London School of Hygiene & Tropical Medicine

The report, Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence, represents the first systematic study of global data on the prevalence of violence against women – both by partners and non-partners. Some 35% of all women will experience either intimate partner or non-partner violence.

Intimate partner violence (physical or sexual harm by a current or former partner or spouse) is the most common type of violence against women, affecting 30% of women worldwide.

The findings highlight the need for all sectors to engage in eliminating tolerance for violence against women and better support women who experience it.

The report details the impact of violence on the physical and mental health of women and girls. This can range from broken bones to pregnancy-related complications, mental problems and impaired social functioning.

The report’s key findings on the health impacts of violence by an intimate partner were:

• Death and injury - The study found that globally, 38% of all women who were murdered were murdered by their intimate partners, and 42% of women who have experienced physical or sexual violence at the hands of a partner had experienced injuries as a result.
• Depression - Partner violence is a major contributor to women’s mental health problems, with women who have experienced partner violence being almost twice as likely to experience depression compared to women who have not experienced any violence.
• Alcohol use problems – Women experiencing intimate partner violence are almost twice as likely as other women to have alcohol-use problems.
• Sexually transmitted infections – Women who experience physical and/or sexual partner violence are 1.5 times more likely to acquire syphilis infection, chlamydia, or gonorrhoea. In some regions (including sub-Saharan Africa), they are 1.5 times more likely to acquire HIV.
• Unwanted pregnancy and abortion –  Both partner violence and non-partner sexual violence are associated with unwanted pregnancy; the report found that women experiencing physical and/or sexual partner violence are twice as likely to have an abortion than women who do not experience this violence.
• Low birth-weight babies – Women who experience partner violence have a 16% greater chance of having a low birth-weight baby.

Report co-author Professor Charlotte Watts, director of the Gender, Violence and Health Centre at the London School of Hygiene & Tropical Medicine, said: “This new data shows that violence against women is extremely common.  We urgently need to invest in prevention to address the underlying causes of this global women’s health problem.”

The data used in the report was taken from two new studies led by researchers at the School.

In a study in the Lancet, Dr Heidi Stöckl and colleagues identified compiled data on 492,340 murders from 66 countries. They found that that worldwide at least one in seven homicides (13.5%) are committed by an intimate partner, with partners responsible for 38.6% of all female homicides compared with just 6.3% of male homicides.

Dr Stöckl said: “Such homicides are often the ultimate outcome of a failed societal, health, and criminal justice response to intimate partner violence. More needs to be done, particularly to increase investment in intimate partner violence prevention, to support women experiencing intimate partner violence (most women killed by a partner have been in long-term abusive relationships), and to control gun ownership for people with a history of violence.”

In a second study published in Science, Dr Karen Devries and colleagues analysed data from 81 countries to estimate the global prevalence of partner-caused violence against women. Their analysis showed intimate partner violence affects 30% of women worldwide.

Dr Devries said: “The levels of violence we observed are very high in every global region, and our work shows that women's main risk is actually coming from inside, rather than outside the home. Our results need to serve as a call to action for all of us, and concerted efforts are needed at all levels to prevent and respond to violence against women."

Fear of stigma prevents many women from reporting non-partner sexual violence. Other barriers to data collection include the fact that fewer countries collect this data than information about intimate partner violence, and that many surveys of this type of violence employ less sophisticated measurement approaches than those used in monitoring intimate partner violence.

The report calls for a major scaling up of global efforts to prevent all kinds of violence against women by addressing the social and cultural factors behind it, as well as the urgent need for better care for women who have experienced violence.

Following the release of the report, new WHO clinical and policy guidelines were released, aiming to address this lack of knowledge and the need to train all levels of health workers to recognise when women may be at risk of partner violence, and how to provide an appropriate response.

Dr Margaret Chan, Director-General, WHO, added: “These findings send a powerful message that violence against women is a global health problem of epidemic proportions. We also see that the world’s health systems can and must do more for women who experience violence.”

Podcast

• Charlotte Watts discusses the issues of gender violence

Find out more

• Gender Violence and Health Centre website
• What works to prevent partner violence? - STRIVE website 
• SASA! Act now against violence - STRIVE website

Publications

• H Stöckl, K Devries, A Rotstein, N Abrahams, J Campbell, C Watts, C Garcia Moreno. The global prevalence of intimate partner homicide: a systematic review. The Lancet doi.org/10.1016/S0140-6736(13)61030-2
• K Devries, J. Y. T. Mak, C. García-Moreno, M Petzold, J Child, G Falder, S Lim, L Bacchus, R Engell, L Rosenfeld, C Pallitto, T Vos, N Abrahams, C Watts. The Global Prevalence of Intimate Partner Violence Against Women. Science doi 10.1126/science.1240937