Intimate 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).
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 possessive and
controlling behaviour on the part of the abuser.
Percentage of ever-partnered women reporting physical and/or sexual IPV by type and when the violence
took place, WHO multi-country study (3)
70
50
50
40
62
59
60
37
50
49
40
47
33
31
29
30
25
23
19
20
47
42
17
16
17
16
31
23
15
23
19
10
0
Bangladesh
(Urban)
Bangladesh
(Province)
Ethiopia
(Province)
Namibia
(Urban)
Peru
(Urban)
Peru
(Province)
Countries included: Bangladesh, Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Thailand,
the former state union of Serbia and Montenegro, and the United Republic of Tanzania.
Serbia
IPV affects adolescent girls as well as older adult women, within formal unions
in settings where girls marry young, and within informal partnerships such as
dating relationships. Estimates of the prevalence of violence against women
and girls within dating relationships vary widely, depending on how they are
measured. The examples below illustrate selected findings:
n a South African study found that 42% of females aged 1323 years reported
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, 1951% of women who had ever been physically abused by their partner
had left home for at least one night, and 821% 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 (3).
What are the causes of and risk factors for intimate partner violence?
The most widely used model for understanding violence is the ecological model,
which proposes that violence is a result of factors operating at four levels:
individual, relationship, community and societal. Researchers have begun to
examine evidence at these levels in different settings, to understand better
the factors associated with variations in prevalence; however, there is still
limited research on community and societal influences. Some risk factors are
consistently identified across studies from many different countries, while
others are context specific and vary among and within countries (e.g. between
rural and urban settings). It is also important to note that, at the individual
level, some factors are associated with perpetration, some with victimization,
and some with both.
Individual factors
Some of the most consistent factors associated with a mans increased
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
Relationship factors
Factors associated with the risk of both victimization of women and
perpetration by men include (2,9):
n conflict or dissatisfaction in the relationship;
n male dominance in the family;
n economic stress;
n man having multiple partners (9); and
n disparity in educational attainment, i.e. where a woman has a higher level of
marriage laws;
n weak community sanctions against IPV;
n broad social acceptance of violence as a way to resolve conflict; and
n armed conflict and high levels of general violence in society.
In many settings, widely held beliefs about gender roles and violence perpetuate
partner violence (1,7,9) (Box 2).
These are described in greater detail in the information sheet Health consequences in this
series.
experienced physical or sexual violence than those who had not (3). In addition,
IPV has also been linked with (2):
n alcohol and drug abuse;
n eating and sleep disorders;
n physical inactivity;
n poor self-esteem;
n post-traumatic stress disorder;
n smoking;
n self-harm; and
n unsafe sexual behaviour.
IPV may also account for a proportion of maternal mortality, although this
association is often unrecognized by policy-makers.
Effects on children
Many studies have found an association between IPV against women and
negative social and health consequences for children, including anxiety,
depression, poor school performance and negative health outcomes (2). A large
body of evidence indicates that exposure to IPV against the mother is one of the
most common factors associated with male perpetration and female experience
of IPV later in life (4,11). A number of studies have found an association between
IPV and child abuse within the same household (23).2 In addition, studies from
some low-income countries, including Nicaragua and Bangladesh have found
that children whose mothers were abused (24,25):
n are less likely to be immunized;
n have higher rates of diarrhoeal disease; and/or
n are at greater risk of dying before the age of five.
legislation;
n strengthen womens civil rights related to divorce, property, child support
and custody;
n build coalitions of government and civil society institutions;
n build the evidence base for advocacy and awareness;
n use behaviour change communication to achieve social change;
n transform whole institutions in every sector, using a gender perspective; in
women;
n ongoing training and support for staff to ensure effective service provision;
n written protocols and referral systems to help survivors access services from
other sectors;
n efforts to strengthen the physical and human resources of the institution;
n educational materials on violence for clients and providers;
n data-collection systems; and
n monitoring and evaluation to assess the quality of service provision and
marriage;
n sensitizing and training police and judges about partner violence; and
n improving the application of existing laws.
References
1. Heise L, Ellsberg M, Gottemoeller M. Ending violence against women. Baltimore, MD,
Johns Hopkins University School of Public Health, Center for Communications
Programs, 1999.
2. Heise L, Garcia Moreno C. Violence by intimate partners. In: Krug EG et al., eds.
World report on violence and health. Geneva, World Health Organization, 2002:87
121.
3. Garcia-Moreno C et al. WHO multi-country study on womens health and domestic
violence against women: initial results on prevalence, health outcomes and womens
responses. Geneva: World Health Organization, 2005.
4. Kishor S, Johnson K. Profiling domestic violence a multi-country study. Calverton,
MD, ORC Macro, 2004.
5. Hindin M, Kishor S, Ansara LD. Intimate partner violence among couples in 10 DHS
countries: predicotrs and health outcomes. DHS Analytical Studies 18. Calverton, MD,
Macro International Inc, 2008.
6. Bott S et al. (forthcoming) Violence against women in Latin America and Caribbean: a
comparative analysis of population-based data from 12 countries. Washington DC, OPS
7. Swart LA et al. Violence in adolescents romantic relationships: findings from
a survey amongst school-going youth in a South African community. Journal of
Adolescence, 2002, 25(4):38595.
8. Philpart M et al. Prevalence and risk factors of gender-based violence committed
by male college students in Awassa, Ethiopia. Violence and Victims, 2009,
24(1):12236.
9. WHO/LSHTM. Preventing intimate partner and sexual violence against women: taking
action and generating evidence. Geneva/London, World Health Organization/
London School of Hygiene and Tropical Medicine, 2010.
10. Johnson KB, Das MB. Spousal violence in Bangladesh as reported by men:
prevalence and risk factors. Journal of Interpersonal Violence, 2009, 24(6):97795.
11. Abramsky T et al. What factors are associated with recent intimate partner
violence? Findings from the WHO multi-country study on womens health and
domestic violence. BioMed Central Public Health, 11:109.
12. Ko Ling Chan. Sexual violence against women and children in Chinese societies.
Trauma, Violence & Abuse, 2009, 10(1):6985.
13. Campbell J, Soeken K. Forced sex and intimate partner violence. Violence Against
Women, 1999, 5(9):101735.
14. Champion J, Shain R. The context of sexually transmitted disease: life histories
of woman abuse. Issues in Mental Health Nursing, 1998, 19(5):46379.
15. Gazmararian JA et al. The relationship between pregnancy intendedness
and physical violence in mothers of newborns. Obstetrics & Gynecology, 1995,
85(6):103138.
16. Campbell JC. Health consequences of intimate partner violence. Lancet, 2002,
359(9314):133136.
17. Heise L, Moore K, Toubia N. Sexual coercion and reproductive health: a focus on
research. New York, Population Council, 1995.
18. Campbell JC et al. The intersection of intimate partner violence against women
and HIV/AIDS: a review. International Journal of Injury Control and Safety Promotion,
2008, 15(4):22131.
19. Devries KM et al. Intimate partner violence during pregnancy: analysis of
prevalence data from 19 countries. Reproductive Health Matters, 2010, 18(36):158
70.
20. Campbell J et al. Abuse during pregnancy in industrialized and developing
countries. Violence Against Women, 2004, 10:77089.
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The full series of Understanding and Addressing Violence Against Women information
sheets can be downloaded from the WHO Department of Reproductive Health web site:
http://www.who.int/reproductivehealth/publications/violence/en/index.html, and
from the Pan American Health Organization web site: www.paho.org
Further information is available through WHO publications, including:
Preventing intimate partner and sexual violence against women: taking action and
generating evidence
http://whqlibdoc.who.int/publications/2010/9789241564007_eng.pdf
WHO multi-country study on womens health and domestic violence against women: initial
results on prevalence, health outcomes and womens responses
http://www.who.int/gender/violence/who_multicountry_study/en/
Acknowledgments
This information sheet was prepared by Claudia Garcia-Moreno, Alessandra
Guedes and Wendy Knerr as part of a series produced by WHO and PAHO to
review the evidence base on aspects of violence against women. Jacqueline
Campbell and Sarah Bott acted as external reviewers for this information sheet.
Sarah Ramsay edited the series.
WHO/RHR/12.36
World Health Organization 2012
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