By Onesmus Kansiime
In the year 2020, the direct economic cost of violence against women in Uganda was and is still approximate to sh77.5b.
However, the total cost of this violence that includes the inferred incidents as a result of violence against women is countless stone-throws away from the sh77.5b.
To estimate the cost of violence against women on health would give a sadder picture on the real costs of violence against women.
The violence leads to physical injuries, mental health problems that may include depression and post-traumatic stress disorders, suicide etc.
Suicide is responsible for 18.67 in 100,000 deaths in Uganda. According to the World Health Organisation 2016, Global Health Repository Data, 9.1 in 100,000 women commit suicide in Uganda most of whom are victims of violence against women.
Research in the US has shown that battered women, compared to women not living with violent men are times more likely to commit suicide.
Other health consequences include behavioral disorders such as alcohol and drug addiction, self-harm, and risky sexual behaviors. To pregnant women, violence increases the risk of maternal mortality and morbidity because of a lack of support to access health care.
They are also likely to give birth to children who risk living in an inter-generational cycle of poverty.
This violence against women could be domestic violence, intimate partner violence, sexual violence, violence at the workplace. The 2016 Uganda Demographic and Health Survey revealed that up to 22% of women aged between 15 and 49 in Uganda had experienced at least one form of sexual violence in their lifetime. In the same report, 13% of women aged between 15 and 49 experience sexual violence each year.
All these put the lives of women affected by violence at risk of disease, death, and unfulfilled life.
One of the most common forms of violence against women is sexual violence that manifests in both intimate partner and non-partner sexual violence at home, work etc through sexual acts or attempts using coercion that includes physical force, psychological attacks among other forms of coercion.
The effects of sexual violence do not end with the physical force or the psychological intimidation used. Forced sex increases the risk of being infected with diseases that include HIV/AIDS especially when this forced vaginal penetration causes abrasions and cuts. There are very limited chances of having protected sex when it is forced or coerced.
Even though HIV/AIDS is also transmitted through consented sex, the psychological effects and mental health disorders caused to an individual who acquires HIV/AIDS or any other STD/I through forced sex are worse.
It is difficult to negotiate condom use when sex is forced even in intimate relationships because using a condom could be interpreted as mistrust and admission of promiscuity.
Different approaches can be taken to reduce incidences of violence against women especially sexual violence and the health consequences it is associated with:
Violence most times is continuously inflicted on ignorant people. Perhaps, education is the intervention needed through comprehensive interventions in institutions of learning, religious institutions, women and youth groups, and workplaces.
The initiative to make a relevant curriculum should also integrate age-specific sexual and reproductive health and violence prevention mechanisms and the ability to negotiate consented and safe sex.
Health care workers interact with victims of violence against women and victims of the health effects of this violence such as rape victims.
There is a need to retool health care workers on reproductive health to include violence against women such as sexual violence, screening victims of sexual violence to make referrals for integrated services such as counselling, equipping victims and community with violence prevention strategies, and Post Exposure Prophylaxis to prevent the spread of HIV/AIDS.
Understanding violence against women and the appropriate management should be core competencies of health care providers. By raising the competencies of health service providers to respond to such cases, we shall be strengthening the health system to respond to violence.
It is our duty, all of us, to work towards the attainment of SDG 5 target “The elimination of all forms of violence against women” not just because it is an SDG target but because we all deserve sustainable human development and good health.
The writer is a Global Health Corps Fellow