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Qualitative methods
Find four articles that use qualitative field research methods (you must have one that uses grounded theory, one using case study, one using ethnography, and one using participatory action research) and critique them according to the following criteria:
a. Research question: Is it clearly stated? Is the need for this type of method appropriate? If yes, why? If not, why not and what would you recommend?
b. What was the role of the researcher? Was this clear throughout the article?
c. What can you say about the relationships between the researcher and the participants?
d. What paradigm underlies this research?
e. Briefly discuss the data collection procedures used. What specific aspects were considered regarding participants and their environment? Can you think of any that were not mentioned?
f. How was the data analyzed? Was the process clearly presented? Are there any other aspects you would include?
g. Was there a clear link between data, interpretation, and conclusions?
h. What ethical issues were considered? What are your thoughts? Can you think of other potential ethical issues that were not addressed?
i. What are the strengths and weaknesses of this research? What limitations do the researchers discuss? Can you think of any others?
j. What can you notice regarding the language used? How different is it from a quantitative study? What terms are used when referring to reliability and validity? Are these aspects discussed? What are your thoughts on how the researchers in the articles approach them?
You are encouraged, but not required, to use articles related to your topic of interest. Each article critique should be approximately one page long.
For personal use. Only reproduce with permission from The Lancet Publishing Group.
In the past few years, WHO, the American Medical
Association, International Federation of Obstetricians and
Gynaecologists, Royal College of Nursing, and other
professional medical organisations have made statements
about the public-health importance of violence against
women.
1
Several organisations have developed guidelines
on how health workers can better identify, support, and
refer victims of violence. These actions result from a
growing recognition that violence represents a serious
violation of women’s human rights, is an important cause
of injury, and is a risk factor for many physical and
psychological health problems. Understanding gender-
based violence and the appropriate case management of
women with a current or previous history of violence are
now recognised as core competencies for health workers.
In the next six editions of
The Lancet,
different authors will
discuss current challenges and debates on violence against
women and public health. As an introduction, we present
an overview of the different forms of violence against
women to convey an idea of its global magnitude, and
discuss characteristics that distinguish violence against
women from other forms of violence.
Distinguishing violence against women from
other forms of violence
The UN Declaration on the Elimination of Violence
Against Women defines violence against women as:
. . . any act of gender-based violence that results in, or is
likely to result in, physical, sexual or psychological harm or
suffering to women.
2
Although broad in its scope, this statement defines
violence as acts that cause or have the potential to cause
harm, and emphasises that these acts are rooted in sex
inequality. This focus on women does not deny the fact
that men experience violence. Indeed, war, ethnic
cleansing, and gang and street violence are significant
causes of male morbidity and mortality.
3,4
However, as
violence against men often differs in its aetiology and
response strategies, it warrants separate consideration.
Lancet
2002;
359:
1232
–
37
See Commentary page 1172
Health Policy Unit, Department of Public Health and Policy, London
School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
(C Watts
PhD
, C Zimmerman
MSc
)
Correspondence to:
Charlotte Watts
(e-mail: [email protected])
In practice, the term violence against women
encompasses an array of abuses targeted at women and
girls (figure 1), ranging from sex-selective abortion to the
abuse of elder women. The term includes geographically
or culturally specific forms of abuse such as female genital
mutilation, dowry deaths, acid throwing, and honour
killings (the murder of women who have allegedly brought
shame to their family), as well as forms of violence that are
prevalent worldwide such as domestic violence and rape.
There are many potential perpetrators, including spouses
and partners, parents, other family members, neighbours,
teachers, employers, policemen, soldiers, and other state
employees.
Violence against women is not only a manifestation of
sex inequality, but also serves to maintain this unequal
balance of power. In some cases, perpetrators consciously
use violence as a mechanism for subordination. For
example, violence by intimate partners is often used to
demonstrate and enforce a man’s position as head of the
household or relationship. For other forms of violence, the
subordination of women might not be the explicit
motivation of the perpetrator, but is nevertheless a
consequence of his actions. For example, a man who rapes
a woman whom he judges to be sexually provocative might
justify his act as being an appropriate punishment for her
transgression of socially determined rules of female
behaviour. Women themselves frequently do not challenge
accepted norms of female behaviour because of the fear of
being attacked or raped. Thus, women’s unequal status
helps to create their vulnerability to violence, which in turn
fuels the violence perpetrated against them.
Global research on violence against women
Over the past 20 years, the evidence of the extent of
violence perpetrated against women has increased and is
beginning to offer a global overview of the magnitude of
this abuse (figure 2). We will now discuss the magnitude of
some of the most common and most severe forms of
violence against women. When reviewing the findings it is
important to note that because of the sensitivity of the
subject, violence against women is almost universally
under-reported.
5–7
Thus, these findings might be more
accurately thought of as representing the minimum levels
of violence that occur.
Although there are many different forms of violence
against women, they nonetheless often share certain
characteristics. For example, most forms of violence,
Violence against women: global scope and magnitude
Charlotte Watts, Cathy Zimmerman
Violence against women I
1232
THE LANCET • Vol 359 • April 6, 2002 • www.thelancet.com
VIOLENCE AGAINST WOMEN I
An increasing amount of research is beginning to offer a global overview of the extent of violence against women. In this
paper we discuss the magnitude of some of the most common and most severe forms of violence against women:
intimate partner violence; sexual abuse by non-intimate partners; trafficking, forced prostitution, exploitation of labour,
and debt bondage of women and girls; physical and sexual violence against prostitutes; sex selective abortion, female
infanticide, and the deliberate neglect of girls; and rape in war. There are many potential perpetrators, including
spouses and partners, parents, other family members, neighbours, and men in positions of power or influence. Most
forms of violence are not unique incidents but are ongoing, and can even continue for decades. Because of the
sensitivity of the subject, violence is almost universally under-reported. Nevertheless, the prevalence of such violence
suggests that globally, millions of women are experiencing violence or living with its consequences.
For personal use. Only reproduce with permission from The Lancet Publishing Group.
including intimate partner violence, child sexual abuse,
and much non-partner sexual abuse do not occur as
unique incidents, but are ongoing over time, even over
decades. Often, the woman not only knows the
perpetrator before the first incident, but might live with
or interact regularly with him. Also particular to most
forms of violence against women is the way in which
society attributes blame to female victims. Women
experiencing intimate partner violence, for example, are
frequently accused of having provoked the violence by
their disobedience, failure as a wife, or infidelity. Girls or
women who have been sexually assaulted or raped are
frequently said to have “asked for it” by the way they were
dressed or behaved—even when the victim is a child.
Intimate partner violence
One of the most common forms of violence against
women is that perpetrated by a husband or other intimate
male partner. Intimate partner violence—often termed
domestic violence—takes various forms, including
physical violence ranging from slaps, punches, and kicks
to assaults with a weapon and homicide
(figure 3); and sexual violence takes forms such as forced
sex, or forced participation in degrading sexual acts.
These are frequently accompanied by emotionally abusive
behaviours such as prohibiting a woman from seeing her
family and friends, ongoing belittlement or humiliation,
or intimidation; economic restrictions such as preventing
a woman from working, or confiscating her earnings; and
other controlling behaviours.
The most accurate data on the prevalence of intimate
partner violence comes from cross-sectional population
surveys. Over the past 16 years, more than 50
population-based surveys on violence by intimate
partners have been done in various parts of the world. In
these studies, women are asked directly about their
experiences of specific acts of violence—eg, “has a
current or former partner ever hit you with his fist or
with something else that could hurt you?”.
8
The findings
of these surveys indicate that between 10% and 50% of
women who have ever had partners have been hit or
otherwise physically assaulted by an intimate male
partner at some point in their lives. In a review of
surveys, between 3% and 52% of women reported
physical violence in the previous year.
9
Research also suggests that many women are sexually
assaulted by their partners. For example, in a cross-
sectional household survey in one province in
Zimbabwe, 26% of women who had ever been married
reported being forced to have sex when they did not
want to, with 20% reporting that this occurred in the
year before the survey. When asked about the type of
force used, 23% reported physical force, 20% reported
that their partner shouted, 12% reported being forced
while they were asleep, and 6% reported the use of
threats.
10
Findings on the prevalence of physical and sexual
violence by intimate partners varies greatly between
studies. This variation can be attributed not only to the
differences in the levels of violence between settings, but
VIOLENCE AGAINST WOMEN I
THE LANCET • Vol 359 • April 6, 2002 • www.thelancet.com
1233
Perpetrators
Forced prostitution, trafficking for sex
Acid throwing
Abuse of widows/elder abuse
Differential access to food/medical care
Psychological abuse by family members
Coerced sex/rape/harassment (including child sexual abuse) by family members
Physical violence by family members
FGM
Female infanticide
Sex-selective abortion
Violence in pregnancy
Non-partner coerced sex/rape/harassment (including child sexual abuse)
Violence organised or perpetrated by states (eg, rape in war)
Differential access to food/medical care
Violence in pregnancy
Psychological abuse by intimate partner
Physical violence (by current or former partner)
Sexual violence (by current or former partner)
Dowry deaths/honour killings
Family members
Intimate partner Others
Reproductive age
Pre-birth Infancy Girlhood/adolescence
Age span
Elderly
Figure 1:
Violence and abuse against women over time
FGM=female genital mutilation.
