Violence against women

Violence against women and girls is a major health and human rights concern. Women can experience physical or mental abuse throughout their lifecycle, in infancy, childhood and/or adolescence, or during adulthood or older age. While violence has severe health consequences for the affected, it is a social problem that warrants an immediate coordinated response from multiple sectors.

Definition of violence against women
A group of international experts convened by WHO in February 1996 agreed that the definition adopted by the United Nations General Assembly provides a useful framework for the Organization's activities. The Declaration on the Elimination of Violence against Women (1993) defines violence against women as "any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life."

This encompasses, inter alia, "physical, sexual and psychological violence occurring in the family and in the general community, including battering, sexual abuse of children, dowry-related violence, rape, female genital mutilation and other traditional practices harmful to women, non-spousal violence and violence related to exploitation, sexual harassment and intimidation at work, in educational institutions and elsewhere, trafficking in women, forced prostitution, and violence perpetrated or condoned by the state."

Growing public health concern
In every country where reliable, large-scale studies have been conducted, results indicate that between 10% and 50% of women report they have been physically abused by an intimate partner in their lifetime.*
Population-based studies report between 12 and 25% of women have experienced attempted or completed forced sex by an intimate partner or ex-partner at some time in their lives.*
Interpersonal violence was the tenth leading cause of death for women 15-44 years of age in 1998.
Forced prostitution, trafficking for sex and sex tourism appear to be growing. Existing data and statistical sources on trafficking of women and children estimated 500,000 women entering the European Union in 1995.

Most studies on violence against women indicate that
the perpetrators of violence against women are almost exclusively men;
women are at greatest risk of violence from men they know;
women and girls are the most frequent victims of violence within the family and between intimate partners
physical abuse in intimate relationships is almost always accompanied by severe psychological and verbal abuse;
social institutions put in place to protect citizens too often blame or ignore battered women.

WHO .Fact sheet N°239 .Revised June 2000.

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.

24 Nov 2005 / Geneva/London

What is meant by “the right to health”?

The right to the highest attainable standard of health (referred to as “the right to health”) was
first reflected in the WHO Constitution (1946) and reiterated in the 1978 Declaration of Alma
Ata and in the World Health Declaration adopted by the World Health Assembly in 1998. It has been firmly endorsed in a wide range of international and regional human rights instruments.
The right to the highest attainable standard of health in international human rights law is a
claim to a set of social arrangements – norms, institutions, laws, an enabling environment –
that can best secure the enjoyment of this right.
The most authoritative interpretation of the right to health is outlined in Article 12 of the ICESCR, which has been ratified by 145 countries (as of May 2002). In May 2000, the Committee on Economic, Social and Cultural Rights, which monitors the Covenant, adopted a General Comment on the right to health. General Comments serve to clarify the nature and content of individual rights and States Parties’ (those states that have ratified) obligations. The General Comment recognized that the right to health is closely related to and dependent upon the realization of other human rights, including the right to food, housing, work, education, participation, the enjoyment of the benefits of scientific progress and its applications, life, non-discrimination, equality, the prohibition against torture, privacy, access to information and the freedoms of association,assembly and movement.

Further, the Committee interpreted the right to health as an inclusive right extending not only
to timely and appropriate health care but also to the underlying determinants of health, such
as access to safe and potable water and adequate sanitation, an adequate supply of safe
food, nutrition and housing, healthy occupational and environmental conditions and access to health-related education and information, including on sexual and reproductive health.

The General Comment sets out four criteria by which to evaluate the right to health:
(a) Availability. Functioning public health and health-care facilities, goods and services, as
well as programmes, have to be available in sufficient quantity.
(b) Accessibility. Health facilities, goods and services have to be accessible to everyone without
discrimination, within the jurisdiction of the State party. Accessibility has four overlapping
dimensions:
• Non-discrimination;
• Physical accessibility;
• Economic accessibility (affordability);
• Information accessibility.
(c) Acceptability. All health facilities, goods and services must be respectful of medical
ethics and culturally appropriate, sensitive to gender and life-cycle requirements, as well
as designed to respect confidentiality and improve the health status of those concerned.
(d) Quality. Health facilities, goods and services must be scientifically and medically appropriate
and of good quality.

What is the link between health and human rights?

There are complex linkages between health and
human rights:
• Violations or lack of attention to human rights can have serious health consequences;
• Health policies and programmes can promote or violate human rights in the ways they are designed or implemented;
• Vulnerability and the impact of ill health can be reduced by taking steps to respect, protect
and fulfil human rights.

The normative content of each right is fully articulated in human rights instruments. In relation to the right to health and freedom from discrimination. Examples of the language used in human rights instruments to articulate the normative content of some of the other key human rights relevant to health follow:

Torture: “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation.”

Violence against children: ”All appropriate legislative, administrative, social and educational
measures to protect the child from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse...” shall be taken.

Harmful traditional practices: “Effective and appropriate measures with a view to abolishing
traditional practices prejudicial to the health of children” shall be taken.

Participation: The right to “…active, free and meaningful participation”

Information: “Freedom to seek, receive and impart information and ideas of all kinds.”
Privacy: “No one shall be subjected to arbitrary or unlawful interference with his privacy...”
Scientific progress: The right of everyone “to enjoy the benefits of scientific progress and its
applications”.
Education: The right to education, including access to education in support of “basic knowledge of child health and nutrition, the advantages of breast-feeding, hygiene and environmental sanitation and the prevention of accidents”.

Food and nutrition: “The right of everyone to adequate food and the fundamental right of everyone to be free from hunger…”
Standard of living: Everyone has the right to an adequate standard of living, including adequate
food, clothing, housing, and medical care and necessary social services.
Right to social security: ”The right of everyone to social security, including social insurance”.

Briefing note on the human rights situation in the Islamic Republic of Iran - 2005

The briefing note has been elaborated in view of the 60th session of the 3rd Committee of the UN General Assembly meeting, as a call for the adoption of a resolution on the human rights situation in the Islamic Republic of Iran

Iran recalls senior ambassadors

Mr Ahmadinejad is likely to appoint his own men to key positionsIranian President Mahmoud Ahmadinejad has recalled a string of ambassadors from high-profile postings .

Iran 'offers shares to the poor'

The Iranian government has approved plans to offer share options to low-income families, the country's official news agency IRNA has reported.
BBC, 3 Nov