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Hoeffler - Domestic Violence

Hoeffler - Domestic Violence

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Hoeffler - Domestic Violence

  1. 1. Domestic Violence in Haiti Anke Hoeffler, Jean Guy Honoré, and Anastasia Gage Research paper prepared for the Copenhagen Consensus Center project ‘Haïti Priorise’
  2. 2. Domestic Violence in Haiti Background Domestic Violence in Haiti Intervention 1: Shelter Intervention 2: National Helpline Intervention 3: Teen Dating Violence Prevention Conclusion
  3. 3. What is Violence Against Women? 1994 UN ‘Declaration’ Violence against women: "any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life." Most violence is perpetrated by the woman’s intimate partner (husband, boyfriend)
  4. 4. Domestic Violence in the Global Context Collective Violence 2% Homicide 13% Non fatal Child Abuse 38% DV 47% Total Annual Cost: 9.5 trillion USD (~ 11% World GDP), IEP and Fearon& Hoeffler 2014
  5. 5. Examples and Reporting Examples of physical and sexual violence:  slapped, pushed, shoved  punched, kicked, beaten  choked, burnt on purpose  threatened with a weapon  physically forced to have sexual intercourse  having sexual intercourse because of fear what a partner might do  being forced to do something sexual that is perceived as humiliating or degrading  Most women never report this abuse, victimization surveys (in conjunction with DHS)
  6. 6. Consequences Health Costs (intangible):  Death – homicide, suicide  Injury  Major depressive disorder  Persistent mild depression (dysthymia)  STDs (including HIV/Aids)  Unwanted pregnancies (abortion, miscarriage)  Substance abuse  Violence against children  Intergenerational cycle Other Costs (tangible):  Medical treatment  Care costs  Lost income  Criminal justice costs
  7. 7. Domestic Violence in Haiti Any physical violence or sexual violence Severe physical violence or sexual violence 15-19 year olds 32.81% 22.54% 20-24 year olds 21.34% 13.79% 25-29 year olds 16.64% 10.35% 30-34 year olds 11.86% 8.47% 35-39 year olds 11.84% 7.84% 40-44 year olds 9.72% 7.24% 45-49 year olds 7.83% 6.25% Total 14.59% 9.87% Reporting past year, source: DHS 2012
  8. 8. Legislation and Support for Victims  Ratified UN convention and Inter-American convention  2005 rape was made a criminal offence, further legislation regarding the prevention of violence against women drafted for presentation to parliament  Gap between legal rights and actual experiences  Government and NGO support for victims (medical&legal), advocacy campaigns – a number of potential local partners for interventions  Specific problems of high teenage pregnancy rates and the Restavèk are not considered here
  9. 9. Intervention 1: Shelter One of the four women’s shelters destroyed in the earthquake – rebuild Unclear how effective shelters are, limited social science research Benefits: Shelter would serve 0.4 % of all victims of IPV The shelter is beneficial for 69% of users Shelter would save one death and 12 YLDs Costs: Build shelter in 2018, use until 2046, building cost HTG 10million &maintanance&running costs 4 full time staff (average or 0.5 earnings HGT 4,830 per month) BCR > 2.1
  10. 10. Intervention 2: National Helpline Set up a National Helpline for the prevention and treatment of IPV victims No social science research evidence on effectiveness but usage appears to increase after campaigns Helpline to be set up in 2017 and run until 2028 Benefit: avoid 1% of deaths and YLDs Cost: 4 full time staff (average or 0.5 earnings HGT 4,830 per month) Training costs, campaign costs USD 0.0425 per woman aged 15-49 Office rent&running costs BCR > 3.3
  11. 11. Intervention 3: Teenage Dating Violence Prevention Teaching safe and healthy relationships reduces IPV (long lasting impact) Strong evidence from HICs, pilot study in Haiti by Gage&Honoré SAFE Dates curriculum taught in 2018 to 14 yr olds 8% population coverage, not all 14yr olds are in school, opt-in programme (31% uptake) treatment of 18,800 students Benefit: four year effect of 56% reduction in deaths and YLDs, then decays geometrically until 2050 Cost: HGT 17.9million, training of 157 teachers, each teaches 4 groups, training 3 days, delivery 5 days, printing materials, support from US experts 0.1< BCR < 3.3
  12. 12. Concluding Comments  DV is a serious problem in Haiti, estimation: 273,200 women suffer severe IPV, 10 % of all 14-49 year old women  Considerable health costs (death, injury, self-harm, depression, pregnancy)  Intergenerational perpetuation of violence& violence against children may be considerable but have not been considered here  Only male on female violence, but there may also be female on male violence, in particular amongst adolescents – under researched area  Violence against women is a human rights, public health and development challenge  Not sufficient to change legislation but attitudes have to change: recognise IPV as a problem that is large in scale with considerable (health) costs but treatment and prevention options exist  BCR for teenage dating violence intervention low due to high cost of delivery and low population coverage

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