16 Days of Activism Against Gender-Based Violence, 25 November – 10 December 2018

Message from Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region on the occasion of the 16 Days of Activism Against Gender-Based Violence

Since 1991, 16 days of Activism against Gender-based Violence (GBV) have been carried out between 25 November – the International Day for the Elimination of Violence Against Women – and 10 December, Human Rights Day. The mid-point of this year’s campaign is an opportune time to reflect on and engage with the many ways violence against women and girls compromises public health, what the health sector can do about it, and why human rights are fundamental to the struggle against GBV.

Doing so is particularly important in the WHO South-East Asia Region. Though 35.6% of women globally have experienced physical and/or sexual intimate partner and non-partner violence in their lifetime, in the South-East Asia Region the figure is almost five percentage points higher, with 40.2% experiencing these violations. That proportion represents the second highest of WHO’s six regions, and is of distinct concern given the Region accounts for more than a quarter of the world’s population.

The health impact of GBV in all forms is significant. Available evidence indicates that women exposed to intimate partner violence are 1.5 times more likely to have HIV. They are also 1.8 times more likely to have a sexually transmitted infection such as chlamydia or gonorrhea. In addition, they are more likely to experience adverse sexual and reproductive health outcomes such as induced abortion, low birth weight and prematurity. Notably, there is a clear causal relationship between women experiencing violence and the onset of mental health problems and their outcomes, including the harmful use of alcohol, substance abuse, depression and suicide.

WHO’s ‘Global Plan on Action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children’, which was developed in 2016, provides a strong basis for health sector action to prevent and respond to GBV.

As the Global Plan outlines, enhancing health service delivery and strengthening human resources for health should be a top priority. Ensuring frontline services can provide post-violence care, including mental health support, is vital as part of efforts to make all health facilities meet the needs of women and girls. Importantly, GBV-specific interventions should be integrated into existing services, while health workers should be provided specific training to ensure care is both effective and sensitive. WHO’s clinical guidelines on Responding to Children and Adolescents Who Have Been Sexually Abused should be implemented Region-wide.

The health sector should likewise support multisectoral programmes to prevent GBV. This could include working with the education sector to implement sexual education programmes that address intimate and non-intimate partner violence. It could also include working with sectors concerned with women’s affairs to promote economic and livelihood programmes that empower women and girls. The health sector has a crucial role to play in monitoring programmatic efficiency, with GBV surveillance providing a key input to gauge the efficacy of these and other interventions.

As part of its commitment to human rights, the health sector should advocate at the highest levels of government for the rights of women and girls as they relate to GBV. In particular, the health sector should urge governments to allocate appropriate resources to prevent GBV, as well as to respond to it as part of the push to achieve universal health coverage. In doing so, the critical link between health and human rights should be emphasized, both in terms of the rights of women and girls to quality care, as well as the right for them to live free of violence.

WHO, alongside UNFPA and UN Women, has been working with Member States Region-wide to achieve these outcomes. In 2017, for example, a joint meeting was held to support Member States adopt the Global Plan and adapt it to country contexts, with an Essential Service Package identified and disseminated. In turn, Member States have developed priority action plans aimed at improving health services to address violence against women and girls, which they are now implementing.

WHO will continue to support these and other initiatives as part of its quest to ensure Member States achieve the Sustainable Development Goals (SDGs), including SDGs 3 and 5, which pertain to achieving health for all and gender equality respectively. Until and unless all women and girls have access to the services they need and are free of the egregious threat to health and human rights GBV represents, that support will be active, steadfast and strong.

Dr Poonam Khetrapal Singh
Regional Director