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Introduction
Violence directed towards women, framed within the family context, is a phenomenon that dates back to the origins of humanity and its various civilizations. This form of aggression has violated essential rights of women, such as life, physical and mental health, and basic freedoms, preventing them, in many cases, from fully enjoying these rights. Throughout history, women have been placed in a subordinate position under male dominance, being treated at times as mere property or slaves. However, as the centuries passed, these circumstances of oppression and marginalization began to be questioned and challenged. Specifically, in the 17th century, the first signs of a movement emerged that would seek to define and claim women's rights. 1
VAW, both within the family and in the sociocultural context, remains a concerning contemporary reality. The World Health Organization (WHO) has repeatedly emphasized that this specific form of violence has become an alarming public health issue with significant economic and social repercussions. However, although the situation is critical, the WHO stresses that it is not an insurmountable problem. With prevention as the key, it is essential to address VAW with a realistic perspective, using all available resources and strategies to find solutions and mitigate its impact on a global scale. 2
The word "violence" is intrinsically associated with the idea of force. Within this framework, women are often the primary victims due to misguided perceptions that place them as weaker or more vulnerable beings. These perceptions expose them to various forms of mistreatment, whether physical, psychological, or even economic, given the financial dependence that some women may have. Associated terms, such as "to violate" or "to rape," reinforce this idea of transgression and abuse towards them. Violence, in any of its manifestations, implies the use of force to inflict harm, whether through direct physical aggression or by depriving rights that should be inalienable for all women. 3
During the COVID-19 pandemic, VAW within the family setting has intensified, becoming a concerning constant. This domestic violence, which was already a problem before the pandemic, has seen an alarming increase in its prevalence. Latin America has not been an exception to this trend. Recent studies indicate that the region has high rates of VAW in households, with countries such as El Salvador, Honduras, Belize, Paraguay, Bolivia, Chile, and Peru standing out. These nations, in addition to the official figures of cases, face the challenge of the so-called "dark statistics," which reflect an even grimmer reality about the true magnitude of the problem. 4-7
Research from Brazil revealed that factors such as ethnicity or race, the education system, income and employment, violence rates, cultural norms, and political conflicts can increase the likelihood of women experiencing manifestations of violence. 8 Therefore, authors emphasize the importance of addressing these associated factors to prevent and reduce lethal VAW in that country. In reality, VAW occurs in all social settings. Another investigation in Australia explored the disconnect between primary prevention and public transportation by conducting a narrative analysis of reviews of women's safety interventions in public transportation. It found that there is a disconnect between primary prevention and public transportation, as the sector places little emphasis on women's safety in the industry's focus on protecting infrastructure. 9
At the same time, a study conducted in Mexico, which used the Socio-Ecological Framework to analyze VAW at different levels, including situational factors such as urban design, distribution, and the presence of infrastructure in specific locations, found that the vulnerability of becoming a victim of VAW was related to factors such as the time of day, urban design, and the presence of infrastructure in a specific location. For this reason, researchers emphasize the importance of improving infrastructure, such as lighting, reducing narrow access routes, and improving sidewalks, as a way to prevent VAW in public spaces.10
A study conducted in Tunisia, aiming to identify the risk factors of physical VAW in the south of the country, found that severe physical violence in Tunisia was statistically related to the relationship with the aggressor, with a higher likelihood of it being committed by an intimate partner because most of the victims of physical violence were married women, unemployed, and of urban origin. Likewise, the study specified that unemployment was a risk factor for physical VAW, as a higher proportion of victims were unemployed at the time they were subjected to physical violence by their partners. The authors also regret that VAW in Tunisia is a widespread practice and, despite legislative advances, Tunisian women continue to be subject to discrimination in various areas. 10
Meanwhile, in India, Afghanistan, Peru, and Rwanda, with the aim of understanding the measures that communities are taking to address harmful social norms and prevent Violence Against Women in low and middle-income countries, it was found that in the fight against this scourge, three mechanisms drive community action to prevent VAW: 1) specific spaces to discuss VAW, 2) leaders fighting against violence towards women as positive role models, and 3) community perceptions of VAW as a problem worth addressing. However, on this last point, in countries like India and Afghanistan, social norms about women's position and the belief that violence is a private family matter create a contextual barrier that hinders community action to address violence. 11
Aiming to examine the relationship between types of disability and various forms of sexual violence, a study conducted in the United States using nationally representative data from the National Survey of Family Growth from 2011 to 2017 found that women with some form of disability reported having experienced sexual violence throughout their lives at approximately twice the proportion of non-disabled women (around 30% compared to 16.9%). Women with multiple disabilities had the highest prevalence and risk of sexual violence (42.1%). Furthermore, women with cognitive disabilities or multiple disabilities were significantly more likely to experience physical or non-physical force during their first sexual encounter compared to non-disabled women. Given the seriousness of these findings, researchers recommend that future research focus more on developing evidence-based inclusive intervention and violence prevention programs for women with disabilities. 12
A study conducted in Australia, aiming to analyze the long-term psychosocial and behavioral outcomes of Australian women who have experienced sexual violence and to determine if social support mediates the relationship between SV and adverse outcomes, found that women who had experienced sexual violence had higher levels of anxiety, depression, and stress, a lower mental health-related quality of life, and less life satisfaction compared to women without a history of sexual violence. Their distress levels remained elevated at all times. Women with a history of sexual violence were also more likely to experience re-victimization and to consume more cigarettes and illicit drugs. The study also suggested that social support was identified as a key factor in reducing distress and breaking the cycle of partner violence among these women. 13
In Peru, VAW is a social reality that affects all social spaces and urgently needs to be studied. One consulted research reports a critical evaluation of the relationship between women's autonomy and Intimate Partner Violence (IPV) in Peru. Through a secondary analysis of the 2019 Demographic and Family Health Survey, researchers reveal that a significant proportion of women with low autonomy experience IPV, particularly psychological/verbal violence. These findings highlight the importance of strengthening women's autonomy as a potential strategy to reduce the prevalence of IPV in the Peruvian context. 14 Likewise, another study conducted in Peru provides a comprehensive assessment of the factors associated with IPV e targeting women of reproductive age in the country. Using data from the National Demographic and Health Survey from 2015-2017, the study reveals that approximately 38.7% of women have experienced some form of IPV, with physical and psychological violence being the most prevalent. Furthermore, the analysis identifies sociodemographic and contextual variables that influence the prevalence of IPV, such as the educational level of the woman and her partner, the region of residence, and a history of violence in the family. In conclusion, these findings highlight the magnitude of the problem in Peru and underscore the need for interventions targeting vulnerable groups to reduce the prevalence of IPV. 15
Similarly, a study was conducted with the aim of carrying out a comprehensive assessment of the scientific literature related to violence directed against women in the current circumstances of the ongoing COVID-19 pandemic. The study reported a quantifiable and classifiable outcome in relation to domestic violence. It was concluded that the measures implemented to eliminate VAW have not proven to be effective. Moreover, there is a lack of sufficient control measures among nations and international organizations, which have the responsibility to safeguard these fundamental rights of individuals and raise awareness among the population. 16
Likewise, a publication aimed to analyze the issue of VAW, determining the involved risk factors and the consequences of its effect in Peru; it found that women are the most affected by physical, sexual, and psychological violence. Where men, girls, boys, and the elderly have a low percentage facing this issue. According to the CEM, a total of 22,095 cases of VAW were reported, in which they provided support to various female victims suffering from physical, psychological, and sexual violence. The research concluded that VAW is a public issue that continues to have repercussions in Peru, which to this day is still minimized by society at large. 17
On the other hand, the Demographic and Family Health Survey (Endes, by its Spanish acronym) found that domestic violence affects 63% of women in Peru, where 11% of them were assaulted by their partners. The highest levels were observed in the southern highland regions, according to figures from the Ministry of Women and Vulnerable Populations (MIMP), with economic, psychological, physical, or sexual violence being predominant. 18 Likewise, among the types of violence that occur in this family group, psychological, physical, sexual, and economic violence stand out. Actions against them include insults, humiliations, mockery, threats, beatings, slaps, kicks, burns, attacks with sharp weapons, forcing them to have sexual relations, taking their money away, forbidding them to work, among other violent acts. 18 This reality reflects the failures in the Peruvian Government's strategy to address the problem, indicating that the available family guidance and rehabilitation centers and institutions are not functioning properly. There is also concern about the lack of strategic direction in assisting victims or potential victims, such as women in the process of separation. In this sense, public policies must be preceded by prevention measures that incorporate multidisciplinary teams in communities, because it is precisely there where violence is generated and where cases are genuinely known.
However, in Peru, the United Nations Development Program, in partnership with mainly the Municipalities of the capital, has been implementing initiatives during the COVID-19 times to reach families during the crisis and convey messages and actions that allow raising awareness and preventing violence. Regrettably, these initiatives have not been implemented in other regions of the country, such as the northern region, where cases of domestic violence have significant social connotations. Also, in Peru, even though the Constitution of the Republic of Peru emphasizes the defense of the human person and the respect for their dignity as the supreme purpose of society and the State, 19 domestic violence remains a persistent issue in the Lambayeque region. Law N°30364, enacted in 2015, establishes comprehensive measures to prevent, punish, and eradicate VAW and members of the family group, identifying four types of violence: physical, psychological, sexual, and economic or patrimonial. 20 However, despite these legal provisions, the Northern region of Peru has experienced an increase in cases of domestic violence, especially during the context of the COVID-19 pandemic.
Factors such as confinement, economic pressure, job loss, and the challenges of distance education have exacerbated interpersonal tensions within the family setting. According to recent research, the northern region of Peru has high rates of domestic violence, with 41% of households made up of single mothers facing conditions of extreme poverty and being victims of physical, sexual, and psychological violence. Despite state interventions and the existence of a regulatory framework, actions have been insufficient to address this issue.
The purpose of this research was to analyze the perception of workers at CEM regarding VAW in the northern region of Peru. This analysis was based on the perception of cases of VAW received at CEM; the most common types of violence received daily at CEM; the level of perception of VAW; the perception that VAW can be prevented; as well as the compliance with protection measures by the National Police of Peru.
Methods
Design
The present study is framed within a multimethodological approach, integrating various methodological strategies to address the complexity of the phenomenon in question. Starting from the exploration of the perception and perceived efficacy of VAW in the CEM of Northern Peru, a descriptive correlational design was used to understand the relationship between the perception of VAW and the perceived efficacy of existing measures to address this problem in the community.
The main variables in this study were the perception of VAW and the perceived efficacy of existing measures. Specific categories of VAW: physical, psychological, and sexual violence were considered as independent variables. Additionally, variables related to the perception of violence and the perception of violence prevention were explored.
Furthermore, a comparison was made between the types of VAW to identify significant differences. The results indicated that physical violence was statistically higher than psychological violence, and the latter was higher than sexual violence. The perceived efficacy of existing measures to address this problem in the community was then evaluated. To understand this perception, an explanatory model was proposed, and a regression analysis was conducted. In this analysis, several predictor variables were used, including the perception of VAW and the perception of violence prevention against women. The dependent variable was the perceived efficacy of existing measures to address this problem in the community.
Participants
In this study, 48 active individuals were included, employed at different CEM distributed in urban and rural regions of Northern Peru. The sample covered both male and female workers, following a representative percentage distribution of 14 (29.2%) and 34 (70.8%) respectively. A variety of roles and responsibilities within the CEM was sought, ensuring the participation of advisors, psychologists, and administrative staff. Likewise, a wide diversity in ages and years of work experience was considered to capture multiple perspectives. In terms of exclusion, individuals not active in the CEM, those who did not give informed consent to participate, and those who had previously participated in similar studies were left out. This rigorous selection was carried out to ensure a representative sample and obtain reliable and valuable data for the analysis of the perception of violence in this specific context.
Techniques and instruments
For the selection of participants and data collection in this study, electronic devices such as computers, mobile phones, and tablets were used, with access to a messaging network and SPSS and Jamovi statistical software. These devices were essential to carry out the recruitment process of the proposed participants by the seeds, who were workers from the CEM located in various urban and rural regions of Northern Peru.
In the context of this research, a meticulously designed structured questionnaire was implemented for the workers of the CEM. This instrument, applied through a virtual platform, is characterized by containing closed questions with predetermined answer options, allowing precise and efficient quantitative data collection. The questions, carefully formulated and aligned with the research objectives, addressed crucial aspects related to violence. This structure enabled a direct comparison of answers, facilitating a detailed quantitative analysis and identifying relevant patterns and trends with valuable insights to address the research objectives. To ensure the reliability of the instrument, an internal consistency analysis was carried out, yielding a rounded Cronbach's alpha value of 0.7. This indicator confirms the good consistency and reliability of the responses obtained.
In terms of validity, an expert judgment validation process was carried out, where specialists in the field of violence and with experience in the CEM evaluated the questionnaire. Their contributions and suggestions resulted in significant improvements in the structure and content of the questionnaire, ensuring its relevance and adequacy. Additionally, to assess construct validity, an exploratory factor analysis was conducted to identify the underlying structure of the questions and their relationship to violence.
The EFA yielded a value greater than 1, which is an acceptable threshold, indicating that one factor explains more variance than a single original variable. The factors explain at least 60-70% of the total variance, ensuring a solid solution. High factor loadings, close to ±1, reflect a strong relationship between the original variable and the factors. The scree plot guides us in determining the appropriate number of factors to retain. This rigorous validation and reliability analysis process ensures that the structured questionnaire used in this study is an accurate tool to measure the perception of violence, thus allowing a robust and well-founded interpretation of the results obtained.
Procedures
The recruitment of participants began with the identification of "seeds" in the CEM. These seeds, workers who met the inclusion criteria and had access to the messaging network, were personally recruited and asked to refer their relevant peers for research. They were explained the purpose of the study and asked for their consent to participate. Subsequently, these new participants were also invited to refer other relevant colleagues.
Once contact was established with the participants through the messaging network, they were provided with a link to the virtual platform where the structured questionnaire would be administered. Participants accessed the platform through their electronic devices and completed the questionnaire, which included closed questions with predetermined answer options, thus allowing precise and efficient quantitative data collection.
Preliminary tests were conducted to ensure the proper functioning of the virtual platform on different devices and operating systems, guaranteeing its accessibility and usability for participants. Also, a tracking and reminder system was implemented to maintain active participation of the participants. Notifications were sent through the messaging network to remind them to complete the questionnaire and motivate their participation.
After data collection, an internal consistency analysis of the questionnaire was conducted to assess its reliability. The Cronbach's alpha coefficient was calculated, yielding a rounded value of 0.7, confirming the consistency and reliability of the responses provided. These procedures ensured rigor and precision in obtaining data on the perception of violence among CEM workers using the snowball sampling methodology with seeds.
The data collected through the structured questionnaire were subjected to a detailed analysis to extract patterns, trends, and significant relationships. Initially, a descriptive analysis was conducted to examine the distribution of responses and obtain summary measures. Subsequently, inferential analyses were carried out using appropriate statistical techniques. Spearman correlation and chi2 tests were applied to explore the relationships between key variables, such as the perception of violence and other relevant factors. Additionally, multiple regression analyses were conducted to understand the possible influences of predictor variables on the perception of violence. These analyses allowed for a deeper understanding of the perception of violence among participants and provided valuable insights to address the research objectives. It should be noted that all analysis was performed using specialized statistical software (SPSS and Jamovi), ensuring the accuracy and robustness of the results.
Ethical considerations
The study titled was conducted rigorously following the ethical principles established in the Helsinki Declaration 21 and the Nuremberg Code. 22 All participants gave their informed consent, being fully aware of the objectives and procedures of the study, as well as any potential risks. The well-being and integrity of the participants were prioritized at all times, taking the necessary precautions to minimize any risk or discomfort. The confidentiality of the information provided by the participants was guaranteed, ensuring that the data were stored securely and used exclusively for research purposes. Participants were informed of their right to withdraw from the study at any time without consequences.
Results
Table 1 displays the distribution of cases received in relation to VAW. Out of a total of 48 cases, the majority, 34 cases (70.8%), report over 100 incidents of violence. On the other hand, 11 cases (22.9%) report between 50 and 99 incidents, and only 3 cases (6.3%) indicate between 20 and 49 incidents. These data show that the vast majority of reported cases present a high frequency of incidents of VAW.
Table 1 Cases received in relation to VAW
| Range | Frequency | % | Valid % | Cumulative % | |
|---|---|---|---|---|---|
| Valid | 20 to 49 cases | 3 | 6.3 | 6.3 | 6.3 |
| 50 to 99 cases | 11 | 22.9 | 22.9 | 29.2 | |
| 100 or more cases | 34 | 70.8 | 70.8 | 100.0 | |
| Total | 48 | 100.0 | 100.0 |
Table 2 outlines the most common types of violence reported daily. Out of a total of 48 cases, physical violence is the most predominant, with 27 cases representing 56.3% of the total. This is followed by psychological violence, with 19 cases, equivalent to 39.6%. Lastly, sexual violence is the least frequent, with only 2 cases, constituting 4.2% of the total. These data underscore that, although physical violence is the most reported, psychological violence also has a significant presence in the cases received.
Table 2 Most common types of violence reported daily
| % | Valid % | Cumulative % | |||
|---|---|---|---|---|---|
| Valid | Psychological Violence | 19 | 39,6 | 39,6 | 39,6 |
| Physical Violence | 27 | 56,3 | 56,3 | 95,8 | |
| Sexual Violence | 2 | 4,2 | 4,2 | 100,0 | |
| Total | 48 | 100,0 | 100,0 | ||
Table 3 provides a summary of the one-sample chi-square test. With a total of 48 cases (N total), the test statistic is 20.375. The test has 2 degrees of freedom and yields an asymptotic significance (two-tailed) of .000. This indicates that there are significant differences in the data analyzed, as such a low significance value (.000) is a strong indicator of statistical significance.
Table 3 One-sample chi-square test summary
| Total N | 48 |
| Test statistic | 20,375a |
| Degree of freedom | 2 |
| Asymptotic sig. (two-sided test) | ,000 |
Table 4 illustrates the level of perception of VAW. Out of a total of 48 cases, 28 (58.3%) perceive a high level of VAW. On the other hand, 11 cases (22.9%) have a low perception, and 9 cases (18.8%) perceive a medium level of violence. These data highlight that more than half of the respondents perceive a high level of VAW, underscoring the severity and prevalence of this issue in the studied population.
Table 4 Level of perception of VAW
| Frequency | % | Valid % | Cumulative % | ||
|---|---|---|---|---|---|
| Valid | Low | 11 | 22,9 | 22,9 | 22,9 |
| Medium | 9 | 18,8 | 18,8 | 41,7 | |
| High | 28 | 58,3 | 58,3 | 100,0 | |
| Total | 48 | 100,0 | 100,0 | ||
Table 5 displays the perception of whether VAW can be prevented. Out of a total of 48 responses, 21 (43.8%) believe it probably can be prevented, while 8 (16.7%) are convinced it definitely can be prevented. However, 15 respondents (31.3%) think it probably cannot be prevented, and 4 (8.3%) believe it definitely cannot be prevented. These data show a division in opinions, although a combined majority of 60.5% (adding "Probably Yes" and "Definitely Yes") hold an optimistic view and believe in the possibility of prevention. On the other hand, 39.6% have a more pessimistic perspective on preventing VAW.
Table 5 Perception that VAW can be prevented
| Frequency | % | Valid % | Cumulative % | ||
|---|---|---|---|---|---|
| Valid | Definitely not | 4 | 8,3 | 8,3 | 8,3 |
| Probably not | 15 | 31,3 | 31,3 | 39,6 | |
| Probably yes | 21 | 43,8 | 43,8 | 83,3 | |
| Definitely yes | 8 | 16,7 | 16,7 | 100,0 | |
| Total | 48 | 100,0 | 100,0 | ||
The perception that respondents had about VAW, as shown earlier, was significantly high. However, in Table 6, it is observed that there is no relationship between the Perception of VAW and the idea of prevention against it due to the negligible value of Rho of 1.26 and the high critical level of 0.395. These two variables would not be related in the sample according to their own perception; therefore, the hypothesis that the higher the perception of violence, the greater the prevention would not be met. This tells us that, according to the respondents, violence could not be prevented.
Table 6 Correlations
| Perception of violence | Prevention Perception | |||
|---|---|---|---|---|
| Spearman's Rho | Perception of violence | Correlation coefficient | 1,000 | ,126 |
| Sig. (bilateral) | . | ,395 | ||
| N | 48 | 48 | ||
| Prevention Perception | Correlation coefficient | ,126 | 1,000 | |
| Sig. (bilateral) | ,395 | . | ||
| N | 48 | 48 | ||
Table 7 shows compliance with protection measures by the Peruvian National Police (PNP). Out of a total of 48 responses, 35 (72.9%) state that protection measures are indeed complied with. On the other hand, 10 respondents (20.8%) answer with "Maybe", indicating some uncertainty or variability in their experience or perception. Only 3 people (6.3%) believe that the protection measures are not complied with. These data highlight that a vast majority of respondents perceive that the PNP complies with the protection measures, although there is a significant segment that has doubts or believes they are not adequately met.
Table 7 Compliance with protective measures by the National Police of Peru
| Frequency | % | Valid % | Cumulative % | ||
|---|---|---|---|---|---|
| Valid | No | 3 | 6,3 | 6,3 | 6,3 |
| Maybe | 10 | 20,8 | 20,8 | 27,1 | |
| Yes | 35 | 72,9 | 72,9 | 100,0 | |
| Total | 48 | 100,0 | 100,0 | ||
In Table 8, the variables Perception of Prevention and Level of Perception of Violence" have a moderate correlation with the compliance of PNP protection measures, but they only explain a small percentage of the variability in said dependent variable.
Table 8 Model Summary
|
| |||||
| Model | R | R squar | Adjusted R-squared | Standard error of the estimate | Durbin-Watson |
| 1 | ,319a | ,101 | ,083 | ,559 | 1,750 |
| a. Predictors: (Constant), Perception of Prevention, Level of perception of violence. | |||||
| b. Dependent variable: compliance with PNP protection measures. | |||||
Table 9 supports the overall significance of the regression model as a whole with its value of 0.06; suggesting that at least one of the predictors significantly contributes to explaining the variability in the dependent variable.
Tabla 9 ANOVA
|
| ||||||
|---|---|---|---|---|---|---|
| Model | Sum of squares | gl | Mean square | F | Sig. | |
| 1 | Regression | 3,425 | 2 | 1,712 | 5,476 | ,006b |
| Residue | 30,335 | 45 | ,313 | |||
| Total | 33,760 | 47 | ||||
| a. Dependent variable: 7. In your opinion, is the National Police of Peru fulfilling its responsibility to comply with protection measures? | ||||||
| b. Predictors: (Constant), Perception of Prevention, Level of perception of violence | ||||||
Table 10 displays the coefficients that indicate the contributions of each predictor variable to the dependent variable, while holding the effect of other variables constant. The p-values suggest that the "Level of Perception of VAW" seems to have a significant effect on the dependent variable. On the other hand, the perception of prevention of VAW does not appear to be statistically significant in this model.
Table 10 Coefficients
|
| ||||||
| Model | Unstandardized coefficients | Standardized coefficient | t | Sig. | ||
| B | Desv. Error | Beta | ||||
| 1 | (Constant) | 2,380 | ,250 | 9,538 | ,000 | |
| Perception level | ,203 | ,070 | ,280 | 2,894 | ,005 | |
| Prevention Perception | -,075 | ,060 | -,121 | -1,252 | ,214 | |
| a. Variable dependiente: In your opinion, is the Peruvian National Police fulfilling its responsibility regarding compliance with protection measures? | ||||||
Discussion
Regarding the perception of workers at CEM in the northern region of Peru in the dimension "Cases of VAW" (received at the CEM), it is pertinent to highlight that, of the 48 cases evaluated, a concerning 70.8% reported having addressed more than 100 incidents of VAW. This statistic, on its own, underscores the alarming frequency and severity of episodes of violence women face in the region. Additionally, 22.9% (equivalent to 11 cases) indicated having managed between 50 and 99 incidents, reinforcing the urgency of addressing this issue. These findings are consistent with recent research. A study conducted in Ecuador reported a 76% increase in cases of VAW during the COVID-19 pandemic. 23 Evidently, VAW often originates within the family nucleus, mainly by partners or close relatives; a fact that experienced an increase during the COVID-19 lockdown, leading to psychological consequences that impact their well-being and the dignified life of the victimized woman. On the other hand, another study in Ecuador on sexual VAW in Pichincha during the pandemic, corroborates these data by diagnosing a 31.8% increase in cases, according to data from the Public Defender's Office. 24
Regarding the perception of workers at CEM in the northern region of Peru concerning the most common types of VAW (received daily at the CEM), out of the 48 cases examined, it is alarming to note that more than half, specifically 27 cases (56.3%), are associated with physical violence. This underlines the severity and prevalence of this type of aggression. However, it's equally concerning that 19 cases (39.6%) are tied to psychological violence, a type of abuse that, while not leaving visible scars, can have devastating and lasting effects on the mental and emotional health of victims. On the other hand, while sexual violence accounted for only two cases (4.2% of the total), it remains a significant concern, as even one case is intolerable. This reality aligns with other research; one study pointed out that 35% of surveyed women experienced physical violence in their homes. 25 Concerning psychological violence, a study conducted in Peru indicated that 75% of the surveyed population fell victim to this type of abuse. 26 This figure is reinforced by another study explaining that psychological violence might be underestimated by institutions that protect women. 27 Although sexual violence is the least reported in CEM, another relevant study found relational violence predominates in dating relationships. That same study suggests that this type of violence might be more prevalent than what is reported in institutions like the CEM. 28 In this context, specialists emphasize the importance of assessing and addressing VAW in different settings. 29,30
Related to the perception of workers at CEM in the northern region of Peru regarding the level of perception of VAW (cases received at the CEM), out of the 48 cases analyzed, a significant majority, meaning 28 cases or 58.3%, have a high perception of VAW. On the other hand, 11 cases, representing 22.9%, have a low perception of violence, which could suggest a lack of awareness or exposure to this issue. Additionally, 9 cases, equivalent to 18.8%, have a medium perception of VAW. It is crucial to emphasize that, according to items 3, 4, and 5, which sought to gather information on how CEM respondents perceive VAW, it was confirmed that a high percentage, 58.3%, perceive a high level of VAW. These findings underscore the urgent need to address and combat this issue, as well as to educate and raise awareness in the community about the severity and repercussions of VAW. This high perception (58.3%) aligns with the findings of a study which points out that many women in violent situations often do not adequately assess the severity of the violence and perceive it as something natural in partner relationships, which could explain the 22.9% of cases with a low perception. 27-31
Regarding the perception of workers at CEM in the northern region of Peru on the dimension "VAW can be prevented", out of the 48 participating workers, a majority (comprising 43.8% who believe "Probably Yes" and 16.7% who think "Definitely Yes") feel that it is possible to take measures to prevent VAW. This perspective reveals a growing awareness and a willingness to tackle and combat this issue. However, it cannot be overlooked that a significant proportion, 15 respondents or 31.3%, feel that it "Probably Cannot" be prevented, and 4 individuals, or 8.3%, are firmly convinced that it "Definitely Cannot" be prevented. This more pessimistic perspective reflects the complexities and inherent challenges in the fight against gender-based violence and underscores the need for ongoing and sustained efforts in education, awareness, and preventive policies. So much so that in Spain, 18.5% of women have suffered sexual harassment in childhood, and in Catalonia, 45.2% of sexual violence victims are minors. In this regard, the macro-survey on VAW revealed that one in two women (57.3%) aged 16 or older have suffered violence; drawing attention to the fact that in the young population, this phenomenon emerges strongly: 71.2% of women aged 16 to 24 and 68.3% of those aged 25 to 34 have suffered some form of violence throughout their lives. 32 Moreover, the sample taken in the Dominican Republic, consisting of 170 women who were victims of partner violence and who voluntarily sought psychological assistance at an NGO located in the country's capital, found that 52.7% of these women were cohabiting with the aggressor, while 47.3% were not. 60% of the participants reported a history of domestic violence. In terms of types of violence, 66.5% reported psychological violence due to control and 91.8% due to humiliation. 64.1% reported physical violence and 44.7% sexual violence. 33 Also, in Brazil, out of a total of 991 women interviewed, psychological violence was the most prevalent throughout their lives, with a rate of 57.6%. Physical violence was the second most prevalent, at 39.3%. Meanwhile, the least prevalent was sexual violence, at 18.0%. 34 In the case of Ecuador, a survey reflected a higher incidence of gender violence in adult and elderly women throughout their lives. This relationship changed when looking at the violence suffered in the last year, where young women registered a higher prevalence of violence. From the total sample, indigenous women reported more IPV throughout their lives (47.10%), followed by Afro-Ecuadorian women (44.88%), white/mestizo women (39.05%), and montubio women (32.06%). The study corroborated that psychological and physical violence are more prevalent among indigenous women, while economic and sexual violence are higher among Afro-Ecuadorian women. Regarding education, it was observed that the prevalence of violence decreases as a higher educational level is achieved. In rural areas, more psychological and physical violence is reported than in urban areas, while in urban areas the prevalence of economic and sexual violence is higher. 35 Lastly, in a qualitative study carried out with 16 young individuals (ages 18-24) in Spain, it was evidenced that physical violence remains the most recognized form of violence by the younger population. Participants acknowledged forms of VAW that are considered subtle, indirect, and normalized in everyday life. 36
Relevant to the perception of workers from the CEM in the northern region of Peru regarding the compliance with protection measures by the PNP (reported daily in the CEM), out of the 48 participants, 72.9% confirm that the PNP fulfills their protective duties and responsibilities. This positive perception reflects a level of trust in the authorities and their efforts to ensure the safety and well-being of women. However, it is essential to pay attention to the 20.8% of respondents, that is, 10 individuals, who express uncertainty on this matter. This response suggests that there are varied experiences or perceptions and that in some cases, there may be inconsistencies or a lack of uniformity in the implementation of protective measures. In this context, the Ombudsman recognizes the PNP as the entity responsible for executing protective measures (Paliza Olivares, 2020. However, the absence of specific data on the degree of compliance or the public's perception of its effectiveness leaves an informational gap. Is the PNP being effective in its role, or are there deficiencies that are not being adequately addressed? The lack of access to these reports by the general public has become a barrier to transparency and accountability. In conclusion, although the general perception of the PNP and its compliance with protective measures is positive, it is essential to address areas for improvement and ensure transparency and accountability. Institutions must be well-coordinated and work together to guarantee the safety and well-being of all women in Peru
Conclusions
The perception of the workers from the CEM in the northern region of Peru reveals an alarming frequency and severity of incidents of VAW, with a significant 70.8% of respondents reporting having attended to more than 100 incidents. These findings highlight the urgency of addressing this issue and align with recent research showing an increase in cases of VAW, especially during the COVID-19 pandemic. It is concerning to see that physical and psychological violence are the most prevalent forms of aggression, with 56.3% and 39.6%, respectively. Although sexual violence is reported less, it remains a crucial concern. These data align with research suggesting that psychological violence may be undervalued by women's protection institutions.
Regarding the perception of the most common types of violence, it is vital to emphasize the gravity and prevalence of physical violence, but also the devastating and lasting impact of psychological violence on the mental and emotional health of victims. Sexual violence, although less reported, is intolerable in any measure. These findings underscore the pressing need to address and combat this issue, as well as educate and raise awareness in the community about the severity and implications of VAW.
Regarding the perception level of VAW, it's essential to note that a high percentage of respondents perceive a high level of VAW, emphasizing the need to tackle and combat this issue. However, there's also a significant percentage with a low or medium perception of violence, potentially reflecting a lack of awareness or exposure to this grave problem.
In relation to the dimension that VAW can be prevented, it's encouraging that a majority of workers perceive it's possible to take measures to prevent VAW. Still, the significant proportion believing it can't be prevented highlights the complexities and challenges inherent in combating gender violence.
Lastly, regarding the compliance with protection measures by the Peruvian National Police, it's positive that a majority of respondents perceive that the PNP fulfills their responsibilities. However, it's essential to address improvement areas and ensure transparency and accountability to secure the safety and well-being of all women in Peru.
Recommendations: Given the alarming frequency and severity of VAW incidents, especially in the current study field, strengthening and expanding prevention interventions and programs is imperative. Implementing awareness campaigns targeted not only at women but the broader community, is suggested to debunk and combat cultural and societal norms perpetuating violence. Institutions, including the Peruvian National Police, should continue gender-based training and sensitization to ensure an appropriate and empathetic response towards victims. With the high percentage of reported psychological violence, strengthening psychological and emotional support services for victims is also recommended. Lastly, further research addressing unexplored contextual and cultural factors is crucial for a holistic understanding and designing more effective interventions.
Limitations: Like all research, our study has its limitations. Despite efforts to address multiple VAW dimensions, unexplored in-depth contextual and cultural factors persist. These factors, varying by region, ethnic group, or cultural traditions, might influence VAW's perception and experience and warrant more detailed investigation in future studies. This limitation should be taken with caution when interpreting and applying the study's findings.
