The risk factor of domestic violence in India

Assessing risk for severe domestic violence and related homicides perpetrated by partners and in-laws: adapted danger assessments for women in abusive relationships in India

Despite domestic violence and related homicides perpetrated by partners and/or in-laws being a significant public health problem in India, there are no reliable and valid instruments to identify and intervene with women in domestic violence relationships. Continued domestic violence can escalate to severe, near-lethal, or lethal violence or homicide. The Danger Assessment (DA) is a risk assessment instrument designed to assess the likelihood of severe, near-lethal, or lethal violence in abusive relationships. However, the DA is not designed to determine the risk of future severe, near-lethal, or lethal violence by in-laws. In-law abuse plays a significant role in domestic violence-related homicides in India and other countries with similar cultural norms. This study addressed this gap by developing the Danger Assessment for in-laws (DA-L) to assess risk from in-laws, alongside the Danger Assessment for Women in India (DA-WI) to assess risk from partners. The study also examined the psychometric properties of the DA-L and DA-WI. Longitudinal data from 150 women in India were used to measure the reliability and validity of the two versions of the DA. The original DA items and additional risk items were examined using relative risk ratios for their relationship with severe violence at three-month follow-ups. Predictive validity was tested with the receiver operating characteristic curve. The study resulted in reliable and valid measures (11 items DA-L and 26-items DA-WI) of risk. The versions of the DA can be useful for practitioners in India and those working with Indian women in the US and other countries. The DAs can be used for identifying women in domestic violence relationships who are at risk for future severe domestic violence and guide the provision of tailored safety plans.

Predictors for the change in intimate partner violence among adolescent married girls aged 15-19 years: Estimates from random effect model

BACKGROUND

Intimate Partner Violence (IPV) is one of the most common forms of violence against women. IPV against adolescents and young adult married women (15-19 years only) is poorly understood and not much researched as compared to their adult counterparts. The present study investigates the changes in multiple forms of IPV and tries to understand its association with different individual factors.

METHODS

The study used longitudinal data from Understanding the lives of Adolescent and Young Adults study (UDAYA), conducted in 2015-16 (wave 1) and 2018-19 (wave 2). The survey was done in two Indian states namely, Uttar Pradesh and Bihar. The sample size of the present study was 4,254 married adolescent girls aged 15-19 years. Multiple forms of IPV were the outcome variables of this study. A random effect regression analysis was used to estimate the association of changes in physical, sexual, and emotional violence with decision-making power and mobility restrictions along with other covariates.

RESULTS

Findings show that physical and emotional violence have increased from wave 1 to wave 2. Furthermore, married adolescent girls who took decisions alone/with others were less likely to suffer from IPV (β=-0.02; p < 0.05). Adolescent girls who agreed with the perception about wife-beating were more likely to report physical (β = 0.07; p < 0.05), sexual (β = 0.13; p < 0.05), and emotional violence (β = 0.14; p < 0.05). The risk of IPV was significantly more among adolescent girls whose family paid dowry compared to those who did not pay it (β = 0.04; p < 0.05).

CONCLUSION

Interventions against those social norms that harm any female adolescents' status in society and negatively impact their educational attainment should be adopted, simultaneously, with programs that promote gender equality in all aspects of their life.

Spousal Violence among Reproductive Age Group Women - A Community-Based Cross-Sectional Study

Background

Spousal or intimate partner violence is the most common form of domestic violence and is a preventable cause of morbidity and mortality in women. The aim of this study was to estimate the prevalence of spousal violence, various types of spousal violence, and the factors associated with it among reproductive age group women.

Materials and Methods

This was an analytical cross-sectional study conducted in the Urban Health Training Center area of a tertiary care teaching hospital in Nagpur, India, among married women between 15 and 49 years of age who were selected using systematic random sampling. The data was collected from a sample of 373 women by face-to-face interview and analyzed using Statistical Package for the Social Sciences (SPSS) v21.

Results

The prevalence of spousal violence among reproductive age group (15-49 years) women was found to be 59.7%, with emotional violence (54.1%) being the most common, followed by physical (51.2%) and sexual (43.4%) violence in that order. Regular alcohol consumption of husband had the highest odds of spousal violence among women (odds ratio [OR] 12.51, 95% confidence interval [CI] 6.51-24.03). Other factors associated with spousal violence among reproductive age group women were early age at marriage, literacy and employment of women and husband, lack of emotional support from the family members, and dowry-related problems in the family.

Conclusion

A multifaceted approach including legal measures, empowerment of women, and sociocultural factors involving families, institutions, governmental, nongovernmental, and civil society organizations is the need of the hour.

Violence Against Women in India: An Analysis of Correlates of Domestic Violence and Barriers and Facilitators of Access to Resources for Support

Purpose

Domestic violence (DV) is a significant public health problem in India, with women disproportionately impacted. This study a) identified risk and protective correlates of DV and, b) barriers and facilitators for seeking and receiving help for DV among women in India.

Methods

A systematic search of 5 databases was performed to identify correlates of DV in the quantitative literature. The search resulted in inclusion of 68 studies for synthesis. For qualitative exploration, data were collected from 27 women in India.

Results

While factors such as social norms and attitudes supportive of DV were both risk correlates and barriers to addressing DV, omen's empowerment, financial independence and informal sources of support were both protective correlates of DV as well as facilitators in addressing DV.

Conclusions

Strong efforts in India are needed to reduce DV-related risk factors and strengthen protective factors and enhance access to care for women in abusive relationships.

Decomposing the gap in intimate partner violence between Scheduled Caste and general category women in India: An analysis of NFHS-5 data

Scheduled Caste (SC) women, one of India's most oppressed and neglected population groups, are the most vulnerable to intimate partner violence (IPV). IPV, on the other hand, is less common among women in the General category. No study has been conducted to measure the gap in IPV between these two groups. This study is an attempt to fill this gap. This study aims to comprehensively explore the factors that underlie and explain the gap in IPV between SC and General women. Information on 10,168 ever-married SC and 9695 ever-married General women aged 15–49 from the fifth round of the National Family Health Survey was analyzed. The Fairlie decomposition (Blinder–Oaxaca decomposition modified for binary outcomes) was used in this study to explain the gap in ever experience of IPV prevalence between SC and General women. About 37.3% and 24.4% of ever-married SC and General women in India suffered either physical or mental or sexual violence from their husbands. The large part of the gap in IPV between SC and General women was due to differences in husbands' alcohol consumption (26.33% gap), wealth index (24.48% gap), controlling behavior by husband (24%) and parental IPV (15.87% gap). With the introduction of appropriate interventions and programs, these gaps can be reduced. Interventions aimed at reducing alcoholism should be emphasized.

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Intimate Partner Violence (IPV) was more prevalent in Scheduled Caste (SC) women than in General category women.

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Wealth, parental IPV, husband’s alcohol consumption and controlling behavior explained 90% of the SC-General gap in IPV.

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Group differences in husband’s alcohol consumption explained about one-fourth of the SC-General gap in IPV.

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Wealth index and husband’s controlling behavior explained about 24.5% and 24.0% of the gap in IPV, respectively.

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In short run, interventions aimed at reducing alcoholism should be emphasized.

Prevalence of Domestic Violence Against Women Undergoing Methadone Maintenance Therapy Programs and its Related Risk Factors

Background

This study aimed to investigate the prevalence of domestic violence (DV) against women who are undergoing methadone maintenance therapy (MMT) and its related risk factors.

Methods

This case-control study was conducted on 195 women who were under MMT and a control group consisting of 195 women who were not under it in the city of Zahedan from 22 May to 1 December 2019. Data were collected using a questionnaire for the measurement of violence against women and a sociodemographic questionnaire. In order to analyze the data, the t test, analysis of variance (ANOVA), Pearson's correlation, and multiple regression analysis were used.

Findings

In the case group, 67.2% of participants had experienced DV during the past year. In the control group, the prevalence was 78.5%. The rate of more than one occasion of DV was significantly higher in the group who were under MMT (P<0.05). The most common type of violence was mental abuse. Physical, sexual, and economic abuses were in the next ranks. Important predictors of DV, in order of importance, were: the women's low educational level, smoking, income level, and polygamy (P<0.05).

Conclusion

MMT is not a risk factor for DV. It seems that the rate of DV against women in Zahedan is very high. The prevalence of recurrent DV in women under MMT was higher than in the general population.

Adverse childhood experiences and maternal self-efficacy: Examining the mediating role of intimate partner violence and the moderating role of caste membership in rural India

Maternal self-efficacy (MSE) is associated with healthy functioning in mothers and children globally. Maternal exposure to adverse childhood experiences (ACEs) and intimate partner violence (IPV) is known to negatively impact MSE in high-income countries; however, the association has not been examined in low-and-middle-income countries, such as India, which face socioeconomic risks including poverty, illiteracy, and discrimination based on caste membership. The present study examines the mediating role of IPV in the association between ACEs (specifically-emotional, physical, and sexual abuse, neglect, household dysfunction, and discrimination) and MSE and tests caste membership as a moderator. A community-based, cross-sectional survey was performed with 316 mothers with at least one child between 0 and 24 months in a rural area in the North Indian state of Uttar Pradesh. A structural equation framework was used to test the moderated-mediation model. Results from the moderated-mediation model indicate that greater ACEs exposure was associated with lower MSE and this association was mediated by IPV exposure for low-caste but not high-caste mothers, even after controlling for wealth and literacy. These findings add to existing evidence on ACEs exposure as a significant burden for rural Indian mothers, negatively impacting parenting outcomes such as MSE. The critical role of caste membership is also highlighted, providing implications for future research.

Intimate partner violence against women with disability and associated mental health concerns: a cross-sectional survey in Mumbai, India

OBJECTIVES

The risk of intimate partner violence (IPV) against women with disability is believed to be high. We aimed to compare the prevalence of past-year IPV against women with and without functional difficulties in urban informal settlements, to review its social determinants and to explore its association with mental health.

DESIGN

Cross-sectional survey.

SETTING

Fifty clusters within four informal settlements.

PARTICIPANTS

5122 women aged 18-49 years.

PRIMARY AND SECONDARY OUTCOME MEASURES

We used the Washington Group Short Set of Questions to assess functional difficulties. IPV in the past year was described by binary composites of questions about physical, sexual and emotional violence. We screened for symptoms of depression using the Patient Health Questionnaire-9 and of anxiety using the Generalised Anxiety Disorder-7. Multivariable logistic regression models examined associations between functional difficulties, IPV and mental health.

RESULTS

10% of participants who screened positive for functional disability had greater odds of experiencing physical or sexual IPV (adjusted OR (AOR) 1.68, 95% CI 1.23 to 2.29) and emotional IPV (1.52, 95% CI 1.16 to 2.00) than women who screened negative. Women who screened positive for functional disability had greater odds than women who screened negative of symptoms suggesting moderate or severe anxiety (AOR 2.50, 95% CI 1.78 to 3.49), depression (2.91, 95% CI 2.13 to 3.99) and suicidal thinking (AOR 1.94, 95% CI 1.50 to 2.50).

CONCLUSIONS

The burden of IPV fell disproportionately on women with functional difficulties, who were also more likely to screen positive for common mental disorder. Public health initiatives need to respond at local and national levels to address the overlapping and mutually reinforcing determinants of violence, while existing policy needs to be better utilised to ensure protection for the most vulnerable.

Trick or Treat: Does a Microfinance Loan Induce or Reduce the Chances of Spousal Violence against Women? Answers from India

It is a common belief that microfinance plays a dual role of poverty alleviation and socioeconomic upliftment of its women participants. However, there are enough researches that negates the positive impact of microfinance loans on spousal violence. Recognized as one of the most predominant social evils, violence against women is not only a violation of their human rights but also an act of exploitation and denial of freedom. In the present study, we have tried to investigate if microfinance loan takers experience more spousal violence as compared to their counterparts by analyzing the National Family Health Survey IV, 2015-16. Our results indicate that 40.8% of women microfinance participants experience spousal violence. Additionally, the likelihood of microfinance participants to experience spousal violence is much higher than the non-microfinance participants (odds ratio = 1.35, p value = .000). Microfinance programs are designed to increase the individual agencies of women participants, which, in turn, reduce the chances of them becoming victims of spousal violence. However, if the credit program participation induces the woman to be a victim of spousal violence together with becoming financially autonomous, then such hidden costs need to be taken into account while evaluating the effectiveness of the gendered policy design.

Prevalence and associated factors of domestic violence among married women in an urban slum in South India

Introduction

Domestic violence (DV) is a public health problem with an estimated global prevalence of 35%. The prevalence rate of spousal domestic violence in Telangana is 36.4% which is higher than the national average of 25.3%. Despite being a punishable offense, DV is still on the rise in India. Hence, there is need to assess its extent and determining factors for planning of remedial measures.

Objective

To estimate the prevalence of domestic violence and its associated factors among married women of an urban slum in Telangana.

Methodology

A cross-sectional study was conducted among 18- to 45-year-old married women in urban slums of Telangana. The sample size was 200. Multistage random sampling was done. Data collection was done using questionnaire with information regarding socio-demographic details, types of domestic violence, help-seeking behaviours, awareness, and outcome. The victims were directed towards medical and legal help, and further counselling. Descriptive analysis was done to find proportion of domestic violence. The associated factors were found using Chi-square test and logistic regression.

Results

Domestic violence was reported by 70.5% of the study participants. Physical abuse (67%) was the main offense followed by emotional abuse (38.5%). Though 89% of women were aware of domestic violence being punishable by law, only 9.5% of women sought help. Woman's older age (COR = 2.015, 95% CI: 1.088-3.733, P = 0.026), illiteracy (COR = 2.181,95% CI: 1.097-4.3381, P = 0.026), longer married life (COR = 1.961, 95% CI: 1.008-3.815, P = 0.047), husband's early exposure to abuse (COR = 4.439, 95% CI: 1-19.705, P = 0.034) and alcohol intake (COR: 1.995, 95% CI: 1.038-3.838, P = 0.037) were found to be significant factors in the bivariate analysis. Husband's exposure to abuse in childhood (AOR = 5.326, 95% CI: 1.163-24.400, P = 0.031) and alcohol intake (AOR = 2.206, 95% CI: 1.109-4.389, P = 0.024) were found to be independent predictors.

Conclusion

Domestic violence is highly prevalent in urban slums of south India. A woman's age, education, duration of marriage, husband's early exposure to abuse, and alcohol intake are determining factors. Awareness programs need to be conducted regarding helplines, medical and legal aspects. All domestic violence cases should be registered, and social, psychological and legal support be provided to the victim.

How to reduce Domestic Violence against married women? a mixed methods study from rural Tamil Nadu

BACKGROUND

Despite government legislations for protection of women, domestic violence (DV) continues to remain as a public health problem in India. Objectives 1. To find out the prevalence of various types of self-reported DV among married women of 18-45 years of age and to identify its social determinants and their help-seeking behavior. 2. To understand the solutions from key informants' point of view.

METHODS

It was a sequential explanatory mixed methods study design, which consisted of quantitative (Survey) followed by qualitative (Interviews) phase. A representative sample of 360 married women was chosen by two-stage cluster sampling from villages in Tamil Nadu, South India. The female investigator conducted the survey by house to house visit. Post-survey, six key informant interviews were conducted to explore the solutions and suggestions from experts' point of view. Bivariate and multivariate regression analysis was carried out to identify the significant predictors of DV. Manual content analysis of qualitative data was done.

RESULTS

The overall prevalence of spousal DV was 49.5% [95% CI: 44.3-54.6] in the last one year. In multivariate analysis, two factors namely 'current alcoholism in husband' and 'controlling behavior of husband' were found to be the significant predictors of DV. In order to prevent alcoholism in husband, the key informants suggested deaddiction services and measures to limit access to alcohol. Furthermore, to prevent controlling behavior of husband, the key informants suggested women's empowerment, employment, helplines, responsible parenting, social change in dowry practice and gender equality.

CONCLUSIONS

The prevalence of spousal DV was found to be high. Current alcohol consumption and controlling behavior of the husband were the important determinants of domestic violence. Key informants suggested interprofessional approach consisting of deaddiction services, women empowerment and strengthening of family life to address the problem of DV.

Perception, Prevalence, and Determinants of Intimate Partner Violence During Pregnancy in Urban Slums of Pune, Maharashtra, India

There is limited evidence on the prevalence and determinants of violence against pregnant women in India. Previous studies were entirely restricted to the violence against women in the reproductive age group. There is lack of evidence about the factors affecting violence against women during pregnancy. Understanding such factors, women's perception regarding violence during pregnancy and their justification of such violence could manifest an important aspect of violence. Women living in slum communities particularly are victims of violence. In this context, this study intended to examine women's perception, prevalence of, and factors affecting the violence against women during pregnancy in the slum communities of Pune. A community-based cross-sectional study of 1-year duration was undertaken in urban slums of Pune city, Maharashtra, India. The study participants were women who have delivered 2 years preceding the survey. Using simple random sampling, 500 women were selected from 10 purposively selected slums. House-to-house visits were made and face-to-face interviews conducted using a pretested structured questionnaire. Univariate, bivariate, and logistic regression analyses were applied. The study results show that 15.3% of women have experienced violence during their recent pregnancy. Furthermore, 9.2% of women experienced physical violence, 1.8% sexual violence, and 11.2% psychological violence. Education level of women, husband's education and alcohol consumption, history of violence in the family, and provision of spurious justification for violence have emerged as some of the leading factors associated with the violence inflicted during pregnancy. Effective interventions at both community and health care settings are needed urgently to reduce the violence inflicted during pregnancy.

Anxiety and depressive symptoms in pregnancy predict low birth weight differentially in male and female infants-findings from an urban pregnancy cohort in India

PURPOSE

This study examined the contributions of antenatal anxiety, depression, and partner violence to low birth weight (LBW) in infants and to sex-specific birth weight outcomes among mothers from a cohort in urban India.

METHODS

Data from 700 mothers from the PRAMMS cohort (Prospective Assessment of Maternal Mental Health Study) were used. Pregnant women were assessed in each trimester-T1, T2 and T3, for symptoms of anxiety, and depression as well as partner violence. Multivariate analyses were performed for the whole sample and then for male and female infants separately. The final multivariable logistic regression models were each built using a backward selection procedure and controlling for confounders. To accommodate longitudinally measured data, change in scores (T2-T1 and T3-T2) of anxiety and depression were included in the model.

RESULTS

Of the 583 women with a singleton live birth, birth weight was available for 514 infants  and LBW was recorded in 80 infants (15.6%). Of these, 23 infants were preterm. Overall, higher T1 Depression scores (OR: 1.11; 95% CI 1.040, 1.187) and an increase in both Depression scores (OR: 1.12; 95% CI 1.047, 1.195) from T1 to T2 and Anxiety scores (OR: 1.32; 95% CI 1.079, 1.603) between T2 and T3 were predictors of LBW. Female infants had a higher chance of LBW with increase in maternal anxiety between T1-T2 (OR: 1.69; 95% CI 1.053, 2.708) and T2-T3 (OR: 1.49; 95% CI 1.058, 2.086); partner violence during pregnancy just failed to reach conventional statistical significance (OR: 2.48; 95% CI 0.810, 7.581) in girls. Male infants had a higher chance of LBW with higher baseline depression scores at T1 (OR: 1.23; 95% CI 1.042, 1.452) and an increase in depression scores (OR: 1.25; 95% CI 1.060, 1.472) from T1 to T2.

CONCLUSION

Increasing prenatal anxiety and depressive symptoms in different trimesters of pregnancy were associated with LBW with sex-specific patterns of association in this sample from a Low and Middle Income Country.

Spousal Violence Against Women in India: A Social-Ecological Analysis Using Data From the National Family Health Survey 2015 to 2016

Even after enactment of the Protection of Women From Domestic Violence Act 2005, over the last 10 years, the rate of decline of prevalence of spousal violence against women has remained low in India. This study attempts to explain the experience of spousal violence using a social-ecological framework. We analyzed the National Family Health Survey 2015 to 2016 (NFHS-4) data of 66,013 ever-married women aged 15 to 49 years. Participants in the domestic violence module of the NFHS-4 reported their experience of violence committed by their husband within the 12 months preceding the survey. Multilevel logistic regression analyses were done to determine the association between spousal violence and different explanatory variables of various levels of social ecology including variables on women's empowerment. About one fourth of ever-married women reported experiencing any form of violence during the last year. The experience of spousal violence was significantly associated with social ecology at multiple levels. At the individual level, the odds of experiencing physical violence were higher among younger women, who married at a younger age, had an age gap of 3 to 4 years with her husband, and had more children. Women in vulnerable groups, with poor economic status, and members of marginalized communities had higher odds of experiencing spousal violence. Women had high odds of experiencing spousal violence if living in a social ecology with unfavorable social norms, higher rates of domestic crimes, and a higher prevalence of underage marriage. The association of spousal violence with women's empowerment remained inconclusive. The results argue for manipulating contextual factors to empower women to challenge gender-related equations and investing in education for gender sensitization at the higher level social ecologies.

Maternal Exposure to Intimate Partner Violence and Child Immunisation: Insights from a Population-based Study in India

Child immunisation is regarded as one of the most essential public health interventions for reducing morbidity and mortality among children. Despite several public healthcare initiatives, a considerable proportion of children are yet to be covered under vaccination service in India. This study attempts to examine the association between maternal exposure to intimate partner violence (IPV) and childhood immunisation in India. Data were drawn from the fourth round of the National Family Health Survey (NFHS-4), conducted in 2015–16. Bivariate and multivariate logistic regression models were employed to assess the associations. About 65% of sample children aged 11–23 months were fully vaccinated. After adjusting for socio-demographic factors, women’s exposure to emotional IPV was significantly associated with a lower likelihood of full immunisation (adjusted odds ratio [AOR]: 0.74, 95% confidence interval [CI]: 0.61–0.90) among children. However, physical and sexual IPV had no significant association with childhood immunisation status in the adjusted analysis. The findings suggest preventive measures against domestic violence to reduce the risk of poor child healthcare services. Furthermore, efforts should be taken for effective reproductive and child healthcare programmes, especially among socio-economically vulnerable women and children, to improve child vaccination coverage.

Prevalence of spousal violence among married women in a rural area in North Kerala

Background

Domestic violence has substantial public health consequences. More than one-third of women globally suffer from physical and sexual violence, mostly by an intimate partner with a lifetime prevalence of 10%-69%. In India, 28.8% of the ever-married women in the reproductive age group, reported domestic violence. Although Kerala, in southern India, performs better than other Indian states on a host of human development indicators for women, 15.8% among the women in this group have ever experienced physical or sexual violence in the past 12 months, the most common perpetrator being the husband.

Methodology

A community-based cross-sectional study was carried out among the ever-married women, residing in a selected area of northern Kerala, who have been married for at least 1 year. One to one structured interview was conducted with a pretested structured questionnaire by the investigator. Spousal violence was defined as proportion of ever-married women with a lifetime experience of violence perpetrated by their spouse, manifested through acts of physical, sexual, and/or emotional violence, even threat.

Results

A total of 290 women were interviewed. The age of the participants ranged from 18 years to 64 years; majority were Muslims. Only 16.5% were college-educated and over 90% were homemakers. 29% reported having experienced spousal violence; with the most common being emotional violence (19%) closely followed by sexual violence (18.6%) and physical violence (14.8%). A little over one-third (39.7%) reported controlling behaviour of their husband. Age of the participant (P = 0.019), absence of social support (P = 0.034), employment status of husband (P = 0.026), controlling behaviour of husband (P < 0.001), alcohol abuse by husband (P = 0.004) and extra-marital relationship of spouse (P < 0.001) were found to have significant influence on spousal violence experience.

Conclusion

More than a quarter of the married women in this rural setting have experienced one or the other form of violence.

Recommendation

A multifaceted approach needs to be employed which takes into consideration legal measures, social sciences, women empowerment, mental health systems and educate the men to curb this menace.

A true face of Indian married couples: Effect of age and education on control over own sexuality and sexual violence

INTRODUCTION

Though there are several interventions evaluated over the past 25 years, significant knowledge gaps continue to exist regarding the effective prevention of sexual violence. This study explored the socio-economic and context-specific distinctive characteristics of husbands and wives on sexual autonomy and unwanted sexual experiences of currently married women in India.

METHODOLOGY

We have utilized the recent round of National Family Health Survey (NFHS-4, 2015-16) data for this exploration. The NFHS-4 survey had adopted a stratified two-stage sample design to reach out to the survey households. A total of 63,696 couples are included in the analysis comprising of women of 15-49 years age and men of 15-54 years age. Multivariate techniques have been applied to understand the adjusted effects of socio-economic and demographic variables on control over their sexuality and sexual violence.

RESULTS

Uneducated women married to uneducated men experienced more sexual violence and had less control over their sexuality than the other categories. The adjusted multivariate logistic model shows that educated husbands were significantly more likely to exercise control over their educated wives' sexuality (AOR = 0.88; CI:0.78-0.99). Women having older husbands were significantly less likely to be having no-control over own sexuality (AOR = 0.89; CI:0.83-0.95) and experienced sexual violence (AOR = 0.81; CI:0.70-0.95). Women having comparatively more-educated husbands were significantly less likely to experience sexual violence (AOR = 0.62; CI:0.47-0.81). Muslim women were significantly more likely to have no control overown sexuality. SC/ST women were significantly more likely to experience sexual violence (28%).

CONCLUSIONS

This study highlights the factors associated with control over one's sexuality and preponderance to sexual violence: age, education, spouse working status, wealth status, husband's alcohol consumption, women autonomy, decision-making, and freedom for mobility. This study suggests that empowering women with education, creating awareness regarding reproductive health, and addressing their socio-economic needs to help them achieve autonomy and derive decision-making power.

"Crisis Within the Walls": Rise of Intimate Partner Violence During the Pandemic, Indian Perspectives

The ongoing coronavirus disease 2019 pandemic has been a social "un-equalizer," besides being a global health threat. Gender inequality has been globally prominent during the outbreak and the consequent lockdown. Although domestic abuse and intimate partner violence have increased due to chronic entrapment, overcrowding in families, enhanced substance use, distorted relationship dynamics, travel restrictions, and reduced healthcare access, coercive sexual practices have also been on the rise. In low- and middle-income countries, the lack of awareness, societal pressure, administrative apathy, fear of legal hassles, and inadequate knowledge-attitude-practice related to help-seeking lead to underreporting and mismanagement of domestic abuse, which can perpetuate its vicious cycle during the ongoing crisis. India, with its socio-culturally diverse population, has been one of the nations worst hit by the pandemic. With the rise in reports of gender-based violence on the premise of preexisting gender inequality and minority stress, concerns behind "closed doors" are as threatening as the infection itself. With this background, the authors highlight the backdrop of domestic violence as a "hidden pandemic" during the coronavirus disease 2019 crisis, drawing on perspectives from India and briefly reviewing the data from other nations. The role of mental health education and digital literacy as mitigating strategies is subsequently discussed.

Economic abuse and its associations with symptoms of common mental disorders among women in a cross-sectional survey in informal settlements in Mumbai, India

BACKGROUND

Domestic violence takes a range of interconnected forms, of which economic abuse is common, but less studied than others. We examine the prevalence of economic abuse, its determinants, and its association with symptoms of depression, anxiety, and suicidal ideation.

METHODS

Our cross-sectional survey in informal settlement areas in Mumbai, India, asked women aged 18-49 years 15 questions about acquisition, use, and maintenance of economic resources, demographic and socioeconomic factors, and physical, sexual, and emotional violence. We administered the Patient Health Questionnaire 9 (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7) scales and asked about suicidal thinking. Determinants of economic abuse and its associations with positive screens for depression and anxiety were explored in univariable and multivariable logistic regression models.

RESULTS

Of 4906 ever-married women respondents, 23% reported at least one form of economic abuse by either an intimate partner or another family member. The commonest were denial of property rights (10%), not being trusted with money (8%), and coercive appropriation of belongings (7%). Economic abuse was more commonly reported by widowed, separated, or divorced women than by married women (aOR 12.4; 95% CI 6.4, 24.1), and when their partners used alcohol or drugs (aOR 1.4; 95% CI 1.2-1.7). Women had greater odds of reporting economic abuse if they had suffered emotional (aOR 6.3; 95% CI 5.0-7.9), physical (aOR 1.9; 95% CI 1.4-2.6), or sexual violence (aOR 5.4; 95% CI 3.6-8.1) in the preceding 12 months. Economic abuse was independently associated with positive screens for moderate-severe depression (aOR 2.6; 95% CI 2.0-3.4), anxiety (aOR 2.7; 95% CI 1.9-3.8), and suicidal ideation (aOR 2.2; 95% CI 1.5-3.1). The odds of anxiety and depression increased with each additional form of economic abuse.

DISCUSSION

To our knowledge, this is the first community-based study in India of the prevalence of economic abuse and its associations with symptoms of common mental disorders. It provides empirical support for the idea that economic abuse is at least as harmful to women's mental health as physical violence. Surveys should include questions on economic abuse and prevention and intervention strategies need to help survivors to understand its forms.

Structured Spatial Modeling and Mapping of Domestic Violence Against Women of Reproductive Age in Rwanda

The main objective of this study was to assess the risk factors and spatial correlates of domestic violence against women of reproductive age in Rwanda. A structured spatial approach was used to account for the nonlinear nature of some covariates and the spatial variability on domestic violence. The nonlinear effect was modeled through second-order random walk, and the structured spatial effect was modeled through Gaussian Markov Random Fields specified as an intrinsic conditional autoregressive model. The data from the Rwanda Demographic and Health Survey 2014/2015 were used as an application. The findings of this study revealed that the risk factors of domestic violence against women are the wealth quintile of the household, the size of the household, the husband or partner's age, the husband or partner's level of education, ownership of the house, polygamy, the alcohol consumption status of the husband or partner, the woman's perception of wife-beating attitude, and the use of contraceptive methods. The study also highlighted the significant spatial variation of domestic violence against women at district level.

Prevalence and predictors of spousal violence against women in Afghanistan: evidence from Demographic and Health Survey data

Spousal violence against women is a serious public health problem that is prevalent in all societies, with one in three women around the world experiencing violence in their lifetime. This study examined the prevalence of spousal violence, and its determinants, in Afghanistan using data from the 2015 Afghanistan Demographic and Health Survey. Univariate, bivariate and logistic regression statistical techniques were used to assess the association of socioeconomic variables with spousal violence. The study sample comprised 20,827 currently married women aged 15-49. Fifty-two per cent of women reported experiencing some form of violence by their husband. A significant association was found between women's justification of violence, women's participation in decision-making in their household (COR=0.476; CI=0.446-0.509) and lower risk of experiencing spousal violence. After adjustment for demographic and socioeconomic factors, women's participation in all of four household decisions, either alone or jointly, was found to be associated with a lower risk of experiencing spousal violence (AOR=0.472; CI=0.431-0.516). In both the crude and adjusted models, the risk of experiencing spousal violence was high if the husband's desire for children was different from that of his wife. In the case of inequality in property ownership, the risk of spousal violence was significantly higher (COR=1.263; CI=1.178-1.353; AOR=1.159; CI=1.051-1.278) when women were joint owners of property compared with when they did not own any property. The findings point to an immediate need for legal and social interventions to prevent spousal violence against women, or at least reduce its prevalence, in Afghanistan.

Associations of Power Relations, Wife-Beating Attitudes, and Controlling Behavior of Husband With Domestic Violence Against Women in India: Insights From the National Family Health Survey-4

This study assesses the relationship of power relations, attitudes toward wife-beating, and controlling behavior of husband with violence against women in India using the recent National Family Health Survey (NFHS-4). In India, about 31% of ever-married women experienced domestic violence committed by their partner during 2015-16. Women's decision-making power was associated with a decreased likelihood of spousal violence. However, the justification of wife-beating and controlling behavior of husband increased the risk of intimate partner violence. This study emphasizes the need for prioritizing girls' education, enhancing women's autonomy, prevention of child marriage, and promoting gender equality in society to address the problem of spousal violence.

Violence against women in urban slums of India: A review of two decades of research

It is estimated that about one-third of women ever experienced violence in their lifetime. India has experienced steady urban growth accompanying increase of urban populations living in slums. Several studies have reported prevalence of various forms of violence in urban slums. To our knowledge, no systematic review has been conducted exclusively reporting violence against women in India's urban slums. The review aims to synthesise the studies of violence against women conducted in the last two decades (2000-2020). We searched PubMed, Scopus and other relevant search engines to identify articles published between years 2000 and 2020, which focused on Indian women slum dwellers' experiences of violence. We included 14 studies, which satisfied the inclusion criteria in this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was used to assess the studies. The prevalence of any form of violence against women, as reported in the studies, ranged from 15% to 59.3%. The major risk factors identified were husband's alcohol abuse, women justifying the violence inflicted on then, low educational levels of both women and men, dowry issues, age difference between the spouses and termination of a previous pregnancy. It is evident from the review that urban slum women experience persistent violence.

Coping with domestic violence: women's voices in Bangladesh

Purpose

This paper aims offer a benchmark by providing an account of women's experiences with domestic violence in Bangladesh and develops illustrations on coping with abuse.

Design/methodology/approach

A case study design was adopted, applying an emic perspective in employing a qualitative research approach to explore and describe women's experiences with and perceptions about domestic violence and their ways of coping in Sherpur District, Bangladesh. In total 25 recently married women participants were purposively sampled by snowballing. In-depth interview data facilitated a latent thematic content analysis.

Findings

The findings indicate that women adopt a range of responses to domestic violence. Two key aspects of coping surfaced in the narratives: (1) emotion-driven and (2) problem-driven approaches to abusive situations. Findings point to a range of research issues that require further study such as domestic violence and taboo; somatization; structural gender inequalities; male perpetrators; family dynamics and the intersections of these issues and contexts.

Originality/value

A more proactive way of coping resulted in resilience amidst an abusive environment, whereas passive ways of coping led to a life in distress. It is important however, to understand ways of coping as a continuum rather than a dichotomy.

Domestic violence against women: A hidden and deeply rooted health issue in India

Background

Domestic violence was identified as a major contributor to the global burden of ill health in terms of female morbidity leading to psychological trauma and depression, injuries, sexually transmitted diseases, suicide, and murder.

Aims

The study was conducted to find out the prevalence of different types of lifetime domestic violence against women, factors associated with it, and care-seeking behavior.

Settings and Design

An observational cross-sectional study conducted at a slum of Burdwan district of West Bengal, India.

Methods and Material

Study was done among 320 ever-married women of 15-49 years of age using a predesigned pretested proforma from March 2019 to December 2019 by face-to-face interview.

Statistical Analysis Used

Data were compiled and analyzed by EpiInfo 6 and SPSS 20 version.

Results and Conclusions

The overall prevalence of any form of violence during the lifetime among the study population was 35.63%. Verbal/psychological violence was the most common form of domestic violence (91.23%) followed by physical (82.46%) and sexual violence (64.91%). Slapping and/or beating, kicking, and object throwing were the major forms of physical violence; humiliation (88.46%) was the commonest form of psychological violence and most common form of sexual violence was forced sexual intercourse (51.35%). About 20% of the study population faced violence every day. Older age, lower age at marriage, longer duration of marriage, lower education of husband and wife, lower family income, unemployment of the husband, and alcohol consumption of husband were associated with the occurrence of domestic violence. We have found that the prevalence of domestic violence in this group of population is high. The alarming issue is that approximately one-third of women (32.46%) who faced violence in their lifetime had never sought any help. The findings indicate to develop appropriate and culturally relevant public health interventions to increase awareness.

A natural disaster and intimate partner violence: Evidence over time

Natural disasters affect about 200 million people annually. Heightened intimate partner violence (IPV) is a gendered impact of these disruptive events. This study examines prevalence and correlates of IPV in four Indian states-TamilNadu, Kerala, AndhraPradesh, and Karnataka-before and after the Indian Ocean tsunami of 2004. Drawing on three waves of National Family Health Surveys of India-six years before, immediately after, and a decade after disaster, this paper evaluates if TamilNadu and Kerala (severely affected) exhibited higher prevalence of IPV than AndhraPradesh (moderately affected) and Karnataka (not directly affected). Logistic regression analyses determine association between IPV, state of residence (proxy for experience of disaster), and other covariates. To test hypotheses guided by vulnerability theory, IPV was regressed on socio-economic and demographic predictors for states across waves. IPV increased by 48% between 2005 and 2015. Increase in physical (61%) and sexual (232%) violence was highest in TamilNadu; emotional violence increased by 122% in Karnataka. State of residence was associated with IPV in the aftermath of disaster. In 2005, compared to Karnataka, odds of IPV were 98% higher in TamilNadu and 41% higher in Kerala. A decade after, odds were two times higher in TamilNadu than in Karnataka. Belonging to disadvantaged groups predicted higher odds of IPV in the year after disaster. Higher socio-economic status predicted lower odds of IPV, except in Kerala. Data point to ways in which socio-economic and demographic vulnerabilities factor into risk of IPV after disaster. Demographic factors of religion and caste appear to lose significance over time, but socio-economic factors continue to matter. Disaster response strategies seldom work without tackling long-standing inequities. Appropriate support systems for women and minorities in non-disaster situations are critical to ensure their conditions are not exacerbated.

Magnitude of domestic violence and its socio-demographic correlates among pregnant women in Delhi

Context:

Domestic violence is violation of basic human rights, and poses a threat to the physical, mental, and social health aspects of women and her children. The causation of domestic violence is precipitated by many risk factors.

Aims:

Aim was to estimate the magnitude of domestic violence overall, and its sub-types, among pregnant women. The study also aimed to find the associated socio-demographic determinants of domestic violence among the subjects.

Settings and Design:

The study was designed as a cross-sectional study to estimate the prevalence of domestic violence and to find socio-demographic correlates in its causation. A total of 1500 apparently healthy pregnant women, with gestation up to 20 weeks were interviewed.

Methods and Materials:

A pre-tested semi-structured interview schedule was used to collect data on socio-demographic variables and details of domestic violence, after explaining the purpose of study to the subjects and obtaining informed consent.

Statistical Analysis Used:

Data was entered in Ms-Excel and IBM SPSS Version 25 was used for statistical analysis.

Results:

The findings revealed overall prevalence of domestic violence to be 29.7%, with emotional and verbal type of violence being most common type. Caste, religion, literacy status of study subjects, and occupational status of spouses of study subjects were reported as significant correlates affecting the causation of domestic violence among the subjects.

Conclusions:

The findings highlight the burden and thus, stress for the need for effective involvement of all sectors in the elimination of domestic violence against women as a public health issue and develop zero-tolerance towards it.

Reciprocate and nonreciprocate spousal violence: A cross-sectional study in Haryana, India

Background:

Prevention of intimate partner violence is an important public health goal owing to its negative psychological and physical health consequence.

Objectives:

Estimate the prevalence of reciprocate and nonreciprocate violence, severity of injuries, and related risk factors.

Materials and Methods:

The present study was a community-based cross-sectional study using multistage random sampling in which a total of 880 currently married women in the age group 15–49 years were interviewed using modified conflict tactics scale. Logistic regression was used to identify factors associated with both the types of domestic violence.

Results:

Total prevalence for spousal violence was 33.2% (283), out of which 14.84% (42) were reciprocally violent. Alcoholic husband [Adjusted Odds Ratio (AOR): 3.262, P = 0.001], late year of marriage (>2 years) [AOR: 0.359, P = 0.001], low education of the participants [AOR: 1.443, P = 0.033], and low socioeconomic class [AOR: 0.562, P = 0.004] are the risk factors for nonreciprocate domestic violence. Alcoholic husband [AOR: 4.372, P = 0.001] and nuclear family [AOR: 3.115, P = 0.001] were found as significant risk factors for reciprocate domestic violence. Women indulging in reciprocate violence were associated with more severe injuries than nonreciprocate violence.

Conclusion:

This study depicts that every third female has experienced spousal violence and also highlights the existence of reciprocate violence in India. Alcoholism, low education of husbands, and living in nuclear family are the important determinants for reciprocate violence. Also, reciprocate violence is associated with severe injuries.

The Formal Systems Response to Violence Against Women in India: A Cultural Lens

Violence against women (VAW) has become an increasingly salient issue in India, with women at risk for different forms of gendered violence. While there may be universal elements in the international phenomenon of violence against women, it is a complex, multifaceted phenomenon that takes shape in a particular sociocultural context. The current study employs a narrative framework to systematically examine how culture is expressed in the formal systems response and women's help-seeking in two metropolitan cities in India. Specifically, we sought to understand, among formal system responders (a) what characterizes the dominant cultural narratives on violence against women in India; and (b) how these are reflected in community narratives of formal responders. Interviews were conducted with formal responders working in different types of local agencies (e.g., police, health centers, and non-governmental agencies). The paper illustrates the major themes that emerged from participants' narratives describing the multilevel influences that shape the formal system response to violence against women and women's help-seeking efforts. The implications of these findings for effective response and directions for future research are summarized.

Husband's Alcohol Use, Intimate Partner Violence, and Family Maltreatment of Low-Income Postpartum Women in Mumbai, India

Husbands' alcohol use has been associated with family-level stress and intimate partner violence (IPV) against women in India. Joint family systems are common in India and IPV often co-occurs with non-violent family maltreatment of wives (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care). Alcohol use increases for some parents following the birth of a child. This study examined 1,038 postpartum women's reports of their husbands' alcohol use and their own experiences of IPV (by husband) and non-violent maltreatment from husbands and/or in-laws. We analyzed cross-sectional, quantitative data collected in 2008, from women (ages 15-35) seeking immunizations for their infants <6 months at three large urban health centers in Mumbai, India. Crude and adjusted logistic regression models estimated associations between the independent variable (husbands' past month use of alcohol) and two dependent variables (postpartum IPV and maltreatment). Overall, 15% of husbands used alcohol, ranging from daily drinkers (10%) to those who drank one to two times per week (54%). Prevalence of postpartum IPV and family maltreatment was 18% and 42%, respectively. Prevalence of IPV among women married to alcohol users was 27%. Most abused women's husbands always (27%) or sometimes (37%) drank during violent episodes. Risk for IPV increased with a man's increasing frequency of consumption. Women who lived with a husband who drank alcohol, relative to non-drinkers, were more likely to report postpartum IPV, aOR = 2.0, 95% confidence interval (CI) = [1.3, 3.1]. Husbands' drinking was marginally associated with increased risk for family maltreatment, aOR = 1.4, 95% CI = [1.0, 2.1]. Our findings suggest that men's alcohol use is an important risk factor for postpartum IPV and maltreatment. Targeted services for Indian women contending with these issues are implicated. Postpartum care offers an ideal opportunity to screen for IPV, household maltreatment, and other health risks, such as husband's use of alcohol. There is need to scale up proven successful interventions for reducing men's alcohol use and design strategies that provide at-risk women protection from alcohol-related IPV.

Association between spousal emotional abuse and reproductive outcomes of women in India: findings from cross-sectional analysis of the 2005-2006 National Family Health Survey

PURPOSE

Spousal violence against women is a global public health problem. In India, approximately 40% of women report spousal violence. Like physical and sexual violence, emotional violence may be a determinant of women's health. This study explores the association between exposure to spousal emotional abuse and poor reproductive outcomes in Indian women.

METHODS

Data on 60,350 women, collected in the Third Indian National Family Health Survey were analysed to assess the impact of spousal emotional abuse on seven reproductive outcomes: age at first birth, number of children, terminated pregnancies, unwanted pregnancies, access to prenatal and skilled delivery care, and breastfeeding. Spousal emotional abuse was assessed using two overlapping constructs: emotional violence and controlling behaviour. Multivariable logistic regression was used for analysis.

RESULTS

Spousal emotional violence and controlling behaviour was reported by 16 and 38% of the women, respectively. In unadjusted analyses, spousal emotional violence was associated with all adverse reproductive outcomes, except breastfeeding. Controlling for socio-demographic risk factors attenuated the association, and further adjustment for other forms of violence removed all significant associations. Spousal controlling behaviour was significantly associated with all outcomes, except breastfeeding. The effects remained statistically significant in multivariable regression.

CONCLUSIONS

Women's experience of violence may be under-reported. When other forms of violence were adjusted for, emotional violence was not associated with adverse reproductive outcomes, whereas controlling behaviour remained associated with all but one adverse reproductive outcome. Therefore, spousal controlling behaviour requires further investigation as a determinant of reproductive health.

Intimate Partner Violence, Childhood Abuse, and In-Law Abuse Among Women Utilizing Community Health Services in Gujarat, India

Previous studies in India suggest high prevalence of intimate partner violence (IPV), childhood abuse, and abuse from in-laws. Yet few studies examined IPV, childhood abuse, and abuse from in-laws together. The purpose of this study is to examine the association between IPV, childhood abuse, and abuse from in-laws, and types of abuse (physical, sexual, and emotional abuse) among women utilizing community health services for the economically disadvantaged in India. This study contributes to expanding the literature on abuse experience and providing knowledge for developing intervention programs and research projects to improve health and safety of economically disadvantaged women. The data were collected from women aged 18 years old or older at 18 community health centers that are primarily for the economically disadvantaged in Gujarat, India, in October and November 2013. Of the 219 women who completed a self-administered survey, 167 participants, who had ever been married and indicated whether they had been abused by their spouse or not, were included in analysis. More than 60% of the participants experienced IPV, childhood abuse, and/or abuse from in-laws, often with multiple types of abuse. Physical abuse is a major issue for IPV, childhood abuse, and in-law abuse. Emotional abuse potentially happens along with physical and/or sexual abuse. Abuse from in-laws requires greater attention because all types of abuse from in-laws were associated with IPV. Community health centers should provide abuse prevention and intervention programs that have involvement of family members as well as women who are at risk of being abused.

Prevalence and Risk Factors of Domestic Violence against Iranian Women: A Cross-Sectional Study

Background

Violence against women in families is the most common form of violence against them. The purpose of this study was to determine the prevalence of domestic violence and its effects on married women of Ilam.

Methods

In this descriptive-sectional research, 334 married women referred to medical health centers in Ilam were selected to participate using a random sampling method. After obtaining their consent to participate in the study, participants responded to a 46 items questionnaire and responses were analyzed using IBM SPSS for Windows ver. 20.0 (IBM Co., Armonk, NY, USA).

Results

The majority of the participants reported experiencing domestic violence and emotional violence was more prevalent than other kinds of violence. Logistic regression analysis showed that lower education level, marriage at a younger age, shorter duration of marriage, fewer children, being a housewife, and husband's unemployment had a significant relationship with domestic violence against women.

Conclusion

The high prevalence of wife abuse in Ilam especially emotional violence due to lower education levels and marriage at younger age could be a serious threat for women's health as well as for other members of the family. This could be a grounding factor for other social harms such as suicide and this issue must be studied from legal, religious, and cultural standpoints.

Socio-demographic factors associated with domestic violence in urban slums, Mumbai, Maharashtra, India

Background & objectives:

Domestic violence is identified as a public heath problem. It is associated with adverse maternal health. This study examined the prevalence and determinants of domestic violence among women in urban slums of Mumbai, India.

Methods:

A community based cross-sectional household survey was carried out among eligible women for the study during September 2012 to January 2013. A total of 1137 currently married women aged 18-39 yr with unmet need for family planning and having at least one child were selected using cluster systematic random sampling from two urban slums. Information on socio-demographic, reproductive and domestic violence was collected through face-to-face interview using a pretested structured questionnaire after obtaining informed written consent. Bivariate and multivariate analyses were carried out to find the socio-demographic factors associated with ever experienced domestic violence among women.

Results:

The prevalence of women ever experiencing domestic violence in the community was 21.2 per cent. Women whose husband consumed alcohol [RR: 2.17, (95% CI: 1.58-2.98)] were significantly at an increased risk of ever experiencing domestic violence than their counterparts. Risk of domestic violence was twice [RR: 2.00, (95% CI: 1.35-2.96)] for women who justified wife beating than women who did not justify wife beating.

Interpretation & conclusions:

The findings showed that domestic violence was prevalent in urban slums. Factors like early marriage, working status, justified wife beating and husbands use of alcohol were significantly associated with domestic violence.

Determinants of Intimate Partner Violence Among HIV-Positive and HIV-Negative Women in India

To reduce the many adverse health outcomes associated with intimate partner violence (IPV), high-risk groups need to be specifically targeted in the fight against domestic violence in India. This study aims to examine the prevalence and correlates of IPV in HIV-positive and HIV-negative women from India. A convenience sample of HIV-positive and HIV-negative women responded to questionnaires to assess their experience and perception of violence. Multivariate logistic regression analysis was used to model the association between IPV and age, education, employment status, contraception use, age at first marriage, and HIV status. Although adjusting for age, education, employment status, contraception use, age at first marriage, and HIV status, women who are employed were 3.5 times more likely to suffer IPV (confidence interval [CI] = [1.5, 8.5]), women aged 18 or above at first marriage are 0.3 times less likely to face IPV (CI = [0.1, 0.6]), and women who use contraception are 7 times more likely to suffer IPV (CI = [1.4, 30.2]). Also, HIV-positive women are 3 times more likely to face sexual violence compared with HIV-negative women (CI = [1.1, 7.6]).

The prevalence of domestic violence and its associated factors among married women in a rural area of Puducherry, South India

Background:

Violence against women is an emerging problem worldwide and more so in India. Considering its adverse effects on women's health, assessing the burden of violence in the community will help in planning services for the victims.

Objectives:

To determine the prevalence of domestic violence and to identify factors associated with domestic violence among married women in reproductive age group in rural Puducherry.

Materials and Methods:

A community-based cross-sectional study was carried out in a rural area of Puducherry, South India. Married women in reproductive age group were interviewed using structured pretested questionnaire. Domestic violence was assessed using 12 questions that were used in National Family Health Survey-3. Adjusted odds ratios (AORs) were calculated using multivariate logistic regression to identify factors associated with violence.

Results:

Of 310 study participants, 56.7% of them reported some form of domestic violence, 51.3% reported psychological violence, 40% reported physical violence, and 13.5% reported sexual violence. A statistically significant association was found between illiteracy of women and domestic violence (AOR: 4.3, 95% confidence interval: 1.1–15.7 P: 0.03). The other factors such as love marriage and nonregistration of marriage were significantly associated with violence.

Conclusion:

The prevalence of domestic violence was found to be high in this rural setting. Multisectoral response such as improving literacy, creating awareness regarding legal aid and screening the victims of violence at primary health centers, should be initiated to mitigate this public health issue.

Intra-household evaluations of alcohol abuse in men with depression and suicide in women: A cross-sectional community-based study in Chennai, India

BACKGROUND

Harmful effects of alcohol abuse are well documented for drinkers, and adverse effects are also reported for the physical and emotional well-being of family members, with evidence often originating from either drinkers or their families in clinic-based settings. This study evaluates intra-household associations between alcohol abuse in men, and depression and suicidal attempts in women, in community-based settings of Chennai, India.

METHODS

This community-based cross-sectional study of chronic disease risk factors and outcomes was conducted in n = 259 households and n = 1053 adults (aged 15 years and above) in rural and urban Chennai. The Alcohol Use Disorder Identification Test (AUDIT) score was used to classify alcohol consumption into 'low-risk', 'harmful', 'hazardous' and 'alcohol dependence' drinking and the Patient Health Questionnaire (PHQ-9) score to classify depression as 'mild', 'moderate', 'moderate-severe' and 'severe'. Multivariate logistic regression models estimated the association of depression in women with men's drinking patterns in the same household.

RESULTS

A significant 2.5-fold increase in any depression (PHQ-9 ≥ 5) was observed in men who were 'alcohol-dependent' compared to non-drinkers (OR = 2.53; 95% CI: 1.26, 5.09). However, there was no association between men's drinking behavior and depression in women of the same household, although suicidal attempts approached a significant dose-response relationship with increasing hazard-level of men's drinking (p = 0.08).

CONCLUSION

No significant intra-household association was observed between men's alcohol consumption and women's depression, though an increasing (non-significant) trend was associated with suicidal attempts. Complex relationships between suicidal attempts and depression in women and male abusive drinking require further exploration, with an emphasis on intra-household mechanisms and pathways.

Enhancing the Dental Professional's Responsiveness Towards Domestic Violence; A Cross-Sectional Study

BACKGROUND

Dentists may be the first health care professionals to treat patients who have experienced Oro-facial trauma resulting from Domestic violence (DV). Hence, as a national health concern, it challenges the social responsibility of a dentist in bringing down its prevalence.

OBJECTIVE

To assess the knowledge of Domestic violence among dentists of Karnataka.

MATERIALS AND METHODS

A cross-sectional questionnaire survey was conducted among dentists of Karnataka to know their knowledge, its relation to dentistry and measures they practice to bring down the prevalence of DV victims.

RESULTS

Overall knowledge about DV was very less among the dentists & out of 64% who said the dentist has a role in bringing down the prevalence, 28% reported the need for training.

CONCLUSION

Based on analysis of the data, dentists were interested and would benefit from additional education opportunities concerning recognizing, referring and managing patients who may be the victim of domestic violence in order to enhance their role.

Intimate partner violence and physical and mental health among women utilizing community health services in Gujarat, India

Background

Intimate partner violence (IPV) is a significant public health threat which causes injury and acute and chronic physical and mental health problems. In India, a high percentage of women experience IPV. The purposes of this study include 1) to describe the lifetime prevalence of IPV, and 2) to examine the association between IPV and physical and mental health well-being, among women utilizing community health services for the economically disadvantaged in India.

Methods

Women utilizing community health services (N = 219) aged between 18 and 62 years completed a self-administered survey in Gujarat, India. Standardized instruments were used to measure perceived physical and mental health well-being. In addition, participants were asked about their lifetime experience with IPV, and socio-demographic questions. Analysis was restricted to the ever-married participants who completed the questions on IPV (N = 167).

Results

Participants with a lifetime history of IPV were more likely to have reported poorer physical and mental health compared to those without a lifetime history of IPV. More than half of the participants with an IPV history experienced multiple types of IPV (physical, sexual and/or emotional IPV). While being in the highest caste was a significant positive factor associated with better health, caste and other socio-demographic factors were not associated with IPV.

Conclusions

Women in India face risk of IPV. Yet those experiencing IPV do not seek help or rely on informal help sources. Community health organizations may take a role in IPV prevention and intervention. Diversity of intervention options would be important to encourage more women with IPV experience to seek help.

Intimate partner violence against women during and after pregnancy: a cross-sectional study in Mumbai slums

Background

At least one-third of women in India experience intimate partner violence (IPV) at some point in adulthood. Our objectives were to describe the prevalence of IPV during pregnancy and after delivery in an urban slum setting, to review its social determinants, and to explore its effects on maternal and newborn health.

Methods

We did a cross-sectional study nested within the data collection system for a concurrent trial. Through urban community surveillance, we identified births in 48 slum areas and interviewed mothers ~6 weeks later. After collecting information on demographic characteristics, socioeconomic indicators, and maternal and newborn care, we asked their opinions on the justifiability of IPV and on their experience of it in the last 12 months.

Results

Of 2139 respondents, 35% (748) said that violence was justifiable if a woman disrespected her in-laws or argued with her husband, failed to provide good food, housework and childcare, or went out without permission. 318 (15%, 95% CI 13, 16%) reported IPV in the year that included pregnancy and the postpartum period. Physical IPV was reported by 247 (12%, 95% CI 10, 13%), sexual IPV by 35 (2%, 95% CI 1, 2%), and emotional IPV by 167 (8%, 95% CI 7, 9). 219 (69%) women said that the likelihood of IPV was either unaffected by or increased during maternity. IPV was more likely to be reported by women from poorer families and when husbands used alcohol. Although 18% of women who had suffered physical IPV sought clinical care for their injuries, seeking help from organizations outside the family to address IPV itself was rare. Women who reported IPV were more likely to have reported illness during pregnancy and use of modern methods of family planning. They were more than twice as likely to say that there were situations in which violence was justifiable (odds ratio 2.6, 95% CI 1.7, 3.4).

Conclusions

One in seven women suffered IPV during or shortly after pregnancy. The elements of the violent milieu are mutually reinforcing and need to be taken into account collectively in responding to both individual cases and framing public health initiatives.