Breaking Cycle of Violence to Save Mothers & Children: Why Ending Gender-Based Violence is Essential for Global Health

Pioneering effort to protect women and children in quarantine centres in Viet Nam Credit: UN Women

By Rajat Khosla
GENEVA, Nov 21 2024 (IPS)

Each year, millions of women and children around the world die from preventable causes. Maternal, newborn, and child health (MNCH) is a shared global priority, yet we often overlook one of its most pressing—and preventable—barriers: violence against women.

As we mark the 16 Days of Activism Against Gender-Based Violence, we are reminded that gender-based violence (GBV) is not just a social issue but a critical health crisis that endangers the lives of mothers and children everywhere.

When we consider that a woman experiencing violence is 1.5 times more likely to have a low-birth-weight baby and that this condition greatly increases infant mortality, the need for urgent, integrated action becomes starkly clear. ¹ Addressing violence is not peripheral to MNCH efforts—it is foundational.

Violence and Health: A Devastating Cycle

Evidence tells us that intimate partner violence (IPV) directly affects maternal and infant outcomes. Pregnant women subjected to IPV face a heightened risk of complications like preterm labor and hemorrhage, often resulting in increased maternal and newborn mortality.^{2 3} The problem doesn’t end with pregnancy: children born to mothers experiencing violence have a higher likelihood of malnutrition, stunting, and developmental delays, perpetuating a cycle of vulnerability. ⁴

The psychological toll is just as concerning. Women subjected to violence are more prone to depression and anxiety, both of which affect maternal health-seeking behavior.⁵ Depressed mothers are less likely to access antenatal care and postnatal services, further endangering the lives of their infants. In turn, these mental health impacts lead to cascading health and social risks for women and their families, affecting entire communities.

Nowhere are these challenges more pressing than in humanitarian settings. Conflict, natural disasters, and displacement magnify the vulnerability of women and children, often leading to spikes in sexual violence and the breakdown of healthcare systems. In conflict zones, over 60% of women report having experienced sexual violence, according to humanitarian reports. ⁶ These women are not only at risk of severe trauma and infection but also of maternal mortality, with rates nearly double those found in stable environments. ⁷

It’s estimated that more than 500 women and girls die every day from preventable complications related to pregnancy and childbirth in humanitarian settings,⁸ underscoring an urgent need for an integrated approach to MNCH and GBV response. These statistics are more than numbers—they represent the lives of mothers, daughters, and children who deserve health, safety, and dignity.

The Overlooked Victims: Women Health Care Workers

It’s not only patients who suffer. Female health workers, the backbone of MNCH services worldwide, are often at grave risk. In fragile and conflict-affected settings, women health workers face high rates of violence, including harassment and physical assault.

Research suggests that up to 80% of healthcare workers in these settings report experiencing violence, a statistic that directly impacts their ability to provide care.⁹ High rates of violence lead to burnout, turnover, and a critical shortage of trauma-informed healthcare providers when they are needed most.¹⁰

For many, this threat is exacerbated by their roles as frontline responders to gender-based violence. The safety and mental health of our healthcare workforce are inextricably linked to the health outcomes we aim to achieve for mothers and children.

A Call to Action for Integrated Policies

As we look to the future, it’s time to broaden our understanding of what it means to support maternal and child health. Policies that address violence against women and protect female health workers must become a central pillar of MNCH efforts. This calls for a multi-pronged approach:
1. Prioritize Funding for Integrated MNCH and GBV Services: Donors and governments should increase funding for programs that integrate maternal health services with GBV prevention and response, particularly in crisis-prone areas.
2. Strengthen Health Systems in Humanitarian Settings: We must scale up support for safe, trauma-informed healthcare in conflict zones, ensuring that women and children have access to life-saving care without the threat of further violence.
3. Protect and Support Women Health Workers: Policies that safeguard the well-being of women health workers are essential. Measures like workplace protections, mental health support, and security protocols can help mitigate the impacts of violence and ensure that healthcare workers can provide essential services safely.

The costs of inaction are too high. Each preventable death of a mother or child as a result of violence marks a failure to uphold the rights to health and safety for all. By placing violence against women at the forefront of our MNCH efforts, we can break the cycle of suffering and create the conditions needed for healthy mothers and thriving children.

This 16 Days of Activism, let’s commit to integrated action against violence—because women’s health, newborn survival, and child development depend on it. Together, we can build a world where women and children live free from violence, and where health and dignity go hand in hand.

¹ World Health Organization. (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization.
² Shah, I. H., & Hatcher, A. (2013). The impact of intimate partner violence on women’s reproductive health: A review. Trauma, Violence, & Abuse, 14(2), 128-137. doi:10.1177/1524838012451845
³ Elizabeth P. Lockington et al. Intimate partner violence is a significant risk factor for adverse pregnancy outcomes. AJOG Global Reports. Volume 3, Issue 4, November 2023, 100283
⁴ Ellsberg, M., & Heise, L. (2005). Researching violence against women: A practical guide for researchers and activists. Geneva: World Health Organization.
⁵ World Health Organization. (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Consequences. https://iris.who.int/bitstream/handle/10665/77431/WHO_RHR_12.43_eng.pdf
⁶ UNODC. (2021). Sexual violence in conflict: Current trends and implications. Vienna: United Nations. Retrieved from UNODC
⁷ UNFPA. (2019). Maternal mortality in humanitarian settings. New York: UNFPA. Retrieved from UNFPA
⁸ UNFPA. (2020). Maternal mortality in emergencies: The hidden crisis. Retrieved from UNFPA
⁹ Médecins Sans Frontières. (2018). Health workers in conflict zones: Risks and realities. Retrieved from MSF
¹⁰ World Health Organization. (2021). Violence against health workers. Geneva: WHO.

Rajat Khosla is Executive Director of the Partnership for Maternal, Newborn & Child Health (PMNCH), the global alliance for women’s, children’s and adolescents’ health and well-being, hosted by the World Health Organization, based in Geneva.

Email: khoslar@who.int

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