In this essay, Elizabeth Doggett and Myra Betron elaborate on health sector policy responses to the increased risk of gender-based violence (GBV) during the COVID-19 pandemic, measures that can mitigate the increased risk, and the additional need for primary prevention to tackle the root causes of GBV. With thanks to Sujata Tuladhar, Technical Advisor for GBV at UNFPA Asia Pacific Region Office for her review and collaboration on the mapping exercise.
Picture a heterosexual, married couple with dependent children who both work outside the home. When COVID-19 hit, the man is let go from his job as a salesperson. The woman, a nurse, continues working outside the home with mandatory overtime and with it, increased stress. Their two young children are sent home from daycare and school. Grandparents are not able to help due to their own high COVID-19 risk profiles. The man feels emasculated to have lost his income and to depend on the wages of his spouse. He had previously relied on his wife for child care and housework because that is how his own parents did it. Home alone with lively kids and few parenting skills, he starts drinking alcohol every afternoon to cope. When the woman comes home, the couple argues constantly. Their apartment is a mess. The children are struggling to contain their energy. The family is unsure whether they will have enough money to pay their monthly bills. None of them can visit friends due to lockdown orders. In this situation, is violence inevitable?
During the COVID-19 pandemic, women around the world experienced an increase in GBV, especially intimate partner violence. The phenomenon of GBV increasing in emergency situations is not unique to COVID-19, and has long been documented in other settings of disaster, conflict, civil unrest, and displacement. Though GBV is rooted in gender inequality and women’s lower status in society, many risk factors for GBV are heightened during emergencies. In particular, life during COVID-19 and other emergency settings is often marked by stress, economic strain, and isolation from social support—factors known to trigger or exacerbate the risks of violence against women.
Due to early documentation of the rise of GBV during COVID-19 and in response to calls to action from global actors, some countries responded by including considerations for GBV in their COVID-19 response policies. Researchers have documented policy changes related to GBV response in COVID-19 in Latin America, the Middle East, and Africa, citing heterogeneous policies focused on helping survivors access multisectoral services, especially health, legal, and justice services, and emergency shelter. Survivors need access to all of these services, and the health sector is a key entry point, particularly during a pandemic when health services are many people’s main contact with public institutions. In health care encounters, patients can be screened for GBV and often feel safe disclosing experiences of violence to their trusted health care providers. Moreover, pandemic response requires a broader focus than preventing and treating viruses, and should proactively address social determinants of health including GBV.
To better understand the health sector policy response to GBV during COVID-19 in the Asia-Pacific region, Jhpiego and UNFPA Asia Regional Pacific Office conducted a mapping exercise in 2021. Parallel to global research, the most common policies we found were meant to facilitate access to GBV survivor services, especially by classifying post-GBV health services as essential during lockdowns. Of 34 countries reviewed, we found 11 policies declaring GBV care services as essential. Other access-related initiatives included digitizing hotlines or expanding their hours, raising awareness about how to seek help, and providing infection prevention guidelines to one-stop centers and shelters. While these policies are to be applauded, gaps remain in survivors’ access to supportive services. Furthermore, a key omission in the reviewed policies is investment in GBV prevention and risk mitigation, which involves not only providing support to survivors of GBV, but also addressing its root causes.
Situations like COVID-19 necessitate a focus on immediate risk factors for intimate partner violence. At a minimum, pandemic and other emergency policies should actively seek to mitigate the added risk of GBV that occurs in emergency situations. Such mitigation measures that can be undertaken from the health sector might include:
- Offering support to couples on nonviolent conflict resolution, which has been shown to decrease GBV;
- Providing counseling and support for reducing alcohol abuse;
- Investing in parenting education and support for men, which may serve dual purposes of reducing conflicts related to the distribution of childrearing responsibilities, but also potentially breaking intergenerational patterns of violence by modeling nonviolence to children; and
- Encouraging virtual support networks for women and men—as a way of releasing stress and reducing social isolation that allows GBV to persist.
Such policies and interventions could help the family we described above from reaching a breaking point and avoid violence within the home.
Future pandemic and emergency responses must also include complementary investments in primary prevention via evidence-based interventions that get at the central root cause of GBV—harmful gender norms and gender inequalities that condone and perpetuate men’s power over women. There is now a robust evidence base that demonstrates that these can be transformed at both micro and macro levels. In times of crises, health and safety concerns are paramount; however, more than two years into the COVID-19 pandemic, with lockdowns becoming less frequent and societies settling into a “new normal,” governments and the global health community have the opportunity to support structural interventions to achieve longer-term lasting change rather than just crisis mitigation. What are we waiting for?
Image credit: Closure by Gabrielle Hender is free to use under the Unsplash license