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South-East Asia and the Pacific Multidisciplinary Advisory Team

ILO/SEAPAT's OnLine Gender Learning & Information Module


Unit 2: Gender issues in the world of work

Emerging gender issues in the Asia Pacific region

Violence against women

Health consequences of gender-based violence

A growing body of research has emerged in recent years on the mental and physical health consequences of violence against women and the burden it places on health care systems. Although much of this research is from the industrial world, clinicians and advocates in developing countries confirm that the U.S.-based literature corresponds well to their experience with battered women and survivors of sexual assault and abuse.

When this literature is considered together with estimates of the prevalence of gender-based violence in different parts of the world, the magnitude of the violence-related health burden begins to become clear. Perhaps the best estimate of this burden comes from a modeling exercise undertaken by the World Bank to inform its policy annual, the World Development Report, which in 1993 focused on health. For this effort, Bank staff and outside experts estimated the healthy years of life lost to men and women due to different causes. The exercise counted every year lost due to premature death as one disability-adjusted life year (DALY) and every year spent sick or incapacitated as a fraction of a DALY, with the value depending on the severity of the disability.

From this analysis, broken down by region and age group, rape and domestic violence emerged as a significant cause of disability and death among women of reproductive age in both the industrial and the developing world. In established market economies gender-based victimization accounts for nearly one in five healthy years of life lost to women age 15 to 44. On a per capita basis the health burden of rape and domestic violence affecting reproductive-age women is roughly the same in industrial and in developing countries, but because the overall burden of disease is much greater in developing countries, a smaller percentage is attributable to gender-based victimization.

The World Bank estimates that rape and domestic violence account for 5 percent of the healthy years of life lost to women of reproductive age in demographically developing countries. In developing countries such as China, where maternal mortality and poverty-related diseases are relatively under control, the healthy years of life lost due to rape and domestic violence again account for a larger share¾ 16 percent of the total burden. At a global level the health burden from gender-based victimization among women age 15 to 44 is comparable to that posed by other risk factors and diseases already high on the world agenda, including the human immunodeficiency virus (HIV), tuberculosis, sepsis during childbirth, cancer, and cardiovascular disease (see Table).

Table: Estimated global health burden of selected conditions for women age 15 to 44

Condition

Disability-adjusted life years (DALYs) lost (millions)

Maternal conditions

29.0

Sepsis

10.0

Obstructed labour

7.8

STDs (excluding HIV)

15.8

Pelvic inflammatory disease

12.8

Tuberculosis

10.9

HIV

10.6

Cardiovascular disease

10.5

Rape and domestic violence

9.5

All cancers

9.0

Breast

1.4

Cervical

1.0

Motor vehicle accidents

4.2

War

2.7

Malaria

2.3

a. Rape and domestic violence are included here for illustrative purposes. They are risk factors for disease conditions, such as STDs, depression, and injuries, not diseases in and of themselves.

Source: World Bank World Development Report 1993: Investing in Health, 1993, Washington, D.C.

[Extracts from Violence Against Women: The Hidden Health Burden, by Lori Heise, Jacqueline Pitanguy and Adrienne Germain (World Bank Discussion Paper 255, Washington, D.C.: The World Bank, 1994).]

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This page was revised  by SF. It was approved by WRB. It was last updated on 2 November 1998.