Effects of individual and proximate educational context on intimate partner violence: a population-based study of women in India

Prevalence and correlates of anxiety and depression among ever-married reproductive-aged women in Bangladesh: national-level insights from the 2022 Bangladesh Demographic and Health Survey

BACKGROUND

The sound mental health of reproductive-aged women is crucial for overall maternal and child well-being. However, mental health aspects are historically overlooked in low- and lower-middle-income countries, including Bangladesh. National-level evidence on common mental disorders like anxiety and depression among reproductive-aged women is limited in Bangladesh. Therefore, this study aims to estimate the prevalence of anxiety and depression among ever-married reproductive-aged women in Bangladesh and examine their individual, marital, household, and contextual correlates.

METHODS

We used data from the Bangladesh Demographic and Health Survey 2022 that collected anxiety and depression data using GAD-7 and PHQ-9 modules, respectively. This study included a total of 19,987 ever-married women aged 15 to 49 years. We used a cluster-adjusted multivariable logistic regression model to examine the factors associated with anxiety and depression.

RESULTS

The national level prevalence of anxiety and depression among ever-married reproductive-aged women was 19.5% and 4.9%, respectively. The odds of having anxiety monotonically increased from the age of 25. Menopause, educational attainment, autonomy, household wealth, and type of residence were not associated with anxiety or depression. Non-Muslim women were respectively 34% (AOR: 0.66, 95% CI: 0.55, 0.80) and 33% (AOR: 0.67, 95% CI: 0.97, 2.77) less likely to confront anxiety and depression than Muslims. Having a husband who completed secondary level education, having weekly marital coitus, and residing under the headship of a father or mother-in-law was associated with lower odds of anxiety and depression. Women from the Rangpur and Khulna divisions had higher odds of anxiety and depression than those from Dhaka.

CONCLUSIONS

This study reveals a high prevalence of anxiety among ever-married reproductive-aged women and highlights that anxiety and depression are not clustered among disadvantageous groups like less educated, less autonomous, rural, and poor women. Anxiety and depression are rather associated with late reproductive age, religious affiliation, marital factors, and region.

The Role of Gender Norms on Intimate Partner Violence Among Newly Married Adolescent Girls and Young Women in India: A Longitudinal Multilevel Analysis

Gender norms have been posited to impact intimate partner violence (IPV), but there is scant evidence of the longitudinal association between community-level gender norms and IPV. Using longitudinal data on 3,965 married girls surveyed in India, we fitted mixed-effects ordinal and binary logistic regression models for physical IPV intensity and occurrence of sexual IPV. We found a 26% increase in the odds that women experience frequent physical IPV per one unit increase in greater community-level equitable gender norms. We did not find an association between community-level equitable gender norms and sexual IPV. Findings suggest that the relationship between gender norms and physical and sexual IPV differs, indicating the need for tailored interventions for different types of IPV.

'Sleeping with the enemy': a cross-sectional study on psychological and emotional violence among couples living in Portugal during the COVID-19 pandemic

OBJECTIVE

This study aimed to evaluate psychological and emotional violence in relation with sociodemographic characteristics and anxiety and depression symptoms during the COVID-19 pandemic in a sample of Portuguese residents.

METHODS

A cross-sectional online study using snowball sampling collected data on demographics, socioeconomic factors, mental health (anxiety and depression symptoms) and couple psychological and emotional violence. The study spanned three months and included 519 individuals aged 18 or above in a relationship since January 2020 or earlier. Data analysis involved descriptive statistics, t-tests, chi-squared tests, logistic regression models (Odds-Ratio [OR] and 95% Confident Interval [CI]), and cluster analysis (K-medoids) using R software (significance threshold of 0.05).

RESULTS

The sample was predominantly composed of women (78.8%) with an average age of 36.8 years and 79% holding higher education degrees. Two clusters emerged: Cluster 1 (n = 420) presented fewer psychological and emotional violence victims, while Cluster 2 (n = 99) presented more. Older age (OR = 1.026, 95%CI 1.000-1.052) and depression symptoms (OR = 1.163, 95%CI 1.080-1.252) increased the likelihood of psychological and emotional abuse. Men also had 2.87 times higher odds of being victims (95%CI 0.203-0.599).

CONCLUSIONS

The study underscores the need for comprehensive interventions and prevention measures to address psychological and emotional violence by acknowledging it as a public health concern and pushing for interdisciplinary methods.

The Role of Formal Schooling, Literacy, and Health Knowledge in Addressing Domestic Violence Against Women in West Africa

When "education" is cited as a solution for domestic violence, different aspects of knowledge acquisition are often omitted. This study uses 2019 Demographic and Health Surveys from four West African countries (The Gambia, Liberia, Senegal, Sierra Leone) with a combined sample size of 12,480 women and generalized ordered logit regression to examine the effects of types of knowledge (years of schooling, literacy, and health knowledge) on domestic violence (physical abuse, emotional abuse, and control issues). The results suggest that literacy has the most reliable beneficial impact on domestic violence and was consistently associated with decreased odds of abuse. However, greater findings suggest that schooling, literacy, and health knowledge function as separate types of education and that their relationships are complex and context-specific. By neglecting to see these types of knowledge as separate entities that can operate together, it is possible that mitigation strategies for domestic violence are going undiscovered.

School Dropout, Absenteeism and Coverage of Sexual and Reproductive Health Services in South Africa: Are Those Most at Risk Reached?

School attendance or completion is important for adolescents' development. Adolescents who drop out or are regularly absent from school are at higher risk of adverse sexual and reproductive health (SRH) outcomes. However, there is little evidence evaluating SRH service coverage among adolescents in and out of school. In the context of a large-scale combination HIV and pregnancy prevention intervention funded by the Global Fund, we compared the SRH intervention coverage and SRH risks among adolescent girls who dropped out of school with those who were still in school or who had completed grade 12 in South Africa. Among those still in school, we compared the SRH intervention coverage and SRH risk profiles of those with high versus low or no absenteeism. In 2017 to 2018, we conducted a household survey of adolescent girls aged 15 to 19 years in six of the ten combination intervention districts. Of 2515 participants, 7.6% had dropped out of school. Among the 1864 participants still in school, 10.8% had high absenteeism. Ever having had sex, and condomless sex were more prevalent among dropouts compared with non-dropouts. Dropouts were more likely to access SRH services such as condoms and contraceptives, except the combination prevention intervention services which were more likely to reach those who had not dropped out and were equally likely to reach those in school with high versus low/no absenteeism. Combination SRH prevention programmes can improve the accessibility of SRH services for adolescents in school/who complete school.

Status (in)consistency in education and violent parenting practices towards children

Violent childrearing practices represent an invisible threat for global health and human development. Leveraging underused information on child discipline methods, this study explores the relationship between parental educational similarity and violent childrearing practices, testing a new potential pathway through which parental educational similarity may relate to child health and wellbeing over the life course. The study uses data from Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS) covering 27 sub-Saharan African (SSA) countries. Results suggest that couples where partners share the same level of education (homogamy) are less likely to adopt violent childrearing practices relative to couples where partners face status inconsistency in education (heterogamy), with differences by age of the child, yet less so by sex and birth order. Homogamous couples where both partners share high levels of education are also less (more) likely to adopt physically violent (non-violent) practices relative to homogamous couples with low levels of education. Relationships are stronger in countries characterized by higher GDP per capita, Human Development Index, and female education, yet also in countries with higher income and gender inequalities. Besides stressing the importance of female education, these findings underscore the key role of status concordance vs discordance in SSA partnerships. Tested micro-level mechanisms and country-level moderators only weakly explain result heterogeneity, calling for more research on the topic.

Men's education and intimate partner violence-Beyond the victim-oriented perspective: Evidence from demographic and health surveys in Central Africa

BACKGROUND

Intimate partner violence (IPV) has increasingly received attention in the last three decades. However, IPV-related studies in both high- and low- and middle-income countries adopted a victim-oriented perspective in which men are perpetrators and women, the victims. Using socio-cultural and resource theories as guiding frameworks, this paper assessed the associations between men's education and IPV in Central Africa, using nationally representative data of married and cohabiting women of reproductive ages.

METHODS

Data included in the analyses come from Demographic and Health Surveys (DHSs) in the Democratic Republic of the Congo (DRC), Cameroon, Gabon, and Chad. Analyzed sub-samples consisted of 3421, 5023, 3930, and 3221 married/cohabiting women of reproductive ages in Chad, DRC, Cameroon, and Gabon, respectively.

RESULTS

Findings indicated significant variations of IPV prevalence within and across countries. Previous research demonstrated that men's education is a protective factor in health-related studies. The present study, however, provide no clear evidence on the linkages between men's education and IPV. In contrast, the paper substantiated that highly educated women were at higher risks of IPV when spouses/partners were less educated.

CONCLUSION

These findings have policy and programmatic implications because they might impede progress towards SDG goals on the elimination of all forms of violence against girls and women in Central Africa, which recorded the worst development indicators in sub-Saharan Africa. On a methodological note, studies are increasingly using pooled data to increase statistical power. Those studies can be very limited to devise effective IPV-interventions since they mask geographical variations within and across countries. More effective IPV-interventions should be culturally rooted and accounting for geographical variations because some areas are more affected than others.

Burden, trend and determinants of various forms of domestic violence among reproductive age-group women in India: findings from nationally representative surveys

BACKGROUND

Violence, a notable human rights concern, has a public health impact across the globe. The study aimed to determine the prevalence and determinants of domestic violence among ever-married women aged 18-49 years in India.

METHODS

Secondary data analysis with National Family Health Survey 5, 2019-21 data (NFHS-5) was conducted. The complex sampling design of the survey was accounted-for during analysis. The primary outcome was domestic violence. Prevalence was reported with 95% confidence interval (CI). Prevalence ratio was reported to provide the factors associated with domestic violence using Poisson regression.

RESULTS

About 63 796 ever-married women aged 18-49 years covered under domestic violence module of NFHS-5 survey were included. Prevalence of domestic violence (12 months preceding the survey) was 31.9% (95% CI: 30.9-32.9%). Physical violence (28.3%) was the most common form followed by emotional (14.1%) and sexual violence (6.1%). Women with low education, being employed, husband being uneducated or with coercive behavior had significantly higher prevalence of domestic violence.

CONCLUSIONS

One-third of the reproductive age-group women were facing some form of domestic violence. Target group interventions like violence awareness campaigns, women supportive services and stringent law enforcement should be implemented to eliminate domestic violence by year 2030.

Men's attitude towards wife-beating: understanding the pattern and trend in India

BACKGROUND

Intimate partner violence (IPV) is a severe human rights violation and a global burden on public health. Wife-beating is a form of IPV and an extension of the patriarchal philosophy that legitimizes men's control over their spouses. This study investigates (a) the trends and patterns of men's attitudes towards justification of wife-beating and (b) the socio-demographic factors associated with changes in men's attitudes towards wife-beating between 2005-06 and 2019-21 in India.

METHODS

The present study utilized data from the last three rounds of the National Family Health Survey (NFHS): NFHS-3 (2005-06), NFHS-4 (2015-16), and NFHS-5 (2019-21) with a total sample of 2,76,672 men aged 15-54. The primary outcome variable was men's attitudes toward wife-beating. Attitude towards the household and the sexual autonomy of the wife were the two key predictors, in addition to other structural factors. Descriptive, bivariate, and multivariate logistic regression analyses were performed on weighted data using Stata. Hosmer-Lemeshow test, Classification table, and ROC curve were carried out to enhance the robustness of the analysis and validity of the model.

RESULTS

In 2005-06, 50% of men justified wife-beating in at least one of the seven contexts, which reduced to 42% in 2015-16 and then marginally increased to 44% in 2019-21. Men with an authoritarian attitude toward household autonomy (AOR: 2.34; CI: 2.30,2.38) and sexual autonomy of the wife (AOR: 1.68; CI: 1.65,1.71) were more likely to justify wife-beating than their egalitarian counterparts. Inadequate education, younger age, family history of IPV, alcohol consumption, poverty, and rural settings are associated with an elevated risk of abusive attitudes towards wife-beating.

CONCLUSION

A sizable percentage of men, more so those socio-economically marginalized, continue to justify wife-beating, albeit with considerable decline over the years. The findings suggest customized policies and programs enhancing gender egalitarian norms among young men, more opportunities to pursue higher education, alleviating poverty through employment opportunities, and raising awareness about domestic violence in rural settings would help develop more egalitarian gender norms and attitudes towards wife-beating.

Using Machine Learning Prediction to Create a 15-question IPV Measurement Tool

Domestic violence, especially intimate partner violence (IPV), is an important issue worldwide, especially in India. Those that experience it may not always be able to come forward or have access to the required social support to act against it. We use National Family Health Survey data (n = 66,013 women) to create machine learning models which can predict IPV instances with a recall of 78%. We use the top 15 best predicting questions that avoid sensitive issues to create a field tool that frontline health workers can use to identify women with a high risk of IPV and provide the support they need.

Relational dynamics associated with adolescent and young adult (13 to 23 years of age) partner violence: The role of inter-parental violence and child abuse

PURPOSE

The study aimed to examine the effect of witnessing inter-parental violence and experiencing childhood abuse on victimization of intimate partner violence (IPV) after marriage among adolescent and young girls.

METHOD

Data were drawn from the second wave of the Understanding the lives of adolescents and young adults (UDAYA) survey (2018-2019). The sample size was 5480 married adolescent and young girls aged 13-23 years. The outcome variable of the study was the victimization of IPV. Descriptive statistics, bivariate analysis and structural equation modelling (SEM) were performed.

RESULT

A total of 39% of married adolescent and young girls experienced physical violence, followed by sexual violence (35%) and emotional violence (28%) by their partner. Around 30% of respondents witnessed inter-parental violence, and 32% of the participants were beaten by their parents during childhood. Participants who had witnessed inter-parental violence were significantly correlated with experiencing childhood abuse, and this association was positively correlated with exposure to IPV in adolescence and young adulthood. Further, the parameter estimates of the indicators of IPV were highest for emotional violence (1.10) followed by physical violence (1.00) and sexual violence (0.62). Witnessing inter-parental violence significantly increases parents' physical violence to adolescents and young adult girls (β = 0.49, P<0.001, CI: 0.47-0.51). No tie between witnessing inter-parental violence and childhood abuse mediates their effect on later victimization of IPV.

CONCLUSION

The findings indicate that witnessing inter-parental violence is a strong risk factor for IPV victimization among adolescent and young adult girls. Our findings advocate prerequisite collaborative effort with multiple service providers for greater empowerment at national, state, community, and family levels to achieve SDG goals pertaining to eliminating violence against women.

Knowledge, perceptions, beliefs, and opinions of the employees about GBV: a national online study in South Africa

BACKGROUND

GBV has been global public health, family, and social problem for several decades as it is expensive for society and the economy. The study was conducted to determine the possible differences in knowledge, perceptions, beliefs, and opinions about GBV, as a whole, across gender and employment sectors in South Africa.

METHODS

This was a cross-sectional study using mixed-method design where we used an online survey with two open-ended questions. Perception about GBV Prevention among Employees (GBVPREV) questionnaire consisting of six Sect. (43 questions) was developed and tested. Cronbach's alpha, Exploratory factor analysis (EFA), including Kaiser-Meyer Olkin Measure of Sampling Adequacy (KMO) and Bartlett's test of Sphericity, one-way analysis of variance (ANOVA) and Tukey HSD were used. Content analysis was used for analysing qualitative information from two open-ended questions.

RESULTS

Among the 2 270 employees, more than half (68.1%) were females. Males were 677 (29.8%), and members of the LGBTQIAP + community were 32 (1.4%). There were statistically significant differences among males, females, and LGBTQIAP + on employee knowledge of adult experiences, employee knowledge of violence against children, employee perceptions, employee beliefs, and employee opinions and recommendations. The employees believe that all sectors of society should collaborate in addressing GBV in South Africa. They felt that victims should be encouraged to come forward, that society should be less judgemental, that stigma should be addressed and that there should be more empathy for victims.

CONCLUSION

Most of the respondents, who were female and had tertiary education, were employed in the private sector, and were very aware of the prevalence of GBV in South Africa, agreed that support for both victims and perpetrators must be provided in private sector organizations. Even though it has been acknowledged for decades that gender inequality and GBV are reciprocal drivers, the persistence of both human rights violations will continue if all stakeholders do not collaborate.

Effects of education and age on the experience of youth violence in a very low-resource setting: a fixed-effects analysis in rural Burkina Faso

OBJECTIVE

The study aimed to investigate the effects of education and age on the experience of youth violence in low-income and middle-income country settings.

DESIGN

Using a standardised questionnaire, our study collected two waves of longitudinal data on sociodemographics, health practices, health outcomes and risk factors. The panel fixed-effects ordinary least squares regression models were used for the analysis.

SETTINGS

The study was conducted in 59 villages and the town of Nouna with a population of about 100 000 individuals, 1 hospital and 13 primary health centres in Burkina Faso.

PARTICIPANTS

We interviewed 1644 adolescents in 2017 and 1291 respondents in 2018 who participated in both rounds.

OUTCOME AND EXPOSURE MEASURES

We examined the experience of physical attacks in the past 12 months and bullying in the past 30 days. Our exposures were completed years of age and educational attainment.

RESULTS

A substantial minority of respondents experienced violence in both waves (24.1% bullying and 12.2% physical attack), with males experiencing more violence. Bullying was positively associated with more education (β=0.12; 95% CI 0.02 to 0.22) and non-significantly with older age. Both effects were stronger in males than females, although the gender differences were not significant. Physical attacks fell with increasing age (β=-0.18; 95% CI -0.31 to -0.05) and this association was again stronger in males than females; education and physical attacks were not substantively associated.

CONCLUSIONS

Bullying and physical attacks are common for rural adolescent Burkinabe. The age patterns found suggest that, particularly for males, there is a need to target violence prevention at younger ages and bullying prevention at slightly older ones, particularly for those remaining in school. Nevertheless, a fuller understanding of the mechanisms behind our findings is needed to design effective interventions to protect youth in low-income settings from violence.

Locating perpetrators of violence against women in India: An analysis of married men's characteristics associated with intimate partner violence

Intimate Partner Violence (IPV) against married women is widely prevalent in India. Using recent data from NFHS-5, we analyzed the association between husbands' characteristics and IPV. Separate logistic regression models were developed for three distinct "husband characteristic groups" namely demographic, social and economic groups, and one final model including only statistically significant variables. IPV has been found to be significantly associated with men's age, age gap between husband and wife, men's educational level, religion, caste, region, number of daughters, wife's decision-making autonomy, men's IPV justifying attitude, alcoholism and substance abuse among men, type of work and wealth. We suggest shifting the policy gaze from women and prioritizing men's education, control on substance abuse and alcoholism among men as well as employment opportunities to tackle the violence against women.

Determinants of intimate partner controlling behavior targeting women in Türkiye

Background/aim

Intimate partner controlling behavior toward women is an important form of intimate partner violence (IPV), both in terms of limiting women's daily lives and in terms of reproducing patriarchal culture and male dominance in societies at the micro level. A limited number of studies in the literature have identified the male intimate partner's controlling behavior as a dependent variable, which is important for understanding the determinants of this type of IPV. There is also a significant gap in the literature in terms of studies focusing on the case of Türkiye. Thus, the main aim of this study was to determine the socio-demographic, economic and violence-related factors that have an effect on women's status in terms of exposure to control behavior in Türkiye.

Methods

These factors were examined by using binary logistic regression analysis, based on the micro data set collected by the Hacettepe University's Institute of Population Studies in the 2014-dated National Research on Domestic Violence against Women in Türkiye. A total of 7,462 women between the ages of 15 and 59 were interviewed face-to-face.

Results

The findings of the study revealed that women are more likely to be exposed to controlling behavior if they live in rural areas, are unmarried, speak Turkish as their mother tongue, have bad or very bad health conditions, justify men's violence and are afraid of their intimate partners. As women's age, level of education and income contribution increase, their likelihood of exposure to controlling behavior decreases. However, women's exposure to economic, physical and emotional violence also increases their likelihood of exposure to controlling behavior.

Conclusion

The findings highlighted the importance of creating public policies that make women less vulnerable to men's controlling behavior, providing women with methods and mechanisms of resistance and raising public awareness of the exacerbating effects of controlling behavior on social inequalities.

Multilevel analysis of factors for intimate partner violence during pregnancy in Gammo Goffa Zone, South Ethiopia: A community based study

Background

Intimate partner violence during pregnancy is a public health problem that can affect both maternal and fetal life. However, its prevalence and associated factors have not been well studied and understood in Ethiopia. Hence, this study was conducted to assess the individual and community-level factors associated with intimate partner violence during pregnancy in Gammo Goffa Zone, South Ethiopia.

Methods

A community-based cross-sectional study was conducted among 1,535 randomly selected pregnant women from July to October 2020. Data were collected using an interviewer-administered, standardized WHO multi-country study questionnaire and analyzed using STATA 14. A two level mixed-effects logistic regression model was used to identify factors associated with intimate partner violence during pregnancy.

Results

The prevalence of intimate partner violence during pregnancy was found to be 48% (95% CI: 45–50%). Factors affecting violence during pregnancy were identified at the community and individual levels. Access to health facilities (AOR = 0.61; 95% CI: 0.43, 0.85), women feeling isolated from the community (AOR= 1.96; 95% CI: 1.04, 3.69), and strict gender role differences (AOR= 1.45; 95% CI: 1.03, 2.04) were among higher-level factors found to be significantly associated with intimate partner violence during pregnancy. Low decision-making power was found to increase the odds of experiencing IPV during pregnancy (AOR= 2.51; 95% CI: 1.28, 4.92). Similarly, maternal education, maternal occupation, living with the partner's family, current pregnancy intended by the partner, dowry payment, and presence of marital conflict were among the individual- level factors found to increase the odds of experiencing intimate partner violence during pregnancy.

Conclusions

The prevalence of intimate partner violence during pregnancy was high in the study area. Both individual and community-level factors had significant implications on maternal health programs related to violence against women. Socio-demographic and socio-ecological characteristics were identified as associated factors. Since it is a multifaceted problem, special emphasis has to be given to multi-sectoral approaches involving all responsible bodies to mitigate the situation.

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.

Considerations in designing trauma-focused interventions for displaced Afghan women

In light of the 2021 United States military withdrawal from Afghanistan, as well as the humanitarian crises of mass displacement and subsequent health system strain that have ensued, practitioners worldwide will need to develop a more nuanced understanding of the adverse life experiences that women from Afghanistan frequently endorse. As they bear a disproportionate impact of constraints within Afghan society, and as patriarchal systems affect most of their life domains, women from Afghanistan may present with high levels of baseline trauma upon resettlement, and health systems may seek to attenuate this distress; However, the nature of these traumatogenic events may shape women's receptivity to psychosocial interventions, particularly those which are at least partially rooted in Western modalities. In the absence of sufficient literature on evidence-based interventions for this population, a diversity of ethnographic and clinical literature is synthesized, including literature on interventions alleged to be compatible with Afghan norms. As it will be essential to support Afghan women's mental health following social reorganization on a massive scale, considerations arising from the interdisciplinary literature are offered so that they may inform the development of structured, trauma-focused interventions and so that the health systems with which they interface may be better prepared to serve them.

Influences and patterns of intimate partner violence among married Akha and Lahu women in northern Thailand

BACKGROUND

Intimate partner violence (IPV) is a major global public health problem. Women are the principal victims of IPV, and some special populations have been particularly impacted. The Akha and Lahu women are vulnerable populations for IPV due to the modernization and changes of their culture and norms. This study aimed to understand premarriage factors related to IPV, including associated factors, influencers, patterns and impacts, in Akha and Lahu women in Thailand.

METHODS

A qualitative method was used to gather information among Akha and Lahu women who had experienced IPV in the previous year and were fluent in Thai. Women who had experienced IPV in the previous year and lived in the border area of Thailand and Myanmar were invited to provide information. A thematic analysis was used to extract information from the participants and develop findings.

RESULTS

A total of fifty-two married women were recruited into the study: 46.2% were Akha and 53.8% were Lahu. Those married Akha and Lahu women younger than 39 years found their partner through social media, had conditions before getting married, had high self-confidence, and tended to marry people from different tribes. While those aged 40 years and over met their husbands in village activities, were highly compliant with the norms of their culture, and married men from the same tribe. Three factors were detected as associated factors of IPV: cultural differences between partners from different tribes, substance use, and personality. Differences in age between partners, living in poor family economic status, and poor education were also detected as influencers of IPV. Four patterns of IPV were observed among Akha and Lahu married women: neglect, emotional abuse, verbal abuse, and physical abuse. Several patterns of the impacts were presented: children were neglected, especially in the preparation of daily food, having stress, having poor family relationships, and having children with unsuccessful lives in terms of education and getting a good job. Almost all married Akha and Lahu women had no particular expectations in their lives.

CONCLUSION

Akha and Lahu women face IPV problems with several key influences and impacts. Effective implementations are required to monitor and reduce the problem in the Akha and Lahu families, especially where the women are younger than 40 years old and married to men from different tribes.

Education and Intimate Partner Violence Among Married Women in Nigeria: A Multilevel Analysis of Individual and Community-Level Factors

Research has documented an inverse relationship between lifetime intimate partner violence (IPV) and a woman's educational accomplishment. Moreover, women without formal education were more likely to report lifetime IPV in comparison with women who completed more than 12 years of education. Therefore, this study examines the individual and community-level factors that determine the degree of IPV vis-à-vis women's education. Data set of currently married women were extracted from 2018 Nigeria Demographic and Health Survey. The study employed three levels of statistical analysis. The result of the analysis reveals that the nature of IPV differs due to women's educational status. Women with the highest level of education experienced the least of all the three IPV indicators identified in this study. A significant relationship exists with women's education and ever experienced physical violence (primary odds ratio [OR] = 1.29; secondary OR = 1.44, higher OR = 0.71). The ORs of ever experienced sexual violence decrease as women's education increases (secondary OR = 1.10, higher OR = 0.63). The higher significant effect of husband/partner who drinks alcohol on all the three indicators of IPV was affirmed (p < .01). Except for community labor participation, all other community variables were significant with emotional violence and sexual violence (p < .05). The study established that both individual and community factors influence the incidence of IPV in the study area. The study concludes that women empowerment alone cannot reduce the incidence of IPV as revealed in the study; community sensitization about the consequences of IPV on the health of women and the well-being of the family should be intensified.

Reaching out to men in ending intimate partner violence: a qualitative study among male civil servants in Ibadan, Nigeria

PURPOSE

The aim of this study was to explore the perceptions of male civil servants in Ibadan, Nigeria about the perpetration of IPV and to document their suggested measures to prevent IPV in our communities in Nigeria.

METHODS

Four focus group discussions were conducted among 36 male civil servants selected from Oyo State Secretariat, Ibadan using purposive sampling technique. Data were transcribed and analysed using thematic approach.

RESULTS

Six major themes were identified; awareness of the forms of IPV, women and men as victims, causes, attitude, consequences as well as the suggested strategies for the prevention of IPV. Physical and psychological abuse were mentioned across the groups. The respondents pointed out that women experience IPV more than men, but that men also experience it. Some respondents stated that physical and psychological abuse against female intimate partners were acceptable in some circumstances according to the societal norms. The negative effects of IPV on physical, mental and social well-being of the individual, families and society were mentioned. Suggested ways of preventing IPV include tolerance and patience which will promote healthy, respectful and non-violent relationships among intimate partners.

CONCLUSION

Considering the perceptions and attitudes of these men to IPV, it is important to reach out to both genders for appropriate preventive and educational intervention in ending IPV among women and men.

Multilevel analysis of factors associated with perinatal intimate partner violence among postpartum population in Southern Ethiopia

Violence around pregnancy is critical in nature and major public health problem worldwide. Thus, the present study aims to determine the extent of perinatal partner violence and to identify its individual and community-level factors among postpartum women in Southern Ethiopia. A total of 1342 postpartum women nested in 38 'Kebles' (clusters) were enumerated using multistage-clustered sampling techniques for multilevel analysis. Different parameters were computed for model comparison and model fitness. The overall prevalence of intimate partner violence before, during, and/or after pregnancy was estimated to be 39.9% [95% CI 36.9-44.5]. About 18% of women reported continuous abuse over the perinatal period. Postpartum women who live in rural areas [adjusted odds ratio (AOR) = 2.46; 95% CI 1.21-5.01], or in neighborhoods with high IPV favoring norms [AOR = 1.49; 95%CI 1.01-2.20], high female literacy [AOR = 2.84; 95%CI 1.62-5.01], high female autonomy [AOR = 2.06; 95%CI 1.36-3.12], or in neighborhoods with lower wealth status [AOR = 1.74; 95%CI 1.14-2.66] were more likely to encounter PIPV. The complex patterns of interplaying factors operating at different levels could put pregnant or postpartum women at higher risk of IPV victimization. Therefore, policies that prioritize the improvement of contextual factors, particularly norms toward IPV and women's empowerment are likely to be the most effective interventions.

Socioeconomic and Geographic Correlates of Intimate Partner Violence in Sri Lanka: Analysis of the 2016 Demographic and Health Survey

Intimate partner violence (IPV) is a serious public health issue and violation of human rights. The prevalence of IPV in South Asia is especially pronounced. We examined the associations between socioeconomic position (SEP), geographical factors and IPV in Sri Lanka using nationally representative data. Data collected from Sri Lanka's 2016 Demographic and Health Survey were analysed using multilevel logistic regression techniques. A total of 16,390 eligible ever-partnered women aged 15-49 years were included in the analysis. Analyses were also stratified by ethnicity, type of violence, neighbourhood poverty and post-conflict residential status for selected variables. No schooling/primary educational attainment among women (OR 2.46 95% CI 1.83-3.30) and their partners (OR 2.87 95% CI 2.06-4.00), financial insecurity (OR 2.17 95% CI 1.92-2.45) and poor household wealth (OR 2.64 95% CI 2.22-3.13) were the socioeconomic factors that showed the strongest association with any IPV, after adjusting for age and religion. These associations predominately related to physical and/or sexual violence, with weak associations for psychological violence. Women living in a post-conflict environment had a higher risk (OR 2.96 95% CI 2.51-3.49) of IPV compared to other areas. Ethnic minority women (Tamil and Moor) were more likely to reside in post-conflict areas and experience poverty more acutely compared to the majority Sinhala women, which may explain the stronger associations for low SEP, post-conflict residence and IPV found among Tamil and Moor women. Policies and programs to alleviate poverty, as well as community mobilisation and school-based education programs addressing harmful gender norms may be beneficial. Trauma informed approaches are needed in post-conflict settings. Further exploratory studies investigating the complex interplay of individual, household and contextual factors occurring in this setting is required.

Interracial Comparisons of Intimate Partner Violence Among Military Perpetrators

Interracial violence is a high-profile issue in the United States; however, there is little empirical research on interracial intimate partner violence (IPV). Interracial relationships are becoming more common. However, interracial couples continue to face stressors (e.g., discrimination) that likely impact the relationship (e.g., IPV) than their monoracial counterparts. Research indicates that military populations more likely oppose interracial marriages than nonmilitary counterparts. Yet, no study to date has investigated IPV within military monoracial and interracial couples. To understand the intersecting effects of race/ethnicity among military couples, this study investigates male perpetrated IPV in interracial and monoracial relationships. Using structural equation modeling, this study sample contains information about 449 male veterans from the National Longitudinal Study of Adolescent to Adult Health (1994-2008): Waves I and IV. Findings indicate that (a) White and Black veterans are more violent in monoracial relationships, meanwhile, Latino veterans have a higher IPV prevalence in interracial relationships; (b) Black and White veterans were more likely to use alcohol and other drugs (AOD) after IPV perpetration in interracial relationships, in contrast to Latino veterans' post IPV perpetrations AOD use in monoracial relationships; (c) veteran mental health status was affected after perpetration of IPV, similar to the effects experienced after combat. In an attempt to address the lack of research on the characteristics associated with interracial violence this study addresses the following questions: (a) Are veterans in interracial families more likely to commit IPV and use of alcohol and other drugs (AOD) than in monoracial families? (b) Among the military samples, is AOD a facilitator for IPV?

Intimate-partner violence and its association with symptoms of depression, perceived health, and quality of life in the Himalayan Mountain Villages of Gilgit Baltistan

Study objectives

We aimed to estimate the prevalence of intimate partner violence (IPV) and associated risk factors in married women in rural villages of Gilgit Baltistan in Pakistan.

Methods

A cross-sectional design to assess the magnitude and factors associated with IPV in a random sample of 789 married women aged 18–49 years. A World Health Organization screening instrument was used to assess the presence of IPV in the previous 12 months. A locally validated instrument was adopted to identify self-reported symptoms of major depression according to the DSM IV. Trained nurses obtained socio-demographic and reproductive history through structured interviews. Bivariate and multivariable logistic regression analyses were used to estimate prevalence and identify significant predictors of IPV.

Results

The mean age of the participants was 38.3 years (SD: ±12.8). The prevalence of IPV in women was 22.8% (95% Confidence Interval: 20.0–25.9), 18.5% in pregnant women (95% CI: 11.7–27.9) and significantly associated with depression in 55.1% of IPV cases. Husband education level (college/higher) (Adjusted Odds Ratio: 0.40; 95%CI: 0.22–0.70) and high household income (AOR: 0.44; 95% CI: 0.29–0.68) were protective against IPV. Increase in age (AOR;1.02; 95% CI: 1.01–1.02) and poor relationship with mother-in-law increased the risk of IPV (AOR = 2.85; 95% CI: 1.90–4.28). IPV was positively associated with symptoms of depression (AOR = 1.97; 95% CI:1.39–2.77), poor perceived quality of life (AOR = 3.54; 95% CI: 1.90–6.58) and poor health (AOR = 2.74; 95% CI: 1.92–3.92).

Conclusion

IPV is substantial public health burden significantly associated with depressive symptoms, poor perceived health and the quality of life.

Domestic Violence Victimization among South Asian Immigrant Men and Women in the United States

Domestic violence is a pernicious social problem in the United States and a cause of national concern. The South Asian culture disempowers individuals experiencing domestic violence from recognizing and reporting victimization. Structural inequities may also discourage reporting victimization. These issues have led to inconsistent findings of domestic violence prevalence rates. Additionally, domestic violence studies with South Asians in the United States have predominantly focused on women, omitting men from this purview of research. The purpose of this study was to examine domestic violence victimization rates as well as their correlates among South Asian immigrant men and women. The sample for this cross-sectional study included 468 South Asians across the 50 U.S. states. Descriptive statistics were used to establish rates of domestic violence victimization. Hierarchical logistic regression was used to examine the correlates of domestic violence victimization. All of the sociodemographic information was added in step 1, and acculturation and gender-role attitudes were added as covariates in step 2.The most prevalent type of domestic violence victimization was physical violence (48%), followed by emotional (38%), economic (35%), verbal (27%), immigration-related (26%), in-laws related (19%), and ultimately sexual abuse (11%). Prevalence rates were higher for women than for men in each type of violence. According to the logistic regression results, education, generational position, family type, and employment were significant correlates of domestic violence victimization. Prior to development of prevention programs by community agencies, it is essential to understand the nature and prevalence of domestic violence experiences among South Asians. The victimization of men in addition to women adds to the novelty of this research study and paves the way for practitioners and scholars to engage in conversations about providing both male and female victims of domestic violence with the needed resources and support. The article will discuss implications for research, practice, and policy.

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.

Exploring the Relationship Between Participation in an Adult-women's Soccer League and Intimate Partner Violence in Rural Kenya

Rates of intimate partner violence (IPV) against women in Sub-Saharan Africa are among the highest of any region in the world. Empirical studies on the effectiveness of IPV-prevention programs in Africa, though few, suggest that successful programs have emphasized community-level engagement and attitudinal change around gender roles. This study explored the relationship between adult women's participation in an all-women's soccer league and IPV in rural Kenya. Nikumbuke Project is a health- and literacy-based program for 702 women in Kwale County, Kenya, that also hosts a women's soccer league. A total of 684 Nikumbuke members completed surveys for this study, 543 of whom identified as having had a partner in the preceding 12 months and were included in this analysis. Participants in the study were, on average, in their late 30s, married with 4-6 children, a primary education or less, and no source of formal employment. Logistic regression models examined the association between a woman's participation in the soccer league and the odds that she would have experienced recent IPV, controlling for other covariates. Women who played on soccer teams had 59% lower odds of reporting physical IPV in the preceding 12 months and approximately 43% lower odds of reporting any form of IPV during the same period compared to women who did not play soccer. Support of more gender-equitable norms was associated with lower odds of all forms of recent violence. More research is needed to identify the underlying reasons for these observed effects and to determine the presence of a causal or temporal relationship between adult women's sports and IPV-risk reduction. Nonetheless, findings from this study point to a novel IPV intervention in communities that might otherwise be resistant to more overt attempts to address gender-based violence (GBV) or where social service agencies with the capacity for IPV-prevention programming may be limited.

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

Domestic violence (DV) is a violation of human rights with adverse intergenerational consequences on physical and mental health. Clinical and psychosocial correlates of DV have been documented internationally, but evidence from South Asia is limited, especially among men. This is a nested cross-sectional study of the control population (N = 856) of a large case-control study in Kandy, Sri Lanka. Multivariable logistic regression models were conducted to estimate the association between clinical and psychosocial factors and experience of DV. Overall associations were examined and stratified by sex and type of abuse. Overall, 19% (95% CI 16%-21%) of the sample reported DV of any form in past year, with a similar prevalence being reported in both men (18% 95% CI 14%-22%) and women (19% 95% CI 15%-23%). Depression symptoms (adjusted OR [AOR] 3.28 95% CI 2.13-5.05), suicidal ideation (AOR 6.19 95% CI 3.67-10.45), prior diagnosis of a mental illness (AOR 3.62 95% CI 1.61-8.14), and previous self-harm (AOR 6.99 95% CI 3.65-13.38) were strongly associated with DV, as were indicators of perceived poor social support (AOR range 2.48-14.18). The presence of in-laws (AOR 2.16 95% CI 1.34-3.48), having three or more children (AOR 2.15 95% CI 1.05-4.41) and being divorced/separated/widowed were also strongly associated with DV (AOR 2.89 95% CI 1.14-7.36). There was no statistical evidence that any associations differed by sex. A multi-sectoral approach is needed to address DV in this context. Enhanced coordination between DV support services and mental health services may be beneficial. Further research and support for men as well as women is needed.

Economic Empowerment and Tolerance of Domestic Violence Among Married Women: A Cross-Sectional Study

We evaluated whether markers of economic empowerment are associated with a tolerant attitude toward spousal physical violence (SPV) among employed married women in Nigeria. Cross-sectional analyses of responses to the 2013 Nigeria Demographic Health Survey by a nationally representative sample of 3,999 women aged 15 to 49 years who reported being employed and married. Tolerance for SPV was defined as supporting statements with justifications for wife-beating. Logistic regression assessed the associations of reporting tolerance for SPV with educational attainment and interspousal equivalency in income, controlling for previous exposure to domestic abuse. The prevalence of tolerance for SPV among the sample was 37%. Women with tertiary education had lower odds of tolerance for SPV relative to their counterparts without formal education (adjusted odds ratio [aOR] = 0.22, 95% confidence interval [CI] = [0.12, 0.40], p < .0001). Compared with women with similar income levels as their partners, women who either earned more (aOR = 2.77, 95% CI = [1.36, 5.62], p = .005) or earned less income relative to their spouses (aOR = 1.93, 95% CI = [1.14, 3.26], p = .02) had higher odds of tolerance for SPV. Odds of tolerance for SPV were also higher among women reporting previous spousal abuse than among their counterparts without such a history (aOR = 1.55, 95% CI = [1.14, 2.12], p = .006). A history of nonspousal abuse was associated with lower odds of tolerance for SPV (aOR = 0.56, 95% CI = [0.37, 0.84], p = .005). Lower educational attainment and interspousal differences in income may contribute to tolerance of SPV. Efforts to increase economic empowerment should be combined with education to recognize cultural norms that foster SPV and build skills to exit violent relationships.

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.

Intersectional inequalities in younger women's experiences of physical intimate partner violence across communities in Bangladesh

Background

Physical intimate partner violence (IPV) risk looms large for younger women in Bangladesh. We are, however, yet to know the association between their intersectional social locations and IPV across communities. Drawing on intersectionality theory’s tenet that interacting systems of power, oppressions, and privileges work together, we hypothesized that (1) younger, lower educated or poor women’s physical IPV experiences will be exacerbated in disadvantaged communities; and conversely, (2) younger, higher educated or nonpoor women’s physical IPV experiences will be ameliorated in advantaged communities.

Methods

We applied intercategorical intersectionality analyses using multilevel logistic regression models in 15,421 currently married women across 911 communities from a national, cross-sectional survey in 2015. To test the hypotheses, women’s probabilities of currently experiencing physical IPV among intersectional social groups were compared. These comparisons were made, at first, within each type of disadvantaged (e.g., younger or poor) and advantaged (e.g., older or nonpoor) communities; and then, between different types of communities.

Results

While our specific hypotheses were not supported, we found significant within community differences, suggesting that younger, lower educated or poor women were bearing the brunt of IPV in almost every community (probabilities ranged from 34.0–37.1%). Younger, poor compared to older, nonpoor women had significantly higher IPV probabilities (the minimum difference = 12.7, 95% CI, 2.8, 22.6) in all communities. Similar trend was observed between younger, lower educated compared to older, higher educated women in all except communities that were poor. Interestingly, younger women’s advantage of higher education and material resources compared to their lower educated or poor counterparts was observed only in advantaged communities. However, these within community differences did not vary between disadvantaged and advantaged communities (difference-in-differences ranged from − 0.9%, (95% CI, − 8.5, 6.7) to − 8.6%, (95% CI, − 17.6, 0.5).

Conclusions

Using intersectionality theory made visible the IPV precarity of younger, lower educated or poor women across communities. Future research might examine the structures and processes that put them at these precarious locations to ameliorate their socio-economic-educational inequalities and reduce IPV in all communities. For testing hypotheses using intersectionality theory, this study might advance scholarship on physical IPV in Bangladesh and quantitative intersectionality globally.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12939-021-01587-z.

"Whose Fault Is It?" How Rural Chinese Women Explain Intimate Partner Violence: A Qualitative Study

Women are often the victims of intimate partner violence (IPV). Though China has established its first statute against domestic violence, the service developments for victims fall behind. It is important to assess community members' perceptions of what causes IPV to create interventions to prevent and address IPV. This study completed the Short Explanatory Model Interview (SEMI) among a subset sample from a large epidemiology study in rural Sichuan China. The social ecological model was applied to analyze qualitative interviews. Among 339 participants, the average age was 46.01 ± 12.42 years old. There were 31.86% of them had been educated, 14.75% of them had migrant worker partners, and 49.26% of them had experienced violence from their partners in the last year. There were 252 participants attributed IPV to individual factors, and they primarily discussed the social characteristics, behaviors, personalities or even health problems of the husband or the wife in the vignette. Under this theme, there were 86 participants blaming the victim for being anxious, social disconnectedness or lazy; and there were 166 participants blaming to the perpetrator being abusive, irresponsibility, lack of understanding, and cheating. There were 44 women believed the cause was relational, in which there were 41 participants attributed the problem to the broken relationship between the couple and three participants attributed to the lack of support. There were 28 participants believed the cause was communal and societal, such as being poor, family problems, fate, and believed IPV was a common scene. There were 15 participants could not identify the cause of IPV. These participants usually provided very brief responses and barely had insight on violent behaviors or confidence in discussing the cause. Our findings offer a direction for understanding the rural Chinese women's beliefs about the etiology of IPV to better develop interventions which must consider raising a public awareness campaign about the risk factors of IPV and focus on reducing self-blame among victims.

Is consanguineous marriage related to spousal violence in India? Evidence from the National Family Health Survey, 2015-16

Violence against women is a global phenomenon, and intimate partner violence is the most common form of violence faced by women in the world. Around 30% of women in the world, on average, and 33% in India experience intimate partner violence during their lifetime. The main aim of this study was to investigate whether consanguinity protects women from spousal violence. National Family Health Survey 2015-16 (NFHS-4) data were used. The study sample comprised 60,824 currently married women aged 15-49 years. The results of the logistic regression model showed that the likelihood of all types of spousal violence against women was higher among consanguineous unions compared with non-consanguineous unions in India. The association between consanguineous marriage and spousal violence was found to be positive and significant in the southern and eastern regions of India and among Scheduled Castes and Scheduled Tribes. The association was not significant among Muslims. Differences in socio-cultural norms and practices across the regions of India, and among different socio-cultural groups, can perhaps explain these variations. Women belonging in higher age groups, from Other Backward Castes, those who were working and those with a low level of educational attainment and socioeconomic standing had a higher risk of experiencing intimate partner violence. Couples in a consanguineous marriage should be given adequate counselling to reduce intimate partner violence in India, and similarly culturally diverse countries. This would also help reach Target 5.2 of the Sustainable Development Goals by 2030.

Correlates of intimate partner violence among adolescents in East Africa: a multi-country analysis

INTRODUCTION

intimate partner violence (IPV) is a global concern not only among adults but also adolescents. It has been reported that 35% of adolescent women have ever experienced IPV - occuring more so in non-industrialized countries. This study sought to understand the correlates associated with experiencing IPV among adolescent women between the ages 15 and 24 in five East African countries: Burundi, Kenya, Rwanda, Tanzania, and Uganda.

METHODS

this was a secondary analysis of Demographic and Health Survey (DHS) data on adolescent women aged 15-24 years in five East African countries. IPV was measured as a composite variable of emotional, physical, and sexual violence. Other sociodemographic, income, maternal, sexual, knowledge, behavioral, and partner-related variables were included in the analysis.

RESULTS

the prevalence of ever experiencing IPV was 45.1% (n=2380). A higher proportion of women who reported experiencing IPV had their first sexual encounter when they were less than 18 years of age (p<0.001). The adjusted odds ratio (aOR) of experiencing IPV increased almost two times for women who were aged 18-24 years (aOR: 1.7; CI: 1.3-2.3), almost four times (aOR 3.8; CI: 1.7-8.3) for those who had two or more children, and two-fold for women who had ever terminated a pregnancy compared to those who had not (aOR 2.2; CI: 1.0-4.9). Additionally, there was a higher odds (aOR: 1.5 (1.0-2.3)) of experiencing IPV if the respondent believed their husband/spouse´s abuse was justified.

CONCLUSION

raising early awareness and educating both the young males and females appropriately to mitigate contributing factors to IPV could ensure stable, healthy relationships free of domestic violence in the future.

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.

Do Laws Promoting Gender Equity and Freedom from Violence Benefit the Most Vulnerable? A multilevel Analysis of Women's and Adolescent Girls' Experiences in 15 low-and-Middle-Income Countries

In this analysis, we assess whether laws that promote gender equity and freedom from violence are associated with a lower risk of prior-year physical and sexual intimate partner violence (IPV) among adolescent girls and adult women (AGW) and whether these laws protect more and less vulnerable AGW equally. We included all 15 countries that administered the Domestic Violence Module in a Demographic and Health Survey since 2015. The primary exposure was a validated, country-level index of laws on violence against women and girls (LoVI). A multilevel approach was used to model five forms of violence (prior-year partner physical, sexual, physical or sexual violence and prior-year non-partner physical violence or sexual violence) among ever-partnered, non-widowed adolescent girls 13–19 years (n = 6691) and women 20–49 years (n = 119 343). Across countries, partner physical violence ranged from 0% to 33% and sexual violence from 0% to 23%. Laws on marital rape, child marriage and sexual harassment were negatively associated with prior-year physical and sexual IPV for women and girls. Comprehensive domestic violence legislation was unrelated to girls’ experiences of prior-year physical or prior-year sexual IPV. No interaction was observed between LoVI component laws and a score meant to capture adolescent vulnerability. Three of the four LoVI component laws had consistent, negative associations with partner violence for girls and women, but negative associations were stronger for women than girls. Thus, while laws promoting gender equity and freedom from violence are generally protective, they may be more so for women than adolescent girls. Future research should explore the impact of gender equitable laws on women’s and adolescent girls’ experiences of violence, and countries may consider more comprehensive legal protections against violence for adolescent girls.

Variations in Emotional, Sexual, and Physical Intimate Partner Violence Among Women in Uganda: A Multilevel Analysis

Evidence shows that a significant proportion of ever-partnered women suffer some form of intimate partner violence (IPV) perpetuated by male partners. The prevalence of IPV in sub-Saharan African countries is considerably higher than global estimates. Although existing studies show the effect of women's and intimate male partner's characteristics on IPV, knowledge on how these factors increase or reduce women's risk to specific types of IPV is limited. Using the 2016 Ugandan Demographic and Health Survey (UDHS), we examine regional variations in women's and intimate male partner's characteristics and their effect on emotional, sexual, and physical violence perpetuated by men and experienced by women in Uganda. The result shows that women's educational status is a significant predictor of all forms of IPV, whereas other characteristics, such as employment and housing ownership, have differential effects on specific types of IPV. Less educated women were more likely to experience emotional, sexual, and physical violence. Alcohol abuse was a significant determinant of men perpetuating all types of IPV; other male characteristics had differential effects on specific types of IPV. Male partners who abuse alcohol "often" and "sometimes" were more likely to commit acts of emotional, sexual, and physical violence against their female intimate partners. The findings also show that ~5%, ~8%, and ~2% of the variance in emotional, sexual, and physical violence (respectively; in the final models) are attributable to regional differences. The findings suggest the need for interventions aimed at increasing women's access to higher education, working with men and boys to reduce the occurrence of alcohol abuse and address harmful constructions of masculinity, and promoting gender equality among men as well as women.

Association of Black Women's Perceptions of the Sex Ratio to Their Attitudes Toward and Experiences of Intimate Partner Violence

This study explores how perceptions of the availability of male dating partners (sex ratio) affect heterosexual Black women's tolerance and experiences with intimate partner violence (IPV). Evolutionary behavioral models suggest that when the sex ratio is high (more available men than women), violence against women is more likely to occur, whereas the Guttentag-Secord model suggests that when there is a surplus of men, violence against women is less likely to occur. Testing these theories, results show perception of a high sex ratio was significantly positively associated with experiences of IPV in the past 12 months and more tolerant attitudes toward IPV.

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.

Iron deficiency anaemia and low BMI among adolescent girls in India: the transition from 2005 to 2015

OBJECTIVE

The current study explored changes in trend of anaemia and BMI among currently pregnant nullipara adolescent women against socio-economic determinants in India from 2005 through 2015. The association between anaemia in currently pregnant nullipara adolescent women v. currently pregnant nullipara older women of reproductive age was also explored.

DESIGN

We used the 2005 and the 2015 nationally representative Indian Demographic and Health Surveys (DHS). The outcomes of interest, anaemia and BMI, were measured based on the DHS methodology following WHO standards and indicators. Place of residence, educational attainment and wealth quintiles were used as determinants in the analysis.

SETTING

India.

PARTICIPANTS

In total, 696 adolescent girls from the India 2005 DHS and 3041 adolescent girls from the India 2015 DHS.

RESULTS

The 10-year transition from 2005 to 2015 showed differences between the least and most wealthy sections of society, with heaviest gains in anaemia reduction over time among the latter (from 50·0 to < 40·0 %). The odds of anaemia were significantly higher among the adolescent population when compared with adult women both in 2005 and in 2015 (OR = 1·2).

CONCLUSIONS

Despite an overall improvement in the prevalence of both BMI < 18·5 and anaemia among adolescents nullipara in India, the adjusted risk of anaemia in the latter category was still significantly higher as compared with their adult counterparts. Since the inequalities evidenced during the first round of DHS remained unchanged in 2015, more investments in universal health care are needed in India.

Prevalence and Factors Associated With Intimate Partner Violence Among Young Women Aged 15 to 24 Years in India: A Social-Ecological Approach

Intimate partner violence (IPV) is a critical public health issue that has reached epidemic proportions. Research investigating IPV among young women in India using large-scale population data is lacking. This study examined the prevalence and factors associated with IPV among women aged 15 to 24 years in India through a social-ecological approach. This cross-sectional study analyzed data from the National Family Health Survey, a population-based survey conducted in India from 2005 to 2006. The past-year prevalence of emotional, physical, and sexual forms of IPV, among ever-married women aged 15 to 24 years were computed. Multivariate logistic regression was conducted to evaluate the association of factors at various levels of the social-ecological framework with the past-year experience of emotional, physical, sexual, and any form of IPV. The past-year prevalence of IPV among women aged 15 to 24 years (n = 16,285) was 29%. Physical IPV was the most common, affecting 23% in the past year. The past-year prevalence of sexual IPV among women aged 15 to 24 years at 9.5% was higher than older women. Individual factors significantly associated with the past-year experience of all forms of IPV were the young age at first marriage, parental IPV, and ever had a terminated pregnancy. At the relationship level, husband's controlling behaviors, his consumption of alcohol, and experience of violence from other family members were positively associated with all forms of IPV in the past year. Poverty and acceptance of IPV increased the women's odds of experiencing IPV. IPV was associated with multiple factors occurring at all levels of the social-ecological framework. Actions to prevent and eliminate IPV in India demand multidisciplinary and collaborative efforts that are tailored specifically for adolescents and young women. It is imperative to protect the girls and young women from IPV; it protects the future of India.

How long was the honeymoon? Accelerated failure time model of spousal violence onset among women in sub-Saharan Africa

For primary prevention of spousal violence which is highly prevalent in sub-Saharan Africa (SSA), an important empirical question is "how early in a marital relationship does spousal violence commence? In this study, we employed descriptive statistics, Kaplan-Meier method and accelerated failure time models to estimate prevalence of parental history of spousal violence; estimate the timing of onset of spousal violence for sub-regions of SSA and assess the associated factors. We analyzed a weighted sample of 62,274 women aged 15-49 years from the domestic violence module of Demographic and Health Surveys conducted in 14 SSA countries between 2015 and 2018. Prevalence of spousal violence among ever married women ranged from 20.5% in Nigeria to 45.9%% in Burundi. The median time to first spousal violence after marriage in Western, Middle, Eastern, and Southern Africa was 2 years. Results from accelerated failure time models showed that age at marriage, educational attainment, and parental history of spousal violence were independently associated with early onset of spousal violence in all SSA subregions (West: TR = 0.21, CI 0.19-0.24; Middle: TR = 0.38, CI 0.34-0.43; East: TR = 0.46, CI 0.44-0.49; South: TR = 0.50, CI 0.46-0.54). Adolescents, youth, and older adults should be targeted for preventive and corrective interventions for spousal violence.

Correlates of intimate partner violence among married women in Uganda: a cross-sectional survey

BACKGROUND

In Uganda, just like in many sub-Saharan countries, studies on Intimate Partner Violence (IPV) among married women are limited. The aim of this paper was to determine the correlates of emotional, sexual, physical IPV and any form of IPV among married women in Uganda.

METHODS

The 2016 Uganda Demographic and Health Survey (UDHS) data was used, and a weighted sample of 6879 married women were selected from the Domestic Violence module. Frequency distributions were used to describe the characteristics of respondents. Chi-square tests were used to establish the association between IPV and the explanatory variables. Binary logistic regressions were used to establish the factors that were associated with IPV among married women in Uganda.

RESULTS

More than half (56%) of the married women experienced some form of IPV. Sexual IPV was the least prevalent (23%) and 4 in 10 women (41 and 40%) experienced physical and emotional IPV, respectively. Factors associated with all the different forms of IPV included, age, region, witnessing parental violence, partner's controlling behaviors, duration of the relationship, and frequency of intoxication of the male partner.

CONCLUSION

IPV among Ugandan married women is far too common. This calls for collective efforts to reduce IPV in Uganda by addressing excessive alcohol consumption, controlling behaviors, and lack of awareness of the issue. Interventions aimed at preventing perpetration and tolerance of violence in the home settings should be promoted.

Is female genital mutilation associated with eclampsia? Evidence from a nationally representative survey data

Background

Studies have shown the impact of female genital mutilation (FGM), especially infibulation (WHO type III), on reproductive health, and adverse obstetric outcomes like postpartum haemorrhage and obstructed labour. However, whether an association exists with maternal hypertensive complication is not known. The present study sought to investigate the role of the different types of FGM on the occurrence of eclampsia.

Methods

The study used data from the 2006 Demographic and health survey of Mali. The proportion of eclampsia in women with each type of FGM and the unadjusted and adjusted odds ratios (OR) were calculated, using women without FGM as reference group. Unadjusted and adjusted OR were also calculated for women who underwent infibulation compared to the rest of the population under study (women without FGM and women with FGM type I, II, and IV).

Results

In the 3997 women included, the prevalence of infibulation was 10.2% (n = 407) while 331 women did not report FGM (8.3%). The proportion of women reporting signs and symptoms suggestive of eclampsia was 5.9% (n = 234).

Compared with the absence of female genital mutilation and adjusted for covariates, infibulation was associated with eclampsia (aOR 2.5; 95% CI:1.4–4.6), while the association was not significant in women with other categories of FGM. A similar aOR was found when comparing women with infibulation with the pooled sample of women without FGM and women with the other forms of FGM.

Conclusion

The present study suggests a possible association between infibulation and eclampsia. Future studies could investigate this association in other settings. If these findings are confirmed, the possible biological mechanisms and preventive strategies should be investigated.

Inversion of traditional gender roles and intimate partner violence against pregnant women

This study analyzed the association between the inversion of traditional gender roles and exclusive psychological and physical/sexual intimate partner violence, in a cross-sectional study of Brazilian pregnant women, identified through prenatal services in the municipalities of São Luís, Maranhão State (n = 992) and Ribeirão Preto, São Paulo State (n = 943). The pregnant women ranged from 12 to 45 years. Inversion of traditional gender roles was assessed by calculating differences in age, education and occupation between pregnant women and their co-residing intimate partners and identifying the largest contribution to family income. The conceptual model was tested with structural equation modeling and showed acceptable fit. The prevalence of any type of intimate partner violence was 29.8% in São Luís and 20.1% in Ribeirão Preto. In both municipalities, pregnant women were more likely to suffer exclusive psychological and physical/sexual violence when they had the highest income in the family (p < 0.005). In São Luís, physical/sexual violence was more common among women who were better educated than their partners (standardized coefficient, SC = -0.466; p = 0.007). In Ribeirão Preto, exclusive psychological violence was more frequent among women who had lower status occupations than their partners (SC = 0.236; p = 0.004). Inversion of traditional gender roles is associated with exclusive psychological and physical/sexual violence against pregnant women by their co-residing intimate partners. These findings suggest that women's empowerment at an individual level does not necessarily relieve them of intimate partner abuse in social contexts where traditional gender norms persist.

Determinants of intimate partner violence against women in Ethiopia: A multi-level analysis

Intimate partner violence (IPV) continues to be a major public health problem globally. Although Ethiopia has a high prevalence of IPV, previous studies in this country have only investigated individual-level determinants of IPV within small geographic areas. The current study aimed to identify the individual-, relationship-, community-, and societal-level determinants of IPV directed against women in Ethiopia since women are predominantly affected. A retrospective analysis of nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS) was conducted. A sample of 3,897 married women of reproductive age (15-49 years) who participated in the domestic violence module of the survey were included in the analysis. Three-level mixed-effects multilevel logistic regression models were used to estimate the individual-, relationship-, community-, and societal-level determinants of IPV. Variability at the community- and societal-level were also assessed. About 1,328 (34.1%) of 3,897 participants reported experiencing IPV (a composite measure of physical, sexual and emotional abuse). In adjusted models, the odds of lifetime IPV experience were higher among women who were older, were married before the age of 18 years, witnessed inter-parental violence during their childhood, had a partner who drank alcohol, and lived in a community with high IPV accepting norms. Alternatively, the odds of IPV were lower among women who had decision-making autonomy in the household, had the same or lower educational attainment as their partner, and lived in a community with low proportions of educated women. These findings reveal that although individual-level factors were significant determinants of IPV, higher level factors, including female education and IPV acceptance in the community, were also important influences on this major public health issue in Ethiopia. These findings suggest combined interventions at different levels may reduce IPV in this country.