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Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14
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Health Sector Approaches to Prevent and Respond to Gender-Based Violence_Phyliss Sharps_5.7.14

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  • 1. GENDER BASED VIOLENCE: THE HIDDEN CAUSE OF POOR HEALTH OUTCOMES Phyllis W. Sharps, PhD, RN, FAAN Professor and Associate Dean Community and Global Programs Johns Hopkins University School of Nursing
  • 2. Gender Based Violence  Violence that results in harm to men and women: Physical Sexual Psychological  Any form of violence or abuse that targets men or women based on their sex
  • 3. Types of GBV  Battering  Intimate partner Violence (IPV)- marital rape  Sexual violence  Dowry Related violence  Female infanticide  Sexual abuse of children in homes  Honor Crimes/killings  Early and/or Forced marriage  Female Genital Cutting & other traditional practice harmful to women  Sexual harassment in the workplace & educational settings  Commercial sexual exploitation  Trafficking of girls and women (and boys)  Violence perpetrated against domestic
  • 4. Victims of GBV  Victims – men and boys –  Trafficking  Conflict  Educational setting  Victims - MOST ARE WOMEN
  • 5. Globally 1 in 3 women (30%) will experience physical and/or sexual violence by a partner in lifetime (WHO)
  • 6. Globally Girls and Women Most Vulnerable  Across the lifespan women are more vulnerable  1 in 5 women are victim of rape in her lifetime  1 in 5 women are sexually abused by age 15  >130 M girls subjected to female genital cutting  800,000 people are trafficked  80% are girls and women  50% are minors
  • 7. GBV Across A Women‟s Life Developmental Phase Violence Specific to Developmental Phase Prenatal Prenatal sex selection (female feticide) Infancy Female infanticide, differential access to food & medical care Childhood Female genital cutting; differential access to food, medical care & education; incest, sexual molestation, commercial sex; violence & abuse in & around school; early marriage Adolescence Harmful initiation rites, incest, commercial sex, school & workplace violence, early marriage, coerced sex, teen dating violence, honor crimes Adulthood IPV, marital rape, dowry abuse & murder, femicide, psychological abuse, violence& sexual abuse & harassment in workplace, honor crimes, abuse of widows, coerced sex& pregnancy, traumatic fistula, perinatal abuse, elder abuse, abuse of women with disabilities
  • 8. Femicide  Femicide - the killing of females by males because they are female (Russell ‟76, „92)  Includes other forms of GBV killings  With the notion that not naming as obscures nature of crime - male hatred of women  More pragmatic to describe femicide as murder of women –but globally many do not 8
  • 9. Global and Societal Cost  Violation of Human Rights  In Bangladesh GBV is equivalent to 2% of GDP  Medical Cost  Legal and Law Enforcement costs  Lost of productive citizens – men and women – lower income  Lack of access to education  Individual psychological despair, anxiety, depression
  • 10. Cost Of Violence Against Women Cost of non-fatal injuries  1995 = $5.8 M  2012 = > $5.8 B Costs are  Direct medical/mental health care  Lost productivity from paid work & household duties – 13.6 M days of lost productivity 10
  • 11. The health effects of intimate partner violence and non-partner sexual violence
  • 12. Perinatal IPV Statistical Overview  Recent studies estimate that 3% to 19% of pregnant women report being abused during the childbearing year – before, during or after the pregnancy (Campbell, Garcia-Moreno & Sharps, 2000). Health Consequences  Poor Maternal Outcomes ◦ Physical health consequences -late entry into/no prenatal care, poor weight gain, preterm delivery , pregnancy loss ◦ Mental health consequences - depression, low self esteem, PTSD, substance use  Poor Fetal and Neonatal Outcomes ◦ Pre-term delivery; Pre-term birth, low birth weight, fetal injuries (Bullock et all, 2001; Marin et al, 1998; Murphy et al, 2001;). Women are at risk for intimate partner homicide, before, during and after of the pregnancy (McFarlane , Campbell, Sharps & Watson, 2002) & IPH is the major cause of maternal mortality 12
  • 13. Comparison Of Infant Mortality Rates By Women's Experience Of IPV 105 29 35 81 90 86 51 43 95 91 20 35 72 109 69 42 43 92 Experienced DV Not experienced DV 13
  • 14.  Each year 3-10 million children are affected by IPV (Campbell & Lewandoski, 1997)  Up to 60% of children of abused women are also abused (record review DeVos, Newberger et. al. „89; Stark & Flitcraft „88)  Step-child in home associated with intimate partner femicide & child murder (Daly & Wilson ‟95; Campbell et al 2003)  20 years of research have reported consequences of IPV for children's physical and socio-emotional health such as:  Depression, poor self-esteem, anxiety, aggression, poor peer relations, poor academic performance,  Physical health symptoms, under immunization  Adolescent risky behavior (Bair-Merritt, et all, 2006; Baldry, 2003; Holden, 2003; Fantuzzo, et al, 1991; Fredland et al, 2008; Kernic et al, 2002; Polillo, 2003). Intimate Partner Violence and Child Abuse Overlap
  • 15. GBV and Associated Factors  Socio-cultural factors  Legal Factors  Policy and Practice Factors  Economic Factors  Institutional Factors  War and Conflict Factors
  • 16.  GBV is a core health issue which requires a health care response  “Whether there is room for neutrality is debatable. Doing nothing may often function as de facto support of the perpetrator” (R Klein) Take-Home Message

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