Clinical and psychosocial factors associated with domestic violence among men and women in Kandy, Sri Lanka

Burden of intimate partner violence, mental health issues, and help-seeking behaviors among women in Nepal

BACKGROUND

Intimate partner violence (IPV) is the most common form of violence, presenting a significant public health concern, especially for women and girls. Help-seeking can reduce future IPV and mitigate adverse health outcomes, including mental health issues.

OBJECTIVES

This study is the first national assessment on IPV, mental health consequences, and associated help-seeking behaviors in Nepal.

DESIGN

A cross-sectional descriptive study.

METHODS

Using secondary data from the 2022 Nepal Demographic and Health Survey, this study includes 5178 women aged 15-49 and employs multivariate regression analysis to explore the association between IPV and mental health problems, as well as factors influencing help-seeking behavior for both issues.

RESULTS

Among participants, 31.4% reported ever experiencing IPV, and most (29.4% of all women) in the past 12 months. Of those ever experiencing IPV, 72.0% had not sought help for IPV, and 92.2% of those who did, opted for informal support. A total of 27.6% (n = 1427) of female interviewees reported anxiety symptoms, 21.5% (n = 1110) depressive symptoms, and 7.1% (n = 368) suicidal ideation within the past 2 weeks. These rates were higher among women who had experienced IPV in the past 12 months, with 41.1% reporting anxiety, 33.2% depression symptoms, and 14.1% suicidal ideation. Of the 4194 respondents with symptoms of anxiety, depression, or suicidal ideation who were asked about help-seeking for mental health issues, 19.4% (n = 812) had sought help, primarily from informal sources (93.4%, n = 759). Emotional IPV in the past 12 months increased the odds of anxiety (adjusted odds ratio (aOR) 3.00, 95% confidence interval (CI) 2.08-4.31), depression (aOR 3.09, 95% CI 2.19-4.37), and suicidal ideation (aOR 1.91, 95% CI 1.20-3.04). Sexual IPV increased the odds of anxiety (aOR 2.88, 95% CI 1.67-4.95) and depression (aOR 2.12, 95% CI 1.32-3.41), while controlling behavior heightened the odds of depression (aOR 2.42, 95% CI 2.02-2.89) and suicidal ideation (aOR 2.24, 95% CI 1.25-4.02).

CONCLUSION

This nationwide study reveals a high prevalence of IPV and related mental health problems among women in Nepal and a low rate of help-seeking behavior, in particular to formal support structures. Stronger health system responses and empowering informal support are essential to improve referrals and raise awareness for violence survivors.

Prevalence of suicidal ideation among married and cohabiting women in Sri Lanka: An analysis of the Sri Lanka Women's Well-being Survey 2019

This study utilized the 2019 Women's Wellbeing Survey conducted by the Department of Census and Statistics (DCS) in Sri Lanka to investigate the factors influencing suicidal ideation among married/cohabiting women. The study sample consists of secondary data from 1462 females, who were 15 years or older and currently married or living with a male partner, extracted from WWS 2019. Binary logistic regression was employed to analyze the association between suicidal ideation in married/cohabiting women and various independent variables. Among the respondents, 13.2% of married/cohabiting women reported having suicidal thoughts. Several factors were found to increase the likelihood of such ideation: a partner's extramarital affair, feelings of worthlessness and restlessness, partners consuming alcohol, experience of psychological violence and physical violence by the current partner, physical violence experienced since the age of 15, and childhood sexual violence. Conversely, lower odds of suicidal ideation were observed among women who married/cohabited between the ages of 20-29 compared to those in the 10-19 age category, and among unemployed women. This study emphasizes the urgency of addressing intimate partner violence, childhood sexual abuse, early marriages, and the mental well-being of vulnerable women, as these factors significantly impact their risk of life-threatening issues.

Intimate partner violence, suicide and self-harm in Sri Lanka: Analysis of national data

There is increasing evidence from South Asia and internationally that intimate partner violence (IPV) is strongly associated with self-harm, however its association with suicide and self-harm has not been extensively examined, nor has this relationship been explored at a national level. Using national datasets, area-level variation in IPV, suicide and self-harm in Sri Lanka were examined. In addition, the association between individual level exposure to past-year IPV and non-fatal self-harm by any household member were explored in a series of multi-level logistic regression models, adjusting for age. Similar patterns in the distribution of suicide and IPV were found, with higher rates evident in post-conflict districts, specifically Batticaloa, Kilinochchi, and Mullaitivu. Experience of past year IPV and its various forms were strongly associated with household-level self-harm in the past year (adjusted odds ratio [AOR] = 3.83 95% CI 2.27-6.46). A similar magnitude was found for physical/sexual abuse (AOR 5.17 95% CI 2.95-9.05) and psychological abuse (AOR 4.64 95% CI 2.50-7.00). A dose-response association was also evident for frequency of abuse, with an increasing risk of household-level self-harm for women reporting abuse 'less often' (AOR 2.95 95% CI 1.46-5.92), and abuse experienced 'daily, weekly, or monthly' (AOR 4.83 95% CI 2.59-9.00), compared to no abuse. This study contributes to a growing body of evidence on the relationship between IPV and suicidal behaviour in South Asia. Addressing IPV and its various forms should be a priority for suicide prevention in Sri Lanka, alongside trauma-informed approaches in post-conflict settings.