The Public Health Nursing Series is a 20-blog collection, written by William (Billy) Rosa, author of the forthcoming title, Nurses as Leaders: Evolutionary Visions of Leadership (June 2016), that sparks a dialogue about each and every nurse's role in advancing and creating the future of global health. With a focus on cultural considerations and the current status of healthcare in nations worldwide, nurses will learn how they are called to contribute to each of the United Nations' 17 Sustainable Development Goals, an international initiative that seeks to end poverty, protect the planet, and ensure prosperity for all over the next 15 years.This series makes the case that every nurse, regardless of title, position, or credential, is a public health leader.

Sustainable Development Goal #5- Gender Equality (Part 8)

Equality between men and women is a major focus of the Sustainable Development Goals (SDGs), seeking to ensure equity in health care, education, economic security, political decision-making, and the right of all women to be compensated fairly for their work. Beyond implementing systems based on gender equality, SDG #5 also seeks to “empower all women and girls” so that societies can continue to develop in peace and prosperity, and be guided by shared power structures between all members of populations (United Nations Sustainable Development [UNSD], 2016). By 2030, SDG #5 seeks to:

• End all forms of discrimination against women and girls
• Eliminate all forms of violence against all women and girls in both public and private settings
• Eliminate harmful practices, such as child, early, and forced marriage and genital mutilation
• Ensure women’s full participation in all levels of national and international leadership
• Adopt and strengthen new policies and legislation that promotes gender equality and the empowerment of women and girls

One of the mechanisms that keep women disempowered is ongoing gender-based violence (GBV). According to the United Nations Population Fund (n.d.), “Violence against women and girls is one of the most prevalent human rights violations in the world… [it] undermines the health, dignity, security and autonomy of its victims, yet it remains shrouded in a culture of silence.” The health implications of GBV victims include sexual and reproductive health complications, unwanted pregnancies and unsafe abortions, sexually transmitted infections, psychosocial trauma, and, in the worst of cases, death. Intimate partner violence (IPV), the mental, emotional, or physical violence experienced by those individuals participating in an intimate relationship, plagues women worldwide. The World Health Organization (WHO; 2013) showed that 35% of women worldwide have been the victims of physical or sexual violence, up to 30% of women in a relationship have experienced violence at the hands of an intimate partner, and that up to 38% of the murders of women are perpetrated by intimate partners.

As women’s health services continue to be developed in low-income countries worldwide, nurses play an integral role in the screening and identification of GBV and IPV and in mitigating the long-term sequelae (O’Connor, Conley, & Breakey, 2015). This requires that all victims are treated with the same health delivery standards as other members of the community and that nurses are prepared to care for victims of GBV and IPV with respect. Support services should include sexual violence protocols and staff training, a secure, clean, and private treatment area, female forensic examiners, a full range of options (including abortion where relevant), a medical/legal report free of charge, and strict confidentiality (Council of Europe, 2008).

Malaysia was the first country to create and implement a “one-stop center” so that all of the services needed for women survivors of domestic or sexual violence were centralized in one location. These centers provide women with immediate physician examination and treatment, consultation with a counselor within 24 hours, and reference to an emergency shelter or admission into the accident and emergency ward for an additional 24 hours if going home is not safe (United Nations Women, 2012). Public health nurses can partner with hospital management, staff, and providers across the spectrum of care to create and sustain welcoming, private, caring, and effective one-stop centers for the safety and protection of GBV and IPV victims.

Gender inequality worsens the health care disparities already impacting women around the world. It places women in high-risk situations that compromise their autonomy and mental, emotional, and physical well-being. Public health nurses must identify opportunities to effectively prevent GBV and IPV, and also educate communities about the link between gender equity and access to quality health care. In this way, nurses become advocates for both the equality and empowerment of all women and girls in all nations where gender-based discrimination continues to exist.

References

Council of Europe. (2008). Combating violence against women: minimum standards for support services. Retrieved from http://www.coe.int/t/dg2/equality/domesticviolencecampaign/Source/EG-VAW- CONF(2007)Study%20rev.en.pdf

O’Connor, A.L., Conley, K.A., & Breakey, S. (2015). Violence against women. In S. Breakey, I.B. Corless, N.L. Meedzan, & P.K. Nicholas (Eds.), Global health nursing in the 21st century (pp. 193-210). New York, NY: Springer.

United Nations Population Fund. (n.d.). Gender-based violence. Retrieved from http://www.unfpa.org/gender-based-violence

United Nations Sustainable Development. (2016). Goal 5: Achieve gender equality and empower all women and girls. Retrieved from http://www.un.org/sustainabledevelopment/gender- equality/

United Nations Women. (2012). Intimate partner violence and/or sexual assault (one-stop) centres. Retrieved from http://www.endvawnow.org/en/articles/683-intimate-partner- violence-and-or-sexual-assault-one-stop-centres.html

World Health Organization (WHO). (2013). Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva, Switzerland: Author.

More About the Author

William (Billy) Rosa, MS, RN, LMT, AHN-BC, AGPCNP-BC, CCRN-CMC, is currently Visiting Faculty, University of Rwanda and ICU Clinical Educator, Rwanda Military Hospital, Human Resources for Health Program in partnership with the New York University Rory Meyers College of Nursing. He currently has over 65 publications for refereed and non-refereed journals, newspapers, magazines, and national platform blogs and his book, Nurses as Leaders: Evolutionary Visions of Leadership, will be released by Springer in June 2016. Billy currently sits on the US Advisory Board for the Nightingale Initiative for Global Health, and most recently received the American Association of Critical-Care Nurses' 2015 National Circle of Excellence Award and the Association for Nursing Professional Development's 2015 National Change Agent/Team Member Award.

Quick Links

Part 1 -  Understanding the Nurse as a Public Health Leader

Part 9 - Sustainable Development Goal #6 - Clean Water and Sanitation