Preventing and addressing intimate partner violence against migrant and ethnic minority women: the role of the health sector
Violence against women is an extreme manifestation of gender inequality in society and a serious violation of fundamental human rights. The United Nations Declaration on the Elimination of Violence against Women defines it as any act of gender-based violence (GBV) that results in, or is likely to result in physical, sexual or psychological harm or suffering to women, including threats of acts such as coercion or arbitrary deprivation of liberty, whether occurring in public or private life (United Nations 1993). Intimate partner violence (IPV) against women is the most common type of violence against women. It takes place within couples, and the perpetrators are almost exclusively men who are or have been in an intimate relationship with the woman (WHO 2013a).
IPV against women occurs in all countries, all cultures and at every level of society (Garcia-Moreno et al. 2006). It varies by region. In 2010, lifetime IPV was at 16.30% in East Asia while it was 65.64% in sub-Saharan Central Africa (WHO 2013b). In the countries comprising the 27 Member States of the European Union (EU),1 it affects between 20% and 25% of adult women who have ever had an intimate partner (European Institute for Gender Equality 2012).
While limited evidence is currently available, it is possible that some populations of women may be at greater risk, such as migrant and ethnic minority women. The stresses of culturization and changes in family or gender roles that often accompany migration or belonging to an ethnic minority group can trigger or intensify IPV (Jampaklay et al. 2009). For both migrant and ethnic minority women, institutional discrimination, lack of access to or knowledge of services, and cultural differences can prevent women experiencing IPV from seeking help (PACE 2009).
In addition to the risk of death, IPV is related to physical and psychological injury, functional impairment, and negative health behaviours (such as smoking, and drug and alcohol abuse), chronic conditions, reproductive health problems, and mental health problems (WHO 2013b). Consequently, women affected by IPV may visit the doctor more frequently, if they are not prevented from doing so by their partners, and require more frequent use of health services, such as primary and specialist care, mental health care and inpatient services (hospitalization) (WHO 2013a). Health professionals are directly involved in treating the health effects of IPV. The health sector is thus in a key position, not only to detect and report IPV cases, but also to help coordinate and implement the tools to address and prevent such violence. Interventions to prevent IPV and respond to the needs of women affected by it will ideally involve a range of stakeholders, from legal services to social and health care institutions, along with civil society.