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Community Psychology: Common Values, Diverse PracticesAssociations with healthWith respect to the impact on health, a strikingly consistent finding is that women who have experienced partnerviolence compared to women who were never abused, were more likely to have• Worse general health• More symptoms of ill health such as pain, memory loss, dizziness in the past 4 weeks• More signs of mental distress• More suicidal thoughts and attempts• More induced abortions and miscarriageViolence seems to have similar impacts on health both in settings where it is very common and in setting where itis relatively rare. This was true in setting after setting, equally true for rural women in Ethiopia or Thailand, orcosmopolitan women in Brazil or Serbia and Montenegro.Violence: normalized as well as stigmatizedAnother key finding of the study is the extent to which women are socialized to accept violence and think that it isnormal. A remark of this woman interviewed in Bangladesh illustrates this:"My husband slaps me, has sex with me against my will and I have to conform. Before being interviewed I didn'treally think about this. I thought this is only natural. This is the way a husband behaves. "What participants shared in the interviews tell us that the way this woman thinks is not unique.Another troubling finding was the degree to which violence remains hidden. At least one fifth (to two-thirds) ofabused women across sites had never told anyone about the partner’s violence prior to being interviewed. Thesocial consequences of disclosing abuse can be severe. As a middle class, urban Bangladeshi woman reported:“If I protest I’ll be marked in the society and then my daughter wouldn’t be able to get married…If I voice myprotest the community will blame me for not bearing it in silence. This helplessness is a torture in itself.”Ecological framework to understand violenceDespite the fact that IPV occurs in the private sphere and is hidden, it is a public and social issue. IPV issupported by and simultaneously reinforcing gender inequality that permeates across different levels of theecology: relationship, family, community and the society as a whole.Thus violence must be understood in the context of influences at the multiple levels of ecology with at every levelfactor that can be either protective or increasing risk.221
Community Psychology: Common Values, Diverse PracticesReferencesEllsberg, M., H.A.F.M. Jansen, L. Heise , C.H. Watts, C. Garcia-Moreno. Intimate partner violence and women'sphysical and mental health in the WHO multi-country study on women's health and domestic violence: anobservational study. Lancet; 371(9619): 1165-72. 2008Garcia-Moreno C., H.A.F.M. Jansen, M. Ellsberg, L. Heise, C.H. Watts, on behalf of the WHO Multi-countryStudy on Women’s Health and Domestic Violence against Women Study Team. Prevalence of intimate partnerviolence: findings from the WHO multi-country study on women’s health and domestic Violence. Lancet 2006;368: 1260–69Garcia-Moreno C., H.A.F.M. Jansen, M. Ellsberg, L. Heise, C. Watts. WHO Multi-country Study on Women'sHealth and Domestic Violence against Women. Initial results on prevalence, health outcomes and women'sresponses. World Health Organization 2005. http://www.who.int/genderGarcia-Moreno C., L. Heise, H.A.F.M. Jansen, M. Ellsberg, C. Watts. Violence Against Women. Science Vol 310.Nov 2005. p 1282-1283.Jansen H.A.F.M., Charlotte Watts, M. Ellsberg, L. Heise, C. García-Moreno. Interviewer Training in the HO Multi-Country Study onWomen’s Health and Domestic Violence. Violence Against Women, Vol. 10 No. 7, July 2004831-849Garcia-Moreno C., C. Watts, H. Jansen, M. Ellsberg, L. Heise. Responding to Violence against Women: WHO'smulti-country study on women's health and domestic violence. Health and Human Rights. Vol. 6, No 2 (2003)113-127World Health Organization. Putting Women first: Ethical and Safety Recommendations for Research on DomesticViolence Against Women. WHO. Geneva (2001). WHO/FCH/GWH/01.1222
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