Literature Review Ending Violence Against Women and Girls
Literature Review Ending Violence Against Women and Girls
Literature Review Ending Violence Against Women and Girls
This literature review was commissioned by the Office of Development Effectiveness (ODE), a unit within the
Department of Foreign Affairs and Trade which monitors the quality and assesses the impact of the
Australian aid program. Its purpose is to inform ODE’s strategic evaluation of Australia’s development
assistance to end violence against women and girls. The strategic evaluation will be a ten-year follow up to
ODE’s 2008 evaluation, Violence Against Women in Melanesia and East Timor: Building on global and
regional promising approaches.
The paper’s authors are Emma Fulu, Executive Director, and Xian Warner, Research and Program
Coordinator, The Equality Institute. Unless referenced otherwise, infographics were developed by Scarlett
Thorby-Lister, Visual Designer, The Equality Institute.
INTRODUCTION I
OVERVIEW 2
1. BACKGROUND 4
A public health issue 7
International commitments 8
Australian context and commitments 12
Drivers of violence and the ecological framework 18
Executive Summary
Global context
There have been significant advances in understanding and addressing violence against women and girls
globally in the last ten years. After decades of advocacy and programming by women’s movements and
feminist activists, violence against women and girls is now widely recognised as a fundamental violation of
human rights, and a serious development and public health issue. This has resulted in increasing financial
investments and several conventions, policies and frameworks to address violence against women, including
through the Sustainable Development Goals.
There is now also general consensus that unequal gender power relations and discrimination against women
and girls are root causes of violence against women, and the Ecological Framework has become the common
framework for understanding the drivers of violence across multiple levels.
While the scale of the issue of violence against women and girls is immense, there is increasing evidence that
rates of violence can be reduced within programmatic timeframes, and several key elements to effective
prevention programming have been identified, although more evidence is needed from low- and middle-
income countries, particularly from Asia and the Pacific.
The next big questions remain around what works to prevent violence against women and girls in different
cultural contexts, how to ensure an intersectional approach, how to continue to support local women’s
movements, and how to address and respond to violence against women and girls on a large scale in a
sustainable way.
Australian support
The Australian Government has made substantial policy and funding commitments to end violence against
women and girls over the past ten years. This review illustrates that the broad framework for Australia’s
funding—access to justice, access to quality services and prevention—is aligned with global best practice. It
also notes that Australian support has made important contributions to the enabling and learning
environments in Asia and the Pacific.
By outlining global evidence of what works to prevent violence against women and girls, this literature
review provides one measure that Australia can use to assess the effectiveness of its investments and
programs. It also offers new and expanding areas of work to inform Australia’s future investments.
Content
The first section of the review provides the background to violence against women and girls globally and in
Australia. It situates the issue of violence against women and girls in the global arena, noting its increasing
recognition as a public health issue. It also highlights:
• the relevant international and regional commitments to which countries within the evaluation’s
scope are party;
• provides an overview of the Australian context domestically and internationally; and
• outlines recognised drivers of violence against women and girls across the socio-ecological model.
The next section presents the available evidence on what we know about prevalence and patterns in
violence against women and girls in Asia and the Pacific, as well as known associations with violence against
children.
The third and fourth sections outline global best practice or ‘what works’ in the investment framework and
specific programs to end violence against women.
The final section provides an overview of approaches to ending violence against women and girls in
humanitarian contexts, as a critically important area that is beyond the scope of the current evaluation.
Violence against women and girls has historically been silenced, overlooked or condoned. However, after
decades of advocacy and programming by women’s movements and feminist activists, this issue is now the
focus of international and national public debate (Michau et al., 2015). Violence against women and girls is
now widely recognised as a fundamental violation of human rights, and a problem with considerable social
and economic cost to individuals, communities and countries.
Intimate partner violence against women has been calculated to cost the world economy more than USD $8
trillion a year: USD $5.8 billion in 2003 in the United States (Centers for Disease Control and Prevention,
2003); GBP £22.9 billion in 2004 in England (Walby, 2004) and Wales, and R 28.4 billion in South Africa
(Bonomi et al., 2009). It is estimated that violence against women costs Australia a total of AU$21.7 billion
per year: $3.4 billion cost to the economy, $7.8 billion cost to the taxpayer, and $10.4 billion cost of pain,
suffering and premature mortality (PricewaterhouseCoopers Australia (PwC), Our Watch, and VicHealth
2015).
Gender-based discrimination against women and inequality of power and resources are the root causes of
violence against women and girls (Fulu et al., 2016). International agreements recognise that violence against
women is characterised by the use and abuse of power and control in public and private spheres and is
intrinsically linked with gender stereotypes that underlie and perpetuate such violence (United Nations, 2013).
Intersectionality
While violence affects women and girls across the world, different layers of people’s identities – such as their
socio-economic status, indigeneity, ethnicity, ability, sexual orientation, gender identity, HIV status, minority
status, age, etc. – impact the ways in which they are discriminated against and the types of violence
Figure 1: Intersectionality – understanding the dynamics of power and privilege, and discrimination and oppression in our
analyses of violence
Source: (The Equality Institute, 2017a), adapted from (Our Watch et al., 2015)
While this literature review recognises that every various layer of a person’s identity shapes the violence
they experience, the review highlights disability and sexual orientation and gender identity, as focus areas
for the Australian Government. See boxes 2 and 3 for further detail.
The increased vulnerability of women with disabilities to violence relates to the intersection between their status
as persons with a disability, the nature of their disability, and gender inequality. Some forms of violence against
women with disabilities have remained invisible due to disability discrimination (Spratt, 2012, ADD
International). The discriminatory misconception, for example, that people with disabilities are asexual or
sexually inactive makes women with disabilities – especially those with intellectual disabilities – particularly at
risk of coercive and involuntary sterilisation (WHO 2014).
Box 3: Violence and discrimination based on sexual orientation and gender identity
Violence and discrimination based on sexual orientation and gender identity exist in all corners of the world, and
lesbian, gay, bisexual, trans and gender non-conforming persons are at heightened risk of physical and sexual
violence (UN Human Rights Council Secretariat 2018). This violence includes:
• Death threats, beatings, corporal punishment imposed as a penalty for same-sex conduct, arbitrary arrest and
detention, abduction, incommunicado detention, rape and sexual assault, humiliation, verbal abuse,
harassment, bullying, hate speech and forced medical examinations, including anal examinations, and
instances of so-called “conversion therapy” (UN Human Rights Council Secretariat 2018).
• Around the world, transgender and intersex people are often forcibly sterilised and intersex children born with
atypical sex characteristics continue to be subject to irreversible and non-medically necessary surgery,
including in Australia (WHO 2014; Transgender Europe 2014; Carpenter 2018).
• Evidence from the United States and the United Kingdom shows that bisexual people face very high rates of
violence.
• In several countries, hate crimes appear to be increasing, with the rise of ultra-conservativism (GLAAD 2018;
UN Human Rights Council Secretariat 2018).
The scant evidence that exists suggests that rates of intimate partner violence in lesbian, gay, bisexual,
transgender, intersex, queer, and asexual (LGBTIQA+) communities are approximately the same as in
heterosexual relationships, but the risk and contributing factors may be quite different (Erbaugh et al., 2007).
For example, research demonstrates that, among men who have sex with men, experiencing intimate partner
violence is linked to HIV (Dunkle et al., 2013), substance use, symptoms of depression, and having unprotected
anal sex (Buller et al., 2014).
There is an urgent need to develop stronger understandings of other manifestations of gendered violence that
are inclusive of the experiences and identities of people with diverse sexual orientations and gender identities
(UN Women, forthcoming).
In recognition of this, the WHO produced clinical and policy guidelines on the health sector response to
partner and sexual violence against women (2013). These emphasise the urgent need to integrate these
issues into clinical training for health care providers.
Further, at the World Health Assembly in May 2016, Member States endorsed a global plan of action on
strengthening the role of the health systems in addressing interpersonal violence, in particular against
women and children (Every Woman Every Child, 2015). The global plan of action will contribute towards the
achievement of the Sustainable Development Goals (SDGs) including Goal 5 (Achieve Gender Equality and
Empower All Women and Girls), Goal 16 (Promote Peace, Justice and Inclusive Societies), and Goal 3 (ensure
healthy lives and promote well-being for all at all ages). It will also contribute to reaching the objectives of
the new Global Strategy for Women’s, Children’s, and Adolescents’ Health (2016-2030) (World Health
Organisation (WHO), 2016).
INTERNATIONAL COMMITMENTS
The international community has acknowledged the importance of addressing violence against women and
girls through several conventions, policies and frameworks, including the Convention on the Elimination of
All Forms of Discrimination against Women (CEDAW), the Beijing Platform for Action, and the 2030 Agenda
for Sustainable Development. The UN Convention on the Rights of Persons with Disabilities (CRPD) and its
Optional Protocol, which were adopted in 2006, take into account the greater risk of violence and
discrimination that women with disabilities face (Spratt, 2012).
There has also been increasing financial investment in addressing violence against women and girls globally. A
few key investments include:
• DFID has invested £25 million in its flagship ‘What Works to Prevent Violence’ research and innovation
program, which engages international experts to produce rigorous evidence on the most effective
interventions to reduce rates of violence against women and girls.
• The European Union (EU) and the United Nations (UN) are embarking on a new, global, multi-year EUR
500 million initiative focused on eliminating all forms of violence against women and girls - the Spotlight
Initiative.
• The World Bank Group currently supports well over $150 million in development projects aimed at
addressing violence against women and girls. With the Sexual Violence Research Initiative, the World
Bank also supports teams from around the world to evaluate and strengthen innovative violence
prevention and response programs as part of their Development Marketplace.
However, addressing violence against women and girls cannot be achieved only through Goal 5. As
illustrated in Figure 3, sustainable development cannot be achieved without addressing violence against
women and girls; and addressing violence against women and girls will contribute to achieving multiple
development outcomes. UN Women has argued that progress on some fronts may be undermined by
regression or stagnation on others, and potential synergies may be lost if siloed approaches to
implementation take precedence over integrated, multi-sectoral strategies (UN Women, 2018).
The evaluation will explore the extent to which national plans address the implementation of the SDG
commitments and the role that Australia can play in supporting these national development agendas.
Regional commitments
In addition to strong global commitments within the SGDs, in the Asia-Pacific there has been a strengthening
of regional commitments towards ending violence against women and girls over the last decade. These
commitments include countries where the Australian aid program is actively engaged. Table 1 (overleaf)
shows the relevant international conventions that nations in Asia and the Pacific have signed or ratified.
Pacific
In August 2012, the Pacific Islands Forum adopted the Pacific Leaders’ Gender Equality Declaration (PLGED).
This was the first statement by Heads of State from each of the twelve Pacific Island Forum member
countries to advance gender equality and it included commitments for countries towards ending violence
against women and girls, specifically to:
This follows commitments in the 2009 Forum Leaders Communique, which recognised the prevalence of
sexual and gender-based violence (SGBV) and committed to eradicate SGBV and ensure all individuals have
equal protection of the law and equal access to justice. Since the 2012 PLGED was adopted, a report of
progress made by countries in meeting these commitments is presented to forum leaders. DFAT’s 10-year
Pacific Women Shaping Pacific Development initiative supports countries to meet the commitments made in
the PLGED.
Pacific:
Cook Islands Ratified Ratified Neither Ratified
Fiji Ratified Ratified Signed Ratified
FSM Ratified Ratified Ratified Ratified
Kiribati Ratified Ratified Ratified Ratified
Marshall Islands Ratified Ratified Neither Ratified
Nauru Ratified Ratified Signed Ratified
Palau Signed Ratified Neither Ratified
PNG Ratified Ratified Neither Ratified
Samoa Ratified Ratified Ratified Ratified
Solomon Islands Ratified Ratified Signed Signed
Tonga Neither Ratified Neither Signed
Tuvalu Ratified Ratified Neither Ratified
Vanuatu Ratified Ratified Ratified Ratified
Asia:
Afghanistan Ratified Ratified Ratified Ratified
Bangladesh Ratified Ratified Ratified Ratified
Bhutan Ratified Ratified Ratified Signed
Brunei Ratified Ratified Ratified Ratified
Cambodia Ratified Ratified Ratified Ratified
India Ratified Ratified Ratified Ratified
Indonesia Ratified Ratified Ratified Ratified
Laos Ratified Ratified Ratified Ratified
Malaysia Ratified Ratified Ratified Ratified
Maldives Ratified Ratified Ratified Ratified
Mongolia Ratified Ratified Ratified Ratified
Myanmar Ratified Ratified Ratified Ratified
Nepal Ratified Ratified Ratified Ratified
Pakistan Ratified Ratified Ratified Ratified
Philippines Ratified Ratified Ratified Ratified
South Korea Ratified Ratified Ratified Ratified
Singapore Ratified Ratified Neither Ratified
Sri Lanka Ratified Ratified Ratified Ratified
Thailand Ratified Ratified Ratified Ratified
Timor-Leste Ratified Ratified Ratified Neither
Vietnam Ratified Ratified Ratified Ratified
Source: (United Nations n.d.)
• The 2006 White Paper on the Australian Government’s Overseas Aid Program positioned sexual and gender-
based violence (SGBV) as both a health and gender equality concern and committed to increasing Australia’s
support for gender-based violence programming and the integration of domestic violence considerations into
existing HIV/AIDS strategies and interventions. The 2012 Effective Aid policy continued to prioritise violence
against women and girls and positioned it as a both a gender equality and safety and security issue. It focused
on programming in services and justice.
• Australia’s current development policy, Australian Aid, developed in 2014, commits Australia to invest strongly
in ending violence against women and girls. It refers to an existing 10 year commitment, Pacific Women
Shaping Pacific Development (Pacific Women), to work with Pacific governments, civil society, the private
sector, and multilateral and regional agencies to inter alia reduce violence against women and increase access
to support services and justice for survivors of violence. Gender-based violence is positioned as a development
challenge requiring a range of interventions targeting multiple sectors and issues.
• The 2017 Foreign Policy White Paper continues Australia’s clear policy commitment to the empowerment of
women and ending violence against women and girls.
• The 2016 Gender Equality Strategy outlines gender equality and women’s empowerment as a priority across
Australia’s foreign policy, economic diplomacy and internal DFAT corporate policies, in addition to the aid
program. Violence against women and girls is recognised as a significant human rights violation that constrains
development. It outlines the framework for action in response to ending violence against women, based
around improved quality services and responses, access to justice, and prevention. The policy also recognises
the diverse forms of violence against women and girls and marks out a role for informal structures and NGOs
in responding. It also recognises that women and girls with disabilities are more likely to experience violence
and face barriers when seeking support.
• A number of commitments are also contained in: DFAT’s Humanitarian Strategy; DFAT’s strategy for disability-
inclusive development, Development for All; Child protection policies emphasising Australia’s zero tolerance of
child abuse in the aid program; Australia’s 2016 Strategy to Combat Human Trafficking and Slavery; and
Australian Federal Police’s (AFP) Gender Strategy 2014-18.
Source: Policy Analysis: Australia’s commitments to ending violence against women and girls (Dicker 2017)
Gender inequality
There is general consensus that unequal gender power relations and discrimination against women and girls
are root causes of violence against women, however gender inequality does not look the same in every
country and context (UN Women, forthcoming, UN Women, 2018, Our Watch et al., 2015). Yet, in almost all
societies around the world, men have greater access to power, status, opportunities, and resources than
women and people of other genders (World Economic Forum, 2014). A study comparing data across 44
countries, found that factors related to gender inequality at the national and subnational level were
predictive of the prevalence of current intimate partner violence (Heise and Kotsadam, 2015). There is,
however, a need for more clarity on the relationship between gender inequality as an underlying cause of
violence against women, and how gender inequality interacts with other factors, so as to ensure that policy
Individual level
Attitudes condoning violence
In many countries, individual attitudes justify men’s violence as a way for men to discipline women who do
not adhere to the gendered expectations of their behaviour (UN Women, forthcoming). In the WHO Multi-
country Study, for example, female infidelity and disobeying a husband were the most commonly accepted
reasons for a man to use physical violence against his wife (García-Moreno et al., 2005). Research suggests
that in many countries in Asia and the Pacific, physical violence is accepted as a form of discipline for women
who do not fulfil their roles of being obedient, faithful, fertile, and performing household chores (UN
Women, forthcoming, SPC, 2010, Hassan, 1995, Jejeebhoy, 1998, Schuler et al., 2011).
Both women and men condone violence in certain situations, but refuse justifications for violence in other
circumstances (Ellsberg et al., 2001, Fulu and Heise, 2015). The nuances of what types of violence are
condoned varies greatly between, and within, countries and women may hold more gender inequitable
views than men. In Afghanistan, for example, 33 percent of women believed that a man was justified in
beating his wife if she refuses to have sex with him, compared to 20 percent of men agreeing with this
justification (CSO et.al., 2017). In Bangladesh, however, only 9 percent of women and 4 percent of men
agreed with this justification (NIPORT, 2009). A study in Laos found that agreeing that a man has a good
reason to beat his wife if she disobeys him was more common among younger women and among women
living in the Northern region (NCAW, 2015).
Studies from more than 35 countries around the world show that condoning intimate partner violence is
highly associated with women’s victimisation (Fulu and Heise, 2015, Fournier et al., 1999, Guoping et al.,
2010, Khawaja et al., 2008, Rani and Bonu, 2009, Uthman et al., 2010). Across Asia and the Pacific, women
Harmful masculinities
When men hold harmful notions of masculinity and believe in rigid gender roles, this increases the risk of
violence against women and girls (UN Women, forthcoming, Our Watch et al., 2015, Jewkes and Morrell,
2012). More than 90 percent of men in Bangladesh, Cambodia, Indonesia and PNG, and more than 80
percent of men in Timor-Leste, agreed with the statement that ‘to be a man, you need to be tough’ (Fulu et
al., 2013, The Asia Foundation, 2016). Similarly, in all of the sites in the UNMCS, as well as in Timor-Leste, the
majority of men who had raped a woman or girl said that they did so because they wanted to and felt
entitled to, regardless of consent (Fulu et al., 2013, The Asia Foundation, 2016).
Men’s use of violence against women, therefore, is intricately connected to their ideas of what it means to
be a man. In several countries, men who were involved in fights with other men, used controlling behaviour
in their relationships, had multiple sexual partners, or engaged in transactional sex or sex with sex workers
were more likely to perpetrate violence against women (Fulu et al., 2013, Jewkes and Morrell, 2012). Men’s
attitudes and practices are often shaped by strict social narratives of what it means to be a man. The
patterns of behaviour associated with harmful models of masculinity, therefore, reinforce gender
inequalities and facilitate violence against women (Knight and Sims-Knight, 2003, The Asia Foundation,
2016).
Family/relationship level
Gender roles in the household
Family-level power dynamics are highly gendered and uphold men’s use of violence against women. The vast
majority of respondents in Bangladesh, Cambodia, Indonesia, PNG, and Timor-Leste agree with the
statement that ‘a woman’s most important role is to take care of her home and cook for her family’ (Fulu et
al., 2013, The Asia Foundation, 2016).
In contexts with highly traditional gender expectations, when women take on new roles, such as paid
employment outside the home, their risk of experiencing violence from their husband or partner increases
(The Asia Foundation, 2016, Gibbs et al., 2017, Bastagli et al., 2016, Atkinson et al., 2005, Macmillan and
Gartner, 1999, Cools and Kotsadam, 2015). Throughout Micronesia, Melanesia and Polynesia, for example,
women’s increasing independence and participation in the formal economy may be seen as a threat to
men’s masculinity, which is being used to justify violence against women (McLeod, 2005, UNFPA, 2013).
Working women’s risk of violence may also be higher in relationships where the man is unemployed (Fulu
and Heise, 2015). Studies have shown that when men are unable to fulfill what they perceive as their
expected role as the head of the household and primary breadwinner, or when power differentials in a
family shift away from traditional gender power relations, men may feel disempowered and use violence as a
Family honour
Concepts of family honour, underpinned by gender inequality, tie into many forms of violence against
women and girls. For example, in many communities where early marriage is practised, girls are less valued
than boys and are considered a burden on their families (UN Women, forthcoming). The opportunity to
marry a daughter off young is seen as a way to ease economic hardship or ensure family financial security,
while also protecting family honour by controlling female sexuality and safeguarding a girl’s virginity and
purity (UN Women, forthcoming, Decker et al., 2015, Verma et al., 2013).
Family honour may also impact women’s help-seeking behaviour. In Timor-Leste, Bangladesh, and Laos, one
of the most common reasons as to why women who experience violence do not seek help is that they are
worried it will bring a bad name to the family (The Asia Foundation, 2016, García-Moreno et al., 2005,
NCAW, 2015). Similarly, in Vietnam, social norms that ascribe to women the responsibility of maintaining
family harmony discourage abused women from seeking support, separation or divorce, and reconciliation
parties often focus on protecting the marriage rather than protecting the woman from violence (Vu et al.,
2014). It is worth noting that this was more frequently cited as a reason for not seeking help in Asia than it
was in Pacific countries.
Community level
As the existing evidence base has focused more on individual-level factors that predispose individuals to
intimate partner violence, there is limited evidence on the community-level risk factors (Fulu and Heise, 2015).
Community norms
There is evidence, however, that norms condoning violence at the neighbourhood, community, and country
level have been found to be predictive of increased partner violence (UN Women, forthcoming). Research
from the WHO Multi-country Study and the DHS from various sites, as well as data from Brazil and Peru,
have found that two of the strongest and most consistent factors that predict differences in the prevalence
of partner violence across sites and countries are the degree to which wife-beating is perceived as
acceptable and the degree to which culture grants men the authority to control female behaviour (Heise,
2011). In India, a link has also been found between community-level acceptance of wife-beating with
women’s individual risk of being beaten (Fulu and Heise, 2015, Boyle et al., 2009).
When violence is considered ‘inappropriate’ or excessive, it is more likely to be condemned by the
community and thus may be more likely to occur in secret. Conversely, when certain acts of violence are
normalised, men can use these ‘disciplinary’ acts of violence with impunity, knowing that they are unlikely to
be shamed by their community (UN Women, forthcoming). Furthermore, just as women who transgress
traditional gender roles in the home often experience more violence, some studies suggest that women who
are pioneers of change in a community may be at a higher risk of violence too (Vyas and Watts, 2009).
Societal level
Social norms and attitudes contribute to the ongoing perpetration and experience of violence against women
and can stall social change (Alexander-Scott et al., 2016). This is why, even with the introduction of new laws,
women’s increased access to economic resources, or changes in individual knowledge and attitudes, we may
not see a reduction in the experiences and perpetration of violence (UN Women, forthcoming).
Social norms
A social norm is a collectively held belief about what others do (what is typical) and what is expected of what
others do within the group (what is appropriate) (Alexander-Scott et al., 2016). In terms of gender, social
norms are essentially the behavioural expectations or rules that pertain to gender roles, identities and
relations, which determine our individual thoughts and actions (Jewkes, 2017). Social norms exist within
reference groups, meaning the social groups or networks that are important to an individual when they are
making a decision about how to act in different situations – such as a person’s extended family, friendship
Table 3: Social norms and gender norms that contribute to violence against women and girls
Political participation
Gender inequality also undermines women’s participation in formal-decision making and civic action at the
national level. While, in Nepal and Timor-Leste women hold more than 30% of seats in national parliament,
women’s political representation in the Pacific is among the lowest in the world, with just 2% of
parliamentary seats held by women in the Solomon Islands and currently no women in parliament in FSM,
PNG, and Vanuatu (Inter-Parliamentary Union 2018). Research has demonstrated that when women are
invited to collectively participate in these processes, they are more likely than men to act in the interests of
securing women’s freedom from violence (Htun and Weldon, 2012, Grey, 2002, Taylor-Robinson and Heath,
Global level
There is increasing attention on the impact of globalisation on violence against women and girls and
recognition that the drivers of this violence do not stop at national borders (Fulu and Miedema, 2015, UN
Women, forthcoming). Historically, colonialism, as an early iteration of globalisation, had an immense impact
on gendered power relations. In the case of Micronesia, for example, land was traditionally inherited
through women but, through the process of colonialism, this pattern of matrilineal land tenure disappeared
and women are now becoming more marginalised and dependent on male wage earners, making it harder
for women to leave abusive relationships (FSM DHSA, 2014, UNFPA, 2013). Recent research also illustrates
that participation in the global economy and use of new communications technologies has shifted gender
relations in Melanesia, creating both new opportunities and new inequalities (Macintyre, 2017).
Some of the ways in which globalisation impacts on gender equality in Asia and the Pacific include, but are
not limited to:
• Rapid economic development has shifted gender roles and gendered power dynamics, in some cases
increasing women’s risk of violence from men. In urban PNG, men’s use of violence is now often an
expression of the frustrations and disappointments of capitalism and development processes (Lusby,
2017).
• Links with the international women’s rights movement can push debate and increase awareness about
women’s rights at the national level, as in Cambodia. However, a backlash to these global discourses can
lead to more patriarchal and unequal gender dynamics, as in the Maldives (Fulu and Miedema, 2015).
• The global spread of religious fundamentalisms is curtailing women’s rights while, at the same time,
models of masculinity predicated on violence and sexual dominance over women are also being
disseminated through films and television (Fulu and Miedema, 2015).
• Trafficking of women and girls is sustained by global economic mechanisms and international crime
networks.
Violence affects girls and women around the world. Intimate partner violence (IPV) and sexual violence are
the most common forms of violence experienced by women and girls globally (Devries et al., 2013), however
women and girls also experience various types of violence during their lives (see Figure 7). While this
violence is usually severe and recurring, most women never report the violence and only a small proportion
access formal support services (García-Moreno et al., 2005, United Nations, 2015). (UNICEF, 2014a).
Figure 8: Lifetime and current prevalence of women’s experiences of intimate partner violence in Asia and the Pacific 1
Across the countries receiving Australian Government support, the rates range from 15 percent of women in
Laos who have ever experienced physical and/or sexual violence from a male intimate partner, to 68 percent
of women in Kiribati and PNG. In Australia, this figure is one in four women (Australian Bureau of Statistics
(ABS) 2017).
1 Image only contains data from countries that have conducted the the World Health Organisation’s Multi-Country Study on Women’s Health and
Domestic Violence against Women (WHOMCS) survey methodology, which is recognised as one of the most accurate and ethical approaches to
collecting data on women and girls’ experiences of violence. Data from other types of surveys may not be comparable across countries.
PACIFIC
2 kNOwVAWdata, launched in 2016, is a partnership between UNFPA, DFAT, the University of Melbourne and Australia’s National Research
Organisation for Women’s Safety (ANROWS) that supports VAW data collection and use in the region, and aims to strengthen regional and national
capacity to measure VAW.
In Vanuatu, 21 percent of women who had been injured by their male intimate partner’s violence reported
that they had a permanent disability as a result of this violence (VWC, 2011). A study on violence against
women with disabilities in Kiribati, Solomon Islands, and Tonga found that women with mental illnesses or
intellectual disabilities frequently experienced sexual violence from multiple men (Spratt, 2012). The
patterns of violence that Pacific women with disabilities experience is different to that of women without
disabilities. For example, Solomon Islander women with disabilities reported that they experienced physical
violence more often from family members than from intimate partners and they were more likely to
experience sexual violence from strangers (Spratt, 2012).
Disability is also more likely to be a factor in sorcery-related violence (see below). In more than two-thirds of
the reported cases of sorcery-related violence in PNG between 2013-2016, the victim was living with a
disability (Thomas, Kauli, and Rawstorne 2017). The increasing use, funded by DFAT in several countries, of
the Washington Group Short Set of Questions on Disability in surveys on violence against women is
beginning to allow more cross-country comparison on experiences of violence amongst women and girls
with a disability (Washington Group on Disability Statistics, Heijden and Dunkle, 2017), although further work
is needed on how to appropriately contextualise these questions.
In Bougainville—the only Pacific site in the 2013 UNMCS—41 percent of men interviewed reported that they
had raped a non-partner woman or girl and 14 percent had perpetrated gang rape (Fulu et al., 2013, p.40).
While, in most Pacific countries, women are much more at risk of violence from their male intimate partners
than from non-partners, in Tonga and Samoa, women experience more physical abuse from other people –
usually fathers and teachers – than they do from their intimate partners (UNFPA, 2017, Jansen et al., 2012).
Figure 11: Associations between violence against women and violence against children in Kiribati
Children living in homes where IPV is occurring are also at risk of being targets. Throughout the Pacific,
witnessing their mother being abused by her partner was associated with children having aggressive
behaviour, experiencing nightmares, and repeating a school year or dropping out of school (UNICEF, 2015).
Kiribati (2009) 3 20
Nauru (2007) 2 27
PNG (2006) 2 21
Samoa (2014) 1 11
Tonga (2012) 0 6
Tuvalu (2007) 0 10
Vanuatu (2013) 3 21
Samoa (2014) 1 11
Source: (UNICEF 2018). Note: Countries whose data was not available have not been included in the table.
Table 6: Prevalence of early marriage in Asia (percentage of women aged 20-24 who were first married or in union before
age 15 and before age 18)
Afghanistan (2015) 9 35
Bangladesh (2014) 22 59
Bhutan (2010) 6 26
Cambodia (2014) 2 19
India (2016) 7 27
Indonesia (2013) 1 14
Laos (2012) 9 35
Maldives (2009) 0 4
Mongolia (2013) 0 5
Myanmar (2015) 2 16
Nepal (2016) 7 40
Pakistan (2013) 3 21
Philippines (2013) 2 15
Thailand (2015) 4 23
Timor-Leste (2010) 3 19
Source: (UNICEF 2018). Note: Countries whose data was not available have not been included in the table.
Positive trends however have been observed in parts of Asia. For example, there has been a steady decline in
prevalence of child marriage in rural Indonesia and the Philippines, as well as drops in rates in urban parts of
Bangladesh. Nepal has also seen a drop in 20 percent over the past five years, and in Bangladesh, there has
been a decrease of 42 percent in girls married by 15, compared with an 11 percent drop for those married by
the age of 18 (Inter-Parliamentary Union and WHO 2016).
Figure 13: Associations between childhood experiences, and witnessing, of violence with women’s experiences of intimate
partner violence (IPV) in adulthood
Violence against children does not cause violence against women. However, a clear cycle of violence exists
between violence against children and violence against women. Studies from around the world have
identified that girls and boys who directly experience violence, or witness their mother being abused, are
more likely to experience or perpetrate violence against women later in life. While the link is well
established, less is known about the exact mechanisms through which early exposure to violence operates to
increase risk of future perpetration or victimisation. Research suggests that those who experience violence in
childhood may learn to accept violence as normal and to view violence as an effective way to resolve
conflicts; this normalisation may make them more likely to experience and/or perpetrate abuse in their
relationships in adulthood (UN Women, forthcoming, Heise, 2011, Gil-González et al., 2008, Jewkes et al.,
2010, Fulu et al., 2017a, Jewkes and Abrahams, 2002, Ellsberg et al., 1999, Martin et al., 2002, Whitfield et
al., 2003, Wekerle and Wolfe, 1999, The Asia Foundation, 2016, Fulu et al., 2013).
Common impacts
Many of the impacts of violence against children overlap with the impacts of intimate partner violence. Both
types of violence are associated with poor mental health, including higher rates of depression and suicidality.
Adolescence
Adolescence, as an intersection between childhood and adulthood, is a period when violence against
children and violence against women overlap (Guedes et al., 2016, Fulu et al., 2017a). As the prevalence data
from Asia and the Pacific above illustrates, in many countries, women aged 15 to 19 years old are at the
highest risk of experiencing intimate partner violence, as most violence occurs early in relationships.
Research from across Asia and the Pacific also illustrates that men’s perpetration of non-partner rape often
Violence against women and girls is multidimensional and has multiple risk factors. The 2008 ODE evaluation
report set out a framework for action to prevent and respond to this issue on all levels of the Socio-
Ecological Framework. The report recommended three main strategies:
1. increasing women’s access to justice
2. increasing women’s access to support services
3. the prevention of violence (Ellsberg et al., 2008).
These three strategies remain the key approaches used globally, and in Australian aid investments, to work
on violence against women and girls.
In recent years, researchers and practitioners have developed a deeper understanding of how social norms
change approaches can be used for violence prevention and, in line with this, recognise the impact of an
enabling environment in addressing this issue. Rather than being distinct areas of work, however, these
strategies impact and inform each other and coordination across sectors is vital. To be effective, all
approaches must include the voices of sexual and gender diverse minorities as well as people with
disabilities.
ACCESS TO JUSTICE
Enacting and implementing comprehensive legislation that recognises violence against women and girls as a
form of pervasive inequality and discrimination is a critical step to discourage violence and impose
consequences on offenders, while also enabling women to protect themselves and their children (UN
Women, 2018, Ellsberg et al., 2008). Even in countries with strong legislation, implementation remains a
serious problem, as many domestic violence laws are not sufficiently budgeted and often face resistance
from male-dominated judiciary and police (Ellsberg et al. 2015; United Nations 2009). If justice system
personnel (including judges, police, and forensic doctors) have gender-inequitable or victim-blaming
attitudes, this can deter women from seeking help through formal mechanisms and, if they do seek help,
such attitudes often have a direct impact on outcomes for women.
A recent unpublished paper (Pacific Women Shaping Pacific Development Support Unit 2018) highlights the
following common legislative barriers to gender equality in the Pacific:
» gaps in the definition of discrimination set out in Constitutions and broad exceptions to the
prohibition on discrimination that may erode gender equality;
Social change is highly context-specific, rarely linear, and a slow and complex process (The Equality Institute,
2017a). Achieving sustainable change requires coordinated, collaborative, intensive and long-term efforts
(The Equality Institute, 2017a, Alexander-Scott et al., 2016). Using approaches that address different forms
of violence that share common risk factors or are upheld by the same social norms, such as intimate partner
violence and violence against children, and identifying key periods where these types of violence intersect,
such as during adolescence, offers an opportunity to more efficiently and cost-effectively reduce multiple
forms of violence (Fulu et al., 2017a).
Figure 16: Guidance on coordination and governance from the Essential Services Package
Donors can encourage national governments to prioritise investment in this prevention infrastructure to
support lasting change, for example by funding research that can be used for policy advocacy (see ‘Building
Evidence’ section below) and by providing financial and technical resources to help States develop National
Action Plans, as the Australian Government has already done in several countries across Asia and the Pacific.
UN Women’s Handbook for National Action Plans on Violence against Women provides tangible guidance on
developing comprehensive, multisectoral and sustained National Action Plans (UN Women 2012).
Ending violence against sexually and gender diverse people begins with creating a more inclusive
environment. A recent report by UNDP and the Parliamentarians for Global Action (UNDP and PGA 2017)
provides guidance on what parliamentarians can do, including:
• Enact comprehensive laws that specifically prohibit discrimination on the basis of sexual orientation,
gender identity and sex characteristics
• Repeal laws that criminalise same-sex activity between consenting adults and laws that criminalise
transgender people on the basis of their gender identity and expression
• Protect individuals from homophobic and transphobic violence by:
Figure 17: World Health Organisation guidance on ethical and safe research on violence against women
FEMINIST MOVEMENTS
Local and global feminist movements, both on the ground and online, also have an important role to play in
spreading key messages about gender equality and facilitating widespread social norm change (The Equality
Institute, 2017a, Htun and Weldon, 2012). Empirical analysis of policy changes over time in 70 countries
suggests that, of all factors, the presence of autonomous women’s movements was the main driver of
progressive government action on violence against women, playing a larger role than left-wing parties, the
number of women legislators, or even national wealth (Htun and Weldon 2012).
However, a recent influx of money into violence against women and girls programming has attracted new
actors to the field, including large, global consulting firms, and some international NGOs with limited
experience in gender or violence-related programming. Funding is being channelled towards these agencies
and technical institutions, while there has been a withdrawal of financial support for women’s organisations
and for the political organising and social mobilisation they do. A recent report by the Association of Women
in Development described this side-lining of feminist activism in development:
“. . . one of the striking paradoxes of this moment is that the spotlight on women and girls
seems to have had relatively limited impact on improving the funding situation for a large
majority of women’s organisations around the world. The ‘leaves—the individual women
and girls—are receiving growing attention, without recognizing or supporting ‘the
roots’—the sustained, collective action by feminists and women’s rights activists and
organizations that has been at the core of women’s rights advancements throughout
history.”
While the scale of the issue of violence against women and girls is immense, there is increasing evidence that
rates of violence can be reduced within programmatic timeframes (Ellsberg et al., 2015).
Key resources that are building this evidence-base on promising practices include:
• The Lancet special series on violence against women and girls, presenting evidence from around the
world that violence is preventable (The Lancet 2014).
• The What Works to Prevent Violence against Women and Girls program of the United Kingdom
Department for International Development (DFID), which aims to understand the most effective
approaches in lower and middle-income countries and in conflict and humanitarian crises.
• The UN and European Union multi-year Spotlight Initiative to eliminate violence against women and girls.
• Both the Prevention Collaborative and the Advancing Learning on Innovation and Gender Norms (ALIGN)
Platform aim to create virtual spaces and communities of practice for learning and advocacy.
It is expected that, over the next few years, all these efforts will further build the evidence base of what
works to prevent violence in diverse contexts and amongst diverse groups.
Although this is an evolving field, the current global evidence has revealed several key elements, illustrated
in Figure 18, that are considered best practice for the prevention of violence against women and girls (The
Equality Institute, 2017a, Michau et al., 2015, Haider, 2017, Ellsberg et al., 2015, Fulu et al., 2014, UN
Women, 2018):
Figure 19: Evidence of effectiveness of interventions to address violence against women and girls
Table 7: Evidence on effectiveness of women’s economic empowerment programs in reducing violence against women
Systematic reviews of the evidence suggest that whether women’s economic empowerment programs
increase or reduce the risk of violence against women depends on context-specific factors, including the
proportion of women in the workforce, and the male partner’s comparative education and employment
status (Heise and Kotsadam, 2015, Vyas and Watts, 2009, Bastagli et al., 2016). In Bangladesh, for example,
participation in microfinance programs was found to be associated with increased risk of violence for women
with a better economic status (Murshid et al., 2016), while a study in Tanzania found that women
experienced less intimate partner violence in areas of the country where more women are in paid work
(Vyas and Heise, 2016). Furthermore, some cash transfer programs that are associated with reduced physical
violence are also linked to increased emotional violence and controlling behaviour (Bastagli et al., 2016).
Evaluations of women’s economic empowerment programs illustrate that, to be effective and mitigate
potential backlash from men, these programs should include components to shift social gender norms and,
in some cases, should involve men (Vyas and Heise, 2016, Ellsberg et al., 2015, Gibbs et al., 2017).
• The Indashyikirwa program in Rwanda aims to prevent intimate partner violence by working with men and
women from CARE’s microfinance village savings and loans associations (CARE).
• Targeting economic empowerment programs at households, rather than focusing on individual women and
men, may be more effective in reducing family violence (Gibbs et al., 2017). The One Community One Family
program in Nepal and Zindagii Shoista (Living with Dignity) in Tajikistan are examples of such approaches
(Gibbs et al., 2017, Shai et al., 2016, Mastonshoeva et al., 2016).
• Programs which aim to transform community gender norms around women’s access to work while also
socially empowering women, such as Stepping Stones and Creating Futures in South Africa and Women for
Women International in Afghanistan, may be more effective at preventing violence against women and girls
than women’s employment programs that do not also focus on norms change and social empowerment (Gibbs
et al., 2017, Jewkes et al., 2014, Women for Women International, 2017).
RELATIONSHIP-LEVEL INITIATIVES
As most violence against women and girls occurs at the relationship or family level, couples and families are
an important entry-point for interventions (Fulu et al., 2015).
Adaptations of Stepping Stones in Tajikistan, Nepal, Bangladesh, and India are being evaluated under the What
Works program, so more evidence on this approach from the Asian region will soon be available (Jewkes, 2017).
• In India, Yaari Dosti, which was based on Programme H, showed a reduction in both physical and sexual
intimate partner violence perpetration amongst participants six months after the intervention (Verma et al.,
2008). Nine out of ten reviewed initiatives showed a decline in participants’ gender inequitable attitudes,
suggesting the potential to contribute to reducing risk factors for violence against women and girls (Fulu et al.,
2015).
COMMUNITY MOBILISATION
Community mobilisation interventions that aim to empower women, engage men, and change gender norms
at a community level have been found to be successful in reducing rates of violence against women (Ellsberg
et al., 2015, Jewkes, 2017, Fulu et al., 2015). The most effective community mobilisation interventions
include participatory workshops exploring gender and relationships, as well as building skills, and engage a
wide range of stakeholders (Jewkes, 2017).
• The Safe Homes and Respect for Everyone (SHARE) Project in Uganda, which used community mobilisation to
change social norms that uphold intimate partner violence and HIV risk, reduced women’s experiences of
physical partner violence in the past year by 21 percent (Wagman et al., 2015, Jewkes, 2017).
• The Tostan model of community mobilisation, which has been used in sub-Saharan Africa, has been shown to
have potential in reducing violence against women and female genital mutilation (Ellsberg et al., 2015, Diop et
al., 2004).
• The award-winning television soap opera, Sexto Sentido (Sixth Sense), produced by Nicaraguan organisation,
Puntos de Encuentro, explored ‘taboo’ issues of violence, gender inequality, sexuality, sexual health, and HIV
in the lives of straight, gay, transgender, male, and female characters. The television show is the basis for a
communication for social change approach called Somos Diferentes, Somos Iguales (We’re Different, We’re
Equal), involving radio call-in programs, education packs for peer educators, youth leadership training,
strategic partnerships, and social movement support in Nicaragua (Heise 2011).
• The Change Starts at Home program in Nepal, which involves radio edutainment and workshops to change
gender social norms and strengthen relationships, is currently being evaluated under the What Works
initiative (Jewkes, 2017).
SCHOOL-BASED INITIATIVES
Although there is very limited evidence on school-based programs in lower- and middle-income countries,
reviews suggest that the most promising models take a whole school approach, include clear policies to
address violence in schools, promote training and open discussion among school staff and management, and
are based in context-specific research with youth (Fulu et al., 2015, Ellsberg et al., 2015).
As part of the What Works initiative, the Right to Play school-based program in Pakistan focuses on shifting
inequitable gender norms to address peer violence among school children, by promoting girls’ confidence and
leadership skills and supporting boys to take up positive and non-violent forms of masculinity (Fulu et al., 2017a).
Systematic reviews of the evidence have found single component communication campaigns and WASH
interventions in schools to be ineffective in reducing violence against women and girls. These reviews have
also found conflicting evidence about the impact of bystander interventions and school curriculum-based
interventions (Fulu et al., 2015).
• A report by the International Centre for Research on Women (ICRW) and Raising Voices explores the
challenges of scaling-up community mobilisation initiatives (Heilman and Stich, 2016).
• In response to one of the recommendations of that report, several organisations working on social norms
change for gender equality in low- and middle-income settings have recently come together to create the
Community for Understanding Scale Up, and are beginning to compile lessons learned on scaling up this type
of work (CUSP, 2017).
While the evaluation research will include some investigation of responses to, and prevention of, violence
against women and girls in humanitarian programming in the study sites, the distinctive characteristics of
this issue in conflict zones and protracted crises require their own study. As such, this section of the review
provides only a brief summary of violence against women and girls in humanitarian and conflict contexts.
In both Asia and the Pacific, climate change is an increasingly significant humanitarian issue which exacerbates
existing gender inequalities (UN Women). Many Asian and Pacific island nations, including Samoa, Vanuatu,
the Philippines, and Indonesia, have experienced recent climate change-related natural disasters. Women and
girls are disproportionately affected by natural disasters and they may have less access to resources for
recovery, they may need to take on new responsibilities if primary income-earners in the family have been
killed or injured, and, if legal and informal support systems break down, women and girls may be at higher risk
of violence (IASC, 2015). For example, following two cyclones in Vanuatu’s Tanna Island, domestic violence
cases increased by 300 percent in 2011, and rates of rape increased in the Solomon Islands after the Gizo
tsunami (UN Women). However new gender-sensitive climate change policies, such as in Tonga (Government
of Tonga, 2016), offer the potential for improved prevention and response mechanisms.
This literature review provides a summary of the global and Asia Pacific regional trends, innovations, and
best practices in ending violence against women and girls, with a focus on approaches with most relevance
to the Australian Government’s aid program. It will inform the Office of Development Effectiveness’ (ODE)
strategic evaluation of Australia’s development assistance towards ending violence against women and girls,
as a ten-year follow up to ODE’s 2008 strategic evaluation on this topic (Ellsberg et al. 2008).
This literature review has implications for the evaluation’s following key evaluation questions and will be
used to triangulate other qualitative and desk-based evidence generated as part of the evaluation:
1. To what extent have DFAT investments and strategies been effective at meeting their objectives over the
last 10 years?
The evidence from this literature review on global best practices in service provision, access to justice,
social norms change, and enabling environment, as well as the examples of effective and promising
approaches, will guide the evaluation’s assessment of the effectiveness of DFAT’s investments and
strategies.
2. How relevant are DFAT investments and strategies to local, national and global ending violence against
women and girls’ needs?
The literature review illustrates that the framework of the Australian Government’s aid investments on
ending violence against women and girls, structured around access to justice, access to quality services,
prevention, and creating an enabling environment, is aligned with global best practice. As prevalence,
forms, and patterns of violence against women and girls vary greatly between countries in both Asia and
the Pacific, it is crucial that DFAT investments are informed by contextual evidence and advised by local
expertise, to be contextually relevant.
3. To what extent have DFAT investments and strategies extended the reach of services and programs to
reach the most vulnerable and marginalised populations?
As this review of literature has demonstrated, women and girls with disabilities, and gender and sexually
diverse populations, face additional and intersecting forms of discrimination and violence and, yet, they
are often not reached by services or violence prevention programs. Given DFAT’s policy commitment to
disability inclusion, bridging this gap could be an area of opportunity for the Australian Government to
show leadership in truly extending the reach of its ending violence against women and girls programming.
In addition, given the geography of Asia and the Pacific, an important area for the evaluation to consider
will be extending reach from urban centres to rural and remote areas.
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