As in many places, gender inequality is prevalent in the Pacific island nation of Kiribati. the WHO commission on Social Determinants of Health underlined in 2008 that gender inequality impacts health through “discriminatory feeding patterns, violence against women, lack of decision-making power, and unfair divisions of work, leisure, and possibilities of improving one’s life,” in addition to limiting access to health care services. A significant consequence of gender inequality is the high level of gender-based violence, including sexual, emotional and physical, perpetrated by intimate partners and non-partners. three years after the final report of the Commission on Social Determinants of Health, WHO convened the World Conference on Social Determinants of Health in Rio de Janeiro, Brazil, in october 2011 to review progress on implementing the recommendations of the commission, draw lessons from experiences and catalyse coordinated global action. this paper was developed in the run-up to the world conference as examples of policy action aimed at tackling key determinants of health and reducing health inequities. covering the period between 2008 and 2011, the paper demonstrates that efforts to measure the extent of a problem can raise political awareness and thereby effectively trigger policy responses on key determinants of gender-based violence and, more broadly, health.
Prior to 2008, health policy-makers were unaware of the prevalence of gender-based violence in Kiribati, as no nationally representative study on the problem had ever been conducted. with support from the Australian government, the United Nations Population Fund (UNFPA) and the Secretariat of the Pacific community (SPC), and drawing on the methodology of the WHO Multi-country Study on Women’s Health and Domestic Violence, the kiribati ministry of Internal and social Affairs (MISA) conducted its first family health and support study in 2008. A committee of stakeholders was assembled to guide the research, support its planning and implementation, and provide a longitudinal sense of buy-in and ownership.