According to the World Health Organization, more than one-third — 35 percent — of women have experienced some form of physical or sexual violence in their lifetime. Although efforts to reduce such gender-based violence have increased in recent years, a new series published in The Lancet shows that much more needs to be done.
Levels of violence against women — including such acts as intimate partner violence, female genital mutilation (FGM), forced marriages and trafficking — remain “unacceptably high,” the authors write, with serious consequences for victims’ physical and mental health. Conflict and other humanitarian crises may exacerbate ongoing violence.
They point out, for example, that between 100-140 million females worldwide have suffered FGM, defined as intentionally causing injury or altering the female genital organs for reasons that are not medically based. Such procedures are most common among girls under the age of 15. In Africa alone, around 3 million girls are at risk of FGM each year (note: they are considered “at risk” because there are no actual records of the practice, only estimates).
While FGM is most prevalent in Africa and Asia, where more than 8,000 girls are estimated to undergo FGM each day, girls in the United States and other industrialized nations are also at risk. According to the CDC, at least 150,000 to 200,000 girls in the U.S. are at risk of being subjected to FGM.
What’s more, around 70 million girls worldwide are married before the age of 18, and the majority of these marriages are forced, the researchers note. Forced marriage is overwhelmingly a form of power and control used against women and girls. Like partner abuse, rape and other forms of sexual assault, it is used to control women, their sexuality, and often, their offspring.
“The effect of violence against women and girls on their health and welfare, their families and communities is substantial,” say the authors.
Although many countries have made substantial progress towards criminalizing violence against women and promoting gender equality, the Series authors argue that governments and donors need to commit sufficient financial resources to ensure their verbal commitments translate into real change. Even where laws are progressive, many women and girls still suffer discrimination, experience violence, and lack access to vital health and legal services.
Significant gaps identified in current efforts to reduce violence against women
Over the past 20 years — as the global focus on violence toward women has increased — there has been a growing emphasis on research into the underlying causes of violence against women. “There has also been enormous growth in the quantity and breadth of interventions in diverse settings, including in health care, justice systems, and social campaigns to address violence against women and girls worldwide,” the authors add.
But despite gaining more attention, the authors say that there have been some major gaps in addressing violence against women. They point out, for example, that the majority of studies investigating potential interventions to reduce violence against women have been conducted in high-income countries — particularly the US, where two thirds of studies were carried out.
Furthermore, reviewing the latest evidence, the authors show that not enough is being done to prevent violence against women and girls from occurring in the first place. Although resources have grown to support women and girls in the aftermath of violence (e.g., access to justice and emergency care), research suggests that actions to tackle gender inequity and other root causes of violence are needed to prevent all forms of abuse, and thereby reduce violence overall.
“Globally, 1 in 3 women will experience intimate partner and/or sexual violence by non-partners in their lifetime, which shows that more investment needs to be made in prevention,” says co-lead author of the series Prof. Charlotte Watts, of the London School of Hygiene & Tropical Medicine in the UK, adding:
“We definitely need to strengthen services for women experiencing violence, but to make a real difference in the lives of women and girls, we must work towards achieving gender equality and preventing violence before it even starts.
No magic wand will eliminate violence against women and girls. But evidence tells us that changes in attitudes and behaviors are possible, and can be achieved within less than a generation.”
Need for greater input from health care systems
But what can be done on a global scale to reduce violence against women? Ultimately, say the authors, working with both the perpetrators of violence (men and boys) and women and girls will be essential to achieve lasting change, by transforming deeply entrenched societal norms on gender relations and the insidious belief that women are inferior.
“Violence-prevention interventions can reduce levels of intimate-partner violence and should seek to address attitudes, norms and beliefs that justify violence against women, link dominant notions of masculinity to male authority over women, and stigmatize victims, especially in low-income and middle-income countries.”
They also point out that, although violence is often viewed as a social and criminal justice issue, the health care system plays an integral important role when it comes to preventing violence and treating the victims.
“Health care providers are often the first point of contact for women and girls experiencing violence,” says co-lead author Dr. Claudia Garcia-Moreno, a physician at the World Health Organization (WHO). “Early identification of women and children subjected to violence and a supportive and effective response can improve women’s lives and well-being, and help them to access vital services.” She adds:
“Health care providers can send a powerful message – that violence is not only a social problem, but a dangerous, unhealthy and harmful practice – and they can champion prevention efforts in the community.
The health community is missing important opportunities to integrate violence programming meaningfully into public health initiatives on HIV/AIDS, adolescent health, maternal health and mental health.”
Five actions that policy makers should take to tackle violence against women
With these points in mind, the authors recommend five actions that should be undertaken by policy makers worldwide:
- They should acknowledge that violence against girls and women affects health and development, and they should ensure adequate resources are allocated for interventions that may help prevent such violence
- They need to enforce and strengthen laws that prohibit violence toward females and ensure that national laws, policies and institutions over all sectors promote equality for women
- They must invest in programs that promote equality for women, as well as those that promote non-violent behavior and offer support for victims
- The role of the health sector needs to be strengthened. There needs to be increased awareness of violence against women among health professionals and training on how to deal with such cases
- There needs to be more investment in research to identify strategies that can prevent violence against women, and these strategies need to be put into action.
“We now have some promising findings to show what works to prevent violence,” says series coordinator Dr. Cathy Zimmerman of the London School of Hygiene & Tropical Medicine. “Our upcoming challenge is to expand this evidence on prevention and support responses to many more settings and forms of violence. Most importantly, we urgently need to turn this evidence into genuine action so that women and girls can live violence-free lives.”
In an editorial linked to the series, Jimmy Carter, former US President and founder of The Carter Center in Atlanta, GA, says that society has become desensitized to violence and it has become increasingly accepted. “As long as this is true, abuse of women and girls will continue,” he says, adding:
“It is my hope that political and religious leaders will step forward and use their influence to communicate clearly that violence against women and girls must stop, that we are failing our societies, and that the time for leadership is now.”