Focus: COVID-19 exacerbates risks of violence for women

Violence against women is highly prevalent and can result in injuries and serious physical, mental, sexual and reproductive health problems, including sexually transmitted infections, HIV, and unplanned pregnancies. Globally, 1 in 3 women worldwide have experienced physical and/or sexual violence by an intimate partner or sexual violence by any perpetrator in their lifetime. Intimate partner violence is the most common form of violence.

Violence against women tends to increase during every type of emergency, including epidemics. Violence against women remains a major threat to global public health and women’s health during emergencies. Although data is scarce, reports from various countries around the world suggest an increase in domestic violence cases since the COVID-19 outbreak began.

Why?

Stress, the disruption of social and protective networks, and decreased access to services can all exacerbate the risk of violence for women.

As distancing measures are put in place and people are encouraged to stay at home, the risk of intimate partner violence is likely to increase. For example: The likelihood that women in an abusive relationship and their children will be exposed to violence is dramatically increased, as family members spend more time in close contact and families cope with additional stress and potential economic or job losses.

The disruption of livelihoods and the ability to earn a living, including for women (many of whom are informal wage workers), will decrease access to basic needs and services, increasing stress on families, with the potential to exacerbate conflicts and violence. As resources become scarcer, women may be at greater risk for experiencing economic abuse.

Access to vital sexual and reproductive health services, including for women subjected to violence, will likely become more limited. Other services, such as hotlines, crisis centers, shelters, legal aid, and protection services may also be scaled back, further reducing access to the few sources of help that women in abusive relationships might have.

What can women do when they are experiencing violence?

The risks of violence that women and their children face during the current COVID-19 crisis cannot be ignored.

Health systems have an important role in ensuring that services for women who have experienced violence remain accessible during the COVID-19 outbreak
Although the COVID-19 pandemic has placed an immense burden on health systems, including frontline health workers, there are things that can help mitigate the effects of violence on women and children.

Governments and policy makers must include essential services to address violence against women in preparedness and response plans for COVID-19, fund them, and identify ways to make them accessible in the context of physical distancing measures.

Health facilities should identify and provide information about services available locally (e.g. hotlines, shelters, rape crisis centers, counselling) for survivors, including opening hours, contact details, and whether services can be offered remotely, and establish referral linkages.

Health providers need to be aware of the risks and health consequences of violence against women.  They can help women who disclose by offering first-line support and medical treatment. First-line support includes: listening empathetically and without judgment, inquiring about needs and concerns, validating survivors' experiences and feelings, enhancing safety, and connecting survivors to support services. The use of mHealth and telemedicine in safely addressing violence against women must urgently be explored.
Health workers, the majority of whom are women in many settings, may be at risk for violence in their homes or in the workplace. Health managers or facility administrators need to have plans to address the safety of their health workers. Frontline providers dealing with COVID-19 might experience stigmatization, isolation, and being socially ostracized.

Provisions for psychosocial support, non-performance-based incentives, additional transport allowance, and childcare support should be planned.

Humanitarian response organizations need to include services for women subjected to violence and their children in their COVID-19 response plans and gather data on reported cases of violence against women.

Community members should be made aware of the increased risk of violence against women during this pandemic and the need to keep in touch and support women subjected to violence, and where information about support and help for survivors is available. It is important to ensure that it is safe to connect with women when the abuser is present in the home.

Women who are experiencing violence may find it helpful:

· To reach out to supportive family and friends who can help practically (e.g. food, child care) as well as emotional support for coping with stress.

· To develop a safety plan for their own and their children’s safety in case the violence gets worse. This includes keeping numbers of neighbours, friends, and family whom you can call for or go to for help; have accessible important documents, money, a few personal things to take with you if you need to leave immediately; and plan how you might leave the house and get help (e.g. transport, location).

· To keep information on violence against women hotlines, social workers, child protection or nearest police station, and accessible shelters and support services. Be discreet so that your partner or family members do not find this information.