partner violence

 Intimate partner violence is one of the most common forms of violence against women and includes physical, sexual, and emotional abuse and controlling behaviours by an intimate partner. Intimate partner violence1 (IPV) occurs in all settings and among all socioeconomic, religious and cultural groups. The overwhelming global burden of IPV is borne by women. Although women can be violent in relationships with men, often in self-defence, and violence sometimes occurs in same-sex partnerships, the most common perpetrators of violence against women are male intimate partners or ex-partners (1). By contrast, men are far more likely to experience violent acts by strangers or acquaintances than by someone close to them (2). BOX 1. FORMS OF INTIMATE PARTNER VIOLENCE (2) IPV refers to any behaviour within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship. Examples of types of behaviour are listed below. Acts of physical violence, such as slapping, hitting, kicking and beating. Sexual violence, including forced sexual intercourse and other forms of sexual coercion. Emotional (psychological) abuse, such as insults, belittling, constant humiliation, intimidation (e.g. destroying things), threats of harm, threats to take away children. Controlling behaviours, including isolating a person from family and friends; monitoring their movements; and restricting access to financial resources, employment, education or medical care. 1 The term ‘domestic violence’ is used in many countries to refer to partner violence but the term can also encompass child or elder abuse, or abuse by any member of a household. ‘Battering’ refers to a severe and escalating form of partner violence characterized by multiple forms of abuse ,terrorization and threats ,and increasingly possesive and controlling behaviour on the part of the abuser .

A growing number of population-based surveys have measured the prevalence of IPV, most notably the WHO multi-country study on women’s health and domestic violence against women, which collected data on IPV from more than 24 000 women in 10 countries,1 representing diverse cultural, geographical and urban/ rural settings (3). The study confirmed that IPV is widespread in all countries studied (Figure 1). Among women who had ever been in an intimate partnership: n 13–61% reported ever having experienced physical violence by a partner; n 4–49% reported having experienced severe physical violence by a partner; n 6–59% reported sexual violence by a partner at some point in their lives; and n 20–75% reported experiencing one emotionally abusive act, or more, from a partner in their lifetime (3). In addition, a comparative analysis of Demographic and Health Survey (DHS) data from nine countries found that the percentage of ever-partnered women who reported ever experiencing any physical or sexual violence by their current or most recent husband or cohabiting partner ranged from 18% in Cambodia to 48% in Zambia for physical violence, and 4% to 17% for sexual violence (4). In a 10-country analysis of DHS data, physical or sexual IPV ever reported by currently married women ranged from 17% in the Dominican Republic to 75% in Bangladesh (5). Similar ranges have been reported from other multi-country studies (6). 1 Countries included: Bangladesh, Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Thailand, the former state union of Serbia and Montenegro, and the United Republic of Tanzania.Why don’t women leave violent partners? Evidence suggests that most abused women are not passive victims – they often adopt strategies to maximize their safety and that of their children. Heise and colleagues (1999) argue that what might be interpreted as a woman’s inaction may in fact be the result of a calculated assessment about how to protect herself and her children (1). They go on to cite evidence of various reasons why women may stay in violent relationships, including: n fear of retaliation; n lack of alternative means of economic support; n concern for their children; n lack of support from family and friends; n stigma or fear of losing custody of children associated with divorce; and n love and the hope that the partner will change. Despite these barriers, many abused women eventually do leave their partners, often after multiple attempts and years of violence. In the WHO multi-country study, 19–51% of women who had ever been physically abused by their partner had left home for at least one night, and 8–21% had left two to five times (3). Factors associated with a woman leaving an abusive partner permanently appear to include an escalation in violence severity; a realization that her partner will not change; and the recognition that the violence is affecting her children .likelihood of committing violence against his partner(s) are (2,9): n young age; n low level of education; n witnessing or experiencing violence as a child; n harmful use of alcohol and drugs; n personality disorders; n acceptance of violence (e.g. feeling it is acceptable for a man to beat his partner) (10); and n past history of abusing partners. Factors consistently associated with a woman’s increased likelihood of experiencing violence by her partner(s) across different settings include (2,9,11): n low level of education; n exposure to violence between parents; n sexual abuse during childhood; n acceptance of violence; and n exposure to other forms of prior abuse. Re