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Violence against women: the health sector responds
  1. C Vives

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    Edited by M Velzeboer, M Ellsberg, C Clavel Arcas, et al. Washington, DC: PAHO, 2003, US $22.00, pp 131. ISBN 92-751229-2

    This book is based on the formulation, development, and implementation of the PAHO’s integrated strategy to cope with gender based violence (GBV). The convention on the elimination of all forms of discrimination against women (CEDAW,1 1979) and the inter-American convention on the prevention, punishment and eradication of violence2 were the principal promoters of a political framework for action against GBV in all states. However, as the authors say, the health sector had traditionally ignored these calls. For this reason, the PAHO with the program for appropiate technology in health (PATH) and the US Centers for Disease Control and Prevention (CDC) have published this book to show the results of the assessments developed since 1993 to promote changes not only in service providers’ attitudes, but also battered women’s expectations and policy makers perspectives about the role of the health sector in this issue.

    The book is structured in two sections. The first one, by the PAHO, gives an overview of why GBV is a public health problem (chapter one) and the two main projects implemented to develop an integrated strategy for tackling GBV. The first project—“Critical Path” studies3—was designed to analyse the problem through the perspective of health professionals and women affected by GBV (chapter 2). The second project aimed mainly to put in place policies, capacities, systems, and networks to better prevent, detect, and care for women involved in GBV. So, it selected gender equity, partnerships, and active participation as cross cutting values and; communities, professional sectors, and national coalitions as the main levels and detection, attention and prevention as the main actions of the programme (chapter three).

    In the second section, PATH presents the lessons learned by the assessments of the PAHO’s strategy. Firstly, there was evidence that although the policy reforms have increased during the past decade in many countries of Latin America, the changes implemented were not always clear and often conflicted with issues of privacy, socialisation practices, and long ingrained cultural patterns (chapter four). For these problematic issues, the necessity of integrating health services in GBV politics was emphasised. It was also learnt that training health providers, coordinating health departments, having officially approved norms and protocols, and organising information and surveillance systems were essential to guarantee the quality of the health services assistance to battered women (chapter five). Screening programmes and the improvement of motivation and training of health staff in these exercises were identified as important actions to make effective the programmes implemented at health services level (chapter six). Finally, the coordination with local leaders, government institutions and NGOs based on the communities were required to ensure the efficiency of bringing health sector into actions for tackling GBV (chapter seven).

    The applicability of the PAHO approach in several settings of Latin America to other places is discussed in the last chapter (chapter eight). In this sense, I agree with the author about the enrichment of the “Critical Path” studies and the lessons learned presented in this book. The “Critical Path” studies are an example of good practice in research because it involved women and institutions from the start. Their results make visible the problems that battered women have to cope with health, justice, educative, and community sectors to escape from their intimate partner. It also provides important empirical information about the active role of women involved in GBV. The integrated strategy developed by PAHO is also a good practice in action for tackling GBV because it integrates gender perspective and the public health functions of capacity and advocacy.

    This book is an important information resource for public health professionals involved in tackling GBV, because it offers a summary of the main strategies developed by PAHO in Latin America. The strength of this information resource is the human perspective of GBV that makes visible women and professional voices. It has to be considered as the platform to look for the original publications in which “Violence against women: the health sector responds” is based on. It is also interesting for other professionals because it breaks with the health sector’s absence in actions for tackling GBV.

    Edited by M Velzeboer, M Ellsberg, C Clavel Arcas, et al. Washington, DC: PAHO, 2003, US $22.00, pp 131. ISBN 92-751229-2

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