The World Health Organization (WHO) has recently updated its fact sheet on violence against women.

Background Information:

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, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.”

Intimate partner violence refers to behaviour by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviours.

Sexual violence is “any sexual act, attempt to obtain a sexual act, or other act directed against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting. It includes rape, defined as the physically forced or otherwise coerced penetration of the vulva or anus with a penis, other body part or object.”

Key Messages:

Violence against women – particularly intimate partner violence and sexual violence – is a major public health problem and a violation of women’s human rights.

Global estimates published by WHO indicate that about 1 in 3 (35%) of women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.

Most of this violence is intimate partner violence. Worldwide, almost one third (30%) of women who have been in a relationship report that they have experienced some form of physical and/or sexual violence by their intimate partner in their lifetime.

The prevalence estimates of intimate partner violence range from

• 23.2% in high-income countries and
• 24.6% in the WHO Western Pacific region to
• 37% in the WHO Eastern Mediterranean region, and
• 37.7% in the WHO South-East Asia region.

Globally, as many as 38% of murders of women are committed by a male intimate partner.

Violence can negatively affect women’s physical, mental, sexual, and reproductive health, and may increase the risk of acquiring HIV in some settings.

Men are more likely to perpetrate violence if they have

• low education,
• a history of child maltreatment,
• exposure to domestic violence against their mothers,
• harmful use of alcohol,
• unequal gender norms including attitudes accepting of violence, and
• a sense of entitlement over women.

Women are more likely to experience intimate partner violence if they have

• low education,
• exposure to mothers being abused by a partner,
• abuse during childhood, and
• attitudes accepting violence, male privilege, and women’s subordinate status.

Risk factors for both intimate partner and sexual violence include:

• lower levels of education (perpetration of sexual violence and experience of sexual violence);
• a history of 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);
• attitudes that condone violence (perpetration);
• community norms that privilege or ascribe higher status to men and lower status to women; and
• 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 behaviors towards their partners.

Factors specifically associated with sexual violence perpetration include:

• beliefs in family honour and sexual purity
• ideologies of male sexual entitlement
• weak legal sanctions for sexual violence.

Gender inequality and norms on the acceptability of violence against women are a root cause of violence against women.

Situations of conflict, post conflict and displacement may exacerbate existing violence, such as by intimate partners, as well as and non-partner sexual violence, and may also lead to new forms of violence against women.

Health consequences

Such violence can:

• Have fatal outcomes like homicide or suicide.
• 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.

  A 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).

 

Prevention

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.

There is evidence that advocacy and empowerment counselling interventions, as well as home visitation are promising in preventing or reducing intimate partner violence against women.

Useful Links:

Link to the updated fact sheet:

http://who.int/mediacentre/factsheets/fs239/en/

Link to WHO infographic on violence against women (PDF):

http://who.int/reproductivehealth/publications/violence/VAW_infographic.pdf?ua=1

Link to infographics on violence against women (jpg):

http://who.int/reproductivehealth/publications/violence/VAW_infographics/en/

Link to WHO’s Global and Regional estimates of violence against women [multiple languages](PDF) (2013):

http://who.int/reproductivehealth/publications/violence/9789241564625/en/

Link to WHO document ‘Preventing intimate partner and sexual violence against women’ [multiple languages](PDF): 

http://who.int/violence_injury_prevention/violence/activities/intimate/en/

Link to WHO Clinical and Policy Guidelines ‘Responding to intimate partner violence and sexual violence against women’ [multiple languages] (PDF) (2013):

http://who.int/reproductivehealth/publications/violence/9789241548595/en/