Growing up Safe and Healthy( SAFE): Addressing Sexual and Reproductive Health and Rights and Violence Against Women and Girls in Urban Bangladesh

Background Bangladesh has high rates of physical and sexual violence against women and girls. Women and girls in Bangladesh are often denied the right to make decisions regarding marriage, sex, and childbearing, yet neither the denial of these rights, nor their consequences, have been adequately recognized and addressed in the context of ongoing interventions to address violence against women. While higher court judgments, and key legal and policy provisions recognize women's rights to exercise choice or the requirements of obtaining their consent with respect to marriage, these are rarely applied or invoked in practice.

In Bangladesh, more than 65 percent of girls are married before the age of 18. Child marriage is associated with demands for dowry, with amounts increasing with age. Additionally, women or girls' ability to exercise their right to consent or choice with regard to marriage, sex and sexuality, is routinely denied. Child marriage represents a set of increased reproductive health risks that are associated with limited knowledge and skills to negotiate adult roles and diminished status in the marital home for an adolescent girl. One major reason for the association with early marriage and negative reproductive health outcomes is that young age at marriage for girls is associated with larger age differences that reduce her power within the marital relationship. This may affect factors such as negotiating timing of births, choice of contraception or use of maternal and child health (MCH) services. Child marriage has highly detrimental sexual and reproductive health (SRH) consequences resulting in early childbirth, and adverse effects on child and maternal nutrition and also maternal morbidity and mortality. Child marriage and economic disempowerment may also be related to the high levels of intimate partner violence (IPV) observed in Bangladesh.

Gender norms and perceptions about male predominance, strength and superiority further exacerbate the problem. Evidence suggests that such presumptions of superiority and acceptance of male prerogative and dominance, and corollary acceptability of violence as a form of control, are associated with greater violence. The reason may be that in settings where there is high acceptance of gender based violence the social costs of violence to perpetrators is lower. There is also some research to show that in addition to such community level attitudes, individual attitudes among women and men independently contribute to higher risk of IPV. Thus, modifying individual attitudes and community norms related to gender based violence is an important basis for behavioural change.

In Bangladesh adolescent girls and women are denied SRHR through patriarchal institutions and long standing practices such as child marriage and force marriage, segregation of the sexes and economic exclusion that relegate women to low status. Inadequate SRHR information and services make men vulnerable to diseases. Gender education is normally geared towards women and girls; thus men miss opportunities to become gender sensitive and responsible. While Bangladesh has traditionally afforded women reasonably good access to family planning services, the context of low status of women means that women are unable to exercise their right to choose in decisions regarding marriage, sex and childbearing to the full extent of their rights and ability. This project will seek to enhance people's ability to exercise their SRHR by strategically expanding their knowledge and understanding of the notions of full and informed consent and choice.

Child marriage and IPV are common in both urban and rural areas, with women in poor urban areas are most at risk, yet most programs and projects aimed at empowering women remain in rural areas. Data from Dhaka slums compared to non-slum populations as well as rural data shows higher prevalence and acceptance of gender-based violence among women living in urban slums. Migrant girls and women, particularly those living in urban slums, lack even the most rudimentary social protection - thus being particularly vulnerable to violence.