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      The health-related impacts and costs of violence against women and girls on survivors, households and communities in Ghana

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          Abstract

          Past research on violence in Ghana primarily discusses domestic violence and some types of sexual violence, but lacks a comprehensive analysis of violence against women and girls (VAWG) and its wider costs and impacts. Our study on the social costs of VAWG is a unique contribution, which aims to fill that gap. Through indepth interviews (IDIs) and focus group discussions (FGDs) with adult women and men, we explored the health impact of VAWG and the resulting social and economic consequences on survivors, their families and their communities. The research, which took place in the Eastern, Central, and Greater Accra regions of Ghana, points to several physical and mental health outcomes among survivors including physical injuries and disability, as well as impacts on mental health such as anxiety and suicidal ideation. Many VAWG survivors also experience stigma and social isolation. Our findings also reveal that survivors’ families can bear various social and economic costs. Lack of public and private service provision and shelters for survivors heighten these impacts. Without institutional support for survivors, families and communities absorb these costs of VAWG.

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          Intimate partner violence and physical health consequences.

          Domestic violence results in long-term and immediate health problems. This study compared selected physical health problems of abused and never abused women with similar access to health care. A case-control study of enrollees in a multisite metropolitan health maintenance organization sampled 2535 women enrollees aged 21 to 55 years who responded to an invitation to participate; 447 (18%) could not be contacted, 7 (0.3%) were ineligible, and 76 (3%) refused, yielding a sample of 2005. The Abuse Assessment Screen identified women physically and/or sexually abused between January 1, 1989, and December 31, 1997, resulting in 201 cases. The 240 controls were a random sample of never abused women. The general health perceptions subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey measured general health. The Miller Abuse Physical Symptom and Injury Scale measured abuse-specific health problems. Cases and controls differed in ethnicity, marital status, educational level, and income. Direct weights were used to standardize for comparisons. Significance was tested using logistic and negative binomial regressions. Abused women had more (P<.05) headaches, back pain, sexually transmitted diseases, vaginal bleeding, vaginal infections, pelvic pain, painful intercourse, urinary tract infections, appetite loss, abdominal pain, and digestive problems. Abused women also had more (P< or =.001) gynecological, chronic stress-related, central nervous system, and total health problems. Abused women have a 50% to 70% increase in gynecological, central nervous system, and stress-related problems, with women sexually and physically abused most likely to report problems. Routine universal screening and sensitive in-depth assessment of women presenting with frequent gynecological, chronic stress-related, or central nervous system complaints are needed to support disclosure of domestic violence.
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            A systematic review and meta-analysis of intimate partner violence during pregnancy and selected birth outcomes.

            Intimate partner violence (IPV) has a detrimental impact on the lives of women worldwide. Several studies have examined the effect IPV has on adverse birth outcomes when it occurs during pregnancy.
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              A global overview of gender-based violence

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                Author and article information

                Journal
                J Public Health Afr
                JPHIA
                Journal of Public Health in Africa
                PAGEPress Publications, Pavia, Italy
                2038-9922
                2038-9930
                01 October 2018
                01 October 2018
                : 9
                : 2
                : 860
                Affiliations
                [1 ]Landesa Rural Development Institute , Washington, DC, USA
                [2 ]Institute of Statistical , Social, and Economic Research, Accra, Ghana
                [3 ]International Center for Research on Women , Washington DC, USA
                [4 ]National University of Ireland , Galway, Ireland
                Author notes
                Landesa, 1255 23rd St. NW, Suite 275, Washington, DC 20037, USA. +1.202.849.8416. ginaa@ 123456landesa.org

                Contributions: GA: research design, tool design, data analysis, interpretation and manuscript preparation; APF, SD, AOC: data collection analysis, interpretation and critical revision of the manuscript; JLM, LOM: data analysis and interpretation, manuscript preparation and critical revision of the manuscript; ND, SS: design, analysis and interpretation of data, critical revision of the manuscript; CS: interpretation of data, critical revision of the manuscript.

                Conflict of interest: the authors declare no potential conflict of interest.

                Article
                10.4081/jphia.2018.860
                6325419
                04a6fe70-9d05-4b99-a346-bc0091f3a2ea
                ©Copyright G. Alvarado et al., 2018

                This work is licensed under a Creative Commons Attribution NonCommercial 4.0 License (CC BY-NC 4.0).

                History
                : 20 February 2018
                : 06 August 2018
                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 23, Pages: 5
                Funding
                Funding: Department for International Development, UK.
                Categories
                Article

                violence,violence against women and girls,gender,ghana
                violence, violence against women and girls, gender, ghana

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