[Domestic violence--public health perspectives]

Domestic violence (DV) implies violence against women by intimate male partners. DV is a serious health issue for women, as well as a violation of human rights. It is a challenge to develop effective public health interventions, as they have to take into account complicated social and psychological background factors. In this paper we present an overview of various interventions in Japan and elsewhere in the world up to now, and propose a strategy for developing effective public health interventions. Governments and NGOs have been involved in various interventions to eliminate DV, e.g., establishing legal frameworks, providing emergency shelters for abused women, and educating male abusers. Health sector interventions include: systematic DV education to health professionals in Europe and the United States; and development of DV victim support networks, in which health facilities play core roles, in Asia and Latin America. The major expected roles of health professionals are identification and treatment of abused women, and prevention of recurrent violence. However, achievement of those goals is insufficient, because of the lack of systematic education, different views on DV between health professionals and abused women, misunderstanding of background factors, and lack of coordination between relevant agencies. The health sector, including clinical and public health services, is expected to play important roles in identifying and supporting abused women in Japan. A possible strategy is to integrate DV interventions into existing maternal and child health service systems. All the front-line health professionals should be provided with systematic training and practical manuals to treat abused women. Further research and evaluation of past interventions are needed to develop effective interventions.