The figures were shocking. A World Health Organization study of 11 countries found between 15 percent and 71 percent of women, depending on the country, had experienced physical or sexual violence by a husband or partner in their lifetime – and between 4 percent and 54 percent had experienced it within the previous year. Ethiopian women suffered the highest rates of violence among the 11 countries, followed by Peru, Bangladesh, and Tanzania.
The findings from Women and Health were presented by Dr. Tonya Nyagiro, Director of WHO’s Department of Gender, Women and Health and discussed at a forum Monday that was hosted by The Aspen Institute’s Ministerial Leadership Initiative for Global Health.
The event drew more than 100 people, including many eager to hear more details about the Obama administration’s new Global Health Initiative and how it would take evidence such as the figures on violence against women and turn it into action. The talk fit into a larger context of looking anew at approaches to global health issues and making sure that health issues pertaining to women were properly addressed.
“The violence data is much more pervasive than any of us really expected – and we knew it was high,’’ said Michele Moloney-Kitts, Assistant US Global AIDS Coordinator.
Moloney-Kitts, who has been a senior PEPFAR official since 2004, nearly since its inception, compared the stigma and discrimination against people with HIV or AIDS a decade ago to the fear today of women unable to speak up about domestic violence around the world. And after reading an article in the Independent newspaper about high rates of violence against women in the U.K., she emphasized that the problem was global – in rich and poor countries.
“Now we have here a new evidence base on violence that we never had before,’’ she told the Aspen audience, suggesting that policymakers could use the evidence to build programs aimed at reducing violence against women. “You cannot do public health without recognizing this is part of public health as well.’’
The discussion was wide-ranging, touching on the impact of the ramp-up of HIV/AIDS services on health systems to the administration’s increased focus on what was described as “women-centered programs’’ in the developing world.
Dr. Julio Frenk, the former Health Minister of Mexico and now the Dean of the School of Public Health at Harvard, said that many HIV/AIDS programs opened up new avenues to provide better health services for women and children. “The work in preventing mother-to-child transmission’’ has advanced the health of large numbers of women in many countries, he said.
Moloney-Kitts also noted that the WHO report showed that AIDS remained the leading cause of death among women aged 20 to 59, underscoring the enormity of the problem. “We have so much left to do,’’ she said. “Our attention is quick to move onto other directions (in global health), but the report grounds you to how much HIV/AIDS affects women.’’
She said that the PEPFAR program now was expanding into areas protecting women against violence, mentioning training programs for police and making rape kits available in primary health care facilities in developing countries. But so far, she said, “what we’ve done is really at a very small scale. The next step going forward is dealing with it more broadly.’’
On the question of violence against women, two audience members said that often policy leaves out men. They wondered why.
Frenk agreed that men are often left out, which he said was a mistake.
`Men are often a big part of the problem, but they are also a big part of the solution,’’ he said.
Frenk’s wife, Felicia Knoll, is a breast cancer survivor and has been a leader in a global effort to increase awareness of breast cancer in the developing world. In her work, she hears directly how men are often a problem for women seeking health care, he said. “A number of women will tell you they won’t do a mammogram because they are afraid if they are found to have breast cancer, their husband or partner will abandon them,’’ he said.
Several in the audience wanted to know more about the administration’s work in family planning globally.
Dr. Susan K. Brems, Deputy Assistant Administrator for USAID’s Global Health Bureau, said her agency has been a pioneer in family planning for years. But next year, she said, “we will have more money available. Family planning, time and again, has proven to be effective. When it comes to family planning, we will keep our eyes on the prize.’’