Update: First published on 21 May 2021
Gaps in public policy are heightening risks to women experiencing violence, a new World Health Organization (WHO) report shows, as around half of countries lack specific health sector policies and guidelines that address violence against women and girls.
For the first time, the report monitors both the existence of national action plans and health policies to prevent and respond to this violence, in line with international commitments, WHO guidelines that support quality health care for survivors, human rights standards,
as well as evidence-based prevention strategies.
Violence against women is prevalent in every country and culture and causes significant health harms. WHO estimates show that, globally, almost 1 in 3 women (30%) fifteen years of age or older have experienced physical and/or sexual violence from a male intimate partner or sexual violence from a non-partner, at least once
in their lifetime.
Monitoring governments’ commitments to end violence against women is important to ensure accountability for the wellbeing of millions of women and girls at risk of or subjected to violence.
Here’s what we have learned so far:
Countries recognize the need to act on violence against women but under half lack clinical guidelines
Countries are recognizing the broad need for action to address violence against women and girls, with 4 in 5 countries (81%) having national multisectoral action plans in place. These aim to prevent violence against women by addressing the
underlying causes and to strengthen the systems that respond to it.
Less than half, however (48%), have health guidelines in place to address violence against women. These help health care systems respond effectively to violence – and help health workers provide quality care to those affected. This includes identification of intimate partner violence, first line support that addresses the practical and emotional needs of survivors, care and treatment for any medical conditions, and comprehensive care in case of rape including prophylaxis for HIV and sexually transmitted infections, emergency contraception and abortion services where legal.
Countries are providing first-line support for survivors, but more attention is needed for mental health
Showcasing significant progress, three quarters of countries (75%) include first-line healthcare support for survivors in their policies. However, only 35% of countries include mental health care in line with WHO recommendations.
More efforts are needed to ensure policies and plans addressing violence against women align with human rights standards for survivor-centered care. This includes respect for privacy and confidentiality so that health care providers do no harm and enhance the safety of survivors. Fewer than half of countries with policies (45%) mention the right to a private consultation and only a quarter (26%) mention providers’ obligations to inform survivors about the limits to confidentiality.
Training of health care providers is essential to ensure care is of quality, provided in an empathetic, non-judgmental manner and meets the practical and emotional needs of survivors. Just over three-quarters of countries (78%) include a commitment to
training health care providers to respond to violence against women in national policies.
Given their particular risks, many more countries must ensure that policies respond to the needs of adolescent girls and young women – specifying how to reach them with tailored services.
A majority of countries recognize the importance of addressing harmful gender norms, attitudes and beliefs for preventing violence against women
Violence against women and girls is rooted in gender inequality, and transformational change across societies is necessary for
prevention.
Challenging norms that uphold male privilege and female subordination, or which condone violence against women, is vital for preventing this human rights violation.
Together with other UN agencies, WHO has published RESPECT women,
a framework for preventing violence against women aimed at policy makers. Each letter of RESPECT stands for one prevention strategy: R-relationship skills strengthened; E-empowerment of women; S-services ensured; P-poverty reduced; E-environments
made safe; C-child and adolescent abuse prevented; T-transformed gender attitudes, beliefs and norms.
In relation to this evidence-based framework, more countries include interventions related to transformation of gender norms (i.e. 78% of countries) in multisectoral plans of action on violence against women, though only 42% of countries mention women’s empowerment interventions.
Availability of data on prevalence of violence against women has increased considerably in the last 20 years
Availability of prevalence data on violence against women is key to monitoring progress towards ending violence against women. 
Globally four out five countries (81%) have conducted at least one prevalence survey on violence against women between 2000 and 2018. Although there are disparities across regions, with only 43% of countries in the WHO Eastern Mediterranean Region having conducted a prevalence survey on violence against women.
Addressing violence against women is critical to universal health coverage and human rights
While it is heartening to see policy commitments that address violence against women reflected across all WHO regions, these commitments must be implemented and financed if they are to translate into measurable change for women and girls.
This is particularly critical as we move into the third year of the COVID-19 pandemic, since emergency response measures have further increased women’s exposure to violence. Only 42% of countries that responded to a WHO policy survey reported having a budget line for violence against women-related services.
Healthcare providers, parliamentarians, ministries of health and finance and advocates are encouraged to use this global status report to raise awareness, strengthen health services and implement evidence-based strategies to prevent and respond to violence
against women.
As Dr Tedros Adhanom Ghebreyesus, WHO Director-General has said, “ To achieve universal health coverage, explicit attention must be given to addressing inequalities, including interventions that counter unequal gender norms and address violence against women.”