Sexual and reproductive health

Violence against women

Health sector response

Research: Addressing violence against women among women in antenatal care

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WHO is initiating a study on addressing violence against women among women attending antenatal care. Antenatal care provides a window of opportunity for identifying women suffering violence during pregnancy. Interventions to identify abuse during pregnancy and offer women support and counselling can potentially help them to improve their health and reduce abuse and its consequences.

Violence against women is a pervasive global problem with significant consequences to the physical, mental and sexual and reproductive health of victims/survivors, both short and long term. These include unwanted pregnancies, sexually transmitted infections, abortions, and gynaecological problems. When it happens during pregnancy it can increase the risk of miscarriage, preterm labour and low birth weight. The health sector thus needs to be able to respond appropriately.

In many settings, health workers who provide care to survivors of partner violence and sexual violence often lack the knowledge and skills (including forensic evidence collection) to respond appropriately. Likewise, people who report a sexual assault to the police may undergo a forensic medical examination without their health needs being addressed.

Women may seek care for other reasons but not readily disclose their abuse status to health-care providers, even when the violence may be the root cause of the health problem for which they seek care. Or they may seek health services for the immediate and long-term health effects of violence, yet often available services do not meet the needs of survivors. In many settings, health workers often lack the knowledge and skills (including forensic evidence collection) to respond appropriately.

To help ensure better care and support for those who have experienced partner violence or sexual violence, WHO works, among other things, to strengthen the health sector response to violence against women.

This initiative includes research and the development of guidelines on how the health sector can appropriately and effectively respond to women who have previously experienced or are currently experiencing violence.

Guidelines

WHO is currently in the process of developing guidelines for the health-care response to intimate partner and sexual violence. These are based on expert consultations as well as available evidence compiled from systematic reviews of evaluated intervention studies, highlighting those that have achieved significant improvements in outcomes related to reduction of abuse or threats of abuse or improved safety, coping, or help-seeking.

Guidelines for medicolegal care for victims of sexual violence were published by WHO in 2003. The guidelines are designed to enable health workers to provide comprehensive care for the medical, and psychological needs, as well as forensic assessment of survivors of sexual assault. This guidance will be updated in the light of new evidence.

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