WHO HUMAN REPRODUCTION PROGRAMME – Latest in Sexual and Reproductive Health – April 2024

Measuring violence against women with disability

Discrimination, stigma and misconceptions about disability, as well as restrictive gender and social norms, can increase the exposure of women with disabilities to violence and influence their experience of it. Women with disabilities are also subjected and vulnerable to specific forms of violence. A recent systematic review of intimate partner violence against women with disabilities, which included studies that compared the prevalence of intimate partner violence against women with disabilities and women without disabilities, found that women with disabilities reported a higher prevalence of all forms of intimate partner violence than women without disabilities.

A multinational analysis of data from the European Union showed that disability status was significantly associated with women’s experience of violence in a sample of countries, and that the intersection of women’s disability with low income resulted in higher levels of violence.

Another systematic review of violence against persons with disabilities identified a pooled prevalence of any recent violence (physical by non-partner, sexual by a non-partner, or intimate partner) of 24.3% (95% confidence interval: 18.3–31.0%) in people with mental health conditions, 6.1% (95% confidence interval: 2.5–11.1%) in those with intellectual impairments and 3.2% (95% confidence interval: 2.5–4.1%) in those with non-specific impairments. But most studies in the latter were not disaggregated by sex.

Analysis of the association between disability and intimate partner violence from seven violence-prevention programmes in low- and middle-income countries indicated that women with disabilities were nearly twice as likely to report intimate partner violence than women without disabilities.

In the context of efforts to improve measurement of violence against women as part of the UN Women–WHO Joint Programme on Violence against Women Data, and the increasing policy, research and programmatic interest in addressing violence against women with disabilities, WHO commissioned a scoping review published in 2022 (7) and held an Expert Meeting on the Measurement of Violence against Women with Disabilities in November 2022 (8) to inform this briefing note and related follow-up work.

Violence against women 60 years and older

Violence has detrimental and long-lasting consequences for women’s lives and their physical, mental and sexual and reproductive health (2). Much of this violence is perpetrated by male intimate partners – globally intimate partner violence affects 26% of ever partnered women 15 years and older. For women aged 50–59 years the lifetime prevalence of physical and/or intimate partner violence is 24% (95% uncertainty intervals (UI): 20–30%) and for women 60 years and older it is 23% (UI 18–31%)

While women of reproductive age (15–49 years) are at higher risk of all forms of intimate partner violence, women 50 years and older continue to experience such violence; however the types and dynamics of violence from an intimate partner may change as women (and their partners) get older. Similarly, while younger women are at higher risk of sexual violence, whether by partners or other perpetrators, older women are also subjected to sexual violence. In addition, women 60 years and older may be more likely to be subjected to neglect and to other types of abuse compared with younger women. For example, specific forms of economic abuse, or specific acts of physical or psychological violence or controlling behaviours (e.g. physical or chemical restraint), including by perpetrators other than partners. These types of violence specific to older women are generally not captured in existing surveys that measure the prevalence of violence against women. As a result of the limited data available for older women, especially in low- and middle-income countries where the surveys mainly focus on women of reproductive age (15-49 years), and the gaps in current survey instruments, the prevalence and magnitude of violence against older women are most likely under-estimated.

However, globally evidence is lacking on the prevalence, patterns and types of violence against women aged 50 years and older, particularly in low- and middle-income countries. We also need more evidence on the risk factors and effects of this violence, and barriers to reporting it and seeking help among older women who are subjected to violence. Recognition of this need for data is growing and an increasing number of population-based violence against women surveys are extending the upper age limit to include older women. However, to obtain more valid data for this age group, a higher age limit must be accompanied with better survey measures on violence against older women. Target 5.2 of the SDGs, agreed in 2015 by all countries at the United Nations General Assembly, focuses on the elimination of all forms of violence against women and girls. SDG indicators 5.2.1 on the prevalence of intimate partner violence and 5.2.2 on the prevalence of non-partner sexual violence apply to women and girls aged 15 years and older. These indicators provide further impetus to strengthen data collection on violence against older women.

Challenging harmful masculinities and engaging men and boys in sexual and reproductive health

More research is needed to address the impact of harmful masculinities on sexual and reproductive health and rights (SRHR), according to a new priority research agenda drawing on a global survey of researchers that was published in The Lancet Global Health.

Harmful gender norms affect boys and men in many ways, for example by increasing risky behaviours such as substance use or unprotected sex, or by causing negative attitudes and practices towards women. However, research on engaging men and boys has often neglected how to address harmful masculinities in ways that promote gender equality in many SRHR programmes.

“Promoting sexual and reproductive health and rights requires challenging harmful and unequal gender power relations by working with men alongside women,” said co-author Dr Maria Lohan, UNESCO Chair in Masculinities and Gender Equality at Queen’s University Belfast.

For the new priority research agenda, the team first established several overarching themes to address this evidence gap:

– understanding masculinities, equality, and SRHR;

– improving programmes to advance gender equality by addressing masculinities in the context of SRHR;

– improving the ways we research gender norms and SRHR; and

– improving equitable and rights-based services and policies at scale.

The researchers asked experts from academic institutions and civil society across 60 countries to identify and rank the most important questions, across these themes… Results showed that some of the top-ranked questions focused on how gender norms impact on SRHR; how to engage men and boys in development, delivery and evaluation of SRHR programmes/services; how to implement gender-transformative approaches to engaging men and boys, including through comprehensive sexuality education; and what are the diverse SRHR needs of men and boys.

Co-authored by Magaly Marques, Senior Advisor for MenEngage Alliance, the study was conducted by the UN’s Special Programme on Human Reproduction (HRP), the World Health Organization (WHO), along with Queen’s University Belfast, MenEngage Global Alliance, University of Western Cape and Stellenbosch University.

SOURCE: WHO News, 12 April 2024