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LONDON -- About a third of women worldwide have been physically or sexually assaulted by a former or current partner, according to the first major review of violence against women.

In a series of papers released on Thursday by the World Health Organization and others, experts estimated nearly 40 per cent of women killed worldwide were slain by an intimate partner and that being assaulted by a partner was the most common kind of violence experienced by women.

"Violence against women is a global health problem of epidemic proportions," WHO Director-General Dr. Margaret Chan said in a statement.

The rate of domestic violence against women was highest in Africa, the Middle East and Southeast Asia, where 37 per cent of women experienced physical or sexual violence from a partner at some point in their lifetime. The rate was 30 per cent in Latin and South America and 23 per cent in North America. In Europe and Asia, it was 25 per cent.

In Canada, 40 per cent of violent crime reported to police was committed against women by former or current spouses or partners, according to Statistics Canada data from 2010. Forty-nine per cent of all solved homicides were women killed by their partners.

Data on domestic violence is largely compiled through police reports. As a result, the figures often understate the extent of the problem, said Sheila Sprague, a PhD student at McMaster University in Hamilton, who recently co-edited a paper on intimate partner violence.

Many women do not feel comfortable reporting abuse, she said, and even if the evidence is clear, there is no mandatory reporting of abuse within Canada.

The research she was involved in found a high prevalence of violence against women. Anonymous questionnaires distributed at orthopedic fracture clinics across Canada, along with a handful in the US, Europe, and one in India, asked women about their personal experience of abuse.

One in three reported they had been a victim of abuse in their lifetime, and one in six in the past year, she said. One in 50 had visited the clinic specifically for a domestic-related injury, and of those, 80 per cent had severe fractures, a point where these women could be "one step away from homicide."

At fracture clinics, she said, surgeons see women with severe fractures every day.

And domestic violence is not limited to a certain profile, she cautioned.

"I think domestic violence covers all education levels, all income levels, all cultures, all ethnicities."

WHO defined physical violence as being slapped, pushed, punched, choked or being attacked with a weapon. Sexual violence was defined as being physically forced to have sex, having sex because you were afraid of what your partner might do and being compelled to do something sexual that was humiliating or degrading.

The report also examined rates of sexual violence against women by someone other than a partner and found about 7 per cent of women worldwide had previously been a victim.

In conjunction with the report, WHO issued guidelines for authorities to spot problems earlier and said all health workers should be trained to recognize when women may be at risk and how to respond appropriately.

Globally, the WHO review found 30 per cent of women are affected by domestic or sexual violence by a partner. The report was based largely on studies from 1983 to 2010. According to the United Nations, more than 600 million women live in countries where domestic violence is not considered a crime.

Some experts said screening for domestic violence should be added to all levels of health care, such as obstetric clinics.

"It's unlikely that someone would walk into an ER and disclose they've been assaulted," said Sheila Sprague of McMaster University, who has researched domestic violence in women at orthopedic clinics. She was not connected to the WHO report.

"Over time, if women are coming into a fracture clinic or a pre-natal clinic, they may tell you they are suffering abuse if you ask," she said.

For domestic violence figures, scientists analyzed information from 86 countries focusing on women over the age of 15. They also assessed studies from 56 countries on sexual violence by someone other than a partner, though they had no data from the Middle East. WHO experts then used modeling techniques to fill in the gaps and to come up with global estimates for the percentage of women who are victims of violence.

In a related paper published online in the journal Lancet, researchers found more than 38 per cent of slain women are killed by a former or current partner, six times higher than the rate of men killed by their partners. Heidi Stoeckl, one of the authors at the London School of Hygiene and Tropical Medicine, said the figures were likely to be an underestimate. She and colleagues found that globally, a woman's highest risk of murder was from a current or ex-partner.

In countries like India, Stoeckl said things like "honour killings," where women are sometimes murdered over dowry disputes or perceived offences like infidelity to protect the family's reputation, adds to the problem.

She also noted that women and men are often slain by their partners for different reasons.

"When a woman kills her male partner, it's usually out of self-defence because she has been abused," she said. "But when a woman is killed, it's often after she has left the relationship and the man is killing her out of jealousy or rage."

Stoeckl said criminal justice authorities should intervene at an earlier stage.

"When a woman is killed by a partner, she has often already had contact with the police," she said.

Stoeckl said more protective measures should be in place for women from their partners, particularly when he or she has a history of violence and owns a gun.

"There are enough signs that we should be watching out for that," she said. "We certainly should know if someone is potentially lethal and be able to do something about it."