Violence Against Women (VAW)

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Lecture Outline
• Definition of violence
• Prevalence and significance of the problem
• Types of violence against women
• Risk Factors and causes of Violence
• Cycle of Violence
• Impact of violence
• Interventions to lower the risks of violence
• VAW in Palestine
• What you need to know about domestic violence

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WHO - Violence against women: Strengthening the health
system response

• https://youtu.be/Qc_GHITvTmI

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WHO definition of violence:

The intentional use of physical force or power, against oneself, another person, or
against a group or community, that either results in or has a high likelihood of
resulting in injury, death, psychological harm, mal-development or deprivation.

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Violence against women (VAW):
• Any act of gender-based violence that results in, or is likely to result
in, physical, sexual or psychological harm or suffering to women,
including threats of such act, coercion or arbitrary deprivation of
liberty, whether occurring in public or in private life.

The United Nations Declaration on the Elimination of Violence against Women (1993) 5
 Violence against men:
A retrospective study was performed to compare men and women abused
by their partner, based on all the medical certificates for victims who
consulted a specialized center in assault victims.
• Consultations for domestic violence occur less frequently in men than in
women.
• Events of violence were more frequently repeated against women than
men.
• Injuries which was in most cases mild, were more frequently found in
men than women.
• A psychological impact was more frequently found in women than in
men.
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https://pubmed.ncbi.nlm.nih.gov/25735783/
Significance of the Problem
• Violence affects all women regardless of culture, socio-economic
status, ethnicity, age, occupation or sexual orientation.

• Violence is a significant cause of morbidity and mortality for women.

• Violence can negatively affect women’s physical, mental, sexual, and

reproductive health, and may increase the risk of acquiring HIV in
some settings.

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Prevalence of VAW

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Global prevalence of VAW:

• Estimates published by WHO indicate that

globally about 1 in 3 (30%) of women
worldwide have been subjected to either
physical and/or sexual intimate partner
violence or non-partner sexual violence in
their lifetime.
Global prevalence of VAW:
• Calls to helplines have increased five-fold in some countries as rates
of reported intimate partner violence increase because of the COVID-
19 pandemic. Restricted movement, social isolation, and economic
insecurity are increasing women’s vulnerability to violence in the
home around the world
• 137 women are killed by a member of their family every day
• At least 155 countries have passed laws on domestic violence, and 140
have laws on sexual harassment in the workplace.

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Global prevalence of VAW
• Violence against women and girls is one of the most systematic and
widespread human rights violations:
• In 2019, one in five women, aged 20–24 years, were married before the
age of 18.
• About 70% of all human trafficking victims detected globally are
women and girls.
• At least 200 million women and girls alive today have undergone female
genital mutilation in 30 countries.
• Around 120 million girls worldwide (over 1 in 10) have experienced
forced intercourse or other forced sexual acts.

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Gender based violence in European union since
the age of 15:
• 37% of Arab women have experienced some form of violence in their
lifetime. There are indicators that the percentage might be higher.
• In Egypt, 92% of women and girls between 15 and 49 years of age have
experienced Female Genital Mutilation. Recent data shows progress with
Female Genital Mutilation reaching 61% in girls between 15 and 17
years of age down from 74% in 2008.
• 700 million women alive today have been married under the age of 18.
14% of Arab girls marry under the age of 18.
 Types of violence

1) Physical violence

Including threats of violence, hitting, slapping, punching, kicking,

burning, cutting or otherwise harming the body. with fists or weapons,
with or without physical injury.

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Types of violence
2) Sexual violence:

Any form of forced sexual activity or inappropriate /unwanted touching,

including rape, assault, forced prostitution, incest, female genital
mutilation, sexual harassment, etc.

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 Types of violence
3) Psychological or emotional abuse
Insults, humiliation, put-downs and shouting, and extreme jealousy
,verbal abuse, threats, control, constant criticism, terrorization,
humiliation, etc.
• Use of the victims emotions to control them - can be through verbal
communication (threats/insults/criticisms) or non verbal
(isolation/humiliation).

These are not crimes under the Criminal Code.

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Types of violence
4) Financial abuse (economic abuse / material exploitation)
• Restricting access to family resources, inheritance or employment
opportunities, overwork, denial of ownership of property, withholding
or taking away earnings, denial of inheritance, withholding education,
unequal pay, not being allowed to work, etc

Financial abuse is not a crime under the Criminal Code, unless threat, fraud, coercion is used

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Domestic Violence:
Spousal abuse = Intimate partner violence (Domestic Violence -DV)

• Physical or sexual violence or psychological or financial abuse within

current or former marital or common-law relationships.

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Types of violence against women:

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Types of violence against women:
• The most common forms of violence are:
• Verbal abuse (50%)
• Sexual harassment (40%)
• Physical abuse (36%)
• Denial of basic needs (35%)
• Denial of means of communication (30%)
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• Seven in 10 women surveyed believe violence against women is common in
their community.
WHO 2021

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Risk factors for both intimate partner and sexual violence include:

• lower levels of education (perpetration of sexual violence and

experience of sexual violence).
• a history of exposure to child maltreatment (perpetration and
experience).
• witnessing family violence (perpetration and experience).
• antisocial personality disorder (perpetration).
• harmful masculine behaviors, including having multiple partners or
attitudes that ignore violence (perpetration).
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Risk factors for both intimate partner and sexual violence include:

• community norms that privilege or ascribe higher status to men

and lower status to women.
• low levels of women’s access to paid employment.
• low level of gender equality (discriminatory laws, etc.).
• harmful use of alcohol (perpetration and experience).

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Causes of violence:

• Cultural:

 Notion of the family as the private sphere and under male control
 Customs of marriage (bride price)
 Acceptability of violence as a means to resolve conflict
 Cultural definitions of appropriate sex roles
 Belief in the inherent superiority of males

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Causes of violence:

• Economic factors

 women’s economic dependence on men.

 Discriminatory laws regarding inheritance, property rights, use of
communal lands and maintenance after divorce or widowhood.
 Limited access to employment in formal and informal sectors.
 Limited access to education and training for women.

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Causes of violence:

• legal factors

-Weak position of women in front of some laws including:

 laws regarding divorce.
 child custody.
 maintenance and inheritance.
 legal definitions of rape and domestic abuse.

- low levels of legal literacy among women.

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Causes of violence:

• Political factors:

Under-representation of women in politics, media, in the legal and

medical professions; make domestic violence perceived as unserious
problem.

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Summary:
• Although alcohol and poverty are often identified as causes, they
are triggers or contributing factors to violence
They are not the root cause of violence.

• Violence against women and girls is a complex issue that is rooted

in gender inequality and discrimination, as well as unequal power
relations between men and women which exist in varying degrees
across all communities in the world.
• Low economic and social status of women increases the risk of
violence that women face. Increasing economic independence is
important to help survivors leave abusive relationships.

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Common Characteristics of victims of abuse:
• low self-esteem • have children
• guilt • poor financial resources
• self-blame • few job skills
• denial • Low level of education
• Traditional women’s roles • few friends
• history of childhood abuse

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Common Characteristics of abuser:
• low self-esteem • have witnessed or experienced
• dependency abuse as children
• jealousy • Victims of abuse usually abuse their
own children
• poor communication skills
• Abuse of alcohol/other drugs
• unemployed/underemployed

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The cycle of Violence:
1. Tension building
• Tension is increased.
• Breakdown of communication
• Victim becomes fearful and feels the need to pacify the abuser.

2. Incident
• Verbal, physical, threats, blaming.

3. Reconciliation
• Abuser apologizes, gives excuses, blames victim, says it wasn't as bad as the victim claims , gifts…etc.

4. Calm
• Incident is forgotten (“Honeymoon” phase)

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What are the consequences of violence against women and girls?

• The impact of violence ranges from immediate to long term physical,

sexual and mental health consequences for women and girls, including
death.

• It also has tremendous personal, societal and economic costs all

around the globe: from greater health care and legal expenses to
productivity losses

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 Effects on physical health

Short- and Long-term

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Effect of violence on reproductive systems of females:

• Fetal loss
• Low-birth-weight infants
• Preterm birth
• Lack of control over reproductive decision making
• STD’s & HIV/AIDS
• Vaginal bleeding or infection, genital irritation
• Unplanned pregnancies

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VAW can begin or increase during pregnancy due to:

• Jealous nature of the abuser with the growing fetus that begins to
occupy more and more of woman’s time and attention
• Other family members becoming more attentive
• Abuser may feel loss of power and control
• Woman’s unavailability for sex

- On the contrary other women report that violence diminishes or stops

while pregnant therefore causing them to become pregnant more
frequently.

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Psychological effect of violence:
• Posttraumatic stress disorder
• Sleep disturbance
• Eroded Self esteem
• Phobias
• Depression
• Substance Abuse
• Anxiety
• Suicide
• Long-term effects on children (increased smoking, drug and alcohol misuse,
and risky sexual behaviors in later life)
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 Psychological stages of battered women
• Women Denial.
The victim refuses to admit… she may call each incident an “Accident”.
• Guilt.
She now acknowledges there’s a problem, but considers herself responsible
for it.
• Enlightenment.
She no longer assumes responsibility for her husband’s abusive
behavior/treatment. She recognizes that she does not deserve to be beaten.
• Responsibility.
Accepts that her husband will not and cannot stop his violent behavior. The
battered woman decides she will no longer surrender to it and starts a new life.

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Costs of VAW:
• The social and economic costs of intimate partner and sexual violence
are enormous and have great effects throughout society.

• Women may suffer isolation, inability to work, loss of earnings, lack

of participation in regular activities and limited ability to care for
themselves and their children.

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 Costs of Violence
• Direct costs: value of goods and services used in treating or preventing
violence ( Medical - Police - Criminal justice system - Housing -
Social services)

• Non-monetary costs: pain and suffering - Increased morbidity -

Increased mortality via homicide and suicide - Abuse of alcohol and
drugs - Depressive disorders

1.6 million people die each year through violence

Estimated economic cost of $151 billion

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How to end violence against women?
1. We need a comprehensive approach that covers the development of
laws and policies, and focuses on prevention of violence before it
happens and access to essential services for survivors of violence.

2. It is necessary to change social norms and behaviors, targeting men

and boys, community and religious leaders, private and public sectors,

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How to end violence against women?
3. Awareness-raising campaigns on the impact of violence as an
important component of prevention efforts. This need to be
complemented with educational programs to generate sustained results.
4. Increasing women's participation in political processes has shown to
result in better legislative outcomes for women and a more responsive
state.
5. The existence of a strong women's civil society movement.

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Screening and referral:
• Identifying and supporting victims of violence
• Advocacy support
• Support and guidance to victims, e.g. counselling, education, legal aid.
• Psychosocial interventions
• Treat emotional & behavioral problems linked to victimization.
• Protection orders
• Prohibit perpetrators from further abusing their victims

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http://www.cdc.gov/violenceprevention/pdf/ipv/ipvandsvscreening.pdf.
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http://www.cdc.gov/violenceprevention/pdf/ipv/ipvandsvscreening.pdf.
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Screening tool

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How to help someone you know?
• Support her by acknowledging the problem
• Affirm that the abusive behavior is not acceptable
• Assist her to gain access to community resources
• Help her to identify options
• Assist her to develop an escape plan

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 What not to do:
• Blame the victim
• Question her in front of the abuser
• Minimize, deny or trivialize what she says
• Confront the abuser
• Suggest joint counselling
• Alienate her by criticizing her partner
• Criticize a woman who chooses to stay

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Violence against women in Palestine
37% of Palestinian women experienced some form of violence by their
husbands in 2011.

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Violence against women in Palestine:
• 23.3% of women who had ever been married reported that they had
been exposed to physical violence,
• 61.7% to psychological violence, and 10% to sexual violence
(PCBS,2011).

• Femicide on the pretext of “family honor”

- 11 victims in 2009
- 9 victims in 2010

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To achieve lasting change, it is important to
pass legislations and develop policies that:
• Address discrimination against women.
• Promote gender equality.
• Support women
• Help to move towards more peaceful cultural norms

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Role of Ministry of Health:
1. To adopt the concept of opposing VAW into the ministry’s vision and
mission, and to translate the concept into one of the ministry’s strategic
goals.
2. To introduce special manuals and curricula on how to deal with VAW
in medical and public health schools and colleges.
3. To set out documented mechanisms that explain how to deal with
VAW cases in health centers, including the reception, referral and
follow-up of VAW cases.

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Role of Ministry of Health:
4. To build a database on VAW cases received in health centers.

5. To include special sections in health centers for receiving VAW cases

in order to maintain confidentiality and safety.

6. To train staff on the mechanisms of documenting reports of VAW in

which psychological harm is included.

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Prevalence of domestic violence:
• 35% of women globally have experienced gender based violence.
however such violence does not include emotional violence or sexual
harassment and hence, if these are included, the prevalence may be
higher.

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Violence is a learned behavior:
- Men who experience abuse and neglect or have witnessed family
violence in their childhood are more likely to perpetrate intimate
partner violence.

- Studies also show that women who experience or have witnessed

family violence in their childhood are at increased risk of experiencing
intimate partner violence. The data suggest that violence is a learned
behavior.

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Norms must be changed:
• Norms that blame women for being raped must change and
perpetrators must be held accountable for their actions.
Norms must also make it unacceptable for men to abuse
power and dominate women

An exhibition “What she wore”

showing clothing of women and
girls who have experienced
sexual violence.
Women are never to blame.

10/7/2022 57
Role of health services in supporting females:

• Women who are abused are more likely to seek health services than those
who are not, even if they don’t openly reveal such violence. Therefore
health services are an important entry point for women experiencing
violence to access health care and to provide psychological support and
referrals that they need.

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VAW is preventable:
• Violence against women is preventable. Increasing evidence on what
works to prevent violence against women shows that we have 7
strategies which are important to end violence against women.

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7 effective strategies for preventing
violence against women:

• R –relationship skills strengthened

• E –empowerment of women
• S –services ensured
• P –poverty reduced
• E –environments made safe
• C –child and adolescent abuse prevented
• T –transformed attitudes, beliefs, and norms

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