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Gender inequity, reproductive rights, violence, and social norms
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Intimate partner violence is prevalent and is associated with significant impairment, yet it remains unclear which interventions, if any, reduce rates of abuse and reabuse.
To systematically review, from the perspective of primary health care, the available evidence on interventions aimed at preventing abuse or reabuse of women.
MEDLINE, PsycINFO, CINAHL, HealthStar, and Sociological Abstracts were searched from the database start dates to March 2001 using database-specific key words such as domestic violence, spouse abuse, partner abuse, shelters, and battered women. References of key articles were hand searched. The search was updated in December 2002.
Both authors reviewed all titles and abstracts using established inclusion/exclusion criteria. Twenty-two articles met the inclusion criteria for critical appraisal.
Following the evidence-based methods of the Canadian Task Force on Preventive Health Care, both authors independently reviewed the 22 included studies using an established hierarchy of study designs and criteria for rating internal validity. Quality ratings of individual studies--good, fair, or poor--were determined based on a set of operational parameters specific to each design category developed with the US Preventive Services Task Force.
Screening instruments exist that can identify women who are experiencing intimate partner violence. No study has examined, in a comparative design, the effectiveness of screening when the end point is improved outcomes for women (as opposed to identification of abuse). No high-quality evidence exists to evaluate the effectiveness of shelter stays to reduce violence. Among women who have spent at least 1 night in a shelter, there is fair evidence that those who received a specific program of advocacy and counseling services reported a decreased rate of reabuse and an improved quality of life. The benefits of several other intervention strategies in treating both women and men are unclear, primarily because of a lack of suitably designed research measuring appropriate outcomes. In most cases, the potential harms of interventions are not assessed within the studies reviewed.
Much has been learned in recent years about the epidemiology of violence against women, yet information about evidence-based approaches in the primary care setting for preventing intimate partner violence is seriously lacking. The evaluation of interventions to improve the health and well-being of abused women remains a key research priority.
The purpose of this Review is to provide evidence for why gender equality in science, medicine, and global health matters for health and health-related outcomes. We present a high-level synthesis of global gender data, summarise progress towards gender equality in science, medicine, and global health, review the evidence for why gender equality in these fields matters in terms of health and social outcomes, and reflect on strategies to promote change. Notwithstanding the evolving landscape of global gender data, the overall pattern of gender equality for women in science, medicine, and global health is one of mixed gains and persistent challenges. Gender equality in science, medicine, and global health has the potential to lead to substantial health, social, and economic gains. Positioned within an evolving landscape of gender activism and evidence, our Review highlights missed and future opportunities, as well as the need to draw upon contemporary social movements to advance the field.
Reproductive rights are essential to the recognition/treatment of women as full-fledged human beings/citizens. Barriers to reproductive rights pose a grave danger to women's well-being. This article explores the origins of these barriers, their nature, and their impact on mental health. The most controversial relationship is between induced abortion and mental health. Barriers, misinformation, and coercion affecting contraceptive, abortion, and pregnancy care are an ongoing danger to women's mental health and the well-being of their families. Mental health professionals are best qualified, and have an obligation, to know the facts, apply them, and provide accurate information to protect women's health.
Violence against women is a worldwide public health and human rights concern with serious consequences for women's health and well-being. The following chapter summarizes existing knowledge on the prevalence and health outcomes of different forms of violence against women: Intimate partner violence, intimate partner violence during pregnancy, sexual violence in conflict setting and in displacement, trafficking of women, child sexual abuse and first forced sex and female genital mutilation. The chapter ends with an outline of responses to violence against women; highlighting the difference health professional can make for women who experience violence in its multiple forms.
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