Investigation by the prof Manuela Stranges

THE PROJECT AND THE OBJECTIVES OF THE INVESTIGATION
"Health is for everyone. Against gender violence, for women's right to health" is the project created by D.i.Re – Women in Network Against Violence, with the support of Novartis, to support the right to healthcare for women who are victims of violence.
As part of the project, a survey was conducted on a sample of 207 women attending the anti-violence centres associated with the Network. D.i.Re, to investigate the impact of violence on the realization of women's right to health, with particular attention to
prevention practices.

 The survey was carried out by Prof. Manuela Stranges, Department of Economics, Statistics and Finance “Giovanni Anania” – University of
Calabria.

The World Health Organization (WHO, 2013) has clearly indicated that violence against women represents a global public health problem and has recommended the systematic integration of recognition and care of victims into ordinary health care pathways, paying particular attention to secondary and tertiary prevention.

The research thoroughly investigated health prevention practices among female victims of violence, while also analyzing any obstacles—structural, personal, or relational—that impact women's access to prevention and care.

THE WOMEN INVOLVED AND THE AREAS OF INVESTIGATION
The survey questionnaire was administered anonymously and voluntarily to a sample of 207 women who had accessed the services of anti-violence centers throughout the country.
o More than half of the interviewees are concentrated in the 35 to 54 age group.
o 39,1% of the women interviewed are separated or divorced and 76,8% have one or more children.
o 40,1% of the respondents have a high school diploma and 31,9% have a university degree.
o Most of the participants are employed (54,2%) and yet approximately three-quarters of the sample declares to be experiencing more or less serious economic difficulties.

The research investigated 5 thematic areas:
o Demographic and socioeconomic characteristics of women
o Physical, psychological and perceived health
o Access to health services
o Practices and frequency of health prevention
o Data relating to care provided by anti-violence centres

SURVEY RESULTS IN SUMMARY
Access to health services and prevention practices is hampered by women's vulnerability due to multidimensional obstacles, in which economic, logistical, and family factors are intertwined with the situation of violence.
 The women interviewed show a reactive approach to their health:
o Almost half of the interviewees (49,8%) turn to the doctor “only in case of symptoms”, indicating a more reactive than preventive approach to managing their health.
o 37,2% of the sample declared that they resorted to visits, check-ups and preventive screenings only in the presence of symptoms.
o 48,8% declare that they have never taken part in screening initiatives promoted in the area

 Violence, combined with economic fragility, hinders access to health services:
o Approximately 14% of the women involved in the survey said they were unable to access the health care they needed.
o Among those in need of care, a portion of the sample encounters barriers to accessing health services for economic reasons (24%), sometimes in combination with logistical or family difficulties, and for problems related to the situation of violence (31%).
Anti-violence shelters play a central role not only as spaces of protection, but also as places of personal reconstruction and empowerment, with a positive impact on women's physical and psychological health.
 The experience at the center has a positive impact on the physical health of women:
o More than half of the respondents (54,6%) declared an improvement in their physical condition after entering the anti-violence centre, a sign of an effect
favorable impact of the support path also on physical well-being, often compromised by the consequences of violence.

 The support of anti-violence centers is perceived by women as fundamental for re-establishing emotional balance and inner security:
o 75,8% of the interviewees reported an improvement in their mental well-being after visiting the anti-violence center.

 Women highlight a strong link between physical and psychological health:
In the comments, many women emphasize the strong correlation between physical and psychological health, acknowledging the impact of violence on both. Furthermore, they credit psychological support with helping them regain balance and independence, with positive effects on their physical health as well.

The psychological health of the women interviewed is in a more fragile condition than their physical health.
 Mental health is compromised following the experience of violence:
In the comments, women describe how the violence they have suffered affects their anxiety, fear, depression, guilt, and self-esteem.
o Almost one in five women (19,3%) defines their perceived psychological health as “bad”, therefore reporting psychological distress of varying degrees.
o Over 70% of those interviewed experienced episodes of loneliness during the year, signaling a widespread sense of relational isolation.
o Approximately 60% of participants had received psychological support or psychotherapy in the last 12 months.

 Perceived physical health status and the impact of violence:
o Comments highlight the impact of violence, direct or indirect, on physical health, as a result of chronic stress, trauma, or neglect of self-care.
o 43,5% of the women interviewed believe that their physical condition is good and almost 7 out of 10 women (69,1%) declare that they have no diagnosed illnesses.
o Among the survey participants who have an illness but do not take their medications regularly, the most frequent reason (61,5%) for not taking them is economic.

CONCLUDING REMARKS: HEALTH AT THE CENTER OF THE REBIRTH FROM
VIOLENCE
The survey results highlight that women who have experienced violence often find their psychological health more fragile than their physical health. Violence acts as a structural factor in the deterioration of mental health: it produces anxiety, isolation, feelings of guilt, and difficulty trusting oneself and others.
Research also shows that economic and job insecurity directly impacts the ability to care for one's own health. Women who care for children and families, or who are unemployed or in precarious employment, are less likely to participate in prevention programs. This is not due to a lack of awareness, but because self-care often remains subordinate to daily survival and/or caring for others.
Anti-violence centers confirm themselves as places of care in the fullest sense of the term: not only spaces where one escapes violence, but also places where one can rebuild health, identity, personal safety, and the power of choice.

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In the women's comments, we read words like help, psychological rebirth, and life. The language itself conveys an ongoing transformation. Health is described as the possibility of "recognizing one's worthy" and "starting a new life."