This report argues for a public health approach to intimate partner and sexual violence that emphasises primary prevention, where issues are tackled at the wider societal level and before they occur. While further research is required on effective public health strategies, it is only by taking action and generating evidence that intimate partner and sexual violence will be prevented.
Intimate partner and sexual violence are not inevitable and vary over time and countries due to a variety of social, cultural, economic and other factors. This variation shows that violence can be reduced through well-designed and effective programmes and policies. For example, factors relating to perpetrators and victims, such as exposure to child maltreatment and attitudes towards violence, can be addressed. However, to achieve change at the wider population level it is important to target societal factors. Approaches include the enactment of legislation and the development of supporting policies that protect women; addressing discrimination against women; and helping to move away from a culture of violence.
At present, the evidence base for programmes for the primary prevention of intimate partner and sexual violence is still in its early stages:
- Currently, there are no effective strategies for preventing sexual violence outside intimate partner or dating relationships.
- Only one strategy has been demonstrated to be effective in preventing intimate partner violence, namely school-based programmes for adolescents to prevent violence within dating relationships – and this still needs to be assessed for use in resource-poor settings.
- Nevertheless, evidence is emerging of the effectiveness of several other strategies, particularly the use of microfinance with gender equality training and of programmes that promote communication and relationship skills within communities.
- There is reason to believe that rigorous outcome evaluations of existing programmes and the development of new programmes based on sound theory and known risk factors will lead to a rapid expansion of evidence in coming years.
Although urgent, the need for evidence and further research in no way precludes taking action now to prevent both intimate partner violence and sexual violence in all countries. Those programmes that have evidence supporting their effectiveness should be implemented and, where necessary, adapted. In terms of research, the following areas should be developed as a priority:
- The evaluation of promising programmes and the further developing and testing of potential programmes – especially in low and middle income countries where rates of intimate partner violence are often high.
- Programmes and evaluations that focus on younger age groups, since evidence suggests that this may be a more effective primary prevention approach.
- New settings for primary prevention programmes. Far more consideration should be given to the use of settings outside of schools, such as the home and healthcare settings.
- Once the effectiveness of a programme has been determined, obtaining more information on the relative cost effectiveness and the wider social and emotional benefits of specific programmes in a variety of settings.