Violence Against Women Is Not a Private Matter, It Is a Global Public Health Problem of Epidemic Proportions
The time has come for health systems to play their part in a multisectoral response to end violence against women that is consistent with their countries' commitments to the promotion of both public health and human rights.
Dr. Claudia Garcia Moreno Esteva
Lead Specialist, Gender, Reproductive Rights, Sexual Health and Adolescence, World Health Organization
11/12/2014 10:42am GMT | Updated February 10, 2015
Yesterday, Wednesday 10 December 2014, marked Human Rights Day and the end of the 16 Days of Activism to end gender based violence, which began on November 25, the International Day for the Elimination of Violence Against Women. The 16 days are meant to symbolically link violence against women with human rights, and to emphasize that such violence is one of the worst violations of women's human rights, and the most tolerated violation of human rights that exists today.
So what do we do now the 16 days have come to an end? Violence against women is continuing and it is widespread. Every day millions of women and girls experience violence. This abuse takes many forms, from intimate physical, sexual, or emotional violence, to female genital mutilation, child, early and forced marriage, sex trafficking and rape. On average, around the world one in three women is beaten, coerced into sex or otherwise abused by an intimate partner in the course of her lifetime. This violence has serious short- and long-term mental health, sexual and reproductive health and other physical health consequences.
In a recent series on Violence against Women and Girls published by The Lancet, the five papers revealed that the most successful strategies to preventing violence are those that address a range of factors and that use multiple approaches across many sectors with an essential role for the health sector. A paper outlining the role of the health system states that, "The health-care system can provide women with a safe environment where they can confidentially disclose experiences of violence and receive a supportive response. Furthermore, women subjected to intimate partner violence identify health-care providers as the professionals that they trust with disclosure of abuse." Yet despite the guidelines published by WHO in June 2013, to help strengthen the role of the health system in addressing violence against women, the sector continues to lag behind in its vital role in addressing such violence.
Health workers have a crucial part to play not only in helping women by treating the consequences of violence, but also providing an empathetic, nonjudgmental first line response, helping women to understand the impacts of their experience of abuse and linking them with existing social and other support services. This type of supportive, potentially life-saving response requires non-judgmental, respectful and compassionate care. An empathetic and supportive response from a well-trained provider can act as a turning point on a woman's pathway to safety and healing.
Although additional research is needed, strengthening of health systems can enable providers to address violence against women, through implementing protocols, capacity building, effective coordination between agencies, and referral networks. Some countries already do have guidelines or protocols articulating this role and health-care workers are being trained in some settings, but generally system development and implementation of training programmes have been slow to progress. This is why research initiatives such as DFID's global research and innovation programme, What Works To Prevent Violence Against Women and Girls, are so crucial. The recipients of the What Works Global Programme have just been announced, and include working with health workers across a range of settings. We welcome leadership on this scale and I am proud to be acting as the Chair of the What Works Independent Advisory Board for the length of the five-year programme. We need to give prevention of and response to violence against women and against girls higher priority in health care settings and advocate to integrate it into existing programmes such as those for sexual and reproductive health, adolescent health, maternal and child health, and HIV prevention. We need health policy makers to show leadership and raise awareness of the heath burden and cost of this violence.
Dr. Claudia García-Moreno is a staff member of the World Health Organization and the Chair of Independent Advisory Board for DFID's global research and innovation programme, What Works to Prevent Violence Against Women and Girls: www.whatworks.co.za. The views expressed are those of the author and do not necessarily represent the policy of the WHO.
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