKM20B+mXHsQO5GoJaD+Pxizp+88cGbChvZfv7DBx98qKnLnXceyPhRgVsLAwMHJFLYILzDYPIAHvVAwP4AmVeHX/EoGAWjYBSMSAAAPWpcQJXdEekAAAAASUVORK5CYII=","orcid":"","institution":"Institut de Formation et de Recherche Interdisciplinaires en Sciences de la Santé et de l'Éducation","correspondingAuthor":true,"prefix":"","firstName":"Souleymane","middleName":"","lastName":"BAYOULOU","suffix":""},{"id":598289836,"identity":"fd50c1fd-0fc0-49ef-9003-bdfc4c06bd8d","order_by":1,"name":"Patrice NGANGUE","email":"","orcid":"","institution":"Institut de Formation et de Recherche Interdisciplinaires en Sciences de la Santé et de l'Éducation","correspondingAuthor":false,"prefix":"","firstName":"Patrice","middleName":"","lastName":"NGANGUE","suffix":""}],"badges":[],"createdAt":"2026-02-08 18:08:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8823508/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8823508/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103933953,"identity":"4f052933-58c5-4cc8-b188-466c3cd5f536","added_by":"auto","created_at":"2026-03-04 17:10:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1265764,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8823508/v1/aa58221d-180f-4a98-af9f-b0b80940a0d8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Social perceptions of gender-based violence among displaced communities in Burkina Faso and their interactions with protection systems","fulltext":[{"header":"Introduction","content":"\u003cp\u003eGender-based violence (GBV) constitutes a major global public health and human rights challenge, affecting individuals across all social, cultural, and economic contexts [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. It encompasses a wide range of harmful acts, including physical, sexual, psychological, and economic violence perpetrated based on gender and sustained by unequal power relations [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Beyond its immediate physical consequences, GBV has profound and enduring effects on mental health, psychosocial well-being, and social functioning, contributing to depression, anxiety, post-traumatic stress, social isolation, and diminished agency [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. As such, GBV is increasingly recognized not only as a violation of human rights but also as a critical determinant of population health requiring coordinated, multisectoral responses [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] .\u003c/p\u003e \u003cp\u003eHumanitarian crises, particularly those involving armed conflict, insecurity, and forced displacement, substantially intensify the risk and severity of GBV [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In these contexts, the disruption of social structures, erosion of community protection mechanisms, and breakdown of institutional services heighten vulnerability among affected populations [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Internally displaced persons (IDPs), especially women, girls, and other socially marginalized groups, are disproportionately exposed to violence both within and beyond the household [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Forced displacement reshapes gender relations, alters social norms, and introduces new forms of economic precarity, all of which may normalize or exacerbate violent practices [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. At the same time, fear, stigma, and mistrust of formal institutions often deter survivors from seeking care, resulting in significant underreporting and unmet psychosocial needs [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn Burkina Faso, the protracted security crisis has led to large-scale internal displacement and a marked increase in reported cases of GBV over recent years [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Data from the GBV Sub-Cluster indicate a steady rise in incidents, including sexual violence, intimate partner violence, forced marriage, denial of access to resources, and psychological abuse. These trends reflect not only the deterioration of security and social cohesion but also the growing strain placed on health, social, and judicial systems tasked with responding to GBV. Importantly, reported figures likely underestimate the true burden of violence, as social norms, fear of retaliation, and limited access to services continue to silence many survivors [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhile a substantial body of literature documents the prevalence and typology of GBV in humanitarian and displacement settings, less attention has been paid to how GBV is perceived, interpreted, and negotiated within displaced communities themselves [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Social perceptions shaped by cultural beliefs, religious norms, and gendered expectations play a decisive role in defining what constitutes violence, what is tolerated or normalized, and which forms of abuse remain invisible. These perceptions directly influence survivors\u0026rsquo; coping strategies, help-seeking behaviors, and psychosocial trajectories [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Understanding GBV through the lens of social perceptions is therefore essential for designing interventions that are both culturally sensitive and effective in promoting mental well-being [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAt the organizational level, GBV prevention and response rely on a complex network of actors, including health professionals, psychologists, social workers, case managers, and judicial personnel[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. These service providers operate at the interface between institutional mandates and community realities, often navigating significant constraints related to resources, security, training, and social resistance. Their perspectives offer critical insight into how protection systems function in practice, how policies are translated into everyday care, and where gaps persist between formal frameworks and lived experiences. Yet, service providers\u0026rsquo; voices remain underrepresented in qualitative research on GBV in displacement contexts, despite their central role in shaping access to care and psychosocial support [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo address these gaps, this study adopts an intersectional qualitative approach grounded in Yuval-Davis\u0026rsquo; framework, which emphasizes the constitutive interplay between social locations, power relations, and institutional structures [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. By combining the perspectives of internally displaced populations with those of service providers involved in GBV care, this research examines GBV as both a lived social experience and an organizational process [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSpecifically, the study explores social perceptions and lived experiences of GBV among internally displaced populations in Burkina Faso, while also analyzing organizational responses through the perspectives of service providers. By bridging community experiences with institutional practices, this study aims to contribute to a more nuanced understanding of GBV and to inform integrated, psychosocially informed public health responses in forced displacement settings.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and reporting\u003c/h2\u003e \u003cp\u003eWe conducted an exploratory qualitative study to examine gender-based violence (GBV) in a forced displacement setting through two complementary lenses: (i) social perceptions and lived experiences among internally displaced persons (IDPs), and (ii) organizational responses as described by GBV service providers. The study combined focus group discussions (FGDs) with IDPs and individual interviews with service providers. Reporting was guided by the Consolidated criteria for reporting qualitative research (COREQ) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], and the methods were designed to maximize transparency, credibility, and analytic rigor.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eConceptual framework\u003c/h3\u003e\n\u003cp\u003eThe study was informed by Yuval-Davis\u0026rsquo; intersectional framework, which conceptualizes power relations as operating across interrelated levels (structural and institutional; organizational; interpersonal and experiential) [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. This framework supported an analysis of how GBV is perceived and negotiated in everyday life within displaced communities (experiential dimension) and how protection and care systems operate and are interpreted in practice (organizational dimension).\u003c/p\u003e\n\u003ch3\u003eStudy setting\u003c/h3\u003e\n\u003cp\u003eThe study was conducted in Kaya, the Centre-Nord region of Burkina Faso, a major area hosting internally displaced populations due to the national security crisis. Data collection took place between 4 February and 8 March 2022across selected displacement/host sites in Kaya.\u003c/p\u003e\n\u003ch3\u003eParticipants and sampling\u003c/h3\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eInternally displaced participants (FGDs)\u003c/h2\u003e \u003cp\u003eIDP participants were recruited to ensure diversity by gender and age group and to capture community-level perceptions and experiences of GBV. Five participant categories were targeted: women, men, adolescent girls, adolescent boys, and community leaders. A total of 58 FGDs were conducted with 352 participants.\u003c/p\u003e \u003cp\u003eSampling followed a stratified approach to ensure representation across these participant categories. Where site-level lists or community structures allowed, selection was conducted using simple random procedures within strata (e.g., drawing from available lists or rosters). When random selection was not feasible due to field constraints, a systematic selection based on order of availability was applied to minimize selection bias while maintaining diversity targets. Eligibility criteria included: (i) being an IDP residing in Kaya during the study period (or a community leader within the sites), and (ii) providing informed consent to participate.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eService providers (individual interviews)\u003c/h2\u003e \u003cp\u003eTo document organizational responses and professional perspectives, we interviewed 28 service providers involved in GBV survivor care, covering medical, psychosocial, social, and judicial support. Care structures were identified through an exhaustive mapping (census) of institutions actively providing GBV-related services in Kaya at the time of the study, including health centers, police/judicial services, social services, and psychosocial support organizations.\u003c/p\u003e \u003cp\u003eWithin identified structures, providers were selected using a purposive strategy based on two inclusion criteria: (i) being present in Kaya during data collection, and (ii) having received prior training in GBV care. Among eligible providers in each structure, one or more individuals were selected depending on availability and willingness to participate. When possible, investigators performed simple random selection using nominative lists provided by institutions; in facilities with few eligible staff, a systematic selection based on availability order was applied. The interviewed providers included health workers (n\u0026thinsp;=\u0026thinsp;16), case managers (n\u0026thinsp;=\u0026thinsp;5), psychologists (n\u0026thinsp;=\u0026thinsp;5), and judicial police officers (n\u0026thinsp;=\u0026thinsp;2). The predominance of health workers reflects the larger number of operational health facilities in the study area.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData collection procedures\u003c/h3\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eField team and training\u003c/h2\u003e \u003cp\u003eData collection was conducted by six trained data collectors organized into three pairs. All data collectors had prior experience in research on GBV and sexual and reproductive health. Training covered the study objectives, qualitative facilitation techniques, trauma-informed and survivor-centred approaches, confidentiality, referral pathways, and the use of mobile data collection tools.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eInstruments and language\u003c/h2\u003e \u003cp\u003eSemi-structured guides were developed for FGDs and service provider interviews. Guides were drafted in French and translated into Moor\u0026eacute; to support participant comprehension. Data collection was conducted in the language preferred by participants. FGDs lasted approximately one hour on average.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eData capture and management\u003c/h2\u003e \u003cp\u003eData were collected using KoboCollect on smartphones to support secure capture of metadata and structured field notes. With participants\u0026rsquo; consent, sessions were audio-recorded. Field notes were taken systematically to document contextual factors (e.g., group dynamics, non-verbal cues, interruptions) and to support interpretation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eData processing and analysis\u003c/h2\u003e \u003cp\u003eAudio recordings were transcribed verbatim. When interviews were conducted in Moor\u0026eacute;, content was translated into French during transcription, with attention to preserving meaning and culturally specific expressions. Data were managed and analyzed using NVivo (version 12).\u003c/p\u003e \u003cp\u003eAnalysis followed reflexive thematic analysis as described by Braun and Clarke [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The analytic process included: (1) familiarization with the data; (2) initial coding across the full dataset; (3) development of candidate themes; (4) review and refinement of themes; and (5) theme definition and reporting. Coding was conducted by multiple team members to strengthen analytic breadth. Regular analytic meetings were held to compare interpretations, refine the codebook, and resolve discrepancies through discussion. Themes were organized to reflect the study\u0026rsquo;s dual focus: (i) organizational dimensions (protection mechanisms, service availability, institutional/legal norms, perceived gaps), and (ii) experiential dimensions (intimate partner violence, stigma and shame, psychosocial distress and recovery, survival strategies such as transactional sex).\u003c/p\u003e \u003cp\u003eTo enhance the robustness of \u0026ldquo;bridging evidence,\u0026rdquo; we explicitly compared patterns emerging from IDP FGDs with service provider interviews, identifying convergences (shared perceptions) and divergences (mismatched understandings) relevant to GBV prevention and care.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTrustworthiness and rigor\u003c/b\u003e [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eMultiple strategies were used to strengthen trustworthiness:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eCredibility: triangulation of perspectives (IDPs and service providers), systematic documentation through field notes, and iterative team discussions to refine interpretations.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eDependability: standardized procedures for training, data collection, transcription, and coding; maintenance of an analytic log describing key decisions.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eConfirmability: use of verbatim excerpts to support themes and a transparent audit trail of coding and theme development.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eTransferability: thick description of setting, participant groups, and service structures to support assessment of relevance to similar humanitarian contexts.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eEthical considerations and participant safety\u003c/h2\u003e \u003cp\u003eThe study protocol received approval from the National Ethics Committee for Health Research (CERS), Burkina Faso (No. 2022-01-012; 17 January 2022). All participants provided free and informed consent before participation. The purpose of the study, the voluntary nature of participation, confidentiality measures, and audio-recording procedures were explained in the participant\u0026rsquo;s preferred language. Given the sensitivity of GBV, facilitators used trauma-informed practices, avoided pressure to disclose personal experiences, and ensured privacy during discussions. Where relevant, participants were informed about available GBV support services and referral options in the study area.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eParticipant characteristics\u003c/h2\u003e \u003cdiv id=\"Sec17\" class=\"Section3\"\u003e \u003ch2\u003eInternally displaced participants\u003c/h2\u003e \u003cp\u003eA total of 352 internally displaced persons (IDPs) participated in the study through 58 focus group discussions. Participants were distributed across five categories: women, men, adolescent girls, adolescent boys, and community leaders. This diversity allowed for an in-depth exploration of gender- and age-specific perceptions and experiences of gender-based violence (GBV) in forced displacement settings. The gender-disaggregated distribution is presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e below.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of focus group discussions by target group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTarget groups\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber of focus groups\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber of participants\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdolescent girls\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdolescent boys\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity leaders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e58\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e352\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe study recorded a high participation rate of 98.3%. Of the seven focus group discussions planned with community leaders, six were conducted. The seventh focus group could not be held due to the absence of the designated community leader at the concerned site.\u003c/p\u003e \u003cp\u003eBelow is the distribution by Internally Displaced Persons (IDP) Hosting Sites, presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of focus group discussions by IDP hosting site\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIDP hosting site\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber of IDPs\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eGirls\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBoys\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLeaders\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTiw\u0026egrave;ga site\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4,994\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKoum-Kuili\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3,661\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWatinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2,985\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZargongo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,659\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e38 Villas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,650\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoulgou-Yarga\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,589\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBisnogho\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e946\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e17,484\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e13\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e13\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e13\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e13\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e6\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e58\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eService providers\u003c/h2\u003e \u003cp\u003eIn addition, 28 service providers involved in GBV prevention and response were interviewed. Among them, 17 were women, and 11 were men. Health workers constituted the largest subgroup (n\u0026thinsp;=\u0026thinsp;16), followed by psychologists/social workers (n\u0026thinsp;=\u0026thinsp;5) and case managers (n\u0026thinsp;=\u0026thinsp;5). Judicial police officers represented the smallest subgroup (n\u0026thinsp;=\u0026thinsp;2).\u003c/p\u003e \u003cp\u003eMost service providers (n\u0026thinsp;=\u0026thinsp;19) reported more than five years of professional experience, while nine had between one and five years of experience. Regarding seniority in their current position, the majority (n\u0026thinsp;=\u0026thinsp;14) had served for more than three years, with others reporting a tenure of one to three years (n\u0026thinsp;=\u0026thinsp;11) or less than one year (n\u0026thinsp;=\u0026thinsp;3). This profile reflects a workforce with substantial professional exposure to GBV-related cases in the study setting. Below is the distribution of participants presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of participants by profile and sex\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParticipants\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth workers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychologists / Social workers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJudicial police officers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCase managers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal respondents\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e11\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e17\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e28\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eOrganizational dimensions of GBV\u003c/h2\u003e \u003cdiv id=\"Sec20\" class=\"Section3\"\u003e \u003ch2\u003eCommunity-based protection mechanisms\u003c/h2\u003e \u003cp\u003eAcross displacement sites, participants described the presence of community-based protection mechanisms, often organized through local committees. These structures were perceived as playing a preventive role by identifying vulnerable individuals, mediating conflicts, and facilitating referrals to formal services. However, their availability and effectiveness varied considerably across sites, with some communities reporting strong coordination and others describing limited or symbolic functionality.\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eWe have a community-based mechanism that reports cases of violence and identifies vulnerable individuals, such as persons with disabilities or those who are ill and in need of assistance.\u0026rdquo;\u003c/em\u003e (Community leader).\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;When someone faces a problem, they approach the committee, which then informs the relevant actors to find a solution.\u0026rdquo;\u003c/em\u003e (Interview with women).\u003c/p\u003e \u003cp\u003eService providers emphasized that community mechanisms often constitute the first point of contact for survivors, but their capacity is constrained by limited resources, insecurity, and sociocultural resistance.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Committees are often the first point of contact for survivors. We work with them to ensure that reported cases are promptly referred for appropriate care.\u0026rdquo;\u003c/em\u003e (Service provider).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eAvailability and accessibility of GBV services\u003c/h2\u003e \u003cp\u003eIDPs generally expressed appreciation for existing GBV services, particularly medical and psychosocial support, noting improvements in awareness and immediate assistance. Nevertheless, access to services remained uneven, with geographic, security-related, and informational barriers limiting utilization in certain sites.\u003c/p\u003e \u003cp\u003eService providers corroborated these observations, highlighting challenges related to workload, insufficient staffing, and interruptions in service delivery due to insecurity.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Many people are not aware that services are available, because there is not enough information and awareness campaigns on the issue. In addition, some IDPs live far from the service centers.\u0026rdquo;\u003c/em\u003e (Service provider).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eLegal and institutional frameworks\u003c/h2\u003e \u003cp\u003ePerceptions of legal and institutional responses to GBV were highly ambivalent. While some participants viewed existing laws and policies as protective of women\u0026rsquo;s rights, others perceived them as conflicting with cultural, religious, or moral norms. This tension was particularly salient regarding legislation related to sexual and reproductive health.\u003c/p\u003e \u003cp\u003eService providers reported navigating these tensions in their daily practice, balancing legal obligations with community resistance and survivors\u0026rsquo; fears of social repercussions.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;The law on gender-based violence is not well known among the population. Some people believe that legal access to safe abortion contradicts cultural and religious norms. Even local actors sometimes share these beliefs, which complicates implementation.\u0026rdquo;\u003c/em\u003e (Service provider)\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eInclusion, social cohesion, and institutional trust\u003c/h2\u003e \u003cp\u003eParticipants frequently described coexistence and cooperation among displaced populations and host communities, emphasizing ethnic and social inclusion within protection structures. However, trust in institutions varied, with some IDPs expressing skepticism toward formal actors due to unmet expectations or perceived discrimination.\u003c/p\u003e \u003cp\u003eService providers acknowledged that trust-building is a gradual process, often hindered by previous negative experiences and misinformation.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Service providers must adhere to ethics and professional standards. We must treat every survivor with dignity and avoid any form of judgment. Otherwise, the service will be perceived as unsafe, and trust in providers will be undermined.\u0026rdquo;\u003c/em\u003e (Service provider).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eExperiential dimensions of GBV\u003c/h2\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eIntimate partner violence and social normalization\u003c/h2\u003e \u003cp\u003eIntimate partner violence emerged as one of the most frequently discussed forms of GBV. While many participants recognized forced sexual relations and physical abuse as violations of individual rights, others described these practices as normalized within marital or religious frameworks.\u003c/p\u003e \u003cp\u003eThis ambivalence reflects deeply rooted gender norms that shape perceptions of consent, authority, and obligation within intimate relationships.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;If it\u0026rsquo;s not the case with you intellectuals, in our context, being a Muslim woman, the day the husband wants to have sex, even if the woman has just given birth, she is obliged to accept. Otherwise, she will cause problems for her husband, and he will go look for other women.\u0026rdquo;\u003c/em\u003e (interview with a woman).\u003c/p\u003e \u003cp\u003eService providers confirmed that normalization of intimate partner violence remains a major barrier to reporting and care.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I know that forcing a woman to have sexual intercourse is unacceptable violence. But in our society, such acts are often considered normal. Women who dare to speak out are often reprimanded. That is why many refuse to report these incidents.\u0026rdquo;\u003c/em\u003e (Service provider).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003ePsychosocial consequences and mental well-being\u003c/h2\u003e \u003cp\u003eSurvivors described a wide range of psychological and emotional consequences associated with GBV, including fear, shame, persistent distress, and social withdrawal. For many, stigma and fear of judgment constituted significant barriers to disclosure.\u003c/p\u003e \u003cp\u003eConversely, access to psychosocial support was associated with emotional relief, restored self-worth, and improved coping capacities.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Before, I lived in constant fear, but thanks to the advice and support I received, this fear gradually disappeared.\u0026rdquo;\u003c/em\u003e (Interview with a survivor).\u003c/p\u003e \u003cp\u003eThe psychological trajectories of survivors remain heterogeneous and are strongly shaped by internal and contextual barriers. Shame and fear of judgment hinder the expression of traumatic experiences.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\"They often feel deep shame after experiencing violence. Many are afraid to speak out and fear not being understood by those they might turn to to share their experiences.\u0026rdquo;\u003c/em\u003e (Service provider).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section3\"\u003e \u003ch2\u003eStigmatization and community attitudes\u003c/h2\u003e \u003cp\u003eAlthough expressions of empathy toward survivors were common, stigmatizing attitudes persisted. Survivors were sometimes blamed, socially isolated, or subjected to gossip, exacerbating psychological suffering and discouraging help-seeking.\u003c/p\u003e \u003cp\u003eService providers identified stigma as a critical obstacle to sustained engagement with care services.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Some survivors are often singled out and criticized by others. They become the subject of gossip and judgment. This stigmatization isolates them and makes their recovery process even more difficult.\u0026rdquo;\u003c/em\u003e (Service provider).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003eSurvival strategies under economic precarity\u003c/h2\u003e \u003cp\u003eSevere economic hardship emerged as a central driver of harmful survival strategies, particularly among women and adolescent girls. Transactional sex was frequently cited as a means of securing food or necessities in the absence of stable livelihoods or social support.\u003c/p\u003e \u003cp\u003eService providers confirmed encountering such situations regularly and emphasized the ethical and psychosocial dilemmas they pose.\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Hunger pushes us to accept indecent proposals, sometimes from people who are actually unable to truly help us.\u0026rdquo;\u003c/em\u003e (Interview with women).\u003c/p\u003e \u003cp\u003e \u003cem\u003e\"Some women find themselves without any support. Their husbands have been killed by terrorists. With no resources or family support, they are sometimes forced into sex work to provide for their children. This situation frequently exposes them to sexually transmitted infections and unwanted pregnancies. Managing these consequences often remains complex.\u0026rdquo;\u003c/em\u003e (Service provider).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003eConvergence and divergence between community and service provider perspectives\u003c/h2\u003e \u003cp\u003eComparative analysis revealed both convergence and divergence between IDP and service provider perspectives. While both groups acknowledged the prevalence of GBV and the importance of psychosocial support, discrepancies emerged regarding perceptions of institutional effectiveness, survivor agency, and the feasibility of legal recourse.\u003c/p\u003e \u003cp\u003eThese divergences highlight gaps between lived experiences and organizational responses, underscoring the need for integrated, context-sensitive GBV interventions.\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eSupport services exist and are accessible, but on the ground, displaced people do not perceive them the same way. Many hesitate to file complaints or go to the facilities out of fear or because they doubt the outcome of the process\u003c/em\u003e.\u0026rdquo; (Service provider).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study examined gender-based violence (GBV) in a forced displacement context in Burkina Faso by bridging social perceptions and lived experiences among internally displaced populations with organizational responses as articulated by service providers. By integrating these complementary perspectives, the findings highlight GBV as both a socially embedded phenomenon and a systemic public health challenge, deeply shaped by gender norms, power relations, and institutional constraints [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec31\" class=\"Section2\"\u003e \u003ch2\u003eGBV, social norms, and the normalization of violence in displacement settings\u003c/h2\u003e \u003cp\u003eThe findings reveal that GBV, particularly intimate partner violence, is simultaneously recognized as a violation of rights and normalized through entrenched social, cultural, and religious norms. This ambivalence has been widely documented in humanitarian contexts, where displacement disrupts social regulation while reinforcing patriarchal structures that legitimize male authority and female subordination [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In this study, forced displacement appears to intensify these dynamics by weakening traditional accountability mechanisms and increasing economic dependency, thereby normalizing practices that would otherwise be contested [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe normalization of violence reported by participants reflects what intersectional scholars describe as the interaction between structural vulnerability and everyday power relations [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Displacement reshapes gender roles and expectations, but often in ways that reproduce inequality rather than challenge it [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This normalization has direct implications for mental well-being, as survivors may internalize violence as inevitable, limit disclosure, and delay or avoid seeking support [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec32\" class=\"Section2\"\u003e \u003ch2\u003ePsychosocial consequences and pathways to recovery\u003c/h2\u003e \u003cp\u003eConsistent with prior research, survivors described profound psychological and emotional distress, including fear, shame, anxiety, and social withdrawal [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. These experiences underscore GBV as a major determinant of mental health in humanitarian settings [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Importantly, the study highlights the dual role of stigma: it not only exacerbates psychological suffering but also constitutes a structural barrier to care by discouraging disclosure and reinforcing silence [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAt the same time, both survivors and service providers emphasized the positive impact of psychosocial support on emotional relief and recovery. Access to listening spaces, respectful care, and sustained follow-up enabled some survivors to regain a sense of safety, agency, and future orientation [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. These findings reinforce the importance of trauma-informed and survivor-centred approaches in GBV programming and align with evidence demonstrating that psychosocial interventions can mitigate the mental health consequences of violence even in highly constrained settings [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec33\" class=\"Section3\"\u003e \u003ch2\u003eOrganizational responses and the limits of protection systems\u003c/h2\u003e \u003cp\u003eFrom an organizational perspective, the study reveals a fragmented landscape of GBV prevention and response. While community-based protection mechanisms and formal services exist, their effectiveness is uneven and often constrained by insecurity, limited resources, and sociocultural resistance [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Service providers described operating at the intersection of institutional mandates and community realities, frequently negotiating tensions between legal frameworks and local norms.\u003c/p\u003e \u003cp\u003eLegal and policy instruments addressing GBV were perceived ambivalently, particularly when they conflicted with prevailing moral or religious values. This gap between normative frameworks and social acceptance complicates implementation and may undermine trust in institutions [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Service providers\u0026rsquo; accounts illustrate how frontline actors absorb these tensions, often assuming roles that extend beyond their formal responsibilities to mediate, reassure, and adapt interventions to local contexts [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec34\" class=\"Section3\"\u003e \u003ch2\u003eSurvival strategies, economic precarity, and ethical dilemmas\u003c/h2\u003e \u003cp\u003eThe emergence of harmful survival strategies such as transactional sex highlights the central role of economic precarity in shaping GBV risks and responses [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. For many women and girls, displacement-induced poverty constrains choice and agency, rendering survival strategies both rational and deeply stigmatized [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. These practices further expose individuals to violence, exploitation, and psychological harm, creating cycles of vulnerability that extend beyond immediate incidents of GBV [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eService providers reported encountering significant ethical and professional dilemmas when supporting survivors engaged in such strategies, particularly in the absence of viable livelihood alternatives [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. These findings underscore the need to situate GBV interventions within broader social protection and economic support frameworks, rather than addressing violence in isolation [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eBridging lived experiences and public health responses\u003c/h3\u003e\n\u003cp\u003eA key contribution of this study lies in its explicit comparison of community and service provider perspectives, revealing areas of convergence and divergence. While both groups acknowledge the prevalence of GBV and the importance of psychosocial support, differences emerge regarding perceptions of institutional effectiveness, survivor agency, and the feasibility of legal recourse [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. These gaps illustrate the limits of top-down interventions that fail to account for lived realities and social meanings attached to violence [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBridging these perspectives is essential for designing public health responses that are both effective and socially legitimate. Integrated approaches that combine community engagement, culturally sensitive psychosocial care, legal protection, and economic support are more likely to address the complex determinants of GBV and promote sustainable improvements in mental well-being [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eImplications for policy and practice\u003c/h3\u003e\n\u003cp\u003eThe findings have several implications for GBV prevention and response in humanitarian settings. First, interventions must explicitly address social norms and power relations that normalize violence, rather than focusing solely on individual behavior change [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Second, strengthening psychosocial services and ensuring continuity of care are critical for mitigating the mental health impacts of GBV [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Third, service providers require sustained training, institutional support, and security to navigate ethical dilemmas and community resistance effectively [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Finally, GBV programming should be embedded within broader public health and social protection strategies that address economic precarity and structural vulnerability [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec37\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations\u003c/h2\u003e \u003cp\u003eThis study benefits from the triangulation of perspectives across diverse participant groups, including internally displaced populations and service providers, which enhances analytic depth and credibility. However, the sensitivity of GBV may have led to underreporting or socially desirable responses. Additionally, the findings are context-specific and may not be directly generalizable to all displacement settings, although they offer transferable insights for similar humanitarian contexts.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study shows that gender-based violence (GBV) in forced displacement settings in Burkina Faso is deeply embedded in social norms and structural inequalities, with significant consequences for psychosocial well-being. By combining the perspectives of internally displaced populations and service providers, the findings highlight how lived experiences of violence intersect with uneven and constrained organizational responses.\u003c/p\u003e \u003cp\u003eGBV is frequently normalized in contexts of insecurity and economic precarity, shaping survivors\u0026rsquo; coping strategies, help-seeking behaviors, and mental health trajectories. While access to psychosocial support contributes to emotional relief and recovery, service providers face persistent challenges related to limited resources, sociocultural resistance, and institutional constraints.\u003c/p\u003e \u003cp\u003eBridging community perceptions with organizational practices is essential to strengthening GBV prevention and response. Integrated, survivor-centred, and psychosocially informed public health approaches that address social norms, economic vulnerability, and service capacity are critical to mitigating the mental health burden of GBV in humanitarian contexts.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003eThis study was conducted in accordance with all relevant institutional guidelines and regulations, as well as the ethical principles outlined in the Declaration of Helsinki. The study was reviewed and approved by the Health Research Ethics Committee (Protocol No. 2022-01-012, dated January 17, 2022). Before participation, the study objectives were explained to all participants, and informed consent was obtained, including consent to audio recordings. The consent process was conducted in Mor\u0026eacute; to ensure the participants' complete understanding. Confidentiality and voluntary participation were emphasized throughout the study.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eAuthors' information\u003c/h2\u003e \u003cp\u003eThe authors come from Burkina Faso, and Cameroon.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis research did not receive any funding from external sources.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eBS developed the research strategy and was responsible for data extraction. PN provided expertise in qualitative methodology. All authors contributed to drafting the manuscript, critically revised it for important intellectual content, and approved the final version of the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eWe would like to acknowledge the study participants and the individuals who assisted with data collection for their invaluable contributions to this research.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eZinyemba KG, Hlongwana K. Men\u0026rsquo;s conceptualization of gender-based violence directed to women in Alexandra Township, Johannesburg, South Africa. 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PLoS ONE. 2025;20:e0337690. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1371/journal.pone.0337690\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0337690\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-mental-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dimh","sideBox":"Learn more about [Discover Mental Health](https://www.springer.com/44192)","snPcode":"","submissionUrl":"","title":"Discover Mental Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Gender-based violence, Forced displacement, Social perceptions, Lived experiences, Service providers, Psychosocial well-being, Public health response, Burkina Faso.","lastPublishedDoi":"10.21203/rs.3.rs-8823508/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8823508/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e \u003cb\u003eBackground\u003c/b\u003e \u003c/p\u003e \u003cp\u003eGender-based violence (GBV) remains a major public health challenge in humanitarian settings, where forced displacement weakens social structures, undermines protection mechanisms, and increases vulnerabilities. In Burkina Faso, the security crisis and the scale of internal displacement have profoundly transformed community norms, lived experiences of violence, and institutional responses.\u003c/p\u003e \u003cp\u003e \u003cb\u003eAim\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThis study aimed to analyze social perceptions and lived experiences of GBV among internally displaced populations, while examining organizational responses through the perspectives of service providers operating in forced displacement contexts.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMethods\u003c/b\u003e \u003c/p\u003e \u003cp\u003eGuided by Yuval-Davis\u0026rsquo; intersectional framework, this exploratory qualitative study was conducted in Kaya, in the Centre-Nord region. Data were collected through 58 focus group discussions involving 352 internally displaced persons, including women, men, adolescent girls and boys, and community leaders. Additionally, 28 service providers involved in GBV care across medical, psychosocial, social, and judicial sectors were interviewed. A comprehensive mapping of GBV-related services was conducted. Data were analyzed using thematic analysis supported by NVivo software.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResults\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFindings indicate that although community-based protection mechanisms exist, their availability and effectiveness remain uneven. Legal and institutional responses are often perceived as misaligned with deeply rooted social, cultural, and religious norms. Forced displacement contributes to the reconfiguration of social relations and the normalization of intimate partner violence. Women and girls adopt harmful survival strategies, including transactional sex, in response to severe economic precarity. Psychological impacts fear, shame, stigma, and emotional distress were widely reported. Access to psychosocial support was associated with emotional relief and pathways toward recovery.\u003c/p\u003e \u003cp\u003e \u003cb\u003eConclusion\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThese findings highlight the need for integrated approaches that link community perceptions, lived experiences, and institutional responses to strengthen GBV prevention and psychosocial care in humanitarian settings.\u003c/p\u003e","manuscriptTitle":"Social perceptions of gender-based violence among displaced communities in Burkina Faso and their interactions with protection systems","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-04 17:09:38","doi":"10.21203/rs.3.rs-8823508/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-02-27T16:52:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-19T05:07:54+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-18T17:47:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Mental Health","date":"2026-02-18T17:41:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-mental-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dimh","sideBox":"Learn more about [Discover Mental Health](https://www.springer.com/44192)","snPcode":"","submissionUrl":"","title":"Discover Mental Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8c6e16d1-5775-4725-a955-7d88d6053436","owner":[],"postedDate":"March 4th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-14T10:23:30+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-04 17:09:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8823508","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8823508","identity":"rs-8823508","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}