No abstract

No abstract

OBJECTIVE:To analyze the results from the "WHO Multi-country Study on Women's Health and Domestic Violence", on the prevalence of intimate partner violence against women found in Brazil. METHODS:This cross-sectional study was part of the "WHO Multi-country Study on Women's Health and Domestic Violence against women", which was carried out in ten countries between 2000 and 2003. All the countries used a standardized structured questionnaire, devised for this study. In order to obtain data from contrasting settings within each country, the biggest city and a rural region were investigated whenever feasible. A representative sample of women aged 15 to 49 years was selected from the city of São Paulo and 15 municipalities in a rural region of the northeast, the Zona da Mata de Pernambuco. The study included 940 women from São Paulo and 1,188 from Zona da Mata de Pernambuco who had had an intimate partner at some time in their lives. Violence was classifi ed as psychological, physical and sexual types, and was analyzed in relation to overlapping, recurrence of episodes, severity and when it occurred. RESULTS:The women in São Paulo and Pernambuco respectively reported the following at least once in their lifetimes: psychological (N=383; 41.8% and N=580; 48.9%); physical (N=266; 27.2% and N=401; 33.7%); sexual (N=95; 10.1% and N=170; 14.3%) violence. There was signifi cant overlapping among the types of violence, which seemed to be associated with the most severe types of violence. The greatest single type was psychological violence, in São Paulo and Pernambuco (N=164; 17.5% and N=206; 17.3%), and the smallest was sexual violence (N=2; 0.2% and N=12; 1.0%). CONCLUSIONS:The results show that violence is a very common phenomenon. The fi ndings reiterate previous international studies results with regard to high magnitude and overlapping of types of intimate partner violence.KEY WORDS: Battered women. Violence against women. Spouse abuse. Domestic violence. Cross-sectional studies.

O presente artigo discute a violência institucional em maternidades sob a ótica de profissionais de saúde, com base nos dados de uma pesquisa sobre o tema na cidade de São Paulo, Brasil. Para tanto, foram entrevistados 18 profissionais de saúde atuantes nas redes pública e privada, dentre médicos obstetras, enfermeiras e técnicas em enfermagem. Foi utilizado um roteiro semiestruturado com questões sobre a experiência profissional e o conceito de violência. A análise revelou o reconhecimento desses profissionais de práticas discriminatórias e desrespeitosas no cotidiano da assistência a mulheres gestantes, parturientes e puérperas. São exemplos citados dessas práticas o uso de jargões pejorativos como forma de humor, ameaças, reprimendas e negligência no manejo da dor. Essas práticas não são geralmente percebidas pelos profissionais como violentas, mas sim como um exercício de autoridade em um contexto considerado "difícil". Tal contexto revela a banalização da violência institucional que travestida de boa prática, porque seria para o bem da paciente, acaba invisibilizada no cotidiano da assistência.

No abstract

OBJECTIVE:To estimate the prevalence of physical and/or sexual violence by intimate partners and factors associated with this, in different sociocultural contexts. METHODS:This cross-sectional study was part of the "WHO Multi-country Study on Women's Health and Domestic Violence against Women". It consisted of representative samples of women from the municipality of São Paulo (Southeastern Brazil) and from the Zona da Mata of Pernambuco (Northeastern Brazil), this latter is a region with more traditional gender norms. Interviews were conducted in the homes of 940 women in São Paulo and 1,188 in the Zona da Mata, in the years 2000-1. The women were aged 15 to 49 years and had all had at least one intimate partnership with a man during their lifetimes. Three sets of factors were constructed, corresponding to hierarchically organized categories: sociodemographic, family and female autonomy/submission characteristics. Hierarchical logistic regression was used to analyze factors associated with intimate partner violence at each location. RESULTS:A prevalence of 28.9% was found in Sao Paulo (95% CI 26.0;31.8) and 36.9% (95% CI 34.1;39.6) in Zona da Mata. Up to eight years of schooling, conjugal physical violence between the women's parents, sexual abuse during childhood, fi ve or more pregnancies and drinking problems were associated with intimate partner violence at both locations. Financial autonomy for the woman, informal partnership, age and consent to the fi rst sexual intercourse were associated with higher rates only in Zona da Mata. The socioeconomic characteristics that presented associations in the fi rst category were mediated by other factors in the fi nal model. CONCLUSIONS:The fi ndings show the relativization of socioeconomic factors in relation to other factors, particularly those representing gender attributes. Sociocultural differences were found between the two locations, and these were refl ected in the associated factors.

Violence against women attending public health services in the metropolitan area of São Paulo, Brazil ABSTRACT OBJECTIVE: To estimate the prevalence of (physical, psychological, and sexual) violence against women by an intimate partner and non-partner perpetrators among users of public health services and to compare these women's perception of having ever experienced violence with reports of violence in their medical records in the different services studied. METHODS:The study was conducted in 19 health services, selected as a convenience sample and grouped into nine research sites, in metropolitan area of São Paulo from 2001 to 2002. Questionnaires on having ever experienced violence in their lifetime and in the last 12 months and perpetrators were applied to a sample of 3,193 users aged 15 to 49. A total of 3,051 medical records were reviewed to verify the notifi cation of violence. Comparative analyses were performed by Anova with multiple comparisons and Chi-square test followed by its partition. RESULTS:The following prevalences were found: any type of violence 76% (95% CI: 74.2;77.8); psychological 68.9% (95% CI: 66.4;71.4); physical 49.6% (95% CI: 47.7;51.4); physical and/or sexual 54.8% (95% CI: 53.1;56.6), and sexual 26% (95% CI: 24.4;28.0). The prevalence of physical and/or sexual violence by an intimate partner in their lifetime was 45.3% (95% CI: 43.5;47.1), and by non-partners was 25.7% (95% CI: 25.0;26.5). Only 39.1% of women reporting any episode of violence perceived they had ever experienced violence in their lifetime and 3.8% of them had any reports of violence in their medical records. The prevalences were signifi cantly different between sites as well as the proportion of perception and reports of violence in medical records. CONCLUSIONS:The expected high magnitude of the event and its invisibility was confi rmed by low rate of reports in the medical records. Few perceived abuses as violence. Further studies are recommended taking into account the diversity of service users.

This essay deals with the theme of violence from the standpoint of violence against women. It discusses the historical precedence of taking violence against women as a Legal issue and as an object of Justice, outlining parallels with the emergence of the problem as a Healthcare issue, as well as one of the targets of the Public Health area and of medical and sanitation practices.