Alessandra Guedes and Manuela Colombini*

Violence against women (VAW) and violence against children (VAC)have been progressivelyrecognized as major human rights and public health issues globally, and international commitments to address these forms of violence are gradually increasing (though more still remains to be done^[1] .Historically, however, research, programs and policies on these forms of violence have often followed parallel, but distinct trajectories. Nonetheless, increasing evidence points to the intersections of these forms of violence and to the need for greater coordination of these fields of work^[2].

As part of the Know Violence in Childhood: A Global Learning Initiative,international experts working on violence against women and violence against children met in London on 22-24 April to discussthe intersections between these forms of violence and to explore opportunities for shared learning and action.

A key focus of the meeting was the identification of the multiple ways in which violence against children and violence against women are linked, with a particular emphasis on the links between child maltreatment (CM) and intimate partner violence (IPV). For instance, one common feature of many forms of VAC and VAW is that they are often supported by social norms that deem such violence to be normal, acceptable or even justified. Other shared risk factors for perpetration include families characterized by marital conflict, economic stress and male dominance in the household and perpetrators’ exposure to violence during childhood.Both forms of violence also tend to co-occur in the same household and certain forms of violence against women and violence against children, such as sexual violence, may result in similar consequences to survivors. Of key relevance is emerging evidence that suggests that some prevention and response strategies may be effective for both.^[3]

For these reasons, meeting experts agreed on the importance of developing a conceptual framework that mapped the intersections of VAW and VAC across the life-course in order to improve our understanding of the links of these manifestations of violence and to identify possible entry points for coordinated policy and programmatic response.

A good starting point for increased coordination is the examination of existing programs that could be expanded to address multiple forms of violence. For instance, with some exceptions, home visitation programs have not been traditionally designed to prevent child maltreatment, but could be strengthened through the integration of discussions and skills building around child discipline, assessing for child maltreatment, as well as intimate partner violence.Existing parent training programs, on the other hand, could be re-vamped to integrate a focus on gender socialization and more equitable treatment of boys and girls, as well as the prevention of child maltreatment and partner violence. Additionally, school-based violence prevention efforts could incorporate discussions on gender and power dynamics and sexuality education should address violence, including its gendered dimensions.

In terms of the response to survivors of both forms of violence, at a basic level, services must be prepared to provide age-appropriate care, including post-rape care. Secondly, the identification of a child or adult survivor should generate a multi-faceted response by systems of care. In other words, if a woman is receiving care for IPV, providers should inquire about her children and engage appropriate services. Likewise, if a child is receiving services in response to violence victimization, their mother should be engaged, asked about her exposure to violenceand provided care, when appropriate. Antenatal services may be a particularly suitable entry point to jointly address violence against women and violence against children.

Adolescence was identified as a key area of common interest for those working on both violence against women and violence against children was adolescence. The UN defines a child as anyone under age 18^[4] . Meanwhile, virtually all studies on IPV against women define a “woman” as an ever-partnered female age 15 or older^[5] . Therefore, by definition, girls aged 15 to 19 should be of concern to those focused on both violence against children and violence against women. In practice, however, adolescent girls sometimes fall through the cracks because initiatives focused on child abuse tend to focus on children below age 15 and many initiatives dedicated to IPV focus on women, usually adult women, who are already married or living with a partner.

Adolescence, nonetheless, presents not only a period of great vulnerability to violence, but also a great opportunity for prevention, among both girls and boys and there are a host of issues that could benefit from greater collaboration between these fields, including: child marriage, non-consensual sexual debut and”dating” violence, among others.

Meeting experts called for the need for more evidence on how to effectively coordinate efforts to prevent and respond to multiple forms of violence that occur within the family and across the life course, but also recognized that further coordination of these areas of work may present some important risks, perceived or real.Firstly, it is important to recognize that there may be valid reasons for interventions that focus exclusively on violence against children or on violence against women. Secondly, we must acknowledge that for those working on the violence against children field, there may be concerns as to whether children’s voices will be heard and whether services will be adequately tailored to meet the needs of children and adolescents. Conversely, those working on violence against women may be concerned about children’s rights taking precedence of women’s rights, as some critics argue occurred within maternal and child health initiatives. Another problematic area is the practical implications of defining child exposure to intimate partner violence as a form of child maltreatment (as some legal systems and UN agencies have done). In settings where laws mandate reporting of partner violence to child protection agencies, it may be difficult to offer women survivors confidentiality, undermining women’s willingness to seek help. These are valid concerns and we need to tackle them head on in order to achieve greater coordination.

He clear conclusion of the meeting is that the intersections between violence against children and violence against women merit further research and that greater efforts should be made to assess the added value of coordinating efforts to prevent and respond to these forms of violence in integrated way.

Alessandra Guedes is the Regional Advisor on Family Violence at the WHO Regional Office for the Americas / Pan American Health Organization (PAHO) in Washington, DC. She sits on the Coordinating Group of the Sexual Violence Research Initiative (based in South Africa). She also serves as Co-Chair of the Workstream 2 of the Learning Group 1 for Know Violence in Childhood.

Manuela Colombini is Lecturer at the Department for Global Health and Development and member of the Gender, Violence and Health Centre, at the London School of Hygiene and Tropical Medicine. She also coordinates the Learning Group 1 for Know Violence in Childhood.

References

1. UN. Ending violence against women: from words to action. In-depth study on all forms of violence against women. Report of the Secretary-General. New York: United Nations General Assembly. 2006.

2. Wilkins N, Tsao B, Hertz M, Davis R, Klevens J. Connecting the Dots: An overview of the links among multiple forms of violence. Atlanta, GA and Oakland, CA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention and the Prevention Institute. 2014. AND Guedes A, Mikton C. Examining the Intersections between Child Maltreatment and Intimate Partner Violence. West J Emerg Med. 2013;14(4):377-9. AND Mercy J, Saul J, Hillis S. The importance of integrating efforts to prevent violence against women and children. New York: UNICEF Office of Research. 2013

3. WHO/LSHTM. Preventing intimate partner and sexual violence against women: taking action and generating evidence. Geneva, WHO, 2010. AND Fulu E. A summary of the evidence and research agenda for what works: A global programme to prevent violence against women and girls. Pretoria, South Africa: Medical Research Council. 2014.

4. UNICEF. Hidden in plain sight: A statistical analysis of violence against children. New York: United Nations Children’s Fund (UNICEF). 2014

5. WHO. Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization (WHO), Department of Reproductive Health and Research, the London School of Hygiene and Tropical Medicine (LSHTM), the South African Medical Research Council (SAMRC). 2013