Gender-based violence¾ including rape, domestic violence, mutilation, murder, and sexual abuse¾ is a profound health problem for women across the globe. Although gender violence is a significant cause of female morbidity and mortality, it is almost never seen as a public health issue. Recent World Bank estimates of the global burden of disease indicate that in established market economies gender-based victimization is responsible for one out of every five healthy days of life lost to women of reproductive age. On a per capita basis, the health burden imposed by rape and domestic violence in the industrial and developing world is roughly equivalent, but because the total disease burden is so much greater in the developing world, the percentage attributable to gender-based victimization is smaller. Nonetheless, on a global basis, the health burden from gender-based victimization is comparable to that from other conditions already high on the world agenda.

Female-focused violence also represents a hidden obstacle to economic and social development. By sapping women’s energy, undermining their confidence, and compromising their health, gender violence deprives society of women’s full participation. As the United Nations Fund for Women (UNIFEM) recently observed, "Women cannot lend their labor or creative ideas fully if they are burdened with the physical and psychological scars of abuse" (Carillo, 1992, p.11).

This paper draws together existing data on the dimensions of violence against women worldwide and reviews available literature on the health consequences of abuse. It also explores the relationship between violence and other pressing issues, such as maternal mortality, health care utilization, child survival, AIDS prevention, and socioeconomic development.

To assist policymakers in addressing this issue, the paper explores interventions in primary prevention, justice system reform, health care response, programs to assist victims, and treatment and reeducation programs for perpetrators. It argues that any strategy to combat violence must attack the root causes of the problem in addition to treating its symptoms. This means challenging the social attitudes and beliefs that undergird men’s violence and negotiating the meaning of gender and sexuality and the balance of power between men and women at all levels of society.