Violence across the lifecycle

HEIDI STOCKL: Hello, my name is Heidi. I’m the director of the Gender Violence and Health Centre here at the London School of Hygiene and Tropical Medicine. Today I’m going to speak about women’s experience of violence across the life course. Gender based violence has long been acknowledged as an important public health and developmental issue through, for example, making intimate partner violence one of the targets of sustainable development goals. Intimate partner violence is one of the most prominent forms of gender based violence. There’s one in three women worldwide reporting physical and sexual intimate partner violence or non-partner sexual violence.

Today, however, I want to go beyond intimate partner violence and talk about the numerous forms that gender based violence can take and that occur across the life course. Gender based violence can start even before birth with sex selective abortions being common in a range of countries across the world often caused by restrictive policies regarding the number of children or a strong preference for male children. However, even in places where sex elective abortions are not major concerns, preference for male offsprings for a variety of reasons can lead to neglect of female children in terms of health care, nutrition, such as shorter periods of breastfeeding, and the worst case, to female infanticide.

Inadequate nutrition due to insufficient resources being preferentially spent on male children is one of the forms of gender based violence experienced by girls in childhood. Others include lack of access to education, child abuse, especially child sexual abuse, and female genital cutting. The latter is still tremendously prevalent in many areas of the world and has huge health consequences for the woman during and after childbirth and later in life. During adolescence, girls face a range of different forms of gender based violence, partly a continuation of those experienced during childhood, but also those related to adulthood, such as forced early marriage, psychological abuse, rape and sexual assault, sexual harassment, and in some cases, sexual exploitation and human trafficking.

Experience of gender based violence that might originate during adolescence often continue into adulthood or start there, such as honour killings, dowry killings, intimate partner violence, sexual abuse or homicide. In a recent global study on the prevalence of intimate partner homicide, for example, we found that at least one in three murdered women was murdered by their intimate partner, while only 1 in 10 murdered men were murdered by their partner. Unfortunately, gender based violence also does not stop with age, as there is numerous evidence on elder and widow abuse, either during care or in caretaking relationships, or in other forms, such as widow burnings or loss of access to land and property.

Investigating these forms of gender based violence is incredibly important due to the numerous health effects they carry, such as mental health issues, injuries, pregnancy complication, infant and child mortality, and its relationship to substance abuse and sexually transmitted infections. Prevention is incredibly important, but for these adults it’s also important to clearly understand the local context. Therefore, I will now pass over to my colleague Dr. Wamoyi, who will discuss the context around transactional sex. DR.

JOYCE WAMOYI: Hello. I’m Dr. Joyce Wamoyi. I’m a senior researcher at the National Institute for Medical Research in Mwanza, Tanzania. Transactional sex is common in many young women’s relationships, sexual relationships, and transactional sex refers to non-marital, non-commercial sexual relationships. The term motivated by the implicit assumption that sex will be exchanged for material benefits and status. Transactional sex relationships often involve some emotionality and not all transactional sex relationships are intergenerational. The motivations for adolescent girls and young women engaging in transactional sex can be grouped into three categories. One is to obtain basic needs. Two is for material expressions of love. And three is for improved social status.

Apart from transactional sex being associated with medical risky sexual behaviours, evidence also shows that transactional sex among adolescent girls and young women in sub-Saharan Africa is associated with different forms of abuse and violence. For example, among young people age 26 years and under, a link has been found between transactional sex and a number of factors related to violence, including previous experience of abuse or violence. And an example is sexual coercion in Liberia and Uganda. Emotional and physical or sexual abuse in South Africa. Intimate partner violence, including physical or sexual violence, has also been reported in studies in South Africa.

The link between intimate partner violence and transactional sex has been explained in sub-Saharan African context through roles and expectations attached by girls about dominate masculinity. These ideals include the expectation that men would both provide for and control their female partner. Regardless of the motivation for engagement in transactional sex, most provisions include an element of control over the recipient, and in this case, you’re talking about girls and women. Therefore, hindering their decision making related to safe sex, for example, on the use of condoms or contraception.