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Landmark study on domestic violence

WHO report finds domestic violence is widespread and has serious impact on health

The first-ever World Health Organization (WHO) study on domestic violence reveals that intimate partner violence is the most common form of violence in women’s lives - much more so than assault or rape by strangers or acquaintances. The study reports on the enormous toll physical and sexual violence by husbands and partners has on the health and well-being of women around the world and the extent to which partner violence is still largely hidden.

"This study shows that women are more at risk from violence at home than in the street and this has serious repercussions for women's health," said Dr LEE Jong-wook, Director-General of WHO at the study release in Geneva. "The study also shows how important it is to shine a spotlight on domestic violence globally and treat it as a major public health issue."

The study is based on interviews with more than 24 000 women from rural and urban areas in 10 countries: Bangladesh, Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Serbia and Montenegro, Thailand, and the United Republic of Tanzania. The Women's Health and Domestic Violence Against Women study makes recommendations and calls for action by policy makers and the public health sector to address the human and health costs, including by integrating violence prevention programming into a range of social programmes.

The study finds that one quarter to one half of all women who had been physically assaulted by their partners said that they had suffered physical injuries as a direct result. The abused women were also twice as likely as non-abused women to have poor health and physical and mental problems, even if the violence occurred years before. This includes suicidal thoughts and attempts, mental distress, and physical symptoms like pain, dizziness and vaginal discharge. The study was carried out in collaboration with the London School of Hygiene and Tropical Medicine, PATH and national research institutions and women's organizations in the participating countries.

“The degree to which the health consequences of partner violence in the WHO study are consistent across sites, both within and between countries, is striking,” noted Dr Charlotte Watts, from the London School of Hygiene and Tropical Medicine, a member of the core research team for the study. "Partner violence appears to have a similar impact on women’s health and well-being regardless of where she lives, the prevalence of violence in her setting, or her cultural or economic background."

Domestic violence is known to affect women's sexual and reproductive health and may contribute to increased risk of sexually transmitted infections, including HIV. In this study, women who were in physically or sexually abusive relationships were more likely to report that their partner had multiple sexual partners and had refused to use a condom than women in non violent relationships. Women who reported physical or sexual violence by a partner were also more likely to report having had at least one induced abortion or miscarriage than those who did not report violence.

Although pregnancy is often thought of as a time when women should be protected, in most study locations, between 4% and 12% of women who had been pregnant reported being beaten during pregnancy. More than 90% of these women had been abused by the father of the unborn child and between one quarter and one half of them had been kicked or punched in the abdomen.

For policy makers, the greatest challenge is that abuse remains hidden. At least 20% of women reporting physical violence in the study had never told anyone before being interviewed. Despite the health consequences, very few women reported seeking help from formal services like health and police, or from individuals in positions of authority, preferring instead to reach out to friends, neighbours and family members. Those who did seek formal support tended to be the most severely abused.

“This is the first ever study conducted in Thailand on this issue and has made us better understand the extent of violence that women experience in our country," noted Dr. Churnrurtai Kanchanachitra from Mahidol University, and a member of the study team in Thailand. "The findings helped us to develop the national plan for the elimination of violence against women and children."

The report recommends a range of vital interventions to change attitudes and challenge the inequities and social norms that perpetuate abuse. It further recommends integrating violence prevention programming into ongoing initiatives aimed at children, youth, HIV/AIDS, and sexual and reproductive health. Health service providers should be trained to identify women experiencing violence and to respond appropriately. Prenatal care, family planning or post abortion care are potential entry points to provide care, support, and referral to other services. Schools need to be safe places, support systems for victims must be strengthened and prevention programmes put in place. Raising awareness of the problem among the general public is critical. . "Domestic violence can be prevented and governments and communities need to mobilize to fight this widespread public health problem," said WHO's Dr Claudia Garcia Moreno, Study Coordinator. "WHO will continue to raise awareness about violence and the important role that public health can play to address its causes and consequences. Globally, we need to stop the violence from happening in the first place, and to provide help and support to women who are in abusive relationships."

WHO's Global Campaign for the Prevention of Violence supports governments to develop comprehensive violence prevention programmes to address domestic violence alongside other types of violence.

Some quotes from women interviewed for the study
  • "I suffered for a long time and swallowed all my pain. That's why I am constantly visiting doctors and using medicines. No one should do this." Woman interviewed in Serbia and Montenegro.
  • "He got this gun, I don’t know from who… And he would tell the girls: "I'm going to kill your mother… The day will break and your mother will be dead right here…" I would sleep in a locked bedroom and with a dog inside the room with me. My dog. So he would not kill me". Woman interviewed in Brazil.
  • "He hit me in the belly and made me miscarry two babies - identical or fraternal twins, I don’t know. I went to the Loayza hospital with heavy bleeding and they cleaned me up." Woman interviewed in urban Peru.

How physical and sexual violence was measured:
For physical violence, women were asked whether a current or former partner had ever: slapped her, or thrown something at her that could hurt her ; pushed or shoved her ; hit her with a fist or something else that could hurt ; kicked, dragged or beaten her up ; choked or burnt her on purpose ; threatened her with , or actually used a gun, knife or other weapon against her.

Sexual violence was defined by the following three behaviours: Being physically forced to have a sexual intercourse against her will ; having sexual intercourse because she was afraid of what her partner might do ; being forced to do something sexual she found degrading or humiliating.

Contact the Department of Gender, Women and Health (GWH) by sending an e-mail: