Journal of the Scientific Society

EDITORIAL
Year
: 2015  |  Volume : 42  |  Issue : 2  |  Page : 57--58

Violence against women: Role of healthcare systems


Vinay Mahishale1, Arati Mahishale2,  
1 Department of Pulmonary Medicine, KLE University's J. N. Medical College, Belgaum, Karnataka, India
2 Dept of Women's Health Physiotherapy, KLE University's Institute of Physiotherapy, Belgaum, Karnataka, India

Correspondence Address:
Arati Mahishale
Dept of Women«SQ»s Health Physiotherapy, KLE University«SQ»s Institute of Physiotherapy, Belgaum, Karnataka
India
Vinay Mahishale
Department of Pulmonary Medicine, KLE University«SQ»s J. N. Medical College, Belgaum, Karnataka
India




How to cite this article:
Mahishale V, Mahishale A. Violence against women: Role of healthcare systems.J Sci Soc 2015;42:57-58


How to cite this URL:
Mahishale V, Mahishale A. Violence against women: Role of healthcare systems. J Sci Soc [serial online] 2015 [cited 2020 Sep 20 ];42:57-58
Available from: http://www.jscisociety.com/text.asp?2015/42/2/57/157022


Full Text

Every day, countless number of women and girls experience violence. This abuse is in many forms, including physical and sexual violence by partner, female genital mutilation (FGM), child and forced marriage, sex trafficking, and above all, rape. It is surprising to note that one in three women experience physical and/or sexual violence by a partner or by someone other than a partner in their lifetime. Violence against women (VAW) and girls is a global human rights violation seen all over the world across the cultural and economic borders. The World Health Organization (WHO) estimates that more than 30% of women worldwide experience either physical or sexual partner violence [1],[2] and about 7% of women experience non-partner sexual assault. About 100-140 million girls and women have undergone FGM and more than 3 million girls are at risk for FGM every year in Africa alone. Nearly 70 million girls have been married before the age of 18 years, many of themagainst their will. [3],[4],[5] This, according to WHO, is a "global public health problem of epidemic proportions." [6]

VAW has become a prominent topic of discussion in India in recent years. Politicians and media have been deliberating on the issue due to continuously increasing trends during 2008-2012. According to the National Crime Records Bureau of India, the reported incidents of crime against women have increased by 6.4% during 2012, and a crime against a woman is committed every 3 min. In 2012, there were a total of 244,270 reported incidents of crime against women, while in 2011, there were 228,650 reported incidents. [7] However, these figures are underestimated as the crimes against women remain unreported many a times in India. The cases of acid attack, bride burning, domestic violence, dowry deaths, honor killings, female infanticide, forced abortions, forced marriages, and human trafficking against women are escalating in India in recent times.

There is substantial effect on women's health and well-being by this violence in many ways, including physical and mental trauma, increased vulnerability to HIV/AIDS, sexual and reproductive health problems. Childhood experience of violence, directly or by witnessing violence at home, is a risk factor for a range of high-risk health behaviors in children. Smoking, drug abuse, alcohol consumption, depression, low self-esteem, self-harm, unsafe sexual practices, and further victimization in later life have been witnessed in these children. VAW and girls is a global phenomenon that historically has been hidden, ignored, and accepted. Child sexual abuse has remained a soundless shame. Rape has often been a matter of dishonor for the victim rather than the perpetrator. Violence at home has been considered a private affair. Despite this being a global public health and clinical problem of epidemic proportions, the health authorities have closed their eyes and turned away. The full extent of abuse is even greater, with multiple different forms of violence around the world often remaining uncounted and under-researched. [8],[9]

The adverse physical, mental, sexual and reproductive health consequences of violence lead women who are abused to make extensive use of healthcare resources. Healthcare providers frequently, and often unknowingly, encounter women affected by violence. The healthcare systems (HCS) can provide a safe environment for women where they can confidentially disclose experiences of violence and receive a supportive response. Women who have experienced intimate partner violence identify healthcare providers as the professionals that they trust with disclosure of abuse. The key role of HCS for women and their children, facing the health effects of violence, is to provide compassionate care. This sympathetic care can contribute to prevention of violence recurrence and alleviation of the consequences. HCS can contribute to a great deal in all the three levels of prevention of VAW. Primary prevention (before the violence occurred) includes advocacy/awareness raising, home visits, and other interventions to reduce child maltreatment and reduce harmful alcohol consumption and drug abuses. The role of HCS in secondary prevention (after violence occurred) is vital as it requires immediate identification of violence, providing acute care and support for health problems, long-term care for health, including mental health, addressing alcohol and substance use disorders, and referral to legal and other necessary support services. Tertiary prevention is a long-lasting process of rehabilitation of the victim both physically and mentally. This requires a team of tender, sensitive, perceptive, and receptive healthcare providers who could deliver long-term mental health support as well as economic rehabilitation. [10]

India, with very fragile, fractured, and poorly funded HCS, is far from addressing this epidemic of global importance. Both central and state governments and health ministries should realize that a functional and well-financed HCS is necessary to both prevent VAW and to respond to victims and survivors in a consistent, safe, and efficient manner to augment their health and well-being. VAW needs to receive higher priority in health policies and budgets. The training of healthcare providers and public health officials of both private and government sectors should be done periodically to enable them to handle this kind of sensitive issues. There should be good coordination between care providers, including referral networks and capacity building. VAW should be integrated into medical, nursing, public health, and other relevant curricula, and in-service training should ensure that healthcare providers know how to respond appropriately and effectively; this training needs to be sustained and supported by ongoing supervision and mentorship. Development of effective HCS can contribute to achievement of the Millennium Development Goals, particularly those on gender equality and reduction of maternal and child mortality and HIV. [11] An inadequate response to VAW from healthcare services has long-term economic and social costs. The time has come for all the stakeholders of HCS to play their part in a multi-sectoral response to VAW that is consistent and dedicated for the promotion of public health and human rights of women in our country.

References

1Devries KM, Mak JY, García-Moreno C, Petzold M, Child JC, Falder G, et al. Global health. The global prevalence of intimate partner violence against women. Science 2013;340:1527-8.
2Stöckl H, Devries K, Rotstein A, Abrahams N, Campbell J, Watts C, et al. The global prevalence of intimate partner homicide: A systematic review. Lancet 2013;382:859-65.
3Feldman-Jacobs C, Clifton D. Female genital mutilation/cutting: Data and trends, update 2014. Washington, DC: Population Reference Bureau; 2014.
4Lee-Rife S, Malhotra A, Warner A, Glinski AM. What works to prevent child marriage: A review of the evidence. Stud Fam Plann 2012;43:287-303.
5Loaiza E, Wong S. Marrying too young, End Child Marriage. New York: UNFPA; 2012. Available from: http://www.unfpa.org/webdav/site/global/ shared/documents/publications/2012/MarryingTooYoung.pdf. [Last accessed on 2014 Dec 13].
6WHO. Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013. Available from: http://www.who.int/reproductivehealth/publications/violence/9789241564625/en/. [Last accessed on 2014 Dec 14].
7"Crimes Against Women." National Crime Records Bureau. 2013. Available from: http://www.ncrb.gov.in/CD-CII2012/cii-2012/Chapter%205.pdf [Last accessed on 2014 Dec 12].
8Jewkes R, Sen P, García-Moreno C. Sexual violence. In: Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, editors. World report on violence and health. Geneva: World Health Organization; 2002. p. 149-81.
9WHO. Violence against women: A 'global health problem of epidemic proportions'. New clinical and policy guidelines launched to guide health sector response. Available from: http://www.who.int/mediacentre/ news/releases/2013/violence_against_women_20130620/en/ [Last accessed on 2014 Dec 14].
10García-Moreno C, Hegarty K, Lucas d'Oliveira AF, Koziol-Maclain J, Colombini M, Feder G. The health-systems response to violence against women. Lancet 2014 [In Press]. Available from: http://www.dx.doi.org/10.1016/ S0140-6736(14)61837-7. [Last accessed on 2014 Dec 10].
11WHO. Addressing violence against women and achieving the Millennium Development Goals. Geneva: WHO; 2005.