Violence & Sexual Reproductive Health

Sexual Violence
Source: https://freezeviolence.wordpress.com/category/sexual-violence/

VIOLENCE & SEXUAL REPRODUCTIVE HEALTH

Definitions

Violence

Violence is defined as the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.

(WHO Global Consultation on Violence and Health. Violence: a public health priority. Geneva, World Health Organization, 1996 (document WHO/EHA/SPI.POA.2))

Sexual Reproductive Health

Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. (1)

Gender Based Violence (GBV)

Physical, mental or social abuse (including sexual violence) that is attempted or threatened, with some type of force (such us violence, threats, coercion, manipulation, deception, cultural expectations, weapons or economic circumstances) and is directed against a person because of his or her gender roles and expectations in a society or culture. In circumstances of GBV, a person has no choice to refuse or pursue other options without severe social, physical, or psychological consequences. Forms of GBV include domestic violence, sexual violence, sexual abuse, sexual harassment, sexual exploitation, early marriage or forced marriage, gender discrimination, denial (such as education, food, freedom) and female genital mutilation. (2)

Introduction

Gender-based violence is a significant public health issue worldwide. Gender-based violence includes many forms of abuses, but not limited to;

1. Domestic violence
2. Sexual violence
3. Traditional harmful practice including female genital mutilation, honour killing and dowry-related violence
4. Human trafficking

Although men might also be the victim of violence, usually this term is directed to girl or women due to its higher prevalence compared to men. Gender-based violence could result in either immediate or long-term physical, mental or sexual harm to a girl or women. It is also linked to an adverse effect of sexual and reproductive health of women. Unfortunately, it is a norm in society to keep silence, especially on sexual violence. Moreover, the victims do not know the way to get help and support, not aware of the law or legislation to get protection, to seek justice and demand their right.

There are multiple health outcomes ensued gender-based violence which can be divided into fatal and non-fatal outcome as explained in the table below;

Table 1: Health outcome of gender-based violence (3)

Fatal Outcomes

Nonfatal Outcomes

i.         Homicide      ii.         Suicide    iii.         Maternal mortality    iv.         AIDS – related

i.         Reproductive health ·      Unwanted pregnancy ·      STIs / HIV ·      Gynecological disorders ·      Unsafe abortion ·      Pregnancy complication      ii.         Physical health ·      Injury ·      Functional impairment ·      Permanent disability    iii.         Chronic conditions ·      Chronic pain syndromes ·      Irritable bowel syndrome ·      Gastrointestinal disorders    iv.         Mental health ·      Post-traumatic stress ·      Depression ·      Anxiety ·      Low self-esteem      v.         Negative health behaviours ·      Smoking, alcohol & drug abuse ·      Sexual risk-taking

Domestic violence

Domestic violence is a pattern of abusive and threatening behaviours which includes physical, emotional, sexual as well as economic control. It is often used by men to establish and exert power and control towards intimate partners includes former spouses, girlfriends, and dating partners. In Malaysia, domestic violence often knows as hidden social problems. It is estimated that approximately 39% of Malaysian women have been abused by their partners(4). This behaviour was learned through observation and reinforcement in family and society. Domestic violence was done repeatedly where the perpetrator gain control on victim thru intimidation and fear.

From the Royal Malaysian Police and Ministry of Women, Family and Community Development Statistics 2000-2013, observed that there are increasing numbers of domestic violence reported.(5)

Sexual Violence

Sexual violence is defined as any sexual act that is executed against a person’s will without consent, refusal to allow the act and includes those who are unable to give consent. Sexual violence can be divided into four types (6);

1. A Completed Sex Act – Defined as contact between penis and vulva or anus which involve penetration, contact between mouth and penis, vulva, or anus, or penetration of anal or genital opening by another person by hand, finger or any objects.
2.  An Attempted Sex Act – Any uncompleted attempt of sex.
3. Abusive Sexual Contact – Defined as intentional touching which can be directly or through clothing of the genitalia, anus, groin, breast, inner thigh or buttock of any person without consent, refuse to allow the act and includes who are unable to give consent.
4. Non-contact Sexual Abuse – Defined as any act of voyeurism, exhibitionism, unwanted exposure of pornography, verbal or behavioural harassment, taking nude photographs of a sexual nature of another person without consent and knowledge or person who are unable to give consent or refuse.

REFERENCES

1. WHO. Sexual Health World Health Organisation; 2014 [cited 2014 20 Oct]. Available from: http://www.who.int/topics/sexual_health/en/.
2. Gender Based Violence Term: United Nation Multilingual Terminology Database; 2001 [updated 5/5/2014; cited 2014 21 Oct]. Available from: http://untermportal.un.org/display/Record/UNHQ/gender-based_violence/c259882.
3. Heise L, Ellsberg M, Gottmoeller M. A global overview of gender-based violence International Journal of Gynecology and Obstetrics 2002;78(Suppl. 1):10.
4. Domestic Violence – The Malaysian context. Available from: http://www.wao.org.my/Domestic+Violence_98_5_1.htm.
5. Royal Malaysia Police and Ministry of Women FaCD. Police Statistics on Violence against Women in Malaysia (2000 - 2013) 2013. Available from: http://www.wao.org.my/Police+Statistics+on+Violence+Against+Women+2000-2012_99_6_1.htm.
6. Basile KC, Saltzman LE. SEXUAL VIOLENCE SURVEILLANCE: UNIFORM DEFINITIONS AND RECOMMENDED DATA ELEMENTS 2002.