Understanding the linkages between violence against women and violence against children
Authors: Deborah A Fry, Stuart P Elliott
Journal: The Lancet Global Health (2017)

Worldwide, it has been recognised that violence against women and violence against children are significant human rights and public health issues,1Hillis S Mercy J Amobi A Kress H Global prevalence of past-year violence against children: a systematic review and minimum estimates.Pediatrics. 2016; 137: 1-13Crossref Scopus (476) Google Scholar, 2UNICEFHidden in plain sight: a statistical analysis of violence against children. UNICEF, New York2014http://www.unicef.org/publications/index_74865.htmlGoogle Scholar with WHO describing violence against women as a "global health problem of epidemic proportions".3WHOGlobal and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. World Health Organization, Geneva2013http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdfGoogle Scholar Globally, a third of women have been the victims of gender-based violence3WHOGlobal and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. World Health Organization, Geneva2013http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdfGoogle Scholar and over 1 billion children have experienced violence in the past year.1Hillis S Mercy J Amobi A Kress H Global prevalence of past-year violence against children: a systematic review and minimum estimates.Pediatrics. 2016; 137: 1-13Crossref Scopus (476) Google Scholar Furthermore, a quarter of all adults report being victims of physical abuse as children, with a fifth of women reporting being victims of child sexual abuse.4WHOUNODCUNDPGlobal status report on violence prevention. World Health Organization / UN Office on Drugs and Crime / UN Development Program. World Health Organization, Geneva2014http://www.who.int/violence_injury_prevention/violence/status_report/2014/en/Google Scholar This violence not only results in injury and mortality, but is associated with further health effects including increased risk of non-communicable diseases and reproductive, developmental, and mental health issues.4WHOUNODCUNDPGlobal status report on violence prevention. World Health Organization / UN Office on Drugs and Crime / UN Development Program. World Health Organization, Geneva2014http://www.who.int/violence_injury_prevention/violence/status_report/2014/en/Google Scholar, 5Coates D Impact of childhood abuse: biopsychosocial pathways through which adult mental health is compromised.Australian Social Work. 2010; 63: 391-403Crossref Scopus (34) Google Scholar Effective and scalable efforts to address violence against women and violence against children have historically developed as parallel but separate fields with distinct funding streams, governing agencies, approach strategies, and bodies of research.6Guedes A Bott S Garcia-Moreno C Colombini M Bridging the gaps: a global review of intersections of violence against women and violence against children.Global Health Action. 2016; 9: 31516Crossref PubMed Scopus (134) Google Scholar Existing global research nonetheless demonstrates important intersections between the two that have significant implications for health programmes, policies and research.6Guedes A Bott S Garcia-Moreno C Colombini M Bridging the gaps: a global review of intersections of violence against women and violence against children.Global Health Action. 2016; 9: 31516Crossref PubMed Scopus (134) Google Scholar Emma Fulu and colleagues' study in The Lancet Global Health7Fulu E Miedema S Roselli T et al.on behalf of the UN Multi-country Study on Men and Violence study teamPathways between childhood trauma, intimate partner violence, and harsh parenting: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific.Lancet Glob Health. 2017; 5: e512-e522Summary Full Text Full Text PDF PubMed Scopus (118) Google Scholar is thus very timely, and is a major advance in understanding the pathways between violence against women and violence against children. Their analyses of the UN Multi-Country Study on Men and Violence in Asia and the Pacific reveal a cycle of abuse, with child abuse leading to higher risk of violence against women and additional child maltreatment, which in turn increases the risk of adult violence.7Fulu E Miedema S Roselli T et al.on behalf of the UN Multi-country Study on Men and Violence study teamPathways between childhood trauma, intimate partner violence, and harsh parenting: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific.Lancet Glob Health. 2017; 5: e512-e522Summary Full Text Full Text PDF PubMed Scopus (118) Google Scholar Overall, this study highlights that violence against women and violence against children can no longer be treated as distinct issues and that a deeper understanding of the pathways between the two are needed.7Fulu E Miedema S Roselli T et al.on behalf of the UN Multi-country Study on Men and Violence study teamPathways between childhood trauma, intimate partner violence, and harsh parenting: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific.Lancet Glob Health. 2017; 5: e512-e522Summary Full Text Full Text PDF PubMed Scopus (118) Google Scholar The UN Sustainable Development Goals (SDGs) include two zero-based targets aiming to end all forms of violence against women and violence against children.8UN General AssemblyTransforming our world: the 2030 agenda for sustainable development. Seventieth Session.https://sustainabledevelopment.un.org/post2015/transformingourworld/publicationDate: 2015Google Scholar In other words, every country that has committed to these global goals must not only reduce, but eliminate, violence against women and violence against children by 2030.8UN General AssemblyTransforming our world: the 2030 agenda for sustainable development. Seventieth Session.https://sustainabledevelopment.un.org/post2015/transformingourworld/publicationDate: 2015Google Scholar Data collection and a clearer understanding of the complex inter-relationship of many factors relating to violence are essential to achieving these goals. Currently, the research on violence against women and violence against children is overwhelmingly concentrated in high-income countries, with a dearth of information from low-income and middle-income countries (LMICs), including those of the Asia and Pacific region.9Lansford JE Deater-Deckard K Childrearing discipline and violence in developing countries.Child Dev. 2012; 83: 62-75Crossref PubMed Scopus (134) Google Scholar Fulu and colleagues' study makes important contributions by demonstrating that child abuse and maltreatment is highly prevalent among women and men in the general population across the Asia-Pacific region, while also pointing to the interface between child abuse and violence against women in a LMIC setting, which has also been found in previous research concentrated in high-income countries.6Guedes A Bott S Garcia-Moreno C Colombini M Bridging the gaps: a global review of intersections of violence against women and violence against children.Global Health Action. 2016; 9: 31516Crossref PubMed Scopus (134) Google Scholar These findings illustrate strong links between childhood experiences of abuse and the perpetration or experience of violence against women in adults, and that this cycle of violence is driven by gender inequality and social norms.7Fulu E Miedema S Roselli T et al.on behalf of the UN Multi-country Study on Men and Violence study teamPathways between childhood trauma, intimate partner violence, and harsh parenting: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific.Lancet Glob Health. 2017; 5: e512-e522Summary Full Text Full Text PDF PubMed Scopus (118) Google Scholar Fulu and colleagues' study recognises the importance of these macro-level factors with regard to both violence against women and violence against children and indicates that the environment in which a child develops is extremely important for violence prevention, complementing other emerging evidence on the drivers of violence.7Fulu E Miedema S Roselli T et al.on behalf of the UN Multi-country Study on Men and Violence study teamPathways between childhood trauma, intimate partner violence, and harsh parenting: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific.Lancet Glob Health. 2017; 5: e512-e522Summary Full Text Full Text PDF PubMed Scopus (118) Google Scholar, 10Maternowska CM Potts A Fry D The multi-country study on the drivers of violence affecting children: a cross-country snapshot of findings. UNICEF Office of Research, Florence2016Google Scholar At this stage, many countries worldwide lack the necessary data to evaluate the progress of the SDGs1Hillis S Mercy J Amobi A Kress H Global prevalence of past-year violence against children: a systematic review and minimum estimates.Pediatrics. 2016; 137: 1-13Crossref Scopus (476) Google Scholar and this research not only provides data for the region but also offers much needed direction for prevention and intervention. This population-based study demonstrates that interventions must change attitudes regarding violence in the home and society, promote positive parenting practices, and tackle the inequality that allows the normalisation of violence and patriarchal power over women and children.7Fulu E Miedema S Roselli T et al.on behalf of the UN Multi-country Study on Men and Violence study teamPathways between childhood trauma, intimate partner violence, and harsh parenting: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific.Lancet Glob Health. 2017; 5: e512-e522Summary Full Text Full Text PDF PubMed Scopus (118) Google Scholar Violence does not occur in isolation and it is necessary to recognise the interconnectedness of its different forms as they often share common root causes.11WHOINSPIRE: seven strategies for ending violence against children. World Health organisation, Geneva2016http://www.who.int/violence_injury_prevention/violence/inspire/en/Google Scholar This study not only indicates a need for cross-collaboration between researchers working in violence against women and violence against children, but also for efforts to address common risk factors and tackle social norms that support both forms of violence. This approach resonates with previous research which shows that interventions addressing the root causes and risk factors have the greatest potential for reducing multiple forms of violence and their detrimental outcomes.6Guedes A Bott S Garcia-Moreno C Colombini M Bridging the gaps: a global review of intersections of violence against women and violence against children.Global Health Action. 2016; 9: 31516Crossref PubMed Scopus (134) Google Scholar, 11WHOINSPIRE: seven strategies for ending violence against children. World Health organisation, Geneva2016http://www.who.int/violence_injury_prevention/violence/inspire/en/Google Scholar While the conceptual framework and theory identifying the nexus between violence against women and violence against children have been established, how these multiple and complex intersections are addressed in practice remains under-researched. Future research must (i) identify opportunities and challenges across existing policies and programmes that straddle both fields, (ii) promote dialogue between violence against women and violence against children practitioners and policy-makers, and (iii) review evidence on what works to achieve mutually reinforcing results across both fields and scope opportunities for greater collaboration. These three areas of research could ultimately promote and accelerate achievement of the 2030 SDGs for eliminating both violence against women and violence against children. The science of public health is linked to action and the use of evidence to drive change, which is essential to achieving the basic human right of a life free of violence.3WHOGlobal and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. World Health Organization, Geneva2013http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdfGoogle Scholar We declare no competing interests. Pathways between childhood trauma, intimate partner violence, and harsh parenting: findings from the UN Multi-country Study on Men and Violence in Asia and the PacificThe data point to both a co-occurrence and a cycle of abuse, with childhood trauma leading to violence against women and further child maltreatment, which in turn increases the risk of experience or perpetration of violence during adulthood. Efforts to prevent both forms of violence would benefit from a meaningful integrated approach. Interventions should promote positive parenting, address inequality and the normalisation of violence across the life course, and transform men's power over women and children. Full-Text PDF Open Access