GENDER-based violence (GBV) is a global issue, disproportionately affecting women and girls, particularly during adolescence and in humanitarian crises. Alarmingly, one in three women globally will experience GBV in their lifetime, encompassing physical, sexual, mental or economic harm inflicted due to their gender. In such settings, the intersection of GBV and malnutrition becomes starkly evident, with higher rates of acute and chronic malnutrition observed among women, girls and their households.
In Pakistan, GBV remains alarmingly prevalent, with 28% of women aged 15-49 reporting experiences of physical violence. Among married women, 34% have faced spousal abuse in physical, sexual or emotional forms. Distressingly, 56% of women affected by physical or sexual violence neither seek help nor disclose their experiences. This silence is rooted in deep-seated socio-cultural norms, economic dependency, limited awareness and the inaccessibility or absence of critical support systems such as healthcare and psychosocial services.
GBV’s impacts extend beyond immediate harm, profoundly affecting maternal and child health. Research shows that women exposed to gender-based violence are more likely to have low-birth weight infants and are less likely to practice recommended breastfeeding. The exposure to GBV correlates with worsened growth outcomes in children, including acute malnutrition, wasting and underweight conditions, underlining the far-reaching consequences of GBV on nutrition and overall well-being.
GBV may negatively impact mothers’ mental health and psychosocial well-being, induce stress responses in both the mother and child, contribute to negative coping mechanisms that are detrimental to fetal and child growth, cause physical injury during pregnancy, and/or contribute to a household environment in which women have less control over key resources and less agency to make decisions regarding the care of their children.
In Pakistan, health professionals do not receive formal pre-service or in-service training on addressing social determinants of health or GBV, and as a result, many healthcare providers often do not perceive addressing this violence as part of their healthcare role. Many health care professionals consider cases of GBV as a medico-legal matter and generally avoid getting involved in them, instead limiting themselves to treating the physical injuries.
Health care providers such as doctors, nurses and lady health workers are respected in households and communities and are, therefore, well placed to detect, treat and document GBV cases. However, gaps exist in their understanding of the social and health outcomes of GBV. Healthcare professionals are also not in a position to refer cases to other support systems because there are a few trained psycho-social counsellors available within the health system and a referral system is not in place to enable the provision of such psycho-social assistance to victims.
A cornerstone of International Rescue Committee programming in Pakistan has been creating safe spaces for women and girls, distributing dignity kits and conducting safety assessments of the community. Longer term efforts to prevent GBV include promotion of women’s social and economic empowerment and community-based education initiatives to address the harmful social norms that perpetuate violence.
It is pertinent to note that civil society organizations (CSOs) play a pivotal role in combating GBV by driving community-based responses and advocating for systemic change. With the support of the European Union, the IRC in Pakistan has strengthened the capacities of 15 local CSOs across five districts in Sindh. These CSOs can serve as critical frontline actors in creating safer, more equitable environments for women and girls.
While integrated GBV and nutrition programming continues to be an evolving area of work, there are already some promising examples emerging from the field. Proactively integrating GBV prevention and response within nutrition programs presents a significant opportunity to improve outcomes for women and children. This approach involves creating safe spaces, providing psychosocial and healthcare services, and implementing long-term strategies such as women’s empowerment initiatives and community education to challenge harmful social norms. By addressing the nexus of GBV and malnutrition, we can foster healthier, more resilient communities while ensuring the safety and dignity of women and girls.
As the global campaign of 16 Days of Activism Against Gender-Based Violence, is commemorated from November 25 to December 10. This campaign underscores the urgency of collective action to address GBV’s pervasive impact, including its intersection with malnutrition. In Pakistan, this offers an opportunity to amplify awareness, strengthen community-based prevention efforts, and highlight the critical role of integrated approaches that address both GBV and its ripple effects on nutrition.
—The writer is a Country Director at International Rescue Committee in Pakistan.
