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Forum on Global Violence Prevention; Board on Global Health; Institute of Medicine. Preventing Violence Against Women and Children: Workshop Summary. Washington (DC): National Academies Press (US); 2011 Sep 12.

Preventing Violence Against Women and Children: Workshop Summary.

• Hardcopy Version at National Academies Press

6 Papers on Research in Preventing Violence Against Women and Children

The science behind preventing violence against women and children has evolved greatly over the past several decades. Several speakers offered overviews of the research and described the growing awareness of the complexities of the causes, risk factors, and adverse effects of such violence. They also explored potential intervention points that were illuminated by this discussion.

The first paper is a reprint from the World Health Organization publication Preventing Intimate Partner and Sexual Violence Against Women ( WHO and LSHTM, 2010b) . The full report provides an overview of the magnitude of the issue; this workshop summary includes Chapter 3 , which is an in-depth analysis of preventive interventions in low- and middle-income countries and was the basis for Claudia García-Moreno's presentation at the workshop.

The second paper is adapted from the International Men and Gender Equality Survey (IMAGES), a multi-country study that explored men's perspectives on gender norms and violence. The survey examined the evolving views of men on gender equality as well as whether these views affected men's sense of well-being and their commitment to reducing violence.

The third paper, by Claire Crooks from the University of Western Ontario and the Centre for Addiction and Mental Health, provides an overview of the intergenerational transmission of violence. It also explores the ways in which violence against children can have long-term impacts as well as what considerations are valuable in designing interventions to prevent child maltreatment.

The final two papers, from Roger Fallot and Julian Ford, explore secondary and tertiary prevention of the long-term effects of violence and associated trauma by including the “trauma lens” in the provision of social services as well as through the empowerment of individuals who are exposed to violence. Trauma-informed care and psychosocial empowerment are two means by which survivors of violence can overcome potential adverse outcomes and prevent the recurrence of violence.

PREVENTING INTIMATE PARTNER AND SEXUAL VIOLENCE AGAINST WOMEN: PRIMARY PREVENTION STRATEGIES 1

Intimate partner and sexual violence are not inevitable—their levels vary over time and between places because of a variety of social, cultural, economic, and other factors. This can result in substantial differences between and within countries in the prevalence of intimate partner and sexual violence ( WHO and LSHTM, 2010a ). Most importantly, this variation shows that such violence can be reduced through well-designed and effective programs and policies. There are important factors related to both perpetration and victimization—such as exposure to child maltreatment, witnessing parental violence, attitudes that are accepting of violence, and the harmful use of alcohol—that can be addressed ( WHO and LSHTM, 2010c) .

At present, evidence on the effectiveness of primary prevention strategies for intimate partner and sexual violence is limited, with the overwhelming majority of data derived from high-income countries (HICs)—primarily the United States. Consequently, current high priorities in this field include adapting effective programs from high-income to lower-income settings; further evaluating and refining those for which evidence is emerging; and developing and testing strategies that appear to have potential, especially for use in low-resource settings, with rigorous evaluation of their effectiveness. At the same time, the dearth of evidence in all countries means that the generating of evidence and the incorporation of well-designed outcome evaluation procedures into primary prevention programs are top priorities everywhere. This will help to ensure that the efforts made in this area are founded upon a solid evidence base. Furthermore, program developers should be encouraged to explicitly base programs on existing theoretical frameworks and models of behavior change to allow underlying mechanisms to be identified and to make replication easier. Most of the evaluated strategies aimed at preventing intimate partner and sexual violence have targeted proximal risk factors—primarily at the individual and relationship levels of the ecological model.

The Need for Upstream Action

In the public health framework, primary prevention means reducing the number of new instances of intimate partner and sexual violence by addressing the factors that make the first-time perpetration of such violence more likely to occur. Primary prevention therefore relies on identifying the “upstream” determinants and then taking action to address these. The impact of widespread, comprehensive programs can then be measured at the population level by comparing the rates at which such violence is either experienced or perpetrated. Given the lifetime prevalence of intimate partner and sexual violence, the hundreds of millions of women worldwide in need of services would outstrip the capacity of even the best-resourced countries ( WHO and LSHTM, 2010a ). A problem on this scale requires a major focus on primary prevention.

Upstream actions can target risk factors across all four levels of the ecological model. To decrease intimate partner and sexual violence at the population level, it is particularly important to address the societal or outer level of the model.

Such measures include national legislation and supportive policies aimed at social and economic factors—such as income levels, poverty and economic deprivation, patterns of male and female employment, and women's access to health care, property, education, and political participation and representation. It is sometimes even argued that programs that aim to reduce intimate partner and sexual violence against women without increasing male–female equity will ultimately not succeed in reducing violence against women. However, while many strategies involving legal and educational reform and employment opportunities are being implemented to increase gender equality, few have been assessed for their impact on intimate partner and sexual violence, making the evaluation of such strategies a priority. Any comprehensive intimate partner and sexual violence prevention strategy must address these sociocultural and economic factors through legislative and policy changes and by implementing related programs.

Creating a Climate of Non-Tolerance

Addressing risk factors at the societal level may increase the likelihood of successful and sustainable reductions of intimate partner and sexual violence. For example, when the law allows husbands to physically discipline wives, implementing a program to prevent intimate partner violence may have little impact. National legislation and supportive policies should therefore be put in place to ensure that women have equal rights to political participation, education, work, social security, and an adequate standard of living. They should also be able to enter freely into a marriage or to leave it, to obtain financial credit, and to own and administer property. Laws and policies that discriminate against women should be changed, and any new legislation and policies should be examined for their impact upon women and men. Legislation and policies that address wider socioeconomic inequalities are likely to reduce other forms of interpersonal violence, which will in turn help to reduce intimate partner and sexual violence.

Legislation and policies that address wider socioeconomic inequalities can make a vital contribution to empowering women and improving their status in society; to creating cultural shifts by changing the norms, attitudes, and beliefs that support intimate partner and sexual violence; and to creating a climate of non-tolerance for such violence.

The human rights of girls and women need to be respected, protected, and fulfilled as part of ensuring the well-being and rights of everyone in society. As a first step toward this, governments should honor their commitments in implementing the following international legislation and human rights instruments:

• Convention on the Elimination of All Forms of Discrimination Against Women (1979);
• The Convention on the Rights of the Child (1991);
• The Declaration on the Elimination of Violence Against Women (1993);
• The Beijing Declaration and Platform for Action (1995);
• The Millennium Declaration (2000); and
• The Inter-American Convention on the Prevention, Punishment and Eradication of Violence Against Women (Convention of Belem do Para, 1994).

Legislation and criminal justice systems must also be in place to deal with cases of intimate partner and sexual violence after the event. These systems should aim to help prevent further violence, facilitate recovery, and ensure access to justice—for example, through the provision of specialized police units, restraining orders, and multi-agency sexual assault response teams. Potentially, legal protection against intimate partner and sexual violence helps to reinforce non-violent social norms by sending the message that such acts will not be tolerated. Measures to criminalize abuse by intimate partners and to broaden the definition of rape have been instrumental in bringing these issues out into the open and dispelling the notion that such violence is a private family matter. In this regard, they have been very important in shifting social norms ( Heise and García-Moreno, 2002 ; Jewkes et al., 2002) . However, the evidence surrounding the deterrent value of arrest in cases of intimate partner violence shows that it may be no more effective in reducing violence than other police responses, such as issuing warnings or citations, providing counseling, or separating couples ( Fagan and Browne, 1994 ; Garner et al., 1995) . Some studies have also shown increased abuse following arrest, particularly for unemployed men and those living in impoverished areas ( Fagan and Browne, 1994 ; Garner et al., 1995) . Protective orders can be useful, but enforcement is uneven, and there is evidence that they have little effect on men with serious criminal records ( Heise and García-Moreno, 2002) . In cases of rape, reforms related to the admissibility of evidence and removing the requirement for victims' accounts to be corroborated have also been useful but are ignored in many courts throughout the world ( Du Mont and Parnis, 2000 ; Jewkes et al., 2002) .

Currently, on the whole, sufficient evidence of the deterrent effect of criminal justice system responses on intimate partner and sexual violence is still lacking ( Dahlberg and Butchart, 2005) . Dismantling hierarchical constructions of masculinity and femininity predicated on the control of women and eliminating the structural factors that support inequalities are likely to make a significant contribution to preventing intimate partner and sexual violence. However, these are long-term goals. Strategies aimed at achieving these long-term objectives should be complemented by measures with more immediate effects that are informed by the evidence base presented in this paper.

ASSESSING THE EVIDENCE FOR DIFFERENT PREVENTION APPROACHES

From the perspective of public health, a fundamental question is, “Do intimate partner and sexual violence prevention programs work?” That is to say, are there certain programs or strategies that are effective in preventing or reducing intimate partner and sexual violence? Effectiveness can only be demonstrated using rigorous research designs, such as randomized controlled trials or quasi-experimental designs. These typically compare the outcomes of an experimental group (which receives the program) with a control or comparison group (which is as equivalent as possible to the experimental group but which does not receive the program). One major concern is to be able to rule out alternative explanations for any observed changes in outcome in order to be confident that the changes really were due to the program and not some other factor.

Although “testimonials” are not a sound basis for evaluating the effectiveness of a program, they can provide insights into its running and on whether participants find it worthwhile. However, approaches that are based upon testimonials might expend significant resources and capacity on programs that may be ineffective or may even make things worse ( Dahlberg and Butchart, 2005) . Various criteria have now been proposed to more systematically evaluate the effectiveness of different programs. The most stringent criteria involve program evaluation using experimental or quasi-experimental designs; evidence of significant preventive effects; evidence of sustained effects; and the independent replication of outcomes.

In spite of the emphasis on and visibility of efforts to promote gender equality and prevent intimate partner and sexual violence, very few of the programs reviewed in this paper meet all of these criteria, while others have not been subjected to any kind of scientific evaluation. Rigorous scientific evaluation of programs for preventing intimate partner and sexual violence are even rarer in low- and middle-income countries (LMICs). The field of intimate partner and sexual violence prevention must therefore be considered to be at its earliest stages in terms of having an established evidence base for primary prevention strategies, programs, and policies. The limited evidence base for intimate partner and sexual violence prevention has three important implications for this paper.

First, the paper extrapolates, when relevant, from the stronger evidence base for child maltreatment and youth violence prevention but clearly signals that these extrapolations remain speculative. Much, however, can be learned from the literature on youth violence and child maltreatment prevention.

Second, the paper describes those primary prevention programs that have the potential to be effective either on the grounds of theory or knowledge of risk factors—even if there is currently little or no evidence to support them or where, in certain cases, they have not yet been widely implemented. In the process, an attempt is made to draw attention to the underlying theories, principles, and mechanisms on which the programs are based. However, it is noted that a firm theoretical base and consistency with identified risk factors do not guarantee the success of a program.

Third, the paper includes programs developed in LMIC settings on condition that they have some supporting evidence (even if it is weak) or are currently in the process of being evaluated, that they appear to have potential on theoretical grounds, or that they address known risk factors. The inclusion criteria are designed on the one hand to avoid setting the bar of methodological standards too high—which would lead to the exclusion of many of the programs developed in low-resource settings on the grounds that they have no or low-quality evidence supporting them. On the other hand, setting the bar too low would run the risk of appearing to endorse programs unsupported by evidence. However, the limitations of the evidence presented are clearly spelt out and the need for rigorous outcome evaluation studies emphasized.

Although still in its early stages, there are sound reasons to believe that this field is poised to expand rapidly in coming years. Some programs have been demonstrated to be effective following rigorous outcome evaluations, evidence is beginning to emerge to support the effectiveness of many more, and suggestions for potential strategies have proliferated. Furthermore, tried and tested methods for developing effective evidence-based primary prevention programs and policies for other forms of interpersonal violence have been reported. The field of evidence-based intimate partner and sexual violence prevention now requires an open mind to promising approaches and to innovative new ideas at all stages of the life cycle.

SUMMARY TABLES OF PRIMARY PREVENTION STRATEGIES AND PROGRAMS

Table 6-1 summarizes the strength of evidence for the effectiveness of those strategies to prevent intimate partner violence and sexual violence for which some evidence is available. Strategies are grouped according to life stage. An important distinction must be drawn between a strategy and a specific program. Although specific programs may have been demonstrated to be effective, this in no way implies that all other programs categorized under the same strategy are also effective. For example, the Nurse Family Partnership, developed in the United States, is a home-visitation program that has been demonstrated to be effective in preventing child maltreatment. Nevertheless, it is the only program within the broader strategy of home visitation (which includes a multitude of different programs) that is supported by solid evidence of its effectiveness (MacMillan et al., 2009). The outcome measures of effectiveness are described in Box 6-1 .

Primary Prevention Strategies for Intimate Partner Violence and Sexual Violence for Which Some Evidence Is Available.

Outcome Measures of Effectiveness. The effectiveness of a program can be evaluated in terms of three different types of outcome—each of which can be measured at different intervals after the program: Changes in knowledge, attitudes, and beliefs regarding (more...)

Strategies are ranked for their effectiveness in preventing intimate partner violence and sexual violence as follows:

• Effective: strategies that include one or more programs demonstrated to be effective. Effective refers to being supported by multiple well-designed studies showing prevention of perpetration and/or experience of intimate partner and/or sexual violence.
• Emerging evidence: strategies that include one or more programs for which evidence of effectiveness is emerging. Emerging evidence refers to being supported by one well-designed study showing prevention of perpetration and/or experience of intimate partner and/or sexual violence or studies showing positive changes in knowledge, attitudes, and beliefs related to intimate partner violence and/or sexual violence.
• Effectiveness unclear: strategies that include one or more programs of unclear effectiveness due to insufficient or mixed evidence.
• Emerging evidence of ineffectiveness: strategies that include one or more programs for which evidence of ineffectiveness is emerging. Emerging evidence refers to being supported by one well-designed study showing lack of prevention of perpetration and/or experience of intimate partner and/or sexual violence or studies showing an absence of changes in knowledge, attitudes, and beliefs related to intimate partner violence and/or sexual violence.
• Ineffective: strategies that include one or more programs shown to be ineffective. Ineffective refers to being supported by multiple well-designed studies showing lack of prevention of perpetration and/or experience of intimate partner and/or sexual violence.
• Probably harmful: strategies that include at least one well-designed study showing an increase in perpetration and/or experience of intimate partner and/or sexual violence or negative changes in knowledge, attitudes, and beliefs related to intimate partner and/or sexual violence.

As shown in Table 6-1 , there is currently only one strategy for the prevention of intimate partner violence that can be classified “effective” at preventing actual violence. This is the use of school-based programs to prevent violence within dating relationships. However, only three such programs—described below—have been demonstrated to be effective, and these findings cannot be extrapolated to other school-based programs using a different approach, content, or intensity. At present, there are no correspondingly evaluated effective programs against sexual violence.

Table 6-2 lists those strategies for which there is currently no evidence or very weak evidence but that appear to have potential on the grounds of theory, known risk factors, or outcome evaluations that are methodologically of lower quality; it also includes some promising strategies that are currently undergoing evaluation.

Primary Prevention Strategies for Intimate Partner Violence and Sexual Violence with Potential.

All the strategies reviewed have been organized according to the main life stages. When strategies are relevant to more than one life stage, they have been categorized under the stage at which they are most often delivered. Strategies relevant to all life stages are described last. Because of the way programs are organized, intimate partner violence is considered here to include instances of sexual violence that occur within an intimate partnership, while sexual violence is used here to refer to sexual violence occurring outside intimate partnerships (i.e., perpetrated by friends, acquaintances, or strangers). Dating violence can be considered to incorporate both possibilities because dating partners can range from being little more than acquaintances to more intimate partners. However, in Table 6-1 and Table 6-2 dating violence is classified for the sake of convenience under intimate partner violence.

During Infancy, Childhood, and Early Adolescence

Home-visitation and parent-education programs to prevent child maltreatment.

As noted in earlier sections of this document, a history of child maltreatment substantially increases the risk of an individual becoming either a perpetrator or victim of intimate partner violence and of sexual violence. It is therefore reasonable to assume that preventing child maltreatment has the potential to reduce subsequent intimate partner and sexual violence ( Foshee et al., 2009) . However, direct evidence of the effect of such programs on the levels of intimate partner violence is currently still lacking.

In general, however, reducing the risk of the different forms of child maltreatment reviewed in Preventing Child Maltreatment: A Guide to Taking Action and Generating Evidence ( WHO and International Society for Prevention of Child Abuse and Neglect, 2006 ) can contribute to reducing the intergenerational transmission of violence and abuse. The most promising strategies for preventing child maltreatment in this area include home-visitation and parent-education programs ( Mikton and Butchart, 2009) . However, neither type of program has been evaluated for its long-term effects on the prevention of intimate partner and sexual violence among the grown-up children of parents who were involved in such programs.

Improve Maternal Mental Health

Maternal depression (which affects at least 1 in 10 new mothers) can interfere with good bonding and attachment processes. This in turn increases the risk of persistent conduct disorders in children (a key risk factor for the later perpetration of violence) by as much as five-fold ( Meltzer et al., 2003) . Effective approaches for addressing maternal depression include early recognition (antenatally and postnatally) followed by peer and social support, psychological therapies, and antidepressant medication ( National Collaborating Centre for Mental Health, 2007) . The long-term effects on the children of mothers treated for maternal depression in terms of their later involvement in intimate partner and sexual violence have not been assessed, but the approach appears to have potential.

Identify and Treat Conduct and Emotional Disorders in Children

Conduct disorders in childhood and adolescence—a precursor of antisocial personality disorder—are associated with an increased risk of experiencing and/or perpetrating intimate partner and sexual violence. Additionally, emotional disorders are associated with later depression and anxiety in adult years and can increase the risk of postnatal depression and persistent maternal depression. As outlined above, these in turn contribute to as much as a five-fold increased risk of emotional or conduct disorders in the children of mothers with poor mental health ( Meltzer et al., 2003) . The early identification and effective treatment of conduct and emotional disorders in childhood and adolescence could therefore be expected to reduce the occurrence of subsequent intimate partner and sexual violence.

Good evidence exists of the links between early conduct disorder and later involvement in violence as both victim and perpetrator and of the effectiveness of interventions to reduce conduct disorder and youth offending. However, despite their potential, there is at present no evidence showing that the strategy of identifying and treating conduct and emotional disorders in childhood or early adolescence leads to reductions in intimate partner and sexual violence during later adolescence and adulthood.

Interventions for Children and Adolescents Subjected to Child Maltreatment and/or Exposed to Intimate Partner Violence

Because children or adolescents who have been subjected to child maltreatment or exposed to parental violence are at increased risk of becoming the perpetrators and victims of intimate partner and sexual violence, interventions in this area are particularly important.

One meta-analysis examined 21 programs involving psychological interventions targeted at children and adolescents who had experienced child maltreatment ( Skowron and Reinemann, 2005) . Results suggested that psychological treatments for child maltreatment yielded improvements among participants: Some 71 percent of treated children appeared to be functioning better than their non-treated counterparts. All of the interventions were designed to improve cognitive, emotional, and behavioral outcomes, with 11 of the studies considered to be experimental. A randomized trial of one of these programs used adolescent dating violence as an outcome and found a reduction in the experiencing and perpetration of physical and emotional abuse ( Wolfe et al., 2003) .

Psychological interventions for children and adolescents subjected to child maltreatment and/or exposed to intimate partner violence therefore appear to represent a strategy for the prevention of intimate partner violence supported by emerging evidence. Their effect on sexual violence remains unclear at present.

School-Based Social and Emotional Skills Development

Factors such as impulsiveness, lack of empathy, and poor social competence—which may be indicative of conduct disorder, a precursor of antisocial personality disorder—are important individual risk factors for perpetrating various forms of violence, including intimate partner and sexual violence. Cognitive-behavioral skills training programs and social development programs that address these factors in children and young adolescents are therefore promising strategies for preventing subsequent violence. These programs seek to promote pro-social behavior and to provide social and emotional skills such as problem solving, anger management, increased capacity for empathy, perspective taking, and non-violent conflict resolution. They can either be population-based or targeted at those at high risk and are typically delivered in schools. Although there is strong evidence that such programs can be effective in reducing youth violence and improving social skills, there is currently no evidence that they can reduce sexual and dating violence among adolescents and young adults or intimate partner and sexual violence later in life ( Lösel and Beelmann, 2003) . Nonetheless, they appear to have potential in preventing subsequent intimate partner violence and sexual violence.

School-Based Training to Help Children to Recognize and Avoid Potentially Sexually Abusive Situations

School-based programs to prevent child sexual abuse by teaching children to recognize and avoid potentially sexually abusive situations are run in many parts of the world, but evaluated examples come mainly from the United States. A recent systematic review of reviews found that although school-based programs to prevent child sexual abuse are effective at strengthening knowledge and protective behaviors against this type of abuse, evidence showing whether such programs reduce its actual occurrence is lacking ( Mikton and Butchart, 2009) . Two studies that measured future experience of sexual abuse as an outcome reported mixed results ( Finkelhor et al., 1995 ; Gibson and Leitemberg, 2000) . Nonetheless, emerging evidence of their effectiveness in preventing subsequent sexual abuse victimization appears to support the use of such programs. Further research on the long-term impact on actual sexual abuse victimization is, however, required ( Finkelhor, 2009) .

Bullying Prevention Programs

Bullying has both immediate and long-term consequences on perpetrators and victims, including social isolation and the exacerbation of antisocial behavior that can lead to juvenile and adult crime (for perpetrators) and depression, suicidal ideation, social isolation, and low self-esteem (for victims). Some of these consequences may increase the risk of later involvement in intimate partner and/or sexual violence either as perpetrator or victim. A number of reviews have concluded that bullying prevention programs are effective in reducing bullying ( Smith et al., 2004 ; Baldry and Farrington, 2007) . A systematic review and meta-analysis of school-based programs to reduce bullying and victimization showed that, overall, school-based bullying prevention programs are effective in reducing both bullying and being bullied ( Farrington and Ttofi, 2009) . On average, bullying perpetration decreased by 20 to 23 percent and the experiencing of being bullied decreased by 17 to 20 percent.

Although such programs are likely to have broader potential benefits, evidence of their effect on the experiencing or perpetrating of intimate partner and/or sexual violence later in life is limited. A number of studies, however, have demonstrated an association between bullying and sexual harassment. Some sexual violence prevention programs in the United States include bullying prevention components for elementary- and middle-school-age children ( Basile et al., 2009) .

During Adolescence and Early Adulthood

School-based programs to prevent dating violence.

Dating violence is an early form of partner violence, occurring primarily in adolescence and early adulthood, and experienced within a “dating relationship.” Dating violence prevention programs have been the most evaluated of all intimate partner violence prevention programs, with 12 evaluations of adolescent dating violence prevention programs, including 5 randomized trials ( Foshee et al., 2008) . Targeted at early sexual relationships, in contexts where marriage is usually entered into from about 20 years of age, these programs have been shown to prevent dating violence and sexual violence. Furthermore, dating violence appears to be a risk factor for intimate partner violence later in life and is also associated with injuries and health-compromising behaviors, such as unsafe sex, substance abuse, and suicide attempts ( Smith et al., 2003 ; Wolfe et al., 2009) . Accordingly, the prevention of dating violence can be assumed to be preventive of intimate partner and sexual violence in later life ( Foshee et al., 2009) .

One dating violence prevention program that has been well evaluated using a randomized controlled design is Safe Dates. Positive effects were noted in all four published evaluations ( Foshee et al., 1998 , 2000 , 2004 , 2005 ). Foshee et al. (2005) examined the effects of Safe Dates in preventing or reducing perpetration and victimization over time using four waves of follow-up data. The program significantly reduced psychological, moderate physical, and sexual dating violence perpetration at all four follow-up periods. The program also significantly reduced severe physical dating abuse perpetration over time, but only for adolescents who reported no or average prior involvement in severe physical perpetration at baseline. Program effects on the experiencing of sexual dating violence over time were marginal. Safe Dates did not prevent or reduce the experiencing of psychological dating abuse. Program effects were primarily due to changes in dating violence norms, gender role norms, and awareness of community services. The program did not affect conflict-management skills. The program was found to have had a greater impact upon primary prevention as opposed to preventing re-abuse among those with a history of previous abuse ( Foshee et al., 1996 , 1998 , 2000 , 2004 , 2008 ).

Two school-based programs for preventing dating violence in Ontario, Canada, have also been evaluated ( Wolfe et al., 2003 , 2009 ). An outcome evaluation of The Fourth R: Skills for Youth Relationships used a cluster-randomized design and found that, based on self-reported perpetration at 2.5-year follow-up, rates of physical dating violence were 7.4 percent in the program group and 9.8 percent in the control group—a difference of 2.4 percent. However, for reasons not fully understood, this decrease of self-reported perpetration was found in boys (7.1 percent in controls versus 2.7 percent in intervention students) but not in girls (12.1 percent versus 11.9 percent). The program—evaluated by sampling more than 1,700 hundred students aged 14 to 15 years from 20 public schools—was integrated into the existing health and physical education curriculum and taught in sex-segregated classes. An underlying theme of healthy, nonviolent relationship skills was woven throughout the 21 lessons, which included extensive skills development using graduated practice with peers to develop positive strategies for dealing with pressures and the resolution of conflict without abuse or violence. The cost of training and materials averaged 16 Canadian dollars per student ( Wolfe et al., 2009) .

The other Canadian school-based program that has been evaluated is the Youth Relationship Project ( Wolfe et al., 2003) . This community-based program aimed to help 14- to 16-year-olds who had been maltreated as children to develop healthy non-abusive relationships with dating partners. The program educated participants on both healthy and abusive relationships and helped them to acquire conflict resolution and communication skills. A randomized controlled trial showed that the program had been effective in reducing incidents of physical and emotional abuse and the symptoms of emotional distress over a 16-month period after the program ( Wolfe et al., 2003) . These three school-based programs therefore appear to be effective for the prevention of physical, sexual, and emotional violence in dating relationships in adolescents and may also help to prevent intimate partner and sexual violence among adults. However, there are a number of necessary caveats concerning dating violence prevention programs. Although high-quality evaluations of the three programs described above found reduced violence at moderately long follow-up periods, the evaluations of most other programs have been of poor quality, used short follow-up periods, and only included knowledge and attitude changes as outcomes (for which some positive effects were found). Whether changes in knowledge and attitudes lead to corresponding changes in behavior is uncertain ( Whitaker et al., 2006) . Moreover, further research is needed to evaluate the effectiveness of dating violence prevention programs in the longer term, when integrated with programs for the prevention of other forms of violence, and when delivered outside North America and in resource-poor settings. A particular concern that has been raised about programs such as Safe Dates is the extent to which they are culture-bound to North America and hence may be of limited value in LMICs.

School-Based Multi-Component Violence Prevention Programs

Universal multi-component programs are the most effective school-based violence prevention programs ( Dusenbury et al., 1997 ; Adi et al., 2007 ; Hahn et al., 2007) . Such programs are delivered to all pupils and go beyond the normal components of curriculum-based teaching to include teacher training in the management of behavior, parenting education, and peer mediation. There can also be after-school activities and/or community involvement. One systematic review estimated that, on average, universal multi-component programs reduced violence by 15 percent in schools that delivered the programs compared to those that did not ( Hahn et al., 2007) .

School-based multi-component violence prevention programs have mostly focused upon bullying and youth violence as outcomes. Given that the risk factors for youth violence and intimate partner and sexual violence are to some extent shared, such programs would appear to have some potential for preventing these latter forms of violence. However, there is currently no evidence of their effectiveness in these areas.

Sexual Violence Prevention Programs for School and College Populations

In the United States, the majority of programs for the primary prevention of sexual violence by strangers, acquaintances, and non-intimate dating partners have focused on college students—though they have also increasingly been delivered to high school and middle school pupils. In settings where few go into higher education this approach has obvious limitations. Developmentally, it makes sense to educate young people in appropriate and inappropriate sexual behavior at a time when their sexual identities are forming and their attitudes to romantic partners are beginning to take shape. However, once again there is a severe paucity of evidence to confirm the effectiveness or otherwise of such programs ( Schewe, 2007) .

Two recent systematic reviews in the United States have evaluated the effectiveness of specific primary prevention programs in this area. The first of these included college, high-school, and middle-school populations and found that programs usually included several components (most often the challenging of rape myths, information on acquaintance and date rape, statistics on rape, and risk reduction and protective prevention skills) ( Morrison et al., 2004) . Of the 50 studies reviewed, 7 (14 percent) showed exclusively positive effects on knowledge and attitudes, but none used the actual experiencing or perpetration of violence as outcomes; 40 (80 percent) reported mixed effects; and 3 (6 percent) indicated no effect. The studies also had a number of serious methodological limitations that led the reviewers to conclude that the effectiveness of such programs remains unclear. These limitations included the use of knowledge and attitude as the only outcome measures, studies of higher-quality design showing poorer results, and the positive effects of the programs being found to diminish over time.

The second systematic review examined 69 education programs for college students on sexual assault and found little evidence of the effectiveness of such programs in preventing such assaults or in increasing levels of rape empathy (the cognitive–emotional recognition of a rape victim's trauma) or awareness ( Anderson and Whiston, 2005) . However, the programs evaluated were found to increase factual knowledge about rape and to beneficially change attitudes toward it. The acute shortage of studies that use behavior as outcomes led the authors to conclude that more research using such outcomes was needed before definitive conclusions could be reached. The effectiveness of such programs, on the basis of these two reviews, is currently unclear. It has been found that the provision of “factual” information as part of addressing rape myths appears to have no effect on attitudes to rape or on the levels of empathy for its victims ( Schewe, 2007) . Evaluation studies indicate that rape awareness and knowledge programs based on imparting such information rarely work. Similarly, educating women on effective self-defense strategies without teaching them actual self-defense skills has been found to be of questionable value and may even be potentially harmful in some contexts ( Schewe, 2007) . Two evaluations of programs that focused on a discussion of self-defense strategies without teaching the corresponding skills found no reduction in sexual assault risk at follow-up ( Breitenbecher and Gidycz, 1998 ; Breitenbecher and Scarce, 2001) . Rape prevention programs that use a style of personal confrontation with participants actually appear to be harmful. One study evaluating such a program found that it resulted in greater tolerance among men of the justifiability of rape ( Fisher, 1986) .

A number of other approaches have been tried for which there is presently very limited evidence of effectiveness. Encouraging victim empathy has been associated with both improvements and worsening of attitudes toward sexual violence and the acceptance of rape myths ( Schewe, 2007) . Educating women on how to avoid high-risk situations (such as hitchhiking, abusing alcohol, or becoming involved with older men) has also led to mixed results, and it too has been associated with greater acceptance of rape myths. To avoid the encouragement of victim-blaming, it is crucial that such education is delivered to female-only audiences. There have also been mixed indications of the effectiveness of programs that emphasize the negative consequences of sexual violence to men and that try to persuade them to see such sex as less rewarding than consensual sex.

Finally, several programs for preventing sexual violence have been proposed that have as yet been neither widely implemented nor evaluated. These include providing universal rape prevention education and parent education in sexual violence prevention throughout schools and workplaces, educating teachers and coaches about sexual violence and its prevention, and changing organizational practices to include activities such as mandatory training in the prevention of violence against women.

During Adulthood

Empowerment and participatory approaches to reduce gender inequality.

Empowerment is an approach that helps individuals and communities to identify their own problems and to develop, through participatory methods, the resources, skills, and confidence needed to address them. This approach emphasizes the role of individuals and communities as agents of change and prioritizes community ownership and leadership of the entire process. Comprehensive programs deal with the community as a whole or with multiple subgroups of the population, have several components, and are designed to effect social change by creating a supportive environment for changing individual and community attitudes and behavior. Such approaches often utilize a combination of participatory rapid needs assessment, education or training, public awareness campaigns, and community action ( Lankester, 1992) .

Two examples of empowerment approaches for preventing intimate partner violence are the use of microfinance with gender-equality training and the Stepping Stones training package.

A number of initiatives involving microfinance have now been established to increase the economic and social power of women. These initiatives provide small loans to mobilize income-generating projects that can alleviate poverty. Stand-alone credit and rural development programs such as Grameen Bank and the Bangladesh Rural Advancement Committee target women and appear to show some promise in reducing intimate partner violence. However, the evaluation of such programs needs to take into account reports of lenders exploiting disadvantaged borrowers with very high rates of interest, which can trap people in debt and contribute to further poverty, as well as reports of increases in intimate partner violence ( Kabeer, 2001 ; Rhyne, 2001) . Disagreements over the control of newly acquired assets and earnings combined with women's changing attitudes toward traditional gender roles, improved social support, and greater confidence in defending themselves against male authority has sometimes led to marital conflicts and violence against women perpetrated by their partners ( Schuler et al., 1996) . Increases in violence following participation in credit programs have also been reported elsewhere, at least in the initial stages of membership ( Rahman, 1999 ; Ahmed, 2005) . Pre-existing gender roles appear to affect the violence-related outcomes of credit programs—in communities with rigid gender roles, women's involvement can result in increased levels of intimate partner violence not seen in communities with more flexible gender roles ( Koenig et al., 2003) . The outcome evaluations conducted to date of such stand-alone microfinance programs have not been as rigorous as that of the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) program described in Box 6-2 .

Intervention with Microfinance for AIDS and Gender Equity (IMAGE). One of the most rigorously evaluated and successful microfinance and women's empowerment programs to date has been the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) (more...)

Although microfinance programs can operate as discrete entities, IMAGE is an example of such a program that also incorporates education sessions and skills-building workshops to help change gender norms, improve communication in relationships, and empower women in other ways and has been shown to be effective at reducing intimate partner violence ( Kim et al., 2009) . Through education and skills building for women and engagement with boys and men and the broader community, IMAGE was effective in reducing intimate partner violence and supporting women. This was achieved without producing the type of negative effects seen in other settings where cultural shifts and other changes have taken place in the absence of efforts to engage men.

The Stepping Stones training package is another participatory approach that promotes communication and relationship skills within communities. Training sessions are run in parallel for single-sex groups of women and men. Originally designed for the prevention of HIV infection, several communities have now incorporated elements of violence prevention. The approach has been used in 40 LMICs in Africa, Asia, Europe, and Latin America. Versions of the program have now been evaluated in a number of countries ( Welbourn, 2009) . The most thorough evaluation to date has been a randomized controlled trial in the Eastern Cape province of South Africa, with participants aged 15 to 26 years. This study indicated that a lower proportion of men who had participated in the program committed physical or sexual intimate partner violence in the two years following the program compared with men in a control group ( Jewkes et al., 2008) .

Furthermore, an evaluation in Gambia compared two villages where the program was carried out with two control villages and followed participating couples over one year. It found that, compared to couples not receiving the program, communication was improved and quarrelling reduced in participating couples. In addition, participating men were found to be more accepting of a wife's refusal to have sex and less likely to beat her ( Paine et al., 2002) .

SASA! is an “activist kit” for mobilizing communities to prevent violence against women, focusing in particular on the connection between HIV/AIDS and violence against women. “Sasa” is a Kiswahili word meaning “now,” and the kit includes practical resources; activities-monitoring and assessment tools to support local activism, media, and advocacy activities; and communication and training materials. It targets community norms and traditional gender roles and aims to change knowledge, attitudes, skills, and behavior to redress the power imbalance between men and women. It was created by Raising Voices, a Uganda-based nongovernmental organization that works in the Horn of Africa and Southern Africa. The London School of Hygiene and Tropical Medicine, Raising Voices, the Kampala-based Center for Domestic Violence Prevention, and Makerere University are currently conducting a joint randomized controlled trial to evaluate the effectiveness of the approach.

Thus evidence is emerging of the effectiveness in LMICs of empowerment and participatory approaches in preventing intimate partner violence through microfinance combined with gender-equality training and through the Stepping Stones training package.

The results of the SASA! evaluation are expected to provide further evidence on the effectiveness of this type of program, which seems to have potential for reducing intimate partner violence. There is a need to replicate and scale up this type of approach. Several other participatory and community-empowerment strategies to prevent intimate partner violence may be of value, although these have seldom been implemented as primary prevention strategies or rigorously evaluated. Couples counseling focuses on violence and/or substance abuse and may be effective for couples who have not resorted to intimate partner violence but who may be at risk. Family programs to promote positive communication and healthy relationships and prevent family violence might also be effective in preventing both intimate partner and sexual violence, given the importance of family factors in their development. In Ecuador one intimate partner violence prevention program that was implemented (but not evaluated) consisted of close friends or relatives being assigned to “monitor” newlyweds and to intervene should serious conflict arise. There is also some initial evidence that social cohesion among residents increases a community's capacity to manage crime and violence (by increasing “collective efficacy”), leading to decreases in both lethal and non-lethal intimate partner violence. Such community-level interventions can beneficially change community-level characteristics and warrant further evaluation.

Home Visitation Programs to Prevent Intimate Partner Violence

A systematic review of home visitation programs ( Bilukha et al., 2005) identified only one evaluation study ( Eckenrode et al., 2000) that examined the effect of home visitation on levels of intimate partner violence. No significant difference in the incidence of such violence among the program and control groups was found.

A five-year project (2007-2012) funded by U.S. Centers for Disease Control and Prevention is currently under way, which will develop, test, and evaluate a program to reduce intimate partner violence among low-income women enrolled in the Nurse Family Partnership during pregnancy and in the first two years postpartum. The Nurse Family Partnership is a nurse home visitation program of demonstrated effectiveness in reducing child maltreatment. The primary aims are to develop a model for an in-home intimate partner violence prevention program for enrolled mothers at risk of such violence, to test the feasibility and acceptability of the program, and in a randomized controlled study to compare the effectiveness of the approach to that of the Nurse Family Partnership alone.

An evaluation of the Hawaii Healthy Start Program—an early childhood home visitation program—found that when compared with a control group, the participation of mothers was associated with reduced perpetration and experiencing of intimate partner violence. The effect persisted for the first three years of a child's life, with small decreases in both the perpetration and experiencing of maternal intimate partner violence at follow-up when the child was seven and nine years old ( Bair-Merritt et al., 2010) . Evidence for the effectiveness of such programs can currently thus be considered to be unclear.

U.S. Air Force Multi-Component Program to Prevent Suicide

This program was primarily aimed at reducing the rate of suicide among U.S. Air Force (USAF) personnel but was also shown to reduce “family violence,” which included both intimate partner violence and child maltreatment. The program was based upon:

• the full involvement of the USAF leadership to ensure the program had the support of the entire service;
• incorporation of suicide prevention into professional military education;
• community education and training of military personnel to identify risk factors, provide appropriate intervention, and refer individuals who were potentially at risk of suicide; and
• the creation of a multidisciplinary team consisting of mental health providers, medical providers, and chaplains who could respond to traumatic events at the community level, including suicides.

The program reduced the rate of suicide by 33 percent and the rates of severe and moderate family violence by 54 percent and 30 percent, respectively. Because of the combination of intimate partner violence and child maltreatment in the same outcome measure, it is not possible to determine the effect of the program on intimate partner violence specifically ( Knox et al., 2003) ; hence this program is considered to have potential, rather than being supported by emerging evidence.

All Life Stages

Reduce access to and harmful use of alcohol.

Harmful use of alcohol is associated with the perpetration of intimate partner and sexual violence ( WHO and LSHTM, 2010c) . It can therefore be hypothesized that reducing both access to alcohol and its harmful use will lead to reductions in intimate partner and sexual violence. However, the relationship between harmful use of alcohol and violence is complex—not everyone who drinks is at equally increased risk of committing violence, and intimate partner and sexual violence can occur at high rates in cultures where alcohol use is taboo. Furthermore, there is disagreement among experts on whether or not alcohol can be considered to be a “cause” of intimate partner and sexual violence or whether it is better viewed as a moderating or contributory factor. It seems clear, however, that individual and societal beliefs that alcohol causes aggression can lead to violent behavior being expected when individuals are under the influence of alcohol and to alcohol being used to prepare for and excuse such violence. To date, research focusing on the prevention of alcohol-related intimate partner and sexual violence is scarce. There is, however, some emerging evidence suggesting that the following strategies aimed at reducing alcohol consumption may be effective in preventing intimate partner violence:

• Reducing alcohol availability: In Australia, a community intervention that included restricting the hours of sale of alcohol in one town reduced the number of domestic violence victims presenting to hospital ( Douglas, 1998) . In Greenland, a coupon-based alcohol rationing system implemented in the 1980s that entitled adults to alcohol equivalent to 72 beers per month saw a subsequent 58 percent reduction in the number of police call outs for domestic quarrels ( Finnish Foundation for Alcohol Studies and World Health Organization, 2003 ).
• Regulating alcohol prices: Increasing the price of alcohol is an effective means of reducing alcohol-related violence in general ( Chaloupka et al., 2002) . Although research evaluating the effectiveness of this approach in reducing intimate partner violence specifically is scarce, one study using economic modeling estimated that in the United States a 1 percent increase in the price of alcohol may decrease the probability of intimate partner violence toward women by about 5 percent ( Markowitz, 2000) .
• Treatment for alcohol-use disorders: In the United States, treatment for alcohol dependence among males significantly decreased husband-to-wife and wife-to-husband intimate partner violence 6 and 12 months later, suggesting that such treatment may also be an effective primary prevention measure ( Stuart et al., 2003) .

Intimate partner and sexual violence may also be reduced through primary prevention programs to reduce the more general harms caused by alcohol ( Anderson et al., 2009) . Approaches for which effectiveness is well supported by evidence include:

• Making alcohol less available: This can be achieved by introducing minimum purchase-age policies and reducing the density of alcohol retail outlets and the hours or days alcohol can be sold. Such an approach has been shown to lead to fewer alcohol-related problems, including homicide and assaults ( Duailibi et al., 2007) .
• Banning of alcohol advertising: Alcohol is marketed through increasingly sophisticated advertising in mainstream media; through the linking of alcohol brands to sports and cultural activities; through sponsorships and product placements; and through direct marketing via the Internet, podcasting, and mobile telephones. The strongest evidence for the link between alcohol advertising and consumption comes from longitudinal studies on the effects of various forms of alcohol marketing—including exposure to alcohol advertising in traditional media and promotion in the form of movie content and alcohol-branded merchandise—on the initiation of youth drinking and on riskier patterns of youth drinking ( Anderson et al., 2009) . However, evidence showing that such measures reduce intimate partner and sexual violence is currently lacking.
• Individually directed interventions to drinkers already at risk: These include screening and brief interventions. Alcohol screening and brief interventions in primary health care settings have proven effective in reducing levels and intensity of consumption in LMICs and HICs ( Finnish Foundation for Alcohol Studies and World Health Organization, 2003 ). However, their direct effect on alcohol-related intimate partner violence has not been measured. Evidence indicates that drinkers may reduce their consumption by as much as 20 percent following a brief intervention and that heavy drinkers who receive such an intervention are twice as likely to reduce their alcohol consumption as heavy drinkers who receive no intervention. Brief interventions include the opportune provision of advice and information in health or criminal justice settings (typically during a 5- to 10-minute period) but can also extend to several sessions of motivational interviewing or counseling ( FPH, 2008 ; Sheehan, 2008) .

School-based education on alcohol does not appear to reduce harm, but public-information and education programs (while again apparently ineffective at reducing alcohol-related harm) can increase the attention given to alcohol on public and political agendas ( Anderson et al., 2009) .

As with most primary prevention programs to prevent intimate partner and sexual violence, programs to reduce access to and harmful use of alcohol have mainly been conducted and evaluated in HICs, and little is known of their suitability or effectiveness outside such countries. For many LMICs, programs such as efforts to strengthen and expand the licensing of outlets could be of great value in reducing alcohol-related intimate partner and sexual violence. In many developing societies, a large proportion of alcohol production and sales currently takes place in unregulated informal markets. One study in São Paolo, Brazil, found that just 35 percent of alcohol outlets surveyed had a license of some form, and that alcohol vendors (whether licensed or not) faced few apparent restrictions on trading ( Laranjeira and Hinkly, 2002) . Furthermore, in many LMICs there are far fewer specialist health facilities, reducing the opportunities for alcohol treatment or screening. In such settings it may instead be beneficial to develop the role of primary health care workers or general practitioners in identifying and alleviating the harmful use of alcohol.

Although evidence for the effectiveness of measures to reduce access to and harmful use of alcohol is only beginning to emerge and high-quality studies showing their impact on intimate partner and sexual violence are still largely lacking, alcohol-related programs for the prevention of intimate partner violence and sexual violence appear promising. The strong association between alcohol and intimate partner and sexual violence suggests that primary prevention interventions to reduce the harm caused by alcohol could potentially be effective. Approaches to preventing alcohol-related intimate partner and sexual violence should also address the social acceptability of excessive drinking as a mitigating factor in violence, while altering normative beliefs about masculinity and heavy drinking. There remains a pressing need for additional research to evaluate the effectiveness of such approaches in reducing intimate partner and sexual violence, especially in LMICs.

Change Social and Cultural Norms Related to Gender That Support Intimate Partner and Sexual Violence

Cultural and social gender norms are the rules or “expectations of behavior” that regulate the roles and relationships of men and women within a specific cultural or social group. Often unspoken, these norms define what is considered appropriate behavior, govern what is and is not acceptable, and shape the interactions between men and women. Individuals are discouraged from violating these norms through the threat of social disapproval or punishment or because of feelings of guilt and shame in contravening internalized norms of conduct. Often traditional social and cultural gender norms make women vulnerable to violence from intimate partners, place women and girls at increased risk of sexual violence, and condone or support the acceptability of violence ( Box 6-3 ).

Examples of Social and Cultural Norms That Support Violence Against Women. A man has a right to assert power over a woman and is considered socially superior. Examples: India (Mitra and Singh, 2007), Nigeria (Ilika, 2005), and Ghana (Amoakohene, 2004). (more...)

Efforts to change social norms that support intimate partner and sexual violence are therefore a key element in the primary prevention of these forms of violence. Approaches have been adopted, although rarely evaluated, throughout the world to break the silence that often surrounds intimate partner and sexual violence, to try to inform and influence social attitudes and social norms on the acceptability of violence, and to build political will to address the problem. The use of research findings for advocacy has been shown to be promising in bringing attention to, and raising awareness of, the problem and in contributing to the shaping of reforms and policies ( Ellsberg et al., 1997) . Currently the three main approaches for changing social and cultural norms that support intimate partner and sexual violence are social norms theory (i.e., correcting misperceptions that the use of such violence is a highly prevalent normative behavior among peers), media awareness campaigns, and working with men and boys. Often several approaches are used in one program.

Social norms theory assumes that people have mistaken perceptions of other people's attitudes and behaviors. The prevalence of risk behaviors (such as heavy alcohol use or tolerance of violent behavior) is usually overestimated, while protective behaviors are normally underestimated. This affects individual behavior in two ways: (1) by increasing and justifying risk behaviors, and (2) by increasing the likelihood of an individual remaining silent about any discomfort caused by risky behaviors (thereby reinforcing social tolerance). The social norms approach seeks to rectify these misperceptions by generating a more realistic understanding of actual behavioral norms, thereby reducing risky behavior.

In the United States, the social norms approach has been applied to the problem of sexual violence among college students. Among such students, men appeared to underestimate both the importance most men and women place on sexual consent and the willingness of most men to intervene against sexual assault ( Fabiano et al., 2003) . Although the evidence is limited, some positive results have been reported. In one university in the United States, the A Man Respects a Woman project aimed to reduce the sexual assault of women, increase accurate perceptions of non-coercive sexual behavior norms, and reduce self-reported coercive behaviors by men. The project used a social norms marketing campaign targeting men, a theater presentation addressing socialization issues, and male peer-to-peer education. Evaluation of the campaign two years after its implementation found that men had more accurate perceptions of other men's behavior and improved attitudes and beliefs regarding sexual abuse. For example, a decreased percentage of men believed that the average male student has sex when his partner is intoxicated; will not stop sexual activity when asked to if he is already sexually aroused; and, when wanting to touch someone sexually, tries and sees how they react. However, the percentage of men indicating that they have sex when their partner is intoxicated increased ( Bruce, 2002) .

Media awareness campaigns are a common approach to the primary prevention of intimate partner and sexual violence. Campaign goals might include raising public awareness (for example, about the extent of the problem, about intimate partner violence, and sexual violence as violations of women's human rights and about men's role in ending violence against women); providing accurate information; dispelling myths and stereotypes about intimate partner violence and sexual violence; and changing public opinion. Such campaigns have the potential to reach large numbers of people. An example of a media-awareness campaign is Soul City in South Africa. This multimedia health promotion and change project examines a variety of health and development issues, imparts information and aims to change social norms, attitudes, and practice. It is directed at individuals, communities, and the socio-political environment. One of its components aims to change the attitudes and norms that support intimate partner and sexual violence. This multi-level intervention was launched over six months and consisted of a series of television and radio broadcasts, print materials, and a helpline. In partnership with a national coalition on preventing intimate partner violence, an advocacy campaign was also directed at the national government with the aim of achieving implementation of the Domestic Violence Act of 1998. The strategy aimed for impact at multiple levels from individual knowledge, attitudes, self-efficacy, and behavior to community dialogue, shifting social norms, and the creating of an enabling legal and social environment for change. An independent evaluation of the program included national surveys before and after the intervention, focus groups, and in-depth interviews with target audience members and stakeholders at various levels. It found that the program had facilitated implementation of the Domestic Violence Act of 1998, had positively impacted on problematic social norms and beliefs (such as that intimate partner violence is a private matter), and had improved levels of knowledge of where to seek help. Attempts were also made to measure its impact on violent behavior, but there were insufficient data to determine this accurately ( Usdin et al., 2005) .

As the Soul City project indicates, evidence is emerging that media campaigns combined with other educational opportunities can change knowledge, attitudes, and beliefs related to intimate partner and sexual violence. Although good campaigns can increase knowledge and awareness, influence perceptions and attitudes, and foster political will for action, evidence of their effectiveness in changing behavior remains insufficient ( Whitaker et al., 2007a) .

Working with men and boys —There has been an increasing tendency to focus efforts to change social and cultural norms on adolescent males or younger boys using universal or targeted programs that are delivered through a variety of mechanisms, including school-based initiatives, community mobilization, and public awareness campaigns.

Objectives typically include increasing an individual's knowledge, changing attitudes toward gender norms and violence, and changing social norms around masculinity, power, gender, and violence. Some programs also aim to develop the capacity and confidence of boys and young men to speak up and intervene against violence, with the goal of changing the social climate in which it occurs ( Katz, 2006) . Failure to engage men and boys in prevention may result in the type of negative effects seen in some settings where cultural shifts and other changes have taken place in the absence of efforts to engage them ( Box 6-4 ).

Nicaraguan Backlash Shows the Need to Engage Men as Well. Since 2000, Nicaragua has pioneered a number of initiatives to protect women against domestic violence. These have included: a network of police stations for women (Comisaria de la Mujer) where (more...)

A review of programs that work with men and boys to prevent violence against women ( Barker et al., 2007) included 13 primary prevention programs, 5 of which were implemented in LMICs. Four of these programs were judged by the reviewers to be “effective,” six “promising,” and three “unclear.” For example, one community outreach and mobilization campaign in Nicaragua judged to be effective was called Violence Against Women: A Disaster We Can Prevent as Men ( Solórzano et al., 2000) . This was aimed at men aged 20-39 years who were affected by Hurricane Mitch. The campaign's main messages addressed men's ability and responsibility to help prevent or reduce violence against their partners. Constructing masculinity without intimate partner violence was a group-education program aimed at men in periurban districts of Managua, Nicaragua ( Welsh, 1997) . The effect of the program was, however, unclear because of the weakness of the outcome evaluation.

Indeed, the methodological quality of most of the outcome evaluations was very low, and outcome measures consisted mainly of attitude changes and self-reported rates of gender-based violence, often using only small sample sizes. One campaign in New South Wales in Australia—Violence Against Women: It's Against All the Rules—targeted 21- to 29-year-old men and aimed to influence their attitudes. Sports celebrities delivered the message that violence toward women is unacceptable and that a masculine man is not a violent man. It also sought to enhance the community's capacity to challenge and address violence against women. A post-campaign survey indicated that the campaign achieved some positive results: 83 percent of the respondents reported that the message of the campaign was that violence against women is “not on,” and 59 percent of respondents could recall the campaign slogan. However, 91 percent of the target group reported that the issue was not one they would talk about with their peers, irrespective of the campaign.

Similarly, in the United States Men Can Stop Rape runs a public education campaign for men and boys with the message: “My strength is not for hurting.” This campaign runs in conjunction with Men of Strength (MOST) clubs—a primary prevention program that provides high-school-age young men with a structured and supportive space to learn about healthy masculinity and the redefining of male strength.

Although programs to alter cultural and social norms are among the most visible and ubiquitous of all strategies for preventing intimate partner and sexual violence, they remain one of the least evaluated. Even where evaluations have been undertaken, these have typically measured changes in attitudes and beliefs rather than in the occurrence of the violent behaviors themselves, making it difficult to draw firm conclusions on their effectiveness in actually preventing intimate partner and sexual violence. Nonetheless, some evidence is emerging to support the use of the three types of programs reviewed above in changing the social and cultural gender norms that support intimate partner and sexual violence. However, these must now be taken to scale and more rigorously evaluated.

KEY MESSAGES

• To achieve change at the population level it is important to target societal-level factors in the primary prevention of intimate partner and sexual violence. Approaches include the enactment of legislation and the development of supporting policies that protect women, addressing discrimination against women, and helping to move the culture away from violence—thereby acting as a foundation for further prevention work.
• Currently, there are no strategies of demonstrated effectiveness 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 programs for adolescents to prevent violence within dating relationships—and this still needs to be assessed for use in resource-poor settings.
• Although it is too early to consider them proven, evidence is emerging of the effectiveness of several other strategies for the prevention of intimate partner and sexual violence, particularly the use of microfinance with gender equality training and of programs that promote communication and relationship skills within communities.
• Developing the evidence base for programs for the primary prevention of intimate partner and sexual violence is still very much in the early stages. But there is every reason to believe that rigorous outcome evaluations of existing programs and the development of new programs based on sound theory and known risk factors will lead to a rapid expansion in coming years.

INTERNATIONAL MEN AND GENDER EQUALITY SURVEY 2

The International Men and Gender Equality Survey (IMAGES) is a comprehensive household questionnaire on men's attitudes and practices—as well as women's opinions and reports of men's practices—on a wide variety of topics related to gender equality. From 2009 to 2010, household surveys were administered to more than 8,000 men and 3,500 women ages 18 to 59 in Brazil, Chile, Croatia, India, Mexico, and Rwanda. Topics in the questionnaire included gender-based violence, health and health-related practices, household division of labor, men's participation in care-giving and as fathers, men's and women's attitudes about gender and gender-related policies, transactional sex, men's reports of criminal behavior, and quality of life. This report focuses on the initial, comparative analysis of results from the men's questionnaires across the six countries, with women's reports on key variables.

Methodology

IMAGES followed standard procedures for carrying out representative household surveys in each participating city, with the exception of Rwanda, where the survey is a nationally representative household sample. The survey was carried out in one or more urban settings in each country (and rural and urban areas in Rwanda) with men and women ages 18 to 59, guided by the following parameters:

• The men's questionnaire has approximately 250 items and took from 45 minutes to an hour to administer; the questionnaire for women is slightly shorter and took from 35 minutes to an hour to administer. The survey instruments were pretested in the participating countries, and the study protocol was approved by the institutional review board (IRB) of the International Center for Research on Women and by in-country IRBs, when such existed.
• The survey instrument was designed to be relevant for adult men and women in stable, co-habitating relationships as well as those not in a stable relationship; women and men who define themselves as heterosexual as well as men and women of different sexual orientations and practices; and women and men who have children in the household (biological or otherwise) and those who do not.
• Double-back translation of the questionnaire was carried out to ensure comparability and consistency of questions across settings. Some country-specific questions were included; some countries excluded items because of local political or cultural considerations.
• In Brazil, Chile, Mexico, and Rwanda the questionnaire was an interviewer-administered paper questionnaire. In India the questionnaire was carried out using hand-held computers, with a mixture of self-administered questions and interviewer-asked questions. In Croatia the questionnaire was self-administered (using a paper questionnaire). Standard procedures were followed for ensuring anonymity and confidentiality.
• All research sites followed standard World Health Organization (WHO) practices for carrying out research on intimate partner violence in terms of offering referrals and information for services and special training of interviewers. Following these guidelines, men and women were not interviewed from the same household in any of the research sites.
• More sensitive questions were asked later in the questionnaire, and some key variables were included in multiple questions (to compare and thus be more informed in affirming validity). The questionnaire was pretested in all the settings prior to application.
• In all settings, male interviewers interviewed male respondents, and female interviewers interviewed female respondents, with the exception of Mexico, where some interviews with men were carried out by female interviewers (but only women interviewed women).
• Survey locations were chosen to represent different contexts in each country to achieve a mixture of major urban areas and a secondary city or cities. Within a survey location, neighborhoods or blocks were chosen based on population distributions from the most recent census data. Rural areas were included only in Rwanda and Croatia. Stratified random sampling and probability proportion to size sampling methods were used within each neighborhood or community to ensure the inclusion of adequate sample sizes by age and residence (and also socioeconomic status in the case of Chile).
• Although every participating country's questionnaire included questions on all the themes that make up IMAGES, the questionnaire is not identical in all countries; thus data are not available from every country for every question. The questionnaire in Rwanda was the most abbreviated of the six study countries because of the much larger sample size—and thus the sheer number of interviews—required to make the study nationally representative. In those cases where Rwandan data does not appear in a table or figure in this document, that particular question was not included in the Rwandan questionnaire.

The questionnaire covers key topics in gender equality, including intimate relationships, family dynamics, and key health and social vulnerabilities for men. Based on previous research that found associations between early childhood exposure to violence and different gendered practices related to childrearing, items on childhood antecedents to particular men's practices were included. Specific topics in the questionnaire include:

Employment. Employment experience; unemployment and underemployment; stress and reactions associated with unemployment; reaction by spouse/partner when unemployed; income differentials between men and women; perceived gender dynamics in the workplace; work–life balance; and job satisfaction.

Education. Educational attainment; perceived gender norms and patterns in school.

Childhood experiences. Victimization by violence as children; witnessing of gender-based violence; gender-related attitudes perceived in family of origin; changes perceived from previous generation to the present; gender balance in work/child care in family of origin; gender patterns of childhood friendships.

Relations at home (in current household). Marital/cohabitation status; division/participation in household chores; perceived satisfaction in family life; household decision making; time use in specific domestic chores and family care, including child care.

Parenting and men's relationships with their children (and with non-related children who may live in the household). Number of children; living situation of each child; time/money spent in care of each child; use of paternity/maternity leave; perceptions/attitudes toward existing parental leave in country; and child-care arrangements.

Attitudes toward women and masculinity. Attitudes toward gender equality (using the Gender-Equitable Men [GEM] Scale and other measures); attitudes toward various gender-equality policies that may have been implemented in each country.

Health and quality of life. Lifestyle questions (substance use, exercise, etc.); use of health services; sexual and reproductive behavior (contraceptive use, condom use); sexually transmitted infections, including HIV (past history, HIV testing); satisfaction with sexual relations; mental health issues (depression, suicide ideation); social support; use of/victimization by violence in other contexts; morbidity.

Partner relations and spousal relations. Current relationship status/satisfaction; use of services/help-seeking in times of violence or relationship stress; relationship history.

Relationship, gender-based violence, and transactional sex. Use of violence (physical, sexual, psychological) against partner (using WHO protocol); victimization of violence by partner (using WHO protocol); men's use of sexual violence against non-partners; men's self-reported purchasing of sex or paying for sex, including with underage individuals.

Sexual behavior. Sexual experience; sexual orientation; behaviors related to sexual and reproductive health, HIV/AIDS; use of health services related to sexual and reproductive health.

Analytical Strategy

The report focuses on men's attitudes and practices related to relationship dynamics, parenting and caregiving, health-related practices and vulnerabilities, violence (intimate partner violence and other forms), transactional sex, and attitudes toward existing gender equality policies. Women's reports of men's practices are included for some key variables.

The selection of questions in this initial data analysis was informed by previous research confirming the associations or impact of early childhood experiences, individually held gender-related attitudes, educational attainment, age (as a proxy of generational differences as well as developmental stage), social class (or income), and employment status and economic stress on women's and men's attitudes and practices in terms of their intimate relationships, their sexual practices, their use of violence, their domestic practices, and their health-seeking behaviors. Men's knowledge of and attitudes toward key policy issues related to gender equality are also included. The report focuses on descriptive statistics and bi-variate analyses of the associations between these practices and educational levels, economic or work-related stress, gender-related attitudes, and age. In all cases where statistically significant differences are reported, these are at the p < .05 level as assessed using the Pearson's chi-square test. As noted earlier, we also have an interest in understanding generational changes, or changes over time, in terms of men's practices. IMAGES is not a longitudinal study; nonetheless, by comparing responses stratified by age groups we can make some inferences about generational change.

Key Findings

Work-related stress.

Work-related stress is commonplace in all survey sites. Between 34 percent and 88 percent of men in the survey sites reported feeling stress or depression because of not having enough income or enough work. Men who experienced work-related stress were more likely to report depression, suicide ideation, previous arrests, and use of violence against intimate partners.

Gender Attitudes

Men showed tremendous variation in their gender-related attitudes, with India and Rwanda showing the most inequitable attitudes. As a measure of men's and women's gender-related attitudes, IMAGES applied the GEM Scale. Rwandan and Indian men consistently supported the least equitable norms among the settings studied. For example, for the statement “Changing diapers, giving kids a bath and feeding kids are the mother's responsibility,” only 10 percent of men in Brazil agreed, whereas 61 percent in Rwanda and more than 80 percent in India agreed with the statement. Men with higher educational attainment and married men had more equitable attitudes; unmarried men had the least equitable attitudes. Homophobic attitudes were common, although they varied tremendously by context. Men who said they would be ashamed to have a gay son ranged from 43 percent of men in Brazil to a high of 92 percent in India. A slightly lower, but still high proportion of men said that being around homosexual men makes them uncomfortable, ranging from a low of 21 percent of men in Brazil to a high of 89 percent in India. Younger men and men with higher levels of education were generally less homophobic.

Relationship Dynamics and Domestic Duties

Younger men, men with more education, and men who saw their fathers do domestic work are more likely to carry out domestic duties. Nearly half of men in all the sites said they play an equal or greater role in one or more household duties—with the exception of India, where only 16 percent of men reported that they played an equal or greater role in household duties. These household or domestic duties included washing clothes, repairing the house, buying food, cleaning the house, cleaning the bathroom or toilet, preparing food, and paying the bills. The tasks that men said they play an equal or greater role in are those traditionally associated with men—namely repairing the house, paying bills, and buying groceries. Men reported higher levels of sexual and relationship satisfaction than women. Women who said their partners do more domestic work are more sexually satisfied. Men reported relatively high rates of sexual satisfaction with their current stable partners, ranging from 77 percent in Croatia to 98 percent in India. In all the countries except India, men who reported more gender-equitable attitudes were more likely to report being sexually satisfied with their current female partner. In India, Brazil, and Croatia, women who reported that their male partner plays an equal or greater role in one or more domestic duties also reported higher levels of overall relationship and sexual satisfaction.

Parenting and Involvement in Childbirth

The majority of men were neither in the delivery room nor in the hospital for the birth of their last child. In Chile, however, a dramatic generational shift is under way in men's presence at childbirth. Younger Chilean men reported much greater rates of presence in the delivery room for the birth of their last child than older men. This shift is largely due to a national policy, aimed at “humanizing” the birth process, which encourages women to have a male partner or other person of their choice present during birth at public maternity wards. Men are taking few days of paid or unpaid paternity leave. Among men who took leave, the average duration ranged from 3.36 to 11.49 days of paid leave and from 3.8 to 10 days of unpaid leave. Younger men and men with more education were more likely to take leave. Close to half of men with children said they are involved in some daily care-giving. Unemployed men are dramatically more likely to participate in the care of children than employed men. For men with children under age four, play is the most common daily activity in which they participate (as affirmed by women and men).

Health Practices and Vulnerabilities

Men's rates of regular abuse of alcohol—defined as having five or more drinks in one night on a once monthly or greater basis—vary from 23 percent in India to 69 percent in Brazil and are significantly higher than women's reported alcohol abuse in all survey sites. In most sites, younger men and men with more inequitable gender attitudes are more likely to regularly abuse alcohol. High proportions of women who reported having sought an abortion affirmed that a male partner was involved in the decision to seek an abortion (ranging from 39 percent to 92 percent). Men reported high self-esteem, with the exceptions of Croatia and India; at the same time, men showed relatively high levels of depression and suicide ideation. The rates of experiencing depression at least once in the past month ranged from 9 percent in Brazil to a high of 33 percent in Croatia. The percentages of male respondents who reported having suicidal thoughts “sometimes or often” in the past month ranged from 1 percent in Brazil and Mexico to 5 percent in Croatia.

Violence and Criminal Practices

Men reported lifetime rates of physical intimate partner violence ranging from 25 percent to 40 percent, with women reporting slightly higher rates. Factors associated with men's use of violence were rigid gender attitudes, work stress, experiences of violence in childhood, and alcohol use. Men's reports of perpetration of sexual violence against women and girls ranged from 6 percent to 29 percent; in India and Mexico the majority of sexual violence took place against a current or former partner. Relatively high percentages of men reported ever having participated in criminal or delinquent acts; between 6 percent and 29 percent of men reported ever having been arrested. In terms of factors associated with men's participation in criminal activity, men's socioeconomic situation was the most significant. Men who owned firearms or carried out violence or criminal behavior were also more likely to report having used intimate partner violence.

Transactional Sex

Between 16 and 56 percent of men surveyed said they have paid for sex at least once. Men with lower educational attainment and less gender-equitable attitudes and men who reported less sexual satisfaction with their current partner were more likely to have paid for sex.

Knowledge and Attitudes About Policies and Laws Related to Gender Equality

Men in all the countries, with the exception of India, were generally supportive of gender equality, with 87 percent to 90 percent agreeing that “Men do not lose out when women's rights are promoted.” Even when asked about specific policies—quotas for women in executive positions, in university enrollment, or in government—men's support for such policies was reasonably high, with 40 percent to 74 percent of men supporting such quotas. Among themes related to gender equality, men reported the highest exposure to campaigns about gender-based violence. At the same time, across the sites, men showed negative attitudes toward laws related to gender-based violence.

Overall, IMAGES results affirm that gender equality should be promoted as a gain for women and men. Change seems to be happening as younger men and men with higher levels of education show more gender-equitable attitudes and practices. Men who reported more gender-equitable attitudes are more likely to be happy, to talk to their partners, and to have better sex lives. Women who reported that their partners participate in daily care work report higher levels of relationship and sexual satisfaction. Findings suggest that most men in most of the survey sites accept gender equality in the abstract even if they are not yet living it in their daily practices.

• THE SCIENCE OF PREVENTION/INTERRUPTING THE CYCLE OF VIOLENCE

Affiliations

This summary describes what we know and, perhaps more importantly, what we don't know about intervening in the cycle of violence. It encompasses both direct child abuse and exposure to domestic violence. First, the term cycle of violence is clarified, as it is a term that has been adopted into the everyday lexicon without much clarity of concept. Next is a review of some of the key findings from comprehensive review papers summarizing child abuse prevention. Finally, five gaps are identified that indicate possible future directions for research into primary prevention in this domain.

What Is the Cycle of Violence

The cycle of violence is a phrase used to describe the observed intergenerational pattern by which many children and youth who experience direct or indirect exposure to violence later come to perpetrate violence in their own relationships. For example, children who experience child abuse and are exposed to domestic violence are at an elevated risk for perpetrating dating violence and domestic violence. Essentially, there is a continuity in their relationships such that problems with violence are evident in different ways at different times. Researchers tend to look at this cycle from different vantage points depending on their main areas of interest. Bullying researchers, for example, might note that children who bully others are more likely to perpetrate dating violence as adolescents. 3 Dating violence researchers might look at the continuity of violence between dating and adult intimate partner relationships. The investigation of direct and indirect exposure to violence has even been segmented, with child abuse researchers tending to focus on the former and domestic violence researchers tending to take on the latter. The result is a greatly segmented landscape, but one that can be pieced together to depict the cycle shown in Figure 6-1 .

Cycles of violence. SOURCE: Crooks, 2011.

It is crucial to understand that the cycle of violence is probabilistic, not determinative. That is, experiencing child abuse increases the risk for subsequently perpetrating violence in relationships, but there is significant variability in trajectories. There are a few important qualifiers for the cycle of violence idea, and they are discussed below.

Abusive Behavior Is Multiply Determined

There is no one pathway to abusive behavior. Rather, it is a final com mon pathway for a host of social, behavioral, biological, and personality risk factors. Results of a 20-year prospective study show that children's direct and indirect exposure to violence are important risk factors for perpetration of abusive behavior ( Ehrensaft et al., 2001) . Furthermore, the risk for experiencing intimate partner violence as an adult (as a victim or perpetrator) increases with the number of types of abuse and additional stressors experienced as a child ( Whitfield et al., 2003) . At the same time, many children and youth who are abused do not become perpetrators of abuse with their own children. A review of studies suggested that approximately one-third became seriously inept, abusive, or neglectful as parents of their own children; an additional one-third remained at risk for perpetrating child abuse because of their vulnerability to social stress; while the remaining one-third were not abusive ( Oliver, 1993) .

Experiences of Abuse Show a Dosage Response

The Adverse Childhood Experiences (ACE) Study 4 carried out jointly by the Centers for Disease Control and Prevention and Kaiser Permanente has conclusively demonstrated a dosage effect for child maltreatment. This ongoing longitudinal study has been analyzing the relationships between multiple categories of childhood trauma and negative health and behavioral outcomes later in life. David Finkelhor's work on poly-victimization is also instructive in identifying both the high frequency of poly-victimization and the relationship between multiple forms of abuse and poor outcomes for children ( Finkelhor et al., 2009) . Research with adolescents has docu mented this same relationship between multiple forms of abuse and the perpetration of violent delinquency as an adolescent, with each additional form of abuse translating to a 124 percent increase in the relative odds of engaging in violent delinquency ( Crooks et al., 2007) .

Co-Existing Adversities Increase the Likelihood of Negative Outcomes

Abuse affects different children differently. The ACE Study has documented the additive detrimental effects of experiences such as exposure to woman abuse, a parent with substance abuse or mental health problems, and incarceration of a parent. Low socioeconomic status can further compound difficulties for children who are experiencing child abuse. Conversely, access to protective factors (including at least one stable, nonviolent caregiver) can mitigate these impacts ( Herrenkohl et al., 2008) .

To summarize what we know about childhood experiences of abuse and exposure to domestic violence as a risk factor for perpetrating violence as an adolescent or adult, it is clear that childhood exposure to violence is a strong risk factor. However, there is still considerable variability among individual outcomes, and additional risk or protective factors can either exacerbate or mitigate the risk conferred by child abuse. Cumulative experiences of child abuse tend to lead to more negative outcomes, both in terms of perpetrating violence and a whole host of other negative social and physical health outcomes. The cycle of violence depicts the what of intergenerational transmission, but it does not explain the how or why. It is important to understand the cycle of violence in terms of how it works, because understanding the mechanisms underlying the intergenerational transmission of violence provides an important basis for understanding intervention opportunities.

How Does the Cycle of Violence Work

At a superficial level, the intergenerational transmission of violence seems counterintuitive—if someone knows how devastating it is to be abused as a child, how can he or she turn around and do the same thing as a parent? The answer lies in understanding the impact of child abuse on a developing child and understanding how experiences of child direct and indirect exposure to violence change how an individual sees the world and others around him or her. This understanding also explains why child exposure to violence is not something that a person can just “get over.” Three particularly useful frameworks and theories for explaining the intergenerational cycle of violence are attachment, social learning theory, and trauma.

The Role of Attachment

Attachment refers to the quality of the relationship that develops between an infant and his or her primary caregiver(s) ( Bowlby, 1980 , 1990 ). Secure attachment emerges within the context of responsive caregiving. The extent to which an infant is fed when she is hungry, changed when she is wet and uncomfortable, and soothed when she is upset or afraid provides a basis for secure attachment. This first relationship becomes a template for future relationships and organizes the way an infant comes to see the world: Is it a safe and predictable place or a scary and bizarrely unpredictable one? Decades of research demonstrate that when attachment develops in a disorganized manner, an individual is at risk for ongoing difficulties in relationships with others. Child abuse and attachment are connected in a number of ways, including the development of attachment, the impacts of abuse, and the later perpetration of abuse ( Bacon and Richardson, 2001) . Experiences of direct and indirect child exposure to violence undermine the potential for secure attachment and provide an early experience of relationships as dangerous and unpredictable.

Although attachment is most often discussed in the context of parent–infant relationships, it continues to play an important role throughout a youth's development. Recent longitudinal research demonstrated that youth dually exposed to direct and indirect violence (i.e., child abuse and exposure to domestic violence) were less attached to their parents in adolescence than those who experienced only direct or only indirect exposure ( Sousa et al., 2011) . Furthermore, attachment to parents during adolescence played an important protective role against antisocial behavior, independent of abuse status.

Social Learning Theory

Social learning theory is a well-established paradigm that highlights the importance of reinforcement for promoting certain behavioral responses and inhibiting others ( Bandura, 1977 , 1986 ). Furthermore, our experi ences with behavior and reinforcement come to shape our attitudes and attributions. One of the key tenets of social learning theory is that humans learn very well from modeling, that is, from what they see others do. This modeling is not indiscriminate. Children do not copy everything around them, but they copy what they see that works. When they are exposed directly and indirectly to violence, they learn harsh but effective lessons about power and may come to see the world as made up of victims and victimizers ( Dodge et al., 1994) . Given such a dichotomy, they may begin to model after the victimizer to avoid further abuse. These children develop a hostile attribution bias , which is a cognitive framework for expecting the worse, even in threat-neutral situations ( Fontaine, 2010) . As a result, these children seem hostile and aggressive to their peers, and may be rejected by their more pro-social peers ( Dodge et al., 1990) . There is some evidence that exposure to family violence is a bigger contributor to later pro-violence attitudes (such as comfort with aggression, aggressive responses to shame, excitement about guns, and violence as means of preserving power) than violence experienced in the school or community ( Slovak et al., 2007) . In addition to underscoring the importance of what children learn, social learning theory would also draw attention to what these children do not learn, namely, egalitarian relationships, non-violent approaches to conflict resolution, and emotional regulation skills.

A third perspective that has been explored for understanding the cycle of violence is the trauma perspective. Based on his work with adolescent boys who have perpetrated lethal violence, James Garbarino has identified a process which he refers to as “hibernation of the soul” ( Garbarino, 1999) . Essentially, under conditions of severe, early, and chronic violence, these children may come to suppress their more humane aspects as a survival mechanism. The detachment from emotion and compassion that allows a person to survive chronic abuse is the same detachment that facilitates perpetration of severe violence without apparent remorse. Even in less extreme cases of trauma, the dysregulation of anger and arousal that develop create potent risk factors for the intergenerational transmission of violence. A significant literature has emerged to support these processes from a neurobiological perspective, which demonstrates that over-activation of the fight or flight response can result in a weak foundation for the development of emotional regulation and self-soothing ( van der Kolk and Greenberg, 1987 ).

In considering these three frameworks for understanding the cycle of violence—attachment, social learning, and trauma—it is evident that there are no quick fixes for breaking this cycle. Child abuse does not arise because of a lack of discipline; consequently, get-tough approaches with parents will not redress the risks. Similarly, it does not arise merely from a lack of parental support; as such, increasing support without targeting the underlying causes will not be very successful in preventing and reducing a child's direct and indirect exposure.

What Programs Are Effective or Promising

In efforts to prevent child abuse and exposure to domestic violence, there are a number of points for possible intervention. Prevention in other areas is often divided into universal (or primary), selective (or secondary), and indicated (or tertiary). However, an argument can be made that using this type of classification locates the abuse with the victim and pathologizes the experience of abuse. Macmillan and colleagues have proposed an alternative schema for identifying intervention points, presented in Figure 6-2 ( Macmillan et al., 2009) . With this approach it is clear that one can work to prevent abuse before it occurs, to prevent abuse from recurring, and to prevent impairment following abuse. Each of these targets is necessary in a comprehensive approach, and different strategies will be effective at different points.

Intervention to prevent child maltreatment and associated impairment. SOURCE: Macmillan et al., 2009.

Comprehensive reviews to identify what works to prevent child abuse or recurrence of child abuse follow one of two basic approaches. The first approach is to look across all previous summaries and reviews and amalgamate all of the existing evidence ( Mikton and Butchart, 2009) . This approach provides a somewhat bleak picture, because when studies are combined, results are generally mixed or disappointing. However, such an approach can be misleading because it includes studies that vary greatly in quality both in terms of the intervention and the research design. By contrast, the review by MacMillan and colleagues looks at high-quality programs that have shown good effects under reasonable research conditions but perhaps have yet to be replicated ( Macmillan et al., 2009) . Reviewing the existing studies in these two ways finds three approaches that can be considered effective or promising. Additional approaches may improve protective factors or reduce risk factors, but these three are the only ones that have been shown to prevent the occurrence or recurrence of abuse.

Home Visitation

Home visitation is the most effective child maltreatment prevention program to date ( Macmillan et al., 2009) . There is considerable variability in home-visiting interventions in terms of their models, service delivery, and home staffing. Two models, the Nurse-Family Partnership and the Early Start program, have been shown to be effective in reducing some indicators of child abuse. However, effects have not been uniform across other approaches to home visiting, and there are a few caveats for the success of home visiting. First, most of what we know is based on David Olds' pioneering work, and efforts to replicate his work have had mixed success. Second, home visitation has proved to be more effective when carried out by nurses than by paraprofessionals. Third, it may be more effective with certain types of families (such as first-time mothers) than others ( Macmillan et al., 2009) . Finally, the presence of domestic violence may undermine the effectiveness of home visiting. In the Elmira Home Visiting study the intervention reduced reports of child maltreatment, but not for families with mothers reporting more than 28 incidents of domestic violence ( Eckenrode et al., 2000) .

Parent Training and Education

The results for parent training and education in general are mixed, but there are two programs that have evidence supporting their use. First, the Positive Parenting Program (Triple P) has shown promise in one study for preventing abuse, and replication is currently under way. The Triple P uses multiple levels of social learning–based programs to meet the needs of different families and offers five levels of intervention with increasing intensity to match higher-needs families ( Prinz et al., 2009) . Mark Chaffin and colleagues' work on Parent–Child Interaction Training has also been very promising in that it has been shown effective in lowering recurrence of physical child abuse ( Chaffin et al., 2004) . Parent–Child Interaction Training uses behavioral conditioning principles and provides immediate and detailed feedback for parents in their interactions with their children. It has been shown to both increase positive interactions and decrease recurrence of child abuse. Both of these programs warrant further investigation, particularly with larger samples of fathers, as most research has focused on mothers.

Educational Prevention of Abusive Head Trauma

The final effective strategy to date is education aimed at preventing abusive head injury (also known as shaken baby syndrome). Offered mainly through hospitals, this education offers normative information about babies' crying, coping strategies for parents, and the impacts of shaking an infant. There is a one study to date that found that the introduction of this program lowered the rates of abusive head trauma ( Dias et al., 2005) . Additional trials are under way. This program appears to be a cost-effective way to reduce one specific type of child abuse.

Interventions Lacking Empirical Evidence

Consistent with the general move to positive psychology, there has been much interest in interventions that build on parents' strengths. Many of these approaches use a mentoring or mutual support model of parents helping other parents in a way to normalize intervention and build informal support networks. The general benefits of mentoring and of encouraging strong social networks are widely accepted, but these approaches have not been found effective in the prevention of child exposure to direct or indirect violence ( Macmillan et al., 2009) . It is critical to recognize the distinction. A parenting program may increase parents' satisfaction with parenting, improve their social connections, and even lead to more positive attitudes and skills, and yet it may not reduce direct child abuse or exposure to domestic violence. If a program is being espoused as a child abuse prevention program, then the research must look at child abuse outcomes and not rely on proxies or interpret the promotion of positive parenting attitudes and skills as synonymous with the prevention of abuse.

Preventing Child Exposure to Direct and Indirect Violence: The Big Picture

A review of the state of the science of child abuse prevention reveals a number of basic facts. First, there are some effective and promising interventions, but even these have limited evidence compared to many other areas of social and medical science. Second, it obscures the picture to collapse evidence across types of intervention (e.g., with meta-analytic techniques) with no consideration for the quality or features of the program. Quality of implementation matters, training of implementers matters, and matching the intervention to the risk level of the families matters. Third, at this point there is little available evidence concerning programs that are effective for preventing emotional abuse. Finally, there have not been any trials on programs to reduce exposure to domestic violence. Community-based approaches to preventing domestic violence have not been well researched, and there are no studies evaluating strategies for preventing exposure when domestic violence is occurring. On a more hopeful note, there are many innovative interventions in varying degrees of development and evaluation. It takes a long time to reach the point where a randomized controlled trial or multi-site replication is feasible.

Gaps and Challenges

A review of the state of the research shows clearly that while we have an emerging idea of effective practice in some specific areas, there are still many gaps. Below are five gaps in research and practice.

Where Are the Dads

Much research has focused exclusively on mothers or not included enough fathers for useful subgroup analysis. This lack of representation in research mirrors the child protection policies and practices, which tend to focus on mothers and view fathers as either dangerous or irrelevant. The reality is that men who have perpetrated violence often remain part of their children's lives and require specific and intentional strategies to change attitudes and beliefs that support their abusive behavior, particularly when these men have also abused the children's mothers ( Scott and Crooks, 2004) . Furthermore, there is a dearth of programs that both address the gendered nature of violence and address men's abuse of their intimate partners and children concurrently. The Fathering After Violence initiative 5 for men who have been abusive to intimate partners and the Caring Dads program 6 for men who have been abusive to their partners and their children are exceptions to the rule.

Is Stopping the Violence Enough for Positive Child Outcomes

When we look for successful outcomes in research, we often use the idea of recidivism or repeat violence as a sign of failure, but the corollary to that is that success is equated with no further violence. The reality is that, in the life of a child who has been victimized, just stopping the violence might not be good enough. There has been some discussion about restorative parenting and applying restorative justice models to the parent–child relationship, but we do not actually have a good sense yet about what that looks like or the implications for the child. Some work has been done in this area of child sexual abuse, but very little has been carried out that looks at father–child relationship restoration after domestic violence. There is a significant need to develop and evaluate protocols for deciding when it is safe to restore parent–child relationships post-violence and how this can be achieved with minimal risk to children.

Compartmentalization of Efforts

There have been some big strides in breaking down silos between types of abuse since the “Greenbook” was published as a model for collaboration between child protection and domestic violence sectors ( Schecter and Edleson, 1999) , but there is still too much compartmentalization within fields. Often researchers emphasize one type of abuse without looking at the complexities of poly-victimization or, what is even trickier, the co-occurrence of perpetration and victimization. For example, most research and programming for children exposed to domestic violence still does not inquire about the direct victimization experience of the children, particularly for abuse perpetrated by the victim parent. There are philosophical and practical reasons for these practices, but they hinder a fuller understanding and more effective response to children.

What Do Culturally Relevant Programs Look Like

Virtually every paper or chapter ends with a plea for more culturally diverse and appropriate services, yet we have only scratched the surface in exploring what this really means. Is it merely resources translated into different languages? Is it trained therapists from the same ethnic or cultural background as the families? Is it program manuals that have different faces on them? It can be argued that we need to go much further than these superficial changes and that we have not done a good job of documenting or evaluating these processes of cultural adaptation. The challenge for cultural adaptation is further complicated when we look at implementing promising practices on a global scale, particularly in countries with less developed child protection or mental health systems.

What Is an Effective Specialized Response in the Highest Risk Cases

Finally, for the most high-risk families, there is a complexity in terms of system involvement and information sharing that can only be addressed by collaboration across systems. Any comprehensive approach to preventing violence against children requires specialized responses that can be activated in the most high-risk cases. With the advent of domestic violence homicide review committees, a clearer picture of the risk factors for lethality to women and their children is emerging ( Jaffe et al., 2003 ; Campbell, 2005 ; Jaffe and Juodis, 2006) . In these cases, home visiting and parent education are not sufficient or appropriate for the degree of risk. In addition to developing clinical interventions for a wide range of families, we need to develop specialized collaborative protocols for the highest-risk cases.

In closing, although reviews that combine all interventions of a certain type tell a disheartening story, there are some bright spots in our search for effective interventions. Home visiting, parent education and training, and education approaches to abusive head trauma have all shown promise and a solid degree of evidence. The science is at the point where we know enough to know that there are no easy answers and no quick fixes. Different families need different types of support and intervention at different points in time, and we need to develop a comprehensive and coordinated system of care to ensure that no children fall between the cracks. It is a colossal task, but a vital one, because at the end of the day our children need to be safe from abuse and violence to develop to their full potential and grow into the type of adults who will contribute to a compassionate and productive society.

• TRAUMA-INFORMED CARE: A VALUES-BASED CONTEXT FOR PSYCHOSOCIAL EMPOWERMENT

We make a fundamental distinction between trauma-informed care and trauma-specific services ( Harris and Fallot, 2001) . Psychosocially empowering, trauma-specific interventions take as their primary goals ameliorating trauma-related difficulties and facilitating trauma recovery and healing. The Trauma Recovery and Empowerment Model, Seeking Safety, Trauma Affect Regulation: Guide for Education and Therapy (TARGET), the Boston Consortium Model, and Beyond Trauma, among others, are manualized approaches to helping women (and sometimes men as well) develop the skills necessary to cope more effectively with the impact of violence and abuse and to avoid revictimization ( Harris, 1998 ; Najavits, 2002 ; Covington, 2003 ; Ford and Russo, 2006 ; van Lier et al., 2009 ; Amaro, 2011) . These interventions and many individual ones that focus primarily on post-traumatic stress disorder, such as exposure therapy, cognitive processing therapy, and other cognitive-behavioral approaches (e.g., Mueser et al., 2008) , are an important component of trauma-informed care ( Resick et al., 2008 ; Powers et al., 2010) .

However, “cultures of trauma-informed care” refer to the programmatic, organizational, and community contexts that are necessary and valuable in supporting survivors and the staff who serve them. Any setting can be trauma-informed when it takes fully into account what we know about trauma, its impact, and the diverse, individualized paths to trauma recovery. In this way, not only behavioral health care settings but also primary care institutions, schools, and even correctional facilities can be trauma-informed. When an organizational culture becomes trauma-informed, it becomes more welcoming and hospitable for trauma survivors (as well as the rare individual who does not have a history of exposure to violence); it minimizes the possibility of revictimization; it indirectly facilitates healing, recovery, and empowerment; and it builds collaborations throughout the service system.

Trauma-informed care is important for a number of reasons:

• Trauma and, in particular, violent victimization are pervasive.
• The impact of trauma is broad, extending well beyond the post-traumatic stress disorders frequently perceived to be the most common outcome.
• The impact of trauma is often deep and life-shaping.
• Trauma, especially caused by interpersonal violence, is often self-perpetuating.
• Violence is even more common in the lives of those who are socially and politically vulnerable, including the poor, many racial and ethnic minorities, women and children, those diagnosed with mental health or substance abuse problems, and people who are developmentally disabled.
• Trauma affects the way people approach the human service setting, heightening fear and suspiciousness.
• The service system itself has too often been retraumatizing.

Retraumatization in the behavioral health care setting is one of the experiences that originally fueled awareness of the need for trauma-informed care ( Jennings, 1998) . Two types of retraumatization are noteworthy. First are the many ways in which traumagenic dynamics may be replicated in service provision. Examples include providers' lack of interest in traumatic violence or their disbelief of individuals' reports of violent victimization; both of these patterns may replicate earlier experiences, in which signs and reports of violence were minimized or denied. Coercive approaches involving involuntary medication and hospitalization are still too common in many settings. And the presumption of incompetence (e.g., the inability to handle one's own finances) may be a part of standard operating procedure in many programs, a visible reminder of the ways in which survivors' skills are overlooked.

Second are instances of “sanctuary harm” ( Robins et al., 2005) . Consumers surveyed about their experiences in behavioral health care settings report violence and the fear of violence (including physical restraint and seclusion) as well as negative interactions with staff involving disrespect and humiliation. Taken as a whole, then, it is not surprising that one prominent psychiatrist has written that the past 30 years has evinced a continuing story of “destroying sanctuary” in the human services system ( Bloom and Farragher, 2010) .

As a counter to this destructive organizational culture, we have developed a model of trauma-informed care that builds on core values of safety, trustworthiness, choice, collaboration, and empowerment ( Fallot and Harris, 2008 , 2009 ). These values are key antidotes to the toxic effects of violence in the lives of consumers and staff members in human service delivery settings. For those who have been exposed to violence repeatedly and unpredictably, physical and emotional safety is a high priority. For those individuals affected by violence perpetrated by those who were supposed to be family or institutional caretakers, trustworthiness is a high priority. For those whose sense of voice and control has been attenuated by violent victimization, choice is a high priority. For those who have experienced the world as consistently arrayed in one-up, one-down relationships in which they have been the one down, the realistic offer to share power in a collaborative way is a high priority. And for those who have felt powerless to do anything about these other realities, empowerment is a high priority.

As a change in organizational culture, then, trauma-informed care extends far beyond any new service; it involves the physical setting, each contact, each activity, and each relationship in the organization. It extends beyond the training of clinical staff by engaging with all staff (including administrators, service staff, and support staff) and, importantly, all consumers to direct and monitor this change. Finally, trauma-informed care represents an opportunity to make these values into a routine part of the setting; it is broader than simply being “trained” in this approach.

Cultures of trauma-informed care balance trauma-specific emphases on individual empowerment and skills development with organizational emphases on safety, trustworthiness, choice, collaboration, and empowerment. This approach is consistent with other values-based approaches that have become prominent in the past two decades in behavioral health: recovery orientation, gender responsiveness, and cultural competence ( Farkas et al., 2005 ; Covington, 2007 ; Whitaker et al., 2007a) . Furthermore, the core values of trauma-informed care are consistent with, and strongly supportive of, many evidence-based interventions, such as motivational interviewing, shared decision making, and psychosocial empowerment groups.

Basic shifts in both understanding and practice are fundamental in changing a traditional human service or community culture to one that is trauma-informed. Our protocol for developing a culture of trauma-informed care thus emphasizes both a paradigm shift in understanding and a thoroughly collaborative way to change practice ( Harris and Fallot, 2001 ; Fallot and Harris, 2009) . For instance, one of the key changes in understanding is establishing a “trauma first” mode of thinking about a consumer or staff member. Thus, we adopt a “trauma lens” through which other aspects of a person's life may be viewed. Rather than asking, implicitly or explicitly, “What is wrong with you?” or “What is your problem?” we ask “What have you been through?” and “How have you tried to cope with it?” This basic change in orientation affects the organization's view of not only consumers and staff members but also the nature of trauma itself, the services provided, and the relationship between consumer and provider. As the basic questions change, so do the approaches, from “Here is what I can do to fix you,” to “How can you and I work together to further your goals for recovery and healing?” Collaborative decision making and planning pervade trauma-informed cultures; not only are consumers' opinions frequently sought and incorporated into individual service planning and organizational strategies, but also staff perspectives become central to administrators' thinking as well.

In putting these ideas into practice, we address six domains of organizational culture in human service settings; three are service-level domains, and three are at the systems-level ( Fallot and Harris, 2009) :

Services-level changes in a culture of trauma-informed care:

Informal service procedures and settings

Formal service policies

Trauma screening, assessment, service planning, and trauma-specific services

Systems-level changes in a culture of trauma-informed care:

Administrative support for developing and sustaining this culture

Staff training and education

Human resources practices

As an example, let us examine our approach to informal service procedures and settings. Here we ask agency workgroups representing all constituencies (upper-level administrators, supervisors and middle management, service staff, support staff, and consumers) to review the sequence of settings, activities, and people to whom consumers are likely to be exposed from the time of their first call to their final visit. We sometimes recommend a walk-through, in which staff literally put themselves in the place of consumers by going through the same procedures as a new consumer would in entering the agency. Once each physical setting, activity, contact, and relationship has been outlined, we ask key questions related to the core values:

• How can we ensure physical and emotional safety for consumers throughout our organization and larger system of care?
• How can we maximize trustworthiness? Make tasks clear? Maintain appropriate boundaries?
• How can we enhance consumer choice and control?
• How can we maximize collaboration and the sharing of power with consumers?
• How can we prioritize consumer empowerment and skill-building at every opportunity?

Agencies have taken this task on with enthusiasm, developing creative solutions to identified problems in these domains. For example, one residential substance abuse setting had a large sign that read “Denial stops here” over the entrance to the residential areas of its building. Deciding that this sign did not create a hospitable or emotionally safe first impression of their setting, they replaced it with a “Welcome” sign that was much more inviting. Clearer and more positive signs, more comfortable waiting rooms (with adequate space and with minimal intrusion of security staff), more positive first contacts via phone or in person, better lighting in hallways and outdoors, and more private intake procedures—among many others—are examples of the sorts of changes organizations have made in efforts to create safer and more welcoming environments.

Once this process is completed, we ask organizational workgroups to follow the same procedure, this time with a focus on the staff's experiences of safety, trustworthiness, choice, collaboration, and empowerment. We have seen this “parallel process” with regard to trauma-related concerns played out repeatedly in a wide variety of settings. Simply put, only when staff members' experiences of physical and emotional safety, of trustworthy relationships (with their co-workers and with supervisors and administrators), of choice in how they go about their daily work, of collaborative power-sharing with administrators and supervisors (so that staff input is weighed significantly), and of empowerment (so that staff members have the resources they need to do their jobs well) are in place is the staff able to create similar experiences for consumers.

Trauma-informed cultures of care develop over time with the collaboration and support of administrators who recognize the invaluable perspectives of both staff and consumers. We have gathered qualitative data in support of this shift in organizational cultures. Consumers report that they feel more accepted. One woman said, for example, “Before this initiative, I had to leave an important part of myself on the doorstep to this agency; now I can bring my whole self inside.” Consumers, staff, and administrators frequently comment that the initiative fostered more collaborative relationships among them. Built on safety and trustworthiness and supported by valuing choice and empowerment, the capacity to share power meaningfully has become a hallmark of trauma-informed care.

As a values-based context strongly supportive of evidence-based trauma-specific interventions, trauma-informed organizational cultures represent a powerful source of engagement for women and their children who have been exposed to violence ( Cocozza et al., 2005 ; Morrissey et al., 2005) . (Also see the Substance Abuse and Mental Health Services Administration's Women, Co-Occurring Disorders, and Violence Study for related discussions and findings. 7 ) To the extent that secondary and tertiary prevention of such violence relies on creating settings that are welcoming and engaging for individuals with complex histories of violent victimization, trauma-informed care is an increasingly central requirement for programs designed to assist women and children.

• ENHANCING EMOTION REGULATION: A FRAMEWORK FOR PSYCHOLOGICAL EMPOWERMENT OF WOMEN AND CHILDREN EXPOSED TO VIOLENCE

The health care and social service professions tend to approach the question of how to assist women and children who are victims of violence by doing research on, and developing practice guidelines for, the treatment of posttraumatic stress disorder (PTSD) ( Forbes et al., 2010) . Extensive surveys of scientifically validated and clinically promising PTSD treatments have been compiled by the International Society for Traumatic Stress Studies, the U.S. Department of Veterans Affairs, the Clinical Resource Efficiency Support Team (part of the Northern Ireland Health Service), the American Psychiatric Association, the British National Institute for Clinical Excellence, the Institute of Medicine, and the Australian Centre for Posttraumatic Mental Health at the University of Melbourne ( CREST, 2003 ; APA, 2004 ; VA, 2004 ; NICE, 2005 ; IOM, 2006 ; Australian Centre for Posttraumatic Mental Health, 2007 ; Foa et al., 2009) . These guidelines were developed to address diagnostic criteria for PTSD in the Diagnostic and Statistical Manual ( APA, 1997) .

Although laudable in that they have made the possible benefits of carefully developed therapies for PTSD increasingly known to professionals who treat victims of violence, this medicalized approach to helping victims recover from violence has several key limitations. First, the very terms, “victim” and “treatment” suggest a degree of passivity and deficiency that does a grave injustice to the typically extremely courageous and resilient survivors of violence. Violence temporarily disempowers those who must survive it, but even prolonged and horrific violence does not strip the survivor of the capacity to be empowered. Being viewed as broken or defective and therefore in need of corrective treatment as a result of having suffered violence adds injury (as well as insult) to injury. Although therapeutic treatments can be empowering, this is the case only to the extent that they emphasize helping the violence survivor restore or build their strengths. PTSD therapies definitely have been shown through both scientific and clinical research to empower children and adults who have experienced violence ( Courtois et al., 2009 ; Ford and Cloitre, 2009 ). However, PTSD treatments tend to provide education and therapy based primarily on a view of PTSD as a breakdown of courage (i.e., avoidance of trauma reminders or memories) or deficits in arousal and anxiety management (i.e., hyperarousal, hypervigilance).

Recent research provides a basis for a paradigm shift from a pathology/deficit perspective to a framework of psychological empowerment for interventions for survivors of violence. Women and children who have been exposed to violence often suffer from aftereffects that either do not fit the criteria for PTSD or that involve symptoms and difficulties in daily living that go well beyond PTSD ( Rayburn et al., 2005 ; Schumm et al., 2006 ; Ford et al., 2008 , 2009 , 2010 , in press-b ; Gill et al., 2008 ; Mongillo et al., 2009 ; Briggs-Gowan et al., 2010 ; Seng et al., in review ). Although these sequelae might at first glance seem to be consistent with the pathology perspective (e.g., depression, panic, dissociation, addiction, oppositional–defiance, eating disorders, personality disorders, guilt, shame, complicated bereavement), in fact what they demonstrate is the extreme degree of biological, psychological, and interpersonal adaptation required to survive violence ( Ford, 2005 ; Ford and Cloitre, 2009 ; Ford et al., 2009) . These adaptations require substantial strength and resilience, rather than being markers for or the results of pathology or deficiencies ( Herman, 1992 ; Courtois et al., 2009) .

As a result of this paradigm shift, in the past decade an impressive array of psychological empowerment interventions has been developed for children and adults who have experienced violence and related forms of complex trauma ( Courtois et al., 2009 ; Ford and Cloitre, 2009 ). As summarized by Courtois and colleagues, psychological empowerment interventions are built upon the following two central philosophical foundations:

Recognizing the uniqueness of the individual . The model is organized around recognition of the primacy and uniqueness of the individual and the maintenance of his/her welfare. Treatment is not one-size-fits-all; rather, each client is assessed, and treatment is planned differentially according to the specific needs of the individual. This is a phenomenological approach…. A “whole person” philosophy prevails: Although symptoms, deficits, and distress are reasons for seeking treatment and generally become the targets for intervention, the individual's strengths, resources, resilience, personalized needs, values, and contexts are identified and reinforced.

Personal empowerment. A strengths- and resilience-based philosophy of personal empowerment and self-determination encourages the therapist to seek to understand the individual's unique phenomenological experience and its specific meaning and its relationship to symptoms, distress, and treatment goals. The individual has authority over the meaning and interpretation of his/her personal life history, current needs and preferences, and goals for the future. The therapist functions as an active, empathic, and responsive listener and a guide to enable the client to openly voice, examine, and therapeutically work through feelings of confusion, shame, or other emotions that have been suppressed or forbidden. The therapist seeks to create relational conditions where the client is emotionally validated and is “seen” and appreciated, to counter the invalidiation experiences typically associated with attachment trauma and subsequent victimization and to encourage emotional expression and development. The therapist strives to create conditions within the treatment that are as egalitarian as possible and that encourage collaboration with and empowerment of the client; however, the responsibilities and inherent power differences in the treatment relationship are explicitly acknowledged. The therapist seeks to use power effectively on the individual's behalf while simultaneously encouraging the client's development and autonomy. Importantly, the therapist conveys an openness to the client's questioning of authority (including that of the therapist) and supports the client's ultimate authority over his/her life, memories, and therapeutic engagement and progress. Moreover, the therapist is careful to maintain appropriate boundaries and limitations and is responsible for avoiding dual relationships and situations in which the client might be subject to pressure, coercion, or exploitation intentionally or inadvertently by the therapist. Treatment should be based in a shared plan that is systematic (not laissez-faire), utilizes effective strategies … organized around a careful assessment and a planned sequence of interventions that are hierarchically ordered and sequenced (86-87; italics in original).

A recent meta-analysis of therapy outcome studies with adult survivors of childhood sexual abuse found that cognitive behavior therapy was superior to other modalities for anxiety, depression, and other internalizing problems but not for problems more specifically related to emotion dysregulation (e.g., externalizing or interpersonal problems) ( Taylor and Harvey, 2010) . Thus, some violence survivors, particularly those with extensive victimization histories, may respond best to therapy focused on enhancing emotion regulation. Survivors who have severe difficulties with emotion regulation and their therapists also may prefer not to engage in trauma memory processing or to not do so until the client has acquired emotion regulation skills ( Cook et al., 2004 ; Cloitre et al., 2010) . Three manualized psychosocial intervention models that do not include trauma memory processing have been designed to enhance skills for emotion regulation, anxiety management, and interpersonal functioning. Skills Training for Emotion and Interpersonal Regulation (STAIR) has shown promise in reducing PTSD and depression symptoms and in enhancing emotion regulation with women survivors of violence ( Cloitre et al., 2010) . Seeking Safety has shown promise in reducing PTSD and substance use problems with girls and women ( Najavits et al., 2006 ; Zlotnick et al., 2009) . Although STAIR and Seeking Safety address emotion regulation, they emphasize becoming more assertively aware and expressive of emotions as a way to overcome excessively negative emotion states and dysfunctional avoidance of trauma memories or reminders of those memories.

Trauma Affect Regulation: Guide for Education and Therapy (TARGET) acknowledges the extreme emotional distress (e.g., depression, anxiety, anger, guilt, shame, and grief) or emotionally numbed and shutdown feelings (e.g., dissociation) that violence survivors often suffer ( Ford and Russo, 2006) . However, these PTSD or trauma-related “symptoms” are currently viewed as adaptive, rather than maladaptive or dysfunctional, reactions which reflect a change in the stress response system in the body that is protective of the individual. TARGET teaches a single sequential skill set described by the mnemonic FREEDOM, designed based on research showing that emotion regulation involves recognizing, modulating, and recovering from negative emotion states as well as accessing and sustaining positive emotion states ( Eisner et al., 2009 ; Kessler and Staudinger, 2009) . Restoring affect regulation is described as requiring seven practical steps or skills denoted by FREEDOM: Focusing the mind on one thought at a time; Recognizing current triggers for emotional reactions; distinguishing dysregulated (“reactive”) versus adaptive (“main”) Emotions; Evaluations (thoughts); goal Definitions; behavioral Options; and self-statements affirming that taking responsibility for recovering from intense emotions is crucial not only to one's own personal well-being but also to Making a positive contribution to primary relationships (e.g., as a parent) and the community.

TARGET has been evaluated in a series of real-world effectiveness studies as a group therapy for women and men in substance abuse treatment as well as for incarcerated women, as a one-to-one therapy for low-income women with complex trauma histories and girls involved in delinquency, and as a combined group and milieu intervention for girls and boys placed in juvenile detention centers ( Frisman et al., 2008 , Ford et al., in press-b , in preparation; Ford and Hawke, in review ). Group and milieu interventions enable participants to provide one another with peer modeling, support, and guidance as well as potentially enabling the program or community in which they take place to become “trauma informed” ( Fallot and Harris, 2008) . Consistent with this view, TARGET was found to enable women and men recovering from substance abuse to maintain a sense of realistic confidence and optimism (“sobriety self-efficacy”), where others who received substance abuse treatment as usual showed a marked decline in this important resilience factor ( Frisman et al., 2008) . The benefits to the entire setting were evident in findings from the evaluation of TARGET in youth detention centers, in which every session of TARGET received by a girl or boy was associated with a reduction in the number of behavioral incidents and punitive sanctions imposed by staff during the first two weeks of youths' stay in the facilities ( Ford and Hawke, in review ). On the other hand, many girls or women who have experienced violence may prefer the privacy of a one-to-one therapy intervention, and TARGET showed evidence of helping both underserved women and girls to not only reduce their PTSD symptoms but also to increase their ability to regulate emotions ( Ford et al., in press-a , in press-b ).

Implications of a Psychological Empowerment Approach for Violence Survivors

To the extent that knowledge is power, providing women and children who have experienced violence with de-stigmatizing explanations of why they are struggling with persistent emotional distress and how they can draw upon their inherent personal strengths to regain their emotional balance is a very direct and essential form of psychological empowerment. Equally, if not more, important is bringing this same knowledge to the many professionals, advocates, policy makers, funders, jurists, and regulators who determine how scarce societal resources will be allocated both to prevent violence and to restore the lives and well-being of survivors of violence. If violence changes how survivors' bodies respond to subsequent stressors (non-violent as well as violent), then traumatic stress disorders such as PTSD and its more complex variants are simply extreme versions of the out-of-balance emotional states that everyone experiences. Therefore, if recovery from the aftereffects of violence involves regaining or restoring innate capacities for re-setting the body's stress reaction systems—and, in so doing, regaining or restoring the innate ability to regulate emotions and maintain a generally healthy balanced emotional state despite expectable perturbations—it is essential that not only violence survivors but also the public at large (including those key determiners and providers of services) are informed about why and how emotion regulation is essential not only for survivors of violence but also on a larger scale to prevent violence. With this perspective, it becomes possible to understand not only the aftereffects of violence but also violence itself as resulting at least in part from emotion dysregulation on a broad scale (e.g., uncivil discourse in politics or extreme economic and social disparities). Knowledge and skills regarding emotion regulation are essential not just for violence survivors, but for everyone.

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Reprinted from World Health Organization and London School of Hygiene and Tropical Medicine. 2010. Preventing intimate partner and sexual violence against women: Taking action and generating evidence. Geneva, Switzerland: World Health Organization.

Adapted from: Barker, G., J. M. Contreras, B. Heilman, A. K. Singh, R. K. Verma, and M. Nascimento. 2011. Evolving men: Initial results from the International Men and Gender Equality Survey (IMAGES). Washington, DC: International Center for Research on Women.

Bullying prevention programs have been researched quite extensively and are outside the purview of this summary. Bullying/peer aggression was included in the cycle of violence figure as a reminder that children exposed to family violence have difficulties in multiple settings and often perpetrate or experience violence in relationships outside their families. A holistic approach to the impact of violence on children's lives requires a commitment to beginning to piece together these formerly disparate areas of research.

Results of the study are available at http://www ​.cdc.gov/ace/index.htm .

See http://endabuse ​.org/section ​/programs/children_families ​/_breaking_cycle .

See http://www ​.caringdadsprogram.com .

Available at http://pathprogram ​.samhsa ​.gov/Resource/Women-Co-Occurring-Disordersand-Violence-Study-Program-Summary-21101.aspx .

• Cite this Page Forum on Global Violence Prevention; Board on Global Health; Institute of Medicine. Preventing Violence Against Women and Children: Workshop Summary. Washington (DC): National Academies Press (US); 2011 Sep 12. 6, Papers on Research in Preventing Violence Against Women and Children.
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Ending Violence against Women and Children in the Philippines: Opportunities and challenges for collaborative and integrative approaches

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Executive Summary

While the fields working to end VAC and VAW have largely developed separately, recent reviews and analyses of large datasets have identified multiple intersections between VAC and VAW including: co-occurrence, shared risk factors, similar underlying social norms, common consequences, intergenerational effects, and the period of adolescence as unique period of heightened vulnerabilities to both types of violence. These intersections suggest that collaboration between the sectors is essential to a more effective prevention and response. Integration of certain aspects VAC and VAW prevention and response across services, programmes, and policies may also be advantageous. However, there are key areas of divergence between the traditional approaches in the VAC and VAW fields that have created challenges to collaboration and may suggest some disadvantages to fully integrative approaches. To date there are no evidence-based or widely accepted integrative models.

This multi country study, commissioned by UN Women, UNICEF and UNFPA, explored existing examples of collaboration and integration of VAC and VAW policies, services, and programmes, as well as challenges and future opportunities in the East Asia and Pacific region, with a focus on four countries – Cambodia, Papua New Guinea, the Philippines, and Viet Nam.

Key research questions This research initiative sought to answer following overarching questions through dialogues and interviews with relevant stakeholders in each country:

What are the existing VAW and VAC policies, action plans, programmes (prevention) or services (response/support)?

What are some examples of policies, action plans, programmes, or services where there is some evidence of VAW and VAC integration (i.e.: addressing both VAW and VAC at the same time)? Include any efforts to try to develop cohesive strategies or plans or collaboration.

How do VAW-focused and VAC-focused stakeholders collaborate or interact? How do donors drive the VAW-VAC agenda?

What are the areas of tension between VAC and VAW work? How do various stakeholders address areas of tension between VAW and VAC?

a. Under what circumstances are boy-children accommodated in places of safety?

b. How are adolescents’ complex needs met and rights protected?

c. How are mothers viewed and “processed” in VAC cases?

• What are some opportunities within the existing policies, action plans, programmes or services where integration and/or collaboration could be introduced or enhanced?

Key findings

Violence against children (VAC) and violence against women (VAW) affect the lives and welfare of millions of people around the world. Many women and children in the Philippines suffer multiple types of violence. The multiple negative sequelae of this violence can be long-lasting throughout the lifespan and across generations as well as impacting on individuals, relationships, communities, and broader society.

Agenda and priorities

• The Philippines has good quality national prevalence data on some forms of VAW and VAC; however, administrative data are poorly coordinated thus not allowing for a holistic picture to understand gaps between national prevalence and service delivery.

• There is no mechanism to ensure national prevalence data on VAC are regularly collected. VAW data is regularly obtained from the National Demographic and Health Survey.

• While there are no data or studies to date on VAW-VAC intersections in the Philippines, stakeholders are aware of various important

intersections in vulnerabilities. Structured data collection protocols or studies would provide useful evidence for policy and programming.

• Improved access to and analysis of reliable data, as well as dissemination of findings, could assist in strategic funding or budget guidelines for the gender and development budget and the child protection budget. Government, legislation and policy • Multiple government departments have a role in both VAC and VAW and serve on the InterAgency Council on Violence Against Women and Their Children (IACVAWC): Department of Social Welfare and Development (DSWD), Department of Interior and Local Government, Philippine National Police, Department of Justice, Department of Health, Department of Education, Department of Labor and Employment, Civil Service Commission, Commission on Human Rights, Council for the Welfare of Children, National Bureau of Investigation, and National Commission on the Role of Filipino Women. This committee did not appear to drive specific integration efforts.

• The Philippine Commission on Women is the primary policy-making and coordinating body on women’s empowerment and gender equality.

• The Philippine Plan of Action to End Violence Against Children includes roles for DSWD, the Department of Education, Department of Justice, Council for the Welfare of Children and the Department of Interior and Local Government.

• The main pieces of legislation applicable to VAC and VAW are Anti Child Abuse Law (RA 7610), Anti-Rape Law (RA 8353), and Anti-Violence Against Women and their Children Act of 2004 (RA 9262).

• While there are councils and committees set up to address VAC and VAW and many service providers see both VAC and VAW survivors, there are no formal integration policies or programming guidelines.

Access to justice

• VAW desks at the barangay or village level facilitate access to justice and support services for VAW and VAC survivors primarily through referral to the Women and Child Protection Desk (WCPD) at police stations.

• Protection Orders, mediation, settlement, conciliation, or arbitration are remedies offered to survivors within the barangay level but the WCPD can refer cases for review to enter the court system.

• There are multiple barriers to accessing justice including a large burden on victims to collect evidence from multiple sources, long and drawn out justice procedures, lack of sensitive or protective judicial processes (especially for children), as well as economic and social stigma issues.

• There are no guidelines for examining intersections between VAW and VAC in any of the judicial or law enforcement protocols.

Response and support services

• There are referral guidelines for VAC and VAW survivors but these have not been integrated nor do they address intersectionality.

• While individual service providers may take an integrative approach when dealing with a VAW or VAC case, this is not protocol-driven. Most service providers called for a separation and specialization of VAC and VAW cases.

• Women and Child Protection Units (WCPU) are usually based within hospitals; however, again, there are not specific integration protocols that provide guidance on managing the various intersections between VAC and VAW but rather that adult and child survivors can access services from this Unit. The intake form for VAW cases includes a query on the children’s welfare. There is collaboration between medical doctors, social workers, and police officers under WCPU; however, they are unable to complete forensic rape examinations because they do not have the facilities or kits available.

• There are few shelters available to women and children and most of them are consistently at or over capacity. Many shelters house both domestic violence survivors and trafficking victims. The shelter provides various services including psychological, livelihood strengthening, social services, medical and dental, dietary services, and orientation to the laws that protect women in the hopes that the women will be able to live independently and seek help if they experience violence again.

Few shelters will accept repeat visits from the same survivor. The shelters are not designed for children. However, in some cases women arrive with their children and the shelters are forced to accommodate them. They generally do not accommodate boys over age 7. There are Havens for Children (separate ones for girls and for boys) but these homes are also for children in conflict with the law, trafficking victims, or orphans thus are not ideal for children having to leave violent homes with their mother. There are no recovery or support services for children within the women’s shelter.

• Adolescent girls are particularly vulnerable because neither the children’s home nor the women’s shelter has the capacity to serve such cases. Therefore, they are often sent to shelters run by non-governmental organiztions (NGOs) if such support is needed.

Humanitarian emergencies

• As in other countries, humanitarian emergencies appear to offer good opportunities for innovation and collaboration on VAC and VAW issues; however, this rapid partnership work does not usually translate into ongoing cohesive and collaborative programming.

• A recent example in the Philippines is the response to Typhoon Haiyan during which GBV Watch Groups led by women were initiated by a local NGO to patrol communities to enhance protection of women and children. These Watch Groups are continuing in the communities and there are plans to initiate them in other communities in rural areas.

• It would be useful to conduct a postemergency analysis to glean lessons learned and key success strategies to collaborative and innovative efforts that address both VAW and VAC in an integrative way.

Prevention programming

• Many stakeholders interviewed for this study considered secondary prevention approaches – for example early identification of and intervention with victims to prevent an escalation or recurrence of violence – as the main effort to prevent VAW and VAC.

• Awareness-raising was the most commonly described approach to primary prevention of VAW and VAC; however, this approach has been shown to be ineffective in preventing violence.

• Economic empowerment of women (especially survivors of violence) was a prevention strategy used by some NGOs and shelters but no evaluation data on prevention of either VAW or VAC were available for these.

• There are some prevention programmes engaging men lead by MSWD and DSWD.

• UNICEF Philippines has supported some positive parenting programmes to prevent VAC but these have not addressed VAW prevention.

• UNFPA worked with the Department of Education to operationalize school-based Comprehensive Sexuality Education, under the mandate of the national Responsible Parenthood and Reproductive Health Law. The curricula is in accordance with international standards and includes components covering gender-based violence and gender equality.

• UN Women is supporting a Safe Cities project to reduce sexual harassment in public spaces.

• Some NGOs have engaged in various prevention projects including addressing problematic gender norms within religious communities to prevent VAW, and preventing online exploitation of youth.

• While prevention programming is, theoretically, a key opportunity for integration of VAW and VAC work, most prevention programmes lack strong evaluations of outcomes and impact available, thus making it difficult to understand the effectiveness of different approaches.

Further, VAC and VAW projects tend to focus on different sets of outcomes making it difficult to gain insight into integrative, accelerative, or cross-cutting impacts on both VAC and VAW.

Integration of VAW and VAC approaches

• It appears that collaboration has worked best when VAW and VAC stakeholders come together on a specific issue (e.g., statutory rape, humanitarian crisis) rather than more broad. This means that there are no overarching efforts at dealing with areas of divergence to develop an overall integrative way forward. This focused kind of collaboration also means that some areas of convergence or synergy between VAW and VAC work may be missed.

Recommendations

• In general, the study participants suggested that integration was not an approach they felt was ideal and there were repeated calls for separated, specialized policies, services, and programmes to address VAC and VAW. However, given the lack of resources as well as the existence of several services that address both VAC and VAW, it seems that pursuing some integrative or collaborative VAC-VAW approaches are warranted.

• Services and programming for adolescents is a particular gap in the Philippines. Generally, adolescents are considered children under the law. More advocacy, research, and innovation is needed to meet adolescents’ needs with regard to VAC and VAW.

• Intake forms and referral guidelines could be reviewed to prompt integrative case management for VAW and VAC survivors.

• VAW and VAC stakeholders, including UN agencies, may engage in a mapping activity to understand the various approaches they are taking and find synergies or strategic opportunities for integration or other kinds of collaboration. This activity could lead into work to develop a theoretical framework of integrative VAC-VAW approaches that are relevant and feasible within the Philippines taking into account the varied resources and needs in different parts of the country.

• Staff at WCPUs, WCPDs, and the VAW desks would benefit from on-going training and capacity building in both VAW and VAC issues - it appears that separate, specialist units are unlikely and therefore service providers will have to continue to work with both VAC and VAW survivors.

• Improvements in both national prevalence and administrative data collection and management could provide opportunities for research on adolescent issues, and intersections between VAC and VAW. The availability of reliable and high quality data could inform ongoing policy, programming, and service work to comprehensively and effectively address VAC and VAW in the Philippines.

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Take action: 10 ways you can help end violence against women

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During the annual 16 Days of Activism against Gender-based Violence , UN Women stands united with survivors, activists, decision-makers, global citizens, and the UN system. Together, we are spotlighting the urgent need for robust funding, essential services, and financing of prevention initiatives and data collection that shape better-informed responses to gender-based violence.

Ending violence against women is everyone’s business. Here are ten ways you can make a difference, safely and impactfully.

1. Listen to and believe survivors

When a woman shares her story of violence, she takes the first step to breaking the cycle of abuse.

It is on all of us to give her the safe space she needs to speak up and be heard.

It is important to remember that when discussing cases of sexual violence, a victim’s sobriety, clothes, and sexuality are irrelevant.

The perpetrator is the sole reason for assault and must bear the responsibility alone. Call out victim-blaming and counter the idea that it is on women to avoid situations that might be seen as “dangerous” by traditional standards.

Survivors of violence are speaking out more than ever before, and everyone has a role to play to ensure they can have justice.

Do not say, “Why didn’t she leave?”

Do say: “We hear you. We believe you. We stand with you.”

2. Teach the next generation and learn from them

The examples we set for the younger generation shape the way they think about gender, respect, and human rights. Start conversations about gender roles early on, and challenge the traditional features and characteristics assigned to men and women. Point out the stereotypes that children constantly encounter, whether in the media, on the street, or at school, and let them know that it is OK to be different. Encourage a culture of acceptance.

Talk about consent, bodily autonomy, and accountability in an age-appropriate way to boys and girls. For example, discuss the importance of a clear “yes” from all involved, the fact your body is yours and you make choices over what happens to it, and of how we must always take responsibility for our actions. It is important to also listen to what children have to say about their experience of the world. By empowering young advocates with information and educating them about women’s rights, we can build a better future for all.

3. Call for responses and services fit for purpose

Services for survivors are essential services.

This means that shelters, helplines, counseling, and all support for survivors of gender-based violence need to be available for those in need.

Every year, the 16 Days of Activism campaign calls for united, global action to end all forms of violence against women and girls.

This year the United Nations, together with our partners, are demanding increased investments to end violence against women and girls.

Join us in calling on governments to bridge funding gaps to address violence against women and girls , invest in prevention initiatives, ensure essential services for survivors of violence are maintained, implement prevention measures, and invest in collecting the data necessary to adapt and improve life-saving services for women and girls.

4. Understand consent

Freely given clear consent is mandatory, every time.

Rather than listening for a “no”, make sure there is a clear “yes”, from all involved. Adopt clear consent in your life and talk about it.

Phrases like “she was asking for it” or “boys will be boys” attempt to blur the lines around sexual consent, placing blame on victims, and excusing perpetrators from the crimes they have committed.

While those that use these lines may have fuzzy understandings of consent, the definition is crystal clear. When it comes to consent, there are no blurred lines.

Learn more about consent .

5. Learn the signs of abuse and how you can help

There are many forms of abuse and all of them can have serious physical and emotional effects. If you’re concerned about a friend who may be experiencing violence or feels unsafe around someone, review these signs and learn about the ways to help them find safety and support.

If you think someone is abusing you, help is available . You are not alone. If you’d like to talk with a trained advocate at a helpline, we compiled this list of resources around the world .

6. Start a conversation

Violence against women and girls is a human rights violation that’s been perpetuated for decades. 

It is pervasive, but it is not inevitable, unless we stay silent. 

Show your solidarity with survivors and where you stand in the fight for women’s rights by oranging your social media profile for the 16 Days of Activism – you can download banners for Facebook and Twitter here . 

On Instagram, you can use UN Women’s face filter to spread the word and encourage your community to do the same. 

Use #orangetheworld, #16Days, and #GenerationEquality to start your own conversation about gender-based violence, or share some of the content from our social media package .

7. Stand against rape culture

Rape culture is the social environment that allows sexual violence to be normalized and justified, fueled by the persistent gender inequalities and attitudes about gender and sexuality. Naming it is the first step to dismantling rape culture.

Every day we have the opportunity to examine our behaviours and beliefs for biases that permit rape culture to continue. Think about how you define masculinity and femininity, and how your own biases and stereotypes influence you.

From the attitudes we have about gender identities to the policies we support in our communities, we can all take action to stand against rape culture.

Learn more ways to stand against rape culture .

8. Fund women’s organizations

Donate to local organizations that empower women, amplify their voices, support survivors, and promote acceptance of all gender identities and sexualities. 

UN Women works with women’s organizations everywhere to end violence against women, assist survivors, and secure equal rights for women and girls everywhere. Donate now . 

Find out more about how women ’ s organizations prevent violence against women and girls.

9. Hold each other accountable

Violence can take many forms, including sexual harassment in the workplace and in public spaces.

Take a stand by calling it out when you see it: catcalling, inappropriate sexual comments, and sexist jokes are never okay.

Create a safer environment for everyone by challenging your peers to reflect on their own behaviour and speaking up when someone crosses the line, or by enlisting the help of others if you don’t feel safe.

As always, listen to survivors and make sure they have the support they need.

10. Know the data and demand more of it

To effectively combat gender-based violence, we need to understand the issue.  

Relevant data collection is key to implementing successful prevention measures and providing survivors with the right support. 

Gaps in gender sensitive data collection have become more glaring than ever. Call on your government to invest in the collection of data on gender-based violence.

Find out at how UN Women works to bring about a radical shift in how gender statistics are used, created and promoted .

Originally published on Medium.com/@UN_Women .

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UNiTE! Invest to Prevent Violence Against Women & Girls! #No Excuse

Violence against women and girls remains one of the most prevalent and pervasive human rights violations in the world. Globally, an estimated 736 million women — almost one in three — have been subjected to physical and/or sexual intimate partner violence, non-partner sexual violence, or both, at least once in their life.

This scourge has intensified in different settings, including the workplace and online spaces, and has been exacerbated by post-pandemic effects, conflicts, and climate change.

The solution lies in robust responses, including investment in prevention. However, alarmingly, data on how much nations are committing to counteract violence against women and girls remains glaringly sparse.

For instance, just 5% of government aid is focused on tackling violence against women and girls, and less than 0.2% is directed to its prevention.

We need more investment in women’s organizations, better legislation, prosecution of perpetrators, more services for survivors, and training for law enforcement officials.

Join our 16 days of activism

The International Day for the Elimination of Violence Against Women will mark the launch of the UNiTE campaign (Nov 25- Dec 10) — an initiative of 16 days of activism concluding on the day that commemorates the International Human Rights Day (10 December).

This 2023 campaign Invest to Prevent Violence against Women & Girls will call on citizens to show how much they care about ending violence against women and girls and call on governments worldwide to share how they are investing in gender-based violence prevention. Join the global movement with the #NoExcuse slogan calling for urgent investments to prevent violence against women and girls.  Dig deeper into the campaign’s proposals –data, prevention, investments– and join the global movement with the #NoExcuse slogan to eliminate violence against women and girls.

UN Women’s action kit

Be a voice for survivors and for associations and movements that fight for women's rights. We can all do something to empower survivors and prevent and reduce gender-based violence. Use UN Women's social media materials and become an activist.

Why we must eliminate violence against women

Violence against women and girls (VAWG) remains largely unreported due to the impunity, silence, stigma and shame surrounding it.

In general terms, it manifests itself in physical, sexual and psychological forms, encompassing:

• intimate partner violence (battering, psychological abuse, marital rape, femicide);
• sexual violence and harassment (rape, forced sexual acts, unwanted sexual advances, child sexual abuse, forced marriage, street harassment, stalking, cyber- harassment);
• human trafficking (slavery, sexual exploitation);
• female genital mutilation; and
• child marriage.

To further clarify, the Declaration on the Elimination of Violence Against Women issued by the UN General Assembly in 1993, defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.”

The adverse psychological, sexual and reproductive health consequences of VAWG affect women at all stages of their life. For example, early-set educational disadvantages not only represent the primary obstacle to universal schooling and the right to education for girls; down the line they are also to blame for restricting access to higher education and even translate into limited opportunities for women in the labour market.

While gender-based violence can happen to anyone, anywhere, some women and girls are particularly vulnerable - for instance, young girls and older women, women who identify as lesbian, bisexual, transgender or intersex, migrants and refugees, indigenous women and ethnic minorities, or women and girls living with HIV and disabilities, and those living through humanitarian crises.

Violence against women continues to be an obstacle to achieving equality, development, peace as well as to the fulfillment of women and girls’ human rights. All in all, the promise of the Sustainable Development Goals (SDGs) - to leave no one behind - cannot be fulfilled without putting an end to violence against women and girls.

Did you know?

• More than five women or girls are killed every hour by someone in their own family.
• Almost one in three women have been subjected to physical and/or sexual violence at least once in their life.
• 86% of women and girls live in countries without legal protections against gender-based violence.

Source: More data from UN Women

You are not alone

Have you experienced abuse and need help? If you have felt threatened, unsafe or need assistance, please see the list of country help lines .

Against the Pushback, We #PushForward | 16 Days 2022

Report on femicide/feminicide 2022

Gender-related killings of women and girls

5 every hour....

That's how many women and girls are killed by someone in their own family. Let's stop this clock and take action to end violence against women & girls NOW. Find out more in the new report on Gender-related killings of women & girls .

In first person

Read about Diana’s story, an Argentine who suffered abuse for almost 30 years and how she managed to get out of her nightmare.

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Let's put an end to this problem by using data

The availability of data on gender violence has improved substantially and there is currently information from at least 161 countries. The United Nations Population Fund (UNFPA) and UN Women are working to draw conclusions from these figures. Visit the UNFPA multimedia website, with data classified by country, as well as UN Women facts , obtained through its Global Database to end gender violence .

Leaving no one behind  

Join us on a new, global, multi-year initiative focused on eliminating all forms of violence against women and girls, The Spotlight Initiative .

The program’s results last year were outstanding: 22% increase in prosecution of perpetrators; eighty-four laws and policies were passed or strengthened; and more than 650,000 women and girls were able to access gender-based violence services, despite restrictions related to the pandemic.

Why do we mark International Days?

International days and weeks are occasions to educate the public on issues of concern, to mobilize political will and resources to address global problems, and to celebrate and reinforce achievements of humanity. The existence of international days predates the establishment of the United Nations, but the UN has embraced them as a powerful advocacy tool. We also mark other UN observances .

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The problem of violence against women and children

By Diana J. Mendoza, PhD

Every year from Nov. 25 to Dec. 12, the Philippines observes an 18-Day Campaign to End Violence Against Women (VAW). This annual 18-day campaign was inspired by the global 16 Days of Activism Against Gender-Based Violence, an international campaign coordinated by the Center for Women’s Global Leadership. First launched in 1991, the core 16 Days of Activism against VAW takes place every year beginning on Nov. 25 and ending on Dec. 10 which is an International Human Rights Day, hence, affirming that violence against women is a human rights violation.

The Philippines joined the global campaign in 2002 through the Philippine Commission on Women. In 2006, the national campaign was extended to 18 days to include Dec. 12 to mark the signing in 2000 of the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, especially Women and Children and to supplement the UN Convention Against Transnational Organized Crimes.

Through Proclamation 1172, Nov. 25 to Dec. 12 of every year was declared as the “18-Day Campaign to End Violence against Women in the Philippines.” Nov. 25 of every year was also declared as the National Consciousness Day for the Elimination of Violence against Women and Children (VAWC) by virtue of Republic Act 10398, signed in 2013.

For the years 2016-2021, “VAW-free community starts with me” is the Philippine’s campaign theme in its annual observance of the 18-Day Campaign to End VAW. Led by the Philippine Commission on Women in coordination with Inter-Agency Council on Violence Against Women and Children (IACVAWC), “the campaign emphasizes everyone’s commitment and contributions on ending VAW, and presents an ideal picture of a VAW-free community, thus inspiring the general public to make a personal commitment to end violence against women and children.” (Philippine Commission on Women)

Almost 16 years ago, the Philippine Congress passed RA 9262 or the “Anti-Violence Against Women and their Children Act of 2004.” The law was considered a policy breakthrough as it provides a comprehensive policy regime that addresses the problem of VAWC in the country. By addressing the limitations and/or inadequacies of the country’s previous laws, the law creates a better policy environment to deal with issues of VAWC.

The Anti-VAWC law recognizes violence against women and their children as a public crime. It defines VAW so broadly that economic abuse is recognized and penalized under the law. It extends protection to all women victims, regardless of their marital or civil status. The law also provides legal and social remedies that protect and secure the rights and interests of the woman as victim. Lastly, the law recognizes and penalizes marital rape as a crime.

It has been almost 16 years now since the passage of the Anti-VAWC law, in that time has the Philippines become a VAWC-free country?

The results of the 2017 National Demographic and Health Survey (NDHS) by the Philippine Statistical Authority (PSA) would show otherwise. The 2017 NDHS is the 6 th DHS survey to be conducted in the Philippines in collaboration with the worldwide Demographic and Health Surveys Program, and the 11 th national DHS in all. It covered a nationally representative sample of 25,074 women age 15-49 in 27,496 surveyed households across the 17 regions in the country.

Violence against women in various forms continue to exist as reported in the 2017 NDHS. Nonetheless, the 2017 NDHS survey recorded a decline of violence against women from the previous 2013 and 2008 surveys.

For instance, “Spousal violence experienced by ever-married women by their current or most recent husband/partner, whether physical, sexual, or emotional has declined slightly from 29% in 2008 and 26% in 2013 to 24% in 2017. Women’s experience of physical violence has decreased slightly over time, from 20% in 2008 and 2013 to 17% in 2017. Similarly, women’s experience of physical violence in the 12 months preceding the survey has declined slightly, from 7% in 2008 to 5% in 2017. Women’s experience of sexual violence declined from 8% in 2008 to 5% in 2017.” (NDHS 2017)

Two alarming findings from the 2017 NDHS survey, however, deserve urgent attention from policymakers and implementers. First, while women’s experience of injuries as a result of spousal physical or sexual violence decreased from 41% in 2013 to 37% in 2017, the figure in 2017 is still higher than the 36% recorded in 2008. Second, while the respondents were aware of the legal and social remedies and protection measures provided by the Anti-VAWC law, still, women who have experienced physical or sexual violence sought help from their own family (65%), followed by friends (18%), and neighbors (10%). Only 6% of women have sought help from the police. These results mirror 2013 and 2008 survey findings.

These key findings prompt us to raise more questions. One, why don’t women who have experienced violence in various forms resort to the legal and social protection measures provided by the Anti-VAWC law? Two, are the legal and social interventions by the government agencies mandated to address VAWC poorly implemented and enforced? Three, aren’t the Filipino publics highly informed, and not just aware, about VAW as a human rights violation and there are legal and social remedies that they can access and resort to for help?

Perhaps, the next NDHS survey will consider these questions to aid our policymakers and implementers for future policy planning and implementation. Perhaps, too, national government and local government units take these findings more seriously so that the women who have experienced violence do not remain as plain statistics or numbers, nameless and faceless. Rather, let these findings be the voice of these women who have been continuously silenced, either by the society or by the law.

Diana J. Mendoza, PhD, is Chair of the Department of Political Science at the Ateneo de Manila University.

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What is VAWC?

VAWC or the Anti-Violence Against Women and Their Children Act of 2004 , is a law passed to protect women and children from violence. Also known as Republic Act ( R.A.) 9262, the law is in keeping with the provisions on human rights enshrined in the Philippine Constitution, as well as the fundamental rights and freedoms guaranteed in various international declarations and documents to which the Philippines is signatory, including:

• Universal Declaration of Human Rights
• The Convention on the Elimination of All Forms of Discrimination Against Women
• Convention on the Rights of the Child

You may also listen to our podcast about VAWC here:  

What does VAWC (violence against women and children) Protect?

The law protects women and children against various acts of violence, whether taking place in or out of the home. These acts generally fall under the following categories:

• Sexual violence
• Physical violence
• Psychological violence
• Economic abuse

What sets this law apart from common criminal acts is that the offender in these cases has an established relationship with the victim. The law defines these relationships to include, but are not limited to:

• Married couples
• Former spouses
• Couples with a common child, whether legitimate or illegitimate
• The legitimate or illegitimate parent of the victim
• A sexual or dating relationship, which include couples living together without the benefit of marriage, or has a continuing romantic involvement over time, with or without sexual intercourse

Violence Against Women and Children (VAWC) Act in the Philippines

Acts that make or attempt sexual violence.

Under VAWC, Women and children are given protection against violent sexual acts that include – but are not limited to – the following:

• Sexual harassment
• Acts of lasciviousness
• Demeaning or sexually suggestive remarks
• Physical attack of a woman’s or child’s sexual parts
• Forcing the victim to watch obscene shows and publications
• Filming sexual acts without the victim’s consent by the perpetrator 
• Forcing the wife and a mistress or lover to live in the same house or sleep together in the same room
• Forcing or attempting to cause the victim to engage in a sexual act through the threat of violence or harm
• Prostituting the victim

Make or Attempt to make Physical Violence

Under VAWC, Physical violence against a woman or child includes acts that result in or threaten bodily harm. These include:

• Causing or result in physical harm to the victim
• Threatening and/or attempting to cause physical harm to the victim
• Placing the victim in imminent physical harm
• Force the victim to engage in acts that the victim has the right to desist from
• Prevent the victim from doing acts they have the right to engage in
• Restrict the victim’s freedom of movement

Attempt to make a woman undergo Psychological Violence/Psychological Harm or Suffering

Under VAWC, Psychological violence or Psychological harm or suffering is defined as acts or omissions that are likely to result in or causing mental or emotional suffering on the part of the victim. These acts include, but are not limited to:

• Intimidation
• Damage to property
• Public ridicule or humiliation
• Mental infidelity
• Mental or Emotional suffering
• Repeated verbal abuse
• Forcing or allowing the victim to witness the abuse on a member of a family
• Unlawful deprivation of the right to custody or visitation of the victim’s children

Economic Abuse

Under VAWC, Economic abuse includes acts that make a woman financially dependent, including but not limited to:

• Withdrawal of financial support
• Preventing the victim from engaging in a legal profession
• Depriving the woman of financial resources and the use and enjoyment of the conjugal home
• Controlling the woman’s finances or the conjugal properties and money

The Victim’s Rights

The VAWC lists down the rights of the victim, including:

• Be treated with dignity and respect
• Confidentiality
• Free public legal assistance
• Paid leave of absence
• Be informed of the rights and services they are entitled to, including protection orders
• Temporary shelter
• Psycho-social services
• Recovery/rehabilitation programs
• Livelihood assistance
• Medical assistance
• Counseling Access to resources and support networks
• Protection from further violence or harassment
• Legal representation and assistance in court proceedings
• Right to refuse mediation or settlement without their consent
• Right to be heard and participate in legal proceedings
• Protection from victim-blaming or discrimination
• Right to privacy and safety
• Access to information about their case and the legal process
• Right to have their children and dependents protected and supported
• Right to compensation for damages and losses
• Right to be kept informed of the status of their case
• Right to be involved in decisions that affect their safety and well-being
• Right to access affordable and quality healthcare services
• Right to access education and training opportunities for their empowerment and independence. 

Do you need the protection of the VAWC? Take the first step and consult the attorneys at Duran & Duran-Schulze here .

You may also checkout this video to learn more:  

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Ending violence against women and children in the philippines, opportunities and challenges for collaborative and integrative approaches.

Violence against children and violence against women is prevalent across East Asia and the Pacific.

Although the fields of violence against children (VAC) and violence against women (VAW) historically developed separately, the international community has paid growing attention to intersections between these forms of violence, including shared risk factors, common underlying social norms, co-occurrence, intergenerational effects, common and compounding consequences, and adolescence as a time of vulnerability to and opportunity for prevention of both VAC and VAW. These multiple and complex links suggest that greater collaboration across those working on VAC and VAW policies and programs may increase the effectiveness of efforts to prevent and respond to both forms of violence.

However, while evidence about intersections among drivers, risk factors, and consequences of VAW and VAC has grown in recent years, knowledge about how policies, programs, and services should respond to these intersections is still preliminary. Important questions remain unanswered about how to strengthen a coordinated approach to addressing VAC and VAW.

Recognizing the need for greater collaboration in this area, UNICEF East Asia and Pacific Regional Office (EAPRO), UNFPA Asia Pacific Regional Office (APRO), and UN WOMEN Regional Office for Asia and the Pacific (ROAP) partnered on a regional, multi-country initiative in Cambodia, Papua New Guinea, the Philippines and Viet Nam to explore opportunities and challenges for better coordination, integration and collaboration for VAW and VAC policies, action plans, programs and services in the East Asia and Pacific region, focusing on violence that occurs within spaces and relationships of trust (e.g., intimate or dating relationships, family violence, school violence).

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Related topics, more to explore, violence against children in east asia and the pacific.

It condenses these findings into a format more easily accessible for governments, policy makers and technical experts in the region

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A Summary on Expanded Violence Against Women and Children

“Expanded” Violence Against Women and Children

Under Republic Act No. 9262, otherwise known as the Anti-Violence Against Women and Their Children Act of 2004 (“VAWC”), the concept of “violence” against women and children includes not just physical violence, but also sexual violence, psychological violence, and economic abuse, including threats of such acts, battery, assault, coercion, harassment, or arbitrary deprivation of liberty. [1] The law penalizes any act or a series of acts “committed by any person against a woman who is his wife, former wife, or against a woman with whom the person has or had a sexual or dating relationship, or with whom he has a common child, or against her child whether legitimate or illegitimate, within or without the family abode.”

In the 15 years since the enactment of the VAWC, some in Congress have perceived the need to expand the law to specifically include acts of violence that utilize electronic communications and social media platforms to inflict psychological violence. One such expression of this urge to modernize the law is embodied by House Bill No. 8655, which seeks to enact the “Expanded” Anti-Violence Against Women and Their Children Act”. It should not escape notice though that Republic Act No. 10175, or the Cybercrime Prevention Act of 2012, had effectively updated the VAWC by criminalizing as cyber-crimes those criminal acts under the VAWC that are committed through the use of information and communications technologies. ¶

Addressing the gaps on cybercrime against women and children

As a response to the recent and emerging threats to the welfare of women and children, the House of Representatives last December approved on final reading a bill that will help victims, law enforcers, prosecutors, and the court to punish violators and abusers who utilize electronic communication and social media platforms to inflict psychological violence through intimidation, harassment, stalking, public ridicule or humiliation, repeated verbal abuse, and marital infidelity against women and children. [2]

House Bill 8655 or the Expanded Anti-Violence Against Women and Their Children [Act of 2004] (E-VAWC) Bill [3] seeks to amend Republic Act No. 9262 by penalizing psychological violence through the use of information and communications technology (ICT) devices. The bill aims to expand the scope of protection afforded to women and children by including psychological violence committed through the use of electronic devices or ICT.

Cybercrime and other laws on ICT-related violence against women and children

Section 3 (a) of the E-VAWC Bill states that Electronic or ICT-related violence refers to any act or omission involving the use or exploitation of data or any form of ICT which cause or is likely to cause mental, emotional, or psychological distress or suffering to the women and her children. The E-VAWC Bill more specifically aims to provide an added layer of protection to a rather vulnerable sector by including acts that were not previously defined or understood. Some of these prohibited acts have recently caught the attention of the public due to apparent ill usage of technology. [4]

It should be noted though that under existing laws, certain acts of violence against women and children involving the use of ICT technologies are already penalized as crimes. Perhaps the most significant of these laws is the Cybercrime Prevention Act of 2012, Section 6 of which imposes a higher penalty for crimes already defined and penalized by existing penal laws and are committed through and with the use of information and communications technologies. Among these existing laws would be the present VAWC.

The Anti-Child Pornography Act, enacted in 2009, defines “child pornography” broadly as to include electronic, mechanical, digital, optical, magnetic or any other means, of any representation, whether visual, audio, or written combination thereof of child pornography. Another existing law, the Anti-Photo and Video Voyeurism Act or Republic Act No. 9995 [5] , prohibits recording videos or taking photos of a sexual act, the male or female genitalia, and of the female breast, among others, without consent of the persons featured in the material. R.A. No. 9995 was crafted to serve as a deterrent against the increasing reproduction, distribution, and publication of the material regardless of whether or not the persons featured consented to the recording. [6]

There could very well be some overlap between acts already penalized under current laws, and those sought to be punished under the E-VAWC Bill. Some of the acts included in ICT-related violence in E-VAWC are unauthorized recording, reproduction, distribution, use, sharing or uploading or any photograph, video, or other form of electronic and/or artistic presentation showing or depicting in any form or manner the genitalia of a women and those of her children, any sexually-related verbal or nonverbal expression or gesture of the woman and her children which may be construed as lewd, indecent, or obscene, any purported violent or errant behavior of the woman and her children or the use of intoxicating or prohibited substance or drugs, and any similar recording, reproduction, distribution, use, sharing or uploading of any audio presentation and data, including sound clips of the same nature previously mentioned. [7]

Similar to the punishable acts in R.A. No. 9995, provisions on E-VAWC include prohibition on any unauthorized use of a photograph, video, voice recording, name or any mark, reference or character identifiable with a woman and her children and suggestive of a wrongdoing, conduct, or attribute that tends to besmirch the reputation of the woman and her children.

Expanding existing laws on VAWC

Nonetheless, the E-VAWC Bill lays particular stress on the elements of harassment, intimidation, coercion, threat, or vilification of the woman and her children through any form, as well as any form of stalking including hacking of personal accounts on social media and the use of location data from electronic devices, fabrication of fake information or news through text messages or other cyber, electronic, or multimedia technology. Another newly-defined act of electronic violence that the E-VAWC Bill has introduced is the penalty against abusers who create fake social media accounts using an alias or a different personal information will ill intent and malice to sow intrigue and inflict harm. [8]

This particular emphasis of the E-VAWC Bill is timely in an era where social media has become increasingly powerful in terms of scope, real-time effect, and the irreparable damage it can cause to the welfare of women and children. The E-VAWC Bill and the attempt to expand what VAWC means, are emerging responses to current and relevant issues that women and children face.

[1] Sec. 3(a), VAWC.

[2] http://newsbytes.ph/2018/12/08/house-bill-against-online-shaming-of-women-kids-approved-on-2nd-reading/

[4] https://news.mb.com.ph/2018/12/08/final-house-nod-on-expanded-vawc-forthcoming/

[5] https://privacy.com.ph/articles/the-anti-photo-and-video-voyeurism-act-of-2009-a-primer/

[8] https://docs.google.com/viewerng/viewer?url=http://newsbytes.ph/wp-content/uploads/2018/12/E-VAWC.pdf&hl=en

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• What Is Violence Against Women And Children | RA 9262

by  RALB Law

Introduction

The deprivation of rights among women and children has been engraved in the history of different places in the world for a long time. In the past, women were not afforded with civil, social, political, and religious rights. They were not allowed to vote, to be employed, to have an education, or even wear dress that will not cover the whole body.

They were prohibited to attend social gatherings and were confined to their respective homes. They were sold by their parents for marriages. Worst, in other places, some perform genital mutilation or even killing right after the baby is born upon discovering that she is female.

The children along with their mothers, being vulnerable, were subjected to slavery or other forms of forced labor, and often experienced sexual, physical, psychological, and emotional abuse. Evidently, women and children were withheld with their inherent rights as human being to live and to enjoy it.

For many decades, this has been the norm of the world and nobody stood up and utter a voice, until the suffering became unbearable. According to United Nation Women Organization, it was only in 1840 that women started to cry out the truth that men and women are created equal.

Recognition of Women’s Rights

Then, the world opened its eyes and started to see the inhumane treatment women experienced. From that year on, the battle for the rights of women had begun.

More than hundred years had passed, violence among women and children are still prevalent. It is evident even in the Philippines wherein Filipinos are known to have close relationship ties with family, friends, and their partners.

To protect the rights of the women and children, the “Anti-Violence Against Women and Their Children Law (VWAC)” was enacted in 2004 or the famous statute known as Republic Act [RA] No. 9262. 1

This is to conform to the Constitutional policy that the State should protect and uphold the dignity of women and children, being an important part of the society and vital to the nation-building.

This is also to show adherence to the Universal Declaration of Human Rights, the convention on the Elimination of all forms of discrimination Against Women, Convention on the Rights of the Child, and other international human rights instruments of which the Philippines is a party.

What is the root of violence against women and children?

The root of violence against women and their children can be seen in different perspectives:

In historical perspective , in the earlier civilization, women were not allowed to go outside to hunt or work in the field because they are considered inferior and possess lesser physical strength as compared to men.

As years passed, this notion became a norm and women were afforded with fewer rights. In the culture and tradition of some countries, after the woman has been married to a man, she became the property of her husband, hence, was subject to the rights of the owner to use and even abuse.

She was restricted to perform some acts without her husband’s consent like entering into contracts. She has been made to depend on her husband even in financial aspect.

In social perspective, despite that the world became modernized and in most places, women were afforded with equal rights, a patriarchal society still remain like in the Philippines.

There are still a lot of women who are not allowed to work outside home, on the other hand, if they have work outside home, they have the double burden of working inside the house and taking care of the family. Still, they are subject to some abuses.

Moreover, the root cause of abuse can be seen in personal perspective. Every person who enter into relationship will have personal differences.

Conflict and misunderstanding would often arise which have resulted to abuses. In some instances, the woman triggers her partner. In other cases, the partner who feels superior would easily inflict abuse even without trigger.

The family which is supposed to be a safe place became a battlefield. The persons who are supposed to be the protector of the women and their children has become their threat and agonizer.

When the love and respect between persons who have committed to love each other were lost, different forms of violence would come in. This violence should not be tolerated.

What are the effects of violence against women and children?

The common effects of violence against women and children can be classified into two, namely, social impact and psychological or personal impact.

Social Impact

The most disadvantageous effect of the violence is its negative impact in the society . Women inherently possess talents and skills which are vital to the society.

The nurturing nature of the woman are needed for child care, elderly care, etc.; their diligence and keenness in work are valuable in the workplace.

These are just few examples of contributions of women which can be hindered when violence comes in whether inside home or outside home. Their fullest potentials cannot be reached when they are entangled in the chain of violence.

Since the women and children are part of the family, when relationships are broken and family life is in chaos, the basic foundation of the society is shaken.

The children as products of chaotic family more likely to experience the same in their adult life, as studies show, unless the cycle is broken. Different criminal and civil cases will surface and would add up to the dockets of the courts as conflict arose.

Psychological or Personal Impact

Moreover, violence has psychological impact to the victims. Violence often result to fear and trauma. In Anti-VAWC cases, the perpetrators have or once have close relationship with the victim. Hence, the emotional wounds are deeper.

The violence even goes for years without being reported because of the idea that these personal matters will be fixed. The families or the partners’ reputation are dragged and tarnished. The children who are trapped in this circumstance are mocked and became the talk of the town.

The victims usually carry this horrific experience even after the violence ceased. In some cases, because of the accumulated anger, depression, frustration, it would result to crime of murder, homicide, parricide , etc.

These harsh effects of violence against women and children are the evil sought to be avoided or remedied through the Anti- VAWC Law.

Discuss Physical Violence, Sexual Violence, Psychological Violence, Economic Abuse, and Stalking

Abuses against women and their children are categorized under the Anti-VAWC Statute, which defines and specifically penalizes such atrocities.

Physical Violence

The Anti- VAWC Law define physical violence as acts that include bodily or physical harm. This bodily harm is the result of employing force or strength by the perpetrator to any part of the body of the victims.

In usual cases, this results to bruises, wounds, scratches, or same acts which qualified as physical injury in the Revised Penal Code .

Sexual Violence

On the other hand, “ Sexual violence “ 2 refers to an act which is sexual in nature, committed against a woman or her child. It includes, but is not limited to:

• rape , sexual harassment, acts of lasciviousness, treating a woman or her child as a sex object, making demeaning and sexually suggestive remarks, 3
• physically attacking the sexual parts of the victim’s body, forcing her/him to watch obscene publications and indecent shows or forcing the woman or her child to do indecent acts and/or make films thereof, 3
• forcing the wife and mistress/lover to live in the conjugal home or sleep together in the same room with the abuser, 3
• acts causing or attempting to cause the victim to engage in any sexual activity by force, threat of force, physical or other harm or threat of physical or other harm or coercion; 3
• Prostituting the woman or child. 3

Under the Family Code, the wife has sexual responsibility with her husband. Despite that, the VAWC Law acknowledges that the wife has still the full control of her body and she could freely decide whether to engage in sexual activity or not under reasonable circumstances.

Forcing a wife to engage in sexual intercourse without her consent would constitute marital rape. In case of prostituting the woman or child, even with full knowledge and consent, if it is initiated and encouraged by the husband, then he is liable under the Anti- VAWC Law.

Since a sexually abusive husband can be persecuted, how much more to any person who is not a husband of the woman which could be lover, ex—lover, ex- husband, or lesbian girlfriend.

Psychological Violence

In addition, the Anti- VAWC Law defines “Psychological violence ” as acts or omissions causing or likely to cause mental or emotional suffering of the victim such as but not limited to intimidation, harassment, stalking, damage to property, public ridicule or humiliation , repeated verbal abuse, and mental infidelity. 4

It includes causing or allowing the victim to witness the physical, sexual or psychological abuse of a member of the family to which the victim belongs, or to witness pornography in any form or to witness abusive injury to pets or to unlawful or unwanted deprivation of the right to custody and/or visitation of common children. 3

Though psychological violence does not result to physical wound or pain, it causes great harm to dignity, morale, or well-being of the victims.

Psychological violence could also result to mental illness, stress, depression, trauma, as well as physical illnesses.

In the recent case decided by the Supreme Court in 2020, 5 it affirmed the appellate court’s decision to punish the husband with 6 moths to 8 years of imprisonment plus moral damages for his infidelity or extra marital affair which resulted to bearing three children with his mistress.

This is the proximate cause of the mental and emotional anguish of his wife for long years and was qualified as “psychological violence” under the VAWC Law.

Economic Abuse

Last, “ economic abuse” refers to acts that make or attempt to make a woman financially dependent which includes, but is not limited to the following: 6

• withdrawal of financial support or preventing the victim from engaging in any legitimate profession, occupation, business or activity, except in cases wherein the other spouse/partner objects on valid, serious and moral grounds as defined in Article 73 of the Family Code; 3
• deprivation or threat of deprivation of financial resources and the right to the use and enjoyment of the conjugal, community or property owned in common; 3
• destroying household property; 3
• controlling the victims’ own money or properties or solely controlling the conjugal money or properties. 3

In usual Filipino family set-up, men enter into employment while women stay at home to take care of the family, especially the children.

Generally, since it is man who earns income for the family, he has the final say as to where the money goes. It is easy to control the not employed woman by threatening her to be withheld with the only means she and her child could live.

This too, is punishable under Anti-VAWC Law for being a form of economic abuse. Also, even the spouses or partners were already separated, when their child is not given sufficient financial support, the man can be held liable.

Stalking, on the other hand, is defined as an intentional act committed by a person who, knowingly and without lawful justification follows the woman or her child or places the woman or her child under surveillance directly or indirectly or a combination thereof. 7

The VAWC Law put high regard in the safety and freedom from surveillance of the woman and her child as it also punishes mere staking wherein no direct harm is being inflicted to them. The law punishes this act to put preventive measure in the possible direct harm the perpetrator could do to woman and her children.

Explain the concept of “Dating Relationship” and “Sexual Relations” and differentiate them  

There are juridical nexus, whether past or existing, for which any abuse that may happen upon a woman and her child will be covered by the Anti-VAWC Law because of that relative relationship of the parties involved.

Dating Relationship

Under the Anti- VAWC Law and its Implementing Rules and Regulations [IRR], “Dating relationship” refers to a situation wherein the parties live as husband and wife without the benefit of marriage or are romantically involved over time and on a continuing basis during the course of the relationship. 8

A casual acquaintance or ordinary socialization between two individuals in a business or social context is not a dating relationship. 3

Sexual Relations

On the other hand, “Sexual relations” refers to a single sexual act which may or may not result in the bearing of a common child. 9

Duration of Relationship

Dating relationship is differentiated in the law from sexual relations. As to duration of the relationship , dating relationship is longer than sexual relation since even a single sexual act can be classified as such and is already covered in the Anti-VAWC Law.

Degree of Emotional Attachment

As to the degree of emotional attachment, there is higher degree of emotional attachment and commitment in dating relationship because the parties are romantically involved over time and on a continuing basis.

On the other hand, in sexual relation, it is not necessary that the parties commit to each other. It does not follow that there is sexual relation in dating relationship or vice versa.

Public Perception

As to how the parties are perceived by the third person, in dating relationship, they are usually publicly known or seen as romantically involved with each other.

Third persons can see these through the couple’s overt acts, as can be inferred from those who are living as husband and wife without the benefit of marriage, or those more than casual acquaintance, regardless whether they label their relationship or not.

As compare to sexual relation, this is usually not known to the public since the act are performed in private.

Does a single act of harassment enough to convict an offender?

Yes, single act of harassment is enough to convict an offender. Under Section 3(a) of R.A. 9262, violence against women and children can be any act or series of act.

The law does not require that the violence is repetitive or continuous in order to have cause of action in filing the case as It can be ‘ ’any act”. The purpose of this is to reinforce and protect right away the woman and her child from further abuses.

What are the elements of the crime of violence against women and their children?

In the case of Rustan Ang Y Pascua vs. Sagud, 10 the Court enumerated the elements of the crime of violence against women through harassment as follows:

• First, the offender has or had a sexual or dating relationship with the offended woman. The offender could include husband, ex-husband, lover, ex-lover, boyfriend, ex-boyfriend, girlfriend or ex-girlfriend since these are the persons a woman will have sexual or dating relationship with, or whom he has common child.
• Second, the offender, by himself or through another, commits an act or series of acts of harassment against the woman. It means that the offender can still be held liable for the crime even if he was not directly the one who inflicted the harm but other persons under his direction.
• Third, the harassment alarms or causes substantial emotional, physical or psychological distress to her. The violence can be physical, emotional, psychological, economic, sexual. The abuser can still be held liable, regardless of the kind of violence as well as the degree

Will a Temporary Protection Order (TPO) applicable or be issued in favor of a man against his wife?

It s not possible. The Anti- VAWC Law expressly provides protection to women and children. Hence, a Temporary Protection Order cannot be granted to a husband against his wife.

The applicable law that a husband can properly assert in his favor is the Revised Penal Code. The law has inclination to women and children because generally they are considered more vulnerable as compared to men who is usually stronger to protect themselves specially from physical violence.

Is it indispensable that the act of violence be a consequence of a dating or sexual relationship?

No, the law does not require that the act of violence be a consequence of dating or sexual relationship. The Supreme Court held that what is required is the committed act of violence may it be in the present wherein the parties are still in relationship or in the past when they had a relationship.

It is a basic rule that when the law does not distinguish, we should not distinguish.

What is battery? What is the concept of a battered woman syndrome?

Battery is repetitive physical abuse of a woman by her partner, husband, or lover which results to emotional, physical, psychological anguish of the woman. Battered woman syndrome is a concept originated from the United States wherein the Supreme Court adopted.

It is scientifically defined pattern of psychological and behavioral symptoms found in women living in battering relationships as a result of cumulative abuse. She always has fear for her life as if her husband or her partner is going to inflict harm to her anytime.

The concept of a battered woman syndrome is best described in the ruling of the Supreme Court in the landmark case of People vs Genosa 11 , t he Supreme Court held that a woman is considered battered if she is:

“repeatedly subjected to any forceful physical or psychological behavior by a man in order to coerce her to do something he wants her to do without concern for her rights. Battered women include wives or women in any form of intimate relationship with men. 12 “Furthermore, in order to be classified as a battered woman, the couple must go through the battering cycle at least twice. Any woman may find herself in an abusive relationship with a man once. If it occurs a second time, and she remains in the situation. 12

“Battered women exhibit common personality traits, such as low self-esteem, traditional beliefs about the home, the family and the female sex role; emotional dependence upon the dominant male; the tendency to accept responsibility for the batterer’s actions; and false hopes that the relationship will improve.” 12

More graphically, the battered woman syndrome is characterized by the so-called “cycle of violence,” which has three phases: 12

(1) the tension-building phase; 12 (2) the acute battering incident; and 12 (3) the tranquil, loving (or, at least, nonviolent) phase 12

Tension Building Phase

During the tension-building phase , minor battering occurs — it could be verbal or slight physical abuse or another form of hostile behavior. 12

The woman usually tries to pacify the batterer through a show of kind, nurturing behavior; or by simply staying out of his way. What actually happens is that she allows herself to be abused in ways that, to her, are comparatively minor. 12

All she wants is to prevent the escalation of the violence exhibited by the batterer. This wish, however, proves to be double-edged, because her “placatory” and passive behavior legitimizes his belief that he has the right to abuse her in the first place. 12

Acute Battering Incident

The acute battering incident is said to be characterized by brutality, destructiveness and, sometimes, death. The battered woman deems this incident as unpredictable, yet also inevitable. 12

During this phase, she has no control; only the batterer may put an end to the violence. Its nature can be as unpredictable as the time of its explosion, and so are his reasons for ending it. 12

The battered woman usually realizes that she cannot reason with him, and that resistance would only exacerbate her condition. 12

At this stage, she has a sense of detachment from the attack and the terrible pain, although she may later clearly remember every detail. Her apparent passivity in the face of acute violence may be rationalized thus: 12

“the batterer is almost always much stronger physically, and she knows from her past painful experience that it is futile to fight back.” 12

Acute battering incidents are often very savage and out of control, such that innocent bystanders or intervenors are likely to get hurt. 13

Tranquil Period

The final phase of the cycle of violence begins when the acute battering incident ends. During this tranquil period , the couple experience profound relief. On the one hand, the batterer may show a tender and nurturing behavior towards his partner. 12

He knows that he has been viciously cruel and tries to make up for it, begging for her forgiveness and promising never to beat her again. 12

On the other hand, the battered woman also tries to convince herself that the battery will never happen again; that her partner will change for the better; and that this “good, gentle and caring man” is the real person whom she loves. 12

A battered woman usually believes that she is the sole anchor of the emotional stability of the batterer. Sensing his isolation and despair, she feels responsible for his well-being. 12

The truth, though, is that the chances of his reforming, or seeking or receiving professional help, are very slim, especially if she remains with him. 12

Generally, only after she leaves him does he seek professional help as a way of getting her back. Yet, it is in this phase of remorseful reconciliation that she is most thoroughly tormented psychologically. 14

The illusion of absolute interdependency is well-entrenched in a battered woman’s psyche. In this phase, she and her batterer are indeed emotionally dependent on each other — she for his nurturant behavior, he for her forgiveness. 14

Underneath this miserable cycle of “tension, violence and forgiveness,” each partner may believe that it is better to die than to be separated. Neither one may really feel independent, capable of functioning without the other . 12

Is a battered woman syndrome a proper defense?

Yes, in the landmark case of People vs Genosa, 15 the Supreme Court adopted the defense of battered woman syndrome and justified the killing of the husband by the accused wife.

A person who is suffering from battered woman syndrome always fear for her life and always feel the urge to defense herself from the repetitive battery of her husband.

In addition, it was expressly stated in Section 26 of R.A. 9262 that victim-survivors who are found by the courts to be suffering from battered woman syndrome do not incur any criminal and civil liability notwithstanding the absence of any of the elements for justifying circumstances of self-defense under the Revised Penal Code. 16

How should the law be construed and why?

The law should be construed in favor of the victims. It is clearly the intent of the legislators to protect the women and children in order for their basic human rights to be realized and be enjoyed. As consequence, they can achieve their fullest potential and they can contribute to the society.

May the abuses committed by another person through conspiracy?

Yes, abuses can be committed by another person through conspiracy . The Anti-VAWC Law expressly provide in Section 47 that the Revised Penal Code and other applicable laws, shall have suppletory application.

Conspiracy is a general principle in the Revised Penal Code wherein the perpetrators shall be held liable as one regardless of the degree of their participation when it is proved that they have common design in committing the crime.

In addition, Section 5 of the Anti-VAWC law also provides that the violence can be committed by offender personally or through another person. Hence, another person can commit the said crime through conspiracy.

Discuss Jurisdiction and Venue. What are the prescriptive periods of acts punishable by this law?

Jurisdiction is the authority of the court to hear and decide the case while the venu e in criminal cases is the place where the elements of the crime were committed. Jurisdiction of the subject matter, as in VAWC cases in conferred by the Anti-VAWC Law itself.

Here, it is expressly stated in Section 7 that Regional Trial Court designated as a Family Court shall have original and exclusive jurisdiction over cases of violence against women and their children.

In the absence of such court in the place where the offense was committed, the case shall be filed in the Regional Trial Court where the crime or any of its elements was committed at the option of the compliant. 17

On the other hand, the prescriptive period or the time wherein the complaint can be filed is provided in Section 24 of the Law which states that acts falling under Sections 5(a) to 5(f) shall prescribe in twenty (20) years. Acts falling under Sections 5(g) to 5(I) shall prescribe in ten (10) years.

How is the crime of violence against women and children be classified?

Section 25 of RA 9262 provides that violence against women and their children shall be considered a public offense which may be prosecuted upon the filing of a complaint by any citizen having personal knowledge of the circumstances involving the commission of the crime. 18

It is against the policy of State and any person stated in Section 9 of the Anti-VAWC Law can file a petition for protection order, namely:

• the offended party; 19
• parents or guardians of the offended party; 20
• ascendants, descendants or collateral relatives within the fourth civil degree of consanguinity or affinity; 20
• officers or social workers of the DSWD or social workers of local government units (LGUs); 20
• police officers, preferably those in charge of women and children’s desks; 20
• Punong Barangay or Barangay Kagawad; 20
• lawyer, counselor, therapist or healthcare provider of the petitioner; 20
• At least two (2) concerned responsible citizens of the city or municipality where the violence against women and their children occurred and who has personal knowledge of the offense committed. 20

Does the Revised Penal Code have suppletory application under this Act? What is the importance of the Protection Order?

Yes, the RPC has suppletory application as it is expressly provided in Section 47 of the Anti-VAWC Law. The general law still applies to special laws when specifically provided in the latter.

The importance of protection order is to give immediate aid to the women and children and to lessen the abuses that will be possibly inflicted to them.

Since there is danger to the life of the victims in VAWC cases, this is considered urgent matter when filed in courts. Through the Protection Order, the abuser will be prohibited to go near the victims.

As consequence, the victims could start to recover and prepare for the further actions that they will take.

What has been decided

In People vs Genosa, 21 despite that the killing of the husband by the wife was justified, the Court warned that in any event, the existence of the syndrome in a relationship does not in itself establish the legal right of the woman to kill her abusive partner. Evidence must still be considered in the context of self-defense. 12

The crucial to the BWS defense is the state of mind of the battered woman at the time of the offense — she must have actually feared imminent harm from her batterer and honestly believed in the need to kill him in order to save her life. 12

Settled in our jurisprudence, however, is the rule that the one who resorts to self-defense must face a real threat on one’s life; and the peril sought to be avoided must be imminent and actual, not merely imaginary. 12

Unlawful aggression is the most essential element of self-defense. It presupposes actual, sudden and unexpected attack — or an imminent danger thereof — on the life or safety of a person. 12

In the present case, however, according to the testimony of Marivic herself, there was a sufficient time interval between the unlawful aggression of Ben and her fatal attack upon him. 12

She had already been able to withdraw from his violent behavior and escape to their children’s bedroom. During that time, he apparently ceased his attack and went to bed. 12

The reality or even the imminence of the danger he posed had ended altogether. He was no longer in a position that presented an actual threat on her life or safety. 12

In Araza vs People , the Court held that the accused is correct that he cannot be convicted based on acts of abandonment of the conjugal home, and pretenses that he was forcefully detained. 5

These were not alleged in the Information. However, there were other acts alleged in the Information that caused emotional anguish and mental suffering on AAA. 22

In this case, the Court finds that the Information contains the recital of facts necessary to constitute the crime charged. 22

It clearly stated that:

(1) The offended party AAA, is the wife of offender Araza; 22

(2) AAA sustained emotional anguish and mental suffering; and 22

(3) such anguish and suffering is inflicted by Araza when he had an extramarital affair with Fabillar and had three illegitimate children with her. 22

Psychological violence is an indispensable element of violation of Section 5(i) of R.A. No. 9262. Equally essential is the element of emotional anguish and mental suffering, which are personal to the complainant. 22

Psychological violence is the means employed by the perpetrator, while emotional anguish or mental suffering are the effects caused to or the damage sustained by the offended party. 22

The law does not require proof that the victim became psychologically ill due to the psychological violence done by her abuser. Rather, the law only requires emotional anguish and mental suffering to be proven. 22

To establish emotional anguish or mental suffering, jurisprudence only requires that the testimony of the victim to be presented in court, as such experiences are personal to this party. 22

In order to establish psychological violence, proof of the commission of any of the acts enumerated in Section 5(i) or similar of such acts, is necessary.

The prosecution has established Araza’s guilt beyond reasonable doubt by proving that he committed psychological violence upon his wife by committing marital infidelity. AAA’s testimony was strong and credible. She was able to confirm that Araza was living with another woman. 22

Final thoughts

No one is superior in power to possess the license to commit violence specially to women and children. Women and children are already deprived for a long time of their inherent right to right to be safe, protected, and to a quality life just like any other persons.

The international community has seen this and many countries joined forces to eliminate this kind of violence. When women and children cannot protect themselves, the law itself should protect them.

The Philippines adheres to this call and continuously prosecute abusers who are supposed to be the protector and provider of the women and children. The purpose of the VAWC Law is very humane.

It acknowledges the equal rights of women and children, and it sees their value in the community. You too can take part of this goal, whether you are witness or the victim to the abuse, never let your voice be suppressed. Let the oppressors be made known.

• RA 9262 [ ↩ ]
• IRR, RA 9262, Rule II, Section 5[c][2] [ ↩ ]
• Id. [ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ]
• IRR, RA 9262, Rule II, Section 5[c][3] [ ↩ ]
• G.R. No. 247429, September 08, 2020 [ ↩ ][ ↩ ]
• IRR, RA 9262, Rule II, Section 5[c][4] [ ↩ ]
• IRR, RA 9262, Rule II, Section 5[f] [ ↩ ]
• IRR, RA 9262, Rule II, Section 5[g] [ ↩ ]
• IRR, RA 9262, Rule II, Section 5[h] [ ↩ ]
• G.R. No. 182835, April 20, 2010 [ ↩ ]
• G.R. No. 135981, January 15, 2004 [ ↩ ]
• Id. [ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ]
• Id. [ ↩ ][ ↩ ]
• Supra. [ ↩ ]
• Section 26, RA 9262 [ ↩ ]
• Garcia vs. Drilon G.R. No. 179267 June 25, 2013 [ ↩ ]
• Section 25, RA 9262 [ ↩ ]
• Section 9, RA 9262 [ ↩ ]
• Id. [ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ]
• G. R. No. 135981, January 15, 2004 [ ↩ ]
• Id. [ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ][ ↩ ]

RALB Law | RABR & Associates Law Firm

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Anti-Violence Against Women and Their Children Act (RA 9262)

• By attykalibre
• April 4, 2014
• No Comments

What is Republic Act No. 9262?

RA 9262 is the Anti-Violence Against Women and Their Children Act of 2004. It seeks to address the prevalence of violence against women and children (VAWC), abuses on women and their children by their partners like:

Husband or ex-husband Live-in partner or ex-live in partner Boyfriend/girlfriend or ex-boyfriend/ex-girlfriend Dating partner or ex-dating partner The Act classifies violence against women and children (VAWC) as a public crime.

What is VAWC under the law?

It refers to “any act or a series of acts committed by any person against a woman who is his wife, former wife, or against a woman with whom the person has or had a sexual or dating relationship, or with whom he has a common child, or against her child whether legitimate or illegitimate, within or without the family abode, which result in or is likely to result in physical, sexual, psychological harm or suffering, or economic abuse including threats of such acts, battery, assault, coercion, harassment or arbitrary deprivation of liberty.

It includes, but is not limited to, the following acts:

Physical violence refers to acts that include bodily or physical harm;

Sexual violence refers to an act which is sexual in nature, committed against a woman or her child. It includes but is not limited to:

Rape, sexual harassment, acts of lasciviousness, treating a woman or her child as a sex object, making demeaning and sexually suggestive remarks, physically attacking the sexual parts of the victim’s body, forcing her/him to watch obscene publications and indecent shows or forcing the woman or her child to do indecent acts and/or make films thereof, forcing the wife and mistress/lover to live in the conjugal home or sleep together in the same room with the abuser; Acts, causing or attempting to cause the victim to engage in any sexual activity by force, threat of force, physical or other harm or threat of physical or other harm or coercion; Prostituting the woman or her child. Psychological violence refers to acts or omissions causing or likely to cause mental or emotional suffering of the victim such as but not limited to intimidation, harassment, stalking, damage to property, public ridicule or humiliation, repeated verbal abuse and marital infidelity. It includes causing or allowing the victim to witness the physical, sexual or psychological abuse of a member of the family to which the victim belongs, or to witness pornography in any form or to witness abusive injury to pets or to unlawful or unwanted deprivation of the right to custody and/or visitation of common children.

Economic abuse refers to acts that make or attempt to make a woman financially dependent. This includes but is not limited to the following:

Withdrawal of financial support or preventing the victim from engaging in any legitimate profession, occupation, business or activity, except in cases wherein the other spouse/partner objects on valid, serious and moral grounds as defined in Article 73 of the Family Code; Deprivation or threat of deprivation of financial resources and the right to the use and enjoyment of the conjugal, community or property owned in common; Destroying household property; Controlling the victim’s own money or properties or solely controlling the conjugal money or properties. Children are those below 18 years of age or those, regardless of age, who are incapable of taking care of themselves (as stated in Republic Act 7610). It includes the biological children of the victim and other children under her care. A dating relationship is one which has a romantic involvement. It means that a relationship existed between a woman and a partner who is abusive or has previously a bused her, whether or not the relationship was formal.

Sexual relations refer to a single sexual act which mayor may not result to a bearing of a child.

Who gets protected under the law?

The law recognizes the unequal relations of a man and a woman in an abusive relationship where it is usually the woman who is disadvantaged. Thus, the law protects the woman and her children.

The victim, the child who is a minor (legitimate and illegitimate), and a person aged 18 years and beyond who doesn’t have the ability to decide for herself/himself because of an emotional, physical and mental illness can make full use of the law. Any child under the care of a woman is also protected under the law.

Is VAWC committed by men alone?

Women can also be liable under the law. These are the lesbian partners/girlfriends or former partners of the victim with whom she has or had a sexual or dating relationship. (Source: Barangay Protection Order RA 9262: A Primer. Department of Interior and Local Government, National Barangay Operations Office, 2004.)

What if the female victim commits violence against her partner?

The law acknowledges that women who have retaliated against their partners or who commit violence as a form of self-defense may have suffered from battered women syndrome (BWS).

BWS is a “scientifically defined pattern of psychological and behavioral symptoms found in women living in battering relationships as a result of cumulative abuse.” (Source: Salient Features: A Guide to Anti-Violence Against Women and their Children [RA 9262]. Philippine Information Agency and National Commission on the Role of Filipino Women, 2004. )

Any victim who suffers from BWS should be diagnosed by a psychiatric expert or a clinical psychologist. This will also help the victim in obtaining a just decision in her case.

What if the male spouse/partner complains about abuses committed by his wife/partner?

He may file a complaint or case under the Revised Penal Code.

What are the penalties for committing VAWC?

If the courts have proven that the offender is guilty of the crime, he may be imprisoned and will be obliged to pay P100,000 to P300, 000 in damages. The length of imprisonment depends on the gravity of the crime.

What can women and children do under the law?

The law allows women and their children to secure barangay protection order and/or temporary or permanent protection order from the courts.

They can also file an independent civil action for damages and criminal action for the violation of anti-VAWC Act.

What is a protection order?

It is an order prescribed in the Anti-VAWC Act to prevent further abuse of or violence against a woman and her child. It also provides them relief from said abuse or violence.

Who may file the protection order?

Anyone of the following may also file the protection order in behalf of the victim/s:

Parent or guardian Grandparents Children and grandchildren Relatives (aunts, uncles, cousins, in-laws) Local officials and DSWD social workers Police Lawyers Counselors Therapists Health care providers (nurses, doctors, barangay health workers) Any two people who came from the city or municipality where VAWC happened and who have personal knowledge of the crime.

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Republic of the Philippines Philippine Commission on Women

Faqs ra 9262: the anti-violence against women and their children act of 2004.

RA 9262: the Anti-Violence Against Women and their Children  Act  of 2004

Frequently Asked Questions

What is RA9262 or the Anti-Violence Against Women and Their Children Act of 2004?

It is a law the seeks to address the prevalence of violence against women and their children (VAWC) by their intimate partners like their husband or ex-husband, live-in partner or former live-in partner,  boyfriend/girlfriend or ex-boyfriend/ex-girlfriend, dating partner or former dating partner.

What is Violence Against Women and Their Children under RA9262?

It refers to any act or a series of acts committed by an intimate partner (husband, ex-husband, live-in partner, boyfriend/girlfriend, fiance, who the woman had sexual/dating relationship):

• against a woman who is his wife, former wife;
• against a woman with whom the person has or had a sexual or dating relationship, 
• against a women with whom he has a common child;
• against her child whether legitimate or illegitimate within or without the family abode, 

Of which results in or is likely to result in physical, sexual, psychological harm or suffering or economic abuse including threats of such acts, battery, assault, coercion, harassment or arbitrary deprivation of liberty.

What are the acts of violence which are covered under R.A. 9262?

R.A. 9262 covers several acts of violence, which are:

• causing/threatening/attempting to cause physical harm to the woman or her child;
• placing the woman or her child in fear of imminent physical harm
• Rape, sexual harassment, acts of lasciviousness, treating a woman or her child as a sex object, making demeaning and sexually suggestive remarks, physically attacking the sexual parts of the victim’s body, forcing him or her to watch obscene publications and indecent shows or forcing the woman or her child to do indecent acts and/or make films thereof, forcing the wife and mistress/lover to live in the conjugal home or sleep together in the same room with the abuser.
• Causing or attempting to make the woman or her child to perform sexual acts (that do not constitute Rape) by use of force, threats, intimidation directed against the woman, her child, or her immediate family.
• Prostituting the woman or her child.
• Threatening to or actually depriving the woman or her child of custody or access to her/his family;
• Depriving or threatening to deprive the woman or her child of a legal right;
• Causing mental or emotional anguish, public ridicule or humiliation to the woman or her child, e.g. repeated verbal and emotional abuse, and denial of financial support or custody or minor children or denial of access to the woman’s child/children
• Threatening or actually inflicting physical harm on oneself for the purpose of controlling the woman’s actions or decisions;
• It includes causing or allowing the victim to witness the physical, sexual or psychological abuse of a member of the family to which the victim belongs, or to witness pornography in any form or to witness abusive injury to pets or to unlawful or unwanted deprivation of the right to custody and/or visitation of common children.
• Stalking or following the woman or her child in public or private places; 
• Peering in the window or lingering outside the residence or the woman or her child; 
• Entering or remaining in the dwelling or on the property of the woman or her child against her/his will; 
• Destroying the property and personal belongings or inflicting harm to animals or pets of the woman or her child; 
• Engaging in any form of harassment or violence
• Preventing the woman from engaging in any legitimate profession, occupation, business or activity except in cases wherein the other spouse/partner objects on valid, serious and moral grounds as defined in Article 73 of the Family Code;
• Controlling the woman’s own money or property; or solely controlling the conjugal or common money/properties;
• Destroying household property;

Define children as used under R.A. 9262 .

“ Children ” refers to those below eighteen (18) years of age or older but are incapable of taking care of themselves as defined under Republic Act No. 7610. As used in this Act, it includes the biological children of the victim and other children under her care.

Define dating relationship as used under R.A. 9262 .

It is a situation wherein the parties live as husband and wife without the benefit of marriage or are romantically involved over time and on a continuing basis during the course of the relationship. A casual acquaintance or ordinary socialization between two individuals in a business or social context is not a dating relationship.

Define sexual relations as used under R.A. 9262 .

It refers to a single sexual act which may or may not result in the bearing of a common child.

Define “Battered Woman Syndrome” as used under R.A. 9262

It refers to a scientifically defined pattern of psychological and behavioral symptoms found in battered women as a result of a long history of abuse.

RA 9262 acknowledges that women who have retaliated against their partner or who commit violence as a form of self-defense may have suffered from Battered Woman Syndrome (BWS). Any victim who suffers from BWS should be diagnosed by a Psychiatric expert or a clinical psychologist. This will also help the victim in obtaining a just decision in her case. The law does not allow the offender to have custody of minor children. Their care is entrusted to the woman even if she is found to have BWS.

Who are the persons protected by R.A. 9262?

The law recognizes the unequal relations between a man and a woman in an abusive relationship where the woman is usually at a disadvantage.

The following are the persons who are protected by R.A. 9262: 

• Former Wife 
• A woman with whom the offender has or had sexual relations with 
• A woman with whom the offender has a common child with 
• The legitimate or illegitimate child of the woman within or without the family abode

Is VAWC committed by men alone?

Women can also be liable under the law. These are the lesbian partners/girlfriends or former partners of the victim with whom she has or had a sexual or dating relationship. 

What if the male spouse/partner complains about abuses committed by his wife/partner? 

He may file a complaint or case under the Revised Penal Code.

What can women and children do under R.A. 9262? 

Under the law, the offended party may file a criminal action, or apply for a Protection Order either as an independent action or as an incident in civil or criminal action and other remedies.

Who may file a complaint under R.A. 9262?

Any citizen having personal knowledge of the circumstances involving the commission of the crime may file a complaint because violence against women and their children is considered a PUBLIC crime. 

Where should cases for VAWC be filed?

Cases may be filed in the Regional Trial Court designated as FAMILY COURT of the place where the crime was committed. These courts have original and exclusive jurisdiction over these cases.

What are the penalties for committing VAWC? 

Offenders proven in court to be guilty of the crime shall be penalized with: imprisonment ranging from 1 month and 1 day to 20 years payment of P100,000 to P300,000 in damages mandatory psychological counseling or psychiatric treatment.

What is the prescriptive period for a complainant to file a complaint?

The criminal complaint may be filed within twenty (20) years from the occurrence or commission for the following acts:

• Causing physical harm to the woman or her child
• Threatening to cause the woman or her child physical harm
• Attempting to cause the woman or her child physical harm
• Placing the woman or her child in fear of imminent physical harm
• Threatening to deprive or actually depriving the woman or her child of custody or access to her/his family
• Depriving or threatening to deprive the woman or her children of financial support legally due her or her family, or deliberately providing the woman’s children insufficient financial support
• Depriving or threatening to deprive the woman or her child of a legal right
• Preventing the woman in engaging in any legitimate profession, occupation, business or activity, or controlling the victim’s own money or properties, or solely controlling the conjugal or common money, or properties
• Inflicting or threatening to inflict physical harm on oneself for the purpose of controlling her actions or decisions
• Causing or attempting to cause the woman or her child to engage in any sexual activity which does not constitute rape, by force or threat of force, physical harm, or through intimidation directed against the woman or her child or her/his immediate family
• Stalking or following the woman or her child in public or private places
• Peering in the window or lingering outside the residence of the woman or her child
• Entering or remaining in the dwelling or on the property of the woman or her child against her/his will
• Destroying the property and personal belongings or inflicting harm to animals or pets of the woman or her child
• Causing mental or emotional anguish, public ridicule or humiliation to the woman or her child, including, but not limited to, repeated verbal and emotional abuse, and denial of financial support or custody of minor children or denial of access to the woman’s child/children.

What is a protection order?

A protection order is an order issued under this act for the purpose of preventing further acts of violence against women or her child. And granting other relief as may be needed. The relief granted under a protection order serve the purpose of safeguarding the victim from further harm, minimizing any disruption in the victim’s daily life, and facilitating the opportunity and ability of the victim to independently regain control of her life. The provisions of the protection order shall be enforced by law enforcement agencies.

What are the various kinds of protection orders?

The various kinds of protection orders are:

• Barangay Protection Orders (BPO) refer to the protection order issued by the Punong Barangay ordering the perpetrator to desist from committing acts under Section 5 (a) and (b) of R.A. 9262. BPO shall be effective for 15 days.
• Temporary Protection Orders (TPO) refers to the protection order issued by the court on the date of the filing of the application after ex parte determination that such order should be issued. The court may grant in a TPO any, some or all of the reliefs mentioned in R.A. 9262 and shall be effective for thirty (30) days. The court shall order the immediate personal service of the TPO on the respondent by the court sheriff who may obtain the assistance of law enforcement agents for the service.
• Permanent Protection Order (PPO) refers to the protection order issued by the court after notice and hearing. The court shall not deny the issuance of protection order on the basis of the lapse of time between the act of violence and the filing of the application. PPO shall be effective until revoked by the court upon application of the person in whose favor it was issued.

Where can I apply for a protection order?

Application for a protection may be filed with the appropriate Regional Trial Court/Family Court or Municipal Court where the petitioner resides in case of Temporary Protection Order (TPO) and Permanent Protection Order (PPO), respectively. Barangay Protection Order may be applied for in the Barangay where the applicant resides or in accordance with Section 409 of the Local Government Code of 1991.

Who may file a Petition for Protection Orders?

A petition for Protection Order may be filed by the following:

• The offended party
• The parents or guardians of the offended party
• The ascendants, descendants or collateral relatives within the fourth civil degree of consanguinity or affinity
• Officers or social workers of the DSWD or social workers of local government units (LGUs)
• Police officers, preferably those in charge of women and children’s desks
• Punong Barangay or Barangay Kagawad
• Lawyer, counselor, therapist or healthcare provider of the petitioner
• At least two (2) concerned responsible citizens of the city or municipality where the violence against women and their children occurred and who has personal knowledge of the offense committed

How can I apply for a protection order?

The application of the Protection Order must be in writing, signed and verified under oath by the applicant. A standard protection order application form, written in English with translation to the major languages, which is readily available, shall contain the following information:

• Names and addresses of the petitioner and the respondent
• Description of relationships between the petitioner and respondent
• Statement of the circumstances of abuse
• Description of the reliefs requested by the petitioner
• Request for counsel and reasons for such
• Request for waiver of application fees until hearing
• An attestation that there is no pending application for a protection order in another court

What can the woman do if the barangay official failed or refused to issue the BPO within 24 hours from application?

• She can file an administrative complaint against the barangay official for failure to perform his/her duties. The complaint must be filed with the Sangguniang Panglunsod or Bayan.
• She can go to the police station to complain against the perpetrator.
• She can go to the Clerk of Court of the Family Court where she lives and request assistance in filing for a Protection Order.

Where can the protection order be enforced?

The Temporary Protection Order and the Permanent Protection Order are enforceable anywhere in the Philippines.

Can the barangay officials mediate or conciliate?

No. Conciliation and mediation of acts of violence against women and their children are not allowed under this law Sec. 33, R.A. 9262 amended sections 410-413 of the Local Government Code. The barangay officials, police or social workers should not attempt to mediate or influence the woman to give up her legal action or application for a BPO, TPO or PPO.

My husband had been cheating on me for over three years now with various women. Is there a way I can apply VAW in filing a case against him?

The acts of your husband cheating on you have caused you mental and emotional suffering. Such acts may be a ground for the filing of a VAW case for “psychological violence ”.

My boyfriend has been hurting me every time we fight and even threatens to kill me. Can I file a case against him for VAW?

Yes. Physical violence against the woman as well as threatening to inflict physical harm on a woman for the purpose of controlling her actions or decisions is deemed as an act of violence against women.

My ex-husband has stopped giving me and our daughter support since 2009. Can I file a case against him for VAW?

Yes, you may file a case for VAW against him as his act of withdrawing financial support. His act of refusing to give financial support to you or your daughter constitutes “ Economic Abuse .”

I have been in an abusive relationship for quite some time. Can I file a case against him considering his abuse was irregular? 

Yes, you can file a case against him. A woman who had a sexual or dating relationship with her assailant and whom the assailant has a common child may file a case against the latter for physical violence.

I am a lesbian and I have been in an abusive relationship with another woman since 2009. Can I file a case against her, even though she is a woman?

Acts of violence covered by VAW may be committed by any person with whom the victim has an intimate relationship with like the woman’s husband, ex-husband, live-in partner, ex-live-in partner, boyfriend, ex-boyfriend, girlfriend, ex-girlfriend, etc., Thus the offense may be committed by a man or a woman with whom the victim has or had a sexual relationship with.

I am a husband who has been mentally, verbally and emotionally abused by my wife. Can I file a case against my wife using VAW? 

No. VAWC has been primarily meant for the protection of women and children. It cannot be used by men to charge their wives or partners. You may file a complaint or case under the Revised Penal Code. 

I have 3 minor children with my husband. I wish to file a case against him. What would be the impact upon my children, esp. if he asks for custody?  

As a victim of violence, you are entitled to the custody of your three children. The woman victim of violence shall be entitled to the custody and support of her child/children. Children below seven (7) years old or older with mental or physical disabilities shall automatically be given to the mother, with right to support, unless the court finds compelling reasons to order otherwise. (Section 28 of the R.A. 9262).

I’ve been running in fear from my husband for 3 months because he threatened to kill me. What can I do? 

If you have been threatened, you may apply for a Barangay Protection Order (BPO) from the barangay of your place of residence. The application must be in writing, signed and verified and it will be effective for fifteen days.

As a Battered Woman, is there a chance I might lose custody of my children? 

No, suffering from Battered Woman Syndrome will not automatically disqualify you from having custody of your children unless the court has some other compelling reasons not to award custody of the children to you.

If custody of my children is not awarded to me, is there any chance that they might be given to my husband?  

No. VAWC explicitly states that in no case shall the custody of the children will be given to the perpetrator of the battered woman syndrome 

What is the liability of a news reporter covering a pending court case for violation of the Anti-VAWC Act if he or she includes in the TV report the name and face of the woman, and other information without her consent?  

The reporter can be liable for contempt of court. All records pertaining to cases of VAWC are confidential. The court may also impose a penalty of one (1) year imprisonment and a fine not more than Five Hundred Thousand Pesos (P500,000.00).

Where to seek help?

Barangay VAW Desk in your Barangay Hall 

Provincial/City/Municipal Social Welfare and Development Office of Local Government Units 

Department of Social Welfare and Development (DSWD) Community-Based Services Section (CBSS)  Legarda, Manila Tel. Nos.: 733-0014 to 18 local 116 / 488-2861

Philippine National Police (PNP) Women and Children Protection Center Camp Crame, Quezon City Tel. No.: 410-3213 / 532-6690 Aleng Pulis Text Hot-line: 0919-777-7377 Emergency Hotline: 911

Women and Children Protection Desk of nearest Precinct 

National Bureau of Investigation (NBI) Anti-Violence Against Women and Children Division (VAWCD) V-Tech Tower, G. Araneta Avenue, Quezon City Main Office: (02) 8523-8231 to 38 / (02) 8525-6028

PNP Women and Children Protection Center (WCPC) Main Office: (02) 8532-6690 / 7410-3213 / 7723-0401 local 5260, 5360, 5361 Visayas: 0917-7085157 / (032) 410-8483 Mindanao: 0917-1806037 Aleng Pulis: 0919-7777377 / 09667255961

DOJ – Public Attorney’s Office (DOJ-PAO) (02) 8929-9436 local 106, 107 or 159 (Local “0” for operator) DOJ Action Center: (02) 8521-2930 / 8523-8481 loc. 403

UP-PGH Women’s Desk Tel. nos.: (02) 8353-0667 / 8542-1512 / 8554-8400 local 2536

DOH Hospitals, Women and Children Protection Unit

Women’s Crisis Center (WCC) Women and Children Crisis Care and Protection Unit Vito Cruz, Manila Tel. no.: (02) 8514-4104 Mobile: 0920-9677852 / 0917-8250320

VAW Helplines (Per Region)

References:

Anti-Violence against Women and Their Children Act of 2004 (Republic Act 9262), Implementing Rules and Regulations. Retrieved here . RA 9262 or the Anti-Violence Against Women and their Children Act Primer by SALIGAN. A guide to Anti-Violence Against Women and their Children (RA 9262). Philippine Information Agency and the NCRFW, 2004. Retrieved here . END VAW: A Complete Reference Book on the Anti-Violence Against Women and their Children Act of 2004 (RA 9262). Published by the Support Service Institute of Women and the Democratic Socialist Women in the Philippines, 2006. Q & A Implementing Rules and Regulations RA 9262 or the Anti-Violence Against Women and their Children Act of 2004: A Handbook for the Philippine National Police. Barangay Protection Order RA 9262 A Primer. Department of Interior and Local Government, National Barangay Operations Office, 2004.

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26 Mar A Summary on Expanded Violence Against Women and Children

“Expanded” Violence Against Women and Children

Under Republic Act No. 9262, otherwise known as the Anti-Violence Against Women and Their Children Act of 2004 (“VAWC”), the concept of “violence” against women and children includes not just physical violence, but also sexual violence, psychological violence, and economic abuse, including threats of such acts, battery, assault, coercion, harassment, or arbitrary deprivation of liberty. [1] The law penalizes any act or a series of acts “committed by any person against a woman who is his wife, former wife, or against a woman with whom the person has or had a sexual or dating relationship, or with whom he has a common child, or against her child whether legitimate or illegitimate, within or without the family abode.”

In the 15 years since the enactment of the VAWC, some in Congress have perceived the need to expand the law to specifically include acts of violence that utilize electronic communications and social media platforms to inflict psychological violence. One such expression of this urge to modernize the law is embodied by House Bill No. 8655, which seeks to enact the “Expanded” Anti-Violence Against Women and Their Children Act”. It should not escape notice though that Republic Act No. 10175, or the Cybercrime Prevention Act of 2012, had effectively updated the VAWC by criminalizing as cyber-crimes those criminal acts under the VAWC that are committed through the use of information and communications technologies. ¶

Addressing the gaps on cybercrime against women and children

As a response to the recent and emerging threats to the welfare of women and children, the House of Representatives last December approved on final reading a bill that will help victims, law enforcers, prosecutors, and the court to punish violators and abusers who utilize electronic communication and social media platforms to inflict psychological violence through intimidation, harassment, stalking, public ridicule or humiliation, repeated verbal abuse, and marital infidelity against women and children. [2]

House Bill 8655 or the Expanded Anti-Violence Against Women and Their Children [Act of 2004] (E-VAWC) Bill [3] seeks to amend Republic Act No. 9262 by penalizing psychological violence through the use of information and communications technology (ICT) devices. The bill aims to expand the scope of protection afforded to women and children by including psychological violence committed through the use of electronic devices or ICT.

Cybercrime and other laws on ICT-related violence against women and children

Section 3 (a) of the E-VAWC Bill states that Electronic or ICT-related violence refers to any act or omission involving the use or exploitation of data or any form of ICT which cause or is likely to cause mental, emotional, or psychological distress or suffering to the women and her children. The E-VAWC Bill more specifically aims to provide an added layer of protection to a rather vulnerable sector by including acts that were not previously defined or understood. Some of these prohibited acts have recently caught the attention of the public due to apparent ill usage of technology. [4]

It should be noted though that under existing laws, certain acts of violence against women and children involving the use of ICT technologies are already penalized as crimes. Perhaps the most significant of these laws is the Cybercrime Prevention Act of 2012, Section 6 of which imposes a higher penalty for crimes already defined and penalized by existing penal laws and are committed through and with the use of information and communications technologies. Among these existing laws would be the present VAWC.

The Anti-Child Pornography Act, enacted in 2009, defines “child pornography” broadly as to include electronic, mechanical, digital, optical, magnetic or any other means, of any representation, whether visual, audio, or written combination thereof of child pornography. Another existing law, the Anti-Photo and Video Voyeurism Act or Republic Act No. 9995 [5] , prohibits recording videos or taking photos of a sexual act, the male or female genitalia, and of the female breast, among others, without consent of the persons featured in the material. R.A. No. 9995 was crafted to serve as a deterrent against the increasing reproduction, distribution, and publication of the material regardless of whether or not the persons featured consented to the recording. [6]

There could very well be some overlap between acts already penalized under current laws, and those sought to be punished under the E-VAWC Bill. Some of the acts included in ICT-related violence in E-VAWC are unauthorized recording, reproduction, distribution, use, sharing or uploading or any photograph, video, or other form of electronic and/or artistic presentation showing or depicting in any form or manner the genitalia of a women and those of her children, any sexually-related verbal or nonverbal expression or gesture of the woman and her children which may be construed as lewd, indecent, or obscene, any purported violent or errant behavior of the woman and her children or the use of intoxicating or prohibited substance or drugs, and any similar recording, reproduction, distribution, use, sharing or uploading of any audio presentation and data, including sound clips of the same nature previously mentioned. [7]

Similar to the punishable acts in R.A. No. 9995, provisions on E-VAWC include prohibition on any unauthorized use of a photograph, video, voice recording, name or any mark, reference or character identifiable with a woman and her children and suggestive of a wrongdoing, conduct, or attribute that tends to besmirch the reputation of the woman and her children.

Expanding existing laws on VAWC

Nonetheless, the E-VAWC Bill lays particular stress on the elements of harassment, intimidation, coercion, threat, or vilification of the woman and her children through any form, as well as any form of stalking including hacking of personal accounts on social media and the use of location data from electronic devices, fabrication of fake information or news through text messages or other cyber, electronic, or multimedia technology. Another newly-defined act of electronic violence that the E-VAWC Bill has introduced is the penalty against abusers who create fake social media accounts using an alias or a different personal information will ill intent and malice to sow intrigue and inflict harm. [8]

This particular emphasis of the E-VAWC Bill is timely in an era where social media has become increasingly powerful in terms of scope, real-time effect, and the irreparable damage it can cause to the welfare of women and children. The E-VAWC Bill and the attempt to expand what VAWC means, are emerging responses to current and relevant issues that women and children face.

[1] Sec. 3(a), VAWC.

[2] http://newsbytes.ph/2018/12/08/house-bill-against-online-shaming-of-women-kids-approved-on-2nd-reading/

[4] https://news.mb.com.ph/2018/12/08/final-house-nod-on-expanded-vawc-forthcoming/

[5] https://privacy.com.ph/articles/the-anti-photo-and-video-voyeurism-act-of-2009-a-primer/

[8] https://docs.google.com/viewerng/viewer?url=http://newsbytes.ph/wp-content/uploads/2018/12/E-VAWC.pdf&hl=en

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NeurIPS 2024 Datasets and Benchmarks Track

If you'd like to become a reviewer for the track, or recommend someone, please use this form .

The Datasets and Benchmarks track serves as a venue for high-quality publications, talks, and posters on highly valuable machine learning datasets and benchmarks, as well as a forum for discussions on how to improve dataset development. Datasets and benchmarks are crucial for the development of machine learning methods, but also require their own publishing and reviewing guidelines. For instance, datasets can often not be reviewed in a double-blind fashion, and hence full anonymization will not be required. On the other hand, they do require additional specific checks, such as a proper description of how the data was collected, whether they show intrinsic bias, and whether they will remain accessible.

The previous editions of the Datasets and Benchmarks track were highly successful; you can view the accepted papers from 2021 , 2002 , and 2023 , and the winners of the best paper awards 2021 , 2022 and 2023

CRITERIA. W e are aiming for an equally stringent review as the main conference, yet better suited to datasets and benchmarks. Submissions to this track will be reviewed according to a set of criteria and best practices specifically designed for datasets and benchmarks , as described below. A key criterion is accessibility: datasets should be available and accessible , i.e. the data can be found and obtained without a personal request to the PI, and any required code should be open source. We encourage the authors to use Croissant format ( https://mlcommons.org/working-groups/data/croissant/ ) to document their datasets in machine readable way.   Next to a scientific paper, authors should also submit supplementary materials such as detail on how the data was collected and organised, what kind of information it contains, how it should be used ethically and responsibly, as well as how it will be made available and maintained.

RELATIONSHIP TO NeurIPS.  Submissions to the track will be part of the main NeurIPS conference , presented alongside the main conference papers. Accepted papers will be officially published in the NeurIPS proceedings .

SUBMISSIONS.  There will be one deadline this year. It is also still possible to submit datasets and benchmarks to the main conference (under the usual review process), but dual submission to both is not allowed (unless you retracted your paper from the main conference). We also cannot transfer papers from the main track to the D&B track. Authors can choose to submit either single-blind or double-blind . If it is possible to properly review the submission double-blind, i.e., reviewers do not need access to non-anonymous repositories to review the work, then authors can also choose to submit the work anonymously. Papers will not be publicly visible during the review process. Only accepted papers will become visible afterward. The reviews themselves are not visible during the review phase but will be published after decisions have been made. The datasets themselves should be accessible to reviewers but can be publicly released at a later date (see below). New authors cannot be added after the abstract deadline and they should have an OpenReview profile by the paper deadline. NeurIPS does not tolerate any collusion whereby authors secretly cooperate with reviewers, ACs or SACs to obtain favourable reviews.

SCOPE.  This track welcomes all work on data-centric machine learning research (DMLR), covering ML datasets and benchmarks as well as algorithms, tools, methods, and analyses for working with ML data. This includes but is not limited to:

• New datasets, or carefully and thoughtfully designed (collections of) datasets based on previously available data.
• Data generators and reinforcement learning environments.
• Data-centric AI methods and tools, e.g. to measure and improve data quality or utility, or studies in data-centric AI that bring important new insight.
• Advanced practices in data collection and curation that are of general interest even if the data itself cannot be shared.
• Frameworks for responsible dataset development, audits of existing datasets, identifying significant problems with existing datasets and their use
• Benchmarks on new or existing datasets, as well as benchmarking tools.
• In-depth analyses of machine learning challenges and competitions (by organisers and/or participants) that yield important new insight.
• Systematic analyses of existing systems on novel datasets yielding important new insight.

Read our original blog post for more about why we started this track.

Important dates

• Abstract submission deadline: May 29, 2024
• Full paper submission and co-author registration deadline: Jun 5, 2024
• Supplementary materials submission deadline: Jun 12, 2024
• Review deadline - Jul 24, 2024
• Release of reviews and start of Author discussions on OpenReview: Aug 07, 2024
• End of author/reviewer discussions on OpenReview: Aug 31, 2024
• Author notification: Sep 26, 2024
• Camera-ready deadline: Oct 30, 2024 AOE

Note: The site will start accepting submissions on April 1 5 , 2024.

FREQUENTLY ASKED QUESTIONS

Q: My work is in scope for this track but possibly also for the main conference. Where should I submit it?

A: This is ultimately your choice. Consider the main contribution of the submission and how it should be reviewed. If the main contribution is a new dataset, benchmark, or other work that falls into the scope of the track (see above), then it is ideally reviewed accordingly. As discussed in our blog post, the reviewing procedures of the main conference are focused on algorithmic advances, analysis, and applications, while the reviewing in this track is equally stringent but designed to properly assess datasets and benchmarks. Other, more practical considerations are that this track allows single-blind reviewing (since anonymization is often impossible for hosted datasets) and intended audience, i.e., make your work more visible for people looking for datasets and benchmarks.

Q: How will paper accepted to this track be cited?

A: Accepted papers will appear as part of the official NeurIPS proceedings.

Q: Do I need to submit an abstract beforehand?

A: Yes, please check the important dates section for more information.

Q: My dataset requires open credentialized access. Can I submit to this track?

A: This will be possible on the condition that a credentialization is necessary for the public good (e.g. because of ethically sensitive medical data), and that an established credentialization procedure is in place that is 1) open to a large section of the public, 2) provides rapid response and access to the data, and 3) is guaranteed to be maintained for many years. A good example here is PhysioNet Credentialing, where users must first understand how to handle data with human subjects, yet is open to anyone who has learned and agrees with the rules. This should be seen as an exceptional measure, and NOT as a way to limit access to data for other reasons (e.g. to shield data behind a Data Transfer Agreement). Misuse would be grounds for desk rejection. During submission, you can indicate that your dataset involves open credentialized access, in which case the necessity, openness, and efficiency of the credentialization process itself will also be checked.

SUBMISSION INSTRUCTIONS

A submission consists of:

• Please carefully follow the Latex template for this track when preparing proposals. We follow the NeurIPS format, but with the appropriate headings, and without hiding the names of the authors. Download the template as a bundle here .
• Papers should be submitted via OpenReview
• Reviewing is in principle single-blind, hence the paper should not be anonymized. In cases where the work can be reviewed equally well anonymously, anonymous submission is also allowed.
• During submission, you can add a public link to the dataset or benchmark data. If the dataset can only be released later, you must include instructions for reviewers on how to access the dataset. This can only be done after the first submission by sending an official note to the reviewers in OpenReview. We highly recommend making the dataset publicly available immediately or before the start of the NeurIPS conference. In select cases, requiring solid motivation, the release date can be stretched up to a year after the submission deadline.
• Dataset documentation and intended uses. Recommended documentation frameworks include datasheets for datasets , dataset nutrition labels , data statements for NLP , data cards , and accountability frameworks .
• URL to website/platform where the dataset/benchmark can be viewed and downloaded by the reviewers. 
• URL to Croissant metadata record documenting the dataset/benchmark available for viewing and downloading by the reviewers. You can create your Croissant metadata using e.g. the Python library available here: https://github.com/mlcommons/croissant
• Author statement that they bear all responsibility in case of violation of rights, etc., and confirmation of the data license.
• Hosting, licensing, and maintenance plan. The choice of hosting platform is yours, as long as you ensure access to the data (possibly through a curated interface) and will provide the necessary maintenance.
• Links to access the dataset and its metadata. This can be hidden upon submission if the dataset is not yet publicly available but must be added in the camera-ready version. In select cases, e.g when the data can only be released at a later date, this can be added afterward (up to a year after the submission deadline). Simulation environments should link to open source code repositories
• The dataset itself should ideally use an open and widely used data format. Provide a detailed explanation on how the dataset can be read. For simulation environments, use existing frameworks or explain how they can be used.
• Long-term preservation: It must be clear that the dataset will be available for a long time, either by uploading to a data repository or by explaining how the authors themselves will ensure this
• Explicit license: Authors must choose a license, ideally a CC license for datasets, or an open source license for code (e.g. RL environments). An overview of licenses can be found here: https://paperswithcode.com/datasets/license
• Add structured metadata to a dataset's meta-data page using Web standards (like schema.org and DCAT ): This allows it to be discovered and organized by anyone. A guide can be found here: https://developers.google.com/search/docs/data-types/dataset . If you use an existing data repository, this is often done automatically.
• Highly recommended: a persistent dereferenceable identifier (e.g. a DOI  minted by a data repository or a prefix on identifiers.org ) for datasets, or a code repository (e.g. GitHub, GitLab,...) for code. If this is not possible or useful, please explain why.
• For benchmarks, the supplementary materials must ensure that all results are easily reproducible. Where possible, use a reproducibility framework such as the ML reproducibility checklist , or otherwise guarantee that all results can be easily reproduced, i.e. all necessary datasets, code, and evaluation procedures must be accessible and documented.
• For papers introducing best practices in creating or curating datasets and benchmarks, the above supplementary materials are not required.
• For papers resubmitted after being retracted from another venue: a brief discussion on the main concerns raised by previous reviewers and how you addressed them. You do not need to share the original reviews.
• For the dual submission and archiving, the policy follows the NeurIPS main track paper guideline .

Use of Large Language Models (LLMs): We welcome authors to use any tool that is suitable for preparing high-quality papers and research. However, we ask authors to keep in mind two important criteria. First, we expect papers to fully describe their methodology, and any tool that is important to that methodology, including the use of LLMs, should be described also. For example, authors should mention tools (including LLMs) that were used for data processing or filtering, visualization, facilitating or running experiments, and proving theorems. It may also be advisable to describe the use of LLMs in implementing the method (if this corresponds to an important, original, or non-standard component of the approach). Second, authors are responsible for the entire content of the paper, including all text and figures, so while authors are welcome to use any tool they wish for writing the paper, they must ensure that all text is correct and original.

REVIEWING AND SELECTION PROCESS

Reviewing will be single-blind, although authors can also submit anonymously if the submission allows that. A datasets and benchmarks program committee will be formed, consisting of experts on machine learning, dataset curation, and ethics. We will ensure diversity in the program committee, both in terms of background as well as technical expertise (e.g., data, ML, data ethics, social science expertise). Each paper will be reviewed by the members of the committee. In select cases where ethical concerns are flagged by reviewers, an ethics review may be performed as well.

Papers will not be publicly visible during the review process. Only accepted papers will become visible afterward. The reviews themselves are also not visible during the review phase but will be published after decisions have been made. Authors can choose to keep the datasets themselves hidden until a later release date, as long as reviewers have access.

The factors that will be considered when evaluating papers include:

• Utility and quality of the submission: Impact, originality, novelty, relevance to the NeurIPS community will all be considered. 
• Reproducibility: All submissions should be accompanied by sufficient information to reproduce the results described i.e. all necessary datasets, code, and evaluation procedures must be accessible and documented. We encourage the use of a reproducibility framework such as the ML reproducibility checklist to guarantee that all results can be easily reproduced. Benchmark submissions in particular should take care to ensure sufficient details are provided to ensure reproducibility. If submissions include code, please refer to the NeurIPS code submission guidelines .  
• Was code provided (e.g. in the supplementary material)? If provided, did you look at the code? Did you consider it useful in guiding your review? If not provided, did you wish code had been available?
• Ethics: Any ethical implications of the work should be addressed. Authors should rely on NeurIPS ethics guidelines as guidance for understanding ethical concerns.  
• Completeness of the relevant documentation: Per NeurIPS ethics guidelines , datasets must be accompanied by documentation communicating the details of the dataset as part of their submissions via structured templates (e.g. TODO). Sufficient detail must be provided on how the data was collected and organized, what kind of information it contains,  ethically and responsibly, and how it will be made available and maintained. 
• Licensing and access: Per NeurIPS ethics guidelines , authors should provide licenses for any datasets released. These should consider the intended use and limitations of the dataset, and develop licenses and terms of use to prevent misuse or inappropriate use.  
• Consent and privacy: Per  NeurIPS ethics guidelines , datasets should minimize the exposure of any personally identifiable information, unless informed consent from those individuals is provided to do so. Any paper that chooses to create a dataset with real data of real people should ask for the explicit consent of participants, or explain why they were unable to do so.
• Ethics and responsible use: Any ethical implications of new datasets should be addressed and guidelines for responsible use should be provided where appropriate. Note that, if your submission includes publicly available datasets (e.g. as part of a larger benchmark), you should also check these datasets for ethical issues. You remain responsible for the ethical implications of including existing datasets or other data sources in your work.
• Legal compliance: For datasets, authors should ensure awareness and compliance with regional legal requirements.

ADVISORY COMMITTEE

The following committee will provide advice on the organization of the track over the coming years: Sergio Escalera, Isabelle Guyon, Neil Lawrence, Dina Machuve, Olga Russakovsky, Joaquin Vanschoren, Serena Yeung.

DATASETS AND BENCHMARKS CHAIRS

Lora Aroyo, Google Francesco Locatello, Institute of Science and Technology Austria Lingjuan Lyu, Sony AI

Contact: [email protected]