International Journal of Community Medicine and Public Health Sreelatha DD et al. Int J Community Med Public Health. 2021 Mar;8(3):1350-1354 http://www.ijcmph.com pISSN 2394-6032 | eISSN 2394-6040
DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20210809
Original Research Article
Prevalence of domestic violence among married women doing unskilled
manual work in a rural area of Trivandrum district
Deena Divakaran Sreelatha1, Nithya Girija1, Benny Purandaran Vasanthamani1,
Resmi Samadarsi2, Anil Bindhu1, Regi Jose1, Manju Leelavathy1, Divija1
1Department of Community Medicine, Sree Gokulam Medical College, Thiruvananthapuram, Kerala, India 2Department of Community Medicine, Government Medical College, Paripally, Kerala, India Received: 26 November 2020 Accepted: 09 January 2021 *Correspondence: Dr. Deena D. S., E-mail: dsdeena@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT Background: Violence against women is an emerging problem in India. It has considerable adverse impact on the physical and mental health of women including suicidal tendencies. Violence against women and associated risk factors in many Indian communities remains unreported. This paper aimed to study the prevalence of physical, psychological, and sexual violence and risk factors of the women facing domestic violence. Methods: A community based cross sectional study was carried out in a rural area of Trivandrum district of Kerala state. Married women doing unskilled manual work were interviewed using a pretested validated questionnaire developed by Indu P V containing 20 items- 13 questions for assessing psychological violence, 5 for assessing physical violence and 2 for sexual violence. Results: The results showed that 26.76% of women experienced domestic violence. Poor educational qualification and having alcohol addiction in husbands were identified as important risk factors for experiencing domestic violence. Conclusions: Our data along with other sources show clearly that domestic violence is exacerbated by alcohol abuse and it may well be more prevalent in poor communities. Experience of domestic violence is more in women whose husbands are alcoholic. Multi sectorial response such as improving literacy, creating awareness regarding legal aid and screening the victims of violence at primary health centres, should be initiated to mitigate this public health issue. Keywords: Domestic violence, Family violence, Intimate partner violence, Women empowerment
INTRODUCTION
Against women as “any act of gender-based violence that results in, or is likely to result in Violence against women particularly intimate partner violence and sexual violence is a major public health problem. It constitutes violation of fundamental rights and freedom of women. The United Nations defines violence 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 in private life.1 Even though women in the developing countries are more vulnerable to different forms of violence, domestic
violence is perceived to be the most common among them.2 A number of individual and household-level risk factors for domestic violence were identified in the studies conducted over the past decades. The protective factors against domestic violence were identified to be higher socioeconomic status and higher levels of education.3
Intimate partner violence is seen in all countries, cultures and religions and sectors of society. It can have deleterious effects like increased anxiety and health conditions like chronic aches and pains, sleep disorders, reproductive health problems, depression etc. Since 1983,
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domestic violence has been recognized as a criminal offence under IPC 498-A. The Protection of Women from Domestic Violence Act came to effect in 2006. The PWDVA defines domestic violence as all forms of physical, emotional, verbal, sexual, and economic violence, and covers both actual acts of such violence and threats of violence.4 A number of studies have examined the role of factors such as education, lower socioeconomic status, younger age of marriage and found to be associated with higher reported physical abuse.3,5,6
According to NFHS-4 data (2015-16) it was found that thirty-three percent of ever-married women have experienced physical, sexual, or emotional spousal violence. The most common type of spousal violence is physical violence (30%), followed by emotional violence (14%). Seven percent of ever married women have experienced spousal sexual violence.7 There is little empirical data on prevalence of domestic violence and its determinants. The Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) aims in improving the livelihood security of households of rural area in India by providing one hundred days of work with guaranteed wage every year to every households in which the adult members are willing to do unskilled manual work.8 In addition to providing financial security MGNREGS also helps in empowering women, protecting environment, reducing migration.9 This study was done among women belonging to poor socioeconomic class working under MGNREGS to understand the extent of this serious problem in a rural setting.
The study aimed to determine the prevalence of do mestic violence and associated risk factors among married women who were unskilled workers in a rural area in Trivandrum district.
METHODS
A population based cross sectional study was conducted among married women from Nellanad panchayat area of Trivandrum district from August 2018 to February 2019. Data were collected using a pretested questionnaire from 140 women in the age group of 18 to 60 years working under MNREGS, using a pretested validated questionnaire Indu PV et al. Sample size was calculated using the formula N=Z1-α/22 *P(100-P)/d2. Where P taken as 56%, the sample size was calculated to be 139 which was rounded up to 140. The questionnaire consisted of 20 items for assessing psychological, physical and sexual violence. 13 items were for assessing psychological, 5 for physical and 2 for sexual violence. Each item was scored from 0 to 4. (0: never, 1: once/twice, 2: 3–5 times, 3: 6–10 times, and 4: 11 times or more). The other socio-demographic variables like age of both husband and wife, educational status, number of years since marriage etc. were collected. As all the participants were from poor socioeconomic class and having the same occupation and same wages the social class, occupation and income of the participants are not
taken into consideration. To assess domestic violence exposure, women were asked several questions on various behaviours of violence during the past and last 12 months. A score of 5 was taken as the cut off. At this cut off, both sensitivity and specificity were optimum, i.e. 89.5 and 87.2%, respectively.11 All the interviews were conducted in local language of the state. Interviews were taken in a private place outside the respondents' home to avoid presence of other family/community members during interviews. The data were entered in MS Excel and analysed using SPSS version 21. Frequencies and proportion were computed for qualitative data and mean and standard deviation for quantitative data. Chi-square test was done for testing association between two categorical variables and the results are presented in tables.
RESULTS
The total number of study participants were 140. The mean age of study participants was found to be 44 years with a standard deviation of 10.98. 49 (35%) participants belonged to the age group of 51-60.
Table 1: Distribution of socio-demographic variables
(n=140).
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Figure 1: Distribution of participants according to
experience of domestic violence.
More than half 72 (51.42%) had studied up to pre degree/ plus two (Table 1). Mean duration of marriage was found to be 24.8 years. Out of 140 respondents, 38 (26.76%) of them were exposed to domestic violence (Figure 1). 34.2 % (48 out of 140) were experienced psychological violence, 32.8% (46 out of 140) physical violence and 12.14% (17 /140) sexual violence. Of this psychological violence was found to be more common. (Table 2).
There was a significant association between husband’s alcoholism and domestic violence (p<0.001). No association was found between education, husband’s age, wives age and domestic violence.
Figure 2: Distribution of participants based on
different behaviors of violence.
Table 2: Distribution of behaviors of domestic violence.
Table 3: Association between socio-demographic variables and domestic violence score.
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Table 4: Association between substance abuse and
domestic violence score.
Domestic violence against women in developing countries like India, is now being recognized as a widespread health problem. Women were always considered weak and vulnerable for exploitation. In majority of studies regarding domestic violence, having “ever” been exposed to physical or psychological abuse during the lifetime or in the past 1 year is assessed. It was found that one quarter (26.76%) of the study participants experienced domestic violence in the past 1 year. In a study conducted in rural Bangladesh by Bates et al. showed that 35% of women experienced domestic violence in past one year.12 When compared to the other studies, here we found that the prevalence was slightly less. This could be due to a better level of education among participants and their husbands; or it also might be due to underreporting of violence. In the present study physical harm by beating (25.2%) was the most common violence reported among many of the women. In another study conducted by Nair et al. in rural Gujarat, slapping (80%), kicking, punching (74%) and forced sex (27%) were the types of reported physical abuse. Frequent beating might lead to deleterious effects on both mental and physical health of women. Many women believe that they were beaten up for their wrong doings and they deserved it. In our patriarchal society, women are poorly equipped to protect themselves against violence from their partners.
This practice of interpersonal violence may affect the health of the women.13 One study from India revealed that higher socio-economic status as a protective factor against domestic violence.6 As we have taken all participants from lower socioeconomic status, comparison could not be made on this variable. In a study conducted in rural Bangladesh have shown that community-level measures of women’s status have significant effects on risk of domestic violence.14 In the present study there was no association between educational level of women and domestic violence. From other studies it was found that violence is less common if women and men were well educated; acceptance of domestic violence appears to be related to the respondent's education level.15 This study showed that
majority of the partners of the study participants were alcoholics and there were significant association between alcoholism and domestic violence. In another study conducted in Mumbai, domestic violence was exacerbated by alcohol abuse and it may well be more prevalent in poor communities where financial and work- related stress often were used to rationalize domestic violence.16 In this study alcoholism is directly associated with physical and psychological violence but not with sexual violence. This may be because, many men have attitudes accepting of violence and a sense of superiority over women. The values and cultures in the society prevent the victims from opting for divorce.
In multivariate analyses, indicators of women's economic autonomy and husbands' alcohol consumption were significantly associated with violence, independent of caste and economic status, which highlights the need to address the links between gender inequalities and marital violence.17 Higher levels of conflict were seen in the wives of alcoholics and on all its sub-dimensions namely negotiation, physical assault, injury, psychological aggression and sexual coercion.18
CONCLUSION
From this study it was found that domestic violence is still prevalent and more than a quarter of the unskilled manual laborers are experiencing domestic violence. Most women experience violence from their husbands who are alcoholic. Alcohol consumption among husbands are found to be significant risk factor for intimate partner violence. Policies and services aimed at preventing domestic violence need to increase. The limitation of the study may include recall bias as it is a retrospective study, and also underreporting of violence.
Funding: No funding sources Conflict of interest: None declared Ethical approval: The study was approved by the Institutional Ethics Committee
REFERENCES
1. Doc.21_declaration elimination vaw.pdf. Available at https:// www. un. org/ en/ genocide eprevention/ documents/atrocity-crimes/ Doc. 21_ declaration %20 elimination%20vaw.pdf. Accessed on 23 August 2020. 2. Heise LL, Pitanguy J, Germain A. Violence against women: the hidden health burden. World Bank Discusssion Papers. Available at https:/ /jhu. pure.elsevier.com/en/publications/violence-against- women-the-hidden-health-burden-2. Accessed on 23 August 2020.
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3. Jejeebhoy SJ, Cook RJ. State accountability for wife-beating: the Indian challenge. Lancet. 1997;349:10-2. 4. Domviolence.pdf. Available at http:// chdslsa. gov. in/right_menu/act/pdf/domviolence.pdf. Accessed on 08 November 2020. 5. Verma RK, Collumbien M. Wife beating and the link with poor sexual health and risk behavior among men in urban slums in India. J Comparative Family Studies. 2003;34(1):61-74. 6. Physical spousal violence against women in India: some risk factors. Available at https:// pubmed. ncbi.nlm.nih.gov/17349066/. Accessed on 9 November 2020. 7. Domestic Violence in India: Insights from the 2005- 2006 National Family Health Survey. Available at https://journals.sagepub.com/doi/abs/10.1177/08862 60512455867. Accessed on 9 November 2020. 8. The Mahatma Gandhi National Rural Employment Guarantee Act 2005. Available at https:// www. nrega.nic.in/netnrega/mgnrega_new/Nrega_home.as px. Accessed on 9 November 2020. 9. National Rural Employment Guarantee Act, 2005. In: Wikipedia. Available at https:// en. wikipedia.org/w/index.php?title=National_Rural_E mployment_Guarantee_Act,_2005&oldid=9843991 00. Available at 10 November 2020. 10. George J, Nair D, Premkumar NR, Saravanan N, Chinnakali P, Roy G. The prevalence of domestic violence and its associated factors among married women in a rural area of Puducherry, South India. J Family Med Prim Care. 2016;5(3):672-6. 11. Indu PV, Remadevi S, Vidhukumar K, Anilkumar TV, Subha N. Development and validation of the Domestic Violence Questionnaire in married women aged 18-55 years. Indian J Psychiatry. 2011;53(3):218-23.
12. Esie P, Osypuk TL, Schuler SR, Bates LM. Intimate partner violence and depression in rural Bangladesh: Accounting for violence severity in a high prevalence setting. SSM Popul Health. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC636 0402/. Accessed on 28 January 2020. 13. Moreno GC, Heise L, Jansen HAFM, Ellsberg M, Watts C. Public health. Violence against women. Science. 2005;310(5752):1282-3. 14. Women’s status and domestic violence in rural Bangladesh: Individual- and community-level effects. Available at https:// link. springer.com/article/10.1353/dem.2003.0014. Accessed on 13 October 2020. 15. Simister J, Makowiec J. Domestic Violence in India: Effects of Education. Indian J Gender Studies. 2008;15(3):507-18. 16. Berg MJ, Kremelberg D, Dwivedi P, Verma S, Schensul JJ, Gupta K, et al. The effects of husband’s alcohol consumption on married women in three low-income areas of greater Mumbai. AIDS Behav. 2010;14(1):126-35. 17. Krishnan S. Gender, caste, and economic inequalities and marital violence in rural South India. Health Care for Women International. 2005;26(1):87-99. 18. Stanley S. Intimate partner violence and domestic violence myths: a comparison of women with and without alcoholic husbands (a study from India). J Comparative Family Studies. 2012;43(5):647-72.
Cite this article as: Sreelatha DD, Girija N, Vasanthamani BP, Samadarsi R, Bindhu A, Jose R, et al. Prevalence of domestic violence among married women doing unskilled manual work in a rural area of Trivandrum district. Int J Community Med Public Health 2021;8:1350-4.
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