Gender-based Violence and Reproductive Health

1. Gender-based Violence and Reproductive Health Herrera/Mexfam

2. Reducing Violence: What Role for Reproductive Health Agencies? • Gender-based violence is a major public health problem • Violence directly affects women’s reproductive health

3. Violence: Facts and Figures • 10 to 67% of women have been physically assaulted by an intimate male partner • Rape and domestic violence account for 5 to 16% of the healthy years of life lost to women • As many as 1 of 4 women is physically abused during pregnancy • 100 to 180 million women and girls globally have undergone FGM Sources: Violence Against Women:The Hidden Burden, The World Bank, 1994; Heise, Popul Rep 2000;L(11).

4. Adult Women* Ever Physically Assaulted by Intimate Male Partner, Selected Countries (%) Papua New Guinea (1982) 67 Bangladesh (1992) 47 New Zealand (1994) 35 Egypt (1995/96) 34 Canada (1993) 29 Nicaragua (1998) 28 United States (1995/96) 22 Switzerland (1994-96) 21 South Africa (1998) 13 Philippines (1998) 10 Source: Heise, Popul Rep 2000;L(11). * Ever-married/partnered except U.S. (all women)

5. Types of Violence Sexual M. Ramos/ReproSalud/Herrera Physical Psychological Psychological

6. Effect of Violence on Women’s Sexual and Reproductive Health • Involuntary sexual activity • Unintended/unwanted pregnancy • Unsafe abortion • Reduced ability to negotiate condom use • STI/HIV transmission • High-risk pregnancies and maternal deaths • Covert contraceptive use • Depression and low self-esteem Source: Heise, Popul Rep 2000;L(11).

7. Psychosocial Risk Factors in Violence against Women • Witnessing marital violence as a child • Being abused as a child • Absent or rejecting father • Alcohol/drug use Mexfam

8. Gender Roles and Partner Abuse • Many men feel entitled to be served by women and failure to meet men’s expectations can lead to violence • Many cultures sanction physical abuse as a way to “correct” women’s behavior • In some cultures, men use extreme violence to maintain gender “honor”

9. Gender Norms Perpetuate Acceptance of Violence • Women are acculturated to accept abuse if they violate gender norms • In Egypt and Papua New Guinea, 59% of women agree wife-beating is justified if a woman talks back/disobeys husband • Healthcare and law enforcement workers share dominant cultural values

10. Approaches to Addressing Violence against Women Train family planning and reproductive health personnel to: • Identify women who are victims of violence • Provide appropriate contraceptive and reproductive health counseling • Refer to appropriate services

11. FP Clinics in Latin America Help Identify Abuse • Three-year pilot project in IPPF affiliates in Peru, Dominican Republic and Venezuela • Screen every woman client in selected clinics for past or current abuse Pan American Health Organization

12. EngenderHealth and Planned Parenthood ofSouth Africa work to change men’s attitudes towards violence and gender equity Working with Male Perpetrators,Law Enforcement Agentsand Anti-violence Advocates • 58% of men surveyed in South Africa believed that a woman could not be raped by her husband EngenderHealth

13. Addressing Socialization, Gender Roles and Coping Mechanisms “Violence Against Women: A Disaster That Men Can Prevent” Puntos de Encuentro – Poster developed in men’s workshop conducted by Puntos de Encuentro

14. Engage Men to Reach Other Men

15. Questions for Debate? • Will reducing violence lead to better reproductive health outcomes? • Do reproductive health agencies have an obligation to help reduce violence, after helping to document the problem? J. Littlewood/World Health Organization • Can reproductive health programs help reduce violence against women by working with men and boys?