Sexual harassment in public spaces is an insidious form of violence against women in South Asia where it is referred to as “eve teasing” and most-often occurs in public spaces. This public phenomenon of sexual harassment may be related to high gender inequality in South Asia compared to other world regions. Despite broad concern for the over 500 million women and girls at risk in South Asia, empirical evidence, including its prevalence, is nearly non-existent. Furthermore, comparison studies are needed across world regions to unpack the influence of cultural norms and gender equity on how sexual harassment is defined and experienced in different contexts. In the first phase of our research, mixed methods were used to define the meaning of sexual harassment in rural India and a questionnaire to measure its occurrence was developed and assessed for face validity and internal reliability (Cronbach's alpha: 0.84). Qualitative findings identified behaviors that characterize sexual harassment and suggest that victimization leads to shame, depression, suicide, and honor killing, which is indicative of a culture where premarital romance is taboo. Prevalence of victimization in the past one year among females age 15-24 in 19 villages was 28.8% (CI:22.5 – 38.3) (N=198). An association was found between victimization and screening positive for common mental disorders (CMD), but only among participants who also screened positive for adverse childhood events (ACES) (OR: 4.5, CI: 1.78 – 11.4, p-value 0.003). Building upon these findings and in preparation for larger studies in other world regions, the instrument was revised and piloted in Ghana, Malawi, South Korea, and other areas of India. The revised instrument includes measures of sexual harassment in the past one year, one month, and ever, and discerns location of perpetration, including workplace, campus, and public settings, and measures level of severity. The questionnaire includes standardized and novel questions to assess physical and mental health status and direct and indirect economic costs associated with victimization. This research advances methodologies to measure the prevalence of sexual harassment in the global south and offers a method to evaluate potential health and economic consequences.