A Call for Global Action to Prevent Violence Against Women and Girls

Violence against women and girls includes physical and sexual violence, female genital cutting, forced marriage, sex trafficking, and rape. Worldwide, one in three women has experienced physical or sexual violence or both. The WHO has declared that violence against women and girls is a global public health epidemic and has made prevention a high-priority goal. In a series of five papers, international experts examine the science of violence prevention and make recommendations for action. Available studies (conducted primarily in high-income countries) generally focus on responses to, rather than prevention of, intimate partner violence. Prevention of violence against women and children depends on a multisystem approach addressing disparity between the sexes, the root cause of violence against women and girls in all societies.

Healthcare Systems Response: Despite limited evidence for effective interventions, healthcare professionals should know how to identify women currently experiencing violence and provide supportive care (i.e., empathetic listening, psychosocial support, and referral). Healthcare systems must support providers by establishing coordination and referral networks, protocols, and the capacity for effective responses to violence. Responses must be specific to the country and setting in which women live; no model is applicable to all situations. Medical, nursing, public health, and other training should incorporate sustained education about appropriate and effective responses to violence. Health policymakers should assume leadership in raising awareness of the burdens of violence against women and girls and the importance of prevention.

Assessing the Evidence for Prevention: Programs in high-income countries have been more successful in improving outcomes for violence survivors than in preventing future violence. In low- and middle-income countries, strategies involving multiple stakeholders and approaches have had some success in preventing various forms of violence (i.e., intimate partner and nonpartner sexual assault, female genital cutting, and child marriage) while also addressing risk factors such as social norms and biases.

Conceptual Shifts in Prevention — Working with Men and Boys: Violence against women and girls is more common in places where men experience high levels of violence. Participation of men and boys in violence prevention programs is necessary, although evidence about such interventions is scarce. All members of a community must be involved in violence reduction programs, and these efforts should include approaches to change community-wide conceptions of masculinity.

Lessons from Practice: Evidence and experience show that violence against women and girls in low- and middle-income countries can be prevented by targeting unequal relationships between sex and power. Programs should be guided by theoretical frameworks that acknowledge the “complexity of individual and social change processes.” Cooperation among civil society sectors in healthcare, criminal justice, security, faith, and education is necessary for meaningful changes within one generation. Women's advocacy and action against violence has been and can continue to be effective.

Call to Action: Leaders and policymakers should commit to the following actions:

• Show leadership (i.e., condemn violence, advocate for equality of the sexes, develop national plans, and ensure resources for implementation).

• Develop and enforce laws, implement policies, and strengthen capacities of institutions.

• Invest in violence prevention.

• Strengthen the role of the health sector.

• Invest in research, data collection, and civil society.