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Violence against Women and Health in Uganda

Violence against Women and Health in Uganda. Dr Olive Sentumbwe, WHO 9 th December 2015 Uganda Christian University. Definition of VAW. Violence Against Women : A broad umbrella term , defined by the United Nations as:

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Violence against Women and Health in Uganda

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  1. Violence against Women and Health in Uganda Dr Olive Sentumbwe, WHO 9th December 2015 Uganda Christian University.

  2. Definition of VAW • Violence Against Women: A broad umbrella term, defined by the United Nations as: “Any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life”. It includes many different forms of violence against women and girls, such as intimate partner violence, non-partner sexual violence, trafficking, and harmful practices such as female genital mutilation.

  3. Some definitions Gender Based Violence (GBV) • Violence that targets individuals or groups of individuals on the basis of their gender it includes acts that inflict physical, mental or sexual harm or suffering, threat of such acts, coercion, and deprivations of liberty, directed to an individual on basis of their gender.UN Economic &Social Council (ECOSOC) Sexual GBV • Violence directed at a person on the basis of gender or sex with sexual intent or affecting the sexual development and or functioning of a individual CEDAW. Dr. Peter Mudiope

  4. Definition of IPV • Intimate partner violence: Behaviour by an intimate partner that causes physical, sexual or psychological harm, including acts of physical aggression, sexualcoercion, psychological abuse and controlling behaviours. This definition covers violence by both current and former spouses and other intimate partners. Other terms used to refer to this include domestic violence, wife or spouse abuse, wife/spouse battering. Dating violence is usually used to refer to intimate relationships among young people, which may be of varying duration and intensity, and do not involve cohabiting. • Intimate partner: A husband, cohabiting partner, boyfriend or lover, or ex-husband, ex-partner, ex-boyfriend or ex-lover.

  5. Global statistics As detailed in the report of the WHO multi country study on women’s health and domestic violence against women (García-Moreno et al.,2005): • Between 13% and 61% of women 15–49 years old report that an intimate partner has physically abused them at least once in their lifetime • Between 6% and 59% of women report forced sexual intercourse, or an attempt at it, by an intimate partner in their lifetime • From 1% to 28% of women report they were physically abused during pregnancy, by an intimate partner.

  6. Intimate partner violence • Intimate partner violence is most common among women in the Eastern and North regions, those of Iteso ethnicity, Pentecostal women, and rural women (Uganda DHS 2011)

  7. Percentage of ever-married women aged 15-49 who have experienced physical and/or sexual violence committed by their current husband/partner, by region, ethnicity, religion, and residence

  8. Trends in VAW in Uganda • Prevalence of intimate partner violence decreased between the 2006 and 2011 DHS surveys in nearly all regions, with the exception of marginal increases in Kampala, Central 2, and the North region

  9. In 2006, 59.1% of ever-married women aged 15-49 reported having experienced physical and/or sexual intimate partner violence by their current partner; in 2011, this figure dropped to 50.5%

  10. Physical violence • 56% of all women aged 15-49 years have ever (i.e. in their lifetime) experienced physical violence by any perpetrator • 27% of women have experienced physical violence by an intimate partner in the past 12 months currently

  11. Sexual violence • 28% of all women aged 15-49 years have ever (i.e. in their lifetime) experienced sexual violence by any perpetrator or partner. • 16% have experienced sexual violence recently (i.e. in the past 12 months).

  12. Risk factors for intimate partner violence in Uganda • Exposure to child maltreatment/abuse; • Harmful use of alcohol • Gender norms • Accepting violence

  13. Health consequences • Physical injuries • Mental health • Sexual health • Reproductive health

  14. Health consequences:reproductive health • 16% women report experiencing physical violence during pregnancy • Women (15-49) who have ever experienced intimate partner violence 1.35 X more likely to have experienced a non-live birth or terminated pregnancy • In Kampala, of 612 women recruited in second trimester, those who had experienced intimate partner violence during pregnancy 1.4X more likely to develop obstetric complications – hypertension, premature rupture of membranes, anaemia and 3.78 times more likely to have low birth weight delivery • A 2003 survey in Mbale – infants of mothers who had ever experienced intimate partner violence 2X more likely to experience illness or diarrhoea

  15. MoH & WHO response in Uganda • The Ministry of Health in partnership with the Ministry of Gender, Ministry of Internal affairs and UN agencies is strengthening capacity and providing health services and medico-legal care for survivors of sexual violence in district hospitals and primary health facilities. • Recent WHO clinical and policy guidelines on responding to intimate partner violence and sexual violence against women provide evidence-based recommendations for the health sector for providing services and care to survivors

  16. References • World Health Organization, London School of Hygience and Tropical Medicine, South African Medical Research Council. Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva, Switzerland, 2013. • World Health Organization. Violence Against Women. Geneva, Switzerland, 2012. • Uganda Bureau of Statistics (UBOS) and ICF International Inc. Uganda Demographic and Health Survey 2001. Kampala, Uganda and Calverton, Maryland: Uganda Bureau of Statistics (UBOS) and ICF International Inc., 2001. • Uganda Bureau of Statistics (UBOS) and ICF International Inc. Uganda Demographic and Health Survey 2006. Kampala, Uganda and Calverton, Maryland: Uganda Bureau of Statistics (UBOS) and ICF International Inc., 2007. • Uganda Bureau of Statistics (UBOS) and ICF International Inc. Uganda Demographic and Health Survey 2011. Kampala, Uganda and Calverton, Maryland: Uganda Bureau of Statistics (UBOS) and ICF International Inc., 2012. • KishorSB, Sarah EK. Women's and Men's Experience of Spousal Violence in Two African Countries: Does Gender Matter? Calverton, Maryland, USA: ICF International, 2012. • KinyandaE, Weiss HA, Mungherera M, Onyango-Mangen P, Ngabirano E, Kajungu R, ... & Patel, V. Prevalence and risk factors of attempted suicide in adult war-affected population of eastern Uganda. Crisis: The Journal of Crisis Intervention and Suicide Prevention. 2013;1(10). • Roberts B, Ocaka KF, Browne J, Oyok T, Sondorp E. Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda. BMC psychiatry. 2008;8:38. PubMed PMID: 18489768. Pubmed Central PMCID: 2397420. • KouyoumdjianFG, Calzavara LM, Bondy SJ, O’campo P, Serwadda D, Nalugoda F, et al. Intimate partner violence is associated with incident HIV infection in women in Rakai, Uganda. AIDS. 2013:1. • Kaye DK. Community perceptions and experiences of domestic violence and induced abortion in Wakiso district, Uganda. Qualitative health research. 2006 Oct;16(8):1120-8. PubMed PMID: 16954529. • KaramagiCA, Tumwine JK, Tylleskar T, Heggenhougen K. Intimate partner violence and infant morbidity: evidence of an association from a population-based study in eastern Uganda in 2003. BMC pediatrics. 2007;7:34. PubMed PMID: 17988374. Pubmed Central PMCID: 2186330. • World Health Organization, London School of Hygience and Tropical Medicine. Preventing intimate partner and sexual violence against women: taking action and generating evidence. Geneva, Switzerland, 2010. • SpeizerIS. Intimate partner violence attitudes and experience among women and men in Uganda. Journal of interpersonal violence. 2010 Jul;25(7):1224-41. PubMed PMID: 19758975. Pubmed Central PMCID: 2877756. • JewkesR, Nduna M, Levin J, Jama N, Dunkle K, Puren A, et al. Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. BMJ. 2008;337:a506. PubMed PMID: 18687720. • World Health Organization. Responding to intimate partner violence and sexual violence against women. Geneva, Switzerland, 2013.

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