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OJHAS Vol. 10, Issue 3:
(Jul-Sep 2011) |
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| An epidemiological
Study of Domestic Violence Against Women and its Association with Sexually
Transmitted Infections in Bangalore Rural. |
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Vaishali
Gaikwad Assistant Professor,
Suwarna Madhukumar,
Associate Professor,
Sudeepa D,
Assistant Professor,
Department of Community Medicine, MVJ Medical College,
Bangalore, India. |
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Address for Correspondence |
Department
of Community Medicine,
MVJ Medical College & RH,
Dandupalya, Kolathur
Post,
Hosakote, Bangalore Rural - 562114,
India.
E-mail:
drvbg@yahoo.com |
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Gaikwad V, Madhukumar S, Sudeepa D. An epidemiological Study of
Domestic Violence Against Women and its Association with Sexually
Transmitted Infections in Bangalore Rural. Online J Health Allied Scs.
2011;10(3):3 |
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Submitted: Jul 19,
2011; Accepted: Oct 10, 2011; Published: Nov 15, 2011 |
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| Abstract: |
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Background: Gender-based violence is universal, differing only in scope from one
society to the other. The most common form of violence against women
is domestic violence or violence within families. Objectives:
1. To study the prevalence and different forms of domestic violence
perpetrated by intimate partner against married women. 2. To study socio
economic and demographic factors which affect the victimization of woman
for domestic violence. 3.To study prevalence of sexually transmitted
infection and its association with domestic violence in the study group. Methods:
Based on a pilot study results, a sample size of 257 was determined.
Total 257 currently married women in the reproductive age group (15-49
yrs) were interviewed by systematic random sampling with prior consent
using a well designed, pre- tested questionnaire . All the women were
screened for sexually transmitted infections as per the WHO guidelines
by syndromic approach. The data was analyzed by percentages and
chi-square test. Results: Prevalence of domestic violence was found to be 29.57% in the study
group. Verbal abuse was reported by 81.58% of the women, Physical abuse
by 31.58% of the women ,Psychological abuse by 27.63% of the women and
Sexual abuse by 10.53% of the women. Among the 76 victimized women none
of them reported to the police. Interpretation
and conclusions: The vulnerability to domestic violence was found
significantly associated with age at marriage, duration of marriage
and addiction of husband to alcohol. The association between domestic
violence and sexually transmitted infections was also found significant.
Key Words:
Abuse; Domestic violence; Sexually transmitted infections; Victimization |
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Gender based
violence is recognized today as a major issue on the international human
rights agenda. Violence against women is present in every country, cutting
across the boundaries of culture, class, education, income, ethnicity
and age. Even though most societies proscribe violence against women,
the reality is that violations against women’s human rights are often
sanctioned under the grab of cultural practices and norms or through
misinterpretations of religious tenets.(1)
Domestic violence
exists in ‘a culture of silence. It has long been considered a ‘private’
affair and has contributed to the serious gap in public health policy
making and the lack of appropriate programmes.
The United
Nations Declaration on the Elimination of Violence against Women defines
violence against women as “Any act of gender-based violence that results
in or is likely to result in physical, sexual or psychological harm
or suffering to women including threats of such acts, coercion or arbitrary
deprivation of liberty; whether occurring in public or private life.”(1)
Domestic violence
includes violence perpetrated by intimate partners and other family
members and manifested through:
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Physical abuse:
It includes slapping, beating, arm twisting, stabbing, strangling, burning,
choking, kicking etc.
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Psychological abuse:
It includes behaviour that is intended to intimidate, persecute and
takes the form of threats of abandonment on abuse, confinement to the
home, threats to take away custody of children, isolation, verbal aggression
and constant humiliation.
Sexual
abuse: It includes coerced sex through threats, intimidation or physical
force, forcing unwanted sexual acts or forcing sex with others.(1)
Gender power
imbalances and lack of autonomy are the leading underlying factors for
women’s vulnerability to sexually transmitted infections. Women’s
limited control over resources in many settings compounds their lack
of decision-making and makes them socially and economically dependent
on their husbands in matters of sex and reproduction as well as in areas
of health care, including care during pregnancy and child birth or at
the time of abortion. Physical and sexual violence leading to high levels
of coercive sexual relations within marriage are also major health related
issues. In some settings, it is impossible for women to deny sex to
their husbands, discourage men from having multiple sexual partners
or insist on condom use. This makes the women vulnerable to gynaecological
morbidity.(2)
In India,
Protection of women from domestic violence Act, 2005 is intended
to protect women from domestic violence of any kind including dowry
related harassment. Even a threat of physical, sexual, verbal, emotional
or economic abuse would attract penal action against the provision of
the act.
Aim
Objectives
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To study the prevalence
and different forms of domestic violence perpetrated by intimate partner
against married women.
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To study socio-economic
and demographic factors which affect the victimization of woman for
domestic violence.
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To study prevalence
of sexually transmitted infection and its association with domestic
violence in the study group.
This is a cross
sectional study in the rural field practice area of MVJ Medical College
and Research hospital in Bangalore rural.
Kolathur and
Parvathipura villages located in Bangalore rural district were selected
by a simple random sampling from among the field practice area about
5 KM around MVJ Medical College and Research hospital. Based on
a pilot study conducted in the area, 28 percent prevalence was reported
and was used to calculate the sample size. Using the formula for sample
size calculation for cross sectional surveys, a sample size of 257 was
determined. A well designed, pre- tested questionnaire was used and
a house to house survey was conducted. The questionnaire addressed both
current and past episodes of domestic violence within one year. All
the women were screened for sexually transmitted infections by Syndromic
approach as per the WHO guidelines. Total 257 currently married
women in the reproductive age group (15-49 yrs) were interviewed by
systematic random sampling with prior consent. There were 13 women who
refused to give consent were excluded from the study. The data was analyzed
by percentages and chi-square test.
Total 257 married
women were interviewed. Out of the 257 women, 76 (29.57%)women reported
domestic violence of which, 62 (81.58%) reported verbal abuse, 24 (31.58%) women
reported physical abuse, 21 (27.63%) women reported psychological abuse
and 8 (10.53%) women reported sexual abuse. Of the 24 women who were
victims of physical violence, 6 (25%) women got injured at some time
during violence episodes.
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Table
1: Domestic violence and the related variables |
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Study
Variable |
Domestic Violence |
p Value |
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Yes |
Total |
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Age group (yrs) |
| 15-25
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24(36.36) |
66 |
p>0.05 |
| 25-35 |
38(32.76) |
116 |
| 35-45 |
12(25.00) |
48 |
| 45-49 |
02(07.41) |
27 |
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Education |
| Illiterate |
08(34.78) |
23 |
p>0.05 |
| Primary School |
10(26.32) |
38 |
| Middle School |
30(39.47) |
76 |
| High school |
20(25.00) |
80 |
| Diploma |
06(25.00) |
24 |
| Graduate |
02(12.50) |
16 |
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Socio
economic status |
| Upper middle |
13(20.00) |
65 |
p<0.001 |
| Lower middle |
16(21.62) |
74 |
| Upper lower |
38(46.34) |
82 |
| Lower |
09(25.00) |
36 |
|
Employment
status |
| Employed |
06(26.09) |
23 |
p>0.05 |
| Unemployed |
70(29.91) |
234 |
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Age
at marriage (yrs) |
| Less
than 18 |
32(42.67) |
75 |
p<0.05 |
| 18-20 |
37(30.08) |
123 |
| 20-22 |
04(13.33) |
30 |
| 22-24 |
02(12.50) |
16 |
| 24-26 |
01(7.69) |
13 |
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Duration
of marriage (Yrs) |
| 0-5 |
28(48.28) |
58 |
p<0.001 |
| 5-10 |
24(28.57) |
84 |
| 10-15 |
14(33.33) |
42 |
| 15-20 |
06(21.43) |
28 |
| 20-25 |
03(15.79) |
19 |
| >25 |
01(03.85) |
26 |
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Education
of Husband |
| Illiterate |
06(35.29) |
17 |
p>0.05 |
| Primary School |
02(12.50) |
16 |
| Middle School |
24(34.29) |
70 |
| High school |
22(25.00) |
88 |
| Diploma |
16(36.36) |
44 |
| Graduate |
06(27.27) |
22 |
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Type
of family |
| Nuclear
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52(27.96) |
186 |
p>0.05 |
| Joint |
24(33.80) |
71 |
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Addicted
to alcohol |
| Yes
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36(64.29) |
56 |
p<0.001 |
| No |
40(19.91) |
201 |
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Presence
of STIs |
| Yes |
23(41.81) |
55 |
P<0.05 |
| No |
53(26.24) |
202 |
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*Figures in brackets represent
percentages |
The frequency
of violence was at least once in a week in 26 (34.21%) women, once in
15 days in 24 (31.58%) women, once in a month in 20 (26.32%)
and once in 1-3 months in 6 (7.89%) women.
Prevalence
of domestic violence was found to be 29.57% in the study group. This
finding is consistent with the findings of the study in Rural Karnataka
by Rao V in which 22% women reported being beaten by their husbands.(3)
Also the finding is coherent with the statistics published in 1997 by
WHO which states the prevalence of domestic violence in women between
20-50% of the interviewed women.(4)
Verbal abuse
was the most common form of violence followed by physical and lastly
psychological violence. However sexual violence may be underreported.
The reason for sexual coercion within marriage could be that marriage
is interpreted as granting men the right to unconditional sexual access
to their wives and the power to enforce this access through force,
if necessary. In a study by Leela Visaria, 23% of the women reported
psychological and physical abuse and 42% of the women reported only
psychological abuse.(5)
Also the women
suffered more than one type of violence. This is similar with the findings
of the study by Khan M E et al that the reported violence was multiple
in nature and most of the women were subjected to more than one type
of violence.(6)
Among the 76
victimized women none of them reported to the police. The reason for
this behaviour may be that a women’s response to the abuse is often
limited by the options available to her. Women remain in abusive relationship
because of lack of other means of economic support, concern for children,
emotional dependence, lack of support from family and abiding hope that
‘he will change’. At the same time denial and fear of social stigma
often prevent women from reaching out for help.
In the present
study it was observed that as age of the women increases the prevalence
of domestic violence decreases .This finding is similar to the
study by Anjali Dave and Gopika Solanki in which 37.2% of the victims
falling within the age group of 25-34 years and 28.2% of the women in
the age group of 18-24 years have reported abuse. Only 4.9% were in
the age group of 40-45 years.(7) This is because in India as women
grow older, they gain more power and have increased access to resources.
In the present
study, reported violence declined with the higher education, so higher
education makes the women less vulnerable to domestic violence. The
women with low education designate their complete dependency because
with low education back ground they will not be able to have economic
independence or would be engaged in occupations with low economic returns.
This finding is similar to the finding by Leela Visaria that abusive
relationship were reported more frequently by illiterate women.(5)
In our study
violence was found prevalent in all the socioeconomic classes. Hence
it can be stated that the socioeconomic status does not determine the
vulnerability to domestic violence.
Housewives
were abused more than working wives. They develop the tolerance of such
violence as they do not have any other option for fulfilling their economic
needs, which places them in a subordinate position as compared to their
husbands. They endorse the traditional gender roles and do not question
the authority of their husbands and maintain their husband’s dominant
position in the conjugal relationship.
It
was observed that as the age at marriage increases the prevalence of
domestic violence decreases. This finding supports the findings of the
study by Mishra P K that out of the total 60 respondents who got married
at the age of below 18 years, 45% were victims of domestic violence
in contrast to this who were married after the age of 21 years, only
24.71% were the victims of domestic violence.(8)
From this findings it was perceived that perhaps violence against women
at during the younger age is a form of socialising the young bride into
the marital family. It cannot be denied that in our society many communities
perceive marriage as a permanent institution and a strong stigma is
attached to singlehood. Violence within marriage is accepted as normal.
Hence women are made pressurised to preserve their marriage.
As the duration
of the marriage increases, the prevalence of domestic violence decreases.
These finding resonates with the findings of Leela Visaria that domestic
violence was more prevalent in the women having duration of marriage
between 5 to 20 yrs.(5) It may be due to the fact that during this
period addition of children in the family puts enormous demands and
stresses which vent out in the form of violence.
Domestic violence
was more common joint families. The finding is contrary to the finding
by Leela Visaria that 53% of the women in joint families report abuse
compared to 73% of the women in nuclear families.(5) It could be due to the interference of the in-laws or other family
members in the daily affairs.
The association
between addiction of the husband to alcohol and vulnerability of women
to domestic violence was highly significant (Odds Ratio=7.25;95% CI
3.62-14.6). Martin S E et al found that a women was one and a
half times more likely to be injured if her partner had been drinking
alcohol.(9) It is seen that conflict escalates into violence
more readily when alcohol has been consumed because alcohol is a psychopharmacological
dis-inhibitor.
This study
showed that women experiencing violence report the symptoms of sexually
transmitted infections more than the women who did not experience violence
(Odds ratio=2.02; 95% CI 1.04-3.93). Violence makes the women vulnerable
to sexually transmitted infections as it may limit women’s ability
to negotiate safe sexual behaviour and it also limits women sexual autonomy.
The findings are similar to the findings by Loke WC et al that women
with a history of STI were more likely to have experienced domestic
violence at some point in their lives (odds ratio [OR]=2.39).(10)
According to one study in North India by Rob Stephenson et al, compared with women who reported no violence, those who had experienced
both physical and sexual violence had elevated odds of reporting gynaecological
symptoms (odds ratio=1.7).(11)
Most of the
women justified wife beating due to the fact that women put themselves
in a submissive and subordinate position compared with men because of
the prevalent cultural and gender norms. This indicates lack of awareness
of violation of human rights. Hence ending violence against
women needs to be addressed at various levels. The co-ordinated efforts
of various sectors such as legal, educational, medical etc., are essential
to combat domestic violence against women.
The authors
are grateful to the families and the community who participated and
extended their full cooperation in the study. We would like to thank
our field team and the local health workers who helped in this work. We sincerely
acknowledge our Management and the Dean of MVJ Medical College, Bangalore,
for their support for this work.
- Kapoor S. Domestic
violence against women and girls. Innocenti Digest No.6; May 2000
- Studying reproductive tract
infections and related disorders in women. Progress in Reroductive Health
Research. 2001;57:4-5. Available at
http://www.who.int/hrp/publications/progress57.pdf
- Rao V. Wife beating in
rural south India: A qualitative and econometric analysis. Social
Science and Medicine.1997;44(8):1169-1180.
- Gender-Based Violence:
An Impediment to Sexual and Reproductive Health: The Women's Advocacy
Session at IPPF Members' Assembly, Prague, The Czech Republic, 29th
of November 1998.
- Visaria L. Violence
against women in India : Evidence from Rural Gujarat. Gujarat Institute
of Development Studies. In Domestic Violence in India: A Summary
Report of Three Studies. International Center for Research on Women:
Washington, DC, September, 1999. p.14-25.
- Khan ME, Rob U, Hossain
SM. Violence against women and its impact on women’s life
– Some observations from Bangladesh. The Journal of Family Welfare. 2000;46(2):12-24
- Dave A,
Solanki G. Examining health records for evidence of domestic violence: A research study in Maharashtra, India. TISS. 1997.
- Mishra PK. Women in south Asia: Dowry death and human rights violation.
1st ed. Authors Press. 2005.
- Martin SE, Bachman R. The
relationship of alcohol to injury in assault cases. Recent Developments in Alcoholism. 1997;13:41-56.
- Loke WC, Torres C, Bacchus L
et al. Domestic violence in a genitourinary medicine setting – an anonymous
prevalence study in women. International Journal of STD and AIDS. 2008
Nov;19(11):747-751
- Stephenson R, Koenig MA, Ahmed S. Domestic violence and symptoms of gynaecologic
morbidity among women in North India. International Family Planning
Perspectives. 2006;32(4):201–208.
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