About

Francis Barchi, Ph.D., is an associate professor at the Edward J. Bloustein School of Public Policy and a core member of the Rutgers Global Health Institute. Her work focuses on ethical issues in global health, with particular attention to the individual, household, and community factors that influence women’s and girls' health and well-being in sub-Saharan Africa. Her research interests include violence against women and children, sexual and reproductive health, capacity-building in research ethics education in low- and middle-income countries, and ethical issues in international research. Dr. Barchi is a committed educator who teaches at undergraduate, graduate, and post-graduate levels both at Rutgers and internationally, utilizing case-based and active learning techniques to teach topics such as global health, health & human rights, and biomedical ethics.

Research topics

• Medicine
• Environmental health
• Psychology
• Demography
• Family medicine
• Sociology
• Developmental psychology
• Nursing
• Clinical psychology
• Gender studies
• Social psychology

Selected publications

• Healthcare Workers’ Views on Approaches to Discussing Alternative Treatment Options in Multidisciplinary Cancer Care

  Cureus · 2026-01-29

  articleOpen access

  Purpose Information about curative treatment options with comparable efficacy (e.g. surgery or radiation) is often not fully provided to patients when those options fall outside the scope of practice of the oncologist(s) who directly see a patient. This study evaluates healthcare workers’ views on the acceptability of this approach compared to others. Methods An electronic survey was sent to all physicians, trainees, nurses, therapists, researchers, and administrators at a cancer center. Respondents were asked to imagine being diagnosed with a potentially life-threatening illness that can be treated and cured in two standard ways, with similar efficacy but different side-effect profiles and impact on short- and long-term quality-of-life (Procedure A performed by Doctor A; Procedure B performed by Doctor B). Likert-type scales ranging from one (completely unacceptable) to five (completely acceptable) assessed Doctor A’s approach to discussing treatment options in each scenario. Results In this study, 266 individuals responded to the questionnaire (response rate 16%). The mean (standard deviation) Likert-type score was 1.58 (±0.93) for Approach #1 where Doctor A only presents Procedure A; 1.75 (±0.98) for Approach #2 where Doctor A presents both options but favors Procedure A; 2.54 (±1.35) for Approach #3 where Doctor A presents both options but favors Procedure A despite offering a referral to Doctor B to discuss Procedure B; and 4.75 (±0.76) for Approach #4 where Doctor A routinely refers all patients to Doctor B so each treatment option is discussed with the physician who performs each. Each of these differences were statistically significant (p<0.01). Conclusion A balanced, multidisciplinary approach to discussing treatment options is strongly favored by a variety of sampled healthcare workers. This is consistent with improving quality of healthcare delivery and patients' experience.

  PublisherOA PDFDOI

• Withdrawal From the Civil Court Protection Process by Female Survivors of Domestic Violence: A Scoping Review of the Literature

  Trauma Violence & Abuse · 2025-12-18

  reviewOpen access1st author

  In many countries, protection orders are the civil court system's primary response to domestic violence. While there is significant evidence as to their effectiveness, as many as half of all temporary protection orders are withdrawn or dismissed before being finalized, with limited empirical research as to why. As the first step in a multi-phased research-community partnership to improve a counseling and service program for survivors of domestic violence in South Africa, we undertook a systematic review of the literature to identify what is known about why some female survivors finalize protection orders and others do not. Using a keyword search strategy in academic databases, we included peer-reviewed studies published from January 2004 to June 2024 that focused on case attrition and the factors associated with retention and/or withdrawal. Of the eight studies that met the eligibility criteria, six reported findings from the United States, one from Ecuador, and one from South Africa. Key reasons for attrition were emotional attachment, concerns for children, perceived behavior change in partner, fear of retaliation, challenges in the court processes, default at hearing, financial dependence, gender stereotypes, and lack of opportunities for economic independence. Most of the data supporting these findings were more than a decade old. Without more contemporary research on why female survivors remain in or exit protective order processes, communities may miss opportunities for intervention to reduce personal, procedural, and structural impediments to safety.

  PublisherDOI

• Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis

  BMC Public Health · 2025-02-05 · 1 citations

  articleOpen accessSenior author

  BACKGROUND: Research examining young people's healthcare-seeking behaviors in Sub-Saharan Africa has largely focused on university or out-of-school youth who are sexually active and/or HIV-positive. Healthcare-seeking behavior in younger adolescents has been less well studied even though it is during secondary school years that the majority of adolescents become sexually active. There is limited evidence to guide strategies that schools, health facilities, and social service agencies use to encourage adolescents to utilize sexual and reproductive health resources prior to sexual debut. METHODS: This study used cross-sectional data collected in 2021 during school hours from eleven secondary schools in the Northwest District of Botswana. Adolescents ages 14-19 years completed surveys using hand-held tablets. Descriptive statistics were run for all variables; bivariate analyses examined their association with skipped visits. Logistic regression identified correlates of forgone visits. The outcome variable of interest was whether a respondent had ever forgone a visit to a health clinic for sexual and reproductive health information or services. RESULTS: 553 adolescents, provided information used for analysis. One fifth of respondents had had sexual intercourse (21%). Most had not been tested for HIV (54%), did not know their HIV status (60%), or had not had an STI other than HIV (92%). Teachers (31%) and female family members (31%) were the most frequently consulted sources on bodily changes during adolescence. In the bivariate analysis, age, gender, sexual experience, HIV testing, awareness of HIV status, and having had an STI were significantly associated with forgone visits. At the multivariate level, younger respondents and those who had never been tested for HIV or had an STI had lower odds of forgone visits compared to their older peers and those who had been tested or had an STI. The most common reasons for forgoing visits reflected perceptions that nurses were unfriendly and did not believe adolescents should have sex. Students identified logistical barriers, including not knowing where to go, long distances to services, and limited operating hours. CONCLUSIONS: While logistical barriers might be easily addressed, perceived barriers, including negative staff attitudes and behaviors towards adolescents, require concerted and collaborative efforts by educators, health professionals, and policy makers to change.

  PublisherOA PDFDOI

• Developing an Evidence-Based Ethics Education Program for Surgical Residents in Guatemala

  Journal of Medical Education and Curricular Development · 2024-01-01 · 1 citations

  articleOpen accessSenior authorCorresponding

  OBJECTIVE This study assessed 2 modalities for teaching responsible conduct of research and human subjects protection (RCR/HSP) to surgical residents in Guatemala—an “off the shelf” online curriculum and a new in-person curriculum specific to the local context. METHODS In 2018, 160 surgical residents in 3 large urban hospitals in Guatemala City completed 2 online programs in RCR/HSP. Residents in the intervention arm also completed 7 weeks of in-person training. Pre- and post-assessments tested awareness of key concepts with particular attention to international and Guatemalan research regulations. Group differences in matched (pre- and post-) mean scores were analyzed using t-tests. RESULTS One hundred forty residents completed pre- and post-training assessments and were included in the analytic sample. Overall mean scores improved modestly from 52.7 to 58.7 points out of 100. Intervention-arm trainees reported greater confidence in recognizing ethical issues, understanding legal and ethical requirements for research, and identifying, reporting and avoiding scientific misconduct than control-arm trainees. CONCLUSION Given the limited availability of RCR/HSP faculty, financial resources, and time in the surgical training schedule, the investigators recommend that academic authorities in Guatemala consider online training programs in RCR/HSP in all surgical residency programs as an affordable and scalable strategy to build ethical research skills in its surgical workforce. Investment in human resources to support in-person ethics education as a way to build self-efficacy in ethical decision-making should be considered.

  PublisherDOI

• Violence Against Children in Sub-Saharan Africa: A Scoping Review of Literature on the Victim–Perpetrator Relationship

  Trauma Violence & Abuse · 2024-10-31 · 6 citations

  reviewOpen access1st author

  Violence against children affects children in every region, nation, and community in the world. Despite a significant body of literature about the victims of such violence, there has been little empirical research, particularly in Sub-Saharan Africa, focused on perpetrators, their relationship to victims, and interventions that might alter their behavior. This scoping review sought to identify and summarize the scholarly literature on perpetrators of violence against children in Sub-Saharan Africa and their relationship with victims. Using a keyword search of academic databases, we included peer-reviewed studies published from January 2013 to June 2023 that focused on physical, sexual, or emotional violence against children in Sub-Saharan Africa and included prevalence data about victim-perpetrator relationships. Eighteen of the 42 studies that met eligibility criteria shared one or more primary data sources with other studies included in this review, most frequently using data from Violence Against Children Surveys (10), the Uganda Good Schools Project (7), and the National Child Homicide Study (3). The most common classifications of perpetrators, in order of frequency, were caregivers/family members, intimate partners, peers, teachers/school staff and strangers, and the most common settings in which research took place were schools. Wide variability in the taxonomies used to define and report frequencies for age, victim, perpetrator, and type of violence obscures our ability to form a complete picture of victim-perpetrator relationships. Research emphasis on victims of violence may lead to missed opportunities to disrupt the perpetration of violence against children through interventions that specifically target its source.

  PublisherOA PDFDOI

• “It Is Like Medicine”: Using Sports to Promote Adult Women’s Health in Rural Kenya

  International Journal of Environmental Research and Public Health · 2021-02-27

  articleOpen access1st authorCorresponding

  Despite the well-documented health benefits of recreational sports, few opportunities exist in lower- and middle-income countries for adult women to participate in recreational physical activities. An explanatory sequential mixed methods approach was used to explore associations between an innovative soccer program for adult women and self-reported health status. Cross-sectional survey data were collected in 2018-2019 from 702 women in the Nikumbuke Project, a health and literacy program in southeastern rural Kenya, followed by focus group discussions with 225 women who also participated in the Project's soccer program. Quantitative findings suggest that women who participated in soccer had 67% greater odds of reporting good or excellent health than their non-soccer playing peers. Thematic analysis of qualitative data indicated that women credited soccer with less pain, fatigue, and stress, as well as weight loss and reduced dependence on medicine for hypertension, pain, and sleep problems. Women equated health benefits with greater ease and efficiency in completing chores, reduced worries, youthful energy, male-like strength, and pleased husbands. Soccer programs for adult women may be particularly effective interventions in settings where access to health care is limited and where lack of opportunity to engage in physical aerobic activity increases women's risks for poor health outcomes.

  PublisherOA PDFDOI

• Social and Behavioral Correlates of Adolescent Sexual Experience and Intention to Use Condoms in Northwestern Botswana

  International Journal of Environmental Research and Public Health · 2021 · 7 citations

  1st authorCorresponding
  • Psychology
  • Developmental psychology
  • Demography

  Adolescent sexual behavior is shaped by individual, social, and structural factors that can increase HIV-risk, unwanted pregnancy, and sexually transmitted disease. To inform the development of a comprehensive sexuality education program, 239 secondary school adolescents ages 14-19 in Maun, Botswana, completed a survey of sexual and reproductive health knowledge, attitudes, and behaviors in February-March 2020. Bivariate and multivariate analyses examined factors associated with sexual experience and perceived ability to insist on condoms. Approximately 21% of respondents reported having had sexual intercourse. More than half felt able to insist on condoms. Sources of information about human reproduction, alcohol use, attitudes about when sex is acceptable, and perceived sexual activity by one's peers were predictive of sexual experience. Age, confidence in correct condom use, perceived acceptability of adolescent sex with condoms, and endorsement of prevailing gender norms were significantly associated with perceived ability to insist on condom use.

  PublisherOA PDFDOI

• "It is Like Medicine": Using Sports to Promote Adult Women's Health in Rural Kenya

  Preprints.org · 2021-02-01

  preprintOpen access1st authorCorresponding

  Despite the well-documented health benefits of recreational sports, few opportunities exist in lower- and middle-income countries for adult women to participate in recreational physical activities. An explanatory sequential mixed methods approach was used to explore associations between an innovative soccer program for adult women and self-reported health status. Cross-sectional survey data were collected in 2018-2019 from 702 women in the Nikumbuke Project, a health and literacy program in southeastern rural Kenya, followed by focus group discussions with 225 women who also participated in the Project's soccer program. Quantitative findings suggest that women who participated in soccer had 67% greater odds of reporting good or excellent health than their non-soccer playing peers. Thematic analysis of qualitative data indicated that women credited soccer with less pain, fatigue, and stress, as well as weight loss and reduced dependence on medicine for hypertension, pain, and sleep problems. Women equated health benefits with greater ease and efficiency in completing chores, reduced worries, youthful energy, male-like strength, and pleased husbands. Soccer programs for adult women may be particularly effective interventions in settings where access to health care is limited and where lack of opportunity to engage in physical aerobic activity increases women's risks for poor health outcomes. .

  PublisherOA PDFDOI

• Contraceptive literacy among school‐going adolescents in Botswana

  International Nursing Review · 2021 · 17 citations

  1st authorCorresponding
  • Medicine
  • Family medicine
  • Nursing

  AIM: To examine adolescent contraceptive literacy and condom knowledge in Botswana. BACKGROUND: In Botswana, adolescent HIV infection rates remain high and unintended pregnancies are the predominant reason girls drop out of school. Despite a national mandate for comprehensive sexuality education and youth-friendly health services, access to accurate sexual and reproductive health information for adolescents remains limited. METHODS: Two hundred forty adolescents attending secondary schools in Maun, Botswana, completed cross-sectional surveys in 2020. Bivariate and logistic regression examined factors associated with contraceptive literacy and self-reported condom knowledge. FINDINGS: Although 90% of students were aware of one or more forms of contraception, only 67% could name a method for which they knew a source and only half of sexually active respondents had used birth control during their last sexual experience. Respondents reported that teachers and family members were the most important sources of information; only 8.2% of respondents identified health professionals in that role. Adolescents who consulted nurses had eight times greater odds of reporting correct condom-use knowledge than those who consulted teachers. IMPLICATIONS FOR NURSING POLICY: The positive association between adolescents' condom-use knowledge and nurses as information resources supports a call to expand nurses' role in health education in secondary schools and clinics in Botswana. Education and training programs for health professionals that build communication skills for working with adolescents should be promoted as an essential step in youth-friendly service provision. CONCLUSION: Contraceptive literacy among adolescents in Botswana is low and may contribute to risk behaviors that drive rates of HIV and pregnancies in this population. Interventions to reduce adolescent HIV risk behaviors and unintended pregnancy may prove more effective if they involve nurses as communicators and educators.

  PublisherOA PDFDOI

• Exploring the Relationship Between Participation in an Adult-women’s Soccer League and Intimate Partner Violence in Rural Kenya

  Journal of Interpersonal Violence · 2020 · 8 citations

  1st authorCorresponding
  • Sociology
  • Demography
  • Medicine

  Rates of intimate partner violence (IPV) against women in Sub-Saharan Africa are among the highest of any region in the world. Empirical studies on the effectiveness of IPV-prevention programs in Africa, though few, suggest that successful programs have emphasized community-level engagement and attitudinal change around gender roles. This study explored the relationship between adult women's participation in an all-women's soccer league and IPV in rural Kenya. Nikumbuke Project is a health- and literacy-based program for 702 women in Kwale County, Kenya, that also hosts a women's soccer league. A total of 684 Nikumbuke members completed surveys for this study, 543 of whom identified as having had a partner in the preceding 12 months and were included in this analysis. Participants in the study were, on average, in their late 30s, married with 4-6 children, a primary education or less, and no source of formal employment. Logistic regression models examined the association between a woman's participation in the soccer league and the odds that she would have experienced recent IPV, controlling for other covariates. Women who played on soccer teams had 59% lower odds of reporting physical IPV in the preceding 12 months and approximately 43% lower odds of reporting any form of IPV during the same period compared to women who did not play soccer. Support of more gender-equitable norms was associated with lower odds of all forms of recent violence. More research is needed to identify the underlying reasons for these observed effects and to determine the presence of a causal or temporal relationship between adult women's sports and IPV-risk reduction. Nonetheless, findings from this study point to a novel IPV intervention in communities that might otherwise be resistant to more overt attempts to address gender-based violence (GBV) or where social service agencies with the capacity for IPV-prevention programming may be limited.

  PublisherOA PDFDOI

Frequent coauthors

• Samantha C. Winter

  Columbia University

  21 shared

• Peggie Ramaphane

  Botswana Predator Conservation Trust

  6 shared

• Danielle Dougherty

  C. S. Mott Children's Hospital

  6 shared

• Brittany Ammerman

  Hospital for Special Surgery

  5 shared

• Millicent Ningoma Dzombo

  Columbia Global Center

  5 shared

• Megan Kasimatis Singleton

  4 shared

• Maria Lorena Aguilera Arévalo

  University of San Carlos of Guatemala

  4 shared

• Luis Fernando Talé Rosales

  University of San Carlos of Guatemala

  4 shared

Education

• PhD

  University of Pennsylvania

  2011