Search

Background: Domestic violence is a leading cause of poor health outcomes during pregnancy and the postpartum period. Therefore, there is a need for integrated domestic violence interventions in reproductive health care settings. India has one of the highest maternal and child mortality rates. This review aimed to identify characteristics of existing evidence-based integrated domestic violence and reproductive healthcare interventions in India to identify gaps and components of interventions that demonstrate effectiveness for addressing domestic violence. Methods: A systematic review of intervention studies was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Three research team members performed independent screening of title, abstracts and full-texts. Results: The search resulted in 633 articles, of which 13 articles met inclusion criteria for full text screening and analysis. Common components of integrated violence and reproductive health interventions that were effective in addressing domestic violence included: psychoeducation/education (n = 5), skill building (n = 5), counseling (n = 5), engaging stakeholders with use of trained lay peer facilitators (n = 3), and engaging male spouses (n = 3). Conclusions: Interventions in India for domestic violence that are integrated with reproductive health care remain few, and there are fewer with effective outcomes for domestic violence. Of those with effective outcomes, all of the interventions utilized psychoeducation/education, skill building, and counseling as part of the intervention. Plain English summary: Domestic violence is a leading cause of poor health outcomes during pregnancy and the time after pregnancy. Thus, there is a need for integrated domestic violence interventions in reproductive healthcare settings. India has one of the highest maternal and child death rates. This review aimed to identify features of existing evidence-based integrated domestic violence and reproductive healthcare interventions in India to identify gaps and components of interventions that demonstrate effectiveness for addressing the problem of domestic violence among women in reproductive healthcare settings. A systematic review of intervention studies was conducted. The search resulted in 633 articles, of which 13 articles met the criteria to be included in this review. Common components of effective integrated domestic violence and reproductive health interventions included: psychoeducation/education (n = 5), skill building (n = 5), counseling (n = 5), engaging stakeholders with use of trained lay peer facilitators (n = 3), and engaging male spouses (n = 3). The key takeaways are that interventions in India for domestic violence that are integrated with reproductive healthcare remain few, and there are fewer with effective outcomes for domestic violence. Psychoeducation/education, skill building, and counseling were commonly used strategies in interventions that were effective in addressing domestic violence. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) increased exponentially during the COVID-19 epidemic. But knowledge of the children's exposure to parental IPV is lacking. Therefore, this study aims to determine the prevalence of children's exposure to parental IPV and its association with self-esteem. 482 adolescents aged 11 to 17 were included in this study from Kerala, India. The samples were chosen using convenient and random sampling methods. The child Exposure to Domestic Violence scale and Cooper smith Self-Esteem scale were used to collect the data. The correlation and gender differences were analysed using Pearson product-moment correlation and an independent sample t-test. Results show that 42.5 % of adolescents were exposed to parental IPV and that exposure to parental IPV is negatively correlated with participants' self-esteem. Sex and age differences were not statistically significantly related to exposure to parental IPV and self-esteem. The findings highlight a need for online interventions and policies to protect adolescents exposed to parental IPV and boost their self-esteem during this pandemic. [ABSTRACT FROM AUTHOR]

Context: Emotional violence is the lesser recognized form of intimate partner violence (IPV) but causes long-lasting harm to a woman's mental and physical wellbeing. Aims: To estimate the prevalence and describe the determinants of emotional violence faced by women residing in a metropolitan city of India. Settings and Design: This cross-sectional study was conducted among 'presently married' women living in an urban residential area of Delhi. Methods and Material: We used the NFHS-3 questionnaire and criteria to record the study participants' responses regarding their experience of 'emotional violence'. Women saying yes to emotional violence further quantified the frequency of each type of abuse into 'often' or 'sometimes' in the past 12 months. Informed consent was obtained from all participants, and the Institutional Ethics Committee approved the study. Statistical Analysis Used: Logistic regression analysis was used to determine emotional violence with various socio-demographic factors and other forms of IPV. Results: A total of 99 (19.8%) women had 'ever' faced psychological abuse by their husbands. 15.2% of women were humiliated by husbands, and 11.6% of women were insulted and made to feel bad about themselves. Women whose husbands consume alcohol (OR = 1.74 (1.07–2.84), exhibit controlling behaviour, (OR = 2.79 (1.74–4.46) exhibit physical (OR = 10.83 (6.4–18.32) or sexual (OR = 5.53 (3–10.2) violence were at significantly higher risk of facing psychological abuse within their marriages. Conclusions: Physical violence and controlling were found to be significantly associated with the experience of emotional violence after adjusting for all other variables. Primary care physicians should be sensitized to this critical health issue. [ABSTRACT FROM AUTHOR]

Domestic violence (DV) is a significant public health problem in India, with women disproportionately impacted. This study a) identified risk and protective correlates of DV and, b) barriers and facilitators for seeking and receiving help for DV among women in India. A systematic search of 5 databases was performed to identify correlates of DV in the quantitative literature. The search resulted in inclusion of 68 studies for synthesis. For qualitative exploration, data were collected from 27 women in India. While factors such as social norms and attitudes supportive of DV were both risk correlates and barriers to addressing DV, women's empowerment, financial independence and informal sources of support were both protective correlates of DV as well as facilitators in addressing DV. Strong efforts in India are needed to reduce DV-related risk factors and strengthen protective factors and enhance access to care for women in abusive relationships. [ABSTRACT FROM AUTHOR]

Intimate Partner Violence (IPV) has been linked to poor health. Economic position may be an important risk factor for IPV. We examined the association between economic position and IPV at country and individual levels. We analyzed Demographic and Health Surveys data of 187,716 everpartnered women between ages 10 and 59 from 20 low- and middle-income countries. We calculated direct age-standardized 12-month prevalence of physical IPV and performed ecological analysis using Gini coefficients and Concentration indexes to assess correlation with 12-month prevalence of physical IPV. We conducted multivariable logistic regression for each country to assess the association between wealth status and physical IPV and a meta-analysis of the regression model to present results across countries. Compared to the Poorest quintile, odds of IPV among wealthier quintiles varied by country. In the Middle quintile, India had significantly reduced IPV (OR 0.75, 95%CI: 0.68-0.83). In the Richer and Richest quintiles, 4 and 6 countries had significant reductions in IPV, respectively. Only Mozambique was found to have significant increased IPV in the wealthiest quintile (OR 2.51, 95%CI: 1.45-4.38). Gini coefficient and physical IPV had a correlation coefficient of 0.502 (p value 0.033), while Concentration index had -0.276 (p value .253). Standardized prevalence for physical IPV ranged from 1.58% to 18.91%. Findings suggest that the relationship between wealth and IPV vary considerably in the included low- and middle-income countries, and that risk of IPV may not necessarily be higher among women in lower wealth brackets. Mozambique was the only country with increased odds of IPV among the Richest group as compared to the Poorest group. This study provides evidence IPV may transcend economic boundaries, and that studies looking at the link between inequality and IPV are paramount for designing adequate preventative policies. [ABSTRACT FROM AUTHOR]

Existing studies show a mixed relationship between intimate partner violence (IPV) and contraceptive use. This study assesses the association between women's exposure to IPV and contraceptive use in India. Furthermore, we aim to determine whether husband's controlling behaviors play a moderating role in the IPV-contraception link. We used nationally representative data from the recent round of the National Family Health Survey (NFHS-4), conducted in 2015-2016. In this study, the use of contraceptives is the outcome variable, categorized into three groups: no/traditional methods, modern methods, and female sterilization. Women's exposure to IPV in the past year is the key exposure of interest. Socio-economic and demographic variables were used as covariates. Multinomial logistic regression models were performed to examine the association between women's exposure to IPV and contraceptive use. Of the total participants (N = 58,891), approximately one in every four women (24.1%) experienced any form of IPV in the past year. Slightly over half (50.8%) reported using either traditional methods of contraception or no contraceptive at all. About 14% of the respondents were using modern methods of contraception and 34.9% had undergone sterilization. After controlling for confounding factors, women who experienced IPV were 8% (95% CI [.87, .99]) less likely to report using modern contraceptives than those who did not face any IPV. Conversely, women who faced IPV were 14% (95% CI [1.09, 1.20]) more likely to undergo sterilization. Furthermore, women who experienced any form of IPV and whose husbands endorse controlling attitudes were 12% (95% CI [.81, .95]) less likely to report using modern contraceptives and 11% (95% CI [1.04, 1.17]) more likely to undergo sterilization. Interventions should be made to prevent violence against women that would increase their ability to choose appropriate contraception methods to avoid unintended pregnancies. [ABSTRACT FROM AUTHOR]

The influence of husband's alcohol consumption and that of women's empowerment has been largely studied separately in relation to the intimate partner violence (IPV) faced by women, which has hindered a nuanced understanding of gender-based violence in India. This study aimed to understand how husbands' alcohol consumption shapes the relationship between women's empowerment and violence among Indian couples. Data from the 2015–16 National Family Health Survey (NFHS) were used in this study. A composite women's empowerment index was constructed and its association with husbands' drunkenness and odds of facing emotional, physical, severe, and sexual violence was examined. This study found that compared to women whose husbands were never drunk, those whose husbands were sometimes or often drunk had significantly higher odds of experiencing physical, emotional, and sexual violence. For all the types of IPV, an increase in the empowerment index was associated with a significant reduction in the odds of experiencing violence. However, increasing frequency of husband's drunkenness in combination with increasing scores on the empowerment index was associated with a significant increase in the odds of IPV, except sexual violence. Our findings highlight the nuances of IPV, situating the experiences of women in the social, cultural, and economic realities of Indian society. [ABSTRACT FROM AUTHOR]

This article is intended to support discussions about how to effectively address domestic and sexual violence. It proposes the following key strategies: expanding beyond police, courts, and prisons; adopting upstream approaches to address the social, structural, institutional, and historical drivers of violence; and using evidence-based strategies to prevent violence from happening in the first place. Comparing the United States, South Africa, India, and Brazil, the article makes the case that advocates working to address domestic and sexual violence have relied too heavily on criminal legal sanctions. Not only does this result in unmet needs of both survivors and their communities but it also expands the repressive powers of police and prosecutors and contributes to steadily growing levels of incarceration. The article concludes by calling for services that better meet the needs of survivors and for the rapid scale-up of prevention strategies, both evidence-based interventions and legal and policy approaches that address the root causes of men's violence. [ABSTRACT FROM AUTHOR]

Pervasive cultural narratives that normalize domestic violence have made efforts to respond to domestic violence in India challenging. An effective response to domestic violence in India needs to be transformative in nature, supporting the empowerment of survivors of violence and empowering communities to support survivors. Various studies have highlighted the importance of settings like grassroots organizations for promoting empowerment of members through community organizing. This qualitative study builds on this growing body of research using a grassroots agency in India as an exemplar to understand (a) empowering processes at the individual and community level associated with the agency's community organizing efforts; and (b) salient mechanisms associated with social change and action in the response to domestic violence in the community. At the individual level, the agency's organizing efforts provided knowledge, skills and resources, and opportunities for participation and leadership. At the community level, the agency engages in capacity building and increases social capital of members. The mechanisms that emerged as salient were increased critical consciousness of members, an emphasis on breaking the silence around domestic violence, community trust and cohesion, and capacity for informal social control. Implications of our findings for intervention and prevention work are discussed. Highlights: Community organizing is an important avenue for change in the response to domestic violence.Community organizing can facilitate empowering processes like participation and leadership.Building capacity and social capital is central to facilitating empowerment of communities. [ABSTRACT FROM AUTHOR]

The impact of microfinance on domestic violence has been widely discussed, but there is still no consensus due to the fact that context and programme implementation mechanisms have a large effect on outcomes. An innovative grassroots microfinance organisation in India, Rojiroti, has a number of unique features which make a positive impact on domestic violence more likely. Using a quasi-experimental design with panel data and matched control sites, this article reports on a study that found a significant reduction in levels of domestic violence among women members of Rojiroti, alongside a significant increase in asset ownership and knowledge of household finances. [ABSTRACT FROM AUTHOR]

To reduce the many adverse health outcomes associated with intimate partner violence (IPV), high-risk groups need to be specifically targeted in the fight against domestic violence in India. This study aims to examine the prevalence and correlates of IPV in HIV-positive and HIV-negative women from India. A convenience sample of HIV-positive and HIV-negative women responded to questionnaires to assess their experience and perception of violence. Multivariate logistic regression analysis was used to model the association between IPV and age, education, employment status, contraception use, age at first marriage, and HIV status. Although adjusting for age, education, employment status, contraception use, age at first marriage, and HIV status, women who are employed were 3.5 times more likely to suffer IPV (confidence interval [CI] = [1.5, 8.5]), women aged 18 or above at first marriage are 0.3 times less likely to face IPV (CI = [0.1, 0.6]), and women who use contraception are 7 times more likely to suffer IPV (CI = [1.4, 30.2]). Also, HIV-positive women are 3 times more likely to face sexual violence compared with HIV-negative women (CI = [1.1, 7.6]). [ABSTRACT FROM AUTHOR]