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Maldives Women’s Health and Life Experiences

Maldives Women’s Health and Life Experiences

Reported, January 2, 2012

This Study on Women’s Health and Life Experiences, the first comprehensive survey of violence against women in the Maldives, shows the extent and prevalence of violence – 1 in 3 women aged 15-49 have experienced some form of physical and/or sexual abuse during their lifetime – and exposes the many facets and patterns of violence against women and girls in the country.
The results of the Study bring to light the many challenges that we face in addressing this matter. It forces us to come out of our comfort zone and admit violence exists in this society and challenge the notions that violence against women is a private issue or an inevitable way of life. It is, in fact, a major development issue related to gender equality, having socio-economic and health implications, whereby the status and health of women and girls are seriously compromised.

The Maldives Study on Women’s Health and Life Experiences was designed to:
1. obtain reliable estimates of the prevalence and frequency of different forms of physical, sexual and emotional violence against women in Maldives, with particular emphasis on violence perpetrated by intimate male partners;
2. document consequences of violence against women including effects on general health, reproductive health, and effects on children
3. document and compare the strategies and services that women in the Maldives use to deal with the violence they experience;
4. explore the impact of the tsunami on violence against women;
5. identify factors that may protect or put women at risk for intimate partner violence.

Aggregate data shows that more than 1 in 3 women (34.6%) aged 15-49 reported experiencing at least one form of physical or sexual violence, or both,during their lifetime.
This can be broken down into different forms of violence as follows:
• 1 in 5 women aged 15-49 (19.5%), who had ever been in a relationship, reported experiencing physical and/or sexual violence by and intimate partner.
• Approximately 1 in 8 women aged 15-49 (13.2%) reported experiencing physical and/or sexual violence by someone other than an intimate partner, since the age of 15.
• Combining physical and/or sexual violence by partners and non-partners, since the age of 15, we find that more than 1 in 4 women (28.4%)have experienced partner or non-partner violence, or both.
• Approximately 1 in 8 women aged 15-49 (12.2%) reported that they had been sexually abused before the age of 15, that is, that they had experienced childhood sexual abuse.

19.5% of women reported intimate partner violence, 13.2% reported non-partner violence, and 12.2% reported childhood sexual abuse. These percentages add up to 44.9%. However the actual overall prevalence rate for violence against women in the Maldives is 34.6% because some women reported multiple forms of abuse.

Physical and sexual violence against women
The Maldives Study shows that violence against women is prevalent. The aggregate data on partner and non-partner violence, including child sexual abuse, indicates that 1 in 3 women aged 15-49 have experienced physical and/or sexual violence at some point in their lives. The majority of violence was perpetrated by a male intimate partner, challenging the assumption that the home is a place of safety and refuge for women.
This prevalence rate many appear very high to many people in the Maldives who have assumed for so long that violence against women does not happen in the Maldives. The sad reality is that it occurs in every country in the world and the Maldives is no exception. While it is vital to recognize the severity of the problem it is also important to note that, compared with other countries who participated in the WHO Multi-country Study, the rate of violence in the Maldives is relatively low. This should not to minimize the seriousness of the situation but help us to learn from the experiences in other countries and develop a better understanding of what factors contribute to a high or low prevalence of violence against women.
Physical and sexual violence by partners
19.5% of women aged 15-49, who had ever been in a relationship, reported experiencing physical or sexual violence, or both, by an intimate partner. Physical violence was more common that sexual violence although there was also significant overlap between these two forms of violence. That is, most women who reported sexual violence by an intimate partner were also experiencing physical partner violence.
Generally, the levels of intimate partner violence were higher in the atolls (particularly in the central and southern regions) than in Male’. This is consistent with the WHO Multi-country Study findings that the rates of partner violence were generally higher in rural settings compared with urban areas.
Women who have been separated or divorced generally reported a higher lifetime prevalence of physical or sexual violence by an intimate partner than currently married women. Also, women with higher levels of education reported lower lifetime prevalence of intimate partner violence than those who had not attended school or only had primary level education. Younger women also seem to be at greater risk of partner violence with a larger proportion of partnered women aged 25-29 reporting violence in the past 12 months than older women.

Emotional abuse by intimate partners and controlling behaviours
Emotional abuse by intimate partners was also explored and found to be relatively prevalent. At the national level, 29.2% of women aged 15-49, who had ever been in a relationship, reported experiencing emotional abuse by a partner at least once. Emotional abuse is an important element of partner violence and often cited by women as the most hurtful, leaving long-term psychological scars. However, it is difficult to accurately measure emotional abuse and as such the focus of this report is on physical and sexual violence.
In this report, when talking about “partner violence” without further specification, it refers to physical and/or sexual violence only (i.e. not including emotional abuse).

Non-partner violence
The Study also examined physical and sexual violence against women since the age of 15 by perpetrators other than their intimate partner. The level of non-partner violence at the national level was 13.2%. Similar to intimate partner violence, sexual violence was less common than physical violence. However, non-partner violence was generally found to be higher in Male’ than in the atolls, which is the opposite of intimate partner violence. This is consistent with findings in other countries. The most commonly mentioned perpetrators of physical violence were the respondent’s male family members, in particular her father or step-father. In contrast, the most commonly mentioned perpetrators of sexual violence were male acquaintances (such as family friend, work colleague) and strangers.

Sexual abuse in childhood and forced first sex
Childhood sexual abuse (sexual abuse before the age of 15) was found to be relatively common in the Maldives. At the national level, we found that 12.2% of women aged 15-49 had been sexually abuse before the age of 15. In Male’ the rate was significantly higher at 16.3%. The data shows that girls are at greatest risk of sexual abuse by male family members and male acquaintances.
Among girls under 18 years of age who took part in the Study, 22% reported emotional abuse by a partner and 7.3% reported physical and/or sexual partner violence. 2.7% reported physical violence by someone other than a partner after the age of 15. 14.5% of girls aged 15-17 have experienced some form of sexual violence at least once in their lifetime.
Approximately 10% of women reported that their first sexual experience was either coerced or forced and the younger the girl at first sexual encounter, the more likely it was that sex was forced.

Associations of violence with specific health outcomes
The Maldives Study provides the first ever data in the country on associations between intimate partner violence and women’s mental, physical and reproductive health. We can not draw direct causal links because of the cross-sectional design of the questionnaire, however we can draw associations. Overall we find that current or previous experiences of intimate partner violence are significantly associated with a range of negative impacts on women’s current physical, mental, sexual and reproductive health. Even after adjusting for age, educational attainment and marital status, these associations remained significant.
Physical health and injury
Women who reported partner violence were more likely to report a range of current physical symptoms such as problems with walking, pain, memory loss, dizziness and vaginal discharge. Most of these differences were highly statistical significant. Women who reported violence were also more likely than women who had never experienced violence to report that their general health was poor or very poor.
Physical violence was also associated with injury and 50% of women who reported injuries reported severe injuries such as eye and ear injuries, fractures and internal injuries.

Mental health
Women who had experienced physical and/or sexual partner violence were significantly more likely to have ever contemplated suicide than women who had not experienced abuse. Women who had experienced partner violence were also more likely to report recent symptoms of emotional distress than women who had never experienced violence. This illustrates that past violence can be associated with current negative mental health consequences. That is, the impact of violence may extend long past the actual violent incident.

Violence during pregnancy and reproductive health
Among women who had ever been pregnant, 6.3% reported being beaten during pregnancy. Of those who reported being beaten, 39% had been punched or kicked in the abdomen. In most cases, women who were physically abused during pregnancy had been beaten prior to getting pregnant; however a significant number (38.3%) reported that the beating had actually started during pregnancy. For the majority of women who were abused before and during pregnancy, the violence stayed the same or was less severe.
Women who reported physical and/or sexual partner violence were significantly more likely to report having had at least one miscarriage, still birth, or a child who died, than those who did not report violence.

Violence against women in the Maldives
Similar to women all over the world the women of Maldives face violence in various forms within their homes, in public space, in the workplace, and within the community in general. Gender based violence greatly affects the overall mental, psychological and physical health of many women and is a major constraint to their full participation in society and development. In order to have a gender equitable and equal society and achieve and sustain ultimate development goals such violence must be eliminated.

Credits: Emma Fulu

More Information at:
http://minivannews.com/files/2010/10/Maldives-Study-on-Womens-Health-and-Life-Experiences-2007.pdf
 

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