Gender-Based Violence and Femicide in Ecuador: A Cross-Sectional Study of Population Mortality Estimates from 2001-2017

Background: Gender-based violence is a major public health concern arising from the structural discrimination of women and girls. In 2014, Ecuador criminalized acts of femicide in response to a growing crisis across the region. As no epidemiological studies on the state of femicides have been published, we estimated trends occurring between 2001 and 2017. Methods: Using data from the National Institute of Census and Statistics we estimated the annual mortality rates, cumulative incidence and relative risks for female homicides, from 2001 – 2017. The impact of aggressions, assaults and violence on years of life lost due to premature mortality was estimated using the Human Capital method. Findings: Over the period, at least 3,236 cases of female homicides were reported. The highest murder rate occurred in the province of Sucumbios (6·5 per 100,000) and in the Putumayo canton (12·5 per 100,000). The most common way to murder their victims was using firearms (38%). The highest relative risk was estimated for women aged between 25-29, at 4·5 (3·9 – 5·1), of primary school attainment at 17·2 (14·6 - 20·3) and of Afro-Ecuadoran descent 18·1 (10·5- 30·9). Femicide-related costs reached, on average, $35 million per year and more than $500 million lost from 2001 to 2017. Interpretation: The high rates, distribution and cost indicate that investments are urgently needed to address the structural causes and reduce the impact of femicides in Ecuador; thereby protecting the livelihood and well-being of their women and girls. Funding Statement: This work was funded by the Universidad de Las Americas Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The current epidemiological study included ecological data from all reported cases of femicide, homicides and crime related deaths in Ecuador. This analysis did not contain access to any source of identifiable information. The entire dataset is anonymized and is publicly available in the following website https://www.ecuadorencifras.gob.ec/nacimientos_y_defunciones/. According to the international good clinical and research practice and in accordance with Ecuadorian legislation on clinical investigation involving humans, ethical approval by a local or international institutional review board (IRB) is not required.