# **EXECUTIVE SUMMARY**

## **Introduction**

In 1993, the United Nations General Assembly defined violence against women as “ _any act of_ **_genderbased violence_** _that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women”_ (United Nations, 1993). The United Nations referred to “gender-based” violence to acknowledge that such violence is rooted in gender inequality and is often tolerated and condoned by laws, institutions and community norms; it is not only a manifestation of gender-inequality, but often serves to enforce it (Heise, Ellsberg and Gottemoeller, 1999). Gender-based violence comes in many forms throughout the life cycle; this review focuses on the two most common types: physical intimate partner violence and sexual violence against women by any perpetrator.

A growing body of international research documents the magnitude and patterns of gender-based violence. Worldwide, men experience higher levels of physical violence than women as a result of war, gang-related activity, street violence, and suicide, while women and girls are more likely to be assaulted or killed by someone they know, such as an intimate partner (Heise and Garcia Moreno, 2002). Population-based surveys have found that between 10-70% of women report being physically assaulted by an intimate male partner at some point in their lives (Heise, Ellsberg and Gottemoeller, 1999). The bonds of family, economic and emotional dependence that accompany intimate partner violence make prevention and protection particularly complex.

In addition, a substantial proportion of girls and women experience child sexual abuse, rape and other forms of sexual coercion in virtually every setting of the world. Population-based studies report rates of forced sexual debut among sexually experienced young people ranging from 7% in New Zealand to 46% in the Caribbean (Heise and Garcia Moreno, 2002). Contrary to popular belief, most victims know the perpetrators, who often include intimate partners, stepfathers, fathers, other relatives, authority figures, teachers, and acquaintances (Heise, Ellsberg and Gottemoeller, 1999). Sexual violence by strangers is common in select settings, such as situations of armed conflict and displacement, for example, when rape is used as a weapon of war (Ward, 2002).

This paper reviews what is known about more and less effective-or at least promising-approaches to prevent and respond to gender-based violence. Within the sections titled **Justice, Health, Education** , and **Multi-Sectoral Approaches** , the paper examines initiatives that have addressed laws and policies, institutional reforms, community mobilization, and individual behavior change strategies. The review also highlights cross-cutting lessons that have emerged from research and programs over the last 30 years.

Unfortunately, the knowledge base about effective initiatives is relatively limited. Few approaches have been rigorously evaluated, even in high-income countries. For example, Chalk and King (1998) found that among several hundred relevant intervention studies, only 34 were deemed methodologically sound. Indeed, evaluating initiatives to prevent or respond to violence against women involves numerous methodological challenges. For example, prevention often appears to require multiple organizations, strategies and sectors - which makes it difficult to determine which specific strategies can be credited with any changes measured (Chalk and King, 1998). Measuring and interpreting changes in prevalence rates have also proven to be complex tasks (Campbell, 2000). As a result, evidence about effectiveness is often lacking, and the most that can be said about certain approaches is that they appear more or less promising.

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