infections following a rape. Tertiary prevention – approaches that focus on long-term care in the wake of violence, such as rehabilitation and reintegration, and attempt to lessen trauma or reduce long-term disability associated with violence. A public health approach emphasizes the primary prevention of violence, i.e. stopping them from occurring in the first place. Until recently, this approach has been relatively neglected in the field, with the majority of resources directed towards secondary or tertiary prevention. Perhaps the most critical element of a public health approach to prevention is the ability to identify underlying causes rather than focusing upon more visible "symptoms". This allows for the development and testing of effective approaches to address the underlying causes and so improve health. The public health approach is an evidence-based and systematic process involving the following four steps: Defining the problem conceptually and numerically, using statistics that accurately describe the nature and scale of violence, the characteristics of those most affected, the geographical distribution of incidents, and the consequences of exposure to such violence. Investigating why the problem occurs by determining its causes and correlates, the factors that increase or decrease the risk of its occurrence (risk and protective factors) and the factors that might be modifiable through intervention. Exploring ways to prevent the problem by using the above information and designing, monitoring and rigorously assessing the effectiveness of programmes through outcome evaluations. Disseminating information on the effectiveness of programmes and increasing the scale of proven effective programmes. Approaches to prevent violence, whether targeted at individuals or entire communities, must be properly evaluated for their effectiveness and the results shared. This step also includes adapting programmes to local contexts and subjecting them to rigorous re-evaluation to ensure their effectiveness in the new setting. In many countries, violence prevention is still a new or emerging field in public health. The public health community has started only recently to realize the contributions it can make to reducing violence and mitigating its consequences. In 1949, Gordon called for injury prevention efforts to be based on the understanding of causes, in a similar way to prevention efforts for communicable and other diseases. In 1962, Gomez, referring to the WHO definition of health, stated that it is obvious that violence does not contribute to "extending life" or to a "complete state of well-being". He defined violence as an issue that public health experts needed to address and