To continue the discussion on the gravity on gender-based violence (GBV) and violence against women (VAW), part II of the fact sheet (issued by WHO) offers the following summary of the literature:
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Risk factors:
Factors found to be associated with intimate partner and sexual violence occur within individuals, families and communities and wider society. Some factors are associated with being a perpetrator of violence, some are associated with experiencing violence and some are associated with both.
Risk factors for both intimate partner and sexual violence include:
• lower levels of education (perpetration of sexual violence and experience of sexual violence);
• exposure to child maltreatment (perpetration and experience);
• witnessing family violence (perpetration and experience);
• antisocial personality disorder (perpetration);
• harmful use of alcohol (perpetration and experience);
• having multiple partners or suspected by their partners of infidelity (perpetration); and
• attitudes that are accepting of violence and gender inequality (perpetration and experience).
Factors specifically associated with intimate partner violence include:
• past history of violence;
• marital discord and dissatisfaction;
• difficulties in communicating between partners.
Factors specifically associated with sexual violence perpetration include:
• beliefs in family honor and sexual purity;
• ideologies of male sexual entitlement; and
• weak legal sanctions for sexual violence.
The unequal position of women relative to men and the normative use of violence to resolve conflict are strongly associated with both intimate partner violence and non-partner sexual violence.
Health consequences:
Intimate partner and sexual violence have serious short- and long-term physical, mental, sexual and reproductive health problems for survivors and for their children, and lead to high social and economic costs.
• Violence against women can have fatal results like homicide or suicide.
• It can lead to injuries, with 42% of women who experience intimate partner reporting an injury as a consequences of this violence.
• Intimate partner violence and sexual violence can lead to unintended pregnancies, induced abortions, gynecological 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 have 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.
• These forms of violence can lead to depression, post-traumatic stress disorder, sleep difficulties, eating disorders, emotional distress and suicide attempts. The same study found that women who have experienced intimate partner violence were almost twice as likely to experience depression and problem drinking. The rate was even higher for women who had experienced non partner sexual violence.
• Health effects can also include headaches, back pain, abdominal pain, fibromyalgia, 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 behaviors in later life. It is also associated with perpetration of violence (for males) and being a victim of violence (for females).
Impact on children:
• Children who grow up in families where there is violence may suffer a range of behavioral and emotional disturbances. These can also be associated with perpetrating or experiencing violence later in life.
• Intimate partner violence has also been associated with higher rates of infant and child mortality and morbidity (e.g. diarrhoeal disease, malnutrition).
Social and economic costs:
The social and economic costs of intimate partner and sexual violence are enormous and have ripple effects throughout society. 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.
Prevention and response:
Currently, there are few interventions whose effectiveness has been proven through well designed studies. More resources are needed to strengthen the prevention of intimate partner and sexual violence, including primary prevention, i.e. stopping it from happening in the first place.
Regarding primary prevention, there is some evidence from high-income countries that school-based programs to prevent violence within dating relationships have shown effectiveness. However, these have yet to be assessed for use in resource-poor settings. Several other primary prevention strategies: those that combine microfinance with gender equality training; that promote communication and relationship skills within couples and communities; that reduce access to, and harmful use of alcohol; and that change cultural gender norms, have shown some promise but need to be evaluated further.
To achieve lasting change, it is important to enact legislation and develop policies that:
• address discrimination against women;
• promote gender equality;
• support women; and
• help to move towards more peaceful cultural norms.
An appropriate response from the health sector can play an important role in the prevention of violence. Sensitization and education of health and other service providers is therefore another important strategy. To address fully the consequences of violence and the needs of victims/survivors requires a multi-sectoral response.
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Reference
World Health Organization, (2013). Violence against women: Intimate partner and sexual violence against women (N°239). Retrieved from World Health Organization website: http://www.who.int/mediacentre/factsheets/fs239/en/.
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