7. Research needs
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Box 9 Priority research needs on gender-based violence and
health
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· Better data on the incidence and prevalence of
gender-related violence in representative populations of women.
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· Data on the percentage of women presenting in different
settings (emergency rooms, family planning clinics) who have been raped or
abused, or both. (Such data should help convince health care providers of the
prevalence of abuse as well as help assess the potential of different settings
as points of identification and referral for victims.)
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· Data on the health care and social costs of domestic
violence and sexual assault and abuse, including estimates of the cost of
emergency services, indirect costs of productivity losses, and costs associated
with increased utilization of primary care services.
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· Descriptive profiles of the typical symptoms of rape and
abuse victims (location of injuries, somatic complaints) to facilitate
identification of victims by health care providers.
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· Data on the mental health consequences of violence,
especially in a developing world context, including relative risk among
victimized and non-victimized women for anxiety, depression, suicide attempts,
sexual dysfunction, somatic health complaints, and alcohol and drug
abuse.
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· Data on the impact of domestic violence and sexual assault
on birth outcomes, pregnancy complications, and rates of miscarriage and low
birth weight.
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· Studies that analyze the relation between gender violence
and such development issues as safe motherhood, child survival, AIDS prevention,
and family planning.
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· Studies that evaluate the effectiveness of different
interventions, including self-help support groups, violence prevention
curricula, and screening for abuse at primary care
facilities.
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This review has revealed that, although existing data are
sufficient to capture the severity of violence against women around the world,
more and better research is needed to spur political action in specific
countries, to refine our understanding of the consequences of gender violence,
and to evaluate the effectiveness of different interventions (see box 9 for the
most important data needs). Well-designed studies of the prevalence of wife
abuse are beginning to emerge, but there is still a large need in the developing
countries for population-based data on the prevalence of sexual assault and
child sexual abuse, and for studies of the mental and physical health
consequences of gender-based violence. In addition, we need to begin collecting
qualitative data on how women experience violence: How does physical abuse
affect women's productivity? What strategies do women use to cope with abuse?
How do different women define violence?
As a first step toward meeting these needs, institutions such as
the World Bank could create forums) for researchers to come together with
practitioners and advocates-at both the national and the international level-to
develop a joint research agenda and discuss outstanding methodological issues.
Creating a dialogue up front between those familiar with the issues (shelter
workers, advocates) and those who understand research will help ensure that
future research is both relevant and defensible. Too often, research pursued by
academics ash the wrong and research pursued by practitioners lacks rigor.
Future progress in research on violence would benefit greatly
from:
· Better-articulated definitions of rape, child
sexual abuse, and other forma of gender violence to facilitate measurement and
comparisons across populations
· Greater consensus on operational
definitions of different forms of violence for the purposes of
research
· More research on which methodologies elicit the most
disclosure on violence-related topics
· Increased collaboration between
researchers and women's NGOs, service providers, and victims of
violence
· Greater emphasis on evaluating the effect of different
interventions.
There are also many unexploited opportunities for integrating
questions related to violence into research funded for other purposes, such. as
focus groups and surveys designed Lo inform AIDS prevention work, or surveys
conducted for family planning or health purposes. An improved Demographic and
Health Survey module on violence and application of the instrument in a large
number of countries, for example, court generate invaluable information. In
addition, multicountry studies are urgently needed to explore how women and men
interpret violence, its causes and correlates, ant the attitudinal and legal
barriers victims face when interacting with public
institutions.