1. Violence against Women in Latin America and the Caribbean: Comparative Findings from Recent Population-Based Surveys November, 2010

2. Collaborators  Mary Goodwin Epidemiologist, Division of Reproductive Health, CDC  Alessandra Guedes Regional Advisor, Intra-Family Violence, PAHO  Sarah Bott Independent Consultant  Jennifer A. Mendoza PhD Candidate, Ohio State University  Thanks: Sunita Kishor, PhD, Macro DHS and staff

3. Summary of presentation  Background and objectives of the comparative study  Comparative findings: Prevalence of violence against women (VAW) Responses Childhood experiences Risk factors and consequences  Implications for policy and programming

4. Population-based Health Surveys in Latin America and the Caribbean  Over 75 population-based health surveys have been conducted in 19 countries in Latin America and the Caribbean over the past 35 years  Most supported by USAID in collaboration with UNFPA, UNICEF, PAHO; IDB, World Bank; other bilateral donors  Since 1998, survey content has increased to include violence against women (>20 surveys in LAC)

5. Comparative Analysis of Data on Violence Against Women from Surveys Population-Based Health Goals:  To increase access to, quality, and use of regional data on VAW women for advocacy, planning, and evidence-based policy development  To raise awareness of VAW as a public health problem and violation of human rights  To examine ways in which future data collection efforts could be improved – data quality and comparability

6. Surveys Included in Comparative Study RHS SurveysDHS Surveys CountryYearNCountryYearN Ecuador20049,576Bolivia200314,655 El Salvador20089,717Bolivia200814,900 Jamaica20088,259Colombia200537,597 Nicaragua200614,165Dominican Rep. 200710,140 Paraguay20086,526Haiti20053,568 Guatemala200916,582Honduras200519,948 Peru200811,894

7. VAW Indicators in RHS and DHS Surveys  Gender norms and attitudes  Childhood experiences  Behavior of spouse/partner: controlling behavior, alcohol use  Intimate partner violence - IPV (current and ex- partners) Emotional/psychological Physical Forced intercourse  Circumstances and consequences of intimate partner violence  Help-seeking behavior  Lifetime sexual violence (by any perpetrator, at any age)

8. Comparative Findings November, 2010

9. Physical IPV, ever and past 12 months (Most DHS asked about current/most recent partner only)

10. Sexual IPV, ever and past 12 months (Most DHS asked about current/most recent partner only)

11. Physical and/or sexual IPV ever: how they overlap

12. Threats from an intimate partner to harm her or someone she cares about

13. Percent of women who believe that wives:

14. Women who believe that husband has right to hit wife

15. Husband/partner controls woman’s movements

16. Number of husband/partner’s controlling behaviors, by experience of physical/sexual IPV in past 12 months, El Salvador 2006/7

17. Help-seeking behaviors of women physically or sexually abused in last year by type

18. Lifetime physical violence and past year help-seeking for physical violence, by ethnicity

19. Awareness or witnessing of father physically abusing mother during childhood

20. Percent of all women with sexual violence in lifetime (any age)

21. Association Between Child Sexual Abuse (<15 years of age) and Intimate Partner Violence in Past 12 Months Source: Speizer, Goodwin, et al., Dimensions of child sexual abuse before age 15 in three Central American countries: Honduras, El Salvador, and Guatemala, Child Abuse Neglect (2008). * p ≤ 0.05; *** p ≤ 0.001; Percent reporting partner physical/ sexual violence in the last 12 months (women ever in union) Adjusted OR CountryNo History of Child Sexual Abuse History of Child Sexual Abuse El Salvador 2002/35.79.7*1.36 Guatemala 200210.123.1***2.40 Honduras 20018.716.3***1.79

22. Women and men in Guatemala and El Salvador who were beaten as a child, by whether they witnessed violence between their parents Source: Speizer, Goodwin, et al. Dimensions of child punishment in two Central American countries: Guatemala and El Salvador. Rev Panam Salud Publica. 2008;23(4):247–56.

23. Use of the data...  Data disseminated to non-traditional users of survey information: VAW advocacy groups, government ministries justice and women’s affairs  Reactions to the data mixed: Underestimation Surprise at the percent of women who did not seek services  Policy impact mixed: Paraguay change in law declaring marital rape a crime Few hospitals in country equipped/trained in sexual assault evidence collection

24. Conclusions  Commitment to use existing data on VAW to the greatest extent possible to develop evidence-based policy, programs, and advocacy  Continue to improve quality and comparability of documentation of these problems  Future of data collection in the region  Look for regional report and related materials in 2011.

25. For more information about the project: Alessandra Guedes (PAHO): guedesal@paho.org Mary Goodwin (CDC): mgoodwin@cdc.govguedesal@paho.org November, 2010

26. Believes that woman does not have right to refuse sex with husband

27. Physical and sexual IPV, ever (Most DHS asked about current or most recent partner only)

28. Percent distribution of age at first forced sex