Gender-based Violence Gender-based Violence and Reproductive and Reproductive

HealthHealth

Herrera/MexfamHerrera/Mexfam

Reducing Violence: What Role for Reducing Violence: What Role for Reproductive Health Agencies?Reproductive Health Agencies?

• Gender-based violence is a major Gender-based violence is a major public health problempublic health problem

• Violence directly affects women’s Violence directly affects women’s reproductive healthreproductive health

Violence: Facts and FiguresViolence: Facts and Figures

• 10 to 67% of women have been physically 10 to 67% of women have been physically assaulted by an intimate male partner assaulted by an intimate male partner

• Rape and domestic violence account for 5 to Rape and domestic violence account for 5 to 16% of the healthy years of life lost to women 16% of the healthy years of life lost to women

• As many as 1 of 4 women is physically abused As many as 1 of 4 women is physically abused during pregnancyduring pregnancy

• 100 to 180 million women and girls globally have 100 to 180 million women and girls globally have undergone FGMundergone FGM

Sources: Violence Against Women:The Hidden Burden, The World Bank, 1994; Heise, Popul Rep 2000;L(11).

Adult Women* Ever Physically Assaulted by Adult Women* Ever Physically Assaulted by Intimate Male Partner, Selected CountriesIntimate Male Partner, Selected Countries

Papua New Guinea (1982) 67

Bangladesh (1992) 47

New Zealand (1994) 35

Egypt (1995/96) 34

Canada (1993) 29

Nicaragua (1998) 28

United States (1995/96) 22

Switzerland (1994-96) 21

South Africa (1998) 13

Philippines (1998) 10

* Ever-married/partnered except U.S. (all women)

Source: Heise, Popul Rep 2000;L(11).

(%)

Types of ViolenceTypes of Violence

M. Ramos/ReproSalud/HerreraM. Ramos/ReproSalud/Herrera

PhysicalPhysical

PsychologicalPsychological

SexualSexual

PsychologicalPsychological

Effect of Violence on Women’s Effect of Violence on Women’s Sexual and Reproductive HealthSexual and Reproductive Health

• Involuntary sexual activity Involuntary sexual activity • Unintended/unwanted pregnancy Unintended/unwanted pregnancy • Unsafe abortion Unsafe abortion • Reduced ability to negotiate condom useReduced ability to negotiate condom use• STI/HIV transmissionSTI/HIV transmission• High-risk pregnancies and maternal deathsHigh-risk pregnancies and maternal deaths• Covert contraceptive useCovert contraceptive use• Depression and low self-esteemDepression and low self-esteem

Source: Heise, Popul Rep 2000;L(11).

Psychosocial Risk Factors in Psychosocial Risk Factors in Violence against Women Violence against Women

• Witnessing marital Witnessing marital violence as a childviolence as a child

• Being abused as a childBeing abused as a child• Absent or rejecting Absent or rejecting

fatherfather• Alcohol/drug useAlcohol/drug use

MexfamMexfam

Gender Roles and Gender Roles and Partner AbusePartner Abuse

• Many men feel entitled to be served Many men feel entitled to be served by women and failure to meet men’s by women and failure to meet men’s expectations can lead to violenceexpectations can lead to violence

• Many cultures sanction physical Many cultures sanction physical abuse as a way to “correct” women’s abuse as a way to “correct” women’s behavior behavior

• In some cultures, men use extreme In some cultures, men use extreme violence to maintain gender “honor” violence to maintain gender “honor”

Gender Norms Perpetuate Gender Norms Perpetuate Acceptance of ViolenceAcceptance of Violence

• Women are acculturated to accept abuse if Women are acculturated to accept abuse if they violate gender normsthey violate gender norms

• In Egypt and Papua New Guinea, 59% In Egypt and Papua New Guinea, 59% of women agree wife-beating is justified of women agree wife-beating is justified if a woman talks back/disobeys husbandif a woman talks back/disobeys husband

• Healthcare and law enforcement workers Healthcare and law enforcement workers share dominant cultural valuesshare dominant cultural values

Approaches to Addressing Approaches to Addressing Violence against Women Violence against Women

Train family planning and reproductive Train family planning and reproductive health personnel to: health personnel to:

• Identify women who are victims Identify women who are victims of violenceof violence

• Provide appropriate contraceptive Provide appropriate contraceptive and reproductive health counselingand reproductive health counseling

• Refer to appropriate servicesRefer to appropriate services

FP Clinics in Latin America FP Clinics in Latin America Help Identify Abuse Help Identify Abuse

• Three-year pilot project in IPPF affiliates in Three-year pilot project in IPPF affiliates in Peru, Dominican Republic and Venezuela Peru, Dominican Republic and Venezuela

Pan American Health OrganizationPan American Health Organization

• Screen every woman Screen every woman client in selected client in selected clinics for past or clinics for past or current abusecurrent abuse

Working with Male Perpetrators,Working with Male Perpetrators,Law Enforcement AgentsLaw Enforcement Agents

and Anti-violence Advocates and Anti-violence Advocates

EngenderHealthEngenderHealth

• EngenderHealth and EngenderHealth and Planned Parenthood Planned Parenthood ofof South Africa work South Africa work to change men’s to change men’s attitudes towards attitudes towards violence and gender violence and gender equityequity

• 58% of men surveyed in South Africa believed that 58% of men surveyed in South Africa believed that a woman could not be raped by her husbanda woman could not be raped by her husband

Addressing Socialization, Gender Addressing Socialization, Gender Roles and Coping MechanismsRoles and Coping Mechanisms

–– Poster developed in men’s workshopPoster developed in men’s workshop conducted by Puntos de Encuentro conducted by Puntos de Encuentro

Puntos de EncuentroPuntos de Encuentro

““Violence Against Women: A Disaster That Men Can Prevent”Violence Against Women: A Disaster That Men Can Prevent”

Engage Men to Engage Men to Reach Other Men Reach Other Men

Questions for Debate? Questions for Debate?

• Will reducing violence lead Will reducing violence lead to better reproductive health to better reproductive health outcomes? outcomes?

• Do reproductive health Do reproductive health agencies have an obligation agencies have an obligation to help reduce violence, after to help reduce violence, after helping to document the helping to document the

problem?problem? J. Littlewood/World Health OrganizationJ. Littlewood/World Health Organization

• Can reproductive health programs help Can reproductive health programs help reduce violence against women by reduce violence against women by working with men and boys?working with men and boys?