الفهرس 
Introduction and Aims of the studyOnly 14 pages are availabe for public view
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Abstract
WHO defines violence as “The intentional use of physical force or power against self or other individual or group that may cause injury, death or any kind of harm”. The term GBV arose as a result of the sub-categorization of violence according to the gender of the targeted person.
Gender-based violence was defined by the United Nations Declaration on the Elimination of Violence against women (1993) as ”Any act that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life”.
There are types of violence that can be classified through the characteristics of the committers such as: self-directed violence, interpersonal violence and collective violence but also according to the nature of the act itself such as: physical, sexual, psychological and deprivation.
This study was carried out to estimate the prevalence of gender based violence among women aged 18-45 years in Helwan, Cairo; to describe the characteristics of women experiencing gender based violence. Also, to assess knowledge and perspectives of women about gender based violence and to assess the help-seeking and health preserving practice(s) in response to gender based violence.
The study was completed in three phases: preparatory, operational and analytical phases. The preparatory phase included review of the literature, writing the study protocol, preparation of the study tool, administrative procedures and pre-test of the study tool.
In the operational phase, a cross-sectional community based survey was carried out in households of families in Helwan, Cairo. Cluster sampling technique was used, and sample size was calculated to be 650 women. A pre-designed structured interviewing questionnaire was used to collect the data from the studied women about their demographic information, knowledge, perspectives, prevalence and health-seeking behaviour regarding GBV.
During the analytical phase, the collected data were revised, coded and analysed using SPSS version 25. Several statistical measures were used such as: descriptive statistics (tests of normality for quantitative variables, count and percentage, arithmetic mean and standard deviation), and analytical statistics (non-parametric tests, logistic regression models).
The main findings of the study showed that:
• Exposure to psychological and physical violence from an intimate partner was reported by 49.1% and 37.3% of women, respectively, while exposure to sexual violence by an intimate partner was reported by only 6.4%. The most frequently reported type of psychological IPV was humiliation by 35.5%, while the most frequently reported type of physical IPV was pushing by 27.5%. Only 5.5% of women reported being forced into sexual intercourse by her intimate partner, while being physically or psychologically forced into an undesirable sexual act were reported by 2.1% of women each.
• Women who reported that they were recently exposed to acts of violence by a non-intimate male partner amounted to 9.7%, while 10.9% reported that they were previously exposed to acts of violence by a non-intimate male partner. Physical harassment occurred in 10% of cases and verbal harassment in 60% of cases.
• Regarding frequency of exposure to IPV, some forms such as humiliation, called names, threat to be harmed and pushing were most frequently repeated 2-5 times by her intimate partner during the previous 12 months by 46.2%, 34.3%, 35.1% and 35.9% respectively. Other forms such as slapping, thrown by objects, hit by the fist, grabbing by their arms and pulling from their hair most frequently took place only once during the past 12 months by 38.5%, 33.7%, 33.3%, 36% and 41.8% respectively. The highest frequency of exposure to verbal harassment was more than 10 times during the previous 12 months by 41.9%.
• Verbal harassment mostly took place in workplace (70.6%), while physical harassment mostly took place in public transportation (46%) and street (31.7%).
• Fathers and brothers were mentioned by women as current non-intimate perpetrators (54.7% and 51.7% respectively) and as previous perpetrator (47.8% and 26.9% respectively).
• Regarding the consequences of exposure to violence, most women (61.4%) mentioned suffering from cuts/bruises/pain. Only 15% of women stated that they suffered psychological consequences. Loss of consciousness and life threatening conditions such as haemorrhage were the least common (1.6% and 2.4% respectively).
• The highest percentage of women had fair knowledge about GBV (47.7%), while 34% had good knowledge and 18.3% had poor knowledge. The knowledge score ranged from 3-22 with a mean of 14.61±3.9 points and a median of 15 points.
• The mean knowledge score of ever- married women was nearly equal among those who were exposed and those who were not exposed to GBV, with no statistically significant difference.
• Most women (79.9%) had favourable perspective against GBV (did not accept GBV), 19.2% had moderate perspective, while only 0.9% had unfavourable (accepted) perspective towards GBV. The perspective score ranged from 5-63 with a mean score of 52.01±7.16 points and a median of 54 points.
• Women with favourable perspectives were 57% less likely to be from slum areas compared to women with unfavourable and fair perspectives (OR=0.436, CI=0.234-0.812). The second factor was level of education. Women with favourable perspectives were 65% less likely to be illiterate compared to women with unfavourable and fair perspectives (OR=0.353, CI= 0.210-0.592). The model correctly classified 79.8% of the cases.
• Women exposed to violence were 2.37 times more likely to be from slum areas compared to unexposed women. Regarding the level of perspective, women exposed to violence were 1.61 times more likely to have unfavourable or fair perspectives about GBV compared to unexposed women.
• Regarding the perceived possible causes of violence, personality was mentioned by most women (64%) to be a cause followed by lack of awareness about violence (56.1%) and discrimination (31.8%). Concerning the perceived causes of IPV, 45.6% of women believed that their partner’s personal temper was the cause and 39.7% mentioned the financial conflict between spouses.
• Two thirds (66.2%) of women exposed to IPV reported that they have never asked for healthcare upon exposure to violence. The most frequently reported reason for not seeking healthcare after exposure to violence were not feeling danger on themselves (41.4%), while reasons for seeking healthcare included inability to withstand violence (45.9%). The majority of women (60.5%) have the intention of seeking medical help if exposed to violence in the future.
• When asked about places where to get help, the majority of women (81.4%) were not familiar with the existence of organizations that provide services to victims of violence, and 68.5% were not familiar with the existence of a national hotline that they can call if exposed to violence.
Conclusion
• Gender based violence, whether perpetrated by an intimate male partner, a non-intimate male or public space harassment was highly prevalent in parts of the Egyptian community.
• The most prevalent type of intimate partner violence was psychological violence, particularly humiliation, calling names and threat to be harmed. Physical violence like pushing took place more frequently than other types of violence such as: slapping, thrown by objects, hit by the fist, grabbing by their arms and pulling from their hair.
• Fathers and brothers were almost equally mentioned by women as current non-intimate partner violence perpetrators.
• Verbal harassment was more prevalent than physical harassment and took place mostly in workplace, whereas, physical harassment took place mostly in public transportation.
• Most women had fair knowledge about violence and GBV but, the level of knowledge was not a predictor of exposure to violence.
• The majority of women had favourable perspectives against GBV.
• Women’s perspectives were mainly predicted by level of education and place of residence.
• Women’s perspectives together with residence were significant predictors of exposure to GBV.
• Most women thought that personality was the main cause of implication of violence. Most women who were exposed to violence, particularly, believed that their partner’s personal temper was the cause.
• Most of the time, women who suffered some kind of violence did not seek help. This was mainly attributed to feeling endangered if they sought help. However, women who had sought help did that because they had been unable to stand violence anymore.
• The majority of women had the intention of seeking medical help if exposed to violence in the future, although they were not familiar with the existence of organizations that provided services to victims of violence, or the national hotline that they could call if exposed to violence.
Recommendations
I) Recommendations related to decision making:
- To prioritize GBV during the assessment planning and strategic planning phases of related authorities e.g. Ministry of Health, Ministry of Social Solidarity, National councils.
- To make available any existing data on affected populations’ risks of and exposure to GBV for inclusion in response strategies.
- To ensure design and implementation of safe and ethical data collection, storage and sharing.
- To prioritize GBV during resource mobilization, and ensure that different cluster/sector programming policies and plans integrate GBV concerns and include strategies for on-going budgeting of GBV-related activities.
- To ensure that national policies and strategies guide good practice on GBV prevention, mitigation and response.
- To regularly monitor reports on actions and results taken to prevent and mitigate GBV as part of the response and use this data in all regular reporting on implementation of national policies, plans and strategies.
- To ensure involvement of all stakeholders (both governmental and NGO sector) and members of the affected communities. This includes leadership, authorities, women and girls alongside with men and boys in the preparation, design, implementation and evaluation of intervention programs addressing GBV.
- To mainstream GBV specific health services and counselling for abused women into the existing health services.
II) Recommendations related to transformation of social norms:
- To start the transformation of social norms with young aged girls and boys by including curricula about definition of gender roles, comprehensive sexual education and girl empowerment in educational systems.
- To shift the view of women exposed to violence from victims to survivors. This is to acknowledge their strength and coping skills in response to GBV. It can be done through designing educational groups that promote understanding of the social and material conditions that foster GBV.
- To involve men and boys in the programming of GBV preparation and response through group education; campaigns, such as social marketing, and community mobilization; health and human services.
- To address GBV through interventions that focus on rebuilding family and community structures and support systems.
- To raise public awareness of men and women regarding GBV by using educational and communication tools.
III) Recommendations for further research:
- To increase funding researches for better understanding of the causes, magnitude, and forms of GBV and guide interventions.
- To generate more knowledge on the causality of the problem focusing on the perpetrators’ characteristics/description rather than the current women centred approach.
- To use the so-called multidimensional or ecological explanatory models, in parallel to the generation of studies centred on the analysis of the possible causal relation between a determined factor and the problem.
- To improve data collection tools to reduce the possible bias derived from women’s refusal to participate as interviewees.
- To avoid the use of convenience sampling as much as possible in both etiological and prevalence studies.
- To consider the recommendations by UNFPA regarding research on GBV, as follows:
• Supporting the development of suitable quantitative and qualitative indicators on GBV and supporting data collection and analysis for these indicators.
• Supporting modules on GBV as well as supporting national and subnational surveys on this type of violence.
• Carrying out evidence-based sociocultural research on how such factors contribute to GBV.
• Collecting service-based data. Such information would include data collected from public and private health centres, shelters, women’s groups, courts, police stations and the agencies that are in contact with women who have suffered violence.
• Filling up key research gaps, such as abuse during pregnancy, and investigating violence in special community settings (e.g. rural, remote, humanitarian settings).