Factors Affecting Violence Against Women during the COVID-19 Pandemic: A Systematic Review

Violence against women is one of the human rights solutions which tends to increase during the COVID-19 pandemic. Various factors increase the incidence of violence against women. This systematic literature review aims to identify the factors that influence the increase in incidence in women. Study literature on the Science Direct, Pubmed, Cinahl, EBSCO host and Cochrane Library databases. The research design set on this systematic review is cross sectional, RCT and review studies in 20192020. The initial search resulted in 313 articles and total of 5 articles were included in this systematic literature study through the PRISMA procedure and the Robvis bias assessment.The factors that influence the increase in the number of violence against women are personal factors, relationships, community and societal context.


INTRODUCTION
Violence against women is a common violation of human rights in which every country has cases of such violations. Women can experience violence in the form of physical, psychological, verbal and sexual violence (Nilan et al., 2014). Local culture or cultural context related to gender inequality between men and women affects the phenomenon of rampant violence against women (Hayati, 2013;Nilan et al., 2014). The condition of women's economic dependence on men is one of the highest triggers for violence against partners (Buntin, 2015;Fulu, 2018). There are many forms of violence including violence by an intimate partner, sexual assault, rape and other forms of sexual violence perpetrated by someone other than a partner, forced prostitution, trafficking of women and child sexual abuse (Fulu, 2018;Hayati, 2013;Nilan et al., 2014).
The incidence of violence against women in Indonesia is relatively increasing every year (Hayati, 2013;WHO, 2012). Various organizations such as government funded organizations, namely Komnas Perempuan and non-governmental organizations (NGOs) such as Rifka Annisa in Yogyakarta, specifically focus on highlighting cases of violence against women in Indonesia (Hayati, 2013). Every country in the world highlights cases of violence against women because the effects are very dangerous. Violence against women can cause physical and psychological injuries, such as mental disorders, decreased quality of life and death (Anne Bogat et al., 2016;Elghossain et al., 2019;WHO, 2011WHO, , 2012. The COVID-19 pandemic is still at the center of global attention (Perez-Vincent et al., 2020;Setiati & Azwar, 2020;Sharma et al., 2020). The increase in the number of people with COVID-19 every day will certainly cause anxiety even though the governments of each country have established policies that are preventive, curative and rehabilitative (Oguntayo et al., 2020). One of the policies set is the lockdown or work from home policy which aims to reduce contact with crowds and prevent air transmission from the COVID-19 (Fontanesi Daniela;Mazza, Cristina;Di Giandomenico, Serena;Roma, Paolo;Verrocchio, Maria Cristina, 2020).
Several studies have shown that lockdown and work from home policies affect the dynamics in families, especially families with middle and low socioeconomics such as decreased family income, increased stress and are more prone to anger. (Evans, 2020;Fontanesi Daniela;Mazza, Cristina;Di Giandomenico, Serena;Roma, Paolo;Verrocchio, Maria Cristina, 2020;Oguntayo et al., 2020). Fear, anxiety and psychological distress due to prolonged territorial restrictions, closure of schools for children, economic strain and conditions of vulnerability to viruses or uncertainty about life have dramatic effects. The psychological distress resulted in violent behavior in which most of the victims were women (Fontanesi Daniela;Mazza, Cristina;Di Giandomenico, Serena;Roma, Paolo;Verrocchio, Maria Cristina, 2020;Hamadani et al., 2020;Oguntayo et al., 2020). Cases of violence against women have also increased. This is influenced by several factors, such as personal and community factors (Perez-Vincent et al., 2020;Sharma et al., 2020). This systematic review study aims to identify the factors that influence the increase in the incidence of violence against women during the COVID-19 pandemic.

METHODS
This study is a systematic review. This study uses a procedure recommended in Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). PRISMA focuses on ways in which authors can ensure the transparent and complete reporting of articles (Liberati et al., 2009)

Inclusion Criteria
The inclusion criteria are specified in the selection of research articles as follows.
(1) Type of research. The research type consists of RCT, quasi experimental, cross sectional, systematic review, and qualitative research.
(2) Type of participants/respondents. The population in this systematic review study is women who have experienced physical violence during the COVID-19 pandemic. (3) The outcome of article selected in this study is factors affecting an increase in the number of cases of violence against women during the COVID-19 pandemic.

Exclusion Criteria
Research with respondents of women who have experienced violence during the COVID-19 pandemic who have mental disorders.

Searching literature
The articles are traced from several electronic databases namely Science Direct, PubMed, Cochrane Library, Ebsco, and CINAHL. The articles are limited to the year 2019-2020. The terminology used to do a search is 'factors', 'violence', 'women', 'pandemic COVID-19'. Language is limited to studies in English.

Critical Appraisal and Risk of Bias Assessment
Research criticism was carried out on nine selected articles using The Critical Appraisal Skills Program (CSAP). The research critique analysis method using the CASP instrument was carried out based on each research design. A total of three articles with narrative and integrative review designs were analyzed with CSAP for review type research. One research article with cross sectional research designs were analyzed by using CSAP for cross sectional study. An research article with RCT research designs were analyzed by using CSAP for RCT study.
Five articles were analyzed through data extraction. Variables acquired through data extraction were: authors name(s), year of study and publication, intervention method, and study findings. All the items were included in the table of data extraction. We used the free software called the Risk-of-bias VISualization (robvis) to visualizing risk-of-bias assessments (McGuinness & Higgins, 2020). The results of bias assessed are shown in Figure 2.

RESULT
The characteristics of the selected studies are outlined in Table 1. We developed a table from five articles selected for this study. Figure 1 shows the flow of article selection using the PRISMA procedure. Figure 2 shows the results of biased selection for each selected article using Robvis software. A community-based cross-sectional study to 682 participants. The data were collected during theperiod of April to May2020 using interviews and a selfadministered standard questionnaire.

Figure 1. Result of a Systematic Search in Databases
Some of the factors that influence the high rate of violence against women during the COVID-19 pandemic are husbands' level of education, women being a housewife, and marrying with arranged marriage.

DISCUSSION
Selected articles in this study show that the condition of economic instability during a pandemic is one of the factors that triggers stress in the family that causes high levels of violence against women by intimate partners or called intimate partner violence (da Silva et al., 2020;Gebrewahd et al., 2020;Hamadani et al., 2020;Moreira & da Costa, 2020;Sánchez et al., 2020). This makes the husband experience stress and feel helpless and express these feelings through rude attitudes and / or hurt his wife. These factors are grouped into personal (individual) factors, relationship, community and social factors (da Silva et al., 2020;Gebrewahd et al., 2020;Hamadani et al., 2020;Moreira & da Costa, 2020;Sánchez et al., 2020).
Personal factors that influence the high level of violence against women are stress, anxiety, depression, and mental health issues. Besides that, loss of job and decreased income, financial problems, abuse of alcohol and substance. Fear of catching COVID-19 and feelings of uncertainty are linked to transmission of the virus. The home school policy for children makes child care responsibilities and stress increases (da Silva et al., 2020;Gebrewahd et al., 2020;Hamadani et al., 2020;Moreira & da Costa, 2020).
Relationship factors that influence the high rate of violence against women during a pandemic are dependence on partners, increased controlling behavior, tense situations in the family, lack of assertive communication and fatigue. In addition, the decrease in social contacts and support around. Community factors also influence the high rate of violence against women, namely the difficulty of accessing social support and the difficulty of accessing sexual reproductive health services (da Silva et al., 2020;Gebrewahd et al., 2020;Hamadani et al., 2020;Moreira & da Costa, 2020;Sánchez et al., 2020).
Societal factors that affect the high rate of violence against women during a pandemic are various policies related to crises in the health, economy and social crises. Restrictions on activities or difficulty in accessing normal activities in the community. Lack of implementation of firm policies related to issues of violence against women (da Silva et al., 2020;Gebrewahd et al., 2020;Moreira & da Costa, 2020;Sánchez et al., 2020).
The factors that influence the high rate of violence against women can then be overcome by knowing the preventive interventions that can be pursued. The New Normal era, which currently continues to coexist with the COVID 19 pandemic case with fluctuative numbers, is an urgent matter that needs attention (Evans, 2020;Oguntayo et al., 2020). In addition, the existing policy on sanctions against perpetrators of violence against women also needs to be assessed for its application. Furthermore, women also have the right to know the protection rights inherent in themselves so that they do not hesitate to disclose if they find themselves injured to report immediately and get immediate protection.

CONCLUSION
The COVID-19 pandemic has an impact on various sectors such as the health sector, socioeconomics which are one of the predictors of an increase in violence against women. Increased stress is mainly due to decreased income, especially in low and middle socioeconomic families, accompanying school activities from home as well as personal, community, societal and relationship context factors that affect the high level of violence against women. Therefore, further research is needed related to stress prevention interventions or stress management to prevent an increase in violence against women, especially during this pandemic, the time limit of which cannot be predicted.