Epidemiological Correlates Of Domestic Violence In Married Women In Urban Area Of Ludhiana, Punjab, India
A Chaudhary, S Girdhar, R Soni
domestic violence. married women. husband induced physical hurt. urban india, epidemiology
A Chaudhary, S Girdhar, R Soni. Epidemiological Correlates Of Domestic Violence In Married Women In Urban Area Of Ludhiana, Punjab, India. The Internet Journal of Health. 2008 Volume 9 Number 1.
Introduction: Domestic violence against women is the most pervasive human rights violation in the world today. Almost two out of five ever married women in India are subject to spousal violence. Objectives: To estimate the extent of problem in married women attending OPD at Urban Health Centre.To ascertain various epidemiological factors associated with domestic violence. And to estimate the strength of association between epidemiological variables and domestic violence. Materials and Methods: The study was carried out in the population covered under the urban field practice area of the Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana city, Punjab, India. All the married women in the age group of 15-45 years attending OPD at Urban Health Centre from Jan to June 2006 were included in the study. Results: Out of 276 women interviewed, 147(53.3%) reported occurrence of domestic violence. It was found to be significantly higher in those women who were working (68.4%) as compared to housewives. In women whose husbands were alcoholic, 87.5% had ever experienced violence. Emotional abuse occurred in 40.6% followed by economical abuse (37.0%) and physical violence (22.4%). The predominant cause of domestic violence was observed to be stress in the family.
Domestic violence is the most common form of gender-based violence. The Declaration on he Elimination of Violence against women, adopted by the United Nations General Assembly in 1993 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”. Women are often in great danger in the place where they should be safest with in their families. For many, ‘home’ is where they face a regime of terror and violence at the hands of somebody close to them – somebody they should be able to trust. In 48 population based surveys from around the world, 10-69% of women reported being physically assaulted by an intimate partner at some points in their lives.1
Domestic violence has many forms, including physical violence, sexual abuse, emotional abuse, intimidation, economic deprivation or threats of violence. Studies on violence against women indicated that the perpetrators of violence against women are almost exclusively men. Physical abuse in intimate relationships is almost always accompanied by severe psychological and verbal abuse. In United States, more than 40% women between the ages of 18 and 64 had experienced one or more forms of violence including childhood abuse (17.8%), physical assault (19.1%), rape (20.4%) and intimate partner violence (34.6%) 2. Although the pervasiveness of domestic violence against women in India is well documented, specific risk factors, particularly those that can be affected by policies and programmes, are not well understood. So to protect the women, Domestic Violence Act, 2005 came into effect from October 2006. The main objective of this act is to enable women to negotiate non-abusive and non-violent matrimonial relationships.
The present study was planned to study various factors associated with causation of domestic violence against married women in Ludhiana city.
Material and Methods
The present study was carried out in the population covered under the urban field practice area of the Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana city, Punjab, India. All the married women in the age group of 15-45 years attending OPD at Urban Health Centre from Jan to June 2006 were included in the study. Those women who were interviewed earlier and had visited Urban Health Centre OPD again for consultation were excluded from the study. Information regarding age, husband education, wife education and occupation, type of family, monthly family income, frequency, type and cause of domestic violence was collected on a pre-designed Performa. The data collected was statistically analyzed. Chi square test was applied to test the association of attributes. Odds ratio with 95% confidence interval were also computed to assess the risk association.
Out of 276 women interviewed, 50.7% were in the age group of 25 to 35 years, 50.0% were educated up to Matric whereas only 8.3% were graduate and above. Majority of women (86.2%) were housewives & 74.6% belonged to nuclear families. Percentage of women reporting monthly family income below 5000 was 77.5%. (Table 1)
Table 2 Shows that majority (72.5%) of the husbands of the subjects were educated up to Matric. Consumption of alcohol by husbands was reported by only 14.5% of women interviewed.
Table 3 shows that 147 (53.3%) women reported occurrence of domestic violence in the past 12 months out of 276 women interviewed. In the present study out of 40 females in 35 – 45 years age group, 62.5% reported intimate partner violence by husbands.
It was observed that Graduate & above subjects reported lesser domestic violence (34.8%) as compared to those who were educated up to Matric (60.1%) & illiterates (48.7%). Difference between these groups was found to be statistically significant.
Occurrence of domestic violence was found to be significantly higher in those women who were working or employed somewhere (68.4%) as compared to 50.8% in housewives (OR = 2.1, 95% CI 0.96 - 4.64).
Out of 147 women reporting domestic violence 56.3% were living in nuclear family as compared to 44.3% of women who were living in joint family. This difference was statistically non significant. Similarly no difference was observed in the occurrence of domestic violence with respect to the family income.
In women whose husbands were alcoholic, 87.5% had ever experienced violence as compared to 47.5% in those women whose husbands were non-alcoholic. Odds ratio was found to be significantly high (7.75 with 95% CI 2.93-20.47) for this variable.
Table 4 shows that 66.7% subjects faced intimate partner violence occasionally, 23.8% chronic and only 9.5% one off. Emotional abuse as type of domestic violence occurred in 40.6% followed by 37% as economical abuse and physical violence in 22.4% of subjects. The predominant cause of domestic violence in the present study was observed to be stress in the family followed by consumption of alcohol by husband. Only 15.6% women reported violence because of refusal to cohabitation.
In the present study, 147 (53.3%) women reported occurrence of domestic violence in the past 12 months out of 276 women interviewed. In a study done in northern India by using representative samples of men, prevalence of wife abuse by men was 18-45%3. According to NFHS-3, 40.0% of ever married women aged 15-49years ever reported spousal violence and 27.0% reported in the past 12 months4. Some studies have found a positive association between women’s age and experience of violence. The finding has been interpreted to mean that women gain more control over their decision making processes when they become older and that age influences spousal relationship5. The results of the present study do not support such a relationship between women’s age and violence. In the present study out of 40 females in 35 – 45 years age group, 62.5% reported intimate partner violence by husbands. A study done in Tanzania in 2005 it was observed that 50.5% women in 35-45 years age group experienced domestic violence6.
Education of husband and wife are important correlates of domestic violence. According to study done in Gujarat, it was observed that 47.0% of women whose husbands were educated above secondary did not report domestic violence and it was also observed that 58% women who were educated above secondary did not report any abuse. According to NFHS-3, 46.0% illiterate women reported spousal violence and 47.0% of women reported violence whose husbands were illiterate.
In this study, women whose husbands were alcoholic, majority (87.5%) had ever experienced violence as compared to 47.5% in those women whose husbands were non-alcoholic.
A.K Ravishankar et al reported that the occurrence of domestic violence was 1.697 times higher in women whose husbands consumed alcohol as compared to those who were teetotalers8.
In the present study, Emotional abuse as type of domestic violence occurred in 40.6% followed by economical abuse (37%) and physical violence in 22.4% of subjects.
In a landmark study done by International Centre for Research on women (ICRW) in partnership with INCLEN in 2000, it was found that 50.0% of women experienced at least one of the behaviour i.e. physical or psychological.9 The proportion of women who had ever suffered physical violence by male partner ranged from 13% in Japan to 61% in Peru10. Leela Visaria also reported that 42.0% women experienced physical beating in Gujarat.
In the present study, half of the women reported occurrence of domestic violence in the past 12 months. It was found to be significantly higher in working women and in those women whose husbands consume alcohol. The predominant form of violence was found to be Emotional abuse.
Highlights of the study
Following were the highlights of this study that could not be quantified but definitely needs to be emphasized.
Recognition of problem
All the women could not recognize domestic violence as a problem. Physical and verbal abuse from their husbands was a part of their life. This further led to below mentioned problem.
Lack of courage
Recognizing domestic violence as an ill treatment and reporting it to someone or even police need a lot of courage. Reporting further means sudden withdrawal of financial support to sustain herself and her children.
Problem of migrant population
Majority of the respondents in this study were migrants. In absence of parental/ relative support, communication/ language barrier, only option left for the women was to bear with the daily dose of physical and verbal abuse. The problem was worst in case of brides bought from other states by native Punjabi males. They (bought brides) were surviving in absolute absence of social and emotional support.
The husband got provoked in most of cases because of trivial situations/provocations like getting irritated from children in household. The root cause was stress because of difficult working conditions e.g. working in night shifts, unemployment and poor financial conditions.
Dilemma of a Physician as primary health care provider
There has been a lot of emphasis on screening for domestic violence by primary health care providers. But in absence of social and community support the primary health care providers face dilemma of acting as a family breaker or family maker particularly in Indian social conditions. Once a physician comes to know about domestic violence by screening, there is a big question mark on the next step. A financially independent and literate woman can go on to get help under Domestic Violence Act. But definitely an illiterate or literate woman who is not financially independent shall not be doing the same even if she recognizes domestic violence a cognizable offence.
There is a need to increase awareness about the law against domestic violence especially in womenfolk. Not only the awareness about the law would suffice but also the provision of shelter homes for the victims of domestic violence is equally important. Therefore there are multiple stakeholders in the prevention and rehabilitation of victims of domestic violence, health professionals are one of them. Health professionals can help in this endeavor by screening for domestic violence and appropriate referral of victims of domestic violence.