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Day 3 of 16 Days of Activism Against Gender-Based Violence

AWC Berlin is participating in 2020’s “16 Days” campaign by posting stories on gender-based violence to inform and inspire action. Follow the series on our blog and social media and let us know what actions you’re taking.

GBV Is a Global Healthcare Crisis

by Claudia Tessier, AWC Member

This article has been adapted from “Gender-Based Violence: A Threat to Women’s Reproductive Health” from Population Action International (2013).

Gender-based violence (GBV) is most commonly inflicted by a family member or partner, but of course strangers and others may also be the perpetrators. Approximately one in three women experience GBV during their lifetime, and no ethnicity, society, class, race, or religion is immune to it.

The health consequences for GBV victims can lead to severe emotional and physical manifestations, such as unwanted pregnancies and sexually transmitted diseases (STDs), including but not limited to HIV. For many, it means losing control of their reproductive health. Barriers to receiving healthcare, whether for reproductive or maternal health consequences of GBV are also common. For those who continue a pregnancy, deliberately or because access to safe and legal abortion is restricted, the likelihood of miscarriage, stillbirth, and premature labor is raised.

Victims of GBV require healthcare that is both integrated and comprehensive. Healthcare providers are likely to be the victim’s first contact, after family members or friends. GBV clinical and policy guidelines from the WHO stress how vital it is that healthcare providers be properly educated and trained, in particular that they respect the privacy and confidentiality of their encounters with GBV victims and that they have in place effective and accessible referral services. Reproductive health services are essential, including emergency contraceptives, as well as confidential testing, counseling, and treatment in order to reduce the risk of infection.

The WHO clinical and policy guidelines mentioned above include the following:

  • Screening all patients for GBV.
  • Asking questions about GBV privately and in a nonjudgmental manner. For example, gently alerting the patient that they will be asked personal questions.
  • Sample questions include the following:
    • Have you been hit, kicked, or slapped by your partner or been threatened with such actions?
    • Have you been forced or pressured to have sex when you didn’t want to?
  • Validating the patient’s responses, including offering support and not minimizing indications of GBV.
  • Evaluating, educating, and referring GBV victims. This includes being empathetic and nonjudgmental, as well as following up during the patient’s next visit.

Attention to GBV expanded under the Obama administration, both within the US and globally. An executive order issued in 2012 and last updated in 2016 called for implementation of the US Strategy to Prevent and Respond to Gender-Based Violence Globally. Its focus is on coordinating and integrating GBV prevention and response. The President’s Emergency Program for AIDS Relief (PEPFAR), founded in 2003 by the Bush administration, has contributed over  $85 billion to GBV programs and offers post-exposure prophylaxis to prevent HIV. Regrettably, the Office of the Global AIDFS Coordinator has restricted PEPFAR funds’ use for emergency contraception. Further, the US remains one of six UN member states that have failed to ratify the 1979 landmark Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW).

US policy recommendations from Population Action International include the following.

  • Incorporating sexual and reproductive health and rights of GBV victims into US legislation dealing with GBV issues.
  • Resourcing GBV programs with technical expertise, funding, and materials, including access to emergency contraception.
  • Implementing strategies to prevent and respond to GBV globally.
  • Engaging in UN-led global community efforts to combat HIV.
  • Increasing involvement in developing countries’ efforts to address GBV.

In summary, GBV is a global healthcare issue that demands attention by healthcare providers, as well as government and societal support through increased resources, including funding, personnel, and materials, as well as education and training.

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