Gender, women and health

Country Findings

WHO Multi-country Study on Women's Health and Domestic Violence against Women


1. Introduction

The Multi-country Study on Women’s Health and Domestic Violence against Women, sponsored by the World Health Organization, between 2000 and 2003 collected data from over 24 000 women in Bangladesh, Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Serbia and Montenegro, Thailand, and the United Republic of Tanzania. The Study assessed women’s experiences of violence using a questionnaire developed and validated for cross-cultural use, with a special focus on violence by intimate partners. It also investigated how such violence is associated with ill-health and injury, and the strategies that women use to cope with the violence.

In Brazil, the Study was carried out by a research team including members from: the Faculty of Medicine and the School of Public Health, University of São Paulo; São Paulo Feminist Collective for Sexuality and Health; SOS Corpo, Gênero e Cidadania Recife, Pernambuco; and the Faculty of Medicine, Federal University of Pernambuco. Data collection in the field took place in 2000 and 2001.

2. Methods

In Brazil, the team interviewed 1172 women in the country’s largest city, São Paulo, and 1473 in the State of Pernambuco’s Zona da Mata region, which has a mixture of urban and rural settings. The women were aged 15–49 years and represented all socioeconomic levels. In the Study in Brazil women were considered “ever-partnered” if they had ever been married, ever lived with a man or were currently with a regular sexual partner.

In the Study, the following definitions of partner violence were used. Physical violence meant the woman had been: slapped, or had something thrown at her; pushed or shoved; hit with a fist or something else that could hurt; kicked, dragged or beaten up; choked or burnt; threatened with or had a weapon used against her. Sexual violence meant the woman had: been physically forced to have sexual intercourse; had sexual intercourse because she was afraid of what her partner might do; been forced to do something sexual she found degrading or humiliating.

3. Main findings

3.1 Prevalence of partner violence

  • Among ever-partnered women, 27% in São Paulo and 34% in Pernambuco reported ever having experienced physical violence, while 10% in São Paulo and 14% in Pernambuco reported sexual violence.
  • Combining the data for physical and sexual violence, 29% of ever-partnered women in São Paulo and 37% in Pernambuco experienced physical or sexual violence by a partner.

3.2 Injuries inflicted by a partner

  • Among the women who experienced physical violence by a partner, 40% in São Paulo and 37% in Pernambuco reported having been injured at least once. Injuries ranged from abrasions and bruises, cuts, punctures and bites to fractures, burst eardrums and burns. More than one in three women who had been injured were so badly injured that they needed health care. Two in ten women who had been injured spent at least one night in hospital as a result of their injuries.

3.3 Physical violence by a partner during pregnancy

  • Among women who had been pregnant at least once, 8% in São Paulo and 11% in Pernambuco reported physical violence during a pregnancy. Among these, 29% of women in São Paulo and 38% in Pernambuco were hit or kicked in the abdomen. About half of the women in both sites were also beaten before the pregnancy and one third of these reported that the beating got worse during pregnancy.

3.4 Non-partner physical and sexual violence since the age of 15 years

  • About 25% of women in São Paulo and 16% in Pernambuco reported physical or sexual violence since the age of 15 years by people other than partners. Physical violence was about three times more common than sexual violence.
  • The main perpetrators of physical violence included female family members, fathers, and other male family members.
  • Sexual violence since the age of 15 years was mainly perpetrated by boyfriends (mentioned by over 32% in both São Paulo and Pernambuco) or strangers (29% in São Paulo and 18% in Pernambuco).

3.5 Sexual abuse of girls under 15 years of age and forced first sex

  • 12% of all women in São Paulo and 9% in Pernambuco reported sexual abuse before the age of 15 years. The majority of this violence was perpetrated by a male family member.
  • The younger a woman’s age at first sex, the greater the likelihood that her first sexual experience was forced. For those women who had their first experience of sexual intercourse before the age of 15 years, this was forced for 14% of women in São Paulo and 11% in Pernambuco.

3.6 Impact on women’s health of violence by a partner

  • 9% of physically or sexually abused women in São Paulo rated their general health as poor compared to 4% of never-abused women; in Pernambuco the rates were 28% versus 14%.
  • In both sites, abused women who had ever been pregnant had more induced abortions and miscarriages than non-abused women.
  • Women abused by their partner were twice as likely to have thought of suicide.

3.7 Help-seeking by women experiencing physical violence by a partner

  • 22% of abused women in São Paulo and 24% in Pernambuco had never told anyone about physical violence by a partner, while 55% and 78%, respectively, had never sought help.
  • If women do seek help, the most commonly used services or persons in positions of authority in São Paulo were police (mentioned by 18% of physically abused women), religious leader (15%), legal advice centre (15%), health services (14%), and women’s police department (14%). In Pernambuco the most commonly used services were health services (11%) and police (10%).

For more information contact:
Ruchira Tabassum Naved PhD
Gender and Reproductive
Health Specialist,
Public Health Sciences Division,
ICDDR,B: Centre for Health and Population Research,
Dhaka 1212,
Dhaka, Bangladesh
Tel.: +880 2 881 1751–60 (Ext. 2241), +880 2 881 0021,
Fax: +880 2 882 6050

Department of Gender,
Women and Health,
World Health Organization,
Avenue Appia 20,
1211 Geneva 27,
Fax: +41 22 791 1585