Attacked from All Sides
Violence Impedes Access to Sexual and Reproductive Health and Rights in El Salvador
Through key stakeholder interviews and focus group discussions with Ministerio de Salud (Ministry of Health, MINSAL) staff and community leaders, including youth leaders, PAI documented the scope of violence against women and girls in El Salvador and its impact on sexual and reproductive rights. This report explores how interacting forms of violence—societal, structural, collective and interpersonal—impede, if not wholly bar, access to quality sexual and reproductive health services, including contraception, as well as education and information.
Violence impedes women, girls and youth from fulfilling their sexual and reproductive health and rights in El Salvador. Official statistics paint a picture of a country where women and girls face egregious levels of interpersonal gender-based violence (GBV), including sexual assault and reproductive coercion. One in four women experiences intimate partner violence (IPV) in her lifetime, though numbers on violence against women are largely believed to be underestimated. There is little accountability for crimes—threats, prejudice and impunity hamper reporting and prosecution, and, in general, reflect a lack of justice for women and girls.
Since the 2009 landmark health system reform that enshrined health as a human right, El Salvador has increased its network of public health services. An increasingly steady availability of contraceptives has improved access for women and girls in low-income and rural communities. However, both rising insecurity and violence against women threaten to undermine the reform’s goals of ensuring the wellbeing and health of the country’s population. The realization of sexual and reproductive health and rights extends beyond the availability of contraceptive methods and related health services. To address GBV against women beyond IPV, and ensure adequate protection and prevention of violence against women and girls, it is critical to look at the wider context in El Salvador and the role that different forms of violence play in limiting their bodily autonomy.