Putting Gender-Based Violence on the Healthcare Agenda in Glasgow

Katie CosgroveCorporate Inequalities ManagerNHS Greater Glasgow & Clyde

“Violence against women and girls is the most pervasive violation of human rights in the world. Its forms are both subtle and blatant and its impact on development profound. But it is so deeply embedded in cultures around the world that it is almost invisible. Once recognised for what it is - a construct of power and a means of maintaining the status quo - it can be dismantled" (‘The Intolerable Status Quo: Violence against Women and Girls; UNICEF)

International Response to Violence against womenInternational Response to Violence against women

Defined as a human rights violation by UN (1993) UN Declaration on the Elimination of Violence

Against Women (1993) Beijing Conference ‘95 WHO defined violence against women as a Public

Health problem -1996 WHO recognition as a health problem - ‘96 PAHO

initiative; WHO Multi-Country Study on Women’s Health &

Domestic Violence (2005,Garcia-Moreno) World Violence & Health Report – (Krug et. al.,

10/02)

Defined as a human rights violation by UN (1993) UN Declaration on the Elimination of Violence

Against Women (1993) Beijing Conference ‘95 WHO defined violence against women as a Public

Health problem -1996 WHO recognition as a health problem - ‘96 PAHO

initiative; WHO Multi-Country Study on Women’s Health &

Domestic Violence (2005,Garcia-Moreno) World Violence & Health Report – (Krug et. al.,

10/02)

What is Gender-Based Violence? Domestic Violence Rape & Sexual Assault Childhood Sexual Abuse Sexual Harassment Prostitution Forced marriage Female Genital Mutilation

Prevalence in UK Between 1in3 and 1in 5 women

over life-time Current abuse approx 1:10 Between 15-17% women abused

during pregnancy 47% women killed are murdered by

partner or ex-partner Domestic abuse = ¼ of all

recorded violence crime 1 in 7 women raped by partner

Key Features Purposeful, deliberate behaviour Escalates in frequency and

severity Often more than one type co-

existing Gendered – overwhelmingly male

perpetrators against women

Health Consequences Poorer health status Injuries Chronic pain Digestive problems Bladder/kidney infections; UTI Pelvic pain Problem pregnancies Gynaecological problems

Mental Health

Depression Anxiety Post traumatic stress disorder Eating disorders Panic attacks Self-harm Alcohol /drug problems Suicidal ideation

Who Is At Risk? Women who experience abuse come

from every: - age group - socio-economic level - religion - educational background - ethnic /racial group - rural and urban areas

Why is it permitted?

Jacky Fleming

Role of the Health Sector

“ Health services have a pivotal role to play in the identification, assessment and response to domestic violence, in promoting health and through the provision of support and services for women and their children…….Early intervention can prevent an abusive situation becoming worse and the level of violence becoming more intense”.

(S E Guidelines)

Health care workers have a responsibility to:

Be educated and trained in how best to help; Be aware of a woman’s often tentative attempt

to seek help – this includes children presenting with a variety of illnesses

Be sympathetic, non-judgemental and show empathy;

Be responsive within a co-ordinated health service, with links to multi-agency help as required;

Value racial, cultural or religious diversity and be sensitive to women’s needs

GBV Programme in Glasgow (1) Maternity Dedicated link midwife service Routine Enquiry of abuse Shared protocols Recording structure

Mental Health Review of Psychology Service Demonstration projects Integrated assessments Training programme Sexual abuse counselling service for men

GBV Programme in Glasgow (2) Addictions Training programme Integrated Assessment Gender toolkit

Homelessness Dedicated Gender-Based Violence team Trauma & homelessness service Out of hours service for women fleeing domestic violence

Primary Care Training programme for GPs, Health Visitors etc Protocol on responding to abuse Joint protocol on domestic violence and child protection

Barriers to change Organisational structures / resistance Dominance of medical model Lack of dedicated resources Not a health priority (or issue?) Leadership / Senior management

support Lack of knowledge & skills

(perceived)to tackle abuse