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.
Most of the issues affecting children, youth and women can be effectively addressed through the Government’s commitment to the obligations of international conventions such as the Convention on the Rights of the Child (CRC) and the Elimination of All forms of Discrimination against Women (CEDAW). Government should provide resources to the Kiribati National Advisory Committee on Children (KNACC) and also put in place effective advocacy structures to ensure children and women’s issues are known and mainstreamed into the national development agenda.
This report of the Kiribati Family Health and Support Study analyses data from the first ever nationally representative research on violence against women and related child abuse in this country. This study replicates the WHO multi-country study on Women’s Health and Domestic Violence against Women. The study was designed to
estimate the prevalence of physical, sexual and emotional violence against women, with particular emphasis on violence by intimate partners
assess the association of partner violence with a range of health outcomes
identify factors that may either protect or put women at risk of partner violence
document the strategies and services that women use to cope with violence by an intimate partner;
assess the association of partner violence with abuse against children
Methodology of the study
The study consisted of a qualitative component and a quantitative component. The quantitative component consisted of population-based household survey that was conducted around the country. The sample for the household survey was designed to be nationally representative and aimed to include 1500 women aged 15–49 years. A stratified multi-stage sample design was used, with 20% oversampling to account for non-response. There were five strata: three for the Gilbert Islands, one for the Line and Phoenix Islands, and one for South Tarawa. Within the first four strata islands were randomly selected, and in South Tarawa enumeration areas were systematically selected. Within the islands or enumeration areas, households were systematically selected using probability proportional to size (based on census information). The total sample size was 2000 households to be visited. In each selected household only one woman was randomly selected to be interviewed for the survey among all eligible women 15–49 years of age.