1.The United Nations defines violence against women as "any act of gender-based violence that results in, or is likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, arbitrary deprivation of liberty, whether occurring in public or in private life."
Almost one third (30%) of all women who have been in a relationship have experienced physical and/or sexual violence by their intimate partner. The prevalence estimates of intimate partner violence varies from developed to developing countries. It is more in developing countries.
Risk factors for both intimate partner and sexual violence include:
1) lower levels of education (perpetration of sexual violence and experience of sexual violence);
2) a history of exposure to child maltreatment (perpetration and experience);
3) witnessing family violence (perpetration and experience);
4)antisocial personality disorder (perpetration);
5)harmful use of alcohol (perpetration and experience);
6)having multiple partners or suspected by their partners of infidelity (perpetration);
7)attitudes that condone violence (perpetration);
8)community norms that privilege or ascribe higher status to men and lower status to women; and
9) low levels of women’s access to paid employment.
Factors specifically associated with intimate partner violence include:
- past history of violence
- marital discord and dissatisfaction
- difficulties in communicating between partners
- male controlling behaviours towards their partners
Health consequences
Intimate partner (physical, sexual and emotional) and sexual violence cause serious short- and long-term physical, mental, sexual and reproductive health problems for women. They also affect their children, and lead to high social and economic costs for women, their families and societies. Such violence have fatal outcomes like homicide or suicide.
It can Lead to injuries, with 42% of women who experience intimate partner violence reporting an injury as a consequence of this violence.
Lead to unintended pregnancies, induced abortions, gynaecological problems, and sexually transmitted infections, including HIV. The 2013 analysis found that women who had been physically or sexually abused were 1.5 times more likely to have a sexually transmitted infection and, in some regions, HIV, compared to women who had not experienced partner violence. They are also twice as likely to have an abortion.
Intimate partner violence in pregnancy also increases the likelihood of miscarriage, stillbirth, pre-term delivery and low birth weight babies. The same 2013 study showed that women who experienced intimate partner violence were 16% more likely to suffer a miscarriage and 41% more likely to have a pre-term birth.
These forms of violence can lead to depression, post-traumatic stress and other anxiety disorders, sleep difficulties, eating disorders, and suicide attempts. The 2013 analysis found that women who have experienced intimate partner violence were almost twice as likely to experience depression and problem drinking.
Health effects can also include headaches, back pain, abdominal pain, gastrointestinal disorders, limited mobility and poor overall health.
Sexual violence, particularly during childhood, can lead to increased smoking, drug and alcohol misuse, and risky sexual behaviours in later life. It is also associated with perpetration of violence (for males) and being a victim of violence (for females).
Impact on children :
-may suffer a range of behavioural and emotional disturbances. These can also be associated with perpetrating or experiencing violence later in life.
- associated with higher rates of infant and child mortality and morbidity (through, for example diarrhoeal disease or malnutrition).
-Social and economic costs: women may suffer isolation, inability to work, loss of wages, lack of participation in regular activities and limited ability to care for themselves and their children.
More resources are needed to strengthen the prevention of and response to intimate partner and sexual violence, including primary prevention – stopping it from happening in the first place.
Advocacy and counselling interventions to improve access to services for survivors of intimate partner violence are effective in reducing such violence. Home visitation programmes involving health worker outreach by trained nurses also show promise in reducing intimate partner violence. However, these have yet to be assessed for use in resource-poor settings.
In low resource settings, prevention strategies that have been shown to be promising include: those that empower women economically and socially through a combination of microfinance and skills training related to gender equality; that promote communication and relationship skills within couples and communities; that reduce access to, and harmful use of alcohol; transform harmful gender and social norms through community mobilization and group-based participatory education with women and men to generate critical reflections about unequal gender and power relationships.
To achieve lasting change, it is important to enact and enforce legislation and develop and implement policies that promote gender equality by:
Ending discrimination against women in marriage, divorce and custody laws
ending discrimination in inheritance laws and ownership of assets
improving women’s access to paid employment
developing and resourcing national plans and policies to address violence against women.
While preventing and responding to violence against women requires a multi-sectoral approach, the health sector has an important role to play. The health sector can:
Advocate to make violence against women unacceptable and for such violence to be addressed as a public health problem.
Provide comprehensive services, sensitize and train health care providers in responding to the needs of survivors holistically and empathetically.
Prevent recurrence of violence through early identification of women and children who are experiencing violence and providing appropriate referral and support
Promote egalitarian gender norms as part of life skills and comprehensive sexuality education curricula taught to young people.
Generate evidence on what works and on the magnitude of the problem by carrying out population-based surveys, or including violence against women in population-based demographic and health surveys, as well as in surveillance and health information systems
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