Koustuv Dalal

Intimate partner violence and reproductive health of women in Kenya.

BACKGROUND Reproductive age represents an augmented risk of intimate partner violence (IPV) despite its occurrence in women of all ages. IPV has been associated with various reproductive health outcomes (e.g. terminated pregnancies and infant mortality), although multi-country studies indicate that the findings may not be consistent across all cultures. STUDY AIM AND METHOD: The current work describes the association between IPV and reproductive health of women in Kenya using the Demographic and Health Survey of 2003. RESULTS A significant association between physical/emotional/sexual abuse of women and negative reproductive health outcomes such as terminated pregnancies and infant mortality was identified. In addition, IPV exposure was associated with use of family planning methods and high fertility. CONCLUSION AND RECOMMENDATIONS Practitioners in the healthcare sector should inquire about abuse. Provision of counselling services and information regarding IPV effects on reproductive outcomes as well as referring abused women to relevant institutions is recommended in secondary prevention of IPV and to improve the reproductive health status of abused women.

Does economic empowerment protect women from intimate partner violence

Abstract: Background: The current study compared working and non-working groups of women in relation to intimate partner violence. The paper aims to explore the relationship between womens economic empowerment, their exposures to IPV and their help seeking behavior using a nationally representative sample in India. Methods: This was a cross sectional study of 124,385 ever married women of reproductive age from all 29 member states in India. Chi-square tests were used to examine differences in proportions of dependent variables (exposure to IPV) and independent variables. Multivariate logistic regressions were used to assess the independent contribution of the variables of economic empowerment in predicting exposure to IPV. Results: Out of 124,385 women, 69432 (56%) were eligible for this study. Among those that were eligible 35% were working. In general, prevalence of IPV (ever) among women in India were: emotional violence 14%, less severe physical violence 31%, severe physical violence 10% and sexual violence 8%. For working women, the IPV prevalence was: emotional violence 18%, less severe physical violence 37%, severe physical violence 14% and sexual violence 10%; whilst for non-working women the rate was 12, 27, 8 and 8 percents, respectively. Working women seek more help from different sources. Conclusions: Economic empowerment is not the sole protective factor. Economic empowerment, together with higher education and modified cultural norms against women, may protect women from IPV.

A National Study of the Prevalence and Correlates of Domestic Violence Among Women in India

This article estimates the national prevalence rate of domestic violence in India and examines the demographic and socioeconomic status of the victims of domestic violence. The study used the Indian National Family Health Survey 3, a cross-sectional national survey of 124 385 ever-married women of reproductive age from all the 29 member states. χ2 Analysis and logistic regression were used. Lifetime experiences of violence among respondents were as follows: emotional violence, 14%; less severe physical violence, 31%; severe physical violence, 10%; and sexual violence, 8%. Women of scheduled castes and Muslim religion were most often exposed to domestic violence. Women’s poorer economic background, working status, and husband’s controlling behavior emerged as strong predictors for domestic violence in India. Elimination of structural inequalities inherent in the indigenous oppressive institutions of religion, caste, and the traditional male hierarchy in society could prevent domestic violence.

Wife abuse in rural bangladesh

Intimate partner violence (IPV) is a global public health and gender problem, especially in low-income countries. The study focused on verbal abuse, physical abuse and abuse by restricting food provision to wives by their husbands by victim and perpetrator characteristics, emphasizing the socioeconomic context of rural Bangladesh. Using a cross-sectional household survey of 4411 randomly selected married women of reproductive age, the study found that a majority of the respondents are exposed to verbal abuse (79%), while 41% are exposed to physical abuse. A small proportion (5%) of the women had suffered food-related abuse. Risk factors observed were age of the wife, illiteracy (of both victims and perpetrators), alcohol misuse, dowry management, husbands monetary greed involving parents-in-law, and wifes suspicions concerning husbands extramarital affairs. Well-established risk factors for wife abuse, along with dowry and husbands monetary greed, have a relatively high prevalence in rural Bangladesh.

Social inequalities in intimate partner violence: A study of women in Kenya

This study examines social inequalities in intimate partner violence (IPV) among women of reproductive age in Kenya. A sample comprising 3,696 women was retrieved from the Kenyan Demographic and Health Survey of 2003. The study design was cross-sectional. Chi-square tests and logistic regression were used to analyze the data. Results indicated that while high education among women reduced the risk of IPV exposure, both being employed and having a higher education/occupational status than her partner increased a woman’s vulnerability to IPV. Age differences between the partners, illiteracy, and lack of autonomy and access to information increased the likelihood of IPV. Finally, being in polygamous relationships was associated with IPV exposure. The findings indicate demographic, social, and structural differences in exposure to IPV with important implications for interventions.

Neighborhood socioeconomic disadvantage, individual wealth status and patterns of delivery care utilization in Nigeria: a multilevel discrete choice analysis

Background High maternal mortality continues to be a major public health problem in most part of the developing world, including Nigeria. Understanding the utilization pattern of maternal healthcare services has been accepted as an important factor for reducing maternal deaths. This study investigates the effect of neighborhood and individual socioeconomic position on the utilization of different forms of place of delivery among women of reproductive age in Nigeria. Methods A population-based multilevel discrete choice analysis was performed using the most recent population-based 2008 Nigerian Demographic and Health Surveys data of women aged between 15 and 49 years. The analysis was restricted to 15,162 ever-married women from 888 communities across the 36 states of the federation including the Federal Capital Territory of Abuja. Results The choice of place to deliver varies across the socioeconomic strata. The results of the multilevel discrete choice models indicate that with every other factor controlled for, the household wealth status, women’s occupation, women’s and partner’s high level of education attainment, and possession of health insurance were associated with use of private and government health facilities for child birth relative to home delivery. The results also show that higher birth order and young maternal age were associated with use of home delivery. Living in a highly socioeconomic disadvantaged neighborhood is associated with home birth compared with the patronage of government health facilities. More specifically, the result revealed that choice of facility-based delivery is clustered around the neighborhoods. Conclusion Home delivery, which cuts across all socioeconomic strata, is a common practice among women in Nigeria. Initiatives that would encourage the appropriate use of healthcare facilities at little or no cost to the most disadvantaged should be accorded the utmost priority.

Women’s attitudes towards discontinuation of female genital mutilation in Egypt

Abstract: Background: To examine womens attitude towards discontinuation of female genital mutilation (FGM) in association with their access to information, knowledge of health effects and cultural beliefs concerning FGM in Egypt. Methods: A cross-sectional study of 9159 women, using data from the household survey in Egypt by Demographic and Health survey 2003. A comprehensive questionnaire covering attitudes towards FGM, demographics, and access to information was used. Chi-square analysis and logistic regression were applied to investigate how demographics, level of education, access to information, knowledge of health consequences and cultural beliefs influence womens attitudes towards FGM. Results: Among the demographic variables, discontinuation of FGM was independently associated with urban residency and post-secondary education. Moreover, women who were informed by the media, and those who had attended community meetings, church, or mosque where FGM was discussed, as well as women who were aware of the negative health consequences of FGM, were more likely to support discontinuation of FGM. By contrast, women with positive cultural conceptions of FGM were less likely to favor its discontinuation. Conclusions: Public education and information dissemination aiming to change current cultural notions favoring FGM practice - through community and religious leaders, and radio and television programs - may play an important role in modifying womens attitudes towards FGM. These findings have some implications for intervention and policy.

Patterns of Intimate Partner Violence: a study of female victims in Malawi

Abstract: Background: The term “intimate partner violence” (IPV) encompasses physical, sexual and psychological violence, or any combination of these acts, and globally is the most common type of violence against women. This study aims to examine the lifetime prevalence of different types of intimate partner violence (IPV) among Malawi women ages 15 to 49, and its association with age, education, and living in rural versus urban areas. Methods: Data was obtained from a cross-sectional study of data as part of the 2004 Malawi Demographic and Health Survey. Women were eligible for the study if they met the following criteria: 1) lived in one of the 15,041 households randomly selected from 522 rural and urban clusters located in 10 large districts of Malawi; 2) were married or cohabitating; and 3) were between the ages of 15 and 49 years. Consenting, eligible women responded to a comprehensive questionnaire covering demographic factors, health issues, as well as items related to physical, emotional and sexual IPV. To assess bivariate associations, chi-squared tests and multivariate logistic regressions were conducted. Results: Among the 8291 respondents, 13% reported emotional violence; 20% reported being pushed, shaken, slapped or punched; 3% reported experiencing severe violence, such as being strangled or burned, threatened with a knife, gun or with another weapon; and 13% reported sexual violence. Data showed women ages 15 to 19 were significantly less likely to report emotional IPV, women ages 25 to 29 were significantly more likely to report being pushed or shaken, slapped or punched (OR 1.35; CI: 1.05-1.73), and women ages 30 to 34 were significantly more likely to report sexual IPV, compared to women ages 45 to 49 (OR 1.40; CI: 1.03-1.90). Finally, women who had no ability to read were less likely to report sexual IPV than their counterparts who could read a full sentence (OR 0.76; CI: 0.66-0.87). Conclusions: The prevalence of different types of IPV in Malawi appears slightly lower than that reported for other countries in sub-Saharan Africa. Further studies are needed to assess the attitudes and behaviors of Malawi women towards acceptability and justification of IPV as well as their willingness to disclose it.

Contraception use and associations with intimate partner violence among women in Bangladesh.

This study examines the association between contraception use and intimate partner violence (IPV) among women of reproductive age in Bangladesh. The observational study of 10,996 women used the chi-squared test and logistic regressions to assess the associations. Almost 80% of all respondents had used contraceptives at some point in their lives. About half of the respondents (48%) were victims of physical violence, while 11% experienced sexual abuse from their husbands. Urban residents, higher educated women and women aged 20-44 were more likely to use contraceptives than their peers in rural areas, those with lower education and those in their late forties (45-49 years). Women exposed to physical violence were almost two times (OR 1.93, CI 1.55-2.41) more likely to use contraceptives compared with their non-abused peers. Sexual abuse had no significant association with contraceptive use. Physical violence is a predictor for higher levels of contraceptive use among women in Bangladesh. The findings emphasize the importance of screening for IPV at health care centres. The differences in urban and rural contraceptive use and IPV exposure identified by the study have policy implications for service delivery and planning.

Cyber bullying prevention: intervention in Taiwan.

Background This study aimed to explore the effectiveness of the cyber bullying prevention WebQuest course implementation. Methodology/Findings The study adopted the quasi-experimental design with two classes made up of a total of 61 junior high school students of seventh grade. The study subjects comprised of 30 students from the experimental group and 31 students from the control group. The experimental group received eight sessions (total 360 minutes) of the teaching intervention for four consecutive weeks, while the control group did not engage in any related courses. The self-compiled questionnaire for the student’s knowledge, attitudes, and intentions toward cyber bullying prevention was adopted. Data were analysed through generalized estimating equations to understand the immediate results on the student’s knowledge, attitudes, and intentions after the intervention. The results show that the WebQuest course immediately and effectively enhanced the knowledge of cyber bullying, reduced the intentions, and retained the effects after the learning. But it produced no significant impact on the attitude toward cyber bullying. Conclusions/Significance The intervention through this pilot study was effective and positive for cyber bulling prevention. It was with small number of students. Therefore, studies with large number of students and long experimental times, in different areas and countries are warranted.