Abstracts
OBJECTIVE:
to analyze the reports and factors associated with violence against women.
METHOD:
this was a cross-sectional, exploratory and analytical study with information about the cases of reported violence, extracted from the Civil Police Report Bulletin, in a mid-sized city in Minas Gerais, Brazil.
RESULTS:
out of the 7,487 reports of violence against women, it was found that 44.6% of the cases were threats, 28.5% aggression, 25.1% bodily injury, 1.1% rape, and 0.7% some other type of injury. In the bivariate analysis, a higher number of cases (p=0.000) committed by partners was evidenced, for all kinds of violence except for rape. Children, adolescents and adults experienced violence by partners, followed by family members. Regarding older women, violence was committed by family members.
CONCLUSION:
there is the need for programs to be established to prevent violence against women in various sectors of society, permeating the life cycle.
Women's Health; Violence Against Women; Epidemiology; Public Health
OBJETIVO:
analisar as ocorrências e fatores associados à violência contra a mulher.
MÉTODO:
trata-se de estudo transversal, exploratório e analítico com informações dos casos registrados de violência, extraídos dos Boletins de Ocorrências da Polícia Civil, em uma cidade de médio porte de Minas Gerais, Brasil.
RESULTADOS:
das 7.487 ocorrências de violência contra a mulher, identificou-se que 44,6% dos casos foram de ameaça, 28,5% de agressão, 25,1% de lesão corporal, 1,1% de estupro e 0,7% de algum tipo de injúria. Na análise bivariada, observou-se maior número de casos (p=0,000) cometidos pelo companheiro para todos os tipos de violência, com exceção de estupro. As crianças, adolescentes e adultas foram violentadas por companheiro, seguido de familiar. Com as mulheres idosas, os casos de violência foram cometidos por familiares.
CONCLUSÃO:
há necessidade de que programas de prevenção da violência contra a mulher sejam instituídos nos diversos setores da sociedade, permeando o ciclo de vida.
Saúde da Mulher; Violência contra a Mulher; Epidemiologia; Saúde Pública
OBJETIVO:
analizar las ocurrencias y factores asociados a la violencia contra la mujer.
MÉTODO:
se trata de estudio transversal, exploratorio y analítico con informaciones de los casos registrados de violencia, extraídos de los Boletines de Ocurrencias de la Policía Civil, en una ciudad de porte medio de Minas Gerais, Brasil.
RESULTADOS:
de las 7.487 ocurrencias de violencia contra la mujer, se identificó que 44,6% de los casos fueron de amenaza, 28,5% de agresión, 25,1% de lesión corporal, 1,1% de estupro y 0,7% de algún tipo de injuria. En el análisis bivariado, se observó un mayor número de casos (p=0.000) cometidos por el compañero, para todos los tipos de violencia, con excepción del estupro. Las niñas, adolescentes y adultas fueron violentadas por el compañero, seguido de familiar. En las mujeres ancianas, los casos de violencia fueron cometidos por familiares.
CONCLUSIÓN:
existe necesidad de que sean instituidos programas de prevención de la violencia contra la mujer, en todo su ciclo de vida, en los diversos sectores de la sociedad.
Introduction
Violence is a historical, social and health issue of great magnitude and worldwide
transcendence, with macrostructural roots. It is diluted in society, polymorphous,
multifaceted and presents several manifestations that interlock, interact, feed back and
become stronger. It owns forms of conjunct expressions present in everyday interpersonal
relationships(
11. Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Impacto
da violência na saúde dos brasileiros. Brasília (DF): Ministério da Saúde;
2005.
-
22. Reichenheim ME, Souza ER, Moraes CL,Mello Jorge MH, SilvaCM, Souza
MinayoMC. Violence and injuries in Brazil: the effect, progress made, and challenges
ahead. Lancet. 2011;377:1962-75.
). Studies highlight the consequences of violence resulting from injuries and
trauma, directly and indirectly, generated by the violent act, that are perceived by the
economic costs of medical assistance, the judicial and penal system, in addition to the
social costs of reduced productivity(
11. Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Impacto
da violência na saúde dos brasileiros. Brasília (DF): Ministério da Saúde;
2005.
2. Reichenheim ME, Souza ER, Moraes CL,Mello Jorge MH, SilvaCM, Souza
MinayoMC. Violence and injuries in Brazil: the effect, progress made, and challenges
ahead. Lancet. 2011;377:1962-75.
3. Lucena KDT, Silva ATMC, Moraes RM,Silva CC, BezerraIMP. Análise
espacial da violência doméstica contra a mulher entre os anos de 2002 e 2005 em João
Pessoa, Paraíba, Brasil. Cad Saúde Pública. 2012;28(6):1111-21. doi:
10.1590/S0102-311X2012000600010
https://doi.org/10.1590/S0102-311X201200...
-
44. Oliveira MT, Samico I, Ishigami ABM, Nascimento RMM. Violência
intrafamiliar: a experiência dos profissionais de saúde nas Unidades de Saúde da
Família de São Joaquim do Monte, Pernambuco. Rev Bras Epidemiol. 2012;15(1):166-78.
doi:10.1590/S1415-790X2012000100015
https://doi.org/10.1590/S1415-790X201200...
).
Among the various forms of violence, domestic aggression against women is a serious
public health issue(
11. Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Impacto
da violência na saúde dos brasileiros. Brasília (DF): Ministério da Saúde;
2005.
), having been summarized in the sociological category known as gender from
the twentieth century(
33. Lucena KDT, Silva ATMC, Moraes RM,Silva CC, BezerraIMP. Análise
espacial da violência doméstica contra a mulher entre os anos de 2002 e 2005 em João
Pessoa, Paraíba, Brasil. Cad Saúde Pública. 2012;28(6):1111-21. doi:
10.1590/S0102-311X2012000600010
https://doi.org/10.1590/S0102-311X201200...
), understood as a set of social, cultural, political, psychological, legal
and economical characteristics attributed to people, as well as to the health-disease
process, differentiated according to gender(
33. Lucena KDT, Silva ATMC, Moraes RM,Silva CC, BezerraIMP. Análise
espacial da violência doméstica contra a mulher entre os anos de 2002 e 2005 em João
Pessoa, Paraíba, Brasil. Cad Saúde Pública. 2012;28(6):1111-21. doi:
10.1590/S0102-311X2012000600010
https://doi.org/10.1590/S0102-311X201200...
,
55. Guedes RN, Fonseca RMGS, Egry EY.Limites e possibilidades avaliativas
da estratégia saúde da família para a violência de gênero. Rev Esc Enferm USP.
[Internet] 2013.[acesso 23 ago 2013]; 47(2):304-11. Disponível em:
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342013000200005&lng=pt
Disponível em:
http...
). Thereby, this category includes types of violence resulting from the
unequal relationships between the genders(
33. Lucena KDT, Silva ATMC, Moraes RM,Silva CC, BezerraIMP. Análise
espacial da violência doméstica contra a mulher entre os anos de 2002 e 2005 em João
Pessoa, Paraíba, Brasil. Cad Saúde Pública. 2012;28(6):1111-21. doi:
10.1590/S0102-311X2012000600010
https://doi.org/10.1590/S0102-311X201200...
).
Recent national and international studies show the high prevalence of at least one form
of violence against women. In rural Nepal, more than half (51.9%) of married women
between 15-24 years of age have experienced some type of partner violence(
66. Lamichhane P, Puri M, Tamang J,Dulal B. Women's Status and Violence
against Young Married Women in Rural Nepal. BMC Women's Health. [Internet]. 2011 .
[acesso 18 dez 2012];11(19):1-31. Disponível em:
http://www.biomedcentral.com/1472-6874/11/19
Disponível em: http://www.biomedcentral....
); in Karachi (Pakistan), the self-reported prevalence among women aged 25 to
60 years was 56.3%(
77. Ali TS, Asad N, Mogren I,Krantz G. Intimate partner violence in urban
Pakistan: prevalence, frequency, and risk factors. Int J Womens Health [Internet].
2011 . [acesso 18 dez 2012];3:105-15.
). In India, the prevalence was 56%(
88. Babu BV, Kar SK. Domestic violence against women in eastern India: a
population-based study on prevalence and related issues. BMC Public Health.
[Internet]. 2009 . [acesso 15 dez 2012]; 9(129):1-18. Disponível em:
http://www.biomedcentral.com/1471-2458/9/129
Disponível em: http://www.biomedcentral....
), and in Spain, 24.8% of women reported having been abused by their partner
at least once in life. There are variations in prevalence according to the region. The
highest percentages have been recorded in Ceuta and Melilla (40.2%) and the Balearic
Islands (32.5%). The lowest percentages registered have occurred in Cantabria
(18%)(
99. Ruiz-Pérez I, Plazaola-Castaño J, Vives-Cases C, Montero-Piñar MI,
Escribã-Agüir V,Jiménez-Gutiérrez E, et al.Variabilidad geográfica de la violencia
contra las mujeres en España. Gac Sanit. [Internet]. 2010 [acesso 16 dez
2012];24:128-35. Disponível
em:http://www.ucm.es/info/seas/comision/tep/mt/Variabilidad_geografica_de_la_violencia_contra_las_mujeres%20en_Espana.pdf
Disponível
em:http:...
) and in the city of Celaya - Mexico(
1010. HerreraParedes, JM eVentura, CAA. Alcohol consumption and domestic
violence against women: a study with university students from Mexico. Rev. Latino-Am.
Enfermagem. 2010;18(spe):557-64.
) (8.1%).
In Brazil, a cross-sectional study conducted in the city of Feira de Santana (BA) showed
that, among individuals who experienced violence, 76.3% of the reports were related to
women(
1111. Rocha SV, Almeida MMG, Araújo TM. Violence against women among urban
area residents in Feira de Santana, Bahia, Brazil. Trends Psychiatry Psychother.
[Internet]. 2011. [acesso 18 dez 2012];33(3):164-8. Disponível em:
http://www.scielo.br/scielo.php?pid=S2237-60892011000300006&script=sci_arttext
Disponível em:
http...
). In research conducted with users of the National Health Service (SUS) in
the city of São Paulo, 15-49 years of age, the prevalence was 59.8%(
1212. Barros C, Schraiber LB, França-Junior I.Associação entre violência
por parceiro íntimo contra a mulher e infecção por HIV. Rev Saúde Pública.
2011;45(2):365-72. doi: 10.1590/S0034-89102011005000008
https://doi.org/10.1590/S0034-8910201100...
).
Some factors have been associated with violence against women by an intimate partner,
such as: alcohol abuse, cohabitation, young age, attitudes supportive of wife beating,
having suffered childhood abuse, and experiencing other forms of violence in
adulthood(
1313. Abramsky T, Watts CH, Garcia-Moreno C, Devries K,Kiss L, EllsbergM,
et al. What factors are associated with recent intimate partner violence? findings
from the WHO multi-country study on women's health and domestic violence. BMC Public
Health. [Internet]. 2011 . [acesso 14 dez 2012];11(109):1-29. Disponível em:
http://www.biomedcentral.com/1471-2458/11/109
Disponível em: http://www.biomedcentral....
).
The effects of domestic violence can have significant impact on women's
lives(
1414. Carneiro AA, Fraga CK. A Lei Maria da Penha e a proteção legal à
mulher vítima em São Borja no Rio Grande do Sul: da violência denunciada à violência
silenciada. Serv Soc Soc [Internet]. 2012. [acesso 13 dez
2012];1109:369-97.Disponível em:
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-66282012000200008&lng=en&nrm=iso
Disponível em:
http...
-
1515. Azambuja MRD, Nogueira C. Qual a importância da violência contra
mulheres na Revista Portuguesa de Saúde Pública?. Rev Port Saude Pub. [Internet].
2010 [acesso 23 ago 2013]; 28(1):57-65. Disponível em:
http://www.scielo.gpeari.mctes.pt/scielo.php?script=sci_arttext&pid=S0870-90252010000100007
Disponível em:
http...
) and society, which demonstrates the scope and magnitude of the
problem(
1515. Azambuja MRD, Nogueira C. Qual a importância da violência contra
mulheres na Revista Portuguesa de Saúde Pública?. Rev Port Saude Pub. [Internet].
2010 [acesso 23 ago 2013]; 28(1):57-65. Disponível em:
http://www.scielo.gpeari.mctes.pt/scielo.php?script=sci_arttext&pid=S0870-90252010000100007
Disponível em:
http...
). However, there are difficulties in preventing its occurrence, or act of
coping, due to: cultural barriers, educational factors, and lack of educational and
professional services to meet the cases of domestic violence(
1616. Bernz IM, Coelho EBS, Lindner SR. Desafio da Violência Doméstica
para profissionais da saúde: revisão da literatura. Saude & Transf Soc.
[Internet]. 2012 [acesso 23 ago 2013];3(3):105-11. Disponível em:
http://www.incubadora.ufsc.br/index.php/saudeetransformacao/article/view/1545/2157
Disponível em:
http...
). Thereby, state intervention in the execution of public policies is
required to produce affirmative actions that are actually effective in reducing gender
violence(
1414. Carneiro AA, Fraga CK. A Lei Maria da Penha e a proteção legal à
mulher vítima em São Borja no Rio Grande do Sul: da violência denunciada à violência
silenciada. Serv Soc Soc [Internet]. 2012. [acesso 13 dez
2012];1109:369-97.Disponível em:
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-66282012000200008&lng=en&nrm=iso
Disponível em:
http...
-
1515. Azambuja MRD, Nogueira C. Qual a importância da violência contra
mulheres na Revista Portuguesa de Saúde Pública?. Rev Port Saude Pub. [Internet].
2010 [acesso 23 ago 2013]; 28(1):57-65. Disponível em:
http://www.scielo.gpeari.mctes.pt/scielo.php?script=sci_arttext&pid=S0870-90252010000100007
Disponível em:
http...
).
The approach of gender violence in health services demand practices congruent with this
perspective(
1717. Pedrosa CM, Spink MJP. A Violência Contra Mulher no cotidiano dos
serviços de saúde: desafios para a formação médica. Saude Soc. 2011;20(1):124-35.
doi:10.1590/S0104-12902011000100015
https://doi.org/10.1590/S0104-1290201100...
), in order to give visibility to violence, to incorporate the gender
perspective in the actions and possibilities of active listening.
Violence is considered a "silent epidemic" and the few studies result from concrete actions, or are associated with them, related to their alleviation or reduction. Thereby, the situation is aggravated even further when the object of analysis is the city space, since most investigations refer to macro-regional areas of the country, leaving undiagnosed the peculiarities and extent of violence against woman in the local space.
Thereby, this study aimed to analyze the reports and factors associated with violence against women in a mid-sized city of the State of Minas Gerais, Brazil.
Method
This was a cross-sectional, exploratory and analytical study. Primary data containing information referring to cases of violence against women registered from January to December of 2010 were extracted from the Civil Police Report Bulletins. These data were collected at the website armazemsids.mg.gov.br "Bussiness Object", of the 11th Civil Police Department of Montes Claros, an organ of the Civil Police at the State of Minas Gerais, Brazil, by institutional workers authorized to perform this collection, so that the identity of offenders and victims was preserved, and so that the authors did not have access to the names of the individuals.
The explanatory variables about the types of violence against women contained in Report
Bulletins collected for analysis were: Aggression, Threat, Rape, Injury and Bodily
Injury. The concepts used in this study for these variables were extracted from the
Brazilian Penal Code(
1818. Decreto-Lei No 2848, de 7 de dezembro de 1940 (BR). Código Penal
Brasil. Diário Oficial da União. [Internet]. 31 dez 1940. [acesso 18 dez 2012].
Disponível
em:http://www.planalto.gov.br/ccivil_03/decreto-lei/del2848compilado.htm
Disponível
em:http:...
), except for aggression, which did not appear in the code.
- Aggression: Attack to physical integrity or act of hostility and provocation, which aims to cause harm to the person to whom it is addressed( 1919. Biaggio AMB. Psicologia do desenvolvimento. Petrópolis: Vozes; 1996. 344 p. ).
- Threat: "Threatening someone, by words, writing or gesture, or any other symbolic
medium, of causing him/her unfair and severe harm (art.147)(
1818. Decreto-Lei No 2848, de 7 de dezembro de 1940 (BR). Código Penal
Brasil. Diário Oficial da União. [Internet]. 31 dez 1940. [acesso 18 dez 2012].
Disponível
em:http://www.planalto.gov.br/ccivil_03/decreto-lei/del2848compilado.htm
Disponível
em:http:...
).
- Rape: "To constrain someone with violence or serious threat, into having carnal
conjunction or to practice or allow lewd acts to be practiced with him/her" (Article
213)(
1818. Decreto-Lei No 2848, de 7 de dezembro de 1940 (BR). Código Penal
Brasil. Diário Oficial da União. [Internet]. 31 dez 1940. [acesso 18 dez 2012].
Disponível
em:http://www.planalto.gov.br/ccivil_03/decreto-lei/del2848compilado.htm
Disponível
em:http:...
).
- Injury: "To injury someone, offending his/her dignity and decorum"
(art.140)(
1818. Decreto-Lei No 2848, de 7 de dezembro de 1940 (BR). Código Penal
Brasil. Diário Oficial da União. [Internet]. 31 dez 1940. [acesso 18 dez 2012].
Disponível
em:http://www.planalto.gov.br/ccivil_03/decreto-lei/del2848compilado.htm
Disponível
em:http:...
).
- Bodily Injury: "To offend the bodily integrity or health of others" (art.
129)(
1818. Decreto-Lei No 2848, de 7 de dezembro de 1940 (BR). Código Penal
Brasil. Diário Oficial da União. [Internet]. 31 dez 1940. [acesso 18 dez 2012].
Disponível
em:http://www.planalto.gov.br/ccivil_03/decreto-lei/del2848compilado.htm
Disponível
em:http:...
).
In addition to the type of violence, information was collected regarding age of the victim (child /adolescent, adult and elderly), seasonality of violence occurrence (first, second , third or fourth quarter) and offender (partner, family, acquaintance, stranger, other). For the latter variable, the categories were grouped according to the records of the Civil Police. Partner was considered: the spouse, ex-spouse, extramarital or intimate relationship. Included in the family category were: grandparents/great grandparents, grandson/great-grandson, son/stepson, brother, parents/legal guardians or other unspecified family relationship. Included within the acquaintance option were: friends, domestic relationship/cohabitation, coworker/superior, business partner/building partner or neighbor. The category "stranger" contained the cases without any kind of relationship, and the category "other" was considered the response option for cases that were not related to any category mentioned.
Data were tabulated and analyzed using the Statistical Package for the Social Sciences (SPSS(r)) software, version 18.0 for Windows(r). Initially, a descriptive analysis was performed, and subsequently, bivariate analysis was using the Chi-square test was applied. For this study, the significance level adopted was 5% (p<0.05), with a confidence interval of 95% (CI 95%).
This study was approved by the General Delegate of Police - Regional Delegate of the Civil Police from the District of Montes Claros, by signing of the Institutional Form of Agreement for Participation in Research involving humans. and also by the Ethics Committee of Universidade Estadual Montes Claros, N. 185/2010.
Results
In 2010, 7487 cases of violence against women were registered by the Civil Police of Montes Claros using police reports from the Integrated Areas of Public Safety (IAPS), headquartered in this city.
Table 1 shows the descriptive data analysis. The 7487 cases of violence against women in the city of Montes Claros were characterized as follows: 3340 (44.6%) threats, 2134 (28.5%) aggression, 1877 (25.1%) bodily injuries, 83 (1.1%) rapes and 53 (0.7%) as some other kind of injury. These acts of violence were committed throughout the life cycle, mostly against adult women (80.9%), followed by children/adolescents (14.5%) and older women (4.6%). Regarding the period of the year, the records of violence against women occurred with a variation of 23.4% recorded in the first quarter to a maximum value of 28% in the fourth quarter.
A high number of reported cases without proper identification of the offender was identified in the registration forms of the Civil Police (n=4260, 56.9% of all cases of violence). Among the valid values for this variable, it was found that cases of violence were committed by someone close to the victim, 45.1% by a partner and 19.9% by a family member.
Regarding the distribution of cases of violence considering the offender and the age of the victims, it was observed in this study that, in the early stages of life (childhood and adolescence), there were similarities in the distribution of offenders according to the type of violence, except for aggression, which presented a much higher value for partner and family. When the cases in adulthood were analyzed, the pattern was peculiar, with an increase in violence caused by the partners of the victims. Regarding the elderly, the family assumed the role of offender (Figure 1).
A bivariate analysis was performed using the variables "offender", "type of violence" and "age" to assess the statistical significance of the data (Table 2). The analysis showed a statistically significant association for all variables (p=0.000), and the higher number of cases of violence was committed by partners for all kinds of violence, with the exception of rape (more common among family members and strangers) and injury (more common among acquaintances). The children/adolescents were more likely to experience violence by a partner (25.2%) followed by a family member (24.9%), and in adulthood this difference was significant (50.8% to 17.1% for partner and family). In older women, 52.1% of the cases of violence were committed by the victims' families.
Graphic pattern of distribution of the cases of violence, considering the offender, by age: A) children and adolescents; B) adult women; C) older women. Montes Claros, MG, Brazil, 2010
Discussion
Gender inequality has, as one of its extreme manifestations, violence against women as a result of the difference in power that translates into relationships of domination and power. Thereby, gender-based violence has been constituted as a social phenomenon which influences the way of life, illness and death of women( 2020. Guedes RN, Silva ATMC, Fonseca RMGS. A violência de gênero e o processo saúde-doença das mulheres. Esc Anna Nery. 2009;13(3):625-31. ).
It was found in this study that, among forms of violence against women, threats were the
most frequent (44.6%). Similar results were observed in a study conducted in eastern
India, where psychological violence against women reached a percentage of
52%(
88. Babu BV, Kar SK. Domestic violence against women in eastern India: a
population-based study on prevalence and related issues. BMC Public Health.
[Internet]. 2009 . [acesso 15 dez 2012]; 9(129):1-18. Disponível em:
http://www.biomedcentral.com/1471-2458/9/129
Disponível em: http://www.biomedcentral....
) and in another study conducted in Nova Friburgo, Rio de Janeiro - Brazil,
where 20.6 % of cases related to such forms of violence were found(
2121. Pazo CG, Aguiar AC. Sentidos da violência conjugal: análise do banco
de dados de um serviço telefônico anônimo. Physis. [Internet]. 2012 [acesso 13 dez
2012]; 22(1): 253-73. Disponível em:
http://www.scielo.br/pdf/physis/v22n1/v22n1a14.pdf
Disponível em: http://www.scielo.br/pdf/...
). In rural Nepal, sexual violence has the highest rates, totaling
46.2%(
66. Lamichhane P, Puri M, Tamang J,Dulal B. Women's Status and Violence
against Young Married Women in Rural Nepal. BMC Women's Health. [Internet]. 2011 .
[acesso 18 dez 2012];11(19):1-31. Disponível em:
http://www.biomedcentral.com/1472-6874/11/19
Disponível em: http://www.biomedcentral....
).
The analyses of this study were statistically significant for all variables (p=0.000), and a higher number of cases of violence was committed by the partner for all kinds of violence, with the exception of rape, which was more common among family members and strangers, and injury, in which acquaintances were the most prevalent offenders.
Authors report that violence against women is mainly expressed through physical, sexual
and psychological violence, affecting a woman's biopsychosocial integrity. Most of the
acts suffered by women happen within the family, by intimates, particularly in the
domestic sphere. Women are at greater risk of violence in relationships with family
members and friends than with strangers and, in the majority of cases, the offender was
their spouse or partner(
2222. Lettiere A, Nakano AMS, Bittar DB. Violência contra a mulher e suas
implicações na saúde materno-infantil.Acta Paul Enferm. [Internet]. 2012. [acesso 13
dez 2012];25(4): 524-29. Disponível
em:http://www.scielo.br/scielo.php?pid=S0103-21002012000400007&script=sci_arttext
Disponível
em:http:...
).
In the present study, the higher incidence of violence among adult women (80.9%) is in
line with that seen in the cases of violence attended in a Women's Division in the
metropolitan region of Porto Alegre, Rio Grande do Sul-Brazil, with ages between 24 and
45 years accounting for 59% of cases(
2323. Gadoni-CostaLM, Zucatti APN, Dell'Aglio DD. Violência contra a
mulher: levantamento dos casos atendidos no setor de psicologia de uma delegacia para
a mulher. Estud Psicol.2011;28(2):219-27.
). Similar results were also found in a study with women in Feira de Santana,
Bahia - Brazil(
1111. Rocha SV, Almeida MMG, Araújo TM. Violence against women among urban
area residents in Feira de Santana, Bahia, Brazil. Trends Psychiatry Psychother.
[Internet]. 2011. [acesso 18 dez 2012];33(3):164-8. Disponível em:
http://www.scielo.br/scielo.php?pid=S2237-60892011000300006&script=sci_arttext
Disponível em:
http...
).
This phenomenon has also been observed internationally. A study performed in eastern
India showed that the prevalence of all forms of violence increased with age(
88. Babu BV, Kar SK. Domestic violence against women in eastern India: a
population-based study on prevalence and related issues. BMC Public Health.
[Internet]. 2009 . [acesso 15 dez 2012]; 9(129):1-18. Disponível em:
http://www.biomedcentral.com/1471-2458/9/129
Disponível em: http://www.biomedcentral....
) and in Spain, the average age of onset of violence against women committed
by their partners was 25 years old(
99. Ruiz-Pérez I, Plazaola-Castaño J, Vives-Cases C, Montero-Piñar MI,
Escribã-Agüir V,Jiménez-Gutiérrez E, et al.Variabilidad geográfica de la violencia
contra las mujeres en España. Gac Sanit. [Internet]. 2010 [acesso 16 dez
2012];24:128-35. Disponível
em:http://www.ucm.es/info/seas/comision/tep/mt/Variabilidad_geografica_de_la_violencia_contra_las_mujeres%20en_Espana.pdf
Disponível
em:http:...
).
A multicenter study conducted in Bangladesh, Brazil, Ethiopia, Japan, Namibia, Peru,
Tanzania, Samoa, Serbia and Montenegro, Thailand, showed that women aged 15 to 49 years
were significantly associated with increased risk of intimate partner
violence(
1313. Abramsky T, Watts CH, Garcia-Moreno C, Devries K,Kiss L, EllsbergM,
et al. What factors are associated with recent intimate partner violence? findings
from the WHO multi-country study on women's health and domestic violence. BMC Public
Health. [Internet]. 2011 . [acesso 14 dez 2012];11(109):1-29. Disponível em:
http://www.biomedcentral.com/1471-2458/11/109
Disponível em: http://www.biomedcentral....
). One of the explanations related to this fact is that, in adulthood, the
woman is in a period of higher sexual and reproductive activity(
2323. Gadoni-CostaLM, Zucatti APN, Dell'Aglio DD. Violência contra a
mulher: levantamento dos casos atendidos no setor de psicologia de uma delegacia para
a mulher. Estud Psicol.2011;28(2):219-27.
). However, one may wonder whether the violent incidents with children and
adolescents have not remained hidden, since they depend on someone else to make the
report, which is a proper attitude, considering that the protection of these individuals
depends on the knowledge of violence by the competent individuals and
organizations(
2424. Garbin CAS, Rovida TAS, Joaquim RC,Paula AM, QueirozAPDG. Violência
denunciada: ocorrências de maus tratos contra crianças e adolescentes registradas em
uma unidade policial. Rev Bras Enferm. 2011;64(4):665-70.
). The frequent omission of health professionals reporting the cases is
noteworthy(
44. Oliveira MT, Samico I, Ishigami ABM, Nascimento RMM. Violência
intrafamiliar: a experiência dos profissionais de saúde nas Unidades de Saúde da
Família de São Joaquim do Monte, Pernambuco. Rev Bras Epidemiol. 2012;15(1):166-78.
doi:10.1590/S1415-790X2012000100015
https://doi.org/10.1590/S1415-790X201200...
).
The relationship between higher levels of violence and the place of its occurrence was
found in a study conducted in the city of João Pessoa, Paraíba, Brazil, which identified
differences related to risk of incidence of violence between neighborhoods(
33. Lucena KDT, Silva ATMC, Moraes RM,Silva CC, BezerraIMP. Análise
espacial da violência doméstica contra a mulher entre os anos de 2002 e 2005 em João
Pessoa, Paraíba, Brasil. Cad Saúde Pública. 2012;28(6):1111-21. doi:
10.1590/S0102-311X2012000600010
https://doi.org/10.1590/S0102-311X201200...
). This fact can be understood by considering that violence is linked to the
socioeconomic conditions of a population, to the issues of lifestyle and characteristics
of the territory. Noteworthy is the use of geoprocessing tools for the study and control
of urban violence, in order to aid the process of decision making of managers in the
construction of public policies compatible with reality in order to confront this
situation(
33. Lucena KDT, Silva ATMC, Moraes RM,Silva CC, BezerraIMP. Análise
espacial da violência doméstica contra a mulher entre os anos de 2002 e 2005 em João
Pessoa, Paraíba, Brasil. Cad Saúde Pública. 2012;28(6):1111-21. doi:
10.1590/S0102-311X2012000600010
https://doi.org/10.1590/S0102-311X201200...
).
In this investigation, when the offender was identified, the intimate partner of the
woman appeared with the highest prevalence (45.1%), higher than that found in
population-based study conducted with women in the city of São Paulo and 15
municipalities in Pernambuco, Brazil(
2525. D'Oliveira AFPL, Schraiber LB, França-Junior I, Ludermir AB,Portella
AP, DinizCS, et al. Fatores associados à violência por parceiro íntimo em mulheres
brasileiras. Rev Saúde Pública. [Internet]. 2009. [acesso 12 dez 2012];
43(2):299-310. Disponível em:
http://www.scielo.br/scielo.php?pid=S0034-89102011000400013&script=sci_arttext
Disponível em:
http...
).
Intimate partners were also the main perpetrators of violence against women
internationally, as observed in eastern India(
88. Babu BV, Kar SK. Domestic violence against women in eastern India: a
population-based study on prevalence and related issues. BMC Public Health.
[Internet]. 2009 . [acesso 15 dez 2012]; 9(129):1-18. Disponível em:
http://www.biomedcentral.com/1471-2458/9/129
Disponível em: http://www.biomedcentral....
) and Spain(
99. Ruiz-Pérez I, Plazaola-Castaño J, Vives-Cases C, Montero-Piñar MI,
Escribã-Agüir V,Jiménez-Gutiérrez E, et al.Variabilidad geográfica de la violencia
contra las mujeres en España. Gac Sanit. [Internet]. 2010 [acesso 16 dez
2012];24:128-35. Disponível
em:http://www.ucm.es/info/seas/comision/tep/mt/Variabilidad_geografica_de_la_violencia_contra_las_mujeres%20en_Espana.pdf
Disponível
em:http:...
). A study in rural Nepal showed that more than half (51.9%) of young married
women reported having experienced some form of violence by their husbands(
66. Lamichhane P, Puri M, Tamang J,Dulal B. Women's Status and Violence
against Young Married Women in Rural Nepal. BMC Women's Health. [Internet]. 2011 .
[acesso 18 dez 2012];11(19):1-31. Disponível em:
http://www.biomedcentral.com/1472-6874/11/19
Disponível em: http://www.biomedcentral....
).
In the multicenter study cited before, it was identified that women who lived with a
partner without being formally married to him had an increased risk for intimate partner
violence. In contrast, women who were not living with their partners had lower risks.
The research also showed that most new relationships were at increased risk for intimate
partner violence(
1313. Abramsky T, Watts CH, Garcia-Moreno C, Devries K,Kiss L, EllsbergM,
et al. What factors are associated with recent intimate partner violence? findings
from the WHO multi-country study on women's health and domestic violence. BMC Public
Health. [Internet]. 2011 . [acesso 14 dez 2012];11(109):1-29. Disponível em:
http://www.biomedcentral.com/1471-2458/11/109
Disponível em: http://www.biomedcentral....
).
The action of a family member in the occurrence of violence against women was also
significant (19.9%) in the present study, coming right after the intimate partner, as
verified in a study conducted in Spain(
99. Ruiz-Pérez I, Plazaola-Castaño J, Vives-Cases C, Montero-Piñar MI,
Escribã-Agüir V,Jiménez-Gutiérrez E, et al.Variabilidad geográfica de la violencia
contra las mujeres en España. Gac Sanit. [Internet]. 2010 [acesso 16 dez
2012];24:128-35. Disponível
em:http://www.ucm.es/info/seas/comision/tep/mt/Variabilidad_geografica_de_la_violencia_contra_las_mujeres%20en_Espana.pdf
Disponível
em:http:...
).
Thereby, for women victims of domestic violence, the home, considered before as a safe
place, began to represent a risk, since the offender is inside(
2323. Gadoni-CostaLM, Zucatti APN, Dell'Aglio DD. Violência contra a
mulher: levantamento dos casos atendidos no setor de psicologia de uma delegacia para
a mulher. Estud Psicol.2011;28(2):219-27.
). From this perspective, violence against women requires a different
approach when caused by an offender who shares intimate relations with the victim, which
is still permeated by historical and cultural issues legitimized and cultivated in the
male dominance in social relations between genders(
33. Lucena KDT, Silva ATMC, Moraes RM,Silva CC, BezerraIMP. Análise
espacial da violência doméstica contra a mulher entre os anos de 2002 e 2005 em João
Pessoa, Paraíba, Brasil. Cad Saúde Pública. 2012;28(6):1111-21. doi:
10.1590/S0102-311X2012000600010
https://doi.org/10.1590/S0102-311X201200...
).
It must be considered that in some cases, women are unable to escape from this situation
of violence because they lack access to the means and resources needed to eliminate
their dependence on the offender. These women require psychological assistance, social
support, legal advice, housing, daycare, school, and/or a job to acquire financial
autonomy and healthcare(
2626. Silva MAI, Ferriani MGC. Domestic violence: from the visible to the
invisible.Rev. Latino-Am. Enfermagem. 2007;15(2):275-81.
). This situation demonstrates the importance of comprehensive, integrated
and effective cross-sector network in the health of women, which includes home-shelters,
centers and rehabilitation, defenders and Women Police Stations, Policy Secretariat for
Women, Health and Planning Department Secretariat, so that the integrality and
effectiveness of care for female victims of violence can be ensured(
33. Lucena KDT, Silva ATMC, Moraes RM,Silva CC, BezerraIMP. Análise
espacial da violência doméstica contra a mulher entre os anos de 2002 e 2005 em João
Pessoa, Paraíba, Brasil. Cad Saúde Pública. 2012;28(6):1111-21. doi:
10.1590/S0102-311X2012000600010
https://doi.org/10.1590/S0102-311X201200...
-
44. Oliveira MT, Samico I, Ishigami ABM, Nascimento RMM. Violência
intrafamiliar: a experiência dos profissionais de saúde nas Unidades de Saúde da
Família de São Joaquim do Monte, Pernambuco. Rev Bras Epidemiol. 2012;15(1):166-78.
doi:10.1590/S1415-790X2012000100015
https://doi.org/10.1590/S1415-790X201200...
).
The essential role of the Family Health Strategy (FHS) in recognizing cases of
gender-related violence is also noteworthy. The cases are recognized through a
translation of a demand for other health care and in coping with health needs of women
who experience it, facilitated by the bond prompted by the logic of its
attention(
55. Guedes RN, Fonseca RMGS, Egry EY.Limites e possibilidades avaliativas
da estratégia saúde da família para a violência de gênero. Rev Esc Enferm USP.
[Internet] 2013.[acesso 23 ago 2013]; 47(2):304-11. Disponível em:
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342013000200005&lng=pt
Disponível em:
http...
) and its assignment to promote intersectorality.
Therefore, it is essential that professionals working in services addressing coping with
violence are able to attend female victims of violence(
2727. Souza JA, Almeida RA, Silva ATMC,Anjos UU. Modelo Baseado em Regras
como Suporte à Atuação da Delegacia Especializada de Atendimento à Mulher no
Encaminhamento de Mulheres em Situação de Violência Doméstica.Rev Bras Cienc Saúde.
2012;16(1):71-8. doi: 10.4034/RBCS.2012.16.01.11
https://doi.org/10.4034/RBCS.2012.16.01....
-
2828. Rodríguez-BorregoMA, Vaquero-AbellánM, Rosa LB. A cross-sectional
study of factors underlying the risk of female nurses' suffering abuse by their
partners. Rev. Latino-Am. Enfermagem. 2012;20(1):11-8.
), with integrated, interdisciplinary interventions with a broader
approach(
1616. Bernz IM, Coelho EBS, Lindner SR. Desafio da Violência Doméstica
para profissionais da saúde: revisão da literatura. Saude & Transf Soc.
[Internet]. 2012 [acesso 23 ago 2013];3(3):105-11. Disponível em:
http://www.incubadora.ufsc.br/index.php/saudeetransformacao/article/view/1545/2157
Disponível em:
http...
-
1717. Pedrosa CM, Spink MJP. A Violência Contra Mulher no cotidiano dos
serviços de saúde: desafios para a formação médica. Saude Soc. 2011;20(1):124-35.
doi:10.1590/S0104-12902011000100015
https://doi.org/10.1590/S0104-1290201100...
), through an emancipatory praxis, allowing these women to face and overcome
this reality(
55. Guedes RN, Fonseca RMGS, Egry EY.Limites e possibilidades avaliativas
da estratégia saúde da família para a violência de gênero. Rev Esc Enferm USP.
[Internet] 2013.[acesso 23 ago 2013]; 47(2):304-11. Disponível em:
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342013000200005&lng=pt
Disponível em:
http...
,
1616. Bernz IM, Coelho EBS, Lindner SR. Desafio da Violência Doméstica
para profissionais da saúde: revisão da literatura. Saude & Transf Soc.
[Internet]. 2012 [acesso 23 ago 2013];3(3):105-11. Disponível em:
http://www.incubadora.ufsc.br/index.php/saudeetransformacao/article/view/1545/2157
Disponível em:
http...
). Furthermore, it is essential that these professionals help uncover this
issue, through notification of the cases, and other forms of reporting and monitoring to
reduce the invisibility of violence as a health issue(
55. Guedes RN, Fonseca RMGS, Egry EY.Limites e possibilidades avaliativas
da estratégia saúde da família para a violência de gênero. Rev Esc Enferm USP.
[Internet] 2013.[acesso 23 ago 2013]; 47(2):304-11. Disponível em:
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342013000200005&lng=pt
Disponível em:
http...
,
1717. Pedrosa CM, Spink MJP. A Violência Contra Mulher no cotidiano dos
serviços de saúde: desafios para a formação médica. Saude Soc. 2011;20(1):124-35.
doi:10.1590/S0104-12902011000100015
https://doi.org/10.1590/S0104-1290201100...
) and break the stigma with which it is associated(
1717. Pedrosa CM, Spink MJP. A Violência Contra Mulher no cotidiano dos
serviços de saúde: desafios para a formação médica. Saude Soc. 2011;20(1):124-35.
doi:10.1590/S0104-12902011000100015
https://doi.org/10.1590/S0104-1290201100...
).
Conclusion
The results of this study confirm the need for programs to prevent violence against women to be structured in universities, schools, institutions of Primary Health Care, health facilities and social movements, in order for change to occur in the context described. Also, the development of educational practices focused on redefining the roles of women in family and society should be advocated.
Therefore, the reduction of violence against women requires intersectoral commitment by governments and society in order to establish a culture of peace and humane care for all age groups, especially children and elderly, who are more vulnerable.
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23Gadoni-CostaLM, Zucatti APN, Dell'Aglio DD. Violência contra a mulher: levantamento dos casos atendidos no setor de psicologia de uma delegacia para a mulher. Estud Psicol.2011;28(2):219-27.
-
24Garbin CAS, Rovida TAS, Joaquim RC,Paula AM, QueirozAPDG. Violência denunciada: ocorrências de maus tratos contra crianças e adolescentes registradas em uma unidade policial. Rev Bras Enferm. 2011;64(4):665-70.
-
25D'Oliveira AFPL, Schraiber LB, França-Junior I, Ludermir AB,Portella AP, DinizCS, et al. Fatores associados à violência por parceiro íntimo em mulheres brasileiras. Rev Saúde Pública. [Internet]. 2009. [acesso 12 dez 2012]; 43(2):299-310. Disponível em: http://www.scielo.br/scielo.php?pid=S0034-89102011000400013&script=sci_arttext
» Disponível em: http://www.scielo.br/scielo.php?pid=S0034-89102011000400013&script=sci_arttext -
26Silva MAI, Ferriani MGC. Domestic violence: from the visible to the invisible.Rev. Latino-Am. Enfermagem. 2007;15(2):275-81.
-
27Souza JA, Almeida RA, Silva ATMC,Anjos UU. Modelo Baseado em Regras como Suporte à Atuação da Delegacia Especializada de Atendimento à Mulher no Encaminhamento de Mulheres em Situação de Violência Doméstica.Rev Bras Cienc Saúde. 2012;16(1):71-8. doi: 10.4034/RBCS.2012.16.01.11
» https://doi.org/10.4034/RBCS.2012.16.01.11 -
28Rodríguez-BorregoMA, Vaquero-AbellánM, Rosa LB. A cross-sectional study of factors underlying the risk of female nurses' suffering abuse by their partners. Rev. Latino-Am. Enfermagem. 2012;20(1):11-8.
Publication Dates
-
Publication in this collection
Jan-Feb 2014
History
-
Received
20 Mar 2013 -
Accepted
23 Sept 2013