Budgeting to prevent family violence

1. Budgeting to prevent family violence Jeanne Flavin, PhD Fordham University Bronx, NY USA

2. For info on Fordham-Unicef “Eyes on the Budget” collaboration, contact:Daryl McLeod, mcleod@.fordham.eduhttp://tinyurl.com/fordham-unicef

3. Greetings from my hometown, in rural Kansas. .

4. My presentation in a nutshell. • Can governments afford to ignore family violence? • No. • Do we know how to prevent (much) family violence? • Yes.

5. Family violence • Takes place across the life course, i.e., child abuse and neglect, intimate partner violence(including dating violence and same-sex violence), and elder abuse. • Definitions usually recognize physical, psychological and sexual violence (including marital rape); threats, and neglect.

6. How much partner violence against women is there? • Between 15 and 71 percent of women who have ever been married or partnered have experienced at least one incident of physical violence from a current or former intimate partner • In the past year: 4 – 54% • Most partner violence is perpetrated by men against their female (ex-)partners. Source: WHO/PATH Violence against Women as a Health and Development Issue; WHO Multicountry Study on Women’s Health and Domestic Violence Against Women.

7. WHO African Region Boys: 17.9 Girls: 12.7 High income countries Boys: 2.2 Girls: 1.3 Child* homicide rates per 100 000 * = < 5 years of age] Source: WHO. 2002.

8. “One of our masimanya girlz was raped and got murderd on sunday we went 2 her memorial service 2day,it was TERRIBLE ND VERY TRAUMATIC,WER VERY SAD. she was the very talktive 1,nd she wrote a play 4 the human rights dae bt she ddnt get 2 act it so i ges wel have 2 do that 4 her now.” • ~ Unathi, March 11, 2010 (photo used with permission)

9. Violence is gendered. • Females are at higher risk for • Infanticide and abandonment • Sexual abuse ( younger pregnancy  higher neonatal mortality) • Forced marriage, forced prostitution • Educational and nutritional neglect • Being hurt or murdered in their home, by an intimate partner • Males are at greater risk • Of harsh physical punishment • Of being perpetrators of violence (inc. sexual violence, and violence against women and girls). • For being killed/injured • In wars • Youth- and gang-related violence • For being hurt or killed on the street, by a stranger • See also: Wiegers and Mekonen. 2010. Budgeting for Children in Africa: Adding a Gender Lens to the Analysis. Addis Ababa: ACPF.

10. Can governments afford to ignore family violence? .

11. Sample estimates. • El Salvador: 6.0% of the GNP to control violence (IADB 2002) • Peru: 5.1% of the GDP was economic losses due to social violence (Buvinic et al. 1999) • USA: 1.0% of the GDP, annual costs of child abuse (Fromm 2001) • Intimate partner violence: • USA: .1% of the GDP • Nicaragua: 1.6% • Chile: 2.0% • Direct medical treatment costs/abused child: $13 781 - $42 518. • Source: Waters H, Hyder A, Rajkotia Y, Basu S, Rehwinkel JA, Butchart A. 2004. The economic dimensions of interpersonal violence. Geneva: WHO Department of Injuries and Violence Prevention.

12. Economic consequences: Direct costs • Medical and health care: Physical:Abdominal/thoracic injuries, brain injuries, bruises and welts, burns and scalds, central nervous system injuries, disability, fractures, lacerations and abrasions, ocular damage. Sexual and reproductive:Reproductive health problems, sexual dysfunction, sexually transmitted infections (including HIV/AIDS), unwanted pregnancy. Psychological and behavioral:Alcohol and drug abuse, cognitive impairment, delinquent, violent, and other risk-taking behaviours, depression and anxiety, developmental delays, eating and sleep disorders, feelings of shame and guilt, hyperactivity, poor relationships, poor school performance, poor self-esteem, post-traumatic stress disorder, psychosomatic disorders, suicidal behaviour and self-harm. Other longer-term health consequences (as result of behavioral risk factors such as smoking, alcohol abuse, poor diet, lack of exercise):Cancer, chronic lung disease, fibromyalgia, irritable bowel syndrome, ischaemic heart disease, liver disease, reproductive health problems (e.g., infertility). [Source: WHO] • Justice response: Costs of policing, prosecution, punishment (inc. incarceration) • Also, child welfare response: foster care. • Source: Waters, H. et al. 2004.The economic dimensions of interpersonal violence. WHO: Geneva.

13. Economic consequences: Indirect costs • Indirect costs: lost earnings, lost productivity, lost investments in human capital, reduced foreign investment, lowered confidence in society’s legal and social structures, psychological costs. • Source: Waters, H. et al. 2004.The economic dimensions of interpersonal violence. WHO: Geneva.

14. The real bottom line. People everywhere have the right to be safe.

15. Family violence is preventable.

16. Prevention requires that we understand the sources of violence within families.

17. For example, partner abuse.

18. Risk factors for children. • Being a baby (birth to age 3) • Being unwanted. • Being disabled. • Being small (low birth weight, prematurity) • Beingfemale.

19. Which of theserisk factors can we do something about? Virtually all of them.

21. In sum, budget allocations to prevent family violence should • Fund evidence-based interventions and prevention programs (public health model vs criminal justice model)

22. Cautionary tale about crime policy • batterer's counseling, mandatory arrest, special prosecution and victim advocacy programs, battered women's shelters, court orders of protection, shock incarceration, boot camps, more police, more prisons . . . And any “named” victim legislation • Do these measures protect or prevent victims in the long-term? Not necessarily. Evidence suggests they may even make things worse.

23. For example: Increase safe, stable, and nurturing relationships between children and their parents and caregivers. • provide home visitation services to families, especially those at greatest risk for abuse (provides support; reduces isolation) • provide training for parents on child development, non-violent discipline and problem-solving skills.

24. Example: Promote gender equality and empower women. • Reduce unintended pregnancies (increases wantedness, reduces household crowding and economic stress) • Reduce early marriage and early pregnancies. • Improve access to high quality pre- and post-natal services (will reduce disabilities, prematurity, small birthweight)

25. Other recommendations. • Community-level • Reduce availability of alcohol • Reduce access to guns and other lethal means • Societal-level • Promote cultural norms that respect women and children and condemn violence.

26. Funds should be mainstreamed, not discretionary. • Accompany anti-violence legislation with budget allocations earmarked (ministerial budget line items) to fund • The implementation of the legislation • The training of key stakeholders (including often-ignored sectors of housing, education, and welfare) • The monitoring of the implementation • Source: Luciano et al. 2003. “How to Make the Law Work: Budgetary Implications of Domestic Violence Laws in Latin America, Central America, and the Caribbean.” International Center for Research on Women.

27. Mitchell County, Kansas. USA Thank you.

28. Sources and recommended readings. • Garcia-Moreno et al., 2005. Multi-country study on women’s health and domestic violence against women. Geneva: WHO. • Krug E et al., 2002. World report on violence and health. Geneva: WHO. • Waters H, Hyder A, Rajkotia Y, Basu S, Rehwinkel JA, Butchart A. 2004. The economic dimensions of interpersonal violence. Geneva: WHO Department of Injuries and Violence Prevention. • Watts C, et al. 2001. Putting women first: Ethical and safety recommendations for research on domestic violence against women. Geneva: WHO. • WHO. 2008. Preventing violence and reducing its impact: How development agencies can help. Geneva: WHO.

29. Fund research and data collection • including evaluation of prevention interventions • Including collecting surveillance data as needed to get a sense of scope of the problem, as well as trends • And . . .

30. What research tells us. And what information is needed.

31. Parental risk factors • Parental substance abuse (Sobsey, 1994; Steinberg & Hylton, 1998; Wolcott, 1997). • Poor coping skills, poor impulse control, and a history of violence (Ammerman & Baladerian, 1993; Sobsey, 1994). • Low self-esteem or who have been diagnosed with depression may be at greater risk for maltreating their children (Sobsey, 1994; Sullivan & Cork, 1996) • History of childhood maltreatment/victimization (Jones, Peterson, Goldberg, Goldberg, & Smith, 1995; Sobsey, 1994).

32. UN Convention on the Rights of the Child. • Article 6: “[E]very child has the inherent right to life … survival and development ….” • Article 19: Children must be protected from “… injury or abuse … including sexual abuse, while in the care of parents … or any other person….”

33. African Charter on the Rights and Welfare of the Child. • Article 11: “States Parties to the present Charter shall take all appropriate measures to ensure that a child who is subjected to schools or parental discipline shall be treated with humanity and with respect for the inherent dignity of the child” • Article 16: Protection Against Child Abuse and Torture. “States Parties to the present Charter shall take specific legislative, administrative, social and educational measures to protect the child from all forms of torture, inhuman or degrading treatment and especially physical or mental injury or abuse, neglect or maltreatment including sexual abuse, while in the care of the child. [Measures] shall include effective procedures for the establishment of special monitoring units to provide necessary support for the child and for those who have the care of the child, as well as other forms of prevention and for identification, reporting referral investigation, treatment, and follow-up of instances of child abuse and neglect.”

34. WHO Consultation on Child Abuse Prevention (1999) • “Child abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.” • [What this definition leaves out.]

35. Family violence is preventable.

36. As communicated in . . . • Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) • UN Convention on the Rights of the Child. • African Charter on the Rights and Welfare of the Child • African Charter on Human and People’s Rights

37. Violence against children. • The home and family • Schools and educational settings • Other institutional settings (orphanages, children in conflict with the law) • The community and on the streets (e.g., early marriage, HIV stigma, post-conflict) • Work situations • Source: UNICEF.

38. Violence against women • Women’s lifetime prevalence • of physical violence: between 13 and 61 percent • of sexual violence: 6 and 59 percent.

39. Men > likely to be victims of violence Are more likely to be killed/injured In wars Youth- and gang-related violence More likely to be hurt or killed on the street, by a stranger Are more likely to be perpetrators Most men murdered by another man Women > likely to be assaulted or murdered by someone they know At greatest risk in our own homes > risk of sexual assault and exploitation 40-70% of homicides of women are perp by male intimate partners Violence is gendered.

40. Family/parental risk factors • Family structure and resources • Family size and household composition • Parental personality and behavioural characteristics • Prior history of abuse** • Violence in the home (National Research Council, 1993; Youssef et al. 1998)