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." (1)
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."
Population-level surveys based on reports from victims provide the most accurate estimates of the prevalence of intimate partner violence and sexual violence. A 2013 analysis conduct by WHO with the London School of Hygiene and Tropical Medicine and the South Africa Medical Research Council, used existing data from over 80 countries and found that worldwide, 1 in 3, or 35%, of women have experienced physical and/or sexual violence by an intimate partner or non-partner sexual violence (3).
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 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 all murders of women are committed by intimate partners. In addition to intimate partner violence, globally 7% of women report having been sexually assaulted by someone other than a partner, although data for non-partner sexual violence are more limited. Intimate partner and sexual violence are mostly perpetrated by men against women.
Factors associated with intimate partner and sexual violence occur at individual, family, community and wider society levels. Some 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:
Factors specifically associated with intimate partner violence include:
Factors specifically associated with sexual violence perpetration include:
Gender inequality and norms on the acceptability of violence against women are a root cause of violence against women.
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 can:
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.
There are a growing number of well-designed studies looking at the effectiveness of prevention and response programmes. 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.
There is some evidence from high-income countries that 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:
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:
At the World Health Assembly in May 2016, Member States endorsed a global plan of action on strengthening the role of the health systems in addressing interpersonal violence, in particular against women and girls and against children.
WHO, in collaboration with partners, is:
1. United Nations. Declaration on the elimination of violence against women. New York : UN, 1993.
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