Married Women's Justification of Intimate Partner Violence in Bangladesh: Examining Community Norm and Individual-Level Risk Factors

Positive and Negative Gender Role Beliefs and Intimate Partner Violence

An ethnically diverse sample of 384 male and female undergraduates was assessed for their gender role beliefs based on positive (family responsibility) vs. negative (male dominance and female submissiveness) aspects derived from Hispanic cultural traditions. Negative male and female gender role beliefs were significantly positively correlated with reported victimization by and perpetration of severe intimate partner violence (IPV) for both men and women. Positive male gender role beliefs were negatively correlated with reported victimization by and perpetration of IPV for both men and women, with women also providing some evidence that positive female gender role beliefs were associated with less IPV.

Exploring Intervention with South Asian Women in the United States Experiencing Domestic Violence

PURPOSE

The current study reports intervention from the perspective of abused South Asian women in the United States (U.S.) aligning with the Center for Disease Control (CDC's) ecological model.

MATERIAL AND METHODS

In-depth telephonic interviews were conducted with a convenience sample of 20 South Asian women in the U.S. The interviews were analyzed using thematic analysis.

RESULTS

Utilizing the CDC's ecological model, the following themes emerged for prevention at the individual level: walk away the first-time abuse occurred; at the relationship level: pre-marital counseling and at the societal level: act on the red flags before the wedding, address the stringent gender roles, socialization, and blame. For protection, the following themes emerged at the individual level: self-determination and strength, protection of children, and financial independence. At the relationship level, the theme of marital counseling emerged and at the community level, the theme of community resources emerged.

DISCUSSION

The South Asian natal family or family members in positions of power can recognize red flags, raise their voice, take constructive action to address misogyny, rigid patriarchal attitudes, and prevent abuse before it occurs.

CONCLUSION

There is an urgent need to recognize and work at both preventative and protective levels to address the abuse among South Asian women in the U.S.

Overlooked Realities: Reimagining "Home" and "House" Among Women Domestic Workers in India

Domestic workers (DWs) are integral to the daily lives of a significant portion of India's urban population, with an estimated 3.9 million individuals employed in domestic roles in urban areas, mostly women. This article explores the perceptions of home, house, and safe spaces among migrant women DWs in Delhi. Through in-depth interviews, it delves into their lived experiences as both breadwinners and survivors of domestic violence, revealing that (a) house and home are differently conceptualized by these workers; (b) their homes are perceived as warzones, reinforcing patriarchy through incidents of domestic violence and gendered subordination; and (c) women DWs navigate the complexities of conflicting identities as breadwinners and survivors within unequal gendered relationships.

Women's Social Mobility and Attitudinal Acceptance of Wife Abuse: A Cross-Sectional Study Among Bengali, Santal, and Garo Ethnic Communities in Rural Bangladesh

Previous studies exploring the influential factors associated with attitudinal acceptance of wife abuse (AAWA) did not widely focus on the relation between women's social mobility (WSM) and different dimensions of AAWA in rural Bangladesh. This current study examined the association between WSM and different dimensions of AAWA in the context of socio-cultural differences among the Bengali, the Santal, and the Garo ethnic communities in rural Bangladesh. Adopting a cross-sectional design, 1,929 married men and women were randomly included in the study from 8 Bengali, 8 Santal, and 8 Garo villages where 50.2% were women and 49.8% were men. Of the sample, 33.2% Garo, 33.2% Santal, and 33.6% Bengali participants were included in this study. Data revealed that 45.5% of women had low social mobility and the prevalence of different dimensions of AAWA was high and varied among the study communities. We used descriptive statistics, chi-square, and binary logistic regression analysis to estimate the association. The multivariate binary logistic regression analysis results revealed that the likelihood of attitudinal acceptance of overall abuse, psychological abuse, physical abuse, abuse on disobeying family obligation, and abuse on challenging male authority were significantly lower for the respondents who belonged to families where women enjoyed high mobility compared to those who belonged to families where WSM was low. This study also showed that the Bengali and the Santal participants were more likely to accept different dimensions of AAWA compared to the Garos. This study suggests that WSM should be considered in policy-making and implementing interventions to reduce the different dimensions of AAWA in rural Bangladesh.

Attitudes Toward Wife Beating in Pakistan: Over-Time Comparative Trends by Gender

We investigate the determinants and over time patterns of perceptions toward wife beating from 2012 to 2018 in Pakistan. We use two waves of the Pakistan Demographic and Health Survey that include ever-married women and men aged 15 to 49 (12,607 women and 3052 men in 2012 and 11,543 women and 3055 men in 2018). Education, employment, wealth, and region influence attitudes toward wife beating. While women are generally more tolerant toward wife beating than men, the presence of a family member during the interview further increased their tolerance toward wife beating. Wife beating support has increased over time among women whose interviews were overheard and men. Additionally, households with joint decision-making have a lower tolerance toward wife beating, even lower than households where the wife is the main decision-maker.

Taking Advantage of a Window of Opportunity: Factors Associated With Jewish Bathhouse Attendants' (Balaniyot) Assistance to Female Victims of Intimate Partner Violence

Victims of intimate partner violence may endure years of pain, fearing to turn for help. Informal service providers are potential sources of assistance. This study explored factors impacting two assistance outcomes provided by Jewish "balaniyot" (bathhouse attendants): actions aimed at protecting the woman, and actions aimed at protecting family integrity. Balaniyot (n = 166) completed self-report questionnaires assessing mastery, organizational commitment, spirituality at work, and beliefs about violence. All variables were associated with at least one outcome. Organizational commitment mediated most of these associations. The findings suggest the need to increase balaniyot's organizational commitment and condemnation of violence and offer them specialized training.

The influences of sociocultural norms on women's decision to disclose intimate partner violence: Integrative review

Sociocultural norms against women can contribute to promoting intimate partner violence (IPV) and shape women's decision to disclose IPV. A cross-cultural analysis of the existing literature is needed to present an overview of the influences of sociocultural norms on women's decisions regarding the disclosure of IPV across different cultural contexts. The purpose of the review was to synthesize published quantitative, qualitative, and mixed methods (MMs) studies to identify known sociocultural norms across different cultures that may influence women's decision to disclose IPV. The Whittemore and Knafl framework, Rayyan software, and PRISMA flow diagram were used. Databases included APA PsycInfo, CINAHL, PubMed, SocINDEX, and Women's Studies International. The quality of studies was assessed by the MMs appraisal tool. A total of 15 research articles written in English and published in peer-reviewed journals were included. Main categories emerged: (1) stigma surrounding IPV disclosure, victimization, and divorce; (2) gender roles; (3) preserving family honor; and (4) Children's well-being and future. A one-size-fits-all approach is not adequate for women who are considering disclosing IPV. Findings underscore that regardless of residing in individualistic countries, those sociocultural norms related to traditional gender roles and gender inequality are still important barriers to the disclosure of IPV among women with collectivist roots.

Does Childhood Experience of Interparental Abuse Shape Women's Attitude Toward Intimate Partner Violence in Their Adult Life? Evidence From 31 Developing Countries

A significant amount of literature exists on the lasting effects of interparental abuse on children's psychological health as adults. However, evidence on how children's childhood experience of interparental violence shapes their attitude toward partner violence in adult intimate relationships is limited. Given the existing evidence that women's acceptance of partner violence as a social norm increases the risk of partner violence, we analyzed the effect of girls' witnessing interparental abuse (where a father is a perpetrator) on their attitude toward partner violence in their intimate relationships as adults. We used data from the Demographic and Health Surveys for 31 low and middle-income countries in Asia and Africa. Aggregating information about women's attitudes toward partner violence into a binary "intimate partner violence acceptance" variable, we found that a woman who witnessed her father beat her mother was 1.62 times more likely to justify partner violence than a woman who did not experience such interparental abuse (adjusted odds ratio [AOR] = 1.62, 95% CI [1.57, 1.66], p < .001). Additionally, using individual components of acceptance as response variables, we found that a woman who witnessed interparental abuse was significantly more likely to justify partner violence if she went out without telling her husband (OR = 1.49, 95% CI [1.45, 1.54], p < .001), neglected children (OR = 1.53, 95% CI [1.49, 1.58], p < .001), argued with the husband (OR = 1.49, 95% CI [1.45, 1.53], p < .001), refused sex with the husband (OR = 1.35, 95% CI [1.31, 1.39], p < .001), or burned food (OR = 1.36, 95% CI [1.31, 1.41], p < .001). This study highlights the need to put in place children-specific social policies to limit the intergenerational transmission of the adverse effects of intimate partner violence.

Exposure to interparental violence and justification of intimate partner violence among women in Papua New Guinea

BACKGROUND

Previous studies have demonstrated that exposure to interparental violence is associated with intimate partner violence justification in a variety of contexts. In this study, we examined the association between exposure to interparental violence and justification of intimate partner violence among women in Papua New Guinea.

METHODS

We used data from the 2016-18 Papua New Guinea Demographic and Health Survey. We included 2839 women of reproductive age (15-49 years) in a sexual union (married and cohabiting) in the study. We used a multivariable binary multilevel regression analysis to examine the association between interparental violence and justification of intimate partner violence. We presented the results of the regression analysis using crude odds ratio (cOR) and adjusted odds ratios (aORs), with their 95% confidence intervals (CIs).

RESULTS

Women exposed to interparental violence were 1.26 (95%CI = 1.05, 1.53) times more likely to justify intimate partner violence than those who were not exposed. Women who resided in the Highlands (aOR = 2.50, 95%CI = 1.78, 3.51), Momase (aOR = 1.96, 95%CI = 1.40, 2.75), and Islands (aOR = 1.42, 95%CI = 1.01, 1.99) were more likely to justify intimate partner violence compared to those in the Southern region. Women who were exposed to one (aOR = 1.38, 95%CI = 1.06, 1.82) mass media were more likely to justify intimate partner violence compared to those who had no exposure to mass media. On the other hand, women aged 25-34 years (aOR = 0.66, 95%CI = 0.48, 0.91) and 35-49 years (aOR = 0.66, 95%CI = 0.44, 0.97) were less likely to justify intimate partner violence compared to those aged 15-24 years.

CONCLUSIONS

Our study has shown that exposure to interparental violence is a predictor of intimate partner violence justification. This study suggests the need for conscious and continuous efforts to identify and assist women who have been exposed to interparental violence to help prevent its transition to later life. Policies and interventions should be developed and implemented to curtail children's exposure to domestic violence in their households. Also, laws and policies need to condemn any violence and demystify community justification and acceptance of intimate partner violence, taking into consideration the significant sociodemographic characteristics of the women highlighted in the study.

Partner alcohol consumption and intimate partner violence among women in Papua New Guinea: a cross-sectional analysis of Demographic and Health Survey

OBJECTIVE

We examined the association between partner alcohol consumption and the experience of intimate partner violence among women in Papua New Guinea.

DESIGN

We performed a cross-sectional analyses of data extracted from the 2016-2018 Papua New Guinea Demographic and Health Survey. We included 3319 women in sexual unions. Multilevel binary logistic regression analysis was used to examine the association between partner alcohol consumption and intimate partner violence, controlling for the covariates. Results from the regression analysis were presented using the crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95% confidence intervals (CIs).

SETTING

Papua New Guinea.

PARTICIPANTS

Women aged 15-49 years in sexual unions.

OUTCOME MEASURES

Physical, emotional, and sexual violence.

RESULTS

The prevalence of physical, emotional and sexual violence among women in sexual unions in Papua New Guinea were 45.9% (42.4 to 47.7), 45.1% (43.4 to 46.8) and 24.3% (22.9 to 25.8), respectively. The level of partner alcohol consumption was 57.3%. Women whose partners consumed alcohol were more likely to experience physical violence (aOR=2.86, 95% CI=2.43 to 3.37), emotional violence (aOR=2.89, 95% CI=2.44 to 3.43) and sexual violence (aOR=2.56, 95% CI=2.08 to 3.16) compared with those whose partners did not consume alcohol.

CONCLUSION

This study found a relatively high prevalence of intimate partner violence among women in Papua New Guinea. Most importantly, this study found partner alcohol consumption to be significantly and positively associated with intimate partner violence. The study, therefore, recommends that interventions seeking to reduce intimate partner violence among women in Papua New Guinea should intensify behaviour change and education on reducing or eliminating partner alcohol consumption.

Cross-National Associations between Age at Marriage and Intimate Partner Violence among Young Women: An Analysis of Demographic and Health Surveys from 48 Countries

We estimated the associations between age at first marriage and recent intimate partner violence (IPV) among women young women aged 20-24 years using data from demographic and health surveys (DHS) conducted at 48 low- and middle-income countries (LMICs). We fitted a multilevel logistic regression model controlling for sociodemographic covariates. Our pooled analyses revealed that age at marriage is strongly associated with past year IPV in a non-linear way, with steep reductions in violence when young women marry after age 15 and a continued decline in IPV for every year marriage is delayed up to age 24. The risk of physical IPV was 3.3 times higher among women married at age 15 (24.4%, 95% CI 19.7; 29.2%) compared to young women married at age 24 (7.5%, 95% CI 5.8; 9.2%). For sexual IPV, girls married at 15 had 2.2 times higher risk compared to those married at 24 (7.5%, 95% CI 5.6; 9.5% vs. 3.4%, 95% CI 2.7; 4.2%, respectively). For psychological IPV, the relative risk was 3.4 for the same comparison (married at 15: 20.1%, 95% CI 14.6; married at 24: 25.5% vs. 6.0%, 95% CI 3.4; 8.6%). Country specific analyses showed that, age at marriage was negatively associated with physical and psychological IPV in nearly half of the countries (n/48) and with sexual IPV in ten countries. Our findings underscore the importance of integrating violence prevention and response interventions into efforts to prevent child marriage, as well as the health, educations and social services young women access.

Magnitude and associated factors of intimate partner violence among youth women in Ethiopia: multilevel analysis based on 2016 Ethiopian Demographic and Health Survey

BACKGROUND

The period of youth is important for the foundation of healthy and stable relationships, women's health and well-being. Youth women face a higher risk of experiencing violence than older women. Intimate partner violence (IPV) against youth women is a significant public health concern. Despite paramount negative health consequences of IPV for the survivor, as per our knowledge, research study on IPV and associated factors among youth women in Ethiopia is scarce. Therefore, this study aimed to assess the magnitude and associated factors of IPV among youth women in Ethiopia.

METHODS

The data was accessed from 2016 Ethiopia demographic and health survey (EDHS) which was a cross sectional population based household survey. It was also conducted using a multi-stage stratified random cluster sampling approach. The data were cleaned, weighted, and analyzed using STATA Version 14 software. The total weighted sample of 1077 youth women were used in this study. Multilevel logistic regression modeling was used to determine factors associated with IPV among youth women. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 were used to declare the significant variables.

RESULTS

Among the total participants, 30.27% (95% CI 27.59, 33.09) of youth women experienced IPV. Individual level variables such as: Being widowed/divorced/separated (AOR = 2.28; 95% CI 1.33, 3.91), having a partner who drinks alcohol (AOR = 5.76; 95% CI 3.42, 9.69), witnessing inter-parental violence during childhood (AOR = 3.45; 95% CI 2.21, 5.37), being afraid of partners (AOR = 7.09; 95% CI 4.30, 11.68), and from community level variables, youth women residing in communities with a low proportion of educated youth women (AOR = 0.31; 95% CI 0.13, 0.78) were significantly associated with having experience of IPV.

CONCLUSION

The magnitude of intimate partner violence among youth women in Ethiopia was relatively high as compared to the global estimate of IPV. Individual and community level variables such as currently widowed/divorced/separated women, having a partner who drinks alcohol, witnessing inter-parental violence, being afraid of partner, and women from a low proportion of community level youth women's education were significantly associated with intimate partner violence. To decrease this public health problem, it is better to strengthen legislation on the purchase and sale of alcohol, provide legal protection for separated/divorced women, establish effective legal response services for IPV, promote gender equality, and provide psychological support for those who witnessed inter-parental violence during childhood to reduce IPV.

Social Norms Sustaining Intimate Partner Violence: A Systematic Review of Methodologies for Proxy Measures

In light of the many robust quantitative data sets that include information on attitudes and behaviors related to intimate partner violence (IPV), and in an effort to expand the evidence base around social norms and IPV, many researchers construct proxy measures of norms within and across groups embedded in the data. While this strategy has become increasingly popular, there is no standardized approach for assessing and constructing these norm proxies, and no review of these approaches has been undertaken to date. This study presents the results of a systematic review of methods used to construct quantitative proxy measures for social norms related to IPV. PubMed, Embase, Popline, and Scopus, and PsycINFO were searched using Boolean search techniques. Inclusion criteria comprised studies published since 2000 in English that either (i) examined a norm proxy related to gender or IPV or (ii) analyzed the relationship between a norm proxy and perpetration of, experiences of, or attitudes toward IPV. Studies that employed qualitative methods or that elicited direct measures of descriptive or injunctive norms were not included. Twenty-six studies were eligible for review. Evidence from this review highlights inconsistencies in how proxies are constructed, how they are assessed to ensure valid representation of norms, and how researchers acknowledge their respective method's limitations. Key processes and reflections employed by some of the studies are identified and recommended for future research inquiries.

Media Use and Men's Approval of Intimate Partner Violence in Honduras

Intimate partner violence (IPV) is a widespread issue that affects millions of individuals each year. Prior research suggests that IPV approval is associated with an increased likelihood of IPV perpetration. However, scant research has examined predictors of IPV approval, and even less has examined the predictors of IPV approval in Latin America. Social cognitive theory describes the acquisition of ideas, values, attitudes, and behaviors through social observation, including through media. This study uses social cognitive theory to examine the effects of media use on men's approval of IPV in Honduras, while controlling for demographic variables and IPV risk factors. We hypothesized that greater engagement with media (via television, radio, and newspapers or magazines) would be associated with decreases in the approval of IPV. Using ordinal logistic regression, we analyzed data from the Men's Survey Module of the 2011-2012 Honduras Demographic and Health Survey. The final sample included 4,760 currently partnered men. Results suggest that listening to the radio one or more times per week was associated with greater IPV approval, while newspaper/magazine and television use were not significantly associated with IPV approval. Education, marital status, increased age at first cohabitation, and having a female partner or someone else making decisions about earnings were all protective against IPV approval. Further investigation into the content of Honduran radio and other media is called for in order to inform interventions to reduce acceptance of IPV.

Trends in attitudinal acceptance of wife-beating, domestic violence, and help-seeking among married women in Nepal

This study aimed to assess the nature and magnitude of perceptions of wife-beating among women and men in Nepal and experiences of domestic violence (DV) and help-seeking among DV victims. The Nepal Demographic Health Surveys (NDHS) (2001, 2006, 2011, 2016) included questions on whether women and men justify wife-beating and whether DV victims sought help (NDHS 2011 and 2016). Covariates in regression models were guided by the socioecological model. We estimated odds ratios for dichotomous outcomes. Compiled data from Multiple Indicator Cluster Surveys was used to understand trends. About 29.1% women justified wife-beating in 2001, 24.2% in 2006, and 29.1% in 2016. About 32.4% of women experienced any DV in 2011 and 28.0% in 2016. In 2011 about 21.8% of those abused sought help and in 2016 about 25.8% sought help. Women who justified wife-beating were more likely to experience DV in 2011 (OR 5.8, p < 0.001) and in 2016 (OR 1.5, p < 0.001) and less likely to seek help in 2011 (OR 0.3, p < 0.001) and in 2016 (OR 0.8, p < 0.001). Perceptions of wife-beating play an important role in actual experiences of DV and help-seeking behavior of DV victims. Societal and individual beliefs are intertwined, and cultural norms have a great bearing on these beliefs. Both individual and wider societal-level acceptance of violence needs to be addressed simultaneously.

Sociocultural Determinants of Attitudes Toward Domestic Violence Among Women and Men in Afghanistan: Evidence from Afghanistan Demographic and Health Survey 2015

Domestic violence (DV), also commonly referred to as intimate partner violence or spousal abuse, is a global public health issue that affects the physical, psychological, sexual, and reproductive health of women. We examined the sociocultural factors associated with the attitude toward DV perpetrated against women in Afghanistan. We used data from the 2015 Afghanistan Demographic and Health Survey, consisting of an ever-married sample of 29,461 women and 10,760 men aged 15 to 49 years. Our dependent variable, attitude toward DV, was determined from responses on acceptance of wife-beating in five scenarios, and the group of socio cultural factors was selected based on evidence from previous studies. Our main analytical method was logistic regression, using the survey design. Our findings indicated that factors such as an increase in years of education and living in a wealthier household reduce the likelihood of acceptance of DV among men and women. Ethnicity was also associated with the attitude toward DV, but the magnitude varied across ethnic groups and gender. Furthermore, an increase in age and living in the urban area were associated with nonjustification of DV among women, but not among men. On the other hand, frequent exposure to the media increases the likelihood of acceptance of DV among men, but not for women. The result of the present study suggests that there are economic, social, and cultural aspects to the attitude toward DV among men and women in Afghanistan. Therefore, policies designed at changing the socio cultural perception of the people are of importance in other to bring about a change in attitude, and even combat the prevalence of DV.

Spousal Role Expectations and Marital Conflict: Perspectives of Men and Women

Intimate partner violence (IPV) affects millions of people across the world and is associated with a significant impact on physical and mental health of the victim. IPV often takes place within the context of marriage, where gender role expectations can play an important part in shaping attitudes towards it. While there is much research carried out to understand the phenomenon of IPV, little relates to how a husband and wife's accounts of spousal role expectations of each other contribute to marital conflict. The issue of IPV within marriage is highly sensitive, particularly in a patriarchy such as Pakistan. The aim of this unique study was to explore the perspective of Pakistani men and women about a husband and wife's role expectations and how fulfillment of such spousal role expectations impacts on marital conflict, and thereby IPV. Using the community setting, data for this qualitative study were collected through 41 individual interviews, including 20 from Pakistan and 21 from the UK. The findings are presented in two main themes, each containing two subthemes. The theme "provider and protector" relates to the role expectations from a husband, whereas "caretaker and household manager" relates to the role expectations of a wife. Overall, husbands and wives have numerous expectations of each other, and these expectations are shaped by gender role attitudes alongside cultural and societal norms. Unmet expectations and deviation of behavior from the perceived norms can result in the development of marital conflict which can escalate to IPV. The significance of this study lies in understanding spousal role expectations from the perspectives of husbands and wives and how unmet expectations contribute to marital conflict and IPV is important for health care professionals within family health contexts. This article provides a detailed insight of this largely hidden phenomena.

Married Women's Attitude toward Intimate Partner Violence Is Influenced by Exposure to Media: A Population-Based Spatial Study in Bangladesh

This study estimated the attitudes of women toward accepting IPV at district level in Bangladesh and examined its relationship with sociodemographic predictors including exposure to media (e.g., newspaper, radio and television) using the Multiple Indicator Cluster Survey-2019 with a sample of 63,689 women. Around 25.6% women accepted IPV that geographically varied from 1.78% (Pirojpur) to 57.14% (Kurigram). Women regularly exposed to media were 17% less likely to accept IPV. Attitude toward accepting IPV was found to be higher among the illiterate women in disadvantaged circumstances, patriotically from poorer households living in remote areas, which suggest that planned interventions are needed for this vulnerable group of women to improve their living status by providing access to education and media. Further research is necessary to assess the impact of women's empowerment on their attitude toward acceptance of IPV.

Women empowerment and sexually transmitted infections: Evidence from Bangladesh demographic and health survey 2014

BACKGROUND

Sexually transmitted infections (STIs) among women have led to substantial public health and economic burdens in several low-middle-income countries. However, there is a paucity of scientific knowledge about the relationship between empowerment and symptoms of STIs among married Bangladeshi women. This article aimed to examine the association between women empowerment and symptoms of STIs among currently married Bangladeshi women of reproductive age.

MATERIALS AND METHODS

We extracted data from the Bangladesh Demographic and Health Survey (BDHS), conducted from June 28, 2014, to November 9, 2014. We utilised cross-tabulation, the conceptual framework and multivariable multilevel mixed-effect logistics regression to explore the association between women's empowerment indicators and women's self-reported symptoms of genital sore and abnormal genital discharge. All of the analysis was adjusted using cluster weight.

RESULTS

We found that among 16,858 currently married women, 5.59% and 10.84% experienced genital sores and abnormal genital discharge during the past 12 months, respectively. Women who depended on husbands to make decisions regarding their health care (AOR = 0.75, 95% CI = 0.67-0.84), significant household purchases (AOR = 0.79, 95% CI = 0.71-0.88), and visiting family or relatives (AOR = 0.72, 95% CI = 0.64-0.80) were less likely to report signs of abnormal genital discharge. Women who could make joint healthcare decisions with their husbands were also less likely to report genital sores (AOR = 0.78, 95% CI = 0.67-0.90).

CONCLUSION

Genital sores and abnormal genital discharge were prevalent across all parameters of women empowerment among currently married women in Bangladesh. Our estimates show that the husband plays a significant role in decision-making about sexual and reproductive health. Efforts need to be invested in establishing culturally relevant gender policies which facilitate the involvement of women in joint decision-making.

Structural Context and the Role of Positive Deviance From Community Norms in Shaping Risk for Sexual Intimate Partner Violence in 32 Low- and Middle-Income Countries

Community norms provide social scripts and pathways to accruing social capital that can alter a woman's risk of experiencing sexual intimate partner violence (IPV). These norms are in turn influenced by the structural environment in which they exist. Missing from the literature is an understanding of how an individual's departure from community norms-positive deviance-influences the risk of sexual IPV and how this effect may vary across structural environments. Demographic and Health Survey data from 32 low- and middle-income countries (LMIC) were stratified into six structural environments by two fundamental structural factors: level of gender inequality and prevalence of sexual IPV. To examine how transcending community norms shape the odds of reporting sexual IPV across environments, six identical multilevel models were fit including statistical deviation from 13 community norms as key covariates. Positive deviance from community norms is associated with both increased and decreased odds of reporting sexual IPV and the nature of these relationships vary by structural environment. Positive deviance had a greater effect on reporting sexual IPV in highly unequal societies. Positive deviance from fertility preferences and controlling behavior was associated with increased odds of sexual IPV across contexts. The accrual of social capital and differences in female autonomy across environments may be two ways positive deviance alters sexual IPV risk. A better understanding of how the salience of community norms varies by structural environment and how transcending these norms shapes the risk for sexual violence may help highlight pathways for interventions to change restrictive social norms and increase female empowerment without increasing the risk of sexual IPV.

Intimate partner violence among ever-married Afghan women: patterns, associations and attitudinal acceptance

Intimate partner violence (IPV) is one of the most prevalent forms of violence that women suffer globally. Women in Afghanistan have been exposed to high levels of IPV which coincided with high levels of conflict during more than four decades. We cross-sectionally examined the Afghanistan Demographic and Health Survey responses of 21,234 ever-married Afghan women. We first performed the frequency distribution analysis to determine the prevalence of IPV and the basic socio-demographic characteristics of the participants. Subsequently we examined the relationship between the independent and dependent variables followed by the bivariate and survey versions of logistic regression analyses. We report odds ratios in order to depict the strength and direction of the associations between the IPV and selected independent variables. P-values less than 0.05 were considered statistically significant. The analyses showed that 55.54% of Afghan women experienced some form of physical, emotional, or sexual violence by their intimate partners during the recall period partners. The most common form of IPV found was physical violence (50.52%). Factors such as being exposed to inter-parental violence (respondent woman's father physically abused her mother) (adjusted OR= 3.69, CI= 3.31-4.10) and respondent's acceptance of IPV (aOR= 1.85, 1.51-2.26) were associated with increased exposure to IPV. Having a spouse with at least a primary education (aOR= 0.76, CI= 0.64-0.91) or a respondent with at least a primary education (aOR= 0.82, CI= 0.68-0.98) was associated with lower exposure to reported IPV. The lifetime experience of IPV occurs to a high extent among Afghan women, and several socio-demographic factors have predisposing attributes. IPV policy formulation and strategizing may benefit from considering these factors.

Social norms and the association between intimate partner violence and depression in rural Bangladesh-a multilevel analysis

BACKGROUND

Intimate partner violence (IPV) is highly prevalent globally and associated with adverse mental health outcomes among women. In IPV-endemic contexts like Bangladesh, previous research has found no association between low levels of IPV and depression. Although IPV and attitudes justifying IPV against women are highly prevalent in this context, nothing is known about how related contextual norms affect associations between individual-level IPV exposure and depression. The present study examines if village-level IPV norms, characterized using village-level (Level 2) prevalence of a) IPV-justifying attitudes (injunctive norms) and b) physical IPV (descriptive norms), modifies the individual-level (Level 1) associations between the severity of recent IPV and major depressive episode (MDE) among women in rural Bangladesh.

METHODS

Data were drawn from a nationally-representative sample consisting of 3290 women from 77 villages. Multilevel models tested cross-level interactions between village-level IPV norms and recently experienced individual-level IPV on the association with past 30-day MDE.

RESULTS

The prevalence of IPV was 44.4% (range: 9.6-76.2% across villages) and attitudes justifying IPV ranged from 1.6% to 49.8% across villages. The prevalence of MDE was 16.8%. The risk of MDE at low levels of IPV severity (versus none) was greater in villages with the least tolerant attitudes toward IPV compared to villages where IPV was more normative, e.g., interaction RR = 1.42 (95% CI: 0.64, 3.15) for low physical IPV frequency and injunctive norms.

CONCLUSIONS

The association between IPV and depression may be modified by contextual-level IPV norms, whereby it is exacerbated in low-normative contexts.

The Role of Social Norm in Acceptability Attitude of Women Toward Intimate Partner Violence in Punjab, Pakistan

Intimate partner violence (IPV) is a public health and human rights issue with the social and economic impacts felt by women. Punjab is a male-dominated society, where partner violence is generally accepted as a cultural norm and viewed as normal behavior within a marriage. It stems from attitudes that partner violence is a private matter and usually a justifiable response to misbehavior on the part of the wife. The focus of the current study is to investigate the impact of this cultural norm in acceptability attitude of women toward IPV in Punjab province. A large-scale sample size of more than 46,000 from Multi-Indicator Cluster Survey (MICS) 2018 has been used. The impact of the cultural norm on the wife-beating attitude has been investigated in five dimensions: wife going out without telling him, neglecting the children, arguing with him, refusing to have sex with him, and burning the food. The logistic regression results indicate that wife-beating is accepted as a community norm. It has been found that if wife-beating is accepted by community, then the individual female is more than 3 times more likely to consider it justifiable in all five dimensions. The other important factors are education level, household wealth, ethnicity, media exposure, and wife-husband age difference. The level of education of women plays the most important role in rejecting the wife-beating norm, as an increase in level of education is associated with an increase in the probability of rejecting the wife-beating. So, the current study suggests that there is a dire need to increase the female education level to overcome this issue.

Survivors' Social Construction of Intimate Partner Violence in Cebu City, Philippines

Intimate partner violence (IPV) is a worldwide social issue perpetrated by intimate male partners against their wives. Studies on IPV have generated accurate comparative information since the 1993 World Conference on Human Rights and the Declaration on the Elimination of Violence Against Women to guide strategy and track progress in attempts to comprehend the IPV issues. In many attempts to understand violence against women, the social construction of IPV was not well documented in the literature. This article aims to explore IPV survivors' social construction of IPV by analyzing the experiential narratives of IPV survivors. To address the objective, this article used the phenomenological approach by examining the lived experiences of 15 IPV survivors. Our study finds that IPV made IPV survivors empowered, and with this social construction, survivors were able to overcome violence perpetrated by their intimate partners. The findings further proved that giving preferential attention to the needs of IPV victims could lead to victim empowerment, a factor needed in the elimination of violence against women and children in all forms. It is suggested for any intervention activities to (a) ultimately address the empowerment of individuals and (b) respond to the needs of individuals because what may work for one victim may not work for another.

An integrated theoretical framework to explain interpersonal moralistic conflict

This paper offers an integrated theoretical framework to explain interpersonal, moralistic conflict that combines the logic of the "pure sociology" approach with a social psychological framework that highlights the importance of the human capacity for language, evaluation, and justification. While violations of normative expectations are the root causes of moralistic conflict, the paper argues that one can only determine the emergence of such conflict by assessing the nature of the behavior in question in relation to the social locations of the participants in combination with the justifications invoked. The central question that the theory addresses can be distilled as follows: What explains the emergence of interpersonal, moralistic conflict? The paper specifies three core assumptions, followed by a delineation of a series of propositions designed to explicate the conditions under which moralistic conflicts emerge. The theory identifies the combination of the social geometry of interpersonal encounters along with the mechanisms that typically are used to justify the grievances that individuals express toward one another.

Exposure to domestic violence and the risk of developing depression within 6 months postpartum in Bangladesh

PURPOSE

Domestic violence (DV) by husbands or in-laws is a recognized problem in many countries and is associated with a wide range of adverse mental health outcomes. However, detailed knowledge on the relationship between DV experience and postpartum depression (PPD) is essential to design appropriate interventions. Therefore, this study assesses the relationship between maternal experience of DV perpetrated by husbands or in-laws and PPD in Bangladesh.

METHODS

A cross-sectional survey was conducted from October to December 2019 among 497 mothers within the first 6 months postpartum who attended a health center in Rajshahi City Corporation, Bangladesh. Multivariable logistic regressions were performed to identify the associations after controlling for potential confounders.

RESULTS

The prevalence of PPD in this sample was 34% within the first 6 months after birth; 58.6% of mothers reported having experienced any form of DV in their lifetime. Maternal experience of any form of DV (Adjusted Odds Ratio [AOR] = 1.87; 95% confidence interval [CI] = 1.19-2.93) was associated with PPD, as were experiences of any physical DV (AOR = 2.25; 95% CI = 1.40-3.59), emotional DV (AOR = 2.07; 95% CI = 1.34-3.19), and controlling behavior (AOR = 1.69; 95% CI = 1.08-2.66). Additionally, the likelihood of PPD significantly increased among women who experienced more forms of DV.

CONCLUSION

DV perpetrated by husband and/or in-laws is highly prevalent and significantly associated with PPD in Bangladesh. Strategies in developing interventions for improving maternal mental health should consider DV perpetrated by either husband or in-laws.

Does childhood experience of family victimization influence adulthood refusal of wife abuse? Evidence from rural Bangladesh

This study examined how different forms of childhood family victimization are associated with the attitudinal (not actual action) refusal of wife abuse among women and men in rural Bangladesh. It included 1,929 randomly selected married women and men. Of the sample, 31.3% (Men = 49.3%, Women = 13.5%) attitudinally refused overall wife abuse, 38.5% (Men = 53.2%, Women = 23.8%) refused emotional abuse, 67.0% (Men = 82.5%, Women = 51.6%) refused physical abuse, 78.0% (Men = 88.6%, Women = 67.4%) refused abuse on wife’s disobeying family obligations, and 32.3% (Men = 50.3%, Women = 14.6%) refused abuse on challenging male authority. Multivariate logistic regression revealed that the odds ratio (ORs) of the attitudinal refusal of overall wife abuse were 1.75 (p = .041) for the childhood non-victims of emotional abuse and 2.31 (p < .001) for the victims of mild emotional abuse, compared to the victims of severe emotional abuse. On the other hand, the ORs of the overall refusal of abuse were 1.84 (p = .031) for the non-victims of physical abuse and 1.29 (p = .465) for the victims of mild physical abuse, compared to the childhood victims of severe physical abuse. Data further revealed that the childhood non-victimization of physical abuse increased all types of attitudinal refusal of wife abuse, e.g., emotional abuse, physical abuse, abuse on disobeying family obligations, and abuse on challenging male authority. Compared to the childhood experiences of severe emotional abuse, data also indicated that childhood exposure to mild emotional abuse might increase the attitudinal refusal of wife abuse on a few issues, e.g., abuse on disobeying family obligations, abuse on challenging male authority, and physical abuse. It appeared that childhood experiences of family victimization greatly influence different types of attitudinal refusal of wife abuse. We argue that the issue of childhood victimization should be brought to the forefront in the discourse. We recommend that state machinery and social welfare agencies should expend significant efforts to stop child abuse within the family and in other areas of society in rural Bangladesh.

Is Attitudinal Acceptance of Violence a Risk Factor? An Analysis of Domestic Violence Against Women in Pakistan

Violence against women (VAW) is a grave problem in Pakistan, and women from all socioeconomic groups are vulnerable to domestic violence in varying degrees. It is argued that patriarchal definition of gender roles may reinforce the internalized inferiority of women. So, it may not be a mere coincidence that a large number of women in Pakistan justify VAW for various reasons. The objectives of this article are threefold: (a) to identify the drivers of VAW, (b) to see if women's attitudinal acceptance of violence is causally linked with observed violence against women, and (c) to see if attitudinal acceptance of violence mediates between the socioeconomic status of women and observed violence. We used data from the Pakistan Demographic and Health Survey (PDHS) 2012-13. The sample consisted of 3,265 ever married women aged between 15 and 49 years who were interviewed for domestic violence. We used multivariate logit regression analysis to identify the drivers of VAW and used the Karlson-Holm-Breen (KHB) method for mediation analysis. We found that women's attitudinal acceptance of violence, their childhood experience of violence in their parental household, the education of both husband and wife, and some occupation types significantly predicted their experience of spousal violence. In addition, we found that women's attitudinal acceptance of violence mediated the relationships between socioeconomic factors (education and wealth status) and VAW. The significance of the study lies in the fact that it highlights the need to modify the perceptions of violence through change in educational policy. Among multiple other factors, an increase in the economic status of women is an effective hedge against the risk of spousal violence.

Individual and societal risk factors of attitudes justifying intimate partner violence against women: a multilevel cross-sectional study

OBJECTIVES

Attitudes justifying intimate partner violence against women (IPVAW) can play an essential role in explaining the prevalence of such public health problem. The study aim was to explain attitudes justifying IPVAW identifying individual and societal risk factors.

DESIGN AND SETTING

A multilevel cross-sectional study of the World Values Survey (WVS) in 54 global countries.

PARTICIPANTS

A representative transnational community-based sample of 81 516 participants (47.8% male, 52.1% female), aged mean of 42.41.

MEASURES

Attitudes justifying IPVAW, sociodemographic, sexism, self-transcendence and conservation values were measured using questions from WVS. Country and regional gender inequality were assessed by Gender Inequality Index.

RESULTS

Around 16% (intraclass correlation=0.16) of individual differences in attitudes justifying IPVAW are explained by countries. Statistically significant predictors at individual and country level were: sex (B=-0.24, 95% CI -0.27 to -0.22), age (B=-0.08 to -0.25, 95% CI -0.34 to -0.03), marital status (B=0.09 to 0.23, 95% CI 0.002 to 0.33), educational level (B=-0.10 to -0.14, 95% CI -0.20 to -0.04), self-transcendence values (B=-0.10, 95% CI -0.20 to -0.12), sexism (B=0.21, 95% CI 0.15 to 0.28), country (B=2.18, 95% CI 1.09 to 3.26) and regional (B=2.23, 95% CI 1.04 to 3.42) gender inequality. Country gender inequality (B=-0.18, p=0.12) and regional gender inequality (B=-0.21, p=0.10) did not moderate the associations between self-transcendence values and attitudes justifying IPVAW. In the same way for sexism, data did not provide support for a moderating role of country gender inequality (B=0.22, p=0.26) and regional gender inequality (B=0.10, p=0.66).

CONCLUSIONS

Individual and country predictors accounted for differences in attitudes justifying IPVAW. However, neither gender inequality of country nor gender inequality of region interacted with sexism and self-transcendence values. Theoretical and methodological implications are discussed.

Area-Level Normative Social Context and Intimate Partner Physical Violence in Mozambique

Violence against women is considered a serious public health problem. It is estimated that about 30% of women who have been in a relationship in the world have experienced some form of physical or sexual violence from their intimate partners. In sub-Saharan Africa, one of the regions in the world with the highest prevalence of intimate partner violence, there have been studies of factors associated with intimate partner violence. However, few studies have explicitly examined the influence of the normative social context on women's accepting attitudes toward spousal abuse and their risk of experiencing intimate partner violence in the region. Using data from the 2011 Demographic and Health Survey in Mozambique, we employ multilevel logistic regression to examine the influence of area-level normative social context factors on 4,864 women's accepting attitudes toward spousal abuse and their likelihood of experiencing intimate partner physical violence in Mozambique. Our findings revealed the importance of religious norms in geographic areas as key predictors of women's acceptance of intimate partner violence. Specifically, area-level normative religious predictors were negatively associated with women's acceptance of spousal abuse. The prevalence of early marriages in a given geographic area was positively associated with both acceptance of spousal abuse and experiencing intimate partner physical violence. The level of female education in a geographic area was negatively associated with accepting spousal abuse and having experienced intimate partner physical violence. As intimate partner physical violence in sub-Saharan Africa continues unabated, programs and interventions to address the problem will need to consider the normative context of geographic areas.

Differences in the acceptance of wife abuse among ethnic minority Garo and Santal and mainstream Bengali communities in rural Bangladesh

Studies on wife abuse in Bangladesh predominantly include the mainstream Bengali population, although there are at least 27 ethnic minority communities including a few 'female-centered' matrilineal groups living in the country. This study explored ethnic differences in the attitudinal acceptance of wife abuse among matrilineal ethnic minority Garo, patrilineal ethnic minority Santal, and mainstream patriarchal Bengali communities in rural Bangladesh. Adopting a cross-sectional design, the study included 1,929 women and men randomly selected from 24 Garo, Santal, and Bengali villages. Multivariate Poisson regression was performed to predict the number of contextual events, where the respondents attitudinally endorsed wife abuse. Of the sample, 33.2% were from Garo, 33.2% from Santal, and 33.6% from the Bengali communities. The acceptance of wife abuse was high in the sample; specifically, 34.1% of the respondents accepted physical wife abuse, 67.5% accepted emotional abuse, and 71.6% accepted any abuse (either physical or emotional) at least on one contextual reason provided in a 10-item scale. The mean for accepting any abuse was 3.0 (SD = 2.8), emotional abuse 2.3 (SD = 2.2), and physical abuse 0.8 (SD = 1.4). The study showed that the rates of accepting any abuse and physical abuse were respectively 16% and 56% lower among Garo as well as 14% and 33% lower among Santal than that of the Bengali community. Data also revealed that individual level factors like younger age, higher education, prestigious occupation as well as family level factors such as higher income, female mobility, and female family authority were inversely associated with the acceptance of wife abuse in the sample. It appears that the gender regime of a society has a great influence on the attitudes toward wife abuse. We argue that a comprehensive socio-cultural transformation of the patriarchal societies into a gender equal order is imperative for the prevention of widespread wife abuse in the country.

Improved child marriage laws and its association with changing attitudes and experiences of intimate partner violence: a comparative multi-national study

Background

Intimate partner violence (IPV) is a multi-national problem with many health consequences. Some research suggests that reducing rates of child marriage can improve gender norms and health outcomes related to IPV. Here, we examine whether changes in national child marriage laws can improve attitudes about domestic violence and reduce intimate partner violence at scale.

Methods

Data on attitudes towards violence and violence experienced were obtained from the Demographic and Health Surveys (DHS) and longitudinal data on child marriage policy from WORLD and MACHEquity databases (1995-2012). Treatment countries were included if they improved their national child marriage policies from harmful (under 18) to more protective and control countries were included if they had a constant child-marriage policy that allowed girls to marry under the age of 18. Our final data set included 5 treatment and 14 control countries for women’s outcomes, 2 treatment and 9 control countries for men’s outcomes and 2 treatment and 7 control countries for IPV outcomes (for which fewer countries collect data). We combined individual level responses to five questions on attitudes about domestic violence to create a scale from 0 (always unacceptable) to 5 (always acceptable). All analyses employed a difference-in-differences approach adjusting for individual and country level predictors.

Results

Data were available for 532 255 women, of which 96 414 also completed the domestic violence modules, and 104 704 men. National changes to a protective child marriage policy were associated with improved attitudes towards violence among women (-0.21 points, 95% confidence interval (CI) = -0.28, -0.14) and men (-0.98 points, 95% CI = -1.13, -0.83). Additionally, the risk of women experiencing physical and sexual abuse reduced by a greater proportion in treatment compared to control countries (odds ratio OR = 0.65, 95% CI = 0.50, 0.84; OR = 0.63, 95% CI = 0.45, 0.88, respectively).

Conclusions

Our large multi-national study is the first of its kind to critically evaluate the role of national policy on attitudes towards and experiences of IPV among both men and women, and finds that these laws have protective outcomes. Our results are consistent with the hypothesis that gender egalitarian laws positively influence norms and health at the national level.

Intimate partner violence and depression in rural Bangladesh: Accounting for violence severity in a high prevalence setting

Intimate partner violence (IPV) against women is highly prevalent globally, and is associated with adverse health outcomes, including depression. Though women living in low- and middle-income countries (LMICs) face a larger burden of IPV, little is known about whether IPV increases the risk of depression among non-pregnant women and in contexts of high prevalence. Within the setting of rural Bangladesh, this study examined the relationship between the severity of marital IPV against women and the risk of depression. Data were drawn from a nationally-representative study focused on individual and contextual determinants of IPV among married women aged 16-37 years in rural Bangladesh, collected through a multistage, stratified sample in 77 villages in 2014 (n=3290). Multivariable log-binomial regression models were used to estimate the association between the severity of IPV (operationalized as the frequency of different acts of psychological, physical, and sexual abuse, as well as injury due to IPV) and risk of major depressive episode (MDE) using the Edinburgh Postnatal Depression Scale (EPDS). One in six women (16.8%) met the criteria for MDE. Past year IPV was endemic; psychological (77.2%) was most common, followed by sexual (58.8%) and physical (44.4%). Nearly a third of women experienced IPV-related injury. There was a positive dose-response relationship between severity of each type of IPV and MDE above the lowest level of exposure. In adjusted models, the highest levels of psychological (RR=2.27, 95% CI: 1.62, 3.17), physical (RR=2.44, 95% CI: 1.94, 3.08), and sexual (RR=1.65, 95% CI: 1.08, 2.52) IPV severity remained significantly associated with MDE, as well as experiencing IPV-related injury (RR=1.72, 95% CI: 1.23, 2.40). In rural Bangladesh, the severity of all types of marital IPV against women is strongly related to increased risk of MDE. Results suggest the limited utility of standard dichotomous IPV indicators in high prevalence settings.

Explaining the links between child marriage and intimate partner violence: Evidence from Ghana

OBJECTIVE

This study examined the relationship between child marriage and intimate partner violence (IPV) in Ghana, looking specifically for possible mechanisms driving the relationship.

METHOD

Nationally representative cross-sectional data were collected from 2289 ever-married Ghanaian women and analysed using random-effects regression techniques.

RESULTS

Women who married as children differed significantly from those who did not in their socio-economic characteristics, attitudes to societal gender norms and autonomy. Compared to those who married as adults, women who married as children had lower levels of education, were more likely to endorse patriarchal gender norms and had lower levels of autonomy within the household. Results also showed significant relationships between child marriage and three dimensions of IPV (physical, sexual and emotional). However, for physical and sexual violence, this relationship was completely mediated by differences in the socio-economic characteristics of the women, their attitude to gender norms and their autonomy within the household.

CONCLUSION

Researchers must pay attention to these intermediary factors when theorizing the relationship between child marriage and IPV. Policy makers in Ghana must ensure that young girls receive formal education and have the self-efficacy and skills to reject patriarchal gendered norms that threaten their security and well-being.

Risk and protective factors of intimate partner violence among South Asian immigrant women and perceived need for services

OBJECTIVES

Limited research exists on multilevel influences of intimate partner violence (IPV) among immigrant groups in the United States, particularly South Asians. Using a socioecological framework, this study examined risk and protective factors of IPV among a diverse group of South Asian immigrant survivors of IPV and identified their perceived need for services.

METHOD

Sixteen South Asian immigrant survivors were recruited from New York; Maryland; Virginia; and Washington, DC, using a snowball sampling method. Participants were 1st-generation and 2nd-generation immigrants born in India (n = 4), Bangladesh (n = 4), Pakistan (n = 5), the United States (n = 2), and Sri Lanka (n = 1). Data were collected using in-depth interviews (n = 16) and a focus group (n = 1). A thematic analysis procedure was used to analyze the data and to identify themes across different ecological levels.

RESULTS

IPV was related to factors at multiple levels, such as cultural normalization of abuse, gender role expectations, need to protect family honor, arranged marriage system, abusive partner characteristics, and women's fear of losing children and being on own. Protective factors included supportive family and friends, religion, safety strategies, education, and empowerment. Women highlighted the need for community education and empowerment efforts and culturally responsive services for addressing IPV in South Asian communities.

CONCLUSIONS

South Asian survivors of IPV have experienced, and some continue to experience, abuse due to factors operating at multiple levels of the ecological framework. Consideration of culturally specific risk and protective factors for IPV at multiple contexts in women's lives could inform culturally responsive IPV prevention and intervention strategies for South Asian communities in the United States. (PsycINFO Database Record

Women's attitude towards wife-beating and its relationship with reproductive healthcare seeking behavior: A countrywide population survey in Bangladesh

Background

Intimate partner violence (IPV) is a global public health problem that has substantial consequences on the physical, mental, sexual and reproductive health of women. This study examined the association between women’s attitudes towards wife-beating and their utilization of reproductive healthcare services.

Method

Two waves of Bangladesh Demographic and Health Survey data were analyzed using multivariate regression. Outcome variables were a set of reproductive healthcare services, namely contraception use, modern contraception use, antenatal visit by skilled health professionals (SHP), delivery in healthcare facilities, delivery by SHP and postnatal check up by SHP. Attitudes towards abuse were assessed by a set of five questions that asked the situation under which ‘hitting or beating’ one’s wife is justifiable.

Results

Around 32% of the participants reported that hitting or beating wife by husband was justified in certain situations. There is a gradient in the relationship between number of healthcare services accessed and number of situations justified for beating wife. Women who strongly reject the justification of wife beating were more likely than those who reject that weakly to report contraception use, antenatal care by SHP, delivery in healthcare facilities, delivery care by SHP, and postnatal care by SHP.

Conclusions

Women’s attitudes towards ‘wife beating’ have a significant association with reproductive healthcare seeking behavior. The impact of this malpractice on women’s health and consequences thereafter need to be brought in the forefront of public health campaign.

How the Community Shapes Unmet Need for Modern Contraception: An Analysis of 44 Demographic and Health Surveys

Unmet need for modern contraception is a major public health concern in resource-constrained countries. Recent research supports the application of social-ecological theories to explain how characteristics of a woman's community shape modern contraception use. However, this research focuses largely on individual countries and uses a limited number of community-level effects. We fitted three random-effects logistic regression models to examine associations between 13 community-level variables and the odds of reporting unmet need, unmet need for spacing, and unmet need for limiting for all parous, female respondents in 44 DHS surveys collected in 2010-2015 (n=528,101). Community variables explain significant variance in unmet need between communities. Associations between community variables and unmet need differ by urban and rural residence. The results highlight several commonalities in how the community shapes unmet need across resource-constrained settings and may help in designing structural-level interventions.

A national survey of attitudes toward intimate partner violence among married women in Kazakhstan, Kyrgyzstan, and Tajikistan: Implications for health prevention and intervention

Attitudes toward intimate partner violence (IPV) can affect the prevalence of IPV, response of victims' to IPV (e.g., whether to seek help), and the response of professionals (e.g., police, social workers, health care professionals) to IPV. Knowledge about IPV-related attitudes is essential for developing effective social work and violence-related programs. Using data from the 2005-2006 Multiple Indicator Cluster Surveys, this study examines attitudes toward IPV and socio-demographic predictors of these attitudes among married women in Kazakhstan, Kyrgyzstan, and Tajikistan. Women were asked whether they approved of a husband beating his wife: if she goes out without telling him, neglects their children, argues, refuses to have sex, and burns food. The prevalence of IPV acceptance for at least one of the five reasons varied from 12.3% in Kazakhstan to 45.3% in Kyrgyzstan and 74.5% in Tajikistan. Women who were less educated, members of Asian ethnic groups, resided in middle-class urban areas, and lived in specific regions were more likely to accept IPV. Few age differences that emerged indicated that young women were more approving of IPV. Proactive efforts are needed to confront attitudes about gender roles and IPV in Tajikistan and Kyrgyzstan.