TAILIEUCHUNG - Violence against Women: Health Sector Responses

Estrogen receptors and serotonin receptors coexist in cells in a wide variety of tissues, and this critical review of the literature suggests that many of E2's effects may be medi- ated by changes in the actions of serotonin (5HT). Serot- onin is usually considered to be a neurotransmitter, but surprisingly, only 1% of serotonin in the human body is found in the CNS [4]. The remaining 99% is found in other tissues, primarily plasma, the gastro-intestinal tract, and immune tissues, where serotonin acts as a hormone regulating various physiological functions including vasodilation[5], clotting[6], recruitment of immune cells [7-9], gastro-intestinal motility,[10] and initiation of uter- ine contraction [11,12]. Serotonin also has peripheral functions in. | Violence against Women Health Sector Responses National health policies institutions and programs must pay greater attention to genderbased violence GBV not only as a public health problem but a key component of the HIV AIDS pandemic. We have some of the tools and knowledge to make a difference -the same tools that have successfully been used to tackle other health problems. Violence is often predictable and preventable. Gro Harlem Brundtland Director General WHO 2002 Violence against Women The Hidden Health Burden Violence against women exists to some degree in virtually all societies and all socio-economic and cultural groups. Estimations on the prevalence of violence against women vary depending on the type of violence in question. A study of 10 countries found that between 13 and 62 percent of women have experienced physical violence by a partner over the course of their lifetime and between 3 and 29 percent of women reported violence within the past year Bott Morrison and Ellsberg 2005 . A growing body of evidence documents the consequences of VAW for women s health and wellbeing ranging from fatal outcomes such as homicide suicide and AIDS-related deaths to nonfatal outcomes such as physical injuries chronic pain syndrome gastrointestinal disorders unintended pregnancies pregnancy complications and sexually-transmitted infections STIs Heise Ellsberg Gottemoeller 1999 . Physical and sexual violence has consequences for women s mental health such as post-traumatic stress syndrome depression anxiety and low self-esteem as well as behavioral outcomes such as alcohol and drug abuse sexual risk-taking and a higher risk of subsequent victimization. It has become increasingly clear that injuries represent only the tip of the iceberg in terms of negative health effects and that violence is more appropriately conceptualized as a risk factor for health problems than as a health condition in itself. See Box 1 for a summary of the health consequences of intimate partner .

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