WHO Multi-country Study on Women's Health and Domestic Violence against Women

This report presents initial results of a study implemented by the World Health Organization (WHO), in collaboration with the London School of Hygiene and Tropical Medicine (LSHTM), Program for Appropriate Technology in Health (PATH) in the USA, research institutions and women's organisations in the participating countries. The report is based on interviews with 24,000 women and covers 15 sites and 10 countries: Bangladesh, Brazil, Ethiopia, Japan, Peru, Namibia, Samoa, and Serbia and Montenegro, Thailand, and the United Republic of Tanzania. Report findings document the prevalence of intimate partner violence and its association with women's physical, mental, sexual and reproductive health. Data is included on non-partner violence, sexual abuse during childhood and forced first sexual experience. Information is also provided on women’s responses: Whom do women turn to and whom do they tell about the violence in their lives? Do they leave or fight back? Which services do they use and what response do they get?

The study found 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.

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. 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.


The report makes the following recommendations:

• Promote gender equality and women's human rights, in line with relevant international treaties and human rights mechanisms, including addressing women’s access to property and assets, and expanding educational opportunities for girls and young women.
• Establish, implement and monitor action plans to address violence against women, including violence by intimate partners.
• Enlist social, political, religious, and other leaders in speaking out against violence against women.
• Enhance capacity and establish systems for data collection to monitor violence against women, and the attitudes and beliefs that perpetuate the practice.
• Develop, implement and monitor programmes aimed at primary prevention of intimate partner violence and sexual violence against women. These should include sustained public awareness activities aimed at changing the attitudes, beliefs and values that condone partner violence as normal and prevent it being challenged or talked about.
• Give higher priority to combating sexual abuse of girls (and boys) in public health programmes, as well as in responses by other sectors such as the judiciary, education, and social services.
• Integrate responses to violence against women into existing programmes for the prevention of HIV and AIDS, and for the promotion of adolescent health, including to promote the prevention of sexual violence as well as intimate-partner violence against women as an integral part of these programmes.
• Make physical environments safer for women, through measures such as identifying places where violence often occurs, improving lighting, and increasing police and other vigilance.
• Make schools safe for girls, by involving education systems in anti-violence efforts, including eradicating teacher violence, as well as engaging in broader anti-violence efforts.
• Develop a comprehensive health sector response to the various impacts of violence against women, and in particular address the barriers and stigma that prevent abused women from seeking help. This includes supporting mental health services to address violence against women as an important underlying factor in women’s mental health problems.
• Use reproductive health services as entry points for identifying and supporting women in abusive relationships, and for delivering referral or support services.
• Strengthen formal and informal support systems for women living with violence.
• Sensitise legal and justice systems to the particular needs of women victims of violence.
• Promote and support further research on the causes and consequences of violence against women and on effective prevention measures.
• Increase support to programmes to reduce and respond to violence against women.