Violence against women and the millennium development goals: Using global evidence to inform policy

Lead Research Organisation: London School of Hygiene & Tropical Medicine
Department Name: Public Health and Policy

Abstract

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Description Violence against women is a significant public health problem, as well as a fundamental violation of women's human rights. The Gender, Violence and Health Centre at LSHTM worked with the World Health Organization and the South African Medical Research Council to conduct the first global systematic review and synthesis of existing scientific data on the prevalence of two forms of violence against women - violence by an intimate partner (intimate partner violence) and sexual violence by someone other than a partner (non- partner sexual violence). Our findings showed, for the first time, aggregated global and regional prevalence estimates of these two forms of violence, generated using population data from all over the world that have been compiled in a systematic way. The report also details the effects of violence on women's physical, sexual and reproductive, and mental health. The findings were striking:

• overall, 35%of women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence.

• most of this violence is violence by intimate partners. Worldwide, almost one third (30%) of all women who have been in a relationship have experienced physical and/or sexual violence by their intimate partner. In some regions, 38% of women have experienced intimate partner violence;

• Globally, as many as 38% of all murders of women are committed by intimate partners;

• Women who have been physically or sexually abused by their partners report higher rates

of a number of important health problems. For example, they are 16% more likely to have a low-birth-weight baby. They are more than twice as likely to have an abortion, almost twice as likely to experience depression, and, in some regions, are 1.5 times more likely to acquire HIV, as compared to women who have not experienced partner violence;

• globally, 7% of women have been sexually assaulted by someone other than a partner. There are fewer data available on the health effects of non-partner sexual violence. However, the evidence that does exist reveals that women who have experienced this form of violence are 2.3 times more likely to have alcohol use disorders and 2.6 times more likely to experience depression or anxiety.

This project, funded by the ESRC, was used to disseminate the findings through a range of fora, and to develop a complementary synthesis of evidence of what forms of violence prevention initiative are effective, with the aim of using these findings to promote a greater recognition of the health impacts of violence, and the need for increased investment in prevention efforts.

We used a range of fora to disseminate the findings. This included conference presentations, academic publications (including in high profile publications), launch events, blogs, and twitter feeds. This combination resulted in the findings gaining substantial media coverage - with more than 1,500 news items arising from the report, including on television different forms of print media globally, as well as creating substantial online coverage.

This coverage is likely to be both a result of the figures, as well as our use of a combined dissemination approach, with one on one meetings with key journalists, academic publications and with media launches in Geneva and London. The results have also been used to inform the development of guidelines on the provision of effective health services to women experiencing violence.
Exploitation Route The findings summarised and disseminated from this work provides new, rigorous data on the global prevalence of intimate partner violence and sexual violence against women, and quantitative measures of the health impacts of this violence. This evidence can be used by a range of non-academic groups, including national and international policy makers and donors; ministries of health and health workers, and civil society groups advocating for a strengthened response to violence against women globally.
Sectors Communities and Social Services/Policy

Education

 
Description Submission to the House of Commons International Development Committee Inquiry on Violence Against Women and Girls
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact The International Development Committee is appointed by the House of Commons to examine the expenditure, administration, and policy of the Office of the Secretary of State for International Development. This year, the Committee held an enquiry into DFID's work on violence against women and girls (VAWG). DFID are answerable to this committee, and obliged to address the recommendations made. The submission made by GVHC drew on the ESRC funded project, and in particular, our synthesis of the state of current research evidence on prevention, discussions with partners involved in the ESRC project, as well as the groups broader experience at conducting research on violence. Many of these recommendations were included in the final report to DFID produced by the Committee, including a recognition of the high prevalence of violence and its health impacts, the potentially strategic role that the health sector could play in addressing violence, and the limited state of evidence on 'what works', and the need to invest both in promising programmes, as well as in careful evaluation, to ensure that there are opportunities for learning and the sharing of best practise as interventions are scaled up.
 
Description Addressing gender inequality and violence as a critical enabler in the HIV response 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact Commonwealth Secretariat World AIDS Day Commemoration and Multi Sectoral Consultation, 11 November 2012.
Year(s) Of Engagement Activity 2012
 
Description Estimating the global prevalence of childhood sexual abuse 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact Invitational side meeting about meta-analysis, hosted by David Finkelhor and Chris Mikton (WHO), and UBS Foundation during the XIXth ISPCAN International Congress on Child Abuse and Neglect, 9 - 12 September 2012, Istanbul.
Year(s) Of Engagement Activity 2013
 
Description Gender based violence 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact Short course: Reproductive Health Services and HIV/AIDS: New Evidence and Practice, at the Public Health Department, University of Heidelberg, March 2012.
Year(s) Of Engagement Activity 2012
 
Description How do we calculate disease burden? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact Sexual Violence Research Initiative Forum: Moving the Agenda Forward, 10-13 October 2011, Cape Town.
Year(s) Of Engagement Activity 2013
 
Description Intimate partner violence & HIV 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact BHIVA Foundation Lecture at BHIVA Autumn Conference 2012
Year(s) Of Engagement Activity 2012
 
Description Intimate partner violence, childhood sexual abuse and non-partner sexual violence 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact Overview of the Global Burden of Disease Project - Claudia Garcia-Moreno

Homicide caused by intimate partner violence - Heidi Stoeckl

Discussion on policy and advocacy implications - Claudia Garcia-Moreno

Non-partner sexual violence - Naeemah Abrahams
Year(s) Of Engagement Activity 2013
 
Description Is intimate partner violence associated with HIV? : systematic review and meta-analysis 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact 'Intimate Partner Violence and the Risk of HIV Infection' at the Sexual Violence Research Initiative Forum: Moving the Agenda Forward, 10-13 October 2011, Cape Town.
Year(s) Of Engagement Activity 2011
 
Description LSHTM launch: global prevalence of violence against women, health outcomes and prevention options 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This launch event was used to synthesis and disseminate the findings from the ESRC, and to promote discussion about the need for prevention. The meeting was timed to co-incide with the launch of the key reports and publications from the ESRC project. The launch was chaired by Baroness Scotland, a leading advocate and expert in the field of violence against women. A range of key stakeholders were invited to this launch event, including representatives from DFID, who are taking the lead globally in their commitment to end violence against women and girls. This launch was used to synthesise in an accessible format the findings from the global prevalence and health burden analysis and the accompanying prevention review. We targeted this event at key policy makers and NGOs working on violence against women. Attendees included several staff from the UK Department for International Development. The materials developed were kept relatively non-technical, and focused upon highlighting the main messages from each component of the project.

This launch was used to synthesise in an accessible format the findings from the global prevalence and health burden analysis and the accompanying prevention review. We targeted this event at key policy makers and NGOs working on violence against women. A
Year(s) Of Engagement Activity 2013
 
Description Presentation at DFID consultation on HIV policy 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact This presentation was given in response to a request by DFID to present at a consultation on DFID's AIDS strategy, attended by a broad range of civil society actors. The remit of the talk was broad, but included the findings from the GBD analysis on evidence on the global prevalence of violence against women, and the links with HIV/AIDS. Lynne Featherstone MP, deputy head of state for development, specifically stayed to hear this presentation, and was visibly surpassed by the global figures on violence presented. The subsequent discussions included a focus on ways to better address the HIV prevention needs of women and girls, and the importance of structural intervention components as part of HIV programmes.

Presentation, that was subsequently posted on LSHTM and UK AIDS Consortium web-sites, and circulated to DFID policy staff.
Year(s) Of Engagement Activity 2013
 
Description Presentation, High level meeting on HIV at the Commission on the Status of Women 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact The focus of most recent Commission on the Status of Women (CSW54) was on the prevention of violence against women. Alongside this meeting, UNAIDS organised a high level meeting in New York to brief ministers and senior policy makers from across Africa on the links between violence against women and HIV, and to work with key civil society groups to develop an action plan for addressing these links. This presentation was the only academic presentation of the days event, and provides a relatively non-technical summary of the relationship between violence against women and HIV, shares the global prevalence figure, and stresses the need for prevention. The list above does not represent the full range of participants.

The list above does not represent the full range of participants.
Year(s) Of Engagement Activity 2013
 
Description Preventing violence against women and girls : an evidence-informed perspective 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Lecture to UN Women, New York, June 2012

Following the lecture, further discussions and contacts were made on researching violence against women.
Year(s) Of Engagement Activity 2012
 
Description Preventing violence against women and girls in conflict : an evidence-informed perspective 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Paper presented at the UK Foreign & Commonwealth Office evidence round table on violence against women and girls.

Further inquiries on research in conflict settings and violence against women and girls as been received from the UK Foreign and Commonwealth Office.
Year(s) Of Engagement Activity 2013
 
Description Summary of press coverage for Launch of global figures 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The co-ordinated launch of the findings on the global prevalence and health impacts of violence against women led to substantial media coverage, with more than 1500 reports globally in the print media alone, with news coverage being widespread, including on the BBC, CNN, India Today, and the Gulf News in the United Arab Emirates. The main headline that most journalists focused on was that one in three women globally are likely to experiencing domestic or sexual violence in their lifetime, which was obtained by combining the figures on the levels of intimate partner and non-partner sexual violence. There was also strong interest in the findings on intimate partner homicide, and the broader health impacts. Alongside the launch of the papers and the synthesis report, and the press releases, each journal did an editorial, that also helped raise the profile of the findings. What was interesting to see was the extent to which health correspondents felt that they had to work hard to justify the issue as being linked to health - illustrating the need to making these health visible more visible. In the UK, some additional interest in the figures was generated by news coverage of Nigella Lawson, that happened the day before the launch. Although we actively did not comment on this, we did see that some journalists used this as a hook to help personalise the figures, and to comment that all women are vulnerable to violence. The attached summary in excel provides a list of the media coverage, up to July 5th 2013. This output reflects the impact of the combined launch and promotion of several ESRC supported outputs, rather than being directly linked to one output.

The attached summary in excel provides a list of the media coverage, up to July 5th 2013. This output reflects the impact of the combined launch and promotion of several ESRC supported outputs, rather than being directly linked to one output.
Year(s) Of Engagement Activity 2013
 
Description The contagion of family violence 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact IOM The Contagion of Violence Workshop, Washington, DC, 30th April - 1st May 2012.
Year(s) Of Engagement Activity 2012
 
Description Violence against women 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact Presentation at 7th Edition of the Women's Forum Global Meeting, Deauville, France, Oct 2011
Year(s) Of Engagement Activity 2011
 
Description Violence against women and HIV/AIDS 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact Paper at STRIVE RPC partner meetings with the Karnataka Health Promotion Trust, Bangalore Dec 2011
Year(s) Of Engagement Activity 2013
 
Description Violence against women and suicide : systematic review of longitudinal studies 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience
Results and Impact Paper given at the 1st European Congress for Social Psychiatry (ECSP 2012), July 4th to July 6th, Geneva, Switzerland.
Year(s) Of Engagement Activity 2013