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Health sector programming can reduce the economic and development costs to societies

1.  Violence against women and girls is costly to societies. 

  • Improving efforts to address violence against women and girls is critical not only because women and girls have a right to live free from violence, but also because violence incurs considerable social and economic costs.  It not only impoverishes individuals, it contributes to the impoverishment of communities and nations through: 
    • Lost workdays, lower productivity and lower income;
    • Overall reduced or lost educational, employment, social or political participation and opportunities;
    • Expenditures (at the level of individual, family and public sector budgets) on medical, protection, judicial and social services.
  • Violence against women and girls drains a country’s existing resources and handicaps women’s ability to contribute to social and economic progress.  In some industrialized settings, the annual costs of intimate partner violence have been estimated in the billions of dollars.  State expenses for one act of rape in the United States, when accounting for both tangible and intangible costs, may amount to US $100,000 (Post et al., 2002, cited in Ward et al., 2005). 
  • The health sector is directly affected by these costs, especially when taking into account the extra burden that caring for survivors of violence places on it. 
    • In Uganda, the annual cost for hospital staff treating women for intimate partner violence-related injuries is US $1.2 million (ICRW, 2009).
    • In just one hospital in Kingston, Jamaica, it was estimated that treating victims of intimate partner violence cost almost half a million dollars as far back as 1991 (World Bank Gender-Based Violence, Health and the Role of the Health Sector website page).  
    • In a first-ever study (2002) to estimate the disease burden of intimate partner violence, Australia found that for women under the age of 45, IPV was responsible for more preventable ill-health and premature death than high blood pressure, obesity or smoking (State Government of Victoria, Australia Victorian Health Promotion Foundation, 2004).
    • The costs of intimate partner violence in the United States were over $5.8 billion each year, $4.1 billion of which is for direct medical and mental health care services (CDC, 2003).

 

Additional Resources: 

Costs of Sexual Violence Worksheet (Minnesota Department of Health). This worksheet, can be used by programme implementers and advocates to raise awareness about the costs of violence against women in the cities. This information can be used to demonstrate that preventing gender-based violence is much more cost-effective than allowing it continue. Available in English.  

See Consequences and Costs in the Programming Essentials Module for additional statistics and for illustrative costing reports and tools. 

 

2.  Responding to and preventing violence against women and girls is a key strategy to help to achieve the health-related Millennium Development Goals.

  • The Millennium Declaration (2000) adopted by 189 nations acknowledges that in order to achieve the Millennium Development Goals (MDGs), it is necessary to “combat all forms of violence against women and to implement the Convention on the Elimination of All Forms of Discrimination against Women” (United Nations General Assembly. United Nations Millennium Declaration. Resolution A/55/L.2). The Secretary-General of the United Nations also launched an unprecedented campaign, UNiTE to End Violence against Women in 2008 running to 2015 in alignment with the deadline of the Millennium Development goals. Violence against women and girls negatively impacts the achievement of all of the MDGs, not only to the extent that gender equality is cross-cutting priority in each of the MDGs, but also in terms of the direct impact that violence against women and girls has in realising six of those goals. (See also the Violence against Women and the Millennium Development Goals in the Programming Essentials module.)
  • The MDGs specifically target health issues such as reducing child mortality, improving maternal health, and combating HIV/AIDS, all of which cannot be accomplished without addressing the problem of violence against women and girls.   
  • In order to support the realization of the MDGs, the health sector must understand the links between achieving the MDGs and addressing violence against women.

 

 

Violence Against Women and Girls and the Health-related Millennium Development Goals

Goal 4:  Reduce child mortality

Violence against women and girls has direct links to child mortality.  In addition to the estimated millions of girls who are ‘missing’ due directly to gender-discriminatory practices such as sex-selective abortion, female infanticide and differential feeding, evidence has indicated that children of women who suffer violence in intimate relationships are significantly more likely to die before the age of five.  The practice of early marriage increases the risk of child mortality: If a girl is under the age of 18 when she gives birth, her baby’s chance of dying in his/her first year of life is 60 percent higher than that of a baby born to a mother over the age of 18 (Black, 2001, cited in Ward et al., 2005).

Goal 5:  Improve maternal health

Intimate partner violence during pregnancy is among the common conditions identified in antenatal screening (Ellsberg, 2006),  and has been associated with adverse pregnancy outcomes, such as low birth weight, premature labour, pre-term delivery, miscarriage, and foetal loss (Campbell, Garcia-Moreno, and Sharps 2004; Ellsberg et al., 2008; Garcia-Moreno, 2009).  Early marriage and early childbearing also pose direct risks to maternal health: A leading cause of death for 15- to 19-year-old girls worldwide is complications from pregnancy and childbearing.  Data indicates that for every girl who dies during pregnancy or childbirth, 30 more will suffer injuries, infections and disabilities (Black, 2001).

Goal 6:  Combat HIV/AIDS, malaria and other diseases

The ‘feminisation’ of HIV/AIDS, particularly in sub-Saharan Africa and particularly among adolescent girls and young adult women, may be directly linked to multiple forms of violence against women, ranging from sexual assault and exploitation to intimate-partner violence.  Girls in abusive relationships, for example, are less likely to be able to negotiate condom use and are also less likely to access treatment for sexually transmitted diseases, including HIV. 

Research conducted across Africa and India has found that women who have experienced abuse by their partner are more likely to be infected with HIV (Van der Straten A et al. 1995 and 1998; Maman S et al., 2002; Dunkle KL et al., 2004; Jewkes R et al., 2010). For girls who marry young, the risk is even greater: studies indicate that HIV rates are higher among married young women than among their unmarried female counterparts (Black, 2001; Otoo-Oyortey and Pobi, 2003).

 

 See also The Facts: Ending Violence Against Women and Millennium Development Goals (compiled by UNIFEM, 2010). Available in English, French, and Spanish.

 

Excerpted from: Ward, 2007 and adapted from “Strengthening Women’s Rights: Ending Violence against Women and Girls –Protecting Human Rights”, Deutsche Gesellshaft fur Technische Zusammenarbeit (GTZ), (Eschborn, 2006), pp. 26-31.