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Intimate partner violence (IPV) has a detrimental impact on the lives of women worldwide. Several studies have examined the effect IPV has on adverse birth outcomes when it occurs during pregnancy.To explore the association between IPV and selected adverse birth outcomes.Multiple databases were searched to identify studies investigating the association between IPV and low birth weight (LBW), preterm birth, and/or intrauterine growth restriction (IUGR).Included studies defined the perpetrator of violence as an intimate partner, the type of violence as physical and/or sexual, and the study outcomes as LBW, preterm birth, or IUGR, with violence preceding delivery.Random-effects meta-analysis was used to calculate adjusted/unadjusted odds ratios (ORs). Subanalyses explored the effect of emotional/psychological violence on birth outcomes.Nineteen studies met the inclusion criteria (15 LBW, 12 preterm birth, 4 IUGR). IPV was associated with LBW (OR 1.18, 95% confidence interval 1.05-1.31; I(2)=0.70, P0.001) and preterm birth (OR 1.42, 95% confidence interval 1.21-1.63; I(2)=0.20, P0.001). No statistically significant association was found for IUGR.There are associations between IPV and LBW and preterm birth that could be causal.

Violence against women (VAW) is a global epidemic that affects women across socioeconomic, cultural, religious, and age groups. Yet, the violence that older women experience often goes ignored in both policy and programmatic dialogues, meaning that survivors aged 50 and older are rendered invisible, with little attention given to their needs and little effort made to prevent the violence they experience. This chapter discusses the gendered social norms that place older women at risk of violence and highlights the forms of violence for which they are at unique risk of experiencing. It then provides examples of approaches to closing the gaps in evidence and action on violence against older women, including through (1) investing in expanded data collection and building the capacity of national statistical commissions to collect data on women older than 49; (2) including older women’s voices and needs in national plans of action on VAW and strategies to remedy gender disparities; and (3) training providers to break down ageist biases that can impede older survivors’ access to essential services. These innovative strategies serve as examples that must be built on and expanded in order for older women to be fully engaged as community members and agents of social change.

Violence in childhood is a widespread human rights violation that crosses cultural, social and economic lines. Social norms, the shared perceptions about others that exist within social groups, are a critical driver that can either prevent or perpetuate violence in childhood. This review defines injunctive and descriptive social norms and lays out a conceptual framework for the relationship between social norms and violence in childhood, including the forces shaping social norms, the mechanisms through which these norms influence violence in childhood (e.g. fear of social sanctions, internalization of normative behavior), and the drivers and maintainers of norms related to violence in childhood. It further provides a review of theory and evidence-based practices for shifting these social norms including strategic approaches (targeting social norms directly, changing attitudes to shift social norms, and changing behavior to shift social norms), core principles (e.g. using public health frameworks), and intervention strategies (e.g. engaging bystanders, involving stakeholders, using combination prevention). As a key driver of violence in childhood, social norms should be an integral component of any comprehensive effort to mitigate this threat to human rights. Understanding how people's perceptions are shaped, propagated, and, ultimately, altered is crucial to preventing violence in childhood.

Adolescent pregnancy places girls at increased risk for poor health and educational outcomes that limit livelihood options, economic independence, and empowerment in adulthood. In Tanzania, adolescent pregnancy remains a significant concern, with over half of all first births occurring before women reach the age of 20. A participatory research and action project (Vitu Newala) conducted formative research in a rural district on the dynamics of sexual risk and agency among 82 girls aged 12-17. Four major risk factors undermined girls' ability to protect their own health and well-being: poverty that pushed them into having sex to meet basic needs, sexual expectations on the part of older men and boys their age, rape and coercive sex (including sexual abuse from an early age), and unintended pregnancy. Transactional sex with older men was one of the few available sources of income that allowed adolescent girls to meet their basic needs, making this a common choice for many girls, even though it increased the risk of unintended (early) pregnancy. Yet parents and adult community members blamed the girls alone for putting themselves at risk. These findings were used to inform a pilot project aimed to engage and empower adolescent girls and boys as agents of change to influence powerful gender norms that perpetuate girls' risk.

Successes in diagnosing and treating pediatric HIV have necessitated care that extends beyond basic medical needs. However, capacity for providing childhood psychosocial support (PSS) remains limited. Programmatic research with young PLHIV, care providers and parents in Uganda and South Africa explored challenges in meeting the psychosocial needs of HIV-positive children. Three areas for childhood PSS were examined: disclosure, stigma, and grief/bereavement. This research identified programming gaps, strategies and good practices in five focal areas: providing immediate postdiagnosis support, stigma reduction, capacity building, addressing grief, and promoting peer support. Recommendations are presented for enhancing PSS for HIV-positive children in resource-limited settings.

In Tanzania, 44% of women experience intimate partner violence (IPV) in their lifetime, but the majority never seeks help, and many never tell anyone about their experience. Even among the minority of women who seek support, only 10% access formal services. Our research explored the social and structural barriers that render Tanzanian women unable to exercise agency in this critical domain of their lives. We collected qualitative data in three regions of Tanzania through 104 key informant interviews with duty bearers and participatory focus groups with 96 male and female community members. The findings revealed numerous sociocultural barriers to help-seeking, including gendered social norms that accept IPV and impose stigma and shame upon survivors. Because IPV is highly normalised, survivors are silenced by their fear of social consequences, a fear reinforced by the belief that it is women's reporting of IPV that brings shame, rather than the perpetration of violence itself. Barriers to help-seeking curtail women's agency. Even women who reject IPV as a 'normal' practice are blocked from action by powerful social norms. These constraints deny survivors the support, services and justice they deserve and also perpetuate low reporting and inaccurate estimates of IPV prevalence.

This paper examines men’s lifetime physical intimate partner violence (IPV) perpetration across eight low- and middle-income countries to better understand key risk factors that interventions can target in order to promote gender equality and reduce IPV. We use data from men (n = 7806) that were collected as part of the International Men and Gender Equality Survey (IMAGES) in Bosnia and Herzegovina, Brazil, Chile, Croatia, Democratic Republic of Congo (DRC), India, Mexico, and Rwanda. Results show that there is wide variation across countries for lifetime self-reported physical violence perpetration (range: 17% in Mexico to 45% in DRC), men’s support for equal roles for men and women, and acceptability of violence against women. Across the sample, 31% of men report having perpetrated physical violence against a partner in their lifetime. In multivariate analyses examining risk factors for men ever perpetrating physical violence against a partner, witnessing parental violence was the strongest risk factor, reinforcing previous research suggesting the inter-generational transmission of violence. Additionally, having been involved in fights not specifically with an intimate partner, permissive attitudes towards violence against women, having inequitable gender attitudes, and older age were associated with a higher likelihood of ever perpetrating physical IPV. In separate analyses for each country, we found different patterns of risk factors in countries with high perpetration compared to countries with low perpetration. Findings are interpreted to identify key knowledge gaps and directions for future research, public policies, evaluation, and programming.

To explore forms of immigration-related partner abuse and examine the association of such abuse and immigration status with physical and sexual intimate partner violence (IPV) among South Asian women residing in greater Boston.Cross-sectional survey data on demographics,immigration status, immigration-related partner abuse, IPV, and health were collected from immigrant South Asian women currently in relationships with men (n=189). In-depth interviews were conducted with immigrant South Asian women with histories of IPV (n=23). The majority of women in both the quantitative and qualitative studies were Indian (96% and 65%), not US citizens (69% and 83%), and highly educated (48% and 39% reported postgraduate training). Logistic regression analyses adjusted for related demographics and 95% confidence intervals were used to assess quantitative data. Qualitative data were assessed via a grounded theory approach.The odds of reporting IPV (23% of the sample)were higher for women who reported that their partners refused to change their immigration status (OR 7.8; CI 1.4, 44.6) or threatened them with deportation (OR 23.0; CI 4.5, 118.8) and for those on spousal dependent visas (OR 2.8; CI 1.1, 7.4) than they were for other women. Abused women interviewed also described how their partners used immigration laws prohibiting them from working or petitioning for status change to limit their autonomy.Immigration policies that prevent women on spousal visas from working and petitioning to change their status increase women's vulnerability to partner abuse. Such legal barriers may constitute human rights violations and should be reformed to protect immigrant battered women and their children.

To assess relationships between intimate partner violence (IPV) and sexual health among South Asian women in Boston. Surveys assessed demographics, IPV and sexual and reproductive health outcomes of women in relationships with men (N=208). In-depth interviews explored these issues with women with a history of IPV (N=23). Subjects were majority Indian, non-U.S. citizens, and highly educated. Quantitative data were assessed by logistic regression, qualitative data by a grounded theory approach. About 21.2% of the survey sample reported IPV in the current relationship. These women are 2.6 times as likely to report discolored vaginal discharge in the past year (95% CI=1.27-6.50), 3.1 times as likely to report burning during urination in the past year (95% CI=1.52-6.31) and 3.4 times as likely to report unwanted pregnancy in the current relationship (95% CI=1.33-8.66). Interviewed women described how abuse reduces sexual autonomy, increasing risk for unwanted pregnancy and multiple abortions. Study findings demonstrate the need for increased gynecologic health outreach to abused South Asian women in the U.S.

The 2012 World Development Report recognized that expanding women's agency - their ability to make decisions and take advantage of opportunities is key to improving their lives as well as the world. This report represents a major advance in global knowledge on this critical front. The vast data and thousands of surveys distilled in this report cast important light on the nature of constraints women and girls continue to face globally. This report identifies promising opportunities and entry points for lasting transformation, such as interventions that reach across sectors and include life-skills training, sexual and reproductive health education, conditional cash transfers, and mentoring. It finds that addressing what the World Health Organization has identified as an epidemic of violence against women means sharply scaling up engagement with men and boys. The report also underlines the vital role information and communication technologies can play in amplifying women's voices, expanding their economic and learning opportunities, and broadening their views and aspirations. The World Bank Group's twin goals of ending extreme poverty and boosting shared prosperity demand no less than the full and equal participation of women and men, girls and boys, around the world.