Why Intimate Partner Violence Is an Under-Recognised Public Health Crisis

Why in the News ?

A recent Lancet analysis using Global Burden of Disease (GBD) 2023 data has highlighted that intimate partner violence (IPV) is a major but under-recognised public health crisis, especially in South Asia, where it poses a greater health risk to women than obesity, smoking, or alcohol use.

Background

• Intimate Partner Violence (IPV) includes physical, sexual, emotional abuse and economic control by a current or former partner.
• Traditionally, IPV has been viewed as a social, legal, or moral issue, addressed mainly through:
  • Criminal law
  • Women and child welfare schemes
  • Crisis centres
• The health system has largely treated its consequences as isolated medical symptoms, not as outcomes of chronic violence.
• India has legal provisions like the Protection of Women from Domestic Violence Act, 2005, but healthcare integration remains weak.
  

Feature

IPV as a Public Health Risk Factor

• IPV is now identified as a measurable risk factor for:
  • PTSD, depression, anxiety, suicide
  • Cardiovascular diseases, chronic pain, gastrointestinal disorders
  • Substance abuse, STIs, adand verse reproductive outcomes
• For women of reproductive age in South Asia, IPV outweighs:
  • Obesity
  • Smoking
  • Alcohol consumption as a driver of disability and poor health.

Chronic and Invisible Nature

• IPV acts as an insidious, long-term exposure, accumulating over the years.
• Women often present with non-specific symptoms:
  • Fatigue, insomnia, panic attacks, chronic pain
• The root cause remains undetected in routine clinical practice.

Gaps in Medical Education and Practice

• IPV is taught largely in forensic medicine, not in clinical subjects.
• Medical professionals lack training in:
  • Trauma-informed care
  • Safe questioning and documentation
  • Referral pathways
• The National Medical Council curriculum devotes minimal time to gender-based violence.

Challenges

• Under-recognition of IPV within healthcare systems
• Fragmentation between healthcare, legal, and social services
• Resistance from families to psychiatric or mental health referrals
• Focus on treating symptoms rather than addressing root causes
• A large “invisible group” of women who do not seek legal or police help

Way Forward

• Reframe IPV as a chronic public health and disease risk factor
• Integrate IPV screening into primary healthcare and OPDs
• Introduce trauma-informed care training for doctors, nurses, and allied health workers
• Strengthen referral linkages with mental health services and social support
• Revise medical and nursing curricula to mainstream gender and violence across disciplines

Conclusion

Recognising intimate partner violence as a public health crisis marks a critical paradigm shift. Unless the health system acknowledges violence as a driver of chronic disease and disability, it will continue treating diabetes, heart disease, anxiety, and depression in isolation, while remaining blind to the violence that fuels them. Addressing IPV through a health lens is essential for preventive, equitable, and rights-based healthcare.