Violence against women has significant negative health consequences for victims. Women who experience partner violence have worse general health, more health symptoms, and increased risk of mental distress and suicidal thoughts. Violence can also negatively impact children who witness it, increasing risks of behavioral issues, low birth weight, and emotional problems. Many women never report the violence due to shame, fear of further violence, or lack of support systems. When they do seek help, it is usually from family rather than formal agencies. Domestic violence represents a major global women's health issue with both immediate and long-lasting impacts.

1. 1 Examples of consequences of VAW

2. Violence impacts on women’s health I suffered a long time and swallowed my pain. That is why I am constantly visiting doctors and using medicines. No one should have to do this. Woman interviewed in Serbia & Montenegro Women who have ever experienced violence by a partner have: Worse general health More symptoms of ill health such as pain, memory loss, dizziness in the past 4 weeks More signs of mental distress More suicidal thoughts and attempts More induced abortions and miscarriages 2

3. Partner violence increases risk of suicidal thoughts 3

4. Violent acts as a risk factor for ill health An association between recent ill health and lifetimeexperiences of violence suggest that the negative consequences of violence can persist long after the violence has ended 4

5. 5 Other outcomes related to violence For children: low birth-weight emotional well-being behavioural difficulties problems at school leave home For women: injuries own health financial status ability to work ability to function participate in society

6. Percentage of women who report her children witnessed violent incidents, among women who reported physical violence 6

7. Associations between physical partner violence and behavioural problems in children 5-12 years old. Table shows odds ratios adjusted for number of children in same age group living in household, partnership status and educational level of respondent and site 7

8. Violence is hidden and brings shame If I protest I’ll be marked in the society and then my daughter wouldn’t be able to get married… If I voice my protest the community will blame me for not bearing it in silence. This helplessness is a torture in itself. Woman, 43 years old, interviewed in Bangladesh One-fifth to two-thirds of women had never told anyone about their partner’s violence prior to the WHO interview 8

9. Silence and stigma Many women never talk about domestic violence with anybody “I went to my mother first..... I told little by little. Her reaction was ‘Didn’t we tell you?’ ‘You brought this upon yourself, now you pay for it’, ‘There is the child, what will you do? Where will you go?’ and so on ....” Woman interviewed in Turkey 9

10. The majority of women never contact formal support services Between 55% and 95% of physically abused women had never sought help from any formal agency or person in a position of authority To the extent that women do reach out, they do so to family and friends, not formal agencies or the police At work I have one close friend. I told her sometimes. She would nod and encourage me to stay in the relationship. For the kids, she said. He is not that bad. No one is perfect. Woman, 25 years old, interviewed in urban Thailand 10

11. Some of the barriers to talking or taking action for domestic violence victims Shame, embarrassment Fear for more violence Fear for her children Thinks it is normal/that he will change Thinks she will not be believed Economic dependence Family honor/not wanting to shame the family Lack of safe alternatives Lack of community/ family support Women are overwhelmed from physical and psychological trauma 11

12. “ I said in the hospital that I had fallen, because if I told the truth he would kill me, and I was also ashamed that they would find out that it was my husband who had beaten me. ” 12

13. 13 Conclusions Domestic violence against women affects a significant proportion of women around the world, with grave consequences for them and their children Violence against women is linked with shame and stigma and represents a hidden burden on health systems

14. 14 Photos: Henriette Jansen