ESTRATÉGIAS DE ENFRENTAMENTO À VIOLÊNCIA CONTRA CRIANÇAS, ADOLESCENTES E MULHERES NO CONTEXTO DO ISOLAMENTO SOCIAL DEVIDO À COVID-19: SCOPING REVIEW

Lettiere-Viana, Angelina; Baraldi, Nayara Girardi; Carlos, Diene Monique; Fumincelli, Laís; Costa, Luiza Cesar Riani; Castro, Paola Cristina de

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Brasil

Texto & Contexto - Enfermagem

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Brasil

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Sumário

Seção Especial COVID-19 • Texto contexto - enferm. 30 • 2021 • https://doi.org/10.1590/1980-265X-TCE-2020-0443 copiar

ESTRATÉGIAS DE ENFRENTAMENTO À VIOLÊNCIA CONTRA CRIANÇAS, ADOLESCENTES E MULHERES NO CONTEXTO DO ISOLAMENTO SOCIAL DEVIDO À COVID-19: SCOPING REVIEW

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

mapear as recomendações das estratégias de enfrentamento à violência contra crianças, adolescentes e mulheres no contexto do isolamento social devido à Covid-19. Método: revisão de escopo conforme Instituto Joanna Briggs, por meio de uma estratégia de pesquisa realizada na literatura cinzenta pelo Portal CAPES e nos bancos de dados SCIELO, LILACS, PubMed, CINAHL, Web of Science, Repositório Institucional para Intercambio de Información da Organização Pan-Americana da Saúde. A análise do material identificado foi realizada por três revisores independentes. Os dados extraídos foram analisados e sintetizados de forma narrativa.

Resultados:

dos 526 estudos encontrados, 59 foram mantidos para revisão e seu conteúdo foi resumido em seis categorias: 1) prevenção; 2) identificação e intervenção; 3) cuidado continuado; 4) cuidado à segurança e saúde mental dos profissionais; 5) intersetorialidade/interdisciplinaridade; e 6) cuidado especial a populações vulneráveis.

Conclusão:

os serviços devem garantir um cuidado contínuo, intersetorial e seguro, em especial, no âmbito da saúde mental, bem como, deve-se promover a conscientização comunitária. Os profissionais da saúde devem estar sensíveis e alertas a sinais de violência, intervindo de forma imediata e conectada à rede de proteção.

DESCRITORES:
Exposição à violência; Violência doméstica; Infecções por coronavirus; Isolamento social; Violência por parceiro íntimo; Maus-tratos infantis; Revisão

Categorias conceituais de recomendações	Estudos
Prevenção
Aprimorar os serviços de saúde mental, promovendo cuidados psicossociais a pais, cuidadores e parceiros íntimos, via remota ou presencial;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ¹³13. Mazza M, Marano G, Lai C, Janiri L, Sani G. Danger in danger: Interpersonal violence during COVID-19 quarantine. Psychiatry Res [Internet]. 2020 [cited 2020 Aug 22];289:113046. Available from: https://doi.org/10.1016/j.psychres.2020.113046 https://doi.org/10.1016/j.psychres.2020.... ^, ²⁹29. Telles LEB, Valenca AM, Barros AJS, Silva AG. Domestic violence in the COVID-19 pandemic: a forensic psychiatric perspective. Braz J Psychiatry [Internet]. 2020 [cited 2020 Aug 22];In Press. Available from: https://doi.org/10.1590/1516-4446-2020-1060 https://doi.org/10.1590/1516-4446-2020-1... ^, ³²32. World Health Organization. Addressing human rights as key to the COVID-19: response. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331811 https://apps.who.int/iris/handle/10665/3... ^, ³⁷37. World Health Organization. Strengthening the health systems response to COVID-19: technical guidance: adapting primary health care services to more effectively address COVID-19. [Internet]. Europe: World Health Organization ; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332783 https://apps.who.int/iris/handle/10665/3... ^, ³⁹39. World Health Organization. Strengthening the health systems response to COVID-19: technical guidance: preventing and managing the COVID-19. [Internet]. Geneva (CH): World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/333067 https://apps.who.int/iris/handle/10665/3...
Aumentar as equipes que atuam na prevenção da violência;	²⁸28. Vieira PR, Garcia LP, Maciel ELN. The increase in domestic violence during the social isolation: what does it reveals? Rev Bras Epidemiol [Internet]. 2020 [cited 2020 Aug 22];23:e200033. Available from: https://doi.org/10.1590/1980-549720200033 . https://doi.org/10.1590/1980-54972020003...
Fornecer apoio e orientação a pais e cuidadores sobre: parentalidade positiva (cuidado responsivo, diálogo familiar, leitura, estratégias de enfrentamento positivo, educação precoce, estimulação e proteção contra tabus e violência, não uso de força e coesão), apoio social e autocuidado (gerenciamento de estresse, exercícios físicos, relaxamento, rotina de sono e alimentação e a prevenção de estratégias inúteis de enfrentamento, como o uso de tabaco, álcool ou drogas);	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ⁹9. World Health Organization. United Nations Children’s Fund (‎‎‎UNICEF)‎‎‎. Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic: interim guidance. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331975 https://apps.who.int/iris/handle/10665/3... 10. World Health Organization. Continuing essential sexual reproductive, maternal, neonatal, child and adolescent health services during COVID-19 pandemic: practical considerations. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 25]. Available from: https://apps.who.int/iris/handle/10665/332162 https://apps.who.int/iris/handle/10665/3... ^- ¹¹11. World Health Organization. Continuing essential Sexual Reproductive, Maternal, Neonatal, Child and Adolescent Health services during COVID-19 pandemic. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 25]. Available from: https://apps.who.int/iris/handle/10665/331816 https://apps.who.int/iris/handle/10665/3... ^, ¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3... ^- ¹⁵15. Crawley E, Loades M, Feder G, Logan S, Redwood S, Macleod J. Wider collateral damage to children in the UK because of the social distancing measures designed to reduce the impact of COVID-19 in adults. BMJ Paediatr Open [Internet]. 2020 [cited 2020 Aug 22];4(1):e000701. Available from: https://doi.org/10.1136/bmjpo-2020-000701 https://doi.org/10.1136/bmjpo-2020-00070... ^, ³⁰30. Marques ES, Moraes CL, Hasselmann MH, Deslandes SF, Reichenheim ME. Violence against women, children, and adolescents during the COVID-19 pandemic: overview, contributing factors, and mitigating measures. Cad Saúde Pública [Internet]. 2020 [cited 2020 Aug 22];36(4):e00074420. Available from: https://doi.org/10.1590/0102-311x00074420 https://doi.org/10.1590/0102-311x0007442... ^, ⁴⁰40. Cuartas J. Heightened risk of child maltreatment amid the COVID-19 pandemic can exacerbate mental health problems for the next generation. Psychological Trauma: Theo Res Pract Policy [Internet]. 2020 [cited 2020 Aug 22];12(S1):195-6. Available from: https://doi.org/10.1037/tra0000597 https://doi.org/10.1037/tra0000597... ^- ⁴¹41. Ragavan MI, Culyba AJ, Muhammad FL, Miller E. Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic. J Adolesc Health [Internet]. 2020 [cited 2020 Aug 22];67(1):18-20. Available from: https://doi.org/10.1016/j.jadohealth.2020.04.011 https://doi.org/10.1016/j.jadohealth.202...
Manter-se atento a pais em uso de bebidas ou substâncias psicoativas e o aumento do estresse intrafamiliar, fornecendo tratamento por telemedicina ou presencialmente;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ²⁹29. Telles LEB, Valenca AM, Barros AJS, Silva AG. Domestic violence in the COVID-19 pandemic: a forensic psychiatric perspective. Braz J Psychiatry [Internet]. 2020 [cited 2020 Aug 22];In Press. Available from: https://doi.org/10.1590/1516-4446-2020-1060 https://doi.org/10.1590/1516-4446-2020-1... ^, ³⁷37. World Health Organization. Strengthening the health systems response to COVID-19: technical guidance: adapting primary health care services to more effectively address COVID-19. [Internet]. Europe: World Health Organization ; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332783 https://apps.who.int/iris/handle/10665/3...
Realizar campanhas estatais para a redução do consumo de álcool e outras drogas durante o período de isolamento social;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3...
Orientar as mulheres a manter o contato com os amigos e familiares através de mensagens de texto, chamadas de vídeo e de voz para que haja rede apoio;	¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3... ^, ²⁸28. Vieira PR, Garcia LP, Maciel ELN. The increase in domestic violence during the social isolation: what does it reveals? Rev Bras Epidemiol [Internet]. 2020 [cited 2020 Aug 22];23:e200033. Available from: https://doi.org/10.1590/1980-549720200033 . https://doi.org/10.1590/1980-54972020003... ^, ³³33. World Health Organization. Gender and COVID-19: advocacy brief. [Internet]. Geneva (CH): WHO ; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332080 https://apps.who.int/iris/handle/10665/3...
Informar e orientar mulheres idosas que tenham cuidadores a reconhecer situações de violência e buscar ajuda via telefone, mensagens e correio eletrônico de maneira segura;	³⁹39. World Health Organization. Strengthening the health systems response to COVID-19: technical guidance: preventing and managing the COVID-19. [Internet]. Geneva (CH): World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/333067 https://apps.who.int/iris/handle/10665/3...
Divulgar à população, por meio de rádio, televisão, avisos em supermercados, farmácias, redes sociais e serviços de urgência e emergência, informações sobre o aumento da violência, sinais para identificação; saúde reprodutiva; apoio às vítimas e serviços disponíveis localmente (linhas de apoio / linhas diretas, abrigos, serviços de aconselhamento). Produzir materiais acessíveis em braille e libras;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ⁸8. Posick C, Schueths AA, Christian C, Grubb JA, Christian SE. Child Victim Services in the Time of COVID-19: New Challenges and Innovative Solutions. Am J Crim Justice [Internet]. 2020 [cited 2020 Apr 22];14:1-10. Available from: https://doi.org/10.1007/s12103-020-09543-3 . https://doi.org/10.1007/s12103-020-09543... ^, ¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3... ^, ¹⁶16. Sharma P, Sharma S, Singh N. COVID-19: Endangering women’s mental and reproductive health. Indian J Public Health [Internet]. 2020 [cited 2020 Aug 22];64:251-2. Available from: https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-544991 https://pesquisa.bvsalud.org/global-lite... 17. World Health Organization. Cuestiones prácticas y recomendaciones para los líderes religiosos y las comunidades confesionales en el marco de la COVID-19: orientaciones provisionales. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332047 https://apps.who.int/iris/handle/10665/3... ^- ¹⁸18. Ghosh R, Dubey MJ, Chatterjee S, Dubey S. Impact of COVID-19 on children: special focus on the psychosocial aspect. Minerva Pediatr [Internet]. 2020 [cited 2020 Aug 22];72(3):226-35. Available from: https://doi.org/10.23736/S0026-4946.20.05887-9 https://doi.org/10.23736/S0026-4946.20.0... ^, ³³33. World Health Organization. Gender and COVID-19: advocacy brief. [Internet]. Geneva (CH): WHO ; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332080 https://apps.who.int/iris/handle/10665/3... ^, ⁴⁸48. Ghoshal R. Twin public health emergencies: Covid-19 and domestic violence. Indian J Med Ethics [Internet]. 2020 [cited 2020 Aug 22];5(3):195-9. Available from: https://doi.org/10.20529/IJME.2020.056 https://doi.org/10.20529/IJME.2020.056... ^, ⁵⁴54. Van-Gelder N, Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, et al. COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence. EClinical Medicine [Internet]. 2020 [cited 2020 Aug 22];21:100348. Available from: https://doi.org/10.1016/j.eclinm.2020.100348 https://doi.org/10.1016/j.eclinm.2020.10... 55. John N, Casey SE, Carino G, McGovern T. Lessons never learned: crisis and gender-based violence. Developing World Bioeth [Internet]. 2020 [cited 2020 Aug 22];20:65-8. Available from: https://doi.org/10.1111/dewb.12261 https://doi.org/10.1111/dewb.12261... 56. World Health Organization. Practical considerations and recommendations for religious leaders and faith-based communities in the context of COVID-19: interim guidance. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331707 https://apps.who.int/iris/handle/10665/3... 57. World Health Organization. Safe Ramadan practices in the context of the COVID-19: interim guidance [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331767 https://apps.who.int/iris/handle/10665/3... ^- ⁵⁸58. Rossi FS, Shankar M, Buckholdt K, Bailey Y, Israni ST, Iverson KM. Trying times and trying out solutions: intimate partner violence screening and support for women veterans during COVID-19. J Gen Intern Med [Internet]. 2020 [cited 2020 Aug 22];35:2728-31. Available from: https://doi.org/10.1007/s11606-020-05990-0 https://doi.org/10.1007/s11606-020-05990...
Criar e implementar leis contra violência doméstica e políticas que garantam emprego e autonomia às mulheres.	¹⁶16. Sharma P, Sharma S, Singh N. COVID-19: Endangering women’s mental and reproductive health. Indian J Public Health [Internet]. 2020 [cited 2020 Aug 22];64:251-2. Available from: https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-544991 https://pesquisa.bvsalud.org/global-lite...
Identificação e intervenção
Manter profissionais, em especial da saúde e educação, alertas e sensíveis, capacitando para identificação de sinais de alerta;	⁵5. Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health [Internet]. 2020 [cited 2020 Apr 22];14(20). Available from: https://doi.org/10.1186/s13034-020-00329-3 https://doi.org/10.1186/s13034-020-00329... ^, ¹⁹19. Mohler G, Bertozzi AL, Carter J, Short MB, Sledge D, Tita GE, et al. Impact of social distancing during COVID-19 pandemic on crime in Los Angeles and Indianapolis. J Criminal Justice [Internet]. 2020 [cited 2020 Aug 22];68:101692. Available from: https://doi.org/10.1016/j.jcrimjus.2020.101692 https://doi.org/10.1016/j.jcrimjus.2020.... 20. Matoori S, Khurana B, Balcom MC, Koh DM, Froehlich JM, Janssen S, et al. Intimate partner violence crisis in the COVID-19 pandemic: how can radiologists make a difference? Eur Radiol [Internet]. 2020 [cited 2020 Aug 22];30:6933-6. Available from: https://doi.org/10.1007/s00330-020-07043-w https://doi.org/10.1007/s00330-020-07043... ^- ²¹21. Thomas EY, Anurudran A, Robb K, Burke TF. Spotlight on child abuse and neglect response in the time of COVID-19. Lancet Public Health [Internet]. 2020 [cited 2020 Aug 22];5(7):e371. Available from: https://doi.org/10.1016/S2468-2667(20)30143-2 https://doi.org/10.1016/S2468-2667(20)30... ^, ³⁶36. Roesch E, Amin A, Gupta J, García-Moreno C. Violence against women during covid-19 pandemic restrictions. BMJ [Internet]. 2020 [cited 2020 Aug 22];369:m1712. Available from: https://doi.org/10.1136/bmj.m1712 https://doi.org/10.1136/bmj.m1712... ^, ⁵⁴54. Van-Gelder N, Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, et al. COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence. EClinical Medicine [Internet]. 2020 [cited 2020 Aug 22];21:100348. Available from: https://doi.org/10.1016/j.eclinm.2020.100348 https://doi.org/10.1016/j.eclinm.2020.10... ^, ⁵⁹59. Vora M, Malathesh BC, Das S, Chatterjee SS. COVID-19 and domestic violence against women [carta]. Asian J Psychiatr [Internet]. 2020 [cited 2020 Aug 22];53:102227. Available from: https://doi.org/10.1016/j.ajp.2020.102227 https://doi.org/10.1016/j.ajp.2020.10222... ^- ⁶⁰60. Gibson J. Domestic violence during COVID-19: the GP role. British J General Practice [Internet]. 2020 [cited 2020 Aug 22];70(696):340. Available from: https://doi.org/10.3399/bjgp20X710477 https://doi.org/10.3399/bjgp20X710477...
Revisar protocolos para identificação e apoio a situações de violências, considerando as peculiaridades de cada região do país;	²⁰20. Matoori S, Khurana B, Balcom MC, Koh DM, Froehlich JM, Janssen S, et al. Intimate partner violence crisis in the COVID-19 pandemic: how can radiologists make a difference? Eur Radiol [Internet]. 2020 [cited 2020 Aug 22];30:6933-6. Available from: https://doi.org/10.1007/s00330-020-07043-w https://doi.org/10.1007/s00330-020-07043... ^, ²⁸28. Vieira PR, Garcia LP, Maciel ELN. The increase in domestic violence during the social isolation: what does it reveals? Rev Bras Epidemiol [Internet]. 2020 [cited 2020 Aug 22];23:e200033. Available from: https://doi.org/10.1590/1980-549720200033 . https://doi.org/10.1590/1980-54972020003... ^, ⁴⁸48. Ghoshal R. Twin public health emergencies: Covid-19 and domestic violence. Indian J Med Ethics [Internet]. 2020 [cited 2020 Aug 22];5(3):195-9. Available from: https://doi.org/10.20529/IJME.2020.056 https://doi.org/10.20529/IJME.2020.056... ^, ⁶¹61. World Health Organization. WHO policy brief: the economic and social impact of COVID-19 in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332818 https://apps.who.int/iris/handle/10665/3...
Realizar atendimentos com respeito, simpatia e confidencialidade, e cuidados com uma abordagem centrada na pessoa, validando experiências e sentimentos;	¹⁰10. World Health Organization. Continuing essential sexual reproductive, maternal, neonatal, child and adolescent health services during COVID-19 pandemic: practical considerations. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 25]. Available from: https://apps.who.int/iris/handle/10665/332162 https://apps.who.int/iris/handle/10665/3... ^, ¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3... ^, ²²22. World Health Organization. COVID-19 and violence against women in the Eastern Mediterranean Region [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332331 https://apps.who.int/iris/handle/10665/3...
Disponibilizar formulários de admissão padrão para avaliação de mulheres submetidas a VPI ou agressão sexual em unidades, clínicas e triagens comunitárias dedicadas à resposta ao Covid-19, com abordagens individuais para aquelas que não conseguem responder de forma privativa;	²³23. Anurudran A, Yared L, Comrie C, Harrison K, Burke T. Domestic violence amid COVID-19. Int J Gynecol Obstet [Internet]. 2020 [cited 2020 Aug 22];150:255-56. Available from: https://doi.org/10.1002/ijgo.13247 https://doi.org/10.1002/ijgo.13247... ^, ²⁹29. Telles LEB, Valenca AM, Barros AJS, Silva AG. Domestic violence in the COVID-19 pandemic: a forensic psychiatric perspective. Braz J Psychiatry [Internet]. 2020 [cited 2020 Aug 22];In Press. Available from: https://doi.org/10.1590/1516-4446-2020-1060 https://doi.org/10.1590/1516-4446-2020-1... ^, ⁵⁴54. Van-Gelder N, Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, et al. COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence. EClinical Medicine [Internet]. 2020 [cited 2020 Aug 22];21:100348. Available from: https://doi.org/10.1016/j.eclinm.2020.100348 https://doi.org/10.1016/j.eclinm.2020.10... ^, ⁴²42. Cohen M, Powell A, Coleman J, Keller J, Livingston A, Anderson J. Special ambulatory gynecologic considerations in the era of coronavirus disease 2019 (COVID-19) and implications for future practice. American J Obstet Gynec [Internet]. 2020 [cited 2020 Aug 22];223(3):P372-8. Available from: https://doi.org/10.1016/j.ajog.2020.06.006 https://doi.org/10.1016/j.ajog.2020.06.0...
Encaminhar imediatamente crianças com lesões suspeitas de violências, se necessário hospitalização para esclarecimento e garantia da proteção da criança;	¹⁵15. Crawley E, Loades M, Feder G, Logan S, Redwood S, Macleod J. Wider collateral damage to children in the UK because of the social distancing measures designed to reduce the impact of COVID-19 in adults. BMJ Paediatr Open [Internet]. 2020 [cited 2020 Aug 22];4(1):e000701. Available from: https://doi.org/10.1136/bmjpo-2020-000701 https://doi.org/10.1136/bmjpo-2020-00070... ^, ⁶²62. Martinkevich P, Langeland LL, Graesholt-Knudsen T, Hesthaven G, Hellfritzsch MB, Petersen KK, et al. Physical child abuse demands increased awareness during health and socioeconomic crises like COVID-19. Acta Orthopaedica [Internet]. 2020 [cited 2020 Aug 22];91(5):527-33. Available from: https://doi.org/10.1080/17453674.2020.1782012 https://doi.org/10.1080/17453674.2020.17...
Conectar as pessoas em situação de violências a serviços de proteção e cuidado continuado, facilitando acesso com segurança.	¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3... ^, ³²32. World Health Organization. Addressing human rights as key to the COVID-19: response. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331811 https://apps.who.int/iris/handle/10665/3... ^, ³⁶36. Roesch E, Amin A, Gupta J, García-Moreno C. Violence against women during covid-19 pandemic restrictions. BMJ [Internet]. 2020 [cited 2020 Aug 22];369:m1712. Available from: https://doi.org/10.1136/bmj.m1712 https://doi.org/10.1136/bmj.m1712...
Cuidado continuado
Não negligenciar os cuidados relacionados à saúde e a violência contra crianças, adolescentes e mulheres;	³3. World Health Organization. Regional Office for the Western Pacific‎. Asia-Pacific Parliamentarian forum on global health ad hoc virtual meeting on COVID-19: calling for solidarity to enhance the role of parliamentarians in the COVID-19. [Internet]. Manila(PH): WHO Regional Office for the Western Pacific; 2020 [cited 2020 June 22]. Available from: https://apps.who.int/iris/handle/10665/333055 https://apps.who.int/iris/handle/10665/3... ^, ¹¹11. World Health Organization. Continuing essential Sexual Reproductive, Maternal, Neonatal, Child and Adolescent Health services during COVID-19 pandemic. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 25]. Available from: https://apps.who.int/iris/handle/10665/331816 https://apps.who.int/iris/handle/10665/3... ^, ¹³13. Mazza M, Marano G, Lai C, Janiri L, Sani G. Danger in danger: Interpersonal violence during COVID-19 quarantine. Psychiatry Res [Internet]. 2020 [cited 2020 Aug 22];289:113046. Available from: https://doi.org/10.1016/j.psychres.2020.113046 https://doi.org/10.1016/j.psychres.2020.... ^, ³¹31. Barbosa JPM, Lima RCD, Lanna SD, Andrade MAC. Intersectionality and other views on violence against women in times of pandemic by covid-19. Scielo Preprints [Internet]. 2020 [cited 2020 Aug 22];Preprint. Available from: https://doi.org/10.1590/SciELOPreprints.328 https://doi.org/10.1590/SciELOPreprints.... 32. World Health Organization. Addressing human rights as key to the COVID-19: response. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331811 https://apps.who.int/iris/handle/10665/3... 33. World Health Organization. Gender and COVID-19: advocacy brief. [Internet]. Geneva (CH): WHO ; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332080 https://apps.who.int/iris/handle/10665/3... 34. Sidpra J, Abomeli D, Hameed B, Baker J, Mankad K. Rise in the incidence of abusive head trauma during the COVID-19 pandemic. Arch Dis Child [Internet]. 2021 [cited 2020 Aug 22];106:e14. Available from: https://doi.org/10.1136/archdischild-2020-319872 https://doi.org/10.1136/archdischild-202... ^- ³⁵35. Rahman MS, Lassi ZS, Islam SMS. Risks to Bangladeshi children and young people during covid-19 outbreak. BMJ [Internet]. 2020 [cited 2020 Aug 22];369:m2299. Available from: https://doi.org/10.1136/bmj.m2299 https://doi.org/10.1136/bmj.m2299...
Classificar os serviços de assistência, proteção e prevenção à violência como essenciais;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ⁴⁸48. Ghoshal R. Twin public health emergencies: Covid-19 and domestic violence. Indian J Med Ethics [Internet]. 2020 [cited 2020 Aug 22];5(3):195-9. Available from: https://doi.org/10.20529/IJME.2020.056 https://doi.org/10.20529/IJME.2020.056... ^, ¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3... ^, ³³33. World Health Organization. Gender and COVID-19: advocacy brief. [Internet]. Geneva (CH): WHO ; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332080 https://apps.who.int/iris/handle/10665/3... ^, ⁴¹41. Ragavan MI, Culyba AJ, Muhammad FL, Miller E. Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic. J Adolesc Health [Internet]. 2020 [cited 2020 Aug 22];67(1):18-20. Available from: https://doi.org/10.1016/j.jadohealth.2020.04.011 https://doi.org/10.1016/j.jadohealth.202... ^, ⁴³43. Thorne JG, Buitendyk M, Wawuda R, Lewis B, Bernard C, Spitzer RF. The reproductive health fall-out of a global pandemic. Sex Reprod Health Matters [Internet]. 2020 [cited 2020 Aug 22];28(1). Available from: https://doi.org/10.1080/26410397.2020.1763577 https://doi.org/10.1080/26410397.2020.17... ^- ⁴⁴44. World Health Organization. WHO interim guidance note: health system response to COVID-19 in the context of internally displaced persons, refugees, migrants and returnees in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://applications.emro.who.int/docs/emcsr279e.pdf?ua=1&ua=1 https://applications.emro.who.int/docs/e... ^, ⁵⁸58. Rossi FS, Shankar M, Buckholdt K, Bailey Y, Israni ST, Iverson KM. Trying times and trying out solutions: intimate partner violence screening and support for women veterans during COVID-19. J Gen Intern Med [Internet]. 2020 [cited 2020 Aug 22];35:2728-31. Available from: https://doi.org/10.1007/s11606-020-05990-0 https://doi.org/10.1007/s11606-020-05990... ^, ⁶¹61. World Health Organization. WHO policy brief: the economic and social impact of COVID-19 in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332818 https://apps.who.int/iris/handle/10665/3... ^, ⁶³63. World Health Organization. Maintaining essential health services: operational guidance for the COVID-19 context: interim guidance [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332240 https://apps.who.int/iris/handle/10665/3...
Adotar estratégias que garantam o cuidado continuado e a segurança de crianças, adolescentes e mulheres, seja presencial ou remoto (desenvolvimento de novas plataformas digitais que possibilitem o contato e atendimento em saúde; plataformas amigáveis e acessíveis; alavancar plataformas existentes; treinamento e suporte para profissionais de saúde atuarem em plataformas digitais);	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^- ⁵5. Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health [Internet]. 2020 [cited 2020 Apr 22];14(20). Available from: https://doi.org/10.1186/s13034-020-00329-3 https://doi.org/10.1186/s13034-020-00329... ^, ⁸8. Posick C, Schueths AA, Christian C, Grubb JA, Christian SE. Child Victim Services in the Time of COVID-19: New Challenges and Innovative Solutions. Am J Crim Justice [Internet]. 2020 [cited 2020 Apr 22];14:1-10. Available from: https://doi.org/10.1007/s12103-020-09543-3 . https://doi.org/10.1007/s12103-020-09543... 9. World Health Organization. United Nations Children’s Fund (‎‎‎UNICEF)‎‎‎. Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic: interim guidance. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331975 https://apps.who.int/iris/handle/10665/3... ^- ¹⁰10. World Health Organization. Continuing essential sexual reproductive, maternal, neonatal, child and adolescent health services during COVID-19 pandemic: practical considerations. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 25]. Available from: https://apps.who.int/iris/handle/10665/332162 https://apps.who.int/iris/handle/10665/3... ^, ¹⁵15. Crawley E, Loades M, Feder G, Logan S, Redwood S, Macleod J. Wider collateral damage to children in the UK because of the social distancing measures designed to reduce the impact of COVID-19 in adults. BMJ Paediatr Open [Internet]. 2020 [cited 2020 Aug 22];4(1):e000701. Available from: https://doi.org/10.1136/bmjpo-2020-000701 https://doi.org/10.1136/bmjpo-2020-00070... ^- ¹⁶16. Sharma P, Sharma S, Singh N. COVID-19: Endangering women’s mental and reproductive health. Indian J Public Health [Internet]. 2020 [cited 2020 Aug 22];64:251-2. Available from: https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-544991 https://pesquisa.bvsalud.org/global-lite... ^, ²⁴24. Instituto de Evaluación de Tecnologías en Salud e Investigación (IETSI). Violencia de género/familiar en tiempos de cuarentena: Revicón crítica de la literatura. [Internet]. Lima (PE): ESSALUD; 2020 [cited 2020 Aug 22]. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1096342 https://pesquisa.bvsalud.org/portal/reso... ^, ³⁰30. Marques ES, Moraes CL, Hasselmann MH, Deslandes SF, Reichenheim ME. Violence against women, children, and adolescents during the COVID-19 pandemic: overview, contributing factors, and mitigating measures. Cad Saúde Pública [Internet]. 2020 [cited 2020 Aug 22];36(4):e00074420. Available from: https://doi.org/10.1590/0102-311x00074420 https://doi.org/10.1590/0102-311x0007442... ^, ³⁸38. Kaukinen C. When Stay-at-home orders leave victims unsafe at home: exploring the risk and consequences of intimate partner violence during the COVID-19 Pandemic. Am J Crim Justice [Internet]. 2020 [cited 2020 Aug 22];45:668-79. Available from: https://doi.org/10.1007/s12103-020-09533-5 https://doi.org/10.1007/s12103-020-09533... ^, ⁴¹41. Ragavan MI, Culyba AJ, Muhammad FL, Miller E. Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic. J Adolesc Health [Internet]. 2020 [cited 2020 Aug 22];67(1):18-20. Available from: https://doi.org/10.1016/j.jadohealth.2020.04.011 https://doi.org/10.1016/j.jadohealth.202... ^, ⁴⁴44. World Health Organization. WHO interim guidance note: health system response to COVID-19 in the context of internally displaced persons, refugees, migrants and returnees in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://applications.emro.who.int/docs/emcsr279e.pdf?ua=1&ua=1 https://applications.emro.who.int/docs/e... ^, ⁴⁶46. Viveiros N, Bonomi AE. Novel Coronavirus (COVID-19): Violence, reproductive rights and related health risks for women, opportunities for practice innovation. J Fam Violence [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://doi.org/10.1007/s10896-020-00169-x https://doi.org/10.1007/s10896-020-00169... ^, ⁵⁵55. John N, Casey SE, Carino G, McGovern T. Lessons never learned: crisis and gender-based violence. Developing World Bioeth [Internet]. 2020 [cited 2020 Aug 22];20:65-8. Available from: https://doi.org/10.1111/dewb.12261 https://doi.org/10.1111/dewb.12261... ^, ⁵⁸58. Rossi FS, Shankar M, Buckholdt K, Bailey Y, Israni ST, Iverson KM. Trying times and trying out solutions: intimate partner violence screening and support for women veterans during COVID-19. J Gen Intern Med [Internet]. 2020 [cited 2020 Aug 22];35:2728-31. Available from: https://doi.org/10.1007/s11606-020-05990-0 https://doi.org/10.1007/s11606-020-05990... ^, ⁶¹61. World Health Organization. WHO policy brief: the economic and social impact of COVID-19 in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332818 https://apps.who.int/iris/handle/10665/3... ^, ⁶⁴64. Froimson JR, Bryan DS, Bryan AF, Zakrison TL. COVID-19, Home Confinement, and the Fallacy of "Safest at Home”. American J Public Health [Internet]. 2020 [cited 2020 Aug 22];110:960-61. Available from: https://doi.org/10.2105/AJPH.2020.305725 https://doi.org/10.2105/AJPH.2020.305725... ^- ⁶⁵65. Davis M, Gilbar O, Padilla-Medina D. Intimate partner violence victimization and perpetration among U.S. adults during COVID-19: a brief report. MedRxiv [Internet]. 2020 [cited 2020 Aug 22];/2020.06.08.20125914. Available from: https://doi.org/10.1101/2020.06.08.20125914 https://doi.org/10.1101/2020.06.08.20125...
Promover serviços de assistência médica e social em caráter de telemedicina e aconselhamento virtual 7 dias por semana, 24h por dia;	⁴⁶46. Viveiros N, Bonomi AE. Novel Coronavirus (COVID-19): Violence, reproductive rights and related health risks for women, opportunities for practice innovation. J Fam Violence [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://doi.org/10.1007/s10896-020-00169-x https://doi.org/10.1007/s10896-020-00169...
Implementar suporte jurídico e de advocacia de maneira virtual;	⁸8. Posick C, Schueths AA, Christian C, Grubb JA, Christian SE. Child Victim Services in the Time of COVID-19: New Challenges and Innovative Solutions. Am J Crim Justice [Internet]. 2020 [cited 2020 Apr 22];14:1-10. Available from: https://doi.org/10.1007/s12103-020-09543-3 . https://doi.org/10.1007/s12103-020-09543... ^, ⁴⁶46. Viveiros N, Bonomi AE. Novel Coronavirus (COVID-19): Violence, reproductive rights and related health risks for women, opportunities for practice innovation. J Fam Violence [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://doi.org/10.1007/s10896-020-00169-x https://doi.org/10.1007/s10896-020-00169...
Fornecer linhas telefônicas gratuitas e disque-denúncias;	¹⁰10. World Health Organization. Continuing essential sexual reproductive, maternal, neonatal, child and adolescent health services during COVID-19 pandemic: practical considerations. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 25]. Available from: https://apps.who.int/iris/handle/10665/332162 https://apps.who.int/iris/handle/10665/3... ^, ¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3... ^, ²²22. World Health Organization. COVID-19 and violence against women in the Eastern Mediterranean Region [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332331 https://apps.who.int/iris/handle/10665/3... ^, ³⁸38. Kaukinen C. When Stay-at-home orders leave victims unsafe at home: exploring the risk and consequences of intimate partner violence during the COVID-19 Pandemic. Am J Crim Justice [Internet]. 2020 [cited 2020 Aug 22];45:668-79. Available from: https://doi.org/10.1007/s12103-020-09533-5 https://doi.org/10.1007/s12103-020-09533... ^, ⁴¹41. Ragavan MI, Culyba AJ, Muhammad FL, Miller E. Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic. J Adolesc Health [Internet]. 2020 [cited 2020 Aug 22];67(1):18-20. Available from: https://doi.org/10.1016/j.jadohealth.2020.04.011 https://doi.org/10.1016/j.jadohealth.202...
Identificar maneiras on-line ou por telefone para manter serviços para autores de violência;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3...
Possibilitar o acesso aos serviços de saúde reprodutiva e sexual (atenção especial ao pré-natal, planejamento reprodutivo, medicações abortivas se legalizado, e ações frente estupro) presencial ou remotamente;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ⁴³43. Thorne JG, Buitendyk M, Wawuda R, Lewis B, Bernard C, Spitzer RF. The reproductive health fall-out of a global pandemic. Sex Reprod Health Matters [Internet]. 2020 [cited 2020 Aug 22];28(1). Available from: https://doi.org/10.1080/26410397.2020.1763577 https://doi.org/10.1080/26410397.2020.17... ^- ⁴⁴44. World Health Organization. WHO interim guidance note: health system response to COVID-19 in the context of internally displaced persons, refugees, migrants and returnees in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://applications.emro.who.int/docs/emcsr279e.pdf?ua=1&ua=1 https://applications.emro.who.int/docs/e... ^, ⁵⁵55. John N, Casey SE, Carino G, McGovern T. Lessons never learned: crisis and gender-based violence. Developing World Bioeth [Internet]. 2020 [cited 2020 Aug 22];20:65-8. Available from: https://doi.org/10.1111/dewb.12261 https://doi.org/10.1111/dewb.12261... ^- ⁵⁶56. World Health Organization. Practical considerations and recommendations for religious leaders and faith-based communities in the context of COVID-19: interim guidance. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331707 https://apps.who.int/iris/handle/10665/3... ^, ⁶¹61. World Health Organization. WHO policy brief: the economic and social impact of COVID-19 in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332818 https://apps.who.int/iris/handle/10665/3...
Garantir a segurança e reduzir a exposição no atendimento remoto (padronizar o formulário de perguntas; expor que essas questões são feitas para todos; realizar perguntas que possam ser respondidas com "sim" ou "não"; avaliar expressões não verbais; disponibilizar um campo em que a mulher possa acesse, em um momento que o agressor não esteja próximo, e que a partir do preenchimento, o servidor da saúde seja avisado/alertado da situação de violência; disponibilizar serviços com mecanismos de segurança à saída rápida da página e histórico de navegação que inviabilizam o controle do agressor);	⁸8. Posick C, Schueths AA, Christian C, Grubb JA, Christian SE. Child Victim Services in the Time of COVID-19: New Challenges and Innovative Solutions. Am J Crim Justice [Internet]. 2020 [cited 2020 Apr 22];14:1-10. Available from: https://doi.org/10.1007/s12103-020-09543-3 . https://doi.org/10.1007/s12103-020-09543... ^, ⁴²42. Cohen M, Powell A, Coleman J, Keller J, Livingston A, Anderson J. Special ambulatory gynecologic considerations in the era of coronavirus disease 2019 (COVID-19) and implications for future practice. American J Obstet Gynec [Internet]. 2020 [cited 2020 Aug 22];223(3):P372-8. Available from: https://doi.org/10.1016/j.ajog.2020.06.006 https://doi.org/10.1016/j.ajog.2020.06.0... ^, ⁵⁴54. Van-Gelder N, Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, et al. COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence. EClinical Medicine [Internet]. 2020 [cited 2020 Aug 22];21:100348. Available from: https://doi.org/10.1016/j.eclinm.2020.100348 https://doi.org/10.1016/j.eclinm.2020.10... ^, ⁵⁸58. Rossi FS, Shankar M, Buckholdt K, Bailey Y, Israni ST, Iverson KM. Trying times and trying out solutions: intimate partner violence screening and support for women veterans during COVID-19. J Gen Intern Med [Internet]. 2020 [cited 2020 Aug 22];35:2728-31. Available from: https://doi.org/10.1007/s11606-020-05990-0 https://doi.org/10.1007/s11606-020-05990... ^, ⁶⁶66. Ruiz-Pérez I, Pastor-Moreno G. Medidas de contención de la violencia de género durante la pandemia de COVID-19. Gaceta Sanitaria [Internet]. 2020 [cited 2020 Aug 22];In Press. Available from: https://doi.org/10.1016/j.gaceta.2020.04.005 https://doi.org/10.1016/j.gaceta.2020.04...
Fornecer informações atualizadas sobre os caminhos e locais que estão disponíveis para promover assistência, formas seguras de buscarem auxílio e colaborar na identificação de familiares, amigos ou vizinhos que poderão ser fonte de apoio e contato às vítimas. Incluir horário de funcionamento, detalhes de contato e se os serviços podem ser oferecidos remotamente;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ⁹9. World Health Organization. United Nations Children’s Fund (‎‎‎UNICEF)‎‎‎. Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic: interim guidance. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331975 https://apps.who.int/iris/handle/10665/3... ^, ¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3... ^, ²²22. World Health Organization. COVID-19 and violence against women in the Eastern Mediterranean Region [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332331 https://apps.who.int/iris/handle/10665/3... ^, ²⁹29. Telles LEB, Valenca AM, Barros AJS, Silva AG. Domestic violence in the COVID-19 pandemic: a forensic psychiatric perspective. Braz J Psychiatry [Internet]. 2020 [cited 2020 Aug 22];In Press. Available from: https://doi.org/10.1590/1516-4446-2020-1060 https://doi.org/10.1590/1516-4446-2020-1... ^, ⁵⁴54. Van-Gelder N, Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, et al. COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence. EClinical Medicine [Internet]. 2020 [cited 2020 Aug 22];21:100348. Available from: https://doi.org/10.1016/j.eclinm.2020.100348 https://doi.org/10.1016/j.eclinm.2020.10...
Manter os prestadores de serviço e líderes comunitários informados sobre alterações nas vias de referência de cuidado às violências;	¹⁰10. World Health Organization. Continuing essential sexual reproductive, maternal, neonatal, child and adolescent health services during COVID-19 pandemic: practical considerations. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 25]. Available from: https://apps.who.int/iris/handle/10665/332162 https://apps.who.int/iris/handle/10665/3...
Os governos devem financiar os serviços assistência, proteção e prevenção da violência para que sejam acessíveis, gratuitos, sem restrição de horário e que sejam criados novos serviços nos locais em que não estão disponíveis;	¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3... ^, ²⁶26. World Health Organization. Overview of public health and social measures in the context of COVID-19: interim guidance. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332115 https://apps.who.int/iris/handle/10665/3... ^, ⁴⁴44. World Health Organization. WHO interim guidance note: health system response to COVID-19 in the context of internally displaced persons, refugees, migrants and returnees in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://applications.emro.who.int/docs/emcsr279e.pdf?ua=1&ua=1 https://applications.emro.who.int/docs/e... ^, ⁵⁴54. Van-Gelder N, Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, et al. COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence. EClinical Medicine [Internet]. 2020 [cited 2020 Aug 22];21:100348. Available from: https://doi.org/10.1016/j.eclinm.2020.100348 https://doi.org/10.1016/j.eclinm.2020.10... ^, ⁶¹61. World Health Organization. WHO policy brief: the economic and social impact of COVID-19 in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332818 https://apps.who.int/iris/handle/10665/3... ^, ⁶⁴64. Froimson JR, Bryan DS, Bryan AF, Zakrison TL. COVID-19, Home Confinement, and the Fallacy of "Safest at Home”. American J Public Health [Internet]. 2020 [cited 2020 Aug 22];110:960-61. Available from: https://doi.org/10.2105/AJPH.2020.305725 https://doi.org/10.2105/AJPH.2020.305725... ^, ⁶⁷67. Bellizzi S, Nivoli A, Lorettu L, Farina G, Ramses M, Ronzoni AR. Violence against women in Italy during the COVID-19 pandemic. Int J Gynaecol Obstet [Internet]. 2020 [cited 2020 Aug 22];150(2):258-259. Available from: https://doi.org/10.1002/ijgo.13270 https://doi.org/10.1002/ijgo.13270...
Os governos devem promover o financiamento de hotéis, pousadas, moradias, bem como utilizar os locais de tratamento de abuso de drogas para que se tornem locais de abrigo de emergência e afastamento do agressor;	¹⁵15. Crawley E, Loades M, Feder G, Logan S, Redwood S, Macleod J. Wider collateral damage to children in the UK because of the social distancing measures designed to reduce the impact of COVID-19 in adults. BMJ Paediatr Open [Internet]. 2020 [cited 2020 Aug 22];4(1):e000701. Available from: https://doi.org/10.1136/bmjpo-2020-000701 https://doi.org/10.1136/bmjpo-2020-00070... ^, ⁴¹41. Ragavan MI, Culyba AJ, Muhammad FL, Miller E. Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic. J Adolesc Health [Internet]. 2020 [cited 2020 Aug 22];67(1):18-20. Available from: https://doi.org/10.1016/j.jadohealth.2020.04.011 https://doi.org/10.1016/j.jadohealth.202... ^, ⁴⁶46. Viveiros N, Bonomi AE. Novel Coronavirus (COVID-19): Violence, reproductive rights and related health risks for women, opportunities for practice innovation. J Fam Violence [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://doi.org/10.1007/s10896-020-00169-x https://doi.org/10.1007/s10896-020-00169... ^, ⁶⁸68. Day CA, White N. Gender-Specific Online Content Is Important and Timely for Women Receiving Treatment for Substance Use Disorders. J Women’s Health [Internet]. 2020 [cited 2020 Aug 22];29(5):605-06. Available from: https://doi.org/10.1089/jwh.2020.8496 https://doi.org/10.1089/jwh.2020.8496...
Manter contato frequente com a mulher e a família após o fim do isolamento social pelos serviços de proteção.	³⁸38. Kaukinen C. When Stay-at-home orders leave victims unsafe at home: exploring the risk and consequences of intimate partner violence during the COVID-19 Pandemic. Am J Crim Justice [Internet]. 2020 [cited 2020 Aug 22];45:668-79. Available from: https://doi.org/10.1007/s12103-020-09533-5 https://doi.org/10.1007/s12103-020-09533...
Cuidado à segurança e saúde mental dos profissionais
Avaliar física e mentalmente, e garantir cuidado e suporte emocional aos profissionais da saúde e da comunidade envolvidos com o cuidado e enfrentamento à violência durante a pandemia, com o cuidado da gestação e maternidade, e respondentes nas linhas de frente;	¹⁰10. World Health Organization. Continuing essential sexual reproductive, maternal, neonatal, child and adolescent health services during COVID-19 pandemic: practical considerations. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 25]. Available from: https://apps.who.int/iris/handle/10665/332162 https://apps.who.int/iris/handle/10665/3... ^, ⁴¹41. Ragavan MI, Culyba AJ, Muhammad FL, Miller E. Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic. J Adolesc Health [Internet]. 2020 [cited 2020 Aug 22];67(1):18-20. Available from: https://doi.org/10.1016/j.jadohealth.2020.04.011 https://doi.org/10.1016/j.jadohealth.202... ^, ⁵⁴54. Van-Gelder N, Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, et al. COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence. EClinical Medicine [Internet]. 2020 [cited 2020 Aug 22];21:100348. Available from: https://doi.org/10.1016/j.eclinm.2020.100348 https://doi.org/10.1016/j.eclinm.2020.10... ^, ⁶⁹69. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Aug 22];29(13-14):2047-49. Available from: https://doi.org/10.1111/jocn.15296 https://doi.org/10.1111/jocn.15296...
Priorizar cuidado a longo prazo desses profissionais;	³⁹39. World Health Organization. Strengthening the health systems response to COVID-19: technical guidance: preventing and managing the COVID-19. [Internet]. Geneva (CH): World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/333067 https://apps.who.int/iris/handle/10665/3...
Promover planos de autocuidado e incentivar que os profissionais se reúnam em grupos de apoio periódicos;	⁴¹41. Ragavan MI, Culyba AJ, Muhammad FL, Miller E. Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic. J Adolesc Health [Internet]. 2020 [cited 2020 Aug 22];67(1):18-20. Available from: https://doi.org/10.1016/j.jadohealth.2020.04.011 https://doi.org/10.1016/j.jadohealth.202...
Aumentar o suporte à família dos cuidadores da saúde. Incrementar vigilância e monitoramento dessas famílias e dos profissionais da saúde a longo prazo;	³⁹39. World Health Organization. Strengthening the health systems response to COVID-19: technical guidance: preventing and managing the COVID-19. [Internet]. Geneva (CH): World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/333067 https://apps.who.int/iris/handle/10665/3...
Reduzir estresse de profissionais - rodízios entre funções; associação de trabalhadores experientes e não; implementar horários flexíveis, em especial, para os trabalhadores diretamente afetados ou que tenham um membro da família afetado por um evento estressante;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ⁴¹41. Ragavan MI, Culyba AJ, Muhammad FL, Miller E. Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic. J Adolesc Health [Internet]. 2020 [cited 2020 Aug 22];67(1):18-20. Available from: https://doi.org/10.1016/j.jadohealth.2020.04.011 https://doi.org/10.1016/j.jadohealth.202...
Promover e capacitar continuamente os profissionais;	¹⁰10. World Health Organization. Continuing essential sexual reproductive, maternal, neonatal, child and adolescent health services during COVID-19 pandemic: practical considerations. [Internet]. Geneva (CH): WHO ; ‎2020 [cited 2020 Aug 25]. Available from: https://apps.who.int/iris/handle/10665/332162 https://apps.who.int/iris/handle/10665/3... ^, ²⁸28. Vieira PR, Garcia LP, Maciel ELN. The increase in domestic violence during the social isolation: what does it reveals? Rev Bras Epidemiol [Internet]. 2020 [cited 2020 Aug 22];23:e200033. Available from: https://doi.org/10.1590/1980-549720200033 . https://doi.org/10.1590/1980-54972020003... ^, ⁴⁸48. Ghoshal R. Twin public health emergencies: Covid-19 and domestic violence. Indian J Med Ethics [Internet]. 2020 [cited 2020 Aug 22];5(3):195-9. Available from: https://doi.org/10.20529/IJME.2020.056 https://doi.org/10.20529/IJME.2020.056... ^, ⁶¹61. World Health Organization. WHO policy brief: the economic and social impact of COVID-19 in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332818 https://apps.who.int/iris/handle/10665/3...
Garantir equipamentos de proteção individual para os profissionais de saúde, comunidade, advogados e especialistas em violência;	⁴¹41. Ragavan MI, Culyba AJ, Muhammad FL, Miller E. Supporting adolescents and young adults exposed to or experiencing violence during the COVID-19 pandemic. J Adolesc Health [Internet]. 2020 [cited 2020 Aug 22];67(1):18-20. Available from: https://doi.org/10.1016/j.jadohealth.2020.04.011 https://doi.org/10.1016/j.jadohealth.202...
Os gestores devem implementar planos para lidar com a segurança e saúde dos trabalhadores;	¹⁴14. World Health Organization. COVID-19 and violence against women: what the health sector/system can do. [Internet]. Europe: World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/331699 https://apps.who.int/iris/handle/10665/3...
Os gestores devem mostrar apreço pela equipe pelo comprometimento e capacidade de continuar a fornecer o nível de serviço necessário.	⁸8. Posick C, Schueths AA, Christian C, Grubb JA, Christian SE. Child Victim Services in the Time of COVID-19: New Challenges and Innovative Solutions. Am J Crim Justice [Internet]. 2020 [cited 2020 Apr 22];14:1-10. Available from: https://doi.org/10.1007/s12103-020-09543-3 . https://doi.org/10.1007/s12103-020-09543...
Intersetorialidade/Interdisciplinaridade
Realizar as ações voltadas para o cuidado e prevenção da violência em equipes interdisciplinares. Pensar o cuidado intersetorial, unindo setores como saúde, educação, justiça, mídia e organizações não governamentais;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ¹³13. Mazza M, Marano G, Lai C, Janiri L, Sani G. Danger in danger: Interpersonal violence during COVID-19 quarantine. Psychiatry Res [Internet]. 2020 [cited 2020 Aug 22];289:113046. Available from: https://doi.org/10.1016/j.psychres.2020.113046 https://doi.org/10.1016/j.psychres.2020.... ^, ⁴⁶46. Viveiros N, Bonomi AE. Novel Coronavirus (COVID-19): Violence, reproductive rights and related health risks for women, opportunities for practice innovation. J Fam Violence [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://doi.org/10.1007/s10896-020-00169-x https://doi.org/10.1007/s10896-020-00169... ^, ⁷⁰70. Bryant DJ, Oo M, Damian AJ. The rise of adverse childhood experiences during the COVID-19 pandemic. Psychological trauma: Theory Res Pract Policy [Internet]. 2020 [cited 2020 Aug 22];12(1):193-94. Available from: https://doi.org/10.1037/tra0000711 https://doi.org/10.1037/tra0000711...
Cuidado especial a populações vulneráveis
Manter atenção e cuidados especiais para crianças e adolescentes com deficiências, problemas crônicos e em situação de pobreza, discriminação ou conflito, marginalizados durante e após a pandemia;	⁴⁵45. Raman S, Harries M, Nathawad R, Kyeremateng R, Seth R, Lonne B. Where do we go from here? A child rights-based response to COVID-19. BMJ Paediatrics Open [Internet]. 2020 [cited 2020 Aug 22];4(1):e000714. Available from: https://doi.org/10.1136/bmjpo-2020-000714 https://doi.org/10.1136/bmjpo-2020-00071...
Minimizar os riscos com políticas que garantam emprego, assistência médica e apoio econômico às famílias desfavorecidas;	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^, ¹⁵15. Crawley E, Loades M, Feder G, Logan S, Redwood S, Macleod J. Wider collateral damage to children in the UK because of the social distancing measures designed to reduce the impact of COVID-19 in adults. BMJ Paediatr Open [Internet]. 2020 [cited 2020 Aug 22];4(1):e000701. Available from: https://doi.org/10.1136/bmjpo-2020-000701 https://doi.org/10.1136/bmjpo-2020-00070... ^- ¹⁶16. Sharma P, Sharma S, Singh N. COVID-19: Endangering women’s mental and reproductive health. Indian J Public Health [Internet]. 2020 [cited 2020 Aug 22];64:251-2. Available from: https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-544991 https://pesquisa.bvsalud.org/global-lite... ^, ⁴⁰40. Cuartas J. Heightened risk of child maltreatment amid the COVID-19 pandemic can exacerbate mental health problems for the next generation. Psychological Trauma: Theo Res Pract Policy [Internet]. 2020 [cited 2020 Aug 22];12(S1):195-6. Available from: https://doi.org/10.1037/tra0000597 https://doi.org/10.1037/tra0000597... ^, ⁵⁴54. Van-Gelder N, Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, et al. COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence. EClinical Medicine [Internet]. 2020 [cited 2020 Aug 22];21:100348. Available from: https://doi.org/10.1016/j.eclinm.2020.100348 https://doi.org/10.1016/j.eclinm.2020.10...
Remover taxas de serviços àquelas mulheres desfavorecidas e disponibilizar acesso à internet de alta velocidade.	⁴4. World Health Organization. Addressing violence against children, women and older people during the COVID-19 pandemic: key actions, 17 June 2020. [Internet]. Geneva (CH): WHO; ‎2020 [cited 2020 June 22]‎. Available from: https://apps.who.int/iris/handle/10665/332458 https://apps.who.int/iris/handle/10665/3... ^- ⁵5. Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health [Internet]. 2020 [cited 2020 Apr 22];14(20). Available from: https://doi.org/10.1186/s13034-020-00329-3 https://doi.org/10.1186/s13034-020-00329... ^, ¹⁶16. Sharma P, Sharma S, Singh N. COVID-19: Endangering women’s mental and reproductive health. Indian J Public Health [Internet]. 2020 [cited 2020 Aug 22];64:251-2. Available from: https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-544991 https://pesquisa.bvsalud.org/global-lite... ^, ³⁹39. World Health Organization. Strengthening the health systems response to COVID-19: technical guidance: preventing and managing the COVID-19. [Internet]. Geneva (CH): World Health Organization; 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/333067 https://apps.who.int/iris/handle/10665/3... ^, ⁴⁴44. World Health Organization. WHO interim guidance note: health system response to COVID-19 in the context of internally displaced persons, refugees, migrants and returnees in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://applications.emro.who.int/docs/emcsr279e.pdf?ua=1&ua=1 https://applications.emro.who.int/docs/e... ^, ⁵⁸58. Rossi FS, Shankar M, Buckholdt K, Bailey Y, Israni ST, Iverson KM. Trying times and trying out solutions: intimate partner violence screening and support for women veterans during COVID-19. J Gen Intern Med [Internet]. 2020 [cited 2020 Aug 22];35:2728-31. Available from: https://doi.org/10.1007/s11606-020-05990-0 https://doi.org/10.1007/s11606-020-05990... ^, ⁶¹61. World Health Organization. WHO policy brief: the economic and social impact of COVID-19 in the Eastern Mediterranean Region. [Internet]. 2020 [cited 2020 Aug 22]. Available from: https://apps.who.int/iris/handle/10665/332818 https://apps.who.int/iris/handle/10665/3... ^, ⁶⁴64. Froimson JR, Bryan DS, Bryan AF, Zakrison TL. COVID-19, Home Confinement, and the Fallacy of "Safest at Home”. American J Public Health [Internet]. 2020 [cited 2020 Aug 22];110:960-61. Available from: https://doi.org/10.2105/AJPH.2020.305725 https://doi.org/10.2105/AJPH.2020.305725... ^, ⁷¹71. Joska JA, Andersen L, Rabie S, Marais A, Ndwandwa E, Wilson P, et al. COVID-19: increased risk to the mental health and safety of women living with HIV in South Africa. AIDS Behav [Internet]. 2020 [cited 2020 Aug 22];24:2751-3. Available from: https://doi.org/10.1007/s10461-020-02897-z https://doi.org/10.1007/s10461-020-02897...

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[1] AUTOR CORRESPONDENTE
Nayara Girardi Baraldi nayyzinha@usp.br