Physical
or sexual violence is a public health problem that affects more than one third
of all women globally, according to a new report released by WHO in partnership
with the London School of Hygiene & Tropical Medicine and the South African
Medical Research Council.
The
report, Global and regional estimates of violence against women: Prevalence and
health effects of intimate partner violence and non-partner sexual violence,
represents the first systematic study of global data on the prevalence of
violence against women – both by partners and non-partners. Some 35% of all
women will experience either intimate partner or non-partner violence. The
study finds that intimate partner violence is the most common type of violence
against women, affecting 30% of women worldwide.
The
study highlights the need for all sectors to engage in eliminating tolerance
for violence against women and better support for women who experience it. New
WHO guidelines, launched with the report, aim to help countries improve their health
sector’s capacity to respond to violence against women.
Impact
on physical and mental health
The
report details the impact of violence on the physical and mental health of
women and girls. This can range from broken bones to pregnancy-related complications,
mental problems and impaired social functioning.
“These
findings send a powerful message that violence against women is a global health
problem of epidemic proportions,” said Dr Margaret Chan, Director-General, WHO.
“We also see that the world’s health systems can and must do more for women who
experience violence.”
The
report’s key findings on the health impacts of violence by an intimate partner
were:
Death
and injury – The study found that globally, 38% of all women who were murdered
were murdered by their intimate partners, and 42% of women who have experienced
physical or sexual violence at the hands of a partner had experienced injuries
as a result.
Depression
– Partner violence is a major contributor to women’s mental health problems,
with women who have experienced partner violence being almost twice as likely
to experience depression compared to women who have not experienced any
violence.
Alcohol
use problems – Women experiencing intimate partner violence are almost twice as
likely as other women to have alcohol-use problems.
Sexually
transmitted infections – Women who experience physical and/or sexual partner
violence are 1.5 times more likely to acquire syphilis infection, chlamydia, or
gonorrhoea. In some regions (including sub-Saharan Africa), they are 1.5 times
more likely to acquire HIV.
Unwanted
pregnancy and abortion – Both partner violence and non-partner sexual violence
are associated with unwanted pregnancy; the report found that women
experiencing physical and/or sexual partner violence are twice as likely to
have an abortion than women who do not experience this violence.
Low
birth-weight babies – Women who experience partner violence have a 16% greater
chance of having a low birth-weight baby.
“This
new data shows that violence against women is extremely common. We urgently
need to invest in prevention to address the underlying causes of this global
women’s health problem.” said Professor Charlotte Watts, from the London School
of Hygiene & Tropical Medicine.
Need
for better reporting and more attention to prevention
Fear
of stigma prevents many women from reporting non-partner sexual violence. Other
barriers to data collection include the fact that fewer countries collect this
data than information about intimate partner violence, and that many surveys of
this type of violence employ less sophisticated measurement approaches than
those used in monitoring intimate partner violence.
“The
review brings to light the lack of data on sexual violence by perpetrators other
than partners, including in conflict-affected settings,” said Dr Naeemah
Abrahams from the SAMRC. “We need more countries to measure sexual violence and
to use the best survey instruments available.”
In
spite of these obstacles, the review found that 7.2% of women globally had
reported non-partner sexual violence. As a result of this violence, they were
2.3 times more likely to have alcohol disorders and 2.6 times more likely to
suffer depression or anxiety – slightly more than women experiencing intimate
partner violence.
The
report calls for a major scaling up of global efforts to prevent all kinds of
violence against women by addressing the social and cultural factors behind it.
Recommendations
to the health sector
The
report also emphasizes the urgent need for better care for women who have
experienced violence. These women often seek health-care, without necessarily
disclosing the cause of their injuries or ill-health.
“The
report findings show that violence greatly increases women’s vulnerability to a
range of short- and long-term health problems; it highlights the need for the
health sector to take violence against women more seriously,” said Dr Claudia
Garcia-Moreno of WHO. “In many cases this is because health workers simply do
not know how to respond.”
New
WHO clinical and policy guidelines released today aim to address this lack of
knowledge. They stress the importance of training all levels of health workers
to recognize when women may be at risk of partner violence and to know how to
provide an appropriate response.
They
also point out that some health-care settings, such as antenatal services and
HIV testing, may provide opportunities to support survivors of violence,
provided certain minimum requirements are met.
·
Health providers have been trained how to ask
about violence.
·
Standard operating procedures are in place.
·
Consultation takes place in a private setting.
·
Confidentiality is guaranteed.
·
A referral system is in place to ensure that
women can access related services.
· In the case of sexual assault, health care
settings must be equipped to provide the comprehensive response women need – to
address both physical and mental health consequences.
