Global rates of violent crime can be halved with the right policies, experts say

Health systems response needed to reduce domestic violence among women

CAMBRIDGE, England — Levels of violent crime such as intimate partner violence, child abuse, murder and gang violence could be halved in 30 years if governments implement the right policies, according to leading researchers at the World Health Organization and University of Cambridge Global Violence Reduction Conference 2014. 

The conference, held at Cambridge's Institute of Criminology Sept. 17 to 19, brings together 150 leading scientists to set out a roadmap for reducing violence worldwide.

At the conference, RTI International researcher Suneeta Krishnan, Ph.D., an epidemiologist and technical lead of RTI India, will address the importance of using health care as an entry point to reduce intimate partner violence against women. Krishnan and Dimagi have partnered on a project in India, supported by the U.S. Agency for International Development, to help health care workers through the use of mobile phone technology to identify, counsel and refer women who experience intimate partner violence.

"Reducing intimate partner violence must be a component of efforts to reduce global violence by 50 percent in the next 30 years," Krishnan said.  "Our research in Bengalore, India, has demonstrated the feasibility and acceptability of a primary health systems response to intimate partner violence. The identification of effective responses to intimate partner violence is an urgent priority in India and globally, with important health and human rights ramifications." 

Research by RTI has found that primary health care is a critical and timely entry point for identifying intimate partner violence. Intimate partner violence, one of the most common forms of violence against women, is widely recognized as a major health and human rights challenge. The World Health Organization estimates that one in three women worldwide have experienced physical or sexual violence by an intimate partner. 

Based on nearly a decade-long research effort, RTI and its partners, Dimagi and the St. John's Research Institute, initiated a project to develop and evaluate the effectiveness of an intervention to build the capacity of urban primary health care providers to respond to intimate partner violence in India.  The intervention trained municipal health care providers on gender, intimate partner violence and its impacts on women's and children's health; increased access to referral services through government and non-government agencies; and advocated to municipal and state governments in Bengalore to implement a policy on health systems responses to violence against women.

"Although Indian women who experience intimate partner violence do not typically seek help from police or support agencies, they will seek health care for injuries as well as a range of other services," Krishnan said. "Women's utilization of reproductive health services, including family planning and maternal and child health services, has increased substantially across India over the past few decades, and has made these services important entry points for intimate partner violence prevention and management." 

Krishnan offers the following key recommendations to policy makers worldwide to prevent and mitigate intimate partner violence: 

  • Articulate a commitment to health systems responses to intimate partner violence
  • Develop guidelines and protocols for health systems responses 
  • Allocate sufficient resources to build systems-level capacities
  • Strengthen inter-sectoral connections to improve access to health and non-health support services
  • Support research and evidence generation on health-based interventions to address intimate personal violence 

In May 2014, the  67Th World Health Assembly adopted a resolution, co-sponsored by India, on "Strengthening the role of the health system in addressing violence, in particular against women and girls, and against children." The resolution calls for WHO to develop a global plan of action and for member states to strengthen their national response to violence against women and girls.