Mujeres abnegadas: The influence of gender expectations on the psychiatric encounter in Mexico

Theories on the cause of mental and emotional distress contribute to illness course and treatment. The theorizing of women's experience "as problem" has been widely critiqued by feminist psychologists yet continues in clinical practice. This qualitative study reports on data collected in a psychiatric outpatient clinic in south/central Mexico on the culturally embedded causal theories of mental illness among Mexican patients, a family member or caregiver, and their psychiatrists. The author reports on the influence of gender expectations and the view of "women as problem" in Mexico. Specifically, stakeholders considered that the idea of "mujeres abnegadas" (self-sacrificing women) was the cause of illness in female patients diagnosed with depressive or anxiety-related disorders. In the face of gendered violence and abuse, Mexican women were expected to be silent and submissive, to suppress their thoughts and feelings, and to endure ("aguantar") their experiences to conform to gender-based expectations, and psychiatrists expressed little hope of alleviating women's suffering. The author discusses her findings in the context of broader sociocultural factors and globalizing forces in psychological theory and practice and provides future directions to help de-pathologize patients' distress, broaden awareness of the contextual forces that influence distress, and galvanize appropriate resources and support.

The Effects of Husbands' Alcohol Consumption and Women's Empowerment on Intimate Partner Violence in India

The influence of husband's alcohol consumption and that of women's empowerment has been largely studied separately in relation to the intimate partner violence (IPV) faced by women, which has hindered a nuanced understanding of gender-based violence in India. This study aimed to understand how husbands' alcohol consumption shapes the relationship between women's empowerment and violence among Indian couples. Data from the 2015-16 National Family Health Survey (NFHS) were used in this study. A composite women's empowerment index was constructed and its association with husbands' drunkenness and odds of facing emotional, physical, severe, and sexual violence was examined. This study found that compared to women whose husbands were never drunk, those whose husbands were sometimes or often drunk had significantly higher odds of experiencing physical, emotional, and sexual violence. For all the types of IPV, an increase in the empowerment index was associated with a significant reduction in the odds of experiencing violence. However, increasing frequency of husband's drunkenness in combination with increasing scores on the empowerment index was associated with a significant increase in the odds of IPV, except sexual violence. Our findings highlight the nuances of IPV, situating the experiences of women in the social, cultural, and economic realities of Indian society.

Empowerment and IPV in Married Women of Reproductive Age: Evidence from Pakistan Demographic Health Survey 2017-2018

The study was an attempt to identify demographic, household, and women empowerment factors that predicted emotional, physical, and sexual violence in ever-married women of reproductive age (15-49 years, n = 3,965) in Pakistan by performing secondary analysis on Pakistan Demographic and Health Survey, 2017-2018. The analysis was done using SPSS (v.22) and binary and multivariate logistic regression techniques were performed for analyses. The analysis found that 30.2% of women experienced emotional, 24.1% reported less severe physical, 6.5% experienced severe physical, and 4.3% experienced sexual violence, respectively. The multivariate analysis found that husband's age, education, wealth, and alcohol consumption were significant predictors of intimate partner violence (IPV). Additionally, womens' age, education, and number of children also significantly predicted IPV. With respect to empowerment variables, ownership of house was a significant predictor of less severe physical violence, ownership of property significantly predicted emotional violence, and autonomy in household purchase decisions was significantly related to severe physical violence. The control on husband's income as a measure of empowerment significantly predicted all four types of IPV. Belief in patriarchy also turned out to be an important factor in determining emotional and less severe physical violence. The study concludes that women empowerment in household context can prevent less serious forms of violence but to hinder serious forms of violence, interventions at family and community level will be required.

Defining Power and Agency in Gender Relations in El Salvador: Consequences for Intimate Partner Violence and Women's Mental Health

Intimate partner violence (IPV) affects thousands of women around the world and is prevalent in the Global South. Unequal social structures perpetuate hierarchies and maintain women’s vulnerability to violence. Difficulties women face in accessing education, economic resources, and employment diminish their power in intimate relationships, increasing the likelihood of IPV. These factors can also have a significant effect on women’s mental health. However, some studies show that economic empowerment does not necessarily translate into greater agency for women if they cannot use the resources they earn to pursue whatever goals or values they regard as important in life. Agency is women’s ability to identify their life goals and act upon them through critical evaluation (intrinsic agency) and autonomous decision-making (instrumental agency). In this article, we aim to analyze the relationship between women’s power (educational and economic) and agency and their influence on intimate partner violence and on women’s mental health in the context of El Salvador. Currently, El Salvador has one of the highest percentages of femicide worldwide. We used data from the first national survey on violence against women in El Salvador to determine empowerment indicators and investigated their influence on intimate partner violence and women’s mental health. Results from a representative sample of 1,274 women aged between 15 and 64 years old and, using a structural equation modeling revealed that education was a protective factor against IPV, but economic power appeared to put women at greater risk of IPV. Education was positively related to both intrinsic and instrumental agency, but only instrumental agency was negatively associated with the likelihood of being a victim of IPV. Finally, both intrinsic and instrumental agencies were positively related to women’s mental health. We discuss the importance of identifying specific factors related to women’s power and agency to prevent IPV and mental health problems and to promote more gender equity in the Global South.

Length of Women's Stays in Domestic Violence Shelters: Examining the Contribution of Background Variables, Level of Violence, Reasons for Entering Shelters, and Expectations

Women's shelters are one of the most important services established for women who are victims of intimate partner violence against women (IPVAW). Studies indicate that women undergo positive processes in shelters, and the longer the stay in the shelter, the more successful the woman will be in leaving the cycle of violence. However, the literature also reveals a remarkable variance in the length of women's shelter stays, and very little research has been conducted to understand the factors contributing to this variance. The current research focused on the contribution of demographics (ethnic origin, age, education, number of children, and employment situation), history of violence (level of violence, characteristics of violence, and separation attempts from the partner), reasons for entering the shelter, and expectations of the shelter framework to the length of women's shelter stays. Research participants consisted of 506 women living in 12 shelters in Israel. The findings revealed a variance in the length of the women's stays in accordance with their ethnic origins. Women who had immigrated to Israel from Ethiopia or from the former Soviet Union (FSU) stayed in shelters for longer periods of time than did Israeli-born Arab women, who stayed in shelters for significantly shorter periods of time than did Israeli-born Jewish women. There was no contribution of the demographic variables to the variance of length of the woman's shelter stay. In addition, previous separations, emotional abuse, and applying to the shelter following the decision of a child protection worker explained 12% of the variance in the length of the woman's shelter stay. The findings point to a specific profile that seems to predict a woman's longer stay in shelters for women who are victims of intimate partner violence.

Household decision-making and its association with intimate partner violence: Examining differences in men's and women's perceptions in Uganda

Introduction

A vast body of evidence identifies intimate partner violence (IPV) as a public health and human rights issue with detrimental health consequences. The exploration of household decision-making, as an indicator of women's empowerment, and its association with IPV has so far yielded mixed results, mostly due to measurement issues. Given the sizeable investment in women's empowerment initiatives, and their potential to improve women's health, it is important to elucidate the relationship between household decision-making and IPV.

Methods

We conducted a secondary analysis of the 2011 Uganda Demographic and Health Survey (DHS) data to explore the relationship between women's household decision-making and experience of physical IPV. The dependent variable in our analysis was past year physical violence and it was constructed using men's reported perpetration of partner violence (men's questionnaire). Six independent variables were included - one each for men and women's perspectives on who usually makes decisions about the following domains: 1) how money earned is spent, 2) health care, and 3) large household purchases. We ran a probit model, controlling for variables featured in our theoretical framework.

Results

The association between household decision-making and women's likelihood of experiencing IPV depended on the decision-making domain and on who reported it. Women's reporting on decision-making did not predict their experience of IPV, whereas men's reporting on two decision-making domains (large household purchases and expenditure of husband's earnings) predicted likelihood of women experiencing IPV. Joint decision-making and women's decisions alone in both of these domains were associated with a lower probability of IPV compared to husband's making the decisions alone, where husband's reported decision-making.

Conclusion

This study demonstrates that men's views on coupled dynamics should be included in program design and evaluation to provide a more holistic picture of the ecological framework and risk and protective factors of IPV.

Intimate Partner Violence in Relation to Husband Characteristics and Women Empowerment: Evidence from Nepal

The purpose of this study is to assess the magnitude of intimate partner violence (IPV) and associated factors among women in Nepal. The secondary data from the Nepal Demographic and Health Survey (NDHS) 2016 was used. This study was confined to the respondents selected for the domestic violence module. The association between experience of IPV 'ever' and 'in the past year' with selected factors were examined by using Chi-square test, followed by multivariate logistic regression. Complex sample analysis procedure was adopted to adjust for multi-stage sampling design, cluster weight, and sample weight. The result revealed that 26.3% of ever-married women experienced any form of IPV at some point in their lives, while only 13.7% has experienced any form of IPV in the past year. The factors associated with both 'lifetime' and 'past year' experience of IPV includes women witnessing parental violence during their childhood, the husband being drunk frequently, women being afraid of their husband most of the times, and women whose husbands shows marital control behavior. Women's experiencing IPV was associated more with husband related factors than with women's empowerment indicators. Reducing IPV requires a commitment to changing the norms that promote the husband's behavior of controlling his wives and beating her.

Behavioral, Psychological, Gender, and Health Service Correlates to Herpes Simplex Virus Type 2 Infection among Young Adult Mexican-American Women Living in a Disadvantaged Community

Herpes simplex virus type 2 (HSV-2) is among the most prevalent sexually transmitted infections in the United States. Despite this, there has been limited research on the correlates to HSV-2 among disadvantaged and marginalized women, particularly among Latinas. Data for the present analysis include 125 young adult Mexican-American women enrolled in a longitudinal study in a disadvantaged urban community in San Antonio, Texas. The current rate of tested HSV-2 infection is 56.8%. Our findings suggest strong comorbidity of genital herpes with injecting heroin use, Hepatitis C, sexual violence, incarceration, and mental illness. Contributing to this population's nexus of risk are the low rates of health service utilization among those infected with HSV-2. Integration between behavioral health and primary care, including access to preventative services, are essential for improving the health of Latinas living in disadvantaged neighborhoods.

Sexual autonomy and contraceptive use among women in Nigeria: findings from the Demographic and Health Survey data

CONTEXT

The persistent low contraceptive use and high fertility in Nigeria despite improvements in educational achievements calls for an examination of the role of factors, which may moderate the use of modern contraception. This article explores the influence of sexual autonomy on the use of modern contraceptive methods among women and its relative importance compared with other, more traditional, indicators of women's autonomy such as education and occupation.

DATA AND METHODS

Data from two Demographic and Health Surveys (DHS), 2008 and 2013, were used in this study. An index of sexual autonomy was constructed by combining related DHS variables, and its association with current use of modern contraception was examined at each time point as well as over time using multivariate regression analysis.

RESULTS

The observed prevalence for use of modern contraception was 2.8 and 2.6 times higher among women who had high sexual autonomy in 2008 and 2013, respectively. The corresponding figures for women with secondary or higher education were 8.2 and 11.8 times higher, respectively, compared with women with no education. But after controlling for wealth index, religion, place of residence, autonomy and experience of intimate partner violence (IPV), the likelihood of use of modern contraception was lowered to about 2.5 (from 8.2) and 2.8 (from 11.8) times during 2008 and 2013, respectively, among women with secondary or higher education. The likelihood of use of modern contraception lowered only to 1.6 (from 2.8) and 1.8 (from 2.6) times among women with high sexual autonomy after controlling for other covariates, respectively, during the same period.

CONCLUSION

Sexual autonomy seems to play an important role in women's use of modern contraceptive methods independent of education and a number of other factors related to women's status. Sexual autonomy needs to be simultaneously promoted alongside increasing educational opportunities to enhance women's ability to use modern contraception.

Association of intimate partner violence with sociodemographic factors in married women: a population-based study in Iran

Intimate partner violence (IPV) is a neglected public health issue in Iran. This study was conducted among married women residing in urban Rasht (northern Iran), to estimate the prevalence and frequency of different forms of IPV from husband and their associations with socio-demographic factors. We carried out a population-based cross-sectional survey with cluster sampling design from February to October 2015. The samples consisted of married women aged ≥ 18 years with total household in Rasht city (north Iran) as the sample frame. We administered the Revised Conflict Tactics Scale (CTS-2) to estimate prevalence of past-year IPV. Of 2091 women, 57.1% had suffered psychological aggression, 27.6% physical abuse, 26.6% sexual abuse, and 6.9% injury. A significant association with IPV was found for women with, age ≤ 40 years, unemployed, low education, husband's addiction and rented-householders. Women who experienced physical abuse, had less age at marriage than women without violence. Also women with sexual coercion had less length of marriage than other non-abused women. On logistic regression, the strongest predictor of psychological, physical and sexual abuse was unemployment of spouse, whereas for injury it was low educational level (<12 years) of women. Our findings suggest that risk of IPV is high in our population. There is an obvious need of preventive and treatment activities. Our findings point at that various forms of abuse are different from each other in terms of differing characteristics of the perpetrators and it might be that also different strategies are needed to reduce and prevent these violence. Confirmation by further research is needed.

Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda

BACKGROUND

Sexually transmitted infections (STIs) are a major reproductive and public health concern, especially in the era of HIV/AIDS. This study examined the relationship between sexual empowerment and STI status of women in union (married or cohabiting) in Uganda, controlling for sexual behaviour, partner factors, and women's background characteristics.

METHODS

The study, based on data from the 2011 Uganda Demographic and Health Survey (UDHS), analysed 1307 weighted cases of women age 15-49 in union and selected for the domestic violence module. Chi-squared tests and multivariate logistic regressions were used to examine the predicators of STI status. The main explanatory variables included sexual empowerment, involvement in decision making on own health, experience of any sexual violence, condom use during last sex with most recent partner, number of lifetime partners and partner control behaviours. Sexual empowerment was measured with three indicators: a woman's reported ability to refuse sex, ability to ask her partner to use a condom, and opinion regarding whether a woman is justified to refuse sex with her husband if he is unfaithful.

RESULTS

Results show that 28 % of women in union reported STIs in the last 12 months. Sexual violence and number of lifetime partners were the strongest predictors of reporting STIs. Women's sexual empowerment was a significant predictor of their STI status, but, surprisingly, the odds of reporting STIs were greater among women who were sexually empowered. Reporting of STIs was negatively associated with a woman's participation in decision-making with respect to her own health, and was positively associated with experience of sexual violence, partner's controlling behaviour, and having more than one life partner.

CONCLUSIONS

Our findings suggest that, with respect to STIs, sexual empowerment as measured in the study does not protect women who have sexually violent and controlling partners. Interventions promoting sexual health must effectively address negative masculine attitudes and roles that perpetuate unhealthy sexual behaviours and gender relations within marriage. It is also important to promote marital fidelity and better communication within union and to encourage women to take charge of their health jointly with their partners.

Stereotypes of Intimate Partner Violence: Do Sex and Sexual Orientation Matter?

Abstract This study analyzed stereotypes on intimate partner violence (IPV) of heterosexual and same-sex couples. The participants, 232 Mexican college students, evaluated physical and psychological IPV exerted by men and women with different sexual orientations. The data were analyzed using the Wilcoxon test. The results indicate that men evaluated women and gay men as having a similar IPV, while men´s perceptions of IPV for these groups were higher than those of women. Women viewed heterosexual men as the most violent and evaluated the other groups with different degrees of IPV. Physical violence is regarded as natural in men, both gay and heterosexual. To conclude, the results suggest that IPV stereotypes are affected by the sex of the evaluators and by their sexual orientation. It is relevant to expand the scope of prevention programs.

Partners' controlling behaviors and intimate partner sexual violence among married women in Uganda

Background

Studies on the association between partners’ controlling behaviors and intimate partner sexual violence (IPSV) in Uganda are limited. The aim of this paper was to investigate the association between IPSV and partners’ controlling behaviors among married women in Uganda.

Methods

We used the 2011 Uganda Demographic and Health Survey (UDHS) data, and selected a weighted sample of 1,307 women who were in a union, out of those considered for the domestic violence module. We used chi-squared tests and multivariable logistic regressions to investigate the factors associated with IPSV, including partners’ controlling behaviors.

Results

More than a quarter (27%) of women who were in a union in Uganda reported IPSV. The odds of reporting IPSV were higher among women whose partners were jealous if they talked with other men (OR = 1.81; 95% CI: 1.22-2.68), if their partners accused them of unfaithfulness (OR = 1.50; 95% CI: 1.03-2.19) and if their partners did not permit them to meet with female friends (OR = 1.63; 95% CI: 1.11-2.39). The odds of IPSV were also higher among women whose partners tried to limit contact with their family (OR = 1.73; 95% CI: 1.11-2.67) and often got drunk (OR = 1.80; 95% CI: 1.15-2.81). Finally, women who were sometimes or often afraid of their partners (OR = 1.78; 95% CI: 1.21-2.60 and OR = 1.56; 95% CI: 1.04-2.40 respectively) were more likely to report IPSV.

Conclusion

In Uganda, women’s socio-economic and demographic background and empowerment had no mitigating effect on IPSV in the face of their partners’ dysfunctional behaviors. Interventions addressing IPSV should place more emphasis on reducing partners’ controlling behaviors and the prevention of problem drinking.

"Amar te Duele" ("love hurts"): sexual relationship power, intimate partner violence, depression symptoms and HIV risk among female sex workers who use drugs and their non-commercial, steady partners in Mexico

A significant body of research among female sex workers (FSWs) has focused on individual-level HIV risk factors. Comparatively little is known about their non-commercial, steady partners who may heavily influence their behavior and HIV risk. This cross-sectional study of 214 FSWs who use drugs and their male steady partners aged ≥18 in two Mexico-U.S. border cities utilized a path-analytic model for dyadic data based upon the Actor-Partner Interdependence Model to examine relationships between sexual relationship power, intimate partner violence (IPV), depression symptoms, and unprotected sex. FSWs' relationship power, IPV perpetration and victimization were significantly associated with unprotected sex within the relationship. Male partners' depression symptoms were significantly associated with unprotected sex within the relationship. Future HIV prevention interventions for FSWs and their male partners should address issues of sexual relationship power, IPV, and mental health both individually and in the context of their relationship.

The Explanatory Role of Relationship Power and Control in Domestic Violence Against Women in Nicaragua

This study offers a feminist psychology analysis of various aspects of relationship power and control and their relative explanatory contribution to understanding physical, psychological, and sexual violence against women. Findings from structured interviews with 345 women from rural Nicaragua ( Mage = 44) overwhelmingly demonstrate that measures of power and control reflecting interpersonal relationship dynamics have the strongest predictive power for explaining violence when compared in multivariate analyses to several of the more commonly used measures. These findings have implications for future research and the evaluation of interventions designed to decrease levels of violence against women.

Women’s Land Ownership and Relationship Power

Violence against women is a widespread societal problem substantiated and perpetuated through inequities that operate within numerous levels of the society. Challenging and ending gender-based violence therefore requires addressing social structures that perpetuate gendered hierarchies and maintain women’s susceptibility to experiencing violence worldwide. The present study examines novel approaches taken by women in two different countries in the Global South, one in Nicaragua and another in Tanzania, to examine macro-level processes involved in land ownership in regions where owning land is a marker of dominance. Using data from 492 women, results from structural equation models and qualitative thematic analyses demonstrate significant links among women’s ownership of land, relationship power, and receipt of physical and psychological violence in both the countries. Collectively, the findings suggest that when women own land, they gain power within their relationships and are less likely to experience violence. Implications for theoretical conceptualizations of eradicating violence against women and practical interventions are discussed.

Empowerment, partner's behaviours and intimate partner physical violence among married women in Uganda

Background

There is dearth of knowledge and research about the role of empowerment, partners’ behaviours and intimate partner physical violence (IPPV) among married women in Uganda. This paper examined the influence of women’s empowerment and partners’ behaviours on IPPV among married women in Uganda.

Methods

The 2011 Uganda Demographic and Health Survey data were used, selecting a weighted sample of 1,307 women in union considered for the domestic violence module. Cross tabulations (chi-square tests) and multivariate logistic regressions were used to identify factors associated with IPPV.

Results

The prevalence of IPPV among women in union in Uganda is still high (41%). Women’s occupation was the only measure of empowerment that was significantly associated with IPPV, where women in professional employment were less likely to experience IPPV. Women from wealthy households were less likely to experience IPPV. IPPV was more likely to be reported by women who had ever had children and witnessed parental IPPV. IPPV was also more likely to be reported by women whose husbands or partners: accused them of unfaithfulness, did not permit them to meet female friends, insisted on knowing their whereabouts and sometimes or often got drunk. Women who were afraid their partners were also more likely to report IPPV.

Conclusion

In the Ugandan context, women’s empowerment as assessed by the UDHS has limited mitigating effect on IPPV in the face of partners’ negative behaviours and history of witnessing parental violence.

Bridging Prevention and Health: Exploring Community Perceptions of Intimate Partner Violence in Rural Honduras

This qualitative study rooted in community-based participatory research principles utilized semi-structured interviews with 2 focus groups (n=9) with female healthcare volunteers (FCVs) and 3 male key informants who were community leaders (MCLs). The study aimed to examine how a rural Honduran community defines and responds to intimate partner violence (IPV) in order to lay the foundation for future interventions. Based on grounded theory, the authors assessed for common themes across transcripts. Authors found that a number of participants denied the existence of IPV. Perspectives on the causes and definitions of IPV varied between FCVs and MCLs. All participants affirmed the need for intervention and many participants mentioned healthcare and legal systems as potential venues to ameliorate IPV. The results highlight potentially important differences between FCV and MCL perspectives that may inform future interventions. Findings suggest health-care workers can play a role in IPV prevention and intervention in rural Honduras.

Democracy, Human Rights and Women's Health

Significant improvements in human rights and democracy have been made since the adoption of the Universal Declaration of Human Rights by the United Nations in 1948. Yet, human rights, especially women's rights, are still being violated in many parts of the developing world. The adverse effects of such violations on women's and children's health are well known, but they are rarely measured. This study uses cross-national data from over 145 countries to estimate the impact of democracy and respect for human rights on various measures of women's health while controlling for confounding socio-economic factors such as income, education, fertility and healthcare. It finds that democracy and regards for human rights contribute positively to women's health outcomes, as do socio-economic variables.

Controlling behavior, power relations within intimate relationships and intimate partner physical and sexual violence against women in Nigeria

Background

Controlling behavior is more common and can be equally or more threatening than physical or sexual violence. This study sought to determine the role of husband/partner controlling behavior and power relations within intimate relationships in the lifetime risk of physical and sexual violence in Nigeria.

Methods

This study used secondary data from a cross-sectional nationally-representative survey collected by face-to-face interviews from women aged 15 - 49 years in the 2008 Nigeria Demographic and Health Survey. Utilizing a stratified two-stage cluster sample design, data was collected frrm 19 216 eligible with the DHS domestic violence module, which is based on the Conflict Tactics Scale (CTS). Multivariate logistic regression analysis was used to determine the role of husband/partner controlling behavior in the risk of ever experiencing physical and sexual violence among 2877 women aged 15 - 49 years who were currently or formerly married or cohabiting with a male partner.

Results

Women who reported controlling behavior by husband/partner had a higher likelihood of experiencing physical violence (RR = 3.04; 95% CI: 2.50 - 3.69), and women resident in rural areas and working in low status occupations had increased likelihood of experiencing physical IPV. Controlling behavior by husband/partner was associated with higher likelihood of experiencing physical violence (RR = 4.01; 95% CI: 2.54 - 6.34). In addition, women who justified wife beating and earned more than their husband/partner were at higher likelihood of experiencing physical and sexual violence. In contrast, women who had decision-making autonomy had lower likelihood of experiencing physical and sexual violence.

Conclusion

Controlling behavior by husband/partner significantly increases the likelihood of physical and sexual IPV, thus acting as a precursor to violence. Findings emphasize the need to adopt a proactive integrated approach to controlling behavior and intimate partner violence within the society.

Intimate partner violence in urban Pakistan: prevalence, frequency, and risk factors

Background:

Intimate partner violence (IPV) is an important public health issue with severe adverse consequences. Population-based data on IPV from Muslim societies are scarce, and Pakistan is no exception. This study was conducted among women residing in urban Karachi, to estimate the prevalence and frequency of different forms of IPV and their associations with sociodemographic factors.

Methods:

This cross-sectional community-based study was conducted using a structured questionnaire developed by the World Health Organisation for research on violence. Community midwives conducted face-to-face interviews with 759 married women aged 25–60 years.

Results:

Self-reported past-year and lifetime prevalence of physical violence was 56.3 and 57.6%, respectively; the corresponding figures for sexual violence were 53.4% and 54.5%, and for psychological abuse were 81.8% and 83.6%. Violent incidents were mostly reported to have occurred on more than three occasions during the lifetime. Risk factors for physical violence related mainly to the husband, his low educational attainment, unskilled worker status, and five or more family members living in one household. For sexual violence, the risk factors were the respondent’s low educational attainment, low socioeconomic status of the family, and five or more family members in one household. For psychological violence, the risk factors were the husband being an unskilled worker and low socioeconomic status of the family.

Conclusion:

Repeated violence perpetrated by a husband towards his wife is an extremely common phenomenon in Karachi, Pakistan. Indifference to this type of violence against women stems from the attitude that IPV is a private matter, usually considered a justifiable response to misbehavior on the part of the wife. These findings point to serious violations of women’s rights and require the immediate attention of health professionals and policymakers.

[Determinants of the most significant characteristics of reproductive health]

INTRODUCTION

Reproductive health of women is determined by females' demographic and socio-economic characteristics, their behaviour, and the complex of environmental factors.

OBJECTIVE

The paper examines the predictive impact of personal and environmental characteristics, health and healthcare characteristics regarding the most important aspects of reproductive health.

METHODS

From a sample of 2,718 women, aged 20-49 years, we collected information on various characteristics using a structured questionnaire. Based on factorial analysis (principal components method, Kaisser Varimax criterion) we selected representative variables (factors), describing personal (demographic and socio-economic) characteristics of women, their environment (family, household, community), health (attitudes towards health, life-style, health status), healthcare (independent) and the characteristics of reproductive health (dependent variables). The predictors were analyzed by multiple regression and correlation.

RESULTS

Sexual behaviour was determined by socio-economic status, personal tidiness, rest, presence of risk factor(s), health evaluation and attitude toward personal responsibility, trust in physicians etc. The predictors of contraception involved satisfaction with one's own health, serious health problems, health evaluation. The presence and number of abortions were determined by personal psychological maturity, rest, risk factors, life-style, health evaluation and its manifestations, and the continuity and timely healthcare.The predictors of adequate protection of reproductive health involved the cultural level of the community, financial standing of the household, satisfaction with one's own life, tidiness and rest, presence of risk factors, health evaluation, attitude towards personal responsibility, and trust in physicians. HIV control was determined by satisfaction with one's own life, physical activity of women, presence of serious health problems, and the content of primary healthcare. Postpartal protection was determined by the cultural level of the community, reasons for dissatisfaction with one's own life, presence of risk factors and deficiencies, and timely contraception. The predictors of reproductive period duration are availability of health care in a community and personal tidiness of women.

CONCLUSION

The study confirmed predictive impact of most of the studied characteristics.

Association of physical violence by an intimate partner around the time of pregnancy with inadequate gestational weight gain

Intimate partner violence has been previously examined in relation to a variety of pregnancy, labor and delivery outcomes. We evaluated whether women who experienced physical violence by their intimate partners around the time of pregnancy were less likely to achieve weight gain according to the US Institute of Medicine (IOM) guidelines. A cross-sectional study was conducted using the 2000-2006 Oklahoma Pregnancy Risk Assessment Monitoring Survey (PRAMS) data for post-partum women, 20 years and older. Physical violence perpetrated by an intimate partner before and/or during pregnancy was prevalent in nearly 6.5% of women. Weight gain was adequate in 38.8%, deficient in 28.4% and excessive in 32.8% of these women, respectively. After adjusting for maternal age, marital status, education, pregnancy intention, stressful life events, third-trimester use of tobacco and alcohol and gestational age at delivery, physical violence by an intimate partner around the time of pregnancy was positively but non-significantly associated with excessive (but not deficient) gestational weight gain. After stratifying by age group, positive and significant associations between physical violence by an intimate partner around the time of pregnancy and inadequate gestational weight gain were observed only among women 35 years and older. With the exception of mothers ≥ 35 years of age, deficient and excessive gestational weight gains were not significantly related to experiences with physical violence by an intimate partner prior to delivery. Prospective cohort studies are needed to establish whether other forms of violence, including emotional and sexual abuse, can affect gestational weight gain and whether gestational weight gain can mediate the effect of physical, sexual and emotional abuse on pregnancy, labor and delivery outcomes.

Attitudes toward wife beating among Palestinian women of reproductive age from three cities in West Bank

A total of 450 women were interviewed in Mother and Child Health Care Centers in three cities in West Bank, Palestine, to assess attitudes toward wife beating. Overall, women perceived wife beating to be justified if a wife insults her husband (59%), if she disobeys her husband (49%), if she neglects her children (37%), if she goes out without telling her husband (25%), if she argues with her husband (11%), and if she burns the food (5%). Sixty-five percent of women agreed with at least one reason for wife beating, but there were statistically significant regional differences: Wife beating was most accepted in Jenin (73% acceptance of at least one reason) and least accepted in Hebron (55%). Lower level of education, not being employed, having more than one child, being married for fewer than 10 years, and making few household decisions were all associated with women's acceptance of wife beating. The implications of these results are discussed.

Democracy and Women's Health

New research on broader determinants of health has culminated into the new paradigm of social determinants of health. The fundamental view that underlies this new paradigm is that socioeconomic and political contexts in which people live have significant bearing upon their health and well-being. Unlike a wealth of research on socioeconomic determinants, few studies have focused on the role of political factors. Some of these studies examine the role of political determinants on health through their mediation with the labour environments and systems of welfare state. A few others study the relationship between polity regimes and population health more directly. However, none of them has a focus on women's health. This study explores the interactions, both direct and indirect, between democracy and women's health. In doing so, it identifies some of the main health vulnerabilities for women and explains, through a conceptual model, how democracy and respect for human rights interacts with women's health.