Definitions and concepts
Gender: Social construct of norms, roles, and relations for males and females for behaviour and action of a given society
Sex: Biological difference between men and women.
Violence: “ intentional use of physical force or power, threatened or actual, resulting in injury death, psychological harm, mal development, and deprivation”.
Harmful Traditional Practices (HTPs): a ‘’traditional practices which violate and negatively affect the physical, sexual or psychological well-being…: eg FGM/C, abduction and child marriage
Harmful Traditional Practices (HTPs) conti….
Causes of HTP
Root, intermediate and immediate causes
A. Root causes :
Low societal consciousness results that undermine women and children
Deep rooted imbalances in power and gender relations and inequality
B. Intermediate causes: Results of root causes and increase vulnerability. These include:
Poverty and Economic Inequalities
Lack of Education and Training
Inaccessibility to quality health facilities and services
Religious and cultural factors
C. Immediate Causes : Limited access to information
Consequences of HTPs
Health Consequences: bleeding, infection, difficulty and complications during delivery, pain, fistula, HIV/AIDS transmission, infertility etc
Economic dependency: The debilitating effects of HTPs in turn limit opportunities
Psycho-social Consequences: High levels stress, unhappiness, and unhealthy relationships with partners and stigma by society
Human right violations: HTPs go to the extent of threatening the lives of women and children thereby affecting their right to life
Limiting one’s life choices: Enforce inferior status and the submissive role
Types of harmful traditional practices
Female genital mutilation (FGM/C) or cutting involves surgical removal of parts or all of the most sensitive female genital organs
Causes reproductive, sexual, and urinary dysfunctions
A human rights violation regardless of a specific law against it
FGM in girls and women (15-49 years) is 65% (EDHS 2016)
Tigray and Gambella have the lowest prevalence (24% and 33%,
Somali and Afar regions have the highest prevalence (99% and 91%)
Types of FGM
TYPE I clitoridectomy: Partial/total excision of the hood of the clitoris.
TYPE II excision/Sunna type: Partial/or total excision of the labia minora clitoris.
TYPE III infibulation: Excision of labia majora together with the above two act
TYPE IV: the above and others like pricking, piercing, or incision of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization by burning clitoris and surrounding tissues etc.
FGM related complications
Short Term Compilications
●Severe pain
●Haemorrhage
●Infection/sepsis
●Acute urinary retention
●Shock
Long Term Compilications
● Clitoral neuroma
●Menstrual disorder
●Vagina adhesion and obstruction
●Sexual problem
●Reproductive & recurrent UTIs
●Infertility
●Chronic difficulty with urination,
●stress urinary incontinence,
●Vesico-vaginal fistula.
HTPS...
Child Marriage: Marriage before age 18 years a risk for violence, exploitation, and abuse.
Abduction: Forcibly taking of someone for purpose of marriage
Nutritional taboos: factors place limits in one way or another on the intake of food
Gender-based violence : can be physical, sexual, or psychological harm or suffering, whether occurring in private or public life
It involves not only direct force but also threats, intimidation, and coercion.
Physical violence, e.g.: slapping, hitting, pushing, choking, shaking, spitting, restraining, use of weapons
Sexual violence, e.g. rape, forced marriage, forced abortion, FGM, trafficking, incest
Psychological violence, e.g. Verbal, intimidation/threats, emotional violence, constant criticism, humiliation,
Epidemiology of GBV
GBV occurs in 30% of cohabiting 15-19 year adolescent women with 10%-30% in high income to 43% in low-income countries.
In Ethiopia,34% of ever-married women experienced spousal physical, sexual, or emotional violence.
Physical and emotional violence were experienced by 24% each, and sexual violence by10% (EDHS 2016).
Causes of GBV
GBV is caused by a combination of factors
The ecological framework is used to understand the multiple causes of GBV and their interrelationship.
Ecological frame, causes of GBV. Source Heise, 1988
Causes continued…
The Individual Factors
●Young age (early marriage)
●Pregnancy
●low level of education,
●Past experiences of violence and
●attitudes of violence as acceptable behaviour.
The Relationship Factors
●focus on women/girls relationships with family and their peers.
●Men with multiple partners,
●Disparities in education status between partners and
●Family blaming the girls instead of the man for sexual violence.
Causes and consequences continued...
Community Level Factors
●Social relationships in
●school,
●workplace,
●neighbourhood.
●A society that challenge violence , low GBV level
Soceital Level Factors
●Cultural and social norms for gender
●Higher GBV with the household of men only decision-making powers
●Ideology of male sexual entitlement is societal level factors
Consequences and responses of GBV
Responses
Primary prevention:
Increasing community awareness of HTPs & challenging harmful gender norms
Secondary prevention:
Early identification of survivors, Evaluation and treatment of injuries
Prompt referral to appropriate services
Tertiary prevention: Mitigate negative impacts of violence
Counseling, HIV testing, PEP, Emergency contraception
STI prophylaxis, including Hepatitis
Understanding gender Value Clarification
Values: Sets of principles and rules that help and guide in decision making and orient oneself within a governing system
Identify them as gender or sex:
●Most building-site workers in Ethiopia are men
●Women often take responsibility for household chores
●Men are naturally responsible to protect and care for the family
●Boys are naturally active in public while girls remain shy
●Wife battering is normal, in fact, it helps to discipline the wife
●Girls/women should take responsibility for the violence they suffered
●Women should tolerate violence to keep the family together
●Forcing a female partner into sex can’t be considered rape
Health systems response to GBV
Health sector is a key entry point for care and referral
GBV survivors should be taken care with an individual context
Health care providers should provide service
Based on a gendered understanding of violence against women
Focus on the human rights and safety of the victims
In an integrated approach,
Takes into account the relationship between victims, perpetrators, children and their wider social environment.
Services aim at avoiding secondary victimization.
Services aim at victim empowerment and economic independence
Services allow protection and support services
Services address the specific needs of the victim
Health care providers should have
Skills to identify survivors and do proper examinations,
Do risk assessments, and provide medical care and safety planning. medical care. This process
Multi-sectoral Response to GBV
Multi-sectoral response
Multi-sectoral response -social, psychological, economic, and legal aspects
Health care providers refer survivors to other services for immediate needs and prevent future incidents of violence
Principles to prevent and respond to acts of violence :
Respect: for the rights, and dignity of the survivor
Confidentiality: except when faces imminent risk
Safety and security: physical safety of the survivor and supporters
Mandatory reporting of suspected GBV cases should be balanced with principles of autonomy and confidentiality
Prevent re-victimization of GBV: in taking testimonials
Protection of staff working with survivors: psychological support
Gender Transformation and Continuum
Gender transformation refers to efforts to change gender and social norms to address inequalities
Gender Continuum
Gender continuum is a tool for designers and implementers to use in planning how to integrate gender into their programs/policies
Gender Continuum Categories
Gender Blind: Absence of any proactive consideration of the larger gender environment
Gender Aware: Explicit recognition of local gender differences, norms, and relations and their importance
Gender Exploitative: Approaches to project design, implementation, and evaluation
Gender Accommodating: Approaches acknowledge the role of gender norms and inequities and seek to develop actions that adjust to and often compensate for them
Gender Transformative: Approaches actively strive to examine, question, and change rigid gender norms and imbalance of power as a means of reaching health as well as gender equity objectives
SUMMERY
What do Gender and Sex mean?
Describe GBV and HTP
Describe types of FGM
Explain the ecological frame for the cause of GBV
What are the consequences and responses of GBV?
Describe the gender continuum category
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