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Billah MA, Khan MMA, Hanifi SMA, Islam MM, Khan MN. Spatial pattern and influential factors for early marriage: evidence from Bangladesh Demographic Health Survey 2017-18 data. BMC Womens Health 2023; 23:320. [PMID: 37340425 DOI: 10.1186/s12905-023-02469-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Early marriage is highly prevalent in Bangladesh. It is linked with a range of adverse outcomes, including maternal and child mortality. However, research on regional variations and factors associated with early marriage is scarce in Bangladesh. This study aimed to explore the geographical variations and predictors of early marriage in Bangladesh. METHODS Data of women aged 20-24 in the Bangladesh Demographic and Health Survey 2017-18 were analysed. The occurrence of early marriage was the outcome variable. Explanatory variables were several individual-, household- and community-level factors. Geographical hot spots and cold spots of early marriage were first determined using Global Moran's I statistic. Multilevel mixed-effect Poisson regression was used to determine the association of early marriage with individual-, household-, and community-level factors. RESULTS Almost 59% of women aged 20-24 reported they were married before reached 18. The hotspots of early marriage were mainly concentrated in Rajshahi, Rangpur and Barishal, and the cold spots were in Sylhet and Chattogram divisions. The prevalence of early marriage was lower among higher educated (adjusted prevalence ratio (aPR): 0.45; 95% CI: 0.40, 0.52), and non-Muslim women (aPR: 0.89; 95% CI: 0.79, 0.99) than their counterparts. Higher community-level poverty was significantly associated with early marriage (aPR, 1.16; 95% CI: 1.04, 1.29). CONCLUSION The study concludes that promoting girls' education, awareness-building programs about the adverse effects of early marriage and proper application of the child marriage restraint act, particularly in disadvantaged communities are recommended.
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Affiliation(s)
- Md Arif Billah
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Md Mostaured Ali Khan
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Syed Manzoor Ahmed Hanifi
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - M Mofizul Islam
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Namapara, Mymensingh, 2220, Bangladesh
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Dixit A, Johns NE, Ghule M, Battala M, Begum S, Saggurti N, Silverman J, Reed E, Kiene SM, Benmarhnia T, Averbach S, Raj A. Association of traditional marital practices with contraceptive decision-making, couple communication, and method use among couples in rural Maharashtra, India. CULTURE, HEALTH & SEXUALITY 2023; 25:521-536. [PMID: 35465833 PMCID: PMC9588848 DOI: 10.1080/13691058.2022.2062052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
Abstract
In India, traditional social practices around marriage, such as non-involvement of prospective brides in choice of partner and timing of marriage, child/early marriage, dowry and purdah, compromise women's agency at the time of marriage and may also affect contraceptive practices in marriage. This paper examines the associations between traditional marital practices and contraceptive behaviours, including women's control over contraceptive decision-making, couples' communication about contraception, and ever use of contraceptives, among married women aged 18-29 years (N = 1,200) and their husbands in rural Maharashtra, India. Multivariable logistic regression was used to examine the association between these marginalising social practices and family planning behavioural outcomes, adjusting for demographic and parity confounders. Wives who were the primary decision-makers on who to marry had higher odds of ever having communicated with their husband on pregnancy prevention (AOR 1.76, 95% CI 1.16-2.68), and ever using modern contraceptives (AOR 2.19, 95% CI 1.52-3.16). Wives who were the primary decision-makers on when to marry also had higher odds of ever having used modern contraceptives (AOR 1.86, 95% CI 1.21-2.93). Women's involvement in marital choice may facilitate couples' engagement related to family planning, possibly via the establishment of better communication between partners.
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Affiliation(s)
- Anvita Dixit
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
- Joint Doctoral Program in Public Health (Global Health track), University of California San Diego/San Diego State University, San Diego, CA, USA
| | - Nicole E. Johns
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Mohan Ghule
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
| | | | - Shahina Begum
- ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | | | - Jay Silverman
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Elizabeth Reed
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
- Division of Health Promotion and Behavior, San Diego State University, San Diego, CA, USA
| | - Susan M. Kiene
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA
- Scripps Institution of Oceanography, University of California San Diego, San Diego, CA, USA
| | - Sarah Averbach
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Anita Raj
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, CA, USA
- Department of Education Studies, Division of Social Sciences, University of California San Diego, San Diego, CA. USA
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Kornhaber R, Pan R, Cleary M, Hungerford C, Malic C. Violence by Burning Against Women and Girls: An Integrative Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:1063-1077. [PMID: 34624204 DOI: 10.1177/15248380211048445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
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.
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Affiliation(s)
- Rachel Kornhaber
- College of Health and Medicine, 3925University of Tasmania, Sydney, AU-NSW, Australia
- National Burns Center, 26744Sheba Medical Center, Tel Hashomer, Israel
| | - Raquel Pan
- Department of Nursing in Hospital Assistance, 74395Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Michelle Cleary
- School of Nursing, Midwifery and Social Sciences, 6939CQUniversity, Sydney, AU-NSW, Australia
| | | | - Claudia Malic
- 6363University of Ottawa, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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Wessells MG, Kostelny K. The Psychosocial Impacts of Intimate Partner Violence against Women in LMIC Contexts: Toward a Holistic Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14488. [PMID: 36361364 PMCID: PMC9653845 DOI: 10.3390/ijerph192114488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Work on the mental health impacts of intimate partner violence in low-and middle-income countries has focused primarily on clinical disorders such as post-traumatic stress disorder, depression, and substance abuse. This paper analyzes how non-clinical, psychosocial impacts from everyday stressors, particularly economic hardships and concern over one's children, cause extensive suffering and damage women survivors' well-being, influencing the development and expression of clinical disorders. Using a social ecological framework, the paper analyzes how psychosocial impacts arise at multiple levels, including societal levels where social norms often devalue women and privilege men, and how the stressor accumulation increases the harm caused by intimate partner violence (IPV) against women (IPVAW). Drawing on survivors' narratives and studies from diverse low and middle income country (LMIC) settings, including armed conflict and natural disaster settings, the paper underscores the importance of understanding both clinical impacts and the non-clinical, psychosocial impacts, which interact with and complement one another. Recognizing the interplay also between IPVAW and other forms of violence against girls and women, the paper calls for a more comprehensive approach to understanding and addressing the impacts of IPVAW. Recognizing the enormous variety within and across countries that are considered to be LMIC settings, the paper cautions against universalized approaches to understanding the effects of IPVAW and helping to support survivors.
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Affiliation(s)
- Michael G. Wessells
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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Khadilkar K, KhudaBukhsh AR, Mitchell TM. Gender bias, social bias, and representation: 70 years of B H ollywood. PATTERNS (NEW YORK, N.Y.) 2022; 3:100409. [PMID: 35199062 PMCID: PMC8848024 DOI: 10.1016/j.patter.2021.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/14/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
We use a suite of cutting-edge natural language processing methods to quantify and characterize societal and gender biases in popular movie content. Our data set consists of English subtitles of popular movies from Bollywood-the Mumbai film industry-spanning 7 decades (700 movies). In addition, we include movies from Hollywood and movies nominated for the Academy Awards for contrastive purposes. Our findings indicate that while the overall portrayal of women has improved over time in popular movie dialogues from both Bollywood and Hollywood, modern films still exhibit considerable gender bias and are yet to achieve equal representation among genders. We also observe a strong bias favoring fair skin color in Bollywood content that occurred consistently across all time periods we considered. While our geographic representation analysis indicates improved inclusion over time for several Indian states, it also reveals a long-standing under-representation of many northeastern Indian states.
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Affiliation(s)
- Kunal Khadilkar
- School of Computer Science, Language Technologies Institute, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA
| | - Ashiqur R. KhudaBukhsh
- Golisano College of Computing and Information Sciences, Software Engineering Department, Rochester Institute of Technology, 20 Lomb Memorial Drive, New York, NY 14623, USA
| | - Tom M. Mitchell
- School of Computer Science, Machine Learning Department, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA
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O'Connor M, Lee A. The health impacts of dowry abuse on South Asian communities in Australia. Med J Aust 2021; 216:11-13. [PMID: 34854086 PMCID: PMC9299937 DOI: 10.5694/mja2.51358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Manjula O'Connor
- University of Melbourne, Melbourne, VIC.,University of New South Wales, Sydney, NSW
| | - Amanda Lee
- Harmony Alliance, Migration Council Australia, Canberra, ACT
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Rodriguez AL, Stephens DP, Brewe E, Ramarao I, Madhivanan P. A Network Analysis of Domestic Violence Beliefs Among Young Adults in India. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP12041-NP12066. [PMID: 31789081 PMCID: PMC7450516 DOI: 10.1177/0886260519889923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study sought to describe the system of beliefs on gender, attitudes toward women, and wife beating, in young adults who live in Mysore, India. Furthermore, it identified structural sex differences in the interplay of values among these matters that can affect individual and community views toward domestic violence. Drawing from survey data gathered from 265 young adult Indian men and women, this study used network analysis to graph a correlation network of beliefs and attitudes toward domestic violence. Node, scale, and network structure descriptions allowed for comparisons among male and female participant responses. The findings support the assertion that there are sex differences among the system of beliefs toward wife beating among Indian young adults. Gender ideology, masculine role in relationships, and legal and social consequences of wife beating emerged as the most important values to focus on when addressing young men's beliefs of domestic violence and attitudes toward women. In contrast, values influencing women's perceptions of domestic violence are more complex and related to multiple beliefs about women's power, family structure, and social and legal implications of domestic violence. The results highlight the importance of recognizing gender differences in the connectivity between gender and wife beating beliefs when designing interventions. There is a need for efforts to accurately target these values and attitudes to more effectively address gendered attitudes and beliefs about domestic violence in this population.
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Affiliation(s)
| | | | - Eric Brewe
- Drexel University, Philadelphia, PA, USA
| | - Indira Ramarao
- Public Health Research Institute of India, Karnataka, India
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8
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Srivastava S, Chauhan S, Patel R, Marbaniang SP, Kumar P, Paul R, Dhillon P. Banned by the law, practiced by the society: The study of factors associated with dowry payments among adolescent girls in Uttar Pradesh and Bihar, India. PLoS One 2021; 16:e0258656. [PMID: 34653223 PMCID: PMC8519446 DOI: 10.1371/journal.pone.0258656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 10/03/2021] [Indexed: 11/29/2022] Open
Abstract
Background Despite the prohibition by the law in 1961, dowry is widely prevalent in India. Dowry stems from the early concept of ’Stridhana,’ in which gifts were given to the bride by her family to secure some personal wealth for her when she married. However, with the transition of time, the practice of dowry is becoming more common, and the demand for a higher dowry becomes a burden to the bride’s family. Therefore, this study aimed to determine the factors associated with the practice of dowry in Bihar and Uttar Pradesh. Methods We utilized information from 5206 married adolescent girls from the Understanding the lives of adolescents and young adults (UDAYA) project survey conducted in two Indian states, namely, Uttar Pradesh and Bihar. Dowry was the outcome variable of this study. Univariate, bivariate, and multivariate logistic regression analyses were performed to explore the factors associated with dowry payment during the marriage. Results The study reveals that dowry is still prevalent in the state of Uttar Pradesh and Bihar. Also, the proportion of dowry varies by adolescent’s age at marriage, spousal education, and household socioeconomic status. The likelihood of paid dowry was 48 percent significantly less likely (OR: 0.52; CI: 0.44–0.61) among adolescents who knew their husbands before marriage compared to those who do not know their husbands before marriage. Adolescents with age at marriage more than equal to legal age had higher odds to pay dowry (OR: 1.60; CI: 1.14–2.14) than their counterparts. Adolescents with mother’s who had ten and above years of education, the likelihood of dowry was 33 percent less likely (OR: 0.67; CI: 0.45–0.98) than their counterparts. Adolescents belonging to the richest households (OR: 1.48; CI: 1.13–1.93) were more likely to make dowry payments than adolescents belonging to poor households. Conclusion Limitation of the dowry prohibition act is one of the causes of continued practices of dowry, but major causes are deeply rooted in the social and cultural customs, which cannot be changed only using laws. Our study suggests that only the socio-economic development of women will not protect her from the dowry system, however higher dowry payment is more likely among women from better socio-economic class.
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Affiliation(s)
- Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Strong P. Marbaniang
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
- * E-mail:
| | - Ronak Paul
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Preeti Dhillon
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
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Adin A, Goicoa T, Hodges JS, Schnell PM, Ugarte MD. Alleviating confounding in spatio-temporal areal models with an application on crimes against women in India. STAT MODEL 2021. [DOI: 10.1177/1471082x211015452] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Assessing associations between a response of interest and a set of covariates in spatial areal models is the leitmotiv of ecological regression. However, the presence of spatially correlated random effects can mask or even bias estimates of such associations due to confounding effects if they are not carefully handled. Though potentially harmful, confounding issues have often been ignored in practice leading to wrong conclusions about the underlying associations between the response and the covariates. In spatio-temporal areal models, the temporal dimension may emerge as a new source of confounding, and the problem may be even worse. In this work, we propose two approaches to deal with confounding of fixed effects by spatial and temporal random effects, while obtaining good model predictions. In particular, restricted regression and an apparently—though in fact not—equivalent procedure using constraints are proposed within both fully Bayes and empirical Bayes approaches. The methods are compared in terms of fixed-effect estimates and model selection criteria. The techniques are used to assess the association between dowry deaths and certain socio-demographic covariates in the districts of Uttar Pradesh, India.
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Affiliation(s)
- Aritz Adin
- Department of Statistics, Computer Science and Mathematics, InaMat2, Public University of Navarre, Pamplona, Spain
| | - Tomás Goicoa
- Department of Statistics, Computer Science and Mathematics, InaMat2, Public University of Navarre, Pamplona, Spain
| | - James S. Hodges
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Patrick M. Schnell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, USA
| | - María D. Ugarte
- Department of Statistics, Computer Science and Mathematics, InaMat2, Public University of Navarre, Pamplona, Spain
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Kalra H, Tran TD, Romero L, Chandra P, Fisher J. Prevalence and determinants of antenatal common mental disorders among women in India: a systematic review and meta-analysis. Arch Womens Ment Health 2021; 24:29-53. [PMID: 32055988 DOI: 10.1007/s00737-020-01024-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/26/2020] [Indexed: 02/06/2023]
Abstract
To review the available evidence about the prevalence and determinants of antenatal common mental disorders (antenatal CMDs) among women in India. We searched Ovid Medline, Embase and Psyinfo systematically from date of inception to Oct. 31, 2019 for publications in English language on the prevalence of antenatal CMDs and their determinants among women in India. All study designs were included. Quality was assessed with Standard Quality Assessment Criteria for Evaluating Primary Research Papers. We performed a meta-analysis using a random effects model. Twenty-seven studies involving 7780 women were analysed. There was a high degree of heterogeneity ((I2 = 97.53%). Publication bias [Egger bias = 0.65 (95% CI: 0.36; .94)] was evident. The overall pooled estimate of the prevalence of antenatal CMDs was 21.87% (95% CI: 17.46; 26.29). Significant risk factors reported in the 18 studies which examined them were negative reaction of husband or in-laws to the dowry, difficult relationship with husband/in-laws, lack of support or experiencing violence perpetrated by an intimate partner and preference for or feeling pressured to have a male child. Protective factors were having more education and being employed, having a supportive husband and opportunities for recreation during pregnancy. Antenatal CMDs are highly prevalent among women in India. There is an urgent need for locally developed policies and programmes for mental health promotion during pregnancy, preventive and early intervention for antenatal CMDs among women to be integrated into maternity care in India.
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Affiliation(s)
- Harish Kalra
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, 3004, Melbourne, VIC, Australia. .,Ballarat Rural Clinical School, University of Notre Dame Australia, 01 Drummond St Nth, 3350, Ballarat Central, VIC, Australia. .,Raphael Services, Ballarat, St John of God Health Care Social Outreach, 105 Webster St, 3350, Ballarat Central, VIC, Australia. .,Ballarat Health Services-Mental Health Services, Sturt St, 3350, Ballarat Central, VIC, Australia.
| | - Thach Duc Tran
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, 3004, Melbourne, VIC, Australia
| | - Lorena Romero
- The Ian Potter Library, The Alfred Hospital, 55 Commercial Rd, 3004, Melbourne, VIC, Australia
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, 560029, Karnataka, India
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, 3004, Melbourne, VIC, Australia
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Arya V, Page A, Armstrong G, Kumar GA, Dandona R. Estimating patterns in the under-reporting of suicide deaths in India: comparison of administrative data and Global Burden of Disease Study estimates, 2005-2015. J Epidemiol Community Health 2020; 75:jech-2020-215260. [PMID: 33257456 DOI: 10.1136/jech-2020-215260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/17/2020] [Accepted: 11/17/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND It has been proposed that the National Crime Records Bureau (NCRB), which reports suicides in India, differentially underenumerates suicides by geographic and demographic factors. We assessed the extent of potential underenumeration by comparing suicides recorded in NCRB data with recent estimates of Indian suicides developed by the Global Burden of Disease (GBD) initiative. METHODS Age-standardised suicide rates were calculated for both data sources by sex, age and state, and rate ratios of NCRB to GBD estimates by corresponding strata were compared to ascertain the relative under-reporting in the NCRB report. RESULTS The GBD Study reported an additional 802 684 deaths by suicide (333 558 male and 469 126 female suicide deaths) compared with the NCRB report between 2005 and 2015. Among males, the average under-reporting was 27% (range 21%-31%) per year, and among females, the average under-reporting was 50% (range 47%-54%) per year. Under-reporting was more evident among younger (15-29 years) and older age groups (≥60 years) compared with middle age groups. Indian states belonging to low Socio-Demographic Index (SDI) generally had greater underenumeration compared with middle and high-SDI states. CONCLUSION NCRB data under-report suicides in India, and differentially by sex, age and geographic area, possibly because of lack of community-level reporting of suicides due to social stigma and legal consequences. While the recent decriminalisation of suicide is expected to improve community-level reporting of suicides, suicide prevention policies should be developed, with a priority to address social stigma attached with suicide and suicidal behaviour, especially among females.
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Affiliation(s)
- Vikas Arya
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, New South Wales, Australia
- International Association for Suicide Prevention, Washington, DC, USA
| | - Andrew Page
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, New South Wales, Australia
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, India
| | - Rakhi Dandona
- Public Health Foundation of India, Gurugram, India
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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Kaur N, Byard RW. Bride burning: A unique and ongoing form of gender-based violence. J Forensic Leg Med 2020; 75:102035. [PMID: 32871350 DOI: 10.1016/j.jflm.2020.102035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/18/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
Despite legislation, dowry is still widespread in many parts of India and adjacent countries. It refers to the transfer of goods, money, and property to a bridegroom, his parents, or his relatives from a bride's family as a condition of the marriage. One of the consequences of the dowry system has been the murder or abetted suicide of young wives, either because more dowry goods were not provided to her husband or his family, or to secure the goods after marriage. In 2015 7634 women died due to dowry harassment, representing approximately 21 cases per day in India. The majority of dowry deaths occur within the first three years of marriage. Common types of dowry death homicides involve fire ('bride burning', drowning, poisoning and hanging/strangulation. In addition to legislation, an organized and multipronged approach is need by investigating police officers, women's' welfare organizations, responsible public servants, and the judiciary with consistent applications of deterrent penalties. Full and properly conducted medicolegal investigation is mandatory which must include scene examinations, full autopsies with photographic documentation and ancillary investigations such as headspace analyses. Significant burns in young Indian women living in traditional circumstances should raise the possibility of dowry-related crime.
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Affiliation(s)
| | - Roger W Byard
- Adelaide School of Medicine, The University of Adelaide, Adelaide, Australia
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Musa A, Chojenta C, Loxton D. High rate of partner violence during pregnancy in eastern Ethiopia: Findings from a facility-based study. PLoS One 2020; 15:e0233907. [PMID: 32497059 PMCID: PMC7272015 DOI: 10.1371/journal.pone.0233907] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/14/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Intimate partner violence during pregnancy can contribute to maternal mortality and morbidity by limiting women's ability to receive maternal health services including antenatal care and skilled delivery care. In Ethiopia, evidence regarding intimate partner violence during pregnancy is limited, and no previous studies have been conducted in the Harari region. Therefore, this study aimed to investigate the prevalence and associated factors of intimate partner violence during pregnancy among women who had given birth in public hospitals in Harari regional state, eastern Ethiopia. METHODS A hospital-based cross-sectional study was conducted from November 2018 to April 2019 among women who had given birth in public hospitals in Harari regional state, East Ethiopia. A systematic random sampling method was employed to select 648 participants. Data were collected using an interviewer-administered standardized questionnaire based on the World Health Organization Multi-Country Study on Women's Health and Domestic Violence against Women survey. Crude and adjusted odds ratios with respective confidence intervals were computed. Variables with a p-value of ≤0.05 were considered to have a significant association with intimate partner violence during pregnancy. RESULTS The prevalence of intimate partner violence during the most recent pregnancy was found to be 39.81%. Furthermore, the prevalence of physical, emotional and sexual violence were found to be 25.93%, 25.62% and 3.7%, respectively. Longer duration of marriage (adjusted odds ratio = 1.68, 95% confidence interval = 1.01-2.79), most recent pregnancy being unplanned (adjusted odds ratio = 1.55, 95% confidence interval = 1.03-2.34), experiencing controlling behaviour by a partner, (adjusted odds ratio = 2.23, 95% confidence interval = 1.46-3.40) and having an attitude that justifies intimate partner violence (adjusted odds ratio = 1.60, 95% confidence interval = 1.09-2.36) were associated with experiencing intimate partner violence. CONCLUSION The prevalence of intimate partner violence during pregnancy was found to be high. Pregnancy monitoring programs, which can detect and intervene with regard to partner's controlling behaviors and women's perception regarding justification of intimate partner violence, especially in those women with an unplanned pregnancy, could help to reduce intimate partner violence during pregnancy. Further, changing social norms that condone violence through advocacy and awareness creation might help in preventing partner violence.
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Affiliation(s)
- Abdulbasit Musa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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Rees S, Mohsin M, Tay AK, Soares E, Tam N, da Costa Z, Tol W, Silove D. Associations between bride price stress and intimate partner violence amongst pregnant women in Timor-Leste. Global Health 2017; 13:66. [PMID: 28847312 PMCID: PMC5574248 DOI: 10.1186/s12992-017-0291-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reducing violence against women is a global public health priority, particularly in low-income and conflict-affected societies. However, more needs to be known about the causes of intimate partner violence (IPV) in these settings, including the stress of bride price obligations. METHODS The representative study of women attending ante-natal clinics in Dili, Timor-Leste was conducted between June, 2013 and September, 2014 with 1672 pregnant women, a response rate of 96%. We applied contextually developed measures for the stress of bride price and poverty, and the World Health Organisation measure for intimate partner violence. RESULTS Compared to those with no problems with bride price, women with moderate or serious problems with that custom reported higher rates of IPV (18.0% vs. 43.6%). Adjusting for socio-demographic factors, multivariate analysis revealed that ongoing poverty (OR = 1.75, 95% CI: 1.20-2.56) was significantly associated with IPV. Importantly, the strongest association with IPV was problems with bride price (OR = 2.73, 95% CI: 1.86-4.01). CONCLUSIONS This is the first large consecutively sampled study to demonstrate a strong association between the stressors of bride price and poverty with IPV. Notably, bride price stress had the strongest association with IPV. Revealing this hitherto unrecognized factor of bride price stress may prove pivotal in guiding policy and interventions aimed at reducing IPV, and thereby improve the health and psychosocial status of women in low income and conflict-affected settings.
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Affiliation(s)
- Susan Rees
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
- Sydney, NSW 2052 Australia
| | - Mohammed Mohsin
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Alvin Kuowei Tay
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Elisa Soares
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Natalino Tam
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Zelia da Costa
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
| | - Wietse Tol
- Johns Hopkins University, Baltimore, USA
| | - Derrick Silove
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool, NSW 2170 Australia
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Abstract
The practice of dowry is widespread in India and refers to the payment of cash/gifts by the bride's family to the bridegroom's family before marriage. Though prohibited by law, dowry is widely practised, and often contributes to severe injuries and even death of young brides. This study examined the prevalence and risk factors for dowry demand and dowry harassment and its psychosocial correlates across different social strata in India, and also by husband and mother-in-law characteristics. In a cross-sectional survey of 9938 women in rural, urban and urban non-slum sites across India conducted in 1998-99, dowry demand was found to be significantly higher (p<0.001) in the urban non-slum and rural areas (26% and 23% respectively) than in urban slum areas (18%). Overall, 17% of groom's families were not satisfied with the dowry, this being higher in rural areas (21%) than in urban slum and non-slum areas (about 14% in both). The overall prevalence of dowry harassment among this group of women was 13.3%. Mothers-in-law who had themselves experienced dowry demand were 14 (95% CI 5.0-40.4) and 5 (95% CI 1.3-18.9) times more likely to demand and harass daughters-in-law over dowry, respectively. Another significant risk factor for dowry-related harassment was mother-in law's status in the family. Interventions related to modifiable risk factors, such as increased social support at the community level, should help reduce dowry harassment.
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Bourey C, Williams W, Bernstein EE, Stephenson R. Systematic review of structural interventions for intimate partner violence in low- and middle-income countries: organizing evidence for prevention. BMC Public Health 2015; 15:1165. [PMID: 26597715 PMCID: PMC4657265 DOI: 10.1186/s12889-015-2460-4] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 10/28/2015] [Indexed: 11/22/2022] Open
Abstract
Background Despite growing attention to intimate partner violence (IPV) globally, systematic evaluation of evidence for IPV prevention remains limited. This particularly is true in relation to low- and middle-income countries (LMIC), where researchers often organize evidence by current interventions strategies rather than comprehensive models of IPV. Applying the concept of structural interventions to IPV, we systematically reviewed the quantitative impact of such interventions for prevention of male-to-female IPV in LMIC in order to (a) highlight current opportunities for IPV research and programming and (b) demonstrate how structural interventions may provide an organizing framework through which to build an evidence base for IPV prevention. Methods We identified articles by systematically searching PubMed and Web of Science, reviewing references of selected studies, and contacting 23 experts. Inclusion criteria included original research, written in English, published between January 2000 and May 2015 in the peer-reviewed literature. Studies evaluated the quantitative impact of structural interventions for the prevention of male-to-female IPV in LMIC through (a) IPV incidence or prevalence or (b) secondary outcomes theoretically linked to IPV by study authors. After initial screening, we evaluated full text articles for inclusion and extracted data on study characteristics, outcomes, and risk of bias, using forms developed for the review. Results Twenty articles (16 studies) from nine countries met inclusion criteria, representing 13 randomized control trials and seven additional studies, all of which reported results from economic, social, or combined economic and social interventions. Standardized at p < 0.05 or 95 % confidence intervals not including unity, 13 studies demonstrated statistically significant effects for at least one primary or secondary outcome, including decreased IPV and controlling behaviors; improved economic wellbeing; enhanced relationship quality, empowerment, or social capital; reduced acceptability of IPV; new help seeking behaviors; and more equitable gender norms. Risk of bias, however, varied in meaningful ways. Conclusions Our findings support the potential effectiveness of structural interventions for IPV prevention. Structural interventions, as an organizing framework, may advance IPV prevention by consolidating available evidence; highlighting opportunities to assess a broader range of interventions, including politico-legal and physical approaches; and emphasizing opportunities to improve evaluation of such interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2460-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christine Bourey
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, Georgia, 30322, USA.
| | - Whitney Williams
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, Georgia, 30322, USA.
| | - Erin Elizabeth Bernstein
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, Georgia, 30322, USA.
| | - Rob Stephenson
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, Georgia, 30322, USA. .,Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing and Center for Sexuality and Health Disparities, 400 North Ingalls, Ann Arbor, Michigan, 48109, USA.
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Belur J, Tilley N, Daruwalla N, Kumar M, Tiwari V, Osrin D. The social construction of 'dowry deaths'. Soc Sci Med 2014; 119:1-9. [PMID: 25129569 PMCID: PMC4394358 DOI: 10.1016/j.socscimed.2014.07.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 07/03/2014] [Accepted: 07/17/2014] [Indexed: 11/22/2022]
Abstract
The classification of cause of death is real in its consequences: for the reputation of the deceased, for her family, for those who may be implicated, and for epidemiological and social research and policies and practices that may follow from it. The study reported here refers specifically to the processes involved in classifying deaths of women from burns in India. In particular, it examines the determination of ‘dowry death’, a class used in India, but not in other jurisdictions. Classification of death is situated within a framework of special legal provisions intended to protect vulnerable women from dowry-related violence and abuse. The findings are based on 33 case studies tracked in hospital in real time, and interviews with 14 physicians and 14 police officers with experience of dealing with burns cases. The formal class into which any given death is allocated is shown to result from motivated accounting processes representing the interests and resources available to the doctors, victims, victim families, the victim’s husband and his family, and ultimately, the police. These processes may lead to biases in research and to injustice in the treatment of victims and alleged offenders. Suggestions are made for methods of ameliorating the risks.
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Affiliation(s)
- Jyoti Belur
- Department of Security and Crime Science, UCL, 35 Tavistock Square, London WC1H 9EZ, UK.
| | - Nick Tilley
- Department of Security and Crime Science, UCL, 35 Tavistock Square, London WC1H 9EZ, UK.
| | - Nayreen Daruwalla
- Society for Nutrition, Education and Health Action, Urban Health Centre, Room No. 110, Dharavi, Mumbai 400 017, India.
| | - Meena Kumar
- Lokmanya Tilak Municipal Medical College and General Hospital, Dr. Babasaheb Ambedkar Road, Sion West, Mumbai 400 022, India.
| | - Vinay Tiwari
- Burns, Plastic and Maxillofacial Surgery, VM Medical College and Safdarjang Hospital, New Delhi 110 029, India.
| | - David Osrin
- UCL Institute for Global Health, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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