THE LANCET: More than a quarter of women have experienced intimate partner violence in their lifetimes, finds new study

Peer-reviewed/Modelling Study/People

• Largest study to present internationally comparable estimates of the prevalence of sexual and/or physical violence against women by a male intimate partner.
• Estimates from a global database of surveys conducted between 2000 and 2018 indicate that 27% of women aged 15-49 have experienced physical and/or sexual intimate partner violence in their lifetime, with 13% experiencing this violence within the past year.
• Evidence suggests intimate partner violence starts early; it is already prevalent in the youngest age groups, with 24% of women aged 15-19 having experienced violence from an intimate partner at least once since the age of 15.
• Authors highlight an urgent need to strengthen the public health response to intimate partner violence in post-COVID-19 reconstruction efforts. 

New research published in The Lancet estimates that over one in four women have experienced domestic violence within their lifetime. Using data from the World Health Organisation Global Database on the Prevalence of Violence Against Women, which covers 90% of women worldwide, these new estimates indicate that prior to the COVID-19 pandemic 27% of ever-partnered women aged 15-49 had experienced physical and/or sexual violence from an intimate partner in their lifetime, with one in seven (13%) experiencing recent violence from an intimate partner (within the past 12 months of the survey).

Intimate partner violence of ever-partnered women (defined as women who are or have been married, co-habit, or have a long-term sexual partner) refers to physically, sexually, and psychologically harmful behaviours in the context of marriage, cohabitation, or any other form of union. It can have major short and long-term impacts on the physical and mental health of the victim, leading to substantial social and economic costs for governments, communities, and individuals.

The UN 2030 Agenda for Sustainable Development has called for an end to violence against women in its Sustainable Development Goals (SDG5.2) [1]. This study aims to provide baseline estimates for intimate partner violence against women on global, regional, and country-wide levels to help governments monitor their progress towards this target and inform policy and programming to prevent and respond to violence.

In 2013, WHO published the first global and regional estimates on the prevalence of physical and/or sexual intimate partner violence, and non-partner sexual violence with existing survey data up to 2010 [2], finding that one in three women experience physical and/or sexual violence from partners and non-partners. Nearly one in three (30%) of women experienced physical and/or sexual violence from partners only.

This new study uses population-based surveys, improved quality of data, and updated methods to provide current prevalence estimates of intimate partner violence across the world, up to and including the year 2018, reporting that one in four ever-partnered women experience violence from intimate partners alone. The study only estimated physical and sexual violence and work is underway by WHO to strengthen measures of reporting psychological harmful behaviours by partners.

This present analysis reveals that governments are not in line to meet targets for eradicating violence against women. “Whilst progress has been made in the past 20 years, it is still grossly insufficient to meet the SDG target for eliminating violence against women by 2030,” says study senior author Claudia García-Moreno, World Health Organisation [3].

She adds: “Intimate partner violence affects the lives of millions of women, children, families and societies worldwide. Although this study took place before the COVID-19 pandemic, the numbers are alarming and research has shown the pandemic exacerbated issues leading to intimate partner violence such as isolation, depression and anxiety, and alcohol use, as well as reducing access to support services. Preventing intimate partner violence from happening in the first place is vital and urgent. Governments, societies and communities need to take heed, invest more, and act with urgency to reduce violence against women, including by addressing it in post-COVID reconstruction efforts.” [3]

The data used in this research were from the WHO Global Database on Prevalence of Violence Against Women and include over 300 eligible surveys and studies conducted between 2000-2018. It covers 161 countries and areas, accounting for 2 million women aged 15 years and older, representing 90% of the global population of women and girls. Statistical analysis allowed estimation of the prevalence of intimate partner violence over different age groups, regions, and time ranges to be calculated.

Globally, 27% or approximately one in four ever-partnered women aged 15-49 years are estimated to have experienced intimate partner violence at least once in their lifetime since age 15 [4]. The estimates suggest that in 2018, up to 492 million women aged 15-49 years experienced intimate partner violence in the past 12 months, equating to 13% or one in seven women. Because estimates in this study are based off women’s self-reported experiences and given the sensitive and stigmatised nature of the issue, the true prevalence of violence that these women are subjected to by an intimate partner is likely to be even higher.

The study also draws attention to high levels of intimate partner violence experienced by adolescent girls and young women. In the youngest age cohort of women (15-19 years), 24% or almost one in four are estimated to have experienced intimate partner violence in their lifetime. The prevalence of recent/current intimate partner violence was highest among ever-partnered adolescent girls and young women aged 15-19 and 20-24 years, with 16% or one in six experiencing intimate partner violence in 2018 (within the past 12 months of the survey).

“The high number of young women experiencing intimate partner violence is alarming, as adolescence and early adulthood are important life stages when the foundations for healthy relationships are built. The violence these young women experience has long-lasting impacts on their health and well-being. Intimate partner violence is preventable and more needs to be done to develop and invest in effective community and school-based interventions that promote gender equality and reduce young women’s risk of being subjected to violence from a partner,” says Lynnmarie Sardinha, World Health Organisation, the lead author of this paper [3].

Regional variations by Global Burden of Disease classifications [5][6] revealed that the lifetime prevalence of intimate partner violence among women aged 15-49 was highest in Oceania (49%), and Central Sub-Saharan Africa (44%). The regions with the lowest lifetime intimate partner violence prevalence estimates were Central Asia (18%), and Central Europe (16%).

These regional patterns were similar for past 12 months prevalence of intimate partner violence with it being highest in Central Sub-Saharan Africa (32%), Oceania (29%), Eastern Sub-Saharan Africa (24%), and South Asia (19%).

Overall, high-income countries had lower estimated prevalence rates of both lifetime and past-year intimate partner violence among ever-partnered women aged 15-49, with regional differences particularly pronounced between high income and low- and lower-middle-income regions for past-year intimate partner violence.

“These findings confirm that violence against women by male intimate partners remains a global public health challenge. Governments are not on target to meet goals to eradicate violence against women by 2030. The authors call for urgent investment in effective multisector interventions and a strengthened public health response in tackling this issue post-COVID-19,” says Claudia García-Moreno. [3]

The authors acknowledge some limitations with the study. These include the reliance on the availability and quality of existing violence against women survey data; some important gaps remain in the data for some geographical regions and sub-populations, for example, those living with disabilities, indigenous/ethnic minority, or migrant women, trans women and women in same-sex partnerships for which data is currently limited. The definition of partnership is also variable across contexts and relies on the definition given in the surveys used. This means that some studies may not have captured all partnership types, especially in younger age groups, although the methodology used, as far as possible, adjusted for this to minimize under-estimation.

Writing in a linked Comment, Jessica Leight of the International Food Policy Research Institute (Washington DC, United States), who was not involved in the study, said: “These findings highlight the importance of analysing more carefully the evolution of intimate partner violence and other related forms of violence targeting girls and women over the life course… This comprehensive new data should only re-emphasize the urgency of developing, evaluating, and scaling strategies that can target the prevention and reduction of IPV for women around the world, particularly the most vulnerable.”

NOTES TO EDITORS

This study was funded by the Department for International Development, DfID (now the Foreign, Commonwealth and Development Office ) of the United Kingdom, through the UN Women–WHO Joint Programme on Strengthening Methodologies and Measurement and Building National Capacities for Violence against Women Data and by the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) in the Department of Sexual and Reproductive Health and Research (SRH) at the World Health Organization (WHO). It was conducted by researchers from the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) in the Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland; the School of Population and Global Health, McGill University, Montréal, Canada; London School of Hygiene and Tropical Medicine, London, United Kingdom; and Medizinische Fakultät, Ludwig Maximilians Universität.

[1] The UN 2030 Agenda for Sustainable Development includes 17 goals. Goal 5.2 relates to the eradication of violence against women.
[2] Global and regional estimates of violence against women, WHO, 2013
[3] Quote direct from author and cannot be found in the text of the Article.
[4] “Lifetime” is defined as since the age of 15 for the purpose of these estimates.
[5] The Global Burden of Disease provides a tool to quantify health loss from hundreds of diseases, injuries, and risk factors, so that health systems can be improved and disparities can be eliminated.
[6] For breakdowns by country, see Table S5 in the appendix.

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