This document discusses violence against women as a global public health issue. It provides statistics showing that around 1 in 3 women worldwide experience violence from an intimate partner. Violence against women has many negative health consequences, including both physical and mental health impacts. It can result in injuries, chronic pain, gastrointestinal issues, depression, PTSD, and other conditions. Addressing violence against women requires a public health response, including screening for abuse in healthcare settings and treating both physical and psychological impacts.

1. B Y :
L A S U M I S H Y L L A
M 2 0 1 6 P H S E 0 1 4
P U B L I C H E A L T H A C R O S S L I F E S P A N
A PRESENTATION ON
VOILENCE AGAINST WOMEN AND ITS
EFFECT ON HEALTH

2. GENDER RELATIONS
Gender relations are socially constructed power
relations between men and women that inter links
with other power relations:
1. Race
2. Caste
3. Class
4. Ethnicity and religion
5. Abilities
6. Sexual orientation and gender identity

3. WHAT IS VIOLENCE AGAINST WOMEN?
It is the violation of human rights
Affects female individuals irrespective of their socio
economic status, and place of residence :urban and
rural settings.
Any act of gender-based violence that results in, or is
likely to result in, physical, sexual or psychological
harm or suffering to women, including threats of such
acts, coercion or arbitrary deprivation of liberty,
whether occurring In public or in private life.
-UN declaration on elimination of violence against
women-1993

4. IT ENCOMPASES
• Battering
• Sexual abuse of female children in the household dowry-related violence
• Marital rape
• Female genital mutilation and other traditional practices harmful to
women
• Non -spousal violence and violence related to exploitation
FAMILY
• Rape
• Sexual abuse
• Sexual harassment and intimidation at work, in
educational institutions and elsewhere,
• Trafficking in women and forced prostitution
COMMUNITY/
• Physical, sexual and psychological violence
perpetrated or condoned by the State,
wherever it occurs.
STATE

5. FORMS OF GENDER BASED VIOLENCE AND
DISCRIMINATION
CHILD ADOLESCENTS ADULT ELDERLY
• Denial for access
to education,
healthcare, good
nutrition
• Child labour
• Trafficking for
sex work
• Physical
abuse/neglect
• Sexual abuse
(incest/molesta-
tion)
• Child/force/ear-
ly marriage
• Violence within
the home by
family members
• Control over
sexuality and
sexual
orientation
• Denial to
education , heal-
thcare
• Rape
• Sexual assault
• Early/force
marriage
• Domestic
violence within
the home/family
members
• Domestic
violence within
relationships ,
marriage, live in
relationships
• Domestic violence
• Denying choice of
partner and
sexual orientation
• Dowry
harrasment
• Denial over:
 Her own body and
sexuality
 Choice over safe
sex and
contraceptions
• Battering during
pregnancy
• Economic abuse
and isolation from
friends/family
• Sexual
harassment at
workplace
• Domestic
violence
• Physical,
• Economic , and
emotional
abuse by adult
children and
caretaker
• Lack of social
security
• Withholding
healthcare and
medication
• Demeaning
widowhood.

6. THE LIFECYCLE APPROACH TO GENDER
BASED VIOLENCE
PREBIRTH
INFANCY
GIRLHOOD
ADOLESCENCE
REPRODUCTIVE
AGE
OLD AGE

7. IS IT A GLOBAL EPIDEMIC??
 1 in 3 women experience violence at the house of their
husband/partner and that is 800 million women worldwide.
 Overall , 35% of women worldwide have experienced either
physical and/or sexual intimate partner violence or non-
partner sexual violence. While there are many other forms of
violence that women may be exposed to, this already
represents a large proportion of the world’s women;
 Up to 38% of murders of women are committed by their male
intimate partner.
 Most of this violence is intimate partner violence. 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.

8. Cont…
 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.

9. A LOOK AT GLOBAL AND REGIONAL
DATA ON VIOLENCE AGAINST WOMEN
Lifetime prevalence of
physical and/or
sexual intimate partner
violence among
ever-partnered women
Source : Global and regional estimates of violence against women
Prevalence and health effects of intimate partner and non sexual partner sexual violence: WHO
WHO REGION PREVALENCE,%
Low and middle
income regions
Africa 36.6
Americas 29.8
Eastern
Mediterranean
37.0
Europe 25.4
South East Asia 37.7
Western paccific 24.6
High income regions 23.2

10. Cont…
 Lifetime
prevalence of
non-partner
sexual violence
by WHO region.
Source : Global and regional estimates of violence against women
Prevalence and health effects of intimate partner and non sexual partner sexual violence: WHO
WHO REGION PREVALENCE,%
Low and middle income regions :
Africa 11.9
Americans 10.7
Eastern Mediterranean -
South East Asia 4.9
Europe 5.2
Western paccific 6.8
High income 12.6

11. LIFETIME PREVALENCE OF INTIMATE PARTNER VIOLENCE
BY AGE GROUP AMONG EVER-PARTNERED WOMEN
Age group, years Prevalence,%
15-19 29.4
20-24 31.6
25-29 32.3
30-34 31.1
35-39 36.6
40-44 37.8
45-49 29.2
50-59 15.1
60-64 19.6
65-69 22.2
Source : Global and regional estimates of violence against women
Prevalence and health effects of intimate partner and non sexual partner sexual violence: WHO

12. INDIA
 In India 35% of women aged 15-49 years have
experienced physical or sexual violence
 Domestic violence is significantly associated
with chronic malnutrition among women at the all India
level
 According to United Nation Population Fund Report,
around two-third of married Indian women are victims
of domestic violence and as many as 70 per cent of
married women in India between the age of 15 and 49
are victims of beating, rape or forced sex.

13. CONTRIBUTING FACTORS
 Strictly defined and enforced gender roles.
 Masculinity is closely associated with toughness,
male honour, or dominance; where punishment of
women and children is accepted.
 Poverty and stress contribute to intimate partner
violence.
 Domestic abuse increases women’s risk of having
many children by limiting heir ability to control the
timing of sex and the use of contraception.

14. JAMMU AND KASHMIR 57.0 RAJASTHAN 81.5
HIMACHAL PRADESH 37.4 GUJRAT 26.3
PUNJAB 39.7 M.P 65.5
CHANDIGARH 64.8 JHARKHAND 40.2
UTTARAKHAND 28.2 WEST BENGAL 73.4
HARYANA 75.7 MAHARASHTRA 54.8
DELHI 184.3 CHATTISGARH 44.8
U.P 34.8 ODISHA 81.9
BIHAR 27.9 GOA 39.9
MEGHALAYA 24.5 KARNATAKA 41.6
ASSAM 148.2 TELENGANA 83.1
ARUNACHAL 62.1 ANDRA PRADESH 62.3
NAGALAND 8.0 PUDUCHERRY 10.9
MANIPUR 20.8 KERALA 54.4
MIZORAM 30.9 LAKSHWEEP 22.0
ANDAMAN AND NICOBAR 51.1

15. A BLEAK PICTURE.
Type of crime Cases reported
during the year
Rape 36,735
Attempt to commit rape 4,234
Kidnapping and abduction of women 57,311
Dowry deaths 8,455
Assault on women with intent outrage her modesty
source: women and men in india 2015, 17th issue MoSPI
ref:
http://mospi.nic.in/mospi_new/upload/womenmen2015/women_men_in
dia-2015.html
8,235

16. VIOLENCE AGAINST WOMEN:A PUBLIC
HEALTH ISSUE BECAUSE:
 Women who are abused have poorer mental and physical
health, more injuries, and a greater need for medical
resources than non-abused woman.
 The impact of gender-based abuse on physical health can
be immediate and long-term.
 Abused women rarely seek medical care and treatment.
 Survivors of abuse often exhibit negative health behaviors,
including alcohol and drug abuse and suffer from high
prevalence mental disorders like depression and anxiety.
 Depression and anxiety is reported to be twice as common
in women compared with men across diverse societies and
social contexts, violence being the major cause.

17. HEALTH CONSEQUENCES OF VIOLENCE AGAINST
GIRLS AND WOMEN
.
NON FATAL
OUTCOMES
FATAL
OUTCOMES
 PHYSICAL
CONSEQUENCES
 Injuries
 Functional impairment
 Permanent disabilities
 PSYCHO SOMATIC
 Chronic pain syndrome
 Irritable bowel syndrome
 G.I Disorders
 UTI
 Respiratory disorders
 NEGATIVE HEALTH
BEHAVIOUR
 Smoking
 Alcohol and drug abuse
 Risky sexual behaviour
 Self harm behaviour
 FATAL INJURIES
 HOMICIDE
 SUICIDE
 HONOUR
KILLING
 REPRODUCTIVEHEALTH
CONSEQUENCES
 Pelvic inflammatory
diseases
 STDs
 Unwanted pregnancy
 Pregnancy complications
 Miscarriage / low birth
weight
 Unsafe abortion
 HIV/AIDS
 Limits sexual and
reproductive autonomy
(use of contraception)
 Affects maternal & child
health
 PSYCHOLOGICAL
CONSEQUENCES
 PTSD
 Depression, fear
 Sleep disorder
 Panic disorders
 Eating disorders
 Low self esteem
 Suicidal tendencies

18. OTHER CONSEQUENCES
SOCIAL COST
 Physical and mental insecurity
 Dissolution of marriages
 Judicial system
ECONOMIC COST: DIRECT AND INDIRECT COST
 Household level
 Community level
 National level
Gender equality is of intrinsic importance and is smart
economics. Period!!

19. HEALTH SYSTEM PROCESSES IN RESPONDING
TO VIOLENCE AGAINST WOMEN
 Identify Abuse
Look for signs and symptoms of violence and abuse
Inquire with sensitivity
Listen to the survivor
Do not force disclosure but create a milieu of support, empathy that will
encourage the survivor
Assure the survivor of confidentiality and make her safety a priority
 Provide Treatment and Medical Support
• Assess for current and past incidences of violence
 ‚Attend to all injuries, and provide treatment for physical and
psychological trauma
 In case all support is not available at your health care facility, ensure
that it is made accessible through coordination with requisite experts
and services. For example, medical experts, surgeons, interpreters ,etc.
 If this is not possible at all, facilitate referrals to the facilities /
providers as per the requirement
 Offer specialized (medico-legal) services for survivors of sexual
violence

20. Cont…
Provide Emotional Support
 Listen carefully
 ‚Believe in the survivor; validate
 ‚Convey that violence is not the survivor’s fault
 ‚Assure the survivor that she is not alone
Document/Record/ Collect and Manage Data
 Register a medico-legal case
 Make a domestic incident report
 Analyse data collected routinely to develop a deeper
understanding about survivors and the response

21. Cont ….
Provide Information and Referrals
 ‚Inform the survivor of her rights
 ‚Convey the importance of filing a police complaint
 ‚Ask and assess about the survivor’s safety
 ‚Refer the survivor to legal and social agencies for further
help
Establish systems / processes for review,
feedback and grievance redressal
 Facilitate processes for feedback from thoseaccessing
services regarding their experiences,satisfaction, gaps
towards future improvement.
 Maintain privacy and confidentiality
Health System Response for Survivors of Acid
Attack which is in the purview of sexual assault.

22. STRENGTHTENING HEALTH CARE SYSTEM
RESPONSE TO FEMALE VIOLENCE
Enhancing perspective
Defining Institutional Policy, Protocols and
Guidelines
Establishing Necessary Infrastructure and
Referral Systems
Human Resources
Health Education and Capacity Building of
Health Care Providers
A collaborative and inter-sectoral approach of
legal , social and ministerial effort along with
the community will go along way in preventing
and controlling violence against women.

23. “There is one universal truth, applicable to all
countries, cultures and communities: violence
against women is never acceptable, never
excusable, never tolerable.”
-United Nations Secretary-General, Ban Ki-Moon
(2008)

24. THANK YOU

25. REFERENCES
1. Violence against women: effects on reproductive health. Shane B, Ellsberg M (2002).
Outlook 20(1): 1-8.
2. Gender Based Violence and Health. Strengthening Linkages and Responses – An
Information Booklet.2013. Sama Resource Group for Women and Health.
3. http://mospi.nic.in/mospi_new/upload/womenmen2015/women_men_india-2015.html