Women's Perceptions and Experiences of Domestic Violence: An Observational Study From Hyderabad, Pakistan

Exclusive breastfeeding and its association with intimate partner violence during pregnancy: analysis from Pakistan demographic and health survey

BACKGROUND

Intimate partner violence (IPV) is a global social issue and increasingly asks for the attention of policymakers. IPV is one of the main factors that affect the health of pregnant women and their infants during pregnancy and after childbirth; it will not only cause direct harm to women themselves but also reduce women's exclusive breastfeeding (EBF) behavior and pose a threat to newborn health. Existing facts on the association between IPV and EBF in the Pakistani context are negligible and incomplete to an enduring measure of IPV practice. To this effect, the present study aims to investigate the relationship between EBF and IPV practiced during the prenatal period and post-delivery.

METHODS

The statistics study has drawn from the Pakistan Demographic and Health Survey (PDHS) 2018. A total of 1191 breastfeeding females aged 15-49 with children under 6 months were selected for the present study. T-test or chi-square test of Univariate test of hypothesis; Logistic regression model was utilized to explore the potential impact of IPV on female exclusive breastfeeding from three dimensions of physical, sexual and psychological violence, to provide data support for the Pakistani government to formulate policies to promote female EBF. All investigations have been performed in STATA software 16.0 (Stata Corp, College Station, TX, USA) at 95% confidence interval.

RESULTS

Among the 1191 participants, 43.6% (520 / 1191) of the females were EBF, while the rates of physical, sexual, and emotional IPV were 47.44%, 30.23%, and 51.72%, respectively. Logistic regression analysis showed that females who have experienced physical IPV were 32% less likely to be exclusively breastfed (aOR = 0.68; 95% CI; 0.490, 0.980; P < 0.05), the chances of EBF were reduced by 22% in women who experienced IPV (aOR = 0.78; 95 CI; 0.55, 1.00; P < 0.05), females who experienced emotional IPV were 31% less probable to exclusively breastfed (aOR = 0.69; 95% CI; 0.47, 0.92; P < 0.05).

CONCLUSIONS

This study determines the adverse effects of sexual and psychological violence on EBF practices in women. Policymakers in Pakistan should actively implement assistance programs to reduce IPV, emphasize monitoring women's experiences of IPV before and after giving birth, and encourage women to break the "culture of silence" when they experience IPV to maximize their access to assistance.

Intimate partner violence among young women in Ibadan, Nigeria: are there slum and non-slum differences?

This study determined the past-year prevalence of physical, sexual and psychological intimate partner violence (IPV) and associated factors among young women in urban slums and non-slums of Ibadan, Nigeria.A cross-sectional study, using a multistage cluster sampling method was used to select 1050 ever-partnered young women aged between 18 and 24 years from the five Local Government Areas (LGAs) in Ibadan municipal. All localities were classified into slums and non-slums using the UN-Habitat 2003 criterion. Independent variables were respondents' and partners' characteristics. Dependent variables were physical, sexual and psychological IPV. Data were analysed using descriptive statistics and binary logistic regression model (α0.05).Prevalence of physical (31.4%, 13.4%), sexual (37.1%, 18.3%), and psychological IPV (58.6%, 31.5%) were significantly higher in the slum than non-slum communities. Multivariate analysis showed that secondary education (aOR:0.45, 95%CI: 0.21 - 0.92) reduced IPV experience while being unmarried (aOR:2.83, 95%CI: 1.28 - 6.26), partner's alcohol use (aOR:1.97, 95%CI: 1.22 - 3.18), and partner's relationship with other women (aOR:1.79, 95%CI: 1.10 -2.91) increased IPV experience in slum communities. In non-slum communities, having children (aOR:2.99, 95%CI: 1.05-8.51), non-consensual sexual debut (aOR: 1.88, 95%CI: 1.07-3.31) and witness of abuse in childhood (aOR:1.82: 95%CI: 1.01 - 3.28) increased experience of IPV. Acceptance of IPV and partner's witness of abuse in childhood increased experience of IPV in both settings.This study confirms that IPV is common among young women in Ibadan, Nigeria, but higher among women in slum communities. Findings also showed different factors associated with IPV in slum and non-slum communities. Therefore, targeted interventions for each urban stratum are recommended.

Men Have Gender and Women Are People: A Structural Approach to Gender and Violence

The relationship between violence and patriarchal gender systems is structural and coconstitutive; yet structural analyses that account for gender in explanations and conceptualizations of violence are often absent from violence scholarship. Additionally, there are numerous underassessed areas in more gender-nuanced, "gender-based" violence paradigms. We address the shortcomings of both types of research and propose a cohesive theoretical framework that captures the ways in which violence is patriarchy-enhancing and patriarchy-facilitated. Violence shapes and influences gender performances and structures and, concomitantly, the gender order shapes and influences violence in given contexts.

Violence by Burning Against Women and Girls: An Integrative Review

Violence against women and girls by burning is a serious and confronting form of gender-based violence. Often, perpetrators aim to disfigure their victims or cause great pain, rather than kill them. Little is known about the characteristics of females who are subjected to violence by burning. This study aimed to review the literature concerning the prevalence, demographic profile, injury event, contributing factors and health outcomes for women and girls who have experienced burn-related violence. A search across five databases (PubMed, CINAHL, PsycINFO, Scopus and LILACS) was conducted up to April 2021 to identify original peer-review research, with a focus on violence by burning against women and girls. The review was guided by the five-stage approach to integrative reviews developed by Whittemore and Knafl (2005). Fifteen studies were identified. Victims were predominantly married, with low socio-economic status, limited education, and high emotional and financial dependency on their partners or families. Burn injuries were mostly caused by flame or acid, with significant morbidity or high mortality. Motives included family/marital issues or property/financial disputes. This review identified the limited evidence available in the peer-reviewed literature related to burn-related violence against women and girls worldwide. Findings suggest the need for further research to provide a clearer understanding of the complex issues involved.

Using mixed models to examine the factors associated with intimate partner violence among married women in Pakistan

Currently, the rate of intimate partner violence (IPV) in Pakistan is 29%, which is likely an underestimate. This study used mixed models to examine the effects of women empowerment, women and husband's education, number of adult women in a household, number of children 5 or under in a household, and place of residence on physical violence and controlling behavior, controlling for women's current age and wealth status. Nationally representative data collected from 3,545 currently married women in the Pakistan Demographic and Health Survey (2012-2013) was used for the current study. Mixed models were estimated separately for physical violence and controlling behavior. Logistic regression was also used to conduct additional analyses. Results indicated that women and their husband's education, and number of adult women in a household were associated with a decrease in physical violence, whereas women's empowerment, and women and their husband's education were associated with a decrease in controlling behavior. The implications and limitations of the study are discussed.

Intimate partner violence against women in Southern Punjab, Pakistan: A phenomenological study

BACKGROUND

Intimate Partner Violence (IPV) refers to behavior by an intimate partner that can cause physical, sexual, or psychological harm; is a common global public health issue requiring immediate attention. IPV is the most common form of violence in rural areas of Punjab, Pakistan.

METHODS

This qualitative phenomenological study collected 46 in-depth interviews from married women who experienced IPV in the rural areas of South Punjab. A semi-structured interview guide was used for data collection. These women were selected through a snowball sampling technique from October 2018 to March 2019. Researchers accessed the study setting with the help of gatekeepers (Lady Health Workers and Village Heads). The interviews were audio-recorded in the local language (Saraiki) and were translated into English. The data were analyzed using the thematic inductive analysis technique.

RESULTS

The study has presented multifaceted factors of IPV by using the socio-ecological framework in rural areas of South Punjab, Pakistan. The current study introduced culturally contextualized terminologies of "protection," "physical submissiveness," "mental delicacy," and "social security". For married women, culturally embedded terms became the primary cause of IPV. In addition, the study also highlighted some of the cultural terminologies (such as run-mureed, watta-satta, beghairat, izzat, etc.) that are ubiquitous in the local context that sometimes intensifies IPV in the family and community sphere. Furthermore, the study discussed how gender-based inequalities trigger a status quo that ultimately creates power discrimination between spouses, which perpetuates violence in the domestic context.

CONCLUSIONS

Gender-prejudiced roles and expectations imposed by orthodoxy, misinterpretations of Islamic teachings, and dominant patriarchy can be contested through awareness campaigns among the public, and gender sensitization drives among public institutions of police and judiciary. Education and employment-based can lead to women's empowerment and help to challenge the orthodox anti-feminist societal norms and the role of kinship-based networks in the family and community sphere.

The Link Between a Husband's Trust in Informal Institutions and Domestic Violence Against His Wife: Evidence From Pakistan

The global and national push to strengthen informal institutions' role in increasing rural households' access to justice has often met with skepticism in South Asia. This is because the impact of such initiatives on women's welfare is debatable in many contexts due to reports of informal institutions' hostile and oppressive behavior toward women. This study contributes to this debate by presenting the first empirical evidence of gender difference in trust in informal village institutions. The study also tests the relationship between a husband's trust in informal institutions and his tendency to commit physical violence against his wife. It uses the Pakistan Rural Household Panel Survey datasets of more than 2,000 households from three provinces (Punjab, Sindh, and Khyber Pakhtunkhwa) of Pakistan. Trust in local political institutions is measured by (a) respondent's reliance on village institutions for handling general community affairs and maintaining law and order and (b) respondent's perceptions of local government's effectiveness in dispute settlement and ensuring public security. Men's and women's trust in informal village institutions and their perceptions of these institutions' legitimacy do not significantly differ in most cases. Women exhibit a greater trust and confidence in informal institutions that hold regular resident meetings than in those that do not. The results also reveal a significant negative relationship between a husband's trust in informal institutions and the incidence of physical violence against his wife. Greater trust in informal institutions has a significant positive correlation with a husband's psychological well-being, his relationship with family, and his perceptions of institutional legitimacy. The findings imply that well-performing informal institutions work as an indirect deterrent for domestic violence in the study areas of Pakistan.

Barriers to help-seeking from healthcare professionals amongst women who experience domestic violence - a qualitative study in Sri Lanka

BACKGROUND

Domestic violence (DV) is a major global public health problem which is associated with significant adverse consequences. Although Sri Lankan women who experience DV receive treatment from healthcare professionals (HCPs) for DV related physical and psychological problems, disclosure of DV within health services is quite low. This study explored barriers to disclosure of DV to HCPs among Sri Lankan women who experience DV.

METHOD

This qualitative study took place in the Central Province of Sri Lanka. Twenty women who had experienced DV were recruited from Gender Based Violence Centers (Mithuru Piyasa Centers) and a toxicology unit of the two selected hospitals. Participants were purposefully selected using maximum variation sampling technique. In-depth interviews were conducted until data saturation was reached. Interviews were recorded, and analyzed using thematic analysis.

RESULTS

Survivor related barriers to help seeking included women's lack of knowledge and perceptions about the role of HCPs, lack of confidence in HCPs, fear of repercussions, personal attitudes towards DV, and their love and loyalty towards the perpetrator. Women preferred it if HCPs initiated discussions about DV, and they valued it when HCPs could be confidential and protect their privacy, and give enough time for DV related issues during consultations. A perpetrator related barrier was the controlling behavior of the perpetrator. Social stigma and social and cultural norms about the role of women emerged as the socio-cultural constraints to disclosure.

CONCLUSIONS

Barriers to help seeking for DV from HCPs exist at individual, healthcare level, and societal level. Community programs are needed to increase women's access to healthcare services and interventions should be implemented to develop effective, preventive, and supportive strategies at the healthcare system level.

The Association Between Child Marriage and Domestic Violence in Afghanistan

Child marriage and intimate partner violence have been globally recognized as human rights violations. Both indicators can derail an individual's future and have various public health implications. Previous studies have shown an association between child marriage and domestic violence in low- and middle-income countries; however, data in Afghanistan are not known. This study aimed to assess the association between child marriage and domestic violence in Afghanistan. We used nationally representative data collected by the Demographic and Health Surveys to conduct logistic regression analyses. Child marriage was separated into three categories: very early marriage (<15 years), early marriage (15-17 years), and adult marriage (≥18 years). Domestic violence was the response variable and was assessed as any violence, physical violence, emotional violence, and sexual violence. Of the sample (N = 21,324), 15% of the respondents were married before the age of 15; 35% were married between the ages of 15 and 17; and 50% were married as adults. After adjusting for current age, place of residence, and socioeconomic status, the odds of sexual violence were 22% higher among women who married before age 15 compared with those married as adults (OR = 1.22, 95% CI = [1.05, 1.40], p = .005). However, the odds of reporting any violence, physical violence, and emotional violence among those who married as children did not differ compared with those who married as adults. This may be due to a shift in traditional norms or underreporting in Afghanistan. This study adds to the body of research on child marriage and intimate partner violence, and specifically provides novel information on this association in Afghanistan.

Prevalence and Predictors of Violence Against Women in Pakistan

Violence against Pakistani women occurs at an alarming prevalence that reflects a significant risk to the health of women and families. Understanding violence against women in Pakistan comes with methodological and cultural complexities. Many of the studies examining prevalence and predictors of violence against women tend to utilize convenience samples contributing to the possibility of an inflated prevalence. Due to the patriarchal family structure and cultural context, domestic violence is normalized resulting in extremely low reporting rates. The present study utilizes a sample of ever-married Pakistani women collected across five provinces to shed light on the prevalence and predictors of women that experience domestic violence (emotional or physical abuse). Data were obtained from the 2012-2013 Pakistan Demographic and Health Survey including a large sample of Pakistani women from five provinces (Sindh, Punjab, Balochistan, Khyber Pakhtunkhwa, and Gilgit Baltistan). Binary Linear regressions were conducted to examine how intrinsic variables (age, education, region, urban/rural, type of marital relationship, and wealth) predicted experiencing emotional or physical abuse from one's husband within the past year. Approximately, 20% of women endorsed experiencing physical violence and 28% endorsed experiencing emotional violence. Results found that educational level, wealth, and type of marital relationship were associated with a higher likelihood of experiencing some form of physical or emotional violence. Implications from this study support policy interventions aimed at education within the family, linking women with resources, and continued investment in the education of young women. Interventions would be best targeted in low wealth regions with a special emphasis on rural areas.

Is Women's Tendency to Negotiate Safer Sex Another Opportunity for Intimate Partner Violence in Nigeria?

Husband's controlling and domineering attitudes have been shown to contribute to women's intimate partner violence experience in Nigeria. Some scholars have suggested that women's safer sex negotiation may create additional opportunity for incurring partner violence. The purpose of the current study was to test the possibility that married women's tendency to negotiate safer sex would contribute significant additional proportions of the variance in their experience of physical, sexual, and emotional violence. Using nationally representative data from a sample of married women in Nigeria (N = 19,360), three separate hierarchical regression analyses were performed to examine the contributions of husband's controlling and domineering attitudes and tendency to negotiate safer sex to the three types of violence experience. Regression analyses revealed that women whose husbands endorsed more controlling and domineering attitudes experienced more physical, sexual, and emotional violence. Furthermore, women with higher tendency to negotiate safer sex experienced more of all the forms of violence. After accounting for the influence of husband's controlling and domineering attitudes, regression analyses revealed that women's tendency to negotiate safer sex accounted for significant additional contributions of the variance in physical, sexual, and emotional violence experience. The additional contributions suggest that specific interventions may be needed for improving women's negotiation skills to reduce husband perpetrated violence risk.

Participation in household decision making and justification of wife beating: evidence from the 2018 Mali Demographic and Health Survey

Background

We assessed the association between women's participation in household decision making and justification of wife beating among married women ages 15–49 y in Mali.

Methods

We employed a cross-sectional study design among 7893 women of reproductive age involving a two-stage sampling technique using version 6 of the Mali Demographic and Health Survey (MDHS) data, which was conducted in 2018.

Results

Approximately 37% participated in at least one household decision while 23.4% reported that they would not justify wife beating in any of the stated circumstances. Women who participated in at least one household decision had lower odds (adjusted odds ratio [AOR] 0.834 [confidence interval {CI} 0.744 to 0.935]) of justifying wife beating. With respect to the covariates, we found that women 45–49 y of age had lower odds of justifying wife beating compared with those ages 15–19 y (AOR 0.569 [CI 0.424 to 0.764]). Women with higher education (AOR 0.419 [CI 0.265 to 0.662]) and those whose husbands had secondary education (AOR 0.825 [CI 0.683 to 0.995]) had lower odds of justifying wife beating. Women who lived in urban areas were less likely to justify wife-beating (AOR 0.328 [CI 0.275 to 0.390]) compared with those who lived in rural areas.

Conclusion

This study suggests that participation in household decision making is associated with a significantly lower rate of justifying wife beating in Mali. These results underscore the need for various interventions to empower women to increase women's participation in decision making to reduce justification of domestic violence.

Understandings and Perceptions of Domestic Violence Among Newly Arrived Afghan Women in Australia

Women's perceptions of domestic violence vary across societies and cultures and might change by moving to a new society. This study aims to explore newly arrived Afghan women's understandings and perceptions of domestic violence and whether they perceive this as acceptable. Semi-structured interviews were conducted with 21 newly arrived Afghan women in Australia. Interviews were audio-recorded, transcribed, and analyzed inductively to generate and organize themes. The findings showed that informants had a sound knowledge and understanding of domestic violence, and many of them identified various forms of violence. Also, informants strongly rejected that violence against women be considered normal or acceptable.

Epidemiological profile of female firearm-related mortality

ABSTRACT

The mortality rate of women due to firearms increases every day in Brazil and globally. This study aimed to evaluate the trends of firearm-related mortality in women from the years 2007 to 2016 in order to determine their profile and to associate these indicators with public policy and strategies to reduce mortality.This is an ecological time-series study using secondary data of women aged 10 to 49 years old collected through the mortality information system (SIM) in Brazil. Furthermore, independent characteristics such as education, color, race and civil status were also collected from SIM. Data was analyzed using the Join Point open source software version.There was an increase in the mortality rate of women who received 4 to the 7 years of education, were single, and brown-skinned. There was a significantly increased rate of mortality in women whose ages ranged from 20 to 29 years followed by 30 to 39 years; the rate was also significantly higher in the northeast region followed by the southeast region.There is a need for professional training to assist women in vulnerable situations.

Epidemiological study of injuries caused by violence and conflict in forensic medical records of selected cities of Sistan and Baluchistan province in 2020

Background and Aims

Interpersonal violence is a socially traumatic and unpleasant phenomenon. These violence-related injuries are sometimes irreparable and can become a permanent problem, Violence in Iran is one of the five most socially harmed and has increased dramatically in recent years, therefore the present research aimed to investigate epidemiological study of injuries caused by violence and conflict in forensic medical records of selected cities of Sistan and Baluchistan province in 2020 considering this subject must be one of our priorities.

Methods

This study was a descriptive study performed in forensic medicine centers of two cities in Sistan and Baluchistan province, Iran. The population consisted of existing citations and records, sample size based on similar studies and the recommendation of professors, all available records were considered and census method was used to select the samples. The data gathering tool consisted of two sections: demographic information and violence and conflict. Content validity method and reliability test were used to determine the validity and reliability. Data were analyzed using SPSS24 software.

Results

The results showed that the majority of the sample was 20-29 years old, male, married, self-employed and high school graduated, living in the eastern part of the city, with no history of mental illness, domestic violence, child abuse, and spouse abuse. The majority of the study units did not use any drugs. The most violent were beatings and bullying. It included several organs such as limbs, soft tissue damage with bleeding.

Conclusion

The results of this study indicate the importance of epidemiological analysis of violence and conflict in the provinces under study and show that appropriate solutions and culture building, as well as increasing awareness of the impact of violence and conflict on individuals and their injuries.

Violent Discipline Behaviors in Mothers of Preschool Children in Malatya, East Anatolia

Violent parenting behavior, whether physical or psychological, give harms to child well-being. This study was conducted to describe and compare the prevalence of discipline methods used by mothers of 2- to 5-year-old children in Malatya, Turkey. This is a cross sectional study and 552 mothers were administered a face-to-face questionnaire describe the methods they use to discipline their children in the year previous the survey. It was observed that nine of 10 women used violence on their children physically and psychologically. The study showed that nine of 10 mothers used physical and/or psychological punishment toward their children in the previous year. Nonviolent discipline was less prevalent than punitive discipline, such as psychological and physical punishment. The most commonly used method was psychological punishment. Significant sociodemographic associations with discipline methods were found. Mother's educational level, family income, child gender, and child age were the independent predictors that explained discipline methods used by mothers. Starting parenting classes and strengthening the child protection systems at national level were suggested.

South Asian Albertan Men's Understandings of Spousal Violence

This qualitative study investigated understandings of spousal violence among 17 South Asian men residing in Alberta, Canada using focus groups. Thematic analysis revealed men's ignorance about sexual coercion as a form of abuse, although they had a solid understanding of physical and financial abuse. The men identified novel forms of emotional torture, as well as two types of transnational abuses that occur in their communities which have not emerged from previous studies: framing wives for false crimes across international borders and forced participation in family chain migration. Implications for violence prevention, assessment, intervention, and transnational law enforcement are discussed.

Assessment of intimate partner violence abuse ratings by recently abused and never abused women

Background

There are a paucity of directly reported intimate partner violence survivors’ experiences, especially in women of color. This study measures recently/currently abused women’s ratings of varied abuse events compared to ratings from never abused women.

Methods

Women in a single, urban, public hospital emergency department (ED) were screened for intimate partner violence using the Abuse Assessment Screen (AAS). Two groups were identified - women abused within 1 year by an intimate partner or family member and those who screened negative for abuse. Using a two-group longitudinal survey and interview format, women completed visual analog scale ratings (0–100) for each of 20 abuse events/types. For analysis, each abuse type was placed on the 0–100 scale according to its designated rating.

Results

Average age of participants in the abuse group (n = 30) was 33. Never abused women averaged age 50 (n = 32). The majority of participants were African-American: abused 67% and never abused 94%. Abused women rated name-calling (p < 0.02) and put-downs (p < 0.01) as more severe than never abused women. Other non-physical and physical forms of abuse such as threats, control, burns or forced sex were perceived more similarly between groups.

Conclusions

Abused women perceive verbal abuse events differently compared to never abused women.

"Women hope the situation will change, and their husbands will change with it": narratives of intimate partner violence in Gaza

The authors' purpose in conducting this study was to identify barriers faced by survivors of intimate partner violence (IPV) in accessing services in Gaza. We collected data via in-depth interviews with women (ages 18-49; n = 25). Respondents were recruited through convenience sampling from women's organizations. Interviews were transcribed, translated, and coded using an inductive approach. Results indicate three main factors that influence help-seeking: perceived transgression of traditional gender roles; distrust of women's centers; and contextual acceptance of IPV. An understanding of emic perceptions of IPV can inform the design and delivery of support services and increase access to interventions for women in Gaza.

Seeking Help in Domestic Violence Among Muslim Women in Muslim-Majority and Non-Muslim-Majority Countries: A Literature Review

OBJECTIVE

Women from different backgrounds and cultures are at risk of domestic violence. Disclosing the abusive experience and seeking help is not straightforward and easy and might be a complicated and long-term process. Muslim women, like other groups of women, may face various barriers to disclose abusive relationships and for seeking help. Some of the barriers may be common for the majority of Muslim women in different contexts, while others might be related to women's situations and the wider society they live. To identify these barriers and make recommendations for future studies, this article reviews related papers conducted in both Muslim-majority and non-Muslim-majority countries.

METHOD

A critical systematic review of the literature was conducted for identifying Muslim women's barriers in disclosing abuse and seeking help.

RESULTS

Twenty-one studies met the inclusion criteria. The main identified barriers are discussed into under four themes: social context, family context, individual factors, and expectations of service providers.

CONCLUSIONS

Although the researchers tried to investigate various barriers in seeking help, many of them have not focused on structural obstacles. Besides, in many Muslim-majority countries, the issue has not been explored. Therefore, the results of the current article will not apply to those countries. Recommendation for future research comprises more qualitative research compatible with the women's cultures and backgrounds in different societies, focusing more on structural and cultural factors to explore and find women's barriers to seek help.

Community stakeholders' views on reducing violence against women in Pakistan

BACKGROUND

Nearly half of the women experience violence across their lifespan in all the provinces of Pakistan at an alarming rate. Despite knowing the prevalence, there has been meager progress in developing strategies to combat violence at individual, family, or community level. Many interventions suggested in other countries have been pilot tested but the effects of those interventions had been limited. Therefore, the aim of this study is to understand the voices of stakeholders to reduce Violence Against Women (VAW) and to explore the possible community-based strategies that could be implemented in Pakistan.

METHODS

A total of 14 Key Informant Interviews (KIIs) and 18 Focus Group Discussions (FGDs) were held across all four provinces of Pakistan. Participants were purposefully recruited and all the interviews were audio-recorded. Transcriptions were open coded and content analysis was done to emerge codes, categories and themes. Ethical approval was obtained from Aga Khan University Ethics Review Committee.

RESULTS

Three major themes emerged on community members and stakeholders' views on VAW: a) community's perception of VAW b) the repercussions of VAW, and c) multiple voices regarding strategies to reduce VAW. Participants voiced the need of standing against the status quo, role of awareness and education: regarding capacity building skills, promotion of women rights and women empowerment through Life Skills Based Education (LSBE) through national health works program, has been proposed as an innovative strategy to reduce VAW.

CONCLUSIONS

The responsibility to bring about a substantial change in behavior and attitudes must begin with engaging men in all the interventions that aim to reduce violence. Since, VAW is very much linked with the cultural norms, so, without community stakeholder's involvement and participation it could never be reduced. Keeping the existing socio-cultural dynamics in mind, the need of time is to design and implement innovative interventions that are culturally and contextually appropriate and can be expanded across the country.

An Assessment of the Prevalence, Perceived Significance, and Response to Dowry Solicitation and Domestic Violence in Bangladesh

The current study focuses on the prevalence of two pervasive gender-related crimes in Bangladesh: dowry solicitation and domestic violence. We assess victim perceptions of how these two crimes rank in significance compared with other types of crimes experienced and the actions victim households took in response. Our research builds on prior qualitative studies by making use of nation-wide household survey data, collected by the World Bank, to examine dowry and domestic violence in the context of all legal conflicts experienced by households in every administrative region of the country. The analyses show that both dowry solicitation and domestic violence rank in the top five most common crimes, including violent and non-violent crimes. Women report more experiences of dowry solicitation and domestic violence, with urban females most frequently disclosing both. Among the households that experienced multiple types of violent and non-violent crimes, 55.9% of dowry and 70.8% of domestic violence victims reported another crime ranked higher in significance. Of the households that considered these two crimes the most serious they experienced, 56.1% of dowry and 32.5% of domestic violence households took no action at all in response. Among the households that took action, most eschewed both police and state judicial institutions. Choosing to act alone or with the help of family members was the most frequent response. The findings illustrate the need for governance reforms in Bangladesh and may inform state and non-state improvement initiatives.

Theory and practice of social norms interventions: eight common pitfalls

BACKGROUND

Recently, Global Health practitioners, scholars, and donors have expressed increased interest in "changing social norms" as a strategy to promote health and well-being in low and mid-income countries (LMIC). Despite this burgeoning interest, the ability of practitioners to use social norm theory to inform health interventions varies widely.

MAIN BODY

Here, we identify eight pitfalls that practitioners must avoid as they plan to integrate a social norms perspective in their interventions, as well as eight learnings. These learnings are: 1) Social norms and attitudes are different; 2) Social norms and attitudes can coincide; 3) Protective norms can offer important resources for achieving effective social improvement in people's health-related practices; 4) Harmful practices are sustained by a matrix of factors that need to be understood in their interactions; 5) The prevalence of a norm is not necessarily a sign of its strength; 6) Social norms can exert both direct and indirect influence; 7) Publicising the prevalence of a harmful practice can make things worse; 8) People-led social norm change is both the right and the smart thing to do.

CONCLUSIONS

As the understanding of how norms evolve in LMIC advances, practitioners will develop greater understanding of what works to help people lead change in harmful norms within their contexts. Awareness of these pitfalls has helped several of them increase the effectiveness of their interventions addressing social norms in the field. We are confident that others will benefit from these reflections as well.

Community perceptions on domestic violence against pregnant women in Nepal: a qualitative study

Background

Globally, knowledge of health sector options to respond to domestic violence during pregnancy is increasing, but this topic is under-investigated in Nepal. This gap affects the provision of adequate antenatal care services and understanding of factors that influence women’s willingness and ability to use available services. It is critical to know more about the social norms in a community that promote and prevent women experiencing domestic violence from seeking antenatal care.

Objective

To explore community perceptions of domestic violence against pregnant women.

Methods

A qualitative study was conducted in Dhulikhel municipality, involving 41 men and 76 women in 12 focus group discussions in different gender and family role separated groups. The interviews were recorded, transcribed in verbatim, and analyzed using content analysis. A socio-ecological model was used as a theoretical framework to illustrate linkages between individual, relationship, community, and societal influences on perceptions of domestic violence during pregnancy.

Results

The community recognized different forms of violence during pregnancy threatening women’s physical and psychological health and presenting obstacles to seeking antenatal care. Some types of culturally specific violence were considered particularly harmful, such as pressure to give birth to sons, denial of food, and forcing pregnant women to do hard physical work during pregnancy, which may leave daughters-in-law vulnerable to domestic violence in extended families. A culture where violence is normalized and endurance and family reconciliation are promoted above individual health was perceived to cause women to tolerate and accept the situation. Participants suggested actions and strategies to address continuing violence, which indicated a societal transition toward increased awareness and changing attitudes and practices.

Conclusions

Domestic violence during pregnancy needs to be addressed at different levels in Nepal, where women are often dependent on others for access to health care. Social norms were perceived to be shifting toward reduced acceptance of violence against women, but restrictions on women’s life options, movement, and decision-making authority were still considered impediments to pregnant women’s health.