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One in three women face gender-based violence in their lifetime, mostly by their intimate partner.

This staggering statistic, however, dates from before COVID-19 and UN Women has reported on emerging evidence that since the outbreak of COVID-19, violence has significantly increased in countries where the ‘stay at home’ measure was implemented to control the spread of the virus. The United Nations Population Fund (UNFPA) estimates that for every 3 months of lockdown, an  additional 15 million additional cases of gender-based violence are to be expected.

The pandemic has painfully exposed the existing (health) inequalities and has further increased them, disproportionately impacting women and girls, particularly those who are already affected by disadvantaged conditions formed by the (social) determinants of health, including, low income, age, race, geographic location, migration status, disability, and health status.

While strong leadership from key decisionmakers is long overdue, now more than ever we need them to up their game, supported by disaggregated data for equity-oriented policies, and powerful awareness-raising campaigns, so that the victims of violence get the care and support they need.

What is gender-based violence?

The European Commission has defined gender-based violence as violence directed against a person because of that person’s gender or violence that affects persons of a particular gender disproportionately. Violence against women is understood as a violation of human rights and a form of discrimination against women and shall mean all acts of gender-based violence that result in, or are likely to result in physical harm, sexual harm (rape, attempted rape, unwanted touching, sexual exploitation and sexual harassment), psychological, or economic harm or suffering to women. It can include violence against women, domestic violence against women, men or children living in the same domestic unit.

Domestic violence is also called ‘intimate partner violence’ and includes physical, emotional, sexual, and economic abuse. It also includes threats of violence, coercion, and manipulation. This can take many forms such as sexual violence, child marriage, female genital mutilation, and so-called ‘honour crimes’.

How is gender-based violence related to health?

Gender-based violence can have devastating short- and long-term impacts on health; it can negatively affect women’s physical, mental, sexual, and reproductive health, and may affect their children’s health and wellbeing as well. The list of negative health impacts is long, ranging from physical injuries and sexually transmitted infections, to unintended pregnancies and induced abortions, to depression and even suicide in some cases.

Although gender-based violence affects all women, certain groups are more vulnerable and disproportionally affected. For example, those with existing health problems or a disability are more often a target for violence, as well as female asylum seekers, migrant and ethnic minority women, Roma, sex-workers, refugees, trafficked women, and women living in institutions. For example, 34% of women with a health problem or disability have experienced physical or sexual partner violence, compared with 19% of women who do not have a health problem or disability.

Women from these vulnerable groups also face barriers when it comes to accessing healthcare services; they either have no money of their own or are not in control of the household budget, they are less likely to have a health insurance, or they simply have no access to the right information on how to access care.

Gender-based violence and COVID-19

The COVID-19 pandemic worsens the situation in multiple ways. Firstly, the incidence of gender-based violence has dramatically increased, mainly because the ‘stay at home’ measures and of the increased insecurity and stress the pandemic has inflicted on the society.

Secondly, the social and health care professionals who provide life-saving support to women who experience violence, such as the clinical management of rape and psycho-social support, have significantly been reduced because of the overburdening and focus on handling COVID-19 cases. This change in focus and resource allocation also undermines the efforts to prevent gender-based violence from happening.

Tackling gender-based violence

“Gender equality is a core principle of the European Union, but it is not yet a reality” is what Ursula von der Leyen, President of the European Commission, said when presenting Europe’s Gender Equality Strategy 2020-2025 last year. The Commission has outlined three key actions – strengthening legal measures to criminalise gender-based violence, ensuring equal opportunities and salaries in the labour market, and pushing gender-balance on corporate boards and women’s participation in politics. The Commission has also set the ambition to ‘integrate a gender perspective in all EU policies and major initiatives’.

Peggy Maguire, Director General at the European Institute of Women’s Health, is clear; “this widespread international public health and human rights issue requires a strong leadership response, which rests with the most senior policymakers. Clearly stated objectives to address gender-based violence in national health strategies, policy and programmes will help establish the issue as a priority for health. The importance of prioritising access to mental health care for those who have experienced sexual violence cannot be understated, with a focus on marginalised and vulnerable groups such as the disabled, pregnant women, Roma, Migrants.”

Maguire also stresses the urgent need for better data; “the design and implementation of effective, evidence-based, and equity-oriented policies and programmes need statistical data that is disaggregated by the relevant inequality dimensions.”

Moreover, in the wake of COVID-19, the national response and recovery plans must include services that identify and support (e.g., provide shelter, health care and legal support to) women in immediate need, strong messages from law enforcement for high priority of zero-tolerance against gender-based violence, and sufficient resource allocation to psycho-social support for the victims of violence.

What we also need, is ambassadors to create and increase awareness, and to make sure that key actors, like the Commission, stick to and don’t forget about their strategies and ambitions. Listen to Nicole Kidman, UN Women Goodwill Ambassador, explaining how also you can help.