Transcript Prevention of intimate partner and sexual violence against women Prof Rachel Jewkes Director, Gender & Health Research Unit, Medical Research Council, South Africa, and Secretary, Sexual Violence Research.

Prevention of intimate partner
and sexual
violence against women
Prof Rachel Jewkes
Director, Gender & Health Research Unit,
Medical Research Council, South Africa,
and
Secretary,
Sexual Violence Research Initiative
Prevalence of victimisation:
• Most research globally on GBV has focused on
victimisation, notably the WHO multi-country
study found:
– 15 - 71% experienced physical or sexual intimate
partner violence (IPV)
– 0.3 - 11.5% experienced sexual violence by a nonpartner when > 15 years
• Rape perpetration research is largely from South
Africa and N America, but important work in is
progress in Asia Pacific region
Community-based randomly selected
sample of adult men and women in Gauteng
Province South Africa
Women
(victims)
Men
(perpetration)
%
%
Any physical IPV
33.1
50.5
>1 episode of physical violence
30.8
43.4
Physical IPV in last 12 months
13.2
5.8
Any rape ever
25.2
37.4
Sexual IPV ever
18.8
18.2
Sexual and intimate partner violence
have a huge impact on social
development and health impact
• Women exposed have a very high prevalence of
mental health problems – especially depression,
anxiety, PTSD and substance abuse
• Research increasing shows that many of the
major development problems facing a country
like South Africa are aggravated by IPV and
rape, including teenage pregnancy, school
completion, economic empowerment, crime and
violence
Prevention is essential
• Primary prevention – prevention of any
occurrence
• Secondary prevention - Responses to assist victim/
survivors of rape/sexual violence and IPV
• These two need to be understood as dynamically
interconnected – the response of a society to survivors
and pursuit of justice for them send powerful messages
about social morality
• So what underlies the problems of rape and IPV?
Motivations for rape
80
Girl<15 yrs
70
Girlfriend
60
Non-partner
Gang rape
50
40
30
20
10
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Multivariable poisson model of relative incidence of rape : n=1147 young
South African men, over 2 years n=217 raped/attempted rape
Any rape during follow up: adjusted for age, treatment,
stratum and person years of follow up (exposure)
IRR
95% CI
p value
PAF
education over grade 10
1.49
1.00
2.23
0.05
6.61
Ever drug use
1.88
1.40
2.52
<0.0001
24.39
8+ lifetime partners
1.57
1.15
2.15
0.004
13.98
Past year physical IPV
Raped or attempted rape
at baseline
1.51
1.12
2.06
0.007
10.94
1.50
1.11
2.04
0.009
13.07
Peer pressure resistance
Told he had made a
girlfriend pregnant
0.84
0.74
0.97
0.015
0.55
0.36
0.85
0.007
Rape prevention: interpreting research
findings, understanding context
• Local knowledge is essential
– Understand the context in which rape occurs
– Understand confounding
• Need theoretical models that draw on
understandings from a range of disciplines
• Rape prevention has to include addressing
the context in which rape is often
perpetrated (social or environmental) as
well as addressing distal factors
Intimate partner violence prevention
• Important to recognise the multiple
overlaps between rape and IPV
• Key areas of difference:
– Relationship factors – conflict, poor
communication, compounded by alcohol
abuse
– Women’s consent to subordination which
contributes to their risk
So what must we do?
• Intervention must address all levels – societal,
community, family and individual
• Interventions with a sound theoretical basis from
which one can realistically anticipate impact on
behaviour change
• Need to combine actions:
–
–
–
–
those aimed at reducing perpetration
those protecting victims
responses for victims those aimed at removing impunity
• Need a long term view of change
Intervention focus:
• Strengthening the home context of childhood –
starting from birth (or before)
• Transformation of the practices of gender
relations, thus working to reduce violence and
improve relationship skills
• Interventions currently proven effective include
school-based programmes, out of school
interventions that focus on skills-building and are
gender transformative (Stepping Stones), +/economic empowerment for women
• Need to recognise that the current research
base of intervention evaluations is very limited
but includes evidence of what does not work!