Thesis (PhD (Social Work))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Domestic violence crosses all boundaries and is regarded as a universal challenge affecting women of all spheres of life. Domestic violence is seen as a serious social problem in South Africa. It is regarded by many researchers as a leading cause of female injury. Domestic violence can be described as an act by a member of a family against another member with intent to do physical injury, psychological or emotional harm, or an assault or a threat that reasonably places that member in fear of imminent physical injury or emotional harm. It has major consequences, not only for the abused woman, but also for her children and society at large. Many low-income women cannot escape their abusive circumstances due to a lack of resources. Despite the fact that they cannot leave their situation, many women display certain strengths, helping them to deal with their difficult situation. These women can be viewed as heroic, assertive and persistent. They are not victims, but active survivors. The social work profession could benefit from greater insight into the strengths and coping mechanisms of low-income female survivors of domestic violence. The goal of the study is to gain an understanding of low-income female survivors’ experience of domestic violence, focusing on their environmental resources (including family, friends and community) and on their coping mechanisms (inner resources/strengths). To achieve this goal, the objectives are: to present a theoretical overview of the nature and extent of domestic violence; to describe the environmental resources (such as family, friends and community) of low-income abused women from the ecological perspective; to explore the coping mechanisms (inner resources) of these women in terms of the principles of the strengths perspective; and to analyse and interpret the data obtained from the study. The research utilises an exploratory and descriptive design. The research question is, “What are the experience (environmental resources) and coping mechanisms (inner resources) of lowincome female survivors of domestic violence?” This question was addressed by means of qualitative research. Twenty participants took part in the study. Purposive and snowball sampling were used to select the participants. They were interviewed by the researcher, and the data obtained from the interviews were organised into themes. Five themes namely, the experience of domestic violence, low-income, resources, coping mechanisms and statutory intervention were identified. These themes were further divided into sub-themes and categories. Conclusions derived from the data included: domestic violence is a phenomenon that cuts across all racial, marital status or age boundaries; some low-income female survivors of domestic violence experience their situation as stressful; low-income is one of the determining factors preventing some abused women to leave their situation; resources play a significant part in the lives of some low-income abused women; certain strengths from some low-income battered women help them cope; and some abused low-income women do not find an Interim Protection Order (IPO) or the police to be helpful. The recommendations are that social workers should assess primary, secondary and tertiary intervention in dealing with domestic violence; the ecological and strengths perspectives combined would be helpful in assessing resources and coping mechanisms in low-income abused women and collaboration between social workers, the court and the police could help low-income abused women to use statutory services effectively. / AFRIKAANSE OPSOMMING: Gesinsgeweld ken geen grense nie en word beskou as ’n universele bedreiging vir vroue uit alle sektore van die samelewing. Gesinsgeweld word beskou as ’n ernstige maatskaplike probleem in Suid-Afrika. Dit word deur baie navorsers beskou as ’n hoofoorsaak van vrouebeserings. Gesinsgeweld kan beskou word as ’n daad deur een lid van die gesin teen ’n ander wat gemik is op fisieke skade, sielkundige of emosionele teistering, of ’n aanval of ’n dreigement wat die lid van die gesin laat vrees vir fisieke beserings of emosionele skade. Dit het grootskaalse gevolge, nie net vir die mishandelde vrou nie, maar ook vir haar kinders en vir die breër gemeenskap. Baie lae-inkomste vroue kan nie uit hulle gewelddadige situasie ontsnap nie, vanweë beperkte bronne. Nieteenstaande die feit dat baie vroue nie hul huidige omstandighede kan ontkom nie, toon hulle sekere sterktes wat hulle help in hulle moeilike omstandighede. Hierdie vroue kan beskou word as heldinne wat nie tou opgooi nie. Hulle is nie slagoffers nie, maar oorleef aktief [Engels: “active survivors”]. Die maatskaplikewerkprofessie kan baat by groter insig in die sterktes en hanteringsvaardighede van lae-inkomste vroue wat gesinsgeweld oorleef. Die doel van die studie is om groter insig te verkry in lae-inkomste vroue se ervaring van gesinsgeweld, veral hulle omgewingsfaktore (insluitende familie, vriende en gemeenskap) en van hulle hanteringsmeganismes (innerlike bronne/sterktes). Om hierdie doel te bereik, is die doelwitte: om ’n teoretiese aanbieding van die aard en omvang van gesinsgeweld te gee; om die omgewingsbronne (soos familie, vriende en gemeenskap) van lae-inkomste mishandelde vroue te verduidelik; om die hanteringsmeganismes (innerlike bronne) van hierdie vroue te eksploreer in terme van die beginsels van die sterkte perspektief; en om die data van die studie te analiseer en te interpreteer. Die navorsingsontwerp is eksploratief-beskrywend van aard. Die navorsingsvraag lui soos volg: “Wat is die ervaring (omgewingsfaktore) en hanteringsmeganismes (innerlike bronne) van lae-inkomste vroue wat gesinsgeweld te bowe kom?” Die vraag is aangespreek deur middel van kwalitatiewe navorsing. Twintig deelnemers het deelgeneem aan die studie. Doelgerigte- en sneeubal steekproeftegnieke is gebruik om die deelnemers te verkry. Die navorser het met hulle onderhoude gevoer en die data wat verkry is, is georganiseer in temas. Vyf temas, naamlik die ervaring van gesinsgeweld; lae inkomste; bronne; hanteringsmeganismes; en statutêre intervensie is geïdentifiseer. Die temas is in subtemas en kategorieë onderverdeel. Gevolgtrekkings wat gemaak is uit die data is: gesinsgeweld is ’n verskynsel wat alle ras-, huwelikstatus- of ouderdomsgrense oorskry; sekere lae-inkomste vroulike oorwinnaars van gesinsgeweld ervaar hulle situasie as stresvol; hulpbronne speel ’n betekenisvolle rol in die lewens van sommige lae-inkomste mishandelde vroue; sekere sterktes van lae-inkomste mishandelde vroue help hulle om die situasie te hanteer; en sekere lae-inkomste, mishandelde vroue vind nie ’n Interim Beskermingsbevel (IB) of die polisie as hulpvaardig nie. Die aanbevelings is dat maatskaplike werkers primêre, sekondêre en tersiêre intervensie behoort te assesseer by gesinsgeweld; die ekologiese en sterktes perspektiewe behoort saam aangewend te word om die omgewingsbronne en hanteringsmeganismes van lae-inkomste mishandelde vroue te ondersoek; en samewerking tussen maatskaplike werkers, die hof en polisie kan lae-inkomste mishandelde vroue help om statutêre dienste beter te benut.

<p>The aim of this thesis was to explore the impact of physical, sexual and emotional violence against women of reproductive age and the level of controlling behaviour in marriage on child health and survival in two different cultural settings: Bangladesh and Nicaragua. </p><p>Data were acquired from four quantitative community-based studies. In two studies, a cohort including a prospective two year follow-up of 3164 mother-infant pairs in rural Bangladesh was investigated. A third study was a case-referent study in Nicaragua including mothers of 110 cases of under-five deaths and 203 referents, and in a forth study an other cohort of 1048 rural Bangladeshi women and their 2691 children was followed until 5 years of age. </p><p>Maternal exposure to any form of violence, including physical, sexual, emotional, and controlling behaviour was independently associated with lower body size at birth, increased risk of stunting and under-weight at 24 months of age, slower growth velocity during the first two years of life and a higher incidence of diarrhoeal episodes and respiratory tract infections. In the Nicaraguan setting, the children of women who experienced any history of physical violence had a two-fold increase in risk of death before the age of 5 years, and those whose mothers experienced both physical and sexual violence had a six-fold increase in risk of death. In Bangladesh, an association between violence against women and under-five mortality was found among daughters of educated mothers who were exposed to severe physical violence or a high level of controlling behaviour in marriage. In all four studies, lifetime violence experience among participating mothers was high (37-69%), and the timing was less relevant than the exposure to violence <i>per se</i>. </p><p>In conclusion, this investigation revealed that violence against women severely affects child health and survival. The findings are especially relevant in a context of high level of child under-nutrition, morbidity and under-five mortality. Efforts for protecting women from all forms of violence are needed as part of the interventions for improved child health.</p>

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Syftet med undersökningen var att utifrån beskrivningar från professionella socialarbetare, som arbetat med kvinnor som varit utsatta för mäns partnervåld, analysera vilka konstruktioner dessa professionella socialarbetare hade av den här klientgruppens situation. Frågeställningen var vilka konstruktioner ett urval av professionella socialarbetare, som arbetat med kvinnor som varit utsatta för mäns partnervåld, hade. Frågeställningen var fokuserad på följande teman: kvinnans livsvärld, förhållandet till mannen, våldet i relationen och faktorer för att stanna kvar i- respektive faktorer för att lämna förhållandet. Metoden var semistrukturerade kvalitativa intervjuer. Fem professionella socialarbetare från olika kvinnojourer och socialtjänster intervjuades. Resultaten analyserades utifrån ett socialkonstruktionistiskt perspektiv samt med stöd från tidigare forskning. Undersökningens viktigaste resultat och slutsats var att de professionella socialarbetarnas konstruktion av den misshandlade kvinnans situation var att hela kvinnans livsvärld påverkades negativt av mannens misshandel. Kvinnan var ambivalent i sitt förhållningssätt till mannen och hon levde hela tiden på hoppet om att mannen skulle förändra sig. Kvinnan upplevde inte våldet som något normalt och hon gjorde alltid på något sätt motstånd mot våldet. / The aim of this study was to analyze the social constructions social workers formed as result of working with women who had been victims of male partner violence. The social constructions analyzed came from the social workers descriptions of the client group’s situation. The question addressed was what social constructions a selection of social workers had that had worked with women who experienced violent abuse from men that they lived in a relationship with. The question was focused on the following themes: the women´s life conditions, the relationship to the man, the violence in the relationship, and what the factors affected whether the woman stayed or left the abusive relationship. The method used was semi-structured qualitative interviews. Five professional social workers from different shelters and social services institutions were interviewed. The interviews were analyzed from a social constructionist perspective with support from earlier research in the area. The most important finding from the study, and conclusion, was that the social constructions the professional social workers made from working with the abused woman was that the entire life situation of the abused women was negatively affected by the abuse from the man. The abused women were ambivalent in their approach to the abusive man, and they lived on the hope that the abusive man would change his abusive ways. The women did not experience the violence as something normal and they always resisted the violence in some way.

This thesis examined the conditions under which taharrush (sexual harassment) has become normalized in Cairo, allowing acts once deemed unethical by Egyptians to become a daily experience. Experiences of taharrush were explored through an ethnographic study of three neighborhoods in Cairo and 20 semi-structured interviews with women from diverse backgrounds and age groups. Through the literature review of key themes and a historical analysis of the Egyptian context, this research explored the rise in sexual harassment over time and under different presidential regimes. The cross-generational aspect of this research highlighted the prevalence of sexual harassment in the past three decades. Furthermore, through the participants’ voices, numerous themes emerged explaining the increase of taharrush, such as: economic difficulties, decline in akhle (sense of community), and violence against women perpetrated by security officials. The interviews showed women’s experiences of sexual harassment, the perceived causes behind the issue of harassment being trivialized and normalized, and ways in which women combat harassment and security issues within Cairo. / February 2016

Although women’s rights have been widely recognized in the international agenda, violence against women in the private sphere does not seem to decrease. Women are still suffering today from not enjoying the most basic human rights. States fail often to recognize domestic violence as a human rights violation because it is committed in the private sphere by non-states actors. Because of this the European Court of Human Rights decided to develop the due diligence standard in 2008 to combat violence against women. This thesis examines the European Convention on Human Rights law regarding domestic violence and the meaning of member states positive obligation and the concept of due diligence. The European Court has established that member states have several positive obligations to fulfill in order to address the issue of violence against women in the private sphere. However states fail too often to exercise the due diligence by not living up to the standards that has been established by the Court. It has been proven that the Convention articles are inconsistent. The Court needs too clarify exactly which measures states should take to address the issue of violence against women and send a clear message how much effort it takes to fill the scope of the due diligence standard. This inconsistency allows states to take stand in the law enforcements, which are contemplated to be dominated by male norms. The consequence of this is that women are usually disadvantaged in state law enforcement when it comes to violence in the private sphere. It is therefor of great importance to pay attention to women’s rights when it comes to domestic violence, as well as analyzing states approach in the domestic violence cases. The purpose of this thesis is to analyze domestic violence as men’s violence against women from a critical gender perspective by highlighting elements that effects states actions in the cases. The point of departure is to recognize similar behavior in states actions by focusing on the concept male norm and private and public sphere. The results revealed a clear pattern of the concepts. In each case signs of male norms expressed in a male position, where men are superior to women were shown. States divisions of the private and public spheres were also proven in the cases. States would prefer not to intervene when a woman was exposed to violence in the private sphere. This leads to women being suppressed and unable to reach legal protection in the private sphere.

Objectifs: Cette étude a documenté la collaboration intersectorielle entre les agents de santé communautaires (ASC) et les enseignants visant à combattre la violence à l’égard des femmes et des filles à Vulindlela, une communauté rurale Sud-Africaine. La collaboration entre ces acteurs, les facteurs qui influencent leur collaboration et les avenues possibles pour une amélioration de cette collaboration ont été explorés. Méthodes: Six ASC et cinq enseignants ont pris part à cette recherche participative qui a inclut l'utilisation du dessin comme méthodologie visuelle. La collecte de données a été réalisée en quatre phases, avec un total de huit entretiens de groupes. La stratégie d’analyse principale a inclus une approche dirigée du contenu narratif et une approche de comparaison constante. Résultats: Le système de collaboration entre les enseignants et les ASC manque de définition et ces acteurs ne peuvent donc en faire l’utilisation. Par conséquent la collaboration actuelle entre ces acteurs a été jugée peu développé, impromptue et informelle. De nombreuses contraintes à la collaboration ont été identifiées, y compris le manque de motivation de la part des enseignants, la nature des relations entre les acteurs, et la capacité individuelle limitée des ASC. Conclusion: Compte tenu des nombreuses contraintes à la collaboration entre ces ASC et les enseignants, il n'est pas évident que cette collaboration conduira aux résultats espérés. Dans l'absence de motivation suffisante et d’une prise de conscience réaliste des défis par les acteurs eux-mêmes, les initiatives externes pour améliorer la collaboration sont peu susceptibles de succès. / Objectives: This study had for objective to document intersectoral collaboration (ISC) between community health workers (CHWs) and teachers aimed at addressing violence against women and girls (VAW/G) in Vulindlela, a rural South African community. The current collaborative paths bringing CHWs and teachers together, the factors that influence their collaboration and potential avenues for future improvement of this collaborative were explored. Methods: A total of six CHWs and five teachers took part in this participatory research which included the use of drawing as a visual methodology. Data collection was divided into four phases and included a total of eight group interviews. The analysis of group interviews utilized a directed approach to narrative data analysis, and a constant comparative approach was used in the analysis of the participants` drawings. Results: There are no well-defined collaborative systems that CHWs and teachers are able to make use of. Consequently teacher-CHW collaboration was found to be poorly developed, unplanned and informal. Numerous barriers were identified as impeding collaboration including the teachers’ lack of motivation to collaborate, the nature of the relationships between these groups of actors and the CHWs’ overall lack of individual capacity. Conclusion: Given the numerous challenges facing collaboration between these CHWs and teacher, it is not clear that such collaboration would necessarily lead to effective outcomes. In the absence of sufficient motivation and a realistic awareness of the challenges from the actors themselves, external initiatives to foster collaboration are unlikely to be successful.

Syftet med följande studie var att undersöka yrkesverksammas upplevelser av möjliga riskfaktorer till mäns våld mot kvinnor i relation till den socio-ekologiska modellen. En kvalitativ intervjustudie genomfördes och fem yrkesverksamma från relevanta organisationer deltog. Teman som identifierades i studien jämfördes med de olika nivåerna från den socio-ekologiska modellen och med tidigare forskning på området. I studien kunde tre av de fyra nivåerna från den socio-ekologiska modellen återfinnas som självständiga teman och den fjärde nivån återfanns som en underliggande faktor i samtliga teman. Resultatet visade även att de yrkesverksamma upplever att det finns personlighetsdrag som karaktäriserar män som utövar våld mot kvinnor men att männen ändå skiljer sig från varandra. Mäns våld mot kvinnor finns i alla samhällsklasser och miljöer vilket gör det svårt att identifiera vilka män som har denna typ av problematik. För att våldet ska minska krävs tidigt förebyggande arbete samt krafttag i hela samhället kring de rådande maskulinitetsnormerna. Vidare behövs mer forskning på hur de män som inte lagförs eller frivilligt söker behandling kan upptäckas samt motiveras till behandling för sin problematik. / The purpose of following study was to examine professional’s experiences of potential risk factors to men's violence against women in relation to the socio ecological model. A qualitative interview study was conducted and five professionals from different organizations participated. Themes identified in the study were compared with different levels from the socio-economic model and with previous research in the field. In the present study, three out of four levels from the socio-ecological model were found as independent themes and the fourth level was found as an underlying factor in all themes. The results also showed that the professionals found personality traits that characterize men who use violence against women, but that the men still differ from each other. Men's violence against women exists in all social classes and environments, which makes it difficult to identify which men that have this type of problem. For the violence to decrease, early preventive work and effort are required throughout society and the current masculinity standards. More research is needed about how men who are not prosecuted or voluntarily seeking treatment can be discovered and motivated to treat their problems.

O presente trabalho tem por finalidade apresentar algumas contribuições da Medicina Legal para a compreensão da violência doméstica contra a mulher. Para tanto, o trabalho parte de uma visão geral sobre a violência como fenômeno social para se chegar à ideia de violência de gênero, na qual a violência doméstica contra a mulher se encontra inserida. Após, são apresentados alguns documentos internacionais sobre violência contra a mulher para se chegar ao processo de formação da Lei nº 11.340/06. As inovações da Lei nº 11.340/06 quanto ao crime de lesão corporal são apresentadas a seguir, culminando com a apresentação de tópicos de relevância médico-legal pertinentes à questão da violência doméstica contra a mulher. / The present work aims to present some contributions of Forensic Medicine to understanding domestic violence against women. To this end, the work presents an overview of violence as a social phenomenon to arrive at the idea of gender violence, in which domestic violence against women is inserted. In the following, some international documents on violence against women are presented to reach at Lei nº 11.340/06s formation process. The innovations of Lei nº 11.340/06 regarding the crime of personal physical injury are presented below, culminating with the presentation of relevant topics pertaining to the medical-legal issue of domestic violence against women.

Estudo de abordagem qualitativa que teve como objetivos conhecer e analisar a percepção dos profissionais de saúde e dos usuários do SUS, sobre a violência de gênero e a compreensão da notificação compulsória de violência contra a mulher no conjunto das ações de enfrentamento, a fim de elencar subsídios para elaboração de um projeto conjunto de intervenção na realidade. O estudo foi realizado com profissionais de saúde representantes das doze unidades da Estratégia de Saúde da Família do Distrito do Capão Redondo, profissionais da Coordenadoria Regional de Saúde Sul e usuários do SUS da mesma região. Os dados foram coletados durante a realização de três sessões de uma Oficina de Trabalho em que os discursos grupais foram gravados, transcritos e submetidos à análise de conteúdo. Os resultados foram analisados segundo as categorias analíticas de gênero e violência de gênero. Os resultados mostram que os grupos possuem uma visão conservadora acerca da construção da masculinidade e feminilidade, evidente pela confirmação de papéis idealizados para o homem e para a mulher, revelando estereótipos próprios do senso comum: homem - provedor e mulher - cuidadora. O grupo reconhece a violência de gênero como violação dos direitos humanos e a interface que ela possui com a saúde. As dificuldades de enfrentamento encontram-se no despreparo dos profissionais de saúde quanto ao reconhecimento e atendimento às mulheres em situação de violência. Associado a isso, está o desconhecimento dos caminhos utilizados para o enfrentamento do problema. Quanto à notificação compulsória da violência, constatou-se que reconhecem a inexistência da utilização do serviço, a despeito da sua importância para conferir visibilidade aos casos de violência. Consideram importante a elaboração de políticas públicas a partir da realidade constatada. No entanto, não diferenciam a notificação compulsória da denúncia por meio de Boletim de Ocorrência. O desconhecimento de todo o processo que envolve a notificação de violência gera desconforto e medo tanto nos profissionais quanto nos usuários. As propostas de intervenção discutidas pelo grupo incluem a capacitação dos profissionais de saúde para o atendimento e a realização da notificação, associada à definição de fluxos e à construção de uma rede de atenção às mulheres em situação de violência. / Qualitative approach study with the objective of knowing and analyzing the perceptions of health professionals and SUS users about violence of gender and their understanding of the mandatory report of violence against women in the set of actions for facing the problem, in order to recruit subsidy for the elaboration of a combined project of intervention in that reality. The study was performed with health professionals representing the twelve units of Family Health Strategy of the District of Capao Redondo, professionals from the Southern Regional Health Coordination and SUS users from that same region. Data was collected during three sessions of a Workshop when the group discussions were recorded, transcribed and submitted for content analysis. The results were analyzed according to the analytical categories of gender and gender violence. The end results reveal that the groups possess a conservative vision about the construction of masculinity and femininity. This was evidenced by the confirmation of roles idealized for man and woman, which revealed common sense stereotypes: man provider and woman keeper. The group recognizes that violence of gender is a violation of human rights and that it interferes with health. Setbacks in facing the situation reside in the health professionals lack of preparation regarding the recognition and service to women in violence situations. Associated with that, is the lack of knowledge regarding the ways to face the problem. As for the mandatory report of violence, it was found that they recognize this service is not used, despite its importance to confer visibility to violence cases. They consider important the elaboration of public politics based on the reality found out. However, they do not differentiate the report [notification] and the accusation (Police Report). The lack of knowledge about the entire process involving the report of violence generates discomfort and fear both in professionals and users. The intervention proposals discussed by the group include enabling health professionals to serve and to use the report associated with the definition of flow and the development of an attention network to serve women in violence situations.