Promoting primary prevention
Develop, implement and evaluate programmes aimed at primary prevention of intimate-partner violence and sexual violence.
Preventing partner violence requires changing the gender-related attitudes, beliefs, and values of both women and men, at a societal as well as at an individual level. Prevention efforts should include multimedia and other public awareness activities to challenge women’s subordination, and to counter the attitudes, beliefs and values – particularly among men – that condone partner violence as normal.
The specific media and key messages should be based on research and consultation. An important objective is to eliminate the barriers that prevent women talking about the problem and using available support services. This involves reducing the stigma, shame and denial around partner violence against women, and strengthening informal support networks by encouraging family and community members to reach out to and support women living with violence.
Special efforts should be made to reach men. Media strategies can encourage men who are not violent to speak out against violence and challenge its acceptability. This will help counter notions that all men condone violence and provide alternative role models of masculine behaviour to those usually portrayed by the media.
Targeted efforts should be carried out in health settings, in schools, at workplaces, and within different professions and sectors. Other communication strategies should be explored including community-based approaches (e.g. legal literacy programmes, HIV/AIDS community mobilization, local media initiatives) and activities to target specific risk factors for violence such as alcohol use. Communities need to be encouraged to talk about partner violence and to challenge its acceptability. Overall, there is a need to strengthen primary prevention efforts.2
Prioritize the prevention of child sexual abuse.
The high levels of sexual abuse experienced by girls documented by the Study are of great concern. Such acts are severe violations of a young girl’s basic rights and bodily integrity, and may have profound health consequences for her, both immediately and in the long term. Efforts to combat sexual abuse of girls (and boys) therefore, should have higher priority in public health planning and programming, as well as in responses by other sectors such as the judiciary, education, and social services.
Advocacy by leaders and other respected figures could make a big difference, because it can help “break the silence” and create social space for discussion of the problem within families and communities.
The health and educational sectors need to develop the capacity to identify and deal with child sexual abuse. This will require protocols, training, and resources for health workers.
Similarly, teachers and other education professionals need training to recognize child abuse, as well as protocols and policies for referral to medical or social services. Schools should also provide preventive programmes and counselling wherever possible.
Integrate responses to violence against women in existing programmes for the prevention of HIV and AIDS, and for the promotion of adolescent health.
The Study findings illustrate the high levels of sexual violence against women and girls, and support other research which suggests that violence contributes to women’s vulnerability to HIV infection. Preventing violence against women will contribute to improving the effectiveness of HIV/AIDS programmes. HIV prevention programmes should therefore include activities to raise awareness and promote the prevention of sexual violence as well as intimate-partner violence, recognize the extent to which sexual activity is forced or coerced, and explicitly address issues of consent and coercion. Strategies are needed to respond to women who are experiencing or who fear violence and who are attending HIV services, family planning or other sexual and reproductive health services. Sexual and reproductive health programmes, as well as those promoting adolescent health also need to address intimate-partner violence, and issues of coercion and forced sex.
Make physical environments safer for women.
Measures to make urban and rural environments safer for women can contribute to primary prevention. Such measures should be implemented systematically, by identifying places where violence against women often occurs and analysing why it occurs there. Depending on the risk factors identified and the available resources, safety can be enhanced through, for example, improving lighting, increasing police and other vigilance, particularly in areas where alcohol or other drugs are consumed, and opening up “blind spots” where an assault could take place without anyone being able to see or hear it happening.
2WHO's Global Campaign for Violence Prevention aims to raise awareness about the problem of violence, highlight the crucial role that public health can play in addressing its causes and consequences, and encourage action at every level of society. For more information please see www.who.int/violence_injury_prevention/violence/en/